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HomeMy WebLinkAboutBUSINESS PLAN , '~ Per it to Operate Permit 10 #:: 015-000-001065 READY GO MARKET ~OCATION: 3620 WILSON RD i \ Hazardous Materials/Hazardous Waste Unified Permit ~ COND~TIONS OF PERMIT ON REVERSE SIDE A*J».rr!~':~J:""'l'~ t11\ ¡ r~fUJ '. " , ., ,,' , '><:;~\1 £( ! i ¡ .~.:#.~.~ It(::'l:~>(:"f' ~'>,:;:,,~,:'(~lS~~1:' ;:., ~ ¡{, '/£ BAKERSFIELD ",to,'!: . ¡ . c. ._t·1' This oermit is issued for the following: ~ Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment .-;;". .' i~:' "-.'·l j .,' TANK HAZAROOU$Sl,ißs'1A~Œ 015-000-001065-0001 UNLEADED GASQI:lNJ=~~:,'?'E 015-000-001065-0002 DIESEL f'i .',¡ 015-000-001065-0003 SUPER UNLEADED GASOL.!JNE 015-000-001065-0004 UNLEADED PLUS¥GA$q~INE; Issued by: ~, Bakersfield Fire Department OFFICE OFENVIRONMENTAL SERVICES' 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: Issue Date I " J June 30, 2003 Per : I I it· to Operate , . ~ , Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: zardous Materials Plan ,;[~round Storage of Hazardous Materials "Qagement Program Waste 3620 PRESSURE ALD PRESSURE ALD PRESSURE ALD PRESSURE ALD : PERMIT ID# 015-021.001065 'READY GO MARKET LOCATION TAN WILSON HAZARDOUS SUBSTANCE , ; ,,>¡rr ANK PIPING PIPING PIPING PIP ',iONITOR TYPE TYPE METHOD 0 ÔJ]jm_ .... .. . .~¡, t"..:', . -.. ,. ... 1 O:~OÓ':QO GA~\; 1 o,O(¡ o~dQ GAl,:"":,,> 5,0ü'ü';ØÕ"G~[ 1 O,OOO:OQ :gÂf'::;i!;;!!!::' ¡iii!; ... ..... 0001 UNLEADED GASOLINE ~, 0002 DIESEL :ç'" 0003 SUPER UNLEADED GASOLlN 0004 UNLEADED PLUS GASOLINE Issued by: '~ ..:=, LPT F LPT F LPT F LPT F Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 *~ ph Huey, ffice of ental Servi es Approved by: Expiration Date: June 30, 2000 ,- . -~----..- --~_._-_._-- r' \ \ . - I CA Cert. No. OOS07 ] City of Bakersfield Office of Environmental Services 1715 Chester Ave., .Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been Issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. ' -- Instructions to the issuing agency: Use the space below to enter the following information in the format of . your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2nd day of November, 1998 to: READY GO MARKET Permit #015-021-001065 3620 Wilson Rd Bakersfield, California 93309 ;~-,..-- - - . - _-.........- /' CO_ECTION NOTI,Cj BAKERSFIELD FIRE DEPARTMENT N~ 589 Location Ilr(),J." ~ G...., r #lIu-hd· Sub Div. _'3~dO Wd~()f\ {l.A. Blk. . Lot ~ ~.3 ~ (; 5"0 Ì' You are hereby required to make the following corrections at the above location: ((1. S <.... "'0. ~tØ f fcc:..J.rØ ~ - ocfe.., &1(( I 1I f\. ~(o.. 3)..fø,.317 Completion Date for COITe~ "tL Date 'J,J'~/e¡.., ",.I Inspector 326-3979 FACILITY PHONE No. g' 3 1. - cD 5'0 7 ID# ID# ID# 3/~~-h ì I :2 3."..4 INSPECTION DATE Product Õ~~~ . Product , ¡J J \. 1/11-.../ TIME IN TIME OUT OL ,'M' Insl Dale Insl Dale Insl Dale INSPECTION TYPE: '9Kc... I ? 9'(;, ,,/ ,f'c. ROUTINE c/ FOLLOW-UP Size Size Size /0 CO ¿;-, l)cI1Ð ..0 't" '(J, lJ8D REQUIREMENTS yes no n/a yes no nIa yes no n/a 1a. Forms A & B Submitted ,/ , 1b. Form C Submitted 1c. Operating Fees Paid II 1d, State Surcharge Paid . V 1e. Statement of Financial Responsibility Submitted J , 1f. Written Contract Exists between Owner & Operator to Operate UST if 2a, Valid Operating Permit V 2b. Approved Written Routine Monitoring Procedure 1\/ 2c, Unauthorized Release Response Plan \/ 3a, Tank Integrity Test in Last 12 Months Iltl?7 ./ 3b, Pressurized Piping Integrity Test in Last 12 Months Ilt/'n V '- 3c. Suction Piping Tightness Test in Last 3 Years II ~ 3d, Gravity Flow Piping Tightness Test in Last 2 Years ,V ~ ~ 3e, Test Results Submitted Within 30 Days ../ ~ 3f, Daily Visual Monitoring of Suction Product Piping II 4 : ,j 4a. Manual Inventory Reconciliation Each Month ./ .. ~ 4b, Annual Inventory Reconciliation Statement Submitted ./ ;: "', 4c. Meters Calibrated Annually tl \J 5, Weekly Manual Tank Gauging Records for Small Tanks vi 6, Monthly Statistical Inventory Reconciliation Results II 7, Monthly Automatic Tank Gauging Results V 8, Ground Water Monitoring V 9, Vapor Monitoring ..¡ 10. Continuous Interstitial Monitoring for Double-Walled Tanks ,V 11. Mechanical Line Leak Detectors vi 12, Electronic Line Leak Detectors V 13, Continuous Piping Monitoring in Sumps J 14. Automatic Pump Shut-off Capability J 15. Annual Maintenance/Calibration of Leak Detection Equipment ¡..J 16, Leak Detection Equipment and Test Methods Listed in LG-113 Series \/ 17, Written Records Maintained on Site ...1 18, Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days ,j 19, Reported Unauthorized Release Within 24 Hours v 20, Approved UST System Repairs and Upgrades 1/ 21, Records Showing Cathodic Protection Inspection ;/ 22, Secured Monitoring Wells V 23, Drop Tube ./ / / RE-INSPECTION ~ !Í1~ RECEIVED BY: / I. .J/~ L ï L-oo<, OFFICE TELEPH.6NE No. t -, j; INSPECTOR: !~'2(..~ 7/ , \- , i UND'ERGROUND STORAGE TANaSPECTION FACILITY NAME . {lro.Jý ÓIf" Mnrh..+ FACILITY ADDRESS ?'(..,,J}I'\ 1JJ./~t'JI" Ild~ ./ ¿j .F"'::;:- (..;-~ ~~-->-'----- ._, ... I Bakersfield Fire DePt.f, Office of Environmental Services Bakersfield, CA 93301 BUSINESS 1.0. No. 215-000 /OG,r;- CITY firM ZIP CODE r1.3ð7 ;j FD 1669 (rev. 9/95) . ~~-4 HAZARDOUS MATERIALS INSPE.ON aakersfield Fire Dept. OFF7f!!f; OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Date Completed -3hrs/'17 Business Name: R ec.dy Þ C, ~. ll1a t~t..{ Location: 3CoJD Úh(~O'" Business Identification No. 215-000 /O,,~ Station No. Shift (Top of Business Plan) Inspector .5'fl'V<... <.JJt¡cruJ()~( Arrival Time: Departure Time: Inspection Time: Address Visable Ade~te Inad6uate Emergency Procedures Posted Ade~te Inad6uate Correct Occupancy ~ 0 Containers Properly Labled 0 0 Verification of Inventory Materials 0 Comments: Verification of Quantities ~ 0 ~ Verification of Location 0 Verification of Facility Diagram 0 Proper Segregation of Material [;I 0 Housekeeping 0 Fire Protection (]I 0 Comments: Electrical [JJI' 0 Comments: Verification of MSDS Availablity 0 (]/ Number of Employees: ~ UST Monitoring Program c¡/ 0 üI Comments: Verification of Haz Mat Training - ~ Permits 0 Comments: Spill Control 0 Hold Open Device 0 rIÝ Verification of ~ Hazardous Waste EPA No. Abbatement Supplies and Procedures 0 rI Proper Waste Disposal 0 Comments: Secondary Containment ~ 0 Security 0 Special Hazards Associated with this Facility: Violations: .JIClt~L fc.lI-tcf ~IHc,(d iJPe,./, t(~Ùtld ~'tHIA_ pun..V¿' i '((t'flt( will,,;' ~t. ...-r' {Jlcas<- ~MSS ¿m.¿6--;e¿jr Business Owner/Manager PRINT NAME II ïn !2? ~ All Items O.K Correction Needed v ~ e; "" LO CD ~ White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy o u. , . ,; . Locatiol1 ,kel1c( / . (;0 , lTÆf2kef . " Sub Div. '3(d).O w,"lSOr1 (~.cBlk. . Lot You are hereby requirèd to make the following correctiöns at the above location: ~~ ,- , -<--....---. - ----~ '. --~~~ --- - - -- C0J¡lE'CTION N031:~ *,", "~,' .:: ;...... ' ,,~~~:' ~'~,! , 7;- . i~' ",1 BAKERSFIELD FIRE DEPARTIVIENT N? 'Ô225- . ' .""! \ -~!¡i ~<o- -;. ;ft¡' 326..3919' ¡~."" ..-....,.:.::~~-...>_:...~~';-.. s.:7....~·;-7:.::-..-:,.\~:·fÇ-:;:Ç:.~- ~....-~-~~.,~ ':-'~-"'-""'-.~-'--~"":':~~.::';-':,";'-''" ~..,;:¡~~~-. : .' ; \: ~/.~;; : ....~ . ,- ~ , ~5~UNDERGROUND STORAGÉ TAN.PECTION' ,--:-." '0-..;';~-~^ f:,--:~,-,~:;:~,c'~':""';¡;:;_'-::è:;:~;;;'::'~":'':''è~''''~'¡;:'';;~'W'<7,:7''' ':.'~',?:;~;7~'~ ." '.~ì·'\B~kerSfh!ld '~i~e 'De'~~.~'~-'-' Hazardous Materials D!vi,sipn . Bakersfield, CA 93~Ol, I ",~ ~ 'F~CILlTY NAME ~... - C::1tO M.µ..t- ";, , ~ACILl1Y 'ADDRESS' ï ~~9--0 (ø ) \ 1<", r-' ~l"~ ',' BUSINESS J.D. No. 215-000 I ó I.... c::- CITY _~.py.¿;Q,<- ~A ZIP CODE 9.3~ '7 FACltlTY PHONE No. INSPECTION DATE TIME IN INSPECTION TYPE: I' ROUTINE V'./" ;. \ .\ " 3a. 3b. 3c. 3d. 3e. 3f. 48. 4b. 4c. ',5. . 6; 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. - -' in/:z/"r . ,,( f" TIME O~T i, (' : f I.~ M J'.,,,: ; ¡"r .. ..HO"",¡.,,,,~,;"t;C... '7 ¡ t· 'I ? ~,""~ ~.. '''í''J'-'I'It~ NÖ ovee..~~\ \ QS",,'Ì~~ ^ ..:..-<-~ FOLLOW-UP REQUIREMENTS 1f. 28. 2b. ,*ý ,jy ID# 01 ID# ID# l (")~ ^"", ';"'4 Product Product Product k n ,'/fJL . ¡ , "C;/De..e.. I { JL -'¡ if!.J! In~~~[Jf ! 'Iniít~~tW^ 'ns/~~h Size Size Size lð C)(!)/'J 5 (JOO Ld.... I a t),rys") yes no nla yes no nla yes no nla, ,. V V , ~ ~ V r/ V , V -- Þ" pi" I./' ý" V ¿..- 1/' ..........- ,/ ........ ý" ,,/ v ,.,... 1a. Forms A & B Submitted ,1 b. .. Form C Submitted """,1c. Operating FeeS Paid 1 d. State Surcharge Paid .. 1e. Statement of Financial Responsibility Submitted . Written Contract Exists between Owner & Operator to Operate UST ST~!!fJ5 Valid Operating Permit t' Approved Written Routine Monitoring Procedure 2c, Unauthorized Release Response Plan Tank Integrity Test in Last 12 Mo~ths 5/ 7 ~¿,¡ Pressurized Piping Integrity Test in Last 12 Months Suction Piping Tightness Test in Last 3 Years Gravity Flow Piping Tightness Test in Last 2 Years Test Results Submitted Within 30 Days Daily Visual Monitoring of Suction Product Piping Manual Inventory Reconciliation Each Month Annual Inventory Reconciliation Statement Submitted Meters Calibrated Annually Weekly Manual Tank Gauging Records for Small Tanks Monthly Statistical Inventory Reconciliation Results Monthly Automatic Tank Gauging Results Ground Water Monitoring Vapor Monitoring Continuous Interstitial Monitoring for Double-Walled Tanks Mechanical Line Leak Detectors A ~ec.) Þ' ,~ ~ Ì' ^ ~ \..... Electronic Line Leak Detectors '\, ~ h...~ oA..."t .4.1 Continuous Piping Monitoring in SumpS Automatic Pump Shut-off Capability Annual MåintenancelCalibration of ' Leak Detection Equipment Leak Detection Equipment and Test Methods,(ísted in LG-113 Seo.. Written;Becords Maintained O!'I Site ';"',1:i.~,,', RePort~Changes in Usagelêonditions to OperatingJMonitoring Procedu~ of US~~ystem Within 30 Days i; 19. Reported,;µ!làûthorizedRelease Withirl'24 Hours 20. ApproveCfil!JST System Repairs and Upgrades ,··,1,._..· 21. Records Showing Cathodic Protection Inspection // "22. Secured Monitoring Wells i.....'.. 23. Drop Tube, ,'. .. 9f:~ .pe.od..:.:'("'t.'...5~ It ,v\ ?- -f ''1 ~....l/!.bI-1S RE-INSPECTION':DATE ' '~I I "" INSPÈtTOR:"~~4 r?¿1J"~ :,' ~ v V'" ....... v v ¥ v ': 'v-- '\: "C~'< _, ,__' , Iý . (., ", "- \ ~-,~.r , , '~ ¡w?rM\ii -ØI'i~IJI!Í\<:H~ \i, '~ 7/¡Vd,(i, v ~ i¡j fl·.., ....,... '''\:..'''''~' v ill r t r 1 ..----'" '-- ", v' v V v v ",-' v V' .-'..."'...""7:;:::-.- ~ ./j ... ,,/ v c/ V"'" .,,/ ), ~;:,,: '\ , " ¡/ .,/ f;~~ ,/ C ,Aw RECEIVED BY: AI; 0}^v\~\I' ";';J OFFICE TELEPHONE No. - '- '3 )~.- '?9 71 FD 1'669, ' " - ¡1~~~ g¡ç,:;::-'1"\~ ,~, }¡:;g¡" t'~ b,~, 4·....> ... r-_ ~;-9'¿ '; &.--- v-- ......... V ,/ ........ v ........ ,/' v' ..- v V"" Y'" ¡.......- ~ ¡"....- V-. '¡ t.- ,,/' I-- , &--- ¡....-- ¡,./ v-- ~. .., .,1-:;'. -'\1': v": "..,- V I-' ..- v V v ,,/ ......... i,.../ ~:'~: ,~; 1~. '1.., v ./ ......... v ,,/ ./ V' V .,:/' ..-' v V· Ýl.-- ¡/ ...... ý ~-.~. .../ ''''/ )" "~""~'~~_'~_"'''_'':'-I'':;;.'' -'"-~~"";.- -~':':';<">V,P<~"'~"'-';';""";'C;'v .t~~';;~'-;-:"'.:·-;~-:;';=:-:;,~ ';;;:;:k,);"·,;":",,,,-,,,~--,,~,";.,,:~-;:''fi:;¡;:C7'~~1:ITt);3.~:'':;;~;?0~~~~"",iœ~"~"''-'' ; UNDERGROUND STORAGETANaSPECTION .' ¡,BakerSf.ield' ~ire De~t.·' Hazardous Materials Division Bakersfield, CA 93301 FACILITY NAME ~ ~~ FACILITY ADDRESS ' IJ~ ' BUSINESS I.D. No. 215-000 I ()6 ~ CITY'~~~,1\A ZIP CODE q'33~ FACILITY PHONE No. IDI IDI IDI ~I ()1 R.I)~ O<¡ INSPECTION DATE Product ' Product P:D,uct :.eJ TIME IN TIME OUT , Ii JL~(,.Ù\t"lQ. '" --"',.., 111.-+- leS . In&t ~;:b '--" ',nst ~~ 'ns~q~ "'~........_. INSPECTION TYPE: S1v...-I\t:.b. ~fº......JoV1 //"-~ ~1'ì ' ",,_J.: Size ~'h Size ROUTINE FOLLOW-UP 10 nee> 1/)¡''t''Jl"\ REQUIREMENTS nIa '.-/ nIa nIa yes no yes- :::>00 yes no 1a. Forms A & B Submitted ¡,/ v' / 1b, Form C Submitted y" ./ ,./ 1c. Operating Fees Paid ,,/ V' --- 1d. State Surcharge Paid ¡,/ .,/ ~ 1e. Statement of Financial Responsibility Submitted V 1f. Written'Contract Exists between Owner & Operator to Operate UST it' ~ ¡,.;' ~' 2a. Valid Operating Permit ,,/ ./ -- 2b. Approved Written Routine Monitoring Procedure \Y ¡,/ V V 2c. Unauthorized Release Response Plan ~, V V t/ 38. Tank Integrity Test in Last 12 Months ¡/ ¡/' t../ 3b. Pressurized Piping Integrity Test in Last 12 Months . v p/ .ooo'" 3c. Suction Piping Tightness Test in Last 3 Years ,1/ V t/ 3d. Gravity Flow Piping Tightness Test in Last 2 Years V' v' ¡,.;- 3e. Test Results Submitted Within 30 Days ¡/ V v 3f. Daily Visual Monitoring of Suction Product Piping v- v V 48. Manual Inventory Reconciliation Each Month "., - ...... 4b. Annual Inventory Reconciliation Statement Submitted -- '6-' ..... 4c. Meters Calibrated Annually t- --- ..... 5. Weekly Manual Tank Gauging Records for Small Tanks ,/ ¡,/' ~ 6. Monthly Statistical Inventory Reconciliation Results Ý V V- 7. Monthly Autom¡¡tï6 Tank Gauging Results ~ V ~ 8. Ground Water Monitoring """"""~~fi ¡,/ ..- r;:)ll rlllnM " V 9. Vapor Monitoring / -- -- 10. Continuous Interstitial Monitoring for Dpuble-Walled Tanks ., .....