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Home My WebLink AboutBUSINESS PLAN City of Bakersfield ~ CUSTONER RECEIPT ~,~ DATE:'2/26/96 81RECEIPT~ 8017587 ~ N~E A~OUNT TP FR TANK TESTING ~55.~0 83 CK TI~E~ 16:31:15 TOTAL CHECK ~55o00 PERMIT STATEMENT Bak~ield Fire Dept.-' l~ff'5 Chester Ave. Bakersfield, CA 93301 AMOUNT AMOUNT UST/AST PERMIT 82 TENTS, LPG 84 STATE SURCHARGE $6 FIREWORKS. POWDER, 84 / OTHER PERMITS COPIES/REPORTS 89 FD1595 HMMP PLAN MAP SITE DIAGRAMS] FACILITY DIAGRAM Business Name: Circle K Stores Inc. #8825 /~ Area Map # 1 of 1 North Name of Area: Circle K Stores Inc. #8825 U 2222 'F' St., Bakersfield Scale 1" = 26' Parking Lot Gas Pumps I 10K Gal I 'F' ~ 10K Gal I 1809 4 23rd St. I 10K Gel I St. ~_ ~ Residence Plan Emergency 6' Brick Driveway Pump Shutoff Counter Dermatology 14 CYLINDERS Firs Ext. Group / ~ Parking ~ '~ Store #8825 O' 2222 'F' Street 5' Chainlink Fsnce Apartments Residence -5- HMMP PLAN MAP SITE DIAGRAM~ FACILITY DIAGRAM Business Name: Circle K Stores Inc. #8825 Area Map # 1 of 1 North Name of Area: circle K Stores Inc. #8825 2222 'F' St., Bakersfield Scale 1' = 26' Parking Lot .............................. SidGWalk'. ............. Driveway Gas Pumps I 10K Gal i 222~ ~ ~r ...... 'F' ~f 10K Gel 1809 St. ~ ~- -- 4 23rd I 10K Gel I St. ~_ ...... ~ Residence Morris Plea Emergency 6' Brick Driveway Pump Shutoff 'F' Counter Yec; (~) 2215 2ard ;hU.~oPf f Kern ~ Dermatology Fire Ext. Group / =~ Parking 4C~ Store #e825 2222 'F' Street 5' Cheinlink Fence Apartmsnt~ Rseidsncc -5- ' ~'~ 'SYMBOLS {~GAS I MSDS~ MSDS STORAGE { FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT (~ WATER ~ ~' GATE IN FENCE ~ -- STANDARD 'DOOR SPRINKLER FIRE DEPT. CONNECTION I 10,000 ~! STORAGE UNDERGROUND i A FIRE HYDRANT PUBLIC L.Ga_l TANKS LIST I - -- -- CAPABILITY ~ RAILROAD TRACKS O-FIRE HYDRANT - PRIVATE ....... 1 0,000 ABOVEGROUND TANKS ( AUTOMATIC SPRINKLERED Gal BUILDING OR AREA ~ EVACUATION AREA (~ FIRE ALARM ~'~PESTICiDE~ ~ J [~ AREAPESTICIDE STORAGE ~, STORAGE U ,TYPES OF HAZARDOUS MATERIALS HMMP PLAN MAP SITE DIAGRAM [~ FACILITY DIAGRAM [-] Business Name: Circle K Corporation #8825 Area Map # 1 of 1 ~ North Name of Area: Circle K Corporation ~8825 2222 'F' Street, Bakersfield CA Pict Plan - Circle K Store #8825 2222 'F' Street, Bakersfield Parking Lot Driveway Get Pumpe 'F' IOK Qsl I ;':)rd <~ .4 st. 8t. I 1OK Gal I Rot, ldefloe Morrl Emergefloy 6' Brick Plan Driveway Pump 2,2/,7 Ex/~ C o u n re-'--~- Jack L. Netlo, ~f Kern ~ Dermatology I Group~ Fire Ext. P r Parking k store ~8826 j 2222 n *F' Street g 6' Chalnllnk Fenoe Apartments ~ld~no~ HMMP PLAN MAP SITE DIAGRAM [] FACILITY DIAGRAM E2 Business Name: Circle K Corporation #8825 Area Map #_1 of 1 North Name of Area: Circle K Corporation #8825 2222 'F' Street~ Bakersfield MoDoneld's Parking Lot Driveway Pumps I 10K Gal I 1809 <~> i.- 4 23rd I 1OK Gal I St. ~_ ...... ~ Residence Emergency .6' Brick Driveway Pump Shutof Wa co; Ex/~/t/C°unter ~ ~,Drain Fire Ext. Parking Store #8825 2222 'F' Street 5' Chainllnk Fence Apartments Vacant Lot' Plot Plan - Circle K Store #8825 2222 'F' Street, Bakersfield Parking Lot Driveway Gas Pumps - 1809 'F' HMH FL ....... ' St. St, F L '~ ~(~l~ -G-a~ - ."' Residence Morrl Plan Emergency 6' Brick Driveway Pump Wall Co: 221 Exl ~,/ Counter 'F' / ~Draln L. Kern NatlO~lns. f Dermatology I Group~ Fire Ext. P a r Parking k Store #8825 i 2222 n 'F' Street g m 6' Chalnllnk Fence Apartments Residence {CHECK ONE) SITE DL~GRAM F^ClLIT¥ BIAGP,~ Inspector's Comments): -OFFICIAL USE ONLY- ...... ,~; - - ~1~'.,. UNIT ~: ~ OF / (CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM [ IInspector's Comments): -OFFICIAL USE ONLY- CIRCLE K STORES INC #8825 SiteID: 015-021-000993 Manager : ~W ~O~~ BusPhone: (661) 324-1758 Location: 2222 F ST Map : 102 CommHaz : Low City : BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:04-856-4975 Emergency Contact / Title Em~ergency Contact / Title SERVICE CONTACT CTR / 24 HOURS ~.~ Business Phone: (661) 324-1758x Business Phone: (661)~A~ -~Q~x 24-Hour Phone : (909) 270-5193x 24-Hour Phone : (~})~$] -0~7~x Pager Phone : ( ) - x Pager Phone : (~{)~$ -777&x Hazmat Hazards: Fire Press Im~lth DelHlth Contact : MICHELLE WILSON Phone: (909) 270-5193x MailAddr: PO BOX 45001 PL 400 State: CA City : bakersfield Zip : 93384-5001 Owner CIRCLE K STORES INC ~8825 Phone: (909) 270-5193x Address : 4954 E. RINCON RD. State: CA City : CORONA Zip : 92879 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: Y ~nt plan ~0~ ~ r~ ~ ~d ~ i~ along with '(N~ o~ ~) I 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: CIRCLE K STORES INC #8825 Cross Street : Business Type: Org Type: Total Tanks : IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : Phone: (661) - x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : Phone: (661) - x Address: City : State: Zip: Type : CORPORATION BOE UST Fee# : 032073 Financ'l Resp: GUARANTEE Legal Notif : Tank Owner Mailing Address Date:01/02/2004 Phone: (909) 270-5193x Name:MICHELLE WILSON Ttl:REGIONAL COMPLIANCE SPECIALIST State UST # : 1998 Upg Cert#: 00800 2 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers on Site Hazmat Common Name... ISpooHazlEPA Hazardsl Frm DailyMax IUnitlMCP MIDGRADE ~LE~ED F IH DH L 10000.00 GAL Mod ~LE~ED GASOLINE F IH DH L 10000.00 GAL Mod PREMI~ ~LE~ED GASOLINE F IH DH L 10000.00 GAL Mod C~BON DIOXIDE F P IH G 2610.00 FT3 Min -3- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~v~v2~ ~v~ / ~ £ ~ ~vj~ MIDGRADE UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: NE PORTION OF PROPERTY CAS# 8006-61-9 F STATE ~ TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE Liquid /Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL 3000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl ~S]BioHazNo N No Radioactive/Amount I EPA HazardsNo/ Curies F IH DH NFPA/// IuSDOT# ModMCP ] MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: A~.Defined3: A~.Defined4: Ag.Defined5: Ag.Defined6: A~.Defined7: A~.DefinedS: A~.Defined9: Ag.Definel0: -- Ag.Definell -4- 07/19/2004 ='CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: NE PORTION OF PROPERTY TANK DESCRIPTION Tank ID#: 1 Mfr: UNKNOWN Compart Tank: N Installed: 0/ 0 Capacity: 10000 Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: UNLEADED PLUS/MIDGRADE Matl Name:MIDGRADE UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Installed: Corr Prot: FIBERGLASS REINFORCED PLASTIC Installed: Spill Cnt : 1998 Alarm : Exempt: No Drop Tube : 1998 Ball Float : Striker Plate: 1987 Fill Tube S/O: 1998 TANK LEAK DETECTION Sgl Wall: Dbl Wall: INTERSTITIAL MONITORING TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -5- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: DOUBLE WALL Mfgr : UNKNOWN Mtl : FIBERGLASS & : Corr : FIBERGLASS Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS DISPENSER CONTAINMENT Installed: 02/18/1987 Type: FLOAT MECH. SHUTS OFF SHEAR VAL. OWNER/OPERATOR SIGNATURE Date: 01/02/2004 Name:MICHELLE WILSON Ttl:REGIONAL COMPLIANCE SPECIALIST Prmt Number: 0993 Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST :03/01/1995 PASS CP CERT. : MANWAY INSP. :07/01/1999 UST MONIT. CERT:03/29/2004 -6- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site.~ -- COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: NE PORTION OF PROPERTY CAS# 8006-61-9 STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Mixture AmbientI~ Ambient UNDER GROUND TANK I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5200.00 GAL I ls - 100.00 Gasoline N 8006619 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F IH DH / / / Mod MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag. Defined4: A~.Defined5: A~.Defined6: Ag. Defined7: A~.Defined8: A~.Defined9: Ag. Definel0: -- A~.Definell -7- 07/19/2004 :~CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: NE PORTION OF PROPERTY TANK DESCRIPTION Tank ID#: 2 Mfr: UNKNOWN Compart Tank: N Installed: 0/1987 Capacity: 10000 Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: REGULAR UNLEADED Marl Name:UNLEADED GASOLINE Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Installed: Corr Prot: FIBERGLASS REINFORCED PLASTIC Installed: Spill Cnt : 1998 Alarm : Exempt: No Drop Tube : 1998 Ball Float : Striker Plate: 1987 Fill Tube S/O: 1998 TANK LEAK DETECTION Sgl Wall: Dbl Wall: INTERSTITIAL MONITORING TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -8- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: SINGLE WALL Mfgr : Mtl : FIBERGLASS & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS DISPENSER CONTAINMENT Installed: 02/18/1987 Type: FLOAT MECH. SHUTS OFF SHEAR VAL. OWNER/OPERATOR SIGNATURE Date: 01/02/2004 Name:MICHELLE WILSON Ttl:REGIONAL COMPLIANCE SPECIALIST Prmt Number: 0993 Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST :03/01/1995 PASS CP CERT. : MAN-WAY INSP. :07/01/1999 UST MONIT. CERT:03/29/2004 9 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: NE PORTION OF PROPERTY CAS# 8006-61-9 Liquid I Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container ~ Daily Maximum Daily Average 10000.00 GALL 10000.00 GAL 3000.00 GAL HAZARDOUS COMPONENTS %Wt. RNo~ CAS# 100.00 Gasoline 8006619 HAZARD ASSESSMENTS TSecret] ~SlBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No N No No/ Curies F IH DH / / / Mod MISC. LOCAL AGENCY DATA Ag.Definedl: Ag. Defined2: Ag.Defined3: Ag.Defined4: Ag. Defined5: Ag.Defined6: Ag. Defined7: Ag.Defined8: Ag.Defined9: Ag.Definel0: -- Ag. Definell -10- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: NE PORTION OF PROPERTY TANK DESCRIPTION Tank ID#: 3 Mfr: UNKNOWN Compart Tank: N Installed: 0/1987 Capacity: 10000 Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: PREMIUM UNLEADED Marl Name:PREMIUM UNLEADED GASOLINE Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Installed: Corr Prot: FIBERGLASS REINFORCED PLASTIC Installed: Spill Cnt : 1998 Alarm : Exempt: No Drop Tube : 1998 Ball Float : Striker Plate: 1987 Fill Tube S/O: 1998 TANK LEAK DETECTION Sgl Wall: Dbl Wall: INTERSTITIAL MONITORING TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -11- 07/19/2004 :'CIRCLE K STORES INC #8825 SiteID: 015-021-000993 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING. CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: SINGLE WALL Mfgr : Mtl : FIBERGLASS & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS DISPENSER CONTAINMENT Installed: 02/18/1987 Type: FLOAT MECH. SHUTS OFF SHEAR VAL. OWNER/OPERATOR SIGNATURE Date: 01/02/2004 Name:MICHELLE WILSON Ttl:REGIONAL COMPLIANCE SPECIALIST Prmt Number: 0993 Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST :03/01/1995- PASS CP CERT. : MANWAY INSP. :07/01/1999 UST MONIT. CERT:02/29/2004 -12- 07/19/2004 CIRCLE K STORES INC #8825 SiteID: 015-021-000993 = Inventory Item 0004 Facility Unit: Fixed Containers on Site CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: IN STOREROOM, BACK OF STORE CAS# 124-38-9 Gas Pure Above Ambient Cryogenic PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 2610.00 FT3I 2610.00 FT3I 1805.00 FT3 HAZARDOUS COMPONENTS 100.00 Carbon Dioxide N 124389 HAZARD ASSESSMENTS TSecretl ~S]BioHazl Radioactive/Amount EPA Hazards NFPA USDOT# I MCP No N No No/ Curies F P IH / / / Min MISC. LOCAL AGENCY DATA Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag. Defined5: Ag. Defined6: Ag.Defined7: Ag.DefinedS: Ag. Defined9: Ag. Definel0: -- Ag. Definell -13- 07/19/2004 TOSCO MARKETING COMPANY 1500 N. Priest Drive Tempe, Arizona 85281 Telephone: (602) 728-8000 TOSCO Circle K Store, Inc. Circle K 76 #2708825 2222 F Street Bakersfield, CA 93301 RE: HAZARDOUS MATERIALS MANAGEMENT PLANS Dear Randy Lormand: Attached is the new Hazardous Materials ihventory and Business Plan Certification for your station. This updated HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP and kept in your "Success at the Pump'.', and available to all employees and agency personnel at all times. THESE FORMS MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE. FAILURE TO RETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning thc packet: 1. Please sign all 3 copies of thc CERTIFICATION where flagged and indicated with a "X". 2. Please retuna the 2 copies marked "AGENCY" and "RHL FILE" to RHL Design in the pre-stamped enclosed envelope. 3. Keep this "DEALER" copy in your Success at the Pump binder, and available for inspection. 4.Have your employees read and understand thc contents of this package and sign thc attached training log. Keep the training log at your station. A copy of this HMMP Certification will be sent to: Bakersfield Fire Department within 30 days If you have any questions regarding the content of this document, please contact RI-IL Design Group, Mr. Roger Beach at (707) 765-1660. If you have any additional questions, including invoicing questions, please contact Tosco Marketing Company, Hazardous Materials Coordinator at (602) 728-7080. Sincerely, Tosco Marketing Company cc: RHL Design Group, Inc. Enclosure 2708825 3 AGENCY USE ONLY Bakersfield Fire artment File #: 1715 Chester Avenue, 3rd Floor Bakersfield CA 93301 Reviewed by: 805-326-3979 Date: HAZARDOUS MATERIALS BUSINESS PLAN / INVENTORY 2002 CERTIFICATION FORM Circle K 76 #2708825 Business Name: Circle K Store, Inc. 661-324-1758 Owner/Operator Name: Phone: 2222 F Street Business Address: Bakersfield CA 93301 City: State: Zip: Environmental Contact: Janette Thompson Phone: 925J277-2404 2000 Crow Canyon PI. Suite 400 Mailing Address: San Ramon CA 94583 City: State: Zip: BIENNIAL REVIEW AND RECERTIFICATION: I certify that the complete Business Plan filed on has been reviewed and the information ~ contained in it is accurate and complete as of the date below. '~ A complete HMBP was submitted within the last three (3) years. I certify that I have reviewed the previously submitted Business Plan and have updated the following items on the attached pages. -- Emergency contacts names and/or phone numbers. Site/Facility map. ~ Other Updates: ANNUAL INVENTORY UPDATE: Inventory Forms are correct for the upcoming reporting year. NO changes are necessary. / ~/' InventOry Forms require updating. A'I-rACHED are only the revised pages. Inventory Forms required updating. Replace previous inventory with attached inventory. As the Business Owner or its official designated representative, I can sign and attest to all statements in this certification and that we are not using the certification statement to comply with the annual federal reporting requirements under the Emergency Planning and Community Right-to-Know Act (EPCRA). Based on my inquiry of those individuals responsible for obtaining the inform~)~, I believe that the submitted information is true, accurate and complete. ~.. , ~/__ Name. ~/~ ~ ~~/L)~ Signature./'~ (Type or Print) Title:~ /4~/+A'//{ C C/~ Date:~ ~,~'-//Z,.' ~ ~ UNIFIED PROGRAM CONE FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION · 3/01/2002 03/1/2003 BUSINESS NAME (Same as FACIL1TY NAME or DBA - Doing Business As) 3 I BUSINESS PHONE . 102 Circle K 76 #2708825 661-324-1758 BUSINESS SITE ADDRESS lo3 2222 F Street CITY io4 CA ZIP CODE 1o5 Bakersfield 93301 DUN & BRADSTREET lo6 SIC CODE (4 digit It) lo7 04-8564975 5541 COUNTY BUSINESS OPERATOR NAME lo~ [ BUSINESS OPERATOR PHONE 11o Circle K Stores, Inc. ':' [ 661-324-1758 II. BUSINESS OWNER OWNER NAME I11 ] OWNER PHONE H2 Circle K Stores, Inc. ] 602-728-8000 OWNER MAILING ADDRESS 113 P.O. Box 52085 CITY 11,* ] STATE H5 ZIP CODE Phoenix ] AZ 85072-2085 Ill. ENVIRONMENTAL CONTACT CONTACT NAME n7 [ CONTACT PHONE 118 Janette Thompson ] 925-277-2404 CONTACT MAILING ADDRESS 2000 Crow Canyon Pl. Suite 400 CITY 120 STATE 121 [ ZIP CODE 122 San.Ramon CA I 94583 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME Tosco Maint. Call Center Justin Peterson TITLE 124 TITLE 129 Dispatch BOM BUSINESS PHONE 125 BUSINESS PHONE ~3o 800-726-2312 909-270-5136 24-HOUR PHONE 126 24-HOUR PHONE 131 800-726-2312 888-436-9073 PAGER # 127 PAGER # 132 ADDITIONAL LOCALLY COLLECTED INFORMATIOI~: Certification~sed on my inquiD' of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar, AvithJthe information submitted and believe the information is tree, accurate, and complete. SIGNATI/~E OP/OWl~R/OI~RATOR OR DESIGNATED REPRESENTATIVE ' DATE 134 NAME OF DOCUMENT PREPARER 135 % /~.~///~.f//ze..~c/f ~ $'/Z'Z~'c~ 2 RHL Design Group, Inc. [NAME OF~NER (p~fit) / 136 { TITLE OF SIGNER 137 2708825 UPCF (1/99 revised) 167 OES FORM 2730 (1/99) "" UNIFIED PROGRAM CONSOLIDATED'I~ORM CHEMICAL DESCRIPTION - One Page Per Material Per Building or Area HAZARDOUS MATERIALS INVENTORY (~.Agg [-IDELETE ["IREVISE 2oo [ Page ..~f~_~ . ~ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) Circle K 76 #2708825 2708825 CHEMICAL LOCATION 2Ol CHEMICAL LOCATION 202 CONFIDENTIAL- [] YES [] NO STORE ROOM EPCV, n ~ 1 F4 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No CARBON DIOXIDE If Subject to EPCRA, refer to instruct/oas COMMON NAME aa7 CO2 - REFRIDGERATED LIQUID EHS* [] Yes [] No CAS# "' 200 124-38-9 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 NON-FLAMMABLE GAS HAZARDOUS MATERIAL ~a. PURE 213 TYPE (Check one item only)~ [] b. MIXTURE [] e. WASTE 211 RADIOACTIVE [] Yes [] No 212 CURIES 215 PHYSICAL STATE ~e. 214 LARGEST comnn, mR 2610 (Check one item only) [] a. SOLID [] b. LIQUID GAS FED HAZARD CATEGORIES ~ ~A 216 (Check all that apply) [] a. FIRE [] b. REACTIVE RESSURE RELEASE CUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 219 [ STATE WASTE CODE 22o 1805.00 2610.00 .CUB 22t I DAYS ON SITE: 222 UNITS* [] a. GALLONS IC FEET [] c. POUNDS [] d. TONS 365 {Check one item only) *"If EHS, mount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER ~c. TANK INSIDE BUILDING ~lg. CARBO¥ [] LBOX []o. TOTEBIN [] d. STEEL DRLrM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STOIL~.GE PRESSURE [] a. AMBIENT ]~b. ABOVE AMBIENT [] c. BELOW AMBI~qT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT '~ CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EI-IS CAS # I 100% 226 CARBON DIOXIDE 227 [] Yes [] No 2:28 124-38-9 2 23o ~l [] Yes [] No .~2 3 ~4 2~ [] Yes [] No 23~ 4 238 239 [] Yes [] No 240 241 5 2~2 243 [] Yes [] No 244 245 If more hazardous eampenents are print at greater than 1% by weight ff nnn-earcinogenig, or 0.1% by weight if eareinngrnle, attaeh eddlflonal sh~ts of paler capturing the r~luir~l Infomation. 246 If EPCRA, Please Sign Here I UPCF (1/99) 169 OES Form 2731 MAP# ~ CALIFORNIA ANNOTA;rED SITE MAP P*~'"~'D"Y: _~~-!I., BUSINESS NAME_ CIRCLE K STORE #2708825 DATE 3/7/2002 DRAWING SCALE BUSINESS ADDRESS 2222 'F' STREET BAKERSFIELD ZIP CODE 95301 1"=30'-0"+ ~(~ A B C D E F G H MAP SYMBOLS NORTH MC DONALD'S (~) ELECmlCALsHuT_OFF PANEL SHUT-OFF ) WATER SHUT-OFF 28FID 8TFIEET ® EMERGENCY PUMP SHUT-OFF T~A TANK MONITORING ~ ALARM 2 ' ~ F, RST AID KiT ....... Z~ FIRE EXTINGUISHER J~ STORM DRAIN STAGING AREA .j EVACUATION/ , ~Z:o,ooo ~^,f)® < .MMP .MMP, AND Msos 8 I ...... I ~ MsDs LOC^T~ON ~ ~ z k ! 10,000 GAL )0 Ld ~ FIRE HYDRANT % "~o.ooo OAL-)® ~ × × FENCE ~ [ -11 C--~ ABO~GROUNO J J STORAGE TANK 4 ~__ ~ (~) ~"- I~--~1 UNDERGROUND JJJ ~- ~ STORAGE TANK n ILl J (~ GASOUNE ~ / CAS~ER ® ~ Z bJ ~ I 0 Q DIESEL FUEL m (COMBUSTlaLE LIQUID,'m)mm~ LL/' J ' J _J Q MOTOR OILS & LUBRICANTS (COM.UST~.LE UQU~DS) FY' ~ CARBON DIOXIDE 5 I,I (COMPRESSED GAS) ~~ Z (FLAMMABLE LIQUID) ' bJ Q PROPANE I (,~ (~ I o ~) ANTIFREEZE/COOLANTS Z I @ I < ® WASTE O~L O (FLAMMABLE LIQUID) ~ - W ~ CAR WASH PRODUCTS 7 VACANT LOT/ JEWELRY STORE Spill/Release Response Procedures for Carbon Dioxi~le (CO2) The refrigerated liquid CO2 used at many locations to produce carbonated beverages can be hazardous in the event ora spill or release, or if there is a fire at the statiOn. Although CO2 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the CO2 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause bums, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the CO2 container, do the following: 1. Dial 911 - inform emergency personnel that there is a release from the refrigerated liquid CO2 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:kHAZMAT~ToscokFORMS\co2 -Spill Plan. doc 2708825 EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE~ SPILL OR SUSPECTED LEAK 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: verbally ANNOUNCE to all persons on thc site: "There is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1 Give the following information: "THERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 2222 F Street" If anyone is trapped or needs medical attention, tell thc answering dispatcher. Stay on thc phone and bc prepared to answer any questions conceming the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the statioh area, and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator ifs/he is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Tosco Maint. Call Center Title: Dispatch Address: Bus#/Home#/Alt#: 800-726-2312 / 800-726-2312 / Alternate Emergency Coordinator: Justin Peterson Title: BOM Address: 495 E. Rincon Rd. Suite #150 Corona, CA 92879 Bus#/Home#/Alt#: 909-270-5136 / 888-436-9073 / 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager Tosco Environmental Compliance Coordinator: North: Janette Thompson (925) 277-2404 South: Stephen Boyd (714) 428-6572 or (800) 759-8888 pin#1267507 Tosco Corporation will notify the State and Local administering agencies within an appropriate time flame, unless the situation requires urgent immediate response by the agencies, in which case the OPERATOR should notify these agencies: a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800) 852-7550 (24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used. 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4.RECORD: Record the event in the daily monitoring log. 5.NOTWY: the dealer of the event. ' EMPLOYEE TRAINING PLAN~ Employees must bc given this training before starting work, and refresher courses must be provided annually. Records must bc kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign thc attached training log upon completion of training. Retain these records for a minimum of three years. I. FIRST TmNGS TO KNOW: A. EMERGENCY PUMP SHUT-OFF: This turns offthe turbine pumps that provide flow to thc dispensers from the underground tanks. In case ora leak, shutting offthe pumps will help to prevent spills. Location: 1-CASHEIR~ 1-FRONT OF BUILDING, 1-PUMP ISLANDS B. ELECTRICAL PANEL: The panel allows you to selectively cut offpower to lights, signs, pumps, etc. The main switch kills all power at the site. Location: 1-REAR OF BUILDING, 1-STOCKROOM C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when ,~t leak is detected by a visual and audible alarm. Location: STOCKROOM D.WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: NONE . E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow in an emergency. Location: NONE F. PROPANE/LPG: If your station has a propane or liquefied petroleum gas tank - In the e~ent of a release or fire, turn offthe manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: 3-IN STORE, 1-PUMP ISLANDS H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it; a vacuum truck should be used to clean up any large spill. Location: SPILL KIT AT CASHIER I. EMERGENCY RESPONSE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material: 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE $. