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BUSINESS PLAN 7/30/2004
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'.-" '- ;~~. 1 \ ~, - ~ '"'" . . r' .'Þ l ;¡- it - '" FARRELLS FASTRIP SiteID: 015-021-000623 Manager : TOM FARRELL Location: 6401 WHITE LN 112 City BAKERSFIELD BusPhone: Map : 123 Grid: 16D (661) 397-0271 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact TOM FERRELL Business Phone: 24-Hour Phone : Pager Phone / Title / OWNER (661) 397-0271x (661) 833-9443x () x Emergency Contact DAVID PALMER Business Phone: 24-Hour Phone Pager Phone / Title / OPERATIONS (661) 393-7000x (661) 393 -7000x () x MGR Period Preparer: Certif'd: ParcelNo: to Fire ImmHlth DelHlth Phone: (661) 393-7000x State: CA Zip 93303 Phone: (661) 393-7000x State: CA Zip 93308 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Hazmat Hazards: Contact : DAVID PALMER MailAddr: PO BOX 1807 City BAKERSFIELD Owner Address City JACO-HILL 300 3101 STATE RD BAKERSFIELD Emergency Directives: 1, U3\Y" \/ cr(\~ hereby certify that' have (Type -; print name) reviewed the attached hazardous materials manage· ment plan fo~~nd that It along with (NameOf~ any corrections constitute a complete and correct man.. agement plan for my facUity. '" ." -1- 07/29/2004 'õ e . SiteID: 015-021-000623 9 By Facility Unit 9 Fixed Containers on Site 9 specHaZEPA Hazards Frm I DailyMax unitlMCP F IH DH L 12000.00 GAL Mod F IH DH L 12000.00 GAL Mod F IH DH L 12000.00 GAL Low F FARRELLS FASTRIP f= Hazmat Inventory f== MCP+DailyMax Order Hazmat Common Name... PREMIUM UNLEADED GASOLINE UNLEADED GASOLINE DIESEL -2- 07/29/2004 e e SiteID: 015-021-000623 9 Facility Unit: Fixed Containers on Site 9 F FARRELLS FASTRIP f= Inventory Item 0001 === COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Locati'on within this Facility Unit W SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS GrJ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod, HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined8: f- Ag .Define11 -3- 07/29/2004 e e F FARRELLS FASTRIP SiteID: 015-021-000623 9 f= Inventory Item 0001 Facility Unit: Fixed Containers on Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: W SIDE OF BLDG TANK DESCRIPTION Tank ID#: 1 Mfr: XERXES Installed: 04/2004 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: PREMIUM UNLEADED MatI Name:PREMIUM UNLEADED GASOLINE Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material{p): FIBERGLASS Material{s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2004 Drop Tube : 2004 Striker Plate: 2004 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 2004 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: 2004 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -4- 07/29/2004 e e F FARRELLS FASTRIP SiteID: 015-021-000623 9 f= Inventory Item 0001 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : UnderGround PRESSURE DOUBLE WALL A.O. SMITH FIBERGLASS AboveGround Piping FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING Installed: 05/04/2004 Date: 05/04/2004 Name:ROY SAUNDRS Prmt Number: 0623 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:VP Approved: Yes AGENCY DEFINED Expiration Date: 06/30/2006 TANK/LINE TEST :05/04/2004 CP CERT. : MANWAY INSP. : 05/18/1991 UST MONIT. CERT:05/04/2004 STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: Yes Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 05/04/2004 Name:ROY SAUNDRS Ttl:VP -5- 07/29/2004 e e e e SiteID: 015-021-000623 9 Facility Unit: Fixed Containers on Site 9 F FARRELLS FASTRIP f= Inventory Item 0003 === COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: r- Ag .Define11 -6- 07/29/2004 e e F FARRELLS FASTRIP SiteID: 015-021-000623 ì f= Inventory Item 0003 Facility Unit: Fixed Containers on Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: W SIDE OF BLDG TANK DESCRIPTION Tank ID#: 1 Mfr: XERXES Installed: 04/2004 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL Matl Name:UNLEADED GASOLINE TANK CONTENTS Petrol Type: REGULAR UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2004 Drop Tube : 2004 Striker Plate: 2004 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 2004 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: 2004 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -7- 07/29/2004 tit e F FARRELLS FASTRIP SiteID: 015-021-000623 9 f= Inventory Item 0003 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : UnderGround PRESSURE DOUBLE WALL AO.SMITH FIBERGLASS AboveGround Piping FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 05/04/2004 Date: 05/04/2004 Name:ROY SAUNDERS Prmt Number: 0623 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:VP Approved: Yes AGENCY DEFINED Expiration Date: 06/30/2006 TANK/LINE TEST :05/04/2004 CP CERT. : MANWAY INSP. :12/22/1998 UST MONIT. CERT:05/04/2004 STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: Yes Installation Inspected & Certified by Registered Engineer: No Installation Inspected by Unified Program Agency: Yes Manufacturer's Checklist Completed: Yes Installer Certified by Contractors' State License Board: Yes Approved Alternate methods: Date: 05/04/2004 Name:ROY SAUNDERS Ttl:VP -8- 07/29/2004 e - SiteID: 015-021-000623 9 Facility Unit: Fixed Containers on Site 9 F FARRELLS FASTRIP p= Inventory Item 0004 F= COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL %wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: - Ag.Define11 -9- 07/29/2004 e e F FARRELLS FASTRIP SiteID: 015-021-000623 9 f= Inventory Item 0004 Facility Unit: Fixed Containers on Site 9 STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 Last Action Type: Location In Site: W SIDE OF BLDG TANK DESCRIPTION Tank ID#: 3 Mfr: XERXES Installed: 04/2004 Capacity: 12000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL Matl Name:DIESEL TANK CONTENTS Petrol Type: DIESEL Cas #: TANK CONSTRUCTION Type : SINGLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2004 Drop Tube : 2004 Striker Plate: 2004 " Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 2004 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: 2004 Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -10- 07/29/2004 .' e e F FARRELLS FASTRIP SiteID: 015-021-000623 ì p= Inventory Item 0004 Facility Unit: Fixed Containers on Site ì STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION Piping Type : Const: Mfgr : Mtl : & : Corr : Prot : UnderGround PRESSURE LINED TRENCH UNKNOWN FIBERGLASS AboveGround Piping FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 05/04/2004 Date: 05/04/2004 Name:ROY SAUNDERS Prmt Number: 0623 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:VP Approved: Yes AGENCY DEFINED Expiration Date: 06/30/2006 TANK/LINE TEST :05/04/2004 CP CERT. : MANWAY INSP. : UST MONIT. CERT:05/04/2004 -11- 07/29/2004 · FARRELLS FASTRIP ~ L SiteID: 1.;;:/. Ý' o10~0623 .