HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF .PERMIT ON REVERSE SIDE
....' · El Hazardous Materials Plan
· ": TI Underground Storage of Hazardous Materials
· :.~ [3'Risk Management Program
' D H,~rdous Waste On-Site Tre~;,~-,ent
PERMIT ID # 015-021-002030 ".~:. ~."
,~"i'~ .:.-~
RITE AID DRUG ..~ ~. · ,:~ :. ..-~.
LOCATION 2717. 93312
'" '~', ~: '~ L:-i% '-
.
.... :... · '~'
..... :'* · .~
OFFICE OF ENVIRONMENTAL SER vicEs'i. ~ " ~ "'"~ '. .. ' .....
1715 Chester Ave., 3rd Floor APPr°vedby: -
Bakersfield, CA' 93301
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: 'June 30. 2003
· MAILING ADDRESS
P.O. Box 3165
Harrisburg, PA ~17105
· GENERAL OFFICE
30 Hunter Lane
RITE AID Corporation Camp Hill, PA 17011
· (717) 761-2633
5/14/2002
OFFICE OF ENVIRONMENTAL SERVICES
1715 CHESTER AVE 3RD FLOOR
BAKERSFIELD, CA 93301
R~: DBA Kite-Aid Pharmacy ....
HAZARDOUS MATERIALS
CLOSED STORES
Dear Licensing Coordinator,
Please be advised that Rite Aid Pharmacy #5819 located at 2717 CALLOWAY
BAKERSFIELD, CA has closed on 4-21-2002. Enclosed is the original license that was
issued to and previously posted at the business address. Please update your records
accordingly.
If you should have any questions or require additional information, please feel
free to contact me directly at (717) 214-8514, fax (717) 730-7762, or email
jcarey~,riteaid.com. Your assistance in this matter is greatly appreciated.
.~ncerely, . ~ _
//Judith A. Carey
Licensing Administrator
Enclosure
CC: Rite Aid Regional Office - File
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF .PERMIT ON REVERSE SIDE
This permit is issued for the followina:
[] Hazardous Materials Plan
[] Underground Storage of Hazardous Materials
[] Risk Management Program
[] Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002030
RITE AID DRUG S
LOCATION 2717 AY '~:~:,~ .. 93312
OFFICE OF EN~R ONMENTAL SER ~CES'
~~u 1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301 om~or~~s~,~=
t~t Voice (661) 326-3979
~~~,~, F~(661) 326-0576 Exp~tionDate: ~~ ~O~ ~OO~
S MARY OF UNIFIED PERMIT CONDITIONS
IN GENERAL: SPECIFICALLY:
1. This permit must be posted or maintained on si1 ~ at all times. HAZARDOUS WASTE:
1. Any amount of a hazardous waste must be'reported tO the Office of
2. ' Any questions regarding this permit shall be direct ~d to the: Environmental Services onlthe chemical description page of the Unified
. Program Consolidated Forms. ·
OFFICE OF ENVIRONMENIAL SER~ !ICES 2. -.. Hazardous waste.4 shall be properly iabeled at all times and properly
Bakersfield Fire Department disposed of in a timely manner, no later than 180 days from accumulating
1715 Chester Avenue, Suite 300 27 gallons (100 kg) at any time, or within 90 days if you accumulate more
Bakersfield, CA 93301 than 27 gallons (100 kg) p4r month.
(661) 326 - 3979 3. Keep all waste disposal receipts or manifests for three years.
3. You must notify the OffiCe of Environmental Services" within 30 days of UNDERGROUND STORAGE TANKS:
any change in ownership. "ti 1. You must ensure that both !the owner and operator of the tank are provided
'~1 with a copy of this permit.!i If you operate but do not own the tank(s), there
4. You must comply with the requirements of the California Health and Safety shall be a Written operatinl~ agreement with the owner to monitor the tanks.
Code, (and associated laws, rules, and regulations) as applicable: 2. You must maintain a moni~toring program which includes a site map and a
4~ Chapter 6.5 for generators or treaters of hazardous ~vastes. monitoring and response pi'ogram appropriate for the design of the tank(s).
4t Chapter 6.67 for aboveground storage of petroleuni. 3. Ihe monitoring program shall be in compliance with state regulations and
· / Chapter 6.7 for underground storage of hazardous ;ubstances. subject to annual review b~ the Office of Environmental Services.
