HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
. ~CONDITIONS OF:~PE.RMIT.ON REVERSE SIDE
~ H~ous g~als Plan
;' ~ Unde~mund
Permit ID~:: 015~00~01425
H~ous
~C~IION: 4450 C~kIFORNIA
OFFICE OF EN~R ONMENTAL SER ~CES'
}~~~VoiceB ~ ~i 1~1715 ChestercA, 26.3979Ave.,9,,013rd Floor.. "~ ': ? x;~.-~:~'~: ''"" ~APpm~ by:
_a_ers_e_, ': 7" . :-::......:':" '~:.:,:, . OmceofE
(661) .
F~(661) 326-0576 ..-~ "~:~':'~Eip~ti°nDate: 'J~ ~0~ 200~
..... ~:-~:. :,: . . '. :' ~,:..:. '-.:
I
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
........ =;~,,,~,¢.¢,,??/;i~%,C}E?=,%,,,?~,~, ....... This permit is issued for the following:
.?:~ii'i j?:i!i;:]' ............. ~iiii!;;:ii!ii~:~,~ ~ii!i;iiiL ~iiiii~iii~?iiii;i!i:~i!U~de:[ground Storage of Hazardous Materials
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LOCATION 4450 CALl FO RN I~% ',,,~',~ ........ ~::.:~' Bake~sf ~6~,~ ~.~.'~?'"....,,,,,~.'~...."'--~:
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Issu~ by:
OFFICE OF E~RON~AL S~ ~CES ~ph Huey~
1715 Chewer Ave., ~rd Floor Office of ~en~!
B~e~fiel~ CA 93301
Voice {805) 326-3979
F~ (80S)~2~0S76 Expiration Date: ~n~ ~O~~ ~OO0
MERVYNS SiteID: 215-000-001425
Manager : AL F BusPhone: (805) 327-4101
Location: 4450 C I ORN Map : 102 CommHaz : Low
'City : Bakersfield Grid: 35A FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 03 ~, SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
YOLANDA LEGRO / STORE MANAGER /
Business. Phone: (805) 327-4101x Business Phone: ( ) - x
24-Hour Phone : (805) 836-1879x 24-Hour Phone : ( ) - x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire ImmHlth DelHlth
Contact : Phone: ( ) - x
MailAddr: 4450 CALIFORNIA AVE State: CA
City : BAKERSFIELD Zip : 93309
Owner MERVYNS Phone: (805) 327-4101x
Address : 4450 CALIFORNIA AVE State: CA
City : BAKERSFIELD Zip : 93309
'Period : to TotalASTs: = 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 DailyMax IunitlMCP
DIESEL FUEL\~, i, . I ~,A,~ F IH DH L 55.00 GAL Low
. I, ?'0~~~0 hereby certify that I have
(Type or p,,int name) ~
reviewed the attached hazardous materials manage-
ment plan fo (u~oo~.~n.,,~) and that it along with
any corrections constitute a complete and correct man-
agement plan fOr my facility.
1 06/09/2000
MERVYNS SiteID: 215-000-001425
~ Inventory Item 0001 Facility Unit: FiXed Containers on Site
-- COMMON NAME / CHEMICAL NAME
DIESEL FUEL Days On Site
365
Location within this Facility Unit Map: Grid:
WEST SIDE OUTSIDE CAS#
F STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid~ /Pure I Ambient I Ambient IDRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
GAL 55.00 GAL I 30.00 GAL
HAZARDOUS COMPONENTS
%Wt.. RS CAS #
100.00 Diesel Fuel 'No. 2 N° 68476302
HAZARD ASSESSMENTS
TSecretI RSIBioHaz Radioactive/Amount EPA Hazards I NFPA USDOT# I MCP
No No No No/ Curies F IH DH / / / Low
2 o /o /2ooo
F MERVYNS SiteID: 215-000-001425
Fast Format
~ NOtif./Evacuation/Medica1 Overall Site
--Agency Notification 10/20/1992
CALL 911
-- Employee Notif./Evacuation 10/20/1992
IN CASE OF EMERGENCY CALL 911
Public Notif./Evacuation 10/20/1992
IN CASE' OF EMERGENCY CALL 911 - EVACUATE THRU NEAREST EXIT, STORE MANAGER
TO CONFIRM PUBLIC EVACUATION.
Emergency Medical Plan 10/20/1992
BAKERSFIELD FAMILY MEDICAL NEXT DOOR
-3- 06/09/2000
f MERVYNs SiteID: 215-000-001425
Fast Format
~ Mitigation/Prevent/Abatemt Overall Site
--Release Prevention 10/20/1992
FUEL KEPT OUTSIDE IN ~CLOSED 55 GALLON DRUM
--Release Containment 10/20/1992
CALL A HAZARD TEAM TO CLEAN UP SPILL.
-- Clean Up 10/20/1992
DIKE 'THE SPILL WITH KITTY LITER OR SAND.
