The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 2/26/1993 P /5-f fI ¡ ¡þ /if . Jot . '.. :f' '~nmJ~~"~ @ @ê ê @ c ',j..' ~ ' I ~ '@~ ~ ~ I @ '@' § ! I@@ @ ¡; ¡; ILS~ <®@@@@> ~m ,enm 1m ~PA ~PA ~~ \ëI. ~.. .. 'èJ LL..J ~ LLJ 'èJ ¡¡; - L~ ¡¡; ¡¡; - - I I I I I I I .... "'.... "!~ I I I I I I I '® rl'Æ;\ rl'Æ;\ ~ fJ ~ en I I '~ I I I~ I ® . :x: :x: @ 9 @> @) @ @ @ ® ® @ @ ® @ ® @ @ @ @ ® @ ® I !91 @ ® ®" t.ñ\... ~" iN\1 I PI ~ ~ : en _ _ N: ~ ~ _ ~, _ ® ' _I ~H~' eJ: @ ~ ¡" u¡u¡ u¡, U¡U¡, . !lU¡I' II I I iñ ~ r.,., , U¡U¡, po ' " ~ -:, '\ I I ~~ ~ ~u I,§/... .... I I I ~ ~ I I I ~Q .... ~ ~ ~ ~ ~It\ U: m ' " ® · ® ® ® ® ® ®~"@ EfJ~ ® @ ® ® ® ® @ @ ® ® ® @ ® ® ® ® ø @ ø ® <§ @) @ @ ® @ @)@>~~@@®@@ i10C m i t W i m ~ ®I I@II t?:. ~ ~ ..... ~...~... ©.;;j f.:I... 121 II II~ r.DI @en®rorl ®~ ~~ \&'~ f't \@)~ ~~ \(ÿ. \&~ ~. I I 11\tJ.. 'eJ.. .. \!:!). ~. _ .. - - -, - ;:ø - to ~ N \c N I I I I - en ëñ _ laG Güi .. .. " '¡ 'i: .. 'i: .. .. ~ . '1 .. I I I I ~ .. .. .. .. .en .. . , ,. I I I I ~o I 1Pc\ OJ Ulšl ..... C ® ~ ~ ~ ~ f.:\1 I Pol I ~I I \&4 I I I I I . I I I I I I I I I I I I I .' I I I I I )1 ~ - I I I I I,.Ø -era IØ ..... .ë5J I 11211 ~ en ~ firi\ I õNŸ I \S en 1- I€J I ~ 'C.I ê At9tð @>®@;® @@®® ~".~ ~ - 1!2\1"""""""'''''' ; ~ 1} ~ o -' @ ~, . - ~I,/, @ '- :::c::J ~.6 . -l~ 4 ß"-\- ~. ~.~ - ;;; ~'i fJV\ """ .unm:J: . , ¡ , ~ r ~ ~::.~ ~. '-J ~f t. ~? C>() ~ ~; F~~~ ~ ~ r:/.. ~ «-' ".0/""", S I' ~~~.>: }I~/Xd' ~-!~r,;)~ )'1) ~ 1) ~ .O-,~C.8/1 NY,d 3NINYZ1'" I 4(J'J ¡,r:: .jQ../:,t1I 0';1;;1 .'/t ~ C ri (?/?J-fiJ .- ~ ) c~ 7: @ ....rb'1 7 / r.= \' . "',. . ~'¡'QD/"f"n'~~ lïîJ I @ I ~~ , @ c ~~~r , fT 9861 'tl !I3,,"31d3S '3J.YD CNII<3dD 01<_ SLS'CZ 1~018 lV J.OJ. 660'~ 'S3JB;O , 3snoH3~VII 9L~'61 1¡001~ S31VS L861 6 ÀèJ\lnN'v f 13J.VO 8t2v # 11\1V'1 013I.:!SèJ3>1\18 JNI'M'N SOnèJO SS31À\ld ~ ~,~ ?ï\ ~ - ~ ...., ~ S ~ .~ à "'P. §ì i611 !3~{!/( lID 08 ® @~ I~JV~ 3snOH3~VII 1I0J..108 3100111 dO.1 @ <@ @ c @ ::f0 ::Y;;fiý A- (J 1 <; N()f' S t)vr/T f)/{I:V;F Wð P ( ® ® Æ ® @ III@ I œ __ (¡) l~) ¡® I f I@ ® @ @ @ @ ~()-IS €Þ @ OVd HO~~Vdno:J ~1 ~ Ì'< '...... Ç: ~ ~. ~ _{9> /l'~( I I I I I I @ 1130VNVII 110011 .1NIIOJ DtaJ.NIlO:I~V @ @ ·øo.¡ '.1SSt J I I :1 ,I ¡; I ^;: \ 110011 H:l1II11 @ 'NO o N3noll @ @ 1111011 NDIS 1/311 @ "~ ~ ~ '\b ~ '\. ~ ~ ~ '\ ~ ~ Per , ,~-' i ; r , , it Operate to Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: zardous Materials Plan round Storage of Hazardous Materials ···agement Program . Waste 1914 PERMIT ID# 015-D2H)01158 PAYLESS DRUGS LOCATION .. Issued by: ;:' ) ,I ' WIBLE Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805)326-0576 *~ ph Huey, . ffice of ental Servi es . Approved by: Expiration Date: June 30, 2000 ~ .., - ...--...... .:;- ;0 . . , P~LESS DRUGS 215-000-00115~ tn~~~:9~6~~lage Overall Site with 1 Fac. Unit L ~ General Information ~8y:::: 1 "" ~ 02/12/96Q Location: 1914 WIBLE RD City : BAKERSFIELD Map:123 Haz:1 Type: 3 Grid: lIB FlU: 1 AOV: 0.0 Contact Name roDD BRUNNER Business Phone: 24-Hour Phone Pager Phone Title I 7?//Î ~/ J<J-/I!.- (805) 832-4111x (805) 832-4143x () x Contact Name F Business Phone: 24-Hour Phone Pager Phone Title I ßh?F 17 en ft/l Jl~ (805) 832-4111x (805) 831-2965x () x Administrative Data Mail Addrs: 1914 WIBLE RD City: BAKERSFIELD Comm Code: 215-007 BAKERSFIELD STATION 07 D&B Number: State: CA Zip: 93309- SIC Code: 5912 Owner: PAYLESS NORTH WEST Address: 9275 PEYTON LN City: WILSONVILLE Phone: (805) 832-4111 State: OR Zip: 97070- ;1 Summary ----- --"-- - .-------- . I'. \€£Q...\ C!.J..aJ¿J4,o hereby certify that I have (Type or print name) reviewed the attached hazardous -materials manage~ ment plan for fìll \e~C' ~111'l and that it along with ~ any corrections constitute a complete and correct man- agement plan for my facility. ".. .. -. ~,Öfu0 l-2B-CJ<p $iòna1Ure Dete '\ i' .' ".f e e 02/12/96 PAYLESS DRUGS 215-000-001158 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-002 PAINT REMOVER ~ Fire, Delay Hlth Liquid 100 High GAL 02-001 POOL CHLORINE ADDITIVE ~ Reactive, Immed Hlth Liquid 60 High GAL 02-006 CHLORINE/POOL CHEMICALS ~ Reactive, Immed Hlth, Delay Hlth Liquid 100 High GAL 02-008 PROPANE ~ Fire, Pressure, Immed Hlth Gas 55 High GAL ·-02 007 PAINT __ ~-Ei.re, Immed Hlth, Delay Hlth Liquid 55 Moderate GAL 02-005 ANTIFREEZE COOLANT ~ Fire, Delay Hlth 02 OOg J(J;'DOSENE t!-û_uzm pt-t() Put:.L- ~ Fire, Delay Hlth Liquid 500 Low GAL Liquid 55 Low GAL 02-004 MOTOR OIL ~ Fire, Delay Hlth Liquid 600 Minimal GAL 02-003 ORTHO-ENFORCER-RAID INSECTICIDES ~ Fire, Delay Hlth Liquid 116 Unrated GAL . - ---- - ~ i'> - e 02/12/96 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-002 PAINT REMOVER ~ Fire, Delay Hlth Liquid 100 High GAL CAS #: 67641 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: PAINTING Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 100 I 50.00 I 300.00 Storage r Press T Temp -:ï Location METAL CONTAINR-NONDRUM Ambient Ambient I SALES FLOOR ¡8-D Conc 30.0% 15.0% 25.0% 16.0% Acetone Toluene Xylene, Mixed Propane - --- Components MCP ~Uide Moderate 26 Moderate 27 Moderate 27 Extreme 22 02-001 POOL CHLORINE ADDITIVE ~ Reactive, Immed Hlth Liquid 60 High GAL CAS #: 7681529 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 60 I 30.00 I 720.00 Storage PLASTIC CONTAINER r Press T Temp -:ï Location Ambient Ambient 1 SALES FLOOR 19-D 1- - Conc l 100.0% Sodium Hypochlorite Components r: MCP ---re;uide I High I 45 < -- ~- -- - -, ~ - 02-006 CHLORINE/POOL CHEMICALS ~ Reactive, Immed Hlth, Delay Hlth Liquid 100 High GAL CAS #: 7681529 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: BLASTING Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 100 I 50.00 I 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:ï Ambient Ambient I SALES FLOOR Location - Conc l 100.0% Sodium Hypochlorite Components 1-= MCP ---re;uide High I 45 e e 02/12/96 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-008 PROPANE ~ Fire, Pressure, Immed Hlth Gas 55 High GAL CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 55 I 20.00 I 100.00 Storage r Press T Temp ~ FIXED PRESS. CYLINDER Above AmbientSALES FLOOR Location - Conc -, 100.0% Propane Components I~ MCP ----rGuide Extreme I 22 02-007 PAINT ~ Fire, Immed Hlth, Delay Hlth Liquid 55 Moderate GAL CAS #: 1344-37-2 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: PAINTING Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 55 I 25.00 I 120.00 Storage r Press T Temp ~ METAL CONTAINR-NONDRUM Ambient AmbientSALES FLOOR Location Conc 0.0% 0.0% 0.0% 0.0% Lead Chromate Methyl Ethyl Ketone Cadmium Sulfide Xylene, Mixed Components MCP ~. uide Moderate 53 Moderate 26 Low 53 Moderate 27 02-005 ANTIFREEZE COOLANT ~ Fire, Delay Hlth Liquid 500 Low GAL CAS #: 107-21-1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 500 I 100.00 I 200.00 Storage PLASTIC CONTAINER r Press T Temp l Below Below SALES FLOOR Location - Conc -, 100.0% Ethylene Glycol Components c- MCP -¡Guide I Low I 27 e e 02/12/96 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 5 Hazmat Inventory Detail in MCP Order 02-009 KEROSENE ~ Fire, Delay Hlth Liquid 55 Low GAL CAS #: 8008-20-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 55 I 12.00 I 100.00 Storage r Press T Temp ~I METAL CONTAINR-NONDRUM Ambient Ambient I SALES FLOOR Location - Conc l 100.0% Kerosene Components r; MCP -¡-Guide Moderate 27 02-004 MOTOR OIL ~ Fire, Delay Hlth Liquid 600 Minimal GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: OIL TREATMENT Daily Max GAL 600 ---¡ Daily Average GAL 50.00 T Annual Amount GAL -- 300.00 Storage PLASTIC CONTAINER r Pres s T Temp -:ì Ambient AmbientSALES FLOOR Location - Conc l Components 100.0% Motor Oil, Petroleum Based r; MCP -¡-Guide Minimal I 27 02-003 ORTHO-ENFORCER-RAID INSECTICIDES ~ Fire, Delay Hlth Liquid 116 Unrated GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: OTHER Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 116 I 60.00 I 400.00 Storage r Press T Temp -:ì Location Ambient AmbientSALES FLOOR 12-E & F - Conc l . 100.0% Insecticides Components I~ MCP -¡-Guide Unrated I 0 · e e 02/12/96 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 6 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation ALL EMPLOYEES ARE TRAINED, WEEKLY MEETINGS OF SAFETY. SEE ATTACHED EVACUATION PLAN. <3> Public Notif./Evacuation WE HAVE EMPLOYEES TRAINED TO DIRECT CUSTOMERS TO NEAREST EXITS. WE ALSO HAVE PERSONNEL TRAINED IN CPR. <4> Emergency Medical Plan NEAREST EMERGENCY ROOM. · e e 02/12/96 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt <1> Release Prevention MONTHLY SAFETY INSPECTION OF OUR STORE, BY OUR SAFETY PERSON. INSPECTIONS BY OUR MAIN OFFICE, ALSO INSPECTIONS FROM OUR PARENT CO. K-MART. <2> Release Containment MATERIALS TO ABSORB <3> Clean Up CHEMICAL SPILL CLEAN UP KIT IN MARKED BOX UNDER RECEIVING DESK. <4> Other Resource Activation cj 4 ïò' .¡, e e 02/12/96 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 8 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - EAST OF BUILDING B) ELECTRICAL - EAST OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 111111111111 FIRE HYDRANT - SOUTH OF RECEIVING DOORS. <4> Building Occupancy Level ~ i ~ ~ e - 02/12/96 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 9 <G> Training <1> Employee Training WE HAVE 25 EMPLOYEES AT THIS FACILITY. ~ WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: TRAIN EMPLOYEES PRECAUTIONS WHEN USING HAZARDOUS MATERIALS. CLEAN UP PROCEDURES, ETC. <2> Page 2 <3> Held for Future Use <4> Held for Future Use i' '+"" ;~ e . ~ 08105/92 PAYLESS DRUGS 215-000-001158 Overall Site with 1 Fac. Unit Page 1 Gene+al Information , Location: 1914 WIBLE RD Map: 123 Hazard: Minimal Community: BAKERSFIELD STATION 07 Grid: 11B FlU: 1 AOV: 0.0 - Contact Name Title Business Phone - 24-Hour Phone ~S \oò.Ó b:u.,,~ <-~ (805) 832-4111 x (805) 832-4143 "i.EE WILSON "'-\~fß"O :G (805) 832-4111 x (805) 831-2965 . . Administrative Data Mail Addrs: 1914 WIBLE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-007 BAKERSFIELD STATIqN 07 SIC Code: 5912 Owner: PAYLESS NORTH WEST Phone: (805) 832-4111 Address: 9275 PEYTON LN State: OR City: WILSONVILLE Zip: 97070- Summary RECEIVED SfP ? ? 1992 - HAZ. MAT.O'V. w, ~ðìJ~~~ Do hereby certify that , have reviewed the attached haæardous materials manageD ment plan for_PQ'I\e~s. Dr~ 5k.tt.and that it along with' , . (NI1In& of B i ess) any'corrections constitute a compiete and correct man- agement plan' for my facility. ¥f· ~~ Signa~19 '8 -10- ?:J.._ Caw ~ i '~! - . 08105/92 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 POOL CHLORINE ctd ,.t,'lVZ Liquid 60 High ~ Reactive, Immed Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Max GAL ~ 60 Daily Average GAL ---r- Annual Amount GAL - 30.00 720.00 Storage PLASTIC CONTAINER r Press T Temp -:ì Location Ambient AmbientSALES FLOOR 19-D - Cone ~ . Components 100.0%· HydrooRlôric Acid ~ ~J/(..tM. HypochLDfè/l-e.. ~ MCP -rList High I 02-002 PAINT REMOVER ~ Fire, Delay Hlth Liquid 100 High GAL CAS #: 67641 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: PAINTING Daily Max ,GAL ~ Daily Average GAL ---r- Annual Amount GAL - 100 50.00 300.00 Storage r Press T Temp -:ì Location METAL CONTAINR-NONDRUM Ambient AmbientlSA~ES FLOOR 18-D J Components I~ MCP ~List Moderate Moderate Moderate Extreme Cone 30.0% 15.0% 25.0% 16.0% Acetone Toluene Xylene, Mixed Propane 02-003 ORTHO-ENFORCER-RAID INSECTICIDES ~ Fire, Delay Hlth Liquid 116 Unrated GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: OTHER Daily Max GAL ~ Daily Averagé GAL ---r- Annual Amount GAL - 116 . 