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Home My WebLink AboutBUSINESS PLAN 8/20/2003 ORTH SCALE: BUSINESS NAME: .-FLOOR: OF None Beacon Bakersfield Truck Stop #51-4 :: DATE: / / FACILITY NAME: UNIT ~: OF 4-12-89 Beacon Bakersfield Truck Stop #51-4 51-4 (CHECK ONE) SITE D[AGR~ J FACILITY DIAGRAM 1. Address: Ident~,t~,l~the 9. Lock (keyJ. Box by the Street JllJlMrl. 10. MSDS Sox 2. Street(s), Alleys, 11. Railroad Tracks Drlveusys, and Parking 12~ Fence or Barrier' Areas adjacent to the property. Include the a. Mire street names, b. ~sonry 3. S~oru Dri/nt, Culverts, Yard Drains c. ~ood 4. Drainers Canals, Ditches. · d. Gates Crse~8, 13. Purlins S. Bulldtnp 8. Frame construction 14. Guard S~t~lofl b. Masonry construction IS. S~ora~ Teaks: Identify ~he c. Metal construction capacity in Ea~. a. A~ve fronnd d. Access Door b, Onderfround 6. Utility Con~rols a. Gao 16. DIk~ or ~ b. ~iectriclty I?. Evacuation Route r C. Water 18. Evacuation Area: Identify the ~. Fire Suppression .Systems: location whe~ employees sill 8. F~re Rydr~, meet. b. Fire Sprinkler lO. Outside Hazardous Connections Smote Store~... c. Firs Standpipe '10, Outlicle ·azardons connections Hatnriai ·torero d. utter control Yalm 21. Outside Hazardous for protection eystm Haterl&l Oem/Handlin~ n. Fire Pump -. ~2. Type of Hazardous '.. ' , NatnrJal/Uaztn 9tarsal or Used (See · . firs Department A~ceza Balsa) ~ Of RAXARDOOS K~T~IAL f · flmbln [ · Explosive L · Liquid · - ·adlolo~ical ..... C · Corrosive O' - Oxidizer O · Gas P - Poison --. e · eater Reactive T · T ~ I · Solid I - Cryopnlc D · easts · · Etioloflcll rdmapia: f)umable Liquid · . ~ (Ha~tirsd tim tn' addltins to tbs abo~) 1. Risers for Sprinklers e. Firs [scapes 8. Partitions O. Air Conditioninf Unite 3. Stairways: Indicate tbs 10. ....... --~- levels served free ' ...... %' '""--~:'"--'- ' ..... 11. Inside Bazardo~ emote . .. . hifheet to loe~ot. ' :' Storos~ · ~'~-.~- .4. Escalator: Indicate the · - ' levels met-end tree 13. Inside HazArdous bifhest to latest. Hatariels Storef~ ' ' IS~ Inside Hazardous - $. Elevator Haterimle Dst/ReAd]iai 8. Attic Access 14. Sewr Drain Inlets · ~ SI TE/'FAC'I L I TY DI AGR~M ·' ' .: ' FLOOR: OF U ' DATE: 7.//$/,~'2 FACILZTY NA~E:l , j: UNIT #: OF :. (CHECK ONE) SITE DIAGRAM FACILITY DIAGR.~ L - ."- Inspector's- Comments): I.- (I ' ' jl ,;CIAL 'USE ONLY- ~.{ - NORTH SCALE BUSINESS NAME: FLOOR: OF ¢. B~T::'~..'Tg,'Tg :~CrLrTY N~E: :NIT -"'.,~D __ .. ..,.. ~:' .. f '' .... .,:. i :.. :'~.~ ,- c°lb~°~ :'"' ... - _ .. ...... ~?' ~ . ~ _._ . .~. -- _ ~' ~,. 5A - BEACON TRUCKSTOP # SiteID: 015-021-000690 Manager : BusPhone: (6'61) 324-9481 Location: 3225 BUCK OWENS BLVD City : BAKERSFIELD ~%%%~%%~% Map : 102 CommHaz. : Low Grid: '23D FacUnits: 1 AOV: CommCode: COUNTY STATION 66 SIC Code:5541 EPA Numb: DunnBrad:00-917-4921 Emergency Contact / Title Emergency Contact / Title JOEL PEREZ / MANAGER JIM RUCH / AREA MANAGER Business Phone: (661) 324-9481x Business Phone: (559) 583-3285x 24-Hour Phone : (661) 587-1669x 24-Hour Phone : (559) 582-4778x Pager Phone : ( ~) - x Pager Phone : (559) 583-4472x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : SANDY HUFF Phone: (559) 583-3298x MailAddr: ~ 685 W 3RD ST State: CA City : HANFORD Zip : 93232 Owner VALERO ENERGY CORPORATION Phone: (559) 583-3298x Address : 685 W 3RD ST State: CA City : HANFORD Zip : 93232 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ' ~"~¢..~:.~D V /-/U~-r'- Do her.~by certify that l have l, reviewec~ l:h~ attacneo ~,~o~-~-,,,~ ,,~..,.,,1,~.. materials manage- ment plan ~o~ ~. ~,~ ~and that it ~ong ~th any ~ections ~nstitute a ~mplete and ~rrs~ m~- agement plan for my fadlity. D~te -- 1 07/15/2003 ~ .:N~3~Y CO~FO~U~'.'-OIg SiteID: 015-021-000690 Manager : BusPhone: (661) 324-9481 Location:-3225 BUCK OWENS BLVD , Map : 102 CommHaz : Low City : BAKERSFIELD ~ Gr',id: 23D FacUnits: 1 AOV: CommCode: COUNTY STATION 66 SIC Code:5541 EPA Numb: DunnBradi: 00 - 917 - 4921 Emergency Contact / Title Emergency Contact / Title JOEL PEREZ / MANAGER JIM RUCH ~/ AREA MANAGER Business' Phone: (661) 324-9481x ' Business Phone: (66~) 583-3285x 24-Hour Phone : (661) 587-1669x 24-Hour Phone : (66-~) 582-4778x Pager Phone : ( ) - x Pager Phone : i~)~s% -sum x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : JOHN WILRODT SA~ ~ ,Phone: (~I0) 5~3-2-4235x MailAddr: ~ ue~5 uP. ~nf~ State: CA City : HANFORD Zip : 9m~2-3~ ~o Owner · VALERO ENERGY CORPORATION Phone: ~ ~ Address~': 525 W 3~D ST ~ ~.~i~+ State: CA City' : HANFORD Zip : 93232 Period : to TotalASTs: = Gal Preparer: ~&~ ~-~-~ TotalUSTs: ~ = .Gal Certif'd: RSs: No Emergency Directives: ~ I, %~ ~kJ~a Do hereby certify ~ha~ I have (TyI~ or print name) ~ reviewed ~he mlached hazardous mmerials manage- ment plan for '~,~:~,~.~o74 and thru it along ~ith (Name of BusineSS} - any corrections constitute a complete and correc~ man- agement plan for my facili~. 1 05/07/2002 VALERO ENERGY CORPORATION SiteID: 015-021-000690 STORAGE CONTAINER DATA (UST'FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: VALERO ENERGY CORPORATION Cross Street : Business Type: Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : ~ UI~~¢ I~ Phone: (~-~) 683~3x Address: ~5 tO %~ ~~- City : ~l~ocd[ State: ~ Zip: Type : TANK OWNER INFORMATION Name : ~M-~TC~ ~%~fa~v~ I~ Phone: ) ~8~-3~x~-' Address: U~ o~ 5~ City : ~6~ State: ~ Zip: T~e : BOE UST Fee~ : 24660 Financ'l Reap: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/06/2000 Phone: (559) 582-0241x Name:S~DY HILL Ttl:OPE~TIONS/E~IRON. SPECIALIST State UST ~ : 1998 Upg Cert~: 00719 ~ Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA Hazards[ Frm I DailyMax IUnit}MCP CARBON DIOXIDE F P IH G 876.00 FT3 Min DIESEL FUEL #1 F IH DH L 20000.00 GAL Low PREMIUM UNLEADED F IH DH L 10000.00 GAL Mod UNLEADED F IH DH L 14000.00 GAL Mod 2 05/07/2002 VALERO ENERGY CORPO~TION SiteID: 015-021-000690 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site CARBON DIOXIDE Days'On Site 365 Location within this Facility Unit Map: Grid: INSIDE.STO~GE ROOM CAS# 124-38-9 F STATE TYPE PRESSURE TEMPE~TURE CONTAINER TYPE Gas !1 Pure Wove AmbientI~ Ambient PORT. PRESS. CYLINDER AMO~TS. AT THIS LOCATION Largest Container /. Daily Maximum Daily Average FT3L 876.00 FT3 657.00 FT3 ~ZARDOUS COMPONENTS 100.00 Carbon Dioxide N 124389 ~ZARD ASSESSMENTS [TSecret ~S BioHaz Radioactive/Amount I EPA Hazards NFPA I ~USDOT#, I MCP No N No No/ Curies F P IH / / / Min = Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ ~U~U~ ~vl~ / ~ £ ~ ~vl~ DIESEL FUEL #1 Days On Site J 365 Location within this Facility Unit Map: Grid: CAS# 8008-20-6 F STATE TYPE PRESSURE i TEMPERATURE ~1 CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average , 20000.00 GAL 20000.00 GAL 15000.00 GAL I HAZARDOUS COMPONENTS %Wt. CAS# 100.00 Diesel Fuel No. ~1 70892103 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F IH DH / / / Low -3- 05/07/2002 VALERO ENERGY CORPORATION SiteID: 015-021-000690 ~ Inventory Item 0005 Facility unit: Fixed Containers on Site PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 F STATE TYPE r PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure AmbientI~ Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL \ 7500.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline 8006619 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F IH DH / / / Mod ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site 9 ~U~ ~Vl~ / ~±~ ~vl~ UNLEADED Days On site 365 Locatlon wlthin thls Faclllty Unlt Map: Grid: CAS# 8006-61-9 Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average i 14000.00 GALI 14000.00 GAL 10500.00 GAL , HAZARDOUS COMPONENTS %Wt. RIgoR8I CAS# 100.00 Gasoline 8006619 HAZARD ASSESSMENTS TSecretINO N~S I Bi°HazINO Radioactive/AmountNo/ Curies FEPA HazardsIIH DH NFPA/// IUSDOT# MCP / 4 ' 05/d7/2002 F VALERO ENERGY CORPORATION SiteID: 015-021-000690 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 01/19/1999 THE EMPLOYEE (MANAGER OR ASSISTANT MANAGER) WOULD FIRST NOTIFY THE L6CAL EMERGENCY RESPONSE PERSONNEL BY DIALING 9-1-1. THEN THE.ZONE MANAGER WOULD BE NOTIFIED, IF THE~RELEASE. IS SMALL THE FACILITY EMPLOYEE TRAINED TO HANDLE THE RELEASE WILL HANDLE IT, BUT IF IT'S A LARGE RELEASE THEN THEY ARE TO NOTIFY THE EMERGENCY RESPONSE AGENCIES. -- Employee Notif./Evacuation 01/19/1999 INoTHE EVENT OF A HAZARDOUS MATERIAL RELEASE, IT IS THE EMPLOYEE(S) RESPONSIBILITY TO~ INSURE THE SAFETY OF OTHER EMPLOYEE(S) AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEE(S) AND THE GENERAL PUBLIC OF THE EMERGENCY. Public-N~tif./Evacuation 01/19/1999 IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR POTENTIAL RELEASE, IT IS THE EMPLOYEES RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEES AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEES AND THE GENERAL PUBLIC OF THE EMERGENCY.. THE EMPLOYEE WILL THEN NOTIFY EMERGENCY RESPONSE PERSONNEL BY DIALING 911. IT IS THE EMPLOYEES RESPONSIBILITY TO SECURE .THE, IMMEDIATE AREA TO PREVENT ANY UNNECESSARY EXPOSURE OF THE PUBLIC OR EMPLOYEES. WHEN THE IMMEDIATE AREA HAS BEEN SECURED, THE EMPLOYEE WILL NOTIFY THE FACILITY MANAGER OR, IF NECESSARY THE ZONE·MANAGER. THE FACILITY MANAGER OR ZONE MANAGER WILL NOTIFY OTHER ADMINISTRATIVE AGENCIES, AS NECESSARY, OF THE Emergency Medical Plan 01/19/1999 IN THE EVENT OF A RELEASE, 'CALL 9-1-1, FOR LOCAL MEDICAL ASSISTANCE AND/OR THE NEAREST HOSPITAL OR EMERGENCY FACILITY. -5- 05/07/2002 F-VALERO ENERGY CORPORATION SiteID: 015-021-000690 Fast Format ~ Mitigation/Prevent/Abatemt~ Overall Site -- Release Prevention 01/19/1999 THROUGH INVENTORY RECONCILIATION, ANNUAL TANK TESTING, MAINTENENACE OF FACILITY' EQUIPMENT AND EMPLOYEE(S) TRAINING . -- Release Containment 01/19/1999 EMPLOYEE(S) HAS BEEN INSTRUCTED TO RESPOND QUICKLY sO THE EXTENT OF THE RELEASE CAN BE MINIMIZED. EMPLOYEE(S) HAS ALSO BEEN INSTRUCTED TO IMMEDIATELY STOP THE'RELEASE (IE. TURN OFF THE POWER, CLOSE THE VALVE, ETC.). AND USE ABSORBENT TO CONTAIN THE RELEASE AND PREVENT IT'S SPREAD TO CRITICAL AREA SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. -- Clean Up 01/19/1999 BASED ON THE SIZE OF THE FACILITY AND EMERGENCY EQUIPMENT AVAILABLE ON SITE, ONLY SMALL RELEASES CAN SAFELY BE ADDRESSED. A LARGE RELEASE CAN ONLY BE ADDRESSED ~WITH ASSISTANCE FROM THE EMERGENCY RESPONSE PERSONNEL AND/OR A CLEAN UP CONTRACTOR. Other Resour9e Activation -6- 05/07/2002 F VALERO ENERGY CORPORATION SiteID: 015-021-000690 Fast Format F Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 01/19/1999 A) GAS - METER S OF BLDG B) ELECTRICAL - SHUT OFF INSIDE STORE C) WATER - NW CORNER OF LOT D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/19/1999 PRIVATE FIRE PROTECTION - EMERGENCY EQUIPMENT MAINTAINED ON SITE IS LIMITED TO TWO (2) FIRE'EXTINGUISHERS; ABSORBENT AND WATER HOSES. ADDITIONAL EQUIPMENT CAN BE BROUGHT ON SITE IF NECESSARY, AS WELL AS EMERGENCY CLEAN UP PERSONNEL. Building Occupancy Level 05/07/2002 VALERO ENERGY CORPORATION SiteID: 015-021-000690 Fast Format ~ Training Overall Site -~ EmploYee Training 01/19/1999 WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE AT THE F~CILITy SITE AND AT THE CORPORATE OFFICE. BRIEF SUMMARY OF TRAINING.PROGRAM: EACH EMPLOYEE, DURING INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER IS INSTRUCTED IN THE BASICS ©F HAZARDOUS MATERIALS HANDLING AND EMERGENCY RESPONSE. THE TRAINING PROG~%M CONSISTS OF, AS A ~MINIMUM, THE FOLLOWING AREA: 1) HAZARD COMMUNICATION STANDARD; 2) METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS; 3) PROPER USE OF SAFETY EQUIPMENT, 4) 'RESPONDING TO EMERGENCY; 5) EMERGENCY EVACUATION PROCEDURES; AND 6) PROCEDURES FOR COORDINATION WITH LOCAL EMERGENCY RESPONSE DEPARTMENT. THE FACILITY MANAGER IS RESPONSIBLE FOR ADMINISTERING THE TRAINING PROGRAM AND INSURING THAT EACH EMPLOYEE(S) HAS BEEN TRAINED ['IN HAZARDOUS MATERIALS PROCEDURES. DOCUMENTATION OF THIS TRAINING IS MAINT~INED AT THE FACILITY AND IS AVAILABLE FROM THE FACILITY MANAGER. (FOR FURTHER INFORMATION, PLEASE SEE ATTACHED ULTRAMAR INC. HMBP'S). -- Page 2 Held for Future Use Held for Future Use 8 05/07/2002 FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIEICATION ~ Page of ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: .'::.':~:::::: .'.:::: :;: ~."': i ~ ~'~:~ ;i~!~?.':~?~ BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 [ BUSINESS PHONE Beacon Truck Stop #3074 iI 661-324-g481 103 BUSINESS SITE ADDRESS 3225 Buck Owens Bird , I ZIE' CODE los CiTY 4o~ cA g31301 Bakersfield DUN & BRADSTREET 4os SIC CODE (4 digit #) I 00-g17-4921 55,41 COUNTY I ~,ern County BUSINESS OPERATOR NAME 4o9 BUiSINESS OPERATOR PHONE Ultrarnar Inc. · , 55g-582-0241 Ultramar Inc. ~ · ' ' · OWNER MAILING ADDRESS I 113 685 W. Third St. CITY . . · 114 STATE ' lls ZIP CODE Hanford ' " I CA i 93230-5000 ................................................................................................................................................................................................................... -447I CONTACT PHONE 448 CONTACT NAME '. I Sandy HuffI 559-583-3298 CONTACT MAILING ADDRESS I 449 685 W. Third St. CITY 120 STATE ~ 121 ZIP CODE 422 ,. Hanford CA I < 93230-5000 NAME 423 NAME I Joel Perez Jim Ruch · TITLE 124 TITLE Station Manager Area Manager I BUSINESS PHONE 425 BUSINESS PHONEi 661-324-g481 559-583-3285 ~ 24-HOUR PHONE 12s 24-HOUR PHONE I 131 661-587-1669 559-582-4778 i I 132 PAGER # 127 PAGER # 559-583-4472 i ADDITIONAL LOCALLY COLLECTED INFORMATION: : ! Cert flcation: Based on my inquiry of those individuals responsible for obtaining the information, I certifylunder penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. NAME O~SIGNER Lod )r~ 138 TITLE OF SIGNER Sandy Huff Operations & Enwionmental Specialist · UNIFIED PROGRAM CONSOLIDATED FORM \ FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of_ J FAOILITYID# [ I Iii iii I I BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) 3 Beacon Truck Stop #3074 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 quantity for [] YES [] NO 4 · HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (OES 2731) 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 (FormedySWRC~ FormA) 1. Own oroperate underground storage tanks? [] YES [] NO 5 · USTTANK(onepagepertank)(FormerlyForma) 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 aUST? [] YES [] NO 7 · USTTANK(closureportion--onepagepertank) 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 materials (per HSC 25143.2)? [] YES I~ NO 10 · RECYCLABLE MATERIALS REPORT (one per mcycler) 3. Treat hazardous Waste on site? · ONSITE HAZARDOUS WASTE [] YES [] NO 11 TREATMENT- FACILITY (FormerlyDTSC Forms 1772) · ONSlTE 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 [] YES [] NO 12 · CERTIFICATION OF FINANCIAL Permit by Rule and Conditional Authorization)? ASSURANCE (Formerly DTSC Form 1232) 5.~ Consolidate hazardous waste generated at a remote site? · REMOTE WASTE / CONSOLIDATION [] YES [] NO 13 SITEANNUAL NOTIFICATION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was [] YES [] NO 14 · HAZARDOUS WASTE TANK CLOSURE classified as hazardous waste and cleaned onsite? CERTIFICATION (Formerly OTSC Form 1249) E: LOCAL REQUIREMENTS (You may also be required to provide additional information by your CUPA or local agency ). I ID('I; }'1/QQ'~ ~,lldD I UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPT ON lone page per material per building or area) r-lADD []DELETE I']REVISE 2o0I Page.of__ BUSINESS NAME (Same as FACILITY NAME or DBA'-Doing Business As) 3 Beacon Truck Stop#3074 202 CHEMICAL LOCATION 2ol I CHEMICAL LOCATION CONFIDENTIAL East of station building I I NO CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 Unleaded Gasoline . Subject to EPCRA, refer to instructions COMMON NAME 207 208 EHS* [] Yes [] No Gas CAS# ~o9 *If EHS is "Yes', all amounts below must be in lbs. 8006-61-9 FIRE CODE HAZARD CLASSES (complete if required by CUPA) 210 3-FLLQ/27 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-I Yes [] No 212 CURIES TYPE (Check one item only) [] a. PURE [] b. MIXTURE [] ¢. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER .14,000 (Check one item only) [] a. SOLID [] b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check allthatapply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ANNUAL WA~¥t: AMOUNT 219 I STATE WASTE CODE 220 I 19,200 24,000 221 I DAYS ON SITE: 222 UNITS* [] a. GALLONS [:] b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount musl 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 r"l 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 1 85-100 220 Petroleum. Hydrocarbons 227 [] Yes [] No 220 Mixture 2.0-15 23o MTBE :,3~ []Yes [] No ~32 1634-04-4 3 >.01 234 Benzene ~ [] Yes [] No 230 71-43-2 237 4 238 239 [] Yes [] No 24o 24~ 5 242 243 [] Yes [] No 244 245 If more hazardous components are present at greater than t % by weight if non-carcinogenic, ar 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the requlre~ ADDITIONAL LOCALLY COLLECTED INFORMATION 24s If EPCRA. Please Sign Here UPCF (1/99) OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM · ' ' HAZARDOUS MATERIALS HAZARDOUS'MATERIALS INVENTORY - CHEMICAL DESCRIPTION lone pie ~3er material ~er building or area) I-lADD I-IDELETE r-IREVISE 200 I . Page__of__ BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 Beacon Truck Stop #3074 CHEMICAL LOCATION 2ol CHEMICAL LOCATION CONFIDENTIAL 202 EPCRA In Station Building I-I YES [] NO I I ~??:?:iii::iiil I I ~i?:i::i::i::i::i?:t [ ] I I I I ~ I MAP# (optional) 203 I GRID# (optional) 204 CHEMICAL NAME Garbon Dioxide ~Subi~to~c~^, refer to instru~lions COMMON NAME ~o? EHS* [] Yes [] No CO2 CAS# *If EHS is "Yes", a amounts below must be in lbs. 124-38-9 FIRE CODE HAZARD CLASSES (complete ~ required by CUPA) 210 2-NFLG/121I HAZARDOUS MATERIAL 211 RADIOACTIVE I'1 Yes [] No 212 I CURIES TYPE (Check one item only) [] a. PURE [] b. MIXTURE [] c. WASTE I 215 PHYSICAL STATE 214 LARGEST CONTNNER (Check one item only) [] a. SOLID [] b. LIQUID [] c. GAS 216 FED HAZARD CATEGORIES (Chock all that apply) r'l a. FIRE [] b. REACTIVE I~ c. PRESSURE RELEASE D d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 I ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 I I 657 876 - 221 I DAYS ON SITE: 2~ UNITS* [] a. GALLONS [] b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Chock 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'rrLE [] 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. TANKWAGON 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 1 100 ~ Carbon Dioxide 227 [] Yes [] No 228 124-38-9 2 230 231 [] Yes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 [] Yes I~1 No 240 241 5 242 243 [] Yes [] No 244 . 245 fmore hazardous compcnente are present at greater than t% by weight If non-carcinogenic, or 0.t% by weight If carcinogenic, attach additional sheets of paper capturing the required ADDITIONAL LOCALLY COLLECTED INFORMATION 246 For Soda Fountain Sales If EPCRA, Please Sign Here · UPCF (1/99) OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM . HAZARDOUS MATERtALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION I°"* Pi' F'~'~'~'l p,r ~,~i.~ or ~r.a) I'-IADD r"IDELETE I-IREVISE 200 I Page__of__ BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 Beacon Truck Stop #3074 CHEMICAL LOCATION ' 201 CHEMICAL LOCATION CONFIDENTIAL 202 EPCRA South of station building [] YES I~] NO Diesel , Subject to EPCR^, refer to instructions COMMON NAME 2o7 20s EHS* [] Yes [] No CAS# 2o9 *If EHS is 'Yes", all amounts below must be in lbs. 68476-34-6 :IRE CODE HAZARD CLASSES (complete if required by CUPA) 3-CMLQ/127 HAZARDOUS MATERIAL 211 RADIOACTIVE [] Yes [] No 212 CURIES TYPE (Check one item only) I~ a. PURE [] b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 20,000 (Check one item only) [] a. SOLID [] b. LIQUID [] c. GAS 216 FED HAZARD CATEGORIES (Check all that apply) [] a. EIRE [] 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 I 15,000 20,000 22~I DAYS ON SITE: 222 UNITS* [] a. GALLONS [] b. CUBIC FEET [:::] c. POUNDS [] d. TONS I 365 (Check one item only) * If EH$~ amounl must be in pounds. I STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE r"l q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN I"'] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY r-I k. BOX [] o. TOTE BIN r-I d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT I-I c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT r-] b. ABOVE AMBIENT [] G. BELOW AMBIENT [] d. CRYOGENIC 225 ............................................................. ..........................................................................................................., ....................:,: :. :.:: :.:.:.:.:.:.:.:.:.:.:.:.:.;.:.:.:.:.:.:.:.: ================================================================================================ :::::::::::: :::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::: 1 100 ~2s Diesel 2~7 [] Yes [] No 22~ 68476-34-6' 22. 2 ~30 23~ I-I Yes [] No 232 2~3 3 234 235 [] Yes [] No 236 237 4 23s 239 [] Yes [] No 240 24~ 5 242 243 [] Yes [] No 244 245 If more hazardeus components are present at greater than 1% by weight If non-camtnogenlc, or 0.t % by weight if carcinogenic, attach additional sheets of paper capturing tile required Infarm~flen ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) OES Form 2731 Emergency Response Plan Underground Storage Tank Monitoring Program This monitoring program must be kept at the UST location at all times. The information' on this monitoring program is a condition of the operating permit. The permit holder must notify Kern County Environmental Health Services Department within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making changes. Required by Sections 2632(d) and 2641 (h)CCR. Facility Name: Beacon Truck Stop #3074 Facility Address: 3225 Pierce Road, Bakersfield California 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, the Kern County Environmental Health Services Department must be notified at (805) 862-8701 within 24 hours. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the impact valve) and use absorbent to contain the release and prevent it's spread to critical areas such as storm drains and adjacent property. If the release is within the station employees' ability to clean up, materials are available, or else a clean up contractor will be called to assist. 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substances. Stations are equipped with absorbent material and metal drums. When a release occurs, the absorbent is used to clean up the material, and is stored in the drum. On a regular basis, the absorbent is picked up by a vacuum truck and taken to a disposal facility. 3. Describe the location and availability of the required cleanup equipment in item 2 abOve. The cleanup materials are kept in the cashier area in a "Ready Bucket" to provide quick access to the employees in a time of emergency. 4. Describe the maintenance schedule for the cleanup equipment. The station manager is responsible for ordering an adequate supply of absorbent, and replacement braoms and dustpans are available from our marketina SUDDIV center. 5. List the names and titles of the persons respor)sible for authorizing any work necessary under 'the plan. Manager: Joel Perez, Zone Manager: Jim Vanderdoes, Area Mana.qer: Jim Ruch and Environmental Specialist: Sandy Huff. toring Pro c e Underground Storage Tank Monitoring Program This monitoring prOgram must be kept at the UST location at all times.' The information on this monitoring program are conditions of the operating permit: The permit holder must notify Kern County Environmental Health-Services Department within 30 days of any changes to the monitoring procedures, unless required to obta n approval before making changes. Required by Sections 2632(k) and 2641(h) CCR Facility' Name: Ultramar Station #3074 Facility Address: 3_2_25' Pierce Road, Bakersfield, California 1. Describe the frequency of performing the monitoring: Tank: Continuous monitorin,q. Piping: Red Jacket Leak Alert Detectors and sump sensors perform continuous monitoring on product lines. Dispenser Containment: Bravo Boxes have float switch that trips impact valve. 