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SITE PLAN ~ ! -"'"'"~"~'" ~6__ R~O MIRADA DRIVE · ' ' .~. ~ - ' I ' i '7}'¢~,:..:.:..:. · ~ CO~t¢ g~ ~ P~IMX<LED ~,./~I~A~A~ ~ Hazardous. Materials/H~Za~d0Us'Waste Unified Permit . CONDITIONS OF :PERMIT ON REVERSE SIDE · -' This _hermit is issued for the followin_.: [] Hazardous Materials Plan [] Underground Storage of H-7-rdOus Materials Permit ID #:: 015-000-00187:3 ri Risk Management Program DAVIES OIL COM [] HazardoUs Waste On-Site Treatment LOCATION: 4200 BUCK OWENS BLVD , , -OFFICE OF ENVIRONMENTAL SER VICES' ,:.ApprOvedby: . 1715 Chester Ave., 3rd Floor :' ' '' "~ LR~_?~HUey,~~ Issue Date Bakersfield, CA 93301 '~" ,~( ' ' .omceof£vi~om~,~rs~ic~ ~ · .-,' -:; .,,: ~_ !, ,:': Voice (661) 326-3979 '~.' ~"'~"':"'" · 17"~ .".,.~ ':-.. ~. FAX (661) 326-0576 ::-"?,Ek~i~i~:Date:'. .une 30. 2003 . '·"- · .~' 17 '., -i~ ;' ~':~:':'~'~'~:";0':~'~"~::" ~;~: ..... :: ': ' Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ..... ~,~,~.~??~?.~y?!~ ....... This permit is issued for the following: .?~??"i' ~!::~5!i:~?":':::~iiiii',iii!: .~4~ :~?~}}~;:~e[ground Storage of H~rdous Materials ~.~ ~. ,: ~=-.~ .~ ~.. . ..~. .... ~-~. ~. ~.=~ .:~. ~&~ ......... PE~ m ~ 0 t 5 -021-001873 ,,(, '-~ ~ ~,..,r~:5.' ' .,~:~~ ~,~ ......' ~.::,'~"=::~g~;'.' ,~.._~:~ . ~ "~' K ~ '~ '~' ~' ~'~'' '~'~ ....... LOCA~ON 4200 ~C O= N~... :::.~'.'..~¢.~r,., ,~ : ,,..,, ~[~L~ CA e~ .,...-.[ ~.~ .... q ~;" ....... ~ , ,/'=~&-~ ~'*~=~ '~j~ ~'~ '_, .-~=, ~ ~ '-. ~-'"-.~ *~ ui~.~ '- .-~--'" ~ ~ ~= ". '". ~ '*:---:3= % ~~-:~ .~ J~ :',."~ ~.~ ~ ~ '[ ~. ..',-.. ~ ~ ~ ~ ,. ,= E ......... ~ ~' .. ~. · .... , .... ~,=.........?.. :,..?;:?~:.."? ,../' :- 0 ,- ~ "%,~.= ..,-' ...'/=..' =.' / ,' .. e / Im~ by: O~CE OFE~RO~L ~ 1715 Chewer Ave., 3rd Floor B~e~eI~ CA 93301 Voice (805) ~2~979 F~ (80S)~S76 Exp~tionDate: J~ne 30~ 2000 :"DAVIES OIL COMPANY CARDLOCK SiteID: 015-021-001873 Manager : RACHEL PHILLIPS BusPhone: (661) 323-6063 Location: 4200 BUCK OWENS BLVD CommHaz : Low BAKERSFIELD ~%~%~% Map : 102 City Grid: 23A FacUnits: 1 AOV: : CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:77-,026-7495 Emergency Contact / Title Emergency Contact / Title JOHN HAVERSTOCK / OPERATIONS BERK HIGH~--' / OPERATIONS Business Phone: (661) 327-9341x Business Phone: (661) 321-9961x103 24-Hour Phone : (~/)~?~ -o?~x 24-Hour Phone : (~/) ~oo-~X,Fx Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : BERK HIGH Phone: (661) 321-9961x103 MailAddr: 4200 BUCK OWENS BLVD State: CA City : BAKERSFIELD Zip : 93308 Owner BILL DAVIES Phone: (661) 321-9961x Address : PO BOX 80067 State: CA City : BAKERSFIELD Zip : 93380 Period ': to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, _~_~c ~, ~ _ Do hereby certify that I have (~¥~ or prim name) revie~ec~ ~he a~ached h~ardous materials manage- ment plan for~~ ~ ~nd tha~ i~ along with {~e Of Bus~) " any co~e~ions contours a ~mp~e~e ~ corr~ man- ageme~ plan ~or my ~adli~. _ . ~.,.~ ~ ' ~ -1- 08/04/2003 ~DAVIES OIL COMPANY CARDLOCK SiteID: 015-021-001873 Fast Format = Training Overall Site -- Employee Training 06/22/2001 WE HAVE 44 EMPLOYEES AT THIS FACILITY. WE DO HAV~ MSDS SHEETS ON FILE AT THIS LOCATION. BRIEF SUMMARY OF TRAINING PROGRAM: OUR EMPLOYEES ARE KNOWLEDGEABLE OF THE HAZARDS, SAFE WORK PRACTICES AND AVAILABILITY OF MEDICAL AND EXPOSURE RECORD_p_$__~RTAINING TO HAZARDOUS MATERIAS IN THE WORKPLACE. ,~,,~U~_R~NT COPY OF/f~IS TR~NING PROGRAM WILL BE AVAILABLE FROM EITHER.CHUC ...... Ti!~O-q'-Tv---~ F Page 2 Held fOr Future Use Held for Future Use 9 08/04/2003 DA~!ES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Manager : RACHEL PHILLIPS BusPhone: (661) 323-6063 Location: 4200 BUCK OWENS BLVD Map : 102 CommHaz : Low City : BAKERSFIELD , Grid: 23A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:77-026£7495 Emergency Contact / Title ~mergency uonsac5 / Title JOHN HAVERSTOCK / OPERATIONS ~" / OPERATIONS Business Phone: (661) 327-9341x Business Phone: (661) 321-9961x103 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager,Phone : ( ) - x Hazmat Hazards: Contact : ~FZo~K--~-T-I~N-- Phone: (661) 321-9961x103 MailAddr: 4200 BUCK OWENS BLVD State: CA City : BAKERSFIELD Zip : 93308 Owner BILL DAVIES Phone: (661) 321-9961x Address : PO BOX 80067 State: CA City : BAKERSFIELD Zip : 93380 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ---- Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax [Unit]MOP DIESEL L 7600.00 GAL Low GASOLINE L 7700.00 GAL Mod GASOLINE , L 9800.00 GAL Mod I,~-/~-,..;4~ v~¢5'~o¢/-4;)o hereby cer~i;y ~h~ ~ h~ ."