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4800 White Lane, Suite o· a er ,
(805) 397-0584
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PLOT PLAN 4IÞ
JOBSITE LOCATION
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TANK
SIZE
PRODUCT
LEGEND
,I ÛC)O'~ F FILL '--1 TURBINE
#1 (?. e. b _ 14 N ~ /~ ¿j
#2 100.).) vt~~ l/! N( {) ~ TURBINE WITH LEAK DETECTOR
#3 I ~) ù z) ~ 1/ (- b (. ,,- ~ OVERSPILL CONTAINER ON FILL
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#4 Ù I (::. , (:- , IRJ FILL
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#5 I~ EXTRACTOR VALVE
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#6 ¿U SYSTEM
#7 ll. MANIFOLD SYSTEM
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
21 01 "H· Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661)395-1349
SUPPRESSION SERVICES
2101 "H· Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326·3951
FAX (661) 326-0576
ENVIRONMENTAL SERVICES
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave,
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
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--
July 1,2002
Fastbreak
4800 White Lane
Bakersfield, CA, 93309
RE: Deadline for Dispenser Pan Requirement December 31,2003 for Site
Location at 4800 White Lane, Bakersfield.
REMINDER NOTICE
Dear Underground Storage Tank Owner,
You will be receiving updates from this office with regard to Senate Bill 989
which went into effect January 1,2000.
This bill requires dispenser pans under fuel pump dispensers. On December
31,2003, which is the deadline for compliance, this office will be forced to
revoke your Permit to Operate, for failure to comply with the regulations.
It is the hope of this office, that we do not have to pursue such actiqn, which
is why this office plans to update you. I urge you to start planning'to retro-fit
your facilities. .
If your facility has been upgraded already, please disregard this notice.
Should you have any questions, please feel free to contact me at (661)326-
3190.
Si2~
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
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BAKERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET
BAKERSFIELD, CA 93301
(805) 326-397~
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OFFICIAL USE ONLY \ ~
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USINESS NAME
RECEIVED
JUN 1 2 1987
Ans'd.
...........
HAZARDOUS MATERIALS
BUSINESS PLAN 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
4. Be as brief and concise as possible.
as a whole.
SECTION 1: BUSINESS IDENTIFICATION DATA
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A. BUSINESS NAME:
B. LOCATION / STREET ADDRESS:
Z I48p~O White Lane, Suite 0 °Qp'@kaa~t;bCA 03309
. (8fJ5S 397.~ . Y11Um.. ~
CITY:
SECTION 2: EMERGENCY NOTIFICATIONS
RECEIVED
JUL 3 1 1987
Alts'd.
RËë·ËiiiËD
SEP 2 1987
AnB'd.
...........
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 J,ITLE DURING BUS. ¡HRS. ~d Hk~TEM~' HRS.
A.~. t(QbR.íC-:,¡U122- Ph# 3q7- O~- ......Ph# .
B.
Ph#
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
Ph#
A. NAT. GAS/PROPANE: , t I
B. ELECTRICAL: 1J.í 1liE: CORAJ~ Ór:: TI+e L. ~ ~M @~
C. WATER: SIDe OFPtct:c
D. SPECIAL: CJ UJ iTCH () ()(JJ5iJ:x::3: 4(,..¿,. v- CðI?1PU'7Eæ,1 STðŒ'
E. LOCK BOX: YES / NO LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO
FLOOR PLANS? YES / NO
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MSDSS? YES / NO
KEYS? YES / NO
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SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE
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SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
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SECTION 6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
MATERIALS: . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . .
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: . . . . . . . . . . . . . . . . . . . . . . . . . .
C. PROPER USE OF SAFETY EQUIPMENT: . . . . . . . . . . . . . . . . . .
D. EMERGENCY EVACUATION PROCEDURES: . . . . . . . . . . . . . . . . .
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:..... ..
INITIAL
YES ~
~~~
?{:t.š> NO
YES ~
REFRESHER
YES Q
~ NO
¿¡ß NO
~ NO
YES @
SECTION 7: HAZARDOUS MATERIAL
---
--------- ---
- ---------- ----.-
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A
SOLID, 55 G~ONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...... ~ NO
~ 'ßae.rA
I, ~ObPIGuF:~ , certify that the above information is accurate.
I 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.