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH OF SITE (MSDS): Location: CASHIER II. NEAREST MEDICAL FACILITY: Employees should know what facilities are available in case customers or other employees need medical attention. 1. NAME BAKERSFIELD MEMORIAL HOPS. ADDKESS:420 34th ST. BAKERSFIELD PHONE NUMBER:6613274647 NEAREST DESIGNATED TRAUMA CENTER: 2. NAME: KERN MEDICAL CENTER ADDRESS: 1830 FLOWER STREET BAKERSFIELD PHONE NUMBER: 6613262000 l]I. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated clothing and shoes. Follow by washing with soap and water. Do not reuse clothing or shoes until cleaned. If irritation persists, get medical attention. C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): E. DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, convulsions or unconsciousness occur before emesis, gastric lavage using a cuffed endotracheal tube should be considered. For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff, RHL Design Group, Inc., $00- 76.~o102.~ Last updated: March 7, 2002 SECTION 1 HAZARDOUS MATERIALS TRAINING REQUIREMENTS As the ownefloperator of a business that handles hazardous materials, you must have the following: · A Hazard Communication Plan (also known as an Employee Right-to-Know Plan) · A SARA Tier II Chemical Inventory Report (in California this report is included in the Hazardous Materials Management Plan, also known as the CA Business Emergency Plan) · An Emergency Response Plan · An Underground Storage Tank Monitoring and Leak Detection Plan · A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. · Training for the Hazard Communication Plan must include the following elements: · An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. · Locations of any operations in their work area where hazardous substances are present. · Location where a copy of the written Hazard Communication program is made available to them. · How to read labels and Matedal Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. · How to detect the presence of or the release of hazardous substances in the work place. · How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). · Emergency and first aid procedures to follow if employees are exposed to hazardous substances. Tosco Marketing Company P.O. Box 52085 Phoenix, Arizona 85072-2085 TO S C O 1500 North Priest Drive M a r k e t i n g Tempe, Arizona 85281 C 0 rn p a n y David A. Waldschmidt Assistant General Counsel 602/728-7470 (direct line) 602/728-5277 (facsimile) April 23,200 l Re: Financial Responsibility 40 CFR Part 280, Subpart H To Agencies Listed on the Attached Exhibit A: I am enclosing information relating to Tosco Corporation's requirement to provide financial responsibility for the ownership and operation of underground storage tanks by its operating entities pursuant to 40 CFR Part 280, Subpart H and similar state regulations. Tosco Corporation meets the financial test of self-insurance set forth under 40 CFR § 280.95. It is intended that this financial responsibility likewise satisfy the requirements of authorized state programs. Tosco provides this financial responsibility for all underground storage tanks at retail locations, terminals and bulk plants which are owned and/or operated by all Tosco entities including Circle K Stores Inc., Tosco Operating Company, Inc., Tosco Refining L.P., Bayway Refining Company, Tosco Terminal Corporation and Tosco Corporation. For your information, Tosco's retail operations are collectively referred to as "Tosco Marketing Company". The information enclosed consists of a Certification of Financial Responsibility, a letter from Tosco's Chief Financial Officer in the form prescribed by the federal regulations and a facility address list for your state or region. Please forward this information to the appropriate person in your agency. You may direct any questions to me at (602) 728-7470. Very truly yours, David A. Waldschmidt Assistant General Counsel DAW/cs 8220C8 I.DOC Tosco Corporation 1700 East Putnam Avenue Suite 500 Old Greenwich, CT 06870 Telephone: 203-698-7675 Facsimile: 203-698-7910 Crai~ .. Doasy Vice President Treasurer CERTIFICATION OF FINANCIAL RESPONSIBILITY Tosco Corporation hereby certifies that it is in compliance with the requirements of Subpart H of 40 CFR Part 280. The financial assurance mechanism used to demonstrate financial responsibility under Subpart H of 40 CFR Part 280 is as follows: Mechanism: Section 280.95 - Financial Test of Self Insurance Amount of Coverage: $2,000,000 in the aggregate Effective Period of Coverage: From January 1, 2001 until April 30, 2002, unless earlier revoked or replaced by written notice to the Implementing Agencies listed on the attached Exhibit A. Coverage: Corrective action and third-party compensation for bodily injury and property damage caused by sudden and nonsudden accidental releases arising from the operation of underground storage tanks. By: crai~ 1~. Deasy Its: Vice President and Treasurer Date: April ~_~, 2001 County of ) _The foregoing instrument was acknowledged before me this rl-'day of by Craig R. Deasy, personally known to me as Vice President and Treasurer of Tosco Corporation, who executed the same on behalf of the corporation. Notary Public My Commission ExpiresT~~Jt~ DENISE G. MECIL! Notary Public, State of Connecticut No. 0111489 Qualified in Fairfield County Commission Expires March 31,2006 Tosco Corporation 1700 East Putnam Avenue Suite 500 Old Greenwich, Connecticut 06870 Telephone: 203-698-7506 Facsimile: 203-698-7903 Jefferson F. Allen P~e~ April 16, 2001 Underground Storage Tank (UST) Financial Responsibility Letter from Chief Financial Officer I am the chief financial officer of Tosco Corporation, 1500 Putnam Avenue, Old Greenwich, CT 06870. This letter is in support of the use of the financial test of self-insurance to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and nonsudden accidental releases in the amount of at least $1,000,000 per occurrence and $2,000,000 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this owner or operator: (See Attached Listings) A financial test is also used by this owner or operator to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: Amount EPA Regulations: Closure (§§ 264.143 and 265.143) $ None Post-Closure Care (§§ 264.145 and 265.145) $ None Liability Coverage (§§ 264.147 and 265.147) $ None Corrective Action (§§ 264.101(b)) $ None Plugging and Abandonment (§ 144.63) $ None Autho ed state programs: Closure $ 28,509,000 Post-Closure Care $ 17,138,000 Liability Coverage $ 49,000,000 Corrective Action $ 5,997,000 Plugging and Abandonment $ None Total $ 100,644,000 This owner or operator has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification fi.om an independent auditor on his financial statements for the latest completed fiscal year. Alternative II 1. Amount of annual UST aggregate coverage being assured by a financial test, and/or guarantee $ 2,000,000 2. Amount of corrective action, cloSure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test, and/or guarantee $ 100,644,000 3. Sum of lines 1 and 2 $ 102,644,000 4. Total tangible assets $ 8,407,200,000 5. Total liabilities $ 6,394,100,000 6. Tangible net worth $ 2,013,100,000 Yes No 7. Total assets in the U.S. (required only if less than 90 percent of assets are located in the U.S.) $ N/A 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are at least 90 percent of assets located in the U.S.? X 11. Is line 7 at least 6 times line 3? N/A 16. Current bond rating of most recent bond issue Baa2 BBB 17. Name of rating service Moocly's Standard Investor & Poors Service 18. Date of maturity of bond January 1, 2047 Yes' No 19. Have financial statements for the latest fiscal year been filed with the: SEC X Energy Information Administration X Rural Electrification Administration X I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) and/or WAC 173-380-470 as such regulations were constituted on the date shown immediately below. ~~ermn F. Allen Chief Financial Officer April 16, 2001 ATTACHMENT .TO LETTER FROM CHIEF FINANCIAL OFFICER All under~ound storage tanks (UST's) owned and/or operated by Tosco Corporation and its affiliates and subsidiaries are covered by this financial test of self-insurance. These entities include Circle K Stores Inc., Tosco Operating Company, Inc., Tosco Refining, L.P. (collectively referred to as "Tosco Marketing Company"), Bayway Refining Company, Tosco Corporation, and Tosco Terminal Corporation. UST's are located at the following refineries, terminals, carbon plant, and bulk plants: REFINERIES & TERMINALS: Bayway Refinery Los Angeles Refinery (Wilmington) Sacramento Terminal 1400 Park Avenue P.O. Box 758 76 Broadway Linden, NJ 07036 Wilmington, CA 90748 Sacramento, CA 95818 Baltimore Terminal Los Angeles Terminal San Francisco Refinery-Rodeo 2155 Northbridge 13707 S. Broadway 1380 San Pablo Avenue Baltimore, MD 21226 Los Angeles, CA 90061 Rodeo, CA 94572 Colton Terminal Portland Terminal San Francisco Refinery- 2301 S. Riverside 5528 NW Doane Avenue Carbon Plant Rialto, CA 92316 Portland, OR 97210 2101 Franklin Canyon Rodeo, CA 94572 Ferndale Refinery Renton Terminal 3901 Unick Road 2423 Lind Ave SW Tacoma Terminal Ferndale, WA 98248 Renton, WA 98055 520 East D Street 'Tacoma, WA 98421 Honolulu Terminal Richmond Terminal 411 Pacific Street 1300 Canal Boulevard Honolulu, HI 96817 Richmond, CA 94804 Los Angeles Refinery (Carson) Riverhead Terminal 1520 East Sepulveda Boulevard 213 Sound Shore Rd. · Carson, CA 90745 Riverhead, NY 11901 BULK PLANTS: 845 Walnut Ave. Greenfield, CA 93927 100 Lee Rd. Watsonville, CA 95076 SUPPLEMENTAL ATTAC~'v~NT TO LETTER FROM CHIEF Fff~'ANCIAL OFFICER FACILITY LIST A list of facilities covered by this financial responsibility mechanism has been filed with: California State Water Resources Control Board UST Program P.O. Box 944212 Sacramento, CA 94244 It may also be obtained from: Tosco Marketing Company 2000 Crow Canyon Place, Suite 400 San Ramon, CA 94583 Attention: David Camille (925) 277-2335 or Tosco Marketing Company 3525 Hyland Avenue Costa Mesa. CA 92626 Attention: Michael Bryan (714) 428-7606 8222CS4.DOC EXHIBIT A US ENVIRONMENTAL PROTECTION AGENCY ARIEL RIOS BUILDING 1200 PENNSYLVANIA AVENUE NW WASHINGTON DC 20460 EPA REGION 1 1 CONGRESS ST SUITE 1100 BOSTON MA 02114-2023 EPA REGION 2 290 BROADWAY NEW YORK NY 10007-1866 EPA REGION 3 1650 ARCH STREET PHILADELPHIA PA 19103-2029 EPA REGION 4 ATLANTA FEDERAL CENTER 61 FORSYTH STREET SW ATLANTA GA 30303-3104 EPA REGION 5 -' 77 W JACKSON BLVD CHICAGO IL 60604 EPA REGION 6 FOUNTAIN PLACE SUITE 1200 1445 ROSS AVE DALLAS TX 75202-2733 EPA REGION 9 75 HAWTHORNE ST SAN FRANCISCO CA 94105 EPA REGION 10 1200 SIXTH AVENUE SEATTLE WA 98101 ALABAMA DEPT OF ENVIRONMENTAL MGMT UST COMPLIANCE SECTION P O BOX 301-463 MONTGOMERY AL 36130 AZ DEPT OF ENVIRONMENTAL QUALITY UST SECTION 3033 N CENTRAL AVE #4T PHOENIX AZ 85012 CA STATE WATER RESOURCES CONTROL BOARD UST PROGRAM P O BOX 944212 SACRAMENTO CA 94244 DE DEPT OF NATURAL RESOURCES UST BRANCH 391 LUKENS DR. .. NEW CASTLE DE 19720 DC ENVIRONMENTAL HEALTH ADMIN UST DIVISION 51 N STREET NE RM 3019 WASHINGTON DC 20002 FLORIDA DEPT OF ENVIRON PROTECTION STORAGE TANK REGULATION SECTION 2600 BLAIR STONE RD. TALLAHASSEE FL 32399 GEORGIA DEPT OF NATURAL RESOURCES UST MANAGEMENT PROGRAM 4244 INTERNATIONAL PKWY STE 104 ATLANTA GA 30354 HI DEPT OF HEALTH SOLID & HAZARDOUS WASTE BRANCH 919 ALA MOANA BLVD RM 212 HONOLULU HI' 96814 LA DEPT OF ENVIRONMENTAL QUALITY UST DIVISION P O BOX 82231 BATON ROUGE LA 70884 MD DEPT OF ENVIRONMENT OIL CONTROL PROGRAM 2500 BROENING HIGHWAY BALTIMORE MD 21224 BUREAU OF WASTE SITE CLEANUP DEPT OF ENVIRONMENTAL PROTECTION 1 WINTER STREET BOSTON MA 02108 MI DEPARTMENT OF ENVIRONMENTAL QUALITY STORAGE TANK DIVISION P O BOX 30157 LANSING MI 48909 DEPT OF ENVIRONMENTAL QUALITY UST SECTION OFFICE OF POLLUTION CONTROL P O BOX 10385 JACKSON MS 39289 NEVADA DIVISION OF ENVIRON PROTECTION BUREAU OF CORRECTIVE ACTION 333 W NYE LANE NUMBER 138 CARSON CITY NV 89710 NH DEPT OF ENVIRONMENTAL SERVICES OIL REMEDIATION AND COMPLIANCE BUREAU PO BOX 95, 6 HAZEN DR CONCORD NH 03302' NJ DEPT OF ENVIRONMENTAL PROTECTION BUREAU OF USTS P O BOX 433 TRENTON NJ 08625 NM ENVIRONMENT DEPT UST BUREAU HAROLD RUNNELS BLDG ROOM N-2510 1190 ST FRANCIS DRIVE SANTA FE NM 87502 NY DEPT OF ENVIRONMENTAL CONSERVATION BULK STORAGE SECTION 50 WOLF ROAD ROOM 360 ALBANY NY 12233 NORTH CAROLINA DIV OF ENVIRON MGMT UST/LUST PROGRAM P O BOX 29578 RALEIGH NC 27626 DEPT OF ENV QUALITY UST PROGRAM 811 SW 6TH AVE 7TH FLR PORTLAND OR 97204 PA DEPT OF ENVIRONMENTAL PROTECTION DIVISION OF STORAGE TANKS . 400 MARKET ST PO BOX 8762 HARRISBURG PA 17105 SC DEPT OF HEALTH & ENVIRON CONTROL DIVISION OF UST MANAGEMENT 2600 BULL STREET COLUMBIA SC 29201 DEPT OF ENVIRONMENT AND CONSERVATION UST DIVISION 4TH FLOOR L&C TOWER 401 CHURCH STREET NASHVILLE TN 37243 TX NATURAL RESOURCE CONSERVATION COMM PETROLEUM STORAGE TANK DIVISION P O BOX 13087 .' AUSTIN TX 78711 VA DEPT OF ENVIRONMENTAL QUALITY OFFICE OF SPILL RESPONSE AND REMEDIATION P O BOX 10009 RICHMOND VA 23240 TOXICS CLEANUP PROGRAM WASHINGTON DEPT OF ECOLOGY P O BOX 47655 OLYMPIA WA 98504 WASHINGTON DEPARTMENT OF LICENSING UST SECTION PO BOX 9020 OLYMPIA WA 98507-9020 -. _ TOSCO MARKETING COMPANY ~,~ ~' 1500 N. Priest Drive ~ Tempe, Arizona 85281 Telephone: (602) 728-8000 TOSCO March 20, 2001 Randy Lormand Circle K Stores, Inc. 2222 F Street Bakersfield, CA 93301 RE: HAZARDOUS MATERIALS MANAGEMENT PLANS Dear Randy Lormand: Attached is the new Hazardous Materials Inventory and Business Plan Certification for your station. This updated HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP and kept in your "Success at the Pump: Keeping the Zone in Compliance Manual", and available to all employees and agency personnel at all times. THESE FORMS MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE. FAILURE TO RETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning the packet: 1. Please sign all 3 copies of the CERTIFICATION where flagged and indicated with a "X". 2. Please return the 2 copies marked "AGENCY" and "RHL FILE" to RI-IL Design in the pre-stamped enclosed envelope. 3. Keep this "DEALER" copy in your Environmental Compliance Book, and available for inspection. 4. Have your employees read and understand the contents of this package and sign the attached training log. Keep the training log at your station. A copy of this HMMP Certification will be sent to: Bakersfield Fire Department within 30 days If you have any questions regarding the content of this document, please contact RHL Design Group, Mr. Steve Skanderson at (707) 765-1660. If you have any additional questions, including invoicing questions, please contact Tosco Marketing Company, Hazardous Materials Coordinator at (602) 728-7080. Sincerely, Tosco Marketing Company cc: RHL Design Group, Inc. Enclosure 2708825 e~J~rt AGENCY USE ONLY Bakersfield Fire D ment File #: 1715 Chester Avenue, 3rd Floor Bakersfield CA 93301 Reviewed by: 805-326-3979 Date: HAZARDOUS MATERIALS BUSINESS PLAN / INVENTORY 2001 CERTIFICATION FORM Circle K Stores, Inc. Business Name: Randy Lormand 661-324-1758 Owner/Operator Name: Phone: - 2222 F Street Business Address: Bakersfield CA 93301 City: State: Zip: Environmental Contact: Tina Berry Phone: 925-277-2319 2000 Crow Canyon PI. Suite 400 Mailing Address: San Ramon CA 94583 City: State: Zip: BIENNIAL REVIEW AND RECERTIFICATION: J certify that the Business Plan has been reviewed and the information contained in it is accurate and complete as of the date below. I certify that I have reviewed the previously submitted BusinessPlan and have updated the.following items on the attached pages. -- Emergency contacts names and/or phone numbers. ~ Site/Facility map. -- Other Updates: ANNUAL INVENTORY UPDATE: Inventory Forms are correct for the upcoming reporting year. NO changes are necessary. Inventory Forms require updating. ATTACHED are only the revised pages. Inventory Forms required updating. Replace previous inventory with attached inventory. I certify under penalty of law, that l have personally examined and I am famili?~ the information submitted in this and all attached documents, and based on my inquiry of those individu/~ls r~., 3ons~/b~r obtaining the information, I believe that the submitted information is true, accurate and ~, (Type o Print) 2708825 PROGRAM CONSOLIDATED FACILITY INFORMATION BUSINESS ACTIVITIES Page I. FACILITY IDENTIFICATION . FACILITY ID# ' I 1 JEPAID# (Hazardous Waste Only) 2 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Stores, Inc. I. ACTIVITIES DECLARATION NOTE: . If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the~ ~ YES ~ NO 4 'V/ HAZARDOUS MATERIALS INVENTORY - applicable Federal threshold quantity for an extremely hazardous ~ CHEMICAL DESCRIPTION(oES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) [~ YES E~ NO 5 ,v/ UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? ,,,// UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade.existing or install new USTs? [] YES [~'NO 6 ,v/ UST FACILITY ,~' UST TANK (One per tank ,~/ UST INSTALLATION - CERTIFICATE OF COMPLIANCE(one page per tank)(Forrnedy Form C) 3. Need to report closing a UST? [] YES ~ NO 7 ~ UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own Or operate ASTs above these thresholds: .__z tank capacity is greater than 660 gallons, or ~-~ YES[~ NO 8 v/ NO FORM REQUIRED TO CUPAS --the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [-~ YES ~-~ NO 9 v/ EPA ID NUMBER-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted [] YES,--~ NO 10 V/ RECYCLABLE MATERIALS REPORT recyclable materials (per HSC t~ 25143.2)?. _~ ~,~ (one per recycler) 3. Treat hazardous waste on site? L_JYES L~ NOll ~ ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formerly DTSC Form 1772) ,,,// ONSITE HAZARDOUS WASTE TREATMENT'UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D. and L) 4. Treatment subject to financial assurance requirements (for Permit [] YES ~ NO12 ,v/ CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site?~[--'] YES~ NO 13 v/ REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly [~//N DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ~[-~ YES O 14 ~/ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2 2708825 U~D PROGRA3VI CONSOLIDATED FORI~ FA CILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION FACILITY ID# ! : · I ' I [ 1 BEGINNING DATE 100 }ENDING DATE 101 ........................... L.._~d_L_ L ~ _L_Z_._._~.~__Z_2___L__ 1/1/2001 ! 12/31/2001 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 iBUSINESS PHONE 102 Gircle K Stores, Inc. i 661-324-1758 IBUSINESS SITE ADDRESS 105 2222 F Street ITY Bakersfield lO4 CA ZIP CODE 93301 105 lO8 SIC CODE (4 digit #) lo7 DUN BRADSTREET 04-65649?5 5541 COUNTY 108 KERN ,BUSINESS. OPERATOR NAME 109 BUSINESS OPERATOR PHONE ~-- Randy Lormand . 800-726-2312 II. BUSINESS OWNER 111 OWNER PHONE 112 ~OWNER NAME Girde K Stor~s;_incJ _ ~02-728-7080 )WNER MAILING ADDRESS ~ 13 P.O. Box 52085 1~,~ STATE 11~ ZIP CODE 11~ ITY Phoenix AZ $50?2-208§ I III. ENVIRONMENTAL CONTACT iCONTACT NAM E 117 ICONTACT PHONE 118 i Ti~ B~rry ~i ~2§-2Z7-251 ~ !CONTACT MAILING AODRESS ~ 19 / 2000 Grow Ganyon PL Suite 400 CITY 120 STATE 121 ZIP CODE 122 Sa~ Ramo, GA 94583 ~ PRIMARY IV. EMERGENCY CONTACTS SECONDARY ~23 NAME 128 Tosco Maint. Call Center Justin Peterson ITITLE 124 TITLE 129 , Dispatch BOM BUSINESS PHONE 125 BUSINESS PHONE 130 800-726-2312 909-270-5136 24-HOUR PHONE - 126 24-HOUR PHONE 131 800-726-2312 888-436-9073 -- PAGER# 127 PAGER# 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: iCertification:,,~ed on my inquir~, of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am ifamiliar withfthe ~formatioff'~l~itted and believe the information is true, accurate, and complete. DATE 134 ,NAME OF DOCUMENT PREPARER 135 ~ !~,,¢!,.'~]44~IJ'~ ~ .~'~7 ~ / iRHL DESIGN GROUP, INC.-ENVIRONMENTAL DEPT. [NAMf~ O~-~"~ (p[in~ ~- '~/' 5' 136 ,TITLE OF SIGNER 137 UPCF ( 1/99 revised) 167 OES FORM 2730 (1/9 I MAP// ~ CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME_CIRCLE K STORE #2708825 _ DATE 3/15/01 BUSINESS ADDRESS 2222 'F' STREET BAKERSFIELD ZIP CODE 93301 DRAWING SCALE 1 "=30'-0"+ X A B C D E F G a MAP SYMBOLS / NOR~ ~ MC DONALD'S SHUT-OFF SHUT-OFF WATER SHUT-OFF 23RD STREET ~' EMERGENCY PUMP SHUT-OFF T~A TANK MONITORING ~ ALARM 2 ' ' ~ FIRST AID KIT ...... ~ ~ FIRE EXTINGUISHER ~ STORM DRAIN SANITARY SEWER STAGING AREA . ~ ~v. cu.T,o./ ' ~ ""MP "MMP, AND MSDS I ( 10,000 GAL )~ 3 I I ~ MSDS LOCATION / 10,000 GAL )~ ~ ~ FIRE HYDRANT ~k /' 10,000 GAL )~ ~ X x FENCE ~ ~ EMERGENCY RESPONSE ~ EQUIPMENT/ABSORBENtS ~ J F ~l ~ ABOVEGROUND ~ j , STORAGE TANK 4 ~ ~ ~ ~ ~ I~-~l UNDERGROUND , ~ ~--~ STORAGE TANK < w ' / ~0 ~ 0 W~ ~ ~ GASOLINE , (FLAMMABLE LIQUIDS) O / CASHIER ~ ~ Z < ~ I 0 ~ DIESEL FUEL (COMBUS~BLE LIQUIDS)~ ~ ~ MOTOR OILS & LUBRIC~ (60MBUS~BLE LIQUlDS)~ ~ ~ CARBON DIOXIDE 5 m (COmPrESSED OAS) Z (FLAMMABLE LIQUID) ~ ~ PROPANE J~ ~ ~ I 0 ~ AN~FREEZE/COOLANTS Z I ~ I ~ ~ WASTE OIL (FLABBABLE LIQUID) - ~ . ~ ~ CAR WASH PRODUCTS 6 7 'RESIDENTIAL RESPONSE PR~ MAJORffNCIDENT: 'FI'~ s--P-~ILL'~RR SUSPECTED LEAK 2708825 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. ~ Give the following information: "THERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 2222 F Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the-situation. 4. ATTEMP-T to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having -difficulty leaving the station are andanyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator if he/she is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Tosco Maint. Call Center Title: Dispatch Address: Bus#/Home#/Alt#: 800-726-2312 / 800-726-2312 / Alternate Emergency Coordinator: Justin Peterson Title: BOM Address: 497 ]E. Rincon Rd. Suite #150 CorQIlg, CA 92879 Bus#/Home#/Alt#: 909-270-5136 / 888-436-9073 / 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager. Tosco Environmental Compliance Coordinator: North: Tina Berry (925)277-2319 or (888)6714350 SoUth: Stephen Boyd (714)428-6572 or (800)759-8888 pin#1267507 Tosco Coporation will notify the State and Local administering agencies within an appropriate time frame, unless the situation requires urgent immediate response by the agencies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire DePartment - PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used' 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. I. FIRST THINGS TO KNOW: A. EMERGENCY PUMP SHUT-OFF:This turns off the turbine pumps that provide flow to the dispensers from the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: 1-CASHEIR, 1-FRONT OF BUILDING, 1-PUMP ISLANDS B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. Location: 1-REAR OF BUILDING, 1-STOCKROOM C. TANK MONITORING ALARM: Monitoring panel'for the Underground Storage Tanks. This panel.will indicate when a leak is detected by a visual and audible alarm. Location: STOCKROOM D. WATER SHUT-OFF: The water shut-offmay be necessary in some cases. Location: ALONG F STREET E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-offthe natural gas flow in an emergency. Location: NONE F. PROPANE/LPG: If your station has propage or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: 3-IN STORE, 1-PUMP ISLANDS H. ABSORBENT: In the form of kitty litter, absorbent can soak up small Spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large .spill, merely try to contain it, a vacum truck should be used to clean up any large spill Location: SPILL KIT AT CASHIER I. PERSONAL PROTECTIVE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH OF SITE HAZARDOUS MATERIAL MANAGEMENT PLAN (HMMP) MATERIAL SAFETY DATA SHEET (MSDS): Location: CASHIER II. NEAREST MEDICAL FAC Employees should know what facih~s are available in case customers or other employees need medical attention. 