~ ,'~ ~ ~1~ ~) re', :,.... ~,.. me mtached h~ardous m~r~s ment plan for~ ~ u c~o ~nd ~ha~ ~ ~long ~i~h ~ny corr~ion~ ~sfi~'u~ ~ ~pl~ ~nd ~rr~ ~~ -1- 04/21/2003 DAVIES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: VAULT CAS# STATE ~ TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Ambient Pure Ambient · OTHER - lLiquid SPECIFY AMOUNTS AT THIS LOCATION Largest Container ! Daily Maximum Daily Average 12000.00 GAL L 7600.00 GAL 6000.00 GAL 100.00 Fuel Oil No. 1 N 70892103 HAZARD ASSESSMENTS ~ lTSecret oRSIBioHaz Radioactive/Amount I EPA Hazards NFPA I USDOT# MCP No N No No/ Curies / / / Low = Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ GASOLINE Days On Site PREMIUM 365 LocatiOn within this Facility Unit Map: Grid: VAULT CAS# 8006619 F STATE TYPE PRESSUREI TEMPERATURE CONTAINER TYPE · ~Liquid Pure Ambient I Ambient OTHER - SPECIFY I I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 7700.00 GAL 5000.00 ,GAL 100.00 Gasoline N 8006619 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA . USDOT#. MCP No N No No/ Curies / / / Mod 2 04/21/2003 DAVIES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site 9 -- COMMON NAME / CHEMICAL NAME GASOLINE Days On Site REGULAR UNLEADED 365 Location within this Facility Unit Map: Grid: VAULT CAS# 8006619 F STATE [TYPEPure Ambient PRESSURE[TEMPERATUREAmbient CONTAINER TYPE SPECIFY Liquid OTHER - AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum .Daily Average 12000.00 GALI '9800.00 GAL 6000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ITsecretl ~slBioHaz Radioactive/Amount I EPA Hazards NFPA I USDOT# I MCP No N No No/' Curies . / / / Mod -3- 04/21/2003 DAVIES OIL~COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Notif./.Evacuation/Medical Overall Site -- Agency NotificatiOn 04/07/1998 IN THE EVENT OF A MAJOR CHEMICAL FIRE OR SPILL, THE FOLLOWING PROCEDURES SHALL BE FOLLOWED: A) EVACUATE ALL EMPLOYEES IN THE AREA OF THE SPILL AND/OR FIRE.' ALL EMPLOYEES ARE TO ASSEMBLE IN A DESIGNATED AREA. B) CALL THE EMERGENCY MEDICAL SERVICES (EMS) DIAL 911. THEY WILL NOTIFY THE CLOSEST FIRE DEPT. INFORM THE OPERATOR OF THE FOLLOWING: 1) TYPE OF EMERGENCY. 2) NAME AND LOCATION OF COMPANY WHERE EMERGENCY OCCURRED. 3) NAME OF EMPLOYEE REPORTING THE EMERGENCY. C) THE AREA MANAGE WILL MEET THE EMERGENCY PERSONNEL & DIRECT THEM TO THE SCENE. THEY WILL ALSO HAVE IN THEIR POSSESSION AN MSDS BINDER TO ASSIST THE EMERGENCY PERSONNEL. D) IF CLEANUP ASSISTANCE IS NEEDED, THE MANAGER WILL CALL. Employee Notif./Evacuation -- Public Notif./Evacuation 04/07/1998 VERBALLY NOTIFY ADJACENT LOCATION. Emergency Medical Plan 04/07/1998 DR DAVID R FIELD, BUSINESS HEALTH NETWORK (M-F 7AM TO 5:30 PM) 321-3781 OR SAN JOAQUIN COMMUNITY HOSPITAL. -4- 04/21/2003 F DAVIES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 04/07/1998 ALL DISPENSER PUMPS ARE EQUIPPED WITH AUTOMATIC FILL SHUT-OFF NOZZLES. hALL DISPENSERS ARE EQUIPPED WITH IMPACT SHEAR VALVES IN THE EVENT OF EARTHQUAKE OR IF DISPENSER IS ACCIDENTALLY HIT. ALL DISPENSER HOSES ARE EQUIPPED WITH BREAKAWAY FITTINGSWHICH WILL STOP FLOW IN THE EVENT CUSTOMER FORGETS TO REMOVE NOZZLE FROM FUEL TANK. ~ Release Containment 04/07/1998 CONFINE THE SPILL TO THE SMALLEST POSSIBLE AREA BY USING ABSORBENT AND OTHER AVAILABLE MATERIALS. -- Clean Up 04/07/1998 SWEEP UP ABSORBANT AND DEPOSIT IN DRUM FOR LATER REMOVAL. Other Resource Activation -5- 04/21/2003 DAVIES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 06/22/2001 A) GAS - NONE B) ELECTRICAL - INSIDE STORE ROOM AT N END OF BLDG C) WATER - NEST TO MEN'S RESTROOM ON E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 06/22/2001 PRIVATE FIRE PROTECTION - BUILT IN FIRE SUPRESSION. NEAREST FIRE HYDRANT - ON BUCK OWENS BLDG ON W 'SIDE OF BLDG NEXT TO STREET. Building~occupancy Level 6 04/21/2003 DAVIES OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Training Overall Site -- Employee Training 06/22/2001 WE HAVE 44 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE~AT THIS LOCATION. BRIEF SUMMARY OF TRAINING PROGRAM: .OUR EMPLOYEES ARE KNOWLEDGEABLE OF THE HAZARDS, SAFE WORK PRACTICES AND.AVAILABILITY OF MEDICAL AND EXPOSURE RECORDS PERTAINING TO HAZARDOUS MATERIAS IN THE WORKPLACE. A CURRENT COPY OF THIS TRAINING PROGRAM WILL BE AVAILABLE FROM EITHER CHUCK MARTIN OR ROBIN Page 2 Held f°r Future use I Held for Future Use -7- 04/21/2003 Bakersfield Fire Dept. UNIFIED PROGRAM PECTION CHECKLIST Enironmental Services ,,, , ......................... , ,,, , , ,, ,' ' ......... - 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: {661)326-3979 tFACIL ITY NAME I INSPECTION DATE I INSPECTION TIME ~'Gh-~ ................. ¥ ~ - -- £ IPHONE NO. / NO, Of Employees ~'~(~NTACT .......... I Business D NOmber Section 1: Business Plan and Inventory Program ~ Routine ~Combined C3 Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection (C=Com.,ance~ OPERATION COMMENTS ~, ¥=Violation APPROPRIATE PERMIT ON HAND BUSINESS PLAN CONTACT INFORMATION ACCU~ VISIBLE ADDRESS VERIFICATION OF LOCATION VERiFiCATiON OF MSDS AVA~LAB~UWE VERIFICAIION OF ABATEMENT SUPPLIES AND PROCEDURES .._.__________.____..______.______..____. ........................................................ . ~ a S'mD'*GRAU AOEOU*I[&O" H,NO ANY HAZARDOUS WASTE ON SITE?; ~ YES I~No EXPLAIN: Inspector Badge No.. ( ~usiness Site Responsible Party White . Environmental Services Yellow - Station Copy P~k~usiness Copy E:'.':.::..':,:::,l,i ]' I<;ER P'IFff;:T'! 4200 PIEF:CE RP - B~:d-:ERSt:' [ ELK:~ CA. Ci4- 2:- 0:3 6: 59 :3"/;::TF:M .'.:.;TAT US H[.I. FI.JNCTlt':'N',:3 ] h~',.,'_F: I,f] '.:::, F.-:V ',,/C'LUME = :3:36'? i ILLAGE = 84 i G HEiC]H'I' = 91.18 INCHES IJfiTER VOL I.,,,.IAT E F~ T 2:DiES£L, NO.2 EAST V,',)LiJME = 0277 GALS '~IDX; IJ!..LA~')E= '77J27 GAL~ T<: '../<,,~IJlflE = ;3242 G~LB HE lC;HT = :30.58 I....J~'I'EF: 'v'OL = 0 G~LS k!A'['ER = 0, O0 i NOHE~ TEMF' = 82,'3 DEG F T ;3:F:Et;ULAR UP,ILEADED 67 'v'OL IJHE = :3115 Iji.I_F4GE =. ~668 TC' ',,/Oi. LJME = :3104 GALS !iEi<-:HT = 2'3.48 INCHE. /,,¥~TEF: VOL = 0 G~LS L.J~TER = 0. O0 I NCHE~ TEMP = 64.8 DEG F T ,I:'.,SLIPEF,' dNLEADED 92 V©LUME = 4688 GALS L;LLA,3E = 7095 GALS 90'.