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Home My WebLink AboutBUSINESS PLAN~ • :r (HMMP) BAKERSFIELD FIRE DEPT. HAZARDOUS MATERIALS MANAGEMENT PLAN ~~^ ~ Prevention Services 1 (UMflED PROGRAM CONSOLIDATED FORM) a _ i3 x s P ? •. n 900 TrUxtun Ave., Suite 210 - FIRE Bakersfield CA 93301 ~~ ~~_,,,JJJ APPLICATION ~Rrer t Tel.: (661) 326-3979 ,,//~~5 BUSII~SSOVVNER/OPERATORIDENTIFlCATIONFORM 'Fax: (661) 852-2171 lj (HAZARDOUS MATERIALS FACILITY INFORMATION) n L~ Page 1 of 2 ~I ~ U,(- J 1: FACILITY IDENTIFICATION' FACILITY ID tvCi. ear egmning too Year Ending to ~ 03/01 /2007 03/01 /2008 BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) a BUSINESS PHONE 10 Mervyn's Store # 37 -- Bakersfield (661) 327-4101 SITE ADDRESS 10 4450 California Ave CITY toa _ Ip /~ to cA j M Bakersfield q 93309 DUNN & BRADSTREET tos IC CODE ~ to 00-796-8670 4 Digit #) 5311 /5399 O~7 couNTY to Kern OPERATOR NAME tos OPERATOR PHONE t1 Mervyns, LLC (510) 727-3000 OWNER INFORMATION OWNER NAME ttf OWNER PHONE tt Mervyns, LLC (510) 727-3000 OWNER MAILING ADDRESS tt 22301 Foothill Blvd, MS 4025 CITY tta STATE tts Ip t1 Hayward _ CA 94541-2771 III. ENVIRONMENTAL CONTACT CONTACT NAME _ __ _ ttt - CUNTr;CT PHONE - - - - 1t Robert Lucacher, Environmental and Energy Manager (510) 727-3237 CONTACT MAILING ADDRESS tt 22301 Foothill Blvd, MS 4025 CITY tzo STATE tzt ZIP t Hayward __ -- -- - -- CA 94541-2771 - - __ _ - - -PRIMARY !V. EMERGENCY CONTACTS -SECONDARY- ..- - - - - I - NAME 12 NAME 12 Beckie Diltz Rosie Gallegos TITLE 12 ITLE 12 Store Manager Assistant Operations Manager BUSINESS PHONE 12 BUSINESS PHONE 13 (661) 327-4101 (661) 327-4101 24HOUR PHONE 12 4HOUR PHONE {~ • 131 (661) 205-1178 J1 (661) 322-8565 PAGER No 12 PAGER No 13 N/A N/A 13 V. CERTIFICATIQN Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that 1 have personally examined and am familiar with the information submitted in this inventory and believe the information is true, accurate, and complete. SIGNATURE OF OWNER/OPERATOR (full printed name) 1 DATE 1 NAME OF DOCUMENT PREPARER (full printed name) 13 Robert Lucacher j~Q / (~ ~. Matthew J Schlesser, Agent of Mervyns, LLC SIGNATURE OF OWNERIOPERATOR/OR DESIGNATED 13 TITLE OF OWNER/OPERATOR/OR DESIGNATED 13 REPRESENTATIVE REPRESENTATIVE (SIGNER) EnVlrOnmental and Energy Manager fU Z14Z (KOV. U9/05) r is _.. -.-.... _ CITY OF BAKERSFIELD >3 s R s >+ ' + ° OFFICE OF ENVIRONMENTAL SERVICES F)4E A1~TM T 1715 Chester Ave., CA 93301 (661) 326-3979 '~"~~ rr'M" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION Q NEW Q ADD Q DELETE _ __~ REMISE 200 ~~~ /Qa Lvs ac.~e,r_ ~11~y. .F- ~N•er4ff~~r .3~9~~?-. (one amt Per mefena! per buNdMg d area) Psge ~ of 2 __ !. FACILfTY INFORMATION SUSINESS NAME (Same as FACILITY NAME or DBA- Dolrg Buskwcs As) ~ 3 Mervyn's Store # 37 -- $akersfield _ + CHEMICAL LOCATION Behind store, west side of building 201, CONE OENTULL (EPCRA) G Yes No 201 FACILITY ID Y _ MAP q {opliona0 1 203 GRID p (optipnaQ D_ 1 204 h. CHEMICAL INFORMATION ~ 205 TRAp£ SECRET Cj Yee ~ No 206 CHEMICAL NAME ' II Subject a EPCRA velar to ins W coons 207 COMMON NAME Diesel Fuel 1p~ EHS• G Yes Jq No 2°B i j CAS p 209 