HomeMy WebLinkAboutBUSINESS PLANHazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
Permit ID#:: 015-000-001008
SEARS ROEBUCK & CO
LOCATION': 3001 MING AVE
Issued by:
This ~ermit is issued for the followin_o:
[] Hazardous Materials Plan
El Underground Storage of Hazardous Materials
[] Risk Management Program
El Hazardous Waste On-Site Treatment
OFFICE OF ENV1R ONMENTAL SER VICES
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301
Office of EvironmentaTServices
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: June 30, 2003
Issue Date
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
PERMIT ID# 015-021001008
SEARS ROEBUCK & CO
LOCATION 3001 MING
Issu~xl by:
~,~,~,,~,'~=-?'??i??Y?y~ i~,,~,~ This permit is issued for the following: '
.... ,,~r??~ ~" ~" / :73~:;~,::';;~;::~;~::;:;~:;:ii,~.: ii: ~5;.!E~Hazardous Materials Plan
.... ,?'~ii'?. !J~!: ::~'~'~'~:':':~iiiiiii!!iiii,:; , i?::'?iilD;O~e[ground Storage of Hazardous Materials
~{h..... '-" ~ $ :~ ~" "~N?". ~ ~: ="~" 47', '".
'~ ......~. '~ ,,~i~I '%~'~, ~ .'. ~ ~'i,'~, · .~ '~ 1~"~ "' .,r'-?'~ .fi' ' '
'~. ""'"'"' ~ ' '~Ji' .~4~a ~,,~:'~,=~"",v..~.- ..=.-.-~-.:-~'~'~,.J:'~:":~ ~ ~ ~ ~ "? ~ ~ '~
"~'". ........ ..% ~ ~ ~":~ ~' ~ i~ ~ ~r ~ '"'~ ~ "~L,~'"~' ' i t,
"::~u~]...-:' ,,' /-," .-" .;' .," ." ," ,' ./ .,' J [~ :i
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:
¥1ph .ucy,~7
Office of i/~m~J~entai Serv/~es
Expiration Date:
June 30:2000
A B C
Site Address: 300i Ming
,Bakersfield tMap #:4 I
F G H I
Ming Ave
-- Val./ey Plaza Mall
Searg Auto Center
(~) Water Main
['F~ Fire Hydrant
o~-~ Storm Drain
~cc~[e:
UnoleFineot
North
4
?
SITE MAP Il Business
Name:
Sears ~1318
F G H I
Emergency Generator
Helium Tank
Spill Kit
/2.~X
Waste Gas
Fire Riser
Gas Main
Electric Main
1,,=56'
{North
.i
CALIFORNIA ANNOTATED SITE MAP
Business Name:
B C D E
Sears Auto Center #6781 iS~te Address: 300i Ming
Bakersfield { Map #:1
F G H I
Electric Main
Water Main
Gas Main
Fire Riser
7
New Batteries
Spill Kit
Winshield Washer
Antifreeze
ATF
Motor Oil
Fire Extinguishers
Used Batteries
Wheel Cleaner
1"=15'
North
A B C
Site Address: 3001 Ming
Bakersfield
D E F G
4
Map #: 2
Basen ent:
Electric Main
(~ Water Main
~ Gas Main
(~ Fire Riser
~-~ New Batteries
/~_k Spill Kit
[] Winshield Washer
(~) Antifreeze
~-~ ATF
~ Motor Oil
~-~ Fire Extinguishers
[-~ Used Batteries
~ Wheel Cleaner
1#=15,
Nor!h
SITE/FACILITY
FORM $
(CHECK ONE) SITE DIAGR~
UNIT ~:l, OF
FACILITY DIAGRAM
,E
Inspector's Comments):
-OFFICIAL' USE ONLY-
l(
Kev~- ~artin
Stor~..~nager
3001 Ming Avenue
Bakersfield, CA 93304
832-2111
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA' 93301 (661) 326-3979
BUSINESS OWNER / OPERATOR IDENTIFICATION
FACILITY INFORMATION
.sgo ]___ o~ 1
I. FAClLITYIDENTIFICATION : "
FACLrR'ol i ~l~il' ' Year Beginning ~°° I Year Ending 2/9/05
............ ! 1._~_ I _.1 ..... ~ ............. 2/9/04
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) ................ %'- / 'E~ u ~i'~-E~-~-O~ b NE- ....................
Sears- Bakers e]d.#13 la / ..................................... J
SITE ADDRESS lO3
3001 ML~g Avenue
CITY Bakersfield 104 CA I ZIP 93304 ~o5
DUN & ~o6J SIC CODE m7
BRADSTREET 001629955 (4 Digit #) 5399, 7549
COUNTY Kern ~o.
OPERATOR NAME Sears Roebuck and Co. '0;"-'I'~;ERAToR P~;N-E' (847)2~-6}-};'i3- ......... ;';;
II. OWNER INFORMATION' ;"
OWNER NAME Sears Roebuck and Co. m OWNER PHONE (847) 246-5313 m
OWNER MAILING
ADDRESS
3333 Beverly Road A2-262A
CITY Hoffman Estates
CONTACT NAME Joel Greene
CONTACT MAILING
ADDRESS
114 STATE IL .5 i zIP 60179
III. ENVIRONMENTAL CONTACT
~7 CONTACT PHONE (84?) 246-5313
3333 Beverly Road A2-262A
113
116
118
119
I
Hoffman
Estates
~20
I STATE IL ~2~ / ZIP 60179 ~22
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY-
NAME Wayne Miller 123 NAME Gary Endicott 129
~25 TITLE Store General Manager 13o
TITLE _Operations Manager
BUSINESS PHONE (661) 833-5389
~2~ BUSINESS PHONE (661) 833-5382
24-HOURPHONE 661-664-8157 127 24-HOURPHONE (661) 654-0731
PAGER # ~28 PAGER # ~33
V. CERTIFICATION ..
Certification: Based on my inquiry of these individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and
familiar~-~ L ,~with the ff~rmation submitted in this inventory and believe the information is true, accurate, and complete.
SIG NA/~'~! ~//~~)I:;ERATO R '--'DAT~'---'-~ '' ..... ~34 ' N~,~'E-b~ Docui~I'NT PRE~AR~'R ~35
/ '~./)/~.///O7 Brian Vernetti, 3E Company
~ oe~l ~~ ~-R/OI~ERATOR (print) 130I J TITLE O~ OW,ER/OPERATOR 137
L. / EH&S Compliance ~anager
UPCF (7/99)
C:\WlNNT40\Profiles\jtraylor.000\Desktop\OES2730.wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2.
3.
4.
5.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be as brief and concise as possible.
You may also attach Business Owner / Operator Form and Chemical Description Form(s) to
the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Sears #1318 / 6781
LOCATION: 3001 Ming Avenue, Bakersfield, CA 93304
MAILING ADDRESS: 3001 Ming Avenue, Bakersfield, CA 93304
CITY: Bakersfield
STATE: CA ZIP: 93304 PHONE: (661)833-5300
PRIMARY ACTIVITY: Retail General Merchandise and Auto Parts Facility
OWNER: Sears Roebuck and Co. PHONE: (847) 286-5313
MAILING ADDRESS: 3333 Beverly Road A2-262A, Hoffman Estates, IL, 60179
EMERGENCY NOTIFICATION
CONTACT TITLE
I. Wayne Miller Operations Manager
BUS. PHONE
(661) 833-5389
24 HR. PHONE
661-664-8157
2. Gary Endicott Store General Manager (661) 833-5311 Hm (661) 654-0731 Cell (661) 203-1392
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
Daily visual inspection by employees.
B. EMPLOYEE AND AGENCY NOTIFICATION:
In the event that outside notification is required, the emergency coordinator will telephone the fire department
and other applicable agencies. Depending on the severity of an emergency incident, a partial or complete
evacuation will be ordered by the emergency coordinator. The emergency coordinator may use the PA system,
telephones or verbal means to initiate evacuation procedures.
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
Asset Protection Manager and Operations Manager or Joel Green, Sears Roebuck & Co. EHS Compliance
Manager.
D. EMERGENCY MEDICAL PLAN:
In the event of a medical emergency, the manager on duty will call 911 or the proper medical facility will be
contacted. Industrial Medical Group at 2501 G Street is the preferred medical facility for this place of business
(Phone: 661-327-2225).
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
ho
HAZARD ASSESSMENT AND PREVENTION MEASURES:
Incompatible chemicals are separated by 20 feet or by one-hour separation, and are stored in their original
containers. Batteries are stored on a designated rack or on a shrink-wrapped pallet in a well-ventilated
room away from drains and sources of electricity. Flammable materials not for retail sale are stored in a
flammables cabinet. Used materials are stored in properly labeled drams, and are also kept away from
drains and source of electricity.
Bo
RELEASE CONTAINMENT AND/OR MITIGATION:
Trained employees manage small spills of identified chemicals as long as there are no threats to human
life or the environment. A spill boom will be used immediately to block the flow of liquids from entering
any nearby drains. The MSDS' for spilled materials are consulted for proper guidance in handling the
substances and the spill kits are obtained. Proper PPE is donned before handling spilled product. In the
event of a large spill, fire, or release that threatens human health and/or the environment, the local fire
department and environmental health department will be contacted. In the event of a small fire, if safe
to do so, a fire extinguisher may be used to extinguish the fire.
CLEAN-UP AND RECOVERY PROCEDURES:
Employees will address small spills following the procedures outlined in the mitigation section of this plan. The
proper disposal, spill and leak procedures for each hazardous material at the facility is detailed in the facility's
Environmental Operations Manual. Trained employees will clean up spilled hazardous materials and used absorbents
and place them in DOT approved containers. These containers will be properly labeled and stored according to local,
state and federal regulations. All hazardous waste materials will be disposed of by outside contractors at RCRA
approved facilities.
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE: Outside - dock ramp: N. Wall
ELECTRICAL: Electric room, northwest comer of the building
WATER: Middle of the building along the north side
SPECIAL:
LOCK BOX: YESQ IF YES, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAIl ,ABILITY
Bo
PRIVATE FIRE PROTECTION: Fire Extinguishers
Sprinkler System Fire Risers Fire Hose (Full Line Store)
WATER AVAILABILITY (FIRE HYDRANT): In the north parking lot
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: 250
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
In Asset Protection & Hub Office
Employees receive a training guide that covers the handling of hazardous materials and environmental management procedures.
Employees are trained on the proper storage and handling methods of hazardous materials during their new employee orientation
period. All employees are trained in the isolation of a spill and prevention of spilled materials from entering storm and sewer systems.
In addition employees are trained in the use of absorbent materials and neutralizers to control and clean up spills, fire prevention and
response, and how to respond to medical emergencies. Annual refresher trainings are conducted and safety meetings are held on an as
needed basis.
Management personnel are trained in the proper procedures for agency notification, emergency response, and evacuation notification.
CERTIFICATION
I, Joel Greene CERTIFY THAT THE ABOVE
INFORMATION 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.
.~~~~~t~~ EH&S Compliance Manager
//~ATURE TITLE DATE
4
SEARS ROEBUCK & CO
Manager-:
Location: 3001 MING AVE
City : BAKERSFIELD
DEC ~ 20&~
CommCode: BAKERSFIELD STATION 07
EPA Numb:
BusPhone:
Map : 123
SiteID: 015-021-001008
(661) 833-5300
CommHaz : Moderate
Grid: 12A FacUnits: 1 AOV:
SIC Code:5399
DunnBrad:
Emergency Contact / Title
FILOMENA EVANS / OPERATIONS MGR
Business Phone: (661) 833-5389x
24-Hour Phone : (661) 397-4220x
Pager Phone : ( ) x
Emergency Contact / Title
GARY ENDICOTT / STORE GEN MGR
Business Phone: (661) 833-5382x
24-Hour Phone : (661) 654-0731x
Pager Phone : ( ) - x
Hazmat Hazards:
Fire Press React ImmHlth DelHlth
Contact : JOEL GREENE
MailAddr: 3333 BEVERLY RD A2262A
City : HOFFMAN ESTATES
Phone: (847) 246-5313x
State: IL
Zip : 60179
Owner SEARS ROSEBUCK & CO
Address : 3333 BEVERLY RD A2262A
City : HOFFMAN ESTATES
Phone: (847) 246-5313x
State: IL
Zip : 60179
Period :
Preparer:
Certif'd:
ParcelNo:
to
TotalASTs: =
TotalUSTs: =
RSs: No
Gal
Gal
Emergency Directives:
I, ~ Do h~reby cattily thai ~ hav~
reviewed ~he ~ached h~ardous ma~e~als
mere p~an ~o~ ~,[~ /~/~ and ~ha~
(~e of Bu~lne~)
any corr~io~s ~ns~itu~ a complete and ~rr~ man-
a~emsnt plan ~or my facility.
-1- 10/21/2003
SEARS ROEBUCK & CO
= Hazmat Inventory
-- MCP+DailyMax Order
Hazmat Common Name...
SULFURIC ACID (BATTERIES)
UNLEADED GASOLINE
WASTE OIL ~
WASTE ANTIFREEZE
BRAKE FLUI D~~
MOTOR OIL
~' R IH
F IH DH
Si~eID: 015-021-001008
/ By Facility Unit
Fix~jontainers on Site ~
Frm xI D~n~tlMcP
-~ I ~ 3~ GAL Mod
~ ~ ~'l~T L
IH DH L
\\%.4~H L
~F--P~--~H -L
· III C
250.00 GAL Low
138.00 GAL Low
Q~GAL Low
1 · '
500.00 GAL Min
~u.00 FT3 Mzn
F
U_Lji% .e,o
-2- 10/21/2003
SEARS ROEBUCK & CO
~- Inventory Item 0007
-- COMMON NAME / CHEMICAL NAME
SULFURIC ACID
Location within this Facility Unit
SiteID: 015-021-001008
Facility Unit: Fixed Containers on Site
51 Days On Site
365
Map: i CAS#
/~/ 7664-93-9
rSTATE TYPE PRESSURE TEMPERATURE
~l ~ .k~, I Ambient ~mbient
/~ r~ AT T~CAT~ON
Largest Container /~(/ Daily Maximum ]
3.50
L~)'S~&]' ~ ~ r] ~-~. 0 C~--~7 7 8. O-0 LB? ,
:~Sulfuric Acid (EPA)
CONTAINER TYPE
Daily Average
CAS# I
7664939
ITsecret slBioHaz
No N No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies -P- R IH
NFPA I USDOT#
= Inventory Item 0006
-- COMMON NAME / CHEMICAL NAME
UNLEADED GASOLINE --~-~ ~
Location within this Facility/~nit Map: .;[
SW CORNER OF BUILDING
~ TYPE ~RESSURE TEMPERATURE
AMOUNTS AT THIS LOCATION
ILargest Container I DailY Maximum
30.00 GAL 30.00 GAL
Fac/i~ity Unit: Fixed Containers on Site
Days On Site
365
CAS#
8006-61-9
~LASTq C -¢~,~ ~ A-IuNER-~
Daily Average
15.00 GAL
I%Wt. I
100.00 Gasoline
HAZARDOUS COMPONENTS
8006619I
ITSecretI ~S BioHaz
No N No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards I~ - ~NFPA / USDOT#
No/ Curies F IH DH
McPI
Mod
-4- 10/21/2003
SEARS ROEBUCK & CO
~ Inventory Item 0001
-- COMMON NAME / CHEMICAL NAME
WASTE OIL
Location within this Facility Unit
SW AUTOMOTIVE GROUND LEVEL
STATE ~ TYPE
Liquid /Waste
PRESSURE
Ambient
Largest Container
250.00 GAL
SiteID: 015-021-001008
Facility Unit: Fixed Containers on Site
~n Site
Ma : '
CAS#
TEMPERA~RE CONTAINER TYPE
I Ambie~ ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Daily Maximum
250.00 GAL
Daily Average
125.00 GAL
HAZARDOUS COMPONENTS
I%Wt. I
100.00 Waste Oil, Petroleum Based
HAZARD ASSESSMENTS
Radioactive/Amount I EPA Hazards
No/ CuriesI F DH
NFPA
USDOT# J MCP
Low
///
= Inventory Item 0010
-- COMMON NAME / CHEMICAL NAME
WASTE ANTIFREEZE
Location within this Facility Unit
AUTO CENTER
Facility Unit: Fixed Containers on Site
Days On Site
CAS#
107-21-1
r STATE ~ TYPE PRESSURE TEMP~J~URE
Liquid I Waste I Ambient I ~ent
AMOUlXI~t~'._'~._AT THIS LOCATION
I Largest Container I /Daily Maximum
CONTAINER TYPE
PLASTIC CONTAINER-A~-
Daily Average
69.00 GAL
%Wt.
HAZARDOUS COMPONENTS
Ethylene Glycol
N 107211
HAZARD ASSESSMENTS
Radioactive/Amount I EPA Hazards
No/ CuriesI F -j[~ DH
NFPA
i l Ol
IUSDOT#
Low
-5- 10/21/2003
SEARS ROEBUCK & CO SiteID: 015-021-001008
~ Inventory Item 0009 Facility Unit: Fixed Containers on Site
BRAKE FLUID Days On Site
365
Location within this Facility Unit Map:; ¥ Grid:~5
~NTAINER TYPE
~M~AL CONTAINR-NONDRUM
F STATE TYPE PRESSURE TEMPERATURE
Liquid { i~a~-e .~bkl Ambient I Ambient I
AMOUNTS AT THIS LOCA~/~N
Largest Container I Daily Maximum/z Daily Average I
~ 6, f> O ~-6:0~H~ GALI [~ ~ ' O O~ GAL 30- O 6)60. 0 ~ GAL
100.00 Brake Fluid, Hydraulic (Diethylene Glycol Monob... N gl~
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards I NFPA
No/ Curies F ~_~ DHI ~/~
IUSDOT#
Low
FREON R-11 ~ -- /D~On Site
Location within this Facil~ml~Unit Map~ 365
BASEMENT/A/C RM MAIN STR ~~ CAS#
~ 75694
STATE TYPE I PRESSURE
I
Ambient
Pure
Liquid
Largest Container
1800.00 FT3
TEMP~
THIS
y Maximum
1800.00
FT3
CONTAINER TYPE
IN MACHINE/EQUIP
Daily Average
1800.00 FT3
%Wt. I //~ARDOUS COMPONENTS
100.00 Freon 11~
.// HAZARD ASSESSMENTS
TSecret, R~ioHazI Radioactive/Amount I EPA Hazards
No ·~ I No No/ Curies F P IH
NFPA
///
CAS#
IUSDOT#
75694
Min
-6- 10/21/2003
SEARS ROEBUCK & CO SiteID: 015-021-001008
~ Inventory Item 0008 Facility Unit: Fixed Containers on Site
MOTOR OIL Days On Site
Location within this Facility Unit Ma · ~ ' ·
CAS#
FSTATE ~YPE,- PRESSURE TEMPE~URE CONTAINER TYPE
Liquid I {~-e ~ [ Ambient I A~ent I ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum I Daily Average
250.00 GALI 500.00 GALI 250.00 GAL
%Wt.
100.00
HAZARDOUS COMPONENTS
Motor Oil, Petroleum Based
RNo~ CAS#
~1 2 O 83 ~
HELIUM
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No/ Curies F . ,~ I I/ I/~/. MiL
Item 0005 // Facility Unit:
/ CHEMICAL NAM~..~
Fixed Containers on
Location this Facility Unit Map: Grid
On Site
365
CAS#
7440-59-7
rSTATE TYPE TEMPE}
-[
Gas ~ Pure Above
I Largest Container I~aily mum
220.00 FT3 220
I ~ARDOUS COMPONENTS
%Wt.
