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Home My WebLink AboutBUSINESS PLAN 6/8/2004 Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE WCATION: 93309 TANK OlS~1~23SS~1 OlS~1~355-02 Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: June 3.0, 2003 Issue Date I '":" · . I 285~ · CA Cert. No. I City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (661) 326-3979 An upgrade compliance certificate has been Issued In connection with the operating permit for the facility Indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in the fonnat of your choice: name of owner; name of operator; name offacility; street address, city, and zip code offacility; facility identification number (from Fonn A); name of issuing agency; and date of issue. Other identifying infonnation may be added as deemed necessary by the local agency. This permit is issued on this 2ih day of September 2002 to: BIG COUNTRY CHEVRON Permit #015-021-002355 3300 WHITE LANE Bakersfield, California 93309 .. ./ ."\ :fj '."" e e BIG COUNTRY CHEVRON SiteID: 015-021-002355 Manager : DAVID BIRD Location: 3300 WHITE LN City BAKERSFIELD BusPhone: Map : 123 Grid: 14D (661) 827-0487 CommHaz : FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code:7349 DunnBrad: Emergency Contact / WNID DIRD ALEX O~íE40/ Business Phone: (661) 24-Hour Phone : (661) Pager Phone : ( ) Title J().\",,<'S MANAGER ~OO(\~ 827-0487x 900 4J1~ S91-J.¡7/7x Emergency Contact BRENDA ETJEIUDGE Business Phone: 24-Hour Phone : Pager Phone : / Title / MANAGER C0l'151.> H~t (661) 327-5008x (611) 900-4312x ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : -!3RENDA ETJERIDGE 4¿,.e¡(. ot¿TfE6A MailAddr: 3300 WHITE LANE City : BAKERSFIELD Owner Address City SULLIVANS LLC : 1508 18TH STREET : BAKERSFIELD Phone: ( 6 61 ) 327 500 ax State: CA e~ì- ol..{~ì Zip : 93307 Phone: ( 661) 327 - 50 0 8~ %6f) State: CA '£,c II Zip : 93301 Period : Preparer: Certif'd: parcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ¡ t1~¡( (H~..-r€EtA .'--..... rr~:;':!~ :.1~ pdnt n.-:Ur.9) Do hereby certify that I have r,.,," ".;I~<; ·:.he attached hazardous materials manage~ ß\b ~\y-'-{ ~~~ mt~:';;{ plan for (.ðÙ c:-~ and that it along with (Name of BusIness) any corrections constitute a complete and correct man- agement plan for my facility. -~~ ~ - 6-01-\ Date -1- 06/08/2004 ./ '. ~ .;r e e F BIG COUNTRY CHEVRON SiteID: 015-021-002355 ì STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BIG COUNTRY CHEVRON Cross Street : Business Type: GAS STATION Org Type: CORPORATION Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : BRENDA EVERIDGE Phone: (661) 327-5008x Address: City : State: Zip: Type : TANK OWNER INFORMATION Name : BRENDA EVERIDGE Phone: (661) 327-5008x Address: City : State: Zip: Type : BOE UST Fee# : Financ'l Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date:09/27/2002 Phone: (661) 327-5008x Name:DAVID BIRD Ttl:RETAIL MGR. State UST # : 1998 Upg Cert#: 28513 -2 - 06/08/2004 ~ ~ e e ~, SiteID: 015-021-002355 9 By Facility Unit 9 Fixed Containers at Site 9 speCHazEPA HazardS Frm I DailyMax IUnitlMCP F BIG COUNTRY CHEVRON f= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... UNLEADED GASOLINE PREMIUM UNLEADED F F IH DH IH DH L L 12000.00 GAL Mod 12000.00 Mod -3- 06/08/2004 ./ ~ " e e SiteID: 015-021-002355 9 Facility Unit: Fixed Containers at Site 9 F BIG COUNTRY CHEVRON f= Inventory Item 0001 == COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 12000.00 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: Ag.Defined5: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: - Ag.Define11 -4- 06/08/2004 ./ ;; .. e e F BIG COUNTRY CHEVRON SiteID: 015-021-002355 ì f= Inventory Item 0001 Facility Unit: Fixed Containers at Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: TANK DESCRIPTION Tank ID#: 1 Mfr: MODERN WELD Installed: 04/2002 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: 1 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): BARE STEEL Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2002 Drop Tube : 2002 Striker Plate: 2002 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 2002 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: 2002 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 06/08/2004 .T' ..~ -:a e e F BIG COUNTRY CHEVRON SiteID: 015-021-002355 ì f= Inventory Item 0001 Facility Unit: Fixed Containers at 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 FIBERGLASS AboveGround Piping PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/29/2002 Date: 09/27/2002 Name:DAVID BIRD Prmt Number: 2355 TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/08/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:RETAIL MGR. Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED -6- 06/08/2004 '. ¿ e e ?' SiteID: 015-021-002355 ì Facility Unit: Fixed Containers at Site ì F BIG COUNTRY CHEVRON f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 Daily Average 12000.00 %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: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag .Define11 -7- 06/08/2004 '. /' " if' e e F BIG COUNTRY CHEVRON SiteID: 015-021-002355 9 f= Inventory Item 0002 Facility Unit: Fixed Containers at Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: TANK DESCRIPTION Tank ID#: 2 Mfr: MODERN WELD Installed: 04/2002 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL MatI Name:PREMIUM UNLEADED TANK CONTENTS Petrol Type: PREMIUM UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): BARE STEEL Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2002 Drop Tube : 2002 Striker Plate: 2002 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 2002 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: 2002 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -8- 06/08/2004 · :.-; ..,' , e e ; /; " F BIG COUNTRY CHEVRON SiteID: 015-021-002355 9 f= Inventory Item 0002 Facility Unit: Fixed Containers at Site 9 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: 04/29/2002 Date: 09/27/2002 Name:DAVID BIRD Prmt Number: 2355 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:RETAIL MGR. Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/08/2003 -9- 06/08/2004 :.' ;",Þ . ",t. , "/ B'IG COUNTRY CHEVRON J 'ì.~~ ~ é.\"~ BusPhone: 3" Map : 123 Grid: 14D . SiteID: 015-021-002355 Manager : DAVID BIRD Location: 3300 WHITE LN City BAKERSFIELD (661) 827-0487 CommHaz : FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code:7349 DunnBrad: Emergency Contact / Title Emergency Contact / Title DAVID BIRD / MANAGER BRENDA EVERIDGE / MANAGER Business Phone: (661) 827-0487x Business Phone: (661) 327-5008x 24-Hour Phone : (661) 900-4311x 24-Hour Phone : (611) 900-4312x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Owner Address : City SULLIVANS LLC 1508 18TH STREET : BAKERSFIELD Phone: (661) 327-5008x State: CA Zip : 93307 Phone: (661) 327-5008x 0660 State: CA Zip : 93301 Contact : BRENDA EVERIDGE MailAddr: 3300 WHITE LANE City : BAKERSFIELD Period : Preparer: Certif'd: parcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~:~/".JDO hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ment plan forSul/, $';¡::>l!:.:zteLt#-Dd that it along with (Name oj dU9íness) any corrections constitute a complete and correct man- agement plan for my facility. ~ --4-~ SignalUre Date -1- 07/15/2003 - e {[) ... ,- ;i' BIG COUNTRY CHEVRON Manager : .J'MŒ1' JOUEC ~ VIe! 73}(~d Location: 3300 WHITE LANE City BAKERSFIELD CommCode: BAKERSFIELD STATION 07 EPA Numb: SiteID: 015-021-002355 BusPhone: Map : 123 Grid: 14D (661) 827-0487 CommHaz : FacUnits: 1 AOV: SIC Code:7349 DunnBrad: Emergency Contact J / Title Emergency Contact / Title J.MŒ'f JONEŠì::J.\~i"'B,r / MANAGER BRENDA EVERIDGE / MANAGER Business Phone: (661) 827-0487x Business Phone: (661) 327-5008x 24-Hour Phone : (to '" $ t:¡c£> - l{.!J 1/ x 24-Hour Phone : (611) 900-4312x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth ~ Contact : BRENDA EVERIDGE Phone: (661) 327-5008x MailAddr: 3300 WHITE LANE State: CA City : BAKERSFIELD Zip : 93307 Owner SULLIVANS LLC Phone: (661) 327-5008x 0660 Address : 1508 18TH STREET State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Pre parer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: 1,~f(~¡Sly...J Do hereby certify ¡hat I have (TyP9OT print 11MIe) rQWiewÐd the attachoo hm;ardous materiai$ manage- ment plan f~//'vPJN~e::r:- and that it afonn with (!Name of 8usIn$SS) 'lII any rorredions oonstit~a a oomplete and correct man- agement plan fer my.fadlity. ~ð""~ ~-19~ SIgnatUre . ~ -1- 01/31/2003 e e F BIG COUNTRY CHEVRON SiteID: 015-021-002355 ì STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BIG COUNTRY CHEVRON Cross Street : Business Type: GAS STATION Org Type: CORPORATION Total Tanks : 2 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : BRENDA EVERIDGE Phone: (661 ) 327-5008x Address: City : State: Zip: Type : TANK OWNER INFORMATION Name : BRENDA EVERIDGE Phone: (661) 327-5008x Address: City : State: Zip: Type : BOE UST Fee# : Financ'l Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date:09/27/2002 Phone: (661) 327-5008x Name:DAVID BIRD Ttl:RETAIL MGR. State UST # : 1998 Upg Cert#: 28513 One Unified List ì All Materials at Site ì p= Hazmat Inventory p== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP PREMIUM UNLEADED UNLEADED GASOLINE F F IH DH IH DH L L 12000.00 Mod 12000.00 GAL Mod -2- 01/31/2003 e e SiteID: 015-021-002355 ~ Facility Unit: Fixed Containers at Site ~ F BIG COUNTRY CHEVRON f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 Daily Average 12000.00 %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 UNLEADED GASOLINE Facility Unit: Fixed Containers at Site ~ Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 12000.00 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- 01/31/2003 e e SiteID: 015-021-002355 ì Fast Format ì Overall Site ì 10/01/2002 F BIG COUNTRY CHEVRON I F Notif./Evacuation/Medical Agency Notification BRENDA EVERIDGE, COMPANY OPERATIONS MANAGER IS TO BE NOTIFIED OF ALL SPILLS. EMERGENCY NUMBERS ARE POSTED TO OFFICE OF EMERGENCY SERVICES AMD 911. Employee Notif./Evacuation 10/01/2002 STORE MANAGER IS RESPONSIBLE TO REPORT ALL SPILLS TO THE COMPANY OPERATIONS MANAGER. AUDITS ARE COMPLETED QUARTERLY TO INSURE COMPLIANCE Public Notif./Evacuation Emergency Medical plan 10/01/2002 EMERGENCY PHONE NUMBERS ARE POSTED AS WELL AS A MAP & PHONE NUMBER TO THE NEAREST HOSPITAL. MERCY SOUTHWEST 400 OLD RIVER ROAD (661) 663-6000 -4- 01/31/2003 e e SiteID: 015-021-002355 ì Fast Format ì Overall Site ì 10/01/2002 F BIG COUNTRY CHEVRON I f= Mitigation/Prevent/Abatemt Release Prevention EMPLOYEES ARE TRAINED TO STOP ALL DISPENSERS IN CASE OF EMERGENCY. THEY ARE TAUGHT AT LEAST 3 DIFFERENT WAYS TO SHUT FUEL SYSTEM OFF Release Containment 10/01/2002 EMPLOYEES ARE TRAINED ON PROPER CONTAINMENT/CLEAN UP AND DISPOSAL Clean Up 10/01/2002 EMPLOYEES ARE TRAINED IN PROCEDURE TO SECURE AREA AND CLEAN SPILL MP ENVIRONMENTAL IS OUR VENDOR Other Resource Activation -5- 01/31/2003 " .... .'