~r Chapter 6.75 for petroleum underground storage U ak cleanup.
~r Chapter 6.95 for hazardous materials response and inventories. ABOVEGROUND STORAGE O[ PETROLEUM:
4t Chapter 6.95 (Article 2) for accidental release prex ;ntion of acutely 1. All new or modified abov~ground storage tanks shall be installed under a
hazardous materials and risk management plans, valid installation permit issued by the Office of Enwronmental Services.
2. Any aboveground petroleo~m storage tank over 660 gallon capacity or 1320
5. You must pay your consolidated annual permit fee and any state service gallons in aggregate storag~e shall file a storage statement with the State
fees, as applicable, for this permit to continue to re main in effect. Water Resources Control l~oard and prepare a Spill Prevention Control and
Countermeasure (SPCC) I~!an. Call (916) 227-4364 for more information.
HAZARDOUS MATERIALS: ~ 3. A the SPCC shall be maintained on site and a copy also forwarded to the
1. Immediately report any release or threatened relea e ora hazardous Office of Environmental Si~rvices.
material if there is a reasonable belief that hfe, health, safety, or the
environment are at risk by calling: n CALIFORNIA ACCIDENTAL ..RELEASE PROGRAM (CalARP):
4r 9-1-1 (for emergencies only), or i[ 1. Any facility required to submit a Risk Management Plan shall implement
4t (661) 326-3979 for Office of Environmeiqtal Services, and the prevention program li~ted in the plan for the covered processes on site.
4t (800) 852-7550 State Warning Center 2. The prevention program shall be self-audited by the facility at least once
2. Report any changes or additions to your hazardou§' materials inventory, during the term of this permit. The results of the self-audit shall be
within 30 days of the change to the Officeof Environmental Services. available to the Office of Environmental Serv. ices for evaluation.
3. Any amount of explosives must be reported to theliOffice of Environmental 3. Accidental release~ of fied~rally regulated or extremelY hazardous
Services on the chemical description page of the Unified Program substances in reportable qUantities shall, in addition to the immediate
Consolidated Forms. reporting requirements, also be reported to the EPA at (800) 424-8802.
S:\CUPAFORMS\Permit Conditions.wpd
~ ~J~//~ OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACiLiTYNAME ..c~'~c3~c6'~ /-6{C ~O/'~'i~O INSPECTIONDATE ~Z~~
Section 4: ~ardous Waste Genera~r Program EPA ID ~
~ Routine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection
OPE~TION C V COMMENTS
H~rdous w~te dete~ination h~ been made ~ ~~-- ~ tc~ ~~
EPA ID Number (Phone: 916-324-1781 to obtain EPA ID ~) ~ o~ A ~~o~ ~~
Au~orized for w~te treatment ancot storage ~~ t~ ~ ~
Reponed releme, fire, or explosion within 15 days of occu~ence
Es~blished or main~ins a contingency plan and training
H~ardous w~te accumulation time frames
Containe~ in good condition and not leaking
Con~inem am compatible with the h~ardous w~te
Conmine~ ~e kept closed when not in use
Weekly inspection of storage area
Ignitable/reactive w~te located at le~t 50 feet from prope~ line
Second~ containment provided
Conducm daily inspection of ranks
