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HomeMy WebLinkAboutBUSINESS PLAN ITE DIAGRAM [ ]. ~ .' ii ~AC~.~ DiAG~ [ ,/ ! ~DEL TACO MOBIL SiteID: 015-021-001905 Manager :-~EY BusPhone: (661) 325-4770 · Location: 3624 CALIFORNIA AVE Map : 102 CommHaz : Low City : BAKERSFIELD , Grid: 35B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code:5541 EPA Numb: DunnBrad: E ~/~ Li~~ mergency ~ontact / Title Emergency Contact / Title n~IE DL~LEY / MANAGER ~ ' JOHN A STUART / VICE PRES Business Phone: (661) 325-4770~q~f~ Business Phone: (661) 325-6320x 24-Hour Phone : (661)-~24~-=2_q~x 24-Hour Phone : (661) 325-6320x Pa~er Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : TACO TWO Phone: (661) 325-4770x MailAddr: 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD Zip : 93311 Owner TACO TWO Phone: (661) 325-4770x Address : 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD Zip : 93311 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, [Jmr,,~ /_./'~ Do hereby certify that ~ have reviewed the a~tzched hazardous materials manage- for~and ~ha~ it along with ment p~an any corrections constitute a complete and correct man- agement plan for my facility 1 / -1- 03/19/2004 F~DEL TACO MOBIL SiteID: 015-021-001905 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: DEL TACO MOBIL Cross Street : Business Type: Org Type: Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : JOHN A STUART Phone: (661) 325-6320x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : JOHN A STUART Phone: (661) 325-6320x Address: City : State: Zip: Type : CORPORATION BOE UST Fee# : 006217 Financ'l Resp: STATE FUND Legal Notif : Tank Owner Mailing Address Date:04/19/2000 Phone: (661) 325-6320x Name:STUARTS' PETROLEUM Ttl:PRES. State UST # : 1998 Upg Cert#: 2 03/19/2004 F~DEL TACO MOBIL SiteID: 015-021-001905 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax lunitlMcP GASOLINE L 10000.00 GAL Mod GASOLINE L 10000.00 GAL Mod DIESEL L 10000.00 GAL Low -3- 03/19/2004 :~DEL TACO MOBIL SiteID: 015-021-001905 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ -- COMMON NAME / CHEMICAL NAME GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006619 FSTATE TYPE PRESSURE--~TEMPERATURE I CONTAINERTYPE Liquid ~ | Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 10000.00 GAL 10000.00 GALI 10000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS lTSecretl ~S BioHazI Radioactive/Amount EPA HazardsI NFPA USDOT# MCP No N No No/ Curies / / / Mod MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag.'Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag. Defined7: Ag. Defined8: Ag. Defined9: Ag.Definel0: -- Ag.Definell 4 03/19/2004 F~DEL TACO MOBIL SiteID: 015-021-001905 = Inventory Item 0001 Facility Unit: Fixed Containers at Site STORAGE 'CONTAINER DATA (UST FORM B and AGENCY-DEFINED)'Page 1 of 2 Last Action Type: Location In Site: UST TANK'DESCRIPTION Tank ID#: 1 Mfr: TRUSCO Compart Tank: N Inst~lled: 07/1998 Capacity: 12000 Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: DIESEL Marl Name:GASOLINE Cas #: 8006619 TANK CONSTRUCTION Type : DOUBLE WALL Material (p) : BARE STEEL Material (s): BARE STEEL Lining .: UNLINED Installed: Corr Prot: UNKNOWN Installed: Spill.tnt : 1998 Alarm : 1998 Exempt: No Drop Tube : 1998 Ball Float : Striker Plate: 1998 Fill Tube S/O: 1998 TANK LEAK DETECTION