1.NAME: BAKERSFIELD MEMORIAL HOPS. ADDRESS: 420 34th ST. BAKERSFIELD PHONE NUMBER: (661) 327~4647 NEAREST DESIGNATED TRAUMA CENTER: 2.NAME: KERN MEDICAL CENTER ADDRESS: '1830 FLOWER ST BAKERSFIELD PHONE NUMBER: 66'I-326-2000 III. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees s. hould also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing'-contaminated clothing and shoes. Followed by washing with soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention. C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, consulsions, or unconsciousness occur before emesis, gastric lavage using a cuffed endotrachael tube should be considered. For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. - This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff RHL Design Group, Inc., 800-765-1025 Last updated: December 21, 1999 ~.~ ~ TRAINING LOG UNIT # 2708825 BUSINESS NAME: Circle K Stores, Inc. ADDRESS: 2222 F Street TO BEMAINTAINED ON SITE EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR INTITAL AND/OR ANNUAL SAFETY TRAINING. DATE OF TYPE OF EMPLOYEE NAME EMPLOYEE SIGNATURE TRAINING TRAINING (updated: February 15, 2000) HMMP PLAN MAP SITE DIAGRAM~ FACILITY DIAGRAM Business Name' Circle K Stores Inc. #8825 ///~ Area Map # 1 of 1 North Name of Area: Circle K Stores Inc. #8825 I I 2222 'F' St., Bakersfield Scale 1' = 26' Parking Lot Gee Pumpu I 10K Gel I 2225 St. I 1OK Gal I St. ~. j Reeidence Morrl. Plan Emergency 6' Brick Driveway Pump Shutoff 'F' Counter Veoenl 2215 23rd 4/95 8phU2oPff Kern Dermetology Group Fire Ext. 0, Parking ~ ~ Store #8825 ~. 2222 'F' Street 5' Chalnilnk Fence Apertmento Reeldenoe -5- .,.F'SYMBOLS (~ GAS [.MSDSI MSDS STORAGE FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT (~ WATER GATE IN FENCE ~ -- STANDARD 'DOOR SPRINKLER FIRE DEPT. CONNECTION ! 10,000 ~ UNDERGROUND ! STORAGE FIRE HYDRANT PUBLIC I_ GS[[ i TANKS- LIST ' - .... CAPABILITY ~ RAILROAD TRACKS O -FIRE HYDRANT - PRIVATE ..... -. 1 0,000 ABOVEGROUND TANKS ( AUTOMATIC SPRINKLERED Gal BUILDING OR AREA O EVACUATION AREA FIRE ALARM h PESTICIDE [~AREAPESTICIDE STORAGE TYPES OF HAZARDOUS MATERIALS CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Manager : BusPhone: (805) 324-1758 Location: 2222 F ST Map : 102 CommHaz : Low City : BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:06-294-4160 Emergency Contact / Title Emergency Contact / Title STAFF / DUTY CLERK TERRI NICHOLSON / DISTRICT MNGR Business Phone: (805) 324-1758x Business Phone: (800) 697-1399x 24-Hour Phone : (805) 324-1758x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : (800) 697-1399x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : MYRON SMITH COMPLIANCE MANAGER Phone: (206) 442-7378x MailAddr: 601 UNION ST 3920 State: WA City : SEATTLE Zip : 98101 Owner CIRCLE K STORES INC #8825 Phone: (602) 437-0600x Address : PO BOX 5604 State: AZ City : PHOENIX Zip : 85072 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I, Do h®mby c~r~ify ~ha~ ~ have (Type or p~nt nam=) reviewed ~he a~hed h~a~s ~a~s ~anag~- mere plan for, ~nd ~ i~ a~o~ ~i~h ang corm~on~ co,s~i~u~ a co~pl~t~ and corm~ ~an- agem~nt p~an for ~y ~c~i~ -1- 01/31/2000 F CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Hazmat Inventory By Facility Unit --Alphabetical Order Fixed Containers on Site Hazmat Common Name... ISpecHazlEPA Hazardsl Frm I DailyMax Unit MCP C~BON DIOXIDE F P IH G 1044.00 FT3 Min PREMI~ ~LE~ED GASOLINE F IH DH L 10000.00 GM Mod ~LE~ED GASOLINE F IH DH L 10000.00 GM Mod ~LE~ED PLUS GASOLINE F IH DH L 10000.00 G~ Mod 2 01/31/2000 CIRCLE K STORES INC #8825 SiteID: 215-000-000993 = Inventory Item 0004 Facility Unit: Fixed Containers on Site ~UIVUVlU~ ~Vl~ / U~I U_,u,_j_, ~Vl~ CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: IN STOREROOM, BACK OF STORE CAS# 124-38-9 r STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient I Cryogenic I PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 174.00 FT3 1044.00 FT3 522.00 FT3 HAZARDOUS COMPONENTS 100.00 Carbon Dioxide N 124389 HAZARD ASSESSMENTS lTSecret RS BioHazl Radioactive/Amount I EPA Hazards I NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min = Inventory Item 0003 Facility Unit: Fixed Containers on Site 9 PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 STATE i TYPE PRESSURE[TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container / Daily Maximum Daily Average 10000.00 GALL 10000.00 GAL 5000.00 GAL HAZARDOUS COMPONENTS %Wt. oRSI CAS# 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl oRSIBioHaz Radioactive~Amount I EPA HazardsI NFPA USDOT# MCP No N No No/ Curies F IH DH / / / Mod -3- 01/31/2000 CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~v~v~ ~v~ / ~! £ ~z~l.~ UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 F STATE TYPE PRESSURE --T TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK I .AMOUNTS AT THIS LOCATION ~ Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl ~S BioHazl Radioactive/Amount I EPA HazardsI NFPA USDOT# I MCP No N No No/ Curies F IH DH / / / Mod ---- Inventory Item 0001 Facility Unit: Fixed Containers on Site 9 UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 F STATE TYPE PRESSURE TEMPERATURE. CONTAINER TYPE Liquid I Mixture Ambient I Ambient I UNDER GROUND TANK AMOUNTS AT THIS LOCATION ~ Largest Container I Daily Maximum I Daily Average 10000.00 GALI 10000o00 GALI 5000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ~ TSecretl oRSIBioHaz RadioaCtive/Amount EPA Hazards NFPA USDOT# I MCP No N No No/ Curies F IH DH / / / Mod -4- 01/31/2000 F CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 05/01/1996 IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND WITHIN STATE OFFICE OF EMERGENCY SERVICES 800 852-7550 24 HRS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: FIRE DEPARTMENT - BAKERSFIELD FIRE DEPARTMENT 9-1-1 POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT 9-1-1 BAKERSFIELD CITY HAZARDOUS MATERIAL DIVISION 9-1-1 -- Employee Notif./Evacuation 05/01/1996 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWNS OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. eVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. -- Public Notif./Evacuation 09/26/1997 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED IF POSSIBLE: AMERICAN GENERAL - 2225 "F" ST - 327-2241 MCDONALDS - 2310 "F" ST - 327-1720 Emergency Medical Plan 05/01/1996 MERCY HOSPITAL - 2215 TRUXTUN AV - 327-3371. -5- 01/31/2000 F CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ MitiHation/Prevent/Abatemt Overall Site --Release Prevention 07/31/1997 1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. 2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. 3. ANTI-LOCK NOZZLES AS PUMPS. 4. NO SALES TO UNAUTHORIZED CONTAINERS. 5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED. 6. TANK MONITORING PROGRAM IMPLEMENTED. -- Release Containment 09/26/1997 1 PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2 SHUT OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILAGE. 3 BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4 AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5 ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6 ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER FOR DISPOSAL. -- Clean Up 09/26/1997 NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. Other Resource Activation 6 01/31/2000 F CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 09/26/1997 A) GAS - NONE B) ELECTRICAL - INSIDE BACK RM OF STORE (BREAKERS); E WALL OF BLDG AT N END (METER) C) WATER - N WALL OF BLDG AT E END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; N WALL OF BLDG, OUTSIDE E) LOCK BOX - NO Fire Protec./Avail. Water 07/31/1997 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF SITE Building Occupancy Level -7- 01/31/2000 CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Training Overall Site -- Employee Training 09/26/1997 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE OF ABSORBENT FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE -- Page 2 Held for Future Use Held for Future Use 8 01/31/2000 FINANCE DEPARTMENT CITY OF BAKERSFIELD P.O. BOX 2057 'BAKERSFIELD, CALIFORNIA 93303 R~RN SERVICE REQUESTED · CIRC08~ ~507~£~ 1~99 1~ Ob/la/O0 FORWARD :C~RCLE K PO BOX PHOENZX AZ ~072-~0~ GROUP INC. ARCHITECTURE * ENGINEERING * ENVIRONMENTAL SERVICES 1137 North McDowell Boulevard, Petaluma, CA 94954-1110 Telephone: (707) 765-1660 Facsimile: (707) 765-9908 John W. Johnson, Architect E s t a b I i s h e d I 9 6 6 J o H N W. J o H NS O N April 14, 2000 Co-President Principal BakersfieldRalph Huey Fire Department 1715 Chester Avenue, 3rd Floor B~.x^N V. ZIT^ Bakersfield, CA 93301 Co-President Principal HAZARDOUS MATERIALS MANAGEMENT PLANS FOR TOSCO/CIRCLE K Dear Ralph Huey: JOHN B. HICKS Vice President Enclosed please find the Hazardous Material Management Plans, HMMP(s), for the Pr i n cip a I TOSCO Corporation station(s) as listed on the attached sheet. These inventories and HMMP(s) are being submitted for your review and approval. c E c i L ~.. S P E N C E R If there are any further correspondence or invoices related to these submissions, Vice President please direct them to: Pr i nc i p a I Regional Compliance Specialist Tosco Corporation P.O. Box 52085 Phoenix, AZ 85072-2085 CHRIS LAWTON Regional Manager Associate Sincerely, RHL DESIGN GROUP, INC. J A M E S E. P R. E S T E N Environmental Department Regional Manager ~/~ Associate Enclosure GARY M. SEMLING Regional Manager Associate ALAN K. SHIMABUKURO Regional Manager Associate BLYTHE l~. WILSON Regional Manager BELLEVUE, WA LA HABR.A, CA MAR.TINEZ, CA PETALUMA, CA Associate SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER., WA 256089 257393 2705186 Country Club Union 76 Inc 6089 Town & Country Union, Inc. #7393 Circle K Store #2705186 2524 Oswell Street 8200 A Stockdale Highway 5401 Stockdale Highway Bakersfield, CA 93306 Bakersfield, CA 93311 Bakersfield, CA 93309 2708605 2708606 2708825 Circle K Stores, Inc. Circle K Stores, Inc. Circle K Stores, Inc. 5600 Auburn Street 1030 Oak Street 2222 F Street Bakersfield, CA 93306 Bakersfield, CA 93304 Bakersfield, CA 93301 2708825 t NIFIED PROGRAM CONSOLIDATED FO.~i,~ . FACILITY INFORMATION BUSINESS ACTIVITIES Page of CILiTY FAClLITYID# · -,: :. ~;:,~:~.::: ,r EPA ID# (Hazardous Waste Only) 2 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Stores, Inc. 02~,~ ~- · :- : I; ACTIVITIES DEcLARATIoN NOTE:i'/f:youcheck YES, to,any' Part'of:this list, Please submit the BbsinessowneriOperator Identification page (oEs Form 2730), .:,Doeslyour;fadiiity.., i,, ,, :i,,, i ,': '-If yes; please c0mPiete these pagesofthe uPCF.;: A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquidS,gases500 pounds for solids, or 200 cubic feet for[--] YES~NO compressed (include liquids in ASTs and USTs); or the JVI HAZARDOUS MATERIALS INVENTORY 4 applicable Federal threshold quantity for an extremely hazardous ~~ CHEMICAL DESCRIPTION (OES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) ~YES r--'-] NO 5 v/ UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? ~ UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ~-~ YES ~ NO 6 v/ UST FACILITY ,,,/' UST TANK (One per tank ~ UST INSTALLATION - CERTIFICATE OF [ COMPLIANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? [] YES NO 7 ,v~ UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) / Own or operate ASTs above these thresholds: tank capacity is greater than 660 gallons, or ~-~ YES~NO 8 ' ~ NO FORM REQUIRED TO CUPAS ~the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [~ YES ~ NO 9 ~' EPA ID NUMBER-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted ~ YES~[-~ NO lO ,~f RECYCLABLE MATERIALS REPORT recyclable materials (per HSC I~ 25143.2)? /~ (one per recyder) 3. Tr~-~t hazardous waste on site? r~ YES~'NO 11 ,,~ ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formerly DTSC Form 1772) ,~ ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) [// (Formerly DTSC Form 1772A, B,C,D, and L) 4. Treatment subject to financial assurance requirements (for Permit~-] YES NO12 ~ CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? .~ ASSURANCE (Formerly DTSC Form 1232) Consolidate hazardous waste generated at a remote site?~ YES~17~NO13 ~ REMOTE WASTE/CONSOLIDATION SITE 5. /NNO ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ~_~ YES 14 ,,,/' HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2 '~12708825 U~ED PROGRAM CONSOLIDATED FORM~ FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page of I. IDENTIFICATION FACILITY ID# ~ ~ . ~ BEGINNING DATE ~00 ENDING DATE ~0~ ' 1/1 ~2000 12/31 ~2000 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 BUSINESS PHONE 102 Circle K Stores, Inc. 661-324-1758 BUSINESS SITE ADDRESS 103 2222 F Street lO4 CA ZIP CODE 105 CITY Bakersfield 93301 DUN _BRADSTREET 106 SIC CODE (4 digit #) lO7 04-8564975 5541 COUNTY 108 KERN BUSINESS OPERATOR NAME I09 BUSINESS OPERATOR PHONE 110 Teri Nicholson 800-270-5123 II. BUSINESS OWNER 111 OWNER PHONE 112 OWNER NAME Florence Clover 661-324-1758 OWNER MAILING ADDRESS 113 2222 F Street 114 STATE 115 ZIP CODE 116 CITY Bakersfield CA 93301 HI. ENVIRONMENTAL CONTACT 117 CONTACT PHONE 118 CONTACT NAME Merliza AIcala 925-277-2319 CONTACT MAILING ADDRESS 119 2000 Crow Canyon PI. Suite 400 12o STATE 121 ZIP CODE 122 CITY San Ramon CA 94583 PRIMARY IV. EMERGENCY CONTACTS SECONDARY NAME 123 NAME 128 Ted Nicholson Tosco Maintenance ~ITLE 124 TITLE 129 Dist. Mgr. Dispatch Ctr BUSINESS PHONE 125 BUSINESS PHONE 130 800-270-5123 800-726-2312 24-HOUR PHONE 126 24-HOUR PHONE 131 800-697-1388 800-726-2312 PAGER# 127 PAGER# 132 ADDITIONAL 'LOCALLY COLLECTED INFORMATION: Certification: Basj~n} my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with thynfoTation su/bfl~tte~d believe the information is true, accurate, and complete. I RHL DES,GN GROUP, ,NC.-ENVIRONMENTAL DEPT. N/.A4ME OF srdl~'~R-,~int) ,,~ / , ~36 I~]~LE OF~SIJ;NER 137 UPCF ( 1/99 revised) 16 OES FORM 2730 HAZARDOUS MATERIALS INVENTORY- CH~;MICAL DESCRIPTION One page per material per building or area) ] ]ADD I ]DELETE I ]REVISE 200 I Page ~., of,~ I. FACILITY INFORMATION BUSINESS NAME Circle K Stores, Inc. 2708825 ~HEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL 202 NORTH SIDE OF LOT E?CRA []YES [] NO GR/D# (optional) 204 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET L._JYes X~O 206 PETROLEUM HYDROCARBON 1£ Subject to EPCRA. refer to instructions :OMMON NAME 207 208 REGULAR UNLEADED ]SHS [~ Yes [~ No CAS# 209 8006-61-9 IfEHS is "Yes", all amounts below must be in lbs. FIRE COD]S HAZARD CLASSES (Complete i£required by CUP^) 210 I-B FLAMMABLE LIQUID HAZARD MATEKIAL 211 212 213 215 PHYSICAL STATE 214 [-~ a. SOUD [~ b. uOtaD [--~ c. GAS LARGEST CONTaC, mR [Cbeck one item only) FED HAZARD CATEGORIES 216 ^VE~OED~L¥ MOUNT2200 21, ~'~MUM D~LY, 0000MOUNT 21~ ~'~U~ W^~TE~OUNT 21~ STATE WASTE CODE ~0 UNITS* ~ a. GALLONS [~ b. CUBIC FEET [~ c. POUNDS ~-] d. TONS 221I DAYS ON SITE: 222 (Check one item only) ifEHS, amount must be in pounds. 365 ~STORAGE a. ABOVE GROUND TANK e. PLASTIC/NONMETALLIC DRUM i, FIBER DRUM m. GLASS BOTTLE RAIL CAR ~ONTAINER b. UNDERGROUND TANK__ -- f. CAN __ -- j. BAG __ n. PLASTIC BOTTLE OTHER c, TANK INSIDE BUILDING g. CARBOY k. BOX : o, TOTE BIN d. STEEL DRUM h. SILO I. CYLINDER ~ p. TANK WAGON .... 223 STOOGE PRESSURE J-Z) ~- ,~aBIENT ~]b. ABOVE A~BiENT [~. BELOW AUBIENT 224 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 15% 226 METHYL TERT BUTYL ETHER 227 [~es [~qo 228 1634-044 229 2 15% 230 TOLUENE 231 [~es [~o 232 108-88-3 233 3 21% 234 XYLENE 235 [~{es [~o 236 1330-20-7 237 4 5% 238 BENZENE 239 [~Yes [~qo 240 71-43-2 241 5 5% 242 1,2,4-TRIMETHYL BENZENE 243 [~Yes [~qo 244 95-63-6 245 If more hazardous componenu ate present at greater than 1% by weight if non. carcinogenic, or O. 1% by weight if carcinogeniC attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 HAZARDOUS MATERIALS INVENTORY- CI-IWlWaCAL DESCRIPTION One page per material per building or area) [ lADD [ I DELETE ) I REVISE 200 I. FACIUTV Ir FOU TION BUSINESS NAME Circle K Stores, Inc. 2708825 CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL 202 NORTH SIDE OF LOT El'CRA [--]YES [~] NO FACiLITY ID# ~ ~ I ~ (optional) 203 GRID# (optional) 204 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET L_JYes X[~No 206 PETROLEUM HYDROCARBON · If Subject to EPCRA, refer to instructions COMMON NAME .207 208 PLUS UNLEADED EHS [] Yes [~ No CAS# 209 8006-61-9 IfEHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CD'PA) 210 I-B FLAMMABLE LIQUID HAZARD MATERIAL 211 212 213 TYPE (Check one item [~] a. PURE ~-~ b. M1XTURE ~-] c. WASTE RADIOACTIVE [-~ Yes ~No CURIE PHYSICAL STATE 214 215 [~ a. SOLID r-~ b. LIQUID [] c. GAS LARGEST CONTAINER (Checlc item only) one FED HAZARD CATEGORIES 216 (Check all that apply) [~ a. FIRE [--q D. REACTIVE ~] c. PRESSUILERELEASE [~ d. ACUTE HEALTH [~ ¢.CHRONICHEALTH AVERAGE DAILY AMOUNT3000 217 MAXIMUM DAILY10000 AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 UNITS* ~] a. GALLONS [~] b. CUBIC FEET [~ c. POUNDS [~ d. TONS 22' DAYS ON SITE: 222 (Check one item only) ifEHS, amount must be in pounds. 365 STORAGE a. ABOVE GROUND TANK e. PLASTIC/NONMETALLIC DRUM I i. FIBER DRUM m. GLASS BOTTLE RAIL CAR CONTAINER ~ b. UNDERGROUND TANK f. CAN j. BAG n. PLASTIC BOTTLE OTHER ¢. TANK INSIDE BUILDING g. CARBOY__~ lc. BOX o. TOTE BIN d. STEEL DRUM __ Ih. SILO I. CYLINDER p. TANK WAGON -- -- -- 223 STORAGE PRESSURE [~ a. AMBIENT [~b. ABOVE AMBIENT [--~c. BELOW AMBIENT 224 STORAGE TEMPERATURE [~ a. AMBIENT ~-~b. ABOVE AMBIENT ~--]c. BELOW AMBIENT ~-]d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 1 15% 226 METHYL TERT BUTYL ETHER 227 [~es [~No 228 1634-04-4 229 2 15% 230 TOLUENE 231 ~Yes [~No 232 108-88-3 233 3 21% 234 XYLENE 235 ~}Yes ~qo 236 1330-20-7 237 4 5% 238 BENZENE 239 [~Yes ~qo 240 71-43-2 241 5 5% 242 1,2,4-TRIMETHYL BENZENE 243 []Yes 244 245 95-63-6 If more hazardous components am present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 JFII~D PROGI~V~ CONSOLI~AtED~V[ · HAZARDOUS MATERIALS HAZARDOUS MATERIALS. INVENTORY - Cm~c~d~ DESCRIPTION One page per material per building or area) I IADD I [DELETE I IREVISE 200 I Page I. FACILITY INFORMATION BUSINESS NAME Circle K Stores, Inc. 2708825 CHEMICAL LOCATION CHEMICAL 'LOCATION CONFIDENTIAL 202 NORTH SIDE OF LOT ' a,c~ [--]rES [~ NO ~^C~ID~ ~ ~ ~ ~ (o.tion~) ~0~ ~# ~o.tiun~) II. CHEMICAL INFORMATION PETROLEUM HYDROCARBON If Subj~:t to EPCRA, refer to in~tmctious COMMON NAME 207 208 PREMIUM UNLEADED EHS [--] Yes [-~ No CAS# 209 8006-61-9 IfEHS is "Yes", all amounts below must bc in lbs. FIRE CODE HAZARD CLASSES (Com~t~ ir r~uir~l b~ CLa'^) 210 I-B FLAMMABLE LIQUID HAZARD MATERIAL 211 212 21:5 PHYSICAL STATE 214 215 [~ ~. SOLID [~ b. LIQUID ~-~ c. OAS L^~GEST CONT~E~ (Check item only) one 216 FED HAZARD CATEGORIES ^vE oE O T 000 D L 10000 W^STE STATE WAS COOE (Check one item only) if EHS, amount must be in pounds. 365 o,O DT -~ b. UNDERGROUND TANK --!f. CAN j. BAG n. PLASTIC BOTTLE OTHER c. TANK INSIDE BUILDING g. CARBOY k. BOX o. TOTE BIN d. STEEL DRUM h. SILO 1. CYLINDER p. TANK WAGON .... STO~ P~SSU~ [~ a. ^~BIENT [~]b. ABOVE ^~BIENT I---It. BELOW ~BIENT STORAGE TEMPERATURE [~]a. AMBIENT [~]b. ABOVE AMBIENT I---lc. BELOW AMBIENT I--Id. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 1 10% 226 METHYL TERT BUTYL ETHER 227 ~]Yes [~qo 228 1634-04-4 229 2 9% 230 TOLUENE 231 [~]Yes [~No ' 232 108-88-3 233 3 14% 234 XYLENE 235 [~cs ~No 236 1330-20-7 237 4 5°,/o 238 1,2,4-TRIMETHYL BENZENE 239 ~]Ycs [~No 24O 241 95-63-6 5 5% 242 BENZENE 243 [~Ycs [~No 244 71-43-2 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogenic, attach additional sheets of paper capturing the requi~d information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 IfEPCRA, Please Sign Here UPCF (1/99) 169 DES Form 2731 MAP//BUSiNESS 1 CALIFORNIA ANNOTATED SITE MAP NAME CIRCLE K STORE //2708825 DATE ~28/00 BUSINESS ADDRESS 2222 'F' STREET BAKERSFIELD ZlP CODE 93301 DRAWING SCALE ~"=3o'-o"_+ ~ A B C D E F G H MAP SYMBOLS NORTH ~ PARKING LOT ~ SHUT-OFF[LECTRICAL PANEL SHUT-OFF ~ WATER SHUT-OFF 23RD STREET ~ ~o~c~ ~u~ SHUT-OFF A TANK MONIIORING TMA ALARM ~% ff ~ ~ FIRS~ AID KIT 2 ~ STOR~ DRAIN ~ SANITARY SEWER STAGING AREA EVACUATION/ I I' ~'~ I ~ MSDS LOCATION j .... : -- -- ~ i ~ FENCE v ~ EMEROENCY RESPONSE EQUIPMENT/ABSORBENTS STORAGE TANK 4 O ~ ~ ~ ~ ~ (~-~) UNDERGROUND ~ ~ ~-~ S~ORAGE TANK ~ ~~A~ ~ ~ GASOLINE (FLAMMABLE LIQUIDS) O O ~ ~ ~ ~ TMA I ~ DIESEL FUEL . ~ (COMBUSTIBLE LIQUIDS~ (COMBUSTIBLE LIQUIB~ j . ~ CARBON DIOXIDE 5 (COMPRESSED OAS) [ ~ PROPANE (FLAMMABLE LIQUID) I ~~ I ~ ANTIFREEZE/COOLANTS I ~ I ~ WASTE OIL (FLAMMABLE LIQUID) 7 RESIDENTIAL SECTION I 2708825 BUSINESS EMERGENCY PLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. 1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL 911 (Fire, paramedics, police, or sheriff) STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 262-1621 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 805-326-3979 PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A HAZARDOUS MATERIALS INCIDENT: · Name: Teri Nicholson Telephone: 800-270-5123 Name: Tosco Maintenance Telephone: 800-726-2312 B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: GOOD SAMARATIN HOSPITAL ADDRESS: 901 OLIVE DRIVE CITY: BAKERSFIELD PHONE: 805-399-4461 ~ ~' 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide information on the steps taken at Your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazardous at this business 'are fire and spills associated with gasoline dispensing. Gasoline dispensing is supervised by trained personnel. Additional hazardous materials are stored in minimum quantities and stored in small, unbreakable containers. All underground storage tanks are monitored using an approved monitoring method. 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill, fire, explosion or airborne release at your facility? Small incidents: For leaks and spills isolate the area and contain with absorbent material. Clean up the spill immediately to prevent spreading. For rites, mm off pumps, use fire extinguisher if it can be done safely. Larger incidents: Turn off pumps using emergency pump shut-off, call 9-1-1, evacuate to emergency assembly area, wait for emergency personnel to respond. Immediately contact the business owner, if not already on site, the Tosco Business Operations Manager or District Manager and the Tosco Maintenance Call Center. 4. ABATEMENT Describe what you would do to .stop and remove each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the release? Small incidents will be handled with the on-site clean-up equipment, (i.e., brooms, shovel, absorbent material, mops, etc.). For larger incidents, the on site manager will mm off the pumps, call 9-1-1, and the Tosco Maintenance Call Center ~ 1-800-726-2312. The Call Center will dispatch a maintenance contractor to assist in abating the hazard. For suspected leaks the operator will notify the Tosco Maintenance Call Center and his/her Business Operations Manager or District Manager who will investigate the incident. If a UST leak is confn'rned, then reporting will be done by Tosco Marketing, which complies with UST regulations. Tosco Marketing will coordinate with any contractors required to stop a release, clean up a release and/or dispose of materials. All materials will be disposed of in accordance with state, federal and local laws and regulations. ~ 5. EVACUATION~ Describe the procedures to be followed for immediate notification and evacuation of your facility.