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Home My WebLink AboutHAZMAT INSP 9/18/1988 ! ! = e IR~rr.. hose ! INSPECTION SUNI~RY: 0 - Does not Apply It~d~I~DOUS IVIATI~-RI AL~{i, BI.II, EAU I NSPECTI ON FC~ ID · ~ l~t~ ~ / (~ / ~Z~ ~2krNUAL INSPECTION ~// EXEMPTION RE-INSPECTION ALL ITEMS OK: [ ~] VIOLATIONS NOTED: [ ] COMPLAINT 1 - In Compliance 2 -.Correction Needed 3 - Verbally Warned 4 - N.O.V 5 - Citation 6 - Referred to (Specify) EMERGENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731 A. Agency Notification Plan (O.E.S., FD) B. Employee Notification & Evac. Plan C. Emergency Responder Notification D. Medical Assistance E. Private Response Team Procedures L. Work Area Safety M. Clean-up Materials placement/availability N. Clean-up Equipment 0. Fire Protection Systems P. Waste Handling & Storage Q. Availability of Protective Equipment .TRAINING REQUIREMENTS (CCR TITLE 19-2732) INV. & DIAGRAM VERIFICATION (CCR TITLE 19-2729) F. Training Records G. MSDS Available to Employees H. Employees Familiar with MSDS I. Use of Personal Protective Equipment J. Waste Material Permits & License K. Employees familiar with evacuation plan. .." Comments: ~L~,S'~ I(~'P ~--~ 2-- R. Inventory Quantities S. Storage, Container Cond., & Labeling T. Location In Facility Unit U. Emergency Water Supply V. Evacuation Plan & Area W. Surrounding Exposures X. Utlltty Shut-offs Y. Other Clearance Granted [ ~/] Started I~- , ]5~' Co.pleted t~ : ~0 Inspector Re-inspection Required [ ] on / Total Time : ~ Owner/~aloager / D.E. Miles on Insp. ~ HMCU 1/~ KERN COUNTY FIRE DEPARTNENT 5642 VICTOR STREET. BAKERSFIELD, CA 93308 BUSINESS NAME INSPECTOR QUEST, IONNAIRE BUSI NESS PLaiN AS A r~rI-IOLE FOR USE WITH THOSE BUSINESSES CONPLETING A BUSINESS PLAN (2A). INSTRUCTIONS: 1. Complete this form only once for each occupancy. 2. Attach this form to BUSINESS PLAN (2A) and forward to Data Entry. BUSINESS PLAN VERIFIED ON: ~ / [ ~ / ~ SECTION 1: RESPONSE SUNNARY (Limit to 4-5 lines) SECTION 2: NOTIFICATION / EVACUATION 0F AFFECTED PUBLIC (Limit to 13 lines) HMCU~ F · R 0 R E T U I N TI OL ..HAZARDOUS'MATERIALS KERN' COUNTY FIRE (805)86t:276 P'.O. BOX 81796 BAKERSFIELD, CA. 93380-1796 · :,, :iDATE DESCRIPT:ION . ,02/22/-89 KCHD TAN~K CREDIT ' · - '-,02/22/89,1988 ANNUAL FEE (GROUP, N) 015~010-000663 02/22/89 DUE BY 03/22/89 FOR BUSINESS'AT:' 9828 'R, OSEDALE',HNY DEBIT 489.00 CREDIT ,140,00 C,U~RRENT ',OVER ~,30 ",OVER 60 ,, OVER 3.49.00 0.00. ' ~ 0.00 0.00 -.~'TH IS ? FE'E- I S FOR--,TH E, REvIEW AN D "pROcESS I NG OF ~ yOuR .EMERGE'N C¥~;,P~AN':~: AN THE INSPECTION OF~YOUR ,BUS~NESS-PER STATE LAN. CHECKS. ONLy :~LEAS K.C.F.D. HAZARDOUS MATERIALS ~ DELIMART P.O. BOX 81796 TOI 962,8 ROSEDALE,HNY BAKERSFIELD, CA. 93,380-1796 BAKERSFIELD ',CA, 93312 o8/3.o/88 DUE BY 09/30/88 · " FOR BUSINESS AT: 9628 ROSEDALE HNY DATE DESCRIPTION DEBIT 08/29/88 KCHD TANK CREDIT 08/30/88 198.8 ANNUAL FEE (GROUP N) 489.00. CREDIT 140.00 BALANCE -1~0.. O0 34 9: :~ 00 CURRENT OVER 30 · ovER' 60 OVER 90 OVE~' 120 . , :349.00 0.00 0.00, 0.00 0.00 · THIS, FEE IS FOR THE REVIEW AND PROCESSING OF YOUR EMERGENCY, pLAN AND THE INSPECTION OF YOUR BUSINESS PER STATE LAN, CHECKS ONLY PLEASE!.. DELIMART 9628 ROSEDALE HWY BAKERSFI ELD ..CA 933.12 015-010-00066.3 RIA~LS K.C.F.D. HAZARDOUS MATE P.O. BOX 81796 BAKERSFIELD, CA. 93380-1796 / J - b pELIMART Manager : Location: 9628 ROSEDALE HWY City : BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: SiteID: 015-021-001395 BusPhone: (661) 589-5640 Map : 102 CommHaz : Low Grid: 29A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact / Title GREG MEYER / OWNER Business Phone: (661) 589-5640x 24-Hour Phone : (661)~-~~~-~ Pager Phone : ( ) - x Emergency Contact / Title DIANA MEYER / OWNER Business Phone: (661) 589-5640x ~,24-Hour Phone : (661)~x~-~ -P"~-3~'~~- . ~, 33~ Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9628 ROSEDALE HWY City : BAKERSFIELD Phone: (661) 589-5640x State: CA Zip : 93312 Owner GREG MEYER & DIANA MEYER Address : 7404 PENNY MARIE City : BAKERSFIELD Phone: (661) 399-9468x State: CA Zip : 93308 Period : to TotalASTs: = Preparer: TotalUSTs: = Certif'd: RSs: No ParcelNo: Gal Gal Emergency Directives: reviewed the a~aChod h~ardous ~and t~ i~ along any corrosions cons~i~uie a comp/,te a~ ~rr,~ man- 'a~ement plan for my facil,y. 7S- 1 07/13/200g F D.,ELIMART STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: DELIMART Cross Street : Business Type: Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : DIANA MEYER Phone: Address: City : Type : CORPORATION Name : DIANA MEYER Address: City : Type : PARTNERSHIP State: Zip: TANK OWNER INFORMATION Phone: State: Zip: SiteID: 015-021-001395 (661) 589-5640x (661) 589-5640x BOE UST Fee# : 006334 Financ'l Resp: Legal Notif : Tank Owner Mailing Address Date:10/01/2097 Name:DIANA MEYER State UST # : Phone: ( ) Ttl:PRESIDENT/MGR 1998 Upg Cert#: 00847 X 2 07/13/2004 QELIMART ~ Hazmat Inventory -- MCP+DailyMax Order Hazmat Common Name. . . PREMIUM UNLEADED REGULAR UNLEADED DIESEL MOTOR OIL SiteID: 015-021-001395 By Facility Unit Fixed Containers at Site ISpecHazlEPA HazardsI Frm DailyMax IUnitlMCP F IH DH L F IH L F IH F DH' L 12000.00 GAL Mod 12000.00 GAL Mod 12000.00 GAL Low 170.00 GAL Min -3- 07/13/2004 DELIMART ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006-61-9 r STATE ~ TYPE Liquid[Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS IRSI CAS# No 8006619 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI F IH DH NFPA/// I USDOT# Mod Ag.Definedl: Ag.Defined5: Ag.Defined8: -- Ag. Definell MISC. LOCAL AGENCY DATA Ag.Defined2: Ag. Defined3: Ag.Defined6: Ag.Defined9: Ag. Defined4: Ag.Defined7: Ag. Definel0: 4 07/13/2004 ~ELIMART SiteID: 015-021-001395 .~ InVentory Item 0001 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: UNDERGROUND TANK S OF BLDG TANK DESCRIPTION Tank ID#: 2 Mfr: MODERN Compart Tank: N Installed: 06/1991 Capacity: 12000 Gals No. Of Comparts: Additional Info: Tank Use: MOTOR VEHICLE FUEL Matl Name:PREMIUM UNLEADED TANK CONSTRUCTION Type : SINGLE WALL W/INT LINER & C.P. Material(p): BARE STEEL Material(s): BARE STEEL Lining :EPOXY LINING Corr Prot: CATHODIC PROTECTION Spill Cnt : 1994 Drop Tube : 1994 Striker Plate: 1994 TANK LEAK DETECTION Sgl Wall: AUTOMATIC TANK GAUGING Dbl Wall: TANK CONTENTS Petrol Type: PREMIUM UNLEADED Cas #: 8006-61-9 Installed: Installed: Alarm : 1998 Exempt: No Ball Float : 1998 Fill Tube S/O: 1998 Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 07/13/2004 ~ELIMART SiteID: 015-021-001395 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: DOUBLE WALL Mfgr : TOTAL CONTAINMENT Mtl : "FLEX" & : Corr : "FLEX" Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/29/1998 Date: 04/27/2000 Name:DIANA MEYER Prmt Number: 1395 TANK/LINE TEST : CP CERT. :10/13/2001 MANWAY INSP. :03/23/1992 UST MONIT. CERT:12/26/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:PRES. DELI MART Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED STORAGE' CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: No Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 04/27/2000 Name:DIANA MEYER Ttl:PRES. DELI MART -6- 07/13/2004 ~ ~ELIMART ---- Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006-61-9 F STATE ~ TYPE PRESSURE Liquid Pure Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS~AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average I 3000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS IRSI CAS# No 8006619 TSecret No HAZARD ASSESSMENTS I oralBioHaz.N No Radioactive/Amount No/ Curies EPA Hazards F IH NFPA /// USDOT# I MCP Mod Ag.Definedl: Ag. Defined5: Ag.Defined8: -- Ag.Definell MISC. LOCAL AGENCY DATA Ag. Defined2: Ag.Defined3: Ag. Defined6: Ag. Defined9: Ag. Defined4: Ag. Defined7: Ag.Definel0: 7 07/13/2004 ~ELIMART SiteID: 015-021-001395 Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: UNDERGROUND TANK S OF BLDG TANK DESCRIPTION Tank ID#: 1 Mfr: MODERN WELD Installed: 06/1991 Capacity: 12000 Gals Additional Info: Tank Use: MOTOR VEHICLE FUEL Marl Name:REGULAR UNLEADED Compart Tank: N No. Of Comparts: TANK CONTENTS Petrol Type: REGULAR'UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : sINGLE WALL W/INT LINER & C.P. Material(p): BARE STEEL Material(s): BARE STEEL Lining : EPOXY LINING Corr Prot: CATHODIC PROTECTION Spill Cnt : 1994 Drop Tube : 1994 Striker Plate: 1994 TANK LEAK DETECTION Sgl Wall: AUTOMATIC TANK GAUGING Dbl Wall: Installed: Installed: Alarm : 1998 Ball Float : 1998 Fill Tube S/O: 1998 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No 8 07/13/2004 DELIMART SiteID: 015-021-001395 ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION underGround Piping AboveGround Piping Type : PRESSURE Const: DOUBLE WALL Mfgr : TOTAL CONTAINMENT Mtl : "FLEX" & : Corr : "FLEX" Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/29/1998 Date: 04/27/1998 Name:DIANA MEYER Prmt Number: Q TANK/LINE TEST : CP CERT. :10/11/2001 MANWAY INSP. :03/23/1992 UST MONIT. CERT:12/26/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:PRES. DELIMART Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: No Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 04/27/1998 Name:DIANA MEYER Ttl:PRES. DELIMART 9 07/13/2004 DELIMART ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME DIESEL Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# STATE ~ TYPE [ Mixture I PRESSURE TEMPERATURE CONTAINER TYPE UNDER GROUND TANK Largest Container 12.000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average I 3000.00 GAL 100.00 Fuel Oil No. 1 HAZARDOUS COMPONENTS IRSI CAS# No 70892103 TSecret' RS BioHazl HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No No NoI No/ Curies F IH NFPA /// USDOT# I MCP Low Ag.Definedl: Ag.Defined5: Ag. Defined8: -- Ag.Definell MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined6: Ag. Defined9: Ag.Defined4: Ag. Defined7: Ag.Definel0: -10- 07/13/2004 DELIMART SiteID: 015-021-001395 = Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: UNDERGROUND TANK S OF BLDG TANK DESCRIPTION Tank ID#: 3 Mfr: MODERN Installed: 06/1991 Capacity: Additional Info: Tank Use: MoToR.vEHICLE FUEL Matl Name:DIESEL 12000 Gals TANK CONTENTS Petrol Type: DIESEL TANK CONSTRUCTION Type : SINGLE WALL W/INT LINER & C.P. Material(p): BARE STEEL Material(s): BARE STEEL Lining : EPOXY LINING Corr Prot: CATHODIC PROTECTION Spill Cnt : 1994 Drop Tube : 1994 Striker Plate: 1994 TANK LEAK DETECTION Sgl Wall: AUTOMATIC TANK GAUGING Dbl Wall: Compart Tank: N No. Of Comparts: Cas #: Installed: Installed: Alarm : 1998 Exempt: No Ball Float : 1998 Fill Tube S/O: 1998 Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -11- 07/13/2004 DE~,IMART SiteID: 015-021-001395 Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping Type : PRESSURE Const: DOUBLE WALL Mfgr : TOTAL CONTAINMENT Mtl : "FLEX" & : Corr : "FLEX" Prot : PIPING LEAK DETECTION UnderGround Piping AUTOMATIC LEAK DETECTORS AboveGround Piping AboveGround Piping Installed: 04/29/1998 Date: 04/27/2000 Name:DIANA MEYER Prmt Number: 1395 TANK/LINE TEST : CP CERT. :10/13/2001 MANWAY INSP. :03/23/1992 UST MONIT. CERT:12/26/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:PRES. DELIMART Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: No Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 04/27/2000 Name:DIANA MEYER Ttl:PRES. DELIMART -12- 07/13/2004 F DELIMART ~ Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit N ASILE - RETAIL DISPLAY SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 r STATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 170.00 GAL Daily Average [ 50.00 GAL HAZARDOUS COMPONENTS I%Wt. I 100.00 Motor Oil, Petroleum Based IRSI CAS# No 8020835 HAZARD ASSESSMENTS I Radioactive/Am°unt EPA HazardsINo/ Curies F DH NFPA /// USDOT# I MCP Min Ag.Definedl: Ag. Defined5: Ag.Defined8: -- Ag.Definell MISC. LOCAL AGENCY DATA Ag. Defined2: Ag. Defined3: Ag. Defined6: Ag. Definedg: Ag. Defined4: Ag. Defined7: Ag. Definel0: -13- 07/13/2004 DELIMART Manager : Location: 9628 ROSEDALE HWY City : BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: BusPhone: Map : 102 SiteID: 015-021-001395 (661) 589-5640 CommHaz : Low Grid: 29A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact / Title GREG MEYER / OWNER Business Phone: (661) 589-5640x 24-Hour Phone : (661) 399-9468x Pager Phone : ( ) - x Emergency Contact / Title DIANA MEYER / OWNER Business Phone: (661) 589-5640x 24-Hour Phone : (661) 399-9468x Pager Phone : (661) 334-6277x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9628 ROSEDALE HWY City : BAKERSFIELD Phone: (661) 589-5640x State: CA Zip : 93312 Owner GREG MEYER / /~ i~1~ · l~1~/~7~ Address : 7404 PENNY MARIE City : BAKERSFIELD Phone: (661) 399-9468x State: CA Zip : 93308 Period : Preparer: certif,d: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: I, reviewed lhe a~ached h~ardous ~a~eri~ls ~nage. men~ P~n for~~ ~ a ' any ~eclions cons~iluie a compleie and corrs~ man- agemen~ Plan ~er my ~aciii~y. -1- 08/04/2003 RICH ENVIRONFIENTAL 5643 BROOKS CT BAKERSFIELD, CA. 93308 OFFICE(661)392-8687 & FAX(661)392-0621 ALERT 1000 UNDERFILL AND ALERT 1050X ULLAGE SYSTEM Precision Underground Storage Tank System Leak Test Test Date:03-13-2002 / -<~-~'~ BILLING:BSSR, INC. [ SITE:TEXACO DELII~uART ~ 6630 ROSEDALE HWY.,#B ~ 9628 ROSEDALE HWY / BAKERSFIELD, CA 93308 ~ BAKERSFIELD, CA J PRODUCT VOLL~4E %FULL WETTED NON-WETTED ~ T,wm~K--~WATER IN (GAL) PORTION PORTION LINE DETECTOR TANK UNL-87 12000 90% +.027-PASS PASS NO TEST NONE 0" PREM-91 12000 79% +.022-PASS PASS NO TEST NONE 0" DIESEL 12000 72% -.018-PASS PASS NO TEST NONE 0" COMMENT:NO PRODUCT LINES OR MECH LINE LEAK DETECTORS TESTED. WATER BALA/qCE Measurements showed that water in the backfill area at the time of testing was below tank bottom, and therefore not a facter in test determination. A monitoring well or a well point was driven in the backfill area to determine that there is no water in the backfill at tank bottom. A precision test was performed on tanks at the above location using the Alert 1000 underfill system and the Alert 1050 ullage system. I have reviewed the data produced in donjunction with this test for purpose of verifying the results and certifying the tank systems. The testing was performed in acorrdance with Alert protocol, and therefore satisfies all requirements for such testing as set forth by NFPA 329-92 and USEPA 40 CFR part 28~.. The results of testing are shown on the following page, and indicate whether the wetted and non-wetted portion passed or failed. Included with the report are reproduction of data compiled during the test which formed the basis for these conclusion. This information is stored in a permanent file if future verification of test results is needed. AL\NC 040 T~ ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA M I N U T E S 0 75 3 5 ~2KHz AMPLITUDE RATIO J5 TEXACO DELIMART 9628 ROSEDALE HWY. BAKERSFIELD, CA J2000 GALLON UNL-87 TANK 750+ 0 75 M I N U T E S 25KHz AMPLITUDE RATIO J5 3 5 750+ ~2KHz DETECTION RATIO = .985 25KHz DETECTION RATIO = .95~ TEST RESULT = PASS DATE AND TIME OF TEST' 3/~3/02 lO: 4~PM BEGINNING BOTTLE PRESSURE = 3200 BEGINNING TANK PRESSURE = 1.5 PSIG ENDING BOTTLE PRESSURE = 2800 ENDING TANK PRESSURE = ~.5 PSIG ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA M I N U T E $ TEXACO DELIMART 9628 ROSEDALE HWY. BAKERSFIELD, CA 12000 GALLON PREM-91 TANK 0.75 12KHZ AMPLITUDE RATIO ,15 750+ 0.75 M T N U T E S 25KHz AMPLITUDE RATIO '1 5 DETECTION RATIO = 1 . 