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Home My WebLink AboutBUSINESS PLAN ~ ~ - 41- SITE MAP t 1.5 Facility Manager . Wffr;w LMA l ~ ® @ 1 {t1-~ r~ -=~ ~ ~ ~ ~~ J . [ ~ ~ I I ð I, t J Ii f I ø n I ~ ~ t Q I . !,fí ~ I ~ t ~ , . 4 \l1 f!'8"" - -- .- ~ ...- ~ WID ID v 0 ' ~ ~ ~..... "" ~ .... @@ qj) El . ¡f.. TANK MONITORING ~ ALARM ø TELEPHONE o FIRST AID KIT ill. FIRE EXTINGUISHER 8 STORM DRAIN r;-1 SANITATION ~ SEWER ® EMERGENCY E ASSEMBLY AREA ~ MSDS LOCATION o FIRE HYDRANT ^ MONITORING L::.. WELLS ... OBSERVATION ~ WELLS ® A,G. PRODUCTTANK ® U,G, PRODUCTTANK ® U,G, WASTE OIL TANK o ABSORBENT Date Prepared: THE COMPLETED SITE MAP MUST BE POSTED CONSPICUOUSL Y ON-SITE, ALONG WITH THE EMERGENCY RESPONSE PROCEDURES. ,/ . ,..// pi" ~ -... ~' ~.. f' .- -- 17. . .,.::.. . V,.Jb~ SITE/FACILITY DIAGRAM FORM 5 2St~ 6jrUfgL/J. ¿¡7j7 IfÎ~' ~ f/kt. e-y .tf,.,-V¡r¡¿ o1f/ FLOO : f OF I (' ~A .1' UNIT #: (OF I o IV -J rrr1o/ll . FACILITY DIAGRA¡'¥t ,,/ NORTH~ SCALE: BUSINESS It:~ W DATE: 1! 3 / ~1 FACILITY NAME: -erV (CHECK ONE) SITE DIAGRAM ífe; f/If'J lbf-tfhov¡t/¿ , ¥Gb~ 6þtSotliV~' T/JÑ!(-ç (FU~) r 1(100 L \ 1100<0" I '\.j o Jl \) ~ ~ .~ ~! .5 '. ,W+þ : II (Inspector's Comments): ClfrtDp¡( olf~ý" ~ ~' ,~.- . o.pfie-~ ,!'f J-5J) :J~ . , £J,~(../ V ~""f..- ritE' ~ evlit,~ frllE'h /(eçr !<fX;W\ .....¿( L (/ ß~ [I te4rr ft(!)ð~ . <-Abide; . Jf¡øý/tr1e" S')O,A-k: é ~ðré" Øtx7lH~ J¡JS&f) aiL. ..J-7 j Itj 'v, Tit.· CA -OFFICIAL USE ONLY- - 5A - ~ ~ ~ 'k ~ \) ~ ~ ~ ~< ,., SITE DIAGRAM (ReqU~Jte.8) 1. Address: Identity the principle bui1din¡s by the Street nu.bers. e 9. Lock (key) Box 10. MSDS Stora¡e Box 11. Rail road Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood d. Gates 13. Powerlines 14. Guard Station 15. Stors!:\! Tanks: Identify the capacity in ¡nl. a. Above rround b. Under¡round 16. Dikina; or Bel'. 17. Evacuation Route 2, Street(sl. Alleys. Driveways. and Parkin¡ Areas adjacent to the propert~, Include the street na.ea. 3, Stor. Drains, Culverts, Yard Drains 4. Draina¡e Canals. Ditches. Creeks. 5. Buildings a. Fraae construction b. Masonry construction c. Metal..construction ~~~",_.,. d. Access DooE' 6. UtilIty Controls a. Gas b. Electricity c. Water 18. Evacuation Area: Identity the location where e.ployeee will .eet. 7. Fire Suppression Syste.s: a. Fire Hydrants b. Fire SpE'lnkler Connections 19. Outside HazaE'dous Waite Storalle c. Plre Standpipe Connections 20. Outside Hazardous Material Storaee d. Water Control Valve. tor protection syste.s 21. Outside Hazardous Material Use/Handl1n¡ e. Fire Pwap 22. Type at Hazardous Material/Waate Stored or Uaed (See Below) 8. P1re Depart.ent Acce.. TYPE OP HAZARDOUS MATERIAL P · Plauable B · Bxplol1ve L · Liquid C · Corrosive 0 · Oxidizer G · Ga. . · Water Reactive T · Taxi c S · SoUd R . Rad10lo¡ical P . po1.on H . Cryo¡en1c D . Waste B . Etioloe1cal Exa.ple: Fla..able Liquid· FL FACILITY DIAGRAM (Requ1red ite.s in addition to the above) 1. RhllFe Iv> 3...1..1\181'11 Z. Pa~tltionl ~ _______8. Plre Escapes ~g. Air Conditlonin¡ Unit. ]~Stair"ayø: Indicate the levels served 11'0. hilhost to low.at. _ 10. WIndows 11. Inside Hazardous We.te Storaa;e 4.~Esealator: Indicate the levels served Irom hiehest to lowest. 13. 5, Elevator 13. 8. Attic Aceeas 14. Sewer Drain Inlets '1.' Skyl1¡hts . . :"'.:' \~ 1 1 ~~ '" ,/'~ (/Y/' ~. .... IIÞ-'/'.- ,. " -.' .~ ../..; . e / e SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: S ~~ÆO~OOR: I OF f 0111' 5f;rf(~,¥ UNIT #: l OF f u/ DATE:1 / J /!1 FACILITY NAM}:¿ . G.41 f!/ t/ ,_. -- ,. \ \ ~ ~ ¿¡f/1/e- o Wl#~¡¿'" :""':ñ ~ úH£,ý¡f(j m~_L' ! ; f 'ß¡"«ffI7~ I II:) &o~ \ l.. { , \J1~ , ~ \ P, '-ò ¡ . ~ a } ~, ~ (CHECK ONE) SITE DIAGRAM ~ ~ :f".s _ C of; J: oP _ ~flfLL- SfM{~JV ~* fJ /VI oN' silt ¡;o"; RH~ r eþtC-<J SffJ1iotY . ¡ . i WooD ¡:ØNC1 (Inspector's Comments): -OFFICIAL USE ONLY- FACILITY DIAGRAM 'v '-...,\ . ~ LL: C/OM Peter /IY/II. /)tl)f~¿ f{.!l o O~ivE I¡v¡V wh -¡ t <:- ¿..y' /..-í (J.tlDIf ~ .s ro ~ HMCU-13 J ~ ~ ~ ~ 0J ~ ~ ..~.. ..... '" ... "'-'- e HlVI 1\1 P 51 T E 01 AG RA~1 lR1 P L ~ 1Vl~L\P FACILITY DIAGRAM 0 3u.s:':1ess ~ame: ¡Job 4!e...vs ¿~µft1()~ I Ar!!a Ma~ # or ^, ~-~-~ Name 0: Ar~a: NO::'''::l -- ~(;,LL ! 1~¥ r~xlÞ '-~ , ,$ fir i'DA/' I --~~ -",--.,,,,,, - -,~.~ ~ Wi: Ie- LA/' .];II. .. '-=-- ~-~. --> - -..... --.... / - . - -- - ,. ~ C'Øè'~ØflV silÞffø,.p- ~J--~ W4.íle- t~, -' @ -=1 - '\..0 ---- f ð 0) 0 r ~ ~ 4' ~ ~ ~ ';: : r~;~1 I . .~L___'] \ : ....---..::; ,. ,. L 1 r' t t,lð 00 I ~ ¡I r ~---:.,I .- - .-, - - I , t I i , I iò,.. (J'lJ.(} I I !. _ __ __ __ _' C4J TIIIVI( t ).."". }. < ~ ô 0 C1 0 8- ~ r -...... --. .. .JI~~ fI/1I1f~ øQ 16 JUN- 7-131 THU 8 : :3 1 FROM B.S.S.R. I N C . ·.Çl~ ...~~~þ~o, MODEL OF MONITO~ING SYSTEM p . 13 1 e &hÞ7 tfO 9!eœUldtf{)Jlltl?ê(P-DS~ .,çøntinuous. M~l}itoring' D,evlce Certification . ." . . ~ ~x~u . ~ ,.. , " FACIL.liY NUMBER· CONTACT PERSON ~r1"..t~g." TeLEPHONE 6(,/- ~3'-¿.. ~7 ZIP CODE 9' ' eV/~r ~-þ , , ' , ·Cônie~t~ofTa~k . , :'2~>': ,ç~P~!çÎty QfTank R9 ,~7. (2000 Iz 0r::IQ fJ/~ ,.~ /' / ;: ......._.~........... , ,Typ~. ~f Product ~Ine: (GravIty, Suctio!,; pres;;ure). '-~ ': INDICATE LOCATION OF THe MONITORING SENSORS TESTED BY PLACING AYES OR No IN APPLICABLE BOX' "..,.,.~ All ................ "." ,. . riui@r Space Sensor ~ Y~5> <'¡e~ 'I~'5 / : '. . r)p ~~~sor '. . . "0 ll~.s '" ~t!::.' /......;... . . . . . " . ,. . .... . . ~ - I .. '~~ 1~1....'~~".~ "' : ~pet¡s~r Contalnmént Sensor' . , -, ,'. ,.. I ~ ~ ',~ ¿, ~çtr~nlç Overfill I Level ?O % ... " Lt g\ ','1 \S ..) , ,,(S .. ¡/ ., ' .., I ., ecl(onlc In-Line Leak Detector . ~&-~ 4e-:>' ~fÇ~ ,/ , . I ' ~ '~'bhal1icalltne leak Detector ....(:I N:O ¡..S:) ,/ Tank Gauging DevIce 4é.5 "(;';,$ t¡~5> /: '-, - > , ..:.....;..:. :":'$u ".: 1'" ~ f ...,.'_. '::"01 . , 'Me .... ,I .. In : . .. .JNljICATË THE FOLlO'N1NG BY PLACING A 'YES OR NO IN APPLICABLE sox; ! , ~" :',' ,', ,w_.~ .' ..:po 1$ ",' ' " , , .. ';' , ' t.¡ ~j. ,/ es th~ monitoring system have audible and visual a1arms? .l.(~ . l.¡6 ¡"I,."'", ' , , , , , I, ': " "'. .14' ," ;cw ,. ,th oes ~h~ turbine automatically ßh~t-clown If the system detects l.{ t:: ~ ' . \.{-(,$ I ~~~¡k f?llls tQ operate or is electronIcally disço~nected? .l¡~ :~}j ~onltori~9'Syste!TI hista1Jed to prévenÙJnauthor~ed tampeñng? l¡.¿. "S V~ l..¡l? '/ :t.h~ .m~nitoring system operable as per the manufacturer's specifications? l.¡G;' l¡,ç;. (¡L ./' , ' , ' . ·r,~"!l.'~:" t. ,', : ...._".. ' - ' 'kl, ~ip·~.· \¡ç;h ponUnuous monitoring devIces Initiate positive shut-down of the turbln'a? Æt 6CJl.D°~ ~.> )J" " -::: .\ "~ .: ö ,.,i,;L :" "'~ :.Is . ...I;,~- : .['\Nt , ,', I" '" .."'............- ! --- " , ~' .' Ç~Ri".F150 TESTER·S I[)# " -.....;,;.......-- '. ,. $r,GNA TURE OF CeRTIFJEO TECHNICIAN " ~,~~:;:.:~",:. I ~,,~ , . . P~~I~'D"NAME OF ÇERTIFIEO,T.eCHNICIAN " " .~~ª;'¡~G¿O~fA~~NAM~&~E~ePHqNE~" ..~I.~;".,~..:;:.., 55Æ ~¿ 66/-688-2.:777' "":0~"~. '.' . ''ArfAC¡¡ Aiï ëéRTIFICATIO~ DÄ~ATO VERiFY THE INFOÎ{MA:TIÒN ÅBOVEI· . . . rr 12 4$:\Ia} '., "', - - - - ---- \. CUST~PE & NO. ES ¿)93~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ~-dh-q,q NEW ACCOUNT! ADDRESS CHANGE CLOSE ACCT ¡ FINANCE CHARGE I . OTHER ADJ ! V f CUSTOMER NAME l ~.ev\O(\ ùsA Prcrl.,ù(1A~ Cñ Bob ~Q¿\€..'I. Ser\J'\c.e.I\'\.C MAILING ADDRESS ;;;l~ ~ <:::. wh:',.-\-€ ~ CITY ~l~r<:>~h,~\d STATE r* ZIP CODE ~3D~ SITE ADDRESS PARCEL NUMBER <IF APPUCABLE) ADJUSTMENT I I REMARKS: ~e ~~~C" sùrckrof ~~\V~ t<')('\\'{ b-ee '^ __ APPROVED BY ~.-----. - - Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA 93301 #95325 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3, Answer the questions below for the business os a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Bob Haley's Chevron LOCATION: 2525 White Lane MAILING ADDRESS: same CITY: Bakersfield STATE: CA ZIP: 93304 PHONE: 805-832-9781 DUN & BRADSTREET NUMBER: 02-787-5673 SIC CODE: 5541 PRIMARY ACTIVITY: Service Station - Gasoline Sales - h, 0 J At A-M!" ..¡- OWNER: Bob Haley MAILING ADDRESS: 2525 White Lane, Bakersfield, CA 93304 SECTION 2: EMERGENCY NOTIFICATION: CONTACT 1. 1J-~b 1-f4 L e-y r f 2, /¿)cb;rV See ffT TITLE BUS. PHONE Oct..! ¡1/ E Jf - I . - "_1__ I - 832-9781 - 9 -- --rr u ~ßl' - 'i-' I 832-9781 - - . -- 24 HR. PHONE 5'81 0 ( 0 ( :r{"J~ ~ J à4 317 cfs / 7 1. b-kJ"~8- Bakersfield Fire Dept. e Hazardous Materials Divia HAZARDOUS MATERIALS MANAGEMENT PLAN #95325 SECTION 3: TRAINING: NUMBER OF EMPLOYESS: 6 MATERIAL SAFETY DATA SHEETS ON FILE: yes BRIEF SUMMARY OF TRAINING PROGRAM: 1. All employees are to read the M.SD.S. Sheets. 2. Read warning labels on products. 3. Be aware of any leaks or spills of gasoline or other chemicals. 4. Use protective equipment if job requires it. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE uCALlFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TlMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I. Bob Haley CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION Will BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET Al.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ¿~ß~ I SIGNATURE Dealer I-J.9.90 b - 2,O-lJr DATE TITLE 2. r:!:. e Bakersfield Fire Dept. Hazardous Materials Divisie #95325 HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Bob Haley's Chevron SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: In the event of a spill the following agencies are notified: 1. Bakersfield Fire Dept - Hazardous Material Division 326-3979 2. State Office of Emergency Services 1-800-852-7550 3. Chevron USA, Inc. - These agencies are contacted by phone. B. EMPLOYEE NOTIFICATION AND EVACUATION: Employees are notified in person if they are on duty and a hazardous material emergency arises. Employees not on duty are notified by phone. C, PUBLIC EVACUATION: In the event of a hazardous material emergency all driveways are to be blocked and all people on the premises are to be evacuated with the help of local police department. . D. EMERGENCY MEDICAL PLAN: In the event of an acident requiring medical anention. 1. Call Hall Ambulance Co. 2. Call City Police 3. Transport injured person to San Joaquin Hospital. 