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Home My WebLink AboutBUSINESS PLAN7-Eleven Food Store #23446 2300 Col umbus Bakersfield, CA 93306 7-Ele~n Food Store #2]~0!:~23446 2300 Columbus Bakersfield, CA 93306 7-Eleven Food Store #2125-23446 2300 Columbus Bakersfield, CA 93306 7-Eleven Food Store #23446 2300 Col umbus Bakersfield, CA 93306 0 ~ z 3 4~¢ BUSINESS/DEAPRTMENT NAME: "t77'-. ('~/~ - ADDRESS: ,~. ~ e:2~__) ('"f~~ , .~L PROJECT NUMBER: <~--( ( ?~'-/'~- ~ DA~: N~: CHGD:. ,COM~~S: PROJECT COMPLETION: DATE: ~'~~ CITY of BAKERSFIELD ~Z.-~,,"'b 3]j ,,~,v. CARV. - H.~g'.~RDOI. JS i~I.~"I'E R 1 2~.LS DIVI S IO~ FIRE DEPARTMENT ~ I ~ C H~RG E D 2101 H STREET S. D. JOHNSON BAKERSFIELD, 93301 FIRE CHIEF 326-3911 PROJECT DESCRIPTION: TIME DATE: N~E: CHGD: CO~ENTS: '.'RETURN PAYMENTS TO ' ' .. , '"'~'-~ ~.,".. ',.. ' . ' ' ~ ; '"',,' - ' ' , -; . , '."' '::;-' ' PLEASE MAKE CHECKS PAYABLE'TO: ,~'.' -'P.O. BOZ2057'" :: .' . ,, [ -: ," . ~' .":,. ~ ::~..'~ . ':'.;,~';'.~':'.'::';,:'"- ;:.' ?,';:'.',~' ~.' ~ CITY OF BAKERSFIELD "'~ BAKER~FELD'CA'93303-~O5~,' '"AccOUnT NO ' ~-'~'~'5'~:'' - "' ': .... ~: ~, · ," ' ,., . .. ,., ,. , .~'"AC , .., .' ~: ~."',,:.. ,:..:.. ., , '~,;",, , MUST RETURN THIS COPY WITH PAYMENT "RETURN PAYMENTS TO: ..... ..... ' .......... · ' ..... ~' PLEASE MAKE CHECKS PAYABLE TO: CiTY OF BAKERS~LD,~f? ~ ]~,.~ ~ ~OOL]S NA~E~ ' ~ ....... ' ' P,O. BOX 2057 ' : ~ CITY OF,BAK~RSFIELD BAKERSFIELD, CA 93303-2057 ACCOUNT NO, . ~D~'2~5"' ' "' INQUIRIES CONCERNING THiS ~ILL, PLEASE PHONE: ~52 5= ~ ~ ~' ': ' ~VOICENUMBER 3],~3 ~!LLD~; R~E.~ SU~T~ CUSTOMER COPY 3o/~l/~z -/ ~L~VEN FOOD STORE #2125-23446 215-~U0(-._~ L -a%o~ age Overall Site with 1 Fac' Unit _ General Information Co--unity: BAKERSFIELD STATION 08 Grid: 0.0 Contact Name Title Business Phone --- 24-Hour Phone- SHINDA UPPLE FRANCHISEES , (805) 871-1438 x (805) 322-2995 TIM JONES ~NAGER '(805) 834-2711 x (805) 834-2711 Administrative Data Mail Addrs: 2300 COLUMBUS ST D&B Number: 00-734-7602 City: BAKERSFIELD State: CA Zip: 93306- Co~ Code: 215-008 BAKERSFIELD STATION 08 SIC Code: 5541 Owner: THE SOUTHLAND CORPORATION Phone: (805) 834-2711 Address: 3128 WILLOW AV SU 301 State: CA City: FRESNO Zip: 93612- Sugary i,<:~_' ~.1 .~ igt~ ~('tDo hareby certify that~ have ~y~ or print n~) reviewed ~h~ z~.;:achec: .......... msnt plan ~c,i' · .,',d ~hat it along with :~ ~Lolt[it~ ~ complete and ~rrec~ man- agemen~ plan ~or my facil~y. 08/31/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 UNLEADED GASOLINE Liquid 12000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use:.FUEL Daily'Max GALI Daily Average GAL ] Annual Amount GAL 12,000 ~ 9,000.00 88,149.00 Storage Press T Temp~ Location UNDER GROUND TANK Ambient/AmbientlUNDERGROUND FRONT PARKING -- Conc Components ~ MCP List 100.0% IGasoline IModeratel 02-002 UNLEADED PLUS GASOLINE Liquid 12000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006r61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI Daily Average GAL ] Annual Amount GAL -- 12,000 ~ 9,000.00 128,066.00 Storage Press T Temp~ ' Location UNDER GROUND TANK Ambient/AmbientlUNDERGROUND FRONT PARKING -- Conc Components ~.. MCP List 100.0% IGasoline IModeratel 02-003 SUPER UNLEADED GASOLINE Liquid 12000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI Daily Average