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CONTAINMENT' IðI MmGAT10N EQUIPMENT + FIRST AID EQUIPMENT "" ~ERGEHCY ASSEMBLY * SENSORS OR PROBES . LEAKDETECTOR I!:!] ~NITORING C - -) UNDERGROUND _ _ STORAGE TANK I7ŸŸiI CO2 LIQUID I GAS ~ CYLINDER [!] DISPENSER SHUTOFF I MOl MOTOR OIL ŒQ FLAMMABLE LIQUID [ÇQ COMBUST1BLE LIQUID I EM I EMERGENCY EXIT o ABSORBENT *** CHAIN LINK FENCE ' ITE I TRASH ENCLOSURE I TB I TRASH BIN ®!I REST ROOM _ CASHIER SCALE 1- = 45 Ft _A_ DIRECnON ~TE/FACILITY D~RAM FORM 5 ~, ~Olð 6.J16/e.J~1.5&¡ 1/l-s';7 NORTH SCALE: BUSINESS NA~E: FLOOR: OF NOT TO SCALE AM PM MINI MARKET #5164 1 1 DATE: 7 /10/87 FACILITY NA¡\fE: UNIT ~: OF (CHECR ONE) SITE DIAGRA~ FACILITY DIAGR.~~ ,WII3LE RD,· ~ FIRE HmRAN'U~~ ,>'H'r:-_, .. .. .- -- --- ATER 0 ' ENTRANCE/EXIT DRIVEWAY SHUT'U:PFF ' Ü ~' - ~ ~ ~ E-I, I ~ r::I 110 K , F ~~ m ~,i 1 - C,,!)CJ) :J H CJ) 0, , H CL ~rlO K t F -- .~ ~ -.- .. W I , - - - ..:_~-...... --' Q ~ ~ ~ 0::: Z !§, I <z ~ --.J grlOKrF ~~ C,,!)~ Z , C,,!) 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' , 'Î" ---'-..--. ~' "_ E1OST1NC [lEC. MET[R [XIS-TlNC CAS. . nEt. - S£AI,1~S -D. EXtST1NC ARCO "'ON ~.1> - [--EXISTING -. _ _ __ _ ~ C.L f(NŒ " _ ~ '..A.,~H':- :(/ -~ (XI$T'ING BUVP(A POSTS t- ( ( Sl1NC 0"1 \ C:l. ~[NC[ \ 'urSTlNC \ ;~~. 'BlOCK \ ' \ Ire ¡ ft \~ :~ \~ \ \ \ - \ 0 \ \ \ \ t \ \J \ (xtSTJHG t:/WATtA "As:.:~~T· "-iii" <- ~~, - E~-(,tJ .t , ='.3 ~{["'S""C ~PAY PHONES G li'ò.., [JOSTlNG t() ~ U.G. TANK S . 10.... aOu 10'" r:::{ n"'..1NG ~ TR"SH CA~ ON CONt. PAD [XJSnNG ...,. UGH OIIS,,"G _:....141.70·. (lCtSTtNC SlD£W"LK - APPROAOi w B E· ./ 0, D R A L ..' .""'" 'L L,~G·;E ~; ,D.:: , .:.:~:':'\"¿:)(\7'::"). o - - ~' w I-' :I: ~ SITE PLAN SCALE: ,"~ 10"-0- . r v I S 0 II S - .' ./ .. .~~ ~~ 0" " >-I'co'~o æ '!§.(/):ñ . ·Ea.~j:'~·9.: . _ :!., II) in o! ,>0 O'i' JJO '" ,"",0> ",. &_ø< (P'ø~~ .gMIÌ);: o~ ~~ ... ~c a. < o .~ ~ a:o := ¿ :;; ... < :2- ~ '= )( a; '0 II: m ......-.! -- - ~ o ~ wen ....0 -P') ~~ Z'O « 0« ....J oU '0.. '" 0' ~d ~fj¡ w ~ t- ~'5:;! iñ ~~ .. ' ::1 " "'~'¡- :\ SITE MAP & .. I CALIFORNIA REPUBLIC BANK ....-1 FIRE HYDRANT LOCATED AC- ROSS STREET ON ¡HBLE RD. I~ ,æ :> Ie: ,0 GAS ISLAND GAS ISLAND o c( o c:<: I..LI -' C%:) .- ~ I:.- g e: c:<: p GAS ISLAND >- l:i I~ 1ê5 '..::.... , :,i" I...... I '......1 1",,1 :51 I~I I I ,-! " '-" PLANTER AREA FACILITY BUILDING COLD BOX SALES AREA , - , I~I I"" I ,0 I - I I '... I -. EMERGENCY PUMP SHUT-OFF SWITCH LOCATED NEAR CASHIER INSIDE SALES AREA PLANTER AREA WHITE LANE Business Name: Address: Phone: AM/PM MINI MARKET #5164 4010 Wible, Bakersfield, CA 93309 [805] 836-9685 TRASH BIN STORAGE & OFFICE AREA E '- ----=-~~ SANTA BARBARA S & L I -'I. , l~ ~.. ":-:::-, . 1 , ,A ð . , I B " I: I·: . i. 1 I" I I Ii c · . . . .. D · . . . . E · . . . . F · . . . . G .. . . . . H · . . . . I Business Name: Address: Phone: ' ~Bakersfield Fire Departm., . '~ Hazardous Materials Divtsio _ , ~ITE PLAN DRAWING 2 I 3 I 4 151 . r . C~LI'FO;NI~ REPUBLIC BANK ...-1 'FIRE HYDRANT ·LOCATED AC- . RQSS. S"FREET . .ON I~IBLE RD. ~. l¡¡j :> ,- e:: 1°· . GAS ISLAND ' GAS ISL~ND ,~. o cr:: w -' co - 2 ~ ..:. ,13 w e' 'P' . r (2\ ·;2\1 ':~"I I:.¿ I I :.¿,. I:.:: I I~I I~. I~I I I I! I I ,.. \ -". '... ~ GAS ISLAflD > I~ I~ I~ '. . . . . . . . . . . . . PLAtHËR AREA FACILITY BUILDING' . COLD BOX· . SALES AREA · . . . I, · . . . EMERGENCY PUNP SHUT-OFf SWITCH LOCATED NEAR CASHIER INSIDE·SALES AREA . , . PLANTER·AREA WHITE LANE. . . . . · . . . . . . . AM/PM MINI MARKET #5164 4010 Wible, Bakersfteldl CA 93309 [805] 836-9685 6 7 . . . . · . . . TRASH BIN SANTA BARBARA S .& b . STORAGE & OFFICE AREA . ·E · . . . · . . . · . . . . ' · . . . · . . . · . . . · . . . If. . ..__~_~.I!H?:._ :~-.a WAIN ..-. . $.IOIIOAAD UISfWrrfG CAS. (lIe. S£RYlaS, -D _IIOSIIN~ ::I:",r. ARt.. ~~,. [(XIS ONC _ . _ __ ~ .C_l~r(HŒ \. .. ~ -.. "\..w '^' ' -- ~ " 4 - ____... f.:!!:____ f_._.- If..' 3 _.Ir" ~' .'è~l/t 1 \ IJ I / 1- / - , ,"" . ,ftrG' , -" ,/ , ~ - \t> t>oO ~I\\.I \Jle, Îf\t1¥.\ _,...:.1:....-..__ [XlSTlNC ..... UGH, (XlSJ1NC APPROACH W B l -Ii E R 0 A 0 ~ (IISTlNC We, "'TEA rXlswa.c C.l. nNe( IIIS,""G =r ØlOO( [JOSnNC BUUP(R P051$ ¡o . ¡û. ~~ ¡ . o (JOSnNQ IRItSH CAN ON CONt. PAD l E G E N o ... ...... I ( ,,!II.../" lIha.... to ) MI ~ JIOIoIt ".".. ODO ( \...-'..t!l ) o 0: w >- :t: ~ SITE PLAN SCALE: 1"= '-0" ,·0" ~) ~9 IfF'.- W--. .,,,, c¡---- ~--:-I , ·-·.b:t~ì ~_.) ~- ~, ¡ . j ... :! . a: o r 0, , ( 10' cr C ~¡; me;: :fu- n: 0"- -" 0<1 '<1 (I" I,' I , ; _ . ,..., .. 55[' ,j ~F -- ~ t ,- PSI #5164 " 4010 WIBLE ROAD *NOT TO SCALE III "'" ... - J-""" , t:5, 1'''''' I I ;: , -i-J?~': . ~~' - CALIFORNIA REPUBLIC BANK ~ ....-1 FIRE HYDRANT PLANTER AREA TRASH LOCATED AC- BIN ROSS STREET ON \HBLE RD. I~ 3: IL.J.J ::::- GAS ISLAND ,...... ~ SANTA 10 FACILITY BUILDING BARBARA COLD BOX S & L GAS ISLAND J ~ STORAGE ~ & OFF! CE L.J.J SALES AREA AREA e: 0 ~ E c:( P ° I c:: GAS ISLAND L.J.J ---l co ...... 2 >- I~ I~ ...... 1ê5 '-3' ILL I I~ I 1° I ~ I I , ~~ I LL I I d31 ~I I \ - / 1- . IW: I I~ I 1° ~ I I '... J , ..' EMERGENCY PUMP SHUT-OFF SWITCH LOCATED NEAR CASHIER INSIDE SALES AREA PLANTER AREA WH IrE LANE .. SITE/FACILITY FORM 5 .. DIAGRAM NORTH SCALE: BUSINESS NA.'IE: FLOOR: OF .... 1\ I NOT TO SCALE AM/PM 'MINI MARKET 15164- 1 1 - I" .... DATE: 7 /10/87 FACILITY ~A.\1E: UNIT .... OF ... (CHECK ONE) SITE DIAGRA.'I " FACILITY DIAGRA.'I X ENTRANCE/EXIT ~ H >< ~ ~ CJ Z ~ ~ i ~ FIRE W EXTINGUISHER ffi FIRE W EXTINGUISHER S ALE S c::::::1 o EMERGENCY FUEL SHUT-OFF SWITCH ARE A EE OFF ICE O EMERGENCY FUEL SHUT-OFF SWITCH (Inspector's Comments): -OFFICIAL ,USE ONLY- - SA - J;IAZ~US MA;;;~ DJSI0N ! . ~/ TIME CHARGED . fO-~7 i -,1 BUSINESS/DEAPRTMENTNAME: !1R.Co· ~ 4ð366- : ,,',,~tO ,'" .'., " ".. fL1 kh laMf¿ ~\!()Jd. .~. . !4olot<)¡6!e ') , \ . " PROJECT'DESCRIPTION:/A s¡--'\S;.l;l¿.ClJj~l'~ . ' ADDRESS: t() ~ Ç'foÆ' PROJECT NUMBER: DATE: NAME: I/-. ,3, 'i'3 7oß~ _.¡J-I~ 4 -'2" ~. 4 4- <gv-&--.-Cl4--' o \..ù \:) 4~-,: ~. t.->&r0Jc.A ,/5~Á. (,}r- , l "'-r ~'~ . AI C(ðSI.Æ'e- \4-¥"' . c2c2i7lu\GJ ".W r ~, . . . .t:!- ~f ....s'" 5- ~W~. ~J r~L1,Ð fí j,e - j}Jif;1' . 1(010 Wtjle ¡:J. /)$1' Çk , '---------~ - ------------ , PROJECT COMPLETION: '.. TIME CHGD: COMMENTS: 0Îl/ IPsw .f~ /ld!? '\ : DATE: /~'", :./, ....;.\,._".:' -. ,,-'" ,;' , -- e .ý"" " ARCO #05365 SiteID: 015-021-000564 Manager : SAYEGH GROUP INC. Location: 4010 WIBLE RD City BAKERSFIELD BusPhone: Map : 103 Grid: 29B (661) 836-9685 CommHaz : UnRated FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact MARK SATER Business Phone: 24-Hour Phone : Pager Phone : / Title / FRANCHISEE (661) 836-9685x (909) 465-1886x (818) 266-9088x Emergency Contact / Title ARCO MISSIONCONTRO / Business Phone: (800) 272-6349x 24-Hour Phone : (800) 272-6349x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : MICHAEL D. WILSON MailAddr: PO BOX 6038 City : ARTESIA Period : Preparer: Certif'd: ParcelNo: to Phone: (714) 670-5321x State: CA Zip : 90702 Phone: (714 ) 670-5321x State: CA Zip : 90702 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Owner Address : City BP WEST COST PRODUCTS LLC PO BOX 6038 : ARTESIA Emergency Directives: I, fk¡)fJf!!!~ Do hereby certify ¡hat f have reviewed the attached hazardous materials manage- ment plan for Sft¡GG1-i ~~ and that it alonn with (N8mè of Business) ~ any corrections constitute a complete anå corrsct man- agementplan for my iacility. " ~ ff~;. Signature {)~/ttrÞ4 Date -1- OS/24/2004 .r" - - F ARCa #05365 SiteID: 015-021-000564 ì STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: ARCO #05365 Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name '. ARCO MISSION CONTRO Phone: (800) 272-6349x Address: City : State: Zip: Type : TANK OWNER INFORMATION Name : ARCO MISSION CONTRO Phone: (800) 272-6349x Address: City : State: Zip: Type : BOE UST Fee# : 000506 Financ' 1 Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:12/26/2001 Phone: (714) 670-5321x Name:MICHAEL WILSON Ttl:ENVIRON. ADMIN. State UST # : 1998 Upg Cert#: -2- OS/24/2004 _I . - . f ARCa #05365 F Hazmat Inventory f== MCP+DailyMax Order SiteID: 015-021-000564 9 By Facility Unit 9 Fixed Containers on Site 9 Hazmat Common ~ame.:. SpecHaz EPA Hazards DailyMax MCP F IH DH L 20000.00 GAL Mod F IH DH L 10000.00 GAL Mod F IH DH L 10000.00 GAL Mod F P IH G 400.00 GAL Min F DH L 30.00 GAL Min F IH S 55.00 GAL UnR UNLEADED GASOLINE MIDGRADE GASOLINE PREMIUM GASOLINE- , CARBON DIOXIDE' MOTOR OIL WASTE ABSORBANT -3- OS/24/2004 "i " e e :; SiteID: 015-021-000564 9 Facility Unit: Fixed Containers on Site 9 F ARCO #05365 f= Inventory Item 0005 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location'within this Facility Unit UNDERGROUND STORAGE TANK Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 20000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 20000.00 GAL Daily Average 10000.00 GAL %WL 100.00 Gasoline HAZARDOUS COMPONENTS ~ No CAS # I . 8006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / I 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: - Ag.Define11 -4- OS/24/2004 e e F ARCa #05365 SiteID: 015-021-000564 ì F Inventory Item 0005 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 STORAGE TANK TANK DESCRIPTION Tank ID#: 3 Mfr: XERXES Installed: 09/1993 Capacity: 10000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL MatI 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 Carr Prot: FIBERGLASS REINFORCED Spill Cnt : 1993 Drop Tube : 1993 Striker Plate: 1993 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1993 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- OS/24/2004 -- e F ARCa # 0 5 365 Sit e I D: 015 - 021- 00 OS 64 ì f= Inventory Item 0005 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 SMITH FIBERGLASS AboveGround Piping FIBERGLASS FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING Installed: 09/16/1993 Date: 04/01/1999 Name:WILLIAQM M ZAPKIN Prmt Number: 0564 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE , Ttl:ENVIRON. ADMIN. Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED TANK/LINE TEST :07/16/1996 CP CERT. : MANWAY INSP. : 07/20/1998 UST MONIT. CERT:I0/27/2003 STORAGE CONTAINER DATA (UST FORM C) Installer Certified by tank/piping manufacturer: res 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: 04/01/1999 Name:WILLIAQM M ZAPKIN Ttl:ENVIRON. ADMIN. -6- , OS/24/2004 ' e e FARCO #05365 f= Inventory Item 0002 === COMMON NAME / CHEMICAL NAME MIDGRADE GASOLINE SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days,On Site 365 Location within this Facility Unit UNDE~GROUND STORAGE TANK Map: Grid: ,CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL , %Wt. I Gasoline HAZARDOUS COMPONENTS ~ CAS# I 8006619: HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod Ag.Defined1: MISC. LOCAL AGENCY DATA Ag .Defined2:' Ag .Defined3: Ag. Defined4:, Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10; Ag.Defined8: - Ag. Define11, '-7- OS/24/2004 e·' e F ARCa #05365 f= Inventory Item 0002 SiteID: 015-021-000564 9 Facility Unit: ,Fixed Containers on Site 9 UST FORM B and AGENCY-DEFINED) Page 1 of 2 STORAGE CONTAINER DATA Last Àction Type: Location In Site: UNDERGROUND STORAGE TANK TANK DESCRIPTION Tank ID#: 1 Mfr: XERXES Installed: 91/9930 Capacity: 10000 Gals Additional Info: Compart Tank:' N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL Matl Name:MIDGRADE GASOLINE TANK CONTENTS Petrol Type: PREMIUM UNLEADED Cas #: 8006-61-9 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1993 Drop Tube : 1993 Striker Plate: 1993 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1993 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 -8- OS/24/2004 e e f ARCO #05365 SiteID: 015-021-000564 ì p= Inventory Item 0002 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 SMITH FIBERGLASS AboveGround Piping FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING , Installed: 09/16/1993 Date: 04/01/1999 Name:WILLIAM M ZAPKIN Prmt Number: 0556 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE TANK/LINE TEST :07/16/1996 CP CERT. : MANWAY INSP. : 07/20/1998 UST MONIT. CERT:10/27/2003 Ttl:ENVIRON. ADMIN. Approved: Yes Expiration Date: 06/30/2006 AGENCY DEFINED 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: 04/01/1999 Name:WILLIAM M ZAPKIN Ttl:ENVIRON. ADMIN. -9- OS/24/2004 e e F ARCO #05365 f= Inventory Item 0004 == COMMON NAME / CHEMICAL NAME PREMIUM GASOLINE SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site 9 . Days On Site 365 Location within this Facility Unit UNDERGROUND STORAGE TANK Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 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.Defined9: Ag.Define10: Ag.Defined8: - Ag.Define11 -10- OS/24/2004 .;\ e e F ARCa #05365 SiteID: 015-021-000564 ì f= Inventory Item 0004 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 STORAGE TANK TANK DESCRIPTION Tank ID#: Installed: / Additional Info: Mfr: Capacity: Gals Compart Tank: N No. Of Comparts: Tank Use: MatI Nam~:PREMIUM GASOLINE TANK CONTENTS Petrol Type: Cas #: 8006-61-9 TANK CONSTRUCTION Type : Material(p) : Material(s) : Lining : Corr Prot: Spill Cnt : Drop Tube : Striker Plate: Sgl Wall: Alarm : Ball Float : Fill Tube S/O: TANK LEAK DETECTION Dbl Wall: Installed: Installed: Exempt: No Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -11- OS/24/2004 -:- e e F ARCO #05365 p= Inventory Item 0004 STORAGE CONTAINER DATA (UST FOR PIPING UnderGround Piping SiteID: 015-021-000564 1 Facility Unit: Fixed Containers on Site 1 M B and AGENCY-DEFINED) Page 2 of 2 CONSTRUCTION Type : Const: Mfgr : Mtl : & : Corr : Prot . AboveGround Piping ! PIPING LEAK DETECTION UnderGround Piping AboveGround Piping Installed: DISPENSER CONTAINMENT Type: OWNER/OPERATOR SIGNATURE Date: Name: Prmt Number: Ttl: Approved: No AGENCY DEFINED Expiration Date: 06/30/2003 TANK/LINE TEST : CP CERT. : MANWAY INSP. : UST MONIT. CERT:10/27/2003 -1~- OS/24/2004 ;;. e e '0 F ARCO #05365 'f= Inventory Item 0006 F== COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SiteID: 015-021-000564 9 Facility Unit: Fixed Containers on Site 9 Location within this Facility Unit BACK ROOM Days On Site 365 Map: Grid: CAS# 124-38-9 , SorATE - TYPE Gas Pure PRESSURE Above Ambient TEMPERATURE Cryogenic CONTAINER TYPE INSUL.TANK / CRYOGENIC Largest Container 400.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 400.00 GAL Daily Average 200.00 GAL Z RDO MP %Wt. RS CAS # 100.00 Carbon Dioxide No 124389 HAA US CO ONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min HAZARD ASSESSMENTS Ag.Definedl: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.DefinelO: Ag.Defined5: Ag.Defined8: - Ag.Definell , -13- OS/24/2004 e e F ARCO #05365 f= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME MOTOR OIL SiteID: 015-021-000564 9 Facility Unit: Fixed Containers on Site 9 Days On Site 365 Location within this Facility Unit BACK ROOM OR FRONT SHELVES Map: Grid:" CAS# 8020835 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 0.25 GAL AMOUNTS AT THIS LOCATION Daily Maximum 30.00 GAL Daily Average 15.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 HAZARD A E MEN . TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies. F DH / / / Min 5S SS TS Ag.Definedl: MISC. LOCAL AGENCY DATA Ag. Defined2: Ag. Defined3 : Ag. Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.DefinelO: Ag.Defined8: ~ Ag. Definell -14- OS/24/2004 ;11 e . '. F ARCO #05365 f= Inventory Item 0003 STORAGE CONTAINE Last Action Type: Location In Site: BACK SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì R DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 ROOM OR FRONT SHELVES TANK DESCRIPTION Tank ID#: 2 Mfr: XERXES Installed: 09/1993 Capacity: 10000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL MatI Name:MOTOR OIL TANK CONTENTS Petrol Type: LEADED Cas #: 8020835 TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt : 1993 Drop Tube : 1993 Striker Plate: 1993 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1993 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 -15- '05/24/2004 · .' e e " F ARCO #05365 SiteID: 015-021-000564 ì f= 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 SMITH FIBERGLASS, AboveGround Piping FIBERGLASS FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping INTERSTITIAL MONITORING Installed: 09/16/1993 Date: 04/01/1999 Name:WILLIAM M ZAPKIN Prmt Number: 0564 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:ENVIRON. ADMIN. Approved: Yes Expiration Date: 06/30/2003 AGENCY DEFINED TANK/LINE TEST :07/16/1996 CP CERT. : MANWAY INSP. :07/20/1998 UST MONIT. CERT:07112/2001 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: 04/01/1999 Name:WILLIAM M ZAPKIN Ttl:ENVIRON. ADMIN. -16-' OS/24/2004 ~ e - -; F ARCO #05365 p= Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME WASTE ABSORBANT SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 LQcation within this Facility Unit BACK ROOM AND OUTSIDE YARD Map: Grid: CAS# STATE - TYPE Solid Mixture PRESSURE Ambient TEMPERATURE" Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 25.00 GAL HAZARDO MPON NT - %Wt. RS CAS# 100.00 MIXTURE OF WASTE OIL HEAVY PETROLEUM DISTILLAT No AND SILICTES No US CO E S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No ' No/ Curies F IH / / / UnR 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 , -17- OS/24/2004 '. '" e e :; F ARCO #05365 SiteID: 015-021-000564 9 p= Inventory Item 0001 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: BACK ROOM AND OUTSIDE YARD TANK DESCRIPTION Tank ID#: 4 Mfr: XERXES Installed: 09/1993 Capacity: 10000 Gals Additional Info: Compart Tank: N No. Of Comparts: Tank Use: MOTOR VEHICLE FUEL Matl Name:WASTE ABSORBANT TANK CONTENTS Petrol Type: REGULAR UNLEADED Cas #: TANK CONSTRUCTION Type : DOUBLE WALL Material(p): FIBERGLASS Material(s): FIBERGLASS Lining : UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt . 1993 Drop Tube : 1993 Striker Plate: 1993 Sgl Wall: PLASTIC Alarm : Ball Float : Fill Tube S/O: 1993 TANK LEAK DETECTION Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No INTERSTITIAL MONITORING Last Used: TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -18- OS/24/2004 . ,.ß ,~ e . s; F ARCO #05365 SiteID: 015-021-000564. ì 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 SMITH FIBERGLASS AboveGround Piping FIBERGLASS FIBERGLASS PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS INTERSTITIAL MONITORING Installed: 09/13/1993 Date: 04/01/1999 Name:WILLIAM M ZAPKIN Prmt Number: 0564 DISPENSER CONTAINMENT Type: DISP. PAN SENSOR w/ POS. SHUTOFF OWNER/OPERATOR SIGNATURE Ttl:ENVIRON. ADMIN. Approved: Yes Expiration Date: 06/30/2003 AGENCY DEFINED TANK/LINE TEST :07/16/1996 CP CERT. : MANWAY INSP. :07/20/1998 UST MONIT. CERT:07/12/2001 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: 04/01/1999 Name:WILLIAM M ZAPKIN Ttl:ENVIRON. ADMIN. -19- OS/24/2004 bp ~~ Ir ~ BP West Coast Products LLC 4 Centerpointe Drive La Palma, CA 90623 June 24, 2003 Ralph Huey Director of Prevention Services 1715 Chester Ave, Bakersfield, CA 93301 Subject: Business Plan for ARCO 00371, 05365, 05526, 01960, 05420, and 00583 Dear R, Huey, Find enclosed the Business Plans for the above stations that were sent to BPI ARCO by your office for review. Several Business Plans have some minor changes. Please feel free to contact me with any questions or concerns at (714) 670-5321. Sincerely, 1M u. Wi- ............. Michael D. Wilson Environmental Specialist Office (714) 670-5321 Cell (714) 815-2455 .cc 00371, 05365, 05526, 01960, 05420, 00583 o .¿...- ARca #05365 . . 4) , ./ SiteID: 015~021-000564 ...-'-..---:' :,,' 5~ . - ~--~.....--- ( Manager: SAYEGH GROUP INC. Location: 4010 WIBLE RD City BAKERSFIELD CommCode: BAKERSFIELD STATION 07 EPA Numb: Jq .¡ 7<~ 'l BusPhone: Map : 103 Grid: 29B (661) 836-9685 CommRaz : UnRated FacUnits: 1 AOV: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact / Title Emergency Contact / Title MARK SATER / FRANCHISEE ARCO MISSION CONTRO / Business Phone: (661) 836-9685x Business Phone: (800) 272-6349x 24-Hour Phone : (909) 465-1886x 24-Hour Phone : (800) 272-6349x Pager Phone : (818) 266-9088x Pager Phone, : ( ) - x Hazmat Hazards: Fire Press ImmRlth DelHlth Contact : MICHAEL D. WILSON MailAddr: PO BOX 6038 City : ARTESIA Period : Preparer: Certif'd: ParcelNo: to Phone: (714) 670-5321x State: CA Zip : 90702 Phone: (714) 670-5321x State: CA Zip : 90702 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Owner Address City BP WEST COST PRODUCTS LLC : PO BOX 6038 : ARTESIA Emergency Directives: II~d M~;; . ' (ypøorPrlntnamø) - Do hereby Ce¡fifyUt rav1ewed the aft h ' at I have ac ad hazardous materials ment plan for-.8~Co S"3lf ' manage- any COrfi. . (NÐmëofSuSIn381J) _snd ~ha~ if along with SdfOns COU}sti~l.Jt~ a¡ oompl~t~ ' :J!1nam ' tilf»©1 o.orr~ man ~ sot plan for m.v U@!Jcl6itJ/. - j§f~ {II - - .~ -1- 06/16/2003 '"'" f": ,...-'. F ARCO #05365 f= Hazmat Inventory f== MCP+DailyMax Order . . SiteID: 015-021-000564 9 By Facility Unit 9 Fixed Containers on Site 9 Hazmat Common Name... ,UNLEADED GASOLINE MIDGRADE GASOLINE PREMIUM GASOLINE CARBON DIOXIDE MOTOR OIL WASTE ABSORBANT SpecHaz EPA Hazards DailyMax MCP F IH DH L 20000.00 GAL Mod F IH DH L ~.oo GAL Mod F IH DH L 10000.00 GAL Mod F P IH G !fO() :}-o G ."'ð 0 GAL Min F DH L 30.00 GAL Min F IH S 55.00 GAL UnR -3- 06/16/2003 :r =---=---:-~ - --- ,l"'/"õ . . f ARca #05365 f= Inventory Item ===COMMON NAME / CARBON DIOXIDE 0006 CHEMICAL NAME SiteID: 015-021-000564 ~ Facility Unit: Fixed Containers ,on Site ì Days On Sitè 365 Location within this Facility Unit BACK ROOM Map: Grid: CAS# 124-38-9 Largest Container ~;OO. 00 GAL AMO~ AT T. HIS LOCATI , ~ Daily Maximum '1)00.00 GAL CONTAINER TYPE INSUL.TANK / CRYOGENIC - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Cryogenic Dai:\..y Average 2()6'~J. 00 GAL %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min 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: - Ag .Define11 -13- 06/16/2003 10"'1-0' "'''po ",...nlT aANTAl '''-!6D-I23T.~ '-135 P,WOZ NI2 -..¡¡,¿/ JUN 02 2003 14;33 ÐKSF~D FIRE PREVENTION (ael)85e-2172 p. l BL(),~ 20 CITY OF BAKERSFIELD '\ ~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersðeld, CA (661) 326-3979 APPLICATION TO PERFORM: A TANK TIGHTNESS TESTI SECONDARY CONTAINMENT TESTINGITRACER TESTING FACUJTY &r¿c (/ 11 ~5fA~ ADDlŒSS PO tD en I ß ¿e ptp PERMlTTOOPBRATE#~ 0/7'- 000- DOC)) ~(gq OPERATORS NAMa 1J1¡/'~'e tJlt. >oA/ OWNBRSNAME ~p w~.src.oA-5~ Plto/)Uc,~·ç ~ ~Lç. , NUMBER OP TANKS TO BB TESTED .~ IS PIPING GOING TO BE TESTED2. T~' --, ~ :s t{ VOLUME !OdJ(J 0 . I ()~ r;o (') 10,00 () . /011"70 . CONTENTS ~7 trAJj~/J/M1J Sf 9' pj uS /(1tI¡,,¡pu;J . q I .CuI4t. l/AI)..~,p/JØ g" 1 UP L"e d/).e/) C.5' f ptr;U) ..-L. /"(}Je ,... TBSTlNGCOMPANY -(lJt/ 1l".A/(/t/)p"unz,.PAJ TJ/¿ S ý'.s ~~ MAnJNO ADDRESS 11'~ 3;J; AI Iff V (~t s ç' 0' 12d.»6 e. ß c'..,. 9 .?Jtl¡'~ NAME" PHONE NUMBER OF CONTACT PBRSON...~J2tAAl ¡)11It~AI ('71C()~7-61{ /3 'œSTMBTHOD~To", .Tlre L{II/(! r~5:r· NAME OF TESTER OR SPECIAL JNSPECTORj)fl,9 &iIJ.A.J fe s (C. CBRTIFICATlON# tI (~S-I . D~i/;'7~ISTOBBCONDU= e,//I/t?3 &:J q:",,,,!!!o j - _~. ß ·or() r;þ/g3 ~ APPROVED BY DATE SIONATURE OF APPUCANT e e / ARCO # 05365 4010 WIBLE RD. BAKERSFIELD, CA 93309 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Fonns included in this package complies with [onns/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: ~BUSINESS ACTIVITIES PAGE ~ BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE [g]EMERGENCY RESPONSE CONTINGENCY PLAN [g]HAZARDOUS MATERIALS INVENTORY LIST C8JFACILITY SITE MAP 1 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of _ Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) 1. Own or operate underground storage tanks? 2. Intend to upgrade existing or install new USTs? 3. Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per H&SC §25143.2)? Treat hazardous waste on site? 3. 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? Consolidate hazardous waste generated at a remote site? 5. 6. Need to report the closure/removal of a tank that was classified as hazardous waste and cleaned onsite? E. LOCAL REQUIREMENTS [gI YES D NO 4. 2, 3, HAZARDOUSMATE~INVENTORY - CHEMICAL DESCRIPTION (OES 2731) UST FACILITY (Fonnerly SWRCB Fonn A) UST TANK (one page per tank) (Fonnerly Fonn B) UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Fonnerly Fonn C) UST TANK (closure portion - one page per tank) NO FORM REQUIRED TO CUPAs EPA ID NUMBER - provide at the top of this page RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Fonnerly DTSC Fonns 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Fonnerly DTSC Fonns 1772 A,B,C,D and L) CERTIFICATION OF FINANCIAL ASSURANCE (FoD11erly DTSC Fonn 1232) REMOTE WASTE I CONSOLIDATION SITE ANNUAL NOTIFICATION (FoD11erly DTSC FOD11 1196) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (FoD11erly DTSC Fonn 1249) (You may also be required to provide additional information by your CUPA or local agency.) 15, [gIYES DYES D NO 5, [gI NO 6. DYES [gI NO 7. DYES [gI NO 8, [gI YES D NO 9, DYES [gI NO to. DyES [gI NO II. DYES [gI NO \2, DYES [gI NO 13. DyES [gI NO 14, UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION FACILITY ID # (Agency Use Only) 101. 1. BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 BUSINESS SITE ADDRESS 4010 WIBLE RD. CITY BAKERSFIELD DUN & BRADSTREET 03-959-6507 COUNTY KERN BUSINESS OPERATOR NAME SAYEGH GROUP, INC. 01/01/2003 12/31/2003 3, BUSINESS PHONE 661-836-9685 102, 103, OWNER NAME BP West Coast Products LLC OWNER MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA 104. ZIP CODE CA 93309 106, SIC CODE (4 digit #) 5541 109, BUSINESS OPERATOR PHONE 661-836-9685 III. OWNER PHONE 714-670-5321 105, 107. 108. 110, 112. 113, CONTACT NAME MICHAEL D. WILSON CONTACT MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA 115, ZIP CODE 90702-6038 116, CONTACT PHONE 714-670-5321 118, 119, 120, 122, NAME MARK SATER / SAM SAYEGH TITLE FRANCHISEE BUSINESS PHONE 661-836-9685 FAX# 661-836-9685 24-HOUR PHONE* H.909-465-1806 /818-240-8623 PAGER # CELL# 818-266-9088 ADDITIONAL LOCALLY COLLECTED INFORMATION: 123, NAME ARCO MISSION CONTROL 124, TITLE 129. 125. BUSINESS PHONE 800-272-6349 126, 24-HOUR PHONE* 800 272-6349 130, 131. 127, 132. 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. DATE 134, NAME OF DOCUMENT PREPARER 135, 136, 02/24/03 TITLE OF SIGNER Environmental Specialist 137, MICHAEL D. WILSON HAZARDOUS MATEIDALS 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 as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO # 05365 LOCATION: 4010 WIBLE RD. BAKERSFIELD, CA 93309 MAILING ADDRESS: BP West Coast Products LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PIDMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-836-9685 OWNER: MARK SATER PHONE: 661-836-9685 MAILING ADDRESS: 4010 WIBLE RD. BAKERSFIELD, CA 93309 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. MARK SATER FRANCHISEE CELL# 818-266-9088 SAM SAYEGH# 818-240-8623 661-836-9685 909-465-1806 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 1 - e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained for the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD ENVIRONMENTAL HEALTH SERVICES: 661-862-8700 C. ENVIRONMENTAL RESPONSE MANAGEMENT: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South side of the site, or at a safe upwind location.' Method of evacuation is verbal. Person responsible for notification is: NAME: MARK SATER / SAM SAYEGH TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 e e SECTION II RELEASE RESPONSE PLAN Emereencv Procedures: Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials: 1. PREVENTION (prevent the hazard) - Describe the kinds of hazards associated with the hazardous materials present at your facility. What actions would your business take to prevent these hazards from occurring? You may include a discussion of safety and storage procedures. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. The on-site coordinator or designee will train all new employees of this facility about the procedures for safe handling of hazardous materials and products for emergency response coordination, and use of emergency response equipment and supplies. Additionally, the on-site coordinator or designee will conduct a refresher-training program for all employees on annual basis. PROCEDURE FOR STORAGE AND DISPOSAL OF HAZARDOUS MATERIALS & HAZARDOUS WASTE: Liquhl CO2 cylinders must be secured to wall with chain (this applies for stations th~t serve soda in the store). Waste absorbent from the gasoline spill, cleanup spills, or used gasoline fuel filters must be stored in a proper UN (DOT) approved container with appropriate hazardous waste label on each container. Each drum or container containing hazardous waste must be stored away from hot or ignition sources and disposed before 90 days from accumulation date. Each container must be kept closed with lid and disposed as hazardous waste and manifested. State manifests of hazardous waste must be kept for three years in compliance kit. 3 e; "_ The hazardous material handled on daily basis is gasoline. Hazards associated with this product are spill, leak, fire, and explosion. Fire Prevention orocedures as follows: 1. The gasoline tanks are equipped with leak detectors that activate an alarm and disable the pump when leak is detected. Few gas stations are equipped with over fill alarm that prevents the spillage of gasoline from over filling the tanks. 2. All the dispensers are equipped with impact valves. 3. Daily inspection of leaks from the pipes, nozzles, and pumps. 4. Any leaks from above mentioned equipment will be fixed immediately. 5. Posting no smoking sign at the dispensers. 6. Monthly inspection of fire extinguishers to ensure that are full and ready to use. 7. Testing of the emergency shut offs located in front of the store. 8. Testing of dispensers' start/stop emergency shut off located on the cash register. 9. Testing the shut offs of turbine pumps. The on/off switch is on the main electrical panel. Gasoline spills will be cleane~-up immediately using absorbent material 2. MITIGATION (reduce the hazard) . Describe what is done to lessen the harm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitigation (continued): In the event of a leak or spill: 1. Attendant'should shutoff electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO MISSION CONTROL. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or oth,er medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordi~ator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There are two exits - front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather in area furthest from danger. Manager on duty will account for all station personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies including NRC, CA OES, Water Board, and County Health Agency.) 3. If neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should: 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close impact valves. 3. Evacuate by stopping all traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. Additional mitiaation procedures: 4 Employees will be informed of the .th and safety hazards involved with the h.ing of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. 4. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55-gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 2, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm drain(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are instructed to call 911 and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local fire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. Followine are the emereency equi >ment of this facility: Item Use Location Maintenance Fire extinguisher Fire, Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROP ANE : NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: DYES IZ]NO IF YES, LOCATION: PRN A TE FIRE PROTECTION/W A TER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR. INSIDE THE STORE. AND IN THE KITCHEN AREA A. B. PRN ATE FIRE PROTECTION DYES IZ]NO WATER AVAILABILITY (FIRE HYDRANT): N/A 5 e" e Emergency review of liquefied ( Cryogenic) Carbon Dioxide Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be finnly secured with chain to the wall. Those large cylinders (containers), which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. All the gas cylinder must be capped at all times and transported with drum cart. The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh to stick fast and tear when one attempts to withdraw from it. A leak will result in the fonnation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture if the safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. Response Plan for Carbon Dioxide Release Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. In the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. . Response to Carbon Dioxide Release Ifthere are signs of visible ice on the cylinder or parts such as pipes, it is a sign of a leak and needs to be reported to your manager immediately. In addition, the Facility Manager will contact their vendor immediately. In the event of a major release, call 911 and evacuate the store. Do not attempt to close the main source valve to stop the release, Emergency personnel such as trained fire fighters must wear special protective equipment to safely respond to a leaking C02 cylinder. 6 · e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 MATERIAL SAFETY DATA SHEETS ON FILE: MSDS and business emergency plan is located in the compliance binder, a yellow plastic box, located in the office area BRIEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up , first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location of the problem. Initial training is conducted after hiring new employee. Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as : 1) hazard communication program, 2) materials safety data sheets, 3) safe handling of chemicals, and 4) emergency equipment& emergency response plan. 7 ';::¡ "";;,,J-Y !r-4Ämii:n :;~t'''¥/''';;'; ;~-" ÿ';;;.;;;" ~;:~r "'-; : '00 CO> ,; ;_~~ ;'-'';'::' -, ('<, -"-:,~,_,,n_':':,^;:'1" "'~-':Y_':}'4"""'i''I''¡':;'1-'''~IIIW¡_q;'-"';'~~"+:',' y" m,..:,!/.lf!(lþì~~e..7iiS.!Jlr¡~~/,I,.^', "'f'!ms.,lþì, '7..' 'f',', ÑJ.;:~,U",i}l-;;CZ'I::-:: :}rffflJ7j-'i/~V;li/4Y¿~;gIIfiii¿ ¡\\~,~ Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. Hazardous Materials Handlina & Emeraency Response TraininQ Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency response organizations; 3. Correct use of emergency response equipment and supplies under the control of the business 4. The Cal OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care 7. Procedures to coordinate with and assist the local emergency personnel that may respond to your business 8. Who and how to call for immediate assistance in the event of an accident involving hazardous materials 9. Procedure for ensuring that appropriate personnel receive initial and refresher training UST EQuipment Operatina and MonitorinQ Trainina Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system 9. Respond to alarms, leaks, or equipment problems ."·LLEMþI:!ø~EÊi~iiìR~JRir JIEÐ'·!'Ä~ Ð!!l.lÞD'ÄiiìE'Ð';~r\IÑfj~I!I!".~;~!;;!'J;!J '¥_"_';"''''''_''''~<~~v,,~TI; 0'm«~"",@,tw~,_""",~",_""")_",,,,,,,w.-.-.-,"_-,wcc7c"d''''''07-___''''''n_m _ __ _ __, ___moo _-,_.,____"C Nif!¥B1nRW$,mNib;r Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? 0 YES [8] NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? 0 YES [8] NO 3. Do you have personnel that will provide site security at your business during and after a hazardous materials incident? 0 YES [8] NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business: Absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. 