3. F'OI~ e Bakersfield Fire Dept. e Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN #95325 SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: All pumps, hoses and nozzles are checked periodicallly for leaks. Nozzles are checked daily to be sure shut off mechanism is working properly. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: In the event of a spill or leak: of gasoline, all personell are to turn their full attention to the emergency at hand. C. CLEAN-UP PROCEDURES: In the event of a spill of gasoline, employees are to shut off all power at station, dilute spill with water and spread so it will evaporate. Also call the local fIre department. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: :N~L~ ~.~. ]" ~'_ "'fQfail-" ð.1ft LiRtUG¿"Q~" 11/'" crlf.. £i,,~vlr/~c4''- /~c L - S-ötrH, ë/vfd o-F £~~ ELECTRICAL: -Qn p"n",l 0fl f':lHt \/\/,.,11 Qr 1118@ Tl1()IIL WATER: on White Ln Street side - north of pumps by pole on sidewalk SPECIAL: LOCK BOX: YES/r(Ø IF YES. LOCA nON: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers in ~ area and lø}u rQQ~. C-;'r.f~/~,.- $~c ¡....~ ~ ð Dh\. 8, WATER A V AllABlllTY (FIRE HYDRANT): be-- h J;Uti t:xJo I- Water faucets at N»side of building and S.!Ii* of building. e;~<I t: Nd 4, ~:" ~;.:' ~. HAZARDOUS PRODUCT ICHEMICAL INVENTORY LIST PRODUCT! MANUFACTURER! CHEMICAL NAME DISTRIBUTOR NAME ADDRESS OTHER INFORMATION - (Example) Chevron Supreme Unleaded Gasoline Chevron U.S.A. Inc. San Francisco, CA 94120 r tank ~D L-.> ~al. e ( w 1IkD-~ ~ Iê. CtBIIRJJN Us. A. IÃC· ~A-/llñAvvCISCO C '''' () '¡:¡)¡K. 9¿¡IJ-o Ii; gl;) c r-( ~ (j¡LE1JJJêð 6flSoW1£. CJ16vetw ¡)s. A .§;¡. 5M~oJ( ~ 9¿j J:) () , C ItGv £.()¡J ;JlO7DR. tf), '- CIf¿?ý£oN U ~,4, J:M:;. ~ ~C.ISCO ,LA, so 6-'1 / 9o/lJ.o ~£cH~ C/t,vttW rJ.5Il .:z;þC ~ I /OML (Þ¡¿o }t e LAS ~æ. hu:rC AíLA-5 5uP~~ C(), »:r, j ~ ;; &Ii.. ~~6-htßb LAS 5:,,,,,. Co. #.5; /lIfI!. DY ~ ML.( - HJB.1) t..i4f1ei~ v! G. I ... !Hr&0¡6 _~ (T1 ~ - Cw'Jwr 3. ¡)f1'tRf)~ )O~ TANK GAUGING AND INVENTORY RECONClUAT10N ANNUAl SUMMARY REPORT Facility No. rJ07.5!>J-S Facility Operator / ~t /lÆL~ Vear (711 :þ~~ç w~ ;- f~ L/V" Faculty Address ;'Æ~ r f ./-, e---~J Ca.-, 7JSO V- I / Check (II) which method report is for: a Inventory Reconciliation (Motor Vehicle Fuel) o Manual Tank Gauging (Used Oil Tanks) Check (II) the appropñate statement if state reqaire~ents were met 18 I hereby certify undec penalty of pe¡jury that all of the inventory variations each month, for the above mentioned facility and year, were within the allowable state limit OR. IF FACILITY IS ON SIR: o I hereby certify under penalty of pe¡jury that all of the Statistical Inventory RecoøciliatiOD Reports. for the above mentioned facility and year, meet the n:quirements under the state law. Check (II) the appropñate statelDeøt(s) if state requirements were aot met o Inventory variaûon{s) exceeded the allowable state limit as noted below. OR. IF FACILITY IS ON SIR: o Statistical Inventory Reconciliation Report(s) did not meet the requirements under the state law as noted below. AND, IF APPROPRIATE: o I hereby certify under penalty of peljury that the source forthe variation{s), or Statistical Inventory Reconciliation Report(s) which did Dot meet the requirements under the state law, was not due to ~uoauthori.zed release. List moatb. tank aumber. and amoant of vañatiOD for each moath that the vañatioa exceeded 1IIe allowable limit. or 1IIe Statistical Inventory Reconciliation Report did not meet 1IIe requiremeats ander tile state law. Mmdh Tank No. Amount of Vañation l. 2. 3. 4. 5. 6. ~1fr Additional months shall be continued on a separate sheet of paper and aaacbed. Note: If tM source of the variation which aceeds Colifomi4 allowoble limbs was due to a leaJ:. the incidelll sMll be reponed to tM local &Ultkrground storage tank agency within twenty-four (24) hours. An untlIIIhorù.eJJ Release Repon shall be submitted wilhinfive (5) days_ For stalions utilizing Invelllory ReconciliDtiorl or Manual Tank Gauging. this repon must be submilted to the local Underground Storage Tank RegultzJion Agency on an D1I1UIQ/ basis.. Facility Operator (Signl1llre Date b - 1.-<:>" r , e e --. ,f .. e RECEIVED - BOB HALEYS CHEVRON SiteID: 215-000-000437 Manager : Location: 2525 WHITE LN City BAKERSFIELD BY: BusPhone: Map : 123 Grid: 13C (805) 832-9781 ComrnHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 05 EPA Numb: SIC Code:5541 DunnBrad:02-787-5673 Emergency Contact / Title Emergency Contact, / Title PERRY SCOTT / MANAGER ' .;rA'~iiA/ eoN / gl\ØIII~R tn!1lVl4-rel Business Phone: (805) 832-9781x Business Phone: (805) 832-9781x 24-Hour Phone : (805) 399-4517x 24-Hour Phone : (805) 31!1-o<fJ7 Pager Phone : ( ) - x Pager Phone : ( ) - x , Hazmat Hazards: Fire React ImrnHlth DelHlth Emergency Directives: F Hazmat Inventory One Unified List ì p== MCP+DailyMax Order All Materials at Site ì Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP UNLEADED PLUS GASOLINE F· R IH DH L 12000 GAL Mod UNLEADED GASOLINE F R IH DH L 12000 GAL Mod SUPREME UNLEADED F R IH DH L 12000 GAL Mod COOLANT - ANTI FREEZE R L 8 GAL Low MOTOR OIL F DH L 40 GAL Min 6 tI..L:;( Do ner@byœrtûfy that ~ ~~\(1(&J ~,ßé ~ f'ij1!8 Of fl . ~g~_ . . <\ó6\/F>~ rru~fj'{Q)oo~ m~~®u$ ffl~ I.... rev~ewoo ~~@ ~~- . I . po/(} H4Le.r~ aM th®t i~ alo~ wötG1 Mlilfßt p'~tr1\ ~@1ì ~e~ I§lny ooV'fí'~åcn~ @:§1i'ù$t6itaGl ~ complete ~OO corr®d mai"ùo ~\9J~m~nt ~ij~M\ ~ov næy facåMty. ~¡'~ J - i --j- £ . ~ -1- 02/26/1998 .' e e SiteID: 215-000-000437 ì Facility Unit: Fixed Containers on Site ì F BOB HALEYS CHEVRON p= Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit UNDERGROUND ~.W.ÇORNER Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 500000.00 GAL HAZARDOUS COMPONENTS ~ CAS#a006619I I %Wt. I ' 100.00 Gasoline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod p= Inventory Item 0002 = COMMON NAME / CHEMI CAL NAME UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UNDERGROUND .5.WCORNER Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 600000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod -2- 02/26/1998 e e SiteID: 215-000-000437 ì Facility Unit: Fixed Containers on Site ì F BOB HALEYS CHEVRON f= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME SUPREME UNLEADED Days On Site 365 Location within this Facility Unit UNDERGROUND ~ORNER Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 500000.00 GAL HAZARDOUS COMPONENTS ~ No CAS#a006619 I %Wt. I 100.00 Gasoline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod f= Inventory Item 0006 = COMMON NAME / CHEMICAL NAME COOLANT - ANTI FREEZE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location. within this Facility Unit 5ðU·f'f!f f)/d?1WALL INSIDE STORE Map: Grid: CAS# 107-21-1 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 8.00 GAL Daily Average 10.00 GAL HAZARD US C M ENT %Wt. RS CAS # 75.00 Ethylene Glycol No 107211 o o PON S HAZ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Low ARD ASSESSMENTS -3- 02/26/1998 e e F BOB HALEYS CHEVRON p= Inventory Item 0005 ¡:::::= COMMON NAME / CHEMI CAL NAME MOTOR OIL SiteID: 215-000-000437 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit Ma~: Grid: NORTHWEST CORNER OF BUILDING OUTSIDE SOUTHW~STwALL INSIDE S CAS# 8020835 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 40.00 GAL Daily Average 150.00 GAL %Wt. RS CAS # 100.00 Motor Oil, Petroleum Based No 8020835 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESSMENTS -4- 02/26/1998 e e SiteID: 215-000-000437 ì Fast Format ì Overall Site ì 11/30/1990 F BOB HALEYS CHEVRON I f= Notif./Evacuation/Medical Agency Notification IN THE EVENT OF SPILL THE FOLLOWING AGENCIES ARE NOTIFIED: BAKERSFIELD FIRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION 326-3979 STATE OFFICE OF EMERGENCY SERVICES 1-800-852-7550 CHEVRON USA, INC. - THESE AGENCIES ARE CONTACTED BY PHONE CALL 911 Employee Notif./Evacuation 11/30/1990 IN CASE OF A SPILL OF HAZARDOUS MATERIALS OR A FIRE ALL EMPLOYEES ARE INSTRUCTED TO TURN OFF PUMPS WITH EMERGENCY SWITHC AND CALL THE CITY FIRE DEPARTMENT OR 911. ALL CUSTOMERS WILL BE EVACUATED FROM THE STATION AND DRIVE WAYS CLOSED EXCEPT FOR THE FIRE DEPARTMENT AND EMERGENCY VEHICLES EMPLOYEES ARE NOTIFIED IN PERSON IF THEY ARE ON DUTY AND A HAZARDOUS MATERIAL EMERGENCY ARISES. EMPLOYEES NOT NO DUTY ARE NOTIFED BY PHONE. Public Notif./Evacuation 11/30/1990 IN CASE OF EMERGENCY, LARGE GAS SPILL, FIRE OR EXPLOSION MYSELF AND MEN ON EMERGENCY CONTACT SHEET WILL BE CALLED IMMEDIATELY AS WELL AS 911 AND FIRE DEPARTMENT. EVACUATE ALL CUSTOMERS FROM STATION LOT AND CLOSE ALL ENTRANCES TO STATION, EXCEPT FOR EMERGENCY VEHICLES. IN THE EVENT OF A HAZARDOUS MATERIAL EMERGENCY ALL DRIVEWAYS ARE TO BE BLOCKED AND ALL PEOPLE ON THE PREMISES ARE TO BE EVACUATED WITH THE HELP OF LOCAL POLICE DEPARTMENT. Emergency Medical Plan 11/30/1990 IN THE EVENT OF AN ACIDENT REQUIRING MEDICAL ATTENTION CALL HALL AMBULANCE CO. .:J, L 1 -tf' (I { CALL CITY POLICE ~ 2-7 -1' t r TRANSPORT INJURED PERSON TO SAN JOAQUIN HOSPITAL ~~S-3(joe MERCY HOSPITAL 2215 TRUXTUN AV ltÞ !JJ- ' S" 000 -5- 02/26/1998 e e SiteID: 215-000-000437 ì Fast Format ì Overall Site ì 11/30/1990 F BOB HALEYS CHEVRON I f= Mitigation/Prevent/Abatemt Release Prevention ALL EMPLOYEES ARE INSTRUCTED IN THE PROPER USE OF GASOLINE PUMPS, USE OF GASOLINE PUMPS, ALL HOSES AND NOZZLES ARE INSPECTED REGULARLY FOR ANY SIGNS OF LEAKING OR MALFUNCTION OF NOZZLES AND AUTOMATIC SHUT OFF DEVICES. ALL EMPLOYEES ARE INSTRUCTED NOT TO SMOKE OR ALLOW CUSTOMERS TO SMOKE IN RESTRICTED AREAS. GASOLINE IS NOT TO BE USED TO CLEANING. ALL PUMPS, HOSES AND NOZZLES ARE CHECKED PERIODICALLY FOR LEAKS. NOZZLES ARE CHECKED DAILY TO BE SURE SHUT OFF MECHANISM IS WORKING PROPERLY. Release Containment 11/30/1990 IN THE EVENT OF A SPILL OF GASOLINE OR OTHER MATERIALS, ALL EMPLOYEES ARE FAMILIAR WITH THE DANGER OF FIRE OR CONTAMINATION OF THE GROUND OR WATER AND HAVE BEEN INSTRUCTED ON THE IMPORTANCE OF IMMEDIATE CLEAN UP. Clean Up 11/30/1990 IN CASE OF SMALL SPILL, WIPE UP AND LET EVAPORATE. IN CASE OF LARGE SPILLS WHICH CONTAMINATE GROUND PLACE CONTAMINATED MATERIA IN DISPOSABLE CARTONS AND CONTACT LOCAL HEALTH DEPART FOR PROPER DISPOSAL OF MATERIAL. Other Resource