Sgl Wall: Dbl Wall: INTERSTITIAL MONITORING TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -5- 03/19/2004 :"DEL TACO MOBIL SiteID: 0'15-021-001905 = Inventory Item 0001 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING DISPENSER CONTAINMENT Installed: 11/24/1998 Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Date: 04/19/2000 Name:STUARTS' PETROLEUM Ttl:PRES Prmt Number: 1905 Approved: Yes Expiration Date: 06/30/2000 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:09/22/2003 -6- 03/19/2004 DEL TACO MOBIL SiteID: 015-021-001905 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# -~ 8006619 F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure AmbientIi Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ITSecretl ~SIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# MCP No N No No/ Curies / / / Mod MISC. LOCAL AGENCY DATA Ag.Definedl: Ag. Defined2: Ag. Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Definel0: -- Ag.Definell 7 03/19/2004 :~'DEL TACO MOBIL SiteID: 015-021-001905 ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: UST TANK DESCRIPTION Tank ID#: 2 Mfr: UNKNOWN Compart Tank: N Installed: 07/1998 Capacity: 12000 Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL· Petrol Type: DIESEL Matl Name:GASOLINE Cas #: 8006619 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): BARE STEEL Material(s): BARE STEEL Lining : UNLINED Installed: Corr Prot: 'UNKNOWN Installed: Spill Cnt : 1998 Alarm : 1998 Exempt: No Drop Tube : 1998 Ball Float : Striker Plate: 1998 Fill Tube S/O: 1998 TANK LEAK DETECTION Sgl Wall: INTERSTITIAL MONITORING Dbl Wall: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -8- 03/19/2004 :'DEL TACO MOBIL SiteID: 015-021-001905 = Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA. (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: DOUBLE WALL Mfgr : UNKNOWN Mtl : FIBERGLASS & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS DISPENSER CONTAINMENT Installed: 11/24/1998 Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Date: 04/19/2000 Name:STUARTS' PETROLEUM Ttl:PRES. Prmt Number: 1905 Approved: Yes Expiration Date: 06/30/2000 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:09/22/2003 9 03/19/2004 DEL TACO MOBIL SiteID: 015-021-001905 ~ 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: UST. CAS# r STATE [ TYPE PRESSURE i TEMPERATUREI CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS %Wt. I RSI CAS# 100.00 Diesel Fuel No. 2 No 68476302 HAZARD ASSESSMENTS TSecretl oRSIBioHaz Radi°active/AmountNo N No No/ Curies EPA Hazards [ NFPA/// IuSDOT# MOP MISC. LOCAL AGENCY DATA Ag. Definedl: Ag. Defined2: Ag. Defined3: Ag. Defined4: Ag. Defined5: Ag. Defined6: Ag. Defined7: Ag. Defined8: Ag. Defined9: Ag. Definel0: -- Ag. Definell · -10- 03/19/2004 :~DEL TACO MOBIL SiteID: 015-021-001905 = Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 ~ Last Action Type: Location In Site: UST TANK DESCRIPTION Tank ID#: Mfr: Compart Tank: N Installed: / Capacity: Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: Petrol Type: Matl Name:DIESEL Cas #: TANK CONSTRUCTION Type : Material(p): Material(s): Lining : Installed: Corr Prot: Installed: Spill Cnt : Alarm : Exempt: No Drop Tube : Ball Float : Striker Plate: Fill Tube S/O: TANK LEAK DETECTION Sgl Wall: Dbl Wall: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -11- 