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HomeMy WebLinkAboutBUSINESS PLAN (2) uslne~ Address: For Otfice U~e Only First In Station: Area Map # of lnsoection Station:N O RT.H M till P SITE DIAGRAM Business Name: Business Address: First in Statiqn: Ins0ection Station: FACILITY DIAGRAM For Office Use Only Area Map # of - NORTH 18/2004 07:48 6613252529 CAL VALLEY PAGE 01 CAL-VALLEY EQUIPMENT 3500 GILMORE AVENUE BAKERSFIELD, CA 93308 (661) 327-9341 FAX: (661) 325-2529 CONTRACTOR'S LIC.#784170 A HAZ [] IJq~ent I'1 For Review t'l Please Comment (-! Please Reply [] Please Re(:yole Comments: 0811872084 07:48 6613252529 CAL VALLEY PAGE 02 ~ ,i~ _/___ m . ~- Secondary Containlnent Testing Report Form 7't~L~'Jbrm ~s mtend¢d f~r use by c~n~racwr~ petf~rm~ng ~eri~dic t~tlng ~f U~T $ec~ndary c~nta~n~ne~tt ~stem$~ U$~ the app .ropriate pag~.$ of this farm Io report results for all compo.~nt$ tested, The completeM form, wrllte, n test procedures° mtd pre. touts fram teats (if applicable), $houM b~ provided to II~e focility owner~operator for submittal to the local regulatory 1. FACILITY INFO,,RMATION l, .Facility Name: ~/75 _L"/t eo Facility ^ddr~ss: q_70_O /~O.C_a t~'a /f~/,' IFacility Contact: Date Local Agency Was Notified of Testing: Name of Local A .g?ncy ln.nPcClOr (,if. pre,,e.t during ~es~ing); [ Pho~e: 2. TESTING CONTRACTOR IHFOI~V/ATIO1N Company Nan.: L"~/~ ~i[ ~v ~,'~ ~ 4~ Technician Conducting Test: ~, '~_ ~oo[a ~ Credentials: ~LB Licensed Con,actor SWRC~ Licensed Ta~ T~ter Li~nse T~c; 1 Lic~e Number: Manufacturer Component(s) Dale Training E.x_pires ~ -$0 - zt.,,.o, C. SUMMARY OF TEST RESULTS Cemponent Pass Fall l'estad Mad; Compo.ant Pa~ r Fall Not Repairs ,, T~ted Made !..3-~ ~./~ y, ~/ ~/1/~ ~ ,, If' hydroslafic lesting was peal'armed, describe what was <lone with the water alter completion et'testa: CERTIFICATION OF TECHNICIAlg RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of nty I~nowledge. the foct.s staled h~ docunteut are nccttrate and ht ~tH compliance n~t/t lsgoI requlreotents I echn.cJan's S] ,nat~ ~' '~~~ " ',' 'g ~: ~ ~~// Date- , ~ '. ~-~"~ 08/1872864 07:48 6613252529 GAL VALLEY PAGE 03 ................ I'ag~: ~ .. m' ...b',.. TANK ANNULAR TESTING Tank Manufacturer ~dust7 $~ndar~ Pro~essional Engineer Other (Spec~) Te~t Method ~sed: Pr~sure .... ~'" Itydrostatic , Othcr ~lmC~O ~~J~ Equipm.~t ~eso,ution: Tank ~ t Tank ~ [ Tank ~ ~ Tank ~ Tank CBpOCily: Ta~ Mnnufactul.~e .... Wall lime between applying pressure/vacuunVwater and linking test: Final Reading (R~,): /0 '~ ~ /~ .'~ .~¢ , /0 ,~ ~C_ ChanSe in R~ding (R~.R0: ~ ~ ~ "' Pas~Fail Threlhold or Criteria: Test Result: '~ P~ O'~ail ' ~ P~Ss.' '0~ii1":.'. ~",:;~':i~ns~" OFnil 0 Pass OFnil Was s~l~r rcmo'ved for I~sfiy!g? ~ No NA ~ ~ HA ~ No NA Yes Nn NA Was re,sar properly replaced and ~ ~' verified functional afar (est~p~? ~ No NA No NA No NA Ym No NA Comments.. - (i.cl.de i,for, mtio. 0, repah's' made prior lo te~ting,, m,d ,~eco,nmendeddeoHow. up fm.folled. /estO: ~ Secondary containment systems where tI~e continuous mnnitoring automatically monitors both thc primary and secondary containment, such ns systems that arc hydrostatically monitored or under constant vacuum, are exempt Imm periodic contalnmcm testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} ' 08/18/2004 0?: 48 66132§2§29 GAL VALLEY PAGE , ~. SECONDARY ~E~~ ,,, Tell Me,md DevelOPed By: ' PipingManu~cturer ~ h,du,~ ~ta,,dar~ Professional E.ui".e. Other Test ~ethod Used'. · ~ Vn~u~ Hydros~(ic ' Pipl~gRun~ / ,,, Wait lime ~tw~. applTin~ pressure/vacuu~water and 'l'esl Du~tion: ,.,/~r /~ ., , /~ ..... Pas~Fail ~reshold ~ Criteria: Comments - (~¢tutle /.forma/io/t o. reptar.~ .~atfe ~rior Jo testing, and recommendqd[oiiow-up for f. ailud te~'t.O 88/18/2884 87:48 6613252529 FAL VALLEY PAGE 85 , Other ~pec~ - - ' 'f'eS( Method Used: Prc~sure Ve~'uum Hydrostatic - ~ ~ ~uipmentkesolmion: . ,.. . Sump Sump Diamet~r: ,. .... Height from Tank Top t~ Top o¢ )lights( Piping Ponelr~tion: Flelghl From Tank"~o~ ~o Lowest " // 5lcc~ical Penetration: Porliun orSump 'rested~ /~ e i~,~ ~] ~, " , Do~s ~u,~i~e shut down when -, sump sensor dctccta liquid (both Yes No NA Y~ No HA Yes No .product and wa.ret}?' NA Y~ No NA 'Putbh~c shutdown response time " Is syslem pmgramme~ For {'ail.safe .... shmdown?' Yes No NA Y~ No NA Yes No N~ Y~ No NA Was Fail-saFe, verified to be opemtio~m[?' Yes No NA Yes No NA Yes , No NA Yes No NA WsJl lime belwccn appJyJng ' ,, pressure/vacuumlwatet a~ slatting 'l'csl Start Ti,ne: '[cst End Ti,,~: Tosl Duration: ~'~ngC in Readin8 (Ri?Ri); -' Pass/Fail Threshold or Criteria: Test Result~ . Was sensor removed for tesfing~ Yes No N~ Y~'' ~o '~A Y~ No NA Y~ No NA ~perly ~placed and ' ' , , Y~s No NA Y~ No NA Yes No NA Y~ Nn NA vedfi~ fu~tional after testin ? i If'the entire depth or the stlmp is not tested, specify hoe m" ' aslcrisk (* is "NO" o ....... ' ., u..~. was tested. If the answer . ) , .tVA . thc entire sump mus~ be te~,,ted,. '.('See SWRCB LO.! 60) to any og tim questions indicated with an 88/18/2884 87:48 6613252529 CAL VALLEY PAGE OG 7. UN'DER-DISPENSER CONTA Test Mclhod Developed ~y: UDC Manufacturer us~~ P'~fe~ional ~n~i~ecr Tern M~tl~d U~ed: ~essu~ ~'cuum Hydrostmlc" Cd,er (Spec~) ~ I ~ ~ r EquJp~nt Re~olutJo~: ' Iiutghl Ikom I II)C I~llom ~o Top ]leight From UDO B~uom to "' /~ Lowest ~lemelcul Pmm~'aliom ~ ~ ~ Condition crUDe prior to ,., 7 Portion of UDC T~le~ ~ ~ ~ ~ Does lurbine shin clom~ when L/DC scmsor dclcci~ liquid (both Yes No NA Y~ No NA Y~ No NA ~ ' Y~ No. NA Tttl~hle sht~onse time-- Is system vmgr?~mcd for Fa/I- safe sh~l~lowff? VCS No NA Yc~ NO NA Y~ ~ NA Y~ No Wes fail-saf~ v~rifi~d to be ' ' opcr~inn~l?' Vas No N? Y~ No NA Y~ NO NA Yes Wait 1i~ bet~cn .pplying .,, presnurelv~cuunVwat~ and Test Sin. Tlmc: ~ ~0 ~ //~~ l'auWFail 'l'h~*hold or C,'ileria: -- ~~ ~ ~ - . O0 Test Result: ' ~ ~ . Oo ~ Was sensor remov~esfi, ,? ~ ~ Pass ~ Pal~: [...