~ If warranted, evacuate to the designated assembly located at: NORTH OF SITE The manager or lead employee will take a head count to verify all employees have evacuated safely. The manager or employee will confer the responding agencies to indicate the magnitude of the emergency. 6. EARTHQUAKES Identify the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drams, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The typical wastes generated at this business are used motor oil and antifreeze. These items will be handled in the same manner as new motor oil or antifreeze. Use absorbent material or rags to clean up spills and place in a container for proper disposal or recycling. 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized releases from an underground storage tank CL!ST). The plan must address a release from a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underground Storage Tank Monitoring and Response plan provided by Tosco Marketing Company. If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up from the secondary containment within 8 hours, or deteriorates the secondary containment, then the local agency will be notified IMMEDIATELY SECTION II BUSINESS EMERGENCY TRAINING. Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum, include: A. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselTces from chemical hazards. B.Procedures for coordination with local emergency response organizations. C. Correct use of emergency response equipment and supplies under the control of the business. D.The Cai OSHA Hazardous Communication Standards. E. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan. F. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care. G. Procedures to coordinate with and assist the local emergency personnel that may respond to your facility. H. Who and how to call for immediate assistance in the event of an accident involving hazardous materials; I. Procedure for ensuring the appropriate personnel receives initial and refresher training. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY Use the attached employee training log or similar form for record keeping. SPONSE PR_O MAJOI~TCIDENT: 'F--~,, ~ ~ SUSPEND LEAK 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1: Give the following information: "THERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 2222 F Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator if he/she is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Teri Nicholson Title: Dist. Mgr. Address: Bus#/Home#/Alt#: 800-270-5123 / 800-697-1388 / Alternate Emergency Coordinator: Tosco Maintenance Title: Dispatch Ctr Address: Bus#/Home#/Al~: 800-726-2312 / 800-726-2312 / 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager. Tosco Environmental Compliance Coordinator: North: Merliza Alcala (925)277-2319 or (888)671-4350 South: Stephen Boyd (714)428-6572 or (800)759-8888 pin#1267507 Tosco Coporation will notify the State and Local administering agencies within an appropriate time frame, unless the situation requires urgent immediate response by the agencies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. EMPLOYEE TRAINING PLAN · . Employees must be given this training before starting work, and refresher courses must be provided annually. '~ Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. I. FIRST TFIINGS TO KNOW: A. EMERGENCY PIJMP SHUT-OFF:This tums offthe turbine pumps that provide flow to the dispensers from the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: 1-CASHEIR, 1-FRONT OF BUILDING, 1-PUMP ISLANDS B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. Location: 1-REAR OF BUILDING, 1-STOCKROOM C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when a leak is detected by a visual and audible alarm. Location: STOCKROOM D.WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: ALONG F STREET E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow in an emergency. Location: NONE F. PROPANE/LPG: If your station has propage or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut offthe power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large f~res on your own; call 9-1-1 for help. Location: 3-IN STORE, 1-PUMP ISLANDS H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it, a vacum truck should be used to clean up any large spill Location: SPILL KIT AT CASHIER I. PERSONAL PROTECTIVE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH OF SITE HAZARDOUS MATERIAL MANAGEMENT PLAN (HMMP) MATERIAL SAFETY DATA SHEET (MSDS): Location: CASHIER II. NEAREST MEDICAL FA__~_~_TY: Employees should know what fac are available in case customers or other employees need medical atterl~n. 1.NAME: GOOD SAMARATIN HOSPITAL ADDRESS: 901 OLIVE DRIVE BAKERSFIELD PHONE NUMBER: 805-399-4461 NEAREST DESIGNATED TRAUMA CENTER: 2.NAME: KERN MEDICAL CENTER ADDRESS: 1830 FLOWER ST BAKERSFIELD PHONE NUMBER: 805-326-2000 ltl. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated clothing and shoes. Followed by washing with soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention. C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, consulsions, or unconsciousness occur before emesis, gastric lavage using a cuffed endotrachael tube should be considered. For further information, consult the Materials Safety Data Sheets for these products and for other hazardoUs materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff, RflL Design Group, Inc., 800-765-1025 Last updated: December 21, 1999 TRAINING LOG UNIT # 2708825 BUSINESS NAME: Circle K Stores, Inc. II II ADDRESS: 2222 F Street TO BE MAINTAINED ON SITE EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR INTITAL AND/OR ANNUAL SAFETY TRAINING. DATE OF TYPE OF EMPLOYEE NAME EMPLOYEE SIGNATURE TRAINING TRAINING (updated: February 15, 2000) ~ . BAKEPa~FIELD CITY FIRE DEPA~ENT OFFfCE OF ENVIRONMENTAL SERVICES ' lh~ llC--~ .-.: ...~. 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 //~ .e~ ~/~/ (805) 326-3979 /~;: ~ ~ ~/~?Z FACILI~ DESCRIPTION CHECKIF BUSINESS ISAFARM [ ] BUSINESS NAME CJrc]e E Store ~gg25 FACILI~ NAME C~c]~ ~ gto~e ~g825 SITE ADDRESS 2222 "F" gtreet Cl~ ~ers~;e]~ STATE CA ZIP 93301 NATURE OF BUSINESS ~on~en;ence grote / GAso];ne SIC CODE 5541 DUN & B~DSTREET 06-294~160 OWNER/OPERATOR Myron Smith; Com?]iance Man,get PHONE MAILING ADDRESS 801 Union Street; Suite 3920 ClTYSeattle STATE WA ZIP 98101 EMERGENCY CONTACTS NAME Staff TITLE Duty Clerk BUSINESS PHONE (8~~1758 24-HOUR PHONE (805) 324-1758 NAME [I"erri Nicholson TITLE Zone Manager BUSINESS PHONE (800) 697-1399 Pager 24-HOUR PHONE (800) 697-1399 Pager BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page_l__ of 3__ 3usiness Name C_ir_cle K Store #8825 Address 2222ZELSiceet Bakersfield 93301 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] Revision D~ Deletion[ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ] 2) Common Name: Gas~J~e; Unleaded Regular 3) DOT# (optional) 1203 Chemical Name: Gasoline: Unleaded Regular AHM [ ] CAS # 8008-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~X~ Reactive [ ] Sudden Release of Pressure [' ] Immediate Health (Acute) ~] Delayed Health (Chronic) ~] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 B) PHYSICAL STATE Solid [ ] Liquid [X~] Gas [ ] Pure [ ] Mixture ~ Waste [ ] Radioactive [ ] CHECK ALI. ?) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal ~ fi3 [ ] a) Container:. 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount 379532 c) Temperature: 4 Largest Size Countainer: 1oooo # Days On Site: 365 Circle Which Months: ~.Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % v~rr AHM the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ ] chemical components or any AHMcomponents 2) Toluene 108-88-3 8 [ ] 3) M-Xylene 108-38-3 7 _ [ ] 10) Location Underground ~nk. approx. 20 feet nodhea~t of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] Revision ~] Deletion [ ] Check if chemical is a NON TRADE SECRET D(] TRADE SECRET [ ] 2) Common Name: Gasoline: Unleaded Plus 3) DOT# (optional) 1203 Chemical Name: Gasoline Unleaded Plus AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) ~] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid ~] Gas [ ] Pure [ ] Mixture ~X] waste [ ] Radioactive [ ] CHECK ALL THAT APPL Y 7} AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal ~ fi3 [ ] a) Container:. 01 Average Daily Amount: 5000 cudes [ ] b) Pressure: 1 Annual Amount 140794 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Methyltert Bu .tyI Ether 1614-044 16 [ ] chemical components or any AHM components 2) Toluene 108-88-3 8 [ ] 3) M-X.vJene _ 108-38-3 7 [ ] 10) Location Underground tank: apgro× 20 feet northeast of store I certify underpenalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I believe the ''e'' S/gna/ ' BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page2__ of 3 iusiness Name Circle K Store #8825 Address 2222 "F" Street Bakersfield 93_301 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision D~ Deletion[ ] Check if chemical is a NON TRADE SECRET [:~ TRADE SECRET [ ] 2) Common Name: Gasoline Unleaded Premium 3) DOT# (optional) 1203 Chemical Name: G~soline Unleaded Premium AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) ~ 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid ~ Gas [ ] Pure [ ] Mixture ~ Waste [ ] Radioactive [ ] CHEC~ AU. T~4T A~pL ¥ 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal [X~] fl3 [ ] a) Container. 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 91822 c) Temperature: 4 Largest Size Countainer: 1000o # Days On Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % VVT AHM the three most hazardous 1) Methyltert Butyl Ether 1634-04-4 16 [ chemical components or any AHM components 2) Toluene 108-88-3 8 [ 3) M-Xylene 108-38-3 7 [ 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision [ ] Deletion[ ] Check if chemical is a NON TRADE SECRET IX] TRADE SECRET [ ] :2) Common Name: Carbon Dioxide 3) DOT # (optional) Chen3ical Name: Carbon Dioxide. CarbonicAnhyddde AHM [ ] CAS # 124-38-9 i 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure ~X] Immediate Health (Acute) ~] Delayed Health (Chronic) [ 5)' WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas ~X3 Pure IX] Mixture [ ] Waste [ ] Radioactive [ ] CH~CK ~ 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 1044 _ lbs [ ] gal [ ] ft3 [:)(3 a) Container. 04 Average Daily Amount: 522 cudes [ ] b) Pressure: 2 Annual Amount: 54288 c) Temperature: 4 Largest Size Countainer: 174 # Days On Site: 365 Circle VVhich Months: (~)Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Carbon Dioxide~ Carbonic Anhydride 124-38-9 100 [ chemical components or any AHM components 2) [ 3) [ 10) Location In Storeroom back of store / certify underpenalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I believe the Pdnt Name & Title of Authodzed Company Representative Signature Date BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY PageS__ of 3 Business Name Circle K Store #8825 Address 2222 "F" Street Bakersfield 93301 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition~] Revision [ ] Deletion[ ] Check if chemical is a NON TRADE SECRET ~0 TRADE SECRET [ ] 2) Common Name: Propane 3) DOT# (optional) 1978 Chemical Name: Propane AHM [ ] CAS # 74-98-6 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive [ ] Sudden Release of Pressure ~] Immediate Health (Acute) ~0 Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid ~] Gas ~)~ Pure D(] Mixture [ ] Waste [ ] Radioactive [ ] ~.~g(;~ Al, l. ~'fAT APPLY 7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 2296 lbs [ ] gal [ ] fi3 D(] a) Container. 04 Average Daily Amount: 1148 curies [ ] b) Pressure: 2 Annual Amount: 119392 c) Temperature: 4 Largest Size Countainer: 820 # Days On Site: 365 Circle Which Months: ~)Year, J, F, M, A, M, J, J, A, S, O, N. D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Propane 74-96-6 lOO [ chemical components or any AHM components 2) [ 3) [ 10) Location Cage in front of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 6) PHYSlCALSTATE Solid[ ] Liquid [ ] Gas[ ] Pure[ ] Mixture[ ] Waste [ ] Radioactive[ ] CHECK ALL THAT APPL¥ 7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ft3 [ ] a) Container:. Average Daily Amount: cudes [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Countainer: # Days On Site: Circle Which Months: All Year, J, F, M, A, M, J. J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % VVT AHM the three most hazardous 1) [ chemical components or any AHM components 2) [ 3) [ 10) Location I certify under penalh/of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I believe the submitted information is true, accurate, ar~ complete. P#nt Name & Title of Authorized Company Representative Signature Date BAKERSFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle K Store #8825 LOCATION:22.22 "F" .qtreet l~akersfield 93301 MAILING ADDRESS: 601 Union Street, Suite 3920 CITY:Seattle STATE: WA ZIP: 98101 PHONE: (805) 324-1758 DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / G~mllne ~t~t;nn OWNER: Circle K Company a Divklon of Tosco Corp MAILING ADDRESS: 601 Union Street, Suite 3920 Seattle WA 98101 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff Duty Clerk (805) 324-1758 (805) 324-1758 2. Terri Nicholson Zone Manager (800) 697-1399 Pager (80.0) 697-1399 Pager Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of absorbent for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of shutoffs for gas and electricky) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTH ER (SPECI FY REASON) SECTION 5: CERTIFICATION: I ~_lkl(~4/4~N~£T- 2)~ C4fF( CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE. INFORMATION CONSTITUTES PERJURY. "t31GNATU RE TITLE DATE 2. ~ Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Circle K Store #§§25 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: If emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division 326-3979 AND State Office of Emergency Services 800-852-7550 WITHIN 24 HOURS If release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, immediately notify: Fire Department - Bakersfield Fire Department 911 Police Department - Bakersfield Police Department 911 Bakersfield City Hazardous Material Division 911 State Office of Emergency Services (800) 852-7550 or (916) 262-1621 B. EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. C. PUBLIC EVACUATION: If evacuation from area deemed necessary, these neighboring properties will be notified if possible: American General 2225 "F" Street 327-2241 McDonalds 2310 "F" Street 327-1720 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRUXTON AVENUE 327-3371 i~Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Anti-lock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent further spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and contact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids wkh absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle K/Tosco Environmental Manager (602)200-4528 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CARBON DIOXIDE, PROPANE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONTAINMENT A_ND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDUKES: Remove ignkion sources. Ventilate area immediately. Contact supplier if leak is in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: a) Inside, backroom of store ,(breakers), b) E~qt wall of building at north end (meter) WATER: North wall of building at east end (main llne gate valve) SPECIAL: Emergency gas shutoff switch: a) At cashier station on console: b) North w~ll of building LOCK BOX: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Northeast corner of site 4. 'SYMBOLS (~ GAS I MSDS,I MSDS STORAGE FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT {~) VCATER GATE IN FENCE J -- STANDARD 'DOOR SPRINKLER FIRE DEPT, CONNECTION I 10,000 '~i STORAGE UNDERGROUND ! Gal I TANKS- LIST FIRE HYDRANT - PUBLIC L -- - CAPABILITY I t i i iii RAILROAD TRACKS (~ FIRE HYDRANT - PRIVATE ....... 10,000 ABOVEGROUND TANKS ( AUTOMATIC SPRINKLERED Gal BUILDING OR AREA ~ EVACUATION AREA ~ J J ~[~ PESTICIDE STORAGE FIRE ALARM PESTICIDE AREA TYPES OF HAZARDOUS MATERIALS FLAMMABLE <~ LIQUID CORROSIVE <~ SOLID <~ WATER R1FACTIVE <~ GAS EX;PLOSIVE <~ RADIOLOGICAL .- , <~ WASTE EXJkMPLE: FLAMMABLE <~LiQUiD E.M.S.S., Inc. Augfi~t 8, 1997 B~ersfield Fire Depa~ment Hazardous Material Division 2130 "G" Street B~ersfield, CA 93301 Gentlemen: Circle K Company a Division of Tosco Corporation has contracted Environmental Management Software Systems, Inc. (EMSS) to provide the required changes to the Business Plan for the 1997 reporting period. Enclosed are copies of the Business Plan Updates for the five Circle K Stores #1242, 1270, 8605, 8606 and 8825 with changes in Business Mailing Address and Emergency Contacts as necessary. Propane was added to the inventory. The new Business Mailing Address is: Tosco Marketing Company Environmental Department 3550 N. Central Ave., 4th Floor Phoenix, AZ 85012 Circle K Company a Division of Tosco Corporation has been instructed by EMSS to ensure that every store keep the Business Plan resident at the store and that all store employees be trained in the Contents of the hazardous material inventory and emergency response sections of the Plan. ? If you have any questions regarding this submittal, please call EMSS at (805) 925-6285. Sharon L. Conley EMSS Compliance Analyst Enclosures ' E.M.S.S., Inc./RO. BOX 56041SANTA MARIA/CA 93456/(805) 925-6285/FAX: (805) 349-2753 CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Manager : BusPhone: (805) 324-1758 Location: 2222 F ST Map : 10 CommHaz : Low City : BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:06-294-4160 Emergency Contact / Title Emergency Contact / Title STAFF / DUTY CLERK TER~ NICHOLSON / DISTRICT MNGR Business Phone: (805) 324-1758x Business Phone: ( ) - x 24-Hour Phone : (805) 324-1758x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : r~J . -.T Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title = Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm ] DailyMax IUnitIMcP UNLEADED PLUS GASOLINE F IH DH L 10000 GAL Mod UNLEADED GASOLINE F IH DH L 10000 GAL Mod PREMIUM UNLEADED GASOLINE F IH DH L 10000 GAL Mod CARBON DIOXIDE ~P IH G 1044 FT3 Min !, CH~-~-3fT _~,',.,¢~ Do hereby certify that i have ~y~ or pdn~ reviewed ti~e aLtached h~ardcus ma'[edals manage- ment plan for ~X~ and that it along with asy corrections constitute n complete and correct mnn- agement plan for my facili~. -1- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~UtV~VlU~ ~ / ~£~ ~ UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture AmbientI/ AmbientIi UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Gasoline No 8006619 -2- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 F STATE -- TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture AmbientIi AmbientIi UNDER GROUND TANK AMOUNTS STORED AND IN USE -- Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. I EHS CAS# 100.00IGas°line No 8006619 -3- p CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~Utv~vlu~ ~ / ~l~ ~ PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. I EHS CAS# 100.00I Gasoline No 8006619 -4- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site CARBON DIOXIDE Days On Site 365 Location within this Facility Unit IN STOREROOM, BACK OF STORE CAS# 124-38-9 ~ STATE -- TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Pure Above AmbientI Cryogenic PORT PRESS CYLINDER Gas . . AMOUNTS STORED AND IN USE ~ Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 1044.00 522.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Carbon Dioxide No 124389 F CIRCLE K STORES INC %8825 SiteID: 215-000-000993 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 05/01/1996 IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND WITHIN STATE OFFICE OF EMERGENCY SERVICES 800 852-7550 24 HRS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: FIRE DEPARTMENT - BAKERSFIELD FIRE DEPARTMENT 9-1-1 POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT 9-1-1 BAKERSFIELD CITY HAZARDOUS MATERIAL DIVISION 9-1-1 -- Employee Notif./Evacuation 05/01/1996 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWNS OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. eVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. -- Public Notif./Evacuation 05/01/1996 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED~/9~~ AMERICAN GENERAL 2225 "F" STREET 327-2241 MCDONALDS 2310 "F" STREET 327-1720 Emergency Medical Plan 05/01/1996 MERCY HOSPITAL - 2215 TRUXTUN AV - 327-3371 -6- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 05/01/1996 1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. 2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. 3 DUAL -,~o= ov~o ~, .... ~ ANTI-LOCK NOZZLES AS PUMPS 4. NO SALES TO UNAUTHORIZED CONTAINERS. 5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED. -- Release Containment 05/01/1996 1. PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2. SHUT OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILAGE. 3. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER FOR DISPOSAL. -- Clean Up 05/01/1996 NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. Other Resource Activation -7- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Site Emergency Factors Overall Site .Special Hazards -- Utility Shut-Offs 05/01/1996 A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS) EAST WALL OF BUILDING AT NORTH END (METER) C) WATER - NORTH WALL OF BUILDING AT EAST END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO Fire Protec./Avail. Water 05/01/1996 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF SITE Building Occupancy Level -8- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Training Overall Site -- Employee Training 05/01/1996 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER ~%~~_E AND USE OF GASOLINE EQUIPMENT. 2) USE OF ~,~ ......... ~~ E~q FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE -- Page 2 -- Held for Future Use Held for Future Use CIRCLE K STORES INC #8825 L ~ ~'i~9/ SiteID: 215-000-000993 Manager : E~sPhone: (805) 324-1758 Location: 2222 F ST 8¥__ ~ap : 10 CommHaz : Low City : BAKERSFIELD ~rid: 25B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:5541 EPA Numb: DunnBrad:06-294-4160 Emergency Contact / Title Emergency Contact / Title STAFF / DUTY CLERK TERq NICHOLSON / DISTRICT MNGR Business Phone: (805) 324-1758x Business Phone: ( ) - x 24-Hour Phone : (805) 324-1758x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ~v~, ~ vv~- Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title ~ Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpocHazlEPA HazardsI Frm I DailyMax Unit MCP UNLEADED PLUS GASOLINE F IH DH L 10000 GAL Mod UNLEADED GASOLINE F IH DH L 10000 GAL Mod .PREMIUM UNLEADED GASOLINE F IH DH L 10000 GAL Mod CARBON DIOXIDE F P IH G 1044 FT3 Min (Type or p~nt name) reviewed the attached .h~ardous materials ~ana~e- (~m~t Bus~e~) any corrections constitute e complete and corrsc~ man- a~emen~ plan for my ~adli~y. '~,,. '/-' $iormlure CIRCLE K STORES INC #8825 SiteID: 215-000-000993 = Inventory Item 0001 Facility Unit: Fixed Containers on Site UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 F STATE -~-- TYPE PRESSURE [ TEMPERATURE CONTAINER TYPE Liquid /Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Gasoline INo I 8006619 -2- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 ~ STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~~Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Gasoline No 8006619 -3- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit TOWARDS NORTHEAST PORTION OF PROPERTY CAS# 8006-61-9 F STATE [ TYPE PRESSURE I TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Gasoline No 8006619 -4- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 = Inventory Item 0004 Facility Unit: Fixed Containers on Site CARBON DIOXIDE Days On Site 365 Location within this Facility Unit IN STOREROOM, BACK OF STORE CAS# 124-38-9 r STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Cryogenic PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 1044.00 522.