Used oil not contaminated with other h~ardous waste
Proper m~agement of lead acid batteries including labels
Proper management of used oil filte~
T~spom h~dous w~te with completed m~ifest
Sends m~ifest copies to DTSC
Retains m~ifesm for 3 yem
Re~ins h~dous w~te analysis for 3 yea~
Re~ins copies of used oil receip~ for 3 years
Dete~ines ifw~te is restricted ~om land disposal
C=Compli~ce V=Violation ~
Office of Environmen~l'Se~ices (661) 326-3979 Business Site Responsible P~y
White - Env. Svcs. Pink - Business Copy
RITE AID DRUG STO .~__ ~ - SiteID: 215-000-001185
Manager : j~ME~ ~. ~;~o^1 BusPhone: ~ '- D--E~- 0~00
Location: ~71~ C~Lt..o~/~-y b;{,'U~ ~OSE~L~ OiLt~Gg) Map : 123 CommHaz : Low
City : ~K~iS~b, c6 ?~3;~- ~&/~ JOCk Grid: 10A FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 07 SIC Code: 5912
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
~& ~. ~oN / MANAGER
Business Phone: (~/) 5-~r - o~OO Business Phone: (¢&!)~-~ -0~X) x
24-Hour Phone : (6~/)5~ ~ 24-Hour Phone : (~!)37~ -7~2 x
Pager Phone : ( ) - Pager Phone : ( ) - x
Hazmat Hazards: Fire Press React ImmHlth DelHlth
Contact : Phone:
MailAddr: State: CA
City : Zip :
Owner RITE AID CORP Phone: (717) 761-2633x
Address : PO BOX 3165 State: PA
City : HARRISBURG Zip : 17105
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... ISpocHazlEPA HazardsI Frm I DailyMax UnitIMcP
MOTOR OIL F DH L 400.00 GAL Min
BLEACH F L 200.00 GAL Hi
PROPANE F P IH G 873.00 GAL Hi
ANTIFREEZE F DH L 100.00 GAL Low
POOL CHLORINE PRODUCTS IH S 600.00 GAL Hi
POOL ACIDS R IH S 50.00 GAL Hi
P R IH L 100.00 GAL Hi
FUEL ADDITIVES I, ~tV ~. ~L~C~ DO hereb/ce~j~ T~ ~aves 700.00 LBS Min
FERTILIZER - r*r, ~ o~ ~ri/~' :~:,-n.~)
INSECTICIDES F IH L 360.00 GAL UnR
COLEMAN FUEL reviewed the a~ached hazardous ~atedals m~Fa.qe-L 200. oo GAL Low
HELIUM F P IH G 600.00 FT3 Min
ment plan for/~iTf /~;b C~.(~. and that it along with
(rCarne o! Business)
any corrections constitute a complete and correct man-
agement plan for my facility.
05/08/2000
RITE AID DRUG STORE #'5~i~ SiteID: 215-000-001185
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site
~ COMMON NAME / CHEMICAL NAME
MOTOR OIL Days On Site
365
Location within this Facility Unit Map: Grid:
AISLE 13 - NORTH WALL CAS#
8020835
STATE -- TYPE PRESSURE i TEMPERATURE CONTAINER TYPE I
Liquid Pure Ambient Ambient PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
GALI 400.00 GAL 200.00 GAL
HAZARDOUS COMPONENTS
100.00 Motor Oil, Petroleum Based N 8020835
HAZARD ASSESSMENTS
TSecretl RSIBioHaz Radioactive~Amount I EPA Hazards I NFPA I USDOT# ' MCP~
No No No No/ Curies F DH / / / I Min
~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~
-- COMMON NAME / CHEMICAL NAME
BLEACH Days On Site
365
Location within this Facility Unit Map: Grid:
SALES FLOOR CAS#
7681-52-9
F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid Pure Ambient Ii Ambient PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
GAL 200.00 GAL I 100.00 GAL
HAZARDOUS COMPONENTS
I I Io SI
100.00 Bleach N 7681529
HAZARD ASSESSMENTS
' ''TSecret' RS'BioHaz' Radioactive/A~ount EPA Hazards NFPA USDOT# MCP
liNe NolIN° No/ Curies F / / / Hi
-2- 05/08/2000
RITE AID DRUG STORE #5~ SiteID: 215-000-001185
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