... e e Fire Protec./Avail. Water SiteID: 015-021-002355 9 Fast Format 9 Overall Site 9 I I I I F BIG COUNTRY CHEVRON I f= Site Emergency Factors ¡== Special Hazards Utility Shut-Offs [ I I Building Occupancy Level -6- 01/31/2003 ,-' '" j" ~ oe; '\. e e F BIG COUNTRY CHEVRON I F Training Employee Training SiteID: 015-021-002355 ì Fast Format ì Overall Site ì 10/01/2002 NUMBER OF EMPLOYEES 9 TO 12 MSDS SHEETS IN BINDER AT FRONT DESK ALL EMPLOYEES RECEIVE A HANDS ON SAFETY TRAINING PROGRAM AND ARE SHOWN THE PHYSICAL LOCATION AND USE OF EMERGENCY RESPONSE MATERIALS AND UTILITY SHUT OFFS PROGRAM ATTACHED Page 2 [ I I Held for Future Use Held for Future Use -7- 01/31/2003 *- CITY OF BAKERSFIELa ~"FICE OF ENVIRONMENTAL VICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 INSTRUCTIONS: HAZARDOUSMATEIDALSMANAGEMENTPLAN !1m (JtJ3 .s5ðO J ES I.f C(ý(J ð 1. To avoid further action, return this fonn within 30 days of receipt. 2. TYPE/PRINT 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 Fonn and Chemical Description Fonn(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA ( BUSINESS NAME: D/(:r G\lI::r:H~j LOCATION: 3300 \/Jh I~ ~p ~ MAILING ADDRESS: ~3.3oc::> \~ h ~ ~ ~ CITY: 6rnu¥~ f;,cid STATE:CA- ZIP:9~o¿~1 BZ7-o'-l&7 PRIMARY ACTIVITY: ~C'l /1trr'1 / ~.501r--It-- I OWNER: Svll, VFt-r-/~t;r-;DI-e-uM.. G ¿¿C-PHONE:3.27~ ( ~ ZZ7 -:. f¡ 1 MAILING ADDRESS: /s-08 /8"'" 50 t5 j:::...-fð J CAr 9..3..3'0) EMERGENCY NOTIFrCA TION ~ r.-JA71Cf ::Jõ'1e-S ;]3",Ó'1 dA þ:"Vff((;LJ'c- TITLE BUS. PHONE ìlb7: 8270'-/8'7 t~ úí :3 2. 7 §"'1?0é3 24 HR. PHONE CONTACT 9ooQ3/Z- , i 1 HAenOUS MATERIALS MANAGE.T PLAN SECTION ILl: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORlNG PROCEDURES: Vec.-d~ f2oc~ D:::>nïì/1~ ,...,on I-rc>("t~q ~Ii?- J/-TYIK-,,$ {- f'fl;::!3' r--'\ol1~r is ¡rJJ;fe~~¿ d~'J ~ f~ofe./' OfUPJí7o--rl ( B. EMPLOYEE AND AGENCY NOTIFICATION: J3('(!/)~ £ vet'" lliS' e-) Co~~/ll 0r..r-rnQ,rJS, n trl' JJ; '7V be...- ,",0"-' -h <cd <JF" PdL·.sp J Ls. . £;-,"7 =7 (1U~ be6. Prr~ f0.t-n=.cl ,....-0 ~u- or ~~":fM15èrvt~ A-f' 911. (~' ( c. ENVIRONMENTAL RESPONSE MANAGEMENT: Sl'Ðre:- ì\Í"O'1;:¿s'lf IS {'CÞf~ib~ -ro f'~-t"---;;- A""te ß¡',/IJ:f<:J ~ j Col'-f~f Op~fr:=t--p~ Ï\1i\'v!~r: Avd.,-z; A-re- Co,,?fLre- Qv~,! 70 ,'r,SUI-C- Ccl'-'fl,¡>m U2- . '. D. EMERGENCY MEDICAL PLAN: ~1A?{:7(~ ?f.ø~ I1vM~..,g ~ r~T<=d ~ ~{ ~ A Mrtp.{ f~~ l"7o.;>r-tÍJ</ 7"0 11-1<-- n~ J h!:>..$f(TA-I-. Me/tj t¡eo SCv n¡. iu~"'- old (2¡ tl'~ f2..ci (p~3 bOcP l 2 C. ( \ HAWDOUS MATERIALS MANAGE.T PLAN SECTION 1I.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: ~p),,/~ ~ / ¡"~cJ {\:::J ~ rt-d UU~.sCZ/ß 1M CA:S-e- or ,E;.-.e-..rJ~ '. I r-k!//' t'-VC- --rY'tv/(,,/ IT7 I~ :3 al, ~ \o.tA-j-S (D S1+v, ~I .c1.£~. oFr: B. RELEASE CONTAINMENT AND/OR MITIGATION: ~(JI.!>yc¿S. Arc!:.- ~~d ON f"::J¡>e/' Con-rrnf'1~ / c:.Jert1') c.fJ /t?1d ell..£' 1-o~1 CLEAN-UP AND RECOVERY PROCEDURES: ~ploy~ I'f"f"e- (l't'~"rÙ1ecl ì N fro (R-d....:>~.....,..,o Set:..v r€- ¡+,.~ ArId c.' ð"'rn ..91' "L L , M f G;, \lrt"l:Y1~/'?'7"f='t- ) ~ o,-,;r tA3./lJ,or UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROP ANE: 0", Horm Side- of '/3tJ¡/d'Ng ELECI'RICAL: Or-f Horn} SIck.... of ~v;lc1h::JS' tn~/~ kt:S WATER:· SPECIAL: LOCK BOX: YES~ IF YES, LOCATION: PRIVATE FIRE PROTECTION/W A TER AVAILABILITY PRIVATE FIRE PROTECTION: FíC- &X.TI'J/vlßkr If;Jc~ o~ .¡:¡; d /ßf ct+-14~ ~CJ ! ~ß.Ie:Le- ..9to~ B. WATER AVAILABILITY (FIRE HYDRANT): A. 3 HA.OUS 1\'IA TERIALS 1\'IANAGE.T PLAN SECTION III: TRAINING ( NUMBER OF EMPLOYEES: 9 ---¡u I 2- MATERlAL SAFETY DATA SHEETS ON FILE:~ ß¡rx:Lv t>r7 ;;"0",' ~I<--. BRIEF SUMMARY OF TRAINING PROGRAM: A-t I ~pl-1C-L.S f2-£C£.A....t:- A- h~~ or! 9rrr-e-7 / ¡z,;;,f')~.JJ' B~C>J~A---M ~ci PtrC- S~~ -n+c- I:?hf-~/()q-/ 1r::JU1Ttor-l r+nd v$-e- Dr ~erJ'~:/ ~fon.$-€.- ()fT~fA-13 rt71d tJr· /7 £hv7 o¡::r...s, ' ;#- ?,-o r~ Arrn~t.d \. ( CERTIFICATION ~~/~~ 6p~ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY F~·S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZ;ARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. - ··.~£-~tllr SIGNATURE . . TITLE / 9-U 'o~ DATE .'AZ MAT MNOMNT PLAN A INSTRUC l 4 ,- CITY OF BAKERSFIELD O.CE OF ENVIRONMENTAL SEAES 1115 Chester Ave., Bakersfield. CA (661) 326-3979 HAZARDOUS ~IA TERIALS FACILITY INFO RIVIA TION INSTRUCTIONS BUSINESS OWNER / OPERATOR FOAAI r. FACILITY IDENTIFICATION: Enter the reporting period (year beginning and ending) for the facility information. Enter the business name and site address and phone number of your business. Do not use P.O. box numbers. Enter the Dun & Bradstreet or federal tax identification number for your business. Enter the Standard Industrial Classification (SIC) number for your business. Each type of business has a Standard Industrial Classification code number. Some common SIC codes are listed on the back of this page. Other SIC codes may be obtained from your worker's compensation insurance forms, the State of California Employment Development Department, or by calling our office at (661) 326-3979. Enter the name and phone number of the person responsible for operating the business. II. OWNER INFORMATION: List the legal business owner or corporation name and provide the headquarter address or residential address if owned by an individual and phone number. III. ENVIRONMENTAL CONTACT: Identify the person who is primarily responsible for environmental compliance at the business. This person may be either the business owner, one of the emergency contacts, an environmental manager, or consultant. IV. EMERGENCY CONTACTS: List the name, title, and phone numbers of two people at the business who can respond if the Bakersfield Fire Department requires additional information or other assistance. These contact persons must have keys or access to all areas of the facility, be available for emergency call-outs, and have decision-making authority to call on other resources (such as hazardous waste clean-up companies) as necessary. V. CERTIFICATION: The business owner or operator must sign, date, and also identify the document preparer. COMMON STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODES '. . o 111 Wh~at production 0115 Corn production 013 1 Cotton production 0139 Field crops, except cash grams o 161 Vegetables & melons 0172 Grapes 0173 Tree nuts 0174 Citrus fruits 0175 Deciduous tree fÌ11its 0179 Other tree fTuits & nuts 0724 Cotton ginning 0541 Groœry store 1541 Dry cleaners 2911 Oil refineries 3441 Weldinglfabrication- structural 3443 Welding/fabrication- boiler 3569 Machine shop 4222 Cold Storage 4925 Compressed gas supplier 0192 General fanns, primarily 5093 Automobile salvage crop 0241 Dairy fanns 0252 Chicken eggs 0253 Turkey eggs 2851 Paint manufacture 0291 General fann, primarily livestock & animal specialties 5169 Chemical supply 5511 Motor vehicle dealers (new & used) 5521 Motor vehicle (used only) 5531 Auto & home supply stores 5541 Gasoline service stations 2 5821 Eating places 5813 Drinking pla¡,;es (Alcohol serviœ) ( 5983 Fuel oil dealers 5984 LPG dealers 7342 Pest control 7532 Auto top, body, upholstery repair Auto paint shops 7533 Auto exhaust repair 7536 Auto glass replacement 7537 Auto transmission reparr 7538 General auto repair (.. 7542 Car washes 8071 Chemical laboratory l ~'~ II#~.~ ~AR'~'" ~~...--. CITY OF BA~ERSFIELO OFF~E OF ENVIRON:\IENTAL SjiVICES 171Whester Ave., CA 93301 (661) "'6-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION . .- -... .'." Page _ 01 .. 4.. .'. _ I. FACILITY IDENTIFICATION FACILITY ID /I. 1 Year Beginning 100 Year Ending tOt BUS~ NAME (Sa;;;~ aš FACiLITY~NAME or DBA. ÕOlng B~sjness AS} 3 BUSINESS PHONE D Il::r Co,,/Y"/ïrj ch~\I';.sr-I , 827 0 cool 8, 7 SITE ADDRESS 103 3.3 0 c:> ,h-(I1,t-t-e- .~~ . _..._'.'._____ _p._.. ,_..___ _ _u. ____ CITY~ F~~(cl ., .._ __.._.____, ..____._,__~~.,;__~~,_, ,Zl~ ,.9.::J?3-1 ~_____________.,__ __~ DUN & 106 SIC CODE -¿J.¡ 107 BRADSTREET . (4 Digit /I.) 557 ~?~~_~~{'~~¡2-~ 2 -~~~'=~~~=~=~=--=-=-~-==~~__~:.~~_~===='_~_ t02 108 OPERATOR NAME 109 OPERATOR PHONE ItO ...---- II. OWNER INFORMATION ~,~~,E.~. ~~~~'~_$.:, I iL;~~ __P~J~I~_ G __~ L~__~~,~~NE~ ,~_H~_~,~9~/_~? 7 ~ It2 ~;DNREERS~AILlNG/s-08 18711 5T -=fZZ Z- '--~_-~-;J:fd 113 114 : STA~~'CA-~,-~·o~;--q 3.3 0 J 116 III. ENVIRONMENTAL CONTACT ..-.--, -" .----..---::;r ---- ,-------------------- CO~!~~! ~A~,:. hÓ:\LfQ ~II' _~_,____..____o,___________u__~.~7__ ~?NT~~~~~?~~ !.~_.;! 2.!_ ~~1,~ CONTACT MAILING ítf "#- 2ZL 119 ~;;~Ess-Js-:.~~~---$7----_------ '" : STATE -~;,-- --;'p 133 ;;;;-------;;; ___,_.,_~~=--__.__ ____.________________,______.._, .,_.. ..._ _._ _____,__2._____,__ _,_ -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY· ~;~~=~~-;;=-·-~~~_>--~__~~~~~E ~-~;~d;;.Ji';;·:;.~~~¿-- -===~=-- 129' TIT~~_o. __,_ _,tJ~ t:' f~_____.__,_____._________.~~~L!~~~~__,_,M_~~,~-.-,.-,...,:._ _..,._,_________ ..__..___.~3~ BUSINE~~, P~?N~,_t2...2: !...Q,tj' 6,7,. ___,..... ___... 12~.! ,s.U.S~~,E~~PHO~~~_?:.?,~.6', . ,_ __ _, 13t 24-HOUR PHO~:.