HomeMy WebLinkAboutBUSINESS PLAN 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 #:: 015-000-000846 [] Risk Management Program
BIG 5 SPORTING GOODS r'lHazardousWasteOn-Sitemreatment
LOCATION: 1619 COLUMBUS ST FIELD
. ,. :.~ .~'
OFFICE OF EN~R ONMENTAL SER VICES
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301
Issue
~te
O~ceof Ev~S~ic~
Voice (661) 326-3979
~~~ F~ (661) 326-0576 Expiation Date:
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
.......... ,,~,,~ ~, ~,~,~, ~,i=~,~, ~,~,~ ,,~, This permit is issued for the following:
:?f""~!i~ "[ ~':~'~:~:~'"~:~:::~iii '~iiii!iil;~,~ ~,~i *!i!i!~ il''ii;:::i::''' !!i~::J~e:[ground Storage of Hazardous Mateflals
BIG 5 SPORTING GOODS #
LOCATION 1619 ~ '": '~ ~ "'~ .... ~" ~=''~' ' _D CA ........... ~.
............. " ~i~.
~-- "' '
[ssu~
1715 Chewer Ave., 3rd Floor
B~enfiel~ CA 93301
Voice (805) 326-3979
~ (805) 3264576 Expiration Date: June 30, 2000
,~'~vEl::l SITE DIAGRAM 5~ ITY DIAGRAM F'"]
AUG 10 1~
~,~',...: .... ,...~ ~:.,~_~ .,~,: t31 ~
" Ncr~h Name c~ Area:
LoT'
Dear Busi~ss~ner:
FIRE OHIEF
RON FRAZE
This notice is meant to act as a ~miqd_._er)that the California Health
ADMINISTRATIVE SERVICES and Safety Code, Chapter 6.95, requires any handler of hazardous materials
2101 'H" Street
Bakersfield, CA 93301 to_~..~.~ _.]r~ise'&eir hazardous materials business plan ~"i~hin 30 da'~s of
any
one
VOICE (805) 326-3941
________ ___~
FAX (805) 395-1349 of the {~vents:
SUPPREssION SERVICES
2101 "H'Street (l) A 100 per cent or more increase in thc quantity of a
Bakersfield, CA 93301 previously-disclosed material.
VOICE (805) 326-3941
FAX (805)395-1349
(2) Any handling of a previously-undisclosed hazardous
PREVENTION SERVICES
1715 Chester Ave. material, subject to the inventory requirements of Chapter
Bakersfield, CA 93301
VOICE (805) 326-3951 6.95.
FAX (805) 326-0576
ENVIRONMENTAL SERVICES (3) Change in business ownership.
Bakersfield, CA 93301
VOICE (805) 326-3979 nbus
FAX (805) 326-0576
TRAINING DIVISION (5) Change of business name.
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (805)3994697 Any questions regarding these required revisions, please call the
FAX (805) 300-5763
Hazardous Materials Division at (805) 326-3979.
Sincerely yours,
Director, Office of Environmental Services
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Manager : BusPhone: (661) 872-5272
Location: 1619 COLUMBUS ST Map : 103 CommHaz : Moderate
City : BAKERSFIELD Grid: 16D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 08 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
KOREN APOLINARIS / MANAGER JENNIFER LUDY / ASST MANAGER
Business Phone: (661) 872-5272x Business Phone: (661) 872-5272x
24-Hour Phone : (661) 664-6838x 24-Hour Phone : (661) 397-1971x
Pager Phone : (661) 637-4772x Pager Phone : (661) 636-5708x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact : Phone: (661) 872-5272x
MailAddr: 1619 COLUMBUS ST State: CA
City : BAKERSFIELD Zip : 93305
Owner BIG 5 Phone: (310) 536-0611x
Address : 2525 E EL SEGUNDO BLVD State: CA
City : EL SEGUNDO Zip : 90245
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
= Hazmat Inventory One Unified List
-- Alphabetical Order Ail Materials at Site
Hazmat Common Name... ISpooHaz EPA Hazardsl Frm I DailyMax Unit MCP
BENZENE F DH L 55.00 GAL Mod
PROPANE E F P IH G 2730.00 FT3 Hi
I, ..... Do hereby certify that ! have
(TyPe or pdnt name) -
reviewed the at~ached hazardous materials mer'~age-
ment plan for and that it along with
(Name of Business) -
any corrections constitute a complete and correct man-
agement plan for my facili~,
06/20/2001
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
= Inventory Item 0005 Facility Unit: Fixed Containers on Site
BENZENE Days On Site
365
Location within this Facility Unit Map: Grid:
20FT FROM NW WALL, ROOM 1 CAS#
100 -14 -1
Liquid Mixture Ambient Ambient METAL CONTAINR- NONDRUM
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
55.00 GAL 55.00 GAL I 40.00 GAL
HAZARDOUS COMPONENTS
~0Wt~o Benzene INoRS I CAS#
· 71432
HAZARD ASSESSMENTS ·
TSecretI oRSIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP
No N No No/ Curies F DH / / / Mod
= Inventory Item 0001 Facility Unit: Fixed Containers on Site
PROPANE Days On Site
365
Location within this Facility Unit Map: Grid:
SALES FLOOR IN BACKROOM CAS#
74-98-6
F STATE ~ TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE
Gas /Pure Ambient Ambient PORT· PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
2730·00 FT3I 2730.00 FT3 2000.00 FT3
RS CAS#
lO0.O01Propane Yes 74986
HAZARD ASSESSMENTS
TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No N No No/ Curies F P IH / / / Hi
2 06/20/2001
F BIG 5 SPORTING GOODS #74 SiteID: 015r021-000846
Fast Format
= Notif./Evacuation/Medical Overall Site
--Agency Notification. 11/02/2000
CALL 911. KERN COUNTY DEPT OF ENVIRONMENTAL HEALTH 861-3636. STATE OF
CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550.
-- Employee Notif./Evacuation 11/02/2000
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS OF
FIRE. EXIT THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
Public Notif./Evacuation 11/02/2000
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT CUSTOMERS OF DANGER. EXIT
THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
Emergency Medical Plan 11/02/2000
MEMORIAL HOSPITAL, 420 34TH ST, 327-1792.
3 06/20/2001
F BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Mitigation/Prevent/Abatemt Overall Site
--Release Prevention 11/02/2000
ALL PROPANE AND WHITE GAS FUEL IS SHIPPED IN FACTORY SEALED/DOT APPROVED
CARTONS. THIS IS THE ONLY ACCEPTABLE MANNER IN WHICH TO TRANSFER OR' RETURN
COMBUSTIBLE MATERIAL.
ALL HAZARDOUS MATERIALS ARE TO BE LOADED AND UNLOADED BY HAND, ONE CARTON AT
A TIME. NEVER THROW OR DROP CARTONS CONTAINING HAZARDOUS MATERIALS.
ALL HAZARDOUS AND COMBUSTIBLE MATERIALS ARE TO BE STORED WELL AWAY FROM HEAT
GENERATING APPLIANCES, AND ARE NOT TO BE STACKED OR SHELVED IN AN UNSAFE
MANNER.
--Release Containment 06/26/1992
PRODUCT PACKAGED IN SMALL QUANTITIES FOR RETAIL SALE.
-- Clean Up 11/02/2000
IN THE EVENT OF A SPILL, THE AREA SHOULD BE SECURED FROM EMPLOYEE AND
CUSTOMER TRAFFIC, AND KEPT WELL VENTILATED. CONTACT THE FIRE DEPT FOR
INSTRUCTIONS REGARDING CLEANUP OR DISPOSAL, AND HAVE THE INFORMATION
REGARDING THE EXACT CONTENTS READY.
Other Resource Activation
4 06/20/2001
BIG 5 SPORTING GOODS #74 SiteID: 015-02i-000846
Fast Format
= Site Emergency Factors Overall Site
-- Special Hazards 06/26/1992
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES.
--Utility Shut-Offs 11/02/2000
A) GAS - NONE
B) ELECTRICAL - S SIDE IN ELECTRICAL ROOM OF BACKROOM
C) WATER - OUTSIDE OF BLDG S SIDE
D) SPECIAL - NONE
E) LOCK BOX - NO
-- Fire Protec./Avail. Water 11/02/2000
PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS IN BLDG, ALL SERVICED
REGULARLY AND ALSO HAVE A SPRINKLER SYSTEM IN CEILING AND ALARM SYSTEM.
FIRE HYDRANT - BY STREET ON COLUMBUS.
Building Occupancy Level
-5- 06/20/2001
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Training Overall Site
-- Employee Training 11/02/2000
WE HAVE 17 EMPLOYEES AT THIS FACILITY.
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE.
BRIEF SUMMARY OF TRAINING: IT IS THE RESPONSIBILITY OF EACH STORE MANAGER
TO SEE TO IT THAT ALL CURRENT EMPLOYEES, AND EACH NEW EMPLOYEE, IS
INSTRUCTED IN THE PROPER PROCEDURE FOR HANDLING HAZARDOUS MATERIALS.