03/19/2004 DEL TACO MOBIL SiteID: 015-021-001905 = Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : Const: Mfgr : Mtl ~ & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping DISPENSER CONTAINMENT Installed: 11/24/1998 Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Date: 11/24/1998 Name:Don Dozah Ttl:Environmental mgr. Prmt Number: 1905 Approved: Yes Expiration Date: 06/30/2003 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:09/22/2003 -12- 03/19/2004 :~DEL TACO MOBIL SiteID: 015-021-001905 Fast Format ~- Notif./Evacuation/Medical Overall Site --Agency Notification 12/21/1998 IN THE EVENT OF A RELEASE BEYOND A NOZZEL SPILL, CONTACT'THE BAKERSFIELD FIRE DEPT 326-3979. -- Employee Notif./Evacuation 12/11/2000 ALL EMPLOYEES WILL BE INSTRUCTED ON EVACUATION PROCEDURES. THERE ARE 3 EXITS IN THE BLDG, EMPLOYEES WILL BE REQUESTED TO USE CERTAIN EXITS AND MEET AT A PLACE SELECTED BY THE SHIFT MANAGER TO ASSURE ALL STAFF HAS EXITED THE BLDG. Public Notif./Evacuation 12/21/1998 THE TWO EXITS IN THE PUBLIC AREA WILL BE USED FOR EVACUATION OF THE PUBLIC. SHIFT MANAGERS WILL BE ENCOURAGED TO KEEP CONTROL TO AVOID PANIC SITUATIONS. Emergency Medical Plan 12/21/1998 CALL 911. -13- 03/19/2004 DEL ~TACO MOBIL SiteID: 015-021-001905 NA~ ..... WEN~DEt=L ! BusPhone: (661) 325-4770 Manager : Location: 3624 CALIFORNIA AVE Map : 102 CommHaz : Low City : BAKERSFIELD Grid: 35B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code:5541 EPA Numb: DunnBrad: ~mergency con5@c5 / Title Emergency Contact / Title .. ~A_.~TIN W~ND~T,T, / MANAGER JOHN A STUART / VICE PRES Business Phone: (661) 325-4770X~o~,' Business Phone: (661) 325-6320x 24-Hour Phone : (661) -~3~lO~3,5~Z~ ~ 24-Hour Phone : (661) 325-6320x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : TACO'TWO Phone: (661) 325-4770x MailAddr: 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD Zip : 93311 Owner TACO TWO Phone: (661) 325-4770x Address : 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD Zip : 93311 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I,~-~{~'~' -~, ~ ~ Do hereb7 cerViX7 ~ha~ ~ have ~y~ orp~m na~) ment Plan ~orT~co~ and ~hm i~ alo~ ~i~h (Na~ ~ ~s~ any c°rr~ions constitute a complete and ~e~ man- agemem plan ~or my ~acili~. -1- 07/15/2002 DEL TACO MOBIL SiteID: 015-021-001905 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: DEL TACO MOBIL Cross Street : Business Type: Org Type: Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : JOHN A STUART Phone: (661) 325-6320x AddreSs: C~ty .... : .......... State: Zip: Type : CORPORATION ~TAN~ --OWNER INFORMATION Name : JOHN A STUART Phone: (661) 325-6320x Address: City : State: Zip: Type :'CORPORATION BOE UST Fee# : 006217 Financ'l Reap: STATE FI/ND Legal Notif : Tank Owner Mailing Address Date:04/19/2000 Phone: (661) 325-6320x Name:STUARTS' PETROLEUM Ttl:PRES. State UST # : 1998 Upg Cert#: ---- Hazmat Inventory One Unified List ~ --Alphabetical Order Ail Materials at Site ~ Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax IUnit'lMcP DIESEL L 10000.00 GAL Low GASOLINE L 10000.00 GAL Mod' GASOLINE L 10000.00 GAL Mod -2- 07/15/2002 DEL TACO MOBIL SiteID: 015-021-001905 ~ 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: UST CAS# F STATE ~ 'TYPE I PRESSURE I TEMPERATURE CONTAINER TYPE Liquid, I Mixture Ambient Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION ' Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS io SI 100.00 Diesel Fuel N©. 