~......_. "-'.", -0 ~ .~,~ ¡/' ....... I-"" 11. Mechanical Line Leak Detectors K': c. q I N, () v' yo I ...... ð ~ '? -' b"'" . ¿...- 12. Electronic Line Leak Detectors..tto~ ..(;·/I^",- I) (., ~.,.... -,L""^--oJ."'....... ¿:;ft;< .....- tø:-- &0-- 13. Continuous Piping Monitòring in Sumps 00", IJ! ... ð u Lt.I:k' v· e.- lL _- 14. Automåtic Pump Shut-off Capability / .,/ -- -- 15. Ann.ual Maintenance/Calibration of Leak Detection Equipment ,¡,:- V v ¡.,..- 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series ,,}. ¡/" V --- 17. Written Records Maintained on Site ~-~ V" ~ --- 18. Reported Changes in Usage/Conditions to OperatinglMonitoring ./ ,/ ¡../ "...,'PrClCedures of UST System Within 30 Days 1 ~;t9' . ¡.,Rëported Unauthorized Release Within 24 Hours ./ / ,.,/ ,~.,l' Approved UST System Repairs and Upgrades 0/ ..- ,..., (21. Records Showing Cathodic Protection Inspection ,,/ """" ----- 22. Secured Monitoring Wells -- ..- ----- 23. Drop Tube 1/ y .v" RE-INSPECTIO~ INSPECTOR: ø~ ,:::i.t~ ~ \ (, :1 11 .'j ~ .~ ~i :! , A i 'jj \fj/, ~ _ '. .A'J, RECEIVED BY:f\JL.":;.(<). ~ OFFICE TELEPHONE No. ~-: ~q7C} FD 1669 ~Zìjl;';~ Ú~~L .'. ¡w"~ ~'i\f¡,.Yi' ' ~~~.l ,-;.~~~ ~' :: ,;.,~:,-,::~,:,;,",,<:r~;,~:. ;,"?'i'.="~::""":;,:_~_,::,'~:.-", -', ;;-~;;-;;~'~.;,;"~;;;.;:" .,¿,':;\: ~~_:;:>, ">';:"""~I~::-~"·r.-,~:, ,:1::~¡~ ;__~~~;:-- -.;'j.;C:;~~: ,~;:--~>;,~~:~"..."~~.,)I"-::~,,,,_ I....:: "~ . . PLOT PLAN tJ,',' ~" JOBSITE LOCATION } t X f ¡~ eO. r1 ~I - (; 0 - N" )1- v' /.t.. e 1- V + ¡ 3 b -i 0 w.. L<;" N R." ~þ. e I ,8"/',",1"'1'/'/ ("n., i f< t ,ç ,lIT....] .~--' ... - .. - - - - -- - .. .--..-- -- A- i (" ¡~ ® ~ ® ~ '0 C0 ~~ /f3 t,1 ).. kt) ~ D 0 D 11", r" d 0 f-l ' /:í- s t <4, ¡.J~- \( -0 ---1 re^'~s 5 To Jt¿b' û ,f4 1 d . , ---------,- I -_._-------~-------- J [- -';.J.J l () p",,).¡ t' _J T;i/,(IL W,' t. ~ ~ ïI:7J ''tJ J PRODUCT -.--.----'/ LEGEND -.----- - - -'- 'l''ANK SIZE ¡ # 1 E t4c, t / (), 11" ,("I ¡.J N L/P. F FILL '~-l TURBINE :ç " "" t!J I - # 2 ¡ç /} t." í C.'M,Ji c-/' 10, nOn PL-s UN Ld. ~ TURBINE WITH LEAK DETECTOR - #3 We,~7' (3!..eN f...r" I(),OOO ¡t)...er¡... ..; IV id ~ OVERS PILL CONTAINER ON FILL - #4 W£Sf C\ ¡,t),oop D/ €.-~ ({!,.¿ ;;:... \R) REMOTE FILL #5 , '(Ê) EXTRACTOR VALVE #6 'M I MONITOR ~ SYSTEM <ï #7 lJ MANIFOLD SYSTEM -, . , I I . I "'-------" J),~.~ë~ ~,.-fo3.?-O . '.~ "". . w:' 'W' .'~ .~ . '- - "-~ -A- --~- -~--'<--'-....>...._~-..., ,..-""0"- I ,-- _.o:~~.~~:. 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G--'I -- -~ ~- -- - -- -~-- 'V;~ <25 ~ Þ --1-- - ~" ,n_ _ ~___ _n - -- -~ ' - - ----.". _.~ --~- u_~_ .____ _________ _ .._. __ -- -- -.---- ..--- .- --- ---- . - - ------- ~_._- - --- .._-~ '"\\ " ~ '1\" r, (U-- - -- - . ----!";-- -- - ----- .--- --------------------------_._.._-------~_._~--------- I ' ------- t-------------- --- --~ -- -------~ ~-~-k~V-~~v-J'ft;æ-~---- - - - -- ---:--~ ---r--- ------"-'----------'--------n----------'-'--f~ks--'-- --,-- _,H , - ---- - --- - - --<-- ---- .------ ----.--.- . - --- -- -- -- - ---~ ¡:'.-- --. t I' i, I ---- --,-- ' ,o- " I , -- -- -- .---------.- -.-----.- -- ---- .-- ----- .-"- - -- -- - - - - - - -. . - - -----.-.-. ---- --.- . -- .-.. - --".- -- -.. - - ~- --- -- ----- - ---- - . -- ~-----~-- - - -.. -- - -- - -. -- ---- it.·. ... _oj MONITORING SYSTEM CERTIFICATION For Use By .r111 Jurisdictions WiThin the State ofCc,lifornia ,H;r!lO},¡~}; CiTed.' Clwpær 6.7; Healch and Safety Code; Chapfer 16, Division 3, Tir/e23, Calijòrnia Code ofRegu/afÍons llli~ J'-unn must be. used to dOCWllem testing and servicing of monitoring eqlÜpment. A separate certification or repon: must be pr~2.'ll:l.:'ci [~2L;·:~!,J,Ul1ùnÌ1L)rim'- SVSlèll1 control panel by Üle œcllnician who performs the work. A copy of this form must be provided 1O thè mnk ,,;y.slcm Ù\VIlè'r/ope I'iHDr , The owner/operator mllst submit a copy of this form to the local agency regulating UST systems wilbin :itì d~!" S c> f [l~~ l dmc, ,''i... ,Gt'1ìccallnfornuìlion CCic'lil\ Name: ~~~. :::;'" .h1dre:ss: .Jbà:.f1 t-J I..~ 'U (ûlll<ìCI Person: Tfl,oy F~lL £0 c. NO-4 UÞEPIl1L!-ðð J Bldg. No,:_____________ Ciry: , ß4Kþe~PJf'(, 0 Zip: ____~'__h.._ Comact Phone No.: ( ) [\bL,,' !\lO.:ìe 1 of l'vloniroring System: Date of Testi.l1g/Servicing: Ù, in V ¡:'llfO i)' of Equipment Tested/Cenified ~=:t';.:L'}Il' ;¡l'J!l:ùjJ,!'i.a¡è)JÙX~? ro.iodie¡1[e s ecilie c ui men! .ins Jccted/serviced: L, ¡¡L [0 t1~,¿j-7- :i: t< L·l.i.llk lì;lUging Probe. f.,'lodel: ,ty)..f6./ '=-_ ! 'iii 'd"W',"" SP"'~' V''''~ S,,,so," Model I(~ _~, _ ,!! 5ët t'¡JilJ,l,>ump I I rench Sensor{s). Model: ~ _ :II VI I" I ' L') ~ '1 d I '\.A ili /'Ç ~'l.\ '>U!!lP JénSOr(s. IV 0 e: (',TV lii...c !\ bil;ì1!.ll'a¡ Linè' Leak De[écrof. Model: D1l t~4'" r-- ii: CJ L kL'lrL\ilill.inc Leak Detecll1f. ¡vlode!: . 'ii Ci ì ~lllk OVCI1ïli ¡ Hii!.h-Lèvel Sensor. Model: 1.1 ~ . iLCitl¡]kr ls~cL'ify è':J.l. i£!!lènt [' e and model in Secrjon E on Page 2), :il'~[;lHklj): _.Jl)H!E'l :;I;a h· f:il1t C;luging Prob", ::¡ Q''-Il!iULir Space or VauJ[ Sensor. 'I)G .\';:)111':; Sump ¡french Sensot(s), :L5¢ l'!li Sump SeJlsor(s), I:;! ~ ¡\lc,lLuÙca! Line U:ak Detector. II iii CJ lkèlr,mic Linè Lèak DefèclOr. Model: __._ ::i -:J l:dJk CJièÚïjj i Higll·Leve! Sensor. Mode]; !¡ ~ lid]':, l~pö:ify cLJ.l.!ipmenr r~ and modè'] in Section E on Fa e 2), li'o=-'-'==, .,. ,. --,' ". ;i Uh¡J"lIS"'l il\___l::..~ , ';i >' 1 '"pclbcf Lülllal11mtnr ~çnsor(s). Modd: ~_, ~ è--!-c.lr \ .11\è'ls) i!"g_~~~'F'c'llS,'r Ç'l)nrainmtnr F!O,U(S) and CJ.!ain(s), :i ûiS¡J¡:;jbL'r lD: £~ ;¡ ). f\;~µèlbl:r Comainmenr Sensor{s). Model: ikLL_. ii .29 :);l.:~¡j' V ,11Vè'(S) , ¡,ICJQISP~!l,)è:rCüntainmèrH 1'10<1[(5) and Chajn(s). TÜ¡,;p¿Hsc:r 1D: ~_. 'I Û 1>'1"-,1\';,,,1' COIHüinm':nI Stnsor(s), l'vlodd: __. :¡ :J ,Sne:L!' V ~dw(s), 1 ,]j)l~?èllié'rCoJ1lJinmèn[ FJoar(s) and Chain(s), '.!JIJ,,' t:¡,:jJj¡y co¡¡¡¡:¡jns more tanks or disptnsers, copy [his form. ------------ .-...- ~._- -I1". ~. J.sð .J!~'/ðc./ _._.JZ!;;.. ___....._/. ...--...-"-. ._--.. ~~~:.~.-=---!¡! Tank lD: ~,.,., '/ ~ In-Tank Gauging Probe. Model: J!!L--'fli]~,~'__=,- Jr Annular Space or Vault Sensor. MOliel: _~______. !il P;p; og Sump IT ,"'noh S,"'OL( s}, MOdd'!if: ir ~ ~_ ~ Fill Sump Sensor(s), !v'lode!: 0 Jl Mechanical Line Leak Detector. Model:, -~~"lr' o Electronic Line Leak Deœclor. Model: _________._. . o Tank Overfill / High-Level Sensor. Model: _______u._ o Orher (s eci', e ui menr t e and model in Se.crion E on P_~~~.2 L Tank ID: o In-Tank Gauging Probe, Model: o Annular Space or Vault Sensor. Model: o Piping Sump / Trench Sensor(s). Model: o FiU Sump Sensor(s). Model: o Mechanical Line Leak DeTecror. ¡"lodel: o Electronic Line Leak DetecTOr. Model: o Tank Overíìll/ High-Level Sensor. Model: ___________.__. o Other (specify equipment type and mOlkl in Section E on f~ag.è ~\ . Dispenser ID: J -~ ,_ ,__________ ~ Dispenser Comainmenr Sensor(s), Model: ~________ j?r Shear Valve(s), o Dis enser Containment FJoat(s) and Chain(s), , Dispenser ID: 7 - <if _.____, ~ Dispenser Containment Sensor(s). Model: ~_____,__ .!1 Shear VaJve(s). o Dis eoseT Conminmem Flom(s) and Chain(s), Dispenser ID: o Dispenser Comainmenr Sensor(s). Model: ____.___, o Shear Valve(s), o Dis enser Containment Float(s) and Chajn{s), Include information for every tank and dispenser at the facility. Model: Model: Model: ~ ModeJ: ~ Model: FJ( ---- ,/'i u " 'Ii il " II ! ii :¡ il .. :1\ '-'il !I I, II 'ii' ---.--.-..-.- ... Ih :i: ii! ,. ill ~'I! '! :11 .;¡ 'i! !!! '---- CèrtiÜcaÜo:n -1 cerrify that {he equipment identified in this document was inspected/serviced in accordance with the manufacwrers' :;lJÜjdilles, Attached to this Certification is informacion (e.g. manufacturers' checklists) necessary to verify that this inform,H[ot\ is ,ucn,c:r and ¡¡ Plot Plan showing {he layout of monitoring equipment. For any equipment capable of generating such repons, l h¡w.: :~Is(\ .,lltil'j¡"rJ a cupy ofrhe report; {¡;hed 111/ that IlppM: ,JiSystem set-up ~ . rm histor report [(c:lhll( l..!.ll NJl11è lprim): I- f~ V V""1Asd~ _ Signature: ' ~ ('C'lllÙ,',ì[](I!l No,: --s::~....7 3 r r<ì ðð License. No.: 61/D40-" 8..99850 lÒlrno;COmµJllyName: RICH ENVIRONMENTAL . Phone No.:(66 1 ) 392-B~~]____u ~ilc.\.,jdfèSS: 3Ü¡'l> LJ II.t¡øv L, 0 8A-K.E¿~FIE L.tJ J (4- Dare ofTesting/Servicing: _,3/ ¡-J,/~9 MUllj[urjug System Certification . . Pnge 1 of3 03,(li ·t ~ i~ ,1-ZC~{~lls of Testing/Servicing :-',c,Ú \'<llÇ \ èr:>iou Insralled: ¡.s:: t:J L- '-~ <_")lilL¡_<:~,iiiè íûllowil1~ checklist: ii~A~~-'>- [-9' No'" ! Is (he a~dible atarm 0 eratiollat? --=~:~~=l: i¡\~>':___~ ~ Nù'" IS,rhevtsualalarm,oJeran,onal? , , ' _, ------i' i",Ä."L_! 0 No'" \~Iere all sensors vlsual1 JJ1~»ected, tlUlctlOnall tested, and contJrmect 0 eranonal? ii !;~ "-' ¡ U No' Were all sensors i.nstalled at lowest point of secondary containment and posiÜoned so that ofher eqllipl~~-~;;-;-'~i-:'Ii: " I nor imerfere with their 1'0 Jër ° eration? :, :-j- ¡ c: -rOi\j'l)"; If alarms are relayed (Q a remote monitoring SIarlOn, is aU communications equipmenr (e,g. m'~;i~';;l; I :i ¡ >'I NiA operJtional? , i,!",-j-'~'~--T Q No'" For pressurized piping systems, does the turbine automatically shut down if the piping secondary COlH¡¡Ü~;I~';I;¡ î: I' 0 N/A. monitoring system delecls a leak, fails W operale, or is electrically disco(Ulected? If yes: which sensors iniliale' 'i ! posiTive shut-do\vn? (Check all rh{,¡{ apply! 'þGsump/Trench Sensors; 0 Dispenser Containmem Sensors, 'I i Did 'Oll confj¡m osirive shur-down due to leaks and sensor failure/disconnection? Yes; 0 No. +M-:,~---!r U No* For rank Syslèms that utilize ule monitoring system as the primary mnk overfilJ warning clevic.; (i~-;:l~~-i, lr- i U NoA 1~1echa,nical overtìll pr~velltion valve i,s insrallee!), is the overfill warning alarmvisible and aUdi,ble aJ.(~ llìnk Ii I hI! Olm(s) and operatmg properly? It so, at what percem of tank capacJIY does [he aJarm (ngger? /V, ","_ _~' " __: ,:--r ) No Was any monitoring equipment replaced? If yes, identify specitìc sensors, probes, or other equipment repbcc'd : and list The manufacwrer name and model for all re lacement am in Secrion E, below, ¡i'-:-~- ---'-rc i¡ )( " c',:;" ! 0 No Was liquid found inside any secondary containment sysrems designed as dry systems? (Check all rhm apply' U ! I Producr; Warer, If es, describe causes in Sterian E, below. i' ---I ,I f{ ,'~ "'-__; U No* Was monirorino s srem ser-u reviewed to ensure proper settings? Attach set up reports, if applicable ~ ~ .'_" ! 0 No* Is all monitoring equipmem operational per manufacturer's specifications? , 1L ':)c'l~fj¡)l! E beJow, describe how and when tilde deficiencies were or will be corrected. , I .....:::.;;::... .~:J.' E, .(,. UlllilltllfS: "- --_.------.._-- ~~ rt:JUuO /;(.) ~~ 9/" ß 9" rF'-II4 1¿~4-V.--------- f)6L .10M~ w+r~"'æ. tlhM<1()/;.'.tJ__" ._---_.._._...._...~ ...---.-----.. --- ... - ...---- ----.--..-., -.--.----."-----... --------- ----- --.-,-_._---_..,_...~-_.,- ------ .--".--.----..-.---..--. .... .-..----.-- ._-----.-_. --------.-.----..." <.... -. . _ n. ,_. _.".__.__.___" ,---- --...."-----------.-- _._..__.______._..__.. .u ..u.____.____'"___ ------------.-.----_.- ,".-.-----.-.----. ----------". -----------.-.. . -----<,.----- .------.-.-".---- "-- --..-----.-------. .------- ----------......... .-..... ._~_._._- __.___..._n.__"'-_·__ n _ __ ....__._________._ -..-------.--.--.- --.. - - . -'-------.----- ---..-----..-----.-.-.- ~ Page 201'3 iJ_hl\ l' . ],'. lll-{;:Illk Giwging J SIR Equipment: "- Check this box if tank gauging is used only for invenwry contruL o Check this box if no mnle gauging or SIR equiprnem is inswlkd, nl~--; sè'c\ion mUST be compleœd if in-tank gauging equipment is used to perform leak deTection monitoring, ~~C',,,;l!}::~:: rí10 îùllowin¡; cheddist: \i,~~-__:~~~'=-\~,--:~û" Has all input wiring been inspected for proper entry and termination, including testing for ground faLLlt~? '~,",~='c'il ii ú "Cò 1 CJ Nû* Were all Hl11k gauging probes visually inspected for damage and residue buildup? ---------- Hi\ \:-'''~.:---''--'.--.---l---- ..... ..f! \i u .. ,c, : U No'l; Was accuracy ot sYStem producT It:Nel readmgs resred? Ii !!ij-:~~-~--I U No" Was accmacy of sys[em \ovate-I' levd readings œs[ed?--i! i¡__~l_\ -~~I-~ No'· Were all probes reiusmlled properly? .__~~~_-_-li L~~_\_~~-_! UNo" Wr:re aJl ¡œms on the eqlliplTlem manufacturer's maintenance check}ist complered? ,,_ :1 " :d lÌle i;ei:riO/l H, below, descriQe how and whtn these deficiencies were or will be corrected. C_J._1HC Lê:ì1~ Detectors (LLD): o Check. Ihis box if LLDs are no[ll1stalled. __':~cJ-,¡jJ.i¡èI'-' rill' following checldist: \!)ð--;-" I: ¡¡-¥-\~ i¡-/~--- II~+: :i Ir-ÜU\-c II li-5n\~ !Iu_nn___ J U \\. II il II--:~.'-'-'- il --J \,~ !I \I~-\- il__~=' ~ , iü dlt S0crioJ1 H, below, describe how and when these deficiencies were or will be corrected. -,..