Other Resource Activation
-4- 06/09/2000
F MERVYNS SiteID: 215-000-001425
Fast Format
F Site Emergency Factors~ Overall Site
iSpecial Hazards '
--Utility Shut-Offs 01/07/1990
A) GAS - WEST SIDE OF BUILDING OUTSIDE ADJACENT TO WEST DOOR
B) ELECTRICAL - WEST SIDE OF BUILDING OUTSIDE IN PG&E POWER ROOM
C) WATER - NORTHWEST CORNER OF BUILDING MANHOLE IN ROADWAY MARKED WATER
D) SPECIAL 2 NONE
E) LOCK BOX - NO
-- Fire Protec./Avail. Water 01/07/1990
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS THROUOUT THE STORE AND MARKED
FIRE ALARM SYSTEM/PLUS CALL TO MANAGEMENT FOR RESPONSE
FIRE HYDRANT - WEST SIDE OF BUILDING
Building Occupancy Level
-5- 06/09/2000
MERVYNS ~E~~~~~~ SiteID: 215-000-001425
Trai~ng ~~~~~~~~ Overall Site i
i~ Employee Traiffing ~~~~6~~6~6 01/07/1990
WE ~VE TO EMPLOYEES AT THIS FACILITY o
o
WE ~VE ~TE~AL SAFETY DATA SHEETS ON FILE o
o
NEW HI~ T~INING - 20 MINUITE VIDEO ABOUT HAZARDOUS MATE~ALS AND o
MATE~AL SAFETY DATA SHEETS o
o
o
O
i~ Held for Fumre Use
o
o
i~ Held for Fumre Use
O
O
08./05/92 MERVYNS 215-000-001425 Page
Overall Site with 1 Fac. Unit
General Information
Location: 4450 CALIFORNIA AV Map: 102 Hazard: Low
Community: BAKERSFIELD STATION 03 Grid: 35A F/U: 1 AOV: 0.0
Contact' Name . Title Business Phone ----r 24-Hour
..n~ E. LUDWiG~ ~),~L~H~m Sro~~¢~ (805.) 327-4101 x~(805)
' ...... V ..... ' N.~%~¥~,~ O~T~51(805) 327-4101 x (805) -83~z~--~91
Administrative Data
Mail Addrs: 4450 CALIFORNIA AV D&B Number:
City: BAKERSFIELD State: CA Zip: 93309-
Comm Code: .2.15-003 BAKERSFIELD STATION. 03 SIC Code:
Owner: ~3:~' ~ /[ ~o~ Phone: ( ) -
Address: State:
City: Zip: -
Summary ' RECEIVED
OCT 1 3 1992
HA .7.. I~ATL OIV.'
08/05/92 MERVYNS 215-000-001425 Page 2
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
02-001 DIESEL FuEL .~ Liquid 55 Low ~
~ Fire, Immed Hlth, Delay Hlth GAL
CAS #: Trade Secret:~ No
Form: Liquid Type: Pure Days: 365 Use: FUEL
~ Daily Max GAL I Daily Average GAL I Annual Amount GAL
55 I 30'.00 205.00
Storage Press T Temp Location
DRUM/BARREL-METALLiC IAmbient~Ambient WEST SIDE OUTSIDE
-- Conc Components MCP List
100.0% IDiese1 Fuel No.2 IModeratel '
08/05/92 MERVYNS 215-000-001425 Page 3
00 - Overall Site
<~> Notif.~Evacuation/Medical
<1> Agency Notification
CALL 911
<2> EmplOyee Notif./Evacuation
IN CASE OF EMERGENCY CALL 911
<3> Public N°tif./Evacuation
-IN CASE OF EMERGENCY CALL 911 - EVACUATE~THRU NEAREST EXIT, STORE MANAGER
TO CONFIRM PUBLIC EVACUATION.
<4>.Emergency Medical Plan
BAKERSFIEL FAMILY MEDICAL NEXT DOOR
08~05/92 MERVYNS 215-000-001425 Page 5
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - WEST SIDE OF BUILDING OUTSIDE ADJACENT TO WEST DOOR
B) ELECTRICAL - WEST SIDE OF BUILDING OUTSIDE IN PG&E POWER ROOM
C) WATER - NORTHWEST CORNER OF BUILDING MANHOLE IN ROADWAY MARKED WATER
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS THROUOUT THE STORE· AND MARKED
FIRE ALARM'SYSTEM/PLUS CALL TO MANAGEMENT FOR RESPONSE
FIRE HYDRANT - WEST-SIDE OF BUILDING'
<4> Building.Occupancy'Level
08/05/92 · MERVYNS 215-000-001425 Page 6
' 00 - Overall Site
<G> ' Training
<1> Page 1
WE HAVE 250'TO 275 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
NEW HIRE TRAINING - 20 MINUITE VIDEO ABOUT HAZARDOUS MATERIALS AND
MATERIAL SAFETY DATA SHEETS
<2> Page 2 as needed
<3> Held for Future.Use
<4> Held for Future Use
08/~05/92 MERVYNS 215-000-001425 Page 4
· / 00 - Overall Site
<E> 'Mitigation/Prevent/Abatemt
<1> Release Prevention
FUEL KEPT OUTSIDE IN CLOSED 55 GALLON DRUM
<2> Release Containment
<3> 'Clean Up
<4> Other Resource Activation
Emergency Phone Number(800) 457-2022
Chevron
Material Safety Data Sheet
CHEVRON Diesel Fuel HO. 2 b Page 1 of 6
/
CPS272102
FRANK ~'SULLIVAN INC MATEKIAL ORDERED FOR:
PO BOX 5007 FO~ FRESNO
BAKERSFIELD, CA 93388 200 EAST MINNER STREET
Print Date: November ~2, 1989 OILDAL~, CA 93388
This Material Safety Data Sheet contaiBs environmental, health and
toxicology information for your employees. Please make sure ~his
information is given to them. It al~o contains information %o help
you meet communi~ rightrto-know/emergency response reporting
requirements under SARA T~tle III and man~ other laws. I~ you rese%l
%his product, this MSDS must be given to/he buyer or the in£ormation
incorporated i~ your MSDS. Discard any previous ed{t~o~ of this MSDS.
