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PER UNIT
- MARKDOWN
REGULAR MARKDOWN AMOUNT
QUA1~TITY
TOTAL
MARKDOWN
NOTE - RECORD ON THIS REPORT ALL
BE FILLED OUT AS FOLLOWS:
a) EMPLOYEE'S NAME, IF SALE TO
b) NAME OF WHOLESALE CUSTOMER,
c) WRITE IN "AD SPECIAL" IF AD
EMPLOYEE
IF WHOLESALE SALE
SALE
D
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SALES
OF MERCHANDISE AT OTHER THAN REGULAR RETAIL PRICE
INDY AUTO STORES, INC
DAILY MARKDO\.JN REPORT
STORE NO DATE
THE CUSTOMER COLUMN MUST
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RETAIL PRICE,
SALES
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IF WHOLESALE SALE
SALE
NOTE - RECORD ON THIS REPORT ALL
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b) NAME OF WHOLESALE CUSTOMER,
c) WRITE IN "AD SPECIAL" IF AD
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AMOUNT QUAl~TITY
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09/29/95
INDY AUTO STORES INC 215-000-001335
Overall Site with 1 Fac. Unit
Page
1
General Information
Location: 1661 UNION AV Map:103 Haz:2 Type: 3
City . BAKERSFIELD Grid: 29C F/U: 1 AOV: 0.0
.
- Contact Name Title ,...-- Contact Name Title
~ JONES/l1;",-udd, / MANAGER AL PINEDA / ASSISTANT MANAG
Business Phone: (805) 327-9968x Business Phone: (805) 327-9968x
24-Hour Phone . (805) 3 ø P :.219 Sx 3ZJ IfY1 24-Hour Phone . (805) 3~5 §§Q.2~ 31.11z2 'I
. .
Pager Phone : ( ) - x Pager Phone : ( ) - x
Administrative Data
Mail Addrs: 1661 UNION AV D&B Number:
City: BAKERSFIELD State: CA Zip: 93305-
Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code:
OWner: INDY AUTO STORES INC Phone: (209) 674-0439
Address: 1025 S MADERA State: CA
City: MADERA Zip: 93637-
Ñdr~Jd b1ttwiv.EÅtrUL '
=to ~~(j ( i OLnuL Úl~d . .
to' 3D-QS pu ~~~oJ.t, ~~~ ~á-~.
-
I, ~",0ti:! Do hereby certify that 1 have
reviewed the attached hazardous materials manage-
ment plan forJv..JJftJ and that it along with
~ . Bullneaa)
any corrections constitute a complete and correct man-
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09/29/95
INDY AUTO STORES INC 215-000-001335
Hazmat Inventory List in MCP Order
Page
2
02 - Fixed Containers on Site
PIn-Ref Name/Hazards Form Max Qty MCP
02-002 ANTIFREEZE Liquid 500 Low
~ Fire GAL
02-001 MOTOR OIL Liquid 6000 Minimal
~ Fire, Delay Hlth GAL
.. ..
--
-
09/29/95
INDY AUTO STORES INC 215-000-001335
02 - Fixed Containers on Site
Page
3
Hazmat Inventory Detail in MCP Order
02-002 ANTIFREEZE
~ Fire
Liquid
500 Low
GAL
CAS #:
Trade Secret: No
Form: Liquid
Type: Pure
Days: 365 Use: COOLANT/ANTIFREEZE
,"
Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL --
500 I 200.00 I 500.00
Storage r Press T Temp -I Location
PLASTIC CONTAINER Below Below SHOWROOM AND BACK ROOM
- Conc l Components fi: MCP iUide
100.0% Ethylene Glycol Low 27
02-001 MOTOR OIL Liquid 6000 Minimal
~ Fire, Delay Hlth GAL
CAS #: Trade Secret: No
Form: Liquid
Type: Pure
Days: 365 Use: OTHER
Daily Max GAL ----r--Daily Average GAL --r-- Annual Amount GAL --
6,000 I ' 3,000.00 I 6,000.00
Storage
PLASTIC CONTAINER
r Press T Temp l Location
Below Below SHOWROOM AND BACKROOM
- Conc l Components
100.0% Motor Oil, Petroleum Based
r; MCP --p;uide
Minimal I 27
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09/29/95
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
4
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
WE WOULD CALL OUR CORPORATE OFFICE THEN LEAVE THE STORE.
<3> Public Notif./Evacuation
COVERED WITH EMPLOYEES, MAPS DRAWN AND ON DISPLAN IN THE STORE. EXITS SIGNS
<4> Emergency Medical Plan
NEAREST HOSPITAL.
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09/29/95
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
5
<E> MitigatiQn/Prevent/Abatemt
<1> Release Prevention
ALL OF OUR HAZARDOUS MATERIALS ARE IN CASES.
<2> Release Containment
IF ONE LEAKS IT IS TAKEN OUT AND SENT BACK TO OUR WAREHOUSING.