2. What methods and equipment, identified by name and model, will be using for performing the monitoring: .Tank: TLS-250 monitors~the annular spaces and Leak Alert Piping: Red Jacket Leak Alert Detector and TLS-250. Dispenser Containment: Bravo Boxes monitored continuously. 3. Describe the location (s) where the monitoring will be performed (facility plot plan should be attached): Leak Alert annular space and sump sensors on tanks. TLS-250 control panel in stora,qe area. 4. List the name (s) and title (s) of the people 'responsible for performing the monitoring and/or maintaining the equipment: Joel perez - Station Mana,qer; Jim Ruch- Area Uana,qer; Jim Vanderdoes - Zone Uana,qer 5. Reporting format for monitoring: Tank: TLS-250 dives visual and audible warnin,q. Manager records daily on inspection.lo,q. Piping: TLS-250 g ves visual and audible warni~n,qs. The Red Jacket leak detector does into slow flow. 6. Describe the preventative maintenance schedule for the monitoring equipment. Note: maintenance must be in accordance with the manufacturers' maintenance schedule but not less than every 12 months. Preventative maintenance on all equipment is in accordance with the manufacturers' instructions. All product lines, leak detectors, and mon torin,q equipment are tested on an annual basis. 7. Describe the training necessary for the operation of UST System, including piping and the monitoring equipment: If monitoring equ pment ,qoes into alarm, store personnel are instructed to call Manager and Manager will call maintenance. ILMORE '-RTREET Genera[or ~"~' '"" ' · .-~. -... . Truck \ · Trash - · L---I I Bin.~~ ~r~~ S/ale Diesel. -- ;/I Dispenser ' I , ",00 000 J s,o,~o,~ o o , i' Building Unleaded . , -- ..... : Dispenser [ Islands >:. .. r lJ I <~. I L J I I ~ U.I · ~- 0 ~ I k emed~abon I ' Compound Replacemen[ I-- I ~ I Gasoline USTs I I Replacemenl~ ~-- Diesel UST < I I ~i i I 'Truck ~ !Wash Approximate Property Boundary ' i~ / ~ORIH 0 50 100 - ^pproximote Scole In ['eel: IIZON ENVIRONMENTAL INC~ . SITE PLAN ._ BEACON STATION NO. 596 TRUCK STOP 5074. Project Number: 1596.17 Drawn By: O. ,~sto./C.B. 5225 PIERCE ROAD 2 Prepared by: R, Smith DaJe: 12/00 BAKERSFIELD, CAUFORNIA Reviewed by: G. Barker Revised Oate: BUSIXESS ~&~it: .FLOOR: OF 'Beacon Bakersfield Truck Soo il-4 DAT~-:: ' / FACILITY S~ME: ~IT l: OF 4-11 leacon Bakersfiel~ Truck (Ca£Cl~ ONE) SITE DIAGRA.~ F~CILITY DZ~GRAN I lnspector's CoHents): _. -OI~FICIAL USE ONLY- .. UNIFIED PROGRAM CONSOLIDATED FORM TANKS (two pages per tank) Page~ of __ 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 reason - for local use only) [] 8 TANK REMOVED 430 LOCATION WITHIN SITE (optional) 431 South east of station building ' . .................................... TANKiD# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK I-lYes [] No 434 3074-1 Trusco , -yea", complete one page for each compa~nent. DATE INSTALLED (YEAR/MO) 43s TANK CAPACITY IN GALLONS 43e NUMBER OF COMPARTMENTS 437 1997 14,000 ADDITIONAL DESCRIPTION (For Ioca~ use Dilly) 438 TANK USE 439 PETROLEUM.TYPE 44o [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JET FUEL 0f marked complete Petmleum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE 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 8006-61-9 (Includes Used Oil) [] 95. UNKNOWN i!i i i il ii :::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: TYPE OF TANK ' [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5, SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2, DOUBLE WALL [] 4, SlGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL-primarytank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 (Chock on~ item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE WI [] 99. OTHER REINFORCED PLASTIC (FRP) 100% METHANOL TANK MATERIAL -secondaTtar~ I-I 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE [] 99. OTHER REINFORCED PLASTIC (FRP) W/100% METHANOL [] 5. CONCRETE [] 10. COATED STEEL DATE INSTALLED 447 TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 448 OR COATING [] 2 ALKYD LINING I-]4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 DATE INSTALLED 449 OTHER CORROSION [] I MANUFACTURED cATHoDIC [] 3 FIBERGLASS REINFORCEI~ PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED ,. 452 (Check ail [] I SPILL CONTAINMENT that apply) 1 997 [] I ALARM [] 3 FILL TUBE SHUT OFF VALVE [] 2 DROP TUBE 1997 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STRIKER PLATE 1997 IF SINGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANKWITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) r"! 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING + (SIR) BIENNIAL TANK TESTING [] 99 OTHER · 455 ESTIMATED QUANTITY OF SUBSTANCE 456 TANK FILLED WITH INERT MATERIAL? 457 ESTIMATED DATE LAST USED (YR/MO/DAY) REMAINING gallons [] Yes [] No UNIFIED PROGRAM CONSOLIDATED FORM TANK UNDERGI POUND STORAGE TANKS - PAGE 2 Page __ of UNDERGROUND PiPiNG ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE 1'3 2. SUCTION I-3 3. GRAVITY 458 [] 1. PRESSURE I-I 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION I [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN .452 [] 2. DouBLE WALL ~ 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MANUFACTURER Smith ~ MANUFACTURER 463 [] 1. BARE STEEL [] 6. FRP CQMPATIBLE w/100% IVETHANOI. [] 1. BARE STEEL [] 6. FRP COMPATIBLE W/100% METHANOL [] 2. STAINLESS STEEL [] 7. GALVA,NIZED STEEL [] UKNOWN [] 2. STAINLESS STEEL [] ?. GALvANIzED STEEL [] 3. PLASTIC COMPATIBLE WI CONTENTS ' [] 99. OTHER [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 8. FLEXlitE (HDPE) [] 4. FIBERGLASS [] 9. CATHOOIC PROTECTION [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465 UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING ,me : SINGLE WALL PIPING 4~7 PRESSURIZED PIPING (Check al tha~ apply):, PRESSURIZED PIPING (Check all ~at apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, 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.!GPH) ' [] 3. ANNUAL INTEGRn'YTEST (0.1GPH) [] 4. DAILYVISUAL CHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Che~ ;d~tha app,/) [] 5. DAILYVISUAL MONITOR NG OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY ! [] 5. DAILYVISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) ~ GRAVITY FLOW (c~ed('all tha~ apply): i [] 8. DAILYVISUAL MONITORING [] 9. BIENNIAL INTEGRITYTEST (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 [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ' [] b. AUTO PUMP SHUT OFF FOR I~EAKS, SYSTEM FAILURE AND SYSTEM D b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION : DISCONNECTION []c. NO AUTo PUMP SHUT OFF , I-lc NO AUTO PUMP SHUT OFF Ii] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) wITH FLOW SHUTOFF OR [] 11. AUTOMATIC LEAK OETECTOR RESTRICTION [] 12. ANNUAL INTEGRITYTEST (0.1 GPH) ! [] 12. ANNUAL INTEGRITYTEST (0.1 GPH) SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM CONTINUOUSSUMPSEN$OR+AUDI~EANDVISUALALARMS [] 13. CONTINUOUS SUMP SENSOR +AUDISLE AND VISUAL ALARMS [3 13. EMERGENCY GENERAT~OR$ ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WlTHOUT AUTO PUMP SHUT OFF +AUDIBLE AND [] 14. CONTINUOUS SUMP SENsoR wITHOUT AUTO PUMP SHUT OFF +AUDIBLE AND VISUAL ALARMS VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK BETECTOR (3.0 GpH TEST) WITHOUT FLOW SHUT OFF OR [] 15. AUTOMATIC LINE LEAK BETECTOR (3.0 GPH TEST) RESTRICTION [] 16. ANNUAL INTEGRITYTEST (0.1 GPH) [] 16. ANNUAL INTEGRITYTEST (0.1 GPH) [] 17. BAILYVISUAL CHECK [] 17. DAILYVISUAL CHECK DISPENSER CONTAINMENT ; [] 1. :FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILYVISUAL CHECK DATE INSTALLED 468 [] 2. , CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING 1997 [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + [] 6. NONE 469 I AUDIBLE AND VISUAL ALARMS · I certify that the i~ormation provided herein is true and accurate to the best of my knowledge. SIGNAT~~P~ DATE 470 1 O/23/O2 '- NAME OF OwNER/oPI~OR (print) TITLE OF OWNER/OPERATOR 472 Huff'-" operations & Environmental specialist Permit Number (For local use only) 473 Permit Approved (For local use only} Permit Expiration Date (For local use only) 475 UNIFIED PROGRAM CONSOLIDATED FORM TANKS UNDERG UND STORAGE TANKS - PAGE1 (two pages per tank) Page__ of __ 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) (Spacify reason - for local use only) [] 8 TANK REMOVED 430 LOCATION WITHIN SITE (o~o,a~) 431 South east of station building ' TANK'ID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 3074-2 Tmsco , '~fes". complete one page for each compall~nent DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 43~ NUMBER OF COMPARTMENTS 437 1997 10,000 ADDITIONAL DESCRIPTION (For ;ocal use only) 43~ TANK USE 439 PETROLEUM TYPE. 44o [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JET FUEL (If marked complete Petroleum Type) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE 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 8006-61-9 (Incluries Used Oil) [] 95. UNKNOWN TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SIGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL - primary tank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/ [] 99. OTHER REINFORCED PLASTIC (FRP) 100% METHANOL TANK MATERIAL -secondarytar* [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE [] 99. OTHER REINFORCED PLASTIC (FRP) W/100% METHANOL [] 5. CONCRETE [] 10. COATED STEEL DATE INSTALLED 447 TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448. DATE INSTALLED 449 OTHER CORROSION [] 1 MANUFACTURED CATHO{:)IC ~ 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION D 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all [] I SPILL CONTAINMENT 1997 [] I ALARM [] 3 FILL TUBE SHUT OFF VALVE that apply) [] 2 DROP TUBE 1997 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STRIKER PLATE 1997 IF SINGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 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 [] 8 TANK TESTING + (SIR) BIENNIAL TANK TESTING [] 99 OTHER 455 ESTIMATED QUANTITY OF SUBSTANCE 456 TANK FILLED WITH INERT MATERIAL? 457 ESTIMATED DATE LAST USED (YR/MO/DAY) REMAINING gallons [] Yes [] No UNIFIED PROGRAM CONSOLIDATED FORM G~O TANK UNDER UND STORAGE TANKS - TANK PAGE 2 UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEMTYPE [] 1. PRESSURE [] 2. SUCTION []~3. GRAVITY 458 D 1. PRESSURE [] 2. SUCTION [] 3. GRAVrFY CONSTRUCTION I [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 4~0 [] 1. SINGLE WALL [] 95. UNKNOWN MANUFACTURER [] 2. DOUBLEWALL r-I 95. UNKNOWN r'l 2. DOUBLEWALL [] 99. OTHER MANUFACTURER Smith ,~ MANUFACTURER [] 1. BARE STEEL [] 6. FRP COMPATIBLE wll00~ METHANOL [] 1. BARE STEEL [] 6. FRP COMPATIBLE Wl~OO~ METHANOl. [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] UKNOWN [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 3. PLASTIC CoMpATIBLE WI CONTENTS [] 99. OTHER [] 3. PLASTIC COMPATIBLE WI CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER · [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION ~ [] 5. STEEL W/COATING [] 95. UNKNOWN 485 UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PI~ESSURIZED PIPING {che~ all thai a~l~/): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONICLINELEAKDETECTOR3.0GPHTESTWITHAUTOPUMPSHUTOFFFOR [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF 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 CI3. ANNUAL iNTEGRITY TEST (0.1GPH) . 1-13. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILYVlSUAL CHECK · CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check ~tha apply) [] 5. DAILY VISUAL MONFrORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST (0.1 GPH) SAFE ~UCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) GRAVITY FLOW (Che~ a~tfla apply}: [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRrrYTEST (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 [] ~ 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 I~c. NO AUTO PUMP SHUT OFF Dc NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LiNE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUTOFF OR [] 11. AUTOMATIC LEAK DETECTOR RESTRICTION [] 12. ANNUAL INTEGRITYTEST (0.1 GPH) [] 12. ANNUAL INTEGRrTY 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 SHUT OFF +AUDIBLE AND- [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +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 (0.1 GPH) [] 16. ANNUAL INTEGRITY'TEST (0.1 GPH) [] 17. DAILYVISUALCHECK [] 17. DAILYVISUAL CHECK DISPENSER [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DAILYVlSUAL CHECK CONTAINMENT DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING 1997 [] 3. · CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + D 6. NONE 469 AUDIBLE AND VISUAL ALARMS .!.!~!~i~i.!~!~?~?!~!i!!i~i~iiiii!ii~i!ii~!!!~!i~i~!~!~iii~!~!~i! :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ii::i::!::iii::!::i::i::i::i::i::i::i] ~ i!~ E R/O I~ E ~ ~ Q~ i!sl!~ N~tJ REi::i::i::i::i::i::::i ............................. ~ssssssss~ssisiiissisi;isisisss:.iiiiiiiiiiiiiiii!ili I certifyl~at tile informatjo~ provided herein is tTue and accurate to the best of my knowledge. 10/23/02 NAME OF OWNI~J~I~RATOR (Pdnl) TITLE OF OWNER/OPERATOR 472 Sand~/Huff~J operations & Environmental Specialist Permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 IFIED PROGRAM CONSOLIDATED FO~ TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) · Page__ of __ 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 RENEVVALPERMIT (Specify reason - for local use only) (Specify reason - for local use ollly) [] 8 TANK REMOVED 430 LOCATION WITHIN SITE (Ol~ional) 431 South west of station building · TANKID# 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 3074-3 Trusco ~ "Yes", comlflete one page for each compar~enL DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 43e NUMBER OF COMPARTMENTS 437 1997 20,000 ADDITIONAL DESCRIPTION (For Ioca~ use o~ly) 438 TANK USE 439 PETROLEUM TYPE 44o [] 1, MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2, LEADED [] 5. JET FUEL (]fmarkedcornpletaPetmleumTypa) [] 11), PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE UNLEADED , I-1 4. GA$OHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Mated;ds Inventory page) 441' CASt (from Hazardous Materials Inventory page) 442 [] 4, HAZARDOUS WASTE 68476-34-6 (Includes Used Oil) I-1 95. UNKNOWN TYPE OF TANK [] 1, SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH IN i ~-~NAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2, DOUBLE WALL [] 4. SlGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL - pdmary tank I~ 1. BARE STEEL [] 3. FIBERGLASS I PLASTIC r'l 5. CONCRETE [] 95.· UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/ [] 99, OTHER ' REINFORCED PLASTIC (FRP) 100% METHANOL TANK MATERIAL -seconda'ylank [] 1. BARE STEEL I~ 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL I-1 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE [] 99. OTHER REINFORCED PLASTIC (FRP) · W/100%'METHANOL [] 5. CONCRETE [] 10. COATED STEEL DATE INSTALLED 447 TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (For local use only) (Check one item only) '. 448 DATE INSTALLED 449 OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local ,use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all [] I SPILL CONTAINMENT 1997 [] I ALARM [] 3 FILL TUBE SHUT OFF VALVE that apply) [] 2 DROP TUBE 1997 [] 2 BALL FLOAT [] 4 EXEMPT [] 3 STRIKER PLATE 1997 IF SINGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) i-I 2 AUTOMATIC TANK GAUGING (ATG) - [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING ' [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING + (SIR) BIENNIAL TANK TESTING [] 99 OTHER I I1::)~.1= /l/~lQ.r~ui¢~4~ I:nrm~rlv RW~C'.I:3. I:'nn-n 13, IIFIED PROGRAM CONSOLIDATED FO, BM TANK UNDERGROUND STORAGE .TANKS - TANK PAGE 2 UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ' I~ 1. PRESSURE [] 2. SUCTION CI 3. GRAVITY 458 [] 1. PRESSURE [] 2, SUCTION [] 3. GRAVITY 459 CONSTRUCTION / [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 46o [] 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURER [] 2. DOUBLE WALL . [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MANUFACTURER Smith 4~ MANUFACTURER 483 [] 1. BARE STEEL [] 6. FRP COMPATIBLE w/100% METHANOL [] 1. BARE STEEL '~ [] 6, FRP COMPATIBLE W/~00% MEmANOL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] UKNOWN I-1 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] 3, PLASTIC COMPATIBLE WI CONTENTS [] 99. OTHER . [] 3. PLASTIC COMPATIBLE WI CONTENTS [] 8, FLEXIBLE (HDPE) [] 99. OTHER [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION [] 5. STEEL W/COATiNG CIg. CATHODIC PROTECTION 464 [] 5. STEEL W/COATiNG [] 95. UNKNOWN 485 UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 4se SINGLE WALL PIPING 4e7 PRESSURIZED PIPING ( .C~e~ all tha~ apply): PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONiCLINELEAKDETECTOR3.0GPHTESTWlTHAUTOPUMPSRUTOFFFOR [] 1, ELECTRONIC LINE LEAK DETECTOR 3.0 GPN TEST W[TH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. ALARMS, I-1 2. MONTHLY 0,2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITYTEST (0.1GPH) [] 3. ANNUAL INTEGRITYTEST (0.1GPH) [] 4, DAILYVISUALCHECK CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check ~lthat app,) [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY [] 5, DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALUES'IN BELOW GROUNDPIPING): [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) [] 7, SELF MONITORING SAFE SUCTION SYSTEMS (NO.VALVES IN BELOW GROUND PiPiNG): .GRAVITY FLOW [] 7. SELF MONITORING [] 9. BIENNIAL INTEGRITY TEST (0,1 GPH) GRAVITY FLOW (Check ,a Nat [] 8. DAILYVISUAL 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 101 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OOCURS [] ~a AUTO PUMP SHUT OFF WHEN A LEAK O00URS [] h. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAIt.LURE AND SYSTEM [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISOONNEOTION DISCONNECTION I~c, NO AUTO PUMP SHUT OFF []c NO AUTO PUMP SHUT OFF ~ 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) Wfl'___~H FLOW SHUTOFF OR [] 11. AUTOMATIC LEAK DETECTOR RESTRICTION [] 12. ANNUAL INTEGRITY TEST (0,1 GPH) [] 12, ANNUAL INTEGRITY TEST (0,1 GPH) SUCTION/GRAVITY SYSTEM . SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUSSUMPSENSOE+AUDIBLEANDVISUALALARMS [] 13. C0NTINUOUS SUMPSENSOR +AUDIBLE AND VISUAL ALARMS - ~ EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERATOR8 ONLY (Check all that apply) [] 14. CONTINUOUS SUMPSENSORWITHOUTAUTO PUMP SHUT OFF +AUDIBLE AND [] 14. CONTINUOUS SUMPSENSORWlTHOUTAUTO PUMP SHUT OFF +AUDIBLE AND VISUAL ALARMS VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION [] 15. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) [] 16, ANNUAL INTEGRITY TEST (0,1 GPH) [] 16. ANNUAL INTEGRITY TEST (0,1 GPH) [] 17. DAILYVISUAL CHECK [] 17. DAILYVISUAL CHECK DISPENSER [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ~ [] 4. DALLY VISUAL CHECK CONTAINMENT DATE INSTALLED 468 [] 2, CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER I MONITORING 1997 [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469 ..... ................................................................................................................................................. SIGNATURE (~Iit~OWNE~R/pPERAiTpR · ~ ~ ' ' I DATE 470 C:~'J ~ ~ Y ' I 10/23/02 . ' ~AaMREd;FF~'Vf~ER/OPRAT~_~ (pnnt) ~r~oC~Ns ~R/~iR~roT~r~ental Specialist Permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 TANKS UNDERGROUND STORAGE TANKS - FACILITY (one page per site) Page of __ TYPE OF ACTION [] 1. NEW SITE PERMIT ~ 3. RENEWAL PERMIT [] 5.CHANGE OF INFORMATION [] 7.PERMANENTLY CLOSED SITE (Check one item only) [] 4. AMENDED PERMIT specify change local use only [] 8. TANK REMOVED [] 6.TEMPORARY SITE CLOSURE 400 NEAREST CROSS STREET 401 FACILITY OWNER TYPE [] 4. LOCAL GENCYIDISTRICT* Highway 99 [] 1. CORPORATION [] 5. COUNTY AGENCY* BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL [] 2. INDIVIDUAL [] 6. STATE AGENCY* TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER 403 [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY* 402 TOTAL NUMBER OF TANKS I Is facility on Indian Reservation or *If owner of UST is a public agency: name of supervisor of division, ss~liu,~ or office REMAINING AT SITE trustlands? which operates the UST (This is the contact person for the tank records.) 3 4O4[ [] Yes [] No 405 40~ ~'~'~'~"~'~9':'~'~:~'~'":~'i~ E' ............................. 407 PHONE 408 Ultramar Inc ] 559-582-0241 MAILING OR STREET ADDRESS 409 685 W. Third Street CITY 410 I STATE 4~1 I ZIP CODE 412 Hanford I CA I 93230-5000 PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL 413 :.i:.i:.iii:.i:,i:.i:.i:.i:.~:.~:.!:.~:.~:.~:.~:.~:.~:.iiiii iiiiii!!i~i~i~iiii!~!ii~ !!i~!!!!i!iiiii!i!i~i~i~!ii!~iiii!i!~ !i } : TANKOWNER NAME 414 [ PHONE 415 Ultramar Inc. [ 559-582-0241 MAILING OR STREET ADDRESS 416 685 W. Third Street CITY 417 STATE 418 [ ZIP CODE 419 ' Hanford CA I 93230-5000 TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 4~o [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY TY0'K) HQ 44- ] 2 [4 [6 [6 [0 [ Call (916) a22-9669 if questions arise 421 INDICATE [] 1. SELF-INSURED [] 4. SURETY BOND [] 7. STATE FUND [] 10. LOCAL GOVT MECHANISM METHOD(s) [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETTER I-1' 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD 422 Check one box to indicate which address should bo used for legal nctificalions and mailing. Legal notifications and mailings will be sent lo the tank owner unless box 1 or 2 is checked, r"l 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK 423 OWNER Certification - I certify that the information provided herein is true and accurate to the best of my knowledge. S~U~~P~ DATE 424 I PHONE 425 10/23/02 559-583-3298 SandYHUff~.-.' Operations & Environmental Specialist STATE UST FACILITY NUMBER (For local use only) 428 1998 UPGRADE CERTIFICATE NUMBER (For local useonly) I 429 I ,ltramar Ultramar, Inc. Fax: 559-583-3282 Environmental 685 W. Third Street 559-583-3256 Retail Administration Hanford, CA 93230-5016 559-583-3330 Human Resource (559) 582-0241 559-583-3382 Maintenance ' HAZARDOUS MATERIALS BUSINESS PLAN Business Name Beacon Truck Stop #3074 Street Address 3225 Buck Owens Blvd. City, State, Zip Bakersfield, CA 93301 Phone Number (661) 324-9481 Nature of Business Retail Sales of Petroleum Products Assessor Parcel Number SIC Code 5541 Operating Hours 24 Hours (7 days) Maximum Number of Employees Per Shift 2-3 Plan Submitted By Sandy Huff Telephone Number (559) 583-3298 Date of Submission c~0/23/02 · ~....- Signature ~....