¡, Manager : /ð/VI lii-rre/Æ Location: 6401 WHITE LN 112 City BAKERSFIELD 1 '\..~~'\.. BusPhone: ~~ Map : 123 ~~ . Grid: 16D (661) 397-0271 CommHaz : Low FacUnits: 1 AOV: CQmmCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title TOM FERRELL / OWNER JOlIN IŒRLE~Lbw,rd ~r OPERATIONS MGR Business Phone: (661) 397-0271x Business Phone: (661) 393-7000x 24-Hour Phone : (661) 833-9443x 24-Hour Phone : (661) 393-7000x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact Ci:)ow/cI P~W1e.r MailAddr: PO BOX 1807 City : BAKERSFIELD Period : Preparer: Certif'd: ParcelNo: to Phone: (661) 393-7000x State: CA Zip : 93303 Phone: (661) 393-7000x State: CA Zip : 93308 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Owner Address : City JACO-HILL 300 3101 STATE RD : BAKERSFIELD Emergency Directives: I~OO.h iI M7'd Do hereby certify th~t 1 lîô.ve ~ype or print nsme) reviewed the attached hazardous materials manage- ment plan forE«r"~ .61¢?and that it along with . (Namo of BUûIn9QS) any oorredions oonsiitu~e a complete and corrsd man- agement plan for my facility. 4J~. A(~~!ð3 -1- 08/05/2003 ./' \ ~-~ .' ~ , . . . SiteID: 015-021-000623 FARRELLS FASTRIP Manager : Location: 6401 WHITE LN 112 City BAKERSFIELD CommCode: BAKERSFIELD STATION 09 EPA Numb: BusPhone: Map : 123 Grid: 16D (661) 397-0271 CommHaz : Low FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title TOM FERRELL / OWNER JOHN KERLEY / OPERATIONS MGR Business Phone: (661) 397-0271x Business Phone: (661) 393-7000x 24-Hour Phone : (661) 833-9443x 24-Hour Phone : (661) 393-7000x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (661) 393-7000x MailAddr: PO BOX 1807 State: CA City : BAKERSFIELD Zip : 93303 Owner JACO-HILL 300, Phone: (661) 393-7000x Address : 3101 STATE RD State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: . TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I, ~})\ctk1 CX~t\r-\~"~O hereby cermy that ~ have . (fyps or pnnt n&rrnI) reviewed ihe attached hazardous materials manage- ment plan feU' Çþ&-h-: ~ and thai it along wiih (Name 0 uslness) any corrections constitute a complete and correct man- agement plan for my faciliiy. ..,:;z'~ ~ '. f< . ~.l~, ; ....~¿ , l~~~J~"J¡,) ') §l'gnature Ie -1- 07/15/2002 \ ,- . . F FARRELLS FASTRIP SiteID: 015-021-000623 ì STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: FARRELLS FASTRIP Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : JOHN KERLEY Phone: (661) 393-7000x Address: City : State: Zip: Type : INDIVIDUAL TANK OWNER INFORMATION Name : JOHN KERLEY Phone: (661) 393-7000x Address: City : State: Zip: Type : BOE UST Fee# : 019753 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/24/2000 Phone: (661) 393-7000x Name:JOHN KERLEY Ttl:VP State UST # : 1998 Upg Cert#: 00762 f= Hazmat Inventory One Unified List 9 f== Alphabetical Order All Materials at Site 9 Hazmat Common Name... SpecHaz EPA Hazards DaïlyMax MCP PREMIUM UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED PLUS GASOLINE F IH DH L 12000.00 GAL Mod -2- 07/15/2002 . SiteID: 015-021-000623 9 Facility Unit: Fixed Containers on Site 9 . F FARRELLS FASTRIP f= Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL %Wt. I 100.00 GasolJ.ne HAZARDOUS COMPONENTS GrJ No 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 0003 = COMMON NAME / CHEMI CAL NAME UNLEADED GASOLINE Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL %wt. I 100.00 Gasoline HAZARDOUS COMPONENTS GrJ No CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies' F IH DH / / / Mod HAZARD ASSESSMENTS -3- 07/15/2002 . SiteID: 015-021-000ß23 9 Facility Unit: Fixed Containers on Site 9 . F FARRELLS FASTRIP f= Inventory Item 0004 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER'GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL %Wt. I . 100.00 Gasoline HAZARDOUS COMPONENTS I~ 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 0002 = COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit W SIDE OF BLDG Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 6000.00 GAL %wt. I 100.00 Gasoline HAZARDOUS COMPONENTS Grl 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- 07/15/2002 . . I f= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-000623 ì Fast Format 9 Overall Site 9 12/01/2000 F FARRELLS FASTRIP EMERGENCY OFFICE 1-800-852-7550 OR Employee Notif./Evacuation 12/01/2000 EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY THEY ARE TO: A. SHUT OFF (IF POSSIBLE) MAIN POWER BREAKER. B. EVACUATE THEMSELVES AND OTHERS FROM PREMISES. C. CALL 911. Public Notif./Evacuation 12/01/2000 NOTIFY SURROUNDING NEIGHBOR(S) OR BUSINESS(S) IF SAFE TO DO SO. Emergency Medical Plan 12/01/2000 CALL 911, MEMORIAL MEDI CENTER, 5201 WHITE LN, 398-1800 OR MERCY HOSPITAL, 2215 TRUXTUN AVE, 327-3371. -5- 07/15/2002 " . . SiteID: 015-021-000623 ì Fast Format ì Overall Site ì 12/01/2000 F FARRELLS FASTRIP I f= Mitigation/Prevent/Abatemt Release Prevention ALL AREAS KEPT CLEAR OF COMBUSTIBLE PRODUCTS PUMPS HAVE EMERGENCY SHUTOFF SWITCH ABSORBENT MATERIALS STORED ON SITE FOR SPILLAGES. Release Containment 12/01/2000 IN THE EVENT OF A SPILLAGE, SHUT DOWN MAIN SWITCH. HOSE AREA OR USE ABSORBENT. IN THE EVENT OF A MAJOR SPILLAGE, NOTIFY FIRE DEPT FOR Clean Up 12/01/2000 USE AN ABSORBANT MATERIAL TO SOAK UP SPILL AND STORE IN AN APPROVED CONTAINER, TO BE PICKED UP BY A HAZARDOUS WASTE DISPOSER. VEHICLE OVERFILLS: HOSE AREA OR USE ABSORBENT. DRIVE OFF'S WITH NOZZLE: SHUT DOWN SYSTEM. VEHICLE DAMAGE TO PUMP(S) RESULTING IN LEAK: SHUT DOWN POWER TO PUMP(S) ONLY. CLEAN AREA, CALL DISTRICT MANAGER. ADJACENT BUILDING(S) FIRE: SHUT DOWN ENTIRE GAS ISLAND(S) EMERGENCY CONTROL SHUT-OFF'S, FIRE DEPARTMENT WILL ADIVSE OF NORMAL OPERATIONS TO RESUME. Other Resource Activation 12/01/2000 NOTIFY DISTRICT (OPERATIONS) MANAGER 393-7000 TO CALL OUT EMERGENCY RESPONSE TEAM. -6- 07/15/2002 .' , . . SiteID: 