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HomeMy WebLinkAboutBUSINESS PLAN .,. '" .,?b-.. ",I i' N· . ~ l qS~ ." ,- CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (80S) 326-3979 ~"t"- IÄ"''\ û;,@,j¿ c= .<-'~~" - _ _ _ ~ ç ~~,~~,~. SITE AND FACILITY DIAGRAM INSTRUCTIONS FOR HAZARDOUSMATEmALS~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 it it is in a remote location. 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: 3. I d 4. 5. 6. 7. 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. Label the location of the hazardous materials and identify them by name and type of hazard (ie. Flammable liquid, corrosive solid). Label the location of utility shutoff points for gas, electric and water services. Label the location of fire hydrants. Label portions of the building protected by automatic sprinkler systems. A,)e7I?C- Label the direction representing north on the diagram. (The diagram form provided includes a north arrow). " - . ~ .. 'Map labeling must be legible-. easily understandable. Try to avoid I use of abbreviations 0;' .' ~ ..$ symbols. If you must use them. provide a legend explaining your system. Maps may be returned for correction if you fail to follow these instruction. I " I 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 form provided that indicated "Facility Diagram". 2,. Print the name of your business as shown on your HM:MP. 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 of4. 4. Follow instruction (3 -7) for site diagrams regarding the specific details to be included on each facility diagram. 2 " \ ! N -- SITE DIAGRAM r"7 ~ Business Name: ' ~ Business Address: ~OO .\J ~ ~~ -~~~ " ~ ~~~ _ t~-}i d. .0£ ~1 ~ " I ~\, -I t '~t \ì ,~ \j ~ ~ ~ \\ ~' -..:' '../ i! ~ ~ " '~ \: ,~'d¡. ' ~ ~ ~ ~ ~ .~ \ {: ~I ~ I ~I lr ...---------- ~ ¡ \., ~¡ ¡ I ¡ e FAcnJTY DIAGRAM 1 ~ 1n7;fw~~~ ~ç. "1<' ~ ¡ '" ~; ~ ~ ~.~: ~'\J o 0 fl -D V) '\, \¡ ~ I '~, , \ ~~ t!(J . -w ; I ! : I ~,.,I I . i I' I ~Ðhk.c ') ¡ ~ r / 250ot/V/G/l:c /~I ~;y ').... ~ ~ ~ .~ ~ .r/ , ---- _._-------;--~;;;) ,--------- v -, L~ne I J ¡ , , i :~ I ,~ ~ ~ ' ~, ~ i~ , i' - - VALU GAS INC 'r';' SiteID: 015-021-001954 Manager : OLEN ARNOLD Location: 2500 WHITE LN City BAKERSFIELD BusPhone: Map : 123 Grid: 13C (661) 634-9293 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ALBERT GONZALES / ASST. MGR. OHEN ARNOLD / PRESIDENT Business Phone: (661) 634-9293x Business Phone: (661) 634-9293x 24-Hour Phone : (661) 205-3890x 24-Hour Phone : (661) 871-9242x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Period : Preparer: Certif'd: Parcel No: to Phone: (661) 634-9293x State: CA Zip : 93301 Phone: (661) 634-9293x State: CA Zip : 93301 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Contact : OLEN ARNOLD MailAddr: 5301 TRUXTUN AVE City : BAKERSFIELD Owner Address City VALU GAS INC : 5301 TRUXTUN AVE 420 : BAKERSFIELD Emergency Directives: -1- 03/10/2004 e e f YALU GAS INC SiteID: 015-021-001954 9 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: VALU GAS INC Cross Street : Business Type: Org Type: Total Tanks : 1 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : OHEN ARNOLD Phone: (661) 634-9293x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : OHEN ARNOLD Phone: (661) 634-9293x Address: City : State: Zip: Type : CORPORATION BOE UST Fee# : UNKNOWN Financ'l Resp: STATE FUND Legal Notif : Tank Owner Mailing Address Date:02/25/2002 Phone: (661) 634-9293x Name:OLEN ARNOLD Ttl:PRESIDENT State UST # : 1998 Upg Cert#: 00873 -2- 03/10/2004 e e SiteID: 015-021-001954 By Facility Unit Fixed Containers at Site F ~ALU GAS INC f= Hazmat Inventory f== MCP+DailyMax Order UNLEADED REGULAR GASOLINE PREMIUM UNLEADED DIESEL F F DH IH DH L L L 9 9 9 DailyMax IUnitlMCP 12000.00 Mod 8000.00 Mod 5000.00 Low Hazmat Common Name... specHaz EPA HazardS Frm I -3- 03/10/2004 e e SiteID: 015-021-001954 9 Facility Unit: Fixed Containers at Site 9 f VALU GAS INC p= 'Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME UNLEADED REGULAR Days On Site 365 Location within this Facility Unit Triple Compartment Tank Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 Daily Average 12000.00 HAZARDOUS COMPONENTS CAS # I 8006619. %Wt. I 100.00 Gasoline ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -4- 03/10/2004 e e ;F VALU GAS INC SiteID: 015-021-001954 9 f= Inventory Item 0001 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: Triple Compartment Tank TANK DESCRIPTION Tank ID#: 1 Mfr: Modern Weld GlasSteel II Installed: 4/1999 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: 2 Tank Use: MOTOR VEHICLE FUEL MatI Name:UNLEADED REGULAR TANK CONTENTS Petrol Type: REGULAR UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): STEEL CLAD W/FIBERGLASS R. P. Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1999 Drop Tube : 1999 Striker Plate: 1999 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1999 LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 03/10/2004 e e F VALU GAS INC SiteID: 015-021-001954 9 f= Inventory Item 0001 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 TOTAL CONTAINMENT "FLEX" "FLEX" AboveGround Piping PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/21/1999 Date: 06/25/1999 Name:DON JAMES Prmt Number: 1954 TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/31/2003 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED -6- 03/10/2004 e e e e SiteID: 015-021-001954 9 Facility Unit: Fixed Containers at Site 9 F VALU GAS INC f= Inventory Item 0002 == COMMON NAME / CHEMICAL NAME GASOLINE PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 Daily Average 8000.00 %Wt. I 100.00 Gasollne HAZARDOUS COMPONENTS ~ CAS#S006619 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.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: ~ Ag.Define11 -7- 03/10/2004 e e F ~ALU GAS INC SiteID: 015-021-001954 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: Triple Compartment TANK DESCRIPTION Tank ID#: 2 Mfr: Modern Weld GlasSteel II Installed: 4/1999 Capacity: 8000 Gals Additional Info: Compart Tank: N No. Of Comparts: 2 TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: PREMIUM UNLEADED Matl Name:GASOLINE PREMIUM UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): STEEL CLAD W/FIBERGLASS R. P. Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1999 Drop Tube : 1999 Striker Plate: 1999 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1999 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -8- 03/10/2004 e e ~F YALU GAS INC SiteID: 015-021-001954 ì f= Inventory Item 0002 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 TOTAL CONTAINMENT "FLEX" "FLEX" AboveGround Piping PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/21/1999 Date: 06/25/1999 Name:DON JAMES Prmt Number: 1954 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/31/2003 -9- 03/10/2004 e e e e F VALU GAS INC f= Inventory Item 0003 === COMMON NAME / CHEMICAL NAME DIESEL SiteID: 015-021-001954 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 5000.00 Daily Average 5000.00 HA U %Wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 ZARDO S COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: - Ag.Define11 -10- 03/10/2004 e e 'F VALU GAS INC SiteID: 015-021-001954 ì f= Inventory Item 0003 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: Triple Compartment TANK DESCRIPTION Tank ID#: 3 Mfr: Modern Weld GlasSteel II Installed: 4/1999 Capacity: 5000 Gals Additional Info: Compart Tank: N No. Of Comparts: 2 Tank Use: MOTOR VEHICLE FUEL MatI Name:DIESEL TANK CONTENTS Petrol Type: DIESEL Cas #: TANK CONSTRUCTION Type : DOUBLE WALL Material(p): STEEL CLAD W/FIBERGLASS R. P. Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1999 Drop Tube : 1999 Striker Plate: 1999 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1999 LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -11- 03/10/2004 e e F VALU GAS INC SiteID: 015-021-001954 9 f= Inventory Item 0003 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 TOTAL CONTAINMENT "FLEX" AboveGround Piping "FLEX" PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING Installed: 04/21/1999 Date: 06/25/1999 Name:DON JAMES Prmt Number: 1954 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/31/2003 STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: Yes Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 06/25/1999 Name:DON JAMES Ttl:OWNER -12- 03/10/2004 e e I ; .. e e ¡ SiteID: 015-021-001954 '9 Fast Format '9 Overall Site '9 09/07/1999 F \ZALU GAS INC I f= Notif./Evacuation/Medical Agency Notification BAKERSFIELD CITY FIRE DEPT. Employee Notif./Evacuation 09/07/1999 SIGNS POSTED INSTRUCTING CUSTOMERS OF EMERGENCY PROCEDURES. A TURN OFF EMERGENCY SHUT-OFF SWITCH. DIAL 911 & ADVISE EMERGENCY PERSONNEL OF Public Notif./Evacuation 09/07/1999 ] 09/07/1999 UNMANNED SITE. Emergency Medical Plan LOCAL URGENT CARE AND MEDICAL FACILITIES. -13- 03/10/2004 i e e SiteID: 015-021-001954 9 Fast Format 9 Overall Site 9 09/07/1999 f ~ALU GAS INC I f= Mitigation/Prevent/Abatemt Release Prevention EACH FILL PIPE IS FITTED WITH AN OVERFILL CONTAINMENT DEVICE. EACH DISPENSER IS FITTED WITH A COMBINATION THERMAL/SHEAR VALVE SHUT-OFF FUEL IN CASE OF IMPACT OR FIRE. THERE IS AN EMERGENCY SHUT-OFF ON BLDG WHICH SHUTS OFF ALL FUEL PUMPS AND TURNS OFF POWER TO DISPENSERS. EACH GASOLINE AND DIESEL HOSE HOSE BREAK-A-WAY DEVICES WHICH CONTAIN THE FUEL IN THE EVENT OF A DRIVE-OFF. ALL LINES AND TANKS ARE MONITORED 24 HOURS A DAY BY AN ELECTRONIC SENSOR AND INVENTORY CONTROL IS MONITORED BY SONITROL 24 HOURS PER DAY. Release Containment 09/07/1999 UNMANNED SITE. LOCATION CHECKED SEVERAL TIMES A DAY. Clean Up 09/07/1999 SMALL SPILLS WILL BE ABSORBED AND DISPOSED. LARGE SPILLS WILL REQUIRE A LOAD OF SAND FOR CONTAINMENT AND ABSORBTION. Other Resource Activation -14- 03/10/2004 , . Ua I v c.' (Òa..5 j...V\~' e e + BTTRGRI( l<IN~ TJl>TOCAL ================================== Si teID: 015 - 021- 001954 + Manager : Location: 2500 WHITE LN City BAKERSFIELD BusPhone: Map : 123 Grid: 13C (661) 746-9107 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 SIC Code: EPA Numb: DunnBrad: +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Titlen r PARTNER ~ þJlliOLD / 'W' il':I.'