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C ~~~~ CIRCLE K #1270 - - _ _ - - - :. ~~ , ~--- --- - ~~ ~ 5634 STINE ROAD ~. ~I ~~ PV ~~~ I ~ ~ -~ ~0 3~3c, ~ ~~ ~~ ~ use ~ ~`~~ ~o/ 1 !~` ~ ~ • r~ ,~7 i ~ - I~ ~~f 6 ~ ~ ~~~ ~~~ ~' • • ~11^ • :I:1 `~(~~~1 j' ~~~ ~~~ \-.__ -_.__.1 ,~~ ~ /~~~ MAP# CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME CIRCLE K STORES INC. #2701270 BUSINESS ADDRESS 56.34 STINE ROAD 2 3 4 5 6 7 A NORTH ([) I- o ...J I- Z « u « > o « o a: w z ~ CJ) B c BAKERSFIELD D VACANT LOT * ro PARKING ~ ~ /~@ / q")\@ /", /.~ // co'?' // ..::, I fG\ /Ç)// '?)~ / <:P / / 0' / /...::, I (....:;::,.//// c, //// q;.) I//Ç)()//0'/ ~./ ( (j / / C, / \ ,~/// Ç)() // ~ (....()?/ I~../ E HMMP MSDS ~ [i] HARRIS ROAD TIMNERS HOME COOKING Te'S VIDEO m 5' . /' E ¡DJ=t= DATE 0.3/20/01 ZIP CODE 93313 F is (0 ^ TMA L....> G RESIDENTIAL 6' CONCRETE WALL (0' CO2 OFFICE SPACE ® EXECUTIVE LOUNGE H PARKING PREPARED BY: DRAWING SCALE 1"=30'-0" MAP SYMBOLS (0 ELECTRICAL PANEG. SHUT-OFF CD NATURAL GAS SHUT-OFF @ WATER SHUT-OFF 0 EMERGENCY PUMP SHUT -OFF TG'A TANK MONITORING L....> ALARM [i] TELEPHONE c{þ FIRST AID KIT is FIRE EXTINGUISHER å STORM DRAIN I SANITARY SEWER STAGING AREA EVACUA TION/ HMMP HMMP, AND MSDS MSDS LOCA TION Ò FIRE HYDRANT *-*" FENCE ...J @D EMERGENCY RESPONSE « EQUIPMENT/ABSORBENTS ¡::: ABOVEGROUND Z c=) W STORAGE TANK 0 ~-~ UNDERGROUND I I (f) STORAGE TANK W 0::: @ GASOLINE (FLAMMABLE LIQUIDS) ® DIESEL FUEL (COMBUSTIBLE LIQUIDS) 0 MOTOR OILS &: LUBRICANT (COMBUSTIBLE LIQUIDS) @ CARBON DIOXIDE (COMPRESSED GAS) ® PROPANE (FLAMMABLE LIQUID) @ ANTIFREEZE/COOLAN'rS " ì @ WASTE OIL (FLAMMABLE LIQUID) @ CAR WASH PRODUCTS ... GROUND WATER MONITORING WELLS I. IJ' , , j....?-"!.r.~ J ¡I\ '. - -.-. HMMP PLAN MAP' SITE DIAGRAMŒJ FACILITY DIAGRAM D Business Name: Circle K Stores Inc. #1270 .ýNOTth Area Map # 1 of 1 Name of Area: Circle K Corporation #1270 5634 Stine Rd., Bakersfield CA Scale 1 u = 25' Residential 6' Concr~ W811--,.. Vacant Lot Vacant Office Space ® Exit Stor8ge Room - 0 ...I - .. Õ - ~ C lIS U Parking ~ Counter ., Store #1270 5634 Stine Rd. Cold Box '. Lr /-,~ /10K // ¥_ ( G81//10K // I "f.. /( G81//10K / lJ\ ,/( G81/ ,/ Residential .......... ....... .............. (§J-4 Sewer 5700 Stine Rd. M8goo'. PIZZ8 5720, 5724, 5728, 5732 Stine Rd. Christ the Rock United Pentecostal Church 5740 Stine Rd. Dent8' L.b Parking -5- ~..~ ..-o<,.,~ . SYMBOLS @GAS ® ELECTRIC @ WATER MSDS . . . . ............ . ~- ~ SPRINKLER FIRE DEPT. ~"o CONNECTION , MSDS STORAGE FENCE (ALL TYPES) INDICATE HEIGHT GATE IN FENCE STANDARD DOOR - - - - -., UNDERGROUND : 10,000 t STORAGE Gal t TANKS - LIST L - - - - - CAPABILITY 6 FIRE HYDRANT - PUBLIC o FIRE HYDRANT· PRIVATE ~ 10,000 Gal ~AS AUTOMATIC SPRINKLERED ~ BUILDING OR AREA C~ @ FIRE ALARM PESTICIDE STORAGE RAILROAD TRACKS ABOVEGROUND TANKS EVACUATION AREA PESTICIDE STORAGE AREA TYPES OF HAZARDOUS MATERIALS <Ê> FLAMMABLE <Ç> LIQUID ~ CORROSIVE <ê> SOLID <fiJ; WATER RE.ACTIVE <@> GAS <§> EXPLOSIVE <§:> RADIOLOGICAL <8> WASTE EXAMPLE: FLAMMABLE ~ LIQUID <ê>POISON EXPLOSIVE GAS ~ 2?0127o UNIFIED PROGRAM CONSOLIDATED FORM ^O~ FACILITY INFORMATION BUSINESS ACTIVITIES ~~~~ Page of I. FACILITY IDENTIFICATION FACILITY ID# i i ~ 1 EPA ID# (Hazardous Waste Only) 2 ; I ' CAL000278585 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS 3 Circle K Store #2701270 I. ACTIVITIES DECLARATION e NOTE:. ff you check YES to any part of this list, ~~Q, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the li bl F h l d ©YES NO 4 HAZARDOUS MATERIALS INVENTORY - / ca ederal thres o d quantity for an extremely hazar ous app e CHEMICAL DESCRIPTION(oES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) YES NO 5 / UST FACILITY (Formerly swRC6 Form A) 1. Own or operate underground storage tanks? / UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? YES ©NO 6 / UST FACILITY ~~~Q® p ® ~ / UST TANK (One per tank M/~i('{, ~, ® ~Q 7 / UST INSTALLATION -CERTIFICATE OF COMPLIANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? :YES NO 7 UST TANK (closure portion-one page per tank C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or YES ©NO $ / NO FORM REQUIRED TO CUPAS ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ~ES NO 9 / EPA ID NUMBER--provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted YES ©N01o / RECYCLABLE MATERIALS REPORT recyclable materials (per HSC ~ 25143.2)? (one per recycler) 3. Treat hazardous waste on site? YES ©N011 / ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) / ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L 4. Treatment subject to financial assurance requirements (for Permit YES ©N012 / CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? YES ©N013 / REMOTE WASTEICONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as YES ©NO 14 / HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DISC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) ( n~\/// C \~V ` I UPCF (1/99) 2201270 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page of _ _ __ _ I. IDENTIFICATION I --- E. FACILITY ID# ~ - ~ - , ! ~ 1 'BEGINNING DATE _ 100 'ENDING DA"fE _~ ~,:~ ~- ~ -- i ~ _ 01 /01 /2007 _ _ -- -' _-- _ 12/31 /2007 _-- i BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 (BUSINESS PHONE j _ _ Circle K Store #2701270 661-834-8625 USINESS SITE ADDRESS 5634 Stine Road Bakersfield iDUN _BRADSTREET 10-5457662 jCOUNTY Kern iBUSINESS OPERATOR NAME Circle K Stores, Inc. iOWNER NAME 104 CA ZIP CODE 93313 108 SIC CODE (4 digit #) 5541 101 ioz- - 103 , 105 ~. 107 108 108 ',BUSINESS OPERATOR PHONE 110 ------ --- ---._ _ -._... _-_ - ----- - . -__ .. _.. ... (951) 270-5183.... _ . __ ._._- 11. BUSINESS OWNER _ _ _ -- Circle K Stores, Inc. IiiOWNER PHONE X951) 270-5193 i1z , (OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 CITY 114 IS"fATE 115 iZIP CODE 116 Corona CA 92879 III,_ENVIRONMENTALCONTACT. - _ , i -_- - _ _- - --- --- ----- ---- --- ------ - -- - -- _ _ ,CONTACT NAME 117 CON`FACT PHONF. 118 Lorraine Soffe 951-270-5183 - - -._. -- ~CONTACT MAILING ADDRESS 118 495 E. Rincon, Suite 150 ;CITY - - _ ---- ---------------- __ _ Corona i PRIMARY r- ------ ---- - -...---..---------- -- - --- ------- NAME SefVICe Contact Center I_ TITLE 24 Hours 120 STATE 121 ZIP CODE 122 --------------- -- - -- --- ---- ; CA I 92879 IV. EMERGENCY CONTACTS SECONDARY --- -- . 123 ,NAME 128 Kevin Quinn --- --- - 124 TITLE 129 District Manager - - -- - 866-805-4357 - - - -- -- --- - ---- - --- - -- _ _..- - ;BUSINESS PHONE 125 !BUSINESS PHONE 130 ' ~ 559-647-6910 -- ------- ----- ------------- -- ------ L- - - --- - 24-HOUR PFIONE 126 X24-HOUR PHONE 131 866-805-4357 559-639-9228 ~PAGER# 127 jPAGER# 132 i I ADDITIONAL LOCALLY COLLECTED INFORMATION: i i (Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ._. -_. SIGNATURE OF OPERATOR DATE 134 iNAMI OF DOCUMLN 1 PREPARER 135 ', RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT --- -- - ---- - ;NAME OF SIG E grin 6 (TITLE OF SIGNER 137 Lorraine Soffe Com (lance Mana er '- -- - ------------ ------- --- ---------- ------- -----------------~--------- - - ---- -- -- - -- -p- - -- ---- -9 -- _ _ ____ _ _- - _ _. . UPCF (1 /99 revised) ~ 6 OES FORM 2730 (l l9 ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ADD ~ DELETE ~X; REVISE 200 ', Page of ' --:-- I. FACILITY INFORMATION 3USINESS NAME Circle K Store #2701270 z~o1270 3 ' _ __ __ ;HEMICAL LOCATION ,CHEMICAL LOCATION CONFIDENTIAL 202 WEST SIDE OF SITE jEPCRA - 'YES (-x~ No ~._-I - -- - ---_ _ ___ , --_ i -,- i i ,- ~ ~ - _ - - - - - ~ 1 I MAP# (optional) 203 GRIDH (optional) 204 - --- -- 'AGILITY IDM I ~ I i l I I ~ 11 i 05 ---- --- ~ _ L ~ i 1_ II. CHEMICAL INFORMATION (CHEMICAL NAME i GASOLINE jCOMMONNAME ------------ -------- REGULAR UNLEADED GASOLINE ~cnsn ! 8006-61-9 205 ~ TRADE SECRET iYes X .No 206 ' i_ _; If Subject to EPCRA, refer to instructions 207 ~ 208 EHS ~ Yes ~ X I No - zos I If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) __ _ _ -.. _ .. - 210 I-B FLAMMABLE LIQUID ; FIAZARD MATERIAL, ~- - _ 211 I RADIOACTIVE ~. Yes TYPE (Check one item i ~ a. PURE ~X ~ b. MIXTURE I ~ a WASTE ~ ; 212' X!No CURIF..S , - . ~ 213 (PHYSICAL STATF. -- 214 i ~~ a. SOLID (~X ~ b. LIQUID ~ ~ c. GAS LARGEST CONTAINER ` ~ 200 215 ! -_ _ ;(Check one item only) ------ --. - ------ -- ----------___._... -- -.- i _ ~~FED HAZARD CATEGORIES !- - - - - _ .._ ... ~ ~X ~ a. FIRE b. REACTIVE ~ ; c.PRESSURE RELEASE.. X , d. ACUTE HEAL ~ L TH i X ! e.CHRONIC HEALTH 216 ~ i(Check all that apply) ~J ___ !iAVERAGE DAILY AMOUNT 2171MAXIMUM DAILY AMOUNT 2181ANNUAL WASTE AMOUNT' 219 iSTA fE WASTF CODE 220 _----- - -~ ---.5000----- --- ----i------- ---1200.0 ___ - -- -- - -- -- _.. i. _ -- - _ _. ~.. _ I---': - - UNITS* I X ~ a. GALLONS b. d. TONS 221 DAYS ON SITE: 222 y ~. - - ~ ~ (Check one item onl) f ENS amount-Imust_be. n pounds.__-_- -' - 365 - I --- -- - -. - ._ .- . _. -- ---.. - _ . 'STORAGE I -la. ABOVE GROUND TANK ~ ~ NT E I- e. PLASTIC/NONMETALLIC DRUM j li. FIBER DRUM i i j _ m.GLASS BOT"fLE ~o. RAIL CAR ~ -~ ~ AIN R j CO I X Ib. UNDERGROUND TANK I f. CAN , ~j. BAG i ~ j jn. PLASTIC BOTTLE ~ ,p. OTHER , ! I c. TANK INSIDE BUILDING ~~ i ~ i ~ I I g. CARBOY , k. BOX ~ o. TOTE BIN ----- i I ~d. STEEL DRUM LJ h. SILO i jl. CYLINDER ~ gip. TANK WAGON i '---- 223 I STORAGE PRESSURE ~X-~ a• AMBIENT ~-Ib. ABOVE AMBIENT i--~c. BELOW AMBIENT i 224 ~' STORAGE TEMPERATURE ~] a. AMBIENT ~~b. ABOVE AMBIENT ic. BELOW AMBIENT L ~ -~ _ . _ --- -- r ;d. CRYOGENIC . ' . 225 %WT ~ HAZARDOUS COMPONENT (For mixture or waste only) EHS ~ CAS# ' I 100 226 ; Gasoline 227 ~ Yes ! X No - 228 8006-61-9 229 .._-- --- ..- ---..i .. ---. ----- ------ -- - --- . _.. .. _. - --- - - - - - _ 230 i 231 ; j iYes ~ X iNo 2 1-9 TOLUENE ' I - _... - _.. . 232 I 108-88-3 33 __ - - - _ _ _ _ --- --- - ----- i3 1-14 234 it XYLENES 235 ' ( ' -' Yes ~X'INo _.. , 236 i , 1330-20-7 237 4 1-5 238 I 1,2,4-TRIMETHYL BENZENE 239 ~ ,Yes X No , ,_ _ _ 240 1 95-63-6 241 -- -- r--.. _ __ -- - ------- - -- ~5 1-5 242 ~ Ethyl Benzene 243 ' Yes '~X ~No 244 100-41-4 245 I If more hazardous components are presem at greater than I % by weight if non-carcinogenic, or 0.1 % by weigh) if carcinogenic, anach additional sheets of paper captu _---------------------~-- --- --- - -- ~--- ring the required information. 1 -- --...-------------- - - - --- ---- ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA. Please Sign Flere UPCF (1/99) 169 OES Form 2731 ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION I One page per material per building or area) ADD ~ DELETE IX; REVISE 200 Page of I. FACILITY INFORMATION (BUSINESS NAME 3 Circle K Store #2701270 2701270 , (CHEMICAL LOCA"fION CIiL'MICAL LOCA7lON CONFIDENTIAL. 202 WEST SIDE OF SITE ;EPCRA ~ ~ivFS _x i No ~ - - - -- -- --- -- ---- - i _ hACILITY ID# --- __ ~ ~ ~ __ - I ; ~ --- ___ i - L_-_ 'I i ~ j , ,... 1- .. _ _ , 1 MAP# (optional) -- . _. _... - . - . 203 GRID# (optionaq 204 i r -, ~ i 1 f EMICAL INFORMATION I I. CH ___ _ _ _ ;CHEMICAL NAME 205 ;TRADE S ECRET i JYes ~ X ,No 206 GASOLINE --- - -------- -- - - - --- If Subject to EPCRA, refer to instructions -- - --- - - -- - ; con~m-loNNnrnE j 207 I ~ EHS Yes ~X ~ No 208 PREMIUM UNLEADED GASOLINE t__! j__- ----- --------- ------------------------- CAS# _ ----- ----.. _.__ -- 209 I " _ . .. - - -- __ ___ _-- ---- " j 8006-61-9 ~ If EHS is , all amounts below must be in lbs. Yes (FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID , r ----------- - ------- 211 (HAZARD MATERIAL r..-- - i - ~ -- 212 j _.._-. _ 213 .1 I I +TYPE (Check one item L 1 a. PURE ~-l b. MIXTURE I ~ c. WASTE - -- RADIOACTIVE i__; Yes ; X jNo I CURIES r __, I PHYSICAL STATE i ~ it ~ 214 ~ ~ a. SOl ID X b. LIQUID a GAS ~ ~ ~ I ~ LARGES"f CONTAINER ~ 2~~0 215 ' _ , __ ,(Check one item only) _ . L -- -- .. _._ _- - --- - - -- - - - ... _. - ___.. _._. ._ _ _ -- - . . . _. r-....__. _ ._ _. - ---- -- - _ FLD HAZARD CATEGORIES ~ i- ~ X i a. FIRE I ~~ b. REACTIVE , i c.PRESSURF, RELEASE ~ X ~ d. ACUTE I IEALT X H e.CHRONIC HEAL"FH 216 I (Check all that aPP!Y) - - - AVERAGG DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2181ANNU AL WASTE AMOUNT 2191STATE WAS'T'E CODE 220 - -. ----- --- -..5000_--- ----- --~------1.2000---- - __' __ - - _ - - _ ~. . _ IUNITS* ; X j a. GALLONS ~----~ b. CUBIC FEET '- , ; c. POUNDS i d. "EONS 221 ;DAYS ON SI'Z'E: 222 L ; .._ , .. :(Check one item only) _. _.-_.__ - if EHS,.amount_must be.in pou nds. - 65 3 S"FORAGE ~a. ABOVE GROUND TANK I e. PLASTIC/NONMETALLIC DRUM i. FIBER DRUM ; ~m.GLASS BOT"fLE Flo. RAIL CAR - 'CONTAINER 1 I ~ X 1b. UNDERGROUND TANK I f. CAN - a Ij. BAG 'n. PLASMIC BO"hTLF. p. O"FIiF.R c. TANK INSIDE BUILDING ~ I ~ ~ g. CARBOY Ik. BOX I ~o. TO"fE BIN i i -- ---- ~d. STEEL DRUM ~~ h. STLO ~ ~~I. CYLINDER i gip. TANK WAGON _ _ 223 STORAGE PRESSURE X I a. AMBIENT ~- - ~b. ABOVE AMBIENT j-- L__~ ~a BELOW AMBIENT 224 I STORAGE TEMPERATURE ~ X_j a. AMBIENT ~ .b. ABOVE AMBIENT ~ _ jc. BELOW AMBIENT I --~d. CRYOGENIC 225 ' __-- .T -- ------ -- ---.-- -- ----_.---_-- _...._---I___.-.___.___.--_ ..... .......... .. ._ /oWT HAZARDOUS COMPONENT (For mixture or waste only) j ° El1S ! CAS# t_ --'-- - -- -- ..._ _..I -..-_. .. - - --.__ .. _ - .. .. . ~1 226 100 GASOLINE I _ I -------------- --- - - 227 i f ~, - ! Yes X No ~ ~_-~' ~ - ~ 228 I j 8006-61-9 229 I - - --- --- - -- ----------- - ----- 230 2 19 I TOLUENE I ~ --- -- - I X 231 ! Yes No 1 ' --- ---- -~- -- ----- - . _ .._ _. .... - -- 232 I 108-88-3 -- 233 -------- -------- ----- -- -.. .-------------- - --- ~3 1-14 234 ~ XYLENES .. - - - _ --- 235 ~ ~ ~~'es ~XNo ._.. 236 ~ 1330-20-7 237 ~, -- --------t------.. 238 i4 1-5 I 1,2,4-TRIMETHYLBENZENE 239 ;-'' Yes IX~INo _ . - 240 I i 95-63-6 241 242 I IS 1 5 I Ethyl Benzene i ; 243 ~ ;Yes ~ X No 244 100-41-4 245 --. _..._ ----- - _-- _.--.-. - ___ 1(more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if carcin°genic, attach additional sheets of paper captur ing the required information ADDITIONAL LOCALLY COLLECTED INFORMATION 246 I If EPCRA. Please Sign f-sere UPCF (1/99) ]69 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEM ICAL DESCRIPTION One page per material per building or aroa) ADD ~ L DELETE IX j REVISE 200 Page of 1. FACILITY INFORMATION _ _ _ !BUSINESS NAME 3 Circle K Store #2701270 z7o1z7o rCHEMICAL LOCATION iCHF.MICAL LOCATION CONFIDENTIAL 202 NORTH SIDE OF FACILITY (EPCRA ~` I --IVES X I NO ,- .._ ' I FACILITY ID# ~ _ ~ ~ -- I ~ ~ i ~ 1 I MAP# (optional) I - - -- - 203 GRIDtI (optional) I _ . 204 ; ~ ,. 1 I I E2 - --_ -- --~ lt. CHEMICAL INFORMATION _ CHEM]CAL NAME 205 i TRADE S _ __ ECRE'C '(Yes ~ X ~No I 206 , I Propane - ~- ~ ' instructions If Sub~ect to EPCRA, refer to ~ --- ~---- '------------------------- -------- ~COMMONNAME 207 ~ EHS -------------.. --'- t__- ~ Y !X, N 208 PROPANE i es o !CAS# 209 ~ 74-98-6 j IT EHS is " Yes', all amounts below must be in lbs. ; i. ----- ------------- ---- - ---- -- - -'------ --- -- - _- - --...- ----- - .- _.. -_ ._.. _ - ~FIRE CODE FIA-LARD CLASSES (Complete if required by CUPA) _ - - 210 , Flammable Gas ~ __ _ _ __-- - ------ --- - --- ------ ~- - -- -_ __ --- 211 , _. -. - - - HAZARD MATERIAL ~ WASTE RADIOACTIVE L I Yes 1, ~ 1 a PURE X l MIXTURC ~ c b ,TYPE (Ch it k --- ~ - _ _ .. .. 212 ! !X;No i CURIES 213 I i . . one em ec -- - -' - - --- - - - _ .. ... _- . -- . _. _ _ ... _ ~PHYSICALSTATE r--' `--- ;- 214' I a. SOLID I X I b. LIQUID c. GAS LARGEST CONTAINER ~ ~ 5 215 , --1 - ~-- (Check one item only) (FED HAZARD CATEGORIES ! a. FIRE ~ ~ b. REACTIVE ~X ; c PRESSURE RELEASE, ~ X ' d. ACUTE HEALT H ~ ~ e.CHRONIC HEALTH 216 ;(Check all that apply) i_ ~ _ ~__ I- -- --------...- - ------_ _ ----- ------- - - - - - - - _- -- _ .. - . - ,AVERAGE DAILY AMOUNT 217 (MAXIMUM DAILY AMOUNT 218 ;ANNUAL WASTE AMOUNT _... -- . ; _ ... - 219 `S"('ATE WASTE CODL' 220 'i--------- - --60 ---------~ -.120_..---- --I- -- ---- _ -- -J_ _ I--1 ""- ~ -' 'IUNITS* ; X) a. GALLONS ~ b. CUBIC FEET ~ 1 c. POUNDS ! d. TONS ~ 221 i DAYS ON SITE: 222 , ~- ~ ;(Check one item only) if EHS, amount_musLb.e_in.pounds._ _-____ _ 365 STORAGE r---, ~ ~ a. ABOVE GROUND TANK fi e. PLASTIC/NONMETALLIC DRUM I i. FIBER DRUM ~ ~ 1 Vim. GLASS BOTTLE o. RAIL CAR 'iCONTAINER i I I b. UNDERGROUND TANK --- f. CAN ! BAG ~ - - jn. PLASTIC BOTTLE ~ !p. OTHER ~ ~ c. TANK INSIDE BUILDING g. CARBOY ~ ~ k. BOX ~ ~o. TOTE BIN _ I. ~ d. STEEL DRUM _ h. SILO ~ X ~ I. CYLINDER gip. TANK WAGON _ _ . ~i - - -- ------------ -- ------- ----- --- --- -- -- ---- ---- - - - - - - - - - - - ' -- _ .. -_ _ ... . ..... .... . 223 i 'STORAGE PRESSURE ~_~ a. AMBIENT ~XJb. ABOVE AMBIENT ! Jc. BELOW AMBIENT ' 224 ' r I i STORAGE TEMPERATURE ~ X ~ a. AMBIENT ~__~b. ABOVE AMBIENT __c. BELOW AMBIENT id. CRYOGENIC , - , 225 -------------------- 1 - _ ----T-- --- -..-_..__.._...- -- -._ _._ %WT i HAZARDOUS COMPONENT For mixture or waste onl EIiS I CAS# _--- - - _~_ _ . -. .. -- - -- --------------------- ------ --------' I ,65 226 I PROPANE 227: i ;Yes X iNo 228, 74-98-6 229 . _ -I- -_ - -- - - - - - -- -- _ . i2 <35 230 i Propylene 231 ~ - Yes X ~TJo 232 ~ 115-07-1 233 ~3 <6 234 ~ Ethane 235 Yes ! X iNo 236 74-84-0 237 ! 238 239 i4 <5 I Total Butanes Yes ~ X ~No 240 78-28-5 241 ~ r ---~ -_ 1 242 ~ 243 ;5 <Q.1 Ethyle Mercaptan Yes X'No 244 75-08-1 245 If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0. I °io by weight if carcinogenic, attach additional sheets of paper captur ing the required information. ' ~' ADDITIONAL LOCALLY COLLECTED INFORMATION l 246 ~ If EPCRA, Please Sign Here ' UPCF (1/99) 169 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ~ ADD ~ DELETE ~X, REVISE 200 '. Pa a of g - ~ -_L ___- -- - -- - -- -- --- -- -- - I. FACILITY INFORMATION iBUSINESS NAME 3 Circle K Store #2701270 z7o1270 ';CHEMICAL LOCATION ~CIiEMICAI. LOCATION CONFIDENTIAL 202 . I SALES AREA EPCRA ~ ,;YES ~ x No i "t ; ~ i I 1 ' MAP# (optional) 203 ~ GRID# (optional) 204 ;FACILITY ID# ~ ~ Ir4, ~ I i ~ ~ j 1 ~ I L ~- I ~ i y I ' t --- ` - --... ..- - - _ - - ----- -- ------ --- - - - - --- 11. CHEMICAL INFORMATION _ .... .. _ _ jCHEM1CALNAME---------- ------~---------- -- -'---- 205 !TRADE SECRET - -- i Yes X ~No 206 CARBON DIOXIDE -- ' I . If Subject to-EPCRA, refer to instructions _-- - ' COMMON NAME 207 , "- 208 EHS ~ CARBON DIOXIDE GAS f ~ ~ ^~ Yes jx~ No !CAS# - ----- ------ ----------- 209 124-38-9 If EHS is " Yes", all amounts below must be in lbs. AFIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 NON-FLAMMABLE GAS __ hiAZARD MATERIAL - 211 I - -, --- - -- (TYPE (Check one item X a. PURE b. MIXTURE ~ ~ c. WASTE ~ RADIOAC"I'IVE ~ _J Yes L_ ~ C_ ~ ~--, ~ - 2121---------- - -- ~ - - -' , X !No CURIES - - - - - 213 . __ _ _ _ ----- ----- ----J-- - ----- -- -- ----- - --------- ( _l Q ~ _ _----214'-- -- -- - iPHYS1CAL STATE 1 ~ a. SOLID b. LI UID I~X c. GAS I LARGEST CONTAINER l ~ Ch k i . . _ _ - - - -- - - 175 _. 215 y) ._ _..- ec one tem on ( -- i - _.. ...._..._ -..__ _._ ----- -------------. ...._ FED HAZARD CATEGORIES a. FIRE ~ i b. REACTIVE rX I c.PRESSURE RELEASE ~ X ~ d. ACUTE HEAL I ~ ! ~ _ .__ . TH ! e.CHRONIC HEALTH 216 -__ ~ -_ '(Check all that apply) --- ,._ _., AMOUNT z18 ANNUM. WASTE AMOUNT !AVERAGE DAILY AMOUNT 217 !MAXIMUM D 219 !STATE WASTE CODE; 220 350 ___ __175 - --- ---- ~------- ----- _ '_--- --- - - -- ~- ... _ ,--- !UNITS* ~ a. GALLONS ~ X ~ b. CUBIC FEF."i f , c. POl1ND5 d. 'EONS 221 DAYS ON SITL'•: 222 -__.. _- .. (Check one item only) _if-EHS...amount must be_in pounds.- -..._._. I -- ----- ----------------- -- --..----------- --- - - - 365 - ,. - STORAGE ' - - ' Ia. ABOVE GROUND TANK I ie. PLASTIC/NONMETALLIC DRUM ~ i. F16ER DRUM ! j im.GLASS BOTTLE o. RAIL CAR __ CONTALNER --- b. UNDERGROUND TANK ~f CAN Ij. BAG I . I n. PLAS"fIC BO"f"fLF., p. O'f)1ER ~ -. -- { i jc. "fANK INSIDE BUILDING i fig. CARBOY i ik. BOX ( jo. TO"fE BIN ~ ~d. STEEL DRUM ~jh. SILO ; X ~I. CYLINDER ~ ip. TANK WAGON - - - 223 STORAGE PRESSURE L- j a• AMBIENT rX fib. ABOVE AMBIENT _~c. BELOW AMBIEN"f 224 . i -------------------------------- ------------------- ---------- STORAGE TEMPERATURE ~ X J a. AMBIENT ~ b. ABOVE AMBIENT c. BELOW AMBIENT ~__ ~_~l i_. l - ------- -_-- -- __..__..._ ~ -~~d. CRYOGENIC _.-. ; 225 %WT II HAZARDOUS COMPONENT (For mixture or waste only) ~ CHS ~ CAS# -- - , I 100% 226 CARBON DIOXIDE 227 ; Yes ~ X ~No ~ ~ 228 ~ 124-38-9 228 - ------ ------ - - --` --------- -------------- - - - ____------ - - I 230 231 i ,Yes ; X i'No L - _ _-- _1-----..._ -- -._._. .-.._ .. 232 ~ 233 ----- - ----- - - - --_ ------ - i ----- ------ -- - ------ --- - - --- _ _ 235 I ~-- Yes [X~No i3 234 I i - _. _ - _ 236 ( 37 - - 4 238 ! 239 'Yes X No ~.-._, I ~-"-. 1 - -. _.._ _. - _. 240 241 -- ---------------- ------------------ -- ---- ---- ---- ----- - --- ----------- -- - 243 ~ i, .Yes -- `X jNo IS 242 ~ _ 244- - ----- - - - _- __ - ------ ~ J 245 If more hazardous components are present al greater than I % by weight if non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper captu nng the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION I 246 i I If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ADD DELETE ~X; REVISE 200 Page of BUSINESS NAME 1. FACILITY INFORMATION !_ Circle K Store #2701270 2701270 CHEMICAL LOCATION ,CFIEMICAL LOCATION CONFIDENTIAL 202 TRASH ENCLOSURE , _ _ ~ - --- _ ..__. ~ ~ - ;EPCRA ~ YES ~ X ~ NO ' I- I 1 MAP# (optional) 203 ~ GRID# (optional) 204 FACILITY ID# ~ ~ i i ~ I ~ _.. _-..------ - ----- -----~~ -- - t -- ~- - - ! _ .. i t------------ ATION - - - ..-- -- II. CHEMICAL INFORM jCHEMICAL NAME !COMMON NAME USED GASOLINE FILTERS jCAS# ~ 8006-61-9 ;FIRE CODE HAZARD CLASSES (Complete if required by CUPA) I-B FLAMMABLE LIQUID 205 ~ TRADE SECRET Yes ~X INo 206 ' If Subject to EPCRA, refer to instructions .'--I. _. ___ _ .. .. 207 _ - - . _.- 208 Elis Yes X i No 209 - ', If EHS is "Yes", all amounts below must be in Ihs. 210 , _ 211 1 - - ~ -- 212 213 HAZARD MATERIAL - I RADIOACTIVE t_. Ycs IX No CURIES TYPE (Check one nem ~-~ a PURE ~ I b. MIXTURE l X ~ c. WASTE --- - - - - - -.. - - - - _I __ _ __ . _ -. _. _ --- - -- -- -- J -~- PHYSICAL STATE X a. SOLID ( b. LIQUID r ~ c. GAS 214 LARGEST CON"fAINER 215 (Check one item only) I~ 1-~ ~-_..l 2~~ - -- ---- _ - r -_ i rr ~ ~ -- ---- ^ -- ----- ----~ ----- - - J -- - -- --... __ .-. FED HAZARD CATEGORIES ~ X a. FIRE ~ b. REACTIVE c.PRESSURE RELEASE X I d. ACUTE HhAL"fH X e.CHRONIC HEALTH 216 , I(Check all that apply) ~- ~--- L-- ~---- - -- -------- ------- --- ---- ---- _ _. __. _ .. -- ._.-----. - !AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 iANNUAL WASTE AMOUNT 219 STATE WAS fC CODE 220 I 200 ' 213 t --- ---- --- 3----- ------- 5--- ---- ---I- -- -- ---- ---- ~.-- ---._ _._ - - --- -.I 221 ~ DAYS ON SITE: 222 UNITS* i~-~ a. GALLONS ~~ b. CUBIC FEET ~~ a POUNDS ~ d. TONS 365 ;(Check one item only) __ ____-ifEHS,-amount-must be_in_pounds ___.-. S"FORAGE i I a. ABOVE GROUND TANK j le. PLASTIC/NONMETALLIC DRUM i. FIBER DRUM I, Im. GLASS BOTTLE !o. RAIL CAR ;C'ONTAINER ' i , I ~- .. ~i ~!b. UNDERGROUND TANK i ~I. CAN ,l I~. BAG ~I jn. PLAS'f1C BOTTLE p. OTHER ~c. TANK INSIDE BUILDING ~g. CARBOY j ~k. BOX ~ Io. TOTE BIN a, ---~ - - - - X d STEEL DRUM I h. SILO ! II. CYLINDER ; gyp. TANK WAGON ~ 1- __~ ,_..-, -_, ~ 223 STORAGE PRESSURE ~ X ' a• AMBIENT ' b. ABOVE AMBIENT ic. BELOW AMBIENT 224 STORAGE TEMPERATURE~I a. AMBIENT j b. ABOVE AMBIENT Vic. BELOW AMBIENT d. CRYOGENIC '----- -- - -- -- --- ---- -- - --- ------- f --- ---- __ -.. _ - - ---- - I~ %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS jl 5 226 ~ GASOLINE _. , 227 ~ ;Yes '~X,No 228 8006-61-9 - 12 230 FUEL FILTER ' _ - - 231 f- -~ -- I Yes ~X!No I ...- - 232 ~3 234 --------- 235 ' f Yes ~ X INo ------- --- - -- - 236 --- -- - -------- ! !4 238 ~ - - 239 , IYes ! i X~No _ -.. 240 I' i5 ' --- 242 ~ _ 243 ~ :` jYes I X~No ' 244 ~ - - i , ! If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information ADDITIONAL LOCALLY COLLECTED INFORMATION 225 CAS# 229 233 237 241 245 ' "_ .. ._.....--._ l 246 If EPCRA, Please Sign Here - - 3 j UPCF (1/99) 169 OES Form 2731 AP# CALIFORNIA ANlV01 A1~LI ~11 ~ iVltlf PREPARED RY: I ~' :V1t1f II[DESION C~sROUP ]NC. BUSINESS NAME CIRCLE K STORE> INC. #2701270 DATE 2/12/2007 DRAWING SCALE BUSINESS ADDRESS 5634 STWE ROAD BAKERSFIELD ZIP CODE 93313 1"-30'-0" A e c ~ E F G H MAP SYMBOLS NORTH VACANT LOT RESIDENTIAL 0 ELECTRICAL PANEL SHUT-OFF O NATURAL GAS 1 SHUT-OFF 6' CONCRETE WALL WU WATER SHU?-OFF ELECTRONIC MONITORING POINTS O EMERGENCY PUMP SUMP SENSOR SHUT-OFF n i ANK MONITORING 0 ANNULAR SENSOR , Ti MA` ALARM 12 XS GAL AU70MATIC TANK GAUGE PROPANE ,~ TELEPHONE ~~ FIRST AID KIT 2 ~ FIRE EXTINGUISHER ~, O ® STORM DRAIN I I ~ SANITARY SEWER I ~ STAGING AREA O E EVACUA iICN/ HMMP MSDS , HMMP HMMP, AND MSDS n ~ ?i MA\ ~; MSDS LOCATION 3 r cQ2 OFFICE SPACE FIRE HYDRANT ~ FENCE ~ ERE EMERGENCY RESPONSE EQUIPMENT/ABSORBENTS O Q ~ W O ABOVEGROUND J 0 STORAGE TANK ~ ~ I~ -'I UNDERGROUND 4 ~ W - ~ STORAGE TANK z W Q z O ~ O GASOLINE ~ (FLAMMABLE LIQUIDS) ~ ~ i ~ O ~ ~ / O DIESEL FUEL IQUIDS) STIB C B E ~ J ~ ~n_\ i ~P ~ ~' OM U L L ( i ~ V i ~ ~ ~' ~ O M070R OILS & LUBRICANTS i VP / ~O ~% (COMBUSTIBLE LIQUIDS) ~ ~ ~O i CARBON DIOXIDE CD (COMPRESSED GAS) 5 i ~ $ A PROPANE j T O D (FLAMMABLE LIQUI ) AO ANTIFREEZE/COOLANTS O WASTE OIL (FLAMMABLE LIQUID) O CW CAR WASH PRODUCTS 6 ~ GROUND WATER MONITORING WELLS HARRIS ROAD ~ ~ ~ PARKING TIMNERS HOME TC'S VIDEO EXECUTIVE LOUNGE PARKING ' COOKING SECTION I z~o~z~o BUSINESS EMERGENCY PLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. ] . EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL 911 (Fire, paramedics, police, or sheriff) STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-8911 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 661-326-3979 PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A HAZARDOUS MATERIALS INCIDENT: Name:.S.ervice-_Contact-.Center.___._____ .._ Telephone:.8.66-805.-43.57 Name: Kevin_Quinn___ _______ . __._ . _ _ Telephone:.559-.64.7-.691-0.. .. _.- B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: MERCY_SOUTHWEST-HOSPITAL.___________-.__ _._ ADDRESS: 2215 TRUXTON AVE CITY: BAKERSFIELD PHONE: _6.61-632-52.8L-----------------------_ ---- --- -- 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide information on the steps taken at your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazards at this business are fire and spills associated wth_gasoline_dispensing.____ _ _ Gasoline dispensing_is supervised by trained personnel. Additional hazardous materials are stored in minimum quantities and stored in_small,_unbreakable containers... All_ _ ___ __ _ underground storage tanks are monitored using an approved monitoring method. 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill fire, explosion or airborne release at your facility? Small incidents: For leaks and spills, isolate the area and contain with absorbent material. _ Clean up the spill immediately to_prevent spreading. For fires, turn off pumps, use fire. extinguisher if it can be done safely. __ ___ Lamer incidents: Turn offpumps using emergency_pump_shut-off,_call 9-1-1, evacuate to ----- - emergency assembl~rea, wait for_emergency_personnel_to respond.. Immediately contact. the District Manager and the Service Contact Center. 4. ABATEMENT Describe what you would do to stop and remove each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the relase? Small incidents will_be_handled_whh the on-site clean-up equipment,_(i.e., brooms, shovel, absorbent material mops, etc.) _For_larger incidents, the on site manager will turn off the pumps,.call_9_1-1_~and_the_Serv_ice_Contact Center__@_1-,866-805=4357._ The_Contact___________ Center_will_dispatch amaintenance contractor to_assist in abating the._hazard,__For_suspected_ .leaks the opera_t_or will notify the_Serv__ice Contact Center and his/her_District Manager._______ who will investi atg e the incident. If a__UST leak_is confirmed then reporting w~ll.____ ---- -- a -- -- -- be_done_by__Circle K which complies with UST regulations. Circle K_will coordinate_with any_contrac_tors_required_ to_stop_a release,_clean up a_release and/or dispose of materials.. All materials will_be._disposed of in_ ,________ _ accordance with state .federal and local laws and,_regulations.______ EVACUATION and RE-ENTRY Describe the procedures to be followed for immediate notification and evacuation of your facility and the re-entry procedures after evacuation has occurred. If warranted evacuate to the designated assembly located at: NORTH SIDE OF SITE The manager or lead employee will take a head count to verify all employees have evacuated safely. The mana eg_r or employee will confer the responding agencies to indicate the magnitude of the emer~enc~ Re-Entry into the facility will onl ty ake place after the dealer or manager verifies with the responding, a~encX,personnel and Circle K Stores, inc. to ensure it is safe. 6. EARTHQUAKES Identify the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The typical waste that is generated at this business is Waste Fuel Filters from the fueling dispensers. This item will be handled in the same manner as used absorbent. Use absorbent material or rags to clean up spills and place in a container for proper disposal or recyclin~ 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized releases from an underground storage tank (UST). The plan must address a release from a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underground Storage Tank Monitoring and Response plan provided by Circle K Stores Inc. If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up from the secondary containment within 8 hours, or deteriorates the secondary containment, then the local agencywill be notified IMMEDIATELY SECTION II BUSINESS EMERGENCY TRAINING Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum include: A Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards; B. Procedures for coordination with local emergency response organizations: C, Correct use of emergency response equipment and supplies under the control of the business; D. The Cal OSHA Hazard Communication Standards; E. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan; F The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care; G. Procedures to coordinate with and assist the local emergency personnel that may respond to your facility; H Who and how to call for immediate assistance in the event of an accident involving hazardous materials; I. Procedure for ensuring the appropriate personnel receives initial and refresher training. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY. Use the attached employee training log or similar form for record keeping. EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK 2~o~z~o MINOR INCIDENT: (less than 5 gallons) FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used L• SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5• NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Call 9-1-I: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 5634 Stine Road If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Kevin Quinn 559-647-6910 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805-4357 Secondary: Kevin Ouinn District Manager Day: 559-647-6910 24-hour: 5 59-639-9228 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by t, he agencies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-891 1 c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-I d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) SpilURelease Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added for fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Shill or Release: In the event of a release from the propane tanklcylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\Circle K Stores\zForms\Propane-Spill Plan.doc Spill/Release Response Procedures for Carbon Dioxide (C02) Carbon Dioxide in the form of compressed gas, liquefied gas or refrigerated liquid used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause burns, sever injury and/or frostbite. Shill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dial 911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. Training• 1. Employees shall be trained on the above hazards associated with carbon dioxide gas and the preventative measures to prevent a release. 2. Training shall include evacuation procedures in the event of a release. 3. If compressed gas cylinders are present, employees shall be training on the handling of the cylinders and the use of the valve caps to prevent accidental damage to the valve. I:\HAZMAT\Circle K Stores\zForms\co2-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS ~c PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: FRONT OF BUILDING ~c TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: REAR OF BUILDING * ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: REAR OF BUILDING ~c WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: STINE ROAD * NATURAL GAS SHUT-OFF: If your facility has natural gas, it may be necessary to shut-off the flow in case of an emergency. Location: NONE ~k PROPANE/LPG SHUT-OFF: If your facility has propane or liquefied petroleum gas, be sure to turn off the manual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dial 9-1-1 as necessary. EMERGENCY EQUIPMENT ~c FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER ~k SPILL/ CLEAN UP KIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: STORAGE * RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE Shovel: STORAGE Gloves: STORAGE Goggles: STORAGE ~k FIRST AID KIT: Use for minor incidents and treatment. Location: CASHIER * EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: NORTH SIDE OF SITE ~c ENVIRONMENTAL DOCUMENTS / HMMP _MSDS SHEETS: Location: CASHIER ~~ .,~ .~ ,,~ EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: MERCY SOUTHWEST HOSPITAL 2215 TRUXTON AVE BAKERSFIELD 661-632-5281 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel); For further information, refer to the MSDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION (Breathing): Remove victim from source of exposure and into fresh air. If victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last Updated.• 12-Feb-07 ~. __ \~ Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan .-Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: * An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. z~o~z~o UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION HAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION FORM 2006 Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials Business Plan (HMBP) certification described below is hereby submitted for the following facility: Facility Name: Circle K Store #2701270 Facility Street Address 5634 Stine Road City: Bakersfield Zip: 93313 I have personally reviewed the Hazardous Materials Business Plan currently on file with the CUPA dated 3/18/2004 and certify that: (Check one.) The Hazardous Materials Business Plan is complete and accurate and no revisions are necessary* (See below for details); or Revisions to the Hazardous Materials Business Plan are necessary. The following new or revised form(s) and/or information are enclosed to reflect the necessary changes: Business Activities form Business Owner/Operator Identification form Hazardous Materials Inventory form(s) E~T~ ~ ~~ Site Map form 1 7 206 Emergency Response Plans and Procedures Employee Training Program *By checking the top box on this form, you are certifying that: a) The information contained in the annual inventory forms most recently submitted to the administering agency is complete, accurate, and up-to-date; and b) There has been no change in the quantity of any hazardous material as reported in the most recently submitted annual inventory forms; and c) No hazardous materials subject to the inventory requirements are being handled that are not listed on the most recently submitted annual inventory forms; and d) There have been no substantial changes in the facility's hazardous materials operations which would require revision of the current HMBP; and e) The most recently submitted annual inventory forms contain the information required by Section 11022 of Title 42 of the United States Code. OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my inquiry of those individuals responsible for obtaining the information reported above, I believe that the submitted information is true, accurate, and complete. I understand that a revised HMBP must be submitted within 30 days of any change in this facility's storage or handling of hazardous materials which would require up ting of the ~ _ Signature of Owner/Operator: Tit ~~ Name of Owner/Operator (grin ~ ; Dat ~' (-(~ Return all forms to: Bakersfield Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield CA 93301 661-326-3979 Business Plan Certification 2006 2701270 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Paor I of I. FACILITY IDENTIFICATION - FACILITY ID# 1 EPA ID# (Hazardous Waste Only) 2 CAL000278585 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Store #2701270 _ _ I: ACTIVITIES DECLARATION NOTE.: If ou check YES to an Y Y part o this ist, please submit the Business Owner/Operator Identification page (OES Form 2730). -Does your facility:... If Yes; please cornplete these pages of he UPCF:.: A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the li l F d l h h ld f l ©YES ^ NO 4 ~ HAZARDOUS MATERIALS INVENTORY - app cab e era t res o quantity or an extreme y hazardous e CHEMICAL DESCRIPTION(OES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) YES ^ NO 5 ~ UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ^YES ©NO 6 ~ UST FACILITY UST TANK (One per tank ~ f ~/ UST INSTALLATION -CERTIFICATE OF COMPLIANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? YES ©NO 7 ^ UST TANK ~ (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ^YES ©NO 8 ~ NO FORM REQUIRED TO CUPAS ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ~ ES ^ NO 9 ~ EPA ID NUMBEf~-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted ^YES ©N010 ~ RECYCLABLE MATERIALS REPORT recyclable materials (per HSC ~ 25143.2)? (one per recycler) 3. Treat hazardous waste on site? ^YES ©N011 ~ ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L) 4. Treatment subject to financial assurance requirements (for Permit ^YES ©N012 ~ CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE(Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ^YES ©NO 13 ~ REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION(Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ^YES ©N014 ~ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION {Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2701270 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNERJOPERATOR IDENTIFICATION Page of ~j I. IDENTIFICATION , 1 BEGINNING DATE 100 ENDING DATE FACILITY ID# ', 101 ~ 01 /01 /2006 12/31 /2006 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE 102 Circle K Store #2701270 661-834-8625 BUSINESS SITE ADDRESS 103 5634 Stine Road crrY 104 CA ZIP CODE 105 Bakersfield 93313 'DUN BRADSTREET 106 SIC CODE (4 digit #) 107 10-5457662 5541 (COUNTY 108 Kern BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 110 Circle K Stores, Inc. 866-805-4357 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 112 Circle K Stores, Inc. (951) 270-5193 OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 CITY 114 STATE 115 ZIP CODE 116 Corona CA 92879 f III. ENVIItONMENTAL CONTACT !CONTACT NAME 117 CONTACT PHONE 118 i Lorranie Soffe 951-270-5183 CONTACT MAILING ADDRESS 119 I 495 E. Rincon, Suite 150 CITY 120 STATE 121 ZIP CODE 122 Corona CA 92879 PRIMARY IV. EMERGENCY CONTACTS SECONDARY NAME 123 NAME 128 Service Contact Center Justin Peterson TTi'LE 124 TITLE 129 24 Hours District Manager BUSINESS PHONE 125 BUSINESS PHONE 130 866-805-4357 661-978-4822 24-HOUR PHONE 126 24-HOUR PHONE 131 866-805-4357 661-978-4822 PAGER# 127 PAGER# 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNA OWNER/OPE T DATE 34 NAME OF DOCUMENT PREPARER 135 ' ~~ RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. AME OF S GNER (pnnt) 136 OF SIGNER 137 Lorraine So a Compliance Manager UPCF (1/99 revised) 167 OES FORM 2730 (1/9 AP# 1 CALIFORNIA ANNOTATED SITE MAP PREPARED BY: gDESIGN GROUP INC. BUS]NESS NAME CIRCLE K STORES INC. #2701270 DATE 3/16/2004 DRAWING SCALE BUSINESS ADDRESS 5634 STINE ROAD BAKERSFIELD ZIP CODE 93313 " ' " 1 -30 -0 a e c ~ E F G H MAP SYMBOLS NORTH RESIDENTIAL VACANT LOT O ELECTRICAL PANEL SHUT-OFF 1 NATURAL GAS C SHUT-OFF 6' CONCRETE WALL O WATER SHUT-OFF ELECTRONIC MONITORING POINTS O EMERGENCY PUMP © ~ 0 SUMP SENSOR SHUT-OFF ~ 0 ANNULAR SENSOR TANK MONITORING Ti MA` ALARM 12 X5 GAL A TOMAT C TA K GAUGE ~ TELEPHONE U I N PROPANE 2 O FIRST AID KIT ~ FIRE EXTINGUISHER O ® STORM DRAIN F SANITARY SEWER O STAGING AREA EVACUATION/ HMMP MSDS A ~ HMMP HMMP, AND MSDS MSDS LOCATION 3 TM ~ 02 OFFICE SPACE- ~ FIRE HYDRANT ~c-x- FENCE ~ ERE EMERGENCY RESPONSE O Q EQUIPMENT/ABSORBENTS ~ ABOVEGROUND O O W STORAGE TANK 4 z ~_ U) I"- ~I UNDERGROUND ~ - ~ W O W STORAGE TANK U Q Z i Q~ © ~ ~ O GASOLINE (FLAMMABLE LIQUIDS) ~ /~ ~P~, ~// ~ J /~ ~ (f~ i O ~~i ' ~ `_U ®S \' / O DIESEL FUEL /~ / Op i~~GP i i ~• ~ i~ J\ O ~ (COMBUSTIBLE LIQUIDS) l / ~ ~ i~ ~, / P ~ O MOTOR OILS & LUBRICANTS ~ ~ ~ ~ i G i (COMBUSTIBLE LIQUIDS) 5 1 / ~~ ~/ ~ ~ ~ 1 S CO CARBON DIOXIDE O (COMPRESSED GAS) / T P PROPANE O - (FLAMMABLE LIQUID) O ANTIFREEZE/COOLANTS O WASTE OIL (FLAMMABLE LIQUID) O CW CAR WASH PRODUCTS 6 ~ GROUND WATER MONITORING WELLS HARRIS ROAD ~ ~ PARKING TIMNERS HOME TC'S VIDEO EXECUTIVE LOUNGE PARKING COOKING EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK 2701270 MINOR INCIDENT: (less than 5 gallons) FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5• NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Ca119-1-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 5634 Stine Road If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who maybe injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Justin Peterson 951-270-5163 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805-4357 Secondary: Justin Peterson District Manager Day: 661-978-4822 24-hour: 661-978-4822 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by the a eg ncies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-8911 c) LOCAL POLICE AND FHtE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) Spill(Release Response Procedures for Carbon Dioxide (C02) The refrigerated liquid C02 used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire. the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause bums, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dia1911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or'cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\Tosco\zFORMS\co2-Spill Plan.doc Spill/Release Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added for fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Spill or Release: In the event of a release from the propane tank/cylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\ConocoPhillips\zFORMS\Propane-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS ~c PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: FRONT OF BUILDING ~c TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: REAR OF BUILDING ~r ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: REAR OF BUILDING ~k WATER SHUT-OFF: The water shut-off maybe necessary in some cases. Location: STINE ROAD * NATURAL GAS SHUT-OFF: If your facility has natural gas, it maybe necessary to shut-off the flow in case of an emergency. Location: NONE * PROPANE/LPG SHUT-OFF: If your facility has propane or liquefied petroleum gas, be sure to turn off the manual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dia19-1-1 as necessary. EMERGENCY EQUIPMENT arc FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER ~c SPILL/ CLEAN UP KIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: STORAGE ~c RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE Shovel: STORAGE Gloves: STORAGE Goggles: STORAGE * FIRST AID KIT: Use for minor incidents and treatment. Location: CASHIER ~c EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: NORTH SIDE OF SITE ~k ENVIRONMENTAL DOCUMENTS / HMMP MSDS SHEETS: Location: CASHIER EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: MERCY SOUTHWEST HOSPITAL 2215 TRUXTON AVE BAKERSFIELD 661-632-5281 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel): For further information, refer to the MSDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION Breathing): Remove victim from source of exposure and into fresh air. If victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last Updated: 28-Ma-'-06 Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan _Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: * An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. ,'~`"' - ;~-..- UNIFIED PROGRAM INSPECTION CHECKLISTr SECTION 1: Business Plan and Inventory Program Prevention Services a E R s F _, n 900 Truxtun Ave., Suite 210 FIRE Bakersfield, CA 93301 ARTM t Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY-NAME ~ ~ ~~ ~ ~~ 0 y ~ INSPECT ATE INSPEC~N TIME , e G~ (~ 1~ ADDRESS ~~ 1 ~ ~ ~~ s6 3 ~ PHONE NL ~~~ NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER a 15-021- ~0 - __ -- Section 1 : Business-Plan and Inventory Program -~--- ^ ROUTINE ~OMBINED - ^ JOINT AGENCY ^ -MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ~\ C V ~ C=Compliance O-P E RAT I O N V=Violation (~ 1 9 200 COMMENT S v ^ APPROPRIATE PERMIT ON HAND ^ BUSitIeSS PLAN CONTACT INFORMATION ACCURATE _ ^ VISIBLE ADDRESS O ^ CORRECT OCCUPANCY {1 ~V/ ^ VERIFICATION OF INVENTORY MATERIALS O \ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OFMSDSAVAILABILITY C~'~ ti{of a~,~r`'LC~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? C ~t ES ^ NO ~-(Q} EXPLAIN: ~- S~~ ~~ O '~ ~ wS "I%~ ~l n, KBF-6013 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 151 In /Shift of Site/Station # Bus ss Site 7 lease Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 _ ~:~ - r a._ "~/ _c CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715~Chester Ave., 3'd Floor, Bakersfield, CA 93301 FACILITY NAME C ~ ~ L~ t Section 4: hazardous Waste Generator Program ^ Routine L~ Combined ^ 3oint Agency INSPECTION DATE i ~- () `~ O 6 EPA ID #~iAL- OOZ.~ ~s J ^ Multi-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number Authorized for waste treatment and/~orsttrtag~, Reported release, fire, or explosion within 15 days of occurrence ")~-~ Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste Proper management of lead acid batteries including labels N Proper management of used oil filters ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years ~ N~~p f ~Q. ~i Retains hazardous waste analysis for 3 years - ~~r C9~ Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal ~=~ompuance ~v=v~otanon ~ Inspector: ~ I G~-1'~-~--- '1 ~"/ Office of Environmental Services (661) 326-3979 White -Env. Svcs. Pink - 9usiness Copy usiness Site Responsible Party r-- K INSPECTIONS B E R S F 1 L D BUSINESS PLAN & ~R~M r INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~ o a,eLE ~ Section 2: Underground Storage Tanks Program BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 INSPECTION DATE: 1~ ^ Routine ~ Combined Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank ;~~ ~~bW ~ ~~~ Number of Tanks --~ Type of Monitoring( .. =a_.. ro~-~ ~ Type f P' mg r`as s.,,.. D ~a OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ~Vo Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overtill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: ~ lC',~~ ~ " C'( Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Busi ess Site Responsible Parry Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) Work Order: 314 4 8 9 2 CIRCLE K AIV~f~UAL ~'AC~[LITY ~NSP~CT(ON Site#: -~ U - 2~. ~ Da#+~: t / ~3 a o ~. -- -7-, ACtdr@S8; 'may ~~`->`"y : ~ ~ I tiE 3Z .