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BUSINESS PLAN 8/15/2002
Hazardous Materials/Hazardous Waste Unified.Permit CONDITIONS OF .PERMIT ON REVERSE SIDE ~, This _~ermit is issued for the followin_~: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-000753 [3 Risk Management Program FIRESTONE STORE #3589 [] Hazardous Waste On-Site Treatment LOCATION: 2331 CHESTER AVE 'IEED Issued by: Bake rs field Fire Department ~~ '~~~ OFFICE OF EN~R ONM~NTAL SER ~CES' ' ' ' 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 9330~ O~ofE~S~ic~ r Voice (661) 326-3979 F~ (661)326-0S76 Expiation Date: SITE'/FACILITY D I AGR~k~ FIRSSTONE'STORE SCATS: eUS~SS ~: Bakers~d, ~ 93301 r~oos: or 'DATE: / / FACILITY N~ME:. ~1~~~1 UNIT ~: OF (CHECK, ONE) SITE DIAGR,~M FACILITYDIAGR.~M ~ Inspector's Comments): -OFFICIAL USE ONLY- SiTE DIAGRAI~ (ReqUi ts,s) ,-. I. Address: Identify the 9. Lock (key) Box principle buildings by.the Street numbers. 10. MSDS Storage 2. Street(s), Allays, 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. Masonry 3. Storm Orains0 Culverts, Yard Drains c, Wood 4. Drainage Canals. Ditches, d. Gates Creeks, · 13. Powerllnes 5. Buildings a.,Fraee construction 14. Guard Station b. Masonry construction iS. Storage Tanks: ~ Identify the c. Metal construction capacity in gal. a; Above ground d. Access Door b. Underground 6. Utility Controls a.-Gas 16. Diking or Ber~ b. Electricity 17. Evacuation Route ., c. Water 18. Evacuation Area: Identify the ?. Fire Suppression Systems: location where a. Fire Hydrants employees will meet. b. Fire 'SPrinkler s 19. O~tstde.Hazardous Connections Masts Storage c. Fire Standpipe 20. Outside Hazardous Connections ' Naterlal Storage d. Water Control Valves ~1. Outside Hazardous for protection systems Material ~sa/Randling e. Fire Pump 22. Type of Hazardous Material/Waste Stored 8. ~ire Department Access or Used ~ee Below) ' TYPE OF HAZARDOUS MATERIA~ F - Flammable g - {Lxploalve L - Liquid R · Radlologlcsl C - Corrosive O "Oxldlzer~ O.~ -- ~----"'Oa' ..... ~-- Poison ~ · Water Reactive T - Toxic S - Solid H - Cryogenic . D · #sate E - Etiological Example: Flammable Liquid · FACILITY DIAGRAM (Required items In addltlon to the above) 1. Risers for Sprinklers 8. Fire Escapes ~. Partitions 9. Air Conditioning Units · ' 3. Stairways: Indicate the 10, Mlndowa levels served from highest to lowest. 11. Inside Hazardous MasSe Storags 4. Escalator: Indicate the levels served fro. 12. Inside Hazardous' highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous '~'~i Materials Use/Handling 6. Attic Access' 14. Se~er Drain Inlets 7. Skylights CITY OF BAKERSFIELD FIRE OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~" Floor, Bakersfield, CA 93301 ADDRESS ~33l ~~ ~ PHONENO. FACILITY CONTACT ~~ ~{~_5 BUSINESS IDNO. ~SPECTION TIME [.~ ~, d NUMBER OF EMPLOYEES Section 1: Business Plan and Invento~ Program ~ Routine bined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ ~e-inspection OPERATION C V COMMENTS Appr. opriate permit on hand Business plan contact information accurate V Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location c/ Proper segregation of material /,/ Verification of MSDS availability Verification of Haz Mat training ./ 'Verification of abatement supplies and procedures / Emergency procedures adequate l/ Containers properly labeled Housekeeping / Fire Protection Site Diagram Adequate & On Hand Any hazardous waste on site?: [2~Yes~9C~ Explain: IA/ - '0 - _' Questions regarding this inspection? Please call us at (661 ) 326-3979 Business ~h(tJe~ l~,espons~le Par~ / White-Env. Svcs. Yellow - Slalion Copy Pink - Business Copy Inspector: ,/q~,, FIRESTONE STORE #3589 == SiteID: 015-021-000753 Manager : RANDALL BROCK BusPhone: (661) 324-6457 Location: 2331 CHESTER AVE Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 30A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:7534 EPA Numb: DunnBrad:00-128-8109 += ........ Emergency Contact / Title Emergency Contact / Title Business Phone: (661) 324-6457x Business Phone: (661) 324-6457x/&~-- 24-Hour Phone : (661) ~ 24-Hour Phone : (661) Hazmat Hazards:~ RSs b3~-~~ Fire Im~lth DelHlth +_' ................................. . ........................................... Contact ': Phone: (661) 324-6457x MailAddr: 2331 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93301 .............................................................................. Owner FIRESTONE STORE ~27E2 Phone: (661) 324-6457x Address : 2331 CHESTER AVE State: CA City : BA~RSFIELD Zip : 93301 ............ ~ ....................................... Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs:-Yes .............................. Emergency Directives: ----+ += Hazmat Inventory One Unified List + +== Alphabetical Order Ail Materials at Site + + + + ~ ~ ~ .... +- - -+ I Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax lUnitlMCP] + + + + + +-~-+ COOLANT //~/~ F IH L 100.00 GAL Low MOTOR OIL z F DH L 250.00 GAL Min WASTE OIL - F DH L . 285.00 GAL Low -1- 03/07/2002 '7 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ADDRESS FACILITY CONTACT O--err,-,., ./'onoo re, BUSINESS ID NO. 15-210- INSPECTION TIME /cA: O0 NUMBER OF EMPLOYEES .