60.00 I 400.00 Storage r Press T Temp ~I Location Ambient AmbientSALES FLOOR 12-E & F - Cone ~ 100.0% Insecticides Components ~ MCP ~List Unrated I -; .. \'1 . . 08Y05/92 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in Reference Number Order 02-004 MOTOR OIL ~ Fire,' Delay Hlth Liquid 600 Minimal GAL . I ! i ! CAS #: 8020835 Trade Secret: No . Form: Liquid Type: Pure Days: 365 Use: OIL TREATMENT Daily Max GAL 600 ---¡ Daily Average .GAL 50.00 I Annual Amount GAL -- 300.00 Storage PLASTIC CONTAINER r Press T Temp -:-1 Ambient AmbientSALES FLOOR Location - Conc _I Components 100.0% Motor Oil, Petroleum Based r; MCP -=--rList Minimal I 02-005 ANTIFREEZE COOLANT ~ Fire, Delay Hlth Liquid 500 Low GAL I CAS #: 107-21-1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max GAL 500 ---¡ DaiÌy Average GAL 100.00 I Annual Amount GAL -- 200.00 Storage PLASTIC CONTAINER r Press T Temp -, Below Below SALES FLOOR Location - Conc l 100.0% Ethylene Glycol Components ~ MCP ~List Low I 02-006 CHLORINE/POOL CHEMICALS ~ Reactive, Immed Hlth, Delay Hlth Liquid ì 100 High GAL CAS #: 7681529 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: BLASTING Daily Max GAL 100 ---¡ Daily Average GAL 50.00 I Annual Amount GAL -- 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:I . Ambient AmbientSALES FLOOR Location - Conc -I 100.0% Sodium Hypochlorite Components r= MCP ~List ¡High I , ! I ! ¡, '. . . 08/05/92 PAYLESS DRUGS 215-000-001158 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in Reference Number Order 02-007 PAINT ~ Fire, Ímmed Hlth, Delay Hlth Liquid 55 Moderate GAL CAS =It: 1344-37-2 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: PAINTING Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL ,-- 55 I ' 25.00 I 120.00 Storage r Press T Temp -:ì METAL CONTAINR-NONDRUM Ambient Ambient I SALES FLOOR Location Components ~ MCP ~List , Moderate Moderate Low Moderate ,I I Cone 0.0% 0.0% 0.0% 0.0% Lead Chromate Methyl Ethyl Ketone Cadmium Sulfide Xylene, Mixed 02-008 PROPANE ~ Fire, Pressure, Immed Hlth Gas 55 High GAL CAS =It: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL,~ Annual Amount GAL -- 55 I 20.00 I ,100.00 Storage r' Press T Temp ~I FIXED PRESS. CYLINDER Above AmbientlsALES FLOOR Location - Cone l 100.0% Propane Components I~ MCP --¡List Extreme I 02-009 KEROSENE ~ Fire, Delay Hlth Liquid 55 Low GAL CAS =It: 8008-20-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL -' Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL -- 55 I 12.00 I 100.00 Storage r Press T Temp ~I ' METAL CONTAINR-NONDRUM Ambient AmbientSALES FLOOR Location - Cone l 100.0% Kerosene Components r; MCP -:-¡List Moderate ~~ . . 08r05/92 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911· <2> Employee Notif./Evacuatio~ ALL EMPLOYEES ARE TRAINED, WEEKLY MEETINGS OF SAFETY. SEE ATTACHED EVACUATION PLAN. <3> Public Notif./Evacuation WE HAVE EMPLOYEES TRAINED TO DIRECT CUSTOMERS TO NEAREST EXITS. WE ALSO HAVE PERSONNEL TRAINED IN CPR. <4> Emergency Medical Plan NEAREST EMERGENCY ROOM. " ". --:--.¡ . . 08105/92 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention MONTHLY SAFETY INSPECTION OF OUR STORE, BY OUR SAFETY PERSON. INSPECTIONS BY OUR MAIN OFFICE, ALSO INSPECTIONS FROM OUR PARENT CO. K-MART. <2> .Release Containment ~~\<'^.\~ -\0 ~..b <3> Clean Up . G~"",<o5l S\T'\\ c..\Q.a,o \A.~ ~;~ "" ~t"~ ~'JI.. ~:(\~ (eci>V\~ ~~ ~.." ~'~ <4> Other Resource Activation '> ;' ~,;, _'it.~ . ò . 08105/92 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - EAST OF BUILDING B) ELECTR!CAL - EAST OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO I <3> Fire Protec .IAvail. Water PRIVATE FIRE PROTECTION - ???????????? N:) FIRE HYDRANT - ??????????? S~ oç '~1\J;~~~~ <4> Building Occupancy Level 1- ;' ~~ ~~., . . ( 080/05/92 PAYLESS DRUGS 215-000-001158 00 - Overall Site Page 8 <G> Training <1> Page 1 WE HAVE?? EMPLOYEES AT THIS FACILITY J...5 WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUM~RY OF TRAINING: TRAIN EMPLOYEES PRECAUTIONS WHEN USING,HAZARDOUS MATERIALS. CLEAN UP PROCEDURES, ETC. <2> Page 2 as needed <3> Held for Future Use /' <4> Held for Future Use Ii,." . )',,:.,' ,> ',. t~~~1~h,; ,,"D' u:' ~ . ' < i :' J ~ CITY OF BAKERSFIELD HAZARDOUS MATERI~S INVENTORY Farm and Agriculture 0 standard Business NON -. TRADE SECRET ¡, '\¡,::}..: . ¡, d',,',,' ',' , ~.:;·'~~iHNESS NAME: '16. V jf:' 55 '7//2 L{~ <; ¡r.i,,'LOCATION: . ,q/£f 'WI bl-e lè.Á II'" (kCITY, ZIP: ~ó C!Q -' 9"33(2)? p;~ PHONE #: ~ f/:,:;:l~f~;\.;- OWNER NAME: ADDRESS: CITY,' ZIP: PHONE J: "- '-~.) ~ f' page_qf....:_' , \'- ~ ç NAME OF THIS"'FACILITY: STANDARD IND. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL ID t --- ---- ¡ I ! 12 Location Where Stored in Facility Sa.l-e.5 'F/oofè. - 19 D 13 " by wt t!iIIP- 14 Names of Mixture/Components See Instructions Physical and Health Hazard (Check all that apply) . 0 Fire Hazard 0 Sudden Release of Pressure C.A.S. Number Component # 1 Name & C.A.S. Number i!fY ¡'¡ydRc>c.h. lo/èC /ìo J- o Reactivity ~mmediate ~layed Component # 2 Name & C.A.S. NUmber Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard (Check all that apply) Fire Hazard 0 Sudden 'ReleaSe 0 of Pressure C.A.S. Number Reactivity 0 Immediate 0 Delayed Health Health hi., r( 'Physical and Health Hazard iiè!,~\ (Check aU that apply) ir <0 Fire Hazard 0 Sudden ~elease of Pressure Component # 1 Name & C.À.s. Number Component # 2 Name & C.A.S. Number Component # 3 Name & C.A.S. Number Component # 1 Name & C.A.S. Number Component # 2 Name & C.A.S. Number Component # 3 Name & C.A.S. Number C.A.S. Number Component # 1 Name & C.A.S. Number 0 o Immediate o Delayed Component It 2 Name & C.A.S. Number Reactivity Health Health Component It 3 Name & C.A.S. Number '2 .,¡," L~:' '. i.:\Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) t~:;i:I certify under peanlty of law that I haver personally examined and am familiar with the information submitted in this arid all attached documents and that based on my inquiry of those ¡'t::,:individualS responsible' for obtaining the information. I believe that the !lubmitted information is true, accurate, and complete. ' I:i~l~ . Ú" RI\ME AND OFFICIAL TITLE OF CMNER/OPERATOR OR OWNER/OPERATOR' S AUTHORIZED REPRESENTATIVE , \-- 11:,'- " Ii' EMERGENCY CONTACTS #1 ¡:., Name Title "', 24 Hr. Phone Title 24 Hr Phone Name DATE SIGNED SIGNATURE ·~._~~ ~~.., -" ABakersfield Fir~ept. .. J ~AZARDOUS MATERIALS DIVISION W/ Business Name: -.fA~ l-e..$.5" " Location: '9 l"l Lv : b l-e Date Completed Business Identification No. 215-000 00 II S- ~ c.. (Top of Business Plan) Inspector /("xr 4: 4--< Station No. 7 Shift Verification of Inventory Materials Verification of Quantities / V- ~/~, ~sÞs . J IV ,"c! 0>- ( N#~ Comments: Verification of Location Proper Segregation of Material Adequate Inadequate ~ D ø D ~ D rnI D Verification of MSDS Availablity ~ ( ) N, umber of Employees f}k-- Verification of Haz Mat Training tJ Comments: Verification of Abatement Supplies & Procedures Comments: D ~ ~ ø D Emergency Procedures Posted Containers Properly Labeled Comments: ro IkJ D D Verification of Facility Diagram J!J __ Special Hazards Associated with this Facility: C ðA/7;4c T ?õ £) fl .ß~ C/ ,A/,4/~/Z &vLo/ A4t:,~) /fifo, // ~/6t v//?/C-.c/Vk, 2 ~ /I~ \7(9~: 7'·641 P(J# (Sð f ) ("£12 - ~/ao 'f;, Wt ~Û s ~rFo, ~\L~ Business Owner/Manager FD 1652 (Rev. 1-90) All Items O.K. D Correction Needed ø White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy ~- ~çp~ . Bakersfield Fire Dept.. \ HAZARDOUS MATERIALS DIVISION D C !(J-/š-<1( ate ompleted -----:¡¡-- '," Business Na f k'/Ll5s Dfl. Ub 5 Location: l.)J I 'ð LL Business Id ntification No. 215-000 ('ì 0 J t ç !5" (Top of Business Plan) Station No. 7 Shift C Inspector --r-; A..Jt, l...l!. Ý I Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Verification of MSDS Availablity Number of Employees Comments: vep"! Haz Mal Training I11Ii/VI . I C'e Æf> Verification of Abatement Supplies & Procedures Comments: Adequate .~ ~ u( o ~ !Æ.5Þ5 ~ \ \ /,,, REcEtVeO " OCT 1 6 1991 HA7 tu1AT.I)IV. Inadequate D D D D ~ o (503) b81.~'f}OD ..-/ D Emergency Procedures Posted Containers Properly Labeled Comments: ~ I:QI ~~ Verification of Facility Diagram Special Hazards Associated with this Facility: D D D Violations: FD 1652 (Rev. 1-90) All Items O.K. Correction Needed ~ D White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy ,,/ -/ .. Bakersfield Fire Dept.1 ~RDOUS MATERIALS DIVI ON 2130 G Street, Bakersfield, CA 93301 (805) 326·3970 v ~'¡-,..~~ v UNDERGROUND TANK QUESTrNAIRE ñ\~e JUl 1 6 1991 HAZ. MAT. DIV. I. FACILITY/SITE No. OF TANKS PARCEL No,(OPTlONAL) oC¡ ./ BOX TO INDICATE CJ INDIVIDUAL CJ PARTNERSHIP CJ LOCAL AGENCY DISTRICTS CJ COUNTY AGENCY CJ STATE AGENCY CJ FEDERAL AGENCY TYPE OF BUSINESS CJ 1 GAS STATION CJ3FARM CJ 2 DISTRIBUTOR KERN COUNTY PERMIT CJ4PROCESSOR :øSOTHER TO OPERATE No, III NIGHTS: NAME (LAST. FIRST) PHONE No, WITH A~EA CODE NIGHTS: NAME (LAST. FIRST) PHONE No, WITH AREA CODE II. PROPERTY OWNERINFORMA TION (MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMA nON /l Cel-? íê /" t/~, ./ BOX TO INDICATE INDIVIDUAL CJ LOCAL AGENCY CJ STATE AGENCY CJ PARTNERSHIP 0 COUNTY AGENCY CJ FEDERAL AGENCY c ZIP CODE 9330 V III. TANKOWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMATION MAILING OR STREET ADDRESS ./ BOX TO INDICATE o INDIVIDUAL CJ PARTNERSHIP o LOCAL AGENCY 0 STA TE AGENCY o COUNTY AGENCY 0 FEDERAL AGENCY èlTY NAME STA TE ZIP CODE PHONE No, WITH AREA CODE OWNER'S TANK No. DATE INSTALLED VOLUME PRODUCT STORED IN SERVICE V/N VI N V/N V/N V/N V/N DO YOU HAVEFINANCIAL RESPONSIBILlTV? V/N TYPE ¡~ <~~ Bakersfield Fire ~t. Hazardous Materials Inspection v· RECEIVED . NOV 2 6 1990 Date Completed If - J'~fiJAZ. MAT Drv. Business Name: P t:ù..l,.J d f 0 rue; f Location: J '1 Lit Í/It L b L.e...- ~ Plan ID # 215-000 It )'6 (Top right comer Business Plan) Station No. ì Shift C-.. Inspector 13 L- It-¡ R Adequate Inadequate Verification of Inventory Materials D fa Verification of Quantities Verification of Location [2J () Proper Segregation of Material ~mments: vY1o~í 6\ \ . D 006 j~ - ~t~ -f(-~e7..~ [Z] Verification ofMSDS Availability Number of Employees Verification of Haz Mat Training [2] Comments: ~ D D D ~00'7~{ D D Verification of Abatement Supplies & Procedures ø Comments: D Emergency Procedures Posted [Z] [Z] Containers Properly Labeled Comments: D D Verification of Facility Diagram [2] Special Hazards Associated with this Facility: D Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office t· .¡ , CrTY -of BAKERSFIELD : ¡.,. .nd ~';culturp ,,--,. ::t;;:.. HAZARD6US MATER:I: ALS :I: NV.ENTOR'Y Stlnd.-¡'d 8u~ ,nn! r:¡:;:- NON-THADE SECRETS_ OWNER NAHE:fA'/LESS AJ 0 ttflfW¡¿Sr ADDRESS: ~2 2~ f/l (4tfJA)' t¡ZAJI qtéITY, ZIP: I ~'Il IJJ,¿I-!i, ¡?;, PHON! .: ' IUCP'D 2"0 Ii1STIlucrIONS ?OR PFlOl'llR CODa N"HE OF TtnS-~Ç.IL1.TI:' STAHbARD IHD: CLASS CODE DUN AND BR~~STR:E1_ ~Me:_~ LL ,7' ~ fR :>.-:h .!;T:..I!.~ 1 Ir~ 'vøe i (00. Coo. J II.. Aat . A".,.. Aat 5 Annuli Est . lINt"", u." tI T IDyl an Sit. , II Coftt Coftt ....... 1- 11 Un cœ. 12 lGQt tan ...... Sttlf'1ld 1ft FDClllty 13 \gy lit It "- of .11It_~. Sot IMtl'UCt i_ ,.-.., ,.-., ~ L - -' De l.,..a L - -' SudcierI 110 1_ """'-' I IBId I.t e II<M It II Cœl!øMnt n __ Ir U, $. I!u:iIIw ~t 13 ... Ir U.S. ~ /.1. 