Activation -6- 02/26/1998 e e F BOB HALEYS CHEVRON I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-000437 ì Fast Format ì Overall Site ì I 05/06/1992 A) GAS - NONE B) ELECTRICAL - LOCKED BOX OUTSIDE SOUTH END OF BUILDING C) WATER - EMERGENCY SHUT OFF IN CASHIER AREA AND OUTSIDE NORTHWEST CORNER OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 05/06/1992 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE KEPT IN THE CASHIER AREA AND CORRIDOR AREA AND IN THE OFFICE. WATER HYDRANTS ARE LOCATED AT NORTH AND SOUTH END OF BUILDING. FIRE HYDRANT - NORTHWEST CORNER OF WHITE LAND AND EL POTERO BY SHELL STATION, SOUTH SIDE OF WHITE LANE BETWEEN TEXACO STATION AND MCDONALDS NORTH SIDE OF WHITE LANE IN FRONT OF COMFORT INN MOTEL Building Occupancy Level -7- 02/26/1998 · ; e e í BOB HALEYS CHEVRON ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000437 íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01/08/1996 ¡ o 0 o WE HAVE 9 EMPLOYEES AT THIS FACILITY. o WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE o o o o o o o ALL PERSONNEL ARE REQUIRED TO READ MSDS BULLETINS ON ALL HAZARDOUS o MATERIALS AND THROUGHLY UNDERSTAND EMERGENCY AND FIRST AID PROCEDURES. o IF MSDS BULLETINS ARE NOT AVAILABLE ON SOME ITEMS, PERSONNEL ARE REQUIRED o TO READ AND UNDERSTAND WARNING LABLES ON ALL MATERIALS. PERIODICALLY o QUIZZES ARE GIVEN TO EACH EMPLOYEE. o o o o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -, .. ø_ ¡ ~ 11/22/95 e - 1 Page 1 BOB HALEYS CHEVRON 215-000-000437 Overall Site with 1 Fac. Unit General Information . Location: 2525 WHITE LN Map:123 Haz:2 Type: 3 City . BAKERSFIELD Grid: 13C F/U: 1 AOV: 0.0 . ...-- Contact Name Title r:-- Contact Name ' , Title ~ PERRY SCOTT / MANAGER GWEN KLINGENBERG .. / CASHIER ..' Business Phone: (805) 832-9781x .' Business Phone: (805) '832-9781x 24-Hour Phone : (805)~Jyq-j 24-Hour Phone · (805) 831-8241x · Pager Phone : ( ) ?7__t(D1 x '-fS'17 Pager Phone · ( ) - x · Administrative Data Mail Addrs: 2525 WHITE LN D&B Number: 02-787-5673 City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-005 BAKERSFIELD STATION 05 SIC Code: 5541 Owner: BOB HALEY Phone: (805) 832-9781 Address: 10016 ENGER ST State: CA City: BAKERSFIELD Zip: 93312- - Summary qf:::CJ::'/1 '. - tt4:;.() ,ÐEe I It 9 1996 ~< 111. ~ì. D!v . I. ß 0 l IIf LfLt.£ Do hereby certify that I ¡,ave Þffype nt nameV' ' reviewed the attached hazardous materials maí:age- ßò 10 fI¡:¡k~/S- ment plan for cA ~ [/; 0 Vand that it along with (Name of Bus ¡ any corrections constitute a complete and correct man· agement plan for my facility. /~~ /, ;......;;.t/ /J- -1c(-"-5 .,. "' e .:L - 11/22/95 BOB HALEYS CHEVRON 215-000-000437 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 UNLEADED PLUS GASOLINE Liquid 12000 Moderate ~ Fire, Reactive, Immed Hlth¡ Delay Hlth GAL 02-003· SUPREME UNLEADED Liquid 12000 Moderate ~ Fire, Reactive, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Reactive, Immed Hlth, Delay Hlth GAL 02-006 COOLANT - ANTI FREEZE Liquid t/~ ,~ Low ~ Reactive GAL l 02-005 MOTOR OIL Liquid ..; Yo -2-6"(J Minimal ~ Fire, Delay Hlth GAL ':\.. e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 UNLEADED PLUS GASOLINE Liquid ~ Fire, Reactive, Immed Hlth, Delay Hlth 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 ' Use: FUEL Daily Max GAL 12,000 ----r-- Daily Average GAL --y-- Annual Amount GAL -- I 8, 000 .--()1 )1 550,000.00 ~ce::aoo·oa r Press T Temp -:ì Location Ambien,~ AmbientlUNDERGROUND NW CORNER Storage UNDER GROUND TANK - Cone l 100.0% Gasoline Components r; MCP -¡Guide Moderate 27 02-003 SUPREME UNLEADED Liquid ~ Fire, Reactive, Immed Hlth, Delay Hlth 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure , Days: 365 Use: FUEL Daily Max GAL 12,000 ----r-- Daily Average GAL --y-- Annual Amount GAL -- I ' ~ / I 550,000.00 ç ÐD6 ~DO'.J r Press T Temp -:ì Location Ambient AmbientUNDERGROUND NW CORNER Storage UNDER GROUND TANK - Cone l 100.0% Gasoline Components 1-; MCP -¡Guide Moderate 27 02-002 UNLEADED GASOLINE Liquid ~ Fire, Reactive, Immed Hlth, Delay Hlth 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL ---- Daily Max GAL ----r-- D~ily Average GAL --y-- 12,000 I 9-, 900.00/)1 I 6c>oo~ òo r Press T Temp -:ì Ambient AmbientlUNDERGROUND Annual Amount GAL -- 1,095,000.00 Storage UNDER GROUND TANK Location NW CORNER - Cone l 100.0% Gasoline Components r; MCP -¡Guide Moderate 27 e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-006 COOLANT - ANTI FREEZE ~ Reactive .:'.. Liquid g~Low GAL CAS #: 107-21-1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- -l-5--€ I ---10. Oe- I 100.00 8/ùo r Press T Temp -:-1 Location Ambient AmbientSOUTHEAST WALL INSIDE STORE Storage PLASTIC CONTAINER - Conc _I 75.0% Ethylene Glycol Components ~ MCP ~uide Low I 27 02-005 MOTOR OIL ~ Fire, Delay Hlth Liquid 200 Minimal GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT ---- Daily Max GAL ----r-- Daily Average GAL --r-- Annual .~ I ~I . ,/0 ~'ðD Storage ~ Press ì Temp PLASTIC CONTAINER Ambien.t Ambient NORTHWEST .";c SOUTHEAST Amount GAL -- 1,800.00 Location CORNER OF BUILDING OUT WALL INSIDE STORE - Conc l Components 100.0% Motor Oil, Petroleum Based r; MCP ~uide Minimal I 27 e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification IN THE EVENT OF SPILL THE FOLLOWING AGENCIES ARE NOTIFIED: BAKERSFIELD FIRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION 326-3979 STATE OFFICE OF EMERGENCY SERVICES 1-800-852-7550 CHEVRON USA, INC. - THESE AGENCIES ARE CONTACTED BY PHONE CALL 911 <2> Employee Notif./Evacuation IN CASE OF A SPILL OF HAZARDOUS MATERIALS OR A FIRE ALL EMPLOYEES ARE INSTRUCTED TO TURN OFF PUMPS WITH EMERGENCY SWITHC AND CALL THE CITY FIRE DEPARTMENT OR 911. ALL CUSTOMERS W¡LL BE EVACUATED FROM THE STATION AND DRIVE WAYS CLOSED EXCEPT FOR THE FIRE DEPARTMENT AND EMERGENCY VEHICLES EMPLOYEES ARE NOTIFIED IN PERSON IF THEY ARE ON DUTY AND A HAZARDOUS MATERIAL EMERGENCY ARISES. EMPLOYEES NOT NO DUTY ARE NOTIFED BY PHONE. <3> Public Notif./Evacuation IN CASE OF EMERGENCY, LARGE GAS SPILL, FIRE OR EXPLOSION MYSELF AND MEN ON EMERGENCY CONTACT SHEET WILL BE CALLED IMMEDIATELY AS WELL AS 911 AND FIRE DEPARTMENT. EVACUATE ALL CUSTOMERS FROM STATION LOT AND CLOSE ALL ENTRANCES TO STATION, EXCEPT FOR EMERGENCY VEHICLES. IN THE EVENT OF A HAZARDOUS MATERIAL EMERGENCY ALL DRIVEWAYS ARE TO BE BLOCKED AND ALL PEOPLE ON THE PREMISES ARE TO BE EVACUATED WITH THE HELP OF LOCAL POLICE DEPARTMENT. <4> Emergency Medical Plan IN THE EVENT OF AN ACIDENT REQUIRING MEDICAL ATTENTION CALL HALL AMBULANCE CO. CALL CITY POLICE TRANSPORT INJURED PERSON TO SAN JOAQUIN HOSPITAL MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention ALL EMPLOYEES ARE INSTRUCTED IN THE PROPER USE OF GASOLINE PUMPS, USE OF GASOLINE PUMPS, ALL HOSES AND NOZZLES ARE INSPECTED REGULARLY FOR ANY SIGNS OF LEAKING OR MALFUNCTION OF NOZZLES AND AUTOMATIC SHUT OFF DEVICES. ALL EMPLOYEES ARE INSTRUCTED NOT TOßMOKE OR ALLOW CUSTOMERS TO SMOKE IN RESTRICTED AREAS. GASOLINE IS NOT TO BE USED TO CLEANING. ALL PUMPS, HOSES AND NOZZLES ARE CHECKED PERIODICALLY FOR LEAKS. NOZZLES ARE CHECKED DAILY TO BE SURE SHUT OFF MECHANISM IS WORKING PROPERLY. <2> Release Containment IN THE EVENT OF A SPILL OF GASOLINE OR OTHER MATERIALS, ALL EMPLOYEES ARE FAMILIAR WITH THE DANGER OF FIRE OR 'CONTAMINATION OF THE GROUND OR WATER AND HAVE BEEN INSTRUCTED ON THE IMPORTANCE OF IMMEDIATE CLEAN UP. <3> Clean Up IN CASE OF SMALL SPILL, WIPE UP AND LET EVAPORATE. IN CASE OF LARGE SPILLS WHICH CONTAMINATE GROUND PLACE CONTAMINATED MATERIA IN DISPOSABLE CARTONS AND CONTACT LOCAL HEALTH DEPART FOR PROPER DISPOSAL OF MATERIAL. <4> Other Resource Activation e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - LOCKED BOX OUTSIDE SOUTH END OF BUILDING C) WATER - EMERGENCY SHUT OFF IN CASHIER AREA AND OUTSIDE NORTHWEST CORNER OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE KEPT IN THE CASHIER AREA AND CORRIDOR AREA AND IN THE OFFICE. WATER HYDRANTS ARE LOCATED AT NORTH AND SOUTH END OF BUILDING. FIRE HYDRANT - NORTHWEST CORNER OF WHITE LAND AND EL POTERO BY SHELL STATION, SOUTH SIDE OF WHITE LANE BETWEEN TEXACO STATION AND MCDONALDS NORTH SIDE OF WHITE LANE IN FRONT OF COMFORT INN MOTEL <4> Building Occupancy Level '~'.. .r: .. e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 8 <G> Training <1> Employee Training WE HAVE~EMPLOYEES AT THIS FACILITY. 'tv WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE ALL PERSONNEL ARE REQUIRED TO READ MSDS BULLETINS ON ALL HAZARDOUS MATERIALS AND THROUGHLY UNDERSTAND EMERGENCY AND FIRST AID PROCEDURES. IF MSDS BULLETINS ARE NOT AVAILABLE ON SOME ITEMS, PERSONNEL ARE REQUIRED TO READ AND UNDERSTAND WARNING LABLES ON ALL MATERIALS. PERIODICALLY QUIZZES ARE GIVEN TO EACH EMPLOYEE. .:~ <2> Page 2 <3> Held for Future Use <4> Held for Future Use I /' ." ?~' it '0 11/22/95 e e BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 9 <M> Inspections 10/27/88 FOLLOW UP. EXTINGUISHERS NEED TO BE HUNG. / / .";.... 12/19/88 OK / / 08/31/89 FOLLOW UP / / 10/30/90 FOLLOW UP / / 01/23/91 FOLLOW UP OK / / 10/08/91 OK / / 08/19/92 OK / / 08/25/93 OK / / 12/09/94 OK / / 03/11/94 UST inspection. OK! / / WATKINS WATKINS R HUEY WATKINS WATKINS R. WATKINS WIGGINS 03 384 TURK .:\.. · "'. '-' e e 11/22/95 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 10 <M> Inspection Summary 10/27/88 FOLLOW UP. EXTINGUISHERS NEED TO BE HUNG. / / 12/19/88 OK / / WATKINS 08/31/89 FOLLOW UP / / NO VERIFICATION OF MSDS NO EMERGENCY PROCEDURES POSTED WATKINS 10/30/90 FOLLOW UP / / NO MATERIAL SAFETY DATA SHEETS ON FILE NO VERIFICATION OF ABATEMENT SUPPL~~S ,& PROCEDURES NO EMERGENCY PROCEDURES POSTED R HUEY 01/23/91 FOLLOW UP OK / / WATKINS 10/08/91 OK / / WATKINS 08/19/92 OK / / R. WATKINS 08/25/93 OK / / WIGGINS 12/09/94 OK / / NEEDS TO REMOVE CONTINUOUS FLOW NOZZLE CLIPS. 03 384 TURK 03/11/94 UST inspection. OK! / / .:\,. ~. :. . . .,. 1 t -:. 03/18/92 BOB HALEYS CHEVRON 215-000-000437 Overall Site with 1 Fac. Unit Page 1 General Information Location: 2525 WHITE LN Community: BAKERSFIELD STATION 05 Map: 123 Hazard: Low Grid: 13C FlU: 1 AOV: 0.0 Contact Name .JOH!