~,; tILLaGE= Sql 6 GALS TC 'v'()LUP1E = 467? GALS i4Ei]i..T = :39.g;5 INC:HEB t.,JF~TE~ ',,."C','L = 0 G~LS WATER = 0.00 INCHES TEMP = 62.9 DEG F D~VIES,~OI~ COMPANY/EXXON CARDLOCK ~ SiteID: 015- 021- 001873 Manager : ~~p~,~c~5 ~// / BusPhone: (661) 323-6063 Lo~ation: 4200 BUCK OWENS BLVD /× /~i Map : 102 CommHaz : Low City : BAKERSFIELD ,~ ~/ Grid: 23A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 ~ SIC Code: 5541 EPA Numb: DunnBrad: 77 - 026 - 7495 Emergency Contact / Title Emergency Contact / Title JOHN HAVERSTOCK / OPERATIONS -~(t~(u~-r~3Z77~/ / OPERATIONS Business Phone: (661) ~'7~98~ Business Phone: (661) 321-9961x/05 24-Hour Phone : (661) - x 24-Hour Phone : (661) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact :~/d6~ /DM~7'~/ Phone: (661) MailAddr: 4200 BUCK OWENS BLVD State: CA City : BAKERSFIELD Zip : 93308 Owner BILL DAVIES Phone: (661) ~-~3-6%~-3~ Address : PO BOX 80067 State: CA City : BAKERSFIELD Zip : 93380 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif 'd: RSs: No Emergency Directives: ~'~ · = Hazmat Inventory One Unified List -- As Designated Order All Materials at Site Hazmat Common Name... ISpecHaz EPA HazardsI Frm DailyMax'[Unit'.-~CP GASOLINE L 7700.00 GAL Mod L 9800.00 GAL Mod GASOLINE DIESEL L 7600.00 GAL Low I,~u~ Do hereby certify tha~ I have reviewed the attached hazardous materials manage- ment plan any corrections constitute a complete andcorrec~ man- agemem plan for my facility. D~VIES~OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ -- COMMON NAME / CHEMICAL NAME GASOLINE Days On Site PREMIUM 365 Location within this Facility Unit Map: Grid: VAULT CAS# 8006619 STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Pure I Ambient IAmbient OTHER- SPECIFY AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 12000.00 GALI 7700.00 GAL 5000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 TSecretl RS,BioHazl HAZARD ASSESSMENTS I I Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No I No No/ Curies / / / Mod -- Inventory Item 0002 Facility Unit: Fixed Containers at Site 9 -- COMMON NAME / CHEMICAL NAME GASOLINE Days On Site REGULAR UNLEADED 365 Location within this Facility Unit Map: Grid: VAULT CAS # 8006619 F STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Pure I Ambient I Ambient I OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 9800.00 GAL 6000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 ITsecretll RS BioHazI HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards NFPA USDOT# MCP No ~No No No/ Curies / / / Mod 2 10/31/2000 D~y~ES~ OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 = Inventory Item 0003 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: VAULT CAS# STATE -- TYPE PRESSURE i TEMPERATURE i CONTAINER TYPE Liquid Pure Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 12000.00 GAL I 7600.00 GAL I 6000.00 GAL HAZARDOUS COMPONENTS I 100.00 Fuel Oil No. 1 N 70892103 HAZARD ASSESSMENTS ~ TSoorotI RSlBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies / / / Low -3- 10/31/2000 F D~VIES~OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 04/07/1998 IN THE EVENT OF A MAJOR CHEMICAL FIRE OR SPILL, THE FOLLOWING PROCEDURES SHALL BE FOLLOWED: A) EVACUATE ALL EMPLOYEES IN THE AREA OF THE SPILL AND/OR FIRE. ALL EMPLOYEES ARE TO ASSEMBLE IN A DESIGNATED AREA. B) CALL THE EMERGENCY MEDICAL SERVICES (EMS) DIAL 911. THEY WILL NOTIFY THE CLOSEST FIRE DEPT. INFORM THE OPERATOR OF THE FOLLOWING: 1) TYPE OF EMERGENCY. 2) NAME AND LOCATION OF COMPANY WHERE EMERGENCY OCCURRED. 3) NAME OF EMPLOYEE REPORTING THE EMERGENCY. C) THE AREA MANAGFAWILL MEET THE EMERGENCY PERSONNEL & DIRECT THEM TO THE SCENE. THEY WILL ALSO HAVE IN THEIR POSSESSION AN MSDS BINDER TO ASSIST THE EMERGENCY PERSONNEL. D) IF CLEANUP ASSISTANCE IS NEEDED, THE MANAGER WILL CALL. Employee Notif./Evacuation -- Public Notif./Evacuation 04/07/1998 VERBALLY NOTIFY ADJACENT LOCATION. Emergency Medical Plan 04/07/1998 DR DAVID R FIELD, BUSINESS HEALTH NETWORK (M-F 7AM TO 5:30 PM) 321-3781 OR SAN JOAQUIN COMMUNITY HOSPITAL. -4- 10/~1/2000 ~ D~VIE~OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 04/07/1998 ALL DISPENSER PUMPS ARE EQUIPPED WITH AUTOMATIC FILL SHUT-OFF NOZZLES. ALL DISPENSERS ARE EQUIPPED WITH IMPACT SHEAR VALVES IN THE EVENT OF EARTHQUAKE OR IF DISPENSER IS ACCIDENTALLY HIT. ALL DISPENSER HOSES ARE EQUIPPED WITH BREAKAWAY FITTINGS WHICH WILL STOP FLOW IN THE EVENT CUSTOMER FORGETS TO REMOVE NOZZLE FROM FUEL TANK. Release Containment 04/07/1998 CONFINE THE SPILL TO THE SMALLEST POSSIBLE AREA BY USING ABSORBENT AND OTHER AVAILABLE MATERIALS. -- Clean Up 04/07/1998 SWEEP UP ABSORBANT AND DEPOSIT IN DRUM FOR LATER REMOVAL. Other Resource Activation 5 10/31/2000 D~V.I_ES..~ OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 04/07/1998 A) GAS- B) ELECTRICAL -i~o~ ~ ~oonq ~ ~o£r~ ~ o~ ~ C) WATER - ~x~ ro /n~~ ~6~'~ ~/ ~-~*~ ~,m~' ~/~ ~" D) SPECIAL E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/07/1998 PRIVATE FIRE PROTECTION - BUILT IN FIRE SUPRESSION. NEAREST FIRE HYDRANT - Building Occupancy Level 6 10/31/2000 D~V~ OIL COMPANY/EXXON CARDLOCK SiteID: 015-021-001873 Fast Format = Training Overall Site -- Employee Training 04/07/1998 WE HAVE 44 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE AT THIS LOCATION. BRIEF SUMMARY OF TRAINING PROGRAM: OUR EMPLOYEES ARE KNOWLEDGEABLE OF THE HAZARDS, SAFE WORK PRACTICES AND AVAILABILITY OF MEDICAL AND EXPOSURE RECORDS PERTAINING TO HAZARDOUS MATERIAS IN THE WORKPLACE. A CURRENT COPY OF THIS TRAINING PROGRAM WILL BE AVAILABLE FROM EITHER C~R~m~7~~ OR -- Page 2 -- Held for Future Use Held for Future Use -7- 10/31/2000 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME 13ldte'~ ~)c~t~(¢Ot~,,- INSPECTION DATE ADDRESS 'q~}l~O ' (30'~{t ~}ta.t~5 fi{vd PHONENO. FACILITY CONTACT ~,av~',t /'~r~t'~ BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES ~--O Section 1: Business Plan and Inventory Program [] Routine ~/~ombincd [] Joint Agency [~l 'Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand b,/ Business plan contact information accurate V/ Visible address Correct occupancy 1/ ' Verification of inventory materials Verification of quantities Verification of location b/ · Proper segregation of material Verification of MSDS availability Verification of Haz Mat training i// Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping ~/ ~t.l~ q 600/ Fire Protection ~/ ~t~f 5'~1'dtcet*/' t' Ol~ 40 Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [] Yes [] No Explain: ~ ~ Questions regarding this inspection? Please call us at (805) 326-3979 Business Site J~esponsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: .~L~t~ CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: ~ ~_ ,,~_"~ 7~ 1. To avoid further action, return this form within 30 days of receipt. [ C) 2. TYPE/PRINT ANSWERS IN ENGLISH. ¢~,_/ ~ 3. Answer the questions below for the business as a whole. ) 5 ~_.hr "~ 4. Be as brief and concise as possible. § c> SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: Davies Oil Company/W. wwmn-~ardl LOCATION: 42(]0 pio_r~.~ ~c]; ~kersfie]-d, Ca 9339E MAILING ADDRESS: Same as above CITY: Bakersfield STATE: Ca ZIP:93308 PHONE: ~3 FEDERAL ID# NUMBER: 77-0267495 SIC CODE:__ PRIMARY ACTIVITY: Dispensing cf fu~L! OWNER: R-[ I 1 MAILING ADDRESS: p.o. Bm× ~nn~7 SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. John Haverstock Opera~5on~ naxrq~ 805.323-6063 2. Larry g~nn~tt Oporation$ Fleet Card Fuc!s 805.321-0961 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 44 MATERIAL SAFETY DATA SHEETS ON FILE: On Location BRIEF SUMMARY OF TRAINING PROGRAM: See Hazard Communication Program SECTION 4: EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, L~ ~4 N~7~ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFIL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: See Attached B & C B. EMPLOYEE NOTIFICATION AND EVACUATION: See Attached C C. PUBLIC EVACUATION: Verbally notify adjacent location D. EMERGENCY MEDICAL PLAN: Dr. David R. Field M.D. Business Health Network (Monday-Friday 7:AM to 5:30 PM) Phone 805. 321-3781 San Joaquin Community Hospital HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PRE .VENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: ~ttachment A & E B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Attachment A C. CLEAN-UP PROCEDURES: Attachment A SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS£PROPANE: please refer to site plan. ELECTRICAL: Please refer to site plan. WATER: Please refer to site plan. SPECIAL: LOCK BOX: YES~_.Q IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AV^I'I.ABILITY A. PRIVATE FIREPROTECTION: Built in Fire Suppession See plot plan B. WATER AVAILABILITY ~IRE HYDRANT): See Site Plan 4 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME Davies Oil ?Company/Exxon-Cardlock FAC~ITYNAME Exxon Tiger Mart SITE ADDRESS 4200 Pierce Rd CITY Bakersfield STATE CA ZIP 93308 NATURE OF BUSINESS Dispensing of fuel Federal I.D. Number SIC CODE D~%Xg~~~R 77 - 0267495 OWNEPJOPERATOR Davies Oil Company PHONE 805-323-6063 MAJLYNGADDRESS P.O. Box 80067 CITY Bakersfield STATE CA ZIP 93380 EMERGENCY CONTACTS NAM]~ John Haverstock TITLE Operations BUS[NESS PHONE 805 - 323 - 6063 24 HOUR PHONE 805- 323 - 6063 NAME Larry Bennett TITLE Operations BUSYNESS PHONE 805-321 -9961 24 HOUR PHONE 805-321 -9961 1 ~- jRDOUS MATERIALS INVENTOr' Page of BusinessNam¢ Davies Oil Co./ Address 4200 Pierce Road -- Exxon Cardlock CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is aNON Trade Secret [ ] Trade Secret 2) Common Name: Pr~-mi,~m 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH H~o~rd Categories Fire IX ] Reactive [ X] Sudden Release of Pressure [ X] Immediate Health (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSIFICATION N /A (3-digit code fxom DHS Form 8022) USE CODE I 9 6) PHYSICAL STATE Solid[ ] Liquid[ X] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF ~LrRE 8) STORAGE CODES lviaximum Daily Amount 7,7 O O. Lbs [ ] Gal [ ] t~3 [] a) Container: 9 9 Average Daily Amount ~ n n t~ Curies [ ] b) Pressure: Annunl Amount 9~ onn c) Temperature Largest Size Container ~ .