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HomeMy WebLinkAboutBUSINESS PLAN 2002 Chevron. Chevron Products Company CERTIFIED MAlL P.O. Box 6004 San Ramon, CA 94583. February 20, 2002 K. L. Norris City of Bakersfield Environmental, Safety & Health Office of Environmental Services Best Practice Team 1715 Chester Ave. 0perati0~s Services Bakersfield, CA 33301 Phone 925-842-5931 Dear Sir or Madam: Re: Chevron 203576, 1125 Coffee Road, Bakersfield, CA 91739 Enclosed are the following updated documents for our Chevron Station listed above: r~l UPCF UST-Facility · (Formerly SWRCB Form A) UPCF UST-Tank I I (Formerly SWRCBForm B) [-~ UPCF UST-Installation (Formerly SWRCB Form C) [~ UPCF Business Activities Underground Storage Tank [~ Monitoring Plan UPCF Business Plan & v'q Emergency Response Plan ~ Consolidated Contingency Plan Hazardous Waste Generator [--] Reporting Form Ifyou have any questions please give me a call at 925-842-5931. Sincerely, Kathy L. Norris Marketing Assistant Cc: Chevron Station - Please place this copy in your Compliance Workbook under section 7 Emergency ResPonse Section. file HAZARDOUS MATERIAL BUSINESS PLAN (BUSINESS PLAN) CHEVRON RETAIL ENVIRONMENTAL, SAFETY AND HEALTH ' : .... ~ CITY OF BAKERSFIELD ~~..~. OffiCE OF ENVIRONMENTAL SERVI~S 1715 Chester Ave., ' · Bakersfield, CA. 33301 (661) 326-3979 BUSINESS ACTIVITIES FACILITY INFORMATION PAGE 1_ OF 7 I. FACILITY IDENTIFICATION FACILITY ID # EPA ID # (Hazardous Waste Only) CAL000126278 BUSINESS NAME Chevron Stations Inc. #1842/203576 II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, Please submit the Business OwnerlOpemtor Identification page (OES Form 2730). A. HAZARDOUS MATERIALS Have on site (for any pul~oee) hazardous mataHal at or six,ye 55 gallons of liquids, 500 pounds for solids, or 200 cubic feet for compressed gaeeee, Include liquids In ASTa and MST): or the HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION applicable Federal threshold quantity for and extremely hazardous [] Yes [] No 4 [] (OES 2731 substance specified in 40 CFR Pa~t 356. Appendix A or B: or handle radlologlcal material In quantities for which an emergency plan Is required pursuant to 10 CFR Parts 30, 40, or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formally SWRCB Form A) t. Own or operate underground storage tanks? [] Yes [] No 5 I-I MST Tank (one page per tank) (Formerly Form B) UST FACILITY UST TANK (one per tank) 2. Intend to upgrade existing or Install new USTs? [] Yes [] No 6 [] UST INSTALLATION-CERTIFICATE OF COMPLIANCE (one per page per tank) (Formerly Form C) 3. Need to report closing a UST? [] Yes [] No 7 [] UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) 8 Own or operate ASTs above these thresholds: [] Yes [] No [] NO FORM REQUIRED TO CUPAS -any tank capacity is greater than 660 gallons, or -the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [] Yes [] No 9 [] EPA ID NUMBER--provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted [] Yes [] No t0 [] RECYCLABLE MATERIAL REPORT recyciable materials (per HSC sec/25143.2)? (one per recycier) 3. Treat hazardous waste on site? [] Yes [] No 11 [] ONSITE HAZARDOUS WASTE TREATMENT-FACILITY (Formerly DTSC Form 1772) 4. Treatment subject to financial assurance requirements (for [] Yes [] No 12 [] ONSITE HAZARDOUS WASTE TREATMENT-UNIT Permit by Rule and Conditional Authorization)? (one page per unit) (Formerly DTSC Forms 1772A, B, C, D, and L) 5. Consolidate hazardous waste generated at a remote site? [] Yes [] No 13 [] CERTIFICATION OF FINANCIAL ASSUSRANCE (Formerly DTSC Form 1232) Yes 6. Need to report the closure/removal of a tank that was [] [] No 14 [] HAZARDOUS WASTE TANK CLOSURE CERTIFICATION classified as hazardous waste and cleaned onsite? (Formerly DTSC form 1249) D. LOCAL REQUIREMENTS 1~, Please not that the 'Yes" box has been check to answer the question "Generate Hazardous waste?". Please understand that hazardous waste is not generated under normal operating conditions. Hazardous waste would only be generated if there is an unauthorized release 2 ':- .' GITY OF BAKER,.