2 N 68476302 HAZARD ASSESSMENTS TSecretI oRS]BioHaz Radios'stirs/Amount I EPA Hazards NFPA USDOT# I MCP No N No No/ Curies / f / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers, at Site 9 -- COMMON NAME / CHEMICAL NAME ! GASOLINE I Days On Site 365 L'ocation within this Facility Unit Map: Grid: UST CAS# 8006619 Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container [ Daily'Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline 8006619 HAZARD ASSESSMENTS ITsecretl ~SIBioHazl Radioactive/Amount EPA HazardsI NFPA I USDOT# MCP No N No No/ Curies / / / Mod -3- 07/15/2002 DEL TACO MOBIL SiteID: 015-021-001905'9 = Inventory Item 0002 Facility Unit: Fixed Containers at Site ~Xvuvl~ ~Vl~ / ~ £ ~ ~Vl~ GASOLINE Days On Site 365 Location within this Facility Unit Map; Grid: UST CAS# 8006619 F STATE ]TYPEPure A~iontPRESS~E I TEMPE~TUREIA~ient ~DERCONTAINER TYPEGRoUND T~K Liquid I ~O~TS .AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL ~ZARDOUS COMPONENTS 100.00 Gasoline N 8006619 ITSecret RS BioHazII I ~Z~D ASSESSMENTS I I Radioactive/Amount EPA Hazards NFPA USDOT# MCP No INo I No No/ Curies / / / Mod '4- 07/15/2002 DEL TACO MOBIL SiteID: 015-021-001905 Fast Format .~ ~ Notif./Evacuation/Medical Overall Site ~--~Agency Notification ~12/21/1998 IN THE EVENT OF A RELEASE BEYOND A NOZZEL SPILL, CONTACT THE BAKERSFIELD FIRE DEPT 326r3979. -- Employee Notif./Evacuation 12/11/2000 ALL EMPLOYEES WILL BE INSTRUCTEDON EVACUATION PROCEDURES. THERE ARE 3 EXITS IN THE BLDG, EMPLOYEES WILL BE REQUESTED TO USE CERTAIN EXITS AND MEET AT A PLACE SELECTED BY THE SHIFT MANAGER TO ASSURE ALL STAFF HAS EXITED THE BLDG -- Public Notif./Evacuation 12/21/1998 THE TWO EXITS IN THE PUBLIC AREA WILL BE USED FOR EVACUATION OF THE PUBLIC. SHIFT MANAGERS WILL BE ENCOURAGED TO KEEP CONTROL TO AVOID PANIC SITUATIONS. Emergency Medical Plan 12/21/1998 CALL 911. -5- 07/15/2002 F DEL TACO MOBIL SiteID: 015-021-001905 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 12/21/1998 THE STATION IS UPDATED TO CALIFORNIA STANDARDS, DOUBLE WALL TANKS, SPILL PROTECTION, OVERFILL PREVENTION MONITORS WITH AUTOMATIC TANK. TIGHTNESS -- Release Containment 12/21/1998 AUTOMATIC SHUT OFF, MANUAL SHUT OFF. -- Clean UP 12/11/2000 NOZZEL SPILLS, SATURATE WITH KITTY LITTER, SWEEP UP & BAG HOLD FOR HAZARDOUS WASTE PICKUP. ANY MAJOR LEAK WE USE CERTIFIED CLEANUP COMPANYS. Other Resource Activation -6- 07/15/2002 ~ DEL TACO MOBIL SiteID: 015-021-001905 Fast Format F Site Emergency Factors ~ Overall Site Special Hazards --Utility Shut-Offs 12/21/1998 A) GAS - NW SIDE OF BLDG B) ELECTRICAL - PANEL AT THE SW SIDE OF BLDG D) WATER - ?????? E) SPECIAL - NONE F) LOCK BOX - NO Fire Protec./Avail. Water 12/21/1998 PRIVATE FIRE PROTECTION - THREE FIRE EXTINGUISHERS, OVER THE STOVES, FIREMASTER FOAM MACHINE. NEAREST ,FIRE HYDRANT - THE CORNER OF EASTON & CALIFORNIA AVE. Buildi?ng Occupancy Level 7 07/15/2002 DEL TACO MOBIL SiteID: 015-021-001905 Fast Format = Training Overall Site -- Employee Training 12/21/1998 WE HAVE 5.3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: THE STATION IS OPEN 24 HOURS, HAS THREE 'SHIFTS AND THREE SHIFT MANAGERS WHO INSTRUCT THEIR PERSONNEL ON PROCEDURES IN THE EVENT OF A RELEASE. Page 2 Held for Future Use I Held for Future Use I -8- 07/15/2002 DE~ TACO MOBIL ...... ---= SiteID: 015-021-001905 Manager : _~k%~A~I=D~B~ -~/~ ~00 BusPhone: (805) ' 325-4770 Map : 102 CommHaz : Low Location: 362~IFO~IA AVE~~ Grid: 35B FacUnits: 1 AOV: City~ : B~ERSFIELD 9~ ~ CommC°de: B~ERSFIELD STATION 03 SIC Code: 5541 ~ . EPA Nu~: DunnBrad: Emergency Contact / Title Emergency Contact / Title JOHN A STUART / VICE PRES ~s~~.