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HomeMy WebLinkAboutBUSINESS PLAN ;:~::;''':-~_:::'-'''''''' =~-::::... ~- ..,:r- \- ièiir' ~~:,'JD ,:~cfr;/:r-' :¡",:",-,:",~ ~ .. . _ . iJ.',;~;::-:, Y\, ~~lt.':e.];!;~8?,";~~1~,.,..~=~,.,..,J; 1,::-16-91 }?S3At1: JHIMMIP- §lltl~ jQ)~~MIMil I, V/I fA(ÇTI~ilV ¡g~AG!RìAM Business Nome: W I, en..'2.. ''f''r, \ iV\ M 'A. Q...~L£.. 'l.' ~-~~-.--_._---- \.. ~ .~~ ~ I ,,- of - - ~ _.bO ~> "d.. ;~- ~ ....-. ,,~ ,-., ~~ " '- ." "7øS-£~4,;'~f::;'~D{:~;;:1i¡~· .~. ßAJP' .-, · JPLAN Business Address: ,33 0 \1~'v-J,~0¿~· . for Offic@ LisŒI On1v First In Sta'i1on: ! \ \ InSl:>ec"On 5"'"On__ ....'~_.... ~;:::;;:;r- ---"'" ----=- -- -..... Area Mop Ii - ~©~ {( \ ?LPlIV2 ~~ - ï ' ri 2'- G... ~ V(J.. o 'Ii \) \:i '{ r \~ S\ j ~0 o Lf N I\' ) , fþ)~ij~ Or~G~~&~ '\.; \ ! \ \ t \ \ \ ,"\ ., (( ~:; " \ \~ c. ., .\ \ 1- ..~. -)"~1' 'þ if> ) _._~ (-- Om"-ë I .s" Mße: . '..r._' ~\ I <;' (¡,{,: \ \ \ . 1'1 \{-/~--:- ,'Û\;\i: '(J0:; " A ~ (\ 'f 'J "--""""""'---1 . \ ~ r:~ ~ ð If'... ~ '---=---- ~' r---.---!r~ ~; ~ g ¡ I--=-~- . '"J ~ )' ",. ~ i 'd i , ð ~ I~ I 1- ,,- ir---- I --' fþ ( ~ 11 Q-/ ~ \ :'try""-""'....!? .QC' I' ">1"..-'-" (....,., I & c.." ~~.J'<- I \ ~. ~~.f~-. ": ~'/. .~~: . ~., "".." ,. ~ ;':;'Y(JI~'" '..... ;'..'. , .: . . '. .. .. .. .-.'..' .. , í',& ...... .,"" . .. .' ....' :.... .. '. \\ , ., . . '.~, ,'. ;,'~ . ¡ . . . - ~ . - . BA1ŒRSF.IELD CITY FIRE DEL~,'::, . 2130 "G" STREET .' 3¡U5f' 5 R Er: ~.I "EO. 8A1ŒRSFIELD, CA 93301 " ./' , - . (805) 326-3979. . ."'.' "A J U l 1 3 1987 . .. lêfl .. . ..' .. '. . f.r,· ..' "Ans'd; .' . . .-....~.... OFFICIAL USE ONLY ID_ 000815 us D1ESS SA.'''E HAZARDOUS MATERXALS BUSXNESSPLAN AS A WHOLE FORM 2A 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. SECTION 1: BUSINESS IDENTIPICATION DATA A. BUSINESS NAME: 7-Eleven Food Store #2125-19610 B. LOCATION / STREET ADDRESS: 3301 Wible Road CITY: Bakersfield ZIP: 93309 . BUS.PHONE: (805) 834-1006 SECTION 2: EMERGENCY NOTIPICATIONS In case ot an eaerlency involvinl the release or threatened release of a hazardous aaterial. call 911 and 1-800-852-7550 or 1~916-427-4341. This will notify your local fire departaent and the' State Office of Emergency Services as required by law. . EMPLOYEES TO NOTIFY IN CASE OP EMERGENCY: NAME AND TITLE A. Store Owner/Onerator DURING BUS. HRS. Ph_ (RO')) A1L..-l nn¡; AFTER BCS. HRS. Ph_ SAmE' ~ B. Kathy Mejia~' District Manager 2125 Ph_ (805) 834-2711 Ph' same . SECTION 3: LOCATIOI.' OP UTILITY SBOT-oPPS POR BUStlESS AS A WHOLE A. NAT. GAS/PROPANE: None B. ELECTRICAL: Back room hallway C. WATER:, Store side front D. SPECIAL: E. LOCK BOX: YES /rN~" IF YES. LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? ~S / NO PLOOR PLANS? (~S / ~O MSDSS? LY....E'S .I NO KEYS? YES / ~O - 2A - I, ;, ,).' . ~ ", ~. \ .' . '...:>:,.. , "-{ , . ~ ~ . '. \;.,.... " ., '" . .'.,~~" f':" ---~.... . ;) ..' "" .~ , ' ~ '.- " ~ .. .. ., .. . '. ",:~,~~~~~:.:. :.