-- COMMON NAME / CHEMICAL NAME
PROPANE Days On Site
365
Location within this Facility Unit Map: Grid:
AISLE 12 CAS#
74-98-6
~ STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE
Gas /Pure Ambient Ambient METAL CONTAIN-R-NON-DRUM
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
GAL 873.00 GAL 430.00 GAL
HAZARDOUS COMPONENTS
100.00 Liquefied Petroleum Gas N 68476404
HAZARD ASSESSMENTS
TSecretNo I NoRS BioHazNo I Radioactive/Am°unt INo/ Curies FEPAp HazardsiH NFPA/// I USDOT# IMCPHi
~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~
· --- COMMON NAME / CHEMICAL NAME
ANTIFREEZE Days On Site
365
Location within this Facility Unit Map: Grid:
107-21-1
STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE
Liquid /Pure Ambient Ambient PLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
GALI 100.00 GAL 50.00 GAL
HAZARDOUS COMPONENTS
100.00 Ethylene Glycol N 107211
HAZARD ASSESSMENTS
'TSecret' RS'BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
I
I
-3- 05/08/2000
RITE AID DRUG STORE #5'~1~ ~/~~/~/~/~/~/~/~5 SiteID: 215-000-001185 i
iE Inventou Item 0005 EE~E~EEE~EEEE Facili~ Unit: Fixed Containers on Site
i~ COMMON NAME / CHEMICAL NAME ~~~~~i~~~i
POOL CHLO~NE PRODUCTS o Days On Site
o 365 o
Location wi~in this FaciliW U~t Map: Grid:
ENDCAP AND WA~HOUSE o CASff o
o 7681_52_9°
iff STATE ~i~ TYPE ~ifi~ P~SSU~ ~fii TEMPE~TU~ ~i~ CONTAINER TYPE
Solid o Mix.re o Ambient o Ambient o PLASTIC CONT~NER o
i~~~fi~i AMOUNTS AT THIS LOCATION
Largest Container o Daily Maximum o Daily Average
GAL o 600.00 GAL o 600.00 GAL o
iEEE~EE~iEE~EE~EEEEE~E ~ZA~OUS COMPONENTS
%Wt. o o RSo CAS~ o
°Sodium Hypochlorite ONo o 7681529°
°Sodim Hydroxide ONo o 1310732°
i~i~i~i~~ ~ZA~ ASSESSMENTS
°TSecret° RS°BioH~° Radioactive/Amount o EPA Hazards o NFPA o USDOTff o MCP o
o No ONoONo o No/ Curies° IH o /// o OHio
Inventory Item 0006 EE6~EEEEEE~EEE Facility Unit: Fixed Containers on Site
i~ COMMON NAME / CHEMICAL NAME
POOL ACIDS o Days On Site o
o 365 o
Location within this Facility Unit Map: Grid:
ENDCAP AND WAREHOUSE o CAS# °
o 7647010°
i~ STATE ~i~ TYPE ~i~ PRESSURE ~i TEMPERATURE ~i~ CONTAINER TYPE ~i
Solid o Pure o Ambient o Ambient o PLASTIC CONTAINER o
i~~~~i AMOUNTS AT THIS LOCATION ~~~~i
Largest Container o Daily Maximum o Daily Average o
GAL o 50.00 GAL o 50.00 GAL o
%Wt. o o RSo CAS# o
10.00OMuriatic Acid °Yes° 7647010°
i~i~~i~~ HAZARD ASSESSMENTS
°TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT# o MCP °
No °No°No o No/ Curies° RIH o /// o OHio
-4- 05/08/2000
RITE AID DRUG STORE #5'-g0 8~888~888~888~8~68~88888 SiteID: 215-000-001185
i8 Inventory Item 0007 88~8~88~8888~ Facility Unit: Fixed Containers on Site
i88 COMMON NAME / CHEMICAL NAME
FUEL ADDITIVES o Days On Site o
o 365 o
Location within this Facility Unit Map: Grid:
AUTOMOTIVE AISLE o CAS#
o
i~ STATE 6i~ TYPE 8~i8~ PRESSURE ~8i TEMPERATURE ~8~8 CONTAINER TYPE
Liquid o Mixture o Ambient o Ambient o PLASTIC CONTAINER o
i~~~~i AMOUNTS AT THIS LOCATION
Largest Container o Daily Maximum o Daily Average o
GAL o 100.00 GAL o 100.00 GAL o
ig~g6~i~6~6~6~ HAZARDOUS COMPONENTS ~E~E~i~i~E~E~E~i
%Wt. o °RS° CAS# o
60.00OMethyl Alcohol ONo o 67561°
20.00OMethyl Ethyl Ketone ONo o 78933°