~,~ O I r A 1~~'~S ('r C L: C'7 lnspecfion Comparty~ ~ ~~~'u I~N~ t.oQ ~Y _-- TPChniriers~ ~ ~vt~ ~3P. ~!`,Gi~ Stage U7'ank Direct Mary ocrll sump sfem ~ Y, ~f, NJA ~ Cvlmmen#s. ; , Svsierat:Manufacfurer. """ dill Swwel U~''-.~ VapnY-Swivzf~Adaptor:Manulactu;er. I ~~ i ~~W bt`+~5~ is there dram'ualvc:in:fll tiuckct? ~, °'What type nf~nvQriitE p"rot,ection (hall ~ - ~- ~.. flaat,.ifapper valve. exEernal alarm}2 .~~=R~~c:'z 'd'f~i~v s- VVEhat 'io ~~ thn overfill set? ~ ~7 f.]ri~ptuke-maniifacturerandcnottel, a~LV~ .. °ls tl`iia;Filt?ukte+niith rrt~;G""f~arn the~~ `b~ttorn of ttieaank?' t is .hBfP.; ~n ~xtR'i-n2~l ny~fFlll alar'rri on' N SrtP.? _ . ~ts there a tank.lottorn,~n=~ili,ran ~ ~- .present ti` fhe:clrop tt,iie IzPects /l! ~f' removed to find out; mark NiA)? " i ..=~. °nny visigleaefects on~~the'Stage~t ~~~~ system? /~ "Any t~~>ttn m~ssiig from ump lids'? ~ . _ .. ArPfilie s;tirip'' li~fs darnaged`?" N _..-_-- AreahE secondary cani~inri9rrl.debl .._. ~ " bo0t5 pulled back frOln ahti (~lylntl? _ 1 --. ,.. i Es UUG`preserit and rn",yr5orl 1 _.._... .wnciitron? '` A JG cap installed properly grid wiie5 ~, , 2ppea%to be irr-good ~c?ndltion;? Are both-the turbine°aritl the fitltya~inr rsser"s grounded (iF not„bc clear oil Y ' what-ls and whr,i"is riotgrourtded}? Page ~-ot 2 3:31Nb Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 ~ W~'rk Order: 3144892 ' ''~, ~~ ~. ' Stage 11 SySteirn Y, N, NIA Goirnirneiiits~ _ _ _ ~y Type, 13alanceJAscist ~ ~ ~~ '•~~ . .~~A L~.rv Gu ~ ~'~ if ebsi~t; System.Menufe~turer. ~ ~• ~~` f~7umber of f~ispensers. y _ I Number of Gasnline Nyzzles per "~ r)ispenser: ~ . 4 ventpiping rn~nifalcle[i? Note if ~'- ~- •~ 1 nianifolded abnvegruunri or tindergroiuiti: ' '~ ^' '~~~'~'~^'~ Number nfP1V Vatves: - ~ ~~~ •~ I'JV Vaiva manufa~aui~er. ~vS}~~ RJV Valve siickec vrsiblc.frnm around. h.• ~ ~~ ... . Is there a prassi;ry.gaiige on the ~ ~ "~ vent(s)? ,ff.yes; pr~ivQ~ reading. ,, r'.ny visiblo detPCts on the 5tage;lf ~ • system? ~ /~ .. _ .. ..::~ Additional .comments: Rage,2:of 2 3!31105 Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 -'; IJ1'_'r'I I :Ikr..:LE }: 55,~~ .~T I hiE FLT . B~}•:Ek:_F I1=:LL~ C:h . y3~ I ;~ L~EC' 14. ''=CiuE I :1'~ FP9 ALL FUfN_'T I i rhi ~ Nt:;kh~tL J `1" ~ I : ~'; IJfJLE~L~ED ''.?~r''L. i If`9F = 1 158 ~ ~: ~r,LS ''91'~;>o IJLLHGE= 1 $`j.F.~. CaHL Ti=. 4?C:~LLIf•'IE = I1508 i:~tiL:=~ '. E,1EI!~H'T = U~..~'~ INt:HES~ WATER = u . I~u I rVCHE: TEt°1F = 5y.~_L~.Ei~ F T '~ : 91 Fk'Et"1 I Ut°i iLUt"lE _ X948 iFi1.; UL.Lr~GE = UyU1 t=F;L 9U"~; ULLi=ii_,E= ~" I r~- i,r~L,; TC: Vs~LUt°lE _ '~4'L'5 C~~L.=; HEIGHT = 'L'? . 59 I hJ4 :HE°. I,.JHTER '~,tOL = CI GHL I;J~TER - 0.00 I tJi:HES ri ~ ~* Et+1Li ~ x ~ t r December 21, 2006 Bakersfield Fire Department 2130 G. Street Bakersfield, CA 93301 UPS: K054 558 389 7 RE: Circle K Stores Inc. Submittal of Certificate of Financial Responsibility Attached is the Certificate of Insurance for Circle K Stores Inc., effective December 17, 2006 through December 17, 2007. Please call me at (951) 270-5183 if you have questions. Sincerely, Lorraine Soffe West Coast Environmental Compliance Specialist Attachments CERTIFICATE OF INSURANCE NAME: SEE SCHEDULE BELOW ADDRESS: SEE SCHEDULE BELOW POLICY NUMBER: ST8089599 ENDORSEMENT: Not applicable PERIOD OF COVERAGE: 12/17/08 - 12!17107 .NAME OF INSURER: AMERICAN Ii~1rERNATIONAL SPECIALTY LINES-fNSURANCE COMPANY ADDRESS OF INSURER: 70 PINE STREET - - - - - ' NEW YORK, NY 10270 NAME OF INSURED: Couche-Yard, Inc., Circle K Stores Inc., and Mac's Convenience Stares, LLC ADDRESS OF INSURED: 1130 West Warner, Building B Tempe, AZ 85284 CERTIFICATION: 1. AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(sl: See "Item 5. Covered Storage Tank Systemtsl" on policy referenced above, for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases in accordance with and subject to the limits of liability, exclusions, conditions and other terms of the policy arising from operating the underground storage tank(sl identified above. The limits of liability are .51,000,000 each occurrence and 52,000,000 annual aggregate, exclusive of legal defense costs, which are subject to a separate limit under the policy. This coverage is provided under ST80$9599. The effective date of said policy is December 17, 2006. 2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: a. Bankruptcy or insolvency of the insured shall not relieve the Insurer of its obligations ' under the policy to which this certificate applies.- b. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or damaged third party, with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible .for which coverage is CI2567 demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95-280.102. :'~ :; ,:. c. Whenever requested by a Director of an implementing agency, the Insurer agrees to furnish to the Director a signed duplicate o~+ginal of the policy and all endorsements. d. Cancellation or any other termination of the insurance by the Insurer, except for non- payment of premium or misrepresentation by the insured, will be effective only upon written notice and only after the expiration of SO days after a copy of such written ~:'','Y notice is received by Elie ii-sured. Cancellation for non-payment of premium ~ or . misrepresentation by tliB insured will be effective only upon written notice and only _ after expiration of a minimum of 10 days after a copy of such written notice is received by the insured. e. The insurance covers claims otherwise covered by the policy that are reported to the Insurer within six months of the effective date of cancellation or non-renewal of the policy except where the new or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior policy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97 4b) (2) and that the Insurer is eligible to provide insurance as an excess or surplus fines insurer in one or more states. J rized Representative of Insurer Authorized Representative of American International Specialty Lines Insurance Company 777 South Figueroa Street, 13'" Floor, Los Angeles, CA 90017 CI2567 2 'Circle K Tank Schedule ~ 12117106-07 West Coast Region -- ---------i s of 12/13/06 ---------I------~-~ ----~I - ---~------- LOC. # ~ Region 2708691 WC 2708691 WC 2708691 i W C 2708691 ~WC 2701939 ~WC 270_1939 jWC 2701939 ~WC 2705709 W C ADDRESS 766 S MAIN, ST ~~ ~- 766YS MAIN ST u.. .._.. 766 S.MAIN ST ~ _ 766 S MAIN ST V .._ 121 E MAIN ST 121 E MAIN ST ~ .~ 121 _EMAIN_S_T _ 1415E 16TH ST _ w__ ^~ I L CITY -~ STATE UST # l GALLONS ~ bATE ~ DATE SAN LUIS AZ , 01; _ }45 20029S FG . 1 Jun 88 ~ 17 Dec-03 SAN LUIS _........___,-___...a ._. AZ ? .,-_._ _- 02 - _w.,f X30 = 9816°S _ FG ; 1-Jun-881, 17-Dec-03 SAN LUIS ~ `AZ 03 .. ~. :05 i .... 9816 S n FG ~ ~..____~...._ 1-Jun-88 ._,. ___ ... 17 Dec-03 SAN LUIS `AZ 04° `05 ' 9816"S FG ; 1 Jun-88j 17 Dec-03 SOMERTON ~ ~ `AZ 01~ 2p ; 9816S FG I 1-Mar-86; 17-Dec-03 SOMERTON ,AZ 02 z 05 ; 9816S FG ; 1-Mar-86 17-Dec-03 ___ SOMERTON~ ~-~_____.__ . .____~_.~,~..._._ AZ _~_._..._ 03, ~.__.w.~,,____ X30 j _.____..._ 9816S FG ~ _ 1-Mar-86s 17-Dec-03 . .____w_,_r ___.~ YUMA AZ ~ ,_ 01 U 30 ~ _ ,_._ ~ 12023 D SF ~ ._.___._.._.__~ __..-..._._~. 1-Jan-93 17-Dec-03 2701849 I WC 270184_9 I W C 2701849 ;WC 2700684 WC ~._._._ 270_068_4 aWC ......h........... 270_0684 iWC .~_. _.~ 27_01847 iWC 2701847 W C 2701847 W C _2701800 ; W C 2701800 °WC 2701800 iWC .a"._._. 2701756 rWC 2701756 ?WC 2701756 IWC 2701394 WC 2701394 (WC 2701394 WC 2708475 !WC _~ _._._ 2708475 ;WC 2708475 iWC 2700212 ;WC 2700212 iWC 2700212 WC 270_1930 i W C _,_~_ 2701930. WC 2701930 ~ W C ~._..-.. 2701923 i W C 2701923 EWC 2701923 'WC 2701948 WC 2701948 W C 2701948 _I W C 27019_48 WC 2701736 'WC 2701736 +WC ~ _.._., 2_701736 WC 2701356 I W C 2701356 WC 2701356 -' W C 2701754 W C 2701754 } W C 2701754 , W C 2700990 W C_ 2~700990._w, W C 2700990 WC 2705008 WC 2705008 WC 1415E 16TH ST :YUMA AZ 021U ?05 { ' 12023a.D sSF 1-Jan-93 17-Dec-03 17984TH AVE `YUMA AZ 01 U 20~ 9728 S ;FG ~ 1-Jul•85; 17-Dec-03 1798 4TH AVE ~ ..._~, YUMA ~ ,AZ 02 U '30 9728:S FG : 1-Jul-85; 17-Dec-03 1798 4TH AVE YUMA AZ 03U 05 1 9728?S FG 1 Jul 85 17 Dec-03 _,_-..._._____ __,_...~~... _-.._._.-._.._.. ___. ~ _ ~ _._.~._..._.. __e._..._..__,_.__ _ __.__.__._ 2089 AVE A YUMA AZ 01 U i05 -:9728 S FGA ' 1µApr-84~ 17-Dec-03 2089 AVE A~. -__.__.. ~~~~ YUMA~~W~~µT__ AZ-~~_' 02 U `30 , 9728'S. FG 1-A r 84 17-Dec-03 2089 AVE A :YUMA AZ 03jU x20 ~ 9816+S FG 1-Apr,84 17 Dec-03 _ _...___,_.___ _.__ .-._._ M_.___m 2090E 32ND ST YUMA _ AZ 01 U s20 s 9816 S FG 1 Jul-85~ 17 Dec-03 _ _._..._- ___..._- .w_._.. 2090E 32ND ST YUMA __.__._ ...... ___.-..__ ~ ___. $ ~ „w__ .m.._._ __~... _ _...._ _...,.... ~ _~,...._.__.__.. _. ~ _ __ _^ 02 U 30 , 9816 S FG _ ! 1 Jul 85~ 17-Dec-03 2090E 32ND ST .YUMA ?AZ 03~U ~05~ ~ 9816tS ;FG E{ 1 Jul 85 17 Dec-03 2398 AVE B YUMA _ AZ 01 U ,30 i 98.161,S, FG ; 1-Nov=85' 17-Dec-03 2398 AVE B ~ PUMA -~~-_..~__"_.w.~.~-~ AZ 02iU 05 ( 9816;5 MFG ~: '1-Nov-85~ 17-Dec-03 2398 AVE B YUMA AZ 03 U 20 f 9816S : FG ~ 1-Nov,85? 17-Dec-03 2400 S ARIZONA AVE YUMA AZ _ 01~U µ X20 } ~ 98164S FGA 1 May-85' 17 Dec 03 2400 S ARIZONA AVE YUMA AZ 02~U `30 9728SFG ~ 1-May=85j 1.7-Dec-03 2400 S ARIZONA AVE PUMA A ~"Nrv~~AZ 03~U 05 ~ 9728 S FG 1 Ma 85 17 Dec-03 .._._...-..____....~._~_.,.~._..~.~ ... _ , y-__._~..__.,_._..__.,., 2409-8TH AVE - _~ .YUMA AZ 01 U 30 $ 9684=D FG i 29-Jun-041 17-Dec-03 2409 8TH AVE YUMA AZ 02 U >05 9684 D FG l 29-Jun-04: 17-Dec-03 2409 8TH AVE YUMA AZ '_. 03 U X20 ` 9684, D FG ; !29-Jun-04, 17-Dec-03 w.._.._..~.._...._,., -._ _.___ __.._-. __.. ~..~.._... _ __ ._,. _._,. ,._....~_ __~.~,..._........ 2505 W 8TH ST YUMA AZ 6 01 U =20 ; 9816,S 'FG "1 Nov-87 17-Dec-03 2505 W 8TH ST YUMA _ iAZ _ 02 U ;05 ' _ 9816 S FG ~ 1-Nov-87 17-Dec-03 2505 W 8TH ST YUMA.____ _~~ ~ =AZ '~~ 03 U 30 t 98'16.S FG 1 Nov-8T' 17-Dec-03 __._.rv~,____._._. _,,._~ ,_._._r.__. _... .µ.. _ _._-,__._.. ..____ I._._......-._._..._..._ 36508TH ST ._._~.~.__~.-~ .YUMA ~~~~ AZ =„' 01;U 20 u~~9816 S FG 1-Nov-85s 17-Dec-03 3650 8TH ST =YUMA 9816 S FG = 1 Nov 85 17 Dec-03 AZ , 02 U 05 9 ___,._~.._._...._ _ _~_~.___...._._.. _.____.._ k.._w__ _...____._, __.._ _..__..___ _...__... _.,-_...r _._...~.,._.__ 3650 8TH ST -.w., ~~ w YUMA _.~_.._.__. _•_ ,_v..__. AZ 03 U 30 ~ 9816 S FG ' 1 Nov=85; 17-Dec-03 --__ _--.__- _ -_ - ._ ~ .-__ma. _ _ _ _ __ . _. .._ .. _. 379W 1ST ST ;YUMA AZ ~ 01 U 20 , 9816•S ,FG 1-Nov-86~ 17-Dec-03 _________._...-....___-__um_. _ ___~_._...~. ._,.. w.~ _..... ____. ~ -_ _ _. .._..,....___._ ,...-,._.~..._._.. 379 W 1ST ST IYUMA IAZ t 02=U 30 , 9816 S FG 1 ,Nov-86 17-Dec-03 _-.,. _ .____~._ __m______m___. _. ._...~~_ ~mm_~.a _.. _ ~ _..__._~.-.._._ 379 W 1ST ST 'YUMA AZ 03°U X05 ; 9816 S FG 1 Nav 86 17-Dec-03 637E 32ND ST =YUMA AZ 01(U ~05 t N~^ 9816 S FG , 1 Dec 85E 17 Dec-03 ..„_. ....__._._..__.,.__... ~ _....._....._.__ .w.__....__ .. _ 637E 32ND ST 'YUMA fAZ ~ 02~U 30 , 9816 S FGs ` 1 Dec 85} 17 Dec-03 637E 32ND ST YUMA ~ I "-"`""' ....._ _,.__.-___ _..__.",__.w.. ,`•20 9816 S FG 1 Dec-85( 17 Dec-03 .._.__-._____.__.__.._ _ . '4Z _. _ __03~U _...- ___.._m ...~ .. ____ 6544 E OLD HWY 80 YUMA ,AZ a 01 °U E45 ~ 20029 S FG 1 Jul-871 17-Dec-03 _~,_______w...~....._______ ______......._.,..__.~."~__ _... __ _..,_u..~.,._....,_ .6544 E OLD HWY 80 ~ YUMA ~~iAZ s ~02 U '130 i 9816"S IFG I 1-Jul-871 17-Dec-03 ____.______..__._,.w.__ _._~,,__. _._.._._._,.__. _.-..~_..__.~,...._... ___.___-~,-_~.,~ m.-.____ __._.._._...... 6544 E OLD HWY 80 ,YUMA PAZ ' - 03~U ;05 y 9816 S 'FG ; 1-Jul-871 17-Dec-03 6544 E OLD HWY 80 -YUMA AZ 04 U :20 ~ 9816 S MFG 1 Jul-87; 17-Dec-03 .__,.,_._._,......F..._.______ ...__. ,_.__._..__....__.._ ~.__._____ _.._....__.. ,_._.._~. 695 S 4TH AVE .YUMA ~ ~ ~' "-" ~ ""~`~ "'-'-""°'" AZ 01 U 05 ; 9816 S { FG ~ 1 Apr 85 s 17-Dec-03 695 S 4TH AVE YUMA AZ _ 02'U 30 ~m9816 S `FG ~ 1-Apr-851 17-Dec-03 _.. _ti._, _....._.. __._____ ._..m_,..~.._..__~,._ ~._- .--,._ 695 S 4TH AVE YUMA _~• ---~- ~---.__ _..,..__ _.,_.__._.__....~,_..__ ~_-.__.,_ _._.._____~..-.~,..__._.__.__.~.._. ,AZ 03~Urt^ ?~ {_._9816 S FG~~ 1-Apr-85 17 Dec-03 _.__._.e..___..._,. 7110 E HWY 95 _ YUMA _ PAZ t 01.U 20 ' 9728 S FG ; 1-Dec-86' 17-Dec-03 7110 E HWY 95 YUMA ~ AZ ~ 021U '05 9728'S FG 1-Dec-86~ 17-Dec-03 7110 E HWY 95 YUMA __ ___. - _ __ ; _.__ ..,_._.____....._.... _r_ _. _...-,.. ___._-.-.__ _ .__.._.._ ____-.. IAZ ~ 03 U 30 , 9728 S FG 1-Dec-861 17 Dec-03 820 W 32ND ST YUMA __._~._._...._.....r___.~_._._____.._...._ AZ 01 U A5 , 9728 S FG 9 1-Apr-85~ 17 Dec-03 r._. .._.,__..______ ___.. .. .___ -. _..m...... ..~..___._ _.__._. 820 W 32ND ST YUMA _ _ - _,M^~_ - mm,mm,AZ 02'U 30 9728 S MFG ~ 1-Apr-85~ 17 Dec-03 820 W 32ND ST YUMA AZ 03 U _ ~~ ' ~`-~""~` "~ __....._~____ 20 9816:S ,FG 1-Apr-85! 17-Dec-03 _.~____... _..__. .._._. .___ _ ..,.._ r_._.,.w......___ 29105 HWY 80 WELLTON AZ ~ 01 O ! 45 9728`S FG E 1-Apr-85; 17-Dec-03 ._.~. _ _~ ..._. -__ ~ _.._ . _ _- _._ ___w-__ _ .. _-~__.._._. _- -~-_-__..,.-_~__ ___.mm__._.w. 29105 HWY 80 WELLTON 'AZ ' 02 O 30 9728S FG 1-A r-85~ --•---~- -~ _---------._ P , 17-Dec-03 29105 HWY 80 WELLTON AZ 03 O X05 ~ 9728 S FG 1-Apr-85: 17-Dec-03 _. . __._..__. .f_. ... - __._ .~.__ 11424 CHAMBERLAINE AVE .ADELANTO CA ; 01 U ~05 ! 9816°D FG 1-Nov-88 17 Dec 03 11424 CHAMBERLAINE AVE •ADELANTO ~ r _ ~ ~ ~" f"'~"~"°`"'~~` . CA 02 ~ U 20 1 98161 D FG M 1-Nov-88 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule 12/17106-07 I _______ West Coast Region ------------------------~as of 12/13/06 ------------t------- ..I----- -----}-__ -~-------- LOC. # ~ Region ADDRESS ~ CITY 2705008 WC 111424 CHAMBERLAINE AVE ~ADELANTO 2708644 IWC 11724 AIRBASE RD ADELANTO 2708644 WC .11724 AIRBASE RD ADELANTO 2708644 !WC 11724 AIRBASE RD ADELANTO 2700736 IWC .56621 STATE HWY 371 PANZA 2700736 jWC 56621 STATE HWY 371 ANZA _._______ 2_700858 iWC ~ _._.___.__ -.M 18465 US HWY 18 ._.,. - _..~..-.__...___._._ jAPPLE VALLEY 2700858~~WC~ 2700858 •WC 2_701232 =WC 2701232 `WC 27 01197 ;WC N18465 US HWY 18 _~. APPLE VALLEY_ ' 1846_5 US HWY 18 _ _ IAPPLE VALLEY 4381 EL CAMINO REAL ~ ATASCAD_ER_0 4381 EL CAMINO REAL ~ATASCADERO 3ATASCADERO ' 6930 MORRO RD ~ _ 2701197 WC 6930 M_ORRO R_D __ ~ ~ ~ATASCADERO 2701197 WC . -'6930 M ORRO RD ATASCADERO __..._.__.n_...~._._._. 5018 ;WC 270 _ .~ ___.__.__ ............. ;1021 SNAPPER RD ._.___WN____.___......._._..._-e_._-. ATWATER _ 2705018 ;WC *'1021 SHAFFER~RD-~~--~ ..._ ___,__. _w_._,_.._.. ,~...-...___.__..___ ._,.-- m~-fw~'ATWATER ~~~~nm~ _.__ _ ..,-...___ ____._.______. ~ 2705018 ?WC 1021 SNAPPER RD ;ATWATER 2701178 IWC ~ 428 SKYLINE BLVD ;AVENAL ~ _ 2701178 sWC ...._.__r_......_., __-.___ _...,....... X428 SKYLINE BLVD~ _._ _.._ __A_....~......_...._._...._ _ AVENAL ~ 2708606 WC =1030 OAK ST ~ . - ;BAKERSFIELD 2708606.!WC ' 1030 OAK ST _ ~.._ „BAKERSFIELD 2708606mWC ;1030 OAK ST ?BAKERSFIELD ___..-~ ,__._--~~ 2708825 iWC 2222 F ST :BAKERSFIELD _.~.._ .~.._ 2 708825- 'WC , __ _..._..... .._ -.._._..v__ ......._ ':2222 F ST ....,.. _.._.___..__._._~._._._ .. BAKERSFIELD _ 2708825 :WC 2222 F ST ~ BAKERSFIELD _- 2708605 ?WC __~.._m~„_.___..- _~~ _._._._ _.. 15600 AUBURN ST ~ _~...~...~.____.___..._-.-.._ ~ 'BAKERSFIELD 27_08605. WC X5600 AUBURN ST BAKERSFIELD ~ 2701270 €WC ~ x;5634 STINE RD ;B AKER SFIEL:D 2701270 !WC ~ _ STINE RD ~5634 _ _ B AKER S FIELD--~~~~ ~~~ ~ 2705731 WC _ _ _ ~ 1501 E MAIN ST~~~ ~ _ _ _ .~ _ ;BARSTOW : __...._ _. ~,....._ 2705731 :WC _ _ ._.. .._ _. __..~._._____._ 1501 E MAIN ST _.___.___._W.._._.._.._w._ _ gBARSTOW 27 01096 'WC ~ 500 R I MR KRD O C BARSTOW _ _ _.___.. 27 01096. tWC _ _ _ _ _ m. 50 0 RIM R O CK RD ~ IBARSTOW~~ _ _ 2700358 ~;WC _ _ _ _ _ _ 540 WBIG-BEAR BLVD __._ _ ;BIG BEAR CITY 2700358 WC 540 W BIG BEAR BLVD iBIG BEAR CITY 2700951' IWC __ r5809MANZANITAAVE ~ ~ ~CARMICHAEL 2700951 WC 15809 MA NZANITA AVE- _..__ ~CARMICHAEL 2705728 WC _ _ _ 4200 CHINO HILLS PKWY s __. _. . _.____... ~._....~._ ;CHINO HILLS . 2705728. IWC :4200 CHINO HIL LS PKWY CHINO HILLS ,~~_ ,._ 2702964 ;WC _ _ ._ ._ __.-.. 60 BROADWAY .__.~--.______._._.v......._.--. ;CHULA VISTA 2702964 EWC ;60 BROADWAY CHULA VISTA 2705708 `WC .--~ .__4.._- ;98 BONITA_RD _... -- ~ ~~~ €CHULA VISTA 2705708 IWC ~ ;98 BONITA RD ;CHULA VISTA 270542_3 iWC ~ _ "77_96 SUNRISE BLVD ~y~~CITRUS HEIGHTS _ 2705423 sWC ;7796 SUNRISE BLVD ICITRUS HEIGHTS 2705423 IWC ,7796 SUNRISE BLVD ?.CITRUS HEIGHTS ____ _..__..._a_. ....__ ~. ._..__..._.___.._.__..._,__....._,..-._____. 2705423 `sWC :7796 SUNRISE BLVD ;CITRUS HEIGHTS 2701922 ~;WC-~ _ '13120~MAGNOLIAAVE "CORONA~~_ 2701922 IWC 13120 MAGNOLIA AVE ~ ?. ORON A 2701922- __ ~WC .13120 MAGNOLIA AVE __ ;CORONA -_-..___.._. 2705705 WC ':304 S MAIN ST `CORONA 2705705 S WC ; 304 S MAIN ST . 'CORONA .____._ 2701914 w.._ ___. WC ____..~._.~.__.,~_____. .__..~_ 11930 LAKE BLVD ___ _.~ DAVIS~ 2701914 - WC -1930 LAKE BLVD - ^~~ DAVIS . ~ -~ ~ 2701914 _.._ "' WC 1930 LAKE BLVD ~ ..-- aDAVISry M ___. 2705017 'WC :2549 BLOSSOM ..._ __ r_-._w__.._ DOS PALOS 2705017 !WC 2549 BLOSSOM -DOS PALOS 2705017 ?WC '2549 BLOSSOM DOS PALOS - STATE UST#1 -'_-L-- _1 _- GALLONS INDATEL RDEARO CA i 03`U 30 9816€D iFG € 1-Nov-881 17-Dec-03 CA a 01'U 30 9816 D (FG 1-Jun-88 17 Dec-03 _ w._. _ ._._. CA 02=U __.._.. _ _ ~ _ ..._ __a.. _ 05 _ ..... 9816`D FG _._ _. ~ __ .. 1 Jun 88 w_ r.._ .-_ _. _ 17 Dec-03 ._ _. ._ _.... CA 033U 20 ~ 9816~D FG 1-Jun-883 17-Dec-03 CA ~ 01 U 05 s 14976 D:FG ; 15-Jun-98; c-03 17-D e CA _ 02 U 30 r 11849}D FG ; 15-Jun-981 _ _ 17 Dec-03 CA 01 }U ~ 20 9816 D FG E ~ 1-May-88 17 Dec 03 CA __ 02fU ~..... ~...~ 05 ,. _... _..~.__ 98163D [FG ; ....-,...___,_._, 1-May-88, 17-Dec-03 CA 03 U X30 9816lD FG ~ 1 May-88 jW Dec-03 17 ___ _ CA ...~ ~.._.___.___, 01 I U OS m_r____..,__ 14976 D 1 FG ~ __._ 20-Oct-98 } m 17-Dec-03 CA 02; U 30 ' :. ~11849~ D FG = _ 20-Oct-98 17-Dec-03 CA ~ 01.U '20 ; ' 9816~D FG + : 1 Jan-85; 17-Dec-03 _CA 02tU 30 ~ 816:D FG `~ 9 1-Jan-85~ : a 17-Dec-03 _ _~ iCA a-._._ _ ~ _ 03.U .. '05 ~ _ _ i.r9816sD FG .._ .__ _ ,1-Jan-85's - -..-,.-_._____. 17-Dec-03 -_._.,_.__. _ ICA _ __.._...-_. 01 U 20 E _...___~_. 9816 D FG ~ -,.M_,_.___.__. _. 1-Nov-88 __..__.._...~..w,~., 17 Dec-03 CA 02°U 05 9816 D FG 1-Nov-88, 17-Dec-03 ~CA 03 U 30 9816 D FG , 1-Nov-88 17-Dec-03 CA 01 U 05 1'1849 D `FG = ':10-Dec-98. 17-Dec-03 .a.__r. ~ CA 02. U _ .._ 30 . _. _..,..__ _ 118 49 D , FG .._____m_._..._.,_..~. 10-Dec=98 ___.....___,-___-.. ec-03 17-D _ - ~ ACA _ ~~~~01 U _ 05 ' ~~ _ ~ 9816D `,FG ~ ~ 1-May-88 _ 17-Dec-03 CA ~ 02 U 30 9816; D MFG t ;_ 1=May-88, 17-Dec-03 __-.,_{CA._ .__p.w.M._ 03 U 20 ~ - _'.9816+D FG : 1-May-88 17-Dec-03 CA 01 U 20 _: 9816~D FG ~ 1 Mar-87 17-Dec-03 3CA ~ 02 U 05 . :. . 9816~D FG I 1-Mar-87 17-Dec-03 ICA 03' U 30 9816: D FG • _: 1-Mar-87; 17-Dec-03 'CA 01 U 30 9816D FG 1-Mar-88` 17-Dec-03 ...._ ._._.._. !CA _ 02 U k20 : _ _ ._... _ .. 9816~D ;FG ~ _._. ..._.__..w. ~.. 1 Mar-88 ...__.__._.~. 17-Dec-03 . .. CA 03'U 05 ; , 9816`.D FG r 1-Mar-881 ._.._....__.. __ .17-Dec-03 CA ? 01iU y05 , , 1497 6~D FG , 24-Aug-98; 17-Dec-03 __. __ CA _ _._____. ._.__ 02xU M_..... 30 _ __ 11849 D FG __...___-.~.,. 24-Aug-98' __...___~.__._.... 17-Dec-03 ._.._ CA .z... _.._ 01 { U _. 05 _ 15154 D FG , _.: __ 1 Nov-96~ -- __ 17 Dec 03 CA 02 U 30 15154 D FG ~ 1 Nov 96 17-Dec 03 A C 01 t U 30 11849' D FG 22-Jan-99`s 17 D ec-03 _ _ CA _ _ t 02 U 05 ~~ 11849. D FG ~E ~ 22-Jan-99 _ 17-Dec-03 CA 01 U 05 1184&D FG ! 30-Nov-98 17 Dec-03 ___ ._._ ;CA w~~.-._..~.. _._ 02~U .-__.__ 30 }__ .. ... ____ __ _11849 D FG _.w..__.__._. .~. 30-Nov-98i . -._-..-._.._._ 17-Dec-03 {CA _ 01 U p06 11 14976 D FG 10 Apr~98~ 17 Dec 03 ..~ CA ~ 02 U i 30 ~ 11849 _D FG ; 10 Apr-98 £ ' 17-Dec-03 _.._ CA ..__.~._..~.._-~--.____ 01;U ...~.w ..;___~..___.. = ;05 ~ w12037:D SF _ ~. 1-Jan-91y ______..____ 17-Dec-03 ICA ~ 02~U ~ 30 i _ 12037~D SF ~ 1Jan-91_ _17-Dec-03 s CA 01 i U ° 05~ _a-,. 9942 S S F 1 A r 811 ~ 17-Dec-03 CA I 02jU X30 '9942rS SF 1 Apr 81~ 17-Dec-03 ~y_~~ ICA 01 U 105 ! . 15154 D SF 1-Jan-96 17 Dec-03 .___...._ CA _--_.~.._._._..._ ~ _. 024U I .._. _...„__ '30 [, ___n .____.. _.._ 15154',D SF ._,..,...._._..._._.~. 1-Ja n-96; .,.w__,_.._. __..... 17-Dec-03 ~CA µ `s 01U =05 ~ 116821D F G _ _ - 1-Ja n-95, 17-Dec-03 CA -_ rn~02?U ._~..._..L...e 105 { _ ___..,_..---~__ 11682?D FG _ 1-Jan-95, 17-Dec-03 _-.__. CA .._. 03 U ._._.a_._. `20 ? _._____. - 11682°D FG 1 Jan 953 .._.__._ 17 Dec-03 -._... ._.__ CA .._ _ -..__-. 04 U- __,~___ s30 _.__ _ ..,w _.. _ 11682~D FG __ -.__.__ -,. 1-Jan-95, ._..~...~_.__._. 17-Dec-03 ......__ ACA _..__.__..._._ . 01=U ... _~_ !20 ; ._._ ...._....„._ ._ . 9816'D FG ,.___w____._. ___.. 1-Jan-87~ ..._____.___m_._ 17-Dec-03 - ~ . CA _ _ ~~ 02 U ' 05 -~ 9816' D , FG ; ~ 1-Jan-87 ~ 17-Dec-03 CA 03 U °30 I 9816'D MFG 1-Jan-87 17-Dec-03 CA _~._ 01 U 30 ' 15154 D pSF 1 1 Jan 95 . 17 Dec-03 CA 02 U ~ >05 , . 15154 D ISF ..._ 1 Jan 95 .w..._._.V.__,.. 17-Dec-03 _. _ CA ~ 01'U _ 05 I _..___,,...i_ .~ 9816;D FG ! . ___ 1 May-8Tj -_._._..,_, 17-Dec-03 CA ` 02 U "30 i 9816gD FG 1 May 87; 17-Decm03 .....___. _.,...., CA _..._ ....,.,.,._.~ _ 03 U _.. ~_._.....,,E.__. X20 ; _. .. , .._. _. , 7950.3D FG =; ... ._. _. .. 1-May-87S _ 17-Dec-03 __.__ __ CA .._ ; 01 U X30 I 9816. D FG 3 ~___._.___._- w. 1-Dec-88 17 Dec 03 CA s 02 U a05 L 9816.D FG a : ! 1-Dec-88 17 Dec-03 __.._. _.__.. ' CA .__. __.._..~ 03 U ___ . 20 1 __ _.. __.._._.~ _ _ 98161 D = FG ? _____..____~ 1-Dec-881 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _ - _ ~ 12/17/06-07 West Coast Regi on as of 12/13/06 CAPACITY INSTALL RETRO LOC # Regio - n ADDRESS - - CITY STATE U ST # GAL LONS DATE DATE 2708545 WC _,.~.. '1161 E VALLEY PKWY ~ ._ ESCONDIDO - CA ~ 01U -- 20 9816D `FG ! I 1-Oct-87` 17-Dec-03 2708545 'WC 1161 EVALLEYPKWY _._____-__.. ESCONDIDO . __...~,._._.___-. 'CA I 02NU 05 ... 9816 D'FG .,,~_...,~._..._._..._.,__ 1-Oct-87 _..___..__-..__. 17-Dec-03 2708545 IWC _ ~ _._. 1161 E VALLEY PKWY _ . ESCONDIDO . _,_ CA _- 03°U~ ~~-.__.,__,._., 30 ' _. ~'~- -_~.__ 9816 D FG k _}~_~~~"~-~~ 1 0ct 87 ~'~~"~'~ 17 Dec-03 2701527 cWC _ _ _ ...._ . _.._.-_..._.r______ 685 PARKER RD _.,_ . ~ ...---.____.,__._. ___..__ FAIRFIELD .__.~..,~._.,~_ ___. _ ,CA , rm , ... 01'U `30 ! ^. . _ 9816D FG ._ - w 1 1-Mar-87 17-Dec-03 2701527 WC 685 PARKER RD FAIRFIE LD _ ACA I 02`U °05 ' 98161D ;FG ~ , 1-Mar-87~ 17-De c-03 2701527 WC ,._. 1685 PARKER RD ~_.___ ._.___. _ _ FAIRFIELD _____ .~_._ ._, iCA g .__~ . 03:U 20 ( 9816D FG ~ 1-Mar-87~~ _ 17-De c-03 2700489 WC 14906 VALLEY BLVD r FONTANA __. _____._ ?CA 014U µ O5 f 9684,D~FG , _ 1-May-95 _ _ _ 17-Dec-03 2700489 IWC 14906 VALLEY BLVD ,FONTANA iCA .. "~`~ "°"" °--°______.__,._ 02U a30 y 9684D'FG ~ 1-May-951 17-Dec-03 2705802 ' WC ~_~_~_ =16900 FOOTHILL BLVD aFONTANA f - ,CA ~ 01 U _ r ~ 05 3 } ,- -11783 S~SF ~ „__.~ _ 1-Jan-83 ,w__~_~._____ 17-Dec-03 2705802 !WC __._. 16900 FOOTHILL BLVD _,.µ „ FONTANA ~ iCA 02~U °30 ° 11783'S ;SF 1-Jan-83~ 17-Dec-03 2708734 WC _ a 247.E OLIVE AVE ~ _,_ a _ __._ _~.... FRESNO _. _._.___.__.~_ ,__.~ _.. . ACA .. ._~ ~,..~ ~..,._ 01'U 05 ~ ' 9816 D'FG ~ _w_.,_,_.. 1 Aug 88 17 Dec-03 _. ~_ ~ 2708734 WC ....__.._., .._.-, :247EOLIVEAVE ._ ._.~.., __ FRESNO ,_ - 'CA 02U 20 zw~ 98`I6NDIFG' T . 1-Aug-88 ._____ __._. 17-Dec-03 2708734 WC 247 E OLIVE AVE .____ _ FRESNO ~..._~ _.._ !CA ~ __ 03~U ? 30 ` - . : 98161D FG' _.~._- g_ _._ x 1-Au .883 ___._.._____ 17-Dec-03 2705063 iWC ..._.._._ 8190 MISSION BLVD GLEN AVON CA 01;U =20 9816°D FG ~ 1-Jun-89 _ 17-Dec-03 2705063: IWC :8190 MISSION BLVD .~ ............._.... GLEN AVON .___.,_..___.,,,_._,r_~ ICA ...._.F_ ._. 02 U _ _w._ ;05 ; .._,_..~_-a--~. _ 9816iD FG £ ___.__._____,.__ _ 1-Jun-89! ..__a.~.__..._ 17 Dec-03 2705063 1 WC _~._. .__ :8190 MISSION BLVD GLEN AVON ._... __,_,_.__,._. __..___.________ `CA 03' U 30 9816~D ~FG s 1-Jun-89! 17-Dec-03 2701028 WC __.,_... ,1665 W HANFORD ARMONA RD;HANFORD _._..~..._._._.___.. ,CA _ 01 U : __ _ '05 N,~. _._ 14976 D `FG ° .__._.____~.w. 10-Jul-98~~ _ 17-Dec-03 2701028 ;`:WC ._...._,__ , 1665 W HANFORD-ARMONA RD HANFORD fCA 02 U 30 11849:D ;FG ~ 10-Jul-983 17-Dec-03 _. _.. _w _._..__._~.. ..... ___-__.____._.__ _.... 2705619 WC ;1150 W PACIFIC COAST HWY~HARBOR CITY ?CA ' ~ 01 aU ~~_ 05 12023 D SF ~ 1 Jan 88, ..__._.___._.__.. 17-Dec-03 2705619 WC 1150 W PACIFIC COAST HWY IHARBOR CITY ~ _ ~ ICA I 02?U 30 , 12023~D SF 1-Jan-~B, 17-D ec-03 2705057 `s,WC ___,_-._.~_,. ;8197 1 ST ~HESPERIA~4~~ _ ~ ~ CA k 01 U '30 9816 .D FG ! "1 Nov 881 _ 17 Dec-03 ..._~_..__.._ _.w.._.. ____,_.,...._.,., 2705057 'WC 8197 t ST :HESPERIA _._ _____I.~.. _._.. _ ,_~.._.__.__..~..._,,_, .__.. .,..,_....~ __,_ :CA 02 U _.__._..__;__.._.__1 ._.. 05 __ ..~.. ~.,. __ " 9816'D IFG i .__.__.__.._...._.~_ 1-Nov-88? m-.__~__.._._ 17-Dec-03 2705057 :WC X81971 ST HESPERIA ICA ~~ ~03IU _ ,... 20 ... ___ 9816~D~FG ~- ~ 1-Nov-881 17 Dec-03 2705242 IWC .3405 E HIGHLAND AVE ;HIGHLAND CA ~ _ 01 `U .30 . 11849 D ;FG 48 Aug 98 17-Dec-03 2705242 WC ,_.___ ~ (3405 E HIGHLAND AVE 'HIGHLAND ~ t 'CA 02~U 05 17849'.D.'FG I 18 Aug-98i 17-Dec-03 2700538 IWC _.~._ 143955 CLINTON ST __..__...___,__._ w.,..w. `INDIO ____-___._ -__u jCA ~ 01;U 05 14947 D~iFG 2 Nov-98{ _.......,._.r.._._ 17-Dec-03 2700538 WC ,-. [43955 CLINTON ST _ -______._. INDIO ___._--__-.~ _.vrv 'CA ~ ,,._.. 02~U _._ 30 11849 D FG .~. 2'Nov 98r ___.. 17 Dec-03 2705786 IWC 5793 ALTON PKWY .IRVINE ~ w CA ~ 01 iU 05 14976 D FG [ 1 Nov 01 ~ 17 Dec-03 2705786 IWC 5793 ALTON PKWY IRVINE °CA 02 U 30 :.14976 D FG _. 1 Nov-01 _...e,-___.. 17-Dec-03 2705911 ,WC ,78364 US HWY 111 LA QUINTA [CA 01 U 05 ; 1.49 76 D ;FG~ ..14-Jan-02# 17-Dec-03 2705911 WC -78364 US HWY 111 ILA QUINTA _ ~Hf' _ CA ___~___ 02 U '30 ~ _ 14976 D FG ~ 14 Jan 02` 1T Dec 03 2705911 WC __._ 78364 US HWY 111 LA QUINTA CA __.. _..__,, _...___ _ ._,,.._~.___..,__.m.._.__.__,_. _W . 03 U ~ 145 1 14976 D FG I '1.4-Jan-02~ 1 _., 17 Dec-03 2700837 WC 17671 GRAND AVE LAKEELSINORE _ _ ~._ CA ` ~ .,._._._ .._.~. 01'U u,..... . 330 ' _, ~ 11849 D =FG ~ -..,._..----,-. 13 Jul 98 -•'_________ 17-Dec-03 2700837 !WC 17671 GRAND AVE _ _ sLAKEELSINORE-~ CA ° 02 U X05. •;_ 11849D'FG ~~ ~413-Jul-981 17-Dec-03 2701205 'WC 16470 CAMBRIDGE !LATHROP ~ CA ~ 01~U '05 11849 _D.FG x 2-Jan-98; •~47-Dec-03 2701205 'WC ,_. __._..~~.. ?16470 CAMBRIDGE ,.,..... LATHROP ._._____ - CA ~I _._.__~_ _..~.....__.._.. _ 02'U w30~ _..._._., 11B49 D FG h ~ 2-Jan-981 z 17-Dec-03 2701215. jWC •1421 OCEAN ~:_.:~_,._ w,X __.._.. ,._... ._ K- wµLOMPOCµ^mm^; ~ 3CA ~ 011U `05 ._..,. .~ 11849 D FG I ._ ~._._,_.-... _ 1 Feb-99, _..__._,._._.._w.. 17-Dec-03 2701215 !WC __ _,._. 1421 OCEAN.. _ LOMPOC ~ _...,.___ ACA i __...__ 02'U ~- '30 __ ~...._ r. 11849 D EFG 1 Feb 99' _.~..~ 17 Dec-03 2709200 IWC _.__. ._,.~_ 1400 N HST LLOMPOC ~- !CA ~ r ._.__.____ _ _:__........ 01~ 05 ~ __, 9684~D FG s :s 74 Jun 05' 17 Dec-03 2709200 1WC .,..___W _. 1400 N H ST - _ _ ._,.__ -____.._._ °LOMPOC 'CA ..~________ _~~.._ _n,. 02` - _ 105 , _ a. 9684~D rFG 14 Juri 05; ._ .. ..._. 17 Dec 03 2709200 'WC _____..,._.~,_._.z____ 1400 N. H ST' -__..__ LOMPOC _._ ACA 031 ~ 301 _ 9684 D IFG ..._ .. 14 Jun 051 _...._..._ __. 17-D ec-03 2709200 'WC . 1400 N HST . .,.. ,_-__.,_..______ `LOMPOC m,_,____ ,CA r --__. _ 04 _ ~ 45 ._.. m._..,~_ 96841D FG 14-Jun-O5~ _ __.__. 17-Dec-03 2703621 ;WC __--__,-_.._.„..~a._ 1704 E PACHECO ._.... ..._...,. ILOS BANGS ACA ._ -____,__._..a.-,._.___-_.._.., - ~ 01 tU I05 96841D `FG ' 14-Jun-951 ~ 17-Dec-03 2703621 iWC ;1704 E PACHECO _ ILOS BANGS ~ 'iCA ~ 02~U q30 ' _ 9684iD rFG ...._..-_._.___ 14-Jun-95; ,-__.u. 17 Dec-03 2703621 ':.WC (1704 E PACHECO ILOS BANGS ~CA ~` ~ 03 U ~45 9684sD ,FG 14-Jun-95' 17-Dec-03 2703614 (WC ;403 MERCY SPRGS RD ILOS BANGS i CA 01,U 05 ` 9684 D'FG a 13-Feb-96 17 Dec-03 2703614 =WC ! ,403 MERCY SPRGS RD LOS BANGS _ !CA i ~ ~~- 02`U 20 - q 9684~D FG , _...____..~ 13-Feb-96 ~ ~._,..,_ 17 Dec-03 2703614 WC 403 MERCY SPRGS RD 'LOS BANGS -` ° FG € 8 , -.~__. _ __ 13-Feb-96} ....___.. 17 Dec-03 2705431, WC S !830 E ST __...._._._,__,._._ __ MARYSVILLE ,_._ .__~.,_.~I .~.. _..~ __,,.,. CA 01 U .___...~ 20 6'D 98 IFG °, ~ 1-Jan-86 17 Dec-03 2705431 WC 830E ' ST MARYSVILLE CA .___ 02 U t _ ..__ OS Y _ 9816 D IFG 1 Jan-86 17-Dec-03 2705431 WC _um_. 830 E ST MARYSVILLE CA ~ I~ _ __ _.._.~._ _....._ _.__.,__.,~_ _ _03 U 30 ~ 9816 D FG 9 1 Jan 86t 17 Dec 03 2708735 WC 2097 MENTONE BLVD ~MENTONE iCA 01 U _ 05 4 9816=D FG ` 1 Dec 88 ~ 17-Dec 03 2708735 ,W_C :2097 MENTONE BLVD ~rr~ !MENTONE ~~ ~ CA r ~~~`~~-TM" -"~" 02 U "- -°- 20 , 9816 D >FG + ~ .-~,-..-.__..-, --. ....w_,._..,.,, 1-Dec-88` .,,«,.... __..., 17 Dec-03 2708735 ;WC _„~,_ _ 2097 MENTONE BLVD , mm ~ ~ MENTONE . CA t 03=U ~ 30 . ._. 9816 D IFG ~ .~~____. 1-Dec-88 _.w._...._ 17 Dec-03 2700337 WC !10597 JURUPA RD MIRA LOMA .. _..__ ............. ~......,.._ ....,.. ACA .............., 01=U ...,.,__. 30 .~ .w._.-_k .....,.-M-.. 11849iD `FG 1 _...,.,......,..,.~...,..,._..,.. 17-Dec-98 17-Dec-03 2700337 IWC .110597 JURUPA RD IMIRA LOMA `CA 02 U 05 11849D FG + _ ._._.... 17-Dec-98', 17-Dec-03 2708843 ?WC 1640 N CARPENTER RD ~MODESTO CA t 01 U 05 98161D iFG 1 Oct 87r 17 Dec-03~ 2708843 ;WC 1640 N_ CARPENTER RD MOD ESTO iCA 02 U 20 9816 D IFG l 1-Oct-87 17-Dec-03' 2708843 ?WC -1640 N. CARPENTER RD _ __ ~MODESTO~~m~~~~~ '~~CA _ ..~.. _ __ _ __ 03~U ~30 : _ 9816?D !FG _ 1-Oct-87? . 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule West Coast Region _ _,_ LOC. # Region ADDRESS ____ 12/17106-07 _ as of 12/13/06 CAPACITY CITY STATE UST # GALLONS INSTALL DATE RETRO DATE 2705432 IWC ._____._______~..., ,899 HAWTHORNE ST _ _ _..~ w.._,.._ +MONTEREY _ ..~ CA 01 U 05 9816€D IFG 1 Jan-90, 17-Dec-03 2705432 ;WC 899 HAWTHORNE ST ~ ___ . MONTEREY ~ ~ =CA 02,U 20 _ _. 9816!D FG ~ 1 Jan 90 __._..__._„ 17-Dec-03 _ 2705432~WC !899 HAWTHORNE ST - _pMONTEREY _v_ M__. .._. __ CA ~ 03 U I 30 ! 9816`D FG : 1-Jan-90 17-Dec 03 2705432 'WC ~. ~ .,..~..__ 899 HAWTHORNE ST MONTEREY t z _~F..___. _.__~._. ~ ,CA ~ _w._ 04;U ,._. ,-._ =45 ! ___ _ _._ 9816°D !FG _.._d__._..,.~,_. 1-Jan-90; ~.._..._..~ 17-Dec-03 270_0872 }WC `13261 PERRIS BLVD _ ~ rMORENO VALLEY ~ ICA F 01~U 30 ~ 11849rD FG 31-Jul-98 17- Dec-03 2700872 SWC ;13261 PERRIS BLVD ~'MORENO VALLEY _ _ ~ CA 021U t05 ? '~ 14976~D FG ~ ~31-Jul-98 _ 17-Dec-03 2701775 SWC r 24051 ,JOHN F-KENNEDY DR MORENO VALLEY ICA ; 01 U 30 ~ 9816sD FG 1-Jun-88{ 17-Dec-03 _27_01775 ;WC :2_4051 JOHN F KENNEDY DR ~MORENO VALLEY m , . '.CA ~ 02 U _ ?05 F 9846~D `sFG r. ~ ~ 1-Jun-88 17-Dec-03 2701775 IWC '24051 JOHN F KENNEDY D ` R MORENO VALLEY ~ ~ CA t 03 U Y~20 ~ . __.w.._ 9816 D s FG ~ _,._w_______.,.M>_ 1 Jun-88 ~~-.-„-_~.__,_ 17-Dec-03 2700770~WC ;49594 29 PALMS HWY _,..._ sMORONGO VALLEY CA ~ 01 U _ X30 i~.11849~D ~FG , 1-May-981 17-Dec-03 2700770 "WC 4959429 PALMS HWY IMORONGO VALLEY ~ ACA 02 U ~05 ` 14976•D FG 1 May 98 17-Dec-03 2701045 ~WC ..,_____ __..~_ .__ - .11408 VENTURA AVE sOJAI .._ ._._._..,.~.. __ .~,_._.__ .____.,_..__W.__._ ~ ~ N jCA ~ ,___ _. 01 U • X05 ^ 9816'D FG : 1-Aug-87 17-Dec-03 2701045 { W C 11408 VENTURA AVE OJAI -_-~ ___. . _._...-. _,. ; ... ~CA . ""."_ 02 U -_ 05 ~ ~ __ _ ..~.. 9816~D FG `. ~._~.. 1 Aug 87 _.,_.,..______ 17 Dec-03 2701045 .1WC 11408 VENTURA AVE OJAI CA ~ 03'U .30 x 9816rD FG 1 Aug 87 17 Dec-03 2705230 WC 316408 ORANGE. a_.._.._ ~,_...._. _. ... _ __ ,PARAMOUNT _ ~~. _ . ___._ . ~. ~ CA 01 SU __ _.._ #_ .._....- 20 9816 S FG , _„ t Jul 83 _ ,. 17-Dec-03 2705230 IWC ;164080RANGE _ . PARAMOUNT . ,.._.._.. t CA _.__.. 02 U ~05 ~ ~ _ 98165 FG .M .__,_. 1 Jul-B3' .~__..__.._.__~ 17-Dec-03 2705230 aWC 16408 ORANGE ,PARAMO UNT ;CA a 031U ;30 . 9816S .FG - 1-Jul-83' 1,7-Dec-03 2705245 IWC .,_,,...,..,...~,~._.__ 16105 CLAY µ ~ ,=-__ .._,...,,,,-__,~.,,.,___....._._.,_. _ PEDLEY ____.. _.__.__,_,.._._...._ .___ ;CA : ~ ; 01, U 20 _ µ 9816_D:FG 1 Nov-87 17-Dec-03 2705245 ;WC '6105 CLAY ,._._ PEDLEY ---.._...__.w. ,._...,,...,_._,.. _._.. ,._.-._, M_ CA ._._.__ 02~U _ 30 ! _ _ . 9816~D %FG M 1-Nov-87; 17-Dec-03 2705245 aWC __~___.. ,.__ °6105 CLAY ._ . ..__~__.-_ PEDLEY __..-..__.._ _ CA ~ ..~... _ 03 U 05 9816ID IFG 1.Nov-87~ " 17-Dec-03 ~ . _ 2705659 ~'WC 18451 SLAUSON AVE ~.,..__ ___.._....._ ...~....~.._._.. _.,_-..._ __.w PICO RIVERA ,,-.~.,___,.__._.,.._.... ____ ___ ._ !CA ~ .~__._.~ ..~.. _ 01 °U _ 05 , .___,~.~._. ., 19703`S IFG ~ . _... _ 3 Dec 01 ..._..___._...__ 17-Dec-03 2705659~WC {8451 SLAUSON AVE PICO RIV_E RA _ ?C A 02 U _, ..Y., , __ X30 ; ._~~_.__.,-., .._.~_ ... 11863!S ~FG _.-_~ ~.__ 3-Dec-01 _.~..._. 17-Dec-03 2705659 `WC '8451 SLAUSON AVE _ PICO RIVERA _ _ _ ~_ ~ CA ~ ~ 03 U 45 ~ A 103691S FG 3-Dec-01 17-Dec-03 2702970- !WC 704 MAIN ST RAMONA CA 01 U _^ 05 ' 11849D FG „ 28-Oct-981 17-Dec-03 2702970 IWC 2705020 WC 704 MAIN ST RAMONA ~ _ 1598NORANGE { CA I~ 02 U 30 ` ~ 118493D FG , µ~ 28 Oct-98 17-Dec-03 ; ~ REDLANDS CA s 01:U 05 ? . 98 6 ,FG ;' " 1-Oct-89: 17-Dec-03 2705020 'WC 11598 N ORANGE REDLANDS CA 02'U °20 ` 9816~D :FG ~ '1-Oct-89; 1.7-Dec-03 2705020 IWC 1598 N ORANGE. REDLANDS ?CA 03'U 30 ~ 9816•D ,FG ~ ^ `. 1-Oct-69 17-Dec-03 2705214 _WC _...,. 765 W REDLANDS BLVD ,~ ...,._.___.__ _ ;REDLANDS :CA , . __.__.~...__,._.__.~.~_____._. _____ ._ 01 U 30 # 11682'D FG r 12-Dec-011 17-Dec-03 2705214 WC ~___ -:76'5 WREDLANDSi3LVD ._._,_.,-.~.._ REDLANDS . , ._.,..__ iCA ~ ___..._ 02 U ._. .. 120 _.,.,.._ _,.~_._. 116821D yFG ? . _ .................._.._. 12-Dec-01? r~__._..~,.,__.-..., 17-Dec-03 2705214 }V11C _ ~._ _. 765 W REDLANDS BLVD -. . REDLANDS _ ..~.___.. ,.__ CA ? ._._._._ _ 03U _. 05 ' _ ._.~._._ ....__ _ 14976#D :FG ___.____,,.__,.,. 12-Dec-01: _ ................k__,. 17-Dec-03 2705252 ;WC ._..__ 518 W FOOTHILt _ __- _ _ ,RIALTO ,~_,. ~_.,._ ~ .. ~ ;CA _r.__ 01 U -,._.., 20 ....__. ~~:' ~ 9728 D FG _ ,_~.._ 1 Nov-88 --.,--.-__._.__ 17- Dec-03 2705252 `WC 518 W FOOTHILL {RIALTO ;CA ~- 02 U ;30 9728 D FG b ' 1 Nov-88, _ 17-Dec-03 2705252 ~V1lC '518 W FOOTHILL pRIALTO mm CA 03;U X05 9728 D FG 1Nov-88 17-Dec-03 2700801 :WC 18965 VAN BUREN BLVD RIVERSIDE CA l -01 SU 130 ' ~ 11849 D IFG ~ -.__._ ., . 8 Sep 98 , 17 Dec 03 2700801 iWC 418965 VAN BUREN BLVD RIVERSIDE ~ ACA 02 U F05 ~ 14976'D;FG ~ ~ p ~ B Sep-981 ~. µ 17-Dec-03 2_705221 I_WC mT~ 38609 GARVEY AVE ~ RO M S E EAD ,~ _m___ iCA ~ 01 U 20 ~ ~ 10810'D IFG - '31-Oct-90? .1 7-Dec-03 2705221 IWC ____ _ 8609 GARVEY AVE t._. m.a _ _ _ _ ROSEMEAD ~/ ..._,___.___.,._ ,__.. ICA~-M~ ~~ ~ ~ ~~ 02~ U - ;05 ~ -{ € : 103101D FG . ' V ~_ ~._ 31-Oct-90.4 . _-..~,__.-.-" 17-Dec-03 2705221 IWC _ 48609 GARVEY AVE ...--. ROSEMEAD __.___._._ _.__..___.. CA~ t µ 03:U w?30 4 s ,10310~D IFG ~ 31 Oct 90; 17-Dec-03 2705733 IWC .998 SUNRISE BLVD 1 996 SUN __._____. w~ ~._____..,._.._~...____ fROSEVILLE +CA 101;U _~. ~ .., (05 __ __ 15154gD SF ~ 1 Jan 963 17 Dec-03 2705247 ~WC . RISE BLVD __ -5804 MISSION BLVD ROSEVILLE .,..,__._..._.,__....-,..._.. -._. RU ICA _. __ g 02 U ,30 I ~- 15154SD ,SF ~`" 1 Jan 961 - 17 Dec-03 "~'-"""~" ~' BIDOUX ._.__ CA ._- 01 U ,05 I 9728+D IFG I 1 May 88; 17-Dec-03 27_05247 IWC _ 5804 MISSION BLVD RUBIDOUX !CA ..__ 02 U r 30 __ 96951D :FG ' _ ....,.. 9-Jun-031 _,. 17- Dec-03 2705247 'WC ;5804 MISSION BLVD ~ ._.._.._ ~_._.._. RUBIDOUX ECA ~~ ~ .~ _,__._..._. _,:.... ____ 03 U 20 € z 9728°D ,FG ~ < 1-May-88~~ _ 17-Dec-03 2705203 ; W C , ._.._.._._-_.__.~-__. i ,6290 MISSION ..,.._,__.__..._...._._.._. __ RUBIDOUX ,CA ~ _ 01 U ~-_- ._._ -05' __._,.,,._,_.__ _. . __, .._ 9816'S FG ~ _ ...._._. _____ 1 Jan-827 17-Dec-03 2705203 IWC ------ ~..-_- .. __.__._...,._..,_,...____..m. 16290 MISSION RUBIDOUX ~._..._..~...____m_...___,_w..._._,_.m_ .....~.__.,. ,CA € .._ 02 U ~ 120 ~ __~____-~-,_ 98161S FG '~"'~"' 1 Jan-82 ~-' 17-Dec-03 2705203 WC _..._ . 16290 MIS510N _.__...._..., _ ~_____._ _ RUBIDOUX _.___....__.__.ti_._.. _ .___.. CA ~ E 03 U `30 ~ 9816IS 4FG 1-Jan-824 17-Dec 03 2701057 yWC -5555 HEMLOCK SACRAMENTO µ _ _ _ ACA I . 01 U .. _~_.. =3 0 I 11849 D FG I 8 Apr 98; _ 17-Dec 03 2701057 WC -~---- --.- .5555 HEMLOCK _ _~_T.~ ;SACRAMENTO ..~_ _ ~ CA ._~. _, ~ 02 U . $ 05 s ~ ~ 14976 D I FG t 8 Apr 98; "~ -~`"- 17-Dec-03 2701212 WC _._ 600 RIO TIERRA AVE __ _,...~,____ SACRAMENTO ~~~ CA , 01 U -~ ~_ 05 ; w.~ _,.._ _ ~ __"~ 14976; D FG i ~ ._,____,__ 1-Apr-98{ ~ -'"`'-`~~~ 17-Dec-03 2701212 WC _ ;600 RIO TIERRA AVE ....._ _...__-_ _ _..... SACRAMENTO _...- _.._._.,__.__ ACA - ~ 02:U 30 11849,D FG 1Apr98, 17 Dec-03 2705439WC - ;1240 N MAIN ST __._.. ,...,,._,.__.w._._w.__ _._..._ .SALINAS __._.__......_..._._.....-_ ..___.._.__.__,_-____._ CA ' ~ .~.w___._ . 01 U 30 ~ ~ ~ 9816 D FG ~ ~ ~'~ ~ 1-Jan-89~ _ ~ ~~ ~-~-- 17-Dec-03 2705439 'WC ----• 4._~ 41240 N MAIN ST _, ~_.,._~., ___ _._,.~.,___.v__„ SALINAS ~~a_~_-_~_-___~__, ..._., . _..__.__.- ' CA _ ~ i 02 U W ` 20 ~ 9816 D FG ~ """°~"°"""""'~'~ 1-Jan-89 '°°~"`~'~"m~° 17-Dec-03 2705439 WC ;1240 N MAIN ST ~ SALINAS _ ~__ ----...____ CA ~ .. _.. 03 U _._._ .__-~.____ 105 ' ___.._,._ _ _ _. 9816 D .FG __._..,_,_,__ 1-Jan-89 -______..._._.,. 17 Dec-03 2705439 ~ WC ----- 1240 N MAIN ST .__ _ . SALINAS i ,CA 04oU ~ ~"" s05 t °'-"~"~"" ~" _ ~" ° 9816;D FG iv""~°`~"-"' -' 1 Jan 89 °`---'_ ° •-° 17 Dec 03 2705239 1WC ~_._., ;2734 DEL ROSA ~ SAN BERNARDINO ~ CA ; 02 U 05 I - __ 11849 D FG _ - . 18 Aug 98 17 Dec 03 2705239 rWC j2734 DEL ROSA ::SAN BERNAR_DINO_ CA ; 03iU 130 , 11849D FG - 18-Aug-981 17-Dec-03 2708641 ;WC .._,.. :295 N WATERMAN AVE 'SAN BERNARDINO CA ; 01 U _ ' -.__ 20 E ._- 9816 D IFG 1 Mar-88' '""~~ 17-Dec-03 2708641 ''=.WC .295 N WATERMAN AVE -.SAN BERNARDINO __r_._.. .__. CA .._._,.. 02 U .,_,.,_ ,m,_ =05 .,._,-_ _ ...,. __. _ 9816D ,FG ; _. .. _...._. 1-Mar-88: __.,_.,____._.__ 17-Dec-03 G:\datalWCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _ _ _ _ West Coast Region _ __ __ __ LOC. # Region ADDRESS - - _ 1 211 710 6-0 7 _ _ ~ as of 12113/06 CITY _ _~____ STATE UST # _ _ _ ____ CAPACITY GALLONS ____ _ ___ ____ ______ __ __ _ INSTALL RETRO DATE DATE - - 2708641 WC _ X295 N WATERM_AN AVE 'SAN BERNARDINO CA 03`.U r30 ` 9816 D ?FG 1-Mar-881 17-Dec-03 2708688~WC 10520 CAMINO RUIZ SAN DIEGO ` `~A 01 U ~30 s 9816`D FG ~ May 89 1 17 Dec-03 2708688 IWC m, , ` '10520 CAMINO RUIZ _ ___..._._ SAN DIEGO _,,. ,._. _..__.___ CA ~ rv. WT~„_ ry _ _ 02~U 20 9816 D FG ~ ~ _ , 1 May 89 17 Dec-03 2708688 -WC ;10520 CAMINO RUIZ SAN DIEGO 'CA r 03 U '05 ' 9816 D ;FGA 1 Ma 89~ 17 Dec-03 2705095 `WC I !4360 GENESEE AVE SAN DIEGO ;CA ? 01=U 30 ' 9684 D FG i 1 Nov-89~ 17-Dec-03 _...~._ 2705095 IWC ;4360 GENESEE AVE SAN DIEGO ;CA 02'U 05 9684 D FG 1 Nov 89' 17 Dec-03 2705095 `WC 4360 GENESEE AVE SAN DIEGO ILA 03?U 20 9684 D iFG 1-Nov-89 17 Dec-03 2703608 'tWC 21.998 COLORADO SANJOAQUIN CA 01'U 05 14976 D iFG ~ __ 15-Sep-97F _. ..._____ 17-Dec-03 _._._.______ _..._____ ___._ ___ 2703608: =WC . __.. _x_-___.,..._,...,_._._._._..~..___..__._ '21998 COLORADO ~,._.,_n_._...,......_________,_._._._, 'SANJOAQUIN ...._.____...._w _ -__. 'CA 02`U _. 30 11849 Dc!FG 15 Sep-97 . 17-Dec-03 2705784 ?WC 981 FRANCISCO BLVD SAN RAFAEL ,CA 01U 05 1.0058 .D `SF 9 Jan 946 17-Dec-03 2705784. 'WC 981 FRANCISCO BLVD SAN RAFAEL ACA I 02U 05 '90058=D :SF 1-Jan-94 17-Dec-03 2705784 WC ' 981. FRANCISCO BLVD SAN RAFAEL _ `CA ` ~~-__.._.. 03U _ "30 _._..___._ - .:':12079=D SF _ .__. 1-Jan=94. _ _.....,.,.._.__ 17 Dec=03 2705238 'WC 765 W HARVARD BLVD '-SANTA PAULA CA ~ 013U '05 ~ '.9816'D ! FG 25 Feb 85 17 Dec-03 2705238 WC {765 W:HARVARD BLVD _ ,SANTA PAULA 'CA 03~U X30 ._9816 D ,FG 25 Feb-85 - 17 Dec-03 2708755 ~N1C X2790 WHITSON RD SELMA ACA i 01 U 05 9816'D MFG ; 1 Apr 88 17 Dec-03 ____ _ _ - ~ . _.___ 2708755 ;WC ___. __..._..___.. _....__._.._ _,_ ._.._ 2790 WHITSON RD ^. _ __. _ .. _ ____...___,_._ °-SELMA _.__...__ ,._. ~ _ CA ~ _ _._ 02;U 20 _ .ww_.~._ ,. _ 9816 D MFG ` __. -.-. _... 1 -Apr-88 _... _ 17-Dec-03 __.. 2708755 IWC =2790 WHITSON RD ~.«__v.__,.~ _ :SELMA !CA i 03rU _ 30 ~ _ _ _ 9816 D FG - , ~ 1 Apr-88 17 Dec-03 2705684 iWC ;27180 MCCALL BLVD SUN CITY .._.__w_ .._...~....V._. !CA 011U X05 12023 D SF 15 Apr-87~ 17-Dec-03 _._..- _._-_ _-___ 2705684 IWC ~ __..~.....Y. -.,~... ~.. 27180 MCCALL BLVD _ ,._,._.. __ SUN CITY .__ ____-~ ±CA € 02 U -- 30 ~" 12023 D SF 15 Apr 87s ...~.~. 17 Dec-03 _ ._.- _-....__.._. _.... _.___._w_.,._ ___ ,~_. ~_ _ . r....,....~..~.._.a-.~ 270001_0. !WC 302 E T_EHACHAPI BLVD TEHACH_API _ _ m ~~ _~ ACA ~~ 01'U ,___.___, ___. ~~ ~ ~~ 30 ..... 11849 D MFG _..___ _ __.£_..._,_i._ ___ , ..____. _ ~ ,29-Jul-98 ,.~._.._,.__._ _ 17 Dec-03 __....____..._ 2700010 6WC 4 302 E TEHACHAPI BLVD ;TEHACHAPI iCA ~ 02`U 05 : 14976:D`FG = 29-Jul-98: 17-Dec-03 2700564 iWC 73010 RAMON RD THOUSAND PALMS !CA 01'U 30 14976 D FG 29-Jul-98' 17 Dec-03 2700564 `WC ;73010 RAMON RD THOUSAND PALMS ILA 02'U _ 05 .. ~ 14976>D ,FG ~. .. 29-Jul-98 '17-Dec-03 2701940 'WC 1600 W MAIN ST ' TURLOCK 'CA 01 U 20 9816 D ,FG ; ` 1 Jul-87 17-Dec-03 ._,..___ ._._ _ 2701940 WC _ _ __._,~_.__._._.._..~, _ -._ 1600 W MAIN ST ___......_._.._.._ w_.__ TURLOCK .____,____,r _._ CA -..._,... 02! U -05 9816 D FG ` ~ _. _ 1 JUI 87 ..~.m_._. 17 Dec-03 _ 2701940 .WC .~.._____. 11600 W MAIN ST _ TURLOCK __ ACA .: 03'U _ 30 _ .. 9816tD IFG ._..~_.__,..~.._ 1-Jul-87• ___w , 17 Dec-03 2700348.=WC .5681 ADOBE RD TWENTYNINE PALMS fCA 01 U 30 11849~D'FG ~ 15 Dec 98' 17 Dec-03 2700348 i1NC 5681 ADOBE RD `TWENTYNINE PALMS yCA 02 U OS I 11849 D FG 15-Dec-98 17-Dec-03 2700743 ;WC 73.943 29 PALMS HWY TWENTYNINE PALMS ~CA _ 01'U ?30 1:1849„D FG 1-Jul-98, 17-Dec-03 2700743 'WC X73 943 29 PALMS. HWY ;.TWENTYNINE PALMS ?CA 02=U 605 91849~D FG = 1-Jul=98~ 17-Dec-03 2701984: WC +795 SHADOW RIDGE DR - VISTA 3CA 01 U 30 9816=D FG 1 Apr 87; 17 Dec 03 2701984 ~WC 1795 SHAD0IN RIDGE DR 6VISTA iCA 02sU g20 ¢ 9816~D FG ; 1 Apr 87 17=Dec 03 ~ _ 2701984 V1IC 3795 SHADOW RIDGE DR ______m__ ___, . ..__~. .VISTA ~~ ~ ~ ... _~...._ _..___ ___rm... _ _.._ 3CA _.._.~...__ _ ,.___..._ ...w 03~IU ._._„~ ~T 605 9816~D FG _ -. 1;Apr-87~ 17 Dec-03 2701161: IWC . ..[.1395 PALM AVE. ;WASCO ACA ~ 01 U g05 14976 D FG 12 Jun 98 17=Dec-03 2701161 IWC X1395 BALM AVE T _ 1NASC0 CA ~~ a 02°U Y ;30 11849 D FG 12 Jun 98 17 Dec 03 2701391. IWC 123 E MAIN ST ,WESTMORLAND m „CA z 01'U X30 `~ 9684'•D .FG .~ 1 Sep-91 17 Dec-03 2701391 IWC 1123 E MAIN"ST; _. WESTMORLAND __.w._....,. ._._.. .GA ~ ~ . 02~U 05 ` .w 9684~.D FG __ _.... _ __._ i-Sep-91 ._._.___ 17 Dec-03 _.._..,._ _._. _._._...___-_.__,..__~._~.._._~ _. 27013911"WC ~~~123~E MAIN ST ~ .._-.____~__.._._._....__~.._____.___.. ._..-...~.._ ~WESTMORLAND ~~~ CA 1 031U ~,20 ~ , 9684~D FG ~ 1 Sep-91 ___..__._....m 17-Dec-03 2701156 'WC 1263 FRANKLIN AVE YUBA CITY CA ~ 01 ~U 05 i 14976~D FG ~ 1TFeb 98 . 17 Dec-03 _,__._ -_.,.___ _.-......1.___ -a~__ _._ _, -___ 2701156 iWC 1263 FRANKLIN AVE I _ m..~,_.__._._.._._._.._..._. _~.. _ _ ._ YUBA CITY -. _ _....,_.~_ CA _ q '" ' " "° 02 U 130 ...~_._~. ._.;____.,,,_. ___.-, '"~'- '-___._„.. 11849 D , FG _ _~. 17 Feb 98 s .._.._ .__ _.._ .. _._.._.... 17 Dec-03 ___._ 2700902 iWC 16940 OLD WOMAN SPRG 'YUCCA VALLEY CA 01'U ?30 1 9816-D'rFG ` 1-Oct-871 17 Dec-03 ~.____,___... 2700902 :WC ~__.__ _ ._ ;6940 OLD WOMAN SPRG IYLICCA VALLEY !CA h_ 02 U _ __...,. _ =05 ' .. ._-_ 98161D €FG £ 1-Oct-876 _w_~.~-..___ 17-Dec-03 2700902 ;WC 16940 OLD WOMAN SPRG ._ _- -_ (YUCCA VALLEY CA : 03-U X20 i 9816;D ;FG ? 1-Oct-871, 17-Dec-03 2700686 IWC ~ _ _ _.____m_..___ X10000 GIBBON SW (ALBUQUERQUE -__ ~NM _ ~ ...__ __ 01 U .T30-,,-_ E _ __.~ 118494D ,FG <- ! --_ .._.___.~ 5-Mar-996 _.__.._,....___ 17-Dec-03 ...._....._... .____. 2700686 IWC _w _ ..__.._......_ 110000 GIBBON SW i ._..~.. _._.~__._...__ ALBUQUERQUE .____....._.._.._.....r___.,_.~ ,NM _._._ 02~U ..~,.,. 05 { ~.._.._ -.__ __.I_ 11849tD~FG , .._,_,~._,~ . 5-Mar-991 ___._..__.. 17 Dec-03 2700379 ,WC ....._.._.-._._.-___-___._ '1200 SAN PEDRO DR SE ___.___-.__..__._...__. =ALBUQUERQUE _,_._..__ .._.._._ NM g __ 01 U ___ ,_.._ 05 4 _____. 98161S ,FG _____.__... ~ 12-Mar-964 ..._,_.._._._ 17-Dec-03 ~ ~ _...__ 2700379 PWC ~~ _ -1200 SAN PEDRO DR SE .___._,.__......_._______.._ :.ALBUQUERQUE ._... (NM ~ ~ 02~U .. 30 _,____ .~ t_._ , .._.. 9816S FG ~ _._._._,_._.__ 12-Mar-96 _______.___. 17 Dec-03 __.._ .~- _.._ _._.~.-_w~..___.__,.,_ .._. _ 2701255 =WC 129001NDIAN SCHOOL RD NE'ALBUQUERQUE _...____,,_.__.__.. €NM ' r 01'U _- ;05 ~ _ 10152yS'SI ~ . ,_..._-___. 1-Mar-7 9 _G_h._..~._. [17-Dec-03 2701255 ,WC ,129001NDIAN SCHOOL RD NEIALBUQUERQUE~~~ ~ jNM 02~U 20 10152,S S _ 1-Mar-79 17 Dec-03 2701255 'WC 12900 INDIAN SCHOOL RD NE ALBUQUERQUE iNM 03'U -;30 6 10152S SI 1-Mar-79' 17-Dec-03 2701313 'WC '1316 YALE SE ~ .ALBUQUERQUE ___ _ ~'NM ~ i 01 U X20 ; 10152 S SI ~ _ 1 Mar 79 17 Dec-03 ..__._ ~~__ 2701313 'WC a:___ '1316 YALE SE ____~.__._._____.__.._ :ALBUQUERQUE _.._.__a,_.,... _________ =NM ~. 02~U 05' ,_ ,._. 10152 S SI 1 Mar 79 ...w.._. 17 Dec-03 2701313 WC ;1316 YALE SE ;ALBUQUERQUE ?NM 033U ';30 ~ 101521S 'SI 1-Mar-79 17-Dec-03 2708779 WC 1401 WYOMING NE ,...._._ ._. _. ~_~._._.____ . `ALBUQUERQUE !NM ! 01'U ,20 9816 S MFG = 1-Jan-89 ~ 17 Dec 03 2708779 WC .__._ ..~..__.___._ 1401 WYOMING NE ._,______w_.._._.._...______._ #ALBUQUERQUE _ _.___ __..__..~. _._. iNM ~ __._.,___ 02,U _.~____.._ 05 ` _._.__.__._ _ _ _.,_ 9816 S FG I .._._.~,...___ 1 Jan 89 _..._.__ _._... 17 Dec-03 2708779 =WC 11401 WYOMING NE ALBUQUERQUE NM . 03PU 130 + 9816 S MFG 1-Jan-89, 17 Dec 03 2701777 WC : ,2001 MENAUL BLVD NE `ALBUQUERQUE .,_.__ ~NM 1 01'U X30 9816 S FG 1 Nov-86 17 Dec 03 ___.~ ___ _._.. 2701777 FWC .__...._ -2001 MENAUL BLVD NE __.___,m._..~___..~._.__ ALBUQUERQUE ~._.._._.... __, _.m,._.~ __ NM ¢ .__,__ ._.. 02'U .~.._... 105 ..__....~....__. 9816,S FG _ _ __.___~ 1 Nov-86 .__._.__~...__w_., 17-Dec 03' E 2701777 IWC ,-__,_-_._._~___..___-_~.__,.._ ;2001 MENAUL BLVD NE (ALBUQUERQUE ...,_._._._..._.. ~ ..___..._.y__ iNM .._._._ 031U _,~__.._;__ 20 ( _. _ ..._._....._~.,.___ 9816rS FG .._._ ~_~.. _ -__~..~_m__._. 1-Nov-86; 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule ~ West Coast Region ___ ____ LOC. # Region ADDRESS 12/17/06-07 asof_12/1_3_1.06_____ CITY _ STATE UST # CAPACITY GALLONS _ ____ INSTALL DATE __ RETRO DATE 2708748 WC `2019 CARLISLE NE ALBUQUERQUE NM ~ 01'U X05 9816°:S=FG 1-Oct-88 17-Dec-03 2708748 WC .~.__M____.w_.~.~-_._..~..___,.~....~_ 2019 CARLISLE NE ALBUQUERQUE INM ? 02=U _ 20 , ._~._ .~._ 9816°S FG - 1 Oct 88 .___._. 17 Dec-03 2708748 WC "2019 CARLISLE NE ALBUQUERQUE NM 03{U 30 = 9816~S FG 1 Oct 88 17 Dec-03 2708551 WC ;2934 EUBANKS NE `ALBUQUERQUE NM 01!U X30 ;~ ~9816'S~FG 1 Jan-88 17 Dec-03 2708551 WC 2934 EUBANKS NE ALBUQUERQUE ENM 02'U 05 ~ 9816`S 'FG 1 Jan 88j 17 Dec-03 2708551 WC 2934 EUBANKS NE ALBUQUERQUE ;NM 03IU ~~ ~ 120 ~ 9816,S {FG , 1 Jan 88 17 Dec-03 _.__._ 2700376 WC _._....M _.___ _._ ':343 WYOMING BLVD NE ~ IALBUQUERQUE ~ _.. ~NM 01 U _.....-__. 05 ! __. -,. _._. .,._ 9816 S FG ... ~ 10 Feb 96? _,~_. 17 Dec-03 _v__, _ - - 2700376 .WC - -_ _w -_. .. _ 343 WYOMING BLVD NE -..w __ =ALBUQUERQUE ~ -_ 'NM t 02sU _ 30 x ~ 9816 S FG ! _ 10 Feb 96 _. 17 Dec-03 _.._....~.~ .__4, _ 2701472 WC _ _ ...____,._,_ .'397 ALAMEDA NE~ ,.~ ~-. ~ ._.___.-. kALBUQUERQUE .-._ ,,____ . fNM 01U ._, . .. 