-, f, :''', " (.tf¡¡';;«(¡í~Þ;'¡~i¡i .. >".~>:, .;, ';;-t..s-:',. .. , , . , ..... -~" SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE ":( \" . 1 M, ~~ ~ " -: ,,!j~: j ~.~' '. '. . , Emergency Coordinator (pre-determined)' shall ·rtotifyallagencies ,and inter- company p~rsoÍls in, the event of' incident.. EmergencY,Coòrdinator shall implement all necessary measures in regard to ,emp'loyeelenvir~>nmental , safety as instructed by training received. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE Police/Fire Department: 911 Nearest E.R. to location is to be used in the event of injury. SECTION 8: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROG~~ WHICH PROVIDES EMPLOYEES WITH I~ITIAL A~~ REFRESHER TRAINING I~ THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~TERIALS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO YES ~O B. PROCEDURES FOR COORDINATING ACTIVITlES WITH RESPONSE AGENCIES:.... ..........,......: .... YES ~O YES ~O C. PROPER USE OF SAFETY EQUIPMENT:......... ......... YES NO YES NO D. E)ŒRGENCY EVACUATION PROCEDURES:................. YES NO .YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:...,... YES NO YES NO SECTION .,: HAZARDOUS JlfATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS RANDLE HAZARDOUS XATERIAL INQU~'TITIES LESS THAN 500POt~DS OF A SOLID. 55 GALLONS OF A LIQUID. OR 200 CUBIC FEET OF A COMPRESSED GAS:...... YES NO .. , I. . Kathy 'Me; ÚI. . . certify that the above intormation jsaccurate. I understand that this intor.ation will be used to tultill .y tir.'s obli¡ations under the new Calitornia Health and Satety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate intorMation constitutes perjury. ., ,.:, ..: , SIGNATURE TITLE DiStrict Manager DATE ./'Þ/~· - 2B - '¡ ~ . " ¡ . . BAKERSFIELD CITY FIRE DE?ARTMEXT 2130 "Goo STREET BAKERSFIELD, CA 93301 - . OFFiCIAL CSE ONLY ID# BUS INESS NA:VŒ: - - -' - - - BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A 1/ INSTRUCTIONS 1. To avoid further action. this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW...", _., _ 4. Be as BRIEF and CONCISE as possible .- --.-'-C--- --..----...,...,.,...~ FACILITY UNIT# FACILITY UNIT Nk~: SECTION 1, !lITIGATION. PREVENTIO~, ABATEMENT PROCEDURES " " ' " " '" "" " I ;." ' ".. ." .". ,I ~ Ô~~ ~~~%::&G.d ~ /avdo ~#~--~;¡";~-~-k~ ~- ~~ 7:::J¡/~$~. ~~~ O>(þ~~ SECTION 2: NOTIFICATION ~\~ EVACGATIO~ PROCEDL~ES AT THIS L~IT ONLY ý~ 9' ~ 91/ ./or ¡æp of ~ t1J- 1/41 euv£) ~ ð¿S - ~~, ?3~ ~ ~ ~ ~ 7/;1 13r D -;do;:; Hod- - 1~ - . RAKERSFIELD CITY FIRE DEPARTMENT FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY r¡:' J.Z- (;~ I. D. t Page 1. of 1 BUS I NESS NAME: 7-Eleven Food Store 112125-19630 ADDRESS: 3301 Wible Rd. @ Planz C J TV, ZIP: Bakersfield. CA 93309 OWNER NAME : The . Southland Corporation FACILITY UNIT .: 100 ADDRESS: 1240 S.. State CòllègeBlvdFACILITY UNIT NAME: CITY; ZIP: Anaheim,' CA 92806 d PHONE .: (805)834-1006 . PHONE ,: (71?1.) 