20. 00 O Ethylene Glycol ONo o 107211°
i~5~i~i~i~~ HAZARD ASSESSMENTS
°TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards ° NFPA o USDOT# o MCP o
O.No ONoONo o No/ Curies °FPRIH o /// o OHio
Inventory Item 0008 ~E~E~EE~EEEEEE Facility Unit: Fixed Containers on Site
i~ COMMON NAME / CHEMICAL NAME ~~~~~i~~~i
FERTILIZER o Days On Site o
o 365 o
Location wi~in ~is Facility U~t Map: Grid:
GALEN ~SLE o CASg o
o O
STATE ~i~ TYPE ~i~ P~SSURE ~f TEMPE~T~ ~i~ CONTAINER TYPE
Solid o ~re o Ambient o Ambient o BOX o
i~E~E~E~~E~i AMOUNTS AT THIS LOCATION
Largest Container o Daily Maximum o Daily Average o
LBS o 700.00 LBS o 700.00 LBS
i~E~i~fi~E~E~6~6~ HAZA~OUS COMPONENTS ~~6~i~ig~g~~i
%Wt. o oRSO CAS~ o
100.00OA~offium Sulfate ONo o 7783202°
i~i~i~i~6~6~ HAZARD ASSESSMENTS
°TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT~ o MCP
No ONoONo o No/ Curies° RIHDH° /// o
-5- 0510812000
RITE AID DRUG STORE #.,5'81~ 5~6~~~ SitelD: 215-000-001185
i~ Inventory Item 0009 ~~e~ Facility Unit: Fixed Containers on Site
i~ COMMON NAME / CHEMICAL NAME ~~~~~i~~~i
INSECTICIDES o Days On Site °
o 365 o
Location within this Facility Unit Map: Grid:
GARDEN AISLE o CAS# o
O O
fleeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeueeeeeeeeeeeeee 8f
i~ STATE EiE TYPE EEE~ PRESSURE ~E~ TEMPERATURE
Liquid o Pure o Ambient o Ambient o GLASS CONTAINER o
Largest Container o Daily Maximum o Daily Average °
GAL o 360.00 GAL ° 360.00 GAL
i~i~~ HAZARDOUS COMPONENTS
° %Wt. o o RSo CAS# o
o 100.00OInsecticides ONo o 0o
i~i~i~i~~ HAZARD ASSESSMENTS
°TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards ° NFPA o USDOT# o MCP o
° No °No°No o No/ Curies°F IH o /// o °UnR°
Inventory Item 0010 ~~~ Facility Unit: Fixed Containers on Site
iE6 COMMON NAME / CHEMICAL NAME 6EEE~EEE~EE~EEEEE~EE~EE~6EEiE~E~EE~EE~EE~EEi
COLEMAN FUEL ° Days On Site o
o 365 o
Location within this Facility Unit Map: Grid:
SEASONAL AISLE ° CAS# o
o 8008_20_6°
aeeeee
STATE ~i~ TYPE ~i~ PRESSURE ~i TEMPERATURE ~i~ CONTAINER TYPE
Liauid ° Pure ° Ambient o Ambient o METAL CONTAINR-NONDRUM o
i~6~~~6~i AMOUNTS AT THIS LOCATION
Largest Container o Daily Maximum ° Daily Average o
GAL o 200.00 GAL o 200.00 GAL
i~i~~ HAZARDOUS COMPONENTS ~~i~i~~~i
%Wt. ° o RS° CAS# o
100.00OKerosene ONo o 70892103°
i~i~i~i~~ HAZARD ASSESSMENTS ~i~~i~~i~i
°TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT# o MCP o
No ONoONo o No/ Curies°F DH° /// o OLow °
-6- 05/08/2000
RITE AID DRUG STORE #~8/~ ~~~~ SiteID: 215-000-001185
i~ Invento~ Item 0011 ~~~ Faciliw U~t: Fixed Containers on Site
i~ COMMON NAME / CHEMICAL NAME
HELIUM o Days On Site o
o 365 o
~cation within ~is Facility Unit Map: Grid:
WA~HOUSE/CHECK OUT o CAS~ o
o 7~0_59_7o
i8 STATE 8i8 TYPE ~8i~ P~SSU~ ~i TEMPE~TU~
Gas o ~re o Above Ambient o Ambient o PORT. P~SS. CYLINDER o
i~~88~~~i AMOUNTS AT THIS LOCATION ~~~~i
Largest Container o Daily Maximum o Daily Average o
FT3 o 600.00 FT3 o 300.00 FT3
i~i~~ ~ZA~OUS COMPONENTS ~~i~i~~~i
%Wt. o o RSo CAS~ o
100.00OHelium ONo o 7440597°
°TSecret° RS°BioHaz° Radioactive/Amo~t o EPA H~ards
No ONoONo o No/ Curies°FP IH o /// o OM~O
-7- 05/08/2000
RITE AID DRUG STORE #Yi/~.
i~ Notif./Evacuation/Medical
i~ Agency Notification
o
CALL 911.