<3> Clean Up
WE USE DRY SWEEP TO CLEAN THE REST.
<4> Other Resource Activation
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-
09/29/95
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
6
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - RIGHT REAR OF THE STORE
B) ELECTRICAL - RIGHT REAR OF THE STORE
C) WATER - RIGHT REAR OF THE STORE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FOUR FIRE EXTINGUISHER FOR FIRE PROTECTION
FIRE HYDRANT - FRONT AND REAR OF STORE
<4> Building Occupancy Level
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09/29/95
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
7
<G>,Training
<1> Employee Training
WE HAVE 5 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
SUMMARY - COVERED OIL SPILL AND ANTIFREEZE SPILL, HOW TO CLEAN UP AND
DISGARD, AND PEOPLE TO INFORM
<2> Page 2
.:.....
<3> Held for Future Use
<4> Held for Future Use
.:.....
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4/21/92 INDY AUTO STORES INC 215-000-001 ~~(Ç~U\#~~'age 1
Overall Site with 1 Fac. Unit
General Information .' MAY 1 8 1992 í
U'
cy",---
Location: 1661 UNION AV Map: 103 Hazard: .~
Community: BAKERSFIELD STATION 02 Grid: 29C , FlU: 1 AOV: 0.0
- Contact Name Title Business Phone - 24-Hour Phone
PETE JONES MANAGER (805)327-9968 x (805) 589-2198
~~~ AL PINE A ASST. MANAGER (805) 327-9968 x (805) ~ti~
J¿.J JJV¿'
Administrative Data
Mail Addrs: 1661 UNION AV D&B Number:.
City: BAKERSFIELD State: CA Zip: 93305-
Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code:
Owner: INDY AUTO STORES INC Phone: (209 ):674:~ 0439
Address: ~ 1025 S. MADERA State: CA
City: ~ MADERA Zip: 93637-
Summary
Jim Farr
(Type or print_
_--~viewed the attached hazardous matettals manage-
..
Do hereby certtfy that I have
ment plan for Tnc1J'.n, Auto Store~nd that it along with
( e of Business) '.
any corrections constitute a complete and correct man-
agement plan for my faciUty.
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04/21/92
INDY AUTO STORES INC 215-000-001335
02 - Fixed Containers on Site
Page
2
Hazmat Inventory Detail in Reference Number Order
02-001 MOTOR OIL
. Fire, Delay Hlth
Liquid
6000 Minimal
GAL
CAS #:
Trade Secret: No
Form: Liquid
Type: Pure
Days: 365 Use: OTHER
Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL --
6,000 I 3,000.00 I . 6,000.00
Storage
PLASTIC CONTAINER
r Press T Temp l Location
Below Below SHOWROOM AND BACKROOM
- Conc -, Components
100.0% Motor Oil, Pet+oleum Based
r; MCP -:-TList
Minimal I
02-002 ANTIFREEZE
. Fire
Liquid
500 Low
GAL
CAS #:
Trade Secret: No
Form: Liquid
Type: Pure
Days: 365 Use: COOLANT/ANTIFREEZE
Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL --
500 I 200.00 I 500.00
Storage
PLASTIC CONTAINER
r Press T Temp l Location
Below Below SHOWROOM AND BACKROOM
- Conc l
100.0% Ethylene Glycol
Components
r=:- MCP --rLi s t
¡Low I
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04/21/92
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
3
<D> Notif./Evacuation/Medical
<1> Agency Notification
CA-H
q f \
<2> Employee Notif./Evacuation
WE WOULD CALL OUR CORPORATE OFFICE THEN LEAVE THE STORE.
<3> Public Notif./Evacuation
COVERED WITH EMPLOYEES, MAPS DRAWN AND ON DISPLAN IN THE STORE. EXITS SIGNS
<4> Emergency Medical Plan
NEAREST HOSPITAL.
· ~
e
e
04/21/92
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
4
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL OF OUR HAZARDOUS MATERIALS ARE IN CASES.
<2> Release Containment
IF ONE LEAKS IT IS TANKEN OUT AND SENT BACK TO OUR WAREHOUSING
<3> Clean Up
WE USE DRY SWEEP TO CLEAN THE REST
<4> Other Resource Activation
\
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e
,;.
04/21/92
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
5
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
'A) GAS - RIGHT REAR OF THE STORE
B) ELECTRICAL - RIGHT REAR OF THE STORE
C) WATER - RIGHT REAR OF THE STORE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FOUR FIRE EXTINGUISHER FOR FIRE PROTECTION
FIRE HYDRANT - FRONT AND REAR OF STORE
<4> Building Occupancy Level
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04/21/92
INDY AUTO STORES INC 215-000-001335
00 - Overall Site
Page
6
<G> Training
<1> Page 1
WE HAVE 5 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
SUMMARY - COVERED OIL SPILL AND ANTIFREEZE SPILL, HOW TO CLEAN UP AND
DISGARD, AND PEOPLE TO INFORM
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for Future Use
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?' @RECEIVEO
JAN 30 1989
Ans'd........... .