05 , 10143,S SI 1 Mar 83 17-Dec-03 2701472 ?WC ~ ~ '397 ALAMEDANE .ALBUQUERQUE µ ~mm~-µ~ ;NM 02IU 30 10143':S SI ~ 1-Mar-83~ 17-Dec-03 2701472 WC ~ 397 ALAMEDA NE ALBUQUERQUE NM : 03,U 20 10143 S 'SI 1 Mar 83 _ 17-Dec-03 __.. _ ., _ 2700403 IWC _ .. ... __ .4212-COAL AVE SE ,d__ .__. -..__. ALBUQUERQUE w_ _. .. NM ? ._ 01U . 30 ~ 9816`S FG 16 May 96 03 17 Dec 2700403 WC 212 COAL AVE SE ALBUQUERQUE iNM f 02 U =05 , 9816 S FG ~ 76-May-96 - 17.Dec-03 .__.,_ .,~.. 2700610. ?WC ._.-.. _....,.___-... m..__.. 4400 COORS BLVD SW ~. __,..~ _ ALBUQUERQUE NM ~. 01 ~U 05 -.,~ ~. _ . 9876 S FG : . _ 1 Feb 96 17-Dec-03 2700610 WC 4400 COORS BLVD SW ALBUQUERQUE ~ ~NM ` 02U `20 9816.S FG ~ 1 Feb 96 17 Dec 03 _...-. _-, ____ .. 2700610 WC 4400 COORS BLVD S1N __.. , . ALBUQUERQUE _~__,_.-___ _i NM t 03 U 30 _~ _ 9816~S FG _.._ 1 Feb 96' . 17 Dec-03 _._._. ...,_ 2707962 IWC ~_ . -_,._,. _ - ;-5101'SAN MATED NE ..-..._ ..____ ,._ IALBUQUERQUE ._.-._,_, _.,._ __.-- NM 01'U ~.._ .. _ _ '.05 ? 11682'S ,FG - . ~.-_ ~ 4 Apr-94? _.__..,. 17 Dec-03 2707962 WC ?.5101 SAN MATED NE N ~ IALBUQUERQUE ~ NM 02 U ,__ ,20 € _ 9816.5 ?FG 4 Apr 94. 17 Dec-03 ..-,,_..._ w_ 2707962 WC w ~. 5101 -SAN MATED NE IALBUQUERQUE -W, ~ ~ NM ~ .~ .- 03xU __ 30 9816 S ?FG t _ 4 Apr 94 17 Dec-03 2700741 "WC ;5501 ACADEMY NE A $ALBUQUERQUE ..._~..~ ,NM ~ 01'U 30 9816 S IFG l 16 Feb-96` ~. _. 17 Dec-03 2700741 'WC !5501 ACADEMY NE ~ . .IALBUQUERQUE INM 02;U 20 , 9816 S =FG ? 16-Feb-96 17-Dec-03 2700741 'WC .~r_...__.,- 5501 ACADEMY NE 'ALBUQUERQUE NM E 03 U `05 .~ __ 9816 5 FG-~ _ _ '16 Feb 96 ,__._..~._.. 17-Dec-03 2701428 sWC 6130 EDITH BLVD NE ALBUQUERQUE NM 01-U 20 10152 S ,SI 1 Mar 81 17-Dec-03 2701428 qWC T6130-EDITH BLVD NE ,ALBUQUERQUE NM I 02;U 05 10152 S SI 1 Mar 81 17 Dec-03 2701428 'WC 6130 EDITH BLVD NE ALBUQUERQUE NM ? ~03RU 45 ' ,> • 10152 S SI 1-Mar-81 17-Dec-03 _.._....__....~,,._W_ 2708745 ?WC _~_ -__~__-..__.-____...._ ?6300 CENTRAL AVE SE .n.__.__.,..~_.__......_~__.__ :ALBUQUERQUE ..~._,w.-_..___ ,___..._._.____ jNM _.__ _.,. 01 U . ..,._ _. 30 -- .~ 9816 S FG , _. 1 Oct 88 _...~.,._..~ 1Z Dec-03 2708745 WG 6300 CENTRAL AVESE ALBUQUERQUE - ~ NM 02 U 05 9816 S FG 1 Oct 88 17 Dec 03 2708745 IWC ,6300 CENTRAL AVE-SE _ A LB UQUE RQUE ~ NM ~ . 03~U 20 FG 9816aS 8~ 1 Oct 8 7 Dec 03 1 2708934 !WC ;1535 COORS BLVD NW~~i _ _ _ ALB0O0ERQUE _ ~ NM I w _ 01~ ~~ _ ~ _ _ X10000 _ _ 1-May-90; _ m14-Dec-05 .,._,_.__ . 2708934 bWC ~ _. 1535 COORS BLVD NW- ~~..._.._._ :ALBUQUERQUE _,.m _ NM ~_-....~ 02' s .. 10000. - 1 May 90~ ..___._ ~.., 14-Dec-05 2708934 WC ?•1535`000RS BLVD:NW '.ALBUQUERQUE `NM ~ ` 03~~ ~ 10000. 1-May-90i '94-D:ec-05 2708935 \NC '5311 QUAIL AVE NW ALBUQUERQUE NM ~ 01 ~ ' 20000 1 Dec 96 14-Dec 05 2708935 IWC '5311 QUAIGAVE NW ALBUQUERQUE _ NM . ..-__. 02~ _ s .-...~., .... .. 10000 __.x_ ~1-Dec-96 .,~ __. 14 Dec-05 __.,_ 2708936 WC ,_ .,-,,_ ,5210 CENTRAL AVE SE _._w.__._.__.__.__ ... ;ALBUQUERQUE _ ._..__._~._..,_ ___ ;NM _.--x--- 01 # ; 120 _ 00/8000 + ~ _ _- 1 Jul 98 __._-U_, 14 Dec-05 2708936 WC 5210 CENTRAL AVE SE =ALBUQUERQUE NM ~ 02' '' 6000 1 Jul 98 14 Dec-05 2708937 `WC '4701- PASEO DEL NORTE =ALBUQUERQUE NM {~~ _ 01 20000' 1-May-99 14-Dec.05 _._..... __ 2708937 WC v W . __ '4701 PASEO DEL NORTE .~ ._ ,ALBUQUERQUE .-_~.__,_..~NM._,- € 02 1 ~ ~ _ - 10DOOe , 1 May 99 µ; __..____ 14 Dec-05 270893T'WC __ w X4701 PASEODELNORTE :ALBUQUERQUE ?NM i 03 ~~' ~ 100004 s 1 w • 1 Ma 99 14 Dec-05 2708940 ?WC 38601 CENTRAL'AVE NE ;ALBUQUERQUE iNM 01; _ ~ 20000 I 1 Feb 00 _ 14 Dec-05 2708940 IWC 8601 CENTRAL AVE NE ~T ALBUQUERQUE _ ~ NM 021 : t ~ 10000's ' 1 Feb-00 14-Dec-05 2708940 IWC :.8601 CENTRAL AVE NE ;ALBUQUERQUE ~NM ; 031 ~ 10000 ~ i 1 Feb OOi 14'Dec-05 _,~._~-.. _ 2708941 `sWC _ ...~.___-.,..-_ .__-____._ __._.-..m,___._____,..~.__.__ 4300 OSUNA RD NE ALBUQUERQUE _. ._ .,~,_... ~NM , 01~ _ F .i__~ 20000°- i _-___.- 1-Sep-00; _..._.._.....,_..__ 14-Dec-05 2708941 tWC 4300 OSUNA RD NE ALBUQUERQUE ;NM 02' 120 _ 00/8000 ; 1 Sep-00; 14-Dec-05 .~--__m~.._ ~ ' ..._ ._..__,_,_.._w. ~ _ ~ ~ ._. ~- ~ --_.__~-~-~-__~ 2708942 WC .....- _._...,__~,._._ 8181 HARPER NE ,.-_ . _.__ __. _ ALBUQUERQUE ~. NM ! 01, 20000 t 1 1 Jul 98 14-Dec-05 270_8942 ?WC w ___... _ .. !8181 HARPER NE ~., -...~__.___.. __ _. , IALBUQUERQUE ._._.. ~,..,.,_..- - ~ ._ (NM I ,_.__._ 02, _ _ _- 10000 ~ --.. 1 Jul 98 I _. ~....._.., 14 Dec-05 2708943 FWC . ,300 LOMAS BLVD NE IALBUQUERQUE NM _ 01 ._.. __, ' __.__.__ . 20000: _ _.~~.._.n_ 1-Dec-00~ -.._....._..____._ 14-Dec-05 a,._~-~ __.__. ._.. 27 08943 IWC ..- W._..~,.-,. _._...m._._..._--_.__... ? :300 LOMAS BLVD NE ~~.,.___.____. ~_.___~,m_~. ~ ;,ALBUQUERQUE -__,.__.__.~. ~__...._,-._..1. ,~ NM , ..-._-. , 02 _ _ .w_., _ . ._-.W-_ 10000 .-_,~.___,.., 1-Dec-00; ._._....,_._,.___~-,. 14-Dec-05 _ 2708944 IWC -1400 MONTANO NE ALBUQUERQUE _ ~ NM .M I ~ 01 , 20000. 1 Aug 021 14-Dec-05 ,_._,_ ....._..~__ ._.._..~_,.,_ _....._-m.-..~..-.-___,.__ 2708944 ,WC ;1400 MONTANO NE ,..,.__,..___._.,...._...,_._._ IALBUQUERQUE _.._.,._.._-,._..,..~,._..,._~_.. <NM ; _.~a 02 - __.._.-,....._ _ ~ 12000/8000 _w__ _ 1-Aug-02' _W.___._....,,_.., 14-Dec-05 2708946 'WC ;9320 COORS BLVD NW ALBUQUERQUE NM I 01= 200001 1-Dec-03 14 Dec-05 m.___ t _ _ _. _. ,......__vw~_ ,~ 2708946 ?WC '9320 COORS BLVD NW °ALBUQUERQUE `NM 02[ _ s 12000/8000 1 Uec 03 14 Dec 05 2708698 WC 6600 2ND ST NW ALBUQUERQUE ?NM 011U 2D 9816~S FG 1 Jun-87; 17 Dec 03 2708698 eWC a 16600 2ND ST NW ALBUQUERQUE ~NM # 02IU 05 I _ 9816 S FG _ 1 Jun 87 17 Dec 03 _~_., ~.- _. 270_8698 ;WC _ _ 66002ND STNW~ ?ALBUQUERQUE ~ ~ r ~ NM 031U ~30 ~ _ 9816'S FG~~ ~ _ _ 1-Jun-87 .-____. r~,.~ 17-Dec-03 2701041 4WC 7660 LOUISIANA BLVD NE ~ _ ALBUQUERQUE -'~~` ~- ,NM --"__.._. 01 U .-~__ .~_. 105 .___.._-. _ __ ; 9816'S FG __--..~..__. 7-Apr-96 _-.__...~.,., ' 17 Dec-03 2701041 4WC _.~ e _ _ _. . _ ..__ _ _w.._ -_ _.._.- __ ;7660 LOUISIANA BLVD NE ._. __ ~.---_. _ .. __ _ . __-. IALBUQUERQUE . __ ~ _._. _. ,_._._ ~NM _ ___ . 02~U __._ _ _... 30 ~ _._ _ _ .. _ 9816'S FG ~ .. _ _ .._ 7-Apr-96 _ ..,---- -.._-_.. , 17-Dec-03 ,.,_ _ _~--. _-- 2701447 ! WC .~ =7817 CENTRAL AVE NE ~__ °ALBUQUERQUE ~--__-....__.._._ iNM 01 fU `30 1 8060SS SI ~ ._..-. 1 Mar-82 17 Dec 03 __.-___,._k__..,_,. 2701447 WC _w_- ._.-, _ __.w._.m.....-.m___.._., ._ ?7817 CENTRAL AVE NE .. ~-__-__.. __._v_ _-__.__ ;ALBUQUERQUE _-__._.._.._, ., ~_ ,~._ iNM __..--- ._,. 02,U _..- _ _,_...._ 20 __.. _._...._._,_ ___M 8060~S SI -._ 1-Mar-82 __._. 1 17-Dec-03 2701447 IWC 17817 CENTRAL AVE NE IALBUQUERQUE INM 03~U 105 8060,S SI 1-Mar-821 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule 12/17/06-07 West Coast Region __ _ _ ____ as of 12113/0_6 _ ____ _ _ __ ____ ___ __ _ _ CAPACITY INSTALL RETRO LOC. # RegionL_ ADDRESS _ CITY __ STATE UST # GALLONS DATE DATE 2705323 WC 18311 GOLF COURSE RD NW ALBUQUERQUE NM E 01 ~U p30 ~ 9816;S FG 22-Jun-96 17-Dec-03 _._.._,_ _,._..w_.....___. w _ ~ _...: ... _. .__.__... 2705323 WC 18311 GOLF COURSE RD NW ALBUQUERQUE sNM ,02 U 20 9816.S FG 22 Jun 96 17 Dec-03 ...._._..._..._._.~._._ __v_____._._..~_._~.._ ..._ .........._,_._ ,...,__......,_._..._.._..___.~.____._____.___~__..-.____ _ ~ .-._. ..._____ 2705323 .WC :8311 GOLF COURSE RD NW .ALBUQUERQUE NM _ 03RU X05 ~ 9816+S FG 22 Jun 96 17 Dec-03 .__.._ .._ _., ..-. _~ _.__, _.w~._ , _ _.._ ......... .____.... __.__ __. _...._ . _x ... _.... . 2700810 WC X712 W MAIN ST 'ARTESIA NM 01 U 45 i 9816vS FG 4 Jun 96 17 Dec 03 2700810 aWC 1712 W MAIN ST IARTESIA ?NM ~ 02=U ~30 I 9816 S ,FG ~ 4 Jun-96 17 Dec-03 2700810 IWC -712 W MAIN ST ,ARTESIA NM 03!U 05 9816 3 FG ` 4 Jun 96 17 Dec-03 __..~..._...._..~_.__.__ __._........ __.._.__. ____~.__..._ ;.~_._____.___ ..._.__ ,__.____.€. ... __.__~.~~_____. ._ ~._ .______. __. __ _ a.......~..._.____s._...__.__._.___ 2700289 ,WC 1700 N MAIN ST zBELEN ~ NM ; 01,U 30' 5960'S FSA 28-May-96~ 17-Dec-03 2700289 WC 700 N MAIN ST .BELEN INM .__ _.. ~....02 U 05 ; 5960 S SSA 28 May 96 17 Dec 03 " 2700699 !WC ,115 W HWY 44' BERNALILLO NM ~ 01!U 20 9816'S ,FG ? 1 Mar 88~ < 17 Dec-03 2700699 ~WC 115 W HWY 44 ~ BERNALILLO NM 02 U 05 9816 S. s FG 3 1 Mar 88..17 Dec-03 2700699 :WC '~115WHWY44 BERNALILLO ~:. .INM ~~031U 30 ~ 9816~S FG `-'-~~ .'_..~"` ,__.__._._._.._._ 1-Mar-881 17-Dec-03 2700561 WC HWY 550 GEN'L DELIVERY CUBA _ NM 01 ~U 05 9684' D. FG l X21-Nov-95~ 17-Dec-03 ..__w_..___.._____ ~..~.____ -._.,.~,_.~...__,..~....._..___._._._.__~W. ._......__._-.__ __...___._.. .._.. .__._ ._ ... _...,____ .__. _~___....._____. ..,_~...~. .__ 2700561 WC ~HWY.550 GEN'L DELIVERY. ;CUBA INM 02U 20 9684 `,D FG_ 21-Nov-95:.17-Dec 03 2700561 ' WC HWY 550 GEN L DELIVERY CUBA ~ NM 03~U 30 9684 D FG . .21 Nov-95 17 Dec-03 _........__._~___ ._....._,__._ __.__._,_.._. ~.. ....u _.- _. ...,_ ._ _______..,... s ~._..__.;~.. 2708945 IWC 6401 HWY 550 CUBA NM 01 1_.~ y~20000' 1 Jun-03 14-Dec-05 _____ ~__._ ..._..-.__,._.__._._....__.__..._,..-__.._.__t.. __..~.___.._..._._.~..._...___ _ ;6401 HWY 550 CUBA _.___ N~_,-.._ ....._..__ .;_,__..~,.._ , . ______ ... __.__._.__ 2708945 ,WC _ ~ _ ~ 02Lr _ ~ ;12000/8000 1-Jun-03 14-Dec-05 2701436 =WC <844HIGHWAY~516-'~.._m. FLORA VISTA NM.__..., ~~~011U `45: ~ °~~'"""""_ .._..__.,.._.._. 9816•S FG : 16-Oct-95 17-Dec-03 2701436 ;WC 844 HIGHWAY 516 FLORA VISTA NM ? 02.U 20 i 9816 S FG t 16-Oct-95- 17 Dec-03 2701436 'WC j844 HIGHWAY 516 'FLORA VISTA NM 03 U _ 05 ` 8816 S FG ' 16 Oct 95~ 17-Dec-03 _.._..__ ...__. ____..s.__ _ _.__..._.__m.__-.. __.._..~ ___.._ ___ :_.. _r _._ ...__.__ ~.._____.._._.__ 2700278 ?WC '617 W PICACHO.AVE 'ALAS CRUCES NM ,,..____ep1lU 30 , 9816rS -FG 24 Feb-95; 17-Dec-03 ._._._,___~--....._.__ _..-.~..___.._______._.___..._._..._, _...,__ ..y__,.._ _w.___._.......,~ __ _n_..._._ ..__~ ~ ________....__ ... ..___.__....__.._._,- _____-._.~,.,___. 2700278 jWC 617. W PICACHO AVE :LAS CRUCES NM = 02 U E05 i 9816S 3FG = ~24-Feb=95f 17-Dec-03 __..~.~ 2700278.gWC '.617 W PICAGHO AVE sLAS CRUCES NM 03 U j20 9816~S FG 24-Feb-95. 17-Dec-03 m___ _.. ~_ .. ,.~.... .... .. 2708938 IWC ,1860 MAIN STREET NW LOS LUNAS NM ~ 01 20000 ~ 1 Aug 99 14 Dec 05 __.__._.. _. __._.~ ,.._......._. _ ~. .__.. .. __.... ____ ...._ _..__., a,~__.. .___.._._ .~... _._.._.. _.,__ ___.,....___._ ..w. 2708938 ?WC 1860 MAIN STREET NW LOS LUNAS `NM 02 ~ ',1.0000/10000 1 Aug 99; 14TDec-05 _.__._ a ._._..._.._._.__ w.M.____~._---- ___._.m_ ..~. 2708939 WC 1100 NM HWY 528 .RIO RANCHO INM 01 20000 1 Apr 00 14-Dec-05 2708939 'WC 11100 NM HWY 528 RIO RANCHO INM 02 e i1.0000110000~ . # 1-Apr-00 14-Dec-05 __...~.--. ,. .__._..-._.._~...w_.._ ._.. __. _ _-___..~......_ _.,._.-_____.__..____,___._ _._ _,___ ___ _._~_ __ __ .....__..__ .._,__-.__.-.__ 2701481 WC 13213 N MAIN ROSWELL ,NM 01 ~U 45 s ` 9994 S SI 1 Mar-83 17-Dec-03 _..,. __, . _. .. . _. ,. _ ... _.. __ ___..._ _._..w._ .__.., , . __ ._.. . _._ _..__. _.__._.,. .-,..._. _-_ .___ __..... _... __ _. ... . 2701481 .?WC' 3213 N MAIN - [ROSWELL INM 02 U 30 , ~. 9994`S~ SI .; 1-Mar=83~ 17-Dec-03~ 2701481 WC :3213 N MAIN _ #ROSWELL NM 03 U ' 05 ~. 8994iS SI 1 Mar-83: 17-Dec-03 2701481' IWC 3213 NMAIN- ~~ =ROSWELL - ~- :NM~mf- ~ ~~ 04:U `20 E :. ~~ 9994~S SI ~_,._• ~ ~~~* ~1. Mar-83 17-Dec-03 __.__. _.,__ ___._ _ __ ~ .. .. _. ` r_ ._ ._.. 2701341 ' WC 'HWY 70 PO BOX 907 ;RUIDOSO DOWNS NM 01,U 120 10152 S SI 1'Mar 79 17 Dec 03 2701341 - WC .HWY 70 PO BOXrv907 :RUIDOSO DOWNS NM ~ Iw~~02~U 30 , 10152n:S SI 1-Mar-79 17-Dec-03 2701341 WC HWY 70 PO BOX 907 'RUIDOSO DOWNS - NM ° 03lU r05 ; ~: 10152 S SI 1 Mar-79 17 Dec-03 .. _._._....,-.. ~......_.._..,...._~_.._.......~___ _...,.___ .~.__ ~._,__.,_.,.._____. _... __ _. .. ,..____...~,.. .._.__..._.__m 2708933 iWC -,1315 E WILL ROGERS DR ;SANTA ROSA .NM 011 G 10000 1 :Jul.92s 14-Dec 05 2708933. ! WC 1315 E WILL ROGERS DR SANTA ROSA NM 02's I 1 10000 ~ 7 'Jut 92~ 14 Dec 05 _m.. 2708933 °WC 1315 E WILL ROGERS DR -SANTA ROSA ;NM 03f ;, , ,10000 1-Jul-92k 14 Dec-05 2700515. IWC I918 N DATE ST : TRUTH OR.CONSEQUENCESJNM 01 U 30 , 9816~S sFG 1-Nov-88`. 17-Dec-03 2700515 1WC 918 N DATE ST ITRUTH OR CONSEQUENCES NM 02 U 05 , 9816',S FG } 1-Nov-88; 17 Dec-03 ___ a _ _-________. _.m_........ -.______._ _.....,_..-..._ ~_. --~-- ~. __. .__~___ 2700515 FWC 918 N DATE ST TRUTH OR CONSEQUENCES NM ¢ 03;U `20 9816 S FG , 1 Nov 881 17 Dec-03 270_0839 iWC 601 ETUCUMCARI BLVD,TUCUMCARI ;NM 01=U 30 9816 S ~FG_~-. 1m Mar 87 17 D_ec-03 2700839 jWC '601 ETUCUMCARI BLVD (TUCUMCARI INM ~ 02U 05 1 98161S IFG I 1-Mar-87~ 17-Dec-03 ... _......_.~.__..._. __x_._._M.__.._....._...~_...~__._.._ ..._._____._.._..___.. ~_.__...._ _~_.__ ._ . ..___..__. ___.__.~____.__ ,~___._ __.w_._ .__._.~._.__.._..._,..._.~._ ~_..__.___._.. 2708931 !WC ',2624 SOUTH 1ST STREET tTUCUMCARI NM 01~ ! 10000] E ! 1-Jul-79 14-Dec-05 ......_..._ _._. _ ...a._...____._ ,_...._.._..,..,.,--._..._.....____..~.._.....__._._ ___.. _ ___ _._.._--~__.._ .~__.~ 2708931 WC :.2624 SOUTH 1ST STREET µ ~mM-µ ~" -M~~~µ~~~~µ~~~w--µµ~"~~~T TUCUMCARI NM 021 10000: ~ ~ 1-Jul-79I 14-Dec-05 ... _ .._...,.._,.,...m.......~..._......,....~... ._._._. _._.._ .. ~.._.. :.. _.__.._.~.. _.,..4..v ..~, r._......._._-..,..__.....~..-.......,___,,..,.~. 2708931 ' WC '2624 SOUTH 1ST STREET TUCUMCARI NM 031 s ~ 10000• 1-Jul-79 14-Dec-05 2708931 `WC 12624 SOUTH 1ST STREET .TUCUMCARI NM ~ 04, j ~ 100000 , I 1-Jan-90, 14-Dec-05 .. _._ __. µ.°-__~ _ _ ___-.. ._..~.. _. 2708932 iWC 201 E TUCUMCARI BLVD TUCUMCARI NM 011 7500- 1 Jan 86' 14 Dec-05 .._ _. _.w _.__,.__ _ __..._.,. 2708932 WC 201 ETUCUMCARI BLVD eTUCUMCARI NM __ 02~ ~ ~~ 7500 1 Jan 86~ 14 Dec-05 __ ~__ _.~,_..__._.W.n_.__.___ .,n.__ ____..m.._.__..._.___._.-.__. _ _. _a_... ..__~_ _-.,____ _.-__. 2708932 WC '201 E TUCUMCARI BLVD TUCUMCARI NM 03` 9 ~ 7500- ( 1-Jan-86' 14 Dec-05 2701641 IWC '601 S MAIN ANTHONY TX ~~ `~ ~ _"~- ~_- ~ ._._._._ 01 U `30 10152:S FG 1 Mar 85 17 Dec-03 ._..,W. .. _..._._._._.__._. _:..~ .__._~ __ _ _ __ ._..._.M. 2701641 jWC 1601 S MAIN ANTHONY TX 02 U 05 10152 S FG 1 Mar 85' 17 Dec-03 2701641 WC ]601 S MAIN .ANTHONY TX 03"U 20 ~ 10152!S FG 1 Mar-85 17-Dec 03 _._. _.; .. ,,~__.__...v._.._..__._._. __. ...__.. __ .._._._ ~_....~_ .__.~__._. .._..____ _. _~.._._. ____. ._.._._. _ ..._, ., ____..-k...-...__.._.._... 2706104 WC 1.10100 MONTANA EL PASO TX ~ 01:U 05 ; 120321S SA 1-Feb-87: 17-Dec-03 2706104 iWC ?10100 MONTANA DEL PASO TX 02'U 20 10152 S SA 1-Feb-87° 17-Dec-03 2706104 WC X10100 MONTANA EL PASO ,TX 03 U 30 I 12032 S SA I 1-Feb-87 17-Dec-03 2701257 WC 110567 RUSHING RD EL PASO TX 01 U 20 10152 S SI I 1 Mar 78; 17-Dec-03 x_._w._._~__ _.......... _ ._ __., __,.~._ _<.. _.__. ..... _ . 2701257 'WC ]10567 RUSHING RD EL PASO TX 02rU 30 , 10152 S ;SI 1-Mar-78; 17-Dec-03 _____ _,_t_ __.w~__.__._____.__._..____~_.____.,____...~..._.___.._.._..~_.._. .n__.____,_,__._._.. , _._.__ __ _ _.r.._.._..____.._._ _.___~.__..._____._.~._.__ ___.__._. 2701257 3WC 110567 RUSHING RD EL PASO TX ~ 03 U 05 10152 S SI ~ 1-Mar-78~ 17-Dec-03 2700481 WC 110616 MCCOMBS ST ~¥EL PASO ~mm~mm.V v rvTX ~y01~U~ 1.05 ' 11682 S ,FG ~~ 1 May-94 17-D_ec 0_3 ..a., .__..__ __ ._ •2700481 iWC ;10616 MCCOMBS ST =EL PASO iTX ? 026U ::20 i 9816~S FG 1-May-94' 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _ -__ 12/17/06-07 ~ ' West Coast Region ____ ______ as of 12_/13/06___ __ ~ -- CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE -~ ----- - 2700481 WC ?10616M000MBSST EL PASO TX 03~U 30 i 7950 S'FG I 1-May-94~ 17-Dec-03 2708515 WC ' 1073 COUNTRY CLUB R_D EL PASO TX 01 U 05 10152 S FG ; 1-Jan-87' 17-Dec-03 -_ _. _ ~_......__.~.._.._,_.__~.._..._.__ _ r _ ___-__.._.__......_.._.__ 2708515 tWC '1073 COUNTRY CLUB RD EL PASO ;TX 02 U 20~` 10152 S ~FG ; 1-Jan-87 17-Dec-03 ~ _ EL PASO - _-_._.....- ~--~ ~.~'~TX 2708515 WC 1073 COUNTRY CLUB RD ~._ __ 03~U +30 ? 10152 S FG 1-Jan-87; 17-Dec-03 --.--- ~__.____ . - ~ _.__Mµ __ . _ ___ __.__m___._._W_-_.________._. 2700020 WC ;10744 VISTA DEL SOL DEL PASO _ F 'TX ~ 01 U 05 11682:µS MFG 25-Nov-93: 17-Dec-03 2700020 WC10744-VISTA DEL SOL DEL PASO iTX 02'U '20 4 9816?S {FG ~ 25-Nov-93 17-Dec-03 2700020 ; WC ~ 10744 VISTA DEL SOL EL PASO TX 03 U 30 7950 S FG = 25 Nov 93 17-Dec-03 2701674. WC ~-10770 DYER ST `EL PASO ;TX 01 `U 30 97i?8 S MFG ` ~~1 Mar 851 17-Dec-03 2701674 WC 10770 DYER ST aELPASO TX 02~U 05 7 , . 9728S FG '1-Mar-85,# 17-Dec-03 ~~ __ _ 2_70_16_74 WC ?10770 DYER ST _ _ EL PASO ~ ~ __ sTX~ 4.mµ _ 03~U ~;20 1 t ; : 9728~ SµiFG i ~ 1-Mar-851 17 Dec-03 ` V µ~ ~~ M 2700213 WC ~1.1096 PEBBCE HILLS BLVD EL.PASO _~ TX 01 U 05 9816 S FG ~ ~ 4 Aug-94~ 17 Dec 03 2700213 WC 1`1096~.PEBBLE HILLS BLVD- EL PASO TX 02 U 20 9816 S FG ; Y 4-Aug-94i 17=Dec-03 00 13. WC' 11096 PEBBLE;H6CLS BLVD EL PASO _ TX 03 U 30 , : ' : .9816 .S FG x 4 Aug-94 17-Dec-03 _ 2700890 WC 11101 MONT.WOOD"DR- ~' '- EL-PASO - _ TX __ 01 U 30 x9728 S FG 1~ 1-Ja n-86:. 17=Dec-0 3 _ _ 2700890. WC 11101 MONTWOOD DR EL.PASO TX " 02 U 05 9728 S FG ~ 1-J8n-86? 17-Dec;03 _ 2700890 WC 11101 MONTWOOD DR EL.PASO TX : 03 U 20 9728 S'. FG t 1 Jan..=86 17-Dec-03' 2706309 WC 11390'MONTWOOD DRIVE EL:PASO" ~ TX ' 01 U 05 ... 11682 S FG .:8-Jan-99 17-Dec-03 2706309 WC 11390 MONTWOOD DRIVE. EL-PASO TX '02 U 20 9816 S FG 1 '8-Jan-99 17-Dec-03 2706309 WC. 11390"MONTWOOD DRIVE EL PASO " " TX 03 U 30 " 9816~ S FG 8 Jan 99 17- Dec -03 2706309 WC . 11390 MONTWOOD DRIVE,• EL•PASO - TX 04 U 45 ;- 7950 _ _ xS'FG 8 Jan.99 17-Dec-03 2705312 WC 11701 MONTWOOD DR' EL PASO TX 01 U 30 96161 r.__._ _„___.._._~. S ~FG ' 1-Nor-94 17-Dec=03 2705312 WC 11701 MONTWOOD DR EL PASO _ TX 02 _ U 20 9816~S ; FG~ ~ 1 Nov-94' 17 =Dec-03 2705312 . WC 11701 MONTWOOD DR " EL PASO TX 03 _ U 05 _ ~-- ~' ~rr~~'~--~ 11682~S FG' 1-Nov-94 '17-Dec=03 2706308 WC. 1320 GEORGE DIETER : _ EL PASO _ TX 01 U 05 - - ~ ~-._--'~- -- 11682: S r FG 5 Mar-98 17-Dec=03 2706308. WC . ".. 1320 GEORGE'DIETER EL PASO TX ` 02 U 20 ?'':::11682 ,S . FG ; 5-Mar-98~ 17-Deo=03 2706308 WC 1320 GEORGE"DIETER EL PASO TX - '03 U 30 9816 S FG 5 Mar-98' :17=Dec-03 2706454 2 .WC : 1400'LEE TREVINO : EL PASO TX - O1 _ U _ _ 05 ~ '20055 S _ _ FG E 2 Aug 0"I~17 Dec-03 706454 WC - 1400"LEE TREVINO EL' PASO .. . ` TX 02 UC1 30 ?12068 S _ FG F f 2-Aug=01; 17+Dec-03 2706454. WC 1400 LEE TREVINO . _ EL' PASO ~ TX : 03 UC2 45 7981 S FG ~~~ 2-Aug-01 ~~ 17-Dec-03 2701227 WC "" 1400 W YARDELL DR EL PASO TX 01 U 30 9728 S FG = 1 Apr-84 17 Dec-03 ~ 2701227. WC 1400.WYARDELL DR EL PASO. TX 02 U 05 ~. .9728 S .~.-. FG 1 AprP84;y 17 Dec-03 2701227, WC _ 1400 W YARDELL DR EL-PASO ` :. _ TX 03 U 20 ;9728 5 FG 1-Apr=8 4S '97-Dec-03 2705305 WC `.14.71 N ZARAGOSA __ EL" PASO- . TX. 01 U 30 _ 9816 ,S _ FG g. 1 Ma y-9617-Dec-03 2705305 WC . 1471 N ZARAGOSA _ _ _ EGPASO ~ --- TX 02 __ U ` 20 ' :; 9816 .S ; _ FG k ~ 1 May96 M1~7 Dec-03 2705305 WC 1471 N ZARAGOSA :. EL'PASO ~' TX 03 U 05 ~ `, '11682 S 3 FG i 1 `May 96~ 17 Dec-03 2701506 •. WC : 1500 GEORGE DIETER DR -- EL PASO TX 01 U 20 ,: .: 10152 S: _._ FG 1 Jan,87:.17-Dec-03 2701506- WC ` 1500 GEORGE DIETER DR' EL PASO - , TX 02 U 30 ;'1-.0152 .S FG-F~~~'1:-Jan-87~ 17-Dec-03' 2701506 WC " 1500 GEORGE DIETER DR EL.PASO ` TX _ - 03 ~ U 05 101:52 S' ~"-'""-~""'~ FG • 1 Jan=8~ 1Z-Dec-03 2708775 .WC :1520 LEE TREVINO : ~ - EL PASO - -- TX `•.'01 U 20 'c .9728 .S FG ! 1 Sep-88~ 17-Dec-03 2708775. WC 1520 LEE TREVLNO _ EL PASO TX 02 U 05 ' 9728 .S -.....__-_.~,_._._..~__...__w.__..._.. FG ~ 1-Sep-881 17- Dec-03 2708775 _WC _ 1520 LEE TREVINO EL PASO - TX 03 U 30 9728 S _ FG ~ ~ 1-S ep-8 8~ 17-D ec-03 2706307 WC1600 ZARAGOSA ~ ~ EL PASO ~ _ TX_ ~~01 U 05 11682 S _ _ _ _ FG ~ 19-Mar-98 17-Dec-03 2706307 t WC ? 1600 ZARAGOSA ~ EL PASO TX 02 U 20 11682 S _ _ FG r 19-Mar-9 81 1 7-Dec-03 2706307 WC _1600 ZARAGOSA EL PASO _ TX _ 03 _ U 30 9816 S _ _ FG °- -LL19- Mar-98 17-D ec-03 2701482 IWC 11798 GEORGE DIETER DR EL PASO _ TX 01 U 20 9816 S _ _ FG ' ~ 1-Mar-84~~17-Dec-03 2701482 WC ;1798 GEORGE DIETER DR ' EL PASO _ TX _ 02 U 05 9816 S _ - 1---"°---~---- FG ~ _ 1-Mar-84= 17-Dec 03 2701482 WC '1798 GEORGE DIETER DR I._... __ EL PASO TX 03 U 30 9816 S - `~-----µ--°-.- -------°-~--~- FG i 1-Mar-84~ 17-Dec-03 2706130 sWC 12200 N MESA ? - EL PASO - TX 01 - U 05 11682 - S ~-_.-___._.._.__-- -_..____....w.~_... FG ; 25-Mar-99' 17-Dec-03 2706130 WC ?2200 N MESA EL PASO TX 02 U 20 9816 S - . _,~ _ __-__,.__.,.___,_ FG 25 Mar-99' 17-Dec-03 2706130 WC '2200 N MESA EL PASO TX 03 U 30 9816 S FG 25-Mar-99' 17-Dec-03 2700026 WC ..3101 MCRAE BLVD ,. _ _ EL PASO -- TX 01 U 05 10152 S ___.._. .._...___,-...._... m SI 1 A 79' 2700026 WC 3101 MCRAE BLVD EL PASO_ T X 02 U - 20 s _ 10152.S - pr- : 17-Dec-03 .... _._. ,w__....~___.. SI 1-Apr-79; 17-Dec-03 2700026 tWC :3101 MCRAE BLVD ~ ___ EL PASO _ TX I 03~ U 30 I 10152 S SI I ~- 1 Apr 79~ 17 De c-03 2701418 1WC 3910 A DYER ST -=--- _ EL PASO -- TX ' 01 U 20 ~ _ ___.. 10152°.S _ SI 1-Apr-81 17-Dec-03 2701418 ; WC :3910 A DYER ST -- EL PASO --. TX . .° 02~ U X - -' 05 I °_ ---- 10152 S ~-.._.---.--____.._,:.~ ...-..-..~..__ SI 1-Apr-81 17-D ec-03 2701418 ;WC =3910 A DYER ST EL_PASO __ ___ ~ TX ~ 03I U ' 30 1 10152'S _ SI ~ 1 A r 81' ~17-Dec-03 p ~ 2708516 ' WC -4101 N PIEDRAS -- -. __ -_______ _ EL PASO _____ __ ~ ~ TX p __-' 01 ~ ~ U '~" 05 1 `~ "" 9816`S -_ _.._._ .M~ ~ FG 1 Apr-87, 17 Dec-03 2708516 FWC :.4101 N PIEDRAS -~---- -.-- -- ---_-_-_ _ ___ EL PASO _ ------_-- _ - i _ ____ T TX = _~ 02 U """ ~ 20 `" 9816: S --~ ~ ------.-.° FG 1 Apr 87 ~ 17-Dec-03 2708516 WC :4101 N PIEDRAS C EL PASO 1 -- TX -m~- 03' $ U 30 ` _ - 9816S ~ ~ ~ FG ~ 1-Apr-87; 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 73 Circle K Tank Schedule 1 West Goast Region 12/17/06-07 of 1 as 2/13!0 6 _ _ _ _ _ ___ LOC # R i _ . _ _____ L I L D . eg on~~_ _ ___ ADDRESS - . _ CITY ` STATE UST # GAL ONS DATE DATE 2705313 ,WC 4501 WOODROW BEAN-TRANSMOUNTAIN I EL PASO I TX 01 U ; 30 ~ 9816#S FG 23-Nov-941 17 Dec-03 2705313 °WC `4501 WOODROW BEAN-TRANSMOUNTAIN _ _ _____ EC PASO ; TX l 02 U 20~ - 9816S FG ; 23 Nov 94 17 Dec-03 2705313 jWC 14507 WOODROW BEAN-TRANSMOUNTAIN , EL PASO i _~ ..__.._ TX ~ . 03. ` U 05 11682ES _ n_._._-... FG € 23 Nov 94j 17 Dec-03 2706288 .WC '5665 DESERT SOUTH BL _ ~~ - EL PASO _ TX 01 U 05 ? 116 82~S FG 25 Jun-9 9~ 17-Dec-03 2706288 ~WC ;5665 DESERT SOUTH BL EL PASO TX 02 U _ 20 ~ 9816rS _ _ FG 25-Jun-99~ ~ 17-Dec-03 _ 2706288 iWC 5665 DESERT SOUTH BL __ EL PASO ~ TX _ 03 U 30 ! __. 9816S FG ~ ~~25-Jun-99~ 17- Dec-03 2706288 ~WC~~ 15665 DESERT SOUTH BL EL PASO TX 04 U 45 ~___._.__..--9816-S _ FG iy~25-Jun-99 17-Dec-03 2705306 WC x6095 MONTANA AVE _:: ' EL PASO TX 01 U 45 i . 7950'S FG : 12 Sep-951 17-Dec-03 _ 2705306. =WC ;6095 MONTANA AVE EC PASO TX 02 U 30 ` ~~9816 S FG ~ x:12 5ep 9 5f 17 D ec-03 2705306 WC ?6095. MONTANA AVE - _ EL PASO TX 03 U _ 20 ~ 9816 S _ _ _ FG X12-Sep-95} 47-Dec-03 -- 2705306 WC ?6095 MONTANA AVE ~-_ EL PASO TX 04 - U . _ 05 11682~S' r ..,.~~ FG t -12 Sep 95~ 17 Dec 03 2706126 -_WC 6148 GATEWAY E • EL PASO ~ TX -` 01 U 05 d ;: 12032S _ ^ .._ SF w. 1-Nov=85; 17-Dec-03 2706 21 6 W t C 16148 GATEWAY E -_ EL PASO TX 02 U 20 ~ 120325 SF I ; ~I-Nov-8 5 17-Dec- 03 2706126 WC ' X6148 GATEWAY E _ _ EL PASO TX 03 _ U 30 S ~' 8068'S _ _ _ SF µ 1 Nov 85 17 Dec-03 ~ ,.._ 2706098 ~WC ~ 6200 N MESA ~ ~ EL PASO ~ ~ ~ ~ TX ~01 U _ 05 b ~~ ~ 11682S~ .FG ~ ~25- Feb;99~ 17-Dec-03 2706098 !WC 6200 N MESA - -- EL PASO . TX 02 U 20 ` 9816'S FG 25 Feb 99~ 17 Dec-03 - - 2706098 ~WC `6200 N MESA --- EL PASO '' TX 03 U _.~_.. _F 30 , ,- 9816S ~..,._._..__.___~..___._-_.~.....__- FG i .25-Feb-991 17-Dec-03 2706098 WC 6200 N MESA EL PASO TX 04 U 45 7950 S z-- y FG =~25 Feb 99 17 Dec-03 . ._..___. ,._.._.. 2700616 ;WC ;6398 DONIPHAN DR EC PASO TX 01 U 05 i ~W' 11682S , - FG ~ 1-Nov-931 17-Dec-03 2700616 WC 6398 DONIPHAN DR EL PASO . TX 02 U 20 ~ 9684S FG 1-Nov-93' 17-Dec-03 2700616 ;WC 16398 DONIPHAN DR• _ EL PASO __ __ TX 03 _ U 30 7950'S FG'~ 1-Nov-93 17-Dec-03 _ 2701534 -WC x650 N RESLER DR ~m _ _ EL PASO _ TX __^01 U 30' ~ 9816.'.'-S. FG ~~~1-Feb-86 . 17-Dec-03 2701534 ?WC -650 N RESLER DR' __ EL PASO TX 02 U 05 „~w~ 984o`S FG ~ 1~Feb-8e: 17-Dec-03 2701534 ;WC 6'50 N RESLER DR EL PASO TX 03 U 20 a 9816 S : FG ; 1-Feb-86' 17-Dec-03 ._...... 2705315 , WC 680 E REDD'RD ~ : ' - -- - EL-PASO TX -- 01 U 30 ; 9816' S . b..._..._..._.mm..-...,. -..._-_...._,___ FG ' w5 Feb 96 1:7-Dec-03 2705315 iWC I680'E REDD RD EL PASO 'fX 02 U 20 g ; 98165 FG '5=Feb-96+ 17-Dec-03 2705315..WC !680~E REDD RD fL PASO TX •03 U 05 -'. 9816S FG ; 5=Feb-96 17-Dec-03 2701190 ANC !6996 ESCONDIDO - := . EL PASO . - :' TX ? 01 U 05 ~ 11682`S FG 1 Apr-94 17=Dec-03 2701190 WC 6996 ESCONDIDO '^ EL PASO . ~ ~ . TX 02 U 20 9816°S . FG ~ 1-Apr-94 17=Dec-03 2701190 WC (6996 ESCONDIDO = EL PASO ` TX 03 U 30 ! ,. 7950S FG 1-Apr-94 .17-Dec-03 2706333 tWC 700 AMERICAS AVE EL PASO _, TX 01 U 05 . 11682 S :FG ? . 7~Oct-99 17-Dec-03 2706333 WC 700'AMERICAS AVE ~ EL PASO. TX . 02 U , 20 9816;S FG , : 7-Oct-99 1.7-Dec-03 2706333 °WC ZOO AMERICAS AVE _ _ _ EL PASO _ TX _ _ 03 U 30 9816•S FG f~'j 7-Oct-99 47=Dec-03 2706333 tWC Z00 AMERICAS AVE :: EL PASO : ~ TX 04 U 45 9816S FG - 7-Oct-99~ 17-Dec-03 2700450 :WC mmY 7100 N LOOP RD _; .' .; ; ._ ° ~ EL PASO ' = ;: _ TX 01 U _ 30 ~ :7950: S, -m___ ~~ FG 7 Apr 941 17: Dec-03 2700450. WC 7100 N LOOP RD ~ ~ __ EL PASO . ~ TX 02 U . OS = 11682 S FG ~-~ 7 Apr 94~ 1Z Dec-03 2700450 . WC '7 ~ _ __ _ ~ 100 N LOOP RD .., _ EL PASO .: TX: ; 03 U 20 9816 S. .FG 7-Apr-94~ 47-Dec-03 2701429 :pWC '7300 N MESA ST EL PASO _ " TX '01 U 30 10152 S SI ' . 1-Mar-82~ 17-Dec-03 270 241 9 WC 7300 N MESA ST _ ~ __ EL PASO..: TX 02 U 05 w;m10152`S SI y w7~Mar-821 .17-Dec-03 2701429 ~WC _. .7300 N MESA ST ~ ~ _ _ EL PASO _ - TX ~ 03 _ __ U ~ 20 . '10152sS SI 1- Mar-82~ 17-Dec-03 2706112 'WC '7800 GATEWAY E IM. _ _ EC PASO __ . TX 01 _ U 05 = ~ 11682`S _ _ FG 17-Jun-98j 17-Dec-03 2706112 iWC 7800 GATEWAY E ___ EL PASO TX 02 _ __ U 20 _ 9816`S _ _ FG ~ 17 Jun-98' 17-D 03 1._._._.__ _ -- --- 2706112 WC )800 -- - ~....,.,.. -._..m_ ec- r~__, .~ ~~._-__e.._.~.m~ ___ . , GATEWAY E EL PASO TX 03 U 30 ~ 9816' S FG ~ 17-Jun-981 17-Dec-03 2706112 sWC ;7800 GATEWAY E ___ EL PASO _ TX 04 U 45 ~ 9816 S FG S 17-Jun-981 17-D ec-03 2701508 (WC X8726 MONTANA AVE ~~ EL PASO TX 01 __ U 20 ; mm ~ -9816:S _ FG 4; 1-Feb-86~ 17-Dec-03 2701508 WC j8726 MONTANA AVE_ EL PASO ___ TX 02 U 05 i ~mm98165 _ FG ~ 1-Feb-86~ 17-Dec-03 2701508 ~WC 8726 MONTANA AVE EL PASO TX _ 03 _ U 30 i.__~..M_ 9816S .~m,-_..~___-_____ ~~._..__.~~.-.~ FG_ 1-Feb-86; 17-Dec-03 2708743 =WC ;8855 N LOOP ' _ ~ - EL PASO -- TX 01 U 30 9816NS ~ FG ' 1-Aug-88' 17-Dec-03 2708743 ;WC '8855 N LOOP _ _ __ 27087 3 ~ ' EL PASO ____ _ TX -- _ 02 --- _U___ ...-_m W__..-..., 05 ~_ 9816~S ~~ _._ .M_ _. FG 1 Aug 88 17 Dec 03 4 WC 8855 N LOOP 2706089 IWC 9497 DYER _ w - - EL PASO EL PASO TX TX 03 01 U U 20 9816S 05 ? 12032`S FG ~ 1-Aug-881 17-Dec-03 SA ` 1-Aug-88 17-Dec-03 2706089 WC :9497 DYER --- -- --- ___ ._ EL PASO _ ___.- TX 02 U _-___.__.-._ _ 20 1 12032;S ~._. -,.,_._ ..._.._-_____ SA ? 1 Aug-88, 17-Dec-03 2706089 WC `9497 DYER - EL PASO TX __._ 03 .. U , -_-_,_ . - 30 10128'S -__..._.._.__-.._. __,.a_..._... SA 1-Aug-8& 17-Dec-03 2701136 .WC '204 5 MAIN ELLENSBURG _ WA 0 i U 05 9816 S FG 30-Apr-95~ 17-Dec-03 2701136 ;WC ':.204 S MAIN __ ELLENSBURG ~ WA _ 02 __ _ U 20 ? ~- ~ 98161S FG 3 0-Apr-95~ 17-Dec-03 2701136 ?WC 1204 S MAIN 2701452 WC -:2415 GRIFFIN AVE .._ ELLENSBURG ENUMCLAW WA WA 03 01 U U 130 9816 S 30 ~ 9816 S ~ _ FG 30-A_pr-95 17_Dec-0_3 FG ° T21-Apr-95 17-Dec-03 __ T __ _-_ 2701452 WC -2415 GRIFFIN AVE 2701452 jWC ;2415 GRIFFIN AVE __--- _ ENU_MCLAW r WA -_-- 02 U .___..._._,.....-...._ 20 9816~S ~ _...._ __ .._.- _..--._.__~___e. FG __21 Apr-95 17-Dec-03 ENUMCLAW WA 03 U 05 ; 9816S FG 21-Apr-95, 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule ----"--------------- West Coast Re ion 9~ 12!17/06-07 ----------------- as of 12/13/06 --- --- --a ---" -~ CAPACITY -- ---------- ----- INSTALL LOC. # Region ADDRESS .CITY STATE UST # GALLONS RETRO DATE D __ ___ ___ __ 2701546 WC i 10255 SE 240TH ST - ._._ .., __ __ KENT WA 01 _ U 30 -- I 9728`S FG ATE ' 1-Mar-85 17-Dec-03 2701546 'WC X10255 SE 240TH ST __ KENT WA 02 U 05 9728°S FG ~ 1-Mar-85 17-Dec-03 _ 2701546 WC '.10255 SE 240TH ST - KENT WA 03 U -i"~"""mm°`""-""" "- 20 9728 S ; '°°°'"'y°-°--°-"y'N~---°°--------- FG ~ 1 Mar 85F 17 Dec 03 --- 2701602 WC .20727 108TH AVE SE ..__. 2701602 W X KENT __ WA 01 U - - 05 9728 S _ ~ " FG ~ 1 Apr 85~ 17 Dec 03 C 20727 108TH AVE SE _,.. ___~ KENT WA 02 U 30 9728 S ~ FG 1 A r 85 17-Dec-03 - 2701602 WC ;20727 108TH AVE SE _..-.- KENT WA 03 U , ._.,. W_ 20 9728',S F ~___ ...p... ~ ,._..__--_~___ FG ; 1-Apr-85~ 17-Dec-03 2708878 'WC ;8007 STATE AVE .., - MARYSVILLE WA 01 U 20 ? 9816S FG ; 1 Sep-87` 17 Dec-03 3 2708878 ;WC ?8007 STATE AVE _ MARYSVILLE .? WA 02 U _ 05 , 9816~S __ a . .,._»__....__._, FG 1 Sep 87 17-Dec-03 2708878 WC -18007 STATE AVE _ MARYSVILLE WA 03 U 30 i 9816~S __ FG . fµ~~1-Sep-87' 17-Dec-03 2708567 WC ;1700 132 ST SE __ - _ MILL CREEK __ WA 01 U ~` 20 9816 S ""-"- ~ ~"`-"'-"-.~. FG ; 1 Oct 88 17-Dec-03 2708567 'WC _ ~ 1700 132 ST SE __ MILL CREEK WA 02 U. . 05 } ~~~ 9816S FG i A~1-Oct-88 17=Dec-03 2708567 `,WC 1700 132 ST SE "M- MILL CREEK ... WA 03 U 30 ' ' ..._. -~-- 9ai~16zS ~ ~~""~ - _,."- ~_ "~' FG ; 1-Oct-88 47-Dec-03 2705925 ?WC 9061 DELRIDGE WAY SW SEATTLE .._ ~. WA 01 U 20 8025 ~D SF I 1-Jan-91 17-Dec-03 2705925 WC ;9061 DELRIDGE WAY SW _ SEATTLE __ WA 02 U 05 t 10058 D SF 1 Jan-91 17-Dec-03 2705925 _ WC 19061 DELRIDGE-WAY SW --.-----."__ SEATTLE ' _ WA 03 - U `"" 30 8025 ;D -" "'"""" ~°`°°°'-~~ SF 1 Jan-91 17-Dec-03 2705925 # WC ;9061 DELRIDGE WAY S_W_ ---• __ SEATTLE _ WA 04 U , -°~° "-~" 45 , 6048 D - --•- - ----~~-__.___ SF 1 Jan-91 17-Dec-03 2708795 WC ;4704 OAKES ST, SUITE 100 .---- TACOMA- -- WA - 01 - U 30 9816 =:D "- '""~"~"" ~""°"-`--'--"- FG ~ 1 Apr-89; 17-Dec-03 2708795 W C ;_4704 OAKES ST,.SUITE 100 - TACOMA _ WA '02 U --v "-.-m- 05 9816 ?D __ . "_.,..._." _„.._. _____.___" FG ~ 1 Apr-89 17-Dec-03 2708795 ~ WC 4704 OAKES ST, SUITE 100' f . _; _ TACOMA WA 03 U 20 # -9816 [ D _ FG W ~ 1-A r-89~ 17-Dec-03 P 2706000 WC 924 S HWY 85 SOCORRO NM - 01 U ..-...".____._. 05 -. 12000 S _. . _..... ._..~,-"__.._... FG 1 Oct-961 17-Dec-05 2706000 WC - 924 S HWY 85 --- SOCORRO - NM 02 -- U 30 - ~ 8000 S _ "„"" °`"`' FG 1 Oct-96 ' - _ 1Z Dec-05 06000 WC 924 S HWY 85 - ; . .. __~_ - _ _ 5OCORRO NM 03 D 45 ~ ~ 10000 S FG . 1 Oct-96 17-Dec-05 2706001 WC 801 E THORPE RD LAS CRUCES NM 01 _ U 05 _ " 12000 S _ FG 1-Jan-00 17-Dec-05 2706001 WC 601 E THORPE RD . LAS CRUDES NM 02A U 05 ; 15000 S FG ~1=Jan-00 17-Dec-05 270600.1 WC _ 801 E THORPE RD' __ _ LAS.CRl1CES _ NM 02B D 30 _ ~ ;,6000 ,S' FG 1-Jan-00 17-Dec-05 2706001 ' WC _ 809 E THORPE RD LAS CRUCES NM 03 U 45 8000 S :FG 1-Jan-00 . 17-Dec-05 2706003' WC _ 29955 HAUN`ROAD __ SUN:CITY _ CA 01 U 05 , - 20000 :D SF _ 1-Feb-02 1 7-D 05 2706003 WC' _ 29955'HAUN ROAD- _ _ _ _ : : ec- __ _ SUN CITY _ CA 02A U 30 15000 D SF 1-Feb- 02 17-Dec-05 2706003 • WC ` _ 29955 HAUN ROAD : SUN CITY ~ CA 02B D 45 _ 5000 D SF . 1=Feb-02 17-Dec-05 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 ;~ D~1F~~D PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Yi'ire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661}326-3979 FACILITY NAME INSP TI GATE INSPECTION TIME -----_- ADDRESS PHO E No. of Employees _ __ ~ c~ 3 ~l_- S~C rv~ -~~_------_... ----------------- -------- ~3~1~ ~~~-- -_ _ _ ~_- - -_. -- FACILITYCONTACT Business 10 Number 15-021- Section 1: Business Plan and Inventory Program ^ Routine ombined 17 Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection C V \V=Vioatoinnce~ OPERATION COMMENTS ~^ APPROPRIATE PERMIT ON HAND BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS L~ ^ CORRECT OCCUPANCY I ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE LX ^ VERIFICATION OF HAT MAT TRAINING Ld' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEOUATE - ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND i ANY HAZARDOUS WASTE ON SITE: ^ YES 'C~"" EXPLAIN: QUESTIONS ARDING THIS NSPECTION? PLEASE CALL US AT ~G6'I ~ 3ZB-3979 1 Inspector Badge No., White -Environmental Services Yellow -Station Copy /" --------~ usin ss Site Rye pent;i le Party --- - Pink -Business Copy - , ~'-- ~~~/w4~' "~~~ ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT ;6 ro; OFFICE OF ENVIRONMENTAL SERVICES ~~' ~ , '~~~` ~ UNIFIED PROGRAM INSPECTION CHECKLIST wE ~~~,~i~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME ~( rc~c_ ~ ~-~S INSPECTION DATE ~ Section 2: Underground Storage Tanks Program ^ Routine ~ Combined _ ^ Joint Agency Type of Tank~u1~'' Type of Monitoring ~C Giti ^ Multi-Agency Number of Tanks _ ^ Complaint ^ Re-inspection Type of Piping ~~ ~ OPERATION C V COMMENTS Proper tank data nn the Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? YeS No c./ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on the with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance Violation Y=Yes N=NO Inspector: Oftlce of Environmental Services (805) 326-3979 AGGREGATE CAPACITY i B sines Site Responsible Party bl'hite -Env. Svcs. Pink -Business Copy "# e ... CIRCLE K STORES INC #1270 SiteID: 015-021-000484 Manager : MICHELLE WILSON Location: 5634 STINE RD City BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: BusPhone: Map : 123 Grid: 23A (661) 834-8625 CommHaz : Low FacUnits: 1 AOV: SIC Code:5541 DunnBrad:04-856-4975 Emergency Contact / Title SERVICE CONTACT CTR / 24 HOURS Business Phone: (661) 834-8625x 24-Hour Phone : (868) 805-4357x Pager Phone : ( ) - x Emergency Contact / Title / Business Phone: ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Fire Press ImmHlth DelHlth Hazmat Hazards: Owner Address City CIRCLE K STORES INC : 495 E. RINCON RD. : CORNONA Phone: (909) 270-5193x State: CA Zip : 92879- Phone: (909) 270-S193x State: CA Zip : 92879 Contact : MICHELLE WILSON MailAddr: 495 E. RINCON RD PL 400 City : CONRONA Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~,~lR.$ ç;¡'Wt'1rUo hsrsby oortify that I have (Type or print name) mvii9wed the ati~chsd hæardous materials manage- ment plan for f0 f .?-~and that it aJong with ~o of SusineSS) any corrections cons~ituts a complete and correct man- agement plan for my 1acility. ~~-* -1- 07/19/2004 - . F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 9 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: CIRCLE K STORES INC #1270 Cross Street : Business Type: Org Type: Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : Phone: ( ) - x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : Phone: ( ) - x Address: City : State: Zip: Type : BOE UST Fee# : Financ'l Resp: SELF INSURED Legal Notif : Date:01/02/2004 Phone: (909) 270-5193x Name:MICHELLE WILSON Ttl:ENVIRONMENTAL SPECIALIST State UST # : 1998 Upg Cert#: -2- 07/19/2004 i I F CIRCLE K STOREß INC #1270 F Hazmat Invent1pry r= MCP+DailyMaxi Order e e SiteID: 015-021-000484 9 By Facility Unit 9 Fixed Containers on Site 9 Hazmat Com~on Name... SpecHaz EPA Hazards DailyMax MCP F IH DH L 10000.00 GAL Mod F IH DH L 10000.00 GAL Mod F IH DH L 10000.00 GAL Mod F P IH G 350.00 FT3 Min UNLEADED GASOLINE UNLEADED PLUS PREMIUM UNLEADED GASOLINE CARBON DIOXIDE -3- 07/19/2004 e e F CIRCLE K STORES INC #1270 f= Inventory Item 0006 = COMMON NAME / CHEMI CAL NAME UNLEADED GASOLINE SiteID: 015-021-000484 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit W SIDE OF SITE Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 5000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 10000.00 GAL HAZARDOUS COMPONENTS GrJ CAS # I 8006619 %wt. I 100.00 Gasollne TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: ~ Ag.Define11 -4- 07/19/2004 e e ¡ F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 ì p= Inventory Item 0006 Facility Unit: Fixed Containers on Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: W SIDE OF SITE TANK DESCRIPTION Tank ID#: 1 Mfr: Xerxes Installed: /1998 Capacity: 15000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL MatI Name:UNLEADED GASOLINE TANK CONTENTS Petrol Type: REGULAR UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1998 Drop Tube : 1998 Striker Plate: 1998 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1998 LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 07/19/2004 e e F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 ì f= Inventory Item 0006 Facility Unit: Fixed Containers on Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : UnderGround PRESSURE DOUBLE WALL A.O. SMITH FIBERGLASS AboveGround Piping FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 08/21/1998 Date: 01/02/2004 Name:MICHELLE WILSON Prmt Number: 0484 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:REGIONAL COMPLIANCE SPECIALIST Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED PASS TANK/LINE TEST :07/12/2002 CP CERT. : MANWAY INSP. : UST MONIT. CERT:06/27/2003 -6- 07/19/2004 e e F CIRCLE K STORES INC #1270 f= Inventory Item 0007 = COMMON NAME / CHEMI CAL NAME UNLEADED PLUS SiteID: 015-021-000484 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit W SIDE OF SITE Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS Ag.Defined1: MIS~. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined8: - Ag.Define11 -7- 07/19/2004 e e F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 9 f= Inventory Item 0007 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: W SIDE OF SITE TANK DESCRIPTION Tank ID#: 2 Mfr: Xerxes Installed: /1998 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL MatI Name:UNLEADED PLUS TANK CONTENTS Petrol Type: PREMIUM UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS f Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1998 Drop Tube : 1998 Striker Plate: 1998 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1998 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -8- 07/19/2004 e e F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 9 f= Inventory Item 0007 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 . PIPING CONSTRUCTION UnderGround Piping PRESSURE DOUBLE WALL UNKNOWN FIBERGLASS AboveGround Piping Type : Const: Mfgr : Mtl . & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS TANK/LINE TEST :07/12/2002 CP CERT. : MANWAY INSP. : UST MONIT. CERT:06/27/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:REGIONAL COMPLIANCE SPECIALIST Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED PASS Installed: 08/21/1998 Date: 01/02/2004 Name:MICHELLE WILSON Prmt Number: 0484 -9- 07/19/2004 e e F CIRCLE K STORES INC #1270 f= Inventory Item 0008 === COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE SiteID: 015-021-000484 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit WEST SIDE OF SITE Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum '10000.00 GAL Daily Average 5000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 HAZARD A S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod SSESSMENT Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined8: I- Ag.Define11 -10- 07/19/2004 1; e e í F CIRCLE K STORES INC #1270 SiteID: 015-021-000484 9 f= Inventory Item 0008 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B d AGENCY DEFINED) P 1 f 2 an - age 0 Last Action Type: Location In Site: WEST SIDE OF SITE TANK DESCRIPTION Tank ID#: Mfr: Compart Tank: N Installed: / Capacity: Gals No. Of Comparts: Additional Info: TANK CONTENTS Tank Use: Petrol Type: MatI Name: PREMIUM UNLEADED GASOLINE Cas #: 8006-61-9 TANK CONSTRUCTION Type : Material(p) : Material(s) : Lining : Installed: Corr Prot: Installed: Spill Cnt : Alarm : Exempt: No Drop Tube : Ball Float : Striker Plate: Fill Tube S/O: TANK LEAK DETECTION Sgl Wall: Dbl Wall: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -11- 07/19/2004 ~ e e ~ CIRCLE K STORES INC #1270 SiteID: 015-021-000484 9 f= Inventory Item 0008 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : PIPING LEAK DETECTION UnderGround Piping , AboveGround Piping Installed: 08/21/1999 Date: 01/02/2004 Name:MICHELLE WILSON Prmt Number: 0484 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:Regional complaince Specialist Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST :07/12/2002 CP CERT. : MANWAY INSP. : UST MONIT. CERT:06/27/2003 -12- 07/19/2004 :¡ e e 'j F CIRCLE K STORES INC #1270 f= Inventory Item 0004 == COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SiteID: 015-021-000484 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit SALES AREA Map: Grid: CAS # 124-38-9 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 175.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 350.00 FT3 Daily Average 350.00 FT3 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS HA TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -13- 07/19/2004 / 03/04/2004 10:34 818840. TRIANGLE - PAGE 03 . -~.- . .~_....,. ........, 'b~£'Q¡;;¡O' .....,&. ....c.. CITY OF BA.KEBSFlELD OFFICE OF ENVIRONME:~AL SERVICES 1715 Chester A vea, Bakerstielé~ CA (661) 326~979 APPLICATION TO PERFORld FUEL MONITORING CERTIFICATION FACILITY ~r D.,cÆJ () t2:JV ADDRESS S1.ø~L\ .s~ U ~~þ~ q33\3 OPERATORS NAMB OWNBRSNAMB. NAMBOPMONlTO,MANUPACTtJRBR \)~ ~~ DOES FACIUIY HA VB DlSPBNSBRPANS'l YIiS_ NOµ ( TANK It I 1... VOLUME 1'-1 q:Jk 11f?LL9 coNmNTs . _(Qj ~CJ~ __pn q~\ ~'"" - NjUd.BOPTBSTINGCOMP~ ~-("1 " cONTRAcroas UCENSB It: 1073 C¡7 J. .:.. NJ\MB&PHONBNtJMBEROPCONrAcrPBRSON Lo~,~>?- (\S'r9¿) tL(ð-7oW DATE&~TBSTISTO'BBCONDUCTED ::'>- yD;;} 2 plvL ~ rJAl'If[) 2-23-Dyd~d.u~S~ / ( APPROVBD BY DATE SIGNATU.RB OF A:PP1J.c1N; , ./¡I' r ,I;¡ e . ,:; t' ~-~ !~~ !~,¡ c ---' p., -'-J SM 495 East Rincon Ste 150 Corona, CA 92879 January 16, 2004 Bakersfield - City 1715 Chester Ave, 3rd FI Bakersfield, CA 93301 61.3'1 ~~ A TTN: UST Compliance Department RE: Circle K Stores Inc. Certificate of Financial Responsibility Attached is the Certificate of Insurance for Circle K Stores Inc., effective December 17, 2003 through December 17, 2004. Please call me at (909) 270-5193 if you have questions. Sincerely, Michelle L. Wilson West Coast Environmental Compliance Manager attachment ,1. · ~ e e CERTIFICATE OF INßURANCE NAME: ADDRESS: SEE ATTACHED SCHEDULE SEE ATTACHED SCHEDULE POLICY NUMBER: ST8089599 ENDORSEMENT: Not applicable ,PERIOD OF COVERAGE: December 17, 2003 to December 17, 2004 NAME OF INSURER: AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY 70 PINE STREET NEW YORK, NY 10270 ADDRESS OF INSURER: NAME OF INSURED: ADDRESS OF INSURED: Circle K Stores, Inc, 1500 N. Priest Dr. Tempe, AZ 85281 CERTIFICATION: 1. American International Specialty Lines Insurance Company, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(s) : LOC. # ADDRESS TANK# UST fAST CAPACITY GALLONS INSTALL DATE SEE ATTACHED SCHEDULE For taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases, in accordance with and subject to the limits of liability, exclusions, conditions and other terms of the policy arising from operating the underground storage tank(s) identified above. The limits of liability are $1,000,000 each occurrence and $2,000,000 annual aggregate exclusive of legal defense costs which are subject to a separate limit under the policy. This coverage is provided under ST8089599. The effective date of said policy is December 17, 2003. Go '\ ". It e }' 2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: a. Bankruptcy or insolvency of the insured shall not relieve the Insurer of its obligations under the policy to which this certificate applies. b. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or damaged third party with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible for which coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95-280.102. c. Whenever requested by a Director of an implementing agency, the Insurer agrees to furnish to the Director a signed duplicate original of the policy and all endorsements. d. Cancellation or any other termination of the insurance by the Insurer, except for non- payment of premium or misrepresentation by the insured, will be effective only upon written notice and only after the expiration of sixty (60) days after a copy of such written notice is received by the insured. Cancellation for non-payment of premium or misrepresentation by the insured will be effective only upon written notice and only after expiration of a minimum of ten (10) days after a copy of such written notice is received by the insured. e. The insurance covers claims otherwise covered by the policy that are reported to the Insurer within six months of the effective date of cancellation or non-renewal of the policy except where the new or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior policy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability and exclusions of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97 (b) (2) and that the Insurer is eligible to provide insurance as an excess or surplus lines insurer in one or more states. ( ~""'" ð tL G:::Þ L-c.YUO .J"-- Signature of Authorized Representative of Insurer Scott Smith Regional Manager Authorized Representative of American International Specialty Lines Insurance Company 1375 E. 9th Street, Cleveland, OH 44114 2 ~, ì' " .. f.' ce K Stores Inc. . Certificate of Insurance Site Listie 2701197 2701205 2701205 2701212 2701212 2701215 2701215 2701232 2701232 2701270 2701270 2701391 2701391 2701391 2701527 2701527 "1421 OCEAN 1421 OCEAN ~~~1§~~~~ I.~()R.§J\L 4381 EL CAMINO REAL 5634 STINE RD 5634 STINE RD ....................................................................... 123 E MAIN ST Page 1013 ;:,. ï;;: .. e K Stores Inc. . Certificate of Insurance Site Listie ,~ _,__":"J.ª~~=~]~Q~iEREY=":".:~.I§I:_ !L.____.'".., rCA [MONTEREY :04 ,.._.------l.-__,9816 . 9816 9816 9816 9816 9816 9816 9816 9816 9816 9816 .................................................. .hmhm...............;...... Page 3 013 ~/ / , ...... ¡ /~ e K Stores Inc. . Certificate of Insurance Site Listie " t¡-]!J~It~~ËJ~~][j~i~~ ¡:: : ~~___E~ SHADOW !'ll:J,º~_~___--0'IST~_--!£~_~IÉ~º_._ 12701984 1795 SHADOW RIDGE DR ¡VISTA ICA ISAN DIEGO ~~~~~:f~~·~'r~r:~gfg~¿~~'''-~~·'=lâEff~~~~r:-··~lâÄ-'~l~~~g:~~g 12702970!704 MAIN ST iRAMONAC' i27õ297~ ;704 MAIN ST ,.."., !RAMONA ICA 127õ3šoã-'·--iii99i¡cmÒRÄõ'õ·'· I SAN JOAQUIN ICA --+"." .,.. ,.. . . ___mm!SANJóÄöÜíN··TCÄ fLOS BANOS ICA ¡LOS BANOS 9816 9816 9728 9728 000000 00"" 000000 ." . ."" ..00 mm~!?8j 9728 9728 9728 ~~'___~~_~_'W 11682 11682 116 11 Page 2 of 3 / I /." ;;? " ~ ,I /' ~ / '( \l- . \ UN leD PROGRAM CONSOLIDATED FO_ TANKS UNDERGROUND STORAGE TANKS - FACILITY (one page per site) TYPE OF ACTION D 1, NEW SITE PERMIT (Check one ffem only) 03, RENEWAL PERMIT 04. AMENDED PERMIT ~5, CHANGE OF INFORMATION (Specify change· local use only) 06, TEMPORARY SITE CLOSURE Page _ of 07, PERMANENTLY CLOSED SITE 08" TANK REMOVED 400 . I. FACILITY I SITE INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 FACILITY 10 # 1 Circle K Stores Inc. #2701270 , .. BUSINESS SITE ADDRESS 401 ,., . FACILITY OWNER TYPE D 4" LOCAL AGENCY/DISTRICT' " . 5634 STINE RD I:8J 1, CORPORATION l D 5" COUNTY AGENCY' o 2. INDIVIDUAL 10 ,. "^,H'''''C~ BUSINESS TYPE I:8J 1. GAS STATION D 3, FARM o 5, COMMERCIAL o 3, PARTNERSHIP D 7, FEDERAL AGENCY' 402 02, DISTRIBUTOR o 4. PROCESSOR o 6, OTHER -, 403 TOTAL NUMBER OF TANKS Is facility on Indian Reservation or 'If owner or UST is a public agency: name of supervisor of REMAINING AT SITE trustlands? division, section or office which operates the UST" (This is the contact person for the tank records,) 2 404 DYes I:8J No 405 406 II. PROPERTY OWNER INFORMATION ."