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Carbon Dioxide No 124389 CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 05/01/1996 IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND WITHIN STATE OFFICE OF EMERGENCY SERVICES 800 852-7550 24 HRS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: FIRE DEPARTMENT - BAKERSFIELD FIRE DEPARTMENT 9-1-1 POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT 9-1-1 BAKERSFIELD CITY HAZARDOUS MATERIAL DIVISION 9-1-1 -- Employee Notif./Evacuation 05/01/1996 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWNS OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. eVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. -- Public Notif./Evacuation 05/01/1996 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED~~~ AMERICAN GENERAL 2225 "F" STREET 327-2241 MCDONALDS 2310 "F" STREET 327-1720 Emergency Medical Plan 05/01/1996 MERCY HOSPITAL - 2215 TRUXTUN AV - 327-3371. --6-- CIRCLE K STORES INC #8825 SiteID:.215-000-000993 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 05/01/1996 1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. 2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. 3 F~JAL ..... cvcm~ ............. ANTI-LOCK NOZZLES AS PUMPS 4. NO SALES TO UNAUTHORIZED CONTAINERS. 5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED. 6 TA ..... ~u~ n~.T ........ ~ FOR T.~c Dy ........... GALLANGE MEASUREMENTS -- Release Containment 05/01/1996 1 PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2 SHUT OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILAGE. 3 BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4 AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5 ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6 ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER FOR DISPOSAL. -- Clean Up 05/01/1996 NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. Other Resource Activation -7- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards -- Utility Shut-Offs 05/01/1996 A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS) EAST WALL OF BUILDING AT NORTH END (METER) C) WATER - NORTH WALL OF BUILDING AT EAST END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO -- Fire Protec./Avail. Water 05/01/1996 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF SITE Building Occupancy Level -8- CIRCLE K STORES INC #8825 SiteID: 215-000-000993 Fast Format ~ Training Overall Site -- Employee Training 05/01/1996 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 2) USE OF :~IT~ LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE -- Page 2 Held for Future Use I Held for Future Use -9- BAKEI~IELD CITY FIRE DEPAI~ENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS ISAFARM [ ] BUSINESS NAME Circle K Store #8825 FACILITY NAMECircIe K Store #8825 SITE ADDRESS 2222 "F" Street CITY Bakersfield STATE CA ZIP 93301 NATURE OF BUSINESS Convenience Store / Gasoline Station SiC CODE 5541 DUN & BRADSTREET 06-294-4160 OWNER/OPERATOR Myron Smith= Compliance Manager PHONE (805) 324-1758 MAILING ADDRESS 601 Union Street= Suite 3920 ClTYSeattle STATE WA ZIP 98101 EMERGENCY CONTACTS NAME Staff TITLE Duty Clerk BUSINESS PHONE (805) 324-1758 24-HOUR PHONE (805) 324-1758 NAME Terri Nicholson TITLE Zone Manager BUSINESS PHONE (800) 697-1399 Pager 24-HOUR PHONE (800) 697-1399 Pager BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page1 of 2-- Business Name Circle K Store #8825 Address 2222 "F" Street Bakersfield 93301 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision ~] Deletion[ ] Check if chemical is a NON TRADE SECRET ~] TRADE SECRET [ ] 2) Common Name: Gasoline Unleaded Regular 3) DOT # (optional) 1203 Chemical Name: Gasoline: Unleaded Regular AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid ~] Gas [ ] Pure [ ] Mixture ~ Waste [ ] Radioactive [ ] CH~CK A~ TH,~T A~ ¥ 7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 10000 lbs [ ] gal D(] fi3 [ ] a) container:. 01 Average Dally Amount: 5000 cudes [ ] b) Pressure: 1 Annual Amount 379532 c) Temperature: Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM l~e three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ ] chemical components or any AHMcomponents 2) Toluene 108-88-3 8 [ ] 3) M-Xylene 108-38-3 7 [ ] ~10) Location U11derground tank: approx. 20 feet northeast of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] Revision JX~] Deletion[ ] Check if chemical is a NON TRADE SECRET ~X] TRADE SECRET [ ] 2) Common Name: Gasoline_ Unleaded Plus 3) DOT# (optional) 1203 Chemical Name: Gasoline. Unleaded Plus AHM [ ] CAS # 8006-61-9 14) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [X~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 16) PHYSICAL STATE Solid [ ] Liquid ~X] Gas [ ] Pure [ ] Mixture ~] Waste [ ] Radioactive [ ] CHE~K ALL THAT APPLY j7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal [~] fi3 [ ] a) Containe~ 01 Average Dally Amount 5000 curies [ ] b) Pressure: 1 Annual Amount: 140794 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 368 Circle Which Months: (~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ ] chemical components or any AHMcomponents 2) ]'oluene 108-88-3 ~ [ ] 3) NI-Xylene 108-38-3 7 [ ] 10) Location Under. ground tank. approx. 20 feet northeast of store I certify underpenalty of/aw, that I have personally examined and am familiar with the information submitted on this and afl attached documents. I befieve the ! submitted inf~s t~e, ~c. urate, and complete..., Print NarJ~-&'Title of Authorized Company Representative Si~ture - ~ Date BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page2__ of 2_ Business Name Circle K Store #8825 Address 2222 "F" Street Bakersfield 93301 CHEMICAL DESCRIPTION INVENTORY STATUS: New [ ] Addition [ ] Revision ~ Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ] 2) Common Name: Gasoline. Unleaded Premium 3) DOT# (optional) 1203 Chemical Name: Gasoline: Unleaded Premium AHM [ ] CAS # 800§-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [X~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~3 Delayed Health (Chronic) [X~] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid[ ] Liquid D(] Gas[ ] Pure[ ] Mixture ~ Waste[ ] Radioactive[ ] CH~CK A~L THAT APPLY 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 10000 lbs [ ] gal ~] ft3 [ ] a) Container. 01 Average Daily Amount: 5000 cudes [ ] b) Pressure: 1 Annual Amount: 91822 c) Temperature: 4 Largest Size Countainer. 10000 # Days On Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Methyltert Butyl Ether 1634-04-4 16 [ chemical components or any AHM components 2) Toluene 108-88-3 8 [ 3) M-Xylene 108-38-3 7 [ 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] Revision[ ] Deletion[ ] CheckifchemicalisaNONTRADESECRET [X~] TRADE SECRET [ ] 2) Common Name: Carbon Dioxide 3) DOT # (optional) Chemical Name: Carbon Dioxide. CarbonicAnhyddde AHM [ ] CAS # 124-38-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure ~] Immediate Health (Acute) IX3 Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [X~ Pure [~ Mixture [ ] Waste [ ] Radioactive [ ] CH~CK AL~ 774A T APP~ Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 1044 lbs [ ] gal [ ] ft3 ~ a) Container. 04 Average Daily Amount: 522 curies [ ] b) Pressure: 2 Annual Amount: 54288 c) Temperature: Largest Size Countainer. 174 # Days On Site: 365 Circle Which Months: (~)Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) Carbon Dioxide: Carbonic Anhydride 124-38-~ 100 [ chemical components or any AHM components 2) [ 3) [ 10) Location In Storeroom back of store / certify under penalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I believe the Manaoer.SUbmittedinf°-rrrjati°nistrue'iaccu~t~e'an'dc°mp/ete'f~~-N~ ~ Pdnt ~lam e ~ Trtle of Au~odzed Co~any Representative · ~g a Date I AP HMMP PLAN SITE DIAGRAMX] FACILITY DIAGRAM Business Name: Circle K Stores Ina. #8825 /~ Area Map # 1 of 1 North Name of Area: Circle K Stores Inc. #882S I I 2222 'F' St., Bakersfield Scale 1" = 26' Parking Lot .'Sidewalk .............. Driveway Gas Pumpa I 10K Gal I 'F' ~( 10K Gal I . 4 23rd St. ~r~ i 1OK Gal I St. ~. ~ Residence Plan Emergency 6' Brick Driveway Pump Shutoff 2217,F, Ex7' Counter Dermatology Fire Ext. Group ~ Parking ~ Store #8825 Q- 2222 'F' Street 5' Chainlink Fence Apartments Roeidenco -5- · 'SYMBOLS (~GAS I"Ms~s I MSDS STORAGE FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT {~ WATER ~ ~' GATE IN FENCE ~-- STANDARD DOOR SPRINKLER FIRE DEPT. CONNECTION I/uuuu"~,~ ~ UNDERGROUND i STORAGE ! (~i~.] I TANKS- LIST FIRE HYDRANT - PUBLIC I- - .... CAPABILITY '1-t"!'!"?'1'1 RAILROAD TRACKS - FIRE HYDRANT - PRIVATE ....... '~ 0,000 ABOVEGROUND TANKS (~ AUTOMATIC SPRINKLERED Gal BUILDING OR AREA ~ EVACUATION AREA FIRE ALARM PESTICIDE AREA TYPES OF HAZARDOUS MATERIALS <~ WATE;R REACTIVE ~ GAS EXPLOSIVE ~ RADII)LOGICAL <~ WASTE EXAMPLE: FLAMMABLE "' LIQUID ~.POI$ON EXPLOSIVE GAS ~ BAKERSFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle K Store #8825 LOCATION:2222 "F" Street Baker.~field 93301 MAILING ADDRESS: 601 Union Street: Suite 3920 CITY: Seattle STATE: WA ZIP: 98101 PHONE: (805) 324-1758 DUN & BRADSTREET NUMBER: 06-294-4160 SiC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / Ga_~oline Station OWNER: Circle K Company a Division of Tosco Corp MAILING ADDRESS: 601 Union Street, Suite 3920 Seattle WA 98101 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff Duty Clerk (805) 324-1758 (805) 324-1758 2. Terri Nicholson Zone Manager (800) 697-1399 Pager (800) 697-1399 Pager ~akersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of absorbent for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipmem (fire extinguishers), the location of and procedures for facility shutdown (including the location of shutoffs for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION $: CERTIFICATION: I ~_/y~ ~/~J~r-~t'f~ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT -- INACCURATE INFORMATION' CONSTITUTES PERJURY. ~ ~IGNATURE TITLE DATE 2. " ersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Circle K Store #8825 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: If emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division 326-3979 AND State Office of Emergency Services 800-852-7550 WITHIN 24 HOURS If release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, immediately notify: Fire Department - Bakersfield Fire Department 911 Police Department - Bakersfield Police Department 911 Bakersfield City Hazardous Material Division 911 State Office of Emergency Services (800) 852-7550 or (916) 262-1621 B. EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. C. PUBLIC EVACUATION: If evacuation from area deemed necessary, these neighboring properties will be notified if possible: American General 2225 "F" Street 327-2241 McDonalds 2310 "F" Street 327-1720 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRLTXTON AVENUE 327-3371 ersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Anti4ock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent further spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and comact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids with absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle K Environmental Director (206)442-7434 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CAKBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONT.MNMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDU1LES: Ventilate area immediately. Contact supplier if leak in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ~Tone ELECTRICAL: a) Inside, backroom of store (breakers), b) Ea~t wall of building at north end (meter) WATER: North wall of building at eaxt end (main line gate valve) SPECIAL: Emergency. gas shutoff switch: a) At cashier station on console, b) North wall of building LOCK BOX: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Northeast corner of site 4. BAKERSFIELD CITY FIRE DEPARTMENT 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS ISA FARM [ ] BUSINESS NAME Circle K Stores Inc. #8825 FACILITY NAME SITE ADDRESS 2222 "F" Street CITY Bakersfield STATE CA ZIP 93301 NATURE OF BUSINESS Commnience Store / Gasoline Station SIC CODE 5541 DUN & BRADSTREET 06-294-4160 OWNER/OPERATOR Myron Smith, Compliance Manager PHONE (805) 324-1758 MAILING ADDRESS 3003 N. Central Avenue, 16th Floor ClTYPhoenix STATE AZ ZIP 85012 ,, EMERGENCY CONTACTS NAME S_taft J TITLE Duty Clerk / BUSINESS PHONE (8~5) 324-1758 v/ 24-HOUR PHONE(805) 324-1758 v/'' NAME Teri Nicholson TITLE District Manager BUSINESS PHONE (805) 335-6032_Eager/' 24-HOUR PHONE (805) 335-6032_Eager BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page1 of 2_ Business Name CJccJe K Stores In~25 .. Address 2222 "F" Street Bakers~f~eld 93301 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] Revision ~ Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ] 2) Common Name: GasoJine, Unleaded ReguJar ~,/' 3) DOT# (optional) 1203 Chemical Name: Gasoline. Unleaded Regular AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire IX3 Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic) [~] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid [~] Gas [ ] Pure [ ] Mixture D<] Waste [ ] Radioactive [ ] CHECK A[L THAT A/~PL ¥ 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal D(] fi3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 379532 c) Temperature: 4 Largest Size Countainer; 10000 # Days On Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D '9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ chemical components or any AHM components 2) Toluene 108-88-3 8 [ 3) M-Xylene 108-38-3 7 [ 10) Location Underground tank. approx. 20 feet northeast of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ]/,Revision D<] Deletion[ ] Check if chemical is a NON TRADE SECRET IX,'] TRADE SECRET [ ] 2) Common Name: Gasoline. Unleaded Plus ~ 3) DOT # (optional) 1203 Chemical Name: Gasoline. Unleaded Plus AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [X~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) (X~] Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 8) PHYSICAL STATE Solid [ ] Liquid [X] Gas [ ] Pure [ ] Mixture [X~] Waste [ ] Radioactive [ ] CHECK ALL THAT APPL¥ 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 lbs [ ] gal [X~] ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 140794 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: ~,Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % w'r AHM the three most hazardous 1) Methyltert But7.1 Ether 1614-04-4 16 [ chemical components or any AHM components 2) ~)Juene 108-88-3 8 [ 3) M-Xylene 108-38~3 7 _ [ 10) Location Underground tank. approx. 20 feet northeast of store 'submiffedinformationi$~ue, accu/~te, andcomplete. Print Name & Title'of Authorized Company Representative I/ f Date BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page2 of Z_ Business Name Cir_cleJ~Sto£esJn_~25 Address 22222F2LSi~et B_akem~eJd 933_01 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition[ ] R~evision D<~] Deletion[ ] Check if chemical is a NON TRADE SECRET D(] TRADE SECRET [ ] 2) Common Name: Gasoline. Unleaded Premium ~' 3) DOT# (optional) 1203 Chemical Name: GasoJkt~JJJ3leaded Premium AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire D(] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X~] Delayed Health (Chronic) ~] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid [X~] Gas [ ] Pure [ C,ECK ALL mar 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: ~0000 lbs [ ] gal [X~] ft3 [ ] a) Container:. 01 Average Daily Amount: ,5000 curies [ ] b) Pressure: 1 Annual Amount 91822 c) Temperature: 4 Largest Size Countainer: 10OOO # Days On Site: ;t65 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) Methyltert Butyl Ether 1634-04-4 16 [ ] chemical components or any AHMcomponents 2) Toluene 108-88-3 8 [ ] 3) M_-Xylene 108-38-3 7 [ ] 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Additign[ ] Revision[ ] Deletion[ ] Check if chemical is a NON TRADE SECRET [Xi] TRADE SECRET [ 2) Common Name: Carbon Dioxide~%/' 3) DOT # (optional) Chemical Name: Carbon Dioxide. Carbonic Anhydride AHM [ ] CAS# 124-38-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure ~ Immediate Health (Acute) IX] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 9_9 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas D<3 Pure [X~] Mixture [ ] Waste [ ] Radioactive [ ] CH~CK ALL 'I'HA T APPLY 7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: J044 lbs [ ] gal [ ] ft3 ~X~ a) Container:. 04 Average Daily Amount: ~522 curies [ ] b) Pressure: 2 Annual Amount 54288 c) Temperature: 4 Largest Size Countainer. ~174 # Days On Site: ;~65 Circle Which Months: ~Year, J, F, M, A, M, J, J; A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) Cad, on Dio),Jcle~7~onic Anhydride 124-38-9 __ 100 [ chemical components or any AHM components 2) [ ] 3) [ ] 10) Location la Storeroom. back of store I certify underpenalty of/aw, that I have personally examined and am familiar with the information submitted on this and all attached documents. I belie/~ the / submitted information is true, accurate, and complete. P~int Name & Title'of Authorized-Company Representa ' ~gn~ture [ -il Oa~e BA SFIELD CITY FIRE DE TMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle K Stores Inc. #8825 LOCATION:2222 "F" Street Bakersfield 93301 MAILING ADDRESS: 3003 N. Central Avenue, 16th Floor CITY:Phoenix STATE: AZ___ ZIP:S5212___ PHONE: (805) 324-1758 DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / Gasoline Stat;on OWNER: Circle K Stores Inc. MAILING ADDRESS: P.O. Box 52084 Phoenix AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff Duty Clerk (805) 324-1758 (J05) 324-1758 2. Teri Nicholson District Manager (805) 335-6032 Pager Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY Of TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION .6: CERTIFICATION: I Myron Smith CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGN''-E/~R - -- --.-- _ _ _ Compliance Manager . TITLE t i~A-iiE 2. Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: .SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. / AGENCY NOTIFICATION PROCEDURES: If emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division ...326-3979 AND State Office of Emergency Services 800-852-7550 WITHIN 24 HOLTRS If release poses present or potential hazard to human health & safety, property or environment, and emergency' assistance is required, immediately notify: Fire Department - Bakersfield Fire Department 911 Police Department - Bakersfield Police Department 911 Bakersfield City Hazardous Material Division 911 State Office of Emergency. Services (800) 852-7550 or (916) 262-1621 B. ,,/ EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignkion sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. / C. v' PUBLIC EVACUATION: If evacuation from area deemed necessary, these neighboring properties will be notified: American General 2225 "F" Street 327-2241 McDonalcls 2310 "F" Street 327-1720 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRUXTON AVENUE 327-3371 Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Dual hose systems on pumps. Anti-lock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent further spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and contact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids with absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle K Environmental Director (602) 530-5089 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: a) Inside, backroom of store ,(breakers), b) East wall of building at north end (meter) WATER: North wall of building at east end (main line gate valvo SPECIAL: Emergency4as shutoff switch: a) At cashier station on console, b) North wall of building LOCK BOX: YES/~ ' IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Northeast corner of site 4. PLAN MAP SITE DIAGRAMX] FACILITY DIAGRAM Business Name: Circle K Stores Inc. #8825 Area Map # 1 of 1 North Name of Area: Circle K Stores Inc. #8825 2222 'F' St., Bakersfield Scale 1" = 26' Parking Lot · 'SideWalk'.'.*.*.'. Driveway Gas Pumpa I 10K Gal I 'F' ~[ 10K Gal I 1809 ~ 2$rd St. ~ ) 1OK Gel ] St, ~. j Reaidenee Morri; Plan Emergency 6' Bri=k Driveway Pump Shutoff 'F' Counter '" .,. Vacant 2215 23rd 4/95 Kern ~ f Dermatology 't' Group L Fire Ext. ~ Parking (~ '~ Store #8825 D. 2222 'F' Street 5' Chainlink Fence Apartments Reeldonco -5- ' ' 'SYMBOLS (~ GAS [MsDsi MSDS STORAGE ( FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT {~ WATER ~ ~ GATE IN FENCE f -- STANDARD 'DOOR S PRINKLER FIRE DEPT. CONNECTION ~ UNDERGROUND ! 10,000 i STORAGE i //~ FIRE HYDRANT PUBLIC 1_ Ga_l TANKS LIST I ' -- -- CAPABILITY ~ RAILROAD TRACKS (~ FIRE HYDRANT - PRIVATE ....... ~ 0,000 ABOVEGROUND TANKS ( AUTOMATIC SPRINKLERED Ga.l BUILDING OR AREA ~ EVACUATION AREA FIRE ALARM PESTICI AREA PESTICIDE STORAGE TYPES OF HAZARDOUS MATERIALS FLAMMABLE <~ LIQUID CORROSIVE ~ SOLID <~ WATER REACTIVE ~ GAS EXPLOSIVE <~ RADIOLOGICAL .... <~ WASTE EXAMPLE: FLAMMABLE <~LIQUiD ~ POISON EXPLOSIVE GAS <~ 06/05/95 CIRCLE K ~434%P #8825 215-000-000993 Overall. Site with 1 Fac. Unit General Information Location: 2222 F ST Map: 10 Haz:2 Type: 3 City : BAKERSFIELD Grid: 25B F/U: 1 AOV: 0.0 Contact Name Title -~/~ i~e,~J~m~ Contact Name Title MYRON SMITH / COMPLIANCE MANA! CIIUCX TOMKGViCii / ZONE MANAGER Business Phone: (602) 437-0600x Business Phone: ~3T6) Z68-~x~ 24-Hour Phone : (602) 530-5089x 24-Hour Phone : ~3-t6) 268-4-368~ ~ Pager Phone : ( ) - x Pager~hone :/ Administrative Dat~ Mail Addrs: P O BOX 5604~~,~~,~mF/~r D&B Nu~er: 06-294-4160 City: PHOENIX State: AZ Zip: 85013- Co~ Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 5541 -" ~~C. ~,~x-~--~ Owner: CIRCLE K~.