The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN j i i '. I 'I ..--....... () 'it- Q '..... ~ F \." . I: ..L t .~ z ,- i~ I~ .3 'V =- It SITE DIAGRAM G:7I ,FACILITY DIAGRAM ~r I BUIÙIeIIName: ~~ 1~\q _ Business Address: '2>~\ \}J~b~e... µ, b~~fW q 3~ tv ì 6 Ie- (2A, ~'(a... "'-1å.,o.~ A L . 1=\o...rv\L.O-b( (.. ~. ~c.J. ~W\~ ~. 6NíUtJ(k 14 o...WleoJo ~ ~I ~ 6W\~y~AM~ f\ . b~~~ (ç,oJ ) . I I '... 1J Cð ~ ~ ~ ~ R 8- ~ E - B--- :s- ~ ,,.- 1¡:- '~ ~"\~\.(ùJ .~"-'4~~ d::f ~ Q/ o -:2 '~ . SITE DIAGRAM I t Bulin.. Name: Bulin.. Address: . FACILITY DIAGRAM I .~::- -.,~ -~ ~i' I .... ,,~ -¡:---,.-.....:- - - LUCK 7 #19 y S~teID: 015-021-000091 : Manager : BusPhone: (661) 397-4553 Location: 3301 WIBLE RD Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 30D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 SIC Code:5541 EPA·Numb: DunnBrad: . ~ ^ 1J. T A 'l. ~ N {y H rJA N lIT rr-A &.\.. il Emergency Contact / Title Emergency Contact / Title ~IY'iWA~Z~S / OPERATOR I=rI CIOOIf=MMOO I OPERATOR , Business Phone: (661) 397-4553x Business Phone: (661) 397-4553x 24-Hour Phone : (¿¿Ø ) iJ)"~'11W 24-Hour Phone : (661) 872-6803x Pager Phone : () - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : ELIAS SHAMEIH Phone: (415) 777-0700x MailAddr: PO BOX 703 MARKET ST 1700 State: CA City : SAN FRANCISCO Zip : 94103 Owner ELIAS SHAMEIH Phone: (415) 777-0700x Address : PO BOX 703 MARKET ST 1700 State: CA City : SAN FRANCISCO Zip : 94103 / Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I(AP- í AP- 5 j T'I & H (Type or print name) Do hereby certify that I have r;:-'¡,¡e'./\¡'9d ~he B+rpnh.ed hazardous materials manage- ment ':'!;;';Hl fer LtA-IíJ;~ 7 and that it along with , (Name Business) any corrections constitute a complete and correct man- agement plan for rQY facility. rr.~ ~~ . Signature ~- &-- o:t Datil -1- 08/06/2002 .. ~.. e e F LUCKY 7 #19 SiteID: 015-021-000091 ; TORAGE CONTAINER DATA (UST FORM A) S Last Action Type: FACILITY/SITE INFORMATION Business Name: LUCKY 7 #19 Cross Street : Business Type: Org Type: ( Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : HI SHAM AHMED Phone: (661) 397-4553x Address: City : State: Zip: Type : CORPORATION ( TANK OWNER INFORMATION Name : HISHAM AHMED Phone: (661) 397-4553x Address: City : State: Zip: Type : BOE UST Fee# : UNKNOWN Financ'l Resp: SELF INSURED Legal Notif : Property Owner Mailing Address Date: Phone: ( ) - x Name: Ttl: State UST # : 1998 Upg Cert#: 00706 f= Hazmat Inventory One Unified List ; ~ Alphabetical Order All Materials at Site ì Hazmat Common Name. . . SpecHaz EPA Hazards DailyMax MCP PLUS UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod REGULAR UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod SUPER UNLEADED GASOLINE F IH DH G 10000.00 GAL Mod -2- 08/06/2002 .. e e SiteID: 015-021-000091 9 Facility Unit: Fixed Containers on Site 9 F LUCKY 7 #19 f= Inventory Item 0003 F= COMMON NAME / CHEMI CAL NAME PLUS UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [ ~TA~E I- TYPE ~ P~ESSURE ---r TEM~ERATURE ~ CONTAINER TYPE =LlqUld ___pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. I 100.00 Gasollne HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS f= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME REGULAR UNLEADED GASOLINE Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid _ Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYI>E UNDER GROUND TANK AMOUNTS AT THIS L ATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL OC HAZARDOUS COMPONENTS ~ CAS # I 8006619 I %Wt. I 100-.00 Gasoline TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -3- 08/06/2002 .' e e SiteID: 015-021-000091 9 Facility Unit: Fixed Containers on Site 9 F LUCKY 7- #19 f= Inventory Item 0002 F= COMMON NAME / CHEMICAL NAME SUPER UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [ STATE I TYPE ~ P~ESSURE --¡ TEM~ERATURE I CONTAINER TYPE ==Gas __pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 08/06/2002 " e e F LUCKY 7 #19 I f= Notif./Evacuation/Medical Agency No.tification SiteID: 015-021-000091 9 Fast Format 9 Overall Site 9 11/07/2000 DIAL 911 GIVE LOCATION, AT THAT TIME IT IS SPECIFIED GAS IS INVOLVED, ALSO NATURE OF EMERGENCY, (FIRE ECT). SUN ,VALLEY OIL IS TO BE NOTIFIED. Employee Notif./Evacuation 11/07/2000 EMPLOYEES ARE NOTIFIED VERBALLY. EVACUATION BY REAR DOOR, COUNT TO BE TAKEN. I Public Notif./Evacuation EVACUATION BY REAR DOOR. I CALL :::~gency Medical Plan 12/17/1991 ] 11/07/2000 ] -5": 08/06/2002 '. e e ." F LUCKY 7 #19 I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000091 9 Fast Format 9 Overall Site 9 11/07/2000 NO SMOKING SIGNS ARE POSTED. STOP ENGINE. SIGNS ARE POSTED. TANKS & EQUIPMENT CHECKED ON A REGULAR BASIS. Release Containment 10/20/1992 TANKS ARE CHECKED ON A REGULAR BASIS. Clean Up 11/07/2000 FOR SMALL SPILLS CAT LITTER IS USED TO ABSORB GAS. FOR LARGE SPILLS CALL THE FIRE DEPT AND SUN VALLEY WOULD BE CONTACTED. Other Resource Activation -6- 08/06/2002 '0' . <. e e F LUCKY 7 #19 I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 015-021-000091 9 Fast Format 9 Overall Site 9 I 11/07/2000 A) GAS - ????????? B) ELECTRICAL - BACK ROOM C) WATER - OUT FRONT BY THE ST D) SPECIAL - GAS PUMPS S SIDE OF BLDG ALSO BACK ROOM E) LOCK BOX - NO I I I Fire Protec./Avail. Water 11/07/2000 PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS & ALARM SYSTEM. NEAREST FIRE HYDRANT - NE CORNER OF LOT. Building Occupancy Level -7- 08/06/2002 ..j- ,\ ,--;,.... e e F LUCKY 7 #19 I F Training Employee Training SiteID: 015-021-000091 ì Fast Format 9 Overall Site 9 11/07/2000 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ONCE A MONTH MEETING TO DISCUSS PROCEDURES IN CASE OF EMERGENCY. Page 2 I I I Held for Future Use Held for Future Use -8- 08/06/2002 From: To: Date: Subject: Pat Beebout Betty Wilson 5/1/02 8:36AM ES 3561 Got your adjustment but too late to do for this month. I see that after the adjustment there will still be a . balance of $144.00 from previous charges. Do you want this statement done in Quattro Pro to reflect the $144. or should I send the statement to you that will come from the system tomorrow?? Let me know! Pat B x3750 / ,'----' \, , ------ ~-- -, ~~~--<' ~ ,~ ~ ~ ~u .. ~... .. .. fu'. - ....