~.?..0~ ~ Member of the Ultramar Group of Companies Quality And Service ULTRAMAR EMERGENCY CONTACTS Name Title Business Phone Home Phone Joel Perez Manager (661) 324-9481 (661) 587-1669 Jim Ruch Area Manager (559) 583-3285 (559) 582-4778 Jim Vanderdoes Zone Manager (559) 583-3248 (559) 582-3248 Sandy Huff Environmental Specialist (559) 583-3298 (559) 732-5554 EMERGENCY RESPONSE AGENCIES Agen~ Business Phone Police Department 9-1 - 1 Sheriff Department 9-1-1 Highway Patrol 9-1-1 Fire Department 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency Facility Toxic Information Center 1-800-233-3360 Chemtrec 1-800-424-9300 REGULATORY AGENCIES Agency Business Phone California Office of Emergency Sen, ices (800) 852-7550 Environmental Protection Agency (415) 974-8131 National Response Cemer (800) 424-8802 Administrating Agency (805) 326-3979 EMERGENCY SERVICES Name Business Phone Home Phone Ultramar Marketing Services (559) 583-3381 (559) 583-6025 (Amber Jones) I.T. Corporation (800) 262-1900 N/A Jim Ruch (559) 583-3285 (559) 582-4778 HMBP3074 Introduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 oftbe State Health and Safety Code (codified sections of AB 2185 and AB 2187 and SARA Title III Federal Law.) The plan is also intended for employee guidance in minimizing potential and actual hazards that could affect our employees, the public, or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface, or ground water. The plan is also designed to set procedures for reporting releases or threatened releases of hazardous materials that may pose a potential hazard to our employees, the public, or the environment. In the event a substantial change is made in the normal business operation, the ioeal regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory Form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Des. cription of Operation The operation of Beacon Truck Stop Station #3074 located at 3225 Buck Owens Blvd., Bakersfield,~ CA 93301 is primarily to serve the general public through retail sale of petroleum products, miscellaneous consumer packaged products, and various food items. The petroleum products (i.e. gasoline, diesel) are stored in underground storage tanks that conform with local, state, and federal laws or regulations. Underground piping and dispensing equipment is also installed and maintained in conformance with local, state, and federal laws or regulations. Control of inventory is maintained through the use of an inventory reconciliation program that allows the facility manager to accurately monitor control the inventory. Product reorders 'are based on the reconciled inventory and maximum tank capacity. Delivery of the product is achieved within the conformity of local, state, and federal laws or regulations. Prior to unloading product, delivery drivers are required to gauge the tank and record this information on the delivery ticket. Upon completion of unloading, the tank is again gauged and the information recordedi Reporting, Notification, and Scene Management In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other.employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. When the immediate area has been secured, the employee will notify the facility manager, or if necessary, the area manager. The facility manager or area manager will notify other administrative agencies, as necessary, of the release. (See page 2-call list'and attached Emergency Response Evacuation Plan.) Prevention and Mitigation The facility has been Constructed and is maintained within local, state, and federal laws or regulations. Prevention of a release is achieved through inventory reconciliation, annual tank testing, maintenance of facility equipment, and employee training. HMP3074 In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn offthe power, close the valve, etc.) and use absorbent to contain the release and prevent it's spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. Emergency_ Equipment Emergency equipment maintained on sire'is limited to fire extinguishers, absorbent, and water hoses. Additional equipment can be brought on site if necessary, as well as emergency clean up personnel. Employee Training Each employee, during initial employment and annually thereafter, is instructed in the basics of hazardous materials handling and emergency response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for cooperation with local .emergency response departments. The facility manager is responsible for administering the training program and insuring that each employee has been trained in hazardous materials procedures. Documentation of this training is maintained at the facility and is available froTM the facility manager. Facility Manager. Joel Perez Phone Number (661) 324-9481 HMBP3074 EMERGENCY RESPONSE - EVACUATION PLAN In the event of a fire, hazardous material spill, or an earthquake... Follow these steps immediately! 1. Turn off the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocaeoons continue, or you cannot use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: "There is a (fire) (dangerous spill) in the facility. Please turn offyour engines and leave the station on foot...immediately!" If you do not have a public address system at your store, yell the above statement. 3. Call help by dialing 9-1-1 and giving the following information: "There is a (fire) (dangerous spill) at Beacon Truck Stop #3074 located at 3225 Buck Owens Blvd., Bakersfield." ff anyone is trapped or needs attention, tell the answering dispatcher. Stay on the phone and be prepared to answer questions about the situation. If the facility phone is not accessible, use the nearest public phone. 4. Look around to insure that all employees and customers have lea the facility, particularly those in vehicles who made need assistance or did not hear the announcement. Assist or direct assistance to any customer having difficulty leaving the station area. 5. Secure the area to prevent any unnecessary, vehicle entry. 6. Attend to the injured and direct medical response to them. 7. Attempt to extinguish any fire if you can do so safely, ffthe fire is small, the fire extinguisher should be used to extinguish it. ffthe fire is large or spreading, oryou determine that there is a potential danger of explosion or personal injury, do not attempt to putout the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material.. 9. Report to arriving emergency response personnel to provide them any information or assistance they may require. 10. Remain calm. (earthquake information on the next page) In The Event of a Large Earthquake HMBP3074 1. The manager or other qualified employee should make a visual inspection'of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes, or other damage that could create a hazard. 2. The manager or other qualified individual will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, the area manager will be notified immediately. 3.If a loss of product is confirmed by the area manager, the area manager will coordinate with the O &E Specialist and/or the Maintenance Department for tank tests and/or repairs. HMBP3074 ULTRAMAR INC. Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facility manager. 'fi, in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Signature Date Signature Date HMBP3074 ultramar Ultramar, Inc. Fax: 559-583-3282 Environmental 685 W. Third Street . 559-583-3256 Retail Administration Hanford, CA 93230-5016 559-583-3330 Human Resource (559) 582-0241 559-583-3382 Maintenance October 24, 2002 CITY OF BAKERSFIELD Office of Environmental Services 1715 Chester Avenue Bakersfield, CA 93301 Re: Beacon Truckstop #3074 3225 Buck Owens Blvd. Bakersfield, CA 93301 Enclosed you will find the completed CUPA forms you requested for the above reference location. If you have any questions, please contact me at (559) 583-3298. Very truly yours, ULTRAMAR INC. Operations & Environmental Specialist /cmm Enclosures A Member Of.the Ultramar. Group of Companies #1 Quality And Service BEACON TRUCK STOP ! _.-~-,~,~ v~3j~ SiteID: 215-000-000690 1 4 ~99 / 'Manager : ' I ~ ~ /~-~J~~ff~¢ O~e,~' BusPhone: (805) 324-9481 Location: 3225 PIERCE RD ~lu~ Map : 10~ CommHaz : Low City : BAKERSFIELD ,t_~~ Grid: 23D FacUnits: 1 AOV: CommCode: COUNTY STATION 66 SIC Code:5541 EPA Numb: DunnBrad:00-917-4921 Emergency Contact / Title Emergency Contact /A~Title B~CKY BARi~ETTJ~ ~/ MANAGER A~--S~R~~/ ~O~E MANAGER Business Phone: (805) 324-9481x Business Phone: (2J~9) 583-~2~x~?3k~ 24-Hour Phone : (805) ~ 24-Hour Phone : (~9) 582-~q~Qxe~u~ Pager Phone : ( ) 6~-±uue x Pager Phone : (~gfl) _ x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact :$a~u$~ Phone: (~) 5S5 -BDq~x MailAddr: PO BOX 466 State: CA , City : HANFORD Zip : 93232 Owner ULTRAMAR INC Phone: (209) 582-0241x Address : 525 W 3RD ST State: CA City : HANFORD Zip : 93232 Period : to To~alASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax Unit MCP CARBON DIOXIDE F P IH G 876 FT3 Mit DIESEL FUEL #t F IH DH L Low PREMIUM UNLEADED F IH DH L Mod UNLEADED F IH DH L Mod ~, ~,5 o. na.~ p,~,~f Do hereby certify thru I have r~ie~,ed the mttached hazardous materials ma, ment plan -,-, ~4 --~,,~.,~,.~., -.__..~ tha? it along with any corrections constitute a complete and correct m~.n- agernent plan for my facility. iOr, a,ure ~ -r- tT~,;?, Oa~e - 12/03/1998 BEACON TRUCK STOP SiteID: 215-000-000690 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME CARBON D.IOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE STORAGE ROOM CAS# 124-38-9 Gas Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average FT3 876.00 FT3 657.00 FT3 HAZARDOUS COMPONENTS 100.00 Carbon Dioxide N 124389 HAZARD ASSESSMENTS TSecretl RSIBioHazl Radioactive/Amount EPA HazardsI NFPA USDOT# MCP No No No · No/ Curies F P IH / / / Min ---- Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME DIESEL FUEL #1 Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8008-20-6 ~ STATE TYPE PRESSURE TEMPERATURE I CONTAINER TYPE }Liquid Pure I Ambient I Ambient . Below Ground Tank AMOUNTS AT THIS LOCATION I Largest Container Daily Maximum I Daily Average 00o I 14ooo HAZARDOUS COMPONENTS 100.00 Diesel Fuel No. 1 N 70892103 HAZARD ASSESSMENTS TSecretl RSIBioHaz Radioactive/Amount I EPA Hazards I NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low 2 12/03/1998 BEACON TRUCK STOP SiteID: 215-000-000690 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED ~ Days365On Site Location withi~ this Facility Unit Map: Grid: CAS# 8006-61-9 STATE = TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~Liquid /Pure I Ambient I Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average IO,0oo ~o,ooo ~0o HAZARDOUS COMPONENTS 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 ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average qcoo J Iqooc) HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecret[ RSIBioHaz Radioactive/Amount EPA Hazards NFPA USDOT# I MCP No' No No No/ Curies F IH DH / / / Mod -3- 12/03/1998 BEACON TRUCK STOP SiteID: 215-000-000690 Fast Format ~ Notif./Evacuation/Medical Overall Site -- AHency Notification 01/25/1993 THE EMPLOYEE (MANAGER OR ASSISTANT MANAGER) WOULD FIRST NOTIFY THE LOCAL EMERGENCY RESPONSE PERSONNEL BY DIALING 9-1-1. THEN THE ZONE MANAGER WOULD BE NOTIFIED, IF THE RELEASE IS AMALL THE FACILITY EMPLOYEE TRAINED TO HANDLE THE RELEASE, BUT IF IT'S A LARGE RELEASE THEN THEY ARE TO NOTIFY THE EMERGENCY RESPONSE AGENCIES. -- Employee Notif./Evacuation 01/25/1993 IN THE EVENT OF A HAZARDOUS MATERIAL RELEASE, IT IS THE EMPLOYEE(S) RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEE(S) AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYE(S) AND THE GENERAL PUBLIC OF THE EMERGENCY. -- Public Notif./Evacuation 01/25/1993 IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR POTENTIAL RELEASE, IT IS THE EMPLOYEES RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEES AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEES AND THE GENERAL PUBLIC OF THE EMERGENCY. THE EMPLOYEE WILL THEN NOTIFY EMERGENCY RESPONSE PERSONNEL BY DIALING 911. IT IS THE EMPLOYEES RESPONSIBILITY TO SECURE THE IMMEDIATE AREA TO PREVENT ANY UNNECESSARY EXPOSURE OF THE PUBLIC OR EMPLOYEES. WHEN THH I~EDIATE AREA ~LAS BEEN SECURED, THE EMPLOYEE WILL NOTIFY THE FkCILITY MANAGER OR, IF NECESSARY THE ZONE MANAGER. THE FACILITY MANAGER OR ZONE MANAGER WILL NOTIFY OTHER ADMINISTRATIVE AGENCIES, AS NECESSARY, OF THE EmerHency Medical Plan 01/25/1993 IN THE EVENT OF A RELEASE, CALL 9-1-1, FOR LOCAL MEDICAL ASSISTANCE AND/OR THE NEAREST HOSPITAL OR EMERGENCY FACILITY. -4- 12/03/1998 BEACON TRUCK STOP SiteID: 215-000-000690 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 01/25/1993 THROUGH INVENTORY RECONCILIATION, ANNUAL TANK TESTING, MAINTENENACE OF FACILITY EQUIPMENT AND EMPLOYEE(S) TRAINING. -- Release Containment 01/25/1993 EMPLOYEE(S) HAS BEEN INSTRUCTED TO RESPONDE QUICKLY SO THE EXTENT OF THE RELEASE CAN BE MINIMIZED. EMPLOYEE(S) HAS ALSO BEEN INSTRUCTED TO IMMEDIATELY STOP THE RELEASE (IE. TURN OFF THE POWER, CLOSE THE VALVE, ETC.) AND USE ABSORBENT TO CONTAIN THE RELEASE AND PREVENT IT'S SPREAD TO CRITICAL AREA SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. -- Clean Up 01/25/1993 BASED ON THE SIZE OF THE'FACILITY AND EMERGENCY EQUIPMENT AVAILABLE ON SITE, ONLY SMALL RELEASES CAN SAFELY BE ADDRESSED. A LARGE RELEASE CAN ONLY BE ADDRESSED WITH ASSISTANCE FROM THE EMERGENCY RESPONSE PERSONNEL AND/OR A CLEAN UP CONTRACTOR. Other Resource Activation -5- 12/03/1998 F BEACON TRUCK STOP SiteID: 215-000-000690 · Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 01/25/1993 A) GAS - METER SOUTH OF BUILDING B) ELECTRICAL - SHUT OFF INSIDE STORE C) WATER - NORTHWEST CORNER OF LOT D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/25/1993 PRIVATE FIRE PROTECTION - EMERGENCY EQUIPMENT MAINTAINED ON SITE IS LIMITED TO TWO (2) FIRE EXTINGUISHERS; ABSORBENT AND WATER HOSES. ADDITIONAL EQUIPMENT CAN BE BROUGHT ON SITE IF NECESSARY, AS WELL AS EMERGENCY CLEAN UP PERSONNEL. Building Occupancy Level -6- 12/03/1998 BEACON TRUCK STOP SiteID: 215-000-000690 Fast Format ~ Training Overall Site --~ Employee Training 01/25/1993 WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE AT THE FACILITY SITE AND AT THE CORPORATE OFFICE. BRIEF SUMMARY OF TRAINING PROGRAM: EACH EMPLOYEE, DURING INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER IS INSTRUCTED IN THE BASICS OF HAZARDOUS MATERIALS HANDLING AND EMERGENCY RESPONSE. THE TRAINING PROGRAM CONSISTS OF, AS A MINIMUM, THE FOLLOWING AREA: 1) HAZARD COMMUNICATION STANDARD; 2) METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS; 3) PROPER USE OF SAFETY EQUIPMENT, 4) RESPONDING TO EMERGENCY; 5) EMERGENCY EVACUATION PROCEDURES; AND 6) PROCEDURES FOR COORDINATION WITH LOCAL EMERGENCY RESPONSE DEPARTMENT. THE FACILITY MANAGER IS RESPONSIBLE FOR ADMINISTERING THE TRAINING PROGRAM AND INSURING THAT EACH EMPLOYEE(S) HAS BEEN TRAINED IN HAZARDOUS MATERIALS PROCEDURES. DOCUMENTATION OF THIS TRAINING IS MAINTAINED AT THE FACILITY AND IS AVAILABLE FROM THE FACILITY MANAGER. (FOR FURTHER INFORMATION, PLEASE SEE ATTACHED ULTRAMAR INC. HMBP'S). -- Page 2 --Held for Future Use Held for Future Use =7- 12/03/1998 Ultramar Ultramar Inc. Telecopy: 209-585-5685 Credit P.O. Box 466 209-583-3330 Administrative 525 W. Third Street 209-583-3302 Information Services Hanford, CA 93232-0466 209-583-3358 Accounting (209) 582-0241 . Januaryll, 1999 Ralph Huey BAKERSFIELD FIRE DEPT. 1715 Chester Avenue Bakersfield; CA 93301 Dear Mr. Huey: RE: Beacon Truckstop #3074 3225 Buck Owens Blvd. Bakersfield, CA 93301 Enclosed is the Hazardous Material Business Plan for the Ultramar Inc. site referenced above. A copy of the Hazardous Materials Business Plans has been sent to the appropriate Ultramar location. · Please call me at (559) 583-3298 if additional information is required. Sincerely, Sandy Huff' Operations & Environmental Coordinator Retail Environmental Services . · , ' BEACON Member of the.Ultramar Group of Companie~ #1 Quality And Service B~EBSFIELD FIRE DEPARTMENT OFFICE OF E~IRO~E~AL SERVICES i715 Chester Ave., Bakersfield, CA 93301 '~ (805} 326-3979 APPLICATION TO PERFORM A TIG~NESS TEST PERMIT TO OPERATE OPERATORS NAME OWNERS NAME NUMBER OF TANKS TO BE TESTED__ IS. PIPING GOING TO BE TESTED TANK 9 VOLUME CONTENT TANK TESTING COMPANY--~--OJx¥~xuloo,, ADDRESS TEST METHOD ~e_e N~E OF TESTER'_ ~~ t~_t>~,~ CERTIFICATION 8 D~TS ~ T~E TSST XS TO SS CO~SUCTS~ ,~-/J-~ DATE- .' - SIGNATURE OF APPLICANT '11o TI,'.IIIS octg~_f~Ol(3 .V~-',-I .qg:~l ~6/9l/Ij0 11/22/95 BEACON TRUCK STOP 215-000-000690 DEC 11 1995 ~ age 1 Overall Site with 1 Fac. Unit General Information Location: 3225 PIERCE RD Map:102 Haz:2 Type: 3 City : BAKERSFIELD Grid: 23D F/U: 1 AOV: 0.0 Contact-Name· Title' '~ Contact Name Title BECKY BARNETT / MANAGER ALAN SASSER / ZONE MANAGER Business Phone: (805) 324-9481x Business Phone: (209) 4~~-~ ~- ~Aix 24-Hour Phone : (209) 582-1325x 24-Hour Phone : (805) ~o 4~z Pager Phone : ( ) 9]b:sq~'x Pager Phone : ( ) -7~%~x Administrative Data Mail Addrs: P 0 BOX 466 D&B Number: 00-917-4921 City: HANFORD State: CA Zip: 93232- Comm Code: 215-066 COUNTY STATION 66 SIC Code: 5541 Owner: ULTRAMAR INC Phone: (209) 582-0241 Address: 525 W 3RD ST State: CA Zip: 93232- City: HANFORD . ., Summary r~iewed the afl=h~ h~M~s mate~ls man~ anY ~rr~io~s ~n~itute a ~mplete and ~ue~ m~.:. ~ement plan for my fa~li~. 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-004 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-007 CONTAMINATED GROUNDWATER - GASOLINE Liquid 130000 Moderate · Delay Hlth PPB 02-008 CONTAMINATED GROUNDWATER - DIESEL Liquid 3300000 Moderate · · Delay Hlth PPB 02-001 DIESEL Liquid 15000 Low · Fire, Immed Hlth, Delay Hlth GAL 02-005 DIESEL #2 Liquid 15000 Low · Fire,~ Immed Hlth, Delay Hlth GAL 02-006 WASTE OIL Liquid 500 Low · Fire, Delay Hlth ~ GAL 02-003 CARBON DIOXIDE Gas 876 Minimal · Fire, Pressure, Immed Hlth FT3 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 3 02 - Fixed Containers on Site Hazmat. Inventory Detail in MCP Order 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL 1 Annual Amount GAL 10,000 I 7,500.00_ 240,000.00 Location Storage.~~Press~T~Temp UNDER GROUND TANK IAmbient~AmbientlCENTER OF FACILITY -- Conc Components ~ 'MCP ----~uide 100.0% IGasoline IModeratel 27 02-004 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 7,500.00 240,000.00 Storage~~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlCENTER OF FACILITY -- Conc Components MCP -~Guide 100.0% IGasoline Moderatel 27 02-007 CONTAMINATED GROUNDWATER - GASOLINE Liquid 130000 Moderate · Delay Hlth PPB CAS #: Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE ' Daily Max PPB Daily Average PPB I Annual Amount PPB 130,000 I · 2,800.00_ 0.00 Storage~~Press TTemp' Location IN SITU IAmbientlAmbient140 FT BELOW SURFACE AT WELL V-3 -- Conc Components ~ MCP ---~uide 0.0% IGasoline IModeratel 27 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 4 '02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-008 CONTAMINATED GROUNDWATER - DIESEL Liquid 3300000 Moderate · Delay Hlth PPB CAS #: Trade. Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE -- Daily Max PPB Daily Average PPB I Annual Amount PPB -- 3,300,000 I ' 5,900.00 0.00 Storage ~ Press T Temp Location IN SITU IAmbient~Ambient 30 FT BELOW SURFACE AT WELL V-4 -- Conc Components MCP ---TGuide 0.0% IDiesel Fuel No, 2 IModeratel 27 02-001 DIESEL Liquid 15000 Low · Fire, Immed Hlth, Delay Hlth GAL CAS #: 64741-44-2 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL I Annual Amount GAL -- 15,000 I 11,250.00 360,000.00 Storage Press T Temp Location UNDER GROUND TANK IAmbie~.AmbientlCENTER OF FACILITY -- Conc Components ' MCP ---/Guide 100.0% IDiesel Fuel No. 2 ? IModeratel 27 02-005 DIESEL #2 Liquid 15000 Low · Fire, Immed Hlth, Delay Hlth GAL CAS #: 68476-34-6 Trade Secret: No. Form: LiqUid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL I Annual Amount GAL 15,000 I 11,250.00 360,000.00 Storage ~~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlCENTER OF FACILITY -- Conc Components i MCP ---~uide 100.0% IDiesel Fuel No. 2 ~Moderate~ 27 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 5 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-006 WASTE OIL ~ Liquid 500 Low · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type:. Waste Days: 365 Use: WASTE Daily Max GAL500 I Daily Average~ 350.00GAL ----~ Annual Amount6,000.00GAL -- Storage ~ Press T Temp~ Location ABOVE GROUND TANK I Ambient~AmbientlEAST OF LUBE BAY -- Conc Components MCP ---TGuide 100.0% IWaste Oil, Petroleum Based ILow ! 27 02-003 CARBON DIOXIDE Gas 876 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 124-38-9 · Trade Secret: No Form:' Gas Type: Pure~ Days: 365 Use: ADDITIVE Daily Max FT3876 I Daily Average657.00FT3 _l Annual Amount10,512.00FT3 Storage press T Temp Location POR . PRESS. IAbove ientl S D . ROOM -- Conc · Components ---~uide 1000% ICarbon Dioxide ILoMwcP ! 21 11/22/95 BEACONTRUCK STOP 215-000-000690 Page 6 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification THE EMPLOYEE (MANAGER OR ASSISTANT MANAGER) WOULD FIRST NOTIFY THE LOCAL EMERGENCY RESPONSE PERSONNEL'BY DIALING 9-1-1. THEN THE ZONE MANAGER WOULD BE NOTIFIED, IF THE RELEASE IS AMALL~'THE FACILITY EMPLOYEE TRAINED TO HANDLE THE RELEASE, BUT IF IT'S A LARGE RELEASE THEN THEY ARE TO NOTIFY THE EMERGENCY RESPONSE AGENCIES. <2> Employee Notif./Evacuation IN THE EVENT OF'A HAZARDOUS'MATERIAL RELEASE, IT IS THE EMPLOYEE(S) RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEE(S) AND THE GENERAL. PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYE(S) AND THE GENERAL PUBLIC OF THE EMERGENCY. <3> Public Notif./Evacuation IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR POTENTIAL RELEASE, IT IS THE EMPLOYEES RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEES AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEES AND THE GENERAL PUBLIC OF THE EMERGENCY. THE EMPLOYEE WILL THEN NOTIFY EMERGENCY RESPONSE PERSONNEL BY DIALING 911. IT IS THE EMPLOYEES RESPONSIBILITY TO SECURE THE IMMEDIATE AREA TO PREVENT ANY UNNECESSARY EXPOSURE OF THE PUBLIC OR EMPLOYEES. WHEN THE IMMEDIATE AREA HAS BEEN SECURED, THE EMPLOYEE WILL NOTIFY THE FACILITY MANAGER OR, IF NECESSARY THE ZONE MANAGER. THE FACILITY MANAGER OR ZONE MANAGER WILL NOTIFY OTHER ADMINISTRATIVE AGENCIES, AS NECESSARY, OF THE RELEASE. <4> .Emergency Medical Plan'~ IN THE EVENT OF A RELEASE, CALL 9-1-1, FOR LOCAL MEDICAL ASSISTANCE AND/OR THE NEAREST HOSPITAL OR EMERGENCY FACILITY. 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 7 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention THROUGH INVENTORY RECONCILIATION, ANNUAL TANK TESTING, MAINTENENACE OF FACILITY EQUIPMENT AND EMPLOYEE(S) TRAINING. <2> Release Containment EMPLOYEE(S) HAS BEEN INSTRUCTED TO RESPONDE QUICKLY SO THE EXTENT OF THE RELEASE CAN BE MINIMIZED. EMPLOYEE(S) HAS ALSO BEEN INSTRUCTED TO IMMEDIATELY STOP THE RELEASE (IE. TURN OFF THE POWER, CLOSE THE VALVE, ETC.) AND USE ABSORBENT TO CONTAIN THE RELEASE AND PREVENT IT'S SPREAD TO CRITICAL AREA SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. <3> Clean Up BASED ON THE SIZE OF THE FACILITY AND EMERGENCY EQUIPMENT AVAILABLE ON SITE, ONLY SMALL RELEASES CAN SAFELY BE ADDRESSED. A LARGE RELEASE CAN ONLY BE ADDRESSED WITH ASSISTANCE FROM THE EMERGENCY RESPONSE PERSONNEL AND/OR A CLEAN UP CONTRACTOR. ~<4> Other Resource Activation 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 8 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - METER SOUTH OF BUILDING B) ELECTRICAL ' SHUT OFF INSIDE STORE C) WATER - NORTHWEST CORNER OF LOT D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Pr°tec./Avail. Water PRIVATE FIRE PROTECTION - EMERGENCY EQUIPMENT MAINTAINED ON SITE IS LIMITED TO TWO (2) FIRE EXTINGUISHERS; ABSORBENT AND WATER HOSES. ADDITIONAL EQUIPMENT CAN BE BROUGHT ON SITE IF'NECESSARY, AS WELL AS EMERGENCY CLEAN UP PERSONNEL. FIRE HYDRANT - NE CORNER OF GILMORE AND PIERCE RD. <4> Building Occupancy Level 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 9 00 - Overall Site <G> Training <1> Employee Training '~ WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS oN'FILE AT THE FACILITY SITE AND AT THE CORPORATE OFFICE. / BRIEF SUMMARY OF TRAININ~ PROGRAM: EACH EMPLOYEE, DURING INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER IS INSTRUCTED IN THE BASICS OF HAZARDOUS MATERIALS HANDLING AND EMERGENCY R~SPONSE. THE TRAINING PROGRAM CONSISTS OF, AS A MINIMUM, THE FOLLOWING ABEA: 1) HAZARD COMMUNICATION STANDARD; 2) METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS; 3) PROPER USE OF SAFETY EQUIPMENT, 4) RESPONDING TO EMERGENCY; 5) EMERGENCY EVACUATION PROCEDURES; AND 6) PROCEDURES. FOR COORDINATION WITH LOCAL EMERGENCY RESPONSE DEPARTMENT. THE FACILITY MANAGER IS RESPONSIBLE FOR ADMINISTERING THE TRAINING PROGRAM AND INSURING THAT EACH E~PLOYEE(S) HAS BEEN TRAINED IN HAZARDOUS MATERIALS PROCEDURES. DOCUMENTATION OF THIS TRAINING IS MAINTAINED AT THE FACILITY AND IS AVAILABLE FROM TH,E FACILITY MANAGER. (FOR FURTHER INFORMATION, PLEASE SEE ATTACHED ULTR~WAR INC. HMBP'S). <2> page 2 <3> Held for Future Use <4> Held for Future Use 11/22/95 BEACON TRUCK STOP 215-000-000690 Page 10. 