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HomeMy WebLinkAboutBUSINESS PLAN 3/9/2001 It -- TEXACO QUICK MART SiteID: 015-021-001984 Manager : Location: 6501 UNION AVE City BAKERSFIELD CommCode: BAKERSFIELD STATION 05 EPA Numb: BusPhone: Map : 124 Grid: 30B (661) 587-0784 CommHaz : Low FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact CRAIG CeRNETT Business Phone: 24-Hour Phone : Pager Phone / Title ~ / OifflEr 0 ptrtr ørr (661) S87 0'1-ß4x 3qf'Cot~ (tala!) ~j\ -~'~1x () x Emergency Coqtact / Title ©~rm. f\\g,f@btV\. ~iì\ða\~ / Business Phone: (Cor, I ) 3ttCU - (oð~2x 24-Hour Phone (~~() ~,ß\ -23~~'& Pager Phone () x Hazmat Hazards: Owner Address City CRÞ I G -Q@RNE!P-T W\~ l~l ~ Abr~~ 73-~~ ft;~ðl ~. tJ~a@(!/\ BAK-E-R'8FIBI:re==== ~ ~ Phone: State: Zip ~a tí\e" Phone: AV4- State: ]g~ Zip (661) 587-0784x CA 93307 Contact : MailAddr: 6501 UNION AVE City BAKERSFIELD (661) CA 93308 &Ðx7U I ölf Period Preparer: Certif'd: to TotalASTs: = TotalUSTs: RSs: No Gal Gal Emergency Directives: I, tlo ~ U C~J~A fl. Do hereby certify thai J hav.o ype or pnnt name) \(; reviewed the attached hazard0t!8 maierials manage- ment plan fof]~ )fa J..o{£y...·rl1 ~ that it along with (Name of USIOGSs) any corrections constitute a comple~s and correct man- agement plan for my facility. ~v S)!J-~ o'Loq,01 ~ 'ß'ãte -1- 03/09/2001 e - F TEXACO QUICK MART SiteID: 015-021-001984 1 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: TEXACO QUICK MART Cross Street : Business Type: - Org Type: Total Tanks : 3 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : Phone: ( ) - x Address: City : State: Zip: Type : INDIVIDUAL TANK OWNER INFORMATION Name : Phone: ( ) - x Address: City : State: Zip: Type : BOE UST Fee# : UNKNOWN Financ'l Resp: STATE FUND Legal Notif : Property Owner Mailing Address Date:08/03/1999 Phone: (661) 587-0784x Name:CRAIG CORNET Ttl:OWNER State UST # : 1998 Upg Cert#: One Unified List 1 All Materials at Site 1 p= Hazmat Inventory f=7 Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP DIESEL GASOLINE PREMIUM L L L 5000.00 GAL 12000.00 GAL 4000,,00 GAL Low Mod Mod -2- 03/09/2001 e - SiteID: 015-021-001984 ~ Fast Format ì Overall Site ì F TEXACO QUICK MART I p= Notif./Evacuation/Medical r== Agency Notification Employee Notif./Evacuation I I I Public Notif./Evacuation Emergency Medical Plan -3- 03/09/2001 e e SiteID: 015-021-001984 ì Fast Format ì Overall Site ì I F TEXACO QUICK MART I f= Mitigation/Prevent/Abatemt r== Release Prevention Release Containment I I I Clean Up Other Resource Activation -4- 03/09/2001 e e Fire Protec./Avail. Water SiteID: 015-021-001984 1 Fast Format ì Overall Site ì I I I I F TEXACO QUICK MART I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs I I I Building Occupancy Level -5- 03/09/2001 e e Held for Future Use SiteID: 015-021-001984 1 Fast Format ì Overall Site ì I I I I F TEXACO QUICK MART I F Training r== Employee Training Page 2 r I I Held for Future Use -6- 03/09/2001 " ( \ )c ( ~;i 0/ e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: <;, llhtlvtO eWtL /hOft t-krc~f (/}oJ'(((.J· wk~ /IJ1()It.,tofu -to ( fvc.1 huJ ~ B. EMPLOYEE AND AGENCY NOTIFICATION: S(oulJ '{Ðù h4(}t. \/'t.JLlL$L H04~c, q ( ( (- ~tl(J ßf:rd h r~ Ðcp~, C. ENVIRONMENTAL RESPONSE MANAGEMENT: .5H1cÜ(. Sp dCS', (J 5 c kd(.'( ~ \.-kr Ct ~ .Ah~d)~(J..lA,i D. EMERGENCY MEDICAL PLAN: T 0..((<- +0 V\co..Qst h(JGp I 4-oJ 2 ~~ ~r e e ~ HAZARDOUS MATERIALS MANAGEMENT PLAN ( SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: Yb\Ot\JOr- ¿'GVt(L~ (,U() rb,~ ~cJ(' ¿".(.d tttt.-y {'c..l<kk- B. RELEASE CONTAINMENT AND/OR MITIGATION: ùS<... a~ k~tl'( kJ·c.r ~v ~fß'l'ld 5pt-t{, fvA.rfL ~fl{( ~t1{( q(( C. CLEAN-UP AND RECOVERY PROCEDURES: t:l Uy ""fer cJ!:.(j o.