Th~ Chevron MSDSs have been reformatted and expanded to provide you
with useful hazard warnings a~d health evaluations and to facilitate
your compliance with local, State and Federal regulations.
1. PRODUCT IDENTIFICATION
CHEVRON Diesel Fuel No. 2
DANOERI - HARMFUL OR FATAL IF S~ALLOWED, - PROLONGED OR R~EATED SKIN CONTACT CAN BE HARMFUL
- MA~ CAUSE SKIN IRRITATION
- COMBUSTIBLE
- KEE~ OUT OF REACK OF CHILDREN
CHEVRON PKODUCT NUMBF~(S): CPS272102
PRODUCT INFORMATION: (800)S82-3835
. .. NDA - No Data Avail~le ~A - Not Applicable
~e~ A~ording ~o ~e O~ Hata=d C~lcation
BCa~ (29 ~ 1910.X200) ~ the ~evr~ ~vl~o~nCn~
Heal~ Cente~, Thc., P.O. ~x 40~4, Rt~d, CA 9490~.
Clt~VRON Dlese! Fuel l~o. 2 Page
· 2, FIRST AID
EYE CONTACT~'
No first aid procedures are required. However, as a precaution flush eyes
with fresh water for 15 minutes. Remove contact lenses if worn.
SKIN CONTACT:
Remove contaminated clothing. Wash skin thoroughly with soap and water.
See a doctor i£ any signs or symptoms described in this document occur.
Discard contaminated non-waterproof shoes a~d boots. Wash contaminated
clothing.
INHALATION: °
Zf any signs or symptoms as described in this document occur, move the
person to fresh air. If any o£ these effects continue, see a doctor.
INGESTION:
1f swallowed, give water or milk to drlnk and telephone for medical
advice. DO NoT make person vomit unless directed to do so by medical
personnel. If medical advice cannot be obtained, then take the person and
product container to the nearest medical emergency treatment center or
hospital. Note to Physician~ Ingestion of this procluct or subsequent
vomiting can result in aspiration of light hydrocarbon l%quid which can
cause pneumonitis. "
3. IMI~IEDIATE HEALTH EFFECTS
g¥g CONTACT=
This sub~tance is not expected to cause prolonged er significant eye
irritation.
SKIN IRRITATION~
This substance is a moderate skin irritant so contact with the skin could
cause prolonged (days) injury to the affected area. The degree of injury
will depend on the amount of material that gets on the skin and the speed
and thoroughness of the first aid treatment. Signs and symptoms may
inc[ude pain or a feeling of heat, discoloration, swelling, and
'blistering. Read the Additional Health Data section (12) of this document
for more information.
DERMAL TOXICITY=
I~ absorbed through the
non-toxic to internal organs.
RESPIRATORY/INHALATION=
Prolongedb~eath~n9 of vapors can cause central nervous system effects.
Th~a hazard evaluation is based on data from similar materials. Signs and
symptoms of central nervous system effects may include one or more of the
following= headache; dizziness, loss of appetite, weakness and loss of
coordination.
IN~ESTION~
If swallowed, this substance is considered practically non-toxic to
internal, organs. Because of the low viscosity of this substance, it can
directly enter the iungs if it is s~allowed (th~s is called aspiration).
This can occur during ~he act of swallowing or when vomiting the
Re~ision Number: 9 ' Revision Date: 09/02/8~ -M~DS Nit. bar; 000525
~DA ~ NO Data Available NA - Not Applicable
' ' ~ ~ X-OtiS02..1
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* REPORT ID: PEPD50-037 DATE: 10/05/92
* JOBNAME: PEP00D50 TIME: 22:51:05
* JOBID: JOB03943 CLASS: T
* DIST ID: STORU037 *
* * H H EEEEEEE L PPPPPP *
* SEND REPORTS TO: * H H E L P P *
* * H H E L P P *
* ~ 1. STORE 37, BAKERSFIELD 6. * HHHHHPIH EEEE' L PPPPPP *
* CALIFORNIA * H H E L P *
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* SPECIAL INSTRUCTIONS: * A A T R R E E *
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, ***********************************************************************
* ~ * PLEASE REDUCE PRINTOUT OF REPORTS AND HELP SAVE A TREE.. ***** *
* * REVIEW THIS REPORT AND DETERMINE IF YOU REALLY NEED IT TO ***** *
* * PERFORM YOUR BUSINESS FUNCTIONS.. ***** *
* * TO DELETE OR CHANGE REPORT SEND THIS PAGE OR ***** *
* END ****************************************************** E-MAIL REPORT ID INDICATING THE CHANGE TO: ***** *
* END ******************************************************* .JOAN ABREU M4AJ ***** *
* END ****************************************************** MERVYNS MCS BUILDING ***** *
' '- C~EVRON Diesel Fuel No. 2 Page 3 o[ 6
· su~stal%ce. Once ~R the Lungs, the substance is very difficult to remove
and can cause severe injury to the lungs and death,'
4. PROTECTIVE ~QUIPM]~T
EYE PROTECTION;
No special eye protection is usually necessary.