-- . PROPERTY OWNER NAME 407 I PHONE 408 Circle K Stores Inc. (510) 245-5219 MAILING OR STREET ADDRESS 409 495 East Rincon Ste 150 CITY 410 STATE 411 I ZIP CODE 412 Corona CA 92879 PROPERTY OWNER TYPE o 2" INDIVIDUAL o 4, LOCAL AGENCY I DISTRICT D 6, STATE AGENCY 413 D 1, CORPORATION D 3" PARTNERSHIP o 5, COUNTY AGENCY D 7" FEDERAL AGENCY III. TANK OWNER INFORMATION TANK OWNER NAME 414 I PHONE 415 Circle K Stores Inc. (909) 270-5193 MAILING OR STREET ADDRESS 416 495 East Rincon Ste 150 CITY 417 STATE 418 I ZIP CODE 419 Corona CA 92879 TANK OWNER TYPE o 2, INDIVIDUAL o 4. LOCAL AGENCY I DISTRICT o 6, STATE AGENCY 420 I:8J 1, CORPORATION o 3. PARTNERSHIP o 5, COUNTY AGENCY o 7. FEDERAL AGENCY TY (rK) HQ 421 INDICATE METHOD(S) D 1, SELF-INSURED o 2, GUARANTEE I:8J 3, INSURANCE " 1:"11 o 4: SURETY BOND 05" LETTER OF CREDIT o 6" EXEMPTION 'TV bd 7, STATE FUND ." o 8, STATE FUND & CFO LETTER o 9" STATE FUND & CD . o 1 O,LOCAL GOV= T MECHANISM D 99, OTHER: 422 '0 2. PROPERTY OWNER I:8J 3, TANK OWNER 423 Check one box to indicate which address should be used for legal notifications and rrailing, Legal notifications and rrailings will be sent to the tank owner unless box 1 or 2 is checked. Certir.cation: I certify that the inforrration provided herein is true and accurate to the best of my knowledge" SIGNATURE OF APPLICANT A PLICA T nvironmental Compliance Manager DATE PHONE (909) 270-5193 425 NAME OF APPLICANT (print) Michelle Wilson STATE UST FACILITY NUMBER (For local use only) 427 1998 UPGRADE CERTIFICATE NUMBER (For local use only) 428 UPCF (1/99 revised) 5 Formerly SWRCB Form A ~ ,,," , uaED PROGRAM CONSOLIDATED FOme FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of I. FACILITY IDENTIFICATION FACILITY ID # I I I I I I II I I I I I I 1 l EPA ID # (Hazardous Waste Only) BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) 3 Circle K Stores Inc. #2701270/ /01270 II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete thesè pages of the UPCF.... A. HAZARDOUS MA TERlALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases HAZARDOUS MATERIALS INVENTORY- (include liquids in ASTs and USTs); or the applicable Federal threshold !8:1 YES D NO 4 CHEMICAL DESCRIPTION (OES 2731) quantity for an extremely hazardous substance specified in 40 CFR Part 355, (This is repoerted with the HMMP.) Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formerly SWRCB Fonn A) 1. Own or operate underground storage tanks? I:8J YES D NO 5 UST TANK (one page per tank) (Formerly Fonn B) 2. Intend to upgrade existing or install new USTs? DYES D NO 6 UST FACILITY UST TANK (one per tank) UST INST ALLA TI0N - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Fonn C) 3. Need to report closing a UST? DYES D NO 7 UST TANK (closure portion -<>ne page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or DYES I:8J NO g NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? I:8J YES D NO 9 EP A ID NUMBER - provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted RECYCLABLE MATERIALS REPORT (one recyclable materials (per HSC 25143.2)? DYES !8:1 NO 10 per recycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE DYES !8:1 NO 11 TREATMENT - FACILITY (Formerly DTSC Fonns 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Formerly DTSC Fonns 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for DYES I:8J NO CERTIFICATION OF FINANCIAL Permit by Rule and Conditional Authorization)? 12 ASSURANCE (Formerly DTSC Fonn 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDA nON SITE DYES !8:1 NO 13 ANNUAL NOTIFICA nON (Formerly DTSC Fonn 1196) 6. Need to report the closure/removal of a tank that was classified as DYES !8:1 NO 14 HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Fonn 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by your CUPA or local agency.) UPCF (1/99) 5 ,'>õ U.ED PROGRAM CONSOLIDATED FO~ FACILITY INFORMATION . 'ß-f: .,. BUSINESS OWNER/OPERATOR IDENTIFICATION 5634 STINE RD CITY BAKERSFIELD DUN & BRADSTREET 15-156-7054 COUNTY KERN BUSINESS OPERA TOR NAME Comoanv Ooerated 104 I CA ZIP CODE 93313 SIC CODE (4 digit #) 5541 Page of 101 ]02 103 105 107 108 ]10 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) I. IDENTIFICATION I I II I I 1:,1 I I I I I I] I BEGINNING DATE 100 I ENDING DATE 31 BUSINESS PHONE (661) 834-8625 FACILITY 10# Circle K Stores Inc. #2701270/ /01270 BUSINESS SITE ADDRESS 106 109 BUSINESS OPERA TOR PHONE (661) 834-8625 II. BUSINESS OWNER OWNER NAME Circle K Stores Inc. OWNER MAILING ADDRESS 495 East Rincon Ste 150 CITY Corona III OWNER PHONE (909) 270-5193 112 113 CONTACT NAME Michelle Wilson - (ConocoPhillios Comoanv) CONTACT MAILING ADDRESS 495 East Rincon Ste 150 CITY 114 I STATE CA III. ENVIRONMENTAL CONTACT 117 \ ]5 I ZIP CODE 92879 116 CONTACT PHONE (909) 270-5193 118 119 -PRIMARY- ]20 I STATE CA IV. EMERGENCY CONTACTS ]2\ I ZIP CODE 92879 -SECONDARY- ]22 Corona NAME Comnanv Onerated TITLE Onerator BUSINESS PHONE (661) 834-8625 24-HOUR PHONE 1-866-805-4357 PAGER # ]23 NAME ]24 TITLE 125 BUSINESS PHONE 126 24-HOUR PHONE 127 PAGER # ]28 129 130 131 \32 ADDITIONAL LOCALLY COLLECTED INFORMA nON: Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE O~ ~NATED REPRESENTATIVE NAME OF SIm~ER (print) Michelle Wilson D, \ 'V \ (') 1)4 I NAME OF DOCUMENT PREPARER TITtE'QF SIGNER ,\ West Coast Environmental Compliance Manager 135 136 137 UPCF ( 1/99 revised) OES FORM 2730 (1/99) ~ --------- INSPECTION RECCW:> -I Bakersfield Fire Dept. 1715 Chester Ave. Bakersfield, CA 93301 ~ ~~~) ~ FACILITY NAME: MANAGER NAME: BUSINESS OWNER NAME, ADDRESS, ZIP CODE BILL TO: (IF DIFFERENT FROM ABOVE}-NAME, ADDRESS, ZIP CODE, PHONE No. FACILITY ADDRESS: 5""0 34 STINE"" 6 R-C.U¿ K ZIP: FEE: RD FACILITY PHONE OCC TYPE OCC LOAD No. OF FLOORS HI RISE BLDG. YES 0 NO 0 DATE OF REINSPECTION RISER DATE VIOLATION NOTICE CORRECTION: 1. 2. IN A¡)EQvÄ'T€: CJ2AS~ PØ:JTEc..ílON AT ~0AJV'E -rANK &CI~ CAG-E. 3. 4. 1=>lA~D()l.I~ MATC.J'llÄLS lM/~P-Y í)CJE<; tv'oí Cvæ..~1Vï¥ UST P(l(;R/JN6', 5. 6. ?LC-A:s'C CfrJTA<:.1 /VIE ....,-0 I11AI(£ ,AI2R.o.rv6€JVl€tlPr$ t=èJR. C't>hPUANc£ p 7. p(Z..( dfL 'TO j;c;¡_ (, 2c.v3- , 8. ~/<: 'r1>tJ 9. 10. 11. 12. 14. 4tf .2/759 .... v/,/ ../ 13. 15. NOTES CUSTOMER: FIRE PREVENTION SERVICES INSPECTOR: -ila...J~ fA.},N'es APNo.~,. 3. (661) 326-3979 WHITE ORIGINAL,OWNER YELLOW·INSPECTOR'S COpy PINK-FILE FD1952 ------ -...,....----~--- '--=".... ¡- --~~, ~;.' ! "'\. "'"' ! ~ \\ SWRCB, January 2002 - . Page l of 2. ff. r; '. Secondary Containment Testing Report Form This form is intended for use by contractors peiforming periodic testing of UST secondG/)' containment :'ystems. Use the appropriate pages of th is form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator jòr submittal to the local regulatOl)' agency. -¡:t ;)7 OJ;170 Facility Name: { Facility Address: Facility Contact: L c:... Date Local Agency Was NotIfied of Testing : Name of Local Agency Inspector (if present during testing): Date of Testing: - So' . \ <ê' -:- I· I Company Name: 'V\ -q"echnician Conducting Test: Credentials: CSLB Licensed Contractor License Type: o SWRCB Licensed Tank Tester License Number: () S ? Manufacturer Date Trainin Ex ires '" ',¡ Component Pass Fail Not Repairs Component Pass Fail Not Repairs Tested Made Tested Made ~7 SOl ~ 'DK.. ß 0 0 0 0 0 0 0 en <:;òì ~~'K $ 0 0 0 0 0 0 0 I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 " " 0 0 0 0 ' - 0 0 D- o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3. SUMMARY OF TEST RESULTS If hydrostatic testing was perfonned, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING . To the best of my knowledge, tl!e facts stated in this document are accurate and in full compliance with legal requirements Tochnidan's Signature' çµt' -Z:~( ;~ D,t" q - I 1. ., (7 j I": ,ò e e Page '2-. of L f SWRCB, January 2002 <¡ 9. SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equi ped With SpilVOverfill Containment Boxes 0 Spill/Overfill Containment Boxes are Present, but were Not Tested 0 Test Method Developed By: 0 Spill Bucket Manufacturer ¡'(Industry Standard o Other (Specify) Test Method Used: 0 Pressure 0 Vacuum o Professional Engineer ;rH ydrostatic Spill Box # Equipment Resolution: f (i ~ ' Bucket Depth: Wait time between applying Ptess¡ge/vacuuml"Yater and startin test: Test Start Time: Initial Reading (R(): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-R(): PasslFail Threshold or Criteria: Test Result: ,. (~C'). i '\L"-~5 Pass 0 Fail Pass 0 Fail o Pass 0 Fail o Pass 0 Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for Jàiled test!» i: ES~957' 0/)" Od-I - OOO<fYV e CiJ e "'" ", .. Conoc~hillips '- " ~ H)rJ ó (j S- /ihJ()/7 SSO()! 5S002- ú'ra 0/ CONOCOPHILLIPS P. 0. Box 52085 (DC40) rßl Phoenix, AZ 85072-2085 (602) 728-8000 (! March 13,2003 Circle K Stores, Inc. Circle K 76#2701270 5634 Stine Road Bakersfield, CA 93313 AGENCY RE: HAZARDOUS MATERIALS MANAGEMENT PLANS Dear Lal Silva: Attached is the new Hazardous Materials Inventory and Business Plan for your station. This new HMMP is intended to replace the current HMMP. The "SITE COpy" should be kept in your "Success at the Pump" binder and available to all employees and agency personnel at all times. -" THESE FORMS MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE F AlLURE TO RETURN THIS PLAN WITHIN 30 DAYS WILL RESULT IN A $25.00 LATE FEE CHARGE TO YOUR ACCOUNT. FAILURE TO RETURN THIS PLAN MAY ALSO RESULT IN FINES AND/OR CIVIL PENALTIES BY GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning the packet: I. Please sign all 3 copies of the HMMP where flagged and indicated with a "X", 2. Please return the 2 copies marked "AGENCY" and "RHL FILE to RHL Design in the pre-stamped envelope provided AS SOON AS POSSIBLE. 3. Keep the "SITE COPY" oìthe HMMP in your Success at the Pump binder, and available for inspection. Use your Site Copy for employee training and have employees sign the training log. Keep training records at your station. A copy of the HMMP will be sent to Bakersfield Fire Department If you have any questions regarding the content of this HMMP, please contact RHL Design Group, Ms. Jennifer Carey or Mr. Steve Skanderson at (707) 765-1660. If you have any additional questions, including invoicing questions, please contact Pam Ruesga, ConocoPhillips, Hazardous Materials Coordinator at (602) 728-4970. Sincerely, ConocoPhillips cc: RHL Design Group, Inc. 2701270 Enclosure , 2701270 -lED PROGRAM CONSOLIDATED FO BUSINESS ACTIVITIES LFACILlTY IDENTIFICÁTION IFACILlTYID# I BUSINESS NAME Circle K 76#2701270 FACILITY INFORMATION "'L ACTlvrFlES DEGILARAJl0N . NOTE:. If youch'eçk YES'tp any part.". of this list, .' . . ' -. . . please stJbrnit theBušll1~~s OWr:iér/Operato(l:d~ntificatiorl pag~'(()ê§ F()rm 2730). ï,fY~Si; please èompletèthesep?gèsbfth·~·ÜF?C;F..·· " Does'yoqf . facility: .:;... A HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B, UNDERGROUND STORAGE TANKS (USTs) 1" Own or operate underground storage tanks? 2, Intend to upgrade existing or install new USTs? 3" Need to report closing a UST? C, ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: --any tank capacity is greater than 660 gallons, or ---the total capacity for the facility is greater than 1,320 gallons? 0, HAZARDOUS WASTE 1, Generate hazardous waste? 2, Recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC 925143,2)? 3, Treat hazardous waste on site? 4" Treatment subject to financial assurance requirements (for Permit by Rule and Conditional authorizaton)? Consolidate hazardous waste generated at a remote site? 5. 6" Need to report the closure/removal of a tank that was classified as hazardous waste and cleaned onsite? E" lOCAL REQUIREMENTS [2 VES D NO 4 r7 ¡øÇES D NO 5 ¡:z DVES[2]NO 6 b f3 D YES [2 NO 7 V DVES[2]NO 8 V DVEs~ 9 h7 DVES[2 N010 V DVES[2]N011 V DVES[2]N012 V DVES[2]N013 V nVES[2]N014 IJ (Vou may also be required to provide additional information by yourCUPA or local agency") 15 UPCF (1/99) 2 HAZARDOUS MATERIALS INVENTORV· CHEMICAL DESCRIPTION(OES 2731) UST FACILITY (Formerly SWRCB Form A) UST TANK (One page per tank) (Formerly Fó'rm B UST FACILITY UST TANK {One per tank UST INSTALLATION - CERTIFICATE OF COMPLlANCE(one page per tank)(Formerfy Form C UST TANK (closure portion,one page per tank NO FORM REQUIRED TO CUPAS EPA 10 NUMBER-provide at the top of this page RECVCLABLE MATERIALS REPORT (one per recycler) V ONSITE HAZARDOUS WASTE TREATMENT· FACILITY (Formerly DTSC Form 1772) ONSITE HAZARDOUS WASTE TREATMENT -UNIT{one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L CERTIFICATION OF FINANCIAL ASSURANCE {Formerfy DTSC Form 1232) REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerfy DTSC Form 1232) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (Formerly DTSC Form 1249) 2701270 UNIeD PROGRAM CONSOLIDATED FOR FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I , i ¡FACILITY 10# I , , IBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) L Circle K 76#2701270 ;BUSINESS SITE ADDRESS ¡ 5634 Stine Road ¡CITY ! Bakersfield ~ of c., 1 BEGINNING DATE 01/01/2003 ENDING DATE 12/31/2003 3 BUSINESS PHONE [ 661-834-8625 04-8564975 1041~ ZiPCODE I 93313 106 ISIC CODE (4 digit #) I 5541 DUN BRADSTREET , ¡COUNTY i KERN 101 102 I I 103 I ¡ 105 i I wrl I , I 108 I 109 BUSINESS OPERATOR PHONE 866-805-4357 110 'I BUSINESS OPERATOR NAME ; Circle K Stores, Inc. i OWNER NAME II. BUSINESS OWNER 111 ¡OWNER PHONE 602-728-7080 Circle K Stores, Inc. ¡OWNER MAILING ADDRESS , bTY I P.O. Box 52085 112 113 ST ATE 85072-2085 116 114 115 ZIP CODE Phoenix AZ ¡CONTACT NAME I I ¡CONT ACT MAILING ADDRESS ¡ ¡CITY , I ~.._--_._--_._---- III. ENVIRONMENTAL CONTACT 117 ¡CONTACT PHONE I 925-277 -2404 Janette Thompson 2000 Crow Canyon PI. Suite 400 ~E IV. EMERGENCY CONTACTS 1231NAME 124 ITITLE I 125 ¡BUSINESS PHONE I 126 124.HOUR PHONE i 127/PAGER# 121 IZIP CODE 94583 SECONDARY San Ramon CA PRIMARY I fÑM'ÏÊ------ , L ;TITLE i Service Contact Center 128 Justin Peterson 129 Retail Terr. Supv. 130 661-978-4822 131 661-978-4822 132 24 Hours [BUSINESS PHONE ! 866-805-4357 i--, " i24.HOUR PHONE I '866-805-4357 I iPAGER# i [ADDITIONAL LOCALL Y COLLECTED INFORMATION: A 118 i 119 I I 122 I I '-------; ,Certitication: Based on my inquiry of those individuals responsible for obtaining the information, I certitY under penalty of law that [ have personally examined and am ¡familiar with the information submitted and believe the information is true, accurate, and complete. ~¡,i" NATURE OF owiíf:~~P\.~~T_OR ' 134 INAME OF DOCUMENT PREPARER 135 ~v 0) I RHL DESIGN GROUP, INC. . ENVIRONMENTAL DEPT- , AME OF SIGNE¡¿rint) - F SIGNER .'7/7 137 ; __ -UC¡Z))/;LJ1 lt1~bL UPCF ( 1/99 revised) 167 OES FORM 2730 (1/9 .. D PROGRAM CONSOLIDATED F M HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION DELETE I REVISE I. FACILITY INFORMATION ADD \BUSfNESS NAME Circle K 76#2701270 ¡CHEMICAL LOCATION I t WEST SIDE OF SITE I IFACILITY ID# I One page per material per building or area) 200 of ~ Page 3 2701270 CHEMlCAL LOCATION CONFIDENTIAL EPCRA DYES [8] NO MAP# (optionaJ) I ¡CHEMICAL NAME PETROLEUM HYDROCARBON ¡COMMON NAME I !CAS# i II. CHEMICAL INFORMA nON 205 TRADE SECRET REGULAR UNLEADED GASOLINE 207 I EHS 209 8006-61-9 202 203 GRID# ( optionaJ) C4 UYes ~o 204 206 If Subject to EPCRA, refer to instructions DYes [8] No 208 FIRE CODE HAZARD CLASSES (Complete if required by CUPA) i I I I-B FLAMMABLE LIQUID I If EHS is "Yes", all amounts below must be in Ibs" 210 HAZARD MATERIAL TYPE (Check one item 211 213 D ~. 212! RADIOACTIVE Yes ~NO I CURIES i5 j {f more hazardous components are present at greater than 1% by weight ìf non.carcìnogenìc. or 0.1 % by weight if carcìnogenìc, attach additional sheets of paper capturing the required information. D a. PURE ŒJ b" MIXTURE 0 c" WASTE D a. SOLID ŒJ b" LIQUID D c. GAS ¡PHYSICAL STATE ¡(Check one item only) IFED HAZARD CATEGORIES ŒJ a. FIRE D b" REACTIVE 0 c,PRESSURE RELEASE ŒJ d" ACUTE HEALTH ¡(Check all that apply) IA VERAGE DAlL Y AMOUNT I 5000 ¡UNITS- (Check one item only) I STORAGE ¡CONTAINER i I I 214 LARGEST CONTAINER . 2171MAXIMUM DAlL Y AMOUNT I 10 ŒJ a" GALLONS c:: b, CUBIC FEET 0 c, POUNDS ifEHS amount must be.i!LpQu Oa" ABOVE GROUND TANK ne" PLASTICINONMETALLIC DRUM R'i" FIBER DRUM ~b. UNDERGROUND TANK nf. CAN Ff:". BAG I lc, TANK INSIDE BUILDfNG ng, CARBOY k" BOX nd STEEL DRUM Oh, SILO L L CYLfNDER 218 ANNUAL WASTE AMOUNT D d, TONS i CO RAGE PRESSURE ! STORAGE TEMPERATURE I I I II 90-100 ŒJa" AMBIENT Db" Db, ABOVE AMBIENT Dc, BELOW AMBIENT Dc BELOW AMBIENT EHS 227 []Yes 'XlNo ~ 231 []Yes ŒJNo 235 []{ es ~o 239 []Y es ŒJNO 243 I DYes ~o I , ŒJa" AMBIENT ABOVE AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) 226 GASOLINE I :2 i 1-14 230 XYLENES <10"0% 234 ETHANOL 1-9 238 TOLUENE ! 1-5% 242 I ETHYL BENZENE b I \4 215 10000 [8] e"CHRONIC HEALTH 219 STATE WASTE CODE .I 216 220 222 Qm,GLASS BOTTLE ~n, PLASTIC BOTTLE 0, TOTE BfN I p, TANK WAGON no, RAIL CAR Dp OTHER Dd, CRYOGENIC 223 ~ 225 CAS# 228 I 8006-61-9 i 232 I 1330-20-7 236 I 64-17-5 240 1108.88-3 244 1100-41.4 I 229 233 237 ! , I 241 245 ADDITIONAL LOCALLY COLLECTED fNFORMA TION 246 If EPCRA, Please Sign Here UPCF (\/99) \69 OES Fonn 2731 D PROGRAM CONSOLIDATED .- '<:'t.__.'"l.s:.~.:v.:.1Jt;~: HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) I i ¡BUSINESS NAME Circle K 76#2701270 I ,¡CHEMICAL LOCATION , WEST SIDE OF SITE I iFACILlTY 10# I r-- i ¡CHEMICAL NAME I PETROLEUM HYDROCARBON I ADD I I DELETE I I REVISE I. FACILITY INFORMATION 200 I Page 2701270 ¡CHEMICAL LOCATION CONFIDENTIAL IEPCRA DYES 0 NO (optional) 203 GRlD# (optional) 04 3 202 MAP# I 204 I I -~ II. CHEMICAL INFORMATION PLUS UNLEADED GASOLINE 205 I TRADE SECRET I I ¡ EHS UYes ~iNo 206 If Subject to EPCRA, refer to instructions COMMON NAME 207 DYes ŒJ No 208 jCAS# i ¡FIRE CODE HAZARD CLASSES (Complete ¡frequired by CUPA) I HAZARD MATERIAL 2111 0 I.;l 2121 TYPE (Check one item D a. PURE [8] b, MIXTURE Dc" WASTE I RADIOACTIVE Yes ~o CURIES ¡PHYSICAL STATE n a, SOLID fXl b, LIQUID n e" GAS 214\ LARGEST CONTAINER 1 0000 (Check one item only) ~ I 1~~c~~a~;~EGORIES [8] a" FIRE Db" REACTIVE 0 e,PRESSURE RELEASE fXl d, ACUTE HEALTH [Z] e,CHRONIC HEALTH iA VERAGE DAlLY AMOUNT 218 ANNUAL WASTE AMOUNT 219[ST A TE WASTE CODE I ~O_O~ I IUNITS> fXl a, GALLONS L b" CUBIC FEET 0 c" POUNDS n d, TONS 2211 DAYS ON SITE: l5S:.heek one item only) if EHS amo.untrnust be in polllli!s I 365 I :STORAGE ~a ABOVE GROUND TANK ¡Ie PLASTICINONMETALLIC DRUM ni F!BER DRUM !mGLASS BOTTLE :CONT AlNER ,~ ~- --" '-'- ; i X lb. UNDERGROUND TANK ! if CAN i U BAG in" PLASTrC BOTTLE i !ie" TANK INSIDE BUILDING ng" CARBOY rlk, BOX ¡ \0 TOTE BIN i r-ld, STEEL DRUM Oh, SILO DI. CYLINDER ! ¡p" TANK WAGON I I I STORAGE PRESSURE ¡------- I STORAGE TEMPERATURE 209 8006-61·9 IfEHS is "Yes", all amounts below must be in Ibs, I-B FLAMMABLE LIQUID 210 213 215 216 I .i I I 220 I ¡ 222 I I no RAIL CAR ~ !p OTHER 223 --------" [Z]a, [Z]a. AMBIENT Db" nb, ABOVE AMBIENT 225 ABOVE AMBIENT Dc" BELOW AMBIENT Dc. BELOW AMBIENT Dd. CRYOGENIC EHS I CAS# i 227 DYes ~o 228 I 8006-61-9 ! 231 I r~es IXNo 232 I 1330-20-7 235 I DYes ~No 236 64-17-5 ! '......J 239 I nYes rx~o 240 I 108-88-3 I 243 I l..-J I DYes Ix!No 244 i 100-41-4 I i 224 AMBIENT %WT I r--- II 90-100 , , HAZARDOUS COMPONENT (For mixture or waste only) 226 GASOLINE 229 !2 1-14 ~ 13 <10"0% I I 14 1·9 I 15 1·5% L I 230 ! XYLENES 233 234 : ETHANOL , 238 i ! TOLUENE 242 ! ETHYL BENZENE 237 241 245 ¡ If more hazardous components are present at greater than I % by weight if non-carcinogenic, Of 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. "-~~~~~--,-~- --.-.----.--. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 U ED PROGRAM CONSOLIDATED F HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION BUSINESS NAME CHEMICAL LOCATION PHYSICAL STATE (Check one item only) I ADD 1 DELETE REVISE I. FACILITY INFORMATION One page per materia) per building or area) 200 Page 15 of Y 3 2701270 ¡CHEMICAL LOCATION CONFIDENTIAL EPCRA DYES 0 NO Circle K 76#2701270 II. CHEMICAL INFORMATION 202 203 GRID# (optionaJ) D4,5 204 2051 TRADE SECRET UYes ~o If Subject to EPCRA. refer to instructions 5.0..0..0 [FACILITY rD# I I ¡'"CHEMICAL NAME PETROLEUM HYDROCARBON I ¡COMMON NAME I PREMIUM UNLEADED GASOLINE ICAS# I ¡FIRE CODE HAZARD CLASSES (Complete ¡[required by CUP A) IHAZARD MATERIAL ,TYPE (Check one item 207 EHS 209 8006-61-9 206 DYes 208 ŒJ No ffEHS is "Yes", all amounts below must be in Ibs" 210 00.0 [8] a, GALLONS C b" CUBIC FEET D c" POUNDS ~Q lQJ.!lli!s ne, PLASTICINONMETALLlC DRUM ni" FIBER DRUM nr CAt'.! IU" BAG ng, CARBOY Ok. BOX Dh, SILO UI. CYLINDER D d" TONS ,---, ~a" ABOVE GROUND TANK LJ<.jb" UNDERGROUND TANK UC, TANK INSIDE BUILDING lc.Jd" STEEL DRUM [8]a. AMBIENT Db, Db. Dc, ABOVE AMBIENT BELOW AMBIENT I-B FLAMMABLE LIQUID D a, PURE [8] b" MIXTURE D c, WASTE D a, SOLID [8] b, LIQUID D c" GAS 2111 RADIOACTIVE 0 Yes ŒJNo 2121 CURIES 213 214 LARGEST CONTAINER 215 10000 Jf [8] e"CHRONIC HEALTH 219 STATE WASTE CODE 216 FED HAZARD CATEGORIES fXl a, FIRE Db" REACTIVE D c"PRESSURE RELEASE fXl d, ACUTE HEALTH I(Check all that apply) ~ ~ AVERAGE DAIL Y AMOUNT 218 ANNUAL WASTE AMOUNT i I ~ ¡ STORAGE PRESSURE ! I I STORAGE TEMPERATURE [8] a. AMBIENT ; i I %WT [ HAZARDOUS COMPONENT (For mixture or waste only) ! 226 I GASOLINE I r UNITS* (Check one item only) STORAGE CONTAINER 220 221 I DAYS ON SITE: 365 I nm" GLASS BOTILE H1n. PLASTIC BOTTLE , 0" TOTE BIN p" TANK WAGON 222 80" RAIL CAR -Jp, OTHER 223 11 90-100 12 1·14 I I 13 <10,0% 14 1-9 Dc ABOVE AMBIENT BELOW AMBIENT 224 nd, CRYOGENIC I I 228 I 8006-61-9 ! 232 11330.20-7 236 I I 64-17-5 I 240 ' I 108-88-3 i 244 I 100-41-4 I 225 230 ¡ I 234 I i I 227 I I 231J 235 I 239 I I 243 I I EHS [JYes [8JNo IIYes ¡'XiNo LJYes I x;No LjYes I x ¡No DYes ~\¡o CAS# 229 ¡ .J I 233 237 241 i5 1-5% i I If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic. attach additional sheets of paper capturing the required infonnation. 245 i XYLENES ETHANOL 238 i TOLUENE 242 I ETHYL BENZENE ADDITIONAL LOCALL Y COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 Ur lED PROGRAM C~NSOLIDATED-"\1 ......~^·r HAZARDOUS MA TER1ALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION I ADD DELETE ¡ BUSINESS NAME I Circle K 76#2701270 ¡CHEMICAL LOCATION i i SALES AREA I IFAClLITY [D# L-_, I ¡ ¡CHEMICAL NAME I CARBON DIOXIDE I ICOMMON NAME CARBON DIOXIDE GAS CAS# j 124-38-9 FIRE CODE HAZARD CLASSES (Complete ¡frequired by CUPA) One page per material per building or area) REVISE I. FACILITY INFORMATION 200 I Page 3 2701270 ¡CHEMICAL LOCA nON CONFIDENTIAL jEPCRA DYES [8] NO i (optional) 2031 G RlD# (optional) I E3 204 i i , -----1 202 11 ~ II. CHEMICAL INFORMATION 205 TRADE SECRET UYes ~o 206 If Subject to EPCRA, refer to instructions 207 208 EHS DYes [8J No 209 I , IfEHS is "Yes", all amounts below must be in Ibs" I , NON-FLAMMABLE GAS 210 213 215 216 i 220 222 HAZARD MATERIAL " TYPE (Check one item (PHYSICAL STATE (Check one item only) [FED HAZARD CATEGORIES 0 a, FIRE Db" REACTIVE I)(l c"PRESSURE RELEASE I)(l d" ACUTE HEALTH IcCheck all that apply) I ,~ ~ iA VERAGE DAlLY AMOUNT I i 175 ¡UNITS- (Check one item only) ¡STORAGE 'la CONT AINER I I I ! , ib Uc Ud, 211 RADIOACTIVE 0 Yes ŒJNo 212 o a. PURE 0 b, MIXTURE 0 c, WASTE U a, SOLID 0 b" LIQUID 0 c, GAS CURIES 214 LARGEST CONTAINER 175 n e"CHRONIC HEALTH 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE I 221 I DAYS ON SITE: i 365 50 o a" GALLONS [K b CUBIC FEET I-.J c, POUNDS iŒHS.Ju!1Q1J.D,UllUsŒjIL¡2Q\.mds l'le, PLASTIC/NONMETALLIC DRUM ni FIBER DRUM ¡If CA1"1 ïij BAG Og" CARBOY I [k, BOX Uh SILO ~I. CYLINDER o d, TONS no, RAIL CAR I lp OTHER [1m, GLASS BOTTLE , in PLASTIC BOTTLE -10" TOTE BIN Up, TANK WAGON ABOVE GROUND TANK UNDERGROUND TANK TANK INSIDE BUILDING STEEL DRUM 223 ì I ---¡ 224 i I --, 225 ¡ , ___1 I STORAGE PRESSURE I I STORAGE TEMPERATURE 0 a. AMBIENT Db ABOVE AMBIENT i %WT I HAZARDOUS COMPONENT (For mixture or waste only) ! ¡ ~ 100% 226 ~ CARBON DIOXIDE ! 230 \ 12 i b 234 I , I I I 14 238 ¡ ! i r ,5 Oa" Œ]b" ABOVE AMBIENT BELOW AMBIENT Dc, AMBIENT DC BELOW AMBIENT Od, CRYOGENIC EHS CAS# 227 []v es DYes 0NO~ ~No 2321 fX1No 2~ , 240 \ I 244 I I I 124-38-9 229 , 231 I I 235 I 239 I 243 I 233 237 [JYes I ¡Yes DYes I~ I~No 245 i ! rXiNo 241 242 ! i , - If more hazardous components are present at greater than] % by weight if non~carcínogenic. or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. '--~---~-'-----~ -------- 246 I ADDITIONAL LOCALL Y COLLECTED rNFORMA TION If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 e e SECTION I 2701270 BusrnESSEMERGENCYPLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. I. EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL (Fire, paramedics, police, or sheriff) 911 STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-8911 ._ ~- 661-326-3979 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A ' HAZARDOUS MATERIALS INCIDENT: Name: _S.eryic.e.f~ontact Center Telephone:~805-4157 Telephone: 661-978-4822 Name: Justin Peterson B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE A V AILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: MERCY SOUTHWEST HOSPITAL ADDRESS: 2215 TRUXTON AVE CITY: BAKERSFIELD PHONE: 661-612-5281 e e 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide infonnation on the steps taken at your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazards at this business are fire and spills associated with gasoline dispensing. Gasoline dispensing is supervised by trained personnel. Additional hazardous materials are stored in minimum quantities and stored in small, unbreakable containers. All underground storage tanks are monitored using an approved monitoring method. 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill fire, explosion or airborne release at your facility? Small incidents: For leaks and spills, isolate the area and contain with absorbent material. Clean up the spill immediately to prevent spreading. For fires, turn off pumps, use fire extinguisher if it can be done safely. Larger incidents: Turn off pumps using emergency pump shut-off, call 9-1-1, evacuate to emergency assembly area, wait for emergency personnel to respond. Immediately contact the business owner, if not already on site, the Wholesale Territory Supervisor or Retail Territory Supervisor and the Service Contact Center. .i' 4. ABATEMENT Describe what you would do to stop and remove each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the relase? Small incidents will be handled with the on-site clean-up equipment, (i.e., brooms, shovel, absorbent material, mops, etc.). For larger incidents, the on site manager ~ill turn off the pumps, call 9-1-1, and the Service Contact Center @ 1-866-805-4357. The Contact Center will dispatch a maintenance contractor to assist in abating the hazard. For suspected leaks the operator will notify the Service Contact Center and hislher Wholesale Territory Supervisor or Retail Territory Su~rvisor who will investigate the incident. If a UST leak is confinned, then reporting will be done by ConocoPhillips/Circle K, which complies with UST regulations. ConocoPhillips/Circle K will coordinate with any contractors reguired to stop a release, clean up a release and/or dispose of materials. All materials will be disposed of in accordance with state, federal and local laws and regulations. ~ e -, 5. EVACUATION AND RE-ENTRY Describe the procedures to be followed for immediate notification and evacuation of your facility Ifwarranted, evacuate to the designated assembly locate at: NORTH SIDE OF SITE The manager or lead employee will take a head count to verifY all employees have evacuated safely. The manager or employee will confer with the responding agencies to indicate the magnitude of the emergency. Re-Entry into the facility will only take place after the dealer or manager verifies with the responding agency personnel and ConocoPhillips/Circle K that it is safe. 6. EARTHQUAKES IdentifY the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. ~" 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The hazardous wastes generated at this business are used motor oil and antifreeze. These items will be handled in the same manner as new motor oil or antifreeze. Use absorbent material or rags to clean up spills and place in a container for proper disposal or recycling. 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized release from an underground storage tank (UST). The plan must address a release from a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underground Storage Tank Monitoring and Response plan provided by ConocoPhillips / Circle K Stores, Inc.. If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up from the secondary containmnent within 8 hours, or deteriorates the secondary containment, then the local agency will be notified IMMEDIA TEL Y. e e SECTION II BUSINESS EMERGENCY TRAINING Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum include: A Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards; B. Procedures for coordination with local emergency response organizations: C. Correct use of emergency response equipment and supplies under the control of the business; D. E. F. G. H. 1. The Cal OSHA Hazard Communication Standards; The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan; The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care; Procedures to coordinate with and assist the local emergency personnel that may respond to your facility; Who and how to call for immediate assistance in the event of an accident involving hazardous materials; Procedure for ensuring the appropriate personnel receives initial and refresher training. >' ALL El\1PLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY. Use the attached employee training log or similar form for record keeping. MAP# CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME CIRCLE K STORES INC, #2701270 BUSINESS ADDRESS 5634 STINE ROAD 2 3 4 5 6 7 A NORTH (] I- o -' I- Z <1: U <1: > 8 * o « o a: w z I- 00 BAKERSFIELD c D E VACANT LOT ELECTRONIC MONITORING POINTS G:) SUMP SENSOR CD ANNULAR SENSOR ® AUTOMATIC TANK GAUGE HMMP MSDS ~ CD ~ /f:0 / Q,'v) ® /~ /.;', ø / û' /// ,,:>" G / ¡) / / 'v J/, / d:J / / û'l" / / ;:, , (,<:J /// ¡) /// ~ J \/ ¡)<:J//0'/ , I <:J /// Û / , ' ¡)<:; // '-'i / ,<:; ,_/ ~ HARRIS ROAD TIMNERS HOME COOKING Te'S VIDEO m DATE 3/12/2003 ZIP CODE 93313 F LfS CD ^ TMA L---.>o G RESIDENTIAL 6' CONCRETE WALL CD CO2 OFFICE SPACE o EXECUTIVE LOUNGE PARKING H < PREPARED BY: DRA WING SCALE 1"=30'-0" MAP SYMBOLS CD ELECTRICAL PANEL SHUT -OFF CD NA TURAl GAS SHUT -OFF ® WA TER SHUT -OFF 0 EMERGENCY PUMP SHUT-OFF ^ TANK MONiTORING TMA ALARM L........-' CD TELEPHONE ? FIRST AID KIT e LfS FIRE EXTINGUISHER ~ STORM DRAIN * SANiTARY SEWER STAGING AREA EVACUATION/ HMMP HMMP. AND MSDS MSDS LOCA nON Ó FIRE HYDRANT *-* FENCE -' @) EMERGENCY RESPONSE <1: EQUIPMEN T / ABSORBEN TS i= z c=J ABOVEGROUND W STORAGE TANK 0 I UNDERGROUND (f) STORAGE TANK W 0::: ® GASOLINE (FLAMMABLE LIQUIDS) 0 DIESEL FUEL (COMBUSTIBLE LIQUIDS) @ MOTOR OilS & lUBRI_ (COMBUSTIBLE LIQUID @> CARBON DIOXIDE (COMPRESSED GAS) 0 PROPANE (FLAMMABLE LIQUID) 0 AN TIFREEZE /COOLAN TS @ WASTE OIL (FLAMMABLE LIQUID) @ CAR WASH PRODUCTS ..... GROUND WATER MONITORING WEllS e e Spill/Release Response Procedures for Carbon Dioxide (C02) The refrigerated liquid C02 used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or ifthere is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause bums, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dial 911 - inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. .¥ 3. Stay upwind of the spill and out oflow-Iying areas. 4. Do not touch or walk thrOugh spilled material. 5 . Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMA 1ìTosco\FORMS\co2-Spill Plan.doc ~GENCY RESPONSE PROCED MAJOR 1!If'CIDENT: FIRE, SPILL OR SUSPECT LEAK 2701270 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EV ACUA TE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the ConocoPhillips/Circle K service station at: 5634 Stine Road If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay òn the phone and be prepared to answer any questions concerning the situation. 4. A TTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator if he/she is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Service Contact Center Address: Bus#/Home#/Alt#: 866-805-4357/866-805-4357/ Alternate Emergency Coordinator: J lIstin Peterson Address: 1380 Lead Hill Blvd Suite ]20 Roseville. CA 9566] Bus#/Home#/ Alt#: 661-978-4822 / 66] -978-4822 / Title: 24 Hours ,; Title: Retail Terr Supv 8. NOTIFY the following IMMEDIA TEL Y to assist in the emergency and agency notification process: Service Contact Center: 1-866-805-4357 Wholesale Territory Supervisor or Retail Territory Supervisor. Environmental Compliance Coordinator: North: Janette Thompson (925)277-2404 South: Stephen Boyd (714)428-6572 or (714)454-8334 ConocoPhillips/Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by the agencies. in which case the Oper~tor should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned' up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. I. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. _EMPLOYEE TRAINING PLAN e Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. I. FffiST THINGS TO KNOW: A. EMERGENCY PUMP SHUT-OFF:This turns off the turbine pumps that provide flow to the dispensers from the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: FRONT OF BUILDING B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. Location: REAR OF BUILDING C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when a leak is detected by a visual and audible alarm. Location: REAR OF BUILDING D. WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: STINE ROAD E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow III an emergency. Location: NONE F. PROPANEILPG: If your station has propage or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. À' G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it, a vacum truck should be used to clean up any large spill Location: STORAGE I. PERSONAL PROTECTIVE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. I. Broom: STORAGE 2. Shovel: -STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH SIDE OF SITE HAZARDOUS MATERIAL MANAGEMENT PLAN (HMMPLMATERIAL SAFETY DATA SHEET (MSDS): Location: CASHIER II. NEAREST MEDICAL FACIMy: Employees should know what facilit'are available in case customers or other employees need medical attention. 'i I.NAME: MERCY SOUTHWEST HOSPITAL ADDRESS: 2215 TRUXTON AVE BAKERSFIELD PHONE NUMBER: 661-632-5281 NEAREST DESIGNATED TRAUMA CENTER: 2.NAME: KERN MEDICAL CENTER ADDRESS: 1830 FLOWER STREET BAKERSFIELD PHONE NUMBER: 661-326-2000 III. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated clothing and shoes. Followed by washing with soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention. C. INHALA TION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not' breathing, give artificial respiration. Get medical attention. .# D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! Ifvomiting occurs spontaneously keep head below hips to prevent aspiration ofliquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, consuls ions, or unconsciousness occur before emesis, gastric lavage using a cuffed endotrachael tube should be considered. For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MA TERlALS: Consult the warning advice on container labels or refer to the MSDS for that product. This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental StajJ. RHL Design Group, Inc., 800-765-1025 Last updated: Dec. 3, 2002 J' ~ ,../'" /.' . L JOHN W" JOHNSON Co-President Principal BRIAN F" ZITA Co,President Principal JOHN B" HICKS Vice President Principal CECIL R. SPENCER Vice President Principal Roy W, PEDRO Regional Manager JOHN W" STROBEL Regional Manager Associate JESSE E. MACIAS Regional Manager Associate ALAN K. SHIMABUKURO Regional Manager Associate BLYTHE R, WILSON Regional Manager Associate ,IÞ ,,-"',. - ARCHITECTURE· ENGINEERING ENVIRONMENTAL SERVICES John W" Johnson, Architect 1137 North McDowell Boulevard, Petaluma, CA 94954,1110 Telephone: (707) 765-1660 Facsimile: (707) 765,9908 1 966 : March 21. 2002 Bakersfield Fire Department Ralph Huev 1715 Chester Avenue, 3rd Floor Bakersfield, CA 93301 Established HAZARDOUS MATERIALS MANAGEMENT PLANS FOR TOSCO/CmCLE K Dear Ralph Huey: Enclosed please find the Hazardous Material Management Plans, HMMP(s), for the Tosco Corporation station(s) as listed on the attached sheet. These inventories and HMMP(s) are being submitted for your review and approval. If there are any further correspondence or invoices related to these submissions, please direct them to: Sincerely, RHL DESIGN GROUP, INC. Environmental Department Enclosure Regional Compliance Specialist Tosco Corporation P.O. Box 52085 Phoenix, AZ 85072-2085 BELLEVUE, WA LA HABRA, CA MARTINEZ, CA PETALUMA, CA SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER, WA 'i - 2708605 Circle K Stores, Inc. 5600 Auburn Street Bakersfield, CA 93306 e -2708825 Circle K 76 #2708825 2222 F Street Bakersfield, CA 93301 ~_.. 2701270 Circle K 76#2701270 5634 Stine Road Bakersfield, CA 93313 ""' í ~ e -- <'Q. ... TOSCO MARKETING COMPANY 1500 N. Priest Drive Tempe, Arizona 85281 Telephone: (602) 728-8000 March 07,2002 Circle K Stores, Inc. Circle K 76#2701270 5634 Stine Road Bakersfield, CA 93313 ~(GJ~~(èW RE: HAZARDOUSMATE~LSMANAGEMENTPLANS Dear Circle K Store- Lal Silva: Attached is the new Hazardous Materials Inventory and Business Plan Certification for your station. This updated HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP and kept in your "Success at the Pump", and available to all employees and agency personnel at all times. THESE FORMS MUST BE RETURNED TO RIlL DESIGN GROUP AS SOON AS POSSmLE. FAILURE TO RETURN AND IMPLEMENT TillS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning the packet: 1. Please sign all 3 copies of the CERTIFICATION where flagged and indicated with a "X". 2. Please return the 2 copies marked "AGENCY" and "RIlL FILE" to RHL Design in the pre-stamped enclosed envelope. 3. Keep this "DEALER" copy in your Success at the Pump binder, and available for inspection. 4. Have your employees read and understand the contents of this package and sign the attached training log. Keep the training log at your station. A copy of this HMMP Certification will be sent to: Bakersfield Fire Department within 30 days If you have any questions regarding the content of this document, please contact RHL Design Group, Mr. Roger Beach at (707) 765-1660. If you have any additional questions, including invoicing questions, please contact Tosco Marketing Company, Hazardous Materials Coordinator at (602) 728-7080. Sincerely, Tosco Marketing Company cc: -RHL Design Group, Inc. Enclosure 2701270 ;: '.1; . Bakersfield Fire DepAent 1715 Chester Avenue, 3rd Floor Bakersfield CA 93301 805-326-3979 AGENCY USE ONLY·· File #: Reviewed by: . Date: HAZARDOUS MATERIALS BUSINESS PLAN I INVENTORY 2002 CERTIFICATION FORM Business Name: Circle K 76#2701270 Owner/Operator Name: Business Address' Circle K Stores, Inc. Ph 661-834-8625 one: 5634 Stine Road City: Bakersfield State: CA Zip: 93313 Environmental Contact: Janette Thompson Phone: 925-277-2404 Mailing Address: 2000 Crow Canyon PI. Suite 400 San Ramon State: CA Z. 94583 IP: City: BIENNIAL REVIEW AND RECERTIFICATION: )( I certify that the complete Business Plan filed on ~ has been reviewed and the information \./ contained in it is accurate and complete as of the date below. ~ A complete HMBP was submitted within the last three (3) years. I certify that I have reviewed the previously submitted Business Plan and have updated the following items on the attached pages. Emergency contacts names and/or phone numbers. Site/Facility map. Other Updates: ANX INVENTORY UPDATE: Inventory Forms are correct for the upcoming reporting year. NO changes are necessary. Inventory Forms require updating. ATTACHED are only the revised pages. Inventory Forms required updating. Replace previous inventory with attached inventory. As the Business Owner or its official designated representative, I can sign and attest to all statements in this certification and that we are not using the certification statement to comply with the annual federal reporting requirements under the Emergency Planning and Community Right-to-Know Act (EPCRA). Based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate and complete. Name:' ~~ ø~'t-v~ ~ f0Lj Y2 Signature::!' 7 ?Jl1~7 ())- Title:f Datey ::- '. ED PROGRAM CONSOLIDATED FO FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION F ACrLITY ID# 100 ENDING DATE 03/1/2003 3 BUSINESS PHONE 661-834-8625 Page of 101 102 103 105 107 108 110 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) Circle K 76#2701270 BUSINESS SITE ADDRESS 5634 Stine Road CITY Bakersfield DUN & BRADSTREET 04-8564975 COUNTY KERN BUSINESS OPERATOR NAME Circle K Stores, Inc. 104 106 ZIP CODE 93313 SIC CODE (4 digit #) 5541 CA 109 BUSINESS OPERATOR PHONE 661-834-8625 II. BUSINESS OWNER OWNER NAME Circle K Stores, Inc. OWNER MAILING ADDRESS P.O. Box 52085 CITY Phoenix III OWNER PHONE 602-728-8000 112 113 CONTACT NAME Janette Thorn son CONTACT MAILING ADDRESS 2000 Crow Can on PI. Suite 400 CITY San Ramon 114 STATE AZ ill. ENVIRONMENTAL CONTACT 117 115 ZIP CODE 85072-2085 116 CONTACT PHONE 925-277-2404 118 119 -PRIMARY- 120 STATE CA IV. EMERGENCY CONTACTS 121 ZIP CODE 94583 -SECONDARY- 122 NAME Tosco Maint. Call Center TITLE Dis atch BUSINESS PHONE 800-726-2312 24"HOUR PHONE 800-726-2312 PAGER # 123 NAME Teri Nicholson 124 TITLE BDM 125 BUSINESS PHONE 909-270-5123 126 24-HOUR PHONE 800-697-1388 127 PAGER # 128 129 130 131 132 ADDITIONAL LOCALLY COLLECTED INFORMA TrON: Certification: Based on my inquiry of those individuals responsible for obtaining the infonnation, I certify under penalty of law that I have personally examined and am familiar with the information submitte and believe the information is true, accurate, and complete. . SENTATIVE 135 137 2701270 UPCF ( 1/99 revised) 167 OES FORM 2730 (1/99) MAP# CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME CIRCLE K STORES INC. #2701270 BUSINESS ADDRESS 56.34 STINE ROAD 2 3 4 5 6 7 A NORTH CD I- o ...J I- Z « u « > B * o « o a: w z r- (J) c BAKERSFIELD D VACANT LOT ~ ~ /~@ / <:iv)l@ /'v /~ // ú'l' // -::, I fC\ /¡;)//<-j)~ / <:f:J / / 0' / ~-::, I I,ÇJ'//// C, //// q¡.) 1// ¡;)ÇJ// 0'/ , I ÇJ? //// ¡;) c,// I '/ / >:) / , I,ÇJ<:J!/ 1,/ E HMMP MSDS ~ [i] HARRIS ROAD TIMNERS HOME COOKING TC'S VIDEO m DATE 0.3 /20 /01 ZIP CODE 93313 F ðS CD ^ TMA L.....-> G RESIDENTIAL 6' CONCRETE WALL ® CO2 OFFICE SPACE ® EXECUTIVE LOUNGE PARKING H PREPARED BY: DRAWING SCALE 1"=30'-0" ...J « f= z w o (f) W 0::: MAP SYMBOLS CD ELECTRICAL PANEL SHUT-OFF ® NA TURAL GAS SHUT-OFF ® WATER SHUT-OFF ® EMERGENCY PUMP SHUT-OFF' T((A TANK MONITORING L-Oo ALARM [i] TELEPHONE c{þ FIRST AID KIT ð. FIRE EXTINGUISHER Ë! STORM DRAIN * SANITARY SEWER STAGING AREA EVACUA TION/ HMMP HMMP, AND MSDS MSDS LOCA T\ON Ò FIRE HYDRANT *-* FENCE (@ EMERGENCY RESPONSE EQUIPMENT/ABSORBENTS ~ ABOVEGROUND "------J STORAGE TANK I I UNDERGROUND STORAGE TANK @ ® ® @ ® @ @ GASOLINE (FLAMMABLE LIQUIDS) DIESEL FUEL (COMBUSTIBLE LIQUIDS) MOTOR OILS & LUBRICA (COMBUSTIBLE LIQUIDS) CARBON DIOXIDE (COMPRESSED GAS) PROPANE (FLAMMABLE LIQUID) ANTIFREEZE/COOLANTS WASTE OIL (FLAMMABLE LIQUID) @ CAR WASH PRODUCTS ... GROUND WATER MONITORING WELLS e e . Spill/Release Response Procedures for Carbon Dioxide (C02) The refrigerated liquid C02 used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills ofthe C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause bums, sever injury and/or fÌ"ostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dial 911 - infonn emergency personnel that there is a release fÌ"om the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers fÌ"om the site and deny entry to unauthorized people. 3. Stay upwind ofthe spill and out oflow-Iying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and finnly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away fÌ"om sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMA 1ìTosco\FORMS\co2-Spill Plan. doc '; e e EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE. SPILL OR SUSPECTED LEAK 2701270 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: verbally ANNOUNCE to all persons on the site: "There is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1 Give the following information: "TIIERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 5634 Stine Road" If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. . 4. ATIEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the statiorÏarea, and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator if s/he is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Tosco Maint. Call Center Address: Bus#/Home#/ Alt#: 800-726-2312 / 800-726-2312 / Alternate Emergency Coordinator: Teri Nicholson Address: Bus#/Home#/Alt#: 909-270-5123/800-697-1388/ Title: Disoatch Title: BDM 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager Tosco Environmental Compliance Coordinator: North: Janette Thompson (925) 277-2404 South: Stephen Boyd (714) 428-6572 or (800) 759-8888 pin#1267507 Tosco Corporation will notify the State and Local administering agencies within an appropriate time ftame, unless the situation requires ur!!ent immediate reSDonse bv the a!!encies. in which case the OPERATOR should notify these agencies: a) LOCAL AGENCY: Bakersfield Fire DeDartment PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800) 852-7550 (24 HOURS) c) LOCAL POLICE AND FIRE DEP AR1MENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, ifused. 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. 't e EMPLOYEE TRAINING PLAN e Employees must be given this training before starting work, and rerresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain these records for a minimum of three years. I. FIRST THINGS TO KNOW: A. EMERGENCY PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers rrom the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: FRONT OF BUILDING B. ELEC1RICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. Location: REAR OF BUILDING C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when a leak is detected by a visual and audible alann. Location: REAR OF BUILDING D. WATER SHUT -OFF: The water shut-off may be necessary in some cases. Location: NONE E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow m an emergency. Location: NONE F. PROP ANEILPG: If your station has a propane or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case oflarge spill, merely try to contain it; a vacuum truck should be used to clean up any large spill. Location: STORAGE 1. EMERGENCY RESPONSE EOUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTII SIDE OF SITE n 1 HAZARDOUS MATERIAL AAGEMENT PLAN (HMMP) & MATE. SAFETY DATA SHEET (MSDS): Location: CASHIER n. NEAREST MEDICAL FACILITY: Employees should know what facilities are available in case customers or other employees need medical attention. 