The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLANHazardous Materials/Hazardous Waste Unified Permit . CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID#:: 015-000-000852 LUCKY 7 DELI-MART This _oermit is issued for the followin_a: ~ Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment TANK HAZARDOU~ 015-000-000852-0001 GASOLINE 015-000-000852-0002 GASOLINE LOCATION: 714 NILES ST /ELD Issued by: Approved by: Expiration 'Date: OfficeofEvironum,~llTScrvices ~ June 30;' 2003 Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Issue Datc Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-021000852 LUCKY 7 DELI-MART LOCATION 714 NILES HAZARDOUS SUBSTANCE GASOLINE GASOLINE ............ ,~,,~,~;:.'.?;~'~.?.!i~,,,~,,,,~,,,~,~,,~ ........... This permit is issued for the following: .:~,~¢"¥ii: i.,!~fi!!!:;::'~'""::;;ii}ii}};i~?:iiL ,,~iii!!![!ii~. iiiiii?:::iiiiii','*:,i;i~;iU~erground Storage of Hazardous Materials ...... ~i..~,.'~,.. ' ~ ~:.-......,.;"~, ~2'06'e;~OS~I~'GAL ¥ ';'"";:;';'1S~ iF ,,.I:;~TG ,'(:";" ~,~' I SW I cP SUCTIoNSUCTION PIPI ONI ALD ALD Issued by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Approved by: Expiration Date: June 30, 2000 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the.number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2"a day of November, 1998 to: LUCKY 7 DELI-MART Permit #015-021-000852 714 Niles St Bakersfield, California 93305 ~ECK F/IClLITy FLoo~ : I oF ! · W/%T~'R HY)RltNT I~ I~tK ERS FI EL~D CITy SCHOOL ..~ISFt~Ir_.T ~1~. 7 BA t(F_R ST RITE. ~ATER L'Iyl)R,QrtT ;[ S"~l.£: = Eol ; - . Fzoo,¢ -t ~)/)TE ~,30. g7 F~c/£1Ty /V, qYI£ tf/,d UNIT l! I /¢~'fINT I~Ai(ERSFIEL~D ClT'/ $c/~OoL. BAI(ER $'1 IRON T :Poor fl/lcK :~ooR TR~N~ Ty- ME TIIO~iST. Ot U~,c N LUCKY 7 DELI-MART Manager : Location: 714 NILES ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 015-021-000852 BusPhone: (661) 325-7281 Map : 103 CommHaz : Low Grid: 29B FacUnits: 1 AOV: SIC Code: DunnBrad:770007-6737 Emergency Contact / Title HARNEK S SANDHU / Business Phone: (661) 325-7281x 24-Hour Phone : (661) 871-7156x Pager Phone : ( ) - x Emergency Contact / Title SHARAN K SANDHU / Business Phone: (661) 325-7281x 24-Hour Phone : (661) 871-7156x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 714 NILES ST City : BAKERSFIELD Phone: (661) 325-7281x State: CA Zip : 93305 Owner HARNEK SANDHU Address : -~n0~_ .~.~ ~,T~.~ #1 57~ ~,~r~ ~/~r~ ~ City : BAKERSFIELD Phone: (661) 325-7281x State: CA Zip :.~3~ 9~06 Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: I//~,v~:~' 5. 5,~/,/~./j Do hereby certify thru ~ have (Type or print name) reviewed ~he at~ached hazardous materials manage- ment plan for/-u~-?-/~r and that i~ alon~ wi~h any corrections constitute a complete and correct man- agement plan for my facility. Signature -1- 09/09/2003 LUCKY 7 DELI-MART Manager : Location: 714 NILES ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 015-021-000852 BusPhone: (661) 325-7281 Map : 103 CommHaz : Low Grid: 29B FacUnits: 1 AOV: SIC Code: DunnBrad:770007-6737 Emergency Contact / Title HARNEK S SANDHU / Business Phone: (661) 325-7281x 24-Hour Phone : (661) ~ Pager Phone : ( ) ~71-~l~x Emergency Contact / Title SHARAN K SANDHU / Business Phone: (661) 325-7281x 24-Hour Phone : (661) ~ Pager Phone : ( ) ~7~_ 7~6x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 714 NILES ST City : BAKERSFIELD Phone: (661) 325-7281x State: CA Zip : 93305 Owner HARNEK SANDHU Address : 1820 ALTA VISTA #1 City : BAKERSFIELD Phone: (661) 325-7281x State: CA Zip : 93305 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: j,/~t~N£~ s~z)~u Do hereby ~.~r~ify that ~ have ~y~ or-p~nt na~) reviewed ~h~ a~hed h~ardous mate~als manag~ ment plan for ~c~y_7- ~ T and ~hat i~ along with (~ of ~s~e~) any corrections ~ns~i~u~e a complete and correc~ man- agemem plan for my facili~. Si~ture ~' ~ %Z'3.0~-~ -1- 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: LUCKY 7 DELI-MART Cross Street : Business Type: Org Type: Total Tanks : 2 IndnRes/Trust: No PA COntact: PROPERTY OWNER INFORMATION Name : SHARAN K SANDHU Phone: (661) 325-7281x Address: City : Type .: Name : SHARAN K SANDHU Address: City : Type : State: Zip: TANK OWNER INFORMATION Phone: State: Zip: (661) 325-7281x BOE UST Fee# : 033568 Financ'l Resp: STATE FUND LeHal Notif : Property Owner MailinH Address Date: Name:HERMEC SANDHU State UST # : Phone: Ttl:MANAGER 1998 UpH Cert#: ( ) - x = Hazmat Inventory --Alphabetical Order Hazmat Common Name... GASOLINE GASOLINE ISpecHazlEPA Hazards One Unified List Ail Materials at Site Frm DailyMax IUnitlMCP F IH DH F iH DH L 4000.00 GAL Mod L 8000.00 GAL Mod -2- 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 ----- Inventory Item 0001 Facility Unit: Fixed Containers on Site GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: S SIDE OF FACILITY CAS# 8006-61-9 F STATE TYPE PRESSURE Liquid Pure I Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 5000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 4000.00 GAL Daily Average I 2000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS 8006619 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI F IH DH NFPA/// I USDOT# Mod ---- Inventory Item 0002 Facility Unit: Fixed Containers on Site GASOLINE Days On Site UNLEADED 365 Location within this Facility Unit Map: Grid: S SIDE OF FACILITY CAS# 8006619 F STATE ~ TYPE Liquid/Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 GAL Daily Average 5000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS 8006619 HAZARD ASSESSMENTS I Radi°active/Am°unt EPA HazardsINo/ Curies F IH DH NFPA/// I USDOT# Mod 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format ~ Notif./Evacuation/Medical --Agency Notification FOR GAS RELATED HAZARDS PETROLEUM. FOR FIRE AND Overall Site 11/28/2000 SPILLS, BP WOULD BE CONTACTED THROUGH STUART OTHER EMERGENCY SITUATIONS HELP'WOULD BE SOUGHT -- Employee Notif./Evacuation 11/28/2000 ONLY ONE TO TWO PERSON WORK AT ONE TIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP TO CONTROL THE SITUATION. -- Public Notif./Evacuation 11/28/2000 BEING A VERY SMALL BUSINESS, EVERYBODY IN THE FACILITY WOULD BE VERBALLY NOTIFIED OR EVACUATED. Emergency Medical Plan 11/28/2000 KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GET EMERGENCY MEDICAL HELP. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS E OF THIS BUSINESS. -4- 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 11/28/20.00 EMERGENCY SWITCH WILL BE ACTIVATED IMMEDIATELY IF SPILL DOES OCCUR, PROFESSIONALLY TRAINED HELP WILL BE REQUESTED ~O PROPERLY HANDLE THE SPILL. --Release Containment 11/28/2000 FIRST AND FOREMOST STEPS WILL BE TO ACTIVATE THE EMERGENCY SHUTOFF SWITCH. THIS WILL STOP PUMP THUS NO MORE GAS WILL BE RELEASE. MOVE ALL VEHICLES AND OTHER SOURCES OF IGNITION TO SAFER AREA. REQUEST THAT SMOKERS EXTINGUISH HIS SMOKE. DIKE WITH SAND OR EARTH TO CONTAIN THE RUN OFF. DISPOSE OF THE SAND IN ACCORDANCE TO RULES AND REGULATIONS. Clean Up 11/28/2000 IF SITUATION WARRANT SPECIAL CLEAN UP TEAM IS NEEDED THEN BP WOULD BE ASKED TO PROVIDE THAT ASSISTANCE. IN OTHER SITUATIONS LOCALLY COMPETENT ESTABLISHMENT WOULD BE CONTACTED TO CERTIFY THE SITUATION. Other Resource Activation -5- 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 11/28/2000 A) GAS - NONE B) ELECTRICAL - E WALL ALONG THE BACK DOOR C) WATER - E WALL AND N WALL D) SPECIAL - EMERGENCY SHUTOFF SWITCH FOR GAS PUMPS N OF ENTRANCE DOOR E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT SITE. 11/28/2000 FIRE HYDRANT - NW CORNER OF BAKER AND NILES. Building Occupancy Level -6- 07/25/2002 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format Training -- Employee Training WE HAVE 2 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. Overall Site 11/28/2000 BRIEF SUMMARY OF TRAINING: ALL THE EMPLOYEES ARE KNOWLEDGEABLE TO ACTIVATE THE EMERGENCY SHUTOFF SWITCH, ELECTRIC MAIN SWITCH, WATER HYDRANT. DEPENDING UPON THE SERIOUSNESS OF SITUATION, THEY ARE ASKED TO CONTACT 911 OR OTHER APPROPRIATE EMERGENCY. GET EVERYBODY OUT OF THE BLDGAND MOVE TO A SAFE CORNER OF BAKER 'AND NILES ST. Page 2 Held for Future Use Held for Future Use 7 07/25/2002 MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE /" ~//-~ / NEW ACCOUNT ADDRESS CHANGE, CLOSE ACCT ' FINANCE CHARGE I OTHER ADJ /, ZIP CODE SITE ADDRESS PARCEL NUMBER (IF APPUCABLE) ADJUSTMENT I CHG DATE' CHARGE CODE I ADJUSTMENT AMOUNT I ! APPROVED By Z~~.. ~,~---""~' LUCKY 7 DELI-MART Manager : Location: 714 NILES ST City : BAKERSFIELD ,/ CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 015-021-000852 BusPhone: (805) 325-7281 Map : 103 CommHaz : Low Grid: 29B FacUnits: 1 AOV: SIC Code: DunnBrad:770007-6737 Emergency Contact / Title HARNEK S. SANDHU / Business Phone: (805) 325-7281x 24-Hour Phone : (805) 861-8121x Pager Phone : ( ) - x Emergency Contact / Title SHARAN K. SANDHU / Business Phone: (805) 325-7281x 24-Hour Phone : (805) 861-8121x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 714 NILES ST City : BAKERSFIELD Phone: ( ) State: CA Zip : 93305 X Owner HARNEK SANDHU Address : 1820 ALTA VISTA #1 City : BAKERSFIELD Phone: (805) 325-7281x State: CA Zip : 93305 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I, SH/~/tA/ K .g'~A,z)/'/~Do hereby certifl/that ! have -- (Type cr ,r.,~;nl r,ame) reviewed the attached hazardous materials manage- ment plan for Lc, c/~ -'7- rn~4 r and that it along with (Name of Business) any corrections constitute a complete and correct man- agement plan for my facility. ii, Date 1 10/31/2000 LUCKY 7 DELI-MART STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: LUCKY 7 DELI-MART Cross Street : Business Type: Org Type: Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : SHARAN K. SANDHU Phone: (805) 325-7281x Address: City : Type : Name : SHARAN K. SANDHU Address: City : Type : State: Zip: TANK OWNER INFORMATION Phone: State: Zip: SiteID: 015-021-000852 (805) 325-7281x BOE UST Fee# : 033568 Financ'l Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date: Name:HERMEC SANDHU State UST # : Phone: Ttl:MANAGER 1998 Upg Cert#: ( ) - x ~ Hazmat Inventory --As Designated Order Hazmat Common Name... GASOLINE GASOLINE One Unified List Ail Materials at Site ISpecHazlEPA HazardsI Frm DailyMax IUnit MCP F IH DH L F IH DH L 4000.00 GAL Mod 8000.00 GAL Mod 2 10/31/2000 LUCKY 7 DELI-MART ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME GASOLINE Location within this Facility Unit S SIDE OF FACILITY SiteID: 015-021-000852 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 8006-61-9 F STATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 5000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum I 4000.00 GAL Daily Average 2000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS N 8006619 ITSecretI RSIBioHaz No No No HAZARD ASSESSMENTS [ Radioactive/Amount I EPA HazardsINO/ Curies F IH DH NFPA /// USDOT# I MCP Mod ~ Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME GASOLINE UNLEADED Location within this Facility Unit S SIDE OF FACILITY Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 8006619 FSTATE -- TYPE Liquid SPure PRESSURE Ambient -- TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 GAL Daily Average 5000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS S CAS# N 8006619 ITSecretI RSIBioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA/// I USDOT# Mod -3- 10/31/2000 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format = Notif./Evacuation/Medical --Agency Notification Overall Site 03/25/1991 FOR GAS RELATED HAZARDS SPILLS, BP WOULD BE CONTACTED THROUGH STUART PETROLEUM. FOR FIRE AND OTHER EMERGENCY SITUATIONS HELP WOULD BE SOUGHT -- Employee Notif./Evacuation 03/25/1991 ONLY ONE TO TWO PERSON WORK AT ONE TIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP TO CONTROL THE SITUATION. -- Public Notif./Evacuation 03/25/1991 BEING A VERY SMALL BUSINESS, EVERYBODY IN THE FACILITY WOULD BE VERBALLY NOTIFIED OR EVACUATED. Emergency Medical Plan 03/25/1991 KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GET EMERGENCY MEDICAL HELP. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS EAST OF THIS BUSINESS. -4- 10/31/2000 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format ~ Mitigation/Prevent/Abatemt --Release Prevention Overall Site 03/25/1991 EMERGENCY SWITCH WILL BE ACTIVATED IMMEDIATELY. IF SPILL DOES OCCUR, PROFESSIONALLY TRAINED HELP WILL BE REQUESTED TO PROPERLY HANDLE THE SPILL. --Release Containment 03/25/1991 FIRST AND FOREMOST STEPS WILL BE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH. THIS WILL STOP PUMP THUS NO MORE GAS WILL BE RELEASE. MOVE ALL VEHICLES AND OTHER SOURCES OF IGNITION TO SAFER AREA. REQUEST THAT SMOKERS EXTINGUISH HIS SMOKE. DIKE WITH SAND OR EARTH TO CONTAIN THE RUN OFF. DISPOSE OF THE SAND IN ACCORDANCE TO RULES AND REGULATIONS. -- Clean Up 03/25/1991 IF SITUATION WARRANT SPECIAL CLEAN UP TEAM IS NEEDED THEN BP WOULD BE ASKED TO PROVIDE THAT ASSISTANCE. IN OTHER SITUATIONS LOCALLY COMPETENT ESTABLISHMENT WOULD BE CONTACTED TO CERTIFY THE SITUATION. Other Resource Activation 5 10/31/2000 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 10/09/1990 A) GAS - NONE B) ELECTRICAL - EAST WALL ALONG THE BACK DOOR C) WATER - EAST WALL AND NORTH WALL D) SPECIAL - EMERGENCY SHUT-OFF SWITCH FOR GAS PUMPS NORTH OF ENTRANCE DOOR E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT SITE 05/01/1997 FIRE HYDRANT - NORTHWEST CORNER OF BAKER AND NILES. Building Occupancy Level 6 10/31/2000 LUCKY 7 DELI-MART SiteID: 015-021-000852 Fast Format Training -- Employee Training Overall Site 10/22/1993 WE HAVE 2 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: ALL THE EMPLOYEES ARE KNOWLEDGEABLE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH, ELECTRIC MAIN SWITCH, WATER HYDRANT. DEPENDING UPON THE SERIOUSNESS OF SITUATION, THEY ARE ASKED TO CONTACT 911 OR OTHER APPROPRIATE EMERGENCY. GET EVERYBODY OUT OF THE BUILDING AND MOVE TO A SAFE CORNER OF BAKER AND NILES STREET. Page 2 Held for Future Use Held for Future Use 7 10/31/2000 LUCKY 7 DELI-MART Manager : Location: 714 NILES ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 215-000-000852 BusPhone: Map : 103 _. ~ Grid: 29B SIC Code: (805) 325-7281 CommHaz : Low FacUnits: 1AOV: DunnBrad:770007-6737 Emergency Contact HARNEK S. SANDHU Business Phone: 24-Hour Phone : Pager Phone : / Title / (805) 325-7281x (805) 861-8121x ( ) - x Emergency Contact SHARAN K. SANDHU Business Phone: 24-Hour Phone : Pager Phone : / Title / (805) 325-7281x (805) 861-8121x ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Agency-Defined Topic Title ~ Hazmat Inventory -- MCP+DailyMax Order Hazmat Common Name... GASOLINE (UNLEADED) GASOLINE One Unified List Ail Materials at Site ISpooHazlEPA HazardsI Frm DailyMax Unit MCP F IH DH L 8000 GAL Mod F IH DH L 4000 GAL Mod (TYpe pr'in~ reviewed "-'~ ' '""'~"-~ ' --¥ ..... mateda~s manag®- co,,o[:,~,~ :-~ ;'"',"~"'": :"-",'},~ sqd corre~ man- any corrections agement plan for my facili~. ..... -1- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 = Inventory Item 0002 Facility Unit: Fixed Containers on Site GASOLINE (UNLEADED) Days On Site 365 Location within this Facility Unit CAS# 8006-61-9 STATE I TYPE PRESSURE Liquid Pure Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cont.this Loc GAL AMOUNTS STORED AND IN USE DailyMax this Loc GAL 8000.00 DailyAvg this Loc GAL 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS EHS CAS# No 8006619 -2- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 = Inventory Item 0001 Facility Unit: Fixed Containers on Site GASOLINE Days On Site 365 Location within this Facility Unit S SIDE OF FACILITY CAS# 8006-61-9 STATE TYPE I PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cont.this Loc GAL AMOUNTS STORED AND IN USE DailyMax this Loc GAL 4000.00 DailyAvg this Loc GAL 2000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. I EHS CAS# 100.00I Gasoline No 8006619 -3- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 Fast Format Notif./Evacuation/Medical Agency Notification Overall Site 03/25/1991 FOR GAS RELATED HAZARDS SPILLS, BP WOULD BE CONTACTED THROUGH STUART PETROLEUM. FOR FIRE AND OTHER EMERGENCY SITUATIONS HELP WOULD BE SOUGHT Employee Notif./Evacuation 03/25/1991 ONLY ONE TO TWO PERSON WORK AT ONE TIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP TO CONTROL THE SITUATION. -- Public Notif./Evacuation 03/25/1991 BEING A VERY SMALL BUSINESS, EVERYBODY IN THE FACILITY WOULD BE VERBALLY NOTIFIED OR EVACUATED. Emergency Medical Plan 03/25/1991 KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GET EMERGENCY MEDICAL HELP. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS EAST OF THIS BUSINESS. -4- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 Fast Format Mitigation/Prevent/Abatemt Release Prevention Overall Site 03/25/1991 EMERGENCY SWITCH WILL BE ACTIVATED IMMEDIATELY. IF SPILL DOES OCCUR, PROFESSIONALLY TRAINED HELP WILL BE REQUESTED TO PROPERLY HANDLE THE SPILL. -- Release Containment 03/25/1991 FIRST AND FOREMOST STEPS WILL BE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH. THIS WILL STOP PUMP THUS NO MORE GAS WILL BE RELEASE. MOVE ALL VEHICLES AND OTHER SOURCES OF IGNITION TO SAFER AREA. REQUEST THAT SMOKERS EXTINGUISH HIS SMOKE. DIKE WITH SAND OR EARTH TO CONTAIN THE RUN OFF. DISPOSE OF THE SAND IN ACCORDANCE TO RULES AND REGULATIONS. -- Clean Up 03/25/1991 IF SITUATION WARRANT SPECIAL CLEAN UP TEAM IS NEEDED THEN BP WOULD BE ASKED TO PROVIDE THAT ASSISTANCE. IN OTHER SITUATIONS LOCALLY COMPETENT ESTABLISHMENT WOULD BE CONTACTED TO CERTIFY THE SITUATION. Other Resource Activation -5- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 Fast Format Site Emergency Factors Special Hazards Overall Site -- Utility Shut-Offs 10/09/1990 A) GAS - NONE B) ELECTRICAL - EAST WALL ALONG THE BACK DOOR C) WATER - EAST WALL AND NORTH WALL D) SPECIAL - EMERGENCY SHUT-OFF SWITCH FOR GAS PUMPS NORTH OF ENTRANCE DOOR E) LOCK BOX - NO -- Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT SITE 10/09/1990 FIRE HYDRANT - NORTHWEST CORNER OF BAKER AND NILES. Building Occupancy Level -6- 04/30/1997 LUCKY 7 DELI-MART SiteID: 215-000-000852 Fast Format Training -- Employee Training WE HAVE 2 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. Overall Site 10/22/1993 BRIEF SUMMARY OF TRAINING: ALL THE EMPLOYEES ARE KNOWLEDGEABLE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH, ELECTRIC MAIN SWITCH, WATER HYDRANT. DEPENDING UPON THE SERIOUSNESS OF SITUATION, THEY ARE ASKED TO CONTACT 911 OR OTHER APPROPRIATE EMERGENCY. GET EVERYBODY OUT OF THE BUILDING AND MOVE TO A SAFE CORNER OF BAKER AND NILES STREET. -- Page 2 -- Held for Future Use Held for Future Use -7- 04/30/1997 pertinent ordinances, to