~ ~ ~ ~ ' "' ~' ~' ~' Circle Which Months: All Year, J, F, M, A, M, J, $, A, S, O, N, D # Days on Site 3 6 5 9) MIXTURE: List bl/A COMPONENT CAS# % WT AHM the three most hazardous 1) [ chemical components or 2) [ uny AHM components 3) [ 10)LOCATION See. Plot P]~n I) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check ff chemical is a NON Trade Seeret [ ]TradeSeeret[ 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH I-hTardCategofies Fire[ ]Reactive[ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ]DelayedHealth(Chrouic)[ 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] C-as[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] E_AMOUNT AND TIME AT FACILiTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] fl3 [] a) Containe~: Average Daily Amount Curies [ ] b) Pressure: Annual Amount ¢) Temperature Largest Size Container # Days on Site Circle Which Months: Ail Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) [ chemical components or 2) [ any AHM components 3) [ 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I believei~..a~the submitted~:...,v~.~,~.~.~.=~information is true, accurate and complete. ~ ~ ~-/:-~[9/ PRINT Name & Title of Authorized Company Representative Signature Date HA~OUS MATERIALS INVENTO ,!~ Page of .. Business Name Davies Oil Co,Exxon Address 4200 Pierce Road Cardlock ~ CHEMICAL DESCRIPTION I)INVENTORYSTATUS:Ncw[ ]Addition[ ]Revision[ ]Ek:lction[ ] Check if ch~nical is a NON Trach: Secret [ ]Trad~Se~:t[ ] 2) Common Name: Rog,,1 ~r Un!eaSe~- Mobil Fuel 3)DOT# (optional) Chemical Name: AHM [ ] :CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ X~ Reactive [ x] Sudden Rcleas~ of Pressure [ X] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ]0 5) WASTE CLASSWICA~ON N /A (3-~g~t cod~ from DHS Form 8022) USE CODE I 9 6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FAC~YFY UNTrS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 9: R O 0 Lbs [ ] Gal [' ~] ft3 [ ] a) Container: 9 9 Average Daily Amount ~; 1313 D Curies [ ] b) Pressure: Annual Amount ~ o '~ a t~ t~ c) Temperature Largest Size ConUfiner ! 2,9 0 9 # Days on Site 3 ~ 5 Circle Which Months: ( All Yeatr,)J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List N/A COMPONENT CAS# % WT AHM the three most b~Tardous 1) [ ] chemical components or 2) [ ] any AHM components 3) [ ] 10)LOGATION See Plot P]an 1) IbWENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trad~ Secret [ . ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION O-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] ~)_AlvIOUNT A_ND TIME AT FACILITY UNITS OF MF_.~S~ 8) STORAGE CODES Maximum Daily Amouat Lbs [ ] Gal [ ] ft3 [ ] a) Container: Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container # Days on Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONE2,~ CAS# % WT AHM the three most hazardous 1) [ ] chemical components or 2) [ ] any Al-IM components 3) [ ] 10)LOCATION I certify undm' penalty o£1aw, that I have personally examined and am familiar with the information on this and all attached decmneats. I believe the submitted iaformation is true, accurate and complete, t PRINT Na~e & Title of Authorized Company Representative Signature Date °. ~..,~,~RDOUS MATERIALS INVENT Page of ~ Business Name Davies Oil Co./ Address 4~.00 P~rc~ goad Exxon Cardlock CHEMICAL DESCRIPTION I)INVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSeeret[ 2) Common Name: Die~el 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ X] Reactive [ X] Sudden Release of Pressure [ X] Immediate Health (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSIFICATION N / A (3-digit code from DHS Form 8022) USE CODE 1 9 6) PHYSICAL STATE Solid[ ] Liquid[x] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF IVlEASURE 8) STORAGE CODES Maximum Daily Amount 1 7,6 O O. Lbs [ ] Gal [ ] 93 [ ] a) Container: 9 9 Average Daily Amount I 2. gq gq ~ _ Curies [ ] b) Pressure: Annual Amount ! ~ 9 5 0 ~ 0 0 0, c) Temperature Largest Size Container 1 9 n n n # Days on Site ~ ~ ~ v v. Circle Which Months: ~ J, F, IvL A, M, $, $, A, S, O, N, D 9) MIXTURE: List N/A COMPONENT CAS# % WT HM the ~aree most b-7~tdous 1) [ chemical components or 2) [ any AHM components 3) [ 10)LOCATION See Plot Plan 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chcmical is a NON Trade Secret [ ]TradeSecret[ 2) Common Name: 3) DOT # (optional) Chemi.cal Name: AI-IM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release ofPressare [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] ~_AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] 93 [ ] a) Container: Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container # Days on Site Circle Which Months: All Year, $, F, M, A, M, $, 3, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) [ chemic, al components or 2) [ any AHM components 3) [ 10 )LOCATION I certify under penalty o£1aw, that I have personally examined and am familiar with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. PRINT Name & Tire of Autherized Company Representative Signature Date ' HAZARDOUS CHEMICAL INVENTORY LIST SITE NAME: PIERCE ROAD, BAKERSFIELD, CA Name of Chemical Location of Use/Storage l, DIESEL FUEL SEE SITE PLAN 2. GASOLINE PREMIUM FUEL SEE SITE PLAN 3. GASOLINE REGULAR FUEL SEE SITE PLAN 4. 