100.00 Helium
Radioactive/Amount EPA Hazards
NO ~-No I .No I NO/ Curies F P IH
CONTAINER TYPE
PORT. PRESS. CYLINDER
'HIS LOCATION
I Daily Average
FT3 220.00 FT3
CAS#.
7440597
NFPA ~
///
MCP
Min
-7- 10/21/200
'i~ ,, .............. CITY OF BAKERSFIELD O
OD OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one/orm per mater~l per buitd/ng or area)
NEW -~.OO O DELETE O REWSE ~00 ~ P* 1~- °' 12 ---
I. FACILITY INFORMATION' ~ ' .' ' '-~"(' i ':i' '[":"" '- 'i '
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ' /
Sears #1318 / 6781
ACHEMIC~L LOCATION ' / '
uto Center · /
II. CHEMIC~ INFORMAl. ON ,
CHEMICAL NAME ~ 205 T~DE SECRET G Yes ~ No 206
If Subject to EPC~, refe~ to [nst~ons
couuou ~,u~ Waste Motor Oil F t EHS' G Y. ~o 20s
FIRE CODE H~RO C~SSES (Complete i~ requested by Io~l fire chle~
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
G Yes ~No 20:'
203 [ GRID # (optional) B4 204
PHYSICAL STATE G s SOLID ~I LIQUID G g GAS 214 LARGEST CONTAINER 30 215
FED HAZARD CATEGORIES ~ ~ F,RE G2 REACT;VE G3 PRESSURE REL~SE ~ ACUTE H~LTH G5 CHRONIC H~L~ 216
(Che~ all Ihal apply) 4
ANNUAL WASTE 217. M~IMUM 218 ] AVENGE 8 219 2~T~TEWASTECOOE 220
AMOUNT 192 DAILY AMOUNT 1 6 ONLY AMOUNT
UNitS' ~ ~ ~AL · G ~ CU.T G ~b CBS G t. TONS 2v 3¢~S~3 ON S~Te m
' If EHS, amount must be in lbs.
G ~ OTHER
STORAGE CONTAINER
(Check all that apply)
ABOVEGROUND TANK G * PLASTIC/NONMETALLIC DRUM G i riSER DRUM 13 m GLASS BOTTLE
UNDERGROUND TANK G ~ c~ G j BAG G n PLASTIC BO3q'LE
TANK ,NS,DE.U,LD,NG G g CARBOY G ~ BOX G o TOrE
STEEL DRUM G ~ smLo Gm CYUNOER G p TANKWAGON
STORAGE PRESSURE ~ a AMBIENT G 'aa ABOVE AMBIENT G be BELOW AMBIENT 224
STORAGE TEMPERATURE .~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT e c CRYOGENIC 225
%WT HAZARDOUS COMPONENT CAS #
· 225 229
1
5
100
230
23~
Waste Petroleum Hydrocarbons
231
Mixture
233
235 237
238 239 241
v 243
242
EHS
G ~es G ~o~3~
G Yes G No 236
G Yes G No
G ~es G No
III. SIGNATURE
245
I PRINT NAME & TITLE OF AUTHORIZED COMPANY ~-EPRESENTATIVE
el Greene - Sears, Roebuck and Co.
SIGNATURE DATE 246
UPCF (7/99) C:\WlNNT40\Profiles\jtraylor,000\Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
XA (one Form per material per buii~.~9 or area)
q NEW DD (~ DELETE q REVISE 200 Page %__ of 12 --
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
HEMI,LLOCATION 201 CHEMICAL LOCATION G Yes ~No 20:2
uto Center -Brake Shop CONFIDENTIAL (EPCRA)
FACILITY ID # [~j [~t 1 MAP # (ootionat) 203 GRID # (optional) 204
II. CHEMICAL INFORMATI.ON
CHEMICAL NAME
COMMON NAME
CAS #
Waste Brake Fluid
205
TRADE
SECRET
~.J Yes ,~1 No 206
If Subject to EPCRA, r~ter to instructions
207
ERS' G Ye, ~ No 208
210
213
215
216
220
222
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
CLIIIB, IRR, OHH
w ~ aYes ~No 212 J CUmES
TYPE G p PuRE G m MIXTURE )J~ fi STE 211 RADIOACTIVE
PHYSICAL
STATE
S SOLID ~ I LIQUID /~'/g GAS 214 LARGEST CONTAINER 30
G
FED HAZARD CATEGORIES ~J~ ~ F'RE G2 REACT G 3 PRESSURE RELEASE )~4 ACUTE HEALTH
(Check all Ihat apply) ~[ 5 CHRONIC HEALTH
ANNUAL WASTE 217 MAXIMUM/
AMOUNT 1560 i DA,LY~OUST ~U 2,8 AVERAGEOAiLYAMOUNT 15 2,9 25T~TE WASTE CODE
lf 6NS, amount must be in lbs.
(CheckSTORAGEaIIthatCONTAINERa~Iy) Ga ~OVEGROUNO TA~G.P~STIC/NONMETALLIC DRUM GJ FIBER DRUM G m G~SS BOTTLE Gq ~IL ~R 223
O. u,o~,~ROU,O TA~ O ~ CZN O j s,~ O n P~STJC BO~LE O, OTHER
G c fANE INSIDE BUILDING G g CARBOY G k SOX G o TOTE BIN
~ a STEEL DRUM G h SILO G 1 CYLINDER G p TANK WAGON
STORAGE PRESSURE )~ a AMBIENT G aa ABOVE AMBIENT Gba BELOW AMBIENT 224
STORAGE TEMPERATURE ~:~ a AMBIENT G aa ABOVE AMBIENT Gba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAs #
1 226 227 229
__ 100 Proprietary Mixture G Yes ~No 228 Mixture
2 238 231 G Ye, G NO232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
- 5 ' 242 '/ 243 a Yes a No 244 248
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
rocl Greene -Sears, Roebuck and Co.
IlL SIGNATURE
SI
DATE 246
.
UPCF (7/99) G:\WlNNT40\Profiles\jtraylor. OOO\Desktop\OES2731 .wpd
Q ~Ew X~^DD~ Q
DELETE
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
~ REVISE 200
(one/orrn per material per buildi'lff or area)
Page 4--- of 12---
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
Sears #1318 / 6781
HEMIC~,L LOCATIQ~I '
utc Center -Battery Room /
II.' CHE~C~ INFORMATION
CHEMICAL NAME .............. ...__ .~
201 CHEMICAL LOCATION .
CONFIDENTIAL (EPCRA>
.203 GRID # (apt,~,,aO G5
G Yes ~No 202
204
205
TRADE
SECRET
G Yes )~ No 206
J~' Subject £o EPCRA, rater lo instructions
EHs' ~Ye, GNo 208
COMMON NAME
Waste Lead-Acid Batter/es
CAS # ¢
FIRE CODE HAZARD CLASSES (Complete it requested by local fire chi
WRII, CORR 2~o
TYPE . G_P PURE G/m M/TURE ~ w WASTE 211 RADIOACTIVE G Yes )~No 212 J CURIES 213
PHYSICAL STATE G s SOLID )1~ 1~4au,o Gg GAB 214 LARGEST CONTAINER3.5 2~s
~C.e~*FED .~ROe,, ,.a, CATEGOR,ESs~.,,~ ' e, F,RE ')i~2 REAcTiVE G3 PRESSURE RELEASE ~4 ACUTE HEALTH e 5 CHRONIC HEALTH 216
ANNUAL WASTE 217 I M~X~MUM 6678 218 AVe~ 5676 2~ 3~I~TE WASTE COOE 220
AMOUNT 283,800 DALLY AMOUNT DAILY AMOUNT
UNITS' G ga GAL G ~ cu FT ~ ~b LBS G tn TONS 221 DAYS ON SITE ~2
' If EHS, amount must be in lbs. ~
STORAGE CONTAINER
(Check all that apply)
G a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM Gi FIBER DRUM Gm GLASS BOTTLE Gq RAIL CAR 223
G b UNDERGROUND TANK G ~ CAN G j B^~ G. P~sr,c BOTTLE )~r OTHEa
G ~ TANK INSIDE BUILDING G g c.,soY G k BOX G o TO~ B,N Ba~e~ Case
G d STEEL DRUM G h SILO G I CYUNOER G p TANK WAGON
STORAGE PRESSURE
~a AMBIENT G aa ABOVE AMBIENT G be BELOW AMBIENT 224
STORAGE TEMPERATURE
AMBIENT G ac' ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
1
%WT
35
34
31
226
230
234
238
242
Sulfuric Acid
Lead
Lead Dioxide -
IoPRINT NAME & TITLE OF AUTHO"IZED COMPANY REPRESENTATIVE
el Greene - Sears, Roebuck and Co. ·
HAZARDOUS COMPONENT
227
231
235
239
243
· EHS CAs #
~[Yes G No 228
G YeS ~No 232
G YeS G NO. 236
G Yes G .o 240
G Yes G No 244
7664-93-9
7439-92-1
309-60-0
229
233
237
241
245
SIGNA~
CATE 246
III. SIGNATURE
UPCF (7/99) . C:\WlNNT40\Profiles\jtraylor.000~Desktop~OES2731.wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
Q NEw XADD Q OE~ETE ~REViSE
BUSINESS NAME (Same as FACILITY NAME o¢ DBA - Doing Business As)
Sears #1318 / 6781
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESC~.~TION
~0o ~ . ~g. ~__ o~ 12--
'1. FACILI~INF~MA~ON ' ~ " ~" ':~ '" :.: '
/
AC~t~'~t°ecp~-'~rake Shop ' / 2Ol cCg~I~C;NLT~C<~%~)
II/CHEMIC~ INFORMATION : ' ·
CHEMICAL NAME /
COMMON NAME Aqueous Brake Solution (Cleaner) /
CAS ~ //
'~:-i-RE CODE HAZARD CLASSES (Complete if requested by local fire c~J/e'0
G Yes :~No 20Z
204
'~lllillu,'llhlllufhhllJllhlll}l .
203 GRID # (optional)F5
205
TRADE
SECRET
e Yes .)~ No 206
It Subject to EPCRA. refer to insltuctions
...........................
EHS' G Yes ~No
209
21(3
211 RADIOACTIVE GYes )~No 212 j CURIES 213
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214 LARGEST CONTAINER 10 215
(CheckFED HAZARDall that CATEGORIESapply) G 1 FIRE G 2 R~CTIVE G 3 PRESSURE REL~SE ~4 ACUTE H~LTH G 5 CHRONIC H~L~ 218
ANNUAL WASTE 217 M~IMUM 218 AVENGE 5 219 3~T~r~ WASTE CODE 220
AMOUNT 120 DAILY AMOUNT J 0 ' DAILY AMOUNT
UNITS' ~ ga GAL G ~f cu ~T G ,~ ~ss G ,. TO.S ~ o.ys ON S,T~ m
' If EHS, amount must be in lbs. 365
STORAGE(check ellthatCONTAINERapply) G a ABOVEGROUND TANK ~;~ e PLASTIC/NONMETALMC DRUM Gi FIBER DRUM Gm GLASS BOTTLE Gq RAIL CAR223
Gb UNDERGROUND TANK G~ CAN Gj BAG Gn PLASTIC BOTTLE Gr OTHER
G C TANK INSIDE BUILDING G g CARBOY G k BOX ' G o TOTE BIN
G d STEEL DRUM G h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ' ~ a AMBIENT O aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ,~ a AMBIENT e aa ABOVE AMBIENT " G ba BELOW AMBIENT e c CRYOGENIC 225
' %WT HAZARDOUS COMPONENT EHS CAs #
1 226 227 ' 229
__ 1+ Sodium Metasilicate G Yes ~No 228 64742-89-8
2 1+ 230 Potassium Hydroxide 23~ GYes )~No232 1330-20-7 233
3. 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
5 242 ',, ' 243 G Yes e No 244 245
LO III. SIGNATURE ·
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGN TE
el Greene ~ Sears, Roebuck and Co.
UPCF (7/99) .. C:\WlNNT40\Profiles\jtraylor. OOO\Desktop\OES2731 .wpd
e CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER / OPERATOR IDENTIFICATION
FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As)
Sears- Bakersfield- #1318/6781 ...................
SITE ADDRESS
3001 Ming Avenue
I. FAClUTY'!DENTIF!CATION . ~' .'.
2/19/2003 2/19/2004
....................... ................. -~-- BU~i~,IESS PHONE- ............
............. _[ .... ( _6_61)
CITY Bakersfield
DUN&
BRADSTREET 001629955
lol
102
103
CA!
106
ZIP 93304 10s
SiC CODE lO7
(4 Digit #) 5399, 7549
COUNTY Kern ~08
OPERATOR NAME Sears Roebuck and Co. v_E'. ,ATOR PHONE (847) 246-5313~ 110
II. OWNER INFORMATION '
OWNER NAME Sears Roebuck and Co. 111 OWNER PHONE (847) 246-5313 112
OWNER MAILING
__A_D__D_~.E?~ 3333 Beverly Road A2-262A ,a
CITY Hoffman Estates .4 STATE IL .s zip 60179 '8
III. ENVIRONMENTAL CONTACT
CONTACT NAME Joel Greene
117 CONTACT PHONE (847) 246-5313
118
CONTACT MAILING
ADDRESS 3333 Beverly Road A2-262A
119
CITY Hoffman Estates 120 I STATE IL 121 ZIP 60179 122
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY-
NAME Filomena Evans 123 NAME Gary Endicott 12g
125 130
TITLE Operations Manager
BUSINESS PHONE (661) 833-5389
24-HOUR PHONE (661) 397-4220
PAGER #
126
127
TITLE Store General Manager
BUSINESS PHONE (661) 833-5382 131
24-HOUR PHONE (661) 654-0731 132
128 PAGER # 133
V. CERTIFIcATIon "
in this inventory and believe the information is true, accurate, and complete.
.................. [--'DATE- ........... ;34 'N~-C)~: DocUmENT PRE~AI~'R
~//~t0//~_~ Jessie Shelhamer/3E Company___
~36 I ~qTLE OF OWNER/OPERATOR
· I EH&S Compliance_Manager
individuals responsible for obtaining the information, I cedify under penalty of law that I have personally examined and ~
135
137
UPCF (7/99) C:\WINNT40\Profiles~jtraylor.000\Desktop\OES2-~30.wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per mate/iai per building or area)
(~NEW (~ADD ~DELETE QREVISE 200 Page 2-- of 12-
I. FACILITY INFORMATION'" '. '= .... i , · =
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
F~I'~CAL LQ.CATION / 201 CHEMICAL LOCATION
L~ne ~tore - West wall of facility CONFIDENTIAL (EPCRA)
FACILITY ID# ~ ~i!it 1 MAP#(op,ional) 203 GRlD#(optional}
II, CHEMICAL INI~ORMATION ....
G Yes ~No 202
204
205
TRADE
SECRET
[.3 Yes ~ No 206
CHEMICAL NAME
Helium If Subject to EPCRA, refer to instructions
207
COMMON NAME Helium EHS' G Ye, ~ No 208
7440-59-7 :
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chic0
NFG, IRR, OHH 2~o
TYPE ~[p PURE G m MIXTURE G w WASTE 2~, RADIOACTIVE G Yes ~No 2,2 [ CUR, ES 2,~
PHYSICAL
STATE
G s SOLID Gi LIQUID ~[~ g GAS 214
LARGEST
CONTAINER
215
FED
HAZARD
CATEGORIES
G 1 FIRE G 2 REACTIVE ~ 3 PRESSURE RELEASE ~4 ACUTE HEALTH ~[ 5 CHRONIC HEALTH 216
{Check alt that apply)
ANNUAL WASTE 219 STATE WASTE CODE 220
AMOUNT
217 MAXIMUM 218 AVERAGE
DALLY AMOUNT DAILY AMOUNT
UNITS' G ga GAL ~ cf CU FT ~J lb LBS G tn TONS 221
* If EHS, amount must be in lbs.
DAYS ON SITE
222
STORAGE CONTAINER G a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM Gi FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE e r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G m SILO ]~ I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
229
f 100 ~2~ Helium 227 GYes ~No 228 7440-59-7
2 230 231 G Yes ~No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
- 5 242 243 G Yes G No 244 245
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
loel Greene - Sears, Roebuck and Co.
DATE
246
UPCF (7/99) C:\WlNNT40\Profiles\jtraylor.000~Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form par material per building or area)
QNEW QADD QDELETE ~REVISE 200 Page ~.___ of ]2---
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business ~) 3
Sears #1318 / 6781
2011 CHEMICAL LOCATION G Yes ~No
202
CONFIDENTIAL (EPCRA)
HMJ CA L LO. CATION
L~ne Store - Receiving Dock
FACILITY ID # L:~:;; i~ 1 MAP # (optionaO 203 GRID # (optional) 204
II. CHEMICAL INFORMATION ~ :
205
TRADE
SECRET
GYes ~No 206
CHEMICAL NAME
[f Subject to EPCRA, refer to instructions
2O7
COMMON
NAME
EHS'
(~Yes ~No 208
Waste Gasoline
CAS # 209 'llJJJil'lll,'l~illllliJlJlllSlJlillJl ·
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
FLIA, IRR, CAR 210
TYPE G,~ PURE G ~n M,XTURE ~ w WASTE ~,, RADIOACT,VE GYes )JENo 2,2 j CUR, ES 2fa
PHYSICAL STATE G s SOLID ~l LIQUID G g GAS 214 ~RGEST CONTAINER 30 ' 215
FED H~RD CATEGORIES ~ 1 FIRE G 2 R~OTIVE G 3 PRESSURE REL~SE ~4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216
(Check alt lhal apply)
ANNUAL WASTE 217 M~IMUM 218 AVENGE ~ 219 ~T~TE WASTE CODE 220
AMOUNT ~0 DAILY AMOUNT ~0 DAILY AMOUNT
' If EHS. amounl must be in lbs.
STOOGE CONTAINER G a ~OVEGROUND TANK Ge P~STIC/NONMETALLIC DRUM G i FIBER DRUM G m G~SS BOTTLE G q ~IL CAR 223
(Check ~11 that apply)
G b UNOERGROUND TANK G ~ CAN G ~ BA~ G..~ST,C BOrnE G r OT.~
G C TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
~d STEELDRUM Gh S,LO G, CYLINDER Gp TANKWAGON ...................
STOOGE PRESSURE ~ a AMBIENT G aa ~OVE AMBIENT G ba BELOW AMBIENT 224
STOOGE TEMPE~TURE ~ a AMBIENT G aa ~OVE AMBIENT G Da BELOW AMBIENT G c CRYOGENIC 225
%WT H~ARDOUS COMPONENT EHS CAS ~
226 227 22~
] 00 g~leaded Gaso]one 8006-6 ]-9
230 231 233
234 235 237
2
'3
4
5
238
242
239
G Yes ~No 228
G Yes G No232
G Yes G No 236
G Yes G NO 240 241
243 G yes G No 244
lmm. SIGNATURE
DATE
245
246 ]
UPCF (7/99) C:\WlNNT40\Profiles\jtraylor.000\Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per bu/Iding or area)
(~NEW QADD (~DELETE ]~REVISE 200 Paga 4--- of 17----
I. FACILITY INFORMATION ' ' '"'=' '~=: "T..'i":"'" : ~ ' 'i
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
GYes~No 202
HEMICLLOCATI(~
ute Center -Battery Room
FACILITY ID # [~;:;~t ;'~iil 1 MAP # {optional) 203 GRID # (optional) 204
CHEMICAL NAME
II. CHEMICAL INFORMATION
205 1 TRADE SECRET G Yes ~[ No 206
......... ~-~'*'-J l' ~)l~],?l_t.o _E.p_c_ R~,_ret3~ to instructions ......