__________.__,_.._._._,..____._____,.______~~~_~-~~~~~,~_~~.?~:_..,___9~ &(~,/ ..~_ __, _, _....._ ~~2_ PAGER # 128 ' PAGER /I. 133 V. CERTIFICATION .-.. ...'-,._. -....--- ---. ----------- :ertification: Based on my inquiry of those individuals responsible for obtaining the Information. I certify under penally of law that I have personally examined ,md am familiar with the information submitted in this inventory and believe the information Is true, accurate, and complete. 51~--c::=)=-------1~-¡~7- -- ----';:¡-~ÑÃ¡¡EÕFocicUMËNTPREPÃ¡¡ËR ------;;;-- .. ., .. .-.......-...-- ......, --', .,--.--, '·nO" -., .'.-.-·-·""---..--1. ~.,..._,. .. -., ,-..' ,....., . . -0 . .. ..,... ..,... -.,-.... ~AMES OF OWNER/OPERATOR (Print~ 136 i TITLE OF OWNER/OPERATOR 0/n/~_C?, .e:~ ,.,. .. J., MItY1~c:ß'- 137 "'CF (7/99) S:\CUPAFORMS\OES2730. T-/4. 'Npd B~ness Owner/Operator Identificlion Please 5ub,T1II the Suslness Act/vibes page, th.ness Owner/Operator Idenâtlcadon page (OES Fo 30). and Hazardous Materials . ~hemjcal' Descnpbon pages (OES Form 273 1) for ail hazardous matenals inventory submissions. For the invenlory to be considered complete thiS page must be signed by the Jppropnate IndiVIdual. ~ote: the numbermg of the InstruCbons follows the data element numbers \tIat are on \tie UPCF pages, These data element numbers are used Jr electronic submission and are the same as the numbenng used In 27 CCR, Appendix C. the Business Section of the Unified Program Data Dicdona( Please number ail pages of ,/our subml"aJ. This helps your CUPA or AA identity whether the submiltal is complete and if any pages are separated, . 1. FACILITY 10 NUMBER· This number is assigned by the CUPA or AA, This is the unique number which identifies your facIlity, J. eUSINESS NAME - Enter the fuillegal name of !he business. 100. BEGINNING DA TE . Enter the beginning year and date of the report, (YYYYMMDD) 101. ENDING DA TE . Enter the ending year and date of the report. (YVYYMMDD) 102, BUSINESS PHONE - Enter the phone number. area code first. and any extension. 103, BUSINESS SITE ADDRESS - Enter the street address where the facility is located. No post office box numbers are allowed, This information must provide a means to geographically locate the facility, 104, CITY· Enter the city or unincorporated area in which business site is located. 105, ZIP CODE - Enter the zip code of business site. The extra 4 digit zip may also be added. 106, DUN & BRADSTREET - Enter the Dun & Bradstreet number for the facility, The Dun & Bradstreet number may be obtained by calling (610) 882-7748 or by Intemel. 107. SIC CODE· Enter the primary Standard Industrial Classification Code number for primary business activity. NOTE: If code is more than 4 digits. report only the first four. 108. COUNTY - Enter the county in which the business site is located. 109. BUSINESS OPERATOR NAME - Enter the name of the business operator. 110. BUSINESS OPERA TOR PHONE· Enter business operator phone number. if different from business phone. area code first. and any extension. ' 111. OWNER NAME· Enter name of business owner, if different from business operator. 112. OWNER PHONE· Enter the business owner's phone number if different from business phone, area code first, and any extension. 113. OWNER MAILING ADDRESS· Enter the owner's mailing address if different from business site address. 114. OWNER CITY· Enter the name of the city for the owner's mailing address. 115. OWNER STATE - Enter the 2 character state abbreviation for the owner's mailIng address. 116, OWNER ZIP CODE - Enter the zip code for the owner=s address. The extra 4 digit zip may also be added. 117, ENVIRONMENTAL CONTACT NAME - Enter the name of the person. if different from the Business Owner or Operator, who receives all environmental correspondence and will respond 10 enforcement activity. 118. CONTACT PHONE - Enter the phone number, if different from Owner or Opera lor, at YA1ich the environmental contact can be contacted, area code first. and any extension. 119. CONTACT MAILING ADDRESS - Enter the mailing address where all environmental contact correspondence should be sent, if different from the site address. ( 120. CITY - Enter the name of the city for the environmental contact=S mailing address. . . ,~ 121. 5T ATE - Enter the 2 character state abbreviation for the environmental contact=S mamng address. 122. ZIP CODE· Enter the zip code for the environmental contact=S mailing address. The extra 4 digit zip may also be added. 123, PRIMARY EMERGENCY CONTACT NAME - Enter the name of a representative that can be contacted in case of an emergency invoMng hazardous materials at the business site. The contact shall have FULL facility access. site familiarity, and authority to make decisions (or the business regarding incident mitigation. 124. TITLE· Enter the title of the primary emergency contact. 125. BUSINESS PHONE· Enter the business number for the primary emergency contact, area code first, and any extensions. 126. 24-HOUR PHONE· Enter a 24-hour phone number for the primary emergency contact The 2+hour phone number must be one which Is answered 24 hours a day. If it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the indMdual stated above. 127. PAGER NUMBER· Enter the pager number for the primary emergency contact. if available. 128. SECONDARY EMERGENCY CONTACT NAME - Enter the name of a secondary representative that can be contacted in the event that the primary emergency contact is not available. The contact shall have FULL facility access, site familiarity, and authority to måke decisions for the business regarding incident mitigation. 129. TITLE - Enter the title of the secondary emergency contact. , . 130, BUSINESS PHONE - Enter the business telephone number for the secondary emergency contact. area code first, and any extension. 131, 24-HOUR PHONE - Enter a 24-hour phone number for the secondary emergency contact. The 24 hour phone number must be one YA1ich is answered 24 hours a day. If it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the individual stated above. 132, PAGER NUMBER· Enter the pager number for the secondary emergency contact. if available. 133, ADDITIONAL LOCALLY COLLECTED INFORMA TJON . This space may be used for CUPAs or Ms to collect any additional information necessary 10 meet the requirements of their individual programs. Contact your local agency for guidance. 134. DATE - Enter the date that the document was signed. (YYYYMMDD) 135. NAME OF DOCUMENT PREPARER - Enter the full name of the person who prepared the inventory submittal infonnat/on. 136. NAME OF SIGNER - En~r the full printed name of!h ;1erson signing the page. The signer certifies to a familiarity with the information submitted and that based on the signer=s inquiry of those individuals responsible for obtaining the infonnation, all the infonnaUon submitted is true. accurate and complete. SIGNATURE OF OWNERJ OPERATOR OR DESIGNATED REPRESENTATIVE· The Business Owner/Operator, or offlcially designated representalive of the Owner/Operator, shall sign in the space provided. This signature certifies that the signer is familiar with the t informallon submitted and that based on the signer=s inquiry of those individuals responsible for obtaining the information it is the '- signer=s belief that the submitted infotmation is !rue. accurate and completo. 137, TITLE OF SIGNER· Enter the tlUe of the person signing the page. CITY OF BAKERSFIELD OFF~ OF ENVIRON~IENTAL SIVICES 1719thester Ave., CA 93301 (661) ..6-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION '¥\:.ew D REVISE 200 DADO D DELETE I. FACILITY INFORMATION BUSINEI6(S(¿:FACI~b~ng'âùs7nc A~-~;ID-J---' - -- - ,- . . t . ,- - - . ..._.'-. CHEMICAL LOCATION .3300 tJh HG ~Cè..-... FA~IL~~ '~~~~~ J=,~_~I~==_-,~,--=~._~ MA:#(õp(~naQ---"'---- _._-_...~. "... -... --------..-.. (OM form psr malSf1al psr Oulldlflg or ~red ) Paçs 01 '-.---") .- ._--...._._... 201, CHEMICAL LOCATION CONFIDENTIAL (EPCRA) . ... 2Óf·" GRió. (opiiÒ;,ai) .., o YØ$ /:Z5-No 202 " --.-.'.---2õ-ï "'-- ....---.-------.-- CHEMlCALNA~--'--· -------.... .. ......, ..--,-.,...., -,-----,-. -------,---,--.'---"" - - -"2oŠ---fRÁöËseëkËi -'--O~~ õJ;o-2õ~" U ~ c1e.d ~ 0 I, rI~ . If Subjec1 10 EPCRA. reler 10 instructions .. __ _ _ ,._.., .,.___._ _0,. ,__..____ ______'______________ __,_____.____._. __..__. ..___.._., __ , _ _ .___. _" ._.. .. 207 COMMON NAME II. CHEMICAL INFORMATION ~~-'---'--" -. c h ~..t.fto,..1 EHS' CAS" Dyes DNo 208 ---- . FiRE CÕDËHAzAR'Õ"ëLASSESfCoinplete ir requested by locaIlirs d1ieI) ..----- 209 oJ( EHS is·Ves.· all llllOUDIS below muse be in Ills. 210 TYPË··-'" -·-------Ö;-~~;--O~ "'I~~~O w-.;;Š~ -----.----..,--.-------. ...-.----.------ ~IOACTIVE ---'O~-[:ï;;-·--·~;;_.. ëÜRÎÈS" .- "---"21"3 215 211 PHY~~~~:~~~_ __C?~. SOl~__ )'I.!_uaUID_ DI/GAS 214 LARGEST CONTAINER ----.---......-..-- -. _. ----- ---------------.. ..-..--- ------ FED HAZARD CATEGORIES I r~"Ck alllhal apply) , WASTE r )8.., FIRE 05 CHRONIC HEALTH .-.-------.-.-.-... D 2 REACTIVE D 3 PRESSURE RELEASE o 4 ACUTE HEALTH ---.-------- 217 MAXIMUM ¿j 0 DAILY AMOUNT Z 7r 0 0 ~ga GAl 0 ct CU FT . If EHS. amount must be in Ibs. 218 I AVERAGE LJ 0 ! DAilY AMOUNT i 7,.00 . !/..-- o II) lBS 0 In TONS " ---- 216 219 STATE WASTE CODE 220 221 DAYS ON SITE 222 UNITS' -------...- ---.------ ..--.--..... STORAGE CONTAINER (Check all that apply) D a ABOVEGROUNOTANK '6!1.0 UNDERGROUND TANK Dc TANK INSIDE BUilDING o d STEEL DRUM o e PlASTIClNÒNMETAlllC DRUM 01 CAN o 9 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 ø TANK WAGON D q RAil CAR Or OTHER 223 .._.__._~._-'..- ...-.--.------.--.--.-...------.---.--.-- .-----.--.. .......----------.------. STORAGE PRESSURE 'tQ. a AMBIENT D aa ABOVE AMBIENT o ba BELOW AMBIENT 224 STORAGE TEMPERATURE J8... AMBIENT 0 aa ABOVE AMBIENT 0 ba BELOW AMBIENT 0 c CRYOGENIC 225 ____ _..%~__._¡_-,---.----~~~~.??M~?~~:" __, ._....__,_,__L__,~~ 1__..____.____~AS # ,..,. ._,.__..__, 228 i (1~J/~c:.