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Home My WebLink AboutBUSINESS PLAN . , ¡ . Permit 10 #:: 015-000-000189 ","": ,;'11.1 -..... ¡ LUCKY STORES INC #281 ONDITIONS:'Q,F'"PERMIT'ON"REVERSESIDE:, .' , , ;.; .,..:.;, >,,:,'../:.tfJ\?}:~"J'.·.. c':::: ';',;~':.,:.~:,:C:'~.",.>, ' ,c;-.., ;'<~' .) -, .~ , - '. .. :;'::"~'. , .... ·t"''1Xr~~''':ThIS oermlUs ISSuedforthefollowl~g:' .... . . ..\: It! HwrdousMaterlals Plan""·· ' ,. «:.:;.::;~':[J UndergroundStorage'of,HaZardous Materials.' ,¡ ';);.::¡~o ~Isk Management Program . .;' . . .' . "':','''; 0 Hazardous Waste On-$lteTreatment' ..... . " , r .' LOCATION: 4'801 WHITE LN . - ".,".: '. Issued by: . ; Bakersfield Fire Department. i OFFICE OF ENVIRONMENTAL SERVICES I . . : 1715 Chester Ave., 3rd Floor 1 Bakersfield,. CA 93301 -: Voice (661) -326-3979 : F~(661)376-0576 .-" . , Approved by: - -j Expiration Date: Ju~e 30,- 2003 " - ---- -~----- ---~------- -", ' PerDl.it to Operate Hazardous Materials/Hazardous Waste Unified Permit . CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-021.000189 LUCKY STORES INC #281 LOCATION Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 4801 WHITE This· permit is issued for the following: :¡¡tI zardous Materials Plan [sround Storage of Hazardous Materials . 'g,agement Program Waste I 'I I I I Approved by: ~~ . ~ê . . .' ph Huey, . . ffice of ental SerVi es . . .~ E"iration-Date: ,'.JunA~~n-,....2ßßn_-~_~.,~~ ....... .~ ~ II NORTH SCALE: :~ 'f: .~'. .~~ .'.- : ,BUSINESS NA.'lE: . LvL DATE =tD.I 12/ ~;7FACILITY NA.'-IE: (CHECK ONE) cv tj / J7 - .~ ¡v o >- ::\ ~ f) I ' .:x:. i (f:i 01 -i f'. t!' I '"""\ ~j , C' I If\ ¡ I I ¡ I ¡ 'I I Ci . ~- "4 . . ,.. . .~~.~. ...,.: .10 () r"" . -. .. : '."'1 ~:.. ¡ ¡ I I ¡ -t t::::¡ t:::::J t---.......--- ...- SITE DIAGRk'l '"= \~~! ~ ~ \()~I ~ <1- .'\L L tf) r- >- f;:.';' . \f\ ;_..____.___,.__.j Ï\ C- ~- \ O~ P r _1 I ,X7') \ , ,- ""'.:' "/;:::."./ ...' . .,~.,.;-:, FLOOR: S-roJ2.6 I IV (.;.. . $-"""',n r2 J. . '., . .UNIT .#: 'u,~~ N<- .', . . . . .. . FACILITYDIAGRk'l OF . OF .. <. ~ -1 "..,.: '" \ ' ! I f ! ¡ I I I i \~ ¡ '~ ¡ , ¡ ¡ i I ¡:r.: "t"\ ¡ ~\» i.' 1 ON h \_~ (t\ ¡ NÑ t'; ! ~\:/ (!"'" 0 f! c I ~ ' ¡~tJ" i 4:. (~ '-- ¡I"-.;: !~~ 1). , ¡ Þ. ¡ ..l\ j ~ ~! _\ ~ : ,'" ¡::&.: i t't\ 10: <"1', ~.! ~ ! "}:of' V -; ¡ - I~j ': ~ ,'" , i ~ 1 i .~ ~ t V· ¡ j j I ¡ . ¡ ¡ ! " ,¡ I ~ ,I .I ~" », ~. , -I - >-:p ~ Ó r t::::J ~ y . ..1S~ r, J~ 00 / -1 ¡~ t ~, r --' '1 .- ,~ ¡. . ¡ ¡-----..---, ,--.---..- 1 J I r---::-......·, r---- II1II _ , ¡ --........- . (Inspector's Comments): .,,',. ~ -OFFICIAL USE ONLY- .' , . , 5A ç:'" I - :');> -- 1."-' ç, -... Çf c. V' r'\ o ß; ? ~\¥:; .0 , c.. ~ð ~ ~ ô '>" &, ()' \-" r'Ò .::... ~ ~ -£ o ..,.. ., , ',- :',', ~.... ~. '" " I Q) - co o E o ... u. <S,Tf D,h\ C,> \l A IV' í ...~.~. ü Q) :c :;] en --....------------ WI; II f" LAJ -.......--...--...----,-.- "...:;o.~ ! i L__.__,_. I ¡ j rf¿~~~ti; ~:~ï----"'-"¡ IlL/ElLI c At~ I C~I x..--3. IJ41" &ti.AL [;". l' A<: 0 íVAtj I f ~ , t ~ j 1. --L E 11-'1 P Bù \ L D E:lL<: ~" , ,~ I Lvc lLï "r"'-'" --, ! Ii I Dr 0 I nL2A l-¡,o¡J,S I j ¡ I :. ~ I _...___1 _______...~___,.J, i L_.,_,._. J.#0Ü/...rr, .Lf I \LC £ L['tTT¿\t'~ L Ot :l ' ' µQ J\. ....--. r.' .....".-....' '. ", '0' '. HOI~ II~~ ' lO(>A.e.11 þ(2.,tl 1 esAà.~~ it ,':"¡,J. ':;' ¡ ct.., o~"lId $0,,11<)' ,,,.,1')\ I i'J£t' I _L..--.. ~ ..1...-7"'- /I ? ..:A I , , AI ( IJ é W , ' f L~ a: w '" « '" :I: U .... « a: U "! a: o u. ::¡; a: o u. II) :¡: .... w II) :;:) .... o z o o I WA~(I<.. "".'. ..... ---.,......:. -- .~ LUCKY STORES INC #281 SiteID: 215-000-000189 Manager : Location: 4801 'WHITE LN City BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: BusPhone: Map : 123 Grid: 14C (805) 834-4861 CommHaz : Low FacUnits: 1 AOV: SIC Code:5411 DunnBrad:00-691-3719 Emergency Contact / Title Emergency Contact / Title DARREL WILLIS / STORE MANAGER MICKEY IMAMURA / ASST MANAGER Business Phone: (085) 834-5893x Business Phone: (805) 834-5893x 24-Hour Phone : (805) 834-9784x 24-Hour Phone : (805 ) 833-0864x Pager Phone : ( ) - x Pager Phone . . ( ) - x Hazmat Hazards: Contact : Phone: ( ) - x MailAddr: 4801 WHITE LN State: CA City : BAKERSFIELD Zip : 93309 Owner LUCKY STORES INC #281 Phone: (714 ) 739-6310x Address : 6565 KNOTT AVE State: CA City : BUENA PARK Zip : 90620 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: CHANGE IN BUSINESS OWNERSHIP, STORE IS NOW A YOUNGS. SEND BP FOR REVISION. One Unified List ì All Materials at Site ì p= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP MOTOR OIL 200.00 GAL Min -1- 12/14/1999 11 '- '¡' j1 10/01/93 LUCKATOF<ES HJC #281 21~:;-(Ji.)O-(.'lB9 Overall Site with 1 Fac. Uni~ / P .::.