07 25KHz DETECTION RATIO = ,1.03 TEST RESULT = PASS 750+ DATE AND TIME OF TEST' 3/13/02 10: 44PM BEGINNING BOTTLE PRESSURE = 2500 BEGINNING TANK PRESSURE = 1.5 PSZG ENDING BOTTLE PRESSURE = 2300 ENDING TANK PRESSURE = ~.5 PSZG ALERT TECHNOL OGLES PLOT OF ULLAGE TEST DA TA M I N U T E S 0 75 3 5 TEXACO DELIMART 9628 ROSEDALE HWY. BAKERSFIELD, CA 12000 GALLON DIESEL TANK ~2KHZ AMPLITUDE. RATIO ~5 750+ 0 75 25KHz AMPLITUDE RATIO ~ 5 12KHz DETECTION RATIO = 1.00 25KHz DETECTION RATIO = .966 TEST RESULT = PASS 750+ DATE AND TIME OF TEST: BEGINNING BOTTLE PRESSURE = 2500 BEGINNING TANK PRESSURE = J.5 PSIG 3/~3/02 12: 52PM ENDING BOTTLE PRESSURE = 2100 ENDING TANK PRESSURE = 1.5 PSIG To: Sessions Tank Liners Inc. SPECIAL INSPECTION REPORT /~8~xaeo~atL_~ Date: March 11, 2002 ~628 Rosedale Hwy~,~ Bakersfield, CA The following res e location represent the conclusions of the Special Inspection which are to be presented to ~the regulatory agency.- .-~ Tank No. 3 Capacity 12,000 gallons Dimensions 8' x 32' Product Diesel PASS FAIL CCR Title 23-2663 (b) Tank has been cleaned so that no residue remains on the tank walls X (c) (A) Determine that tank has been vacuum tested at a vacuum of 5.3 inches of Hg for not less than one minute. X (B) Witness ultrasound test -average of 75% or greater of original thickness. X Visually checked the internal lining for discontinuity, compression, tension cracking and corrosion. X Test for thickness and hardness of the lining in accordance with nationally recognized industry codes. X Test the lining using an electrical resistance Holiday Detector in accordance with nationally recognized industry codes, Holidays located, repaired and re-tested. X (d) Tank is suitable for continued use for a minimum of five (5) years X (e) Tank is suitable for continued use for a minimum of five (5) years ONLY if it is relined, or other improvements are made. (d)_ T_be_tank !i~g_is_no_looger.~uj~table for continued use_and s._halJ be__ closed in accordance with Article 7. ,, Coating Inspector Dan Lawhom Professional Engineer Robert Paul P.E. Address 3225 Rio Vista Dr. # 64 Laughlin, NV 89029 Phone Number (702) 460-8300 ,,~ ~g~nature: '~, _~,,.~ .,'~~'~~---~ ~ered Professional Engineer No. Corrosion 111 ~tion Date: 3/31/2006 ' STAMP To: Sessions Tank Liners Inc. SPECIAL INSPECTION Site: Texaco Deli Mart Address: 9628 Rosedale Hwy Bakersfield, CA REPORT Date: March 11, 2002 The following results for the above location represent the conclusions of the Special Inspection which are to be p.r~s_e~nted to_ ~tb.e_regulatory agency.. Tank No. 2 Capacity 12,000 gallons Dimensions 8' x 32' Product Gasoline CCR Title 23-2663 (b) Tank has been cleaned so that no residue remains on the tank walls (c) (A) Determine that tank has been vacuum tested at a vacuum of 5.3 inches of Hg for not less than one minute. (B) Witness ultrasound test -average of 75% or greater of original thickness. Visually checked the internal lining for discontinuity, compression, tension cracking and corrosion. Test for thickness and hardness of the lining in accordance with nationally recognized industry codes. Test the lining using an electrical resistance Holiday Detector in accordance with nationally recognized industry codes, Holidays located, repaired and re-tested. (d) Tank is suitable for continued use for a minimum of five (5) years (e) Tank is suitable for continued use for a minimum of five (5) years ONLY if it is relined, or other improvements are made. .(_d) _ The tank !in~in~g is no longest suitable for continued us_e_~nd shall be closed in accordance with Article 7. PASS FAIL X X X X X X X Coating Inspector Dan Lawhorn Professional Engineer Robert Paul P.E. Address 3225 Rio Vista Dr. # 64 Laughlin, NV 89029 Phone Number ~ (~702) 460-8300 Signature: Registered Professional Engineer No. Corrosion 111 Expiration Date: 3/31/2006 STAMP To: Sessions Tank Liners Inc. SPECIAL INSPECTION Site: Texaco Deli Mart Address: 9628 Rosedale Hwy Bakersfield, CA REPORT Date: March 11, 2002 The following results for the above location represent the conclusions of the Special Inspection which are ~to be p_r_e_sented to the r__egul_~_o, ry__agency .... : .............. Tank No. 1 Capacity 12,000 gallons Dimensions 8' x 32' Product Gasoline CCR Title 23-2663 (b) Tank has been cleaned so that no residue remains on the tank walls (c) (A) Determine that tank has been vacuum tested at a vacuum of 5.3 inches of Hg for not less than one minute. (B) Witness ultrasound test -average of 75% or greater of original thickness. Visually checked the internal lining for discontinuity, compression, tension cracking and corrosion. Test for thickness and hardness of the lining in accordance with nationally recognized industry codes. Test the lining using an electrical resistance Holiday Detector in accordance with nationally recognized industry codes, Holidays located, repaired and re-tested. (d) Tank is suitable for continued use for a minimum of five (5) years (e) Tank is suitable for continued use for a minimum of five (5) years ONLY if it is relined, or other improvements are made. ..... (d) The Lank lining is no longer s_ujtab~le f_o?_c~ontinu_e_d- us~e and ~shall be closed in accordance with Article 7. PASS X X X X X X X FAIL Coating Inspector Dan Lawhom Professional Engineer Robert Paul P.E. Address 3225 Rio Vista Dr. # 64 Laughlin, NV 89029 Phone Number ,~702~~ Signature: . . Registered Professional Engineer No. Corrosion 111 Expiration Date: 3/31/2006 STAMP items 1,2, and 3. Also complete if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the fr_0nt if sPace permits. - ..... 1. Article Addressed to: A. Received by (Please Print of Delivery re item 17 I--lYes address below: :~ No 3. Service Type E~ Certified Mail [] Registered [] Insured Mail [] Express Mail [] Return Receipt for Merchandise [] C.O.D. 4. Restricted Deliver? (Extra Fee) [] Yes 2. Article Number (Copy from service label) 70("'""3520 0021 9610 7677 ,'1 102595-99-M-1789 · Sender: Please pn~yo_ur name, address,--and ZIP+4 in this box ° OFFICE OF ENVIROI~iENTAL SERVICES 1715 CHESTER AVENUE BAKERSFIELD, CA 93301 Ihl,,,,ii,,;Ihll,,,,i,ll,I,'h,,i,l',,,llli,,;,,lhl,l,ll,,,i _n Certified Fee 13- ~'. Return Recelpt'Fee (Endorseme nt Required) (Endorsement Requireal Reclplent'~ Name (Please Print Clearly) (To be/~'~mple, te.d by mailer) , '1: D July 13, 2001 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661 ) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Ms. Diana Meyer Delimart 9628 Rosedale Hwy. Bakersfield, CA 93312 REMINDER NOTICE Mandatory Lining Inspection on three (3) 12,000 Gallons Underground Fuel Tanks Located at 9628 Rosedale Hwy., Bakersfield, CA Certified Letter Dear Ms. Meyer: A review of our files indicate that your tanks located at the above-mentioned address were interior lined on March 13, 1992. Section 2663(h) of the California Code of Regulations, Title 23, Division 3, Chapter 16 of the Underground Storage Tank Regulations requires the following actions: "Within 10 years of the lining, and every five years thereafter, a coatings expert or special inspector must conduct an evaluation of the tank lining. Written certification of the inspection shall be provided by the tank owner and the party performing the inspection to the local agency within 30 calendar days of completion of the inspection. The inspection shall include all of the following: 1) Determine that the tank has been cleaned so that no residue remains in the tank. 2) Determine that the tank has been vacuum tested at a vacuum of 5.3 inches of rig for no less than one minute. 3) Testing the entire tank interior using a thickness gauge on a one- foot grid pattern with metal wall thickness recorded on a form that identifies the location of each reading in order to verify that average metal thickness is greater than 75 percent of the original wall thickness. 