015-021-000623 9 Fast Format 9 Overall Site 9 I F FARRELLS FASTRIP I f= Site' Emergency Factors r== Special Hazards Utility Shut-Offs 12/01/2000 A) GAS - BEHIND FRONT COUNTER B) ELECTRICAL - REAR OF BLDG C) WATER - REAR OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO BETWEEN TWO REGISTERS Fire Protec./Avail. Water 12/01/2000 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE THROUGHOUT THE INSIDE OF THE STORE FOR EASY ACCESS. FIRE HYDRANT - W SIDE OF GASOLINE ISLAND. Building Occupancy Level -7- 07/15/2002 . . SiteID: 015-021-000623 ì Fast Format ì Overall Site ì 12/01/2000 F FARRELLS FASTRIP I F Training Employee Training WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE INSTRUCTED IN EMERGENCY PROCEDURES INVOLVING OVERFILLS IN A VEHICLE TANK, CUSTOMER DAMAGES NOZZLE RESULTING IN SUBSTANTIAL FLOW OF GASOLINE, IF THERE IS DAMAGE TO A PUMP, AND IF THERE IS AN ADJACENT BUSINESS/BLDG ON FIRE. [ Page 2 I I Held for Future Use I I Held for Future Use I -8- 07/15/2002 '" r, e - FARRELLS FASTRIP / /' Manager : //~ Location: 6401 WHITE LN 112 ;/ City BAKERSFIELD -I e SiteID: 015-021-000623 BusPhone: Map : 123 Grid: 16D (805) 397-0271 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title TOM FERRELL / OWNER JOHN KERLEY / OPERATIONS MNGR Business Phone: (805) 397-0271x Business Phone: (805) 393-7000x 24-Hour Phone : (805) 833-9443x 24-Hour Phone : (805) 393-7000x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: PO BOX 1807 State: CA City : BAKERSFIELD Zip : 93303 " Owner JACO-HILL 300 Phone: (805) 393-7000x Address : 3101 STATE RD State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I, J~"t-.' ~/¿l~ Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ment plan forht lM.ds ~£~ and that it along with (Name of BU81n3SS) , any corrections constitute a complete and correct man- agement plan for my facility. .': . (1-30-00 Date -1- 10/31/2000 1 e e F FARRELLS FASTRIP SiteID: 015-021-000623 9 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: FARRELLS FASTRIP Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : JOHN KERLEY Phone: (805) 393-7000x Address: City : State: Zip: Type : INDIVIDUAL TANK OWNER INFORMATION Name : JOHN KERLEY Phone: (805) 393-7000x Address: City : State: Zip: Type : BOE UST Fee# : 019753 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/24/2000 Phone: (661) 393-7000x Name:JOHN KERLEY Ttl:VP State UST # : 1998 Upg Cert#: 00762 F Hazmat Inventory One Unified List 9 f== As Designated Order All Materials at Site 9 Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP PREMIUM UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED PLUS GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod -2- 10/31/2000 e e SiteID: 015-021-000623 ì Facility Unit: Fixed Containers on Site ì F FARRELLS FASTRIP p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit WEST SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 3000.00 GAL 'lrWt . I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS#S006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit WEST SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 6000.00 GAL 'lrWt. I 100.00 Gasoline HAZARDOUS COMPONENTS CAS#S006619 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -3- 10/31/2000 e e F FARRELLS FASTRIP p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 015-021-000623 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit WEST SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL twt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0004 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit WEST SIDE OF BLDG Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 12000.00 GAL Daily Average 7000.00 GAL tWt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -4- 10/31/2000 'i e e SiteID: 015-021-000623 ì Fast Format ì Overall Site ì 12/06/1994 F FARRELLS FASTRIP I p= Notif./Evacuation/Medical Agency Notification CALL 911 IF NEED, CALL STATE EMERGENCY OFFICE: 1-800-852-7550 1-619-262-1621 Employee Notif./Evacuation 12/06/1994 EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY THEY ARE TO: A. SHUT OFF (IF POSSIBLE) MAIN POWER BREAKER. B. eVACUATE THEMSELVES AND OTHERS FROM PREMISES. C. CALL 9-1-1 Public Notif./Evacuation 12/06/1994 NOTIFY SURROUNDING NEIGHBOR(S) OR BUSINESS(S) IF SAFE TO DO SO. Emergency Medical Plan 12/06/1994 CALL 9-1-1 MEMORIAL MEDI CENTER 5201 WHITE LANE 805-398-1800 MERCY HOSPITAL 2215 TRUXTUN AVENUE 805-327-3371 -5- 10/31/2000 'i e. e SiteID: 015-021-000623 ì Fast Format ì Overall Site ì 12/06/1994 F FARRELLS FASTRIP I p= Mitigation/Prevent/Abatemt Release Prevention ALL AREA'S KEPT CLEAR OF COMBUSTIBLE PRODUCTS PUMPS HAVE EMERGENCY SHUT-OFF SWITCH ABSORBENT MATERIALS STORED ON SITE FOR SPILLAGE'S. Release Containment 12/06/1994 IN THE EVENT OF A SPILLAGE, SHUT DOWN MAIN SWITCH. HOSE AREA OR USE ABSORBENT. IN THE EVENT OF A MAJOR SPILLAGE, NOTIFY FIRE DEPARTMENT FOR ASSISTANCE. Clean Up 12/06/1994 USE AN ABSORBANT MATERIAL TO SOAK UP SPILL AND STORE IN AN APPROVED CONTAINER, TO BE PICKED UP BY A HAZARDOUS WASTE DISPOSER. VEHICLE OVERFILLS: HOSE AREA OR USE ABSORBENT. DRIVE OFF'S WITH NOZZLE: SHUT DOWN SYSTEM. VEHICLE DAMAGE TO PUMP (S) RESULTING IN LEAK: SHUT DOWN POWER TO (PUMP (S) ONLY. CLEAN AREA, CALL DISTRICT MANAGER. ADJACENT BUILDING(S) FIRE: SHUT DOWN ENTIRE GAS ISLAND(S) EMERGENCY CONTROL SHUT-OFF'S, FIRE DEPARTMENT WILL ADIVSE OF NORMAL OPERATIONS TO RESUME. Other Resource Activation 12/06/1994 NOTIFY DISTRICT (OPERATIONS) MANAGER (805) 393-7000 TO CALL OUT EMERGENCY RESPONSE TEAM. -6- 10/31/2000 e e SiteID: 015-021-000623 ì Fast Format ì Overall Site ì I F FARRELLS FASTRIP I f= Site Emergency Factors ¡== Special Hazards Utility Shut-Offs 09/13/1993 A) GAS - BEHIND FRONT COUNTER BETWEEN B) ELECTRICAL - REAR OF BUILDING C) WATER - REAR OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO TWO REGISTERS Fire Protec./Avail. Water 09/13/1993 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE THROUGHOUT THE INSIDE OF THE STORE FOR EASY ACCESS. FIRE HYDRANT - WEST SIDE OF GASOLINE ISLAND. Building Occupancy Level -7- 10/31/2000 ", -:0 .... .,. e e F FARRELLS FASTRIP I F Training Employee Training SiteID: 015-021-000623 ì Fast Format ì Overall Site ì 11/03/1992 WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE INSTRUCTED IN EMERGENCY PROCEDURES INVOLVING OVERFILLS IN A VEHICLE TANK, CUSTOMER DAMAGES NOZZLE RESULTING IN SUBSTANTIAL FLOW OF GASOLINE, IF THERE IS DAMAGE TO A PUMP, AND IF THERE IS AN ADJACENT BUSINESS/BUILDING ON FIRE. Page 2 [ I I Held for Future Use Held for Future Use -8- 10/31/2000 " - - Flft2/lE.LJ...'5 FA-sn¿.