%'- Section 1: Business Plan and Inventory Program [~ Routine [~ Combined [~ Joint Agency [~ Multi-Agency ~l Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?:. I~ Yes Questions regarding this inspection? Please call us at (661) 326-3979 Business ~'i~~:ible Pans Whi,c - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES '-2.._.~.~ UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME /~~'~/~' INSPECTION DATE ~/?~'-~/{~) ADDRESS ~ ~ ~ { C{-/JSf,.~7'",L~-'/~ PHONE NO. ~ ~ / -- ~ FACILITY CONTACT ~PcMD,qdy-- ~oc./c. BUSINESS ID NO. 15-210- INSPECTION TIME ~_.C2) ~! tM NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~Routine [~ Combined [~ Joint Agency [] Multi-Agency [] Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address / Correct occupancy / Verification of inventory materials / Verification of quantities / Verification of location / Proper segregation of material / / Verification of MSDS availability / Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled / / Housekeeping Fire Protection x/ / Site Diagram Adequate & On Hand d n C=Compliance V=Violati°n Any hazi~rdous .waste.on site?: []~l..Yes [] No Questions regarding this inspection? Please c~ll us at (661)326-3979 Bu,, Partyo White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector'/f~~~At..--~ Hazardous Materials Disclosure Infer tion EiVED Bakersfield, CA Kern County '1 OUl iI% 1999 Site I.D. 215-000-00~ 6/0/99 Busine~ Phone: (661)324-6457 Map: 103 Gdd: 30A CommHaz: Low EPA · CAD 981 981 459 FacUnits: I AOV SIC Code: ' 5531 'Mail Notices to: lFirestone Store' · 3589 "~ Bridgestone / Fire,one Distd~ Office (AMTS) 2331 CheWer Ave. 2361 Butane Drive Bakemfield, CA 93301 .. Sacramento, cA 95825 Attention: Brian Miller Ph: (916) 486-3852 IPhone: (661)324-6457 I Fire District: ~ Bakemfield Fire Dept. ~ Section 2~ontact Info~ation A. Name of ~n~ct dudnR busings houm: Sh~ Houm Name / T~e Phone Numar 17AM-6PM Randall'Brock, Store Manager ~ ~(661)324-6457 ~ B. Two names etc. to ~n~ct after business houm: Sh~ Hours Name / T~e ' Phone Number 17AM-6PM Randall BrOck, Store Manager I (home) 1(661) 399-4311 I Sh~ Houm. Name./T~e Phone Numar 17AM-6PM Chuck Robitaille / Asst. Dist. Mgr. (Page) ~(916) 828-6288 ~ Sh~ Houm Name / T~e Phone Numar 17AM-6PM Bdan Miller/DiSt. eps. Asst. I (page) 1(916) 828-5446 I Shift Houm Name / T~e Phone Numar [7AM-6PM Mike Robe~s, Asst. Mgr. I , (home) [(661) 834-7215 ] C. T~ names to ~n~ in ~ of emergency Haz. Mat. Incident: Sh~ Houm Name / T~e Phone Numar ]7AM-6PM Randall Brock, Store Manager I (home) [(661) 399-4311 ] Sh~ Houm Name / T~e Phone Numar [7AM-6PM ' Chuck Robitaille / As~. Dist. Mgr. (page) [(916) 828-6288 ~ Section 3-General and Buildin~ Info~ation DBA (Doing Business As) if d~erent ~an business name · . Firestone Tire and Se~ice Center Description of main business operation Automobile and light truck servicing and repair. NOTE: The undergrOund waste oil storage tank has been removed from this site. Waste oil is now stO'red in the shop area at the south end of the building. (285 Gal. Cap.) ., .. Page 1 Employee information - # of employees on site Per shift hours: Additional Business Info: Shift Hours ' Day of Wk. Number of employees ~tandard Industriai Code (SIC) I 5531 I 7:30A-6PM - M - F - 7 UBC). Shift Hours " Number of employees iniform Building / Occupancy Code I B-1 / B-2 I 8AM,5PM SAT.' 7 · Shift Hours Number of employees .ot Size (square. feet' or acrea, ge) I Unknown SUN. Closed Number of Floors ' ' ' I 1 There is second floor fire storage accomplished with raised metal grating behind shop area. Reporting Status (section 4) J E Section 4-Chemical Disclosure Information-Reportin,q Status A. No chemicals are used in any way in our business. · B. Chemicals are used in our company, but we do not meet the requirements for discloSure. We have no chemicals in amounts requiring disclosure. C. chemicals are used in our business and we are submitting our initial Hazardous Materials Disclosure Packet. D.' We have reviewed our records and we have no changes from previously submitted information. E. We are submitting a renewal with changes as indicated. ' ~SPEClAL NOTICE FOR DISCLOSURE PACKET UPDATES**** ,~..~ If any of the following occur, you are required to notify our department within.30 days to complete an updated disclosure form! 1 Change of business address. 6 Reclassification of TRADE SECRET INFORMATION. ~ 2 Change of business ownership. 7 Change of handling or usa of previously undisclosed 3 Change of business name. hazardous material, waste, or combination thereof. 4 Cessation of'business oPeration. 8 ' Storage of any new hazardous material that would 5 Change of business occupany class (UBC). require you to comply with disclosure laws. · 9 A significant change in handling inventory quanity (100%) of any hazardous material for which disclosure information has already been made. Page 2 Section $--Siqnature I certify, under the penalty of perjury, that the above information is true and correct to the~best of my knoWledge. -' ~~/Z~'~ ' 6/8/99 '~ture ' ~ .... Date Brian N. Miller District Staff Assistant Please return form to: Bakersfield Fim Department Administrative Services 2101 'tH" Street Bakersfield, CA 93301 (661) 326-3941 (661) 395-1349 (fax) hazmatfm.xls 3/23/98 IMPORTANT: Business are required to update their Business Plan & Disclosure information annually. Page 3 FIRESTONE STORE SiteiD:.