111(nTA'deaxibklpsk+M FIRE CODE HAZARD CLASSES {Compkk it roques4d by local fire aFieQ I LII, IRR, OHH 210 TYPE G p PURE ~ m MIXTURE G w WASTE 211 RADIOACTIVE G Yaa No 212 CURIES 213 f- _' --' ' PHYSICAL STATE G s SOLID ~ I LIQUID G q GAS 214 LARGEST CONTAINER I25 215 FED HAZARD CATEGORIES ~ i FIRE G 2 REACTIVE G 3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ~ 5 CHRONIC HEALTH 216 (Check all Ihal apply) AMOUNTWASTE 0 217 4 ~ AMOUNT 12S 218 DAILY~AMOUNT 100 219 STATE WASTE N/~E J20 ' UNt75' ~ qa GAL G d CU FT G Ib LBS G to TONS 221 DAYS ON SITE 222 • M EHS, amount muss be in Ibs. - 365 ~ S70RAGE CONTAWER ~ e ABOVEGROUND TANK G s PLASTIClNONMETALLIC DRUM G i FIBER DRUM G m GLASS BOTTLE G q RAILCAR 223 1 7Chsd al! Itfet spply} >G` b UNDERGROUND TANK G i CAN G j BAG G n PLASTIC BOTTLE ~ r OTHER G t TANK INSIDE BUILDING G g CARBOY G k BOX G 0 TOTE BIN Gm ergenc y G en erator _ _ __ _ _ _ i G d STEEL DRUM G b SILO G I CYLINDER G D TANK WAGON ~^ ~- STORAGE PRESSURE ~ a AMBIENT Gas ABOVE AMBIENT G Da BELOW AMBIENT 224 I - ~ STORAGE TEMPERATVRE ~ aAMB1ENT G as ABOVE AMBIENT G ba BELOW AMBIENT G c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS CAS # 1 1 228 227 G Yss ~ No 228 229 2 ~ 210 f'--~~'-- 3 234 231 235 ~'j Yes G No 232 ~ 233 ~ -- ~ --'-- Cj Ves G No Z38 237 4 238 239 Cj Yes G No 240 241 I 5 i 242 ` 243 ~ rj Yas G No I44 i --_ 245 III. SIGNATURE PRINT NAME 6 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE ~ DATE 248 UPCF (7199) C:\W INNT401Profiles\jtraylor.0001Desktop\OES273T.wpd ~~ {HMMP) FIAZARt3C?tJ5 MATERIALS MANAGEMENT PLAN APP~ICATIQN ~ f~~ri FOR SECTION DISCOVERY AND a1!'Tl/ T NOTIFICATION {FORMS) INSTRUCTIONS 1. To avoid fuRher action, return this form within 30 days of receipt 2. TYPEIPRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. d Rc ae hriof and rnnricsa ac nnscihlP BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: {661) 326-3979 F'ax: 1661) 852-2171 Page 1 at 2 31CTiON I: FACILITY IDENTlFICATIC3N BUSINESS NAME (Same as FACILITY NAME ar DBA -Doing Business As) Merv n's Store # 37 -- Bakersfield ~ ADDRESS (FOf toast ase onry/ 4450 California Ave, Bakersfield, CA 93309 - - FACILfTY 4D NO. f SECTION 11.1; DISCOVERY A{~D NOTIFICAT!{ONS A. LEAK DETECTION AND MONfrORING PROCEDURES: A monthly inspection of the emergency generator is conducted by the Store #037 Mobile Maintenance Tech. Any problems with the unit are immediately communicated to Mervyns Building Services and a work ore issued to have the problem sdved. B. EMPLOYEE ANO AGENCY NOTIf (CATION: Incases where a HazMat spill poses an immediate threat to human health and/or the environment, local emergency response personnel (i.e. fire department, law enforcement), will be summoned by calling 911. In conjunction with this notification, an eMemal contractor, capable of safely deaning up the spill, will be summoned to the site by the Mervyns Hazardous Materials Response Consultant. ~ ~. ^ `^ C. ENVIRONMENTAL RESPONSE (WWAGEMENT: - The on-duty Store Manager, Fadlity Manager, and the Hazardous Materials Response Consultant work together as a team to abate the hazard. If the on-duty Store Manager and HazMat Response