GAL 1 Annual Amount GAL 12,000 ~ 9,000.00 21,383.00 Storage~ I ~ ·Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlUNDERGROUND FRONT PARKING -- conc Components MCP List 100.0% IGasoline IModeratel 08/31/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBALLY AND CALL .911 BUSINESS EMERGENCY PLAN ON FILE UNDER 7-11 EMERGENCY COORDINATOR SHALL IMPLEMENT PROCEDURES FOR THE SAFETY OF ALL PERSONS AND THE ENVIRONMENT. NOTIFICATION WILL BE COMPLETED BY THE EMERGENCY COORDINATOR, AS INSTRUCTED. <3> Public Notif./Evacuation THE EMERGENCY COORDINATOR SHALL IMPLEMENT PROCEDURES FOR THE SAFETY OF ALL PERSONS AND THE ENVIRONMENT. NOTIFICATION WILL BE COMPLETED BY THE EMERGENCY COORDINATOR, AS INSTRUCTED. <4> Emergency Medical Plan NEAREST E.R. TO LOCATION IS TO BE USED IN THE EVENT OF INJURY POLICE/FIRE DEPARTMENT: 911 08/31/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page. 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention STANDARD GASOLINE STATION SAFETY FEATURES FOR GAS PUMPS. AUTOMATIC SHUT OFFS, VAPOR SHIELDS, SHUT OFF VALVE--COMPRESSED GASSES PROPERLY STORED IN SMALL SAFETY CONTAINERS AND WITH PROPER FITTINGS. BUSINESS EMERGENCY PLAN ON FILE AT EACH STORE TRAINING OF ALL STORE OPERATORS COMPLETED REGARDING USE OF EQUIPMENT AND PROPER PROCEDURES PERTAINING TO THE HANDLING OF HAZARDOUS MATERIALS. MSDS SHEET AVAILIABLE FOR ALL PERSONS TO REVIEW. <2> Release Containment TO BE HANDLED BY THE SOUTHLAND CORPORATION UPON NOTIFICATION BY OWNER. <3> Clean Up PROCEDURES IN RESPONSETO A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS WILL BE HANDLED BY THE SOUTHLAND CORPORATION UPON NOTIFICATION BY THE EMERGENCY COORDINATOR. ~ <4> Other Resource Activation 08/31/92 7 ELEVEN FOOD-STORE #2125-23446 215-000-000811 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - BACK ROOM HALLWAY C) WATER - STORE SIDE C) WATER - STORE SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS LOCATED AT THE FACILITY FIRE HYDRANT - (WHERE IS YOUR NEAREST ONE?) <4> Building Occupancy Level 08/31/92 7 ELEVEN FOOD STORE 92125-23446 215-000-000811 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 5 EMPLOYEES AT THIS FACILITY WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE TRAINING OF ALL STORE SOPERATORS COMPLETED REGARDING USE OF EQUIPMENT AND PROPER PROCEDURES.PERTAINING TO THE HANDLING OF HAZARDOUS MATERIALS. MSDS SHEETS AVAILABLE FOR ALL PERSONS TO REVIEW. <2> Page 2 as needed <3> Held for Future Use \ <4> Held for Future Use 04/27/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 RECEtVE~age ~. Overall Site with 1 Fac. Unit 1 5 1992 ~ General Information Location: 2300 COLUMBUS ST Map: 103 Hazard: Low Co.unity: BAKERSFIELD STATION 08 Grid: 15C F/U: 1 AOV: 0.0 ~ Contact Name . ~ Title ~ Business Phone 24-Hour Phoneq I~u~ a JU~ ~,~,,~: /FRANCHISEES '(805) 871-1438 x ~)S~z -2qq~ Administrative Data Mail Addrs: 2300 COL~BUS ST D&B Number: 00-734-7602 City: BAKERSFIELD State: CA Zip: 93306- C6~ Code: 215-008 BAKERSFIELD STATION 08 SIC Code: 5541 Owner: THE SOUTHLAND CORPO~TION Phone: %~ )~ - ~%k Address: 3128 WILLOW AV SU 301 State: CA City: FRESNO Zip: 93612- Sugary reviewed the attached hazardous me!!., rials merit pmn for-7-E/-~,'c-~ and that It along with any ¢:orrection$ constitute a complete and correct man° agement plar~ ~or my facile. 