display, store~ instol~, us~; opera, sell or handle materials; ditions deemed hazardous to life or property as follows: .:' m-ao~el o~ ~D FIR~~' DEFART4; ' . ~pray Rib:e, 700 Nfles~ .flnkernffe!fi, CA 11/01/95 LUCKY 7 DELI-MART 215-000-000852 Overall Site.with 1 Fac. Unit General Information Location: 714 NILES ST Map:103 Haz:2 Type: 3 I City : BAKERSFIELD Grid: 29B F/U: 1 AOV: 0.0 Contact Name Title HARNEK S. SANDHU / Business Phone: (805) 325-7281x 24-Hour Phone : (805) 861-8121x Pager Phone : ( ) - x Contact Name. Title SHARAN K. SANDHU / Business Phone: (805) 325-7281x 24-Hour Phone : (805) 861-8121x Pager Phone : ( ) - x Administrative Data Mail Addrs: 714 NILES ST City: BAKERSFIELD Comm Code: 215-002 BAKERSFIELD STATION 02 D&B Number: 770007-6737 State: CA Zip: 93305- SIC Code: Owner: HARNEK SANDHU Phone: (805) 325-7281 Address: 1820 ALTA VISTA #1 State: CA City: BAKERSFIELD Zip: 93305- Summary 11/01/95 Pln-Ref Name/Hazards LUCKY 7 DELI-MART~ 215-000-000852 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Form Max Qty Page MCP 02-001 GASOLINE · Fire, Immed Hlth, Delay Hlth Liquid 4000 Moderate GAL 02-002 GASOLINE (UNLEADED) · Fire, Immed Hlth, Delay Hlth Liquid 8000 Moderate GAL 11/01/95 LUCKY 7 DELI-MART 215-000-000852 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 02-001 GASOLINE · Fire, Immed Hlth, Delay Hlth Liquid 4000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 4,000 Daily Average GAL 2,000.00 Annual Amount GAL 24,000.00 Storage UNDER GROUND TANK Press T Temp Location -- Conc 100.0% IGasoline 'Components MCP ---~uide ModerateI 27 02-002 GASOLINE (UNLEADED) · Fire, Immed Hlth, Delay Hlth Liquid 8000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 8,000 Daily Average GAL 5,000.00 Annual Amount GAL 70,000.00 Storage UNDER GROUND TANK Press T Temp AmbientlAmbientI Location -- Conc 100.0% IGasoline Components MCP ----~uide IModerateI 27 11/01/95 LUCKY 7 DELI-MART 215-000-000852 Page 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification '~ FOR GAS RELATED HAZARDS SPILLS, BP WOULD BE CONTACTED THROUGH STUART PETROLEUM. FOR FIRE AND OTHER EMERGENCY SITUATIONS HELP WOULD BE SOUGHT THROUGH 911 <2> Employee Notif./Evacuation ONLY ONE TO TWO PERSON WORK AT ONE TIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP TO CONTROL THE SITUATION. <3> Public Notif./Evacuation BEING A VERY SMALL BUSINESS, EVERYBODY IN THE FACILITY WOULD BE VERBALLY NOTIFIED OR EVACUATED. <4> Emergency Medical Plan KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GET EMERGENCY MEDICAL HELP. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS EAST OF THIS BUSINESS. 11/01/95 LUCKY 7 DELI-MART 215-000-000852 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt 5 <1> Release Prevention EMERGENCY SWITCH WILL BE ACTIVATED iMMEDIATELY. IF SPILL DOES OCCUR, PROFESSIONALLY TRAINED HELP WILL BE REQUESTED TO PROPERLY HANDLE THE SPILL. <2> Release Containment FIRST AND FOREMOST STEPS WILL BE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH. THIS WILL STOP PUMP THUS NO MORE GAS WILL BE RELEASE. MOVE ALL VEHICLES AND OTHER SOURCES OF IGNITION TO SAFER AREA. REQUEST'THAT SMOKERS EXTINGUISH HIS SMOKE. DIKE WITH SAND OR EARTH'~TO.CONTAIN THE RUN OFF. DISPOSE OF THE SAND IN ACCORDANCE TO RULES AND REGULATIONS. <3> Clean Up IF SITUATION WARRANT SPECIAL CLEAN UP TEAM IS NEEDED THEN BP WOULD BE ASKED TO PROVIDE THAT ASSISTANCE. IN OTHER SITUATIONS LOCALLY COMPETENT ESTABLISHMENT WOULD BE CONTACTED TO CERTIFY THE SITUATION. <4> Other Resource Activation 11/01/95 LUCKY 7 DELI-MART 215-000-000852 Page 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - EAST WALL ALONG THE BACK DOOR C) WATER - EAST WALL AND NORTH WALL. D) SPECIAL - EMERGENCY SHUT-OFF SWITCH FOR GAS PUMPS NORTH OF ENTRANCE DOOR E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT SITE FIRE HYDRANT - NORTHWEST CORNER OF BAKER AND NILES. <4> Building Occupancy Level 11/01/95 LUCKY 7 DELI-MART 215-000-000852 Page 00 - O~erall Site <G> Training 7 <1> Employee Training WE HAVE 2 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: ALL THE EMPLOYEES ARE KNOWLEDGEABLE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH, ELECTRIC MAIN SWITCH, WATER HYDRANT. DEPENDING UPON THE SERIOUSNESS OF SITUATION, THEY ARE ASKED TO CONTACT 911 OR OTHER APPROPRIATE EMERGENCY. GET EVERYBODY OUT OF THE BUILDING AND MOVE TO A SAFE CORNER OF BAKER AND NILES STREET. <2> Page 2 <3> Held for Future Use <4> Held for Future Use LU~ '7 DEL I-MART 215-OOO-O,:}C~ Overall Site witi~ 1 Fac. Ur, it 00TBl1993 ~/i'~ 1 Ger, era I I r, format i or, By. v/--t.. ,- ......... Loc. atior~: '714 NILES ST Map: 103 Hazard: Low tCc, r,m~ur~ity: BAKERSFIELD STATION 02 Grid: 29B F/U: I AOV: 0.0 i........ Cor~tact Name ..... [ ........... Title HARNEK S. SANDHU SHARAN K. SANDHU Mail Addrs: 714 NILES ST City: BAKERSFIELD Corem Code: 215-002 BAKERSFIELD STATION 02 Busir, ess Phor~e i 24-Hour Phor, e.1 ~-~= - ,. ,~ .-,. (805) 325-'7281 x (8.J~) 8~1-~,-1] 'F, (805) 861--8121 ~ (80~) 325'-7281 x Admir~istrat ive Data D&B Number: 770007-6737- State: CA Zip: 93305- SIC Code: -)~_- Owner: HARNEK SANDHU Phor~e: (SL~) 325-7281 Address: 1820 ALTA VISTA ~1 State: CA City: BAKERSFIELD zip: 9~L~- Summary ~y~ ~ ~nt ~) .... reviewed the a~ached ment plan br ~d~.~-~'~ and.t~ ~it along ~h (~me of B~I~) ~ement plan ~o~ m~ f~cilit~. Signature Date 09/30/93 Page LUCKY 7 DELI-MART 215-000-000852 Hazr~at Ir~ver~tory List ir~ MCP Order 02 - Fixed Cor~tair~ers c,r~ Site P 1 r~-Ref Na~e/Hazards 02-001 GASOL I NE F o r rf~ Liquid Max Qty MCP .-~' Moderate Fire, Ir~r~ed Hlth, Delay Hlth GAL 02-002 GASOL I NE (UNLEADED) Fire, Ir~med Hlth, Delay Hlth Liquid 8000 Moderate GAL 09/30/93 I 7 DEL I-MART 215-000-000~:: 02 - Fixed Cor~tairsers ors Site Hazrnat Irsventory Detail irs MCP Order. Page 02-001 GASOL I NE Fire, Irnn~ed Hlth, Delay HIth Liquid 8800 Moderate GAL CAS ~$: 8006-61-9 Trade Secret: Nc, Forrn: Liquid Type: Pure Days: 365 Use: FUEL ~ Daily Max GAL Storage UNDER GROUND TANK Daily Average GAL Arsrsual Ar~ourst GAL ~- Press T ]"ernp .~ Locat ior~ Ar~bier~t~Ambier~t~S SIDE OF FACILITY -- Corsc - 100.0% ~Gasoline Corn por~er~t s ..... MCF. .... Guide [ Moderat e I 2"7 02 -002 GASOLINE (UNLEADED) Fire, Irnn~ed Hlth, Delay Hlth Liquid 8000 Moderate GAL CAS ~: 8006-61-9 Tr. ade Secret: Nc, Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 8,000 Daily Average GAL 5,000.00 Anr~ual Arnourrb GAL -- 70,000.00 Storage UNDER GROUND TANK Press T Ternp -T Arn b i erst |A~n b i errbI Locat i oYs -- Cor;c -. 100.0~ lGasolir~e ! Comporser~t s .... MCP --~uide IModer. at ~ I 27 09/30/93 LUCKY 7 DELI-MART 215-000-000852 Page 00 - Overall Site <D> Notif. /Evacuatior~/Medical 4 <1> Agency Notification FOR GAS RELATED HAZARDS SPILLS, BP WOULD BE CONTACTED THROUGH STUART PETROLEUM. FOR FIRE AND OTHER EMERGENCY SITUATIONS HELP WOULD BE SOUGHT THROUGH 911 <2> E~ployee Notif./Evacuation ONLY ONE TO TWO PERSON WORK AT ONE TIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP TO CONTROL THE SITUATION. <3> Public Notif./Evacuation BEING A VERY SMALL BUSINESS, EVERYBODY IN THE FACILITY WOULD BE VERBALLY NOTIFIED OR EVACUATED. <4> E~erger~cy Medical Plar~ KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GET EMERGENCY MEDICAL HELP. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS EAST OF THIS BUSINESS. 09130/93 7 DELI-MART 215-000-~ 00 - Overall Site <E> Mitigation/Prevent/Abater~t Page 5 <1> Release PreverJtion EMERGENCY SWITCH WILL BE ACTIVATED IMMEDIATELY. IF SPILL DOES OCCUR, PROFESSIONALLY TRAINED HELP WILL BE REQUESTED TO PROPERLY HANDLE THE SPILL. <2> Release Cor~tairJ~ent FIRST AND FOREMOST STEPS WILL BE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH. ]'HIS WILL STOP PUMP THUS NO MORE GAS WILL BE RELEASE. MOVE ALL VEHICLES AND OTHER SOURCES OF IGNITION TO SAFER AREA. REQUEST THAT SMOKERS EXTINGUISH HIS SMOKE. DIKE WITH SAND OR EARTH TO CONTAIN THE RUN OFF. DISPOSE OF THE SAND IN ACCORDANCE TO RULES AND REGULATIONS. <3> Clean Up IF SITUATION WARRANT SPECIAL CLEAN UP' TEAM IS NEEDED THEN BP' WOULD BE ASKED TO PROVIDE THAT ASSISTANCE. IN OTHER SITUATIONS LOCALLY COMPETENT ESTABLISHMENT WOULD BE CONTACTED TO CERTIFY THE SITUATION. <4> Other Resource Activatior~ 09/30/93 LUCKY ? DELI-MART 215-000-000852 00 - Overall Site <F> Site ~Er~ergency Factors Page 6 <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELE[]TRICAL - EAST WALL ALONG THE BACK DOOR C) WATER - EAST WALL AND NORTH WALL D) SPECIAL - EMERGENCY SHUT-OFF SWITCH FOR GAS PUMPS NORTH OF ENTRANCE DOOR E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT SiTE FIRE HYDRANT' - NORTHWEST CORNER OF BAKER AND NILES. <4> Building Occupancy Level 09/~0/9S 7 DELI-MART 215-00( 00 - Overall Site <G> Trair~ir~g Pa~e 7 <1> Page 1 WE HAVE ~ EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF ]'RAINING: ALL THE EMPLOYEES ARE KNOWLEDGEABLE TO ACTIVATE THE EMERGENCY SHUT-OFF SWITCH, ELECTRIC MAIN SWITCH, WATER HYDRANT. DEPENDING UPON THE SERIOUSNESS OF SITUATION, THEY ARE ASKED 'TO CONTACT 911 OR OTHER APPROPRIATE EMERGENCY. GET EVERYBODY OUT OF THE BUILDING AND MOVE TO A SAFE CORNER OF BAKER AND NILES STREET. <2> Page 2 as r~eeded <3> Held for Future Use <4> Held for Future Use 09/30/93 LUCKY ? DELl-MART 215-000-000852 00 - Overall Site <H> RMPP DATA Page 8 <1> Release Cor~tairm~ent <2> Offsite Cor~sequer~ces <3> In House Capabilities <4> Plar~t Shutdowr~ Ir~structior~ 03/06/91 RECEIVED Overall Site with 1 Fac. Unit Aas'd ............ General Ir~formation Page Location: 714 NILES ST Map: 1(:)3 Hazard: Low Ident Number: 215-()[)(])-(:)()(')852 Grid: 29B Area of Vul: O. 0 C,:,nt act Name ....... T i t 1 e Busir, ess Phone 24 Hour Ph,:,ne. HARNEK S. SANDHU (805) 325-7881 x (805) 861-8181 SHARAN K. SANDHU (805) 385-7881 x (805) 861-8181 .... -- Admir, istrative Data Mail Addrs: 714 NILES ST City: BAKERSFIELD State: CA Zip: 933C)5- Corem Code: 215-002 BAKERSFIELD STATION -),... SIC Code: Owner: HARNEK SANDHU Phor, e: Address: 1820 ALTA VISTA #1 State: CA City: BAKERSFIELD Zip: 93305- Surnrnary ~, i.)4~FA $. ~,F,~,u Do hereby certi~ that ~ h~v~ ~,-.~,,~ materials reviewed the ~ttached m~nt Plan (hr ~-? - ~ ~:, md tha~ it alon~ any corre~ions con~itutm a completm and corrs~ plan for my facility. Signature I:' 1 r,- Re f Name/Hazards LUCKY 7 DELI-MART Hazmat Inverstory List irs MCP Order 02 - Fixed Containers on Site Fc,~--rn Quarst i t y Page MCP 2 02-OA 1 GASOL I NE Fire, Immed Hlth, Delay Hlth Liquid 8,800 GAL Moderate 03/06/91 L~CKY 7 DELI-MART 215-000-£~852 oO - Overall Site <D> Notif. /Evacuation/Medical Page <2_> Erllployee Notif. /Evacuatior, ONLY ONE TO TWO PERSON WORK AT ONE 'rIME. EACH PERSON IS DIRECTED TO LEAVE THE PLACE IMMEDIATELY AND SEEK EMERGENCY HELP' TO CONTROL THE SITUATION. <3> Public Notif. /Evacuation <4> Er~ergency Medical Plar~ KERN MEDICAL CENTER IS ONLY A COUPLE OF MILES. IF NECESSARY 911 COULD BE ACTIVATED TO GE]' EMERGENCY MEDICAL HELP'. HALL AMBULANCE IS LOCATED ONLY A FEW BLOCKS EAST OF THIS BUSINESS. 03/06/91 LUCKY 7 DELI-MART 215-000-000852 O0 - Overall Site <E> Mit igat ior,/Prever, t/Abater~t Page 4 <1> Release Prever, tion EMERGENCY SWITCH WILL BE ACTIVATED IMMEDIATELY. IF SPILL DOES OCCUR, PROFESSIONALLY ]'RAINED HELP' WILL BE REQUESTED TO PROPERLY HANDLE ]'HE SPILL. <2~ Release Cor, tair, mer, t <3> Clear, Up <4> Other Resource Activation 0~/06/91 KY 7 DELI-MART 215-000-0~m~.)852 O0 - Overall Site <F> Site Ernerger, cy Factors Page 5 <1> Special Hazards <2> Utility Shut-Offs A> GAS - NONE B) ELECTRICAL - EAST WALL ALONG THE BACK DOOR C) WATER - EAST WALL AND NORTH WALL D) SPECIAL - EMERGENCY SHUT-OFF SWITCH FOR GAS PUMPS NORTH OF ENTRANCE DOOR E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTEC]'ION - FIRE EXTINGUISHERS AT SITE FIRE HYDRANT - NORTHWEST CORNER OF BAKER AND NILES. <4> Held for Future use 03/06/91 Page 6 LUCKY 7 DELI-MART 215-000-000852 00 - Overall Site <G> Trainir~g < 1> Page 1 WE HAVE 3 EMPLOYEES AT '[HIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE {2> Page - as needed <3> Held for Future Use <4> Held for Future Use LUCKY 7 DELI-MART 2i5-000-000852 OYerall Site with 1 Fac. Unit Page Ger, eral I'nfr, rmat ior~ ILocatic, r,: 714 NILES ST - Map: 103 Hazard: Low Ider~t Number: 215-000-000852 Grid: 29B Area of Vul: 0.0 Contact Name IHARNEK S. SANDHU SHARAN K. SANDHU Mail Addrs: 714 NILES ST City: BAKERSFIELD Com~ Code: 215-002 BAKERSFIELD STATION 02 Title' Business Phnne (8(:)5) 325-7281 x 805) 861-8121 (805) 325-7281 x 805) 861-8121~ Admir~istrative Data St ate: CA ~Zip: 93305- SIC Code: Owner: HARNEK SANDHU Phone: ( ) - Address: 1820 ALTA VISTA #1 State: CA City: BAKERSFIELD Zip: 93305- Summary I, Do hereby certify that I have = (Type ~' i~int name) reviewed t~,e a~ach~d h~,~,,~,~ ms~eriais manage- ment p~an bt_ <N,,.,..~o~,.~,~.~.) .~md ~.hat it along with any corrections constitute a complete and correct man- agement plan for my facility. ........ ~ Sigr.,sture . D'~te .... _ CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY NON--TRADE SECRETS BUSINESS NAME' LUc~<'I-7-!~£LI'/U/~RT OWNER NAME: ////R/Y'£t( $, ~~U NAME OF THIS FACILITY: ~T~ . ~ t~~~ -- 8~ES~_ t~z~ ~T~ ¢~5T~ ,~/ STANDARD IND. CLASS CODE~ u~/~ ~1~: ~~ ~ ~t~oT ~,~ ~ZP: ~ER~F~ ~ q~3~ DUN AND BRADSTREET NUMBER ' REFER TO~NS~UU~IONS ~O~ PRO~ CODES I 2 3 4 5 6 1 89 l0 I1 12 Hlgy Names of Wixture/Comoonents Tr,ns !y~e Hax Average A,nual Heasure l~y~' Con~ Cent Cent ~le Loc,tjon?ece.~t Code ~ooe Amt Amc Est Units on 5ice Type Press Temp Stored in Pacl/1Cy See ]nstru'ct~ons ... Physical and Health Hazard C.A,S, Number Component I1 Hame ~ C,A,S, Number (Check all that apply) Component 12 Hame [ C.A,S. Number [~]XFire Hazard O Reactivity;l~ O Delayed ~ Suddan Release ~ Immediate Health of Pressure Health :~ Component 13 Name I C.A.S. Humber Physical I~d Health Uazard {Check al/ that app/M ;~ C,A.S, Humber Component I1 Name & C.A.S. Humber Component t2 Name & C.A.S, Number U Fire Hazard ~ Reactivity~ 0 Delayed ~ Sudden Release ~ ~: Health of Pressure ~ Component 13 Name I C.A,S, Humber Physical and Health Hazard C,A.S. Number Component I1 Name I C,A.S. Number {Check all thet app!y) : Component 12 Name & C,A.S. Number D ~ire Hazard ~ Reactivity ~ Delayed [] Sudden Release ~ Health of Pressure Component 13 Name & C,A,S. Number Phv$ica'l'~hd Health Nazard C,~.S. Number Component I~ Here & ¢.