¡ 9 E.' 1 General Information .---....----..--..._.._...__._~_....___......__.___...__..__..___..___.._________.__.__.._.._..__..___....__.._..__........0...-__....._.......______.__.......____._ Lc:~~a t~;;'¡rl :-'~;~~;;:_'- WH I-~'E -~;;-'-------·--·---_·-----'--·-~1,:t p: _.~~;- Ha ;'~~~d-;-~O;_·---¡ ,_~~~~~~~~~,:~~~~~~.,~_~_,~!A~=~:::~=~_~,._:~~A T I Œ:_-=-~~_._.______ _,__,_~~~:_~~ : __,~:~ ,__ F /,~..~._..__=_~~~~~~_..,._~~,:~.1 r:--:=-,.. ~~~~)"I·~ac~ ~~lame ~----r:::-~,~::--, l~i,t ~:: ------T-::- ~us~·~~es: :'lïom:? ---- -. ;~L:::HC<I.\:,~Plìo.'rf~:'] I DARREL l.-JÎLLIS . {"1~6-F--!'t1ANAGEH (805) 8.;.l~-5B9; x (B\:>5) 834--'37~1.~ ~i c.-¡,;.,---I'Wï,^17Ji(-rJrÄ-.JiLbr...L-m~~-'-----~- 6~--4-J.II·" tJ 81~ --- ~"()~---·~$3--ðð-¿..r¡ I --------------- .ß::~sT - Adm~¡rlist~~at 1 'Ie Data -,---5.$-1.1-,--,----,----,-----------.. Ma i 1 r-.dd~~s: 4801 WH I TE LN D&B Numbe~-': Of; C 1/17/ f -City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code:, ÇVII --.........---...-..--....--......--..--.-..-------..--....----......-.----.------------..--...---..--.--..-......--..--.-----..----- Owner: LUCKY STORES INC #281 Address: 6565 KNOTT AV C i t y: BUENA P¡'::¡RI-\ ~h CIne: ('! 14) '7 3':.1-' '~~ 1íG . btatE?: CA ~ '/ð J _________ ~~~,_ r:¿.~~:~(~_=_._____..____ _._._-_...._---_...~..__._--------_..__..__..__......_-- I· S llrnrîl a ~~y -----------"----,.-----,..,----'------~'-'----:--..----'-..-----..--..-----;-..----,---,-,-------,----,- RECEiVED l OCT 2 8 1993 HAZ. MAT. DIV . ,______..._.._,___,__~______,_,___________,__________,.______.,_,_.__,_____:....__..__._______..:..._______..______,_________.....J ______.._.._.____..___.._....___._______...._....__...______.._______..___...____M__..__..______....__.________._ ··;...,r··¡.,. ALLEN QUIGNON " , Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage.. ment plan for L fA {k-'i' 5'tý-( ind ,that 'it along with (NaI'i'ie of BuaIneae) any œrfectionsoonstitute a complete anCilcorr'eQ man- agement plan for my facility. (J{!gU7 I ()- '2 ~ 9.3 DsI9 ~ -~ i" , 'fi 10/0:l/'33 PIn-Ref Name/Hazards LUC¡"~.TORES INC#281 215--000-l.e18'3 Hazmat IY'lveY'lto"r-'y List in \71CP O~-:-de~-' 02 - Fixed Containers 6n Site F o~-"m Page ï::: Max Qty \71CP 02-001 MOTOR OIL ----..-..--------..--..--....---..--..........------.-..........--..-..-_........_.._~..__._---_.._._--_......._._---_...._.__....__..._--_.-..--- ? 200 I';' i rfÌ ma 1 Gr~L ....-..------......--..--....--..-..---.........-----.-..........-.-....-.-.....--..-..----------.--....--- /í\ 10/01/93 ,¡, LUCK.TORES INC ~::281 215-'000--(.189 02 - Fixed Containers on Site PaHe -;;. ..., HazMat Inventory Detail in MCP Order -------.---.-.--.--..------..--..---..--..-....-------------.--.----... 02-001 MOTOR OIL '? 200 !vIi '('ii mal GI~L .----.--.--....-.-..-......---..--. ..---.....-------------- .---......------.. [:I~S #: T¡:~ade Seci'~et: Nc< Form: Unknown Type: Pure Use: LUBHIC~~Î'n Days: ---- Dai ly tr1ax GAL -------r---- Dai ly Avei'~age _ G~~ --r--- A'('"(ual Amc'l.mt: GAL 200 u.uu 750.00 -...... PLASTIC S~~;~~Ä~N~-~""-----r Pi'~ess T Tefllp -T~IS~E --;'L3'=~ -- L<.:.c¡at iCI'('1 -----.---- - [:O'('IC _1-----·------:---------------'- COfll pO'('le'(I t s ------..,..-----..,--'--..,----'-f.:'- 171CP ---1..-8 U ide 100.0% Motor Oil, PetroleufIl Based ¡Minifllal 27. '1\ '" lO/01/93 LUC¡"~.ToRES INC ::~2Hl ~~15-000--(.lBI3 00 - Overall Site ., Page l¡. (D> Notif./Evacuation/Medical -------..-------.-.-..-...-------...-...-....---.--..--.--.- (1) Agency Notification -.----------.- IN SITUATIONS IN WHICH A HAZARDOUS MATERIAL SPILL OR LEAKAGE OCCURS, NOTIFY THE DIVISION'SAFETY OFFICE (71i¡.) 739-~m ' DUFHNG NoRIT1¡::¡L BUSINESS HOURS (B A. \'11. - 5 P.IY\., 1~10NDAY - FRIDAY), FOR I ~~!ER INSTRUCTIONS Ohl NOTIFIcrHION OF APPROPRIATE AGENCIES. '- , See" r,'/r DURING NON-OPERATIONS HOURS TELEPHONE THE DUTY -E']::~~-E:fY REPRESENHHI~BY ('~IIIÞ; :~r~ ~~3 e71 i¡.) '-'~. ~ JI:ili-THE DUTY REPRESENT¡:.n I VE h\OCS r40T KE fUr1rJ':~ CALL J' I{ J ·~n tr1IN~ ~, tfX:f"'\I YOUR DISTRICT SAFETY REPRESENT~HIVE. 01. 7t1i,-S~ ~~ ll/~ SIJ-"l £-1¡,/(~ , THE SAFETY REPRESENTATIVE SHALL NOTIFY THE LOCAL FIRE DEPARTMENT (805) 326-3979 OF THE INCIDENT. AFTER CONTACTING THE DIVISION SAFETY MANAGER A DECISION WILL BE MADE AS TO WHETHER THE STATE OFFICE OF EMERGENCY SERVICES WILL BE NOTIFIED (800) 852-7550. (2) Employee Notif./Evacuation ...