THESE INSTRUCTIONS SHALL INCLUDE CORRECT METHODS FOR LOADING, UNLOADING,
STORAGE, AND SHELVING OF THESE MATERIALS.
ALL EMPLOYEES SHOULD BE MADE AWARE OF THE LOCATION OF EMERGENCY EQUIPMENT
AND INSTRUCTED IN ITS USE.
AN EMPLOYEE CHECK-OFF LIST SHALL BE MAINTAINED IN THE MANAGERS OFFICE, TO
INSURE THAT EACH EMPLOYEE HAS BEEN INSTRUCTED PROPERLY.
-- Page 2
Held for Future Use
Held for Future Use
-6- 06/20/2001
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
SITE AND FACILITY DIAGRAM INSTRUCTIONS
FOR
HAZARDOUS MATERIALS MANAGEMENT PLANS
These instru~ons explain the use of the site diagram and the facility diagram. Normally, small
and medium size businesses will only have to submit a site diagram, If you have subdivided your
business into smaller areas because of the complexity or size, then you will be completing and
additional detail map, facility diagram, for each of these areas. Include instructions that show the
route to your business it it is in a remote location. .. ·
SITE DIAGRAM INSTRUCTIONS
The site diagram is used to show your busi~e~ and to indicate'the businesses that immediately
surround your property, usually within :300 feet. If you will be showing specific area detail on "'
facility diagrams, use the site diagram to show an overall layou~ of the plant. If you will not b~
submitting facility diagrams, the site map must include all of the following information:
1. Check the box on the top lef~ comer of the form provided that indicated "Site
Diagram".
2. Print the name of your business, as shown in your HMMP, on the top of the
3. Label the location of the hazardous materials and identify them by name and ty~
of hazard (ie. Flammable liquid, corrosive solid).
4. Label the location of utility shutoff points for 8as, electric and water services.
5. Label the location of fire hydrants.
6. Label portions of the building protected by automatic sprinkler systems.
7. Label the direction representing north on the diagram. (The diagram form
provided includes a north arrow).
Map labeling must be le and easily understandable. Try to d the use of'abbreviations or
symbols. If'you must use them, provide a legend explaining your system,
Maps may be returned for correction if'you fail to follow these instruction.
FACILITY DIAGRAM INSTRUCTIONS
Facility diagrams are supplements to the site diagram. Use them to show the subdivision details
of a large business.
1. Check the box in the upper right hand comer of the form provided that indicated
"Facility Diagram". ,
2. Print the name of your business az shown on your HMM. Print the name of the
area that this map represents. This name should be the same name that you used
on this area's inventory report.
3. Indicate which area the diagram represents and the total number of facility
diagrams that you are including. Ifa map represented the first of four areas, it
would be labeled #1 of 4.
4. Follow instruction (3 -7) for site diagrams regarding the specific details to be
included on each facility diagram. -.
2
Map labeling must be leg ~d easily understandable. Try to a the use of'abbreviations or
symbols, ffyou must use them, provide a legend explaining your system.
Maps may be returned for correction if'you f'~! to follow these instruction.
FACILITY DIAGRAM INSTRUCTIONS
Facility diagrams are supplements to the site diagram. Use them to show the subdivision details
of a large business.
1. Check the box in the upper right hand comer of the form provided that indicated
"Facility Diagram".
2. Print the name ofyour business as shown on your ttMMP. Print the name of the
area that this map represents. This name should be the same name that you used .-
on this a~ea's inventory report.
3. Indicate which area the diagram represents and the total number of facility
diagrams that you are including. Ifa map represented the first of four areas, it
would be labeled//1 of 4.
' 4. Follow instruction (3 -7) for site diagrams regarding the specific details to be
included on each facility diagram.
2
SIT~ DIAGRAM ~-- FACILITY DIAGRAM
Bu~lnm Nme:
I Bustn~ Adch~ss:
~"-.~ I SITE DIAGRAM __ FACILITY DIAGRAM
'~"~' ~ Business Name:
_o_ Business Address:
BIG,5 SPORTING GOODS #74 /~O~,~ ''~ SiteID: 015-021-000846
~ ~V~ BusPhone:
Manager: ' "f/0?/~;/'/~ ~%; (805) 872-5272
Location: 1619 COLUMBUS ST /~~ Map : 103 Com~az : Moderate
City : B~ERSFIELD ~-- '~ Grid: 16D FacUnits: 1 AOV:
CommCode: B~ERSFIELD STATION ,8 3~. SIC Code:
EPA Nu~: DunnBrad:
Emergency Contact/ / Title [,~[ % Emergency Contact/ / Title
~ ~ / ~AGER %'- ' ~ ~ / ASST ~AGER ~{)
Business Phone: (~) 872-5272x Business Phone: (~ 872-5272x ~
24-Hour Phone : (~~~% 24-Hour Phone : (~ ~~~,
Pager Phone : (~)~6~ -41gm x Pager Phone : (~ ~~~-5'~-~
Hazmat Hazards: Fire Press Im~lth DelHlth
Contact : -'Phone: ( ) - x
MailAddr: 1619 COL~BUS ST State: CA
City : B~ERSFIELD Zip : 93305
O~er BIG 5 Phone: (310) 536-0611x
Address : 2525 E EL SEG~DO BL~ State: CA
City : EL SEG~O Zip : 90245
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: Res: No
Emergency Directives: ;~' ~ )~-~-q~ D~~?~~-0~ ~~~
= Hazmat Inventory One Unified List
-- As Designated Order All Materials at Site
Hazmat Common Name... ISpocHaz]EPA HazardsI Frm DailyMax IUnitIMcP
PROP~E F P IH G 2730.00 FT3 Hi
G~ PO~ER~ ~o ~ ~ F DH S 10000.00 LBS Hi
PRIMER~ ~ ~V ~ F DH S 175.00 LBS Hi
B~CK POWDER~ ~ ~ ~ F DH S 20.00 LBS Hi
BENZENE F DH L 55.00 G~ Mod
reviewed ~be a~ached h~a~dous ma~da~s manage-
mere 9~a~ ~o~ sod ~m ~ a~0o9 w~b
auy 00~e~o~s o0us~u~e a 0omp~e~s and o0~ec~ mare
/~,, . /0~/~0 i0/i2/2000
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
= Inventory Item 0001 Facility Unit: Fixed Containers on Site
PROPANE Days On Site
365
Location within this Facility Unit Map: Grid:
SALES FLOOR IN BACKROOM CAS#
74-98-6
STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Gas /Pure [ Ambient J Ambient I PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum I Daily Average
FT3I 2730.00 FT3I 2000.00 FT3
HAZARDOUS COMPONENTS
100.00 Propane Yes 74986
HAZARD ASSESSMENTS
TSecretINO N~S I Bi°HaZNo Radioactive/AmountNo/ Curies FEPAp HazardsiH NFPA/// IUSDOT# HiMOP
= Inventory Item 0002 Facility Unit: Fixed Containers on Site
~iv~v~ ~v~ / ~ ~-~L~ ~vl~
GUN POWDER Days On Site
365
Location within this Facility Unit Map: Grid:
MIDDLE WEST WALL, ROOM 1 CAS#
r STATE ~ TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE
Solid I Mixture Ambient Ambient BOX
AMOUNTS AT THIS LOCATION
Largest Container { Daily Maximum Daily Average
LBSI 10000.00 LBS 8000.00 LBS
%Wt. RS CAS#
80.00 Nitroglycerin, Solution No 55630
6.00 Barium Nitrate No 10022318
6.00 Arsenic Disulfide No 1303328
HAZARD ASSESSMENTS
TSecret I oRS I BioHazNo N No Radioactive/AmountNo/ Curies EPA HazardsF DH NFPA/// IUSDOT# HiMCP
2 10/12/2000
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
PRIMER Days On Site
365
Location within this Facility Unit Map: Grid:
MIDDLE WEST WALL, ROOM 1 CAS#
r STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Solid I Mixture I Ambient I Ambient BOX
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
LBSI 175.00 LBS 150.00 LBS
%Wt. RS CAS#
20.00 Barium Nitrate No 10022318
20.00 Lead No 7439921
20.00 Antimony No 7440360
HAZARD ASSESSMENTS
TSecret, RS'BioHazl Radioactive~Amount, EPA Hazards, NFPA USDOT# MCP
NoI ° I I I IN No No/ Curies F DH / / / Hi
~ Inventory Item 0004 Facility Unit: Fixed Containers on Site
~UIVUVIU~ ~Vl~ / ~£ ~_/--~/J ~Vl~
BLACK POWDER Days On Site
365
Location within this Facility Unit Map: Grid:
MIDDLE WEST WALL, ROOM 1 CAS#
r STATE TYPE PRESSURE --r TEMPERATURE CONTAINER TYPE
Solid Mixture Ambient/ Ambient BOX
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
LBSI 20.00 LBS 20.00 LBS
%Wt. RS CAS#
80.00 Cellulose Nitrate No 9004700
20.00 Nitroglycerin, Solution No 55630
TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No N No No/ Curies F DH / / / Hi
-3- 10/12/2000
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
~ Inventory Item 0005 Facility Unit: Fixed Containers on Site
~lVUVlUl~ ~Vl~ / ~ ~_~-~J~ ~Vl~
BENZENE Days On Site
365
Location within this Facility Unit Map: Grid:
20FT FROM N-W WALL, ROOM 1 CAS#
100-14-1
F STATE i TYPE PRESSURE { TEMPERATUREI CONTAINER TYPE
Ambient METAL CONTAINR-NONDRUM
Mixture Ambient
Liquid
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum I Daily Average
HAZARDOUS COMPONENTS
50.00 Benzene N 71432
HAZARD ASSESSMENTS
TSecretI ~S{BioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP
No N No No/ Curies F DH / / / Mod
-4- 10/12/2000
F BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Notif./Evacuation/Medical Overall Site
--Agency Notification 06/26/1992
CALL 911
KERN COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH (805) 861-3636
STATE OF CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550
Employee Notif./Evacuation 06/26/1992
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS OF
FIRE. EXIT THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
Public Notif./Evacuation 06/26/1992
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALLERT CUSTOMERS OF DANGER. EXIT
THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
Emergency Medical Plan 06/26/1992
MEMORIAL HOSPITAL - 420 34TH ST - 327-1792
-5- 10/12/2000
F BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Mitigation/Prevent/Abatemt Overall Site
--Release Prevention 06/26/1992
ALL PROPANE AND WHITE GAS FUEL IS SHIPPED IN FACTORY SEALED/DOT APPROVED
CARTONS. THIS IS THE ONLY ACCEPTABLE MANNER IN WHICH TO TRANSFER OR RETURN
COMBUSTIBLE MATERIAL.