1. NAME MERCY HOSPITAL ADDRESS:2215 TRUXTON AVE BAKERSFIELD PHONE NUMBER:805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: 2. NAME: KERN MEDICAL CENTER ADDRESS: 1830 FLOWER ST BAKERSFIELD PHONE NUMBER: 661-326-2000 ill. All employees should review the Hazardous Material Plan, of which this 1raining plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated clothing and shoes. Follow by washing with soap and water. Do not reuse clothing or shoes until cleaned. If irritation persists, get medical attention. C. INHALATION Œreathing): Remove victim to fresh air and provide oxygen if breathing is difficult. Ifnot breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): E. DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! Ifvomiting occurs spontaneously keep head below hips to prevent aspiration ofliquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: Ifmore than 2.0 m1 per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, convulsions or unconsciousness occur before emesis, gastric lavage using a cuffed endotracheal tube should be considered. For further infonnation, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. , This nazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last updated: March 7,2002 e - SECTION 1 HAZARDOUS MATERIALS TRAINING REQUIREMENTS As the owner/operator of a business that handles hazardous materials, you must have the following: · A Hazard Communication Plan (also known as an Employee Right-to-Know Plan) · A SARA Tier II Chemical Inventory Report (in California this report is included in the Hazardous Materials Management Plan, also known as the CA Business Emergency Plan) · An Emergency Response Plan · An Underground Storage Tank Monitoring and Leak Detection Plan · A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. · Training for the Hazard Communication Plan must include the following elements: · An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. · Locations of any operations in their work area where hazardous substances are present. · Location where a copy of the written Hazard Communication program is made available to them. · How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. · How to detect the presence of or the release of hazardous substances in the work place. · How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). · Emergency and first aid procedures to follow if employees are exposed to hazardous substances. )~ e e ~ .. IJII!. I TOSCO MARKETING COMPANY 1500 N. Priest Drive Tempe, Arizona 85281 Telephone: (602) 728-8000 Tosca March 20,2001 AGeNC~ Circle K Stores, Inc. Circle K 76#2701270 5634 Stine Road Bakersfield, CA 93313 RE: HAZARDOUS MATERIALS MANAGEMENT PLANS Dear Placidus "Lal" Silva: .__ _~_ n .__ Attached is the new Hazardous Materials Inventory and Business Plan Certification for your station. This updated HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP and kept in your "Success at the Pump: Keeping the Zone in Compliance Manual", and available to all employees and agency persOIlllel at all times. ~#€~~,\~~?Jr~;~ï§~~~'~Y,~¥~~~~~~ti~M,M~,·:,,~ THESE FORMS MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE. FAILURE TO RETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning the packet: 1. Please sign all 3 copies of the CERTIFICATION where flagged and indicated with a "X". 2. Please return the 2 copies marked "AGENCY" and "RHL FILE" to RHL Design in the pre-stamped enclosed envelope. 3. Keep this "DEALER" copy in your Environmental Compliance Book, and available for inspection. 4. Have your employees read and understand the contents of this package and sign the attached training log. Keep the training log at your station. A copy of this HMMP Certification will be sent to: Bakersfield Fire Department. within 30 days If you have any questions regarding the content of this document, please contact RHL Design Group, Mr. Steve Skanderson at (707) 765-1660. If you have any additional questions, including invoicing questions, please contact Tosco Marketing Company, Hazardous Materials Coordinator at (602) 728-7080. Sincerely, Tosco Marketing Company cc: RHL Design Group, Inc. Enclosure 2701270 ;~ Bakersfield Fire Depaltent 1715 Chester Avenue, 3rd Floor Bakersfield CA 93301 805-326-3979 GENCY USE ONLY File #: ¡, Reviewed by: Date: HAZARDOUS MATERIALS BUSINESS PLAN I INVENTORY 2001 CERTIFICATION FORM Business Name: Circle K 76#2701270 Owner/Operator Name: Circle K Stores, Inc. Ph 661-834-8625 one: Business Address· 5634 Stine Road Ci~y: Bakersfield ' State: CA Z. 93313 IP: Environmental Contact: Tina Berry Phone: 925-277-2319 ___ ____ n ___ Mailing Address: 2000 Crow Canyon PI. Suite 400 City: San Ramon State: CA 94583 Zip: BIENNIAL REVIEW AND RECERTIFICATION: >( I certify that the Business Plan has been reviewed and the information contained in it is accurate and complete as of the date below. I certify that I have reviewed the previously submitted Business Plan and have updated the following items on the attached pages. )( Emergency contacts names and/or phone numbers. Site/Facility map. Other Updates: AN~ INVENTORY UPDATE: Inventory Forms are correct for the upcoming reporting year. NO changes are necessary. Inventory Forms require updating. ATTACHED are only the revised pages. Inventory Forms required updating. Replace previous inventory with attached inventory. I certify under penalty of law, that I have personally examined and I am familiar with the information submitted in this and all attached documents, and based on my inquiry of those individuals responsible for obtaining the information. I b~lieve that the submitted information is true. accurate ant1mpre~e. Name:~ 0-:1l t'1ú... ffi ~ Di' \Z.:Q.v\ Signature7- :J.AJIla.. m~ (Type or Print) Title1 ~ f· ~~f, "fY\q, ,"'- - Date7 4,t~- 01 2701270 lED PROGRAM CONSOLIDATED FOR FACILITY INFORMATION ~...' BUSINESS ACTIVITIES Page ) ofd- I. FACILITY IDENTIFICATION FACILITY ID# I I I I I I I I I I I I I I I 1 I EPA ID# (Hazardous Waste Only) 2 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K 76#2701270 I. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the ~YESD NO 4 J HAZARDOUS MATERIALS INVENTORY- applicable Federal threshold quantity for an extremely hazardous CHEMICAL DESCRIPTION(OES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS lUSTs) ~YEsD NO 5 J 1. Own or operate underground storage tanks? UST FACILITY (Formerly SWRCB Form A) J UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? DYES~ NO 6 J UST FACILITY J UST TANK (One per tank J UST INSTALLATION - CERTIFICATE OF COMPLlANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? DYES:g'J NO 7 J UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS lASTs) Own or operate ASTs above these thresholds: DYES~NO 8 -any tank capacity is greater than 660 gallons, or J NO FORM REQUIRED TO CUPAS --the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? DYES~NO 9 J EPA ID NUMBEÆ-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted DYES(ZN010 J RECYCLABLE MATERIALS REPORT recyclable materials (per HSC 925143.2)? (one per recycler) - DYES0N011 3. Treat hazardous waste oñ site? J ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formerly DTSC Form .1772) J ONSITE HAZARDOUS WASTE TREATMENT-UNIl(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L) 4. Treatment subject to financial assurance requirements (for Permit DYES I)a' NO 12 J CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? DYESçgJN013 J REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as DYES o/N014 J HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaneQ onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS . 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2 · 2701270 UNI PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION i f--- Page of k__,_ 100 ENDING DATE ! 12/31/2001 3 BUSINESS PHONE 661-834-8625 FACILITY 10# 1 BEGINNING DATE 1/1/2001 BUSINESS NAME Circle K 76#2701270 BUSINESS SITE ADDRESS 5634 Stine Road CITY 104 ZIP CODE CA Bakersfield 93313 ¡DUN BRADSTREET I I ,¡COUNTY SIC CODE (4 digit #) 5541 106 04-8564975 KERN i BUSINESS OPERATOR NAME Placid us "Lal" Silva ---..- - ----------~~~---------- --... .-...--- ------ 109 BUSINESS OPERATOR PH, ONE 800-726-2312 II. "BUSINESS OWNER 101 - _o- j 102 I 103 105 107 108 110 OWNER NAME ¡OWNER PHONE I 602-728-7080 111 Circle K Stores, Inc.__ _,___ OWNER MAILING ADDRESS P.O. Box 52085 CITY 114 [STATE AZ. 115 III. ENVIRONMENTAL CONTACT 117 IZIP CODE I 85072-2085 I roo' Phoenix ---~------------~--------- ---------~¡cONTACT-PH-ONE·--..'-- . I ICONT ACT NAME Tina Berry ICONTACT MAILING ADDRESS 925-277 -2319 CITY 2000 Crow Canyon PI. Suite 400 San Ramon CA 94583 120 STATE 121 ZIP CODE PRIMARY SECONDARY IV. EMERGENCY CONTACTS 123 NAME 124 ITITLE I !NAME Tosco Maint. Call Center Teri Nicholson 112 I I 113 'I 116 I I ..., 118 119 122 ---------. -- ..-....- -... 128 BDM 129 : --.---..--- -.---- ------ ---.-_._----- -- BUSINESS PHONE 125 BUSINESS PHONE 130 800-726-2312 909-270-5123 24-HOUR PHONE - 126 24-HOUR PHONE 131 800-726-2312 800-697-1388 I PAGER# 127 PAGER# 132 ! ¡TITLE Dispatch ¡ADDITIONAL LOCALLY COLLECTED INFORMATION: ..---- -- ------,.,~- !Certification: Based on my inquiry of those individuals responsible for obtaining the information, [ certify under penalty of law that [ have personally examined and am Itàmiliar with the information submitted and believe the information is true, accurate, and complete, --~------_. .- DATE 134 NAME OF DOCUMENT PREPARER 135 - t& r 0 I RHL DESIGN GROUP, INC. - ENVIRONMENTAL DEPT. 136 TITLý-VF SIGNER 137 If ~ - ~ßt-: ~~v ___,____ UPCF ( 1/99 revised) OES FORM 2730 (1/9 167 ...., GENCY RESPONSE PROCEDURE "'IDENT: FIRE. SPILL OR SUSPECT LEAK 2701270 '({ 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EV ACUA TE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1: Give the following information: "THERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 5634 Stine Road If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having ,difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator if he/she is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Tosco Maint. Call Center Address: Bus#/Home#/ Alt#: 800-726-2312 / 800-726-2312 / Alternate Emergency Coordinator: Teri Nicholson Address: Bus#/Home#/Alt#: 909-270-5123/800-697-1388/ Title: Dispatch Title: BDM 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager. Tosco Environmental Compliance Coordinator: North: Tina Berry (925)277-2319 or (888)671-4350 South: Stephen Boyd (714)428-6572 or (800)759-8888 pin#1267507 Tosco Coporation will notify the State and Local administering agencies within an appropriate time frame, unless the situation requires urgent immediate response bv the agencies. in which case the Ouerator should notify these agencIes. - a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for ~ills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. '. &MPLOYEE TRAINING PLAN e "Employees must be given this training before starting work, and refresher courses must be provided annually. 'Records must be kept to show when each station employee has been given hislher safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. I. FIRST THINGS TO KNOW: A. EMERGENCY PUMP SHUT -OFF:This turns off the turbine pumps that provide flow to the dispensers from the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: FRONT OF BUILDING B. ELECTRICAL PANEL: The panel allows yöu to selectively cut off power to lights, signs, pumps, etc. The main" switch kills all power at the site. Location: REAR OF BUILDING C. ' TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when a leak is detected by a visual and audible alarm. Location: REAR OF BUILDING I D. WATER SHUT -OFF: The water shut-off may be necessary in some cases. Location: STINE ROAD "-- ----". --- E. NATURAL GAS SHUT -OFF: If your station has natural gas, it may be necessary to shut-off the n'atural gas flow III an emergency. Location: NONE F. PROP ANEILPG: If your station has propage or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it, a vacum truck should be used to clean up any large spill Location: STORAGE I. PERSONAL PROTECTIVE EOUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH SIDE OF SITE . HAZARDOUS MATERIAL MANAGEMENT PLAN ŒMMP) MATERIAL SAFETY DATA SHEET (MSDS): Location: CASHIER II. NEAREST MEDICAL FACIL'-": Employees should lmow what facilitilre available in case customers or ~other employees need medical attention. l.NAME: MERCY HOSPITAL ADDRESS: 2215 TRUXTON AVE BAKERSFIELD PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: 2.NAME: KERN MEDICAL CENTER ADDRESS: 1830 FLOWER ST BAKERSFIELD PHONE NUMBER: 661-326-2000 III. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and lmow how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated'clothing and shoes. Followed by washing with soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention. C. INHALATION ffireathing): Remove victim to fresh air and provide oxygen if breathing is difficult. Ifnot breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 rn1 per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, consulsions, or unconsciousness occur before emesis, gastric lavage using a cuffed endotrachael tube should be considered. For further infonnation, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. - This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last updated: December 21, 1999 e TRAINING LOGe .. UNIT # 2701270 BUSINESS NAME: Circle K 76#2701270 ADDRESS: 5634 Stine Road TO BE MAINTAINED ON SITE EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR INTITAL AND/OR ANNUAL SAFETY TRAINING. DATE OF TYPE OF EMPLOYEE NAME EMPLOYEE SIGNATURE TRAINING TRAINING ~ - , , (updated: February 15, 2000) -;. -. r. rr ~.L e TOSCO Marketing Company Tasca Marketing Company P.O. Box 52085 Phoenix, Arizona 85072-2085 1500 North Priest Drive Tempe, Arizona 85281 David A. Waldschmidt Assistant General Counsel 6021728-7470 (direct line) 6021728-5277 (facsimile) April 23, 2001 Re: Financial Responsibility 40 CPR Part 280, Subpart H To Agencies Listed on the Attached Exhibit A: I am enclosing information relating to Tosco Corporation's requirement to provide financial responsibility for the ownership and operation of underground storage tanks by its operating entities pursuant to 40 CPR Part 280, Subpart H and similar state regulations. Tosco Corporation meets the financial test of self-insurance set forth under 40 CPR § 280.95. It is intended that this financial responsibility likewise satisfy the requirements of authorized state programs. Tosco provides this financial responsibility for all underground storage tanks at retail locations, terminals and bulk plants which are owned and/or operated by all Tosco entities including Circle K Stores Inc., Tosco Operating Company, Inc., Tosco Refining L.P., Bayway Refining Company, Tosco Terminal Corporation and Tosco Corporation. For your information, Tosco's retail operations are collectively referred to as "Tosco Marketing Company". The information enclosed consists of a Certification of Financial Responsibility, a letter from Tosco's Chief Financial Officer in the form prescribed by the federal regulations and a facility address list for your state or region. Please forward this information to the appropriate person in your agency. You may direct any questions to me at (602) 728-7470. Very truly yours, 1/ ftM¡,thll~ David A. Waldschmidt Assistant Genc, .~; Counsel DAW/cs 8220CS I.DOC ~~,E*-ONI ~'flifI.~ " rr e e Tosco Corporation 1700 East Putnam Avenue Suite 500 Old Greenwich, CT 06870 Telephone: 203·698-7575 Facsimile: 203-698·7910 TOSCO Craig R. Deasy Vice President Treasurer CERTIFICA TION OF FINANCIAL RESPONSIBILITY Tosco Corporation hereby certifies that it is in compliance with the requirements of Subpart H of 40 CPR Part 280. The financial assurance mechanism used to demonstrate financial responsibility under Subpart H of 40 CPR Part 280 is às follows: Mechanism: Section 280.95 - Financial Test of Self Insurance Amount of Coverage: $2,000,000 in the aggregate Effective Period of Coverage: From January 1, 2001 until April 30, 2002, unless earlier revoked or replaced by written notice to the Implementing Agencies listed on the attached Exhibit A. Coverage: . Corrective action and third-party compensation for bodily injury and property damage caused by sudden and nonsudden accidental releases arising from the operation of underground storage tanks. By: ~ '£¿¿ crai~DeaSy ~ Vice President and Treasurer Its: Date: April liz, 2001 .. e e ~ State of ~f)NC-lra,-I- County of Fë,¡'r.ßt H ) ) ss. ) "1 The foregoing instrument was acknowledged before me this kl-ctay of CJ'0~ I by Craig R. Deasy, personally known to me as Vice President and T Tosco Corporation, who executed the same on behalf of the corporation. . M/J1uæÆ Notary PublIc MYCOmmiSSiOnEXPires~ 3/. ,;)ðð (" / DENISE G. MECIU . Notary Public, State of ConnectIcut No. 0111489 Qualified in Fairfield County Commission Expires March 31, 2006 -; II e e Tosco Corporation 1700 East Putnam Avenue Suite 500 Old Greenwich, Connecticut 06870 Telephone: 203-698·7506 Facsimile: 203·698,7903 TOSCO Jefferson F. Allen President April 16, 2001 Underground Storage Tank (UST) Financial Responsibility Letter fÌ"om Chief Financial Officer I am the chief financial officer of Tosco Corporation, 1500 Putnam Avenue, Old Greenwich, CT 06870. This letter is in support of the use of the financial test of self-insurance to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and nonsudden accidental releases in the amount of at least $ 1,000,000 per occurrence and $2,000,000 annual aggregate arising fÌ"om operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this owner or operator: (See Attached Listings) A financial test is also used by this owner or operator to demonstrate evidence of financial responsibility in the following amounts under other EP A regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: Amount EP A Regulations: Closure (§§ 264.143 and 265.143) Post-Closure Care (§§ 264.145 and 265.145) Liability Coverage' (§§ 264.147 and 265.147) Corrective Action (§§ 264.101(b» Plugging and Abandonment (§ 144.63) $ None $ None $ None $ None $ None Authorized state programs: Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment Total $ 28,509,000 $ 17,138,000 $ 49,000,000 $ 5,997,000 $ None $ 100,644,000 e - This owner or operator has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification ITom an independent auditor on his financial statements for the latest completed fiscal year. Alternative n 1. Amount of annual UST aggregate coverage being assured by a financial test, and/or guarantee $ 2,000,000 2. Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test, and/or guarantee $ 100,644,000 3. Sum of lines 1 and 2 $ 102,644,000 4. Total tangible assets $ 8,407,200,000 5. Total liabilities $ 6,394,100,000 6. Tangible net worth $ 2,013,100,000 Yes No 7. Total assets in the U.S. (required only ifless than 90 percent of assets are located in the U.S.) $ N/A 8. Is line 6 at least $10 million? X 9. Is line 6 at least 6 times line 3? X 10. Are at least 90 percent of assets located in the U.S.? X 11. Is line 7 at least 6 times line 3? N/A 16. Current bond rating of most recent bond issue Baa2 BBB 17. Name of rating service Moody's .:, lauuard Investor & Poors Service 18. Date of maturity of bond January I, 2047 e -: 19. Have financial statements for the latest fiscal year been filed with the: SEC Energy Information Administration Rural Electrification Administration e i Yes No x x X I I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) and/or WAC 173-380-470 as such regulations were constituted on the date shown immediately below. ~.Cùr- " erson F. AJlen Chief Financial Officer April 16, 2001 e A TT ACHMENT TO LETTER FROM CHIEF FINANCIAL OFFICER e .." ':--'-"-'.' ""'''. -,...-' .-_.. .--.~_...~~..---'- ._~.-.",--¡,¡.,:;.;. ì All underground storage tanks (UST's) owned and/or operated by Tosco Corporation I and its affiliates and subsidiaries are covered by this financial test of self-insurance. These entities: include Circle K Stores Inc., Tosco Operating Company, Inc., Tosco Refining, L.P. (collectively referred to as "Tosco Marketing Company"), Bayway Refining Company, Tosco Corporation, and Tosco Tenninal Corporation. UST's are located at the following refineries, tenninals, carbon plant, and bulk plants: REFINERIES & TERMINALS: Bayway Refinery 1400 Park Avenue Linden, NJ 07036 Los Angeles Refinery (Wilmington) P.O. Box 758 Wilmington, CA 90748 Sacramento Tenninal 76 Broadway : Sacramento, CA 95818 Baltimore Tenninal 2155 Northbridge Baltimore, MD 21226 Los Angeles Tenninal 13707 S. Broadway Los Angeles, CA 90061 Colton Tenninal 2301 S. Riverside Rialto, CA 92316 Portland Tenninal 5528 NW Doane Avenue Portland, OR 97210 Femdale Refinery 3901 Unick Road Femdale, W A 98248 Renton Tenninal 2423 Lind Ave SW Renton, W A 98055 Honolulu Tenninal 411 Pacific Street Honolulu, HI 96817 Richmond Tenninal 1300 Canal Boulevard Richmond, CA 94804 Los Angeles Refinery (Carson) 1520 East Sepulveda Boulevard Carson, CA 90745 Riverhead Tenninal 213 Sound Shore Rd. Riverhead,~ 11901 BULK PLANTS: 845 Walnut Ave. Greenfield, CA 93927 100 Lee Rd. Watsonville, CA 95076 San Francisco Refinery-Rodeo 1380 San Pabl() Avenue Rodeo, CA 94572 San Francisco Refinery- Carbon Plant 2101 Franklin Canyon Rodeo, CA 94572 I Tacoma Tenninal 520 East D Street Tacoma, WA 98421 , i '. e e ~ SUPPLEMENTAL A TTACHivŒNT TO LEITER FROM CHIEF FINANCIAL OFFICER FACILlTY LIST A list of facilities covered by this tìnancial responsibility mechanism has been tìled with: California State Water Resources Comrol Board UST Program P.O. Box 944212 Sacramento. CA 94244 It may also be obtained from: Tosco Marketing Company 2000 Crow Canyon Place. Suite 400 San Ramon, CA 94583 Attemion: David Camille (925) 277-2335 or Tosco Marketing Company 3525 Hyland Avenue Costa Mesa. CA 92626 Attention: Michael Bryan (714)418-7606 8222CS4.DOC e EXHIBIT A US ENVIRONMENTAL PROTECTION AGENCY ARIEL RIOS BUILDING 1200 PENNSYLVANIA AVENUE NW WASHINGTON DC 20460 EPA REGION 1 1 CONGRESS ST SUITE 1100 BOSTON MA 02114-2023 EPA REGION 2 290 BROADWAY NEW YORK NY 10007-1866 EPA REGION 3 1650 ARCH STREET PHILADELPHIA PA 19103-2029 EPA REGION 4 ATLANTA FEDERAL CENTER 61 FORSYTH STREET SW A TLANT A GA 30303-3104 EPA REGION 5 77 W JACKSON BLVD CHICAGO IL 60604 EPA REGION 6 FOUNTAIN PLACE SUITE 1200 1445 ROSS AVE DALLAS TX 75202-2733 EPA REGION 9 75 HAWTHORNE ST SAN FRANCISCO CA 94105 I, EPA REGION 10 1200 SIXTH AVENUE SEATTLE WA 98101 ALABAMA DEPT OF ENVIRONMENTAL MGMT UST COMPLIANCE SECTION POBOX 301-463 MONTGOMERY AL 36130 e e AZ DEPT OF ENVIRONMENTAL QUALITY UST SECTION 3033 N CENTRAL AVE #4T PHOENIX AZ 85012 CA STATE WATER RESOURCES CONTROL BOARD UST PROGRAM POBOX 944212 SACRAMENTO CA 94244 DE DEPT OF NATURAL RESOURCES UST BRANCH 391 LUKENS DR. NEW CASTLE DE 19720 .. " DC ENVIRONMENTAL HEALTH ADMIN UST DIVISION 51 N STREET NE RM 3019 WASHINGTON DC 20002 FLORIDA DEPT OF ENVIRON PROTECTION STORAGE TANK REGULATION SECTION 2600 BLAIR STONE RD. TALLAHASSEE FL 32399 . , GEORGIA DEPT OF NATURAL RESOURCES UST MANAGEMENT PROGRAM 4244 INTERNATIONAL PKWY STE 104 ATLANTA GA 30354 HI DEPT OF HEALTH SOLID & HAZARDOUS WASTE BRANCH 919 ALA MOANA BLVD RM 212 HONOLULU HI- 96814 LA DEPT OF ENVIRONMENTAL QUALITY UST DIVISION POBOX 82231 BATON ROUGE LA 70884 MD DEPT OF ENVIRONMENT OIL CONTROL PROGRAM 2500 BROENING HIGHWAY BALTIMORE MD 21224 BUREAU OF WASTE SITE CLEANUP CEPT OF ENVIRONMENTAL PROTECTION 1 WINTER STREET BOSTON MA 02108 e e e .'."" MJ DEPARTMENT OF ENVIRONMENTAL QUALITY STORAGE TANK DIVISION POBOX 30157 LANSING MI 48909 DEPT OF ENVIRONMENTAL QUALITY UST SECTION OFFICE OF POLLUTION CONTROL POBOX 10385 JACKSON MS 39289 NEVADA DIVISION OF ENVIRON PROTECTION BUREAU OF CORRECTIVE ACTION 333 W NYE LANE NUMBER 138 CARSON CITY NV 89710 NH DEPT OF ENVIRONMENTAL SERVICES OIL REMEDIATION AND COMPLIANCE BUREAU PO BOX 95, 6 HAZEN DR CONCORD NH 03302' NJ DEPT OF ENVIRONMENTAL PROTECTION BUREAU OF USTS POBOX 433 TRENTON NJ 08625 NM ENVIRONMENT DEPT UST BUREAU HAROLD RUNNELS BLDG ROOM N-251 0 1190 ST FRANCIS DRIVE SANTA FE NM 87502 NY DEPT OF ENVIRONMENTAL CONSERVATION BULK STORAGE SECTION 50 WOLF ROAD ROOM 360 ALBANY NY 12233 NORTH CAROLINA DIV OF ENVIRON MGMT UST/LUST PROGRAM POBOX 29578 RALEIGH NC 27626 DEPT OF ENV QUALITY UST PROGRAM 811 SW 6TH AVE 7TH FLR PORTLAND OR 97204 PA DEPT OF ENVIRONMENTAL PROTECTION DIVISION OF STORAGE TANKS 400 MARKET ST PO BOX 8762 HARRISBURG PA 17105 '--i~~ e e . SC DEPT OF HEALTH & ENVIRON CONTROL DIVISION OF UST MANAGEMENT 2600 BULL STREET COLUMBIA SC 29201 DEPT OF ENVIRONMENT AND CONSERVATION UST DIVISION 4TH FLOOR L&C TOWER 401 CHURCH STREET NASHVILLE TN 37243 TX NATURAL RESOURCE CONSERVATION COMM PETROLEUM STORAGE TANK DIVISION POBOX 13087 .. AUSTIN TX 78711 VA DEPT OF ENVIRONMENTAL QUALITY OFFICE OF SPILL RESPONSE AND REMEDIATION POBOX 10009 RICHMOND VA 23240 TOXICS CLEANUP PROGRAM WASHINGTON DEPT OF ECOLOGY POBOX 47655 OLYMPIA WA 98504 WASHINGTON DEPARTMENT OF LICENSING UST SECTION PO BOX 9020 OLYMPIA WA 98507-9020 $' ~ " ;?1 "' L JOHN W, JOHNSON Co' President Principal BRIAN F, ZITA Co,President Principal JOHN B" HICKS Vice President Principal CECIL R, SPENCER Vice President Principal CHRIS LAWTON Regional Manager Associate e e ARCHITECTURE ENVIRONMENTAL SERVICES ENGINEERING 1137 North McDowell Boulevard, Peta/uma, CA 94954,1110 Telephone: (707) 765-1660 Facsimile: (707) 765,9908 John W, Johnson, Architect Established 1 966 May 05, 2000 Bakersfield Fire Department Ralph Huey 1715 Chester Avenue, 3rd Floor Bakersfield, CA 93301 HAZARDOUS MATERIALS MANAGEMENT PLANS FOR TOSCO/CIRCLE K Dear Ralph Huey: Enclosed please find the Hazardous Material Management Plans, HMMP(s), for the Tosco Corporation station(s) as listed on the attached sheet. \ These inventories and HMMP(s) are being submitted for your review and approval. If there are any further correspondence or invoices related to these submissions, please direct them to: Regional Compliance Specialist Tosco Corporation P.O. Box 52085 Phoenix, AZ 85072-2085 Sincerely, RIlL DESIGN GROUP, INC. JAM EsE, PRE S TEN cfjnvironmental Department Regional Manager Associate GARY M. SEMLING Regional Manager Associate ALAN K" SHIMABUKURO Regional Manager Associate BLYTHE R, WILSON Regional Manager Associate Enclosure BELLEVUE, WA LA HABRA, CA MARTINEZ, CA PETALUMA, CA SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER, WA .,., .¡} ''!¡." ;,# -- e e 2701270 Circle K Stores, Inc, 5634 Stine Road Bakersfield, CA 93313 ~ ¡. r.- UNIFIED PROGRAM CONSOLIDATED FORM e e/ / \ FACILITY INFORMATION BUSINESS ACTIVITIES~// ,// 2701270 ~ 'r,' '- ""\ ; J , \ of !~",t~ÆgI~¡~"IiS~N~I€lig~¡tIÕ'~:~á§;¿~:'1'f¡f¡f:C¡~4¡;fj!éi¡~r¡5'!1'Tf::[~'j' "NßTÊ:."lfI,,ÔJJ:¡chè'ç K:'!:YES,'fo'a n ..".i,a rt>Óf' th is:O ¡sf>:' , ·"·5 ". ,.,".'.... ,....,. ,.'..' .·.....Y:;.0.,':':-k" .,..,...... ',"i.., ,..,..,..........' ,,', ..."...'.. ,...,Y.I?.'.,. ..,.,., ".' .i' ".' . ii".···" ......"...., ,i!:{:",~;- ;,~,I~~~;ß:,~·~.þ¡~,iththe<.~~~lry~~~~9~r"!:r!9p~r~fg~;I~~pfificafi ()p·p~~~'.(8i~S(EÓrl11',·..,2730l. oó&? ÿqur ·fªcilitY... pleasecômþl~tethése pa~ê~i'Of t~elr8Æ;;F:.; A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in AsTs and USTs); or the D YES ~ NO 4 I applicable Federal threshold quantity for an extremely hazardous ~ ý substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION (OES 2731) B. l!JNDERGROUND STORAGE TANKS (USTs) YESD NO 5 ../ UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? DYES DfNO 6 ../ UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ../ UST FACILITY ../ USTTANK (Onepertank ../ UST INSTALLATION - CERTIFICATE OF DYESBNO 7 COMPLlANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? ../ UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: þ DYES Œ(NO 8 -any tank capacity is greater than 660 gallons, or ../ NO FORM REQUIRED TO CUPAS -the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? DYEs[}j NO 9 ../ EPA ID NUMBER-provide at the top of this page 2, Recycle more than 100 kg/month of excluded or exempted DYES Q.rN010 ../ RECYCLABLE MATERIALS REPORT recyclable materials (per HsC § 25143.2)? (one per recycler) 3. Treat hazardous waste or site? DYESæ] N011 ../ ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formerly DTSC Form 1772) ../ ONSITE HAZARDOUS WASTE TREATMENT-UNIl(one page per unit) DYES~12 (Formerly DTSC Form 1772A,B,C.D, and L) 4. Treatment subject to financial assurance requirements (for Permit ../ CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? DYESEJN013 ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ../ REMOTE WASTE/CONSOLIDATION SITE DYES~4 ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ../ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 . (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2 F -- ~ ;0 2701270 UNIF, PROGRAM CONSOLIDATED FORM' e BUSINESS OWNER/OPERATOR IDENTIFICATION FACILITY INFORMATION ') r.\ .; Page of.s- FACILITY ID# I. IDENTIFICATION 1 BEGINNING DATE 1/1/2000 101 BUSINESS NAME 102 Circle K Stores, Inc. BUSINESS SITE ADDRESS 103 5634 Stine Road CITY II. BUSINESS OWNER 104 CA ZIP CODE 93313 106 SIC CODE (4 digit #) 5541 109 BUSINESS OPERA TOR PHONE 909-270-5123 111 OWNER PHONE 602-728-7080 105 Bakersfield DUN .BRADSTREET 107 04-8564975 COUNTY 108 KERN BUSINESS OPERATOR NAME Diana Marshall 110 Circle K Stores, Inc. OWNER MAILING ADDRESS OWNER NAME 112 113 P.O. Box 52085 CITY 114 STATE 115 AZ ZIP CODE 116 85072-2085 Phoenix CONTACT NAME III. ENVIRONMENTAL CONTACT 117 CONTACT PHONE 118 Merliza Alcala 925-277-2319 CONTACT MAILING ADDRESS 119 CITY 2000 Crow Canyon PI. Suite 400 San Ramon 120 STATE 121 ZIP CODE 122 CA 94583 Teri Nicholson IV. EMERGENCY CONTACTS 123 NAME SECONDARY PRIMARY NAME 128 TITLE Dist. Mgr. Tasca Maintenance 124 TITLE Dispatch Ctr 125 BUSINESS PHONE 800-726-2312 126 24-HOUR PHONE 800-726-2312 127 PAGER# 129 BUSINESS PHONE 130 909-270-5123 24·HOUR PHONE 131 800-697-1388 P AGER# 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of those individuals responsible for obtaining the infonnation, I certify under penalty oflaw that I have personally examined and am familiar with the infonnation submitted and believe the information is true, accurate, and complete, NAME OF DOCUMENT PREPARER 135 RHL DESIGN GROUP, INC. - ENVIRONMENTAL DEPT. 137 UPCF ( 1/99 revised) 16 OES FORM 2730 (1/9 ",/ '" ¡ UNW:D PROGRAM CONSOLIDATED FO. \ HAZARDOUS MATERIALS - HAZARDOUS MATERIALS INVENTORY - ¡ CHEMICAL DESCRIPTION One page per material per building or area) I I AD!) I I DELETE I)( REVISE 200 I Page 1. of ç I. FACILITY INFORMATION BUSINESS NAME Circle K Stores, Inc. . 3 2701270 CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL 202 WEST SIDE OF SITE EPCRA DYES ŒJNO FACILITY ID# I I I I I I I , 11 MAP# (optional) 203/ GRID~;PtiOnal) 204 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET UYes ~o 206 PETROLEUM HYDROCARBON If Subject to EPCRA. refer to instruction, COMMON NAME 207 206 REGULAR UNLEADED EHS DYes ŒJNo CAS# 209 8006-61-9 If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID HAZARD MATERIAL 211 RADIOACTIVE DYes ŒJN° 2121 213 1YPE (Check one item D a. PURE [8] b. MIXTURE Dc. WASTE CURIE PHYSICAL STATE D a. SOLID [8] b. LIQUID D c. GAS 214 215 (Check one item only) LARGEST CONTAINER 10000 FED HAZARD CATEGORIES [8] a. FIRE D b. REACTIVE D c.PRESSURE RELEASE [8] d. ACUTE HEALTH [8] e.CHRONIC HEALTH 216 (Check all that apply) AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 216 IANNUAL W AST~ AMOUNT 211STATE WASTE CODE 220 5000 10000 UNITS· [8] a. GALLONS D b. CUBIC FEET D c. POUNDS D d. TONS 2211 DAYS ON SITE: 222 (Check one item only) ifEHS amount must be in nounds. 365 STORAGE ~. ABOVE GROUND TANK ~,. PLASllCJNONMETALLICDRUM ~. FlBERDRUM ~mGLASS BOTILE Bo, RAIL CAR CONTAINER X b. UNDERGROUND TANK f. CAN '. BAG n. PLASTIC BOITLE p. OTHER c. TANK INSIDE BUILDING g. CARBOY k. BOX 0. TOTE BIN d. STEEL DRUM h. SILO I. CYLINDER p. TANK WAGON 223 STORAGE PRESSURE [8]a. AMBIENT Db, ABOVE AMBIENT Dc. BELOW AMBIENT 224 STORAGE TEMPERA TVRE [8] a. AMBIENT Db. ABOVE AMBIENT Dc. BELOW AMBIENT Dd. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS ' - CAS# 1 15% 226 METHYL TERTBUTYLETHER 227 []v es ŒJN° 226 1634-04-4 229 2 15% 230 TOLUENE 231 []v es ŒJN° 232 108-88-3 233 3 21% 234 XYLENE 235 []v es ŒJNo 236 1330-20-7 237 4 5% 238 BENZENE 239 []v es ŒJN° 240 71-43-2 241 5 5% 242 1,2,4-TRIMETHYL BENZENE 243 DYes ŒJN° 244 95-63-6 245 If more hazardous components are present at greater than 1 % by weight if non-carcinogenic. or 0.1 % by weight if carcinogenic, attach additioñal sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED lNFORMA nON 246 If EPCRA, Please Sign Here '", ~ UPCF (1/99) 169 OES Form 2731 :;; <$ ¡ UNWD PROGRAM CONSOLIDATED FW HAZARDOUS MATERIALS - , HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) I I ADD I I DELETE I Xf REVISE 200 I Page -"-'¡ of ,~ I. FACILITY INFORMATION BUSINESS NAME 3 Circle K Stores, Inc. 2701270 CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL 202 WEST SIDE OF SITE EPCRA DYES 0NO I I I I I I , I I 11 MAP# (optional) 2031 G~# S (optional) 204 FACILITY ID# 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET UYes ~o 206 PETROLEUM HYDROCARBON If Subject to EPCRA, refer to instructions COMMON NAME 207 208 PLUS UNLEADED EHS DYes ~No CAS# 209 8006-61-9 If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete ¡frequired by CUPA) 210 I-B FLAMMABLE LIQUID HAZARD MATERIAL 211 . 2121 213 TYPE (Check one item o a. PURE ŒJ b. MIXTURE Dc. WASTE RADIOACTIVE DYes 0N0 CURIE PHYSICAL STATE o a. SOLID 0 b. LIQUID o c. GAS 214 215 (Check one item only) LARGEST CONTAINER 10000 FED HAZARD CATEGORIES ŒJ a. FIRE o b. REACTIVE 0 c.PRESSURE RELEASE 0 d. ACUTE HEALTH o e.CHRONIC HEALTH 216 (Check all that apply) AVERAGE DAlLY AMOUNT 217 MAXIMUM DAlLY AMOUNT 218 I ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5000 10000 UNITS * ŒJ a. GALLONS o b. CUBIC FEET 0 c. POUNDS o d. TONS 2211 DAYS ON SITE: 222 (Check one item only) ifEHS amount must be in Dounds. 365 STORAGE ~. ABOVE GROUND TANK M" PLASTIClNONMETALLlC DRUM R' FIBER DRUM Mm'GLASS BOTTLE Bo, RAIL CAR CONTAINER X b, UNDERGROUND TANK f. CAN '. BAG n. PLASTIC BOITLE p. OTHER c. TANK INSIDE BUILDING g. CARBOY k. BOX 0. TOTE BIN d. STEEL DRUM h. SILO I. CYLINDER p. TANK WAGON 223 STORAGE PRESSURE ŒJa. AMBIENT Db, ABOVE AMBIENT Dc. BELOW AMBIENT 224 STORAGE TEMPERATURE ŒJ a. AMBIENT Db. ABOVE AMBIENT Dc. BELOW AMBIENT Dd. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) -"- EHS CAS# 1 15% 226 METHYL TERT BUTYL ETHER 227 []Yes 0No 228 1634-04-4 229 2 15% 230 TOLUENE 231 []Yes 0N0 232 108-88-3 233 3 21% 234 XYLENE 235 []Yes [8JN0 236 1330-20-7 237 4 5% 238 BENZENE 239 []Yes [8JNo 240 71-43-2 241 5 5% 242 1,2,4-TRIMETHYL BENZENE 243 DYes [8JN0 244 95-63-6 245 If more hazardous components are present at greater than I % by weight if non~cinogenic. or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMA nON 246 If EPCRA, Please Sign Here <, UPCF (1/99) 169 OES Form 2731 ~ i:! HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION UNWD PROGRAM CONSOLIDATED F. ~\ One page per material per building or area) ADD DELETE REVISE I. FACILITY INFORMATION 200 Page BUSINESS NAME CHEMICAL NAME 2701270 CHEMICAL LOCA nON CONFIDENTIAL EPCRA DYES 0 NO MAP# (optional) 3 Circle K Stores, Inc. CHEMICAL LOCA nON 202 WEST SIDE OF SITE PETROLEUM HYDROCARBON 205 TRADE SECRET 204 FACILITY ID# 206 If Subject to EPCRA, refer to instlUctions COMMON NAME 207 EHS o Yes ~No 208 PREMIUM UNLEADED CAS# 209 IfEHS is "Yes", all amounts below must be in Ibs" 8006-61-9 FIRE CODE HAZARD CLASSES (Complete ¡frequired by CUPA) 210 I-B FLAMMABLE LIQUID HAZARD MA TERlAL TYPE (Check one item 211 212 D a. PURE ŒJ b. MIXTURE D c. WASTE RADIOACTIVE 0 Yes 0No CURIE D a. SOLID ŒJ b. LIQUID Dc. GAS 214 LARGEST CONTAINER 10000 ŒJ e.CHRONIC HEALTH 213 PHYSICAL STATE (Check one item only) 215 ~~c~a~;~GORIES ŒJ a. FIRE D b. REACTIVE D c.PRESSURE RELEASE ŒJ d. ACUTE HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 5000 10000 ŒJ a. GALLONS D b. CUBIC FEET 0 c. POUNDS ifEHS amount must be in ounds. 216 219 STATE WASTE CODE 220 UNITS· (Check one item only) D d. TONS 222 STORAGE CONTAINER Ma. ABOVE GROUND TANK ~e. PLASTICINONMET ALLIC DRUM R·. FIBER DRUM X b. UNDERGROUND TANK f. CAN '. BAG c. TANK INSIDE BUILDING g. CARBOY k. BOX d. STEEL DRUM h. SILO \. CYLINDER ~m. GLASS BOTTLE n. PLASTIC BOITLE o. TOTE BIN p. TANK WAGON DO. RAIL CAR Dp. OTHER 223 STORAGE PRESSURE ŒJ a. AMBIENT Db. ABOVE AMBIENT Dc. BELOW AMBIENT STORAGE TEMPERATURE ŒJ a. AMBIENT Db. ABOVE AMBIENT Dc. BELOW AMBIENT Dd. CRYOGENIC %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 10% 226 METHYL TERT BUTYL ETHER 227 []v es [9Jo 228 1634-04-4 2 9% 230 TOLUENE 231 []v es (8]No 232 108-88-3 3 14% 234 XYLENE 235 []v es (8]No 236 1330-20-7 4 5% 238 1,2,4-TRIMETHYL BENZENE 239 []v es (8]No 240 95-63-6 5 5% 242 BENZENE 243 DYes 0N0 244 71-43-2 224 225 229 233 237 241 245 If more hazardous components are present at greater than 1 % by weight if non--carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 IfEPCRA, Please Sign Here UPCF (1/99) 169 OES Fonn 2731 ~ i ,ED PROGRAM CONSOLIDATED FW HAZARDOUS MATERIALS . ; HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) I I ADD I I DELETE 1)(1 REVISE 200 I Page 5 of S- I. FAtILITY INFORMATION BUSINESS NAME 3 Circle K Stores, Inc. 2701270 CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTlAL 202 SALES AREA EPCRA DYES Œ]NO I I I I I I I I I 11 MAP# (optional) 2031 GRID# (optional) 204 FACILITY ID# 1 F"? II. CHEMICAL INFORMA nON CHEMICAL NAME 205 TRADE SECRET UYes ~o 206 CARBON DIOXIDE If Subject to EPCRA. refer to instructions COMMON NAME 207 208 CO2 EHS DYes [8] No CASH 209 124-38-9 If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete ¡frequired by CUPA) 210 INERT GAS HAZARD MATERIAL 211 RADIOACTIVE 0 Yes ~o 2121 213 TYPE (Check one item o a. PURE 0 b. MIXTURE Dc. WASTE CURIE PHYSICAL STATE D a. SOLID 0 b. LIQUID o c. GAS 214 215 (Check one item only) LARGESTCONTAJNER 175 FED HAZARD CATEGORIES o a. FIRE o b. REACTIVE 0 c.PRESSURE RELEASE 0 d. ACUTE HEALTH D e.CHRONIC HEALTH 216 (Check all that apply) AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ¡ANNUAL W AST~ AMOUNT 219 I STATE WASTE CODE 220 350 UNITS · D a. GALLONS o b. CUBIC FEET D c. POUNDS D d. TONS 221 [ DAYS ON SITE: 222 (Check one item only) jfEHS amount must be in nounds. 365 STORAGE n'· ABOVE GROUND TANK n'· PLASTIClNONMETALUCDRUM ~. FIBER DRUM nm.GLASS BOTTLE Bo, RAILCAR CONTAJNER b. UNDERGROUND TANK f. CAN '. BAG n. PLASTIC BOTILE p. OTHER c. TANK INSIDE BUILDING g. CARBOY k. BOX 0. TOTE BIN d. STEEL DRUM h. SILO X I. CYLINDER p. TANK WAGON 223 STORAGE PRESSURE Da. AMBIENT 0b. ABOVE AMBIENT Dc. BELOW AMBIENT 224 STORAGE TEMPERATURE o a. AMBIENT Db. ABOVE AMBIENT Dc. BELOW AMBIENT Dd. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CASH I 100% 226 CARBON DIOXIDE 227 []v es (8]N0 228 124-38-9 229 2 230 231 []v es (8]No 232 233 3 234 235 []v es (8]N0 236 237 4 238 239 []v es (8]N0 240 241 5 242 243 DYes (8]N0 244 245 If more hazardous components are present at greater than 10/0 by weight if non-carcinogenic., or 0.1 % by weight if carcinogenic. attach additiohal sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here ~, UPCF (1/99) 169 OES Fonn 2731 r MAP# CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME CIRCUE K STORES INC. #2701270 --BUSINESS ADDRESS 5634 STINE ROAD A NORTH CD B ® BAKERSFIELD c D E DATE 03/29/00 ZIP CODE 93313 F G RESIDENTIAL 6' CONCRETE WALL 2 ð CD HMMP CD MSDS ^ 3 ®=if TMA L......> ŒJ CO2 OFFICE SPACE 'f- -0 0 ~ ...J 0 4 f- a;: Z W « (), Z « 1-- > (J) 5 6 7 ~ VACANT LOT ~ /J§) / </'') ~@ "~,,/.\@ " (;J " "iY; G / ~ / / ...... " OCS " " ~ " ~-0 I ( ....0. ,,"/ Co ,,"/ ~; \ ""CO""~,, ~/( CS ,," C:> " \ ....~",," CO /' ~ (....Or:;s/ \~/ m HARRIS ROAD -TIMNERS HOME COOKING TC'S VIDEO ® EXECUTIVE ,LOUNGE PARKING H ~ 4.;' '. PREPARED BY: ~. DRAWING SCALE 1"=30'-0"· MAP SYMBOLS CD ELECTRICAL PANEL SHUT -OFF ® NATURAL GAS SHUT -OFF ® WA TER SHUT -OFF ® EMERGENCY PUMP SHUT-OFF ^ TANK MONITORING TMA ALARM L......> CD TELEPHONE c{þ FIRST AID KIT ð FIRE EXllNGUISHER ~ STORM DRAIN m SANITARY SEWER ® STAGING AREA EVACUA TlON/ HMMP HMMP. ANO MSDS MSDS LOCATION Ò FIRE HYDRANT -><-* FENCE ...J @D EMERGENCY RESPONSE « EQUIPMENT/ABSORBENTS ¡::::: Z C=> ABOVEGROUND W STORAGE TANK 0 ~-~ UNDERGROUND I I Vi ~-~ STORAGE TANK W 0::: @ GASOLINE (FLAMMABLE LIQUIDS) ® DIESEL FUEL (COMBUSTIBLE LIQUIDS) ® MOTOR OILS & LUBRICANTS (COMBUSTIBLE LIQUIDS) @ CARBON DIOXIDE (COMPRESSED GAS) ® PROPANE (FLAMM ABLE LIQUID) 0 ANTIFREEZE/COOLANTS @ WASTE OIL (FLAMMABLE LIQUID) @ CAR WASH PRODUCTS Á GROUND WATER MONITORING WELLS ·, ¿ SECTION I e e " . 2701270 BUSllŒSSEMERGENCYPLAN:EMERGENCYPROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. 1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL (Fire, paramedics, police, or sheriff) 911 STATE OFFICE OF EMERGENCY SERVICES: or (800) 852-7550 (916) 262-1621 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 805-326-3979 PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A HAZARDOUS MATERIALS INCIDENT: Name: Teri Nicholson Telephone: 909-270-5123 Name: Tosco Maintenance Telephone: 800-726-2312 B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: ADDRESS: CITY: PHONE: MERCY HOSPITAL 2215 TRUXTON AVE BAKERSFIELD 805-327-3371 1 I ... '? e e " 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide infonnation on the steps taken at your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazardous at this business are fire and spills associated with gasoline dispensing. Gasoline dispensing is supervised by trained personnel. Additional hazardous materials are stored in minimum quantities and stored in small, unbreakable containers. All underground storage tanks are monitored using an approved monitoring method. . 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill, fire, explosion or airborne release at your facility? Small incidents: For leaks and spills isolate the area and contain with absorbent material. Clean up the spill immediately to prevent spreading. For fires, turn off pumps, use fire extinguisher if it can be done safely. Larger incidents: Turn off pumps using emergency pump shut-off, call 9-1-1, evacuate to emergency assembly area, wait for emergency personnel to respond. Immediately contact the business owner, if not already on site, the Tosco Business Operations Manager or District Manager and the Tosco Maintenance Call Center. 4. ABATEMENT Describe what you would do to St3p and remove each hazard. How do you handle the complete process of stopping ã release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the release? Small incidents will be handled with the on-site clean-up equipment, (i.e., brooms, shovel, absorbent material, mops, etc.). For larger incidents, the on site manager will turn off the pumps, call 9-1-1, and the Tosco Maintenance Call Center @ 1-800-726-2312. The Call Center will dispatch a maintenance contractor to assist in abating the hazard. For suspected leaks the operator will notify the Tosco Maintenance Call Center and hislher Business Operations Manager or District Manager who will investigate the incident. If a UST leak is confinned, then reporting will be done by Tosco Marketing, which complies with UST regulations. T osco Marketing will coordinate with any contractors required to stop a release, clean up a release and/or dispose of materials. All materials will be disposed of in accordance with state, federal and local laws and regulations. 2 ..., ~ '. 5. EVACUATION e e ~ ,¡ - Describe the procedures to be followed for immediate notification and evacuation of your facility . Ifwarranted, evacuate to the designated assembly located at: NORTH SIDE OF SITE The manager or lead employee will take a head count to verify all employees have evacuated safely. The manager or employee will confer the responding agencies to indicate the magnitude of the emergency. 6. EARTHQUAKES Identify the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The typical wastes generated at this business are used motor oil and antifteeze. These items will be handled in the same manner as new motor oil or antifteeze. Use absorbent material or rags to clean up spills and place in a container for proper disposal or recycling. 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized releases ftom an underground storage tank (UST). The plan must address a release ftom a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underwound Storage Tank Monitoring and Response plan provided by Tosco Marketing Company. If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up ftom the secondary containment within 8 hours, or deteriorates the secondary containment, then the local agency will be notified IMMEDIATELY 3 ...~ c ~ ~ . '. e e SECTION II BUSThŒSSEMERGENCY~G Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum, include: A. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards. B. Procedures for coordination with local emergency response organizations. C. Correct use of emergency response equipment and supplies under the control of the business. D. The Cal OSHA Hazardous Communication Standards. E. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan. F. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care. G. Procedures to coordinate with and assist the local emergency personnel that may respond to your facility. H. Who and how to call for immediate assistance in the event of an accident involving hazardous materials; 1. Procedure for ensuring the appropriate personnel receives initial and refresher training. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY Use the attached employee training log or similar form for record keeping. 4 -, EMERGENCY RESPONSE PROCEDURES MAJO~IDENT: FIRE, SPILL OR SUSPECT.EAK 2701270 , ,~ 6 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. CALL 9-1-1: Give the following information: "THERE IS A FIRE / GASOLINE SPILL at the Tosco 76 service station at 5634 Stine Road If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATIEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station operator ifhe/she is not already at the station. Use the list below for emergency contacts: Emergency Coordinator: Teri Nicholson Address: Bus#/Home#/Alt#: 909-270-5123/800-697-1388/ Alternate Emergency Coordinator: Tosco Maintenance Address: Bus#/Home#/Alt#: 800-726-2312/800-726-2312/ Title: Dist. Mgr. Title: Dispatch Ctr 8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process: Tosco Maintenance Call Center: 1-800-726-2312 Tosco Business Operations Manager or District Manager. Tosco Environmental Compliance Coordinator: North: Merliza Alcala (925)277-2319 or (888)671-4350 South: Stephen Boyd (714)428-6572 or (800)759-8888 pin#1267507 Tosco Coporation will notify the State and Local administering agencies within an appropriate time frame, unless the situation requires urgent immediate response by the agencies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS) c) LOCAL POLICE AND FIRE DEPARTMENTS, 911 d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS). MINOR INCIDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in doubt, consider the incident a major release and use the above procedures. 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H for additional direction. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the daily monitoring log. 5. NOTIFY: the dealer of the event. ,..