00 - Overall Site <G> Training <4> Held for Future Use (Continued) 11/22/95 BEACON TRUCK STOP 215-000-000690 Page O0 - Overall Site <M> Inspections 03/09/88 OK / / 08/22/89 OK / / ANGELLO 12/06/90 FOLLOW'UP '~ / / RALPH HU 12/20/90 FOLLOW UP OK / / 03 384 3225PIER 06/05/95 UST inspection. Minor paPerwork needed. / / 11/22/95 BEACON TRUCK STOP. 215-000-000690 Page 12 00 - Overall Site <M> InSpection Summary 03/09/88 OK / / OK 08/22/89 OK / / POST EMERGENCY pROCEDURES - PHONE FOLLOW UP OK ANGELLO 12/06/90 FOLLOW UP / / 'NO VERIFICATION OF MSDS NO EMERGENCY PORCEDURES POSTED RALPH HU 12/20/90 FOLLOW UP OK / / 03 384 3225PIER 06/05/95 UST inspection. Minor Paperwork needed. / / .Ultramar Ultramar Inc, Telecopy: 209-584-6113 Credit & Wholesale P.O. Box 466 209-583-3330 Administrative 525 W. Third Street 209-583-3302 Information Services Hartford, CA 93232-0466 209-583-3358 Accounting (209) 582-0241 RECEIVED FEB 1% 199, Februa~ 13, 1993 ,HAZ. MAT. DIV. -City of ~sfield F~e ~~t ~z~o~ ~t~ials Division 2130 "G" ~t ~sfield, ~ 93301 ~ ~. ~~ass: ~: ~n ~top ~51-4 3225 Pi~ ~. ~sfield, ~ ~ ~ o~ telephone ~nv~tion on J~ 25, 1993, ~is lett~ is ~ a~i~ ~e ~sfield Ci~ F~e ~~t ~t ~e ~~o~ ~s~ oil ~ list~ on ~e ~z~ ~ials di~lo~e fo~ ~s repla~ wi~ ~ ~ve ~o~ ~. oil ~. I a~l~ize for ~e ~or ~ I ho~ ~is ~ not ~ ~e ~~t ~y ~nv~i~. PI~ ~11'~ at 209/583-3247 if additio~l ~o~tion is r~~. ~C. Enclosures CERTIFIED MAIL A Member of the UIt, ramar-GrouP of Companies #1 Quality and Service Ultramar Ultramar Inc. ' Telecopy: 209-584-6113 Credit & Wholesale P.O. Box 466 209-583-3330 Administrative 525 W. Third Street 209-583-3302 Information Services Hartford, CA 93232-0466 209~583-3358 Accounting (209) 582-0241 HAZARDOUS MATERIALS BUSINESS PLAN Business Name Beacon Bakersfield Truck Stop #51-4 Street Address 3225 Pierce Road City, State, Zip Bakersfield, CA 93301 Phone Number (805) 324-9481 Nature of Business Retail Sale of Petroleum Products Assessor Parcel Number 332-162-16-00-8 SIC Code 5541 Operating Hours 24 Maximum Number of Employees Per Shift 5 Plan Submitted By ~ M. Caldwell Phone Number ~~-83-32-~-- Date Of Submission Nov ber 5~ 99 ~ ~ Signature HMBP51-4 A Member of the. Ultramar Group of Companies #1 Quality and Service ULTRAMAR EMERGENCY CONTAC~ Name Title Business Phone Home Phone Becky Barnett Manager (805) 324-9481 (805) 393-4921 Rick Copeland Zone Manager (209) 485-6540 (209) 582-1325 Brain Skillern District Manager (209) 583-3201 (209) 432-1393 Robert C. Vryhof Risk Manager (209) 583-3279 (209) 584-4555 EMERGENCY RESPONSE AGENCIES Agency Business Phone Police Department 9-1-1 Sheriff Department 9-1-1 HighwayPatrol 9-1-1 Fire Department 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency Facility Toxic InformatiOn Center 1-800-233-3360 Chemtrec 1-800-424-9300 REGULATORY AGENCIES Agency Business Phone California Office of Emergency Services (800) 852-7550 Environmental Protection Agency (415) 974-8131 National Response Center (800) 424-8802 Administrating Agency (805) 861-2761 EMERGENCY SERVICES Name Business Phone Home Phone Beacon Marketing Services (209) 583-3381 (209) 583-8991 (Sandy Edwards) I.T. Corporation (800) 262-1900 N/A Rick Copeland (209) 485-6540 (209) 582-1325 HMBP51-4 Introduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 of the State Health and Safety Code (codified sections of AB 2185 & AB 2187 and SARA Title III Federal Law). The plan is also intended for employee guidance in minimizing potential and actual hazards which could affect our employees, the public or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface or ground water. The plan is also designed to set procedures for reporting releases or threatened releases of hazardous materials which may pose a potential hazard to our employees, the public or the environment. In the event a substantial change is made in the normal business operation, the local regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Description of Operation The operation of Beacon Bakersfield Truck Stop #51-4 located at 3225 Pierce Road, Bakersfield, California is primarily to serve the general public through retail sale of petroleum products, miscellaneous consumer packaged products and various food items. The petroleum products (i.e. gasoline, diesel) are stored in underground tanks which conform with local, state and federal laws or regulations. Underground piping and dispensing equipment is also installed and maintained in conformance with local, state and federal laws or regulations. Control of inventory is maintained through the use of an inventory reconciliation program which allows the facility manager to accurately control the inventory. Product reorders are based on the reconciled inventory and maximum tank capacity. Delivery of the product is achieved within the conformity of local, state and federal laws or regulations. Prior to unloading product, delivery drivers are required to gauge the tankage and record this information on the delivery ticket. Upon completion of unloading, the tank is again gauged and the information recorded. '~ Reporting, Notification and Scene Management In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. When the immediate area has been secured, the employee will notify the facility manager or, if necessary, the zone manager. The facility manager or zone manager will notify other administrative agencies, as necessary, of the release. (See page 4 call list and attached Emergency Response Evacuation Plan). HMBP51-4 Prevention and Mitigation The facility has been constructed and is maintained within local, state and federal laws or regulations. Prevention of a release is achieved thru inventory reconciliation, annual tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the valve, etc.) and use absorbant to contain the release and prevent it's spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. Emergency Equipment Emergency equipment maintained on site is limited to fire extinguishers, absorbent and water hoses. Additional equipment can be brought on site if necessary, as well as emergency clean up personnel. Employee Training Each employee, during initial employment and annually thereafer is instructed in the basics of hazardous materials handling and emergency response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for coordination with local emergency response departments. The facility manager is responsible for administering the training program and insuring that each employee has been trained in hazardous materials procedures. Documentation of this training is maintained at the facility and is available from the facility manager. Facility Manager Becky Barnett Phone Number (805) 324-9481 HMBP51-4 ULTRAMAR INC. EMERGENCY RESPONSE - EVACUATION PLAN In the event of a fire, hazardous material spill or an earthquake... Follow these steps immediately! 1. Turn off the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocarbons continue or you can not use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: "There is a (fire) (dangerous spill) in the facility. Please turn off your engines and leave the station on foot...immediately~" If you do not have a public address system at your unit, yell the above statement. 3. Call help by dialing 9-1-1 and giving the following information. "There is a (fire) (dangerous spill) at Beacon Bakersfield Truck Stop #51-4 located at 3225 Pierce Road, Bakersfield, California." If anyone is trapped or needs attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. If the facility phone is not accessible, use the nearest public phone. 4. Look around to.insure that all employees and customers have left the facility, particularly those in vehicles who may need assistance or did not hear the emergency announcement. Assist or direct assistance to any customer having difficulty in leaving the station area. 5. Secure the area to prevent any unnecessary vehicle entry. 6.' Attend to the injured and direct medical response to them. 7. Attempt to extinguish any fire if you can do so safely. If the fire is small the fire extinguisher should be used to extinguish it. If the fire is large or spreading, or you determine that there is a potential danger of explosion or personal injury, do not attempt to put out the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material. 9. Report to arriving emergency response personnel to provide them any information or assistance they may require. 10. Remain calm (earthquake information on next page). HMBP51-4 In The Event of a Large Earthquake 1. The manager or other qualified employee should make a visual inspection of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes or other damage which could create a hazard. 2. The manager or other qualified employee will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, then the zone manager will be notified immediately. 3. If a loss of product is confirmed by the zone manager, the zone manager will then coordinate with our marketing services for tank tests and/or repairs. HMBP51-4 ULTRAMAR INC. Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facility manager. If, in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Signature Date Signature Date HMBP51-4 1993 CHEMICAL INVENTORY INFORNATION Business Name: Beacon Bakersfield Truck Stop ~51-4 Site Address:._3225 Pierce Road, Bakersfield, CA 93301 Pg: 1 of 3 Phone: 805-324-9480 Dun & Bradstreet # 00-917-4921 Chemical Name: Unleaded Gasoline Physical State: (So[i~Gas) Circle One Trade Name: N/A Trade Secret?(~Y Number of Days on Site/Year: 365 v Daily Amount: 10,000 (~ Lbs., cu. ft.) Average Dai[y Amount: 7,500 ('~(ga[s.~ Max Lbs., CU. ft.) D.O.T. #: 1203 O~7i~tass/D.O.T. CLass: 3-FLLQ/27 CAS #: 8006-61-9 Physical Hazards: X Fire ~ Pressure ~ Reactivity Check One Health Hazards: X Immediate (acute). X Delayed (chronic)~ Irritant Check One Storage Type: AG Tank X UG Tank Drum __Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient Storage Location: Center of facility Chemical Name: Unleaded Gasoline Physical State: (Sotid~d~as) Circle One Trade Name: N/A Trade Secret?(~'/~ Number of Days on Site/Year: 365 Max Daily Amount: 10,000 (~[s~. Lbs., cu. ft.) Average Daily Amount: 7,500 (,~ga~s~. Lbs., cu. ft.) D.O.T. #: 1203 UN/Class/D.O.T. Class: 3-FLLQ/27 CAS #: 8006-61-9 Physical Hazards: X Fire__ Pressure __ Reactivity Check One Health Hazards: X Imnlediate (acute). X Delayed (chronic)__ Irritant Check One Storage Type: AG Tank X UG Tank Drum Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient Storage Location: Center of facility Chemical Name: Diesel Fuel Physical State: (Solid,Liquid, as) Circle One Trade Name: N/A Trade Secret?~_.~Y Number~of Days on Site/Year: 365 Max Daily Amount: 15,000 ~d'~[bs., cu. ft.) Average Daily Amount: 11,250 ~'~g'g~, Lbs., cu. ft.) D.O.T. #: 1993 UN/C[ass/D.O.T. CLass: 3-CMLQ/27 CAS #: 64741-44-2 Physical Hazards: X Fire Pressure Reactivity Check One Health Hazards: X immediate (acute). X Delayed (chronic).~Irritant Check One Storage Type: AG Tank X UG Tank Drum . Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient .iF) Storage Location: Center of facility HMP51-4A-1 1992 CHEMICAL INVENTORY INFORMATION Business Name: Beacon Bakersfietd Truck Stop~51-4 Site Address:3225 Pierce Road Pg: 2 of 3 Phone: 805 -324-9481 Dun & Bradstreet # 00-917-4921 Chemical Name: Diesel Fuel Physical State: (Soli~Gas) Circle One Trade Name: N/A Trade Secret?~__J~aY Number of Days on Site/Year: 365 Max Oai ly Amount: 15,000 (,~lbs., cu. ft.) Average Daily Amount: 11,250 ('~(ga~. lbs., cu. ft.) D.O.T. #: 1993 UN/Class/D.O.T. Class: 3-CMLQ/27 CAS #: 64741-44-2 Physical Hazards: X Fire Pressure Reactivity Check One Health Hazards: X Immediate (acute). X Delayed (chronic) Irritant Check One Storage Type:.__AG Tank X UG Tank Drum Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient ,(F) Storage Location: Center of facility Chemical Name: Carbon Dioxide Physical State: (So[id/Liqui~ Circle One Trade Name: N/A Trade Secret.~____bL~f Number of Days on Site/Year: 365 Max Daily Amount: 876 (gals., lbs.~ Average Daily Amount: 657 (gals., lbs.~K~u, ft~ D.O.T. #: 1013 UN/Class/D.O.T. Class: 2-NFLG/21 CAS #: 124-38-9 Physical Hazards: Fire X Pressure__ Reactivity Check One Health Hazards: X Immediate (acute)__ Delayed (chronic)~__ Irritant Check One Storage Type: AG Tank UG Tank Drum X .Cylinder Other: Check One Storage Pressure: 1000 PSIA Storage Temperature: Ambient Storage Location: Inside of storage room Chemical Name: Waste Oil Physical State: (Solid i~as) Circle One Trade Name: N/A Trade Secret?~)/Y Number of Days on Site/Year: 36__5 Max Daily Amount: 500 ~ga[_~', lbs., cu. ft.) Average Daily Amount: 350 (~a~s~., lbs., cu. ft.) D.O.T. #: 9189 -'ON/Class/O.O.T. Class: 3-CMLQ/2? CAS #: N/A Physical Hazards: X Fire Pressure Reactivity Check One Hearth Hazards: X Immediate (acute) X petayed (chronic).__Irritant Check One Storage Type:__ AG Tank_..Z~.~UG Tank Drum Cylinder Other: Check One Storage Pressure: Atomsphere Storage Temperature: Ambient (F) Storage Location: East of lube bay HMP51-4A-2 1992 CHEMICAL INVENTORY INFORMATION Business Name: Beacon Bakersfietd Truck Stop #51-4 Site Address:3225 Pierce Road Pg: 3 of Phone: 805 -324-9481 Dun & Bradstreet # 00-917-4921 Chemical Name: Motor Oil Physical State:,,(Sol~Gas) Circle One Trade Name: N/A Trade Secret?~_____~ N~rof Days on Site/Year: - 36__5 Max Daily Amount: 825 y~s.,~[bs., cu. ft.) Average Daily Amount: 620 (~s.~ lbs., cu. ft.) D.O.T. #: 1270 '--(JflT'C[ass/O.O.T. Class: 3-CMLQ/27 CAS #: Physical Hazards: X Fire __ Pressure__ Reactivity Check One Rea[th Hazards: X Immediate (acute) Delayed (chronic).__ Irritant Check One Storage Type:__ AG Tank 'UG Tank X Drum__~ylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient (F) Storage Location: In lube bay HMP51-4A-3 ULTRAMAR INC. HAZARDOUS WASTE INVENTORY 1993 FACILITY NAHE Beacon BakersfieLd Truck Stop #51-4 DATE November 5, 1992 FACILITY ADDRESS 3225 Pierce Road, BakersfieLd, CaLifornia 93301 PHONE NUMBER (805) 324-9481 VoLume Chemicat/Conmon UN/NA DOT Hazard CLass/' Type of A) At One Time Unit' of Disposal Name CAS Number Number DOT Guide Number Storage Location B) In a Year Measure Method Waste OiL 64741-44-2 1270 CMLQ/27 Underground See Site Map A) 500 GaLLons Reclaimer B) 6,000 HMP51-4B Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street- Bakersfield, 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· BUSINESS NAME: Beacon Bakersfield Truckstop ¢t51-4 LOCATION' 3225 Pierce Road MAILING ADDRESS: 3225~ Pi~kceiRdad CITY: Bak~r. sfield STATE' CA~, ZIP: 93301 PHONE: (805) 324-9481' DUN & BRADSTREET NUMBER' 00'917~492] SiC CODE: 554l PRIMARY ACTIVITY: Retail sale of Petroleum Products OWNER: UL T RAiCk~R INC. MAILING ADDRESS: 525 w. Third Street SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Becky Barnett Manager (805) 324-9~81 (805) 393-4921 2. Rick Copeland Zone Manager (209) 485-6540 (209) 582-1325 Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: (12) Twelve employee(s) MAIERIAL 'SAFELY DAIA SHEETS ON FILE: Yes, at the facility site a~d at the C~rp. office. BRIEF SUMMARY OF'TRAINING PROGRAM: Eac~ employee, during initial employment and annually thereafter is instructed in the basics of Hazardous Materials handling and emergency response. The training program consists of, as a minimum, the following area: 1) Hazard .... Communitcation Standard; 2) Methods for safe handling of hazardous Materials; 3) Proper use of Safety equipment; 4) Reponding to emergencyl;' 5) Emergency evacuation procedures; and 6) Procedures for corrination with lodal emergency response department. The facility manager is reponsible for administering the training program and insuring that each employee(s) has.been trained in Hazardous Materi~ls procedures. Documentation of this training is maintained at the facility and is availabe from the facility.~anager. (For further information,..please see attached Ultramar Inc. JHMBP's~j). 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, Julie M. Caldwell, Safety Specialist CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE, I UNDERSTAND THAT THIS INFORMATION WILL BE USEDTO 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. ATURE ~' ~ ~j TI/TLE/ DATE 2, Bakersfield Fire DePt. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Beacon Bakersfield Truckstop #51-4 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: The emploYee (manager or asst~ manager) .would first notify:~he local Emergency Reponse Personnel by dialing (9'1'1). Then the Zone Manager would be notified, if the release is small the facility employee is ".-.' trained to handle the release, but if it's a large release then they are to notify the Emergency Response Agencies (for further information please see Attached Ultramar Emergency Contact sheet & Emergency Respone Evacation Plan in the HMBP Packet). B. EMPLOYEE NOTIFICATION AND EVACUATION: in the e~ent of a Hazardous Material release, it is the employee(s) .. responsibility to insure the safety or other employee(s) and the- general public. The employee will first notify, over the public address system or by Voice, all other emploYee(s)and the general public of the emergency/ C. PUBLIC EVACUATION' In the event of a release (large o~ small) .it is the sole discretion of the Emergency Response Personnel to determine if the public (surrounding'areas) should be~evacated; D. EMERGENCY MEDICAL PLAN' In the event of a release, call 9~'1'1, fo~ local medical assistance and/or the nearest Hosiptal or Emergency Facility. Bakersfield Fire De~ Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT pLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE' PREVENTION STEPS: Through inventory reconciliation , annual Tank Testing, maintenance of facility equipment and employee(s) training. B.. RELEASE' CONTAINMENT AND/OR MINIMIZATION: Employee(s) has been instructed to ~esponse~¥q~c~l-y~th~ ~en~.-~ the release can be minimized. Employee(s) has also be instructed to immediately stop the release (i.e. turn off the power, close the valve, etc.) and us absorbent.to contain the release and prevent it's spread to critical area such as storm drains or adjacent properties. C. CLEAN-UP PROCEDURES: Base on'the size of the facilitY and emergency equipment available on site, only small releases can safely be addressed. A large release can oh~y be addressed with assistance from the Emergency Response Personnel and/or a Clean up contractor. SECTION 8: UTILITY sHuT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: Right outside the office (south) ELECIRICAL: Before entering the cold box, from the outside WATER: adjacent of sale area, on Gilmore street SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Emergency equipment maintained on site is limited to fire e×tin§uishers, absorbent, and ~ater hoses. Additional equipment can be brou§ht on site ±f necessary, as ~ell as emergnec¥ ¢leag ?ersonnel. B. WATER AVAILABILITY (FIRE HYDRANT): North/East corner (Gilmore & Pierce Rd.) 4. BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 2130 "G" STREET BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME Beacon Bakersfield Truckstop #51-4 FACILITY NAME Beacon Bakersfield .Truckstop #5-1.---'.~/ SITE ADDRESS 3225 Pierce Road CITY Bakersfield STATE CA ZIP 93301 NATURE OF BUSINESS Retail sale of Petroleum Products SIC CODE 5541 DUN & BRADSTREET'NUMBER 00-917-4921 OWNER/OPERATOR Ultramar Inc. PHONE (209) '853-0241 MAILING ADDRESS 525 w. third Street CITY Hanfora STATE CA ZIP 93230 EMERGENCY CONTACTS NAME Becky Barnett TITLE Manager BUSINESS PHONE (805) 324-9481 24-HOUR PHONE (805) 393-4921 NAME Rick Copeland TITLE Zone Manager BUSINESS PHONE (209) 485-6540-- 24-HOUR PHONE (209) 582-1325 Se~em~ef 3% lg~2 REGION¥ LE-PC STANOARDFORM BAKERSI LD CITY FIRE 'DEPA t'MENT HAZARDOUS MATERIALS INVENTORY Page: BusinessNar~e ,~eacon Bakersfield TlS ¢/51-4 Address 3225 Pierce Rd. CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] .~evision [~] Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ] 2) Common Name: Waste 0il ~/ 3) DOT# (optional) 9189 ChemicalName: Waste Oil AHM [ ] CAS# 64741-44-2 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION 22 ]. (3-digit code from DHS Form 8022) USE CODE 40 6) PHYSICAL STATE Solid [ ] Liquid KZ Gas [ ] 'Pure [ ] Mixture [ ] Waste ~[X] Radioactive [ ] 7) AMOUNT AND TIME AT FACILiTY UNITS OF MEASURE 8) STORAGE CODES Maximum OallyAmount: 500 lbs [ ] gal ~ fi3 [ ] a) Contalner: Average Daily Amount: 350 cudes [ ] b) Pressure: ~ Atomsphere Annual Amount: 6 ? 000 c) Temperature: I_-~1..._~ ien__~__ Largest Size ~ontalner: 5~ Gal. - ~ ~'/: / #OaysOnSite 365 Circle Which Months: J, F, M, A, M, J, J, A, , N, O 9) MIXTURE: list COMPONENT CAS % WT AHM the three most hazardous 1). [ ] any AHM components 3,2, ~/'~/'[--' ~ ~.~, .(~ ~J ' (~.~ ~"~ ~~-~/]~ I- lO)Location East of Lube Bay ,,/~,~ ~ ~~~,~ CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [] Deletion [ ] Check if chemiceJ is a NON TRADE SECRET ~ TRADE SECRET 2) Common Name: ~/ 3) DOT # (optional) 1 ~03 Chemic~Name: Unleaded GasolineV/k/ AHM[] CAS# 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [~] Delayed Health (Chronic) 5) WASTE CLASSIFiCATION (3-digit code from DHS Form 8022) USE CODE 1 ~ 6) PHYSICAL STATE Solid [ ] Liquid ]~ Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES MaXimum Oaily Amount: 20~000 lbs [J gal ~,[~J 1~3 [ ] a) Contalner: Average Daily Amount: 15~000 cudes [ ] b) Pressure: Annual Amount: ~ c) Temperature: ~b lent Largest Size Container: ~, 0.0 0 0 #DeysOnSite 365 Circle Which Months: ~AIIYear/,~J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT' AHM the three most hazardous 1) [ ] chemical components or ..~ any AHM components 2) [ ] 3) [ ] 10) Location Center of Facility I cer~'h/uncler penalty of law, that I have personally examined and am familiar with the infoma~on submitted on this and all attached documents. I be//eve th~ submitted informafion is true, accurate, and complete. Julie M. Caldwell. Safety Special ~.~t. Date PRINT Name &'T/fie of Authorized Company Representative Signature .. BAKER i:IELD CITY FIRE DEPdiiRTMENT · "HAZ]a[RDOUS MATERIALS INVEIq'TORY Page 2of 2 Business'Name Be~con-,BaRe~.sfi~tdi-T/S/~/,5~i:~4-~!Address 3225 Pierce Rd.', Bakersfield, CA CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision k:~ Deletion [ ] Check if chemicaJ is a NON TI=lADE SECRET ~] TRADE SECRET 2) Common Nlulle: ~ 3) DOT # (opUonaJ) 199~, Chem~Name: Diesel Fuel NlM [ 1 CASe 64741-44-2 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire 7~ Reactive [ ] Suck:lin Release of Prea.