.r.f~R f{J' II:- / usiness Phone: (6'Ól) 746-~107x O1§u'i§'Iness Phone: (661) 634-9293x""--- 24-Hour Phone: (661)-G64-0440x 24-Hour Phone H(661) ~J2 52ðêx~/-7' Pager Phone : (661) 059 121SAOFFTC Pager Phon~~: (~())DS--s~;>K +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire ImmHlth DelHlth I +------------------------------------------------------------------------------+ Contact : Phone: (661) ~~107x MailAddr: 2500 WHITE LN State: CA &~cf-~2.-'1.3 City : BAKERSFIELD Zip : 93304 +------------------------------------------------------------------------------+ Owner ~OLD/JAME5 G.1{uUP t/aw-645 JhVC-/2 Phone: (661) ~6-~16'7x -.,. Address : .á-381 TRUXTU1<1 AYJ!. - 5')01 ~ p7W{ 2)¡State: CA "3 <f -92-93 City : BAKERSFIELD V Þ d2---D v-Zip : 93309 +----------------------------------~-------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No +------------------------------------------------------------------------------+ Emergency Directives: +==============================================================================+ fJ L~é-fL-'T 6cJz-A-l/e-~ ~Jtf-~2-9s tv If CbL >oS- -- 3 ç¡9 D -1- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + +==================== STORAGE CONTAINER DATA (UST FORM A) =====================+ I Last Action Type: +------------------------- FACILITY/SITE INFORMATION --------------------------+ Business Name: BURGER KING UNOCAL Cross Street : Business Type: Total Tanks 1 IndnRes/Trust: No +------------------------- PROPERTY OWNER Name OHEN ARNOLD Address: City Type CORPORATION +--------------------------- TANK OWNER INFORMATION ---------------------------+ Name OHEN ARNOLD Phone: (661) 634-9293x Address: City Type CORPORATION +------------------------------------------------------------------------------+ BOE UST Fee# : UNKNOWN Financ'l Resp: STATE FUND Legal Notif : Tank Owner Mailing Address +------------------------------------------------------------------------------+ Date: 06/25/1999 Phone: (661) 746-9107x Name:DON JAMES Ttl:PARTNER State UST # 1998 Upg Cert#: 00873 +==============================================================================+ Org Type: PA Contact: INFORMATION -------------------------+ Phone: (661) 634-9293x State: Zip: State: Zip: += Hazmat Inventory ========================================= One Unified List + +== Alphabetical Order ================================= All Materials at Site + +--------------------------------+-------+-----------+-----+----------+----+---+ I Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP +--------------------------------+-------+-----------+-----+----------+----+---+ DIESEL L 5000.00 Low GASOLINE PREMIUM UNLEADED F IH DH L 8000.00 Mod UNLEADED REGULAR F DH L 12000.00 Mod +==============================================================================+ -2 - 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + += Inventory Item 0003 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ DIESEL I Days On Site I 365 +----------------+ I CAS # I Location within this Facility Unit Triple Compartment Map: Grid: +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Mixture I Ambient I Ambient I UNDER GROUND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 25000.00 5000.00 5000.00 +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I IRS I CAS# I 100.00 Fuel Oil No.1 No 70892103 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I TSecretI RSIBioHazl Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies / / / Low +=======+===+======+====================+=============+=========+========+=====+ += Inventory Item 0002 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ GASOLINE PREMIUM UNLEADED I Days On Site I 365 +----------------+ I CAS # I 8006-61-9 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Mixture I Ambient I Ambient I UNDER GROUND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 25000.00 8000.00 8000.00 +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I l~~~åoIGaSOline IN~SI CAS#8006619I +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ ITsecret RSIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F IH DH / / / Mod +=======+===+======+====================+=============+=========+========+=====+ Location within this Facility Unit Triple Compartment Map: Grid: -3- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + += Inventory Item 0001 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ UNLEADED REGULAR I Days On Site I 365 +----------------+ I CAS# I 8006-61-9 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Mixture I Ambient I Ambient I UNDER GROUND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 25000.00 12000.00 12000.00 +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I I RSI CAS # I 100.00 Gasoline No 8006619 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I TSecretI RS BioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F