~8825 Phone: '(805) 324-1758 Address: P O BOX 5604 State: AZ City: PHOENIX Zip: 85013- Sugary 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 1044 Minimal · Fire, Pressure, Immed Hlth FT3 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: /~/~e~~- Days: 365 Use: FUEL Daily Max GAL Daily Average GAL Annual Amount GAL o,ooo I ,ooo.oo -7- Storage ~ Press T TempI Location UNDER GROUND TANK I Ambient[AmbientlTOWARDS NORTHEAST PORTION OF PRO -- Conc Components MCP ---TGuide 100.0% IGasoline IModeratel 27 - Notes 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: qh~e Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL ~ Annual Amount GAL 10,000 I 5,000.00 ! Storage ~~Press T Temp Location UNDER GROUND TANK [Ambient[Ambient[TOWARDS NORTHEAST PORTION OF PRO -- Conc~ Components ~ MCP ---~Guide 100.0% IGasoline IModeratel 27 -- Notes 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL T Annual Amount GAL 10,000 I 5,000.00 / -~ Storage i~Press T Temp Location UNDER GROUND TANK IAmbientlAmbientlTOWaRDS NORTHEAST PORTION OF PRO -- Conc Components ~ MCP ---TGuide 100.0%""lGasoline IModeratel 27 -- Notes 02-004 CARBON DIOXIDE Gas 1044 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3I Daily Average FT3 I Annual Amount FT3 1,044 ~ 522.00 54,288.00 Storage~ Press T Temp .~ Location PORT. PRESS. CYLINDER IAbove ICryogenlIN STOREROOM, BACK OF STORE -- Conc Components MCP ---~uide 100.0% ICarbon Dioxide IL°w / 21 06/05/95 CIRCLE K CORP %8825 215-000-000993 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation OUR TRAINING PROGRAM INCLUDES THE FOLLOWING: 1. HOW TO HANDLE REPORTING AND CLEAN UP OF UNAUTHORIZED SURFACE SPILLS OF MOTOR FUELS 2. HOW TO CHECK THE EQUIPMENT AND INSURE IT'S CORRECT USE TO PREVENT UNAUTHORIZED SPILLS OF MOTOR FUELS <3> Public Notif./Evacuation WE HAVE A LIST WITH PHONE NUMBERS, OF NEIGHBORING BUSINESSES, RESIDENCES, SCHOOLS, HOSPITALS, ETC. IN CASE OF EMERGENCY WE WOULD NOTIFY THEM BY PHONE OR IN PERSON. <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 6 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-QUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY CAMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment GASOLINE - PREVENTIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITHCES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up ~ ~ASOLINE - NOTIF~ CIRCLE K E~VIROMMENTAL DIRECTOR (~) ~S-O~ FOR COORDINATION WIT. ~AZARDOOS WASTE DISPOSAL COMPANY TO REMOVE CONT~INATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS) EAST WALL OF BUILDING AT NORTH END (METER) C) WATER - NORTH WALL OF BUILDING AT EAST END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF SITE <4> Building Occupancy Level 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 8 00 - Overall Site <G> Training <1> Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE OF KITTY LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL, DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use 06/05/95 CIRCLE K CORP #8825 215-000-000993 Page 9 O0 - Overall Site <G> Training <4> Held for Future Use (Continued) 04/3.8/94; CIRCLE K CORP #8825 215-000-000993 Page 1 Overall Site with 1 Fac. Unit General Information Location: 2222 F ST Map 10 : Community: BAKERSFIELD STATION 01 Grid: 25B F/~.' 1 AOV: 0.0 I Contact Name Title ~ Business unone /~/COMPLIANCE MANAGERI 24-Hour Phoneq I MYRON SMITH ~. Administrative Data · 16~ ~/DO/~/ D&B Number: 06-294-4160 City: ~A~F~A-~4~nX~-A ~h~/X State:. ~r~ZZip: Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 5541 Owner: CIRCLE K CORP.#8825 Phone: (805) 324-1758 Address: P O BOX 52084 State: AZ City: PHOENIX Zip: 85072- Summary i, .}~ ~~ Do hereby certify that ~ have reviewed the a~tached hszardous materials manage- ment plan for ~;~lek ~ ~,~and ~h~'~ a~ong with ' (~e of Bus~) 04/'18/94 CIRCLE K CORP #8825 215-000-000993 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL .02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 1044 Minimal · Fire, Pressure, Immed Hlth FT3 04f18/9~ CIRCLE K CORP #8825 215-000-000993 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL I Annual Amount GAL -- 10,000 ~ 5,000.00 46,042.00 Storage ~~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlTOWaRDSNORTHEAST PORTION OF PRO -- Conc Components MCP -~Guide 100.0% I Gasoline I Moderate [ 27 -- Notes 02-001 UNLEADED PLUS GASOLINE Liquid 10000 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 10,000 ~ 5,000.00 70,597.35 StorageI~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlTOWARDS NORTHEAST PORTION OF PRO -- Conc Components MCP ---~uide 100.0% IGasoline IModeratel 27 -- Notes 04/k8/94' CIRCLE K CORP #8825 215-000-000993 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-002 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily. Max GAL I Daily Average GAL 'I Annual Amount GAL 10,000 ~ 5,000.00 190,306.00 Storage ~~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlTOWARDS NORTHEAST PORTION OF PRO -- Conc Components MCP ---~uide 100.0% IGasoline IModerateI 27 -- Notes 02-004 CARBON DIOXIDE Gas 1044 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3I Daily Average FT3 I Annual Amount FT3 1,044 ! 522.00 54,288.00 Storage~ Press T Temp~ Location PORT. PRESS. CYLINDER Iabove ~CryogenlIN STOREROOM, BACK OF STORE -- Conc Components MCP lGuide 100.0% ICarbon Dioxide IMinimal ~ 21 04/'18/94 CIRCLE.K CORP #8825 215-000-000993 Page ~5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation OUR TRAINING PROGRAM INCLUDES THE FOLLOWING: 1. HOW TO HANDLE REPORTING AND CLEAN UP OF UNAUTHORIZED SURFACE SPILLS OF MOTOR FUELS 2. HOW TO CHECK THE EQUIPMENT AND INSURE IT'S CORRECT USE TO PREVENT UNAUTHORIZED SPILLS OF MOTOR FUELS <3> Public Notif./Evacuation WE HAVE A LIST WITH PHONE NUMBERS, OF NEIGHBORING BUSINESSES, RESIDENCES, SCHOOLS, HOSPITALS, ETC. IN CASE OF EMERGENCY WE WOULD NOTIFY THEM BY PHONE OR IN PERSON. <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 04/18/9~ CIRCLE K CORP #8825 215-000-000993 Page 6 00 - Overall Site <E> Mitigation/PreVent/Abatemt <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-QUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY CAMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment GASOLINE - PREVENTIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITHCES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation 04/18/94 CIRCLE K CORP #8825 215-000-000993 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS)' EAST WALL OF BUILDING AT NORTH END (METER) C) WATER - NORTH WALL,OF BUILDING AT EAST END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION -~FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF SITE <4> Building Occupancy Level 04/18/94 CIRCLE K CORP #8825 215-000-000993 Page 8 00 - Overall Site <G> Training <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE OF KITTY LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 04/18/9~ CIRCLE K CORP #8825 215-000-000993 Page 9 00 - Overall Site <G> Training <4> Held for Future Use (Continued) 04/C)1/93 CIRCLE K CORP . 4588~-.~ 215-000-00 Pa ge Overall Site with 1 Fac. Ur, it Ger~eral Ir~format ior~ Locatior,: 2222 F ST ~ Map: 102 Hazard: Low Community: BAKERSFIELD STATION 01 Grid: 25B F/U: 1 AOV: 0.0~ Admir~istrative Data Mail Addrs: P.O. BOX 5604 D&B Number: 06-294-4160 City: SANTA MARIA State: CA Zip: 93456- Corem Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 5541 Owr~er: CIRCLE K CORP.~$8825 Phone: (8]=(~5) 3~4-1758" Address: P 0 BOX 52084 State: AZ City: PHOENIX Zip: 85072- Summary revie the a ached h rdo s materials 04/01/93 CIRCLE K CORP' ~$8825 215-000-000993 Page 2 Haz~at Irsver~tory List irs MCP Order 02 - Fixed Cor, tair, ers o'r~ Site Pl r~-Ref Na~e/Hazards For~ Quar, t ity MCP 02-003 PREMIUM UNLEADED GASOLINE Liquid I0000 Moderate Fire, I;,~r,~ed Hlth, Delay Hlth GAL 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Modera'be Fire, I~r~ed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOL I NE L i q u i d 10000 Mod erat e Fire, I~,~r~ed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 1044 M i'r~i~,~a 1 Fire, Pressure, Irnr~ed Hlth FT3 04/01/93 CIRCLE K CORP $$8825 215-00C~-000993 Page 3 02 - Fixed Cor~tainers or~ Site Hazmat Ir~ver, tory Detail in MCP Order 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate Fire, I~med Hlth, Delay Hlth GAL CAS ~: 8006-61-9 Trade Secret: Nc, Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL .... i .... Daily Average GAL ~ Ar~r~ual A~ount GAL --- 10,000 ~ 5,000.00 ~ ~ Storage T Press T Ternp ~ Locatior~ UNDER GROUND TANK ~Ambier~t~A~,~bier, t~TOWARDS NORTHEAST PORTION OF PRO -- Cor, c ~ Co~por~er~ts F-- MCP ~uide 100.0%~ Gasol ir~e ~Moderate ~ 27 -- Not es 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate Fire, Im~ed Hlth, Delay Hlth GAL CAS ~: 8006-61-9 Trade Secret: No For~: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ' I'" Daily Average GAL ~'T---Ar~r~ual A~ou'nt GAL ---/ 10,000 ~ 5,000.00 / ~ / Storage T Press T Te~p '-7 Lc, cat ic, r~ UNDER GROUND TANK /A~bier~t/A~bier~ttTOWARDS NORTHEAST PORTION OF PRO -- Cor, c ~ Cc, mpc, r~er~ts F MCP ~-~uide 100.0%/Gasol ir, e IModeratel 27 -- Not es 04/01/93 CIRCLE K CORP ~8825 215-000-0009~3 Page 4 02 - Fixed Cor, tair~ers on Site Haz~at Ir~ventory Detail in MCP Order 02-002 UNLEADED GASOLINE Liquid 10000 Moderate Fire, I~,~,~ed Hlth, Delay Hlth GAL CAS ~: 8006-61-9 Trade Secret: No For~: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL ~ Ar~nuat A~our~t GAL ~- i 0,000 I 5,000.00 J ~0 Stc, rage Press - Ter~p Locat ic, r~ UNDER GROUND TANK [ [ ! ~Ar~bier~t~Ar~bient TOWARDS NORTHEAST PORTION OF PRO - Corec ~ Cor~pc, r~er~t s F-, ,MCP ~ui de 100.0% ~Gasolir~e ~Mcderatel 27 -- Notes 02-004 CARBON DIOXIDE Gas 1044 Mirsir~a 1 Fire, Pressure, I~,~ed Hlth FT3 CAS ~: 124-38-9 Trade Secret: No Fc, rr~: Gas Type: Pure Days: ~ Use: OTHER Daily Max1,044FT3~i Daily Average522.FT300 .......~ ....... Ar~r~ua I Ar~our~t54,288.FT300 - S c t_,rage l- Press T Ter,~p ---f Lc, cat ior~ PORT. PRESS. CYLINDER ~Above ~Cryoger~IN STOREROOM, BACK OF STORE -- Cc, nc -.~ Ccm~pc, r~errb s ~M~'iMCP__~u i de 100.0% ,Carbon Dioxide r, ir~al ~ 21 ; / 04/01/93 CIRC[~E K CORP' $$8825 215-000-000993 Page 5 00 - Overall Site <D> Not i f. /Evacuat ion/Medical <1> Agency Notificatior~ CALL 911 <2> E~ployee Notif./Evacuation OUR TRAINING PROGRAM INCLUDES THE FOLLOWING: 1. HOW TO HANDLE REPORTING AND CLEAN UP OF UNAUTHORIZED SURFACE SPILLS OF MOTOR FUELS 2. HOW TO CHECK THE EQUIPMENT AND INSURE IT'S CORRECT USE TO PREVENT UNAUTHORIZED SPILLS OF MOTOR FUELS <3> Public Notif. /Evacuation WE HAVE A LIST WITH PHONE NUMBERS, OF NEIGHBORING BUSINESSES, RESIDENCES, SCHOOLS, HOSPITALS, ETC. IN CASE OF EMERGENCY WE WOULD NOTIFY THEM BY PHONE OR IN PERSON. <4> E;~ergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 04/01/93 CIRCLE K CORP ~8825 215-000-00 3 Page 6 00 - Overall Site <E) Mit igat ion/Prevent/Abater~t <1> Release Prevention GASOLINE - STEEL. POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-QUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY CAMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Contain~ent GASOLINE - PREVENTIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITHCES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS'AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, []PEN ALL DOORS TO VENTILATE. <3> Clean Up GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activatior~ 04/01/93 CIRCLE K CORP ~8825 2i5-000-00 Page 7 00 - Overall Site <F> Site Ers~ergerscy Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS) EAST WALL OF BUILDING AT NORTH END (METER) C) WATER - NORTH WALL OF BUILDING AT EAST END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF' SITE <4> Buildirsg Occupancy Level 04/01/93 CIRCLE K CORP ~88~ 215-000-000993 Page 8 00 - Overall Site <G> Trainirsg <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE OF KITTY LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT ~FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 as needed <3> Field for Future Use <4> Held for Future Use 04101/93 CIRCLE K CORP ~$8825 215-000-000993 Page 9 00 - Over-all Site <G> Tr. aining <4> Held for~ Futur~e Use (Continued) 'SYMBOLS {~GAS [MSDSI MSDS STORAGE ) FENCE (ALL TYPES) ELECTRIC ~ INDICATE HEIGHT {~ WATER GATE IN FENCE ~-- STANDARD DOOR ' SPRINKLER FIRE DEPT. CONNECTION I 10,000 ~ UNDERGROUND I STORAGE Gal I TANKS - LIST FIRE HYDRANT - PUBLIC L - CAPABILITY ~ RAILROAD TRACKS ( - FIRE HYDRANT- PRIVATE ....... 1' 1 0,000 ABOVEGROUND TANKS (~ .AUTOMATIC SPRINKLERED Gal BUILDING OR AREA ~ EVACUATION AREA AREA TYPES OF HAZARDOUS MATERIALS FLAMMABLE ~ LIQUID CORROSIVE <~ SOLID <~ WAT'ER REACTIVE <~ GAS <~ EX;PLOSIVE <~ RADIOLOGICAL <~ WASTE EXAMPLE: FLAMMABLE LIQUID ~ -POISON EXPLOSIVE GAS 03/26/92 CIRCLE K CORP #8825 215-000-000993, Page 1 Overall Site with 1 Fac. Unit General Information I Location: 2222 F ST Map: 102 Hazard: Low I Community: BAKERSFIELD STATION 01 Grid: 25B F/U: 1AOV: 0.0 Contact NameI Title i Business Phone i 24-Hour Phoneq IMIKE KARVELOT ENVIRON DIR (714) 823-0691 x (619) 247-1914! i.-L~.~EE SPI..~ZDf ZONE MANAGER (805) 321-8522 x (805) 321-8522/ /~ ~T ~trative Data -~ Mail Addrs: P.O./B~X~ D&B Number:~4-4160 ..C~y~.' SANTA MARIA State: CA Zip: 93456~ C~m~ Code:~15-001 BAKERSFIELD STATION 01 SIC Code: 554~__ _~ Owner: CIRCLE K CORP.#8825 Phone: (805) 324-175% /. Address: P O BOX 52084 State: ~-A--~ ) I I . / 1 7 1992 HAZ. MAI. DI¥. 03/26/92 CIRCLE K CORP #8825 215-000-000.993 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail'in Reference Number Order 02-001 REGULAR GASOLINE ~U~E~ ~L~5 Liquid 10000 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 T Annual Amount GAL 10,000 I 5,000.00! 118,319.00 Storage~lPress T Temp Location UNDER GROUND TANK I AmbientlAmbientlTOWARDS NORTHEAST PORTION OF PRO / -Conc Components ~CP~List 100.0% I Gasoline IMo~te I . --'Notes 02-002 UNLEADED, GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL T Annual Amount GAL 10,000 I 5,000.00 ! 318,947.00 Storage Press T TempI Location UNDER GROUND TANK Ambient~AmbientlTOWARDS NORTHEAST PORTION,OF PRO / -- Conc Components ~ MC/~List 100.0% IGasoline ~rate.I - Notes 03/26/92 CIRCLE K CORP #8825 215-000,000993 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL T· Annual Amount GAL 10,000 I 5,000.00 ! 77,165.00 Storage IIPress T Temp Location UNDER GROUND TANK IAmbientlAmbientlTOWARDS NORTHEAST PORTION OF PRO -- Conc Components MCP --~List 100.0% I Gasoline [ Mod~eI ' -- Notes 02-004 CARBON DIOXIDE Gas 1044 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: pUre Days: 36.5 Use: OTHER -- Daily Max FT3I Daily Average FT3 I Annual Amount FT3 1,044. ~ 522.00 54,288.00 Storage Press T Temp I Location PORT. PRESS. CYLINDER IAbove ~CryogenlIN STOREROOM, BACK OF STORE -- Conc Components MCP List 100.0% ICarbon Dioxide IMinimal I 03/26/92 CIRCLE K CORP %8825 215-000-000993, Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation OUR TRAINING PROGRAM INCLUDES THE FOLLOWING: 1. HOW TO HANDLE REPORTING AND CLEAN UP OF UNAUTHORIZED SURFACE SPILLS OF MOTOR FUELS 2. HOW TO CHECK THE EQUIPMENT AND INSURE IT'S CORRECT USE TO PREVENT UNAUTHORIZED SPILLS OF MOTOR FUELS <3> Public Notif./Evacuation WE HAVE A LIST WITH PHONE NUMBERS, OF NEIGHBORING BUSINESSES, RESIDENCES, SCHOOLS, HOSPITALS, ETC. IN CASE OF EMERGENCY WE WOULD NOTIFY THEM BY PHONE OR IN PERSON. <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 i03/26/92 CIRCLE K CORP ~8825 215-000-000993 Page" 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment ~ GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE iF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up ~ GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation 03/26/'92 CIRCLE K CORP #8825 215-000-000993 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE BACK ROOM OF STORE (BREAKERS) EAST WALL OF BUILDING AT NORTH END (METER)' C) WATER - NORTH WALL OF BUILDING AT EAST END (MAIN LINE GATE VALVE) · D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE; NORTH WALL OF BUILDING, OUTSIDE E) LOCK BOX - NO <3> Fire Protec../Avail. Water PRIVATE FIRE PROTECTION - NONE LISTED ?????????? FIRE HYDRANT - NORTHEAST CORNER OF SITE <4> Building Occupancy Level 03/26/92 CIRCLE K CORP %8825 215-000-000993 Page 7 00 - Overall Site <G> Training <1> Page 1 WE .HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: ~ 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE'OF KITTY LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE'LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER.USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 as needed <3> Heid for Future Use <4> Held for Future Use E.M.S.S., Inc. An Environmental Regulatory Compliance Service Company Bakersfield City Fire Department~ Hazardous Materials Division 2101 "H" Street Bakersfield, CA 93301 Gentlemen: Circle K Corporation has contracted Environmental Management Software 'Systems, Inc. (EMSS) to provide the required changes to the Business Plan for the 1992 reporting period. Enclosed are the updated Business Plans for the 5 Circle K gasoline stores on the Bakersfield City update forms provided by your office. Changes are highlighted. Circle K Corporation has been instructed by EMSS to ensure that every store keeps the Business Plan resident at the store and that all store employees be trained in the contents of' the hazardous material inventory and emergency response sections of the Plan. If you have any questions regarding this submittal, please call EMSS at (805) .925-6285. Sincerely, RDB:slc Enclosures E.M.S.S., Inc./RO. BOX 5604/SANTA MARIA/CA 93456/(805) 925-6285/FAX: (805) 349-2753 ~ Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION Date Completed J(~ Business Name: ~/'~,-~'.//d Location: ;~,~ ~z.. ",~-,, ~,/, RECEIVED - OCT ~ 5 i991 _ Business Identification No. 215-000 '~o,~3 (Top of Business Plan) I ,o An$'dJ. ......... StationNo. / Shift ~ Inspector ,_,~, Adequate Inadequate Verification of Inventory Materials I~] Verification of Quantities I~ Verification of Location ~ Proper Segregation of Material~ Comments: Verification of MSDS Availablity ~ ~' Number 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: Violations: All Items O.K. I~ ~ (/~ _~.[~.~. -~~-A~__~, ,~ Correction Needed ~ B usi'~-~ss ~wn~/Manager FD 1652 (Rev. 1-90) Whit~-Haz Mat Div. Yellow-Station Copy Pink-Business Copy Bakersdeld Fire Dept. t{~-ardous ACate~als Division 2130 "G" Street B~ersfie!d, C~ 93301 HAZARDOUS MATF. RIALS MANAGF. MF. NT PLAN INST;~UCTION$.' 1, To avoic~ further c=tion, return this torrn within 30 C=ys ot r~ei~t. 2. ~FE/~RINT ANSWER5 IN 3. Answer ~e ~uestions DeJow for ~ne Dusine~ cs a whole. · SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAM:. ..Circle K Corporation ,-.8825 LOCATION: 2222 "~" Street Circle K Corporate MAJLiNGADDRESS: P. O. Box 52084, Phoenix, AZ 85072 CITY: Bakersfield STATE:., CA ZIP: 93301 PHON~-:(805)324-1758 DUN & BRADSTREE7 NUMBER: 06-294-4160 S]C COD"-: 5541 PRIMARY ACTIVITY: Convenience Sto~e/Gas Station OWN-~t~: Circle K Corporation (602)229-8706 MAILING ADDRESS: P. o. Box 52084, Phoenix, AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHON~ Beeper ~ Beeper ~ ~. Mike S~inuzzi - Zone Manager (805)321-8522 (805)321-8522 2. Mike Karvelot _ £nv~r0n. D~r. (714)823-0691 (619)247-1914 BakersMeld Fire Dept. O Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Prop~¥ maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown {including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day ,business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, Mike Schumacher CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.9,5 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ~ ~~~~ Division Manager SI G N ~"~U-R E TITLE DATE 590 Pict Plan - Circle K Store #8825 2222 'F' Street, Bakersfield . Parking Lot Driveway Gas Pumps 'F' HMS "~ ~ (~1~ -G-a~ - ', 1009 St. HMH FL ~ - ...... ' 23rd F, ~ ~(y~ -~-~ - -, st. ...... ' Residence Morrh Plan Emergency 6' Brick Driveway Pump Wa Co: ~H('2 I 221 Exit/ U1 'F' '/ Counter 03 St. ,~Drain L. (~ ~ 2215 23rd SI. i.zj Natlo Ins. f Kern ..~.._~ I~ Dermatology Fire Ext. Group~ P a r Parking k i Store #8825 2222 R 'F' Street g m 6' Chalnllnk Fence ~' Apartments Residence Oo ,O IDENTIFY THE TYPE 1' - 100' - SCALE OF MAP OF CONTAINER USING THE FOLLOWING SYMBOLS. [~ ELECTRIC METER ~ ABSORPTIVE MATERIAL (~ ABOVE GROUND TANKS /~ ALARM ELECTRIC SHUTOFF ~00 Q GAL [] DRAIN [~] GAS METER .~M,s ---// 'x----DRIVEWAY (~ GAS SHUTOFF BELOW GROUND TANKS ---/--DOORS (~) PUMP SHUTOFF /10K~ /'~i~'K"''x ~ EVACUATION ROUTE WATER METER "-" ~ EVACUATION/STAGING AREA (~ WATER MAIN LINE GATE VALVE ~'~ INSULATED TANKS I '~' FIRST AID PRESSURIZED TANKS I (~) FIRE HOSE ~/e FIRE DEPT. CORR - CORROSIVE SPRINKLER CONNECTION C - COMBUSTIBLE [] FIRE EXTINGUISHER ? 1~ FIRE DEPT. E - EXPLOSIVE I STANDPIPE CONNECTION F - FLAMMABLE ~' FIRE DOOR / G - GAS ' ' FIRE WALL I--~ FIRE HYDRANT L - LIQUID OXY - OXIDIZER ~ GAS PUMPS i~'~i attic scuTTLE R RADIOACTIVE ,-, S - SOLID A ;~3" COOLER OR t - TOXIC GUARD STATION :-~ REFRIGERATION UNIT WR ' WATER REACTIVE IERPI~ MATERIAL SAFETY DATA SHEEt & I~il ju~t4~ RAILROAD TRACKS HAZARDOUS MATERIAL EMERGENCY RESPONSE PLAN ~ STORAGE AREA,..HMS ~PPe) PERSONAL PROTECTIVE EQUIPMENT ~) SEWER HAZARDOUS MATERIAL I~ PUBLIC TELEPHONE " . HANDLING AREA...HMH : SL : SKYLIGHT RR - REST ROOM ...... HAZARDOUS WASTE ~ ]]]]~] STAIRS · STORM DRAIN STORAGE AREA...HWS I-IAZA~ DOUS IMAI' ER ~ALS ~ NV E IXl'l'Ol-~Y firm Ind Agriculture [] Stindlrd Nosiness l~l NON--TRAIZ)E SECRETS Pmqe _! ..... oil USIflESS tlAHE' Circle K Corporation # 8825 0~/IIER flAI4E: Circle K Cor~ ItAME OF 1tl]$ FACILITY: ci, r_~l_e DCAIIOII: ' 2222 F StrP_~t Pi~urelC~uonents 5Lured in ........ Under 9und Tank ~['~ ~ 30000 ~ 1~000 ~ 26~'56 F Ogk ~ 365 ~ O1 ~~4. ] ~pprox. ~ no. east of 'hysical Ind Ilellth ,,z,rd C.A.S. Number 8006-61-9 CoeponenL Il }lame I C.l.S. Number IChecA ~11 th,t Ipplyl Toluene 108-88-3 CoBponeflL I~ Nsmo I C.A.S. ~ ~ire 118zord ~ Pe~ctivit~ L~ Pel~yed U Sudden Pel,ase [1 i,~edl,te Xylene 1330-20-7 Ilem/th of Pressure lie, ICh ComponenL 13 NsBe I C.A.S. Number ~ethylte~t Butyl [the~ 1634-04-4 'hv~lcll lpd Pellth Hlzlrd C.A.S. Number 124-38-9 ComponenL II Hame I C.A.S. Humber ICheck ~11 lhlL CompoflonL If Name I C.A.S. Humber ~ ~irl ~4.rd ~ ,e,ctlvlt~ ~ Delayed [~ Sudden Release [J Immediate Ilea ILh of Pressuru Ilea ILh ComponenL IJ Name I C.A.S. Humber hyslcll Ind Hellth ~z,rd C.A.S. Number Component Il Hlme I C.l.S. Number {Check 811 Lhl{ Componefli 12 Nome I C.A.S. Number ~ rite H,z,rd ~ Re,ctlvitl Il ,ehy~ [J Sudden Pel~se [3 l/em/kb of Pressure Ilealth CompoflenL Ii Name I C.A.5. Humber h~sicII Bpd Hellth H~llrd C.l.S. Number ComponenL II H~m~ I C.l.S. Number Compoflefl& I~ Hsme I C.A.S. Number U fire H,zlrd ~ Re~cklvl~y 'U ~elAy~d II Sudden Pelease ~ ImmedlaLe Ilea/Lh of Pressure JlealLh Componenk I~ HBme I C.A.S. Number INle~Mike Spinuzzi - Zone M~r. -.Beeper{lltll (805)321-8522n.nr_p~onl~ ff2NAB~Mike Karvelot - Environ. Dir.lltl~ (714)823-0691 or (619)247-1914 UERGEHCY RifLed IfllormsLion I{ crum, ICCUrlLe. mhd compleLe. ~{ke Schumache~ - D~v{s{on Hanagec -Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION Oate Completed d/,. [ ?. ~.~ Business Name: C~ P-..c,'£.~ /~ ~--~/Q. --~,~,? - Location: ,,Z,Z..2,. Z._. F' ~7'. Business Identification No. 215-000 ~ c/~/.~ (Top of Business Plan) Station No. ! Shift /'~ Inspector t~.n ~ Adequate Inadequate Verification of Inventory Materials Verification of Quantities .. Verification of Location ;i"~ ~~ Proper Segregation of Material ,~_~omments: .~ ~ Verification of MSDS Availablity Number of Employees Verification of Haz Mat Training Comments: Verification of Abatement Supplies & Procedures Comments: ./~v~: ~Ye F,'n~£¢~vcF' Pez~G-z)~:~-s oT//C-~-- 77,/4~ ¢ 4z. zi,,,~ /~ ~), Emergency. Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: All Items O.K. I~ L-"h/.~~"~:J..-4-("~ (~c~,. _~'"'-' Correction Needed ~ Business Owner/Manager FD 1652 (Rev, 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy l Bakersfield Fire Dept. ~ Hazardous Materials Inspection Date Completed Location: ~ ~ a ~ '(~ '( ~. Plan ID ~ 215-000~?