HomeMy WebLinkAboutBUSINESS PLANRECYCI. E
STORE # 30138
ROSEDALE @ COFFEE RD.
BAKERSFIELD, CA. (7012)
NEW STORE FLOORPLAN
FIXTURE PLAN
FIXTURE SCHEDULE ,~
LOWALL- 0 ~4'X16'X54'
HIGHSTEEL-60 ~4'XlB'XlO'
HIGHSTEEL-0 ~)3'XlB'XlO'
HIGHSTEEL-20 04'X24'XlO'
HIGHSTEEL-O- ¢)3'X24'XlO'
HS ENDCAPS- 5 UNITS-3'XIO' '
HS:ENDCAPS- 2 UNITS-4'XIO'
GONDOLA- 70 ~4'X16'X60'
[NDCAPS- lO UNITS-3'X60'
,7-~ i. iiii-.7'i,~.!I :-..~J.-:iF,: ~ - HIGHWALL- ;1.3 ~4'X24'X7'
.... :'""':-' ' :':"r' ~'HIGHWALL-:' 1' @3'X24'xT
.... :.'""~'.'.* "' ':" 'N'SiDE' CORNER- 1 UNIT 36'xT
· ,.:.., ;: ......
BATTERY RACK- 16'
· ' ::.! .: 5-;i~ i, i':~_:. ':-.~--' ..'COUNTERS' AS SH0WNi.
' ,.OIL- FLO:RACK-.. 5-4L!SECTIONS.-.
... 'i, i,:i ' ...... 1-"BATTERY CHARGE STATION' -
NOTE: BELTS &/OR HOSES MAY
BE HUNG ON BACK HIGHSTEEL
IF DESIRED.
Questions? Coil 972
12/11/96I~°a/26/98-~'
3/32' = 1' M.
Po n t u s ~(~,~'~-/~.,,...-.~
. I
...........
LOW
TYP
FLUSH
CURBI
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Ba__kersfield, CA (805) 326-3979
INSTRUCTIONS:, r ' ' [O~'~O~~~hi rmwi 3 r '/1~~2~319~8-~'-~/
1. To avoid further act'on, emro t's fo 'thin d ys o eceipt. ~
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
BUSINESS NAME:
LOCATION:
MAIl.lNG ~D~SS:
C~Y: ~ ~ C ~
--::~STATE: O p
ZIP:~ffPHONE:
DUN & BRADSTREET NXJlVIBER: { % - ~ i~ - 7sOct 13
SiC CODE:
SECTION 2: EMERGENCY NOTIFICATION
CONTACT
TITLE BUS. PHONE 24 HR. PHONE
,.G/ore
· ..
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING
'NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REOUEST
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:
'= :: '~'-~-Y~tE DO NOT HANDLE HAZARDOUS MATEKIALS.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT
NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION
I, 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
OUS MATERIALs (DIV. 20 CHAPTER 6.95 SEC. 25500
INFORMATION CONSTITUTES PERJURY.
TITLE DATE
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN
Ao
Co
RELEASE PREVENTION STEPS:
RELEASE CONTAINMENT AND/OR
CLEAN-UP PROCEDURES:
SECTION 8: UTII,!TY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)_
NATURAL GAS/PROPANE:
ELECTRICAL:
SPEC~:
LOCK BOX: YES~ IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY
Bo
WATER AVAII.ABILITY (FIRE HYDRANT): &oec)s~ ~,'~Cee~ '*o ,he...
4
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
AGENCY NOTIFICATION PROCEDURES:
B. EMPLOYEE NOTIFICATION AND EVACUATION:
C. PUBLIC EVACUATION:
D2 EMERGENCY MEDICAL PLAN:
General Facility
I,~,;~rmation, Continued
Waste
disposal
information
If you are a hazardous waste generator, identify your hazardous
waste hauler(s) or recycler(s) here:
I~ecycler{s):
Name: Asbury
Demeno Kerdoon
Address: 2100 North Alameda
2000 North Alameda
City:
Zip code:
Phone #:
EPA ID #:
Compton, CA
90222
(310] 886-3400
CAD028277036
Compton, CA
90222
(310) 537-7100
CA TO80013352
Additional:
Additional:
Emergency Proc~'~res
Internal
response
team
· Designate your internal hazardous materials response team and
their responsibilities.
