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Home My WebLink AboutBUSINESS PLAN (2) ~ r . '-- .a -_0#' , " I . .' I ' . "., Öperate I Per LOGA nON I I TANK o 15~000-000 152-000 1 o 15~000-000 152-0002 I 015;-000-000152-0003 I 0) ~-OOO-OOO) 52-0004 Issued by: it to Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE this permit Is Issued for the following: IiJ Hazardous Materials Plan I 11Û" ¡ , , : J' ' -.'. ~ " )I\> riUnderground Storage of Hazardous Materials . . '( )þ""'" 't1A . ~,:>-, 0 Risk Management Program .1 . ; ~~j,,~-a<:¡ .' .~7rr~ ~~ .<.~ 1 ~..,., . ¡~~':"'. 0 Hazardous Waste On-Site Treatment t., ,.J' ~\' "I.~. ..,.....~ - ~-'[. .~ '.,", ~~~..- \ jJ. (~,._. ~ ~ ...... .... I" f 1'\' ~ 1 0(... . If''' . . ~..-:.' ....\"-. '-- .,.. '1"r:-':",'" . '~ .. .'" ... ,-'. - f" J ' >, ~.. . ~ "'-"1"- \,. ... } "'",~', ~ -_.....~ ~~ . 13001 93312 HAZARDOU~ßÛBSTANCE ", <. . Midgrade Unlead~d \ '.. \; " I I ·1 I I Unleaded Unleaded Super Unleaded Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: Issue! Date J~une 30, 2003 Expiration Date: r I _.~~~~~ ':~ .-'" . . 5/TE {o 44 {'T)':¿. SITE DIAGRAM ( ./ FACILITY DIAGRAM ( 1 Business Name: .s~....v--:2>A/,¡I: ~/"'- Business Address: /300/ S~~A~' 4 . SrCJC.t:Z>~c..£- Mo,e./L- Þ~/c. Þ~A£~ --_.~._---_._~_.,.- .....------- Jr;; ,ú5'.PK pÆ7"~~ MCllVI'Ø1I!.... ~.dS -7 --T I ! I I i A/K¡S ! MIJMVAL J'Ht:lr o~t'" ,J ~ Wt:l17P N~I 0.. ~ ~ . '\' --' \ ,z::>t./'1,r?:s : I ! I L__¡_ ¡ i , -. \ s 1'.-- ;1""4eL ~~;?Nr .4l.c~_ E- .A I X1:i4 /...> -' ,." -- e -¡;.~ STOCKDALE MOBIL #83063 SiteID: 015-021-000152 Manager : Location: 13001 STOCKDALE HWY City BAKERSFIELD CommCode: BAKERSFIELD STATION 11 EPA Numb: BusPhone: Map : 122 Grid: 02B (661) 323-2832 CommHaz : Low FacUnits: 1 AOV: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact MUNN & FGlNG CHAU Business Phone: 24-Hour Phone : Phone / Title / OWNER (661) 588-2861x (661) 589-5982x (lobI ) 301 - UrJf. Emergency Contact LOUNG CHAO Business Phone: 24-Hour Phone Pager Phone / Title / BROTHER (661) 836-3766x (661) 589-2407x (60/ )3 t.fs-'-QoiX Hazmat Hazards: Fire Press ImmHlth DelHlth Period Preparer: Certif'd: ParcelNo: to Phone: (661) 58ft¡!lJ11 State: CA Zip ~3311 91.11 ..;J , Phone: (661) 589-5982x State: CA '1:53/,/ Zip 93 3 1~ , TotalASTs: = Gal TotalUSTs: Gal RS : No MØ\4 :- 7 ~ , - Contact : MailAddr: 13001 STOCKDALE HWY City BAKERSFIELD Owner Address City MUNN & FaNG CHAU 13702 TABLE ROCK AVE BAKERSFIELD Emergency Directives: I, , 00 hereby certify that I hav& reviewed the attached hazardous materials manage- ment plan fo'(t;W~ fYlj,~Land that it along with (Name of \3usinees) any corrections constitute a complete and correct man- agement plan 10'( my facility. ~(C) :0:":, ~ t"... ,":" .U,e / d(1 ~5 Dacü -1- 12/01/2003 ~ e e F STOCKDALE MOBIL,#83063 SiteID: 015-021-000152 ì STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: STOCKDALE MOBIL #83063 Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : LOUNG CI~IJ.,V\.¿:fmkálÅ. Phone: (661) 836 3N~;z Addre s s: 370,).. --r:¿ ~ 57ft¡ - City : ~~.e--v3+-,' State:CfÎ Zip: q 33/Z¡ Type : ) .1\\ LaIDIG. CII1\-6 \ TANK OWNER INFORMATION J766~ Name : S~ ó-4 ~oV ~ Phone: (661) Q36 Address: City : State: Zip: Type : BOE UST Fee# : 006217 Financ'l Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date:02/12/2001 Phone: (661) 325-6320x Name:DON DOZAH Ttl:FIELD SUP. State UST # : 1998 Upg Cert#: 00711 -2 - 12/01/2003 ~ e e 0).... F STOCKDALE MOBIL #83063 f= Hazmat Inventory f== MCP+DailyMax Order SiteID: 015-021-000152 9 By Facility Unit 9 Fixed Containers on Site 9 Hazmat Common 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 IH DH L 10000.00 GAL Low F P IH G 448.00 FT3 Min REGULAR UNLEADED REGULAR UNLEADED PREMIUM UNLEADED GASOLINE DIESEL CARBON DIOXIDE -3- , 12/01/2003 Ii 7\'-' e e -4- 12/01/2003 :,,- e e SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site ì F STOCKDALE MOBIL #83063 f= Inventory Item 0002 == COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 HAZARDOUS COMPONENTS ~ CAS # I 8006619 %wt. I 100.00 Gasoline TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS f= Inventory Item 0003 F== COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 -5- 12/01/2003 · e e SiteID: 015-021-000152 9 Facility Unit: Fixed Containers on Site ì f STOCKDALE MOBIL #83063 f= Inventory Item 0005 = COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 4000.00 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 f= Inventory Item 0001 === COMMON NAME / CHEMICAL NAME DIESEL Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit E SIDE OF LOT Map: Grid: CAS# STATE - TYPE Liquid Mixture 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 ENT %Wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 HAZARDOUS COMPON S N TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSME TS -6- 12/01/2003 " e e F STOCKDALE MOBIL f= Inventory Item = COMMON NAME / CARBON DIOXIDE #83063 0004 CHEMICAL NAME SiteID: 015-021-000152 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit STORAGE AREA OF FACILITY Map: Grid: CAS# 124-38-9 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 224.