8 The On-Site Coordinator or designee will train all new employees of this facility about the following procedures for the saWlllLandling of hazardous materials, proced~for emergency response coordination, and use~mergency response equipment and su~s. Additionally, the On-Site coordinator or designee will conduct a refresher-training program for all employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste oil onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees will know the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of, how and when to use dry chemical fire extinguishers that are located on the premises. 4. Employees will know the location and proper use of first aid kit(s), fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant immediate evacuation of premises. Circumstances include: a. Any gasoline, diesel, or other type of fire. b. Any spill, fuel leak, or vapor leak that has the potential for igniting or exploding. c. Any spill or leak where employees or customers notice gasoline vapors. EMPLOYEE TRAINING RECORDS The BP manager, for BP store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (initial and refresher). These documentation records will be retained at the facility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: Training Topic - Procedures for handling hazardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (Le. cashier, Emergency Coordinator, Alternate) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spill control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation Persons Trained: Facility Staff (All Employees) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in. 9 e e CERTIFICATION I, MICHAEL D. WILSON CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE, I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SI TITLE ENVIRONMENTAL SPECIALIST 10 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) D MATERIAL(NON-WASTE) [g WASTE DADD DDELETE ~REVISE REPORTING YEAR 2003 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES ~ NO 203 GRID# (optional) D9 CHEMICAL NAME WASTE ABSORBENT 1 of 1 II. CHEMICAL INFORMATION 205 TRADE SECRET Yes ~ No If Subject to EPCRA. refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER CAS# N/A FIRE CODE HAZARD CLASSES (Complete if required by CUPA) HAZARDOUS MATERIAL TYPE (Check one item only) 207 209 EHS" 0 Yes ~ No "If EHS is ''Yes", all amounts below must be in Ibs. RADIOACTIVE DYes I8INo 212 CURIES o a, PURE 211 Db. MIXTURE 181 c, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 181 a. SOLID Db, LIQUID D c, GAS 214 LARGEST CONTAINER 55 181 a, FIRE Db, REACTIVE D c. PRESSURE RELEASE 0 d, ACUTE HEALTH De, CHRONIC HEALTH 25 55 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 55 221 UNITS' Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db, CUBIC FEET D c, POUNDS 0 d, TONS . If EHS. amount must be in ounds, D a, ABOVE GROUND TANK Db, UNDERGROUND TANK Dc. TANK INSIDE BUILDING 181 d, STEEL DRUM De, PLASTIC/NONMETALLIC DRUM D f, CAN D g. CARBOY o h, SILO o i. FIBER DRUM o ¡,BAG o k, BOX o I. CYLINDER o m, GLASS BOTTLE 0 q. RAIL CAR D n, PLASTIC BOTTLE 0 r, OTHER o o. TOTE BIN D p, TANK WAGON STORAGE PRESSURE 181 a. AMBIENT o c, BELOW AMBIENT o b, ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT o d, CRYOGENIC o b, ABOVE AMBIENT o c. BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS 89-90 226 WASTE ABSORBENT & DISPENSER FUEL FILTER 227 DYes ~ No 2 230 231 DYes 0 No 3 234 235 DYes 0 No 4 238 239 DYes DNo 5 242 243 DYes DNo CAS # 228 N/A. MIXTURE 232 236 240 244 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 \, '. 1-) UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) r;g] MATERIAL(NON-WASTE) D WASTE (one paoe oer rraterial ner buildina or area) DADO DDELETE IZIREVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM (EPCRA ) DYES IZI NO FACILITY 10 # I I I I I I I I I I 1 I MAP# (optional) 2031 GRID# (optional) 204 1 of 1 05 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes t8I No 206 CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME 207 EHS· DYes IZI No 208 CAS# 124-38-9 209 ·If EHS is ''Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL 212 I CURIES 213 TYPE (Check one item only) 181 a, PURE Db, MIXTURE Dc. WASTE 211 RADIOACTIVE DYes I8INo PHYSICAL STATE 215 (Check one item only) D a. SOLID I8Ib, LIQUID o c, GAS 214 LARGEST CONTAINER 400 FED HAZARD CATEGORIES 216 (Check all that apply) 181 a, FIRE D b, REACTIVE D c. PRESSURE RELEASE D d, ACUTE HEALTH D e, CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 200 400 N/A N/A 221 I DAYS ON SITE: 222 UNITS· Da, GALLONS Db, CUBIC FEET 181 c. POUNDS D d. TONS 365 (Check one item onlv1 . if EHS. amount must be in pounds, STORAGE CONTAINER D a, ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i. FIBER DRUM D m. GLASS BOTTLE D q. RAIL CAR Db. UNDERGROUND TANK D f. CAN D j,BAG D n, PLASTIC BOTTLE D r, OTHER Dc, TANK INSIDE BUiLDING D g. CARBOY D k, BOX D 0, TOTE BIN D d, STEEL DRUM D h. SILO 1811. CYLINDER D p, TANK WAGON 223 STORAGE PRESSURE D a. AMBIENT 181 b. ABOVE AMBIENT D c, BELOW AMBIENT 224 STORAGE TEMPERATURE D a, AMBIENT Db, ABOVE AMBIENT D c, BELOW AMBIENT 181 d, CRYOGENIC 225 ; HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # O/OWT 1 100 226 CARBON DIOXIDE 227 DYes IZI No 228 124-38-9 229 2 230 231 DYes 0 No 232 233 3 234 235 DYes 0 No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes DNa 244 245 If more ha:zardous components are present at greater than 1% by weight if non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ~ MATERIAL(NON-WASTE) D WASTE DADD DDELETE [8JREVISE REPORTING YEAR 2003 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES [8J NO 202 203 GRID# (optional) 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes [8J No MIDGRADE II Subject to EPCRA. relerto instructions COMMON NAME GASOLINE 207 EHS· 0 Yes [8J No CAS# 8006-61-9 209 ·If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CompleteilrequiredbyCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) H5 206 208 210 213 o a, PURE I8Ib, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8INo 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 o a, SOLID I8Ib, LIQUID o c, GAS 214 LARGEST CONTAINER 10,000 216 181 a. FIRE 0 b. REACTIVE 0 c. PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 221 222 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5,000 10,000 N/A UNITS' Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db, CUBIC FEET 0 c, POUNDS 0 d, TONS . II EHS. amount must be in ounds, o a, ABOVE GROUND TANK 181 b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING o d, STEEL DRUM STORAGE PRESSURE 181 a, AMBIENT De. PLASTIC/NONMETALLIC DRUM o f.CAN o g, CARBOY o h, SILO o b, ABOVE AMBIENT o i. FIBER DRUM o j,BAG o k. BOX o I, CYLINDER o m, GLASS BOTTLE 0 q, RAIL CAR o n, PLASTIC BOTTLE 0 r. OTHER o 0, TOTE BIN o p, TANK WAGON 223 o c, BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a. AMBIENT o b. ABOVE AMBIENT o c, BELOW AMBIENT o d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes [8J No 228 71-43-2 2 0-7 230 ETHANOL 231 DYes [8J No 232 64-17-5 3 8-15 234 XYLENE 235 DYes [8J No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes I8J No 240 1 08-88-3 5 242 243 DYes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1% by weight if non-carclnogenic, or 0,1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 e e UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [gJ MA TERIAL(NON-WASTE) D WASTE (one caae Der material Der buildina or area) DADD DDELETE ~REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVES (EPCRA ) DYES ~ NO FACILITY ID # I I I I I I I I I I 1 I MAP# (optional) 2031 GRID# (optional) 204 10F1 F7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes ~No 206 MOTOR OIL tf Subjecl to EPCRA, refer 10 instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 EHS· o Yes ~ No 206 CAS# NJA 209 -If EHS is ''Yes'', all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CompleleifrequiredbyCUPA) COMMBUSTIBLE LIQUID 210 HAZARDOUS MATERIAL 2121 CURIES 213 TYPE (Check one item only) D a. PURE I8Ib. MIXTURE Dc, WASTE 211 RADIOACTIVE DYes 181 No PHYSICAL STATE 215 (Check one item only) D a, SOLID I8Ib. LIQUID D c. GAS 214 LARGEST CONTAINER 0.25(ONE QUART) FED HAZARD CATEGORIES 216 (Check all that apply) 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH De, CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 15 30 NJA NJA 221 I DAYS ON SITE: 222 UNITS· l8Ia, GALLONS Db, CUBIC FEET D c. POUNDS D d. TONS . 365 (Check one item onlv) . If EHS, amount must be in Dounds, STORAGE CONTAINER D a, ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i, FIBER DRUM D m, GLASS BOTTLE D q, RAIL CAR Db. UNDERGROUND TANK D f. CAN D j,BAG 181 n, PLASTIC BOTTLE D r. OTHER Dc, TANK INSIDE BUILDING D g, CARBOY D k, BOX D 0, TOTE BIN D d. STEEL DRUM D h. SILO D I, CYLINDER D p, TANK WAGÕN 223 STORAGE PRESSURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 LUBRICANT BASE OIL 227 DYes ~ No 226 NJA, MIXTURE 229 2 5-6 230 ADDTIVES, ANTI-OXIDANT 231 DYes ~No 232 NJA, MIXTURE 233 3 234 235 DYes 0 No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes DNo 244 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) I:8J MA TERIAL(NON-WASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2003 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # GRID# (optional) H4 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 181 NO 203 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes 181 No P REM I U M If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS' 0 Yes 181 No CAS# 8006-61-9 209 'If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) D a. PURE 211 RADIOACTIVE DYes I8INo 212 CURIES I8Ib, MIXTURE Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Ib, LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 10,000 221 UNITS' Check one item onl STORAGE CONTAINER 181 a , GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS . If EHS, amount must be in ounds. D a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f, CAN D g. CARBOY D h, SILO Db. ABOVE AMBIENT D i, FIBER DRUM D j.BAG D k, BOX D I. CYLINDER D m, GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTLE D r, OTHER D 0, TOTE BIN D p, TANK WAGON STORAGE PRESSURE 181 a, AMBIENT D c, BELOW AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d, CRYOGENIC Db, ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-7 230 ETHANOL 231 DYes 181 No 232 64-17 -5 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOULENE 239 DYes 181 No 240 1 08-88-3 5 242 243 DYes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenic, or 0,1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one/orm) [g MATERIAL(NON-WASTE) D WASTE DADD DDELETE ~REVISE REPORTING YEAR 2003 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 ' CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) D YES ~ NO 202 203 GRID# (optional) G5 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET D Yes ~ No UNLEADED If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* D Yes ~ No CAS# 8006-61-9 209 *If EHS is "Ves", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) 206 208 210 213 D a. PURE I8Ib. MIXTURE Dc. WASTE 211 RADIOACTIVE DYes I8INo 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a. SOLID I8Ib. LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 216 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e. CHRONIC HEALTH 221 222 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5,000 10,000 N/A UNITS' Check one item onl STORAGE CONTAINER 181 a , GALLONS Db. CUBIC FEET D c. POUNDS D d, TONS . If EHS, amount must be in ounds, D a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f,CAN D g, CARBOY D h. SILO D i. FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTLE D r, OTHER D o. TOTE BIN D p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 224 STORAGETEMPERATURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 D Ves ~ No 228 71-43-2 2 0-7 230 ETHANOL 231 DYes ~ No 232 64-17-5 3 8-15 234 XYLENE 235 D Ves ~ No 236 1330-20-7 4 7-14 238 TOLUENE 239 DVes ~No 240 1 08-83-3 5 242 243 DVes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1 % by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALL V COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [g MATERIAL(NON-WASTE) D WASTE DADD DDELETE [8IREVISE REPORTING YEAR 2003 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES [81 NO 202 203 GRID# (optional) 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes [81 No UNLEADED If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS" 0 Yes [81 No CAS# 8006-61-9 209 "If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) F5 206 208 210 213 D a. PURE I8Jb. MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8JNo 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a. SOLID I8Jb. LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 216 I8J a. FIRE D b. REACTIVE D c, PRESSURE RELEASE I8J d, ACUTE HEALTH I8J e, CHRONIC HEALTH 221 222 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5,000 10,000 N/A UNITS· Check one item onl STORAGE CONTAINER l8Ja, GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS " If EHS, amount must be in ounds, D a, ABOVE GROUND TANK I8J b, UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d. STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f. CAN o g, CARBOY D h. SILO D i, FIBER DRUM D ¡,BAG D k, BOX D I. CYLINDER D m, GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTLE D r, OTHER D 0, TOTE BIN D p, TANK WAGON 223 STORAGE PRESSURE I8J a, AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE I8J a, AMBIENT Db, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-7 230 ETHANOL 231 DYes [81 No 232 64-17-5 3 8-15 234 XYLENE 235 DYes [81 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-83-3 5 242 243 DYes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 LEGEND SEWER FLOOR DRAIN STORM DRAIN FIRE HYDRANTS & CONNECTIONS ! e -- + SPRINKLER SYSTEM VALVES ELECTRICAL SHUTOFF GAS SHUTOFF WATER SHUTOFF EMERGENCY SHUTOFF ( Le. GAS PUMP} DISPENSER ISLAND MSDS & CONTINGENCY PLAN I BUSSINESS PLAN PERSONAL PROTECTIVE EQUIPMENT FIRST AID EQUIPMENT EMERGENCY ASSEMBLY AREA CASHIER 1" = 45 Ft DIRECTION WASTE ABSORBENT SPILL CONTAINMENT & MITIGATION EQUIPMENT SENSORS OR PROBES LEAK DETECTOR RONAN ALARM MONITORING CONSOLE C02 LIQUID I GAS CYLINDER DISPENSER SHUTOFF MOTOR OIL FLAMMABLE LIQUID COMBUSTIBLE LIQUID EMERGENCY EXIT FIRE EXTINGUISHER ABSORBENT CHAIN LINK FENCE TRASH ENCLOSURE TRASH BIN REST ROOM SAFETY SHOWER & EYEWASHES AIR CONDITIONING SHUTOFF UNDERGROUND STORAGE TANK ® ~ ... ø IAC ® @ ® o - . IMSDSI & BP 6 \ð7 ~ + .... * . ~ c==) IC021 [!J IMol [IT] [fb] IEM o *** ITEI ITBI IRRI - SCALE -~- @ DATE: 01/10/01 HAZZARD DO US MATERIAL PLAN SITE ADDRESS: SITE MAP + KERN COUNTY HAZARDDOUS MATERIAL DIVISION BUSINESS NAME: ARCO # 05365 4010 WIBLE RD BAKERSFIELD, CA 93309 J H ¡ ¡¡ ¡ 0:: : ::: W : ::: I- Z · ... za ¡ ¡ : : ¡ w U) ...~. ...~................;................;.... .. ....;...ü._. : : : : : w> : : : : ÚJ üO ¡ SO~THERN ¡ ¡ dð > Z : AUTO SUPPL:V : (:" 0:: 0:: : : : : 'l-'ww ...:.. .. '":''' ..............~ ................!.... ... ....,: ~..U).~. · . . ¡ WHITE LN ¡ · . . · . . ---,-- . . · . . · . . · . . b%a;' . ~: · . . · . . · . .. .....,¡........... ¡ - >- ¡ : : « : : . . ::;=;:: · .'. . . I . ...)........ ........~................~ ............ ....¡... ~ . "ð'~' : : : : : 0 ~:s: . . . . . : : ¡ ¡ : _ a:: MIS~ FUNERA~ HOME ~OUTHWE~T f ~ ð G F E D ........... .... ............................ . ................... d. C "" I- a ....J .. .. ..(9. Z ::::s:::: 0:: « a.. w ~ a I ....J ......~. W Z ~ LL a.. :2: ~ z o ~ LL a.. :2: Œ LL o ~ LL B ¿" Q> ~ ~ ¿,) :t) : A 2 3 4 5 6 7 8 9 ~4¡ ~ e e- ARCO # 05365 4010 WIBLE RD. BAKERSFIELD, CA 93309 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Fonns included in this package complies with fonns/attachment required by the appropriate city or county under which the Unified Program Agency applies, This Hazardous Materials Business Plan includes: [SJBUSINESS ACTIVITIES PAGE [SJ BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE [SJEMERGENCY RESPONSE CONTINGENCY PLAN r:g]HAZARDOUS MATERIALS INVENTORY LIST ~FACILITY SITE MAP 1 ~ UNIFIED PROGRAM CONSOLIDATED FO FACILITY INFORMATION BUSINESS ACTIVITIES Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CPR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) 1. Own or operate underground storage tanks? 2. Intend to upgrade existing or install new USTs? 3. Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: -any tank capacity is greater than 660 gallons, or --the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per H&SC §25143.2)? 3. Treat hazardous waste on site? 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? 5. Consolidate hazardous waste generated at a remote site? 6. Need to report the closure/removal of a ,tank that was classified as hazardous waste and cleaned onsite? E. LOCAL REQUIREMENTS ~ YES 0 NO 4, ~ YES 0 NO 5, DyES ~ NO 6, DyES ~ NO 7. o YES ~ NO 8, ~YES o NO 9, DyES ~ NO 10. DYES ~ NO 11. DYES ~ NO 12. DyES ~ NO 13. DyES ~ NO 14. Page 1 of 3. ?'~6·>~>:i.tt::>?/;,'}:~:> ,.' ; }-~:: ~~<~~'~;:~~jl r:J;: ~ ~ -;:::;'::~;/~b;; ;-;,...,- : /~~./.'~;:;~ ',' HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (OES 2731) UST FACILITY (Fonnerly SWRCB Fonn A) UST TANK (one page per tank) (Fonnerly Fonn B) UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per~) (Fonnerly Fonn C) UST TANK (closure ponion - one page per tank) NO FORM REQUIRED TO CUPAs EPA ID NUMBER - provide at the top of this page RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Fonnerly DTSC Forms 1m) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Fonnerly DTSC Forms 1m A,B,C,D and L) CERTIFICATION OF FINANCIAL ASSURANCE (Fonnerly DTSC Fonn 1232) REMOTE WASTE I CONSOLIDATION SITE ANNUAL NOTIFICATION (Fonnerly DTSC Fonn 1196) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (Fonnerly DTSC Fonn 1249) (You may also be required to provide additional information by your CUPA or local agency.) IS. UNIFIED PROGRAM CONSOLIDATED FO FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION OWNER NAME BP West Coast Products LLC OWNER MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA ENDING DATE 12/31/2002 3, BUSINESS PHONE 102. 661-836-9685 103, 104, ZIP CODE 105. CA 93309 106, SIC CODE (4 digit#) 107. 5541 108. 109. BUSINESS OPERATOR PHONE 110, 661-836-9685 BUSINESS NAME (Same as FACIUTY NAME or DBA - Doing Business As) ARCO # 05365 BUSINESS SITE ADDRESS 4010 WIBLE RD. CITY BAKERSFIELD DUN & BRÀDSTREET 03-959-6507 COUNTY KERN BUSINESS OPERATOR NAME SAYEGH GROUP, INC. 112, 113. CONTACT NAME MICHAEL D. WILSON CONTACT MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA CONTACT PHONE 714-670-5321 118, 114, 115. ZIP CODE 90702-6038 116. 119. 120, 121. ZIP CODE 90702-6038 "l:S~~~Nñ~¥~:" ;,>"'':i'n,-''4Jii-;,~'': --, - ----_:,:<'::','><,~... '" 122, NAME MARK SATER / SAM SAYEGH TITLE FRANCmSEE BUSINESS PHONE 661-836-9685 24-HOUR PHONE'" H.909-465-1806 /818-240-8623 PAGER # CELL# 818-266-9088 ADDITIONAL LOCALLY COLLECTED INFORMATION: NAME ARCO MISSION CONTROL 124, TITLE 129. 125. BUSINESS PHONE 800-272-6349 126. 24-HOUR PHONE'" 800 272-6349 130, 131. 127, 132. 133, Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accunìte, and complete, IGNATED REPRESENTATIVE DATE 134, NAME OF DOCUMENT PREPARER 135, NAME OF MICHAEL D. WILSON 136, 11/15/2002 TITLE OF SIGNER Environmental Specialist Ramtox 137, .,.... . . . '. . . ...,"'~'< -,;.'~~iW~~F"IJ~~~f¡t~I)' "a" , ,." {( ,"Fi¢Ë:QFENWRÓNMENTAL'SËRVI€. " . ··'t\:~'~~;"~i~t~~~I~""~~~~!'I'~~~~\~~II~~~91:i "', '" 'f'./,. ;'-',;' . H, '--:':'1:" ,.;',_""'i~- ..' , . " HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this fonn within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Fonn and Chemical Description Fonn(s) to the ftont of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO # 05365 LOCATION: 4010 WIBLE RD. BAKERSFIELD, CA 93309 MAILING ADDRESS: BP West Coast Products LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-836-9685 OWNER: MARK SATER PHONE: 661-836-9685 MAILING ADDRESS: 4010 WIBLE RD. BAKERSFIELD, CA 93309 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. MARK SATER FRANCHISEE CELL# 818-266-9088 SAM SAYEGH# 818-240-8623 661-836-9685 909-465-1806 2. ARCa MISSION CONTROL 800-272-6349 800-272-6349 I e e HAZARDOUS MATEIDALS MANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITOIDNG PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained for the use of personal protection equipment to minimize contact with hazàrdous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD ENVIRONMENT,AL HEALTH SERVICES: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South side of the site, or at a safe upwind, location. Method of evacuation is verbal. Person responsible for notification is: NAME: MARK SATER / SAM SAYEGH TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 .../ 2 e e SECTION II RELEASE RESPONSE PLAN Emer2:encv Procedures: Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials: 1. PREVENTION (prevent the hazard) . Describe the kinds of hazards associated with the hazardous materials present at your facility. What actions would your business take to prevent these hazards from occurring? You may include a discussion of safety and storage procedures. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. The on-site coordinator or designee will train all new employees of this facility about the procedures for safe handling of hazardous materials and products for emergency response coordination, and use of emergency response equipment and supplies. Additionally, the on-site coordinator or designee will conduct a refresher-training program for all employees on annual basis. PROCEDURE FOR STORAGE AND DISPOSAL OF HAZARDOUS MATERIALS & HAZARDOUS WASTE: Liquid CO2 cylinders must be secured to wall with chain (this applies for stations that serve soda in the . store). Waste absorbent from the gasoline spill, cleanup spills, or used gasoline fuel filters must be stored in a proper UN (DOT) approved container with appropriate hazardous waste label on each container. Each drum or container containing hazardous waste must be stored away from hot or ignition sources and disposed before 90 days from accumulation date. Each container must be kept closed with lid and disposed as hazardous waste and manifested. State manifests of hazardous waste must be kept for three years in compliance kit. 3 The hazardous material handled! daily basis is gasoline. Hazards as'elated with this product are spill, leak, fire, and explosion. Fire Prevention ørocedures as follows: 1. The gasoline tanks are equipped with leak detectors that activate an alarm and disable the pump when leak is detected. Few gas stations are equipped with over fill alarm that prevents the spillage of gasoline from over filling the tanks. 2. All the dispensers are equipped with impact valves. 3. Daily inspection of leaks from the pipes, nozzles, and pumps. 4. Any leaks from above mentioned equipment will be fixed immediately. 5. Posting no smoking sign at the dispensers. 6. Monthly inspection of fire extinguishers to ensure that are full and ready to use. 7. Testing of the emergency shut offs located in front of the store. 8. Testing of dispensers' start/stop emergency shut off located on the cash register. 9. Testing the shut offs of turbine pumps. The on/off switch Is on the main electrical panel. Gasoline spills will be cleaned-up immediately using absorbent material 2. MITIGATION (reduce the hazard)· Describe what is done to lessen the harm or the damage to person(s}, property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitiaation (continued): In the event of a leak or spill: 1. Attendant should shut off electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO MISSION CONTROL. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There are two exits - front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather in area furthest from danger. Manager on duty will account for all station . personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies including NRC, CA OES, Water Board, and County Health Agency.) 3. If neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should: 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels"and close impact valves. 3, Evacuate by stopping all traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. Upon arrival of these person'nel, the Emergency Coordinator will cooperate with and offer assistance, as requested. Additional mitiQation procedures: 4 Employees will be Informed of the he and safety hazards Involved with the han g of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. 4. ABATEMENT (remove the hazard) . Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it In a 55-gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 2, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm drain(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are instructed to call 911 and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local fire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. Followin ment of this facili : Location Entrance & kitchen area , Back room/Su ly room Inside office or cashier Maintenance Yearly Service Re-stock as needed Inventory twice a ear Item Fire extin isher S ill absorbent First Aid Kit UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GASIPROP ANE : NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDEWALK SPECIAL: ' LOCK BOX: DYES ~NO IF YES, LOCATION: PRIVATE FIRE PROTECTIONIW ATERA V AILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. B. PRIVATE FIRE PROTECTION D YES ~NO WATER AVAILABILITY (FIRE HYDRANT): N/ A 5 e e Emergency review of liquefied ( Cryogenic) Carbon Dioxide Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be finnly secured with chain to the wall. Those large cylinders (containers), which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. All the gas cylinder must be capped at all times and transported with drum cart. The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh to stick fast and tear when one attempts to withdraw from it. A leak will result in the fonnation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture ifthe safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. Response Plan for Carbon Dioxide Release Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. In the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. . Response to Carbon Dioxide Release If there are signs of visible ice on the cylinder or parts such as pipes, it is a sign of a leak and needs to be reported to your manager immediately. In addition, the Facility Manager will contact their vendor immediately. In the event of a major release, call 911 and evacuate the store. Do not attempt to close the main source valve to stop the release. Emergency personnel such as trained fire fighters must wear special protective equipment to safely respond to a leaking C02 cylinder. 6 e HAZARDOUS MATEIDALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFf, THERE ARE THREE SHIFfS AND TOTAL EMPLOYEES ARE ABOUT 5 MATEIDAL SAFETY DATA SHEETS ON FILE: e MSDS and business emergency plan is located in the compliance binder, a yellow plastic box, located in the office area BIDEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up , first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location of the problem. Initial training is conducted after hiring new employee. Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as: 1) hazard communication program, 2) materials safety data sheets, 3) safe handling of chemicals, and 4) emergency equipment& emergency response plan. 7 tr:HJ'.:":<;-~, ",-,-,,\~--'--'^_'~-,^"'-"rs~~;c'__--~-'::' ""''''r_7',"'''' -"'"""""""Io/.}'''~'"~'-:_'~-'- . ,,^: ,'-' ---: ., "" ::.- >; .". - ., -,' . ·"jß,"" 'rnI3rz;s.~ss;¡;fr!m?JÌ.~1^11I'^/Ï'0'::Yrn EJ~~ 17i;'I2\"!)zI4~C::S":~t:lf~' IN' ·1·~'_,C1¥1wl;\(~,\,;1 Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. Hazardous Materials Handlina & Emeraency Response Trainina Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency response organizations; 3. Correct use of emergency response equipment and supplies under the control of the business 4. The Cal OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care 7. Procedures to coordinate with and assist the local emergency personnel that may respond to your business . 8. Who and how to call for immediate assistance in the event of an accident involving hazardous materials 9. Procedure for ensuring that appropriate personnel receive initial and refresher training UST Equipment Operatina and Monitorina Trainina Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system 9. Respond to alarms, leaks, or equipment problems t%:jfu""X":'~':'<:_':<-'::-:':::_-'':' ':_>-; --'-'---T".i::-'---'::~:~ -., _,no,;_ ~c__" n_ '+,:;:-~-. '~-Y' ._~ '~'""'..,"~' <>+'~'~¥''',*^?'''''''-'''\j''''_._' :*'1'f",'O: "'Y">'fq·" ',''''",' -~-r,^,~::,_,_,q, "';_"_ '''- 'n_'., n,._, .~-_:' - __, -_~ .c. "'_~--_'_' '-'" -;.000-'_'-"-- 'r. .', .,-,- rtt """"'Ø-'''''''' k'·'n~:'0''''' "y," ",.,::^...,n' ,"'^, :~~'j,ü7~~k~¡tjiÆl£t:;EMPEO~EE'JmRÆlNING1Sff~U~BE~ÐOClJMEN¡¡-ED~~ÐU1,BÐÆT "~""~'<"''''''''. <y~~ .,.,ne '.'.". .', ''''''.' -'- "., '<'. .^n"', """""."'O;;"''-~';;'-'''-_'^~';""":=.;.':»'f«J'«I'i¡,~«d¡,,.'4t<¡^'0!"'~'&1~1"'~>:"'Î'~"&",!--,,'/,y;,¿':. '.".",,,-,. ".<.'"",',n",:;'.." .,. .'.';, ..<___.L"n"." ':'" . ".'. ;i''"'~C'i .", '."'__~'- '~"'v<,~"",·,Xh;...Ø.>,,,, n...'. "'~''''~';;''';''''''<^.'<'.n·,.,i'"._ <,,-i_, Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? 0 YES ~ NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? 0 YES ~ NO 3. Do you have personnel that will provide site security at your business during and after a hazardous materials incident? 0 YES ~ NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business: Absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. 8 , I ne un~lte \,;ooramator or aeslgnee Will tram all new employees 0' tms 'aclllty aooul me ,ollowmg procedures for the safe _dling of hazardous materials, procedures for emergency response coordination, .and use ~ergency response equipment and sup" Additionally, the On-5ite coordinator or designee will conduct a refresher-training program'~1I employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste oil onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees will know the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of, how and when to use dry chemical fire extinguishers that are located on the premises. 4. Employees will know the location and proper use of first aid kit(s)1 fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant immediate evacuation of premises. Circumstances include: a. Any gasoline, diesel, or other type of fire. b. Any spill, fuel leak, or vapor leak that has the potential for igniting or exploding. c. Any spill or leak where employees or customers notice gasoline vapors. EMPLOYEE TRAINING RECORDS The BP manager, for BP store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (initial and refresher). These documentation records will be retained at the facility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: Training Topic - Procedures for handling hazardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank oveñlow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment Is provided at each facility. ' For major spillage, employees are instructed to call 911 and report. They will then notify the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (i.e. cashier, Emergency Coordinatorl Alternate) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spill control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation Persons Trained: Facility Staff (All Employees) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in. 9 ~ e e CERTIFICATION I, _ MICHAEL D. WILSON CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ¡J¡~ 6~ /SIGNATURE TITLE /2ßß2 DATE ENVIRONMENTAL SPECIALIST 10 " UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) D MA TERIAL(NON-W ASTE) [8J WASTE DADD I8IREVISE REPORTING VEAR 2002 I. FACILITY INFORMATION DDELETE BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 VES 181 NO 203 GRID# (optional) D9 CHEMICAL NAME WASTE ABSORBENT 1 of 1 II. CHEMICAL INFORMATION 205 TRADE SECRET If Subject to EPCRA, refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER CAS# N/A FIRE CODE HAZARD CLASSES (Complete if required by CUPA) HAZARDOUS MATERIAL TYPE (Check one item only) 207 209 EHS· 0 Ves 181 No ·If EHS is "Yes·, all amounts below must be in Ibs. RADIOACTIVE DYes I8INo D a. PURE Db. MIXTURE 211 212 CURIES 181 c. WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 181 a, SOLID Db. LIQUID D c. GAS 214 LARGEST CONTAINER 55 181 a. FIRE D b, REACTIVE D c. PRESSURE RELEASE D d. ACUTE HEALTH D e. CHRONIC HEALTH 25 55 55 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 221 UNITS· Check one item ani STORAGE CONTAINER l8Ia. GALLONS Db. CUBIC FEET D c. POUNDS D d, TONS . If EHS, amount must be in unds. D a. ABOVE GROUND TANK Db, UNDERGROUND TANK Dc. TANK INSIDE BUILDING 181 d, STEEL DRUM De. PLASTICINONMETALLlC DRUM D f.CAN D g. CARBOY D h. SILO D i. FIBER DRUM D j.BAG D k. BOX D I. CYLINDER D m. GLASS BOTTLE D q. RAIL CAR D n. PLASTIC BOTTLE D r. OTHER D o. TOTE BIN D p. TANK WAGON STORAGE PRESSURE 181 a. AMBIENT D c. BELOW AMBIENT D b. ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d. CRYOGENIC D b. ABOVE AMBIENT D c. BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS 89-90 226 WASTE ABSORBENT & DISPENSER FUEL FILTER 227 o Ves 181 No 2 230 231 DVes 0 No 3 234 235 DVes DNo 4 238 239 DVes DNo 5 242 243 DVes DNo CAS # 228 N/A, MIXTURE 232 236 240 244 If more hazardous components are present at greater than 1% by weight If non-(;arclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALL V COLLECTED INFORMATION No 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 . UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [8J MA TERIAL(NON-W ASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 181 NO 202 CHEMICAL NAME CARBON DIOXIDE COMMON NAME CAS# 124-38-9 FIRE CODE HAZARD CLASSES (Co!t"4>lete If required by CUPA) MAP# (optional) 1 of 1 II. CHEMICAL INFORMATION 205 TRADE SECRET 203 GRID# (optional) D5 204 No 206 207 209 If Subject to EPCRA, refer to Instructions EHS* 0 Yes 181 No *If EHS is "Yes", all amounts below must be in Ibs. 206 HAZARDOUS MATERIAL TYPE (Check one item only) 210 213 ~ a. PURE Db. MIXTURE 0 c. WASTE 211 RADIOACTIVE DYes ~No 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT, 215 o a, SOLID ~b, LIQUID o c, GAS 214 LARGEST CONTAINER 300 216 ~ a. FIRE 0 b. REACTIVE 0 c. PRESSURE RELEASE 0 d, ACUTE HEALTH 0 e. CHRONIC HEALTH 221 222 217 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 150 300 N/A UNITS' Check one item onl STORAGE CONTAINER Oa. GALLONS Db. CUBIC FEET ~ c. POUNDS 0 d. TONS . If EHS, amount must be in unds. STORAGE PRESSURE o a, AMBIENT De. PLASTIClNONMETALLlC DRUM Of. CAN o g. CARBOY o h. SILO ~ b. ABOVE AMBIENT o i. FIBER DRUM o i·BAG o k. BOX ~ I. CYLINDER o m. GLASS BOTTLE 0 q. RAIL CAR o n, PLASTIC BOTTLE 0 r. OTHER o o. TOTE BIN o p, TANK WAGON 223 o a. ABOVE GROUND TANK Db. UNDERGROUND TANK Dc. TANK INSIDE BUILDING o d, STEEL DRUM o c. BELOW AMBIENT 224 STORAGE TEMPERATURE o a. AMBIENT o b, ABOVE AMBIENT o c. BELOW AMBIENT 181 d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 100 226 CARBON DIOXIDE 227 DYes 181 No 226 124-38-9 2 230 231 DYes 0 No 232 3 234 235 DYes 0 No 236 4 238 239 DYes DNo 240 5 242 243 DYes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1% by weight If non-<:arclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 . UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) cgJ MA TERIAL(NON-W ASTE) [] WASTE . /DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCa # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 202 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No M I DG RAD E If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS· 0 Yes 181 No CAS# 8006-61-9 209 ·If EHS is "Yes·, all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Con1>lete If required by CUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) 203 GRID# (optional) H5 204 206 208 Dc. WASTE 211 RADIÓACTIVE DYes I8INo 210 213 D a. PURE I8Ib, MIXTURE 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a, SOLID I8Ib. LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 216 181 a. FIRE D b. REACTIVE D c. PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e. CHRONIC HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5000 10000 N/A 221 222 UNITS' Check one item onl STORAGE CONTAINER l8Ia. GALLONS Db, CUBIC FEET D· c. POUNDS D d, TONS . If EHS, amount must be in unds, D a. ABOVE GROUND TANK 181 b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d, STEEL DRUM De. PLASTICINONMETALLlC DRUM D f. CAN D g, CARBOY D h, SILO D i. FIBER DRUM D j.BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTLE D r. OTHER D o. TOTE BIN D p. TANK WAGON 223 STORAGE PRESSURE 181 a. AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a. AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 o Yes 181 No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 o Yes 181 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-88-3 5 242 243 DYes ONo 244 229 233 237 241 245 If more haurdouscomponents are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 e e UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) ~ MATERIAL(NON-WASTE) D WASTE (one Dace Der material Der buildino or areal DADD DDELETE I8IREVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVES (EPCRA ) DYES 181 NO FACILITY ID# I I I I 1 T I I I I 1 I MAP# (optional) 203 I GRID# (optional) 204 10F1 F7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No 206 MOTOR OIL If Subject to EPCRA, refer to instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 EHS' DYes 181 No 208 CAS# N/A 209 'If EHS is '"Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete it required byCUPA} COMMBUSTIBLE LIQUID 210 HAZARDOUS MATERIAL 212 I CURIES 213 TYPE (Check one item only) D a, PURE I8Ib. MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8INo PHYSICAL STATE 215 (Check one item only) D a. SOLID I8Ib. LIQUID D c. GAS 214 LARGEST CONTAINER O.25(ONE QUART) FED HAZARD CATEGORIES 216 (Check all that apply) 181 a. FIRE D b. REACTIVE D c. PRESSURE RELEASE D d. ACUTE HEALTH D e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 15 30 N/A N/A 221 I DAYS ON SITE: 222 UNITS· l8Ia. GALLONS Db, CUBIC FEET D c. POUNDS D d. TONS 365 (Check one item onlv\ . If EHS, amount must be in nounds. STORAGE CONTAINER D a. ABOVE GROUND TANK De. PLASTICINONMETALLlC DRUM D i. FIBER DRUM D m, GLASS BOTTLE D Q. RAIL CAR Db. UNDERGROUND TANK D f, CAN D j.BAG 181 n. PLASTIC BOTTLE D r. OTHER Dc. TANK INSIDE BUILDING D g. CARBOY D k. BOX D o. TOTE BIN D d. STEEL DRUM D h. SILO D I. CYLINDER D p. TANK WAGON 223 STORAGE PRESSURE 181 a. AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a. AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT D d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 LUBRICANT BASE OIL 227 DYes 181 No 228 N/A, MIXTURE 229 2 5-6 230 ADDTIVES, ANTI-OXIDANT 231 DYes 181 No 232 N/A, MIXTURE 233 3 234 235 DYes 0 No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes ONo 244 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 ... UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [g MA TERIAL(NON -WASTE) o WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 202 203 GRID# (optional) 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No PREMIUM If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* D Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Cor!1>leteifrequiredbyCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERiAl TYPE (Check one item only) H4 206 208 210 213 D a. PURE ~b. MIXTURE Dc. WASTE 211 RADIOACTIVE DYes ~No 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a. SOLID ~b. LIQUID D c. GAS 214 LARGEST CONTAINER 10,000 216 ~ a. FIRE D b. REACTIVE D c. PRESSURE RELEASE ~ d. ACUTE HEALTH ~ e. CHRONIC HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAl WASTE AMOUNT 219 STATE WASTE CODE 220 5000 10,000 N/A 221 222 UNITS· Check one item onl STORAGE CONTAINER ~a. GAlLONS Db. CUBIC FEET D c, POUNDS D d. TONS . If EHS, amount must be in unds, D a, ABOVE GROUND TANK ~ b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d. STEEL DRUM De. PLASTICINONMETALLlC DRUM D f. CAN D g, CARBOY D h. SILO D i. FIBER DRUM D j.BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q. RAIL CAR D n. PLASTIC BOTTLE D r, OTHER D o. TOTE BIN D p, TANK WAGON 223 STORAGE PRESSURE ~ a. AMBIENT D b, ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~ a. AMBIENT D b, ABOVE AMBIENT D c. BELOW AMBIENT D d, CRYOGENIC 225 OfoWT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 7143-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER ( MTBE) 231 DYes 181 No 232 1634-04-4 233 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 237 4 7-14 238 TOULENE 239 DYes 181 No 240 1 08-88-3 241 5 242 243 DYes DNo 244 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 '. ~ UNIFIED PROGRAM (UP) FORM ~ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [8] MATE RIAL{N 0 N -WASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILlTYNAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # 203 GRID# (optional) G5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes No UNLEADED If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes'. all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Co/T1)letelfrequlreclbyCUPA) FLAMMABLE LIQUID, CLASS 18, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) D a. PURE I8Ib. MIXTURE 211 RADIOACTIVE DYes I8INo 212 CURIES Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a. SOLID I8Ib. LlaUID D c. GAS 214 LARGEST CONTAINER 10,000 181 a. FIRE D b. REACTIVE D c. PRESSURE RELEASE 181 d. ACUTE HEALTH 181 e. CHRONIC HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 5000 N/A 10,000 221 UNITS· Check one item on STORAGE CONTAINER l8Ia, GALLONS Db. CUBIC FEET D c. POUNDS D d, TONS . If EHS, amount must be in unds, D a, ABOVE GROUND TANK 181 b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d. STEEL DRUM De. PLASTIClNONMETALLlC DRUM D f. CAN D g. CARBOY D h. SILO D i. FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q. RAIL CAR D n. PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p. TANK WAGON STORAGE PRESSURE 181 a, AMBIENT D c. BELOW AMBIENT D b. ABOVE AMBIENT STORAGE TEMPERATURE 181 a. AMBIENT D d. CRYOGENIC D b. ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-83-3 5 242 243 DYes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ·~"\ '" -' UNIFIED PROGRAM (UP) FORM C/ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [8J MA TERIAL(NON-W ASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # F5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) , 0 YES 181 NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No UNLEADED If Subject to EPCRA. refer to Instructions COMMON NAME GASOLINE 207 EHS* 0 Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes·, all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CorI1>lete ¡frequired byCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) D a, PURE fgJb. MIXTURE 211 RADIOACTIVE DYes fgJNo 212 CURIES Dc. WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID fgJb. LIQUID D c. GAS 214 LARGEST CONTAINER 10,000 fgJ a. FIRE D b. REACTIVE D c. PRESSURE RELEASE fgJ d. ACUTE HEALTH fgJ e. CHRONIC HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 5000 10,000 N/A 221 UNITS· Check one item on STORAGE CONTAINER fgJa. GALLONS Db, CUBIC FEET D c. POUNDS D d, TONS . If EHS. amount must be in unds. D a. ABOVE GROUND TANK fgJ b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d. STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f, CAN D g, CARBOY D h, SILO D i. FIBER DRUM D ¡,BAG D k. BOX D I. CYLINDER D m, GLASS BOTTLE D q. RAIL CAR D n, PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p, TANK WAGON STORAGE PRESSURE fgJ a. AMBIENT D c. BELOW AMBIENT D b, ABOVE AMBIENT STORAGE TEMPERATURE fgJ a, AMBIENT D d. CRYOGENIC D b. ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No ' 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-83-3 5 242 243 DYes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. > ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 <yn:~qF~~ bp S8 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET Notification Date: ARCO Fac#: Address: City: State: Agency Name: Person Contacted: Time Contacted Comments/Requirements é£~ Testing Scope (check all component:; that apply) Tank Aimular ..£ .L ~ UDC Fill Sumps Secondary Piping Spill Buckets Turbine Sumps ReDair Scope (describe CDmponents and anticipated repairs) vn Contractor Name: Contractor Phone: ARca Contact Distribution: Origît1al to Agency Copy to Sleshire Environmental Services p.2 ~: ~/º~-'10~ No. of Pages: ~~~ ..\.lIit.tll. ...~~ ~~.. ~..- -~.... ~~.~~ "~ Notifcation For: Initial Test: Repairs: Re-test: L Notifcation Method: Fax E-mail: Verbal: X- L X X Phone: fcØ) -Z3hLJ¡6%5 ',' 1'1 ~ It - ARCO # 05365 I~ ~ I 'I A 4010 WIBLE RD. BAKERSFIELD, CA 93309 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Forms included in this package complies with forms/attachment required by the appropriate city or county under which the Unified Pro'gram Agency applies. This Hazardous Materials Business Plan includes: IZ BUSINESS ACTIVITIES PAGE IZ BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE IZ EMERGENCY RESPONSE /CONTINGENCY PLAN [g HAZARDOUS MATERIALS INVENTORY LIST [g FACILITY SITE MAP 1 ,+' ,.. UNIFIED PROGRAM CONSOLIDATED FO FACILITY INFORMATION BUSINESS ACTIVITIES Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Pàrts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) I. Own or operate underground storage tanks? 2. Intend to upgrade existing or install new USTs? 181 YES 0 NO 4. 181 YES 0 NO 5. o YES 181 NO 6, 3, Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ---the total capacity for the facility is greater than 1,320 gallons? D.HAZARDOUS WASTE I. Generate hazardous waste? o YES 181 NO 7. o YES 181 NO 8, 181 YES o NO 9. DYES 181 NO 10, DYES 181 NO II. 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per H&SC §25143.2)? Treat hazardous waste on site? 3. 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? Consolidate hazardous waste generated at a remote site? DYES 181 NO 12, DYES 181 NO 13. DYES 181 NO 14, 5. 6. Need to report the closure/removal of a tank that was classified as ,hazardous waste and cleaned onsite? E. LOCAL REQUIREMENTS Page 1 of _ EPA ID # (Hazardous Waste Only) CAL000244294 2, 3, HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (OES 2731) UST FACILITY (Formerly SWRCB Form A) UST T ANK(one page per tank) (Formerly Form B) UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) UST TANK (closure panion - one page per tank) NO FORM REQUIRED TO CUPAs EPA ID NUMBER - provide at the top of this page RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) CERTIFICATION OF FINANCIAL ASSURANCE (Formerly DTSC Form 1232) REMOTE WASTE I CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1196) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (Formerly DTSC Form 1249) (You may also be reQuired to provide additional information by your CUPA or local agency,) 15, ". ~¡;., , ! UNIFIED PROGRAM CONSOl,IDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION FACILITY ID # (Agency Use Only) BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 BUSINESS SITE ADDRESS 4010 WIBLE RD. CITY BAKERSFIELD DUN & BRADSTREET 03-959-6507 . COUNTY KERN BUSINESS OPERATOR NAME SAYEGH GROUP INC. 104, ", ,. ,","',,···':1~:::/r:;~It:i~~ri¡;¡g;:~till;;:J!ìj\iR~;jii:~~:~¡j)¡;¡~n:}:j;~:øSíNlt$$'Ø~R,>.:,..( ,111. OWNER NAME BP West Coast Products LLC OWNER MAILING ADDRESS: BP West coast Pr~ducts LLC P.O. BOX # 6038 CITY ARTESIA 114, STATE CA 117, CONTACT NAME MICHEAL D, WILSON CONTACT MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA 120, 3. 103, CA ZIP CODE 93309 SIC CODE (4 digit If) 5541 105, 106, 107. 108. 109, BUSINESS OPERATOR PHONE 661-836-9685 110. OWNER PHONE 714-670-5321 112. 113. 115. 118, 116. CONTACT PHONE 714-670-5321 119. 122. NAME ARCO MISSION CONTROL 124, TITLE NAME MARK SATER TITLE FRANCHISEE BUSINESS PHONE 661-836-9685 24-HOUR PHONE* H.909-465-1886 PAGER # CELL#818-266-9088 ADDITIONAL LOCALLY COLLECTED INFORMA nON: 125, BUSINESS PHONE 800-272-6349 126, 24-HOUR PHONE* 800 272-6349 127, PAGER # 129, 130, 131. 132, 133, Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete.' OF OWNER! PERATOR OR DESIGNATED REPRESENTATI\;'E DATE 134, NAME OF DOCUMENT PREPARER 135, 04/10/2002 TITLE OF SIGNER 136, MICHEAL D. WILSON 137, Environmental Specialist ~;:., e' , , ,eIw~9J{~i\:~8SFIt:~ºc'i"'. OFFJ:tE'Ô~;ENwªØNI\ßtÑTALSÊ)ltY,ICÉES" " ' t 71'SCb(!stef Avé{,'BâJ<é~~eld,¢A; (661'~'3'~~~j979' ,., , " ", :.... .:_:{c,'.' "".,:, "'.:_":'.; ,_,'H.~~:-,,:.· . -'~" -,!_'~ "'_'. . J': '-":';¡ -~-':;::-:':,{/ÿ,';j::'::' _. . ~ ,-; '¡':;':'_ '." ::.r- 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 as a whole. 4. Be as briefand concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO # 05365 LOCATION: 4010 WIBLE RD. BAKERSFIELD, CA 93309 MAILING ADDRESS: BP West Coast Products LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-836-9685 OWNER: MARKSATER PHONE: 661-836-9685 MAILING ADDRESS: 4010 WIBLE RD. BAKERSFIELD, CA 93309 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS. PHONE 24 HR PHONE 1. MARK SATER CELL#818-266-9088 FRANCHISEE 661-836-9685 909-465-1886 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 / 1 .. .:;) e e HAZARDOUS MATEIDALS MANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITOIDNG PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: 'In the event of minor tö major spill, or fire, elDployee or owner will call 9-1-1 and local agency. Employees are trained on the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD FIRE DEPARTMENT: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South East side corner of the site, or at a safe upwind location. Method of evacuation is verbal. Person responsible fòr notification is: NAME: MARK SATER TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner; or store manager will call either 9-1-1, or may contact the closest medicaVclinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: 2 MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 e e ::> I ! . SECTION II RELEASE RESPONSE PLAN Emen!:cncv Procedures: Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials: PREVENTION (prevent the hazard) - Describe the kinds of hazards associated with the hazardous materials present at your facility. What actions would your business take to prevent these hazards from occurring? You may include a discussion of safety and storage procedures. Gasoline spills can result in environmental contamination, fire, and explos,ion. Releases of gasoline cali occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. The on-site coordinator or designee will train all new employees of this facility about the procedures for safe handling of hazardous materials and products for emergency response coordination, and use of emergency response equipment and supplies. Additionally, the on-site coordinator or designee will conduct a refresher-training program for all employees on annual basis. PROCEDURE FOR STORAGE AND DISPOSAL OFHAZARDOUS MATERIALS & HAZARDOUS WASTE: Liquid CO2 cylinders must be secured to wall with chain (this applies for stations that serve soda in the store). Waste absorbent from the gasoline spill, cleanup spills, or used gasoline fuel filters must be stored in a proper UN (DOT) approved container with appropriate hazardous waste label on each container. Each drum or container containing hazardous waste must be stored away from hot or ignition sources and disposed before 90 days from accumulation date. Each container must be kept closed with lid and disposed as hazardous waste and manifested. State manifests of hazardous waste must be kept for three years in compliance kit. 3 " MITIGATION (reduce the hazard) - scribe what is done to lessen the H or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitiaation (continued): I the event of a leak or spill: 1. Attendant should shut off electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO Maintenance, If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There are two exits.... front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather In area furthest from danger. Manager on dutywill account for all station personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that Is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies Including NRC, CA OES, Water Board, and County Health Agency.) 3. If neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should:' 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close Impact valves. 3. Evacuate by stopping all traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offèr assistance, as requested. I I I I I Additional mitiaation procedures: Employees will be informed of the health and safety hazards involved with the handling of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? 4 .' e e ,gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUTOFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILL~I 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION., EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? In the event that a spill is small, station personnel should apply absorbent, to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55-gallon drum. If the spill Is larger, call 911, attempt to contain it, arid follow the scene management instructions in Section' 2, Mitigation. Large spills are cleaned by PSI designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm draln(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are Instructed to call 911 and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local tire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. 4. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. Followin are the emer enc Item Use Fire extinguisher Fire Control S ill absorbent S ill Control First Aid Kit Minor Injury ment of this facili : Location Entrance & kitchen area Back room/Su ply room Inside office or cashier Maintenance Yearly Service Re-stock as needed Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROP ANE : NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: DYES [g NO IF YES, LOCATION: 5 .. SPECIAL: e e LOCK BOX: DYES [g NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/W ATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR. INSIDE THE STORE. AND INTHE KITCHEN, AREA A. B. PRIVATE FIRE PROTECTION DYES [g NO WATER A V AILABILITY (FIRE HYDRÀNT): N/ A HAZARDOUS MATEIDALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 I, MATEIDAL SAFETY DATA SHEETS ON FILE: MSDS and business emergency plan is located in hazard communication kit, a yellow plastic box, located in the office area BIDEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up , first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location ofthe problem. Initial training is conducted after hiring new employee. ,Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as: 1) hazard communication program 2) materials safety data sheets, 3) safe handling of chemicals, and 4) emergency equipment& emergency response plan. ,6 .. E' 'It.""@"~:~~::'>Æ':Æ":>''f/j¡':~'';:~'i/';;t"'fyJP'Y/r"fyJ'\4.,; " !'" \ -' . : ,,!'..,C1 Ji ¡ ..,,"!' :~'~ ""'-'. -j X_i :': "'''. """~'é) JjfJ -t l0 ,;;-,,' ~ ;f& ;,; Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. ' Hazardous Materials HandlinQ & EmerQencv Response TraininQ Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including, familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency response organizations; 3. Correct use of emergency response equipment and supplies under the control of the business 4. The Cal OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. Thè emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care 7. Procedures to coordinate with and assist the local emergency personnel that may respond to your business 8. Who and how to call for immediate assistance in the event of an accident involving hazardous materials ' 9. Procedure for ensuring that appropriate personnel receive initial and refresher training UST Equipment OperatinQ and MonitorinQ TraininQ Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system 9. Respond to alarms, leaks, or equipment problems Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? DYES t8J NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? DYES t8J NO ' 3. Do you have personnel that will provide site security at your business during and after a hazardoùs materials incident? DYES t8J NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business:, ' Absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. 7 .' . "'" "",,-_n_ _"""" ""'".;U."" u. Uç~.~.."'''' ."", ". CUll &.all 1I\õii.. .........,."'7Ç'.....o::II VI ........ """,uuJ' aUUUL UI~ IUIIUVVIIIY procedures for the safe handling of hazardous materials, procedures for emergency response coordination, and use oA,ergency response equipment and supPA. Additionally, the On-Site coordinator or designeJllll'II conduct a refresher-training program" ~II employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be Informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste 011 onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees wiUknow the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of, how and when to use dry chemical fire extinguishers that are located on the ,premises. 4. Employees wiU know the location and proper use of first aid kit(s), fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant Immediate evacuation of premises. Circumstances Include: a. Any gasolinel diesell or other type of fire. b. Any spiUI fuel leak, or vapor leak that has the potential for Igniting or exploding. c. Any spiU or leak where employees or customers notice gasoline vapors. I- EMPLOYEE TRAINING RECORDS The PSI managerl for PSI store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (Initial and refreshår).' These documentation records will be retained at the faèility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: , Training Topic -Procedures for handling hazardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify the PSI manager, for PSI store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (i.e. cashier, Emergency Coordinator, Alternate) TrainingTime: 1/2 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the PSI manager, for PSI store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. ' Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spiU control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation . Persons Trained: Facility Staff (All Employees) , Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in. 8 e CERTIFICATION e I, _ MICHEAL D. WILSON CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. #{~ SIGNATURE ff%¿;; J-- DATE ENVIRONMENTAL SPECIALIST , TITLE ,9 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION . Indicate material OR waste (Do not combine material and waste on one form) 0 MATERIAL(NON-WASTE) [8J WASTE .. OADD ODELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 181 NO 10F1 II. CHEMICAL INFORMATION 205 TRADE SECRET CHEMICAL NAME WASTE ABSORBENT COMMON NAME ABSORBENT WASTE CAS# N/A FIRE CODE HAZARD CLASSES (Complete if required by CUPA) HAZARDOUS MATERiAl TYPE (Check one item only) 0 a. PURE Db, MIXTURE . 181 c. WASTE ~ 203 GRID# (optional) D-9 207 209 If Subject to EPCRA, refer to Instructions No EHS· 0 Yes 181 No ·If EHS is "Yes·, all amounts below must be in Ibs. 211 RADIOACTIVE DYes I8INo PHYSiCAl STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 181 a, SOLID Db. LIQUID o c, GAS 214 LARGEST CONTAINER 5 212 CURIES 218 ANNUAl WASTE AMOUNT 181 a, FIRE 0 b. REACTIVE 0 c. PRESSURE RELEASE 0 d. ACUTE HEALTH 0 e, CHRONIC HEALTH 219 STATE WASTE CODE 217 MAXIMUM DAILY AMOUNT 5 50 10 UNITS· Check one item onl STORAGE CONTAINER l8Ia. GALLONS Db, CUBIC FEET 0 c, POUNDS 0 d, TONS . If EHS, amount must be in unds. 221 o a, ABOVE GROUND TANK Db. UNDERGROUND TANK DC. TANK INSIDE BUILDING o d. STEEL DRUM oi , FIBER DRUM o j.BAG o k. BOX o I. CYLINDER o m, GLASS BOTTLE 0 q. RAIL CAR 181 n. PLASTIC BOTTLE 0 r. OTHER 00, TOTE BIN o p, TANK WAGON De. PLASTIC/NONMETALLIC DRUM o f.CAN o g, CARBOY o h, SILO STORAGE PRESSURE 181 a. AMBIENT o c. BELOW AMBIENT o b. ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT o c. BELOW AMBIENT o b, ABOVE AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS o d. CRYOGENIC CAS # 100 MIXTURE OF WASTE OIL, HEAVY PETROLEUM DISTILLATES AND SILICATES 227 0 Yes 181 No 226 2 231 DYes 0 No 232 235 DYes 0 No 236 239 DYes ONo 240 243 DYes DNo 244 230 3 234 4 238 5 242 If more hazardous components are present at greater than 1% by weight if non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Infonnatlon. ADDITIONAL LOCALLY COLLECTED INFORMATION 228 NI A, M IXTU RE 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 <I e e UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) ~ MA TERIAL(NON-WASTE) D WASTE (one page per material oer buildina or areal DADD DDELETE ~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM (EPCRA ) DYES ~ NO FACILITY ID # I I I I I I I I I I 1 I MAP# (optional) 2031 GRID# (optional) 204 10F1 ' E5 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET o Yes ~ No 206 CARBON DIOXIDE If Subject to EPCRA, refer to Instructions CQMMONNAME 207 EHS* o Yes ~ No 208 CAS# 124-38-9 209 *If EHS is "Yes·, all amounts belowl'!'ust be in Ibs. FIRE CODE HAZARD CLASSES (Corrplete if required by CUPA) 210 HAZARDOUS MATERIAL 212 I CURIES 213 TYPE (Check one item only) 181 a. PURE Db, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8INo PHYSICAl STATE 215 (Check one item only) D a. SOLID I8Ib. LIQUID D c. GAS 214 LARGEST CONTAINER 50 FED HAZARD CATEGORIES 216 (Check all that apply) 181 a. FIRE D b, REACTIVE D c. PRESSURE RELEASE D d. ACUTE HEALTH D e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 21.71 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 50 .' 200 N/A N/A ~1 I DAYS ON SITE: 222 UNITS· Da. GALLONS Db, CUBIC FEET 181 c, POUNDS D d. TONS 365 (Check one item onlv) . If EHS. amount must be in DOunds, STORAGE CONTAINER D a, ABOVE GROUND TANK De, PLASTICINONMETALLlC DRUM D i, FIBER DRUM D m, GLASS BOTTLE D q, RAIL CAR D b. UNDERGROUND TANK D f. CAN D ¡,BAG D n. PLASTIC BOTTLE D r. OTHER Dc. TANK INSIDE BUILDING D g, CARBOY D k, BOX D o. TOTE BIN D d, STEEL DRUM D h. SILO 1811. CYLINDER D p, TANK WAGON 223 STORAGE PRESSURE D a, AMBIENT 181 b, ABOVE AMBIENT o c, BELOW AMBIENT 224 STORAGE TEMPERATURE D a. AMBIENT D b. ABOVE AMBIENT D c, BELOW AMBIENT 181 d, CRYOGENIC 225 " %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 227 o Yes ~ No 226 124-38-9 229 2 230 231 DYes 0 No 232 233 3 234 235 DYes 0 No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes DNo 244 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Infonnatlon. ADDITIONAL LOCALLY COLLECTEDJNFORMATION 246 ,~ UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [g MATERIAL(NON-WASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business ~) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 181 NO 202 203 GRID# (optional) 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No MIDG RAD E If Subject to EPCRA. refer to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes·, all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CompleteifrequiredbyCUPA) FLAMMABLE LIQUID, CLASS 1B HAZARDOUS MATERiAl TYPE (Check one item only) H5 206 208 210 213 o a. PURE ~b. MIXTURE Dc. WASTE 211 RADIOACTNE DYes ~No 212 CURIES PHYSICAl STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 o a, SOLID ~b. LIQUID o c. GAS 214 LARGEST CONTAINER ·'10,000 216 ~ a. FIRE 0 b. REACTIVE D c, PRESSURE RELEASE ~ d. ACUTE HEALTH ~ e. CHRONIC HEALTH 221 222 , 217 MAXIMUM DAilY AMOUNT 218 ANNUAl WASTE AMOUNT STATE WASTE CODE 220 5000 10000 N/A . UNITS* Check one item onl STORAGE CONTAINER ~a. GALLONS Db, CUBIC FEET 0 c, POUNDS 0 d, TONS . If EHS. amount must be in ounds. D a. ABOVE GROUND TANK ~ b. UNDERGROUND TANK Dc. TANK INSIDE BUilDING o d, STEEL DRUM De. PLASTIClNONMETAlLlC DRUM o f. CAN o g, CARBOY o h, SilO D i. FIBER DRUM D ¡.BAG o k, BOX o L CYLINDER D m. GLASS BOTTLE 0 q. RAil CAR o n, PLASTIC BOTTLE 0 r, OTHER o o. TOTE BIN D p. TANK WAGON 223 STORAGE PRESSURE ~ a, AMBIENT D b, ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~ a, AMBIENT o b, ABOVE AMBIENT , o c. BELOW AMBIENT o d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE '" 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-88-3 5 242 243 DYes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by welghtlf carcinogenic, attach additional sheets of paper capturing the required Information. ' ADDITIONAL LOCALLY COLLECTED INFORMATION 246 G' UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [g MA TERIAL(NON-WASTE) o WASTE DADD DDELÈTE I8IREVISE REPORTING VEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM OR FRONT SHELVES FACILITY ID # GRID# (optional) F7 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 VES '181 NO 203 10F1 II. CHEMICAL INFORMATION 205 TRADE SECRET CHEMICAL NAME MOTOR OIL COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 CAS# N/A 209 FIRE CODE HAZARD CLASSES (Co~leleifrequiredbYCUPA) COMMBUSTIBLE LIQUID HAZARDOUS MATERiAl TYPE (Check one item only) If Subject 10 EPCRA, refer 10 instructions EHS* 0 Ves 181 No *If EHS is "Yes·, all amounts below must be in Ibs. D a. PURE I8Ib. MIXTURE Dè. WASTE 211 RADIOACTIVE DYes I8INo 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DArL Y AMOUNT D a. SOLID I8Ib, LIQUID D c. GAS 214 LARGEST CONTAINER 0.25(ONE QUART) 181 a. FIRE D b. REACTIVE D c. PRESSURE RELEASE D d. ACUTE HEALTH D e. CHRONIC HEALTH 40 N/A, 217 MAXIMUM DAILY AMOUNT 218 ANNUAl WASTE AMOUNT STATE WASTE CODE 100 221 UNITS· Check one item onl STORAGE CONTAINER l8Ia. GALLONS Db, CUBIC FEET D c, POUNDS D d. TONS . If EHS. amount must,be in unds, D a. ABOVE GROUNDTANK Db. UNDERGROUND TANK Dc. TANK INSIDE BUILDING o d, STEEL DRUM De. PLASTIC/NONMETALLIC DRUM o f. CAN o g. CARBOY o h. SILO o b. ABOVE AMBIENT o i. FIBER DRUM OJ.BAG o k, BOX o I. CYLINDER o m. GLASS BOTTLE 0 q. RAIL CAR 181 n. PLASTIC BOTTLE D r. OTHER o o. TOTE BIN o p. TANK WAGON STORAGE PRESSURE 181 a. AMBIENT o c. BELOW AMBIENT STORAGE TEMPERATURE 181 a. AMBIENT D d. CRYOGENIC o b, ABOVE AMBIENT o c. BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 94-95 226 LUBRICANT BASE OIL 227 o Ves 181 No, 228 N/A, MIXTURE 25-6 230 ADDTIVES, ANTI-OXIDANT 231 DVes 181 No 232 N/A, MIXTURE 3 234 235 DVes ONo 236 4 238 239 DVes 0 No 240 5 242 243 DVes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALL V COLLECTED INFORMATION No 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ¡"; , UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [g MA TERIAL(NON-W ASTE) D WASTE DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO #05365 CHEMICAL LOCATION UNDE~GROUNDSTORAGETANK FACILITY ID # 203 GRID# (optional) H4 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME' 205 TRADE SECRET No PREMIUM If Subjecllo EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* DYes 181 No CAS# 8006-61-9 209 *If EHS is "Yes-, all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES CCorr1>!ele if required byCUPA) FLAMMABLE Ll.QUID, CLASS 18, UN12Q3 HAZARDOUS MATERIAL TYPE (Check one item only) D a. PURE I8Ib. MIXTURE 211 RADIOACTIVE DYes I8INo 212 CURIES Dc. WASTE PHYSiCAl STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a. SOLID I8Ib. LIQUID D c. GAS 214 LARGEST CONTAINER ,10,000 181 a, FIRE D b, REACTIVE D c. PRESSURE RELEASE 181 d. ACUTE HEALTH 181 e. CHRONIC HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 5000 10 000 N/A 221 UNITS' . Check one item ani STORAGE CONTAINER l8Ia. GALLONS Db. CUBIC FEET D c. POUNDS D d, TONS * If EHS. amount must be in unds, D a. ABOVE GROUND TANK 181 b. UNDERGROUND TANK Dc. TANK INSIDE BUILDING D d, STEEL DRUM D i, FIBER DRUM D ¡,BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q. RAIL CAR D n. PLASTIC BOTTLE D r. OTHER D 9, TOTE BIN D p, TANK WAGON De. PLASTICINONMETALLlC DRUM D f, CAN D g, CARBOY D h. SILO STORAGE PRESSURE 181 a. AMBIENT D c, BELOW AMBIENT D b. ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d. CRYOGENIC D b; ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER ( MTBE) 231 DYes 181 No 232 1634~04-4 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOULENE 239 DYes 181 No 240 1 08-88-3 5 242 243 DYes DNo 244 If more hanrdous componentS are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheetS of paper capturing the required Information. ' ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 I' ,~~) UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMfcAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [8J MA TERIAL(NON -WASTE) o WASTE DADD DDELETE I8!REVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA':" Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY ID # CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 0 YES I8!NO 202 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No UNLEADED If Subjecllo EPCRA, refer 10 instructions COMMON NAME GASOLINE 207 EHS' 0 Yes 181 No CAS# 8006-61-9 209 "If EHS is "Yes", all amounts below must.be in Ibs. FIRE CODE HAZARD CLASSES (~etelfrequlredbyCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) 203 GRID# (optional) G5 .204 206 208 Dc. WASTE 211 RADIOACTIVE DYes I8INo 210 213 o a, PURE I8Ib. MIXTURE 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT o a, SOLID I8Ib. LIQUID o c, GAS 214 LARGEST CONTAINER ' 10,000 215 181 a. FIRE 0 b. REACTIVE 0 c, PRESSURE RÈLEASE 181 d. ACUTE HEALTH 181 e. CHRONIC HEALTH 216 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5000 10000 N/A UNITS' Check one item onl STORAGE CONTAINER l8Ia. GALLONS Db, CUBIC FEET 0 c. POUNDS 0 d. TONS . If EHS, amount must be in unds. 221 222 o a. ABOVE GROUND TANK 181 b. UNDERGROUND TANK DC. TANK INSIDE BUILDING o d. STEEL DRUM De. PLASTIClNONMETALLlC DRUM o f. CAN o g, CARBOY o h. SILO o i. FIBER DRUM o ¡,BAG o k. BOX o I. CYLINDER '0 m. GLASS BOTTLE 0 q. RAIL CAR o n. PLASTIC BOTTLE 0 r. OTHER DO, TOTE BIN o p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT STORAGE TEMPERATURE 181 a. AMBIENT o b. ABOVE AMBIENT o b. ABOVE AMBIENT o c. BELOW AMBIENT 224 o c. BELOW AMBIENT o d. CRYOGENIC 225 O/OWT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 229 , 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 233 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 DYes 181 No 240 1 08-83-3 241 5 242 243 DYes ONo 244 245 If more hazardous components are present at greater than 1% by weight If nono(;¡ rclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 '"" UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ~ MATERIAl(NON-WASTE) o WASTE OADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # F5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET No UNLEADED If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* D Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Colr4>lete if required by CUPA) FLAMMABLE LlQU 10, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) o a. PURE I8Ib. MIXTURE 211 RAD,IOACTIVE DYes I8INo 212 CURIES Dc. WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT o a, SOLID I8Ib. LIQUID Dc. GAS 214 LARGEST CONTAINER '10,000 181 a. FIRE 0 b, REACTIVE 0 c. PRESSURE RELEASE 181 d. ACUTE HEALTH 181 e, CHRONlè HEALTH 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 5,000 10,000 N/A 221 UNITS· Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db. CUBIC FEET 0 c. POUNDS 0 d. TONS * If EHS, amount must be in unds, o a, ABOVÉ GROUND TANK 181 b, UNDERGROUND TANK DC, TANK INSIDE BUILDING o d. STEEL DRUM De, PLASTICINONMETALLlC DRUM o f, CAN o g. CARBOY o h, SILO Oi. FIBER DRUM o ¡.BAG o k, BOX o I. CYLINDER o m, GLASS BOTTLE 0 q. RAIL CAR o n. PLASTIC BOTTLE 0 r. OTHER o o. TOTE BIN o p. TANK WAGON STORAGE PRESSURE 181 a, AMBIENT o c. BELOW AMBIENT o b. ABOVE AMBIENT STORAGE TEMPERATURE 181 a. AMBIENT o d, CRYOGENIC o b, ABOVE AMBIENT o c. BELOW AMBIENT %WT ' HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 o Yes ~ No 236 1330-20-7 4 7-14 238 ' TOLUENE 239 DYes ~No 240 1 08-83-3 5 242 243 ' DYes ONo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ' ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 ' 237 241 245 246 \', ,,, SITE MAP DA'Æ :01110101 KERN COUNTY HAZARDDOU8 MATERIAL DM8JON . HAlZARDDOU8 MATERIAL PlAN BUSINESS NAME: ARCO FACIUTV lOll 0Ø38& srrE ADDRESS: 4010 WIBLE AD . BAKERSFIELD. 