ALL HAZARDOUS MATERIALS ARE TO BE LOADED AND UNLOADED BY HAND, ONE CARTON AT
A TIME. NEVER THROW OR DROP CARTONS CONTAINING HAZARDOUS MATERIALS.
ALL HAZARDOUS AND COMBUSTIBLE MATERIALS ARE TO BE STORED WELL AWAY FROM HEAT
GENERATING APPLIANCES, AND ARE NOT TO BE STACKED OR SHELVED IN AN UNSAFE
MANNER.
Release Containment 06/26/1992
PRODUCT PACKAGED IN SMALL QUANTITIES FOR RETAIL SALE.
-- Clean Up 06/26/1992
IN TH EVENT OF A SPILL, THE AREA SHOULD BE SECURED FROM EMPLOYEE AND
CUSTOMER TRAFFIC, AND KEPT WELL VENTILATED. CONTACT THE FIRE DEPARTMENT FOR
INSTRUCTIONS REGARDING CLEAN-UP OR DISPOSAL, AND HAVE THE INFORMATION
REGARDING THE EXACT CONTENTS READY.
Other Resource Activation
-6- 10/12/2000
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Site Emergency Factors Overall Site
-- Special Hazards 06/26/1992
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES.
--Utility Shut-Offs 06/26/1992
A) GAS - NONE
B) ELECTRICAL - SOUTH SIDE IN ELECTRICAL ROOM OF BACKROOM
C) WATER - OUTSIDE OF BLDG SOUTH SIDE
D) SPECIAL - NONE
E) LOCK BOX - NO
-- Fire Protec./Avail. Water 06/26/1992
PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS IN BUILDING, ALL SERVICED
REGULARLY AND ALSO HAVE A SPRINKLER SYSTEM IN CEILING AND ALARM SYSTEM
FIRE HYDRANT - BY STREET ON COLUMBUS.
Building Occupancy Level
-7- 10/12/2000
BIG 5 SPORTING GOODS #74 SiteID: 015-021-000846
Fast Format
= Training Overall Site
-- Employee Training 06/26/1992
WE HAVE ~ EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: IT IS THE RESPONSIBILITY OF EACH STORE MANAGER
TO SEE TO IT THAT ALL CURRENT EMPLOYEES, AND EACH NEW EMPLOYEE, IS
INSTRUCTED IN THE PROPER PROCEDURE FOR HANDLING HAZARDOUS MATERIALS.
THESE INSTRUCTIONS SHALL INCLUDE CORRECT METHODS FOR LOADING, UNLOADING,
STORAGE, AND SHELVING OF THESE MATERIALS.
ALL EMPLOYEES SHOULD BE MADE AWARE OF THE LOCATION OF EMERGENCY EQUIPMENT
AND INSTRUCTED IN ITS USE.
AN EMPLOYEE CHECK-OFF LIST SHALL BE MAINTAINED IN THE MANAGERS OFFICE, TO
INSURE THAT EACH EMPLOYEE HAS BEEN INSTRUCTED PROPERLY.
-- Page 2
Held for Future Use
Held for Future Use
-8- 10/12/2000
BIG 5 SPORTING GOODS #74 p F 13 SiteID: 015-021-000846
Manager : ~ BusPhone: (805) 872-5272
Location: 1619 COLUMBUS ST Map : 103 CommHaz : Moderate
City : BAKERSFIELD Grid: 16D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 08 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
GASPER MANUZ / MANAGER MELISSA WALKER / ASST MANAGER
Business Phone: (805) 872-5272x Business Phone: (805) 872-5272x
24-Hour Phone : (805) 256-1369x 24-Hour Phone : (805) 665-7789x
Pager Phone : ( ) - x Pager Phone : (805) 632-3974x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact : Phone: ( ) - x
MailAddr: 1619 COLUMBUS ST State: CA
City : BAKERSFIELD Zip : 93305
Owner BIG 5 Phone: (310) 536-0611x
Address : 2525 E EL SEGUNDO BLVD State: CA
City : EL SEGUNDO Zip : 90245
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... ISpeoHazlEPA HazardsI Frm DailyMax lUnit MCP
PROPANE F P IH G 2730.00 FT3 Hi
GUN POWDER F DH S 10000.00 LBS Hi
PRIMER F DH S 175.00 LBS Hi
BLACK POWDER F DH S 20.00 LBS Hi
BENZENE F DH L 55.00 GAL Mod
I, Do hereby ce~i~ thru ~ have
~y~ or*pdnt name)
reviewed the a~ached haza~ous mmedals manage- /
ment plan for and that it along with -~
(Name of Busing)
any corre~ions constitute a complete and corre~ man-
agement plan for my facili~. ~ ,,,, ~"~'~ O~ ~,,~ ~
-1- 09/28/2000
Signature ~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ~)VI//RO3t ~¢:EF1VICE$ ..
INSPECTION TIME [ /:'~ ~ ' · NUMBER OF EMPLOYEES
Sec~usiness Plan and Inventory Program
I~l~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 k '
Proper segregation of material ~/ /
Verification of MSDS availability k/
Verification of Haz Mat training //
Verification of abatement supplies and procedures ~' "
Emergency procedures adequate ~,~·
Containers properly labeled
Fire Protection ~'~'~
Site Diagram Adequate & On Hand /~ /'
C=Compliance V=Violation
Any hazardous waste on site?: -~Yes [~o
Questions regarding this inspection? Please call us at (661) 326-3979 Business Site ble Party
White- Env. Svcs. Yellow-Station Copy Pink-Business Copy Inspector'~-'7~,/17~ -,~0.
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 1
Overall Site with 1 Fac. Unit
General Information
Location: 1619 COLUMBUS ST Map:103 Haz:3 Type: 3
City : BAKERSFIELD Grid: 16D F/U: 1 AOV: 0.0
Contact Name Title Contact Name Title
[GASPER MANUZ / MANAGER ~1 i~D~ '%A~L~/~_ /~kf~.
[ Business Phone: (805) 872-5272x Business Phone: ~o~)~_.-~QZx
[ 24-Hour Phone : (805) 256-1369x 24-Hour Phone :
[ Pager Phone : ( ) - x Pager Phone :
Administrative Data
Mail Addrs: 1619 COLUMBUS ST D&B Number:
City: BAKERSFIELD State: CA Zip: 93305-
Comm Code: 215-008 BAKERSFIELD STATION 08 SIC Code:
Owner: BIG 5 Phone: (310) 536-0611
Address: 2525 E EL SEGUNDO BLVD State: CA
City: EL SEGUNDO Zip: 90245-
Summary
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES
APR 1
HAZ. MA~
I, C~,,~,~c f,~/~ Do hereby ce~i~ that I have
reviewed the affached h~a~ous m~tefials manage-
ment plan for~~,~~ and that it a~ ~th
any ~rr~ions constitute a complete and ~ff~ man-
agement plan for my faciliH.