~215_000_000753 Manager : ~~J~ ~/~' SusPhone:. ~! ) 324-6457 Location: 2331 CHESTER AVE Map-: 103 CommHaz ~ Low City : BAKERSFIELD Grid: 30A FacUnits: 1 AOV: C°mmCode: BAKERSFIELD STATION 01 SIC Code:~/ EPA Numb: ~/~-~i~ ~/~ DunnBrad:00-128 Emer~encvC~ntact / Title Emer~encZ Contact / Title ~~i ~~. / ~AGER ~/~ ~~ / ~SIST~ 324-6457x Business Phone: ~/~324-6457x Business Phone: 2~-Hour Phone : {~/~ ~-~/ 24-Hour Phone : (~,)'~ Pa~er Phone : ( ) - x Phone : ( Hazmat Hazards: Fire . DelHlth Emergency Directives: += Hazmat Inventory One Unified List + +== MCP+DailyMax Order Ail Materials at Site + ~ ....... + ~ ..... + .......... + .... +__ -+ Hazmat Common Name... ISPecHazlEPA HazardsI Frm I DailyMax IUnitIMCPI + ....... + ........... + ..... +_ ~ .... +_ _ _+ WASTE OIL ~:~ F DH L ,~'~' 24Y0- GAL Low MOTOR OIL . F DH L 250 G~ Min ~ewed the ;~acn~d ha~;a~:::.~:,.: ~ m~ ma~ + FIRESTONE STORE#~1 SiteID: 215.000-000753 + + ............ Fast Format + += Notif./Evacuation/Medical Overall~ Sit~ + +== Agency Notification 02/28/1991 + CALL 911 AND oFFICE OF EMERGENCY SERVICES 1-800-852-7550 +=== Employee Notif./Evacuation 02/28/1991 ALL EMPLOYEES ARE TO LEAVE BY' SHOP DOORS IN EMERGENCY. .... Public Notif./Evacuation 02/28/1991 · PUBLIC TO' LEAVE BY MARKED EXITS OR SHOP DOORS Emergency Medical Plan 02/28/1991 SAN JOAQUIN COMMUNITY - 2615 EYE ST - 327-1711 (2 BLOCKS AWAY). -2- / -FIRESTONE STORE~2 siteID: 215-000-000753 Fast Format ~a~on/Prevent/Abatemt Overall Site .==~=~-'-'----Release Prevention 02/28/1991 WASTE OIL IS "STORED//%/~/~A~/'~ TANK. ALL SPILLS ARE WIPED UP WITH RAGS THEN-PUT IN METAL CONTAINERS. .... Release Containment 02/28/1991 OCTOSORB SYSTEM .... Clean Up 02/28/1991 OCTOSORB SYSTEM ...... Other Resource Activation ..... + FIRESTONE STORE~ SiteID: 215-000-000753 + ~ Fast Format + += Site Emergency Factors' Overall Site + +== Special Hazards . ~ -=== Utility Shut-Offs 02/28/1991 + A) GAS..- NONE -- , · B) ELECTRICAL - STORAGE ROOM SOUTHWEST CORNER C) WATER - ALLEY D) SPECIAL - NONE · ~ E) LOCK BOX - NO + .... Fire Protec./Avail. Water 02/28/1991 + 'PRIUATE· FIRE PROTECTION - FIRE EXTINGUISHER ~ FIRE HYDRANT - ON 24TH ST NORTH END OF BUILDING Building Occupancy Level -4- / + FIRESTONE STORE SiteID: 215-000-000753 + + Fast Format + += Training .. Overall Site + +== Employee Training 02/28/1991 + WE HAVE'EMPLoYEES AT THiS FACILITY EMPLOYEES :- EMPLOYEES ARE BRIEFED ON SAFETY PROCEDURES ~=== Page 2 + .... Held for Future Use I, + ...... Held for Future Use FIRESTONE TIRE & RUBBER CO '~:1:~,~ SiteID: 215-000-004~*~ = Inventory Item 0002. Facility unit: Fixed Containers on Site 9 --'COMMON NAME / CHEMICAL NAME NEW OIL ' Days On iSite · 365 Location within this Facility Unit Map: Grid: 8002-65/9 = STATE --~- TYPE . PRES'SURE TEMPERATURE CONTAINER TYPE Liquid I.'Mixture I Ambient IAmbient ABOVE GROUND TANK AMOUNTS AT THIS. LOCATION Largest Container ' Daily Maximum Daily Average 250.00 GAL 250.00 GAL 150.00 GAL HAZARDOUS COMPONENTS 100.00 Motor Oil, Petroleum'~Based 8020835 HAZARD ASSESSMENTS ITSocrotlNoRSIBioHazI Radioactive/Amount I EPA Hazards NFPA I USDOT# I MCP No No No/ Curies DH / / / Min FIRESTONE TIRE & RUBBER CO # ~~~~ SiteID: 215-000-000~ [~ Inventory Item 0004 ~~~ Facility Unit: Fixed Containers on Site o Days On Site ELECTROLYTE STORAGE BATTERY o · .~ocation within this Facility Unit Map: Grid: ¢" ~f~,-~.,,~. . _,W~~. ~.,~-./_ ./,W.~,~. ~'~'W'~.~" ' o° ~7664-93-9o # £~ STATE ~ TYPE'.~~ PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE Liquid o MiXture o Ambient o Ambient o PLASTIC CONTAINER £~~~~~~x AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average 5.00 GAL o 10.00 GAL o 10.00 GAL ~~&~&~A~&~&A~6~6~A~eeeeeeeeeeeeeeeeueeeeeeeeeeeeeeeeeeeeeeeee~ o RSo CAS# %Wt. o 34 00°Lead ONo o 7439921 · oyeso 7664939 11.00oSulfuric ACid (EPA) · . ......................... ~~~~~~~~~~~eeeeeueeeueeeeeeeeeeeeeee$ .TSecreto RSOBioHazo Radioactive/Amount °'EPA Hazards o NFPA o USDOT# o MCP No °No ~ No o No/ Curies o R IH DH o / / / o o Hi ' ' ~'~~ Facilit Unit'- Fixed Containers on Site ~1 Inventory Item 0005 eaeaa e Y . . ............. [~ COMMON NAME / CHEMICAL NAME ~~~~~~eee~eeeeeeee~eeee~eel o Days On Site Location within this Facility' UP~ Map: Grid: ~~~~ .......... - .... ' o CAS# £~ STATE ~ TYPE ~~ PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE eeeeei Liquid .o Pure o Ambient o Ambient o pLASTIC CONTAINER Largest Container o Daily Maximum o Daily Average 55.00 GAL o 100.00 GAL o 100.00 GAL f~e~e~i~~~ HAZARDOUS COMPONENTS ~~~~~~~i o RSo CAS# %Wt. o 100.00OEthylene Glycol ONo o 107211 .TSecreto RSOBioHazo Radioactive/Amount o EPA Hazards o NFPA o USDOT# o MCP No ONo o No o No/ Curies o F IH o / / / o o Low MISCELLANEOUS RECEIVABLES ADJUSTMENT ,~ ./ /-.-~ ~^~ ~-/~-~ .~ccou.