SKIN PROTECTION:
Avoid'contact with skin or clothing. Skin contact should be minimized by
wearing protective clothing including gloves.
RESPIRATORY PROTECTION:
This material may be an inhalation hazard and, unless ventilation is
adequate, the use of approved respiratory protection is recommended.
VEI~TI~?ION:
Use this material only in veil ventilated areas.
5. FIRE PRO~BC~IOIq
FLASH POINT: (P-M) 125F (52C) Min. ·
AUTOIGNITION: NDA
EXTINGUISHIN~ MEDIA:
CO2, Dry Chemical, Foam and Water Fog.
NF~A RATINGS: Healt~ 1= Flammability 2; ~ea:t~tty O= Special ~A;
~XS ~TINGS: Health 2; Fla~abiltt~ 2; Reactivity 0; Other NDA;
(beast-O, 81ightLl, M~erate-2, High-3, gxtreae-t). These values
obtained ~ing the guidelines or.published evaluations prepared by the
National Fire Protection ~soclation or, fi applicable, the National
Paint and Coating ~sociation, and do not necessarily reflect the hazard
evaluation of the Chevron Environmental Health Center. Read the entire
dot,eat and 1~1 ~f6re ~ing this pr~uat.
FI~ FIG~ING PR~D~S:
~iquid eva~rates and for~ vapor (f~es) which can catch fire and burn
with explosive violence. Invisible va~r spreads easily and can ~ set on
iire by ma~y ~our~es sv~ as pilot lights, veldin~ e~ipment, and
elec:r~cal motors and switches. Fire hazard ts greater as li~id
temperature rises a~ve 85 F. ':
For fires involving this ~aterial, do not enter any enclosed or confined
/ire space without proper protective equi~ent. This may include
self-contalned breathing apparatus to protect against the hazardo~
effects of normal pr~ucts cf co~ustion o~ oxygen deficiency. Read the
entire doc~ent.
~U~ION p~DU~S:
No~al c~ustion fo~ caren dioxide and water vast; incomplete
c~ustion can pr~uce ~r~n monoxide.
Revision Number:9 ' Revision Bate: 09/02/89 -MSOS Nuuberl 000525
NDA - No Data Available HA - Not Applicable
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* REPORT ID: PEPD50-037 DATE: 10/05/92
* JOBNAME: PEP00D50 TIME: 22:48:28
* JOBID: JOB03943 CLASS: T ,
* DIST ID: STORU037
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* SPECIAL INSTRUCTIONS: * A A T R R EEEEEEE EEEEEEE *
* PLEASE REDUCE PRINTOUT.OF REPORTS AND HELP SAVE A TREE.. ***** *
* * REVIEW THIS REPORT AND DETERMINE IF YOU REALLY NEED IT TO ***** *
* * PERFORM YOUR BUSINESS FUNCTIONS.. *****
* TO DELETE OR CHANGE REPORT SEND THIS PAGE OR ***** *
'* START ****************************************************** E-MAIL REPORT ID INDICATING THE CHANGE TO: ***** *
* START ****************************************************** JOAN ABREU M4AJ ***** *
* START ****************************************************** MERVYNS MCS BUILDING ***** *
CHEVI~ON Diesel 2 ' Pape 4 el 6
STORAGE, HANDLING, AND. 'R~ACTIVlTY
HAZARDOUS DECOMPOSITION PRODDCTS=
NDA.
STABILITY=
Stable.
HAZARDOUS .pOLYHERIZATION~
polymerizatlon will not occur.
INCOMPATIBILITY:
May react with strong oxidlz{n~ agents, such as chlorates, nitrate=,
peroxides, etc.
SPECIA~ p~CAUTIONS:
READ AND O~SERY~ ALL PRECAUTIONS ON PRODUCT LABEL.
DO NOT US~ OR STORE near ~lame, sparks or hot surfaces. USE ONLY IN
VENTILATED AREA. Keep container closed. DO NOTweld, heat or drill
con~=iner. Replace cap or bung. Ealptt~d container sti~l contains
hazardous or explosive vapor or liquid. CAUTION! Do not u=e pressure to
emp=y ~rum or explo=~on may result. WARNING! Not for use as portab~
h~ater or appliance fuel. Toxic f~es may accumulate and cause death.
7. PH~SICAI~ PROPERTII~..S
SOLUBI [,IT%i: Soluble
APP~CS= Pal~ yellow l~qu~d.