~Yes G NO 208
209 / 'lllll~l,s,'~m!~lhl!,a!fhhll~ ~ '~
COMMON NAME
Waste Lead-Acid Batteries
CAS #
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
WRII, CORR
TYPE G p PURE G m MIXTURE ~ w WASTE 211
PHYSICAL STATE G s SOLID RI LIQUID G g GAS 214
RADIOACTIVE G Ye~. ~No 212 IcuR~Es
210
213
LARGEST CONTAINER 3.5 215
FED HAZARD CATEGORIES G 1 FIRE ~[2 REACTIVE G 3 PRESSURE RELEASE ~4 ACUTE HEALTH G 5 CHRONIC HEALTH 216
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 5676 219 35TfTE WASTE CODE 220
AMOUNT 283,800 DalLY AMOUNT 6678 DAILY AMOUNT
UNITS* G ga GAL G cl' cu FT ~ lb LBS G tn TONS 22.1 3~A~Ys ON SITE 222
· If EHS, amount must be in lbs.
STORAGE CONTAINER G a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE ~[r OTHER
G c TANK,NS~OEBUILDING Gg CARBOY G k BOX Go TOTE BIN Batte~___C__a_s~ ......
Gd STEEL DRUM G h SILO GI CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE
AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
1
%WT
HAZARDOUS COMPONENT
EHS
227 ~]~ Yes G No 228
231 G Yes ~No232
235 G Yes G No 236
239 G Yes G No 240
243 G Yes G NO 244
226 229
35 Sulfuric Acid 7664-93-9
233
34 23o Lead 7439-92-1
234 237
31 Lead Dioxide 1309-60-0
238 241
242 245
III. SIGNATURE
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
reel Greene - Sears, Roebuck and Co.
DATE 246
UPCF (7/99) C:\WINNT40\Profiles\jtraylor. OO0\Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per matede! per bM#ding er area)
QNEW QAOD ODELETE ~REVISE 200 Page 5-- o~ 12---
I. FAClLIW INFOR~ON .. ~=., . ..'"' .... i:..
BUSINESS NAM~ (Sa~ as FACILI~ NAME or DBA - Doing Business As) 3
',ears ~1318 / 6781
HEMICLLOCATI(3N
ute (.;enter -Brake Shop
FACILITY ID # I~ ~}l 1MAP#(optionaO
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
203 GRID # (optional) F5
G Yes ~ No 20;Z
204
II. CHEMICAL INFORMATION ~ · :
205 TRADE SECRET G Yes ~ No 206
CHEMtCAL NAME
..........................................................................207 If Subject to EPCRA, refer to instructions
COMMON NAME Aqueous Brake Solution (Cleaner) EHS' G Yes ~ No 208
I
FiRE CODE HAZARD CLASSES (Complete if requested by local fire chie0
210
IP,_~
TYPE G p PURE G m MIXTURE ~]~ w WASTE 211 RADIOACTIVE GYes ~No 212 I CURIES 213
PHYSICAL STATE G s SOLID BI LIQUID G g GAS 214 LARGEST CONTAINER 10 215
FED HAZARD CATEGORIES G 1 FIRE e 2 REACTIVE e 3 PRESSURE RELEASE ~4 ACUTE HEALTH e 5 CHRONIC HEALTH 216
(Check a~l that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 5 219 3~T~,TE WASTE CODE 220
AMOUNT 1 20 DALLY AMOUNT 1 0 DALLY AMOUNT
UNITS* ~ ga GAL G cf cu FT G lb LBS G tn TONS 221 DAYS ON SITE 222
* If EHS, amount must be in lbs. 365
STORAGE CONTAINER G a ABOVEGROUND TANK ~ e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM Gm GLASS BOTTLE Gq RAIL CAR 223
(Check all that apply)
e b UNDERGROUND TANK G f CAN e j BAG G n PLASTIC BOTTLE G r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~11 a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EH$ CAS #
229
1 226 227 GYes ]~No 22~ 64742-89-8
1 + Sodium Metasilicate
233
2 1+ 230 Potassium Hydroxide 231 GYes ~]~No232 1330-20-7
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 ! 241
5 242 243 245
IlL SIGNATURE .'
G Yes G NO 244 !
SIGNATU
DATE 246
UPCF (7/99) C:\WlNNT40\Profiles\jtraylor.000\Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form par material per bu#d,~g or area)
O NEW Q ADD O DELETE I~.EV,SE 200 Pa.e 6-- o' 12 ---
'1. FACILITY INFORMATIoN:.:... ': ]''~ ~!:: ":]'..']": ' =
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION
~uto Center -Brake Shop
FACILITY ID # ~il'!ii~il {~'.17~ I MAP # {optional)
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
.203 GRID # (optional) F5
Yes ~No 202
204
II. CHEMICAL INFORMATION ;....
205
TRADE
SECRET
G Yes ~[ No 206
CHEMICAL NAME
If Subject to EPCRA, refer to instructions
207
COMMON
NAME
Brake Fluid Ess. G Yes ]~ No 2011
CAS # 209 'lfllli~*hl,'~l~mlulhietndlldh .
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief]
CLIIIB, IRR
TYPE G p PURE ~ m MIXIURE G w WASTE 211 RADIOACTIVE G Yes ~No 212 I CURIES 213
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214 LARGEST CONTAINER 30 215
FED HAZARD CATEGORIES
(Check alt that apply)
FIRE G 2 REACTIVE G 3 PRESSURE RELEASE ~4 ACUTE HEALTH
G s CHRONIC HEALTH
AMOUNT 0 DAILY AMOUNT 60 DAILY AMOUNT
UNITS' ~ g~ GAL O cf CUFT G ,b LBS G tn TONS 221 3~AsYS ON S'TE
' If EHS, amount must be in lbs.
216
220
222
STORAGE CONTAINER G a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b U"DERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE G r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
~]~ d STEEL DRUM G h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
1 226 227 G Yes ~No 228 Mixture
__ 100 Proprietary Mixture 220
2 230 231 G Yes O No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
5 242 243 e Yes (~ NO 244 245
III. SIGNATURE
PRINT NAME & roLE OF ^UT.OR~ZED COMPANY REPRESENT^T~VE DATE ~S
eel Greene - Sears, Roebuck and Co
UPCF (7/99) C:\WlNNT40\Profiles\jtraylor. OOO\Desktop\OES2731 .wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
Q NEw RADD Q DELETE Q REVISE
(one form per material ~er build/rig or area)
Page %_ of 12--
I.
FACILITY
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
CHEMIC~,L LOCATION 201 CHEMICAL LOCATION G Yes ~No 20:'
Auto Center -Brake Shop CONFIDENTIAL (EPCRA)
ID # i~;i:i ~:';~i~ 1 MAP # (optional) 203 GRID # (optional) 204
II. CHEMICALINFORMATION· , .
2O5
TRADE
SECRET
~3 Yes ~ No 206
CHEMICAL NAME
if Subject to EPCRA, refer' to instructions
207
COMMON
NAME
EHS'
(~ Yes ~ No 208
Waste Brake Fluid
CAS # 209 'lltllis'hl.'lllamIlhllmllhlllh .
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
CLIIIB, IRR, OHH 2~o
TYPE G p PURE G m MIXTURE ~ w WASTE 211
PHYSICAL STATE G s SOLID ~l LIQUID G g GAS 214
RADIOACTIVE G Yes ~No 212 ICURIES 213
LARGEST CONTAINER 30 215
FED HAZARD CATEGORIES ~1 FIRE G2 REACTIVE G3 PRESSURE RELEASE ~4 ACUTE HEALTH ~[ 5 CHRONIC HEALTH 216
(Check ail that appty)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 15 219 25TfTE WASTE CODE 220
AMOUNT 1560 DAILY AMOUNT 30 DAILY AMOUNT
UNITS' ~ ga GAL G cf CUFT Gtb LBS G tn TONS 221 3~YSON SITE 222
· If EHS, amount must be in lbs.
STORAGE CONTAINER G a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE e r OTHER
G c TANK INSIDE BUILDING e g CARBOY G k BOX G o TOTE BIN
)~ ~ STEEL DRUM G h SILO G i CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 2~5
%WT HAZARDOUS COMPONENT EHS CAS #
229
226 22? G Ve~ ~Uo 220 Mixture
100 Proprietary Mixture
230 23a G Yes G No232
234 235 G Yes G No 236 237
238 239 GYes G No 240 241
242 243 O Yes G No 244 245
IIL SIGNATUR~
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SI ~ ~'~"~ /.~'~ ~~ ~ DATE 246
~! Greene-Sears, Roebuck and Co.
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'i : ................... CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per buildi/~g or area)
(~ NEW (~ ADD (~ DELETE ~REVISE 200 Page 8--- of 12 --
I. FACILITY INFORMATION:... ': :~= ' '" ::"" '' =:'/' ':
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
CHEMIC~,L LOCATION
Auto Center
CHEMICAL NAME
201
CHEMICAL
LOCATION
G Yes ~No 20Z
CONFIDENTIAL (EPCRA)
I 203 t GRID # (optional) B4 204
II. CHEMICAL INFORMATION
· ' 205 TRADE SECRET G Yes ~ No 206
If Subject to EPCRA, refer lo instructions
EHS* G Yes ~ NO 208
COMMONNAME
CAS #
Motor Oil
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
CLIIIB, IRR
210
TYPE G p PURE ~]~ m MIXTURE G w WASTE 211 RADIOACTIVE G Yes ~No 212 [ CURIES 213
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214 LARGEST CONTAiNER 250 215
FED
HAZARD
CATEGORIES
~ I FIRE ~ 2 REACTIVE ~ 3 PRESSURE RELEASE /~4 ACUTE HEALTH ~.~ 5 CHRONIC HEALTH 216
(Check all that apply)
ANNUAL WASTE 2~? MAXIMUM 2'8 AVERAGE 250 2'9 ~7~,TE WASTE CODE 220
AMOUNT 0 DAILY AMOUNT 5 00 DALLY AMOUNT
UNITS* ~ ga GAL G cf cu FT (~ lb LBS G tn TONS 221 3~A5YS ON SIlK 222
* If EHS, amount must be in Ihs.
STORAGE CONTAINER ~ a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G ~ CAN G j BAG G n PLASTIC BOTTLE G r OTHER
G c TANK INSIDE BUILDING G g CARBOY (~ k BOX G o TOTE BIN
G d STEEL DRUM G h SILO G i CYLINDER G p TANKWAGON ..................
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
1 226
1.1 Zinc Alkyldithiophosphate
2 93 230 Fuel Additive
3 234
4 238
5 242
229
227 G Yes ~No 228 68649-42-3
231 G Yes G NO232 64742-65-0 233
235 G Yes G No 236 237
239 G Yes G No 240 241
243 G Yes G NO 244 245
III. SIGNATURE
SIGNATURE
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per buitding or area)
ONEW QADD ODELETE ~aEV,SE 20O P~e 9--- of 12--
I. FACILITY INFoR~TIoN''''''" '' == ' ' :: =': '=' ....
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION 201 CHEMICAL LOCATION
_Auto (Jcntcr CONFIDENTIAL (EPCRA)
C4
II. CHEMICAL INFORMATION ,
G Yes ~No 20:'
204
205
TRADE
SECRET
~ Yes ~ No 206
CHEMICAL NAME
If Subject to EPCRA, refer to instructions
207
COMMON
NAME
EHS*
G Yes ~[ No 208
Waste Motor Oil
CAS # 209 'l[]l~isl~l,' II[lllllll J~ie i~llhlll}l
FIRE CODE HAZARD CLASSES {Complete if requested by local fire chiel)
CLIIIB, IRR 2~o
TYPE G. PURE G m M,XTURE ~ w WASTE 2.. RADIOACTIVE GY.s 2,21 CUR,ES 2,3
PHYSICAL STATE G s SOLID RI LIQUID (~ g GAS 214 LARGEST CONTAINER 250 215
FED HAZARD CATEGORIES ~ 1 FIRE G 2 REACTIVE G 3 PRESSURE RELEASE ~4 ACUTE HEALTH G5 CHRONIC HEALTH 216
(Check all that apply~
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 250 219 25TfTE WASTE CODE 220
AMOUNT 3000 DAILY AMOUNT 250 DAILY AMOUNT
U.,TS' ~gaOAL GcfCUFT GIbLBS GtnTONS 22~ 3~SONSITE 222
' If EHS, amount must be in lbs.
STORAGE CONTAINER ~ a ABOVEGROUND TANK G e pLASTIC/NONMETALLIC DRUM G i FIBER DRUM e m GLASS BOTTLE G q RAIL CAR 223
(Check all thai al)ply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTrLE e r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G h SILO G i CYLINDER G p TANK WAGON ..................
STORAGE PRESSURE ~ a AMBIENT (~ aa ABOVE AMBIENT (~ ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
229
~ 100 226 Waste Petroleum Hydrocarbons 227 G Yes ~No 228 Mixture
2 230 231 G Yes G No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
243 G Yes G No 244
III, SIGNATURE
-T 242
P~RINT NAME & TITLE-~F AUTHORIZED CO'-MPANY REPRESENTATIVE
~_e.! Greene - Sears, Roebuck and Co.
SIGN~
DATE
245
246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
Q NEw R^DD Q DELETE Q REV,SE 200
(one form per material per building or area)
Page 10- of 12---
I. FACILITY INFORMATION ~ '"':::': "' ·
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
G~e,~No
z~HEMICAL LOCATION 201 CHEMICAL LOCATION
ute Center CONFIDENTIAL (EPCRA)
FACILITY ID # fill li.,.'!' ~! ::'~":'}l 1MAP#{optional) I 203 GRlD#(optional) B4
II. CHEMICAL INFORMATION· , · . ': '
204
205 TRADE SECRET G Yes ~ No 206
CHEMICAL NAME
If Subject to EPCRA, refer to instructions
207
COMMON NAME EHS* G Yes ~[No 208
Waste Motor Oil Filters
CAS # 209 'lfll[h'IIs,'llamllhhlllllhblh .
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
CLIIIB, IRR
rY,E G p PURE G m M,XTURE ~ w WASTE
PHYSICAL STATE G s SOLID ~]~1 LIQUID G g GAS 214 LARGEST CONTAINER 30 215
FED HAZARD CATEGORIES ~ 1 FIRE e 2 REACTIVE e 3 PRESSURE REL~SE ~4 ACUTE H~LTH e 5 CHRONIC H~LTH 216
(Che~ all Ihat apply~
ANNUAL WASTE 217 M~/MUM 218 AVENGE ~ 219 ~T~TE WASTE CODE 220
AMOUNT 192 DAILY AMOUNT 16 DA~LY AMOUNT
UNITS' ~ ga GAL G cf cu FT G lb LBS G tn TONS 221 DAYS ON SITE ~2
* If EHS, amount must be in lbs, 36~
STORAGE CONTAINER G aABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTrLE e r OTHER
(~ c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
~ d STEEL DRUM G h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~!1 a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT G aa ABOVE AMBIENT (~ ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
229
226 227 G Ye, ENo 220 Mixture
100 Waste Petroleum Hydrocarbons
230 231 233
1
GYes GNo232
234 235 G Yes G No 236 237
238 239 G Yes G No 240 241
242 243 G Yes (~ No 244 245
' III. SIGNATURE '
PR,at NAME ~ T,TLE OFAUTHOR,ZED COMPANY REPRESENTAT,VE B,GNATU~ -- L ~ 2~0
~_~°el. Greene - Sears, Roebuck and Co. ~~.O ~/~/~
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(oDe form per material per build/ag or area)
QREVISE Page 14:- of 12--
Q NEW RADD Q DELETE
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
Sears #1318 / 6781
,z~HEMIC~L LOCATION 201 CHEMICAL LOCATION '"~No
G
Yes
20:Z
uto Center CONFIDENTIAL (EPCRA)
II. CHEMICAL INFORMATION
2O5
TRADE
SECRET
~Yes ~lNo 206
CHEMICAL NAME
If Subject to EPCRA, refer to instructions
207
EHS' G Yes ~[ No 208
COMMON NAME Waste Antifreeze
CAS # 209 'lfllii~ln,'~amllh~lalfilbll~ .
FIRE CODE HAZARD CLASSES (Complete d requested by local fire chief)
CLIIIB, IRR, OHH ~o
TYPE G p PURE G m MIXTURE ~ w WASTE 211
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214
RADIOACTIVE G Yes ~No 212 [CURIES 213
LARGEST CONTAINER
FED
HAZARD
CATEGORIES
G
,~311 1 FIRE 2 REACTIVE ~ 3 PRESSURE RELEASE .~4 ACUTE HEALTH ~ 5 CHRONIC HEALTH 216
(Check all that apply~
ANNUAL WASTE TBD- new operation and 217 MAXIMUM 218 AVERAGE 69 219 3~T~TE WASTE CODE 220
AMOUNT no local history DALLY AMOUNT 138 DALLY AMOUNT
UNITS' ~ ga GAL G cf CU FT G lb LBS G tn TONS 221 DAYS ON SITE 222
· If EHS, amount must be in lbs. 365
STORAGE CONTAINER G a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G t CAN G jBAG G n PLASTIC BOTTLE e r OTHER
G c TANK INSIDE BUILDING G g CARBOY G kBOX G o TOTE BIN
}~ dSTEEL DRUM G h SILO G ICYLINDER e p TANKWAGON ..................
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
229
1 226 227 GYe~ ~No 228 107-21-1
80-96 Ethylene Glycol
233
0-8 ~o Diethylene Glycol ~a~ G Ye~ G No~ 111-46-6
234 235 G Yes G No 236 237
238 239 G Yes (~ No 240 241
5 242 243 (~ Yes (~ No 244 245
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
Ioel Greene - Sears, Roebuck and Co.
III. SIGNATURE
$1~
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per building or area)
Q NEW O ADD Q DELETE ~[REVISE 200 Page l-~:- of 12 ---
I. FACILITY INFoRMATIoN.:.. '.' =~ ': : "!:'':~ '.:
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
G Yes ~No 207
201
CHEMICAL
LOCATION
CONFIDENTIAL (EPCRA)
CHEMIC&L LOCATIO~I
Auto Center -Battery Room
1
G5
CHEMICAL NAME
COMMON NAME
Lead-Acid Batteries
CAS #
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chiel)
WRII, CORR
II. CHEMICAL INFORMATION
205 TRADE SECRET G Yes ~ No 206
........ ~-(~'7 ....... If .S_~!??l_ t.?._E_~_C_..~_ ::,f_e.i t0 in?traction? ......
EHs' 18~Yes G No 206
2og I 'm~w,~.!!.,~,,,,/~,~,~, . ].
210
TYPE G p PURE ~ m MIXTURE G w WASTE 211 RADIOACTIVE G Yes ~No 212 [ CURIES 213
PHYSICAL STATE G s SOLID RI LIQUID G g GAS 214 LARGEST CONTAINER 3.5 215
FED HAZARD CATEGORIES
(Check att thai apply)
ANNUAL WASTE
AMOUNT 0
G 1 FIRE ~2 REACTIVE G 3 PRESSURE RELEASE ~4 ACUTE HEALTH
2'17 MAXIMUM 218 AVERAGE 1050
DAILY AMOUNT 2100 DAILY AMOUNT
UNITS' G ga GAL G cf cu FT ~ lb LBS G tn TONS · If EHS, amount must be in lbs,
G 5 CHRONIC HEALTH 216
219 }X~7~.TE WASTE CODE 220
DAYS ON SiTE 222
221 365
STORAGE CONTAINER
(Check all that apply)
G a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
eb UNDERGROUND TANK Gf CAN Gj BAG Gn PLASTIC BOTTLE ~r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN Batte]7_- Case
G d STEEL DRUM G h SILO GI CYLINDER G p TANK WAGON
STORAGE PRESSURE ~31 a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~1 a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
1 226 227 ~Yes (.~ No 226 7664-93-9
35 Sulfuric Acid 229
2 34 230 Lead 231 GYes ~No232 7439-92-1 233
3 3] 234 Lead Dioxide 235 GYesGNo 236 1309-60-0 237
4 238 239 G Yes G No 240 ! 241
5 242 243 (~ Yes (~ NO 244 245
IlL SIGNATURE '
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2.