-~-(805) 325-4770x Business Phone: (805) 325-6320x ~24-Hour Phone : (805) ~ 24-Hour Phone : (805) 325-6320x Pager Phone : ( ) ~o~x Pager Phone : ( ) - x Hazmat Hazards: Contact : TACO TWO Phone: (805) 325-4770x MailAddr: 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD -,~. Zip : 93311 Owner TACO TWO Phone: (805) 325-4770x Address : 9902 RANCHO VERDE DR State: CA City : BAKERSFIELD Zip : 93311 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~,~~~jz~:~_~~ Do hereby certify ~,hat t ha~e reviewed the attached hazardous materials manage" for~and~ tha~ it along with ment plan any corrections constitute a complele and correct man- agement plan for my facility. - \S,Onature - - Date -1- 10/31/2000 DEL TACO MOBIL SiteID: 015-021-001905 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: DEL TACO MOBIL Cross Street : Business Type: Org Type: TOtal Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : JOHN A sTUART Phone: (805) 325-6320x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : JOHN A STUART Phone: (805) 325-6320x Address: City : State: Zip: Type : CORPORATION BOE UST Fee# : 906217 Financ'l Reap: STATE FUND Legal Notif : Tank Owner Mailing Address Date:04~19~2000 Phone: (661) 325-6320x Name:STUARTS' PETROLEUM Ttl:PRES. State UST #' : 1998 Upg Cert#: ~ HaZmat Inventory One Unified List -- As Designated Order Ail Materials at Site ~ Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax lUnitlMCP GASOLINE L 10000.00 GAL Mod GASOLINE L 10000.00 GAL Mod DIESEL L 10000.00 GAL Low -2- 10/31/2000 DEL TACO MOBIL SiteID: 015-021-001905 = Inventory Item 0001 Facility Unit: Fixed Containers at Site GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# ~ 8006619 F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Pure~ I Ambient I Ambient ~ I UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 10000.00 GALJ 10000.00 GALJ 10000.00 GAL HAZARDOUS COMPONENTS 100.0'0 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl ~SlBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No N No No/ Curies / / / Mod F Inventory Item 0002 Facility Unit: Fixed Containers at Site 7 ~ COMMON NAME / CHEMICAL NAME GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006619 Liquid JPure Ambient Ambient LTNDER GROUND TANK ~ AMOUNTS AT THIS LOCATION Largest COntainer Daily Maximum I Daily Average ~ 10000.00 GAL 10000.00 GALJ 10000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSeorotlNoRSlBioHaz Radioactive/Amount EPA Hazards I NFPA USDOT# I MCP No No No/ Curies / / / Mod -3- 10/31/2000 DEL TACO MOBIL SiteID: 015-021-001905 ~ = Inventory Item 0003 Facility Unit: Fixed Containers at,Site ~ -- COMMON ,NAME / CHEMICAL NAME ~ DIESEL I Days On Site 365 Location within this Facility Unit Map: Grid: UST. CAS# Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 10000.00 GAL 10000.00 GALI 10000.00 GAL HAZARDOUS COMPONENTS 100.00 Diesel Fuel No. 2 N 