---- IF IN-STORE MANAGEMENTS OPINION IS THE STORE MUST BE EVACUATED OR YOU'RE INSTRUCTED TO EVACUATE BY LOCAL AUTHORITIES (FIRE DEPT/POLICE DEPT) DO SO ACCORDING TO ESTABLISHED POLICY AND PROCEDURE. REFER TO RED/GRAY EMERGENCY PROCEDURE BULLETIN FOR INSTRUCTIONS. MANAGEMENT SHALL WALK THROUGH STORE INFORMING ASSOCIATES TO LEAVE THE STORE IMMEDIATELY THROUGH SAFEST EXIT. PUBLIC ADDRESS SYSTEM SHALL ONLY BE USED IN SITUATIONS THAT REQUIRE IMMEDIATE EVACUATION, TO MINIMIZE PANIC AMONG CUSTOMERS AND ASSOCIATES. (3) Public Notif./Evacuation ' ---.---.-----.........---....--....--....-........-..---.-....-- REFER TO RED/GRAY EMERGENCY PROCEDURE BULLETIN FOR INSTRUCTIONS. STORE MANAGEMENT AS ASSOCIATES SHALL WALK THROUGH STORE INFORMING CUSTOMERS TO LEAVE PURCHASES IN STORE AND EXIT THROUGH SAFEST EXIT. PUBLIC ADDRESS SYSTEM SHALL ONLY BE USED IN SITUATIONS THAT REQUIRE IMMEDIATE EVACUATION, TO MINIMIZE PANIC AMONG CUSTOMERS AND ASSOCIATES. (4) Emergency Medical Plan -"'--"-'--"---" -.--.--- ASSOCIATES OR CUSTOMERS WHO SUSTAIN INJURY OR ILLNESS DUE TO HAZARDOUS MATERIAL SPILL DR LEAKAGE SHALL BE REFERRED TO COMPANY DESIGNATED MEDICAL CLINIC FOR TREATMENT. IF INJURY OR ILLNESS IS SERIOUS OR-LIFE THREATENING NOTIFY PARAMEDICS OR EMERGENCY SERVICES IMMEDIATELY. 0' LUCK&TORES INC #281 2i~5-000-.189 00 - Overall Site Pëige E;:' -' . 10/01/93 CD> Notif./Evacuation/Medical ------------....----.-.......,...--............-.....---....--.....-....--------------..--..-------.---........-....-..-.--..-----..--. (4) Emergency Medical Plan (Continued) ---.----.------.- 'J', 10/01/93 LUCF.&ToRES INC #281 00 - Ove¡--'a 11 215--000--e 18'3 SitE? Page E, <E> Mitigation/Prevent/Abatemt ---------....--..--..-......-..-..-...-..---.--.....--..-..-..-...----...------.-----.-..-..--.......---..-----..----.-..........---- (1) Release Prevention ITEMS PACKAGED FOR RESALE ARE IN SMALL QUANTITY CONTAINERS. STORE USE ITEMS ARE CONTAINED IN MANUFACTURER APPROVED CONTAINERS. (2) Release Containment -------.---.------. PUT UP JT~:¡UTION WED FLOOR" SIGNE; DR ROPE OFF AREf=! TO PREVEI\IT CUSTOMERS/ASSOCIATES FROM ENTERING SPILL AREA. IF STRONG OR IRRITATING ODORS ARE PRESENT, WARN OTHERS TO MAINTAIN SAFE DISTANCE FROM SPILL AREA. IF MATERIAL IS DRY, KEEP ASSOCIATES/CUSTOMERS' FROM WALKING THROUGH MATERIAL, SPREADING IT TO OTHER AREAS. IF MATERIAL IS WET DR LIQUID, SPRINKLE ABSORBENT MATERIAL AROUND EDGE OF SPILL TO CONTAIN LIQUID (3) CIE'an Up ---- USE APPROPRIATE PROTECTIVE EQUIPMENT AS REQUIRED BY MATERIAL SAFETY DATA SHEETS (J7ÎSDS). IF SPILL IS GREATER THAN ONE GALLON NOTIFY THE SAFETY DEPARTMENT IMMEDIATELYFOR CLEAN-UP INSTRUCTIONS. IF MATERIAL SPILLED IS DRY, SCOOP OR GENTLY SWEEP UP DRY MATERIAL AND PLACE IN DOUBLE BAGGED PLASTIC TRASH BAG. DO NOT SWEEP VIGOROUSLY AS YOU MAY SPREAD MATERIAL. IF MATERIAL SPILLED IS WET OR LIQUID, SPRINKLE ABSORBENT MATERIAL AROUND EDGE OF SPILL. GENTLY SWEEP ABSORBENT TO CENTER OF SPILL TO ABSORB LIQUID. GENTLY SWEEP UP USED ABSORBENT AND PLACE IN DOUBLE BAGGED PLASTIC TRASH BAG. LABEL TR¡:'~SH BAG ¡~S "HAZARDOUS J71¡:'~TERIAL" (~ND PUiCE IN \,oH::¡REHoUSE TEi~1Pol:;¡¡:HHL Y. WET MOP AREA OF SPILL WITH MILD DETERGENT AND WAT~R. SAVE USED ABSORBENT, MOP, PRODUCT CONTAINER AND WASH WATER. CONTACT THE SAFETY DEPARTMENT (71L.) 739--+&f::'rËJ FOR PfWPER DISPOSAL INSTRUCT Im..¡. C3/t> THOROUGHLY WASH HANDS/ARMS WITH SOAP AND WATER AFTER CLEAN-UP. (4) Other Resource Activation ------ ~,~ ----='~'" ,-'. '" '.), -"': 10/01/93 LUC¡"~.:TORES INC #281 ;':::15-000-.189 00 - Overall Site Page "1 (E) Mitigation/Prevent/Abatemt ---........---....--....------....------------....------............-.-------....-....--.........-..--------..----..-............--........--....--.---- (4) Other Resource Activation (Continued) ..--..-.-- ~ ~ 10/01/93 LU[:¡.<aTOR~S INC #;':::~81 215--000--1..e189 00 - Overall Site Page 8 (F> Site Emergency Factors ..-......---....----..----.. ...---..-....--------..--.-..---..-..-----....--..------- (1) Special Hazards ..-------------- PROPANE TANKS ARE STORED OUTSIDE BUILDING FOR USE BY FLOOR BUFFER. REFRIGERATION ~YSTEM USES FREON #'S 12,22,502 FOR COOLING OF FOOD PRODUCT THROUGHOUT STORE. (2) Utility Shut~Offs ----......----.--.-..----- A) GAS - NONE B) ELECTRICAL - BACK SOUTH SIDE OF STORE - UPSTAIRS IN MEZZANINE C) WATER - BACK SOUTH SIDE OF STORE NEXT TO MAIN RECEIVING DOCK DOOR D) SPECIAL - SPRINKLER, SOUTHEAST CORNER AT RECEIVING DOCK DOOR E) LOCK BOX '0- NO (3) Fire Protec./Avail. Water -..--.------.-..------......-..--..--..---..--..--..--..-..--- PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLER PROTECTION, FIRE EXTINGUISHERS, FIRE HYDRANT - ???????????? (4) Building Occupancy Level -----.---.-..............--.-----....--..- 1'; rlJ LUCK...nOHES INC #':::81 215-000--(_18'3 00 - Overall Site Page 9 10/01/93 (G) Trair'Jirlg -....