635-7711 10FFICIAL USE CFIRS CODE , ,- ONLY ] 2 3 4 5 6 7 8· 9 10 TVPE MAX ANNUAJ. CONT USE LOCATION IN THIS , BY HAZARD O.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE lÎ M Est. 118~ 10,000 89,076 GAL 01 19 corner Wible/Planz 100 Gasoline/Unieaded . FLLQ 1203 I .~ 10 , 000 215,719 GAL 01 19 " 100 Gasoline/Regular FLLO ' 1203 3)' 10,000 82,105 GÀL 01 19 " 100 Gasoline/Suner Unleaded FLLO .~ 1201 .M ~M :2. J 2.s- .26"~ .-...;J Id~J :a::. .~ Ft3 04 99 nr. sales counter . 100 C02 / Carbon n; rw; rlø NFLG 1013 . . .~ ,. , : ': . <- , - NAME: Jack Doolittle EMERGENCY CONTACT:' Store Manager TITLE: Gasoline Manager SIGNATURE: TITI.E: Manager , ' ;v ~ -'EMERGENCY CONTACT: 'Kathy Mejia TITLE: District Manager 2125 PRINCIPAL RUSINESS ACTIVITY: Convenience store with self-serve gasoline PHONE. BUS HOURS: AFTER BUS HRS: PHONE' BUS HOURS: AFTER BUS HRS: DATE: (805) 834-1006 (805) 834-1006 (805) 834-2711 (805) 834-2711 I ~. - 4A-l - I, CD I 1...:) ... z S oo o z ;;: ... !í > r- oo ... '" o c ~ ... () ... z ;;¡ III " Facility Ide"lIflcallon . Tier Two ( . EMERGENCY \ AND HAZARDOUS CHEMICAL INVENTORY Specific Information by Chemical 7-ELEVEN S'IDRE 3301 WIB1Æ BAKERSFIELD CDUNTY: KERN NO: 19630 CA Q3309 SIC: 5541 ( S'IDRE NO: 19630 . .... .-..-...... _.....:-. ... . " '~:: . .: ':. .:-.;:- :-: - "-::"'..:- - ", :-. .: -'. :- -.. . ': "-::" ,::. :.--:;.-:::::'-, ::';"":.:.«":: :._", . .,:::;:"\.,::::: .'-.-.-.-.::.,,-, Chemiç~l[)esçrjpti9nnn CASITIIIIJ [I] 0 Chern. Name IJnlPndPò r~solinp Trade 0 Secr.t Check all 0 Ihøl øpply: Pur. [!] o Solid [! liquid o ·Gal Mix CASITIIIIJ·[IJ 0 ~C:;D Chern. Name prerrrrum Unleaded Gasoline Check all 0 lX] 0 [X] 0 Ihal apply: Pu'. Mix Solid Liquid Ga. CASITIIIIJ [I] 0 Trade 0 Seer.1 Chern. Name Regu] ar r~so] ine Check all 0 [!l 0 [!] 0 Ihl apply: Pure Mix Solid Liquid Gal ,'yJ ßcY5 /wpS 5 Page -L 01 ---1- pages Form ApptOYed 0t.A8 No, .2050-0072 Owner/Operator Name '\ The Southland Corrx:>ration Phone I 214 I 522:....4790 2828 N. Haskell ~Dallas. Texas 75204 Name Mail Addr.ss Z.ip Emergency Contact Store Manager Name Phone· " ,_r-r-r-rl ~.~ L..L....L-L-J I I NAME : TITLE: PHONE: 24 hOUG S'IDRE MANAGER (805) 834-1006 J80.5J.,83A 10.Q.6 Linda Gathric¡ht! (214) 522 4790 Name Phone .-P JetinR form Physical n...... and Health Hazards Reporting Period From January t 10 December 31, 111 i Storage C()desand LoCations ". '-.-. .., . . -.-..-: . -'-.,'. . H ··.···(Non-Confidential) > . · ··Inventory Max. ,:'Avg. . No. 0' Dally ··Callv Cays Amount Amount On-site (code) .. (code) (days) Storage LocationS (check all \hat apply) , ~Flre Sudden Release 01 PresSU'e Reac1ivlty immediate (acute X Delayed (clvonlc) Parkinçr lot near DlIlTJP islands. ~FIr. . . . Sudden R.lease 01 Pres.... ' Reacilvity [QI]] ~. ' . Immedial. (acule) . . . '.. .: X Delayed (clvoníc) ........ Parking lot near pump islandS.. 