3.
4.
5.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be as brief and concise as possible.
You may also attach Business Owner / Operator Form and Chemical Description Form(s) to
the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Sears #1318 / 6781
LOCATION: 3001 Ming Avenue, Bakersfield, CA 93304
MAILING ADDRESS: 3001 Ming Avenue, Bakersfield, CA 93304
CITY: Bakersfield
STATE: CA ZIP: 93304 PHONE: (661)833-5300
PRIMARy ACTIVITY: Retail General Merchandise and Auto Parts Facility
OWNER: Sears Roebuck and Co.
PHONE:(847)286-5313
MAILING ADDRESS: 3333 Beverly Road A2-262A, Hoffman Estates, IL, 60179
EMERGENCY NOTIFICATION
CONTACT
Filomena Evans
TITLE
Operations Manager
BUS. PHONE
(661) 833-5389
24 HR. PHONE
(661) 397-4220
2. Gary Endicott Store General Manager (661) 833-5311 Hm (661) 654-0731 Cell (661) 203-1392
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
Daily visual inspection by employees.
B. EMPLOYEE AND AGENCY NOTIFICATION:
In the event that outside notification is required, the emergency coordinator will telephone the fire department
and other applicable agencies. Depending on the severity of an emergency incident, a partial or complete
evacuation will be ordered by the emergency coordinator. The emergency coordinator may use the PA system,
telephones or verbal means to initiate evacuation procedures.
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
Asset Protection Manager and Operations Manager or Joel Green, Sears Roebuck & Co. EHS Compliance
Manager.
D. EMERGENCY MEDICAL PLAN:
In the event of a medical emergency, the manager on duty will call 911 or the proper medical facility will be
contacted. Industrial Medical Group at 2501 G Street is the preferred medical facility for this place of business
(Phone: 661-327-2225).
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION I1.2: RELEASE RESPONSE PLAN
HAZARD ASSESSMENT AND PREVENTION MEASURES:
Incompatible chemicals are separated by 20 feet or by one-hour separation, and are stored in their original
containers. Batteries are stored on a designated rack or on a shrink-wrapped pallet in a well-ventilated
room away from drains and sources of electricity. Flammable materials not for retail sale are stored in a
flammables cabinet. Used materials are stored in properly labeled drams, and are also kept away from
drains and source of electricity.
Co
RELEASE CONTAINMENT AND/OR MITIGATION:
Trained employees manage small spills of identified chemicals as long as there are no threats to human
life or the environment. A spill boom will be used immediately to block the flow of liquids from entering
any nearby drains. The MSDS' for spilled materials are consulted for proper guidance in handling the
substances and the spill kits are obtained. Proper PPE is donned before handling spilled product. In the
event of a large spill, fire, or release that threatens human health and/or the environment, the local fire
department and environmental health deparUnent will be contacted. In the event of a small fire, if safe
to do so, a fire extinguisher may be used to extinguish the fire.
CLEAN-UP AND RECOVERY PROCEDURES:
Employees will address small spills following the procedures outlined in the mitigation section of this plan. The
proper disposal, spill and leak procedures for each hazardous material at the facility is detailed in the facility's
Environmental Operations Manual. Trained employees will clean up spilled hazardous materials and used absorbents'
and place them in DOT approved containers. These containers will be properly labeled and stored according to local,
state and federal regulations. All hazardous waste materials will be disposed of by outside contractors at RCRA
approved facilities.
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE: Outside - dock ramp: N. Wall
ELECTRiCAL: Electric room, northwest comer of the building
WATER: Middle of the building along the north side
SPECIAL:
LOCK BOX: YESQ
IF YES, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
mo
PRIVATE FIRE PROTECTION: Fire Extinguishers
Sprinkler System Fire Risers Fire Hose (Full Line Store)
B°
WATER AVAILABILITY (FIRE HYDRANT): In the north parking lot
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: 250
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
In Asset Protection & Hub Office
Employees receive a training guide that covers the handling of hazardous materials and environmental management procedures.
Employees are trained on the proper storage and handling methods of hazardous materials during their new employee orientation
period. All employees are trained in the isolation of a spill and prevention of spilled materials from entering storm and sewer systems.
In addition employees are trained in the use of absorbent materials and neutralizers to control and clean up spills, fire prevention and
response, and how to respond to medical emergencies. Annual refresher trainings are conducted and safety meetings are held on an as
needed basis.
Management personnel are trained in the proper procedures for agency notification, emergency response, and evacuation notification.
CERTIFICATION
I, Joel Greene CERTIFY THAT THE ABOVE
INFORMATION 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.
~/,~ EH&S Compliance Manager
TURE TITLE DATE
,
~ I 1'~l'te~3001 ~g { Map #:1
CALIFORNIA ANNOTATED SITE MAP Business Name: Sears #1318/#6781 Bakersfield, CA
A B C D E F G H t
1
4
7
FE
FE
FE
PARTS
ROOM
Spill Kit
Electric Main
(~ Water Main
Gas Main
Fire Exit
~ Waste Antifreeze
~-~ New Batteries
~ Used Batteries
~ Motor Oil
~-] Waste Oil Tank
~ Waste Oil Filters
~ Brake Fluid
(~) Waste Brake Fluid
~ Brake Cleaner
UndeFined
North
?
CALIFORNIA ANNOTATED SITE MAP Business Name: Sears #1318/~6781 Site Address: 3001 Ming Ave Map #: 2
Bakersfield
A B C D E F G H !
BaSe
ent
JUNK
TIRE
JUNK
·
(~ Electric Main
(~ Antifreeze
~ Waste Antifreeze
~-~ Waste Motor Oil Filters
~-~ Waste Motor Oil
North
UndeFined
A B C
$
4
5
7
Business Name:
Sears #1318/#6781
Address: 3001 Ming Avenue
Bakersfield, CA
D E F G
Upp.er-' Lever
X~
~] Fire Riser
~ Fire Hose
~ Gas Main
I (~
ElectricPanels
UndeFined
North
CALIFORNIA ANNOTATED SITE MAP Business Name: Sears ~1318/#6781 Site Address: 3001 Ming
Bakersfield
A ~ C D E F G FI I
Fu[[i Line gl-tore -'
~ Low~e~ Level
4
TRU~K
....... OOCK
Map {{: 4
Emergency Generator
(natural gas)
Spill Kit
Waste Gas
Fire Riser
Gas Main
Electric Panels
North
A B C D E F G H I
Ming Ave
'Sears Full Lihe Store
Val,iey Plaza Mall
Sears Auto Center
Water Main
Fire Hydrant
Storm Drain
UndeFined
North
FACILITY NAME _c~_
ADDRESS '~oo I ~
FACILITY CONTACT
~SPECTION TIME ~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
.2DO 2-
INSPECTION DATE i -
PHONENO. (o6,_1- rg23
BUSINESS IDNO. -15-210-
NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
Routine [~l Combined I~ Joint Agency I~ Multi-Agency ~.] Complaint [~ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
OeA''3-~- ~-,.~','~,~-r.r ?l,~
Business plan contact information accurate
Visible address
Correct occupancy
Verification
of inventory
materials
Verification of quantities
Verification of location
Proper segregation of material : X
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate '~,
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Explain: it3 e...C4-e_ O ,' I
Yes ~] No
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
B'US~S S'[te l~e~ponsible Party
Inspector:
.~~bi E R $ 1= I ! D
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2.
3.
4.
5.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be as brief and concise as possible.
You may also attach Business Owner / Operator Form and Chemical Description Form(s) to
the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Sears #1318 6781
LOCATION: 3001 Ming Avenue, Bakersfield, CA 93304
MAILING ADDRESS: 3001 Ming Avenue, Bakersfield, CA 93304
CITY: Bakersfield
STATE: CA ZIP: 93304 PHONE: (661)833-5300
PRIMARY ACTIVITY: Retail Merchandise and Auto Parts Facility
OWNER: Sears Roebuck and Co. PHONE: (847) 286-5313
MAILING ADDRESS: 3333 Beverly Road A2-262A, Hoffman Estates, IL, 60179
EMERGENCY NOTIFICATION
CONTACT TITLE
1. Rick Bell Operations Manager
BUS. PHONE
(661) 833-5311
24 HR. PHONE
(661) 654-0731
C
CITY OF BAKERSFIELD
OF iE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER / OPERATOR IDENTIFICATION
FACILITY INFORMATION
I. FACILITY IDENTIFICATION·
t l._g ........... J~__¥ear~eg/~ning]/°]_/~_°__°__]_
BUsiN'E~§s NA-~E (Same as FACILITY NAME or DBA- Doing Business As)
Sears #1318 / 6781
SITE ADDRESS
3001 Ming Avenue
'oo [ Year Ending 12/31/2002 ' m
~- / 'Bu§iNES~i~i~)N E- ........................ ~b'2
I (661) 833-5300
103
CITY Bakersfield lo4 CA
106
DUN &
BRADSTREET 001629955
ZIP 93304
SIC CODE ~o7
(4 Digit #) 5399, 7549
COUNTY Kern ~08
OPEP. ATOR NAME Sears Roebuck and Co. I°9-'I'oPERATOR PHONE (847) 246-5313 110
II.OWNER iNFORMATION · ..
OWNER NAME Sears Roebuck and Co. m OWNER PHONE (847) 246-5313 .2
OWNER MAILING
ADDRESS 3333 Beverly Road A2-262A 113
CITY HoffmanEstates 114 ] STATE IL .5 ;iZIP 60179 ~6
III. ENVIRONMENTAL CONTACT
CONTACT NAME Joel Greene ~17 CONTACT PHONE (847) 246-5313 .8
CONTACT MAILING
ADDRESS 3333 Beverly Road A2-262A
119
CITY Hoffman Estates 120 I STATE IL a21 ZIP 60179
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARy-
NAME Rick Bell 123
TITLE Operations Manager
BUSINESS PHONE (661) 833-5311 126
24-HOURPHONE (805) 664-1145
PAGER #
127
NAME Gary Endicott 129
TITLE Store General Manager
130
BUSINESS PHONE (661) 833-5311 131
24-HOUR PHONE (661) 654-0731
132
128 PAGER # 133
V. CERTIFICATION .'
Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and
familiar with the information submitted in this inventory and believe the information is true, accurate, and complete.
s~oPERATOR DATE- ................. ~34 'N~'-~)~' Do'urgENT PREPAR~'R ~35
1/01/02 [ Jolene Beaton
~A)MEs O~./~/NER/OPERATOR (print) a38 TITLE OF OWNER/OPERATOR 137
V
Joel Greene ............................... EH&S Cornpliarme_Manager ....................................
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
Q NEW Q ADD Q DELETE ~ REV,SE 200
(one fo~n per male, iai )er bM#ding or area)
Pete 2--- of 8 --
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 67'81
201 CHEMICAL LOCATION G Yes G No 202
CHEMICAL LOCATION west wall of facility CONFIDENTIAL (EPCRA)
FACILITY ID # t~il'='~'":,i ti!~~[ I MAP # (opfionaO I 203 GRID # (optional) B3 204
II, CHEMICAL INFORMATION· .= · : . : '
2O5
TRADE
SECRET
~ Yes ~ NO 206
CHEMICAL NAME
Helium ~f Subject to EPCRA. refer to instructions
207
COMMON
NAME
Helium EHS° G Yes ,~ NO 208
7440-59-7 = '.
FIR[:: CODE HAZARD CLASSES (Complete if requested by local fire chief~
NFG, IRR, OHH
TYPE ~[p PURE G m M,XTURE G w WASTE
PHYSICAL STATE G s SOLID Gl LIQUID ~ g GAS 214. LARGEST CONTAINER 215
FED HAZARD CATEGORIES G1 FIRE G~REACTIVE ~3 PRESSURE RELEASE ~4 ACUTE HEALTH ]~5 CHRONIC HEALTH 216
(Check alt that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 I STATE WASTE CODE 220
AMOUNT DALLY AMOUNT DALLY AMOUNT
UNITS' e ga GAL ,~ cf CU FT G lb LBS G tn TONS 221
DAYS
ON
SiTE
222
° If EHS. amount must be in lbs.
G q RAIL CAR 223
G r OTHER
STORAGE CONTAINER
(Check all that apply)
G a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G h SILO ]~ I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
~ 100 2,~ Helium 227 (~ Yes ~No 225 7440-59-7 229
2 230 231 G Yes ~No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
5 242 243 G Yes ~ No 244 245
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE - '
II1.
SIGNATURE
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(olte fo.q'n pet' male/iai per build.~.lg or area)
NEW q ADD 0 DELETE ~ REVISE 200 Page 3--- of 8
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION
SW comer of building
FACILITY ID # ~ ~! 1 MAP # (optional)
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
G Yes ~No 207.
] 203 GRID # (optional) B3 204
II. CHEMICAL INFORMATION . .
205 TRADE SECRET G Yes ~[ NO 206
CHEMICAL NAME
Unleaded Gasoline r~ Subject to EPCRA, refer to instructions
20?
COMMON NAME EHS° G Yes ]~ No 208
Waste Gasoline
CAS # 209 'lllliilltl,'flallulllhlll,lllll}~ .
Mixture
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
FLIA, IRR, CAR vo
~YPE G p PURE G m MIXTURE )~ w WASTE 2,, RAD,OACT,VE G Yas )8[.o 2,2 j CUR, ES 2,3
PHYSICAL STATE G s SOLID ~1 LIQUID G g G~ 214 ~RGEST CONTAINER 30 215
FED H~RD CATEGORIES ~ 1 FIRE G 2 R~CTIVE G 3 PRESSURE REL~SE ~4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216
(Che~ all that apply)
ANNUAL WASTE 217 M~IMUM 210 AVENGE 219 ~T~TE WASTE CODE 220
AMOUNT 720 DAILY AMOUNT 30 DAILY AMOUNT15 3
' If EHS, amount must be in lbs.
STORAGE CONTAINER G a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
(Check all Iha! apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE G r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
]~ d STEEL DRUM G h SILO G i CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]J~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G ¢ CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAs #
~ 100 22e Waste Gasoline 227 GYes J~No zz~ Mixture 22g
2 230 231 G Yes G No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 241
5 242 243 (~ Yes (~ No 244 245
TITLE OF AUTHORIZED COMPANY REPRESENTATIVE - IlL SlJ~NATUsiGNATuRERE
DATE 246
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E R S F I ~ D
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per bui!d~g or area)
NEW O AOD O DELETE ~ REVISE 200 Page 4--- of 8 ---
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION 201 CHEMICAL LOCATION G Yes ~No
202
CONFIDENTIAL (EPCRA)
FACILITY ID # t~=:';'::: [~: ![![~ I I MAP # (optional) ]. 203 GRID # (optional} G5 204
· II. CHEMICAL INFORMATION = :. . ·
CHEMICAL NAME
Sulfuric Acid
COMMON NAME
Used Lead-Acid Batteries
CAS #
7664-93 -9
FiRE CODE HAZARD CLASSES (Complete if requested by local fire chic0
WR_II, COP_R
205 TRADE SECRET (~ Yes ~[ No 206
EHS' G Yes ~ No 208
2091 '~lll~l,.'ilam~hhm~lbblh .
210
TYPE G p PURE G m MIXTURE ~ w WASTE 211 RADIOACTIVE GYea ~No 212 [ CURIES 213
PHYSICAL STATE G s SOLID ~1 LIQUID (~ g GAS 214 LARGEST CONTAINER 3.5 215
FED
H~RD
CATEGORIES
G 1 FIRE ~2 R~CTIVE G 3 PRESSURE .EL~SE ~4 ACUTE H~LT. ~ 5 CHRONIC H~LTH 216
(C~ att ~at apply)
Auou.~ 36400 i DAILY AMOUNT DALLY AMOUNT 350 ~T~.TE
WASTE
CODE
220
' If EHS, amount must be in lbs,
~ lb LBS G tn TONS 221 222
STORAGE CONTAINER G a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM (~ i FIBER DRUM G m GLASS BOTTLE (~ q RAIL CAR 223
(Check all that apply)
Gb UNDERGROUND TANK Gf CAN Gj BAG G. PLASTIC BOTTLE )~r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G h SILO G i CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT (~ c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
' 40 226 Sulfmic Acid 227 ~[Yes G NO 22~ 7664-93-9 22"
2 22 230 Lead 231 G Yes ~No232 7439-92-1 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes (~ No 240 241
5 242 243 G Yes G No 244 245
III. SIGNATURE
SlGNATUR/~
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
One form par mater~al per bu~lSng or area)
Page 8--- of 8 ---
Q NEW (~ ADD (~ DELETE ~J REVISE 200
I. FACILITY INFoR~TIoN
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
G Yes ~No 202
CHEMICAL LOCATION
FACILITY ID # '~ ' ;,~:~ 1 MAP # (optional) 203 GRID # (optional) 204
II. CHEMICAL INFORMATION ~ · :
205 TRADE SECRET G Yes ~[ No 206
CHEMICAL NAME Motor Oil
207 If Subject to EPCRA, refer Io instructions
COMMON NAME Motor Oil EHS* G Yes ]~No 208
CAS # Mixture 209 J 'llllJi~l,l,'~tl!!lllh!llll. lldtiJl . "
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chiD0
CLIIIB, IRR 2,0
r~.E G p PURE G m MIXTURE ~ w WASTE 2. RAD,OACT, VE GYes )t~No ~,2 [ CUR,ES
PHYSICAL STATE O s SOLID ~m LIQUID O g GAS 214 ~RGEST CONTAINER 250 215
FED H~RD CATEGORIES ~ 1 FIRE G 2 R~CTIVE G 3 PRESSURE REL~SE ~4 ACUTE H~LTH G 5 CHRONIC H~LTH 216
{Che~ ai~ that apply)
ANNUAL WASTE 217 M~tMUM 218 AVENGE 219 ~TE WASTE CODE 220
AMOUNT 0 DAILY AMOUNT 500 DAILY AMOUNT 250
UNITS* ~ ga GAL ~ cf CU FT ~ lb LBS G tn TONS 221 DAYS ON SITE
' If EHS, amount must be in lbs. 365
STORAGE CONTAINER ~a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM Gi FIBER DRUM Gm GLASS BOTTLE gq RAIL CAR 223
(Check all Iha! apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE {~ r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM e h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC '225
%WT HAZARDOUS COMPONENT EHS CAS #
1 226 227 O Y.s j~No 228 Mixture 229
100 Motor Oil
2 230 231 G Yes G No232 233
3 234 235 G Yes G No 236 237
4 238 239 G Yes G No 240 : 241
I5 e Yes G No 244
242
243
245
PRINT NAM,,,~..I.L~LE OF AUTHORIZED COMPANY REPRESENTATIVE II!. SIGNATURE .' ...
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per mate/iai per build;ag or area)
QNEW QADD O 0E'ETE ~ REV,SE 200 Pe0, 5--- o, 8 --
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION 201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
FACILITY ID# ti~ dill 1 MAP # (optional) I 203 GRlD#(optional)
G5
II. CHEMICAL INFORMATION =
CHEMICAL NAME
Motor Oil
COMMON NAME
Waste Oil
205
20?