~.:pnss D ~all . /. a PiS~ D Fall ~s~ Yes No NA Ye~ No NA Y~ No NA Y~ No NA Was ~nsor properly replnced and v~ified fi.lctional after teslin ? Ye~ No 'NA Yea No NA Y~ No NA Yes No NA (flwlud* it.~formalhm_on re ~atr~. mad¢ rior to l~tin , ond recomme.d~~ ' Il'the elllir~ dcplh oFIhe [JDC is .ut tested, spec/ry how much was tested. Ir'the amwer to any of'thc questions indicalcd with an asterisk (*) is "NO" or "N^", thc cat/re UDC must be tested. (See SWRCB LO-/60) 88/18/2884 87:48 6613252529 CAL VALLEY PAGE 87 7. UNDER-DISPENSER CON '/'est MaUled Developed ny: UDC Ma,ml'actttrer ln___dustry Sta_ndar,d. "~ Pro£ession.! Eflgincer m Od,er 'l'e.n! Mc~hod Used: P~c~s~re Vactmm Hydrostatic UDC # t~. 1~ UDC # /1-1 ~. UDC # , !J DC Manu{.aettarcr: ' .,, lleight from I~DC Botlom to Top or Hiahest Piping Penetration: ~'/ ./~ ~' 1 leight from UDC Botlom to Lowesl Electrfca] Peflctration: ~ e Condition or UDC ~tior to '~' # Portion of UDC Tested~ .~7._.~" 9'~.e ~ ~ [)ocs turbine shut dowll xvl~en - UDC sensor detects liquid (both Yes No NA Yes No NA Yes No NA Yes No NA Turbhle shutdow~l response time is system prog$'amlr~ed rot Ibil- sa [b shutdown?' Yes No NA Yes No NA Yes No NA Yes No NA Was i'~ii.sare vcrif]~ 'lo bc operational?' Yes No NA Yea No NA Yes No NA ¥~s No NA Wall dm~ be~v~een applying ._ pr~s~ure/vacuu m/water and ~test , Test Start Time: ~ ~ 'l'¢st Duration: ~ ~ Teat Result: °'-----'aTe-'~g~a--~ ~ Was sensor ~-~ovcd {'or testing? Y~s No NA Y~ No ~ Y~ No NA Yes No NA ~operly ~pla~d and veri~ic~n~tional a~ar lcatm ? Y6s No N~ Yes No NA Y~ No NA Yes No NA -- (iacht¢/e i.formafio, o. re irs made riot to testi.g, a.d recommenc/~ t If the cnth'e depth of Ihe UDC is not teslcd, specify how milch was tested, if thc answer to alLY o£fl~e queslions indicated will! an asl~risk (*) is "NO" or "NA". thc entire [}'DC must bs 08/18/2004 07:48 66132§2S29 OAL VALLEY PAGE 08 8. FILL RISER CO 'TAI~ ' "~' ':'~'-'" '"~'- Facilit is Not E ui cd With Fill Riser Con.lament SU~ NT SUMP TESTING 'Fc~t Mclhod Devclop~d By: Sump Manufac~rer esslonsl Engineer Other (3pec~y~ -~ ' Test Method Used: ~llCtcr: Height ~h3m Tank Top to 'l'op-"~ ~Pcnetrat J on; Heillhl from T~k Top to Lowest Electrical Peqct~a~ion; s.mp prior Io of Sur Tested Mulet'iai: Wait dmc between applying PressureA, acuum/waler and , test: Start Time: Initial '1'~1 lind l'ime~ Rea ~ion: m R. endin Test Result: or Criteria: there ia scn,qm, in lite Sum 111~ sCflsor alal'ln Wh¢ll cilhcr prnktitct or water i$ Hydrostatlc Equlpn~ent Res~ltt(ioJt.' Pass 0 .b'nll Yes No Yes No NA seH$or I'¢rllov¢~,{ Ibr lc$1.il Ye~ No proper~y reI {lcd/bnctional of'tm, tcstin Yes No NA D Pflas Pns.~ 0 Fnil FI Pass 0 Fall Yes Yes No Yes No Yes No NA Yes No NA Ycs No NA Yes No NA Yes NO Yes .!% NA Yes No NA Yes No NA Ycs No NA Commen ts -~.a~io, o.' r~odrecon.ne~lded~g 08/18/2004 07:48 66132§2§29 OAL VALLEY PAGE 89 9- $PILKIOVI~R.F ._Factllly is N~I ~quipped Wilh Spill/Overfill C'omninmt:ltl Doxe$ Spill/O?rl'tll Conlainmcnt Box.es arc Presen, t, b~l were Nol T~i~d '" 'l'e~.Mclh~ Deve:ot~d By: Spill Bucku~ Manufacturer ~ Pro~ssional ~ngincer Other (~pe~?) 'l'~t Method' Used: Pressure Vacuttm /'lydrostalic -- lltlck~t Dian,¢te,': ~ . ~ . ~ [ SPill BOX ~& Spill Box ~ _ Bucket Depth: _ Wai~ time belw~fi applying pr~s~re/vacmml/wat~r and starling t~l: 'resl End Tine.. ~ :,i { ~:/ Test Duralion: · C'l~ngc in Reading (R,,-R,): ~~ Pas~q;ail Tllreshold or Criteria: Teat Result~ ~ Pass D Fail ~ .P~ ~ ~nJl -'". ~ 0 Pass Q Fall ("Om lllelits - (im'h~;h, i,~h~t'.,nr/tlm~ on rc. ~,air, t /m/de~#ld /,¢:¢Ot~lme/.fi,,~.d 08113/2004 15:35 BOB4767114 SHIRLEY ENVIRONHENTL Environmental Testing, L.L. C~ 9595 LUCa~ Ranch Ro~d- ~ ~onga- ~ 9~730 ~ O~e 80~533~030 F~ 90~7~114 ~.sk~n~nme~m PAGE 81/01 CUPA Notification 8/1312004 City of Bakersfield Steve Underwood Phone: (661) 326-3979 Fax: (661) 326-0576 Email: Dear Steve : Shirley Environmental Testing scheduled compliance tearing at: Facility: AM/PM Mini Mart 03090 3333 Union Ave. Bakersfield Phone SEW Job 019509 Time: Test(s): 8/16t04 at 0800 Te~t Name Test Date ELD Inoculation ELD Sampling Cathodic Protection Lines t_-~_.k Detector Monitor Certification $1~-989 Tank Meter Calibration Ovedill Protection Healy Vac Helium leak detection Construction start date 8161O4 8/16104 If you have queaUons about this schedule, please contact our ofl~e at 909-476-74z,3 or by fax at 909-476-7t 14. Thank you. Shirley Environmental Testing 88/1272884 88:45 6G1833G425 THE RENN'S PAGE 01 08/12/2004 88:45 6618336425 THE RENN'S PAGE 02 ' ' ' ' Remit thle potion with your check made payable to: City of Bakersfield, P.O. Box 2057, Bakemfleld, CA 93303-2057 'l ~u~ NUMBER-'-.? i"! ?"1'.: ~CYCLE I BILL DATE· I I 70??-12~'~4 .......... 1'Ol-oll I To,al Cu~on~ Cha~gos Balance Fo~ma~d Total ~mount Due DUE DATE 1/31/01 316.41 .00 316.41 ..' CHEVRON'U 8 A RAY BUTTON INC 9700 ROBEDALE HNY BAKERBF[ELD CA om3oo?oqqoooo'l, eq 1.1,t OOOO 3'1.1=q. ld= ?700 ROSEDALE HWy m?BILL='DATG?~ Last Bill Amount /-'7'~'~7'~il i/~l/OilPa~ments ' Adjustments Rate Clai~ : SEWER PLANT # 3 Balance Forward La~t payment amount/date: ~16.41 12/20/00 316.41 316.41- .00 .00 8eevice Service Peeiod 8W I 3 YD BIN-2 DAY/WK 12/31/00 1/~1/01 8W I COUNTY ~ATE FEE 12/31/00 1/~1/01 TOTAL QARBAQE FEE gg 143 ~URCHARQE FOR EXCEB~ 1~/31./00 1/91/01 TOTAL 8EWER FEE :'. .. ,g ~,Total Cu~ent Cha~ge5 ~?.'