04/27/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 UNLEADED GASOLINE Liquid 12000 Moderate · · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI Daily Average GAL I Annual Amount GAL . 12,000 ~ 9,000.00. 88,149.00 Storage~~Press I Temp Location UNDER-GROUND TANK IAmbient~AmbientlUNDERGROUND FRONT PARKING -- Conc Components MCP List 100.0% i Gasoline I ModerateI 02-002 UNLEADED PLUS GASOLINE Liquid 12000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GALI Daily Average GAL 1 Annual Amount GAL 12,000 ! 9,000.00 128,066.00 Storage}~Press T Temp Location UNDER GROUND TANK IAmbientlAmbientlUNDERGROUND FRONT PARKING -- Conc Components MCP List 100..0% IGasoline IModeratel 02-003 SUPER UNLEADED GASOLINE Liquid 12000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL. Daily Max GALI Daily Average GAL I Annual Amount GAL 12,000 ~ 9,000.00 21,383.00 Storage$$Press T Temp Location UNDER GROUND TANK IambientlAmbientlUNDERGROUND FRONT PARKING -- Conc . Components ~ MCP List 100.0% IGasoline IModeratel 04/27/92 7 ELEVEN FOOD ~STORE #2125-23446 215-000-000811 Page 3 00 - Overall Site · <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBALLY AND CALL 911 BUSINESS EMERGENCY PLAN ON FILE UNDER 7-11 EMERGENCY COORDINATOR SHALL IMPL'EMENT pRocEDURES FOR THE SAFETY OF ALL PERSONS AND THE ENVIRONMENT. NOTIFICATION WILL BE COMPLETED BY THE EMERGENCY COORDINATOR, AS INSTRUCTED. <3> Public Notif./Evacuation THE EMERGENCY COORDINATOR SHALL IMPLEMENT PROCEDURES FOR THE SAFETY OF ALL PERSONS AND THE ENVIRONMENT. NOTIFICATION WILL BE COMPLETED BY THE EMERGENCY COORDINATOR, AS INSTRUCTED. <4> Emergency Medical Plan NEAREST E.R. TO LOCATION IS TO BE USED IN THE EVENT OF INJURY POLICE/FIRE DEPARTMENT: 911 04/27/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page 4 00 - Overall Site ~ ~ <E> Mitigation/Preven~/Abatemt. <1> Release Prevention STANDARD GASOLINE STATION SAFETY FEATURES FOR GAS PUMPS. AUTOMATIC SHUT OFFS, VAPOR SHIELDS, SHUT OFF VALVE--COMPRESSED GASSES PROPERLY STORED IN SMALL SAFETY CONTAINERS AND WITH PROPER FITTINGS. BUSINESS EMERGENCY PLAN ON FILE AT EACH STORE TRAINING OF ALL STORE OPERATORS COMPLETED REGARDING USE OF EQUIPMENT AND PROPER PROCEDURES PERTAINING TO THE HANDLING OF HAZARDOUS MATERIALS. MSDS SHEET AVAILIABLE FOR ALL PERSONS TO REVIEW. <2> Release Containment <3> Clean Up PROCEDURES IN RESPONSE TO A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS WILL BE HANDLED BY THE SOUTHLAND CORPORATION UPON NOTIFICATION BY THE EMERGENCY COORDINATOR. <4> Other Resource Activation 04/27/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE ~ B) ELECTRICAL - BACK ROOM HALLWAY C) WATER - STORE SIDE C). WATER - STORE SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS LOCATED AT THE FACILITY FIRE HYDRANT - ? <4> Building Occupancy Level 04/27/92 7 ELEVEN FOOD STORE #2125-23446 215-000-000811 page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 5 EMPLOYEES AT THIS FACILITY WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE TRAINING OF ALL STORE SOPERATORS COMPLETED REGARDING USE OF EQUIPMENT AND PROPER PROCEDURES PERTAINING TO THE HANDLING OF HAZARDOUS MATERIALS. MSDS SHEETS AVAILABLE FOR ALL PERSONS TO REVIEW. <2> page 2 as needed <3> Held for Future Use '' <4> Held for. Future Use HAZARDOUS MATERIALS DIVISION Date Completed//- ! Z-"/Z.. Business Name: "7- I ~ £7D£e" -'~'~, / gS- -- Z,~ Location: '-6900 cocu n,~ 1'~c~ $ RFCE!VED Business Identification No. 215-000 4:;001~'// {Top of Business Plan) NOV 1 '6 1092 Station No. ~" Shift ~;) Inspector HAZ. MAT. DIV. Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location ~] Proper Segregation of Material J~] J~] I Comments: Verification of MSDS AvailablityJ~] J~] ..,-,~t~,l~~ " -c/t~"' Number of Employees O ~ Verification of Haz Mat Training J~] J~] ~/,,,,~ Comments: Verification of Abatement Supplies & Procedures J~] J~] Comments: Emergency Procedures Posted J~] J~] Containers Properly Labeled J~] J~ Comments: Verification of Facility Diagram J~ J~] Special Hazards Associated with this Facility: Violations: All Items O.K. JJ~] Correction Needed JJ~] Business Owner/Manager FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy / HAZARDOUS MATERIALS INSPECTION nUS~NSSS ~U~E: 7- ~/~ ~r~ %~'-~ RECEIVED ~.s..:IO. ~: /X~/_~ i.s~.~.: ~~ DEC 5 1988 ~n~'d ............ V~I~I~IO~ O~ ~III~ ~ VERIFICATION OF HAZ MAT TRAINING VERIFICATION OF MSDS AVAILABLE VERIFICATION OF ABATemENT S~Pp~.TF~S & PRO~ED~R~S ~--~ VIOLATIONS: Steven S. Jones {~3'~e or ~rin~ name Do hereby cerzify that I have reviewed the RECEIVED FEB I 4 1989 attached Hazardous Ma%erials business 'Dlan HAZ. MAT..DiV. for 7-Eleven Food_~ore __ {name of business) and that it along with the attached additions or cor-ections, consti'~u*e~ a comp!ere and co~-=ct._._ Business Plan for my .facility. ' " ~na~dre '~ - aa'~e - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805} 326-3979 INS'mO~ l. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer tho questions belo,~ for the business as a whole. " 4. Be as b~tef and conc[~ as possible. A. BUSINESS NAME:_ ]-E_leven Food Storg #:'27~,0-23446. , , , B. LOCATION / STREET CITY: Bakersf%~,%d ...... ZIP: ..93~Q,6~_ BUS.PHONE: (805)_ 871-1438 In case of an emergency !nvolv~n~ the release or threatened release of a your local fire dep~rt~en~ ~a~ th~ Sta~e Office of gmerff~ncy Service~ as required by law. E,~PLOYEES TO NOTIFY IN CA$~ O~ F~PfRGENCY: NAME AND TITLE ~ DL~ING BUS. ERS. AFTER BLS. ERS. A. Ron & Judy KniEht,, Franchisees.~ PhC (805) 871-[438.=_.phm.~ . same "~' ~- ~ "~-'~'~ -' ~' 4 B. :$t~.-.~o~e:~,_.~~.,- .... ~-Ph~ (805~ 83~33~ Ph~ same A. NAT. GAS/PROPANE: None B. L CT. IC : ' C. WATER: Store side/fr.~._~ont ..... D. SPECIAL: E. LOCK BOX: YES IF YES, LOCAT!ON:_~_~.._~.~. IF YES, DOES IT CONTAIN SITE PLANS? (YE~ / NO ~SDSS? (YES)/ NO FLOOR PLANfi? YES / NO KEYS? ~£S / NO - 2A - Emergency Coordinator(pre-determined) shall notify all agencies and i, nter-company persons in the event of £nc£den~. Emergency Coordinator shall implem~en= all necessary measures in regard to employee/environmental safety as instructed by [rianing received. POlic/Flre Department: 911 Nearest E.R. to location is to be used in the event of injury. EMPLOYERS ARE REQUIRED TO }lAVE A PR0~R/u~ WMICR PROVIDES r_WPt0Y~ES WITH INITIAL ~TER fALS: ....................................... ~. PROPE~ USE OB $~E'i~ ~QUZP~,~: .................. ~.~ ~NO ~0 :~ , D. E~RGEN~ ~ACUATIO~ P)'t~ED~ES: ................. ~ NO NO E ~ YOU ~kI~[AIN E~LO~B ~ .... N~ RECO~S: ....... NO CIRCLE ~S OR NO DOES YO~( BUSI~ ~ F~US ~TERIAL IN QU~ITIE~ ~ESS ~ ~00 ~0%~S OF A~ SOLID. ~5 ~[.LON'S O~ .