$ure [ ] Immediate HeaJth (.Acute) :~ Delayed HeeJth (Chronic) 5) WASTE CLASSIFICATION ,(3-digit code from DHS Fon~ 8022) USE CODE 19 6) PHYSICAL STATE Solid [. ] Liquid IX] (3al [ ] Pure [] Mixture [ ] Wamte [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES M~mmumDeilyAmount: _30'~'000~ il:m [ ] ga E] u [] .)Container. ¢1 Average Daily Ameunt: ~ ~' curi~ [ ] b) Pm~um: Am'F, AnnuaJ Amour~t: "~60. Q(")~ c) Temperature: Am'h'i P, TI 1- · Day~ On Site ~65 Circle Which Month~: ~ J, F, M. A, M, J. J, A, S, O, N. D 9) MIXTURE: ~ COMPONENT CA~ · % ~ AHM the ttv~ mo~ hazardou~ l) [ ch~mioM components or m~/NlM component~ 2) [ 3) [] 10) Location Center of the facility CH EMICAL DE~RIPTION 1) INVENTORYSTATU$:'New[ ] AddtUo~[ ] I~mi~onL~ Deletic~{ ] Checkifohemiodi~aNONTRAJ3~SECRET:~ TRADE SECRET 2) Common Name: 3) DOT · (optional) 1013 ChemicalName: Carbon Dlo×lde ¢"'""/ NlM [ I CASe [24-38-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZAJ~D CATEGORIES Rtl [~] I~ [ I ~ldOIfs Release of Prellu~l [ ] IfTlflt~lil~ HIIIUt (Aoutl) [~] Delayed 5) WASTECLASS~CA~nON (~ag~ooe. fmmCX~SPom, S0=) US~COO~ 99.~'(Fbz~ the soda S) pHymCALSTATE SO~ [ ] Lk~d [3: e~ [ ] ~'um [ ] Ubaum [ ] Wmm [ ] p. mioaoaw [ ] 7) AMOUNT AND TIME AT FACIUTY UNIT~ OF MF.A~A,J~ ~) ~,TO~ CODE~ M~X~mumD~Amou~: 876~--'~. ~ I1~ [ ! GN [ ] ~t~ NContair~. 04 AvetlgeDeilyAmeunt 657 ourm~ [ ] b) Prll~ft: '[000 pgTA Annual Amount: 1~~' ;) Temmratum: Lacgeat Size Conmml~. R 7 A eDey~On Site 365 CircteWhioh Month~: (~Yeat.,~ J, F. M, A, M, J, J, A, S, O, N, O 9) MIXTURE: U~ COMPONENT CAS # % mi' AHM the ~hree moat ha,7~r~ou~ 1), chemic~ coml~onen~ or imy NlM oomponem 2) [ 3) 10) ~a~n Inside of suemitted information i$ true, a~¢urate, ~ ¢omplere. Julie M. Caldwell; Safety Specialist= eRINT Name & ;7#e of Au~odze~ Company Re, receSsive $ig~um Dam · 10/29/92 TRUCK STOP 015-010-0~ i35 Page 1 Overa~' Site with 1 Genera~ Information I I Location: 3225 PIERCE RD Map: 012 Hazard: Unrated ICommunity: CITY/66 RESPONSE AREA Grid: 23D : 1 AOV: 0.0 ~/~/¢/~]/~0~~ IMANAGER 1(805) 324-948'1 x · I BRIAN SKILLERN IREGIONAL MANAGER I (J~t¢~'2¢)_ 58.3-3201 x 1(209) 432-1393 --~--- Administrative Data Mail Addrs: PO 8X 466j/~'~'/~E~C.//~tC.~t~- D&B Number: 009174921 City: HANFORD/ / ~ State: CA Zip: 93232- Comm Code: 015-908 CITY/66 RESPONSE AREA SIC Code: 5541 Owner: ULTRA~4AR INC/¢'8/~/9¢~,~/.. ' .......................... Phone: (88u,~'~'~-¢;=~'-"~'¢~o2o-9481 Address: 525 W 3RD ST ' State: CA City: HANFORD Zip: 9_.32_3_3_3~ Summary ~ ........ (Type or print n'~me) reviewed the attached hazardous materials manage- ment plan for,~lc_~n ~lL_¢sl-~ and that it along with - (Name of Business) any corrections constitute a complete and correct man- age;'.'~~y. . . 0/ 9/92 TRUCK STOP O S-O 0-0/3S Page Fixed Containers at SEe Hazmat Inventory Detail in ReCerence Number Order 02-00i ~G~OLINE Liquid 10000 Moderate > Fine, Zmmed H]th, Delay.Hlth GAL CAS ~: 8006619 Trade Secret: No Form: Liquid Type: Pure Days: Use: FUEL Daily Max GAL -- Daftly Average GAL Annual Amount GAL -- 10,000 0.00 0.00 ...... Storage .press I Temp - Location AmbientlAmbient -Conc -I Components I- MCP --IList 100.0% IGasoline IModeratel 02-002 UNLEADED GASOLINE Liquid 10000 'Moderate > Fire, Immed Hlth, Delay Hlth GAL CAS ~': 886619 Tra~e Secret: No Form: Liquffd Type: Pure Days: Use: FUEL · Daily Max GAL .... t-- Dai'iy Average GAL --I-- Annual Amount GAL -- 10,000 I 0.00 I 0.00 S~o~age "l Press I Temp -I- Location IAmbientlAmbientl -Conc -t Components 'l- MCP --IList 100..0% IGasoline IModeratel 02-003 DIESEL Liquid 30000 Low > Fire, Immed Hlth, Delay Hlth GAL CAS ~: 68476302 Trade Secret: No Form: Liquid Type: Pure Days: Use: FUEL Dai]y Max GAL --.Dai'ly Average GAL I Annual Amount GAL -- 30,000 0.00 I 0.00 S~orage I Press I Temp -I Location - IAmbientlAmbientl. - Cone -I Components I- MOP --IList 100.0% IDiesel Fuel No.2 IModeratel 10/29/92 :ON 'TRUCK STOP 015-010-( ;35 Page - Fixed Containers at Hazmat Inventory Detaff] in R.eCenence Number Order 02-004 CARBON DIOXIDE Gas 8?6 > Ffine, Pressure, Immed H~th FT3 CAS ~: 124389 Tnad'e Secret: No Form: Gas Type: Pure Days: Use: WELDING SOLDERING Daftly Max FT3 I Daiqy Average F.T3 Annua~ Amount FT3 8?6 I 0.00 0.00 Storage I Press Temp -I Locatfion ,. lahore AmbientI - Cone -I Components I- MOP --I'List 100.0% ICarbon Dioxffde IMffnffma] ".10729/92 ' TRUCK STOP 015-010-0 35 ~ Page 4 O0 - Overall Si~e <H> SCHOOLS WITHIN 1/2 ~4ILE · <1> Hffgh Schools '<2> Jr. Hffgh Schools <3> Elementary Schools -<4> Private & Pre Schools $ "-,_~%/_. ~ ~ RECEIVED 02/20/92 BEACON TRUCK STOP 215-000-000690 I~AR 13 1992Page Overall Site with 1 Fac. Unit Ans'd ............ General Information Location: 3225 PIERCE RD Map: 102 Hazard: Low Community: BAKERSFIELD STATION 01 Grid: 23D F/U: 1AOV: 0.0 Contact Name Title Business Phone /24-Hour ~,AY ELANTCN /MANAGER 1( o5) 324-9481 x - ' -~ ~MANAGER 1(209)~>-~ x (~(209) ~ ae~q ~~ ~ ~~~ative Da~a~-~0 I Mail Addrs: P O BOX 466 D&B Number: 00-917-4921 City: HANFORD State: CA Zip: 93232- Co~ Co~e: 215-001 BAKERSFIELD STATION 01 SIC Code: 5541 Owner: ULTRAMAR iNC Phone: (209) 582-0241 Address: 525 W 3RD ST State: CA City: HANFORD . Zip: 93232- Sugary ~y~ or ~lnt ~) reviewed the a~ached h~rdous m~te~ials ~~ ~~~ --~~~ 'it ~ith' ' merit plan ior nd that ~ong any corrections constitute a comp!~e and ~rre~ ~m,nt~ ~r my (acility.. 02/20/92 BEACON TRUCK STOP 215-000'000690 Page ,2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 DIESEL Liquid 15000 Low' · Fire, Immed Hlth, Delay Hlth GAL cas #: 64741-44-2 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL I Annual .Amount GAL 15,000 I 11,250.00 . 1,133,016.00 Storage~~Press T Temp Location UNDE~ GROUND TANK IAmbient~AmbientlWEST SIDE OF FACILITY -- Conc Components MCP List 100.0% IDiesel Fuel No.2 ILow I 02-002~ULAn CASOLII:E ~m~aJ~ ~5o/,~ 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 '1 ' 7,500.00 500,000.00 Storage ' Press T Temp~ Location UNDER GROUND TANK Ambient{AmbientlWEST SIDE OF FACILITY- -- Conc· Components MCP List 100.0% IGasoline Moderatel 02-003 CARBON DIOXIDE' Gas 876~ Minimal~ · Fire, Pressure, Immed Hlth FT3 CAS #: 124-38-9 Trade Secret: No . Form: Gas' Type: Pure Days: 365 Use: ADDITIVE Daily Max FT3 ~, Daily Average FT3 1 Annual Amount FT3 876 ~ I · 65'7.00 20,512.00 Storage I Press I Temp I Location PORT. PRESS. CYLINDER Above {Ambient INSIDE STORAGE ROOM --,Conc Components ~ MCP List 100.0% ICarbon Dioxide ~ IMinimal I 02/20/92 BEACON TRUCK STOP 215-000.-000690 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-004 UNLEADED GASOLINE Liquid i0000 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 ~ 7,500.00 560,000.00 Storage Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlWESTSIDE OF FACILITY -- Conc Components MCP ---~List 100.0% IGasoline ModerateI 02-005 DIESEL #2. Liquid 15000 Low · Fire, Immed Hlth, Delay Hlth GAL CAS #: 68476-34-6 Trade Secret:' No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI 'Daily Average GAL --l-- Annual Amount GAL -- 15,000 ~. 11,250.00 '1,133,016.00 Storage Press T TempI- Location " UNDER GROUND TANK Ambient~AmbientlWEST SIDE OF FACILITY - ConcI Components .MCP iList 100.0% Diesel Fuel No.2' Low . ~ 02/20/92 BEACON TRUCK STOP 215-000-000690 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation /-?% IMMEDIATELY MAKE SURE THAT ALL PERSONS IN STATION STORE ARE WARNED AND EVACUATE THE PREMISES. <3> Public 'Notif./Evacuation IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR POTENTIAL RELEASE, IT IS THE EMPLOYEES RESPONSIBILITY TO INSURE THE SAFETY OF OTHER EMPLOYEES AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEES AND THE GENERAL PUBLIC OF THE EMERGENCY. THE EMPLOYEE WILL THEN NOTIFY EMERGENCY RESPONSE PERSONNEL BY DIALING 911. IT IS THE EMPLOYEES RESPONSIBILITY TO SECURE THE IMMEDIATE AREA TO PREVENT ANY UNNECESSARY EXPOSURE OF THE PUBLIC OR EMPLOYEES. WHEN THE IMMEDIATE AREA HAS BEEN SECURED, THE EMPLOYEE WILL NOTIFY THE FACILITY MANAGER OR, IF NECESSARY THE ZONE MANAGER. THE FACILITY MANAGER OR ZONE MANAGER WILL NOTIFY OTHER ADMINISTRATIVE AGENCIES, AS NECESSARY, OF.THE RELEASE. <4>~ Emergency Medical Plan · MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 02/20/92 BEACON TRUCK STOP 215-000-000690 Page 5 ~ 00 .- Overall Site <E> Mitigation/Prevent/Abatemt "<1> Release Prevention ' DAILY PHYSICAL INVENTORY READINGS'ALONG WITH DAILY METER READINGS AND VISUAL OBSERVATION OF IMMEDIATE AREA AROUND UNDERGROUND TANKS. DAILY EADINGS ARE KEPT IN DAILY LOG PER REQUIREMENT OF KERN COUNTY HEALTH DEPT. THE FACILITY HAS BEEN CONSTRUCTED AND IS MAINTAINED WITH LOCAL, STATE AND FEDERAL LAWS OR REGULATIONS. PREVENTION OF A RELEASE IS ACHIEVED THRU INVENTORY RECONCILIATION, TANK TESTING, MAINTENANCE OF FACILITY EQUIPMENT AND EMPLOYEE TRAINING. <2> Release Containment '.USE ABSORBANT TO CONTAIN THE RELEASE AND PREVENT ITS SPREAD TO CRITICAL AREAS SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. '- <3> Clean Up IN THE EVENT OF A RELEASE, EMPLOYEES HAVE BEEN INSTRUCTED TO RESPOND QUICKLY SO THE EXTENT OF THE RELEASE CAN BE MINIMIZED. EMPLOYEES HAVE BEEN INSTRUCTED TO IMMEDIATELY STOP THE RELEASE (I.E. TURN OFF'THE POWER, CLOSE THE VALVE, ETC.) AND USE ABSORBANT TO CONTAIN THE RELEASE AND PREVENT ITS SPREAD TO CRITICAL AREAS SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. BASED ON THE SIZE OF THE FACILITY AND EMERGENCY EQUIPMENT AVAILABLE ON SITE, ONLY SMALL RELEASES CAN BE SAFELY ADDRESSED. A LARGE RELEASE CAN ONLY BE ADDRESSED WITH ASSISTANCE FROM EMERGENCY RESPONSE PERSONNEL AND/OR A CLEAN UP CONTRACTOR. <4> Other Resource Activation 02/20/92 BEACON TRUCK STOP 215-000-000690 Page 6 00 - Overall Site <F> Site Emergency Factors > <1> Special Hazards <2> Utility Shut-Offs A) GAS - METER SOUTH OF BUILDING B) ELECTRICAL - SHUT OFF INSIDE STORE C) WATER -~ NORTHWEST CORNER OF LOT D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire protec./Avail, water PRIVATE FIRE PROTECTION - TWO (2) FIRE EXTINGUISHERS; ONE (1) AT ENTRANCE TO FRONT DOOR AND ONE (1)~ IN STOCK ROOM BEHIND DOOR TO STOCK ROOM FIRE HYDRANT = IMMEDIATELY ACROSS THE STREET (PIERCE RD) FROM STATION, APPROXIMATELY 150 FT. <4> Building Occupancy Level 02/20/92 BEACON TRUCK STOP 215-000-000690 Page 00 - Overall Site <G> Training <1> Page 1 WE HAVE'll EMPLOYEES AT THIS FACILITY' WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE EACH EMPLOYEE, DURING INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER IS INSTRUCTED IN THE BASICS OF HAZARDOUS MATERIALS HANDLING AND EMERGENCY RESPONSE. THE FACILITY MANAGER IS RESPONSIBLE FOR ADMINISTRATING THE TRAINING PROGRAM. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use Ultramar Ultramar Inc. Telecopy: 209-584-6113 Credit & Wholesale P.O. Box 466 20g*$83-3330 Administrative 525 Wi Third Street 209-583-3302 Information Services Hanford, CA 93232-0466 209-583-3358 Accounting (209) 582-0241 HAZARDOUS MATERIALS BUSINESS PLAN Business Name Beacon Bakersfield Truck Stop #51-4 Street Address 3225 Pierce Road City, State, Zip Bakersfield, CA 93301 Phone Number (805) 324-9481 Nature of Business Retail Sale of Petroleum Products Assessor Parcel Number 332-162-16-00-8 SIC Code 5541 Operating Hours 24 Maximum Number of Employees Per Shift 5 Plan Submitted By /Ju%ie M. Caldwell Phone Number7-----r--~ Date Of Submission No em er 91 'Signature HMBP5i-4 A Member of the Ultramar Group of Companies #1 Quality and Service 1992 CHEMICAL INVENTORY INFORMATION Business Name: Beacon BakersfieLd Truck Stop #51-4 Site Address: 3225 Pierce Road, Bakersfield, CA 93301 Pg: 1 of 3 Phone: 805-324-9480 Dun & Bradstreet # 00-917-4921 Chemical Name: Unleaded GasoLine Physical State: (SoLi as) Circle One Trade Name: N/A Trade Secret? N/Y Number of Days on Site/Year: 365 Max Daily Amount: 10,000 (gaLs~, lbs., cu. ft.) Average Dai[y Amount: 7,500 (gals., lbs., cu. ft.) D.O.T. #: 1203 UN/CLass/D.O.T. Class: 3-FLLO/27 CAS #: 8006-61-9 PhysiCaL Hazards: X Fire __ Pressure Reactivity Check One HeaLth Hazards: X Immediate (acute). X De[ayad (chronic) Irritant CheckOne Storage Type: AG Tank X UG Tank. Drum~.Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient Storage Location: Center of facility Chemical Name: UnLeaded GasoLine Physical State: (SoLidyL~quid~Gas) CircLe One Trade Name: N/A Trade Secret? N/Y Number of Days on Site/Year: 365 Max Daily Amount: 10,000 (gaLs., lbs., cu. ft.) Average Dai[y Amount: 7,500 (gals., Lbs., cu. ft.) D.O.T. #: 1203 UN/C[ass/D.O.T. Class: 3-FLLO/2? CAS #: 8006-61-9 Physical Hazards: X Fire ~ Pressure__Reactivity Check One HeaLth Hazards: X Immediate (acute). X Delayed (chronic)__ Irritant Ch'ack One Storage Type: AG Tank X UG Tank Drum~.Cy[inder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient Storage Location: Center of facility Chemical Name: Diesel Fuel Physical State: (So[iiqo~Gas) Circle One Trade Name: N/A Trade Secret? N/Y Number of Days on Site/Year: ~65 Max DaiLy Amount: 15,000 (gaLs., Lbs., cu. ft.) Average DaiLy Amount: 11,250 (ga[s., lbs., cu. ft.) D.O.T. #: 1993 UN/CLass/D.O.T. Class: 3~CMLQ/27 CAS #: 64741-44-2 Physical Hazards: X Fire Pressure Reactivity Check One HeaLth Hazards: X Immediate (acute). X DeLayed (chronic) Irritant Check One Storage Type: AG Tank X UG Tank Drum Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient iF) Storage Location: Center of facility HMP51-4A-1 1992 CHEMICAL INVENTORY INFORMATION Business Name: Beacon Bakersfield Truck Stop ~51-4 Site Address:3225 Pierce Road Pg: 2 of 3 Phone: 805 -324-9481 Dun & Bradstreet # 00-917-4921 Name: Diesel Fuel Physical State: (Soli~Gas) Circle One Chemical Trade Name: N/A Trade Secret? N/Y Numbe~'~-ol~ Days on Site/Year: 36__5 Max Daily Amount: 15,000 (gals., lbs., cu. ft.) Average Daily Amount: 11,250 (gals., lbs., cu. ft.) D.O.T. #: 1993 UN/C[ass/D.O.T. Class: 3-CMLQ/2? ' CAS #: 647'41-44-2 Physical Hazards: X Fire Pressure Reactivity Check One Health Hazards: X Immediate (acute). X Delayed (chronic) Irritant Check One Storage Type: AG Tank X UG Tank - Drum Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient .(F) Storage Location: Center of facility Chemical Name: Carbon Dioxide Physical State: (So[id/Liqu~d/Ga~)~ Circle One Trade Name: N/A Trade Secret? N/Y Number of'Oa?~'on Site/Year: 36__5 Max Dai[y Amount: 876 (gals., lbs., cu. ft.) Average Daily Amount: 657' (gals., lbs., cu. ft.) D.O.T. #: 1013 UN/Class/D.O.T. Class: 2-NFLG/21 CAS #: 124-38-9 Physical Hazards:__ Fire ~ Pressure Reactivity Check One Health Hazards: X Immediate (acute)__ Delayed (chronic)__ Irritant Check One Storage Type: AG Tank__ UG Tank Drum X .Cylinder Other: Check One Storage Pressure: 1000 PSIA Storage Temperature: Ambient Storage Location: Inside of storaae room Chemical Name: Waste Oil Physical State: (Solid/~iquid~as) Circle One Trade Name: N/A Trade Secret? N/Y Nu~ber-F-~ Days on Site/Year: 36__5 Max Daily Amount: 500 (gals., tbs., cu. ft.) Average Daily Amount: 350 .(gals., lbs., cu. ft.) D.O.T. #: 9189 UN/Class/D.O.T. Class: · 3-CMLQ/27 CAS #: Physical. Hazards: X Fire __Pressure Reactivity Check One Health Hazards: X Immediate (acute) X Delayed (chronic) Irritant Check One Storage Type: AG Tank UG Tank Drum Cylinder__ Other: Check One Storage Pressure: Atemsphere Storage Temperature: Ambient ,(F) Storage Location: East of lube bay HMP51-4A-2 1992 CHEMICAL INVENTORY INFORMATION ~ Business Name: Beacon Bakersfield Truck Stop ~51-4 Site Address:3225 Pierce Road Pg: 3 of 3 Phone: 805 -324-9481. Dun & Bradstreet # 00-917-4921 Chemical Name: Motor Oil Physical State: (Solid'Gas) Circle One Trade Name: N/A Trade Secret? N/Y Numnber-~"6~ Days on Site/Year: ~65 Max Daily Amount: 825 (gals., lbs., cu. ft.) Average DaiLy Amount: 620 (gals., lbs., cu. ft.) D.O.T. #: 1270 UN/Class/D.O.T. Class: 3-CMLQ/27 CAS #: N/A Physical Hazards: X Fire __ Pressure Reactivity Check One Health Hazards: X Immediate (acute).__ Delayed (chronic)__ Irritant Check One Storage Type: AG Tank UG Tank X Drum Cylinder Other: Check One Storage Pressure: Ambient Storage Temperature: Ambient iF) Storage Location: In lube bay HMP51-4A-3 ULTRAMAR INC. HAZARDOUS WASTE INVENTORY 1992 FACILITY NAME Beacon Bakersfield Truck Stop #51-4 DATE November 13, 1991 FACILITY'ADDRESS 3225 Pierce Road, Bakersfield, California 93301 PHONE NUMBER (805) 324-9481 Volume Chemical/Common UN/NA DOT.Hazard Class/ Type of A) At One Time Unit of Disposal Name CAS N~nber Number DOT Guide NotCher Storage Location B) In a Year Measure Method Waste Oil 64741-44-2 1270 CMLQ/27 Underground See Site Map A) 500 Gallons Rectaimer B) 6,000 HMP51-4B ULTRAMAR EMERGENCY CONTACTS Name Title Business Phone Home Phone Becky Barnett 'Manager (805) 324-9481 (805) 393-4921 Rick Copeland Zone Manager (209) 485-6540 (209) 582-1325 Brain Skillern District Manager (209) 583-3201 (209) 432-1393 Robert C. Vryhof Risk Manager (209) 583-3279 (209) 584-4555 EMERGENCY RESPONSE AGENCIES Agency Business Phone Police Department 9-1-1 Sheriff .Department 9-1-1 Highway Patrol 9-1-1. Fire Department 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency-Facility Toxic Information Center 1-800-233-3360 Chemtrec 1-800-424-9300 REGULATORY AGENCIES Agency Business Phone California Office of Emergency ServiCes (800) 852-7550 Environmental Protection Agency (415) 974-8131' National Response Center (800) 424-8802 Administrating Agency (805) 861-2761 EMERGENCY SERVICES Name Business Phone Home Phone Beacon Marketing Services (209) 583-3214 (209) 582-0781 (Roger Gamble) I.T. Corporation (800) 262-1900 N/A Rick Copeland (209) 485-6540 (209) 582-1325 HMBP51-4 Introduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 of the State Health and Safety Code (codified sections of AB 2185 & AB 2187 and SARA Title III Federal Law). The plan is also intended for employee' guidance in minimizing potential and actual hazards which could affect our employees, the public or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface or ground water. The plan is also designed to set procedures for reporting releases or threatened releases of hazardous materials which may pose a potential hazard to our employees, the public or the environment. In the event a substantial change is made in the normal business operation, the local regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Description of O~eration The operation of Beacon Bakersfield Truck Sto~ #51-4 located at 3225 Pierce Road, Bakersfield, California is primarily to serve the general public through retail sale of petroleum products, miscellaneous consumer packaged products and various food items. The petroleum products (i.e. gasoline, diesel) are stored in underground tanks which conform with local, state and federal laws or regulations. Underground piping and dispensing equipment is also installed and maintained in conformance with local, state and federal laws or regulations. Control of inventory is maintained through the use of an inventory reconciliation program which allows the facility manager to accurately control the inventory. Product reorders are based on the reconciled inventory and maximum tank capacity. ~ Delivery of the product is achieved within the conformity of local, state and federal laws or regulations. Prior to unloading product, delivery drivers are required to gauge the tankage and record this information on the delivery ticket. Upon completion of unloading, the tank is again gauged and the information recorded. Re~ortin~, Notification and Scene Management In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will~ then notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public'or employees. When the immediate area has been secured, the employee will notify the facility manager or, if necessary, the zone manager. The facility manager or zone manager will notify other administrative agencies, as necessary, of the release. (See page 4 call list and attached Emergency Response Evacuation Plan). HMBP51,4 Prevention and Mitigation The facility has been constructed and is maintained within local, state and federal laws or regulations. Prevention of a release is achieved thru inventory reconciliation, annual tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respOnd quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the-power, close the valve, etc.) and use abSorbant to contain the release and prevent it's spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. Emergency Equipment Emergency equipment maintained on site is limited to fire extinguishers, absorbent and water hoses. Additional equipment can be brought on site if necessary, as well as emergency clean up personnel. Employee Training Each employee, during initial employment and annually thereafer is instructed in the basics of hazardous materials handling and emergency'response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for coordination with local emergency response departments. The facility manager is responsible for administering the training program and insuring that each employee has been trained in hazardous materials procedures. Documentation of this training is maintained at the facility and is available from the facility manager. Facility Manager Becky Barnett Phone Number (805) 324-9481 HMBP51-4 ULTRAMAR INC. EMERGENCY RESPONSE - EVACUATION PLAN In the event of a fire, hazardous material spill or an earthquake... Follow these steps immediately! 1. Turn off the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocarbons continue or you can not use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: "There is a (fire) (dangerous spill) in the facility. Please turn off your engines and leave the station on foot...immediately~" If you do not have'a public address system at your unit, yell the above statement. 3. Call help by dialing 9-1-1 and giving the following information. "There is a (fire) (dangerous spill) at Beacon Bakersfield Truck Stop #51-4 located at 3225 Pierce Road, Bakersfield, California." If anyone is trapped or needs attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. If the facility phone is not accessible, use the nearest public phone. 4. Look around to in~ure that all employees and customers have left the facility, particularly those in vehicles who may need assistance or did not hear the emergency announcement. Assist or direct assistance to any customer having difficulty in leaving the station area. 5. Secure the area to prevent any unnecessary vehicle entry. 6. Attend to the injured and direct medical .response to them. 7. Attempt to extinguish any fire if you can do so safely. If the fire is small the fire extinguisher should be used to extinguish it. If the fire is large or spreading, or you determine that there is a potential danger of explosion or personal injury, do not attempt to put out the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material. 9. Report to arriving emergency response personnel to provide them any information or assistance they may require. 10. Remain calm (earthq6ake information on next page). HMBP51-4 In The Event of a Large Earthquake The manager or other qualified employee should make a visual inspection of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes or other damage which could create a hazard. 2. The manager or other qualified employee will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, then the zone manager will be notified immediately. 3. If a loss of product is confirmed by the zone manager, the zone manager will then coordinate with our marketing services for tank tests and/or repairs. HMBP51-4 ULTRAMAR INC. Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facility manager. 