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I EM I I!UI!AOENC't EXIT ® MIC ~T "*** CHAIN 1.N( ÆNCE 111: I 1RMH ENe 1m] 1MIH_ (B8J IBT RDOI _ CAII-ER SCALE 1-. 45 F ... DIREC1'JOIo _H_ e:.. ' " , 'eJ "... ..., 17/.n (;..[ , .~\' .'_...~: ~ 1" '- - - ).~))fl1, f.;[~),,). ;>f~;, :,:< ;¡ f t- C', '-\,:< ,f' ~ "'- ~ _c_ ,,'1; - ,,' >M<;;' ARCO # 05365 4010 WIBLE RD. BAKERSFIELD, CA 93309 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Fonns included in this package complies with fonns/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: ~BUSINESS ACTIVITIES PAGE ~ BUSIN,ESS OWNER/OPERATOR IDENTIFICATION PAGE ~EMERGENCY RESPONSE /CONTINGENCY PLAN ~HAZARDOUS MATERIALS INVENTORY LIST ~FACILITY SITE MAP 1 ,¡; i "I U IFIED PROGRAM CONSOLIDATED FO FACILITY INFORMATION BUSINESS ACTIVITIES FACILITY ID # Page 1 of_ EPA ID # (Hazardous Waste Only) CAL000244294 , 2, 3, ARCO # 05365 4010 WIBLE RD. BAKERSFIELD, CA 93309 . II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does our facilit ... If Yes, lease com lete these a es of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applic"able Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emer enc Ian is re uired ursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS CUSTs) , 1. Own or operate underground storage tanks? 2. Intend to upgrade existing or install new USTs? 3. Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS CASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ---the total capacity for the faciJity is greater than 1,320 gallons? D, HAZARDOUS WASTE 1. Generate hazardous waste? 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per H&SC §25143.2)? 3, Treat hazardous waste on site? 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? 5. Consolidate hazardous waste generated at a remote,site? 6. Need to report the closure/removal of a tank that was classified as hazardous waste and cleaned onsite? E. LOCAL REQUIREMENTS I8J YES D NO 4. I8J YES D NO 5, DYES I8J NO 6, DYES I8J NO 7. DYES I8J NO 8, I8J YES D NO 9, DYES I8J NO 10, DYES I8J NO 11. DYES I8J NO 12, DYES I8J NO 13, DYES I8J NO 14, HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (OES 273 I) UST FACILITY (Fonnerly SWRCB Fonn A) UST TANK (one page per tank) (Fonnerly Fonn B) UST FACILITY , UST TANK (onepertank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Fonnerly Fonn C) UST TANK (closure portion - one page per iank) NO FORM REQUIRED TO CUPAs EP A ID NUMBER - provide at the top of this page RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Fonnerly DTSC FOITI1S 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Fonnerly DTSC Forms 1772 A,B,C,D and L) CERTIFICATION OF FINANCIAL ASSURANCE (Fonnerly DTSC Fonn 1232) REMOTE WASTE / CONSOLIDATION SITE ANNUAL NOTIFICATION (Fonnerly DTSC Fonn 1196) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (Fonnerly DTSC Fonn 1249) (You may also" be required to Drovide additional infonnation by your CUP A or local agency,) 15, 'Ì' J :1\ U FlED PROGRAM CONSOLIDATED FO , FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION P~Of"_ of FACILITY ID # (Agency Use Only) BUSINESS NAME (Same as FACILITY NAME or DBA - D~ing Business As) 11/01/2001 ARCO # 05365 . BUSINESS SITE ADDRESS 4010 WIBLE RD. CITY BAKERSFIELD DUN & BRADSTREET 03-959-6507 COUNTY KERN BUSINE~S OPERATOR NAME SAMSAWEGH 104, II. BUSINESS OWNER OWNER NAME BP West Coast Products LLC OWNER MAILING ADDRESS: BPWest coast Products LLC P.O. BOX # 6038 CITY 114, STATE 115, ZIP CODE 90702 ARTESIA CA III. ENVIRONMENTAL CONTACT 117. CONTACT NAME CARLOS RODRIGUEZ CONTACT MAILING ADDRESS: BP West Coast Products LLC P.O. BOX # 6038 CITY ARTESIA 120, -PRIMARY- STATE CA IV. EMERGENCY CONTACTS NAME SAM SA WEGH TITLE FRANCHISEE BUSINESS PHONE 661-836-9685 24-HOUR PHONE* H.661-393-1480 PAGER # ENDING DATE 101. 3, 102. 103, CA ZIP CODE 93309 SIC CODE (4 digit #) 5541 105, 106, 107, 108, 109, BUSINESS OPERATOR PHONE 661-836-9685 110, I I I. OWNER PHONE 714-670-5402 112 113, 116, CONTACT PHONE 714-670-5402 118, 119, ZIP CODE 90702 -SECONDARY- 122, 123, NAME 128. ARCO MISSION CONTROL 124, TITLE 129, 125. BUSINESS PHONE 130, 800-272-6349 126, 24-HOUR PHONE* 131. 800 272-6349 127, PAGER # 132, 133, ADDITIONAL LOCALLY COLLECTED INFORMATION: Ceriifi ion: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am Ü i ar wi the information su itted and believe the information is true, accurate, and complete. DATE 134, 137, 135, 136, 11/01/2001 TITLE OF SIGNER Environmental Specialist Ramtox IÎI ( ï, .. 5' CITY OF BAKERSFIELD. OFFICEOFENVIRONMENl'AL S ICES '1715 Chester Ave., Bakersfield, 'CA (661) 32"6-3979 HAZARDOUS MATEIDALS MANAGEMENT PLAN , INSTRUCTIONS: 1. To avoid further action, return this fonn within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Fonn and Chemical Description Fonn(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO # 05365 LOCATION: 4010 WIBLE RD. BAKERSFIELD, CA 93309 MAILING ADDRESS: BP West Coast Products LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 ' PIDMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-836-9685 OWNER: SAM SA WEGH PHONE: 661-836-9685 MAILING ADDRESS: 4010 WIBLE RD. BAKERSFIELD, CA 93309 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS. PHONE 24 HR PHONE 1. SAM SA WEGH FRANCHISEE 661-836-9685 661-393-1480 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 1 <1 ' 1\ . :.. ? . . HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.1 DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF THE FILL PIPES OR LEAK IN THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAK/SPILL IS FROM THE DISPENSER , UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT AND IF A LEAK IS FOUND THE LEAK PROBE WILL SENSE THE LIQUID RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS C02 GAS CYLINDERS USED FOR SODA DRINKS. THE C02 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. I , . I B. EMPLOYEE AND AGENCY NOTIFICATION: IN THE EVENT OF MINOR TO MAJOR SPILL, OR FIRE, EMPLOYEE OR OWNER WILL CALL 9-1-1 AND LOCAL AGENCY. EMPLOYEES ARE TRAINED ON THE USE OF SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATE RIAL S/W ASTE. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 LOCAL OFFICE: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL EMPLOYEES LEAVE THE PREMISES BY THE SAFEST EXIT. ALL EMPLOYEES WILL BE ASKED TO ASSEMBLE AT A SAFE ASSEMBLY AREA LOCATED AT SOUTH SIDE OF MT. VERNON AVE., AT PARKING LOT OF HOLLYWOOD VIDEO, OR AT A SAFE UPWIND LOCATION. PERSON RESPONSIBLE FOR NOTIFICATION IS: NAME: SAM SA WEGH TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: FOR SMALL INJURIES THE OWNEROR STORE MANAGER WILL UTILIZE THE FIRST AID KIT BOX. FOR MINOR TO MAJOR INJURIES, THE OWNER, OR STORE MANAGER WILL CALL EITHER 9-1-1, OR MAY CONTACT THE CLOSEST MEDICAL/CLINIC CENTER, WHICH IS LOCATED AT: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 '1 ., \' '. ;? . SECTION 11.2: RELEASE RESPONSE PLAN . I ]. A. HAZARD ASSESSMENT AND PREVENTION MEASURES HAZARD ASSOCIATE TO THIS RETAIL GASOLINE STORE IS : GASOLINE, FLAMMABLE LIQUID, CLASS IB, UN1203 GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF FILL PIPE OR LEAK INTO OR ON THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAKS/SPILLS IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT, IF A LEAK IS FOUND, THE LEAK PROBE WILL SENSE THE LIQUID RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS C02 GAS CYLINDERS USED FOR SODA DRINKS. THE C02 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. B. RELEASE CONTAINMENT AND/OR MITIGATION IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL EMPLOYEES LEAVE THE PREMISES BY THE SAFES;r EXIT. ALL EMPLOYESS WILL BE ASKED TO ASSEMBLE AT SOUTH SIDE OF MT. VERNON AVE., AT PARKING LOT OF HOLLYWOOD VIDEO. FOR SMALL FIRE, OWNER OR EMPLOYEE WILL USE PORTABLE FIRE EXTINGUISHER. FOR SMALL SPILL, OWNER OR EMPLOYEE, WILL USE ABSORBENT MATERIAL FOR MAJOR SPILLS OR LEAKS, CALL ARCO MISSION CONTROL: 800-272-6349 I , I' C. CLEAN UP AND RECOVERY PROCEDURES THE OWNER OR MANAGER WILL MAKE SURE THAT ELECTRIC POWER AND NATURAL GAS ARE TURNED OFF AND THAT ALL EMPLOYEES WILL BE EVACUATED FROM THE PREMISES. OWNER WILL SHUT DOWN THE WHOLE OPERATION OF GASOLINE PUMP BY PRESSING THE EMERGENCY SHUT OFF PUMPS LOCATED EITHER AT THE CASHIER OR OUTSIDE AND WILL SHUT OFF TURBINES CIRCUIT BREAKER LOCATED AT THE ELECTRICAL PANEL AREA. HAZARDOUS WASTE FROM SPILL CONTAINMENT WILL BE DISPOSED BY CALLING ARCO MISSION CONTROL: 800-272-6349 Followin2; are the emer2;ency equipment of this facilitv: Item Use Location Maintenance , Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURALGAS/PROPANE: NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: DYES !ZINO IF YES, LOCATION: PRIV A TE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. B. PRIV A TE FIRE PROTECTION DYES !ZINO WATER AVAILABILITY (FIRE HYDRANT): N/A 3 'Î' .,,, '. ~. HAZARDOUS MAtauALS MANAGEMENT PLAN . SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5. MATERIAL SAFETY DATA SHEETS ON FILE: MSDS AND BUSINESS EMERGENCY PLAN IS LOCATED IN HAZARD COMMUNICATION KIT, A YELLOW PLASTIC BOX, LOCATED IN THE OFFICE AREA BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TRAINED ON USE OF SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/W ASTE.EMPLOYEES ARE TRAINED AND REQUIRED TO DIAL FOR EMERGENCY CALLS, ESPECIALLY 9-1-1, AND EV ACUATE THE PREMISES. EMPLOYEES ARE TRAINED IN THE USE OF SPILL ,CLEAN UP SUPPLIES, FIRST AID KITS, AND FIRE EXTINGUISHERS, ELECTRICAL AND GAS SHUT OFF AND USE OF TELEPHONES. EMPLOYEES ARE TRAINED TO ADVISE ANY RESPONSE AGENCY AS TO THE NATURE AND LOCATION OF THE PROBLEM. INITIAL TRAINING IS CONDUCTED AFTER HIRING NEW EMPLOYEE. , TRAINER IS THE OWNER OR MANGER OF THE STORE. REFRESHER TRAINING IS DONE EVERY YEAR. TRAINING TOPICS ARE SUCH AS : 1) HAZARD COMMUNICATION PROGRAM 2) MATERIALS SAFETY DATA SHEETS, 3) SAFE HANDLING OF CHEMICALS, AND 4) EMERGENCY EQUIPMENT & EMERGENCY RESPONSE PLAN. CERTIFICATION I, _CARLOS L. RODRIGUEZ , CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ENVIRONMENTAL SPECIALIST SIGNATURE TITLE 4 ,¡' ..\ UNIFIED PROGRAM (UP) FORM HAZARDOUS MATE IALS INVENTORY FORM - CHEMICAL DESCRIPTION "Indicate material OR waste (Do not combine material and waste on one form) D MATERIAL(NON-WASTE) r8J WASTE DADD DDELETE [8JREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM FACILITY ID # 3 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES [8J NO 202 203 GRID# (optional) 204 CHEMICAL NAME WASTE ABSORBENT COMMON NAME ABSORBENT WASTE CAS# Nt A FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 10F1 II. CHEMICAL INFORMATION 205 TRADE SECRET D-6 DYes [8J No 206 If Subject to EPCRA, refer to instructions 207 209 EHS' 0 Yes [8J No 'If EHS is "Yes", all amounts below must be in Ibs. 208 HAZARDOUS MATERIAL TYPE (Check one item only) PHYSICAL STATE (Chéck one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 210 213 D a, PURE Db, MIXTURE 181 c, WASTE 211 RADIOACTIVE DYes I8INo 212 CURIES 215 181 a, SOLID Db, LIQUID D c, GAS 214 LARGEST CONTAINER 5 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH D e, CHRONIC HEALTH 216 UNITS' Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db, CUBIC FEET D c, POUNDS D d. TONS . If EHS, amount must be in ounds, 221 222 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5 10 50 D a. ABOVE GROUND TANK Db, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM De, PLASTIC/NONMETALLIC DRUM D f, CAN D g, CARBOY D h, SILO D i, FIBER DRUM D j,BAG D k. BOX D I. CYLINDER D m, GLASS BOTTLE D q: RAIL CAR 181 n, PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT Db, ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a, AMBIENT Db, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS 100 226 MIXTURE OF WASTE Oil, HEAVY 227 DYes 181 No PETROLEUM DISTillATES AND SILICATES 2 230 231 DYes 0 No 3 234 235 DYes DNo 4 238 239 DYes DNo 5 242 243 DYes DNo CAS # 228 NtA, MIXTURE 229 232 233 236 237 240 241 244 245 If more huardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. . ADDITIONAL LOCALLY COLLECTED INFORMATION 246 '} ."\ -:~ . . UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) ~ MATERIAL(NQN-WASTE) D WASTE (one oaoe oer material oer buildi'ng or area) DADD DDELETE I8IREVISE REPORTING YEAR 2002 200 I Page of I. F ACILlTYINFORMA TION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM (EPCRA ) DYES 181' NO FACILITY ID #1 I II I I I I I I 1 I MAP# (optional) 2031 GRID# (optional) 204 10F1 E 5 ' II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No 206 CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME 207 ' EHS" DYes 181 No 208 CAS# 124-38-9 209 "If EHS is "Yes", all amounts below must be in Ibs: FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL 212 I 213 TYPE (Check one item only) 181 a, PURE Db, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8INo CURIES PHYSICAL STATE 215 (Check one item only) D a, SOLID I8Ib, LIQUID D c, GAS 214 LARGEST CONTAINER 50 FED HAZARD CATEGORIES 216 (Check all that apply) 181 a. FI RE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH D e, CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 50 200 N/A N/A 221 I DAYS ON SITE: 222 UNITS· Da, GALLONS Db, CUBIC FEET 181 c, POUNDS D d, TONS 365 ¡Check one item onlv\ . If EHS, amount must be in oounds, STORAGE CONTAINER D a, ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i, FIBER DRUM ' D m, GLASS BOTTLE D q, RAIL CAR Db, UNDERGROUND TANK D f,CAN D ¡,BAG D n, PLASTIC BOTTLE D r, OTHER Dc, TANK INSIDE BUILDING D g, CARBOY D k, BOX D o. ,TOTE BIN D d, STEEL DRUM D h, SILO 1811. CYLINDER D p, TANK WAGON 223 STORAGE PRESSURE D a, AMBIENT 181 b, ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE D a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 181 d, CRYOGENIC 225 O/OWT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 227 DYes 181 No 228 124-38-9 229 2 230 231 DYes DNo 232 233 3 234 235 DYes DNa 236 237 4 238 239 DYes DNo 240 241 , 5 242 243 DYes DNa 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADÒJTIONAL LOCALLY COLLECTED INFORMATION 246 1,1' "'. ,'.- '~ t" UNIFIED PROGRAM (UP) FORM HAZARDOUS MATE IALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on onèform) ;g MATERIAL(NON-WASTE) D WASTE DADO Page of DDELETE [8JREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY 10 # H5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES [8J', NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes [8J No M I DG RAD E If Subject to EPCRA, refer to instru~tions COMMON NAME GASOLINE 207 EHS* DYes [8J No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (CompleteifrequiredbyCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) o a, PURE 211 RADIOACTIVE DYes I8INo 212 CURIES I8Ib, MIXTURE Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT o a, SOLID I8Ib, LIQUID o c, GAS 214 LARGEST CONTAINER 10,000 181 a, FIRE 0 b, REACTIVE 0 c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 10,000 221 UNITS· Check one item onl STORAGE CONTAINER 181 a , GALLONS Db, CUBIC FEET 0 c, POUNDS 0 d, TONS . If EHS, amount must be in ounds, De, PLASTIC/NONMETALLIC DRUM o f, CAN o g, CARBOY o h, SILO o a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK DC, TANK INSIDE BUILDING o d, STEEL DRUM o i, FIBERDRUM o j,BAG o k, BOX o I. CYLINDER o m, GLASS BOTTLE 0 q, RAIL CAR o n, PLASTIC BOTTLE 0 r, OTHER o 0, TOTE BIN o p, TANK WAGON STORAGE PRESSURE 181 a, AMBIENT o c, BELOW AMBIENT o b, ABOVE AMBIENT STORAGE TEMPERATURE l8Ia. AMBIENT o d, CRYOGENIC o b, ABOVE AMBIENT o c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes [8J No 228 71-43-2 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER 231 DYes [8J No 232 1 634-04-4 3 8-15 234 XYLENE 235 DYes [8J No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes [8J No 240 1 08-88-3 5 242 243 DYes DNo 244 If more huardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ~< ~ ,.~; .10"".. ~. > " ' UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [8] MATERIAL(NON-WASTE) D WASTE DADD DDELETE I8JREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION BACK ROOM OR FRONT SHELVES FACILITY ID # GRID# (optional) F7 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES I8J NO 203 10F1 II. CHEMICAL INFORMATION 205 TRADE SECRET CHEMICAL NAME MOTOR Oil COMMON NAME ENGINE Oil, lUBRICANT MOTOR Oil 207 CAS# N/ A 209 FIRE CODE HAZARD CLASSES (Complete if required byCUPA) COMMBUSTIBlE LIQUID HAZARDOUS MATERIAL TYPE (Check one item only) DYes I8J No If Subject to EPCRA, refer to instructions EHS* 0 Yes I8J No *If EHS is "Yes", all amounts below must be in Ibs. D a, PURE 211 RADIOACTIVE DYes I8INo 212 CURIES I8Ib, MIXTURE Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Ib, LIQUID D c, GAS 214 LARGEST CONTAINER O,25(ONE QUART) 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH De, CHRONIC HEALTH 40 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 100 221 UNITS' Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS . If EHS, amount must be in ounds, De, PLASTIC/NONMETALLIC DRÙM D f, CAN D g,CARBOY D h, SILO D a, ABOVE GROUND TANK Db, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM D i, FIBER DRUM D j,BAG D k, BOX o I. CYLINDER D m, GLASS BOTTLE D q. RAIL CAR 181 n, PLASTIC BOTTLE D r. OTHER Do,' TOTE BIN D p, TANK WAGON STORAGE PRESSURE 181 a, AMBIENT D c, BELOW AMBIENT D b, ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d, CRYOGENIC D b, ABOVE AMBIENT D c, BELOW AMBIENT O/OWT HAZARDOUS COMPONENT (For mixture or waste only) EHS 94-95 226 lUBRICANT BASE Oil 227 DYes I8J No 2 5-6 230 ADDTIVES, ANTI-OXIDANT 231 DYes I8J No 3 234 235 DYes 0 No 4 238 239 DYes DNo 5 242 243 DYes DNo CAS # 228 N/A, MIXTURE 232 N/A, MIXTURE 236 240 244 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION L- 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ~ "!..t',," !'.. '7 UNIFIED PROGRAM (UP) FORM HAZARDOUS MAT IALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate 'material OR waste (Do not combine material and waste on oneform) I:8J MATERIAL(NON-WASTE) D WASTE DADO DDELETE ¡:g REVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY 10 # H4 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES ¡:g NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes ¡:g No P REM I U M If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS· 0 Yes ¡:g No CAS# 8006-61-9 209 'If EHS is "Yes", all amounts below must be in Ibs. FIRÈ CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) D a, PURE 211 RADIOACTIVE DYes I8JNo 212 CURIES I8Jb, MIXTURE Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Jb, LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 I8J a, FIRE D b, REACTIVE D c, PRESSURE RELEASE I8J d, ACUTE HEALTH I8J e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 10,000 221 UNITS' Check one item ani STORAGE CONTAINER l8Ja, GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS . If EHS, amount must be in ounds, D a, ABOVE GROUND TANK I8J b, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM De, PLASTIC/NONMETALLIC DRUM D f,CAN D g, CARBOY D h, SILO D b, ABOVE AMBIENT D i, FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D m, GLASS BOTTLE D q, RAIL CAR D n, PLASTIC BOTTLE D r, OTHER D 0, TOTE BIN Dp, TANK WAGON STORAGE PRESSURE I8J a, AMBIENT D c, BELOW AMBIENT STORAGE TEMPERATURE I8J a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes ¡:g No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER ( MTBE) 231 DYes ¡:g No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes ¡:g No 236 1330-20-7 4 7-14 238 TOULENE 239 DYes ¡:g No 240 1 08-88-3 5 242 243 DYes DNo , 244 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 l' '0. If :. 1"': UNIFIED PROGRAM (UP) FORM _ IALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on oneform) I:8J MATERIAL(NON-WASTE) D WASTE HAZARDOUS MAT DADD DDELETE I8IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # G5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES 181 NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No UN LEAD ED II Subject to EPCRA, reler to instructions COMMON NAME GASOLINE· 207 EHS' DYes 181 No CAS# 8006-61-9 209 'If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete ilrequired byCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) D a, PURE 211 RADIOACTIVE DYes I8INo 212 CURIES I8Ib, MIXTURE D c,WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Ib, LIQUID D c, GAS 214 . LARGEST CONTAINER 10,000 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 10,000 221 UNITS' Check one item onl STORAGE CONTAINER 181 a , GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS , If EHS, amount must be in ounds, D a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK Dc, TANK INSIDE BUiLDING D d, STEEL DRUM De, PLASTIC/NONMETALLIC DRUM D f, CAN D g, CARBOY D h, SILO D b, ABOVE AMBIENT D i, FIBER DRUM Dj,BAG D k, BOX o I. CYLINDER D m, GLASS BOTTLE D q, RAIL CAR D n, PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN Dp, TANK WAGON STORAGE PRESSURE 181 a, AMBIENT D c, BELOW AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d. CRYOGENIC %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes 181 No 240 108-83-3 5 242 243 DYes DNo 244 If more haurdous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ~ ~.-'f:¡ /~ UNIFIED PROGRAM (UP) FORM , IALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine materialand waste on one form) ~ MATERIAL(NON-WASTE) D WASTE "7! HAZARDOUS MAT DADO DDELETE I:8:IREVISE REPORTING YEAR 2002 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY 10 # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 1:8:1 NO 202 203 GRID# (optional) 204 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes 1:8:1 No UNLEADED II Subject to EPCRA, reler to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes 1:8:1 No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Completeilrequired byCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) F5 206 208 210 213 D a, PURE ¡g b, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes ¡g No 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a, SOLID ¡g b, LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 216 ¡g a, FIRE D b, REACTIVE D c, PRESSURE RELEASE ¡g d, ACUTE HEALTH ¡g e, CHRONIC HEALTH 221 222 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5,000 10,000 N/A UNITS' Check one item onl STORAGE CONTAINER ¡g a, GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS . If EHS, amount must be in ounds, D a, ABOVE GROUND TANK ¡g b, UNDERGROUND TANK D c, TANK INSIDE BUILDING D d, STEEL DRUM STORAGE PRESSURE ¡g a, AMBIENT De, PLASTIC/NONMETALLIC DRUM D f, CAN D g, CARBOY D h, SILO D b, ABOVE AMBIENT D i, FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D nì, GLASS BOTTLE D q, RAIL CAR D n, PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p, TANK WAGON 223 D c, BELOW AMBIENT 224 STORAGE TEMPERATURE ¡g a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 O/OWT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 o Yes ~ No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 DYes ~ No 232 1634-04-4 3 8-1 5 234 XYLENE 235 o Yes ~ No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes ~No 240 108-83-3 5 242 243 DYes DNo 244 229 233 237 241 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 , SIrE MAP DAlC : 0111Q101 KERN COU' MATERIAL DM8ION . HAZZARÐDOU8 MATERIAL PlAN BUSINESS I ARoo FACIUTV.1DtI 05385 SITE ADDRESS: 4010 WIBLE AD BAKERSFIELD, CA 83309 ABC D E F G H I J I: : : : : : : : I · . . . . . . . · . . . . . . . · . ... . . . . 1 ;;;::;:: Z ¡. ¡ ¡ ¡ 1 ¡ ,¡ ¡ 0 .... .. ..... ·t ~.................~..................~..,..............j........:........j..............·..t......·..·......·~··.. ....... ....j... .~...... ~ ~ ~ ~ SOUTH: ERN ~ ~ W~O 2 ....., '~ . .. .. Gill ¡ ¡ ¡ AUto SUPPl.:Y ¡ éJ i .' .... ..... .. ......~. ....... ..... .....~...... ....... ....¡....... ....,....).. ....... ........~................ ..~... ......... .Æþw.1Jj.~...... ¡ ¡ ¡ WHITE LN ¡ ~ -V--¡ 3 _ ....... "" : : . : . : · . . . . . · . . . . . ..... .. ..... .... ................' .......~...........L................L................L...............l..................L ...... ,..Z............... : : : : : WI- : : : : : æ ~O 4 I' I ~(ß)k1rl! f~ , . 11 : ,; , II III I J! 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't........ ..u(. uu 1 i:..u.... -8' 18..... al -, ,. ¡ MIS~ FUNE~ HOME ~~ r elf ð v - . . ~p ~.'" \.~-ít: ' ,,,j¡ , ® DRAIN '¡æ .. ", --'II 1& ø .-...a.I!R8Y811!M VALVES IN:I _HI ® II.I!C1WIQ1ÞL IIM'OFP " @ GMIHUI'OFF", . .Q\ WA11!R ØII'QIIF '" ~ "'- Ii' B 1B'I8ENC'r 8tMOFF'x. ~ (.... GAB PUlP), "- _ J:W: __&.AND . ARE~ IiIšðII IIIDII & cx:INTIiœNCY' LI.IfJ PLAN I. ...·ne.. PUN ð. ~. ~ PER8CfW. PROI"IC'IM! ~ I!!QWIIENT IV'I ...u. CDNrANIENT & IðI EICU'IoENT + QURII!NT lilt y .. BIÌEIB yo * ftPRDIEB . :raR ~ mR«i C--) UtI) __ W« ~ 1 GAB [!] : IHU1'OFF ~ ŒQ ! LIQUID {gJ LE LIQUID IEMI ~ÐGT ø r *** PENCE [1i] [fI] ü!!I - SCALE _6_ ¿;,~. - i, ~ -I I ,.., " e e ARCO FACILITY ID# 05365 4010 WIBLE RD. BAKERSFIELD, CA 93309 ARCOPRODUCTSCOMPANY- ARCO FACILITY ID# 05365 Hazardous Materials Business Plan 1. FACILITY INFORMATION ~ SECTION ARCO/F ACILITY ID# 05365 ./ /" 49,J~WIBLE RD. , BkKERSFIELD, CA 93309 '.J To be completed by all businesses, regardless of program type. Fonus included in this package complies with [onus/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: [8JBUSINESS ACTIVITIES PAGE cg¡ BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE [8JEMERGENCY RESPONSE /CONTINGEN,CY PLAN [8JHAZARDOUS MATERIALS INVENTORY LIST r;g]FACILITY SITE MAP 1 .. UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES !.. FACILITY ID # ~ Page 1 of _ EPA ID # (Hazardous Waste Only) CAL000032618 2, 3. Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) 1. Own or operate underground storage tanks? 2. Intend to upgrade existing or install new USTs? 1:81 YES D NO 4, 1:81 YES 0 NO 5, DYES 1:81 NO ' 6, 3. Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE I. Generate hazardous waste? DYES 1:81 NO 7, DYES 1:81 NO 8, 2, Recycle more than 100 kg/month of excluded or exempted recyclable materials (per H&SC §25143.2)? Treat hazardous waste on site? 1:81 YES D NO 9, DYES 1:81 NO 10, DYES 1:81 NO 11. 3. 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? Consolidate hazardous waste generated at a remote site? DYES 1:81 NO 12, DYES 1:81 NO 13, DYES 1:81 NO 14, 5, 6. Need to report the closure/removal ofa tank that was classified as hazardous waste and cleaned onsite? E. LOCAL REQUIREMENTS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (OES 2731) UST FACILITY (Fonnerly SWRCB Form A) UST TANK (one page per tank) (Fonnerly Fonn B) UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) . UST TANK (closure portion - one page per tank) NO FORM REQUIRED TO CUPAs EP A ID NUMBER - provide at the top of this page RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Fonnerly DTSC Fonns 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Fonnerly DTSC Fonns 1772 A,B,C,D and L) CERTIFICATION OF FINANCIAL ASSURANCE (Fonnerly DTSC Fonn 1232) REMOTE WASTE I CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Fonn 1196) HAZARDOUS WASTE TANK CLOSURE CERTIFICATION (Fonnerly DTSC Fonn 1249) (You may also be required to provide additional information by your CUP A or local agency.) 15, '. UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION ! FACILITY ID # (Agency Use Only) BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 'P(I(T¡:;> nf ENDING DATE 101. 3, 102, 103, 104, ZIP CODE 105, CA 93309 106, SIC CODE (4 digit,#) 107, 5541 108, 109, BUSINESS OPERATOR PHONE 110, 661-836-9685 Z ARCO AMPM , PSI STORE, FACILITY ID # 05365 BUSINESS SITE ADDRESS 4010 WIBLE RD. CITY BAKERSFIELD DUN & BRADSTREET 07-190-3868 COUNTY KERN BUSINESS OPERATOR NAME RAULPENA II. BUSINESS OWNER OWNER NAME PRESTIGE STATIONS, INC., PSI STORE OWNER MAILING ADDRESS P.O. BOX # 6038 CITY ARTESIA 111. OWNER PHONE 714-670-5402 112, 113, STATE CA . III. ENVIRONMENTAL CONTACT 114, 115, ZIP CODE 90702 116, CONTACT NAME CARLOS RODRIGUEZ CONTACT MAILING ADDRESS ARCO PRODUCTS COMPANY, P.O. BOX # 6038 CITY ARTESIA 117, CONTACT PHONE 714-670-5402 118, 119, -PRIMARY - STATE CA IV. EMERGENCY CONTÂCTS 120, 121. ZIP CODE 90702 -SECONDARY - 122, NAME RAULPENA TITLE PSI STORE MANAGER BUSINESS PHONE 661-836-9685 24-HOUR PHONE* H.661-835-1377 PAGER # 123, NAME 128, ARCO MAINTENANCE 124, TITLE 129, 125, BUSINESS PHONE 130, 661-836-9685 126, 24-HOUR PHONE* 131. 800 272-6349 127, PAGER # 132, 133, ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Ba d on my inquiry of those individuals responsible for obtaining the information. I certify under penalty of law that I have personally examined and am familiar wit th info ation submitted and believ e information is true, accurate, and complete. DATE 134, NAME OF DOCUMENT PREPARER 135, NAME OF SIGN 136, 01/26/01 TITLE OF SIGNER Environmental Specialist, ARCO 137, CARLOS RODRIGUEZ .. . CITY OF"'BAKERSFlELD e OFFICE OF ENVIRONMENTAL SERVICES· 17J5Chester Ave.,Bak~rsfield, CA(661»)t6-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN î INSTRUCTIONS: 1. To avoid further action, return this fonn within 30 days of receipt 2. TYPEIPRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Fonn and Chemical Description Fonn(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO AMPM -, PSI STORE ID # 05365 LOCATION: 4010 WIBLE RD. BAKERSFIELD, CA 93309 MAILING ADDRESS: ARCO PRODUCTS COMPANY CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-836-9685 OWNER: PRESTIGE STATIONS, INC., PSI STORE PHONE: 661-836-9685 MAILING ADDRESS: 4010 WIBLE RD. BAKERSFIELD, CA 93309 EMERGENCY NOTIFICÀTION CONTACT TITLE BUS. PHONE 24 HR PHONE 1. RAUL PENA PSI STORE MANAGER 661-836-9685 661-835-1377 2. ARCO MAINTENANCE 661-836-9685 800-272-6349 1 ;;; 'e,' e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.1 DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF THE FILL PIPES OR LEAK IN THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAK/SPILL IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND'EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT IF A LEAK IS FOUND THE LEAK PROBE WILL SENSE THE VAPOR RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS C02 GAS CYLINDERS USED FOR SODA DRINKS. THE C02 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. LEAKS ARE DETECTED BY VEEDER-ROOT TANK MONITOR CONSOLE. THIS MONITOR ALSO HAS ABILITY TO DETECT LEAKS USING A VAPOR SENSOR WHICH IS LOCATED IN ANNULAR SPACING OF THE DOUBLE WALL TANK. ONCE SENSOR DETECTS LEAKS OF GASOLINE OF TANKS, THE ALARM GOES OFF. B. EMPLOYEE AND AGENCY NOTIFICATION: IN THE EVENT OF MINOR TO MAJOR SPILL, LEAK, FIRE & EXPLOSION EMPLOYEE, OR OWNER, WILL CALL 9-1-1 AND LOCAL AGENCY. EMPLOYEES ARE TRAINED ON THE USE OF ANY REQUIRED SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. EMPLOYEES ARE TRAINED TO REQUIRED EMERGENCY CALLS, ESPECIALLY 9-1-1.0FFICE OF EMERGENCY SERVICE: 1-800-852-7550 LOCAL OFFICE: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL PERSONS LEAVE THE PREMISES BY THE SAFEST EXIT. ALL PERSONS WILL BE ASKED TO ASSEMBLE AT A SAFE ASSEMBLY AREA LOCATED BEHIND THE STORE, AT THE EAST SIDE OF WHITE LN. OR AT A SAFE UPWIND , LOCATION. PERSON RESPONSIBLE FOR NOTIFICATION IS: NAME: RAUL PENA TITLE: PSI STORE MANAGER D. EMERGENCY MEDICAL PLAN: FOR SMALL INJURIES THE OWNER OR STORE MANAGER WILL UTILIZE THE FIRST AID KIT BOX. FOR MINOR TO MAJOR INJURIES, THE OWNER, OR STORE MANAGER WILL CALL EITHER 9-1-1, OR MAY CONTACT THE CLOSEST MEDICAL/CLINIC CENTER WHICH IS LOCATED AT NAME OF THE HOSPITAL & TELEPHONE NUMBER: ,MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 e e SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES ~ HAZARD ASSOCIATE TO THIS RETAIL GASOLINE STORE IS : GASOLINE, FLAMMABLE LIQUID, CLASS IB, UN1203 GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF FILL PIPE . OR LEAK INTO OR ON THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAKS/SPILLS IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT, IF A LEAK IS FOUND, THE LEAK PROBE WILL SENSE THE VAPOR RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS C02 GAS CYLINDERS USED FOR SODA DRINKS. THE C02 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. B. RELEASE CONTAINMENT AND/OR MITIGATION IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL PERSONS LEAVE THE PREMISES BY THE SAFEST EXIT. PERSON WILL BE ASKED TO ASSEMBLE BEHIND THE STORE, AT THE EAST SIDE OF WHITE LN. FOR SMALL FIRE, OWNER OR EMPLOYEE WILL USE PORTABLE FIRE EXTINGUISHER. FOR SMALL SPILL, OWNER OR EMPLOYEE, WILL USE ABSORBENT MATERIAL FOR MAJOR SPILLS OR LEAKS, A CLEAN UP COMPANY WILL BE CALLED. NAME OF THE COMPANYIS INDUSTRIAL WASTE UTILIZATION: 805-925-0391 C. CLEAN-UP AND RECOVERY PROCEDURES IN CASE OF EMERGENCY, THE OWNER OR MANAGER WILL MAKE SURE THAT ELECTRIC POWER AND NATURAL GAS ARE TURNED OFF AND THAT ALL PERSONS ARE EVACUATED FROM THE PREMISES. OWNER WILL SHUT DOWN THE WHOLE OPERATION OF GASOLINE PUMP BY PRESSING THE EMERGENCY SHUT OFF PUMPS LOCATED EITHER AT THE CASHIER OR OUTSIDE AND WILL SHUT OFF TURBINES CIRCUIT BREAKER LOCATED AT THE ELECTRICAL PANEL AREA. HAZARDOUS WASTE FROM SPILL CONTAINMENT WILL BE DISPOSED BY INDUSTRIAL WASTE UTILIZATION: TEL# 805-925-0391 Followmg are the emergency equi ment of this facility: Item Use Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROP ANE : NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: DYES ~NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE. AND IN THE KITCHEN AREA A. B. PRIVATE FIRE PROTECTION D YES ~NO WATER AVAILABILITY (FIRE HYDRANT): N/A 3 ,. e HAZARDOUSMATEIDALSMANAGEMENTPLAN e SECTION III: TRAINING NUMBER OF EMPLOYEES: " 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES AREA ABOUT 5-7. MATEIDAL SAFETY DATA SHEETS ON FILE: MSDS AND BUSINESS EMERGENCY PLAN IS LOCATED IN HAZARD COMMUNICATION KIT, A YELLOW PLASTIC BOX, LOCATED IN THE OFFICE AREA BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TRAINED ON THE USE OF ANY REQUIRED SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATEIDALS/W ASTE. EMPLOYEES ARE TRAINED AND REQlJIRED TO DIAL FOR EMERGENCY CALLS, ESPECIALLY 9-1-1, AND EVACUATE THE PREMISES. EMPLOYEES ARE TRAINED IN THE USE OF SPILL CLEAN UP SUPPLIES, FIRST AID KITS, AND FIRE EXTINGUISHERS, ELECTRICAL AND GAS SHUT OFF AND USE OF TELEPHONES. EMPLOYEES.ARE TRAINED TO ADVISE ANY RESPONSE AGENCY AS TO THE NATURE AND LOCATION OF THE PROBLEM. INITIAL TRAINING IS CONDUCTED AFTER HIIDNG NEW PERSON. TRAINER IS THE OWNER OR MANGER OF THE STORE. REFRESHER TRAINING IS DONE EVERY YEAR. TRAINING TOPICS ARE SUCH AS : 1) HAZARD COMMUNICATION PROGRAM 2) MATERIALS SAFETY DATA SHEETS, 3) SAFE HANDLING OF CHEMICALS, AND 4) EMERGENCY EQUIPMENT EMERGENCY PLAN CERTIFICATION I, CARLOS L. RODIDGUEZ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEe. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. IRONMENTAL SPECIALIST TITLE 4 e e Employee Training Program Check all boxes which apply. 1. Personnel are trained in the following procedures: 2. Chemical Handlers are additionally trained in the following: 3. Emergency Response Team Members are capable of and engaged in the following: J. Recordkeeping: 1. Check all boxes which apply. The following records are maintained at the facility. [Note: Items marked with an asterzsk (*) are required.