~,S. Humber : ~Check all.that apply| Component 12 Name I C,A.S. Number 0 Fire Hazard 0 Reactivity 0 Delayed [] Sudden Release [] lm~i~ Health of Pressure : Component t3 Name & C.A.S. Number EMERGENCY coNTACTS #1~me Title 24 Hr Phone N~e Title fertification .(Re~. ~.n.d.~fgn after completiOnS.al? secCi,on~) certify under eenalt~ el)aW tnqt J nave peEsonal~y, examlnqOeqoQm tamil~ar.~ith the information ~u~mittCd in this 8nd all at~ached.dQc~ments, an~ t~at oaseo on.my inquiry Qr.cnose lnOlvIOua/s responsiome for obtain(n9 the information. I believe that the suemltteo lntormatlon IS true, accurate, ano complete. ~)~F~le of owner/op~ritor eH owner/o~tOt's muthorized~)~[itive Bakersfield Fire ept. Hazardous Materials Inspection Date Completed RECEIVED EC 0 3 Business Name: LU~Ck,U Location: ~ldr ~(k.~, Plan ID # 215-000-~L~(~$?-- (Top right corner Business Plan) Station No. ~-- Shift ~ Inspector RECEIVED .u~:t; 0 8 1990 HA7 ~4AT. DIV. Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Verification of MSDS Availability Number of Employees ~ Verification of Haz Mat Training Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office Bakersfield Fire D pt. Hazardous Materials Inspection Business Name: oca on: Plan ID # 215-000°e'~gS' (Top right corner Business Plan) Station No. ~T'~ o Shift f~ Inspector Date Completed Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Verification of MSDS Availability Number of Employees RECEIVED 0CI 0 fi 19/~9 H~7_. MAT. DIV. Verification of Haz Mat Training CO1TLrnents .' Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office IUSINESS NAME BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 OFFICIAL USE ONLY ID# RECEIVED JUL 2 3 1987 A,n ............ 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 B. LOCATION / STREET ADDRESS: 71gp MILE CITY: c4q ziP: q3gob- BUS.PHONE: (~off) gZ~-TZ~I SECTION 2: EMERGENCY 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 TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE pURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A NHOLE A. NAT. GAS/PROPANE: ' B. ELECTRICAL: E~/4~ ~ ~ ~ ~r6-)~' C WATER: ~?~7 ~ ~~', , , E LOCK Box: YES / Nd~F YE~, LOCATI0~: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO MSDSS? YES / NO YES / 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 A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...- .................................... (YE~ NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES ~ YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. E~ ~ YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YESN~ YES NO REFRESHER SECTION ?: HAZARDOUS WATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUND. OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ~ NO I, S~4~ , 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. SIGNATURE '~ TITLE ~ DATE BAKERSFIELD CITY FIRE DEPARTMES~ 2130 "G" STREET BAKERSFIELD, CA 93301 BUSINESS NAME: OFFICIAL USE ONLY ID# BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoJ. d 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# FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AN~ EVACUATION PROCEDURES AT THiS UNIT ONLY - 3A - SECTION 3: HAZARDOUS MATERIALS FOR THIS b~IT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~ NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ If No, complete a separate hazardous' materials inventory form marked: NON-TRADE SECRETS ONLY ~(white form #4A-l~ If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION $: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPON~ERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS,/PROPAN~ B. ELECTRICAL: C. WATER: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO MSDSs9 YES / NO YES / NO KEYS? YES / NO - 3B · BAKEIISFIEI. D CITY FI. RE DEI'ARTMENT I.D. ~ FORM 4A:-I Page ~ of ~ NON--TRADE SECRETS ;~" HAZARDOUS MATERI ALS - INVENTORY ~ ADDRESS: 7~Ai~.Aii¥£~'s STfLZ£T ADDRESS: 1~--6 ~LT/)~II3TB-Y~z/FACILITY UNIT NAME: Za~-'t- ' . CITY, ZIP: g~'f~EL~ C~ ~3~6~ CITY,ZIP: ~R~flfL~ ~.~ q~fof ~ PHONE ~: (~df)]~_TZg). PHONE ~: ~5' ~/~flZ~ ~0FFICIALoNLY USE CFIRS C0Dg 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T ,CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE GUIDE. '1 E~ERGENCY cONTACT: TITLE: piibN~ BUS HOURS: AFTER BUS HRS: EMERGENCY CONTACT: f~gfl~ ~~D TITLE: fi'd~ PHONE ~ BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: ~~ AFTER BUS. HRS: ~a~2~'-TZ~l - .4~-1 -