~Y'Balance Forward ~. ,' · Chaege 1~1.E~ 51.9& 143.20 Total 173.21 143.20 31~.41 .00 316.41 MONTH A l~ FINANCE CHARGE "ILL BE. ~"PLIED TO THIS RAY SUTTON CHEVRON INC Manager : MARIANA RAMIREZ Location: 9700 ROSEDALE HWY City : BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: SiteID: 015-021-001532 BusPhone: Map : 102 Grid: 30B (661) 589-9011 CommHaz : Low FacUnits: 1 AOV: SIC Code:5541 DunnBrad:95-386-5706 Emergency Contact / Title RAY SUTTON / OWNER Business Phone: (661) 589-9011x 24-Hour Phone : (661) 399-8938x Pager Phone : ( ) - x Emergency Contact / Title MARIANA RAMIREZ / MANAGER Business Phone: (661) 746-1576x 24-Hour Phone : (661) 366-3537x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9700 ROSEDALE HWY City : BAKERSFIELD Phone': (661) 589-9011x State: CA Zip : 93312 Owner RAY SUTTON Address : 6805 NORRIS RD CitY : BAKERSFIELD Phone: (661) 399-8938x State: CA Zip : 93308 Period : to TotalASTs: = Preparer: TotalUSTs: = Certif'd: RSs: No Gal Gal Emergency Directives: 1-11-01 MR SUTTON PHONED, HE SOLD HIS BUSINESS 12-29-00. CLOSE BP. WILL BE IN TO -1- Ol/lO/20Ol RAY SUTTON CHEVRON INC STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: RAY SUTTON CHEVRON INC Cross Street : Business Type: Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : MARIANA RAMIREZ Phone: Address: City : Type : Name : MARIANA RAMIREZ Address: City : Type : State: Zip: ~ TANK OWNER INFORMATION Phone: State: Zip: SiteID: 015-021-001532 (661) 746-1576x (661) 746-1576x BOE UST Fee# : 031913 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/12/2000 Name:HAL OREAR State UST # : Phone: (805) 986-5527x Ttl:ESH SPECIALIST 1998 Upg Cert#: 00860 = Hazmat Inventory --As Designated Order Hazmat Common Name... SUPREME UNLEADED GASOLINE REGULAR UNLEADED GASOLINE UNLEADED PLUS GASOLINE One Unified List All'Materials at Site ISpecHaZlEPA HazardsI Frm F IH DH L F IH DH L F IH DH L DailyMax IUnitlMCPI 11600.00 GAL Mod 11600.00 GAL Mod 11600.00 GAL Mod -2- 01/10/2001 RAY SUTTON CHEVRON INC SiteID: 015-021-001532 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~Vl~~ ~Vl~ / ~£ ~ ~v~ SUPREME UNLEADED GASOLINE. Days On Site 365 Location within this Facility Unit Map: Grid: NE CRNR UNDERGROUND 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 11600.00 GAL Daily Average 5000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS N° S CAS#8006619 I TSecretINo N~S BioHazNo HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI F IH DH NFPA/// I USDOT# Mod ~ Inventory Item 0002 -- COMMON NAME / CHEMICALNAME REGULAR UNLEADED GASOLINE Location within this Facility Unit NE CRNR UNDERGROUND 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 11600.00 GAL Daily Average 5000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS  SI CAS# N 8006619 TSecret N~S BioHazI HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No No No/ Curies F IH DH NFPA /// USDOT# MCP Mod 3 01/10/2001 FRAY SUTTON CHEVRON INC ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Location within this Facility Unit NE CRNR UNDERGROUND SiteID: 015-021-001532 Facility Unit: Fixed CQntainers at Site Map: Grid: Days On Site 365 CAS# 8006619 F STATE I TYPE PRESSURE Liquid Pure Ambient -- TEMPERATURE [Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 11600.00 GAL Daily Average 5000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS IRSI CAS# No 8006619 TSecret ~S BioHaz No N No HAZARD ASSESSMENTS Radioactive/Amount EPA, Hazards No/ Curies F IH DH NFPA/// I USDOT# Mod -4.- 01/10/2001 RAY SUTTON CHEVRON INC SiteID: 015-021-001532 Fast Format ~ Notif./Evacuation/Medical --Agency Notification IN CASE OF EMERGENCY DIAL 9-1-1. Overall Site 02/13/1995 -- Employee Notif./Evacuation 02/13/1995 IN THE EVENT OF IMMEDIATE NOTIFICATION, ALL EMPLOYEES HAVE BEEN INSTRUCTED TO CALL, DEPENDING UPON EMERGENCY, 911 OR CHEVRON EMERGENCY PHONE NUMBER. IF THE SPILL WARRANTS EVACUATION, ALL EMPLOYEES & CUSTOMERS WILL BE INSTRUCTED TO LEAVE THE PREMISES, IN THE SAFEST POSSIBLE WAY. Public Notif./Evacuation 07/30/1999 BUSINESSES AROUND THE STATION MAY NEED TO BE NOTIFIEDOR EVACUATED IF THE SITUATION 'WARRANTS. Emergency Medical Plan 07/30/1999 FIRE DEPT LOCATED 2 BLOCKS EAST OF BUSINESS. NEAREST HOSPITAL IS LOCATED ABOUT 6 MILES EAST OF BUSINESS. TWO TELEPHONES ARE LOCATED INSIDE THE BUSINESS & TWO PAY PHONES ARE LOCATED ON THE LOT. EMPLOYEES HAVE BEEN INSTRUCTED TO CALL 911 IF THEY CAN NOTHANDLE THE EMERGENCY PROPERLY. -5- 01/10/2001 RAY SUTTON CHEVRON INC SiteID: 015-021-001532 Fast Format Mitigation/Prevent/Abatemt' Release Prevention Overall Site 02/13/1995 PHASE II NOZZLES HAVE BEEN INSTALLED. OVERFILLING THE GAS TANK. THESE ARE DESIGNED TO PREVENT --Release Containment 02/13/1995 -TO PREVENT RELEASE OF SPILLS OF GASOLINE LEAK DETECTORS HAVE BEEN INSTALLED AROUND GAS TANKS. EMERGENCY SHUT-OFF SWITCH IS LOCATED ON OUTSIDE OF BLDG ON BRACE BY FRONT WINDOW. ALL GASOLINE PUMPS HAVE PHASE II NOZZLES. GASOLINE STORAGE TANKS ARE CHECKED BY DAILY READINGS. ALL OUTSIDE LIDS ARE LOCKED IN THE EVENT OF A SPILL OR LEAK. CHEVRON USA HAS PROVIDED STATION WITH GUIDLINES. THIS INFORMATION IS FOUND IN THE SERVICE STATION GUIDE. -- Clean Up 02/13/1995 IF IT IS A SMALL SPILL WE CLEAN UP DIRECTED IN OUR GUIDE BOOK. IN THE EVENT OF A LARGER SPILL WE WILL NOTIFY THE PROPER AUTHORITES TO TAKE CARE OF THE SITUATION. Other Resource Activation -6- 01/10/2001 RAY SUTTON CHEVRON INC SiteID: 015-021-001532 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 02/13/199s A) GAS - IN CURB (W SIDE OF ENTRANCE ON ROSEDALE HWY) B)'ELECTRICAL - OUTSIDE (N END OF BLDG, E OF BACK DOOR) C) WATER - IN CURB (W SIDE OF ENTRANCE ON ROSEDALE HWY). D) SPECIAL - EMERGENCY SHUT OFF SWITCH FOR PUMPS INSIDE BLG BETWEEN REGISTERS. ALSO ONE LOCATED ON E SIDE OF BLDG. E) LOCK BOX - NO -- Fire Protec./Avail. Water 02/13/1995 PRIVATE FIRE PROTECTION - FACILITY IS EQUIPPED WITH TWO FIRE EXTINGUISHERS & WATER HOSES. NEAREST FIRE HYDRANT - TWO FIRE HYDRANTS LOCATED BY FACILITY.. BOTH ARE ON S SIDE OF ROSEDALE HWY. Building Occupancy Level -7- 01/10/2001 RAY SUTTON CHEVRON INC SiteID: 015-021-001532 Fast Format Training -- Employee Training Overall Site 02/13/1995 WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE SHOWN HAZ MAT & EMERGENCY VIDEOS & READ ALL MATERIALS PERTAINING TO THIS. THEY HAVE BEEN INSTRUCTED AS TO HOW TO HANDLE AN EMERGENCY. A LIST OF WHAT TO DO & WHO TO CALL IS AVAILABLE AT ALL TIMES. Page 2 --Held for Future Use Held