---......--............-..---..-..-----..-......----------........-..--..--..-.--..--..--.--.--.....--..---....-----.-..-----..- (1) Page 1 WE HAVE 102 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ALL ASSOCIATES RECEIVE INITIAL HAZARD MATERIAL COMMUNICATIONS TRAINING AT THE TIME OF THEIR INITIAL ASSIGNMENT. TRAINING INCLUDES BUT IS NOT LIMITIED TO 1) VIDEO ENTITILED "CHEMICAL SAFETY", 2) DISCUSSION OF HAZARDOUS MATERIALS IN THE DEPARTMENT, 3) LOCATION OF MSDS, 4) QUESTION/ANSWER PERIOD. ASSOCIATES RECEIVE RE-FRESHER TRAINING ON HAZARDOUS MATERIALS ON AN ANNUAL BAS IS. EMERGENCY PROCEDURES ARE RANDOMLY COVERED WITH ASSOCIATES AND ARE POSTED THROUGHOUT THE STORE ON EMERGENCY PROCEDURE BULLETINS (RED/GRAY POSTER) (2) Page 2 as needed -------.-----..---- (3) Held for Future Use ..-------.-...... (4) Held for Future Use ---...---....---........-----..-- ,~, -" 10/01/93 :.' LUCK_nORES I NC #281 00 -- Over-'ë:\ 11 (8) Tr~ë:\ i 1'"1Ì 1'"lg ----..... 215--'000--'.189 Site Page 10 ..--........---..............-....-....---..---..--....-....-..--.---..-.--..-................----..-..---- --- (4) Held for Future Use (Continued) ,~-::~I ~ j LUCF,.;:nORES INC *t2181 2i5-000-iA!a189 00 - 'Ove~all Site <H} RM~P DATA ---------------------------·-----1----------------'--------,----..---,---,--'.'-------------------,-- I ! Pë:lge 1 1 / 10/01/93 <1> Release Containment --, <2> Offsite Consequences <3> In House Capabilities (4) Plant Shutdown Instruction -..---------.-------..------....---.-- 1/ /1 I . . -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Page: 1 Account Billinglcollection Activity Inquiry SUTL108 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Acct SSN Name Svc Add: 384402 Cyc St: CL Parcel: LUCKY 7 MARKET 2501 WHITE LN - STE A Bill St: NO Cyc: 5 Rt: Svc CIs :e Seq: .-------------------------------------------------------------------------------- Amt due: 5.00 Lst Pmt: -99.97 Pmt Dte: (01/20/93 Prior Bills -- Date Balance G1/01/93 5.00 01/01/92 0.00 Type Desc 99 PAYMENT Current Period Postings Date Amount 01/20/93 -99.97 Receipt # 63959 ================================================================================ Enter 'I' For Billing History, 'pi To Print Report, 'D' For Detail Page, or '/C' For Credit and Deposit History or 'XX' To Exit . ALT-F10 HELP ADDS vp I FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR CR 1;) 6 WilfL ~ ~ !'U-'dv -tD ~ ~wh:J ~ '" " '~ 7"-. - -.,. e I. \Cl~ PAGE 1 APRIL 1991 LUCKY STORES INC. General Information l{ijèKY.~,~-~' Location: 4801 WHITE LN. BAKERSFIELD, CA 93309 Ident Number: REC£WiD \M~Y 2 0 \99' HAl MA"· [)\V. Contact Name BERT MILLER ARREL WILLIS· Tit le STORE MGR ASST MGR Business Phone (805) 834-5893 (805) 834-5893 Home Phone (805) 833-8942 (805) 834-9784 Administrative Data 4801 WHITE LN BAKERSFIELD 215-013 BAKERSFIELD STATION 13 LUCKY STORES INC 6565 KNOTT AVE BUENA PARKCA 90620 D&B Number: State: CA Zip: 93309- SIC Code: Phone: (714) 739-7466 Contact: SHAWN THOMPSON SAFETY MGR T al Number of Associates: ay 30 Associates ight 45 Associates 102 Hours of Operation: Business Hours: 24 HOURS ~' ~ e APRIL 1991 LUCKY STORES INC Hazmat Inventorv List - PAGE 2 ' TO BE PROVIDED WITHIN 60 DAYS AS AGREED TO BY RALPH HUEY. ~ '" 'i -- . PAGE 3 APRIL 1991 LUCKY STORES INC Notif./Evacuation/Medical 1) Aqency Notification · In situations in which a hazardous material spill or leakage occurs, notify the Division Safety Office (714) 739-7806, during normal business hours (8 a.m. - 5 p.m., Monday - Friday), for further instructions on notification of appropriate agencies. ¡I. During non-operational hours telephone the Duty Safety Representative by paging ~ (714) 255-4620. If the Duty Representative does not return the call within 30 minutes, notify your District Safety Representative. · The Safety Representative shall notify the local fire department (805) 326-3979 of the incident. After contacting the Division Safety Manager a decision will be made as to whether the State Office of Emergency Services will be notified (800) 852-7550. 2) Associates Notif./Evacuation · If in-store managements opinion is the store must be evacuated or you're instructed to evacuate by local authorities (fire dept/police dept) do so according to established policy and procedure. Refer to Red/Gray Emergency Procedure Bulletin for instructions. J · Management shall walk through store informing associates to leave the store immediately through safest exit. · Public address system shall only be used in situations that require immediate evacuation, to minimize panic among customers and associates. 