£¿ _~~L-..~&--~:..~-C?Y~No 228..L._,_________,__~_ 2 .. ,2~:.L... __ ..,r:ì.º~__V~6l~-~¿~~,~..~9-Y~,~~,2~~+ _"._. . ...____.,..........._:3__ 234 i 235 ! 0 Yes 0 No 236 ¡ 237 _..M'·" ...l............__.. .._....__.. ._.. ...___._..._..... _.-._ ___._.___.__.. __ ..____._. .......-. -_.._...~._-- .._~.._._._- ---j-.. -.". - . ---. ..... .-.-.------- 4 , 238 I 239 i Dves ONo 240 i 241 . .i_,..... . '- -··-··-r-·-----··-....·-·'---'-----··------·------·-..-'---'--' ,.,.. ..··..'-----r--'-'·-,·-·..··,·..·--··,;··..· ,..-_...,- '.-.- .---,. ,~_~_____,__ 2421___ __,______________.___ _..____ ___,____~:J.. 0 ~~_O ~_~~l___.___....__.____,__~ p~ffrWh~RÏ~~~PRESÈÑTATÑC-··'·-·--,--~ ~~-~.- 9!;;7/f?rE7 246·· ...... '" -".. . -.... - . - ..........-.. S:\CUPAFORMS\OES2731.TV4.wpd PCF (7/99) Haza.ls Materials Inventory· Chemical De.ption You '1'1U11 ':0''''01'"0 I "'0,",11" ",'~.\("\Jus \1.1I<1t1.IIS '''',~n'O('1 ' Chem'Cdl O"sc"pllon pag" :or "acn ndlarlJouS malotlal (naZardOus suOSfa"ce. J(1d ,nalardous ....I.) th.. vou 1'1.1""'" II /"ur ',11:1101'/ " "<Jf'ltJ...e 'IUd"',II... '''IUdl'O ,¡r¡roa'er Ihan 500 ;JOunds, 55.,jallons, ZOO cuDoc reel ot 'J'IS (calCulated Jt1ta"dard :emperalurlt ancl pr".ure) 11( 'h., '#)thtr 11 'n(lnnoh1 .J1.tnf111111 'lu~"flly fOf E.-.:tr'tmøly ~al3'''OlJ' SuO!I4.1"ces. "NhlCneVer I' 1695. Also cOmølet8 oJ pa98 lor ðacn "adlodctl'vð malenal "an<Jð(j OYer 'lu,I(1""'" 'or ..n,cn 1/1 'Im"'?""C'1 ;)'dn ,s ro.r¡UltO<1 :o,e 'oopled pu19uanllO 10 CFR Parts JO, JO, or 10, The completed ,nven/ory ~nould 'enoCI a/I (oportaD,. qu.nl"le. 1)1 n,l.l3(rjOlJ'i "n.)ton.)-¡ .J( (our I.lt.:lhty. 'epottðd tep,oIf31.ly ICt "tacn OUI)d'''q or \Jutslde .JdÎ.1Canl .Jrea. 'Nlth 'lpar:U. oages (or unIQue 0Ccur,ences:J1 ;)nY'IC31 "3te. storage 10rnpeUlur., ,n,j Hongo pr'!sSur'!, ,NOI": In.. "umOm",,! ,¡, 'ne ,nS"uCIIO"S (o"o~ the ojala ~Iemønt numDers Inal .1'" on Ihe UPCF pa<)es, rnese ,jala ~Iement numbers Jr6 ~s6<J 'or "I.,Clm",c suOrn'SSlon Jnd ",e 11'1" ~am., a. '1'16 numOeflng used ,n 27 CCR. ,""ppendix C, Ine BusIness Secllon 01 the Un,fied ?rogr~m Dala D,cl/onary,) Pleas. numD"r ," Pdq'" ,J' 'lour submittal. rhls helps your Ct;P", or ~ 'denloly oNn"tner Ihe suDmlttal ,s complete Jnd ,I any pages are ,eparah'd, I, FACILI ry /0 NUMBER, rhls "umDer IS Jsslgnoo Jy ¡nO CUPA or AA, Th,s IS Ine unique "umDer ",hrcn Identlfie. your raclllty, 3. BUSINESS NAME, Enler tn" rulllegal name at Ine JUSlneSS, 200, ADD/DELETEI REVISE· Ind.cate II the malenalls Je'ng added 10 the Inventory. deleted (rom lhe ,nvenIOry. or il Ihe inlormallon prevoously suDmllled is Delng revised. NOTE: You may choose 10 leave Ih.s òlank II you resuDml1 your entire inventory annually, 201, CHEMICAL LOCA nON· Enter Ihe Duo/d.ng or OutsldeJ aCjacenl area ..here the hazardous malerial is handled, A chemicallJ1at is stored allhe same pressure and temperature. In mullople locations ..,In", a òuoloing. can De reported on a single page, NOTE: This inlormation is nol suDject to puDllc disclosure pu(Suanl to HSC §25S06, 202, CHEMICAL LOCA TlON CONFiDENTIAL - EPCRA . All ouslnesses whicn are subject to the Emergency Planning and Community Ri<]hltO Know Act (EPCRA) must cheCk -Yes' 10 "eel' cnemo:allocation InlormatlOn confidenlial. II Ihe Dusiness does not wish 10 keep chemicallocallon inlormation confidenllal check "No', 203, MAP ,\lUMBER, 'I a map IS included. enler the numDer 01 the map on wnicn the location 01 Ihe hazardous malerial is shown, 204, GRID NUMBER· II gnd coordinates are used, "nler Ihe gnd coordinates 01 the map that correspond to the location 01 Ihe hazardous malerial, II applicaDle. multiple grid coordinates can oe lisled, 205, CHEMICAL NAME· Enter the proper chemIcal name associated 'NÌlh the Chemical Abstract Sef'líce (CAS) numDer 01 the hazardous malerial. This should be the Intemational Union 01 Pure and Applied Chemistry (IUPAC) name lound on the Material Salety 0.11.1 Sheet (MSDS), NOTE; If Ihe chemical is a mixture. do not complele this field; complete t"" "COMMON NAME' tløld instead. 206, TRADE SECRET. Check "Yes' if the inlormalion in this section is declared a trade secret. or "No' if it is not. Stale requirement: If yes. and business is not suD8d to EPCRA. disclosure of the designated trade secret infonnaoon is bound by HSC §255", Federal requirement: If yes, and business is ~ubject to EPCRA, disclosure of the designated Trade Secret information is bound by 40 CFR and the busil188S must submit a "SubStantiaoon to Accompany Claims of Trade Secrecy" form (40 CFR 350.27) to USEPA. 207, COMMON NAME - Enter the common name or trade name of th. hazardous material Of mOOure 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, Appendix A. If the material is a mixture ccntaining an EHS. leave tnis section Dlank and complele the section on hazardous componenlS below, 209, CAS" - Enter the Chemical Abstrad Sef'lice (CAS) numDer lor the hazardous material, For mixtures. enler the CAS number of the mOOure if it has been assigned a numÞør distind from ilS components, If Ihe mixture has no CAS number. leave this column Dlank and report the CAS numbers of the individual hazardous components in Ihe appropriate section Delow, 210, FIRE CODE HAZARD CLASSES - Fire Code Hazard ClassØ$ describe to firsl responders Ihe type and level of hazardous materials whien a business handles. This inlormation shall only De provided il the local r.re chiel deems it necessary and requesls (he CUPA or AA to collacl it A list of tne hazard classes and insltuclions on how to delermine ..hien class a material lalls under are included in lJ1e appendices of Attkle 80 of Ihe Uniform Fire Code. If a material has more than one . applicaDle hazard class. include all, Contact CUPA or AA for guidance. 211, HAZARDOUS MATERIAL TYPE - Check the one Þox that Þøst describes the type of hazardous materiat pure. mOOure or waste. If waste material, check only that box. If mixture or wasle. complete hazardous components secoon. 212, RADIOACTIVE - Check ·Yes· if lJ1e hazardous material is radioactive or 'No' if it is nol 213. CURIES· If the hazardous material is radioactive. use Ihis area to report the activity in curies. You may use up to nine d'IQits with a floating decimal point to report activity in curies. 214, PHYSICAL STATE· ChecIc the one box that best describes the state in which the hazardous material is hal1dled: solid. liquid or gas. 215, lARGEST CONTAINER· Enter the total capacity of lhe largest container in which the material is stored. 216, FEDERAL HAZARD CATEGORIES - Check all cat cries that describe the h ' I aod health hazards associated with the hazardous material. PHYSICAL HAZARDS HEALTH HAZARDS Fire: Flammable uids and Solids. Combuslible L' uids, hones. Oxidizers Acute Health (lmmedlata): Highly Toxic. Toxic, Irritants. Sensitizers. Corrosives, Reactive: UnslaDle 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 Agenls ChronIc Health (Del.yed); Carcinogens. other hazardous Chemicals with an adverse effect with 10 tenn ex sure 217, AVERAGE DAILY AMOUNT. Calculate the average dady amount of the hazardOus material or mixture containing a hazardous material, in each building or adjacentl outside area, Calculations shall De Dased on tile previous year's inventory of material reponed on this page, Total all daUy amoul1ts 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 location, the amount shall be the average daily amount you project lo-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 materia'. which is handle<! in a building Of adjacent/outside area at any one lime over the course of the year. This amount must contain at a minimum last year's inventory of the malerial reponed on this page. with the reßection of additions, deletions. or revisions projected for the currenl year, This amount should be consistent with the uni1s reported in box 221. 219, ANNUAL WASTE AMOUNT· If the hazardous material Þøing inventoried is a waste. provide an estimate of the annual amount handled. 220, STATE WASTE CODE ·If thflhazardous material is a waste. enter the appropriate Califomia 3~igit hazardous waste code as fISted on the back of the Unifonn Hazardous Waste Manifest 221, UNITS - Check the unit of measure that is most appropriale for the material being reported on this page: gallons. pounds. cubic feet Of tons. NOTE; If the material is 8 lederally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If malerial is a mixture conlaining an EHS. reponll1e unils that tho malerial is stored in (gallons. pounds. cuDic foe~ or Ions), 222, DAYS ON SITE· List the tOlal number of days during the year that the material is on site, 223, STORAGE CONTAINER. Check all boxes thaI describe Ihe Iype of storage containers in which the hazardous malerial is stored, NOTE: If appropriale. you may choose more than one, 224, STORAGE PRESSURE - Check the one box Ihat Dest descriÞøs the pressure .11 which the hazardous material is stored, 225, STORAGE TEMPERATURE· CheCk the one Dox Ihat besl describes the temperature at which t/'lo hazardous material is stored, 226, HAZARDOUS COMPONENTS 1-5 (% BY WEIGHT) . Enler Ihe percentagø weight of the nazardous component in a mixture. If a rango 01 percenlages 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 repMing a hazardous materia/that is a mixture, list up to fivø chemical names of hazardous componenls in that mixlure Dy percent weighl (reler to MSDS or. in the case of trade secrets. refer to manufaclurer). All hazardous components in the mixture presenl at greater than 1 % Dy weight if non-carcinogenic, or 0,1 % by weight if carcinogenic. should be reported. If more than fIVe hazardous components are present above these pnrcentages, you may allach an additional sneet of paper to capturo the required inlormation. When reporting waste mixtures. mineral and chemica/ compos;oon should De listed, (Report lor componenls 2 through 5 in 231, 235. 239, and 243,) 228, HAZARDOUS COMPONENTS 1·5 EHS . Check 'Yes' if t/'lo component of the mixture is considered an Extremely Hazardous Substance as defoned in 40 CFR. Part 355. or ·No· i'it is nol. (Report for components 2 Ihrough 5 In 232. 