¡ f' ~TftIP FeOD STORE *112; 215-000-000623 Overall Site with 1 Fac. Unit v/ '- " ~ 10/18/94 ~ Page 1 General Information Location: 6401 WHITE LN ~ City CI4 'j330 Map:123 Haz:2 Type: 3 Grid: 16D FlU: 1 AOV: 0.0 Contact Name lQ'YY\ FA~lL- Business Phone: 24-Hour Phone Pager Phone Title I OuJN E. \'2- (BOG") "3Q'7 -O:J7(x (lro~ i'3~ -~ ~~ () x Contact Name ;m~~ 24-Hour Phone Pager Phone Title IIJ/QÆ1/IJIfJS-J?IJVIt6Ø. (805 >df3-'7tJØs'!- ( 805 > 39.3 -?oòCi;:x~jfJff (> x Administrative Data Mail Addrs: P. o· jj.o~ /.J?07 - City: BAKERSFIELD ' Comm Code: 215-009 BAKERSFIELD STATION 09 Owner: ;J'A,CO ~ (4 t '-,l., ~QQo-~, Address: ;:SlO{· ~-jR.I~. "; Ci ty: BAKERSFII!:LD ., D&B Number:/7- ð6~9'~ State: CA Zip: 9:330.3 SIC Code: .ss-4/ ~~_..- Phone: (805 >.á9~,:,'lIJt!)O State: CA " Zip: '933GB Summary ~c~ ~Oy lV~D ? J.¡4<: It? tJ 1991/ '4 )'- D . 'Iv ~. JQtÁM ~LE.Y Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ... men~ plan for tlhlatit along with MY ooll'mdioro$OOrls~it!Jte ~ oomplei~ and œITGdt man-- agem~mt plain \'©r mlf~aciliiy. ~ .. - fI 10/18/94 FASTRIP FOOD STORE #112 215-000-000623 Page 2 ,ò Hazmat Inventory List in MCP Order '4 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 PREMIUM UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED PLUS GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-003 UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL It e 10/18/94 FASTRIP FOOD STORE #112 215-000-000623 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 PREMIUM UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 3,000.00 I 300,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc -I 100.0% Gasoline Components ,-; MCP ----rGuide Moderate 27 02-002 UNLEADED PLUS GASOLINE. ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 6,000.00 334,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc -I 100.0% Gasoline Components ~ MCP ----rGuide Moderate 27 02-003 UNLEADED GASOLINE ~ Fire, Immed H1th, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 7,000.00 I 95,700.00 Storage UNDER GROUND TANK '. r Press T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc l 100.0% Gasoline Components r; MCP ----rGuide Moderate 27 e e 10/18/94 FASTRIP FOOD STORE #112 215-000-000623 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-004 UNLEADED GASOLINE . Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 7,000.00 I 95,700.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc l 100.0% Gasoline Components r; MCP ---¡Guide Moderate 27 ~,; .. e e 10/18/94 ç FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 ~ 'tZtIÆ ('d( ûM ~jMCY If /.Jì/O ~ g5;2-7550 tPt I-ÞI9 - 2~;:;-J~.:2/ <2> Employee Notif./Evacuation ~; 1\NÐ :'~/i~J/d Nt þß~~~~ . ~'kJr~·: 11.Jk;t~ c¡g~d¿J~.'/~~ · ~ ./1. ~~ ....../~ l ~þ~~~ '"~. ~ f'../- I · ;]). Jff~ ~h/~6);t;ft~ 4~//' <3> Public Notif./Evacuation \lIi~t~ý·~{j)H. ~(S)-i ~I ~ <4> Emergency Medical Plan (!df f-¡-I 'f/rml1td ':4~ .~ ~~I ~f¿d~ J'Pb-' .39ý~ 1~t1t' n ' ~P1-øJ/4¿ ~;2fS~~ Sð5" - 3;1. 7- 3:3 7 I e e 10/18/94 -; FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention tfl( ~¿? j- ~ø~ ~~~. ~~ ¡'-" <2> Release Containment ~s PUMPS HAVE EMBRSENC1 SHUT OFF BUTTONS, ABSORBENT MATBRIAL 10 ûTORED NEAR ¡':¡d :;R:¡¿h~~~~ . ~ £b H.. ~~ r4~~ ~ /}A-4r..;h ~~ ~ i Wf~ ~~~~ --- p /.¿7P'V 1"7",/-" <3> Clean Up USE AN ABSORBANT MATERIAL TO SOAK UP SPILL AND STORE IN AN APPROVED CONTAINER, TO BE PICKED UP BY A HAZARDOUS WASTE DISPOSER. '"YÆd4~/~~~~~ ~ ~""~ ~~ . ~el ~~p~~s)~ ~:Z~~~~f~ .4-~(f)~:doL.a-v:.c.t' ~~4#~ a~~~h~tS)~/~~~~~ )¡/fæ.t!(s) ~ ~~-V~?;s; ~~/;r<-(;VU(æ <4> Other Res&urce A~~ ion "'I ~d ~~.!-l$- ~ lJ~d~~a,{~ ~.5-3?3-700ð;tt- ~ ~ ~r7(:;ka-u - e e 10/18/94 6 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 7 . ~ <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - BEHIND FRONT COUNTER BETWEEN TWO REGISTERS B) ELECTRICAL - REAR OF BUILDING C) WATER - REAR OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE THROUGHOUT THE INSIDE OF THE STORE FOR EASY ACCESS. FIRE HYDRANT - WEST SIDE OF GASOLINE ISLAND. <4> Building Occupancy Level ~ e e J 10/18/94 ~ , ~ FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 8 <G> Training <1> Employee Training WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE INSTRUCTED IN EMERGENCY PROCEDURES INVOLVING OVERFILLS IN A VEHICLE TANK, CUSTOMER DAMAGES NOZZLE RESULTING IN SUBSTANTIAL FLOW OF GASOLINE, IF THERE IS DAMAGE TO A PUMP, AND IF THERE IS AN ADJACENT BUSINESS/BUILDING ON FIRE. <2> Page 2 ~ <3> Held for Future Use <4> Held for Future Use ~ ,; ~..,. _/ ~ 09/03/93 e e ./ Page 1 FASTRIP FOOD STORE #112 215-000-000623 Overall Site with 1 Fac. Unit General Information Location: 6401 WHITE LN 112 Map: 123 Hazard: Low Community: BAKERSFIELD STATION 09 Grid: 16D FlU: 1 AOV: 0.0 r- Contact Name Title Business Phone - 24-Hour Phone ( ) - x ( ) - TOM FARRELL OWNER (805) 397-0271 x (805) 833-9443 Administrative. Data Mail Addrs: 6401 WHITE LN UNIT 112 D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-009 BAKERSFIELD STATION 09 SIC Code: Owner: THOMAS &VICTORIAFARREI.¡L --- - - - c - Phone: (805) 833-9443 Address: 7900 CALLE TORCIDO State: CA City: BAKERSFIELD Zip: 93309- Summary RECEIVED - SfP 1 31993 HAZ. MAT. DIV. . ()~ l11þf 6*ß.rlIJ,r. Do hereby certify that t have , (fype or print name) , reviewed the attached hazardous matèrials manage- and that it along with ment plan for (Name of Business) any corrections constitute a complete and correct man- . agementPI~ 1 'If} Date ~- .oj e e 09/03/93 FASTRIP FOOD STORE #112 215-000-000623 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 PREMIUM UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 UNLEADED PLUS GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-003 UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 UNLEADED GASOLINE Liquid 12000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL .' .. - e 09/03/93 FASTRIP FOOD STORE #112 215-000-000623 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 PREMIUM UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Dåily Average GAL --r-- Annual Amount GAL -- 12,000· 3,000.00 300,000.00 Storage UNDER GROUND TANK r Press T Temp ~I Location Ambient AmbientWEST SIDE OF BLDG - Conc l . 