'If, 'in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Signature ' Date Signature Date HMBP51-4' Ultramar Ultramar Inc. Telecopy: 209-584-6113 Credit & Wholesale P.O. Box 466 209-583-3330 Administrative 525 W. Third Street 209-583-3302 Information Services Hanford, CA 93232-0466 209o583-3358 Accounting (209) 582-0241 March 25, 1991 Mr. Ralph E. Huey CITY OF BAKERSFIELD Fire Department 2130 "G" Street Bakersfield, CA · 93301 Dear Mr. Huey: RE: Revised Hazardous Materials Business Plans Enclosed are the Hazardous Materials Business Plans for the Ultramar Inc. sites referenced on the attached page. This information is intended to satisfy the reporting requirements for 1991. Copies of the Hazardous Materials Business Plans have been sent to the appropriate Ultramar locations. These plans were previously sent to City of Bakersfield Fire Department and were subsequently returned to us because the submitted information was not on Bakersfield Fire Department forms. Thank you for indicating and returning the computer forms for update. Please call me at 209/583-3247 if additional information is required. /~nTrely, - Enclosures CERTIFIED MAIL A Member of the Ultramar Group of Companies #t Quality ond Servi(~e Beacon Station #1-578 BeacOn Cardlock Fuels #608 6601 Ming~Avenue 241 Union Bakersfield,'CA Bakersfield, CA Beacon Cardlock Fuels #598 Beacon Bakersfield Truck Stop #51-4 Stine Rd. & District Blvd. 3225 Pierce Road Bakersfield, CA Bakersfield, CA Beacon Cardlock Fuels #597 3311 Truxton Bakersfield, CA · ~ []~l~ral.l' Site with 1 .Fac. Get, era 1 I ~f,:,rmat i c,~'~ 1. Locatlo~: 322~= PIERCE RD Map: lO2 "Hazard: Low Ider~t Number: 215-000-000690 Grid: 23D . A~-ea of Vul: O. RAY BLAN'I'ON ,MANAGER (805) 324-~481 x (805) B~G-231~/ ( 2¢)9 ) ' 432-1'3 ~3 BRIAN SKILLERN REGIONAL .MANAGER (209) 783-3201 x . .Administrative Data Mail Addrs: P 0 BOX 466 .. D&B Number: 00-917-4921 City: HANFORD St'ate: CA Zip:~93232- Corem Code: 215-0(~)1 BAKERSFIELD STATION O1~ SIC Code: 5541 Owner: ULTRAMAR INC Phor~e: ~<S~5~ 324-S481 Address: 525 W 3RD ST State: CA City: HANFORD Zip: 93232- Summary RECEI~D HAZ~ MAT, DIV. I, '~/I¢-./9'],/~//'//~// DO hereby certify 'that have (Type or print name) reviewed .the attached hazardous materials manage- ment plan for~z,~~ ~.~¢that it along with any, Corrections constitu'[~ a coCplete and.correct man° age~f1~f~r ~y facility. . ,//' Signature BE~'~ TRUCK STOP 215.£)0(1)-(1)00 P~ge . 2 02/22/91 Haz~ Ir~ver~tcry'-' List ;i MCP 02 - Fi xed' .COr, taioers or, Si~e Pln-Ref;~ Na~e/Hazards ., For~ Quar, tity ' MCP 08-008 REGULAR GASOLINE Liqui~d 10, (:)00 Moderate Fire, Ir,~,~ed'Hl~h,' Delay Hlth 0 GAL_ .[)8-0()4 UNLEADED GASOLINE Liquid' 1[), 0()(~ Moderate Fire, Ir~n~ed Hl~h, Delay Hlth ~ GAL 02-0[) 1 DIESEL Liquid 30, ()00 Low Fire,' Ir~,~ed Hlth, Delay~ Hlth GAL 02-[)[~3 CARBON DIOXIDE Gas 876 Mir~if~a 1 Fi~;e, Pressure~ I~,~ed Hlth F"[3 . 02/22/91 ' "' BEt IN TRUCK .STOP' 215-000-004 Page .3 ~ ~ 00 - Overall Site {D) Not if. /Evacuat ion/Medical <1> Agency. Notification . CALL 911 <2> Eraployee Notif./EYacuation cASHIER ON DUTY CALLS THE MANAGER OR SHIFT SUPERVISOR. CASHIER THEN WOULD IMMEDIATELY MAKE SURE THAT ALL PERSONS IN STATION STORE ARE WARNED AND EVACUATE '['HE PREMISES. <3> Public Notif./Evacuation IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR POTENTIAL RELEASE, IT IS THE EMPLOYEES RESPONSIBILITY. TO INSURE THE SAFETY OF OTHER EMPLOYEES AND THE GENERAL PUBLIC. THE EMPLOYEE WILL FIRST NOTIFY, OVER THE PUBLIC ADDRESS SYSTEM OR BY VOICE, ALL OTHER EMPLOYEES AND ]'HE GENERAL~PUBLIC OF THE EMERGENCY. THE EMPLOYEE WILL THEN NOTIFY EMERGENCY RESPONSE PERSONNEL BY DIALING 911. I/¥ IS THE EMPLOYEES RESPONSIBILITY TO SECURE'THE IMMEDIATE AREA TO PREVENT ANY UNNECESSARY EXPOSURE OF THE PUBLIC OR EMPLOYEES. WHEN ]'HE IMMEDIATE AREA HAS BEEN SECURED, ]'HE EMPLOYEE WILL NOTIFY ]'HE FACILITY MANAGER OR~ IP NECESSARY THE ZONE MANAGER. THE FACILITY MANAGER OR ZONE MANAGER WILL NOTIFY OTHER ADMINISTRATIVE AGENCIES~ AS NECESSARY~ OF THE RELEASE. <4> Emergency Medical .Plar~ MERCY-HOSPi]'AL . 22i5 TRUXTUN AV 327-3371 02/22~9i BE~N ?RUCK STOP' 2152000-000 Page 4 ' 00 - Overall Site <E> Mitigatiori/Prevent/Abatemt ,- '. ~. "' < 1 > Reiease Prevent ior~ '~ "' DAILY PHYSICAL INVENTORY READINGS. ALONG WITH DAILY METER READINGS AND VISUAL OBSERVATION OF IMMEDIATE A'REA AROUND UNDERGROUND -'TANKS. DAILY ., EADINGS ARE KEPT IN DAILY LoG.PER REQUIREMENT OF KERN COUNTY HEALTH DEP'r. THE,FACILITY HAS .BEEN CONSTRUCTED AND. IS MAINTAINED WII'H LOCAL, ST~'I.'E AND FEDERAL LAWS OR R~GULATIONS. PREVENTION OF-A RELEASE IS ACHIEVED THRU INVENTORY RECONCILIATION, TANK.TES]'ING, MAINTENANCE OF FACILITY EQUIPMENT AND EMPLOYEE TRAINING. <~> Release Cor, tairm~er~t USE ABSORBANT TO CONTAIN THE RELEASE AND PREVENT ITS SPREAD TO CRITICAL' AREAS SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. <3) Clean Up . IN THE'EVENT OF A'RELEASE, EMPLOYEES HAVE BEEN INSTRUCTED TO RESPOND QUICKLY SO.THE EXTENT OF THE RELEASE CAN BE MINIMIZED. EMPLOYEES H~VE BEEN INSTRUCTED TO IMMEDIATELY"STOP THE RELEASE (I.E. TURN OFF.THE POWER, CLOSE THE VALVE, ETC.) AND USE ABSORBANT 'TO CONTAIN 'THE RELEASE. AND PREVENT ITS. SPREAD-TO CRITICAL AREAS SUCH AS STORM DRAINS OR ADJACENT PROPERTIES. BASED ON THE sIzE OF THE FACILITY AND EMERGENCY EQUIPMENT AVAILABLE ON SITE, ONLY 'SMALL RELEASES CAN BE SAFELY ADDRESSED.. A LARGE RELEASE CAN'ONLY BE ADDRESSED WITH ASSISTANCE FROM EMERGENCy RESPONSE PERSONNEL AND/OR A CLEAN UP CONTRACTOR. .. <4> Other Resource Activation , ! 02/22/91 BE )N TRUCK STOP 215-000-00, Page 5 ,~ ~ . 00 - Overall Site <F> Site Emerger~cy Factors <1> Special Hazards <2> Utility Shut-Offs A)~GAS - METER SOUTH OF BUILDING Bi) ELECTRICAL - SHUT OFF INSIDE STORE C) WATER - NORTHWEST CORNER OF LO]' D) SPECIAL a NONEs. E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECT~ION -' TW° (2) FIRE~EXTINGUISHERS~; ONE (1) AT ENTRANCE TO FRONT DOOR AND~ONE (i)~ IN STOCK ROOM BEHIND DOOR TO STOCK ROOM FI:RE HYDRANT - IMMEDIATEEY ACROSS THE STREET (PIERCE .RD) FROM STATION, APPROXIMATELY 15(:) FT. ~ <4> Held for Future use 02/22/91 .~ BE~ N TRUCK STOP 215-000-00£~0 Page 6 ~ ?~ ~ · 00 = Overall site ~ , <G> Trair~in'g '~ <1> Page 1 .~ WE HAVE Il'EMPLOYEES AT THIS EACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE .~ EACH EMPLOYEE~ DURING INITIAL EMPLOYMENT AND ANNUALLY THEREAFTER IS INSTRUCTED IN THE BASICS OF HAZARDOUS MATERIALS HANDLING AND EMERGENCY RESPONSE. THE FACILITY MANAGER IS RESPONSIBLE FOR ADMINISTRATING THE TRAINING PROGRAM. Page 2 as r~eeded Held for Future Use <4> Held for Future Use UItrarnar Ultramar Inc. Te~ecopy: 209-584-6113 Credit &Wholesale P.O. Box 466 209-583-3330 Administrative 525 W. Third Street 209-583-3302 Information Services Hartford. CA 93232-0466 '. 209-583-3358 Accounting (209) 582-0241 March 25, 1991 Mr. Ralph E. Huey CITY OF BAKERSFIELD Fire DePartment 2130 "G" Street Ba'kersfield, CA 93301 Dear Mr. Huey: 'RE: Revised Hazardous Materials Business Plans Enclosed are the Hazardous Materials Business Plans for the Ultramar Inc. sites referenced on the attached page. This information is intended to satisfy the reporting requirements for 1991. Copies of the Hazardous Materials Business Plans have been sent to the appropriate Ultramar locations. These plans were previously sent to City of Bakersfield ·Fire DePartment and· were subsequently returned to us because the submitted information was not on Bakersfield Fire Department forms. Thank you for indicating and returning ~he ·computer forms for update.· Please cali me at 9-09/583-3247 if additional information is required. ~S~incere ly, .... ULTRAMAR INC. '- // /Julie M. Caldwell , / Safety Specialist Enclosures CERTIFIED MAIL ~ · BEAC- N Member.of the Ultramar Group of Companies #t Quality and Service CITY of BAKERSFIELD,, "WE CARE" FIRE DEPARTMENT 2101 H STREET D. S: NEEDHAM BAKERSFIELD. 93301 FIRE CHIEF - : · . . 326-3911 January 11, 1991 Ms. Carol Fraser Beacon Truck Stop 3225 Pierce Road Bakersfield, CA 93308 Ns, Fraser: Enclosed are the sections of the Uniform Fire Code 'and Bakersfield Municipal Code which regulate the use of latch open devices on fuel dispensers at service stations. I discussed the use of latch open devices with Captain Goatcher of the Fire Safety Division. Section 15.64.180 of the Municipal Code disallows use of these devices on dispensers of Class I (flammable) liquids. As diesel fuel is a Class 2 (combustible) liquid, you may install latch open devices on the diesel dispensers. Latch' open devices are NOT allowed on gasoline dispensers.- Please call Captain Goatcher at the Fire Safety Division, 326-3951, if you have any further questions regarding dispensing flammable or combustible liquids. I have also enclosed a list of all the environmental contractors, .who we know of', that may be able to haul away soiled absorbent material. The waste oil pick-up haulers may also be willing to accept used absorbent. If you decide.to leave absorbent out for customer use at unattended stations, you may want to' use a product such as sand or rice hulls as 'kitty litter might be stolen. Be sure to post emergency procedures and phone numbers at the unattended stations as well. Please call me at 326-3979 anytime that I can be of assistance with hazardous material planning. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc: Captain Goatcher ~'~ BakerSfield Fire ',Dept . ~ · HAZARDOUS' MATERIALS DIVISION '"' '. '. .... DateC0mpleted 1,,1_~-_ ?o.:. '. I BusinessUame: j,2)ec~o.,,t...~--~-~_z__~ .:?t',_'t'op Location: ',~. '.2~5<': "~,. ~¢-c:.~' ~r~.' .. Business Identificati°nN0! 215-000 ~ {Top of Business Plan) .. Station No.' 'i' Shift. '~' Inspector l~,(~-e.[/~ --. u // : ' . '. Adenuate Inadeouate · Verification of InYento~ Materials' 'l~-. I~] Verification of Ouantities 'l~'. I~ · ' Verification 0t LocatiOn .- ~' I~] .~ . Proper Segregation of'Material ' ~ comments: .. - . Verification of MsDs Availablity~ ' lber of Employees. ' . "I I ' · verification of Haz Mat Tr ,., ,or'om'men,,.:. · . . Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted ~ " Containers Properly Labeled I~ I~] Comments: Verification of Facility Diagram ~ ~] Special Hazards Associated with this Facility: Violationsi · .. All Items O.K. 'X ('[ ' · Correction Needed ~us,neJs---O'~ner/lt(lan-"a~ -v-"7 '~.--' : - - ' ' · .' FD 1652 (Rev. 1-90)°' ,, "¥.- .: . ~, White-Haz Mat Div. Yellow-Station'Copy 525 W. Third Street J~u~ 30, 1990 B&ersfield F~e Dep~ent 2130 G Street Bakersfield, CMffo~a 93301 Attention: R~ph Huey Re: ~1-578, gl-608, g2-597, g4-598, g27-3, g514 B~ersfield H~dous MatefiMs Bushess Plan De~ ~. Huey: Enclosed ~e the H~dous MatefiMs Business PI~ for ~e above-hsted Ultramar hc. sites. ~s ~o~afion is htended to satis~ ~e repon~g requ~ements for 1990.. A copy of ~e H~dous Matefi~s Business PI~ h~ been sent to the appropriate Beacon locatiom. Plebe note that we have ch~ged our co.orate name kom Beacon Oil Company to ~tr~ Inc. effe~ive October 1, 1989. ~ ~pects of the co~oration ~11 continue ~ they have ~ the p~t--o~y the co.orate name w~ changed. Plebe call me at (209) 583-3279 ff addition~ i~o~ation is reqUired. Shcerely, Robert C. V~hof Co~orate~ SMe~ CoordNator RCV:rem Enclos~es BAKERSFIELD BEACC;N #1 Quality and Service An Ultramar Company - 525 WEST THIRD STREET · HANFORD, CA 93230 · (209) 582-0241 RECEIVED April 12, 1989 I 3 19§9 HAZ. MAT. DI~ Bakersfield City Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, CA 93301 Attn: Duane Meadows RE: Beacon Oil Company Site~ #51-4, #1-~78, ~2~-3, #1-608, #2-597, #4-598 Dear Duane: Enclosed are the Hazardous Material Business Plans for the Beacon Oil Company sites in Bakersfield City. The station at 631 Baker Street is no longer a Beacon Oil Company site. Please address all inquiries-to the 631 Baker Street address. Please call me at (209) 583-3279 if you have any questions. Sincerely, Robert (2. Vryhof Corporate Safety (2oordinator RCV/cvn ,' ~~_ ~ ~,.~ ~ 2130 'G' STREETW BAKERSFIELD, CA. 93301 (805) 326-3979 OFFICIAL USE ONLY ID# BUSINESS NAME II HAZARDOUS MATERIALS "-~-,-.', .... BUSINESS PLANFoRMAS2AA WHO~~~ . INSTRUCTIONS: 1. To avoid further action, return this from within 30 days of receiDt. 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, ~ECTZON 1; BUSINESS IDENTIFICATION DATA A. BUSINESS NAHE' Beacon Bakersfield Truck Stop ~51-4 B. LOCATION / STREET A.DDRESS' 3225 Pierce Road CITY:. Bakersfield ZIP: 93301 BUS. PHONE: (805) 324-948[ SECTION 2: ENERGENCY NOTIFICATIONS In case of an emergency involving the release or [hrea~ened release of a hazardous ma~er~al, ~ and 1-800-852-7550 or 1-916-427-4341. Th~s w~11 noilly your local fire department and [he S%a[e Off~ce of Emergency Ser¥~ces as resulted by law. ENPLOYEES TO NOTIFY ZN CASE OF ENERGENCY: NAHE AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A.Ray Blanton, Manager PH~ 805-324-9481 pH~_805-366-2316 .s.Brian Skillern, Regional Manager PH~ 209-583-3201 PH~ 2__.09-432-1393 '~E~TION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUS~N'ESS AS A WHOLE A. NATURAL GAS/PROPANE: south side of building at meter B, ELECTRICAL: inside the store C. WATER' Gilmore Road at the meter O. SPECIAL: ~-~ no E. LOCK BOX: YES / ~! IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / .NO HSDSS? YES / NO FLOOR PLANS? yES / ~O. KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE This location has a minimal work force and, consequently, does not have a private response team. Each employee is trained to respond to minor emergencies. Major emergencies will be responded to by the Beacon Marketing Service Department. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUS~NESS AS A WHOLE Medical assistance' ~l~be notified by dialing 9-1-1 with transport to the nearest medical facility'capaBl~ of treating the injured personnel. Minor injuries will be treated at Mer~y ~ECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH pRoVIDES EMPLOYEES WITH INITIAL AND. REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY 9 B. 'DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS · MATERIAL YOU HANDLE ? yes C. GIVE A BRIEF SUHMARY.OF YOUR HAZARDOUS MATERIALS TRAINING PROGRAM: Each employee, during initial employment and annually thereafter is instructed in the basics of hazardous materials handling and emergency response. The facility manager is responsible for administrating the training program. SECTION 7: EXEMPTION REQUEST I CERTIFY UNDER'PENALTY OF PERJURY THAT NY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION I, Robert C.,Vryhof , certify accurate. I unders=and that this information wi33'b® used to ~u~i3] my ~irm's obligations under the new Ca3i~ornia H®a3th and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. SIGNATURE 2130 'G' STREET BAKERSFIELD, CA. 93301 (805) 326-3979 OFFICIAL USE ONLY ID# NAM~ HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 3A INSTRUCTIONS 1. TO avoid further ac=ion, [his ~orm mus= be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer [he questions below for THE FACILITY UNIT LISTED BELO~ 4. Be as BRIEF and CONCISE as possible FACILITY UNiT · 51-4 FACiLiTY UNIT NAME: Beacon Bakersfield Truck Stop SECT[ON 1: MITIGATION. PREVENT[ON. ABATEMENT ~ROCEDURES The facility has been constructed and is maintained within local, state and federal laws or regulations. PreVention of a release is achieved thru inventory reconciliation, tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the valve,~etc.) and use absorbant to contain the release and prevent it's spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. SECT[ON 2: NOTTF]:CATTON AND EVACUAT]:ON PROCEDURES AT THE UNIT ONLY In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. it is the empl~oyee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. · When the immediate area has been secured, the employee will notify the facility, manager or, if necessary, the zone manager. The facility manager or zone manager will notify other 'administrative agencies, as necessary, of the release. SECTION 3; HAZAROOU~ MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~E~' NO [f Yes, see @. If NO, continue with SECTION 4 Ar® any of the hazardous materials a bona fide Trade Secret? YES If NO, complete a separate Hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-1) If YES, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (Yellow form #4a-2) in addition to the non-trade secret form. List only the trade Secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTIOH The facility has several fire extinguishers on site. SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDER,~ (Fire Hydrant;) ~ A fire. hydrant is located across Pierce Road. SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NATURAL GAS/PROPANE: south side of building at meter. B. ELECTRICAL: inside the store. C. YiATER: Gilmore Road at the meter. O. SPECIAL: no E. LOCK BOx: YES ! ~ IF YES, LOCATION: IF YES, -SITE PLANS? YES / NO MSOSs?' WES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - CITY of BAKERSFIELD ~51-4 Deacon B ~rs fiel ( ],,s[~ss ~*He:Be~con Bakersfield Truck Sto~HER ~*HE: Ultramar, Incu._ . .(,caTio~: 3225 Pierce Road 'ADDRESS: 525 W~' ~rd ~tr6et'- STANDARD IND.-~ASS CODE 'ITY, ZIP: ~kevsfield. CA 93301 CITY, ZIP: H~nfnvd. CA ~Rfl DUN AND BRADSTR~ET HUHBER HONE ~: (805) 324-9481 PHONE ~: (209) 583-3279 0 0 - 9 1 7- 4 9 2 1 · ~e (~e ~t ' bt Est ~iti m Site IW ~l 1~ C~ .. SI~ Iff FKtllty ~ b I~t~ti~ NJ PI 15,0001~250.11~33~1~all 365 I 01J i I 4 I 19 I W~* ~ido nf V,oillty..~~~__ t/ .... , .............. ~.. :; ....... , ......... ,~,c,, ~ ,.~t~ ~,.~ c.i.s. ~ 64741-44-2 ~, e, ~ & C.A.S. ~ .' X] Fire Hlllrd ~--~ -- ~t 12 ~ & C.i.S. ~ ~ ~1 ~&C.i~S.~ N P 15,000 11,250 ,133'01 al 365 '01 I · ' '' . [ I ...l .............. P~ ........ ~...1 ...... I___~..L~J~~~m: =~ ~, ~,,~, / ' i ~11 t~t ~lg.} . · it I1 k & C;I.S. J . ._1__1~ ~ ....... 'o.oo~ L ........... ~.5oo j soo.oo~.,!: ~,5 I ~:! ~ I ~ 1~ Iwe~ S~,~ o~ ~a~,~ *00' "~.,.~ ~.~o,~.~." ,,~ ' .~, .ii ,~, ..I,) 100 Mixture of Petroleum HydroCarbo~ s ~41~h of P~su~ ~lth .......... / .........q[ M I 10 . .............. .5~ L 5_ fiaIJ_.~l~Lj. ] I 4.1~ I~t_ ~i.~ .r ~.~,,+~ 100 ~,"c'~""i~",~lv)~ c.~.s: ~._~0_6~ ........ c~t~ g~ ~ & c.,.s. ~ ~. 100 Mixture of Petroleum Hyd~oea~bo] s . ' ' . . , , Hfllth of PrflSUrl Hlllth ' ..... . ~t Il ~&C'.i.S. filly ~dlr ~lly 0f IW Iht I ~vl ffrs~ellyl.emm~ Kd I. Ilmlltlr' .lib t~ Inf~NIl~ s~ttt~lln thll ~ eli ItlK~etl. ~ t~t ~Sff m ' ' ,,~o 011,~1i1-I1ll. or~,r/oE;ico, u.~,/o~rii~; i-i;IE;ii~-;ii~iiElii;;i S;]~il;;i ............... ~ ............................ .~ ~i'i'sii;~--' .... ';---;-: .............. / CITY of BAKERSFIELD : ,. s'~s~szss ~A~:~eac0n Bakersfield Truck ~, HA~E: Ultramar. Inc. HAME OF T~S EO~IL~ r,, o,~ ~ - ~.OcATION: 3225 Pierce Road ADDRESS: 525 W.3~d Street ~ STANDARD IND. CLASS CODE 5541~ *~TY. ZIP: Bakersfield, CA 93301 gITY, ziP: Hanford. CA 932~ DUll AHD BRADSTREKT HUMBER ~ ~ ~U~IO~ ~H ~OP~ ~0~ '~'~*~ ~ "~"'~ ~,*~ C.A.S. ~ ~2~-~ ~t 8t ~ ~ C.A.S. ~ ~t IJ ~&C.i.S. ~ .,' ...L.J.'. .... :L.j .............. I,- ..... j ..... ~ ...... L_J~LD, ~ _ ' ..... k oll t~t - r-~ r--~ -- r--~ - ~t 82 ~&C.A.S. ~ ~lth of fm~ blch .............. .' ~t I] ~iC.A.S. ~ q _L_.l_..: ....... L ...... L ..... L ..... :, .... J I I J I I A ----~--. - Hfllth of PrflSure Health ..... - ...... . ~t'l] ~ &C.A.S. ~ nGENCY C~IACIS Itllm~ ~2~on Manager (805)366-2316 82 Brian SkilJern Re~onal Man~z_. (209)432-139~ ,If,cat,~ '(Reid and sign ~ffcr co.pi~tin~ ali sec(ions) ~obert C. Vrvhof Corporate ~afet~ Coordinator ' December 2, 198.9 ------~' S I TE / FA(: I L ]~ TY (2RAM FoRM $ NORTH SCALE: BUSINESS, NAME: ,FLOOR: OF None Beacon Bakersfield Truck Stop #51-4 '~ DATE: ' / FACILITY NAME: UNIT ~: OF 4-12-89 Beacon Bakersfield Truck Stop #51-4 51-4 (CHECK ONE) SITE DIAGR~ FACILITY DIAGRA~ .~J Inspector's Colments}: _.. -OFFICIAL USE ONLY- Oy th~ Street nua~mrm. 10. ~ Stor~ 2, Str*et(~l. Alleys. XX, aaXir~d Trick~ 3. S~o~ Drains. CuJ~rcl. ~ ~ ~':::~ 4. Orolnalt Canals. Ditches. d. ~teu ~,-~,'~.~.~:=,~ ~: , ~.., ~':~,..~,.,. -.. .... .~.'.' .- ... ~ . -- Creeks. ; ~.~, ,, :.,. ,,/._,~ :. ,-,,, : ..,~ ..... ~., 13. S. ~ul ldtn~ a. ~rn~ conltrOctl~ 14. G~ StatJ~ ~.~;/-.':. ~='.~?..~:~'~/.~ -' . J.'" -- -'~': ~. ~,::~:~:' .) '.;,'~ ~:: ¥..:'V'~r,-=".- ' Identify tM ~'.:'..~ ~::-;~,'..: .: .. d. Access ~r 6. Utility Controls :.:': ...... .~.... ,-,,....~ ..~ ~.~: '~:..~. . . :" Identity b. Fire 9prt~er lt. ~tmtM CO~Ctt~ ~ote StO~ ' ' :--.-*'~' Comttim ~terJl~ Sto~ " ~terial~ I. fft~ ~f~t ~ er ~ (~ ...~ ~ ~ ~ M~I~ ..... ~, . . ~le: frills Ltetd ' ~ ' '~ ' FACIL~ Ol~ (MJM ltm ~ ~ltlm ~ tM m) ' I. RJoe~ f~ ~iiJe~ I. fin W ~ ' .... : ~' ~ '~-,'""" I. P~tJttM O. ~f MitJmtq bail - · ' . .. 3. Stii~: IMJ~ W 10. I. 4ttJc 14. ~f ~lJm Imleto ACORN . ~l~4~ml~ An Ultramar Company : ... ~..' .. 525 WEST THIRD STREET · HANFORD. CA 93230 · (2091 582-0241 HAZARDOUS MATERIALS BUSINESS PLAN ' r '' ''& Business Name Beacon Bakersfield Truck Stop #51',4 ]' · Street Address 3225 Pierce Road City, State, Zip Bakersfield, California 93301 · Phone Number {805) 324-9481 . Nature of Business Retail Sale of Petroleum Products Assessor Parcel Number 332-162-16-00-8 SIC Code .... 5541 Operating Hours 24 Hours Maximum Number of Employees Per Shift 5 Plan Submitted By Robert C. Vryhof Phone Number (209). 583-3279 Date Of Submission D6'oember. 2, 198~' Signature REVISION 0352tl CITY of BAKERSFIELD " N()N--'I'i~Ai) E SEC R Eq'S ' '. m,SINESS .aHa: BeacOn Bakersfield Truck Sto~WH~a HAME: Ultramar, Inc. .aHz oF T~S FaCILITY~...~ ~;'V ~-- LUCATIUN:.., 3~25 Pierce Road -ADDRgSS: 525 W. 3rd strg~t STANDARD ZND.~SS CODE '~ ~ 10,000 *,soo ,00~alI 36s ! 01 I'1 I t L~ IWest Side of Facility ~o0 ae~u!a, GasoUne .... t_A ....... k ........... 1 soo ............ ' ~ ~ , Petroleum ~r (C~k ,n t~t .wly) · 100 Mixture o~ Petroleum -Hy~oea~bo] Health of Pr~sure Helllh .... ClrTll,Cltlm (Reed and sign after to.plating all sections) . Rabe~t C. ~vhaf Cor~ate 8~fetv Coordinator "~ ~~-~-- ' · .~cemb'er ~'. 1989 CITY of BAKERSFIELD m, sx,zss N~H~: Beacgn- Bakersfield Truck ~ Beacon akersfield c~rv, z~v: Bakersfield, CA 9330i ciTY, zI~: Hanf~d,' CA '"932~0 ~uH ~HD Ba~DSTa~T HUHB~R J Fire Hazard -- ~tiVity Hfllth of Prflsure ' Heilth N[~GENCY CMIACTS II1~_.~]~~ .... ............. Manager (805)366~23~6 i~ Brian Skil]em Re~o~a] Man~r (209)~3~39~ carl t/y ~dffr ~lty Of lay I~t I ~ve Nrsmellye.e.,n~ end ea. Illililr with t~ tnlorNtim l~hitt~ In thll ~ II~ ltt~ k~tl. RObert C: Vrvhof C0rnorate ~afet~"Coordinator} ..~~.~=-:~~~ ............................... ' '' 'D~cember,~, .1989.'.. , Ultramar, tnc HAZARDOUS ~ASTE IHVENTORY ,, FACILIIY NAME Beacon Bakersfield Truck StOp #51-4 ' December 2,1989 DATE . .... FACILITY ADDRESS 3225 Pierce Road, Bakersfield, CA 93301 'PHONE NUMBER (805~ 324-9481 · Volume C. em,ca',/.oa~onk ~ ,.