~ ADDRESS CHANGE ' CLOSE ACCT j · FINANCE CHAReE t · OTHER ADJ I'~X CUSTOMER NAME MAILING ADDRESS CITY ~~_~'s '~ 'c~Ot', STATE (~.~' ZIP CODE~'B (~/ SITE ADDRESS PARCEL NUMBER OF,APPLICABLE) ADJUSTMENT I I CHG DATE CHARGE CODE ADJUSTMENT AMOUNT =lOIS ::ISH::::IA::::IH NO IlINH=Id dO SNOIIlONOD ~!m,~od po!j!ull o~SeA~_ snopa~z~H/Sl~!.~O~lAI snopaezeH 09/03/93 FIRESTONE STORE~'15~000-000753 Page Overall Site with % Fac. Unit General'~nformation Location: 2331 CHESTER AV ~ Map: 103 HaZard: 'Low Community: BAKERSFIELD STATION 01 Grid: 30A F/U: 1 AOV: 0.0 2~-Hour Phone- C°ntaCt Name I Title / I Business Phone li(8~5~83~250 IMARCHI MANAGER (805) 324-6457 x ~SS~- ~K' ~ (,805) 324-6457 x ( ) · Administrative Data Mail Addrs: 2331 CHESTER ST D&B Number: 00-128-8509 City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 7534 Owner: FIRESTONE STORE ~ Phone: (805) 324-6457 Address: 2331 CHESTER ST State: CA, City: BAKERSFIELD Zip: 93301- Summary · RECEIVED HAZ? ~AT. DIV. 0... I, -;~,~,~,, /'~/,'//~-~ - D° hereby certify that I have '" (TY~ orprint name) ' reviewed the attached hazardous materials manage- /~;~/~,,,~ ~/~and that it along With ment plan ~0r any corrections constitute a complete and correct man- · agement plan fOr my facility. 09/03/93 FIRESTONE STORE~15~000-000753 Page. 2 Hazmat Inventory List in MCP.Order 02 --Fixed containers on Site .Pln-Ref Name/Hazards Form Max Qty MCP 02-001 WASTE OIL Liquid 300 Low · Fire, Delay Hlth GAL 02-002 MOTOR OIL Liquid 250 Minimal · Fire, Delay Hlth GAL 09/03/93 FIRESTONE STORE~215~000-000753 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 WASTE OIL Liquid 300 Low · Fire; Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: WaSte Days: 365 Use: WASTE -- ~Daily Max GAL ~ Daily Average GAL Annual AmOunt GAL I ' o.oo I ,ooo.oo S~o~age .press T ~emp Loca~io~ ABOVE GROUND TANK AmbientlAmbientlSOUTH END IN SERVICE AREA -- Conc Components -~Guide 100.0% IWaste Oil, Petroleum Based ILo~cP ! 27 02-002 MOTOR OIL',. LiqUid· 250 Minimal · Fire, Delay Hlth ~. GAL CAS #: .8020835. Trade Secret: No Form: Liquid· Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL250 ,I Daily Average200.00GAL I Annual Amount800.00GAL .Storage ~~Press T.Temp Location ~ABOVE GROUND TANK IAmbientlAmbientlS END SHOP AREA -- Conc Components MCP ,--~Guide .100.0% IMotor-Oil, Petroleum Based Minimal I 27 09/03/93 FIRESTONE STOREs~15~000-000753 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 AND OFFICE OF EMERGENCY SERVICES 1-800-852-7550 <2> Employee Notif./Evacuation ALL EMPLOYEES ARE TO LEAVE BY SHOP DOORS IN EMERGENCY. <3> Public Notif./EvaCuation PUBLIC TO LEAVE BY MARKED EXITS OR SHOP DOORS <4> Emergency Medical Plan SAN JOAQUIN COMMUNITY - 2615 EYE ST - 327-1711 (2 BLOCKS AWAY). 09/03/93 FIRESTONE STORE ='~15~000-000753 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention WASTE OIL IS STORED IN UNDERGROUND TANK. ALL SPILLS ARE WIPED UP WITH RAGS- THEN PUT 'IN METAL CONTAINERS. <2> Release Containment OCTOSORB SYSTEM <3> Clean-Up ocToSORB.SYSTEM <4> Other Resource Activation 09/03/93 FIRESTONE STORE='~15~000-000753 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - STORAGE ROOM SOUTHWEST CORNER C) WATER - ALLEY 'D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER FIRE HYDRANT - ON 24TH ST NORTH END OF BUILDING <4> Building Occupancy Level 09/03/93 FIRESTONE STORE %~5~000-000753 Page 7 00 - Overall Site <G> Training <1> Page I WE HAVE 8 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: MATERIAL SAFETY DATA SHEETS ARE AVAILABLE TO EMPLOYEES - EMPLOYEES ARE BRIEFED ON SAFETY PROCEDURES <2> Page 2 as needed <3> Held for FutUre Use <4> Held for Future Use · ~ Bakersfield Fire Dept. " HAZARDOUS' MA]'ER~LS DIVISION Bus~n~Sldentification No. 215-000. ©c)c)75'-$~' ('l'opof~]B.usiness~3~) ' Station No. ~ Shift' i~,' inspector ~,/~ Adequate Inadequate RECEIVED Verification of Inventory Materials Verification of Quantities. [~ [[~ HA? ~.,~T. DIV. Verification of Location · Proper Segregation of Material Comments: .,,- ,~.~ Verification. c~°f MSDS Availablity [~] ~.~, Nu__m_mber of EmplOyees Verification of Haz Mat Training Comments: Verification of Abatement Supplies & Procedures Comments: ' Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram [~] [[~] Special Hazards Associated with this Facility: ViolmionS~ · "~ All Items O.K. [~ { ~/ ' Correction Needed ~] 'r/l~lanager FD l~5~.(Rev. 1:90) '. ' ' Whita-Haz Mat Div. Yellow-Station Copy Pink-Business Copy 02/11/92 FIRESTONE STORE -215-000-000753 Page 1 Overall Site with 1 Fac. Unit General Information Location:. 2331 CHESTER AV Map: 103 Hazard: Low Community: BAKERSFIELD STATION 01' Grid: 30A F/U: 1 AOV: 0.0 ~~,,,~ ~t~~lA~ ["~l Title Business Phone 24-Ho~o~- Administrative Data Mail Addrs: 2331 CHESTER ST D&B Number: 00-128-8509 City: BAKERSFIELD State: 'CA Zip: 93301- Comm Code:. 215-001 BAKERSFIELD STATION 01 SIC Code: 7534 Owner: FIRESTONE STORE Phone: (805) 324-6457 Address: 2331 CHESTER ST State: CA City: BAKERSFIELD Zip: 93301- Summary RECEIVED M&lq 3 I 1992 HA7' I~a&T..DIV. '"' r~v" - m ,'_.