68476302 HAZARD ASSESSMENTS ITSecretl RSlBioHazl Radioactive/Amount I EPA HazardsI NFPA USDOT# I MCP No No No No/ Curies / / / Low '/ -4- 10/31/2000 DEL TAco MOBIL ~~~~~~ SitelD: 015 -021-001905 i i~ Notif./Evacuatio~Medical ~~~~~~ Overall Site i i~ Agency Notification ~~~~~~~ 12/21/1998 i o IN THE EVENT OF A RELEASE BEYOND A NOZZEL SPILL, CONTACT THE BA~RSFIELD o FIRE DEPT 326-3979. O o i~ Employee Notif./Evacuation EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE 12/21/1998 i o ALL EMPLOYEES WILL BE INSTRUCTGED ON EVACUATION PROCEDU~S. THERE ARE THeE EXITS IN THE BLDG, EMPLOYEES WILL BE REQUESTED TO USE CERTAIN EXITS AND MEET o AT A PLACE SELECTED BY THE SHIFT MANAGER TO ASSURE ALL STAFF ~S EXITED THE o iEEEE ~blic Notif./Evacuation EEEEEEEEEEE~EE~EEEEEE~EEE~EEEE 12/21 / 1998 i O THE ~O EXITS IN THE PUBLIC A~A WILL BE USED FOR EVACUATION OF THE PUBLIC. SHIFT MANAGERS WILL BE ENCOU~GED TO ~EP CONTROL TO AVOID PANIC SITUATIONS. o i~EEE Emergency Medical Plan EEEEEEEEEEE~EEEE~EEEEEEEEEEEEEEEEEEEE 12/21/1998 i O CALL 911. o -5- 10/31/2000 DEL TACO MOBIL ~~~~~6~ S itelD: 015 -021-001905 i~ Mitigatio~Prevent/Abatemt ~~~~~ Overall Site i i~ Release Prevention ~~~~~~~ 12/21/1998 O THE STATION IS UPDATED TO CALIFORNIA STANDARDS, DOUBLE WALL TANKS, SPILL PROTECTION, OVE~ILL PREVENTION MONITORS WITH AUTOMATIC TANK TIGHTNESS O i~ Release Contaiment ~~~~~~ 12/21/1998 o AUTOMATIC SHUT OFF, MANUAL SHUT OFF. o O NOZZEL SPILLS, SATU~TE WITH ~TTY LITTER, SWEEP UP & BAG HOLD FOR ~ZARDOUS WASTE PICKUP. ANY ~JOR LEAK WE USE CERTIFIED CLEAN-UP COMPANYS. o O i~g O~er Resource Activation O O aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee -6~ 10/31/2000 i DEL TACO MOBIL ~~/~EEE~/~EE~E~~ SiteID: 015-021-001905 i ~ Site Emergency Factors E~EE~E~EEEEEEE~EEEEE~EEEE~EE~EEEEEE~EE Overall Site lEE Special Hazards O O O o O o o A) GAS - NW SIDE OF BLDG o B) ELECTRICAL - PANEL AT THE SW SIDE OF BLDG o o D) WATER - ?????? o o E) SPECIAL - NONE ° o F) LOCK BOX - NO o o o iEEE~ Fire Protec./Avail. Water EEEEEE~EE~EEEE~EEEEE~EEEE~EEE~EEE 12/21/1998 o o o PRIVATE FIRE PROTECTION - THREE FIRE EXTINGUISHERS, OVER THE STOVES, o o FIREMASTER FOAM MACHINE. o o o o O O o NEAREST FIRE HYDRANT - THE CORNER OF EASTON & CALIFORNIA AVE. o O o iEEEEE Building Occupancy Level O O O ; O -7- 10/31/2000 i DEL TACO MOBIL/~/~5~5~6~/~/5/5/5~/~5~5/~/~66~~ S iteID: 015 -021-001905 i~ Trai~ng ~~~~~~~~ Overall Site i~ Employee Trai~g ~~~~~~~ 12/21/1998 i o o o WE HAVE 53 EMPLOYEES AT THIS FACILITY. O O o WE DO HAVE MSDS SHEETS ON FILE. O O o B~EF SUMMARY OF T~INING PROG~M: THE STATION IS OPEN 24 HOURS, ~S THREE o o SHIFTS AND THREE SHIFT MANAGERS WHO INSTRUCT THEIR PERSONNEL ON PROCEDURES o IN THE EVENT OF A ~LEASE. o 'O O O O O O iE6~ Held for Fumre Use O O O O iE~EE Held for Fumre Use o O O o -8- 10/3!/2000 OFFICE OF ENVIRONMENTAL SERVICES' 1715 Chester Ave., Bakersfield, CA (805) 326-3979 UA mALS IsV STOaV CHECK IF BUSINESS IS A F~ [ ] SIC CODE ~/ ' D~&B~S~ET~ER OWNER/OPERATOR ~ ~ PHONE .