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS HAZARD TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ASSESSMENTS -7- 12/01/2003 ~ e e SiteID: 015-021-000152 9 Fast Format 9 Overall Site 9 03/02/2001 F STOCKDALE MOBIL #83063 I p= Notif./Evacuation/Medical Agency Notification EACH MORNING THE GILBARCO MONITOR PRINTS THE VOLUME OF GAS THAT IS IN THE TANKS. AT THE OFFICE WE TAKE THE PRIOR DAYS TOTAL, SUBTRACT SALES, ADD DELIVERYS AND BALANCE TO THE GALLONS IN THE TANKS. Employee Notif./Evacuation 03/02/2001 ANY LEAK BEYOND A MINOR NOZZEL LEAK, WILL BE CALLED TO THE OFFICE, A MAJOR SPILL WILL BE REPORTED TO THE BAKERSFIELD FIRE DEPT 326~3979 AND A CERTIFIED HAZARDOUS WASTE COMPANY WILL BE CALLED FOR CLEANUP. Public Notif./Evacuation 09/1611996 1 10/11/2000 ALARM SHALL BE GIVEN BY SHOUTING. Emergency Medical Plan CALL 911 AND REPORT, PARAMEDICS WILL RESPOND. -8- 12/01/2003 '. e e ,Y F STOCKDALE MOBIL #83063 I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 03/02/2001 THE TANKS AND PUMPS HAVE AUTOMATIC SHUTOFFS IN TEH EVENT OF ANY LEAKS. THE PUMPS HAVE PANS TO COLLECT ANY LEAK. THE MONITOR WILL BE CERTIFIED ANNUALLY. Release Containment 03/02/2001 NOZZEL SPILLS ARE NORMALLY THE MAJOR LEAKS AAT OUR STATIONS, A MAJOR SPILL, WE WOULD CONTACT A CERTIFIED HAZARDOUS WASTE CO. Clean Up 03/02/2001 NOZZEL SPILL, SATURATED WITH KITTY LITTER, SWEPT UP WITH A DUST PAN AND BROOM, KEPT IN THE STORE, STORED IN A PLASTIC BAG UNTIL THE NEXT HAZARDOUS WASTE PICKUP. Other Resource Activation -9- 12/01/2003 ,.' e e - F STOCKDALE MOBIL #83063 I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs A) GAS - WALL FACING SHOPPING CENTER B) ELECTRICAL - S SIDE OF BLDG IN OFFICE C) WATER - N SIDE OF SITE OFF STOCKDALE D) SPECIAL - EMERGENCY FUEL PUMP SHUTOFF NEAR THE CASHIER E) LOCK BOX - NO SiteID: 015-021-000152 9 Fast Format 9 Overall Site 9 I 03/02/2001 AND STORAGE AREA SWITCH IS LOCATED IN THE SALES AREA Fire Protec./Avail. Water 03/02/2001 PRIVATE FIRE PROTECTION - TWO FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - LOCATED AT NE CORNER OF STOCKDALE AND ALLEN. Building Occupancy Level 05/30/1991 1 I B-2 -10- 12/01/2003 ,. e e ;¡ F STOCKDALE MOBIL #83063 I F Training Employee Training SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 03/02/2001 WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE AT THIS FACILITY. BRIEF SUMMARY OF TRAINING PROGRAM: WHEN HIRED EACH EMPLOYEE IS REQUIRED TO READ THE HAZARDOUS WASTE MANUEL. REFRESHER COURSES WILL BE GIVEN ANNUALLY BY THE STORE MANAGER. Page 2 r I I Held for Future Use Held for Future Use -11- 12/01/2003 - - ß~+f q f 1l, \!> ~ C\ L uJø. 5 ~/L.\~fe.d-(~( Q~' ~""€~"'ø~ J ~ \" ~- H~ ~ ~\~f ;¡. p\ ß () lJ {C cJ Ct\h r ~cy5"(3 ... ,f ~ - .. -- -- .,--" ,1/.1 STOCKDALE MOBIL #83063 SiteID: 015-021-000152 Manager : Location: 13001 STOCKDALE HWY City BAKERSFIELD /' / BusPhone: Map : 122 Grid: 02B (661) 323-2832 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 11 EPA Numb: SIC Code:5541 DunnBrad:51-012-0713 / Title / FACILITY ~()WH (661) 588-.2861x (661) Sg7 9C95x 5rI-S () x / TitleeyO~' / PRESIDEN'P 336-37 " (661) J2:;-6J20K (661) ~301 J079xCElJb ( ))89- ~i./~7 Emerge y Contact JOHl~ 51'UAlt'f JR Business Phone: ~ 24 - Hour Phone Pager Phone Hazmat Hazards: Fire Press ImmHlth DelHlth Owner Address City S'IUART5 PETROLEUM rvt IAlI\l1 +- t:='e.~ CÌt.ttIÄ. ·11 E: 4TH £'P- '370;1. -r d f~ ~od:-t:.. ¡}V' J¿ BAKERSFIELD Ø14 .. Phone: (661), J25-ó320x State: CA '78"8'",. ;L8'~ / Zip :~3:ðG-9'q:33f;L Phone: (661) ...32~ 6J20x State: CA l?i"9-fj<l~;L Zip 9JJ07" q3~/.;;2.. Contact : I J f¡ /1- MailAddr: 11 E 4TH ßT 13()()/ 51fJU<..~ f./-wy City BAKERSFIELD Period Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: " u~ -F¡¿~~ . er~ ¡f¡;lrOOtl'f4!tmf)\ D@ ¡Ir.~ ~iW ~ a rél)fflé.W~ ~ ~~_,...., , .. ~ . ~~~~ ' m8t'lf rAaØjffK.sf~/,; I. . . ~,$}o. _æJ:liJ ~ ñi ~~ ~ith ~N'y oorr~Oß$ 006iS11itUit ' sa OOffl¡p¡'ete afbd ro~ ~~m~m pl~fi for my iadfiiy. ¡ mavr. , ..- ,', '. ",'.;~r'<:"i,'i(;'~ .;~?;~~.::~ ~~,:""" <;;-"'",.'\. ~. -. 'è .iX~~jJ¡!ÒI '" - -1- 11/02/2001 .' It -- F STOCKDALE MOBIL #83063 SiteID: 015-021-000152 "I STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: STOCKDALE MOBIL #83063 Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : .JOlIN STU.".R'I' JR rv1 u Vl Vl .... ~¿V\.j ¿k&. L-l Phone: (661) 325 '6320x ,Address: ~9- ~r-:J- City : State: Zip: Type : TANK OWNER INFORMATION Name : JOHN 8'fUAR'I' J~ yY1 \A.~ \1\ \- Pé. "'j é k£A Lt Phone: (661) ~25 ê32.Q~ Address: ?%'II- çz:¡ gJ- City : State: Zip: Type : 'I BOE UST Fee# : Ü"ÖG2 J:.--7 Financ' 1 Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date:02/12/2001 Phone: (661) 325-6320x Name :-ÐON DOZAH' Ttl:FIELD SUP. State UST # : 1998 Upg Cert#: 00711 Hazmat Common Name... SpecHaz EPA Hazards One Unified List "I All Materials at Site "I DailyMax MCP G 448.00 FT3 Min L 10000.00 GAL Mod L 10000.00 GAL Mod L 10000.00 GAL Mod L 10000.00 GAL Mod f= Hazmat Inventory f== Alphabetical Order CARBON DIOXIDE n ~OLINE MIDORADE UNLEADED Ü ì e.s-e..X PREMIUM UNLEADED GASOLINE REGULAR UNLEADED REGULAR UNLEADED F P F F F F IH IH DH IH DH IH DH IH DH -2 - 11/02/2001 "' It - F STOCKDALE MOBIL f= Inventory Item = COMMON NAME / CARBON DIOXIDE #83063 0004 CHEMICAL NAME SiteID: 015-021-000152 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit STORAGE AREA OF FACILITY Map: Grid: CAS# 124-38-9 - TYPE Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 224.