Responsibilities
Manager
or person in charge
on duty
Notify all persons in the store in the
event of an emergency and tell them to
to evacuate. Contact Fire Department and other
agencies es required. Give information as requested
by such agencies. Tell employees what to do (clean
up procedures or evacuate). Notify manager if not on
duty. See that spill Is contained and that it is blocked
off $o that no 'one may walk in the area except
persons cleaning up spill. Oversee spill cleanup and
proper disposal of waste per federal, state and local
laws.
· Describe procedures for notifying your team of an emergency:
iX] voice
iX] phone
iX] public address system
iX] 'alarm system
iX] other (describe): Manager or person on duty will notify
everyone in the store verbally, by public address system or
audible alarm.
Employee
no b¥ica tion
· List procedures for notifying employees who could be exposed to
hazardous conditions by a release.
iX] voice
iX] phone
iX] public address system
iX] alarm system (sirens, bells, etc...)
· Designate an individual responsible for notification: Manager or
person on duty will notify everyone in the store verbally, by .
public address system or audible .alarm.
Continued on next page
6
Emergency Procedures, Continued
Technical
advisors
List personnel who will provide technical advice to off-site
emergency responders (fire, police) in case of an emergency
incident.
[] Owner
[X] Manager Store Manager or person in char_ae on duty
[ ] Supervisor
[] Other
Neighbor
no tifica tion
procedures
· List procedures for notifying neighboring residences, businesses,
schools, etc, which could be affected by a release threatening
off-site.
[X] voice, personal visit
[X] phone
[ ] public address system
[ ] alarm system (sirens, bells, etc...)
· Designate an individual who will perform the notification:
Manager or person in charge on duty.
· ,Keep a list of those to be notified (see next page).
Continued on next page
Emergency Procedures, Continued
Containment
procedures
Describe procedures for containing spills, releases, fires or
explosions:
[ ] blocking drains
iX] diking with absorbent/other material
[ ] berm in storage/work area
iX] other
,411 areas where spill happens shall be marked off and on/.v
those people c/eaniny up the spill shall be allowed in the spill
area. Clean up with absorbent and dispose fo all clean up
materials in accordance with federal, state and local laws.
Clean-up
procedures
Describe your clean-up procedures:
iX] use absorbent
[ ] evaporate
· [ ] dilute/flush (those chemicals acceptable to the
sanitary sewer)
[ ] equipment clean-up as described here:
iX] other (describe): (1)notify Emergency Supervisor; (2)
check MSDS sheet for spill clean up information and chemical
handling; (3J use absorbent to soak up spill; (4) sweep into storage
bags for pickup by tank line driver if oil or waste oil is spilled; (5)
clean up remainder with cleaning agents and rags; (6) if spill is too
big for employees to clean up, call the tank line that picks up your
oil (for oil spills)Or 911 for assistance Jrom the fire department.
Continued on next page
Emergency Procedures, Continued
Hazardous
waste
disposal
List the name of the hazardous waste disposal company you will use
should your emergency generate hazardous wastes:
Asbury, 1-800-974-~.~.95 or (310] 886-3400
Recyc/er
List the name of the hazardous waste recycling company you will
use should your emergency generate recyclable wastes:
Asbury, 1-800-974-4495 or (310) 886-3400
lO
Emergency Phone Numbers
Emergency
response
phone
numbers
Name of medical facility/nearest hospital: * * *
Phone number Of medical facility/hospital:
Fire ...... 911
Sheriff ..................................... : ...... ' 911
California Highway Patrol .... 911
Sacramento County Hazardous Materials
Division 386-7681
24 hours ............................... 366-2911
Ambulance Service ...........................................911
Poison Control Center .................................... 1-800-342-9293
Agency
notification
numbers
California Office of Emergency
Services ................................................... 1-800-852-7550
State Department of Health Services,
Radiologic Health Branch ....................................445-0931
State Department of Toxic Substances
Control ........................................................ 324:1826
State Water Quality Control Board,
Central Valley Region ......................................... 255-3000
US Environmental Protection Agency ................ 1-415-744-1500
National Response Center ............................... 1-800-424-8802
Other
Other Important Numbers
13.
Emergency Equipment
Equipment .
list
Provide a complete list of your emergency response equipment.