~FIELD ~ . CE OF ENVIRONMENTAL SER~S ~ 1715 Chester Ave., ~, Bakersfield, CA. 33301 (661) 326-3979 BUSINESS OWNER/OPERATOR IDENTIFICATION FACILITY INFORMATION PAGE 2 OF 7 ! I. IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 BUSINESS PHONE:(5) lO2 Chevron Stations Inc. #203576 (661) 588-9066 SITE ADDRESS 1125 Coffee Road lO3 CITY 1o4 ZiP CODE lO5 Bakersfield CA 93308 DUN & BRADSTREET lO~ SIC CODE (4 digit #) lO7 00-914-0559 5541 COUNTY Kern BUSINESS OPERATOR NAME lO9 BUSINESS OPERATOR PHONE Station Manager (661) 588-9066 II. BUSINESS OWNER OWNER NAME 111 I OWNER PHONE 112 Chevron Products Company - Permit Desk[ (925) 842-9002 OWNER MAILING ADDRESS 113 P.O. Box 6004 CITY 114 ISTATE 115 ZIPCODE 116 San RamonI CA 94583 II1. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 118 Chevron Products Company Permit Desk (925) 842-9002 ! CONTACT MAILING ADDRESS 119 P.O. BOX 6004 CITY 120 I STATE 121 ZIP 122 San RamonI CA 94583-0904 -PRIMARY IV. EMERGENCY CONTACTS SECONDARY (26) NAME: Chevron Maintenance 123 (31) NAME: Chevron Emergency Information Center 128 (27) TITLE: Duty Clerk 124 1321 TITLE: Staff 129 (28) BUSINESS PHONE: (800) 423-691 1 125 (33) BUSINESS PHONE: (800) 231-0623 13o (29) 24-HOUR PHONE: (800) 231-0623 12S (3~) 24-HOUR PHONE: (800) 231-0623 131 (30) PAGER #: 127 (35) PAGER #: 132 (37) ADDITIONAL LOCALLY COLLECTED INFORMATION 133 i(a) Please describe the main operation of your business. Gasoline Station -- (b) Do you have a license to purchase commercial grade pesticides? If yes, give number: (c) EPA ID #: Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that i have personally examined and am familiar with the information submitted and believe the information is true accurate and complete, NAME OF DOCUMENT PREPARER (39) Signatura of Ow~/, ~,~j~,~_. DATI~ 134 135 ' ~.~./.,3C~("C;'~. Bruce Carpenter NAME OF SIGNER 136 \ " V TITLE OF SIGNER 137 Kathy Norris Compliance Manager ' = ~ '- CITY OF BAKERSFIELD . O/CE OF ENVIRONMENTAL SERVES v 1715 Chester Ave., · Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION [] ADD [] DELETE [] REVISE 200 . PAGE 3 OF 7 I. FAClLI'I~ INFORMATION BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business As) 3 Chevron Station Inc. #203576 BUSINESS SITE ADDRESS lO3 1 125 Coffee Road CITY lo4 ZIP Bakersfield CA 93308 CHEMICAL LOCATION 2m I FACILITY MAP 203 GR D COORD NATE 204 Underground tank, southeast of store I 1 I1., CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET I-I Yes [] No 2o6 COMMON NAME Chevron Regular Unleaded Gasoline 207 *EHS I"1 Yes [] No 2o8 CAS # 86290-81-5 209 If EHS is"Yes" amount must be in lbs. HAZARDOUS MATERIAL TYPE ~ 212 CURIES 'Check one item only) [] a. PURE [] b. MIXTURE [] c. WASTE 211 RADIOACTI__ Yes [] No 213 PHYSICAL STATE LARGEST CONTAINER 215 'Check one item on~y) [] a. SOLID []b. LIQUID [] c. GAS [] d. DUST 214 12,000 FED HAZARD CATEGORIES []a. FIRE [] b. REACTIVE I-lc. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 216 Check all that apply) AVERAGE DAILY 217 IMAX DAILY 218 ~ANNUAL WASTE 219 STATE WASTE 220 AMOUNT 6,000 ~MOUNT 12,000 ~AMOUNT CODE DAYS ON 222 UNITS* [] a. GALLONS I"1 b. CUBIC FEET [] c. POUNDS [] d. TONS .. [] OTHER 221 SITE 365 Check one Item only) *If EHS, amounts must be in lbs. 223 STORAGE CONTAINER 'Check all that apply) [] a. ABOVE GROUND TANK [] e. PLASTIC/NON METALLIC DRUM [] i, FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDER GROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STORAGE PRESSURE [] a, AMBIENT [] b, ABOVE AMBIENT [] c, BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 % WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# i I 100 226Gasoline (Generic) 227 I-lYes I-I No 228 86290-81-5 229 230 231 []Yes [] No 232 233 234 235 []Yes [] No 236 237 238 239 []Yes [] No 240 241 242 243 []Yes [] No 244 245, If more hazardous components are present at greater than t% by weight if non-carcinogenic, or 0.t% by weight if carcinogenic, attach additional sheets NOTES (Trade names/synonyms or other information relevant to the substances listed/ 246 PRINT NAME AND TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE ~ DATE ~.(,~[0/~,~4~ 4 CE OF ENVIRONMENTAL SERVI~ES 1715 Chester Ave., Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION [] ADD [] DELETE [] REVISE 2OO PAGE 4 OF Z !. FACILITY INFORMATION FACILITY ID# ' ' ' 1 BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business As) 3 Chevron Station Inc. #203576 BUSINESS SITE ADDRESS lO3 125 Coffee Road CITY lo4 ZIP lo5 Bakersfield CA 91739-9318 CHEMICAL LOCATION 201 I FACILITY MAP 203 GRID COORDINATE 204 Underground tank, southeast of store I 1 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 2o6 COMMON NAME Chevron Supreme Unleaded Gasoline 207 *EHS [] Yes [] No 208 CAS # 86290-81-5 2o9 If EHS is"Yes" amount must be in lbs. HAZARDOUS MATERIAL CURIES TYPE [] a. PURE [] b. MIXTURE [] c. WASTE 211 RADIOACTI~ 2~2 'Check one item only) Yes [] Nb 213 PHYSICAL STATE LARGEST CONTAINER 215 'Check one item only) [] a. SOLID I~b. LIQUlD [] c. GAS [] d. DUST 214 12,000 FED HAZARD CATEGORIES []a. FIRE [] b. REACTIVE I'lc. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 216 'Check all that apply) AVERAGE DAILY 217 IMAXDAILY 218 ~NNUALWASTE 219 STATEWASTE 220 AMOUNT 6,000 ~AMOUNT 12,000 ~MOUNT CODE UNITS* [] a. GALLONS [] b. CUBIC FEET [] c. POUNDS [] d. TONS .. [] OTHER '221 DAYS ON 222 'Check one Item only) *If EHS, amounts must be in lbs. SITE 365 ~ 223 STORAGE CONTAINER Check all that apply) [] a. ABOVE GROUND TANK [] e. PLASTIC/NON METALLIC DRUM [] i. FIBERDRUM [] m. GLASS BOTTLE [] q. RAILCAR [] b. UNDER GROUND TANK [] f. CAN [] j. BAG [] n, PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT, [] b. ABOVE AMBIENT [] c. BELOTM AMBIENT [] d. CRYOGENIC 225 % WI' HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 1 100 22sGasoline (Generic) 227 []Yes [] No 228 B6290-81-5 229 230 231 []Yes []N0232 233 234 23,~ []Yes [] No 236 237 238 239 []Yes [] No 240 241 242 243 []Yes [] No 244 245, If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0,t% by weight if carcinogenic, attach additional sheets NOTES (Trade names/synonyms or other information relevant to the substances listed/ 246 PRINT NAME AND TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATUR. E [~~ DATE~::~//'.~.~.._24~ e CITY OF BAKERSFIELD ~) FICE OF ENVIRONMENTAL SER~TCES 1715 Chester Ave., Bakersfield, CA. 33301 (661) 326-3979 H~ARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION [] ADD [] DELETE [] REVISE 200 PAGE 5 OF · Z I, FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business As) 3 Chevron Station Inc. #203576 BUSINESS SITE ADDRESS lO3 125 Coffee Road CITY ~o4 I ZIP lO5 Bakersfield I CA 93308 CHEMICAL LOCATION 2m FACILITY MAP 203 GRID COORD NATE 204 Underground tank, southeast of store 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 COMMON NAME Chevron Plus Unleaded Gasoline 207 *EHS [] Yes [] No 208 CAS # 86290-81-5 209 If EHS is"Yes" amount must be in lbs. HAZARDOUS MATERIAL a. c. CURIES I'YPE I-I PURE [] b. MIXTURE [] WASTE 211 RADIOACTI~ 212 Check one item only) Yes [] No 213 PHYSICAL STATE LARGEST CONTAINER 215 Check one item only) I"] a. SOLID I~b. LIQUID [] c. GAS [] d. DUST 214 12,000 FED HAZARD CATEGORIES []a. FIRE [] b. REACTIVE []c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 216 Check all that apply) AMOUNT 6,000 IAMOUNT 12,000 IAMOUNT CODE DAYS ON 222 UNITS* [] a. GALLONS [-I b. CUBIC FEET [-I c. POUNDS [] d. TONS .. [] OTHER 221 SITE 365 Check one Item only) *If EHS, amounts must be in lbs. 223 STORAGE CONTAINER Check all that apply) [] a. ABOVE GROUND TANK [] e. PLASTIC/NON METALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDER GROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g .CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b .ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 % WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 23¢ 231 []Yes [] No 232 23~ 234 235 []Yes [] No 236 237 23~ 23c~ []Yes [] No 24c 241' 242 243 []Yes [] N02~ 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets NOTES (Trade names/synonyms or other information relevant to the substances listed/ 246 3RINT NAME AND TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE ~ DATE (~)~... 24~ 6 ~ .-- ~ CITY OF BAKERSFIELD i~  ~/FICE OF ENVIRONMENTAL SER'~"~ES 1715 Chester Ave., Bakersfield, CA. 33301 (661) 326-3979 -~-.--'~~'-'""- HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION [] ADD [] DELETE [] REVISE 200 PAGE _6 OF 7 I, FACILITY INFORMATION ESTABLISHMENT # ITEM NUMBER 1-2 FACILITY ID # 1 BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business As) 3 Chevron Station Inc. #203576 BUSINESS SITE ADDRESS 103 1125 Coffee Road CITY lo4 I ZIP 105 Bakersfield CA 93308 I CHEMICAL LOCATION 201 I FACILITY MAP 203 GRID COORDINATE 204 In car wash tunnel I 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 COMMON NAME Aries 1011 207 *EHS [] Yes [] No 208 CAS # 209 If EHS is "Yes" amount must be in lbs. HAZARDOUS MATERIAL a. c. Yes ' CURIES TYPE [] PURE [] b. MIXTURE [] WASTE 211 RADIOACTI~ 212 Check one item only} [] No 213 PHYSICAL STATE Check one item only) [] a. SOLID []b. LIQUID [] c. GAS [] d. DUST 214 21LA5RGEsTcONTAINER 20~000 FED HAZARD CATEGORIES I~a. FIRE [] b. REACTIVE I-lc. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 216 Check all that apply) AMOUNT 27 ~MOUNT 55 ~AMOUNT CODE DAYS ON 222 UNITS* [] a. GALLONS [] b. CUBIC FEET [] c. POUNDS [] d. TONS.. [] OTHER 221 SITE 365 Check one Item only) *If EHS, amounts must be in lbs. 22." STORAGE CONTAINER Check all that apply) [] a. ABOVE GROUND TANK [] e. PLASTIC/NON METALLIC DRUM [] i. FIBER DRUM [] m, GLASS BO'I-rLE [] q. RAIL CAR [] b. UNDER GROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 % WT HAZARDOUS COMPONENT (Formixture orwaste only) EHS CAS# 23( Sodium Hydroxide 231 []Yes [] No 23; 233 23z 2-Butoxy ethanol 235 []Yes [] No 23( 237 23( Nonionic Surfactant Blend 239 []Yes [] No 24(: 241 24; d-Limonene 243 []Yes [] No 24z 245 p If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0,1% b weight If carcinogenic, attach additional sheets RINT NAME AND TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 24( 7 .... GITY OF BAI~ER~SFIELD . · ' ' i~[~I=ICE OF ENVIRONMENTAL SE! . 1715 Chester Ave., i' Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION [] ADD [] DELETE [] REVISE 200 PAGE 7 OF 7 I. FACILITY INFORMATION ITEM NUMBER 1-2 FACILITY ID # ~ BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business As) 3 Chevron Station Inc. #203576 BUSINESS SITE ADDRESS lO3 1125 Coffee Road CITY lO4 ZIP 105 Bakersfield CA 93308 CHEMICAL LOCATIONinside storage area 204 FACILITY MAP I 203 GRID COORD NATE 204 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes I~ No 206 COMMON NAME Carbon Dioxide 207 *EHS [] Yes [] No 208 CAS # 124-38-9 209 If EHS is ~Yes' amount must be in lbs. HAZARDOUS MATERIAL I rYPE [] a. PURE [] b. MIXTURE [] c. WASTE 211 RADIOACTIVE 212 CURIES 213 Check one item only) [] Yes [] No PHYSICAL STATE Check oneitem only) [] a. SOLID []b. LIQUID [] c. GAS [] d. DUST 214 LARGEST870CONTAINER 215 FED HAZARD CATEGORIES Ea. FIRE [] b. REACTIVE