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min HAZARD ASSESSMENTS f= Inventory Item 0001 === COMMON NAME / CHEMICAL NAME GASOLINE MIDGRADE UNLEADED Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -3- 11/02/2001 e e F STOCKDALE MOBIL #83063 f= Inventory Item 0005 = COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 4000.00 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 f= Inventory Item 0002 === COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 Gasollne 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 -4- 11/02/2001 e e F STOCKDALE MOBIL #83063 p= Inventory Item 0003 F== COMMON NAME / CHEMICAL NAME REGULAR UNLEADED SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -5- ,I ì 11/02/2001! e e F STOCKDALE MOBIL #83063 I f= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 03/02/2001 EACH MORNING THE GILBARCO MONITOR PRINTS THE VOLUME OF GAS THAT IS IN THE TANKS. AT THE OFFICE WE TAKE THE PRIOR DAYS TOTAL, SUBTRACT SALES, ADD DELIVERYS AND BALANCE TO THE GALLONS IN THE TANKS. Employee Notif./Evacuation 03/02/2001 ANY LEAK BEYOND A MINOR NOZZEL LEAK, WILL BE CALLED TO THE OFFICE, A MAJOR, SPILL WILL BE REPORTED TO THE BAKERSFIELD FIRE DEPT 326-3979 AND A CERTIFIED HAZARDOUS WASTE COMPANY WILL BE CALLED FOR CLEANUP. Public Notif./Evacuation 09/16/1996 1 10/11/2000 ALARM SHALL BE GIVEN BY SHOUTING. Emergency Medical Plan CALL 911 AND REPORT, PARAMEDICS WILL RESPOND. -6- 11/02/2001 e e F STOCKDALE MOBIL #83063 I ~ Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000152 9 Fast Format 9 Overall Site 9 03/02/2001 THE TANKS AND PUMPS HAVE AUTOMATIC SHUTOFFS IN TEH EVENT OF ANY LEAKS. THE PUMPS HAVE PANS TO COLLECT ANY LEAK. THE MONITOR WILL BE CERTIFIED ANNUALLY. Release Containment 03/02/2001 NOZZEL SPILLS ARE NORMALLY THE MAJOR LEAKS AAT OUR STATIONS, A MAJOR SPILL, WE WOULD CONTACT A CERTIFIED HAZARDOUS WASTE CO. Clean Up 03/02/2001 NOZZEL SPILL, SATURATED WITH KITTY LITTER, SWEPT UP WITH A DUST PAN AND BRQOM, KEPT IN THE STORE, STORED IN A PLASTIC BAG UNTIL THE NEXT HAZARDOUS WASTE PICKUP. Other Resource Activation -7- 11/02/2001 e e F STOCKDALE MOBIL #83063 I f= Site Emergency Factors .r== Special Hazards Utility Shut-Offs SiteID: 015-021-000152 9 Fast Format 9 Overall Site 9 I 03/02/2001 A) GAS - WALL FACING SHOPPING CENTER B) ELECTRICAL - S SIDE OF BLDG IN OFFICE C) WATER - N SIDE OF SITE OFF STOCKDALE D) SPECIAL - EMERGENCY FUEL PUMP SHUTOFF NEAR THE CASHIER E) LOCK BOX - NO AND STORAGE AREA SWITCH IS LOCATED IN THE SALES AREA Fire Protec./Avail. Water 03/02/2001 PRIVATE FIRE PROTECTION - TWO FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - LOCATED AT NE CORNER OF STOCKDALE AND ALLEN. Building Occupancy Level 05/30/1991 ] I B~2 -8- 11/02/2001 ". ~ i e e F STOCKDALE MOBIL #83063 I F Training Employee Training SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 03/02/2001 WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE AT THIS FACILITY. BRIEF SUMMARY OF TRAINING PROGRAM: WHEN HIRED EACH EMPLOYEE IS REQUIRED TO READ THE HAZARDOUS WASTE MANUEL. REFRESHER COURSES WILL BE GIVEN ANNUALLY BY THE STORE MANAGER. Page 2 [ I I Held for Future Use Held for Future Use -9- 11/02/2001 " " í " ( ( '. <', - - CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUSMATEmALS~AGEMENTPLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPEIPRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner / Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA BUSINESS NAME: $"7tO~¿¿ MoPJl¿..- LOCATION: / 5e&' 5"'?C>~L>.4:V .&'" ~ MAILING ADDRESS: / /~. .d ~ $7. CITY:~~d .;-e-';::'fþ STATE: 0.1J ZIP:~3?51""" PHONE: 3Ã.s-~3UJ I PRIMARY ACTIVITY: ;14/;;../1- A4tOÆr - &AoG SnQnoN OWNER: _);..ljA2..,,?:,< ~~ r£it:)il!!:il~ PHONE: 3.:25-c' ~c) MAILING ADDRESS: / / e. 4¡z./~. """;a¿Q¡/::;Ø£S"cI(F/ ^ ~ I EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE l. ~~ A .;$Wß.l2=r 7êS' ~.g2S- t::,:90 .:3'9Þ-.89Z.9 , 2. JOHN IA/. .:r 7"u¿::J¡¿r J/-p£e.s 3':¡5'-63z..o 30/- 3eJ7'1 1 )c c e e HAZARDOUS MATEIDALS MANAGEMENT PLAN '. SECTION II.I: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: . EA~H ~/A¥ /H;? C;~t...IðAt2.æo A1'øAJl-r~ 7>J!1./AJrs 7;'"4!i! t0t..UH4 t:}.c- G..e.s- '4;tAr /G /N 'ffl'.é' 7;:>AI~.s-... .4r 7'H¿£" o,.:-C/c.ê we 7P4:::I!£. 7Pø£ 7>ælc:J/£... 7:>,a.y$ 70TPJ¿... ~ .;J"Uß7)?AQ"" .;)~£.4.S" ~2J '")eJ..lue.eys A~ Ä3~IUc.e: ?õ -n:JJ£. c;~ /N ~ø /,q~. B. EMPLOYEE AND AGENCY NOTIFICATION: A7~ LP:aJ:? ß~yfOA-lb 4 m/~ Nør?'F'( ~A:::.../ u,/.LL. 732' (l~)::. ~ ~ ~,I7C£ "" /I Jt.f~£. $P/&-t- .ttJILL 78/£ IGæpc:æ.:rE."l> 7é ~ ~,&;t~~ø F/1ZtJi!' -:iJe.P¥!J;æ~T/ 3.:z6- 3?79. &1µD A tJ.ø4.::r;"Ç/é,b H~.eL::xevS l<P1~r£ ~PA"~ ~/¿.¿.. ~ C2J~2> ~ (l¿.,.¡¡æAAi- tiP . C. ENVIRONMENTAL RESPONSE MANAGEMENT: ~E As A-~IL' D. EMERGENCY MEDICAL PLAN: t1A¿.L ~ // 2 ( ( ( e e v HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: ~ 7....;¡AJA::$.qA.7.Þ PvM/fIP:1 ~I.IÆ. ,()~hr,c. $"~pr tOAS='S /N ñr'.e ~~ 0# .&lAJ7' ~«.a~6. ~.e: PVMP..r #~ ;Z>~.,. ~ ~C? ~ ./~. y~ ~17Þ/l!.. um-L- ~ C!.dA.r'I'¡t:'AiiJ!;þ -9A,)4)'¿lA~. B. RELEASE CONTAINMENT AND/OR MITIGATION: Al6z:..z:.ttL $P/U--5 .qØr. ~ ~ M~.I~ ~ø~tr;$ ~r~.e ~?.Qr~s.... ¿; ;14;£:J¿,~~I'.u.. WE ¿U~¿,ìÞ Q!.ç:MJ~.4 ~~/~ #A';F!:.~(.J'£ ~ WI4 ~ 72;" Gø . C. CLEAN-UP AND RECOVERY PROCEDURES: Af:;~¿. S-,,,,¿.t./ ~¿;;~.qr4Z> é-lJ..rH k'/"1""Yÿ L",~....5a #,!FP.... uP ¿V~ A ~,... ~ ""A.,Ã?) ~.... ~r,..;oJ #J'G.;lr~. ;$'~ "IS ¿: ;;þ..G<?.snc- ~ ~.,V~ ~ N¿;:¡c..r ~ ~"%,,<Q~ â;QffT£;t. :;l>/~ QJP. UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURALGAS/PROPANE: ~AN ..cAC/~ ~ ~A~ O,AJ7£,A:2... ELECTRICAL: #A/A/ ;ÞA;uF/ /AJ ::3"72:::JR.A' - 'Sao_ ,z>~;: ;2:>~ WATER: ~ ~ ~:s ;:1:>£ 6P p;¡z;,Pé..