DH / / / Mod +=======+===+======+====================+=============+=========+========+=====+ Location within this Facility Unit Triple Compartment Tank Map: Grid: -4- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + +================================================================= Fast Format + +- Notl'f /Evacuatl'on/Medl'cal ------------------------------------ Overall Sl'te + -. ------------------------------------ +== Agency Notification =========================================== 09/07/1999 + BAKERSFIELD CITY FIRE DEPT. +==============================================================================+ +--- Employee Notl'f /Evacuatl'on ----------------------------------- 09/07/1999 + --- . ----------------------------------- SIGNS POSTED INSTRUCTING CUSTOMERS OF EMERGENCY PROCEDURES. A TURN OFF EMERGENCY SHUT-OFF SWITCH. DIAL 911 & ADVISE EMERGENCY PERSONNEL OF +==============================================================================+ +---- Publl'C Notl'f /Evacuatl'on ------------------------------------ 09/07/1999 + ---- . ------------------------------------ UNMANNED SITE. +==============================================================================+ +----- Emergency Medl'cal Plan ------------------------------------- 09/07/1999 + ----- ------------------------------------- LOCAL URGENT CARE AND MEDICAL FACILITIES. +==============================================================================+ -5- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + +================================================================= Fast Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +== Release Prevention ============================================ 09/07/1999 + EACH FILL PIPE IS FITTED WITH AN OVERFILL CONTAINMENT DEVICE. EACH DISPENSER IS FITTED WITH A COMBINATION THERMAL/SHEAR VALVE SHUT-OFF FUEL IN CASE OF IMPACT OR FIRE. THERE IS AN EMERGENCY SHUT-OFF ON BLDG WHICH SHUTS OFF ALL FUEL PUMPS AND TURNS OFF POWER TO DISPENSERS. EACH GASOLINE AND DIESEL HOSE HOSE BREAK-A-WAY DEVICES WHICH CONTAIN THE FUEL IN THE EVENT OF A DRIVE-OFF. ALL LINES AND TANKS ARE MONITORED 24 HOURS A DAY BY AN ELECTRONIC SENSOR AND INVENTORY CONTROL IS MONITORED BY SONITROL 24 HOURS PER DAY. +==============================================================================+ +--- Release Contal'nment ------------------------------------------ 09/07/1999 + --- ------------------------------------------ UNMANNED SITE. LOCATION CHECKED SEVERAL TIMES A DAY. +==============================================================================+ +---- Clean Up ---------------------------------------------------- 09/07/1999 + ---- ---------------------------------------------------- SMALL SPILLS WILL BE ABSORBED AND DISPOSED. LARGE SPILLS WILL REQUIRE A LOAD OF SAND FOR CONTAINMENT AND ABSORBTION. +==============================================================================+ +===== Other Resource Activation ==============================================+ I I +==============================================================================+ -6- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + +================================================================= Fast Format + += Site Emergency Factors ======================================= Overall Site + +== Special Hazards ===========================================================+ I I +==============================================================================+ +--- Utl'll'ty Shut-Offs -------------------------------------------- 09/07/1999 + --- -------------------------------------------- A) B) C) D) E) GAS - NONE ELECTRICAL - ON THE WATER - HUGHES LN - SPECIAL - NONE LOCK BOX - NO BACK SIDE OF BLDG 50FT OFF WHITE LN +==============================================================================+ +---- Fl're Protec /Aval'l Water ----------------------------------- 09/07/1999 + ---- ----------------------------------- . . PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN BLDG. NEAREST FIRE HYDRANT - ON THE CORNER OF HUGHES LN & WHITE LN ON PROPERTY. +==============================================================================+ +===== Building Occupancy Level ===============================================+ I I +==============================================================================+ -7- 02/25/2002 e e + BURGER KING UNOCAL ================================== SiteID: 015-021-001954 + +================================================================= Fast Format + += Training ===================================================== Overall Site + +== Employee Training ============================================= 09/07/1999 + THERE ARE NO EMPLOYEES AT THIS 'FACILITY IT IS AN UNMANNED SITE. DO YOU HAVE MSDS SHEETS ON FILE??????? BRIEF SUMMARY OF YOUR TRAINING PROGRAM: WHEN ON SITE PERSON IS INSTRUCTED TO TURN OFF EMERGENCY SHUT OFF AND DIAL 911 AND GIVE DETAILS OF EMERGENCY. +==============================================================================+ +=== Page 2 ===================================================================+ I I +==============================================================================+ +==== Held for Future Use =====================================================+ I I +==============================================================================+ +===== Held for Future Use ====================================================+ I I +==============================================================================+ -8- 02/25/2002 ; " , e . I ; BURGER KING UNOCAL SiteID: 015-021-001954 Manager : Location: 2500 WHITE LN City BAKERSFIELD BusPhone: Map : 123 Grid: 13C (661) 746-9107 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code: DunnBrad: Emergency Contact WILLIAM COUGHLIN Business Phone: 24-Hour Phone P P / Title / PARTNER (661) 746 - 9107x (661) 664-0448x (û(,ø() ~ /J,I)' x o~<: Emergency Contact -8frl3N ARNOLD Business Phone: 24-Hour Phone Pager Phone / Title / PARTNER 12 qy (661) 634 9Z6~X (661) 332-5208x () x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 2500 WHITE LN City BAKERSFIELD Phone: (661) 746-9107x State: CA Zip 93304 Owner Address City ARNOLD/JAMES GROUP ~ f, Phone: (661) 257 £ CENTR.'\.L-VAT,p·'y-HWY 5'38( JtJ.'€1tIt"AŒtate: CA ..&HÞFTER G~( Zip : ~ q 73&1' Period Preparer: Certif'd: to TotalASTs: TotalUSTs: RSs: No Gal Gal Emergency Directives: PHONE NUMBER CHANGED TO 859-1215 AND OFFICES MOVED TO 5381 TRUXTUN AVE, 09. ~Y'-E'~,t<JAI.L. M:~ hereby certify that I have (fype or pont name) reviewed the attached hazardous materials manage- ment pJan for~. hMlr lo~~ cht~Jmd that it along with ~Name of Bu Iness) anY<OOrrections constitute a complete and correct man- Ç;! ~e I -1- 05/09/2001 , e e F BURGER KING UNOCAL SiteID: 015-021-001954 ì STORAGE CONTAINER DATA UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BURGER KING UNOCAL Cross Street : Business Type: Org Type: Total Tanks : 1 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : GLEN ARNOLD Phone: (661) 634-9263x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : GLEN ARNOLD Phone: (661) 634-9263x Address: City : State: Zip: Type : CORPORATION BOE UST Fee# : UNKNOWN Financ'l Resp: STATE FUND Legal Notif : Tank Owner Mailing Address Date:06/25/1999 Phone: (661) 746-9107x Name:DON JAMES Ttl:PARTNER State UST # : 1998 Upg Cert#: 00873 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP L 5000.00 Low F IH DH L 8000.00 Mod F DH L 12000.00 Mod One Unified List ì All Materials at Site ì p= Hazmat Inventory p== Alphabetical Order DIESEL GASOLINE PREMIUM UNLEADED UNLEADED REGULAR -2- 05/09/2001 e e SiteID: 015-021-001954 ì Facility Unit: Fixed Containers at Site ì F BURGER KING UNOCAL p= Inventory Item 0003 = COJ'.1MON NAME / CHEMI CAL NAME DIESEL Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 5000.00 Daily Average 5000.00 HAZARDOUS COMPONENTS %Wt. RS CAS # 100.00 Fuel Oil No. 1 No 70892103 HAZAR E T TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low D ASS SSMEN S p= Inventory Item 0002 = COJ'.1MON NAME / CHEMICAL NAME GASOLINE PREMIUM UNLEADED Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 Daily Average 8000.00 %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 -3- 05/09/2001 e - SiteID: 015-021-001954 l Facility Unit: Fixed Containers at Site l F BURGER KING UNOCAL f= Inventory Item 0001 F== COMMON NAME / CHEMICAL NAME UNLEADED REGULAR Days On Site 365 Location within this Facility Unit Triple Compartment Tank Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 Daily Average 12000.00 %wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BióHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod HAZARD ASSESSMENTS -4- 05/09/2001 e e Employee Notif./Evacuation SiteID: 015-021-001954 ì Fast Format ì Overall Site ì 09/07/1999 j 09/07/1999 F BURGER KING UNOCAL I p= Notif./Evacuation/Medical r=: Agency Notification ~AKERSFIELD CITY FIRE DEPT. SIGNS POSTED INSTRUCTING CUSTOMERS OF EMERGENCY PROCEDURES. A TURN OFF EMERGENCY SHUT-OFF SWITCH. DIAL 911 & ADVISE EMERGENCY PERSONNEL OF Public Notif./Evacuation 09/07/19991 09/07/1999 UNMANNED SITE. Emergency Medical Plan LOCAL URGENT CARE AND MEDICAL FACILITIES. -5- 05/09/2001 e e SiteID: 015-021-001954 1 Fast Format 1 Overall Site 1 09/07/1999 F BURGER KING UNOCAL I f= Mitigation/Prevent/Abatemt Release Prevention EACH FILL PIPE IS FITTED WITH AN OVERFILL CONTAINMENT DEVICE. EACH DISPENSER IS FITTED WITH A COMBINATION THERMAL/SHEAR VALVE SHUT-OFF FUEL IN CASE OF IMPACT OR FIRE. THERE IS AN EMERGENCY SHUT-OFF ON BLDG WHICH SHUTS OFF ALL FUEL PUMPS AND TURNS OFF POWER TO DISPENSERS. EACH GASOLINE AND DIESEL HOSE HOSE BREAK-A-WAY DEVICES WHICH CONTAIN THE FUEL IN THE EVENT OF A DRIVE-OFF. ALL LINES AND TANKS ARE MONITORED 24 HOURS A DAY BY AN ELECTRONIC SENSOR AND INVENTORY CONTROL IS MONITORED BY SONITROL 24 HOURS PER DAY. Release Containment 09/07/1999 UNMANNED SITE. LOCATION CHECKED SEVERAL TIMES A DAY. Clean Up 09/07/1999 SMALL SPILLS WILL BE ABSORBED AND DISPOSED. LARGE SPILLS WILL REQUIRE A LOAD OF SAND FOR CONTAINMENT AND ABSORBTION. Other