I~c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 216 Check all that apply) AMOUNT 435 ~AMOUNT 870 ~MOUNT CODE DAYS ON 222 UNITS* [] a. GALLONS [] b. CUBIC FEET [] c. POUNDS [] d. TONS .. [] OTHER 221 SITE 365 Check one Item only) *If EHS, amounts must be in lbs. 223 STORAGE CONTAINER Check all that apply) [] a. ABOVE GROUND TANK [] e. PLASTIC/NON METALLIC DRUM [] i. FIBER DRUM [] m. GLASS BoI-rLE [] q. RAIL CAR [] b. UNDER GROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 % WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# I 100 22(~'Carbon Dioxide 227 []Yes [] No 228 124-38-9 229 23(: 231 []Yes [] No 232 233 23~ 235 []Yes [] N023~ 237 23E 23S []Yes [] No 24¢ 241, 242 243 []Yes [] N024~ 245 Ip more hazardous are greater than by weight or 0.1% by weight if carcinogenic, attach additional sheets components present at If non-carcinogenic, RINT NAME AND TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE~~ .~(C~f~DATE 246 vv ~,v~ ! SITE DIAGRAM ~'J .,,.. . ..FACILITY DIAGRAM [--'] Business Name: CHEVRON STATIONS INC. #1842/203576 A Area Map # I of 1 North Name of Area: BUSINESS AS A WHOLE SCALE 1" = 43.5' VACANT LAND DRIVEWAY z o o < z z CAR ~ PRODUCTS ~> ~ =-I TAN~ ~ g: PANEL O SPILL I~IIPMEHT ~ ~{ LO~ING ~ ~ VACA~ ~ND VACA~ .~ ~D CITY OF BAKERSFIELD SYMBOL LEGEND I (~) GAS ~ FENCE (ALL TYPES) INDICATE HEIGHT (~ ELECTRIC ~'** GATE IN FENCE (~ WATER --/-- STANDARD DOOR  SPRINKLER FIRE DEPT. CONNECTION ...... ' l~0K , UNDERGROUND ;_ __C~_L._', STORAGE /~ FIRE HYDRANT- PUBLIC TANKS - LIST CAPACITY (~) AUTOMATIC SPRINKLER ~ ABOVEGROUND BUILDING OR AREA STORAGE TANKS (~ FIRE ALARM "~ RAILROAD TRACKS ~ MATERIAL SAFETY ~ PESTICIDE STORAGE DATA SHEET STORAGE AREA ) ~ EVACUATION AREA TYPES OF HAZARDOUS MATERIALS FLAMMABLE <~ LIQUID <~ CORROSIVE <~ SOLID <~ WATER REACTIVE ~ GAS EXPLOSIVE <~ RADIOLOGIcAL <~ WASTE EXAMPLE: FLAMMABLE .<~ LIQUID POISON EXPLOSIVE GAS <~ lo ; :-'- CITY Of: BAKERSFIELD · ' ' · ICE OF ENVIRONMENTAL SEROES . 1715 Chester Ave., .r Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of the plan instead of competing SECTION 1 below for initial submission SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Chevron Stations Inc. #203576 LOCATION: 1125 Coffee Road Bakersfield 93308 MAILING ADDRESS: P.O. Box 6004 CITY: San Ramon STATE: CA ZIP: 94583 PHONE: (925) 842-9002 DUN & BRADSTREET NUMBER: 09-140-0559 SIC CODE: 5541 PRIMARY ACTIVITY: Gasoline Station/Mini-Mart/Car Wash OWNER: Chevron Products Company MAILING ADDRESS: P.O Box 6004 San Ramon CA. 94583 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1.Chevron Maintenance Dispatcher (800423-6911 (800) 231-0623 2. Chevron Emer,qency Information Center Staff (800) 231-0623 (800) 231-0623 11 ' ':-" CITY OF BAKERSFIELD ,~~ :ICE OF ENVIRONMENTAL SElF. ES 1715 Chester Ave., ~,--e~--r Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION I1.1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES Aboveground: Visual observation and regular inspection Underground: Fuel storage and delivery system monitored via Veeder-Root TLS 350 B. EMPLOYEE AND AGENCY NOTIFICATION a. In any incident that jeopardizes human health and safety: 1) Activate appropriate emergency shutoff; 2) Evacuate personnel from facility using safest routes available according to the situation; and 3) Go to an upwind area and maintain a safe distance. b. Coincident with evacuation, notify emergency response agencies by dialing 911 if incident represents an immediate threat. c. Deny entry to the area by anyone other than 911 emergency response personnel until area is declared safe. d. Standby to assist emergency response personnel. e. Any incident involving a fire, release, or threatened release of a hazardous material must also be reported to the Station Manager. The Station Manager will notify