é.Í';:::" -~= ;Þ¿eJ7 ':;¡>~ SPECIAL: ~.ue . LOCK BOX: YF.@£2 IF YES, LOCATION: PRIVATE FIRE PROTECTION/W A TER A V.A.ILABILITY A. PRIVATE FIRE PROTECTION: ~ ¡r.-.e.e ex:7'";'^'4'o"/S~ ~ /N ~ :;¡~ B. WATER AVAILABILITY (FIRE HYDRANT): "'~~ ¿J z;ø- ~ .,e=A:5r ~~ p~ 7#s:- ?~~y 3 ( ( ( " e e HAZARDOUS MATEIDALSMANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: S- MATERIAL SAfETY DATA SHEETS ON FILE: Yé6:· BRIEF SUMMARY OF TRAINING PROGRAM: ~4fd"# M-~"e~ 8n7Vi.OVrl!!£ /.:5 ¡¡Ç~/~ ?6 tf?642> ~ PA-~' ~~ ~L.J. R~~~ ~ WøL. ~ .L:! A- ~ Sr~ A4.a.;V~.,a.... . <.:;r;¿,¿,;A,) AA.JiU(j&~ '""'" CERTIFICATION I, ~c..J~zA hi- CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. a~o~~ SIGNATURE TITLE ~~ - ..;< -C) / DATE HAZ MAT MNOMNT PLAN & INSTRUC 4 ~,"'~ I/~'~~ // ,~.:~"..~- '..... _..."'~,- B ERSFI D e e -..-------..---,.- ,--_....--------._---------- CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA/93g01 (661) 326-3979 /// FACILITY INFORMATION f!" ,', //g¿- " Business Activities -rf?2 --./ .-.-._-------"---..._-----------------.- I. FACILITY IDENTIFICATION -------------;-P~PA 10#-·----·--------·-··- 2 ¡ L.------------.-__.__.___..___J 3 ' Page of ( --' - - Does Your Facility... If Yes, Please Complete... A. HAZARDOUS MATERIALS ~S ONO 4 V" OES FORM 2731 (Chemical Description Form) 1. Have on site (for any purpose) hazardous materials at or V" CONSOLIDATED COMPLIANCE PLAN above 55 gallons for liquids, 500 pounds for solids, or 200 Minimum required plannino elements: cu ft for compressed gases (include liquids in ASTs and · Emergency Response Plan ~Thr I · Maps 2. Have any amount of an explosive material (other than ®YES ONO 5 · Training I ammunition) on site? I · Prevention ~ · Certifications REGULATED SUBSTANCES (RS) OYES ®NO 6 V" OES FORM 2731 (Chemical Description Form) I Have onsite RS at greater than the threshold planning V" RISK MANAGEMENT PLAN (RMP Submit to USEPA) quantities established by the California Accidental I V" \ CONSOLIDATED COMPLIANCE PLAN I Release Prevention program (CaIARP)? · Incorporating CalARP Program Elements I (yYES ONO - I ¡C. UNDERGROUND STORAGE TANKS (USTs) 7 V" UST FACILITY FORM , i.1 Own or operate Underground Storage Tanks? V" UST TANK FORM (one per tank) Intend to upgrade existing or install new USTs? OYES f!JNO 8 V" UST FACILITY FORM ¡-- V" UST TANK FORM , I V" UST INSTALLATION FORM (onepertank) I i L__._.. i D. TANK CLOSURE / REMOVAL OYES ONO 9 V" UST TANK FORM (ctosure section-one per tank) I 1. Need to report closing a UST that held hazardous I , materials or waste? i , OYES ONO I I 2. Need to report the closure/ removal of a tank that was 10 V" TANK CLOSURE FORM i I classified as hazardous waste and cleaned onsite? ! r E. OYES ONO ----- ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) 11 V" CONSOLIDATED COMPLIANCE PLAN I Own or operate ASTs above these thresholds: any tank · Incorporating Federal Spill Prevention capacity is greater than 660 gallons or the total capacity Control and Countermeasure (SPCC) I for the facility is greater than 1,320 gallons. Elements pursuant to 40 CFR Part 112 I F. HAZARDOUS WASTE: OYES ~O V" EPA ID number-provide on this page 1. Generate hazardous waste? 12 To obtain EPA ID#, please phone (916) 324-1781 2. Recycle more than 100 kg/mo of recyclable materials at OYES (Y1<Ío 13 V" RECYCLING FORM the same locati()n it was generated? OYES ~O I 3. Recycle more than 100 kg/mo of recyclable materials at 14 V" RECYCLING FORM an offsite location different from the point of generation? 4. Treat Hazardous Waste on site? OYES QN'o 15 V" TP FACILITY FORM (DTSC Form 1772) V" TP UNIT FORM (one per unit) 5. Subject to Financial Assurance requirem~nts? ciYES ONO 16 V" CERTIFICATION OF FINANCIAL ASSURANCE 6. Consolidate Hazardous Waste generated at a remote OYES ~ 17 V" REMOTE WASTE / CONSOLIDATION SITE site? NOTIFICATION FORM -----...--. OŸES ®NO _._-------~_. G. PERMIT CONSOLIDATION lONE: 18 V" CONSOLIDATED COMPLIANCE PLAN Intend to consolidate other Cal/EPA agency permits? . Incorporating all other environmental (If yes, please complete Section III and attach) permit requirements per 27 CCR 10410 JTE: I ./ If you checked YES to·any part of Sections IIA-IIG above, then in addition to the forms requested above, ,please Submit OES Form 2730. - I ___.__________,_.____._,_____ rCILlTY 10 # (For office use only· please leave blank) ¡.._____.._____n_.___.n__._________..__ , DBA/FACILITY NAME I , ' I :S-rOCK.ÞA¿¿- Mßß I J- 1-------··-- ~ I -l I II. ACTIVITIES DECLARATION ( UPCF (7/99) S:ICUPAFORMSIACTIVITY,wpd e e CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 FACILlTV INFORMATION Business Activities Addendum Page of ,----------. I. FACILITY IDENTIFICATION FACILITY ID # (For office use only - please leave blank) I DBA/FACILITY NAME i I EPA ID # 2 .------ 3 ' ~_re;J~~4t...