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-004 BLACK POWDER Solid 20 High
· Fire, Delay Hlth LBS
02-002 GUN POWDER Solid 10000 High
· Fire, Delay Hlth LBS
02-003 PRIMER Solid 175 High
· Fire, Delay Hlth LBS
02-001 PROPANE Gas 2730 High
· Fire, Pressure, Immed Hlth FT3
02-005 BENZENE Liquid 55 Moderate
· Fire, Delay Hlth GAL
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-004 BLACK POWDER Solid 20 High
~ Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBS I Daily Average LBS I Annual ~ount LBS
20 ~ 20.00 80.00
Storage Press T TempI Location
BOX Ambient[AmbientlMIDDLE WEST WALL, ROOM 1
-- ConsI Components i MCP ~uide
80.0% Cellulose Nitrate High 26
20.0% Nitroglycerin, Solution High 26
02-002 GUN POWDER Solid 10000 High
~ Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBS I Daily Average LBS ----~ Annual Amount LBS --
10,000 i 8,000.00 50,000.00
Storage Press T TempI Location
BOX I Ambien,t/Ambient I MIDDLE WEST WALL, ROOM 1
-- Conc Components MCP Guide
80'0% INitr°glycerin, S°luti°n IHigh I 26
6.0% Barium Nitrate High 42
6.0% Arsenic Disulfide Moderate 53
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 4
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-003 PRIMER Solid 175 High
· Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBS I Daily Average LBS I Annual ~ount LBS
175 ~ 150.00 700.00
Storage ~lPress T Temp Location
BOX Iambient~bientlMIDDLE WEST WALL, ROOM 1
-- Conc Components MCP Guide
20'0% IBarium Nitrate IHigh I42
20.0% Lead Low 53
20.0% Antimony Low 53
02-001 PROPANE Gas 2730 High
· Fire, Pressure, Immed Hlth FT3
CAS #: 74-98-6 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: OTHER
Daily Max FT3I Daily Average FT3 I Annual Amount FT3
2,730 ~ 2,000.00 25,800.00
Storage Press T Temp ~ Location
PORT. PRESS. CYLINDER Ambient~AmbientI SALES FLOOR IN BACKROOM
-- Conc Components MCP ----~uide
100.0% IPropane IExtreme I 22
02-005 BENZENE Liquid 55 Moderate
· Fire, Delay Hlth GAL
CAS #: 100-14-1 Trade Secret: No
Form: Liquid Type: Mixture Days: 365 Use: OTHER
Daily Max GALI Daily Average GAL I Annual Amount GAL
55 ~ 40.00 720.00
StorageIIPress T Temp Location
METAL CONTAINR-NONDRUMIAmDient~AmDientl20FT FROM NW WALL, ROOM 1
-- ConcI Components MCP ----~uide
50.0% IBenzene ModerateI 27
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 5
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
KERN COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH (805) 861-3636
STATE OF CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550
<2> Employee Notif./Evacuation
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS OF
FIRE. EXIT THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
<3> Public Notif./Evacuation
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALLERT CUSTOMERS OF DANGER. EXIT
THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
<4> Emergency Medical Plan
MEMORIAL HOSPITAL - 420 34TH ST - 327-1792
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 6
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL PROPANE AND WHITE GAS FUEL IS SHIPPED IN FACTORY SEALED/DOT APPROVED
CARTONS. THIS IS THE ONLY ACCEPTABLE MANNER IN WHICH TO TRANSFER OR RETURN
COMBUSTIBLE MATERIAL.
ALL HAZARDOUS MATERIALS ARE TO BE LOADED AND UNLOADED BY HAND, ONE CARTON AT
A TIME. NEVER THROW OR DROP CARTONS CONTAINING HAZARDOUS MATERIALS.
ALL HAZARDOUS AND COMBUSTIBLE MATERIALS ARE TO BE STORED WELL AWAY FROM HEAT
GENERATING APPLIANCES, AND ARE NOT TO BE STACKED OR SHELVED IN AN UNSAFE
MANNER.
<2> Release Containment
PRODUCT PACKAGED IN SMALL QUANTITIES FOR RETAIL SALE.
<3> Clean Up
IN TH EVENT OF A SPILL, THE AREA SHOULD BE SECURED FROM EMPLOYEE AND
CUSTOMER TRAFFIC, AND KEPT WELL VENTILATED. CONTACT THE FIRE DEPARTMENT FOR
INSTRUCTIONS REGARDING CLEAN-UP OR DISPOSAL, AND HAVE THE INFORMATION
REGARDING THE EXACT CONTENTS READY.
<4> Other Resource Activation
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 7
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES.
<2> Utility Shut-Offs
A) GAS - NONE
B) ELECTRICAL - SOUTH SIDE IN ELECTRICAL ROOM OF BACKROOM
C) WATER - OUTSIDE OF BLDG SOUTH SIDE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS IN BUILDING, ALL SERVICED
REGULARLY AND ALSO HAVE A SPRINKLER SYSTEM IN CEILING AND ALARM SYSTEM
FIRE HYDRANT - BY STREET ON COLUMBUS.
<4> Building Occupancy Level
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 8
00 - Overall Site
<G> Training
<1> Employee Training
WE HAVE 13 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: IT IS THE RESPONSIBILITY OF EACH STORE MANAGER
TO SEE TO IT THAT ALL CURRENT EMPLOYEES, AND EACH NEW EMPLOYEE, IS
INSTRUCTED IN THE PROPER PROCEDURE FOR HANDLING HAZARDOUS MATERIALS.
THESE INSTRUCTIONS SHALL INCLUDE CORRECT METHODS FOR LOADING, UNLOADING,
STORAGE, AND SHELVING OF THESE MATERIALS.
ALL EMPLOYEES SHOULD BE MADE AWARE OF THE LOCATION OF EMERGENCY EQUIPMENT
AND INSTRUCTED IN ITS USE.
AN EMPLOYEE CHECK-OFF LIST SHALL BE MAINTAINED IN THE MANAGERS OFFICE, TO
INSURE THAT EACH EMPLOYEE HAS BEEN INSTRUCTED PROPERLY.
<2> Page 2
<3> Held for Future Use
<4> Held for Future Use
04/03/96 BIG 5 SPORTING GOODS #74 215-000-000846 Page 9
00 - Overall Site
<G> Training
<4> Held for Future Use (Continued)
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 1
Overall Site with 1 Fac. Unit
General Information
I
Location: 1619 COLUMBUS ST Map:103 Haz:3 Type: 1
Community: BAKERSFIELD STATION 08 Grid: 16D F/U: 1 AOV: 0.0
Contact Name Title , Business Phone ~ 24-Hour Phone-
SUE JERECZE~ MANAGER I (805) 872-~z ~E I~-~ ~
Administrative Data
Mail Addrs: 1619 COLUMBUS ST D&B Number:
City: BAKERSFIELD State: CA Zip: 93305-
Comm Code: 215-008 BAKERSFIELD STATION 08 SIC Code:
Owner: BIG 5 Phone: (310) 536-0611
Address: 2525 E EL SEGUNDO BLVD State: CA
City: EL SEGUNDO d Zip: 90245-
Summary
~MMUNITION AND GUNPOWDER LOCATED ON PREMISES RECEIVED
d
l, ~e/~//:.~.. F)~//~4~/¢//J~4;)O hereby certify thal t have
revved the a~ h~us m~e~ls
ment p~n for _ ~ t~ ~ along w~h
any ~r~ions ~nstitute a ~mplete and ~ m~
agement plan for my fa~.
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-004 BLACK POWDER Solid 20 High
· Fire, Delay Hlth LBS
02-002 GUN POWDER Solid 10000 ~High
· Fire, Delay Hlth LBS
02-003 PRIMER Solid 175 High
· Fire, Delay Hlth LBS
02-001 PROPANE Gas 2730 High
· Fire, Pressure, Immed Hlth FT3
02-005 BENZENE Liquid 55 Moderate
· Fire, Delay Hlth GAL
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-004 BLACK POWDER Solid 20 High
· Fire, Delay Hlth LBS
CAS #: Trade seCret: No
Form: Solid Type: Mixture Days: 36.5 Use: OTHER
Daily Max LBS20Ii Daily Average20.00LBS I Annual Amount80.00LBS --
Storage ~ Press T Temp~ Location
BOX IAmbientlAmbientlMIDDLE WEST WALL, ROOM 1
-- Conc Components MCP ---iGuide
80-0% Icellulose Nitrate IHigh ~ I26
20.0% Nitroglycerin, Solution' High 26-
02-002 GUN POWDER Solid 10000 High
· Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBSI Daily Average LBS I . Annual Amount LBS --
10,000 ~ 8,000.00 50,000.00
Storage Press T TempI Location
BOX Ambient~AmbientlMIDDLE WEST WALL, ROOM 1
--ConsI Components I MCP ---iGuide
80.0% Nitroglycerin, Solution High ~ 26
6.0% Barium Nitrate High ! 42
6.0% Arsenic Disulfide ModerateI 53
03/28/~4 BIG 5 SPORTING GOODS #74 215-000-000846 Page 4
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-003 PRIMER Solid 175 High
· Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBSI Daily· Average LBS ] Annual Amount LBS --
175 ~ 150.00_ 700.00
Storage Press T TempI Location
BOX Ambient~AmbientlMIDDLE WEST WALL, ROOM 1
--ConcI Components '1 MCP 7uide
20.0% iBarium Nitrate High 42
20.0% Lead Low 53
20.0% Antimony Low 53.