Specify all equipment available for your use during an emergency.
IXl phone
IX) broom
IX) fire extinguisher
[Xl absorbent (kitty litter,
rice hull, ash, sand)
[ ] shovel
[ ] decontamination shower
IX) eyewash fountain
[ I water hose
IX] personal protective equipment
IX) face shields, safety goggles, glasses
IX! rubber gloves
[ ] rubber boots
[ ] respirator
[ ] protective clothing
IX} Other: (e) 6 gallon waste can (all products placed in can shall Erst be put in an
individual hazrnat bag. Chemicals should not be mixed due to the unknown and
dangerous teach'ohs of mixing chemicals; (b) Flaz mat disposals bags; (c) zfplock bags
(large); (d) power sorb padz/paper towels; (e) robber gloves and Ap/ash goggles; (O
hezmat labels; (g) large yellow hazmat bags for return to warehouse of defective
materials; (h) Erst aid kit; (I) posted Est of emergency procedure and phone numbe~.
Evacuation Procedures
Notification
of evacuation
List your procedures for spreading the alarm to evacuate.
iX] voice
iX] phone
iX] alarm system
iX] public address system
[ ] other (describe):
The individual responsible for spreading the alarm is:
Manager or person in charge on duty.
Evacuation
route
Define your evacuation route on your site map and post copies for
employees.
I have posted the evacuation route, iX]yes [ ]no
Evacuation
coordinator
The individual responsible for accounting for all employees and
visitors after evacuation:
Manager or person in charge on duty.
Emergency
assembly
area
Indicate on your map the emergency assembly area for evacuees;
describe here:
Other
procedures
Describe additional' evacuation procedures here: ff the store needs to be
evacuated, persons in store shall I~e instructed I~y Emergency Supervisor to leave
the store through a specified door or doors end meet at location outside of store, as
shown on the site plan. At meeting place outside of the store, make sure afl
employees and other persons in the store at the time of the evacuation are safe and
uninjured.
Emergency Services
Description
Describe any arrangements you have made for emergency services
With:
· local fire and police departments
· hospitals
· contractors
· other (describe):
Chief Auto Parts has contracted with Valvoline Inc. to pick up all
of Chief's collected oil. Valvoline Inc. has contracted with
Asbury, to our oil hauler in California. Asbury I owned l~y
Demenno-Kerdoon which will recycle/re-refine the used off.
When
required
Advance arrangements for emergency services should be made as
appropriate for potential need in an emergency.
You may decide that such contingency planning arrangements are not
necessary for your facility.
Emergency Response Plan Use Record
When
required
A record must be kept for each time the emergency response plan is
utilized, In some cases, you are required to make specific agency
notifications as a result of the emergency,
It is therefore important to keep adequate records of any incidents at
your facility and to understand your reporting responsibilities.
Procedure
Follow this procedure anytime you must utilize your emergency
response plan to ensure that you make proper agency notifications as
necessary,
Step Action
I Record date, time and details of incident in operating log.
2 Does the incident/emergency threaten human health or the
environment off site?
· If yes, go to step 3.
· If no, go to step 5.
3 Emergency coordinator notifies the HMD and local emergency response
agencies as appropriate (fire, police, etc...).
4 Emergency coordinator notifies the State Office of Emergency Services
(OES) and reports:
· date and time of incident
· name and phone number of person reporting to OES
· facility's name and address
· type of incident occurrence
· names and amounts of hazardous materials involved
· description of any injuries
· description of hazards to people or the environment off-site
5 Emergency coordinator verifies that prior to resuming operations:
· no incompatible wastes are left in affected areas, and
· emergency equipment is cleaned up and ready to use.
If OES was not required to be notified, stop here.
6 Owner/operator notifies OES, prior t~ resuming operations, that
requirements of step 5 have been met.
7 Owner/operator submits a written report to OES within 15 days
confirming or revising emergency coordinator's initial report, and
reporting the amount and disposition, of recovered waste.
15
EmplOyee Training
Law
California Health and Safety Code Chapter 6.95 requires:
training for all employees on safety procedures and the
emergency response plan
· training for all new employees
· an annual refresher course for all employees
Suggestions
You may currently have a Hazard Communication Training Program in
place. If so, review your program to be certain it meets the
requirements described here.