CITY of Brl}(ERSFIELD
"HE C-IRE"
Pete Jones
or
namei
Do he::-eby certif~,- that I ha-\-e revieh-ed the
RECEIVED
JAN 1 9 1989
ADS'd.
...........
att~ched Hazardbus Materials business plan
for
Indy Auto Stores, Inc.
(name o~ business)
and that it alopg with the attached additions
c::- corrections constitute a complete and correct
Business Plan for my facility.
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INDY AUTO STORES INC
ì G¡:J 1 UNION Fill
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10 NUMBER 215-000-001335
HIGH HAZARD RATING Z
1. OVERVIElJ
LAST CHANGE 11/04/88 BY VAL
JURIS CODE 215-00Z JURIS BAKERSFIELD STATION 02
MAP PAGE 103 GRID Z9C FACILITY UNITS 1 HAZARD RATING Z
RESPONSE SUMMARY
ZA SEC 4} NO PRIVATE RESPONSE TEAM.
EMERGENCY CONTACTS ZA SEC 2>
PETE JONES - 327-9968 OR 5B9-2Y98
TODD ROBINSON - 327-9968 OR ahð Z9CrG 833 - 9;2 5';;;-
UTILITY SHUTOFFS ZA SEC 3)
A) GAS - RIGHT REAR OF THE STORE B) ELECTRIC - RIGHT REAR OF THE STORE
C> WATER - RIGHT REAR OF THE STORE Q) SPECIAL ~ NONE E) LOCI< BOX - NO
Z. NOTIFICATION 1 PUBLIC EVACUATION
LAST CHANGE J 12 /'ili BY
c.""'érd lV',·\\-, 4£.v>lf\\)1.s:.<Q.~1 (V1~.p's ()fA-\<J¡J AIUJ ON C\,s p\A\.t
5 {...o If' '-" 't.. ';( +\ j ¡' <ð N.ttJ .
< NO INFORMATION RECORDED FOR THIS SECTION >
.
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MATERIfiL SAFETY DATA SYSTEMS" INC. (805) 648-68Ø'J
12/23/88 10:27
PAGE
~
,¡~HJ!;II\!ESS Nf-iME II\jOY :a STORE~¡ II\IC
LOCATION 1661 UNION AV
10 NleR :: 15-li)Ø0-Çj01335
HIGH HAZARD RATING Z
J. HAL MAT TRAINING SUMMARY
l..¢ v ..c:L vJ 0 ~ L
~ Oìbc":-9 V'~
Spill
A""..!
UiST CHANGE , I;)... ,'8<-1 BY
~ Å rv .... \ f f'"Q..Q.. ~ ~ P j \\ I ~ W
()~.p I..r.. To "[:N\=O...H"""-
+0 c.. \....a." N '-' P
< NO INFORMATION RECORDED FOR THIS SECTION>
4. LOCAL EMERGENCY MEDICAL ASSISTANCE
LAST CHANGE 11/04/88 BY VAL
ZA SEC 5> NEAREST HOSPITAL.
. .
PAGE Z
12123/88 10:Z7
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 64B-6800
~, i;
"8U~) HiE '.:~.; Nfmr:
LOCATION
FACILITY UNIT
INDY HI STOHES
165 j UNION rw
Øi
INC
IIJ NU.R ?15-ØØØ-<ð01335
HIGH HAZARD RATING Z
A. OVERALL HAZARDOUS MATERIALS INVENTORY
Lf~ST CHHNGE ¡ /04/88 BY VAL
IO
TYPE NAME
lOCATI ON
CONTAINMENT
MAX AMT UNIT HAZARD
USE
PURE MOTOR OIL 750 GAL UNKNOWN
N CORNER STOCKROOM PLASTIC CONTAINER[SJ COOLING
10 PERCENT COMPONENTS HAZARD LIST
Z808.ØØ 100.0 MOTOR OIL UNKNOWN
Z PURE ANTIFREEZE 500 GAL UNKNOWN
SHOWROOM PRONT PLASTIC CONTAINER£SJ COOLING
ID PERCENT COMPONENTS HAZARD LI ST
Z802.00 100.0 ETHYLENE GLYCOL UNKNOWN
B. FIRE PROTECTION / WATER SUPPLIES
LAST CHANGE 11/04/88 BY VAL
3A SEC 4) FOUR FIRE EXTINGUISHER FOR FIRE PROTECTION.
3A SEC 5) FIRE HYDRANT FRONT & REAR LOCATION OF STORE.
'PAGE J
, 2123/88 10: Z7
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-680Ø
. .~"mJ~;INES~'; ¡'>JANE II'>JDY fa STOF{ES INC
... '..r
~ LOCATION 1661 UNION AV
10 h!l.:R í' ¡ ~:;-(j¡ØØ-(ö(i)1335
HIGH HAZARD RATING Z
D. EMPLOYEE NOTIFICATION / EVACUATION
lf1ST CHANGE 11/04/88 BY VAL
3A SEC 2) WE WOULD CALL OUR CORPORATE OFF! C£ THEN LEAVE THE STORE.