236. 240. and 244,) 229, HAZARDOUS COMPONENTS 1-5 CAS - Lisllho Chemical Abslract Service (CAS) numbe" as related to Ihe hazardous components in the mixture, (Repeat lor 2·5.) 246, LOCALLY COLLECTED INFORMATION· This space may be used by the CUPA or AA 10 collocl any additional information necessary 10 meellhe requirements of their individual programs, Contact the CUPA or AA for ~uidance, UPCF (1/99) OES Fonn 2731 7 ( c ( ,:~~ II (. ~,,~~~_~I .,i¡ A.r. r ..0...- -"""" - ',-' .. CIT\' OF BAKERSFIELIja OF~E OF ENVIRONiVlENTAL ~VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 FAÒi.iTv 10. (For otiïëë use on"; '--pleasëiëå~ëtÏiånk) I. FACILITY IDENTIFICATION ( FACILITY INFORMATIOr, Business Activities Addendurr Page 01 .------ ~_. _._ 4 _4 ....__._ _ .___u._. ~".__..._._..._. __.._....__..._. . ,'.' - . _... .06;~NA~~ry Che..l/;cJ¡-) EPA /0 # ..--.-.-- 2 ..--.----.-.....---- - .....-.--- --------...----........----.---.-- -----_. -------.. -'--"----- -..-- -- -,."..-.---.- .... _.. .._-- - ------ .----. ------- III. CONSOLIDATED PERMIT ACTIVITIES -----.---.. Is your Facility Compliance Plan subject to review by... for satisfying the conditions of these permits? '--H~DËPÃRTMEiiiTöFTÕXicsuBsTÃNèËšCÕÑTRõï..---·--C::WESØNÕ- --"-;;---- ·'STÄNOÄFfõizEOPERMIT--" -- --.-----~---- , I. All Modifications :V' aVES @No . aVES - /0 ¡ V' NATIONAL POLLUTION DISCHARGE @N : ELIMINATION SVSTEM (NPDES) KCÃÜFOR-ÑiAïNiËGRATEDWÃSTEMANÃGEMENTOO'ARD ÖYES~Õ--:-.7-REGïšTRÃTlOÑ PERMIT : aVES ~NO aVES ~O .. -I~' SÃÑ'JoÃöüiNVÃLCË)ïÜÑiFïËõ-ÃiR-POLLUTION ------~S ONO CONTROL DISTRICT / ~VES ONO aVES ~O aVES Q'No -..,.--------------.------ J. STATE WATER RESOURCES CONTROL BOARD :NTRAL VALLEV REGIONAL WATER QUALITY CONTROL ~ ;..ï.~ËRN-COÙÑTvR-ÈSOURCE MÃÑÃGËMËÑTAGËNC-ÿ----·-;~ES ¿NO - aVES c'NO aVES QNO aVES 0N0 aVES QNO aVES (JNO .V' IV' 'V' ¡V' :V' ¡V' I ; , ;V' I I !V' :V' ¡V' i V' Non-RCRA HAZARDOUS WASTE FACILITY RCRA HAZARDOUS WASTE FACILITY ---------.--..-------. AUTHORITV TO CONSTRUCT PERMIT TO OPERATE -_. ----_. WASTE DISCHARGE REQUIREMENT (WDR) GENERAL PERMITS SPECIFIC PERMITS (' V' ENVIRONMENTAL HEALTH SERVICES PERMITS Domestic Water Well Permit Haz Mat Monitoring Well Permit Septic System Permit Public Swimming Pool Permit Food Facility Construction Permit Solid Waste Local Enforcement Agency (LEA) Related Permits aVES ciNO i V' Medical Waste Related Permits 'CoiiY OF BÄiŒRSFIËlDwAsTEWATE-RÓlïíísi6N·----·~~·ÖyËi,- 1.0 ·---·-¡-~-·-~~'Ifn.riiíÄLWÄS-¡ËwÄTER-ÕISëHARGE-- NOTE: V' 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. S.\CUPAfOflMS\AcIMy _wpd Jo.ir I. looe l ~'~ "" ·:kii/~ ......~~.- . CITY OF BAKERSFIELD OFF. OF ENVIRON~IENTAL S.lCES 1715 Chester Ave., CA 93301 (661) 326-3979 FACILITY INFORMA nON Business Activities FACILITY 10 ~ rFa< ",rrce use only, ordaS8 rea.e Olank) I. FACILITY IDENTIFICA nON PJçe ,,; EPA rO # 2 OB~I~r¡;~~vr1rrt Ch e\fr~;i 330C> .\ J h,t:G., ~ -. ._..,.,..__ d_...,__..__._ ___h. Þ JCJleI C.A q 33 0 9 II. ACTIVITIES OECLARA TION ;,n· HA~RDOÚS~~;~'~'RIÄiS·· ·.~õ~~_.ÿ~~·~'~a~i~~ ~'·~~·~=-~-¿è~-'·:~~~ .----.~~~.~:-' ~'~~·-..-~ES,I;::~, 2~~~~::m~~~jl~i:~~~-)~~== 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 planninQ elements; cu ft for compressed gases (include liquids in ASTs and . Emergency Response Plan USTs)? ¡ . Maps Have any amount of an explosive material (other than j øYES ONO 5 . Training ammunition) on site? . . Prevention . Certifications B, REGULA TED -süasTÄÑë-ëš"(RS)'- ,.., ------- ·--:C5"YES""'®NO'~~--ö"ES· FORMÙj1-(ë~~'i~ïô";~PI;on F;;,;,'----·· __On. Have onsite RS at greater than the threshold planning V' RISK MANAGEMENT PLAN (RMP Submillo USEPA) quantities established by the California Accidental V' CONSOLIDATED COMPLIANCE PLAN Release Prevention program (CaIARP)? ' .. Incorporating CalARP Program Elements C',-ÜÑDERGRÖÜNifsTÕRÄGE-TANKS-(ÜSTŠ)·----'---..~Š-bNO ---~V--·---ÜŠT-FACiLITy·FÓRM -, .,-----... -- - ..---- 1 Own or operate Underground Storage Tanks? , V' UST TANK FORM (one pet tank) , Intend to upgrade existing or install new USTs? : QVES aNO 8 ~ V' UST FACILITY FORM I V' UST TANK FORM ! ! V' UST INSTALLATION FORM (one pet tank) (5,.' TANK -CLÕSÜREï'RËMÕVAL. . ----------- : QYES~- -97-;¡--usfTÃÑK·FORM(d~~·'~~ecti;;-~e P;'~;;kr----' 1, Need to report closing a UST that held hazardous materials or waste? ..-. -.--.-. -.. ..--.----.-. ..---..--...------- E. ABOVE GROUND PETROLEUM STORAGE TANKS lASTs) Own or operate ASTs above these thresholds: any tank capacity is greater than 660 gallons or the total capacity I for the facility is greater than 1,320 gallons. , . ".--- ,. ".. . .-.. >----.- ---.-------:.....-.----.--. F. HAZARDOUS WASTE: 1. Generate hazardous waste? ¡ QYES Ø'NO 2, Recycle more than 100 kg/mo of recyclable materials at ! QYES @NO the same location it was generated? Recycle more than 100 kg!mo of recyclable materials at QYES ~NO an offsite location different from the point of generation? Treat Hazardous Waste on site? QYES ~O Subject to Financial Assurance requirements? QYES coCo Consolidate Hazardous Waste generated at a remote QVES ~O G, PER~i~e~ONŠÒÜÖÄTjÒÑ ·ZÓÑE: ---,........., -..- '.-- -·----1 -OŸËS·"@Õ·- Intend to consolidate other Cal/EPA agency permits? ! (If yes, please complete Section III and attach) 2, 2, 3. 4, 5, , 6. QYES ~O 10 i V' TANK CLOSURE FORM :-ÖYËs~o---~-~-'----ëOÑ-Š-ÕUDÄÏ'ËD CÕMP-ÜÄÑCE PL.ÃÑ- _.,-- . Incorporating Federal Spill Prevention Control and Countermeasure (SPCC) Elements pursuant to 40 CFR Part 112 ....-.-.... -....-.--.-. -.---.---.----- EPA 10 number--provide on this page To obtain EPA 10#. please phone (916) 324-1781 RECYCLING FORM Need to report the closure! removal of a tank that was classified as hazardous waste and cleaned onsite? 12 13 14 V' 15 V' V' 16 V' 17 V' ..,.+..... 18 V' ." ..--.. ---- ...- -.. .-....-.-.----.--. V' V' RECYCLING FORM TP FACILITY FORM (DTSC Form 1772) TP UNIT FORM (one per unit) CERTIFICATION OF FINANCIAL ASSURANCE REMOTE WASTE / CONSOLIDATION SITE NOTIFICATION FORM ._........ .,... .......M.. ..__ ......_....,.._.. .__.""W9 ____._._._... CONSOLIDATED COMPLIANCE PLAN . Incorporating all other environmental permit requirements per 27 CCR 10410 -E: , IOU checked YES to any part of Sections IIA-IIG above. then in addition to the forms requested above, please Submit OES Form 2730. UPCF (7/99) S:ICUPAFORMSIACTlVITY.wpd STATE \v:.-\S I'E CODE . .. . ' ., . , 220 It thl:: haL:mlous mat~rra a waste:, enter the approprrate: Calltom/a J-dlglt h.\zardous wastt: ~odl:: as /rste:d on tht: back ùf the: Uniform Hazardous \Va.ste Manif~st. A list of common Statl:: Wastl:: Cùdt:s are included on page 4 of thes~ instructions, UN[TS 221 Chc:ck the unit of m~asure that is most appropriate for the: material b~ing reported on this page; gallons. pounds. cubic feet or tons. NOTE: [f the material is a federally defined Extremely Hazardous Substance (EHS). all amounts must be reported in pounds. ff material is a mixture containing an EHS. report the units that the material is stored in (gallons, pounds, cubic feet. or tons). DA YS ON SfTE 222 List the total number of days during the year that the material is on site. STORAGE CONTAfNER 223 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. STORAGE PRESSURE 224 Check the one box that best describes the pressure at which the hazardous material is stored. STORAGE TEMPERATURE 225 Check the one box that best describes the temperature at ~hich the hazardous material is stored. HAZARDOUS COMPONENT 1 - 5 (% by weight) 226, 230, 234, 238, 242 If a range of percentages is available, report the highest percentage in that range. HAZARDOUS COMPONENT 1 - 5 Name 227,231,235,239,243 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). AU 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 paper to capture the required information. When reporting waste mixtures, mineral and chemical composition should be listed. HAZARDOUS COMPONENT 1 - 5 EHS 228, 232, 236, 240, 244 Check "Y" for yes if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "N" for no, if it is not. HAZARDOUS COMPONENT 1 - 5 CAS 229,233,237,241,245 List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. III. SIGNA TIJRE: Please print name. title, sign and date each chemical description form. 246 If you have any questions please call us at (661) 326-3979 3 · ' .ALIFORNIA \V ASTE coo. Cnut: Dt:s~rintiol1 InorC!:Il1il:s [ II :\l:Ï\j solution 2 < pH < 7 with metals (antimony, arsenic, barium, beryllium. cadmium. chromium. cobalt, copper. lead. mercury, molybdenum, nickel, selenium. silver. thallium. vanadium and zinc) 112 Acid solution without metals (13 Unspecified acid solution 121 Alkaline solution pH >12.5 with metals (see III) 122 Alkaline solution without metals 123 Unspecified alkaline solution 131 Aqueous solution (2 < pH < 12.5) containing reactive anoins (azide, bromate, chlorate, cyanide, fluoride, hypochlorite, nitrite, perchlorate and sulfide anions) 132 Aqueous solution with metals (see Ill) 133 Aqueous solution with total organic residues 10% or more 134 Aqueous solution with total organic residues less than 10% 135 Unspecified aqueous solution 141 Off-spec, aged, or surplus inorganics 151 Asbestos containing waste 161 FCC Waste 162 Other spent catalyst 171 Metal sludge (see Ill) 172 Metal dust and machining waste (see 111) 181 Other inorganic solid waste Oreanics 211 Halogenated solvents (methylene chloride, chloroform, TCE, TCA) 212 Oxygenated solvents (acetone, butanol, MEK) 213 Hydrocarbon solvents (stoddard solvent, xylene) 214 Unspecified solvent mixture 221 Waste oil and mixed oil 222 Oil/water separation sludge 223 Unspecified oil - containing waste 231 Pesticide rinse water 232 Pesticide and other waste associated with pesticide production S.lCIIP,.