~ , ' -r-- CUST ~ & NO. C'-J-, ~S-b I MISCELLANEOUS RECEIVABLES ADJUSTMENT - DATE ;-=)--Q 1-0 ( NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT i : FINANCE CHARGE I , : OTHER ADJ ¡V , CUSTOMER NAME ~-\"J .:t~ ( 'S i~ Q. 10 MAILING ADDRESS rD. 6 ~ \ \ ex-- CITY ~b,-~(' _' STATE c_A ZIP CODE q~:2..45 SITE ADDRESS 33()\ L0~J,~, Pr~ PARCEL NUMBER (IF APPUCABLE) . . ADJUSTMENT APPROVED BY ~ f;J1-U I'- Customer ID . . Last statement . . Last invoice Current balance . . Pending . . . . Previous balance Deposit balance . Type options, press Enter. l=Select Opt Code Description HM005 HAZ MAT HANDLING FEE E HM017 HAZ MAT ANNUAL INSPECTION SSOOl CA STATE SURCHARGE SS002 UST STATE SURCHARGE UTO 0 1 UNDERGROUND TANK ANNUAL . . . CITY OF BAKERSFIELD CX)-O( 3/12/01 M~ellaneous ReceivableSIn~y 10:09:22 3561 Name: LUCKY 7 STORE 19 ~-~£.!~L--" 3/01/01 Addr: EMIL DAB BAS ~ ~u~ 0/00/00 POBOX 118 \. 572.00 .' LEBEC, CA 93243 ç \ \~ ~ (~J'£UM,~ \. \ .00 ~~A ACTIVE ENV. I RONME. NT. AL SERV~C'S " 572.00 ; \4tt -10-?) M -(keJ\ ~ . .00 . . V ( n Q. I"rO{) Open Activity ~ C(:~""\(\<:':f:"'\ fI/l. ,/cut/\. r.. /, ~.,U \ qL{ ,ã) Overdue ( .' Total due 11~~001 116.00 53.00 53.00 10.00 10.00 24.00 24.00 369.00 369.00 Current .00 .00 .00 .00 .00 ~IR4'3'èI01 F3=Exit F10=Combined detail F14=Deposit detail F7=Pending activity F11=Invoice inquiry F21=Other tasks F8=Charge hsty F12=Cancel F9=payment hsty F13=Auto charges p -...... ~- -- MR430I07 Customer ID . . Last statement Last invoice Current balance Pending . . . Type options, 5=Display Opt Trans Date 11/01/00 10/01/00 9/01/00 8/01/00 6/01/00 6/01/00 6/01/00 6/01/00 6/01/00 :~ CITY OF BAKERSFIELD ~~ ~scellaneous Receivables I~iry . .. . 3561 11/01/00 0/00/00 342.00 .00 Name: Addr: ,I \ 12/04/00 08:10:57 LUCKY 7 STORE 19 EMIL DAB BAS POBOX 118 LEBEC, CA 93243 A ACTIVE ENVIRONMENTAL SERVICES press Enter. Combined Detail Code Description stmrn Statements Processed stmrn Statements Processed stmrn Statements Processed stmrn Statements Processed stmrn Statements Processed UTO 0 1 UNDERGROUND TANK ANN SS002 UST STATE SURCHARGE SSOOl CA STATE SURCHARGE HMO 0 5 HAZ MAT HANDLING FEE F3=Exit F12=Cancel * = Pending .-- ~ --. "--- .~ "--'-- --..-- ..-. -_.-.~. , 7 ;'., . ,', . , ' , . "'Ci~ Bäkersfield,q ".. . ' UI IER RECEIPT 'itu OPER: SORTIZ 'oc -DRAWER:· 1 .. ., DATE: 12/04/ee Ø1,· RECEIPT: Ø048627 tSTOBæ LOCATIO. ·ABOUIT TP TIt 3561, 3561 1$198.00 IAR CS oexy 1 STORE ,19 ' ' TElDERDETAIl. CS ' DATE: 12/04/00 TOTAL CASH dOUR! TEJDERED CHAJlGE . . S200.ee TIllE: 12:43:37 S198.ee ' sm.ee ' S2.ee -- -..-'. ..-"_.~. , Balance 342.00 342.00 342.00 ,342.00 342.00 342.00 144.00 120.00 110.00 CUI' fO\+ dPf'f'- ¡t pi. '/ Qú'tS 111)/\> I!¿;t (( Chg Bnk G Typ Cd L A A A A + é5flv, Q t' :; ,- ~\\ // / V - LUCKY 7 #19 SiteID: 015-021-000091 Manager : Location: 3301 WIBLE RD City BAKERSFIELD BusPhone: Map : 103 Grid: 30D (805) 397-4553 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 - EPA Numb: SIC Code:5541 DunnBrad: Emergency Contact / Title MQH~mÐ kL:BA5MIRT / OPERATOR Business Phone: (805) 397-4553x 24-Hour Phone (805) 832 6924~ Pager Phone () x Emergency Contact HISHAM AHMED Business Phone: 24-Hour Phone Pager Phone / Title / MANAGER (805) 397-4553x (805) 872-6803x () x Owner Address City EMIL DAB BAS PO BOX 118 GORMAN DO ImmHlth DelHlth Hazmat Hazards: /" Contact : EMIL DAB BAS MailAddr:/PO BOX 118 Ci ty :' GORMAN Phone: (805) 863-0162x State: CA Zip 93243 Phone: (805) 509-3046x State: CA Zip ,: 93243 Period Preparer: Certif'd: to TotalASTs: TotalUSTs: RSs: No Gal Gal Emergency Directives: I .\-\-fS.(.\Af\A AJA.#..~ Do hereby cartify that I haw~ (Type or print I\ame) reviewed the attached hazardous materials manage.. ment plan for L'^-w}/ 1M9 and that it along with (N~BU8InGSS) any corrections constitute a complete and correct man" agement plan for my facility. ~~ \\-'1-0\) Date -1- 10/31/2000 -: e e F LUCKY 7 #19 NTAINER DATA UST FORM A Last Action Type: FACILITY/SITE INFORMATION Business Name: LUCKY 7 #19 Cross Street : Business Type: Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : HI SHAM AHMED Phone: (805) 397-4553x Address: City : State: Zip: Type : CORPORATION TANK OWNER INFORMATION Name : HISHAM AHMED Phone: (805) 397-4553x Address: City : State: Zip: Type : BOE UST Fee# : UNKNOWN Finane'l Resp: SELF INSURED Legal Notif : Property Owner Mailing Address Date: Phone: ( ) - x Name: Ttl: State UST # : 1998 Upg Cert#: 00706 STORAGE CO SiteID: 015-021-000091 ì ) One Unified List ì All Materials at Site ì SpecHaz EPA Hazards DailyMax MCP F IH DH L 10000.00 GAL Mod F IH DH G 10000.00 GAL Mod F IH DH L 10000.00 GAL Mod , - f= Hazmat Inventory f== As Designated Order Hazmat Common Name... REGULAR UNLEADED GASOLINE SUPER UNLEADED GASOLINE PLUS UNLEADED GASOLINE ¿!{r;~ 777"07aJ -2- 10/31/2000 ~. r; e e F LUCKY 7 #19 p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE SiteID: 015-021-000091 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ---r TEM~ERATURE I ==Llquld __pure ~mblent ---1 Amblent ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 10000.00 GAL 10000.00 GAL CONTAINER TYPE UNDER GROUND TANK Daily Average 5000.00 GAL %wt. I 100.00 Gasollne HAZARDOUS COMPONENTS ~ CAS#a006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME SUPER UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [STATE I TYPE ~ P~ESSURE ---r TEM~ERATURE I CONTAINER TYPE ==Gas __pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %wt. I 100.00 Gasoline HAZARDOUS COMPONENTS I~ CAS#a006619 HAZARD ASSESSMENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod S -3- 10/31/2000 '. e e F LUCKY 7 #19 f= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME PLUS UNLEADED GASOLINE SiteID: 015-021-000091 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ---r TEM~ERATURE ~ CONTAINER TYPE =Llquld __pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 10/31/2000 .. e e í LUCKY 7 #19 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000091 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë N otif. IEvacuation/Medical ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Agency Notification ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o DIAL 9-1-1 GIVE LOCATION, AT THAT TIME IT IS SPECIFIED GAS IS INVOLVED, ALSO 0 o NATURE OF EMERGENCY, (FIRE ECT). 