Resource Activation -6- 05/09/2001 e e SiteID: 015-021-001954 l Fast Format l Overall Site l I F BURGER KING UNOCAL I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs 09/07/1999 A) GAS - NONE B) ELECTRICAL - ON THE BACK SIDE OF BLDG C) WATER - HUGHES LN - 50FT OFF WHITE LN D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 09/07/1999 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN BLDG. NEAREST FIRE HYDRANT - ON THE 'CORNER OF HUGHES LN & WHITE LN ON PROPERTY. Building Occupancy Level -7- 05/09/2001 · e e í BURGER KING UNOCAL ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-001954 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 09/07/1999 ¡ o 0 o THERE ARE NO EMPLOYEES AT THIS FACILITY IT IS AN UNMANNED SITE. o o o o DO YOU HAVE MSDS SHEETS ON FILE??????? o o o o BRIEF SUMMARY OF YOUR TRAINING PROGRAM: WHEN ON SITE PERSON IS INSTRUCTED TO 0 o TURN OFF EMERGENCY SHUT OFF AND DIAL 911 AND GIVE DETAILS OF EMERGENCY. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë ¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf \-. :ï' ,',.,;¡' - . h~ '\~. ....;.~ ~ -- BURGER KING UNOCAL SiteID: 215-000-001954 Manager : Location: 2500 WHITE LN City BAKERSFIELD CommCode: BAKERSFIELD STATION EPA Numb: j BusPhone: .. RECE " "~-ì'DJ aI? : 123 __..<I '( r1.d: 13C SEP -~ 1989 07 /' , (661) 746-9107 CommHaz : Low FacUnits: 1 AOV: ¡~'T:. _ . _~' .l- IC Code: þunnBrad: Emergency Contact / T i tile Emergency Contact / Title WILLIAM COUGHLIN / PARTNER GLEN ARNOLD / PARTNER Business Phone: (661) 746-9 107x Business Phone: (661) 634-9263x 24-Hour Phone : (661) 664-0 448x 24-Hour Phone : (661) 332-5208x Pager Phone : ( ) - x Pager Phone : ( ) - X I Hazmat Hazards: I Fire ImmHlth DelHlth Contact : Phone: (661) 746-9107x MailAddr: 2500 WHITE LN State: CA City : BAKERSFIELD I Zip : 93304 I [ (661) Owner ARNOLD/JAMES GROU~ Phone: 746-9107x Address : 257 S CENTRAL VALLEY HWY State: CA City : SHAFTER [ Zip : 93263 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I I i I I i, a'll, 1""'t'"h Do hereby certify that I have (TVP3 0 pnnt fIÐI'II\9) r~\1i®w~©1 ~~~ 2~a~hs©1 hazardous materials manage- m~i1~ ~ialiî 1brr~~~~rl~ ~ff'ð©1 ~ha~ ¡~ slong with I \II 0 ellS) any oori"sd¡bn~ ooftì)s~ityts fa oomplsts and COIT~d man- I agsmsn~ ¡í)1~~ ~©rr my ~m~. I I ! ~ -1- 08/06/1999 i' e e F BURGER KING UNOCAL SiteID: 215-000-001954 ì STORAGE CONTAINER DATA (UST FORM A) PermitStatus: Business Type: Manager : Phone : (661) 746-9107x Location : 2500 WHITE LN State / Zip : CA 93304 City : BAKERSFIELD #Tanks/EPA# : Org.Type : IndnRes/Trust: No EMERGENCY CONTACTS Primary Name: WILLIAM COUGHLIN Second Name : GLEN ARNOLD Day Phone : (661) 746-9107x Day Phone : (661) 634-9263x Night Phone : (661) 664-0448x Night Phone : (661) 332-5208x Prop Owner : Org. Type : Mail Address: Phone : ( ) - x City : State / Zip : Tank Owner : Org. Type : Mail Address: Phone : ( ) - x City : State / Zip : BOE UST Fee#: Financ'l Resp: Legal Notice: Org. Type : /Billing : 2500 WHITE LN Phone : (661) 746-9107x : BAKERSFIELD State / Zip : CA 93304 One Unified List ì All Materials at Site ì f= Hazmat Inventory f== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP DIESEL GASOLINE PREMIUM UNLEADED UNLEADED REGULAR F F IH DH DH L L L 5000 8000 12000 Low Mod Mod -2- 08/06/1999 e e SiteID: 215-000-001954 ì Facility Unit: Fixed Containers at Site ì f BURGER KING UNOCAL f= Inventory Item 0003 F= COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 5000.00 Daily Average 5000.00 HAZARDOUS COMPONENTS %Wt. RS CAS # 100.00 Fuel Oil No. 1 No 70892103 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME GASOLINE PREMIUM UNLEADED Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Triple Compartment Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 Daily Average 8000.00 %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 IH DH / / / Mod -3- 08/06/1999 e e SiteID: 215-000-001954 ì Facility Unit: Fixed Containers at Site ì F BURGER KING UNOCAL f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME UNLEADED REGULAR Days On Site 365 Location within this Facility Unit Triple Compartment Tank Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 25000.00 AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 Daily Average 12000.00 %wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -4- 08/06/1999 e e SiteID: 215-000-001954 ì Fast Format ì Overall Site ì F BURGER KING UNOCAL I p= Notif./Evacuation/Medical Agency NotifiC~. ion ~-e,-..:5 r/~dJ c::::::;:;- ~ hre ~ep-7. E!TIployee Notif. /.EvacuatioIJ. . _ ~?:Þ-6 ~ //?d:/j-HC7/dQ~ c?«ð ~~..r0 ¿?; ~;nc?"~?;7CY ß w~ .,4J 72trn ø~-/, £.~ry~n¿.'7 ~huf-ð#c:6'C(//k~ ' Public Notif./Evacu~tion U/1/J1))1)1Æi 6í~e-, Emergency Medical Plan ~60¿ t7rrJ'(ÞJ1J &Ji~ e::.?nc/ »~c~ é ;5¿Q6 ;ç~~ -5- 08/06/1999 e e SiteID: 215-000-001954 ì Fast Format ì Overall Site ì I F BURGER KING UNOCAL I p= Mitigation/Prevent/Abatemt ~Release Prevention Release Containmept t¡1'1111:J)'J)')~d d)./~ Ao Að- t? Clean 'Qp, - e)7. ~ .