4) 5) Testing for thickness and hardness of the lining in accordance with nationally-recognized industry codes to verify that the lining meets the standard under which the lining was applied. .Testing the lining using an electrical resistance holiday detector in accordance with nationally-recognized industry codes. The owner or operator shall have all holidays repaired and checked in accordance with nationally-recognized industry codes. Certified Letter to: Page 2 Ms. Diana Meyer, Delimart REMINDER NOTICE Mandatory Lining Inspection on three (3) 12,000 Gallons Underground Fuel Tanks Located at 9628 Rosedale Hwy., Bakersfield, CA 6) Certification fi-om the special inspector or coatings expert that: a) The tank is suitable for continued use for a minimum of five years. b) The tank is suitable for continued use for a minimum of five years only if it is relined or other improvements are made. c) A lined tank shall be closed in accordance with Article 7 at the end of its operational life." Therefore, prior to March 13, 2002, you shall have your tanks inspected conforming to the above-mentioned code requirements. As a courtesy, this office is giving you advanced notification so that you may prepare accordingly. Should you have any questions, please feel flee to call me at (661) 326-3979. sT, Steve Underwood, Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SU/db S:~JULY 2001~Kang 1102 34~ St 90 Day Noti~ sLhmd~wd LTRwpd DELIMART Manager : Location: City : 9628 ROSEDALE HWY// BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: SiteID: 015-021-001395 BusPhone: (661) 589-5640 Map : 102 CommHaz : Low Grid: 29A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact / Title GREG MEYER / OWNER Business Phone: (661) 589-5640x 24-Hour Phone : (661) 399-9468x Pager Phone : ( ) - x Emergency Contact / Title DIANA MEYER / OWNER Business Phone: (661) 589-5640x 24-Hour Phone : (661) 399-9468x Pager Phone : (661) 334-6277x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9628 ROSEDALE HWY City : BAKERSFIELD Phone: (661) 589-5640x State: CA Zip : 93312 Owner GREG MEYER Address : 7404 PENNY MARIE City : BAKERSFIELD Phone: (661) 399-9468x State: CA Zip : 93308 Period : to TotalASTs: = Gal Preparer: ~TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: reviewed the attached,ha~rclous materials manage- ,or~~?6-~d that it along with rnent plan any corrections constitute a complete and correct man- agement plan for my facility,. 10/31/2000 ~ DELIMART SiteID: 015-021-001395 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: DELIMART Cross Street : Business Type: 0rg Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : DIANA MEYER Phone: Address: City : Type : CORPORATION Name : DIANA MEYER Address: City : Type : PARTNERSHIP (661) 589-5640x State: Zip: TANK OWNER INFORMATION Phone: (661) 589-5640x State: Zip: BOE UST Fee# : 006334 Financ'l Resp: Legal Notif : Tank Owner Mailing Address Date:10/01/2097 Name:DIANA MEYER State UST # : Phone: ( ) Ttl:PRESIDENT/MGR 1998 Upg Cert#: 00847 x ~ Hazmat Inventory --As Designated Order Hazmat Common Name... GASOLINE GASOLINE GASOLINE MOTOR OIL ISpecHazI EPA HazardsI Frm F IH DH L F IH L F IH L F DH L One Unified List All Materials at Site I DailyMax IUnitlMCP 12000.00 GAL Mod~ 12000.00 GAL Mod 12000.00 GAL Mod 170.00 GAL Min 2 10/31/2000 DELIMART ---- Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME GASOLINE PREMIUM UNLEADED Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 STATE ~ TYPE Liquid ~Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum I 12000.00 GAL Daily Average 3000.00 GAL %Wt. [ 100.00 Gasoline HAZARDOUS COMPONENTS N 8006619 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# I MCP Mod ~ Inventory Item 0002 m COMMON NAME / CHEMICAL NAME GASOLINE UNLEADED REGULAR Location within this Facility Unit UNDERGROUND TANK S OF BLDG Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 FSTATE ~ TYPE Liquid [Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum I 12000.00 GAL Daily Average 3000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS S CAS# N 8006619 TSecretINo N~S BioHazNo HAZARD ASSESSMENTS I Radioactive/Amount I EPA Hazards I NFPA No/ Curies F IH / / / USDOT# I MCP Mod -3- 10/31/2000 DELIMART ---- Inventory Item 0003 m COMMON NAME / CHEMICAL NAME GASOLINE DIESEL Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 015-021-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 STATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum I 12000.00 GAL Daily Average 3000.00 GAL I%Wt. [ 100.00 Gasoline HAZARDOUS COMPONENTS N 8006619 TSecretINo NoRSIBi°HaZNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH NFPA /// USDOT# I MCP Mod = Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit N ASILE - RETAIL DISPLAY Facility Unit: Fixed Containers at~ Site Map: Grid: Days On Site 365 CAS# 8020835 STATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 170.00 GAL Daily Average 50.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Motor Oil, Petroleum Based N 8020835 TSecret No HAZARD ASSESSMENTS I Radi°active/Am°unt I EPA Hazards INo/ Curies F DH NFPA /// USDOT# MCP Min -4- 10/31/2000 F DELIMART SiteID: 015-021-001395 Fast Format ~ Notif./Evacuation/Medical --Agency Notification Overall Site 08/16/1996 AS WE ARE A CONVENIENCE STORE WITH GAS, WE WOULD NOT HAVE AN EXPANSIVE PLAN TO EVACUATE. TELLING THE CUSTOMERS THAT WE HAVE AN EMERGENCY SITUATION AND TO EXIT. THIS CAN EASILY BE ACCOMPLISHED WHILE DIALING THE FIRE DEPARTMENT. -- Employee Notif./Evacuation TRAINED. 07/30/1999 Public Notif./Evacuation USING PA SYSTEM. 07/30/1999 Emergency Medical Plan 911 AND DIAL DIRECT TO ROSEDALE STATION. 10/08/1997 -5- 10/31/2000 ~ DELIMART SiteID: 015-021-001395 Fast Format ~ Mitigation/Prevent/Abatemt --Release Prevention Overall Site 08/16/1996 OUR FACILITY DOES NOT HAVE LARGE QUANTITIES OF HAZARDOUS MATERIALS, IN FACT INSIDE THE FACILITY WE ONLY HAVE CLEANING PRODUCTS, OIL AND OTHER CARE PRODUCTS, BATTERIES ALL ONLY BASIC CONVIENCE STORE PACKAGES. OUTSIDE, WE STORE GASOLINE IN THREE 12000 GALLON TANKS. THE ONLY TIME THERE WOULD BE A PROBLEM WITH SPILLAGE WOULD BE AT DELIVERY. IN THIS CASE, WE WOULD CALL THE ROSEDALE FIRE STATION, ONE BLOCK EAST OF OUR STORE. A HAZARDOUS WASTE TEAM WOULD HAVE TO COME OUT FOR THIS KIND OF CLEAN-UP. ANY TANK LEAKAGE PROBLEM WOULD BE CAUGHT EARLY DUE TO OUR DAILY INVENTORY WORK REQUIRED BY THE KERN COUNTY HEALTH DEPARTMENT. LOST PRODUCT MUST BE REPORTED TO THE E.P.A. --Release Containment FLOW OF SPILL WILL BE STOPPED BY FUEL SHUTOFF OR QUAKE VALVE. 10/08/1997 -- Clean Up 10/08/1997 WE USE KITTY LITTER TO ABSORB SPILL AND PLASTIC BAG CONTAMINATION. Other Resource Activation CALL FIRE DEPT IF THE RELEASE IS HUGE. 10/08/1997 -6- 10/31/2000 F DELIMART SiteID: 015-021-001395 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 10/08/1997 A) GAS - B) ELECTRICAL - IN CAGE AT N OUTSIDE WALL C) WATER - D) SPECIAL - FUEL BREAKERS LOCATED IN BREAKER BOX BEHING FRONT COUNTER E) LOCK BOX - NO -- Fire Protec./Avail. Water 07/30/1999 PRIVATE FIRE PROTECTION - WE HAVE AN IN-STORE SPRINKLER SYSTEM, AN AUDIO FIRE ALARM, AND THREE FIRE EXTINGUISHERS. OUR DELI AREA HAS AN ANSUL FIRE PROTECTION DEVICE BUILT IN TO THE GRILL HOOD. ALL ARE IN A SERVICE CONTRACT WITH JORGENSON. NEAREST FIRE HYDRANT - WE HAVE A FIRE HYDRANT TWENTY FEET FROM OUR GAS TANKS/PUMPS, ON ROSEDALE HWY SIDE. THE WATER LINE IS LOCATED IN THE SAME PLACE. OUR FIRE DEPARTMENT SPRINKLER VALVE IS ON THE EAST SIDE OF THE BUILDING NEAR THE REAR. BUILDING WATER VALVE IS ON WEST SIDE ALSO NEAR THE Building Occupancy Level -7- 10/31/2000 F DELIMART SiteID: 015-021-001395 Fast Format Training -- Employee Training HOW MANY EMPLOYEES AT THIS FACILITY????????????? DO YOU HAVE MSDS SHEETS ON FILE???????? BRIEF SUMMARY OF TRAINING PROGRAM: EXTENSIVE SAFETY MEETINGS. EMPLOYEES REQUIRED TO BECOME FAMILIAR WITH OUR SAFETY BINDER. Overall Site 10/08/1997 NEW -- Page 2 --Held for Future