"""'r_. _. _. ........ _. __"'I~ ~",""".:.. .-"". +__
, :':."'.~,.;> E. MITIGATION / PREVENTION / ABATEMENT
;-'~ ....
lAST CHANGE 11/04/88 BY VAL
. . .".~'
'..
3A s'Eé';;~'t;')'AlL OF OUR HAZARDOUS MATERIALS ARE IN CASES. IF ONE LEAKS IT IS
, ..,"" TAKEN OUT AND SENT BACK TO OUR WAREHOUSING. WE THEN USE DRY SWEEP
. ..~.:~- :"~~.t.".
TO CLE~N THE REST.
. '. ...~.'
,'~ '
'.
PAGE 4
rZlZ3f88' 10: Z7
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 548-6800
CIT}T of BAKERSFIELD
.--, St"ndard Bus;ness '9 HAZARDOUS MATERIALS INVENTORY
Far. and Aqricu !ture L..-J
NON-TRADE SECRETS , P"ge __\_ of u_\
BUSINESS NAME: .µ, .~u+o OWNER NAME :Co.p~·(M~ 0;:';""-< NAME OF Tn1Š ~~JL~TY:
LOCATION: I bj -
-U. ¡J ADDRESS, 8....~ S~^'r STANDARD IND, CLASS CODE
CITY, ZIP:-ßA ~ \ I~ C i\ \ \ ~ c.: i.95 r"H3'S'~ DUN AND BRADSTREET NUMBER
PHONE II: g>o~ .2La '~ '" ? CITY. ZIP: C-. ¡ g ~,.v v....u:{ - -
- PHONE .: &' - 9.0 I - - - -- - - --
RÐ!D 2'0 IIIS'I7lUcrIOIIS roR PROPD CODIIS
-
1 2 . 5 5 , I t 10 II n 1] It
Irans Tyøe Aver. Annual IIMsu... IOys Cant Cant . Cant Un locat1an ....... 'by __ of lIixture/Colloanlntt
Cod. Cod. Aat Est Units an SIt. ' Type Prest T ..., Code Stlll'ecl In FICtl1ty lit SIt IMtructi_
--ª-~C~_~~~ ~ /ße<-~ßaa~ _J~ ?--~£.~~lV~ (
Ph~icll "'"' HtI lth Hiz.rcI CoIIoanInt 1\ .... C,A.S. ...... __1Y.._~~_L_
ICheck 111 that .pply) --- . --
~ r-., r-., r-., r-" ec..nnt 12 .... C .A.S. ......
ir. Haz'l'd L_..I RHCtivity L_..I 0111," L_..I Suddtn hl_ L_..I I..i.t.
HH Ith of P....1U1'I ....Ith
V t? I'l_ I
---
CoIIoanInt II
- - -----
r-, r-" ~~., r-" r-' ea.oc.-t 12 .... C.A.S. ......
~ _..I FI... Hiz'l'd L _..I hlctlvity L _..I 01 l.yed L _..I Suddtn hI_ L -... 1..I.t.
HH It h of P....IVI'I ....lth
ea.oc.-t n .... C.A.S. .......
---- --
Pmic.1 lAd IfHlth Hiz.rcI C.A,S, ...... CoIIoanInt 1\ .... C.A.S. ......
( ,*k ,11 that .pply) ---
r-, r-" ,.-., r-' ,.-, ea.oc.-t 12 11_' C.A.S, ......
~ -..I Fire Haz.rd L_..I RHCtivity L_..I 0.1.," L_..I Sudden R.I.... L_..I I"i.t. -
HHlth of P....SUI'l IfHlth --------
ea.oc.-t 13 .... C.A,S. ......
----~______l___________1_.____________JL____________J______l_________l____J_~JL_____L______ ------ ------ -
P~ic.llAd Htllth Hizercl C,A.5. ..,. --------------------------- eo.,on.nt 1\ .... C. A. 5, ......
( heck 111 that ""I,) -------"
r--, r-' ,.-, r-, r-, Co.ICIIIIIIt 12 .... C.A.S. IIùIIbIr
~ _..I Fire Haz'l'd L - J RHctivity L _..I OIl"," L _..I Sudden 1It1.... L _..I l-.di"ta
Heal th of Pressure H.alth -- - ------------------------------------------
I eo.øonent 13 .... C. A. 5, .....1'
"fRGENCY CIMT ACTS 11 RiyE.:t-Ç--::5~~-~-~------------- n't~1Ý-~~---------- ~~~-'3-'1b¥ I2Q~jJJL~~LV..5ô-1..J---------- TŒi-~~~---- ~~~,?: 'i f?