0 o SUN VALLEY OIL IS TO BE NOTIFIED. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Employee N otif. IEvacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o EMPLOYEES ARE NOTIFIED VERBLY. EVACUATION BY REAR DOOR, COUNT TO BE TAKEN. 0 o 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Public Notif.lEvacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o EV ACUA TION BY REAR DOOR. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Emergency Medical Plan ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o CALL 9-1-1. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -5- e e 10/31/2000 .. '. e e í LUCKY 7 #19 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000091 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Fornaat j íë Mitigation/Prevent/ Abatemt ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Release Prevention ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/20/1992 j o 0 o NO SMOKING SIGNS ARE POSTED. STOP ENGINE SIGNS ARE POSTED. TANKS & o EQUIPMENT CHECKED ON A REGULAR BASIS. 0 o 0 o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Release Containment ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/20/1992 j o 0 o TANKS ARE CHECKED ON A REGULAR BASIS. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Clean Up ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/20/1992 j o 0 o FOR SMALL SPILLS CAT LITTER IS USED TO ABSORBE GAS. FOR LARGE SPILLS CALL 0 o THE FIRE DEPT AND SUN VALLEY WOULD BE CONTACTED. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Other Resource Activation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -6- 10/31/2000 ,- -.. e e í LUCKY 7 #19 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000091 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëFast Format j íë Site Emergency Factors ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Special IIazards ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Utility Shut -Offs ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 i o 0 o A) GAS - ????????? o B) ELECTRICAL - BACK ROOM o C) WATER - OUT FRONT BY TIlE STREET o D) SPECIAL - GAS PUMPS SOUTII SIDE OF BLDG ALSO BACK ROOM o E) LOCK BOX _ NO 0 o 0 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Fire Protec./Avail. Water ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISIIERS & ALARM SYSTEM. o o o o o o o NEAREST FIRE IIYDRANT - NORTII EAST CORNER OF LOT. o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Building Occupancy Level ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -7- 10/31/2000 o o o .~ '- ...,~ e e í LUCKY 7 #19 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000091 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast F onnat j íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site ¡ íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 j o 0 o WE HAVE 3 EMPLOYEES AT THIS FACILITY. o o o o WE DO HAVE MSDS SHEETS ON FILE. o o o o BRIEF SUMMARY OF TRAINING PROGRAM: ONCE A MONTH MEETING TO DISCUSS o PROCEDURES IN CASE OF EMERGENCY. 0 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf - \ . .. '.. '-""_i'·'·""~'''''U.i".·· ,"'. CUST~e&NO. ¡::;:s -~l MISCELLANEOUS RECEIVABLES ADJUSTMENT it ..... ~ ....- DATE3-/~ -Ð NEW ACCOUNT 1 ADDRESSCHANG6 CLOSE ACCT I : FINANCE CHARGE I J J ' OTHER ADJ I ~ CUSTOMER NAME kl¿ d~--y ] p. 01 ~ö-K STATE ~A-O( L_ 19 (l ¥ rA- W~b~e..-_ &. MAILING ADDRESS CllY LeJo--e-c ZIP CODe C(3:¿ 43 3-::0 l I SITE ADDRESS PARCEL NUMBER (IF APPUCASLE) ADJUSTMENT I R:~S:~ ~ ~ç,;>rc.ha~~ sloJ\cÁ'v~ APPROVED BY -<:;íl ~ - ~ -~~--:" ~.--::;---.-~- .----. -- -..---~ I' 11 I:: ~ ~. ~ ~ 'State'of California-Environmental Protection Agency , Form Approved OMB No. 2050-0039 (Expires.<'¡-30-99) ,Please print or type. Form desi~¡f~ for!:,'" 0'; e.!ite (12-pi ;\ " '-~ I;' I:: [I: " o I(') I(') ~ N I(') ex> Ô o "? " ¡.. .;...J !: :;:{ :"^IU , ~ ~ ' -O~' O~ 02 ~U)~ ,QUI Q)~ I, O')!::: - ~;,G ;-.... E ' 8 N ~ E ~ R ~ A 6 T g 0 , R ~~ ....J « 'z o ¡:: « Z w I i-" ....J 4: u ....J' ....J ã: V) cc: o ~ () Z w o cc: w ::'2: w u. o w V) « u Z See Instructions òn back age 6. Department of Toxic Substances Control Sacramento, California Information in the shaded areas is not requi:ed by Federal law. UNIFORM HAZARDOUS WASTE MANIFEST 2. Page 1 of I 3. Generator's Name and Mailing Address EM" ( DAIÒ~#t~ . P. 0 ,ß €;)( , $ I j¡(¡:III.iI;r &-0 r,.','u1 '" I 4. Generator's phone (2?05 ,;J. 4/f· &. 0 5. Transporter 1 Company Name (J,,r, q3:J-t/~ 6. US EPA ID Number tJæ lIVe .. I '1 .. 9. Designated Facility Name and Site Address , PíNer ReiJ.If(.'III'.J'151i1JJ1¿e. IgO IAJ. lV10 Ie RJ -,'} ~ I 11. aNDN t<e12f1 H. P1 JZfH'2.j) Ofi" ¡¡Jilt:; Ie St;,/¡'d b. c. d. 15, Special Handling Instructions and Additional Information .. iN (!.¡¡:ãlt G¿ fÙvlt:.('ljeN(!1.j e,;)/ VV"fil' 1'\¡JI[rofI4\f. s.¡i).F-€''nj eß.,,.'.....~R YJ..{.' . ~@@R (JRfGONAl 16, GENERATOR'S CERTIFICATION: I hereby declare that the cont~nts of this consignment are fully and accurately"described above by proper shipping name and are classified, packed, ,marked, and labeled, and are in all "respects in proper condition for transport by highway according to applicable international and national government regulat¡~ns. If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the enviro~ment; OR, if I am a small quantity generator, I have made, a good faith effort to minimize' my waste generation and select the best waste management method that is available to me and that I con offord. ", ..... o'w¡j ement of Recei t'of Materials 19, Discrepancy. Indication Space erator Certification of recei t as noted in~lteni ,19.. DO N()T WRITE BELOW THIS LINE.: DTSC B022A 14/97) EPA 8700-22 Yellow: GENERATOR RETAINS i',; '",-~ ~. ~ ------:i e e LUCKY 7 #19 RE JUN 1 B 1998 BY: SiteID: 215-000-000091 Manager : Location: 3301 WIBLE RD City BAKERSFIELD """~'-" .....