~ (Top right comer Business Plan) Station No. ] S~R ~ Impector Adequate Inadequate Verification of [nvento~ Materials ~EGEIV~O Verification of Quantities JUL 0 ~ ~ Verification of Location H~Z. MAT. DIV. ~oper Se~egafion of Matefi~ Co~B: Verification of MSDS Availabfli~ Nmber of ~ployees Verification of Haz Mat Trai~ng Ve~cadon of Abatemem Supples & Procedures . Co~m: ~0 ~ ~ A ~W I L A 8~ ~e~ency Pr~ed~s Posted Containe~ Properly Labeled Co~: ~ ~ ~ fi~ ~ PL~ Ve~ca~on of Fac[~ Dia~ Speci~ Haz~ds ~sociated ~th t~s Fac~: FD 1652 (~v. g~) White-H~ Mat Div. Yellow-Station Copy Pink-Business Office · · RECEIVED I I Environmental Management H~A MAT. DIV. Software Systems Inc. November 9, 1989 Bakersfield City Fire Department Hazardous Materials Division 2130 G Street Bakersfield, CA 93301 Gentlemen: Circle K Corporation has contracted Environmental Management Software Systems, Inc. to prepare a Hazardous Materials Management Plan in accordance with the requirements of Chapter 6.95, Division 20, Section 25550 et seq. of the State Health and Safety Code and Title III of SARA. In most cases, this submittal is a replacement of an existing plan. Circle K Corporation's intention is to provide each store with a standard format so that training of personnel can be accomplished uniformly throughout the State. If you have any question concerning these submittals, please contact EMSS at (805) 925-6285. Sincerely yours, ~ ~~ Rivera Jr. JVR:sb Enclosure P.O. BOX 5604 / SANTA MARIA / CA 93456 / (805) 925-6285 RECEIVED c~Y o~ NOV 2 1 I~0~ B~KERSFIELD H.~z. MAT. DIV. HA~.~RDOUS MATERI~LS MANAGEMENT PLANS Submitted Pursuant to CALIFORNIA HEALTH AND SAFETY CODE CHAPTER 6.95 (AB 2185/87/89) AND CHAPTER 6.5 (Hazardous Waste Control Law) FOR Circle K Corporation # 8825 2222 "F" Street Bakersfield .,CA 93301 - 1- Circle I( Corporation # 8825 (C) E.H.S.S.-10/88 CITY OF BAKERSFIELD I declare that to the best of my knowledge and belief, the statements and information provided in this document are correct and true. I understand that additional information to that provided may be required before plan approval from: Bakersfield City Fire Dept., Hazardous Materials Division I also understand that I am required by law to notify the Administrating Agency within thirty days of any one of the following changes: 1. The addition of one or more previously undisclosed material(s) in quantities equal to or greater than 55 gallons, 500 pounds, or 200 cubic feet at STP. 2. A 100 percent or more increase in the quantity of a previously disclosed material. 3. A change in the business address. 4. A change in the business ownership. 5. A change in the business name. Failure to notify the appropriate Administrative Agency': Bakersfield City Fire Dept., Hazardous Materials Division may result in the imposition' of civil penalties. --~~ Division Manaqer Signature Title Name: Mike Schumacher Dated: Tele'~hone Number: (916) 331-2540 FOR OFFICE USE: Approved/Denied by Date: - 2- CircLe K Corporation # 8825 (C) E.#.S.S.-10/88 CITY OF. BAKERSFIELD BUSINESS PLAN ANNUAL CHEMICAL INVENTORY 1. BUSINESS NAME: Circle K Corporation # 8825 2. FACILITY ADDR: 2222 "F" Street CITY: Bakersfield STATE CA ZIP: 93301 3. MAILING ADDR: 3437 Myrtle Avenue, Suite 440 CITY: North Hiqhlands STATE CA ZIP: 95660 4. BUSINESS PHONE NUMBER: (805) 324-1758 5. BUSINESS HOURS: 12:00 AM TO 11:59 PM SUN-SAT : TO : · TO - : TO : 6. TOTAL NUMBER OF EMPLOYEES: 3 NUMBER OF SHIFTS PER DAY: 7. NATURE OF BUSINESS: Convenience Store/Gas Station 8. SIC CODE (Standard Industrial Classification): 5541 9. CONTACT PERSONS ABLE TO ASSIST EMERGENCY PERSONNEL: Staff Duty Clerk (805) 324-1758 (805) 324-1758 Spinuzzi Mike Zone Manaqer (209) 298-3036 (805) 833-8881 Lewis Don District Office (209) 298-3036 (209) 291-~910 Schumacher Mike Division Manaqer (916) 331-2540 ( ) - - - Wriqht Pat Environ. Director (916) 331-2540 (916) 966-9139 10. _ FARM OR AGRICULTURE ~ STANDARD BUSINESS 11. ASSESSOR's PARCEL NUMBER: 12. REASON FOR FILING: INITIAL FILING ANNUAL REPORT CHANGE IN REPORTING STATUS ~ REPLACEMENT OF AN EXISTING PLAN 13. NUMBER OF UNDERGROUND TANKS: 3 TOTAL CAPACITY: 30000 - 3- Cinc[e I( Corporation # 8825 (C) E.l~.S.$.-10/88 FACILITY DESCRIPTION The following information is used to orient new employees to the major aspects of this facility. BUSINESS NAME: Circle K Corporation % 8825 FACILITY ADDR: 2222 "F" Street CITY: Bakersfield STATE: CA ZIP: 93301 FACILITY CONSTRUCTION: Stucco, wood and drywall NUMBER OF FLOORS: 1 FACILITY SIZE: 4614 (sq. ft./floor) THE TYPE OF FACILITY IS : Convenience Store/Gas Station THE PRODUCTS OR SERVICES THAT-ARE PRODUCED OR MARKETED BY THIS FACILITY ARE: a. Gasoline THIS FACILITY IS 5+ YEARS OLD. IT HAS BEEN USED IN ITS PRESENT CAPACITY FOR 5+ YEARS HAZARDOUS MATERIALS ARE USED IN THE OPERATION OF THIS BUSINESS IN THE FOLLOWING MANNER: a. Gas sold to public NAME OF OWNER: Circle K Corporation PHONE #: (916) .331-2540 ADDRESS: 3437 Myrtle Avenue, Suite 440 CITY: North Hiqhlands STATE: CA ZIP: 95660 - 4- Circle K Corporation # 8825 (C) E.#.S.S.-10/88 100' ' SCALE OF MAP I OF CONTAINER USING THE FOLLOWING SYMBOLS. ~7 ABSORPTIVE MATERIAL ~ ELECTIRC METER ABOVE GROUND TANKS /~ ALARM "-' O fOO ~ HFidL8 [] DRAIN (~ ELECTRIC SHUT'OFF ~ DRIVE'MIrY ~ GA8 METER BELOW GROUND TANK8 /1OK ~ EVACUATION ROUTE ~ GAS SHUT'OFF ~GAL/ ' ~ L GAL ' ~ EVACUATION/STAGING AREA ~ ~TER ~iNSULATED TANK8 ~ ~ FIRE HOSE ~ FIRE DEPT. CORA - CORROSIVE Y SPRINKLER CONNECTION C - COMBUSTIBLE ~ FIRE EXTINGUISHER t ~ FIRE DEPT. E - EXPLOSIVE ~ FIRE DOOR ~ STANDPIPE CONNECTION F - FLAMMABLE G ' GAS ' FIRE ~LL FIRE HYDRANT L - LIQUID OXY - OXIDIZER R ' RADIOACTIVE e*S CUSPS ~,_. ATTIC SCUTTLE 8 ' 80LIO ~ ;L-~ COOLER OR T - TOXIC GUARD STATION REFRIGERATION UNIT WR - ~TER REACTIVE ~ K N OX B OX L 0 CAT, 0. l??~h~:~::~ ~::a~ ~i~g ~i~l III FENCE/BARRIER8 ~ LADDER ~ HEATING UNIT MATERIAL SAFETY DATA SHEET & ~ RAILROAD TRACK8 HAZARDOUS MATERIAL EMERGENCY RESPONSE PLAN ~1~ STORAGE AREA...HM8 ~E~ PERSONAL PROTECTIVE EQUIPMENT ~ 8EWER HAZARDOUS MATERIAL ~ PUBLIC TELEPHONE ...... , HANDLING AREA...HMH : ~L : SKYLIGHT RR - REST ROOM ' ..... HAZARDOUS ~STE ~ STAIR8 ~ 'STORM DRAIN STORAGE AREA...HW8 CITY OF BAKERSFIELD H A Z A R D O U S M A T E R I A L S I N V E N T 0 R Y PAGE 1 FARM OR AGRICULTURE: _ STANDARD BUSINESS: [ REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989 ADNIN AGENCY ACCT. #: REASON FOR FILING: _ INITIAL _ ANNUAL REVIEW - CHANGE IN STATUS ~ REPLACE EXISTING PLAN BUSINESS NAME: Circle K Corporation # 8825 SIC C~E: 5541 EPA#: ASSESSOR's PARCEL #: FACILITY ADDRESS: 2222 "F" Street , Bakersfield DUN & BRADSTREET #: 06-294-4160 ITITYPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT ICONT l USEI DOT IRANGE I IDOTI IclCODEI ANT I AMT I AM~NT IUNtTI O/SICODEIPRESSlTEMP ICODEICLASS I XWT I COMPONENTS CAS # IGD#I IA!M I 10000 I 500O lSOO00 I GALl 365J 01 J 1 I 4 ) 19 IFL IlO0 )//////////////////////////////////////////////// 8006-61-9! - I CHEMICAL NAME: Gasoline J 25 ITo[uene 108-88'3127 COMMON NAME: Gasoline, Regular 120 Ixylene 130-20-7127 I LOCATION: Under~round tanks, approx. 20 ft. northeast of store I 10 IMethy[tert Butyl Ether 1634'04'4126 ~ FIRE SUDDEN RELEASE OF PRESSURE _ ACUTE I I I - REACTIVITY ~ CHRONIC I I I I iITYPEI MAXI AVG IANNUAL I IDAYSICONTICONT )CO,T I USEI DOT =RANGEI 100TI IcIcoDEI AMT I AMT I AM®,T IU"ITI O/SICODEIPRESSITEMP ICODEICLASS 1%WT I COMPONENTS CAS # IGD#1 IAI. l looooI SO00 1170000 I GALI 3651 011 1 I 4 119 IFL !100 !//////////////////////////////////////////////// 8006-61-9l-I J CHEMICAL NAME: Gasoline I 25 IToluene 108-88-3127 I J COMMON NAME: Gasoline, Unleaded I 20 IXy[ene 130'20'7127 I I LOCATION: U~erground tanks, approx. 20 ft. northeast of store ) 10 IMethyltert Butyl Ether 1634'04'4126 I I ~ FIRE SUDDEN RELEASE OF PRESSURE ACUTE J I I I ITiTYPEI MAX I AVG I ANNUAL I JDAYSJCONTICONT ICONT I USEI DOT IRANGEI IDOTI IclC~EI AMT I AMT I AM~NT IUNITI O/SlCODEIPRESSITEMP ICODEICLASS I XWT I COMPONENTS CAS # IGD#1 IAIM I 10000 ) 5000 160000 I GALl 365l 01 I 1 ) 4 119 IFL II00 I//////////////////////////////////////////////// 8006-61-9l - I' I CHEMICAL NAME: Gasoline 125 JToLuene 108-88-3127 i i COMMON NAME: Gasoline, Super Unleaded ) 20 )Xy[ene 13o-20-7127 I i LOCATION: U~erground tanks, approx. 20 ft. northeast of store 110 IMethyltert Butyl Ether 1634'04'4126 I I FIRE SUDDEN RELEASE OF PRESSURE ACUTE I I I I _ REACTIVITY ~CHRONIC - I I I I I I II FIRST NAME LAST NAME TITLE BUSINESS PHONE/AFTER HRS PHONE Staff ,Duty Clerk 324-,,1758 324-1758 Mike SpinuZzi Zone Manaqer 298-3036 833-8881 -- 7-- CircLe K Cor~ration # 8825 (C) E.M.S.S. - 01/89 CITY OF B/~KERSFIELD H A Z A R D O U S M A T E R I A L S I N V E N T O R Y PAGE 2, OF 2,,. BUSINESS NAME: Circ[e K Corporation # 8825 REPORTING PERIO0: JANUARY 1 TO DECEMBER,31 ITITYPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT Ic°NT I USEI DOT IRANGE I I IOoTI IclCOOEI AMT I AMT I AMOUNT IUNITI o/slCODEIPRESSlTEMP ICODEICLASS I ~WT I COMPONENTS I CAS # IGD#1 IAIP I 80 I ,o 1192o I LBSl 3651 04 I 2 I 4 I 99 INFG II00 I////////////////////////////////////////////////I 124-38-9121 I CHEMICAL NAME: Carbon Dioxide~ Carbonic Anhydride I 99 = Used for soda fountain COMMON NAME: Carbon Dioxide I LOCATION: In Storeroom, back of store I I - FIRE ~ SUDDEN RELEASE OF PRESSURE - ACUTE ) I I - REACTIVITY ~ CHRONIC I I II ITITYPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT ICONT l USEI DOT IRANGE IDOTI lclCOOEI ART I AMT I AMOUNT IUNITI O/SlCOOEIPRESSiTEMP ICOOEICLASS I ~r I COMPONENTS CAS # I CHEMICAL NAME: I I I I J COMMON NAME: I I I I I LOCATION= ! I I I I - FIRE SUDDEN RELEASE OF PRESSURE - ACUTE I I I I _ REACTIVITY _ CHRONIC I I ITITYPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT ICONT l USEI DOT IRANGE I DOTI ,IclcooEI AMT I AMT I AMOUNT IUNITI o/slcODEIPRESSITEMP ICODEICLASS I XUT I COMPONENTS CAS # GO#1 II I I I I I I I I I I I I//////////////////////////////////////////////// I I CHEMICAL NAME: I I I coM.oN NAME: ] I I LOCATION= 1,, I I I - FiRE SUDOEN RELEASE OF PRESSURE - ACUTE J I I -'REACTIVITY - CHRONIC I I I I I I I ITITYPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT ICONT l USEI DOT IRANGE I IOOTI IclcooEIAMT I AMT I AMOUNT IUNITI O/SlCOOEIPRESSlTEMP ICODEICLASS I ~T I COMPONENTS CAS # ! I I I I I I I I I I I I I//////////////////////////////////////////////// I I CHEMICAL NAME: I I I I COMMON NAME: I I I I LOCATION: I I I i _ FIRE SUDDEN RELEASE OF PRESSURE . ACUTE J I I - REACTIVITY _ CHRONZC ,k,,, I I ITITYPEI mX I AVG I ANNUAL I IDAYSlCONTICONT IcONT I USEI DOT IRANGE J lOOTI IclceoEI ANT I AMT IAMOUNT IUNITI o/slCOOEIPRESSlTEMP ICOOEICLASS'I ~T I COMPONENTS CAS # I®#l ! I I I I I i i i i i I I I//////////////////////////////////////////////// I I CHEmCAL NAME: ,[... I I I COMMON NAME: I I I I LOCATION: I I I - FIRE SUDDEN RELEASE OF PRESSURE - ACUTE J I I- REACTIVITY -c,eoNIc I I I I I I I CircLe K Corporation # 8825 (C) E.M.S.S. - 01/89 INVENTORY FORM CODE8 TC - TRANSACTION COOE (CoLumn 1) TYPE CODE (CoLumn 2) ~' A = Add this neu material to the business' inventory. P = pure or LargeLy pure substances D = DeLete this material from the business' inventory. H = mixtures of pure substances R = Revise the information about this materiaL. N = uaste (aLso append the three digit E.P.A. uaste code). CONT COOE- CONTAINNENT CODE (Cotunn 8) CONT PRESS - CONTAINER PRESSURE (CoLLeen 9) 01 Underground Tank 10 PLastic Container(s) 1 = Ambient Pressure O? Aboveground Tank 11 Box(es) Z = Greater than Ambient Pressure O] Fixed Pressurized Tank 12 Bag(s) 3 = Less than Ambient Pressure 04 PortabLe Pressurized CyLinder(s) 13 He[aL Container (not drums) 05 InsuLated Tank (incLudes cryogenics) 14 In Hachinery or processing 06 Drums or BarreLs - HetattJc equipment CONT TEHP - CONTAINER TENPERATURE (CoLumn 10) O? DrL~ns or BarreLs - non-He[aL[ir 15 Bin(s) 08 Carboy(s) 16 UnLined Sc~np 4 = Ambient Temperature 09 GLass Container(s) 99 OTHERS 5 = Greater than Ambient Temperature 6 = Less than Ambient Temperature but not cryogenic 7 = Cryogenic Conditions USE CODE (Column 11) · DOT CLASS - DEPARTHENT OF TRANSPORTATION (DOT) HAZARD CLASS CODES (CoLumn 12) 01 Additive 13 EmuLsifier 25 Instruction 37 Storage 46 Aircraft Sys. 02 Adhesive 14 Etching 26 Lubricant 38 Stripper &7 ELectroLyte EXP A = ExpLosive A PYRO = Pyrophorfc or sponta- FS = FLammabLe So[id 03 Aerosol 15 Experimanta[ 27 Medics[ Aid 39 ~ashing 48 Breathing Air EXP B = ExpLosive B neousLy CombustibLe W = Water 04 Anesthetic 16 Fabrication 28 NeutraLizer 40 Haste 49 Drafting Aids EXP C = ExpLosive C PO[S A = Poison Gas RAD = Radioactive 05 Bactericide 17 FertiLizer 29 Painting 41 ~ater 50 End Product BA = BLasting Agent PO[S B = Poison Liquid/So[id OXY = Oxidizer 06 BLasting 18 FormuLation 30 Pesticide Treatment 51 Fire Protect FG = FLammabLe Gas FL = FLammabLe Liquid OP = Organic Peroxide O? CataLyst 19 Fuel 31 PLating 42 We[ding 52 Hydrau. Equip NFG = Nonf[aranab[e Gas CL = CombustibLe Liquid RTl = EtioLogic Agent 08 CLeaning 20 Fungicide 32 Preservative 43 NeLL 53 Road/H~y COR = Corrosive ORHE = Hazardous Haste ORHA = Anesthetic, 09 Coo[ant 21 Grinding 33 Refining Injection Haintenance CR = Cryogenics ORHS = Other ReguLated Hateria[s Irritant 10 CooLing 22 Heating 34 Sea[er 44 OiL 54 Testing Chem. (materiaLs B, C, and D) 11 DriLLing 23 Herbicides 35 Spraying Treatment 55 ~ho[esa[e 12 Dryer 24 .insecticides 36 SteriLizer 45 ResaLe 99 OTHER ESTIHATED VOLUNE OR WEIGHT RANGE IN POUNDS (Co[ 3,4,5) UNITS - HEASUREHENT UNITS (CoLumn 6) RanRe Code From T__o Las = Pounds 1 0 99 GAL = GaLLons 2 100 999 FT3 = Cubic Feet 3 1,000 9,999 TON = Tons (2000 Lbs) 4 10,000 99,999 BBL = BarreLs (42 ga[s) 5 100,000 999,999 6 1,000,000 9,999,999 CircLe K Corporation # ~825 (C) E.H.S.S. - 06/89 REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989 HAZARDOUS WASTES INVENTORY GENERAL CHEMICAL AND MINERAL COMPOSITION FACILITY NAME: Circle K Corporation # 8825 FACILITY ADDRESS: 2222 "F" Street WASTE NAME/ MIN MAX MAX CATE DESCRIPTION CONC CONC AMOUNT UNIT % % ,None --10- CircLe I( Corporation # 1~25 (C) E.H.S.$.-10/88 CITY OF BAKERSFIELD H~ZARDOUS MATERIALS EMERGENCY RESPONSE PLANS AND PROCEDURES Submitted Pursuant to CALIFORNIA HEALTH AND. SAFETY CODE CHAPTER 6.95 (AB 2185/87/89) AND CHAPTER 6.5 (Hazardous Waste Control Law) FOR Circle K Corporation # 8825 2222 "F" Street Bakersfield CA 93301 -Il-- CircLe K Cor~ration # 8825 (C) E.H.$.S.-IO/~ EMERGENCY RESPONSE PLAN 1. EMERGENCY RESPONSE PERSONNEL The following persons have been designated to coordinate and assist in the event of a hazardous incident at this facility. a. EMERGENCY COORDINATOR: The Emergency Coordinator is responsible for managing hazardous materials emergencies, and coordinating all emergency measures. The Coordinator shall be thoroughly familiar with the facility emergency response plan, the facility's operations, hazardous materials, and facility layout. Other tasks of the emergency coordinator include: writing the emergency response plan, updating it when necessary, and overseeing the training of personnel in its use. LAST NAME FIRST NAME TITLE Staff ~t¥ Clerk BUSINESS PHONE: (805) 324-1758 AFTER HRS. PHONE: (805) 324-1758 b. ALTERNATE EMERGENCY COORDINATOR: The Alternate Emergency Coordinator shall be familiar with the duties and responsibilities of the primary Emergency Coordinator and shall perform those duties when the Coordinator is not available. The Alternate Coordinator may also assist the Coordinator in writing, updating the ERP, and to oversee the training of employees and on-site emergency response personnel. LAST NAME FIRST NAME TITLE Spinuzzi Mike Zone Manager BUSINESS PHONE: (209) 298-3036 AFTER HRS. PHONE: (805) 833-8881 c. EMERGENCY RESPONSE TEAM: The Emergency Response Team are those individuals who have been trained to respond and handle emergencies dealing with the mitigation, abatement or prevention of releases or threatened releases of hazardous materials. Lewis Don District office (209) 298-3036 (209) 291-5910 Schumacher Mike Division Manaqer (916) 331-2540 ( ) ._Wright Pat Environ. Director (916) 331-2540 (916) 966-9139 ( )__- ( )__-__ ( )__- ( )__-__ ( )__- ( )__- ( )__- ( )__-__ ( )__- ( )__- -12- Circle I( Co~po~ation # 8825 (C) E.H.S.S.-lO/88 ~AZARDS ~SSESSMENT AND NOTIFICATION PROCEDURE 2. H~Z~RDS ~SSESSMENT In the event there is a reported release or threatened release of toxic or hazardous material, the Coordinator or Alternate Coordinator will be advised. If, in their assessment, there is a need to call the Emergency Response Team, this will be done before notification to any required agencies is done. 3. REPORTING REQUIREMENTS Section 25504 of the Health and Safety code requires that the release or threatened release of hazardous materials be reported. This is required even if the situation does not warrant emergency response assistance. A. REQUIRED TIME OF NOTIFICATION= 1. Immediate notification is required as soon as the release or threatened release is acknowledged and as long as notification can be proVided: (a) without impeding immediate control of the release/threatened release, AND (b) without impeding emergency medical measures. 2. Immediate notification is not required if: (a) there is reasonable belief that the release or threatened release poses no significant present or potential hazard to human health and safety, property, or the environment, AND (b) the situation does not require emergency assistance. B. NOTIFICATION PROCEDURES= 1. When the incident DOES NOT require immediate notification as described above, contact your administrating agencies within 24 hours of the incident: Bakersfield City Fire Dept., Hazardous Materials Division Phone: 326-3979 and State office of EmerqencY Services Phone: (800) 852-7550 When a hazardous materials release or threatened release occurs which DOES require immediate notification as described above, refer to the Emergency Notification Roster on the next page and following directions described in the reporting requirements. -13- circle K Corporation # 88Z5 (C) E.H.$.$.-10/88 EMERGENCY NOTIFICATION TELEPHONE ROSTER 4. EMERGENCY NOTIFICATION Of the five agencies listed below, all (execpt Paramedics) must be contacted in the event of a hazardous materials release or threatened release. Reporting information required by these agencies is listed in the box below. A. LOCAL EMERGENCY RESPONSE PERSONNEL C A L L 9 i 1 PARAMEDICS : PHONE : (__) __-__ (Non-emergency Number) FIRE AGENCY: Bakersfield city Fire Department PHONE : (805) 324-4542 (Non-emergency Number) LAW ENFORCEMENT: Bakersfield City Police Department PHONE : (805) 327-7111 (Non-emergency Number) B. ADMINISTRATING AGENCY AGENCY: Bakersfield City Fire Dept., Hazardous Materials Division~ PHONE : ( ) 911-__ (24-hour Emergency Number) C. STATE OFFICE OF EMERGENCY SERVICES (OES) PHONE: (800) 852-7550 OR (916) 427-4341 * REPORTING REQUIREMENTS * * The following information should be known when reporting an emergency * so that response personnel will know what to expect and how to react. * * 1. Time and type of incident (fire, chemical release, etc.) * 2. The exact location of the release or threatened release. * * 3. Name and quantity of material(s) involved, if known. 4. The extent of injUries. * * * 5. Name of person reporting the incident. * * 6. The potential hazards presented by the material(s). * ************************************************************************** -14- circle K Corporation # 8825 (C) E.M.S.S.-lO/88 B. NEIGHBORING PROPERTIES The following (by name, address, and phone number, if available) list the neighboring businesses, residences, schools, hospitals, etc. which could be affected by a hazardous materials incident from this facility. These phone numbers are to be used in the event of an emergency to provide notification if evacuation from the area is deemed necessary. NAME ADDRESS PHONE Morris Plan 2225 "F" St. 347-2241 Jack L. Nation Insurance 2217 "F" St. 323-4779 McDonalds 2310 "F" St. 327-1720 6. COMPANY EMERGENCY MEDICAL ASSISTANCE This section includes the names, addresses, and phone numbers of the primary company medical facility and doctor, who would be available to treat employees injured by a hazardous, materials incident at this business. Use this information in the event of an emergency. DOCTOR : None ADDRESS : CITY : PHONE : ( ) __-__ FACILITY: Mercy Hospital ADDRESS : 2215 Truxton Ave. CITY : Bakersfield PHONE : (805) 327-3371 7. ADDITIONAL CLINICS AND HOSPITALS FACILITY: ADDRESS : CITY. ' PHONE : ( . ) __-__ FACILITY: ADDRESS : CITY : PHONE : ( ) __-__ (Medical facilities continued on the next page.) -15- Circle K Corporation # 8825 (C) E.H.S.S.-lO/88 7. MEDICAL FACILITIES (Cont) FACILITY: ADDRESS : CITY : PHONE : (__) __-__ FACILITY-. ADDRESS : CITY : PHONE : ( ) __-__ 8. UTILITIES SHUT OFF LOCATIONS GAS/PROPANE: None ELECTRICAL: a. Inside back room of store (breakers) b. East wall of building at north end (meter) WATER: North wall of buildinq at east end (main line gate valve) FIRE HYDRANT: Northeast corner of site LOCK BOX: None EMERGENCY RESPONSE PLAN: At the cashier station SPECIAL (IDENTIFY):Emergency qas shutoff switch: a. At cashier station on console b. North wall of buildinq, outside 9. UTILITIES INFORMATION DO NOT NOTIFY these companies in the event of an emergency. This information is for reference only and may be helpful in assisting emergency response personnel in responding to a hazardous materials emergency at this facility.. . UTILITY NAME PHONE Electric Company: Pacific Gas and Electric (805) 324-3981 Gas Company: None()(80~) Sanitation District:City of Bakersfield 327-7111 Water District: city of Bakersfield (805) 327-7111 Number of underground tanks on site: 3 Total Capacity: 30000 -16- Circte ~ Corporation # 8825 (C) E.#.s.S.-10/88 EMERGENCY RESPONSE PROCEDURES 1. EMERGENCY ASSESSMENT Upon recognition of a release or threatened release, the Facility Emergency Coordinator or the Alternate Emergency Coordinator should be alerted (see Sec. la&b in the Emergency Response Plan of this HMMP). In the event that neither of the above persons can be contacted, then the next person on the Response Team roster should be called. This roster is to be used until a member of the Facility Response Team is contacted. It is then that Response Team member's responsibility to contact and assemble the remainder of the Response Team. 2. NOTIFICATION a. (Local Agencies) The Coordinator or Alternate will determine whether immediate notification of local emergency response agencies is necessary. In the absence of either of these persons, any member of the facility response team or any designated representative may make that decision. The individual making this final decision should make use of the Reporting Requirements outlined in Section 4 of the Emergency Response Plan to gather the appropriate information and then utilize the Emergency Notification Telephone Roster also on the same page. b. (On-site) If the situation so warrants, other employees of the facility will be notified using one or more of the following step(s): ~ INFORM THE EMERGENCY COORDINATOR ~ ACTIVATE THE RESPONSE TEAM ~ NOTIFY ALL OTHER SITE PERSONNEL USING: _ AUDIBLE ALARM SYSTEM_ PUBLIC ADDRESS (LOUDSPEAKER) _ VISUAL ALARM ~VERBAL (SHOUTING) TELEPHONE 3. EVACUATION a. Evacuation of the facility, if required, will follow the designated routes (if unobstructed) as diagrammed on the Site Plot Plan. These are posted in highly visible areas through the facility. Employees will be notified to evacuate by the following signal: _ AUDIBLE ALARM SYSTEM_ PUBLIC ADDRESS (LOUDSPEAKER) _ VISUAL ALARM ~VERBAL (SHOUTING) TELEPHONE -17- circle K Corporation # 8825 (C) E.H.