for Future Use -8- 01/lO/2001 RAY SUTTON CHEVRON INC Manager : Location: 9700 ROSEDALE HWY City : BAKERSFIELD CommCode: COUNTY STATION 65 EPA Numb: SiteID: 215-000-001532 BusPhone: (805) 589-901~ Map : 102 CommHaz : Low Grid: 30B FacUnits: 1 AOV: SIC Code:5541 DunnBrad:95-386-5706 Emergency Contact / Title RAY SUTTON / OWNER Business Phone: (805) 589-9011x 24-Hour Phone : (805) 399-8938x Pager Phone : ( ) - x Emergency Contact / Title ~J--~q~-~DN / MANAGER 7~¢"1~7~ Business Phone: (805) ~ 24-Hour Phone : (805) 366-3537x Pager Phone : ( ) - Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 9700 ROSEDALE HWY City : BAKERSFIELD Phone: ( ) State: CA Zip : 93312 X Owner RAY SUTTON Address : 6805 NORRIS RD City : BAKERSFIELD Phone: (805) 399-8938x State: CA Zip : 93308 Period : Preparer: Certif'd: to - TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~ Hazmat Inventory --Alphabetical Order Hazmat Common Name... REGULAR UNLEADED GASOLINE SUPREME UNLEADED GASOLINE UNLEADED PLUS GASOLINE One Unified List Ail Materials at Site ISpecHazlEPA HazardsI Frm F IH DH L F IH DH L F IH DH L ~, ~fi~ ~a~_ Do hereby certify hav~ ~y~ or ~nt ~) r~vie~ed ~he a~ached h~a~ous ma~e~als m~nag~- men~ plan ;or~)~;~... a~ ~ha~ i~ along ~i~h [i~me o1 Busi~) an~ corrections constitute a comple~ an~ correc~ man- agsmen~ plen ;or m~ ~dli~. ~_ /-. DailyMax Unit MCP 11600 GAL Mod 11600 GAL Mod 11600 GAL Mod 07/20/1999 FRAY SUTTON CHEVRON INC = Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE Location within this Facility Unit NE CRNR UNDERGROUND SiteID: 215-000-001532 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 STATE I TYPE PRESSURE Ambient Liquid Pure TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 11600.00 GAL Daily Average 5000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS  S CAS# N 8006619 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# MCP Mod = Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME SUPREME UNLEADED GASOLINE Location within this Facility Unit NE CRNR UNDERGROUND Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 r STATE = TYPE Liquid ~Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum I 11600.00 GAL Daily Average 5000.00 GAL %Wt. 100.00 Gasoline HAZARDOUS COMPONENTS CAS# 8006619 HAZARD ASSESSMENTS I Radioactive/Amount I EPA Hazards INo/ Curies F IH DH NFPA /// USDOT# MCP Mod -2- 07/20/1999 RAY SUTTON CHEVRON INC ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Location within this Facility Unit NE CRNR UNDERGROUND SiteID: 215-000-001532 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8006619 STATE -- TYPE PRESSURE Ambient Liquid Pure TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 11600.00 GAL Daily Average 5000.00 GAL 100.00 Gasoline HAZARDOUS COMPONENTS 8006619 ITSecretI RSIBioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA/// [ USDOT# Mod -3- 07/20/1999 RAY SUTTON CHEVRON INC SiteID: 215-000-001532 Fast Format ~ Notif./Evacuation/Medical --Agency Notification IN CASE OF EMERGENCY DIAL 9-1-1. Overall Site 02/13/1995 -- Employee Notif./Evacuation 02/13/1995 IN THE EVENT OF IMMEDIATE NOTIFICATION, ALL EMPLOYEES HAVE BEEN INSTRUCTED TO CALL, DEPENDING UPON EMERGENCY, 911 OR CHEVRON EMERGENCY PHONE NUMBER. IF THE SPILL WARRANTS EVACUATION, ALL EMPLOYEES & CUSTOMERS WILL BE INSTRUCTED TO LEAVE THE PREMISES, IN THE SAFEST POSSIBLE WAY. Public Notif./Evacuation 02/13/1995 BUSINESSES AROUNG THE STATION MAY NEED TO BE NOTIFIED OR EVACUATED IF THE SITUATION WARRANTS. Emergency Medical Plan 02/13/1995 FIRE DEPT. LOCATED 2 BLOCKS EAST OF BUSINESS. NEAREST HOSPITAL IS LOCATED ABOUT 6 MILES EAST OF BUSINESS. TWO TELEPHONES ARE LOCATED INSIDE THE BUSINESS & TWO PAY PHONES ARE LOCATED ON THE LOT. EMPLOYEES HAVE BEEN INSTRUCTED TO CALL 911 IF THEY CAN NOT HANDLE THE EMERGENCY PROPERLY. -4- 07/20/1999 RAY SUTTON CHEVRON INC SiteID: 215-000-001532 Fast Format ~ Mitigation/Prevent/Abatemt --Release Prevention Overall Site 02/13/1995 PHASE II NOZZLES HAVE BEEN INSTALLED. OVERFILLING THE GAS TANK. THESE ARE DESIGNED TO PREVENT -- Release Containment 02/13/1995 TO PREVENT RELEASE OF SPILLS OF GASOLINE LEAK DETECTORS HAVE BEEN INSTALLED AROUND GAS TANKS. EMERGENCY SHUT-OFF SWITCH IS LOCATED ON OUTSIDE OF BLDG ON BRACE BY FRONT WINDOW. ALL GASOLINE PUMPS HAVE PHASE II NOZZLES. GASOLINE STORAGE TANKS ARE CHECKED BY DAILY READINGS. ALL OUTSIDE LIDS ARE LOCKED IN THE EVENT OF A SPILL OR LEAK. CHEVRON USA HAS PROVIDED STATION WITH GUIDLINES. THIS INFORMATION IS FOUND IN THE SERVICE STATION GUIDE. -- Clean Up 02/13/1995 IF IT IS A SMALL SPILL WE CLEAN UP DIRECTED IN OUR GUIDE BOOK. IN THE EVENT OF A LARGER SPILL WE WILL NOTIFY THE PROPER AUTHORITES TO TAKE CARE OF THE SITUATION. Other Resource Activation -5- 07/20/1999 RAY SUTTON CHEVRON INC SiteID: 215-000-001532 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 02/13/1995 A) GAS - IN CURB (W SIDE OF ENTRANCE ON ROSEDALE HWY) B) ELECTRICAL - OUTSIDE (N END OF BLDG, E OF BACK DOOR) C) WATER - IN CURB (W SIDE OF ENTRANCE ON ROSEDALE HWY) D) SPECIAL - EMERGENCY SHUT OFF SWITCH FOR PUMPS INSIDE BLG BETWEEN REGISTERS. ALSO ONE LOCATED ON E SIDE OF BLDG. E) LOCK BOX - NO -- Fire Protec./Avail. Water 02/13/1995 PRIVATE FIRE PROTECTION - FACILITY IS EQUIPPED WITH TWO FIRE EXTINGUISHERS & WATER HOSES. NEAREST FIRE HYDRANT - TWO FIRE HYDRANTS LOCATED BY FACILITY. SIDE OF ROSEDALE HWY. BOTH ARE ON S Building Occupancy Level 6 07/20/1999 RAY SUTTON CHEVRON INC SiteID: 215-000-001532 Fast Format Training -- Employee Training WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. Overall Site 02/13/1995 BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE SHOWN HAZ MAT & EMERGENCY VIDEOS & READ ALL MATERIALS PERTAINING TO THIS. THEY HAVE BEEN INSTRUCTED AS TO HOW TO HANDLE AN EMERGENCY. A LIST OF WHAT TO DO & WHO TO CALL IS AVAILABLE AT ALL TIMES. -- Page 2 -- Held for Future Use Held for Future Use -7- 07/20/1999 MISCELLANEOUS RECEIVABLES ADJUSTMENT CUSTOMER NAME MAILING ADDRESS CITY NEW ACCOUNT i ADDRESS CHANGE CLOSE ACCT j · FINANCE CHARGE I. ~ I · OTHER ADJ ZIP CODE ~'~'~ Io~.