- 'j I u No" For equipment start-up or annual equipment certification, was a leak simulated to verity LLD perfonnan~ I [¡ NlA (Check all ¡hm appl)} Simulated leak rate: ß13 g,p.h.; o 0.1 g,p.h ; o 0,2 g.p,h. i - I ._----'- :) I 0 No" Were all LLDs confirmed operational and accurate within regulatory requirements? --1' - \Vas rhe testing apparatus properly calibrated? ------- ", ¡ U N ,. _ 0 -¡;= .~_. S I U No'~ For mechanical LLDs, does the LLD restrict product flow if it detects a leak? I 0 NiA , , --, ~.__. 'j 10 No* For e1ècrronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ¡ ~ t~iA ---. ,~-roNo" For eleen-onic LLDs, does the turbine automatically shut off if any portion of tbemonitoring system is disabk I ~ N/A or disconnected? --r' ----.- 'S i U No" f or electronic LLDs, does the turbine automm:ically shÚr off if any p0l1ion of the moniwring sysrem ma Ifunc(Ín! I~ N/A or fails a reSI? ',..s I~ ~,~: For electronic LLDs, have all aCCèssible wiring connections been visually inspected? .~ 0 No* Were all items on the equipment manufacturer's maintenance checklist complered? L, '.-...-. -::;'\1 !i !! ¡¡ .-._--. ¡ ~ --;1 ,\ ------'.i 'I --il :1 :¡ i --:-1 ,¡ l ! _I:,:, 'i ... q --- h. ('ùüHnems: . ...------.----------- --------.--..-- -- . -. -------------- --.------.-- .-.... .-----.--.-..-..-.-- --...--.----...- .--------- -..--..--.---..---.. -- ."---"-- --- .-------...---- ... .-.---.---..-- ..-----.--..--. ._.____._~_...n_..·___~..·__ .. Page 301'3 OJ/Of 'J ìVhJi,iwcing Sysrelll Certification Sir" ,'\c1drèss:lbJCL eJlLSðv UST lVfonitoring Site Plan (lD, ß.Iú~SFIELtJ, c+ . . . . . . -.----------- . .- . . . . . . - ., , l') (L </?) ;A' , ~. ¡Jl../ r, L...-'. ,/),,/'1' . .c. ..1[/ . '.' \ [j~ ~Q ~,. : Åti.C ØL~ , , '\.:.,' ,f1~ , . ,...., ,.:¡o .J :~ , \)(L~' ,1. , , , Da[e map was drawn: -J-I..à:JJ.-.t2$ Instructions :ja~ ~D~ ~' C"¡.( , ~, , ~~uf. :~ : -lL.L' . , , ~ t, , , :\:J: "..-,_.~._- .\ If \ ¡,Ill alrecH.iy have a diagram that shows all required information, you may include it, rather than this page, widl \ (Ill! 1\lCl11ÙorÜlg SysTem Certification. On your site plan, show the general layout of tanks and piping. Clearly icknlti\ [uulian:; of the following equipment, if installed: monitoring system control panels; sensors monitoring. tank ClIHlLI Ltr :;p'¡,.:èS. ')LImps, dispenser pans, spill containers, or other secondary containment areas; mechan.ical or electronic line kèlk dè'lèèrors; and in-Œnk liquid level probes (if used for leak detection). In the space provided, note the date this S¡œ FLlI) \\ ,j,S [1 l'c:p an" d , Page --Y- Of!J- 05'(10 '. MONITOR CERT. FAILURE REPORT SITE NAME: JV1ðß ( I ADDRESS: ?b}é) ù.JJL~ðV flO... CITY: $1K-GI-5Flþ¿{) SITE CONTACT: T(lð<j (11M DATE:]"";}) -~:Y TECHNICIÞ.N: ¡Z.Y4v 1'V/4s't:J-<J SIGNATURE, ~¡v7.~ THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE MONITOR CERTIFICATION TESTING. LIST OF PARTS REPLACED/REPAIRED: REPAIRS: - «,¡;M04..o ~ ,f-f"'£ ~ F ~rv1 i 7. '0 O~ L 10"1(.5 LABOR: ~ H-R- L J{Jo~ Fe; (l ¡'!£ ýVYJcJ /~tj ¿J./IffF ~ PARTS INSTALLED: 4/()~~ '; RICH ENVIRONMENTAL 5643 BROOKS CT BAKERSFIELD,CA,93308 OFFICE(66~)392-8687 ~ FAX (66l)392-062~ MECHANICAL LEAK DETECTOR T~ST WORK SHEET wi 0#: Facility N~e:~o6IL Product Line Type (I?ressure, Suction, Gravity) ß&-tzS ¡:¡E¿tJ fru 5{ tJ ¡(.,~"- Facili ty Address: J¿IJ-Ó iA.//LJO --'Ù ILO PRODUCT LEAK DETECTOR TYPE SERIAL NUMBER TEST' BELOW TRIP PSI PASS OR LID TYPE ¡tIIRt-t!,f"tJIeA'G.., Sli:RIAL :jj: ~~~M ¿,£ /0 ,~ 7 LID TYPEMitJUv/L-f1... SERIAL # l/AJIi:.I{),/..,g'-'t Y:Ii: NO / 1 fL LID TYP Ii: MP C I .;fulr ¡fL Sli:RIAL # ø-"It--( ES () IQ LID TYFE SERIAL # YES NO FASS FAIL I certify the above tests were conducted on this d~te according to Red JacNet Pump~ field test apparatus testing proced~re an limitations. The Mechanical Leak Detector Test pass I fail is determined by using a,low flow threshold trip rate of 3 gallon per hour or less at 10 PSI. I acknowledge that all data collected is true and correct to the bese of my knowledge. Tech: Date ;, 1-)-01 .dY Signacure: , I ~OFTWARE R~VISION LEVEL ERSION 15.01 'OFTWARE~ 346015-100-B REATED - 97.10.23.08.56 ~O SOFTWARE MODULE ~YSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS SYSTE!"! SET UP ------- MAR 22. 2004 9:53 AM SYSTEl"l UNITS U.S. SYSTEI"I LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD "1"1"1"1 HH:MM:SS xM READY GO J"IOBIL 3620 WILSON RD BAKERSFIELD CA 93309 661-833-6507 SHIFT T11"1E SHIFT TIt-IE 2 SHIFT TIt-IE 3 SHIFT 1.II"IE 4 4:00 At-I DISABLED DISABLED DISABLED TANK PERIODIC WARNINGS , DISABLED I TANK ANNUAL WARN I NGS DISABLED LINE PERIODIC WARNINGS . DISABLED , LINE ANNUAL WARNINGS ! DISABLED , PR I NT TC VOLUMES I ENABLED TEMP COMPENSATION VALUE (DEG F): 60.0 STICK HEIGHT OFFSET DISABLED DAVLIGHT SAVI,NG TIt-IE ENABLED START DATE APR WEEK 1 SUN START TIME 2:00 AM END DATE OCT WEEK 6 SUN END TII"IE 2:00 AM SVSTEJ-¡ SECUR ITY CODE : '000000 ,IN-TANK SETUP ------ T 1: UNLEADED PRODUCT CODE THERMAL COEFF TANK DIAI"IETER TANK PROFILE FULL VOL : 11 : . 0007001' : 113.75 : 1 PT 150231 FLOAT SIZE: 4.0 IN. 849~ WATER WARNING : 2.D HIGH WATER L II'1 IT: 3 . 01 MAX OR LABEL VOL: OVERFILL LIMIT HIGH PRODUCT DELIVERY LII"IIT LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT : MANIFOLDED TANKS TIi: NONE LEAK MIN PERIODIC: LEAK MIN ANNUAL 150231 90%:, . 1 35201 95%1, 14271 10%; 1502: 500; 991' : 50 0.00\ , I ; , 10%1 15021 I 10%1'; 1 502 '~ , ì " ~'~ ; PERIODIC TEST TVPE STANDARD! ; ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARI"I DISABLED' GROSS TEST FAIL ALARM DISf.lBLED LOW PRODUCT : 500 LOW PRODUCT : LEAK ALARM LIMIT: 99 LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: 50 J;·SUDDEN LOSS LIMIT: TANK TILT· 0.00 TANK TILT r"lAN I FOLDED TANKS MANIFOLDED TANKS TI*: NONE T#: NONE LEAK MIN PERIODIC: 10% LEAK MIN PERIODIC: : 1007 : LEAK MIN ANNUAL 10% LEAK MIN ANNUAL 1007 , , -, T 2: PREr"1 I UI"I PRODUCT CODE THERt-1AL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 2 ': .000700 11 3 . 75 1 PT, 10074: FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 10074 OVERFILL LIMIT 90% 9066 HIGH PRODUCT 95% 9570 j)ELIVERV LIMIT 10% 1007 PERIODIC TEST TYPE STANDARD! ,ANNJJf!lL, TESlh~lÞ""~""'" ': : ' ALARM DI SABLED \ PERIODIC TEST FAIL \ ALARM DISABLED GROSS TEST FAIL ' ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOT I FV : OFF ANN TEST AVERAG I NG : OFF' ' PER TEST AVERAGING: OFF TNK TST SIPHON BREAK:OFF ¡ TANK TEST NOTIFY: OFF; DELIVERV DELAV : 15 MIN TNK TST SIPHON BREAK:OFF: DELIVERV DELAV .:., 15 MI N ' \ T 3:DlESEL PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 3 : .000450 118.75 1 PT 5037 FLOAr SIZE: 4.0 IN. 8496 WATER WARNING : HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL LIMIT : HIGH PRODUCT DELI VERV L 11"1 I T 2.0 3.0 503'7 I 90% ' 4533 95~. 4785 ¡ 10% 503 500 99 50 0.00 10}. 503 10% 503 PERIODIC TEST TYPE STANDARD ¡ ANNUAL TEST FAIL ALARI"I DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ÄNN TEST AVERAGING: OFF PER TEST AVERAG I NG: ' OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 1"11 N LEAK TEST METHOD - - - - - - - - - - - - TEST ANNUALLY: ALL TANK FEa WEEK 1 MON START TIME: 1:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 HOURS LEAK TEST REPORT FORMAT ¡ ENHANCED LIQUID SENSOR SETUP - - - - - - - - - - L 1: UNL STP . TRI -STATE (81 NGLE FLOAT> CATEGORY : STP SUMP L 2: PREI"I STP TR I -STATE (S I NGLE FLOAT) , CATEGORY ; STP SUMP L 3:DIESEL STP TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP OUTPUT RELAY SETUP - - - - - - - - - - R 1: UNL STP TYPE: STANDARD NORMALLY CLOSED LIQUID SENSOR ALMS L 1 :FUEL ALARI"I L 4:FUEL ALARM L 7:FUEL ALARM R 2:PLUS STP TYPE: STANDARD L 4:UNL FILL ' ,NORI"1ALLY CLOSED TRI-STATE (SINGLE FLOAT) ! CATEGORY : MONITOR WELL I L 5:PREM FILL TRI-STATE (SINGLE FLOAT) CATEGORY : MONITOR WELL L 6:DIESEL FILL TRI-STATE (SINGLE FLOAT) CATEGORY ; MONITOR WELL L 7:UNL ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 8:PREM-DIESEL ANNULAR TRI -STATE (81 NGLE '"FLOAT> CATEGORY : ANNULAR SPACE .~\ LIQUID SENSOR ALMS L 2:FUEL ALARM L 5:FUEL ALARM L 8:FUEL ALARM R 3:DIESEL STP TYPE: STANDARD NORI"1ALL Y CLOSED' LIQUID SENSOR ALMS L 3:FUEL ALARM L 6: FUELALARI"1 L 8:FUEL ALARM R 4:0VERFILL ALARM TYPE: STANDARD NORI" ALLY OPEN -I ALARM H I STORY REPORT. \ ---- IN-TANK ALARM ----l T 1: UNLEADED i SETUP DATA WARNING FEe 7. 2003 6:21 PM OVERFILL ALARM FEe 22. 2004 8:53 AM FEe 20. 2004 7:17 PM JAN 14. 2004 5:21 PM DELIVERY NEEDED OCT 81. 2008 1:55 PM OCT 3. 2003 10:50 PM SEP 24. 2003 12:08 PM ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ALARM HISTORY REPORT IN-TANK ALARMS , , ALL :OVERFILL ALARI"1 ;. ---- I N-TANK ALARM ALL:HIGH PRODUCT ALARMi T l:UNLEADED SETUP DATA'WARNING FEE 7. 2003 6:21 PM OVERFILL ALARM FEe 22. 2004 8:53 AM FEE 20. 2004 7:17 PM JAN 14. 2004 5:21 PM - ~-- .¡ i' ALAR!"1 HISTORY REPORT :¡ ----- SYSTEI"1 ALARM ...---'1 PAPER OUT ' DEC 2. 2003 8:34 AM PRINTER ERROR DEC 2. 2003 8:43 AM BATTERY IS OFF ' JAN 1. 1996 8:00 AM DELIVERY NEEDED OCT 31. 2008 1:55 PM OCT 3. 2003 10:50 PM SEP 24. 2003 12:08 PM -,'; {,~",¡¡~;! ;.; ;,'.. ",'~~i¡''' H1'{ ALARM HISTORY REPO~T ---- IN-TANK ALARM T 2:PREMIUM HIGH PRODUCT ALARM FEe 7. 2008 6 :48 'P!"I DELIVERY NEEDED SEP 8. 2008 6:86 PM ~ ~ ~ ~ ~ ~ END ~ * * * ~ ALARM HISTORY REPORT ---- IN-TANK ALARM T 3:DIESEL * * * * * END ~ * * * * ALARM HISTORY REPORT ----- SENSOR ALARM L 1: UNL STP STP SUf"IP FUEL ALARM JAN 2. 2004 12:16 PM ~ ~ * ~ ~ END ~ * ~ ~ ~ FUEL ALARM FEe 11.'- 2003 9:36 AM FUEL ALARM .oW ÌIi "';¡ ~ END ~ ~ ~w ÌIE FEE 10. 20Ò3 11:42 AM AL.AJ<["¡ H! ::ìTUkY R1::PUkT --~-~ SENSOR ALARM ---- L 2: PRE!1 STP STP SUMP FUEL ALARI"I FEE 11. 2003 9:40 AM FUEL ALARM FEE 10. 2003 11:40 AM '" '" '" '" '"' END'"' '"' '" '"' : ALARM HISTORY REPORT ----.- SENSOR ALARI"1 L 3:DIESEL STP STP SUMP FUEL ALARM FEE 11. 2003 9:88 AM FUEL ALARM FEE 11. 2003 9:34 AM FUEL ALARM FES 10. 2003 11:38 AM ~ ~ ~ ~ ~ END ~ ~' ~ ~ ALARM HISTORY REPORT: ----- SENSOR ALARM L 4:UNL FILL MONITOR WELL FUEL AwARl1 FEE 11. 2003 9:37 AM FUEL ALARM , FEE 10. 2003 11: 42 AI"I';' ALARM HISTORY REPORT ----- SENSOR ALARM L 5:PREM FILL r"lONITOR WELL FUEL ALARM FEE 11. 2003 9:41 AM FUEL ALARI"' FEB 10. 2003 11:41 AM '" '" '" ~ '" END '" '" '" ~ ALARM HISTORY REPOR~__I ----- SENSOR ALARM Î L 6:DIESEL FILL I I"ION I TOR WELL FUEL ALARM i FEB 11. 2008 9:39 AM FUEL ALARI"! FEB 10. 2003 11:89 AM ~~' ~ ~ ~ ~ ~ END ~ '" ~ ~. ~ , ALARM HISTORY REPORT ~---- SENSOR ALARM L 7:UNL ANNULAR ANNULAR SPACE FUEL ALARM FEB 11. 2008 9:32 AM FUEL ALARM FEB 10. 2008 11:48 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 8:PREM-DIESEL ANNULAR ANNULAR SPACE FUEL ALARI"! FEB 11. 2003 9:32 AM FUEL ALARM FEB 10. 2003 11:44 AM ~ '" '" . ~ END ~ '" '" '" '" ALARM HISTORY REPORT __l___ SENSOR ALARM o¡¡¡ i1: OT/'iER SENSORS ~ ~ ~ '" ~ END ~ ~ '" ~ '" l' . \i t-l 'I -7~- i -~-:-- SENSOR A~ARM "L,a;PREM STP," S'tPiSUMP Fµç:~ ALARM , M~rç!22 . 2004 1 0 : C1 AM -~-~- SENSOR ALARM ----- L 1: UNL STP STp:SUMP F4E~ ALARM, M~R!22. 2004 10:11 AM ----- SENSOR ALARM L 4:UNL FILL MONITOR WEI,.L FUEL ALARM MAR 22. 2004 10:12 AM ~~ I I I I ----- SENSOR ALARM I L 5:PREM FILL MONITOR WELL \ f~~L ~~:A~~O~ ,10-: '18: 'AM, ' ~~" :,~~;~~~;-.~.¡~~^~'~~L~ , I I I I L .-- --.--.--- t ! ----- SENSOR A4ARM r!,' L 8:DIESEL STP , STP SUMP FUEL ALARM I1AR 22. 2004 10:18 AM " ----- SENSOR ALARM L 6:DIESEL F,ILL MONITOR WELL\, FUEL ALARM " MAR 22. 2004 I 1 0 : 1 9 AM ' i , \ ¡ I I' , ----- SENSOR A~ARM L 7: UNL ANNULAR ANNULAR SPACE FUEL 'ALARM MAR 22. 2004 10:21 AM (" ----- SENSOR ALARM L e:PREM-DIESELANNULAR ANNULAR SPACE FUEL ALARM . MA~ ~2.. 2004 1 0 : 22 Al"l , \ . .t <if *COpy REQUESTED PLEASE FAX(66l)392-062l ' CITY OF BAKERSFIELD OFFICE OFl}NVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 FAX ( 66 1) 73S '2 - 7.. J 7 'Z APPLICATION TO PERFORM 'FUEL MONITORING CERTIFICATION FACiliTY (Y)() 'If¿ \ L ADDRESS ·3«(\~O(A.JlL~ .'\Qt) --ßA-\-<~~\ELb~Cfr ' OPERATORS NAME 1\'C.0 ~A . OWNERS NAME.: '\\'Q 0'-1 C' ~A-, i ~~ - -, NAME OF MONITOR MANUF ~CTURERVü2.b'fÐQ Roor I L S - '3 SO DOES FAÇlllTYHAVEDISP~SERPANS7 YEsK- NO_ VOLUME \~ \< Ib~ ~k TANK # ' \ '2.... ':S DIF~\C.l_ NAME OFTESTlr:~"G CQMPANY RIC~. ~fYI~ONt:1ENTAL CONTRAcTORS UCENSEif 90-1072,' . '. \., NAME&PHONENlJ¥BEROFCONTAÇT:f~SON JAMES RICH 1661 }392-8687 DATE&TIMETESTISTOBECONDUq;TEp, '13/é).é).!OLJ .- q.'ôOA-m APPROVED BY 3/j~AO~ I' ; {', . D4\TE,,·' r; -C. mccCU-rL S GNATURE OF APPUCANT " ,1 " \1" \i READY, GO MARKET '- SiteID: 015-021-001065 Manager : Location: 3620 WILSON RD City BAKERSFIELD BusPhone: Map : 123 Grid: lID (661) 833-6507 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: v SIC Code:5541 DunnBrad:77-020-8038 Emergency Contact / Title Emergency Contact / Title ~HUY CHAO / OWNER MOY CHAO / OWNER Business Phone: (66l) 833-6507x Business Phone: (661) 833-6507x '24-Hour Phone : (661) 588-3185x 24-Hour Phone : (661) 588 -3185x Pager Phone : (66~ ;3')t,_8-:~~~ Pager Phone : (66l)~ "" F , ~ Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (66l) 833-6507x MailAddr: 3620 WILSON RD State: CA City : BAKERSFIELD Zip : 93309 Owner CHHUY K CHAO Phone: (661) 588-3l85x Address : 3620 WILSON RD State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, Æ 4 y: ¿h C7~Õ hereby certify that I, h8ve ~or/pnntname) , reviewed the attached hazardous materials manage- ment plan for R-edv ßO 8í'i"j1 ;,hl,'1Íi: it along with (Name of BusinGss) any corrections constitute a iComp¡6~v iCti1d correct m.an- agement plan for my facility. ~~ , Signatu~ :?