% LIQUID. OR 200 CUD~C FEET OF A CO.RESEED G~: ...... ~S NO~ I. Ron ~h~ , , ..... certlfy that the a~ve ~.nformatloa Is accurate. ~ ~der.tand tha~ ~hi~ l~foru, a~ion will be u~ed %o fulfill ~y firm's obll~t!ons under the new Callfornla R~l~h ~d S~t~ e0d~ on R~rdou~ ~%e~i~l~ (Div. RO chap%er 6.95 Sec. ~5500 Et Al.) and that Inaccurate ~nforu~cion con~tl~u~es perjury. SIG~E ~ T~E . ?ra.gchi~e_e .... DA~ -BAKE RSF. IF. LD~-CA -~93308 OFFICIAL USE ONLY ID# BUSINESS NAME: BUSI NESS PLAN SINGLE FACILITY UNIT INSTRUCT I ONE 1. To avoid further action, this form must be returned by: 2. TYPE/PRI~'T YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for TItE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# FACILITY UNIT NANE: 7-Eleven Food Store 2720-23446 SECTION 1: I~ITIGATION~ PRBVF~rrION~ ABATENENT PROCEDOP~$ PREVENTION - Training of all store operators completed regarding use of equipment. and proper procedures pertaining to tile handling of 'hazardous materials. MSDS sheets available for all persons to review. MITIGATION - Procedures in response to a release or tl;reatened release of a hazardous materials will be handled by T.be Southland Corporation upon notification by the Emergency Coordinator. SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY The Emergency Coordinator shall impleme;~t procedures for tile safety of all persons and the environment. Notification will be completed by the Emergency Coordinator, as instructed. HMCU-6 SECTION 3: HAZARDOUS ~IATERIALS FOR TRIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~ NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret as defined by Section 6254.? of the Government Code? ......... YES~NO=~ If No. complete a separate hazardous materials Inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) 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 for! 4A-2. SECTION 4: PRIVATE FIRE PROTECTION 1. ·Fire extinguishers located at the facility. 2. Call 911 or (805) 861-2577. SECTION 5: LOCATION OF MATER SUPPLY FOR USE BY F_~ERGENCY RESPONDKRS SECTXON 6: LocATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. ~',~"~' A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO.. m~CU-6 NON--TR/~D E S ~iCRETS ~usI~sS ~A~: 7-Eleven Stoz'e 272()~23446. OW~i NA~:~: 7-Eleven Market 2~_ ~v:~ o~' T~ E~c~L!~: ]-Eleve~ LOCATION:~~ ~DD~ZSS: 4008 White Lane STANDarD IND. CLASS CODE ~4 11 crrY, ZI~: Bakersfield 93306 CITY, ziP: Bakers[ield ~.~ DUN AMD ~RADSTR~E'f NUNBER ....... ,_ y_~o~_~Lr.e~;_ ~ ] -.- ,~.,,,,,~, .,,',~,'""~,,.,":"' ~.,.,. ~:~,. .-.8°°6'6 ,9 ~,: ,, ~ ; c.,.s. ~ .... [~ ~]~ ~ ~]~~ I---i / . I ~er .Unleaded C~l~%2~i _ He~lth of ~r~ s~r~ ~eslth :,t~:~ c~;*c~S ~ Ron Knight Franchisee 805/871-1438~2~ Steve Jones Market Mana~ 805/6647~ Steven S. Jonea, Markee Mana.*er ~ .... ~' ~ n..~ ~ · Facility Identification. ': ::.':: ':... ':: Owner/Operator Name ': ' :' ' EMERGENCY SIr. IA~ ~EC C0LU~US/MT V~NON Mail~es, 2828 N. H~kell -.~las, ~ 75204 AND BAKERSFIELD CA ~3305~ ' -:' CHEMICAL Sto~e M~age~ ST0~ N0 INVENTORY --~ ~ TITLE: STO~E F~ANAGER byChemical PHONE: (gO5) 371-1438 Important: Read all Jnstructio~ before completing form Chem. N~e __ of that apply: ~e ~i~ ~ L~ Gas ' ' Che~. Name Chem. N~e __ Certification "(Reed and lila afttr compltting alt lection~) ' · Optional Attachments (C~eck oneJ Fo~m AplXoved OM8 NO. ~72 Tier Two ~.