the CSI Territory Manager and Chevron Maintenance Dispatch immediately. Chevron Maintenance Dispatch will: 1) Dispatch Company/Contractor assistance if necessary; and 2) notify Chevron Compliance Marketing Assistant for proper notification to regulatory agencies. C. ENVIRONMENTAL RESPONSE Small spill: Taken up with inert absorbent and place in sealed spill drum. Contents of spill drum are removed by authorized service and legally disposed. Underground release: If an underground release is confirmed, the fuel system shall be shutdown and emptied until cleanup is completed under supervision of Chevron Maintenance Dispatch. Contaminated earth and other materials shall be removed and disposed by a licensed matedal cleanup contractor D, EMERGENCY MEDICAL PLAN: MEDICAL FACILITIES: Memorial Urgent Care 6501 Ming Ave.. 397-4004 Bakersfield Memorial 420 34th Street 327-1792 12 CITY OF BAKERSFIELD ~.~~. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., · Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.2: RELEASE RESPONSE PLAN: A. RELEASE PREVENTION STEPS: a. Barriers installed to prevent vehicle collision with pumps. b. Vapor Recovery Systems used when filling underground tanks. c. Anti-lock nozzles on pumps. d. No sales to unauthorized containers. e. "No Smoking" signs posted. Self-serve instructions posted. f. Monitoring Program implemented. g. Double walled tanks with leak detection system B. RELEASE CONTAINMENT AND/OR MITIGATION: a. Stop source of release as necessary and safe. If gasoline, stop source of release by activating emergency pump shutoff switch. b. Evacuate all nonessential personnel from area. c. Extinguish or remove all ignition sources. Use fire extinguisher if necessary. d. While using proper personal protective equipment, contain and absorb spill with inert absorbent. Avoid breathing gasoline vapors by approaching from upwind. C. CLEAN-UP PROCEDURES: a. Keep nonessential personnel away from area. b. Notify Chevron Maintenance Dispatch (800) 423-6911 for coordination with Hazardous Material Contractor to remove contaminated absorbent materials if required. c. Materials involved in cleanup will be disposed of in accordance with all applicable Federal, State, and Local regulations. UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: Inside Food Mart ~back room" (main is in breaker box). WATER: Meter: In northeast sidewalk of Brimhall Road SPECIAL: Emer.qenc¥ Pump Shutoff-a) Cashier console; b)Northeast corner of Food Mart outside. LOCK BOX: YES [] N© [] IF YES, LOCATION_.' PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: Fire extinguishers are kept throughout the facility. B. WATER AVAILABILITY (FIRE HYDRANT): Southwest corner of Brimhall Road and Coffee Road. 13 ~~.~. FICE OF ENVIRONMENTAL SER~CES 1715 Chester Ave., Bakersfield, CA. 33301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION IIh TRAINING NUMBER OF EMPLOYEES: 9 MATERIAL SAFETY DATA SHEETS ON FILE: Yes BRIEF SUMMARY OF TRAINING PROGRAM: Training includes but is not limited to: a. Hazard Communication Program, written and audio/video program including MSDS review. b. HAZWOPER, written and audio/video program--Awareness Level. c. Hazardous Material Business Plan(additional emergency procedures) d. Operating Procedures (including proper use of gasoline equipment and additional emergency procedures) e. Wdtten Underground Monitoring Procedures (including proper notifications) all employees attend the formal Chevron Stations Inc. Training Program. Training is provided upon hire and annually thereafter at the minimum. New Employees work under the direct supervision until required training is completed CERTIFICATION: ! Kathy Norris CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. l&~~SIGNATURE Compliance Marketing ^ssistant TITLE ~ !~ ('0 ~'="'"~- DATE 14