__ (-t:? V - DÐls -- -l- 03/01/2004 " ,r, F READY GO MARKET SiteID: 015-021-001065 9 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: READY GO MARKET Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : MOY CHAO Phone: (661) 833-6507x Address: , City : State: Zip: Type : INDIVIDUAL TANK OWNER INFORMATION Name : MOY CHAO Phone: (661) 833-6507x Address: c City : State: Zip: Type : INDIVIDUAL BOE UST Fee# : 039984 Financ'l Resp: STATE FUND I. Legal Notif : Property Owner Mailing Address Date:02/11/2000 Phone: (661) 588-3185x Name:CHHUY K CHAO Ttl: State UST # : 1998 Upg Cert#: 00807 F Hazmat Inventory One Unified List 9 f== Alphabetical Order All Materials at Site 9 Hazmat Common Name. . . SpecHaz EPA Hazards DailyMax MCP DIESEL F IH DH L 9000.00 GAL Low SUPER UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod UNLEADED GASOLINE F IH DH L 15000.00 GAL Mod -2- 03/01/2004 ,~ SiteID: 015-021-001065 ì Facility Unit: Fixed Containers on Site ì F READY GO MARKET f= Inventory Item 0002 ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit W OF MARKET Map: Grid: CAS# 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GRdUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 9000.00 GAL Daily Average 4000.00 GAL %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS f= Inventory Item 0003 ~ COMMON NAME / CHEMICAL NAME SUPER UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UST 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 10000.00 GAL %wt. I 100.00 Gasol1.ne 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 -3- 03/01/2004 r " F READY GO MARKET f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 015-021-001065 ï Facility Unit: Fixed Containers on Site ï Loc'ation within this Facility Unit UST 'Days On Site 365 Map: Grid: CAS# 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container l5000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 15000.00 GAL Daily Average 15000.00 GAL %wt. I 100.00 Gasollne 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 ~4- 03/01/2004 ~. .i', F READY GO MARKET I f= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-001065 ì Fast Format ì Overall Site ì 02/17/2000 CALL 911, NOTIFY FIRE DEPT, OFFICE OF ENVIRONMENTAL SERVICES AT 326-3979 OR CALL 1-800-424-8802. Employee Notif./Evacuation 10/16/1990 TELL EVERYONE TO LEAVE IN A LOUD VOICE. Public Notif./Evacuation 10/16/1990 WORD OF MOUTH. STATION EMPLOYEE AT EACH ENTRANCE TO KEEP PUBLIC OUT OF THE HAZARDOUS AREA. Emergency Medical Plan 03/30/1998 ] I CALL 91l - AMBULANCE. -5- 03/01/2004 " F READY GO MARKET I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-001065 9 Fast Format 9 Overall Site 9 10/16/1990 GAS PUMPS HAVE NOZZLES EQUIPPED WITH VAPOR RECOVERY SYSTEM. ALL STORAGE TANKS ARE MONITORED DAILY. Reiease Containment 10/16/1990 KITTY LITTER OR OTHER ABSORBANT MATERIAL. Clean Up 10/16/1990 CALL ENVIRONMENTAL CLEAN-UP COMPANY. Other Resource Activation -6- 03/01/2004 ~ F READY GO MARKET I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 015-021-001065 9 Fast Format 9 Overall Site 9 I 03/30/1998 A) GAS - NONE B) ELECTRICAL - INSIDE W WALL OF STORE C) WATER - ALL FOUR CORNERS OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 03/30/1998 PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - 200FT S OF STORE ON WILSON RD, NEXT TO MAIL BOX. Building Occupancy Level -7- 03/01/2004 .. F READY GO MARKET I F Training Employee Training SjteID: 015-021-001065 9 Fast Format 9 Overall Site 9 03/30/1998 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: ON THE JOB TRAINING FOR NEW EMPLOYEES IN THE USE OF GAS CONSOLE, PUMPS ETC. Page 2 r I I Held for Future Use Held for Future Use -8- 03/01/2004 + READY GO MARKET ------------------------------------- ------------------------------------- SiteID: 015-021-00l065 + Manager : Location: 3620 WILSON RD City BAKERSFIELD BusPhone: Map :l23 Grid: lID (661) 833-6507 CommHaz : Low ÞacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 SIC Code:5541 EPA Numb: DunnBrad:77-020-8038 +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title SHHUY CHAO / OWNER MOY CHAO / OWNER Business Phone: (661) 833-6507x Business Phone: ~661) 833-6507x 24-Hour Phone : (661) 588-3185x 24-Hour Phone : (66l) 588-3185x Pager Phone : (661) 703-8898x Pager Phone : (661) 703-8697x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire' ImmHlth DelHlth, I +------------------------------------------------------------------------------+ Contact: Phone: (661) 833-6507x MailAddr: 3620 WILSON RD State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ Owner CHHUY K CHAO Phone: (661) 588-3185x Address : 3620 WILSON RD State: CA City : BAKERSFIELD Zip : 93309 +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: +------------------------------------------------------------------------------+ Emergency Directives: +==========~=============-=====================================================+ -1- 03/01/2004 + READY GO MARKET ===================================== SiteID: 015-021-0010'65 + +==================== STORAGE CONTAINER DATA (UST FORM A) =====================+ I Last Action Type: I +------------------------~ FACILITY/SITE INFORMATION ----------------------~---+ Business Name: READY GO MARKET Cross Street : Business Type: Total Tanks 4 IndnRes/Trust: No. +-----------------------~- PROPERTY OWNER Name MOY CHAO Address: City Type INDIVIDUAL +--------------------------- TANK OWNER INFORMATION ---------------------------+ Name MOY CHAO Phone: (661) 833-6507x Address: City Type INDIVIDUAL +------------------------------------------------------------------------------+ BOE UST Fee# : 039984 Financ'l Resp: STATE FUND Legal Notif : Property. Owner Mailing Address +------------------~-----------------------------------------~-----------------+ Date: 02/11/2000 Phone: (661) 588-3185x Name:CHHUY K CHAO Ttl: State UST# 1998 Upg Cert#: 00807 +==============================================================================+ Org Type: PA Contact: INFORMATION -------------------------+ Phone: (661) 833 - 6507x State: Zip: State: Zip: -2- 03/01/2004 ~ + READY GO MARKET ===================================== SiteID: 015-021-001065 + += Hazmat Inventory ========================================= By Facility Unit + +== MCP+DailyMax Order ============================== Fixed Containers on Site + +--------------------------------+-------+-----------+-----+----------+----+---+ I Hazmat Common Name... ISpecHazlEPA Hazards Frm DailyMax UnitlMCpl +--------------------------------+-------+-----------+-----+----------+----+---+ UNLEADED GASOLINE F IH DH L 15000.00 GAL Mod SUPER UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod DIESEL F IH DH L 9000.00 GAL Low +==============================================================================+ -3- 03/01/2004 !' + READY GO MARKET ===================================== SiteID: 015-021-001065 + += Inyentory Item OOOl =============== Facility Unit: Fixed Containers on Site + +== COMMON NAME / CHEMICAL NAME ==============================+================+ UNLEADED GASOLINE I Days On Site I 365 +----------------+ I CAS# I 8006-61-9 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Pure Ambient Ambient UNDER GROUND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I ,15000.00 GAL 15000.00 GAL 15000.00 GAL +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt . I IRS I CAS# I 100.00 Gasoline No 8006619 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I TSecret IRS I BioHaz I Radioactive/Amount I EPA Hazards '/ NFPA I USDOT# I,MCP I No No No No/ Curies F IH DH / / / Mod +=======+===+======+====================+=============+=========+========+=====+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: Location within this Facility Unit UST Map: Grid: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: +- Ag.Definell --------------------------------________________________________+ +==============================================================================+ -4- 03/01/2004 ~ + READY GO MARKET ===================================== SiteID: 015-021-001065 + += Inventory Item 0001 =============== Facility Unit: Fixed Containers on Site + +===== STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 =====+ I Last Action Type: I Location In Site: UST +------------------------------ TANK DESCRIPTION Tank ID#: 1 Mfr: MODERN WELD Installed: 02/2003 Capacity: 15000 Gals Additional Info: +-------------------------------- I Tank Use: MOTOR VEHICLE FUEL MatI Name:UNLEADED GASOLINE +----------------------------- TANK CONSTRUCTION Type DOUBLE WALL Material(p): BARE STEEL Material(s}: STEEL CLAD W/FIBERGLASS R. P. Lining UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt 2003 Drop Tube : 2003 Striker Plate~ 2003 +---------------------------- TANK LEAK Sgl Wall: ------------------------------+ Compart Tank: N No. Of Comparts: TANK CONTENTS -------------------------------+ Petrol Type: REGULAR UNLEADED ; I Cas #: 8006-61-9 ------------------------------+ PLASTIC Alarm Ball Float Fill Tube S/O: 2003 DETECTION -----------~-----------------+ Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No +==============================================================================+ -5- 03/01/2004 Type : Const: Mfgr Mtl & Corr Prot +--------------------------- PIPING UnderGround Piping AUTOMATIC LEAK DETECTORS + READY GO MARKET ===================================== SiteID: 015-021-001065 + += Inventory Item 0001 =============== Facility Unit: Fixed Containers on Site + +===== STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 =====+ +----------------------------- PIPING CONSTRUCTION --------------------~-------+ UnderGround Piping AboveGround Piping PRESSURE DOUBLE WALL TOTAL CONTAINMENT "FLEX" "FLEX" LEAK DETECTION ----------------------------+ , AboveGround Piping +--------------------------- DISPENSER CONTAINMENT ----------------------------+ I Installed: 02/11/2003 Type: DISP. PAN SENSOR w/ POS. SHUTOFF I +-------------------------- OWNER/OPERATOR SIGNATURE --------------------------+ Date: 02/l1/2000 Name:CHHUY K CHAO Ttl:OWNER Prmt Number: 1065 Approved: Yes Expiration Date: 06/30/2006 +------------------------------- AGENCY DEFINED -------------------------------+ TANK/LINE TEST :02/1~/2003 PASS CP CERT. :07/15/1998 MANWAY INSP. : l2/22/1998 UST MONIT. CERT:02/11/2003 +==============================================================================+ '-6- 03/01/2004 " " + READY GO MARKET =========~=========================== SiteID: 015-02l-001065 + += Inventory Item 0003 =============== Facility Unit: Fixed Containers on Site + +== COMMON NAME / CHEMICAL NAME ===============~==============+================+ SUPER UNLEADED GASOLINE I Days On Site I 365 +----------------+ I CAS# I 8006-61-9 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Pure I Ambient I Ambient I UNDER GROµND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I 10000.00 GAL 10000.00 GAL 10000.00 GAL +=================~========+==================~======+=========================+ +=======+==~=========== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I ' I RSI CAS# I 100.00 Gasoline No 8006619 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ ITsecretl RS BioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F IH DH / / / Mod +=======+===+======+====================+=============+=========+========+=====+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: Location within this Facility Unit UST Map: Grid: Ag .Defined5:, Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: +- Ag.Define11 ----------------------------------------------------------------+ +==============================================================================+ -7- 03/01/2004 + READY GO MARKET ===================================== SiteID: 015-021-001065 + += Inventory +~em 0003 =============== Facility Unit: Fixed Containers on Site + +===== STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 =====+ I Last Action Type: I Location In Site: UST +------------------------------ TANK DESCRIPTION Tank ID#: 3 Mfr: MODERN WELD Installed: 02/2003 Capacity: lOOOO Gals Additional Info: SPLIT TANK +---------------~---------------- TANK CONTENTS --------------------------_____+ I Tank Use: MOTOR VEHICLE FUEL Petrol Type: PREMIUM UNLEADED I MatI Name:SUPER UNLEADED GASOLINE Cas #: 8006-61-9 +---------~--------~---------- TANK CONSTRUCTION ----------------------________+ Type DOUBLE WALL Material(p): BARE STEEL Material(s): STEEL CLAD W/FIBERGLASS R. P. Lining UNLINED Corr Prot: FIBERGLASS REINFORCED Spill Cnt 2003 Drop Tube : 2003 Striker Plate: 2003 +---------------------------- TANK LEAK Sgl Wall: ------------------------------+ Compart Tank: Y No. Of Comparts: 2 PLASTIC Alarm Ball Float Fill Tube S/O: 2003 DETECTION ---------------------------__+ Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled:· No +==============================================================================+ ( -8- 03/01/2Ò04 " Type : Const: Mfgr Mtl & Corr Prot +-----~--------------------- PIPING UnderGround Piping AUTOMATIC LEAK DETECTORS + READY GO MARKET ===================================== SiteID: Ol5-021-001065 + += Inventory Item 0003 =============== Facility Unit: Fixed Containers on Site + +===== STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 =====+ +----------------------------- PIPING CONSTRUCTION ----------------------------+ UnderGround Piping AboveGround Piping PRESSURE DOUBLE WALL TOTAL CONTAINMENT "FLEX" "FLEX" LEAK DETECTION ----------------------------+ AboveGround Piping +--------------------------- DISPENSER CONTAINMENT ----------------------------+ I Installed: 02/11/2003 Type: DISP. PAN SENSOR w/ POS. SHUTOFF I +-------------------------- OWNER/OPERATOR SIGNATURE ------------~-------------+ Date: 02/11/2000 ' Name:CHHUY K. CHAO Ttl:OWNER Prmt Number: 1065 Approved: Yes Expiration Date: 06/30/2006 +------------------------------- AGENCY DEFINED -------------------------------+ TANK/LINE TEST :02/11/2003 PASS CP CERT. :07/15/1998 MANWAY INSP. : 12/22/1998 UST MONIT. CERT:02/1l/2003 +==============================================================================+ -9- 03/0l/2004 ===================================== SiteID: 015-021-001065 + 0002 =============== Facility Unit: Fixed Containers on Site + CHEMICAL NAME ==============================+================+ I Days On Site I 365 +----------------+ I CAS# I 68476-34-6 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Pure I Ambient I Ambient I UNDER GROUND TANK I +=========+==========+===============+===============+=========================+ +==========================+ AMOUNTS AT THIS LOCATION =========================+ I Largest Container I Daily Maximum I Daily Average I lOOOO.OO GAL 9000.00 GAL 4000.00 GAL +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt . I IRS I CAS# I 100.00 Diesel Fuel No.2 No 68476302 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ Tsecretl RSIBioHaz Radioactive/Amoun, t I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F IH DH / / / Low ) +=======+===+======+====================+=============+=========+========+=====+ ~+========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: + READY GO MARKET += Inventory Item +== COMMON NAME / DIESEL Location within this Facility Unit W OF MARKET Map: Grid: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: +- Ag.Define11 --------------------------------------------------------___~____+ +==============================================================================+ -10- 03/01/2004 + READY GO MARKET ------------------------------------- ------------------------------------- SiteID: Ol5-021-001065 + Site + =====+ I += Inventory Item 0002 ===~=========== Facility Unit: Fixed Containers on +===== STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 1 of 2 I Last Action Type: Location In Site: W OF MARKET +-------------------,----------- TANK DESCRIPTION Tank ID#: 2 Mfr: MODERN WELD Installed: 02/2003 Capacity: 5000 G~ls Additional Info: SPLIT TANK ------------------------------+ Compart Tank: Y No. Of Comparts: 2 +-------------------------------- I Tank Use: MOTOR VEHICLE FUEL Matl Name:DIESEL +----------------------------- TANK CONSTRUCTION Type SINGLE WALL W/INT LINER & C.P. Material(p): BARE STEEL Material(s): BARE STEEL Lining PHENOLIC LINING Corr Prot: CATHODIC PROTECTION Spill Cnt 1997 Drop Tube : 1997 Striker Plate: 1997 +---------------------------- TANK LEAK Sgl Wall: TANK CONTENTS -------------------------------+ Petrol Type: DIESEL I Cas #: 68476-34-6 ------------------------------+ Alarm Ball Float : 1997 Fill Tube S/O: 0 DETECTION -----------------------------+ Dbl Wall: INTERSTITIAL MONITORING Installed: Installed: Exempt: No TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No +==============================================================================+ ~ -11- 03/01/2004 + READY GO MARKET ======i================================ SiteID: 015-021-001065 + += Inventory Item 0002 =============== Facility Unit: Fixed Containers on Site + +===== STORAGE CONTAINER DATA (UST FORM Band AGENCY-DEFINED) Page 2 of 2 =====+ +----------------------------- PIPING CONSTRUCTION ----~-----------------------+ UnderGround Piping AboveGround Piping PRESSURE DOUBLE WALL TOTAL CONTAINMENT "FLEX" Type : Const: Mfgr Mtl & Corr Prot "FLEX" +--------------------------- PIPING UnderGround Piping AUTOMATIC LEAK DETECTORS LEAK DETECTION ----------------------------+ AboveGround Piping +--------------------------- I Installed: 02/11/2003 +-------------------------- Date: 02/11/2000 ' Name:CHHUY K CHAO Ttl:OWNER Prmt Number: 1065 Approved: Yes Expiration Date: 06/30/2006 +--------~---------------------- AGENCY DEFINED -------------------------------+ TANK/LINE TEST :02/11/2003 PASS CP CERT. :07/15/1998 MANWAY INSP. : 12/22/1998 UST MONIT. CERT:02/1l/2003 +==============================================================================+ DISPENSER CONTAINMENT ----------------------------+ Type: DISP. PAN SENSOR W/ POS. SHUTOFF I OWNER/OPERATOR SIGNATURE --------------------------+ -12- 03/01/2094 ,~ + READY GO MARKET ===================================== SiteID: Ol5-02l-00l065 + +================================================================= Fast Format + +- Notl'f /Evacuatl'on/Medl'cal ------------------------------------ Overall Sl'te + -. -----------------------~------------ +== Agency Notification =========================================== 02/17/2000 + CALL 911, NOTIFY FIRE DEPT, OFFICE OF ENVIRONMENTAL SERVICES AT 326-3979 OR CALL 1-800-424-8802. +==============================================================================+ +--- Employee Notl'f /Evacuatl'on -------------------------~--------- 10/16/1990 + --- . ----------------------------------- TELL EVERYONE TO LEAVE IN A LOUD VOICE. +==============================================================================+ +~--- Publl'C Notl'f /Evacuatl'on ------------------------------------ 10/16/1990 + ---- . ------------------------------------ WORD OF MOUTH. STATION EMPLOYEE AT EACH ENTRANCE TO KEEP PUBLIC OUT OF THE HAZARDOUS AREA. +==============================================================================+ +----- Emergency Medl' cal Plan ---------.:'---------------------------- 03/30/l998 + ----- ------------------------------------- CALL 911 - AMBULANCE. +==============================================================================+ -13- 03/01/2004 ~ ~ + READY GO MARKET ======================~============== SiteID: 015-021-001065 + +================================================================= Fast Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +== Release Prevention ============================================ 10/16/1990 + GAS PUMPS HAVE NOZZLES EQUIPPED WITH VAPOR RECOVERY SYSTEM. TANKS ARE MONITORED DAILY. ALL STORAGE +==============================================================================+ +--- Release Contal'nment ---------------------------------~-------- 10/16/1990 + --- ------------------------------------------ KITTY LITTER OR OTHER ABSORBANT MATERIAL. +==============================================================================+ +---- Clean Up ---------------------------------------------------- 10/l6/1990 + ---- ---------------------------------------------------- CALL ENVIRONMENTAL CLEAN-UP COMPANY. +==============================================================================+ +===== Other Resource Activation ==============================================+ I I +==============================================================================+ -14- 03/01/2004 ~ , + READY GO MARKET ===================================== SiteID: 015-021-001065 + +================================================================= Fast Format + += Site Emergency Factors======================================= Overall Site + +== Special Hazards ===========================================================+ I +==============================================================================+ +--- Utl'll'ty Shut-O·ffs -------------------------------------------- 03/30/1998 + --- -------------------------------------------- A) GAS - NONE B) ELECTRICAL - INSIDE W WALL OF STORE C) WATER - ALL FOUR CORNERS OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO +==============================================================================+ +---- Fl're Protec /Aval'l Water ----------------------------------- 03/30/l998 + ---- .. ----------------------------------- PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT.- 200FT S OF STORE ON WILSON RD, NEXT TO MAIL BOX. +==============================================================================+ +===== Building Occupancy Level ===============================================+ I I +==============================================================================+ -15- 03/01/2004 - ..~ + READY, GO MARKET ==============~====================== SiteID: 015-02l-001065 + +================================================================= Fast Format + += Training =======~============================================= Overall Site + +== Employee Training ============================================= 03/30/1998 + WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: OF GAS CONSOLE, PUMPS ETC. ON THE JOB TRAINING FOR NEW EMPLOYEES IN THE USE +==============================================================================+ +=== Page 2 ===================================================================+ I I I +==============================================================================+ +==== Held for Future Use =====================================================+ I' I +==============================================================================+ +===== Held for Future Use ====================================================+ I I +=================~============================================================+ -16- 03/01/2004 '-...... .. . ,... ."t .,~:::. 'ii. _ ---.:¡ .,. ,. . ~.~ - ~ . , . ·---~.l.' READY GO MARKET 'Y'f .F ::::3 1 6 2001) -0 ~-,.~ \".-' ,- », .. .. ~ ..-- .. .--~,~"',.... . .. SiteID: 215-000-001065 'Manage'r : Location: 3620 WILSON RD City BAKERSFIELD BusPhone: Map : 123 Grid: 11D (805) 833-6507 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code:5541 DunnBrad:77-020-8038 Emergency Contact / /1I.4ðitle JOHN STUART ~ C HI1U ýf '"OWNER Business Phone: (865) 833-6507x ,~~~ 24-Hour Phone : (805) ~5 63~ô~58~~m/ Pager Phone : ('Gf»)p) -~9~x Emergency Contact I/' tt-P.. Title .JOHN STUART JRftt?Y WJ OWNER Business Phone: (805) 833-6507x 24-Hour Phone : (805) ,32: GJ2"tDc Pager Phone : ('&1) ?P 3 -'86.1'.4. Hazmat Hazards: Contact : eN tl'f e H 4(/ MailAddr: 3620 WILSON RD City : BAKERSFIELD Fire ImmHlth DelHlth Phone: (t6/) sg?š -f/8S-x State: CA Zip : 93309 Owner Address City CHl'iiL... nOON CI!I!tf7 k. CHI/tl : 3620 WILSON RD : BAKERSFIELD Phone: (805) 833-6507x State: CA Zip : 93309 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: .- I, Cflllt{¥ C/lk¿J Do hereb~' "':~r:¡fy !h.s'i ! ha"e (Type'or print name) , .' reviewed the attached hazardous mateïÎè:.\¡:~:·nEL ,aql3- ment plan for I(.¡),~ J;;,Wl n4R~that it alan:. . 'I;' , ~ ot'iruS'mÐ8ll) .. any corrections constitute a complete and correct man- agement plan for my facility. h a/ ~",Lja"--~ J-- /J-¿?¿J ~~ fi)at$ 1 -1- 01/31/2000 ,I , I :i e - F READY GO MARKET p= Hazmat Inventory p== Alphabetical Order SiteID: 215-000-001065 ~ By Facility Unit ~ Fixed Containers on Site ~ specHaz EPA HazardS Frm I DailyMax IUnit MCP Hazmat Cornman Name... DIESEL SUPER UNLEADED GASOLINE UNLEADED GASOLINE UNLEADED PLUS GASOLINE F F F F IH DH IH DH IH DH IH DH L L L L 9000.00 GAL 5000.00 GAL 10000.00 GAL 10000.00 GAL Low Mod Mod Mod , , -2- 01/31/2000 e e F READY GO MARKET p= Inventory Item 0002 F== COMMON NAME / CHEMICAL NAME DIESEL SiteID: 215-000-001065 ~ Facility Unit: Fixed Containers on Site ~ Location within this Facility Unit WEST OF MARKET Days On Site 365 Map: Grid: CAS # 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 10000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 9000.00 GAL Daily Average 4000.