~ O-~t(Jr~d.n.l- f- f('(()pc.rlty ¿JP()sc( ( 6 {-, UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GASIPROPAN!ì:~' ;~~~I-c ß",Ú'4 ELECTRICAL: 'II, s,lL _ t ___ (/t. , WATER: ¡.(, ~fiL tiT- ~(4 ' SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: PRIVATE FIRE PROTECTIONIW A TER AVAILABILITY A. PRIVATE FIRE PROTECTION: ( B. WATER A V AILABILITY (FIRE HYDRANT): 3 J' e e HAZARDOUS MATERIALS MANAGEMENT PLAN ( SECTION III: TRAINING NUMBER OF EMPLOYEES: 71 'I MATERIAL SAFETY DATA SHEETS ON FILE: 'f l~ BRIEF SUMMARY OF TRAINING PROGRAM: d T tõ..t"'-lÁ l~ vSl.. of- ÚtQb\JQ(/"W( dtcJ(Ct..( dl Olt ( {\{ ¿.ule. (If- èf rI '(i r ( CERTIFICATION I,l1Jn..11. (fin L 0 CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. I1c&Ji ~ SIGNAT (1)~~ TITLE 03~()9-Ð J' DATE l HAZ MAT MNGMNT PLAN & INSTRUC 4 ~..-. . ~ -- e HAZARDOUS MATE CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 l \Cf6L\dJ - u o,C(, . ./)<: ~ /AU LS INVENTORY jJx'< oA~ .-- ~ FØ~ ~P\ß l ?-c.\ ~ JJ ~lÀ-, ~ FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME _¡rì<JACo l('f:Yl.Gft: II/l ÞZ-T. FACILITY NAME A-5 H..,vi,- , SITE ADDRESS b5" DIU IVlOM ,ð-tI(; , CITY g /h{~~/EL,O STATE C;f ZIP 7'73 D7 NATURE OF BUSINESS r; ,4-ç ~''T /J-7ì rJ.J SIC CODE ç !; '-t I DUN & BRADSTREET NUMBER eOPERATOR CRA1(~ (-D;è/VPr/ PHONE .<"8'7-071('-1 MAILING ADDRESS 7JoÝ Ht//V'T7/1/&Tð r--/ c::1. . CITY j7i~(?(S7~/G-~ STATE C,#-. ZIP ~7(í ð' EMERGENCY CONTACTS G9/1u.{ ,c e-. ~L ¡t; NAME ~ç A-zB ovE- TITLE BUSINESS PHONE MO t lÞ ~1J1 '!Þu( "1c+ 24 HOUR PHONE NAME TITLE BUSINESS PHONE 24 HOUR PHONE 1 _--"c -" ... . .,~ Business Name nwm>0US MATERIALS INVENT. - ~)<!.4-c-¿) cpv reI? MA?e/1 Address G So I C/lIVtò'/\/ ~\ CHEMŒCALDESC~ON Page'1..-- of~ I) INVENTORY STATUS: New ~Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: 6 ~ oL-( r/(- 3)OOT # (optional) Chemical Name: ~ ~~= , ARM [ ] CAS 1# 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code fi'om DHS Fonn 8022) USE CODE 6) PHYSICAL STATE Solid [ Liquid 9Ó Gas [ ] Pure [ Mixture [ ] Waste [ ] Radioactive [ 7) AMOUNT AND TIME AT F ACll..ITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal ["IÓ ft3 [ ] a) Container: CJ \ Average Daily Amount curils 1 ] b) Pressure: f Annual Amount c) Temperature 'i Largest Size Container # Days on Site Circle Which Months: ~ Ì, F, M, A. M, I, I, A. S, 0, N, D 9) MIXTIJRE: List COMPONENT CAS# % wr ARM the three most hazardous 1) [ ] chemical components or 2) [ ] any ARM components 3) [ ] 10)LOCATION/, (0)0/ [/" /v/otV Æ--VC 1) INVENTORY STATUS: New (>(j Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: GA-:>o ....{/V'f 3) OOT # (optional) Chemical Name: ARM [ ] CAS # 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute)[ ] Delayed Health (Chronic)[ 5) WASTE CLASSIFICATION (3-digit code ftom DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ Liquid [(1 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site Gas [ ] Pure [ UNITS OF MEASURE Lbs [ ] Gal [~ ft3 [ ] Curies [ ] Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: 0 I b) Pressure: I c) Temperature L ~~, F, M, A. M, I, J, A, S, 0, N, D CAS# % wr ARM [ ] [ ] [ ] Circle Which Months: 9)~: List the three most hazardous 1 ) chemical components or 2) any ARM components 3) COMPONENT 10)LOCATION I certifY under penalty oflaw, that I have personally examined and am familiar with the information on this and all attacl1ed documents. I believe the submitted infonnation is true, accurate and complete. c Co PRINT Name & Title of Authorized Company Representative 11- q ---17 Date ~RDOUS MATERIALS INVENWY . /, -, ~ Page ¿ of .3 c?u (~tt (1/l~ AdJJress ¡; 5"0 I ~,)~./ V l/<.:" , CHEMICAL DESCRIPTION ~I .. Business Name 7è!