~ ~ ~ge 1 ~ ~ ~uthl~d Co--rations_.. ~ ( 214, 522-4790 2828 N. H~kell Texas 75204 EMERGENCY Str., A~,esl Mail ~,s, AND City State Z,p · . : · · ~ INVENTORy N~ Information Numar I I i-m 24 ~. ~ ( ) Important: Read all i~xtr~ction$ bg/or~ com~lgtin~ [orm Repomlng Period Fr~ Januau I to ~ 31. 19 Chem. N~o __ of ~ess~e that apply: ~l Mix ~1~ Lipid Gal I S~ Re~a~ : Chem. N~e __ of ~ess~J ~iate (a~tel -- S~den Release Chem. N~e ~ et Press~e Reactivity i~ ~ m m -- ~iate (acute) m m Certification (~ead ~nd ~i~n ~ter tompleging all ~eczion~) Optional Attachments ~ my i~u~ Of t~se I~lvlduall res~llblJ I~ Obtainl~ the infamalt~, I ~li~e that t~ su~itt~ Inf~mali~ is t¢~, 8cc~ale, and complete ~ I have attac~ed a Sita plan HAZARDOUS MATERIALS HANDLING PROCEDURES FUEL SPILLAGE EMERGENCIES 1) In case of large fuel spill, (50 square feet or larger or any- thing that looks potentially hazardous) CALL THE FIRE DEPARTMENT. 2) In case of small fuel spill 50 square feet or smaller, determine potential hazard. Use absorbent material (kitty litter or sand), absorbent pad, or for very small spills, let evaporate. UNDER NO CIRCUMSTANCES HOSE OFF WITH WATER. THIS WOULD CAUSE UNDER- GROUND CONTAMINATION AND WE COULD BE FACED WITH A VERY LARGE CLEAN-UP BILL. Keep used clean-up material in a metal container with metal lid. 3) For removal of clean-up material for #1 or #2, call Tom Carmichael at 1-800-541-0334. 4) Know where the fire extinguisher is and how and when to use it. If you have to use a fire extinguisher, A~WAYS CALL THE FIRE DEPARTMENT FIRST. In our store the fire extinguishers are located: . 5) Know where and how to shut off power to gasoline equipment. Every store is different; have someone show you. In our store the gaso- line power shut-off is located: CO2 TANK HANDLING 1) All CO2 tanks are to be stored with metal cap in place (except when in use). Replace metal cap on tank after use (empty). 2) AI__I CO2 tanks are to be chained up tightly 3/4 way up at all times. Signed: Witness: Employee Franchisee/Store Manager Complete and file in each employee file. ~IZARDOUS ~TERIALS HANDLING PROCEDURES FUEL SPILLAGE EMERGENCIES i ,;-. 1) In case of large fuel spill, (50 square feet or larger or any- thing that looks potentially hazardous) CALL THE FIRE DEPARTMENT. ' ' 2) In case of small fuel spill 50 square feet or smaller, determine potential hazard. Use absorbent material (kitty litter or sand), absorbent pad, or for very small spills, let evaporate. UNDER NO CIRCL51STANCES HOSE OFF WITH WATER. THIS WOULD CAUSE UNDER- GROUND CONT,~MINATION ~ND WE COULD BE FACED WITH A VERY LARGE CLEAN-UP BILL. Keep used clean-up material in a metal container with metal lid. 3) For removal of clean-up material for PI or #2, call Tom Carmichael at 1-800-541-0334. 4) Know where the fire extinguisher is and how and when to use it. If you have to use a fire extinguisher, ALWAYS CALL THE FIRE DEPARTMENT FIRST. In our store the fire extinguishers are located: 5) Know where and how to shut off power to gasoline equipment. Every store is different; have someone show you. In oue store t.he line power shun-off is located: CO2 TANK HANDLING 1) All CO2 tanks are to be stored with metal cap in place (except when in use). Replace metal cap on tank after use (empty). 