~PO hereby cerli~ that ~ have' I~,m or Pint name) .' reviewed the a~c~,. ~,~s,~n,~ materials manage- merit ptan for~~~ aha ~ha~ it along wi~h any conec~ions ~nSdtu~e a complete and corrcc~ man- agement plan ~or my 02/11/92 FIRESTONE STORE ~215-000-000753 Page 2 02 - Fixed Containers on Site HaZmat Inventory Detail in ReferenCe Number Order 02-001 WASTE OIL Liquid 200 Low · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily avera~ Annual Amount GAL -- Daily Max GAL { !/~.[~ I 1,000.00 Storage I/Press T Temp Location ~d~JDER CROUND~*I~AT,,~K--~ · IAmbient~Ambient~ END F.,~O~T .~ Components MCP List ~00.0% IWaste Oil, Petroleum Based IL°w I 02-002 MOTOR OIL 'Liquid 250 Minimal · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form:Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL Daily Average GAL Annual Amount GAL -- 250 I 200.00 I 800.00 Storage . Press T Temp~ Location ABOVE GROUND TANK AmbientlAmbientls END SHOP AREA -- Conc Components I MCP List 100.0% IMotor Oil, Petroleum Based IMinimal I 02/11/92 FIRESTONE STORE. 2~15-000-000753 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 AND OFFICE OF EMERGENCY SERVICES 1-800-852-7550 <2> Employee Notif./Evacuation ALL EMPLOYEES ARE TO LEAVE BY SHOP DOORS IN EMERGENCY. <3> Public Notif./Evacuation PUBLIC TO LEAVE BY MARKED EXITS OR SHOP DOORS <4> Emergency Medical Plan SAN JOAQUIN COMMUNITY - 2615 EYE ST - 327-1711 (2 BLOCKS AWAY). 02/11/92 FIRESTONE STORE 215-000-000753 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention WASTE OIL IS STORED IN UNDERGROUND TANK. ALL SPILLS ARE WIPED UP WITH RAGS THEN PUT IN METAL CONTAINERS. <2> Release Containment OCTOSORB SYSTEM <3> Clean Up OCTOSORB SYSTEM <4> Other Resource Activation 02/11/92 FIRESTONE STORE 215-000-000753 Page 5 00 -Overall Site <F> Site Emergency ~actors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - STORAGE ROOM SOUTHWEST CORNER c),WATER - ALLEY D) SPECIAL'- NONE E) LOCK. BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER FIRE HYD.RANT .ON 24TH ST NORTH END OF BUILDING <4> Building Occupancy Level 02/11/92 FIRESTONE STORE 215-000-000753 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 8 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: MATERIAL SAFETY DATA SHEETS ARE AVAILABLE TO EMPLOYEES'- EMPLOYEES ARE BRIEFED ON SAFETY PROCEDURES <2> Page. 2 as needed <3> Held for Future Use <4> Held for Future Use 02/11/92 .FIRESTONE STORE 215-000-000753 Page 1 Overall. ':Site ;:with ~,1 ~;;Fac;: Unit' '':: "103 Haz rd:.,LoW~] Location: 2331JCHESTER:.AV . - ' . · ' .' ...Map:. ~ ' . Co'unity :- BAKERSFIELD ~ STATION .,01'~-,~:~-:~;-~-::. ;~' ~, ~:'~,Grtd .~¢30A-;:3F/U.-~'-~:1 AAOV-. ~:0-~ 0 Contact. Name Title-~'. '- Business-:~Ph°ne 'v'~ ..... 24-Hour ]Phon~ City: 'BAKERSFIELD · · ' "' ' '- ' Zip. '93361:" ' ' ] .~ Sugary .... r I, .... '" D° hereby'~Ce~i¢ t~t I hav~ '" ffv~ ~ ~n~) . ' · ~-~,~,,~,~ r~az~rdous materials manage- "' ment plan for ..~ ~, -. ...... ~,,~ ,nat it along with any mrroctions ~nst~t[qe a complote and m~¢~ man- agement plan for my faci~. ' ' ',. CITY of BAKERSFIELD Farm and Agticulture E] Standard Business [-]HAZARDOUS HATERTALS INVENTORY · ' NON--TRADE SECRETS BUsINEss NAME: ~1:5)~._'C~ ~ OWNER NAME: Z~ NAME OF THIS FACILITY:~[~~ ~-( ~ ~ / REFER TO ~,~,RU~'/~N5 ~uR PROPER CODES Trans ~y~e ~4x Average' Annual Hea~ure I ~ys Cent ConC ConC Us Location?eEo. Code ~oee AmC Amc EsL Units on ICe Type Press Temp Co~eStored In ~aCl/ICy Physical and Heatth Hazard ; C.A,S. Humber Component II Name C,A,S. Number (Check all that apply) ' ' ; Component 12 Name I C,A,S, Number ~re Hazard ~ Reactivitr ~ Pelayed ~ Sudden Release ~ : ~Health of Pressure ~, Component t3 Name I C,A,S, Number Physical 80d Health Hazard ~ C,A.a. Number Component II Name I C,A,S, Number '. (Check 8/1 Chat appl~) Componen~ 12 Name & C.A,S. Number ~Fire Hazard U Re,ctivit~~DelayedHealLh U Suddenof PressureRetease U : Component 13 Name & C.A.S, Number Physical end He81th.~azard :,~ C,A,S, Number ~~ ~/ I Component t1' Name & C,AJS, Number (Check all that apply) · ~ Fire Hazard ~ Reactivit~ ~elayed ~ Sudden Release ~mediate Componeng 12 Name A C,A,S, Number - ,, ? Health of Pressure ~Health · ~. Component 13 Name I C,A,S. Number Physical and Health ~zard' : C,A,S, Number ~ Component l1 Name I C;k,S, Number / (Che;k .all that apply)~ ' Component 12 Name & C,A.S, Number ~ire Hazard ~ ReactiveLy~layedHeaiCh ~ Suddenof PressureRelease ~ ~ Component t3 Name I C,A,S. Number . - Z4Hr Phone' N~me ·" ertifi atio ',(Re~ a.nd.