-- BusPhone: Map : 103 Grid: 30D (805) 397-4553 CommHaz : Low FacUnits: 1 AOV: ~~~m~~: ~ BAKE~~~~ ïJ>AT,Wf8 ~S H ; R,' SIC Code:5541, ~, DunnBrad: ~/ S 1/111'1 r7T7/V1.. ~p Business Phone: 24-Hour Phone : P:l~cr Phone / Title / PAR.'fNER. W\l\.~ (805) 397-4553x ~~~~3~ - ~~1~ Emergency Co J Business Phone: 24-Hour Phone ~ Phone Fire / TitleM.e:;:.....~ / PM.l.ÑER 0 (805) 397-4553x (805) 58"'ft A'I9"1/\. ( '8ó5T1?.2 - to d>o3x Hazmat Hazards: ImmHlth DelHlth Emergency Directives: F Hazmat Inventory One Unified List l p== MCP+DailyMax Order All Materials at Site l Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP REGULAR UNLEADED GASOLINE F IH DH L 10000 GAL Mod SUPER UNLEADED GASOLINE F IH DH G 10000 GAL Mod PLUS UNLBADBD GASOLINB F IH DH L 10000 GAL Mod ~ø I-I-/S!M1t1 /}1I1V'é.!::> [)O h~U'eb~ oortiCoo ft~~~ ~ \1a1'\fS (Tv~orlJl!~fIGM:)) ;¡ 'Y r@'\ficaw~©1 ~~~ lIDk~~ 1rJ~®m~$ mfãl~~&'iÏ®JI$ ffi~r!~ge- m~n~ ~aln g~fi' 1.. ~.~ 2~~ 9 tatoo ~~~ ,å~ @!©)~ wm~ ~ny œU'6'\~ci8(Q)U'jS ooOilsti~utG a ooMp~rsa~ oordJ oorr®©ft mm- a~em(3nt [Q)~fi'8 ~@U' swy ~(:å!M1f. , ., ~~ 6-,:.uP -1- 03/18/1998 ;' ~ e e F LUCKY 7 #19 p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE SiteID: 215-000-000091 ì Facility Unit: Fixed Containers on Site ì . Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE , Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS Z D A ESSMEN TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HA AR SS TS p= Inventory Item 0002 F= COMMON NAME / CHEMI CAL NAME SUPER UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [STATE I TYPE ~ P~ESSURE ~ TEM~ERATURE --I CONTAINER TYPE =Gas __pure ~mb~ent ~ Amb~ent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -2- 03/18/1998 ... ,¡ e' e F LUCKY 7 #19 p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME PLUS UNLEADED GASOLINE SiteID: 215-000-000091 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST IN FRONT OF STORE Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ~ TEM~ERATURE I CONTAINER TYPE =L1QUld __pure ~mblent ~ Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS I' I 1 -3- 03/18/1998 " e e F LUCKY 7 #19· I f= Notif./Evacuation/Medical Agency Notification SiteID: 215-000-000091 ì Fast Format ì Overall Site ì 12/17/1991 DIAL 9-1-1 GIVE LOCATION, AT THAT TIME IT IS SPECIFIED GAS IS INVOLVED, ALSO 'NATuRE OF EMERGENCY, (FIRE ECT) . SUN VALLEY OIL IS TO BE NOTIFIED. Employee Notif./Evacuation 12/17/1991 EMPLOYEES ARE NOTIFIED VERBLY. EVACUATION BY REAR DOOR, COUNT TO BE TAKEN. I Public Notif./Evacuation : EVACUATION BY REAR DOOR. I CALL :~:::~ncy Medical Plan 12/17 /1991 1 12/17/1991 ] -4- 03/18/1998 ~ e e F LUCKY 7 #19 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000091 1 Fast Format ì Overall Site 1 10/20/1992 NO SMOKING SIGNS ARE POSTED. STOP ENGINE SIGNS ARE POSTED. TANKS & EQUIPMENT CHECKED ON A REGULAR BASIS. Release Containment 10/20/1992 TANKS ARE CHECKED ON A REGULAR BASIS. Clean Up 10/20/1992 FOR SMALL SPILLS CAT LITTER IS USED TO ABSORBE GAS. FOR LARGE SPILLS CALL THE FIRE DEPT AND SUN VALLEY WOULD BE CONTACTED. Other Resource Activation -5- 03/18/1998 ';' e e F LUCKY 7 #19 I f= Site Emergency Factors ~ Special .Hazards Utility Shut-Offs SiteID: 215-000-000091 ì Fast Format ì Overall Site ì I 12/17/1991 A) GAS - ????????? B) ELECTRICAL- BACK ROOM C) WATER - OUT FRONT BY THE STREET D) SPECIAL - GAS PUMPS SOUTH SIDE OF E) LOCK BOX - NO BLDG ALSO BACK ROOM Fire Protec./Avail. Water 12/17/1991 PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS & ALARM SYSTEM. NEAREST FIRE HYDRANT - NORTH EAST CORNER OF LOT. Building Occupancy Level -6- 03/18/1998 ~ ... ,I;. e e í LUCKY 7 #19 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000091 íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 12/17/1991 ¡ o 0 o WE HAVE 3 EMPLOYEES AT THIS FACILITY. o o o o o o WE DO HAVE MSDS SHEETS ON FILE. o o BRIEF SUMMARY OF TRAINING PROGRAM: ONCE A MONTH MEETING TO DISCUSS o PROCEDURES IN CASE OF EMERGENCY. o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj ~e . City of Bakersfield II' CUSTO}\ER RECEIPT u, OPF.R: !}\ORT01t OC DRAWER: 1 DATE: 6/18/98 01 RECEIPT: 0056367 CUS'TOIIER LOCP.TIOIt A}\OUMT TP T1{ 3877 3877 1 $400.50 AR Cit LUCKY 7 STORE 19 Cit: 1132 TIME: 9:49:08 TOTAl. CHECK 5400.50 City o{ Bakersfield ... CUSTO!ER RECEIPT ,., OPER: }\}\ORTOR ac DMWER: 1 DATE: 6/18/98 01 RECEIPT: 0056369 CUSTO~ER \.OCAT10J AKOUMT TP 1M ~77 3877 1 $69.69 AR CK l.UCKY 7 STORE 19 CK: '5193 3561 3561 1 $708.'50 AN CK LUCKY 7 S1'GRE 19 CK: W)3 1H\E: 9:50:12 TOUl. CHECK S778.1'3 " \, . . ~ ;dJ'-'f!:; ,\ SITE LOCATION :' l BULK TRANSFER ,Lu~~t 7 W,71L'E ~/~/ mA¡¿-; , s. 3. ð / tJ /7/J.. e If<1> BUSINESS NAME OLD OWNERS NAME ,... , ~ '" Own'? L)I:ií'7;;"-Y =?-30 I l.U,' /;>iL c:..P7 I' e -ElL" U.A:ëil4A~ , . . ~ J êXJ.Jt17 NEW OWNERS NAME fI1~ 3t:)~1J J1««¿]~/, ,,::¡ël-/Q 'leu ~_';&'I .& ~A~.6";!,N /~""'G<. l.vc~ 1 NEW OWNERS ADDRESS 330 I tJ /2 LG ~ ACCOUNT NUMBERS ~G-1 J~~02. v1¡:¡/ii1-;'-;:¡;)o l r6 "-.-.. - - - -- - ----' ~~(~:Uð 102- ~ T '~4 7'0 J? ¿;;O,ó<O '-__________-1 DATE OF TRANSFER (!.¡.:S" 12~- 4 ·22..94 ESCROW COMPANY /J ~,,-- l·.."E/JrU~T "I Tl-i:;; BY 109~.ý /- m~ ~~ß ESCROW NUMBER THIS INFORMATION IS TAKEN FROM THE DAILY REPORT·AND SHOULD BE VERIFIED PRIOR TO ANY CHANGES BEING HADE. j[J;¡::- t¡ù--- ~ Sanitation ' Wastewater Hazardous Materiáls P~ D. - Alarms ___ 10°011) DISTRIBUTION: II , errv Of BAKE~Sfi¡¡:1l.1I» P.O. BOX 2057--~~- , BAKERSFIELD, CALIFORNIA 93303-2057 ;'1:31: E:~:}:: Ef:::S~ I ELf:: "" ,I ~ ~ ~\....., ' ,,~. . . ~ . . ,I _, '=', _<::C.~, ~~ ()~, 'C ~ /,. '-VC'FJf';""" ",,- , ~ PP'~ ".JQ(¡}" " ,'" ,.,,);1",0 ? ~ - r: ~" ). ~..,. ~'-J l' ~, " , ~'C, " ;¿¡¡~~.!J:;:~, r,:& -....J ~ 1'1)' ,. -. ~- \, ,J ' I ?Jt..:[ '11.".(. . \'\ '- r ~~'/t' Of) (-. Uh ~"..7 ~ f~);:-;r""'·'~"""IIIiI"0 ", ,.' " " '4-.....~..¡Q~"\J® . ' I, ADDRESS CORRECTION REQUESTED DO NOT FORWARD w I I; '/'; - ö:::; :;:!3~:~tT~22:~f} ::"1.\1 ~?;~~·=~c:=_~=";' ,--r: \ ,: ~íi',;'!tI", :.~ .j ~/. .' 1-.1. ,/ . , YI~lE'~ITMi ~~RK~' HN724701 OOæ A]BAS¡, J YO~SSEfl ß R P~TEl 'f 0 5 ::;t ~ 3G ~ 2 (i;)A~;;:~~Frr¡:llj), (¡¡),. -~"'3,t42 RETURN PAYMENTS TO: ¡ CITY OF BAKERSFIELD , í: P.O, BOX 2057 ,;" ~AKERSFIELD, CA 93303~2057 ' PLEASE MAKE CHECKS PAYABLE TO: " \ , , '\ ACCOUNT NO. ''',,-1 CITY OF BAKERSFiElD >..d)(¡;~S :Ji,'~t\i'ri <5! l$ tî¿¡ndl,i"'0 . .....,_ '::.::..;"..