5. Program Administrator Date Attachment A ' EMERGENCIES Emergency Action Plan 1. SPILLS The accidental release of petroleum product greatly increases the possibility of fire and poses a threat to ecology. It is therefore extremely important for all employees to have a thorough knowledge of how to handl spills. NOTIFY SUPERVISOR IMMEDIATELY. a. For spills less than 10 gallons 1. Stop flow of product using emergency breaker. Confine the spill to the smallest possible area by using absorbent and other available materials. 2. Place Delineators - Safety Cones. 3. Cover spill area with absorbant. 4. Stir absorbant with a broom until fuel is absorbed. 5. Sweep up absorbant and deposit in dram for later removal. 6. Obtain fire extinguisher and keep it close at hand. 7. Warn everyone to move away from spill area. 8. Prevent vehicle movement and smoking. 9. Call the Fire Department if fire hazard exists. 10. Immediately notify your manager and the IPP. b. For spills greater than 10 gallons but less than 40 gallons: 1. Stop flow of product using emergency breaker. Confine the spill to the smallest possible area by using sand, dirt, rages and other available materials. 2. Call the Fire Department (Bakersfield City 324-4542; Kern County 324-6551). 3. Obtain fire extinguisher and keep it close at hand. 4. Warn everyone to move away from spill area. 5. Prevent vehicle movement and smoking. 6. Immediately notify your manager and the IPP. c. For spills exceeding 40 gallons: 1. Stop flow of product using emergency breaker. Confine the spill to the smallest possible area by using absorbent. 2. Call Hazmat 326-3951. 3. Call the Fire Department (Bakersfield City 324-4542; Kern County 324-6551). 4. Obtain fire extinguisher and keep it close at hand. 5. Warn everyone to move away from spill area. 6. Prevent vehicle movement and smoking. 7. Immediately notify your manager and the IPP. Attachment B DAVIES OIL HAZARD COMMUNICATION PROGRAM Section 1 - PURPOSE The purpose of Hazard Communication program is to ensure our employees are knowledgeable of the hazards, safe work practices and availability of medical and exposure records pertaining to hazardous materials in the workplace. It is management's hope that this information may contribute to @ better understanding of potential occupational hazards by everyone involved and ultimately help maintain a healthful working environment. Section 2 -WRITTEN PROGRAM A. A current copy of this training program will be available in the location(s) and/or by the personnel designated below: 1. Larry Bennett 2. Andrea Albitre 3. B. The Safety and Operating Managers will be responsible for updating and maintaining the current program. Section 3 - CHEMICAL INVENTORY A. A current inventory list will be available as part of the written program in the location(s) and/or personnel designated below. 1. Larry Bennett 2. Andrea Albitre 3. B. The inventory list shall include all chemicals in the workplace. C. When a chemical is added/deleted from the workplace, the operating department shall be responsible for: 1. Assuring the inventory list is updated. 2. Dating new chemical MSDS when put in service. 3. Note location and purpose of new chemical on MSDS (use backside if necessary to be thorough). 4. Adding new chemical MSDS to the active file. 5. Notifying the Safety Department of any change by means of update inventory. D. Inform Fire Department of location and inventory of all chemicals at each location and the location of MSDS files. Section 4 - MATERIAL SAFETY DATA SHEETS A. Current MSDS's for all chemicals in service shall be available as part of this program as designated below: 1. __L_a.r_~_Bennett, Program Administrator, Davies Oil Company 805-323-6063 2. B. Prior to use of chemicals new to an operation, an MSDS will be solicited and forwarded to the Safety and Operating Departments. C. MSDS's shall be readily accessible during each work shift and in the work area. D. When a chemical is discontinued, that MSDS will be pulled from the active file. E. Any time an employee incurs a potential exposure to a chemical(s) and is referred for medical examination/treatment, an MSDS shall be made available to the physician. F. The Operating area shall be responsible for updating, maintaining current and monitoring the MSDS system. G. The information on an MSDS will include: 1. The chemical name, any common names and the Chemical Abstracts Service. (CAS) number. 2. The hazards and risks in using the material including the potential of fire, explosions and reactivity and the concentration and/or temperature at which these reactions might occur. 3. The acute and chronic health effects or risks from exposure to the material. 4. How potential exposure may occur (skin, eyes, inhalation, ingestion, absorption, etc.) 5. Proper precautions, handling practices, necessary personal protective equipment and other safety precautions to us in handling the substance. 6. Emergency procedures to follow in case of a spill, file or accident. 7. Fire aid. 8. Month and year the information was complied. Section 5 - LABELING A. All chemical storage containers received and/or used in the work will have, legible displayed on the container, the proper warning label. The label shall contain, as a minimum, the following information: 1. Identity of the chemical. 