100.0% Gasoline Components r; MCP ---p;uide Moderate 27 02-002 UNLEADED PLUS GASOLINE ~ Fire, Immed Hlth, Delay H1th Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 6,000.00 I 334,000.00 Storage UNDER GROUND TANK r Press ·T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc l 100.0% GasolineJ Components r; MCP ---p;uide Moderate 27 02-003 UNLEADED GASOLINE ~ Fire, Immed H1th, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- ' 12,000 ~ I 7,000.00 95,700.00, Storage UNDER GROUND TANK r·press T Temp ~I Location Ambient AmbientlWEST SIDE OF BLDG - Conc l 100.0% Gasoline Components r; MCP ---p;uide Moderate 27 I 09/03/93 e e FASTRIP FOOD STORE~#112 215-000-000623 . 02 - Fixed Containers on Site 4 Page Hazmat Inventory Detail in MCP Order Liquid 12000 Moderate GAL 02-004 UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture· Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL -- ,12,000 . 7,000.00 I 95,700.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient AmbientWEST SIDE OF BLDG - Conc l 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 · e e 09/03/93 FASTRIP FOOD STORE #112215-000-000623 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL AND CALL 911 <3> Public Notif./Evacuation VERBAL AND CALL 911 <4> Emergency Medical Plan e e 09/03/93 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention STANDARD GAS STATION SAFETY EQUIPMENT AND SHUT-OFFS. <2> Release Containment GAS PUMPS HAVE EMERGENCY SHUT OFF BUTTONS, ABSORBENT MATERIAL IS STORED NEAR GAS ISLANDS FOR EASY ACCESS IN CASE OF A SMALL SPILL. <3> Clean Up USE AN ABSORBANT MATERIAL TO SOAK UP SPILL AND STORE IN AN APPROVED , CONTAINER, TO BE PICKED UP BY A HAZ~~DOUS WASTE DISPOSER. <4> Other Resource Activation 't. -- e 09/03/93 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS- BEHIND FRONT COUNTER BETWEEN TWO REGISTERS B) ELECTRICAL - REAR OF BUILDING C) WATER - REAR OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE I' . THROUGHOUT THE INSIDE OF THE STORE FOR EASY ACCESS. -...-,----,- - --- - ..'-- :--J'l-.·.·__·:-_ _-_".-: L/ -- FIRE HYDRANT - WEST SIDE OF GASOLINE ISLAND. <4> Building Occupancy Level ..,¡ r _ }é;. e e 09/03/93 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site- Page 8 <G> Training <1> Page 1 WE HAVE 8 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE INSTRUCTED IN EMERGENCY PROCEDURES INVOLVING OVERFILLS IN A VEHICLE TANK, CUSTOMER DAMAGES NOZZLE RESULTING IN SUBSTANTIAL FLOW OF GASOLINE, IF THERE IS DAMAGE TO A PUMP, AND IF THERE IS AN ADJACENT BUSINESS/BUILDING ON FIRE. <2> Page 2 as needed <3> Held for,Future Use <4> Held for Future Use " ~. jW - - ~~(Ç~ll~~ij ~ NOV 3 1992 ~e BJ~ _I .-............" 1 ~ ~,-.. ~ 07/29/92 FASTRIP FOOD STORE #112 215-000-0006 Overall Site with 1 Fac. Unit General Information Location: 6401 WHITE LN 112 Map: 123 Hazard: Low Community: BAKERSFIELD STATION 09 Grid: 16D FlU: 1 AOV: 0.0 --- Contact Name Title Business Phone - 24-Hour Phone --- --- ---- -- - . --- , \ ,-., -- TOM FARRELL OWNER (805) 397-0271 x (805) 833-9443 Administrative Data Mail Addrs: 6401 WHITE LN UNIT 112 D&B Number: , City: BAKERSFIELD State: CA Zip: 93309- CommCode: 215-009 BAKERSFIELD STATION 09 SIC Code: Owner: THOMAS & VICTORIA FARRELL Phone: ~r )1)33 'it./113 Address: 7900 CALLE TORCIDO State: CA City: BAKERSFIELD Zip: 93309- Summary . \ I, r:;- /tt r-;'~L.· (Type or print name) reviewed the attached ¡"¡£iZ;:;¡1CiOUS matsri(~lI~mlnag.. msni plgn for FþT¡Z'? ~L>"5T-ând thS\t i~ &iiijng 'with (Name of BUßiness) MY oorrectßlt)ns com;;titut@ ~ complet~ an@torrect M&\n- ~@m~tnt plan f()f m~ foolity 0 ---. , [)©~erebyçertiiy th@t , h~v~ ~., . .; t, . .. 'l#l.&~t ~ I- .. -- - . ~ 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 02 - Fixed Containers on,Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 REGULAR GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 6,000.00 I 31,000.00 Storage UNDER GROUND TANK r Press T Temp ~I Location Ambient AmbientlWEST SIDE OF BUILDING UNDERGROUN - Conc -I 100.0% Gasoline Components MCP -:-rList r;oderate 02-002 UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 8,000.00 I 50,000.00 Storage UNDER GROUND TANK r Press T Temp -;¡ Ambient Ambient UNDERGOUND Location - Conc l 100.0% Gaso,line Components 1-; MCP -:-rList Moderate 02-003 PREMIUM UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 12,000 . I· 3,000.00 5,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Ambient Ambient UNDERGROUND Location - Conc l 100.0% Gasoline Components r; MCP -:-rList . Moderate, - e ~ 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in Reference Number Order 02-004 PREMIUM UNLEADED GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 12000 ,Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 12,000 I 3,000.00 I 5,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Ambient Ambient UNDERGROUND Location - Conc -I 100.0% Gasoline Components MCP ~List f;oderate I tit e . 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL AND CALL 911 <3> Public Notif./Evacuation VERBAL AND CALL 911 <4> Emergency Medical Plan o e . 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 5 <E> Mitigation/prevent/Abatemt <1> Release Prevention STANDARD GAS STATION SAFETY EQUIPMENT AND SHUT-OFFS <2> Release Containment GAS PUMPS HAVE EMERGENCY SHUT OFF BUTTONS, ABSORBENT MATERIAL IS STORED NEAR GAS ISLANDS FOR EASY ACCESS IN CASE OF A SMALL SPILL. <3> Clean Up USE AN ABSORBANT MATERIAL TO SOAK UP SPILL AND STORE IN'AN APPROVED CONTAINER, TO BE PICKED UP BY A HAZARDOUS WASTE DISPOSER. <4> Other Resourçe Activation u e ~ '. 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS -' BEHIND FRONT COUNTER BETWEEN TWO REGISTERS B) ELECTRICAL - REAR OF BUILDING C) WATER - REAR OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ARE ON ALL GASOLINE ISLANDS AND THROUGHOUT THE INSIDE OF THE STORE FOR EASY ACCESS. FIRE HYDRANT - WEST SIDE OF GASOLINE ISLAND I <4> Building Occupancy Level ~ e ~~ .to, .. 07/29/92 FASTRIP FOOD STORE #112 215-000-000623 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE 8 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON,FILE BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE INSTRUCTED IN EMERGENCY PROCEDURES INVOLVING OVERFILLS IN A VEHICLE TANK, CUSTOMER DAMAGES NOZZLE RESULTING IN SUBSTANTIAL FLOW OF GASOLINE, IF THERE IS DAMAGE TO A PUMP, AND IF THERE IS AN ADJACENT BUSINESS/BUILDING ON FIRE. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use -- .-- CITY OF BAKERSFIELD :I: HAZARDOUS MATERIALS INVENTORY /, J o Farm and Agriculture Standard Business Page ~Of~:' ~ NON - TRADE SECRET ~\ ':; BUSINESS NAME' FL1 I *\3& 0 . OWNER NAME: -' ·l . &. NAME OF THIS FACILITY: ,/)+r-/P \ LOCATION: . , ~ ADDRESS: ,d. m, STANDARD IND. CLASS COD}!;: CITY, ZIP~fi.¥ :~-.'~~'Î ~'~Ð'j CITY, ZIP' ~~~.\t q3:~=- DUN AND BRADSTREF ~UMÄEY.fFEDERAL ID · PHONE t: - - _ PHONE ,t: R£l.Ç' -~ "3q~ - '7 CJlJ'ð . L '1 -..3 ~ ~ - '1. t¡¿ ;;. 5 6 Physical and Health Hazard C.A.S. Number grolol.JJl9-- Component It 1 Name & C.A.S. Number . (Check all that apply) 'rd 0 ~ Component It 2 Name & C.A.S. Number ,~ Fire Hazard 0 Sudden Release Reactivity 0 Immediate . elayed of Pressure ,Health ealthc Component It 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number ~ Component It 1 Name & C.A.S. Numbe~ (Check all that apply) - rdi n ~- Component /I 2 Name & C.A.S. Number ~ Fire Hazard 0 Sudden Release 0 Reactivity U Immediate Delayed of Pres!3ure Health ealth Component /I 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component /I 1 Name & C.A.S. Number ~Ch ck all that apply) ~ ' . Component H 2 Name & C.A.S. Number Fire Hazard 0 Sudden Release 0 Reactivity 0 Immedíate·. Delayed of-Pressure Health Health /I 3 Name & C.A.S. Number Pr Ph'Ysical and Health Hazard C.A.S. Number Component /I 1 Name & C.A.S. Number ~c ck all that apply) 0.' Component /I 2 Name & C.A.S. 'Number . Fire Hazard D Sudden Release 0 Reactivity 0 Immediate -,~laYed of Pressure Health~alth Component /I 3 Name & C.A.S. Number EMERGENCY CONTACTS #1 (J()hY'\ ~ Al &,~ r~. fo.s"-3Cß-7Ð?O#2---.Æ ' - Name T tIe 24 Hr. Phone Nlt 24 Hr Phone Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify unde.r peanlty of law that I haver personally examined and am familiar with the information submitted in this d documents and that based on my inquiry of,those individuals responsible for obtaining the information. I believe that the submitted information is true, . ,q~ REPRESENTATIVE 04/'03/91 d/ú\~ / /d-- I:J FASTlp FOOD STORE #112 215-00.)00bi.~3 Overall Site with 1 Fac. Unit Pa~le 1 ~ General Information 1 -----;ap: -'1.:::3 Ha'~~~d: LO';- ___._~t~id: 160 At~ea ,::,f V~l~~j ~ 24 HÔut~ Phc'Y'le·, I (805) ~39a.-4'6q~j L~~S ) e3~ ~443 Location: 6401 WHITE LN 1.12 Ident Number: 215-000-000623 ~- COY'ltact Name -L: Title --J}; BusiY'less Phc'Y'le BDm I 8' RaSE Al\lII\ÐTE l3E'o . MA\)A~OL . (805) 39-~ -O~? I. x 'TV^" PARR,EL:L . . O(.Ùt-)€12... (Æ!os") :3:i'"];' -0 2..7L x -..- -- Adm ÌY',i stt'at ive Data -.--. UNIT 112 Mail Addrs: 6401 WHITE LN City: BAKERSFIELD Comm Code: 215-009 BAKERSFIELD STATION 09 D&B Numbet~: State: CA Zip: SIC Code: 93309- Owner: THOMAS & VICTORIA FARRELL Address: 7900 CALLE TORCIDO City: BAKERSFIELD Ph'::'Y'le: ( State: CA Zip: 93309- r Summat'Y I I' II RECEIVED II AUG ? 3 1991 I HAz:-TVmî:-ut\t.--~-----_·~-~J I' ! ô I, Á1J1VETrE" 6RoLÙ~ Do hereby certify that ¡ have (Type or print name) reviewed the attached b(~zardf)us materiáls manage· ment plan for fÃs.-r:-R!.p---__Gmd that it along with , (N:¡r,;f. of ß...",i¡¡·~,'.:; , any corrections consíiìute a complete and correct man· agement plan for my facility. 0~~~ . Signature "f / IB/q I Date 0'+/03/~-31 FASTlp FOOD STORE #112 215-00_)006;::':3 Haz~at Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards F C't~fI1 02-001 GASOLINE Fire, Immed Hlth, Delay Hlth QuaY"lt it Y Liquid 48,000 GAL Page i:::: MCP Mc<derate 04/03/91 e FASTRIP FOOD STORE #112 00 - fJvet~a II ? '='1 c;:' -,OI(l.-ln....l£: ,=.-;;- t:;;. \.J ........ ...... ...O~W Site Page ~ " <D> Notif./Evacuation/Medical <1> Agency Notification Call 911 <2> Employee Notif./Evacuation VERBAL AND CALL 911 <3> Public Notif./Evacuation V~ßAL A~ù CALL- C\ t I <4> Emergency Medical Plan Call 911 for properrly trained medical personnel to respond 04/03/r::31 e FASTRIP FOOD STORE #112 00 - Ovet~a II 215-00.100523 Site Page 4 (E) Mitigation/Prevent/Abatemt (1) Release Prevention STANDARD GAS STATION SAFETY EQUIPMENT AND SHUT-OFFS (2) Release Containment Gas pumps have emergency shut off buttons, absorbent material is stored near gas islands for easy access in case of a small spill (3) Clear! Up c) SE ArJ p. ßSO e. (bp..ÑT Wlf\-rE:2-/l~L- ïV JÑ ArJ APPeoveÞ CONTAIµ~ -ro \¡\)AS~ '1)1 ~Pos.€:ì2. So~ K.. Ù P ,$p It...£- A(\.)1) , .5n ec BE' 'l>tCK.E"b uP fb'1 A tlAZAR.DOù~ (4) Other Resource Activation 04/03/r:31 FAS-! P FOOD STORE =» 112 215-00.000623 00 - Overall Site Page <= ~I (F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS _.~ l-OeA~ ~EHIt.)ò -FeoJ-)T CO¡JNi"£R. ~EXN ~ð ~~5T£12..S.. B) ELECTRICAL - REAR OF BUILDING C) WATER - REAR OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water. PRIVATE FIRE PROTECTION - ???????????? h 11 gasoll'ne l'slands and through out the inside Fire extinguis ers are on a of the store for easy access. FIRE HYDRANT - ?????????????? West side of gasoline island <4> Held for Future use " . ,.~ 04/03/91 e- FASTRIP FOOD STORE,#112 215-00'000523 00 - Overall Site Page 5 (G}r Tra i y"!i ...,g <1) Page 1 WE HAVE e EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ~-¡:>(.OyEE~ Pr.r¿£ }t.J5T12.oCTE''D /N EMe:Ré:le-ruQ..Y -'"pRCCXî:){.)I2.£""S ItJ" OUl ¡IV t:¡ ovæt:", LLJ> It.! A. V ~ Ie L€. TPcNK., c..ùs,7ð rY'D2- DA'(VIAé7t;-S. t-102'Z.-Lt 'KC5Ua INt:¡ l~ ..st>ßSTA-~ r,AL F(..()~ of é1ASou rJ E? If ~e12e IS. ":Dp.-'YIAt:¡é"TO p.. ru(VI P, A~D l? ~THt:.-e.E ,\ S AIJ A:l>:f'Ac"t:'""ÑI Ôù~1 ~t:::~S / ""'ß~Jt<...D1 ~l::¡ D1Q r e.E . <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use - e _ Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA 93301 Co ...__~. _.. "______, co '.._.~_.______. HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business asa whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: FA!:.~I p fúou $lOec LOCATION: '~40 I w~ I\'E' kAt-.)E MAILING ADDRESS: (040 I l.ot"\ I\"€' I-A ~ E A CITY: ~f>-~S.FUEl...~ STATE: CA ZIP: cr33~ PHONE: 80$'- 3C},-D271 DUN & BRADSTREET NUMBER: SIC CODE: PRIMARY AC1IVITY: Fe:?op STO~C:- OWNER: ,~ ç-f2..I2.~ MAILING ADDRESS: &40 I LV H ITlE 1-A t-:) €: A. SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS, PHONE 24 HR. PHONE 1. ---ro /Y\ 1=Ã.i2.