}: A copy of the Inspection Check Sheet (s) or Log(s) used in conjunction with required routine self- inspections of your facility must be submitted wÙh your HMBP. (Exception: Available from your local agency is a Hazardous Materials/ Waste Storage Area InspectioI,1 Form that you may use If you do not already have your own form. If you use the example provIded, you do not need to attach a copy.) e e INSPECTION LOG INSPECTION . DATE OBSERVATION CORRECTIVE ITEM & ACTIONS TIME TAKEN AND DATE Hazardous materials storage area: Leaks, containers stored closed, secondary containment intact; labeled Hazardous waste storage area: Leaks, containers stored closed; secondary containment intact; accumulation date; hazardous waste label Safety equipment:Adequate supplies; broken'or missin~; out of date Monitoring equipment:Tested; working properly;Not in alarm condition Emergency Equipment:Adequate supplies; þroken or missin~; out of date Security and containment:Tested regularly; no breaches in fence; NFP A placard at entrance; stora!!e of haz. Wastes and materials secure UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) 0 MATERIAL{NON-WASTE) ~ WASTE DADO Page of DDELETE I8JREVISE REPORTING YEAR I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO AMPM , PSI STORE, FACILITY ID # 05365 CHEMICAL LOCATION INSIDE THE GARAGE AND OUTSIDE YARD FACILITY 10 # E8 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES I8J NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION 205 TRADE SECRET CHEMICAL NAME WASTE ABSORBENT COMMON NAME ABSORBENT WASTE CAS# N/ A FIRE CODE HAZARD CLASSES (Complete if required by CUPA) HAZARDOUS MATERIAL TYPE (Check one item only) D a, PURE Db, MIXTURE 181 c, WASTE DYes I8J No If Subject to EPCRA, refer to instructions 207 209 EHS· 0 Yes I8J No 'If EHS is "Yes", all amounts below must be in Ibs. 211 RADIOACTIVE DYes I8INo 212 CURIES PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a. SOLID I8Ib, LIQUID D c, GAS 214 LARGEST CONTAINER 5 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH D e, CHRONIC HEALTH 2 5 50 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 221 UNITS' Check one item onl STORAGE CONTAINER 181 a , GALLONS Db, CUBIC FEET D c. POUNDS D d, TONS , If EHS. amount must be in ounds, D a, ABOVE GROUND TANK Db, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d. STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f.CAN D g, CARBOY D h, SILO D i. FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q, RAIL CAR 181 n, PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p, TANK WAGON STORAGE PRESSURE 181 a. AMBIENT D c, BELOW AMBIENT D b, ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d, CRYOGENIC D b. ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS 100 226 MIXTURE OF WASTE OIL, HEAVY 227 DYes I8J No PETROLEUM DISTILLATES AND SILICATES 2 230 231 DYes 0 No 3 234 235 DYes 0 No 4 238 239 DYes ONo 5 242 243 DYes ONo CAS # 228 N/A, MIXTURE 232 236 240 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc. or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3' 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 " e e UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not comb(ne material and waste on one form) ~ MA TERIAL(NON-WASTE) D WASTE (one page oer material per building or area) DADO DDELETE I8IREVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AMPM , PSI STORE, FACILITY ill # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM (EPCRA ) DYES 181 NO FACILITY 10 # I I . 1 I JIl 1 I I 1 1 1 1 I MAP# (optional) 2031 GRID# (optional) 204 10F1 E5 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No 206 CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME 207 EHS" DYes 181 No 208 CAS# 124-38-9 209 "If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL 212 -I CURIES 213 TYPE (Check one item only) 181 a, PURE Db, MIXTURE Dc. WASTE 211 RADIOACTIVE DYes I8INo PHYSICAL STATE 215 (Check one item only) D a, SOLID Db, LIQUID 181 c, GAS 214 LARGEST CONTAINER 83 FED HAZARD CATEGORIES 216 (Check all that apply) 181 a, FIRE D b, REACTIVE D c. PRESSURE RELEASE D d, ACUTE HEALTH D e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 166 ' 250 N/A N/A 221 I DAYS ON SITE: 222 UNITS· Da, GALLONS I8Ib, CUBIC FEET D c, POUNDS D d. TONS 365 (Check one item on Iv) . If EHS, amount must be in pounds, STORAGE CONTAINER D a, ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i, FIBER DRUM D m, GLASS BOTTLE D q. RAIL CAR Db, UNDERGROUND TANK D f, CAN D ¡,BAG D n, PLASTIC BOTTLE D r. OTHER Dc, TANK INSIDE BUILDING D g, CARBOY D k, BOX D o. TOTE BIN o d, STEEL DRUM o h, SILO 1811. CYLINDER D p. TANK WAGON 223 STORAGE PRESSURE D a, AMBIENT 181 b, ABOVE AMBIENT D c, BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a, AMBIENT o b, ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 227 DYes 181 No 228 124-38-9 229 2 230 231 DYes DNo 232 233 3 234 235 DYes D No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes DNo 244 245 If more huardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1 % by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [8J MATERIAL(NON-WASTE) o WASTE DADD DDELETE I8IREVISE REPORTING YEAR I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO AMPM , PSI STORE, FACILITY ID # 05365' .- CHEMICAL LOCATION UNDERGROUND STORAGE TANK FACILITY ID # H5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES 181, NO 203 GRID# (optional) 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes 181 No M I DG RAD E If Subject to EPCRA. refer to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes 181 No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) D a, PURE 211 RADIOACTIVE DYes I8JNo 212 CURIES I8Jb, MIXTURE Dc, WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Jb, LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 I8J a, FIRE D b, REACTIVE D c, PRESSURE RELEASE I8J d, ACUTE HEALTH I8J e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT STATE WASTE CODE 10 000 221 UNITS· Check one item onl STORAGE CONTAINER l8Ja. GALLONS Db. CUBIC FEET D c, POUNDS D d, TONS * If EHS. amount must be in ounds, D a, ABOVE GROUND TANK I8J b, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM D e, PLASTIC/NONMETALLIC DRUM D f, CAN D g: CARBOY DIÍ,SILO D b, ABOVE AMBIENT D i. FIBER DRUM D j,BAG D k, BOX D I. CYLINDER D m. GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTlE D r. OTHER D 0, TOTE BIN D p, TANK WAGON STORAGE PRESSURE I8J a, AMBIENT D c, BELOW AMBIENT STORAGE TEMPERATURE I8J a, AMBIENT D d. CRYOGENIC Db, ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 DYes 181 No 226 71-43-2 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER 231 DYes 181 No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes 181 No 236 1330-20-7 4 7-14 236 TOLUENE 239 DYes 181 No 240 1 08-88-3 5 242 243 DYes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 206 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 :> e e .. UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) ~ MATERIAL(NON-WASTE} D WASTE (one Daoe Der material Der buildinq or area) DADO DDELETE I8IREVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AMPM , PSI STORE, FACILITY ID # 05365 CHEMICAL LOCATION 201 . CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVES (EPCRA ) DYES 181 NO FACILITY 10 #, I I I I I I I I I I 1 I MAP# (optional) 203 T GRID# (optional) 204 10F1 F7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No 206 MOTOR Oil If Subject to EPCRA, refer.to instructions COMMON NAME ENGINE Oil, lUBRICANT MOTOR Oil 207 EHS" DYes 181 No 208 CAS# Nt A 209 "If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CompleteifrequiredbyCUPA) COMMBUSTIBlE LIQUID 210 HAZARDOUS MATERIAL 212 I CURIES 213 TYPE (Check one item only) D a, PURE I8Ib, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes 181 No PHYSICAL STATE 215 (Check one item only) D a, SOLID I8Ib, LIQUID D c. GAS 214 LARGEST CONTAINER .25(ONE QUART) FED HAZARD CATEGORIES 216 (Check all that apply) 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE D d, ACUTE HEALTH D e, CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 40 300 NtA NtA 221 I DAYS ON SITE: 222 UNITS· 181 a , GALLONS Db, CUBIC FEET D c, POUNDS D d. TONS 365 (Check one item onlv) " If EHS, amount must be in Dounds, STORAGE CONTAINER D a, ABOVE GROUND TANK, De, PLASTIC/NONMETALLIC DRUM D i, FIBER DRUM D m. GLASS BOTTLE D q. RAIL CAR Db, UNDERGROUND TANK D f, CAN D j,BAG 181 n, PLASTIC BOTTLE D r, OTHER Dc, TANK INSIDE BUILDING D g, CARBOY D k, BOX D 0, TOTE BIN D d, STEEL DRUM D h, SILO D I. CYLINDER D p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 224 , STORAGE TEMPERATURE 181 a, AMBIENT D b, ABOVE AMBIENT D c. BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 lUBRICANT BASE Oil 227 o Ves 181 No 228 N/A, MIXTURE 229 2 5-6 230 'ADDTIVES, ANTI-OXIDANT 231 DYes 181 No 232 NtA, MIXTURE 233 3 234 235 DYes 0 No 236 237 4 238 239 DYes DNo 240 241 5 242 243 DYes DNo 244 245 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1 % by weight If carcinogenic, attach additional she.ets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 , UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) ~ MATERIAL(NON-WASTE) D WASTE (one Dace Der material oer buildino or area) DADO DDELETE I8IREVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AM PM , PSI STORE, FACILITY ID # 05365 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANK (EPCRA ) DYES 181 NO FACILITY ID # I ' I WI 1 I . I 1 1 1 1 11 1 MAP# (optional) 2031 GRID# (optional) 204 10F1 H4 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 181 No 206 PREMIUM If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* DYes 181 No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (CompleteifrequiredbyCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 210 HAZARDOUS MATERIAL 212 I 213 TYPE (Check one item only) D a, PURE I8Ib. MIXTURE Dc. WASTE 211 RADIOACTIVE DYes 181 No CURIES PHYSICAL STATE 215 (Check one item only) D a, SOLID I8Ib, LIQUID D c, GAS 214 LARGEST CONTAINER 10,000 FED HAZARD CATEGORIES 216 (Check all that apply) 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 5,000 10,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS' l8Ia. GALLONS Db. CUBIC FEET D c. POUNDS D ¡j, TONS 365 (Check one item onlv) . If EHS, amount must be in pounds, STORAGE CONTAINER D a; ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i, FIBER DRUM D m, GLASS BOTTLE D q, RAIL CAR 181 b, UNDERGROUND T~NK D f, CAN D j.BAG D n. PLASTIC BOTTLE D r, OTHER Dc, TANK INSIDE BUILDING D g, CARBOY D k, BOX D 0, TOTE BIN D d, STEEL DRUM D h. SILO D I. CYLINDER D p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 224 STORAGE TEMPERATURE 181 a, AMBIENT D b: ABOVE AMBIENT D c, BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 DYes 181 No 228 71-43-2 229 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER ( MTBE) 231 DYes 181 No 232 1634-04-4 233 3 8-1 5 234 XYLENE 235 DYes 181 No 236 1330-20-7 237 4 7-14 238 TOULENE 239 DYes 181 No 240 1 08-88-3 241 5 242 243 DYes DNo 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1 % by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material. OR waste (Do not combine'material and waste on oneform) ~ MATERIAL(NON-WASTE) D WASTE DADO . DDELETE ¡:g: REVISE REPORTING YEAR I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO AMPM , PSI STORE, FACILITY ID # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK 3 FACILITY 10 # CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) DYES ¡:g: NO 202 , 203 GRID# (optional) 204 I 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes ¡:g: No UN LEAD E D If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes ¡:g: No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1B, UN1203 HAZARDOUS MATERIAL TYPE (Check one item only) G5 206 208 210 213 D a, PURE I8Ib, MIXTURE Dc, WASTE 211 RADIOACTIVE DYes I8INo 212 CURIES PHYSIÇAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT 215 D a, SOLID I8Ib: LIQUID D c. GAS 214 LARGEST CONTAINER 10,000 216 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 221 222 217 MAXIMUM DAI~ Y AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 220 5,000 10,000 N/A UNITS' Check one item anI STORAGE CONTAINER 181 a , GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS . It EHS, amount must be in ounds, D a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK . Dc, TANK INSIDE BUILDING D d, STEEL DRUM De. PLASTIC/NONMETALLIC DRUM D f. CAN D g, CARBOY D h, SILO D i, FIBER DRUM D j,BAG D k, BOX D I, CYLINDER D m, GLASS BOTTLE D q, RAIL CAR D n. PLASTIC BOTTLE D r. OTHER D 0, TOTE BIN D p, TANK WAGON 223 STORAGE PRESSURE 181 a, AMBIENT D b, ABOVE AMBIENT D c, BELOW AMBIENT 224 S~ORAGETEMPERATURE 181 a, AMBIENT Db, ABOVE AMBIENT D c. BELOW AMBIENT D d. CRYOGENIC 225 O/OWT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 o Yes ~ No 228 71-43-2 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER 231 DYes ¡:g: No 232 1634-04-4 3 8-15 234 XYLENE 235 DYes ¡:g: No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes ¡:g: No 240 1 08-83-3 5 242 243 DYes DNo 244 229 233 237 241 245 It more hazardous components are present at greater than 1% by weight It non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. . ADDITIONAL LOCALLY COLLECTED INFORMATION 246, UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on oneform) ~ MATERIAL(NON-WASTE) D WASTE DADD DDELETE " ~REVISE REPORTING YEAR I. . FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO AMPM , PSI STORE, FACILITY ID # 05365 CHEMICAL LOCATION UNDERGROUND STORAGE TANK """ F5 CHEMICAL LOCATION CONFIDENTIAL (EPCRA ) 0 YES ~ NO 203 GRID# (optional) FACILITY ID # 10F1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET 0 Yes ~ No UN LEAD E D If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* 0 Yes ~ No CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL TYPE (Check one item only) D a: PURE 211 RADIOACTIVE DYes I8INo 212 CURIES I8Ib, MIXTURE Dc. WASTE PHYSICAL STATE (Check one item only) FED HAZARD CATEGORIES (Check all that apply) AVERAGE DAILY AMOUNT D a, SOLID I8Ib, LIQUID D c. GAS 214 LARGEST CONTAINER 10,000 181 a, FIRE D b, REACTIVE D c, PRESSURE RELEASE 181 d, ACUTE HEALTH 181 e, CHRONIC HEALTH 5,000 N/A 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT STATE WASTE CODE 10,000 UNITS· Check one item onl STORAGE CONTAINER l8Ia, GALLONS Db, CUBIC FEET D c, POUNDS D d, TONS * If EHS, amount must be in ounds, 221 D a, ABOVE GROUND TANK 181 b, UNDERGROUND TANK Dc, TANK INSIDE BUILDING D d, STEEL DRUM De, PLASTIC/NONMETALLIC DRUM D f, CAN D g, CARBOY D h, SILO D i, FIBER DRUM D ¡,BAG D k, BOX D I. CYLINDER D m, GLASS BOTTLE D n, PLASTIC BOTTLE D 0, TOTE BIN , D p. TANK WAGON D q, RAIL CAR D r, OTHER STORAGE PRESSURE 181 a, AMBIENT D c, BELOW AMBIENT D b, ABOVE AMBIENT STORAGE TEMPERATURE 181 a, AMBIENT D d, CRYOGENIC D b, ABOVE AMBIENT D c, BELOW AMBIENT %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1-5 226 BENZENE 227 o Yes ~ No 228 71-43-2 2 0-1 5 230 METHYL TERTIARY BUTYL ETHER 231 DYes ~ No 232 1634-04-4 3 8-1 5 234 XYLEN E 235 o Yes ~ No 236 1330-20-7 4 7-14 238 TOLUENE 239 DYes ~No 240 1 08-83-3 5 242 243 DYes DNo 244 If more hazardous components are present at greater than 1% by weight If non-carclnogenlc, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 3 202 204 206 208 210 213 215 216 220 222 223 224 225 229 233 237 241 245 246 ~f':~ -./:~- ..4RCð 11- -E'¥1£ j¡x;¡ jf~I/g4. AM PM MINI MARKET #5365 ~ Manager : Location: 4010 WIBLE RD City BAKERSFIELD SiteID: 015-021-000564 BusPhone: Map : 123 Grid: 13A (805) 836-9685 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: -" SIC Code:5541 DunnBrad:51-012-0713 Emer~ency Contact / Title RAUL ;ŒNA t.ktl/ MANAGER Business Phone: ~ 836-9685x 24-Hour Phone Ø/~ 835-1377x Pager Phone () x Emergency Contact .L Title ' KElVIN KI~EDAoc€D /NtIP11!11/J1tcc¡ Pi:J:!.l.JU ~U.t'I!:W.T~O Business Phone: (B-Q~r ~~9 4203Xj.~ . 24-Hour Phone (~~/2-6349x~ðÐ) Pager Phone () x 1JI(âJ-, '{h' Hazmat Hazards: Fire Press ImmHlth DelHlth Owner Address City PRESTIGE STATIONS PO BOX 5077 BUENA PARK ,~ '-" Phone: (111{ ) (P?O - sz;o L State: CA Zip 906225077 Contact : l~ MailAddr: ro BOX 5077 City BUBllA :fJARIC ENVIRON. SERVICES Phone: (714) 670 State: CA Zip 906225077 S13~J[ SjtJ2-.. Period Preparer: Certif'd: to TotalASTs: TotalUSTs: = RSs: No Gal Gal Emergency Directives: I, hereby certify that I have (Type or print name) reviewed the attache azardous materials manage- ment plan for-BRW#- ~~~d that it along with (Name of Business) any corrections constitute a complete and correct man- agement plan for fRY facility. , Û~' ~JI&r þ/(,þ-ooo Date -1- 10/31/2000 .~ .....,Ji " - - STORA E ONTAINER DATA UST FORM A Last Action Type: FACILITY/SITE INFORMATION Business Name: AM PM MINI MARKET #5365 Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : ~ErvTIll REED ~to Phone: (~ðS} :)8~ 420J][- Address: (:zIt{) C,7o-sHO "") City : State: Zip: Type : TANK OWNER INFORMATION Name : KEVIN ~EEV ~~ Phone: ~Sg8) ~OJ 420J]C~ Address: (j/~ ~'?O-g¡ lY2- '. City : State: Zip: Type : BOE UST Fee# : 000506 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/01/1999 ~ Phone: (714) 670 ~H)1][ Name :W~LLI.M1 pq ~l\.PKnh· /.. ~~"t"2..!rtl: ENVIRON. ADMIN. STlO2- State UST # : 1998 Upg Cert#: G C SiteID: 015-021-000564 ì ) F AM PM/MINI MARKET #5365 F Hazmat Inventory One Unified List ì f== As Designated Order All Materials at Site ì Hazmat Common Name.. . SpecHaz EPA Hazards DailyMax MCP GASOLINE MIDGRADE UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE ARCO UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE ARCO UNLEADED F IH DH L 10000.00 GAL Mod CARBON DIOXIDE F P IH G 448.00 FT3 Min GASOLINE ARCO EC-PREMIUM F IH DH L 10000.00 GAL Mod -2- 10/31/2000 ,{-. - e F AM PM MINI MARKET #5365 p= Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME GASOLINE MIDGRADE UNLEADED SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: , Grid: CAS # 8006-61-9 [ ~TA~E I TYPE -----r: P~ESSURE ~ TEMPERATURE I CONTAINER TYPE ~L~qu~d __pure ~mb~ent ---1 Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3000.00 GAL HAZARDOUS COMPONENTS ~ CAS#a006619 I l~~~ôoIGaSOline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod p= Inventory Item 0002 ;::::= COMMON NAME / CHEMI CAL NAME GASOLINE ARCO UNLEADED Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt, ·1 100.00 Gasoline HAZARDOUS COMPONENTS ~ No CAS#a006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -3- 10/31/2000 r¡ T e e F AM PM MINI MARKET #5365 p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME GASOLINE ARCO UNLEADED SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %WL I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 D A MEN TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod , HAZAR SSESS TS p= Inventory Item 0004 = COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 124-38-9 STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 224.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 ARD N %'Wt. RS CAS # 100.00 Carbon Dioxide No 124389 HAZ OUS COMPO ENTS HAZARD A E SMEN TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min SS S TS -4- '10/31/2000 .' 'i e e F AM PM MINI MARKET #5365 p= Inventory Item 0005 = COMMON NAME / CHEMICAL NAME GASOLINE ARCO EC-PREMIUM SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS#a006619 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -5- 10/31/2000 ~ ~ e e F AM PM MINI MARKET #5365 I p= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-000564 9 Fast Format ì Overall Site 9 03/10/1998 CALL 911. THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT. Employee Notif./Evacuation 07/24/1990 IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. Public Notif./Evacuation 03/10/1998 EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING. Emergency Medical Plan 03/10/1998 MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7. -6- 10/31/2000 ...";'-.. 1'"\ e e F AM PM MINI MARKET #5365 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000564 ì Fast Format ì Overall Site ì 11/18/1993 FACILITY UTILIZES FOUR 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. Release Containment 11/18/1993 FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK",· AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. Clean Up 11/18/1993 CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. Other Resource Activation -7- 10/31/2000 ".i· ; J'~ " e e F AM PM MINIMARKET #5365 I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 015-021-000564 ì Fast Format ì Overall Site ì I 03/10/1998 A) GAS - N/A B) ELECTRICAL - E SIDE OF BLDG IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE RD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO Fire Protec./Avail. Water 03/10/1998 PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. NEAREST FIRE HYDRANT - LOCATION N OF WHITE LN ON WIBLE RD APPROXIMATELY 200 FT FROM INTERSECTION. Building Occupancy Level -8- 10/31/2000 ~' ~ .;:-:.(~ e e \. F AM PM MINI MARKET #5365 I F Training Employee Training SiteID: 015-021-000564 1 Fast Format 1 Overall Site 1 03/10/1998 WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. Page 2 I I I Held for Future Use Held for Future Use -9- 10/31/2000 ~"., , ,(....~+_...~_-:r: - /\ (/ ~~- I, AM PM MINI MARKET #5365 SiteID: 015-021-000564 Manager : Location: 4010 WIBLE RD City BAKERSFIELD BusPhone ': Map : 123 Grid: 13A (80S) 836-9685 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPANumb: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact / Title Emergency Contact / Title, RAUL RENA / MANAGER KEVIN' REEß £0 ðSIA/,SIU / FIELD SUPERVISO Business Phone: (80S) 836-9685x Business Phone: ( -&05 ) 509 4. J 0 3x SRc:rll~S , 24-HourPhone : (80S) 835-1377x 24-Hour Phone : (-8-&07- 272 63 4. 9;x 3~5 .mB Pager Phone : ( ) - x Pager Phone : (~11 ) S S'1 - d.-..H:)., x .' Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: PO BOX 5077 State: CA City : BUENA PARK Zip : 906225077 , Owner PRESTIGE STATIONS Phone: (714) 670-5136x Address : PO BOX 5077 State: CA City : BUENA PARK Zip : 906225077 Period : to TotalASTs: = Gal I Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: II.b1>e td\ I, Í) ~ RAve. {£.";f\, Do hereby certify that I have , (Type or print name) reviewed the attached hazardous materials manage- ment plan for A~(Ð AMPM and thatit along with (Name of Business) any correctionsc"onstitute a complete and correct man- '. ~ agement plan fòr my facility. //~g(2~v J 7 ~:l2 -fYo Date -1- 11/28/2000 ;:/ ',' /fii e e F AM PM MINI MARKET #5365 STORAG E C AINER A US FRMA Last Action Type: F ", FACILITY/SITE INFORMATION Business Name: AM PM MINI MARKET #536'5 I Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : KEVIN REED Phone: (805) 589-4203x Address: City : State: Zip: Type : TANK OWNER INFORMATION Name : KEVIN REED Phone: (805) 589-4203x Address: City : State: Zip: Type : BOE UST Fee# : 000506 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/01/1999 Phone: (714) 670-5404x Name:WILLIAM M ZAPKIN Ttl:ENVIRON. ADMIN. State UST # : 1998 Upg Cert#: ONT DAT T 0 SiteID: 015-021-000564 ì ) p= Hazmat Inventory One Unified List ì p== As Designated Order All Materials at Site ì Hazmat Common Name.. . SpecHaz EPA Hazards DailyMax MCP GASOLINE MIDGRADE UNLEADED F IH DH L 10000.00 GAL Mod ( GASOLINE ARCO UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE ARCO UNLEADED F IH DH L 10000.00 GAL Mod CARBON DIOXIDE F P IH G 448.00 FT3 Min GASOLINE ARCO EC-PREMIUM F IH DH L 10000.00 GAL Mod 'g -2- 11/28/2000 i(- .;¡ e e F AM PM MINI MARKET #5365 p= Inventory Item 0001 F= COMMON NAME / CHEMI CAL NAME GASOLINE MIDGRADE UNLEADED SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE --¡ TEM~ERATURE ~ CONTAINER TYPE =L1qu1d __pure ~mb1ent ---1 Amb1ent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average , 10000.00 GAL 10000.00 GAL 3000.00 GAL %WL I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS#a006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod p= Inventory Item 0002 F= COMMON NAME / CHEMICAL NAME GASOLINE ARCO UNLEADED Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL HAZARDOUS COMPONENTS ~ No CAS#a006619 %Wt. I :. 100,00 Gaso1ine HAZARD ASSESSMENTS TSecret RS' BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -3- 11/28/2000 ~ e e F AM PM MINI MARKET #5365 F Inventory Item 0003 F= COMMON NAME / CHEMICAL NAME GASOLINE ARCO UNLEADED SiteID: 015-021-000564 , Facility Unit: Fixed Containers on Site, Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ----¡-; P~ESSURE -¡ TEM~ERATURE I = Ll.qul.d __pure ~mbl.ent ----1 Ambl.ent ~ AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL Daily Average 5000.00 GAL %WL I 100.00 Gasoline HAZARDOUSJCOMPONENTS ~ CAS#a006619 MEN TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESS TS F Inventory Item 0004 = COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Facility Unit: Fixed Containers on Site, Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 124-38-9 STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 224.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 HAZARDO %Wt. RS CAS # 100.00 Carbon Dioxide No 124389 US COMPONENTS HAZARD ASSESSMENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min S -4- 11/28/2000 ? e e F AM PM MINI MARKET #5365 p= Inventory Item 0005 i== COMMON NAME / CHEMICAL NAME GASOLINE ARCO EC-PREMIUM SiteID: 015-021-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 [, ~TA~E I ~YPE ~ P~ESSURE. ---r. TEM~ERATURE -I =L~qu~d __M~xtur~ Amb~ent ---1 Amb~ent ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 10000.00 GAL 10000.00 GAL CONTAINER TYPE UNDER GROUND TANK Daily Average 5000.00 GAL %WL I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS#a006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 11/28/2000 ~ e e SiteID: 015-021-000564 ì Fast Format ì Overall Site ì 03/10/1998 F AM PM MINI MARKET #5365 I f= Notif./Evacuation/Medical Agency Notification CALL 911. THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT. Employee Notif./Evacuation 07/24/1990 IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. Public Notif./Evacuation 03/10/1998 EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING. Emergency Medical Plan 03/10/1998 MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7. -6- 11/28/2000 ~. e e F AM PM MINI MARKET #5365 I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-000564 9 Fast Format 9 Overall Site ì 11/18/1993 FACILITY UTILIZES FOUR 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. Release Containment 11/18/1993 FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. Clean Up 11/18/1993 CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. Other Resource Activation -7- 11/28/2000 f-.,. ;. e e F AM PM MINI MARKET #5365 I f= Site Emergency Factors [:: Special Hazards Utility Shut-Offs SiteID: 015-021-000564 ì Fast Format ì Overall Site ì I 03/10/1998 A) GAS - N/A B) ELECTRICAL - E SIDE OF BLDG IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE RD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO Fire Protec./Avail. Water 03/10/1998 PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. ·1 NEAREST FIRE HYDRANT - LOCATION N OF WHITE LN ON WIBLE RD APPROXIMATELY 200 FT FROM INTERSECTION. Building Occupancy Level -8- 11/28/2000 .,' ':' e F AM PM MINI MARKET #5365 I F Training Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. e SiteID: 015-021-000564 ì Fast Format ì Overall Site ì 03/10/1998 BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. Page 2 I I I , Held for Future Use Held for Future Use -9- 11/28/2000 ~ - \ CUSr-.E & NO. ~S 'd·ct9s9 MISCELLANEOUS RECEIVABLES ADJUSTMENT - i· ..,.:!: . DATE ~-~b'C{S NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT ¡ . FINANCE CHARGE I , OTHER ADJ i CUSTOMER NAME À M .p M ~\(\\ Mû(ket ~\:(Ù Pr()d~ds> ComFY MAILING ADDRESS p- O. &Y... é-J2J3?) CITY áí-\~c;,Q STATE r * SITE ADDRESS 40 I D LJ It b \ €- ed S~bÇ ZIP CODE 9{)"7('})-(JJ3 PARCEL NUMBER (IF APPUCABLE) ADJUSTMENT REMARKS: ~~ ~~(" 5of- cìo..Î.3~ ~hc:Jd 'lIe_ (9f\\Y bee~ ---' APPROVED BY 4~ ". .¡ e AM PM MINI MARKET #5365 Manager : Location: 4010 WIBLE RD City BAKERSFIELD 9 1998 CommCode: BAKERSFIELD STATION 07 EPA Numb: ..., Emergency Contact J.oRCE AV.TþPR'l Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / MANAGER (805) 836-9685x (805) 831 771.1x ¡" ( ) ~ 3 ~- t 3 t~ Emergency Directives: .' BusPhone: Map : 123 Grid: 13A SiteID: 215-000-000564 (805) 836-9685 ComrnHaz : Low FacUnits: 1 AOV: SIC Code:5541 DunnBrad:51-012-0713 Emergency Contact KEVIN REED Business Phone: 24-Hour Phone Pager Phone Fire Press / Title / FIELD SUPERVISO (805) 589-4203x (800) 272-6349x () x ImrnHlth DelHlth One Unified List l All Materials at Site l SpecHaz EPA Hazards DailyMax MCP F IH DH L 10000 GAL Mod F IH DH L 10000 GAL Mod F IH DH L 10000 GAL Mod F IH DH L 10000 GAL Mod F P IH G 448 FT3 Min J, f= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... GASOLINE MIDGRADE UNLEADED GASOLINE ARCO UNLEADED GASOLINE ARCO UNLEADED GASOLINE ARCO EC-PREMIUM CARBON DIOXIDE I, :) c ~ ¡/ t ~,J", lQ)@ oor&Jby OOU'ÛB~ ~hat ~ ~®\1® ~Ot~~~) i'<Wi~'W®@ ~~S ~OO~ ~&!2Z~~~ M~~®trit&l$ MM~~®D m®fI1I~ ~n ~@r A /I/J "R"Þ1 ®oo ~~ ö~ ~~tn@ wï¡h (~~) @WI~ oorr~dions OOIN$~i~u~rs a oomplet~ and OOiT®©iì MSlri- a@Sm~fI1I~ ~~¡'j) gi:) i' my ~cmtty. ~ ¿-4P ___ nature ' éJ"J-09r7 f ~ -1- 03/09/1998 e e F AM PM MINI MARKET #5365 p= Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME GASOLINE MIDGRADE UNLEADED SiteID: 215-000-000564 l Facility Unit: Fixed Containers on Site l Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum '10000.00 GAL : Daily Average 3000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS 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 F== COMMON NAME / CHEMICAL NAME GASOLINE ARCO UNLEADED Facility Unit: Fixed Containers on Site l Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE Liquid TYPE Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt, RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMENTS -2- 03/09/1998 - - F AM PM MINI MARKET #5365 p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME GASOLINE ARCO UNLEADED SiteID: 215-000-000564 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS HA T TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ZARD ASSESSMEN S p= Inventory Item 0005 = COMMON NAME / CHEMICAL NAME GASOLINE ARCO EC-PREMIUM Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit S OF LOT Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 5000.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -3- 03/09/1998 e e F AM PM MINI MARKET #5365 p= Inventory Item 0004 F== COMMON NAME / CHEMICAL NAME CARBON DIOXIDE SiteID: 215-000-000564 1 Facility Unit: Fixed Containers on Site 1 Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 124-38-9 STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT, PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 448.00 FT3 Daily Average 224.00 FT3 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min HAZARD ASSESSMENTS -4- 03/09/1998 e e F AM PM MINI MARKET #5365 I f= Notif./Evacuation/Medical Agency Notification SiteID: 215-000-000564 , Fast Format , Overall Site , 07/24/1990 CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT Employee Notif./Evacuation 07/24/1990 IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. Public Notif./Evacuation 07/24/1990 EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING Emergency Medical Plan 07/24/1990 MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 -5- 03/09/1998 e e F AM PM MINI MARKET #5365 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000564 ì Fast Format ì Overall Site ì 11/18/1993 FACILITY UTILIZES FOUR 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. Release Containment 11/18/1993 FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS, Clean Up 11/18/1993 CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. Other Resource Activation -6- 03/09/1998 ,; , . . e e F AM PM MINI MARKET #5365 I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-000564 ì Fast Format ì Overall Site ì I 03/20/1990 A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO Fire Protec./Avail. Water 03/20/1990 PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION, INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. Building Occupancy Level ----- -7- 03/09/1998 r-. : ' '. '= e F AM PM MINI MARKET #5365 I F Training Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE e SiteID: 215-000-000564 ì Fast Format ì Overall Site ì 03/20/1990 BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. Page 2 [ I I Held for Future Use Held for Future Use -8- 03/09/1998 ____~:::I ...f~ .. "-' - ~:~ ¡-+'. ·..i ~- - f<-LO!J. ç"! ~ :;- ! P fI if S7 (, Y ~ ~(Ç~DW AUG 291996 ~ e 1 , ~ 07/26/96 AM PM MINI MARKET #5365 215-000-0005 Overall Site with 1 Fac. Unit General Information Location: 4010 WIBLE RD City : BAKERSFIELD Map:123 Haz:2 Type: 3 Grid: 13A FlU: 1 AOV: 0.0 Contact Name JORGE ALVAREZ Business Phone: 24-Hour Phone Pager Phone Title / MANAGER (805) 836-9685x f89S) 53] 6246x~ ( ) - X'" Contact Name l,;l1td5 1fAIUt ~ Business Phone: 24-Hour Phone Pager Phone Title / FIELD SUPERVISO ~S()5) 8~é 9é8§JC & (866) 553 624~x@ () x Owner: Address: City: ~R~ES~~1[ &25 215-007 BAKERSFIELD STATION 07 PRESTIGE GTA!I~3Cè~) P U JjuX 6225 ~ A.RTE8Ih 9 ,ðdministrative Data ~ D&B Number: 51-012-0713 State: CA Zip: ~ÐYa2-~ SIC Code: 5541 Mail Addrs: City: Comm Code: _ @ Phone: .( 310) 462 12Y8' State: CA Zip: ~a702 ® Summary TANKS: HAS OWNER OPERATOR AGREEMENT HAS FINANCIAL RESPONSIBILITY HAS SPILL RESPONS AND MONITORING PLAN I, JJ w,el (;,OJ\ 0..7 Do hereby certify that 1 have ype Of prlnt name) reviewed the attached hazardous materials manage- ~-- M"y\',' ~d:.~t /:t}! (, c¡ ment plan fof ' and that It a10ng with (Nama of BuaJness) any corrections constitute a complete and correct man· agement plan for my facility. (0 (~oS')'i3/-17<11 & µvil'\ R..e.e.J 6) (9t)5"') >~f - f.(~~ @) (f'bC) ø-7~'" fc ') <11 (0 po f3..0x )07ì @ f3 u ~Q. P~("k. (£ 90Cø ~~- $'"077 ® PO ~x !)o17 ~ ßv~ø.... P c.flc ® t6 (1P() C, 70-'> '~b @ 90lP J.).; - >~ 77 ,~Yßvf~ s/z,/ø /cU~ I DIJB e e 07/26/96 AM PM MINI MARKET #5365 215-000-000564 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-003 GASOLINE ARCO UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 GASOLINE ARCO UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-001 GASOLINE MIDGRADE UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-005 \ASOLINE ARCO EC-PREMIUM Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 448 Minimal ~ Fire, Pressure, Immed Hlth FT3 e e 07/26/96 AM PM MINI MARKET #5365 215-000-000564 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-003 GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL .~ Annual Amount GAL -- 10,000 5,000.00 I 850,000.00 Storage UNDER GROUND TANK r Press T Temp ~I Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components r; MCP --rGuide Moderate 27 02-002 GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 I 5,000.00 I 850,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components r; MCP ~Guide Moderate, 27 02-001 GASOLINE MIDGRADE UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 10,000 3,000.00 I 330,000.00 Storage UNDER GROUND TANK r Press T Temp ~ Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components I~ MCP ~Guide Moderate 27 e e 07/26/96 AM PM MINI MARKET #5365 215-000-000564 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-005 \ASOLINE ARCO EC-PREMIUM ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 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 -- 10,000 5,000.00 I 200,000.00 Storage UNDER GROUND TANK r Press T Temp -:ì Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components r; MCP -¡Guide Moderate 27 02-004 CARBON DIOXIDE ~ Fire, Pressure, Immed Hlth Gas 448 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 448 I 224.00 I 5,824.00 Storage r Press T Temp -:I PORT. PRESS. CYLINDER Ambient Ambient Location - Conc l 100.0% Carbon Dioxide Components ~ MCP -¡Guide Low I 21 e e 07/26/96 AM PM MINI MARKET #5365 215-000-000564 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 e e 07/26/96 AM PM MINI MARKET #5365 215-000-000564 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention FACILITY UTILIZES FOUR 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. <4> Other Resource Activation . . e - 07/26/96 AM PM MINI MARKET #5365 215-000-000564 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) , 07/26/96 e e AM PM MINI MARKET #5365 215-000-000564 Page 8 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. <4> Building Occupancy Level ~ " . e . 