2. Appropriate hazard warnings. 3. Name & address of the chemical manufacturer, importer or other responsible party. B. Chemical containers include, but are not limited to, day tanks, drums, bulk storage, contact vessels, etc. Section 6 - INFORMATION AND TRAINING A. The Safety and Operating Department are responsible for developing, implementing, monitoring and documenting the employee training and information program. B. Hazardous material orientation will be conducted for employees, upon initial assignment/ reassignment, who potentially may be exposed to hazardous materials. C. Hazard communication refresher training will be conducted annually for all employees who 7 potentially may be exposed to hazardous materials. D. Before a new material is introduced into the workplace, the MSDS shall be reviewed to determi.ne if the material will present a new or unique hazard(s) within the workplace. When the potential for a new or unique hazards(s) is deemed present, the following will be completed: 1. The Safety and Operating Departments will formulate a training program predicated upon the unique hazard(s). 2. The area manager will conduct a tailgate safety meeting with all employees under his/her supervision who could potentially incur an exposure with the material(s). 3. Documentation of the required training will be completed by the manager. 4. The following outline is recommended for the training: a) Educate the employees in the identification & safe handling procedures of any hazardous substances they may encounter while performing their work, how exposure can occur, what first aid treatment may be required and what cleanup/disposal requirements are necessary. b) Ensure employees are trained in the use of personal protection (hand, foot, head, eye, ear, respiratory etc.) first aid & rescue equipment. c) Ensure personal protective equipment, as well as any other required safety equipment necessary to perform specific jobs, is available & employees fully understand the proper use, maintenance & storage. Section 7 - ACCESS TO EXPOSURE & MEDICAL RECORDS Any employee who feels they are or were exposed to toxic substances or harmful physical agents have a right to examine or copy their own medical records or records of exposure, for example: A. Exposure records such as work place monitoring or measurement (test or monitoring results will be posted); biological monitoring results (if taken; MSDA; or any other information which reveals its identity. B. Employee medical records such as medical and employment questionnaires or histories; results or medial examinations & laboratory or diagnostic test (hearing, respirator, etc.); medical opinions, diagnoses progress notes & recommendations; etc. The above records must be kept at least for 30 years, Definition of toxic substances is chemical substances or biological agents (bacteria, virus, fungus, etc.). Harmful physical agents are physical stress (noise, heat, cold vibration, repetitive motion, ionizing and non ionizing radiation, hydro- orpyperbaric pressure, etc. of which. A. Regulated by state/federal law or rule because it is harmful or potentially harmful to health. B. Is listed in the latest printed edition of National institute of Occupational Safety & Health (NIOSH) or Registry of Toxic Effects of Chemical Substances (RTECS), C. Known to have produced positive evidence of an acute or chronic health hazard in human, 4 animal or other biological testing or is described by an MSDS as possible posing a hazard to human health. Employees have several ways to gain information. They should use the following procedures to request them: A. When an employee has been exposed to any potentially toxic or hazardous substances, upon receipt of a written request from the employee, we will provide access to accurate records of that employee's exposure to the potentially toxic or hazardous substances to the employee or their representative. If available. B. Whenever an employee has been or is being exposed to toxic materials in concentrations or levels exceeding those prescribed by applicable standards orders or special order; they will be notified promptly, in writing of the fact & of the corrective action being taken. C. When an employee exposure requires first aid or medical treatment, the supervisor will supply the information on the MSDS & any additional information that may be needed (i.e. quantity, duration, etc.) to the treating physician. D. Any test results of dust, fumes, mists, vapors, noise or gases will be posted. E. Records will be maintained for 30 years. Should we cease to do business, we will transfer exposure and medical records to the next employer to be maintained or, if there will be no successor employer, notify affected employees and make arrangements to transfer the records to NIOSH according to CAC, Title 8, section 3204. Section 8 - POSTING Each location will post any readings or measurements taken to hazardous substances or harmful physical agents. When testing for any dusts, fumes, mists, vapors, noise or gases, the following must be listed: A. Location of testing. B. Date of testing. C. What is being tested. D. Test results E. Instruments used for testing. F. Who did the testing? The Safety Department will retain this information for 30 years. Section 9 - EMERGENCY NOTIFICATION In the event of a major chemical fire or spill, the following procedures shall be followed: A. Evacuate all employees in the area of the spill and/or fire. All employees are to assemble in a designated area. B. Call the Emergency Medical Services (EMS)m dial 911. They will notify the closest County Fire Department. Inform the operator of the following: 5 1. Type of emergency. 