~icn af~r compl~tT(]g.all sectipn~) ~ certify un'er enamc~ o~a~ cnqc Jrt,ye pe~sonal~y.exaAlnq~eqo ~m ramil~ar, vitb the intormac)pn ~u~mittpd in thiS.Qnd a11 at~ached,doc~men~, 8nO C~ac oaseo on.my ~nqu]ry ~.cnose ~no~v~oua~s responsible ~or obta~nin9 cne ~ntormac~on, ] be~eve Cha. C the ~~ titl~ oi ou~erloper~tor uH o~ner/operstor'[s ~utnorlzeo reuresentac~ve CITY of BAKERSFIELD Farm and Agriculture ri Sta.ndard Business riHAZARDOUS MATERIALS INVENTORY ,. ............................. '? TRADE ':~SECRETS PttONE ~: ~ ~,~ - , · ~' -- .' PHONE ~: ' ~ ~ ~ ~ ), REFER TO~NSTRU~ONS FUR PROP~ CODES - - 1 2 3 4 5 G , 8 9 10 11 I~ Trane ~y~e ~ax Average Annual Heasure I~[e ConL ConL Cont ~e Locqtion?ece. Code ~ooe AmC AmL ~. EsL Un,ts on Type Press lemp Stored IC~eci ~1/ that ~ll) - ~tre Hazard ~ Reactivity n Delayed ~udden Release n lm~i~ Component Health of Pressure Component 13 ~aae I C.A.S. Number ~1~ I :~ls~. I i1~ I~l:~ql~l ~-I v' I~1 ~ire Hazard B Reactivity. B Delayed ~udden Release B Im~i~ Component 12 ,am,~ C.A.S. Number ~ · Health ~ of Pressure Component 13 Name t C.A.S. Number ~-I ~1~ I~ Ilo ~ I~1 ~~ ~1 ~L ~ I~l.s~ ~c~ ' ~7~ ~ ~'~ Component P~y'sical Health'Ualard C,A,S. Number (Check all LhaL lpp/~J ~ire Hazard ~ Reactivity ~ Delayed ~Sudden Release ~ ]m~i~ C°mp°nenL Health ~ of Pressure Component Physicil igd Health UaTard C.A.S. Number ~ ~ ~-'e CoAponent II Name (Check all-that apply) ~ ' , ~i~e ,~zard D ,e~ti~ity ~ 0el,ed ~ Su,ae. ,e~ease ~ [,~i~ Co=,o,ent ~ ,a. ~ C.A.S. ,,~ber Hea/[h of Pressure Component 13 Name I C.A:S. Nueber er:i[iHLioq ,(Repfl p.nd.~ign af¢pr compl~Cfpg.all securing) certify under pena~tX gl~a~ tnqt ~navepe[sonaJ~y, exaaln~g~qoie ta~i~ta(.~it~ the ~n[oreat)pn ~u~aittpd in thisAnd all Ge~t ~p'd ~tlcJ81 [t(~o.nerioperltor UH o~ner/operator;~ 8u[horJled representative ' Page 1 Overall Site wi th 1 Fac]. Ur, it d ~ '~ ) i~ GerJeral Ir~format iorJ Locatior~: 2331 CHESTER AV Map: 103 Hazard:- Low Ident Number: 215-000-0o0753. -- Grid: ~)A~(' Area of Vul: 0.0~ Contact Narne ~ Title I Business ,Phone ~ 24 Hour Phc, ne] I (805) 384-6457 x --'~0~' ' .... VINCE MILLER ~~ ~ R" ( ) - x (A9> }~¢ Administrative Da~a Mail Addrs: 2331 CHESTER ST~ D&B Number:~ City: BAKERSFIELD .~~ State: CA Zip: 93301- Corem Cc, de: 215-0C)1 BAKERSFIELD STATION C)l SIC Cc, de:'7~-- Owner: FIRESTdNE STORE Phone: (~S)~ - Address: 2~31 CHESTER ST State: CA City: BAKERSFIEUD Zip:''94~J1--' Summary ~EB 0 1 1~I~ I HAZ. MAT, DIV. (])1/24/91 FIRESTONE STORE 215 (])0(])-0(Zi(.753 Page Hazr~at Ir~verstory List irs MC~ Order (:)2 - Fixed Contair~eris ors Site Pln-Ref Nars~e/Hazards Fc, rf~ Qu~r~t ity MCP 02-(~01 WASTE OIL _ Fire~ Delay Hlth Liquid 20(:) Low GAL £)2-()£)2 MOTOR OIL Liquid .25() Mirsif~al Fi~Je, Delay Hlth GAL F'~ESTONE STORE 215-00A-000~ Page 01/24/.91 00 - Overall Site <D> Not if. /Evacuat lotto/Medical <1> ~Agency Notificatiorm <2> Employee Notif./Evacuation ALL EMPLOYEES ARE TO LEAV'E BY SHOP DOORS IN EMERGENCY. <4> Emergency Medi'cal Plan SAN JOAQUIN COMMUNITY - 2615 EYE ST - 327-1711 (2 BLOCKS AWAY). [)1/24/91 FIRESTONE STORE ~ 1 ~-(.)(.)(.)-(.)(.)(. 7 ~ ~ Page 4 00 - Overall Site <E> Mit igat ior~/Prevent/Abater~t <1 > Release' Prever, t ior, ~ WASTE OIL IS STORED IN UNDERGROUND TANK. ALL SPILLS ARE WIPED UP WITH RAGS ]'HEN PUT IN METAL CONTAINERS. <2> Release Cor, tain~er, t- Clean Up <4> Other Resource Act i vat i or, 01/24/91 F~S'TONE STORE 215-'000-000] Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards '<2> Utility Shut-Offs · A) GAS - NONE B) ELECTRICAL - STORAGE ROOM SOUTHWEST CORNER C) WATER - ALLEY D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECTION - FIRE HYDRANT - ON 24TH ST NORTH END.OF BUILDING <4> Held for Future use 01/~4/9'1 FIRESTONE STORE ~ 15-000-000753 00 - Overall Site Page 6 <G> Training <1> Pag~ 1 WE HAVE 8 EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DA]'A SHEETS ON FILE? ~, <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use July 26, 1990 Mr. Vince Miller Firestone Store 2331 Chester Avenue Bakersfield, Ca. 93301 Dear Mr. Miller: Enclosed-you will find s computer printout of the Hazardous Materials Mansgement Plan that we have in the computer, please updste snd address all highlighted areas. Due to a change in the lsws ths~ went into effect Jsnusry, 1989~ we need to have a new inventory form (enclosed) filled out. This form must be filled out and returned to our office by August I0, 1990. If you have any questions please don't hesitate to contsct us at ~805) 326-3B?B. Sincerely Yours, Ralph £. Huey Hazsrdous Materisls CoordinatOr GENERAL INFORMATION: Important; If you reqUire more inventory forms than the one provided, you should make .photocopies of the forms prior 'to en{ering any information'on them. The additional copies must be on the same color paper as the original. 'Information must be typed/printed in English. Make a copy for' your records. Complete business name and address inf0rmaAion. If t hey have been required, the number of Separate facilit~ units will be determined by the Bakersfield City Fire Department. Give each facility unit a common name, and a one or two digit number. NOTE: An inventory form must be made for each separate facility unit. The top of the form must be completed for each facility - s h owl ng Business name and location as well as owner name and mailing address. Also include "SIC'~ Standard Industrial Classification Code and if available Dun and Bradstreet Number. Non-Trade Secrets.