BO~LING POINT: 176 - 370C (348-698F)
MELTING ~INT: NA.
EVAPO~TI~: NDA
SPECIFIC G~VITY: 0.8~ ~ 15.6/1~.6C (T~cal)
VAPOR P~SSU~: 0.04PSIA ~ &0C
PERCENT VOLATIL~ (WOLFE %): NDA
VAPOR D~SITY (AIR=l): ~A '
V~SCOSITX: 1.9 cst ~ ~0C (M~n.)
8. SPILL RESPONS~ AND DISPOSAL
·
CHEMTREC EI4~RGENCY PHONE NUMBER: (800) 424-9300 {24 hour).
SPILL/LEAK PRECAUTIONS:
'This material is not expected tO present any environmental problems other
than those associated with oil spills.
Eliminate all open flame in vicinity of spill or released vapor. Stop the
" source of the leak or release. Clean up release~ as soon as possible,
observing precautions in Protective Equipment. Contain llquid to prevent
further contamination of soil, surface water or groundwater. Clean up
small spills using appropriate techn~que~ such as sorbeat materlals or
pumpin§. W~ere feasible and appropriate, remove contaminated soil.
Revision ~umber: 9 ReviSion Date: 09/02/89 MSDS Numbe=: 000525
~DA - Ne Data Available NA - Not Applicable
X-DOS{J21 (~-~)
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* REPORT ID: TCPW85OTR037 DATE: 10/06/92
* JOBNAME: TCPDOW85 TIME: 00:07:36
* JOBID: JOB03684 CLASS: Y
* DIST ID: STORU037 -
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* SEND REPORTS TO: * H H E L P P
, * H H E L P P
* 1. STORE 37, BAKERSFIELD 6. * H}5{HH}~ EEEE L. PPPPPP
* CALIFORNIA * . H H E L P
, * H H E L P
* 2. 7~ * H H EEEEEEE LLLLLLL P
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* 4. 9. '' * S A A V V E
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, * SsssS A A V EEEEEEE
* 5. 10. *
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, *A A T R R E E
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, * PLEASE REDUCE PRINTOUT OF REPORTS AND HELP SAVE A TREE.. *****
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* START ****************************************************** E-MAIL REPORT ID INDICATING THE CHANGE TO: *****
* START ****************************************************** JOAN ABREU M4AJ *****
* START ****************************************************** MERVYNS MCS BUILDING *****
* START ******************************************************************************************************************** START
· -~O~ Diesel Fuel No. 2 Pape
· Fellow prescribed procedures for reporting and respond~n§ ~o
DISPOSAL t4ETHODS= .
Place contaminated materials in disposable coatalners and dispose of in a
~anner consisten~ with applicable repv~ations' contact
enviromnental or hea~h avtho~It~es ~or approved d~spo~a~
~ateFia~o
9. EXPOSUR]~ STANDARDS, llEGULATOI~]~ LIMITS AND COMPOSITION
COMPOS ITX ON COMMENT:
All the components of this material are on the Toxic Substances control
ACt Chemical Substances Inventory.
The percent compositions are 9iven to allow for the various ranpes of
the components present in the whole product and may not equal 100%.
PERCENT/CAS# COMPONENT/REGULATORY LIMITS
100.0 % CHEVRON Diesel Fuel No. 2
CONTAIN I NG
100.0 % PETROLEUM MID-DISTILLATE
CAS684763~6 ,~ -
TLV - Thr'eshold Limit Yalue PEL - Permissible Exposure Limit
STEL - Short-term Exposure Limit TPQ - Threshold ~lanning Quantity
RQ - ~eportable Quantity CPS - cUSA Product Code
CC - Chevron Chemical Company CAS - Chemical Abstract Service Number
10. REGIILATOllY INFORMATION
DOT SHIPPING NAMEi FUEL OIL, NO. 2
DOT HAZA/~D CLASS; COMBUSTIBLE LIOUID
DOT. ID~NT1F~dATION NUMBER: NA1993
sARA 3~1 CATEGORIES: 1. Immediate (Acute) Health Effects~
2. Delayed (Chronic} Health Effects~ YES
3. Fire Ha~ardl YES
&. Sudden Release of Pressure Hazard;
5. Reactivity Hazard; NO
WHEN A COMPONENT OF THIS MATERIAL IS SHOI~N IN THIS SECTION, THE
REGULATORY LIST ON I~HICH IT APPEARS {S INDICATED.