ŒTON- MARNEY Title Business Phone (805) 832-9781 x (805) '832-9781 x 24-Hour Phone (805) (805) ·SALESMAN- Administrative Data ail Addrs: 2525 WHITE LN City: BAKERSFIELD omm Code: 215-005 BAKERSFIELD STATION 05 BOB HALEY Home. C¡05) 5 ~C¡-Ol 0 I 10016 ENGER ST BAKERSFIELD D&B Number: 02-787-5673 State: CA Zip: 93304- SIC Code: 5541 S mmary -::Pe(-r-~ S<!.ô-tt - fVkxrJOBer- ~ kl.'N3eNbe~-Ca.s.h;eï Phone: (805) 832-9781 State: CA Zip: 93312- ,;J.4-lIodï P¡"'oÑ (J'o5) 6 pc¡- ¿, :261 (.Ýð5) ;;3 J - F;l.<!-/ RECeIVED ,l4PR 2 0 1992 OV I. -p.,.... (~ LJ" ¡ 1ð · I Do hereby œrtily that I have) ~ . reviewed the attached hazardous materials manageJo ·ment plan for1306 JlnJ..ei; ~k~ha~ it along with (N,~":! 01 Ou 00) any corrections constitute a complete and correct mano agement plan for my facility. þ~ /- /5:-9;;>'" om . . 03/18/92 BOB HALEYS CHEVRON 215-000-000437 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 REGUbARv GASOLINE UNleaded PILl~ Liquid ~ Fire, Reactive, Immed Hlth, Delay Hlth 8998-- Moderate /'2-~GAL , CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: Use: FUEL ---- Daily Max GAL ----r-- ,-8,9Se I \ /';¿,OCO Storage UNDER GROUND TANK erage GAL -r- 4,996-.00 I ~DDO Temp ~ Ambient UNDERGROUND Annual Amount GAL -- hQQ, eaa .1>0 650J 000 Location NW CORNER - Cone l 100.0% Gasoline Components 1-; MCP -:-rList Moderate 02-002 UNLEADED GASOLINE ~ Fire, Reactive, Immed Hlth, Delay Hlth I CAS #: 8006-61-9 Trade Secret: No Liquid 10009- Moderate I ;;2.,000 GAL Average GAL -r- ,6,OOO.ðO I 9, 000 r Press T Temp ~ Ambient Ambient UNDERGROUND Use: FUEL Form: Liquid Type: Pure ---- Daily Max GAL ----r-- 10,0ø-e- I J ~ }OOO Storage UNDER GROUND TANK Annual Amount GAL -- AOO,QOQ-;-OO l/JiJI$"OOO Location . NW CORNER - Cone l 100.0% Gasoline Components MCP ~List -;odera te I 02-003 SUPREME UNLEADED ~ Fire, Reactive, Immed Hlth, Delay ~lth I CAS #: 8006-61-9 Trade Secret:, No Liquid ~OOo- Moderate /;2.1000 GAL Form: Liquid Type: Pure Use: FUEL ----,Daily Max GAL ----r-- Average GAL -r- 4,000 I 2,500.00 I 1 fJ¡OCX!J . ~ D 00 Storage r Press T Temp ~ UNDER GROUND TANK Ambient AmbientlUNDERGROUND Annual Amount GAL -- 350,000.00 5$0, (JOD Location NW CORNER - Cone -, 100.0% Gasoline Components MCP ~List [;oderate I ,. 03/18/92 02-004 ¡/o ~Néjer ¡.j If ¡)e Was+€.- é); , . . Hazmat BOB HALEYS CHEVRON 215-000-000437 I 02 - Fixed Containers on Site Inventory Detail in Reference Number Order I ~lth / Low Page 3 550 GAL Trade Form: Liquid Type.: . Use: WASTE Daily Max GAL T Annual Amount GAL - 0 550 2,000.00 Storage Location UNDER GROUND TANK SW BUILDING - Conc I Components MCP ¡List Waste rø-Ú, ........... 100.0% Petroleum Based Low //' MOTOR OIL Jlth Liquid ~ Minimal ~ Fire, Delay éJ.œJ GAL I CAS #: Trade 0 Form: Liquid Type: Pure 365 Use: LUBRICANT 02-005 Daily Max GAL -á-e-& Storage PLASTIC CONTAI ER - Conc l I 100.0% Motor Oil, Average GAL --r--Annual Amount GAL - 3-00.00 I -2,400.09- I$Z> / ?ðO r Press T Temp ~ Location Ambient Ambient I WESIl' WAIñ.. -eP Irt:JÐE- ReðM- + s . d~ N.W Cvr-Ner- ô-Í hu.'\c\ìN'j ou: t C t :5. E'. Wed I ì n5ide.. .s.-lcr--e..-CP L· t omponen s L 00' :-r 1S Petroleum Based IMinimal I 02-006 COOLANT - ANTI FREEZE ~ Reactive Liquid ~ Low /5' GAL CAS #: 107-21-~ Trade Secret: No Form: Liquid 365 Use: COOLANT/ANTIFREEZE Type: Pure Storage PLASTIC CONTAINER Cone l 75.0% Ethylene Daily Average GAL --r-- Annual Amount GAL - 50.00 I 300.0Q " I o. I DO. I' Pres T Temp ~ Location Ambient AmbientWEST ~ALL eP-~ ROOM 3. £ '^'a.) j '1 n.S ide... 5-+0 ~e.. Components I~ MCP ~List I Low I Daily Max G~ -¡ 15 Glycol e . 03/18/92 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 4 <D> Notif./Evacuation/Medica1 <1> Agency Notification IN THE EVENT OF SPILL THE FOLLOWING AGENCIES ARE NOTIFIED: BAKERSFIELD FIRE DEPARTMENT - HAZARDOUS MATERIALS DIVISION 326-3979 STATE OFFICE OF EMERGENCY SERVICES 1-800-852-7550 CHEVRON USA, INC. - THESE AGENCIES ARE CONTACTED BY PHONE CALL 911 <2> Employee Notif./Evacuation IN CASE OF A SPILL OF HAZARDOUS MATERIALS OR A FIRE ALL EMPLOYEES ARE INSTRUCTED TO TURN OFF PUMPS WITH EMERGENCY SWITHC AND CALL THE CITY FIRE DEPARTMENT OR 911. ALL CUSTOMERS WILL BE EVACUATED FROM THE STATION AND DRIVE WAYS CLOSED EXCEPT FOR THE FIRE DEPARTMENT AND EMERGENCY VEHICLES EMPLOYEES ARE NOTIFIED IN PERSON IF THEY ARE ON DUTY AND A HAZARDOUS MATERIAL EMERGENCY ARISES. EMPLOYEES NOT NO DUTY ARE NOTIFED BY PHONE.. <3> Public Notif./Evacuation Pe.f'5DN.5 IN CASE OF EMERGENCY, LARGE GAS SPILL, FIRE OR EXPLOSION MYSELF AND~ ON EMERGENCY CONTACT SHEET WILL BE CALLED IMMEDIATELY AS WELL AS 911 AND FIRE DEPARTMENT. EVACUATE ALL CUSTOMERS FROM STATION LOT AND CLOSE ALL ENTRANCES TO STATION, EXCEPT FOR EMERGENCY.VEHICLES. IN THE EVENT OF A HAZARDOUS MATERIAL EMERGENCY ALL DRIVEWAYS ARE TO BE BLOCKED AND ALL PEOPLE ON THE PREMISES ARE TO BE EVACUATED WITH THE HELP OF LOCAL POLICE DEPARTMENT. <4> Emergency Medical Plan IN THE EVENT OF AN ACIDENT REQUIRING MEDICAL ATTENTION CALL HALL AMBULANCE CO. CALL CITY POLICE TRANSPORT INJURED PERSON TO SAN JOAQUIN HOSPITAL MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 ~ ' e .~ ' 03/18/92 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention ALL EMPLOYEES ARE INSTRUCTED IN THE PROPER USE OF GASOLINE PUMPS, USE OF GASOLINE PUMPS, ALL HOSES AND NOZZLES ARE INSPECTED REGULARLY FOR ANY SIGNS OF LEAKING OR MALFUNCTION OF NOZZLES AND AUTOMATIC SHUT OFF DEVICES. ALL EMPLOYEES ARE INSTRUCTED NOT TO SMOKE OR ALLOW CUSTOMERS TO SMOKE IN RESTRICTED AREAS. GASOLINE IS NOT TO BE USED TO CLEANING. ALL PUMPS, HOSES AND NOZZLES ARE CHECKED PERIODICALLY FOR LEAKS. NOZZLES ARE CHECKED DAILY TO BE SURE SHUT OFF MECHANISM IS WORKING PROPERLY. <2> Release Containment IN THE EVENT OF A SPILL OF GASOLINE OR OTHER MATERIALS, ALL EMPLOYEES ARE FAMILIAR WITH THE DANGER OF FIRE OR CONTAMINATION OF THE GROUND OR WATER AND HAVE BEEN INSTRUCTED ON THE IMPORTANCE OF IMMEDIATE CLEAN UP., <3> Clean Up IN CASE OF SMALL SPILL, WIPE UP AND LET EVAPORATE. IN CASE OF LARGE SPILLS WHICH CONTAMINATE GROUND PLACE CONTAMINATED MATERIA IN DISPOSABLE CARTONS AND CONTACT LOCAL HEALTH DEPART FOR PROPER DISPOSAL OF MATERIAL. <4> Other Resource Activation " e . 'i- (> 03/18/92 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) -EJ.A& - BEHINÐ- BUILDING SOUTH EAST CORNER 'ds-' +h €.o¡( ~ bL.lI·}.d"l'\lj B) ELECTRICAL - TN~ ~@U EASL.P> W1rhb t..-oclœd. bo-:i OVi-SI ~N ~¡"ìer o.~ c:uíld C) WATER - BY SIDEWALK NORTH EAST OF LOT gme.í3el'&c.~ 5s..<Å-t., ff I Ì' };Il..A i \ c1.. N j' , ou.tSide (Lt- No. Wes+<:!...orNer 0, D) SPECIAL - NONE E) " LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - AND IN THE ..()FFICE . WATER CORNERS OF BUILDING. ca::f¡¡eí a~ q....C!.t:>r-r-idor FIRE EXTINGUISHERS ARE KEPT IN THE -i:.UBE ROOM AREA HYDRANTS ARE LOCATED AT BOU'l'HWEST-AND ...NORTIIEA;f b 'ld')J f\Jorl-h Q- Soû;i-h end UI I ~ FIRE HYDRANT - NORTHWEST CORNER OF WHITE LAND AND EL POTERO BY SHELL STATION, SOUTH SIDE OF WHITE LANE BETWEEN TEXACO STATION AND MCDONALDS NORTH SIDE OF WHITE LANE IN FRONT OF COMFORT INN MOTEL <4> Building Occupancy Level ;;, ...) ~ e . 03/18/92 BOB HALEYS CHEVRON 215-000-000437 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE 11 EMPLOYEES AT THIS FACILITY. DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? Yes ALL PERSONNEL ARE REQUIRED TO READ MSDS BULLETINS ON ALL HAZARDOUS MATERIALS AND THROUGHLY UNDERSTAND EMERGENCY AND FIRST AID PROCEDURES. IF MSDS BULLETINS ARE NOT AVAILABLE ON SOME ITEMS, PERSONNEL ARE REQUIRED TO READ AND UNDERSTAND WARNING LABLES ON ALL MATERIALS. PERIODICALLY QUIZZES ARE GIVEN TO EACH EMPLOYEE. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use ·' . f\ ,t ~r ~ Page-1-0f Z , .; OF ·BAKER.SFIELD MATERIALS INVENTORY 'j¡' TRADE ' SECRET CITY HAZARDOUS and Agriculture 0 Standard Business o ron NAME OF THIS'<FíCILITY:~ 0...' STANDARD IND.: CLASS coDi: "41 DUN AND BRADSTREET NUMBER/FEDERAL ()ø-J.f.Z-.5.~:J..3. NON OWNER NAME: ADDRESS: I ( CITY, ,ZIP: PHONE '.J : f; Farm BUSINESS NAME LOCATION: CITY, ZIP' PHONE #: Number NÍ1mber Number C.A.S. C.A.S C.A.S S , '& & & 4 1 Component It 1 Name Component It 2 Name Component It 3 Name ,œ:elaYed Health 'i ~mmediate Health Number ~eaCtiVity C.A.S Physical and Health Hazard (Check all that apply) ~ire 0 Sudden Release of Pressure Hazard Number Number & C.A.S. & C.A.S. Name Name Component It 1 It 2 Component Component ~elaYed Health MImmediate Health Number '~Reactivity C.A.S Physical and Health Hazard (Check all that apply) n:{' Fire 0 Number ~T & C.A.S Name It 3 Sa. Sudden Release of Pressure Hazard '-'I Number Number Number C.A.S. C.A.S. & & & Name Name Name Component Component It 2 Component It 3 ~laYed Health Number ~mmediate Health C.A.S MReaCtiVity Sudden Release of Pressure Physical and Health Hazard (Check all that apply) fØ"Fire 0 Hazard Number & C.A.S. Name Component It 1 Number C.A.S Physical and Health Hazard (Check all that apply) Number & C.A.S Component It 2 Name o o Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I haver personally examined and am familiar with the information submitted in this and all attached documents individuals responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete. I OWNER/OPERATOR' S AUTHORIZED REPRESENTATIVE Number & C.A.S. Component It 3 Name Delayed Health o Immediate Health Reactivity Sudden Release of Pressure #1 EMERGENCY CONTACTS o Fire Hazard o of those inquiry -/J-iJ- SIGNED my based on and that " ) " ::,~, ,-., L '.' , ~ Page· ),rof .x . " CITY OF BAKERSFIELD HAZARDOUS MATERIALS INVENTORY . oW. - TRADE SECRET Farm o ~ . . :., ......:.,.,(.:¡. NAME OF THIS'1;FÂ¿ILITY~ STANDARD IND.. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL Q2 -13.. 