02-001 PROPANE Gas 2730 High
· Fire, Pressure, Immed Hlth FT3
CAS #: 74~98-6 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: OTHER
Daily Max FT3I Daily Average 'FT3 I Annual Amount FT3
2,730 ~ 2,000.00 25,800.00
Storage ~ Press T Temp ~ Location
PORT. PRESS. CYLINDER IAmbient~AmbientI SALES FLOOR IN BACKROOM
-- Conc Components MCP --TGuide
100.0% IPropane IExtreme I 22
02-005 BENZENE Liquid 55 Moderate
· Fire, Delay Hlth GAL
CAS #: 100-14-1 Trade Secret: No
Form: Liquid Type: Mixture Days: 365 Use: OTHER
Daily Max GAL55I~ Daily Average40.00GAL I Annual Amount720.00GAL --
Storage Press T Temp~ Location
METAL CONTAINR-NONDRUMIAmbient~Ambient120FT FROM NW WALL, ROOM 1.
-- Conc Components MCP IGuide
50.0% ISenzene IModerateI 27
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 5
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
KERN COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH (805) 861-3636
STATE OF CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550
<2> Employee Notif./Evacuation
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS OF
FIRE. EXIT THROUGH REAR EMERGENCY DOORS'OR FRONT DOORS.
<3> Pubiic Notif./Evacuation
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALLERT CUSTOMERS OF DANGER. EXIT
THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
<4> Emergency Medical Plan
MEMORIAL HOSPITAL - 420 34TH ST - 327-1792
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 6
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL PROPANE AND WHITE GAS FUEL IS SHIPPED IN FACTORY SEALED/DOT APPROVED
CARTONS. THIS IS THE ONLY ACCEPTABLE MANNER IN WHICH TO TRANSFER OR RETURN
COMBUSTIBLE MATERIAL.
ALL HAZARDOUS MATERIALS ARE TO BE LOADED-AND UNLOADED BY HAND, ONE CARTON AT
A TIME. NEVER THROW OR DROP CARTONS CONTAINING HAZARDOUS MATERIALS.
ALL HAZARDOUS AND COMBUSTIBLE MATERIALS ARE TO BE STORED WELL AWAY FROM HEAT
GENERATING APPLIANCES, AND ARE NOT TO BE STACKED OR SHELVED IN AN UNSAFE
MANNER.
<2> Release Containment
PRODUCT pACKAGED IN SMALL QUANTITIES FOR RETAIL SALE.
<3> Clean Up
IN TH EVENT OF A SPILL, THE AREA SHOULD BE SECURED FROM EMPLOYEE AND
CUSTOMER TRAFFIC, AND KEPT WELL VENTILATED. CONTACT THE FIRE DEPARTMENT. FOR
INSTRUCTIONS REGARDING CLEAN-UP OR DISPOSAL, AND HAVE THE INFORMATION
REGARDING THE EXACT CONTENTS READY.
<4> Other Resource Activation
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 7
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
AMMUNITION .AND GUNPOWDER LOCATED ON PREMISES.
<2> Utility Shut-Offs
A) GAS - NONE
B) ELECTRICAL - SOUTH SIDE IN ELECTRICAL ROOM OF BACKROOM
C) WATER - OUTSIDE OF BLDG SOUTH SIDE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS IN BUILDING, ALL SERVICED
REGULARLY AND ALSO HAVE A SPRINKLER SYSTEM IN CEILING AND ALARM SYSTEM'
FIRE HYDRANT - BY STREET ON COLUMBUS.
<4> Building Occupancy Level'
03/28/94 BIG 5 SPORTING GOODS #74 215-000-000846 Page 8
00 - Overall Site
<G> Training
<1> Page 1
WE HAVE 13 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: IT IS THE RESPONSIBILITY OF EACH STORE MANAGER
TO SEE TO IT THAT ALL CURRENT EMPLOYEES, AND EACH NEW EMPLOYEE, IS
INSTRUCTED IN THE PROPER PROCEDURE FOR HANDLING HAZARDOUS MATERIALS.
THESE .INSTRUCTIONS SHALL INCLUDE CORRECT METHODS FOR LOADING, UNLOADING,
STORAGE, AND SHELVING OF THESE MATERIALS.
ALL EMPLOYEES SHOULD BE MADE AWARE OF THE LOCATION OF EMERGENCY EQUIPMENT
AND INSTRUCTED IN ITS USE.
AN EMPLOYEE CHECK-OFF LIST SHALL BE MAINTAINED IN THE MANAGERS OFFICE, TO
INSURE THAT EACH EMPLOYEE HAS BEEN INSTRUCTED PROPERLY.
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for Future Use
03/28/94 BIG 5 SPORTING GOODS #74~ 215-000-000846 Page 9
00 - Overall'Site
<G> Training
<4> Held for Future Use (Continued)
04/14/92 BIG .5 SPO.TI.G GOODS #V4 215-000-00084 I ~A¥ 18 199f ~ 1
Overall Site with i Fac. Unit
General 'Information By.,
Location: 1619 COLUMBUS ST Map: 103 Hazard: Moderate
Community: BAKERSFIELD STATION 08 Grid: 16D F/U: 1 AOV: 0.0
Contact Name , Title Business Phone 24-Hour Phone-
I
I
Administrative Data
Mail Addrs: 1619 COLUMBUS ST D&B Number:
City: BAKERSFIELD State: CA Zip: 93305-
Comm Code: 215-008 BAKERSFIELD STATION 08 SIC Code:
Owner: BIG 5 Phone: (310)
Address: 2525 EAST.. EL..SEG~UNDO BLVD. State: CA
· City: ELSEGUNDO, CA. Zip: 90245
Summary
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES
~,Gabrie! Friederichsen DO hereby c~rllf~ ~ha~ ~ have -
r®viewed th~ ~h~d h~ardous m~terials manage~
and ~ha~ ~ along wi~h
~y ~rm~o~ ~ns~ ~ ~p~e~ ~nd corr~ man-
"~ ~ 5/15/92
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 2
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
02-001 PROPANE Gas 2730 High
~ Fire, Pressure, Immed Hlth FT3
CAS #: 74-98-6 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: OTHER
Daily Max FT3I Dail~ Average FT3 I Annual Amount FT3
2,730 ~ 2,000.00 25,800.00
Storage~~Press T.Temp Location
PORT. PRESS. CYLINDER I Ambient~AmbientlSALES FLOOR IN BACKROOM
-- Conc Components MCP ~List
100.0% IPropane IExtreme I
02-002 GUN POWDER Solid 10000 High
~ Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBSI Daily Average LBS I Annual Amount LBS
10,000 ~ 8,000.00 50,000.00
Storage Press T TempI Location
BOX AmbientlAmbientlMIDDLE WEST WALL, ROOM 1
-- Conc I Components I MCP ~List
80.0% Nitroglycerin, Solution High
6.0% Barium Nitrate High
6.0% Arsenic Disulfide ModerateI
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
02-003 PRIMER Solid 175 High
· Fire, Delay Hlth LBS
CAS #: Trade Secret: No
Form: Solid Type: Mixture Days: 365 Use: OTHER'
Daily Max LBS175 I Daily Average150.00LBS I ~ Annual Amount700.00LBS
Storage Press T Temp~ Location
BOX AmbientlAmbientlMIDDLE WEST WALL, ROOM 1
--ConsI Components MCP iList
20.0% Barium Nitrate High
20.0% Lead Minimal
20.0% Antimony Low
02-004 BLACK POWDER Solid 20 High
· Fire, Delay Hlth LBS
CAS #: Trade Secret: No ·
Form: Solid Type: Mixture Days: 365 Use: OTHER
Daily Max LBSI Daily Average LBS I Annual Amount LBS
20 ~ 20.00 · 80.00
Storage Press T Temp~ Location
BOX AmbientlAmbientlMIDDLE WEST WALL, ROOM 1
--ConsI Components MCP iList
80.0% Cellulose Nitrate High
20.0% Nitroglycerin, Solution High
02-005' BENZENE Liquid 55 Moderate · Fire, Delay Hlth GAL
.. CAS #: 100-14-1' Trade Secret: No
Form: Liquid Type: Mixture Days: 365 Use: OTHER
Daily Max GALI Daily Average GAL I Annual Amount GAL
55 ~ 40.00_ 720.00
Storage I PreSs T Temp~ Location
METAL CONTAINR-NONDRUMIAmbient~Ambientl20FT FROM NW WALL, ROOM 1
-- Conc Components MCP List
50.0% I Benzene I Moderate [
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL911
KERN COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH (805) 861-3636
STATE OF CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550
<2> Employee Notif./Evacuation
MANAGER ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS OF
FIRE. EXIT THROUGH REAR EMERGENCY DOORS OR FRONT DOORS.