é Mo6/t- l III. CONSOLIDATED PERMIT ACTIVITIES ¡ ! , Is your Facility Compliance Plan subject to review by... j for satisfying the conditions of these permits? i ! i H. DEPARTMENT OF TOXIC SUBSTANCES CONTROL -roVES ~NO II STANDARDIZED PERMIT I I . All Modifications I ! I OVES ONO II Non-RCRA HAZARDOUS WASTE FACILITY I OVES ONO II RCRA HAZARDOUS WASTE FACILlTV II. SAN JOAQUIN VALLEY UNIFIED AIR POLLUTION &YES ONO II AUTHORITV TO CONSTRUCT , CONTROL DISTRICT , ¡ OVES ONO II PERMIT TO OPERATE i OVES ~O , J. STATE WATER RESOURCES CONTROL BOARD II WASTE DISCHARGE REQUIREMENT (WDR) I :NTRAL VALLE V REGIONAL WATER QUALITY CONTROL OVES @No II GENERAL PERMITS I ôOARD j OVES ONO II SPECIFIC PERMITS i I I I . OVES ONO II NATIONAL POLLUTION DISCHARGE I ELIMINATION SVSTEM (NPDES) i TCALlFORNIA INTEGRATED WASTE MANAGEMENT BOARD OVES @NO II REGISTRATION PERMIT I L. KERN COUNTV RESOURCE MANAGEMENT AGENCV ENVIRONMENTAL HEALTH SERVICES PERMITS OVES ®NO II Domestic Water Well Permit OVES ~O II Haz Mat Monitoring Well Permit OVES @NO II Septic System Permit OVES ®NO II Public Swimming Pool Permit OVES øN'o II Food Facility Construction Permit OVES ~O II Solid Waste Local Enforcement Agency (LEA) Related Permits OVES ~O II Medical Waste Related Permits OVES ®NO - --- M. CITV OF BAKERSFIELD WASTE WATER DIVISION II INDUSTRIAL WASTE WATER DISCHARGE PERMIT NOTE: II If you checked VES to any part of Sections III-H to III-M above, then please address all applicable permit requirements in the Facility Compliance Plan. I ( S:\CUPAFORMS\Activlly adondum,wpd Juty I, 1998 tit CITY OF BAKERSFIELD e OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION Page _ Of _ I. FACILITY IDENTIFICATION FACILITY ID # I ill ;-- BUSINESSNAME (same' as FACILITY NAMÈ or DBA· Doing BUSin~) __ ____.;f"D::'è/" ~A / $---.M L'9Æ /,t..- SITE ADDRESS /3LJ/ ~7Þ~¿é PÍ~4Y : CITY 2:;)A/¿;,e.~//~ ~ Year Beginning 100 i Year Ending ----1 3 I BUSINESS PHONE ---_____________~_" ~~ª¡:ß_~JJ_2_L.L_ 101 102 ----- 103 i DUN& ¡BRADSTREET , 1;GA ¡ ZIP 93307 i 106 [SIC CODE , (4 Digit #) 105 i ! i 107 i ~ÆAI / i OPERATOR NAME $ '7?:/.oÆ!..-rS PE7ïeOt.e'v/V? 'II: OWNER INFORMATION OPERATOR PHONE :32.5"- ~ :3z.ð i I 108 : 110 ¡ , , . ¡ COUNTY c:r TV.¿2L. r...s .PÆ7"~LeU~ I 111 I OWNER PHONE .:::1 :zs- ~ ~ zo , I 112 ¡ , I i ; OWNER NAME i OWNER MAILING ¡ ADDRESS / / Æ. ¿:. r¿./ I /' i( Z>~~.c-'/¿L;Z> ~. '"","'--'" ,.".,.'" : ',': ' ._. ' ":~"H_,,,, . '. -\~..~.: ':'. ' ! '., ...._,;.1,.:._._', ,," $r. 113 ' I 114 I'STATE (l/i 115 I ZIP 933ð7 116 ¡ -l - -} . '. III.. ENYIRqNMENT At.. CONT ÂCT ~C>#N L- 5rvA¿::r J 117 f CONTACT PHONE .:3~ 5- 6~o~~_' CONTACT NAME i ¡ CONTACT MAILING ! ADDRESS // 119 ' é. ¢ ~ .57. I 120 I STATE G..4 121 ZIP ?":!3 -=a eJ 7 ~ ,'. . ' '. .-SECONDARY. . ! CITY i I .. . . , 122 , I I I I 129 : I 130 I '7!iJ,¡q K£ £..5" ,r ~ G L- .è:> ·PRIMARY -: " I NAME JoHN Â. r-- L TITLE /l>RE" S . , J BUSINESS PHONE ~c:. / - 3~.5 -6 i5 "Z.e> , i 24-HOUR PHONE ! , ..j...., IV'; "EM,ERGENCY CONTACTS .5'77J¿!)R ..,.. I 123 NAME 125 TITLE "'/¿'r/ AI .A/ S r¿J-a£ -r . t/-P~. BUSINESS PHONE tIt ¿ / - 3-75 6:7 ~~ 24-HOURPHONE 66/- .30/ 3079 , i 126 PAGER # J9S-- K'9z.. 128 i PAGER # 131 i , 132 I 133 I I 127 , ' "V. CERTIFICATION , II 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 a . iar with t . rmation submitted in this inventory and believe the information is true. accurate. and complete. r- SIG ATUR OF 0 NERI PERATOR DATE 134 NAME OF DOCUMENT PREPARER 135 II i ~ ./- "30-<0/ ~cðA/ ~¿J- !NAMES OF ÒWNERlOPERATOR (print) 136 TITLE OF OWNERlOPERATOR"----------- ~ I ( .." \ ~~._._._________ ___'_______ ________________________.___ .-J UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd e CITYOFBAKERSFIELDe OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION DNEW 200 DADD D DELETE D REVISE r---'--'---'- --..------.------.-----. I _ f BUSINESS NAME (Same as FACILITY NAME or DBA.. Doing Business As) (one (orm per material per bui'ding or area) Page of ------~-_._----_._-_.-_.-------. 3 I. FACILITY INFORMATION 2ô5fTRADE SECRET' 0 Yes 0 No 206 I If Subject to EPCRA, refer 10 instructions L_____~L£.. fr'1([!)J'ðJ'-- , , j CHEMICAL LOCATION .;s TC~¿¿;; I !FACILlTY ID #1 ,- 2011 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 203 GRID # (optional) - ~ i , ! CHEMICAL NAME II. CHEMICAL INFORMATION .------------ I I i COMMON NAME i i I CAS# I FIRE CODE HAZARD CLASSES (Complete if requested by loè:al fire chief) L ì TYPE I I PHYSICAL STATE , , ,-- i FED HAZARD CATEGORIES I Ir''!Ck all that apply) ¡( AL WASTE i À".vUNT I ! 207 c;;..4 s: OL/µ,£ EHS' Dyes 0 No 202 204 o Yes 0 No 208 209 , .i -If EHS is"Ves," all amounts below must be in Ibs. I I I i ~' MIXTURE oNo o p PURÈ o w WASTE DYes 211 RADIOACTIVE o s SOLID ~aUID 214 LARGEST CONTAINER DgGAS 210 212 I CURIES 213 215 uK FIRE o 5 CHRONIC HEALTH 216 o 2 REACTIVE o 3 PRESSURE RELEASE o 4 ACUTE HEALTH 217 MAXIMUM DAILY AMOUNT 218 AVERAGE DAILY AMOUNT UNITS' æ--g; GAL 0 d CU FT . If EHS, amount must be in Ibs. o Ib LBS o tn TONS 223 STORAGE CONTAINER (Check all that apply) o a ABOVEGROUND TANK ~UNDERGROUNDTANK Dc TANK INSIDE BUILDING o d STEEL DRUM De PLASTIC/NONMETALLIC DRUM Of CAN o g CARBOY o h SILO o i FIBER DRUM OJ BAG Ok BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON STORAGE PRESSURE ~AMBIENT ~MBIENT o ba BELOW AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT STORAGE TEMPERATURE o aa ABOVE AMBIENT 219 STATE WASTE CODE 220 221 DAYS ON SITE 222 o q RAIL CAR o r OTHER I I I I 224 I --:l . .. " . .' I~·'. . :, HAZARDOUS COMPONENT '. EHS " o c CRYOGENIC CÄS#, :%m R " 226 230 1--_ ---..-- I-~-- ----- ---- 234 l~ 238 5 242 . . 227 Dyes 0 No 228 , t:::7.d $ð.L/;IAØC ~~~j 0 Yes _~~0~32 , ' =iili-- ~5 _DYeso~~ ---- 239 0 Yes 0 No 240 ---~----- 2:...1 0 Yes 0 No 244 POlf\T NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE I ¡( G~N'-o~ L._______.