Use Held for Future Use -8- 10/31/2000 DELIMART Manager : Location: City : I CE't VED / /B¥:, ~ CommCode: CO~TY STATION 65 EPA Nu~: SiteID: 215-000-001395 BusPhone: (805) 589-5640 Map : 102 CommHaz : Low Grid: 29A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact / Title GREG MEYER / OWNER Business Phone: (805) 589-5640x 24-Hour Phone : (805) 399-9468x Pager Phone : ( ) - x Emergency Contact / Title DIANA MEYER / OWNER Business Phone: (805) 589-5640x 24-Hour Phone : (805) 399-9468x Pager Phone : (805) 334-6277x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9628 ROSEDALE HWY City : BAKERSFIELD Phone: ( ) State: CA Zip : 93312 X Owner GREG MEYER Address : 7404 PENNY MARIE City : BAKERSFIELD Phone: (805) 399-9468x State: CA Zip : 93308 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~ Hazmat Inventory --Alphabetical Order Hazmat Common Name... IspecHazI One Unified List Ail Materials at Site I DailyMax UnitlMcP EPA HazardsI Frm GASOLINE GASOLINE GASOLINE MOTOR OIL F IH DH F IH F IH F DH I, [)ittDd ~/,~Y Do hereby certify that I have mvia~ ~h~ a~hed h~dous matsfials manage- L L L L 12000 GAL Mod 12000 GAL Mod 12000 GAL Mod 170 GAL Min rnent plan for_[~eAi~¢4-- and that it along with (Name of Busing) any ~rr~ions ~nsfitu~e a ~mplat~ and corre~ man- agernont plan [or my P~cili~o iz.-' i Date' '" 07/20/1999 DELIMART SiteID: 215-000-001395 Inventory Item 0001 Facility Unit: Fixed Containers at Site ~pUVI~ ~Vl~ / ~PI £ ~.~-k.L~ ~Vl~ GASOLINE Days On Site PREMIUM UNLEADED 365 Location within this Facility Unit Map: Grid: UNDERGROUND TANK S OF BLDG CAS# 8006619 STATE 7 TYPE PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS RN~oRS CAS#8006619 TSecretINO N~S BioHazNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# I MCP Mod =Inventory Item 0002 Facility Unit: Fixed Containers at Site GASOLINE Days On Site UNLEA/DED REGULAR 365 Location within this Facility Unit Map: Grid: UNDERGROUND TANK S OF BLDG CAS# 8006619 STATE TYPE PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS TSecret No HAZARD ASSESSMENTS RS BioHazI Radioactive/Amount EPA Hazards No NoI No/ Curies F IH NFPA /// USDOT# MCP · Mod -2- 07/20/1999 DELIMART ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME GASOLINE DIESEL Location within this Facility Unit UNDERGROUND TANK S OF BLDG SiteID: 215-000-001395 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 STATE I TYPE PRESSURE Ambient Pure Liquid -- TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS 8006619 ITSecretI RSIBioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH NFPA/// I USDOT# Mod = Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit N ASILE - RETAIL DISPLAY Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 FSTATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 170.00 GAL Daily Average 50.00 GAL HAZARDOUS COMPONENTS I%Wt. I 100.00 Motor Oil, Petroleum Based I ~S CAS# N 8020835 ITSecret No HAZARD ASSESSMENTS II Radioactive/Amount INoRS BioHazNo No/ Curies FEPA HazardsIDH NFPA I. II USDOT# MCP Min -3- 07/20/1999 DELIMART &&&~~&~~&~&&~&&~&~&~~ SiteID: 215-000-001395 i~ Notif./Evacuation/Medical ~~~~~~~~ Overall Site i~ A~ency Notification ~~~~&~~~~~ 08/16/1996 AS WE ARE A CONVENIENCE STORE WITH GAS, WE WOULD NOT HAVE AN EXPANSIVE PLAN TO EVACUATE. TELLING THE CUSTOMERS THAT WE HAVE AN EMERGENCY SITUATION AND TO EXIT. THIS CAN EASILY BE ACCOMPLISHED WHILE DIALING THE FIRE DEPARTMENT. i&&& Employee Notif./Evacuation &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& 10/08/1997 TRAINED aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeef i~ Public Notif./Evacuation ~&~~~~~~&&~ 10/08/1997 USING PA SYSTEM 911 AND DIAL DIRECT TO ROSEDALE STATION. aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee e~ -4- 07/20/1999 DELIMART ~~~~~~~~~ SiteID: 215-000-001395 i~ Miti~ation/Prevent/Abatemt ~~~~~~~ Overall Site i~ Release Prevention ~~~~~~~~~ 08/16/1996 OUR FACILITY DOES NOT HAVE LARGE QUANTITIES OF HAZARDOUS MATERIALS, IN FACT INSIDE THE FACILITY WE ONLY HAVE CLEANING PRODUCTS, OIL AND OTHER CARE PRODUCTS, BATTERIES ALL ONLY BASIC CONVIENCE STORE PACKAGES. OUTSIDE, WE STORE GASOLINE IN THREE 12000 GALLON TANKS. THE ONLY TIME THERE WOULD BE A PROBLEM WITH SPILLAGE WOULD BE AT DELIVERY. IN THIS CASE, WE WOULD CALL THE ROSEDALE FIRE STATION, ONE BLOCK EAST OF OUR STORE. A HAZARDOUS WASTE TEAM WOULD HAVE TO COME OUT FOR THIS KIND OF CLEAN-UP. ANY TANK LEAKAGE PROBLEM WOULD BE CAUGHT EARLY DUE TO OUR DAILY INVENTORY WORK REQUIRED BY THE KERN COUNTY HEALTH DEPARTMENT. LOST PRODUCT MUST BE REPORTED TO THE E.P.A. FLOW OF SPILL WILL BE STOPPED BY FUEL SHUTOFF OR QUAKE VALVE. WE USE KITTY LITTER TO ABSORB SPILL AND PLASTIC BAG CONTAMINATION. aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeef CALL FIRE DEPT IF THE RELEASE IS HUGE. -5- 07/20/1999 DELIMART ~~~~~~~~~ SiteID: 215-000-001395 i~ Site Emergency Factors ~~~~~~~~ Overall Site ~ee~eeeeee~e~eee~eeeeee~eeeeee~e~eeeee~e~ee~ee~eeee~eeeeeeee~eee~e~ Utility Shut-Offs ~~~~~~~~~ 10/08/1997 A) GAS - B) ELECTRICAL - IN CAGE AT N OUTSIDE WALL C) WATER - D) SPECIAL - FUEL BREAKERS LOCATED IN BREAKER BOX BEHING FRONT COUNTER E) LOCK BOX - NO £g~ F±re Protec./Avail. Water PRIVATE FIRE PROTECTION - WE HAVE AN IN-STORE SPRINKLER SYSTEM, AN AUDIO FIRE ALARM, AND THREE FIRE EXTINGUISHERS. OUR DELI AREA HAS AN ANSUL FIRE PROTECTION DEVICE BUILT IN TO THE GRILL HOOD. ALL ARE IN A SERVCIE CONTRACT WITH JORGENSON. NEAREST FIRE HYDRANT - WE HAVE A FIRE HYDRANT TWENTY FEET FROM OUR GAS TANKS/PUMPS, ON ROSEDALE R-WY SIDE. THE WATER LINE IS LOCATED IN THE SAME PLACE. OUR FIRE DEPARTMENT SPRINKLER VALVE IS ON THE EAST SIDE OF THE BUILDING NEAR THE REAR. BUILDING WATER VALVE IS ON WEST SIDE ALSO NEAR THE i~ Building Occupancy Level 6 07/20/1999 DELIMART ~~~~~~~~~ SiteID: 215-000-001395 Training ~~~~~~~&~~~~&& Overall Site i~ Employee Training ~~~~~~~~&~ 10/08/1997 HOW MANY EMPLOYEES AT THIS FACILITY????????????? DO YOU HAVE MSDS SHEETS ON FILE???????? BRIEF SUMMARY OF TRAINING PROGRAM: EXTENSIVE SAFETY MEETINGS. NEW EMPLOYEES REQUIRED TO BECOME FAMILIAR WITH OUR SAFETY BINDER. i~ Held for Future Use ~eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeef i&&&&& Held for Future Use DELIMART Manager Location: 9628 ROSEDALE HW City : BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: SiteID: 215-000-001395 BusPhone: (805) 589-5640 Map : 102 CommHaz : Low Grid: 29A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact GREG MEYER Business Phone: 24-Hour Phone : Pager Phone : / Title / OWNER (805) 589-5640x (805) 399-9468x ( ) - x Emergency Contact Business Phone: 24-Hour Phone : Pager Phone : Title 589-5640× cc i / / (805) (805) (~) 35q -~z77x Hazmat Hazards: Fire ImmHlth DelHlth Emergency Directives: ~ Hazmat Inventory --MCP+DailyMax Order Hazmat Common Name... GASOLINE, PREMIUM UNLEADED GASOLINE, UNLEADED REGULAR GASOLINE, L~JL~AD~D .H~GL~ARDt~5~-t- MOTOR OIL ISpecHazlEPA HazardsI Frm F IH DH L F IH L F IH L F DH L One Unified List Ail Materials at Site DailyMax Unit MCP 12000 GAL Mod 12000 GAL Mod 12000 GAL Mod 170 GAL Min -1- 09/29/1997 DELIMART SiteID: 215-000-001395 Inventory Item 0001 Facility Unit: Overall Site ~lVUVl~ ~Vl~ / ~1~ ~_~A_.L, ~vl~ GASOLINE, PREMIUM UNLEADED Days On Site Location within this Facility Unit Map: Grid: UNDERGROUND TANK S OF BLDG CAS# 8006-61-9 r STATE I TYPE PRESSURE Liquid Pure Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS ~_ly Ave ra~ EHS CAS# No 8006619 TSecret EHS BioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# MCP Mod F Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME GASOLINE, UNLEADED REGULAR Location within this Facility Unit UNDERGROUND TANK S OF BLDG Map: Facility Unit: Overall Site Grid: Days On Site 365 CAS# 8006619 F STATE T TYPE PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE ITNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS Daily Aver~ _ 0o0 oo GAL EHS CAS# No 8006619 TSecret No HAZARD ASSESSMENTS EHS BioHazl Radioactive/Amount I EPA HazardsI No No No/ Curies F IH NFPA /// USDOT# MCP Mod 2 09/29/1997 DELIMART SiteID: 215-000-001395 Inventory Item 0003 Facility Unit: Overall Site ~lV~VlU~ ~Vl~ / ~ ~vl~ GASOLINE, ~ REGULAR~i~ ~-~'-1-~ Days On Site - 365 Location within this Facility Unit Map: Grid: UNDERGROUND TANK S OF BLDG CAS# 8006619 STATE TYPE PRESSURE Ambient Pure Liquid -- TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS - Daily Aver~q~3e~ 2,. o0 00 GAL ..