07/26/96 AM PM MINI MARKET #5365 215-000-000564 00 - Overall Site Page 9 <G> Training <1> Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 <3> Held for Future Use <4> Held for Future Use ·' '.- e . Psi ~ 5lbc.j , - F11)-Co .,J- t:i pb ç 215-000-000564 Page Fac. Unit 1 ...-' ~ 01/31/95 AM PM MINI MARKET #5164 Overall Site with 1 General Information Location: 4010 WIBLE RD City : Bakersfield Map:123 Haz:2 Type: 3 Grid: 13A FlU: 1 AOV: 0.0 Contact Name JORGE ALVAREZ Business Phone: 24-Hour Phone Pager Phone Title I MANAGER (805) 836-9685x (805) 831 7741X (~ ) .,e¡1; - I:;l.c!løx Contact Name CHRIS WARR Business Phone: 24-Hour Phone Pager Phone Title I FIELD SUPERVISO (805) 6-65 146~}(~~-q (800) 553-6246x () x Administrative Data Mail Addrs: P.O. BOX 6225 City: ARTESIA Comm Code: 215-007 BAKERSFIELD STATION 07 D&B Number: 51-012-0713 State: CA Zip: 90702- SIC Code: 5541 Owner: PRESTIGE STATIONS Address: P.O. BOX 6225 City: ARTESIA Phone: (310) 402-1278 State: CA Zip: 90702- Summary TANKS: HAS OWNER OPERATOR AGREEMENT HAS FINANCIAL RESPONSIBILITY HAS SPILL RESPONS AND MONITORING PLAN ~ FEB 13 1995 ~ By I, l¥~:Q.~,j..;.\j}Mo hereby certify that I have reviewed the-attached hazardous materials mar~e. j /fJA (P(/l 11\/'rt. ~rr -II $1fí'/ ' ment plan for and that it along with (Name or BulIMIa) any corrections constitute a complete and correct man- agementplan for my facility. \. .~_ trxh ß-~7) ! c¡r.. .' e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-003 GASOLINE ARCO UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 GASOLINE ARCO UNLEl:\.DED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-001 GASOLINE MIDGRADE UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-005 GASOLINE ARCO EC-PREMIUM Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth 02-004 CARBON DIOXIDE Gas 448 Minimal ~ Fire, Pressure, Immed Hlth FT3 e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-003 GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 -----r- Daily Ave~a<JE!_~-¡ I ~OO I t? OOÒ r Press T Temp ~ Ambient AmbientlS OF LOT Storage UNDER GROUND TANK - Cone l 100.0% Gasoline Components r; MCP ~Guide Moderate 27 Annual Amoun~- ~OO.OO, g-t7V , l!JC"Ò Location 02-002 GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL -----r- Daily Average GAL -¡ 10,000 I 5,000.00 I Storage UNDER GROUND TANK r Press T Temp ~ Ambient AmbientlS OF LOT - Cone -I 100.0% Gasoline Components 1-; MCP ~Guide Moderate 27 Annual _ ~~~- ~~OO.~p . ~'Öt> "øoð Location 02-001 GASOLINE MIDGRADE UNLEADED ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 -----r- Daily Ave~a~~-¡ I ~O.~O I Ô rOoO r Press T Temp ~ Ambient Ambient S OF LOT Storage UNDER GROUND TANK - Cone l 100.0% Gasoline Components r; MCP ----p;uide Moderate 27 Annuëil Amount ~ ~.OO ~ÐOe.~ Location e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-005 GASOLINE ARCO EC-PREMIUM ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max 10,000 I Daily Averag~ ~O ._00 I ¡..f ,(JOO r Press T Temp ~ Ambient Ambient S OF LOT Annual.~~~~ ~_uO_O...::~O . ?A& I OOÔ Locatiorf - Storage UNDER GROUND TANK - Conc -, 100.0% Gasoline Components r; MCP ---p;uide Moderate 27 02-004 CARBON DIOXIDE ~ Fire, Pressure, Immed H1th Gas 448 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 448 224.00 5,824.00 Storage r Press T Temp -:-, PORT. PRESS. CYLINDER Ambient Ambient Location - Conc l 100.0% Carbon Dioxide Components ~ MCP ---p;uide Low I 21 e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT i <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention FACILITY UTILIZES FOUR 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. <4> Other Resource Activation e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) ~ e e 01/31/95 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 8 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO <3>, Fire Protec./Avai1. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. <4> Building Occupancy Level ~ ' , ~ . e e ~ 01/31/95 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 9 <G> Training <1> Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 <3> Held for Future Use <4> Held for Future Use ~ ;1", BAKERSFI'ELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 2130 "G" STREET BAKERSFIELD, CA. 93301 (805) 326-3979 /' RECEIVED Nav 0 3 1993 HAZ. MAT. DIV. HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION I ,'¡ CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME PRESTIGE STATIONS. INC. #5164 FACILITY NAME AM/PM MINI MARKET #5164 'I SITE ADDRESS 4010 Wible Road CITY Bakersfield NATURE OF BUSINESS SIC CODE 5541 STATE CA ZIP 93309 Convenience Store with Retail Gas Sales DUN & BRADSTREET NUMBER 510120713 OWNER/OPERATOR MAILING ADDRESS CITY Artesia PRESTIGE STATIONS. INC. PHONE 1310] 402-1278 c/o E. H & S - Post Office Box 6225 STATE, CA ZIP 90702 EMERGENCY CONTACTS NAME Jorge Alvarez TITLE Facility Manager BUSINESS PHONE ~ 836-9685 24-HOUR PHONE ~ 831-7741 NAME Chris Warr BUSINESS PHONE 131m 402-1278 TITLE Field Supervisor 24-HOUR PHONE mom 553-6246 Septerrber 30. 1992 REGION V LEPC STANDARD ...... \ . . BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page 1 of -ª Business Name AM/PM MINI~MARKET #5164 Address 4010 Wible Road, Bakersfieldl CA 93309 , CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [] Addition [ ] Revision'[X] Deletion [ ] Check if chemical is a NON TRADE SECRET [X] TRADE SECRET [] , / 2) Common Name: ARca MIDGRADE UNLEADED GASOLINE 3) DOT # (optional) 1203 , Chemical Name: GASOLINE AHM[] CAS # 08006.61.9 4) PHYSICAL & HEALTII PHYSICAL HEALTH HAZARD CA lEGORIES Fire [X] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [X] 5) W ASlE a..ASSIFICA TION (3 Digit Code From DHS Fonn 8022) USE CODE 12. 6) PHYSICALSTAlE Solid [] Liquid [X] Gas[ ] Pure [ ] Mixture [X] Waste [ ] Radioactive [ ] 1) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10.000 Ibs [] gal [X] ft3 [ ] a) Container: 01 . Undel'1!J'ound Average Daily Amount: 4.000 r curies [ ] b) Pressure: 1. Ambient Annual Amount: 400.000 c) Temperature 4. Ambient Largest Size Container: 10.000 # Days on Site: 365 Circle Which Months: All year: J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CASlI %WT AHM the three most hazardous 1)~ 1330.20.7 1:l.5!i. [ ] chemical components or 2) Methy Tertlarv Butyl Ether 1634.04.4 J!.:œi. [ ] any AHM components 3) Toulene 108-88·37 1.:1.ö. [ ] , 10) Location: SOUTH SIDE OF SITE (TANK #n >, 'I CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [] Addition [ ] Revision' [X] Deletion [ ] Check if chemical is a NON TRADE SECRET [X] TRADE SECRET [ ] 2) Common Name: ARca UNLEADED GASOLINE / 3) DOT # (optional) 1203 Chemical Name: GASOLINE - AHM[] CAS # 08006·61-9 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CA lEGORIES Fire [X] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [X] 5) W ASlE a..ASSIFICA TION (3 Digit Code From DHS Fonn 8022) USE CODE 12. 6) PHYSICAL STAlE Solid [ ] Liquid [X] " Gas[ ] Pure [ ] Mixture [X] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10.000 Ibs [] gal [X] ft3 [ ] a) Container: 01 . Under\'l'ound Average Daily AmOlDlt: 5.000 curies [ ] b) Pressure: 1 Ambient Annual Amount: 1.000.000 c) Temperature 4. Ambient Largest Size Container: 10.000 " # Days on Site: 365 " Circle Which Months: All year: J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CASlI %WT AHM the three most hazardous 1)~ 1330.20.7 1:l.5!i. [ ] chemical components or 2) Methv Tertiary Butvl Ether 1634-04-4 J!.:œi. [ ] any AHM components 3) Toulene 108,88-37 1.:1.ö. [ ] 10) Location: SOUTH SIDE OF SITE ITANK#2) I certify under penaffy of law, that I have personally examined and am familiar with the Information submitted on this and all :~:::O:~:~::::~:~~:::~:~:~:~:I:::~~m~ ~P/~¡~~~ 1~~ Print Name & Title of Authorized Company Representative Signature Date Septerrber 30. 1992 REGION V LEPC STANDARD FORM , . . BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page 2 of a Business Name AMlPM M{NI MARKET #5164 Address 4010 Wible Road. Bakersfield. CA 93309 CHEMICAL DESCRIPTION 1) INVENTORYSTATIJS: New(] Addition [ ] Revision [X] Deletion [ ]i Check if chemical is a NON mADE SECRET [X] mADE SECRET [ ] 2) Common Name: ARCO UNLEADED GASOLINE ./ 3) DOT 1# (optional) 1203 - AHM[] Chemical Name: GASOI,INE CAS 1# 08006.61.9 4) PHYSICAL & HEAL 111 " PHYSICAL HEAL11I HAZARD CATEGORIES Fire [X] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [X] 5) WASTE CLASSIFICATION (3 Digit Code From DHS Fonn 8022) USE CODE 12 6) PHYSICALSTATE Solid [ ] Liquid [X] Gas[ ] Pure [ ] Mixture [X] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 10 000 Ibs [] gal [X] ft3 [ ] a) Container: 01 . Undenn-ound Average Daily AmOlDlt: 5.000 curies [ ] b) Pressure: 1. Ambient Annual AmOlDlt: 1.000.000 c) Temperature 4. Ambient Largest Size Container: 10.000 1# Days on Site: 365 Circle Which Months:, All year: J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CASI# %WI' AHM the three most hazardous I)~ 1330-20-7 I:Jä. [ ] chemical components or 2) Methv Tertian Butvl Ether 1634-04-4 .!l:Jä. [ ] any AHM components 3) Toulene 108-88-37 1:1ö. [ ] 10) Location: SOUTH SIDE OF SITE frANK #3 ) CHEMICAL DESCRIPTION I) INVENTORY STATUS: New [] Addition [ ] Revision'[X] Deletion [ ] Check if chemical is a NON mADE SECRET [X] mADE SECRET [ ] / I 2) Common Name: ARCO EC-PREMIUM GASOLINE 3) DOT 1# (optional) 1203 Chemical Name: GASOLINE AHM[] CAS 1# 08006,61-9 4) PHYSICAL&HEAL11I PHYSICAL HEAL 111 HAZARD CATEGORIES Fire [X] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [X] 5) WASTE CLASSIFICATION (3 Digit Code from DHS Fonn 8022) USE CODE 12 6) PHYSICALSTATE Solid [] Liquid [X] Gas[ ] Pure [ ] Mixture [X] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily AmolDlt: 10.000 Ibs [] gal [X] ft3 (J a) Container: 01 . Undereround Average Daily AmOlDlt: 4.000 curies [ ] b) Pressure: 1. Amhlent Annual AmOlDlt: 470.000 ., c) Temperature 4. Ambient Largest Size Container: 10.000 1# Days on Site: 365 Circle Which Months: AIl year: J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CASI# %WI' AHM the three most hazardous 1) Hvdrocarhons JWW: 80·100% [ ] chemical components or 2) Metbv Tertiarv Butvl Ether 1634·04.4 ~ [ ] any AHM components 3) Toulene 108·88.37 ~ [ ] 10) Location: SOUTH SIDE OF SITE frANK #4) I certify under penalty of law, that I have personally examined and am familiar with the Information submitted on this and all attached documents. , I beneve tha submlttedlnlormatlon Is 'l1Ie, BCCUtats, ::;~et;fL i ,'\ /1 ~ NANCY B. WALT!. MGR.'ENVIRONMENTAL.HEALTH&SAFETY ~ U\ ~ ~~ Print Name & Title of Authorized Company Representative Signature 10-29-93 Date Seplerrber 30, 1992 REGION V LEPC STANDARD FORM · . BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY Page ~ of ~ Business Name AM/PM MINI MARKET #5164 Address 4010 Wible Road, Bakersfield. CA 93309 CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [] Addition [ ] Revision[X] Deletion [ ] Check if chemical is a NON mADE SECRET [X] mADE SECRET [ ] 2) Common Name: Carbon Dioxide (Co2) I 3) DOT # (optional) 1013 Chemical Name: CARBON DIOXIDE AHM[] CAS#~ 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [] Reactive [ ] Sudden Release of Pressure [X] Immediate Health (Arote) [X] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 Digit Code From DHS Fonn 8022) USE CODE JU. 6) PHYSICALSTATE Solid [ ] Liquid [ ] Gas [X] Pure [X] Mixture [ ] Waste [] Radioactive [ ] 7) AMOUNT ANDTIMEATFACll..ITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 448 " Ibs [] gal [] ft3 [X] a) Container: 04 . Portable Average Daily Amount: 224 rories [ ] I b) Pressure: 2. Above Ambient Annual AmOlDlt: 5824 c) Temperature 4. Ambient Largest Size Container: 174 # Days on Site: 365 Circle Which Months: All year: J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS# %Wf ARM the three most hazardous 1) Carbon Dioxide ~ ~ [ ] chemical components or 2) [ ] any AHM components 3) [ ] , 10) Location: SOUTH SIDE OF THE BUILDING (#5\ CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [] Addition [] Revision [ ] Deletion [ ] Check if chemical is a NON mADE SECRET [X] mADE SECRET [ ] 2) Common Name: 3) DOT # (optional) \ Chemical Name: AHM[] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 Digit Code From DHS Fonn 8022) USE CODE 6) PHYSICALSTATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive I ] 7) AMOUNT AND TIME AT FACll..ITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: Ibsl] gall] ft3[] a) Container: Average Daily AmOlDlt: rories I ] b) Pressure: Annual Amount: c) Temperature Largest Size Container: # Days on Site: , Circle Which Months: All year: J, F. M. A. M, J, J, A. S, 0, N, D 9) MIXTURE: List COMPoNENT CAS# %Wf ARM the three most hazardous 1) [ ] chemical components or 2) " I ] any AHM components 3) I] 10) Location: I certify under penalty of law, that I have personally examined and am familiar with the Information submitted on this and all attachsd documents. I believe the submlttad Inlonnal/on Is 11IIØ, øccutalo, e~PI;~ ¡f\ rl ,,/ NANCY B. WALT!. MGR-ENVIRONMENTAL. HEALTH & SAFETY ~ :12~ JV~ Print Name & Title of Authorized Company Representative Signature 'V ' 10-29-93 Date Septerrber 30, 1992 REGION V LEPC STANDARD FORM 'î '. " . . ./1 Page 1 " ~,¡- , 10/15/93 -; AM PM MINI MARKET #5164 215-000-000564 Overall Site with 1 Fac. Unit General Information Location: 4010 WIBLE RD Map: 123 Hazard: Low Community: BAKERSFIELD STATION 07 Grid: 13A FlU: 1 AOV: 0.0 --- Contact Name Title . Business Phone - 24-Hour Phone JORGE 'ALVAREZ MANAGER (805) 836-9685 x (805) 831-7741 CHRIS WARR FIELD SUPERVISOR (805) 665-1469 x (800) 553-6246 Administrati ve Data . Mail Addrs: P.O. BOX 6225 D&B Number: 51-012-0713 City: ARTESIA State: CA Zip: 90702- Comm Code: 215-007 BAKERSFIELD STATION 07 SIC Code: 5541 Owner: PRESTIGE STATIONS Phone: (310) 402-1278 Address: P.O. BOX 6225 State: CA City: ARTESIA Zip: 90702- Summary TANKS: HAS OWNER OPERATOR AGREEMENT HAS FINANCIAL RESPONSIBILITY HAS SPILL RESPONS AND MONITORING PLAN .' I ,)tílf> &~J? ' ~H1 ~ Do hereby certify that I have " rrý(i& or prlnt nam9) reviewed the attached hazardous ma1erJa!s ma¡-;aqe- 1I1(.,(fS'Í1e,~ ..~ ~V7\JS ~ ment pian for 1Jf .s 1(, cf . _and that it a.long with (Namo ot Bu¡; n6SS) any corrections constitute a complote a.nd correct man· agement plan for my facilíty. 't.. c-f! ¡J/;t!a!r; SIgnature 10 ...:< 9 - 0¡.3 ,Date . . iO/15/93 AM PM MINI MARKET 041=5164 . 215-000-000564 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-003 GASOLINE ARCO 3UPER UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-,002 GASOLINE ARCO UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-001 GASOLINE MIDGRADE UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth / GAL 02-00'S GASOLINE ARCO UNLEADED ~C - P'(rm"t.lAm / Liquid 10000 Moderate ~ ~ Fire, Immed Hlth, Delay Hlth 02-00~ CARBON DIOXIDE Gas 448 Minimal S" ~ Fire, Pressure, Immed Hlth FT3 10/15/93 02-00~ q. . . Page 3 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site HazmatInventory Detail in MCP Order / GASOLINE ARCO t:ifiFf~ UNLEADED' 6'C- Y"'~M""M vtiquid ~. Fire, Immed·fflth, Delay Hlth CAS #: 8006-61-9 Trade secre";l No Form: Liquid Type: Pare Vr~'(~ays: 365 Use: FUEL 10000 GAL Moderate Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 10,000 I 4,000.00 I 470,000.00 02-002 GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hlth Storage UNDER GROUND TANK r Press T Temp -:-, Ambient AmbientlS OF LOT Location - Conc l 100.0% Gasoline Components r; MCP ~uide Moderate 27 Liquid ,10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL - Daily Max GAL ,----r-- Daily Average GAL -r-, Annual Amount GAL -- -I . 10,000 I 5,000.00 I, 1,000,000.00 I 02-001 GASOLINE MIDGRADE UNLEADED ~ Fire, Immed Hlth, Delay Hlth Storage UNDER GROUND TANK r Press T Temp -:I ' Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components r; MCP ~uide Moderate 27 Liquid ' 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Daily Max GAL ----r-- Daily Average GA.L --r-- Annual Amount GAL ~ J 10,000 I ,4,000.00 I 899,009.90 '~ q:to 1m· ~ Location Form: Liquid Type: Pure Days: 365 Use: FUEL Storage UNDER GROUND TANK r Pres s T Temp -:I Ambient Ambient S OF LOT - Conc -, 100.0% Gasoline Components ,-; MCP ~uide Moderate I . 27 . . iO/15/93 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail inMCP Order 02-00\ ~ GASOLINE ARCO UNLEADED ~ Fire, Immed Hlth, Delay Hl~h CAS #: 8006-61-9 Trade Sec~t: No Mì~~ 7~ Form: Liquid Type: Pttfoe {" Days: 365 Liquid 10000 Moderate Use: FUEL Daily Max 10,000 r-- DailY, Average I 5,000.00 I Al1nual Amount 1,000,000.00' Storage UNDER GROUND TANK . r Pres s T Temp -:ì Ambient Ambient S OF LOT Location - Conc l 100.0% Gasoline Components r; MCP --rGuide Moderate 27 02-00~ CARBON DIOXIDE ~ ~ Fire, Pressure, Immed Hlth Gas 448 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 -- 448 I 224.00 I 5,824.00 Storage r Press T Temp -:-1 PORT. PRESS. CYLINDER Ambient Ambient Location - Conc -, 100.0% Carbon Dioxide Components r; MCP --rGuide Minimal I 21 . . 10/15/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site <D> Notif./Evacuation/Medical Page 5 ' I <1> Agency Notification CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ~LARM SHALL BE GIVEN BY SHOUTING <4> Emèrgency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 . . 10/15/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention IJ.\V j FACILITY UTILIZES ~I~£ 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SI~NS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY,' IF NECESSARY. <4> Other Resource Activation . . 10/15/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) .,' , ~ 0.,;, . . . , .. ' '10/15/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 8 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO ! <3> Fire Protec./Avail. Wat~r PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN'ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY ,200 FEET FROM INTERSECTION. <4> Building Occupancy Level ", "'-. '~ I( . . .. -1'0/15/93 ,. AM PM MINI MARKET #5164 215-000-000564 00 - Overall ~ite Page 9 <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON ,FILE BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use ~ Ú E .. 15 .. .!I rn 8. i CI. .' Prestige Stations, Inc. 17215 Studebaker Road Cerritos, California 90701 P.O. Box 6225 Artesia, CA 90702 October 5, 1993 Bakersfield City Fire Department Ha,zardous Materials Division 2130 "0" Street Bakersfield, CA 93301 . ;' i1ECE.\\tEO , QCI 0 n \993 H ~, -/ r.. f i:..\ 1', t~, ~ \.1' , 1".t.... ",u' ' Certified Mail P 395-623-976 Re: Updated Hazardous Materials Management Plan Dear Sir/Madam, Enclosed please fmd the above for facility: PSI #5164/ARCO #5365: 4010 Wible Road, Bakersfield Three (3) tanks @ 12,000 were replaced to four (4) @ 10,000 gallon tanks. Please see site map for details. If there are any questions, corrections or comments, please call me at (310) 402-1278, extension 3. Sincerely yours, c!?c,,-rn"-..~ . ~ Oemma S. Cortes Environmental Assistant . ARCOENVffiONMENTALCOMPUANCE @ ï,.~ _./' ' e . / ... ~ 09129/93 AM PM MINI MARKET #5164 215-000-000564 Overall Site with 1 Fac. Unit Page 1 General Information Location: 4010 WIBLE RD·' Community: BAKERSFIELD STATION 07 Map: 123 Hazard: Low, Grid: 13A FlU: 1 AOV: 0.0 Administrative Data 24-Hour Phone (805) 831-7741 (800) 553-6246 Contact Name JORGE ALVAREZ Title MANAGER FIELD SUPERVISOR Mail Addrs: P.O. BOX 6225 City: ARTESIA, Co~ Code: 215-007 BAKERSFIELD STATION 07 D&B Number: 51-012-0713 State: CA Zip: 90702- SIC Code: 5541 Owner: PRESTIGE STATIONS Address: P.O. BOX 6225 City: ARTESIA Phone: (310) 402-1278 State: CA Zip: 90702- Summary TANKS: HAS OWNER OPERATOR AGREEMENT HAS FINANCIAL RESPONSABILITY HAS SPILL RESPONS AND MONITORING PLAN J I. -1J. ,W ~ L T1 '.',' Do hereby OS:i!!y that I have (Type or pnnt nama) ,', reviewed the attached h8.Z(ì!"dous m;iter¡ais maiïa(;t;¡- -pe ES Î ,'c::::¡ ~ . .. ment plan for ~~ \ tº!.:?.§._~Jmd that it along with (t Jamtí ~: ß~~sínú¡;¿;) any corrections cOllstit\..i'£~} a ctirnpieh.i end com~ct man- agement plan for my faciHty. ~ - " - - 09/29/93 AM PM MINI MARKET #5164 215-000-000564 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-003 GASOLINE ARCO SUPER UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-002 GASOLINE ARCa UNLEADED Liquid . -=¥fM8rZ-Moderate ~ Fire, Immed HI th , Delay Hlth GAL 02-001 GASOLINE MIDGRADE UNLEADED Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL 02-004 CARBON DIOXIDE Gas 448 Minimal ~ Fire, Pressure, Immed Hlth FT3 ?-o) (5) 000 ( to OðO S I ·, . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-003' GASOLINE ARCO SUPER UNLEADED ~ Fire, Immed Hlth, Delay H1th Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 Daily Average GAL 4,000.00 -¡ T Storage UNDER GROUND TANK r Press T Temp ~~ Ambient Ambientl~ OF LOT - Conc l 100;0% Gasoline Components I~ MCP ----rGuide Moderate I' 27 , / 02-002~.,.2 . GASOLINEARCO,UNLEADED vi . ~ Fire, Immed Hlth, Delay CAS #: 8006-61-9 Trade Liquid Hlth Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL - Daily ~~~ -----¡- Daily Average GAL ~ -:I:'"V"7 v v ~~ I 5 , 0 0 0 _. 0 0 ' I þAJ I friî) 10 I nJ1) Storage r Press T Temp ~ UNDER GROUND TANK Ambient Ambientl~ OF LOT ~ - Conc l ' Components 100.0% Gasoline Annual Amount GAL ~ 470,000.00 Location 10000 GAL Moderate Annual Amount GAL -- ~ , 500 , 000 . 0 Q ;;:< / ~ 1?If"Y Location r; MCP ----rGuide Moderate I . 27 02-001 GASOLINE MIDGRADE UNLEADED ~ Fire, Immed Hlth, Delay H1th Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No , Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 Daily Average GAL 4,000.00 -¡ T Storage UNDER GROUND TANK r Press T Temp ~I ' Ambient Ambientl~ OF LOT - Conc l 100.0% Gasoline Components , r; MCP ----rGuide Moderate 27 Annual Amount GAL -- 800,000.00 Location . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-004 CARBON DIOXIDE ~ Fire, Pressure, Immed Hlth Gas 448 Minimal FT3 CAS #: 124-38-9 Trade Secret:'No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ----r--. Daily Average FT3 ~ Annual Amount FT3 -- 448 I 224.00 I 5,824.00 Storage r Press T Temp -:-, PORT. PRESS. CYLINDER Ambient Ambient I , Location - Conc _I 100.0% Carbon Dioxide Components r; MCP ~uide Minimal I 21 . . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification ,CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING <4> Emergency Medical Plan MERCY HOSPITAL ~ 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 ... ...;; . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention FACILITY UTILIZES THREE 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. '''NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO-CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR'A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED ,DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR 'VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. , CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. <4> Other Resource Activation ., ~ . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt . <4>' Other Resource Activation (Continued) ~ .; . 1 ~... . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site J ' Page 8 <F> Site Emergency Factors <1> Special Hazards I <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO I <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT ~ NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. <4> Building Occupancy Level ;;; I '. t.., '. . . 09/29/93 AM PM MINI MARKET #5164 215-000-000564 00 - Oyera11 Site Page 9 <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 as needed I <3> Held for Future Use I <4> Held for Future Use CITY OF BAKERSFIELD HAZARDOUS MATERIALS INVENTORY HAZARDOUS MATERIALS DIVISION, 2130 "G" Street, Bakersfield, CA 93301 DFarm and Agriculture ~Standard Business ' BUSINESS NAME: AMlPM MINI MARKET #5164 OWNER NAME: PRESTIGE STATIONS, INC. #5164 LOCATION: 4010 Wible Road ADDRESS: P. O. BOX 6225 CITY, ZIP: Bakersfield, CA 93309 CITY, ZIP: ARTESIA, CA 90702 PHONE It. [805] 836ø9685 PHONE #: [310] 402-1278 **REVISED** 2/22/93 Name of this Facility: Standard Ind. Class Code: Dun & Bradstreet Number, & FederallD # 5541 52.()12-o713 ( REFER !l'O INSTRUCTIONS FOR PROPER CODES PaQe 1 of 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trans Type Max Average Annual Measure # Days Cont Cont Cont Use Location Where %by Names of Mixture/Components Code Code Amt Amt Est Units On Site Tvee Press Teme Code Stored in Facilitv Wt See Instructions , T U M 10,000 4,000 800, 000 GAL 3 6 5 0 1 1 4 19 Southwest comer Gasoline-MIDGRADE Unleaded . ( Physical and Health Hazard CAS. Number 1634-04-4 of lot o to 15 Methyl Tertia¡y-Butyl Ether, Check all that apply (1634-044) 8 to 15 Xvlene (1330-20-7) CI i -1R tivity .-1 i-I .--. 7 to 14 Toluene (108-88-37) LJÇ¡Fire Hazard L_J eac '~JDelayed L _ISudden Release 1_ _,Immediate Health of Pressure Health I U 1M 10,000 5,000 1.5 million IG A L 13 6 51 0 1 1 I 4 19 Southwest comer Gasoline-ARCO UNLEADED Physical and Health Hazard CAS. Number 1634-04-4 of lot 9 9 'HYdrocarbons (none) . Check all that apply 1 o Methyl Tertiary-Butyl Alcohol C75-65-C)) -- --. -. --. .--. txJFire Hazard L _ ~ Reactivity ~~Delayed :.. _ :Sudden Release L _:Immediate 1 1 Methyl Tertiary-Butyl Ether Health of Pressure Health (1634-04-4) T U TM 10,000 4, 000 470,000 GAL 13 6 51 0 1 1 I 4 19 Southwest comer GasoIine-ARCO SUPER UNLEADED Physical and Health Hazard CAS. Number 1634-04-4 of lot 9 9 HYdrocarbons (none) Check all that apply 1 o Methyl Tertiary-Butyl Alcohol C75-65-0} ,., ..-, 1"" .--, ,--, 1 1 Methyl Tertiary-Butyl Ether ~x..! Fire Hazard !.. _~Reactivity !!C ~ Delayed !... _ !Sudden Release !_ _!Immediate Health of Pressure Health (1634-04-4) T U T P T 4 4 8 2 2 4 5,824 cU.ft. F T 31 3 6 51 0 4 1 I 4 99 ** Storage Area CARBON DIOXIDE ~ ,PhYSiCal and Health Hazard CAS. Number 124-38-9 1 0 o CARBON DIOXIDE . Check all that apply **Used In soft drInk dIspensing (124-38-9) []Fire Hazard r -IR tivity 1-1 .--1 '--iI d' L_J eac I~JDelayed .~ _,Sudden Release 1__' mme late Health of Pressure Health EMERGENCY CONTACTS #1 Jorge Alvarez Facility Manager r8051831-7741 Name Title 24-hr Phone #2 Luke Ozcelik Field Supervisor [8001 553ø6246 Name Title 24-hr Phone <j .~ CertfflcÌJtlon (Read and sign after completing all S&Ct1ons) I certify under penalty of law that I have personaJly examined and am familiar with the information submitted in this and aJl attached documents, and that based on my ''''''. 01 ""~ ""'...., __" rol ob_ "" I,ro~"" I "'"~ ihot It. ,"'m'"", '''''''''''00'' IN, =",.... "'" ~p'" ~ NANCY B. WAL TI, Manager-Environmental, Health & Safety ~¡f¡If1J)())(:l:1___ Name and official title of owner/operator OR owner/operator's authorized representative Signature 2/22/93 Date Signed ; Co . _r' ~, 'I' . . ~- - 02/04/93 AM PM MINI MARKET #5164 215-000-000564 Overall Site with 1 Fac. Unit Page 1 General Information Location: 4010 WIBLE RD Map: 123 Hazard: Low Conimunity: BAKERSFIELD STATION 07 Grid: 13A FlU: 1 AOV: 0.0 - Contact Name Title Business Phone - 24-Hour'Phone JORGE ALVAREZ MANAGER (805) 836-9685 x (805) 831-7741 LUKE OZCELIK FIELD SUPERVISOR (805) 834-2978 x (800) 553-6246 Administrative Data Mail Addrs: P.O. BOX 6225 D&B Number: 51-012-0713 City: ARTESIA State: CA Zip: 90702- Comm Code: 215-007 BAKERSFIELD STATION 07 SIC Code: 5541 Owner: PRESTIGE STATIONS -IfS7to'/ Phone: (310) 402-1278 Address: P.O. BOX 6225 , . ,Stç¡,1;.e: CA City: ARTESIA 'Zip: 90702- Summary TANKS: HAS OWNER OPERATOR AGREEMENT HAS FINANCIAL RESPONSABILITY HAS SPILL RESPONS AND MONITORING PLAN -' I, NANCY B. WAL TI Do hereby certify that Ihave (Type or print name) reviewed the attached hazardous materials manage- ment pian for Ar~/PM ~1INI t~ART~5riJihat it along with . , ' (Name of Buain8lS) any corrections constitute a complete and correct man. agement plan for my facility. ./7Al.~ 2/22/93 DIÌìt - " ' ,i ~. . . 02/04/93 AM PM MINI MARKET #5164 215-000-00,0564 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on 5.i,t.e PIn-Ref Name/Hazards Quantity MCP 02-003 GASOLINE (REGULAR) Liquid 10000 Moderate ~ Fire, Immed Hlth, GAL 02-002 GASOLINE (SUPER UNLEADED)' Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay GAL 02-001 GASOLINE (UNLEADED) Liquid 10000 Moderate ~ Fire, Immed Hlth, GAL 02-004 CARBON DIOXIDE Gas 448 Minimal ~ Fire, Pressure Hlth FT3 ~~ fJV! Î '. . - > 02/04/93 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-003 GASOLINE (REGULAR) ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid ( Days: 365 Use: FUEL Type: Pure Daily Max GAL 10,000 Daily Average GAL 2,000.00 I ---¡ Storage UNDER GROUND TANK r Press T Temp -:I Ambient Ambient 5W OF LOT - Conc l 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 Annual Amount GAL -- 549,000.00 Location 02-002 GASOLINE (SUPER UNLEADED) ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Days: 365 Use: FUEL Type: Pure Daily Max GAL 10,000 Daily Average GAL 2,000.00 I ---¡ Storage UNDER GROUND TANK r Press T Temp -:I >Ambient Ambient SW OF LOT - Conc l 100.0% Gasoline Components r; MCP --¡Guide Moderate 27 Annual Amount GAL -- 549,000.00 Location 02-001 GASOLINE (UNLEADED) ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ 10,000 I Daily Average GAL ~ 4,000.00 I Storage UNDER GROUND TANK r Press T Temp ~I Ambient Ambient SW OF LOT - Conc l 100.0% Gasqline Components r; MCP --¡Guide Moderate 27 Annual Amount GAL -- 585,000.00 Location l . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-004 CARBON DIOXIDE . Fire, Pressure, Immed Hlth Gas 448 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3 ~ Daily Average FT3 ~ Annual Amount FT3 - 448 I 224.00 I 5,824.00 Storage r Press T Temp ~ PORT. PRESS. CYLINDER Ambient Ambient I Location - Conc l 100.0% Carbon Dioxide Components r; MCP ---p;uide Minimal I 21 ~ . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 THEN NOTIFY FIELD SUPERVISOR '(805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 ..J - . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Preventio~ FACILITY UTILIZES THREE 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP. OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY.' FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. i <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED ,BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. <4> Other Resource Activation ß ~ . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 7 <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) :.!Ì ~ " r.; . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 8 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. <4> Building Occupancy Level -ð :: ,. .,~ -, '.' ..~. . . 02/04/93 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 9 <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY ,OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 as needed <3> Held for Future Use " <4> Held for Future Use BUSINESS PL&nd CHEMICAL INVENTOR.PDATE FORM BAKERSFIELD FIRE DEPARTMENT, HAZARDOUS MATERIALS DIVISION 2130 "G" STREET BAKERSFIELD, CA 93301 FACILITY NAME: ADDRESS: AM/PM MINI MARKET #5164 4010 Wible Road Bakersfield, CA 93309 CONTACT PERSON: Jorge Alvarez, Facility Manager BUSINESS PHONE NUMBER: [805] 836-9685 ANNUAL INVENTORY UPDATE [&J No significant changes in inventory have occurred since the last business plan or inventory was submitted. o NEW INVENTORY FORMS ARE ATTACHED. o REPLACE PREVIOUS INVENTORY WITH ATTACHED INVENTORY. o REPLACE ONLY DESIGNATED PAGES OF INVENTORY. SPECIAL INSTRUCTIONS: BIENNIAL REVIEW AND RECERTIFICATION [RJ I CERTIFY THAT THE BUSINESS PLAN HAS BEEN REVIEWED AND THE INFORMATION CONTAINED IN THE BUSINESS PLAN IS ACCURATE AND COMPLETE AS OF THIS DATE WITH THE BELOW CORRECTIONS. OTHER UPDATES [RJ Please incorporate the following information into the business plan for this facility. FACILITY MANAGER: Jorge Alvarez MANAGER HOME PHONE: [805] 831-7741 FIELD SUPERVISOR: Luke Ozcelik SUPERVISOR HOME PHONE: [805] 834-2978 I declare. under penalty of perjury. that the information provided herein is true and correct to the best of my knowledge. Signature: Printed Name: /lA'10 [¡J rJ~ Date: 12/31/92 Nancy B. Walti, Manager-Environmental, Health & Safety NOTE: DEHS provides this information to local police and fire jurisdictions. Please provide three (3) copies of all update information. + ~ · · · <>1 M.ERIAL SAFETY DAT.HEET ARCO MIDGRADE UNLEADED GASOLINE MSDS No. APPC 308 Rev. Date 09/17/92 IMPORTANT: ARCO PRODUCTS COMPANY DIVISION OF ATLANTIC RICHFIELD COMPANY 1055 WEST SEVENTH STREET LOS ANGELES. CALIFORNIA 90051 Read this MSDS before handling and disposing of this product and pass this information on to employees, customers, and users of this product II. GENERAL TELEPHONE NUMBERS: Emergency: 213/222/3212 LA POISON 800/424-9300 CHEMTREC Customer Service: 800/322-2726 INFO ONLY TRADE NAME ARCO MIDGRADE UNLEADED GASOLINE OTHER NAMES ARCO CLEAR GASOLINE, UNLEADED MOTOR VEHICLE GASOLINE, UNLEADED REGULAR GASOLINE OR PETROL GENERIC NAME PETROLEUM NAPHTHAS (BLENDED) CHEMICAL FAMILY PETROLEUM HYDROCARBONS CAS NUMBER 0008006-61-9 COMPANY ID NUMBER 1009710096 DOT PROPER SHIPPING NAME GASOLINE UN/NA NUMBER UN 1203 DOT HAZARD CLASS 3 -FOR "DISCLAIMER OF LIABILITY", SEE THE STATEMENT ON PAGE I2"*" Rage 1 of 12 ARCO MIDGRADE UNLEADED GASOLlN. /11. . -~ MSDS No, APPC 30B IMMEDIATE HAZARDS I · DANGER HIGHLY FLAMMABLE! OSHA/NFPA CLASS-IA FLAMMABLE LIQUID. KEEP A WAY FROM HEAT, SPARKS. AND OPEN FLAME, MAY CAUSE IRRITATION TO EYES, SKIN, AND RESPIRATORY SYSTEM. AVOID BREATHING VAPORS OR MISTS. USE ONLY WITH ADEQUATE VENTILATION. ABSORPTION OF LIQUID THROUGH THE SKIN OR INHALATION OF VAPORS CAN CAUSE CENTRAL NERVOUS SYSTEM (CNS) DEPRESSION AND/OR SYSTEMIC EFFECTS. HARMFUL OR FATAL IF SWALLOWED. CONTAINS PETROLEUM DISTILLATES! IF SWALLOWED, DO NOT INDUCE VOMITING SINCE ASPIRATION INTO THE LUNGS MAY CAUSE CHEMICAL PNEUMONIA. OBTAIN PROMPT MEDICAL ATIENTION. BASED ON THE RESULTS OF ANIMAL STUDIES, COMPONENTS OF THIS MATERIAL HAVE PRODUCED TOXIC EFFECTS ON THE LIVER, KIDNEY, AND OTHER INTERNAL INTERNAL ORGANS AND THE FETUS. LONG TERM EXPOSURE TO COMPLETELY VAPORIZED GASOLINE HAS CAUSED CANCER IN LABORATORY ANIMALS. GASOLINE MAY SENSmZE THE HEART TO SYMP A THOMIMETICS LIKE EPINEPHRINE RESULTING IN IRREGULAR HEART BEATS. SEE SECTIONS IV AND XI FOR ADDITIONAL INFORMATION. · · Page 2 of 12 'f · · · .0 MIDGRADE UNLEADED GaLlNE MSDS No. APPC 308 Rev. Date 09/17/92 ~~I ~~ 1m. FIRE AND EXPLOSION FLASH POINT METHOD=( D-56) AP _450 F AUTOIGNITION TEMP. METHOD = (E-659) GT 6000 F FLAMMABLE LIMITS (% VOLUME IN AIR) AT NORMAL ATMOSPHERIC TEMPERATURE AND PRESSURE LOWER: AP 1.3 UPPER: AP 7.6 BASED ON GASOLINE HAZARD RATINGS NFPA RATINGS HEALTH HAZARD RATING: (1)SLlGHT FIRE HAZARD RATING: (3)HIGH REACTIVITY HAZARD RATING: (O)INSIGNIFICANT FIRE AND EXPLOSION HAZARDS HIGHLY FLAMMABLE! THIS MATERIAL RELEASES VAPORS AT OR BELOW AMBIENT TEMPERATURES. WHEN MIXED WITH AIR IN CERTAIN PROPORTIONS AND EXPOSED TO AN IGNITION SOURCE, THESE VAPORS CAN BURN IN THE OPEN OR EXPLODE IN CONFINED SPACES. BEING HEAVIER THAN AIR, FLAMMABLE VAPORS MAY TRAVEL LONG DISTANCES ALONG THE GROUND BEFORE REACHING A POINT OF IGNITION AND FLASHING BACK. EXTINGUISHING MEDIA HALON, FOAM, WATER FOG, C02, OR DRY CHEMICAL. CONSULT FOAM MANUFACTURER FOR APPROPRIATE MEDIA, APPLICATION RATES AND WATER/FOAM RATIOS. WATER AND WATER SPRAY MAY COOL THE FIRE BUT MAY NOT EXTINGUISH THE FIRE. SPECIAL FIREFIGHTING PROCEDURES FOR FIRES INVOLVING THIS MATERIAL, DO NOT ENTER ANY ENCLOSED OR CONFINED FIRE SPACE WITHOUT PROPER PROTECTIVE EQUIPMENT, THIS MAY INCLUDE SELF- CONTAINED BREATHING APPARATUS TO PROTECT AGAINST THE HAZARDOUS EFFECTS OF COMBUSTION PRODUCTS AND OXYGEN DEFICIENCIES. IF FIREFIGHTERS CANNOT WORK UPWIND TO THE FIRE, RESPIRATORY PROTECTIVE EQUIPMENT MUST BE WORN, COOL TANKS AND CONTAINERS EXPOSED TO FIRE WITH WATER. -FOR 'OISCLAIMER OF LIABILITY', SEE THE STATEMENT ON PAGE 12""* Page 3 of f2 . 