Consultant determine the spill is small, within the capabilities of onsite resources, and applicable to the scope of employee training, store personnel will cleanup the spill. Waste materials will pe placed in 5 gallon containers, sealed with the lid, labeled with appropriate identification information, and stored in accordance with local, state and federal regulations. If the on~uty Store Manager, Fadliry Manager and HazMat Response Consultant determine the spill exceeds the capabilities of on-site resources, capabilities or training, and/or poses a spedal or unique hazard to life, safety or the environment, the local HazMat response agency will be notified and an external contractor ppable of safely deaning up the spill will be summoned to the site. D. EMERGENCY MEDICAL PLAN: 4 Incase of injury or exposure, employees will be taken to: Hospital -Bakersfield Occupational Center Address -4570 California Avenue Bakersfield, CA 93306 SECTItJN 1i.2: RELEASE RESPONSE PLAN A HAZARD ASSESfNEN7 AND PREVENTION MEASURES: Diesel fuel for the store's emergency standby generator is the hazardous material covered by this Hazardous Matadors Business Plan. Hazards tndude diesel as a source of fuel in the avant of fire and as a potential source of pollution in the event of a spill. In order to reduce this hazard, Mervyn's provides: 1. Store personnel with basic training on hazarous materials. 2. Material Safety~Data Sheets through ou Hazardous Materials Consultant. 3. The emergency generator is inspected and tested monthly by Store #37 Mobile Maintenance Tech. Store personnel are insWcted to notice and report any hazardous materials spills 5. Barriers to prevent vehicles from impacting the generator or its protective housing. _.._. . . _ ... . . . . . _ _ ____........... ._....._. -_W_._ .. ... . . . . . ...._.__.._._..._ ~ - _ _ B. RELEASE CONTAINMENT AND/OR MITIGATION: In the event of a hazardous materials spill the area will be immediately isolated and the Manager On Duty (MOD) notified. If the hazardous materials spill is deemed an immediate threat to human health, safety or the environment, local emergency response personnel (i.e, fire department, law enoorcement), 911 will be called. The MOD notifies Mervyn's Alert One Alartn Center which operates 2417, to report the hazardous materials inddent. Mervyn's Alert One then notifies the site's Fadlities Manager (FM) and other Mervyn's fadlity personnel. If the spill requires additional guidance and support beyond the cepabilities of store personnel, the FM contacts Mervyn's Hazardous Materials Response Consultant which operates 2417. The Hazardous Materials Response Consultant will assist the FM and appropriate store personnel in the proper isolation and management of the spill situation. ___ C. CLEAN-UP AND RECOVERY PROCEDURES: -.