~- EHS CAS# 8006619 HAZARD ASSESSMENTS TSecret EHS BioHazl Radioactive/Amount I EPA HazardsI NFPA No No No No/ Curies F, IH / / / USDOT# I MCP Mod Inventory Item 0004 Facility Unit: Overall Site ~UIVUVlU~ ~Vl~ / ~ffli ~t-~/J ~Vl~ MOTOR OIL Days On Site Location within this Facility Unit Map: Grid: N ASILE - RETAIL DISPLAY CAS# 8020835 STATE TYPE PRESSURE Liquid [ Pure I Ambient TEMPERATURE Ambient CONTAINER TYPE I' PLASTIC CONTAINER Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 170.00 GAL Daily Averag~__~ 60 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# Min -3- 09/29/1997 ~ DELIMART SiteID: 215-000-001395 Fast Format = Notif./Evacuation/Medical --Agency Notification Overall Site 08/16/1996 AS WE ARE A CONVENIENCE STORE WITH GAS, WE WOULD NOT HAVE AN EXPANSIVE pLAN TO EVACUATE. TELLING THE CUSTOMERS THAT WE HAVE AN EMERGENCY SITUATION AND TO EXIT. THIS CAN EASILY BE ACCOMPLISHED WHILE DIALING THE FIRE DEPARTMENT. -- Employee Noti~ [/EvaCuation -- Public Notif./Evacuation Emergen~'d Medica~-i~lak~n- -4- 09/29/1997 F DELIMART SiteID: 215-000-001395 Fast Format = Mitigation/Prevent/Abatemt --Release Prevention Overall Site 08/16/1996 OUR FACILITY DOES NOT HAVE LARGE QUANTITIES OF HAZARDOUS MATERIALS, IN FACT INSIDE THE FACILITY WE ONLY HAVE CLEANING PRODUCTS, OIL AND OTHER CARE PRODUCTS, BATTERIES ALL ONLY BASIC CONVIENCE STORE PACKAGES. OUTSIDE, WE STORE GASOLINE IN THREE 12000 GALLON TANKS. THE ONLY TIME THERE WOULD BE A PROBLEM WITH SPILLAGE WOULD BE AT DELIVERY. IN THIS CASE, WE WOULD CALL THE ROSEDALE FIRE STATION, ONE BLOCK EAST OF OUR STORE. A HAZARDOUS WASTE TEAM WOULD HAVE TO COME OUT FOR THIS KIND OF CLEAN-UP. ANY TANK LEAKAGE PROBLEM WOULD BE CAUGHT EARLY DUE TO OUR DAILY INVENTORY WORK REQUIRED BY THE KERN COUNTY HEALTH DEPARTMENT. LOST PRODUCT MUST BE REPORTED TO THE E.P.A. -- Release Containment · 5~Clean Up Other Resource Activation absov b s ! -5- 09/29/1997 fi DELIMART SiteID: 215-000-001395 Fast Format Site Emergency Factors Special Hazards Overall Site ~k~ ~Utility Shut-Offs -- Yi~e ~o~ec./A~ail. ~a~e~ 08/16/1996 WE HAVE AN IN-STORE SPRINKLER SYSTEM, AN AUDIO FIRE ALARM, AND THREE FIRE EXTINGUISHERS. OUR DELI AREA HAS AN ANSUL FIRE PROTECTION DEVICE BUILT IN TO THE GRILL HOOD. ALL ARE IN A SERVCIE CONTRACT WITH JORGENSON. WE HAVE A FIRE HYDRANT TWENTY FEET FROM OUR GAS TANKS/PUMPS, ON ROSEDALE HWY SIDE. THE WATER LINE IS LOCATED IN THE SAME PLACE. OUR FIRE DEPARTMENT SPRINKLER VALVE IS ON THE EAST SIDE OF THE BUILDING NEAR THE REAR. BUILDING WATER VALVE IS ON WEST SIDE ALSO NEAR THE REAR. Building Occupancy Level -6- 09/29/1997 £ F×DELIMART SiteID: 215-000-001395 Fast Format Training Overall Site Empl0yee Training -- Page 2 -- Held for Future Use Held for Future Use -7- 09/29/1997 B A K E R S F I E L-D FIRE DEPARTMENT PORTANT FIRE CHIEF MICHAEL R. KELLY ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93,301 (805) 326-3941 FAX (805) 395-1349 ' P~EVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SEEVICF.$ 1715 Chester Ave. Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0,576 TRAINING DIVISION 5642 Victor Street Bakersfield, CA 93308 (805) 3c~-4697 FAX (805) 399-5763 DO NOT DISCARD Dear Business Owner: California Law requires that all Businesses, which at any time during the year handle reportable quantities of hazardous materials, file a Hazardous Materials Business Plan, including inventory of hazardous materials, with the local administering agency. Your business has filed such a plan. This same regulation requires that these businesses review the business plan submitted to determine if revisions are needed, and to certify t° the administering agencies that the review was made and that any necessary changes were made to the plan. To facilitate this review we have enclosed a computer print-out of the plan you have submitted. Please review this plan in its entirety and make any necessary revisions on the print-out. . When the review and revisions are completed sign the first page of the plan in the appropriate space certifying that the plan is complete and correct. Return the business plan along with any revisions to this office within 30 days of receiving these forms. If you have any questions or if we can be of any assistance please do not hesitate to call 326-3979. ~l-- ,.~// /c~,~ "~ Sincerely yours, Hazardous Materials Coordinator KEH/ed 08/16/96 DELIMART 215-000-001395 Overall Site with 1 Fac. Unit Page General Information Location: 9628 ROSEDALE HWY Map:102 Haz:0 Type: 3 City : BAKERSFIELD Grid: 29A F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title GREG MEYER / OWNER DEBBIE YOST / Business Phone: (805) 589-5640x Business Phone: (805) 589-5640x 24-Hour Phone : (805) 399-9468x 24-Hour Phone : (805) 664-1210x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 9628 ROSEDALE HWY D&B Number: City: BAKERSFIELD State: CA Zip: 93312- Comm Code: 215-065 COUNTY STATION 65 SIC Code: 5541 Owner: GREG MEYER Phone: (805) 399-9468 Address: 7404 PENNY MARIE State: CA City: BAKERSFIELD Zip: 93308- r Summary CORNER CONVENIENCE STORE WITH GAS PUMPS OUTSIDE AND LUNCH COUNTER WITH GRILL INSIDE. UNDERGROUND TANKS LOCATED BETWEEN STORE AND N SIDE OF ROSEDALE HWY. FIRE DEPT. CONNECTION LOCATED AT NE CRNR OF BLDG. 08/16/96 Pln-Ref Name/Hazards DELIMART 215-000-001395 Hazmat Inventory List in MCP Order 02 - Fixed Containers at Site Form Max Qty Page MCP 02-001 GASOLINE, PREMIUM UNLEADED · Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL 02-002 GASOLINE, UNLEADED REGULAR · Fire, Immed Hlth Liquid 12000 Moderate GAL 02-003 GASOLINE, UNLEADED REGULAR · Fire, Immed Hlth Liquid 12000 Moderate GAL 02-004 MOTOR OIL · Fire, Delay Hlth Liquid 170 Minimal GAL 08/16/96 DELIMART 215-000-001395 02 - Fixed Containers at Site Hazmat Inventory Detail in MCP Order Page 3 02-001 GASOLINE, PREMIUM UNLEADED · Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Daily Max GAL 12,000 I Days: Use: FUEL Daily Average GAL 6,000.00 [ Annual Amount GAL 200,000.00 Storage UNDER GROUND TANK Press T Temp Location IAmbientJAmbientlUNDERGROUND TANK S OF BLDG -- Conc 100.0% IGasoline Components MCP Guide Moderate 27 02-002 GASOLINE, UNLEADED REGULAR · Fire, Immed Hlth Liquid 12000 Moderate GAL CAS #: 8006619 Trade Secret: No Form: Liquid Type: Pure Daily Max GAL 12,000 I Days: 365 Use: FUEL Daily Average GAL 7,000.00 { Annual Amount GAL -- 500,000.00 Storage UNDER GROUND TANK Press T Temp iAmDiontjAmDiontlUNDERGROUND Location TANK S OF BLDG -- Conc 100.0% IGasoline Components MCP Guide IModerate I 27 02-003 GASOLINE, UNLEADED REGULAR · Fire, Immed Hlth Liquid 12000 Moderate GAL CAS #: 8006'619 Trade Secret: No Form: Liquid Type: Pure Daily Max GAL 12,000 I Days: 365 Use: FUEL Daily Average GAL 6,000.00 ] Annual Amount GAL 300,000.00 Storage UNDER GROUND TANK Press T Temp iAmDiont/AmbiontlUNDERGROUND Location TANK S OF BLDG -- Conc 100.0% IGasoline Components iMCP --TGuide ModerateI 27 08/16/96 DELIMART 215-000-001395 02 - Fixed Containers at Site Hazmat Inventory Detail in MCP Order Page 02-004 MOTOR OIL ~ Fire, Delay Hlth Liquid 170 Minimal GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: Use: LUBRICANT Daily Max GAL 170 I Daily Average GAL 100.00 Annual Amount GAL 1,000.00 Storage PLASTIC CONTAINER