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS p= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME SUPER UNLEADED GASOLINE Facility Unit: Fixed Containers on Site ~ Days On Site 365 Location within this Facility Unit UNDERGROUND TANK Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 5000.00 GAL Daily Average 2500.00 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- 01/31/2000 e e F READY GO MARKET p= Inventory Item 0001 F== COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 215-000-001065 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UNDERGROUND TANKS Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Largest Container 12000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 8000.00 GAL %Wt. I 100.00 Gasoline HAZARDOUS COMPONENTS ~ CAS # I 8006619 TS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod HAZARD ASSESSMEN p= Inventory Item 0004 F= COMMON NAME / CHEMI CAL NAME UNLEADED PLUS GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit UNDERGROUND TANK SOUTHWEST CORNER Map: Grid: CAS # 8006-61-9 [ ~TA'~E I TYPE -¡-; P~ESSURE ~ TEM~ERATURE I CONTAINER TYPE =Llquld ~~pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 10000.00 GAL 8000.00 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 -4- 01/31/2000 " .' e tit í READY GO MARKET ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-001065 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Notif./EvacuationlMedical ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Agency Notification ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 03/30/1998 j o 0 o CALL 911. NOTIFY FIRE DEPT OFFICE OF ENVIRONMENTAL SERVICES AT 326-3979 OR 0 o CALL 1-800-424-8802. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Employee Notif./Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/16/1990 j o 0 o TELL EVERYONE TO LEAVE IN A LOUD VOICE. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Public N otif. /Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/16/1990 j o 0 o WORD OF MOUTH. STATION EMPLOYEE AT EACH ENTRANCE TO KEEP PUBLIC OUT OF THE 0 o HAZARDOUS AREA. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Emergency Medical Plan ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 03/30/1998 i o 0 o CALL 911 - AMBULANCE. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -5- e e 01131/2000 '. e e í READY GO MARKET ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-001065 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast F onnat j íë Mitigation/Prevent/ Abatemt ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site i íëë Release Prevention ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/16/1990 j o 0 o GAS PUMPS HAVE NOZZLES EQUIPPED WITH VAPOR RECOVERY SYSTEM. ALL STORAGE o TANKS ARE MONITORED DAILY. 0 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Release Containment ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/16/1990 j o 0 o KITTY LITTER OR OTHER ABSORBANT MATERIAL. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Clean Up ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/16/1990 j o 0 o CALL ENVIRONMENTAL CLEAN-UP COMPANY. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Other Resource Activation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -6- 01/31/2000 .' e e í READY GO MARKET ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-001065 ¡ íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Site Emergency Factors ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Special Hazards ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë i o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Utility Shut-Offs ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 03/30/1998 j o 0 o A) GAS - NONE o B) ELECTRICAL - INSIDE W WALL OF STORE o C) WATER - ALL FOUR CORNERS OF BLDG o D) SPECIAL - NONE o E) LOCK BOX - NO o o o o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Fire Protec.l Avail. Water ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 03/30/1998 j o 0 o PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS. o o o o o o o o NEAREST FIRE HYDRANT - 200FT S OF STORE ON WILSON RD, NEXT TO MAIL BOX. o 0 o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Building Occupancy Level ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -7- 01/31/2000 ;;, '0- e e ::-. í READY GO MARKET ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-001065 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast F annat i íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë03/30/1998 j o 0 o WE HAVE 3 EMPLOYEES AT THIS FACILITY. o o o o WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. o o o o BRIEF SUMMARY OF TRAINING: ON THE JOB TRAINING FOR NEW EMPLOYEES IN THE USE 0 o OF GAS CONSOLE, PUMPS ETC. 0 o 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf ... #!. ..' ~__ 4:"~" -- - e READY GO MARKET SiteID: 215-000-001065 Manager : Location: 3620 WILSON RD City BAKERSFIELD BusPhone: Map : 123 Grid: 11D (805) 833-6507 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA' Numb: SIC Code:5541 DunnBrad:77-020-8038 Emergency Contact / Title Emergency Contac~ / Title ~ ~ Jòhlî stvof' 4- P'OWNER ~I:;SE\7ðhl 5 ft;p r I- J '" / Ml'.nf~aIJR o<...ù ¡V (3.1<- Business Phone: (805) 833-6507x Business Phone: (805) 833-6507x 24-Hour Phone : (805) 327 J333~32.S-~32C 24-Hour Phone : (805) 63..6 lé~~x::3ZSt.eð¿ Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Emergency Directives: o f= Hazmat Inventory p== MCP+DailyMax Order One Unified List l All Materials at Site l specHaz EPA Hazards Frm ,I DailyMax IUnit MCP Hazmat Common Name... UNLEADED GASOLINE UNLEADED PLUS GASOLINE SUPER UNLEADED GASOLINE DIESEL F F F F IH DH IH DH IH DH IH DH L f),tl!J~ 10 8 Ð'O""" GAL L ll{()(){) a. 0 ô ð 0 GAL L r 2( IQO 0 5"'01'fõ GAL L t €:I t Ct) C 9i1't'rtJ GAL Mod Mod Mod Low J ¿ ¿"- ~ h . I (Yv~orprlnt~) @ \Sr~by œi10iy th¿¡~ i ha,,@ i'tWi(9WSd thŒÞ a~acl1s@ haz~f'OOUS m~t(9iial~ m~i'1Ølg@- mrs~t plan f@i' /-&,Ij.~fllé ,¡o/Hk4nd Ula~ å~ ~1©1i'M'I wi~h (1\!em3 of ~) '"lei any C@i'redi©r¡s oo¡r¡smut(9 a complete and œIT~d ~n- agemsnt plan for my ~cility. ~ 3,i~ßð ·-1- 03/19/1998 " . e e F READY GO MARKET p= Inventory Item 0001 F== COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE SiteID: 215-000-001065 1 Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit 3 UNDERGROUND TANKS Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~ P~ESSURE ---¡ TEM~ERATURE I CONTAINER TYPE =Llquld ~~pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 8000.00 GAL %'Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS HAZARD ASSESSMENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod S p= Inventory Item 0004 F== COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Facility Unit: Fixed Containers on Site 1 Days On Site 365 Location within this Facility Unit UNDERGROUND TANK SOUTHWEST CORNER Map: Grid: CAS # 8006-61-9 [ ~TA~E I TYPE ~, P~ESSURE ---¡ TEM~ERATURE I CONTAINER TYPE =LlqUld ~__pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 8000.00 GAL HAZARDOUS COMPONENTS ~ No CAS#a006619 %wt. I 100.00 Gasoline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -2- 03/19/1998 ;. . '. e e SiteID: ,215-000-001065 ì Facil,ity Unit: Fixed Containers on Site =¡ F READY GO MARKET p= Inventory Item 0003 ;::= COMMON NAME / CHEMI CAL NAME SUPER UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit ~ERGROUND TANK Map: Grid: CAS # 8006-61-9 [STATE I TYPE --¡-; P~ESSURE -¡ TEM~ERATURE I CONTAINER TYPE , Liquid ~~pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5000.00 GAL 5000.00 GAL 2500.00 GAL HAZARD US COMPONENT %'Wt. RS CAS # 100.00 Gasoline No 8006619 o S HAZ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME DIESEL Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit WEST OF MARKET Map: Grid: CAS # 68476-34-6 [ ~TA':~'E I TYPE --¡-; P~ESSURE ~ TEM~ERATURE I CONTAINER TYPE =Llquld ~~pure ~mblent ---1 Amblent ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 9000.00 GAL 4000.00 GAL %'Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS , I -3- 03/19/1998 ~. e e SiteID: 215-000-001065 ì Fast Format l Overall Site ì 10/16/1990 F READY GO MARKET I p= Notif./Evacuation/Medical Agency Notification CALL 911 NOTIFY FIRE DEPARTMENT HAZARDOUS MATERIALS DEPARTMENT AT 326-3979 OR CALL 1-800-424-8802 Employee Notif./Evacuation 10/16/1990 TELL EVERYONE TO LEAVE IN A LOUD VOICE. Public Notif./Evacuation 10/16/1990 WORD OF MOUTH. STATION EMPLOYEE AT EACH ENTRANCE TO KEEP PUBLIC OUT OF THE HAZARDOUS AREA. Emergency Medical Plan 10/16/1990 1 I CALL 911 - AMBULANCE -4- 03/19/1998 c. e e F READY GO MARKET I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-001065 l Fast Format l Overall Site l iO/16/1990 GAS PUMPS HAVE NOZZLES EQUIPPED WITH VAPOR RECOVERY SYSTEM. TANKS ARE MONITORED DAILY. , ' ALL STORAGE ~ Release Containment ~TTY LITTER OR OTHER ABSORBANT MATERIAL. I Clean Up . CALL ENVIRONMENTAL CLEAN-UP COMPANY. I 10/16/1990 10/16/1990 ] 1 I Other Resource Activation -5- 03/19/1998 '. e e SiteID: 215-000-001065 ì Fast Format ì Overall Site ì I F READY GO MARKET I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs 08/21/1990 A) GAS - NONE B) ELECTRICAL - INSIDE WEST C) WATER - ALL FOUR CORNERS D) SPECIAL - NONE E) LOCK BOX - NO WALL OF STORE OF BUILDING Fire Protec./Avail. Water 08/21/1990 PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS FIRE HYDRANT - 200FT SOUTH OF STORE ON WILSON RD, NEXT TO MAIL BOX. Building Occupancy Level -6- 03/19/1998 .." (' t- 't e e SiteID: 215-000-001065 1 Fast Format 1 Overall Site 1 10/16/1990 F READY GO MARKET I F Training Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: ON THE JOB TRAINING FOR NEW EMPLOYEES IN THE USE OF GAS CONSOLE, PUMPS ETC. Page 2 [ I I Held for Future Use Held for Future Use -7- 03/19/1998 ~-,- ~ .. FIRE DEPARTMENT D,S NEEDHAM FIRE CHIEF ,- Ti~ . .~< :CITYof BAKERSFIELD "WE CARE" ~ g33-fo ~~~ ,Llf û.~r-N f'Á'V{ , 10 rrl qJ~' c:::::.~ ~,- ;;;, 1/ ,q·QO ~ -\) yr;;; ~, , 2101H STREET .N'. r: 11, ,'iOl9-h /'~ J ltd. ,. W.u., /V\Ct; ( r.J ~~--- BAKERSFIELD,93301 I' I l£-U r - 326:3911 O~ &¡-~S O:r:..f ' AUGUST::!,: 99Ø ' , Ð . 1~ow¿, ,bL'h~/t ~,,~~;~~,.9-~o. DEAR r1R. MOO~/?-fo'Ph(()N c&1J./ f,(/J,;r, 'J¡f\1 ,wtD· ThtA.{ d¡)r1 '.¡ f!et.i"-f 'Ì'1cÆ.~rt¡ , ¡:Qr^'<s. b.pvl ç-/)t'/'vL'S. IJpclúQ d.~ ~ JO/JO/~t) NOTICE OF VIOLATION AND, SCHEDULE FOR COMPLIANCE . , ' =============================================== IN THE INSPECTION OF YOUR BUSINESS, READY GO MARKET, LOCATED AT 3620 WILSON ROAD, BAKERSFIELD, CA 93309 ON AUGUST Z0, ISSØ THE FOLLOWING HAZARDOUS MATERIALS REGULATION VIOLATIONS WERE IDENTIFIED: 1. THE HAZARDOUS MATERIALS INVENTORY MUST INCLUDE THE DIESEL FUEL AND PROPANE GAS. ALL HAZARDOUS MATERIALS STORED OR HANDLED IN QUANTITIES EXCEEDING 2øØ CUBIC FEET, 55 GALLONS OR 5ØØ POUNDS SHALL, BE REPORTED ON THE ANNUAL INVENTORY; VIOLATION OF CALIFORNIA HEALTH AND SAFETY CODE, CHAPTER 6.95, ZSSøS(A) The annual inventory forM shall include, but shall not be liMit~d to, inforMation on all of the following which· are handled in quantities equal to or greater than the quantities equal to or greater than the quantities specifiediM subdivision (a) of Section 25503.5: Sufficient inforMation on how and where the hazardous Materials disclosed in paragraphs (1), (2), and (3) are handled by the business to allow fire, ~afety, health, and other appropriate personnel to prepare adequate eMergency responses to potential . releases of ,the hazardous Materials. .., .:. . THE HAZARDOUS MATERIALS BUSINESS PLAN MUST CONTAIN CURRENT INFORMATION AND INCLUDE A REALISTIC EMERGENCY RESPONSE.'PLAN. VIOLATION OF CH., 6.95 CALIFORNIA HEALTH AND SAFETY ,CODE SEC.2SSØS _(b) In addition to the requireMents of Section 25510, whenever a substantial change in the handler's operations occurs whIch requires a ModIfication of its ~' - '~ e . !' busineS5,pian, the handler shall SUbMit d copy of the plan revision to the adMinistering agency within 30 davs of the operational change:' (c) The handler shall, in any case reView the business plan, subMitted pursuant to subdivisions !a) ànd (b), 011 or before January 1, 1988, and at lea.st once. every two ·yearsthereafter, to deterMine if a revision is needed and shall certify to the adMinistering agency that the review was Made and that any necessary changes were Made to the plan, A. copy of t;hese change~ shall be subMitted to the adMinistering agency as part of this certification. Cd) Uriles5.BxeMpted froM the business plan requireMents under this chapter, any business which haMdles a hazardou~ Material shall annually SUbMit a cOMpleted inventory forM to the adMinistering agency of the county or city in which the business is located. Notwithstanding any other' provisions of the law" an inventory forM shall be filed on or before January 1. 1988" for the 1988 calendar year, and annually thereaft,er. This .inventory shall be filed annually, notwithstanding the review requireMents of subdivision. I VIOLATION OF CALIFORNIA HEALTH AND SAFETY CODE CHAPTER 6.95, 25504(8) B~siness plans shall include all of the following: EMergency r~spon5e plans and procedures in the event of a repQrtable or threatened release of a hazardous M~terial. including, but not liMited to, all of the following: (1) IMMediate notification to the adMinistering agency and to appropriate local eMergency rescue personnel and the office. (2) Procedures for the Mitigation of ð release or threatened release to MiniMize any potential harM or daMage to persons, property, or the environMent. I (3) Evacuation pl~ns and proced~~es, including iMMediate notice; for the business site. I ! ,I'Ø . ' ,. e e I, ;) . EMPLOYEES' SHALL BET~AINED REGARDING THE HAZARDS OF MATER I A 1._ S I NUSE . OR S TORA,GE IN THEr R WOR~: PLACE. MATERIAL, ~AFETY DATA SHEETS SHALL BE- MAI~TAINED ON THE PREMISES AND MADE, AVAILABLE TO ALL EMPLOYEES. I VIOLATION OF OSHA 1910. 