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BUSINESS PLAN 10/5/2004 (COPY2)
¡ e e ~FLOWER ST MINI MART SiteID: 015-021-001244 Manager : Location: 928 FLOWER ST City BAKERSFIELD BusPhone: Map : 103 Grid: 20D (661) 328-0732 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact '" / Title Emergency Contact / Title .þqútli'tP'~ AtiI HaS5..¿t VI MANAGER 6 ~ HUSSEIN A HUSSEIN / OWNER Business Phone: (661) ~~~7~~::1.2-~ð Business Phone: (661) 322-1521x 24-Hour Phone (661) 328-0958x 24-Hour Phone (661) 872-6544x Pager Phone () x Pager Phone : () X Period Preparer: Certif'd: parcelNo: to Fire ImmHlth DelHlth Phone: (661) 328-0732x State: CA Zip 93305 Phone: (661) 328-~x State: CA ob"1 J Zip 93305 TotalASTs: Gal TotalUSTs: Gal RSs: No Hazmat Hazards: Contact : MailAddr: 928 FLOWER ST City BAKERSFIELD Owner Address City HUSSEIN A HUSSEIN 1200 FLOWER ST BAKERSFIELD Directives: I, Id~~~~, ~/?:.., (!'< .~~;. .,·¡+:.L:3~ Do hereby certify ~hSl~ .~ h~1S ;:'.h3·;:;; !r\f: 8.ttached haZardous materials m¡QK'b~~ I:'.:~ ';, plan for_£X-ps~,,), ~A5 ~!nd that i~ ~©î'ì~ w~~h (Namo of BU~lnass) GI a! ¡ i corrections constitute a oomp!f)ì~ ~nd OOfH'®cK MMo agement plan for my facility. ìò'>5'- 0 t Datø -1- 10/01/2004 " e e F,FLOWER ST MINI MART SiteID: 015-021-001244 =t STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: FLOWER ST MINI MART Cross Street : Business Type: Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : HUSSEIN A HUSSEIN Phone: (661) 322-1521x Address: City : State: Zip: Type : INDIVIDUAL TANK OWNER INFORMATION Name : HUSSEIN A HUSSEIN Phone: (661) 322-1521x Address: City : State: Zip: Type : BOE UST Fee# : UNKNOWN Financ'l Resp: STATE FUND Legal Notif : Business Mailing Address Date:10/31/2000 Phone: (661) 322-1521x Name:HUSSEIN A HUSSEIN Ttl:OWNER State UST # : 1998 Upg Cert#: 00829 -2- 10/01/2004 e e SiteID: 015-021-001244 9 By Facility Unit 9 Fixed Containers on Site 9 specHaZEPA Hazards Frm DailyMax UnitMCP F IH DH L ~.oo GAL Mod F IH DH L 00.00 GAL Mod G 50.00 FT3 Min F~FLOWER ST MINI MART f= Hazmat Inventory f== MCP+DailyMax Order Hazmat Common Name... GASOLINE GASOLINE CARBON DIOXIDE V<eWl'Ùvt!\ ~ eeÓÙJ\¡L. 1f) It-- Sf1 ,- + 'f;..N f- -3- 10/01/2004 e e SiteID: 015-021-001244 9 Facility Unit: Fixed Containers on Site 9 F~FLOWER ST MINI MART p= Inventory Item 0001 == COMMON NAME / CHEMICAL NAME GASOLINE REGULAR UNLEADED Location within this Facility Unit UNDERGROUND TANK Days On Site 365 Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure 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 12000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS [;f] CAS#B006619 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.Defined?: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -4- 10/01/2004 e e F'FLOWER ST MINI MART SiteID: 015-021-001244 ì 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: UNDERGROUND TANK TANK DESCRIPTION Tank ID#: 1 Mfr: EFS Installed: 03/2004 Capacity: 20000 Gals Additional Info: SPLIT TANK Compart Tank: Y No. Of Comparts: 2 Tank Use: MOTOR VEHICLE FUEL Matl Name:GASOLINE TANK CONTENTS Petrol Type: REGULAR UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): BARE STEEL Material{s): STEEL CLAD W/FIBERGLASS R. P. 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: Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 10/01/2004 e e F'FLOWER ST MINI MART SiteID: 015-021-001244 9 f= Inventory Item 0001 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 DOUBLE WALL A.O. SMITH FIBERGLASS FIBERGLASS AboveGround Piping PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 06/07/2004 Date: 10/31/2000 Name:HUSSEIN A HUSSEIN Prmt Number: 1244 TANK/LINE TEST :07/13/2004 CP CERT. : MANWAY INSP. : 12/22/1998 UST MONIT. CERT:07/16/2004 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED ELD PASS -6- 10/01/2004 e e SiteID: 015-021-001244 ~ Facility Unit: Fixed Containers on Site ~ F FLOWER ST MINI MART f= Inventory Item 0003 === COMMON NAME / CHEMICAL NAME GASOLINE PREMIUM UNLEADED Location within this Facility Unit UNDERGROUND Days On Site 365 Map: Grid: CAS # 8006-619 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 8000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 GAL Daily Average 8000.00 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 Ag.Definedl: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Definel0: - Ag. Definell -7- 10/01/2004 e e F;FLOWER ST MINI MART SiteID: 015-021-001244 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: UNDERGROUND TANK DESCRIPTION Tank ID#: 2 Mfr: EF8 Installed: 03/2004 Capacity: Additional Info: SPLIT TANK 8000 Gals Compart Tank: Y No. Of Comparts: 2 Tank Use: MOTOR VEHICLE FUEL MatI Name:GASOLINE TANK CONTENTS Petrol Type: PREMIUM UNLEADED Cas #: 8006-619 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): BARE STEEL Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 2004 Drop Tube : 2004 Striker Plate: 2004 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube 8/0: 2004 LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -8- 10/01/2004 e e F'FLOWER ST MINI MART SiteID: 015-021-001244 ì p= Inventory Item 0003 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 DOUBLE WALL A.O. SMITH FIBERGLASS FIBERGLASS AboveGround Piping PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS Installed: 06/07/2004 Date: 10/31/2000 Name:HUSSEIN A HUSSEIN Prmt Number: 1244 TANK/LINE TEST :07/13/2004 CP CERT. : MANWAY INSP. : 12/22/1998 UST MONIT. CERT:07/16/2004 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED ELD PASS -9- 10/01/2004 e It ; F FLOWER ST MINI MART f= Inventory Item 0002 == COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SiteID: 015-021-001244 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit SODA FOUNTAIN Map: Grid: CAS# STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 50.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 50.00 FT3 Daily Average 50.00 FT3 HA %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 ZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min 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 -10- 10/01/2004