You may wish to use your Business Plan in conjunction with Material
Safety Data Sheets for each chemical as your core training program.
You should also include instruction on proper chemical handling,
safety, and personal protection procedures.
Proof of
training
required
You are reqbired to keep written documentation of your employee
training sessions.
A sign-off sheet stating dates, employee names and positions, and
the training material covered will meet the requirements.
Waste
generator
requiremen t
In addition to the above requirements, training records at hazardous
waste generator facilities must include a brief job description as well
as the employees' names.
Conffnued on next page
16
Employee Training, continued
Tra/ning
elements
Check off the training elements you currently implement.
[X] new employee orientation and familiarization with hazardous
including:
IX! handling & safety
IX! notification & reporting
IX] emergency response, mitigation, cleanup, and recovery
IX! annual refresher training
[X! documentation of training
materials,
Training
outEne
You must attach an outline or condensed version of your
Communication Employee Training Program or lesson plan.
[X] My plan is attached.
[ I Plan is described in the space below.
Hazard
W:\DATA\BERP~ERP.REV
Property No.
~USINE$~ EMERGENCY.pLAI~
RELEASE OR SPILL OF HAZARDOUS MATERIAL: EMERGENCY PROCEDURES
If you see a chemical spill quickly tell the EMERGENCY SUPERVISOR.
1. EMERGENCY SUPERVISOR (MANAGER OR PERSON IN CHARGE ON DUTY) VV]LL NOTIFY ALL PERSONS IN THE
STORE IN THE EVENT OF AN EMERGENCY, AND WILL TELL THEM TO EVACUATE THE STORE, IF NECESSARY, AND
REMIND THEM OF WHERE TO MEET IF EVACUATION IS REQUIRED.
2. EMERGENCY SUPERVISOR WILL: 1) CONTACT THE FIRE DEPARTMENT AND OTHER AGENCIES AS REQUIRED;
2) GIVE INFORMATION REQUESTED BY SUCH AGENCIES; 3) TELL EMPLOYEES WHAT TO DO (CLEAN UP
PROCEDURES OR EVACUATE); 4) NOTIFY MANAGER IF NOT ON DUTY.
3. IF NO EVACUATION IS NEEDED, EMERGENCY SUPERVISOR SHALL SEE THAT AREA OF SPILL IS CONTAINED AND
THAT IT IS BLOCKED OFF SO THAT NOONE MAY WALK IN THE AREA EXCEPT PERSONS CLEANING UP SPILL.
4. EMERGENCY SUPERVISOR SHALL OVERSEE 1) SPILL CLEANUP; 2) PROPER DISPOSAL OF WASTE PER
FEDERAL, STATE AND LOCAL LAWS.
A spill or possible spill of hazardous materials that could cause serious present or future harm to people or the
environment must be reported Immediately to the agencies below. FINES AND JAIL TIME may result if not reported.
(Health and Safety Code Section 25507a)
The EMERGENCY SUPERVISOR shall report the spill as soon as h.e/she knows of the spill; unless 1) calling the agencif~
would slow down the immediate control of the sDill or 2) calling the agencies would slow down getting medical helD.
You do not need to report a spill [[you reasonably think that the spill causes no serious present or future hazard unless
the spill goes outside of the store.
Items to consider in deciding if there is a sedous present or future hazard:
1. How much was or may be spilled?
2. Are employees {~n~l customers safe?
3. What spilled and where is spill going? (example: chemicals go into storm drains)
B. IF THERE IS A SPILL OUTSIDE[ OF THE STORE IT MUST BE REPORTED.
The EMERGENCY SUPERVISOR shall Imm~iatel~ call:
Information to be provided when reporting a release/spill:
1. Fire. Police, paramedics
2. Office of Emergency Services
3. Local Administering Agency
4. National Response Center
Othe~ numbers that rna~ ~ to be called:
5. Infotrac-Emergency Response Info
6. County Public Health Services
7. Regional Water Quality Control Board
8. Poison Control Center
9. Toxic Control Center
10. Medical facility on health plan
11.. Medical facility on health plan
12. Any other medical facility
911
(800) 8S2-?SS0
(800) 424-8802
(800) 535-5053
(916) 386-7681
(800) 342-9293
(916) 255-3000
1. your name and title .