7. "':.5~7 3 NON OWNER NAME ADDRESS: CITY, ,ZIP: PHONE 'J :-: Standard Business and Agriculture 0 S FOR PROPER INSTRUCTIONS 11 6 4 1 '(1 l' .. Number NWnber Number S. S. C.A C.A & & Component # 1 Name Component # 2 Name Component # 3 Name ~aYed Health C.A.S. Number PhYsical and Health' Hazard. (Che~ all that apply) ~Fire C.A.S Immediate Health o Reactivity D Sudden Release of Pressure o Hazard 00 o 5 Number Number Number & C.A.S. & C.A.S & C.A.S. Component # 1 Name Component # 2 Name Component # 3 Name Delayed Health o D1- Immediate Health Number o '~eactivity C.A.S Sudden Release of Pressure Physical and Health Hazard (Check all that apply) o Hazard Fire o Number & C.A.S. Number &·C.A.S. Number & C.A.S Name Name Name Component # 1 Component # 2 Component # 3 Delayed Health o Immediate Health Number o Reactivity C.A.S D Physical and Health Hazard ,,,' (Check all that apply) Sudden Release of Pressure o Fire Hazard D I i I I & C.A.S. Number & C.A.S. Number Component # 1 Name Component # 2 Name Number C.A.S Physical and Health Hazard (Check all that apply) Number & C.A.S Name Component # 3 Delayed Health o o Immediate Health Reactivity o Sudden Release of Pressure #1 EMERGENCY CONTACTS o Fire Hazard D Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanltyof law that I haver personally examined and am familiar with the information submitted in this and all attached documents individuals responsible for obtaining the information. I believe that the submitted information is true, accurate,· and complete. those -- inquiry of "';\...'':'';'''~~-~'''_~H my .- :... based on and that ,.:¡. AUTHORIZED REPRESENTATIVE ';~~i~:_~~~""!i.t·d ~p~ · Bakersfield Fire DfPt. Hazardous Materials Inspection Date Completed to - 30 ~ C'( ð v Business Name: -.Püb ~}Al&{ t 5 01b\J (C.ØrJ \ Location: 2..'5 2-5 LJ h \k LN ~AtlÕ~ RECEIVED OCT 3 , 1990 Plan ID # 215-000 437 (Top right comer Business Plan) HAZ. MAT. 01V. Inspector ~t.k'\1\J5 / R-b'E- ¡ Station No. 5 o Shift Adequate Inadequate Y, rification of Inventory Materials [yf Cït Q1 g D D D D Verification of Quantities Verification of Location Proper Segregation of Material Comments: Verification ofMSDS Availability Number of Employees '0 D cd Verification of Haz Mat Training ~ D Comments: Verifi.cation of Abatement Supplies & Procedures D crt Comments: Emergency Procedures Posted D li ~ D Containers Properly Labeled Comments: Verification of Facility Diagram sz( D Special Hazards Associated with this Facility: Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div, Yellow·Station Copy Pink-Business Office I . '. ~,' ,$' ~PJkvÆa Bakersfield Fire Wept. Hazardous Materials Inspection e o Date Completed ~ J r '3 /; i? '/ Business Name: Þ 6 HOf /~ /' -5 C 0 .¿: ¡/ /,ðV1 r- Location: 2.. S-2- 5"" V0 (f--e L &f,.., -<. Plan ID # 215-000 431 (Top right comer Business Plan) Station No. ~ ;3 Inspector W M- \< \ NS ~ \<0 'E:.... RECEIVEO ~ D '5EP 2 7 1989 [0f D HAZ. MAi. DIV. ~ D W D Shift o Verification of Quantities Ve 'fication of Inventory Materials Verification of Location Proper Segregation of Material Comments: Adequate Inadequate o td Verification ofMSDS Availability Number of Employees >S Verification of Haz Mat Training Comments: Verification of Abatement Supplies & Procedures ctJ3 ~ ~ ~ ~ " \~ Comments: Emergency Procedures Posted Containers Properly Labeled Comments: J D 0-- o ~ ~ ~ D Verification of Facility Diagram Special Hazards Associated with this Facility: ~D Violations: \ \ \ FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office e . Chevron III Chevron U.S.A. Inc. 2410 Camino Ramon, San Ramon, California · Phone (4151 842-9500 Mail Address: P.O, Box 5004, San Ramon, CA 94583-0804 ~6l Marketing Department :;J.. - I'd- - 10 ~sÇ~Q~e-~t. ;L l ~ 0 &-. ç;+-~ ~~~~, cÆ. CJ'3SD I I RECEIVED FEB 1 6 1990 Ans'd............ Enclosed p~ease find the Hazardous Material Business Plan for our d5~Ç W~t-€. ~ ~5~~JDJ cA. facility. If there are any questions you have regarding this plan please call David Johnson at (415)842-9050. Chevron USA C\~ \ Q .i:LH&;.ev/ ~9( A.M. Meier It:>. V ' t " e . Bakersfield Fire Dept. Hazardous Materials Division 2130 IIG" Street Bakersfield, CA. 93301 #95325 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3, Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Bob Haley's Chevron LOCATION: 2525 White Lane MAILING ADDRESS: same CITY: Bakersfield STATE: CA ZIP: 93304 PHONE: 805-832-9781 DUN & BRADSTREET NUMBER: 02- 787 - 5673 SIC CODE: 5541 PRIMARY ACTIVITY: Service Station - Gasoline Sales OWNER: Bob Haley MAILING ADDRESS: 2525 White Lane, Bakersfield, CA 93304 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Jim Johnston - Salesman - 832-9781 - 366-3839 2, Jess Marney - Salesman - 832-9781 - 845-2539 1 . e Bakersfield Fire Dept. Hazardous Materials Divis HAZARDOUS MATERIALS MANAGEMENT PLAN #95325 SECTION 3: TRAINING: NUMBER OF EMPLOYESS: 6 MA TERIAL SAFETY DATA SHEETS ON FILE: yes BRIEF SUMMARY OF TRAINING PROGRAM: 1. All employees are to read the M.S.D.S. Sheets. 2. Read warning labels on products. 3. Be aware of any leaks or spills of gasoline or other chemicals. 4. Use protective equipment if job requires it. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS. BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES, OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I. Bob Haley CERTIFY THA T THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. /£g¡: ~ SIGNA TURE Dealer 1-19-90 DATE TITLE 2. ¡:c· ~. , e Bakersfield Fire Dept. Hazardous Materials Divisi. #95325 HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Bob Haley's Chevron SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: In the event of a spill the following agencies are notified: 1. Bakersfield Fire Dept - Hazardous Material Division 326-3979 2. State Office of Emergency Services 1-800-852-7550 3. Chevron USA, Inc. - These agencies are contacted by phone. B. EMPLOYEE NOTIFICATION AND EVACUATION: Employees are notified in person if they are on duty and a hazardous material emergency arises. Employees not on duty are notified by phone. C, PUBLIC EVACUATION: In the event of a hazardous material emergency all driveways are to be blocked and all people on the premises are to be evacuated with the help of local police department. . D. EMERGENCY MEDICAL PLAN: In the event of an acident requiring medical attention. 1. Call Hall Ambulance Co. 2. Call City Police 3. Transport injured person to San Joaquin Hospital. 3, ;01:->: e Bakersfield Fire Dept. . Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN #95325 SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: All pumps, hoses and nozzles are checked periodicallly for leaks. Nozzles are checked daily to be sure shut off mechanism is working properly. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: In the event of a spill or leak of gasoline, all personell are to turn their full attention to the emergency at hand. C. CLEAN-UP PROCEDURES: In the event of a spill of gasoline, employees are to shut off all power at station, dilute spill with water and spread so it will evaporate. Also call the local fire department. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: Natural Gas - SE corner of building, behind rest rooms ELECTRICAL: on panel on east wall of lube room WATER: on White Ln Street side - north of pumps by pole on sidewalk: SPECIAL: LOCK BOX: YES/rQ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers in office area and lube room. ß, WATER AVAILABILITY (FIRE HYDRANT): Water faucets at NE side of building and SW side of building. 4, F:" :-.;,~, L;1 y UT öAt\t:K0I.lt:LU HAZARDOUS MATERIALS INVENTORY #95325 Standard BusIness [] NON-TRADE SECRETS 1 of 1 NAME OF THIS FACILITY:l ST ANDARD IND. CLASS CODE:SS4------------- DUN AND BRADSTREET NUMBEW'· L_____,__ - - 02-787-5673 - - - - Page o 3USINESS NAME: Bob Haley's Chevron OWNER NAME:Bob H _OCATlON' 2525 WhÜe Lane ADDRESS' lOgl~ Er: ~ITY J. ZIP: BakerstlelSh CA9~õ4---- CITY ¡.. zip: a ers!:le.Lâ, CA )HONt: It: 80~-tJjL::-g¡g-1 --_.,.,----- PHONt: it: 8o-s-=3l3-g=-U1Ul ..-- -- -------------REFER TO-TNSTRUCTIONS-FOR-PROPER CODES ture cu and Agt Farm 1 2 J 4 5 6 1 8 9 10 11 12 13 U Tr~ns Type ~ax Average Annual Hea$ure . ~YS Cont Cont Cont uSå loc~tion Whe~e , by Nar.es of ~ixture{çOrDonents Co e Code Ant Ant Est Units on I te Type Press Temp Co e Store In Fac! Ity 'i/t See Instru: Ions _ U -r p I 22000 I 15000 I 1000000 I Gal I 365 I 1 I 1 I 4 I 19 T Pht~ictl ,nd ~ealth Hajard C,A,S. Humber 8006-61-9 Component', Hame & C.A,S. Number 100% - All Gasoline I ,ec a I t at apply ~ F ire Hazard I\SI Reactivity ~ Oelared o suddf" Re lease Component 12 Name & C,A.S. Humber o Immediate e Hea th o Pressure Health Component 13 Name & C.A.S. Number U I p I 500 I 350 I 2400 I Gal I 365 I 10 I 1 I 4 I 26 I Pht~iC~1 ,nd ~ealth Hafard C.A,S. Humber NA Component., Hame & C.A.S. Number I ec a I t at apply 100% - Motor Oil ~ Reactivity I\SI Oe hred o Suddf" Re I ease Component.2 Name & C.A.S, Humber BJ Fire Hazard [] Immediate Hea th o Pressure Health Component.3 Name & C.A,S, Humber U I w I 550 I 250 I 2000 I Gal I 365 I 1 I 1 l 4 I 40 I PheSical fnd ~ealth Hafard C,A.S, Number NA Component., Name & C,A.S. Number ( heck a I t at apply 100% - Waste Oil [] SUddf" Re 1 ease Component 12 Name & C.A.S. Nu~ber (g Fire Hazard EI Reactivity ~ De Jared [] Immediate Hea th o Pressure Health Component'3 Na~e & C,A,S, Nu~ber .1 pi 75 I 50 I 700 I Gal I 365 I 101 1 I 4 I 9 I PÞtSiC~l tnd ~ealth Haiard C,A.S, HUllber NA Co~ponent" Name & C.A.S, NUllber 100% - Coolant I hec a I t at apply f2I Reactivity ~ Delared o suddf" Re 1 ease . Component 12 Name & C,A,S. Humber o Fire Hazard [] ImmedIate Hea th o Pressure Health Component'3 Name & C.A,S. HUllber EMERGENCY CONTACTS tl1 Jim Johnston Salesman 366-3839 tl2 Jess Marney Salesman 845-2539 R!IIe Tttle Zf1lnnõñe- Rã1ie TttTe Zn¡ftlim-- Qr.ª~ UH~-S Certifiratio~ \ReCfl and ~ifn 8fJft c9mf'~til1g ¡'ill sections) I certl y un er enal 0 a th t I av persona exam!n 0 II familIar it the information $U ~itted in his ond all attaçhed doc~lIen~s an~ t at ~ase~ on IIY In~uiry ~ lhose Inå,vl~ua's responsib1e ~or obtaIning the In~orllatlon. i belIeve that the subm1tted In orllatlon IS true. accurate, an COllp ete, ") Bob L. HalM Dealer ~Th~~MoriCnnme rator UR owner pefã~š-ãü1horllea representative SlgñHure " ~ .$ e ,. BAKERSFIELD FIRE DEPARTMENT BUREÄU OF FIRE PREVENTION APPLICATION Q-3~S- G/r/qo Date Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made by: !å1 ~A.J. çu:::. fO/l... 931.-1- f~, Ç2Q '73'792- Nome otic pony , 'Áddress v . ~. to display, store, install, use, operate, sell ar handle materials or processes involving or creating con- ditions deemed hazardaus to life or property as follows: (3)/Dù7i7) ~ ;;LS-:¿S v1/Ic·l.