~ SITE ADDRESS PARCEL NUMBER' ADJUSTMENT CHARGE CODE CHG DATE J ADJUSTMEN'I'.AMOUNT REMARKS: / APPROVED I715 :CHESTER"AVF-': ' BAKERSFIELD, CA. 93301 ~ %~~0{ "~ARDO, , MANAGEME 1. To avoia further action, return this form within 30 days of receipt. 2. ~PE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a w~ole. 4. Be brief and concise as po~ible. SECTION 1: BUSINESS IDENTIFICATION DATA PRIMARY ACTIVITY: MAILING ADDRESS: ¢5-3s~57a ~ slc CO~E:. 5¢"4-/ '/ oo SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 247R. PHONE · .,.. Bakersfield Fire Dept. dous 1V~aterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAIN1N(~: NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM' . SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT-MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS' WE OD NOT HANDLE HAZARDOUS MATERIALS.- WEDO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEED 'THE MINIMUM REPORTING QUANTrTtES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: 1. ~/]~L~ ~ ~O'""l CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATiON WILL BE USED TO FULFILL' MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY coDE" ON HAZARDOUS MATERIALS (DIV., 20 CHAPTER 6,95 SEC, 25500 ET AL,) AND THAT NACCUr AT NFOr MATIO'N-CONST TUT S TITLE DATE BakerSf~elcl Fire Dept. Hazardous 1Viaterials Division HAZARDOUS MATERIALS MANAGEMENT' PLAN FacilH7 Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: Ao AGENCY NOTIFICATION PROCEDURES: EMPLOYEE NOTIFICATION AND EVACUATION: I ~ '-Frt~ &O~f" o~ i m m~ ~ ~e. iuo~ F-i C~?~ o~J/ '4'cc ~?~¢~ PUBLIC EVACUATION: O. EMERGENCY MEDICAL PLAN: ,'~ _ ,=015' · Bak~rs~eld Fire Dept. Hazardous iV~aterials Division C HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: AD RELEASE PREVENTION STEPS: -i~¢¢~e :2-'poZz~ ~oc 1~£~o /.tasT~ ,'7~Ns3¢~.'¢~¢--~~' B. RELEASECONTAINMENT AND/OR MINIMIZATION: C, CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: ELECTRICAL: 037-$,0% (~~ 0 SPECIAL: I~6f~W LOCK BOX: Y~~ JFYES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:. 6o~TPr-' £~ O ~ [p,c. Izo~DA4~ PRIVATE FIRE PROTECTION: .WATER AVAILABILt~ (FIRE HYORAND' BAKF--'iI~I;FIF_LD· 'CITY FIRE: D .B~ARTM~=NT HAZARDOUS MATERIALS DIVISION ].7].5 CHESTER AVE. BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK tF BUSINESS IS A FARM BUSINESS NAME SITE ADDRESS NATURE OF BUSINESS s~c cape d'~ 4-1 STATE OWNE.=,/CPERATCR --'~ ~'~'"("'01',,-~ MAILING ADDRESS ~(~0-~- /~.~0Et¢--~.-~ PHONE EMERGENCY CONTACTS NAME /~'Y, (.~IUSP~ BUSINESS PHONE TITLE ' I::IAi I:H I-II"LL,I I: .Y I-IHI" UbHAH I MI:.Pi I US MATERIALS INVENT( Y Page_of-. CHEMICAL DESCRIPTION INVENTORY STATUS: New~ Addition { ] Revision ( ] Deletion ( ] Check if chemical is a NON TRADE SECRET,~. 'nRADE SECRET PHYSICAL & HEALTH HAZARD CATEGORIES Fire PHYSICAL Reactive { ] Sudden Release of Pressure [ ] HEALTH Tmmediate Hearth (Acute) [ ] Delayed Health (Chronic) WASTE CLASSIFICATION .{3-digit code from DHS Form 80221 USE CODE [ q PHYSICAL STATE Solid [ ] Uquid ~ Gas [ ] Pure ,~ Mixture [ ] WaSte [ ] Radioactive ['] 7) AMOUNT AND TiME AT FACILITY MaxJmum Oaiiy Amount: Average Daily Amount: AnnuaJ Amount: Largest SizeContmner: '//~ # Days On Site UNITS OF MEASURE I~ il ga~ ~ ' curies { } 8) STORAGE CODES a) Contmner: b) Pressure: c) Temperature: Circle Which Months: ~ J, F, M, A, M, J, J, A, S, O, N, D I O) Location CHEMICAL DESCRIPTION Check if chemical is a NON TRADE SECRET ~j TRADE SECRET [ ] 1) INVENTORY STATUS: New~[ Addition [ ] Revision[ ] Deletion[ ] PHYSICAL & HEALTH PHYSICAL Fire '~ Reactive [ ] Sudden Release of Pressure [ ] HAZARD CATEGORIES f' 5') WASTE C~ASSIFICATION HEALTH Immediate Health (Acute) [ ] Delayed HeaJth (Chronic).~.~ code from OHS Form 80221 USE CODE Jq PHYSICAL STATE Solid [ ] li~!uid ~,. Gas [ ] Pure (~ Mixtur~ [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY Maximum 0rely Amount: Average 0aJly Amount: AnnuaJ Amount: Largest Size Contmner: m Da~s On Site 9) MIXTURE: IJst the three most hazardous cnem~c~ components or any AHM components //./,~ UNITS. OF MEASURE Ihs [ I gaJ ~., ~3 [ ] cunes[ ] STORAGE CODES b) Pressure: ~J ~ . c) Tempe~ure: ~ ~l ~ -.- Circie Which Months: COMPONENT 8) '~j. F, M, A. M, J. J, A, S, O, N, D ce~ unaer ~en~ ot laW. ~at.I nave oe~onmly ex~m~ uDmi~ in~aoon iS ~e, accuse, ~ complete. . , ." ' Dam ' ~RI~ Name &' ~fle of A~onz~ Como~y ~eprese BAKERSFIELD .cITY FIRE DEPARTMENT HAZA~IlOUS MATERIALS INVENIIRY Page Z"of 2.,,.- Cheil( if chemicaJ is a NON TRADE SECRET ~ TRADE SECRET [ ] 3) DOT # (optional) AHM ~ ~ ~A~, ~o~ / ¢' PHYSICAL & HEALTH HAZARD CATEGORIES ..... '%'JPHYSICAL Fire [~ Reactive ( ] Sudclen Release of Pressure { ] HEALTH Immediate Health (Acute) [ ] Delayed Hearth (Chronic) [~ WASTE CLASSIFICATICN (3.d git code from OHS Form 8022) USE CODE ['~ PHYSIOALSTATE Soil. ~ "0u,O :~ Gas ~ ~ Par. ~ M~.. I~ Waste AMOUNT AND TIME AT FAClUl-Y MaXimum Da~ly Amount: Average Daily Amount: AnnuaJ Amount: L.z~rgest Size Cont~'ner: # Da~s On Site UNITS OF MEASURE ~0 curies [ ] ~'-~7..~oo /I,~oo ~ C~rcle ~ich ~om~s: STORAGE CODES b) Pressure: c) Tem~ure: .~/~ ~J, F, M, A, M, J, ~, A, S, O, N, D CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New ( ] Addition [ ] Revision ( ] Deletion [ ] Chect( if chemical isa NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) ChemicaJ Name: AHM [ ] CAS # PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive( ] Su(~den Release of Pressure [ ] I'mmeaiateHeaith (Acute) [ ] Delayed Health (Chronic) [ ] WASTE CLASSIFICATICN ,(3-dicjit code from OHS Form 8022) USE CODE 5) PHYSICAL STATE Solid [ ] Liqui(~ [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] AMOUNT AND TIME AT FACII, JTY UNITS OF MEASURE Ma~,mum Oz~Iv Amount: tbs [ ] gaJ [ ] ~3 [ AverageD~uiy Amount: cunes[ ] Annual Amount: Largest Size ContaJner: # Days On Site 8) STORAGE CODES a) Container: b) Pressure: c) Teml3erature: CircteWhich Months: All Yea~. J. F, M. A, M, J, J, A, S~ O. N, O MIXTURE: List .