12~Ø I I ( Ç,¡ ì The eM p 1 0 y e t~ S hall M a i n i a i n é Q pie S 0 f t he required Material safety data sheets, for each hazardous, cheMiqal in the workplace, and shall ensure that they are re~dily accessible during ea~h work shift to eMp1oy~e5whenthey are 1n their work' area(~') (h)(1) INFOR.MATION. EMployees shall be inforMed of: I I I I (i )The requireMents of this section <1i )Any operations in their work area where ' hazardous cheMicals are present; and, (iii The'locat~Qn and availability of the written hazard cOMMunication prograM, including the required list(è) of hazardous cheMicals, and Material safety data sheets required by this section. VIOLATION OF OSHA 1910.1200(6) I I e91 Material safety data 5he~ts May ,be kept in ~ny forM,including'operating procedures, and May be designed to cover groups of hazardous cheMicals in a wo~k area where it May be More appropriate to address the hazards of a process rather than individual hazardous cheMicals. However, the eMployer shall ensure that in allcase5 the required inf~rMation is provided for each hazardous cheMical. and is readily accessible during each work shift to eMployees when they are in their work area(s). The above violations Must be corrected by SepteMber 21, 199Ø. The departMent will schedule a re-in~pectionof your facilit~ to verify cOMpliance. If you ,have any questions regarding this notice, please contact Barbara Brenner at 326-3979. Sincerely, , ' Barbara Brenner Hazardous Materials Planriing Techniciari I aity of Bakersfield I ""'RA.NSMlnAL SLIP ,'"' ..;;::.-. . <...~ --,., ,., Date... ........7..,:.:..... ::._7..;], ........,....... ..... T o......,_E.:~":r:.,t:!...E.6....:::,,...._...é:I"!?~..,..../??.~-~........,..................... From=i~1?,,;,~.~....-::_......~.~~.~.?I..4.5::.......................--........ For Your:- o Signature çYAction ßmformation ~ile Please:- o Return 0 See Me 0 Follow Up 0 Prepare Answer Copy to: ..................................................................................................-........... Memo : .......................,..........................................................,..................--....-- .................................................-................-...... ...............-.....-................................-....--.....-.-............ ......... ....................................................-......................-............................................-...........-......... ........................................................................................................-..................-...-.....-.....--....- , ' .-..............................-...........................................-...........-................-.............-..--...-....-. ..................................................................................................................-....-...............--.. .................................................................................-.............................-..........-...........-. ....... ..... ....... u ..n...... . ..n....... ..............._..... ..... ...... ....... ....... ........ ........ ......-.............. ......... .-.. ...... ................ ......... .................. ..... ..n..._,..n..... ...... ...n. ................n.. ......... ...... ... ..................... ..... . .;.----=-:.... ~. e !-r _~ }....-z~' . BULK TRANSFER BUSINESS NAME "í( e A'l) It ,Gr 0 m 4 R..I.(I~ r 3(P'¡O W/)..$.OIlJ Kn Y C:noJ 6- Sú 1<. J.. ~ ç SITE LOCATION OLD OWNERS NAME NEW OWNERS NAME , IJ I íL rn F1 L S I U L.. 1-1 ~', Æ! I i:1. ð H A J S / .u & 1-/ NEW OWNERS ADDRESS 41 ì I CA L. I ~ 0 R..'A..114 Av~ /-h~ 7' '2-oS: 1== ACCOUNT NUMBERS }-/ fY7 '/ J./ ¡( 10 I RECEIVED ~ T 7 & 620 I jUL 0 8 1993 S& 3004(J3 HAZ. MAT. DIV. ESCROW COMPANY ì - , if) - Cf ~ Œt;-IJ -r-u It Y' ,.,-; 'rLG' DATE OF TRANSFER ESCROW NUMBER lo ~ 7 3 a - /1.& ~I ff~ -aJ¡J- BY THIS INFORMATION IS TAKEN FROM THE DAILY REPORT AND Hazardous Materials ~ PRIOR TO ANY CHANGES BEING MADE. DISTRIBUTION: Sanitation USI!I'.ulitør P. B. l_lsHiB I, Farm and Agticultufe D. Standard Business ~AZARD~~~_~~:~:I~~~R~~~ENTORY I ~g~ÃYïð~.NAM5-:þ':10~~~!tÆ~'~7" " ~~~~~S~~ME: ~6~~AJ¡II.~/::'d:O' ~~~~D~~DT~~B.F¿EçPtòo[:__'--- I BtI6~~ ~P'): '~ff!¿:~~~:r3q-9-~~ ~~IÒ~Ë fi~P~ðJ[1t5f"1£(V), 97.309 DUN AND BRADSTREET NUMBER·-' ------'-----,---- REFER TO-rNSTRUCTIONS-FDR-PROPER CODES - - - - . c~nt d~t locat i~~ Where ,'6y Nues of "ìx~~re{çc'oonents Press Temp Stored In Facility lit· See Instruc Ions ' / tvJtSf' o~ #/tlllá, ,GA s gL./A.I€ Co~ponent 11 Name & C.A.S. Number CITY'. o.f' HAKEHS~1 ELU· 1 Tr~ns ' Code 3 Max Allt , Average Amt 5 Annual ~ire Hazard o Reactivity\ ~elayed 0 Sudden Release , . Health of Pressure O 'Component 12 Name I C.A.S. Number I mmed is te Health Component 13 Name I C.A.S. Humber y IIi-S Ii t.. / 9' lulLs'1' o/:#A-f{·K¡¡7" Component' 11 Na~e & C.A.S. Number (9'1ire Hazard , Component 12 ' Hamel C.A.S. Humber o Immediate Health Component 13 Name I C.A.S. Humber o React ivity . (31Je layed 0 Sudden ~Re I ease Health, of Pressure Phy~ical ~nd Hea1th Halard (Check all that apply) .Fire Hazard .D Reactivity C.A.S. Number ' Component .1 ,Name I C.A.S. N~lI1ber o Oe,layed 0 SUddfn Release Health ' ·0 Pressure O ,Component 12 Name I C.A.S. Number Immediate Health Component 13 Name & C.A.S. Number Physical and Health Halard (Check all that apply, C.A.S. Nu~ber Component.1 Name I C.A.S. Nu~ber O . Component 12 Name I C.A.S. Number Immed ute Health Component 13 Name I C.A.S. Number EMERGENCÝ CONTACTS .1 (!/t/l-A->(j. Hðg,¡f/' O¿,.o;f/¡Zre.. ~:17-.::r:?:7.7 112 í)uK t.JI! Rue Ttt1e z4Hr phone fUme Certif¡ç3tio~ fReed and $ign afjf!JrC9mp7eting. tt77. ~. ections) . . 1 certify under øenallx ~ la~ th~t I have pe{sona I, examlnQQ e~d om famllla( WIt, the Info(matlPn $ubmltted In this end all ' I attaçhed dQcUlents~ anQ t at based.o~ my InQUlr, Q those IndIvIduals responsIble or obtaInIng the InformatIon. I belIeve that th submitted Infoflatlon IS true, accurate, and co~plete. .' , , " ., .,. . , . , . , _ e/lA:/V C- /1'(/(7.¡r/ l R~e ~rõ~fiël1rnt Ie of o,lInmoperator UK owner/operator's. aut~orlZeO representative . o F ire Hazard o Reactivity o Delayed 0 Sudden Release Health of Pressure H ,k)V' A- G- "" ¡2... nt1e .' -7; -I".' Page òf (~" ~--" .------- 9'3;·'?C~'" 2nlrrn~ I I 9'",;7 -'7ð ' I b H ~-s r q ñ 21---'------1 e Mr. JiM Sweo Ready Go Mini Market 3620 Wilson Road Bakersfield, CA 93309 Mr. Sweo, Attached are the inventory hazardous Materials inventory for quantities equal to or exceeding Must be reported. This includes separately according to grade, antifreeze, lubricants, etc. which above. e SepteMber 26, 1990 forMs to be used to update the Ready Go. All Materials stored in 55 gal, Søø lbs or 2ØØ cubic f~et all fuels, which should be listed and any retail products such as are ~tored in the quantities stated Please cOMplete the inventory forM and return it to this office by October 10, 1990. Call Me at 326-3978 if you have any questions. Sincerely, Barbara Brenner Hazardous Materials Planning Techni~ian l 08/21/'30 .: :Ji ,..~_···_·:tt) '"tr . " READY . fYlARKET 215-000-001065 Overa~Site with 1 Fac. Unit ----- ,.~ .". General Information ,1~tt ~ e RECet\e"lEO"' '¡:.~ ge OCT 0 5 1990 1 I I LClcat-i C')"I: ',3620 ' WILSON RD Ident Number: 215-000-001065 HAZ. MAT. DIV. Map: 123 Hazard:, Low Grid: liD Area of Vul: 0.0 r Bus i )"Iess Phcl)"lf? ~ 24 Hc.I_\1'~ - Ph.:I)"le ( ) 833-6507 x () 834-0158 () x () 3'2.7- ?l3? Data Mail Addrs: 3620 WILSON RD . City: BAKERSFIELD Comm Code: 215-007 BAKERSFIELD STATION 07 Owner: RICK EWENS Address: 11901 OLD TOWNE City: BAKERSFIELD Pho)",e: ( State: CA Zip: 93312- SI_tmmat~y I II (JRCt!J.< f.e¥¡'~ aLl /~( /Y1a-f,~ t vpdcd~ CMU; c:t£~Ct5 ¡µ-f¡tJ¿ -H0e r¿ f1{Àff Bu~ ~C<--h(f5 . fl fa Sf hI! I'l\.l d-1 h,,-/, (,tbJ O/?eCt,5, '1?'í;TVîN (o/'fp~:~ 01 e¡ - .)/- 90. "~l' if '~où ~~ CUIl~ ~c.J4?6T'~. :rVÙ\LL ~ ,On cJJ ~rACPJ -; .J1'1¡j-lf}i.vn¡. fY\ ù S -c: Iµ. ¡)fJc!o.b d IW'-> ~& ntw ;_1'0., . -:J;r1Clucie 0Lr e.5£ß F .!1h (Í V(/71v~ ?J J..e.pc>..rod:; yA¿ ~ef' 3D¡ýa~s /)9~-I: ~. Cf~e J2eFrfu:t ,/¡cL,'v,ëLJ .J;fl[ Iv ~ ~e pro petit(., ()h. +h~ ,-1"'\ vl/n-to r -/PrD .' 1M <- (YlCtT.¿r,·4ß ~~~ der-{q ~çs /}/¡ùS-C tx ~ IN. píqy¡/5r5 ì {;t fCl,dCÀ.b4 ~ . t/h¿ frY1f75, &hP/7:5 fYlvS-t I;;t' #!a,-/Je-d ,Ke?ffd.A~ 0ht ÆCi?;:,(él5 ~ .jA¿ X US<.. ~¿ C-f~{{otJ pðuY1phuj, ,C<$ (h 1Y/~ . _ l\0ù v.>;LU \2:t.c¡-LH. 0\. .f.(McJ Ylo,,'U ~" VI-&{aTi ~ . M. <4hu..~; l , ~"..\< lO<.W _'Qe1>J~((S ~OLi #>~5.<.. '~t,?()r.:\i~·rt7;~(~~n-fS ~ ¥~~ucl. ih-cM"i-~.A 'B~{I -, L' ','2\, Fey ~ -. -- - _. -- --------.. -- -----..,..... ._-=-.-~~ - -:=~ ~ /~.....-~ - Nw~tJTAQ2 - , : I tJaw \2lwt£.s - ~~ f ¡:::- 6' D :r: 'D 1::1= I I -~ I _ ~----~_..~._~~- ! . .. ~-~-'--- -- ~'-~~-'j J- . . .. '. -- H I ~. . . .~-_'__,:I --,.~:~,~~-~~-~ -- ---- l ~ . --= . -~~~~- --~~-~1 1._.__- _ ___~___. '.. ._ __ _~_.-_____, ! i c -- .----- - --=""----=---:E"-'-_ =---- _......~__._.'--__"'-'---"-_-=-- _ _-=_"---"-___-'" ~--_==-_ ~"",,-,",<""C..._ =-~~ _ _= ~_--= ~ -~------ -~ ~ --~- --- - -- - - ~- -- --- ---- . ~ .', .':! ° - .' - ~-~. ¿'~...t °t_ /ì' 08/21/'30 READY GO MARKET 215-000-001065 Hazmat Inventory List in Reference Number Order Page 2 02 - Fixed Containers on Site PlY-I-Ref Name/Hazards" F cl\'~m QuaY-It it Y MCP , , 02-001 GASOLINE; ? 12,000 Mc.det~at e GAL -- ---~ ...... '-,,--- .-. ~------ -~ -'- ..;: ---.,......",- .~... --. .- - It . Iì ,,~'-' -- + \ '. " 08/21/':30 READY.. MARKET 215-000-0Ò 1 065 _ _ ) - Ovet~al1 Site .. Page 3 (D) Notif./Evacuation/Medical (1) C:~_nc-y_~r.:d~_i::fn:~-ë:Xt-i-cì' \'l Wha-t bei5¿ (;IJù uJd. ~éJv'- c1c rYA. CALL '311 ' Who. .t Ix , would ~Ov /)o-hfo (' 'N{)'fi Fj FiR. Jt i)rpAIZTI1It NT..., II A Z A Po (;)tÞ41 .s ,,'~ IfAf€t< fA'1:z,. 'J«pt fir J':J t- '3' 97' 1 "ð'6i') 'f'A 'f nO 1:, (2) Employee Notif./Evacuation TELL EVERYONE TO LEAVE IN A LOUD VOICE. (3)rpuDliç~~~~_~ þOIU) €Jf'Z /1ðurll, JiJ I~A-N(!,.tf Itl J(dllf' I~,-dt-I'~ Ol£-T' @¡;:- .s 1"'à 7"1 (J ¡oJ ,I/' f'I fJ I. Ii j IJf IE Æ- 1" /1' Æ {J" n 1I;t~A~f)dJ WooS ¡f-l2aA-. '> (4)CE-me~gency-MePT~al:"81~ 111=- A-H tJ/ltth-N4t' , , ÜBl21190 READY GO MARKET 215-000-001065 00 - Overall Site Page 4 (E> Mitigation/Prevent/Abatemt (1) Release Prevention GAS PUMPS HAVE NOZZLES EQUIPPED WITH VAPOR RECOVERY SYSTEM. ALL STORAGE TANKS ARE MONITORED DAILY. ~2~'Re~~_ase~Co~~ainmeò~~ /<,"I-r:¡ ,L.lrrtlA- flit. 6-tlJlll1- AI3StJff.JØ/AflI1A-;l!/trlktb. f3:}.::::::.ô 1 eaì'ltJt¡ t1.A-<t iJ. I! N Y II<, d III 1111111 "1ìt t, (!. l, it /TN '" 14 ~ (J-IJ.~¡tJ A- øy" (4) ~t:J;\~~ . . ., 1...', ,(J '/) - _...:. .----..:...--~ I ' .' "i'\ ~~.'- -._~ .______ .~v..,.;;.-~~ :..-_.,.--.-:....----s::~::.-. ~ ~;¡;"--':;::¿-~---: ~~---- ~ 08/21/90 READY . MARKET 215-000-001065 .. . .J - Overall Site ~ Page 5 <F) '8i te Erne1'''geY'lcy Factclrs < 1)~ì :¡"i.J! 1 l~eI=> (2) UtilityShut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE WEST WALL OF STORE C) 'WATER - ALL FOUR CORNERS OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3) Fire PrQtec./Avail. Water PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS FIRE HYDRANT - 200FT SOUTH OF STORE ON WILSON RD, NEXT TO MAIL BOX. <4).,) Ie] -'WI" ~tl'\; UI"S -=Ët.ze- 0,8/21/90 READY GO MARKET 215-000-001~65 00 - Overall Site Page 6 ." <G> Tt'a i YIÎ ng <1> Page 1 . Jt>-.. WE HAVE 3 EMPLOYEES AT THIS FACILITY ~Y.OU:-1:.i82E_fflB'TEHTE:f~ST-f¡rELY~DAJ:.8 ,SAEETS=OI~CF--I-bEi:-,¡) , Y £ $" J ¡ \B'"RI_EE-SJ.J.l'1J~Q.RY-~OF-I:R~tI:~:I:~Q':;':;7 (7 N 17'¡1l J lJ t1 -/1t4+'-' ,vJ II! ~ F& If- 11'£ fA} 12 11 ¡tJ J,. () Y d t! go I AI' .,-11- £t1 fIt' - (;) ~ ~A-J' (! &''''' S (ì ~Jt.J ¡Of;( "'1fAS I Æ '7t- ((!,.., . , ~ - .-- . <2> Page 2 as needed ~ <3> Held for Future Use ~. <4> Held for Future Use ,.> -< of" IJ () It . ~. ~ 11 '!' . ~ '2: ; ~-.",-:.~ ·e e CITY of BAKERSFIELD "WE CARE" FIRE DEPARTME~IT D. ,S NEEDHAM FIRE CHIEF 2101 H STREET BAKERSFIELD, 9330r , 326-3911 .- AUGUS,T ., 1 ..., , 19BØ DEAR r1R. MOON,- 'NOTICE OF VIOLATION AND S.CHEDULE FOR COMPLIANCE ======~======================================== I I IN THE INSPECTION OF YOUR BUSINESS, READY GO MARKET, LOCATED AT 3620 WILSON ROAD, ,BAKERSFIELD, CA 93309 ON AUGUST 20, 1990 THE FOLLOWING HAZARDOUS MATERIALS REGULATION VIOLATIONS WERE IDENTIFIED: . I I . I fvÞ 1. THE ,HAZARDOUS MATERIALS INVENTORY MUST INCLUDE THE DIESEL FUEL AND PROPANE GAS. ALL HAZARDOUS MATERIALS STORED OR HANDLED IN QUANTITIES EXCEEDING 2ØØ CUBIC FEET, 55 GALLONS OR Søø POUNDS SHALL, BE REPORtED ON THE ANNUAL INVENTORY. ' I VIOLATION OF CALIFORNIA HEALTH AND SAFETY CODE, CHAPTER 6.95, ZSS09(A) The anriualinventary forM shall include, but shall not be liMited to, inforMation on all of the following, which ére handled in quantities equal to or greater than the quantities equal to or greater than the quantities . specified in subdivision (a) of Section 255Ø3.5: SuffltieMt inforMation' on how and where the hazardous Materials disclosed in paragraphs (1 >, (2), and (3) are handled by the business to allow fire, safety, health, and other appropriate personnel to prepare adequate eMergency responses to potential . releases of the hazardous Material~. 