Þ" £. .:> G' -,~ . . ,-, ," I \/ '\ ¿/V/7'~--'--"" ~__~_~~__"'-/'/ ~:,d~_-:::.~_________ ___-' Authorized Representative c. ¡'"l!e;. 0 ........... ..... .............................. Date By. .... ...!-:.5...1s:.... ..... _... ....... .... ................ ..............-. ....... (Æ-1J ) Fire Marshal ~' q"7-J 1 ~e~~ . ;¡: . . P~-3-+S- GARY J. WICKS ~ncy Dlreclor (805) 861·3502 STEVE McCALLEY Director RESOURCE 2100 M SIreel. Suite 300 Bakersfield. CA 93301 Telephone (805) 861-3636 T elecopler (805) 861-3429 AGENCY ~rt... 0 \J Ä{..... PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A 1135-31 OF UNDERGROUND HAZARDOUS . SUBSTANCES STORAGE FACILITY ..._~.:..~,~ FACILITY NAMEI ADDRESS: OWNER(S) NAME I ADDRESS: CONTRACTOR: Bob Haley's Chevron 2525 White Lane Bakersfield, CA 93304 Chevron USA P. o. Box 5004 San Ramon, CA 94583 California Petroleum Equipment, lne P. O. Box 9364 Fresno, CA. 93792 Phone: (415) 842-9500 License # 432613 Phone: (209) 276-1881 PERMIT FOR CLOSURE OF PERMIT EXPIRES September 5, 1990 .i TANK(S) AT ABOVE LOCATION APPROVAL DATE June 5, 1990 APPROVED BY «~1wJ- Laurel Funk Hazardous Materials Specialist ..................,.....,.".,...................."..,....,..",..",......,., P 0 S TON PRE MIS ES ....."",.......... ~....".".......,' ....".".............,.....,....,..". , CONDITIONS AS FOLLOWS: 1. It is the responsibility of the Permiltee to obtain permits which may be required by other rc:gulatory agencies prior to beginning work (i.e., Ci[ Fire and Building Departments). 2. Permittee must notify the Hazardous Materials Management Program at (805) 861-3636 two working days prior to tank removal or abandonmer; in place to arrange for required inspections(s). 3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-3' 4. It is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation or treatment of hazardOl! materials. 5. The tank removal contractor must have a qualified company employee on site supervising the tank removal. The employee must have tank remov:. experience prior to working unsupervised. 6. U' any contractors other than those listed on permit and permit application are to be utilized, prior approval must be granted by the speciali' listed on the permit. Deviation from the submilted application is not allowed. 7. Soil Sampling: a. Tank size less than or equal to 1,000 gallons - a minimum of two samples must be retrieved from beneath the center of the tank at dep!!. of approximalely (WO feet and six feet. h. Tan~ size greater tban 1,000 to 10,000 gallons - a minimum of four samp!.:s must be retrieved one-third of the: way in from the ends, each tank at depths of approximalely IWO feet and six t'eet. c. Tank size greater than 10,000 gallons - a minimum of six samples must be: relrieved one-fourth of the way in from [he ends of each tal~ and beneath the cenler of each (ank at depths at' ;¡pproximately IWO feel and six feet. 8. Soil Sampling (piping area): A minimum of two samplc:s must be retrieved ;¡t dc:pths of apprmdmately two feet and six fc:c:[ for every 15 linear feet of pipe run and under I: dispc:nser area. ~ of)' :i:' . . ~ f¥\..O" Ai- ,{MIT FOR PERMANENT g¡.QiU~B F UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY PERMIT NUMBER A 1135-31 ADDENDUM 9. Soil Sample: analysis: a. All soil samples retrieved from beneath gasoline (leaded/unleaded) tanks and appurte:nances must be analyzed for benzene, toluene, xylene. and total petroleum hydrocarbons (for gasoline). b. All soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel.; and benzene. c. All soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total organic halides, lead, oil and grea$e, d. All soil samples retrieved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease. e. All soil samples retrieved from beneath tanks and appurtenances Ihat contain unknown substances must be analyzed for a full range or substances (hat may have been stored within the tank. f. All soil samples retrieved from beneath tanks and appurtenances that contained furfuryl alcohol resin must be analyzed for phenols, formaldehyde and furfuryl alcohol. 10. ~:The following timetable lists pre- and post-tank removal requirements: ACTIVITY DEADLINE Complete permit application submitted to Hazardous Mah:rials Management Program At least two weeks prior to closure Notification to inspector listed on permit of date and time of closure and soil sampling Two working days Transportation and tracking forms sent to Hazardous Materials Management Program. All hazardous waste manifests must be signed by the receiver of the hazardous waste No later than 5 working days for transportation and 14 working days for the tracking form after tank removal Sample analysis to Hazardous Materials Management Program No later (han 3 working days after completion of analysis 11. PurginglInerting Conditions: a. Liquid shall be pumped from tank prior to purging such that less than 3 gallons of liquid remain in tank. (CSH&SC 41700) b. Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) c. No emission shall result in odors detectable at or beyond property line. (Rule 419) d. No emission shall endanger the health, safety, comfort or repose of any person. (CSH&SC 41700) e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. RECOMMENDATIONS/GUIDELINES FOR REMOVAL OF UNDERGROUND STORAGE TANKS This department is responsible for enforcing the Kern County Ordinance Code, Division 3 and state regulations pertaining to underground storage tanks, Representatives from this department respond to job sires during tank removals to ensure that the tanks are safe to remove/close and that the overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interests and expectations for this department. 1. Job site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by CAL-OSHA regulations. The job ..[«eman is responsible for the crew and any subcontractors on the job. As a general rule, workers are nOI permit ted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designeJ function. For example, backhoe buckets are never substituted for ladders. 2. Propc:rly licensed contractors are assumed to understand the requirements of the permit issued. The job foreman is responsible for knowing :mJ abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. Individual conlractors will he held responsible for their post-removal paperwork. Tracking forms, hazardous waste manifests and analyses documental ion are nCCL"ssary for each site in order to close a case file or move it into mitigation. When contractors do not follow Ihrough on necessary paperwork, an unmanagc:abk backlog of incompletc cases results. If Ihis continut."S, processing lime for completing new closurt."S will incrc:ase. " / .' 'f ",.' (~I .___--- , C - v. '(~// ~/. J C /~, "', I / J .. /" ..... t. )--, - ' ç)WNElt OR AGENT ~ , /;/7 /Š-':C) DATE (-. Accenled ßv: Lfo:cas \a1l35-3I.ptc r-,' '>'~~~ .... ., . "'<:::?,Aí(~-" ./'Ó'Î .... ;;i,.. Jr-s');\, .... ,,.:.... ,.,', ~\ \ , _. (" .' iJ ;:0.1 ~ 0' ) i' =.~~J~, . ....~J.... \~<('~~: -~/ '::1!.ltóß~\!/J .~ I Do hereb~- e · ~ 31 *"::'~!.~ CITY of B. AKERSFIELD . ~/q1<61~7,·;:~D;d·ò~~.\~ "IVE C-IRE" ~3 :§~::o ?,& -:/::::: ~... ~" ,~ ~"'-"":',~"7\...:.." J¡I~ á"Îííj~ ßð b L, /,?rLev print na-fuei ~ ~ RECE\VEO JAN 3 \) 1989 the . ~ns d u··· t\ ....... (tYDe or ce:-tify that I ha-\'e re"l.-ieh-ed attached Hazardous Materials business plan for &b ~Le/~ Ch€:-prÆ7o~ (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility.. tJ1¿:8 """ r 0 0- ((~~ ,J / - ø1. 7-rr? date o~ 1/~1 Dr~~. 'i e BUSINESS NAME BOB .HALEYS CHEVRON LOCATION 2525 WHITE LN I D NAR 2 t 5-'000-000437 HIGH HAZARD RATING Z 1. OVERVIEW LAST CHANGE 08/15/88 BY ESTER JURIS CODE 215-005 JURIS BAKERSFIELD STATION 05 MAP PAGE 123 GRID t3C FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS 2A SEC Z) JIM JOHNSTON - 832-9781 OR 366-3839 JESS MARNEY - 932-9781 OR 845-2539 UTILITY SHUTOFFS ZA SEt 3) A) GflS - BEHIND BUILDING SOUTH EAST CORNER B) ELECTRICAL - IN LUBE ROOt1 EAST tJALL C) WATER - BY SIDEWALK NORTH EAST OF LOT D> SPEcr AL - NONE E) lOCK BOX - NO Z. NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION> ~~4:~)~~~Þ ~~ ry~~~Crvl./ ~~~~~~ ~ Ú4.~ ~ 9//~-:J-~~ ~~~~~~ ~~~~~,~ ~~~ ¿/~- j PAGE 1 t 2/Z3/88 t 5: 23 MATERIAL SAFETY DATA SYSTEMS, INe. (80S} 648-6800 '. e BUSINESS NAME BOB HALEYS CHEVRON LOCATION 2525 WHITE LN 10 NUiltR 215-000-000437 HIGH HAZARD RATING Z 3. HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION> úh ~ 6-0? ~ ~ ~ ¡1I/,~-tJ_S ~~¿¿ß(/ ~ ~ ~ ~~ ~ ~. 7 ~J(}'.J. ' Cvvf~~~~~/~r ~~~~~ -. ~ ~é/K~~~~~ ~~~~~~ 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 12/16/87 BY EVAMC ZA SEC 5) MERCY HOSPITAL Z2 15 TRUXTLJN AV 327-3371 PAGE 2 12/23/88 15: 23 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 '. e BUSINESS NAME BOB HALEYS CHEVRON LOCATION 2525 WHITE LN FACILITY UNIT 01 10 NU~R 215-000-000437 HIGH HAZARD RATING 2 A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 08/15/88 BY ESTER 10 TYPE NAME MAX AMT UNIT HAZARD LOCATI ON CONTAINMENT USE PURE REGULAR GASOLINE 8000 Gfll. HIGH UNDERGROUND NW CORNER UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LIST 1182.00 100.0 GASOLINE HIGH Z PURE UNLEADED GASOLINE IØØ00 GAL HIGH UNDERGROUND NW CORNER UNDERGROUND TANKS FUEL 10 PERCENT COMPONENTS HAZARD LIST 1182.00 100.Ø GASOLINE HIGH 3 PURE SUPREME UNLEADED 4Ø0Ø GAL HIGH UNDERGROUND NW CORNER UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LI ST 1182.0Ø 100.0 GASOLINE HIGH 4 WASTE WASTE OIL 550 GAL UNI< NOWN UNDERGROUND SW BUILDING UNDERGROUND TANKS WASTE 10 PERCENT COMPONENTS HAZARD LIST 1598.00 100.0 WASTE OIL UNKNOWN 5 PURE MOTOR OIL 500 GAL UNKNOWN WEST WALL OF LUBE ROOM PLASTIC CONTAINER[S1 LUBRICANT 10 PERCENT COMPONENTS HAZARD l.I 5T Z80B.ØØ 100.0 MOTOR OIL UNKNOWN 6 PURE COOLANT - ANTI FREEZE 75 GAL UNKNOWN WEST WALL OF LUBE ROOM PLASTI C CONTAINER£S1 COOLANT 10 PERCENT COMPONENTS HAZARD LIST Z80Z.00 100.0 ETHYLENE Gl.YCOL UNKNOWN PAGE 3 12123/88 15: 23 MATERIAL SAFETY DATA SYSTEMS, INC. (80S) G48··6800 · BUSINESS NAME BOB HAtS CHEVRON LOCATION 2525 WHITE LN 10 NU'R Z 15-Ø00'~0Ø0437 HIGH HAZARD RATING Z B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 12/J5/87 BY ESTER 3A SEC 4) FIRE EXTINGUISHERS ARE KEPT IN THE lUBE ROOM AREA AND IN THE OFFICE. WI-HER HYDRANTS ARE LOCATED AT SOUTHWEST AND NORTH EAST CORNERS OF BUILDING. 