1-- GS p- IJ () R... I ~~ ¡<l)Al,t') tRJi~~l£. - C. ð bJ.. ./IIr ¿¡@ :Þ1-#~-¿"!5irJ£:, '-~L V¿~--- ·......c.J III>d JoIN't" Hu.~ (1--._ ,II tl'llt 'CIOIYI C,A,S. ~ ~t II. am. Ir C,A,S, ~ . _.J fj.... H4urd L_-oJ, ftNctlvHy ~ OIl0y0pd :..;z; ~ 1le1_ ::: 11œIId1.tI '....It" of PrœIIIVI"t ","Itll c-t 11 IIc2J Ir C.!.S, ~ c-t 13 I!r:.Io Ir U,S, ~ , \) ,. " , I1lGS "", dol( t;r< WA-A P [-I' f7J J-E u JYI D J J; t.J.. LJ.1ì tf --~ ---j ~ Ir U. S. IIMièsr :~ ~;... HU~ró: : RlHCt;vHy : I i : Del.~ : : ~ IItl..,. :~ IØlllld1ate IINlt" of Prftsu,.. 11M It II tœÞcn8nt 11 __ Ir C.U. ~ ~t 13 IIœIt Ir C,A,$, ~ i [i~fi"Hallrd _ ::: IIooct;vHy :: ~ o.1avod L._.J SudcIt;n "loot. :=~ IC!IIIdlah' tIN It" ot PreIS"'" Mea It II 1_~21-_- -5- -l;-øt1 ¡¿ _ I) ¿. 1-5..,11 J: ¡\SJi c-t 11 1Ie.. U,S, IIumW ¿ßr . fßl D J.t oJ, .. /1 c ~ t ¿ 1/ I 1!.-: _ fte¡;'tR-t' ~__~__________~__ ---- . ~ ------ . £",QGf~-'" cœlACTS II 11 ---" , I 1..----------------------------------·- nH¡-------.....------------- 't-A¡:-Pfüj¡-----· Qõi-------------- nnr- I l.~l_ L_____~_~L----:-------L---~5::J.~~3-J. ~ I ~ ' ¡ '~'c,1 Ð>d I4Mlth lIIIu..d . C,A,S, ....... ! L;»e> ,II t~t 1IJ01rl. - -- ,J ,_ Clll!iCftØlt ~C..,.'" CœIoonsftt IJ tsœa. U, $, ~ 7tïiI'~FAðIIf--- i - 'C"";!;C't!OII (Read ',md sj~n Ifft'~r coøplt>fing all sections) ; ",,,ty ~ ~lty of 1.. t~oIJt. I ha". I»",onally .....,"9d GI'd,1)a (¡¡ailier wit" the infonoot;an sue-Hted 1ft this ÐNI .11. tt~1IC docuaants. Ðftd that bond 0'1 Pf Ü'Gulry of tholv IndlvlduðlJ MIS;IIII'Is;bl0 '" '0', Obt~'U. ,nf_fion,.1 twÌt""" tho, tllP tUOIIHtO<l intON>ltlOl1 't trw, accurat., end C~~' ¡ JIJ .. . ' 'I ... --,- -,,4'-f.tf'---T----.I!1A:-.. --J¡k~R7-~R--rr~~--~~---------r-r---' S'- - -~---II~_- ---------. ------------ ,,~ Z-s::: ?~£- ~------- 1 ....... ~o 0 'c 1. "{ 1t ".0 ~rIOOE'r4to,. VI'( ~ o::>t"nnOr,s IUlnorllro "ftM"""H't 1"9' 1 U". . ",,(i-S1¡;;¡¡-'-" f-" I I '- ~-- ---.>¿. ~. . "-.. 1'(·:- '<-. - '" : '. -- ~ -~ I~,.c -' --~'- .~~..~-;-~-""-' -;.~~----:::,--- -:-~- ~ - - , CIT}i of BAKERSFfELD-. , ,/ / /' -:,,-'~ . .. ---~'=-. ,/ :1 ¡ ore and 40rieu hurt ~ .---, Stllfld.rd 8U51nf55 '---' HAZARDOUS MATERXALS XNVENTORY NON-TRADE SECRETS ~~~k BUSINESS NAME: LOCATION: CfTY. ZIP, PHONE .: OWNER NAME: ADDRESS: CITY. ZIP: PROIIE tI: IUlI'D - ro II1Sr'ltrlC'rIOIIS ro. PlfOPIfIt CODD . , NAME OF TitS ~~JL~TY: STANDARD IND. CLASS CODE DUNANO BRADSTREET NUMBER Ph~ ie.1 IIId Hø It II l1li1,"" I (hKk .11 tllet, 'l1li,1,) /j :.:c ( ,..-, ,..-, . r'ç,f '. '-_.J hleyed '-_.J SudIMn "1_ ~ .....I.t. ' "" It II of ,........ ....Itll ~~---_. :3 ó ea..Nnt It .... C.A.S. ..... ,..-., L _ .J f ;r. M.urd '- _.J "-tlvlt, c-.nt n .... C.A.S. ....... "I.- () Of c:a..-t II .... C.A.S. ..... r - ., .,. -., ,. -., ,.. - ., ~ L _.J Fire fleu..d '-_.J IINcltvtl' '-_.J OIl.,. '-_.J SudiMn ..1_ '-_.J I"-Iet. . ""Itll of "'-_ ....Itll . c:a..-t It .... C.A.S. ...... r - , ,. - ., r - , r - ... r - ~,... L _.J fl... HIl."" '- _.J AHCtivllY '-_.J OII.ywd '- _.J SuIIdIn ..1.... ,","';.J I..I.t. ....Itll of P......".. ....1111 c-t It .... C.A.S, .... ~t n .... C.I.S. ...... - .-l__l__________L_________l__________L_ . L_l~l """'e.1 end IIMltll IIlln ({heck .11 lIIeI ...1,) C.A.S. ...._________ ~t II .... C.A.S...... r-., ".-,' r-, ,..-, ,..-, L _..J FI,., HIl...d .. _.J IIIIctlVIIY '- -:-.J 1111.ywd .. _.J Sudden ..I.... '- ~.J 1..1.1. IIMlth 0' P......".. IIMllh .~. ~t 12 .... C.I.S, .... ---- c-t n .... C.A.S. ...... If RGEIICY CGlTlC1S 11 .¡¡¡-~------------------------------ nn¡------------- 7I-Ap-Pfiiiiië--- " It a¡¡--- nn.-'" ~ I' 'r-:- (er! if 'elt'Oft (Rt1l1d and .ign II'ter eo.pl,.tJne ,,11 ."et ions} . . . ' I certify...... ....lty of 1..lhetl he.... ....,_l1y ....;ned end .. ,..ili.,. .itll the 1,,'_tiOft sdilIttlll -1" tilt. .., .nett"" '*-11. IIId thet IIIsIII Oft ., illCUlryof t....lnd'.i...1ì ...._iIl1.· for obtaIn.", the ¡"'_110ft. I "Ii_ tllel 1~""IU.itttd iÍlt_t;Oft ., tMM. ICcur.I.. end co.olltl, . / " " .. ' I " .¡.." . I J,. 1-'- .,;a-ömmnim-õ'-õ.ñ¡rToDimör·DI-ÕW¡:7õ~¡:¡tõr·šïütfiõriiia:;:w¡;¡ñtif¡;¡ . 5iijiiitü¡:¡--,......----- . I ii -:-.. . ' i I' I ,. I',.·· , I ,.. . ..«-'~'- V:: . . \.. _~~~.,.~i-: "-'. :~L~ -: ,. ~ ,f:" ~>_:'.-..~_- "~-':., ~.'"' .:. .-. .- 'J;,_.~ _ _ ' -. - . . ¡.-- ------------- Ditï519fIH .. . ----- ",;..,-,,:>, CIT}f of BAKERSFIELD ~ I f... oM 'o.;cultu", L.-J ~ StM>Ó..d 8U5'n~5 ,HAZARDOUS NON MATERIALS INVENTORY TR^DE SECRETS 3. I p. . __ 0' -\1.- ¡ ."on1 Ivve I r.- Cod. 1 RrI. Alat . a""". Aat 5 ""- ¡ . Est OWNER NAME: ADDRESS: CITY, ZIP: PHON! .: 1tDD TO IlISrRUCTIOIIS FOR PROPIDt CODa NAME OF 'rR1s ~fIL!.T.x: STANDARD IND. CLASS ~CODE DUN AND BRADSTREET NUMBER , ' I IWS I HESS NAME: LOr:ATION: (' ¡ TY. ZIP" ~-rHOHE " I' i _.tl 11/__ ~i~fõ 1 I~IL ._.;.....__. j,,~ 'c.1 and, lIoN It II Kor.MI ¡ 1(-=. ,II tMt '!ply) .' j -- )~ fi.. Haurd : - ~ IIGKthlty i ..., ~ ....;:::;" L -... OoI/lYft '- Sud6s> lel_ ';~IGßSllt.t. IIoNlth' 01 Prw-. IIMlth ~t" ~tn '--t 11 .. ¡.~ r-~ r-" ~ ,..-.., . ~ i .",- f'r-t Hallrd L _.J. IINctlvlty L _.J' 031cv" L _.J ~ l!itloa!!lil ~ laadl.U ".¡ ~Ith of Pr8svrt Heelth i Î ~, \!_LMl_Sff~L~..~_-_ C--t\ 11 16SI' C.A.S, ~ ¿gol!. ! L./1p.lLL '-='-t 13 f!Il!æ' C.U, ~ ~t I] Iaœo. C,A,S, ~ - ---... i '.......cll ;lid KoNltll Plalilrl ¡ ,tn:oc. ,il thlt .oo\y) ,\ ~ fl,.. Ii.ura : =~ RClðCt;vlty ~ = ~ OtI..,..d ~ = ~ ~ 1Iv11101IO ~~ll!I!JOdlatt I 11911 th 01 Pr9u"rw Hell th :1 ' ". '. , ' Il,\h&LL.:_~___L~__~_____"L__L;b_nL__--'_-ð..&-¿ L-4J. / I b'1.(!'Lt SðUS I ! ~"v1'c.I·11Ad KNIt" NoI i (r.c~ all tNlt nely) . i ~ =~ F \.. HtÌard ~ Ib)oct ;vhy I I i . .1 I - -. t"'PGf/ll(T COiHAäs " . L'~ ~ II_"~----------------------------~--';'-- nn¡------...:.------------- 'r"R¡:-Pf1õñi----- C,A,S,~ ~t 11 &3æa. C,A.S. IwW' ~t f1 ~. C,A,S, ~ C,A,S, ~__________..:_...__ ,-"",t 11 ..-~ ,_ C~t 12 __. C.A,S, ~ L_.J 1~I.tt tIN Ith eo--t n __. U.S, ~ 11 ¡¡¡æ¡¡----------------- T1tW------:- n-wr~--- ,C..., if Icanon '(RetÌd and si~ s(t~r cOÐ~Jf"tJng sll sec'U¡'ns) I Of" <Iv .,.,.¡~ _Ity of 1/)01 thøt I hø... ~'Qnllly .._,~ INi ... 'eail;.. with tire 1n'_t;(III ,u!lcitt8d, In this '1IId.11 ettec:ft!¡¡d __t~, md thet bnllCl on "'f ;"'I\I;ry of till!S. Indlvldueh 1'9!I_.ib\. ,,,.- oct'.,n'nq !ht ,nt_tl(lll, I bil,_ the! t~ IUO!OHt&C ¡ntorution " trv4!, accurate, INi cOIõIOltte,' ' " " , " I ,... . .;,a - õ in ë i..'" f ì n ¡~õT - ~¡:. ro¡x;¡:.;¡¡ õ;:" O'R~ öö.;;~; ìõ~;:. ï:õ;: 'š"¡¡; £ 1iõr1i¡a-;:wii¡;¡¡ in.. _ Si ~£ ü¡:¡------------------~--------~ --------~~---. -~--- lliti-)i~---------··---------- , I .- ~ ~ ' . .¡- CITY of BA~KERSFIELD '.... ",d 'Qr;cultur, '--'~ Stenð.rd 8u~ In"~ HAZARDOUS NON MATERIALS ~INVEN~ORY ~r R ^ D E SEeR Eï' S If- ~_ ~Poq" ~. _of .w_ :1 fillS IHESS NAME: l-Or.ATION: ('¡TY. ZIP, 'PHONE I, OWNER NAME: ADDRESS: CITY, ZIP: PHO"l~': RBFfDf ro IlISTltUCTIOIIS FOR P'ROPIDl CODa NAMEOF-TR1s ~Ç~~~T~: STANDARD IND. C~ASS CODE DUN AND BRADSTREET NUMBER -I - - -- 1 J 4 S , T . , 11 11 , - ""1 I YØI Iita. AYOf'Iqe AMulI "anUf"9 I o.,¡ tQftt Cant Cant Un !(.- Coct. AIIt Mt Est Unin on Sit. J~ Prwt 1_ eo. I. ~~lffiJ.___~{) _.l_1~__J._ -5 ~___~I ~J.sìJ ~ I,~.",c.l and ....Itll KllIl'd ¡ I"r....d ,II t"'t ~ellØ¡Y - iVF-' ,. - ., ~ ,. - ., ,. - ., !:..:"""" /1. :ö-~ Fire H.urd L _.J I!eKtÍYHy L _.J Dal.vvd L _.J SucIdcin IItJ_ ~ 11!I!Sd1.t. ~ "" It II of P...-. Nee It II i , 17 laett1011 ~ StOl"et '" f III: II I ty ~~O_të_ 1J 'by lit '14 __ of IHIltWeItJ I ~.U _ IlIttl'llCt 1_ C,A,S,...,,_ ~t II a-, c.A.S, ~ ~r !P...4_ /.) I>~ .~ ~ A¿ C-())I~L ~t n nc., C,A,S, ~ ~t n Ibtt. U,S, ..... ,·.....,0.1 and IIoe It II H,uM/ êi>o-::..,II tl\el '1I01y} ~ :~ Fi/"9 i;;¡urd' ~=:'l1cKttv¡ty ~ Del..... ~=: SuddøI ..I.... ::gj h:m.let. !toe It II of PrVs- .....Itll s ¡; ¿ t 5 t" () 12. IIV ~t II --, u,s, ";--lj?(t:J/fJ[;'1'J;t.JJ.. EÂJl ¡ ~, ~t" __, c.A.S, ~ c-t ì3 __, u,s, ~ , SA¿£s' ~t II IIœ; & C.A.S, ~ . r -., .r.......-~ ,.-.., L_.J De I.V\Id L ~ Suddtn lit Ion. L _.J lrö!llldl.t. HNlth of PI"ftSU1'9 Ilol It II ~t 11 1IM1' C.A,S. ~ ~t 13 1IæI' C,A,S, ~~ rlJ~tl~,JitL.ÆÇ, ·If[.fx;f~< -.m· C,A,S, 1Iu:IIIv_________________ c-t 81 Rosa & C,A,S, ~ ':i;;JI..t= /Þ7-fti:A¿ F Q£ - ..~ A S/'J/ /\/Ì.I"k-__~ ,. - ., ,. - .... ,. - ., r.;::;;:.;t '- _.J ~t ivhy L - .J [)r 1.V\Id L _.J Sudden 1I.It,". L~ IImadl.t. IINlth of p~"SU'" Ilol It II ,_ CO<:!OI\ØIt n 1Iœa. C.A,S. ~ ~ ---------------- -- Cosoon=rtt Ø3 1Ieœ& t.A, S, ~ I : ta<QGE'*CY COIIACIS II : l~. ~ II_------------~--u-"---------------~- Tlni---·-------·-----~--- WR¡:-"Iiãñi----- CO"';¡ 'C'I1Oft (Resd IJnd si7m RftC'r cOlllpJ,.Ung all sections) n 11:*------------------ TIt" 'lrm'-II'I\Mr--"'- ~ ~ ~ " , i ~:on < IV >JnÒtH' ~ _!ty of l00i thet' t he... ~!onIl1y ,~,,'111i'd end 00 f.ì1 i,r .with thl Infoncet ion !ul=Htod In this eM .11 eUtehad docuB¡¡ftn~,ØId thlt besjld on .,., illGUiry of thote tndhid:u¡ 11 r"WR1\f ib 19 ,,.~ O!H..n'nq tho ,nf_lion, I IMP!,....... tNI t'" IuOII1ttO<! in(OMWtícn 'I t!'Uf. Kcuret., MId cOlOOI.to. , , -." ~ ,I.... ~ o.:.a- ôìlìë i' rml~"õn;;ñ?;: iõ~r.rõr -OR-öör.~r¡õ~¡:ãfõ¡:·š"¡¡¡fF.öriÏM-rwH¡¡;f å£i'~ Siijñi t ü¡:.----------------~-------------~-------··- . !lecf5ïqñõõ--u-------:--------- -. .." ,0 CIty f!f BA"KERSFI~LD .J ~,r. tnd Ao,..;cultur, '---' St _..d 8u. In~" -HAZARDOUS .- NO N .MATE~IALS 'INVENTORY TRADE SECRETS ~ ,_ P~ ~__~ of _ID_ fll1SrNESS NAME: LOCATION, ··C.lTY. ZIP' rH'ONE ',: OWNER NAME: ADDRESS: CITY, ZIP: PHON! .: IUCYlDf ro I11STRUC'f'IOr¡s roR nopa CODa NAME OF Tft1S ~AfJL~T~: STANDARD IND. CLASS CODE DUN ANDBRADSTR!ET NUMBER : .~.,.. I c,l and .... I tll IlAr.MI ¡ f(hKk ,II tl\et ell,) I i~F;rt Heierd ~ = ~ Roðc:ti.lty I ( ,- '. . I, 1 , '."". Ivoe ·1'nM (()(~ ) 'As. "t , A...... Aat 5 Annue I Est , 1INs",,- 1""tI 1 IOys on Sit, , It 11 Cant teAt Un Prvn ,_ C. U locet Ion ...... StOl"Oll In fac: Illty s/jJ,.e~ 1] 'by 1ft ,. __ of .1Irt_~ SA I lilt nlet 1_ C,A.S, ~_ ~t II lieu. C.A,S, ~ /Þ"ðR.__ (Ó4 ~:] SudéS> b 1_ ~~.ihlOOdI0t' of p,...-. Hoe It II CosI!øMrIt It Ie&!' O. S. ...,. ) ....... 'c;1 and tIN Ith HarlMl j: ! (r-..::. ,II tl>lt IIII;ly)' ! . '. . j....:. "": ,--, i i '1··.- ~ Fi~ /Ward ~ -:' AMeII.!ty, I ! . ! ·1IœIt. 0.5, ~, I!æI . U.$, ~ ¡-y-¡;:~ \ ! I '~~~; ~='::.~i;;'~---"---1 ,..-.., rï" r-., . _.J Ft.... HIaMl ~_:' Re.cti.ity ~_:' Dtl..,..; ~_:' ~ "19l!l. ~_.J Il!iIIIIdi.U 1 Ilea It h 01 PI'ftIU~ Nee I t h , ~,u-1LYll_~_",-_~_º_L_____j:·___~___~"~_.J __J_ .šS'fL1P J_ (J; I '/12tQJ ,,£5 I ~'cal IfAod Keeltll "uanl· I· C.A,S, IIosbv c-t 1 . i .:;~. ,II tl\et ""'y). --------------- ·1 .' 1- -'. .. ",-' "I' c. ,,-, "CR .' ~t 12 i i I'· - ~ fl., H,Ûrd . ~ -:' IllïlGcti.ity ~ -:' D.i.""; ~ -:' Sudden "l..n ~ 1=*lot. . -' . ·1 lleallh 01 PrftlUrt- llealth I! I _ . I i i f"'<GfI$(Y COIuers " , -I t II-~~~------------r-----m-----~----- nm-----------------:--- wRnr,¡¡¡¡¡----- I . C...·Hlc.non (Read Bnd si~n IIft~r coøp},.tJnl! /I}l sections} , .! ,,,,,,, 'n"',¡... _Ity !If 1... thot 1.1\e,1 ø.,,'-QrWI1!y ..oa,niM Iftd ... ID8ih.r .ith tlla inf_tion ,ulDitted In this I'\d al1 .ttlldlsd __II. GfId thotbned on r;;y ;l'\OIIi'1' of tllonlndhl6aols 1'O!ItIn,ib1. f-' O)"'"'~ the ,ntoraøtton, I t»I,.W' hoItt,.. luoa1!t~ intOMlltion " IIVV, KCU'ICO, tnd ctaIIl.t., - _' ' . ~ , . I ... -- - I . -. '. - . . "~ _~. . . _____ - ""a õrr;ë;;¡rnf1p-õT-~"7õõf.".[õ;:-OR-¡;w;;pnõ~r.tÕ"-Š-":;¡F.õ;:.;¡êG~rWfl¡¡;¡it¡;; S;qñi{ü".-----------~-----------~....--~-------~--------- . ";~i. .'9ñir'----------- . '. 