<3> Public Notif./Evacuation
NONE LISTED
SAME AS ABOVE¢D
<4> Emergency Medical Plan
MEMORIAL HOSPITAL - 420 34TH ST - 327-1792
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 5
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
THE PROPANE AND WHITE GAS ARE STORED STANDING UPRIGHT. TAKEN OFF TRUCK WITH
HAND CART AND STORED IN BACKROOM, TAKEN AS NEEDED FROM BACKROOM TO SHELVES
FOR SELLING. IF SPILL OCCURED I WOULD CALL EMERGENCY SERVICES, IF IT WAS A
SERIOUS SPILL. IF NOT I WOULD CLEAN IT UP WITH MOP.
<2> Release Containment
<3> Clean Up
SEE ATTACHED.
<4> Other Resource Activation
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 6
00 - Overall Site
<F> Site Emergency Factors
Special Hazards
AMMUNITION AND GUNPOWDER LOCATED ON PREMISES
<2> Utility Shut-Offs
A) GAS - NONE
B) ELECTRICAL - SOUTH SIDE IN ELECTRICAL RoOM OF BACKROOM
C) WATER - OUTSIDE OF BLDG SOUTH SIDE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS IN BUILDING, ALL SERVICED
REGULARLY AND ALSO HAVE A SPRINKLER SYSTEM IN CEILING AND ALARM SYSTEM
FIRE HYDRANT - BY STREET ON COLUMBUS.
<4> Building Occupancy Level
04/14/92 BIG 5 SPORTING GOODS #74 215-000-000846 Page 7
00 - Overall Site
<G> Training
<1> Page 1
WE HAVE 13 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: GEE ATTACHED)
<2> Page 2 as needed
<3> Held for .Future Use
<4> Held for Future Use
EMERGENCY RESPONSE PLANS
IN THE EVENT OF FIRE:
1. CALL THE FIRE DEPARTMENT FIRST. Do not attempt to fight the
fire until someone has called the Fire Department. Small fires
can quickly get out of hand.
2. Turn off the air conditioning.
3. Obtain the most accessible fire extinguisher and proceed to
the fire. Our dry chemical extinguishers can be used on all
types of fires (i.e., combustibles, liquids, electrical) from
a distance of eight feet to twenty feet from the flame or
smoldering material.
4. All-purpose, dry chemical extinguishers are installed in every
store, and are located in strategic areas. All employees should
be aware of these locations.
5. Get employees and customers out of the store if danger exists.
6. Notify the Operations Department, the Security Department, and
your District Supervisor.
7. Cooperate with Fire Authorities. Follow through on suggestions
and corrective measures. If help is needed from the Maintenance
or ~Security Departments, contact the Operations Department or
your District Supervisor if they are not already there. See
that these things are done as soon as possible.
8. Do NOT throw out any burned or water damaged merchandise until
an insurance inspection has been made, and then only if directed
to do so.
9. The Fire Department can supply you with exhaust fans to remove
smoke from the store.
10. Reopen the store if approved by the Fire Authorities.
11. Stay with the store and protect the company's property after
the fire.
12. If guard service protection is needed, contact your District
Supervisor or the Operations Department.
JRM:jw
~DFI:030
HANDLING HAZARDOUS MATERIALS
All propane and white gas fuel is shipped in factory sealed/D.O.T.
approved cartons. This is the only acceptable manner in which
to transfer or return combustible material.
All hazardous materials are to be loaded and unloaded by hand,
one carton at a time. Never throw or drop cartons containing
hazardous materials.
All hazardous and combustible materials are to be stored well
away from heat generating appliances, and are not to be stacked
or shelved in an unsafe manner.
In the event of a spill, the area should be secured from employee
and customer traffic, and kept well ventilated. Contact the
Fire Department for instructions regarding clean-up or disposal,
Lnd have the information regarding the exact contents ready.
JRM:jw
DF1:029
EMPLOYEE TRAINING
It is the responsibility of each store manager to see to it
that all current employees, and each new employee, is instructed
in the proper procedure for handling hazardous materials.
These instructions shall include correct methods for loading,
unloading, storage, and shelving of these materials.
All employees should be made aware of the location of emergency
equipment and instructed in its use.
An employee check-off list shall be maintained in the manager's
office, to insure that each employee has been instructed properly.
JRM:jw
DF1:028
March 30~ 1990
United Merchandising Corp.
DBA Big 5 Sporting Goods
P.O. Box 92088
World Way Postal Center
Los Angeles) Ca. 90009-2088
Ms. Lococo:
We show that a Hazardous Materials Handling Fee for Store #?4
wss sent at the same time as the other fee was sent. If as of this
date) you still have not received the billing for Store #74 please
let us know and we will see to it that a duplicate bill is sent,
If we can be of any further service please do not hesitate to
contact us.
Sincerely~
Rslph £o Huey
Hazardous Materials Coordinator
REH:vp
GENERAL OFFICES
14440 OCEAN Gate AVENUE
HAWTHORNE. CAlIFORNIa 90250
PHONE (213) 772-2772
FaX (213) 676-7248
UNITED mERChANDISING CORP.
ADDRESS REPlYTO
March 1, 1990 p.o. BOX 92o8B
WORLD WAY POSTAL CENTER
LOS aNGELES, ca. 90009-2088
City of Bakersfield
Hazardous Materials Division RECEIVED
P.O. Box 2057
Bakersfield, CA 93303-2057 MAR 0 8 1990
h~7_, ~4AT. DIV.
Gentlemen:
We received a bill for $100 for the hazardous mater~.~ handling fee for
one of our stores in Bakersfield, but have not receiVed this bill for
the second store.
Please ad, se if a bill is forthcoming for the following:
Big 5 Sporting Goods (Store #74)
1619 Columbus St.
Bakersfield, CA 93305
Store Phone: 872-5272
Store Manager: Susan Jereczek
Thank you.
Sincerely yours,
UNITED MERCHANDISING CORP.
d. b.a. Big 5 Sporting Goods'
Dorothy A, Lococo
Assistant Controller
Bakersfield Fire Dept.
Hazardous Materials Inspection
Date Completed
Loca~on:BUshe~N~e: ~~~ ~'__ RECEIVED1990
Hfi7. O~T. DIV.
Plan ID ~ 215-000 ~/~ (Top right comer Business Plan)
tat,o. o. /
Adequate Inadequate
Vefifica~on of Invento~ Materials
Verification of Quantities
Verification of Location
~oper Se~egafion of Ma~efi~
Verification ofMSDS Availab~i~
N~ber of ~p]oyees
Verification of Haz Mat Trai~ng
Verification of Abatement Supplies & Procedures ~ [-]
Emergency Procedures Posted ~ [~]
Containers Properly Labeled ~ [-]
ColTLments:
Verification of Facility Diagram
Special Hazards Associated with this Facility:
Violations:
FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
"WE CARE"
JAH 'i'2 1990
D S. NEEDHAM ~$'~,.o....oo.oo BAKERSFIELD. 93301
FIRE CHIEF 326-3911
Enclosed please find a copy of your response to the Hazardous
Material Management Plan (HMMP) request. We have found it
necessary to re.ject your plan for the following reason(s) as
checked below.
~--~ Illegible Management Plan (please print or type
information).
Section(s) D6 ~ of HMMP incomplete,
Inventory issing or ~ Incomplete.~¢~~
Diagram Missing or Incomplete
This is to be corrected and resubmitted within 30 days to:
City of Bakersfield, Fire Department ~__ ~/
Hazardous Materials Division
2130 G Street
Bakersfield, CA 93301
If additional copies of any forms are needed they can be picked up
from the Hazardous Materials Division at 2130 G Street in person.
Sincerely yoprs,
H~rdous Materials Coordinator
R~ed
<1> A<aenov 'Notlfioagion
A. In Case of Emergency - 911
B. Kern County Department of Environmental Health
(805) 861-3636
C. State of California
Office of Emergency Services
(800) 852-7550
<2> Emplovee Notif./Evaouation
5A SEC 2) MGR ON DUTY WOULD USE A PA SYSTEM TO ALERT EMPLOYEES OR CUSTOMERS
OF FIRE. EXIT THROUGH REAR EMERGENOY DOORS OR FRONT DOORS.