~ UN/NA DOT Hazard Class/ Type of A) At One Time Unit of Disposal ~ Name CAS Nunber Nunber DOT Guide NtJnber Storage Location B) In · Year Neasure Nethod NO HAZARDGU$ UASTE 0342t3- Q%TRAMAR EMERGeNcy CONTACTS Name Title Business Phone Home phone' Ray Blanton Manager (805) 324-9481 (80'5) 366-2316 Brian Skillern Zone Manager (209) 583-3201 (209) 432-1393 · Robert Vryhof Corp. Safety Coord. (209) 583-3279 (209) 584-4555 EMERGENCY RESPQN$g AGENCIES Agency ~ us~lness phone Police Department 9-1-1 Sheriff Department 9-1-1 Highway Patrol 9-1-1 Fire DepartmenU 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency Facility Toxic Information Center 1-800-233-3360 Chemtrec ' 1- 800-424- 9300 REGULATORY AGENCIES A zenc_y Busine$~ Phone California Office of Emergency Services (800) 852-7550 Environmental Protection Agency (415) 974-8131 National ResponSe Center (800) 424-8802 Administrating Agency (805) 326-3979 EMERGENCY SERVIQ~ ~ · Name Business Phone ~Home PhOne' Ultramar. Inc. ConstruCtion (209) 583-3381 ' N/A. and Engineering (Sandy Edwards) Ultramar Inc. Cons=ruction (209) 583-321~ N/A and Engineering (Roger Gamble) Brian Skillern (209) 583-3201· (209) 432-1393 · Introduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 of the State liealth and Safety Code (codified sections of AB 2185 & AB 2187 and SARA Title III Federal Law). The plan is also intended for employee guidance tn'.minimiztng potential and actual hazards which could affect our employees, the public or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface or ground water. The plan is also designed to set procedures for reporting releases or threatened releases of hazardous materials which may pose a potential hazard to our employees, the public or the environment. In the event a substantial change is made in the normal business operation, the local regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Description of Operation The operation of Deacon Bakersfield Truck Stop #§1-4 located at 39.9.5 Pierce Road, Bakersfield, California is primarily to serve the general public, through retail sale of petroleum products, miscellaneous consumer packaged products and various food i:ems. The petroleum products (i.e. gasoline, diesel) are stored in underground tanks which conform with local, state and federal laws or regulations. Underground piping and dispensing equipment is also installed and maintained in conformance with local, state and federal laws or regula~ions. Control of inventory is maintained through the use of an inventory reconciliation program which allows the facility manager to accurately control the inventory. Product reorders are based on the reconciled inventory and maximum tank capacity. Delivery of the product is achieved within the conformity of local, state and federal laws or regulations. Prior to unloading product, delivery drivers are required to gauge the tankage and record this information on the delivery ticket. Upon completion of unloading, the tank is again gauged and the information recorded. ReDortin~. Notification and Scene Ma~aKp~en~ In the event of a hazardous materials release or potential release, it is the employee's responsibi~ity to insure'the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will =hen notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. 14hen the immediate area has been secured, the employee will notify the facility manager or, if necessary, the next contact on the emergency contact list. Further notification of other administrative agencies will be completed by the Ultramar Inc. environmental or safety department. Prevention and MStl_~atfo~ The facility has been constructed and is maintained within local, state and federal laws or regulations. Prevention of a release is achieved throu§h inventory reconciliation, tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the valve, etc.) and use absorbant to contain the release and prevent it's spread to critical areas such as storm drains-or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. Emergency E ~uiDment Emergency equipment maintained on site is limited to fire extinguishers, brooms, and absorbent. Additional equipment can be brought on site if necessary,' as well as emergency clean up personnel. Employee Tra[ntne Each employee, during initial employment anti.annually thereafter is instructed in the basics of hazardous materials handling and emergency response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for coordination with local emergency response departments. The facility manager is responsible for administering the training program and insuring that each employee has been trained in hazardous materials procedures. Documentation of this training is maintained at the facility and is available from the facility manager. Facility Manager Ray Blanton Phone Number (805) 324-9481 ULTRAMAR INC. EMERGENCY RESPONSE - EVACUATION PLAN In the event of a fire, hazardous material spill Or an earthquake... Follow these steps ~mmedtate~y~ 1. ~ the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocarbons continue or you can not use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: ~ "There is a (fire) (dangerous spill) in the facility. Please turn off your engines and leave the .station on foot...tmmediately!" If you do not have a public address system at your unit, yell the above statement. 3. Call help by dialing 9-1-1 and ~iving the following information. "There is a (fire) (dangerous spill) at Beacon Bakersfield Truck Stop ~51-4 located at 3225 Pierce Road, Bakersfield, Ca If anyone is trapped or needs attention, tell the answering . dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. If the facility phone is not accessible, use the nearest public phone. ~ to insure that all employees and customers have left the facility, particularly those in vehicles who may need assistance or did not hear the emergency announcement. Assist or direct assistance to any customer having difficulty in leaving =he station area. 5. Secu~9 the area to prevent any unnecessary vehicle entry. 6. AtteB~ to the injured and direct medical response to them. 7. Attempt to extin~uish any fire if you can do so safely. If =he fire is small the fire extinguisher should be used to extinguish it. If the fire is large or spreading, or you determine that there is a potent/al danger of explosion or personal injury, do not attempt to extinguish the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material. 9. ReDoF~ to arriving emergency response personnel to provide them any information or assistance they may require. 10. ~ (earthquake information on next page). I~ The Event of a Large Earthquake 1. The manager or other qualified employee should make a visual inspection of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes or other damage which could create a hazard. 2. The manager or other qualified employee will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, then the zone manager will be notified immediately. 3. If a loss of product is confirmed by the zone manager, the zone manager will then coordinate with our consulting amd engineering group for tank tests and/or repairs. ULTRAMAR INC. Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facil{ty manager. If, in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Signature Date Signature Da~e 0163T OFFICIAl. USE ONLY ID# " BUSINE$8 NAME "* HAZARDOUS MATERIALS RECEIVED BUSINESS PLAN AS A WHOLE APR_ 1 5 1989 ,~ FORM 2A INSTRUCTIONS: 1. To avoid f'url;her acl;ion, tel;urn this from within 30 days of' receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH, 3. Answer t;he quesl;ions bel°w f'or 1;he business as.a whole. 4, Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: Beacon Bakersfield Truck Stop ~t5l-4 B. LOC'AT[ON / STREET A.DDRESS: 3225 Pierce Road CITY:. BakersfieTd ' ZIP: 93301 BUS. PHONE: ( 805 ) 324-9481 SECT[ON 2: EMERGENCY NOTIFICATIONS In case of an emergency involving 1;he release or threatened release of' a hazardous mal;erial, ~ and 1-800-852-7550 or 1-916-427-4341. This wi 1 1 noCi fy your local fire department and the Sta~e Office of Emergency Services as required by law, EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A.Ray Blanton, Manager .PHil 805-324-9481 pHil_805-366-2316 B.Brian Skillern, Regional Manager .PHil 209-583-3201 PHil 209-432-1393 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NATURAL GAS/PROPANE: south side of building at meter B. ELECTRICAL: inside the store C. WATER' Gilmore Road at the meter O. SPEC[AL: ~-~ no E. LOCK BOX: YES / ~ TF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO NSDSS? YES / NO. FLOOR PLANS?-YES / NO.. KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE This location has a minimal work force and, consequently, does not have a private response team. Each employee is trained to respond to minor emergencies. Major emergencies will be responded to by the Beacon Marketing Service Department. SECT[ON~:5~;~'.~.:..~LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINE$~ AS A wHOLE Medical assistance'will be notified by dialing. 9-1-1 with transport to the nearest di?~! ifalc~'~fi~y capable Of treating the injured personnel. Minor injuries will be ea~e~ At Mercy Hospital. SECTION 6: EMPLOYEE TRAINING EHPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. A. NUHBER OF EHPLOYEES AT THIS FACILITY 9 B. 'DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS · MATERIAL YOU HANDLE ? yes C. GIVE A BRIEF SUMMARY OF YOUR HAZARDOUS MATERIALS TRAINING PROGRAM: 'Each employee, during initial employment and annually thereafter is instructed in the basics of hazardous materials handling and emergency response. The facility manager is responsible for administrating the training program. SECTION 7; EXEMPTION REQUEST I CERTIFY UNOER PENALTY OF PERJURY THAT MY BUSINESS I'S EXEHPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS HATERIALS. WE DO HANDLE HAZAROOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION I, Robert C. Vryhof , cert;ify that; 1;he above information is accurate. I understand that this information will'be used 1:o fulfill my firm's obligations under :he new California Heall;h .and Safety code on Hazardous 'Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. ./ ~,,.~ BAK~SFIELD CITY FIRE DEI~TMENT 2130 'G' STREET BAKERSFIELD, CA. 93301 (805) 326-3979 ~ .I t OFFICIAL USE ONLY I ~ ID# II BUSINESS NAME HAZARDOUS 'MATERIALS BUSINESS PLAN AS A WHOLE FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the Questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible FACILITY UNIT · 51-4 FACILITY UNIT NAME: Beacon Bakersfield Truck Stop SECTION 1: MITIGATION. PREVENTION. ABATEMENT PROCEDURES The facility has been constructed and is maintained within local, state and federal laws or regulations. 'PreVention of a release is achieved thru inventory reconciliation, tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release '(i.e. turn off the power, close the valve, etc.) and use absorbant to contain the release and prevent its spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. ~ECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THE UNIT ONLY In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. It is the employee's resPonsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees..When the immediate area has been secured, the employee will notify the facility manager or, if necessary, the zone manager. The facility manager or zone manager will notify other administrative agencies, as necessary, of the release. SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... Y~S~ NO [f 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 separat;e Hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-1) If YES, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (Yellow form #4a-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. ~ECTZON 4; PRIVATE FIRE PROTECTION The facility has several fire extinguishers on site. SECT[ON 5: LOCATION OF WATER SUPPLY FOR USE BY ENERGENCY RESPONDERS (Fire Hydrant;) ~ A fire hydrant is located across Pierce Road. SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONL, Y. A. NATURAL GAS/PROPANE: south side of building at meter. B. ELECTRICAL: inside the store. C. WATER: Gilmore Road at the meter. D. SPECIAL: no E. LOCK BOX: YES /~' IF YES, LOCATION: IF YES, SITE PLANS? YES / NO HSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B- CITY of BAKERSFIELD N ¢) [Xl -- '!~ I:~ A i,) ' ~....~. o* ~... ~51-4 ~m~sg~ss ~HE:Beacon Bakersfield Truck Sto~HER HAHE: ~fl~n ~i1 CDmn~nv I[.OCATION: 3~25 Pierce Road ADDRgSS: 525 W. 3rd St~t" STANDARD IND. CLASS CODE K~A1 (~ITY, ZIP:. Rn~field~ CA 933~1 CITY, zIP: Hnnfn.d_ CA ~2~2~ DUN AND BRADSTRE~T NUHBER i'HOHE ~: ~805) 324-94U1 PRONE e: (209) 583-3279 0_~ - 9 i 7- 4 9 2 1 i ~ ! I S I I I I II II Ir~s IyH ~l l~ ~l ~IU~ I ~ Cmt ~t ~t ~ L~ttm k T ~ k of Ilttn~tl (~o [~e bt bt [It ~itl ~ Sits i~ ~l I~ C~, St~ in F~lilty ~ ~ I~t~tt~ Ph~*cll ~ Hflith ~le~ C.A.S. ~64741-44-2 ~t ii k i C.A.S. hilth ol Pm~ ~lth ..................... "N/ PI 15,000 111,250 h,13~'01~al/ 365 / 01 I i 14 /i9. I,,.., ~a. ~. · ,,,.,West Side o F '' .... ~ .... J ............ J .............. i~ ......... j: .... ~ ...... ~____~..~__~..~ .,~- ~-~- ~ ,~_ (C~k ell t~t a~iy) ,'_ - r-- ~t 12 ~&C.A.S. ~lth of Prom blth ~t 13 ~&C.I.S. '~._.[ .... ~ l ....... ~o,ooo k*,soo l soo,oo~l .s I o~J ~ I ~ Ij~ I~-t" si~ of ~.~.it~ ~oo "~.~. ~.o~n~ ........ ,.~,c,I ~ ~,h ~,,~ C.A.S. ~ 800fl-fil:~ ~, et ~ & c.A.s. ~ 100 Mixture of Petroleum hydrocarbo~ s Hlilth of P~lu~ ~lth ',~icel ~ Hfllth ~IIN C.t.S. ~._J~y~ ........ C~t II b i C.A.S. ~ 100 Mixture of Petroleum HydrocarboI s . He~lt~ 0~ Pr~sure HelJ~K ~1~ ~ & C.AS. ~ ,,~, ~,,~,~ ,,.~aa~.~t~ .................. ~,~,. ............ ~~ .~i~ trtlltcltl~ (8~wd and s JAn aftcr completing ail sections) cerll'~der ~lty 0f ia, t~t I ~vl ffrs~lllyeaem~n~ ~d Is Ilmlltlr with t~ tnforNti~ gublttd In this W eli IttK~ ~Itl. d t~t biff m W t~l~ 0f t~l I~lvl~le r~eiblt 3.r obt~nlnq ~ Jnl~tl~. I ~ltevt t~t t~ lu~ltt~ inlorNti~ ~! tr~. Iccurltl. ~d cmolitl. R~eXi C. ~vhflf. ~or~graic S~fetv Coordinator / '"' . March l0t 1989 · i ~ ~a~'o,, ,~111'lill, or~er/~E;~i~r'OP'~ie/~rii~; i'iME;li~';i~;EElitl;i Si~iI;;i ................ ' .................................... ~li'ST~;~ ............................ CITY of BAKERSFIELD B ~3-4 C blTX Beac°n ~kersficlc [:ITY. ZIP: Bakersfield, CA 93301 CITY. ZIP: "Hanford, CA 932~Q Dull AND ~p,osE ~: (805~ 324-9481 PHONE ~: (209} 583-32~9 itek ~11 t~t ~ppiy) ~lth of f~ ~lth (C~k ~11 t~t a~ly) Hfllth of Prflsurl Health ............. ,,E~GENcY Cm,AClS ,t,;~..~]~ ................. Manager (805)366-2316 ,2 Brian Skillern Re~onal Mana~r (209)432-139: ~,r~l,e,t,~ (Read aod sign alter co,ple[~n~ ~} seciions) Robert C. Vrvhof Corporate ~afet~ Coordinator ,.'..'-;. '. March 1~ 1989 RECEIVED BEAC¢)N An Ultramar Company 525 WEST THIRD STREET · HANFORD, CA 93230 · (209) 582.0241 HAZARDOUS MATERIALS BUSINESS PLAN Business Name Beacon Bakersfield Truck Stop #5]-4 Street Address 3225 Pierce Road City, State, Zip Bakersfield, California 93301 Phone Number (805) 324-9481 Nature of Business Retail Sale of Petroleum Products Assessor Parcel Number 332-162-16-00-8 SIC Code 5541 Operating Hours 24 Hours Maximum'Number of Employees Per Shift 5 Plan Submitted By Robert C. Vryhof Phone Number (209) 583-3279 Date Of Submission November 2B, 1988 Signature ~ .i REVISION _ ~ March 10, 1989 0352tl CIT}' of BAKERSFIELD ~51-4 Beacon Bake~sfiel~ BUSINESS NAME: Beacon Bakersfield Truck Sto~HNER NAME: ~n Dil C~m~nny NAME OF T~S F~.~LZ~w~]Ck ~Op ~I-A LOCATION: 3225 Pierce Road ADDRESS: ~25 W. 2rd ~t~t STANDARD IND. CLASS CODE ~dl CITY, ZIP: ~k~sfield. CA 93301 CITY, ZIP: ~ng~d. ~A ~2~ DUN AND BSADSTREET rHOdE P: (805) 324-9481 PnOW~ P: (209) 583-3279 0_~ - 9 i 7- 4 9 2 1 (~e (~e ~t ~t Est ~its m Site I~ hi lm C~ St~ Iff F~tllty ~ ~ I~t~tl~ hilth of Pm~ blth ............... with of Pmm ~lth ............ .... ~____l. 000 ........... a~* O1 ! 1 I ~ [JO of Faeilit~ 10.0' ae~ular Gasoline ~41th of P~lu~ blth P~,c,~ ~ ,,~,~ ~,,~ C.A.S. ~-_~fl0~:~!z~ ........ C~, et ~ & C.A.S. ~ 100 Mixture of Petroleum Hydrocarbon: s : ~ Flee Hazard L_J ~tivity ~ll~ ~ Reline I~lete Hfllth of Prflsure Health ............. tertlficlt~ (Heed and sJKn after to.plating all sections) certify ~der ~ity of la. t~t I ~ve ~rs~/llye.emin~ end ae feeilJar .Ith t~ tnfor~tim sy~itt~ In thil ~ alt IttK~ ~tl. CITY of BAKERSFIELD ,, -. ~,r. ,nd lqricul/ure ~ 5tenderd 8us,-,ss ~X flAZARDOT~S ~4ATI~-RT ACS N () ~ '-- '1' i~ ~ i.) ~ '~ ~ C ~ ' Pege ...~of ~._ ~,~-4 Beacon Bakersfield ~,s~gss ~AHg:Beacon. Bakersfield Truck~.~NER NAHE: ~flo~n ~] ~m___~nv NAHE OF T~S FACILITYfFp,,o~ ~tOn ~1-4 LOcATIOn: 3225 Pierce Road ADDRgSS: 525 W. 3rd Street ~ STANDARD IND.~ASS CODa 5541 ..... c~ry, Z~P: Bakersfield, .CA 93301 CITY, ZIP: Hanford. CA 93230 DUN AND PHn~a ,: (805) 3Z4-9481 ' PHONg e:. (209) 583-3279 (~. C~e bt ~t Est ~*cs m Site l~ hi Im C~ . St~ Iff FKtlIty ~ ~ I~t~t~n Ph~c,I ~ Hfllth ~zl~ C.A.S. ~ 1~~ wt ii ~ i C.A.S. i ~- r-, - _ _ ~t 12 M&C.A.S.i hllth of Pm~ ~lth ........ -- .... ~t Il ~&c.i.s. ~ ..... [,_J ............ 1 ........ ,_,.I 1 ..... 1 ...... 1 ..... ~..~__~.. . 1~ ......... (C~k eel t~t a~ly) -~ - -- - v--~ ~t 12 ~&C.i.S. ~ ~lth Of Pmm blth ................. ~t I~ ~ &C.A.S. ~ .... ~i__l ....... L ........... l ........ 1 I I ! I,L ! .............. P~Icil ~ ~lth ~ieN C.A.S. ~ ~t II h i C.l.S. ~ (C~k ell t~t e~ly) ~ ] Fire Hazard ~~ ~ Rflct,vlty u--~ hl,~ ~ ~ ~ Reline ~ ~ I~lete ~t 12 ~&C.A.S. ~ . He41th of P~su~ ~lth " I(~ iii t~t i~ly) ..................... - r--~ r--~ -- -- C~t 12 ~&C.I.~. ~ Hfllt~ of Prflsure ~Jth ~ ............ ~tg3 N[RGENCY C~IACIS ItnG~..~]~_~ ................. Manager (805)366-2316 ,~ Brian Ski]]ern Rexona] Mana~r (209)432-139, lot obtiming t~ ini~tt~. I ~l~eve t~t t~ au~itt~ info ~i~ i1 tr~, Iccurltl, Ifld ~_. ,~' ~a'GIT;~;]I-T T[I&'~'~&~TG~'Og-~&~7~ ~-;M~r;}~'~G~[ iT;;& 3~gnlture / ............................... ~[i'sTi~ ............................. BEACOH OIL COMPANY HAZARDOUS UASrE INVENTORY FACILITY NAME Beacon Bakersfield Truck Stop #51-4 DATE #ovember 281 1988 FACILITY ADDRESS 3225 Pierce Road~ Bakersfield, CA 93301 PHONE NUMBER (805) 324-9481 Volume Chemical/Common UN/NA DOT Hazard Class/ Type of A) At Ore Time Unit of Di'sposal · Name CAS Number Number OOT Guide #mber Storage Location B) In a Year Measure Nethod NO HAZARDOUS UASTE 0342t3 BEACON EMERGENCY CONTACTS Name Title Business Phone Home Phone Ray Blanton Manager (805) 324-9481 (805') 366-2316 Brian Skillern Zone Manager (209) 583-3201 (209) 432-1393 Robert C. Vryhof Corp. Safety Coordinator (209) 583-3279 (209) 584-4555 EMERGENCY RESPONSE AGENCIES AKenc¥ Business Phone Police Department 9-1-1 Sheriff Department 9-1-1 Highway Patrol 9-1-1 Fire Department 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency Facility Toxic Information Center 1-800-233-3360 Chemtrec 1-800-424-9300 REGULATORY AGENCIES AKency Business Phone California Office of Emergency Services (800) 852-7550 Environmental P~otection Agency (415) 974-8131 National Response Center (800) 424-8802 Administrating Agency (805) 326-3979 EMERGENCY SERVICES Name Business Phone Home Phone Beacon Marketing Services (209) 583-3214 (209) 582-0781 (Roger Gamble) I.T. Corporation (800) 262-1900 N/A 0352t4 ' Introduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 of the State Health and Safety Code (codified sections of AB 2185 & AB 2187 and SARA Title III Federal Law). The plan is also intended for employee guidance in minimizing potential and actual hazards which could affect our employees, the public or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface or ground water. The plan is also designed to set procedures for reporting releases or threatened releases of hazardous materials which may pose a potential hazard to our employees, the public or the environment. In the event a substantial change is made in the normal business operation, the local regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Description of Operation The operation of Beacon Bakersfield Truck Stop #51-4 located at 3225 Pierce Road, Bakersfield California is primarily established to serve the general public through retail sale of petroleum products, miscellaneous consumer packaged products and various food item~. The petroleum products (i.e. gasoline, diesel) are stored in underground tanks which, conform with local, state and federal laws or regulations. Underground piping and dispensing equipment is also installed and maintained in conformance with local, state and federal laws or regulations. Control of inventory is maintained through the use of an inventory reconciliation program which allows the facility manager to accurately control the inventory. Product reorders are based on the reconciled inventory and maximum tank'capacity. .Delivery of the product is achieved within the conformity of local, state and federal laws or regulations. Prior to unloading product, delivery drivers are required to gauge the tankage and record this information on the delivery ticket. Upon completion of unloading, the tank is again §auged and the information recorded. ReportinK, Notification and Scene Management In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. When the immediate area has been secured, the employee will notify the facility manager or, if necessary, the zone manager. The facility manager or zone manager will notify other administrative agencies, as necessary, of the release. (See page 4 call list and attached Emergency Response Evacuation Plan). 0352t5 Prevention and Mitigation The facility has been constructed and is maintained within local, state and federal laws or regulations. Prevention of a release is achieved thru inventory reconciliation, annual tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the valve, 'etc.) and use absorbant to contain the release and prevent it's spread to critical areas such as stor~ drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. EmerKency Equipment Emergency equipment maintained on site is limited to fire extinguishers, absorbent and water hoses. Additional equipment can be brouEht on site if necessary, as well as emergency clean up personnel. Employee TraininK Each employee, durin§ initial employment and annually thereafer is instructed in the basics of hazardous materials handling a~d emergency response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper'use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for coordination with local emer§ency response departments. The facility manager is responsible for administerin~ the training program and insuring that each employee has been t~ained in hazardous materials procedures. Documentation of this training is maintaine~ at the facility and is available from the facility manager. Facility Manager Ray Blanton Phone Number (805) 324-9481 0352t6 B~ACON OIL COMPANY EMERGENCY RESPONSE - EYACUA~ION PLAN In the event of a fire, hazardous material spill or an earthquake... Follow these steps immediately! 1. Turn off the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocarbons continue or you can not use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: "There is a (fire) (dangerous spill) in the facility. Please turn off your engines and leave the station on foot...immediately!" If you do not have a public address system at your unit, yell the above statement. 3. Call help by dialing 9-1-1 and giving the following information. "There is a (fire) (dangerous spill) at Beacon Bakersfield Truck Stop #51-4 located at 3225 Pierce Road, Bakersfield." If anyone is trapped or needs attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. If the facility phone is not accessible, use the nearest public phdne. 4. Look around t6 insure that all employees and customers have left the facility, particularly those in vehicles who may need assistance or did not hear the emergency announcement. Assist or direct assistance to any customer having difficulty in leaving the station area. 5. Secure the area to prevent any unnecessary vehicle entry. 6. Attend to the injured and direct medical response to them. 7. Attempt to extinguish any fire if you can do so safely. If the fire is small the fire extinguisher should be used to extinguish it. If the fire is large or spreading, or you determine that there is a potential danger of explosion or personal injury, do not attempt to put out the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material. 9. Report to arriving emergency response personnel to provide them any information or assistance they may require. 10. Remain calm (earthquake information on next page). 