1\!119 & c-..U, IIIœIIsr ,,-, __ ~ C.~.5. ~ s ~, IS. '-tn 11 q¡¡---------------- nt1r-------· nïW-1It\6I\I----- -' i L 4' , . t~ '. . ' eIT);' oj ,BAKERSFIELD. -- _ 7~ ~.r.· ~ 4o";cultu,., - 5t _..d 8u. ''''~n HAZARDOUS. NON MA, T l!: RIAL s:X: NVE NTO R-Y TR^D_E SECRE'TS_ p~ f#.._ of _f¡¿_ -,:~~ . .)~ '---' ~17S r NESS NAME: :"OCATION: r. r ïY. ZIP, rHONE ,: OWNER NAME: ADDRESS: CITY, ZIP: PRONE .: fUBJf ro IlISntUC1'IOItS· !'OR PROPIl1t CODa n UlcatI011 ~ StOl'ed In FacllH, , \ #",ltn1 hnð4J .~~ IC'! and ....,th Kar.MI !('-Ok ,II t"'t 01101,) ~L(J/) I( "- . u. S. IIua:::Gr ,..-., firt Huo.d L _.J h«thHy Ilea . u.s. ~ ,...... IC, ¡ and tie.! Ith H.IIMI ,:,,-"::._,11 t"'t '1IØIy) C ,A, S, IIIøIIIr ~t II .... C.A,S, ...... . _.J <I,.. !Ward ~-~ r-~ r-~ L"':'.J Ae.ctivHy L _.J 1:111.,. L - j SudcIcn "1_ - lief Ith of ~__ C-t n ae.. C.A.S, ...... ,..-., L _.J I~itt. Metlth C-t 13 Ii!cu' U, 5, III!a!ior , ..l___l_~_____ '''YY IC' and IIN Ith Haronl tl'OC' -.11 t"'t '1IOIy) U,S,-~ ~t 11 ..... U.S. ~ - _.J r i,., H.a,.d ,..-., L_.J Cœøonc<nt n __. U.S, .... ,.-., r-., L _.J o.l.¥9d L _.J SudcIon 11.1.,,. HN Ith 01 P,,"IV" ,..-., t..._j Aooct iviry 1",,*lot. Heelt" ~t n "-. U,S, .... [, - ~l-_L--_______L____________L_m_____L__--'__~L__J. '_~'c.l and Keelth IIIrOl'd i :Ì>K' .11 t"'t ~r) 1--" r-, r-., r-~ _1- - J r i., H,u,.d L _.J a..ctivity L _.J Otlo¥9d L _.J SuódOft 11.1,", L _.J lœsdt.t. , HeMlth 01 '''"sv,.. HNltll 1__--1 C_1.5, ..... c-t 11 ..... U,S, ~ -------------- _, C~t 12 "-. C.A,S, IIUeIIw ~t n __. U,S, ..... t",~GfI(Y COIIJAcTS " , - L Ii_-~---------------------------------- nn¡-------------------- '.-R;:-Pfèjñ¡----- -"'. NAME OF TinS ~fIr.l.T.!:: . STANDARD IND. CLASS CODE DUN AND BRADSTREET NUMBER 13 'Dr 1ft .. __ of 1I111t'"~' See I",tructl_ -- --- --------------- - n 1IJii---------------- ntTr- -- 7rR!'-III\Mr--_ C...'¡f'C.t1on (Read and sj~ aft~r co.pip-ting all sections) I ,~,qy ~_ _Ity of 1... thet I. he". .,..,....l1y ....,nt'd 1tId... '.Ih.. with !t..- ¡nl_tiCln ~'*'ittød In thlsllfWl .l1tttec:hod_6ocuscnts. endthlt bnod 011 "'I ;'lQulry-of thllllo Il1IdlylMh I'flllIIO",ib1ø I ~ ot". In '"Ç tho ,nl_fiCln, I W 11_ thet tM sub!lHtod inl_nO"! 11 true, ICCU"'U-, ¡¡nd COIIO I.tl, I.- . o;:.a~-õ T Jië i ,1- f H 1.- õT - ¡;;;;;.;: Toõi;:.i õ¡:-OR- ¡;;¡;;.¡: ìõ~;: ~fõ¡:'š-¡¡¡f F.õ<'iiiè-;:wniñt iti~ ~'"' Siqñitü;:.---..----~--~-----.,-----~--__--~~ ------------- Uiti-S¡-~-----:---------------~-· r~~ ~. . -- ,I _~"~:;~1~\ ""'. - "- ..¡,~'~.( --., ~ :: i . ',;';;_--\.+ -' _r $V"J 4IÞBAKERSFIELD CITY FIRE DEPAR~ 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 \G.- , rd~-\ \0 IÚDf/ OFFICIAL CSE ID# US IXESS ~A.'1E HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2cA ( INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. RECEIVED DEC'1 1 1987 Ans'd, ............ -,111158 ~~.f ""-œ Gt· .ß . SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: f/J ~ L/3 c;s 0/2 u ~~ B. LOCATION / STREET ADDRESS: / Ý /$£ to / ß L.;!;' /fd. CITY: f)ffK£¡f?c..JZ/ÆLd (JtZIP: 933tJ 9 BUS.PHONE: (?oS') R3;;J--4/ // 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. E~PLOYEES TO NOTIFY IN CASE OF E~ERGENCY: NAME AND TITLE A. L I)ß.« Y' Dl7lJ/g B. (? I? f} lj .z;~ c,.rr£ DURING BUS. HRS. Mf1IV/tj1j(Ph;,/: R.3d-41 II ~SgtM~~~~ ~3~-~/H AFTER BUS. HRS. Ph;'/: f?3:J- -~ / 9'..3 Ph# 39ð'" R'?~() SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LQCK BOX: YES / éV IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / ~O FLOOR PLANS? YES / NO - 2A - MSDSS? YES / NO KEYS? YES / NO . . ':"~ ~~; \ \~~."~ " 1 . 1 :.' : . SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSINESS AS A WHOLE '4" ", Ii. " ..... '-... 3·.... \: - 'Yl..tv..~ t~~~ ----=--------;..------ r~·· : ';..::\.:............,;- "-" ,~ ,..... .._....~!, .;-"-' .. ~,' ~;''fl t . .J!. .: ',,-- "- I-~ SECTION 5: LOCAL EMERGENCY ~EDICAL ASSISTANCE FOR YOÚ~ BUSINESS AS A WHOLE .~ NO N €! ( SECTION 6: EMPLOYEE TRAINING /"' .I E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E~PLOYEES WITH INITIAL AXD REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO I~ITIAL A. ~~~~~~L~~~.~~~~.~~~~~~~~.~~.~~~~~~~~~........... ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .............. ..... ....... J NO C. PROPER USE OF SAFETY EQUIPMENT:......... ......... NO D. E~ERGENCY EVACUATION PROCEDURES:.............. .... NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:....... NO REFRESHER YES NO YES :\0 YES NO YES NO YES NO SECTION 7: HAZARDOUS MATERIAL C IRCLE~ ...,. NO - NONE DOES YOUR BUSINESS HANDLE HAZARDOUS ~~TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF~ S0::2;7 5n 0t~LONS OF A LIQ.U.ID' OR 200 CUBIC FEET OF A COMPRESSED GAS:,. , . .. YES 0.V I. ~ ~~ . certify that the above information is accurate. I unde.stand that this info.m~ ion will be used to fulfill my firm's obligations unde. the new Cal'lfo.nia Health and Safety code on Hazardous Mate.ials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. SIGNATURE -R~~TITLE~ '1>'l~OATE J~- ?~ - 28 - .;..~' :' " .4 ;L:;. ,<~~". .. ~. ,~ ~.ç . . G. _ ~~ ,¡; BAKERSFIELD CITY FIRE DEPARTIrEXT 2130 "G" STREET BAKERSFIELD. CA 93301 OF?lCTAL CSE OXLY ID# ------ BUSINESS ~AME: 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 UXIT LISTED BELOW 4. Be as BRIEF and CONCISE as »ossible. FACILITY UNIT#: / FACILITY UNIT ,NA.'fE: PfJ-f./ LES.J (l)f( (J 9-.S rm&¿p<#fd1. ~ SECTION 1: MITIGATION. PREVENTION ABATEM~-r PROCEDL~ES , ; ~/ . ~ /1T:A~' ~ b/d:1 ~~,~T ~.~~/.... .. .., O~.¿n~ . ø£~ ~r~ ~.. X.~~ SECTION 2: NOTIFICATION A~~ EVACUATION PROCEDL~ES AT THIS L~rT ONLY a,il... ~~~ fMi-.:t:l~) w~ ~,a-~ ~-A' . Þ a.ff~ &~ ~ - 3~ - . e .. ..., . ,- /_'~: <-~~~ .¡ '¥': -~\ II,' ..,...ì S:::CTIO~ 3: HA7.1\RDm;S :'>fAT::RIALS FOR THIS ¡ì~nT O~LY A. Does this F~cility Unit contain Hnz~rdous ~ate~j~ls?" ø~o If YES, see B. If NO. continu~ with SECTIOX 4. B. Are any of the hazardous materials a bona fide Tr~cle Secret YES €)- '-- If No, complete a separate hazardous materials inventory form marked:~OX-TRADE SECRETS OXLY (white form :';4A-1) If Yes, complete a hazardous materials inventory form mark~d: TRADE SECRETS O~LY (yellow form #4A-2) in addition to the non-trade secr~t form. List ~nly the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTIO~ ·._#····.4_ ,__ SECTION 5: LOCATION OF WATER Su~PLY FOR USE BY ~RGENCY RESPO~ERS SECTIO~ 6: LOCATIOX OF UTILITY SHLï-OF¡S A, XAT. GAS/PROPA~E: e~ B. ELECTRICAL: þ /}7l ap C. ~'lATER: 0, SP¡::C~AL: E !.OrK BO'(. YC S '@ ¡, YES, LOn T! OX, rF YES, STir: P~A\S~ ~~,OOR ~r,\:\S~ ?ES / ~··n ~[SDS:,; '; ~:?,"S " r~..:-:: r:; \.::; ':'?<; \0 ''"'r: ,.... !. '. .) \:0 - 33 - " iI^KLHSFIEI.Ut;ll)' 1'lHE UEI'^HHIEIH ' . ' FORM 4 A -:- 1 P ¡} geL 0 f. " ¿;J. NON - T R A DES E eRE T S - 'Ò ~~..,; HAZARDOUS MATERI ALS' INVENTORY ."'. ;~\IJSJNESS NMIE: P/iL¡LE.sS.' [)l(u £1,<; OWNER N^ME: f/J'?/..EftJE j.Jo~flj-·f,/..)£57· ·F^.CIl.ITV UNIT I: - I~;'~;~ ,\[1111'" S S , ? .' ^ b D RES ~ : q 70S" pt¡¡..u -'..,.,~ IL IT Y UN I T N ^ ME' l,9'VLé 9 5 "ÐE.,,:I.r$' : I IITY, ZIP: /3r+k£f0;¡::¡£td. Gf}-' 91'3"3ð,9cITv zIP:'u.JIJ..3fJ/Ji///1L.E ,...Q!{.£qo9'707ò I . I'll ( -¡;, r. 44 . (1. ! < , ï I' . tdõ':J- / ' HJ r: !: ? (J,:; ~ g", ,;:;)- ~ / II PIIONE .: f)tJ3 / ¿¡, IOFFICIM. USE CflHS conr. ._. - . - ONLY 2 :1 4 !j 6 7 8 9 \ 0 I: ~'^ X ^NNIJ^" CONT USE LOC^TION IN TillS !t OY H^Z^H) )),(),T ~ ^MOUNT ^MOUNT UN IT COUE COUE 'F^CILITY UNIT HT. CIIEMIC^L OR comlON N^ME COUE GUIDE ---_.--- .. I Cf·- .J) -- \ . ,&~.. 7)-0 ()~, ºtf [;/fLé.S /ø1 .. p ;'~i. êL 0 f( / /¡) g. /07'1 ¡.. 10 PLlJof. fJLldtt p.;ó.., tlV ~..s" . . < . '\ .( IJd-- I ,,~o ~ ctÌJni 1fO ~aD /D or 3 /fL 6S,-'~ FLpo ,e · .pfJO L- It f2 I J. I..... 1"/Q2' , 3ð-Ø ~ 1.3 ;Ji'f S17-L¿3'.s . ,t D I~b ~;:;o l/ jb -IS I/I'fs-;;¡t;;.. 1f5"6. D.:L I " 1Þ 'd ¡::¿ d o¡e. ~g!) PI? I v.f II AJd. f,q I JJ1" ¡(£J'v1ov&J!.. f¿La . f -- ,;2lJ )- J>-! ~ðÆ.. J~ 1'1 }8/ß )00 fj{ð P;9-JJE ¡CBS' -- , 'jd 0 CðL;&.#/5¿) -- 3(} 100 13 /9' /¡$ J oD f cJff L &:-~ ..... /.1) /f0 :;"f /0 ;)./ r £f--F ,'1ð 1lLCfioL- f£f!.DX/ d E FLL~ _. .._~- S .;20 ;¡J. '9 07 I~ ·15 ' /!IfilL foL I S# 17J)d K£/VlDUQ. .f ¿L- hl "--- - ._- ,1,~( -. I gal, )Q7 \, \ if _.",-. 50 :J')tJ, ) J'" E. t.F Ö ~t#¿o; -ff{ I ð 'I- ,Or ,. I ,. . I f ~ . -, r--' -J'1 r J :.- ) ; ) :;. 'þ. 'tF , ,,.-.... 6 :~ '"íT/ô_,-UJFf.d.;:/J-(;o4J /-;., ,: p i--Þ' ?, . :' ì .. · I ',,..0 .,' ~ /' , -- J .' -( ~ ·f 7 J ' . '] I'- . I '7 -:: ;.~'~ /.2 £-r éJ ?f1 /lD -DD./<!r1' AT DI..$.f6.Q /' 'f"" ':' - I' t...; I /."L , -~ "" J/-£¡: ',' d., ' ~ i ,,.' . , tJ;' .-<\ -7:1 ~(j.;/ ,; .'1 I ! U;-:;;.....() " I' . ~- . <~ ¿:t ) ..'+ """'. · 1-- '1 .ef.:ttfò··, Ka£ IV ; if ¡?- / '(! . ¿-l .1', I ..¡"IUI·j, ".j;, ... , .. I .r r' , (,' ."':": . I r·--·' = ( , \ I ',-IN hb / I . .. , 17 '/~;;V" .... .----.:- ' '..() f.ill-a M.1iL It ~IIJ fill )0 _.~ P' , . - J '. . Ir...r ~íJ/ , " .j ~. \ II 1/ }1 f ... - ... ~. .yCYi-j ?1 ì ! A crf(tflð7J)L~ E. v J )J .' . . d.,. " 01 .-;". _;;J I' ~ t1 ' \ \.... . I {\ /, 1 !t;~1")f ,'~ ,~",-¡i~.J'~Û~~ ..~ 1 ~~ ,/ <::J ~~ I :-<- j / -" . l) . d.' / I It;" ~."'(~ ',. ,- , f:. " ~ ' ~-. <', rr ./ ~:; :2.- YJ l.' ¡ 1 '7 .1. \t ,7 ./ ) ~ . \/ Ö1<t!fv D, Lf;,,4:;t!±J}¿,:. . /Î - . ""i , ( - £1'-/ \I 1" L- u- U / 1-,~f) /:'f,/ T ITLÈ: .FL tlð Ie \A1ß-All1n~,tI ON^TURE: ..l" .- .. D^TE: 1//- :r~~? --. ...;,... , . - --- - '-~ f - . . .' , .' \ f) IJI h'11 ~ ff? f M M ,M I !~ 1--15\ :12 Ii ~ i I: ~ . .- " Mlr. ¡ r'IEf¡(,UnV CONTM:T: ¿R1f?.1< Y"" Dlt-vJ.S r-I",rq;F.NCY C';lNT^CT : (;?If..é'i Z, : .'. '. '1/ IN!; 1:1' ^ , n,lJ SIN F. S S ^ C T IV I T Y : -3 i?-rf3 / 1.. TIT .. E: .lit! ~ .1/17,' é R. TITLE: IdS'Si· c ~TO ¡¡f ¡:::: PHONE f nus 1m1.JRS.. Ji:.;;L~ ¥/ / I AFTER nus fiRS: -~ ~"-~ ,¢/ ~ ~ MlJ-tJl.!J.g~A? PIIONE-' BUS !lOURS: 8'.. j...-s.t~.II- ^FTER' BUS, !IRS: 3r~-t::r .s-O .,."'1\-' - - - --- __ - ~_~ - ~~_._ _____ .-________;-u ,--------"-- ...,-----'----;----,.,-..--,.-----,----------- -,------ ---. -------------- - --- --..----- - .- - ,-.-- I 'r~ . , .:". ';, .' ,ß ^ KEn S FIE L U C I T Y F1 R H IJI~I' ^ R nll~ N 'J' · -,-,:::~;- '->·'<'FORM4A~/ ¡,' ,AJò:,v:;:'TRADE SECRETS. ' ,.', HAZA_R,D,QtJS.~~i;;iMA~,ERI ALS, 'I NVENTORY, t' IIJ!; J Nf:!;~ N^~:Ir. :-~f/ #,f!.L £Q3 nR0~~~}r¡~W:1f{-:?f? )~':~.;,;:i/'~~:~~:',,pß yL£S-s:1) () ^;f#tt!f£§/'~FACì LI TY UN IT': '. J DURESS,: '" /q I~ '~:- l./~r KA~";·cf",:-,~' ADDRESS: - '-F '.5.).. 7,'rr'h(¡/rntll-· FACILITY UN I~ Nt\ME: '.1 TY;;':?' ì f': ~ ,f-( ~ k' J-::'J'?f::, ¡::;1¡:;;¿Ac - -r rA:'''?..1'J4! TV; Z I r.'"t 'ih I L C!o:/lJJ/I·LEE. 'I~ K,&·~;4"~¡i'-' r~Vjt7-¿-m'i~. ,~,,:. " , '/fONE ',:-;Pb~- J?-"':< ¿". l..I7 //':"<·;-:"""'·~.'ONJ~;"_'j:,, ' ----- .....·"H, OFFIC~AL,USE CFIRS CODE ',' ". .' -- :-'. '":'','. ',;"""""'" :~..".. "','- .." ".""".",:""i".' 0 Ñ i. Ý -"'-1' .-" , . 2 3 ",. 4 5" 8', '_:,,'--;.~'''':..c::'..: 7",'i".~!_":"":" 8 . ',9-,' ,-.. __'_..,.,--::-'.~'::.-d 10 "'t MMC ANNUAl. .. CONT USE: ,,,,:t.OC'\Ttor(:tN TillS: 'BY" " IIA7.ARO 0 0 T IJE AMUUNT MIUUNT-. UNIT CUUE CODE:' FACILITVUNIT· "T. CIIE'MICAL OR COMMON NAME' CODE GUIDE ~M-' -;¡;- -7'Þ )Ji..'3&- :,: P~;ð:fj'1/Þ5',~\ff-2:¿1J f. . f 7 D R£,j'a ¿", ':'"~(jjiEJ"""'~I'Jr tJ f:. fI1 ~ ' ;tv1'Y;p Cð ~ü..L:, -r- -~;-"...'" "-"..~ .. ..-' 1..1 -R'Ou)ki''-'6p~'wi'id''Ç¿7m~ ~ M ,:X"Ò ',-5:lf6' .Lð /~ ~/ 1 .:r~~';·~-::--":::T:·:>., .-,---"- r1J3~ç:k...$:lJztrv¡~tE.'(/f,j:¡M();;;A C214f" T"".· "" -"" .- 1 1 ~ tii)) --^çi:j,:rJ iÎ :z;;./! '-- ", u _. . · 1 1J 1.. 