Press T Temp IAmbient~Ambient IN ASILE - Location RETAIL DISPLAY -- Conc, Components 100.0% IMotor Oil, Petroleum Based MCP ---TGuide IMinimal I 27 08/16/96 DELIMART 215-000-001395 Page 00 - Overall Site <D> Notif./Evacuation/Medical 5 <1> Agency Notification AS WE ARE A CONVENIENCE STORE WITH GAS, WE WOULD NOT HAVE AN EXPANSIVE PLAN TO EVACUATE. TELLING THE CUSTOMERS THAT WE HAVE AN EMERGENCY SITUATION AND TO EXIT. THIS CAN EASILY BE ACCOMPLISHED WHILE DIALING THE FIRE DEPARTMENT. <2> Employee Notif./Evacuation <3> Public Notif./Evacuation <4> Emergency Medical Plan 08/16/96 DELIMART 215-000-001395 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention OUR FACILITY DOES NOT HAVE LARGE QUANTITIES OF HAZARDOUS MATERIALS, IN FACT INSIDE THE FACILITY WE ONLY HAVE CLEANING PRODUCTS, OIL AND OTHER CARE PRODUCTS, BATTERIES ALL ONLY BASIC CONVIENCE STORE PACKAGES. OUTSIDE, WE STORE GASOLINE IN THREE 12000 GALLON TANKS. THE ONLY TIME THERE WOULD BE A PROBLEM WITH SPILLAGE WOULD BE AT DELIVERY. IN THIS CASE, WE WOULD CALL THE ROSEDALE FIRE STATION, ONE BLOCK EAST OF OUR STORE. A HAZARDOUS WASTE TEAM WOULD HAVE TO COME OUT FOR THIS KIND OF CLEAN-UP. ANY TANK LEAKAGE PROBLEM WOULD BE CAUGHT EARLY DUE TO OUR DAILY INVENTORY WORK REQUIRED BY THE KERN COUNTY HEALTH DEPARTMENT. LOST PRODUCT MUST BE REPORTED TO THE E.P.A. <2> Release Containment <3> Clean Up <4> Other Resource Activation 08/16/96 DELIMART 215-000-001395 Page 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs <3> Fire Protec./Avail. Water WE HAVE AN IN-STORE SPRINKLER SYSTEM, AN AUDIO FIRE ALARM, AND THREE FIRE EXTINGUISHERS. OUR DELI AREA HAS AN ANSUL FIRE PROTECTION DEVICE BUILT IN TO THE GRILL HOOD. ALL ARE IN A SERVCIE CONTRACT WITH JORGENSON. WE HAVE A FIRE HYDRANT TWENTY FEET FROM OUR GAS TANKS/PUMPS, ON ROSEDALE HWY SIDE. THE WATER LINE IS LOCATED IN THE SAME PLACE. OUR FIRE DEPARTMENT SPRINKLER VALVE IS ON THE EAST SIDE OF THE BUILDING NEAR THE REAR. BUILDING WATER VALVE IS ON WEST SIDE ALSO NEAR THE REAR. <4> Building Occupancy Level BUSINESS NAME KERN COUNTY FIRE DEPARTMEN' 5642 VICTOR STREET B~J(ERSFIELD, CA 93308 (805) 861-2761 ID# DO NOT WRITE ABOVE'THIS LINE HAZARDOUS MATERIALS BUSINESS PLAN FORM 2A INSTRUCT IONS: 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for your business as a whole. 4. Be as brief and concise as possible. But explain fully. RF_..CEt V~D HAZ~ MAT. D~V. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: DELIMART' B. PHYSICAL LOCATION/STREET ADDRESS: ~Zfi ~0SED~L~ H~Y CITY: BA~E~S~'~EL~ ZIP: q3~'lZ- BUS.PHONE: C. MAILING A'DDRESS: 51~N~-. CITY: ZIP: BUS.~ PHONE: ( ) SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency Involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES WHO sHOULD BE NOTIFIED IN CASE OF EMERGENCY: SAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. PIRNA OR ~-KE~ Mk-~/~ Ph#Sqq.~qq~$/~gq'$bq3'h# I SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A tfliOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: ~0~'t%4 D. SPECIAL: E. LOCK BOX: YES / ~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLaiNS? YES / NO MSDSS? YES / NO KEYS? YES / NO OVER SECTION 4: PRIVATE RESP TE~d~ FOR BUSINESS AS A WHOLE Do you have a group of employees trained to handle minor accidents involving hazardous materials? Yes No %/ If so. please explain. SECTION 5: 'C~'OSEST LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS ADDRESS: PHONE: SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: ....................................... ~}NO 8. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES ~NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES ~ E, DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ REFRESHER NO YES ~ YES ~ YES NO i, ~~ ~~ certify that the above information is accurate. I under~tand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. ~0 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. SIGNATURE ~~~f.A HMCU-4 KERN COUNTY FIRE DEP~ 5642 VICTOR STREET BAKERSFIELD. CA 93308 BUSINESS ID, _ AUG 2 5 1988 KCFD HMCU BUSINESS PLAN FORM 3A 1. ro avold ~urther action, this form~ust be returned b~: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELO~ 4. Be as BRIEF and CONCISE as possible. But explain fully DELIMART FACILI~ ~IT NA,qE: ~fl ROSEDALE HWY. BAKERSFIELD~ CA. 93312 . SECTION 1: PREVF. NTION~ ]~ININIZATION, ANn CT.£AN-UP PROc£nrr~..~ .._ ........ SEC'.TION i:MiTiGATION~ PREVENTiON~ ABATEMENT OUR FACILITY DOES NOT HAVE LARGE QUANTITIES OF HAZARDOUS MATERIALS. IN FACT INSIDE THE FACILITY WE ONt. Y HAVE CLEANING PRODU£:TS~ OiL AND OTHER CAR PRODUCTS~ BATTERIES ALL ONLY BASIC CONViENCE STORE P~CKAGES. OUTS!DE~ WE STORE GASOLINE IN THREE !2~BM GALLON T~NKS. THE ONLY TiME THERE WOULD BE A PROBLEM WITH SPILLAGE WOULD BE AT DELIVERY. IN THIS CASE WE WOULD CALL THE ROSED4LE FiRE ST4TiON~ ONE BLOCK EAST OF OUR STORE. A HAZARDOUS WASTE TEAM WOULD HAVE TO COME OUT FOR THIS KiND OF CLEAN-UP= ANY TANK LEAKAGE PROBLEM WOULD BE CAUGHT EARLY DUE TO OUR DAILY iNVENT- ORY WORK REQUIRED BY THE KERN COUNTY HEALTH DEPARTMENT. LOST PRODUCT MUST ,,EP,.RT~D TO THE E.P.A ...... ~S£CTTON~-~N(rflIg'IC, ATION ~ EVACUATION PROCED~S FOR ~ ENPLOYP. ES ~ USE THAT ~ IN TliI8 FACILITY SECTION 2:NOTiFICATiON AND EVACUATION × '~'VF AS; NE ARE~ A CONVIENCE STORE WITH GAS~ NE ~OULD NOT HAVE AN E..PAN:=,~ _ PLAN TO EVACUATE~ TELLING THE CL~STOMERS THAT WE HAVE AN EMERGENCY SITUATION AND TO EXIT. THIS CAN EASILY BE ACCOMPLISHED WHILE DIALING THE FIRE DPT. ~CTION 3: BAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... If YES, see B. If NO, continue with SECTION 4. YES ~0 B. Are any of the hazardous materials a bona fide Trade Secret as defined by Section 6254.7 of the Government Code? ......... YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE pROTEcTION SYS~ SECTION 4:PRIVATE FiRE PROTECTION SYSTEMS WE HAVE A IN-STORE CEILING SPRINKLER SYSTEM, AN AUDIO FIRE ALARM, AND THREE FIRE EXTINGUiSHERS~ OUR DELI AREA HAs AN ANSUL FiRE PROTECTION DEVICE BUILT iN TO THE GRILL HOOD. ALL ARE tN A ~R=~;~CE CONTRACT WITH jORGENF;(]N. SECTION $: 'LOCATION OF WATER SUPPLY FOR_USE_BY ~RC~MmV ~.e~Mn~:~,e WE HAVE ~ COUNTY FIRE HYDRANT TWENTY FEET FROM OUR GAS TANKS/ PUMPS~ ON ROSEDALE HWY. SIDE. THE WATER LINE iS LOCTED iN THE SAME PLACE. OUR NEaR FiRE D~,~RT, t,-,~T SPRINKLER VALVE IS ON THE EAST SIDE OF THE BUILDING THE BE_AR._~"~,~=~"TB'rN~c~"u WATER VALVE iS ON WEST SiDE~ ALSO N~R THE REAR. ...... .4'.'- X~. OAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO MSDSs? YES / NO YES / NO KEYS? YES / NO HMCU-6 I.D. g£Rtl Ct)lINTY FIRE I)EPARTMENT FORM 4A-3 FARM & AGR I CULTURE ]IAZ ARDOUS MATER I ALS I NVEN'FORY FACILITY FACILITY UNIT OFFICIAL USE CFIRS 'COl)~r ONLY I 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAl, CONT USE LOCATION IN THIS · BY IIAZARI) D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY* UNIT #T. CIIEMICAL OR COMMON NAME CODE GUIDE 0 NAME DIA~]~ ~.¥~ TITLI~(~N~J ~i~)Ji~rE~ SIGNATURE: ~ ~~ DATE: ENERG~CY CONTACf:~ O~ ~IAUA M~ ~ITL~: DA~/~AM~ PIIONE ~ BUS .' ' a Tea Bus ESERGENCY CONTACT:D~gI[ Y~ TITLE: ~ST. ~ PIIONE t BUS HOURS:._¢¢~:~U~ .... , ....... PRiNCIPal, BIISINI{NS ACTIVIYY:_~~ ~ ~OLI~[ AFTER RUS IIaS: 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) .v 13 Metal Containers (Not Drums,) 14 In Machinery or processing equipment 15. Bin(s) 99. OTHER - Specify on separate sheet USE CODES 01. Additive 02. Adhesive 03. Aerosol 04. Anesthetic 05. Bactericide 06. Blasting 07. Catalyst 08. Cleaning 09. Coolant 10. Cooling 11. Drilling 12. Drying 13. Emulsifier/Demulstfier 14. Etching 15. Experimental 16. Fabrication 18 19 2O 21 22 Fertilizer Formulation Fuel Fungicide Grinding Heating 23. Herbicide 24. Insecticide 25. Instructional 26. Lubricant 27 Medical Aid or Process 28 Neutralizer 29 Painting 30 Pesticide 31 Plating 32 Preservative 33 Refining 34 Sealer 35 Spraying 36 Sterilizer 37 Storage 38 Stripper 39 Washing 40. Waste 41. Water Treatment 42. Welding Soldering 43. Well Injection 44. 