3. where was the spill (inside or out~ide~of store; in air, soil, water,
parking lot)
4. Type of spill (liquid, gas, solid)
5. How much was spilled.
6. What hazardous material was spilled.
6. extent of injuries.
7. possible hazards to human health and/or the environment.
8. EPA ID~ .....
9. 'Is the chemical extremely hazardous? (If known) Used oil is ~
extremely hazardous.
10. how long did spill occur. (minutes, hours)
11. methods taken to cleanup/recover hazardous materials(s)
12. What will be done with the spilled materials after they are cleaned
up? (1) put in hazmat bag for waste oil tank line if waste oil or (2)
hazardous materials will be picked up by hazardous materials
handler that removes such waste in accordance with federal, state
and local laws).
1. NOTIFICATION AND EVACUATION PROCEDURES:
Property No. '~
Persons in store shall be notified verbally, by public address system or audible alarm. If the store needs to be evacuated,
persons in store shall be instructed by EMERGENCY SUPERVISOR to leave the store through a specified door or doors and
meet at location outside of store, as shown on the site plan.
At meeting place outside of the store, make sure all employees and other persons in the store at the time of the evacuation
are safe and uninjured.
If no evacuation is required the area of the spill shall be blocked off until the spill is cleaned up. Only those persons cleaning
up the spill shall be allowed in the spill area.
At the same time as the EMERGENCY SUPERVISOR is reporting the spill, other employees will immediately cleanup and
contain the spill and carry out all necessary action to keep spill from getting worse, as employees have been trained to do.
The EMERGENCY SUPERVISOR shall direct and supervise the clean up.
2. MITIGATION/PREVENTION
Procedures for preventing a hazardous matedal release or spill.
A. Periodically, the store shall be inspected for leaking product as well as the condition of the waste oil container. When
product is delivered, the employee accepting such shipment shall visually inspect the merchandise for leaking containers.
B. Waste oil tanks/drums shall be 1) an 85 gallon steel drum with a 55 gallon liner drum inside to provide a double wall
contained system; or 2) a double walled above ground storage tank which holds 185 gallons of waste oil. It is pressure tested
steel and is made to above ground storage tank UL lab specs 142.
C. All new employees receive training on: safety, evacuation, meeting place in the event of an evacuation, spill clean up, fire
alarms, fire extinguishers, first aid kit and spill response equipment. Specific training in how to read MSDS sheets, "Right to
Know'' laws, warning labels, consumer products, earthquake preparedness, and oil collection is also provided to all new
employees. (See Chief employee manual). See also Facility Training Plan below.
D. All employees are required to read and understand this Emergency Business Plan and shall be required to read this plan
semi annually, such reading of the plan to be documented by the store manager.
E. Ail employees are trained regarding elements of oil collection (a bdef summary is attached). Oil levels must be regularly
checked so that the drum or tank is not filled beyond its capacity. Call for oil pickup when needed if more often than as
regularly scheduled. Waste oil containers shall be labeled as "waste oil." Waste oil manifest receipts shall be kept for three
years. Clean up from waste oil spill shall be properly disposed of by the waste oil hauler.
F. The store will be kept in a neat and orderly condition so as to prevent general safety and environmental hazards.
G. WITHIN 30 DAYS AFTER A SPILL OCCURS, ALL STORE EMPLOYEES SHALL RECEIVE REFRESHER TRAINING
(VVHICH SHALL BE DOCUMENTED IN VVRIT1NG) ON THE PROCEDURES TO BE FOLLOWED IN THE EVENT OF A SPILL
OR RELEASE OF HAZARDOUS MATERIALS.
3. ABATEMENT
A. Ail areas where spill happens shall be marked off and only those people cleaning up the spill shall be allowed in the spill
area. Clean up spill with absorbent and dispose of all clean up materials in accordance with federal, state and local laws.
C. Hazardous materials response kits shall be replenished as needed by Emergency Supervisor.
D. How to clean up a chemical spill:
1. notify EMERGENCY SUPERVISOR.