~ " . . EMPLOYEE TRAINING PLAN .' ' ~ Em~loyees must be given this trainin.fore starting work, and refresher courses st be provided annually. - : Records must be kept to show when each station employee has been given hislher safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. I. FIRST THINGS TO KNOW: A. EMERGENCY PUMP SHUT-OFF:This turns off the turbine pumps that provide flow to the dispensers from the underground tanks. In case of a leak, shutting off the pumps will help to prevent spills. Location: FRONT OF BUILDING B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. Location: REAR OF BUILDING C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate when a leak is detected by a visual and audible alarm. Location: REAR OF BUILDING D. WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: STINE ROAD E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow in an emergency. Location: NONE F ~ PROP ANEILPG: If your station has prop age or liquefied petroleum gas tank - In the event of a release or fire, turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as appropriate. G. FIRE EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: CASHIER H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it, a vacum truck should be used to clean up any large spill Location: STORAGE 1. PERSONAL PROTECTIVE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: STORAGE 2. Shovel: STORAGE 3. Gloves: STORAGE 4. Goggles: STORAGE J. FIRST AID KIT: Location: CASHIER K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency. Location: NORTH SIDE OF SITE HAZARDOUS MATERIAL MANAGEMENT PLAN (HMMP) MATERIAL SAFETY DATA SHEET (MSDS): Location: CASHIER ""¡ (:1 II.. NEAREST MEDICAL FAC~ Employees should know what facilitiAre available in case customers or other employees need medical attentio . .- ,¡... I.NAME: MERCY HOSPITAL ADDRESS: 2215 TRUXTON AVE BAKERSFIELD PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: 2.NAME: SAN JOAQUIN COMMUNITY HOSPITAL ADDRESS: 2615 EYE ST BAKERSFIELD PHONE NUMBER: 805-395-3000 ID. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emergency Response Plan filed by your business to the appropriate local agency. Thirdly, employees should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station and must be drilled in all emergency response procedures contained herein. IV. FffiST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: Flush with water for 15 minutes while holding eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated clothing and shoes. Followed by washing with soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention. C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. Ifnot breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! Ifvomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. F. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, consulsions, or unconsciousness occur before emesis, gastric lavage using a cuffed endotrachael tube should be considered. For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. This hazardous material management plan meets the requirements of a hazardous waste contingency plan. Document prepared by: Environmental Staff, RHL Design Group, Inc.. 800-765-1025 Last updated: December 21, 1999 .. J .. <1 -f; " TRAINING LOG UNIT# 2701270 BUSINESS NAME: Circle K Stores, Inc. ADDRESS: 5634 Stine Road TO BE MAINTAINED ON SITE EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR INTITAL AND/OR ANNUAL SAFETY TRAINING. DATE OF TYPE OF EMPLOYEE NAME EMPLOYEE SIGNATURE TRAINING TRAINING " (updated: February 15, 2000) ~.,"'::'~}J:5~g'1ii;ir~1~;~:t;L~"¡£~~i1:..t~".:..~¿:fjU1~;:i~'{:At~'W.:;m'},';tt&;:§~~~l~~~;W.bili}'.\tti~~~~·:J.i\S~~t;IT":Uùl:;:;J.~::-~\11.&~:¡~~~~~~b.u~l¡1>·Ij:'J-J;::':_ ...j.'.,.. ."S'?~. . ,.J -- ~ -~- CITY OF BAKERSFIELD CLAIM VOUCHER I Vendor No. I certify that this claim is correct and valid, and is a proper charge against the City Agency and account indicated. CLAIMANT'S NAME AND ADDRESS: Circle K Stores Inc 1270 POBox 52084 Phoenix, AZ 85072 (AUTHORIZED SIGNATURE OF CITY AGENCY) 5b~i-# st~ PLEASE PROVIDE SHORT EXPLANATION OF PAYME Date: 04-01-99 Initials of Preparer : CITY DEPARTMENT: FINANCE (Including Contract Number if Applicable) This customer overpaid their Haz Mat bill by $37.50. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $46.00. Fund Dept. Base Ell Objt Project # Invoice # Amount Date of Invoice 11 0000 123 7900 $46.00 VOUCHER TOTAL $46.00 SECTION 72, PENAL CODE FINANCE DEPT. USE ONLY Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, Examined & Approved for Payment Amount or writing, is guilty of a felony. / ~'" ~\ '. - STATEMENT OF ACCOUNT . CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD, CA 93301-5201 ~ (805); i326";¡3979;~ TO: ~~~~~:¡I~G Sri~~~S nà~£ '. ":/¿';:'~~~3;~:~ ~~O~~; X ~2~~4 fj5d72 y,:~~t:~3~)$~t~~h¡~ CUSTOMER NO: 2959 CUS~QMER~~*PE: ESt 2959 -----------------~~-----'~---------------------------~~---~~~-------------~-- CHARGE DATE DESCRIPTION ." i i':REF-NUMBER \'bbEiiöÄ-fE TOTAL AMOUNT " ' , "> __ _ ., ,'> :~ ,; 'n ';- ,", '\' ';,' ¡' " ~':~'>. ? ~~ \,'>- ",~/ '('.-...,,,:-'.,:,.; ------ -------- -------------------------<,---------- .-------- -------------- BE~INNING BAL,ÂNCE ' : ::{#:,'&i~[j;;'·!: PA"fMENT ' Charge ad'justment , CASTATE SURCHARGE '. DATE: 4/01/99 FOR QUESTIONS OR CHANGÊS TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. ( [,~"y;~;,_,,' J 55001 3/01/99 1/27/99 3/31/99 ":,,- }-- ~ /,", i .00 37. 50-- 8. 50-- <!""-é ,/«) ,/ ^¿~>/ /' -------------- -------------- -------------- -------------- CURRENT OVER 30 OVER 60 OVER 90 -------------- -------------- -------------- -------------- 8. 50- DUE DATE: 5/03/99 PAYMENT DUE: TOTAL DUE: 46.00- $46. 00-- I' - - - \ CUST~NO. ES dqSCi MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE 3- r ( -Pr NEW ACCOUNT 1 ADDRESS CHANGE CLOSE ACCT I . FINANCE CHARGE , OTHER ADJ MAILING ADDRESS CITY P""--O~" i SITE ADDRESS Ci rc.,\e.. K S+OrE5 IÃc \ ~7D ~\~eA?,i(\D, Dep-t (JC-Sl, p·O. bo'l ~~~y STATE A -¿ ZIP CODE'8SJ7.) Sbo~ ~ ed . CUSTOMER NAME PARCEL NUMBER (IF APPUCA8LE) ADJUSTMENT R~~;S:b~; ~ó ~ùrc-har<J~ doJ\J'v~ APPROVED BY ~~ /" ----------- . >".',,", {\-~. .. f.. Per... it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: , !:it,l@Z8rdous Materials Plan ,:Unàerground Storage of Hazardous Materials '¡iJ""""~;:: '::'",,-, agement Program Waste 5634 PERMIT ID# 01S-G21.o00484 CIRCLE K STORES INC #1270 TAN HAZARDOUS SUBSTANCE PIPING PIPING METHOD ONITO 001 UNLEADED PLUS GASOLINE SW S PRESSURE ALD 002 UNLEADED GASOLINE SW S PRESSURE ALD 003 SUPER UNLEADED GASOLlN SW S PRESSURE ALD LOCATION Issued by: STINE Bakenfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805)326-0576 #~ ph Huey, ffice of ental Servi es December 22, 1998 - Approved by: Expiration Date: .. BAKERSFIELD CITY FIRE DEPARTME~-;~ OFFI!: OF ENVIRONMENTAL SElcE! ~ (f;; Iff /J ~ 1715 CHESTER AVENUE, 3RD FLOOR!( Stp 1 1t;fJ¡1 BAKERSFIELD, CA 933, 01 ¡-¿~_)-...¡- 1., 9 1997 Ijj! (805) 326-3979 ~ &¡/ HAZARDOUS MATERIALS INVENTORY---~ FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [] BUSINESS NAME Circle K Store #1270 FACILITY NAME~irc1e K Store #1270 SITE ADDRESS 5634 Stine Road CITY Bakersfie]d STATECA ZIP93316 NATURE OF BUSINESS ConYenienee Store / Gaso]ine Station SIC CODE 5541 DUN & BRADSTREET 06-294-4160 OWNER/OPERATOR :raseo MarketinE Company MAILING ADDRESS l550 North Central Ave, 4th Floor CITY Phoenix PHONE (80S) 8:14-8625 STATE AZ ZIP 85012 NAME Staff EMERGENCY CONTACTS TITLE Duty Clerk 24-HOUR PHONE (805) 834-8625 BUSINESS PHONE (8.05) 834·8625 NAME Teri Nieho]son TITLE Zone Manager BUSINESS PHONE (800) 697·1399 Pager 24-HOUR PHONE (800) 697-1399 Pager .' e e BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUS MATERIALS INVENTORY PageL of L Business Name Circle K Store #1270 Address 5634 Stine Road Bakersfield 93316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision Þ<J Deletion [ ] Check if chemical is a NON TRADE SECRET Þ<J TRADE SECRET [ ] 2) Common Name: Gasoline Unleaded Regular 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Regular AHM [ ] CAS # 8006·61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire Þ<J Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) ~ 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid ~ Gas [ ] Pure [ ] Mixture ~ Waste [ ] Radioactive [ ] PPI V 7) AMOUNT AND TIME AT FACIUìY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal ~ ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 234814 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @Year, J, F. M, A, M, J. J, A. S. O. N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ ] chemical components or any AHM components 2) Toluene 108-88-3 8 [ ] 3) M-Xylene 108-38-3 7 [ ] 10) Location Underground tank approx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision ~ Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ] 2) Common Name: Gasoline Unleaded Plus 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Plus AHM [ ] CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire Þ<J Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) ~ 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid Þ<J Gas [ ] Pure [ ] Mixture Þ<J Waste [ ] Radioactive [ ] ""."K "TUAT '1>Ø1 v 7) AMOUNT AND TIME AT FACIUìY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal Þ<J ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 87108 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @Year. J, F, M, A, M, J, J. A, S, 0, N. D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614·04-4 16 [ ] chemical components or any AHM components 2) IoLuene 108-88-3 8 [ ] 3) M-Xylene 108-38-3 7 [ ] 10) Location Underground tank approx 40 feet southwestoLstore I certify und submitted i ~ Manag Print Name &}; 0; Ä~e~ompany Mre~t~þ II e e BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUS MA TERIALS INVENTORY PageL of L Business Name Circle K Store #1270 Address 5634 Stine.Road Bakersfield 93316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ J Addition [ J Revision Þ<I Deletion [ ] Check if chemical is a NON TRADE SECRET Þ<I TRADE SECRET [ J 2) Common Name: Gasoline Unleaded Premium 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Premium AHM [ J CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire Þ<I Reactive [ J Sudden Release of Pressure [ J Immediate Health (Acute) Þ<I Delayed Health (Chronic) Þ<I 5) WASTE CLASSIFICATION (3-digít code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid Þ<I Gas [ ] Pure [ ] Mixture Þ<I Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal Þ<I ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 56810 c) Temperature: 4 largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %'Nf AHM the three most hazardous 1) Methyllert Butyl Ether 1634-04-4 16 [ ] chemical components or any AHM components 2) Toluene 108-88·3 8 [ ] 3) M-Xylene 1 08-38-3 7 [ ] 10) location Underground tank approx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check. if chemical is a NON TRADE SECRET Þ<I TRADE SECRET [ ] 2) Common Name: Carbon Dioxide 3) DOT # (optional) Chemical Name: Carbon Dioxide Carbonic Anhydride AHM [ ] CAS # 124-38-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ J Reactive [ ] Sudden Release of Pressure Þ<I Immediate Health (Acute) Þ<I Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99 6) PHYSICAL STATE Solid [ ] liquid [ ] Gas IX! Pure Þ<I Mixture [ ] Waste [ ] Radioactive I ] C""CK AH "'AT APPL Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 1044 Ibs [ ] gal [ ] ft3 Þ<I a) Container: 04 Average Daily Amount: 522 curies [ ] b) Pressure: 2 Annual Amount: 54288 c) Temperature: 4 largest Size Countainer: 174 # Days On Site: 365 Circle Which Months: @vear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: list COMPONENT CAS # %'Nf AHM the three most hazardous 1) Carbon.Qioxide, Carbonic Anhydride 124-38-9 100 [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location In.S1oreroom back of store I certify under penalty of law, that I have personally examined and am familiar with the information submitted on t . submitted' formation is true, accurate, and com pie , M -A Print Name TItle of Authorized Company epresentative 1 , e e BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUS MATERIALS INVENTORY PageL of L Business Name Circle K Store #1270 Address 5634 Stine Road Bakersfield 93,316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition Þ<J Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET Þ<J TRADE SECRET [ ] 2) Common Name: eropane 3) DOT # (optional) 1978 Chemical Name: Propane AHM [ ] CAS # 74-98-6 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire Þ<J Reactive [ ] Sudden Release of Pressure Þ<J Immediate Health (Acute) Þ<J Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid Þ<J Gas ~ Pure Þ<J Mixture [ ] Waste [ ] Radioactive [ ] '''''''''K A" TUn ApPI v 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 2296 Ibs [ ] gal [ ] 113 Þ<J a) Container: 04 Average Daily Amount: 1148 curies [ ] b) Pressure: 2 Annual Amount: 119392 c) Temperature: 4 Largest Size Countainer: 820 # Days On Site: 365 Circle Which Months: @!:Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Propane 74-98-6 100 [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location locked cage in front of store 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 PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] CHECK AU THA T APPL Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: Ibs [ ] gal [ ] 113 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: largest Size Countainer: # Days On Site: Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) location na/ty of law, that I have personally examined and am familiar with the information submitted on t i atiem is true, accurate, and compl l ~ nd all attached documents, I believe the l Date G e e BAKERSFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Cirde K Store #1270 LOCATION:%,4 Stine Road Bakersfield 93316 MAILING ADDRESS: 6011Jnion Street, Suite 3920 CITY: Seattle STATE: ~ ZIP:98101 PHONE: (805) 8,4.8625 DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / Gasoline Station OWNER: Tosco Corproation db Tosco Marketinr; Company MAILING ADDRESS: POBox 52084 Phoenix AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff Duty Clerk (805) 834-8625 (805)..834-8625 2. T eri Nicholson Zone Manager (800) 697-1399 Pa¡>;er (800) 697-1399 Par;er 1. e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FilE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of absorbent for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Tosco Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and C02. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOllOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I CERTIFY THAT THE ABOVE 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 INACCURATE INFORMATION CONSTITUTES PERJURY. ~\~, VW\oJWfl.AI( SIGNATURE Manager TITLE c¡¡ 1/97 DATE 2. tþÐakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN e Facility Unit Name: Circle K Store #12Z0 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: If emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division State Office of Emergency Services 326-3979 800-852-7550 AND WITHIN 24 HOURS If release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, immediately notify: Fire Department - Bakersfield Fire Department Police Department - Bakersfield Police Department Bakersfield City Hazardous Material Division State Office of Emergency Services 911 911 911 (800) 852-7550 or (916) 262-1621 B. EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. C. PUBLIC EVACUATION: If evacuation from area deemed necessary, these neighboring properties will be notified if possible: Magoo's Pizza Christ the Rock Church Hallenbeck Dental Lab 5700 Stine Road 5720-32 Stine Road 5740 Stine Road 834-2000 833-8740 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRUXTON AVENUE 327-3371 3. e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Anti-lock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tank monitoring program implemented B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent further spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and contact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids with absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle KlTosco Environmental Director (602)200-4528 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CARBON DIOXIDE, PROPANE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDURES: Remove ignition sources. Ventilate area immediately. Contact supplier if leak in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: a) Tnsidp., hack room of store (breaker!», h) Fast wall of huildine, {outside) WATER: a) North wan of huildinE at east end (main line eatP. valvp.), h) South sidp. of site (in planter) SPECIAL: Fmerep.ncy r;as shutoff switch· a) At cashier station on consolp., h) Circuit hrp.ahrs #40, 42 in hackroom LOCK BOX: YE@ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTIONIWATERAVAILABILlTY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Southwest of site (meter) 4. e e HMMP PLAN MAP SITE DIAGRAMOO FACILITY DIAGRAM D Business Name: Circle K Stores Inc. #1270 ~North Area Map # 1 of 1 Name of Area: Circle K Corporation #1270 5634 Stine Rd., Bakersfield CA Scale 1" = 25' - o ...I - ... Q - c as u ~ Parking Residential 6' Co nc r!!!...a.. Wall_ Vacant Lot ® Storage Room Vacant Office Space ~ Parking Store #1270 5634 Cold Stine Box Rd. ti /-,~ /10K // ¥_ ( Gal//10K // I "'I- /( Gel//10K / uo ,/( Gel/ ,/ Residential . ........,.". ..... .... .. ....... .. -. ..........,. @. Sewer 5700 Stine Rd. Magoo'8 Plzze 5720, 5724, 5728, 5732 Stine Rd. Chrl8t the Rock United Pentoco8tet Church 5740 Stine Rd. Dente! Leb Parking -5- e 'SYMBOLS e ® GAS ® ELECTRIC @ WATER MSDSJ . . . . ~. ~- ~ SPRINKLER FIRE DEPT. ~"'o CONNECTION MSDS STORAGE FENCE (ALL TYPES) INDICATE HEIGHT GATE IN FENCE STANDARD DOOR - - - - -., UNDERGROUND : 10,000 I STORAGE Gal I TANKS· LIST L - - - - - CAPABILITY ~ FIRE HYDRANT· PUBLIC 0- FIRE HYDRANT· PRIVATE ¡J ! ¡ ¡::¡ 10,000 Gal ~AS AUTOMATIC SPRINKLERED V::3J BUILDING OR AREA c:> @ FIRE ALARM PESTICIDE I " S~O~A~E ;:¡ RAILROAD TRACKS ABOVEGROUND TANKS EVACUATION AREA PESTICIDE STORAGE AREA TYPES OF HAZARDOUS MATERIALS <f> FLAMMABLE <6> LIQUID \9> CORROSIVE ~ SOLID <!iJ; WATER REACTIVE <@> GAS <§> EXPLOSIVE <§> RADIOLOGICAL <W WASTE EXAMPLE: FLAMMABLE ~ LIQUID ~ POISON EXPLOSIVE GAS ~ 'i e . CIRCLE K STORES INC #1270 SiteID: 215-000-000484 Manager : Location: 5634 STINE RD City BAKERSFIELD BusPhone: Map : 123 Grid: 23A (805) 834-8625 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 13 EPA Numb: SIC Code:5541 DunnBrad:06-294-4160 Emergency Contact STAFF Business Phone: 24-Hour Phone Pager Phone / Title / DUTY CLERK (805) 834-8625x () x () x Eme;gency Contact / Title TERt NICHOLSON / DISTRICT MNGR Business Phone: (805) 335-6032x 24-Hour Phone () x Pager Phone n ImmHlth DelHlth Hazmat Hazards: Fire Press Agency-Defined Topic Title p= Hazmat Inventory One Unified List 9 p== MCP+DailyMax Order All Materials at Site 9 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP UNLEADED PLUS GASOLINE F IH DH L 10000 GAL Mod UNLEADED GASOLINE F IH DH L 10000 GAL Mod SUPER UNLEADED GASOLINE F IH DH L 10000 GAL Mod CARBON DIOXIDE þ(p IH G 1044 FT3 Min Po/~ pP II (fL ¿;¿;)/fl FT3 I, j)~t~~~;yn.1!Z.1~r4~ r.,-::-eby certify that I have revie~ied r".. : ,,)¡ed haz::::·..·,:ljS nl:¡terials manage- ment p:.]¡-¡ f;:' "'-', , ._and tha~ it along with ~~....~r!!e oj 8UA;:¡ë:-...:) any corrections constitute a complete and correct man- agement plan for my facility. , ?" ij ~/f) Dete' -1- \ e F CIRCLE K STORES INC #1270 p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE e SiteID: 215-000-000484 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL Dai1yMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Gasoline No 8006619 -2- e e F CIRCLE K STORES INC #1270 p= Inventory Item 0002 === COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 215-000-000484 , Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Lac GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL AMOUNTS STORED AND IN USE I l~~~åoIGaSOline HAZARDOUS COMPONENTS ~ CAst I 8006619 -3- e e F CIRCLE K STORES INC #1270 p= Inventory Item 0003 === COMMON NAME I CHEMICAL NAME SUPER UNLEADED GASOLINE SiteID: 215-000-000484 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL AMOUNTS STORED AND IN USE %Wt. EHS CAS# 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS -4- e e F CIRCLE K STORES INC #1270 ¡- Inventory Item 0004 ¡-c COMMON NAME / CHEMICAL NAME I CARBON DIOXIDE Location within this Facility Unit IN STOREROOM BACK OF STORE SiteID: 215-000-000484 ~ Facility Unit: Fixed Containers on Site 9 Days On Site 365 CAS# 124-38-9 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Lrgst Cant. this Loc FT3 DailyMax this Loc FT3 DailyAvg this Lac FT3 1044.00 522.00 Dai1yMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 AMOUNTS STORED AND IN USE %Wt. EHS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS -5- e SiteID: 215-000-000484 9 Fast Format 9 Overall Site 9 05/06/1996 e F CIRCLE K STORES INC #1270 I p= Notif./Evacuation/Medical Agency Notification IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION STATE OFFICE OF EMERGENCY SERVICES 326-3979 800-852-7550 WITHIN 24 HOURS IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, NOTIFY: FIRE DEPARTMENT - BAKERFSIELD FIRE DEPARTMENT POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION STATE OFFICE OF EMERGENCY SERVICES SAFETY, IMMEDIATELY 9-1-1 9-1-1 9-1-1 800-852-7550 OR Employee Notif./Evacuation 05/06/1996 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. Public Notif./Evacuation 05/06/1996 MAGOO'S PIZZA CHRIST THE ROCK CHURCH HALLENBECK DENTAL LAB 5700 STINE 5720-32 STINE 5740 STINE ROAD 834-2000 833-8740 Emergency Medical Plan 05/06/1996 MERCY HOSPITAL - 2215 TRUXTUN - (805) 327-3371 -6- · F CIRCLE K STORES INC #1270 I f= Mitigation/Prevent/Abatemt Release Prevention e SiteID: 215-000-000484 1 Fast Format 1 Overall Site 1 05/06/1996 1- 2. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTMES USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUA~8YSTEHC ON PUMP£. ANTI-LOCK NOZZLES AT PUMPS. NO 0 NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED.~ T~CMECKED PERIODICALLY FOR LEAKS Bx" COMPARING GALLON'~("j.-J. ~ ~EA~TTR:e:Þ1EN':I'8 WITH -SALES RECORDS. í fJ1V)t. Y)1871iftJy¡7 ~í1r "7 ~ ~ 3. 4 . 5 . 6. Release Containment 05/06/1996 i. PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2. SHUT OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. 3. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER. Clean Up 05/06/1996 GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOOR/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. Other Resource Activation -7- e SiteID: 215-000-000484 9 Fast Format 9 Overall Site =¡ I e F CIRCLE K STORES INC #1270 ". I p= Site Emergency Factors ~ Special Hazards ____ Utility Shut-Offs 04/21/1992 A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER D) SPECIAL - EMERGENCY GAS SHUTOFF SWITH: A) CASHIER STATION ON CONSOLE; B) CIRCUIT BREAKERS #40, 42 IN BACK ROOM E) LOCK BOX - NO Fire Protec./Avail. Water 04/21/1992 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - SOUTHWEST CORNER OF SITE (METER) Building Occupancy Level -8- F CI~R~LE iK STORES INC #12. I F Training Employee Training . SiteID: 215-000-000484 ì Fast Format 9 Overall Site 9 06/29/1995 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING A~PER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. USE OF K R FOR SMALL SPILLS. EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPT., EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPT. EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. Page 2 l I I Held for Future Use Held for Future Use -9- BAKERilELD CITY FIRE DEPARWENT OFFICE OF ENVIRONMENTAL SERVICES 1715 ÇHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [] BUSINESS NAME Cirde K Store #1270 FACILITY NAMECirde K StOfe. #1270 SITE ADDRESS 5634 Stine Road CITY Bakersfield STATECA ZIP 93316 NATURE OF BUSINESS Convenience Store / Gasoline Station SIC CODE 5541 DUN & BRADSTREET 06-294-4160 OWNER/OPERATOR Cirde K Company a division of Tosco PHONE (602) 437-0600 i , , MAILING ADDRESS . CITY Phoenix I P.O. Box 52084 . . STATE Arizona:\ ZIP ,85072-2084 NAME Staff EMERGENCY CONTACTS TITLE Duty CIe.rk BUSINESS PHONE (805) 834-8625 I NAME Terri Nicholson 24-HOUR PHONE (805) 834-8625 TITLE Zone Manager BUSINESS PHONE (800) 697-1399 Pager 24-HOUR PHONE (800) 697-1399 Par;er 'f ,¡ - f e e BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUSMATE~LS~NTORY PageL of L Business Name Circle K Store #1270 Address 5634 Stine Road Bakersfield 93316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ J Addition [ J Revision !XI Deletion [ J Check if chemical is a NON TRADE SECRET !XI TRADE SECRET [ J 2) Common Name: Gasoline, Unleaded Regular 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Regular AHM [ J CAS # 8006-61·9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire !XI Reactive [ J Sudden Release of Pressure [ J Immediate Health (Acute) !XI Delayed Health (Chronic) !XI 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ J Liquid !XI Gas [ J Pure [ J Mixture !XI Waste [ J Radioactive [ J "HFCK AU THAT APPI" Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 10000 Ibs [ J gal !XI ft3 [ J a) Container: 01 Average Daily Amount: SO DO curies [ J b) Pressure: 1 Annual Amount: 234814 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 36S Circle Which Months: @DYear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methylterl Butyl Ether 1614-04-4 16 [ J chemical components or any AHM components 2) Toluene 108-88-3 8 [ J 3) M-Xylene 108-38-3 7 [ J 10) Location Underground tank approx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ J Addition [ J Revision !XI Deletion [ J Check if chemical is a NON TRADE SECRET !XI TRADE SECRET [ J 2) Common Name: Gasoline Unleaded Plus 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Plus AHM [ J CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire !XI Reactive [ J Sudden Release of Pressure [ J Immediate Health (Acute) !XI Delayed Health (Chronic) !XI 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ J Liquid !XI Gas [ J Pure [ J Mixture !XI Waste [ J Radioactive [ J CHFCK ALL THA T APPL Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 10000 Ibs [ J gal !XI ft3 [ J a) Container: 01 Average Daily Amount: 5000 curies [ J b) Pressure: 1 Annual Amount 87108 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @þYear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ J chemical components or any AHM components 2) Toluene 108·88-3 8 [ J . 3) M-Xylene 108-38-3 7 [ J 10) Location Underground tank approx 40 feet southwest of store '; e e .- BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUSMATEroALSThNENTORY PageL of L Business Name Circle K Store #1270 Address 5634 Stine Road Bakersfield 93316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ I Addition [ 1 Revision IX1 Deletion [ I Check if chemical is a NON TRADE SECRET IX1 TRADE SECRET [ 1 2) Common Name: Gasoline Unleaded Premium 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Premium AHM [ I CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire Þ<I Reactive [ I Sudden Release of Pressure [ ] Immediate Health (Acute) Þ<I Delayed Health (Chronic) Þ<I 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid Þ<I Gas [ ] Pure [ ] Mixture Þ<I Waste [ ] Radioactive [ ] CU¡:CK All TUAT APPI Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal Þ<I ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount 56810 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %wr AHM the three most hazardous 1) Methyllert Butyl Ether 1634-04-4 16 [ ] chemical components or any AHM components 2) Toluene 1 08-88-3 8 [ ] 3) M-Xylene 1 08·38-3 7 [ ] 10) Location Underground tank approx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ I Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET Þ<I TRADE SECRET [ ] 2) Common Name: Carbon Dioxide 3) DOT # (optional) Chemical Name: Carbon Dioxide Carbonic Anhydride AHM [ I CAS # 1 '4-38-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ I Reactive [ I Sudden Release of Pressure IX1 Immediate Health (Acute) IX1 Delayed Health (Chronic) [ I 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99 6) PHYSICAL STATE Solid [ I Liquid [ I Gas ~ Pure IX1 Mixture [ I Waste [ I Radioactive [ I CHECK AU THA T APPL Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 1044 Ibs [ ] gal [ ] ft3 IX1 a) Container: 04 Average Daily Amount: 522 curies [ I b) Pressure: 2 Annual Amount: 54288 c) Temperature: 4 Largest Size Countainer: 174 # Days On Site: 365 Circle Which Months: @vear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %wr AHM the three most hazardous 1) Carbon Dioxide Carbonic Anhydride 124-38-9 100 [ ] chemical components or any AHM components 2) [ I 3) [ I 10) Location In Storeroom back of store HM~P PLAN ~AP " SITE DIAGRAMŒJ FACILITY DIAGRAM D Business Name: Circle K Stores Inc. #1270 .ýNOfth Area Map # 1 of 1 Name of Area: Circle K Corporation #1270 5634 Stine Rd., Bakersfield CA Scale 1" = 25' ... o ..J ... .. õ ... c ca () ~ Parking Residential 6' Caner!!!........ Well_ Vacant Lot Vacant Office Space ® Exit Storege Room Counter ~ Parking Store #1270 5634 Cold Stine Box Rd. N / I~ /10K // ¥_ ( Ge!//t OK // I ,,/-. /( Gel//10K / LA\ ...... /( Gel/ ....../ Residential . . . . . . . . . .. ....... ..- ~. Sewer 5700 Stine Rd. Megoo's Plzze 5720, 5724, 5728, 5732 Stine Rd. Christ the Rock United Pentecostel Church 5740 Stine Rd. Dentel Leb Parking -5- . ., e 'SYMBOLS 'Î' @GAS ® ELECTRIC @ WATER jMSDSJ . . . . t-f/ . ---'" - ~ SPRINKLER FIRE DEFT. ç¿"O CONNECTION e MSDS STORAGE FENCE (AL.L TYPES) INDICATE HEIGHT GATE IN FENCE STANDARD DOOR 1- - - - - -¡ UNDERGROUND J 10,000 I STORAGE Gal I TANKS.. LIST 1.. - - - - - CAPABILITY ~ FIRE HYDRANT.. PUBLIC 0- FIRE HYDRANT· PRIVATE ~ 1 0,000 Gal ~AS AUTOMATIC SPRINKLERED ~ BUILDING OR AREA c=:> @ FIRE ALARM PESTICIDE > S~O~A~E ;:¡ RAILROAD TRACKS ABOVEGROUND TANKS EVACUATION AREA PESTICIDE STORAGE AREA TYPES OF HAZARDOUS MATERIALS o FLAMMABLE <6> LIQUID <9> CORROSfVE <§> SOLID 1]> WATER REACTJVE <@> GAS <§> EXPLOSrVE <ê> RADIOLOGICAL <8> WASTE EXAMPLE: FLAMMABLE <EÞ LIQUID ~POISON EXPLOSIVE GAS ~ .; INSTRUCTIONS: BAKE"FIELD CITY FIRE DEPA~MENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN 1. To avoid further action, return this form within 30 days of receipt. 2. TYPElPRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle K Store #1270 Bakersfield LOCA TION:5634 Stine Road 93316 M~ILlNG ADDRESS: P.O. Box52084 CITY: Phoenix i STATE:ArizonaZIP~5072-2084ÞHONE: (602) 437-0600 , , DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / Ga.~oline Station OWNER: Circle K Company a Division of Tosco Corp MAILING ADDRESS: P.O. Box 52084 Phoenix Arizona , 85072-2084! SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff 2. Terri Nicholson Duty Clerk (805) 834-8625 (805) 834-8625 Zone Mana¡>;er (800) 697-1399 Pager (800) 697-1399 Pa¡>;er 1. · eakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN e J' SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of absorbent for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and C02. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I CERTIFY THAT THE ABOVE 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 INACCURATE INFORMATION CONSTITUTES PERJURY. TITLE 2. ~ _akersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN e .' Facility Unit Name: Circle K Store #1270 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A." AGENCY NOTIFICATION PROCEDURES: U emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division State Office of Emergency Services 326-3979 800-852-7550 AND WITHIN 24 HOURS U release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, immediately notify: Fire Department - Bakersfield Fire Department Police Department - Bakersfield Police Department Bakersfield City Hazardous Material Division State Office of Emergency Services 911 911 911 (800) 852-7550 or (916) 262-1621 B. EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. C. PUBLIC EVACUATION: U evacuation from area deemed necessary, these neighboring properties will be notified if possible: Magoo's Pizza Christ the Rock Church Hallenbeck Dental Lab 5700 Stine Road 5720-32 Stine Road 5740 Stine Road 834-2000 833-8740 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRUXTON AVENUE 327-3371 3. '. -.. eakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN e ., ~ SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Anti-lock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tank monitoring program implemented B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent funher spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and contact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids with absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle K Environmental Director (206)442-7434 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: a) Tn~ide, back room of ~tore (breakers), b) Fast wall of buildine, (out~ide) WATER: a) North wall of building at ea~t end (main line eate valve), b) Soutb side of site (in planter) SPECIAL: Emergency ga.~ sbutoff switch· a) At ca~hier station on console, b) Circuit breakers #40, 42 in backroom LOCK BOX: YES@ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTIONIWA TER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Southwest of site (meter) 4. .. i:. ;. e CIRCLE K STORES INC #1270 e SiteID: 215-000-000484 Manager : Location: 5634 STINE RD City BAKERSFIELD BusPhone: Map : 123 Grid: 23A (80S) 834-8625 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 13 EPA Numb: SIC Code:5541 DunnBrad:06-294-4160 Emergency Contact STAFF Business Phone: 24-Hour Phone Pager Phone I Title I DUTY CLERK (80S) 834-8625x () x () x EmeJg~ncy Contact I Title TERt NICHOLSON I DISTRICT MNGR Business Phone: (805) 335-6032x 24-Hour Phone () x Pager Phone Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title p= Hazmat Inventory One Unified List ì p== MCP+DailyMax Order All Materials at Site 9 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP UNLEADED PLUS GASOLINE F IH DH L 10000 GAL Mod UNLEADED GASOLINE F IH DH L 10000 GAL Mod SUPER UNLEADED GASOLINE F IH DH L 10000 GAL Mod CARBON DIOXIDE F P IH G 1044 FT3 Min I. iO~'2!;,.,i?~,"rebY cartily that I have reviewed (,: ; '_;;led haz2r'~'CIJS materials manage- ment P:,J.i"'¡ L:' ,___. 'f,":;--;--,___and that it along with '\,·.ume 01 Bua*,.a~~) any correctiOíì$ constitute a complete and correct man- agement plan for my facility. , y, -1- , -. e e f CIRCLE K STORES INC #1270 f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE SiteID: 215-000-000484 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZA US C NEN %Wt. EHS CAS# 100.00 Gasoline No 8006619 RDO OMPO TS -2- e e F CIRCLE K STORES INC #1270 f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 215-000-000484 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK AMOUNTS STaR D ND I S Lrgst Cant. this Lac GAL DailyMax this Lac GAL DailyAvg this Lac GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL E A N U E %Wt. EHS CAS# 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS -3- .' i e e f CIRCLE K STORES INC #1270 p= Inventory Item 0003 == COMMON NAME / CHEMICAL NAME SUPER UNLEADED GASOLINE SiteID: 215-000-000484 9 Facility Unit: Fixed Containers on Site 9 Days On Site 36'5 Location within this Facility Unit 40FT SOUTHWEST OF STORE UNDERGROUND CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 10000.00 5000.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL AMOUNTS STORED AND IN USE %Wt. EHS CAS# 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS -4- .' , e e F CIRCLE K STORES f= Inventory Item = COMMON NAME / CARBON DIOXIDE INC #1270 0004 CHEMICAL NAME SiteID: 215-000-000484 , Facility Unit: Fixed Containers on Site, Days On Site 365 Location within this Facility Unit IN STOREROOM BACK OF STORE CAS# 124-38-9 STATE - TYPE Gas Pure PRESSURE---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 1044.00 522.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 %Wt. EHS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS -5- , . e e F CIRCLE K STORES INC #1270 I f= Notif./Evacuation/Medical Agency Notification SiteID: 215-000-000484 ì Fast Format ì Overall Site ì 05/06/1996 IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION STATE OFFICE OF EMERGENCY SERVICES 326-3979 800-852-7550 WITHIN 24 HOURS IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: FIRE DEPARTMENT - BAKERFSIELD FIRE DEPARTMENT POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION STATE OFFICE OF EMERGENCY SERVICES 9-1-1 9-1-1 9-1-1 800-852-7550 OR Employee Notif./Evacuation 05/06/1996 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. Public Notif./Evacuation 05/06/1996 MAGOO'S PIZZA CHRIST THE ROCK CHURCH HALLENBECK DENTAL LAB 5700 STINE 5720-32 STINE 5740 STINE ROAD 834-2000 833-8740 Emergency Medical Plan 05/06/1996 MERCY HOSPITAL - 2215 TRUXTUN - (805) 327-3371 -6- .. ;; .. e e F CIRCLE K STORES INC #1270 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000484 9 Fast Format ì Overall Site 9 05/06/1996 1. 2. 3 . 4. 5. 6 . BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTMES USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. OOA~I~ SYSTEm::: ON PUMP£. ANTI - LOCK NOZ ZLES AT PUMPS. NO ~~O NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED.~ T~CMECKED PERIODICALLY FOft LEAKS B} COMPARING GALLON~E / ß t1EA~TTREHENT5 WITH -SALES RECORDS. -r fJ1V)<. Yì1ð71ifrJy'7 )'1r1r JY~~ I Release Containment 05/06/1996 1. PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2. SHUT OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. 3. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER. Clean Up 05/06/1996 GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOOR/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. Other Resource Activation I -7- " '; '" e e F CIRCLE K STORES INC #1270 I p= Site Emergency Factors [:: Special Hazards Utility Shut-Offs SiteID: 215-000-000484 ì Fast Format ì Overall Site ì I 04/21/1992 A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER D) SPECIAL - EMERGENCY GAS SHUTOFF SWITH: A) CASHIER STATION ON CONSOLE; B) CIRCUIT BREAKERS #40, 42 IN BACK ROOM E) LOCK BOX - NO Fire Protec./Avail. Water 04/21/1992 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - SOUTHWEST CORNER OF SITE (METER) Building Occupancy Level -8- ~.'.: ¡". -... .~ ~ ~ .. . e e F CIRCLE K STORES INC #1270 I f= Training Employee Training SiteID: 215-000-000484 ì Fast Format ì Overall Site ì 06/29/1995 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING A~PER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. USE OF K R FOR SMALL SPILLS. EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPT., EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPT. EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. I Page 2 I I Held for Future Use I I Held for Future Use I -9- ,,/ BA~SFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SIVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [] BUSINESS NAME Cirde K Stores Inc. #1270 FACILITY NAME SITE ADDRESS 5634 Stine Road CITY Bakersfield STATECA ZIP 93316 NATURE OF BUSINESS Convenience Store / Gasoline Station SIC CODE 5541 DUN & BRADSTREET 06-294-4160 OWNER/OPERATOR Myron Smith, Compliance Manager PHONE (805) 834-8625 MAILING ADDRESS 3003 N. Central Avenue, 16th Floor CITY Phoenix STATE AZ ZIP 85012 BUSINESS PHONE ~834-8625 EMERGENCY CONTACTS TITLE Duty Clerk 24-HOUR PHONE (8Q5) 834-8625 NAME Staff NAME Ieri Nicholson TITLE District Manager BUSINESS PHONE (R05) 335-6032 Pager 24-HOUR PHONE (805) 335-6032 Pager e e BAKERSFIELD CITY FIRE DEP AR TMENT HAZARDOUS MATERIALS INVENTORY PageLof L Business Name C.lrcle K Stores Inc #1270 Address 56.3A-Stine Road B.akersfield 93316 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ I Addition [ I Revision [><J Deletion [ I Check if chemical is a NON TRADE SECRET [><J TRADE SECRET [ I 2) Common Name: Gasoline Unleaded Regular Ii 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Regular AHM [ I CAS # 8006-61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [><J Reactive [ I Sudden Release of Pressure [ I Immediate Health (Acute) [><J Delayed Health (Chronic) [><J 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ I Liquid [><J Gas [ ] Pure [ I Mixture [><J Waste [ ] Radioactive [ ] CH~CK ALL THA T APP Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal [><J ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ I b) Pressure: 1 Annual Amount: 234814 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @DYear, J, F, M, A, M, J. J, A. S, 0, N. D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methyltert Butyl Ether 1614·04-4 16 [ ] chemical components or any AHM components 2) Toluene 108·88-3 8 [ I 3) M-Xylene 108-38-3 7 [ I 10) Location Under~round tank apprnx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ I Addition [ Ii Revision [><J Deletion [ I Check if chemical is a NON TRADE SECRET [><J TRADE SECRET [ I 2) Common Name: Gasoline Unleaded Plus J 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Plus AHM [ I CAS # 8006.61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [><J Reactive [ I Sudden Release of Pressure [ I Immediate Health (Acute) [><J Delayed Health (Chronic) [><J 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ I Liquid [><J Gas [ I Pure [ I Mixture [><J Waste [ I Radioactive [ I CHE"K ALL THAT APP Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal [><J ft3 [ I a) Container: 01 Average Daily Amount: 5000 curies [ I b) Pressure: 1 Annual Amount: 87108 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @þYear. J, F. M, A. M, J, J, A. S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Me1b11tert Butyl Ether 1614-04-4 16 [ I chemical components or any AHM components 2) Ioluene 108-88-3 8 [ I 3) M-Xylene 108-38-3 7 [ I 10) Location Underground tank approx 40 feet southwest of store I certify under penalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. submitted information is true, accurate, and complete. Myron Smith Compliance Manager Print Name & Title of Authorized Company Representative e e BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY PageLof L Business Name Clrcle..K.S1are.s Inc #1270 Address 5.63A..Sline.Boad Bakersfield 93316 - CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] ReyjsiOn t><! Deletion [ ] Check if chemical is a NON TRADE SECRET t><! TRADE SECRET [ ] 2) Common Name: Gasoline Unleaded Premium j 3) DOT # (optional) 1203 Chemical Name: Gasoline Unleaded Premium AHM [ ] CAS # 8006·61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire t><! Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) t><! Delayed Health (Chronic) t><! 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19 6) PHYSICAL STATE Solid [ ] Liquid t><! Gas [ ] Pure [ ] Mixture t><! Waste [ ] Radioactive [ ] CH~CK ALL THAT APPLY 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10000 Ibs [ ] gal t><! ft3 [ ] a) Container: 01 Average Daily Amount: 5000 curies [ ] b) Pressure: 1 Annual Amount: 56810 c) Temperature: 4 Largest Size Countainer: 10000 # Days On Site: 365 Circle Which Months: @þYear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Methyltert Butyl Ether 1634-04-4 16 [ ] chemical components or any AHM components 2) Toluene 1 08-88-3 8 [ ] 3) M-Xylene 108-38-3 7 [ ] 10) Location Under.ground tank approx 40 feet southwest of store CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET t><! TRADE SECRET [ ] 2) Common Name: Carbon Dioxide 3) DOT # (optional) Chemical Name: Carbon Dioxide Carbonic Anhydride AHM [ ] CAS # 124-38·9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure t><! Immediate Health (Acute) t><! Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas t><J Pure t><! Mixture [ ] Waste [ ] Radioactive [ ] CHECK ALL THA T APPL Y 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 1044 Ibs [ ] gal [ ] ft3 t><! a) Container: 04 Average Daily Amount: 522 curies [ ] b) Pressure: 2 Annual Amount: 54288 c) Temperature: 4 Largest Size Countainer: 174 # Days On Site: 365 Circle Which Months: @þYear, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) Carbon Dioxide Carbonic Anhydride 124.38-9 100 [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location In Storeroom back of store Myron Smith Compliance Manager Print Name & Title of Authorized Company Representative I certify under penalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I bel" submitted information is true, accurate. and complete, e _ BAKERSFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: C:ircle K Stores Tnc #1270 LOCATION:5634 Stine Road Bakersfield 93316 MAILING ADDRESS: 3003 N C:entral Avenue, 16th Floor CITY: Phoenix STATE: ~ ZIP: 85012 PHONE: (805) 834-8625 DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store / Ga.~oline Station OWNER: Circle K Stores Tnc MAILING ADDRESS: POBox 52084 Phoenix AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Staff Duty C:lerk (805) 834-8625 (805) 834-8625 2. T eri Nicholson District Manager (805) 335-6032 Pager (805) 335-6032 Par;er 1. e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Proper maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and C02. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: . I My~on Smith 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 INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE Compliance Manager TITLE DATE 2. e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: If emergency response assistance not required, notify: Bakersfield City Hazardous Materials Division State Office of Emergenc.y Services 326-3979 800-852-7550 AND WITHIN 24 HOURS If release poses present or potential hazard to human health & safety, property or environment, and emergency assistance is required, immediately notify: Fire Department - Bakersfield Fire Department Police Department - Bakersfield Police Department Bakersfield City Hazardous Material Division State Office of Emergenc.y Services 911 911 911 (800) 852-7550 or (916) 262-1621 B. EMPLOYEE NOTIFICATION AND EVACUATION: Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging area where all employees will be accounted for. C. PUBLIC EVACUATION: If evacuation from area deemed necessary, these neighboring properties will be notified: Magoo's Pizza Christ the Rock Church Hallenbeck Dental Lab 5700 Stine Road 5720-32 Stine Road 5740 Stine Road 834-2000 833-8740 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: MERCY HOSPITAL 2215 TRUXTON A VENUE 327-3371 3. e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: 1. Barriers installed to prevent vehicle collision with pumps. 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction. 3. Dual hose systems on pumps. Anti-lock nozzles at pumps. 4. No sales to non-authorized containers. 5. No Smoking signs posted, self-serve instructions posted. 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventive diking with absorbent materials. 2. Shut off of all emergency switches to prevent further spillage. 3. Barricade area to prevent possible exposure to general public. 4. Avoid personal exposure to fumes/vapors and contact with liquid. 5. Eliminate all sources of ignition in area of spill or vapors. 6. Absorb liquids with absorbent materials and place is sealed container for disposal. C. CLEAN-UP PROCEDURES: Notify Circle K Environmental Director (602) 530-5089 for coordination with hazardous waste disposal company to remove contaminated absorbent materials if required. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate. C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: a) Inside, back room of store (breakers), b) Ea.~t wan of bllildinr;, (outside) WATER: a) North wan of building at ea.~t end (main line Eate valve), b) South side of site (in planter) SPECIAL: Emergency Ea.~ shutoff switch· a) At cashier station on console, b) Circuit breakers #40,42 in backroom LOCK BOX: YES€9 IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTIONIWATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers B. WATER AVAILABILITY (FIRE HYDRANT): Hydrant: Southwest of site (meter) 4. ". HM\1P PLAN t1:AP SITE DIAGRAMOO FACILITY DIAGRAM D Business Name: Circle K Stores Inc. #1270 VNorth Area Map # 1 of 1 Name of Area: Circle K Corporation #1270 5634 Stine Rd., Bakersfield CA ... o ..J '... .. ë '... c as o as > Parking Residential 6' Concr~ Wall_ Vacant Lot Vacant Offl ce Space ® Exit """ Storage Room Counter ~ Parking Store #1270 5634 Cold Stine Box Rd. tI / I~ /10K // ¥_ ( Gal//10K // I ~(.. /( Gal//10K / UO ..... /( Gal/ ...../ ........ ........ .... ...... @<4 Sewer Residential 5700 Stine Rd. Magoo'. Pizza 5720, 5724, 5728, 5732 Stine Rd. Chri.t the Rock United Penteco.tal Church 5740 Stine Rd. Dental Lab Parking -5- ·f:> -. ;>. .. . e "SYMBOLS e .@GAS ® ELECTRIC ® WATER MSDSI MSDS STORAGE . . . . FENCE (ALL TYPES) INDICATE HEIGHT f--.t/ . GATE IN FENCE --/' - STANDARD DOOR ~ SPRINKLER FIRE DEPT. ~"O CONNECTION ~ FIRE HYDRANT· PUBLIC - - - - - -¡ UNDERGROUND ~ 10,000 J STORAGE Gal I TANKS - LIST L - - - - - CAPABILITY 0- FIRE HYDRANT· PRrVATE n::t::nP 1 0,000 Gal RAILROAD TRACKS ABOVEGROUND TANKS ~~® AUTOMATIC SPRINKLERED BUILDING OR AREA @ FIRE ALARM C~ EVACUATION AREA PESTICIDE STORAGE ~ PESTICIDE'" AREA ~ STORAGE ¡; TYPES OF HAZARDOUS MATERIALS i> FLAMMABLE <6> LIQUID %> CORROSrVE <ê> SOLID <i]; WATER REACTrVE ~ GAS <ê> EXPLOSrVE <§> RADIOLOGICAL <W WASTE EXAMPLE: FLAMMABLE ~ LIQUID ~POISON EXPLOSIVE GAS ~ General Information 1 -- -. ~. -- --'\~. ~w~e6~N~ tþ CIRCLE K CORPORATION #1270 215-000-000 Overall Site with 1 Fac. Unit ~ 06/05/95 . Contact Name MYRON SMITH Business Phone: 24-Hour Phone Pager Phone Title / COMPLIANCE MANA (602) 437-0600x (602) 530-5089x () x Map:123 Haz:2 Type: 3 Grid: 23A FlU: 1 AOV: 0.0 Cohtact Name Title CIIUCK 'l'm~KOVICH / ZONE MANAGER Business Phone: (906) 268 4J68x~ 24-Hour Phone: ~16) 268 4368x-~ Pager Phon : ) - Location: 5634 STINE RD City : BAKERSFIELD Owner: Address: City: Administrative Data POBOX 5604-~3 tfJC~HYeI IC#! FJIOY' D&B Number: 06-294-4160 PHOENIX State: AZ Zip: 85013- 215-013 BAKERSFIELD STATION 13 SIC Code: 5541~~ CIRCLE K ~~~~1&Ñ Phone: lf1r6~8'34~:~ POBOX 52084 State: AZ PHOENIX Zip: 85072- Mail Addrs: City: Comm Code: Summary I, rjJ~,r:all.-S.m,.t.h- ~""c '~C'~2;ì\ ('.c;r-~~"f':\"';::Ü I hav@ 7iïvr;>e or print nama) reV1G'l'.'ed the attar:;,','" __"ii."· :718.tcri8Js manaº~Ø ment p~8.r: 1f;;:,-CLrç,JtJ~LJa:l0_and that it é:!O{!';) with (~~ém~ C\ :=,,1)::':[1:";.;;3) any ooij'1'edi~ns ~cmsti'iJ.Úe a complete and correct mSiîd agemem plan for my 1acility. ~ -; e . 06/05/95 . CIRCLE K CORPORATION #1270 215-000-000484 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-iQ03 SUPER UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 1044 Minimal ~ Fire, Pressure, Delay IIlthJ:~ /I.t.sIfh FT3 -. e e 06/05'/95 . CIRCLE K CORPORATION #1270 215-000-000484 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 UNLEADED PLUS GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: ~ Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL -- 10,000 5,000.00 I 21,263.00 6;). /51:,5", þt) r Press T Temp ~ Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO Storage UNDER GROUND TANK - Conc l 100.0% Gasoline Components r; MCP ----p;uide Moderate 27 - Notes 02-003 SUPER UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: ~ Days: 365 Use: FUEL Daily Max GAL ~ Daily Averµge GAL ~ Annual Amount GAL -- 10,000 I 5,000.00 I 32,603.00 'O)~) b r Press T Temp ~I Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO Storage UNDER GROUND TANK - Conc l 100.0% Gasoline Components r; MCP ----p;uide Moderate 27 - Notes e e 06/05/95 . CIRCLE K CORPORATION #1270 215-000-000484 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-002 UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No mt~ Form: Liquid Type: ~ Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 I 5,000.00 I ~1,e87.0e J 63) 7~ '?l r Press T Temp -:ì Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO Storage UNDER GROUND TANK - Conc -I 100.0% Gasoline Components 1-; MCP --p;uide Moderate 27 - Notes 02-004 CARBON DIOXIDE ~ Fire, Pressure, Delay Hlth Gas 1044 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 1,044 522.00 54,288.00 Storage r Press T Temp -:ì Location PORT. PRESS. CYLINDER Above Ambient IN STOREROOM BACK OF STORE - Conc l 100.0% Carbon Dioxide Components ri: MCP --p;uide Low I 21 '. e e 06/05/95 . CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 WITHIN 24 HOURS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH AND SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT - 911 BAKERSFIELD POLICE DEPT - 911 BAKERSFIELD HAZARDOUS MATERIALS DIVISION - 911 STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 OR (916) ~2Y 434~. E)l,dr- -}6 ~ J <2> Employee Notif./Evacuation UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. <3> Public Notif./Evacuation IF EVACUATION FROM AREA DEEMED NECESSARY THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED: ~C'3 VIDEO 397 4415, AND EXECUTIVE LOUNGE 832 221~. MAGOO'S PIZZA 834-2000 tta)l~k~ ~~ ~ ~:6~r'6?LfD) chrtb} ~~ ~- f~lf? <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN - (805) 327-3371 " e e 06/05/95 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 6 <E> Mitigation/prevent/Abatemt i <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up ~O;2.) 530 -?t>Se¡ GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823 6691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation , " . '. e e - 06/05/95 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER D) SPECIAL - EMERGENCY GAS SHUTOFF SWITH: A) CASHIER STATION ON CONSOLE; B) CIRCUIT BREAKERS #40, 42 IN BACK ROOM E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FI,RE HYDRANT - SOUTHWEST CORNER OF SITE (METER) <4> Building Occupancy Level y. u . ~ e e - 06/05/95 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 8 <G> Training <1> Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: SPECIAL ON-T~JOB TRAINING IN THE HANDLING OF H~ZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. USE OF KITTY LITTER FOR SMALL SPILLS. EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPT., EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPT. EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZA~ION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use "L- _--..-::;. ~.. - e I~ ~ 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 Overall Site with 1 Fac. Unit Page 1 I' , ~-- General Information Location: 5634 STINE RD Community: BAKERSFIELD STATION 13 Map:123 Haz:2 Type: 3 Grid: 23A FlU: 1 AOV: 0.0 Contact Name MYRON SMITH Title COMPLIANCE MANAGER ZONE MANAGER 24-Hour Phone ( bO.;?) 5"&/ -5lJðq ) Adm~pistrative Data Mail Addrs: P .0. DOX ~604·.w3 {V,CQ/n'Ird/ ~:; )~117 FIOPr D&B Number: 06-294-4160 City~ SANTA lVll\K.rA fJh(#J)x State: :eMi.Zip: -%.!i::.ï6' 5S1)r3 Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code: 5541 Owner: CIRCLE K CORPORATION Address: POBOX 52084 City: PHOENIX Phone: State: AZ Zip: 85072- Summary RECEIVED (MAY 1 2 1994 i, J1h¡('{}11 ...QtJ1i+h Do hereby certify that I havs (Type Of pnnt name) rsviewed the attached hazardous materials manage- meni plan foil' C}rd.e.J<Jt kl?O and ~hm it 81long with (Name of BU8IneSll) any oorrrediotrn$ constitute a complete andJoorred mane agement plan fOr my facility. " -. .. It e 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-003 SUPER UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 1044 Minimal ~ Fire, Pressure, Delay Hlth FT3 .. i e e 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 UNLEADED PLUS GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 10,000 5,000.00 21,263.00 Storage UNDER GROUND TANK r Press T Temp -:ì Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO - Conc l 100.0% Gasoline Components r; MCP --,-Guide Moderate 27 - Notes 02-003 SUPER UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 10,000 5,000.00 I 32,603.00 Storage UNDER GROUND TANK r Press T Temp -:ì Location . Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO - Conc l 100.0% Gasoline Components r; MCP --,-Guide Moderate 27 - Notes e e 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-002 UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Dåys: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 5,000.00 I 87,887.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO - Conc l 100.0% Gasoline Components r; MCP ~uide Moderate 27 - Notes 02-004 CARBON DIOXIDE ~ Fire, Pressure, Delay Hlth Gas 1044 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 1,044 I 522.00 I 54,288.00 Storage r Press T Temp ~ Location PORT. PRESS. CYLINDER Above Ambient IN STOREROOM BACK OF STORE - Conc l 100.0% Carbon Dioxide Components 1-; MCP ~uide Minimal I 21 It e 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 WITHIN 24 HOURS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH AND SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT - 911 BAKERSFIELD POLICE DEPT - 911 BAKERSFIELD HAZARDOUS MATERIALS DIVISION - 911 STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 OR (916) 427-4341. <2> Employee Notif./Evacuation UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. <3> Public Notif./Evacuation IF EVACUATION FROM AREA DEEMED NECESSARY THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED: TC'S VIDEO 397-4475, AND EXECUTIVE LOUNGE 832-2212. MAGOO'S PIZZA 834-2000 <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN - (805) 327-3371 , .' e It 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation It tit 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER D) SPECIAL - EMERGENCY GAS SHUTOFF SWITH: A) CASHIER STATION ON CONSOLE; B) CIRCUIT BREAKERS #40, 42 IN BACK ROOM E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - SOUTHWEST CORNER OF SITE (METER) <4> Building Occupancy Level e e 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 8 <G> Training <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: SPECIAL ON-TH-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. USE OF KITTY LITTER FOR SMALL SPILLS. EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPT., EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPT. EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZARTION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use .... . ¡. .: ....; , , .: . ~ e - 04/18/94 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 9 ! <G> Training <4> Held for Future Use (Continued) ......-~-- - " ',~ iJ).-; _ , -:. ,~ CI RCLØ~< CORPORAT I ON :ff 1270 215--.I-00048i+ Overall Site with 1 Fac, U~it Page 1 04/01/'33 Ge~eral l~formatio~ 'r- LQ;~-:-::---~~~;:-' S; I ~~ -:D ~==~=--~'~==--===~=~~~==~~~~;-~-~~~:--~'~1;~~:=~-;---~~~:.-=~ ,I CC1mmuy-.it·,,..: BA~ŒRSFIEt:D STATION 13 Gr-'id: 23f.i FlU: 1 1'40'h o,oJ'1 ~¡-:Þh-- \,/ / ·-··-fø7J7ClttJtëmttt--ffJ-tH;~--fptJi)·%~tª-~--- -.----.---- [ lr~~j',tam I\f~me --. _':':J..~ Titlf-:?è..L.':".--J- ~_\siJ",ess Phorle J ;:::I.~·-HQur~ PhQ~e Þ1IJ-:C (¡qFNCLOT R-C"l":") 023 OWl ){ ':f,Ü'3) 2/17-1~lL~ JOHN HART ZONE MANAGER (805) 321 Q,{5r'2 ){ / (805) ·;t;21 û5¿¡¡:2 ___________.__ ___________________.__ ____$2..=..'6.'2ILLZ-.. --.----f9l.62--::-'i5.!2E roo ---------- Adm i i"1 i s t ra t i ve Data -----..--.------.--.---------.. Mail Addrs: P"O. BOX 5604 D&B Number: 06-294-4160 City: SANTA MARIA State: CA Zip: '33456- CI~~_~Q~e: __.~ 15--0 13 _ BA~~E~SF I_E~~_ ST~~_~ O~~~ 3 ___.______:~_~.. Code ~_ 5~~~__.___..___ L OVH"ler~: CI RCLE K CORPORATION Phoi",e: (805) 83i+--86i.~5 Address: POBOX 52084 State: AZ ______C i ~~~~~OEN I X ______.______________________.____________.!..: i ~_~_~:~~:2_=____' I~ - .::¡ummar~y ------ --..-..--..--------............----....--....---- L ------..-..------......-......--....----........-......-.. .. ......-----......-......--- --..-- ..----...-......---------..----......-..- ~, JilYflJn c ~ ì th ' On hereby certify that I have (fV1>8 or print nama) reviewed the attached hazardous materials manage- ment plan for C ~.....I" 1.- .u- j:::J')fJ and·that it along wi~h ~ any Wli'fedioln$ OO\!'b$tityt~ a complete Btndoorred man- agem~nt ~Ufðln 1/@\F m~ mcl~. ( "'~" 7' CIRCL'K CORPORATION #1270 215--(.--00048L~ Hazmat Inventory List in MCP Order 04/01/'33 02 - Fixed Containers on Site PIn-Ref Name/Hazards Fc.}'~m ---..---..-----.------......-..--..-..-....-- Quantity !'riCP ..--..------....--..--------..--.. 02-001 UNLEADED PLUS GASOLINE Fire, Immed Hlth, Delay Hlth Liquid Page .-, .::. 10000 MClde}'~ate GAL 02-003 SUPER UNLEADED GASOLINE Fh~e, Immed Hlth, Delay Hlth Liquid -..-....------..--..---..---..-......-..---..-..--..---....-------..-..-....--....--------..- 10000 Mc.def~ate GAL ---.. 02-002 UNLEADED GASOLINE Fire, Immed Hlth, Delay Hlth Liquid --....-......---....-------....----..-..-....---- ...------..-----------..----..---....---....------..- ------..-----....-----..--..----......-..--.... 02-004 CARBON DIOXIDE Fire, Pressure, Delay Hlth Gas ----..--..-----..-..------------ --..--..--..----.. 10000 Moderate GAL -..---....--- 10L~4 Mi '('¡imal FT3 ? ~' CIRCLa CORPORATION #1270 215'-(_-000484 02 - Fixed Containers on Site Page 3 04/01/93 Hazmat Inventory Detail in MCP Order ----...- ---- ---.. 02-001 UNLEADED PLUS GASOLINE Fire, Immed Hlth, Delay Hlth Liquid 10000 J'ikldet~ate GAL ---..---------- CAS #: 8006-61-9 Tt~ade SecTet: Nc, FC"r~m: Liquid Type: PI_n~e Days: 365 Use: FUEL ---- Daily Max GAL 10,000 Da i I Y Averëlge GAL t=¡YH",Ua 1 Amccurlt GAL - 5,000.00 --I' -22. 13Er. 00 'b( 1)~63 V' r Press - Temp . Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO Stclt~age UNDER GROUND TANK - Corlc -.....---------.. 100.01- Gë\sc,l i r,e CompC1rley,t s - . MCP -----r8u i de -r;;odet~ate I 27 - Notes .---..---------.. 02-003 SUPER UNLEADED GASOLINE Fire, Immed Hlth, Delay Hlth Liquid 1 0000 J'ik.det~at e GAL ---- CAS #: 8006-61-9 Tt~ade Sect~et: No F c.rm : L i qui d Type: PlIre Days: 365 Use: FUEL -- Dai ly 'flax GAL ---r-- Dai ly AVE,t-'age GAL --I AYIYlual Amc.unt GAL -- 10,000 I 5,000.00 I 1"1, ':¡62. O(/' _ . 3;;(, bD3 " --- Stcct~age -----'T· Pt~ess T· Temp -,------------ Locat lor, - --...,- UNDER GROUND TANK Ambient Ambient ¡40FT SOUTHWEST OF STORE UNDERGRO - COYIC -r:.:-- 100"01- ¡Gasoline ---- Compc:ly,ent s---------r: J'i1CP -TGlI ~ de ¡Moderate ê.7 - Nc.t es .._--------_..~-----..- l' ,: CIRCL_t. CORPORATION :U1270 215--('-0004f}L~ 02 - Fixed Co~tai~ers o~ Site Page 4 04/01/93 Hazmat l~ve~tory Detail i~ MCP Order --..--..- ..-------..--------------------------..----..------------..--..---- 02-002 UNLEADED GASOLINE Fit~e, Immed Hlth, Delay !-Hth Liquid 10000 Mc:.de}'~ate GAL ..--_...... -----..------------..------------- CAS #: 8006-61-9 T}'~ade Sec}'~et: No F C:1}'~m : L i q II i d Type: Pln~e Days: 365 Use: FUEL -- Dai ly l'r1ax GAL -------T Dai ly Ave}'~age GAL AYï(lual Amol_I....lt GAL '- 10,000 5,000.00 --59. b::..5. Uti _. . <:6 7', ßg? V" UNDER G~~~;~;g~~:¡~1 A~~~~::.t T Ar~~r~l~....I;T:o;;~ SOUTH~ES~o~~t ~~~~R~--~~DERGR; - CO....IC ~----------- CompO....le·(lts -----------------1- MCP --¡I.lide 100.0% ¡GaSoli~e Il'r1oderate 27 - Not es ----------.-----------------------------.---------------.- ---..-..------ ..-----......-.-----....---....-..........------..-......-----------.... 02-004 CARBON DIOXIDE Fire, Pressure, Delay Hlth Gas 1 04L~ jV¡ i '(1 inla 1 FT3 --....-.. --........-------..-----..-............-..---....----.......---- CAS #: 124-38-'3 T}'~ade Sec}'~et: No Fc:.}'·'m: Gas Type: Plwe Days: 365 Use: OTHER Daily tr1ax FT3 ---T- Daily Ave}'~age FT3 --'---r'-- A....mual AmC:rl.mt FT3 --- 1,044 522.00 54,288.00 PORT. P~~~~~g~Y~~ND~;_TA~:~:s T A~~r~l~....,;T~;~--~~:;~~;OOI~ ~~~~t ~~""'ST;RE -- CO....IC ---r::--:- 100.0% ICarbo~ Dioxide CompCr....le....lts -----.----1':::. f'r1~P --Îl¡~de I 'it¡ ....1 1 ma 1 i:::: 1 .' '1' CIRCLA CORPORATION #1270 215-(_-00048Lt 00 - Overall Site Page 5 04/01/'33 (D) Notif./Evacuation/Medical ------------- (1) Agency Notification IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3'37'3 AND STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 WITHIN 24 HOURS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH AND SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED1 IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT - 911 BAKERSFIELD POLICE DEPT -- '311 BAKERSFIELD HAZARDOUS MATERIALS DIVISION - 911 STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 OR ('316) 427-4341. (2) Employee Notif./Evacuation UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. (3) Public Notif./Evacuation ----.. IF EVACUATION FROM AREA DEEMED NECESSARY THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED: - \IMD[I~ ¡IO \-1[ GOOHIN' 033 1606" TC'S VIDEO 3'37-Lt475, AND EXECUTIVE LOUNGE 832-2212. J1'1ð#&fJ/;i6 ØJ21-'J <61/1 -é).f)f)O ';,// (4) Emergency Medical Plan -----.- MERCY HO~PITAL - 2215 TRUXTUN - (805) 327-3371 · " ~' 04/01/'33 C I RCLA CORPORAl' I ON # 1 ;:'::70 215'-(.-00048'~t 00 - Overall Site Page 6 (E) Mitigation/Prevent/Abatemt .. ------- ...------ (1) Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. (2) Release Containment GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. (3) CleaY, Up GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-06'31 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. (4) Other Resource Activation ---- ---- / J¡ C I RCL_< CORPORAT I ON # 1270 215-(1-000484 00 - Overall Site Page 7 04/01/93 (F) Site Emergency Factors --........-..------------......---..--..-..---.--..-------....--..--------..-------- (l) Special Hazards (2) Utility Shut-Offs --------..- A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER D) SPECIAL - EMERGENCY GAS SHUTOFF SWITH: A) CASHIER STATION ON CONSOLE; B) CIRCUIT BREAKERS #40, 42 IN BACK ROOM E) LOCIJ~ BOX - NO C3} Fire Protec./Avail. Water ---- PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - SOUTHWEST CORNER OF SITE (METER) C4} Building Occupancy Level '''i CIRCL~ CORPORATION #12ìO 215-(1--'000484 00 - Overall Site Page 8 04i01i'33 <G} T'r~a ÌY'tÌ )'"19 -----.--------.-..--.....---.. -..----..----------....--- --------..--......- (1) Page 1 j - 3 WE HAVE X EMPLOYEES ·AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: SPECIAL ON-TH-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. USE OF KITTY LITTER FOR SMALL SPILLS. EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPT., EMERGENCY MEDICAL AND CIRCLE t\ ENVIRONMENTAL DEPT. EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZARTION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. (2) Page 2 as needed (3) Held for Future Use ..----- (4) Held for Future Use t' ~.. 'j CIRCL.. CORPORATION #1270 215-('-000i~84 00 - Overall Site Page '3 04/01/r:33 < G} Tt~ë:d '(I i '(Ig ----------.------------ -------......-----......---..---..-..-..-........-....------ <4) Held for Future Use (Continued) ,~ '.) ,i' ......." C I RCL" CDRPDRAT I ON # 1270 215-(_--'000484 00 - Overall Site Page 10 O.l~/01 /93 (I-- } RI't1PP D~ìTA ---------------------..-----..-..------------------..----..----- C1} Release Containment C2} Dffsite Consequences - --- C3} In House Capabilities ------------ C4} Plant Shutdown Instruction --..--... .------- ~~, l&MP PLAN Mtp SITE DIAGRAM [XJ FACILITY DIAGRAM 0 Business Name' Circle K Corporation #1270 .0 North Area Map #~of 1 Circle K Corporation #1270 5634 Stine Rd" Bakersfield Name of Area: CA V a c a n t D i r t L o t Parking Vacant Lot ~ Parking ~( un ,~..\ <B> " : .- , I' ,,"'OK,,~" . ,__ ".'Gal,,~"'OK "~ ,, : I..: .../":""G8!""",,íOK,,'" -( '.......,,":" Ga},," - ' 5700 Stine Rd. Magoo's Pizza Residential e' Concrete Wall- Ex i t c=:> RI \ C 2 X 0 <§>g eetð Storage Room ® Vacant Office Space Store #1270 5634 Cold Stine Box Rd. @_Sewer Residential- 5700 Stine Rd. TC'S Video 5732 Stine Rd. Executive Lounge Parking -5- ~.\.~~ e SYMBOLS @GAS ® EL.ECTRIC @ WATER IMSDS . . . . ......., . ----' - $l...o SPRINKLER FIRE DEPT. ~""o CONNECTION e MSDS STORAGE FENCE (AL.L TYPES) INDICATE HEIGHT GATE IN FENCE STANDARD DOOR 6. FIRE HYDRANT· PUBL.IC - - - - -., UNDERGROUND : 10,000 I STORAGE Gal (TANKS. LIST L - - - - - CAPABILITY 0- FIRE HYDRANT· PRIVATE ¡¡:¡¡¡¡¡ 10,000 Gal QAS AUTOMATIC SPRINKLERED ~ BUILDING OR AREA C~ @ FIRE ALARM PESTICIDE STORAGE RAILROAD TRACKS ABOVEGROUND TANKS EVACUATION AREA PESTICIDE STORAGE AREA TYPES OF HAZARDOUS MATERIALS <5> FLAMMABLE <6> LIQUID <§> CORROSIVE <§> SOLID 1]> WATER REACTrVE <ê> GAS % EXPLOSIVE <§>RADIOLOGICAL <W WASTE EXAMPLE: FLAMMABLE ~ LIQUID <é>POISON EXPLOSIVE GAS ~ t" t:.,..,.r¡- .-" e e t 03/26/92 CIRCLE K CORPORATION #1270 215-000-000484 Overall Site with 1 Fac. Unit Page 1 General Information Location: 5634 STINE RD Community: BAKERSFIELD STATION 13 Map: 123 Hazard: Low Grid: 23A FlU: 1 AOV: 0.0 Contact Name MIKE KARVELOT -MIKE 3PlNUZZ"i Title ENVIRON DIR ZONE MANAGER Business Phone (714) 823-0691 x (805) 321-8522 x 24-Hour Phone (609) 247-1914 (805) 321-8522 /Administrative Data D&B Number: 06-294-4160 State: CA Zip: 93456- SIC Code: 5541 Mail Addrs: P.O. BOX 5604 City: SANTA MARIA Comm Code: 215-013 BAKERSFIELD STATION 13 Owner: CIRCLE K CORPORATION Address: POBOX 52084 City: PHOENIX Phone: (805) 834-8625 State: AZ Zip: 85072- Summary RECE\VEO 'APR , 7 \992 HAZ. MAT. OW. If );J¡ j¡ (., f(¡;I'tt/11' i; f Do hereby certify that I have (Type or print nømÐ) reviewe(~ U¡a attac~- -:.." · '":,,:,~::\rdouS materials manage- ment plan for fì~£~..l~~~· _and that it a10ng with (() {J . . any corrections c;n~::tuI9 a complete and correct man- ~ "" &gament plan for my tadlity. -ø.¿JI- SIgnatUre f~~z, · ~.. 'Ï ./ CIRCLA CORP,ORATION #1270 215-.000484 02 - Fixed Containers on Sitê Page 2 01/21/92 / 02-001 ¡ Hazmat Inventory Detail in R~GULAR GASOLINE /J.j1)LlZ4tJ& 0 fl-Jt5 Fire, Immed H1th, Delay H1th Reference Number Order Liquid 10000 GAL Moderate CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Storage UNDER GROUND TANK Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 5,000.00 I 84,407.00 a,;}, J3ó r Press T Temp ~ Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO '-'= MCP ~t Mo~1 - Cone l 100.0% "Gasoline Components - Notes 02-002 UNLEADED GASOLINE Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL " Daily Max GAL 10,000 ----r-- Daily Average GAL ~ Annual Amount GAL -- 5,000.00 " 227,533.00 " 5ll,tõ5" r Press T Temp -:-1 Location Ambient Ambient 40FT SOUTHWEST OF STORE UNDERGRO Storage UNDER GROUND TANK - Cone -I 100.0% Gasoline Components r; M~~a~, List MOdeV - Notes , ;~ 1ì CIRCL~ CORPORATION #1270 215-~000484 02 - Fixed Containers on Site Page 3 01/21/92 Hazmat Inventory Detail in Reference Number Order 02-003 SUPER UNLEADED GASOLINE Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 I 5,000.00 I 55,048.00 111 e¡~ r Press T Temp -:I Location Ambient Ambientl40FT SOUTHWEST OF STORE UNDERGRO Storage UNDER GROUND TANK - Cone l 100.0% Gasoline Components r; MCP 3.~,st MOder,. . - Notes 02-004 CARBON DIOXIDE Fire, Pressure, Delay Hlth Gas 1044 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER ---- Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 -- 1,044 I 522.00 I 54,288.00 Storage r Press T' Temp -:I . Location PORT. PRESS. CYLINDER Above Ambient I IN STOREROOM BACK OF STORE - Cone l 100.0% Carbon Dioxide Components r; MCP -=---rList Minimal I .. . "ì e . 03/26/92 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 WITHIN 24 HOURS. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH AND SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT - 911 BkKERSFIELD POLICE DEPT - 911 BAKERSFIELD HAZARDOUS MATERIALS DIVISION - 911 STATE OFFICE OF EMERGENCY SERVICES (800) 852-7550 OR (916) 427~4341. <2> Employee Notif./Evacuation UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING) NOTIFY,ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED EVACUATION STAGING AREA WHERE AL~ EMPLOYEES WILL BE ACCOUNTED FOR. <3> Puplic Notif./Evacuation IF EVACUATION FROM AREA DEEMED NECESSARY THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED: KIMBER HOME COOKIN' 833-1606, TC'S VIDEO 397-4475, AND EXECUTIVE LOUNGE 832-2212. <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN - (805) 327-3371 ~ ~ .~ 1 e . 03/26/92 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 5 <E> Mitigation/prevent/Abatemt I <1> Release Prevention GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED, SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS. CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. <2> Release Containment GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE TO SAFE AREA FOR EVAPORATION. CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE. <3> Clean Up GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. <4> Other Resource Activation ~ , " ." ~ .. CIRCL~ CORPORATION #1270 215-~000484 00, - Overall Site 01/21/92 <F> Site Emergency Factors Page 6 <1> ~~~ <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE, BACK ROOM OF STORE OUTSIDE, EAST WALL OF BUILDING C) WATER - NORTH WALL OF BUILDING, OUTSIDE (MAIN LINE GATE VALVE) SOUTH SIDE OF SITE IN PLANTER â' ' D) SPECIAL - NONE Þ1JJ~(j.B:ItJy ø.A5SI/ttt()FFS!v/1r!H: tJ~.(.fJ-151f S77J:'f1{)¡¡) P1!)()&I')~ E) LOCK BOX - NO b, C:YCJ,Ûft3~ N '1~ l(;J. ;11 (j~ ~ <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - SOUTHWEST CORNER OF SITE (METER) <4> Building Occupancy Level ~ ·' " "-'" ~- e e . 03/26/92 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 7 <G> Training I ; <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: SPECIAL ON-THE-JOB TRAINING IN THE HANQLING OF HAZARDOUS MATERIAL(S) IS PROVIDED IN THE FOLLOWING AREAS: 1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT. 2) USE OF KITTY LITTER FOR SMALL SPILLS. 3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT. 4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH MSDS'S FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN (INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS. 1<2> I I Page 2 as needed <3> Held for Future Use <4> Held for Future Use .' ,:~ :: ~ e e 03/26/92 CIRCLE K CORPORATION #1270 215-000-000484 00 - Overall Site Page 8 <G> Training <~> Held for Future Use (Continued) r; :- e . - --- -- -------- r~ ííJ.~ ..... ..... ..... E.M.S.S., Inc. An Environmental Regulatory Compliance Service Company ~ c!øf-'d ~. K Bakersfield city Fire Department Hazardous Materials Division 2101 "H" street Bakersfield, CA 93301 April 10, 1992 Gentlemen: Circle K Corporation has contracted Environmental Management Software Systems, Inc. (EMSS) to provide the required changes to the Business Plan for the 1992 reporting period. Enclosed are the updated Business Plans for the gasoline stores on the Bakersfield city update forms your office. Changes are highlighted. Circle K Corporation has been instructed by EMSS to ensure that every store keeps the Business Plan resident at the store and that all store employees be trained in the contents of the hazardous material inventory and emergency response sections of the Plan. 5 Circle K provided by If you have any questions regarding this submittal, EMSS at (805) 925-6285. please call Sincerely, RDB:slc Enclosures E.M.S.S., Inc. /P.O. BOX 5604/SANTA MARIA/CA 93456/(805) 925-6285/FAX: (805) 349-2753 of-- e Bakersfield Fire Jtpt. Hazardous Materials Division 2130 "G" Street Ba...~ersñeld, C....\. 93301 RECEIVED MAR 1 2 1991 ".. H \7 ~~AT. DIV. HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To ovoid tul1ner e::tion. return tnis torm within 30 days of re-::eipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer 1tIe ouestions beiow tor tne busine~ es 0 wnole. 4. Be eClet end ::onoise os pos.s:ble. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Circle K Corporation *1270 LOCATION: 5634 Stine Road Circle K Corporate MAILING ADDRESS: P. O. Box 52084, Phoenix, AZ 85072 CITY: Bakersfield SiAiE: CA ZI?: 99316 PHONE: (805) 834-8625 DUN & 5RADSïR:=T NUMBt:R: 06-294-4160 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience Store/Gas Station OVVNER: Circle K Corporation (602)229-8706 MAILING ADDRESS: P. O. Eox 52084, Phoenix, AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITlË BUS. PHONE 24 HR. PHONE Beeper # Beeper # l. Mike SDinuzzi - Zone Manaaer (805)321-8522 (805)321-8522 2. Mike Karve10t - Environ. Dir. (714)823-0691 (609)247-1914 1. FOI S90 Bakersfield Fire Dept. " . Hazardous Materials Divisio. HAZAlmOUS MATERIALS MANAGE~NT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS: 3 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Prop~í maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police. fire department. emergency medical and Circle K Environmental Department. ' 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and C02. A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers). the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOllOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, Mike Schumacher 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 INACCURATE INFORMATION CONSTITUTES PERJURY. >n.~ SIGNATURE TITLE Z,pt,/91 DATE Division Manager 2. FOIS00 · V a · c a n t D i r t L 0 t · e e HMMP PLAN MAP SITE DIAGRAM 0 FACILITY DIAGRAM 0 Business Name: Circle K Corporation # 1270' 6 North Area Map # J.- of..!.. Name of Area: Circle K Corporation #1270 5634 Stine Rd., Bakersfield CA Plot Plan - Circle K Store #1270 5634 Stine Road, Bakersfield Residential Vacant Lot C:J i Parking ~ Parking " ;r(Þ "íOK,;;' ;,"", .'Gat;'10K," : mY.,,' ..,'('G~!::'10~,,' un ...,';' G~!, ~ , .' 6' Conor.t. Wall- ® Vacant Office Space @ Store #1270 5634 Stln. Rd, Cold Box Œ).. Sewer Residential 5700 Stine Rd. Klmbere Home Cook In 5700 Stln. Rd. TC·S VIdeo 5732 Stine Rd. Executlv. Lounge Parking - 5 -' . ._, ,-. ..-." . ,.. . 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R:<~::I)'::V::VM: '~::::::::"'" '\1/" '\:.?t::< I:V ,:- . <::::;. <.:,,:0:;:::::::;:;:;:;>:::;:;:;:::;:;:;:::::;:;:;::-::;:::::;..;.;......... . ... ..............................'...._..-.........._'...................._..'.'...............'.-.....-.'.'....,..................-.........._'.....'.'...-.-...:.._..-.....'.........._........'.'..............,......'....................,...............,.-................,....-....,.....-......... - N. REFERENCE TO NORTH l' . 100' - SCALE OF MAP I 0'\ I I···,·,··· ..,..............................,.......,..:-...................-:-:-:..............'..........................-:......' '...-:.....-:-:-:.................-:.... .....................................................I . ¡Nª@Øgiâ.ki8P.#Àç~Nt$T:irE.~i$ ..~WRWM~r @ ABSORPTIVE MATERIAL 6. ALARM ~ DRAIN -I "'- DRIVEWAY ---.I - DOORS Þ EVACUATION ROUTE ~ EVACUATION/STAGING AREA <{}> EYE WASH + FIRST AID ® ŒJ ¿? FIRE HOSE FIRE EXTINGUISHER FIRE DOOR FIRE WALL = [j¡( GAS PUMPS ~ GUARD STATION ŒJ KNOX BOX LOCATION I I=zI LADDER IMSDSI MATERIAL SAFETY DATA SHEET & ERP EMERGENCY RESPONSE PLAN 8 PERSONAL PROTECTIVE EQUIPMENT 1m PUBLIC TELEPHONE RR - REST ROOM § f/lIIlIIIIII/1 STAfRS ~{..:....................,.,......... . § AIR CONDITIONING [ID ELECTRIC METER ® ELECTRIC SHUTOFF [Q] GAS METER @ GAS SHUTOFF ® PUMP SHUTOFF ~ WAT E R MET E R Y FIRE DEPT. SPRINKLER CONNECTION Y FIRE DEPT. STANDPIPE CONNECTION .... FIRE HYDRANT :X~ ATTIC SCUTTLE )..;' COOLER OR *' ~ REF RIG E R ATI 0 NUN IT *** FENCE/BARRIERS œ HEATING UNIT Ff#:fj RAILROAD TRACKS @) SEWER :-;~-: SKYLIGHT '- - - -... . . STORM DRAIN l?r·<$-rqRÄÓ.ETÅN.kS ···.rHJ IDENTIFY THE TYPE OF CONTAINER USING THE FOLLOWING SYMBOLS, SPECIFY TANK CAPACITY IN GALS.. LBS., OR CU.FT. ABOVE GROUND TANKS 200 @ (I GAL· eoo HM' HIot' GAL fL f L BELOW GROUND TANKS ~...... (10K I \GALl ....../ r--10K-', \. GAL I --- -"" 81NSULATED TANKS 8PRESSURIZED TANKS CORR - CORROSIVE C - COMBUSTIBLE E - EXPLOSIVE F - FLAMMABLE G - GAS L - LIQUID OX Y - OX I D I Z E R R - RADIOACTIVE S - SOLID T - TOXIC WR - Wt\TER REACTIVE ..........'.....................................................................:...............................:.................. H·ÄZÄáDÓUi~MÂfERrÂLà ~J"~~~~Æø~ßšN, I~~~N~ ....."..,.................~-.....,...... .... ............................ , HAZARDOUS MATERIAL STORAGE AREA...HMS HAZARDOUS MATERIAL HANDLING AREA...HMH HAZARDOUS WASTE STORAGE AREA...HWS .... ...... .'. .,..,.. ...................'....................',..................................................................................................................:.......................................................:.......................:..........«<:...:1 ~"" ., e e C1TYof UAI\EH~Fll:LIJ ..~ ... '. .,. , HAZARDOUS MATERIALS INVENTORY _ flrl Ind Agtlculture (! Stlndlrd Business El " . NON-TRADE SECRETS P&qe __L.. of L I "US¢"iSS "AHE: Circle K Corporation #1270 OWflEß tlAI~E: Circle K cor~oration tI AH F., nú TillS FACIlITVÒ' Circle K Corporation lOe rOil' 5634 Stine Road AlIlJ/ŒS,' P.O. Box 520 4 stAtlD m HID CLASS (; Df'---5'541 ..----.....-- CII ,. ll(>~ Bal<.erSt1el<l, \;a Yjjlb .-.-- CitY. Ir'Phoenix Az 85072 DUll ^' BHAIJSrflHI HU~mEn"" .-.,.-... ...-..,-.. ---, PIIOIlt: -: ---r805 834-86?5 .------- P IÙf ~ . ~·-T6õ-r-~---· - - . . :--- \' --) --- ---- - REFEIl 1'o--lf:/~rRù'f!rY8f¡¡s-FDn-Pf?Of'En CODES Q..L 2.... ~ J 4_ L .6. ..0 . I I I , . , -2 1 . ~ & o~ ~He 8 , 10 II 12 13 .. rr~ns Iy~e 1111 Av¡r1ge Annuli HeI$urI ~ont ~ont ~ont us~ toc~tlon Vhe~e , by HI'es or ~i,ture{C~'conents Co e Co e _It ' : It Est UnIts rpe ress ellp Co I Store n facl It, III See Instru, Ions , R r M J 30000 J~~ooo I r GAL ~--r~;-Ll-[-;--r-;; jge~3~fag~, sìg~~ox. - - 187753 lQO. Gasoline Phl~i(tl fnd ~erlth "'llrd C.A.S. !lullber 8006-61-9 COllponent .1 HIIII I C.A.S. NUllber I ee I I t I .pplr 25 Toluene 108-88-3 ,1330-20-'- - [J r inlllwd [) Reactlvlt, (] Þelared [J SUdd¡n Relelse COllponenl 12 NIIII & C.A.S. Nuøber [1 Il1l11ed Ia I.e 20 Xylene Ilea lh o Pressure Ilea Ilh Component U NI1I8 . C.A.S. Kuøber 10 Methyltert 1634-04-4 -1L.Q 1044 ( 522 I 54288 ~I 365 I 04 I 2 I 4 I 99 I In storeroom back of store 100 Carbon Dioxide. Carbonic Anhydride Phl~lefl I~d ~elllh "1llrd C.A.S. KUl1ber 124-38-q COllponent '1 Hall8 , C.A.S. NUllber . I ee t l It Ippl, - o fire Hllard (] React hit, [] Þrhred ~ SUddf" Relelse COllponent 12 NIII I C.A.S. NUllber fJ 111IIIp.dlAle - I U lh o Pressure Ilea Ilh - COllponent U HIIII & C.A.S. HUl1blr =c1 I I I~ I I l r I ,- Phl~ic.1 ,nd ~elllh Hallrd C.A.S. lIullber COllponent II Nile I C.A.S. HUl1ber I eck I I t It Ipply COllponenl 12 Nllle I C.A.S. NUllber o rire Hllard [] Reecl'lvlt, [J Of lared [] SUddr" Þe I ease n Il1l\ediale e- - lea th o Pressurl - lIellth COllponent 11 Nlft8 I C.A.S. NUlber 1 ( I I . D r [~ 1 I Phl~icfl ,nd ~eatlh ~I,ard C.A.S. NUllber COllponenl II Nall8 & C.A.S. KUllber I ee I I t It IPP , . [J Df lared [] Suddfn Release I COllponent'2 NI18 I e.A.S. NUllber U fire Hllard o Reacthlt, II hilled ale - I II lh o Pressure Ilea Ilh COllponent 13 NaIl I e.A.S. NUl1ber I HIEnGEtlCY cotlTACTS ;11' Mike Spinuzzi - Zone Mgr. - Beeper # (805) 321-8522 112 Mike Karvelot - Environ. Dir. - (714)823-0691 or (619)247-1914 I RUe Tlt1l 2t-nr-pfiðfil- RIIII ,- I1tn 21'ßfTMñr- - ---' .. I feu:, If:t ~~~er enll~ R~rr. f~Jr "~a~f';errorIÇrv~.iíÇl:'r.'f t./ f~~"r.lllt~tW ~!r~/~fil n ubIIllt d In his end III ðltlc~ed ðocullenfll InX t~ít ~Ise~ on II' InQui.,. 01 [hose In~lvl~ul'S respons\bfe for oblalning t~1 ¡nforlltlon. I bellevl thlt the , ubftllted Inlorlll on Is truI, .ccurlte, Ind co~pletl. Mike Schumacher - Division Mana~er , Jrr~M'õTlé1J rT111'o'o~ñ~rTð~¡;HðrOlr7it¡ñU'lipHHõf'r'1U[fiõ¡llëa,!p¡nëñrH In SI~ñUüf! PIf '"1lfr.U- e ~ ()D~ . Bakersfield Fire Dept. Hazardous Materials Inspection ~CtIVtO AUG ,'990 ~ns·d.... .00..00. Date Completed Business Name: C(?t:Lr Ie' ~~A-TIO,J *'1270 Location: 003l\ STINF.J' ~, Plan ID # 215-000- '-19.1..11 (Top right comer Business Plan) Station No. 13 Shift c. Inspector S"cÆ/rc¿.¡hl:U1¡ ~u;/ Mu1rrt.zwf Adequate Inadequate Proper Segregation of Material ~ 0 ej/ 0 e:( 0 ~' 0 Verification of Inventory Materials Verification of Quantities Verification of Location ~ Comments: VI 1/ erifiealion of MSDS Availability NurnberofEmployees ~ o ..ø Verification of Haz Mat Training o ;i Comments: Verification of Abatement Supplies & Procedures ß o Comments: Emergency Procedures Posted o ø jZJ o Containers Properly Labeled Comments: Verification of Facility Diagram o ø Special Hazards Associated with this Facility: Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office 1"'- e Bakersfield F:irAbept. Hazardous 1Iaterials Division 2130 fiG" Street Bakersñeld, CA. 93301 I~~~ (f)JL HAZARDOUS MATERIALS MANAGEM:NT PLAN INSTRUCTIONS: 1. To ovoid further cction. return this form within 30 days of r~e¡pt. 2. TYPE/PRINT ANSWERS IN ENGLlSH. 3. Answer the ouestions beiow for the business os c whole. 4. Be Crief ond concise os possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAM:: Circle:K Corporation 11270 LOCATION: 5634 Stine Road Circle X Corporate MAILING ADDRESS: P. O. Box 52084, Phoenix, AZ 85072 CITY: Bakersfield STATE: CA ZIP: 9~~1 n PHONE: (805) 834-8625 DUN & BRADSTREET NUMBER: 06-294-4160 5:::'41 SIC CODE: -- PRIMARY ACTIVITY: Convenience Store/Gas Station OVVNER: Circle K Corporation (602)229-8706 MAILING ADDRESS: P. o. t\ox 52084, Phoenix, AZ 85072 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Mike SDinuzzi - Zone Manag'er (209)298-3036 C80S) 833-8881. 2- Don Lewis - District Manager (209)298-3036 (209) 291-5910 1. ." Hakersheld 14'ire Uept. - , . Hazardous Materials Divisi0I}a HAZAR!'JOUS MATERIALS MANAGE~T PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS: 3 MATERIAL SAFETY DATA SHEETS ON FilE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Special on-the-job training in the handling of hazardous material(s) is provided in the following areas: 1. Prop~í maintenance and use of gasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental Department. . 4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and COZ· A review of the contents of the Emergency Response Plan will be made by all new employees within one month of hiring and by all employees on an annual basis. Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown (including the location of turnoff valves for gas and electricity) and the proper use of equipment used in the day to day business. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOllOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS. BUT THE QUANTITIES AT NO TlMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I. Mike Schumacher 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 CODEII ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. 'Yh~ I SIGNATURE Division Manager s-Ä /57ð TITLE DATE 2. FOI&90 .." Bakersñeld Fire De"Dt. . . ~ardous Materials Division e HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Nams: Circl~ K CorDoration ~H270 SECTION 6: NOTIFICATION AND EV ACUATION PROCEDUR=S: A. AGENCY NOTiFICATION ?ROC=DUR=S: If e~rgency response assistance not required, Bakersfield City Hazardous Materials Division State Office of Emeraencv Services notify: 326-3979 ANI> (800) B52-~ WITHIN 24 HOURS If release poses present or potential hazard tD human health & safety, property or environment, and emergency assistance is required. -il1!!!ediately notify: . Fire DeDartment - Bakersfield Fire Denar~ment 911 Police Denar~ment - Bakersfield Police Deuartment 911 Bakersfield City Hazaràous Materials Division 911 State UTTlce or ~rneraencv ~erVlces (800) 852-7550 or (916) 427-4341 B. EM?LOY~E NOTì¡:¡CATION AND ::VACUAlILJN: Upon recognition of a release. the Duty clerk will verbally (shouting) notify all other site personnel. The Clerk will ensure the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes (if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting) method to a pre-determined evacuation staging.area where all employees will be accounted for. c. PUBLIC EVACUATION: If evacuation from area deemed necessary, ~hese neighboring properties will be notified: nAM£ ADDRESS PHONE Kimbers Home Cookin' 5700 Stine Road 833-1606 TC's Video 5700 Stine Road 397-4475 Executive lounge 5732 Stine Road 832-2212 D. EMERGENCY MEDICAL PLAN: The primary Company medical facility to treat employees injured by a hazardous materials incident: Mercy Hospital - 2215 Truxton Avenue, Bakersfield - (805) 3273371 -- Additional Clinics and Hospitals: -- -- 3. fDlSiC -,r Bakersfield Fire Dept~ e Hazardous Materials Divisie HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: GASOLINE A. RELEASE PREVENTION STEPS: 1. Steel posts installed to prevent vehicle collision with pumps 2. Vapor Recovery Systems used when filling underground tanks which are of fiberglass construction 3. Dual hose systems on pumps. Anti-lock nozzles at pumps 4. No sales to non-authorized containers 5. No smoking signs posted, self serve instructions posted 6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Preventative diking with absorbent materials 2. Shut off all emergency switches to prevent further spillage 3. Barricade area to prevent possible exposure to general public 4. Avoid personal exposure to fumes/vapors and contact with liquid 5. Eliminate all sources of ignition in area of spill or vapors 6. Absorb liquids with absorbent materials and remove to safe area for evaporation C. CLEAN-UP PROCEDURES: 1. Notify Circle K Environmental Director (714) 823-0691 for co-ordination with hazardous waste disposal company to remove contaminated absorbent materials if required CARBON DIOXIDE A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors to ventilatE C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None a. Inside, back room of store ELECTRICAL: b. Outside, east wall of building a. North wall of building, outside (main line gate valve) WATER: b. South side of site (meter) Emergencv gas shutoff switch: a. At the cashier station on console SPECIAL: b. At circuit breaker box in back room. hrprlkpr~ !40 ~ 4? LOCK BOX: YES@ IF YES. LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers 8. WATER AVAILABILITY (FIRE HYDRANT): Southwest corner of site (meter) 4. FOI <~ e e HMMP PLAN MAP SITE DIAGRAM 0 FACILITY DIAGRAM D Business Name: Circle K Corporation #127<Y 6 North Area Map #....!:.... of ...!.- Name of Area: Circle K Corporation # 1270 5634 Stine Rd., Bakersfield CA Plot Plan - Circle K Store #1270 5634 Stine Road, Bakersfield Residential Vacant Lot c==> V a c a n t D i r t ~ Parking L o t , 'A .. : r-'<../ ,'10K,~;" ; .~__\ , Gal "10K ',' , my ,~~GaL':10K) IJ\\'" :',/'(i8!," \., ~' .. I 8' Conorate Wal!- ® Storage Room Vacant Office Space (K) Store #1270 6834 Stine Rd. Cold Box Sewer Residential Park ing 15700 Stine Rd. Kimber. Home Cookln 15700 Stine Rd. TC'S Video 15732 Stine Rd. Executive Lounge Parking ------ - - ---- - --- - - I - . ,..., CITY of BAKEHBJ~l1:LU ~ , " FI,. Ind Agtlcultur. [] Stindlld Business ~HAZARDOUS MATERIALS INVENTORY Plqe L_ afL NON-TRADE SECRETS rUS¢N~SS NAHE: Circle K Corporation #1270 ~W'Fi~ NAHE: Circle K Corporation NAHn 0u THIS FACIL1T~¿ Cir£k..K Corporatiol)____.__ ~C T OU' 5634 ~tl ne Koad JUV sr P. O. Box 52084 81 A 00 W AND c~ yS . ur 55.41 C b ~ ~IÞ~ Bakersfleld~ CA 93316 Cl b ip: . 072 DU A B AOSTU E HUH R-··'· --. . ..-.-- - - ,r I ~A ·-~~M,Sg - Q.. 6_ - Z. ~ ~ - 4.. 1 .ß a. P I II : (BD5) 834-8 25"-·' fF . lO-IN C I NS-FUR-PROPER CODES I Z J . 5 . o~ hr. 8 9 10 u" 12 13 II , Ir~ns Ir~e ~II AYr·gt A~null H~a$Ure ~ont ~ont ~ont loc~tlon Vhe~' , bt "I~es o( Vi,ture(c~rconents , , Co e Co I ht It st nits rpe ress up c~~e Store n Fael Itr Wl See Inslru: Ions R , M , I I 84407 I GAL I I 01 I 1 I 19 I 4HÇ1d~&3tR~~gt tßr stgµgrox. - 10000 5000 365 I 4 100 Gasoline - Regular -. Phl~icfl Ind ~er'th "liard C.A.S. HUllber 8006-61-9 COllponent II Hall I C.A.S. Number 25 Toluene 108-88-3 ; ( et lit a app I r . o d COllponent 12 Nall8 I C.A.S. NUllber ,130~ - ~ Fire Huard o Reactlvltr fI 0r"¡rd o Suddf" Release hl,e ate 20 Xylene lea lh o Pressure leallh Component 13 Nall8 I C.A.S. Humber 10 Methyltert Butyl Ether 1634-04-4 , ¡ RIM I 10000 I I 227533 I GAL I I 01 I I I 19 I 40~ndse¿-Jfh<>JIens' TJ'pkstgµgrox. -. \ 5000 365 1 4 100 Gasoline - Unleaded - ~ Phl~icfl ,~d ~ellth ~allrd C.A.S. HUllber 8006-61..9 Component II Halle I C.A.S. HUllber 25 Toluene 108-88-3 i , ec a L at app , . , - - [] d I COllponent 12 Halle I C.A.S. HUllber ! o Fire "aurd o Reacthltr o 0rltred [] Suddf" Release 1II1IIp. ate 20 Xylene 130-20-7 lea lh o Pressure lIeallh - - COllponent U Kall8 I C.A.S. HUllber 10 Methyltert Butyl Ether 1634-04-4 : i :! I GAL I I 01 I I 19 IlIn~nderground T"apkd~~£rox. R I M I 10000 I 5000 I 55n4A l 100 Gasoline - Super Unleaded I 365 1 4 - , Phl~lcll ,nd ~ellth "liard C.A.S. Humber 8006-61-9 Component II Halle & C.A.S. Number 25 Toluene 108-88-3 , , e tk I I t It I pp I r ! o d I COllponent IZ Hal18 I C.A.S. NUllber 20 Xylene 130-20-7 i ~ Fire Haurd [] Ruethltr o Drltred [] Sudd," Release rille ale 163£ lea lh o Pr essure lIeallh C t 13 - " Halle I C.A.S. "ullber ollponen 10 Methyltert Butyl Ether , ! ! R , p I I I I FT31 I I I I IIn storeroom, back of store '1 696 348 36192 365 04 2 4 99 100 Carbon Dioxide, Carbonic Anhydride , ," Ph~~icfl ,nd ~e(lth ~allrd C.A.S. Number 124-38-9 Component II Nal18 & C.A.S. HUl1ber . , ee I It. app, I : : [] dl Component 12 Halle I C.A.S. HUllber U F Ire Huard [] Ruethltr .~ °flt¡pd ~ SUddf" Release IIIIIIP. ale ¡ lea th o Pressure Ilea Ilh 1 COllponent 13 Name I C.A.S. HUllber EHERGEUCY emn ACT S 111 Mike Spinuzzi Zone Manager (805)833-8881 112 Don Lewis District Manager (209J291-5g1r~ nlfie Tlt1l 2nlrPMIir- Rlfie Ilttl H'RfT~ n ~iHtlfipllo~ ~Rer.r. 8l1p ~jtn I1f1flr Cf¡nr'ftfp9 fl" ~tlC~;OI1:;{ . ter I , un er enal 0 a th I av pe{sona exal n , II alii a It he n(o(lIat n U I1ltt In his end III attatted doc~lIenrll lot t It ~ase~ on I' n~ulr~ i (hose nåIYI~ua's respons~b1e or obtaining t~e tnrorllatfon. 1 believe that the I ,suballled In aria on s truI, accurate, an co pete. . ; MIKE SCHUMACHER - DIVISION MANAGER PH~)'~r.u~ : 'nr~. ¡;~ õ r Ii' H rn nnf'õ7ñHTõnfJfõrmrõWñlrr~ìi~ fHõr nffŒõfl1êar1.ffmëñn r1V~ S1~iiHiìre _.. ._.. _ .__1 "="'-aù>:<~~~ ~ e e CITY OF BAKERSFIELD HAZARDOUS MATERIALS MANAGEMENT PLANS Submitted Pursuant to CALIFORNIA HEALTH AND SAFETY CODE CHAPTER 6.95 (AB 2185/87/89) AND CHAPTER 6.5 (Hazardous Waste Control Law) FOR Circle K Cor oration 5634 Stine Road // / Bakersfield A , .....~ H~ L..hf0. jÀ.-/ CA 93316 Circle K Corporation # 1270 - 1- RECEtVED NOV 2 1 1989 H~7:. MAT. DIV. (C) E.M.S.S.-10/88 1\ e e CITY OF BAKERSFIELD I declare that to the best and information provided understand that additional before plan approval from: Bakersfield City Fire Dept., Hazardous Materials Division of my knowledge and belief, the statements in this document are correct and true. I information to that provided may be required I also understand Administrating Agency changes: 1. The addition of one or more previously undisclosed material(s) in quantities equal to or greater than 55 gallons, 500 pounds, or 200 cubic feet at STP. that I am required by law to notify the within thirty days of anyone of the following 2. A 100 percent or more increase in the quantity of a previously disclosed material. 