~f_5' ~-/7 7~ . CITY EMERGENCY CONTACTS NAME ~-~v~¢~C'~~ TITLE ~ (~'~,~) 9o0 --~,~w~ BUS.SS PH0~ ~_ ~ 77& 24 H0~ N~ ~H~ ~. g ~ ~ TI~E BUS.SS PHO~ ~- ~Z~' 24 HO~ Page of CHEMICAL DESCRIPTION 1) 12q~-'NTOR¥ STATUS:New [ [~^ddition [ ],Revision [ ,] Deletion [ ] Check ii'chemical is a NON Trade Secret [ ] Trade Seeret Chemical Name: '- AH2vf [. ] CAS # 4) Physical 8; Health PHYSICAL HEALTH Hazard Categories Fire[v/~Reactive[ ]S~dde~aReleaseofPressure[ ].ImmediateHealth(Acute)[ ]DelayedHealth(Chroni¢)[ ] 5) WASTE CLASSIFICATION - O.digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] . Liquid [ V(/Cras [' ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UN1TS OF MEAS,,URE g) 'STORAGE CODES Maximum Daily Amount ~ Lbs [ ] Gal [ i/]' ft3 [ ] a) Container. Average Daily Amount ~ Curies [ ] b) Pressure: - Annual Amount' ~ . ¢) Temperature 9) MIX'IURE: List COMPONENT ~...' .,~ '¥.~ .... .,, '.. x ' CAS# 2~ % WT AFIM the tlu'ee most hazardous 1) - [ ] chemical components or 2) ' [ ] 1 ) INVENTORY STATUS: New [ ] Addition[ ] R~vision [:'.]'Deletion [ .']:,.. CheCle,ifchemical is a NON Trad~ Secret [ ] Trade Sem~'[ ] 2) Common Name: ' 3) DOT # (optio .n~l, ) Chemical Name: AHM [ ] CAS # - 4) Physical & Health' .. ~. '- .~. FHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] S~aA~Release of Pressure [ ] 'l~nm,edlate H~Ith (Acu~) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIHCATION - ~',. ' :, .." - (3.~ligit:F-od~from DHS Form 8022) - , 'USE C, ODE 6) FHYSICAL STATE ~. c-Soh'd[ ] Liquid [ ] ~ [. ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASLrRE 8) STORAGE CODES Maximum Daily Amount Lbs [. ] Gal [ ] ft3 [ ] a} Contame~. Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container # Days On Site Circle Which Months: Ail Year, Ji F, M, A, M, ~, $, A, S, O, N, D 9) MIXTURE:' List ~OMFONENT c' 'CAS~' ' '"" % WT ARM the three most b~n:tous .1._) .. [ ]' any AHM components 3) [ ]. I certify under penaltyof law, that I have personally examined and am familiar with theim'~ormation'on . _this and all attached docummts. I believe the submitted information is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date ' CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3999 INSTRUCTIONS: 1. To aV6id further %tion, l-~turn this form Within 30 da3~s of receipt. ' ' '"~' ' 2. TYPE/PRINT ~ANSWERS IN. ENGLISH. -- ,~ .... ,. - " 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA D~ & B~S~ET ~ER: SIC CODE: SECTION 2: EMERGENCY NOTIFICATION '" cONTACT , .. TITLE . BUS. PHONE 24 I-IR. PHONE HAZARDoUs MATERIALs MANAGEMENT PLAN SECTION 3 :. TRAINING ~ ~ . NUMBER OF EMPLOYEES: _5'~: . MATERIAL SAFETY DATA SHEETS ON FILE: >,'~. BRIEF SUMMARy OF TRAINING PROGRAM: 7-.,,,~- 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 TIlE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. orHE} (SPECIFY RE. ON) SECTION 5: CERTIFICATION ~ I; ~o,--'-~/c~r-"'~-r cERTIFY THAT THE ABOVE INFORMATION IS AccURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDous MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.)~ND ,THAT INAC CURATE. INFORMATION CONSTITUTES e. ER JURY. 'SIGNATURE TITLE DATE HAZARDouS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVA(~UATION PROCEDURES A. AGENCY NOTIFICATION PROCEDUREs: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN 3 HAZARDOUS MATERIALS MANAGEMENT PLAN 'SECTION 7: MITIGATION. PKEVENT~ON AND ABATISMENT PLAN A. RELEASE PREVENTIONSTEPS: 7~' ,.x,~aT-/~:v,~ /,c a,a-'~,~c~) ~ C?,a,~-- B. 1LELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION, OF SHUT-OFFS AT YOUR FACILITY) WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY B. WATER AVAIl.ABILITY (FIRE HYDRANT): ' 4