2. THE HAZARDOUS MATERIALS BUSINESS PLAN MUST CONTAIN CURRENT INFORMATION AND INCLUDE A REALISTIC EMERGENCY RESPONSE PLAN. . VIOLATION OF CH. 6.9t CALIFORNIA HEALTH AND SAFETY CODE SEC.25S0S (bl In addition to the requireMents of ~ection . 25510, whenever a substantial change in the handler's op~ration5 oc¿~~s which requires a ModIfIcation of its / // I I ...i~,.,. ~ ~ . e business plan~ the handler shal.l SUbMit a copy of the' plan revision to the adMinistering agency withIn 30 days of the operatioAal change. (c) The handle,- shall, ineny ce,se, t~eVJ.el"¡ the, business plan, subMitted pursuant to subdivisions (a) and (b), 0 nor b e f Ó r e J a n u ar y . 1, 1 988, a)l d a tIe a st 0 n c e every two years thereafter, to deterMine if a revision is needed and shall certify to the adMinistering agency that the review ~as Made and that any necessary cha~ge~_ were Made to the plan, A copy of the~echanges shall be subMitted to the adMinistering agency as part of this certification. (d) Unless exeMpted froM the business plan requireMents under this chapter, any business whi~h handles a hazardous Material shall annually 5ubMita cOMpleted inventory forM to the adMinistering agency of the county or city in which the bU5i~ess is located. Notwithstanding any other provisions of the law, an inventory forM shall be filed on or before January 1 1988, for the 1988 calendar year, and annually thereafter. This inventory shall be filed annually, notwithstanding the review requireMents of subdivision. VIOLATION OF CALIFORNIA ~EALTH AND SAFETY CODE CHAPTER 6.95, 25504(8) I Business plans shall include ~ll of the following: EMergency response plans and procedures in the event of a reportable or threatened release of a hazardous Material, including, but not liMited lo, all of the following: (1) IMMedi~te notification to the adMinistering agericy and to appropriate local eMergency rescue personnel and the office. I (2) Procedures for the Mitigation .of a release or threatened release to MiniMize any potential harM or daMage to persons, property, or the env i ronM,en t . ' . / ," (3) Evacudtio~ plans and procedures, including iM~ediate notice, for the busines5 site. ~~ -.~." ,~ at . j . Ei'1FLOYEES SHALl- BE TRAINED RE(3h.¡~DI¡'.JG HiÈ HfiZARIJS OF MATERIALS IN USE OR STORAGE IN THEIR WORKPLACE~ MATERIAL SAFETY DATA SHEETS SHALL BË MAINTAINED ON THE PREMISË5 AND MADEA~AILABLE TO ALL. EMPLOYEES. VIOUHION OF OSHAI910.12ØØ (g) The eMployer shall Maintain copies of, the, required Material 5~fety data 5hee1s for ~ach hazardous cheMical in the workplace, and sha)l ~n5ure 1hat they are readilyaccBsSible during each ~ork shift to eMployees when they are in"their work area(s) (h)( 1) INFORMATION. EMployees shall 'be in,forMed of: I I , . (i )T~e requireMènts of this sectï'on (ii }Any òperations in their work area where hazardous cheMicals ?re present; and, Ciii)The location and availability, of the written hazard COMMunication prograM, including the reqiJiret;! lii3t( s) of ,hazardous cheMicals, and Material safety data sheets required by this section. VIOLATION OF OSHA 1910.12ØØ(G} (9) Material safety data sheets May be kept in any forM, including oþerating procedures, and May bé designed to cover groups of hazardous cheMicals in a work area where it May be More ðppro~riate to address· the hazards of a process rather than individual hazardous cheMicals. However, the eMployer shall ensure that in all cases the'required inforMation is provided for each hazardous cheMical, and is readily accessible during~ach work shift to e~ployee5 when they ~re in their work area(s). The above violations Must be corrected by SepteMber 21, 1990. The departMent will 5chedule a, re-inspectionof" your facility to verify cOMpliance. If you ha~e ~ny questions regarding this notice, pleai3e contact Barba~a Brenner at 326-3979. Sincerely, Bar'bars Brenner Hazardous Materials PI~nning Technician RECEIVED . AUG 7 1990 j-:- fa -11) 'Ans'd............ - ~"~cr~:,' \.~--, ./' takersfield Fire De~l! J l!azardous Materials Inspection .... '\ ,: . . Date Completeq., " ", '.1 Business Name: ~ e.. A d¿ ~ ~.;) 9.-Á... ^ ~ '\ . ~, .'. , Location: ~ t.o '2... å Lù', \ ~ b ~ ~&>. -'......~ Plan 1D # 215-000 \0 1.0 ~ , (Top right comer Business Plan) Inspector r¡~ /IÁ.//b~.s~/L, , ,I .'. Adequate Inadequate ¡ ~~ ~tation No. \ S~ft R ! 1 Verification of Inventoty Materials II \111,vJJ' ' ~~ Verificatio~ of QU,antities " I ~jJ0 Verification of Location ~ . Proper Segregation ofM~terial ~ Comments: /~. Verification of MSDS Availability ~~ yf7? Number of Employees ...3 ~ Verification of Haz Mat Training ~ D l2r' D , , " 12(' D ø D D ~ if Comments: D Verification of Abatement Supplies & Procedures ;z( Comments: ,- " Emergency Procedures Posted z( % Containers Properly Labeled Comments: D D D Verification of Facility Diagram D Special Hazards Associated with this Facility: ø Violations: r-- / / FD 1652 (Rev, 3-~)/ :-Á,_ White-Haz Mat Div. Yellow-Station Copy Pink-Business Office ,-.'-, ,,~, ,"¡:';~"'~ '"~x':-::'~,..,."~': ,.,.:~~!:;;": ~""', 'r'~'::"""~':'¡'~"'~~:;~;"::L~rfJ¡~~I:',~!,-'f,"~l\'f;Ain~...~'tt~'A'.p:t'·"'-·~~"'V~J$':~!"!+'o-~'-':""·"!4~"'''',...~r7-1'''t1Y'''''~J'~;':¿''''~~-;~- v~~""~":'J:" ..... .....~ . I \ ....'} ,. ~ ~"1 ."", 1 - - tJ ~:J~\! ~ ~,-1~} '~~'" ~"'l " . : ',-- : . . - i I ' , " '"" ' " " ' , ,j P(}O~ t' q'¡I/\ ~ ."'} . l.... '\ ~.. 0" ',¡ J, \ j' ¡, :I'i ~...- .,..."'....'_.. -I). ~ _'..... \'""::: ,,:.) . - tÌ1v.-(f'Jrlvi\·/;¡tt)'h¡Jltf~ -' pfòJ»nf 1/ c:lJe<Ø - am¡;i~ w¡µ fi-ð/!¡;A-1; ~ /fl'505'; ". ' _ OuJlltI~,þ í 1L,f J1eK tv Iú!.~, ,: , ' .' .. r¡ I)t k po(¥. cI ~ r-- '¡.". __. ,"" . .,'~ ,. > '. ~- \ . owner :: "'~'ð~'~~ y. (YìDOr) - ~UJr}er OJ»IlU not ~~. "~, ùJt C'tJ#I pdt{/' p~llf t) vf.!f p.1C!11--. / ¡1/[czrbC- Up }f Uv, ,~,,^- ~ CA1- 1IC<6 0fr1¡Vt~ GVI2ld~/l4> ", ~~"C~ f \,Ù(,.tft" ì AW' JC+ßYlS ,fr::,k"c' ~-f DuNe r cClØ. ;.1 ù tl 15~ ~ß ra r Ji-:fø r '\"Î ~ .. ì ,..-'::.?- I -:....~ ',6'';1 ~ " J.-7. \'~ , ;....':'. -I';'. --~, / I~ ": ,_/)( , ~~ )hr .' . BAKERSFIELD CITY FIRE DEPARTIŒNT 2130 "G" STREET REf.F.IVED BAKERSFIELD. CA 93301 (805) 326-3979 ' 0 CT 1 91981 /:;)3-11 0 G ::;:A)S{? 7 Ans·d............ OFFICIAL USE ONLY ID# ()879 Ò 001"065 BUS !.NESS ~AME HAZARDOUS MATERIALS BUSINESS PLAN Àis A WHOLE FORM 2A ~. dxa ~ ~,G-'E INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT k~SWERS IN ~~GLISH. 3. Answer the questions below for the business 4. Be as brief and concise as possible. as a whole. ..... -- . SECTION 1: BUSINESS IDENTIFICAT~ONDATA A. BUSINESS >1A1-IE, iiac1¡ bo /1¿¡ric¿ f- B. LOCATION / STREET ADDRESS: ,1hL() le.J2 /iav¡, CITY: /Jtblæi'Sfíe{j .... ' ß/ ZIP: iJJ07 BUS. PHONE: (l3tE) !JJJ- 6$07 ' 'I SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material. call 911 and 1-800-852-1550 or 1-916~427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NA¡\fE AND ;r;rTLE / / J DURING BUS. HRS. A. ~,t, c:wep¡J \éJW^~I/I, Ph#: ~'»-r;;:JtJ7 AFTER BeS. HRS. Ph#: If ~ tr- tJ/ .fl!3 B. Ph#: Ph#: SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. ~AT.. GAS/PROPA~E: B. ELECTRICAL: £I1S(~ C. WATER: ,£)L r ~ðèJf/\ . D. SPEC IAL: E. LOCK BOX: YES icf9J IF YES. LOCATION: ø we<ö.+ C ð-J--Ap r5 We;-( I ~ ' 9~-e... ðF .(Ju, Id...Ç / IF YES. DOES IT CONTAIN SITE PLANS? YES! ~o FLOOR PLA~S? YES / ~O MSDSS? YES! NO KEYS? YES! ~O - 2/\ - . . ',~ i; ; ':' .}'\~ -~~;. ~-:. SECTION;4:. PRIVATE RESPONSE TEA" FOR BUSINESS AS A WHOLE P.. , ; (~< k 8wiA.Þ""' ~~ L ( (¡<-~ (....:./ ( -I- /.... t (;' i}aOl0ú '-'~'- .. , ~~i. .::~. if:: ., ..rJ-( ',-: ' ~.:t--"" .. ¿" "1 ~ c' '~-,,- SECTION,S: LOCAL'EMERGENCY MEDICAL ASSISTAJ.'lCE FOR YOUR BUSINESS AS A WHOLE 0¡<~ I~)¿, M~clt~r '" SECTION 6: EMPLOYEE TRA INING ,-.... " ' ) ,,:.- ... ....,.,........... , - ,- ~PLOYERS ARE REQUIRED TO HAVE A PROGRA}! WHICH PROVIDES EMPLOYEES WITH INITIAL ~~~ REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR YO r~tTIAL A. ~~~~~L;~~.~~~~.~~~~~~~.~~.~:~~~~~........... ~ ~O B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE' AGENCIES:........ ....... ........... ~ ~O C. PROPER USE OF SAFETY EQUIPME~i: ........... ....... NO D. EMERG~NCY EVACUATION PROCEDGR~S: ... ...... ..... ... YES ~O E. DO YOU MAINTAIN EMPLOYEE TRAI~ING RECORDS:....... S ~ SECTION 7:· HAZARDOUS MATERIAL -~'. REFRESHER ~~O '&~O ~ NO . YES NO YES @ CIRCLE YES OR NO DOES YOUR BGSINESS HANDLE HAZARDOGS )t~TERIAL I:i QüA~TITIES LESS THAX 500 POt.'"N~OF A SOLIDZLONS OF A LIQGID. OR 'ZOO CUSIC FEET OF A COMPRESSED GAS, ,..... ~ NO I. ' £~~ , certify that the above information is accurate.' I understand that this information will be used to fulfill my firm's obligations under the new California Health and,Safety code on Hazardous ~aterials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. SIGNATL"RE g ¿ '-f ~ ./ TITLE [)~ - -- ~B - \ DATE /ð¡(é/~ ----'" :.~ ~ "'t',, ~~ ~~'~':¡ " r -- e BAKERSFIELD CITY FIRE DEPART)IE~T 2130 "G" STREET BAKERSFIELD. CA 93301 OFFICIAL bSE ONLY ID# - - -' -, _. - BUSINESS NAME: BUSINESS, PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED 4. Be as BRIEF and CONCISE as 9ossible. BELOW ~ I'. FACILITY UNIT#: / FACILITY UNIT N~~: l~~ be; Hav,{f!!IZ- SECTION 1: MITIGATION, I) 0tø- U ðf»v , _.tu~~ H ('o~7 PREVENTION, ABATEME~~ PROCEDURES Ab--K--, /J ð:2Z~ . . '.-' si'~'f~~ \ ~!-ê1yÞl., i<J (, K I J /:J I-- L-- 1S fow&~ ~I::-s Ótrt:- ~ ¡L I ft;v<êPf af¿ I SECTION 2: NOTIFICATION Ar."D EVACUATION PROCEDL"RES AT THIS TJNIT ONLY ~/( .t2<Ye'í tMz rk-. ~ I ~ 6 ;;d6~ 'UOz.c«Y - 3.\ - " ~ ,;~~ . e '2"" SECTIO~ 3; HAZARDOT;S ~fATERIALS FOR THIS U~IT ONt Y A. Does tÌ1 i sFaci 1 i ty Unit coil t:a i n Hazardous ~Ia ted aL:;? , . , . , . '(!;;J NO If YES, see B. If NO. continua with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ® If No, complete a separate hazardous materials inventory form marked: KON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS OKLY (yellow for~ #4A-2) in addition to the non-trade secret form.' List only the trade secrets on form 4A-2. .SECTION 4: PRIVATE FIRE PROTECTION ~ f¡ Íú .Q x.- +1 d u', (~ 1-.-.t¿v:S .~.. -,"', ,: . ~ ~. .--~~.,-........,_..-.., --~~"... . .- ~'.'.- -. ~ ..~. 1-... ; , , - ~ "._~-._"o<~~~,...,",~_."""",. '-" .'._......_ "' SECTION 5; LOCATION OF WATER Su~PLY FOR USE BY E~RGENCY RESPO~ERS hr.¿ !lit>4dV-\ ~, ð-ð Ft- S":;...; ~ ..) (: SfêJv~ ~ L<./L I~~ M" )Je,,-,* 'l-ö. ~/. f1A SECTION 6: LOCATION OF UTILITY SHU~-OFFS AT THIS UNIT ONLY. A. NAf. GAS/PROPAN~~ /" . B. ,ELECTR I CAL : $+6 r.J&' ~lT'"~ w~ /-.;,~~~ i~ f'Vv 6-ftL p~ 1£/ ), C.WATER: S ,t:. CIJr- f¡\..(Je.".-.. 6'f Sì6r-e- bUv!dti 0, SPECAL: E, LOCK BOX: YES i'@ IF YES, LOC\TIO~;: IF YES, SITE PLA~S? FLOOR ~L-\XS') '~rES ! :'0 YES / \"0 :-.-rSDSs? ::E'::s ') ~....... ("'- y i:~ -, \.,.., " 1.-, YES \:0 - 38 - BAKERSFIEI,'U t;lTY FIRE UEI'AHINENT- _ . F·O R M 4 A-I / , NON-~RADE SECRETS HAZA;nD'OUS MATERI ALS' INVENTORY . 'BUSINESS NA~II~:· '.~. ~2' /;'0 ".Pt.:/:;' ,--~-- OWNER NAME: ¿i£?ûens FACILITÝ UNIT;: ^IJJJRE.SS: " . ;:1 b'}Jj' . Aß.,: ,.".". ADDRESS:·. ~'Tc>( '/)/~jJ ~Ì¡.p. FACILITV UNrT NAME: r; , TY. Z J r: [j~_ ~_' . ~ ,_CITV, ZIP: /},.~k'£)¡,~~,p/,/) 91?/7 c PII,ONE ,:: .~:n-¿'S-úl,-./ " _ PIIONE f: ~f!h-f}..~'J...~ ,IOFFICIAL USE CFIRS COUE I ONLV" I,' '. , " , (), f -- .- . . . -- -- - Page L-- of _ r;-. -. ~ , , '. " , , -- ,. . 1 2 :3 ~y I' F· M ^ X .^ N N IJ ^ L ;OJ}E ~1I.Q!ll!.L AMOUNT ,IJ¿ . Il C5l5O , .~ M ótÞ . '" , 4 5 6 7 8 -- " 9 CO NT lISE LOCATION IN TillS % nv UNIT CODE CODE FACILITV UNIT ' - WT. CIIEMICAL OR COMMON NAME brvf. /51 Iq '3 {)1tL Þ" F. r ~ ~ Jáð t.b:<' ~ It 4'1?' I/x?-. ' (j ..... , - to !lAZAR ) CODE f;:z~ -' I- -~ I, I , , - - - /J . ;¡^ME: 1/,/_1:: é~pY ~ '~~IERr.ENCY CONTACT: /1¿ý ~- SIGNATURE: L-' í7 ______ DATE: ¿>WII..~(^ --;:::;;> PJlONE f BUS JlOURS: ¿,o:J-.-~cJ AFTER nus !IRS: Æ;)'Cf'-ðt'51! rUÖNE f BUS HOU~S: ' TIT L E : Z)WfLI?v'- ,F.wðll T 1 TIrE: UI r. R r, ENe Yf. 0 N T ^ CT : r I NC IrH nlJS I NFoSS ACT I V I TV:. 9>/1' Si>élH 6Þ' TITLE: {~/¿¡'.{<:V ' - ,41\-1 - Sf0:\Q. !,FTER BUS, IIRS: ' f I , 'r f,' ~., \~ ~ , ~< ".f: {q¡¡- . I },(},T GUIDE I I 'I -- ---. 1 ,I I ~eJk 'HAZARDOUS,fv1ATERIALS INSPEC"fION 1 . ../ /1 tJ({)s . BUSINESS NNŒ: ¡2£ If ¡2 « ,G-ÇJ" I'I/fR/c.Cr LOCATIon: 3 (; z 0 't;JJ It- ~e::. N. nJSPECTI0NDAT~: //-22.--96 INSPECTOR: 1'-1, CoblC¡\{ ¡}µ..~ <Œ'p:~SC{~ ¡/øJJ . kruJ , " VERIFICATION OF BAZ MAT 'l'Rl\.IRING /0 J 000 I 'iIfNlc£ m [;lJ ~. ŒJ o¡¢£ ,wl-r1l VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES VERIFICATION OF ~TIOH FnOpER. SEGREGATIOH OF MATERIAL o 'VERIFIC1\TIOH OF MSDS AVAXLABLB D " . .,' 'S: &('11[0 Y£.£5 'PIP ¡.JõT·I:,Á(é) u..J , , , TftLk£'v /6,. /7(;..;< 'c... /I /1 ¿ F!.. ¡.J £ ~TA ÎEI2 .(/1 '~,' I/fi-r 'T/fCY, tVOUi-t:l 6-£r 77'-/E~ ¡:::-,€OI""'7 Fu£,¿, ~ ~CI\TION .OF ABATEl!l!NTSOPPLIES . PllOCBDORI!S C3J comŒK1'S: ' S'4f"f'L7'£~ P,UERGENCY PRQCEDURBS POSTED ø= [$), . c.'OlfI'AI!fERS PROPERLY IJ't'1tt.1m' COf9ŒNTS: , , VERI.PI~OW OF FACn.I.TY DIAGRAM '~. SPECIAL DZARDS ASSOCIATED WITH THIS FACILITY: VIOLATIONS: I