3) Public Notif./Evacuation · Refer to Red/Gray Emergency Procedure Bulletin for instructions. J. Store management and associates shall walk through store informing customers to leave purchases in store and exit through safest exit. · Public address system shall only be used in situations that require immediate evacuation, to minimize panic among customers and associates. 4) EmerqencvMedical Plari J. Associates or customers who sustain injury or illness due to hazardous material . spill or leakage shall be referred to company designated medical clinic for treatment. · If injury or illness is serious or life threatening notify paramedics or emergency services immediately. ' c. _:I:> ~. e It PAGE 4 APRIL 1991 LUCKY STORES INC Mitiqation/Prevent/Abatement 1) Rélease Prevention J · Items packaged for resale are in small quantity containers. · Store use items are contained in manufacturer approved containers. 2) Release Containment · Put up "Caution Wet Floor" signs or rope off area to prevent customers/associates from entering spill area. · If strong or irritating odors are present, warn others to maintain safe distance -from spill area. ~. If material is dry, keep associateslcustomers from walking through material, spreading it to other areas. . · If material is wet or liquid, sprinkle absorbent material around edge of spill to .contain liquid. 3) Clean Up · Use appropriate protective equipment as required by Material Safety Data Sheet (MSDS). · If spill is greater than one gallon notify the Safety Department immediately for clean-up instructions. · If material spilled is dry, scoop or gently sweep up dry material and place in double bagged plastic trash bag. Do not sweep vigorously as you may spread material. · If material spilled is wet or liquid, sprinkle absorbent material around edge of spill. Gently sweep absorbent to center of spill to absorb liquid. Gently sweep up used absorbent and place in qouble bagged plastic trash bag. · Label trash bag as "HAZARDOUS MATERIAL" and place in warehouse temporarily. · Wet mop area of spill with mild detergent and water. · Save used absorbent, mop, product container and wash water. Contact the Safety Department (714) 739-7806 forúproper disposal instructions · Thoroughly wash hands/arms with soap and water after clean-up. 4) Other Resource Activation J · Safety Representative shall request additional assistance such as Haz-Mat clean-up service if situation requires. . '..,~ 0 !'o. :. ~~ - APRIL 1991 e e PAGE 5 .LUCKY STORES INC Site Emerqency Factors 1) Special Hazards ~ Propane tanks are stored outside building for use by floor buffer. · Refrigeration system uses freon '·s 12,22.502 for cooling of food product throughout store. 2) Utility Shut-Offs A) B) J C) D) E) F) GAS - NONE ELECTRICAL - BACK SOUTH SIDE OF STORE - UPSTAIRS IN MEZZANINE WATER - BACK SOUTH SIDE OF. STORE NEXT TO MAIN RECEIVING DOOR LOCK BOX - NONE FIRE SPRINKLER - SOUTHEAST CORNER AT RECEIVING DOCK DOOR ALARM CO - ESM TECH. - ORANGE, CA (714) 538-3563 3) Fire Protec./Avail. Water J PRIVATE FIRE PROTECTION - * STORE IS EQUIPPED WITH AUTOMATIC SPRINKLER PROTECTION WHICH IS MONITORED BY ESM TECHNOLOGY, ORANGE, CA 714/538-3563, 24 HOURS A DAY, 7 DAYS A WEEK. * PORTABLE MULTIPURPOSE (ABC) FIRE EXTINGUISHERS MOUNTED THROUGHOUT BUILDING ~':' ,::' ~.'. r~ e e PAGE 6 APRIL 1991 LUCKY STORES INC Trainina 1) Paae 1 · Material Safety Data Sheets are on file for all hazardous materials used in the store. · All associates receive initial Hazard Material Communications Training at the time of their initial assignment. ) Training includes but is not limited to 1) video entitled IIChemical Safetyll, 2) iscussion of hazardous materials in the department, 3) location of MSDS, 4) Question/answer period. · Associates receive re-fresher training on hazardous materials on an annual basis. · Emergency procedures are randomly covered with associates and are posted throughout the store on Emergency Procedure Bulletins (Red/Gray Poster). a: 281. haz \ "'-...,,-. 6565 Knott Ave, ,/ B- , 90620'..... , 714/739-2200.....;...:;--- ..-..,................. - -- .~. _.~"..... - . ~ ,-...-..-- /'" , // / Au.Iut / Stores, Inc. - Southern California Divi ' n í i ! \ ;-......r· ,~' , ~ REceIVED NOV 0 6 1990 HAl, MAT. n,v. November 1, 1990 - =-=-:-- ----,--- ..~~-,:~---.::;,~--:-~, ~ - - ~-""'-'"- ~"""'-".-.~--,- - - ..,...,-...,.-'~~:'~-. .