o
i~EE Employee Notif./Evacuation
O
SHOULD A HAZARDOUS CONDITION OCCUR, MANAGER ON DUTY IS TRAINED TO: NOTIFY o
LOCAL AGENCY (FIRE DEPT); SHUT OFF I-IVAC IF SMOKE OR FUMES ARE PRESENT; °
NOTIFY DISTRICT MANAGER; AND EVACUATE THE STORE IF NECESSARY. °
o
i~ Public Notif./Evacuation
O
USE STORE PUBLIC ANNOUNCEMENT SYSTEM TO DIRECT CUSTOMERS TO EMERGENCY EXITS. o
EMPLOYEES ARE ALSO TRAINED TO EVACUATE CUSTOMERS. o
O O
i~ Emergency Medical Plan
o O
o NEAREST EMERGENCY ROOM. o
O O
-8- 05/08/2000
RITE AID DRUG STORE #5~/? ~~~~ SiteID: 215-000-001185 i
i~ Mitigatio~Prevent/Abatemt ~~~~~ Overall Site
i~ Release Prevention ~~~~~~~ 05/02/1991
o
ALL EMPLOYEES ~ INSTRUCTED IN PROPER ~NDLING OF ALL MERCHANDISE AND o
MATE~ALS AT TIME OF HIffiNG AND WITH ON~ING INSTRUCTION THROUGH MONTHLY o
MEETINGS AND DI~CT SUPERVISION. o
o
i~ Release Conta~ent
O
o
i~ Clean Up ~6~6~~~~~~~ 05/02/1991
o
~AD CONTAINER LABELING OR ~TE~AL SAFETY DATA SHEET FOR CLEAN UP PROCEDU~ o
IF UNSU~, USE PROTECTIVE GLOVES, SAFETY GLASSES, USE SWEEPING COMPOUND. o
O
i6~ O~er Resource Activation
O o
O O
-9- 05/08/2000
RITE AID DRUG STORE # 5rr~y ~8~88~8~~ SiteID: 215-000-001185 i
i~ Site Emergency Factors ~~~~~~ Overall Site i
0
o
i~ Utility Shut-Offs ~~~~~~/~/~/~ 05/18/1998
0
A) GAS - NONE o
B) ELECTRICAL - NE CORNER OF STOCKROOM °
C) WATER - E SIDE OF BLDG NEXT TO SIDEWALK
D) SPECIAL - NONE °
E) LOCK BOX - NO °
o
ii~i~E6 Fire Protec./Avail. Water/~E~E/5/5/SEE/5/~E~E/~E/5E/~5/~Ei~EEEE~EEE 05/18/1998
O
PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLERS, ABC FIRE EXTINGUISHERS AND o
SMOKE DETECTORS. o
o
o O
o O
o FIRE HYDRANT - LOCATED ON SW CORNER OF MING AND CHESHIRE. o
O o
aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee e~f
i/~E~5 Building Occupancy Level
O O
O O
-10- 0510812000
RITE AID DRUG STORE
i~ Trai~ng
i~ Employee Trai~ng
o
WE ~VE 14 EMPLOYEES AT THIS FACILITY. o
o
WE ~VE MATE~AL SAFETY DATA SHEETS ON FILE AT HOME OFFICE. o
O
B~EF SUM~RY OF T~INING: ~ZCOM, PPE, EVACUATION, FI~ EXTINGUISHER. o
o
i~ Page 2
0 0
0 0
O O
O O
0 0
0 o
-11- 05/08/2000
Section II1: Inventory
INVENTORY SUMMARY
$1TEADDRESS: 27/7 CRL~o~Y
-- Invento~ Summa~
Eem ~ame of Hazardous Material or Waste Maximum Unit of
~ Quantity Measure
1 Kodak Rexi~lor Developer Repllnlsher LORR 4 gallons
2 Kodak Flexicolor ~ Bleach Repllnlaher NR 1 gallons
3 Kodak Flexicolor ~ Fixer & Re~llnisher 4- gallons
4 I, Kodak Flexi~ior Stabilizer & Reptinlsher LF 8 gallons
5 Kodak Ekta~ior ~ Developer Reptinisher 14 gallons
6 Kodak E~a~lor ~ Bleach Fix & Repiinlaher 14 gallons
7 Kodak E~acolor PHme Stabilizer & Replinlsher 28 gallons
Date Prepared:
Summs~e Ihe bustnsu plan inventoP/on Mil page. Plato in front of lnvenlory sectt~n ef business plan. Make c~l~tel of this sheet or (replicate on
a computer) ee new,i-fy.