~' "'~ .~ J .' B-alonce PaYI!ê~nt , ~ ~ '....' , i. '.,:' ':!" ' CONCER~INGTHIS Bill, PLEASE PHONE: '{I1@Sl 326"';¡¡~1?> MUST RETURN THIS COpy WITH PAYMENT ÎH~l[ fH~H r;At~J;';~T ,¡:mp241ºl i'2.. A~8A$¡ 4' ,j VO¡¡JS$E.&:I, ',£6 fi PATtI,. fP Ö ~ (¡ ¡t 4]0 ~? aAg~Rs~I~Lßø CA 9~~~t.]o.? INVOICE NUMBER RETURN PAYMENTS TO: CITY OF BAKERSFIELD ' , P.O. BOX 2057 ,"' BAKERSFIELD,' CA 93303-2057 ' (' P,LEASE MAKE CHECKS· PAYABLE TO: ,', '-. N,Al !\~ [;' '~.Hf"~ ~.~:\ r ;~R 1 A LS VI v· ¡~, 1 Ü;4 ACCOUNT NO. ? ~7~Á . \ r'~~ \ ) :CITYOF BAKERSFIELD " " !\.í~\j$ , ,;~ 'i:eda l $ (.¡ iH''h:! t:i '''ð ref f. . ~~ðl ,;, fie (> \J~(ð() :_;. i'lt?: ¡~o,~r ':~3¡"l\,.,:J.m...\f.i~¡) ;¡:",;"'c{:', h,Fi':l.l f, f.~ S Vi:JN ~·t.¡~.,'. :", ,1~. :.If', ¡;.'.U' " ' ¡:"AVi'H?ì4~'~~ l'ü,'{¡;1 l!I~0ái'!?ðiE~ ~¡lI..l'j~.l ~I' Ûln~ .f": ·l1BJ· ~ìZ~ (~~,¡~i:' ~!,,~r t~ "~ ' r " ~ (¡¡ biV r~' ·,n.l·)!pú¡~""'~"¡;(FÍ ::;.> "'-;-~, ¥íUiÞ.! l~~JJ')' fHX~,\~Cf' ci, ,.3 l;~' ':;~P~îk- f'~J~J;¡':~'Ú'U~' P :aY;1'~n t í{! U;.f~r(¡Yp tt.: ,'; H';~ Þi) ~i 1 N ~. t:~~ð (l, (1 ~&-~, INQUIRIES CONCERNING THIS Bill, PLEASE PHONE: (. ,,;, {~5 ) '2.) 2 :t.:... '.:;, ''Ii 7 J INVOICE NUMBER ' WIÐLf MINI t^~K~' H~7247Ul ~ø AHBA~,lpj VO~SSffl L R P~TEl ~~ t) t~ '.J-.l;~ 4 34; f. 2 ~AKER~flrL~, (A Q]1~\~~(42 I @ PRINTEDO,N REGENÉSIS® 'POST CONSUMER RECYCLED PAPER CUSTOMER COPY . :j, ". ----- " - " , .,~ ../ . . " 7~ "~"~, J"";;"~""'-;;'- .;:..::~.,~~-). ,;-' I " , ~~~........~. ~~\r~'~i <>." ,.·"".··.···..···1 « . a ,~, '" ··CITY"'OfBAKERSflEI:D,-;;-é.,.. , . .".0; ~OX 2057 'BAKERSFI''''Õ, CA~IFORNIA 93303-2057 e , I ' e' ADDRESS CORRECTION REQUESTÊ~ ·'.DO NOT FORWARD; " " AC .:::. '!I¥1' :it ~"':<I <;t; ~~"""'-\i'"~'_ ~"f (;, >~ 'Î I I , ~/."" " * '-", ,> (, ~ ,~,~" ~. : . ----..~~":~1!~· ;~OORDlftÐCPIlIIÞ . f' I "'1\' , I '-'f' MAIL TO WIBLE MINI MA~KET M ABB~SI~ J VOUSSEFi P 0 60X' 430,42 . BAKERSfIELO,. CA , UT16410t, . & RPATEl ,\ ,...,'C -~----~~~ , RETURN PAYMENTS TO:" ~, CITY OF BÃKERSFIELD ~i\~t\~OOijS MAftR! Ali· IU \1 tS'JO~ ....P~KE~~E~~~CA 93~.2OWA~fOUNT NO. I.ff~l <c,' CITY OF BAKERSF::~~... ~lF.e, fr.:tt ,ij'ri4et@,rOMnd, $tor",~èT~ii)~Op,~ra ti n,g Perttii tPr ev'¡ out; 'alsnçe' ~~41o2~ .",', ",--, H,' L ..... ---'~>';~'2.;;~":\c·",.-:," .' -.. "-""';::,-~"----"'--""" -,-' ;ml*c!~~£;3~:~ ~:~~E1~9~r~D~~Î$.,~~~i~¡h!;;;'?'::i'r:::T:: 'liÍi"\ . . .,'. .J' ." i~~'f(~jk.t\Ítli. 'å?'f.tER'~'2/3~t~4:,A~ft~OT:~_?~':>ts':ST~;T'~~~t1,~,i;O ':'. . ¡'iJ~~ 2Slifj~ P 8yli'len~.. "':-~i~4.,Or}.'·.. I h <I..J u d ". "t. f.<!~MJ:Y'" ". ";';':' .c' ",.~ø~ 211M ¡ U$ t ,,"(' t .' . ., >,? C.2 ~ ,', . ,.:œ~@(I¡\:()~JG'~~,:,y '. ': ':' ..~,.. \~3::." '. :. .." ··.Ä,,~~Ä~:ii,t~~~ii~iïWi:~~'~~~~~Yij;0i~::f! '~;¡:x ;:':i:~\:·":I~(~r~!~óð~~;;1j;;,¿?·::;~·;4!:,:,.t;~~Nt}/~~~¡Ú:f\i:~?jt ~~~; " .,¡.;¡~1 . \ "(. PLEASE MAKE CHECKS PAYABLE TO: .. , . , : _. "'; ':'_ _ _ ".".' _," ' : <" . ',' <_. .'.', "', r :,,' ". "", '. _ ·;r. " . ~''- " '.,'" . - -.' , .1~Qtf~Ri~~~ÔNfË~~iN,G,.T-HIS:BIL~, "P~E~S{ P~?N~:...·::( $iJ':$)" ~,~~ø;,;;~ fjt~...;· . . '... . -. . '.' - f ' . .. ,... ' ~ .;' ~.; ';" :" ., ~':, :; , ';..-; ;. t·, ,:, " ,~;.;,.'. "' :::.. ~'~I:9l~Ï'h~f 't\~~~KET' -, ,tfr1641~'" ,. ~,.A68'Á&J" J,YOJ.3SSEfl ~R PATEL· . ";, . P 0 fSl}Jt ,4 StJ ~ 2 . ,'" ¡ \ ' , t1~~€.RS\\lELQ,. tiS. 933$1.-:;042' . . ' . '1lj~: ::~;": INVOICE NjJMBER ' ~. . . ...l. MUST RETURN THIS COpy WITH PAYMENT RETURN PAYMENTS TO: CITY OF BAKERSFIELD . \ P.O. BOX 2057- AKERSFIElD,CA 93303-2057 .' HAl~RUy0! NATEq!AL$, DIVISIQN .^ j:->t..'\..1., ACCOUNT NO. UT r 6'q·t[¡~ . . J' ~ ,Annual f~e f~r U~d~r~round jtoreJ~T~nkDper~tins ~~r~it 2 Ill. .:n!.: ,·,!·nr-: 01/aiiA.5,~,_ ",0 ' A .~'. '.' . It'; >.1 "~' ,.,' ~1te koør =~Jvl ~I~~t RD r ;':~,r'¡! T rU? 5 f':.H~ Jul" l.9'~,J. 994. lti [-' ^ 'f'NU~ T~_,lh E!~ 12 .t3'i:/lt:,¡"i;-it¡: ì~ i) . ~I (j j ,,4.$ ~ rntHH.";'Jf ~ e,r ~i (,r. : . +~,,'. , . t' . ';'. ;\ .~.¡ i~í 1 J\ I r. l.¡:ê I'>: if,. q: ~" . , .' . . ' ',"rd-:;',- ¡;¡'!Ll +;; - ;J¡:"1)N,t·~t:C~-lPl<> - 2'?~(J ,:; t·". Üif,i ,: C\:t i1{; OF '1~, flU;; INQUIRIES CONCERNING THIS BILL, PLEASE PHONE: H,}~') .$ 21/,,,,,- ~': ~? ?¡,~\ ...... ," .~. - . PLEA~E M.A.K~ CHECKS PAYABLE TO: "C'ITY OF BAKERSFIElD t: r e \d ö;;¿!$ ? ¡¡¡ L'ì i'll' (: ,. ~4/25/9' Payment , Å@ j ~$ t rid:''\) t 2 íU. t> 2....: "'204.. Of' ~2(!' .,;,1 :" . ;·;··If. <::-~,..,C;::::)~~~...... .1' rOT At. ~,~i\tA·:i(f j).~þ )/" ~l<" .........~........,..,"'ì'"""..~f- . ,~ . U:":.l K j'J:.- '51'- i~:: A ¡Ii:.i.; A~)¡;.~lN St f)V"('H.¡ ~(Ô)(Ô)R ORIG~~A~ INVOICE NUMBER /. I _/ ~IcL~ 0I~i MA~K~T ,-', ,f1,i.i;:'!~ L.. J Vû!JSSf:,~! ì> ~'\ f/t'fi' -l·)"':~:'I::~J·jÌ . :.,¡ . .".. '., ~4 . . __ ....t. ¡¡".~ t\T '¡r(¡ II' 7' j, ~~ :".f;.('"Ti.-L I @PRINTEDONREGENESIS® POSTCONSUMERRECYCLEDP~PER CUSTOMER COpy d_ ,}{~¡,,>=:~., ! ~:t..D? (f:¡, '.~n·n '~:Hj (,;{ 0,,0(\ . ....,. :;~ . tit / ~'} CENTURY TITLE & GUARANTY COMPANY , ESCROW DEPOSITORY ACCOUNT 5405 STOCKDALE HWY., NO. 103 BAKERSFIELD, CA 93309 . .~ PARAMOUNT BANK, FSB TOWJI orul CounJr Bmllc" 8200 StocA:dlM HighwØJ BoünJløl4, CA 93311 4327 90-8599/3222 ESCROW NO. 69241-MB April 22, 1~4 SEVEN HUNDRED SIXTYNIHB AND 20/100 PAY ******769.20 DOLLARS $ r TO City of Bakersfield THE P.O. Box 2057 ORDER Bakersfield, Califomia 93303 OF Attn. SG316202 & 55636102 ì :1 ,:_~ ~~. IIIOO~:l2 'jI1I1 1::12228 SqqSI: ~(U~w~u~. ~o 70:l~ 'jIq SOqll1 CENTURY TITLE & GUARANTY CO. DETACH AND RETAIN THIS STATEMENT THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW. IF NOT CORRECT PLEASE NOTIFY US PROMPTL.Y. NO RECEIPT DESIRED. DELUXE FORM WVC-3 V·2 DATE DESCRIPTION AMOUNT 04-22-94 Escrow I 69241-HB Emil Dabbas and Leila Dabbas to Hasoud Abbasi and John Yous~fi andRamesh Patel Wible Hini Hart, Bakersfield, Califomia $******769.20 For. . Claill to Escrow ~~îi.oÇ 'å \ ~ .,~ ç t( 03 Seø1.. 'ß \lo~.43 ß doLl. 0.:> Sb6\tø~Dd ~sto~fp' Cd. 't-\m ï d-~" () \ UïlloL\ \0\ r Y-2 r' \ ~_ þ--..i .,,-...,,-, ~._-a: t . 03/16/94 - . '- ~. ~(Ç~O,¥~.