___ ________ ~--_._. 229 233 ¡ ------1 I 237 i I I , 241 ' i 245 I D""~ I /- ~ð 4:)/ I UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd i e e Hazardous Materials Inventory· Chemical Description ( You must complete a separate Hazardous Materials Inventory· Chemical Description page for each hazardous material (hazardous substances and hazardous waste) that you handle at your facility in aggregate, quantities equal to or greater than 500 pounds. 55 gallons. 200 cubic feet of gas (calculated at standard temperature and pressure) or the federal threshold plannIng quantIty for Extremely Hazardous Substances. whichever is less. Also complete a page for each radioactive material handled over quantities for which an emergency plan is required to be adopted pursuant to 10 CFR Parts 30, 40, or 70, The completed inventory should reflect all reportable quantltJes of hazardous materials at your facility, reported separately for each building or outside adjacent area, with .aparata pages for unique occurrences of physical state. storage temperature and storage pressure, (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR. Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or AA identify whether the submittal ;s complete and if any pages are separaled. 1, FACILITY ID NUMBER· This number is assigned by the CUPA or AA, This is the unique number which identifies your facility. 3. BUSINESS NAME· Enter the full legal name of the business. 200, ADD/DELETE! REVISE - Indicate if the material is being added to the inventory. deleted from the inventory. or if the Information previously submitted is being revised. NOTE: You may choose to leave this blank if you resubmit your entire inventory annually. 201. CHEMICAL LOCATION· Enter the building or outside! adjacent area where the hazardous material is handled, A chemical that is stored at the same pressure and temperature. in multiple locations within a building. can be reported on a single page. NOTE: This information is not subject to public disclosure pursuant to HSC §25506. 202. CHEMICAL LOCATION CONFIDENTIAL - EPCRA - All businesses which are subject to the Emergency Planning and Community Right to Know Act (EPCRA) must check 'Yes' to keep chemical location information confidential. If the business does not wish to keep chemical location information confidential check 'No'. 203, MAP NUMBER· If a map is included, enter the number of the map on which the location of the hazardous material is shown. 204. GRID NUMBER - If grid coordinates are used, enter the grid coordinates of the map that correspond to the location of the hazardous material. If applicable. multiple grid coordinates can be listed, 205, CHEMICAL NAME· Enter the proper chemical name associated with the Chemical Abstract SelVica (CAS) number of the hazardous material. This should be the Intemational Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mix1ure. do not complete this field; complete the 'COMMON NAME' field instead. 206. TRADE SECRET - Check "Yes' if the information in this section is declared a trade secret. or "No' if it is not State requirement If yes, and business is not subject to EPCRA, disclosure of tha designated trade secret information is bound by HSC §25511. Federal requirement: If yes. and business is ~ubject to EPCRA, disclosure of the designated Trade Secret information is bound by 40 CFR and the business must submit a 'Substantiation to Accompany Claims ofTra<le Secrecy" form (40 CFR 350.27) to USEPA. 207. .cOMMON NAME - Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. 208. EHS . Check "Yes' if the hazardous material is an Extremely Hazardous Substance (EHS). as defined in 40 CFR. Part 355, AppandixA If the material is a mixture containing an EHS. leave this section blank and complete the section on hazardous components below. 209, CAS # - Enter the Chemical Abstract Service (CAS) number for the hazardous malerial. For mixtures. enter the CAS number of the mixture if it has been assigned a number distinct from its components. If the mixture has no CAS number. leave this column blank and report the CAS numbers of the individual hazardous components in the appropriate section below, 210. FIRE CODE HAZARQ CLASSES - Fire Code Hazard Classes describe to first responders the type and level of hazardous materials which a business handles. This information shall only be provided if the local fire chief deems it necessary and requests the CUPA or AA to collect it. A list of the hazard classes and instructions on how to determine which class a material falls under are included in the appandices of Article 80 of the Uniform Fire Code. If a material has more than one applicable hazard class. Include all. Contect CUPA or AA for guidance. 211. HAZARDOUS MATERIAL TYPE - Check the one box that best describes the type of hazardous material: pure. mixture or waste. If wastè material. check only that box. If mixture or waste, complete hazardous components section. 212. RADIOACTIVE - Check "Yes' if the hazardous material is radioactive or 'No' if it is not 213. CURIES· If the hazardous material is radioactive. use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. 