- t2.E"LL ANtJc.lTe" ~w¡.J O¡,.ð \,.) E"e... .3q,-02..' , 2. M P<-tJ PcC:1 CJè:... 3~-¡-OZì l 3<=1 2.... (Ce:>9-"7 1 . FD1590 _ Bakersfield Fire Dept. e Hazardous Materials Division :A" o. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NuMBER OF EMPLOYEES: tl~H( ~_____. _ ..__··_>_'__"._4>____·___· _.__.____.__~_. ~c-_.___ MATERIAL SAFETY DATA SHEETS ON FILE: Ye:-~ BRIEF SUMMARY OF TRAINING PROGRAM: £,(Y\"?t.oy CES Aff ,foJSTI2.-VQTE"Ì) ,tJ ~ EfVlEI2.éIÐ.Xl'1 712.0C€"bc)~ . IN 1/0<-1)/ NL, S olf~Fr<..L"S IfJ A VE.tflC.t-t ìAt.>K... , <:lJ5ï()ME"2.. J)AMA.~«:~ tJOZ2t£ "Kt5L}(...:n~qlN SOßSoTA-IJ"rIAL FL-Ow CJf- é7ASOU \.) E I ' ¡; ït+CI2.e- /.$ :ÞA-M.P.~E It' A -rofVl P, AtJD J ç ï1-tei2..e I~ AtJ AÙ.TAoëtV, OUStI\JËs'S / '"B0u.b1 t.Ji:::¡oJ..) F ((2E . ALL 't120G€""'j::)ù~«:-s Ae£ /lvAL.p<-Bl.e- uJ A Etv)I:12é:1«:r.J~l.( r42.0Q..CDùR.c-- N\. r.1rOJ Ve:l.- Kd'T AT tHE' H2o Ù "\ C.O ù kJlER... . SECTION 4: EXEMPTION REQUEST: Ñ/A I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALlFORNIA 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) SECTION 5: CERTIFICATION: I, CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALlFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV, 20 CHAPTER 6.95 SEC, 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY, c1J~ ~M»7U SIGNA TURE iVlANÀ~~ TITLE '//2; !q¡ DATE· 2, FD1590 ~j ". ;11" . Bakersfield Fire Dept. e Hazardous Materials Division .. .. HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: FÃS-r1?1 p ~D"i) S-w\2.e" -". -- -...- -------- ~-- -- "- .------~ SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES':'-'-"---' -- ___u-OU_'''~~'~''_U--C=''-'~'"'-=--=-'_'U A, AGENCY NOTIFICATION PROCEDURES: Dial 911 B, EMPLOYEE NOTIFICATION AND EVACUATION: '{(£ReAL ArJ~ CALL '11 ( C. PUBLIC EVACUATION: Væf!:,At- ANi:) Q~W- 911 D. EMERGENCY MEDICAL PLAN: Call 911 for the medial personnel to respond properly trained 3. FDlfilO · Bakersfield Fire Dept. Hazardous Materials Division .' ~~ '",:¡ .)' -...., HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: - ._------,----~._---._-..--._-- -_. .--_._-~.. _'. __..___.___._ ____."_.___.,-,.._ -- ---··-----·~·7"'"..-·---n---· u _".. _._ ,__ A, RELEASE PREVENTION STEPS: ~t..)ÞA:-f2-'.ð qA'S. $f7::\TìO~ 6AF'E:Tl1 ~~ÚI Prv\E)0T- P--i,St:> 6ttùl- oFFS. B, RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: ~E" 5-rne£ ~ AÑ N350 e...ß~\ 'Y\-A~( Pt L- \0 .SðP.K.., UP 5 PII-L- A~1:> \\\.) AIJ A7i=>eotJ£'b Cbl-S\~(,j~, Z) 86 7tC~,K..-ro Ut' p.. \-tA-z.A R..j:)0ù~ Wf\-s,"Œ j)1~f=b.stL L SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: "&t\ u0b A20tJT Q.oùf-,rŒ12.. "'&nNœ10"Th)O ~€C:1Is.Th-e..S ELECTRICAL:~'i2- op '"3Ù/LDfr06¡ WATER: -:t<.~ oç. J3ðlLDI()~ SPECIAL: ~ot-.)~ LOCK BOX: YES@ IF YES, LOCATION: ~ ì I>c. SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY: A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 4, FD1590 Page ___, of '_ +ÕC??~__~~_~- i:3AKEH~J-ltLU s ,I Ii NAME OF nhs FACILITY' FÃST~IP S. T ANDARD IND. CLASS CÒDE:-'-----:- DUN AND ,BRADSTREET NUMBER-,-'-- ,- \- - - - - - - - i CITY of ~ i ~AZARDOUS MATERIAL INVENT9RY NON-TRADE SECRETS OWNER NAME: Tom t=Ä.~2.EC...I-- ADDRESS' ---:.7!iQO CA..¿£ïOl<.C.. CITY I- zIp: "l5A~fl~I.'J) PHON!: It: -eo-s ~3~- REFER TO-¡nSTRUCT ONS ness Bus Staridard I I o I I i I I , , J ture BUS !NESS NAME: L OCA TI ON;, (,;" CITY ZIt" PHON~ It: and Agticu Farll - p U ~ixturelçCfDonents Instruc Ions Hailes of See 3 , by Wt CODES 12 on Vhere n Facility NUlllber Number Number Underground 'ROPER Loc~t Stored C,A,S C,A,S C,A.S Name Nallle Name 11 Use Code 12 .3 COllponent Immediate Component Health Component 10 Cont Temp 4 9 Cont Press 1 8 Cont Type o at Sudden Release of Pressure o :(geDe I ayed Health o 2 Iyae Code Hazard 1 Tr~ns Code A' ty Reactiv re Gas.oline Underground 19 4 1 01 9" 365 "8 al PhYSic, I 'od Health'Hafard ICheck a I that apply 'I ~ 0 React j ¡ ! ~ lzLooL Physical' 'nd Healt~ Ha~ard (Check a I that apply) ; " EJ F ire Hazard ~ 0 React r ~i "A P 12:000 I 300b Physic,1 'fod Health "afard ¡ (Check a I that apply I I . I ~:xFire Haza.rd ¡ 0 Reactivity ~ ì I EMERGENCY CONTACTS #1~~ ¡ RI~ Tft CertifiçatioQ ¡fReed and $ign af1f3r c9mp1-;t leer tfy under enall 0 la th t I have persona I~ examln 0 0 d II attaç~ed dQCu~en~s, ~n~ t at ~ase~ on ~y Inquiry 0 lhose In~lvl~ua's s~bmttted 'nfor~atlon IS true. accurate. and cOllplete NUllber NUllber C.A,S C.A.S Nalle Nue Component . 12 Immediate Component Health Component o SUdd¡n Re lease o Pressure NUllber o C.A.S t}c De layed Health ty v Hazard re klxF Nu~ber v NUllber C.A.S C.A.S Nalle Nallë 13 12 Component Immediate Health o Sudden Release of Pressure o De layed Health [J I') NUllber C.A.S Nalle Component .3 ne Premium Unleaded gasol o Underground 19 4 1 01 365 gal 5000 I ! Nu~ber NUllber C,A,S C.A,S Nalle Name Component Component .2 mmed ía te Health o 886619 Sudden Release of Pressure NUllber o S De layed Health C,A H NUllber C,A,S Nalle .3 Component .$97-ð7..7/ (l'1ffTfiOñe- Mp.ç~~~ Ht 112 ~k)~ -B~~ Rãñie ï I, ond a II ¡ leve that: the ~ubllitte~ in this InformatIon, I be 8~3-C¡44S 2lìIrP1ïõñr- ing fJ 11. sect ions) familIar with the informatIon responsible for obtaIning the CO-:)~~ Fp.,~ '7-/!3-CjI Oãt!-Síqr.ë~------- ~~: presenU~- lì~eëñöO ,1{",.\ e---'@20-'V\ e HAZARDOUS rv1ATERIALS INSPECTION BUSINESS NAME: F4-'::>T>P..\P vn{\,Q....\L€T LOCATION: GL\O\ W l-\- \TE L f'\ ~d3~ INSPECTION DATE: -~ -- , l ~ 58 INSPECTOR: -p.'-{. {ì')~\Ot:. VERIFICATION OF INVEN'l'ORY MATERIAI.S G.2I VERIFICATION OF QUANTITIES 1...........1 VERIFICATION OF LOCATION 0 . -V": JJ1~' O~ SEGREGA:. TION OP MATERIAL . J:::: 0' . ¡Vð-<1 ~I!/ illCL~~~&.Ð-~ ":",ù . COMMENTS: ~*=5L ~ ('.A.. nY\~''''''Q~ ~~dL ~&.t&-;. ICATION OF HAZ MAT TRAINING D D \0\0 ~5ot~oÔO~D- t<"\^-~~S()S. ~~ VERIFICATION OF MSDS AVAILABLE COMMENTS : IPICATION OP ABATEMENT SUPPLIES & PROCEDURES D COMMENTS: v/1o~ _ EMERGENCY PROCEDURES POSTED Œ::J GLt CONTAINERS PROPERLY üŒ1U·F.n COMMENTS : VERIPICATION OF PACJ:LITY DIAGRAM ~. SPECIAL HAZARDS ASSOCIATED VITB THIS FACILITY: VIOLATIONS: () t{!f-.. ~ :Ý~ V~ -. ..;; ~;J 1r e ß¡¡jŒRSFIELD CITY FIRE DEPARA 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 3' Ii? 1) \'1.- ® =IVSPj OFFICIAL USE ONLY ID# ) ~SlL\ \ USINESS NAME HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS ;-- 00062:J. 