--
.rr i~ (Røad and sign after co.plp-ting all søctlons)
c r';¡' 11ft hav. Dlrs~ll1t. e.".ined "nd .. fHi 1i.1' with the inforllllt IIICI .11 .tteclwd doc_fl, IIICI that based an -V inquiry of tho.. tndiYidu.1s ....ponsibl.
\'
0'" '1j~ i~ IPve that the su ittld ~ol'lllti~ is tl'Ut!, "ccurlt., Ind
),~ ' £. t:e: . ~ ""fY'I~~" Dã\¡;~;?--19
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2130 ..:;- :mtE:.-:' '
OFitC:At Cst ONLY
j{p-;H ~
-:l ItVSP
RECEIVED'
SEP 1 2 1988
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3AJŒ:tSF!'='T·~, C.\ 93:01
(aOSI 3:8-3919
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HAZARDOUS
BUSXNESS PLAN AS A
J,,::F,?~ 2A
ù01335
MATERJ:ALS JD¡)axSk ~
WHOLE, if.øzGJ·¿;"
..:.-
". ",
"'."
. R"ÊCçIVED
SEP 1 2 1988,_
Ans'd,
......
.......
"
0.., ~kD~-:lmlS:
1. To avoid rur1:her actioll. r'eT:Unl w.rors b~ b" 14 ~ C(
z. TYPE/pam ~SWERS a GGtISI.
3. Ans.,er the que.t:loDS belo., tor the bulu.. .. a "1101e.
4. Be as brier &øÄ caDci.. .. poaaible. .
"' .
, ~.^ ~,
SEC':'!OY 1: !US~SS ~~lTl:-!c:.T!cm ')"TA
".
, ,
A. Bt.~IT~S NA:Œ:
Indy Auto Stores. Inc.
" .
~:;::'1. ~,'~ B. t.Cc;.-r:~:: I :a :~!~ ADDR!SS: 1661 Union.
c::?: Bakersfield
z:?: '933ÓŠ
. , -
::' -., .'
,.. BCS ~ P!c:æ: '(805) '~n qqhR·
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SE~ON' %: ~GaCT ~O~ !P!~Tt~
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. ID cue ot aD. ..er:eDC7 1Dvolv1nr the releae 01'" thnae'IIH rellae at a
hazardous ·2aterial. =11 911 anci 1-800-'5%-1'S50 or 1-118-'21-'"1., th1I .111 _City
raur loca.L tire ciepuaaent &Dei dw Stae. .Cr:ice ,ot Eme~DC7. Servtce. u requUed by
law , '. , ',' , , '. ..'.. . . .
, .. .:.;, ;-. ""'I,' ";' ¡ .¡ ~ ." t'J . .." ~ ~ . . .'.
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.' DP!.O~S TO YOTIFY D CASE: OF ~.!!G~iC?:
lAX! AID TtTtZ
A. Pete Jones, Manager
DOBt5GIVS. ·IRS. '::: .~ KS.,III.
Pb. 805 177 qq¡;R Pb_An~~aa 7' Pi
, .
..
Todd Robinson, Asst: 11gr,.
Ph- 805 327 g968 , 'Ph- Rn.. s:I':t':t ')a~5 '
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O¡.' ;.<' ;' 'J¿;: ;~': . SE~ION 3: T.OC.\T':ON 0' trptrn SKti":..J)f!P! !IJR msmSS.A§ A WROtE
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, . .". ,..,\~. SAT.' G.\S/~Q~~:' Right rear Qf the store '
.' I. ELEc-:2ICAL: ~~rnp '. "<
·C. WATER: SRmp
. ¡',: D. SPEC :.\t.:
E. LOCt 30=<:
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YES ,I @ Ii' '/ES. LQc:.-::œ:
IF YES. DOES IT ca:."TÂt: Si:E P~S? .
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I ,. ",:,~.-.'~" ·~!.C":~s ~£ R!Qt':R~ ':'0 H.\\~ ¡; ,.,OGiW! ;''iI';., , ,::to.'-¡::~S '!:-!P!.OY!!S~J:='Z;;;:::;~ ~;t~_ -' '!
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A. ErRODS lOR S.\F! BA.'1)LI~G 01 IlA%.UtDC:S . . £\., .
~.I.:,J(I,\LS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'. . . . ;.~ '. . ¡ > -"'..$ ~,.:. r:.S' XO',:~
B. PROCEDt,,-es iOR COORJ)INA'l"ING AC'::VI'l"IES .' .
WITH R!SPONSE" AGENCIES: . . . '. ~ ~ . : .,. . . . . . . . ~ . . . . .' ,~ ,. '. 'I:. XC' - r:.S ,~O ~, . L
C. PROPER CSE OF SAnTY EQUIPMCT................ .,.. . 50 YES NO·!,
1). r-!£RG~CY EVAt:A'rIOX PROC!I)t;R!S:......... ~ .. . .. . ~ -. ~O \"!S ~O· ~
E. DO yoa XAINTAIN DSPLOYEE TRAIXING RECORDS:....... ts NO YES NO
.' ..... .