'ARCO MIDGRADE UNLEADED GASOLINE IIV. . HEALTH HAZARDS SUMMARY OF ACUTE HAZARDS LIQUID, MIST OR VAPORS CAN CAUSE EYE, SKIN AND RESPIRATORY TRACT IRRITATION AND CNS DEPRESSION. ASPIRATION INTO THE LUNGS MAY CAUSE CHEMICAL PNEUMONIA. ROUTES OF EXPOSURE INHALATION -- PRIMARY ROUTE VAPORS OR FUMES FROM THIS MATERIAL CAN IRRITATE THE NOSE, THROAT, AND LUNGS, AND CAN CAUSE SIGNS AND SYMPTOMS OF CENTRAL NERVOUS SYSTEM DEPRESSION, ( DIZZINESS, LOSS OF COORDINATION, COMA AND DEATH) DEPENDING ON THE CONCENTRATION AND DURATION OF EXPOSURE. EYE CONTACT EYE IRRITATION MAY RESULT FROM CONTACT WITH LIQUID, MIST, AND/OR VAPORS. SKIN CONTACT NO SIGNIFICANT SYSTEMIC EFFECTS ARE EXPECTED UNDER NORMAL USE CONDITIONS. COMPONENTS OF THIS MIXTURE CAN BE ABSORBED THROUGH THE SKIN AND MAY PRODUCE CENTRAL NERVOUS SYSTEM (CNS) DEPRESSION OR OTHER TOXIC EFFECTS, DEPENDING UPON THE CONCENTRATION AND DURATION OF EXPOSURE. SKIN IRRITATION MY OCCUR UPON SHORT TERM EXPOSURE. INGESTION MAY CAUSE IRRITATION OF THE MOUTH, THROAT AND GASTROINTESTINAL TRACT LEADING TO NAUSEA, VOMITING, DIARRHEA, RESTLESSNESS AND CENTRAL NERVOUS SYSTEM DEPRESSION SIMILAR TO THAT CAUSED BY VAPOR INHALATION. SUMMARY OF CHRONIC HAZARDS AND SPECIAL HEALTH EFFECTS PROLONGED OR REPEATED SKIN CONTACT MAY PRODUCE SKIN IRRITATION OR MORE SERIOUS DISORDERS. MAY SENSITIZE THE HEART TO SYMPATHOMIMETICS LIKE EPINEPHRINE RESULTING IN IRREGULAR HEARTBEATS AND POSSIBLE CARDIAC ARREST. A CHRONIC INHALATION STUDY WITH A GENERIC UNLEADED GASOLINE FORMULATED BY API, CAUSED KIDNEY DAMAGE AND KIDNEY TUMORS IN MALE RATS AND LIVER TUMORS, IN FEMALE MICE. THE EXACT RELATIONSHIP BETWEEN THESE RESULTS AND POSSIBLE HUMAN EFFECTS IS NOT KNOWN. CONTAINS BENZENE, A KNOWN HUMAN CARCINOGEN, OVEREXPOSURE TO VAPORS OR LIQUIDS MAY CAUSE LEUKEMIA, APLASTIC ANEMIA OR OTHER BLOOD DISORDERS OR IMMUNOTOXICITY, PERSONNEL WITH PRE-EXISTING CNS DISEASE, SKIN DISORDERS,IMPAIRED LIVER OR KIDNEY FUNCTION OR CHRONIC RESPIRATORY DISEASES SHOULD AVOID EXPOSURE. SEE SECTION XI FOR ADDITIONAL INFORMATION. MSDS No, APPC 308 I . . . Page 4 of 12 1 ~~I ~~ · IV, MSÐS No. APPC 308 Rev. Date 09/17/92 .0 MIDGRADE UNLEADED G.LlNE PROTECTIVE EQUIPMENT I CONTROL MEASURES RESPIRATORY PROTECTION r=ûi='; VAPOR/MIST CONCENTRATIONS IN EXCESS OF THE OCCUPATIONAL EXPOSURE LIMITS IN SECTION VI, USE A NIOSH/MSHA APPROVED ORGANIC VAPOR/MIST, SUPPLIED AIR OR SELF CONTAINED BREATHING APPARATUS. RESPIRATOR SHOULD FOLLOW OSHA 29 CFR 1910.134 OR EQUIVALENT. EYE PROTECTION EYE PROTECTION SHOULD BE WORN. IN THE LIKELIHOOD OF SPLASHING OR SPRAYING, CHEMICAL TYPE GOGGLES AND/OR A FACE SHIELD SHOULD BE WORN, IF CONTACT LENSES ARE WORN, CONTACT THE SAFETY DEPARTMENT FOR USER POLICY OR AN EYE SPECIALIST FOR ADDITIONAL PRECAUTIONS. SUITABLE EYE WASH WATER SHOULD BE AVAILABLE IN CASE OF EYE CONTACT WITH MATERIAL. · SKIN PROTECTION AVOID PROLONGED AND/OR REPEATED SKIN CONTACT. IF CONDITIONS OR FREQUENCY OF USE MAKE PROLONGED CONTACT LIKELY, CLEAN AND IMPERVIOUS CLOTHING SUCH AS GLOVES, APRON, BOOTS, AND FACIAL PROTECTION SHOULD BE WORN. ENGINEERING CONTROLS USE ADEQUATE VENTILATION TO KEEP VAPOR AND MIST CONCENTRATIONS OF THIS MATERIAL BELOW THE OCCUPATIONAL EXPOSURE LIMITS SHOWN BELOW IN SECTION VI. ELECTRICAL EQUIPMENT SHOULD FOLLOW NATIONAL ELECTRICAL CODE (NEe) STANDARDS. OTHER HYGIENIC PRACTICES USE GOOD PERSONAL HYGIENE PRACTICES. IN CASE OF SKIN CONTACT, WASH WITH MILD SOAP AND WATER OR A WATERLESS HAND CLEANER. IMMEDIATELY REMOVE SOAKED CLOTHING AND WASH THOROUGHLY BEFORE REUSE. DISCARD GASOLINE-SOAKED SHOES. OTHER WORK PRACTICES RESPIRATOR USE SHOULD COMPLY WITH OSHA STANDARDS 29 CFR 1910.134 OR EQUIVALENT. MAINTAIN EXPOSURE LEVELS BELOW 1 PPM BENZENE IN ADDITION TO THE 300 PPM GASOLINE TLV. NEVER SIPHON GASOLINE BY MOUTH. SEE SECTION XI, FOR ADDITIONAL INFORMATION. · -FOR "DISCLAIMER OF LIABILITY". SEE THE STATEMENT ON PAGE 12- Page 5 of 12 - ----- --- ARCO MIDGRADE UNLEADED GASOLlN. . MSDS No, APPC 308 I VI. OCCUPATIONAL EXPOSURE LIMITS I SUBSTANCE SOURCE DATE TYPE VALUE/UNITS TIME · BENZENE ACGIH 1992 TWA 0,1 PPM 8 HRS OSHA 1992 PEL 1 PPM 8 HRS STEL 5 PPM 15 MIN CUMENE ACGIH 1991 TWA 50 PPM 8 HRS OSHA 1991 PEL 50 PPM ' 8 HRS CYCLOHEXANE ACGIH 1991 TWA 300 PPM 8 HRS OSHA 1991 PEL 300 PPM 8 HRS ETHYL ALCOHOL ACGIH 1991 TWA 1000 PPM 8 HRS OSHA 1991 TWA 1000 PPM 8 HRS ETHYL BENZENE ACGIH 1991 TWA 100 PPM 8 HRS STEL 125 PPM 15 MIN OSHA 1991 PEL 100 PPM 8 HRS STEL 125 PPM 15 MIN GASOLINE ACGIH 1991 TWA 300 PPM 8 HRS STEL 500 PPM 15 MIN OSHA 1991 PEL 300 PPM 8 HRS STEL 500 PPM 15 MIN N-HEXANE ACGIH 1991 TWA 50 PPM 8 HRS OSHA 1991 PEL 50 PPM 8 HRS N-OCTANE ACGIH 1991 TWA 300 PPM 8 HRS STEL 375 PPM 15 MIN OSHA 1991 PEL 300 PPM 8 HRS STEL 375 PPM 15 MIN TOLUENE ACGIH 1992 TWA 50 PPM 8 HRS STEL 150 PPM 15 MIN OSHA 1992 PEL 100 PPM 8 HRS STEL 150 PPM 15 MIN TRIM ETHYL BENZENE ACGIH 1991 TWA 25 PPM 8 HRS OSHA 1991 PEL 25 PPM 8 HRS XYLENE ACGIH 1991 TWA 100 PPM 8 HRS STEL 150 PPM 15 MIN OSHA 1991 PEL 100 PPM 8 HRS STEL 150 PPM 15 MIN · I VII. EMERGENCY AND FIRST AID INHALATION IMMEDIATELY MOVE PERSONNEL TO AREA OF FRESH AIR. FOR RESPIRATORY DISTRESS, GIVE OXYGEN, RESCUE BREATHING OR ADMINISTER CPR ( CARDIO PULMONARY RESUSCITATION), OBTAIN MEDICAL ATTENTION. EYE CONTACT FLUSH WITH CLEAN LOW-PRESSURE WATER FOR AT LEAST 15 MINUTES,. OCCASIONALLY LIFTING THE EYELIDS. IF PAIN OR REDNESS PERSISTS AFTER FLUSHING, OBTAIN MEDICAL ATTENTION. SKIN CONTACT IMMEDIATELY REMOVE CONTAMINATED CLOTHING. WASH AFFECTED SKIN THROUGHLY WITH SOAP AND WATER. IF IRRITATION PERSISTS, OBTAIN MEDICAL ATTENTION, INGESTION DO NOT INDUCE VOMITING. OBTAIN PROMPT MEDICAL ATTENTION, EMERGENCY MEDICAL TREATMENT PROCEDURES SEE ABOVE PROCEDURES. · Page 6 of 12 , - I ~~I ~~ 4IIIIÞ I 11111. 4IIIIÞ 4IIIIÞ '; .0 MIDGRADE UNLEADED G.LlNE MSDS No. APPC 308 Rev. Date 09/17/92 SPill AND DISPOSAL PRECAUTIONS IF MATERIAL IS SPILLED OR RELEASED ELIMINATE ALL POTENTIAL SOURCES OF IGNITION, HANDLING EQUIPMENT MUST BE GROUNDED TO PREVENT SPARKING. STOP SOURCE OF RELEASE WITH NON-SPARKING TOOLS. VENTILATE ENCLOSED AREAS TO PREVENT FORMATION OF FLAMMABLE OR OXYGEN DEFICIENT ATMOSPHERES. WATER SPRAY MAY BE USED TO REDUCE VAPORS. AVOID VAPOR CLOUD EVEN WITH PROPER RESPIRATORY EQUIPMENT. ISOLATE THE HAZARD AREA AND DENY ENTRY TO UNNECESSARY PERSONNEL. DIKE AND CONTAIN LARGE SPILLS. SOAK UP RESIDUE WITH AN ABSORBENT SUCH AS CLAY, SAND, OR OTHER SUITABLE MATERIAL. PREVENT SPILLED MATERIAL FROM ENTERING SEWERS, STORM DRAINS AND OTHER UNAUTHORIZED TREATMENT DRAINAGE SYSTEMS AND NATURAL WATERWAYS, NOTIFY FIRE AUTHORITIES AND APPROPRIATE FEDERAL, STATE AND LOCAL AGENCIES. IMMEDIATE CLEANUP OF ANYSPILL IS RECOMMENDED. IF SPILL OF ANY AMOUNT IS MADE INTO OR UPON U.S. NAGIVABLE WATERS, THE CONTIGUOUS ZONE, OR ADJOINING SHORE LINE. NOTIFY THE NATIONAL RESPONSE CENTER (800) 424-8802 WASTE DISPOSAL METHODS MAXIMIZE PRODUCT RECOVERY FOR REUSE OR RECYCLING. UNUSED LIQUID SHOULD BE DISPOSED ON BY APPROVED TREATMENT, TRANSPORTERS, AND DISPOSAL SITES IN COMPLIANCE WITH ALL APPLICABLE LAWS. TANK BOTTOMS AND TANK WATER BOTTOMS MAY BE HAZARDOUS TO HUMAN, ANIMAL, AND AQUATIC LIFE. IF SPILL IS INTRODUCED INTO A WASTEWATER SYSTEM THE CHEMICAL AND BIOLOGICAL OXYGEN DEMAND WILL LIKELY INCREASE. SPILL MATERIAL IS BIODEGRADABLE IF GRADUALLY EXPOSED TO MICROORGANISMS, A POTENTIAL DISPOSAL METHOD IS INCINERATION, IF PROPERLY PERMITTED. -FOR "DISCLAIMER OF LIABILITY", SEE THE STATEMENT ON PAGE 12- Page 7 of 12 I - I ARCO MIDGRADE UNLEADED GASOLlNø . MSDS No, APPC 308 IX. COMPONENTS (This may not be a complete list of components.) COMPONENT NAME CAS NUMBER CARCINOGEN 1 %COMPOSITION BY VOLUME GASOLINE 08006-61-9 N/AP EQ 100 WHICH CONTAINS: BENZENE 71-43-2 1,2,3,4 AP 1-5 CUMENE 98-82-8 N/AP LT 1 CYCLOH EXAN E 110-82-7 N/AP LT 2 ETHANOL 64-17-5 N/AP AP 0-10 ETHYL BENZENE 100-41-4 N/AP AP 1-3 METHYL TERTIARY BUTYL ETHER ( MTBE ) 1634-04-4 N/AP AP 0-15 N-HEXANE 110-54-3 N/AP AP 2-5 N-OCTANE 111-65-9 N/AP LT 1 TOLUENE 108-88-37 N/AP AP 7-14 1,2,4 TRIMETHYL BENZENE 95-63-6 N/AP AP 1-4 TRIMETHYL BENZENE 25551-13-7 N/AP LT 5 XYLENE 1330-20-7 N/AP AP 8-15 ;Listed by: 1 =NTP, 2=IARC, 3=OSHA, 4=Other See qualification below. Compositions given are typical values, not specifications. . Qualifications EQ - Equal L T - Less Than GT - Greater Than AP - Approximately UK - Unknown TR - Trace NIP - No Applicable Information Found NIAP - Not Applicable N/DA - No Data Available . Page 8 01 12 1 · · · ~~I ~~ Ix. .0 MIDGRADE UNLEADED G.LlNE MSDS No. APPC 308 Rev. Date 09/17/92 PHYSICAL AND CHEMICAL DATA BOILING POINT /l.P 350 TO 4370 F PH N/AP FREEZING POINT N/AP DRY POINT A P 430F SPECIFIC GRAVITY (H20=1 AT 39.2° F) AP .7 TO .8 VOLATILE CHARACTERISTICS APPRECIABLE VISCOSITY UNITS, TEMP. (METHOD) N/AP SOLUBILITY IN WATER SLIGHT VAPOR PRESSURE, AP 5 TO 15 (PSI AT 100 F) STABILITY ST ABLE VAPOR SP GR (AIR=1 AT 60° . 90° F) AP 4.0 HAZARDOUS POLYMERIZATION NOT EXPECTED TO OCCUR OTHER CHEMICAL REACTIVITY N/AP OTHER PHYSICAL AND CHEMICAL PROPERTIES WATER IN CONTACT WITH OXYGENATED GASOLINE CAN CON- TAIN UP TO 80% OXYGENATE & HYDROCARBON MATERIALS. APPEARANCE AND ODOR COLORLESS TO STRAW-COLORED LIQUID; PETROLEUM NAPHTHA ODOR. CONDITIONS TO AVOID HEAT, SPARKS, AND OPEN FLAME, AND BUILD UP OF STATIC ELECTRICITY. MATERIALS TO AVOID HALOGENS, STRONG ACIDS, ALKALlNES AND OXYDIZERS, HAZARDOUS DECOMPOSITION PRODUCTS BURNING OR EXCESSIVE HEATING MAY PRODUCE CARBON MONOXIDE AND OTHER HARMFUL GASESIVAPORS INCLUDING OXIDES AND/OR OTHER COMPOUNDS OF SULFUR. -FOR ~DISCLAIMER OF LIABILITY', SEE THE STATEMENT ON PAGE I2"*" Page 9 of 12 ARCO MIDGRADE UNLEADED GASOllNø . I MSDS No, APPC 308 I XI. ADDITIONAL PRECAUTIONS I · HANDLING STORAGE AND DECONTAMINATION PROCEDURES STORE AND TRANSPORT IN ACCORDANCE WITH ALL APPLICABLE LAWS. KEEP AWAY FROM HEAT, SPARKS, AND OPEN FLAME! KEEP CONTAINERS CLOSED , PLAINLY LABELED, AND OUT OF CLOSED VEHICLES. CONTAINERS SHOULD BE ABLE TO WITHSTAND PRESSURES EXPECTED FROM WARMING OR COOLING IN STORAGE. GROUND ALL DRUMS AND TRANSFER VESSELS WHEN HANDLING. STORE IN COOL (80F OR BELOW) WELL VENTILATED LOCATION. ALL ELECTRICAL EQUIPMENT IN STORAGE AND/OR HANDLING AREAS SHOULD BE INSTALLED IN ACCORDANCE WITH APPLICABLE REQUIREMENTS OF THE NATIONAL ELECTRICAL CODE, (NEC). KEEP OUT OF REACH OF CHILDREN! EMPTY CONTAINERS RETAIN SOME LIQUID AND VAPOR RESIDUES, AND HAZARD PRECAUTIONS MUST BE OBSERVED WHEN HANDLING EMPTY CONTAINERS. AVOID CONTACT WITH SKIN. AVOID INHALATION OF VAPORS OR MISTS. USE IN A WELL VENTILATED AREA AWAY FROM ALL IGNITION SOURCES. ADDITIONAL TOXICOLOGY INFORMATION COMPONENTS SEVERAL COMPONENTS OF THE GASOLINE LMIXTURE HAVE BEEN FOUND TO AFFECT EITHER MALE OR FEMALE REPRODUCTIVE CAPACITY OR TO BE TOXIC TO THE FETUS IN LABORATORY STUDIES. INHALATION EXPOSURE TO HIGH CONCENTRATIONS OF MTBE (4,000 TO 8,000 PPM ) HAS CAUSED FETAL TOXICITY AND MALFORMATIONS ( CLEFT PALATE, SKELETAL VARIARIONS) IN LABORATORY ANIMALS. MATERNAL TOXICITY WAS REPORTED AT THESE LEVELS. THE NO OBSERVED EFFECT LEVEL (NOEL) FOR FETAL EFFECTS WAS REPORTED TO BE 1000 PPM. EXPOSURE TO OTHER COMPONENTS OF GASLlNE SUCH AS BENZENE, TOLUENE, XYLENE, ETHYLBENZENE, TRIMETHYLBENZENE AND N-HEXANE HAVE ALSO BEEN SHOWN TO AFFECT REPRODUCTIVE CAPACITY AND/OR FETAL DEVELOPMENT IN LABORATORY ANIMALS. THE EXACT RELATIONSHIP BETWEEN THESE EFFECTS AND HUMANS IS NOT KNOWN. · EXPOSURE TO N-HEXANE, A COMPONENT OF GASOLINE, HAS BEEN ASSOCIATED WITH PERIPHERAL NEUROPATHY IN HUMANS. CHRONIC EXPOSURE TO VERY HIGH LEVELS (8000 PPM) OF MTBE HAS PRODUCED URINARY SYSTEM EFFECTS ( NEPHROSIS, NEPHROPATHY OR ABNORMAL KIDNEY EFFECTS) IN LABORATORY ANIMALS. THE RELATIONSHIP BETWEEN THESE EFFECTS AND HUMANS IS NOT KNOWN, BUT COMPARABLE HUMAN EXPOSURES WOULD BE CONSIDERED HIGHLY UNLIKELY UNDER TYPICAL USE CONDITIONS, · Page 10 of 12 ' · · · ~' ~~I ~~ I XII. eco MIDGRADE UNLEADED G&LlNE MSDS No. APPC 308 Rev. Date 09/17/92 REGULATORY INFORMATION SUPERFUND AMENDMENTS AND REAUTHORIZATION ACT OF 1986 (SARA), TITLE III SECTION 311/312 HAZARD CATEGORIES DELAYED (CHRONIC) HEALTH HAZARD FIRE HAZARD SECTION 313 THIS PRODUCT CONTAINS THE FOLLOWING CHEMICALS SUBJECT TO THE REPORTING REQUIREMENTS OF SARA TITLE III. SECTION 313 AND 40 CFR 372: BENZENE CUMENE ETHYL BENZENE TOLUENE 1,2.4 TRIMETHYL BENZENE XYLENE TOXIC SUBSTANCES CONTROL ACT (TSCA) All COMPONENTS OF THIS PRODUCT ARE LISTED ON THE TSCA INVENTORY. COMPREHENSIVE ENVIRONMENTAL RESPONSE, COMPENSATION AND LIABILITY ACT (CERCLA) THIS PRODUCT CONTAINS THE FOLLOWING CHEMICALS SUBJECT TO THE REPORTING REQUIREMENTS OF CERClA: BENZENE CUMENE CYClOHEXANE ETHYL BENZENE TOLUENE XYLENE REPORTABLE QUANTITY (RQ), LBS 10#/4.54KG 5000#/2270KG 1000#/454KG 1000#/454KG 1000#/454KG 1000#/454KG CALIFORNIA SAFE DRINKING WATER AND TOXIC ENFORCEMENT ACT OF 1986· PROPOSITION 65 THIS PRODUCT CONTAINS THE FOllOWING CHEMICAl(S) LISTED BY THE STATE OF CALIFORNIA AS "KNOWN TO THE STATE OF CALIFORNIA TO CAUSE CANCER". AND/OR REPRODUCTIVE TOXICITY. BENZENE TOLUENE -FOR "DISCLAIMER OF LIABILITY', SEE THE STATEMENT ON PAGE 12- Page 11 of 12 'ARCO MIDGRADE UNLEADED GASOLlN~ ¡XIII. . . SUPPLEMENT . MSDS No, APPC 309 I . I I XIV. DISCLAIMERS Disclaimer of Liability The information in this MSDS was obtained from sources which we believe are reliable. HOWEVER, THE INFORMATION IS PROVIDED WITHOUT ANY WARRANTY, EXPRESS OR IMPLIED, REGARDING ITS CORRECTNESS, The conditions or methods of handling, storage, use and disposal of the product are beyond our control and may be beyond our knowledge. FOR THIS AND OTHER REASONS, WE DO NOT ASSUME, RESPONSIBILITY AND EXPRESSLY DISCLAIM LIABILITY FOR LOSS, OR DAMAGE OR EXPENSE ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE HANDLING, STORAGE, USE OR DISPOSAL OF THE PRODUCT. This MSDS was prepared and is to be used only for this product. If the product is used as a component in another product, this MSDS information may not be applicable. . . Page 12 of 12 '~.. CITY OF BAKERSFIELD HAZARDOUS MATERIALS INVENTORY HAZARDOUS MATERIALS DIVISION, 2130 aGa Street, Bakersfield, CA 93301 o Farm and Agriculture [; Standard Business BUSINESS NAME: AMlPM MINI MARKET #5164 LOCATION: 4010 Wible Road CITY, ZIP: Bakersfield, CA 93309 PHONE #: [805] 836-9685 Ll0810t RECEIVED MAR 1 1 1992 ~i OWNER NAME: PRESTIGE STATIONS, INC. #5164 ADDRESS: P. O. BOX 6225 CITY, ZIP: ARTESIA, CA 90702 PHONE II: [310] 402-1278 REFER 2'0 INSTRUCTIONS FOR PROPER CODES Name of this Facility: Standard Ind. Class Code: Dun & Bradstreet Number & FederallD # ~1"A~J. DfV. 52-012-0713 Qt--' I I ¡ I I I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trans Type Max Average Annual Measure # Days Cont Cont Cont Use Location Where %by Names of Mixture/Components Code Code Amt Amt Est Units On Site Type Press Temp Code Stored in Facility Wt See Instructions I U M 20, 000 12,000 2.8 million GAL 3 6 5 0 1 1 4 19 Southwest corner Gasoline-ARCO UNLEADED Physical and Health Hazard CAS. Number 1634-04-4 01 lot 9 9 Hydrocarbons (none) Check all that apply 1 0 Methyl Tertiary-Butyl Alcohol . (75-65-0) -. .--, ,-, '--I ,-.. 1 1 Methyl Tertiary-Butyl Ether 'X/Fire Hazard :_ _: Reactivity :!:Delayed : _ _:Sudden Release / 'Immediate .... ,-.. (1634-04-4) Health of Pressure Health " I U I M 10,000 I 4, 000 1500, 000 IG A L 13 6 5 0 1 1 4 19 Southwest corner Gasoline-ARCO SUPER UNLEADED Physical and Health Hazard CAS. Number 1634-04-4 01 lot 9 9 Hydrocarbons (none) Check all that apply 1 0 Methyl Tertiary-Butyl Alcohol (75-65-0) r1 '--I I-I '--I r-, 1 1 Methyl Tertiary-Butyl Ether ~ Fire Hazard ~_ _ ~ Reactivity ~! ~ Delayed ! _ _~ Sudden Release ! _ jlmmediate Health of Pressure Health (1634-04-4) I U I P I 4 4 8 I 2 2 4 15,824 cU.ft. IF T 3 3 6 51 0 4 I 1 4 99** Storage Area CARBON DIOXIDE Physical and Health Hazard CAS. Number 124-38-9 1 0 0 CARBON DIOXIDE Check all that apply **Used In soft drink dispensing (124-38-9) [ j Fire Hazard := =: Reactivity :!:Delayed :!=:sudden Release i - -¡ Immediate 1_-' Health of Pressure Health I I I I I I I I Physical and Health Hazard CAS. Number ~ Check all that apply -. .--, ,-, 1--. ,-- ~ ~ Are Hazard :__: Reactivity : _ ~ Delayed , ~ _ _: Sudden Release ' 'Immediate ,-.. Health of Pressure Health EMERGE",CY CONTACTS #1 Robert Sorce Facility Manager [805] 871-7306 Name Title 24-hr Phone #2 Everado Velasco Field Supervisor [805] 589-2507 Name Title 24-hr Phone Page 1 of 1 Certification (Read and sign after completing all sections) I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents, and that based on my inquiry of those individuals responsibility for obtaining the information, I believe that the submitted information is true, accurate, and cor~et,' IL " \~ NANCY B. WALTI, Manager-Environmental, Health & Safety /)j \. D ¿ W~ Name and official title of owner/operator OR owner/operator's authorized representative Signature 3/6/92 Date Signed I I _~f ~.---..- ' . . ~ 02/20/92 AM PM MINI MARKET #5164 215-000-000564 Overall Site with 1 Fac. Unit Page 1 General Information Location: 4010 WIBLE RD Community: BAKERSFIELD STATION 07 Map: 123 Hazard: Low Grid: 13A FlU: 1 AOV: 0.0 Administrative Data Contact Name ROBERT SORCE Title MANAGER FIELD SUPERVISOR " Owner: PRESTIGE STATIONS Address: P 0 BX 6225 Ci ty: GERRI'rOS 1!-¡¿7l.f IA- D&B Number: 51-012-0713 State': CA Zip: ~997Ql-907ù.:L SIC Code: 5541 Phone: ~~~) ~t9~ZK State: CA Zip: 9.e-:7-Ø-i--- 9 O?ð ~ Mail Addrs: PO BOX 6225 City: -GERRITOS. f+i(-rðiA- Comm Code: 215-007 BAKERSFIELD STATION 07 Summary .RECEIVED MAR 1 1 1992 HA7 MAT. DIV. ,.N¡¡~;t!/!!;;,TJ Do hereby car!lly lhall have reviewed the attaGl1ød Ìl8.z~(rd ,E;~" materials manag~o ment plan foy.~H !~~_~!.~ ~~~/5~d~~: t~IOng wiih (N:ti'¡'~' >j, ~·_:i.rn,J:":~, any correc:Óc¡)s ccr¡~l;:L:û a conlplete and corrsct mano agement plan for my facility. -1.6, ¡¿of{ 3~~~ 'Date ." . } . t 02/20/92 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site a Page 1 02-001 GASOLINE (UNLEADED) ~ Fire', Immed HI th, Delay HI th Liquid Hazmat Inventory Detail in Reference Number Order 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Days: 365 Use: FUEL Type: Pure Daily Max GAL ----r-- 10,000 ' I Daily Average GAL --r-- 4,000.00 Storage UNDER GROUND TANK r Press T Temp -:I Ambient Ambient SW OF LOT - Conc l 100.0% Gasoline Components r; MCP -:-¡List Moderate Annual Amount GAL -- 585,000.00 Location 02-002 GASOLINE (SUPER UNLEADED) ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 Daily Average GAL 2,000.00 I ~ Storage UNDER GROUND TANK r Press T Temp -:I Ambient Ambient SW OF LOT - Conc l 100.0% Gasoline Components MCP -:-¡List I~oderate Annual Amount GAL -- 549,000.00 Location 02-003 GASOLINE (REGULAR) ~ Fire, Immed Hlth, Delay Hlth Liquid 10000 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL 10,000 ~ Daily Average GAL ~ 2,000.00 Storage UNDER GROUND TANK r Press T Temp -:I ' Ambient AmbientlSW OF LOT - Conc l 100.0% Gasoline Components \-; MCP -:-¡List Moderate \ Annual Amount GAL -- 549,000.00 Location ".. . fe 02/20/92 AM PM MINI MARKET #5164 215-000-000564 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-004 CARBON DIOXIDE ~ Fire, Pressure, Immed Hlth Ga~ 448 Minimal FT3 CAS #: 124-38-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Us&: OTHER Daily Max FT3 ~ Daily Average FT3 ~ Annual Amount FT3 -- 448 I 224.00 5,824.00 Storage r Press T Temp ~ PORT. PRESS. CYLINDER Ambient Ambient Location - Conc l ,100.0% Carbon Dioxide Components r; MCP -=--rList Minimal I ~. . . 02/20/92 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical <1> Agency Notificat~on CALL 911 THEN NOTIFY FIELD SUPERVISOR (805) 837-0141 WHO WILL NOTIFY CORPORATE MANAGEMENT <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEµ (I.E. FACILITY MANAGER, ASSISTANT, CASHIER -OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED, EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation EMPLOYEES WILL EVAUCATE PUBLIC THROUGH NEAREST EXIT. ALARM SHALL BE GIVEN BY SHOUTING , <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371 BAKERSFIELD CITY FIRE DEPARTMENT - 4030 SORRANO AVE - STATION #7 0. ~ " . . 02/20/92 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 4 <E> Mitigation/Prevent/Abatemt <1> Release Prevention FACILITY UTILIZES THREE 10,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTHWEST END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT ' A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED AT EACH FACILITY. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOFITY EMERGENCY CONTACT PERSONNEL. <2> Release Containment FOR MINOR SPILLAGE EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIALS SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT IS PROVIDED. FOR A MAJOR SPILLAGE, EMPLOYEES ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY THE EMERGENCY RESPONSE PERSONNEL. INVENTORIES ARE MONITORED DAILY AND ARE KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "DO NOT TOP OFF TANK", AND "PLEASE TURN OFF YOUR ENGINE" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. CONTAINMENT SHALL BE COMPLETED BY DIKING WITH ABSORBANT/OTHER MATERIAL. <3> Clean Up CLEAN UP PROCEDURES INCLUDE USING ABSORBANT, EVAPORATION, AND A LICENSED HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL COMPANY, IF NECESSARY. <4> Other Resource Activation ... '. .. . ., , - 02/20/92 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page ' 5 <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) " ", .. J' .. ',' . . . 02/20/92 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards I , <2> Utility Shut-Offs A) GAS - N/A B) ELECTRICAL - EAST SIDE OF BUILDING IN OFFICE/STORAGE AREA C) WATER - LOCATED AT WIBLE ROAD DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATIONS OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NORTH OF WHITE LANE ON WIBLE ROAD APPROXIMATELY 200 FEET FROM INTERSECTION. <4> Building Occupancy Level r: :' 0; ,.... .i'-'~ . . 02/20/92 AM PM MINI MARKET #5164 215-000-000564 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ALL PERSONNEL, NEW AND EXISTING, ARE GIVEN INSTRUCTION ON COMPLYING WITH THE CITY OF BAKERSFIELD BUSINESS EMERGENCY PLAN. UPON COMPLETION OF SAID INSTRUCTION, EMPLOYEE WILL SIGN AN ACKNOWLEDGE SLIP. IN ADDITION, A TRAINING LOG WILL BE KEPT BY THE FACILITY MANAGER TO ENSURE THAT INSTRUCTION HAS BEEN CARRIED OUT. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use .~~:......; -,,,---~.; Attn: _PRESTIGE STATIONS. IN<* ( En onmental. Health & Safet~epartment P. O. Box 6225 Artesia. CA 90702 [213] 402-1278 ""'" ........... ,:~:::~::::~::::~:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~:~:::::::::::::::::::::::::~:~:~::~::::::::::::::~:::::œlf\iß:::llil,~~;,,::::::::::::]::ºJ?::z;ª,~z;~~: UPDATED EMERGENCY CONTACT INFORMATION \.¡afiJ t')......~\ \) /\.) to, (To be attached to current Business Response Plan) ARca- #: 5365 PSI -#-:- 5164- Facility: AM/PM MINI MARKET #5164 4010 Wible Road Bakersfield. CA 93309 County: KERN Facility Telephone: [805] 836-9685 Field Supervisor: [805] 873-8821 [805] 834-2927 [213] 313-0134 Robert Sorce Mary Scheiber Fernando Sendejas Facility Manager: Area Manager: MAINTENANCE: PSI Maintenance [800] 553-6246 ARCO Maintenance [213] 402-9126 WHEN CALLING ARCO MAINTENANCE, GIVE ONLY THE ARCO # PSI CERRITOS MAIN OFFICE: 213-402-1299 ~ , I / ~,. "';. .', .' e',' . OK Bakersfield Fire Department RECEIVED Hazardous Materials Division 2130 "G" Street :JUN 2 5 1990 Bakersfieldl CA 93301 H.i~ 7 rvt"AT. DIV. ¡¡¡¡¡¡:¡¡::::¡¡¡¡¡¡¡¡¡':¡:'::::::::::::::::::::¡::¡¡¡¡¡¡¡¡¡¡¡:¡:::::::::::¡:¡:::¡:¡:¡¡¡¡¡¡¡¡¡¡¡:::::¡:¡¡¡¡¡¡¡¡¡¡¡¡¡:¡:¡¡:::::j'¡'::¡:::¡¡¡:::¡:¡:¡::¡:¡¡¡¡¡¡¡¡¡¡¡¡¡¡¡:::::::::¡j¡:¡¡¡¡¡¡¡:¡¡¡¡¡¡¡¡¡¡:¡¡¡¡¡::¡¡¡¡¡¡¡¡¡¡¡¡:'¡¡¡:¡¡¡:r'¡:::¡:::¡¡¡:::::¡:¡:¡¡::¡¡:¡:¡¡:::¡:::¡¡¡::::::::::::::::¡:::::¡¡¡:::::::::::::¡:::::::::::::::::::::::::¡:¡"¡:¡::"::::¡:::¡:¡:::::¡¡::¡¡¡:¡¡¡¡¡¡¡r:¡r:::::::¡:lllAll!;::¡::::¡!lIt;lllgg HAZARDOUS MATERIALS MANAGEMENT PLAN l. 2. 3. 4. To avoid further action. return this form within 30 days of receipt. 1YPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be brief and concise as possible. Instructions: ~6Lf SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: AM/PM MINI MARKET #5164 WCATION: 4010 Wible, Bakersfield, CA 93309 BUSINESS PHONE: [805] 836-9685 MAILING ADDRESS: Prestige Stations, Inc. #5164 Attn: Environmental Analyst P. O. Box 6225 Cendtos,CA 90701 PHONE: [213] 402-1278 DUN & BRADSTREET NUMBER: 51-0120713 SIC CODE: 5541 PRIMARY ACTIVI1Y: Convenience store with retail gas sales OWNER: Atlantic Richfield Company OPERATOR: PRESTIGE STATIONS, INC. P. O. Box 6225 Cendtos, CA 90701 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR PHONE l. 2. Donna M. Clevenger Facility Manager Ron Taft , Field Supervisor [805] 836-9685 [805] 837-0141 [805] 871-7756 [805] 837-0141 1 ,> <¡ . . Bakersfield Fire Department Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: Average total 12 for the faciHty Shift 1= 3; Shift 2= 2; Shift 3= 1 MATERIAL SAFE1Y DATA SHEETS ON FILE: FaciHty copies of MSDS is located in the yellow HAZARD COMMUNICATION PROGRAMS binder BRIEF SUMMARY OF TRAINING PROGRAM: All employees are instructed as follows: 1. For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. protective rubber gloves and clean up equipment is provided at each facUity. For major spillage, employees are instructed to call 911 and report. They will then notify the Emergency Coordinator or his alternate who will then activate the NOTIFICATION procedures. 2. Use and location of absorbant, protective clean-up equipment and flre extinguishers. Annual inspection and maintenance of safety equipment (fire extinguishers, rubber gloves and clean up equipment), and review of procedures for proper use of safety and spill control equipment. 3. Review of Emergency Response Plan: evacuation procedures: location of emergency fuel shut-off switches and main electrical shut-off switch: use and location of absorbant, protective clean-up equipment and fire extinguishers: and the list of ALL pertinent people to call in case of an emergency. Make sure employees know the location of the Emergency Response Plan. SECTION 4: EXEMPTION REÇ}UEST: I CERTIFY UNDER PENAL1Y OF PERJURY THAT MY BUSINESS IS EXEMPT FROM 1HE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF 1HE "CALIFORNIA HEAL1H & SAFE1Y CODE" FOR 1HE FOLLOWING REASONS: WE DO Nar HANDLE HAZARDOUS MATERIALS WE DO HANDLE HAZARDOUS MATERIALS, BUT 1HE QUANTITIES AT NO TIME EXCEED 1HE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, MITCHELL K. NG, CERTIFY THAT 1HE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT 1HIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATION UNDER 1HE "CALIFORNIA HEALTH AND SAFE1Y CODE" ON HAZARDOUS MATERIALS (DN. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. Manaeer. Admin. Svcs. 06/22/90 .NG 2 I . . . Bakersfield Fire Department Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: AM/PM MINI MARKET #5164 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A AGENCY NOTIFICATION PROCEDURES: Fire Pollce Ron Taft, Field Supervisor 911 911 [805] 837-0141 The Field Supervisor will then notify: Bruce Taylor PSI CORPORATE OFFICE MAINTENANCE California Office of Emergency Services Environmental Protection Agency National Response Center [213] 838-5670 213-402-1299 800-553-6246 800-852-7550 415-974-8131 800-424-8802 B. EMPLOYEE NOTIFICATION AND EVACUATION: Job Title: FaciUty Manager a. For any emergenCYI call 911 and report. b. Evacuate, if necessary, to a site opposite danger area. c. Call your Field Supervisor; give details of emergency. d. Your Field Supervisor will notify Atlantic Richfield maintenance, Area Manager and main office. Job Title: FaciUty Personnel (i.e. cashierl maintenance). a. For any emergency, call 911 and report. b. Evacuate if necessary, to a site opposite danger area. c. Call your FaciUty Manager; give details of emergency. d. Your Facility Manager will call Field Supervisor and report. e. Your Field Supervisor will notify Atlantic Richfield maintenance, Area Manager and main office. C. PUBLIC EVACUATION Alarm shall be given by shouting. D. EMERGENCY MEDICAL PlAN CALL 911 AND REPORT - PARAMEDICS WILL RESPOND 3 '. . . Bakersfield Fire Departmen.t Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: Facilities are equipped with red jacket leak detectors which shuts down if leak occurs. Inventories are monitored daily and are kept at a minimum to minimize risk. "No Smoking", "Please Turn Off Your Engine", and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employees. Compliance to posted signs minimizes potential risk and hazards. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: For minor spillage (i.e. customer gas tank overflow) employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided. For a major spillage, employees are to call 911 and report. They will then notify the emergency response personnel. Inventories are monitored daily and are kept at a minimum to minimize risk. "No Smoking". "Please Turn Off Your Engine", and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employees. Compliance to posted signs minimizes potential risk and hazards. Containment shall be completed by Diking with Absorbant/Other Material. C. Cleanup Procedures Cleanup procedures include using Absorbant, Evaporation, and a Licensed Hazardous Waste Treatment, Storage. and Disposal CompanYI if necessary. SECTION 8: UTILITY SHUT-OFFS (WCATION OF SHUT-OFFS AT YOUR FACILITYI NATURAL GAS/PROPANE: NONE ELECTRICAL: East side of building in office/storage area WATER: West side of site in sidewalk off Wible Road SPECIAL: Emergency Fuel Pump Shut-Off Switch is located in the sales area near the cashier LOCK BOX: YES/[NO] IF YES. LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: NONE B. WATER AVAILABILI1Y (FIRE HYDRANT): Located across street on Wible Road 4 nHAZARDOUS MATERIALS. INVENTORY 1 farll and ~gticulture 0 Standard Business U NON-TRADE SECRETS Page _~_u of I..' ~, ÂY~~~' Nt~rå :~6f~ tUNI MARKET # 5164 ~~N~~SN~~'bämP ST~I~ STAT¡~Sl!u IN~ N~MR ~~OTH~B. F¿CIL!,T~6o~1Æ~5~INI MAR~lL#5}64 , TV lÞ:a-;¡vãWõ e C YQ ~lp: ---,! 9Ó~Ž x - 5u~ RND B~ADSTR~E~: NUMB~R-'- --,..--'------ ION~ . .JoI~rr~HL__GA--,gæe.g,-.._-- p ION~ i. Z' _ - § -- ~1. - bl [- 0 7 1 3 , '. --i805) ð36-9685 ' - R FEFl 7'O-¡NSTRUCTIONS-'FVR-PROPER CODES - - - - - - - - - . I 2 3 4 6 7 8 9 10 11 12 13 U rans TYQe (ax Average Meuure' Oys Cant Cant Cant Us~ location Where 'by HUles of li~ture/Col"conents ode Code Allt Allt Units on Site Type Press Tellp Code Stored In FacIlity lit See Instrucllons ,U M 10 000 2 000 01 4 Pg. 5 F-3 ARGO REGULAR GASOLINE ,huical end Hea1th Halard COllponent II Hille I C.A.S. HUllber 00 Hydrocarbons (none) ICheck all that apply ¡ --....iIÍÍÍÞ.Hazard 0 Reactivity ~layed 0 Sudden Release ~ Health of Pressure CITY of HAKEHSrlELU O COllponent.2 Halle I C.A.S. HUllber IlImed is te Hea I th Component.3 Hame I C.A.S. HUllber C.A.S. HUllber p . 5 F-3 COllponent.1 Nalle' C.A.S. HUllber o Reactivity 'Delayed 0 Sudden Release Health of Pressure O COllponent.2 Halle I C.A.S. HUllber IlIlIIediate Hea I th COllponent.3 Halll I C.A.S. HUllber P 5 F-4 Component 'I Hame I C.A.S. HUllber o Reactivity E1'oe layed 0 Sudden Re I ease Health Of Pressure O COllponent.2 Halle I C.A.S. HUllber IlIlnediate Hea I th COllponent.3 Halle I C.A.S. Humber Phl5ical end Health Ha¡ard (Check all that applyl C.A.S. HUllber COllponent.1 Nalle I C.A.S. NUllber 13 Toluene (108-88-3) 15 Etbe Methyl Terti ARCO UNLEADED GASOLINE 00 10 11 00 10 11 00 Carbon Dioxide (124-38-9) J 0 COlnponent'2 Halle I C.A.S. NUllber o Fire Hazard 0 Reactivity 0 Delayed \{] Sudden Release IlImediate Health of Pressure Health COllponent '3 Halle I C.A.S. Number **99 = used in soft drink dis ensin EMERGENCY CONTACTStt1Donna fC Clevenqer' Facility r~gr. 805-871-7756 112 Ron Taft Field Supervisor 805-837-0141 ,Rue ntle,. 2Tlfnfiõñr- HIlie T1tle 2nlftfiðñr 1 re~iHI~~t~~~er enal\R~pPa fr~ J ~atf~e{~faÇ~rex~fnmflft.j~~¡i1r."itl?fh~~tf~~~t/on $U lIitte~ in his end all attached dQCvmen~s an~ t~at ~ase~ on IY InquIry 01 those In~lvl~ua's respons~b1e Vor obtaIning the 1n~orllatlon. I believe that the )ub~~ted Inlorllatlon IS truI, accurale¡ and COllplltl. " ___A Mìtchell K. Ng, Manager-Administrative Services ' ' 6-22-90 q!~~~~~frirtr-t1t'e of own~r,ooeratðr UN owner/operator's authorlzea reørrfiñtatlve ' S1~ñ~tur~-' UBt~f~r.ëð----- }, ~ . . . CALL: 911 ARca #: 5365 PSI #: 5164 STATION MANAGER: [805] 871-7756 Donna Clevenger FIELD SUPERVISOR: [805] 837-0141 Ron Taft AREA MANAGER: [213] 313-0134 Fernando Sendejas MAIN1ENANCE: PSI Maintenance ARCO Maintenance [800] 553-6246 [213] 402-9126 WHEN CALLING ARCO MAINTENANCE, GIVE ONLY TIlE ARCO # CERRITOS MAIN OFFICE: 213-402-1299 ,: .. :::. :.;..... :;':. ":":;::'::::: ..:;..::....:.:.:::.::.,.~,. ,..,:.:. .).:',':':,:::;:;.;::.;.;:::.::::::,:.:::;:,.;::,:::;:::.:.::.:.....:.:.:..::.::.~'..:.:..::::..:'...:::.::<.:;': " ..,.; , , ... '. ::. .. .:::. ;", ".. ..". """.' " """, ATTACHMENT AA 27 __ '~, ,l_ . . Bakersfield Fire Department Hazardous Materials Division 2130 "G" Street Bakersßeldl CA 93301 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 as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: AM/PM MINI MARKET #5164 WCATION: 4010 Wiblel Bakersfleldl CA 93309 BUSINESS PHONE: (805) 836-9685 MAILING ADDRESS: Prestige Stationsl Inc. #5164 Attn: Environmental Analyst P. O. Box 6225 Cendtos,CA 90701 PHONE: (213) 402-1278 DUN & BRADS1REET NUMBER: 51-0120713 SIC CODE: 5541 PRIMARY ACTIVITY: Convenience store with retail gas sales OWNER: Atlantic Richfield Company OPERATOR: PRESTIGE STATIONS, INC. P. O. Box 6225 CendtoslCA 90701 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR PHONE 1. 2. Donna M. Clevenger Facility Manager Ron Taft , Field Supervisor (805) 836-9685 (805) 837-0141 ,(805)871-7756 (805) 837-0141 1 r;; . ..... ~ . . Bakersfield Fire Department ' Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: Average total 12 for the facility Shift 1= 3; Shift 2= 2; Shift 3= 1 MATERIAL SAFElY DATA SHEETS ON FILE: Facility copies of MSDS is located In the yellow HAZARD COMMUNICATION PROGRAMS binder BRIEF SUMMARY OF TRAINING PROGRAM: All employees are instructed as follows: 1. For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. protective rubber gloves and clean up equipment is provided at each facility. For major splllage, employees are instructed to call 911 and report. They will then notify the Emergency Coordinator or his alternate who will then activate the NOTIFICATION procedures. 2. Use and location of ab80rbant, protective clean-up equipment and fire extinguishers. Annual inspection and maintenance of safety equipment (fire extinguishers, rubber gloves and clean up equipment), and review of procedures for proper use of safety and spill ~ontrol equipment. 3. Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbant, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in case of an emergency. Make sure employees know the location of the Emergency Response Plan. SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENAL1Y OF PERJURY THAT MY BUSINESS IS EXEMPT FROM TIlE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF TIlE "CALIFORNIA HEALTIl & SAFElY CODE" FOR fHE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS WE DO HANDLE HAZARDOUS MATERIALS, BUT TIlE QUANTIT1ES AT NO TIME EXCEED TIlE MINIMUM REPORTING QUANTIT1ES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I. MITCHELL K. NO. CERTIFY THAT TIlE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TIllS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATION UNDER TIlE "CALIFORNIA HEALTIl AND SAFElY CODE" ON HAZARDOUS MATERIALS (DN. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. Man8ler. Admin. Svcs. 3/7/90 Signature: K.NG 2 f "-;; . . Bakersfield Fire Department Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: AM./PM MINI MARKET #5164 SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: Fire PoUce Ron Taft. Field Supervisor 911 911 [805) 837-0141 The Field Supervisor will then notify: Bruce Taylor PSI CORPORATE OFFICE MAINTENANCE CaUfornia Office of Emergency Services Environmental Protection Agency National Response Center [213)838-5670 213-402-1299 800-553-6246 8,00-852-7550 415-974-8131 800-424-8802 B. EMPWYEE NOTIFICATION AND EVACUATION: Job Title: Facility Manager a. For any emergency. call 911 and report. b. Evacuatel if necessaryl to a site opposite danger area. c. Call your Field Supervisor; give details of emergency. d. Your Field Supervisor will notify Atlantic Richfield maintenance I Area Manager and main office. Job Title: Facility Personnel (i.e. cashier. maintenance). a. For any emergencYI call 911 and report. b. Evacuate if necessary. to a site opposite danger area. c. Call your Facility Manager; give details of emergency. d. Your Facility Manager will call Field Supervisor and report. e. Your Field Supervisor will notify Atlantic Richfield maintenance. Area Manager and main office. C. PUBLIC EVACUATION Alarm shall be given by shouting. D. EMERGENCY MEDICAL PLAN CALL 911 AND REPORT - PARAMEDICS WILL RESPOND 3 L> 7' " . . . Bakersfield Fire Department Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A RELEASE PREVENTION STEPS: Facillties are equipped with red jacket leak detectors which shuts down if leak occurs. Inventories are monitored daily and are kept at a minimum to minimize risk. '''No Smoking"l "Please TurD Off Your Engine"l and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employees. CompHance to posted signs minimizes potential risk and hazards. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: For minor spillage (i.e. customer gas tank overflow) employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided. For a major spillage, employees are to call 911 and report. They will then notify the emergency response personnel. Inventories are monitored daily and are kept at a minimum to minimize risk. "No Smoking", "Please Turn Off Your Engine", and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employees. CompHance to posted signs minimizes potential risk and hazards. Containment shall be completed by Diking with Absorbant/Other Material. C. Cleanup Procedures Cleanup procedures include using Absorbant, Evaporation, and a Licensed Hazardous Waste Treatmentl Storage, and Disposal Company, if necessary. SECTION 8: UTILITY SHUT-oFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: NONE ELECTRICAL: East side of building in office/storage area WATER: UNKNOWN SPECIAL: Emergency Fuel Pump Shut-Off Switch is located in the sales area near the cashier LOCK BOX: YES/[NOJ IF YES. LOCATION: SECTION 9: PRIVATE FIRE PROTECTION /WATER AVAILABILITY: A PRIVATE FIRE PROTECTION: NONE B. WATER AVAILABILITY (FIRE HYDRANT): Located across street on Wible Road 4 02/16/90 AM PM MaAHKET #5164 215-000-00. Overall Site with 1 Fac. Unit ~ú Page 1 General Information Location: 4010 WIBLE RD 215-000-000564 Map: 123 Hazard: Low Grid: 13A Area of Vul: I ] 0.0 II !.II II Ma i I Addt~s: City: Gec.SubD i v: Ti tIe I BI.lsi ~F- "'?'Ó~ MANAGER (B05> ~~~:~,' x FIELD SUPERVISOR (805) ~ ~¥ì x Administrative Data 17315 STUDEBAKER ROAD CERRITOS 215-007 BAKERSFIELD STATION 07 -,24 P HC'l.n~ ~h cne] I I I I .j¡ ik ~' \' D&B Numbet~: State: CA Zip: 90701- SIC Cc.de: 5541 \; f~ Owner: PRESTIGE STATIONS Address: P 0 BX 6225 City: CERRITOS Phone: (805) 836-9685 State: CA Zip: 90701- ; )' I II I 1 I I Summat~y U E ! J9 U & J ~~...",.~.~ ...~ . . Prestige Stations, Inc. 5&~' 4od-\~lf} (9- ,7:J ') 17215 Studebaker Road Cerritos, California 90701 March 20, 1989 Ralph E. Huey City of Bakersfield, Fire Dept. Hazardous~Materials Division 2130 G Street Bakersfield, CA 93301 Re: Business Emergency Response Plan Dear ,Mr. Huey, @ ";':C~i \I~O MAR 2 1 1969 HAZ- MAT" DIV. Enclosed for your review is a Business Emergency Response Plan for a location that we operate within your jurisdiction. If you should have this plan on file then consider the enclosed as an update. PSI#5l64 4010 Wible Road Bakersfield I will be your contact for any additional information or questions you may have. My number is (213)402-1299. Sincerely, ")~l :~~ger, AJLinistrative Services Enc cc: M. M. Zawacki C. L. Connor F. Seguin w/o Enc w/o Enc w/Enc ARca oj){ ,"¡'-ß, '~ " \., ~7· . . .. ~, STANDARD BUSINESS EHERGENCY RESPONSE PLAN FOR CITY OF BAKERSFIELD ***************************************** , I Address Hhere Business Is Conducted: 4010 Wible Road Bakersfield, CA Zip Code: 93309 Unit Type: Unit Number: HORK PHONE NUMBER Business Owner Name: PRESTIGE STATIONS INC. t 5164 (213)402-1299 On-Site Manager: Buddy Fiorio (805)836-9685 ~ J .. . Emergency Contact: Buddy Fiorio EMERGENCY PHONE NUMBER (24-HOUR) (805)366-0922 , 'AI ternate I; Standard Emergency Contact: CHARLIE CONNOR ARCO MAINTENANCE 1-800-553-6246 ( 213) 4 02 -912 6 Industrial Classification (SIC) Code of Business: 9200 'Below is your mailing address. Please make corrections on the space provided to the left. AM/PM MINI MARKET '5164 P.O. BOX 6225 ATTN: ADMIN. SVC. CERRITOS, CA 90701 I, ~Oescribe the business operations that use or handle hazardous materials: Maximum number of employees: CONVF.NTF.NCF. STORE WITH GAS SALES 12 Total square footage of facility: 2,000 EST er or Authorized Representative Manager Admin. -: SVc s . Ti tie 16MARRq Date ,I Office Use Only 1 902: ¡ I nsp. I. D. : Date: D/E I.D.: Date: CIT}T of BAKERSFIELD ;; F,r. //lid AqricuJtur. ,--, St,nd.rd BU51n.ss L.-.: HAZARDOUS MATERXALS XNVENTORY NON-TRADE SECRETS P'9. ____ of ____ ... '--' BUSINESS NAME: LOCATION: CITY, ZIP: PHONE ,: M1~PM Mini-Market # 4U U Wible Rd. Bakersfleld 93309 ¡jU~/tUb-~b¡j~ OWNER NAME: ADDRESS: CITY, ZIP: PHONE .: IUØ'IØI 10 1 2 3 t r 8n' T YIlt III. (oft Cod. Mt . Aver. Mt 5 Mnuil Est , .....ure Units PhysiC.lend H..1th 11111", 1r.lIKk .11 tlllt . pl,) t Cant Pren 01 1 4 u.s. ......,__ 8006-61~ , IOys CII Sit. ~x~ Fir. Hmrd ~:~ llelcth"t, ~:x~ OII.yed ~X~ SucIØn ..1_ ~~ l-.dl.t. ....Ith of P......... ....Ith PRESTIGE STATIONS. INC. P.O. BOX 6225 CERRITOS. CA 90701 (213)402-1299 IIISr7fucrIOItS roll PlfOPIlR CODIlS NAME OF Tn1S ~~~L~tI: STANDARD IND. CLASS CODE DUN AND BRADSTREET NUMBER 11 Un Code U locattCII .... Stored In feelltt, 13 ,by 1ft 1& __ of ,,1JIt.....'c-tI SIt Instruct iCIII _______ 1 QQ G~.s..Q.L.illL Ca.pantnt" .... C.i.S. .... REGULAR ---.--------- ~t 12 .... U.S. .... ---- Ca.pantnt 13 .... C...S. ..... Phys ie.1 end ....Ith Her.", ({"-ek .11 tlllt 'l1li1,) 100 GASOLINE ----- - --- ~x~ fire 1111'", {:] hlcttvlt, rX] DtI.,.cI rX] Suddtn ..1_ :)(] l-.dt.t. ...., th ot P.......... ....lth Ca.pantnt II .... C.i.S. .... UNLEADED Ca.pantnt IZ .... C.i.S. ..... Ca.pantnt 13 .... C.i.S. ..... Phys ic.1 end ....1th 1111'"," /CIreck .11 tlllt ."ly) 8006-61-9 --------- ___e. C.i.S. ..... ,.x' ,.-, ,.X' ,.X' X-' L --' Fir. HII.M! '--'" IINctivit, '---' DeI.yed '--'" SudcIØI R.I.... ,,-... 1-.d11t. HHlth of P!'IIsure ....Ith ---1--l---________L____________L_____~___1____1__l__1 Phys ie.1 end ....1th IItlard ({"-ek .11 tlllt ..1y) 00 GASOLINE Ca.pantnt II .... C,.,S. ..... SUPER UNLEADED Ca.pantnt 12 .... C...S. ..... -------- Ca.pantnt 13 .... C...S. ....... 1___-1___ C...S, .......__________________ ec...an.nt II .... C...S. ..... Cœøonent 12 .... C...s, .... ,..-, r-, r-, r-, ,.-.., L - -' Fir, Hn.rd '- -... IIIIctivlty '- -... Del.ytd '- -... Sudden lit I lIS. '- _.J 1-.dI.t. H..lth of Prn.ure ",.lth ------- ----- ------------------------- ------ ec...an.nt 13 .... U:S. ..... 1 I· IiIfRGfNCY COmCTS ItIl¡ii~~ªªY__E_t9Xj.g________m__ Mfin-ªg-~X-------------- U3R?-~~~-9..2.2.- I2Qie..R.-Re.g.eJ:________________ Ff~Q-.-.s.upe~~k- n-itr~+g.+!;- C.rtl/iC.tion (Rflad and sign after co.plp.tJng all sflctJonsJ : I c.rt 1Iy und.r 111M Ity of I.. thet I hey, Itrson.n, ....;nitd tnd .. t..; h.r with the intor..tiCII SUbllr-ln this end .n .tteehed doc_tl, end thet btsllcl on ., inquiry of thos. tndtvidut I. rn ICII.ibl. for obt,in,,,, the inf_tlon. I tJ.1i.,,@ tlllt th@ subllittllcl intorution i, true, ICcur.t., end e.-pl.t . -1-1,. J 4- "' - In TI'H E."4Lf,NG ...--~NA.-G~DRR-z---l).7mu:fþt·---ßf~B:{"J.Ç~§-f-f.-- S----f--------- ~l---- \;-----------___________ DifJS§--:~~.L£h-J!2-------------- ... ðña óTTîcI.ífl . õl own.r,OMr.tor own,r ODf'r. or 5 au ""rUn r.ørlfSen . IV. 19n. ur, Ó ,. 19n"" ·} . e STANDARD BUSINESS PLAN BP-S (b) MEDICAL ASSISTANCE - in the event of a reportable hazardous materials or waste release or threatened release: v. list all local emergency medical facilities that will be used: Fi re Department Dial - 911 (c) EVACUATION PLAN - How will immediate notification and evacuation o f th e bus in e s s bed 0 n e ? (I n c 1 u d e a de sc rip t ion 0 f the s t e p s needed to evacuate employees and/or residents of the area surrounding the business in the event of a spill or release.) Are all new employees who may be impacted trained on evacuation procedures? Check one: ~Yes ____No. Are all employees who may be impacted given refresher training on evacuation proedures? Check one: XX Yes No. Evacuation routes, emergency exits, and staging areas for employees at the facility: Wo rk a re a : Evacuation route: Facility Sales Area Leave facility; go to area opposite danger. Two doors only. Emergency ex its: Staging area: Area opposite danger zone. Work area: Office/Storage Evacuation route: Leave fac il ity; go to a rea oppos ite~anger. ~' Eme rgency ex its: Two doors only. Staging area: Area opposite danger zone. · e STANDARD BUSINESS PLAN BP-5 6. EMERGENCY RESPONSE PLANS (a) NOTIFICATION PROCEDURES - in the event of reportable hazardous ITIdterials or waste release or threatened release: 1. Will the State Office of Emergency Services, DES, (telephone number 1-800-852-7550 or 1-916-427-4341) immediately be notified? Check one: XX Yes No II. Will local emergency respnse personnel immediately be notified by dialing 911? Check one: XX Yes No If business has an additional emergency response notification system, explain here. Job Title: Facility Manger For any emergency, call 911 and report. Evacuate, if necessary, to a site opposite danger a rea. Call your Field Supervisor; give details of emergency. Your Field Supervisor will notify Atlantic Richfield maintenance, Area Manager and main office. III. How will people within the business facility who must respond to an incident be noti fied? Job Title: Facility Personnel (i.e. cashier, maintenance). For any eme rgency, call 911 and report. Evacuate, if necessary, to a site opposite danger a rea. Call your Facility Manager; give details of emergency. Your Facility Manager will call Field Supervisor and report. Your Field Supervisor will notify Atlantic Richfield maintenance, Area Manager and main office. ! '. . STANDARD BUSINESS PLAN BP-S (d) MITIGATION (RECUE THE HAZARD) - Describe what procedures will be followed to reduce any harm or damage to persons. property. or the environment. "NO Smoking". "Please Turn Off Your Engine". and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employee. Compliance to posted signs minmizes potential risk and hazards. Facility personnel are instructed to clean-up minimal spills and dispose of properly and to report any major incident by calling 911. If needed. personnel will proceed to call all pertinent people listed on Attachment AA. (e) ABATEMENT (STOP THE HAZARD): Describe what actions your business will take to stop any hazard caused by the release of a hazardous material or waste. For minor spillage (i.e. customer gas tank overflow), employee's are instructed to clean and dispose of materials safely. Protective rubber glo es and clean-up equipment is provided at each faci 1 ity. For major spi llage, employee's are instructed to call 911 and report. They will then notify personnel listed on At tachment AA. 7. PREVENTION PLAN - (how will an unathorized release be prevented?) Facilities are equipped with red jacket lead detectors which shuts system down if leak Occurs. In addition, inventories are also monitored on a daily basis and are kept at a minimum to' minimize risk. 8. NEW EMPLOYEE TRAINING (a) Employees handling hazardous materials: All personnel, new and existing. are given instruction on complying with the City of Bakersfielë!us iness Emergency Plan. Upon completion of said instruction, employee will sign anAcknowledge Slip (Attachment C). In addition, a Training Log (Attachment D) will be kept by the facility manager to ensure that instruction has been carried out. One copy is kept at the facility and one copy is kept in employee's file located at 17215 Studebaker Road, Cerritos. CA, in Employee Relations Department. ., . . STANDARD BUSINESS PLAN BP-5 (b) Employees responsible for coordinating with first responders: Facility personnel are instructed to call 911 and report. They will then call all pertinent people listed on Attachment AA and report. I (c) Employees responsible for deployment of emergency equipment: Employee's are instructed on location of fire extinguishers and their proper use and operation. Insttuction is also given on locations of emergency fuel pump shut-off switches. See Attachments A and B. (d) Employee training on Emergency Response Plans: Personnel are instructed to call 911 and report emergency. Personnel are then instructed to proceed to a site opposite danger. If needed, personnel will proceed to call all pertinent people listed on Attachment AA. All secondary entities will then be notified. 9. REFRESHER TRAINING (a) Employees who handle hazardous materials: A Training Log (Attachment D) will be kept at facility to ensure that initial instruction has been carried out. Said training log will also be used for refresher training of said employee corrrnensurate with employee's anniversary date. (b) Employees responsible for coordinating with first responders: Facility personnel are instructed to call 911 and report. They will then call all pertinent people listed on Attachment AA a nd report. I~ . . STANDARD BUSfHESS PLAH BP-S (c) Employees responsible for deployment of emergency equipment: E~p10yee's are instructed on location of fire extinguishers and their proper use and operation. Instruction is also given on locations of emergency fuel pump shut-off switches. See Attachments A and B. (d) Refresher training on Emergency Response Plan: A Training Log (Attachment D) will be kept at facility to ensure that initial instruction has been carried out. Said training log will also be used for refresher training of said employee commensurate with employee's anniversary date. This Is How Most Fire Extinguishers Work I AllhouUh Ihe maJorllV 01 ellhnglllshe.s work wllh ou. dlfec:hons. Ihe.e a.e ellcephoflS Rc.JC1lhe "'Slrucllons on you. ellhngulshe, 10' Vdrldhofls Fllc a ptclu,e In you, mind Ihal will hI Ihe Inslruchons on Ihe elChngulshe, you will be uSII'g 2, If lhere's a Ii,e, gel everyone oulside Call1he Ij'e department Then IIghl a small li,e only. II Ihe Ii,e gels la,ge, gel out Close dooIs 10 slow lhe Ii,e spread, Slay between lhe hre and an exit Don'llel lire block your escape palh In case II goes oul 01 conlrol. 3 Make sure you don'l use one Iype elCllngUlsher on anolt\ef Iype 'lfe-it may make lhe 'lie worse Common errors (Ihey can be 'alai) a'e uSlOg wale, (A) on a grease Of on an elec'"ca' IIIe (8 or C) '3J Þ- ~ ~ g. a ~ r þI ~ :.;- . Learn How To Pass ---- i. Pull - Pull Ihe pm Some UOIls require Ihe releasing 01 a lock lalch, ptess"'g a punClure lever, or olhe, mohon 2.Aim - Aim Ihe ellhngUlsher nOllle (horn. 0' hose) . al Ihe base 01 Ihe ".e 3.~ze - SQlJeele or pless Ihe handle 4. Sweep - Sweer) lrom side 10 side al Ihe base ollhe "re unlll II goes oul Shul olllhe ellhngulshe, Walch lor rellash and 'eachvale lhe elChngUlshe, II nt..'CesSélty fOdm dnd waler elChngUlshe.s 'equlfe shghlly dlllerelll acllofl Head Ihe Inslruchons Learn Not To Bum --------------) (-------------- --------------) -------------- 2. This Is Your New ABCD's Of Portable Fire Extinguishers A '"" f!.h'IQ"'~ is A Sln'aqf!cnnlalncr tor "n edln· (¡HI!;""'" ~tt."" such AS walm u. chu....cats 1115 designed II) 11,,1 out itlimall h.e. nol a lJey olle An eohngu.sher IS labeled acCO....IIO 10 whelhe. lhe tlfe Oil whICh II IS 10 be used OCCUfSln wood Of clolh. lIammable tlQUlds, electrICal. 01 melat sources USIl'O nile Iype e.hnOUlsher on anolher lvue IlIe can make lhe IIIemuchWOfS8 Soleamhowelllmgulshersare labelel! and used 1.;t("honallvlhela~ls AB,C, Of Ohal/e been used 10 .ncltea'e lhe tvpe 01 hre on whICh an e.hngulsher IS 10 be used >' IT IT III () :::r :3 It> ~ ~ f?1 -;..'...., n.!Ct>nlly prclog. ams hal/e come Inlo use 1hese pee....e In blue lhe Iype of IlIe un whICh an eohnyulshet IS 10 be "St.''' Shown In ht¡l(;k wllh a red slash aut J)lchlfCS ul t..es Oil which Ihe e.'''~IUlshc. 1'100110 be ..sect Fnr eoall1l1'e. on a class 'A Iype.lhe loIlowlllylilbel would appear , " t Jœra NFPA 10. Slandard lor Portable Fife EohngUlshers. reconvnends lhal eJlhngulshers be labeled wllh PlClo- grit"" ttoweVef lheusef mavhndthe IradlllOnal A,B,C.D labets. Of bolh the P'CIOOfams and the A.B.C,D labels on 111 .xllngulshef You need .. ellllngulshef .. home. II you plan to buy one extlnguishet, a mulll'purpose dry chemical labeled ABC puts oul moSllypes 01 II'es - wood, papef, and cloth, lIa~able liquld,OI eleclrlcallires. II you buy more I~.."one, you mighl wanllo gel a BC lor Ihe kllchen. an A lor Ihe hI/lug room, and an ABC 101 Ihe basemenl and gar age Ordinary Combu.llbI.. Fires In papef, cloth, wood, rubber, and many plaslics require a walet IWJe extInguisher labeled A, Fire ~.linguishers where you work, .. r.¡ fIIoln¡UW"It'1I1 S ,II" III "¡'VI! .!...... ,...... If"" ,IV,l" .1"1f! I... IISC itlltl YIIII. III" III "'IIÞW how 'h"V w..... Buying and maintaining an ..lIngullh.,. I, EJlllngUlshers come in dry c.hemlcal.loam. calt>On diooKIe. waler. or halon IVIM!S Whatever Iype you lmy. It 5houkJ lie lal)eled hy a lest""J lahor, alory 2 1he higher Ihe number rahng on Ihe eldinglJlsher. Ihe mote '''e II puis OUI I"yh laled ones a.e often .nol always) Ihe heavier models. Make sure you can hold and operale Ihe one you mighl buy lor home use Of be required 10 use al work 3 Ask your dealer how 10 hal/e your extinguisher se",iced and Inspeeled RechiSlge II aile. ANY U5e A partìallv used OIIe mlghl as well be emµIy, .. Exlinguishers should be Inslalled awaV 'rom polenllalllle hazalds and near an escape roule, 5 FOI mOle delalls. see Slandard'OI Portable Fire ExtingUishers, NfPA 10, . n /'" Çd~~ tJ:1 rnlEJ rRjC!) Flammabl. liquid. Fire. In oils, gasoline. some palnlS, lacquers, grease f' a Irylng pan Of In Ihe oven, lolllenls and Olhet lIa~able lIQuidS require an extln· gUlSher labeled B, Electrical Equipment Fires In wiring, 'use bolles, ener· glzed eleclllcal equipmenl and oCher eleclrlcal SOUICes lequlfe an extinguisher labeled C, * M.tal. Combushble melals such as mag· neslum and sodium rec:luil8 special elftingU1shanlS labeled l) L1 . ~ , ~ --- --- · . I. · . · . · . · . · , · . · I · I · . , . · . · , · , , . --------.---- .- ----.-------------------.-- ~~~») (0{A)~ . - .' . . ,¡. ,. " . "' .¡¡ !- j; .. a: 1 L~' . . PrestIge Stations. Inc. National Headquarters 17215 Studebaker Road Cerritos. California 90701 ACKNOWLEDGMENT SLIP I have been instructed on the use of the Business Emergency Plan Manual and have read and understand all the information and instructions as stated. Further, I agree to abide by the statements and gUidelines outlined. I further acknowledge that failure to conduct my actions in compliance with these guidelines may result in the termination of my employment. Signed this day of , 19 - Employee Signature Facility Number Witnessing Supervisor Signature Attachment C BUSINESS EMERGENCY TRAINING LOG -. ..' :Þ rT rT ).J () ~ :3 CD :::s rt o ~ ~ INSTRUCTOR TITLE DATE OF TRAINING EMPLOYEE'S SIGNATURE INSTRUCTOR'S SIGNATURÉ' .. , I: , ' , I i ; , . e ,.. ~-¡, / '. , " . IN CASE OF EMERGENCY CALL: 911 STATION MANAGER Buddy Fiorio 805/366-0922 FIELD SUPERVISOR R. Reger 805/664-7875 AREA MANAGER J. Barker-Klein ' 702/873-5168 MAINTENANCE 1-800-553-6246 BOB ELKINS 213/402-9126 ARC a . 5365 PSI . 5164 WHEN CALLING ARca MAINTENANCE GIVE ONLY THE ARca .. CERRITOS MAIN OFFICE: 213/402-1299 Attachment AA ~- ~'r> ". ------------------------------------------------------------------------------------------------------------------------------- , TI ER TWO Facility Identification Phone. (805) 836-9685 1 Operator Name I 1 Name . PRESTIGE STATIONS INC 5164 I Mail Address . 4010 WIBLE 1 . BAKERSFIELD CA 93309 1-------------------------------------------------------- SIC Code: I 5541 1 Dun & Brad No. 1 04-542-6723 1 1 Emergency Contact ------- ------------- 1 n,.~A".,f' --------------------------------------------------------I Name: I~ ~~ FOR 1 Phone80S.89G. -'i~- OFFICIAL I ID # 1 -I '-, USE ------------------------------------------ I Name: ARCO MAINTENANCE ONLY I Date Received I I Phone (213) 404-5356 ------------------------------------------ 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~!~~~~~~~~l~~~~~~!~~~~~~~~~~~~~~~~~~~~~~~~~~~i~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ EMERGENCY 'AND HAZARDOUS CHEMICAL INVENTORY Name . ARCO FACILITY NO. 05365 Street Address. 4010 WIBLE City and State. BAKERSFIELD CA 93309 Speci fi c Information By Chemical 24 Hr. Title~A., Phone 8t>'S ,~"-09:J;} '100- 5!s3- lø:2~ Phone (213) 402-3166 24 Hr. CHEMICAL DESCRIPTION PHYSICAL AND HEALTH HAZARDS check all that apply Max Daily Amount , code INVENTORY Avg Daily Amount code No of Days On-site days STORAGE CODES AND lOCATIONS (Non-Confidential) Storage Code Storage Location --------------------- ---------------------- ---------------------------------- ----------------------------------------------- CAS. 008006-61-9 X Fire 1 04 I Chem. Name PETROLEUM Sudden Release NAPTHAS (Blended of Pressure Gasoline) Reactivi ty Type. LIQUID ONLY X Immediate (acute) Delayed (chronic) 1031 13'651 1BT41 --------------------------------------------------------------------------------------------- --------------------------------- .ertification: (Read and sign after completing all sections I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents, and that based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete. , ..-1/ FRED T. SEGUIN, C . M ADMINISTRATOR 1..-1 ~ d- )¡;-~7 Owner/Operator or Authorized Representative gnature Date Signed Optional Attachments (check one) I have attached a site plan I have attached a list of site coordinate abbreviations ------------------------------------------------------------------------------------------------------------------------------- r, ð~iv '"4Jv , I BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSPIELD, CA 93301 (805) 326-3979 IZ'!:J-/3!f-- 5 rf/ .r!) ~Î' :JJJS (J 'i> ¡ OFFICIAL USE ONLY ID# BUS INESS SA!<fE HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: .000564 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. BUSINESS NAME: AM/PM MINI MARKET 1.5164 B. LOCATION / STREET ADDRESS: 4010 Wible Road CITY: Bakersfield ZIP: 93309 BUS. PHONE: (213) 402-1299 SECTION 2: EMERGENCY NOTIFICATIONS In case of an e.ercency involvin¡ the release or threatened release of a hazardous material, call 911 and 1-800-8~2-7ð50 or 1-916-427-4341. This will notify your local fire departaent and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CAS! OF EMERGENCY: **ALSO SEE PAGE 2C** NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Bruce Wilkes Ph# 213/402-1208 Ph# 509/754-3174 B. Ron Rose Ph# 213/402-1299 Ph# 916/487-5500 SECTION 3: LOCATIOR 01' UTILITY SHUT-OFFS FOR BUSINESS AS A ROLB A. NAT. GAS/PROPANE: , NIA B. ELECTRICAL: Located in back room storage area (See Page SA) C. WATER: Located at Wible Road driveway (See Paqe SA) D. SPECIAL: Emerqency fuel shut-off located on cash reqister(see Paqe SA) E. LOCK BOX: YES / NO IF YES, LOCATION: No IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSS? YES / NO KEYS? YES / NO - 2A - . . SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE For a minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided at each facility. For ~jor spillage, employees are instructed to call 911 and report. They w111 then notify personnel listed on Page 2C. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE The following is the closest facility to our business: Mercy Hospital 2215 Truxtun Avenue (805) 327-3371 Bakersfield City Fire Department Station 17 4030 Soranno Avenue (Emergency medical technician on site) SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HA¥E A PROG~~ WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~TERIALS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6iJ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:........ ..... ..... .... .....NO C. PROPER USE OF SAFETY EQUIPMENT:...... ... ......... NO D. EMERGENCY EVACUATION PROCEDURES:. .... ........ .... S NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:. ...... NO SECTION '1: RAZARDOUS MATERIAL REFRESHER €iJ NO is :~, NO NO CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS TWU~ 500 POt~DS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO I, Mitchell Nq , certify that the above information is accurate. I understand that this inforaation will be used to fulfill IIY firll's obli~ations 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 perjury. SIGNATURE " TITLE Retail Operations DATE Analyst - 2B - 7ÞIr, I { I t-.,) (') I IN CASE OF EMERGENCY CALL: 911 STATION 'MANAGER JOHN HART (805) 835-0369 FIELD SUPERVISOR BRUCE WILKES (509) 754-3174 AREA MANAGER RON ROSE (916) 487-5500 MAINTENANCE VINCE CORSELLO (213) 402-8026 ARCO . 5365 PSI . 5164 WHEN CALLING ARCO MAINTENANCE GIVE ONLY THE ARCO .. Cerritos Main Office: (213) 402-1299 (213) 402-1203 . . . . BAKERSFIELD CITY FIRE DEPARTME~7 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL ~SE OXLY ID# BUSINESS NA-'tE: - - -' - - - BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action. this form must be returned by: 2. TYPE/PRIXT 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# 5164 FACILITY UNIT NA.'IE: AM/PM Mini Market SECTION 1: ~ITIGATION, PREVENTION, ABATEME~~ PROCEDURES Facility utilizes three 10,000 gallon underground tanks located at the S.W. end of the site. Inventories are monitored daily and are kept a~ a minimum to' minimize risk. DNo Smoking·, ·Please Turn Off Your Engine·, and BOO Not Top Off TankD signs are posted in clear vision of consumer and employees. Compliance to posted signs minimizes potential risk and hazards. For minor spillage (i.e. .customer gas tank overflow) employees are instructed to clean and dispose of. materials safely. Protective rubber gloves and clean-up equipment is provided at each facility. For a major spillage, employees are to call 911 and report. They will then notify personnnel listed on Page 2C. SECTION 2: NOTIFICATION AND EVACUATION PROCEDL~ES AT THIS u~ITOYLY In the event of any major incident, our facility personnel (i.e. facility manager, assistant, cashier or maintenance) will immediately call 911 ~nd report. If evacuation is necessary, and after 911 has been called, employees are directed to a site opposite the danger area. Facility personnel will then call and notify personnel listed on Page 2C. - 3A'- · '. SECTIO~ 3: HAZARDOUS MATERIALS FOR THIS U~IT O\tY A Does this Facility Unit con~ain ~az;H'åo1ts ~rate!'i"~s?.,,.. ® xo If YES, see 8. If XO. continue with S~CTIOX 4. B. Are any of the hazardous materials a bona fide Trade Secret YESe If No, complete a separate hazardous m?terials inventory form marked: ;.iON-TRADE SECRF.TS OXLY (t~hite form #.1A-1) If Yes, complete a hazardous materi~ls invento~y form ma~k~¿: TRAnE SECRETS O~LY (yellow form ~~A-2) in addition to the non-trade s~cret form, List only the trade sec~ets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTIO~ Employees are instructed on location of fire extinguishers and their location. Instruction is given on use and operation. Instruction is also given on locations of emergency fuel pump shut-off siwtches. See Attachment A and B. SECTION 5: LOCATION OF WATER SGPPLY FOR USE BY EMERGENCY RESPONDERS Fire hydrant is located north of White Lane on Wible Road approximately 200 feet from intersection. SECTION 6: LOCATIO~ OF L~ILITY SHUT-OFFS AT THIS ~!T ONLY. ..l" XAT. (~,\s·· PROP.\Xi::: N/A B. ELECTRICAL: Main electarical panel is located in the back room storage area (see Page SA). C. WATER: Water shut-off is located at the Wible Road driveway (see Page SA). D. SPE:C"Ai: Emergency Pump Shut-Off Switch/located at cash register (see Page SA). E. LOCK BOX: YES ®!F YES, LOCATIO~: IF YES, SITE PLANS? FLOOR PLAXS? YES / NO YES í NO :.tSDSs? YES KEYS? YES XO XO - 38 - II. D. · , ßAKERSFIELD CITY FIRE DEPARTMENT FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY Page ---1- of 1 - I; I BUSINE~S NAME: AM/PM Mini Market t 5164 ADDRESS: 4010 Wible Road CITY, ZIP: R~kpr~fipld 93309 PHONE .: (Ana:;) A 16 q685 OWNER NAME: ADDRESS: CITY,ZIP: PHONE .: Prestiqe Stationsr Inc. FACILITY UNIT .: 5164 P. O. Box 6225 FACILITY UNIT NAME:AM/PM M1n1 Mkt Cerritos. CA 90701 213/402-1299 1 , TyrE , CODE : I) P I; , 10p 2.400 374.400 gal 2 3 4 5 6 7 8 MAX ANNUAL CONT USE LOCATION IN THIS ~ BY AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. 4rOOO 624rOOO <tal 01 19 S. W. of lot 100% , 9 IOFFICIAL USE CFIRS ONLY 10 HAZARD CODE CODE CHEMICAL OR COMMON NAME D.O.T OUIDE Gasoline (Unleaded) iI'6d-. FLLQ one 10rOOO gallon 01 19 S.W. of lot 100% Gasoline (Super Unleaded) 118d-. FLLQ one 10rOOO gallon ~P 2r400 374r400 gal 01 19 ./ ! 1 !, I -- , - . S.W. of lot 100% Gasoline (Regular) \ \'E,ð FLLQ one 10rOOO gallon , NAME: Mitchell Ng TITLE: Rtl Oper AnalystSIONATURE: !EMERGENCY CONTACT: Bruce Wilkes TITLE: Field Supervisor ~ I !i EMERGENCY CONTACT: Ron Rose TITLE: Area Manager ,PRINCIPAL BUSINESS ACTIVITY: Self-serve Gas Station/M1nor Auto Hepa1r Ii ' 1 .I ¿ ¿/ _'./7 / ~ I 17/1 PHONE. BusfHOURS: AFTER BUS HRS: PHONE' BUS HOURS: AFTER BUS. HRS: I / DATE: 71jo7J'1 213/402-Í2991 509L754-3174 2137402-1299 916/487-5500 This Is How Most Fire Extinguishers Work , )I rT rT DI ('1 Ii' '(D I' ::s IrT )I 1, Although the majority of extinguishers work with our directions. there are exceptions Read the instructions on your extinguisher for variations Fix a picture in your mind that will fit the instructions on the extinguisher you will be using 2, If there's a fire, get everyone outside. Call the fire department. Then fight a small fire only. If the fire gets large, get out. Close doors to slow the fire spread, Stay between the fire and an exit. Don't let fire block your escape path in case it goes out of control. 3, Make sure you don't use one type extinguisher on another type fire-it may make the fire worse, Common errors (they can be fatal) are using water (A) on a grease or on an electrical fire (B or C), ... , ... Learn How To Pass ---- 1. Pull - Pull the pin. Some units require the releasing of a lock latch, pressing a puncture lever, or other motion. 2. Aim - Aim the extinguisher nozzle (horn. or hose) at the base of the fire, 3.lqueeze - Squeeze or press the handle, 4. §weep Sweep from side to side at the base of the tire until it goes out. Shut off the extinguisher, Watch for reflash and reactivate the extinguisher if necessary Foam and water extinguishers require slightly different action Read the instructions, e Learn MotTo Bum --------------) C-------------- --------------) -------------- 2. ...... I ,I , This Is Your New ABCD's Of Portable Fire Extinguishers ^ lire extinguisher is a storage container for an extin- guishing agent such as water or chemicals" is designed 10 put out a small fire, not a big one ^n extinguisher is labeled according to whether the fire on which it is to be used occurs in wood or cloth. flammable liQuids, electrical, or metal sources Using one type extinguisher on another type fire can make the fire much worse So learn how extinguishers are labeled and used, Traditionally the labels A,B.C. or 0 have been used to indicate the Iype of fire on which an extinguisher is to be used Recently pictograms have come into use These picture in blue fhe type of fire on which an extinguisher is to be used Shown in black with a red slash are piclures of fires on which Ihe extinguisher I!'; not to be used For example. on a class '"A'"lype. the following label would appear: \ t, ~œ- .-~ ..~ ] 1. r' NFPA 10. Standard lor Portable Fire Extinguishers, recommends that extinguishers be labeled with picto- grams, However the user may find the traditional A.B.C,O labels. or both the pic tog rams and the A.B,C.O labels on an extinguisher, You need an extinguisher at home. " you plan to buy one extinguisher, a multi-purpose dry chemical labeled ABC puts out most types 01 lires - wood, paper, and cloth, lIammable liquid, or electricallires, _ . If you buy more trtà"one, you might want to get a BC lor the kitchen, an A for the living room, and an ABC for the basement and garage, Fire extinguishers where you work. It is milnrlgemenls lob 10 hrlve exlingtllshers ilVill , rlble lor use rind your job to know how they work BuyIng and maintaining an extinguisher. 1, Extinguishers come in dry chemical, loam, carbon dioxide, water. or halon types, Whatever type you buy, it should be labeled by a testing laboratory. 2, The higher the number rating on the extinguisher, the more lire it puts out, High rated ones are ohen (not always) the heavier models. Make sure you can hold and operate the one you might buy lor home use or be required to use at work, 3, Ask your dealer how to have your extinguisher serviced and inspected, Recharge it aller ANY use, A partially used one might as well be empty. 4. Extinguishers should be installed away lrom polentiallire hazards and near an escape route. 5, For more details, see Standard for Portable Fire Extinguishers, NFPA 10. e" >' rt rt ØI o § II) ::s rt ttI [11& (TI[§] Ordinary Combustibles Fires in paper, clolh, wood, rubber, and many plaslics require a waler type extinguisher labeled A. 9\ Flammable Liquids Fires in oils, gasoline, some painls, lacquers, grease in a Irying pan or in the oven, solvents and other lIammable liquids require an extin- guisher labeled B. õ2Jø (J ~ . , J I , 1,-.- rk.'~""J~j" 8 (II i' . ' "_ ....r Electrical Equipment Fires in wiring, luse boxes, ener- gized electrical equipmenl and other etectrical sources require an extinguisher labeled C, * ---.__.~~-- Metals Combustible melals such as mag- nesium and sodium require special extinguishanls labeled 0, _.'.' --- . -.- --- -:-: -;:-.. " ~+» (Ç~ co co OJ t:] 0' OJ 0' '0 OJ 0' '0 '0 01 0' o I '0 BUSINESS EMERGENCY TRAINING LOG I INSTRUCTOR TITLE DATE OF TRAINING EMPLOYEE'S SIGNATURE INSTRUCTOR'S SIGNATURE . u oS e Prestige Stations, Inc. National Headquarters e: " 17215 Studebaker Road Cerritos, California 90701 ACKNOWLEDGMENT SLIP I have been instructed on the use of the Business Emergency Plan Manual and have read and understand all the information and instructions as stated. Further, I agree to abide by the statements and guidelines outlined. I further acknowledge that failure to conduct my actions in compliance with these guidelines may result in the termination of my employment. Signed this day of , 19 Employee Signature Facility Number Witnessing Supervisor Signature