\FORMSI/fA7.MAT FACILITY INFO INST, " --:....... Codt: Dc:saiPtiol1 ( 241 Tank bottom \1i:1Stc: 25 ¡ Still bottoms with halogenated organics 252 Otht:r still bottom waste 261 PCS's and material containing PCS's 271 Organic monomer waste (includes unreacted resins) 272 Polymeric resin waste 281 Adhesives 291 Latex waste 311 Pharmaceutical waste 321 Sewage sludge 322 Biological waste other than sewage sludge 331 Off-spec, aged or surplus organics 341 Organic liquids (nonsolvents) with halogens 343 Unspecified organic liquid mixture 351 Organic solids with halogens Sludges 411 Alum and gypsum sludge 421 Lime sludge 431 Phosphate sludge 441 Sulfur sludge 451 Degreasing sludge 461 Paint sludge 471 Paper sludge/pulp 481 Tetraethyllead sludge 491 Unspecified sludge waste ("' Miscellaneous 511 512 513 521 531 541 551 561 571 581 591 611 612 Empty pesticide containers 30 gal or more Other empty container 30 gal or more Empty containers less than 30 gal Drilling mud Chemical toilet waste Photo chemicaVphoto processing waste Laboratory waste chemicals Detergent and soap Fly ash, bottom ash, and retort ash Gas scrubber waste Baghouse waste Contaminated soil from site clean-ups Household wastes l ~....... ... 4 . . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE., BAKERSFIELD, CA (661) 326-3979 SITE AND FACILITY DIAGRAM INSTRUCTIONS FOR HAZARDOUSMATERIALS~AGEMENTPLANS These instructions explain the use of the site diagram and the facility diagram. Normally, small and medium size businesses will only have to submit a site diagram. If you have subdivided your business into smaller areas because of the complexity or size, then you will be completing and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business if it is in a remote location. All diagrams must be on 8 ~ x 11 paper and dr~wn using a straight edge tool. SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following information: 1. Check the box on the top left comer of the form provided that indicated "Site Diagram". 2. . Print the name of your business, as shown in your HMMP, on the top of the diagram. 3. Label the location of the hazardous materials and identify them by name and type of hazard (ie. Flammable liquid, corrosive solid). 4. Label the location of utility shutoff points for gas, electric and water services. 5. Label the location of fire hydrants. 6. Label portions of the building protected by automatic sprinkler systems. 7. Label the direction representing north on the diagram. (The diagram form provided includes a north arrow). 8. All labeling edentitication on the diagram must ~ible and easily understandable at the scale submitted. Diagrams must be sufficiently legible to produce a legible copy. \ Try to avoid the use of abbreviations or symbols. [f you must use them, provide a legend explaining your system. Maps may be returned for correction if you fail to follow these instructions. FACILITY DIAGRAM INSTRUCTIONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. 1. Check the box in the upper right hand comer of the fonn provided that indicated "Facility Diagram". 2. Print the name of your business as shown on your HMMP: Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. 3. Indicate which area the diagram represents and the total number of facility diagrams that you are including. If a map represented the first of four areas, it would be labeled #1 of 4. 4. Follow instructions (3 -8)* for site diagrams regarding the specific details to be included on'each facility diagram. UNDERGROUND STORAGE TANK FACILITIES PLEASE NOTE: * If you operate an Underground Storage Tank (UST) facility, the facility diagram shall also specify the location(s) of the UST continuous leak monitoring system and/or the location(s) where the UST monitoring will be performed. (, 2 sm: DIAGRAM ~ _ F^~DIAGRAM' X I Bulin.. Name: ;(-c.C>--~\Î ,'" ' Buoinesa Address: _. òe> I <-I ¡; :-H"' _ (~"'--'- -. ':( ~ () "2 -- ~ ,/1 ~ 1 v bd V $$;1 , I j;-: ///~/ \.....1 '. /..... , // 9- .--/ \; /- ,/- x \ ' // . -" ..- \k/ ~ '. \. / '''; , \ \ ..-/ \'\// , /<') \\ ~: \--"\.../ ../~ ) .-- - ,(' . \1'/hr-rL- ~' --,.. , r\J "- \1 --..,..........J ,J ........... '-------.Q ,,' -- <- .:-.-/ . 1~ S~DIAGRAM~' . ~ FACILlTYDIAGRAM[ j Busmeu Name: 7' ~ '- Buainesa Address: --- - - - :°5.> c \ ~ ¿ rl'. (/ ~ ~ . f , I f , I PROPOSED : SMART t I FINAL , I ~----- PROJECT LOCA TION jV\G1 f-I~ ¡-I GV¡'- A--:-::> ~~': .-,1 -.: o < o 0::: ~ WHITE LANE - VJí~ d C- $-1 o it {XJ~ \?~ø . " . . SULLIV AN PETROLEUM, LLC Presents BIG COUNTRY CHEVRON SAFETY MANUAL 1 ~ . . SAFETY POLICY It is the Company's policy to provide a safe and healthy work environment for its employees and customers. The company is committed to the development and education of safe work habits. The following systems have been developed to support and comply with Occupational Safety and Health Standards (OSHA). RESPONSIBLE INDIVIDUALS Meeting infonnation and training programs are the responsibility of supervisors. COMPLIANCE SYSTEM Safety training will be conducted on site. All newly hired employees are required to attend initial training programs and on-going safety meetings, which are to be held monthly at the locations. Initial training and safety meetings will be documented as to subject matter and attendees. COMMUNICATION SYSTEM All unsafe conditions should be reported directly to the management. At the option of the employee, such a report can be made anonymously without fear of reprisal. HAZARD EVALUATION AND INSPECTION Inspections are conducted on a regular basis (quarterly). To be documented with an inspection checklist with employees at safety meetings. CORRECTION PROCEDURES Based on the severity/nature of the hazard, a system for abatement procedures does exist, involving either Chevron Maintenance or Chevron Emergency Maintenance Your safety and our customers' safety are top priorities. You will be working around flammable materials and some toxic substances; you will receive Hazard Communication and Hazardous Waste Operations and Emergency Response (HAXCOM and HAZWOPER) training to teach you what to do in an emergency. As part of this training you also must know where the following items are located at your station: (attached is a site plan showing you where these items are) · Emergency pump shut-off switches · Electrical control panel(s) · Air and water shut-off switches 2 . . · Portable fire extinguishers · First aid kit · Emergency telephone numbers Awareness and prevention go hand-in-hand. Following are some general tips to help keep you and your work environment safe. · Do not smoke within 50 feet of any gasoline dispenser, even inside a vehicle · Do not refuel a vehicle while the engine is running · Do not put gasoline in any container that is not approved specifically or this purpose · Do not use gasoline for cleaning or any other purpose other than fuel · To avoid a possible static electricity-sparked fire, ask customers to remove portable gasoline containers from vehicles and set on the ground prior to fueling · A void prolonged skin contact with all petroleum products. If you come into contact with any irritating substance, wash the affected area immediately with soap and water. · Clean up small spills immediately. At the pump islands, use the tools and absorbent material specifically provided for this purpose. In the store, mop the floor; remember to place a "wet-floor" sign by the spot until it dries · If a separate container is provided for different types of refuse, put waste materials into the proper container · Place oil or paint soaked rags in covered metal containers to prevent spontaneous combustion. · Do not put broken glass, scrap metal, etc., in containers used for rags and papers. · Keep clear space in front of all electrical panels and other emergency equipment · Use protective gloves when cleaning restrooms and for other cleaning processes as directed. · Keep all passageways, including driveways, aisle, and doors, clear · Do not leave boxes, products, or any other material where they can become a tripping hazard. · Avoid back strain by using a back belt and bent knees when lifting · Observe station policies for locking doors, requesting ID's, securing purses and other personal property, and maintaining unobstructed views of customer service areas. 3 '-- . . · Correct or report any usage conditions immediately, before accidents occur. EMERGENCY CONSOLE & PUMP STOPPAGE Listed below are ways to STOP the fuel pumps in case of spills or other emergencies. Make sure you are familiar with them at each site to tum off the fuel pumps. · Located on both Gilbarco and Wayne registers there is an ALL STOP button (please learn the location of this button) · There is a big red button outside located on the front of the building. FIRE EXTINGUISHER LOCATIONS . See location on facility maps · Have manager point them out FIRST AID KIT LOCATION Location of first aid kits vary at each site. Manager will show them to you on station tour, upon hire "*remember all on the job injuries must be reported to your manager at once. DIESEL SPILLS AND POWER FAILURES Steps: · STOP the spill. Use the emergency shut off to stop any spill · Immediately notify your manager or any manager on duty · Contain the spill using the absorbent/spill kit located at that site to confine the spill as much as possible · Notify the proper agencies that a spill has occurred If containable use proper absorbent If it leaves the property call 911 4 . . POWER FAILURE PROCEDURES In the event of power failure the P~S system will continue to run on the battery back up or UPS. The UPS can operate on its battery supply for only a short time. If the power does not return to the UPS and you do not turn it off, the UPS will shut itself down, taking the system with it. BEFORE this happens you must back out the system and turn it off. To do this take the following steps: · Call 800-435-7277 (located on register display) IMMEDIATELY · Contact Manager Other things to be aware of are: . Flashing lights are located under the counter and in the supply room · Be sure to check for customers in the restrooms · Do not allow anyone to walk through any part of the facility in the dark · Emergency phone list is located close to phone in the sales area & in the employee area close to the time clock 5 .. . .i . STATION TOUR & SAFETY CHECKLIST Company policy, as well as state and federal regulations, prohibit anyone from working in the station until they have completed safety training. This checkJist must be completed at the beginning of "on-the-job" training, at the site assigned, As well as the beginning of the employee's first day at their home station. Emp Initials Emp Initials Office/Register Area Location of first aid kit and what to do in case of employee or customer injury Location and use of goggles, disposable gloves, and disinfecting cleaner Importance of washing hands Location of Labor/Safety posters, Sexual harassment policies Company policy regarding proper lifting technique Location and use of Tank monitoring system, remote, printer. Location of, and how to use fire extinguishers Location of all manuals, (Operations, Emergency, forms. Service Station Maintenance Guide, HAZCOM, HAZWOPER, Robbery pkt. Etc Location of Emergency Phone Numbers. Location of Site Map Emergency response procedures for fuel island leak' or fires Isolating a pump Emergency shut-off switch on registers Calling 911 Use of the intercom system Location and use of tank line monitoring system Procedure for alarm response for tank monitors Evacuation and Meeting location Outside Building Designated parking for employees Location of emergency shut-off switches Location of outside fire extinguisher(s) Location of absorbent material for cleaning petroleum product spills Location of electrical panels, circuit breakers, main power switch 6 ,;. ~ r', . . Location, capacity and product type of underground storage tanks Location of fill caps and maintenance of spill containment box Location and use of water main Location of sprinkler system control Employee Name (print) Employee Signature Social Security Number Station Assigned Date Signed Manager Date 7 ~ >to ". 'C .' . . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES HAZARDOUS UNDERGROUND STORAGE FACILITY PERMIT SUMMARY OF CONDmONSIPROHmmONS CONDITIONSIPROHmmONS 1. The facility owner and operator must be familiar with all conditions specified within this permit and must meet any additional requirements to monitor, upgrade, or close the tanks and associated piping imposed by the permitting authority. 2. If the operator of the underground storage tank is not the owner, then the owner shall enter into a written contract with the operator, requiring the operator to monitor the underground storage tank; maintain appropriate records; and implement reporting procedures as required by the Department. ':> 3. The facility owner and operator shall ensure that the facility has adequate financial responsibility insurance coverage, as mandated for all underground storage tank~ containing petroleum, and supply proof of such coverage when requested by thè permitting authority. 4. The facility owner must ensure that the annual permit fee is paid within 30 days of the invoice date. 5. The facility will be considered in violation and operating without a permit if annual permit fees are not received within 60 days of the invoice date. 6. The facility owner and/or operator shall review the leak detection requirements provided within this permit. The monitoring alternative shall be implemented within 60 days of the permit issue date. 7. The facility underground storage tanks must be monitored, utilizing the option approved by the permitting authority until the tank is closed under a valid, unexpired permit for closure. 8. Any inactive underground storage tank which is not being monitored, as approved by the permitting authority, is considered improperly closed. Proper closure is required and must be completed under a permit issued by the permitting authority. ;;: . . 9. The facility owner/operator must obtain a modification permit before: a. Uncovering any underground storage tank after failure of a tank integrity test b. Replacement of piping c. Lining the interior of the underground storage tank d. Any other work which alters the tank or piping. 10. The tank owner must advise the Bakersfield Fire Department within 10 days of transfer of ownership. 11. Any change in state law or local ordinance may necessitate a change in permit conditions. The owner/operator will be required to meet new conditions within 60 days of notification. 12. The owner and/or operator shall keep a copy of all monitoring records at the facility for a minimum of three years, or as specified by the pennitting authority. They may be kept off site if they can be obtained within 24 hours of a request made by the local authority. 13. The owner/operator must report any unauthorized release which escapes trom the secondary containment, or trom the primary containment if no secondary containment exists, which increases the hazard of fire or explosion or causes any deterioration of the secondary containment within 24 hours of discovery. ':! MONITORING REOUIREMENTS: 1. Any underground storage tank not utilizing interstitial monitoring or a State approved automated tank gauging method shall be monitored utilizing the following method: a. Standard Inventory Control Monitoring (tank gauging five to seven days per week). Ifneeded forms can be obtained trom the Bakersfield Fire Department. Inventory reconciliation and/or tank gauging shall not be used on any tank for leak detection after December 1998. 2. All tanks shall be tested annually utilizing a tank integrity test which has been certified as being capable of detecting a leak of 0.1 gallon per hour with a probability of detection of 95 percent and a probability of false alarm of 5 percent. The first test shall be completed before December 31, 1992, and subsequent tests completed each calendar year thereafter. All tank integrity tests completed after September 16, 1991, shall be completed under a valid, unexpired Pennit to Test issued by the Bakersfield Fire Department. 3. Manual tank gauging and/or inventory reconciliation for purposes ofleak detection shall not be allowed after 1993 for tanks located in areas where the highest historical ground water is within twenty feet of the bottom of the tank. ...ii ,.". 'i: . . 4. All suction piping shall be monitored for the presence of air in the pipline by observing the suction pumping system for the following indicators: a. The cost/quantity display wheels on the metered suction pump skip or jump during operation. b. The suction pump is operating, but no motor vehicle fuel is being pumped. c. The suction pump seems to overspeed when first turned on and then slows down as it begins to pump liquid; and d. A rattling sound in the suction pump and erratic flow, indicating as air and liquid mixture. 5. All underground storage tanks containing motor vehicle fuel shall be retrofitted with overspill containers, over fill protection, automated tank gauging /inventory control and/or interstitial monitoring devices and corrosion protection by December 1998, or shall be removed and replaced with a system that meets new construction standards specified by the State regulation. All tanks containing a hazardous substance other than motor vehicle fuel shall have secondary containment and meet all other State standards by December of 1998. , J 6. All equipment installed for leak detection shall be operated and maintained in accordañce with manufacturer's instructions, including routine maintenance and service checks (at least once per year) for operability or running condition. 7. An annual report shall be submitted to the Office of Environmental Services of the Bakersfield Fire Department each year after monitoring has been initiated. ANY QUESTION, RELEASE REPORTS, ETC. SHOULD BE SUBMITTED TO THE OFFICE OF ENVIRONMENTAL SERVICES, BAKERSFIELD FIRE DEPARTMENT 1715 CHESTER AVE., 3RD FLOOR, BAKERSFIELD, CA 93301 (805) 326-3979 Map labeling must be lee and easily understandable. Try to . the use of abbreviations ~r symbols. If you must use them, provide a legend explaining your system. .':J Maps may be returned for correction if you fail to follow these instruction. FACILITY DIAGRAM INSTRUCTIONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. 1. Check the box in the upper right hand comer of the fonn provided that indicated "Facility Diagram". 2. Print the name of your business as shown on your HMMP. Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. 3. Indicate which area the diagram represents and the total number of facility diagrams that you are including. If a map represented the first of four areas, it would be labeled # 1 of 4. 4. Follow instruction (3 -7) for site diagrams regarding the specific details to be included on each facility diagram. 2 i:: -~ e CITY OF BAKERSFIELDe OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 SITE AND FACILITY DIAGRAM INSTRUCfIONS FOR HAZARDOUS MATERIALS MANAGEMENT PLANS These instructions explain the use of the site diagram and the facility diagram. Normally, small and medium size businesses will only have to submit a site diagram. If you have subdivided your business into smaller areas because of the complexity or size, then you will be completing and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business it it is in a remote location. SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your busineŠ; and to indicat~· the businesses that immediately , SWTound your property, usually within 300 feet. If you will be showing specific area detail on ::', ' facility diagrams, use the site diagram to show an overall layout of the plant. If you will not 1>0:. submitting facility diagrams, the site map must include all of the following information: - ~. 1. Check the box on the top left comer of the fonn provided that indicated "Site Diagram" . 2. Print the name of your business, as shown in your HMMP, on the top of the:, diagram. ,-. 