3A SEC 5) FI RE HYDRANTS: NORTH WEST CORNER OF WHITE LANE AND EL POTERO BY SHELL STATION, SOUTH SIDE OF WHITE LANE BETWEEN TEXACO STATION AND MCDONALD'S, NORTH SIDE OF WHITE l.ANE IN FRONT OF COMFORT INN MOTEL. D. EMPLOYEE NOTIFICATION I EVACUATION LAST CHANGE IZ/1G/87 BY EVAMC 3A SEC Z> IN CASE OF A SPILL OF HAZARDOUS MATERIALS OR A FIRE ALL EMPLOYEES ARE INSTRUCTED TO TURN IFF PUMPS WITH EMERGENCY SWITCH AND CALL THE CITY FIRE DEPARTMENT OR 911. ALL CUSTOMERS WILL BE EVACUATED FROM THE STATION AND DRIVE WAYS CLOSED EXCEPT FOR THE FIRE DEPARTMENT AND EMERGENCY VEHICLES PAGE 4 J Z/23/88 15: 2:3 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ':::'..., ..'..; e BUSINESS NAME BOB HALEYS CHEVRON LOCATION 2525 WHITE LN 10 N~ER 215-ØØ0-0Ø0437 HIGH HAZARD RATING Z E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 12/16/87 BY EVAMC 3A SEC 1) ALL EMPLOYEES ARE INSRUCTED IN THE PROPER USE OF GASOLINE PUMPS AND THE IMPORTANCE OF THE IMMEDIATE CLEAN UP OF EVEN SMALL SPILLS. THE IMPOR- TANCE OF NOT SMOKING OR ALLOWING SMOKE IN RESTRICTED AREAS. CW)~-~~~4Ú/~. . 7~ 07/ ~~~ cJ¡J~ ð---1"£.~ ~ ~~~~~~ðk-~~ ~~~~. . A ~ .--¡t~ 'h_~L~~ t:£-ýC~~ C/J) ~. aLf ~"-y~'";' r" ~ ~ ¡ ~Á~-'- ;t;h~ U4Æuf~~- ~.. ~ ~~~~~dJaØ- ¿7r ~-fí· ú-t£~ ~;:::Ç;. ~- ~r .~~~~ ~~ . . ~~þ~L~~. ~_~~ T' CC)~ (~) , ~ ~ uf~, u.J~ V-1 µ û~. ~~~ ~~ci~~~ ' ~~ ~ I- ~ j;u.¡ ¡::k j~·fv~~i'~· PAGE 5 1 ZlZ3J 88 15: ZJ MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 of BAKERSFIELD Z HAZARDOUS MATERIALS XNVENTORY NON-TRADE SECRETS E: ~ ~ CIT}T .~ '--' n 13 lacat10n Ihrt , by StONd In fie I IIty lit ~'!1J-H:¡g, rd:__ (0..2 CoIIpcnnt II .... C.A.S. ...... Ic -~ c..nnt 12 .... C.A.S. ...... CoIIpcnnt 13 .... C.A.S. ...... r;,"¿ #~,~ £9- ___ CoIIpcnnt 11 .... U.S. ...... 10-0 t/;1/L~ed ~oL-~____ CoIIpcnnt 12 .... C.A.S. ...... CoIIpcnnt U .... C.A.S. ...... , PaCJ~ uC of .1:;: NAME OF TrrtS ~-';JL.lTY: ON if- b . STANDARD IND. CLASS CODE ~ ~~ DUN AND 8RO'~E2~Z~~ÞZ3 St.nd.rd Bus in~S5 tur~ icu F.r. .nd Aqr BUSINESS LOCATION: CITY, ZIP: PHONE II: 1& ..... of "ht_/ea.an.nt. s.. IMtructlCIIII _-II Gf (/ Ýf.!i. Ç-riJ'c<. t. ~ £~~JZflt!t__~o£;/Ve __.._ 7 I , 10 I Oyt Cont Cant Cant on Sit. Typt PrIll T.. J6S' ŒZJ =rTI2 ...·8:f-w- 9 ,.-., L _..I 1-.elI.t. ....Ith 1 2 3 . 5 , frans Tyøe .... AYII'ICJ' AnnulI .....ure Codt Codt Mt Mt Est Units _ilIEI__JQ~_LíQ.<LQ__.! K6jO_0'.£__~ Physical .and HHlth Hez.1'd C.'.S. Lr.tlKk "that .pply) ,.~ ,.-., J Firt Haz.rd L _..I IIHcti.,ity L - J SucIdIn RlI_ 0' Pressure ¿ _..I Del.yed h Htllt ,. L ; J{ðo 000 ---------- ,.-., L_.I ,./ L _..I Del.yed ....Ith _ (Ll.fJlQ_Q.Q-O______?_º-Q_º__ Phys ic.1 and Htllth H.z.1'd (Chtck a" that a""ly) . r/ r~ L_.I Flrt Hez.,.d L_..I RHctl,.-ity ,JGS ~Ó ( U.S. ... CoIIpcnnt ., r/ ,.-, ?~6 -6/-7 CoIIpcnnt 12 ,,_. C.,.S i.,ity L_..I Delayed L_J SlId... R~I_~ L_.I 1-.elI.t. HHI th of PrtI.ure HHI th ea.pon.nt 13 .... C...S _._1~-L..rQQ.-L-~fº---_1.¿.g-º-9_--~-~f l 0 ( _l--LLi-l£qJr¥¿~1'ð C4ul S.W, ~~ Cda..;. P:r~=larrt::.':I~~j.1'd C.U, .....----....~ »;?i--- Caltlanlnt 11 .... U.S. ...... ~_ r /. ,./ r J r -, ,. -, Cu.panent 12 .... C...S, IIùeber L - J Flr~ Haurd L:-..I hectivity L _..I Otl.yed L -... Sudden R.I_~ L - J 1-.elI.t. HHlth of Prn.ur. lltalth --- ea..-t 13 .... C.A,S. ....r 12~~~.JL--~~Jf?~~----__----_ -. ---- ¡/,y£~ CrlJo4r ----_. ----- ---- IUÆSre 0;1- .1...".9.. __t~/,lfe-r e- 35"0000 _ ~f,rJ-~~-m---m} fi-~r~'?2----- II ~~~__;1ó_6~:tP.,v' r.~ , - .-f,f,-f~~--------- ~~~~ ---- that NSic on ~ inquiry of thos. Ind1.,1c1ua1. ....pon.ib1. Øi~t¡-S~;;~~~~---------------- and In this and .11 .ttICNd doc_u s.---t-~.-.----~~-~~.- -- '9na urt IL_=---7' Nf RGENCY CONTACTS 'Certification {RfUJd and sign after co.pJp.ting all sf!ctions} " I certify und.r ICII\Ilty of 1.. that I hav~ ..r5on.lly ....intd .nd .. ,..ili.r .lth the Infor..tion su¡'Httd for ~)(ainin9 the in'OI'Mtlon. I believ, that tilt su¡'Httd infol'tlltion is tMH!. .çcur.t~. and co.pl~te, II~~ - ...' -anf...ß<;1-'·tk.l---.-k..~-7ii/L~OLR-~7-----t~~~~--------t-r'-- 4~,n 0, rltl' n to, own,r ODfr'tor .~¡;: O;lfr' or 5 .u,,,,,,:1'ii'a-r,oresen a"v~ - " ~- .. -! ~-;,;.~".:~ ~':;::::-:'~::~:::;':;'~~;::-::-~':;"'7 ,..,.,.J /;~-~~~~.."§:_ ~ HAZARDOUS MATER X ALS X NV:e:NT,OR·'!~·: NON-TRADE SECRETS 6 /H-L 1-~i.;'_ .,--:~"".~~~,:.:;:-:,.~::;::-,,:,.... CIT}T of BAKERSFIELD '~~."':''''. "¡::';:;i,~~-',..'.!.~:-~~~';:-t,~-~~~;,~ ,--, L...-J -:~:;~: ~. Far_ ,nd ,Aqr;,eu "f-'_"-";-;" ~,- ~~~:~' PI91 i!= of ~. NAME OF TInŠ FA£~L.!.TY: C/A/'Ff- 0 I STANDARD IND. CLASS CODE .. DUN AND BRADSTREET .NUMBER - - -- --- --- r!.-- St,ndlrd BusIness turl - 11 ..... of IIi lIture/Ccllllclnlfttl See Instructians -, /Jt~£2.11. __9 ; L- 1] 'by 1ft ~<lo -t;o Il LOCIt 1an IIhIrt Stored In fec1ltty ... ... ... 1 1 t It 11 1 Ors Cant Cant Cant Un an 5 It. T ypt Prell T... Code m=/ð [ ~~Jlt/..~ IIuàr _ ... r ~ tc.paMnt 11 ... - ., ta.aønlnt 12 I. -..I I-.li.t. ....Ith c.pan,nt 13 , ....su... Units C.A.5. 5 Annul Est _ ~(02- ...V( I. _..I Otl:::'th '2 3 . I r Ins T yøe 11111 AverlCJe (~f C~f Mt Mt :'f7TïfT - - ~~_L~.L..š.::ti..l :3 ó ~__ P"yliell tnd H..lth HUlrd (~II thit 'lIPly) . ..~, . ''''17! ... _.J Fire HIZ.rd I. _.J AlICti.,fty SuddIn ..1_ of Prasure ...-, 1.-..1 , , /00 I-.lin. ....Ith ...-., 1.-..1 SuddIn ..1_ of Prasure ...-, 1.-..1 Otl,ytd ....1 th ...-., I._.J _ Y-'1_t_L__1..£__du__?:.Q____ P"vsie.llIId Hetlth HUlrd (Check 111 thtt Ipply) ... ..-, ...--./ ... _.J Fire HlII~d I.M" I!Hctiylty tc.paMnt to.øanInt c.pan,nt ------l.~~~__-L_.______;.___l_______._J.._L_L__1.____L.._!__~_ Physie.I.1nd IINlth ",llrd C.A.5. IIœbtr tc.ponInt (Check III thtt""ly) ------- .. - , ,. - ., ... - ., Co.poIIIIIt ... _.J Firl HIZ.rd 1.:-..1 IItIctivity I._.J I-.lilt, H,,1 th tc.paMnt , --------- -- =T · C.A.S. · C.A.S. -- .....,. IIùIIbtr . U.S. · C.A.S~ · C.A.S ...' 1- ... ... ... II 12 13 11 I-.li.t. H..lth ______1 C.A.5. ......_ ...-., 1.-..1 Sudden III1IISI of Pl'tSsure ...-., Del.yed 1.-..1 H..lth ...-., I._.J --- -' -----, Physicl Lind tiel Ith ",rlrd (Chick, 111 thtt Ippl~l ' ,..-, ,.-~ ... _.J Firl HlZlrd ,,:1. __ ~ A..etiyity ~ -..: -' 12 Sudden IIIIIISI of Pressure ,.-, Del.yed I. _..I Health ,.-, I._.J ----- L~ -.., "fc- ' F'f/SJ5J ~ .----------------------- 21-WP-PftðftI-~---- ... . C.A.S. IluMtr 12~~Jr __~~~~~________.___ 13 .,~~-_-~h~~-~-.m-.-.21t(;<#!!!~~-_--.--m.! ~;f-!w!i¿---- ------ Irtd thtt blsed on "y inquiry of thor, fndfvfdull. 1'tSDII.ibl. Ð¡tç:;~7£ ,liE RGENCY COIITACTS \. :·R.t\iéition (Read and sil!n after co.pJeting all s/!!ctions) I c.rdf~ undrr ØII1Ilty of 1.w that I hay! ~rson.l1y I...inN end .. l..i1i.r with the inlor_tian for.,,~U:ininq the InfOMNtion. I beli,.,e thtt the subIoitted inforNtion is trlH!, ,ecur.te, II1d eo.p ,1 . ·.L f6 L ~ '. ' \,. .. .t:;J L, (fCVA/l 14"~. ;¡~~ÕH1ë-\' ¡,~<;'nïõWñir 7õPi;:. tõr ~õWñ~¡:ãtõ;:·š-.ütliõ¡:ji¡a-;:iørišiñtãtjÿf <~, . ,. :~._~.. ""-,,, ......... I ~'fI .~ e . BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 I d3 ~}ðA @ ~PQ - ,:"~¡¡ OFFICIAL USE ONLY ID# \~~b't BUSINESS NAME HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 000431 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business 4. Be as brief and concise as possible. as a whole. SECTION 1: BUSINESS IDENTIFICATION DATA / A. BUSINESS NAME: Bob H/t£FY J ?IfEI/~o¥ B. LOCATION / STREET ADDRESS: ;¿ S )... 5 Ll/hi ft::.. L/ftVe" CITy:ß¡fKfVý;£I/~ ¿J ZIP: c¡ 3"Jo'f BUS.PHONE: (8'05) R31-7'79/ SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY ~~ME AND TIT~I.H 'fé>S IN CASE OF EMERGENCY: B. -:r;; h IVS- ~ t.l JI1 fJ-K IV eY . I DURING BUS. HRS. Ph# X' Ã 1-97 i'1 Ph# f3J-Y7 ¡ I AFTER ßUß. HRS. '"} Q Ph# 3 &b ~tf d-- L Ph# ~f5J-5'3-1 SECTION 3: A. NAT:@PRORANE: B. ELECTRICAL: Lv. C. WATER: aA D. SPECIAL: E. LOCK BOX: YES /@ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSS? YES / NO KEYS? YES / NO - 2A - " - e ~~ "'- ""- "" . "04 ::. ï, .¡ c ~" '-. SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE ~o¡t/ ç SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ¡J1eÆl:../(, {fo5¡Jtf4'L '.' L.: í I· .~_.\ g ,I ¡ . ). J-/Ç "TrJJxfü'l/' ,l/-tl& SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E~PLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS, CIRCLE YES OR NO A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . .'. . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:. . . . . . . . . . . . . . . . . . . . . . . . . . C. PROPER USE OF SAFETY EQUIPMENT:. .. ............. .. D. EMERGENCY EVACUATION PROCEDURES:.... ............. E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:...... . INITIAL REFRESHER eYE§) NO ~ES NO NO ES :-¡'O YES~ @NO @VNO ~NO ~ NO YES <]Q) SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:... . .. YES <§[? Le , certify that the above information is accurate. nformation will be used to fulfill my firm's obligations under th and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 that inaccurate information constitutes perjury. 'SIGNAroRE!k- Pf TITLE þ~ DATE 1- 3-111 - 2B - ~------ fo / ./ /' e, e ';; ('.. H''''...· 'Î / ,./ / ;,. " BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" . STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY /' ID# - - -' - - - BUSINESS NAME: -. ,BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action. this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. " FACILITY UNIT# I FACILITY UNIT NAME: (!,IIEr{(on/ Jf-ÆT/~1f/ . SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDu~ES frf.,¡L ~/"t. ¡J L.oc:¡e-c:f frJ-e... / ~J-fJ-~of~d. /-/1/ Me" ¡J)-o'//'€4: t/S e..- o..¡:.. /A!oluve.. fJtJí'I1-lS 1fN"J, 'f'/' ~ I'PtjJorl111/G-e of -HIe /""~;fffe.. bLe.rl-N" t..J¡J o~ ~(/e.--,v .J;h/j'Þ/' ~¡J,UJ ~ '¡,~ f--fJ°rl/l~c.-e.- . ó-f A/oT- SM-otCflt/7 or jJ-f.,¡t-OW¡;v.7 .J,uok"e.. ;;f/ ¡-f!!:,!frlG-f-C/d /'fl!¿;-/!-S" :ECTION 2: NOTIFICATION AND EVACUATION PROCEDu~ES AT THIS u~IT ONLY ¡IV C;q.-Je., 0+ A- Sl'it-L of- hlt1-A-rduv5 1H1t'f~{Jl/-t-5 0;- It F/i..