CAS # 209
Mixture
G Yes ~No 20:'
204
TRADE SECRET G Yes ~[ No 206
If Subject to EPCRA. refer to instructions
EHS' G Yes ]~No 208
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chie0
CLIIIB, IRR
TYPE G p PURE G m MIXTURE ~ w WASTE 211
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214
210
RADIOACTIVE G Yes ~No 212 [CURIES 213
LARGEST CONTAINER 250 2~s
FED
HAZARD
CATEGORIES
~ 1 FIRE G 2 REACTIVE G 3 PRESSURE RELEASEW,,~4 ACUTE HEALTH G 5 CHRONIC HEALTH 216
(Check alt that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219
AMOUNT 3000 DAILYAUOUNT 250 DAILY AMOUNT 125 212TE wAsTE cODE
220
° If EHS, amount must be in lbs.
STORAGE CONTAINER ~ a ABOVEGROUND TANK Ge PLASTIC/NONMETALLIC DRUM G i FIBER DRUM Gm GLASS BOTTLE Gq RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE G r OTHER
G c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
G d STEEL DRUM G h SILO G I CYLINDER G p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT Oba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAs #
226 227 Gves~No220Mixmre
100 Waste Oil 229
I 230 231 G Yes G No232 233
i 234 235 G Yes G No 236 237
238 239 G Yes G No 240 241
i 242 243 G Yes (~ NO 244 245
Ill..SIGNATURE ..' .'..
PRINT NAME~.~ TITLE OF AUTHORIZED COMPANY REPRESENTATIVE -
DATE
246
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.~.B E R S F I ~, D
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per building or area)
O NEw OAoo OOELETE ~ REV,SE 200 Pa~e ~__ of 8 ---
'1, FACILITY INFo"MATIoN:'':
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Sears #1318 / 6781
CHEMICAL LOCATION 201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
FACILITY ID # '.'~/. ~ I 1
f~ t~[ MAP # (optional) 203 GRID # (optional)
II. CHEMICAL INFORMATION :: ·
Yes ~]~No 202
204
205
CHEMICAL NAME
Brake Fluid
207
COMMON NAME
Brake Fluid
CAS # 209
Mixture
FiRE CODE HAZARD CLASSES (Complete if requested by local fire chico
CLIIIB, IRR
TYPE G p PURE ~[ m MIXTURE G w WASTE
PHYSICAL STATE G s SOLID ~1 LIQUID G g GAS 214
TRADE SECRET G Yes ~ No 206
If Subject to EPCRA, refer to instructions
ERS' G Yes ~No 208
210
RADIOACTIVE G Yes ~No 212 IcuRIEs 213
LARGEST CONTAINER 30 215
FED
HAZARD
CATEGORIES
~ I FIRE G 2 REACTIVE G 3 PRESSURE RELEASE W,,~4 ACUTE HEALTH~ 5 CHRONIC HEALTH 216
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 i~I,~TE WASTE CODE 220
AMOUNT 0 DAILY AMOUNT 60 DAILY AMOUNT 30
UNITS' :~ ga GAL (~ cf CUFT ~--~ lb LBS e tn TONS 221 3~.~;S ON SITE 222
* If EHS. amount must be in lbs.
STORAGE CONTAINER
(Check ali that apply)
ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAIL CAR 223
UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE G r OTHER
TANK INSIDE BUILDING (~ g CARBOY (~ k BOX (~ O TOTE BIN
STEEL DRUM G h SILO G i CYLINDER G p TANK WAGON
STORAGE PRESSURE
AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT ' 224
STORAGE TEMPERATURE
%WT
226
100
2 230
3 234
4 238
5 242
AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT 225
HAZARDOUS COMPONENT
229
G c CRYOGENIC
CAS #
EHS
227 G Yes ~No 228
231 G Yes G No232
235 G Yes G No 236
239 G Yes G No 240
243 G Yes G No 244
Proprietary Mixture Mixture
233
237
241
245
III. SIGNATUR~~
SIGNATURE
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE
DATE 246
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per building or area)
QNEW O ADD O DELETE ~ REVISE 200 Page 7--- of 8 ---
i. Fo~o-':''"~]N ':"'==" ~ '"" :'=.~" · '""'" =:: ~' .~ ' '=
FACIL~
BUSINESS NAME (Sa~ as FACILI~ NAME or DBA- ~ing Business ~) 3
Sears ~131g / 67~1
CHEMICAL LOCATION 201 CHEMICAL LOCATION GYes ~No 202
CONFIDENTIAL (EPC~)
FAC,L,~ ,D ~ ~ ~(;~t 1 ~P.(opt~naO 1 2031GRiD'(°pt~naO 204
II. CHEMICAL INFORMATION ·
205 TRADE SECRET G Yes ~ No 206
CHEMICAL NAME
Brake Fluid If Subject to EPCRA. refer to inslructions
COMMON NAME EHS° GYes ]~ No 206
Used Brake Fluid
CAS # 209 'll]liifl.,'~tll.IIl~l. tifllblh
Mixture ·
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
CLIIIB, IRR, OHH
~PE G, PURE ~[ m MIXTURE G w WASTE 2. RAD,OACT,VE GYes ~No 212 [ CUR, ES ~13
PHYSICAL STATE G s SOLID RI LIQUID G g G~ 214 ~RGESTCONTAINER 30 215
FED H~RO CATEGORIES ~ 1 FIRE G 2 R~CTIVE G 3 PRESSURE REL~SE ~4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216
(Che~ all that apply)
ANNUAL WASTE 217 M~MUM 218 AVENGE 219 2~T~TE WASTECODe 220
AMOUNT 3 ] ~0 DAILY AMOUNT ~0 DAILY AMOUNT ~0
UNITS* ~ ga GAL G dcu FT G lb LBS G tn TONS ~1 DAYS ON SiTE ~2
* If EHS, amount must be in lbs, ~
STORAGE CONTAINER (~ a ABOVEGROUND TANK G e PLASTIC/NONMETALLIC DRUM G i FIBER DRUM (~ m GLASS BOTTLE G q RAIL CAR 223
(Check all that apply)
G b UNDERGROUND TANK G f CAN G j BAG G n PLASTIC BOTTLE G r OTHER
(~ c TANK INSIDE BUILDING G g CARBOY G k BOX G o TOTE BIN
~ d STEEL DRUM G h SILO GI CYLINDER G p TANKWAGON
STORAGE PRESSURE ~ a AMBIENT G aa ABOVE AMBIENT (~ ba BELOW AMBIENT 224
STORAGE TEMPERATURE ]~ a AMBIENT G aa ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
~ 100 22e Proprietary Mixture 227 G Yes ]~No ~2~ Mixture
2 230 231 G Yes G No232 233
3 234 235 G Yes G No 236 237
4 238 239 (~ Yes G No 240 241
III. SIGNATURE .. ~... .
I PRINT NAME & TIILE OF AUTHORIZED COMPANY REPRESENTATIVE S
DATE 246
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2. Gary Endicott
Store GeneralManager
(661) 833-531 ! (661) 654-0731
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
Daily visual inspection
B. EMPLOYEE AND AGENCY NOTIFICATION:
In the event that outside notification is required, the emergency coordinator will telephone the fire department
and other applicable agencies. Depending on the severity of an emergency incident, a partial or complete
evacuation will be ordered by the emergency coordinator. The emergency coordinator may use the PA system,
telephones or verbal means to initiate evacuation procedures.
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
Asset Protection Manager and Operations Manager
D. EMERGENCY MEDICAL PLAN:
In the event of a medical emergency, the manager on duty will call 911 or the proper medical facility will be
contacted. Industrial Medical Group at 2501 G Street is the preferred medical facility for this place of business
(Phone: 661-327-2225).
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
Ao
HAZARD ASSESSMENT AND PREVENTION MEASURES:
Incompatible chemicals are separated by 20 feet or by one-hour separation, and are stored in their original
containers. Batteries are stored in a designated rack or on a shrink-wrapped pallet in a well-ventilated
room away from drains and sources of electricity. Flammable materials not for retail sale are stored in a
flammables cabinet. Used materials are stored in properly labeled drams, and are also kept away from
drains and source of electricity.
Bo
RELEASE CONTAINMENT AND/OR MITIGATION:
Trained employees manage small spills of identified chemicals as long as there are no threats to human
life or the environment. A spill boom will be used immediately to block the flow of liquids from entering
any nearby drains. The MSDS' for spilled materials are consulted for proper guidance in handling the
substances and the spill kits are obtained. Proper PPE is donned before handling spilled product. In the
event of a large spill, fire, or release that threatens human health and/or the environment, the local fire
department and environmental health department will be contacted. In the event of a small fire, if safe
to do so, a fire extinguisher may be used to extinguish the fire.
CLEAN-UP AND RECOVERY PROCEDURES:
Employees will address small spills following the procedures outlined in the mitigation section of this plan. The
proper disposal, spill and leak procedures for each hazardous material at the facility is detailed in the facility's
Environmental Operations Manual. Trained employees will clean up spilled hazardous materials and used absorbent~
and place them in DOT approved containers. These containers will be properly labeled and stored according to local,
state and federal regulations. All hazardous waste materiald will be disposed of by outside contractors at RCRA
approved facilities.
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRiCAL: Electric room, northwest comer of the building
WATER: Middle of the building along the north side
SPECIAL:
LOCK BOX: YESQ IF YES, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
mo
PRIVATE FIRE PROTECTION: Fire Extinguishers
Sprinkler System
WATER AVAILABILITY (FIRE HYDRANT): In the north parking lot
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: 250
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
In Asset Protection & Hub Office
Employees receive a training guide that covers the handling of hazardous materials and environmental management procedures.
Employees are trained on the proper storage and handling methods of hazardous materials during their new employee orientation
period. All employees are trained in the isolation of a spill and prevention of spilled materials from entering storm and sewer systems.
In addition employees are trained in the use of absorbent materials and neutralizers to control and clean up spills, fire prevention and
response, and how to respond to medical emergencies. Annual refresher trainings are conducted and safety meetings are held on an as
needed basis.
Management personnel are trained in the proper procedures for agency notification, emergency response, and evacuation notification.
CERTIFICATION
I, Joel Greene CERTIFY THAT THE ABOVE
INFORMATION 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.
EH&S Compliance Manager 1/01/02
4
TITLE
DATE
CALIFORNIA ANNOTATED SITE MAP Business Name:
A B C
1
2
3
4
5
6
?
Sears Auto Center #67§1
J ~'ite Address: 3001 Ming I Map #:
Bakersfield
D E F G H I
Y
, {
Electric Main
(~ Water Main
Gas Main
Fire Riser
New Batteries
Spill Kit
Winshield Washer
Antifreeze
ATF
Motor Oil
Fire Extinguishers
Used Batteries
Wheel Cleaner
New Oil Tank
Waste Oil Tank
§co, Le:
1"-1.5'
North
CALIFORNIA ANNOTATED SITE MAP I Business Name: Sears Auto Center #6781 {Site
A B C D E F
2
3
7
Basement
Address: 3001 Ming Ave ] Map #: 2 ]
Bakersfield
G H I
Y
(~ Electric Main
Fire Riser
~-~ Winshield Washer
~ Antifreeze
ATF
Motor Oil
Wheel Cleaner
~cole:
1~=60'
North
7
CALIFORNIA ANNOTATED SITE MAP
IBusiness Name: Sears FLS #1318
Site Address: 3001 Ming Avenue [ Map #:
Bakersfield, CA
!
A B C F G H I
D E
Upp.~r Lev.~t
Y
3 I
§c~Le:
1~=56'
North
CALIFORNIA ANNOTATED SITE MAP
A B
IBusiness Name: Sears ~i318
C D E
Site Address: 3001 Ming
Bakersfield
F G H
Map #: 4
1
7
Y
Emergency Generator
Helium Tank
Spill Kit
Waste Gas
Fire Riser
Gas Main
Electric Main
1~=56'
North
A B C D E F
Address: 3001 Ming I Map #: 5
Bakersfield
G H I
7
Ming Ave
Y
~il ~~~ ~! Val,iey Plaza Mall
Water Main
Fire Hydrant
Storm Brain
Scale:
UndeFined
North
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER / OPERATOR IDENTIFICATION
FACILITY INFORMATION
I. FACIMTY'IDENTIF!CATION "
' 1 Year Beginning
' 1.._.~. I ~._.1.. I..[__l_~ ............. 1/01/2002
NAME (Same as FACILITY NAME or DBA- Doing Business As) ............. 3-J 'Buslh~-15~bN E- ........................
Sears-Bakersfield-#1318 / 6781 -] ....... (6~61) 8-3):-5--3_0.9 ........................
SITE ADDRESS
3001Ming Avenue
CITY Bakersfield
/ x -A
DUN &
BRADSTREET 00]629955
103
lO4 CA
106
ZIP 93304
SIC CODE lO7
(4 Digit #) 5399, 7549
COUNTY Kern
OPERATOR NAME Sears Roebuck and Co.
108
II. OWNER INFORMATION ..
OWNER NAME Sears Roebuck and Co.
11~ OWNER PHONE (847) 246-5313
112
OWNER MAILING
ADDRESS
3333 Beverly Road A2-262A
113
CITY Hoffman Estates
STATE IL 115 ;i ZIP 60179
116
Iil. ENVIRONMENTAL CONTACT
CONTACT NAME Joel Greene
117 CONTACT PHONE (847) 246-5313
118
CONTACT MAILING
ADDRESS 3333 Beverly Road A2-262A
CiTY Hoffman Estates
120 I STATE IL 121 ZiP 60179
119
122
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARy-
NAME Filomena Evans 123 NAME Gary Endicott 129
125 TITLE Store General Manager 130
TITLE Operations Manager
BUSINESS PHONE (661) 833-5389
126 BUSINESS PHONE (661) 833-5382 131
24-HOUR PHONE (661) 397-42201
PAGER #
127 24-HOUR PHONE (661) 654-0731
128 PAGER # 133
V. CERTIFIcATiON
132
Certification: Based on my inqu~ef those ~n
SI GNATURE,,13¢~~ information is true, accurate, and complete.
familiar with the i~,,~a!tted in this inventory and ?Ii_eve the ...... l DATE- ................. ~34 'N~i{/i~-~: DocumENT PREbAI~[}'R
i
TOR (print) ....... ;;~ ......... / 3/1/02 I Jolene Beaton
i EH&S Compliance_Manager
individuals responsible for obtaining the information, I certi~ under penalty of law that I have personally examined and ~
135
137
UPCF (7/99) C:\WINNT40\Profi les~jtraylor.000\Desktop\O ES2730.wpd
.~~B E R S F 1
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2.
3.
4.
5.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.'
Be as brief and concise as possible.
You may also attach Business Owner / Operator Form and Chemical Description Form(s) to
the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Sears- Bakersfield - #1318 / 6781
LOCATION: 3001 Ming Avenue, Bakersfield, CA 93304
MAILING ADDRESS: 3001 Ming Avenue, Bakersfield, CA 93304
CITY: Bakersfield
STATE: CA ZIP: 93304 PHONE: (661)833-5300
PRIMARY ACTIVITY: Retail Merchandise and Auto Pans Facility
OWNER: Sears Roebuck and Co. PHONE: (847) 286-5313
MAILING ADDRESS: 3333 Beverly Road A2-262A, Hoffman Estates, IL, 60179
EMERGENCY NOTIFICATION
CONTACT
Filomena Evans
TITLE
Operations Manager
BUS. PHONE
(661) 833-5389
24 HR. PHONE
(661) 397-4220
.1
2. Gary Endicott Store General Manager (661) 833-5311 Hm (661) 654-0731 Ce11(661) 203-1392
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
Daily visual inspection
B, EMPLOYEE AND AGENCY NOTIFICATION:
In the event that outside notification is required, the emergency coordinator will telephone the fire department
and other applicable agencies. Depending on the severity of an emergency incident, a partial or complete
evacuation will be ordered by the emergency coordinator. The emergency coordinator may use the PA system,
telephones or verbal means to initiate evacuation procedures.
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
Asset Protection Manager and Operations Manager
D. EMERGENCY MEDICAL PLAN:
In the event of a medical emergency, the manager on duty will call 911 or the proper medical facility will be
contacted. Industrial Medical Group at 2501 G Street is the preferred medical facility for this place of business
(Phone: 661-327-2225).
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
HAZARD ASSESSMENT AND PREVENTION MEASURES:
Incompatible chemicals are separated by 20 feet or by one-hour separation, and are stored in their original
containers. Batteries are stored in a designated rack or on a shrink-wrapped pallet in a well-ventilated
room away from drains and sources of electricity. Flammable materials not for retail sale are stored in a
flammables cabinet. Used materials are stored in properly labeled drams, and are also kept away from
drains and source of electricity.
RELEASE CONTAINMENT AND/OR MITIGATION:
Trained employees manage small spills of identified chemicals as long as there are no threats to human
life or the environment. A spill boom will be used immediately to block the flow of liquids from entering
any nearby drains. The MSDS' for spilled materials are consulted for proper guidance in handling the
substances and the spill kits are obtained. Proper PPE is donned before handling spilled product. In the
event of a large spill, fire, or release that threatens human health and/or the environment, the local fire
department and environmental health department will be contacted. In the event of a small fire, if safe
to do so, a fire extinguisher may be used to extinguish the fire.
CLEAN-UP AND RECOVERY PROCEDURES:
Employees will address small spills following the procedures outlined in the mitigation section of this plan. The
proper disposal, spill and leak procedures for each hazardous material at the facility is detailed in the facility's
Environmental Operations Manual. Trained employees will clean up spilled hazardous materials and used absorbents
and place them in DOT approved containers. These containers will be properly labeled and stored according to local,
state and federal regulations. All hazardous waste materials will be disposed of by outside contractors at RCRA
approved facilities.
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT yOUR FACILITY)
NATURAL GAS/PROPANE: Outside - dock ramp: N. Wall
ELECTRICAL: Electric room, northwest comer of the building
WATER: Middle of the building along the north side
SPECIAL:
LOCK BOX: YES(~ IF YES, LOCATION:
11/14/00
09:49
~'661 326 0576 BFD ltlZ MAT DI¥ -~004
CITY OF BAKERSFIELD
OFFICE OF ENVIRON~NT~ SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER I OPERATOR IDENTIFICATION
FACJUTY INFORMATION
Pa0~ 1 o; 4
.... 1/1/01
J Year Beginning
BUSINESS NAME (Same as FAI~ILITY NAME or DBA, D~Tng ausiaess As) Sears Valley Plaza
[ SITE ADDRESS
3001 Ming Ave
I Year Ending
I1/1/02
BUSINESS PHONE
1(661) 833-S300
CIIY Kem l~ i CA ZIP 93304-4119
DUN & l~ SIC CODE
BRADSTREET 001629955 (4D~5399, 7549
102
10~
107
COUNTY .._.l~utk~I.~fig~_
OPERATOR. NAME ~.eRoh~'rtqnn lOS J OPERATOR PHONE ~(6~1),833_5300 11n
t , '" ' ,.O~-b..l',', .. ' ':: .a'"'.l~.q',x,.-' ~'~'~... ,T~p~.,.;,U:~'~""~,'~, ..... ,,,~,,-,; '~...,, ~,. ~. ........ :.-,,,, ., - ,,,~.,
'"'~ ''w' '~,~",~ ',~ .. ":" .;i~l~-'~- ' ~,. '.~e..;. .'~ ........ ~ '~' "~ ','~'~' ': '~ .J ',,'. '.'. ", ,."'".~' ' 1"" ': "' '"' ~' ' ~,:,'~v ·
.... -,--.'~.,' :.,,:~ .... .~*., ~.~.,.:~,~; ~/:lrOO~E~ ~N~~ON ...... ,~.",.* ,..',:~. ,..',. ' '~''
...... . ........ . . ..,.,.........~: ::,..,::.....,~ .....