1/ '" JLiii" "'Ü,; :£ £..J ¡;~d F.l.~~ (!j 7 0... C-oA/rRfi-; Pð~/So-.u ps¡vß · 7 f) ¡¿ -ft)J, ßO?If$1!... OftSs.£SJ 7 , J E 1J ~ I;) f ~£ R-;,·:::J,,(f.c ¡ïi.-' 0, ~M L j .1 ! / J .,. - -- 'R'oltc-If'''~ J d.. '; " (,. / / ().;J1t S -p ¿ ffof iJE.1.-1 ;' II f ¡-Ë.¡r s ril1 'I i r< Pr ) d:. HÞ (J "$;:'-.¡:r~cL r 4À-~~ "- 1/ "9~ (i'iÇll)l+~d ,'- ".. f \J M I 1 ~1 0 1!... . , ' 11 f' ~ . ',~.. ' ,.,~ p8gr.~ o'f.51-" !' , s ~..~..... .. .. -J- _ . J '~I- ) O,tJ,Ò r l --r- ,--O(,j ¡ -7.·' ! f- /~lY'- - ! Of) , "\ ) ¡ ¡ ! I .. \ ) \ .~ 11 Lf) 5 / J¡. 3' C?, ð.Q. -1-, ~i· ~ "I " ;J ..34 ~ If.. , I, .-,.. ... .. I .., 1 ,,, .. .. -..,..' I . '. , .* -'..'. .)-i- ./1. . , ·ì ,/VI /I (/ / . f/ I"¡ { .. - rt6G \" ,,"- --- ¡ ~ ¡:' (\ ¡' I t I' . . -H \ "-- - .. ¡ I "f' \ -- " I , ,. , / ! I ./ fJ .. I, " f-:'-- IHE: if. II~RGENCY f'- . íÈRGENCV ~ ' N r. , r ^ T; ~ '. ;' :>~' ,': . . " - .. -, . " , ! TITLE: , SIGNATURE: DATE: 'CONTACT: TIT J, E: - CONTAcT: . _ J.1S I NF.~,r.^CT J V I TV: TITLE: -:~ pnONE t. BUS IIOURS: ,,< AFTER BUS fiRS: PIIONE , BUS IIOURS:, .,,_ AFT,ER BUS IIRS) .... .~. . . .~ - , - ..' -' "11.-" _ .,.:dí-· '" ~ 7".!~";-. $ . . SITE/FACILITY DIAGR~~ FORM 5 . . <:.., ~ ç,..' ¡~ - ;;Y;¡. ,- . . NORTH SCALE: FLOOR: ) OF '/ UNIT .::: I OF I (CHECK ONE) SITE DIAGRA~ FACILITY DIAGR.~~ (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - SITE DIAGRAM (Reqtllltd items) . 1. Address: Identify the principle buildings by the Street numbers. 9. Lock (key) BOK 10. MSDS Storage Box I I 2. Street(s), Alleys, Driveways. and Parking Areas adjacent to the property. Include the street names. 12. Fence or Barrier a. Wire 11. Raiiroad Tracks b. Masonry 3-. Stor.. Drains, Culverts. Yard Drains c. Wood 4. Drainage Canals, Ditches, Creeks, d. Gates 5. Buildings a. Frame construction 13. Power lines 14. Guard Station 15. Storage Tanks: Identify the capacity in ~al. a. Above ~ound b. Under¡round 16. Dikin¡ or Bel'. 17. Evacuation Route b. Masonry construction c. Metal construction d. Access Doot' e. Utility Controls a. Gas b. Electricity c. Water 18. Evacuation Area: Identity the location wbet'e e.ployees will .eet. 7. Fire Suppression Systems: a. Fire Hydrants b. Fire Sprinkler Connections 19. OUtside Hazardous Waste Storace c. Fire Standpipe Connections 20. Outside Hazardous Material Storage d. Water Control Valves tor protection systems 21. Outside Hazardous Material Use/Hancl1ing e. Fire Puap 22. Type of Hazardous Material/Waste Stored or Used (See Below) 8. Fire Department Access TYPE OF HAZARDOUS MATERIAL F - Flu.able E - Explosive L -Liquid C - Corrosive 0 - Oxidizer G - Gas W . Water Reactive T - Toxic S - Solid R - Radiological P - Poison H - Cryogenic D .. Waste B - Etiological Example: Fla..able Liquid - FL FACILITY DIAGRAM (Required items in addition to the. above) 1- Risers tor Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served (rom highest to lowest. 11. Inside Hazardous Waste Storaie 4. Escalator: Indicate the levels served (rom 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets 7. Skylights ~ ~"\ (.- ~ ~.!.... ~..4 ;. .' ", " 1. .E.MERGENCY EVACUATIO~ . .;, -;-", "..1. Establish an eva~tion team with the following assignments: "-~ !., a. Management - announce emergency s ituat i on over the pub 1 i c address system. In the event the P. A. system is not in service, voice announcements must be made. b. Information counter - call emergency services. c. Warehouse persons - check offices and restrooms to verify total evacuation. Check sprinkler valve to be sure that it is in the open position. Evacuate the building. d. Department managers - check immediate area. Man fire extinguishers as necessary. If fire is out of hand, evacuat~- the building. ( e. First aid personnel - assist with evacuation of customer~{ Administer first aid as required. / f. Unassigned personnel - assist with evacuation of customers. Get yourself out of the bulding. 2. The following should be planned in advdnce and all personnel should be advised of same: a. Management personnel should be aware of the number of people on duty at any given time during the day. b. A preplanned gathering place is to be arranged. The area selected should be away from the building and from any emergency vehicles. Employees should be instructed to go to this area immediately upon completion of their evacuation assignment. The first management person to arrive at this area should make a head count so as to be certain that all employees are accounted for. ti· No one is to re-enter the building unless it is absolutely ! necessary. In this event, two or three man teams should enter. Under normal circumstances, the emergency authorities will be the ones to enter the building. d. Employees should be thoroughly familiar with emergency escape routes. Floor plans must be prepared showing escape routes, fire extinguisher locations, etc. These floor plans must be posted in strategic l~cations and all employees must be instructed regarding building evacuation. '-..-.. 3/85 Section VI Page 6-A ...~ ·..----.- . _" __.._.___.________ __ ______..._ _.__.___..__~_"_.._ "_"_. .,____ ..__ *_ __H ~ __ ____. -----~ ---. .._~. - - -. íP " -I ," ~. 7' '~ " <;.i r,' ~; .'..... '-- 3/85 . ~-.. . . '.., e. Emergency telephone numbers must be posted on those telephones that may be used for outgoing calls. Phones that are used for incoming calls only should be marked with the "incoming calls only" sticker. These stickers as well as emergency number stickers may be obtained through the Construction/Safety Office. 3. Fire Protection a. Instruct all employees in the proper use of fire extinguishers. b. Instruct all employees as to fire extinguisher locations. c. Mark all fire extinguisher locations. Fire extinguisher signs may be obtained through the Construction/Safety Office. We also suggest a 2" red band at the top of the post on which the fire extinguisher is mounted. d. Inspect fire extinguishers regularly for evidence of tampering. e. Maintain clear access to the main sprinkler valve, padlock it in the "OPEW' position and inspect it regularly. f. Do not block sprinkler heads at any time. g. Strictly enforce "NO SMOKING" rules h. Call the fire department on all fires regardless of how sma 11 they are. 4. Fire Emergencies a. When a fire is discovered, set in motion your emergency evacuation plan. b. When information personnel call the fire department, they should: 1. Give fire department 1) your name 2) your store name 3) your store address 2. Do not hang up until the fire department is through talking to you. Let them hang up first. .. Section VI Page 6-B ~ ., ... '¡., '" ø " -.., .., ft' "- '- . . c. If fire is not too larg~, use extinguishers to try and put the fire out. d. Evacuate the store as necessary. 1. Stay Calm 2. Assist customers in evacuation e. After fire is 'out: a. Fire department will shut off sprinkler system b. Restore system as soon as possible c. Begin salvage operations d. Arrange for fire watch, security services, etc. 5. During an earthquake: a. 3tay calm. If you are indoors, stay indoors; if outdoors, stay outdoors. Many injuries occur as people enter or leave buildings. b. If you are in an office, stand against the wall toward the center of the building, in a doorway, or get under a desk or sturdy furniture. If you are on the Sales Floor away from any protective doorway, wall, etc., it is suggested that you push merchandise off of the base deck and crawl in under the t lowest shelf. This will offer some protection in the event of the collapse of the roof. c. If you are outdoors, stay in the open. Keep away from overhead electric wires or anything that might fall such as parapets and cornices on buildings. d. Don't ùse candles, matches or other open flames. 6. After an earthquake: a. Evacuate the building if possible. b. Check yourself and people nearby for injuries. Provide first aid if needed. c. Check water, gas and electric lines. If damaged, shut off valves. , 3/85 Section VI Page 6-C I, I: I ~v -;;:; ..~ -;f'...... ' .,'" ~ ~ ,f -i' _ ¿- ~;Î .;; ',,-, -...:-' '~.~ ,to, ... . . "-.. d. Check for leaking gas by odor only. If it is detected, open all windows and doors, leavè immediately and report to authorities. e. Turn on the radio for emergency instructions. Do not use the telephone, it will be needed for high priority messages. , f. Do not flush toilets until sewer lines are checked. g. Expect aftershocks, they may cause additional damage. 7. Miscellaneous a. Flashlights should be available in strategic locations. All employees should know these locations. Flashlights should be checked periodically to make sure that the batteries have not run down. b. Have a battery powered radio available. c. Know where water main, gas and electrical shutoff valves and panels are located and how to operate them. d. Establish a preferred method of announcing and reporting fires and other emergencies. Obvio/lsly, you do not want to shout "emergency!" over the P.A. system. An example of announcing an emergency would be to say "attention all employees - 911 is not in effect". Whatever you use, be sure that all employees are properly instructed as to what the code means. e. During emergency situations, two employees should be assigned the responsibility of assisting handicapped employees from the building. f. The manager, assistant manager, floor manager and floor . supervisors should be thoroughly indoctrinated in all aspects of the emergency evacuation program. These management people must be available to answer questions for employees. 8. An Emergency Plan will work "ONLY" if store personnel have been indoctrinated in the plan and have practiced same. A Plan is worthless if you don't know how to use it. While it is management's responsibility to instruct employees, the employee, likewise, has a responsibility to make every effort to follow the Program as outlined. 3/85 Section VI Page 6-0 ¡ ..-" . ~'" ..__.'~ EMPL'EE TRAINING GUIDELINES FOR 'E I I , i I HAlARD COMMUNICA nON "RIGHT TO KNOW" ACT Prepared May 1986 The Hazard Communication "Right to Know" Act was enacted by the Occupational Safety and Health Administration (OSHA) to ensure that employers and employees are aware of the possible dangers associated with hazardous materials present in their workplace. ¡ ¡ I ! The Right- to Know Act requires employers to: 1 . Label all containers containing hazardous materials. ",. 2. ,Have Material Safety Data Sheets (MSDS) ,on ,file.for all products containing, hazardous ma.terials. 3. Provide a' written, hazard communication program to be available at each worksite.; 4. Train employees regarding the Hazard Communication Program, detection and protecti ve measures to use when handling a hazardous material. 1 . What is a Hazardous Material? A hazardous material is any substance or mixture of substances having properties capable of producing adverse effects on the health ,:' or safety of a human being. Materials which are explosive, flammable, unstable or water-reactive are· also considert':!d hazardous. 2. How a Hazardous Material can, enter the body. A hazardous material can enter the body through inhalation, ingestion, . inject!on, and absorption (skin contact). 