214. PHYSICAL STATE - Check the one box that best describes the state in which the hazardous material is handled: solid. liquid or gas. 215. LARGEST CONTAINER - Enter the totel capacity of the largest container in which the material is stored. 216. FEDERAL HAZARD CATEGORIES· Check all cat ories that describe the lcal and health hazards associated with the hazardous material. PHYSICAl HAZARDS HEALTH HAZARDS Fire: Flammable Li uids and Solids. Combustible L' uids. ro horics. Oxidizers Acute Health (immediate): Highly Toxic, Toxic, Irritants. Sensitizers, Corrosives. ReactIve: Unstable Reactive, 0 anic Peroxides, Water Reactive. Radioactive other hazardous chemicals with an adverse effect with short term ex ure Pressure Release: Explosives. Compressed Gases. Blasting Agents Chronic Health (Delayed): Carcinogens, other hazardous chemicals with an adverse effect with 10 term ex sure 217. AVERAGE DAILY AMOUNT - Calculate the average daily amount of the hazardous material or mixture containing a hazardous material, in each building or adjacent! outside area. Calculations shall be based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the number of days the chemical will be on site, If this is a material that has not previously been present at this locatJon. the amount shall be the average daily amount you project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. 218. MAXIMUM DAILY AMOUNT - Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacent/outside area at anyone time over the course of the year. This amoùnt must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions. deletJons, or revisions projected for the current year. This amount should be conaistent with the units reported in box 221. 219. ANNUAL WASTE AMOUNT - If the hazardous material being inventoried Is a waste, provide an estimate of the annual amount handled. 220, STATE WASTE CODE ·If the hazardous material is a waste. enter the appropriate Califomia 3-digit hazardous waste code as listed on the back ofthe Uniform Hazardous Waste Manifest. 221. UNITS· Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS. report the units that the material is stored in (gallons. pounds, cubic feet. or tons). 222. DAYS ON SITE - List the total number of days during the year that the material is on site. 223. STORAGE CONTAINER· Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one. 224, STORAGE PRESSURE - Check the one box that best describes the pressure at which the hazardous material is stored. 225, STORAGE TEMPERATURE· Check the one box that best describes the temperature at which the hazardous material is stored. 226. HAZARDOUS COMPONENTS 1-5 (% BY WEIGHT) . Enter the percentage weight of the hazardous component in a mixture. If a range of percentages is available, report the highest percentage in that range. (Report for components 2 through 5 In 230. 234. 238. and 242.) 227. HAZARDOUS COMPONENTS 1·5 NAME· When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that mixture by percent weight (refer to MSDS or. in the case of trade secrets, refer to manufacturer), All hazardous components in the mixture present at greater than 1 % by weight if non-carcinogenic. or 0.1 % by weight if carcinogenic, should be reported. If more than five hazardous components are present above these percentages. you may attach an additional sheet of papar to capture the required information. When reporting \'Vaste mixtures, mineral and chemical composltJon should be listed, (Report for components 2 through 5 in 231, 235. 239, and 243,) 228, HAZARDOUS COMPONENTS 1-5 EHS . Check "Yes' if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355. or "No' iU is not. (Report for components 2 through 5 in 232. 238, 240. and 244.) 229. HAZARDOUS COMPONENTS 1-5 CAS· List the Chemical Abstract SelVice (CAS) numbers as related to the hazardous components in the mixture. (Repeat for 2-5.) 246. LOCALLY COLLECTED INFORMATION· This space may be used by the CUPA or AA to collect any additional information necessary to meet the requirements of their individual programs. Contact the CUPA or AA for guidance. , 'I ( UPCF (1/99) 7 OES Fonn 2731 ... :-j". ..5~ H'o/ß~L- :??~,~ ~ PM MTl\TI P1:l'.RKE'l #~:,,:w63-- _ S~ Hø-6¿L-- Manager : 7.3"êA2.7/..v.a. /SAliJéC-C.-- Location: 13001 STOCKDALE HWY City BAKERSFIELD - SiteID: 015-021-000152 BusPhone: Map : 122 Grid: 02B (661) 323-2832 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 EPA Numb: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact / Title Emergency Contact / Title BERTINA ISABELL / FACILITY MGR IHSSAN YASSIN / FIELD SUPER Business Phone: (661) 589-3733x Business Phone: (310) 456-8494x 24-Hour Phone : (661) 587-9695x 24-Hour Phone : (805) 701-2796xCELL Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact: ~ Phone: (310) 456-8494x State: CA ~~~~Addr~. .._ ? Zip : 90622-5077 Owner LLO GAS INC Phone: (310) 456-8494x Address : 23805 STUART RANCH 220 State: CA City : MALIBU Zip : 90265 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: F Hazmat Inventory One Unified List ì p== As Designated Order All Materials at Site ì Hazmat Common Name.. . SpecHaz EPA Hazards DailyMax MCP GASOLINE MIDGRADE UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE ~ UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE ~ UNLEADED F IH DH L 10000.00 GAL Mod CARBON DIOXIDE F P IH G 448.00 FT3 Min GASOLINE AR06" SUPER UNLEADED F IH DH L 10000.00 GAL Mod -@;v ~~Ó?Gl' Do hereby certi4., that I have (Type or pnnt name) I Y reviewed the attached hazardous materials manage- ment plan for~L;t:£ . H~"-and that it along with (Name of BuslnGss) any corrections constitute a complete and co:-rect man- ~ ..... ""'. 