O~ER NAME Scars, Rocbuck~ a Co. A~: ~ocl Greene m ] O~ER PHONE (847) 2~6 531~
iOWNER MAILING
ADDRESS 3333 BEVERLY RD, A2-262A
HoffmanEstates - ~'~ I STATEIL ~s I ZIP 60179
CITY
CONTACT NAME Joel Greene. ,r I CONTACT PHONE (847) 286 5313
CONTACT MAILING
ADDRESS 3333 BEVERLY RD, A2-262A
CITY Hoffman Estates. uo [ STAI'EiL ~z~ I ZiP 60179
NAME Rick Bell ~za N~E Sue Robertson
TITLE Ope-rations Manager ~ TITLE Store General Manager
136
BUSINESS PHONE(661) 833-5300
24-HOUR PHONE (805) 664-1145
PAGER#
BUSINESS PHONE (661) 833-5300
2d-HOURPHONE (805) 665-8405
PAGER. fl
. ~ . ,,,~ .) : . ,~&,,e! ! ,,, ' "i " ~ "
' '"":" .'; .... ' ..... ~,~.~'". :: ...... hV,, CERTIFI,CATION.. ,.~.. r :, .. i' '::',. . ... :.: ~
" " /;'' j'".",','~,~b h,~..'.,',' · . ' · :' ,' ,..', ~,, ',::
-- · ,':,,-5.::: ,,:,,,':~ "' "' . ' ,
Certifioal~on: Based on my inqul~ of tho~e indlvldua]s responsible FOr obtaining b%e ]nforma§on, I ce~/under penalty of law Ihat I have personally examined
and am Pamlllar with the informaUon subrniRed in this Inventory and believe the infom'mllon is true, eceurate, and complete.
S:~E~I/OPERATOR
Sears, Roebuck and Co., by R. Joel Greene
DATE ~ NAME, OF DOCUMENT PREPARER
~'7t5~/~O/ Krista Brown
rfl'~r'~"~
EHS Compliance. Manager
137
UPCF (7/99) S;~CUPAI=ORMS~OES2730,~/4.wpd
~ r~ 11/14/00 09:52 9661 326 '6 BFI) EAZ ~.T DIV ~009
OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(o~8 fOt~ IJ~r O~mnal per budding oe
............ '1~ FA~ ~A~ON :' ':' '," ' ' ', J
Soars VaUoy Piaza
~ m~a Auto Se~ice Center ( ~m~ (~) ~ Y~ ~ ~
', CHF. MIC~. NAME
Sulfuric Acid
· comMoN N~a
' Used lead acid batteries
:210
7664-93-9
CODe H~.ARD ¢_J. AS~$ (Complete if ~m ~y ~ r~e ~
CO~, W~I
--
STOI~G~PRE$$URP- [] a AMBIffi~' [] ~ ABOVEAI~IL~ff [] Im 8ELOWAbI~IEH? ~4 j
233 '
~37
F1 ¥~ FI N~ 236
~38 ~ 0 ¥~ 0 NO 240 24.'1
242 243 [] Y~s [] NO 244
2~5
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~ 1~./1¢/00 09:52 9551 326 76 BiD
o ~009
OFFICE OF ENVIRONMENTAL SERVICES
- ~ Fr~S I
e~,~~rr 1715 Chester Ave., CA 93301 (661) 326-3979
'~"~~--"" HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIP~ON
(0~ ~ ~sr m~mnal per ~d~g or ama)
.... , .... . .,.: , , .'., ',':..., '; . *1; FACILITY ~ORMATION :' ':'...' ·
Sears Valley Plaza
,.
I ' . ' ..' .. ' .-' '.,.: ,' '.~;,'.. ". · '. *.'," ' .' '..' .,:", ' ;'-'"; .' ^ '**'. :'".:
' ; , :'; ""i, '' :, ",.. .~...:,,:; .:,: , ..'~ILCHkllC;i~..'II~iFORI~ATIO,N,,; ....... '
', CHEkUCN. N~IE
Helium
'.Helium
CAS #
,__' 7440-59-7 .
~q~ CODe ~ CLASSES (C~mp~m ;f ns~esr~ t~y ~ r~e et~.O
[]Y~s []No 2o2
NFG, IRR
TYP-~' ~p PURE O m lulXI1JRE 0 w wASTE 2,1 ! RADIOAC'riv~ OYeS [] N~ 2'12 ~"~ 21'3--
I
[] ~ 8OUD [:]! UQUID ~ g C~a,S ~4 I LARGF~rCONTAINER 3.5
PHYSICAL ~TATE
2'15
FEDHAZARO CATleC,-OJ:~-~ [] I FII~,~ ~12 P~F. AG~ 1~]3 Ja,R~S~:dJRIE REJ..EA.,e~ ~4. A~I,rl~HF..ALTH r""~.s CHRONIC HEALTH 215
(c~ec~ gl~ ~,m apply)
ANNUALWAS'T~ Z17 I II,~XJMUM 2,. I AVERAGE 2'1. STATEWASl'ECODI~ 220
~OUUT N/A , OAILYAMOuhrr 220 I DAILYAMOUN~ 120 .~ N/A __
UNITS' rl ~a ~ [] ~ CUFT 0 · ~ ~'l ~ TON~ 221
STORAG£CONTA/~F.R 0 ~ A~OVEC, ROUNOTANK I-Tn Pt. ASq'IC/NONIvlEI'ALUC DRUM I-Il FleER DRtJM l'-~m ~ flOTTLE f-Ia RAtLCAR 223
nil UNOERGROUNOTAN~ L--I; CAN Eli BAG I-In el.,~c~"K~ BO1-TLE Elf OTHER
ri c TAJ~ INRI0~ BUILDING [] g ~Y [] k BOX [] o TOTE BIN
STORaGEPRE$$U~- F'I a AMB~:~' [] nn ,~OVE~a,~mN'? [] bn BELOW.4Uae[ENT ?.24 j
I I
231
i--'1 yee r~ No 2'32
234 ~$ [] Y~ [] NO ~ ~7
[]Y~ ~]No 240
241
24.5
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11/14/00 09:52 ~'651 32 ;75 BFI) EAZ IIAT DIV ~009
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one ~ot17~ Der m~Cunal per buSd~g ar ama)
, ' ' ' ,.,. *.;,,": ,,,,' . ,, :*"'~: · *,'?' '"':~." . ,
.... , . , , ..,., , , .'., ',%, ', . '1: FAC~ ~~0~ ',' '~".,,' - * "
Sears Valley Plaza
2011 ~H~MIC,~. L.OC.~TION
~ c~EMICAt. L~CATtON ~~ (~)
Unleaded Gasoline ~
.
'Used unleaded gasoline
[] Yes ~i~ No 202
Mixture
CODE HAZARD ~$
FL~, I~, CAR
STORaGE PRESSURE I~ a JUWFr. NT [] ~a A~OV~EN'r [] b8 BELOWAMe~.an' z24 j
m IUnleaded
Gasoline Mixture
Z~0 231 233 '
234 ~ 237
242 243
' ,"~' ', .~; .,$,, · ',,~:' ,,.A . ,,- ',,,,:, ~ ~A,'* ,, ,;'
: ':'" '. :k',',, '. , ' . ~. ~'.?/', ,' ' '*'..'*" "
I:~INT_NAME &_'rTrLE_OF_J ,U:i~3RJ2~D GOMpANY_REE_RF_.~=~F~'~VE
Sears, Roebuck and Co., by R. Joel Greene
2*5
.':', ,.,,,,., ~ ,
DATE 2~
UPCF (-/Igg) S:\CUPAFORMSAOES2731 .TV4.wpd
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-3979
INSTRUCTIONS:
2.
3.
4.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be as brief and concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Sears Valley Plaza
LOCATION: 3001 Ming, Bakersfield, CA
MAII'.ING ADDRESS: 3333 BEVERLY RD, A2-262A
CITY: Hoffman Estates
DUN & BRAI)STREET NUMBER: 1629955
STATE: IL ZIP: 60179
PHONE: (847) 286 5313
SIC CODE: 5399, 7549
PRIMARY ACTMTY: Retail General Merchandise and Auto Service Center
OWNER: Sears, Roebuck, & Co., Attn: Joel Greene
MAILING ADDRESS: 3333 Beverly Rd, A2-262A, Hoffman Estates, IL 60179
SECTION 2: EMERGENCY NOTIFICATION
CONTACT TITLE
1. Rick Bell Operations Manager
BUS. PHONE
(661) 833-5300
24 HR. PHONE
(805) 664-1145
2. Sue Robertson
Store General Manager (661) 833-5300
(805) 665-8405
HAZARDOUS MATER/ALS MANAGEMENT PLAN
SECTION 3: TRAINING
NUMBER OF EM~PLOYEES: 240
MATERIAL SAFETY DATA SHEETS ON FILE: MSDS are on file
BRII~.F SUMMARY OF TRAINING PROGRAM:
Employees receive a training guide that covers the handling of hazardous materials and environmental managern~ent procedures.
Employees are trained on the proper storage and handling methods of hazardous materials during their new employee orientation
period. All employees are trained in the isolation of a spill and prevention of spilled materials from entering storm and sewer
systems. In addition employees are trained in the use of absorbent materials and neutralizers to control and clean up spills, fire
prevention and response, and how to respond to medical emergencies. Annual refresher trainings are conducted and safety
meetings are held on an as needed basis.
Management personnel are trained in the proper procedures for agency notification, emergency response, and evacuation
notification.
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 MATER/ALS.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT
NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION
Sears, Roebuck and Co., by R. Joel Greene
I, ~' CERTIFY THAT THE ABOVE
INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE
USED TO FLrLFII.L 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.
~ EHS Compliance Manager
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
A. AGENCY NOTIFICATION PROCEDURES:
In the event that outside notification is required, the emergency coordinator will telephone the fire department and other
applicable agencies.
'B.
EMPLOYEE NOTIFICATION AND EVACUATION:
Depending on the severity of an emergency incident, a partial or complete evacuation will be ordered by the emergency
coordinator. The emergency coordinator may use the PA system, telephones or verbal means to initiate evacuation
procedures. Employees are instructed to escort customers through the nearest emergency exit and meet at the designated
staging area in the store parking lot.
C. PUBLIC EVACUATION:
Employees are instructed to escort customers through the nearest emergency exit and meet at the designated staging area
in the store parking lot.
D. EMERGENCY MEDICAL PLAN:
In the event of a medical emergency, the manager on duty will call 911 or the proper medical facility will be contacted.
Industrial Medical Group at 2501 G Street is the preferred medical facility for this place of business (Phone:
661-32%2225).
3
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MIT!QATIQN, PREVENTION ,AND ABATEMENT PLAN
ho
RELEASE PREVENTION STEPS:
.Incompatible chemicals are separated by 20 feet or by one-hour separation, and are stored in their original containers. Batteries are
stored in a designated rack or on a shrink-wrapped pallet in a well-ventilated room away from drains and sources of electricity.
Flammable materials not for retail sale are stored in a flammables cabinet. Used materials are stored in properl3; labeled drums, and are
also kept away from drains and source of electricity.
Co
RELEASE CONTAINMENT AND/OR MINIMIZATION:
Trained employees manage small spills of identified chemicals as long as there are no threats to human life or the environment. A spill boom will be
used immediately to block the flow of liquids from entering any nearby drains. The MSDS' for spilled materials are consulted for proper guidance in
handling the substances and the spill kits are obtained. Proper PPE is donned before handling spilled product. In the event of a large spill, fire, or release
that threatens human health and/or the environment, the local fire department and environmental health department will be contacted. In the event of a
small fire, if safe to do so, a fire extinguisher may be used to extinguish the fire.
CLEAN-UP PROCEDURES:
Employees will address small spills following the procedures outlined in the mitigation section of this plan. The proper disposal, spill and leak
procedures for each hazardous material at the facility is detailed in the facility's Environmental Operations Manual. Trained employees will clean up
spilled hazardous materials and used absorbents and place them in DOT approved containers. These containers will be properly labeled and stored
according to local, state and federal regulations. All hazardous waste materials will be disposed of by outside contractors at RCRA approved facilities.
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)_
NATURAL GAS/PROPANE:
ELECTRICAL: Electric room, northwest comer of the building
WATER: Middle of the building along the north side
SPECIAL: West side of building
LOCK BOX: YES~ IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAII,ABILITY
Bo
PRIVATE FIRE PROTECTION:
Fire Extinguishers
Sprinkler System
WATER AVAILABILITY (FIRE HYDRANT):
In the north parking lot
4
SEARS ROEBUCK & CO
Manager :
Location: 3001 MING AVE
City : BAKERSFIELD
: /
BusPhone:
Map : 123
Grid: 12A
CommCode: BAKERSFIELD STATION 07
EPA Numb:
SIC Code:
DunnBrad:
SiteID: 015-021-001008
(805) 833-5311
CommHaz : Moderate
FacUnits: 1 AOV:
Emergency Contact / Title
DARRELL TIDMORE / PROTECTION MNGR
Business Phone: (805) 833-5311x
24-Hour Phone : (805) 832-8204x
Pager Phone : (805) 632-3351x
Emergency Contact
SUE ROBERTSON
Business Phone:
24-Hour Phone :
Pager Phone :
/ Title
/ STORE MANAGER
(805) 833-5300x
(805) - x
( ) - x
Hazmat Hazards:
Fire Press
ImmHlth DelHlth
Contact :
MailAddr: 3001 MING AVE
City : BAKERSFIELD
Phone: ( )
State: CA
Zip : 93304
x
Owner SEARS ROEBUCK & CO
Address : 3001 MING AVE
City : BAKERSFIELD
Phone: ( )
State: CA
Zip : 93304
^
~- TotalASTs: =
~'~~ 1~0 TotalUSTs: =
~ RSs: No
x
Period :
Preparer:
Certif'd:
to
Gal
Gal
Emergency Directives:
= Hazmat Inventory
--As Designated Order
Hazmat Common Name...
WASTE OIL
FREON R-ii
ISpecHazI
EPA HazardsI
F DH
F P IH
One Unified List
All Materials at Site
Frm I DailyMax Iunit MCP
L 550.00 GAL Low
L 1800.00 FT3 Min
~ Do hereby certify that I have
reviewed the attached hazardous mater/als manage-
ment plan fO~and that it along with
any corrections constitute a Complete and correct man-
agement plan for my facility../?
11/06/2000
SEARS ROEBUCK & CO SiteID: 015-021-001008
Inventory Item 0001 Facility Unit: Fixed Containers on Site
WASTE OIL Days On Site
365
Location within this Facility Unit Map: Grid:
SW AUTOMOTIVE GROUND LEVEL CAS#
221
F STATE TYPE PRESSURE
Ambient
Waste
Liquid
TEMPERATURE
Ambient
CONTAINER TYPE
ABOVE GROUND TANK
Largest Container
550.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
550.00 GAL
Daily Average
100.00 GAL
I%Wt.
100.00
HAZARDOUS COMPONENTS
Waste Oil, Petroleum Based
CAS#
0
HAZARD ASSESSMENTS
TSecretl RoS BioHazl Radioactive~Amount I EPA HazardsI NFPA
No N No No/ Curies F DH / / /
USDOT# [ MCP
Low
Inventory Item 0004 Facility Unit: Fixed Containers on Site
~iVUVl~ ~Vl~ / ~ £ %i&kJ.~ N~Vl~
FREON R-11 Days On Site
365
Location within this Facility Unit Map: Grid:
BASEMENT/A/C RM MAIN STR CAS#
75694
F STATE T TYPE PRESSURE
/
Ambient
Pure
Liquid
TEMPERATURE
Ambient
CONTAINER TYPE
IIN MACHINE/EQUIP
Largest Container
1800.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum I
1800.00 FT3
Daily Average
1800.00 FT3
%Wt.
100.00 Freon 11
HAZARDOUS COMPONENTS
CAS#
75694
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F P IH
NFPA
///
USDOT# [MCP
Min
2
11/06/2000
SEARS ROEBUCK & CO
SiteID: 015-021-001008
Fast Format
F Notif./Evacuation/Medical
AL Agency Notification
L 911
Overall Site
09/24/1991
-- Employee Notif./Evacuation
11/18/1997
VERBAL AND CALL 911
FIRE DRILL SOUNDED WITH DESIGNATED AREA ANNOUNCED AND ASSET PROTECTION STAFF
AND SECURITY MANAGER IN ATTENDANCE
Public Notif./Evacuation
DONE VIA PA SYSTEM THROUGHOUT STORE.
09/24/1991
Emergency Medical Plan
LOCAL HOSPITALS: MERCY HOSPITAL
MEMORIAL HOSPITAL
2215 TRUXTUN AV
420 34TH ST.
09/24/1991
327-3371
327-1972
3 11/06/2000
SEARS ROEBUCK & CO
SiteID: 015-021-001008
Fast Format
= Mitigation/Prevent/Abatemt
--Release Prevention
Overall Site
01/17/1996
SMALL OIL, BRAKE FLUID, BATTERY ACID SPILLS ARE CLEANED UP BY EACH
INDIVIDUAL MECHANIC RESPONSIBLE FOR HIS BAY (NO LARGE SPILLAGE IN THIS
-- Release Containment
APPROVED CONTAINERS FOR ALL MATERIALS.
01/17/1996
-- Clean Up
BAKING SODA
EYE WASH KIT
WATER FLUSH
01/17/1996
Other Resource Activation
-4- 11/06/2000
SEARS ROEBUCK & CO
SiteID: 015-'021-001008
Fast Format
Site Emergency Factors
Special Hazards
Overall Site
--Utility Shut-Offs
11/18/1997
A) GAS - RECEIVING DOCK RAMP (SOUTH-WEST)
B) ELECTRICAL - NW CORNER OF BASEMENT
C) WATER - BASEMENT-GIRLS DEPT(OVERHEAD)
D) SPECIAL - FIRE SPRINKLER-FOUR SYSTEMS-(N BASEMENT WALL: NW CORNER, NORTH
EMERGENCY EXIT, REFRIGERATORS, NE CORNER)
E) LOCK BOX - NO
Fire Protec./Avail. Wate~
11/18/1997
PRIVATE FIRE PROTECTION - 1) OVERHEAD FIRE PROTECTION SPRINKLER SYSTEM
GOVERNED BY TEL-TEC ALARM SERVICE TO THE FIRE DEPT. 2) FIRE EXTINGUISHERS
PLACED THROUGH OUT BUILDING 3) FIRE BRIGADE TEAM
FIRE HYDRANT - IN MAIN STORE LOCATED OUTSIDE OF NORTHWEST ENTRY.
IN AUTOMOTIVE IT IS LOCATED ON THE NORTH SIDE ADJACENT TO THE MING AVE MALL
ENTRANCE.
Building Occupancy Level
-5- 11/06/2000
SEARS ROEBUCK & CO
SiteID: 015-021-001008
Fast Format
~ Training
-- Employee Training
WE HAVE 300 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: ASSOCIATES TRAINED ON HAZARDOUS MATERIALS WITH A
TRAINING FILM AND A DISCUSSION PERIOD.
Overall Site
01/17/1996
-- Page 2 I
-- Held for Future Use I
Held for Future Use
-6- 11/06/2000
SEARS ROEBUCK & CO
Manager :
Location: 3001 MING AV
City : BAKERSFIELD
CommCode: BAKERSFIELD STATION 07
EPA Numb:
SiteID: 215-000-0.~'8~2~_<~;;
BusPhone: (805) ~
Map : 123 CommHaz : Moderate
Grid: 12A FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / .~/t%~eo~,b~ ~_~Emergency Contact
~ ~d~o-~ / ..... z ....... ~ I SUE ROBERTSON
Business Phone: (805) 833-5311x ~ Business Phone:
24-Hour Phone : (805) ~~?-X2°~r ~ ~ ~ne ~
Pager Phone : (50g) g U~h
Hazmat Hazards: Fire Press
/ Title
/ STORE MANAGER
(805) 833-5300x
(805) - x
( ) - x
ImmHlth DelHlth
Emergency Directives:
~ Hazmat Inventory
--MCP+DailyMax Order
Hazmat Common Name...