- COMPONENT CAS # % WT AHM the tl~ree most h~za~clous 1) [ ] chemicaJ components or any AHM components 2) [ ] [ I 10) Loc~lon ~rofy. unaer oen~u~y or ~aw, ~a~ J nave persona, y examinea eno am famliiar wi~ ~e~~nrOma~on submitted on ~m ~a ~1 a~cn~ aocumen~ t Dec,eve me Name & Title of A~onz~ Com~y ~epresen~five BAKERSFIELD CITY FIRE DEPARTMENT H .A ous 3usiness Name Address Page__of_. CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition { 1 Revision { ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delaye~i HeeJth (Chronic) 5) WASTE CLASSIFICATION .(3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste. [. ] Radioactive [ ] 7) AMOUNT AND TIME AT FAClUTY Maximum Daily Amount: Average Daily Amount: Annual Amount: La~'gest Size'Contmner: # Days On Site UNITS OF MEASURE 8) STORAGE CODES lbs [ ] ga [ ] ft3 [ ] a) Con'~ainer: curies { ] b) Pressure: c) Temperature: CircleW1~ich Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List the three most hazardous chemica~ comDonents or any AHM components COMPONENT CAS # %WT AHM 1) [] 2) [ ] 3) [ ] 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New { ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] 'TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH HAZARD CATEGORIES PHYSICAL Fire [ ] Reactive[ ] Sudden Release of Pressure [ ] HEALTH Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from 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: Lm'gest Size Container: # Days On Site UNITS OF MEASURE Ihs [] ga [ ] ~3 [ ] cunes[ ]. 8) STORAGE CODES a) Container: b) Pressure: c) Temperature: Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List the three most hazardous chemica~ components or any AHM components COMPONENT CAS # %'~Yr AHM 1) [] 3) [ ] 10) ~c.a~ion cer~ty unaer pen~u~ of /aw, ~a¢ i have .oersona/iy examined aha am fam~iiar w/~h the infornaDon suDrnirted on 63is aha a~l artectm~ ~ocumenl~. t believe ~ubrniEed informebon is true, accurate, ancl complete. °RINT Name & Title of Au~ortzeo Comoany F{epresentalive Signature Date "Ri g hr-to' Kn°~Fu 1 '1 List/by CommCode and, RAY SUTTON CHEVRON INC 015--010-0001~g Overall Site wfth. I General Information 9700 ROSEDALE BAKERFIELD HNY Nap: 102 Hazar;d.-'. UnPated Name ,uT~ON.,,, ess Phone: 'Phone : !g...e:i~` Phone : T i t '1 e X X x --- Con'Cact Name ~i T::~'t~e ~/LT~. ~o/~b~J/ '""?" ., .?.~,?~.. Business Phone: ._~,,,._-:'~'~.;~, x 2 -Ho. ho.. : ,x , ..,~ .-;::,,~, '~:~ ..... , Pager Phone : , ;~ L'. Administ~atfve Data Idns: 9700 ROSEDALE HNY D&B NumbeP: .'. i"i;ii';i! City: BAKERSFIELD State: CA Zip,: '93312- Coi~m Code: 015-651 CITY/KCFD 65 RESPONSE AREA .SZC Code.;7554,1 -OwneP: RAY SUTTON Phone: (805) · ,AddPess: 6805 NORRIS RD State: :": Clty: BAKERSFIELD Z~p: 9330.8 ', jJSER~)ZOE STAT[ON- ALL TANKS UNDERGROUND. (Type 0r Print Hame) r~:vie'¢~/~d the ~,,,;,~.J ..d hazardous materials management pi8n and that it, along with any cor:-~ct~".r'.:: ::'x:~':.'.~;~:ub.:s a complete and corfec1 management RAY SUTTON CFIEVRON INC 015-010-000119 02 -.~ F'ixed ContaJners at Site Page 2 Hazm~t Inventory Data13 in MCP Order 02-002 REGULAR UNLEADED GASOLINE Lffquffd 11600 Moderat~ > Fffre, De'lay H'lth GAL CAS ~: 8006619 'f'rade Secret: No Form: l. fquffd Type: Pure Days: 365 Use: FUEL " .... Dai'ly Max GAL .... I-'- Dai'ly Average GAL --I-- Annual Amount GAL - 11,600.00 I 5,000.00 I 1,825' 000.00' Storage ........... I Pr'ess I Tamp -J ..... Locatton UNDER GROUND TANK tAmbientlAmbffentl "C°nC' '1 Components 100.0~ IGaso]ffne I- MCP --IGuic ~ IModeratel2? 02-001' SUPR'ENE UNLEADED GASOLINE Liqufd '11600 ,'Moderate >.'!'iFlr'e, De'lay H'lth CAs.'~= 8006619 'Trade Secret: No GAL Form: Lfquffd Type: Pure Days: 365 Use: FUEL -~-- Oaf'ly Max GAl_ - ........... t'-- Da'f'ly Average GAL J Annual A~ount GAL,- 11,600.00 I 5,000.00 I 438,000.°00.. --~--- Storage .......... I Press I 'l'emp .................. Locatlon UNDER GROUND TANK IAmbientlAmbient -Conc '1 100.0~ IGasol~ne .............. Components I- MCP -'lGuic I Nod~eratel 27 ' i · !. ;i R~ght-to-Know ]] L~st/by CommCode and/ Site ID Page 3 RAY SUTTON CI4EVRON INC 015-010-000119 02 -- F'fxed Containers at Sffte Hazm~t inventory Detail in MCP Order 02-003 UNLEAED PLUS GASOLINE" > Fire, De'lay H]th Llqufd 11600 GAL CAS ~: 80066'19 Trade Secret: No Form: l. iqufid Type: Pure Days: 365 Use: FUEL .... Daf'ly Max GAL ......... t-'- Dai'lylAverage GAL --I'-- Annual Amount GAL - 11,600.00 I 5,000.00 I 547,500.00 Storage UNDFR GROUND TANK '%'done -I . .100. O~ IGasol ine Press Ambient Tamp ~'t Location AmbientI Components ' MCP --~lGui(: Moderate I' , /~~ight-to-Know/alm~l 'Page RAY SUTTON CHEVRON INC 015-010-000119 00 .- Ovena'l'l Site <D> Notif./Evacuation/Medical ~1> Agency Notification IN CASE OF AN EMERGENCY DIAL. 911 <2> Employee Notif./Evacuation IN THE EVENT OF IMMEDIATE NOTIFICATION, ALL EMPLOYEES HAVE BEEN INSTRUCTED TO CALL,".'",DEPENDING UPON EMERGENCY, 911 OR CHEVRON EMERGENCY PHONE' NUMBER. IF' THE SPILl WARRANTS EVACUATION; ALL EMPLOYEES AND CUSTOMERS WILL:BE INSTRUCTEO"TO LEAVE THE PREMISES, IN T'HE SAFEST POSSIBLE NAY. <4> Emergency Medical Plan FIRE DEPT LOCATED 2 BLOCKS EAST OF BUSINESS. NEAREST HOSPITAL IS LOCATED ABOUT 6 MILES EAST OF BUSINESS. ONE TELEPHONE IS LOCATEO INSIDE aU~INIE~&~ AND TWO (3) PAY PHONES ARE LOCATED ON THE LOT. EI~PLOYEES HAVE .BEEN INSTRUCTEO.. TO CALL 911 IF THEY CAN NOT HANDLE THE EMERGENCY PROPERLY. ...... R. ight-to-Know '1 List/by CommCode and/ol ire ID Page RAY SUTTON CHEVRON INC 0'15-0'10-000'1'19 O0 - Overall Site <E> Prev./Minimiza.