- ~ ko 2) Common Name: . ¡)/YGC I) INVENTOR Y STATUS: New Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 3) DOT #I (optional) Chemical Name: AHM [ ] CAS #I 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ J Sudden Release of Pressure [ J Immediate Health (Acute) [ J Delayed Health (Chronic) [ 5 ) WASTE CLASSIFICATION (3-digit code &om DHS Form 8022) 6) PHYSICAL STATE Liquid K1 Gas [ ] Pure [ Solid [ 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container #I Days on Site UNITS OF MEASURE Lbs [ ] Gal Þ<J ft3 [ J Cunes [ J Circle Which Months: 9)~: Li~ the~mo~~~ 1) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: &1 b) Pressure: I c) T emperatw'e '1 All Year, J, F, M. A. M. J, J, A. S, 0, N, D CASII %Wf AHM [ J [ } [ J IO)LOCATION 2) Common Name: 1) INVENTORY STA ruS: New [ J Addition [ J Revision [ } Deletion ( J Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] Chemical Name: 3) DOT II (optional) AHM [ } CAS II 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire [ } Reactive [ } Sudden Release of Pressure [ } Immediate Health (Acute) [ } Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) 6) PHYSICAL STATE Gas [ ] Pure [ Solid [ Liquid [ 7) AMOUNT AND TIME AT F ACILlTY Maximum Daily Amount A verage Daily Amount Annual Amount Large~ Size Container #I Days on Site UNITS OF MEASURE Lbs [ } Gal [ J ft3 [ ] Curies [ } Circle Which Months: 9)~: Li~ the~mo~~~ 1) chemical components or 2) any AHM components 3) COMPONENT IO)LOCATION USE CODE Mixture [ ] Waste [ ] Radioactive [ ] 8) STORAGE CODES a) Container: b) Pressure: c) Temperatw'e All Year, J, F, M, A. M, I, I, A. S, 0, N, D CAS# %Wf AHM [ } [ ] [ ] I certify under penalty of law, that 1 have personally examined and am familiar with the in.tònnation on this and all attached documents. I believe the submitted infonnation is true, accurate and complete; ~'£#h Ú~&/ PRINT Name & Title of Authorized Company Representative -I-tf Signature ?1--'17 Date ~ ,,¡ .;---.. ~OUS MATERIALS INVENTOe Address I) INVENTORY STATUS: New ( ] Addition ( ] Revision ( ] Deletion ( ] Check if chemical is a NON Trade Secret ( ] Trade Secret ( ] 2) Common Name: 3) DOT II (optional) Chemical Name: ARM ( ] CAS # 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire ( ] Reactive ( ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ Business Name CHEMICAL DESCRIPTION 5) WASTE CLASSIFICATION (3-digìt code ftom DHS Fonn 8022) 6) PHYSICAL STATE Gas [ ] Solid [ Liquid [ PW'e [ 7) AMOUNT AND TIME AT F ACn.ITY Maximwn Daily Amount Average Daily Amount Annual Amount Largest Size Container ## Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ Curies [ ] Circle Which Months: 9)~: Li~ the three most hazardous I) chemical components or 2) any AHM components 3) COMPONENT 10)LOCATION Page_of_ USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M. A. M. J, J, A. S, 0, N, D CAS## %wr AHM [ ] [ ] [ ] 2) Common Name: 1) INVENTORY STATUS: New ( ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret [ ] Chemical Name: 3) DOT ## (optional) AHM [ ] CAS ## 4) Physical & Health PHYSICAL HEAL rn Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute)[ ] Delayed Health (Chronic)[ S) WASTE CLASSIFICATION (3-digìt code ftom DHS Fonn 8022) 6) PHYSICAL STATE Gas [ ] PW'e [ Solid [ Liquid [ 7) AMOUNT AND TIME AT F ACn.ITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container ## Days on Site UNITS OF MEASURE Lbs[ ]Gal[ ]ft3[ ] Curies [ ] Circle Which Months: 9)~: Li~ the three most hazardous 1 ) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture ( ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M. A. M. J, J, A. S, 0, N, D CAS# %wr AHM [ ] [ ] [ ] IO)LOCA TION I certify under penalty of law, that I have personally examined and am tåmiliar with the intòrmation on this and all attached documents. I believe the submitted infonnatioo is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date