1 4 ŒIillJ ~Fire Sudden Release 01 Pressure . Reacllvily . [J2[J] m Irnmediale (acute) Delayed (clvoníc) Pnrki ng lor nPnr puJ'1'1!1 i s1nndc;. UIiliJ Optional Attachments {Checl< one} Certification· (Rll1d ilnd $;SII øjICr complt/illS 111/ sections) I CerlJ1y under penalty 01 law that I have personally .xamlned and am lamillar wilh t.... Intormallon .ubmilled In Inis and all allacnlld documenls, and Inal based on my inquiry 01 those lnØIv!dual. r.._Ib'. lor obtaining Ihe inlormalion. I believe Ihal r,. submilled Inlorm ion i. !rue, .¡occur ale. and complele, T ,inda Gathriqht Code Corrpliance Admin. Name aM ofl1ci,:'IIIUe 0' owner/()ØP.f'ator OR owr.erloperatOf·. au:horiled r.ptesent,ati'". B I have all ached a .il. plan I have allacned a iSI 01 Iii. coordinate' a.bCr.....aI10n. 01-30-89 Dal" ':Qned v Tier Two EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY Specific Information by Chemical FacUllyJdenllflcallon See page 1. Na,.,. Sin"l Address City· Owner/Operalor Name Name Mail Address The Southland Corooration Phone (214) 522-4790 2828 N. Haskell Dallas. Texas 75204 ~ SIal" _ Zip Emergency Conlac:l Name Title 24 Hr. Phone Dun & Brad r-TI_~_r-r-lII Number L..:...L-J L-L-L-J L...L-l.--.L-J SIC Code ~ .····.··.FOR ..·.110, OFFICIAL ···:USE· .'1 ':.»"..ONLY :,d Dale Received Phone Code Compliance Name Linda Gathriqht (214) 522-4790 Tille 24 Hr. Phone Phone CAS CI:III::::CJ [I] 0 Trade 0 Secrel . .(D Chem, Name . ? ni F'se 1 Fuel ~ No Check all 0 ~ 0 ~ 0 that apply: Pure Mix Solid Liquid Gal CASCIIIII] CD 0 Trade 0 Secrel Chern. Name ... z 0 ChICk all 0 0 -0 0 D z 3: that apply: ... Pur. Mix Solid· Liquid Gal ~ CASCIIIII] CD 0 r- Trade 0 '" Secrel ... <II Chern. Name 0 c ~ ... 0 m ì:' Z Cheek all 0 0 0 _'0 0 ¡; '" Ilral apply: Pure Mix Solid Uquid Gal Reporting Period From January 1 to Decømb8r 31, Ig Physical . and Health Hazards . Invento:')' . Avg. No. of Dally Days . Amount" . On-site .. (code) (days) Storage Lccations <Storage Codes and Locations . .. ..(Non::-Confidential) . . . . StorageC()de ~Flr. Sudden Release 01 Pressure Reactivity nvr-dlate (acut. Delayed (c/vonlcl Parkinq lot near pump islands.· B 1 4 [QU)·lj[3] .[iliJšJ ~Flre Sudden Release . . 01 Preuure . [IJ ïTI . Reactivity LL.J Immedial. (acute) . Delayed (e/vonlc . ITTI ~Fire . Sudden Release 01 Pressure Reaellyily Immediate (aeule) . Delayed (e/vonic:) CD CD ITTI Opllonal Attachments (Check one) Certiflcallon (Read and ·$Î&n ajur complelin& all uction$) I CØf'1!ty. ~r, ~alt.y,o"law_ that I ha,ve personally examined and 11m 'amilla, with- the infOl'mation suCm.tted In tn'l and all. attach!d documents. and _that based ~ rñy-i~uiry·of t~~_e Individuals 'r.sPon~.bleJOf'_obtAi-nlng the in'OIm~1iòn. I t;-tÙevê that lhe submitted In'OIm.lion is ~rue. ~ccu(ale. IInd compl~te -- SEE FRONT ~ P"ÄGE ' 0, i haye attached. a site plan D I h~.... AltaChed a lilt of ,it. coordinate abCrevl.IIonl Name aM OffICI..1 tllIe of c"wner/oOftrator OR ØVoIr.8rJopet'ator·1 au:hOIiled reptes&n1aIi"Je SIQna:l,.;rp. Dal" 'iQ~e<I