<5> Publio Notif./Evacuation
CITY of BAKERSFIELD
HAZARDOUS HATERIALS INVENTORY
Farm =nd AgLiculture El Standard Business El
NON--TRADE SECRETS
~USINESS NAME: Bi.q 5 Sporting Goods Store #74OWNER NAME: United Merchandising Corp. NAME OF THIS FACILITY: '
LOCATION; -1619 Columbus Street ADDRESS: 14440 Ocean Gate Avenue STANDARD IND. CLASS CODE:
,.?,ITY, ZIP~. Rnl~.r.~?i~.ld. Cn,_9_33_0_~ -- CITY, ZIPS._ Ha~tho~e. Ca. 90250 DUN AND BRADSTREEI' NUMBER .......
lrans [y~e ~ax Average Xnnual Hea~ure I OYSeSiC ConL ConC Cont Us LocaL(on?eEc.
Code code AmC AmC EsL Units on Type Press Tamp Co~e
/
Stored ~n PaCl/1Cy V
Physical end Health HAzard C.A.S. Humber N/A Component Il Hame t C.A.S. Humber 6 Barium Nitrate
(Check ali that apply)
99 = Reto~ Sd~es
~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Immediate Component 12.Hame & C.A.S. Humber 6 Arsenic Disulfide
Hal lth of Pr~ssure '~:
Health Component 13 Hame & C.A.S.Humber
/
Physical and Health Hazard C.A.S. Humber N/A Component I1 Hame I C,A.S. Humber 20 Barium Nitrate
{Check a11 that apply)
99 = Retail Sales
CoAponenC t2 Ha~e & C,A,S. Humber 20 Lead
~Fire H~zArd ~ Reactivity ~ 0elayed ~ Sudden Release ~ Immediate
He~lCh of Pressure Health
Componenb 13 Hame ~ C,A,S, Humber 20 Antimony
Physical ~nd Health Hazard C.A.S. Humber 74-98-6 Co~ponent I1 Hame I C,A.S. Humber iOd Propane 74-98-6
(Check ali that apply)
99 = Retail Sales Component 12 Hame & C.A.S, Number
~ ~ire Hazard D Reactivity ~ Delayed ~ Sudden Release ~ Immediate
Hca/Ch ' of Pressure He,ICh Component 13 Hame & C,A.S. HUmber
Physical And Health Hazard C.A.S. Number N/A Component II Hame I CA,S. Humber 20 Nitroglycerin Solution
{Check all that apply] · ' '
99 = Retail Sales
~Fire Hazard ~ Reactivity ~ Oelayed ~ Sudden Release ~ Immed~ateC°~p°nent ~2 Hame I C.A.S. ~umber
Health of Pressure Health
Component 13 H~me & C.A.S. Humber
EHERGEHCY COHTACTS fll SHeen Jereczek Sto~e Mendger (805) 664-1662 fl2 Joseph Wette~ 1st Asst.
:erCi~i~Cioq .(Re~ An~.~ign after c~mpT~Ci(]g.~ll secCi~n~)
,cerc"yunoer penalLyO~]a~:, cn{clnavepeEsonajlLexamlnqqQqo{mTamilis{.~ith the intormsclon~u~miLL~d in his endall
,C~'ached.d~cvmenc~, aflO L~ac casco on.my Inquiry 9r.cnose !noivlouals responslo/e for obtain(n9 the ln~ormacIon. ~ believe
!~OmlLLeo information 1~ crqe,' Accurate, and comp!ace,
;~'~ ' :./':'.'':Gabriel A. Friederichsen, Operations Manager ' 1/10/90
CITY of BAKERSFIELD
i? :" HAZARDOUS MATERIALS INVENTORY
"Farm and Agriculture El . Standard Business []
:~. ' NON--TRADE SECRETS Page
)USINESS NAME:Bic~ 5 Sporting Goods Store #74 OWNER NAME: United Merchandising Corp. NAME OF THIS FACILITY;
~OCATION; ~79 Columbus Street ADDRESS: 14440 Ocean Gate A~enue STANDARD IND. CLASS CODE:
,IIY, ZIP~ Rn~mne~i~l~ On. 93~fl5 ' - CZTY, ZIP~wtho~e. Ce 90250 DUN AND BRADSTREE1 NUMBER .........
)HONE fl: -- (fin,~ ~7~272. ....... PHONE ~:--~37- 77Z-~77~ - -
..... ...... REFER TO~TRUCTXONS-~R-'PROPER CODES
! 2 3 . ~ 4 5 6 I 8 9 10 11 12 13
Irons !Yqe Max Average Annual ~ea~ure IS 0la Cont Cont Cont Us tocqtion whale %wbt
~ooe LoDe Amt Am~ EsL Un~Ls on ~te Type Press Iemp Co~eStored ~n Fac~/)Ly y )lames See°f ~ixture/C~mDonentSinstrucL~ons
Physical and Health Hazard :' C.A,a, Number 100-14-1 Component II Name t C,A,S. Number 50 Benze, ne 100-14-1
(Check all that applT) .
99
Retail
Sales
Component 12 Name
~'Fire Hazard ~ Reactivit~ '~Delayed ~ Sudden Release ~ Immediate
.. .~ HeaIth of Pressure Health Component ~3 ~ame & C.A.S. Number
Physical and Hemlth Hazard ~' C.A,S. Humber Component II Hame & C,A,S. Humber
(Check all that apply)
;: /: Component 12 Hame & C.A,a, Humber
B Fire Hazard B Reactivity B 0elayed B Sudden Release B Immediate
Hem ICh of PressureHearth
:: ~ Component 13 Name & C,A.S. Humber
Physical mhd Hemlth Hmz8rd C,A,S, Humber Component I1 Hame & C,A,S, Humber
(Check all that apply)
,, *'. : Component 12 Name & C,A,S, Humber
~.B Fire Hazard ~ Reactivity B Delayed B Sudden Release ~ Immediate
- .~.:: HeaKh ' of Pressure Health
~ ;¢, Component 13 Name t C.A,S. Number
I, "I I ',,I I I i I
Ph,s}[~ls~d ~:tlth lazard::, C.A.S. Number Component ,, Name , C.A.S. Mu,bar
(Ch t , aPP Y) ~ . ,,
~; :; ?:' "::';~;:: .... Component 12 Hame & C.A.S. Humber
~;~ Fire Hazard'''~ B Re'~'~iyi~y B Delayed B Sudden Release B
Health of Pressure
~"' ' : , Component 13 Name I C.A.S, Humber
~.,. ~:,'..,..~.~T..: :::~ Health
EMERGENCY CONTACTS~:;. ¢1 Susan Jereczek Store Manager (805) 664-1662 fl2 Joseph Wetter 1st Asst. Manager
' '..',' :"~..:~ ~me Title 2~ne
ertifi aCiD "' Re ' end ~ n ~ ~ corn ~ C~ng. ~1
t~acn~d.dQcvmen[~, anQ t~a[ oaseo on.m~ inquiry Qr.[nose ~notvtaua)s responsiome for obLatn~ng the ~nforeac~on. I bel)eve that the
~O)lt[eo Inlorll[IO~.ll [¢qt, l~¢~rl[e, !~o colp/e[t,
¢.' ' r*; .... *,:~¢: ', h. ,. ' . ' ',
)~-, ', C7.' ';;;~':" ':'GBbF(e] A. Fr~eder~chsen, Operations Manager ,
B~iF~~i o~er/op~r~tor OH o~n~rlope~~~rized representative
OFFICIAL USE ONLY
HAZARDOUS ~TERI ALS
BUSINESS PLAN AS A WHOLE
FORM 2A
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
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emerMency involvinM the release 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 EmerMency Services as required by
law.
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY:
NAME AND TITLE ~DURING BUS. HRS. ~w~FTER BUS. HRS.
SECTION 3: LOCATION OF UTILIT~ SHUT-OFFS FOR BUSINESS AS A WEOLE
A. NAT. GAS/PROPANE:
B. ELECTRICAL: ~7~i
C. WATER: .. D~%5/D~ ~F
D. SPECIAL:
s.
- 2A -
SECTION 4: PRIVATE RESPONSE: TE'.~M 'FOR BUSINESS AS A WHOLE
SECTION 5: LOCAL EMERGENCY MEDICAL ASSIST~YCE FOR YOS'R BUSINESS AS A WHOLE
SECTION 6: EMPLOI~EE TRAINING
EMPL0%~RS ARE REQUIRED TO HA¥~ A PROGRAM WHICH PROVIDES EMPLOYEES WITH iNITIAL AND
REFRESHER TRAiNiNG IN THE FOLLOWING AREAS.
CIRCLE YES 0R NO INITIAL REFRESHER
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
>~TERIALS:...- ....................................~ NO YES
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: ..........................~ NO YES
C. PROPER USE OF SAFETY EQUIPMENT: .................. NO YES NO
D. EMERGENCY EVACUATION PROCEDURES: ................. · ~ YES NO
E. DO YOU MAiNTAiN EMPLO%~E TRAINING RECORDS: ....... YES N~ YES NO
SECTION ?: HAZARDOUS .~TERIAL
CIRCLE YES - NO - NONE
DOES YOUR BUSINESS HASSLE HAZARDOUS ~RTERIAL IN QUANTITIESLESS THAN 500 POUNDS 0F~
SOLid, ~ GA~:O~S O~ A ~IQUI~, OR ~00 c~BIC ~EET OF ~ COMPRESSE~ OAS: ...... ~ES ~
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.