-!' ...::S'~// dp)/~ /V/ '6 ~¿?.n ~r~~ ð'.A?I(/~ Ø//'/ ~7H/re c:::;/ Other Resource Activation ~ Q¿>Å 7;;JJ ,iJiPe /..:5 h#~ Ø/'-IA óJ/7d. -~pe.r-40 (Por¡.£;/n/11ð";fJ lkiJ/~e Æ:~clt J)J:SptPh6/Pr /6 F,)kd to/I'" d tJOnJd//:k;:;Ae'rr. 77IiPr/n.-J¿ßA'evræ/t-Je c:..::>Áu~ o/-/"/iteL../i¡ a.;¿.~ 0/ /m~ ð'/' ;r;~ ./7ere. /~ ¿9n K/71~';-7l!"'/?¿:Y d4#/ (7'# tPh ¿J,p,ç W4¡è¿ ðAwk, o/J. a/I ~ Î / '_ He ,Ptf/11¡IÓJ o...:>nol:/pr'/?6 ð)'-f- ~a/r'r .,to' JJópt?'F1c:>e:ró. .-., 4Yc: h ~(::hth-e eVl1d l);~~¿ At7e1e:;.. ~ð'C ¿;~o/.i:. -4- pA¿¡ ~f/~ teJIJlc-Á.. c?oP£;/Ÿ¡ -lIe htD¿ /n /",f¡!> .J!:Þ~/1f 0 /' é) rZJ..ve - 0-/1 ~II ¿I;'e~ e\)/loL /evni::-ó õ:)rd /Y1~71;JcY"e"cI tZ'9AOÚ'r'dct::' o1..,y 6y e:;;J/7 eo ;"'C7'~¡ø.17 'c 02"> h .$c>.>- .:J.>701 / n Þ~r/"''J OÞ ~p¿ ..ü /?}:J /71;6 re-d ,6 ~ y ...:J;,O/ ~C ~Þ<!t?l/tICj riP, 06y- -6- 08/06/1999 · .. e e SiteID: 215-000-001954 ì Fast Format ì Overall Site ì I F BURGER KING UNOCAL I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs 08/02/1999 A) GAS - NONE B) ELECTRICAL - ON THE BACK SIDE OF BLDG C) WATER - HUGHES LN - 50FT OFF WHITE LN D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 08/02/1999 PRIVATE FIRE PROTECTION - A/~4~ hrt;5' 1Ié>e~ &?~ ðd/Å//)'lS NEAREST FIRE HYDRANT - ON THE CORNER OF HUGHES LN & WHITE LN ON PROPERTY. Building Occupancy Level tin ~/j /.)-pr;L- -7- 08/06/1999 ----- /' ;; ,,- ~/' // /' c~ F BURGER KING UNOCAL I F Training Employee Training e e SiteID: 215-000-001954 9 Fast Format 9 Overall Site 9 08/06/1999 HOW MANY ,EMPLO~EES DO YO~ ~VE A¡ THIS fACILITY?????????? , - tI¡j~I..J)?~d dj7r=- ' DO YOU HAVE MSDS'SHEETS ON FILE??????? A-Jo ~ GIYE A BRIEF SUMMARY OF YOUR TRb.lNING PROGRAM: tlJAtPn on d/ (::3 /t?r~c~ /Ib /n...:r*#è/t-DoI~.ø r:-t:lr.n ð~ -r:-/77P~r>~.':I d;þ;f// .e?,c ¿;;);7J c0..:JL 9// Page 2 [ I I Held for Future Use Held for Future Use -8- 08/06/1999 _ /;rJ- e jþ lqS~ ~'~ôqí CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 " - ~. INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: 4c.opld ßm If?!> ç~¥, U¿ - ß'Y ,..ck,,;S 4"'Q C. LOCATION: ~~oo ¿vh/;f~ ~t- cÆL¿e-,-..:$¿(;,-/d 9~oey MAILING ADDRESS: ~s:"7 -5: ç-~ /;""j/ d/~y L/tuý CITy:J~/kr STATE: .6!Z....-ZIP:ß7~HONE: 7~-7/ð?, DUN & BRADSTREET NUMBER: PRIMARY ACTMTY: ~;(;,. ¿::: OWNER: .Æd/2.Ø-"P MAILING ADDRESS: .;:t.S-7 c s:- SIC CODE: ~~ £~,; ~k£/ - ,ç-..-h L ú!&y JI!17 fj¿þPU~3 SECTION 2: EMERGENCY NOTIFICATION CONTACT 1. c2)o.Y? , ¿{¿?1~ ..... 2.qJ/ì,/..J';' f11Lj'bhn TITLE BUS. PHONE -Ørhe='r- 7R-7/¿::J7 ¡ltl/lnt?r 7?¿-9/t7,? 24 HR. PHONE t?7,Z - / JL?...3 ~/ ¿?"Y~¿ 1 .. ..~ e - HAZARDOUSMATE~SMANAGEMENTPLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: ð ( ~J'\.óJfJ-eKded~ MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REOUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TIllS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 'I I~, e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: 3 ~ ,,~. 'Ï. e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTll..ITY SHUT -OFFS (J..OCATION OF SHUT -OFFS AT YOUR F ACILITV) NATURAL GAS/PROPANE: AJo Þ7 e- ELECTRICAL: 0 V\-f h. t- ~ c t:.. S- \ 'd.~ O.r b u;; Ie! ~ V\.. ~ WATER: #~th'7!':< ¿n -SO # o/P ~A;Ic. Ä~~ SPECIAL: LOCK BOX: YE@ IF YES, LOCATION: SECTION 9: PRlV ATE FIRE PROTECTION/W ATER AVAILABILITY A. PRlV ATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE H):DRANT): J 011 fie. {!orner of i/tt7A¿ø~ pr'O¡JBf't( ¿ 11e- F'I JeJ ¡, ¡je ~ J1 c.... o V\. 4 7' ~. -<"- e . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield,. CA (805) 326-3979 FACILITY DESCRIPTION ~~ t/~ 0~ <'.¡ J'þ eJ /( ~^ (9~~ -«..J HAZARDOUSMATEmALS~NTORY CHECK IF, BUSINESS IS A FARM [ ] , ..,.ç?r .n'p/é,t N /?'7 ~ c;;;-,...."';O. ¿¿ ~ BUSINESS NAME &r"'y~'-~~ £dCoJL· .'< , FACILITY NAME SITE ADDRESS '-<\5""~ ~h/;.cð' ~j?'-- CIT~~~...cs'~;bJ STATE &- ZIP 9d'-?d~ NATURE OF BUSINESS ~?ýd c:::c,c¿f. ~~/tC:;- ~,k~'. SIC CODE DUN & BRADSTREET NUMBER OWNER/OPERATOR .....aY7 \.A/??~~ PHONE 7~ - 9/t:?.7 MAILING ADDRESS ;2..6 7 CITYJh:J/kr ~~Æ &HktJJC~hj" £Ivy STATE {'.r4 ZIP ~tz~~ EMERGENCY CONTACTS NAME (Í?J,(.f¡;<l~ ;þqfl;h /1 BUSINESS PHONE .7~ - 7?'t:/ /' NAME ¿1/",n ,4/ht?/d BUSINESS PHONE ~~~¿.,/, rh~J TITLE ..f2,/k~r- " 24 HOUR PHONE ~~~-o?"~ TITLE L21'-'h, e"--' / 24 HOUR PHONE J:Y:l -6,;{ 0 ý-'" 1 ~~.-'-! 'Ì¡,~ ~OUS MATERIALS INVENTOe BusinessName.4l.:.'n,,/¿L,"~~ t?n??~ þ7 J: &"'1,.. é (.,Mey P,"Jm;f- , ~ ' CHEMICAL DESCRIPTION ~~ 1) INVENTORY STATUS: New [ Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: ~~'7 ~ ;¡ 7 ~.bF1¡C:> 3)OOT#(optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEAL 1H Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code &om. DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid ~ 7) AMOUNT AND TIME AT FACll.ITY Maximum Daily Amount Average Daily Amçunt Annual Amount Largest Size Container ~ØO # Days on Site Gas [ ] Pure [)4 UNITS OF MEA$URE Lbs [ ] Gal [Ý] ft3 [ ] ~uries [ ] , . " Circle Which Months: 9)~: Li~ the three most hazardous chemical components or any AHM components COMPONENT lO)LOCATION ~C? tOJJ/~ 6nE-. g/lcJ 7:?