~. LUCKY 7 #19 ~15-000-00009~ . MAY 31994 L' ge Overall Site wlth 1 Fac. Unlt . , General Information By 1 Location: 3301 WIBLE RD Community: BAKERSFIELD STATION 07 Map:l03 Haz:2 Type: 1 Grid: 30D FlU: 1 AOV: 0.0 Contact Name EþlTT, fî~':UUS M~~Abb L!LA DAnJªASJñhn Vo~-e.fç.¡ Business Phone (805) 397-4553 x (805) 397 4553 x Mail Addrs: 3301 WIBLE RD City: BAKERSFIELD Comm Code: 215-007 BAKERSFIELD STATION 07 D&BNumber: State: CA Zip: SIC Code: 24-Hour Phone (805) 8-3-4-6625- (805) 8-34 6623 & £1- 33 5Y8"... D 9.:2 93309- 5541 GER Owner: 'VŒS'f COA£T P~R'l'NERS Address: 8501 K~KN CAN10N R& City: DAKERSFIELD Phone: (805) 397-4553 State: CA Zip: 93306- Summary I. . LJ " "ú wi AbhÆ9 Do hereby certify that' have ~ reviewed the attaChed hazattJous materials m3t-~~I:J. ment plan for ~7.-I1/9 and th::~;t along with I'" ,...... .,) any corrøctiOftsconstitute a complote and correct man- agement p~n for my facility. /~ L~ :'://'1 ·,,~ ..r- . ~ 03/16/94 LUCKY 7 #19 215-000-000091 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Forni Max Qty MCP 02-001 REGULAR UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 SUPER UNLEADED GASOLINE Gas 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-003 PLUS UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL · ~ 03/16/94 LUCKY 7 #19 215-000-000091 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 REGULAR UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 I 5,000.00 I 100,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientlUST IN FRONT OF STORE - Cone l 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 02-002 SUPER UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Gas 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Gas. Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 I 5,000.00 . I 100,000.00 Storage UNDER GROUND TANK r Press T Temp -:-, Location Ambient AmbientlUST IN FRONT OF STORE - Cone -, 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 02-003 PLUS UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 I 5,000.00 I 100,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientUST IN FRONT OF STORE - Conc l 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 ·" . ~ 1, ,'\ .~.. 03/16/94 LUCKY 7 #19 215-000-000091 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification DIAL 9-1-1 GIVE LOCATION, AT THAT TIME IT IS SPECIFIED GAS IS INVOLVED, ALSO NATURE OF EMERGENCY, (FIRE ECT). SUN VALLEY OIL IS TO BE NOTIFIED. I <2> Employee Notif./Evacuation EMPLOYEES ARE NOTIFIED VERBLY. EVACUATION BY REAR DOOR, COUNT TO BE TAKEN. <3> Public Notif./Evacuation EVACUATION BY REAR DOOR. I <4> Emergency Medical Plan CALL 9-1-1. ~ -ì . . . -- 03/16/94 LUCKY 7 #19 215-000-000091 00 -, Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention NO SMOKING SIGNS ARE POSTED. STOP ENGINE SIGNS ARE POSTED. TANKS & EQUIPMENT CHECKED ON A REGULAR BASIS. ! <2> Release Containment TANKS ARE CHECKED ON A REGULAR BASIS. i <3> Clean Up FOR SMALL SPILLS CAT LITTER IS USED TO ABSORBE GAS. FOR LARGE SPILLS CALL THE FIRE DEPT AND SUN VALLEY WOULD BE CONTACTED. <4> Other Resource Activation -' ~: l: ~ ''¡' .. . . 03/16/94 LUCKY 7 #19 215-000-000091 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ????????? B) ELECTRICAL - BACK ROOM C) WATER - OUT FRONT BY THE STREET D) SPECIAL - GAS PUMPS SOUTH SIDE OF BLDG ALSO BACK ROOM E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS & ALARM SYSTEM. NEAREST FIRE HYDRANT - NORTH EAST CORNER OF LOT. <4> Building Occupancy Level ~ ,:....' ..te" -.~ . . ~' 03/16/94 LUCKY 7 #19 215-000-000091 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS F~CILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ONCE A MONTH MEETING TO DISCUSS PROCEDURES IN CASE OF EMERGENCY. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use BUSINESS NAME SITE LOCATION OLD OWNER-NAME NEW' OWNER NAME NEW OWNER ADD. -- BULK TRANSFER (business) ú.J /¡},t. € /Î?n// /'7,<¡;z. T 330 I - 0 /'6 ~<f - ';27) E /?7 It.. e' ~ € It~ /'7 VA1 <š'~ ß.5 I IA.JG~., COA.I 7'"" ?/?IZ..-r-U€1l.:S f ~o I I< €R.IC/ t!A ¿(j So' 0 A..{ --::<.-";) ACCOUNT NUMBERS INVOLVED u.. I 7 ~ 4 7 () I :5& ~/~~o2 H/?J 72 '170 / :PR~':;;:"H -I, /9<;" r' 6Ai<.é-¡L5F/~--7), t!..A . THIS INFORMATION IS TAKEN FROM THE DAILY REPORT AND SHOULD BE \~RIFIED PRIOR TO ANY " CHANGES. DISTRIBUTION: Sanitation W2t[--.....-·ð'r Mnl!!'¡"'ð~ 1.': ~--r1ls - Hazaråous Materials ~_:r:f ~ 7¡/~~YkZ) ~~ q-; i:& ~ - "')~ II CSt~ \~ - .- rc .-:. -- , ~ 08/05/92 WIBLE MINI MARKET 215-000-000091 Overall Site with 1 Fac. Unit Page 1 General Information \ Location: 3301 WIBLE RD Map: 103 Hazard: Low Community: BAKERSFIELD STATION 07 Grid: 30D F/U: 1 AOV: 0.0 . \ r-- Contact Name Title Business Phone - 24-Hour Phone EMIL DABBAS OWNER/MANAGER (805) 397-4553 x (805) 834-6625 LILA DABBAS OWNER/ASST MANAGER (805) 397-4553 x (805) 834-6625 Administrative Data Mail Addrs: 3301 WIBLE RD D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-007 BAKERSFIELD STATION 07 SIC Code: 5541 Owner: EMIL DABBAS Phone: (805) 397-4553 Address: 3301 WIBLE RD State: CA City: BAKERSFIELD Zip: 93309- Summary .. RECEIVED SfP 1 8 \992 HA7. MAT. ntV. ()~ I, J..t-ì L D~~\ Do hereby œrtify that I have (Type or print reviewed the attac~ed hazardous materials manage· ment plan foc.~.i~~and that it along with (Nømø of BusInGS!!) any corrections constitutE!! a complete and correct man· agement plan for my facility. If' ifr~~ ivy G Slgn;du18 q I Lt· 1rJ ~ .. -- -- 7' 08/05/92 WIBLE MINI MARKET 215-000-000091 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 REGULAR UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No For~: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 5,000.00 100,000.00 Storage UNDER GROUND TANK r Press T Temp ~I Loèation Ambient AmbientUST IN FRONT OF STORE .