~---'-''-'-~~'--~-~=.,,--- ~. _._ - '0- Ralph E. H\,1ey Hazardous Materials Coordinator City of Bakersfield Fire Department 2101 H Street Bakersfield, California 93301 Re: Lucky Stores, Inc. Hazardous Material Plan Dear Mr. Huey: This letter will serve to confirm the-agreement made during our phone conversation this morning. On behalf of Lucky Stores, I appreciate the 60 day extension granted for. completing the Hazardous Material Management Plan. You will receive our completed documents on or before January 5, 1991. Thank.you for your understanding in this matter. Should you need to reach me, my phone number is 714/739-7880. Sincerely, - ~ --- . , - -.--:---.,... ----=-= ",-,"..-. ...,..-~" ----.."......,.."s~ - - - ..~. ~ - . - . -::;-:: -..:.,0-- - ..............'- - --- ~._. ..,..-..-- - - .-- LUCKY STORES, INC.' ~.uy.&#I. #~ Mary Beth Hennessy Safety Representative MB/sh cc: Shawn Thompson Linda Stephens .~.:'~~. .", e Bakersfield Fire Dépt. Hazardous Materials Inspection Date Completed i/;-?-j ~ or . ~ \J ~ \( 0\ S"\ u --<é... ~ -rV'-c _ -'* "2.. ð \ 'i !:' Business Name: Location: A. 0 D \ \...A....) "^ -, "' \.. '-...... Plan ID # 215-000 '\ ß~ (Top right comer Business Plan) Station No. -, Shift 8 Inspector n E¡;P/è D Verification of Inventory Materials Ô~veD AUG 2 4 f9R9 HAZ. MAT. OlV. Verification of Quantities Verification of Location Proper Segregation of Material Comments: ~. . I' Adequate Inadequate o ~ 5'1 D .~ D o D o h Ve'ñfication of MSDSAvailability ~ Number of Employees . 90 Verification of Haz Mat Training /.~~ ~~ Comments: D ~ ~ D Verification of Abatement Supplies & Procedures Comments: s D Emergency Procedures Posted Containers Properly Labeled Comments: &L o D D Verification of Facility Diagram Special Hazards Associated with this Facility: m D Violations: FD 1652 (Rev. 3-89) White~Haz Mat Div. Yellow-Station Copy Pink-Business Office ~-,-- - '...~~~ "J~ \ '-'\ . . . "'""" .---- . . ~&~ HAZARDOUS ~1A TERIALS INSPECTION ~'61 BUSINESS lIME: L \..J Co ~ ~ ~ ð Ö J. oS", ð"'( ~ ... 'IX' 2. ß l 1 ~ E C E , V E 0 SEP 8 1988 ~I\S' d.....··..··· LOCATIOB: 4. 00 C \ L.,...,) '" ~ "'\ ~ l.. """ , INSPECTIOB DATE: Q-7-<ßc& De~()(d , c::r ~ [3' G-. $'11 "*r r. Atll #Aw:-pfØT' D till), ¡:,.¡ V, INSPEcroR: VERIFlCATIOB OF IBVENTORY MATERIALS VERIFICATIOB OF QUABTITIES VERIFICATION OF IDCATION PROPER SEGREGATIOB OF MATERIAL œMIŒM'l'S: ¡no1ötL ();/¡ o,N/V ôtV ~"ÇWJ()ltt¡ i2, £ $ t;.( b,w.:+ / rc:J 5 rØ n. ¿- (b,.Æ VERIFICATIOB OF BAZ MAT 'l'RAIHIMG VERIFICATION OF IISDS AVAILABLE ~ œMIŒM'l'S : VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES ~ COMIŒH'l'S : EMERGENCY PROCEDURES POSTED ).....I·'V\ ø CEJ COMTADŒRS PROPERLY ¡.¡a~~.1m œMIŒM'l'S : i.?!) ,} VERIÍ"ICA'nœ OF FACn.ITY DIAGRAM [3""' SPECIAL BAZARDS ASSOCXATED WITH THIS FACILITY: VIOLATIONS: / /~A' '" " ,/ /'ß' 'í(¿"-,. "Ót ;;,,~~). ,t ..-.' ~\\ '- ::=.111>-.... (', ; ,l,; -- '-AI ~ ç:),) ( - " -'/,-.,-', i -,~)...¡ . ....- , \ . > . :-'(' ::". '/' .~ -. . e e CITY 0)' BAKERSFJ~!D . , IV E C.-l R E .. ~ ú\!H1177"1h.. \\\\\\,~w;:~!!1!7¡ ~/,,\.iJ .--_'~ .§¡f:t' ~';,'\~~ ~I; "'J ,ill ::'~:5 =~~ . -~ ~~.:.:::: ;:~~ '. ""','::::: ~\ ,,--':' ,/§' ~-_~"c ,-",C",' ~ u~J'lÍíÍ~ T Charles Smith (tYDe or print name) REC£\VEO fEB , 7 \9ð~ the V HAZ. MAT, 01 . Do here b:;c cert i f~, tha t I ha \-e re\- i eh'eà attached Hazardous Materials business plan for Lucky Stores (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. (jt/J1f ~ Úß!it date sig:nat.ure of BAKERSFIELD == HAZAR.DOUS MATE:R.XALS XNVENTORY NON-TRADE SECRETS CIT}T PI'" ____ of NAME OF Tft'tS ~A_qL.!.TY: LUcky 11281 STANDARD IND. CLASS CODE 5411 DUN AND BRADSTREET NUMBER -º~ - 6_ ~ l - 1 L 1. 2. OWNER NAME ADDRESS:_ CITY. ZIP: PHONE .:_ ~ 0 IUl1"llR ro IlISrRUC%'IOIIS 7'01f PltOPIllt CODIlS Inc. ness 11281 Standard 8U5 ,~ '---' turf BUSINESS NAME: LOCATION:_4801 CITY. ZIP: PHONE .: 'qr;co Far. and II __ of .illtUt'etc-tl Set IMtruct1_ Motor Oil 13 'by 1ft Petroleum distillates:! CAS64 7,42650 --------. ---.- ..... ..... ..... 17 leat ton --. Stored In f.cillt, Sales Floor ... . C.A.S. 11 Un Code 26 t II Cont Cont Press 1.-p , Cont 1 YIlt 1 Oyt Sit. I on , ~ UnIts . b.r"" Mt 3 .... Mt 2 Tvøe Code 1 Iran, (ode 4 1 P and HHlth Hn.reI .11 thet .",,1,) ,.-., L. _.J lluctivlt, N Phys;cI ((heck ... L __ ea.nnt II eo.a..-tl2 ea.nntn ...,. C.A.S · C.A.S ... ,.-., L._..I SudcIen "1_ of P,..._ ,.-., L._.J Otl.yeII 11M Ith ,.-., L._.J ere H.urd · C.A.S. ... ¡-.dl.t. ....Ith ..... ... ... · C.A.S. · C.I.S ... ... ea.nnt , ea.nnt 12 C-t .3 ...,. C.A.S Pt.ys ie.1 and 11M 1th Hn.reI Itn.ck .11 thet 'l1li1,) r-., ~-, L_.J Fire Maun! L._.J Rtacttvlty ,.-., L._..I SuddIn ..1_ of Prw_ ,.-., "_.J ,.-., L._.J · C.A.S ... l-.dt.t. ....Ith Otl.yed 11M Ith ..... ..... ..... · C.A.S. · C.A.S ... ... ea.nnt .1 ec.oon.ntl2 ea.nnt 13 l-.di.t. ....Ith .... - ,.