10/11/2000 /Ó??-~ Date S~~e."7:>.aL£ M~,<::.....- .ZO~ ~ F .. ];'pIl nun Ill'Æ.l>'.tiT #u¿ó6"3 p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME GASOLINE MIDGRADE UNLEADED e SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT 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. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMI CAL NAME GASOLINE~ UNLEADED Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ----r TEM~ERATURE I CONTAINER TYPE =Llquld __pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -2- 10/11/2000 · .:s 7oC.~7>/K£. Mð8 /L- 't-ó (p "3 F ~ M PM MUTT Þ4A R T{IiI'P ;ij n ? lì.G J- p= Inventory Item 0003 ¡::::::= COMMON NAME / CHEMICAL NAME GASOLINE ~ UNLEADED e SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit E SIDE OF LOT Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ~ TEM~ERATURE -, =Llquld ____pure ~mblent ---1 Amblent ~ AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL Daily Average 5000.00 GAL %wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0004 = COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit STORAGE AREA OF FACILITY Map: Grid: CAS # 124-38-9 STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 224.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 %Wt. RS CAS # 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No , No/ Curies F P IH / / / Min HAZARD ASSESSMENTS -3- 10/11/2000 e S""T~"'þAt...E.- H~ð /"- p.·1U~ PÞ1 nnn fi~l\.J::!d :¡:¡:~;,Wh3 p= Inventory Item 0005 F= COMMON NAME / CHEMICAL NAME GASOLINE ARCØ SUPER UNLEADED e SiteID: 015-021-000152 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit E SIDE OF LOT Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE --r TEM~ERATURE -I =Llquld __pure ~mblent ---1 Amblent ~ AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL Daily Average 4000.00 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 -4- 10/11/2000 e e F AM PM MINI MARKET #82063 I p= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-000152 9 Fast Format 9 Overall Site 9 03/13/1998 FIRE - 911 POLICE - 911 FIELD SUPERVISOR TO NOTIFY - PSI CORPORATE OFFICE, MAINTENANCE, OES, EPA AND NATIONAL RESPONSE CENTER. Employee Notif./Evacuation 09/16/1996 FOR ANY EMERGENCY CALL 911 AND REPORT. EVACUATE IF NECESSARY TO A SITE OPPOSITE DANGER AREA. CALL YOUR FIELD SUPERVISOR GIVE DETAILS OF EMERGENCY. YOUR FIELD SUPERVISOR WILL NOTIFY ATLANTIC RICHFIELD MAINTENANCE AREA MANAGER AND MAIN OFFICE. I Public Notif./Evacuation . ALARM SHALL BE GIVEN BY SHOUTING. I CALL Emergency Medical Plan . 911 AND REPORT - PARAMEDICS WILL RESPOND. 09/16/19961 09/16/19961 -5- 10/11/2000 e e F AM PM MINI MARKET #82063 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 10/04/1990 FACILITIES ARE EQUIPPED WITH RED JACKET LEAK DETECTORS WHICH SHUTS DOWN IF LEAK OCCURS. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE" AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. Release Containment 02/22/2000 FOR MINOR SPILLAGE (IE CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEANUP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE" AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT AND OTHER MATERIAL. Clean Up 02/22/2000 CLEANUP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE AND DISPOSAL COMPANY IF NECESSARY. Other Resource Activation -6- 10/11/2000 .; .. '. t e e F AM PM MINI MARKET #82063 I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 015-021-000152 ì Fast Format ì Overall Site ì I 03/13/1998 A) GAS - NONE B) ELECTRICAL - S SIDE OF BLDG IN OFFICE AND STORAGE AREA C) WATER - N SIDE OF SITE OFF STOCKDALE D) SPECIAL - EMERGENCY FUEL PUMP SHUT-OFF SWITCH IS LOCATED IN THE SALES AREA NEAR THE CASHIER E) LOCK BOX - NO Fire Protec./Avail. Water 03/13/1998 PRIVATE FIRE PROTECTION - NONE'. NEAREST FIRE HYDRANT - LOCATED AT NE CORNER OF STOCKDALE AND ALLEN. Building Occupancy Level 05/30/1991 1 I B-2 -7- 10/11/2000 ~ ~ - .~ . e F AM PM MINI MARKET #82063 I p= Training Employee Training SiteID: 015-021-000152 ì Fast Format ì Overall Site ì 02/22/2000 WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE AT THIS FACILITY. BRIEF SUMMARY OF TRAINING PROGRAM: FOR MINOR SPILLAGE (IE CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY, PROTECTIVE RUBBER GLOVES AND CLEAN UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR MAJOR SPILLAGE, EMPLOYEES ARE INSTRUCTED TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY COORDINATOR OR HIS ALTERNATE WHO WILL THEN ACTIVATE THE NOTIFICATION PROCEDURES. USE AND LOCATION OF ABSORBANT, PROTECTIVE CLEANUP EQUIPMENT AND FIRE EXTINGUISHERS. ANNUAL INSPECTION AND MAINTENANCE OF SAFETY EQUIPMENT (FIRE EXTINGUISHERS, RUBBER GLOVES AND CLEAN UP EQUIPMENT), AND REVIEW OF PROCEDURES FOR PROPER USE OF SAFETY AND SPILL CONTROL EQUIPMENT. REVIEW OF EMERGENCY RESPONSE PLAN; EVACUATION PROCEDURES; LOCATION OF EMERGENCY FUEL SHUT-OFF SWITCHES AND MAIN ELECTRICAL SHUTOFF SWITCH; USE AND LOCATION OF ABSORBANT, PROTECTIVE CLEAN UP EQUIPMENT AND FIRE EXTINGUISHERS; AND THE LIST OF ALL PERTINENT PEOPLE TO CALL IN CASE OF AN EMERGENCY. MAKE SURE EMPLOYEES KNOW THE LOCATION OF THE Page 2 [ I I Held for Future Use Held for Future Use -8- 10/11/2000