2. Check MSDS sheet for spill clean up information and chemical handling
3. use absorbent to soak up spill:
4. sweep into storage bags for pickup by tank line driver if oil or waste oil is spilled;
5. Clean up remainder with cleaning agents (ie Simple Green) and rags.
6. If spill is too big for employees to clean up, call the tank line that picks up your oil (for oil spills) or 911 for assistance
If spill flows outside of the store call:
do
fire department 911'
Office of Emergency Services (800) 852-7550'
Local Administering Agency* ().
(City or County if different from fire dept)
National Response Center (800) 424-8802*
Infotrac-emergency response Information service (800) 535-5053
Property
THEY WILL TELL YOU HOW TO CLEAN UP SPECIFIC CHEMICALS. THE CHIEF WAREHOUSE NEAR YOU OR THE
LEGAL DEPARTMENT OR CHEMICAL PRODUCT MANAGER CAN ALSO PROVIDE MSDS INFORMATION ON CLEAN
UP OF A SPILL.
f. County Public Health Services (916) 386-7681
g. Regional Water Quality Control Board
h. Poison Control Center (800) 342-9293
i. Toxic Control Center (916) 255-3000
*Must call--other calls will be made depending on the actual spill, or emergency.
4. FACILITY TRAINING PLAN: All new Chief employees receive video based training, wdtten materials and worksheets.
Training includes among other things: safe work practices; employee and customer injuries; Right to Know laws; hazardous
materials information; responding to emergencies (including equipment required, chemical exposure, and spill training);
disposal and storage of hazardouS waste; emergency response and evacuation procedures, emergency contacts; and
earthquake preparedness. A practice test and final exam are also included in the training materials. Store Managers document.
that new employees have received training and that employees as necessary have received refresher training.
5. FACILITY EMERGENCY EQUIPMENT
a. 6 gallon Waste Can (ALL PRODUCTS PLACED IN CAN SHALL FIRST BE PUT IN AN INDMDUAL HAZMAT aAO, CHEMICALS
SHOULD NOT BE MIXED DUE TO THE UNKNOWN AND DANGEROUS REACTIONS OF MIXING CHEMICALS.
b. Haz mat disposal bags
c. ziplock bags (large)
d. power sorb pads/paper towels
e. rubber gloves and splash goggles
f. hazmat labels
g. Large yellow hazmat bags for return to warehouse of defective materials
h. fire extinguishers
i. first aid kit.
j. Posted list of emergency procedures and phone numbers.
6. ARRANGEMENTS/AGREEMEMTS. Chief Auto Pads has contracted with Valvoline Inc. to pick up all of Chiefs collected
oil. Valvoline Inc. has contracted with Asbury, to be our oil hauler in California. Asbury is owned by Demenno-Kerdoon which
will recycle/re-refine the used oil. (3'10) 886-,1400 or '1-800-974-4495
7. REVISIONS TO BUSINESS PLAN AND HAZARDOUS WASTE INVENTORY.
This Business Plan must be revised if store moves, new owner, new business name; amount of waste oil increases by 100%;
emergencY contact chan_~es, use or handling of previously undisclosed reportable hazardous material; change of storage
location of used oil drums/tank; or notify within 30 days of closing the business; and must be recertified to by January 1
of every even numbered year, The hazardous material Inventory must be updated by January I of each year,
Chief Auto Parts Inc.
Store a_ddress: ~ ,. . ~. ·
This Business Plan was prepar~l by Loss Prevention Department, Loss Prevention Manager ~r..-,~;~ ~rr~
Regional address: .B~OO:
I DECLARE UNDER PENALTY OF't~W THAT I HI
oocu ..s ,s
Regional Vice President:,
Name: Simon Smith
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
SIC CODE
OWNER/OPERATOR ~----~x ~,.~
MAILING ADDRESS
CITY ~ (~ C' c tx va e a 3LO
STATE ~ ~ ZIP
EMERGENCY CONTACTS
NAME bac~ k%o,,-, i/Oz.:c?
BUSINESS PHONE
NAME "~ r% ~ t:, z--.