0352t7 In The Event of a Larqe Earthquak~ 1. The manager or other qualified employee should make a visual inspection of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes or other damage which could create a hazard. 2. The manager or other qualified employee will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, then the zone manager will be notified immediately. 3. If a loss of product is confirmed by the zone manager, the zone manager will then coordinate with our marketing services for tank tests and/or repairs. 0352t8 BEACON OIL COMPANY Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facility manager. If, in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Siqnature Date Siqnature Date 0342t BUSINESS LICENSE NO; . PERMITREQUIRE~ .. PERMITNO~ . / ..' :.' ,f " BUSINESS OWNER: :. ' BUSINESS MGB:/RESPONSlBLE . .... .BuSINESS;pHONE- . . :' HOME PHONE ': "-:' NO. oF.FLOORS "':' SQUAREFOOTAGE 'wo~o,~O~CE~SSU~D~, :.., ... , ~qPECTOR'"; ' "'~ .... ," '- · · ,: S~ON/SH'IFTTSTATIONPHON~ ;i ": '.~ ! "I .BLOC ~.N.O:. ~)ATE';.i' ~ii'~ "?;~.. ;';"';'; ;,'~'D"DRESS ' Ji- '' ' ;ZIP CODE ., /' -~' , FEE . :- BUS NESS LICENSENO. '- · PERMIT'REQUIRED PERMIT I~0s~ssoW~ ~ ,"~ BUSINESS'MGR./RESPONSIBLE . s' ;'-"; , ;' " ' ';' ' ';' . ' ' ,' ,,, ~. : ,. ~,'.-. , . -' , -. : _ , : .- .. ROME PHONE_. .- BUSINESS PHONE '~ . '. . .~'. /. ,~Fl. : . NO.OF FLQORS ' SQUARE FOOTAGE " .. · .... .. ,:. . .... " .... ' ¥' ..... -x, 6' ' "' .... 0CqUPANT:.LOAD .. ~l.~l~k' .VlOLATI0~NOTICE-ISSUED? ,,Z -.. .' - :' , . ..., ,- , . fEo , .:.. . . . , · .. , '.,.L'-: - . . .' .... . . · .' ' . , · ', , , . .. ":: ., - '.". ' . ': · : ':'."'...." o~,',,. '~¥ ~/.~',: - DATEOF'-REI~SPECTION · .'('1) .. "' '(2) . · (3)":.'.: .' .'~. .... : :' '-7~ ~1 ~r/'U ' ' '. NS~ECTOR .' ',.' ':22 ' ' . ' '' "- ": : STATIONISHiF~/STATION'PHONE ~ ' '::re .... ' '*" .~ "~.':. ?~- . ". ' ':"' ..:".,:.'t.' . '. ,., .. /'.:,,. '"',": ~ '. ,~:'.' .'. '..' ". '. ~ '- '.' ·., ~. '~' , ->,.' · ..' '. .,. · . . ' - .... ' '. ,. , ?z..,. . ' ,. - ,, - , · · .. · , ~DWD.U~.U.~ -' :~.~-¢~LIFORNIA HAZARDOus M AL INCIDENT REPORT FORM-QUESTI EE iNSTRUCTiON MANUAL o~8~' R PORTING AGENCY AGENCY ID NO AGENCY INCIDENT NO ' COUNT¥ J CI'~' ~ ; ~ ,~ ~:: :::: ...: :.: ::...: :~ ~ ' ~ FOR TME BEST OR P~ARY OESCRIPTOR. "S' FOR ONE OR MORE SECONOARv DESCRIPTORS tF NEED~. ............................................................. ~..~..~ m' Z ........... ~ ................ ........................................................................................ m ~ L,GHT"HASE ~"~ATHER UPON RELEASE ~:~EA T:~U~TRiAL '~ENE~:~EHWY ~'__ EM,TYLOT ~ ~ . U~N RELEASE '~ 0~ -- FOG 06-- COLD ~ ~ RAIN · 0w FAIR 02 ~ COMMERCIAL 02 ~ COUN~ RD ~ __ LAKE ~ND m O 01 ~ DAWN / 02 ~ ' ~ - ...... ~ CI~ R~ . 10 ' OCEAN , NOW 98 UNKNOWN I03 RE5 U~N/IAL ~ -- 02 ~ DAY . } 03~S ~ ~ ~- .... R ' ~ PRIVATE RO 11 ~OOED AREA ~ 98 ~ UNKNOWN /EST,M~.C~ ..... .~'~MP: ~O DEG F. I '~ ........ . 07 ~ WATERWAY' HARBOR ~ ~ OTHER. ~Z P' FOR THE BEST OR PRIMARY DESCRIPTOR.' S FOR ONE OR MORE SECONDARY DESCRIPTORS IF NEEDED SOURCE OF' RELEASE CIRCUMSTANCES OF RELEASE CAU~.E OF RELEASE 01 ~ OIL REFINERY 01 ~ WHILE BEING MANUFACTURED 11 ~ DURING sHIPwRECK 01 ..~ EQUIPMENT FAILURE 02 ~ CHEM MANUFACTURER 02 ~ WHILE IN STORAGE · 12 ~ DURING FiRE EXPL 02 ~ SUSPECTED NEGLIGENCE 03 r MIsc. FIXED FACILITY 03 ~ DURING NORMAL END USE 13 ~ DURING AIR CRASH . 03 ~ SUSPECTED CRIMINAL ACT I 04 ~ MOTOR VEHICLE . 04 ~ WHILE BEING LOADED .... ':' "~ '" '. ' ' "?i' 14 ~ WHILE SHIP DOCKED 04~ VANDALISM · 05 ~ TRAIN '- ' -" 05 ~ WHILE BEING UNLOADED' ' 15 ~ DURING CONTAINER 05 ~ ACT OF NATURE I 0~ ~ AIRCRAFT 06 ~ DURING CAR CONNECT DISCONNECT ' - " OR CONDUIT REPAIR 98 ~ UNKNOWN · '-: ' 16 ~ WHILE ABANDONED · ' 08 ~ SHiP :~: ~" 07 ~ WHILE IN TRANSIT - ' ""'" 17 ~ UNAUTHORIZED DUMP ' : · ' :' "" ' "I 09 ~ PIPELINE · . 08 ~ DURING CAR DE-RAILMENT -'-' 98 ~ UNKNOWN ' :' ..: ' . 09 ~ WHILE VEHICLE PARKED .. ' ' ?'~ . 9~ ~ UNKNOWN · .; '' - .. ' '.~-., · · 99 ~ OTHER . ..... . . 10 ~ DURING VEHICLE ACCIDENT .... ~' , 99 ~ OTHER ' ' .... _.._.._.j .- LIST THE ONE. TWO. OR THREE MOST SIGNIFICANT SUBSTANCES INFLUENCING YOUR RESPONSE AND MITIGATION EFFORTS ' ~'- ~ ' '- ' ': .~'~ '":: :,''~:" '~3:1t f ........ ~.. PURE so~.' CONCENTRATIO" AMOUNTA'R'SK ~S ~OuNTRE'~A~ED LBS CHEM NAME MAJOR COMPONENT: p,'~,~ I ..... ','.. ':" MIX ~ ..:: ...... . GAL ~00 '~) DOT 10 NUMBER: .: WASTE GAS .. %~W'r FT3 . CHEM NAME MAJOR COMPONENT. .. '; " PURE S~L CONCENTRATION AMOUNT AT RISK lBS AMOUNT RELEASED 'LBS · · , GAL , -. .. . : MIX LIQ. '. GAL ' :' '' ' FT3 ,.. DOT lO NUMBER: ' .................. :'!: ....... :::'7~;.' ':' WASTE GAS % w'r ......... :" F%3 - ...:' -.i:. CHEM. NAME..MAJORCOMPONENT: .'- .... :.,.. --.-~.?:,: ;: -.,, PURE SOL CONCENTRATION AMOUNT AT I~SK lBS AMOUNT RELEASED I~BS · . . ' '..' ..... ..~:; MIX - LIQ. · .: '- ~". DOT ID NUMBER:"'- ' "' ' .. "' ' ' ' WASTE GAS -. :%.WT ' - FT3 ' ' "' ': '.'-' '." - ' ..' FT3 '°~ R T . '"'P" FOR PRIMARY, "S" FOR SECONDARY IF NEEDED " · MORE THAN 3 INFORMATION SOURCES ' · . SUBSTANCES 01 __ TEXTBOOKS . 05 __ CONSULTANT ':]; '* . INVOLVED? 02__SOFTWARE '~-' 06 __ ON-LINE SERVICE : ;: : ~ YES 03 ~ POISON CENTER ' ': - 07 ~___..~TAFF CHEMIST · _.t_.t_.t_.t_.t_.t_~NO 04 ~ TOX CENTER· 99 ~ OTHER: ., CODES ENTER CODES AS APPROPRIATE · ' . ' '~ . · . AGENCIES RESPONOING AGENCIES PROVIDING AGENCIES ' * LOCAL FIRE . ' LI* cOuNTY FIRE Cl ' '- :~ "TO THE INCIDENT- - ' '.:. OFF-SCENE SUPPORT _.. "~_ - NOTIFIED ONLY :.'" ' POLICE - L2 . ·SHERIFF C2 ' '" ''~ ' "~ ' ' HEALTH :~i.. Iq HEALTH C~ OTHER t.9 - ' ....HAZMAT TEAM C7 · STATE CAL TRANS SI .' OTHER . C9 CDF S2 FEDERAL DOD F1 CHP 53 EPA .. F2 DFG ' S4 FEMA F3 .' . .. · :.~' OHS': ':' S5 .'*- -' USCG , ~. F4 . DES 56 USFS ' ' F5 : iI OSFIVl '' "S7 ,-'-OTHER :.' ~ WRCB S~ ' .,. '" -' ' OTHER .S9 . ": MISC. SPILLER M, CLEANUP CONTRACTOR ,MS MED,A M2 TOX.'POISON CENTER M6 '' CONSULTANT M3. OTHER Mg · RED CROSS M4 'P" FOR PRIMARY. "S" FOR SECONDARY IF NEEDED '" ENTER NUMBERS AS APPROPRIATE .. ': ": :': *, . :; ':= : "-'. ':~' " ........ · HUMAN CASUALTIES ; *' * :' :" ". '.'''' ""'"" '" ,'' ". '.:r':.,'.' '--~ '"' :''': .~7':.':'::' :':' ": ": ''.:' '"'" : '"'ENVIRONMENTALCONTAMINATION ' CHEMICAL ' DEAO TRANSPORTED EVACUATED : : DECONTAMINATED . .. * CHEM 1 CHEM 2 CHEM RESPONDERS ' 01 AIR ~ ~ ~ WORKERS . 02 WATERWAY/HARBOR ~ ~ ~ PUBLIC ~ ~ ~ ~ ~ ~ ~ 03 LAKE~POND ~ ~ ~ 0~ OCEAN FIRERESPONDERS IN AODITION TO ABOVE IF ANY :['*' '' : 0~05 CRopsSOIL *. :... .... ~ -- -- WORKERS 0, L,VE'TOC" -- -- -- PUBLIC ' -- -- -- -- 08 WILDLIFE -- -- -- OTHER TRAUMA IN ADDITION TO ABOVE IF ANY 09 WOODED AREA -- -- -- RESPONDERS 10 DESERT ~ --- ~ WORKERS . 11 BPUSHLAND -- -- -- · PUBLIC 99 OTHER· /' ' -- -- DAMAGE ESTIMATE ' / COST OF RESPONSE LABOR PRIVATE PROP $ .... . ~ TOTAL PERSON HRS ..... (CHECK ON. Ei UNKNOWN . ~..~,,,._,~ ? 5-o o o 'i TOT*~COST ~ . '' ~_,c,_~,, !¢~. J,..~- ~,"' .(~ PERSONNEL RESPONDING ~'-. 'L~,,. ¢/C) j ........................ · ... CAPTAIN~ - ' · REPORTED AT THIS TIME INJURIES DEA~S STORYOF ALARM ~ ~+~'.- ~d ~ ~ "7 ~ .... ~ .................. _/ ........ ~ ........ ~. ' . . '. .~ .........~ ....... . ,,, ............. -- ,': ..... .,- ........ . ' .. . ........... "~ .'..., '. .... '":..:' : ,..'..,.h'~, :.'.-' --..' --'-"._ .... '--~' ~ .. '" . · "" ~.. -i'~.' ".: .-.' :. :::"~':;'..;: ": ~o, ~a. or ~.[ N ....... ~ "-~' ................__ . y'?..}._ .~ .... ... · :. ~ . .... ~. : . ~-~ . ~ . .~ .. . .: . . .., .- ~..:~: ..... ~L~I~' ~'.4% ~o~ ... ,: . '~ .:. . ..- .. '.~'..:.: ~- ~ REPORT PREPARED BY BATTALION COMMANDER HL$..XEI42 SM 6/86 ~ ~~7~7 L~_} An Ultramar Company WEST T.,R[~ S*.E~*' HANFO..D. C^ 03230. (200) ~82-0~ October 6, 1988 Dear Title III Manager: Superfund Amendments and Reauthorization Act of 1986 (SARA), Sections' 311 and 3!2, require all business facilities to report hazardous chemicals located at the facility which exceed the established Title III levels. This notification must be submitted to the State Emergency Response Commission (SERC), Local Emergency Response Committee (LERC), and the Local Fire Department (LFD). This letter and attachment are intended to satisfy the Title III reporting requirements of Beacon Oil Company. Title III allows for the submission of Material Safety Data Sheets or an alternative list. Beacon Oil Company has decided to provide the alternative list. The Material Safety Data Sheets will be provided to the SERC, LERC and LFD if this information is requested. If additional Title III information is required, all requests or questions should be directed to Robert C. Vryhof at the above listed address or by calling (209) 583-3279. Sincerely, BEACON OIL COMPAN?,/~ l~obert C. Vryhof Corporate Safety Coordinator RCV/sek Enclosures 0387t 525 WEST THIRD STREET · HANFORD, CA 93230 * (209) 582-0241 SARA TITLE III REPORTING INFORMATION Facility: Beacon Truck Stop #51-4 Address: 3225 Pierce Road City: Bakersfield County: Kern County State: California Zip: 93308 CHEMICAL HAZARD CATEGORY Gasoline Immediate (acute) Health Hazard Delayed (chronic) Health Hazard Fire Hazard Diesel Immediate (acute) Health Hazard Delayed (chronic) Health Hazard Fire Hazard 0388t/0389t RECEIVE DEC 7 198 . · An Ultramar ' ~S'~ ............ ~~~~~ Company 525 WIST IHI~D SI~[[I · H~FO~D, C~ 03230 · (200) 582-0241 Business Name Beacon Bakersfield Truck Stop #51-4 Street Address 3225 Pierce Road City, State,.Zip Bakersfield, California 93301 Phone Number (805) 324-9481 Nature of Business Retail Sale of Petroleum Products Assessor Parcel Number 332-162-16-00-8 SIC Code 5541 Operating Hours 24 Hours Maximum Number of Employees Per Shift 5 Plan Submitted By Robert C. Vryhof Phone Number (209) 583-3279 Date Of Submission November 28, 1988' Signature .,~~-~"'~/~"~ 0352tl BEACON OIL COMPANY HAZARDOUS MATERIALS INVENTORY FACILITY NAME Beacon Bakersfield Truck Stop #51-4 DATE November 28, 1988 FACILITY ADDRESS 3225 Pierce Road, Bakersfield, CA 93301 PHONE NUMBER (805) 324-9481 Volume Chemical/Common UN/NA DOT Hazard Class/ Type of A) At One Time Unit of Product MSDS Name CAS Number Number DOT Guide Number Storage Location B) In a Year Measure Use Available See Site A) 15,000 Diesel 64741-44-2 1993 CMLQ/26 Underground Map B) 1,133,016 Gallons' Retail Sale Yes See Site A) 15,000 Diesel 64741-44-2 1993 CMLQ/26 Underground Map B) 1,133,016 Gallons Retail Sale Yes See Site A) 10,000 Gasoline 8006-61-9 1203 FLLQ/2? Underground Map B) 500,000 Gallons Retail Sale Yes See Site A) 10,000 Gasoline 8006-61-9 1203 FLLQ/2? Underground Map B) 560,000 Gallons Retail Sale Yes Portable See Site A) 876 Soft Drink Carbon Dioxide 124-38-9 1013 NFLG/21 Pressurized Map B) 10,512 Cubic Feet Carbonization Yes Cylinders 0342t3 BEACON OIL COMPANY HAZARDOUS WASTE INVENTORY FACILITY NAME Beacon Bakersfield Truck Stop #51-4 DATE November 28, 1988 FACILITY ADDRESS 3225 Pierce Road~ Bakersfield~ CA 93301 PHONE NUMBER (805) 324-9481 Volume Chemical/Con~aon UN/NA DOT Hazard Class/ Type of A) At One Time Unit of Disposal Name CAS Number Number DOT Guide Number Storage Location B) In a Year Measure Method NO HAZARDOUS WASTE 0342t3 BEACON EMERGENCY CONTACTS Name Title Business Phone Home Phone Keith Jackson Manager, (805) 324-9481 (209) 276-1351 Brian Skillern Zone Manager (209) 583-3201 (209) 432-1393 Robert C. Vryhof Corp. Safety Coordinator (209) 583-3279 (209) 584-4555 EMERGENCY RESPONSE AGENCIES Aqency Business Phone Police Department 9-1-1 Sheriff Department 9-1-1 Highway Patrol 9-1-1 Fire Department 9-1-1 Ambulance 9-1-1 Physician Emergency Room Physician Hospital Nearest Emergency Facility Toxic Information Center 1-800-233-3360 Chemtrec 1-800-424-9300 REGULATORY AGENCIES Aqency Business Phone California Office of Emergency Services (800) 852-7550 Environmental Protection Agency (415) 974-8131 National Response Center (800) 424-8802 Administrating Agency (805) 326-3979 EMERGENCY SERVICES Name Business Phone Home Phone Beacon Marketing Services (209) 583-3214 (209) 582-0781 (Roger Gamble) I.T. Corporation (800) 262-1900 N/A 0352t4 ~ntroduction This Hazardous Materials Business Plan is designed to satisfy the requirements of Section 6.95 of the State Health and Safety Code (codified sections of AB 2185 & AB 2187). The plan is also intended for employee guidance in minimizing potential and actual hazards which could affect our employees, the public or the environment during fire, explosion, or any unplanned sudden or non-sudden release of hazardous materials to the air, soil, surface or ground water. The plan is also designed to set procedures for reporting all releases or threatened releases of hazardous materials which may pose a potential hazard to our employees, the public or the environment. In the .event a substantial change is made in the normal business operation, the local regulatory agency will be notified within 30 days of that change. The Hazardous Materials Inventory form will be resubmitted on an annual basis. A complete Hazardous Materials Business Plan will be resubmitted every two years. Description of Operation The operation of Beacon Bakersfield Truck Stop'#51-4 located at 3225 Pierce Road, Bakersfield, California is primarily established to serve the general public through retail sale of petroleum products, miscellaneous consumer packaged productsland various food items. The petroleum products (i.e. gasoline, diesel) are stored in underground tanks which conform with local, state and federal regulations or laws. Underground pipping and dispensing equipment is also installed and maintained in conformance with local, state and federal regulations or laws. Control Of inventory is maintained through the use of an inventory reconciliation program which allows the facility manager to accurately control the inventory. Product reorders are based on the reconciled inventory and maximum tank capacity. Delivery of the product is achieved within the conformity of local, state and federal regulations or laws. Prior to unloading product, delivery drivers are required to gauge the tankage and record this information on the delivery ticket. Upon completion of unloading, the tank is again gauged and the information recorded. Reportinq, Notification and Scene Manaqement In the event of a hazardous materials release or potential release, it is the employee's responsibility to insure the safety of other employees and the general public. The employee will first notify, over the public address system or by voice, all other employees and the general public of the emergency. The employee will then notify emergency response personnel by dialing 9-1-1. It is the employee's responsibility to secure the immediate area to prevent any unnecessary exposure of the public or employees. When the immediate area has been secured, the employee will notify the facility manager or, if necessary, the zone manager. The facility manager or zone manager will notify other administrative agencies, as necessary, of the release. (See page 4 call list and attached Emergency Response and Evacuation Plan). 0352t5 Prevention and Mitigation The facility has been constructed and is maintained within local, state and federal regulations or laws. Prevention of a release is achieved thru inventory reconciliation, annual tank testing, maintenance of facility equipment and employee training. In the event of a release, employees have been instructed to respond quickly so the extent of the release can be minimized. Employees have been instructed to immediately stop the release (i.e. turn off the power, close the valve, etc.) and use absorbant to contain the release and prevent it's spread to critical areas such as storm drains or adjacent properties. Based on the size of the facility and emergency equipment available on site, only small releases can safely be addressed. A large release can only be addressed with assistance from emergency response personnel and/or a clean up contractor. Employee Equipment Emergency equipment maintained on site is limited to fire extinguishers, brooms, absorbent and water hoses. Additional equipment can be brought on site if necessary, as well as emergency clean up personnel. Employee Training Each employee, during initial employment and annually thereafer is instructed in the basics of hazardous materials handling and emergency response. The training program consists of, as a minimum, the following areas: 1. Hazard Communication Standard. 2. Methods for safe handling of hazardous materials. 3. Proper use of safety equipment. 4. Responding to emergencies. 5. Emergency evacuation procedures. 6. Procedures for coordination with local emergency response organization. The facility manager is responsible for administering the training program and insuring that each employee has been trained in hazardous materials procedures. Documentation of this training is maintained at the facility and is available from the facility manager. Facility Manager Keith Jackson Phone Number (805) 324-9481 0342t6 BEACON O]L COHPANY EHERGENCY RESPONSE - EVACUATION PLAN In the event of a fire, hazardous material spill or an earthquake... Follow these steps immediately! 1. Turn off the pumps by pressing the "stop button" on the attendant's console. Should the flow of hydrocarbons continue or you can not use the console, turn off the emergency shutoff switch on the electrical panel. 2. Announce over the public address system: "There is a (fire) (dangerous spill) in the facility. Please turn off your engines and leave the station on foot...immediately!" If you do not have a public address system at your unit, yell the above statement. 3. Call help by dialing 9-1-1 and giving the following information. "There is a (fire) (dangerous spill) at Beacon Bakersfield Truck Stop #51-4, located at 3225 Pierce Road, Bakersfield." If anyone is trapped or needs attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. If the facility phone is not accessible, use the nearest public phone. 4. Look around to insure that all employees and customers have left the facility, particularly those in vehicles who may need assistance or did not hear the emergency announcement. Assist or direct assistance to any customer having difficulty in leaving the station area. 5. Secure the area to prevent any unnecessary vehicle entry. 6. Attend to the injured and direct medical response to them. 7. Attempt to extinquish any fire if you can do so safely. If the fire is small the fire extinguisher should be used to extinguish it. If the fire is large or spreading, or you determine that there is a potential danger of explosion or personal injury, do not attempt to put out the fire with the fire extinguisher. If a fire or explosion requires you to evacuate the facility, lock the cash drawer and leave the facility. 8. Attempt to contain any hazardous material spill utilizing an absorbent material. 9. Report to arriving emergency response personnel to provide them any information or assistance they may require. 10. Remain calm (earthquake information on next page). 0352t7 In The Event of a Larqe Earthquake 1. The manager or other qualified employee should make a visual inspection of the facility and equipment. A visual inspection should also be made of the dispenser piping, checking for leaks, loose pipes or other damage which could create a hazard. 2. The manager or other qualified employee will reconcile the tank records, taking into account gallons sold, etc. If the records show a loss, then the zone manager will be notified immediately. 3. If a loss of product is confirmed by the zone manager, the zone manager will then coordinate with our marketing services for tank tests and/or repairs. 0342t8 BEACON OIL COMPANY Hazardous Materials Business Plan Training Record I certify that the Hazardous Materials Business Plan and the procedures for emergency response and evacuation have been reviewed with me by the facility manager. If, in the future, questions concerning the Hazardous Materials Business Plan occur, I will meet with the manager and discuss these questions. Siqnature Date Siqnature Date 0342t BAI<ERSFIELD CITY FIRE DEPAR,.TMENT BAKERSFIELD, cA 93301 10& _ (805) 326-3979 ~2~0 0F~[C[AL USE ONLY H~Z ~RDOUS ~TERI ~LS BUSINESS PL~ AS ~ WHOLE INSTRUCTI 0NS: 1. To avo~d'furthe~ action, ~eturn this fo~m 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 .XA:.;...- ' 7.~ _ SECTION 2: E~RGENCY NOTIFICATIONS In case of:an e=ergency involving the ~elease or threatened Velease of a hazardous aa~er~al, call 911 and 1-800-852;?550' or 1-916-42T-4841. This ~i~1 notify your local fire'departmen~ and the State Of[ice of Emergency Services as required by law. EXPLOYEES TO NOTIFY IN CASE 0F E~ERGEXCY: DD~ING ~US. ERS. AFTER ~US. ~S. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE c. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: 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 A WHOLE SECTION 5: LOCAL E~RGENCY ~DICAL ASSISTanCE FOR YO~ BUSI~SS AS ~ W~OLE SECTION 8: EMPLO~E ~INING EMPLO~RS ARE REQUIRED TO ~%~ A PROGRAM WHICH PROVIDES EMPLOYES WITH INITIAL A~ REFRESHER TRAINING IN THE FOLLOWING AREAS cIRcLE ~S OR NO INITI~ .REFRESHER ' A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~TERIALS: . . .' .................................... (YESJ NO ~S NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO ~S NO C. PROPER USE OF SAFE~ EQUIPMENT:.. ................. ~ NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO YES NO E. DO YOU ~INTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ ~S NO SECTION 7: ~Z~OUS CIRCLE ~S OR NO DOES YOUR BUSINESS ~NDLE HAZARDOUS' ~TERIAE IN~ QUANTITIES. LESS THAN ~00 POL~DS OF~ SOLID, S~GALLONS OF A~QUID, OR ZOO CUBIC FEET OF A COMPRESS:D GAS: ....... YES I under~ ~ha~ ~h~nFormarlon ~11 be used ~o ~ul~li a~ ~rm s obi~gar~ons under the ne~ California ~ealth and $a~et~ code on 8azardous ~a~er~als (D~v. ~0 Chapter Sec. 25~00 ~t Al.) and that ~naccurare ~n~or~ar~on~consr~tutes perjur~. 'B ERSF. ELD. CITY FTRE DEPART T' · 2130'"G" STREET 0FF~CIAL USE ONLY BUSINESS NA~E: SINGLE FACILITY UNIT FORM SA INSTRUCTIONS' 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3..Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE ~as .possible. ,. FACILITY UNIT#, S/-kl .FACILITY UNIT NAME: ~eqcOt~[ Tpucg' SECTION 1: MITIGATION, PRE%FENTION, ABATEMEN~r PROCEDURES SECTION 2: NOTIFICATION. BaND EVACUATION PROCEDURES AT THIS b~IT ONLY - 3A - SECTION 3: HAZARDOUS?MATERIALS FOR THIS UNIT ONLY A. Does this FaCility Un!t,cont. ain 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 ~ u,,.~:~;.?~i!~~''N°'~''~ " ' complete a separate' hazardous materials inventory ~[m marked: NON-.TRADE.' SECRETS ONLY (white form ~4A-/) 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 t. rade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THiS UNIT ONLY. A. NAT. GAS/PROPANe] B. ELECTRICAL: . D. SPECIAL: E. LOCK BOX: YES / IF YES, LOCATION: IF YES, S.~TE PLAMS? YES /' NO MSDSs'? YES / NO FLOOR PLANS? YES // NO KEYS? YES / NO - 3B - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page __ 6,~f NON--TRADE SECRETS '~' -- HAZARDOUS MATERI ALS I NVENTORY .USINESS NA~E: ~ectco~ T~K ~o? OWNS. N~: Ee~co~ ~;t ~ · ~AC~L~TY UN.~T ADDRESS:. '~L~ ~;eCC~ ~ ADDRESS: ~f~ ~4 4h~r~ g~. FACILITY UNIT NAME: CITY, ZIP: :~a~e~sf~elA., CM CITY,ZIP: ~aq~or~ ~ C~ q3~30 PHONE ~: ~ YZ~-QV~/ PHONE *: ('zoq]ffSZ-~Zq/ IOFFIClAL USE CFIRS CODE ..-I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T ,CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. 'CHEMIqAL OR COMMON NAME CODE GUIDE EMERGENCY CONTACT: PRONE ¢ ~US ~OURS: "'" ~ AFTER BUS HRS: E,~.~ROHNCV CONTACT: TLR: ,, PHONE ¢ BUS HOURS: ,~-¢~/' P,~NCIPAL, BUSINESS ACTIVfTY :. ~/¢~¢/ ~ AFTER BUS HRS: ~/-, ~/¢~