011 Treatment 99. OTHER-Specify on TYPE CODES P = Pure M - Mixtures of pure substances W = Wastes (Also add appropriate waste code) UNIT CODES LBS - Pounds TON - Tons (2,000 lbs) GAL = Gallons BBL - Barrels (42 gals) Ft3 = Cubic Feet CUR = Curies HAZARD CODES EXPL - Explosive CMLQ - Combustible Liquid CMSL - Combustible Solid CRKT - Corrosive Material FI,aS - Flammable Gas FLLQ - Flammable Liquid FL~L - Flammable Solid NFI,G - Non-Flammable Gas OG~X - Organic Peroxide OXiD - Oxidizer CRY0 -~ Cryogenics ORNA - Anesthetic, Irritant 0RME - Hazardous Waste OHMS - Other regulated Material B,C,and D PSNA - Poison A (Gas} PSNB - Poison B (Liquid or Solid) RADI - Radioactive WATR - Water Reactive 'ETIO - Etiological Agent PYRO - Pyrophoric, Hypergolic or spontaneously combustible ITE/FACILITY D I AGR,~u~[ F O RI~[ $ ' DELIMART 9~28 ROSEDALE HWY. BAKERSFIELD, CA. 93312 : FLOOR: OF ~OR."'. SCAL.- ~S~N~.SS N~E:n~W~..,.,.,~... ~. DATE:B/Zq/~f FAC[L[W N~E: UNiT ,: OF (C~ECK ONE) SITE DIAGR~ / FACILI~ DIAGR~ ~ J, U N DEI~GRO~D Inspector's Comments): -OFFICIAL USE ONLY- H~CU-13 '.',Farm and Agr9culture '--' KERN COUNTY FIRE DEPARTMENT O/~?Of~" HAZARDOUS MATERI ALS I NVE N'I'O RY LF~..j~ DUN AN[) BRAOSlRiiff~ BUSINESS NAME:~imar~ OWNER NAME: ~Q~¢y~r. K. V0u~,~~N~ ADDRESS: 7~ ~e nn~ ~ ............................ LOCATION: qNZ~ ~oLe~le ~ - ' -' J~ - CITY, ZIP: ~oke?s~IPIJ ~a'- ~IZ CITY, ZI~:'~ke~¢%~ ~a ~Eo$ PHONE ~: ~56~6 ~$~ ..... PHONE ~ :~qq~ Page ..... [ .... of ....... R~FER rO INSTRUCTIONS FOR PROPER CODES Trans [ype Max Average Annual Measure CoLt Cont Cont Use % by Names of Mix,uTe/Components ~ J ~ JJJ~ J JA~ J~ ~ J~jjC°de Code ~mt Amt Est Units Type Press l'emp Code Nt . See Instructions Health ...... .................................. ' : " ;' ' - ~Fire ~e3ayed Health C.A.S. Number .......... ~._l. . ~,. :, .... ~ Reactivi[y L__J Sudden Release of Pressure on Site .J ,, ~ ..., .. !%_0_o_Q .~9_~ aDD ......~ ...... UN~D_~___~_QUN~ ......................... L__J Immediate ~U-%.~. - - Health ~ Fire ~ Delayed Health C.A.S. Number___~_~.~_]_~ -- ~ ~, I L--J Reactivity L._J Sudden Release of Pressure on Site L_- J Immedfate ...... · Heai [ h L J Reactivity L .... J Sudden Release of Pressure on Site ~ ~ ~ ~ ~ ~ ~ Name ........... .' ,JCle , z, .~ Fnone FEB 2 ~ - ' ~m~ ...... . ............ '~,~ · - . ,~ ................ ........................... : ................................. . ....................................................................... Ce~tio~.[~ead and siEn afLer, completinE all sections) ' ru HMCU '" [ cart], fy u'nder p.enalt, y of law that I ............. have personally examined and am familiar with the information submitted in this and all at(ached documentsu, ~nd. that based, on my inquiry of those ~nd~v~duals responsible for obtaining the ~ntormat~on, I believe that the s~ ~mati~ i~true, accurate, and complete. flam~F~c~a~-t t /operato ~r/ope p . · g ~ 4 INVE~ORY Tra~ Code (Column 1) ~ A = Add This Item D = Delete This item R = Revised Information Type Code (Column 2) P = Pure Material M = Mixture of Substances W = Waste (Must Also: Add Appropriate Waste Code from "Waste Code Sheet") Measure Units (Column 6) LBS = Pounds TON = Tons (2,000 lbs) GAL = Gallons BBL = Barrels (42 ga]s) Ft3 = Cubic Feet CUR = Curies Container Type (Column 7) 01. ..Und~rgroBn~ Tank 02. CODE SHE~ Use Codes (Colum~.i0) 01 02 03 04 O5 o6 07 O8 09 10 ll 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Ab o ~ eg r o u nd~ a-~k ~-~ ........ ~ .... - .....2'8x~ --N~ utr a-l-iz e r ............. 03. 04. 05. 06. 07. 08 09 10 11 12 13 14 15. 16. Fixed Pressurized Cylinders Portable Pressured Cylinders Insulated Tank (Includes Cryogenics) Drums or Barrels - Metallic Drums or Barrels - Non- Metallic Carboy(s) Glass Container(s) Plastic Container(s) Box(es) Bag(s) Metal Containers (Not Drums) In Machinery or Processing Equipment Bin(s) Unlined Sumps Container Pressure (Column 8) 1 = Ambient Pressure 2 = Greater Than Ambient Press 3 = Less than Ambient Press Container Temperature (Column 9) 4 =. Ambient Temperature 5 = Greater than Ambient 6 = Less than Ambient Temp but not Cryogenic 7 = Cryogenic Conditions 29 30 31 32 33 34 35 36 37 38 39 4O 41 42 43 44 45 46 47 48 49 5O 51 52 53 54 55 99 Painting Pesticide Plating Preservation Refining Sealer Spraying Sterilizer Storage/In Storage Stripper Washing Waste Water Treatment Welding Soldering Well Injection or Service 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 on another page Additive Adhesive,..~ Aerosol / inf l~:t io'~ Anesthetic Bactericide ,::-, Blasting · Catalyst Cleaning 'Coolant/Antifreeze Cooling Drilling Drying Emulsi fier/Demulsifier Etching Experimental/Analytica/ Fabrication Fertilizer Formulation/Manufacturing Fuel Fungicide Grinding Heating Herbicide Insecticide Instructional Lubricant Medical Aid or Process r--, KERN COUNTY FIRE DEPARTMENT Farm and Agriculture ~---u HAZAI~DOU$ MATE'RI ALS INVENTO]~Y Standard 8usiness ~ 4 1 2 3 4 5 6 ? 8 9 10 11 12 'frans Type Max Average Annual Measure Cent Cent Cent Use % by Names of Mixture/Components Code Code Amt' Amt Est Units Type Press. Temp Code Wt See instructions Immediate Health Fire ~ Delayed Health C.~.S. Number Reactivity ~ ....~ Sudden Release of Pressure on Site ~Delayed Health C.A.S. Number ~ ~ Sudden Release of Pressure on S~te ~ ---~ Immediate Health ~Fire ~---~ Reactivity Health r ..... n r ...... ~ ~ ....... ~ Fire c_..~ Delayed Health L ~ Sudden Release of Pressure C,A.S. Number 13) ~ Days i I on Site ~ .... J ~_ u Immediate '~ Health L ---.J Fire c ..... ' Delayed Health ~ ...... ~ Sudden Release of Pressure ~ ---~ Immediate Health L ...... ~ Fire L__J Delayed Health L---J Reactivity Sudden Release of Pressure C.A,S. Number .................................. 13) ] Days i ~ on Site ~ ....... u C.A.S. Number ........................... 13) ~ Days i I on Site Trans Code (Column 1) Use Codes (Column 10) A = Add This Item D = Delete This item R = Revised Information Type Code (Column 2 P = Pure Material M = Mixture of Substances W = Waste (Must Also: Add Appropriate Waste Code from "Waste Code Sheet") Measure Units (Column 6) LBS = Pounds TON = Tons (2,0Ob lbs) GAL = Gallons BBL = Barrels (42 gals) Ft3 = Cubic Feet CUR = Curies Container Type (Column 7) 01. 02. 03. 04. 05. 06. 07. 08 09 10 11 12 13 14 15. 16. O1 02 03 04 O5 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Additive Adhesive Aerosol/Inflation Anesthetic Bactericide Blasting Catalyst Cleaning Coolant/Antifreeze Cooling Drilling Drying Emulsifier/Demulsifier Etching Experimental/Analytical Fabrication Fertilizer Formulation/Manufacturing Fuel Fungicide Grinding Heating Herbicide Insecticide Instructional Lubricant Undemground_~a~ ...... ~-~ 2? Medical Aid or Process Aboveground Tank Fixed. Pressurized Cylinders Portable Pressured Cylinders Insulated Tank (Includes Cryogenics) Drums or Barrels - Metallic Drums or Barrels - Non- Metallic Carboy(s) Glass Container(s) Plastic Container(s) Box(es) Bag(s) Metal Containers (Not Drums In Machinery or Processing Equipment Bin(s) Unlined Sumps Container Pressure (Column 8) 1 = Ambient Pressure 2 = Greater Than Ambient Press 3 = Less than Ambient Press Container Temperature (Column 9) 4 = Ambient Temperature 5 = Greater than Ambient 6 = Less than Ambient Temp but not Cryogenic 7 = Cryogenic Conditions 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 5O 51 52 53 54 55 99 Painting Pesticide Plating Preservation Refining Sealer Spraying Sterilizer Storage/In Storage Stripper Washing Waste Water Treatment Weldin~ Soldering Well Injection or Service 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 on another page