REGULATOR2 LISTSI
01=SARA 313 02-MAS~ RTK 03-NTP CarcinoGen
0&~CA Prop. 6S 0S=MI 406 06=IARC Group 1
Revision Numbe£: S Revision Date: 09/02/89 MSDS N,~ebe£:'o0052s
NDA'- No Da[a A~allable NA - Not Applicable
" X-DOSQ21 (01-89)
REPORT NO. 02 Store Sales Flash Page 1
Store by Selling Area
Rpt Date: 10/09/92 11:56
Run Date: 10/09/92 11:59
Sell Area Area Sales % To Total
1 $614.98 6.76%
10 $1165.63 12.82%
30 $814.72 8.96%
40 $1132.76 12.46%
50 $684.64 7.53%
53 $327.26 3.60%
60 $2049.69 22.54%
78 $163.05 1.79%
80 $99.80 ' ~ 1.I0%~
89 $137.97 1.52%
99999999 i $1902.81 20.93%
Total $9093.31
~ - CHKVROH Diese~ No. 2 i rage 6 o~
07~IARC Group 2X 08=IARC Group 2B 09=SARA 302/304
10=PA RTK il=NJ RTK .12=CERCLA 302.~
~3=M~ RTK i$-ACGI~.TbV I$-ACGIH STEL
16-ACGIH Calculated TbV 17~OSHA PEL 16--OSHA STEL
19=Chevron TLV 20=EPA Carcinogen 21=TSCA SECT 4
22=TSCA SECT 5 SNUR 23=TSCA SECT 6 RULE 24=TSCA SECT 12 EXPORT
25=TSCA SECT 8A CAIR 26~TSCA SECT 8D REPORT 27=TSCA SECT 8E
11. PRODUCT TOXICOLOGY DATA
EYE IRRITATION:
NDA.
SKIN IRRITATION=
NDA.
DERMAL TOXICITY:
The dermal LDS0 in rabbits i~ > S ml/kg.
RESPIRATORY/tN1iJLLATION:
NDA. The hazard evaluation was based on data from
IN6ESTION:
The or~! LI~50 in ra~s is
12. ADDITIONAL ]~EALTH DATA
ADDITIONAL HEALTH DATA COMHENT:
Thi~ product contains a mixture of petroleum hydrocarbons called
middistillates. Toxicology data developed for similar mld-distil~ates
support the conclusion that this material may pose an increased risk of
.. skin cancer following prolonged or repeated skin contact.
~rief or intermittent skin contact with this pro~uct is not expected to
produce any serious effects if ~t is washed from the skin. Wh~le noz~a!
handling of this product ~s not likely to cause ca~cer ~n humans, skin
', con,act and breath~ng of mists, fumes or vapors should be reduced to a
The above information is based on the data of. ~hich we are aware and is
believed to be correct as of the date he£eo~. Since the
contained herein may be applied under conditions beyond out cofltrol and
vikh ~hich ye =ay be ua£am~liat and since data ;ade available subsequent
· . to the date hereof may suggest modification of the information, we do not
assuae any responsibilitg for the results of its use. This information is
..: furnished upon COndition that the person receiving, it Shall make his ova
determination et the suitability o~ the eaterta[ for his particular
~urpose. ...
Revision Number: 9 Revision Date: 09/02/89 ~SDS Number: 000525
~DA ~ ~o Data Available ~A - ~ot Applicable
x-o0S0m tm-~)
REPORT NO. 02 Store Sales Flash P~ge'ii
Store by Selling Area
Rpt Date: 10/b9/92 13:02
Run Date: 10/109/92 13:06
Sell Area Area Sales % To otal
1 $855.36 5.70%
10 $1967.69 13.11%
30 $1266.89 8.44%
40 $1817.07 12.10%
50 $1028.49 6.85%
53 $633.04 4.22%
60 $3565.83 23.75%
78 $233.26 1.55%
80 $367.85 2.45%
89 ($117.03) 0.00%
99999999 $3394.29 22.61%
Total $15012.74
BAKERSFIELD, CA. 9330 (805) 326-3979
OFFICIAL USE ONLY
BUSINESS NAME
RECEIVED
HAZARDOUS MATERIALS
BUSINESS PLAN AS A WHOLE OC! 0 3 1989
FORM 2A HR.Z, MAT. DIV.
INSTRUCTIONS:
1. TO avoid further action, return this from within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
SECTION 1: BUSINESS IDENTIFICATION DATA
Mervyn's
A. BUSINESS NAME:
4450 California Ave.
B. LOCATION / STREET ADDRESS:
CITY:. Bakersfield ZIP: 93309 BUS. PHONE: (209) q77-4!0!
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or threatened release of
a hazardous material, ca]] 911 and 1-800-852-7550 or 1-916-427-4341. This
will notify your local fire departmen% and the State 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 Roy E. Ludwig PH# 327-41~3 PH# 664-4987
Claude Richardson
B. PH# 327-4101 PH# Rl?-17ql
SECTION 3; ~OCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NATURAL GAS/PROPANE: west side of Bldg outside
B. ELECTRICAL: West side of Rld? n,,~ ~n PC&E po;For
C WATER: N.W. corner of b~g mRmh~3~ ~ .... ~
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
SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
SECTION 6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EHPLOYEES
WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS
MATERIALS.
A. NUMBER OF EMPLOYEES AT THIS FACILITY ~- ~ ~
B. 'DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS
MATERIAL YOU HANDLE ~ ~
C. GIVE A BRIEF SUMMARY OF YOUR HAZARDOUS MATERIALS TRAINING PROGRAM:
SECTION 7: 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 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; CERTIFICAT~QN
I, , certify that the above information is
accurate. I understand that this information will be used to fulfill my
firm's obligations under the new California Health and Safety code on
Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that
inaccurate information constitutes perjury.