-., L._.J Sudden Rt INSe of Preslure C.A.S ,.-., Otl.ywd L._.J HNlth ,.-., L._.J Ith Mar.reI .""Iy) ,.-., r-, L - J Fir, Her.n! L. _..I RHCt;vit, ..... Iübtr IIœber · C.A.S · C.A.S · C_A.S ... ... ... .1 12 1-----1--1-_ ....,. ________ to.øonInt ,. - ., COIIIIOIItftt L._.J to.øonInt l-.diete HilI th Suddtn R, INS' of PrtllUre ___l____________1--.___________JL_____________J__l Pt.ysiellll\d HNlth IItr.reI C.A.S (tn.ck .11 thet ."ly) ,.-., ,.-., L - J Fire H.urd L._..I ,.-., Dtl.ywd L. _.J HfI Ith ,.-., L._.J IINc:tivity · C.A.S ... 13 T1t1¡--------------- 2rT!¡r-PIIII/I,----- of those indiV:dut~ resOlllibl. Oiti-s¡/fÞlfL------------ thet belld on -V i!\QUiry 12 't-Rr-Pnõñ¡-------- ~------------------------------ í C.r ~~t;on (RtuJd lJnd sign lJfter co.pJp.ting lJlJ s~ctionsJ / certify under llllt1ty of 1.. that I hev, Dfrsonll1y ....ined end .. f..;1I.r wtth the infor..tion SU.~'t i ~~ __u or 9bta1~,;n9 the infOl'llltlon. I ~h.vl! that the lub.l1tttd Infol'tlltlon II tMlt, .eeur.tt, end eo-ølete, \ Siijñ¡tü¡:ë ---------- ---- end ---- Tim Ii... ~ ãña-õmci¡nm!õf-õëië¡:ìõØimõ¡:-O¡¡-¡;.ñë¡:7õ~¡:¡tõPš-¡ütliõmëOrëörëšiñtmYë II lii.-----' cCJlUcrs "E RGfNCY !" BUSINESS NAME LUCKY STORES INC #281 LOCATION 4801 WHITE LN e e ID NUMBER 215-000-000189 HIGH HAZARD RATING 2 1. OVERVIEW LAST CHANGE 06/16/88 BY ESTER JURIS CODE 215-007 JURIS BAKERSFIELD STATION 07 MAP PAGE 123 GRID 14C FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 2) CALL 911 EMERGENCY CONTACTS 2A SEC 2) RICHARD WEBB - 834-4861 OR 834-5893 JOE MEEK - 834-4861 OR 832-9769 UTILITY SHUTOFFS 2A SEC 3) A) GAS - NONE B) ELECTRICAL - W BACK SIDE OF STORE C) WATER - S SIDE DF STORE D) SPECIAL - NONE E) LOCK BOX - NO 2. NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY USe: ~u\,\\~ ~ress S~;~ ~I't>-to 1~~ ~r5 crt ff&~ ~~.~ . < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/13/88 16:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME LUCKY STORES INC #281 . LOCATION 4801 WHITE LN ID NUMBER 215-000-000189 HIGH ~AZARD RATING 2 3. HAZ MAT TRAINING SUMMARY ~ .~ \ . LAST CHANGE I I ~'J . ~~~ ~~O('M'e.d ~ðJ e~~ù&-b ~~~~~~... reJct\ . wotÙ\ ~(1)e~ ct\-{.~'t. ~ 'wipe. a..J. ~~ euer- a W\'tMJ ~~$U.tJ . \ 1 li\Ì'to cb.c:tð '\ t'\~ ,",-eo w ~tik~ ~~ . < NO INFORMATION RECORDED FOR THIS SECTION > 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE I I BY ~: w~þ~~~~ OIW~q-~ ~ "~3aq < NO INFORMATION RECORDED FOR THIS SECTION > ~: PAGE 2 12/13/88 16:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~. .... - - ·-,-~-~.:;:;:::¿. ~-..;-_- ..,-_ -..:=iT_~- _:.....;-'_~~___..=::-c--_ __--__ ___ ~- .~~ - "'"7' ~-"---_ ~ . ~~~::--- !3, BUSINESS NAME LUCKY STORES INC #281 LOCATION 4801 WHITE LN FACILITY UNIT 01 " e - ID NUMBER 215-000-000189 . HIGH HAZARD RATING 2 A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 06/16/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE 1 PURE MOTOR OIL AISLE #3-B PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 2808.00 100.0 MOTOR OIL 200 GAL UNKNOWN LUBRICANT HAZARD LISTS UNKNOWN B . FIRE PROTECTION ~~'^~~~'t11" ~~~ ~~~ ~\~. / WATER SUPPLIES LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 3 12/13/88 16:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME LUCKY STORES INC #281 LOCATION 4801 WHITE LN ID NUMBER 215-000-000189 HIGH HAZARD RATING 2 D. EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 06/16/88 BY ESTER 3A SEC 2) NOTIFY DISTRICT OFFICE IN SAN LUIS OBISPO - 1-544-4600. NOTIFY DIVISION OFFICE IN BUENA PARK - 1-714-730-2200. USE PUBLIC ADDRESS SYSTEM IN STORE TO INFORM SHOPPERS OF PROCEDURES FOR EVACUATION. E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 06/16/88 BY ESTER 3A SEC 1) THESE ITEMS PACKAGED FOR RESALE IN SMALL QUANTITY CONTAINERS. PAGE 4 12/13/88 16:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~~ ~ .!¡ - . ,r",:, (. .' .' " . . ' .' ~. _ "t ;.--~ "'<, ---~~~ . ,..... ". ,"J ~ " . " .;, , .:.' _ 0"'" . .- ,~ ,r. '''<' . ,';,.-. ~. .' .'';' ~ BAKERSFIELD CITY PIRE.DEPARTMENT 2130 "G"STREET , BAKERSPIELD, CA 93301 Q " (805) 326-3979 .'V . . Pl-\j>(, OFFICIAL USE ONLY .' . . '" ,_..,:~.'" -:. :.- ,,:' -.,:~ '.\ '-<~'";-. . ~ '- . , .-...... ~'~ '-.',-1-' ,'",-, '~" '. , ~, ,:-,.":",..:. ". .;.! "RÈCEIVED . !., . JUN81987 i '." . ~A' n8~.'d '. ,. , . :" ! ............. $n) i2k~ II~·(. ID# --1.5 t 7D 000189 c#:{) {J¿h 2 ~(d-: ¿ ". ". HAZARDO,US MATER I ALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: '. .' . ~.. 1. To avoid further' action, return thisform.qby * 2. TYPE/PRINT ANSWERS IN ENGLISH. . 3. Answer the questions'below fÓr the" business a,s 4. Be as brief and concise as possible . ,"'..., ./' t ~r:: -~ ~ l.