3. Label the location of the hazardous materials and identify them by name and ~ of hazard (ie. Flammable liquid, corrosive solid). 4. Label the location of utility shutotfpoints for gas, electric and water services. S. Label the location of fire hydrants. 6. Label portions of the building protected by auto",?+:~ ~.,rinkler systems. 7. Label the direction representing north on the diagram. (The diagram fonn provided includes a north arrow). r~, '< . . :,;r ~ Q -:2 :=~~ ~ Cz:. G-.. II. ~CILlTY DIAGRAM [ BusinessAdm-: .~ ~~OD \d'h'~ - C~ ~ ------------ PROJECT LOCA nON ~\G1 ¡..t~ {.¡ $'-\::P ~ ¡ N.::J , 1 I , I PROPOSED : SMART _ I FINAL , , '--=----- ~~/: Gt#t#ffitHftD i 1 -'1 o < o 0:: ; WHITE LANE " - 'j7b ¡( t-- $) -.--'-- ---. - ----. ----------- o 1 ~ \?pJp ¡ - ~ iJ a -:2 ò sm: DI'AGRAM~. 7~DI'AGRAM LX I Bulin.. Name: 1(,.. ~TY' , Business Address: 00 Co. +e ~ ~ J:>.=.-,. "v~ Iv1 $$;1 )x '> \\ /' \'/ / '" \ r-Ij., r-rC ~ ~ 0i ~ '--.SJ ~ ~ t---" . CITY OF BAKERSFIELlA FICE OF ENVIRONMENTAL s!fvrcEs 1715 Chester .-\ vc., Bakersfield, CA (661) 326-3979 HAZARDOUSMATEmALS~~NAGEMENTPLAN INSTRUCTIONS SECTION r. - BUSINESS IDENTIFICATION DATA: The Business Owner / Operator Form, Chemical Description Form(s) and other Forms (e.g.: underground storage tank information, hazardous waste treatment, etc., as needed) may be submitted as the first section of the Hazardous Materials Management Plan in order to avoid duplication of information for initial submissions. HAZARDOUSMATERIALSMANAGE~ŒNTPLAN SECTION 11.1 - DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: ( Describe the procedures and equipment used to detect any release or threatened release of a hazardous material from any storage container, tank, or vessel at your business. Please provide a written explanation that also includes the make and model number of any automated or electronic leak detection equipment in use at your facility. B. EMPLOYEE AND AGENCY NOTIFICATION: What agencies and or corporate officials are notified in case of a hazardous materials spill or emergency - What procedures are used to notify these parties? At a minimum, you must call 9-1-1 and the Office of Emergency Services at 1-800- 852-7550 to report any spills that are a threat to life, safety or the environment, or for other non-emergency spill reporting, please call our office at (661) 326-3979. C. ENVIRONMENTAL RESPONSE MANAGEMENT: Please describe who will be responsible for what activities (notifYing authorities, clean-up companies, etc.), and what the chain-of-command is at your facility for making sure these activities are carried out. D. EMERGENCY MEDICAL PLAN: Summarize your plan for handling medical emer! 'ncies occUlTing at your business. List the local medical facility capable of handling an accident involving Hazardous Materials used at your business. HA.DOUS MATERIALS MANAGE.T PLAN SECT£ON [£.2 - RELEASE RESPONSE PLAN ( A. HAZARD ASSESSMENT AND PREVENTION MEASURES: Explain the procedures that you have developed and implemented to help prevent an incident trom occurring. These steps could include, but are not limited to, storage methods, container types, segregation, safety equipment, and/or procedures used. B. RELEASE CONTAINMENT AND/OR MITIGATION: Explain the procedures that you have developed and implemented to assist in keeping a hazardous materials incident at your business as small or confined as possible. C. CLEAN-UP AND RECOVERY PROCEDURES: Explain what clean up procedures will be implemented in case of a release at your business. This should address small spills, as well as a major release of material once the material is contained. ( Hazardous Waste: Please provide the name of the hazardous waste company that regularly removes the wastes trom your business, and how often that waste is removed. Please keep all disposal receipts for the last three years available on site for inspection. (' UTILITY SHUT -OFFS List locations of shut offs using compass points and known or obýious landmarks. If you have a lock box containing keys and maps of the facility for the Fire Department to use, please list its location also. PRIVATE FIRE PROTECTION/W A TER AVAILABILITY ," A. Private Fire Protection: Describe on-site fire protection for your ·business or facility unit, including sprinklers, fire extinguishers, alann systems and private ~oonse teams. B. Water Availability (Fire Hydrant): Give the location of the closest water supply or fire hydrant to be used by the Fire Department in case of an emergency. l 2 FIRE CHIEF "RCN FRAZE ADMINISTRATIVE'SERVICES 2101 "H· Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H· Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Viclor Ave. Bakersfield. CA 93308 VOICE (661) 399·4697 FAX (661) 399-5763 ( . . Dear Business Owner: This packet contains important information regarding your business and the requirements of Hazardous Materials Inventory Regulations. Both State and Federal laws may require that your business complete a Hazardous Materials Management Plan (HMMP). Please read all the enclosed information carefullv. failure to comply with any portion of the Business Plan requirements may result in Civil Liabilities of up to $2,000 for each day in which the violation occurs. WHAT BUSINESSES MUST COMPLY If you handle, use, store or dispose of Hazardous Substances at any time during the year in excess of the minimum reporting quantities you must submit a Plan. Typical everyday Hazardous Materials you may find in your facility may include, but are not limited to: compressed gasses; fuels - all types including propane; solvents - most solvents would be Hazardous Materials; oils - new and waste; thinners; caustic or corrosive materials; poisonous or toxic materials, and radioactive materials. Minimum State Reporting quantities are any quantity of explosives and any quantity of hazardous waste. For all other hazardous materials they are: 55 gallons for liquids 500 pounds for solids 200 cubic feet (at standard temperature and pressure, for gasses) For all acutely Hazardous Materials the minimum reporting quantities are found on the list of Extremely Hazardous Substances on the current EP A List (Vol. 52 No, 77 of the Federal Register.) This list is available at the Office of Environmental Services of the Bakersfield Fire Department, 1715 Chester Ave., Bakersfield, CA 93301. Your reporting requirements are either the State quantities or the Federal (threshold planning quantity) -- W HIe H EVE R IS LOW E R ! 1t1t9ð"V~ de g;'~ ..¥(;,.." ./,f6tJPe.r~ .A WeAbl'~" . . .,- , ( WHAT BUSINESSES ARE EXEMPT If you do not handle Hazardous Materials or if the quantities of Hazardous Materials are below the minimum reporting quantities at all times during the year, you are exempt. Hazardous Materials which are stored in transit or temporarily maintained in a fixed facility for less than (30) thirty days during the course of transportation are exempt trom the inventory requirements of the law. -- NOTE -- (Hazardous Materials contained solely in a consumer product for direct distribution to, and use by, the general public are NOT exempt from the reporting requirements of the law per this Administering Agency.) HOW DO BUSINESSES COMPLY Businesses that are required to comply with requirements of Chapter 6.95 Of California Health and Safety Code must submit a Plan. This Business Plan consists of: 1) Emergency Response Plans and Procedures. 2) Inventory of Hazardous Materials. 3) Training Program for Employees. The forms for completing the Hazardous Materials Management Plan are attached to this letter. ( By correctly filling this Business Plan in, you satisfy both the Federal Requirements (Tier I and Tier II ., Inventory Requirements of SARA Title III) as well as the California Requirements of Chapter 6.95 of the California Health and Safety Code. Business owners are urged to read and become familiar with Chapter 6.95 of the California Health and Safety Code. Copies are available at the Office of Environmental Services of the Bakersfield Fire Department, 1715 Chester Ave., Bakersfield, Ca. 93301 (661) 326-3979. The completed Business Plans are required to be submitted within 30 DAYS of receipt of this letter. On-site inspections are required to insure compliance with the law. If you have any questions or need assistance with completing the Business Plan please call (661)326-3979. Sincerely, Ralph E. Huey Hazardous Materials Coordinator REH\ed l S:\PIlOCEDUPJ! MAMJALICOVEIlLTIl,WPD SECTION ([[ . TRAIN!. . List [h~ number of employees that are working in the area of th~ hazardous materials, use or storage. Include all employees who have any occasion to be in those areas. Give the location where Material Safety Data Sheets (MSDS) are kept on tile. The MSDS must be readily available on site in a place where employees can access them. Give a brief summary of your Hazardous Materials Training Program. Employees are required by State law to have a program which provides employees with initial and refresher training in the following areas: 1) Methods for safe handling of the hazardous materials used by your business. 2) The Cal OSHA Hazard Communication Standard. 3) Correct use of emergency response equipment and supplies available at your business. 4) The prevention» minimizing and clean up procedures you have developed for your business. , ' , 5) The emergency evacuation plans you have developed» as well as, your notification procedure and medical plan. ( 6) Procedure to coordinate with and assist the local emergency personnel that may respond to your business . 7) Who and how to call for immediate assistance in the event of an à6cident involving hazardous materials, ÇERTIFICATION Please fill in your name, title, and sign and date on the signature line. IMPORTANT You must'retum this plan, inventory forms, and map within 30 days of receipt. If you have any questions please call us at (661) 326-3979 - Thank youjòr he/ping /0 keep our All America City cleaner and safer. 3