2. Name and location of company where emergency occurred. 3. Name of employee reporting the emergency. C. The area manager will meet the emergency personnel & direct them to the scene. They will also have in their possession an MSDS binder to assist the emergency personnel. D. If cleanup assistance is needed, the manager will call: This written program outlines how we will provide information and control employee exposure to any known hazardous substances. This program is available for review during normal working hours and is located at each location. Section 10 - CONTRACTORS A. We will provide a copy of this written program to contractors/subcontracotrs and require adherence to the program. 1. Receipt of the written information by the contractor/subcontractor will be documented. B. The contractor/subcontractor will provide out manager MSDS's of hazardous materials which are brought to the workplace. C. Copies of MSDS's obtained from contractors/subcontractors will be provided to the Safety and area managers. D. Contrators/Subcontractors will provide their own safety and personal protective equipment, including monitoring instruments, to complete job duties in our workplace. Further, the contractor/subcontractor will assure adequate training of their personnel. AUTHORIZATION LETTER FOR THE RELEASE OF EMPLOYEE MEDICAL RECORD INFORMATION TO A DESIGNATED REPRESENTATIVE. I ., (Full name of worker/patient) hereby authorize , (Individual or organization holding the medical records) to release to (Individual or organization authorized to receive the medical information); the following medical information from my personal medical reports (Describe generally the information desired to be released). I give my permission for the medical information to be used for the following purpose: Expiration Date of Authorization: Full Name of Employer or Representative: Signature of Employee or Representative: Date of Signature: 7 RECEIPT OF INFORMATION & AGREEMENT HAS RECEIVED A COPY OF DAVIES OIL/FLEET CARD FUELS HAZARD COMMUNICATION AND EMPLOYEE ACCESS PROGRAM AND FULLY AGREES TO ADHERE TO THE PROGRAM. (SIGNATURE OF CONTRACTOR) ('~ITLE) (DATE) Attachment C EMERGENCY ACTION PLAN LOCATION: DAVIES OIL CO/EXXON-CARDLOCK, 4200 PIERCE RD, BAKERSFIELD, CA 93308 EMERGENCY ESCAPE ROUTES FOR THIS LOCATION: NEAREST EXIT. MEET IN COMPANY PARKING LOT AND REPORT TO YOUR SUPERVISOR. CRITICAL OPERATIONS TO BE PERFORMED BEFORE EVACUATION: IF TIME PERMITS, SHUT DOWN OPERATING MACHINES & COMPUTERS UNDER NO CIRCUMSTANCES WILL PERSONAL SAFETY BE JEOPARDIZED. PROCEDURES TO ACCOUNT FOR ALL EMPLOYEES AFTER EVACUATION: PERSONAL CONTACT BY SUPERVISORS OF EACH DEPARTMENT. SUPERVISORS THEN REPORT TO THE MANAGERS. RESCUE AND MEDICAL DUTIES FOR ALL EMPLOYEES AFTER EVACUATION: SUPERVISOR OR PERSON DESIGNATED BY SUPERVISOR IS TO ADMINISTER FIRST AID IF NEEDED WHILE WAITING FOR EMERGENCY PERSONNEL. MEANS OF REPORTING FIRES AND OTHER EMERGENCIES: SUPERVISOR OR PERSON DESIGNATED BY SUPERVISOR IS TO CALL 911. PLEASE CONTACT THE FOLLOWING FOR FURTHER INFORMATION: LARRY BENNETT - SAFETY PROGRAM ADMINISTRATOR 805-321-9961 WEST SIDE ANDREA ALBITRE - SAFETY COORDINATOR 805-327-9341 WEST SIDE VALERIE HUARTE - RETAIL SUPERVISOR 800-549-0081 EAST SIDE SIGNATURE DATE PRINT NAME SAFETY AND HEALTH TRAINING Awareness of potential health and safety hazards, as well as knowledge, of how to control such hazards, is critical to maintaining a safe and healthful work e'nvironment and preventing injuries, illnesses, and accidents in the workplace. Davies Oil is committed to instructing all employees in safe and healthful work practices. To achieve this goal, Davies Oil will provide training to each employee with regard to general safety procedures and with regard to any hazards or safety procedures specific to that empl,)yee's work assignment. A. When Training Will Occur Training will be provided as follows: 1. Upon hiring; 2. Whenever an employee is given a new job assignment for wh.'ich training has not previously been provided; 3. Whenever new substances, processes, procedures or equipment which represent a new hazard are introduced into the workplace; 4. Whenever the Company is made aware of a new or previousl.~ unrecognized hazard; and 5. Whenever the Company, Larry Bennett, or the department managers believe that additional training is necessary. Attachment E PREVENTION All dispenser pumps are equipped with automatic fill shut-offnozzles. All dispensers are equipped with impact shear valves in the event of earthquake or if dispenser is accidentally hit. All dispenser hoses are equipped with breakaway fittings which will stop flow in the event customer forgets to remove nozzle from fuel tank.