ACETYLENE
SODIUM DICHLORO-S-TRIAZINIETRION
WASTE OIL
FREON R-i~
MOTOR OIL
SPECTRUM OIL
One Unified List
Ail Materials at Site
ISpooHaz EPA Hazardsl Frm DailyMax Unit MCP
F P IH~ G ~~ FT3 Hi
IH DH L ~.,~jL~TLBS Mod
F DH L ~,,~d ~'-~q6-fr ~i[kL Low
/
F P IH ~
F DH L ~.~8~-5 GAL Min
F DH L ~,/t-3~z~'GAL Min
~-. -1- 10/14/1997
SEARS ROEBUCK & CO SiteID: 215-000-001008
~ Inventory Item 0006 Facility Unit: Fixed Containers on Site
%.;U.I. Vll. vluJ.~l J.~.Z-.~.vJ..LS / ~._;~-J.~.l. vJ..L ~._;.Z..-~.~ JNJ-~j. vj.~;
ACETYLENE Days On Site
Location within this Facility Unit Map: Grid:
AUTO SHOP CAS#
74-86-2
STATE -- TYPE PRESSURE
Ambient
Pure
Gas
TEMPERATURE
IAmbient
CONTAINER TYPE
FIXED PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest C~erFT3 I Daily Maxim~ I Daily Averag~
HAZARDOUS COMPONENTS
%Wt. EHS CAS#
100.00 Acetylene No 74862
HAZARD ASSESSMENTS
TSecret EHS BioHazl Radioactive/Amount I EPA HazardsI NFPA
No No No No/ Curies F P IH / / /
USDOT#
MCP
Hi
Inventory Item 0007 Facility Unit: Fixed Containers on Site
~UIv~vluN N~vl~ / ~ ~.~--~_J_~ ~vl~
SODIUM DICHLORO-S-TRIAZINIETRIONE Days On Site
Location within this Facility Unit Map: Grid:
NW CORNER MAIN STORE CAS#
2893789
STATE T TYPE
Liquid ~ Pure
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
PLASTIC CONTAINER
Largest Cont.~.'ner
LBS
AMOUNTS AT THIS LOCATION
I Daily Maximum I
!27.00 LBS
Daily Average
%Wt.
100.00
HAZARDOUS COMPONENTS
Sodium Dichloro-s-triazinetrione
EHS CAS#
No 2893789
TSecret EHS BioHaz
No No No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies IH DH
NFPA
///
USDOT# [ MCP,
Mod
2 10/14/1997
SEARS ROEBUCK & CO SiteID: 215-000-001008
Inventory Item 0001 Facility Unit: Fixed Containers on Site
~UlVUVl~ ~Vl~ / ~± ~_Y-k.l.J ~Vl~
WASTE OIL Days On SAte
Location within this Facility Unit Map: Grid:
SW AUTOMOTIVE GROUND LEVEL CAS#
221
STATE TYPE PRESSURE
Liquid Waste Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
ABOVE GROUND TANK
Largest Containers~o GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
550.00 GAL
%Wt.
100.00
HAZARDOUS COMPONENTS
IWaste Oil, Petroleum Based
Daily Averag~___~
EHS
No
CAS#
0
ITSecret EHS BioHaz
No No No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F DH
NFPA
///
USDOT#
MCP
Low
Inventory Item 0004 Facility Unit: Fixed Containers on Site
~lVUVl~ ~Vl~ / ~l& ~./.-k. LJ ~Vl~
FREON R-11 Days On Site
365
Location within this Facility Unit Map: Grid:
BASEMENT/A/C RM MAIN STR CAS#
75694
F STATE T TYPE
~ Pure
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
IN MACHINE/EQUIP
AMOUNTS AT THIS LOCATION
Largest C°ntainer ~SI1~'00 ~ l~O0./Daily Maximum ~'~S'14-9~x3~8~ ~ /~00Daily Average ~j~ ~T~
%Wt.
100.00 Freon 11
HAZARDOUS COMPONENTS
EHS
CAS#
75694
TSecret EHS BioHaz
No No No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F P IH
NFPA
///
USDOT#
IMCP
Min
-3- 10/14/1997
SEARS ROEBUCK & CO SiteID: 215-000-001008
Inventory Item 0002 Facility Unit: Fixed Containers on Site
~lV~Vl~ ~vl~ / ~ ± ~.&.~_~ ~vl~
MOTOR OIL Days On Site
Location within this Facility Unit Map: Grid:
SALES FLR AUTO CNTR SKRM CAS#
8020835
~ STATE T TYPE PRESSURE
Ambient
Pure
Liquid
TEMPERATURE
Ambient
CONTAINER TYPE
PLASTIC CONTAINER
Largest CO. GAL
AMOUNTS AT THIS LOCATION
I Daily Maximum I
_~~ GAL
Daily Average
~025. ~ GAL
%Wt.
100.00
HAZARDOUS COMPONENTS
Motor Oil, Petroleum Based
EHS CAS#
No 8020835
TSecret EHS BioHaz
No No No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F DH
/ / / Min
Inventory Item 0003 Facility Unit: Fixed Containers on Site
SPECTRUM OIL Days On Site
Location within this Facility Unit Map: Grid:
AUTO SHOP MAIN FLOOR CAS#
8020835
STATE ~ TYPE
Liquid/Pure
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
ABOVE GROUND TANK
Larges~nerGAL
AMOUNTS AT THIS LOCATION
Da.~. Maximum~ GAL I
Daily Average
6~0 GAL
%Wt.
100.00
HAZARDOUS COMPONENTS
Motor Oil, Petroleum Based
EHS CAS#
No 8020835
TSecret
No
EHS BioHaz
No No
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F DH
NFPA I USDOT# IMCP/// Min
-4- 10/14/1997
SEARS ROEBUCK & CO
SiteID: 215-000-001008
Fast Format
= Notif./Evacuation/Medical
--Agency Notification
CALL 911
Overall Site
09/24/1991
-- Employee Notif./Evacuation 09/24/1991
VERBAL AND CALL 911 ~~.~ ~+a~c
FIRE DRILL SOUNDED WITH DESIGNATED AREA ANNOUNCED AND ....
~ AND SECURITY MANAGER IN ATTENDANCE
-- Public Notif./Evacuation ~
DONE VIA PA SYSTEM THROUGHOUT STORE.
09/24/1991
Emergency Medical Plan
LOCAL HOSPITALS: MERCY HOSPITAL
MEMORIAL HOSPITAL
2215 TRUXTUN AV
420 34TH ST.
09/24/1991
327-3371
327-1972
-5- 10/14/1997
SEARS ROEBUCK & CO
SiteID: 215-000-001008
Fast Format
= Mitigation/Prevent/Abatemt
--Release Prevention
Overall Site
o / 7/ 996
SMALL OIL, BRAKE FLUID, BATTERY ACID SPILLS ARE CLEANED UP BY EACH
INDIVIDUAL MECHANIC RESPONSIBLE FOR HIS BAY (NO LARGE SPILLAGE IN THIS
--Release Containment
APPROVED CONTAINERS FOR ALL MATERIALS.
01/17/1996
-- Clean Up
BAKING SODA
EYE WASH KIT
WATER FLUSH
01/17/1996
Other Resource Activation
6 10/14/1997
F SEARS ROEBUCK & CO
SiteID: 215-000-001008
Fast Format
Site Emergency Factors
Special Hazards
Overall Site
--Utility Shut-Offs
01/17/1996
A) GAS - RECEIVING DOCK RAMP (SOUTH-WEST)
B) ELECTRICAL - NW CO~R/OF BASEMENT
C) WATER - BASEMENT-~DEPT (OVERHEA~e/
D) SPECIAL - FIRE SPRINKLER-FOUR SYSTEMS-(NAWALL: NW CORNER, AEMERGENCY EXIT,
E/ OeK BOX - NO
-- Fire Protec./Avail. Water
01/17/1996
PRIVATE FIRE PROTECTION - 1) OVERHEAD FIRE PROTECTION SPRINKLER SYSTEM
GOVERNED BY TEL-TEC ALARM SERVICE TO THE FIRE DEPT. 2) FIRE EXTINGUISHERS
PLACED THROUGH OUT BUILDING 3) FIRE BRIGADE TEAM
FIRE HYDRANT - IN MAIN STORE LOCATED OUTSIDE OF NORTHWEST ENTRY.>~;~9~¢.A~w~ ~
IN AUTOMOTIVE IT IS LOCATED ON THE NORTH SIDE ADJACENT TO THE~.
Building Occupancy Level
-V- 10/14/1997
SEARS ROEBUCK & CO
SiteID: 215-000-001008
Fast Format
~ Training
-- Employee Training
WE HAVE 300 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: ASSOCIATES TRAINED ON HAZARDOUS MATERIALS WITH A
TRAINING FILM AND A DISCUSSION PERIOD.
Overall Site
01/17/1996
-- Page 2
--Held for Future Use
Held for Future Use
-8- 10/14/1997
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-3979
HAZARDOUS MATERIALS INVENTORY
FACILITY DESCRIPTION
CHECK IF BUSINESS IS A FARM [
BUSINESS NAME
FACILITY NAME
]
SITE ADDRESS
STATE
~ Co-
zw q jo4-
SIC CODE
DUN & BRADSTREET NUMBER
OWNER/OPERATOR
MAII.ING ADDRESS
PHONE
CITY
STATE
ZIP
EMERGENCY CONTACTS
NAME
BUSINESS PHONE
NAME
BUSINESS PHONE
TITLE
24 HOUR PHONE
TITLE
24 HOUR PHONE
Business Name
~ZA~OUS MATERIALS INVENTORY
co.
Page ~ of_~
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition [ ]~d~sion [
2)Common Name: cz j /
] Deletion
Check if chemical is a NON Trade Secret ~ Trade Secret [ ]
Chemical Name:
3) DOT # (optional)
~[ ] CAS# 74-~6-.2.
4) Physical & Health
Hazard Categories Fire [><J Reactive [
5) WASTE CLASSIFICATION
PHYSICAL HEALTH
Sudden Release of PressureJ>~ Immediate Health (Acute) [~<] Delayed Health (Chronic) [
(3-digit code from DHS Form 8022)
USE CODE
6) PHYSICAL STATE Solid [ ] Liquid [
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount i~
Average Daily Amount 62f
Annual Amount
Largest Size Container fe~
# Days on Site ._~
9) MIXTURE: List
the three most hazardous 1)
chemical components or 2)
any AHM components 3)
10)LOCATION -
1) INVENTORY STATUS: New [ ] Addition [
] Oas 1><! Pure ~3
UNITS OF ~URE
Lbs[ ]Gal[ ]ft3[><]
Curies [ ]
Circle Which Months: I)]~ AIIYeer, J,F,M,A,M,J,J,A,S,O,N,D
COMPONENT CAS# % WT
2) Common Name:
Chemical Name:
Mixture [ ] Waste [ ] Radioactive [
8) STORAGE CODES t
a) Container: i } [ ;/~
b) Pressure: h / I '~
c) Temperature t '~ | --
[ ]
[ ]
] Revision [ ] Deletion [X~ Check if chemical is aNON Trade Secret IX] Trade Secret [
~nv~[ I CAS# 28757f?
4) Physical & Health
Hazard Categories Fire [ ] Reactive [
5) WASTE CLASSIFICATION
PHYSICAL HEALTH
] Sudden Release of Pressure [ ~,'J Immediate Health (Acute) D<] Delayed Health (Chronic)
(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [ ] Liquid D<] Gas [ ]
l~re I><j Mixture [ ] W~te [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average Daily Amount .
Annual Amount
Largest Size Container
# Days on Site
UNITS OF MEAS~ 8) STORAGE CODES /
Lbs D<'] Gal [ ] R3 [ "] a) Container:
Curies [ ] b) Pressure:
c) Temperature ITM /
Circle Which Months: U/~ All Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS# % w'r AI-IM
the three most hazardous 1) [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10)LOCATION . , /" .
,va Io,voe.~ ~ /~c,c~l/F~-/
I certify under penalty ~1~ law, that I have personallir~xamined and am familiar with the i~on ~,//Tl~ttached documents. I
believe the submitted, informationj,sArue,:~ accurate and .co~np]ete.
PRINT Name & Title of Au~orized Company Repres~n'mtive - ' Date
Business Name
H~ARDO US MATERIALS
Address
Page ~-.-of~
CWE~MICAL DESCRIPTION
1 ) INVENTORY STATUS: New [
2) Common Name:
Chemical Name:
4) Physical & Health
Hazard Categories
5) WASTE CLASSIFICATION
] Addition [ ] Revision [x~ Deletion [ ] Check if chemical is a NON Trade Secret [~<'] Trade Secret [ ]
~l~ <~L~.. ~ ;l / 3) DOT # (optional)
aI-IM[ ] CASa
PHYSICAL HEALTH
Fire [><] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [
(3-digit code fi'om DHS Form 8022)
USE CODE
] Delayed Health (Chronic)
6) PHYSICAL STATE Solid [ ] Liquid ['>('1
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average',Daily Amount
Annual Amount
Largest Size Container 5 ~-O
# Days on Site
9) MIXTUI~: List
the three most baTan:ious 1) IA./a
chemical components or 2)
any AH/vi components 3)
Gas[ ] ha~[
UNITS OF MEASURE
Lbs[ ]C-al{><3a3[ ]
Cur/es [ ]
Circle Which Months:
COMPONENT
] Mixture [ ] W~te D<] Radionetive [ ]
8) STORAGE CODES
b) Pressure: - ~ - el ~, ~ ~ e ~'~
c)Tamporature 4-- t~r~bie&&..
(~J, F, M, A, M, J, J, A, S, O, N, D
CAS# % WT AHM
p. 2~ tOO q~ [ ]
[
[ ]
10)LOCATION
1) INVENTORY STATUS: New [ ] Addition [ ] Revision IX] Deletion [ ] Check if chemical is a NON Trade Secret L.~ Trade Secret [
2) Common Name: F~_OLO ~ - l) 3)I)OT#(optional)
Chamic~ Name: ~ [ ] cas # '7 ¢' 694-
4) Physical & Health PHYSICAL HEALTH
Hazard Categories Fire [~<] Reactive [ ] Sudden Rel~ of Pressure ~ Immediate Health (Acute) [~] Delayed Health (Chnmic) [
5) WASTE CLASSIFICATION
(3-digit cxx~ fi'om DHS Form 8022)
USE CODE
6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas
Pure[~(] Mixture[ ] Waste[ ] Radioactive[ I
7) AMOUNT AND TIME AT FACILrrY
Maximum. Dai.'ly Amount
Average Dai,l~ Amount 1900 .//
Annual Amount- ,//
Largest Size Container
# Days on Site
UNITS OF MEASURE
L~[,><]C.,aI[ ]Pt3['. ]
curies [ ]
Cimle Which Months:
8) STORAGE CODES
a)Container: /4-T,,/tlac~;~r~ ] ~o/~s. ~;
b) Pressure: t- ~{~ ~'
c) T~~ ~ - ~ ~;e~
~-"~ J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS# % WT AHM
the three most hazardous I) ('raaco II -~5-gq4- 100~ [ ]
chemical components or 2) [ ]
any AI-nVl components 3) [ ]
Business Name
Address
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [3~ Check if chemical is a NON Trade Secret [ ] Trade Secret [ ]
2) Common o4-o 3 I /
Chemical Name:
4) Physical & Health
Ha~a~'d Categories Fire D(] Reactive [
5) WASTE CLASSIFICATION
6) PHYSICAL STATE Solid [ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount ~f
Average Daily Amount .~
Annual Amount
Largest Size Container ~
# Days on Site ~
9) MIXTURE: List
the three most hazardous 1)
chemical components or 2)
any AHM components 3)
10 )LOC ATION
l) INVENTORY STATUS: New [
2) Common Name: ,C~ ? E C'~c~ ~
Chemical Name:
3) DOT # (optional)
am,i[ ] cas# goqOg35-"
PHYSICAL HEALTH
] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic)
(3-digit code fr~n DHS Form 8022) USE CODE
Liquid[x] Gas[ ] Pure[3~ Mixture[ ] Waste[ ]
UNITS OF MEASURE 8) STORAGE CODES
Lbs [ ] Gal D<] ft3 [ ] a) Containe~. ~
Curie~ [ ] b) Pressure: A
c) Temperature I k,/
Cimle Which Months: AJ~ All Year, J, F, M, A, IV[ J, J, A, S, O, N, D
COMPONENT CAS# % WT
[ ]
[ ]
] Addition [ ] Revision [ ] Deletion [~ Check if chemical is a NON Trade Secret [ ] Trade Secret [ ]
~)', I ~/ 3) DOT # (optional)
4) Physical & Health
Hazard Categories Fire D<'] Reactive [
5) WASTE CLASSIFICATION
am,~[ ] cas# go2083.~
PHYSICAL
] Sudden Release of Pressure [ ] [~,,,edia~e Health (Acute) [
O-digit code from DHS Form 8022)
6) PHYSICAL STATE Solid [ ] Liquid D<] Cras [ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount ~f
Average Daily Amount ,if
Annual Amount
Largest Size Container F/f
# Days on Site ./~f
USE CODE
] Delayed Health (Chronic)
Pure[X] Mixture[ ] Waste[] Radioactive[ ]
UNTrS OF MEASURE 8) STORAGE CODES j
Lbs [ ] Gal D<~ it3 [ ] a) Container:. / ~
Curies [ ] b) Pressure: I I / ~
¢) Temperature IV/ ' '
Circle Which Months: ]J/)q All Year, J, F, M, A, M, J, J, A, S, O, N, U
9) MIXTURE: List COMPONENT CAS# % WT AHM
the three most hazardous 1) [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10)LOCATION ,~ J / . ]r~ ./. J
I c..ertify under penalty of law, l~t I_~ve personally exanmied and am familiar with
beheve~.thc submitted mfo~ true, accurate and completu~
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-3979
HAZARDOUS MATERIALS INVENTORY
INSTRUCTIONS
FACILITY DESCRIPTION:
Check if your business is a farm.
Enter the full legal name and site address of your business. Do not use post office box
numbers.
Give a brief description of the nature your of your business activities.
Enter the Standard Industrial Classification (SIC) number for you business. Each type of
business has a Standard Industrial Classification code number. Some common SIC codes
are listed on page 4. Other SIC codes may be obtained from your worker's compensation
insurance forms, the State of California Employment Development Department by giving
them you employer number, from the U.S. Labor Department or from the Standard
Industrial Classification Manual.
Enter the Dun & Bradstreet or federal tax identification number for your business.
Enter the name of the owner, their mailing address and phone number.
EMERGENCY CONTACTS:
List two persons who have full access to the facility, including locked areas, and that are
knowledgeable about your materials and process.
CHEMICAL DESCRIPTION:
Make as many copies of the chemical description form as necessary to report your entire
inventory of hazardous materials. Report every hazardous material handled in quantities
equal to or exceeding 55 gallons of a liquid, 500 pounds of a solid or 200 cubic feet of a
gas.
Enter the full legal name and site location of your business at the top of the form. Enter
the page number in the right hand comer.
Each of the instructions below correspond to the entry field with the same number on the
chemical description form.
01.
02.