~ ItkL.., E~¡f'hr.e.e..J flrG- 14/..rfr~vT~cl 1--0 rv¡fA/ off fJ LI""'-I S W ¡fit E"", -e--ry e,-JVj ¡ w-¡ f¡:,~ A-;vc:I CA-'t- t- -f1, <- c. i fy p,H. f)'~1Mrf 1"1 ~II/~ off U I" AU vv~fo"'M- f, ¿pi t.,{,.. fa e.- -e. VltG--()lf'fe/J -f¡-<J~ 14, c.. ).f-;¡-fr~n/ IJ-,vcl d¡-t{/o w-/fyf C. Lased. e)cG- e- fr f- fa i- fhe- ñ ~ .d. yl1TA< ~f- frN"'£ Eft< -r e-,r-Ï' t/d;{./L eS - 3A - '. e e " " .' ~ ">- .... ;: ,-, ;..-. .. SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facili ty Uni t contain Hazardous Mat.erials? . . . '. ~ NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form j4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION - . LJ yf. -;f H~ EXf/ívrvj"St(-e,-r.J ¡fife.. lé~f- /,v- ~e.- ¿vie.. /LoOh? /f. ~ /J-v¿ /~ 7-'4 ~ ofFI è-e.,. ú/¡ffe-r H'1¿rtfw:rs 11i(e.. L,oV'fr~ If7- .$'ðtJfC,.~u/es+ ...f /Vorl/:' E/fJ-,L- GoJr/Ve.rr ~ 0 r gv7Upp'j. SECTION 5: LOCATION OF ~'¡ATE~ SUPPLY FOR USE BY EMERGE. NCY RESPONDERS . ] . ø 1/O¡ff-4 w..eJ'f'CGÆIV~ of wh¡fc{...,vý-£L- !'c'f-t:;,¡-o .ìŸ, tndt.. .J~{cA/ f¡¡-~ (j;)5o(/fIt .s ,Je-- 0+ wh:,fc- '-/1/ h~~e.tV íe-~kc.-o .ff#o"'+-/I1c;;.~()v;fU~ If'l¿r¡f~ (]) ¡1/oA-fA ~í./c- ().þ Wh:f~ '-'v- 1/1/ ..fr-oA/t of- ~fJfoYr //Y/V /l'to"f-C/L.- SECTION 6: LOCATION OF UTILITY SHUT,-OFFS AT THIS UNIT O:'\LY, A ~~$~?~~~o~~'i~ìU;N7 ~. """'<V B. ELECTRICAL: //YS/cÍe.. . Lv/'e, ÆoopVf o¥ Eð.fT U,/-'f-¿L- C. WATER: ;1-.'( J ¡cf '" <v..¡-t.-k - ¡I/o r+Þí - ¿Ç,f'S T 00r 4/ e-I(' 0 +- £-0 7, D. SPECIAL: E, LOCK BOX: YES /@7IF YES, LOCATION': IF YES, SITE PLA~S? YES / NO FLOOR PLA~S? YES / ~O MSDSs? YES I ~o KEYS? YES / \'0 - 38 - of L Page BAKERSFIELD CITY FIRE FORM 4A-1 NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY DEPARTMENT # D I (' ~~ - CODE UNIT # /.k-~_A- OWNER NAME gob II~~ FACILITY ADDRESS: 'ot:J/€ E/V< e- ~ACILITY UNIT NAME: CITY,ZIP: nA.Lr~f,4¿U- 9l~/J.- PHONE #: c:;¡;c¡o/O! lOFFI.CI.A.L USE QNLY BUSINESS NAME: ¡;'oj If,+Le.,YJ chf!rl/Æð/V ADDRESS: ~ J...' U/A7M. L-v C I TV, ZIP: ~J1fk .e,¡""r~ie.¿,cI .f 5 S oJ.,C PHONE #: ~? 2.97 ~ I CFIRS 9 10 HAZARD D.O.T CODE GUIDE !J-o)' JL--OJ 8 % BV -1fT. rJ __ (r { Ý!!? '-b /LIe- [(/fft£ of £V¿e oM DC; uJe5r Cû¡yU, ofLv6e- 041 7 LOCATION IN THIS FA.CILITY UNIT U 1V4 e, ;-(,.¡fovv c:I #ÓRfh úI~ c.orv~1" II 6 USE CODE 11 1 2 3 4 5 TYPE MAX ANNUAL CONT CODE AMOUNT AMOUNT UNIT CODE i)L 8000 1-¥06oO GIrL. 01 o 1I1oooo (TIrl- c> f ~ 000 ;1.. )...000 G1 J, 0/ ~).# S"s 0 ;., 0" o( Dt. 7-ioo ~ 10 ~ ;LSo &rf,. 5'00 15 - --- \ \ DATE: 7-3-~Z ...ß ?:1 vt7 ð' I S8~% I 19.1r:;~'7!i ~~~ . PHONE # BUS HOURS: AFTER BUS HRS: PHONE # BUS HOURS: AFTER BUS HRS : (PJ,'-"-<' ~~/(' SIGNATURE: TITLE:_ ðCVA/~i( ~IJLE: tr.rvf-ltìL Ie¡;.. 4A-l TITLE 7.f;FL .e. V / r¡-e,/Vc4 ACTIVITY: If~it.. ~ /f(/-r:c~ cf7 Ì;e; \ NAME; 7J~-6 ~l..e.y_~ EMERGENCY CONTACT! ß,..£, .' ,., OJ' EMER~ENCY CONTACT: PRIN'C I PAL BUS INESS lJ/tL \ fl Optional Attachments (Check one) E3 I have attached a slta plan I have attached a list 01 slta coordinate abbravlations '4(\ i t! Page -f- o. iL pages Form Appro.ed OMB No. 2050-<>072 051 K 3 )-77;;. ons to December 31 .. - ... ... .. ... -.. .. - - .... ..... Storage Codes and Locat .... . (Non':'Confidential) Phone Locations Tltla Phone Title 24 Hr, Phone - 19h L-c.- Stórage 24 Hr, Certification (R,ad (lId 11&11 alt,r compl,ting all slCtions} I certify under penalty of law that I have personally axamlned and am familiar with the Information submitted In this and all attached documents. and that based on my Inquiry of those Individual. responsible for obtaining the Inlormatlon. I believe that the sublnl Inlø'maH Is tn... a, ta, and complete, ð.~£ L - L .J)e-A-Le4~ ;$ -/-r Name and official tl ~'operator·. authorlZ8d representatlva Data signed . \..... ................ .......... ß I '" @ill . [MRI . .... . . . . . .. ... - - .., . . ... , .. . - ...., .. ... .... ".' . .. .. ...... ".. · .... ' ... - . .. - - - -. - ,. . .. . . ,", --,"... . ... . ".. .. . .. , . ,.. . · ..... ...... ... .... .. .-...... .... .. ...." .. ... . -. .... · .....,......... -, '.". - "..... . .,-... -. .. ,. .. - -... .. "--'." "," ........--....... -.' ,-- . .... ..... .... .. . .... - .. .. '.......... .... .. ...... .. .. .,.. , .. ..........,..... ..., . ..... ....... .. ..... ,. . , -..- - .. ..... . ..... ... .. . . . . -...... . ...... ,. - . . ... . . .'. .'. .. ._-. · . .. . . ... .... .... - ... . . .... -." .. ... . -, .. . ... ..... . , , -" ..-.. .. "-.." -. ..-... . CQrn[$J ..~ .. ... ..... ... .., ß ( I.f '" . ,. . ... -.' .'.... '::':.'":...::-:'.:.:- .-:.\::<.... :'.:. .-:::::':-:-:.::-:-::::-";.:" . .. .... ..... .. .. - -,- ............. . .... -... - " ....... .-. . .. - -... .. . ...-... .. ........ .. ..............-, .. ........... .. .... - . ...... " .... ...... ., .... -..-.... . - 00_.. _ . _ _ _ .... .. ...."..-.. -.. - -..... -..... .. . -- - ...... . - ,- -. - - .... [QI1].[illl ..~... Reporting Period Inventory Avg. No. of Dally Days Amoun On-site (code) (days) . - - c IV" _ _ _ Mai ~ Zp~JSoy:J - Em Nama Dun & Brad r::m ~ ~ Numbw~-~-~ ~ o iFlra Sudden Release _ of Prassura _ Reactivity Immedlata (acute Delayed (chronic o fZl 0 Solid Liquid Ga. - -- [ill] ~ l:cr~ 0 c;", o g] 0 Solid Liquid Ga. - -- [ill] [1] ~r: 0 ~Flra A/ C/.--/ _1 _ f Sudden Release """"-- !:!:....I:::.. IIõI.Si:CR of Pressura _ _ _ Reactivity _ _ _ immediate (acutt Delayed (chronic) o rð 0 Solid Liquid Gas Physical·.·.... and Health Hazards ........... .11 that all()IY( Name Street Address City. SIC Coda CAS Chem - - ChICk all 0 IZJ that apply: Pura Mix CAS~ Chem. NamedQ,£/J'?, t/'A/LeA4 -e.-¿ Check all 0 fgJ that apply: Pura Mix - CAS[I]11 ill Chem, Name r:. ~ G J4ç, L...A - ChICk. all 0 ~ fhat apply: Pura Mix Read all Chemical . Tier Two EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY Sp,cific Informalion by Chemical ..c . e Date BAKERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION ÂPPLICA TION x - ;270- Application No. & J')'1flq '; ~ I. I t_ In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made by: 90. '--~ ..r?L ~, <%--tl--f <-t ð /~ _ 93 ç.L ,_:1~) Name af CóÍripony ) ) Address v to display, store, install, use, operate, sell or handle materials or processes involving or creating con- dition.j deemed hazardous to life or property as follows: þ,c.v<4'-~ (3) /.1::' -(je/"f.J~....fq·, þ""h-:J ú./+ <2L.:./v~-,:r:v, .",2.5 J,_-) ß.y,..¥G ~. , """ , ~'~ ;l ,¿11k!~¡;:Øa~ø5--- (j Authorized Repre;fu;~e ~K By. ..... ............ .......... .. _ .................... ......... .............. -....... (£.:1 \ Fire Marshal ~- , ) j permi~....~..!¿1j2!:¿..................._. Cote '. ·RECEIVED JUt· 5 1990 . Anst~..~....... . z .. . . j~ 13.qt- ...~ GJvun CJY1 v ~-~- · -- DEPART 2700 M SlrHI. Suite 300 Bakerstleld. CA 93301 Telephone (805) 861 -3636 Te/ecop/er (805) 861-3429 GARy"l WICKS A~4T>CY Dlreclor "tIlOS) 861-3502 STEVE McCALLEY Director RESOURCE \E N T AGENCY -:~MENTAL s PERMIT TO CONSTRUCT UNDERGROUND PERMIT NUMBER 310036B STORAGE FACILITY Phone No. (415) 842-9657 CONTRACTOR: California Petroleum Equipment P.O. Box 9364 Fresno, CA 93792 LIcense # '432613 Phone No. (209) 276-1881 FACILITY NAMEI ADDRESS: Bob Haley Service, Inc. 2525 White Lane Bakersfield, CA 93304 OWNER(S) NAMEI ADDRESS: Chevron USA, Inc. 2410 Camino Ramon San Ramon, CA 94583 x NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER PERMIT EXPIRES June 25, 1991 APPROVED BY June 25, 1990 q:nd ~ Laurel Funk Hazardous Materials Specialist APPROVAL DATE .... .............................................................................. POST Q N PREM ISES............................................................··......· CONDITIONS AS FOLLOW: Standard Instructions 1. All construction to be as per facility plans approved by this department and verified by inspection by Permitting Authority. 2. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. 3. Permittee must contact Permitting Authority for on-site inspection(s) with 48 hour advance notice. 4. Backfill material for piping and tanks to be as per manufacturers' specificatións. 5. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfillings. 6. Construction inspection record card is included with permit given to Permittee. This card must be posted at job site prior to initial inspection. Permittee must contact Permitting Authority and arrange for eacr. group of required inspections numbered as per instructions on card. Generally, inspections will be made of: a. Tank and backfill b. Piping system with secondary containment leak interception/raceway c. Overfill protection and leak detection/monitoring d. Any other inspection deemed necessary by Permitting Authority. · e .5tandard Instructions Permit No. 3100368 7. All underground metal connections (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. , 8. Primary and secondary containment of both tank(s) and underground piping must not be subject to physic:l or chemical deterioration due to the substance(s) stored in them. Documentation from tank, piping, anc seal manufacturers of compatibility with these substance(s) must be submitted to Permitting Authority prío to construction. 9. Spark testing (35,000 volts) required at site prior to installation of tank(s). Test(s) must be certified b' the manufacturer, and a copy of test certification supplied to the Permitting Authority. 10. No product shall be stored in tank(s) until approval is granted by the Permitting Authority. 11. Monitoring requirements for this facility will be described on final "Permit to Operate." 12. Monitoring wells on "Typical Drawings" are not allowed unless monitoring probes are installed anc functioning. Construction must be in accordance with Hazardous Materials Management Program standard. as per UT #50. 13. Purging/Inerting Conditions: a. Liquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid temair in tank. (CSH&SC 41700) b. Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) c. No emissions shall result in odors detectable at or beyond property line. (Rule 419) d. Vent lines shall remain attached to tank until the inspector arrived to authorize removal. ACCEPTED BY: ·u~ / I DATE: t --:l ç - ,,9-0 LF:ch funk\310036b.ptc .'