- tone l 100.0% Gasoline Components r; MCP -:-¡List Moderate 02~002 SUPER UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Gas 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 I 5,000.00 I 100,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientlUST IN FRONT OF STORE - Cone -, 100.0% Gasoline Components MCP -:-¡List r;oderate I 02-001 PLUS UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 I 5,000.00 I ,100,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientlUST IN FRONT OF STORE - Cone l 100.0% 'Gasoline Components \-; MCP -:-¡List Moderate I ~ . - , ~ 08/05/92 WIBLE MINI MARKET 215-000-000091 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical ¡ <1> Agency Notification DIAL 9-1-1 GIVE LOCATION, AT THAT TIME IT IS SPECIFIED GAS IS INVOLVED, ALSO NATURE OF EMERGENCY, (FIRE ECT). SUN VALLEY OIL IS TO BE NOTIFIED. <2> Employee Notif./Evacuation EMPLOYEES ARE NOTIFIED VERBLY. EVACUATION BY REAR DOOR, COUNT TO BE TAKEN. <3> Public Notif./Evacuation EVACUATION BY REAR DOOR. <4> Emergency Medical Plan CALL 9-1-1. 7 - , 08/05/92 WIBLE MINI MARKET 215-000-000091 00 - Overall Site Page 4 <E> Mitigation/Prevent/Abatemt <1> Release Prevention NO SMOKING SIGNS ARE POSTED. STOG EN~INE SIGNS ARE POSTED. TANKS & EQUIPMENT CHECKED ON A REGULAR BASIS. <2> Release Containment TANKS ARE CHECKED ON A REGULAR BASIS. <3> Clean Up FOR SMALL SPILLS CAT LITTER IS USED TO ABSORBE GAS. FOR LARGE SPILLS CALL THE FIRE DEPT AND SUN VALLEY WOULD BE CONTACTED. <4> Other Resource Activation ~ I '. -- -- :-¿> "'~. 08/05/92 WIBLE MINI MARKET 215-000-000091 00 - Overall Site Page 5 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ????????? B) ELECTRICAL - BACK ROOM C) WATER - OUT FRONT BY THE STREET D) SPECIAL - GAS PUMPS SOUTH SIDE OF BLDG ALSO BACK ROOM E) LOCK BOX -NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS .& ALARM SYSTEM. NEAREST FIRE HYDRANT - NORTH EAST CORNER OF LOT. <4> Building Occupancy Level '.. .,.,: ,:.~.' 08/05/92 -- -. Page 6 WIBLE MINI MARKET 215-000-000091 00 - Overall Site <G> Training <1> Page 1 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ONCE A MONTH MEETING TO DISCUSS PROCEDURES IN CASE OF EMERGENCY. <2> Page 2 as needed ; <3> Held for Future Use <4> Held for Future Use b Farm and Agriculture IRI standard Business NON - TRADE SECRET \~I \ I page_of ~ NAME OF THIS'FACILITY:~ STANDARD IND. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL ID t CITY OF BAKER.SFIELD- HAZARDOUS MATERIALS INVENTORY BUSINESS NAME: \).1; ~ \e... N\; VI" M~ . LOCATION, ~~ ~'~~ ~ ' : ~~~~É :~P: ( - n r.- ~ -1.S~ q,p,OC? :~$' '=-'Ì~-rl.j"'~~" (' : 1 2 Trans Type L Code Code OWNER NAME: EM~ L ~,,~~S !i~SSÙp: è ~h~~~~ ~~~ INSTRUCTIONS FOR PROPER CODES 9 10 11 12 Cant Cant Location Where Press Tem Stored in Facilit -"- -- 'i/tJ "" ¿'.n/*._90 " C':::'.,f;,/·"; .,~ ~ 13 % by wt 14 Names of Mixture/Components See Instructions I: physical and Health Hazard (Check all that apply) C.A.S. Number Component 1/ 1 Name & C.A.S. Number Component 1/ 2 Name & C.A.S. NUmber Component 1/ 3 Name & C.A.S. Number o Fire Hazard o Sudden Release of Pressure o Reactivity 0 Immediate 0 Delayed Health Health phyáicàl and Health Hazard C.A.S. Number Component 1/ 1 Name & C.A.S. Number (Check all that apply) 0 0 0 Ò o Delayed Component 1/ 2 Name & C.A.S. Number Fire Hazard Sudden Release Reactivity Immediate Ii. ot Pressure Health Health Component 1/ 3 Name & C.A.S. Number :'; Physical and Health Razard (Check all that apply) : D Fire Hazard 0 Sudden Release 0 R~ctivity 0 Immediate 0 Delayed of Pressure Health Health C.A.S. Number Component 1/ 1 Name & C.A.S. Number Component 1/ 2 Name & C.A.S. Number l. Component 1/ 3 Name & C.A.S. Number :1 i: i 'I r ~ ),1 EMERGENCY CONTACTS 11 --... Name Title Component 1/ 1 Name & C.A.S. Number Component 1/ 2 Name & C.A.S. Number Component 1/ 3 Name & C.A.S. Number 12 24 Hr. Phone Name Title 24 Hr Phone Physical and Health Hazård C.A.S. Number '·(Check all that apply) D Fire Hazard 0 Sudden Release 0 Reactivity 0 Immediate 0 Delayed of Pressure Health Health Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) . I certify under peanlty of law that I haver personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquirÿ--of those ..individuals responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete. . yA{~¿'Y~~ OPERATOR OR OWNER/OPERATOR'S AUTHORIZED REPRESENTATIVE - - SIGNATURE --.!:l. US" Of d' DATE SIGNED ~ 5Et'n BY: DABÁA5 E~1 I L .1. __ C:U;12-16-91 7 : 39Ar'1 ; - :30.7Ø314~ 3951349;1=1 2 ~ DX- JBWkeJrsifield Fire Depto Hazwrdous MS1,'íreril6'J.W JJJJlVJÏSJi.OIDl 213ij IilG}Vi StR'OOlG 1BùeIé'Sfield~ CA 93301 ll~·1b\ ~~ß~!ti\K*D(:jijjS MATERIAl~ ,~M~NìT [?[LA~ . i\C{\ f (20 CÞ MŒWED OfC 1 7 1991 HAZ. MAT. DIV. f U~~mM(;iR©N$: 1. 2. 3. 4. 10 avoid further actton, return thIS form within 30 days of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answsr ths questions below for the business as a whole. Be brief and concise Q$ possible. la~-lsA 7-7C $[E{;1I!©1M ~: ~RJJmIN¡¡e~$ mD~!NJlf~IF~CA11IO~ DA1b\ BUSINESS NAME: WIBLE MINI MARKET LOCATION: 3301 WIBLE ROAD. BAKERSEJELD. CA 9~309 ----- MAILING AD.DRESS: SAMF. AS AROVF. CITY: BA¥"'~5FI~LD STATE:cþ. ZIP: 93309- PHONE: (805) 397-<41553 DUN & BRADSTREET NUMBER: SIC CODE: PRIMARY ACTIVITY: SALES OF GROCERIES AND GAS OWNER: EMIL DABBAS MAILING ADDRESS: 330 1 WIBLE ROAD. BAKERSr:u, ,O.,--6A.~:' ,':1~ --....-. $~{;1~©W!~: œ:MIEIR<((§7~NC~ N©1~¡¡;ijCA1í~©~: CONTACT 1. EMIL DABBAS 2, LILA DABBAS TITLE BUS. PHONE 24 HR. PHONE OWNER/MANAGER (805) 397-4553 (805)834-6625 OWNER/ASST MANAGER (805) 397-4553 (805)834-6625 1. FD159( >. ·> -. e Bakersfield Fire Dept. -- Hazardous Ma.terials Division HAg:A~¡gÖIUJ$ MAìí!E~~Al$ MANA~~ME!Nìí ~LAN SECT~OIM~: mA~IN!~fi'\1]G: NUMBER OF EMPLOYEES: .:3 MATERIAL SAFETY DATA SHEETS ON FILE: u.. e..ß BRIEF SUMMARY OF TRAINING PROGRAM: Ð \J u:.... p.." .,......... 0 t.J"\ ,.... ~ e... ~ \, \I..) ('!, 3- ~ M~f:;. u.c £..vv...~€-~~ ' ,0 ~ \<;.~~~ ""'Ç> QtJ c- 't.-PCA..f2... ~~ ~~e'ii'~ON 4: EXEM"~ON! REQU~~W: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH &. SAFETY COOP FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) ~@@~ Q ~/G!~4J4 I. CERTIFY THAT THE ABOVE INFOR- . MATlON IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE IICALlFORNIA HEALTH AND SAFETY COOP ON HAZARDOUS MATERIALS (DIV, 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. I L ¡); tJt&óJc 12 /íI71OwA Gel!. r- ~-V TITLE I ~IEC110N~: CERTIfiCATION: DATE 2, 17 :t~6ÞZTS6Z ....17 T ZØ¿6ZSØEi ~ WöTÞ:¿ T6-9T-ZT~a) -, I ¡"l3 ~;öt:l!3:öa: /.8 .lH3E SENT B\': DABAAS Et"'1 I L e.12-16-91 7:40AM; 'e 80a0314-1 3951349;*=1 3 Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MAT1ERITAlS MA~A®IEMEJN!T PllA~ Facm'iy Unãf !NIOIme: W \ ~ L~ 'fÇ'\ \ N \ f"\r-"''(~_K.