$.$.-10/88 4. SHUTDOWN All operation clerks or designated operators are responsible to ensure the shutdown of their area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. 5. PREVENTION A ~revention/maintenance program has been implemented for the review of methods leading to the potential reduction of a hazardous material release. One or more of the following methods has been used: ~ PERIODIC INSPECTIONS CORROSION MAINTENANCE ~ PERIODIC EQUIPMENT MAINTENANCE ~ APPROVED CONTAINERS ~ MARKED EMERGENCY EXIT (S) ~ FIRE EXTINGUISHER(S) SERVICED CHEMICAL HANDLING TRAINING ~ SAFETY TRAINING CORROSION MONITORING PROGRAM ~ DAMAGED CONTAINER INSPECTIONS ~ PROPER WARNING LABELS ON CONTAINERS ~ APPROVED FLAMMABLE STORAGE AREA ~ PROPER SEPARATION OF CHEMICALS ~ GENERAL HOUSEKEEPING ~ PROPER VENTILATION ~ OTHER a. Steel posts installed to prevent vehicle collision with pumps. b. Vapor Recovery Systems used when fillinq underqround tanks. c. Dual hose systems on pumps. d. Anti-lock nozzles at pumps. e. No sales to non-authorized containers. f. No smokinq siqns posted. q. Self-serve instructions posted. h. Tanks checked periodically for leaks by comparinq gallonaqe measure- ments with sales records. i. Underqround tanks are of fiberqlass construction. See next page(s) for applicable Emergency Response Steps! -18- C~rcLe K Cor~ration # ~25 (C) E.N.S.S.-IO/~ EMERGENCY RESPONSE STEPS MITIGATION ~ND ]tBATEMENT A. FOR THE FOLLOWING SUBSTANCE(S): Gasoline - All Grades MITIGATION: 1. Follow emerqency notification procedures as indicated in plan. 2. In case of spill take protective measures to control spread of fluid such as preventative diking with absorbent materials. 3. Shut off all emergency switches to prevent further spillage. 4. Barricade area to prevent possible exposure to general public. 5. Avoid personal exposure to fumes/vapors and contact with liquid 6. Eliminate all sources of ignition in area of spill or vapors. 7. Absorb liquids with absorbent materials and remove to safe area for evaporation. ABATEMENT: 1. Notify Circle K Environmental Director for co-ordination with hazardous waste disposal company to remove contaminated absorbent materials if required. B. FOR THE FOLLOWING SUBSTANCE(S): Carbon Dioxide MITIGATION: 1. Evacuate all nonessential personnel from affected area. 2. Close valve if possible. 3. Open all doors to ventilate affected area. ABATEMENT: Contact supplier of material release. -19- Circte K Corporation # 8825 (C) E.M.S.S. - 01/89 TI~[N~N~ OUTLINE ~o ~L~N~ H~i~OUS I~TER~L Special on-the-job training (OJT) in the handling of hazardous material(s) is provided in the following area(s): 1. Proper maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual. The MSDS for each appropriate hazardous substance is used to provide: 1. Recognition of the physical and chemical properties of each substance. 2. Knowledge of the toxicity involved in usage of the substance. 3. Knowledge of'the potential health hazards from use of the chemicals. 4. Understanding the first aid steps to counteract any effects of improper exposure to the chemical. 5. Knowledge of any precautions or protective equipment which must be used or worn when handling the chemical. The information learned from the study of the MSDS for each appropriate hazardous material will be reinforced through one or more of the following methods: 1. Reading each appropriate MSDS. 2. Worksheets. 3. Classroom instruction. _ 4. Use of videos/films where available. 5. Training Labs. ~ 6. OJT. B. EI~ER~ENCY I~ESPONSE PLAN A review of the contents of the Emergency Response Plan will be made by all new employees within one month(s) of hiring and by all employees on an annual basis. During this review, one or more of the following objectives will be accomplished: 1. Familiarization with the ERP in general. 2. Familiarization with the procedures for notifying the on- site emergency response team 3. Familiarization with the procedures for notification and coordination with local emergency response organization. 4. Familiarization with the use of the Emergency Telephone Roster. .5. Familiarization with the evacuation procedures and routes involved in the case of an emergency. Escape routes are posted in highly visible sections of the facility and exit doors are clearly marked. -20- CircLe K Corporation # 8~25 (C) E.#.S.S.-10/88 TRAINING OUTLINE (con,t) ERP training may be reinforced by: ~ 6. Practice emergency drills and exercises. ~ 7. Repeated instructional tours of the facility. C. SAFETY AND EMERGENCY EQUIPMENT USAGE Formalized training will provide familiarization with one or more of the following: ~ 1. The location and proper use of fire fighting equipment. ~ 2. The location of and procedures for facility shutdown. This includes the location of the turnoff valves for gas and electricity. _ 3. The proper use and wearing of protective gear and clothing. 4. The location and use of emergency communication equipment. ~ 5. The proper use of equipment used in the day to day business. The training will be accomplished through one or more of the following methods: ~ 1. Reading of material. ~ 2. Classroom environment. 3. Instructional Labs. ~ 4. OJT D. RECORD KEEPING Training records are kept on each employee as to: Overall Traininq. Dates Traininq Received. E. TRAINING COORDINATOR The following person has been designated as the training coordinator: Barbara Myatt - Corporate Trainer He or she may be reached at (209) 298-3036. -21- circle K Corporation # 8825 (C) E.#.S.S.-10/88 Circle K Corporation # 8825 YEAR 1989 EMPLOYEE TRAINING RECORDS I DATE DATE DATE DATE I HAZARDOUS EMERGENCY EMERGENCY I OF INITIAL ANNUAL ANNUAL IHATERIAL RESPONSE EQUIPMENT EMPLOYEE NAME ~ H I RE TRAIN I NG REVI Et~ REVI EI~ I HANDL I NG PLAN SAFETY USAGE I I I I I ~ I -22- CircLe K Cor~ration # 8825 (C) E.M.S.S. - 12/~ 'BAKERSFIELD, CA 93301_ ~..~C'~ RECEIVED (805) 326-3979 SEP I 1987 ............ OFFICIAL USE ONLY ID# BUSINESS NAME HAZARDOUS MATERIALS 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 A. BUSINESS NAME:. B. LOCATION / STREET ADDRESS: ~~.. CI'TY: ~~~/~/~ ZIP: ~ ~m/BUS.P~ONE: ~~-/~ SECTION 2: E~RGENCY NOTIFICATIONS In case of an emergency involving 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 Emergency Services as required by law. EMPLOYEES T0 NOTIFY IN CASE 0F EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: /[./,~"~x'7'- ~ /./.),~3/~/~-/A) B. ELECTRICAL: //(./,~'/zQ, z:: ~%'~Z70/~ ./,'Ii _./~,~,,~f_.,~OD,'~. ~,'~.~ ---~;~-~ _ C. WATER: /'o/~-7-- ~t'3 /~.~,z~/~/. /,fi ~-~.,~ E. LOCK BOX: YES'~ IF YE~,' LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / N0 MSDSS7 YES / N0 FLOOR PLANS? YES / N0 KEYS? YES / N0 - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A 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 MATERIALS:...' .................................... ~ NO (~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO-- ~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. (~ NO (f~) NO D. EMERGENCY EVACUATION'PROCEDURES: ................. ~ NO~(~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... ~ NO(~ NO SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIALmlN QUANTITIES LESS THAN 500 POUNDS OF~ SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES ~. I, .A4~ -g~-uvz~~-- , 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. · ~,-,~ ERSFIELD CITY FIRE DEPARTME ~ 2130 "G" STREET . ' ~ BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: tBUSI I~ESS 1~ I~ AN ' SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 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. SECTION 1: MITIGATION, PREVEN"rION, ABATEMEN~r PROCEDURES OUR TRAINING PROGRAM INCLUDES FOLLOWING: 1. HOW TO EVACUATE ALL PEOPLE FROM THE SITE. 2. T~'I,V. PHONE NUMBERS FOR FIRE DEPARTMENT AND REGULATORY AGENCIES FOR TIIWE, LY NOTIFICATION. ~ SECTION 2: NOTIFICATION A~\q] EVACUATION PROCEDURES AT THIS L~IT ONLY OUR TRAINING PROGRAM INCLUDES FOLLOWING: 1. HOW TO t{ANDLE REPORTING AND CLF3kN U~ OF UNAUTHORIZED SURFACE SPII.LS OF MOTOR lq3ELS. 2. HOW TO CHECK THE EQUIPMENT AND INSURE IT'S CORRECT USE TO pREVENT UNAU~ORIZED SPILLS OF MOTOR lq3ELS. BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page __~ i--:?f NON--TRADE SECRETS HAZARDOUS MATERI ALS I NVENTORY ,UsINESS NAMe,: ~/~/e ~ ~~. O~n ~n~:~/~gf~ /~. ~~,FACILITY UNIT AUURESS:j2~2 '/ ' f~~ ADDRESS: /~/ ~C~ 7~ ~ 'FACILITY UNIT NAME: CITY, ZiP: ~e~ffre/Z. ~ CITY,ZlP:~me~,z~ F~m~ PHONE ~:/{o;)32g /73--f PHONE {: (~)12~ ~9/ ~OFFICIAL USE CFIRS CODE - ' ,. ,. ' { ONLY , I 2 3 4 ~ ~ 7 8 9 10 TYPE BAR AHNUAL CONT US~ LOCATION IN THIS · BY HAZARD D.O.T COD~ AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT ~T. CHEMIQAL OR COMMON NAME CODE GUIDE - ~f~o~ *,~k~ ' ~/~ 3MHR~ENCV CONTACT: ' TiTi, E:~~ ~a~ac~- P}{ONH ~ 6US'HOURS:~~3~~ ~.~s~cv coaT,CT: ~R~ ~_~3~ T[TL~:,~~ ~a~a/~., PHO~H ~ BUS ~R[NC~PAL BUS~NESS ACTiViTY: '~~a~ ~~ aFTER BUS HRS:~397~3 BAKERSFIELD, CA 93301 (805) 326-3979 ~r'~ ~-~~" OFFICIAL USE ONLY ID# BUSINESS NAME HAZARDOUS lW_ATERI 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 I: BUSINESS IDENTIFICATION DATA A. BUS INESS NAME: · C/~9(¢.~. /~ ~~~~~? ~ ~~ nocAz o / sz s Z AOn SSS: SECTION 2: E~RGENCY NOTIFICATIONS In case of an emergency involving the release o~ 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. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE D~ING BUS. HRS. AFTER BUS. HRS. SECTION S: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WMOLE A. NAT. GAS/PROPANE: .g_/,~'_~'7'- Y-'g} /13,~.~A/,~7 ~/~_.~" ~Q,z~ ~~~~/~) B. ELECTRICAL: /~/~ C. WATER: ~~ ~ /~M- /~ ~~ ~ ~~, ~~ ~~) E. LOCK BOX: YES'~ IF ~,' LOCATION: IF YES, DOES IT CONTAIN SITE PLUS? YES / NO MSDSS? YES' / NO FLOOR PLANS? ~S / NO KEYS? YES / NO 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A 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 .MATERIALS:... .................................... ~_~ NO ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... (~ NO (~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO (~ 'NO D. EMERGENCY EVACUATION PROCEDURES: .................~ NO (~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... ~ NO(~ NO SECTION ?: HAZ~RDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ,',t4TERIAL IN QUANTITIES LESS THAN $00 POUNDS OF/~ SOLID, SS GALLONS OF A LIQUID, 0R 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES ~ I, /w,/~'o --S-r,d('~ ~ ~.,,?.~f~-', ~ertlfy 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. 25800 Et Al.) and that inaccurate information constitutes perjury. SIG TLE ~ DATE - 2B - KERN COUNTY FIRE DEPARTMENT ~ ~. ~2 VICTOR STREET BA~L~RSFIELD, CA 93308 ~ OFFICIAL USE ONLY ID# BUSINESS NAME: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# f~'~.~=~ FACILITY UNIT NAME: SECTION 1: MITIGATIONz PREVENTIO~ ABATEMENT PROCEDURES Our training program includes the following: 1. How-to handle reporting and clean-up of unauthorized '. surfacespills of motor fuels. 2. How to check the motor fuels equipment and insure its correct use to.prevent unauthorized spills of motor fuels. 3. Unauthorized release of product due to leaking tanks and ' product lines is handled by the Environmental Geology Department. SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY Our training program includes, the following: 1. How to turn off all power to pumps. 2. Proper instruction to evacuate all people from the site. 3. Make sure that all five extinguishers have proper service and maintenance. 4. Emergency list of telephone numbers for Fire Departn~nt, Hospital and Regulatory Agency for timely notification. HMCU-6 BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page _~:_of NON--TRADE SECRETS - HAZARDOUS MATERI ALS I NVENTORY ADDRESS:~222 '~ ' ~~ ADDRESS: /~/ ~~ Y~ ~ 'FACILITY UNIT NAME: ~F~ . PRONE ~:~)32~/~ ' PHONE ~: ~d~)~ ~/ OFFICIAL USE CFIRS CC ONLY 1 2 3 4 5 6 7 8 9 10 ~YPE ~AX ANNUAL CONT USE LOCATION IN THIS · BY {lAZARD D 'ODE AMOUNT A~OUNT UNIT CODE CODE FACILITY UN ~T. CHEMIqAL OR CO~M'ON NAME CODE O~ ~tEROENCY CONTACT: ~~ ~P_~SO TITLE: ~/~ ~a~Ace~ PliONE ~ BUS Farm and Agricult c~_.~ KERN COUNTY FIRE DEPARTMENT -\ HAZARDOUS MATERIALS INVENTORY Standard Business ~n DIlN ~N[) ltRA[~SI Rt ~I NliM~h k STANDARD IND. CLASS REFER TO INSTRU~TIOHS FOR PROPER OODES ' I 2 3 4 5 6 7 8 9 10 11 I~ans [ype Max Average Annual MeasuPe Cent Cent Con~ Use % by Names of Mixture/Components Code Code imt Amt Est Units l?pe Press lamp Code Wt See instruct runs ~ Fire ~ Oelayed Health C.A.S. Number ...... _~_~_~.~!._~ ......... ~ ....' Reactivity L ....~ Sudden Release of PpessuPe on Site ...... ~ Fire ~ Delayed Health C.A.S. Number ...... ~.~.~J.~ ............ ~ ....... ] .__~_~ ............................... ~--~ Reactivity ~---' Sudden Release of Pressure on Site .... Heai t h bB~.tu'~n ... ~ Fire ~ Delayed Health C.A.S. Number ~ ............... r .... ~ , ..... ~ 13) ~ Days I~1 ~---' Reactivity u._. ~ Sudden Release of Pressure on Site ....... Cer[it)~Y)o(It'rv/-"(Aead and ,sJ~n after completJnL, al] sections) I ~ti[y~un,ler penalty of law that I have personally examined and am familiar with the information submitted in Jh~i a~d all at,ached documents, and ,ha, based on my ~se individuals responsible for o~ining ~he information, I believe ~hat ~he submitted inform~Js~ru~, accurate, and complete. Farm and Agriculture' ~---~ KERN COUNTY FIRE DEPARTMENT HAZARDOUS MA-TERI ALS INVENTORY BUSINESS NAME ~o OWNER NAME: ~ o~a~,,a ..... LOCATION: ~~'" ~., ...... ADDRESS: ~dnS~ ~_hg..~!. ...... ................ ~ .... HAZ. PHONE ~:..._~~--~_ PHONE ~: .... ~Q~ ~_~r.~ ~ ......................... STANDARD IND. CLASS CODE: ~ NAME OF THIS FACILITY:_~~ ~~ ...... ~'o%Z~ .............. 1 2 3 ~ 5 ' ~ ? 8 9 ~0 il lrans [ype Max Ave~'age ~nnual Measure Cont Cont Cont Use % by Names of Mix~ure/Componen~s Code Code Amt ~mt Est Units lyre Press lemp Code Wt See Instru~t ,ohs Immediate l ................................................ ~o ~-~0~ ~ o1~ ~~ Hea lt h ) ~..~._~_ ~Fire ~Oelayed Ilealth C.A.S. Numbe~ ~1 ~ ..............................,.__~ _ ~~ t2 " ,, r--~ r--~ 13) ~ Oays i~ I ~ .... Reac~ivi~,l k---~ Sudden Release of Pressure on Site ~ ~ Immediate Health ........................................................................ c--J Fire ~---~ Oelayed Health C.A.S. Number ................................ r--~ r--~ 13) ~ Days i k--J Reactivity L__.~ Sudden Release of Pressure on Site ~---J ~---~ Imm~diate Hea I th ~--' Fire L.-. ' Delayed He(~lth C.A.S. Number t ..... ~ ~ .... ~ ~ 13) ~ gays ~ I ................................................................... .... ..... .... ~ Tiile '- l~'~-~6~ T .......... 98g ..................... ......... inauiPy of those individuals respons~e for obtaining ~e ~nformation, I believe that the submitted info~ti~n is~r~, ~cupete, and complete. ~-~-6~rT~T~, tltTe ct owner/~perator ~K owner/operator s autEor~ze~ repF~entat~ve 5~Onature ....... ~~5-. Oate b~qned Farm griculture ~- J Ki~ltJl CO! ,! FIi~ Standard Business LOOATION: ~ 'F' ~T.z ~R ~0 ZNSTRUC~O~S FOR PROPER CODES lrans [ype Max Average Annual Measure Cont C~t Cont Use % by Names ot Ni~ure/,'nmpon~n(~ Code Code Amt Amt Est Units )ype Press letup ~ode Wt See Instruct ~ -' ~eactivity ~ ---' Sudden ~elease of Pressure on S~te ~ ...... ~ ~ ~ Health Fire ~ Delayed Health C.A.S. Number ~-- ~ Reactivity ~ ....~ Sudden Rele6se of Pressure on S~te ..... ~ Fire ~ Delayed Health C.A.S. Number ....... ~.~.).~ ....... L ....I Reactivity ~-- j Sudden Re)ease ()f Pressure on Site ..... EMER(iENCY L':ONIACT5 llNa~,,,~ ~ ~os~ ~ ~ li~le- 24 Hr"P e I ~i~y~un~er penally of )a. that , have persuna)ly examined anO am ,amil,ar .~th the inform,,io, subm,,ted ,n }hj~ a~d all a,tached documents. y~nqu)lVllO~ tSse individuals responsible for o~ining the intimation, I believe thai the submitted intorm~s~ruCaccurate, and complete. ~[itle o[ owner]o~erator O~ owner/6perator s authorized represe~[~{~ve blgnature '~ ' ' .................... ~ ~ , Faclllly Idenllflcallon Ownor/Operntor Name Tier Two ,~.~. CI~LR K ~I~ ~ ~ RR25 ,,~. CI~ K ~~Ti~ ~. t602 ) 253-9600 EMERGENCY SlgletAddr.iI 2222 "F" ~RERT M.llAdd .... P.O. ~X 52084, P}~. ~. 85006 AND O,V B~PSFI~D st,,. ~ z,, 93301 ....... HAZARDOUS Emergency CoDtact , ~HEMICAL ~ INVENTORY Name S~ ~R J ,, Title ~ ~R OFFICIAL ~ t MI~ SPI~ZZI ~;. DI~ ~R N~me Title ONLY Date R~elv~ Phone ..( 805 ) 833-8811 ';: ~ ~. ~. ( ) Physical I~ Stdrage Codes. and: Locations..,/:,.: ... :.. Amount Amount On-ella Sodden ~ele~e ' ' Ihdl d~p~y: Pure Ml~ Solid Liquid 0~1 S~ret ~ Fire ., Sudden Release Chem. Name of Pressure .... Oelayed (chronic) S~rel I J Sudden flelehse ~f~ '~. Chem. Name of P~essu~e __ ____ Imm~Jlale (acute) Delay~ (chr~lc) ~ I Ce~lllV undar ~nally of law that I have ~r$onally examined and am familiar wllh the Informallo- ItJbmllled In Ibis end all ellhch~ d~umentl, a~ that ~ L~.,o ~nd n,l.ct~l tllie '' ownqrlope~at~ O~ owne¢,'~uo, a~oC ~ 8uthoH~o~ ~ep~e~nnlallve SIg.alu~e / Oate sl~no~ ~ c~rd~nele ab~evlall~ ~Bakersfie~d Fire Del~ Hazardous Materi~ Division 2130 "G" Street (~Q ~ ~ _ Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. TO ovoiCl further c:ction, return this form within 30 ctoys of rec, eipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the ClUeStions Delow for the Du$iness ¢:s o whole. 4, E~e brief c:ncl concise c~$ possiDie. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle A Corporation #8825 LOCATION: 2222 "F" Street ~- :' Circle K Corporate MAILING ADDRES$: P. O. Box 52084, Phoenix, AZ 85072 CITY: Bakersfield STATE! CA 7~p: 93301 PHONE:(805)324-1758 DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Sto~e/Gas Station OWNER: Circle K Corporation (602)229-8706 MAILING ADDRESS: P. O. Box 52084, Phoenix, AZ 85072 SECTION 2: EMERGENCY NO~FICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE I. Mike Spinuzzi - Zone Manager (209)298-3036 (805) 833-8881 2. Don Lewis - District Manager (209)298-3036 (209) 291-5910 Bakersfield Fire Dept. · ~ Hazardous Materials Division ~ HAZARDOUS MATERIALS MANAGEM T PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS' 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Prop:~- maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity)and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES, OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, Mike Schumacher CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT .INACCURATE INF RMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE FOISt) I~zardous Mat~rial~ Division H AZARDOIJS MATERIALS MANA. F.M NT PLAN Fc:cili~y Unit N=me: Circle K CorDoratlon ,~8825 $SCTION 6: NOTIFIOATION AND EVACUATION A. AGENCY NOTIFICATION PROCEDURES: If eme._rgency response assistance not required, notify: Bakersfield City Hazardous Materials Division 326-3979 ANO State Office of Emerpenc? Services (BDO) B52-7550 WITHIN 24 HOURS If release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, in~_ediately notify: -' tire Deoartm. ent - Bakersfield Pire Oeoarr~..~nt 911 Police Oeoar:ment - Bakersfield Police Deoartment 911 Bakersfield City_Hazardous Materials Division 911 'Sta:e UTT~Ce OT :meroencv ~rwces (SOD) 85~-7550 or (916) 427-4341 B. EMPLOYES NOTiFICAIION AN~"svACUAIION: Upon recognition of a release, the Duty clerk will verbally (shouting) notify all other site personnel. The Clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging.area where all employees will be accounted for. C. PUBLIC EVACUATION: If evacuation from area deemed necessary, .these neighboring properties will be notified: f~A~ ADDP~SS PHONE Morris Plan 2225 F Street 347-2241 Jack L Nation Ins. 2217 F Street 323-4779 McDonalds 2310 F Street 327-1720 D. EMEIt.$ENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: Mercy Hospital 2215 Truxton Ave. 327-3371 Additional Clinics and Hospitals: ~akersSeld F~e Dept~ Hazardous Materials Divisior~"~ HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: GASOLINE A. RELEASE PREVENTION STEPS: ' 1. Steel ~osts installed to prevent vehicle collision with pumps 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction 3. Dual hose systems on pumps. Anti-lock nozzles at pumps 4. No sales to non-authorized containers 5. No smoking signs posted, self serve instructions posted 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventative diking with absorbent materials 2. Shut off all emergency switches to prevent further spillage 3. Barricade area to prevent possible exposure to general public 4. Avoid personal exposure to fumes/vapors and contact with liquid 5. Eliminate all sources of ignition in area of spill or vapors 6. Absorb liquids with absorbent materials and remove to safe area for evaporation C. CLEAN-UP PROCEDURES: 1. Notify Circle K Environmental Director (71~) 823-0691 'for co-ordination with hazardous waste disposal company to remove contaminated absorbent materials if required CARBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors to ~entil~te C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve ' SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None a. Inside back room of store (breakers) b. East wall of building a north end (meter) ELECTRICAL: WATER: North wall of building at east end (main line gate valve) Emergency gas shutoff switch: SPECIAL: (a) At cashier station on console. (B) North wall of building, outside. LOCK BOX: YES/~O~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANt: Northeast corner of site , I~01599" HAZARDOUS MATERTALS TNVENTORY FIrmlndXgtlcultur! I'] Standard Business ~ NON--TRADE SECRETS USINESS.NAHE: Circle K Corporation ~ 8825 OWNER NAME: Circle K Corporation ~AHF OF THIS FACILITY: Circle K Corporation ~88~ OCA[JOtl. 22~' F 5tr~' ' ADDRESS: P. 0;' Box 52084 SI'A~DAllD iND. CLASS CODE~ ..... ~[~i ....... ~.[~ ~iP~]B~kersfield, [A~ql CJIY. ZlP~ P~oeaix;'AZ 850~2 DUI{ AIID BI(ADSilIEE/ NUHDEii ........... Code LO~I AEt XEt Units on e lype ~ress Aemp Stored Iff FaCiliTy See InstrucLions ~hysjcJl lad flellth ~llird C.A.S, Humber 8006-G~-9 Component II Itamg I C.A,S. Humber 25 Toluene Z08-88-3 Componen& I~ NAme I C,A,~, fl~Aber ~ Fire Ilmrd ~ ~e~cLiviL~ ~ Pelaye~ ~ Sudde~ Release ~ Immediate ilea/Lh o( P~ess~rd Ilea ILh Component I~ Ilame I C.A,S. Humber ~ zo ~eLh~lCe~ Bu~l E~her 1634& " . . ' . '' pnde~ ~oun T~nk~ approx. ]0~ GaSOline - Unleaded ~hysJctl IO~ ~ellth ~alltd C.l.S. Humber 8006-61~9 Component II HAme I C,A,S. Humber 25 Toluene 108-88-3 ComponenL If Hame I C,A.J, ~uAber 2o ~ ~ir~ ~4~rd ~ ~eactlvlt~ ~ ~l~yed ~ Sudden Release ~ ImmedlaLe Ilellkb of Pressure IiealLh ~ ' Component 13 HAme I C.A.S, Humber lo Re~h~lCe~C BuCk1 Ethe~ 1634-04-4 Physical In~ ~etlth Hlilrd C.~.S, ~uAber 8006-61-9 CoAponenk II llama I C,A,S, Humber 25 Toluene X08-88-3 Component I~ HAme I C,A,S, Humber Ilea/Lb of Pressure Ilealkh , CompongflL I~ Haa8 I C,A.S. Humber , I , I' I,. I .m36192 10".. I" i" Istoreroom,.~ac~.of store 102 CarbonDiox.ide, Carbon,cAnhydride Physical Ind ~e!lth ~allrd C.A.S, Humber 124-38-9 CoApoflen[ II NAAe I C.A,S, ICheck all that ~pp/~l Component If Hame I C,A.S, Humber Ilea ICh of Pressure CoAponant IJ Na~o I C,A.S, Humber ..... MJ"~e Spinuzzi Zone Manager (805)833'8881 fl2fll~,n Lewis District ~fanager (209)291-5910 in this.lad ;UDIILL~O IAlO[llLlOfl II Lrul, icCUrl&O~ lac complete, MIKE SCH~CHER - DIVISION ~NAGER