,
BAKERSFIELD CITY FIRE DEPARTMENT
2130 'G' STREET
BAKERSFIELD, CA. 93301
(805) 326-3979
OFFICIAL USE ONLY
ID#'
BU~IN=_SS NAi~t E
HAZARDOUS MATERIALS
BUSINESS PLAN AS A WHOLE
FORM 3A
INSTRUCTION~
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 # 37 FACILITY UNIT NAME: Hervyn'~
SECT[ON 1: MITIGATION, 'PREVENTION, ABATEMENT PROCEDURES
SECT[ON ~; NOTIFICATION AND EVACUATe[ON PROCEDURES AT THE UNIT ONLY
e/l-
~ECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY
A Does this Facility Unit conta'in Hazardous Materials? ...... O NO
If Yes, see B.
If NO, continue with SECTION 4
B. Are any of the hazardous materials a bona fide Trade Secret? YES~*NO~
If NO, complete a separate Hazardous materials inventory
form marked' NON-TRADE SECRETS ONLY (white form ~4A-1)
Zf 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 PROTECTION
8ECTZQN ~; ~OCAT~ON OF WATER SUPPLY FOR USE BY ENERGENCY RESPONDER8
(Fire Hydrant)
SECTION 6: LOCATION OF UTZLZTY SHUT-OFFs AT TH~S UNiT ONLY.
A. NATURAL GAS/PROPANE:
E. LOCK BOX: YES / NO IF YES, LOCATION:
IF YES, SITE PLANS? YES / NO MSDSs? YES / NO
FLOOR PLANS? YES / NO KEYS? YES / NO
- 3B-
CITY of BAKERSFIELD
NO N--TRAD E S E C RE T S - ' Page ....
BOCATI0~: ~t~M~ ~ ADDRESS: STAHDARD I~D. C~ASS CODg
CITY, ZlP:~e~pi~ ~ q%~Oq CITY, ZIP: DUN AND BRADSTREET NUMBER
1 2 ] 4 S 6 7 8 g I0 11 12 13
Trens Ty~ ~x Avenage ~nual ~asu~ I ~ Cmt ~t ~t ~l LKItt~ N~e ~N~-- New of Nixtuq/~ts
C~e C~e MC ~t Est Units m Site TyM Pr~s Tmp C~e StoP~ in Faciltcy ~ Insc~ctims
Physical and Health Hazard C.A.S. ~ C~t I1 h i C.l.S. ~
(C~k ~11 t~ apply)
~ J Fire Hazard ~ ~ Reactivity u J ~le~ ~ J ~m RelHse u--J
Health of P~sure Hmlth ..........
(C~k ell t~t apply)
P~cal ~d H~lth Hazard C.A.S. ~ ~t I1 ~ & C.A.S. ~
(C~k all t~t apply)
.... r--~ ~t 12 NaN& C.A.S. ~
~ ~ Fire Hazard ~--~ Reactivity [ ~ ~la~ ~ ~ ~dd~ eel~se ~--d I~ate
Health of Pr~sure Health -~
P~ical ~ HHlth ~zaed C.l.S. NumNr Cm~mt II Nm A C.l.S. N~
(C~k all t~t apply)
r--~ r--~ r--~ r--~ r--~ Cat 12 NM ~ C.A.S. Ndm~e
L~ Fire Hazard ~_d RHct~vlty ~_d ~lay~ ~--~ ~dd~ Release ~_d
Health of Pr~sure Nra)th ....... '
~t 13 Nm & C.A.S. Numar
~NERGENCY C~TACTS I1
Certff~cat~ (Read and s~n after compJet~n~ all sectJons)
certtfy under ~alty of 1au t~t ] ~ve ~rs~allyexamm~ and am fam~Dar vith t~ ~nfor~ti~ su~tt~ tn tMs a~ oll atticM d~u~ts, and tMt ~s~ ~ ~nqu~ry
~ of t~e t~tviduals eu~s~ble
CITY OF BAKERSFIELD FIRE DEPARTMENT ~ ....
OFFICE OF ENVIRONMENTA~' SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME /4//t?tt o .~ ,,t' x' INSPECTION DATE OO- ~ '/- -O O
ADDRESS /-t/.q~'6 C~/{.,~o~n ,',~_ ..glo PHONENO. '32)- qlo l
FACILITY CONTACT ~tl}~-,,~, /--¢5 ~o BUSINESS IDNO. 15-210-
INSPECTION TIME $ O ~.-~ NUMBER OF EMPLOYEES ! 7. f-
Section 1: Business Plan and Inventory Program
[~ Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint '[] Re-inspection
N OPERATION C V COMMENTS
Appropr~ permit on hand
Business planX~tact information accurate
Visible address
C°rrect °ccupancy %
Verification of inventory materiaX~N
Verificati°n °f quantities %
Verification Of location NN,,N
Proper segregation of material 'N~%
Verification of MSDS availability
Verification of Hag Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate 'x~ ·
Containers properly labeled
Housekeeping '
Fire Protection
Site'Diagram Adequate & On Hand
C=Compliance V=Violation /410th' ~ it_
Any hazardous waste on site?: [] Yes [~'No
Explain:
Questions regarding this inspection? Please call us at (661) 326-3979 .Business Site Responsible Party
White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspec '
BAKERSFIELD
FIRE' DEPARTMENT
August 5, 1998
Karen Bridges
Encee Tech
FIRE CHIEF
MICHAELR. KELLY · 373 Van Ness Avenue, Suite 1 I0
Torrance, CA 90501
ADMINISTRATIVE SERVICES
2101 'H" Street RE:/4450californih Av~h~be in Bakersfield
Bakersfield, CA 93,301
(805) 326-3941
FAX (805) 395-1349 Dear Ms. Bridges:
SUPPRESSION2101 'H' StreetSERVICES This is to inform you that this department has reviewed the result of the Hydraulic
Bakersfield, CA93301 ' Lift Removal Soil Extraction Report dated June 29, 1998 associated with the Mervyn's Store
(805) 326-3941 # M - 3 7.