2) All COp tanks are to be chained up tightly 3/4 way up at all times. PLEASE POST IN STORE SITE/FACILITY DIAGRAM FORM S NORTH SCALE: BUSINESS NAHE: FLOOR: OF 7-Eleven Food Store DATE: / / FACILITY NAME: UNIT #: OF 7-Eleven 2720-23446 ' (CHECK ONE)' SITE. DIAGRA~ FACILITY DIAGRAM ~ (Inspector's Comments) -OFFICIAL USE ONLY- HNCU-13 BAKERSPIELD CITY FIRE DEPARTMENT R E ~, F,. ! V F_ D 213o "G" S~EET B~RSFIELD, CA 93301 JO~ 1 3 1987 (805) 326-3979 OFF[C[AE ~SE HAZARDOUS ~TERI ALS BUSINESS PL~ AS A WHOLE ~OR~ ~A 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 A. BUSINESS NAME: 7-Ete~en Food Store #2125-23446. B. LOCATION / STREET ADDRESS: 2300 Columbus CITY: Bakersfield ZIP: 93306 BUS.PHONE: (805) 871-1438 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800o852-7550 or 1-916-427-4341. This will noti,fy your local fire department and the state Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE O~ EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Ron & Judy Knight, Franchisees Ph~ (805) 871-1438 Ph~ same B. Kathy Me2ia~ District Manager 2125 Ph~ (805) 834-2711 Pht same SECTION 3: LOCATIOWOF UTILITY SRUT-OFFS FOR BUSINESS AS A MBOLE A. NAT. GAS/PROPANE: None B. ELECTRICAL: back room~hallway C. WATER: Store side/front D. SPECIAL: --~ -E. LOCK BOX: YES /(N~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? (-YE~ / NO MSDSS?/~YES)/ NO FLOOR PL~S? YES / ~0 KEYS? YES / NO - 2A -~ sEcTIoN'4': PRIVATE RESPONSE TEAM FOR BUSINESS AS A W~OLE Emergency COordinator(pre-determined) shall notify all agencies and inter-company persons in the event of incident. Emergency Coordinator shall implement all necessary measures in regard to employee/environmental safety as instructed by trianing'received. SECTION 5:' LOCAL ENER6ENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE POlic/Fire Department: 911 Nearest E.R. to location is to be used in the event of injury. SECTION 6: EI~LOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRA~ WHICH PROVIDES EMPLOYEES WITH INITIAL A~ REFRESHER TRAINING IN THE FOLLOWING AREAS~ CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS: ....................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. PROPER USE 0F SAFETY EQUIPMENT: .................. YES NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES NO YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO SECTION ?: ~AZARDODS ~ATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ,~TERIAL IN QUANTITIES LESS THAN §00 POL~DS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES .NO I, Ron Knight , certify that the above lnfor~ation 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 - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFiCiAL USE ONLY ID# BUSINESS NAME: BUS I NESS PLAN SINGLE FACILITY UNIT FOPdVI 3A INS~UCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW -.--. ...... : 4. Be as BRIEF and CONCISE as possible. . ..... FACILI~ WIT# FACILI~ WIT N~: SECTION I: mITIGATION, PREVENTION, ABATE~ PROCEDO~ES SECTION 2: NOTIFICATION ~\q] EVACUATION PROCEDURES AT THIS L~'IT ONLY - 3A - BAKERSFIELD CITY FIRE DEPARTMENT I.D. ~ FORM 4A-1 Page 1 of NON--TRADE SECRETS HAZARDOUS I~[ATERI ALS INVENTORY BUSINESS NAME: ?