3. a. b. ...; c. d. e. f. g. h. 1. Precautions to use when handling a Hazardous Material. Read labels to familiarize yourself with the properties of the product and any special precautions that should be taken. Take caution while. opening cases to assure that containers are not damaged. If you smell a strong odor which you suspect may be a hazardous material, vent the area immediatel y . Wash your hands after handlin'g products containing hazardous material. Do this before eating, smoking or drinking anything. Wear gloves while stocking shelves or pric:ing products containing hazardous materials if you have cuts on your hands. If you spill a product containing a hazardous material on your skin, immediately wash it off. Never mix products containing hazardous materials unless you are certàin it is safe to do so. Make sure that caps are firmly sealed while stocking or pricing products. Use adequate retainer strips to prevent accidental breakage, especially if the· products are in glass jars. ,," i I ¥ .:';'jr' Hazard Communication Training Page 2. 4IÞ 'I ! ç- 10.< 4IÞ ~ " 4. D~tection of a hazardous material. Generally, detection of a hazardous material is by sight or smell, but you may also experience the, following symptoms: a. Burning of the eyes" nose, throat or skin. b. Itching of the skin. c. Fatigue and/or drowsiness. d. Dizziness. e. Narcosis (feeling high) or shortness of breath. f. Peculiar ,taste in mouth. " ~ < '. j ~ ' If any of the, above symptoms occur, leave the area immediately. Cordon off the area and vent the area by opening the nearest. door 'to ,an outside air supply. I ~ 5. Clean-up procedures. Caution must be taken when cleaning up a spill or a leak of a product containing a hazardous material. Quick action is necessary, so know where your clean-up kit is and always keep it well stocked. The ,clean-up kit should contain the following: i . a. Vermiculite or unscènted kitty litter. b. Baking Soda (optional). c. Broom and dust pan. d. Chemical respirator., , A dust mask is not adequate protection and should not be used. e. Liquid repellent gloves - vinyl or rubber. NO LEATHER GLOVES. f. Goggles. g. Plastic Bags. Although the immediate concern is getting the spill cleaned up, we should not forget about customer and employee safety. Never leave a spill unguarded as you go and retrieve your clean-up kit. Either call another employee to guard it or ask a customer to stand by while you go get your kit. .of To clean a spill or leak, the following steps are to be taken. I' I, Ii i I I: ¡ 11 ¡:,'-,~., - '." '...' a. Get the clean-up kit. b. Have someone vent the area by opening the doors and using large fans to exhaust the fumes. c. Put on the respirator. Make sure it is tightly fitted to,the face and clear the respirator by holding your hands over the expulsion valve and blowing out. Then test the fit of the ,respirator by holding your hands over the cartridge and breathing in. (Note: If the person using the respirator has facial hair; 1. e., a beard, it may be impossible to obtain a tight seal.) d. Put on the goggles, making sure that they fit snugly to the face. ,- ~ ~~ , ',,'~~zard 'Communication *nlng Page 3. . ,;¡ ~ '~ . ¡ I e. Put on the gloves. f. Take the vermiculite or unscented kitt Y litter and pour a contain- ment ring around the spill. Then pour absorbent on the spill itself. Give it adequate time to absorb the liquid. g. Sweep the absorbent material along with the broken container into the dustpan and put it in a plastic bag. h. Optional: ' Pour baking soda on the remaining chemical, sweep it up and put this in the plastic bag as well. This step helps to deodorize and get rid of some of the smell. i. Wipe the floor. with clean paper towels. and deposit the, . ^ conta'minated towels in~o the pla'stic bag. " 'j., ,. Wash the floor" with"warm, soapy water. Wipe this up and then rinse the area with clean water. and ~ wipe the entire area dry' with clean paper towels. Deposit all towels into the plastic bag. k. Seal the sack and dispose of it properly. If you need' to store the sack prior to proper disposal, put it in a container with a tight-fitting lid. If instructions are needed, the Department 'of Env ironmental Qualit y, Agricultural Department, F ire Department, or the chemical manufacturers may be contacted. 1. . Thoroughly wash and rinse the dustpan and .broom and allow them to dry. Perform this procedure with "gloves on and then do the same with the gloves. m. Disinfect the gloves and respirator with alcohol before putting them away. . n. . , Wash your hands thorol.lghly with soap and water. o. - .," F ill out a '. Incident Onl y report. ~ ,\-' . . . . , : I : I ,I ; 1 ~ I " :1 6. . ,.,,' \", ,'. , ' Coping with large spills. . ~, . .Þ 1" j J. ¿ ; ,i !.- . .,' ~ '..,.~' .;:..' ','. .' . ~ .' .'. Because our company handles products ,which are packaged-for the" customer,. it is unlikely you will need to deal with a large spill. " However, if one does occur, immediately evacuate the 'area and seal it off. Have someone call the Fire Department and request their assistance. Be sure to give the Fire Department the NAME OF THE HAZARDOUS MATERIAL so they will know how to respond. .. 7. FIRST AID PROCEDURES a. If an employee or customer is overc:ome with the effects of a hazardous material, Immediately get them to fresh air. b. If they are sprayed with a product containing a hazardous material, rinse' the area of contact with plenty of clear, cold water ,; 'f for at least 15 minutes. Then wash the area with soap and 'rinse again. , c. If a hazardous chemical has been splashed into the eye, hold the eye open and rinse with plenty of cool, clear water. Be sure the affected eye is on the bottom. d. If a hazardous chemical is accidentally ingested I give one " glass of water and immediately contact the poison control center. 'I ,- ..~:fi- '. " Hazard Communicat ion.aining Page 4. ~. '7 '!~ '" ' .' 8. L.ABELS All containers must be labeled with the following information: a. Identity of the hazardous ma~erlal. b. Appropriate hazard warning; I.e., flammable, combustible, toxic, ~arcinogenic, etc. 'c; Name and address of the hazardous material manufacturer, importer or other responsible party. d. All labels must be in English and predominantly displayed. . Containers! wlÜ; manufacturer labels containing the above· information ,do not need to be re-labeled. . , '., ~. ~.:} EXCEPTION: Portable containers into which hazardous materials are transferred from labeled containers, and are intended only for the immediate 'use of the employee who performs the transfer, are not required to be labeled. Immediate use is interpreted as to be used during the same day as transferred. .,,; ., 9. Material Safety Data Sheets (MSDS) Manufacturers, importers and distributors are required to provide Material Safety Data Sheets on all products containing a hazardous material. Material Safet y Data Sheets are to contain the name of the hazardous material, the name of the manufacturer and emergency telephone numbers, as well as information concerning the physical data, fire and explosive data, health hazard data, reactivity, spill or leak procedures, and special protection and precautions to use when handling this material. Material Safety. Data Sheets will be available from the Main Office Safet y Department upon request. 1;0. The Written Hazard èommunication Program. The written, Hazard Communication Program will explain training and labeling requirements, methods of documentation, and how to access the information. The written' Hazard Communication Program will be incorporated into the safety manual and will be available to any employee or employee representaU ve upon request. \ , . ¡ ~ ,. ., . ..;¡-.;:,.~¡.:.,,' ,c+~~ _.....~ ." .'. (.--:.., 1,11' ,·,':,:,··.¡.·.,K.:.'..'..... .:...,,'.. .:'. ê.t.: i,'i ~j:)" '< ~,.' ': ,: · ~' I,">';:H' .. . ~.~.~' '.~: ~ (, I . ~ 0-. '_~"~ t;·.. /t lV, to ~·Irf;Jflu,k~I{~: ¡ IYt &rté¡¿ b Ì}(sl ',..... ,·1 ' , ¡"'",;¡t;f:.+ ~,') ~ . 1U"'~ ,: EMPLOYEE TRAINING GUIDELINES FOR THE " . , HAZARD COMMUNICATION "RIGHT ,TO 'KNOW". ACT I I ¡ , ¡ I ¡ i I i ). ì~ .~! J.¡,:~! ..... '.- ,. , ..t f .~.¡~~ ~.,: < !f' ',/f¡\t L . ~, Ii" The Hazard Communication "Right to Know"Ac{ was ··enacted by the Occu- pational Safety and Health Administration (OSHA). to ensure, that employers ~w ~.. and employees are aware of the possible dangers" 'associateq,'i w,ith ,hazardous materials present in their workplace. ,'f';:' ,", ' ,. ..,,/:.'.. "! ¡.. 'I'- ; - '.1-:, ':....:: ~ ,r , f. '. ~ . >' P.. ~. " ":.'; -The Right to Know Act requires ;employers¡ to:~:~~::'~: " "'ì:." .; ~ ,- . '! i"\ ,j ;' '::~;'<i;'~"~~,;'>" 1. Label all containers containing hazardous materials. .: ,': '; (' ','((,-, 'r-><.:.> f;.....~.:.:. i ,)~ ~ _';0;'" . ~, 2. Have Material Safety Data Sheets (MSDS) oniUe for all products containing hazardous materials. \ 'r¡ it· ,"., ; , \,:.U" ; ,.' I ., - "'.. " . .-::. {"("1' .'~·tq Jtt)\t J~ 'r~ í ¡ 'II ' ! ' I ¡ I I ,I Ii ! ~..},~ . 3. Provide a written hazard communication program. ,:to be available at. each worksite. . .' ,,' ".,. : "~, ,,' ':1 .:~'u::i'I¡;'~ 4. Train employees regarding the Hazard' Communicatiòn . Program, detection· and protective measures to use 'when handling, a h,~z~rd0':ls material .' '", ;,',.t;. /; ~ ''1;;..;: ",;. , ¡ . . . { ,t ., : ¡ . '.'(;"', ~ r;~ What is a Hazardous Material?q .<.",';~~¿:'!i' ",i<'¡~:'-, ,\ '.' 1. A hazardous material is any substance or mixture of "substances having properties capable of producing adverse effects on, the health or safety of a human being. Materials which are explosive, flammable, unstable or water-reactive are also considered hazardous. '.', '- " ',I- , . ; "1':, "';¡,','(' "l~ -.', ~ .,; \r._~ -'n ';: ! ~ . "Ú.",· 2. How a Hazardous Material can enter the bodY.·':;;J~''',1.}~:: ji' ';':,1 . . . -'-! l ¡ " -'.: .-, '. ~ ',.' . '.", :. . , ' > ~ .' 1 :..~ A hazardous material can enter the body through,Jnhalation, ~ngestion, , . , injection, and absorption (skin contact). ,>i:~':)'~".~¡;l.~:· ;'~i,..H1,¡' ': .', .," ."~)J.r 3. -¡ Precautions to use when handling' a Hazardous Materiat'\¡F,··:r '\,' i . '; "~; . .1..' ,~c~~;;.,,· ';t, .. a. Read . 'labels to familiarize yourself with ,. . the properties' of the product and any special precautions that should 'be 'taken. ::~¡~ :~Vf (I .. b. ; ,~ Take caution while opening cases' to :'assure : that'·; containers are not damaged. ~ : ., ; ',~'l: ;":'f~~)~; :Jtlf..i~l'~ . ft ,_. c. If you smell a strong odor which you suspect may be a hazardous material, vent. the area immediately,"! ,,>..,. hq.- !(}('\.Ii,q f' .. 1o.1!· i~ r¡c" c' d. Wash' your hands after handling products ~ containing' hazardo,ys material.' Do this before eating, smoking or ,drinking 'anything."I;>.,; , e. Wear gloves while stocking shelves or pricing products containing hazardous materials if you have cuts on your hands. . ¡ í ¡ 835 8-5'':'88 f~ ------ :Y":¿::ri; .' >:~~:~~~~ 1.: ~', " ", , '1' \ ," ",', II :: : . I ./ ,¡ I~'F - "]I., , , ,', >,'~, 'I :;::~; , . l\ n . ',::;~!/~":' , l ¡l ¡' ," :,:;} ¡ . ':" II . ~,- ! , ,I ,',' '! ;;.".; " ' I , , \; ¡ .1 '.. ~1l' ';:/. ~,~. " . I;· ,.,,;,' ",1',' , ;. :',..... Ii, '". .jl '. j! .,-; :H ' 11 II ' 'II " ' !' , " ,1:, "., ( , . . , , . . II, -:' .: '(, . , i I J ! I /, I·l "'11:.:,;.<, ! .'. - \ :- '''f ; , {¡.. ji ;¡I 1: r ~ , i J '1¡ I ..r i . J ¡ I I·· . .. , " . ~ il } , ~ , , ~,'('. ;í . . '.,.J :-'¡ . . ~ ...' . " , . ~ Hazard Communication Training Page 2 ' f. ';! t ." ;/." · ¡'f' !~'7ì If 'you spill a product containing a - hazar~?J.1s. rpaterial on your skin, immediately wash it off. ¡ ¡ 1:::.!.I:'~:'! (:\,} .'