FAX (805) 395-1349
PREVEN11ON SERVICES Based upon the information provided, this department has determined that
1715 Chester Ave. appropriate response actions have been completed, that acceptable remediation practices
Bakersfield, CA 93301
(80,5) 326-3951 were implemented, and that, at this time, no further investigation, remedial or removal action
lAX (805)326-0576 or monitoring is required at the above stated address.
ENVIRONMENTAL SERVICE$ Nothing in this determination shall constitute or be construed as a satisfaction or
1715 Chester Ave.
Bakersfield, CA 93301 release from liability for any conditions or claims arising as a result of past, current, or future
(805) 326.3979 operations, at this location. Nothing in this determination'is intended or shall be Construed to
lAX (805)326-0,576 limit the rights of any parties with respect to claims arising out of or relating to deposit or
disposal at any other location of substances removed from the site. Nothing in this
TRAINING DIVISION
,5x~42 Victor Street determination is intended or shall be construed to limit or preclude the Regional Water
Bakersfield, CA 93308 Quality Control Board or any other agency from taking any further enforcement actions.
(805) 399-4697
FAX (8O5) 399-5768
This letter does not relieve the owner of any responsibilities mandated under the
California Health and Safety Code and California Water Code if existing, additional, or
previously unidentified contamination at the site causes or threatens to cause pollution or
nuisance or is found to pose a threat to public health or water quality. Changes in land use
may require further assessment and mitigation.
If you have any questions regarding this matter, please contact me at (805) 326-
3979.
Sincerely,
Howard H. Wines, III
Hazardous Materials Specialist
cc: Ralph Huey
Y. Pan, RWQCB
Haz Mat Incident Notification Sheet
data from ECC
Date ~"-//Z (_o/~ ~. OES Staff Contact C,~J~-v~ 5
Time 0 cb 30 ~Fer~( by L~d,~ ~ ~c~
Location of~e Incident ~~7~ 's/ 4q~ ~I,~ g
Description.
Has ~e H~ Mat te~ been dispatched? Y N
data from Haz Mat Team
Contact Haz Mat Team at 322 - 7865 (Van Cellular)
Has an OES number been obtained Y ~ Number
Description ofthe Incident ~nr~,r-,'e- occoo-~ So~, ~/47 ~ t%: ~
Probable H~dous W~te cle~ up Y ~
Discussion and Disposition
e~re~ ~y ,~c,d~q ,. ~ S~ s~*t ~j ~t,~.
Responding to Call .~ N
BAKERSFIELD
FIRE DEPARTMENT
April 9, 1997
FIE CHIEF Ms. Patty Pinc
MICHAEL R. KELLY Mervyns California
22301 Foothill Blvd. M2AA
ADMINISTEAllVE SERVICES
CA
9454
2]0] 'H' Street
Bokersfleld, CA 93301
(805) 326-394!
FAX (~05) 39&1349 Dear Ms. Pinc:
$1JPI~l~ION210] 'H' StreetSEIBtl~ DLI~g a routine inspection at 4456 California Avenue in Bakersfield
Bokersfleld, CA 93301 California~ our office discovered several 55 gallon drums of used motor oil.
(805) 326-3941
FAXC~OS) ags-m9 Several smaller containers were open with various greases, automotive solvents,
and auto parts.
PREVENTION SERVICES
1715 Chester Ave.
Boke~eld, CA 93301 These items were located in the back of the vacant building in a unsecured
(805) 326-3951
FAX (805) 326-0.576 fenced area. In a conversation with you by phone on Friday, April 4, 1997, I was
assured of your full cooperation in cleaning this up.
ENVIRONMENTAL SERVICES
1715 Chester Ave.
~ke~,e~d,C^ ~3~0] In order to avoid any further regulatory action, please complete the clean
(805) 326-3979 up of your facility at 4456 California Avenue within 30 days of this notice (May 8,
FAX (80,5) 326-0576
1997).
~2 ¥~orstroot If'you have any questions, please feel free to contact this office at 805-326-
Boker~fielO, CA 9330S
(~) 3w-~,7 3 979.
FAX (81~5) 399-5763
Sincerely, .
Ralph E. Huey
Hazardous Materials Coordinator
by:
Steve Underwood
Inspector
S~d~