(White Form). Non-Trade Secret Materials in one facility unit. Trade Secrets (Yellow Form). Trade Secret Materials.in one facility unit. 1. TRANSACTION CODE: Is this inventory sheet new, an addition, deleti6n or update to your hazardous materials business plan.' - A '= Addition D = Deletion ... U = Update N = New 2. TYPE/CODE: For the purpose of this entry,' there are three types of hazardous materials: P = Pure M = Mixtures of pure substances W = Wastes. (Also add appropriate waste code) 3. MAXIM13MA~IOUNT: This should repres~nt the maximum'number of units of this material present at any one time. (Refer to the "UNIT" section of these instructions) 4. AVERAGE A~OUNT: · .This should represent the average amount, usually on hand at any one. time. !1. USE CODES: (Continued) 21. Grinding 34, Sealer 22. Heating S§. Spraying 23. Herbicide, S6. Sterilizer 24.~ Insecticide S?. Storage 25. Instructional 38. Stripping 26. Lubricant S9. Washing 27. Medical Aid or Process 40. Waste 28. Neutralizer 41. Water Treatment 29. Painting 42. Welding Soldering SO. Pesticide 4S. Well ~Injection Si. Plating 44. Oil Treatment S2. Preservative 99. Other - Specify SS. Refining 12. LOCATION WHERE STORED IN THIS FACILITY Briefly indicate the location of the material within the · . building/facility unit using compass points and obvious landmarks. 1S. PERCENT BY WEIGHT Indicate the concentration of each pure substance as a percentage of total weight. In the case of mixtures and wastes enter the maximum expected concentration of the three most Hazardous Components. Round off %. 14. NAMES OF MIXTURE/COMPONENTS EMERGENCY CONTACTS: Enter the name, title and phone numbers of two persons who are knowledgeable about this facility. PLEASE BE CERTAIN THAT FORMS ARE 'PROPERLY SIGNED AND DATED AT'THE BOTTOM CITY OF BAKERSFIELD ~ HAZARDOUS MATERIALS INVENTORY~ %~"~ Farm and Agriculture ~--] Standard Business ir' 'Page.. of ~Q~] NON - TRADE SECRET BUSINESS NAME: OWNER NAME.-, NAME OF THIS FACILITY: LOCATION: ADDRESS: STANDARD IND. CLASS CODE: CITY, ZIP: CITy, ZIP: DUN AND BRADSTREET NUMBER/FEDERAL ID #' PHONE #: PHONE #:. _ _ - - · ; REFER TO INSTRUCTIONS FOR PROPER CODES '. I 2 3 ,, 4 5 6 7 8 9 10 11 12 13 14 Trane Type Max Average Annual Measure # Days Cunt Cunt Cunt Use Location Where % by Names of Mixture/Components Code Code Amt Amt Amt Units on Site Type Press Temp Code Stored in Facility wt See Instructions Physical and Health Hazard C.A.S. Number Component # 1 Name & C.A.S. Number (Check all that apply) Component # 2 Name & C.A.S. Number [] Fire Hazard ~ Sudden Release '~ Reactivity ~ Immediate ~-~ Delayed of Pressure Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component # i Name & C.A.S. Number (Check all that apply) ~ Component # 2 Name & C.A.S. Number ' of Pressure Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component # 1 Name & C.A.S. Number (Check all that apply) , Component # 2 Name & C.A.S. Number I ~ Fire ~azard ~ Sudden Release ~ lleactivity [] Immediate ~ Delayed __ · of Pressure Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Co~onent # 1 Name & C.A.S. Number (Check all that apply) · Component # 2 Name & C.A.S. Number Fire Hazard of Pressure Health Health Component # 3 Name & C.A.S. Number EMERGENCY CONTACTS # 1 #2 Name Titl, e 24 Hr. Phone Name Title· 24 Hr Phone !ertification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) certify under peanlty of law that I hayer personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those individuals responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete. NAME AND OFFICIAL TITLE OF OWNER/OPERATOR OR OWNER/OPERATOR'S AUTHORIZED REPRESENTATIVE SIGNATURE . . DATE SIGNED .... :.,:~~?./ . ~,,,,~ C )L~~ RECEIVED ~ ty~e o: ~:in~ ~e ) JAN O g 1989 An~'d ............ Do' a=~=b,' ~.~ : c~rt~ _fy that I have reviewed the " attached Hazardous M~erz~z~ business ~lan -- a~d that ±t ~.lon~ with the attached a~d±t±ons or corrections constitute a complete and c'orrect Business Plan for m}. facility. :- - ' signature date BUSINESS NAME FIRESTONE STORE ID NUHBER 215-000-0007S3 LOCATION 22~gl CHESTER AU HIGH HAZARD RhTING 2 1. OVERVIEW LAST CHANGE 88/38/88 BY ESTER JURI'S COOE ZLS-001 JURIS BEKERSFtELO STATION 01 MAP P~GE 10~ GRID 30A F~CILiTY UNITS t- H~ZARD RATING Z RESPONSE SUHMARY Z~ sEC 4) NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS VINCE HILLER - 324-B4S? DR~=~°-~'~!~.~¢. UTIt. ITY SHUTOFFS A) GAS - N/A B) ELECTRICAL - STORAGE RO0~ SW CORNER C) NATER- ALLEY D) SPECIAL - NONE E) LOCK BOX .- NO NOTIFICATION / PUBLIC EVACUATION L~ST CHANGE / / BY < NO INFORMA'FION RECORDED FOR Tt!IS SECTION > PACE 1 12/28/88 11:34 MATERIAL SAFETY DATA SYSTEMS, INC. (805) G48-BG.(~ BUSINESS NAME FIRESTONE STORE ID NUMBER Z15-000-0007S3 LOCATION 2~1 CHESTER RV HIGH HAZARD RflTt~ Z ~. HAZ MAT TRAINING SUMMARY LAST CH~N~E / / BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHAN43E ~?/01/88 BY ESTER SEC S> SAN $OAQUIN COMMUNITY .- ZG1S EYE ST - 327-1711 (Z BLOCKS AWAY>. PAGE 2 12/28/88 I1:34 MATERIAL SAFETY DRTR SYSTEMS, INC. (805) $48-G800 BUSINESS NRME FIRESTONE' STORE ID NUMBER 215-OOO-OOO753 LOCRTION Z~.! CHESTER BV HIGH H~Z~RO R~I'ING 2 .. FRCILI'T¥ UNIT Ot ~ R. OVERRLL H~ZRRDOUS MRTERI~LS INVENTORY LRS1' CHRNGE O?