-Eleven Food Store #2125-23446 OWNER NAME: The Southland Corporation FACILITY UNIT ~: 100 ADDRESS: 2300 Columbus ~ ~t, Vernon ADDRESS: 1240 S. State Col~ege BY, FACILITY UNIT NANE: CITY, ZIP: Bakersfield, CA 93306 CITY,ZIP: Anaheim, CA 92806 P~ONE ~: (805) 871-1438 PHONE ~: (714) 635-7711 ]OFFICIAL USE CFIRS COOE I 1 2 3 4 5 6 7 8 9 TYPE ~AX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D,O,T CODE A~OUNT ABOUNT UNIT CODE CODE FACILITY UNIT WT, CNE~I~AL OR CO~ON NANE CODE GUIDE ~ 12,0~0 88,1~9 G~ 01 19 store front/Columbus 100 Gasol~ne/~nleaded FLLQ 1203 '" M 12.0.00 128,066 GAL ...01 19 " 100 Gasoline/Regula~ ~/f~ FLLO 1203 H ~ ,,~ ~ fi& .~q ~ ~1~ ~.~t~ 100 CO?/Carbon D~ox~de NFLO 1013 NAME :~ol~ttla TITLE: Gasoline Manager SIGNATURE: ~ DATE: 6/8/87 EMERGENCY CONTACT: Ron & Judy Knight TITLE: Franchisees ~ BUS MOURS: AFTER BUS MRS: EMERGENCY cONTACT: Wm~hv ~m, TITLE: ~4mtr~ ~mnmg~r: 9]?~ PHONE ~ BUS MOURS: (8fi~)834-2711 PRINCIPAL BUSINESS AcTiVItY: Conv~n~n~m mt~rm w~th Melf-se;ve ~asollne AFTER BUS MRS: (805)834-7711 - ~-~ - October 27, 1987 Jack Doolittle 7-Eleven Stores 1240 South State College 81vd, Suite 100 Anaheim, CA 92806 Dear Mr. Doolittle: Per your request I have indicated which of your facilities are located within the City of Bakersfield. Per the joint powers agreement with Kern Oounty some of these 'facilities may be covered by either' Kern County of the City of Bakersfield under an emergency situation. The Hazardous Materials Business plans for all 14 of the facilities located in Bakersfield are the responsibility of the local administering agency - Bakersfield Fire Department. The business plans that were for facilities outside of the Oity were forwarded to the County upon our receipt. I do hope this clears up any questions on your part. Sincerely, Ralph E. Huey Hazardous Materials Coordinator REH/ed October 21, 1987 RECEIVF.q OCT 2 2 Bakersfield City F±re Department .~ll$'d 2130 ';G" Street Bakersfield, Calif. 93301 Attn: Ralph Huey Dear Mr. Huey, Recently we have received returned packets of HaZardous Materials Business Plans Chat had been submitted to your office as required. These returned Business Plans are being sent back from Kern County Fire Department, rather than from the City of Bakersfield Fire Department~which are requested to have further information submitted and to be returned to the proper agency. In July of 1987, I sent a letter with information that you had requested of our 2-Eleven locations(see attached). This.had been sent to ensure that all material was being completed and submitted to the proper agency. There now.seems to be a problem with which 'fire agency to report to. I am asking for yOur assistance:_in this matter. Attached is a list of all 7-Eleven facilities in the County of Kern. This is a complete list of all of our locations in the area, both gasoline and non, gasoline facilities are listed. Please check the list and notate in the area Provided those locations that are covered by Bakersfield City Fire Department. I would like to thank you in advance for your prompt attention and co-operation in this matter. Please return the form after completion in the pre-addressed stamped envelope. Sincerely,J ~ / Jack Doolittle Division Gasoline Manager Western Pacific Division JD:jas attachments 7-Eleven Stores/Western Pacific Division 1240 South State College Blvd. / Suite 100 / P.O. Box 6520 / Anaheim, California 92806 / Phone (714) 635-7711 ~") CORPORATION