.J.~~f.,;.~~-~f1. '. , , '; . . g. Never mix products containing, hazardous materials, unless you are certain it is safe to do so., ,~~., 'f~,i·t'·"i 'mrI1P" \ ":""'È~¡ .;,¡!: "n~~t'.1 ..1.f ~':.~~.', ~,;r~:.:t;;~· ·~·';'t>rt..lt,:~,i'l';~· ~i~~~-f~{j<:"~t:.. _,.:. ' ' , h. ,Make ,sure t~at caps are, firmly J se~~d,~ .,~hi~~,,: stockin~.1.or } pricing products. . 'i}~n:\ ¡,;:~d.i ~1,r:h"''':I~';D ;"t.t,¡)¡<;:~~' ,', I I i. Use adequate retainer strips: to .. preventc¿accidental breakage, especially if the products are in glass jars. 4. ! . i. :;t~:~'~ ,{::? . >~t;~!',,7'\ JJf~ l~~.;'~ ~,~ Detection of a hazardous material." .. ,;, , . :" \t~í.)1;'.:~~ ;'1'.1·~~f:' :,.,]' '.f ~. Generally, detection of a hazardous material' is..,by .. sight or smell, but you may also experience the following symptoms: . , ~" , . ,;! ~,.;f "- ,\l¡'fÞ~.~: ~\, :~~h.i'-~c:·'''''r. a. Burning of the eyes, nose, throat or skin. ",:,' ~ :~':r! i:'!'!"' " , ' b. Itching of the skin.' ~ ~ r . , :. t:?, '1 ,1 ~ ! (f: . '~ i '; t r , '. ,_ ". ... C,: ,,' " ',' .~;,¡ p ~, . '0,' ", ,. ~:. !-, . I ~ : ':':; ',! 1 ,~.; ø '.: í c. Fatigue and/or drowsiness. .1 $. ':,l¡,f" d. Dizziness. : .:, . -1:,;1,1SJ';'; "t~;);> ¡;)$'-GJ'; r;: :::" ·~tsfr/i . " . ....~.',_....., - , e. Narcosis (feeling high) or shortness pf b,reath.;: ~ ' " , . . !'~' ;. d f, ~ I, ,,' f. (t ~ ~ '. r.,.", . '.' ~~,: ".r·tr.:~ ;~"~~J' . " !"¡";\fdPr ': "t ; Peculiar taste in mouth., ,. " , ';fU1 " :~,~·'t>; :,·~·t ,~,,\>,#,'-t:': '1~- ,. ··:i'··.I'''!~t If any of the above symptoms occur, leave the area immediately. Cord off the area and, vent the ,. ar~a ¡~ by,: >:,,~open~ng.: ¡ the· : n~arest : door to an outside air supply.- -~ . ." ' -....~, ' 5. Clean-up procedures. f¡~~) Jrl'~~~~~'{J:! ~:-"1";L~c1'~f";f~ ~, 'q"~. '.:f:.)~ f;;·....!t'i'~1t}.·~!i',:: !~r~.·. ~\ .··1i"'1.~~ic·';' , , ',!, Caution must be taken when cleaning up,a¡spil!.orra leak o~,.a product containing a hazardous material. . Quick action is' necessary, . so know where your clean-up kit, is and always'\ keep ;.it;J;well ,,;stocked. The clean-up kit should contain the, following: ,'~ ·1rri.. hiH~ :1;.": :YV! a. Vermiculite or unscented kitty, litter. 1';' p"! l1J¡3~:'~' ",1 . ! " b. Baking Soda (optional). . h"'-~!,\iS:" ,?:~." 31,~ ¡ ¡,!,. ; \ ctti":"; ~" U">j';,\?; to. ;'J "\1 r~,~','~r.: '-:r:: ". "~'? ~h"l~-~f~ '-,:';:""'-i If . ~ c/) c. Broom and dust pan. '.., '¡,"\, ,'. ',d. Chemical respirator. A dust·, mask:,! is j' not," ,adequate p¡:otection and ~should not be used..i ,>" ~ ¡ :';'~f ¡ ',; IIh.'...j~!;\'~I'·/q I I I e. Liquid repellent gloves - vinyl or rubber.', NO,;LEATHER GLOVES. ;1 t ;! "<~\~ .}¡ ~~ t ~';-~::; it 1Ui 1~:~f\~r.).d ,.,.1 "" Hazard Communication , . ¡ , '¡ Page 3 .: : ;:;~~:\; ",,' - "::..' ", 'i '~-.' _," "':" ~.\t~·';"I; ._.¡.~..·.f. ~.: Goggles. _..".. -~~. :¡~:'~-'~~", -, ... . -,.' . .--~. . ,'\<r-15.~·f'~· " . g. I'~~stic ,þ~gs. ," , , , ~'.:~~rt..: >"~' I \ ,t' , . ; .''-..- ,. ,"", ~ ~-' '-. -~' , ,'. .:"'1" . ~~i) ":¡"'''' .' ;. .:", ,".- ...t~'¡Y-'fj , ,f)~I .~~ '.~~¡~ ¡ 1 '.~, . ,- , Erd-f;! ,~' ,.' .^'....-:...' . ',(:-'::>';'" , > ...: . ; . ,- !, .1: . , -'., " ,-" ".- . . . " ::.' :q~c~,,:,tr n'\_¿~~· ~·t~}i;¡~·'f1j!;lf/.) b'\r'1'~.7~il1 t, "'i~ß-l 1'1 .... Training ..:, t: ;-~~~;r·. ~1:.f~··; 1.t~:~'~J j~; i"~~ ", "; .~,~ -~'J~~3~ "t'}r1:ì . ..;-'! ". ,~ . 'J'\/" " \ >,.~ ¡ " . 4" ~ .' ' .. .~-: ~ '~:r:~ ê :;! ¡,,_;!¡.~~.J~~ . ;.~ ',' . ;·_~·~·;.·;·~~·",~~~~)',;~f·\ff~~~,""'~'~ . -: ,. h ~. ·fl' -:1!ti r-;,,;J.1 ~{r~~ /1:t~:·.t¡: : '..' .... . . , , , Although tþe immediate, concern ' is getting the'( spill ,'~cleaned r up, we should not' forgetab9ut customer' and, employee \'safety.,{¡:;" Never leave a spill unguarded as' you go and" r~trieve'1y;our . clean-up;¡Jdt. Either call another employee to guard' it or ask a customer .to stand by ~~ile, YO~,go get your kit. ,:;,' , , ' ¡ . ;-!: ';.;' :i:' 'f _",¡;~, . w ~~ 1':-t'1<\ : ; "} To clean a spill or leak, the following steps are to" be taken: a. Get the clean-up kit. .J:' j..;;1p ~ .:~~1'~ .... ;~f'tr:·~-t'.¡· ~,~t~$~~~ .P \ .' "~ .. . ";.'f..;:~.~i ,':" . .~{.~,~.:-. '~'~~'->o , ,'t:', b. have someone vent the area by opening the doors and using large fans to exhaust the fumes. flÎ\'i.~ "1d "'¡î~~f "';'Jg'.;~.(\ 't .: , c., Put" ,on the respirator. Make" sure it.,:Ís., tightly ,~. fitted, to the face! and: clear the respirator' by' holding' your .~ands;;'over "the expulsion valve', and blowing, out. ,':': Then: test, the Lfit çf "the respira- tor, by ,holding your hands over the cartridge, ;and breathing,' inj (Note: 'If the' person using the respirator', has l,faciah hair; h Le.,. .a beard, it,' may be impossible to obtain' a tight f seal. hJ.ì ~:¡ ¡Í : , ' ~ ' : . 1.. f ...! ,. ...' , ".,<1,. " t-:¡'\ '1 . ~ ; '. ; ~ ~.' : ' , d. Put on the goggles, making sure '. th~~:;.they i fi.t¡{-ßI1ugly:¡ to, "the face. ' '..--",' . ' d,' ,,,-,-,.~~,, ' '...._, . " ',': e. ':", ~ut on: the'g~oves. .îi '><~~h'q:~ . ~~.~, ~~-:::4-)~;J;1fXi~·~:,.i~~'~~I.~~~·;11 ;.':',.::,--:. {'~':'~~;:" :; ( ~j~, .\ 'Ii "Y'¡YÙ~j;: ,;q¡;H.¡,~~~~;~, ", !,.., ,~! !:h,,' f. '. Take ,the -vermiculite or unscented kittyJitter"and pour a contain- '~ "',, ment ring" around the' spill.": Then.pour. absorben~,,~on' the" spill <;..' I i~self.,; Give it ade,quate time,¡to' a~sor~\I~~e .li~uid~!'.:!;="i';;' Ì, '; ,:r.;:-\0 , : t" ':' t· . ~ .. i ~ g. ~!'. ",', ~ . .' 'l ~: f: g.: Sweep the absorbent material' along with the broken container into th~ d,us~ pa,n and put it in apléis~ic?~~g. ;:;~~l.ìri' ,Ú 'i' _j ',' . ::.\ . '.~:._, .', '..¡, ...~.'1}l"~¿)11.~1"}" ..~. -~')ff~~'/<'. h. Optional: "Pour baking soda on 'the,remaining,-'che~ical, sweep it up and. put this in the; plastic bag as well. t ~,Jh~s: step helps to deodorize and get rid of' some of the smell. ,I, ¡~'" . ... ~< . ".:..,. ~. t ~ ,. f ! i." Wipe the floor with clean paper towel~¡\~rd,.;<!ep,?~~,~\~t~~;: ~ontamina~ ted towels' into the plastic. bag.'" 'if',";" "",i¡i, '('" ,~'" j":¡ìÌ,' '~~) , .t (1 , j. Wash the floor with warm, soapy water. Wipe this up and then 'rinse the area with clean water and, wipe ,the entire· area." dry with clean paper towels. 'Deposit 'all towels . ,into ," the "plastic bag. 1~ i ~ ':'i . >1 , ,I 1 ¡ ! 'J I :¡Ii , II f, r Iii ii I ìi \' ii Ii II jl II j¡ Ii 11 1'- . I; .1; " , \1 . Jil I, I I: ! I! i I., !~¡'. I i i' I II ..'! : î¡'j I ¡ I . ; II II: !I I, I, II 1 ! i I , II 11' ¡ , 1 i I , ,.' I I 'I \\ ~~l' ',: '" I ,~,J ,'" ,¡' I' ". , '£~ " , I, 'I, . , , ..= . . ",'1<>, .;... . Hazard Communication, Training Page 4 " I ,II ·1 :11 ' Ij' !, I: 1! ! , , , ~ <.": "." ,'" " k. I.: (l~_~;"'t': ij;',,:1f'" ~':.Oi~1~~j(~ t-t~~J'~1;;'~' ~^! ;' . ~. \ "." -X'~. ~. " Seal ' the sack and ,dispose of it properly. ' If you needt'o store the sack prior to proper disposal, put it in a. container with a tight-fitting lid. ' If instructions are needed/'the Department of Environmental Quality, Agricultural Department" Fire, Depart- ment, or the' chemical manufacturers may be icontacted~ ,~~ ~_~_. ~ 'w 'I . ¡ ;:' '~ . . '.' "i~!; :~~t\;1.. :.!-{,:..., ¡,.··f·,f-.· "',\1.1- , 1.' : Thoroughly wash and rinse' the dust i' pan! and', broom' : and allow . . ~ ~ . , ' -t; . t } ,J . ~ them to' dry. ' , 'Perform this procedure with" glóves :", on ~nd then , d hi. h h I "')'1' ,"q f""'" ,"it:; ,;..,! ;~L,:' <, , 0 t e,same..Wlt t e goves.,· . . ".",,~; .r;~'~:~:;";'::'H.tl'."k"" :..../... , . .".' ~ -:'"'' ." .:' ~:,.,:.l?'[.'~ :;".}l' d'- i.:", .'\.~~ 6. Coping with large spills. , I Because "'our company handles' products :~which "~¡~re ¡1:pa~kaged ':> for the 'customer, it:' is 'unlikely you: will need': ~o 'deal !)'With' a large spill. ".' ,'However, 'if one does occur~' immediately" evacuate",'the ,area and seal ~, it off. ;'¡:'Have someone call the' F.ire"Department :an,d': request their :'assistance.' 'Be sure to give'the'Firè' Department 'the NAME OF THE HAZARDOUS MATERIAL so they wl1f~know':hòw';to respond. ,:' , ...:,. >': ',\ i 1_ 1 ~ ~: , ' i ' .. ' ~ . ¡ " ~ ¡. m. "~'')' 1'~ ' ," " Disinfect the gloves and, respiratòr', with " alcohol' 'before putting , them a~ay. ,',,' ,"" ' ',", ,~:t:.'d ),", 1"{3;) F; ," ;, ,:'\ n. Wash your hands thoroughly with soap and "water.;J" . ,I: ~'~¡I/Y;' :::"~~~: ;;,};'/, ; Fill out an Incident Only report., ~1~:\ 'J :~ ''{'8~~i~1n'? .,,0, I tfl I' ~... ,,~~t~ ~"(t'" o. .' ) ~::. " '+> !:"~J :-'~1r,~£ " ô' ; '7.' FIRST AID PROCEDURES ;;q~ r.~>...{o·.': n-r~ ~ nr) : ~ j~~ , ., ~ , ~ ,!,.., " " t - .~ : . "':t r., ,', " '.. tlf" J' i! ' j .1,' l' ;1 , , ," (.., " f .. :;,,,. , ,d. ~, ; #', ¡ : 1 ¡ ,¡ \ I j 1 1, t. . ~~ '-;' a. If an employee or customer is overcome ',with : the ef.!ects" of a hazardous material, immediately get 'them; to,';f~~sh.. air."",,, (1" " , . ¡ . ,.'" . . . '. ,. r'J ,. .~ .: '1 . If they are sprayed with a product con~aining a hazardous material rinse' the, area of contact with p,lenty; of c:lear,,~,cold' water for at least 15 minutes. Then wash ¡ the' area" with soap and rinse again. ,,', , '\ ''''¡O:ff.1l~l~,¡:,,\:¡~,.i::;h ;:"\' , .. ''; " ,,,' , , If' a hazardous' chemical has" been'~ splashéd". i~to'" the eye, hold the eye open, and rinse with plenty of "cool, ',clear " water. Be sure' the affected eye is' "downstream" "~ so, ,tha,t; th,e che'micals being rinsed out do not get into the other ey~. ", t..,,,.'; , . "".,~, . ...:.:;.' \''r~ ~l"~'¡'~~ I b. c. If 'a hazardous chemical is accidentally ingested, give oQe glass of water and immediately contact the' poison 'control center.' . :' '.:, E¡..:· 1"J:_: ~:J\)ý~".' ~,:",'- .. , " ! , , ',' ,'to C"· ,.:....{. . :,. ! ;~{j r'~ i~ HI1 ;;/,:J .:;~-r:{~':';,r ::'111'- (u';~l=) :iq~..: I ,} ~tr,r(~'f;~ ' j . ",~ 'i ¡, )'1 ,:::,.( ¡ "..1;'1" 1 1 ;:' ';" ¡" ,,: , I 1 ". -. " ] ",:.; . ~ ," .... , , .f: .~. .' . "., '" '1_;',' ~'. {, , , ." "-. ' .>;'<. "...' " ...: -. I I , ¡ ! . - '.~ " "rf'îh :-:'" " . \. Hazard Communication Training Page 5,.' ,. , ., ,c':' ,. ">, ' : .t . ~ ~ 1'::. ." ~ ; " '..~ ~" -J - ~~ .,/} ;~.' ~ .~."t'~~~J<~~~.(~~~-s~r~! f~~)~¿~3., . f~ : . .~ Cr,,) j~l' , Labels 'of" . '. 1<: ".~ . 1~:\'~ .~ ';í~r~'~"'!' ï'~~;,:"r( ~':!:{"'C All containers, 'must '¡be labeled with the 'following ,information: ,,;{Y\ f' ',,; a.:" IdentitY¡jof, the hazardous material,';"\"¡,J~' r~'~;}N~~) ~~:~f;¿;.k··"(::.:'··J~5t¿~:k! " . . t'~. ',. .:. '. ',;. ~J. ".~' - '. .~" j' . ~ . ' . ~ _JO~ \., ~: :~~ì~ ¥ ~.: ~ ¡- '-r"f r~. '-"~iJb~ 1:1. -,tl.~f) ·!\:b\}d~~,'!~; i ~·ít·Ttl(r\~l,·:·~ .' - \ b. Appropriate, hazard ,warning; i.e., flammable,' combustible, toxic carcinogenic, etc. \~J .' " '_..4~.._ " '.~.. ,.,t.,."~_-,·~~,...,......w.",,,~,,·-~·.···~· ~, \- :'C, c. , Name and address of the hazardous' material-manufacturer, iimporter or other responsible party ~ . ' l:-!·d,~" ~ ~r"'~' ~.4~f1'Î .f: ~. .:;·!:t~J¡H' d. All labels must be in English and predominantly displayed. Containers with manufacturer labels containing the above information ;"do not need to be relabeled. ~XCEPTION:,} >ç..< J ... ',,,,,~,.,,,...., ~~'-; ;: 1, J$ r' '. ~~'fi~: ~·~"~·-?r~"tt¡~;;'· t ~ ~'t'{:i~-?"