SE~OR 'f:' RA%ARDOUS JltAT!RIAf.~~·~-"" w''''..:~!~;:::~t;~';;;', ..~:..~.
J':" . ,t..: ~:\ _ _:.:~~:.::.~ ..;..~~_~:~ ;:.
.'.' . .).:
CIRCLE <!y> - NO - Jam;:. ' J.
.1)OES YOt:R BtSI~~SS BA.\9J)L! BAZ.\RD01:S *'I.:..'tIAt I~ Qti,u7I":I!S L!SS 'l'BA.~ 500 PO~ OF A
SOLID. S5 GALLONS OF It. LIQC'ID. OR 200 C3IC F!:."" or Å CO~R!SSEÐ 'G.\S: . . . .:..; ~ XO
,'-1&-..'. ..1
I. Ant'T~Y ~1 JU''k . c.r~1fy tbat t~ aboveJ.A!orm&tion is ,accurate.
i uncie:-s1:i.IlC,\tbal.:this 1ötor1l8tioa .111· ~ ¡¡se~f to :~1~111 :¡y~~rm 's 1:IbHpt1ofts un4er
,the Dew California Health and Sate~ coåe on Hazardous ~aterials JD1V, 20 C~&pter I~IS
Sec. 25500.!t A1.) ud that inaccurate J.Aforaat1oD oonl~1tut'l-perjUl'7. ,.,' ~
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T:nz Controller
DATE A_'tA_AA
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3A.í~[RS?!ELD CI7y'" FIRE DE?.:\RT;Të:':T
2130 "G" STREET
BAKERSFIELD, CA 93301
OFFICIAL CSE ONLY
ID#
------
BUS PrESS :\:-\;,1?-:
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCT I O:-JS
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 eXIT LISTED BELOW
4. Be as BRIEF and CONCISE as possible.
FACILITY tJNIT NA.'Œ: I N D Y Ä.-ù\-ö ~~ 1t:.-o \
SECTION 1: ~ITIGATION. PREVENTION. ABATEMENT PROCEDú~ES
J:\ l \ D.ç.. 0 <.J..r ~ 0-. -.L <Q.Y"d C:>1..1 ~ t'YI A-'~-R..II' \ p,.-l5, QJ'o...tl... 1 N <:-A-ß ~:~ , \.1': D ~ ~,...o..A'KS'
ì T I ~ -\-A.~~i\) O~ ~} G.. iVd S...;¡<V --\- bas-K +c 0'-' 1/ W ~~, t.k,u<."-\,
\Nlž..i1rI"--Q... U 'S~ d t'-f 5'-V-A..û..-p +c c..,.\ JLA..N' +-Vl~ f~¢
FACILITY UNIT.#:
SECTION 2: NOTIFICATION A~~ EVACGATION PROCEDL~ES AT THIS G;IT ONLY
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SEC'-:'-TO:~ 3: H,"'Z,~RDC)TjS \ft\7'SPL\LS fOR THIS ¡~::TT GXr.v
A. Does this Facility Unit contain Ha7~rdous Materials?... ..
"-s ~o-
y t. tsV
I f ~lE S t S e f:-~ B.
If ~n. continue with SECTIOX ~.
B. Are any of the hazardous materials a bona fide Trade Secret YES XO
If No. complete a separ~te hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form #4A-l)
If Yes; complete 2. hazardntiS mGterials inventor':.' form mar',:"d:
TRAOE SECRETS œ,LY (yellow form ;:4A-2) in addition to the non-trade
sècret form. List only the trade sec:'ets on fo!'", 4A-2,
SECTION 4: PRIVATE FIRE PROTECTION
W& WA. Vù". ~...> r \ - ~ .~ ~y\-\ IV ~ LJ\ $"'Y\"-'Lf"S "
SECTIO~ 5: LOCATION OF WATER SUPPLY FOR USE BY E)ŒRGENCY RESPO\uERS
roro rv ~ ~ r-"-Mr 0 ~ ~ -\-ðJ'~
SECTIO~ 6: LOCATION OF DTILITY SHUT-OFFS AT THIS ù~IT ONLY.
A. XAT. G~S:PROP.\~~~
Al-Ð t{J.::.. ~ ~QS....ç
.'
B. ELECTRICAL:
^-.NJ-.í \-- ~ ~~-\.
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C. ~'¡ATER:
l'vov ~ eA..-b ~
D. SPSC ~ :~.~-' :
t. LOCK BO'" ~'E5 ..§:)F YES. LOCA TI O~,
IF YES, S~TE ?LA~S?
~!..OOR pT :\XS?
YES / ::0
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B ^ K E R SF I E L IJ (; I 'f Y FIR f~ II E" ^ H 'HI F, N T ~,--'
IJ f FORM 4A-2 page , of
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TRADE SECRETS
HAZARDOUS MATERIALS INVENTORY
".-
'"' S J N E S S N ^ ~I Av~~ .