HAZARDOUS MATERIAL INVENTORY FORM
Hon-Trada Secret Page
Chemical Name: ~ Re~ ~
Common Name: ~m
Physicat Hazard: FIRE: PRESSURE: R~CTIVE:
Health Hazard: IMMEDIATE HEALTH: DE~YED HEALTH:
Physi~i S~te: FORM: Solld:~ Liquid: x
~PE: Pure: ~ Ml~um: x
~ Day,year on-site: 385 Unit of Measure:
Amount and
~me at Facili~: M~lmum Amount: .
Average Amount:
Confiner Type:
Storage Pra~su~: ~e~ S~mge Tamp: ~t
Storage NI ~ ~e e~
Laotian(s):
(PrOvide ~dd coordinate~ from
Percent Con~ntmUon & Componen~
.%
%
I
DATE PREPARED:.. M~ COPIES OF ~IS FORM A8 NEED~
REMEMBER TO A~ACH MSDS TO ~IS FORM IF ~E ~R~L IS NOT LlS~ IN ~PEND~ I.
HAZARDOUS MATERIAL INVENTORY FORM
Non-Trade Secret Page
FAClLITYNAME: ~IT~ ~lO . ~(~'"/~ ITEMe 2
ChemiGal N ama: Kaesk FMxicek~ RA ~ ~t~W, NE CAS ~
Common Name: ~ 8~ DOT ~
p~ysicai Hazard: FIEE:~ PRESSURE: R~CTNE:
~ealth Hazard: IMMEDIATE HEALTH: DRAYED H~LTH:
Physical S~: FORM: Solid:~ Liquid: x G8~: ~ Du8~ ~
~PE: Pure: ~ Ml~um: x
~ DiyilYear on-aEe~ 385 Unit of Measure:
Amount and
Average Amount: ~ ~ I~l: ~
Container ~pe: ~*~ ou · ~
L°~°n(8): (Provide ~rld coor~inat~e from comple~ faclil~ map.)
Percent Con~ntmtlon & com~nents
B ~ N~
1 ~ 1,~~~~c a~
NOTES: Tm~ n~(I) I lynen~ [I) or e~i[ ~;b~n ~¢~ te ~i~nal(i) I~.
I
DATE PREPARED: ~ COPIES OF THIS FORM AS N~D~
R~EMBER ~ A~ACH MeDe TO ~IS FORM IF ~ ~~ ~ NOT U~D IN APP~D~ 1.
HAZARDOUS MATERIAL INVENTORY FORM
Hon.Trsda 8acrat Piga
3
Chemical Name: ~ Flexl=31~' PA, Fi~et & Re~llnlahef CAS #-
Common Name: r~ F~ DOT #-
Physical Hazard: FIRE: PRESSURE: REACTIVE: ~
Health Hazard: IMMEDIATE HEALTH: DELAYED HEALTH: ~
Physical State: FORM: Solid: Liquid: x Gel: Dult:
TYPE: Pure: Mixture: x~
;~ Dayatyear on-alta: 386 Unit of Measure:
Amount and
Time at Facility: Maximum Amount: s~JJOlll gals: r~
Average Amount: 4 gaa~ lbs:
Container Type: ~ aot~ cu ft.
Storage Pressure: Ambient. Storage Tamp:
Location(s):
(Provide ~lrid coordinated from completed facility map.)
Percent Concentration & components
0
1-5 Sodium 8ullll
% _
%
NOTES: Tadl nem~m) I mynonym (e) or ottmr mfon~auo, miyata m mmnm~m) I~IO.
DATE PREPARED: MAKE COPIES OF THIS FORM AS NEEDED
REMEMBER TO ATTACH MSDS TO THIS FORM IF THE MATERIALI8 NOT LISTED IN APPENDIX 1.
~_~X' - J ff~
HAZARDOUS MATERIAL INVENTORY FORM
Hon-Trldl 8acret
Chamicai Name; ~ Re~m 8a~l~ & ~D~hlr LF CAS ~
Rim
Common Name: DOT
P~ysicsi Hazard: FIRE: PRESSURE: R~CTNE:
Health Hazard: IMMEDIATE HEALTH: DE~YED HEALTH: a
Physical Sta~: ~pE;FORM: Pure:S°iid:~ Liquid:Mixture: x x Gaa: ~ Du~t: ~ A
~ Days/year on-aLta: 385 0hit of Measure:
~mount an~
Confiner ~pe: ~aom~ CU~
S~mge Premium: ~ Storage Tem~: ~
Lo~tion(.): (~rovlde ~dd ~ordinate~ from completed ~cill~ map.} , _
Pement con~ntmtlon & componan~
_%
/
% ,
%
NOTES: Tm~ n~) I ~ym (a) or o~ l~a re~vam to ml~l(I)
DATE PREPARED: ~E COPIES OF ~IS FORM ~ N~DED
REMEMBER TO A~ACH MaDS TO ~lS FORM IF ~E ~R~ IS NOT U~ IN APP~D~ 1.