~~+' , ' Portable containers into which hazardous materials are transferred from labeled containers, and are intended ' only for the immediate ;"::.",, use of the employee who performs' the'-"transfer,"'¡are r'not' 'required . ',) to be labeled. Immediate use is interpreted as to be used during the same day as t(ansferred. !' w; ," ¡I(d;¡ ,,':1':1''''('/) :""';'::',\) r!1h·· '... " ',.. >i·'J . \., trr:'~ ;~:'~ -' " ," 9. Material Safety Data Sheets (MSDS) ! : , \ ~ \ , 'o~:>t. '" -f " Manufacturers, importers and distributors are required " to "provide Material Safety Data Sheets, on all products containing a hazardous .. material.'" Material Safety Data Sheets ;:~are -~ tö ~'contain ,,·~the1·1 name, ',,' of the hazardous material, the name of the manufacturer and emergency telephone numbers, as well as information concerning the physical data, fire and explosive data, health hazard data, reactivity, spill or leak procedures, and special protection and pr~qautions; ;;tOy\ ,4se when handling this material. ..... ,,;¡?~""" . '.'" ,.,..w ' ',,; -: ,q':,' ~;'1'. Material Safety Data Sheets will be available from ~ the Main Office Safety Department upon request. : "~,,, .:. t, 10. The Written Hazard Communication Program. .". '-. .~. . ..... ,"_._ ,- #'>~"'" r ~" ::" The written Hazard Communication Program will explain training and labeling req4.Ïrements, methods of documentation, and how to . access the information. ",i' . (:1. ", ',The written Hazard Communication Program ;will1be: incorporated into the safety manual and will be available·' to \ any employee', or employee representative upon request. '.' .\¡ , t'. .~. '>.-' ~ ,;. "!" " . ~.: ',' ! . 'J"¡fl":¡~:'~7~J{'r';;7~~ ,:~,;Ú\;i' ' /..,.,.".--,....,j' ,'. .<'"" ""'" ~. jl···'·~';;?}t";'i:f¡ ,~ ir ' 'LII . I ' I' ¡i/I I: I I' '111 i II II :/ ;¡ :/ II II '/ I I , i -.".. .- \. "t'" I.' HAZARD COMMUN¡CATION TRAINING CERTIFICATION: ,i;.ìt;'i ·¡r1.t:Ht\~ ~ ' ,. '" 'l"':· 1" r~:~~;':',i£ { . , -#- '.¡}, -~.; ". ';,:--: 2~':';{,¡,:, ,1.',:' I,:,,, '. This form must be completed after completion of the' training' program. A copy of ,this fonn Is to be placed' In the employee's personnel' fUe. I" ,.", . '. . ' ".~ , ., . . . I '" '. . (~_ . I have received Hazard Communication Training:'ás 'described';in the.G . ,written Hazard Communication Program. The' tralnlj1g was. ,conducted),on '" 'i ' ' L '¡,." " ;'; . '};~" ';«.~~;':,~;~>;;" ",,,¡.. - " 103 " ; '~', I hav~ been instructed that' I am to. foUow':al( related~safety procedures ~; > :.~-'" 'fr:~:.:ìl!"~'~'~ ~ t " ;.~ ''./\:. " outlined in this ~raining. . I- 'I: f' t ;I..~~~ :~~;:...f'- " , :~~ ! . <1',1 ii' '¡¡\~ i ~ - . '1, ;. i¡_ 7ft ~ ¡ ~:" ~ r ' (,I'l ;.~11; ~' ,f l"f " . ~ . ~ j '(·(;',:.tfl ~ j ~"~: ! ~... , ~ "V'~ :~ :'} p <J ....... :\:r: .h: ; .d ! Èmployee Name (Print) Employee Signature " ~1 I, ~ ~;"/;'~r >.t ~. be", . ".' ""¡>,.,.., .",'.n", . ,. . '\. .. "',!I' , ,,:.,.r,' ,'lr,i;; ~. . ;J~'~(j-;j~;::¡ ~" ~~~ " f:'JJA'i "~Ii': <:, . . """'" '1 herby "certify. that : the above named ¡.employee 'I)as,\~een'" provided ¡j1I ~ì~h Hazard Comm~~lcatlon Training on · '. ",F, r<':i~' ';,;!):,::; : ' , , . ; r ,~.. I : ;""í r ¡; t ,'~ ": .. : . f1t,h . I··· I ;!t. C· ·H'~-; -.; "4~.: i? .r r.~ ~ i..I.t'ì ~ ~ f.ì .~i: . ., ",.~~ .~ {Ì ¡.... " . . ~t:Uf~.'" . :"1'; i ('Í¡(J j~ij ~ .,' .,ê.f,~·,',,: ~,.'.'~'~'.(~ ",f ~f':,,:,~,...,;,!,l,.~,'\ ~ r~ ':',:1 ~,~ 1..,:;"( V._.. ~ _ . . ,-: , ~ '. ~; : "". ·f; ,,' . ~",:,;j-:.., Instructor Signature .. ,::('~i ;,t:¡~,'>; ':'t:~{!¡,~)",.. ~' " ,~::,_:'~/~;~'1 ;-\ .~ ~. :'," /rù-·~~'r \ i¡:.~ 1 ;! ~~d': ":)f:.f!~'.~1"~-1tf ri:"~dv;~' ,r,i: :<l '. ~i¡Ynstructor Name (Print) .. I~I¡'i~~' 'I::' , . , \ ; "!. ,~ . i i ":-I; ; " . ..' ¡.. ,-.. ~ ' .... r . .. ~. , HI;]'" :;:,~t.'Store Location: i ~ . }:.. . '; ! ,.;~:~ >:-.i ,:1 .. . ~t~re Number: ;):ì!lt ~t ":;J .,;,: ',i:=r¡ p,lf;,:' :~,~'..,'" ~,~ . ~ \ , "·t ,~-:r,.l ~ ,~.t'}\~i ·~t í { ~- ,(J¡ i{!1i!1iç, - " ' ~ . f. ; f :~'~ .. . ';./,.',: ',-; , ::>:r~;' ~. .,:. :~~?; \~~~:'<'.:i ¡ . I"~dt rt;"-~-18 .. .' ~ "t' . , ; ',' r.~: !T.\~.. ,/. . f;;;'}·.Ìf~ -;}.,; . . -¡' '¡. '1 "t.....; < ..:~ "do. -':"'.' . : '.\:r. f\ 1 , 1 .'n 't ; 1'- ~J , f··,> ,. !"t;t'r '. j r~ { " ~ . '"1 . ~ " ..... :/';j i '~:è ""!:! f' '-;'n~ ,J "h1 ,!< ~'" ~"<.j .1": ~¡:~' ..."..' .... ~,q : ! j I I Î I I ¡ I' I) It " if i' ¡ , I , 'II fJ " ! ' .¡.- I Brand Name Brand Name ~ " .~ : " ~., t ~- "\ " Brand Name Brand Name " ",- - .. " .'- " ~. . ... . ',.. . ,~...' . ~., '. , , ... , i I ¡ ! I, Ij II I I IJ ! ! , I , ! i " .¡ .:; ¡ I I , . -- ¡i I' '" ~,' ," , II III ,,'>'i, 'j !' ill, I I / ¡ .,:, " , ".~ "I, .,;', II! ¡ i I' Ii ¡ I I: ,I I ¡II," ! ¡I,i Ii . 'I' I II , i I 111/' {II Ii I , , I :1 ! ! I I ' i ¡ í I ( .. ,'< "0' . "-. .:.- ,'~. ;. ., , " , .", ~. , \. ,. . '. ""~"'~,;¡ . /'~'::~'~f~~i ~~,I': '. (It=' " : <: :, ';-~~ ;:F~ CUSTOMER AND EMPLOYEE 'f!:':;~ ; ~ -',' , ¡ . ., ~, .. "~ ' , REQUEST FOR MATERIAL SAFETY DATA ',I I " ~, . ~J";i'~ t.· This form' is provided for your convenience when "requesting:: Material SafetY'Data Sheets. The Material Safety'; Data Sheets;'will be sent· directly to the party requesting them. '. ¡. " "f:~ :'-. .1.~.·'~ :!""" PLEASE PRINT .",' ~,~- .' ·1}.';- ,', Business Name . , .! t t, ~~ ~_ f <.. ... r i' r '~"" d {' ~ ~ r, Attention: .... ..: f~r~ ":~-~'~,~iT~- . ..-~ . ; . , , " Street Address t., '. <...(. ".~~.?J:~~¥' " !. , ,'. ~ . .", q.-,.¡", 'j~o1-" (tiy¡.-L¡'if:< r'~~~',' fi.'i~ ~. City ( , State " Zip Are you. ~n Employee? If yes, store location: ) ~- : Yes 'No' '(Circle One) ,'r" , ", . t <~ ':'~ ~ '~~7:;'~' . . ."'~:: t i , >c" Store Number: ~~¡!I /.<.:.. (I~j,¡~( , , Please' list' the name of the product(s) you· .are requesting Material Safety Data Sheets for: .' I" . '. tr' .~. , ~~':~\-f}: :' ~ { .. '" . t' ~'. ,- ~ ." z ~ ..' ....-:.: Complete.Product Name ,,~ ~ ' nf ~ ~ Complete Product, Name'; 'I. ''". . ~ , ~ ~.. '. ~ q't .. ",'. -'-r.'~ r:: Complete Product Name .' ~T~' ¡~\f. :".r:j..r..', :~. ..... ;".J~:t,!",..#",;r_·! Complete Product Name When this for~' is completed, please forward ¡ to Pay ~ Less' Drug'¡¡Stores NW, Inc. Safety Department, 9275 SW Peyton Lane,' Wilsonville, OR'!97070. ~ . \... ! ".0;:(1'; :- ~:",ri¥.Þ:i:~rt,:, . . ~ :-;-:.; f ,., ' I BUSINESS NAME PAYLES~ DRUr,S LOCATION 1914 WÍ8LE ~D 10 NUM8ER 215-ØØØ-ØØ1158 HIGH HAZARD RATING I 1. OVERVIEW J'URI S CODE Z 15-007 J'URI'S 'BAIŒR . .' LflST CHANGE" 06'f f"3TB'B" BY' ESTER MAP PAGE 1Z3 GRID 11B' " ,t. SFIEtD STATIDN flf7 - " FflC¡tITY' UNlrS-r " HAZARD'RATING t RESPONSE SUMMARY IA SEC 4) NO PRIVATE RESPONSE TEAM. \ ·...t.\ . EMERGENCY CONTACTS ZA SEe 2) (...Ç."e,LVI¿Sð~~RRY DA~IS - 83Z-4it1 OR 832-4143 HI II3LKKE: - 832-4111 OR 480 BJ~Ø 83 /.~;J 06, r- .UTILITY SHUTOFFS ZA SEC 3) 7 ~ A} GAS - E OF SLOG B - C} WATER _. E 51 DE ) ELECTRI CAL - E OF BLOG E> LOCK BOX _ NO OF BLOG 0> SPECIAL -. NONE ~~\;.;. ~ - . Z. NOTIFICATION I PUBLIC EVACUATION l.AST CHANGE I 1 BY '. W£ l/-~rI E C < NO INFORM,AnON RECORDED FOR THIS SECTION> J- /J1PLof/E~- ' ' ;. .s ,/(4/ /OE /) rt:> R .E 1/ t'1 ~ (/I)t)(/» DI R£c- r 0U'SrrJIì1 £K r~ ¡1JEfI.-/('£~rlr#.9R/J1I9C'p eJl1p¿QPÞ.£S /f)¡RE(!::f- P.t:o¡;t£ ;t"cJ 8A¿): .I5.x/Î ;). C,4øER/J-~ LFrT ¡:Iê()~ j)òðR ¡t:h'c:?/Å/~ Sr¡¿¡:ø- 3 Co~/fIfirl0 /7ÿLJ /Al7o;YtHiJó/¡J ?,EK'S¿;1{j RI!JI? FR'o-t/1' D()IJ!ê p¡qC/Nj 3ræ/f! Et-: wz:: ;9'-$0 H,~U,!t 7;RB//f/£ D ß-Æ'S'OA/..?~ PAGE 1 / ¡(/ c.P I? ' MATERIAL SAFETY OAT~ r'YSTE~C t2/20/88 ti 4ö , n;:¡ n~. INC. (805) 648-6800 I: <> , ... , 3' :ì' :. ~ i~ . re ~ .J, . , ~ BUSINESS NAMf;: LOCfUlON ,~ C< "'?':. USINES5 NAflt PAYLESS DRUGS 1914 WIBLE RD :3. HAZ MAT TRAINING SUMMARY , .. IO NUMBER Z 15-000-0 HIGH.IARO RATING 1 LAST CHANGE I I BY < NO INFQRMATION RECORDED FOR THIS SECTION> 4. LOCAL EMERGENCY MEDICAL ASSISTANCE- ." ~AST CHANGE 06/1 3[88 BY ESTER ZA SEC 5) NEAREST EMERGENCY ROOM. PAGE 2 MATERIAL·' SAFETYOOTHSYSTEMS. 1NC.·' TBWS) ·64'8;':5900 r2'fZ0I88" íí=4B' l-.~~:~ ""--, ó ~ -~--~-- ·c- BUSINESS NAME PAYLI:;SS DRUGS LOCATION tS14 WIBLE RD FACILITY UNIT 01 , 10 NUMBER Z15-000-001158 HIGH HAZARD RATING 1 , I : I A. OVERALL HAZARDOUS MATERIALS INVENTORY lAST CHANGE 06/13/88 BY ESTER 10 iYPE NAME L.OCATION CONTAINMENT PURE POOL CHLORINE SALES FLOOR 19-0 PLASTIC CONTAINER£5J 10 PERCENT COMPONENTS 1073.00 100.0 HYDROCHLORIC ACID 2 PURE PAINT AND PAINT REMOVER SALES FLOOR 18~O METAL CONTAINERS 10 PERCENT COMPONENTS 10ØE.Ø0 30.0 ACETONE 1118.0Ø 25. ø )(Y_LENE> MI ~ED - li55.0Z 16.0 PROPANE 1130.00 15.0 TOLUENE 3 MIXTURE ORTHO'-ENFORCER-RAID INSECTICIDES·' SALES FLOOR 12~E & F OTHER 10 PERCENT COMPONENTS -1056.00 100.0 INSECTICIDES B. FIRE PROTECTION / WATER SUPPL~E5 MAX AM"!' UNIT HAZARD USE , DO -00 GAL HI GH CLEANING Hf~ZARO LIST HIGH 100 GAL EXTREME PAINTING HAZARt) l.I5T HIGH '--HIGW-- - o---~,,:t'- EXTREME HIGH 1 16 GAL \JNK NOWN OTHER HAZARD LIST UNKNOWN LAST CHANGE 06/13/88 BY ESTER < NO INFORMATION RECDHDEO FOR THIS SËCTION > PAGE 3 MATERIAL Sf¡FETY'DATA SYSTEMS> Ii'lL (805) 64B-6600 1Z1Z0/88 11:46 - ~ . . " ,. BUSINESS NAME PAYLESS ols LOCATION 1914 WIBLE RD 10 NUMB~.- 15-000-001158 HIGH , ZARD RATING 1 ~ ,> D. EMPLOYEE NOTIFICATION j EVACUATION . 'lAST CHANGE 06/13/88 BY ESTER 3A SEC 2) ALL EMPLOYEES ARE TRAINED, WI:;:EI<L Y MEETINGS OF SAFETY. SEE ATTACHED EVACUATION PLAN. E. MITIGATION / PREVENTION / flBATEt1ENT LAST"CHANGE 06/13/88 BY ESTER 3A SEC 1 } MONTHLY SAFETY INSPECTIONOF'OIJR'STORE, 'By OUR SAFETY PERSON. INSPECTIONS BY OUR MAIN OFFICE, ALSO INSPECTIONS FROM OUR PARENT CO. K-MART. PAGE 4 {'znøIEU:š- rr:'4'8' , r1ATERIAL SfiFETYDATA'SYSn:MS , 'TNt:. 'rB(5)'648.;.'EiB00 ,1/ ' . -. .. '~ p~"- · Bakersfield Fire D't. Hazardous Materials Inspection Date Completed Business Name: ?ß+k s s 't)íV') S Loëàtion: } JILl t;) \' \n\e~ ~J ;: . I '., \ "-- - Plan: 10 # 215-000()Ò I' S-<ï(Top right comer Business Plan) Station No. 7 Shift a.- Inspector f(A.A 5 " fk~c.K ~J'j Rl iTiJf>t.- Verification of Inventory Materials RECEIVED Verification of Quantities AUG 2 3 1969 HAZ. MAT. DIV. Verification of Location Proper Segregation of Material Comments: Adequate Inadequate ø ø ø' ßf D D D D D ~- ~ D Verification ofMSDS Availability F / Number of Employees ."'13 /' . Aì Verification of Haz Mat Training ~. Comments: f\I\:s \) S /,)D' Ä¡')P\" [" \:, \ "- AT .5Tð ~ E.. Verification of Abatement Supplies & Procedures I8J-. D Comments: Emergency Procedures Posted ""1/Containers Properly Labeled Comments: % ~ D D Verification of Facility Diagram .. Special Hazards Associated ~th this Facility: - Is \ Violations: ~ D - rYì re...... FD 1652 (Rev. 3-89) . White-Haz Mat Div, Yellow-Station Copy Pink-Business Office . 7"',~ '. ':~~-:;~ /. :,.' /~ ~".i(l:..r;;" ",,/::'0' .,.'", <S'~. J't>. ! .,,.1. _. : t"', \ ',:::; ",..1 Jt...... f",' ; ,,", - -·;:'1 ______ ". .'.) .' " : , -:-';---/,-,,-',' ~. i \ ':. ....."...d.:;;;::"'~) -,..., I V ':' 4Þc,.t', . f\:. . - ,~ ...... (""". . ,..j ",,,,¿ '::1/_~>: ~'Y Q ~v y~ ("~,1! . ,. , 1 11ffiT!. '\ ~\\\~~i;~~~!~1Ìh.- ~ ,I .\LJ S~f'l.~ ~I~~\·- . '-~¡-..... #, $.'~ "~/I . " :::::~;; \\ (~1 "2.~~ ~~;:, :','~ ::;,~;= ......-:... I I -.0:::::.... ~ ~ J ~-... ::'0t:""""7...\.:.." 1/;: LJ)JiìíÍÍ~ ~.p. 'l V:::!J CITY Of'I~:~~:',SFIELD 1\<:; ~ ~ ~AI\ 1 £' d> ., # (]v I L./. ¿') I!.. Y (tYDe or print name) , , ~/ Doh ere b y c e r t i f y t hat I h a -\.. ere vie h' e d the R E eEl V E D JAN 3 1 1989 attached Hazardous ~laterials business plan ~ns'd............ - for {1; 51 J. é.S' <; / ,DIZ U', 1~ ReceIVED (name of business) JUL , J '989 and that it along wi th the attached addi tionsHA~. MAT. D,V. or corrections constitute a complete and correct , Business Plan for my facility. -t~~, ,Sli'!na{ure ?!J- C). J - :;lS-- c?' c¡ date <:' " vo~ \ \ \ , j