OWNF.R N^MF.: -,::: ^ " F^CILITY UNIT t: -
^,))RESS: / ^OORESS: ~y~ cl rA. FACILITY UNIT NAME:
CJTY, 7,1": d C JQ-t; r-. CITY,ZIP: å-d -r1J c..."g l i F
- IOFF ~~r~
!'\lONE fI: PIIONE .: ~..: L(-OYJ of USE CFIRS CODE
--
J 2 :1 .t 5 fI 7 I ,. 8 BY 9 "^;'~Rnlo,o.T
IY!'F. HAX A NNtI^ f CONT USE I.O(:^TION IN TillS
LoDE _M!!!!lJrL ...AM.QIJN,L UNll cOUE CODE FACII.ITY UNIT WT. CIIE'MICAL OR COMMON NAME CODE GUIDE
,YV) _ 30 . )V r.> llti. c]~ ~ 5c:. N~N .$ how roo.\.-\ ~ ~ 1/'( S /()7 ro -e-
r~l T7 Çb '"lÇù ~ Il? 10 . l\J~r (' u1'NIl"'. ~ ) , I dð(J X
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- ~NB t BUS IIOURS
ïï ^HE : -'_~~:\~ """'-''; (") "'- TITLE 'VA~~v- SI
n'ERnENCY CONTACT: 'S'.Aw\-...<- T I tf. E :_,
AFTER BUS IIRS:
EHERßENCY CONTACT: -- TITLE: - PIIONB , BUS IIOURS
"Hfflr.TrAJ. flIlSINf.~f, ACTIVITY: AFTF.R BUS IIRS:
--~
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CITY of BAKERSFIELD
~
'-
ARE DEPARTMENT
D. S. NEEDHAM
ARE CHIEF
2101 H mEET
BAlŒRSRELD. 93301
326-3911
~ -5 -<òð
Dear Business Owner:
"
Enclosed please find a copy of your r~sponse
,;. < >,._,. _. Plan request. We have found it necessary to
i ::·;;;:":::~~:~L;'::f.,reaSon(s) as checked below. < ':.' ,
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Bak sfield City Fire, Department;
Ha rdous Materials Division
2 0 IIG" Street
akersfie14, CA 93301
. If additional copies of any forms are needed they can be picked up from the
Hazardous Materials Division at 2130 "G" Street in person.
Sincerely Yours,
.-
,
,:
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..
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"
Coordinator
..
.
REH/eg
-
...'-...~- ) '~~
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CITY of BAKERSFIELD
ARE DEPARntEHT
Q, S. NEEDHAM
ARE CHIef
2101 H STREET
BAKERSRaD, 93301
321-3911
Dear Business Owner:
.
Enclosed pTease find a copy of your r~sponse to the Hazardous Materiat Business
, <. ,<,~Plan request. We have founå it necessary to reject your. pian for the foHowing .
..c,,_~,~~J~::;{reason ( 5) as checked be T ow.~ ,-";{i';;;;~}~~f~¿~t~~;~~}~~~f~2~#~:~;~¿f;£,:;:.~~:\11¥i;;~~~Yg,!:~;i:/ '.'
.' ,'..::~ D Illegible Business P1an (please pri~t or.type.inf0rmation in Engl~Sh).:~ù~~~h
.'~'~"'~",~,.... ':::': ...: i~::::ffQ'1~~:~:;';~1;i:~;~'Z~.·"Ii~\.· :~i~
." .':,~:__,':-::....'.:;.;.:'.~:.-.",:"..'.:::~..,:-,;.,j: ,_' f '. ,- "" ~~... "'.0 ,.' '''0+- =.';1i:'1."'.' .-i';:.'.\t "......... " ,..', ~~,. ..
7_ .,..... -. ' Fo~ '4Å D Mi'~~i~9F':~" ·~...~~ò;;l;t:~'~:·~i1I~j.~·«'^~'- ',:" 'e. .} '.' " :--.' ,'~"3~..;::~,).,: ,,:,,'Š:'
. .,,"'- W' N '~, S . .' ~~ r· :..,~~~~~..,
FO~~:AD;a;'; 0 M;~;n'C~~ [·:c·I.'~te·,:~,~~i
Fac;J;t;e.. Diagram 0 M;ss;nZInc et~· .... ...
q -6-<6<6
"
This is to be corrected anä resu
"..
Bakersfield City Fire Department
Hazardous Materia1s Division
2130 "GtI Street
Bakersfield, CA 93301
, If additional copies of any forms are needed they can be picked up from the
Hazardous MateriaTs Division at 2130 "G" Street in person..
SincereTy Yours,
Coordinator
REH/eg
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HAZARDOUS MATERXALS
BUSJ:NESS PLAN AS A WHOL~"
. PQR.~ 2A
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IR~ ,~Ol..~ .l.Q:qs:
.