03.
04.
05.
06.
07.
08
09
10
11
12
13
14
15.
16.
17.
18.
19.
HAZARDOUS MATERIALS INVENTORY INSTRUCTIONS
Check the appropriate box for a new inventory or for additions, revisions or deletions to
an existing inventory. Check non-trade secret unless the chemical composition meets the
criteria for trade secret status per Section 6254.7 of the California Government Code and
Section 1060 of the California Code of Evidence. Copy trade secret pages onto yellow
paper before submitting your inventory so that they will be easily identified.
Enter the common name or the manufacture's product name. Enter the standard chemical
name. If a pure material is an acutely hazardous material (AHM), check the box labeled
AHM. Report the components of mixtures under item 9 below.
Enter the Dept. of Transportation (DOT) identification number and the Chemical Abstract
Service (CAS) number for this chemical. CAS numbers are commonly found on Material
Safety Data Sheets.
Check the box(es) which describe the physical and health hazards associated with the
chemical.
If the material is a waste, enter the appropriate three-digit California waste code.
California's non restricted waste codes are listed on page 4 of these instructions.
Questions regarding the waste classification codes and requests for hazardous waste
manifest form #8022 may be addressed to the Department of Health Services, Toxic
Substances Control Program at (916) 322-3670.
Enter the appropriate use code from the following list.
USE CODES
Additive 20. Fungicide 39.
Adhesive 21. Grinding 40
Aerosol 22. Heating 41
Anesthetic 23. Herbicide 42
Bactericide 24. Insecticide 43
Blasting 25. Instructional 44
Catalyst 26. Lubricant 45
Cleaning 27. Medical aid/process 46.
Coolant 28. Neutralizer 47
Cooling 29. Painting 48
Drilling 30. Pesticide 49
Drying 31. Plating 50
Emulsifier/demulsifier 32. Preservative 51
Etching 33. Refining 52
Experimental 34. Sealer 53.
Fabrication 35. Spraying 54.
Fertilization 36. Sterilizer 55.
Formulation 37. Storage 99.
Fuel 38. Stripper
2
Washing
Waste
Water Treatment
Welding/soldering
Well injection
Oil Treatment
Resale
Aircraft systems
Battery electrolyte
Breathing air
Drafting aid
Finished product
Fire protection
Hydraulic equipment
Road/hwy maintenance
Testing
Wholesale chemicals
Other- specify
Check the boxes which describe the physical state of the chemical. Pure materials are
100% of the chemical listed in item #2. Chemicals that have been diluted with water or
combinations of two or more chemicals should be reported as mixtures and the
components listed in under item #9.
Enter the maximum daily amount, the average daily amount and the total annual amount
of material in storage or use at your facility. Enter the largest container size and the
number of days/year that the material is on site. Circle the months that the material is on
site.
10.
11.
Enter the units of measure. Report solids in pounds, liquids in gallons, gases in cubic feet
and radioactive materials in curies.
Select the appropriate storage codes from the lists below
a) CONTAINER CODES
01. Underground Tank
02. Aboveground Tank
03. Fixed Pressurized Tank
04. Portable Pressurized CYlinders
05. Insulated Tank
(Includes cryogenics)
06. Drums or barrels - metallic
07. Drums or barrels - non-metallic
08. Carboy(s)
09. Glass container(s)
10. Plastic container(s)
11. Box(es)
12. Bag(s)
13. Metal Containers (not drums)
14. In Machinery or Processing
equipment
15. Bin(s)
99. Other- specify
b) PRESSURE CODES
1 - The material is
2 - The material is
3 - The material is
stored at ambient (normal atmospheric) pressure.
stored at greater than ambient pressure.
stored at less than ambient pressure.
C) TEMPERATURE CODES
4 - The material is
5 - The material is
6 - The material is
7 - The material is
stored at ambient (surrounding) temperature.
stored at greater than ambient temperature.
stored at less than ambient temperature.
stored under cryogenic conditions.
Enter the maximum % concentration by weight of the three MOST hazardous components
in the material. Round up to the nearest whole number percentage. Enter the CAS
number for each component of the mixture. If the component is an acutely hazardous
materials, check the box labeled AI-IM.
Briefly describe the location of the material within the building/facility using compass
directions and obvious landmarks.
0111 Wheat production
0115 Corn production
0131 Cotton production
0139 Field crops, except cash grains
0161 Vegetables & melons
0172 Grapes
0173 Tree nuts
0174 Citrus fruits
0175 Deciduous tree fruits
0179 Other tree fruits & nuts
0192 General farms, primarily crop
0241 Dairy farms
0252 Chicken eggs
0253 Turkey eggs
2851 Paint manufacture
0291 General farm, primarily
livestock & animal specialties
0724 Cotton ginning
0541 Grocery store
1541 Dry cleaners
2911 Oil refineries
3441 Welding/fabrication - structural
3443 Welding/fabrication - boiler
3569 Machine shop
4222 Cold Storage
4925 Compressed gas supplier
5093 Automobile salvage
5169 Chemical supply
5511 Motor vehicle dealers (new &
used)
5521 Motor vehicle (used only)
5531 Auto & home supply stores
5541 Gasoline service stations
5821 Eating places
5813 Drinking places
(Alcohol service)
5983 Fuel oil dealers
5984 LPG dealers
7342 Pest control
7532 Auto top, body,
upholstery repair
Auto paint shops
7533 Auto exhaust repair
7536 Auto glass replacement
7537 Auto transmission repair
7538 General auto repair
7542 Car washes
8071 Chemical laboratory
NONRESTRICTED WASTE CODES
Code Description Code
Description
Inorganics 251
111 Acid solution 2 < pH < 7 with metals (antimony, 252
arsenic, barium, beryllium, cadmium, chromium, 261
cobalt, copper, lead, mercury, molybdenum, nickel, 271
selenium, silver, thallium, vanadium and zinc) 272
112 Acid solution without metals 281
113 Unspecified acid solution 291
121 Alkaline solution pH >12.5 with metals (see lll) 311
122 Alkaline solution without metals 321
123 Unspecified alkaline solution 322
131 Aqueous solution (2 < pH < 12.5)containing 331
reactive anoins (azide, bromate, chlorate, cyanide, 341
fluoride, hypochlorite, nitrite, perchlorate and 343
sulfide anions) 351
132 Aqueous solution with metals (see 111)
133 Aqueous solution with total organic residues 10% or Sludges
more 411
134 Aqueous solution with total organic residues less 421
than 10% 431
135 Unspecified aqueous solution 441
141 Off-spec, aged, or surplus inorganics 451
151 Asbestos containing waste 461
161 FCC Waste 471
162 Other spent catalyst 481
171 Metal sludge(see 111) 491
172 Metal dust and machining waste (see 111 )
181 Other inorganic solid waste
Organics
211
212
213
214
221
222
223
231
232
241
Halogenated solvents (methylene chloride,
chloroform, TCE, TCA)
Oxygenated solvents (acetone, butanol, MEK)
Hydrocarbon solvents (stoddard solvent, xylene)
Unspecified solvent mixture
Waste oil and mixed oil
Oil/water separation sludge
Unspecified oil - containing waste
Pesticide rinse water
Pesticide and other waste associated with pesticide
production
Tank bottom waste
Still bottoms with halogenated organics
Other still bottom waste
PCB's and material containing PCB's
Organic monomer waste (includes tmreacted resins)
Polymeric resin waste
Adhesives
Latex waste
Pharmaceutical waste
Sewage sludge
Biological waste other than sewage sludge
Off-spec, aged or surplus organics
Organic liquids (nonsolvents) with halogens
Unspecified organic liquid mixture
Organic solids with halogens
Alum and gypsum sludge
Lirae sludge
Phosphate sludge
Sulfur sludge
Degreasing sludge
Paint sludge
Paper sludge/pnlp
Tetraethyl lead sludge
Unspecified sludge waste
Miscellaneous
511 Empty pesticide containers 30 gal or more
512 Other empty container 30 gal or more
513 Empty containers less than 30 gal
521 Drilling mud
531 Chemical toilet waste
541 Photo chemical/photo processing waste
551 Laboratory waste chemicals
561 Detergent and soap
571 Fly ash, bottom ash, and retort ash
581 Gas scrubber waste
591 Baghouse waste
611 Contaminated soil from site clean-ups
612 Household wastes
(Restricted waste codes are listed on the back of form #8022)
HAZARDOUS MAT/ALS
INSPECTION
Business Name:
Location:
Business Identification No. 215-000 ~/~
Station No. ~ Shift ~ Inspector
Ar~val Time: /~ Depa~ure Time:
Verification of Inventory Materials
Verification of Quantities
/ ~~,~~p Verification of Location
roper Segregation of Material
y~/ Comma ts.
~:'Y-~kersfield Fire Dept.
H~'~rdous Materials Division
Date Completed /~ 2_~ - ~
/
(Top of Business Plan)
/ //
Inspection Time:
Adequate Inadequate
Number of Employees:
Comments:
Verification of MSDS Availability
Verification of Haz Mat Training
Verification of Abatement Supplies & Procedures
RECEII/ED
OCT 0.~; 1994
Comments:
Emergency Procedures Posted
Containers Properly Labeled
Comments:
Verification of Facility Diagram
Special Hazards Associated with this Facility:
Business'Owner/Manager PRINT NAME
~I'GNATURE
All Items O.K
Correction Needed
White-Haz Mat Div Yellow-Station Copy Pink-Business Copy
cITy OF BAKERSFIELD
Public Works ~D¢lmrtm~n~
Wastcwater. Division
SURCHARGE REVIEW'
Date
Property Owner
Mailing Address
AccoUnt.No.
Parcel No. 6 ~' ~ - -'q'~ b - 0 / -. 0 0 - '?
Adjustment
to next
Last Corrected Billing
Billing Billing Add
Amount Amount .(Subtract)
Effective Date
Cal. Wau:r No. Type of Change New Account
Billing Ad justincnt
Close Account
Surcharge Schedule
Date
$£P 0,9
~RS ROEBUCK & CO 215-(.')(}1
1 Site with 1 Fac.
Ger, era 1 I r, format i or,
1008 Pa ge 1
t
i
Ider, t Number: 21'5-c)c)C)-c)(]1c}c)8. ..... ' Grid: 12A Area of ..y~_,: :. '/°"!~!1 I"1
~ C_r, tact Name , , Title
........... ; ~-. <.-;.--m~ ~:m~ _ ~ Adm i n i.st rat i ve Data
Mail Addrs: 300i MING AV ·
City: BAKERSFIELD
Corem Cnde: 215-007 BAKERSFIELD STATION 07
D&B Number:
St ate: CA Zip: 9~04-
SIC Code:
Owr, er: SEARS ROEBUCK & CO Phor, e: ( ) --
Address: ~C)01 MING AV State: CA
City: BAKERSFIELD Zip: 93304-
S L',rnnl a'r'y
RECEIVED
I 6 19 1
HAZ. MAT. DIV.
{Typ~ ~, print
correction3 const&t~ a c,(,m~- · nn,Me and corr~
plan for my facility.
(:)4/23/91
P 1 n- Ref
ARS ROEBUCK & CO 215-00(~010(z)8
zmat Irlveretory List ire MC~p'~Order
(:)2 - Fixed ContairJers ors Site
Name/Hazards Forrn
Quarlt i ty
Page
MCP
2
02-006
ACETYLENE
400
FT3
High
.
02-007
TIRPOLENE PAINT THINNER
./
GAL
High
127 LBS
· Moderate
02-001
02-C)04
WASTE OIL
FREON R 11
55(:)
GAL
Low
4,939
FT3
M i re i ma 1
02-o02
PENNZOIL/SPECTRUM/QUAKER STATE OIL
SPECTRUM []IL
M i re i rna 1
M i re i rna 1
(.'.)4/23/91
iRS ROEBUCK & CO 215-00~
O0 - Overai 1 Sit e
1008
<D> Not if. /Evacuat iors/Medical
Page
<1> Ager~cy Notificatiors
CALL 911
<2> Employee Notif. /Evacuatior~
VERBAL AND CALL 911
FIRE DRILL SOUNDED WITH DESIGNATED AREA ANNOUNCED AND STORE FIRE
CHIEF AND SECURITY MANAGER IN ATTENDANCE
<3> Public Notif. /Evacuation
<4> E~,~erger, cy Medical Plar,
LOCAL HOSPITALS: MERCY HOSPITAL
MEMORIAL HOSPITAL
2215 TRUXTUN AV
420 34TH
327-3371
327-1~72
04/23/91
SE'ARS ROET~UCK' ' ~ ' & CO 215-000-001008
00 - Overall Site
<E> Mi't igat ion/Preverst/Abater~t
Page
4
,<1> Release Prevention
SMALL OIL', BRAKE FLUID, BATTERY ACID SPILLS ARE CLEANED UP BY EACH
INDIVIDUAL MECHANIC RESPONSIBLE FOR HIS BAY (NO LARGE SPILLAGE IN THIS
AREA). (NO LARGE SPILLAGE IN THIS AREA)
<2> Release Corstairm~ent
<3> Clear~ Up
<4> Other Resource Activatior~
[)4/23/91
~RS ROEBUCK & CO 215-00~
0[) - Overall Site
1 [)[)8 Pa~ ge
<F> Site Ernerger~cy Factors
5
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS:RECEIVING DOCK RAMP (SOUTH-WEST) E)LOcK BOX-NO /
C). WATER: BASEMENT-RETAIL STORE (NORTH WALL OVERHEAD DIV. 9 STOCKROOM)
D) SPECIAL: FIRE SPRINKLER-FOUR SYS]'EMS-(NORTH WALL STOCK ROOM BASEMENT)
<3> Fire Protec. /Avail. Water
PRIVATE FIRE PROTECTION - 1) OVERHEAD FIRE PROTECTIN-SPRINKLER SYSTEM
GOVERNED BY TEL-'T'EC ALARM SERVICE TO THE -FIRE DEP'T. 2) FIRE EXTINGUISHERS
PLACED THROUGH OUT BUILDING 3) FIRE BRIGADE TEAM
<4> Buildir~g Occupar~cy Level
[)4/23/91
~SEARS ROEBUCK & CO 215-c)c)Ci-o01008
00 - Overall,Site
<G> Training
Page
6
<1> Page:~ ~1
WE HAVE 30 EMPLOYEES AT THIS F'ACILITY.
WE HAVE~MATERIAL SAFETY DATA SHEETS ON FILE
--~IEF--,SOMMARy OF' TRAINING:
<2> page 2 as needed
<3> Held for Future Use
<4> Held f,z,r Future Use
USINEsS NANE
BAKERSFIELD CITY FIRE DEPART)lENT
2130 "G" STREET
I~AKERSFIELD, CA 93301
(805) 326-3979
I ECEIVED
Ansd ............
-00 008
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: ~.~C~(~/
SECTION 2: ENERGENCY 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 n~tlfy
your local fire department and the State Office of Emergency Services 'as required
law. "
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY:
NAME AND TITLE DURING BUS. HRS.
A. ~_~,,~L// ~ ~-f,'P~---~=-~ Ph# ,~ .'>~~ ' ~ ~'/f/ Ph#
B. ~-Z~/~ ~~///~'~ Ph# ~~ ~*~// Ph#
AFTER BUS. HRS.
SECTION 3: LOCATION OF UTILITY ShUT-OFFS FOR BUSINESS AS A WHOLE ~' :~'~ J)
E. LOCK BOX: YES /~__~ IF YES, LOCAT¥ON: -
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO ..
FLOOR PLANS? YES / NO KEYS? YES / NO
- 2A -
SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS'AS A WHOLE
SECTION 5:
LOCAL EMERGENCY I~EDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
SECTION 6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A PROORA~ WHICH PROVIDES E~PLOYEES WITH INITIAL AND
REFRESHER TRAININO IN THE FOLLOWING AREAS.
CIRCLE YES OR NO
A. METHODS FOR SAFE HANDLINO OF HAZARDOUS
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: ...... .................... (~-~) NO ~-Y~-~JNO
C. PROPER USE OF SAFETY EQUIPMENT: .................. ~_~ .. N0 ~ NO
D. EMERGENCY EVACUATION PROCEDURES: ................. ~ NO" ~ NO
E. DO YOU MAINTAIN E~PLOYEE TRAINING RECORDS: .... i... NO ~'~-~-~' NO
INITIAL REFRESHER
SECTION ?: HAZARDOUS MATERIAL
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS~_.~OF A
SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ..... ~'--S~ NO
I, ~-~' ~>~/~~)~ ~ ~ '~ , certify that the above information is accurate.
I understand that this information will be used to fulfill .my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
Sec. 25500 Et Al.) and that inaccurate information constitutes perjury.
SECTION $: HAZARDOUS MATERIALS 'FOR THIS UNIT ONLY
A. Does this Facility Unit. contain"~Hazardous Materials? ....... ~
If YES, see B.
If NO, continue with SECTION 4.
'
B. Are any of the hazardous materials a bona fide Trade Secret YES
If No, complete a. separate hazardous materials inventory
form.marked: NON-TRADE SECRETS ONLY (white form ~4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (yellow form ~4A-'2) in addition to the non-~Pade
secret form. List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION ~ ,
SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E~RGENCY RESP0~ERS
SECTION ~: LOCATION OF UTILITM SHUT-OFFS AT THIS UNIT ONLY,
A. NAT. GAS.,'PROPANE~ ~ ~. ~. ~ ,
B. ELECTRICAL~ ~:.~>, , ~- ~:~ .--
~. LOCN BOX: YES .I~ ~F YES) LOCATION:
YES, SITE PLANS9
FLOOR PLANS?
YES / NO MSDSs? YES ./ NO
YES ! NO .KEYS? YES'./ NO
- 3B -
BAKERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET
~AKERSFIELD, CA 93301
0FFICIAL~..us'E ONLY
BUSI NESS PLAN
SINGLE FACILITY' UNIT
" FORM 3A
INSTRUCTIONS
· 1. To avoid further action, this form must be returned by:
2. TYPE/PRiNT YOUR ANSWERS IN ENGLI$~ ...... ....... -
3. Answer the questions below for THE FACILITY UNIT LISTED BELOW
4. Be as BRIEF and CONCISE as possible.
FACILITY UNIT# ~Z FACILITY UNIT NAME: ~/~//~.. ~ ~.
SECTION 1: MITIGATION, PREVENTION, ABATEMENT .PROCEDURES
SECTION 2: NOTIFICATION AND EVACUATION PROCEDL~ES 'AT THIS L~IT ONLY
I.D. #
BUSINESS NAME:
ADDRESS:
CITY, ZIP:
BAKERSFIELD CITY FIRE DEPARTMENT
FORM 4A-1
NON--TRADE SECRETS
HAZARDOUS MATERI ALS I NVENTORY
~c~ ..... ~/~ ..... OWNER NAME:
Page~, ~ o£
' FACILITY UNIT #:
FACILITY UNIT NAME:
PRONE #:....f~,G'> ,~Z,'~~ N?:/ PHONE #: ]OFFICIAL USE CFIRS COOE
~ ~ [ ONLY
1 2 3 4 5 6 7 8 9 10
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT ~ WT. CHEMICAL OR COMMON NAME CODE GUIDE,
~,-. :'"///~ 4'¢ ') TITLE: f ','> " ~-~'/n:.'-;: SIONATURE:
,N~ME: ~C,' ~' ' .~.,' ~u~z~/,,~...~,~.~zX:_...~./~.. DATE
EMERGENCY CONTACT: ~ f /,! /-' ¢)/'¥ /?~-./;~ /.)TITLE: ~f(/::':, ~-.'? .... PRONE # BUS HOURS:
" , c/~:G, AFTER BUS HRS:
- 4A-1 -