SIGNATUR~~O
TITLE ~
DATE ~-=éJl--8'1
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SECTION 3:.f~ZARDOUS MATERIALS FOR THIS u~IT ONLY
A. Does this Facility Unit contain Hazardous Materials?, . . , " B NO
If YES, see B.
If NO. continue with SECTION 4.
B, Are any of the hazardous materials a bona fide Trade Secret YES (f§)
If No., complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form #4A-1)
If Yes. complete a hazardous materials inventory form ~arked:
TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade
seq:et {(:n~m. List l.:m1t the trade ~eSJ'e_t~$, 9n. for;m~ 4A-~.
SECTION 4: PRIVATE FIRE PROTECTION
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SECTION
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5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS
On .5 ì'd. €.. o-t' tV hit~ h..fVì €- by -/-t..e ì ce !r\ e.rc.hctn d ¡'s«
f= " re.. h y d rd..11.,Å: 0')'\ W k..Lt.€. L.".
SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY,
A, ~AT. GAS/PROPANf~
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8, ELECTRICAL:
C. WATER:
D. SPECIAL:
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E. LOCK BOX, YES 16;) IF YES, LOCATION,
IF YES, SITE PLANS?
FLOOR PLANS?
YES Ie;)
YES I~ .
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MSDSs?
KEYS?
YES / Q
YES / ~
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BAKERSFIELD CITY FIRE DEPARTMENT
2130' "G" STREET
BAKERSFIELD, CA 93301
fAIT 11~1t1)i ONLY
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BUSINESS N . ..
4800 White Lane, Suite 0 It Bakersfield, CA 93309
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 ù~IT NA~:
SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES
N C ON2 ì S (1 U-øwe.&.. + ..~m. ö I<e.. ì Y\ ~ 6 -h, r-e 0 ( ~'-t ~ p,:-ñU..Ses I
Err.p/6yees ~I"e. ~f)€'J. ~ ~ -tt>d., ~~3e tt 'hY cra.d / f.- 0.-
Ctu..~h~y I ~ Smofc..i ('\~. ~f.ofY\.€.V.3 ax-e...4;:o {~ lV~ YL.ècely)-ic>
f.,~ uJ- +k-ù- \ _JLL r . , . ~
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SECTION 2: ~OTIFICATION ~~D EVACUATION PROCEDURES AT THIS uÑIT' ONLY
t!oJ..t ~,f!.-t>bÞð Uf?'2. - 3q 7-:DstÝ- ... .,
I,?mf/oye~s aæ -Iro.:,,,d .-jÐ ev~ ød M€-wesi-
c{DC r QY\d h.e(Lc;{ 0 uJ:; fv ~ ~ h'rte CU1)0- Ý
from +t,¿ tad +M k
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BAKERSFIELD CITY FIRE DEPARTMENT
FORM 4A-1
NON-TRADE SECRETS
HAZARDOUS MATERIALS INVENTORY
Page
of
BUSINE!:;S NAME:
ADDRESS:
CITY, ZIP:
PHONE #:
1
TYPE
CODE
2
MAX
AMOUNT
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4IIU( White Lone, Suite 0 .. BakersflAld. C.~ 93399
(805) 397-0584
4 5 6
CONT USE
UNIT CODE CODE
3
ANNUAL
AMOUNT
c<..ppftt'K. ,
1ßo ð7Jl>
IL r../toI
vll fll. G ,Ii 0
1(50 ~ wV ~,
71 6~
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OWNER NAME
ADDRESS:
CITY, Z I.P :
PHONE #:
FACILITY UNIT #:
UNIT NAME:
-
~An~~~OFFICIAL USE CFIRS CODE
I ONLY
4800 White Lone, Suite 0 . ft.
(8051 397.l1AA4
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LOCATION IN THIS % BY
FACILITY UNIT WT. CHEMICAL OR COMMON
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TITLE:
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SIGNATURE :"- c=5Z~ j n(f../Jl1/CYU.}l ~
()UJ/l/CZì<L PH,ONE (jBU~ HOURS:
\J' AFT~R Btis HRS:
PHONE # BUS HOURS:
AFTER BUS HRS:
NAME: .ß. 'f:Q()!Gt6I.Jb2 TITLE:
E,. ERGENCY CONTACT: ,(.Q f?t.o.f)~16¡)e2-
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EMERGENCY CONTACT:
P~INCIPAL BUSINESS ACTIVITY:
TITLE:
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