~:·. <,","',"1 a"whole. SECTION 1: BUSINESS IDENTIFICATION DATA . I. ;; A. BUSINESS NAME: ~~:LSTD e.t.~ lIVe ~~.. B. LOCATION / STREET ADDRESS;. <&;.41:¿"'7è\' 0J ¡'f-tR"!.-J..J· CITY: ·..<':£u15.A~'¥ ç t="¡ 8.-') Z I-p..;-2,~S.2"2._,__, BUS. PHONE: LUCKY STORES, INC. #281 4801 WHITE LANE BAKŒSFIElD, CA 9330f (&$) ~ '3 1..) -LJ 'B"0) 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 Off:i..-G.~ ·of Emergency Services as required by law. "', . .' ' EMPLOYEES TO NOTIFY IN CASE OF NAME AND TITLE A . \<.-\ lY'. Cl ( Co\ \JÆ. ~ '0 B . 'j\.) [ M a'lc. EMERGENCY: DURING BUS. HRS. Ph#~"B4lj~~1 Ph# ~ -4$,-= ) AFTER BUS, HRS. Ph# ~ 3 ~ 5'6 '1 ::3> Ph# 83 t-Q'7f,S SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. B. C. '- D. E. NAT. GAS/PROPANE: ~ Do-µ( , ELECTRICAL: """,U,J.~ii:'£EAct:::.:. 5 i DC of- ~TD /2.E WATER: .d'~~-i' :::~ I DG ôF çro LC SPECIAL: tk. LOCK BOX: YEs'=/(§51">7;~'YES ,LOCATION: IF YES, DOES IT CONTAIN SITE·PLANS? FLOOR PLA1~S? .~) YES /. N ¡ YES / ~ MSDSS? YES / ŒQ) KEYS? YES I ~-º') ~ _. ?A ._ . ,- "', ,-" '. \...,....:" ; ,~ , " .,'( .:_~,'1'J ..' .,' .' '< " '," .'\tu. " . .', "'. " ~ " " ' , ' , . ' ;SECTION 4 : ','PRIVATE "RESPONSE TEAM FOR BUSINESS AS A WHOLE . ,:1. , ,;>. t, 1'\ t ~ .1 ~"Þ;J ,t ~, l¡r~ C uJUz 011 SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ; . . '. .~ Ce>., \ \ lj, l'(~d...e. fOvV\ ';¿Úr>~/1 - ~ U '. " .!, . '-1" (¡ /,V'\ -t wt.,.{, 5f (Î y ·,¡:......tl C CL~ (0' ---.' , ì."'· " , , \ '-\- . f'¡ \ \ V\ \ "." SECTION 6: EMPLOYEE TRAINING '... ~~~~Wj.J::~;· EMPLOYERS ARE REQUIRED TO HAV~ 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 REFRESHER YES~ YES 4i? YES ~ YES ~ YES NO ~.. )~,~Ó"~':'" , ~~~:g ~,\~O' 51" NO ~ - SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOÙ~ BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POU~OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...... (~~) NO . certify that the above information is accurate. I understand that this information will b~ used ~o f~lfiil'iy firm's Ðbllgations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate infor~ation constitutes'~erjury. SIGNATURE ~~"'? ' ,"~I¡:¡$'ò'_, ~. ~ r. q ,p.',. ~.~, '-:"'"'~- ...... ' --... ,-, TITLE ~a-Þ('C~(L DATE/ïJlfìl.(Z'?/^87 ...... "'. ' ," - 2B - ¡ "!\. . ". .:. .' ;-;'.: '. - ~ .. >, . : ' '. .(., .-,.." -or - f~,i~ : '.,,- >..,.-. " ~ .-', . ~ ~.." .,' . -:,> -' . -~ . . -. """.' ~ '~.- "., . '... . ~ '. ,-'-'.- - ,;;, .. . ' BAKERSFIELD Cl'l'Y FlRE DEPARTMENT 2130 ~G" STREET BAKERSF IEJ.D, . CA 93301. " . ~;;: .. .. " , OFFICIAL .IJSE ONlY BUS ¡NESS NAME:' Lt..JCk1 STùl:tS ) IUL~ . ID# - - -"'.-. - - .. BUSINI?SS 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 fot THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# 1-81 FACILITY UNIT NAME:'~ ~ftt..1 '5íò12E'S SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES --r{,CSê ;T[:K1$ f6(~Yltd £;('- ~$~ ¡J Q.v.4'7U ì'í~ ~'1.1J11µ ¡;r¿S - .. .5.¡71 /f1..,~ SECTION 2: NOTIFICATION AA~ EVACUATION PROCEDL~ES AT THIS ù~IT\ONLY Q) f.-.j ()'Tl ~ D IS í'j;?.,t (: '1 û t-F I ( C I ÞÙ s'A-10 ~l s () 'iSl 5> 'ß-u I -.s-44-4b(YD @JvO\\ Fj "b /VISüi\.J 'ù Ph L ( 110 '2:u€.-1'1 a.- ? ~ t. . 1- r¡ 14-73.9 -22.ðò GÐ V f::. (Ç <pI..) 'è:i1-l C:.. ..L -r /ll)\) ,'2.(;.-~ S. S";î S'/C..t-1 I....J 1,\r1Co I?..Y\ ,S;;. ~'~\')'::"12.- '- .... c: , '- ...} ....'- ?~ce..~lr'ê- S e\J ð. ('.; -.J .s.....\-.. ú .~_ .--., ,... ~T01L(;. '1-0 Pv~ - 3A - .. ~ :\ Þ~'··.T .:~ ~o·¡ ,... ' Page I.D CITY FIRE FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY DEPARTMENT BAKER.SFIE , D I ~. ~ ~, . : UNIT , : FACILITY FACILITY UNIT NAME : OWNER NAME ADDRESS: CITY,ZIP: PHONE #: / BUSINESS N.AME: ~cJ~ ADDRESS: . l./'ð'O I hlK ~ ì1..P _ _ CITY, zip: "B1<:'f'U) c.. Q'5309 PHONE ,: 5rf3 L/ l/Sf(¿, fOFFICI.AL USECFIRS CODE ONL.Y rf.,Ô,.T !3ÚiDE 10 HAZARD Ç,.,ODE.;.;. 9 8 % BY WT. 7 LOCATION FACILITY A/flEd CHEMICAL OR COMMON NAME /!10TQ''R... 0,,_ ~Û~ IN THIS UNIT '3.1) (- L - \ r:'R. 6~ 2,6 fe5í t¿f:P é S IrfLÙ12..'N~ c rpOOL /9A- '5 ¿(l-..-:# I A ~~(~ =-,- OZ'¡; ~~\ ~1 ~ ~t; it ~ m¡ '.u..:. ~ " \. I A /117 Ii- , c¡ 456 CONT USE UNIT CODE CODE 3 ANNUA J~ AMOUNT 2 MAX AMOUNT ::IÀ-:;~~~::¡:"'" ~:2. 0 ð GAt;.. 7.~~ 0 (:¡11.. :1. 00 &Ai I 1/ ~L E -# L/{jJ E:1i/L ,,!- 5" 6A.1- 1 TYPE ·CODE ~ f¥ .~ _I'~ ~J' . A 300 GI1L. .2.. ~, ("l\1.. S'OC:pA¿ : ~)' ~-" ---. . ;", ~', :' ~ -- -- .:.... .' .:...;. " ~, . ," " A . ' , ~ T ._:, - ~:,.~ ,; ,;:: ,.i: "f' ;~ ,::. ; ~ H . . DATE · · · PHONE # BUS HOURS AFTER BUS HRS: PHONE 'BUS HOURS AFTER BUS HRS: : SIGNATURE . - i TITLE TITLE : TITLE : ACTIVITY c'ONTACT: CONTACT: BUSINESS NAME: EMERGENCY EMERGENCY PRINCIPAL