- 2B -
SECTION 2: HAZARDOUS MATERIALS FOR THIS b~.'IT ONLY
A. Does this Facil'*'
I~¥ Unit contain Hazardous Materials? ......
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form ~4A-1)
If 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 PROTECT!O~
SE~ION 5: LOCATION OF WA~R SL~PLY FOR USE BY ~RGEN~ RESPO~ERS
SECTION 6: LOCATION OF L~rlLITY SHL~-OFFS AT THIS %TIT 0STY.
A. NAT. GA~.:PROP.XXEi
..... ca BOX: . XO rF YES, LOCATIOX:
BAKERSFIELD CITY FIRE DE?ART3.~E.YT
2130 "G" STREET
BAKERSFIELD, CA 9S$01
USE ONLY
ID~
BUSINESS NAME:
BUSINESS PLAN
SINGLE FAC ILI T'f
F 0 l:~/vI ~A
INSTRUCTIONS 1. To avoid further action, this form must be'r?tlu?ned by:
2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.
3. Answer the auestion~, below for T,,. ~ACIL..Y ~.T ____ B~0W
4. Be as BRIEF and CONCISE as possible. '
FACILI~ ~IT~ FACILI~ ~'IT
~ION 1: MITIGATION~ PR~ION, ABA~ ~0C~L~ES
SECTION 2: NOTiFICATiON A,.%q] EVACUATION PROCEDL~ES AT
21.
Ih¥1li,l'.ll(,Y (;OIlTAI:T' ~~ ~/~~~ TITI,BI · 5vL~i~ ' ~ }i[O~E I fills IlOllflS,
(:~,~ AFTER flUS liftS: ,
:11.1~(IE[~c¥ (:()ltTACT: TITLE I PIIOHB I BU~ II()IIRS:
,.Ih~'ll'Al.. flllSl/ll~S9 ACTIVITY: AFTER ~fiS. IIRS:
CITY of/SAK£.rCSF£E£D
Dear Business Owner:
Enclosed please find a copy of your response to the Hazardous Material Business
Plan reques:. We have founu it necessary :o reject your plan for the following
reason(s) as checked below.
r'"T Ill~ible Business Plan (please print or t~e infomation in English).
Fom 2A ~-I 'Missing °rF-~ Incomplete
Farm CA ~ Missing or ~ Incomplete cuZJ~ _ ~o~.,~.~. ,$7~-~ , c~.,,.~~
Form 5A
Site Oiagr~ [~issin~'or ~ Incomplete
Facilities Diagr~ [~Missing or F--T Incomplete
This is to be corrected and resubmitted within 30 days to:
Bakersfield City Fire Department
Hazardous Materials Division
2130 "G" Street
Bakersfield, CA 93301
If additional copies of any forms are needed they can be picked uD from the
Hazardous Materials Division at 2130 "G" Street in person.
Sincerely Yours, /
/Ralph E. Hu~Ir"~ Y '
/ Hazardous Materials Coordinator
~EH/eg
1. To avoid further action, return this form by
2. TYPE/PRINT ANSWERS
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
SECTION 1: BUSI}IE$S IDE!NTIF!CATION DATA
SECTION 2: EMERGE'NC~f NOTIFICATIONS
In case of an emergency involvinM the release or threatened release of a
hazardous material, call 911 and 1-800-852-?~0. or 1-916-42T-4Z41. This will notify
your local fire depmrtment and ~he State Office of Emergency Services as required by
law.
EMPLOYEES TO NOTIFY IN CASE OF F3!ERGENCY:
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A W~OLE
A. NAT. GAS/PROPANE:
B. ELECTRICAL: ~-F77-~ ~,D,i~/~ ,~c~C~2,~,4~-
C. WATER: , f?U~$iP~ ~)~ ~q/-?/~ ~//~
D. SPECIAL: ~___
E. LOC~ 80X:~.,' ~'0 [F YES, LOCATIO~¢:
IF YES DOES [T CONTA[}: SITE PLANS. YES /~', MSDSS? YES '.
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
EMPLC%~RS ARE REQUIRED TO HA%~ A PROGRAM WHICH PROVIDES EMPLOYEES WITH iNITiAL AND
REFRESheR TRAi~iNG IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INiTiAL REFRESHER
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
~TERIALS:... .................................... ~ NO %~S NO
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: .......................... ~ ~0 .YES NO
C. PROPER USE OF SAFETY EQUIPMEL~: .................. ~ NO YES NO
D. EMERGENCY EVACUATION PROCEDURES: ................. -~YES,,.Y~I,~ %~S ~0
E. DO YOU MAiN~AiN EMPL0%~E TRAINING RECORDS: ....... ¥~S NO
SECTION ?: ~AZARDOUS .~ATER!AL
CIRCLE YES - NO - NONE
DOES YOL~ BUSINESS HASSLE HAZARDOUS ~TERIAL IN_QU~YTITIES LESS THAN 500 POL~DSv 0F_J~/,.~
SOLID. 55 GALLONS OF A LIQUID, OR ~00 CUBIC FEE~ OF A COMPRESSED GAS: ...... YES ~
I, ~1~ ~~,~'- , certify that the above information is accurate.
I understand that this information will'be used to fulfill my firm's obligations under
~he-.new-Cali~nia Health and Safety code on Hazardous.Materi~ls (Div.~ZO'Chapter 6.95.~ ......
Sec. 2~500 Et Al.) and that inaccurate information constitutes perjury.
BAKER.qF!E"-D CiT'~' FiEE
2!30 "G" STREET
BAKERSFIELD, CA 93301
BUSiNE£S XAZE:
INSi'RUCTIONS
1. TO avoid further action, this form must be'rm, tttrn~d by:
Z. TYPE,,'PRIh"r YOUR ~YSWERS ~N ENGLISH.
3. Answ-- the ~uestions below f~r
4. Be as BRIEF and CONCISE as ~ssible. "'
FACIL~ ~IT~ FAC~I~ ~IT ~:
NGN--TITAI]P~ ,G I~I G IR I~I T S
IIAZ AI{fIOU~ ~ATEllI ALS' I N VEN'[Oi~Y
. . ~
AFTER BUS IIRSt
I~ I'lid'll'~l., III~SlIIES9 ACTIVITYt__ AFTER
EMERGENCY RESPONSE PLANS
IN THE EVENT OF FIRE:
1. CALL THE FIRE DEPARTMENT FIRST. Do not attempt to fight the
fire until someone has called the Fire Department. Small fires
can quickly get out of hand.
2. Turn off the air conditioning.
3. Obtain the most accessible fire extinguisher and proceed to
the fire. Our dry chemical extinguishers can be used on all
types of fires (i.e., combustibles, liquids, electrical) from
a distance of eight feet to twenty feet from the flame or
smoldering material.
4. All-purpose, dry chemical extinguishers are installed in every
store, and are located in strategic areas. All employees should
be aware of these locations.
5. Get employees and customers out of the store if danger exists.
6. Notify the Operations Department, the Security Department, and
your District Supervisor.
7. Cooperate with Fire Authorities. Follow through on suggestions
and corrective measures. If help is needed from the Maintenance
or Security Departments, contact the Operations Department or
your District Supervisor if they are not already there. See
that these things are done as soon as possible.
8. Do NOT throw out any burned or water damaged merchandise until
an insurance inspection has been made, and then only if directed
to do so.
9. The Fire Department can supply you with exhaust fans to remove
smoke from the store.
10. Reopen the store if approved by the Fire Authorities.
11. Stay with the store and protect the company's property after
the fire.
12. If guard service protection is needed, contact your District
Supervisor or the Operations Department.
JRM:jw
DF1:030
HANDLING HAZARDOUS iqATERIAL$
All propane and white gas fuel is shipped in factory sealed/D.O.T.
approved cartons. This is the only acceptable manner in which
to transfer or return combustible material.
All hazardous materials are to be loaded and unloaded by hand,
one carton at a time. Never throw or drop cartons containing
hazardous materials.
All hazardous and combustible materials are to be stored well
away from heat generating appliances, and are not to be stacked
or shelved in an unsafe manner.
In the event of a spill, the area should be secured from employee
and customer traffic, an~ kept well ventilated. Contact the
Fire Department for instructions regarding clean-up or disposal,
and have the information regarding the exact contents ready.
JRM:jw
DF1:029
EMPLOYEE TRAINING
It is the responsibility of each store manager to see to it
that all current employees, and each new employee, is instructed
in the proper procedure for handling hazardous materials.
These instructions shall include correct methods for loading,
unloading, storage, and shelving of these materials.
All employees should be made aware of the location of emergency
equipment and instructed in its use.
An employee check-off list shall be maintained in the manager's
office, to insure that each employee has been instructed properly.
JRM:jw
DF1:028