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business 4. Be as brief and concise as possible. as- a whole. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUS INESS NAME: R~T¡¿I P ÇovD '5 Tð.Ld B. LOCATION / STREET ADDRESS: ~·6t¡o( to/J/T£ I.JJ..JG t;/J/T fll=- CITY; jJÁl0-t5~ /6-i.J C//-/ F ZIP; t933c) 1'1 BUS. PHONE: ('lrl/J) !J'i7o;27! I SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE~ DURING BUS. HRS. A.pE.MVís ¡::a5t;" Ph# 90/7°77/ . AFTER BUS. ~RS_ Ph# .3~q-43t...~- B. Ph# C. John Kerley, JACO OIL CO. 805-393-7000 office Ph# 805-398-8298 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: /~1 E. LOCK BOX~ NO »o).)¿ ;¿¿Aiè. op SLOG- l?¿ A Jl- £1;-::' i3l-W þ(} U [:;- IF YES, LOCATION: ~~ IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? /.......), YES ~ YES / (@J MSDSS? ~ [iðJ KEYS? ~ NO - 2A - 1. e e _ ð- "1°"$' '" .¡ . ~ .... SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE '/vOA.J ¿: SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE þtJ-Vt.: ., ".- :\ .-, :í ~ ( ¡ . '..: ;.J ~'<i"~ ;j SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROG~~ WHICH PROVIDE~ E~PLOYEES WITH INITIAL'AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE' HANDLING OF HAZARDOUS' _. '/:~"~' MATERIALS: . . .. . . . . . . . . . . , . . . . . . . . . . . . . , . . . . . . . . .. YES~YES~ B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:......................,... ~sJ ~O ~~ NO C. PROPER USE OF SAFETY EQUIPMENT:.................. ~ NO <YEsJ NO D. EMERGENCY EVACUATION PROCEDURES: . . . . . . . . . . . . . . . .. YES~) YES ® E. DO YOU ~~INTAIN EMPLOYEE TRAINING RECORDS:.....,. YES ~ YES~O) SECTION 7: HAZARDOUS MATERIAL CIRCLE YES O~ DOES YOUR BUSINESS HANDLE HAZA~DOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS O~ SOL~55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:.,..... YES '~) I. J /rh; trill$. 8 FJi2i2J'L1- . certify that the above information is accurate. r understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. , ..& r SIGNATURE\ / ~d dL~ß' , TITLE o--urxJ.Á- '7 VVVO "3-odiT t)ÞL1( / _1 .... í . ,., DATE {? pi.~ -)j' I - 2B - ~ e e '?'- -;; ~ BAKERSFIELD CITY FIRE DE?ART~EXT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL CSE ONLY ID# - - -' - - - BUSINESS NA.'Œ: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action. this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW _~: _ , .. 4. Be as BRIEF and CONCISE as possible. - ..---..-----------:-:-;--.- FACILITY UNIT;/: FACILITY UNIT N~~: SECTION 1: MITIGATION, PREVENTION, ABATEMEÑ~ PROCEDURES I t- SfJ - Q,S. 5-i;Ct6oN ~Q.fety 13"'1'" ~ It,u.,_. ,~rf~ d __, .___ ,.. ,'_' _ __ ,...;, __..:.-......:.- ____ .., -- ..- .._- SECTION 2: NOTIFICATION _~\~ EVAC0ATIO~ PROCEDL~ES AT THIS UNIT O~~Y ~~hce¿ f {Íú. /1 ? II -, 1~ - " n^KERSFIELD CITY FIRE DEPARTMENT ~ I,D. f FORM 4A-l Page _of ~ NON-TRADE SECRETS .) HAZARDOUS MATERIALS INVENTORY H"¿,r.¿I! ¡::Öv¡) ~ OWNER NAME: 7f.;r".11¿¿ tI-{/¡CTC1tf'-¡A FAR/lt!2t-- BUSINESS NAME: d T?Jl¡f FACILITY UNIT #: ADDRESS: bt~DI f.ù;J ¡!Y LA Vt: ADDRESS: 79C/:J C/Ju_ti' TDKC/v,') FACILITY UNIT NAME: CITY, ZIP: EA (...,;.-y'.-S Flt:rz.O I C)- Ç"'33F.'l CITY, ZIP: Blf¿1...7'£~:I::=If_r'].ù, rJ;f- PHONE 1t: <;sor·3"i7- C.'7-71 PHONE 1t: ðc>j- S:??J.CiLi'+3 IOFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CO NT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE [ P 48,000 1,110,00 gal. 01 19 see plot: plan 100% gasoline I/fà FLGS e, 1 .",,:,,::fh; l2- .f'}, ~ ¡ I \J ~~ /0-0 660' lC\cJl /D . l:?b . ~ 100 ;( ~. 'c0ïß CHLQ - - - 'v " irl -'-'" -' hv'\. . c 12 t:) ¡¿ V " ", ø/ E' __ A ___ 10M ç,// j2i2171..L TIT L E: Cn.V t..,JC, '){.. S I G N A T U R E : .JIVlY...#/J f-tYA/JLI DATE: b'ZI ~ 7 ....-. - ~ - - __I PRONE # BUS HOURS AFTER BUS HRS: PRONE # BUS HOURS AFTER BUS HRS: (...~ A" TITLE TITLE t.r¡; D '3 JP4;s' ""T'V /1-( :Jô)j II) ACTIVI ENERGENCY CONTACT E~ERGENCY CONTACT: PRINCIPAL BUSINESS .. . ,~ _IT~/FACILITY DAaGRAM FORM 5 J Jt. ~ f1' .. r¡. (Ó~3 ~ In~p ~ NORTH SCALE: BUS INESS NAJ'Œ:FA ~,r FLOOR:. I OF I nlllP Am" DATE:b /¡rIS7-FACILITY NAME: ú;;JD / Wh ,t~ L".. UNIT :!#: OF. (CHECR ONE) SITE DIAGRA)I FACILITY DIAGRk~ I ,@)-'- Tdi'Auef-· 1 ~?E'/l S7Þl'~ - - ~o~tf.D -=7 ,@ '" n ì~ I ~ I 1 I I ! i , 1 ( f ~ ~ ~ ~ ~ I ~. ~I ~ (,'õ/.I) BO"t - ~ -"..- -.. -.-.' .- -"-~-.-,,_...~--.. . ~ SALES AiEJr , ¡ ! ¡ I J~ : ~ --) ~+ µ l/\j::-~ SJtC- FPoJ.Jr ~j2t'4 6~ol eøidJ fllû41'" ì "'!to (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - ~., , .:'. , .,:::'.,,'.. 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".\;" Q/ V I \/ "," l " c.." -' ; 1 =-!L... , " !71 r ... äII~~·'> ~~ '1~1L _'4 µ'<.t1 I;] ,L.~ . ... .1 . ,.¡.,¡... ~"'~N= ........,- " ""'4I(D(UoNf-It f.. "< f~ , ·~r· ", 1--- .",.;.~' ~(I""'_) /,'\1>',.."..,..... """ ,... ""'"'"' , ~11 ..., ......,-~,..-¡.. r.::;¡ ~.J , . ' I ,I . ~, I _f ~-.. .'. i - -.<f.....-.1. J~: ,_ . ~ 'i~""'" ~. - -i¡f;t -:: .. ) Çi ~~I (" . _ _ ! \ '~e.lfø.lfo"'t' ~F l- U ~..~---+ 1:-11 ~ ~lr//¡¿ r4.At--J v..\I~. ~.\"ø' ¡;;IJ:VJ-]loIJ~ ~~.~ ~'..' I '... ~ '¡'W '. I L~' . e EXPLANATION OF SITE FACILITY/BUSINESS/OWNERS At this particular location the actual owners of the business are shown on Form 2A Section 1 Part A. Please be advised that the owners of the business do not ow~ the gasoline facility portion of their business. The gasoline tanks and equipment are owned by: JACO HILL CO. P. O. BOX 1807, Bakersfield, Ca. 93303-1807 (mailing) 3101 State Road, Bakersfield, Ca. 93308 (location address) John Kerley, Operations Manager, (805) 393-7000 office The business owners completed the total package with the exception of items 1 through 10 on form 4A-l (being the description of the Hazardous Materials Inventory sheet). The store owners operate the gasoline facilities for JACO HILL CO. on a commission basis and they (store owners) provide the employees who have control over the gasoline pumps. JACO HILL CO. -makes the arrangements to have the gasoline delivered to the location and also provides maintenance on the gasoline equipment for major repairs. Normal routine maintenance of the gasoline equipment is the responsibility of the store owner. ..... Howards Mini Mart, 4201 Belle Terrace, Bakersfield . '. ." '-',-" .. ".' .r-.....' '.; .:_.....,....~-:.;>O~',. 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