-?t7~ 1) INVENTORY STATUS: New [c~tion [ '] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ 2) Common Name: ~ .<:'0 ~ ~ e 9 2 CJCJ..-.hn~ 3) OOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Héalth . PHYSICAL , HEAL 1H Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute)[ ] Delayed Health (Chronic)[ 1) 2) 3) 5) WASTE CLASSIFICATION (3-<Ìigit code &om. DHS Form 8022) 6) PHYSICAL STATE, ' Solid L] Liquid [ I 7) AMOUNT ~ ~ AT FACµ..¡:¡:yO cp Maximum DaIly Amount ~ Average Daily Amount 6'C:Þ 6' (') Annual Amount Largest Size Container 5?Ú{;J cP # Days on Site Gas[] Pure [ UNITS OF MEAS'URE Lbs [ ] Gal pI] ft3 [ ] Curies [ ] Circle Which Months: 9)~: List the three most hazardous 1 ) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: 17 / þ) Pressw-e: c) Temperature .~, F,~· A. M. I, I, A. S, 0, N, D CAS# % wr AHM [ ] [ ] [ ] ..,- . ] Trade Secret [ ] USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, I, F, M, A. M, I, I, A. ·S, 0, N, D CAS# %wr AHM [ ] [ ] [ ] lO)LOCATION I certifY under penalty of law, that I have personally examined and am familiar with the in.tòrmation on this and all attached documents. I believe the submitted infonnation is true, 8CCmate and complete. PRINT Name & Title of Authorized Company Representative Signatw'e Date .' '-.' £OUSMATERlALSINVEN.RY Busmcss Name ,~/lO~__' _ t'/ ,If( Address ¿67.f. ?htMßl/e'f JJ;t~::k- CHEN.nCALDESC~ON I) INVENTOR Y STATUS: New ( Addition ( J Revision ( ] Deletion ( ] Check if chemical is a NON Trade Seaet ( J Trade Seaet ( J 2) Common Name: ø.;:¿ b~..5.~ é 3)OOT/I(optional) Chemical Name: AHM [ J CAS II 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire ( ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code from DHS Fonn 8022) 6) PHYSICAL STATE Solid ( Liquid ()(J 7) AMOUNT ~ ~ AT FACILITY A 'I Maximum Daily Amount ~t.:/ Average Daily Amount ~-e Annual Amount Largest Size Container ,..::í:12e>-Ø /I Days on Site g~ ~ Gas ( J Pure ( UNITS OF MEASURE Lbs( ]Gal( ]ft3( ] Curies ( ] Circle Which Months: 9)~: Li~ the three most hazardous I) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste ( ] Radioactive ( 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M, A, M, J, J, A, S, 0, N. D CASII %wr AHM ( ] [ ] [ ] 10)LOCATION..;<L <Çè?<:Y ¡J¿)~k) ÁJri-:, æ~e~~k-iJ a f330-¿j . I) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is aNON Trade Secret [ ] Trade Secret [ 2) Common Name: 3) OOT II (optional) Chemical Name: AHM ( ] CAS II 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire ( ] Reactive [ ] Sudden Release of Pressure ( ] Immediate Health (Acute)[ ] Delayed Health (Chronic)[ 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) 6) PHYSICAL STATE Liquid [ Gas [ ] Pure [ Solid [ 7) AMOUNT ANDTIMEATFACILlTY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container II Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ ] Curies [ ] Circle Which Months: 9)~: Li~ the three most hazardous I) chemical components or 2) any AHM components 3) COMPONENT IO)LOCATION USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M, A, M, J, J, A, S. 0, N. D CASII %wr AHM [ ] [ ] [ ] I certifÿ under penalty of law, that I have personally examined and am tiuniliar with the' Ormation on this and all attacl1ed documents. I believe the submitted infonnation is true, accurate and complete. \ PRINT Name & Title of Authorized Company Representative Signature Date - . -::~OUS MATERIALS INVENTO. Business Name Address CHEMICAL DESCRIPTION ~.~ '>. Page_of_ 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: 3) DOT II (optional) Chemical Name: AHM [ ] CAS II 4) Physical & Health PHYSICAL HEAL lH Hazard Categories Fire [ J Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code ftom DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] I PW'e[ UNITS dF MEASURE Lbs[ ] Gal [ Jft3[ ] Curies [ ] 7) AMOUNT AND TIME AT F ACn.ITY Maximwn Daily Amount Average Daily Amount Annual Amount Largest Size Container II Days on Site Circle Which Months: 9)~: Li~ the three most hazardous 1 ) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperatw'e All Year. J. F. M. A. M. J. J. A. S, 0, N. D CASII %Wf ARM [ ] [ ] [ ] 10)LOCATION I) INVENTOR Y STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: 3) DOT II (optional) Chemical Name: AHM [ ] CAS II 4) Physical & Health PHYSICAL HEAL lH Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ S) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] Pure [ 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container II Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ Curies [ ] Circle Which Months: 9) MIXTURE: List the three most hazardous 1 ) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressme: c ) Temperature All Year, J, F, M. A. M. J, J, A, S, 0, N. D CASII %Wf ARM [ ] [ ] [ ] IO)LOCA TION I certify under penalty of law, that I have personally examined and am familiar with the intòrmation on this and all attached doctJments. I believe the submitted infonnation is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date