~ion/C'ieanup 1> Release Prevention 2> Release Containment TO PREVENT RELEASE OF SPILLS OF GASOLINE LEAK DETECTORS HAVE BEEN INSTALLED AROUND GAS TANKS. EMERGENCY SHUT-OFF SHITCH IS LOCATEO ON OUTSIDE'OF BLDG oN BRACE BY FRONT HINDONS. ALL GASOLINE PUMPS HAVE PHASE II NOZZLES. GASOLINE STORAGE TANKS ARE CHECKED BY DAILY TANK READINGS. ~ Z-E~aCJCG;;D TNz~b WEEKb¢. ALL OUTSIDE LIDS FOR ALL TANKS ARE LOCKED. IN THE EVENT OF A SPILL OR LEAK CHEVRON U.S.A. HAS SUPPLIED THE BUSINESS WITH A GUIDE WHICH-IS TO BE STRICTLY FOLLOWED. THIS INFORMATION IS FOUND IN THE SERVIOE STATION GUIDE. SMALL SPILLS WILL BE CLEANEO UP 8Y EMPLOYEES AND LARGER SPILLS; NEEDING ASSISTANCE, OR LEAKS, WILL BE REPORTED TO THE PROPER AUTHORITIES. ACTION WILL 8E 'TAKEN ACCOROING TO THEIR INSTRUCTIONS. Clean Up Other Resource Activation Rtght-to-Kno~ '1 List/by CommCode and/or Site ID Page RAY SUTTON CHEVRON INC 015-0'10-000'1'19 O0 - Overall Site <E> Pi-er./M in'f m'i zat ~ on/C'l e,~nu p <4> Othen Resounce Activa¢ion (Continued) t Site ID Page RAY SUTTON CHEVRON INC 01.5-010-000119 O0 .- 'Overa'l'l Site Site Emergency Factors <1> Specie3 Hazards <2> Utility Shut-Offs A) GAS/PROPANE - ~ ...... N'~ REh.~CO~R OF B~DG S) E'LECTR~CAL -~,'- ~: ,q~CP, T OF OA,CK D~ D): SPECIAL E) LOCK BOX' - IN CURB ................ ON ROSEDALE HNY SI. DE ' - ENERGENCY SHUT OFF SNITCH FOR PUNPS <3> Fire Protec,/Avail. Hater ? FACILITY. IS EQUIPED HITH THO (2) FIRE EXTINGUISHERS'AND HATER HOSES, THERE ARE.'THO (2) FIRE HYORANTS LOCAI'EO BY I'HE FACILITY, 80TH ARE LOCATED ON THE S SIDE OF ROSEDALE HHY. ONE IS IN FRONT OF THE SECOND HOUSE, <4> Earthquake. Vu]nerabi'l Right-to-Know '1'1 List/by CommCode and/c Site Page RAY SUTTON CHEVRON INC 015-010-000119 00 - Overall Site "8¸ <G> Trainffng ¢1> Training Record Location <3> Emer;'-..Agency Coordination <4> Emer. Response Equipment 'Il Lffst/by CommCode and/o~ S~te Page 9 RAY SUTTON CHEVRON INC 015-010-000'11'9 00.- Overall Site ., <Fl> SCHOOLS WITHIN 1/2 NILE <1.> High Schools <2> Jr. High Schools ~3> ' E3emen~an'y Schools : -.6REEN?;,ACRES SCHOOL <4> Pr'Ivate & Pre Schools RAY SU'T"T'C)N (}HI!"_"VI~C)N :[NC ~;I ..,.-.-u ~u~ , -~ ...n~oPm~tlon P_a. ge ............ Contact Name .......................... "l"fi t ] e ..................... RAY SU'T"T'CiN /' Busfiness Fhu,~e: ([-~()S) 589....901tx 24.--.HouP Phone : (805)' Pager Fhon~ : ( ) .... x .......... Contact: Name ..........................."!"fit:. 1 e ....................... A, ,J, W :!: I... S ()N / [:{~usfiness Phone: (805) 589---.g01'ix 24-1"toup Phone ; (805) Pager Phone : ( ) .... x ........................................................................................................... Administrative Data ................................................................................................................ tvtai'l Addns: 9'700 RC)SE!C)AI...E t--iK!Y D&Et Number: Cfity: 8AI<ERSi::::[EL[) State,, C:A Zfip: 93:3i2 .... Comm C:ode: 015.--850 GREENAC:I:~ES AI:~EA.-.S'T'A 85 SI:C: (;:ode: 554'i Owner': RAY SUT'T'ON Phone: (805) Address: 6805 NORI~]:S IRE) State: C:A (}ity: 8AI{E~!:~SF:::[EL. i3 Zfip: 93:308 .... Summan~ ............ ~ SEI:;~V]:C E s"r'A"r'T('~N ALL '"" ......... '-" , AN,~...., UN[)I!!!I:~(i;I~C~UN[), ,..) .....SERVI:Z ONLY W]:"i"H PUIvlps i..()CA"I'E![) I-2! Oi::: S'T'A"f' :[ ON I:::UI...t .... S:[ZE F::OC)I])IvlA!;~'T' W]:"f'H CAR N A S l"I, · 000 '1 't 9 P a g e 2 Hazmat :Inventory I:)eta~; ~n Reference Number Order 0 '.2 --.- ,, ,, I .<SUP.:~ !:!lvl.!!! UNI..[!!ADED GASO!.. liNE L.i qui d '! t 600 Ivloderate >.F:ire, Delay Hl'~h (';.:~.~.'I ....'"'A._> <:' ~: 8006F;'19.. "l"rmde Secret: No F:orm: Liqufid Type: ?ute Da:y's: :'-385 Use: i:::UEL .............. l.')ai'ly lVlax GAL - .............. I ........ Oa'i'iy Average GAL · ....... i ........ Annua'i Amount. GAL . ....... 11,600 I 5,000.00 . ! 438,000.00 ........................ St:..orage ............................ ! Press i "f'emp .... i ............................................... i...ocat=Yon ........................................ UNi::)E!~ GI:ZOUND "f'ANi( I AmbYentlAmbfientlN!!!! C!:~NR .... C:onc -" I ....................................................................................... Component=-.?, ................................................ i .... IvtC:P ........ ! Gu'i dm 100.0~ ! Gasoq ir, e ! tvtoderate I '.,.~ ? 02....002 REGU...AI:;~ UNLEADEil] GASOI..:[NE Liquid 11600 ivioderate > F fir e, ..r') e '1 a y H ~ t: h ,.:,"' A' ~...~ C:AS ~,, ~'.~006619 "i"rade Secret: No F:orm: Liqufid "l":ype: Pure D a y s: :3 (~ .~ U s e: F U E L ................ [)ai'iy !vlax GA!... · ............... I ........ iX)afi']y Average ,':;;Al... . ....... ! ........ Annual Amount: GAL. . ....... i '1,600 I 5,000,00 I '1 , 8~.~.5,000.00 ........................ Storage .......................... i P~e.~ I "f'emp .... I ............................................. t..oc.'.a~ion ....................................... LIN "' '~ "' "'" [...,.,N R I.) ....:,I~L)UNI:) "f'ANK j Ambfi ent: I Ambi er:t:. I NE-' "'"' .... Conc .... ! ........................................................................................ C:omponent:s ................................................... ] .... IvtC:P ....... ! ',.i;u fi de 100.()~ IGaso]ir, e iIvloderatel 2"! 02 --.- 003 U N I... E A E D P L. U S G A S O I... :[ N E L fi q u fid 'i 1600 trio d e r a t: e > F::ire, ~..)e,ay H'ith GAL el;AS q:; 80066'19 Trade Secret: No Form: i...fiqufid Type: Pure Da',_/s: :385 Use: I=UEL. ................ l..,ai'iy tvtax ,.:,At.... ............... i ........ i3ai~,y Average ,":;Al... · ....... ! ........ Annua'i Amoun't: ',':;,Al... · ....... 't '1,600 I 5,000.00 t 54"!, 500.00 ........................ ..St=orage ........................... ! Press i "l"emp .... I ............................................. t...oce't=fi on ........................................ U N ~") ~':" G I:~ C) LIN I:} ''~'' ~ N" .... ~ ,~*., f AmbfientlAmbJentJNl!!! CI~NI:~ -.- C:onc .... i .................................................................................... ,'3ompon en t:. s ................................................ ! .... IVlC: P ....... I Guide 100 ' ~ . .0~ iGaso~ine llvlodera~.el 2'7 i:~ A' (:" ~ J 'T'""'"'"'~ "'~ ........... .......... ,,~ (..,,"J I:::VI:~(']N :[NC: 0 'I 5"--0 O00.'l. 1..Tr' .Pang .ce. :3 O0 .... Overall Sfite <i:)> Not: i 'f./[!va¢.'.uat i on/.Med i oa 'J <i> Agency No't:iefication T N C A S !!!! ,'"~ .... . ............. ..... I- A N i::: Ivi F: 1:~ (: E N C:t" t"] ]: A L 9 '1 '1 , <2> ...mpl,.,yee Notif./Evacuation IN THE EVI!!!NT C)F: :[MME: ')TA'T'I!!! NO'I"]: I::: ]: CA"!" :[ ON , AL.L !!!!MPI...OYEI.:.!.!!~ HAVE BEE~N ]:NS'T'IRUC'T'!~}[) ~ l"~C''' .... ' ' ; ", i .... )' ' . ..... 'i"C] C:ALI... I:)[~F'!~N[)]:N(~; (.JF'C]N Ei~I[~.-x.:,::N(..,Y 91i ()i:~ L,I"I~:::V!.¢..]N ['::MF::!~(~;I~NC:Y ]:F: 'T'I"Ii~i SP]:!_I_ NAi:~iRAN"I"S EVACUA'T'ION, AL.L IEIvlPLOY.~[~S AND CUS'I"(]MI~I~S N]:l..I... :I:NS'T-I.,U,, ............. I ED 'T'(") EAVF: "l"l"tl~ PI:~['~M]:SI;~S, ]:N THF: .............. ...>Al ..S'T' ,.,.,..,,...,... NAY . <4> Emengency Medical Plan F ]: I:~ E D E P T L ~"}.. (;:. 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D 'T' O P I:( E V E N T ,..~ r.. ,.) ~/,::: I:~F: :[ L LNG 'T'H E GAS 'T'AN K ~ <~..> Release <3> C'le..an Up Il:: ]:"f' :IS A SlvlALL. SP]:I...L NI!JJ C'L. EANUP AS I:)]:I~.EC:'T'ED ]]N ()U!::¢ GU]JDI!!!({:JC)OK. ]:N "!"HI!!! t!!!VI:.Z.'N'I'' ('il::: A ..~,'~"'('; .... '"~ SP]:I...L. Ht!!! bl]:l...I N (']'T' ]: I::: ¥' "I"HI!!! ""' .... ' S F: "' .... P .,()P ... I:~ AU""H('] ::~ T 'T' ]: ' 'l"C) "f'A?( C;A!:~F:: O F: T i'-I E! S :[ 'l" U A"I" :[ C; N, · t 1 / 1 ';:/9 ,z . ·., .., ... PAY SIJ'T'"f'C;N C:HI!.:.Vt:~.()N :[NC 0'I 5-.--0 000'119 00 .... () v e r a ] 'i .!!) i t e Page ..5 <F:> Sfite IEme~genc. v l:::act, oPs · <i> Speoial I--!azands <2> Ut. filfity Shut. ..--.('.)¢ ,'"s A) ,'i;AS/PROPANE! .... OUTS]:DE NW RE!AI:~ CORN.!;!R OF 8L. DG B ) E: I F: ~':'t'R T ,.../A !... C ) W A'1' E R D ) c' r, F: (" ...,, r' ...... :[ A L .... 'I'N [";UI:~R :IN vii I)DL.E! S ::" ........ '(")': ..... I ....... I :[ C) N O N I:) A L. iE I--t M Y S ]; I) E ........ . x .. ,.;) ~Z; .... i!!! !vt E! I:~ G I!:! N C: Y SkiLl"." Cf':::.'" . .... r: ......... , t'" SW];"f'C:H F:()!:;" I:':"I,.I!~F'.<.!~ ;I:NSI'f:)E! E'~l...O(i; ['3clWc:l ,4 I:~.E!G:[STE!I:~.S. A!...SO ()NE I... C) C: A 'T' E! I) ON E S]:!)I!!! ()1::: E'~I...i]~G S O1::: ii! N'"!" i:;~ A N ,'::: E!. .... N () <3> i:::fire Protec,/Avai] , Water FAC:]:L]:'!"Y :IS EQU];F'IED WI'l"H "I"NO (2) i::: :[ I:~ E! E!)Ci'IN(:;tI]:SHI...,.,....:,:::r"':' AND WA'!"l.::'l~ HOSE!c: 'I"HEI2I!!! AI:~.E! "l"WO ( 2 ) F:: :1: !:~i!!! kIYEII:~.Ai',I'i"S LOC:A'T'E!D E~Y 'l"t"{t:J! i::: A',:;: :i: !... :1: 'i"Y. E{O'T'H At:~.!:!! I...C)CATI!.:.'EI ON '""'.' ': S S ..... l... I I:)E! O1:: I:;~()SI!::7)AI E t--tWY ONE <4> Ear'thquake Vu.'lnen.a. bi'lity 'l '! / '! 5 / § 'J, i:~ A ¥ .<3 U 'l""l*' O ~ C H E V I:;~ C) N i1~ N C: 0 *1 5 ...- 0 '! 0 0 0 1 1 <G> 'T'raining <1> Training Record Location ALL "' "~ v' ,'t A ~.. I A I & "I" R A iii N ]i N (i; Rt..':: t. "' [,"' ~-,.'"' D S A N'" '::.~ If t!!! ~"1" O N <:~.~ 1 '~ I..::: '~.. i::: 7[ N S"I" () R A (i; E A t:,'. E A B ¥ 'T' H ~..~ ..... .. ~.., <2> l)~scribe "f'rmining Program E Ivl F' !.. O Y !'~! E S ~ ::: '" ' AI.L ~,lq,.)~N I"IAZ--ivlAT & i!!! iq !:!! R (i; I!~ N (i: Y ¥IDE:!OS AND I~I::~A.). ALL IVIA'T'I~:.i~]~ALS PERTAZN];N~':; T() TH!S. """':' . ..... " <' , · , '. ,-' .. t!t ...Y !-'!AVE~ [:li:::i~:~N .i.N...> tNL,[. I,:::[) A~ 'l"C) I-'{()W 'T'() HAN :)L.~ AFl,..] ':: v :: ,,' ~.:: ~- (" v ~, A L ~ .......A V A ]: t A B I... E A'T' A L L T :t: lvl E S; , ...111... t~,.,,..,~ .,. . A.L]:ST 0t::: NHA'I .... I"O DO & 9~1"{0 'T'O C' ~ i'% ... <2> .Jr. High Schoo'ls F: R U ;I; 'l"',! A L E ..J R H ;[ Gt'-! 2'I'14 CAL, L()~AY DR ( S O I:: i~,{.l S :I: N E S S ) (805) 589.-..::)8:]0 (805) 589--::.)9:]:] <:3> E!lementsry Schooq$ (':; I:;~ i':: I::: N ¢' ("' :'" "' <'' . ..... ...... ,* .., :'*: ..> S C I"t [")O I ,: '14 C:A !... !... O~A Y (805) 5 O 9.-..:'-)830 (805) 589....:;39:;-):3 <4> Priva~.e & Pre Schools CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT M. R. KELLY FIRE CHIEF January 11, 1995 1715 CHESTER AVENUE BAKERSFIELD, 93301 326-3911 Ray Sutton Chevron 9700 Rosedale Hwy Bakersfield, CA 93312 Dear Business Owner: Because of the annexation of the location of your business on November 10, 1994, the Hazardous Materials Business Plan and Inventory reporting requirements of both Federal and State "Community Right to Know" regulations, as well as the underground storage tank regulations, will now be administered by the Bakersfield Fire Department Hazardous Materials Division. We have made arrangements to transfer the plans that you have previously filed with Kern County, to our office. Therefore, we will not need a new business plan and inventory from you at this time. California law does require all inventories to be updated annually and your business plans to be amended within 30 days of any one of the following events. 1) A 100% or more increase in the quantity of a previously disclosed hazardous matedal subject to the inventory requirements. 2) Any handling of a previously undisclosed hazardous material subject to the inventory requirements. 3) Change of business address. 4) Change of business ownership. 5) Change of business name. You should also report any significant changes to your business plan such as contact information, telephone numbers etc., as well as your annual tank maintenance and monitoring reports to this office. We will be issuing you a new Underground Storage Tank Operating Permit as soon as we verify fees and compliance with existing regulations. For any of these changes or any questions regarding the handling or storage of hazardous materials on your site please contact us at 1715 Chester Ave., Bakersfield, CA 93301, or call 326-3979. Sincerely y?urs, Ralph E. ~ Hazardous Materials Coordinator