BUSINESS PHONE ~l~,- q~,~-
TITLE ---%~r~ Irrx~qc~(~o~
24 HO~ PHO~ ~ -~.3~- ~
1
Business Name
~ZARDOUS MATERIALS INVEN~Y
- Page
CHEMICAL DESCRIPTION
of
I ) INVENTORY STATUS: New [34 Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ]
2) C°mmon Name: rv'x c%6v~ f~ f~ ~ C, 3) DOT # (optional)
ChemicalName: .W~C~',~Cf) f- Ol,(-~ AI-IM[ ] CAS#
4) Physical & Health PHYSICAL HEALTH
Hazard Categories Fire.DC].Reactive[ ]SuddenReleaseofPressure[ ] ImmediateHenlth(Acute)[ ] Delayed Health (Chronic) [ ]
5) WASTE CLASSWICATION O-digit code fi'om DHS Form 8022) USE CODE ~ <~
6) PHYSICAL STATE Solid[ ] Liquid~ Gas[ ] Pure~ Mixture[ ] Waste[ ] Radioactive[ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average Daily Amount
Annual Amount t
Largest Size Container
# Days on Site
UNITS OF MEASURE
Lbs[ ] Gal,D<,] ft3 [
Circle Which Months:
8) STORAGE CODES
a) Container:.
b) Pressure:
c) Tempem~
~$, F, M, & M, $, $, & S, O, N, D
9) lvEXTURE: List COlvlPONENT. CAS# % VdT AHM
the three mosth~ardous 1) gY'~t~'a, o~ ~- ~, 6 Oq'v~._~ -(~5-t~{,, l OO°/(> [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10)LOCATION
1)INVE2qTORYSTATUS:New~Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Seeret [ ]TradeSeerfft[ ]
2) Common Name: L& ~ ~ ~c.,,3, ~, o3 i '(.~ 3) DOT # (optiomfl)
ChemicalName: k.x~ ~4r9 (51 (a AHM[ ] CAS#
4) Physical & Health PHYSICAL HEALTH ._
I-lazardCategories Fire. Reactive[ ]SuddenReleaseofPressure[ ] Immediate Health (Acute) [ ] Delayed Health (ChroniC) [ ]
5) WASTE CLASSIFICATION
(3-digit code from DHS Form 8022)
USE CODE
6) PHYSICAL STATE Solid[ ] Liq~d,[~<~ Cms[ ]
Pure[ ] Mixta~[ ] Wastel~ P. adiomiw[ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount {qb~
Average Daily Amount O- I ~,~
Annual Amount ~
Largest Size Container I <~'-~
# Days on Site 7-~C~ ~
UNITS OF ~URE
L~[ ] G~I.~ ft3 [
curies [ ]
Circle Which Months:
8) STORAGE CODES
a) Container.
b) Pressure:
c) Temperature
~, F, M, A, M, $, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS#
the three most hazardous 1) ~ ~.0 O, ~c.~% o~ o, C~
chemical components or 2) ~,a ~ 4t e t-
any AHM components 3)
[ ]
[ ]
[ ]
lO)LOCATION _
I certify under penalty ~ law, that I have personally examined and am familiar with the inforr)~Ui~ on this and all attached documents. I
beli,v, e thesubmittedinformafionistrue,~:x.m~teandcomplete.. (~~h /-7z--
PRINT Name & Title of Authorized Company Representative ' ~i~ture Eklte
Business Name
HAZARDOUS MATERIALS INVENTORY
~0 ~'~r-l-~ -~no_Address ~;'q~oC) ~c~e"~,,~te,
CI~MICAL DESCRIPTION
Page
of
I ) INVENTORY STATUS: New [k~]'Addition [
2) Common Name:
·
4) Physical & Health PHYSICAL
Hazard Categories Firel~Reactive[ ]SuddenReleaseofPressure[
5) WASTE CLASSIFICATION
] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ]
O-digit cocle from DHS Form 8022)
6) PHYSICAL STATE Solid [ ] Liquid,[~J C-~ [ ]
3) DOT # (optional) ...
] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ]
USE CODE c~
7) AMOUNT AND TIME AT FACILrrY
Maximum Daily Amount
Average Daily Amount
Annual Amount
# Days on Site
Pure.p~ ~tute [ I w. ste [ ] ~u,e [ ]
UNITS OF MEASURE 8) STORAGE CODES
Lbs[ ]G-alD, qft3[ ] a) Container. ~o
Curie~ [ ] b) Pressure: i
c) Temperature ~1
Circle Which Months: (~~, F. M, A, M. $. $, A, S, O, N, D
CAS#
%WT AItM
~ oo °/o [ ]
[ ]
]
9) MIXTURE: List COMPONENT
the three mo~t lnmmtou~ 1)
chemical comtxmonls or 2)
any AHM c, omp~ent~ 3)
10)LOCATION
I)~ORY. ST_.A~TUS:New[ ]Addition[ ]Revision[ ]Deletion[]
Check if chemical is a NON Trade Secret [ ]Trad~[ ]
2) Common Name:
3) DOT # (optional)
Chemical Name: AHM [ ] CAS #
4) Physical & Health PHYSICAL HEALTH
Hazard Categories Fire[ ]Reactive[ ]Sudd_~nReleaseofPressure[ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION
(3-digit cod~ fi'om DHS Form 8022)
USE CODE
6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ]
rute[ ]Mimre[ ] Waste[ ] P, eaioe~ve[. ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average Daily Amount
Annual Amount
Largest Size Conta/ner
# Days on Site
UNITS OF MEASURE 8) STORAGE CODES
Lbs [ ] Gal [ ] fl3 [ ] a) Contain~
Curies [ ] b) Pressure:
c) Temperature
Circle Which Months:
AIl Year, J, F, M, A, M, J, J, A, S, O,.N, D
9) MIXTURE: · List
the three most hazardous 1)
chemical componems or 2)
any AHM compom~m 3 )
10 )LOCATION
COMPONENT CAS# % WT
[ ]
[ ]
[ I
I certify under penalty of law, that I have personally examined and am familiar with the information on_this and ail attached documents. I
believe the submilXed information is In,e, accurate and compleX. ~~-//~
,,4o s '
PRINT Name & Tide of Authorized Company Representative . v Date
Business Name
~A~OUS
MATERIALS INVENT~Y
Page
Addre~
CHEMICAL DESCRIFrlON
of
I) INVENTORY STATUS: New [
2) Common Name:
Chemical Name:
4) Physical & Health
Hazard Categories Fire [
5) WASTE CLASSIFICATION
6) PHYSICAL STATE Solid [ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average Daily Amount
Annual Amount
Largest Size Container
# Days on Site
]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secre~ [ ]TradeSecret[ ]
PHYSICAL
] Reactive [ ] S~dd~ Release ofPressure [
, (3-digit code flora DHS Form 8022)
Liquid[ ] Gas[ ] Pure[ ]
UNITS OF MEASURE
Lb~[ ]Gal[ Irt3[ ]
Curies [ ]
3) DOT # (optional)
AHM[ ] CAS#
] Immediate Health (Acute) [ ] Delayed Health (Chronic) [
USE CODE
Mixture[ ] Waste[ ] ~Uo~dve[ ]
8) STORAGE CODES
a) Container:.
b) Pressure~
¢) Temperature
Circle Which Monfl~ Ali Year, $, F, M, A, M, $, $, A, S, O, N, D
9) MIXTOKE: List COMPONENT CAS~ % WT AHM
the three most ha:,ardous 1) [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10)LOCATION
I)INVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Checkifchemic~isaNONTrnde_~Se~xet_[ ]Trac~__~S~et[ ]
2) Common Name: 3) DOT # (optional)
Chemical Name: Al-nv[[ ] CAS #
4) Physical & Health PHYSICAL HEALTH
Hazard Categories Fire[ ]Reactive[ ]SuddenReleaseofPressure['] Immediate Health (Acute) [
5) WASTE CLASSIFICATION
(Ydigit code fious DHS Form 8022)
USE CODE
6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] '
] Delayed He~th (Chronic) [ ]
7) AMOUNT AND TIME AT FACILITY
Maximum Daily Amount
Average Daily Amount
Annual Amount
Lar~e~ Size Container
# Days on Site
Pure[ ] Mixture[ ] W~te[ ] ~,~iio~ive[ ]
Lbs[ lGal[ Iff3[
Curies [ ]
8) STORAGE CODES
a) Containex:,
b) Pressure:
c) Temperature
AIl Year, J, F. M, A, M. J. J, A. S, O, N, D
9) MIXTURE: List
the three most hazardous 1)
chemical components or 2)
any AHM components 3)
Circle Which Months:
CAS# % WT
10)LOCATION
COMPONENT
[ ]
[ ]
I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached do.meats. I
believe the submitted information is true, accurate and complete.
PRINT Name & Title of Authorized Company Representative Signature Date