3. A change in the business address. 4. A change in the business ownership. 5. A change in the business name. Failure to notify the appropriate Administrative Agency: Bakersfield city Fire Dept., Hazardous Materials Division may result in the imposition of civil penalties. Signat"Z?? ~~ Division Manager Title Name: Mike Schumacher Dated: // ~ "£//7 , r Telephone Number: (916) 331-2540 FOR OFFICE USE: Approved/Denied by Date: - 2- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 r e e CITY OF BAKERSFIELD BUSINESS PLAN ANNUAL CHEMICAL INVENTORY 1. BUSINESS NAME: Circle K Corporation # 1270 2. FACILITY ADDR: 5634 stine Road CITY: Bakersfield STATE CA ZIP: 93316 3. MAILING ADDR: 3437 Mvrtle Avenue. suite 440 CITY: North Hiqhlands 4. BUSINESS PHONE NUMBER: (805) 834-8625 STATE CA ZIP: 95660 5. BUSINESS HOURS: 12:00 AM 11:59 PM SUN-SAT · · -- TO TO TO TO · · --- · · -- · --- · · --- · -- NUMBER OF SHIFTS PER DAY: ~ 6. TOTAL NUMBER OF EMPLOYEES: 3 7. NATURE OF BUSINESS: Convenience Store/Gas station 8. SIC CODE (Standard Industrial Classification): 5541 9. CONTACT PERSONS ABLE TO ASSIST EMERGENCY PERSONNEL: PHONE NUMBERS IAST NAME FIRST NAME TITIE BUSINESS AFTER HRS Staff DJtv Clerk (805) 834-8625 (805) 834-8625. Spmuzzi Mike Zone Manaqer (209) 298-3036 (805) 833-8881 Lewis IX>n District Office (209) 298-3036 (209) 291-5910 Schumacher Mike Division Manaqer (916) 331-2540 (-) -- Wriqht Pat Environ. Director (916) 331-2540 (916) 966-9139 10. FARM OR AGRICULTURE X STANDARD BUSINESS 11. ASSESSOR's PARCEL NUMBER: 12. REASON FOR FILING: INITIAL FILING ANNUAL REPORT CHANGE IN REPORTING STATUS X REPLACEMENT OF AN EXISTING PLAN # 13. NUMBER OF UNDERGROUND TANKS: 1- TOTAL CAPACITY: 30000' - 3- Circle K Corporation # 1270 (C) E.H.S.S.-10/88 r e e FACILITY DESCRIPTION The followin9 information is used to orient new employees to the major aspects of thls facility. BUSINESS NAME: Circle K Corporation # 1270 FACILITY ADDR: 5634 Stine Road CITY: Bakersfield STATE: CA ZIP: 93316 FACILITY CONSTRUCTION: Brick, wood and drywall NUMBER OF FLOORS: 1-- THE TYPE OF FACILITY IS FACILITY SIZE: 2720 (sq. ft.jfloor) Convenience Store/Gas station THE PRODUCTS OR SERVICES THAT ARE PRODUCED OR MARKETED BY THIS FACILITY ARE: a. Gasoline THIS FACILITY IS 1A- YEARS OLD. IT HAS BEEN USED IN ITS PRESENT CAPACITY FOR 1A- YEARS HAZARDOUS MATERIALS ARE USED IN THE OPERATION OF THIS BUSINESS IN THE FOLLOWING MANNER: a. Gas sold to public NAME OF OWNER: Circle K Corporation ADDRESS: 3437 Mvrtle Avenue, suite 440 CITY: North Highlands PHONE #: (916) 331-2540 STATE: CA ZIP: 95660 - 4- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 n ., n - C1) 7<: n + 0 ., '8 N ., I» .. I 0 ::J 'II: ..... N ....,¡ 0 V a C a n t D i r t U1 l I 0 t " n ..... m 3: en en o ~ ..... CD -0 Parking Plot Plan - Circle K Store #1270 x 5634 Stine Road, Bakersfield Vacant lot x t Residential CO2 @ ~ @ Ex It ~ ~ Storage Room Vacant C 0 u n te r Office @ Spac e ~ Store #1270 Park ing 5634 Cold Stine Box Rd. I , , '" I r--' '10K ,.;" ,: ~__ ,. "" , . ,,/ Gall'~"10K ,,",,' I i' "G I " / :". ",...,'( a ,;,/10K," ::: ~....."~" GaJ,," . ' .......' HMS FL @J+Sewer 5700 Stine Rd. Klmbers Home Cook In 5700 Stine Rd. TC'S Video 5732 Stine Rd. Executive Lounge 6' Concrete Wall- E Residential Parking :; e t j tþI ~O t'JH ~t-3 mt< bj HO t'Jbj t"I Cj e ;; ............ ..... .... ...."... .... :"He¡I\'ll5ìiS¡f'Ae¡'!iriAII.tAíïÁÆe<îÂE a(îffie.15BfriiA'Á62ô'Š./BffoeîÂe.HI ¡N5H))))i ...... ......................................................·····..····t;··I:N··:V::· ··nu I:M·IV..·C·1N·::::tl:.\L¡·······IVJ ·l:\l~·M,\:J,·t:·'I_Y:l· . ···,·I:N·,;=:t:········O,\J·P:·}I:::··::V:VM·n·a:¡·······O:;:I::O<t:"'I:::·I:Y.I:Q· ..... ··I:~··U···········..············-:············-:········........................... .. - N. REFERENCE TO NORTH 1· . 100' - SCALE OF MAP I ~ I I··.,·.'·..··..,'·..··········,······,····..........,.......,....,..............,......,........·············'······'·'··············.·:··.··1 , t,~ç£9.p~~g~ip~~ç~N.!!lfl!@îi!X~~M~ ..... @ ABSORPTIVE MATERIAL b. ALARM ~ DRAIN -I "- DRIVEw\Y ---.I - DOORS iii EVACUATION ROUTE ~ EVACUATION/STAGING AREA .¡þ EYE W\SH + FIRST AID ® FIRE HOSE ŒI FIRE EXTINGUISHER ~ FIRE DOOR = FIRE W\LL lÏt( GAS PUMPS ~ GUARD STATION 00 KNOX BOX LOCATION Iþ:2I LADDER ¡MSDS MATERIAL SAF ETY DATA SHEET & ERP EMERGENCY RESPONSE PLAN § PERSONAL PROTECTIVE EQUIPMENT !ï:I PUBLIC TELEPHONE RR - REST ROOM § .uJ STAIRS ~....<....:).:.:".,.,..................... @ AIR CONDITIONING [[] ELECTIRC METER ® ELECTRIC SHUT-OFF @] GAS METER @ GAS SHUT-OFF @J W\TER IHH'" 'H H".HH.I ......... ....................".................................................... .... ..,.-......... ,......................................-............. ....... ............ "................................-................ .................... .,..............,....................--....-......... ....................,..................................................... fI.Rg?'º~~ijtªªlpijªy~igM~ V FIRE DEPT. SPRINKLER CONNECTION Y FIRE DEPT. STANDPIPE CONNECTION ... FIRE HYDRANT :ij ATTIC SCUTTLE ... COOLER OR ~ ~ REF RIG E R AT ION U NIT *** FENCE/BARRIERS æ HEATING UNIT ~ RAILROAD TRACKS @J SEWER :'-~~-: SKYLIGHT 1- _ _ _... . STORM DRAIN E..... ........ ...H...H...... '...·H·.. ....:.,~ t)·..:·.:.$tø¡:Ü\q.E:.tAN.K$ ~ IDENTIFY THE TYPE OF CONTAINER USING THE FOLLOWING SYMBOLS. SPECIFY ,TANK CAPACITY IN GALS.. LBS.. OR CU.FT. ABOVE GROUND TANKS e aDo @) 8 GAL 800 HU8 HUI GAL fL fL BELOW GROUND TANKS ~...... /10K I \GAL/ -- ..... f --1ÕK- - \ \.. GAL , I --- 8 INSULATED TANKS 8PRESSURIZED TANKS CORR - CORROSIVE C - COMBUSTIBLE E - EXPLOSIVE F - FLAMMABLE G - GAS L - LIQUID OXY - OXIDIZER R - RADIOACTIVE S - SOLID T - TOXIC WR - YATER REACTIVE e ·..···ij^Ž^RPºÔ$·~^T~â.I^M~ ....i~Š~~~~~~l$~~~~~~<? HAZARDOUS MATERIAL STORAGE AREA...HMS HAZARDOUS MATERIAL HANDLING AREA...HMH HAZARDOUS W\STE STORAGE AREA...HWS . .. '.' .................................................................,.....,...........,...,...:.........:...:.:.........:.....,.,.,...>.:.:,.::...::..::::.::::::::::::.::::::;:::::::/i>::'::":':'·:··':'::::·:::::::::'::}::':}:::;::,.,::::::;:::;:,::;:.,:::,:::;::;:'.::,':.'...',:..,:...<.'<.......:,............::.................,.::...1 -" CITY OF BAKERSFIELD H A Z A R D 0 U SMA T E R I A L SIN V E N TOR Y FARM OR AGRICULTURE: STANDARD BUSINESS: ~ ADMIN AGENCY ACCT. #: REASON FOR FILING: BUSINESS NAME: Circle K Corporation # 1270 FACILITY ADDRESS: 5634 Stine Road "' PAGE L OF L INITIAL ANNUAL REVIEW _ CHANGE IN STATUS SIC CODE: 5541 EPA#: , Bakersfield REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989- ~ REPLACE EXISTING PLAN ASSESSOR's PARCEL #: DUN & BRADSTREET #: 06-294-4160 I IDAYS CONT CONT ICONT I USE I DOT IRANGE IUNITI O/SICOOElpREssITEMP ICODElcLASS %\.IT GALl 3651 01 I 1 I 4 I 19 IFL 1100 25 20 10 IT TYPEI MAX I AVG I ANNUAL IclcODEI AMT I AMT I AMOUNT ¡AIM I 10000 5000 160000 I CHEMICAL NAME: Gasoline I COMMON NAME: Gasoline, Regular I LOCATION: Underground tanks, approx. 40 ft. southwest of store I ~ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I _ REACTIVITY ~ CHRONIC I TITYPEI MAX AVG I ANNUAL I 10AYSICONT CONT ICONT IclcODE AMT I AMT I AMOUNT IUNITI O/SICOOE PREssITEMP ¡AiM I 10000 I 5000 1150000 I GALl 3651 01 I 1 I 4 I CHEMICAL NAME: Gasoline I COMMON NAME: Gasoline. Unleaded I LOCATION: Underground tanks. approx. 40 ft. southwest of store I ~ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I _ REACTIVITY ~ CHRONIC 1 IT/TYPEI MAX I AVG / ANNUAL I /DAYSICONT CONT ICONT IclcODEI AMT I AMT I AMOUNT IUNITI O/S CODElpRESS TEMP IAIM I 10000 I 5000 150000 I GALl 3651 01 I 1 I 4 I CHEMICAL NAME: Gasoline I COMMON NAME: Gasoline, Super Unleaded LOCATION: Underground tanks. epprox. 40 ft. southwest of store I ~ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I _ REACTIVITY ~ CHRONIC 1 I USE DOT ICODElcLASS I 19 I FL USE DOT CODElcLASS I 19 I FL EMERGENCY CONTACT: FIRST NAME LAST NAME Staff Mike Spinuzzi RANGE I %\.IT 1100 I 25 20 I 10 I I I RANGE I %\.IT 1100 I 25 I 20 I 10 1 I I I COMPONENTS I 1////////////////////////////////////////////////1 IToluene IXylene I IMethyltert Butyl Ether I I I I I I I I I I COMPONENTS I 1//////////////////////////////////////////////// IToluene IXylene IMethyltert Butyl Ether I I I I COMPONENTS 1//////////////////////////////////////////////// Toluene I ¡Xylene I IMethyltert Butyl Ether I I I I I I I lOOT I CAS # IGD#I 8006-61-91 - I 108-88-3127 I 130-20-7127 I 1634-04-4126 I I I I I I I IDOTI CAS # IGD#\ 8006-61-91 - I 108-88-3127 I 130-20-7127 I 1634-04-4126 I I I I I IDOTI CAS # IGD# 8006-61-91 - 108-88-3127 130-20-7127 1634-04-4126 I I e e TITLE Dutv Clerk Zone Manaqer BUSINESS PHONE/AFTER HRS PHONE 834-8625 834-8625 298-3036 833-8881 Circle K Corporation # 1270 - 7- (C) E.M.S.S. - 01/89 BAKERSFIELD MAT E R I A L S H A Z A R D 0 U S BUSINESS NAME: Circle K Corporation # 1270 ITITYPEI MAX I AVG I ANNUAL I IDAYSICONT CONT ICONT I USE DOT IRANGE I¡CI¡CODEI¡ AMT I¡ AMT Ii AMOUNT IUNIT o/slcODElpRESslTEMP ICODElcLASS I %WT .A.P . 80 . 40 .1680 ¡ LBSi 36Si 04 i 2 I 4 I 99 INFG 1100 I CHEMICAL NAME: Carbon Dioxide. Carbonic Anhydride I I COMMON NAME: Carbon Dioxide I I LOCATION: In Storeroom. back of store I I _ FIRE ~ SUDDEN RELEASE OF PRESSURE ACUTE I I _ REACTIVITY ~ CHRONIC I I IT TYPE MAX AVG ANNUAL OAYS CONT CONT ICONT I USE DOT RANGE I¡CI¡CODEI¡ AMT Ii AMT Ii AMOUNT '¡UNITI o/slcODElpRESS TEMP ICODElcLASS I %WT ... . . . i i ì i I I I I CHEM I CAL NAME: I I COMMON NAME: I I LOCATION: I I _ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I I _ REACTIVITY CHRONIC I I I T TYPE MAX I AVG I ANNUAL I DAYS CONT CONT CONT I USE DOT RANGE :C:CODEI AMT : AMT : AMOUNT :UNIT: O/S:CODE:PRESS:TEMP :CODE CLASS I %WT CHEM I CAL NAME: I I COMMON NAME: I I LOCATION: I _ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I I _ REACTIVITY CHRONIC 1 I IT TYPE MAX I AVG I ANNUAL I OAYSICONT CONT ICONT USEI DOT IRANGE I¡CI¡CODEI¡ AMT Ii AMT Ii AMOUNT IUNITI o/sIcODElpREsslTEMP CODElcLASS I %WT ... . . i i ¡¡I I I I I CHEMICAL NAME: I I COMMON NAME: I I LOCATION: I I _ FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I I _ REACTIVITY CHRONIC I I ITITYPEI MAX I AVG I ANNUAL I IDAYS CONTICONT ICONT I USE DOT IRANGE C ¡I CODE ¡I AMT ¡I AMT ¡ AMOUNT ¡'UNITI o/sIcODElpREsslTEMP ICODE CLASS I %WT .. . . . i ¡ ¡¡I I I CHEMICAL NAME: I COMMON NAME: I LOCATION: I FIRE _ SUDDEN RELEASE OF PRESSURE ACUTE I I - 8- Circle K Corporation # 1270 OF L .. I N V E N TOR Y PAGE L REPORTING PERIOD: JANUARY 1 TO DECEMBER 31. 1989 I COMPONENTS I CAS # (GD# I1111111111111111111111111111111111111111111111111 124-38-9 21 99 = Used for soda fountain ~ COMPONENTS 111111111111111111111111111111111111111111111111 I CAS # lOOT IGD# I I I I I I lOOT GD# e COMPONENTS 111111111111111111111111111111111111111111111111 ( I I I I I I COMPONENTS I111111111111111111111111111111111111111111111111 CAS # CAS # lOOT GD# e COMPONENTS 1111111111111111111111111111111111111111111111111 I I I I I I I I CAS # I DOT I IGD# I I I I I I I (C) E.H.S.S. - 01/89 INVENTORY FORM CODES TC . TRANSACTION CODE (Column 1) A = Add this new material to the business' inventory. D = Delete this material from the business' inventory. R = Revise the information about this material. CONT CODE - CONTAINMENT CODE (Column 8) 01 Underground Tank 10 02 Aboveground Tank 11 03 Fixed Pressurized Tank 12 04 Portable Pressurized Cylinder(s) 13 05 Insulated Tank (includes cryogenics) 14 06 Drums or Barrels - Metallic 07 Drums or Barrels - non-Metallic 08 Carboy(s) 09 Glass Container(s) Plastic Container(s) Box(es) Bag(s) Metal Container (not drums) In Machinery or processing equipment 15 Bin(s) 16 Unlined Sump 99 OTHERS 01 Additive 02 Adhesive 03 Aerosol 04 Anesthetic 05 Bactericide 06 Blasting 07 Catalyst 08 Cleaning 09 Coolant 10 Cooling 11 Drilling 12 Dryer USE CODE (Column 11) 13 Emulsifier 25 Instruction 37 Storage 46 Aircraft Sys. 14 Etching 26 Lubricant 38 Stripper 47 Electrolyte 15 Experimental 27 Medical Aid 39 ~ashing 48 Breathing Air 16 Fabrication 28 Neutralizer 40 ~aste 49 Drafting Aids 17 Fertilizer 29 Painting 41 ~ater 50 End Product 18 Formulation 30 Pesticide Treatment 51 Fire Protect 19 Fuel 31 Plating 42 ~elding 52 Hydrau. Equip 20 Fungicide 32 Preservative 43 ~ell 53 Road/Hwy 21 Grinding 33 Refining Injection Maintenance 22 Heating 34 Sealer 44 Oil 54 Testing Chern. 23 Herbicides 35 Spraying Treatment 55 ~holesale 24 Insecticides 36 Sterilizer 45 Resale 99 OTHER ESTIMATED VOLUME OR YEIGHT RANGE Range Code From 1 2 3 4 5 6 IN POUNDS (Col 3,4,5) To o 100 1,000 10,000 100,000 1,000,000 99 999 9,999 99 , 999 999,999 9,999,999 Circle K Corporation # 1270 . TYPE CODE (Column 2) P = pure or largely pure substances M = mixtures of pure substances ~ = waste (also append the three digit E.P.A. waste code). CONT PRESS - CONTAINER PRESSURE (Column 9) 1 = Ambient Pressure 2 = Greater than Ambient Pressure 3 = Less than Ambient Pressure i CONT TEMP - CONTAINER TEMPERATURE (Column 10) e 4 = Ambient Temperature 5 = Greater than Ambient Temperature . 6 = Less than Ambient Temperature but not cryogenic 7 = Cryogenic Conditions DOT CLASS - DEPARTMENT OF TRANSPORTATION (DOT) HAZARD CLASS CODES (Column 12) EXP A = Explosive A EXP B = Explosive B EXP C = Explosive C BA = Blasting Agent FG = Flammable Gas NFG = Nonflammable Gas COR = Corrosive CR = Cryogenics PYRO = Pyrophoric or sponta- neously Combustible POlS A = Poison Gas POlS B = Poison Liquid/Solid FL = Flammable Liquid CL = Combustible Liquid ORME = Hazardous Yaste ORMS = Other Regulated Materials (materials B, C, and D) UNITS - MEASUREMENT UNITS (Column 6) LBS = Pounds GAL = Gallons FT3 = Cubic Feet TON = Tons (2000 lbs) BBL = Barrels (42 gals) - 9- FS = Flammable Solid ~ = ~ater RAD = Radioactive OXY = Oxidizer OP = Organic Peroxide ETI = Etiologic Agent ORMA = Anesthetic, Irritant e (C) E.M.S.S. - 06/89 '.' e e REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989 HAZARDOUS WASTES INVENTORY GENERAL CHEMICAL AND MINERAL COMPOSITION FACILITY NAME: Circle K corporation # 1270 FACILITY ADDRESS: 5634 stine Road WASTE NAME/ MIN MAX MAX CATE DESCRIPTION CONC CONC AMOUNT UNIT % % None - - - - - - - - - - - - - - - - - - - - - - - - - - - -10- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 I.. e e CITY OF BAKERSFIELD HAZARDOUS MATERIALS EMERGENCY RESPONSE PLANS AND PROCEDURES Submitted Pursuant to CALIFORNIA HEALTH AND SAFETY CODE CHAPTER 6.95 (AB 2185/87/89) AND CHAPTER 6.5 (Hazardous Waste Control Law) FOR Circle K Corporation # 1270 5634 Stine Road Bakersfield CA 93316 -11- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 ,. e -- EMERGENCY RESPONSE PLAN 1. EMERGENCY RESPONSE PERSONNEL The following persons have been designated to coordinate and assist in the event of a hazardous incident at this facility. a. EMERGENCY COORDINATOR: The Emergency Coordinator is responsible for managing hazardous materials emergencies, and coordinating all emergency measures. The Coordinator shall be thoroughly familiar with the facility emergency response plan, the facility's operations, hazardous materials, and facility larout. Other tasks of the emergency coordinator include: wr1ting the emergency response plan, updating it when necessary, and overseeing the training of personnel in its use. LAST NAME FIRST NAME TITLE Duty Clerk AFTER HRS. PHONE: (805) 834-8625 Staff BUSINESS PHONE: (805) 834-8625 b. ALTERNATE EMERGENCY COORDINATOR: The Alternate Emergency Coordinator shall be familiar with the duties and responsibilities of the primary Emergency Coordinator and shall perform those duties when the Coordinator is not available. The Alternate Coordinator may also assist the Coordinator in writing, updating the ERP, and to oversee the training of employees and on-site emergency response personnel. LAST NAME FIRST NAME TITLE Spinuzzi Mike Zone Manager BUSINESS PHONE: (209) 298-3036 AFTER HRS. PHONE: (805) 833-8881 c. EMERGENCY RESPONSE TEAM: The Emergency Response Team are those individuals who have been trained to respond and handle emergencies dealing with the mitigation, abatement or prevention of releases or threatened releases of hazardous materials. IAST NAME FIRST NAME mONE TITIE BUSINESS AFTER HRS. District Office (209) 298-3036 (209) 291-5910 Division Manaqer (916) 331-2540 (-) -- Environ. Director (916) 331-2540 (916) 966-9139 (-) - (-) - -- -- (-) - (-) - -- -- (-) - (-) - -- -- (-) - (-) - -- -- (-) - (-) - -- -- -12- Lewis Schumacher Wriqht Don Mike Pat Circle K Corporation # 1270 (C) E.M.S.S.-10/88 ~ e - HAZARDS ASSESSMENT AND NOTIFICATION PROCEDURE 2. HAZARDS ASSESSMENT In the event there is a reported release or threatened release of toxic or hazardous material, the Coordinator or Alternate Coordinator will be advised. If, in their assessment, there is a need to call the Emer~ency Response Team, this will be done before notification to any requ1red agencies is done. 3. REPORTING REQUIREMENTS section 25504 or threatened required even assistance. of the Health and Safety code requires that the release release of hazardous materials be reported. This is if the situation does not warrant emergency response A. REQUIRED TIME OF NOTIFICATION: 1. Immediate notification is required as soon as the release or threatened release is acknowledged and as long as notification can be provided: (a) without impeding immediate control of the release/threatened release, AND (b) without impeding emergency medical measures. 2. Immediate notification is not required if: (a) there is reasonable belief that the release or threatened release poses no significant present or potential hazard to human health and safety, property, or the environment, AND (b) the situation does not require emergency assistance. B. NOTIFICATION PROCEDURES: 1. When the incident DOES NOT require immediate notification as described above, contact your administrating agencies within 24 hours of the incident: Bakersfield City Fire Dept.. Hazardous Materials Division Phone: 326-3979 and state Office of Emergency Services Phone: (800) 852-7550 When a hazardous materials release or threatened release occurs which DOES require immediate notification as described above, refer to the Emergency Notification Roster on the next page and following directions described in the reporting requirements. -13- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 ~ e - EMERGENCY NOTIFICATION TELEPHONE ROSTER 4. EMERGENCY NOTIFICATION Of the five agencies listed below, all (execpt paramedics) must be contacted in the event of a hazardous materials release or threatened release. Reporting information required by these agencies is listed in the box below. A. LOCAL EMERGENCY RESPONSE PERSONNEL C ALL 911 PARAMEDICS : PHONE (___) ___-____ (Non-emergency Number) FIRE AGENCY: City of Bakersfield Fire Department PHONE (805) 324-4542 (Non-emergency Number) LAW ENFORCEMENT: city of Bakersfield Police Department PHONE : (805) 327-7111 (Non-emergency Number) B. ADMINISTRATING AGENCY AGENCY: Bakersfield City Fire Dept., Hazardous Materials Division PHONE: (___) 911-____ (24-hour Emergency Number) C. STATE OFFICE OF EMERGENCY SERVICES (OES) PHONE: (800) 852-7550 OR (916) 427-4341 ************************************************************************** * REPORTING REQUIREMENTS * * * * The following information should be known when reporting an emergency * * so that response personnel will know what to expect and how to react. * * * * 1. Time and type of incident (fire, chemical release, etc.) * * * * 2. The exact location of the release or threatened release. * * * * 3. Name and quantity of material(s) involved, if known. * * * * 4. The extent of injuries. * * * * 5. Name of person reporting the incident. * * * * 6. The potential hazards presented by the material(s). * * * ************************************************************************** -14- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 '. e - 5. NEIGHBORING PROPERTIES The followin9 (by name, address, and phone number, if available) list the neighborlng businesses, residences, schools, hospitals, etc. which could be affected by a hazardous materials incident from this facility. These phone numbers are to be used in the event of an emergency to provide notification if evacuation from the area, is deemed necessary. NAME ADDRESS PHONE 833-1606 397-4475 832-2212 Kimbers Home Cookin' TC's Video Executive Lounqe 5700 stine Road 5700 stine Road 5732 stine Road - -- -- - -- - -- - -- - -- - -- 6. COMPANY EMERGENCY MEDICAL ASSISTANCE This section includes the names, addresses, and phone numbers of the primary company medical facility and doctor, who would be available to treat employees injured by a hazardous materials incident at this business. Use this information in the event of an emergency. 7. ADDITIONAL CLINICS AND HOSPITALS FACILITY: ADDRESS CITY PHONE DOCTOR ADDRESS CITY PHONE FACILITY: ADDRESS CITY PHONE FACILITY: ADDRESS CITY PHONE None (-) -- Mercy Hospital 2215 Truxton Bakersfield (805) 327-3371 (-) - -- . . (-) - -- (Medical facilities continued on the next page.) Circle K corporation # 1270 -15- (C) E.M.S.s.-10/88 't !io e I» 7. MEDICAL FACILITIES (Cant) FACILITY: ADDRESS CITY PHONE . . (-) - -- FACILITY: ADDRESS CITY PHONE (-) - -- 8. UTILITIES SHUT OFF LOCATIONS GAS/PROPANE: None FIRE HYDRANT: a. Inside, back room of store b. outside, east wall of buildinq a. North wall of buildinq, outside (main line qate valve) b. South side of site in µlanter Southwest corner of site (meter) ELECTRICAL: WATER: LOCK BOX: None EMERGENCY RESPONSE PLAN: At the cashier station SPECIAL (IDENTIFY) : Emerqency qas shutoff switch: a. At cashier station on console b. At circuit breaker box in back room, breakers # 40 and #42 9. UTILITIES INFORMATION DO NOT NOTIFY these companies information is for reference emergency response personnel emergency at this facility. UTILITY NAME PHONE --------------------+----------------------------------------+-------------- in the event of an emergency. This only and may be helpful in assisting in responding to a hazardous materials (805) (-) (805) (805 ) - - - Electric Company: Pacific Gas and Electric Gas com~any: None Sanitat~on District:City of Bakersfield Water District: City of Bakersfield 324-3981 -- 326-3715 326-3715 Number of underground tanks on site: 2- Total Capacity: 30000 -16- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 .. I- '" e e EMERGENCY RESPONSE PROCEDURES 1. EMERGENCY ASSESSMENT Upon recognition of a release or threatened release, the Facility Emergency Coordinator or the Alternate Emergency Coordinator should be alerted (see Sec. 1a&b in the Emergency Response Plan of this HMMP). In the event that neither of the above persons can be contacted, then the next person on the Response Team roster should be called. This roster is to be used until a member of the Facility Response Team is contacted. It is then that Res~onse Team member's responsibility to contact and assemble the rema1nder of the Response Team. 2. NOTIFICATION a. (Local Agencies) The Coordinator or Alternate will determine whether immediate notification of local emergency response agencies is necessary. In the absence of either of these persons, any member of the facility response team or any designated representative may make that decision. The individual making this final decision should make use of the Reporting Requirements outlined in section 4 of the Emergency Response Plan to gather the appropriate information and then utilize the Emergency Notification Telephone Roster also on the same page. b. (On-site) If the situation so warrants, other employees of the facility will be notified using one or more of the following step(s): X INFORM THE EMERGENCY COORDINATOR X ACTIVATE THE RESPONSE TEAM X NOTIFY ALL OTHER SITE PERSONNEL USING: - AUDIBLE ALARM SYSTEM PUBLIC ADDRESS (LOUDSPEAKER) VISUAL ALARM X VERBAL (SHOUTING) TELEPHONE 3 . EVACUATION a. Evacuation of the facility, if required, will follow the designated routes (if unobstructed) as diagrammed on the Site Plot Plan. These are posted in highly visible areas through the facility. Employees will be notified to evacuate by the following signal: AUDIBLE ALARM SYSTEM VISUAL ALARM TELEPHONE PUBLIC ADDRESS (LOUDSPEAKER) X VERBAL (SHOUTING) -17- Circle K Corporation # 1270 (C) E.M.S.s.-10/88 · ~,' "":... e e 4. SHUTDOWN All operation clerks or designated operators are res~onsible to ensure the shutdown of their area of responsibility (~f possible) before evacuating. This includes elimination of potential ignition sources in the case of the release of flammable material. 5. PREVENTION A prevention/maintenance program has been implemented for the review of methods leading to the potential reduction of a hazardous material release. One or more of the following methods has been used: X PERIODIC INSPECTIONS CORROSION MAINTENANCE X PERIODIC EQUIPMENT MAINTENANCE X APPROVED CONTAINERS X MARKED EMERGENCY EXIT(S) X FIRE EXTINGUISHER(S) SERVICED CHEMICAL HANDLING TRAINING X SAFETY TRAINING CORROSION MONITORING PROGRAM X DAMAGED CONTAINER INSPECTIONS X PROPER WARNING LABELS ON CONTAINERS X APPROVED FLAMMABLE STORAGE AREA X PROPER SEPARATION OF CHEMICALS X GENERAL HOUSEKEEPING X PROPER VENTILATION X OTHER a. Steel posts installed to prevent vehicle collision with pumps. b. Va?or Recovery Systems used when filling underground tanks. c. Dual hose systems on pumþs. d. Anti-lock nozzles at pumps. e. No sales to non-authorized containers. f. No smokinq siqns posted. q. Self-serve instructions posted. h. Tanks checked periodically for leaks by comparinq gallonaqe measure- ments with sales records. i. Underqround tanks are of steel construction. See next page(s) for applicable Emergency Response Steps! -18- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 · "j' oF.. e e EMERGENCY RESPONSE STEPS MITIGATION AND ABATEMENT A. FOR THE FOLLOWING SUBSTANCE(S): Gasoline - All Grades MITIGATION: 1. Follow emergency notification procedures as indicated in plan. 2. In case of spill take protective measures to control s~read of fluid such as preventative diking with absorbent mater1als. 3. Shut off all emerqency switches to prevent further spillage. 4. Barricade area to prevent possible exposure to qeneral public. 5. Avoid personal exposure to fumes/vapors and contact with liquid 6. Eliminate all sources of iqnition in area of spill or vapors. 7. Absorb liquids with absorbent materials and remove to safe area for evaporation. ABATEMENT: 1. Notify Circle K Environmental Director for co-ordination with hazardous waste disposal company to remove contaminated absorbent materials if required. B. FOR THE FOLLOWING SUBSTANCE(S): Carbon Dioxide MITIGATION: 1. Evacuate all nonessential personnel from affected area. 2. Close valve if possible. 3. Open all doors to ventilate affected area. ABATEMENT: Contact supplier of material release. -19- Circle K Corporation # 1270 (C) E.M.S.S. - 01/89 · . ,- ~ e e TRAINING OUTLINE A. HANDLING HAZARDOUS MATERIAL special on-the-job training (OJT) in the handling of hazardous material(s) is provided in the following area(s): 1. Proper maintenance and use of qasoline equipment. 2. Use of kitty litter for small spills. 3. Employees are instructed on proper response to police. fire department. emergency medical and Circle K Environmental Department. 4. Each Circle K qasoline store has a Company supplied qasoline manual. The MSDS for each appropriate hazardous substance is used to provide: Recognition of the physical and chemical properties of each substance. ' Knowledge of the toxicity involved in usage of the substance. Knowledge of the potential health hazards from use of the chemicals. Understanding the first aid steps to counteract any effects of improper exposure to the chemical. Knowledge of any precautions or protective equ.ipment which must be used or worn when handling the chemical. The information learned from the study of the MSDS for each appropriate hazardous material will be reinforced through one or more of the following methods: X 1. X 2. X 3. X 4. X 5. X 1. 2. 3. 4. 5. X 6. Reading each appropriate MSDS. Worksheets. Classroom instruction. Use of videos/films where available. Training Labs. OJT. B. EMERGENCY RESPONSE PLAN A review of the contents of the Emergency Response Plan will be made by all new employees within one month(s) of hiring and by all employees on an annual basis. Durin~ this review, one or more of the following objectives will be accompl1shed: Familiarization with the ERP in general. Familiarization with the procedures for notifying the on- site emergency response team Familiarization with the procedures for notification and coordination with local emergency response organization. Familiarization with the use of the Emergency Telephone Roster. Familiarization with the evacuation procedures and routes involved in the case of an emergency. Escape routes are posted in highly visible sections of the facility and exit doors are clearly marked. X 1. X 2. X 3. X 4. X 5. -20- Circle K corporation # 1270 (C) E.M.S.S.-10/88 · IIIÍ t, ...... e e TRAINING OUTLINE (canlt) / ERP training may be reinforced by: X 6. Practice emergency drills and exercises. X 7. Repeated instructional tours of the facility. C. SAFETY AND EMERGENCY EQUIPMENT USAGE Formalized training will provide familiarization with one or more of the following: The location and proper use of fire fi9hting equipment. The location of and procedures for fac1lity shutdown. This includes the location of the turnoff valves for gas and electricity. The proper use and wearing of protective gear and clothing. The location and use of emergency communication equipment. The proper use of equipment used in the day to day business. X 1. X 2. 3. 4. X 5. The training will be accomplished through one or more of the following methods: X 1. Reading of material. X 2. Classroom environment. 3. Instructional Labs. X 4. OJT D. RECORD KEEPING Training records are kept on each employee as to: Overall Training. Dates Traininq Received. E. TRAINING COORDINATOR The following person has been designated as the training coordinator: Barbara Myatt - Corporate Trainer He or she may be reached at (209) 298-3036. -21- Circle K Corporation # 1270 (C) E.M.S.S.-10/88 \ -::: - f'Jn h'/~ ~ý NO p~ o n tQ.. I REceiVED cth c.JIO 1(ov 2 1 1989 ~)t:,... DHA7.. MAT. OlV. fæ-(J# L . dSf\ \(}O- RC\~ Q)~ Bakersfield City Fire Department Hazardous Materials Division 2130 G street Bakersfield, CA 93301 November 9, 1989 ~CJ~ Gentlemen: Circle K Corporation has contracted Environmental Management Software Systems, Inc. to prepare a Hazardous Materials Management Plan in accordance with the requirements of Chapter 6.95, Division 20, section 25550 et seq. of the State Health and Safety Code and Title III of SARA. In most cases, this submittal is a replacement of an existing plan. Circle K corporation's intention is to provide each store with a standard format so that training of personnel can be accomplished uniformly throughout the State. If you have any question concerning these submittals, contact EMSS at (805) 925-6285. please Sincerely yours, I;:::v~'~?r President JVR:sb Enclosure .' ~O. BOX 5604 I SANTA MARIA I CA 93456 I (805) 925-6285 / ';"' \ I.~----. _.. ." ..... ~ - .'.:- . 6,'\ 1" . ..e KERN COUNTY FIRE DEPARTMENTeœ rn © rn n o/J m [Q) 5642 VICTOR STREET BAKERSFIELD, CA 9~308 ,OCT 1 91987 (805) 861-2761 KGFD HMGU OFFICIAL USE O~LY :# /~72J ID# \30 (c; HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A ~( ~Gr~ 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business 4. Be as brief and concise as possible. OOI!@/H'&&/Q) SEP 1 7 ?QQ'¡ as a wh~P:D HMCU INSTRUCTIONS: SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: . t'V£c?¿ç : k ¿?¿)£~ð...e..47J/)1Ù # /D270 B. LOCATION / STREET ADDRESS: (")~Lq¢ ¿T/AJ'&"" Ro,4,O CITy:~/J.e£~~/¿¿¿) ZIP: 9-5~/)L/ BUS.PHONE: (8cõ) 834-gt:,¿)~~ SECTION 2: E~RGENCY 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. E~PLOYEES TO NOTIFY IN CASE OF EMERGENCY: NA.\fE Ai'iD TITLE ~RING BUS. ]IRS .Æ;R BGS. HRS. A. .c-Æ$;'./.~¿/} ~~~~Á) Ph# '%J5Jtl3'1-ð/f~Ph# )8.s~-1.þ'.:?.5 ),4 ^" e;s SAt)· 1) tZ6 . . g:5 2.. - S-fS04- B. /9A./AJ ~6f/"vÓSO Ph(8tl5)8ð1--IJ~.;1.~ Ph¿gC6)5~-¿0.31 - SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT.GAS/PROPANE. B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: ðõR77/ IF YES, DOES ,IT CONTAIN SITE PLANS1 YES / NO FLOOR PLANS? YES / NO MSDSS? YES / NO KEY~7 ,YES / NO .,~.: " ~ - 2A - . " "' ·e SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSINESS AS A WHOLE Yes e SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTk~CE FOR YOL~ BUSINESS AS A WHOLE /Vi eY"~c..¡ Á/& S ¡Jl-hl- fíllxfvYl (J ~~\ S 3~7'- 33 'n . SECTION 6: EMPLOYEE TRAINING /!-r/¿, / a ~ ,../; .If. . ,,',/1 '!7 a..; e..r'"5:!~!'(1/ c., EXPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EXPLOYEES WITH INITIAL A~D REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO A. METHODS FOR SÀFE HANDLING OF HAZARDOUS :'vIATERIALS: . . .'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:.............. ............ C. PROPER USE OF SAFETY EQUIPME~T:............. ... . . D. EXERGENCY EVACUATION PROCEDGRES:................. E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:....... SECTION 7: HAZARDOUS MATERIAL I~ITIAL @ NO i ~O ES NO ES ~O Y NO REFRESHER @) ~O IXO .YES ~O S 1':0 E NO CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~4TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF~ SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...... YES ~ I, /v¡ i !(p S't"_ f I/'IM. at" £ ~ v- , certify that the above information is accurate. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. Zf)~? TITLE~ »?f DATE - 28 - ----... rc WN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD, CA 93308 e ~ \ Bes ¡NESS NAME' OFFICIAL USE ONLY ID# ------ BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# I .¿ 70 FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTION. ABATEMENT PROCEDURES Our training program'includes the following: 1. How to handle reporting and clean-up of unauthorized surface spills of motor fuels. 2. How to check the motor fuelsequiprnent and insure its correct use to 'prevent unauthorized spills of motor fuels. 3. Unauthorized release of product due to leaking tanks and product lines is handled by the Environmental Geology Departrœnt. SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY Our training program includes, the following: 1. How to turn off all power to pumps. 2. Proper instruction to evacuate all people from the site. 3. Make sure that all five extinguishers have proper service and rraintenance. 4. Erœrgency list of telephone numbers for Fire Department, Hospital and Règulatory Agency for timely notification. , .' HMCU·6 . BAKERSFIELD CITY FIRE DEPARTMENT FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY US I NESS NAME: C-~y-¡~(e..~ r!-oyp:J. OWNER NAME: (2/ Y C. (e /-( Œo r¡ð, - FACILITY UNIT #:1 :¿7ð ,DDRESS:_5"'6~1I ..L..L"1..~ ~È-.cl' ADDRESS: J~lJl N'l"Jy¡h -7.0(. 5""1: FACILITY UNIT NAME: '1!:./:<.70 'I TV, ZIP: ß..df:{~'_s. (e !d-(!!i1 CITY I ZIP :2Jl.~pw f y A 7__ RS-oo ~ HONE #:(s¡I.ð.s-) ð'3'f <;;1..2..5 PIIONE #: {¿:ð2)..1. 29 X/.C}, IOFFICIAL USE CFIRS CODE ONLY .. .-. D. # ,. 7 : ,jO (/ Page J...,:~...'o f 'IL . 2 3 4 5 6 7 8 9 10 PE MAX ANNUM, CaNT USE LOCATION IN THIS % BY HAZARD D.O.T DE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE r:::J 9 a I. o I /9 v KdeY'1 yo VlA.d +-~tt. ( ApQviar & ;;J. r; cJ It ,,;. {L J/c:;,~ l!.M L (þ fi!- / (!) 0 ('J n t.. (fJ J') I",r) 5"1Þ3 L¡. 5f,;"'e ¿il J 100 't ;}f. l/kdeV- fY'- 0 v"'-d-rd- k.K , (J in (Jf')() IS-ð) oeo ð I /9 5iØ3 4 5-1-,~-e. ~oa.cI I (j 0 l/Y1. I..ed.. k d r:; ~ ç;") If; <2- ~ML 'P¡/ L . lV)- d.e.r-rYOv!A.d -rélk./C. ¡J 10 ððl"J 5"""0 ()OO 'fa-f, 0' I? ls' ~ J If S f, ~ e.. I!..o a. cl 100 ';Ll,.P.»r I UW1 ¿;'Y1.1e.~¿d !:'iJ,so((":CJ (2M. L(¡> J/l" , o e-' I "',: . A A A I ME: f../~+ W'rIC'~ + TT.TLE: <Jvðex-//r.fa'r SIGNATURE: ~rJ~ /,.J~,/c/ß DATE: 8-:J..~-f?71 ERGENCV CONTAf;T: { ¡!Jc;ooú ~.JVtdçpv . TITLE:ZðYl'€ MclJlt~ CPr PHONE # nus HOURS:(~I1~\Ç'1l,t.81¡.2..2- I 1/ if cT . / 'AFTER BUS HRS :(s:'~S éJ!:t<J. ø3. 4 8 II ERG E N C Y CON T ACT: ;1- Vl Yl ;(J ¡:; Y Y1 (!J S n TIT L E: ð fftC!.e M dYf ~ ? e r- ' PH ONE # BUS H 0 U R S: ðS 83 q. a /.I ¿ 2. I" INCIPAL nUSINESS ACTIVITY: t"".ó.xr l/P_Y1Ie.Jrl¿e.. stbh_ AFTER BUS HRS:Œ 3:¿93031 J' " I.. 1\ r .e ¡"(JE}RNCOUNTY )F)11RJE )[) E P>A\)RTMI)E~.. '_~, ADMIN~~~~~~VEERD;~~¡L~~~~ 5642 Victor Street Bakersfield,California93308 'IU} -::;'.=-:": ~.' PERATIONS DEPUTY CHIEFS ¡----..:::.::...:::........:::,_::-: " I DANIEL G. CLARK HAZARDOUS MATERIALS CONTROL UNIT W ... , ii CHARLES E. DOWDY (805) 861-2761 SEP 28 . if: .;1 CHARLES A. VALENZUELA (800) 322-0722 Ex!.. 2761 1987 !Ii II ADMINISTRATIVE /I~' I{ SERVICES OFFICER L/ NORMAN R. BRIGGS e FIRE CHIEF THOMAS P. McCARTHY Checked: 1 / J/ 1 Ó r¡ Sent : '11 ,2,5'/ 27 - -::;-r ()o 1'7 Due : ;0 I~/~ Dear Business Owner: The busjness plan you filed '~ith the Kern County Fire Department is being returned to ~ou for the following reasons: Form 2Anot returned -LForm 2A not complete Form 3A not returned ~Form 3A not complete Inventory Sheet(s) not returned - Inventory Sheet(s) not complete - Facility Diagram: ímissing _incomplete Site Diagram: -Lmissing _incomplete -' IJ ,., C t" --, -' J (í N -' M - Comments: rl}I\M J..-À ¡ JC:;(í -:;) - LIJ tM~ËJ1 f.D/CfÌL rACiLiTi CÞ.PJ;-l(JLf.. ------ ,. . o I~ r REfJT!Nb A V Ie. T,I/Y\ 0 f ~ Ex po:; f)¡4[ To 0 ßJ£ 0 R. ,")CAr of Y cf1R HÞIZ:.A,Rt\ûOl/<; MA7Ef!../~\LS~ F9f?/l'( 3,tj Sr:.cr j : THiS SEcnor!) ASK ;=t;>f!. frlE"·'f¡';D)jC. ío ßf 1,4£)ED WIT,4 ALS.PEcT --(Q y'OiJtt ¡{LJ, Z:..¡~d,bOl(.5 I1ÁTi'~"aIAL5- YDL¡ APþ;;,PR, T'o HJvt f<,~ùE.P.."5[D THE INFo«f.1ATtrJj{ PLACE I) !N ~~!:-cÎlc'¡J5 1""r2_ F'Of\M 3'P, , SEcT 2. : ßE SPEC/Fir ~1j!Tµ i~E5f'tcr To ¡HIS: {]lA[s-(iaN. l,e: /,'(,f ./ HAVE' a~çSTloN5/ ßPLt:ASE'C!-\LL AN ::r:.,fÏisP[.c:ToP,. PLEASE RETURN THIS FORM ALONG WITH THE CORRECTED BUSINESS PLAN BY ( /0-1.6 - g 7 ) Very truly yours. Geoff Wilfo¡'d, Captain Hazardous Materials Control Unit G\\'/jb ID# ) '30 iL_ t~~ < Protecting Tne Go/den Empire ~ I ~ÖRTH i\ ".··m ... , .í' SCALE :/11 I) c: I BUS INESS NAME :/'. /) LL Y . 'Î FLOOR: I OF / '::.6S. U ICo C c-- f'- S 7ð R é:t£ /2 r'(} DATE:/OI¡187 ILITY NAMESG3 '1 ST/Né I~,Y #: ¡OF ! . (CHECK ONE) SITE DIAGRAM ¡ I- I J <:;( ~ ------------ f ~ \ \ \ ~/ u/ . I 5b3.~ (§TDItt) ~ <:i.. GA~:: ¡ ~ù~ P ,', "'L.¡ S Hv\t--(R"J , ~ __ 64<; . ,< P h '~tv\ps .. V) . I' IO{ O()o 64l I , I / ~ k:f[· /'/~ > IO(OCiO 6A L ~< / / /', ~L. / /" lÒ{OcJd 6A-t... ~/ t; ..... 4: c; ~ ::t ..-- --. \ f+ ftRR\ S ,~,d . FACILITY DIAGRAM ~ --- ~~E, 1\' \ , \ I I I ,·V --- --t t I r r I ~r (J t ... '. I r I 'fT~ L-J g'?- Y C C> FF I C é: ) --,........,.~--~ ...... .-- (Inspector's Comments): OFFICIAL USE ONLY- ,;"......Jw¡;;.. }I/=-fóg' UU";¡UH.."" ~'''''·~¡;;'Cf(èCLf.::... K. 7óf?t.. DATE)()/ (1?7.ILITY NAMESb3 '-/ 5TJNé. I:. . ß J<R.¡~ Þ (CHECK ONE) SITE DIAGRAM ~ FACILITY DIAGRAM I ...,VC\...I.L 'i} ,- '""\r ~~, . .. ." .. ':?~ ..: ... --,.-....._-- ..,,- ~ ,.. .......... ..,. t/oM E:S V A- C f) f,-J T' " I'".,~ t.L. J ^ ..::;. j:'..., \ ) "'I' ~'. -e- \J <:;... ,·0 J..,."'" l- vt í' ,- -. t i..... ' (t.... yo"',' f'~j .. --I p' t.. ,,-- ¡';l.IVVL". tv. I OF .-.......--.--- \ ~~~ /Y11t~~ 6 A1-0 1+ i/é ( ffO M t: S , ) . ¡ q I' e:¿ ¡ i ! í ¡ c , i ¡ ! 1 ¡ ¡ ! I . '.' l tiOMé r ~ . 5~3'-J <:: 'ItS 1 J:: .P~i¥$ '-'ì · ~L ~ ~ '.' 6¢~J:l ~HY~--~-~-- j-l t~~~\S RJ ¡'fd~4¡.~~. (t,r;~ I 'f' AA f:.' ( llu11fl........) j Off-1t6S J (Inspector's Comments): , -OFFICIAL USE ONLY- - If' - a' .' w"';'" . . "~"':èr,~+;~'? ~',~;~:,::,~~\~\;.~, ~~iJff~;,:c;;, , ~,.- ,..."" :.' . ::~;,{\:':,,:\:,::~«i\~:":,;::;~, ., ., . 1, .; :I.';3:'t0~~'F ' .... -:~: ~~,~.. 't+/~~,j~:;. .,1....~: '.' ~ . ~ 1: .~~.; ,>, 'i':>')\ ,R::, ... :. .\. '." .. //11/1 NO POSTAGE NECESSARY IF MAILED . IN1HE UNI1ED STAlES BUSINESS REPLY MAil FIRST ClASS PERMIT NO. 5427 PHOENIX, AZ. . Postage will be paid by addressee ATTN: Property Management THE CIRCLE K CORPORATION P.o. Box 5208S-- Phoenix, AZ 85072-208Ç C7:':".M ,r;Ji:J VALERIE UNZENMEYER Farm and Agriculture r-, L_.J KERN COUNTY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY -4P/36þ ù/~_, 4 Standard Business BUSINESS NAMEc..,~c."t:. '( C::;þlQ..4¡ \,ys \~.:1 C_ OWNER NAME ~Q":~C\..éJ¿Qo~,~~~~___~_ LOCATION:, S~'ß4. ~'''''IS ~~______ ADDRESS:__...D1qL_~~,~~.,,__>r_~"_h'___"_'_____ CITY, ZIP: '"ßÅ~s",~ Co... Q,~'6Q4. CITY, ZIP: Q..... IJI? c::...I>, ~'1l~_______.._'n PHONE #: ,__-00sJ....,~4-~-3_4~.5____,__,_,____ PHONE #: :1li ~i.::.-,~-'-~C::.--------~-------'-'~.. STANDARD IND. CLASS CODE: ,,___,?Jj,'2..-______ NAME OF TH FACILITY:__'....l~~_ì(..S,~-h"-~ REFER TO INSTRUCTIONS FOR PROPER CODES \~"10 ~ OUN AND ßRA051Rf~1 NUM~ER f'ag? at ,', ~_..___.___..__,__._.__.__~_.__.__._.~~_._____.. _~..____....___.___,_____.__".__ _~..__..__. ..__ H~,__ ____._..__,._.._.__.__._..__.____.__.___'....~.___'__.___h··__·__'''_._..._____..._ .... ..._'......_..___._.__.____..._.__..._......~ ..__...._.. _...._..._-" _._._,._,.........___.. ....___.. 1 2 Trans rype Code Code 3 Max Amt 4 Average Amt 5 Annual Est 6 Measure Units 1 Cont lype 8 9 10 Cont Cant Use Press 1 emp Code 11 % by Wt 17 Names of Mixture/Components See instructions ., Q~-(,...I"'!'ç,- ,__,_, ., 'n_ ____. .______ .~ ~.__.._...._ _.,. _______. ..'_....___ .u __._.,_..__. C.II.S. Number -----,----~-1::~~-)~--,-, Lac.,. 0,.) '. L..ck\W' ,,.¡ Q Qe.. r - , r -'-1 13) " Days i ~(. S I ,-, - ",n. '\"'noon___'___\. .. . ,... n.'?'!'!.. -, ~""º"n_<>£..,n~~ L_ -, Reactivity L -- ,I Sudden Release of Pressure on Site L -- -" J " ,~ \L -~~~~~~J~jf~~~J~~~~~I-~~[~~~~[~~~~~~~~~~]~~~~]~~~~~~~]~~~~~~~~~~[~~~~~J~~~~~c;~~~ ~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ,'-' , \ n l _--I Im~:~~~~e . _ _\~ _, ~:-,lº~__~h....____l?t_e;.__, ::'?~--,..:r-~~.!'----" -- -,---- -, _n' Uù ~~ G ~ '-"~G '-'-.it!' ,.., __h, _." ...._.,______"~,_.__..,_"___ _,.., _n'_._ __. ...' ,..___n. .. ~ Fire ~ Delayed Health C.A.S. Number ______~_~-,,'1,--,1.<þ-yL \~ r' .-- -., 1 13) " Days i 3(p~ on Site L_,_.J f"- , L -- J React i vity r ,-, , L._ ,- , Sudden Release of Pressure ,__., ~~\-Cl~__:..--__!c5-"~~~t:;"-"---.-'.m-' .._.- .. - -... - - - --;---]-f'---]---;~--r-~~--r--~:;~----]-~-~]---~-;-]----~---------4:--J--~-~---~ ~-~ ~--~~~~~~~~--~~~--~~-~~-~---~----~-----~------~~~-~~~~~~~----~ (~]- I~:~i~:~--- mT~,~_~~~~~~~~~~:_~~ - ~j~,,",~--~~ ~~_~,¡~:~_J-~__-_-_m 0 u .., Q 'k>< o~ (1_ Q...., ~,"or _, ,__~________.._l __,..__ . ,.. _ _ ' __ ,,__, _____ ..,_ ~ Fire ~ Delayed Health C.A,S, Number __,__,:1,~,~\~____,._ .'.,_, ~~\~!':::'__'-._,~~".~~:<'~n.. _ _,,_n_,,___, __,no, ____, __ _ :; [~~; Re'3ctivìty [:~: ~ Sudden Rplease of Pressure 13) ~n Dgr~e ~ 3.C.2,:1 ~ ---~-..~--~--~-- - c :~--:---~--~-~-~----------------------------~-~----------------- ----- -----------------~~-~~~~4i~~:-~~~i:---------------- ~ \Æ ~~RW,;¡¡;I C1S. Hi!;--- -- - __~__;_"~'o__, ð~,,,,"____ ---"""'r¡il' -- --- -- - -- ---- -- -------- --- " --~l,i'" - -, -  ~ ~ APR 1 4 ¡g89 "2 ~,~.:I, ~~ .n~~_~_\.~~y~W~,-2--'-'O.€H:T.-~-~.. ,_, ....__.. ,_,_, ,___, ~;,~ ~~j,'h~~~~,~ § flame line l. Ph0n~1 c .,; -----~-~¡r[T---t4~------------------------------------------------------------------------------------------------------------------------------------------------- ~ Certihcatiol1 (Head and ¡dun after comµleUng all Sf.'cUOl1s) . l ' I certify under penalty of la~ that I have personally examined and am familiar with the informa' ubm'tte in this and a1 I attached documents, and that based on my inq, uiry of tho~~1 individuals I'es~le for obtai~ the information, I believe that the su i te i f rma .ion is true, accura~e, and complete, Ñä~~â1;;íC~äm;~-~~ñ~7õrill~~~e¡;~~~~n~~-¡;e~~}gHÿë 5íçjñãfü¡;-- .--- ---- --- ____n' -, - - - -- - - - --, -, ---, -., -,.. - 'Gãf1dqñ~I-'l- , INVENTORY CODE SHEET ,I Trans 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 gals) Ft3 = Cubic yeet CUR = Curies Container Type (Column 7) 01, Underground Tank 02. Aboveground Tank 03. Fixed Pressurized Cylinders 04. Portable Pressured Cylinders 05. Insulated Tank (Includes Cryogenics) 06. Drums or Barrels Metallic 07. Drums or Barrels - Non- !'t1etallic 08. Carboy(s) 09. Glass Container(s) 10. Plastic Container(s) 11 . Box ( es ) 1 2 . Bag ( s ) 13. Metal Containers (Not Drums) 14. In Machinery or Processing Equipment 15. Bin(s) 16. Unlined Sumps Container Pressure (Column 8) 1 = Ambient Pressure Greater Than Ambient Press 3 = Less than Ambient Press " £. Container Temperature (Column 9) 4 = Ambient Temperature 5 = Greater than Ambient 6 Less than AmbientTe~p but not Cr'voqenic _ 7 = Cryogenlc Condltlo~ Use Codes (Column 10) Ol. 02. 03. 04. 05. 06. 07. 08. 09. 10. ll. 12. 13. 14. 15. 16. 17. 18. 19. 20. 2l. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44, 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 99. ---. 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 Medical Aid or Process Neutralizer 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 6Air Drafting Aid Finished Product Fire Protection Hydraulic Equipment Road/Hwy Maintenance Testing Wholesale Chemicals OTHER-Specify on an,er page -< '. f' HAZARDOUS MATERIALS BUREAU e I NSPEC~I ON F~ " ~J fZc..c...G K ;tl. (Z 7 D ID. 13o&:; DATE l å / IO¡ / <6~ ANNUAL INSPECTION ~EXEMPTION ___ RE-INSPECTION ___ COMPLAINT___ ALL ITEMS OK: [ /] VIOLATIONS NOTED: [ ;¡ INSPECTION SUMMARY: o - Does not Apply 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.. PD) ( B. Employee Notification & Evac. Plan -r- C. Eaergency Responder Notification -L- D. Medical Assistance -L- E. Private Response Team Procedures -L- TRAINING REQUIREMENTS (CCR TITLE 19-2732) P. Training Recordst G. MSDS Available to Employees -r- H. Employees Familiar with MSDS -1- I. Use of Personal Protective Equip.ent f J. Waste Material Permits & License ~ K. Employees familiar with evacuation plan. " -+- - ----------~- ComJlents: ~,-¿..... CHA-tJG6 IN //,,- J '/' 'bùRu~& tl\)~P:::::L-"1LD " '~ L. Work Area Safety M. Clean-up Materials place.ent/availability N. Clean-up Equipment o. Fire Protection Systems P. Waste Handling & Storage Q. Availability of Protective Equipment INV. & DIAGRAM VERIPICATION (CCR TITLE 19-2729) 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. Utility Shut-offs Y. Other E....., G :26Gr>.JC.V c.c.v,) r-At.-~___ M .fo\.ì')fE' Li ± o -r. ..L ( ( ± t AL.L ---'\) '.~~ YtTff f~ r cl í T GN'l$ ~K. 1&/;;7/r; " 1/ ..,~! ((~".,/ ~~'\\ Clearance Granted [ Started~: ~ v( Re-inspection Required [ r"" ,r-" co.pleted~: D~ ò ~W7(4« ~ Inspector ~ . \\ ,'/ on_/ / D.E. . ZS- Total Time_____._____ Miles on Inap ~~~ k/. Owner/~anager ) / V HMCU 14 ~, "" . . KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD. CA 93308 lei f<.c..LS 1< ~ 1"- (ö BUSINESS NAME ID# _ J~c:~ _ INSPECTOR QUESTIONNAIRE BUSINESS PLAN AS A WHOLE FOR USE WITH THOSE BUSINESSES COMPLETING 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: 10 / ('1 / ~ SECTION 1: RESPONSE SUMMARY (Limit to 4-5 lines) ¡VI. OJ ( - N\ A(L~ vJ l 'ï~ G~ S ~AcL~5 L-Dt:...ATEO DN ~ /'Jo.Q.. T 1:+ EA s -r Co-a. f0"E ~ oÇ" f-..ÖA;ùS, A SMAU_ 'F'uEI... \~L.ANJ) -LIÑO GAs.. tpUMPS 15. L()c.AíE~ A'í or ?a.C>P~TY, s: Tt tV £ A",H') HAJ(.Q I S c..of\JS'SïlrV(r' or:: ONL~ ~ $ð(./íHW{;~T Cc);IêN(SQ¡ SECTION 2: NOTIFICATION / EVACUATION OF AFFECTED PUBLIC (Limit to 13 lines) ( " j ~rr í. '\ ~_ur HMCU-:Q.