£_l SECTION 6: NOTIF~CA110N AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: \ - ~~. ~\\ - G,vE.... U~'\C.JrJ}. ç..,,,,, '"î\,,~"" ,'~~ 'Spf.c\~,~o G~'5 \"'::::. '~VCH_Vé...Ú A,-9.o ~r...\\.Á.R...Jë.., ) ~ ) l. ~ \ e ~} 'ùL-0. :;L.- c:::;. ~ V r->t-\...L'\. 0 I L- \ ":::. ,,0 \3 ~ r-..\ 0, \ ç \ b Ie 3- £....." L '1:>.. ~""" S (à vv UL / "'"'.. "'A<'>~) \\ ,~ O\: B. EMPLOYEE NOTIFICATION AND EVACUATION: \ - Ëf"V'$OLO \.4... ~€-~ A¡ Q.e., N t.iT1 ('I ßO v U<....Q.u-'\ :,\.- E.. vla.¡e.\A~"O~ ""ß~ ~€AfL Ì) C'o~ _ C....O~," D ß~ \9::1''-.'80 \\-\~ C, PUBLIC EVACUATION: ~Plt"Yì~ ~~ 'A ~CI)G D. EMERGENCY MEDICAL PLAN: QA'-L <\\\ t~tJ@1h ~IlIGIJ&]fl 3. I{) 18;10 e .' . Bakersfield Fire Dept. . Hazardous Materials Division HAtl.AR!tj)©M$ IMAT!ERDAL£ MANAG~MEN'jj' [?!LAINJ I SECTION 1: MIT~GA1i'~OIN. PREVIEN'ii10N AND A~AYEMENr f>LAN: A. RELEASE PREVENTION STEPS: ,....\ 0 s:. "" b IU tUG. S, 6 fV c;, A. KZ.. G ~ O'S." ~ S t..?~ ~c, - ~ \ 0p..)"S. ",,-~e..... ":$o'S\ ~ \" .p... ~\i.....c:;. <:1.- E .f'. q lÁ.\ 'f> _ c...........~ 0 \tV 'Pt -R.. ~'\ l.J.....L,f;- Q.. l' ~~ So ( ~ B. RELEASE CONTAINMENT AND/OR MINIMIZATION: T ~\L'S ~Q 'ë- CA-\. ~ (¡::) UN p., ~ E£\ '^-LA ~ ß A <r.-. I $. C. CLEAN-UP PROCEDURES: Q oº-.. ~ "",",~u.- "':?.øy \ 1-<-::' ~, L\ "' ""'( ~ \ ~ La... ~-=c..- "" 0 þ..., ~ ov..J2....t.. .c. PI S ' ~bR. ~~~"\-"'\'-~) f~'R.L ~ "-R\' ~ ~ \) u... ~ 'R U-..~ WÚ u..LC ~~ 1>0...1'.. 'F\~_.i' ~ -4. SEC"ilON 8: ifflLmf SH!l6T-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ElECTRICAL: ~A~ \<VðVV'""'\ WATER: ()I..\..-"- Ç;<R..DN"'"'\ ßù. ,µ,'L <¡;,QE...L\ , SPECIAL: C GPtS Yu"",,",{> "S.) "3. ov......,...... '5.\'0 "t- 0 ~ ~LD<Ò Þ,L~ð ßtAu(... \?~ LOCK BOX: YES/NO IF YES, LOCATION: SECT10Nl9: PRIVATE F~RE PRQTEC1i101\lJ/WATER AVAILABilITY: ~@@[f¿ ?RIGO!P(jßJ~ A, PRIV A TE FIRE PROTECTION: 3 ~,oQ.."¿. 'ë..^I, N6\A 1<2:. }1 'U.S. cy A- Lp.,~ ~u....<;.'"'- ~ B. WATER AVAILABILITY (FIRE HYDRANT): \Ñ.u~~+\ 2..-""'5" ~ÐQN~ c)\- '\-'\£...-, LDT, 4. 1'0\690 5 1=I~6Þ2T562 E-þ T 20¿6250:::: ~ WÖ2Þ:¿ T6-9T-2T~O~ ~IW3 Söö8öa:A8 LN3S C Jl.. ulLu'if ~ ~ Farm and ã9ricultur~~Stm~d&rd E~œin~~ø :u: (fì ~ ~~~~~~g:: NAME: _ v.¡;,:-~, ~MA.Q..\~t.i\ ~:ITY, ZIP: ~~L\ ~~_~ q33n~ H01\1E 9: __- _...,:w.. - - ~- ~~ ~1I«::~ ~'L.- ~ p.. ~(bA So. ~~ P.!äg <J..j) Æ' lB)&:.JK.œ;; IR?. S 1F' 1C m;; LID ~~ ~mm1r~ 1r~m¡y OWNER NAME: ãDDRESS: CITY, ZIP: PHONE f: NAME OF ~~IS l~CELX~~8 ST~~ IND. C~S$ OO~E: DUN ~D ~~STRŒET W~ER/FEDERAL ID . - -..- -- 1 anm TO 7 II f1 Days Cont OD aite 12 Location Where StorGd in Facil!t V-"MJ t..Q6~ou....'NO \ \\J 'T"" :3 'hYlllical Gnd. 8._1t" 8.Ð.\\ard 1"0 ~CbÐCk 11 that apply) Q ~ FiCQ Hazard r:J BuddQn RQl.&mQ Gi of IPresllu= Q II) C..I\.S. IlUØIbÐK Compon~ot a 1 ~Qœ9 ; c.A.B. 13 'by wt 1<1 ~~g of M~tucQ/CamponQnto Sœo :tnotruct!olW ?;'~~ - . :. o ROÐçt;ivity D Igaa¡c¡l¡atQ ~Y£d Bœaltb Boslth Compon<mt a <I ~Q_ Ió c..Il.B. ¡;:¡~ cOlilpOnont () ] 1i\1""'" m C..Il.8. Q\1œbQr 'hygical snd l!lsalth BsJ:6Icd C.A.8. RUIIIbQr (Check Qll that ¡apply) o Firm Ha2&rc!J 0 8uddGn AiolGQOO 0 RQQctivity 0 Il!!I!IIISdiQtJS 0 DGh>yO!>d E of Pr_IIIIUrQi !!II_ltll ØSIÐlth Œ. ¡-') <:t ComponQnt 0 1 ~amø ¡ C.A.S. 1tUJDbÐr Coçcmont a 2 QÐDI Ii C..II..8. ~\DIIIbQr Cosponant 0 3 ¡;:¡ame ß C.A.8. ~umber .. e"- bJflõlical ¡¡mc1 BØ£llth Hazard C.1!..S. I'IWiIb3Ir .... (ChCllck ¡Ill th&t apply) 0) 'h Ci FiJrQ lI!¡;¡zard 0 8udc1lSn RølesQQ D. lR<!t£Ictivlty 0 YlllllEldiQOO 0 DlSlayed i' of Pr.0Bure 1I_!th BlôlÐlth 0J .... iì o CoœponQDt 0 1 g~ ~ C.A.8. l'fumbeJr COIIIpon<rmt 0 2 Nama 5 C..I\.8. !<WiIb<!¡¡r Co¡¡¡ponont 0 ] NaJDiõ , C..Il.8. g\lIØbQ¡r '.a Coœponcmt a 1 ¡;QJIœ 13 C..Il.S. [;UIIJbtar »~f1f Ol'~a~ ColiiponQDt 0 :;¡ [;a¡¡¡:a ð C.1!..S. IlIIIiibar Coçonœt 0 :1 QiQIIID & C..Il.S. RWIIbw bysical and. Healtb Bsz&rd C.Ji.8. Number (ChlSclt Ql1 that apply) o !Fire 1S!Qz=d 0 Sudden RøleaQe 0 lR_ctivlty 0 Il!!IIICiiiQW 0 DC!llayO!>d of PrCll8sucQ SIiQ!th Hcaalth -1 ili E'MERGE~CY CONTACTS ~ p,fØ, .s. MAlU. 8'3 A/-biR~5 :2 2(1 Ik. Phone;) L.J L.fl £'IQJQ ACß~~ ~'S.T. ~,J <ritlQ {, 2<1 Br PhGln.. rn ct S rt1C1c¡;¡tion (READ AND SIGN AP"J!.'ElR COMPLJ:TINa Få.L SECTIONS) g :Câlrtif)f unc1Qr ß)oonlty of 1/j!1!/ that r havQl' p:mrlilonQUy m!uilllllol:d and CIlJ f&IJiHal' tilth thlõ1 information oubJaittc4 .. :Uvilll\!J¡)!o IrGOpDnDiblQ for obtaining tho lnformmtion. ]I: bel1QV8 tJu:1t th.. outmittGdl infoDnation io true;), QCO >- ; ~¿1d::: 7J/4ßI3PS OWNeR.. / /Y)14I\.Jr.:I (!, ~ ill ¡¡g; i:'.!!JYJ OOI1X¡:;XP.L '!i?1!'n!l OJ.' a:m1m/OPIZM.'l'OR OR ~c:rfmummoli1 AUTiltDXUZJm m:!PJm8JmmTIW (0 thio and 11 Qttœboo dooUl!lmto anèl thet ba¡¡C>d on ¡ay inquiry of thos. Qt¡), and c ~\:t~ IImi'.i:! sramm v / ¡ / e- .1'-' 16 ,\:,.. <=.- -91 7: 39At'1 ; SEt'? BY: DABAA:::; E~1 I L / ~ ~.' WIIii!.,(Q MINII'J~ffi' J!3O! WI~~ ~~. ~~R~IELI), eA ~ /f77"¡J ?A-J...PH E. flA ~R:D OtA. ç . !a0314" 3951349;¡:¡ 1 ¡-) U &1-/ rY'J¡P¡ 1'. (! () tJ Ro f fV;~?() (If" ~ ~BèS{'lêLO (!.rrý /ÎfG£ .'JJtSf'r . ~ . y I i I .... ~J ~~ v1 ~ \ ~ ~ . ~ ~ '..J ~ .~ ~ ~ .~.~' . .- -~---.-~-...--- - -- --- --" . ~N ~-- i ¡ ì , ! ¡ 1 \ \ \ \ ¡ î I -- ---------- ---. ------~."-_._. -~-- - ---I \ i ! ------------~-'-7-----'-----~ ~--ZkcL--frJ~k--2 ___1__________ ----.--..-------..- __~(il_33J)~--W c/Xv _,_______~_J, , !, -- --+--------- - -------- -------------- ------- ______3 _,_ta~ ___f/Ju__çp &:c.unc1...J----\ ~ J]..vm. ov-tcL - .. ----,------,; -----. _d' -----, u__ ---.-- -'- -' . -. . -... -,_.- .--- .----- i _______~~-~---- _IJJL 115 ---'---'-'\ ------~-- ---------~-,-----,- ------ ---_... --,-------.-.------ ,--..---.------.--\ , ; í I ______.______.n_ __. ___~ - ---,------- í -- \ ¡ _-n-..:-~-.....n. ...-.=-J ---- ----.. .ou I I I - _-__n] \ .--~--~--_.__. -----. . . -~- ------- -- ---- --- -- -- ---- ----- - - ---'- - -- ------ -.+-..--_--_0. ., - -- -- -- --- -- _..- ..---'- ..- .- -- --. --..