/O1/~8 BY ESTER ID TYPE NRME M~X ~MT UNIT HRZ~RD LOCRTION CONTAINMENT USE 1 ~RS1'E ~ST~ OIL ~00 GRL UNKNOWN S END FRONT P~R~ING, LOT UNDERGROUND TRNKS ~flSTE iD PERCENT-COMPONEN¥S HRZRRDLIST 1S~B,OO 1OO.O' ~RSTE 0IL UNKNOWN Z PURE MoToR 0IL ~ ~50 GRL UNKNOgN S END SHOP RRER DRUMS OR BRRRELS MET.. LUBRI£RNT ID PERCENT COMPONENTS HRZRRD LIST Z~OB.ee) 1OO.O MOTOR OIL UNKNOWN FIRE PROTECTION / ~flTER SUPPLIES LRST CHANGE 07/0t/88 BY E,STER SEC 4) NO PRI~RTE FIRE PROTECTION. SEC S> FIRE HYDRRNT ON Z4TH ST NORTH 'END-OF~BLD[~. ............. PRGE 3 127Z'8788-1'1~3~ MRTERIflL SRFETY DRTR'.'S¥STEMS; I'NCL CG~S) G~'8;68~' . BUSINESS NAME FIRESTONE STORE ID NUMBER Z15-000-~075~ LOCATION ~31 CHESTER RV HIGH HAZARD RRTiNG 2 D. EMPLOYEE NOTIFICATION / EVRCURTION LAST CHANGE ~7/0~/88 BY EST.ER SEC Z) ALL EMPLOYEES ARE TO LEAVE BY SHOP DOORS IN EMERGENCY, E. MITIGATION / PREVENTION / RBRTEMENT LAST CHANGE 07/01/88 BY ESTER 3R SE(;' 1 ) ~RSTE OIL, IS STORED IN UNDERGROUND TANK. F~LL SPILLS ARE WIPED UP tJI'fH RRGS THEN PUT IN METRL CONTAINERS. PAGE 4 1Z/28788 1t:34 MRTERIRL SAFETY DATA SYSTEMS, INC, (805) G48-G800 CITY of BAKERSFIELD NON--TRADE SECRETS CITY, ZIP: ~.~C ~ ~ ~ ~.~ ~ CITY, ZIP: DUN AND BRADSTREET NUMBER C~e C~e Mt Mt Est Units m Site l~ ~1 I~ ~ St~ tn FKtltty~ Ic~k all t~t a~ly) ~lth of Fmc. ~lth P~icll ~ Mlth Ha/l~ C.A.S. i at II ~ i C.A.B. i (C~k 'ell t~t ~ly) ~-~ -- r--~ r-- r--~ ~t ~ ~iC.A.S. ~ ~lth of P~ ~lth P~Ical ~ ~lth ~za~ C.A.S. ~ at I1 h & C.A.S. ~ (C~k ~11 t~t - _ - r--~ ~--~ ~t ~ N~iC.A.S. ~ H~lth of P~sum ~lth , (C~k all t~t Mly) ' ~ Hfllth o~ PeflsuPe Nfllth ~ ........... % ~t.13 ~&C.A.S. ~P ~NERGENCY C~TACTS I1 Certificatim' (Read and sJ~ after coepletJnE ail sections) fo~'"6btain~ng., t~ inf~ttm. I ~lieve tMt t~ su~itt~ info~ti~ is t~, accurate, ~d c~tete . ~ / ' BAKERSFIELD CITY FIRE DEPARTMENT; I.D. # ' FORM 4A-1 Page NON TRADE SECRETS~ .... ~";---- HAZARDOUS I~IATERI ALS I NVEN, TORY FIRESTONE STORE FIRBSTONE STORE:' BUSINESS NAME: 2331C,hestorSL 0~N~R NA~E: .... FACILITY UNIT ADDRESS: -- ; ADDRESS: ~,0~t ~beS[~F~. FACILITY UNIT NAME: ..... C i TY, Z I P: mane, sfield, CA 93301 c I TY, Z I P: gakers~o, CA 9~01 PHONE ~: 2~2W~llO~Y PHONE ~:27E2W{-O] __ , I° r'cIA[oNLY USE CFIRS CODE 1 2- 3 4 5 6 7 8 / 9 l0 TYPE ~AX ANNUAL CONT USE LOCATION. IN T~IS ~ BY ~ HAZARD :D.O.T ~DE ~OU~T ~O~T ~IT CODE CODE F~ClBIT~~I,,T~ ~T. C~I~h OR CO~O~ ~g CODg MA"E: ~ ~, TITLE: SIGNAT""E: ~~ ~ ~' ' E~ERGENCY CONTACT: TITLE:,_~ ~/-- PfiONE '~ B~S S ~ ¢ M ~ ' ', AFTER BUS "RS: ~g~ ~ EMERGENCY CONTACT: TITLE: ... PHONE ~ BUS HOURS: PRINCIPAL .USINESS ACTIVITY: ~f~.~ ~~~ ~~)~, AFTER BUS "RS: SECTION 3J-HAZARDOUS MATERIALS FOR ~THIS UNIT ONLY Does. this Facility Unit contain Hazardous Materials? ...... YES A. 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-t) If Yes, complete a hazardous materials inventory form marked: TRADE.SECRETS ONLY (yellow form #4A-2) in addit{on to the non-trade secret ?orm. List only the trade secrets on form 4A-2. SECTION-4: PRIVATE F~RB~PR6TECTION SE'CTION ~: LOCATION OF WATER SuppLy FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A..'NAT. GAS./PROPANi?: B. ~LECTRICAL: C. WATER: ,_ ~ ' D. SPECIAL: · · E. LOCK BOX: YES ,,/ ~ IF YES, LOCATION: iF YES, SITE PLANS? YES / NO MSDSs9 YES /.NO FLOOR PLANS? YES / NO KEYS? YES / NO BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" 'STREET BAKERSFIELD, CA 93301 OFFiCrAL USE ONnY FIRE, STONE STORE 2331 Chester St: BUS I NESS pLAN sINGLE MAGILITY UNI FORM 8A INSTRUCTIONS 1. To avoid further action, this form must be returned 2. TYPE/PRINT YOUR.ANSWERS IN ENGLISH. 4. Be as BRIEF and CONCISE as possible. FACILI~ ~IT~ FACILi~ b~IT N~: . PROCEDURES SECTION 1 :' MITIGATION, PRE~NTION, ABATEMEN~ . SECTIOS 2: ROTIFICATION~ EVACUATIO~ PROCEDURES AT THIS - 3A - SECTION 4: PRIVATE RESPONSE TEA~ 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 PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A, METHODS FOR SAFE HANDLING OF HAZARDOUS ~ ~S' MATERIALS: . . .' ..................................... NO NO B. PROCEDURES FOR COORDINATING ACTIVITIES C. PROPER USE OF SAFETY EQUIPMENT: .................. NO NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO NO SECTION ?: HAZARDOUS I~%TERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE' HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OFz_~ SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES (NOJ I, ///k~¢~ .~[~L~ 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. A1.) and that inaccurate information constitutes perjury. 2130~ "G" STREET R E C E I V E O BAKERSFIELD, CA 93301_ ~,. JUL 13 1987 (005) 326-3979 I OFFICIAL USE ONLY BUSINESS .~ HAZARDOUS MATERI ALS BUSINESS~ PLAN AS A WHOLE~_~__~"/ - INSTRUCTIONS: '- 1. ?To avoid further action, return this form by "~---, 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a. whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA FIRESTONE STORE 2331 Chester St. A'. BUSINESS NAME': B. LOCATION / STREET' ADDRESS: CITY: ZIP: BUS.PHONE: (~ SECTION 2: E~RGENCY NOTIFICATIONS In case of an emergency involving the ~elease or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. , ~-x E~PLOYEES TO ~OTIFY IS CASE OF E~ERGESCY: NA~ AND TITLE DURING BUS. HRS. AFTER BUS. HRS. B. Ph~ Ph~ SECTION 3: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS,A ~OLE D. SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO NSDSS? YES / NO FLOOR PLANS? YES / N0 KEYS? YES / NO - 2A -