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1. To _void tunher ac~1oll. re~ t:ü.rOnl by b -It(. ~ c.¿
z. T'lP!/PRaT ~SWDS a E!GtISI.
3. ÁI1s..r ë. qu..~~OI1S below for the buaLana as a whale.
,
4. Be as brier &A~ cQllc~ae .. po.sible.
SE~OY 1: !'CS~ss m!:.:ln:-!.~T:o:f ',\T.\
A. BCSIrJ:.5S ~:
Indy Auto Stores. Inc.
. ,
- .
'd,.- - - I. r.::c:.7.":O: I S"rn!'=-: AIm~S: 1661 Union.
%j: 933ó5
, .
c:~: Bakersfield
ItS. ".0:'-£: 't 805) 117 QQf.H
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SEC":'!ON %: ~~C? :f01.!.:r!~T!~
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In cue at &II. ..er¡el1C? 1DvaS.v1n~ :tie :'81.... Or" thn.~.lIeci reI...e ot &
hazardous '2&1:.r~al. =11 911 anci 1-300-tS%-rsao or l-t18-'ZT~1. this .111 a.o1:1fy
,au:' la=l t1:-e cieQartJllenc uui ~ St;¡~. ct:~ca at EMrþI1CV. SeC'Y1ce. u ~ by
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œa!.c~ TO mn!'Y Dr c.\Si or ~Gc.:jC1:
%fAX! ~ TITU
A. Pete Jones. Mana~er
DUlIm IUS. as.
Ph. RO~ "7 qqnR
Ph.Rn~ ~ga ~]Pi
.;;AItD 11:S..IIS..
,'. .
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\:. <=~í': .~.~.
Todd Robinson, Asst. H~r·.
~ 805 327 99ñR
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C. WATD:
. D. SPEC~L;
E. toe 30X:
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Right rear Qf the store
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tF YES. OOES rr ca:.-r~t: S~:! flWS?
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~¿ .AIALS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .'. . . ¡ :... -""'..1 ~- - .. r=-s :co- ~
B. PRO~1I~ =OR COOlU)I~A'l'ING AC":Vn"I~ .' .
WITH RtSPONSE AG~CI!S:...~...................~~. 'I' - SO' y-~;~'
C. PROPER t:SE OF SAF!'r'l EQUIPMCT:...................· 50 YES:"1) .l ,
D. ~ŒRG~CY !VAc:~nox !lROC!Dt'a!s:......... ~...... ~-. ~o y-~ m-
E. DO Yet ~INTAIN ~LO\"EE TRAIXING RECORDS:....... !S NO YES NO
....
SEC":'TOR ":' WA~ctTS ~T!RIAr..-- +-.. _._;,~;';;~;:-~t~;;, -- _.
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I unàe~s~a¡¡Q :nat~i. 1nto~a~ioD w111'be ~e='t~ :~1:111 =V~~r='s obli:a~1ofts unå=
,tbe Dew Cal1!Qr~. Health and Sa!e~ coåe aD iaZardous ~acerials'D1v, 20 C~apcer I,~
Sec. %5500.!t Al.) and tha~ 1naccurate lAfo~at1oD con.~1tu~..'p.rjur7. ~
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IELU CITY fIRJ~ IIEllARnl
FORM 4A-2
TRADE SECRETS
HAZARDOUS MATERIALS INVENTORY
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IbCoI . ()/LJ\OV ADDRESS: ~ L- I(' S vY1 Pod rÄ. FACILITY UNIT NAME:
1': ßA Y\-.D If' ~I~j "'- L~ Co JQ l ~ r-. CITY,ZIf': åd"..4,... C...ol j F !
-.3,).r4'1G? PIIONE ,: ~-:¡, G. )Y-O'1) 0, 10FFICIAL USE CFIRS CODE
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IYI'E ~I^ X AN Nil AI, CONT IISE I.O(:ATION IN TillS , BY IIAZARO O.O.T
LOUE _~ !~ !! !lH 1_ -AM.º IJ NL Jiliil. ~OOE CODE FAC 11.1 TY UN IT WT. CIII~'M I CAL OR COMMON NAME CODE GUIDE
1!L 30 l!h. ~q $L 5( O"NlJ.N .s ~"vJ ro~·v\ J1 ^.Jl II t/"V <:
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-~. ....1)00 (;-0. \ Iì 10 ' ,"uo.? 11'00 ~'V\ oJ: ('..)~ r 4- / ,:: ~ lV.\., ~ r~~ ï J
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iï ^ HE: 'i,)"p ±€...Q. ~I"'>." f'>.... TITLE: MANAi,...ev- S I G N A T U R E 1'\.- "\..,{..k"l DATE:
<s;. A'W\........ T I I. E : ~ -So IN\.' \. '-....../ 2:"'PIIONE ; BUS nOURS: ~ì 'Y'ì68
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AFTER BUS IIRS:
PHONE , BUS HOURS
AFTER BUS IIRS:
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CONTACT:
nIlSINf.Sf,
ERGENCY
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