~u ~.gy- j /~. ~-~
HAZARDOUS MATERIAL INVENTORY FORM
Non.Trade Seoret Page
FACILi~
Chemical Name: ~ak ~ ~ O~ ~ln~ CAS
Common Name: DOT
Physical Hazara: FLEE:__ PRESSURE:__
~eatih Hazara: IMMEDIATE HEALTH: __ DELAYED H~LTH:
Physical Stare: FORM: Solid: Liquid: ~ Ga~: , Dust: __
~PE: Pure: Ml~m: ~
' ~ Days/year on-.ire: 385 Unit of Measure:
kmount an~ m
~me at Facili~: Maximum Amount: ~ gals:
Average Amount: 4~ lbs: a E
Container Type: ~e ~ cu
P~um: ~ S~mge Tem~: ~ R
Storage
Lo~tlon(s): (Provide ~fld ~ooralnli~l ~m ~mple~ flall~ map.) ,
Percent con~ntmfion & componen~
~1o0 % wa~ A
% _
I I
DATE PEEPAEED: ~KE COPIES OF ~18 FO~M ~ NEEDEB
REMEMBER TO A~ACH MSDS TO ~15 FORM IF ~E ~R~ I~ NOT ~8~D IN ~P~D~ 1.
HAZARDOUS MATERIAL INVENTORY FORM
Non.Tre;ie Se=ret PIga
FACiLITY NAME: ~t'[-~. i¢)lr~ ...~/~ ITEM#
Chemical Name: Kod~ Bt~caa' RA ltle~a~ FI~ & Re~r CAS
Common Name; ~r a~mm F~ DOT
Physical Hazard: FIRE: PRESSURE: R~CTNE:
Health Hazard: IMMEDIATE HEALTH: ~ OE~YED H~LTH:
IVl
Physi~lS~te: FORM: Solid:~ Liquid: x Ga~: ~ Duet: ~
~PE: Pure: ~ Mixture: x
~ Days/Year on-cite: 385 Unit of Measure:
Amount and m
~me at Facility: Maximum Amount: s ~ gala:
Average Amount: 4 ~
Container Type: ~ ~ ca
S~mge Pressure: ~t S~mga Tamp: ~
(Provide ~dd ¢~r~lnatel from ~m~ieted ~¢lllt~ map.)
PerCent Con~ntmtion & Component=
0
<1 ~um a~
NOTES: T~e n~(a) i~ (,) Or omar mm~um relevant m ~i~inal(l) ~a{.
DATE PEEPAgED: ~E COPIES OF ~lS FORM A8 N~ED
REMEMBER TO A~ACH MSDS TO ~IS FORM I~ ~E ~~ IS NOT LIS~ IN APP~DIX 1.
HAZARDOUS MATERIAL INVENTORY FORM
Non. Trade Secret Page
7
Chemical Name: Kodak Ek~r Prima ~ & ~ CAS ~- ,
Pa~r g~, DOT
C~mmon Name:
Physical Hazard: FIRE; , PEESSUEE: E~GTIVE:
Health Hazard: I~MEDIATE HEALTH: DELAYEB H~[TH:.,
~mount and T
~me at Facility: Maximum Amount: a~ gale:
Average Amount: ~ lbs: E
Con~lner Type; ~ ~' cu
S~mge P~um: ~ent S~mge Tamp:
Lo~aon(s): ~Provi~e ~a coorll~te~ from mmpleted fa=ll~ map.) I
Percent con~ntmfl~n & cem~nent~
m
NOTES: Tm~e na~m) I myn~ym tm) or ~ ~n~n m~vam m mmtm~m) ~.
DATE PREPARED:, MAKE COPIES OF THIS FORM AS NEEDED
REMEMBER TO ATTACH MSDS TO THI8 FORM IF THE MATERIAL IS NOT LISTED IN APPENDIX 1.