__ . In keeping with the section on Mitigation, the MOD, FM, and the Mervyn's Hazardous Materials Response Consultant work together as a team to abate the hazard. If the MOD and HazMat Response Consultant determine the spill is small, within the capabilities of onsite resources, and applicable to the scope of employee training, store personnel will cleanup the spill. If the MOD, FM and HazMat Response Consultant determine the spill exceeds on-site resources capabilities or training, and/or poses a spedal ar unique hazard to human health, safety or the environment, the HazMat Response Consultant will immediately dispatch an appropriately trained HazMat crew to manage all aspects of the spill cleanup. f U L 1 Oy (Rev. 09/U3) Page 2 of 2 - SECTION ii.2; RELEASE RESPONSE PLAAI--~CON'T: --- - - UTILITY SHUT-0fFS {LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS(PROPANE North side of the building, outside. ~ ELE TRICAL: West side of the building in PG&E room. _ _ _ ~~_ WATER: North side of building, outside. sPECfAL. None. PRIVATE FIRE PROTECTIONIWATERAVAlLABILITY: A PRVATE FIRE PROTECTION: Fire extinguishers are located throughout the store in addition to an automatic sprinkler system. 8. WATER AVAILABILnY {f IRE HYDRANT): Fire hydrant located North West of building on California Ave. SECTItJN ill: TRAINII+IG - - - -- ,: __ _ --- -- NUMBER OF EMPLOYEES: 120 - 230 (Seasonal) MATER4LL SAFETY DATA SHEET"S ON FILE: MSDS are available online and via facsimile from Mervyn's Hazardous Materials Response Consultant (operating 24/7, 800-602-8200) BRIEF SUMMARY OF TRAINING PROGRAM: All location employees receive training in the safety of proper hazardous materials management, the fundamentals of this Hazardous Materials Business I Plan, Hazards Communication and other various aspects of workplace safety. 1 I - - _- CERTi'FICATION Based cm my inquiry of those individuals responsible for obtaining the information, !certify under penalty of law that t have persortally examined and am familiar with the information submitted and believe the information is true, aectrrate, and complete. SIGNATURE OF OWNER ! OPERATOR OR DESIGNATED REPRESENTATIVE DATE 477 ~ 3 oy o ~- NAM F SIGNER (print) 478 TITLE OF SIGNER 4T9 Robert Lucacher Environmental and Energy Manager FO 2169 {Rev. ostosJ ALIFORNIA ANNDTATED SITE MAP (BUSINESS NAME MERVYN'S #0037 A B C D E 2 :~ 2 ( SITE ADDRESS RN ~ Map #~1 OF 2 I BAKERSFIE D CA 93309 F G H I : ~ NORTH O ELECTRIC MAIN 0 A ~ ~ z Q - GE EMERGENCY o GENERATOR o ~ ® FLOOR DRAIN x u .y.~ a ~~ F `°"" ~ FIRST AID .. ,. . S70GK eau. ~ FOYER wcxs F ~ ¢,a FIRE F ' EXTINGUISHER ~"'~ ' ~ FIRE RISER , . z> ~ F F ..._ ....__...... ; .... __........F o ....; ~ a ~ F a~ ~ ~ ~ Prepared by: M1 1 SCAL' ~ 1905 Aston Aveaue 3E Carlsbad, CA 92008 ,., GAS MAIN O WATER MAIN ,, ~4. ~~ Y X~ GEN EMERGENCY GENERATOR ® STORM DRAIN Prepared bp: •r . v -. 3 d 1905 Aston Avenue Carlsbad, CA 92008 CALIF^RNIA ANN^TATED SITE MAP BUSINESS NAMES (SITE ADDRESS~4450 CALIF^RNIA AVE. ~ Ma #~2 ^F 2 MERVYN'S #0037 BAKERSFIELD, CA 93309 P A B C D E F G H I MERVYNS 37 SiteID: 015-021-001425 Manager BECKIE DILTZ ocation: 4450 CALIFORNIA AVE ~ity BAKERSFIELD BusPhone: (661) 327-4101 Map 102 CommHaz Moderate Grid: 35A FacUnits: 1 AOV: CommCode: BFD STA 11 EPA Numb: SIC Code:5699 DunnBrad:00-796-8670 Emergency Contact / Title Emergency Contact / Title BECKIE DILTZ / STORE MANAGER ROSIE GALLEGOS / ASST OPS MGR Business Phone: (661) 327-4101x Business Phone: (661) 327-4101x 24-Hour Phone (661) 205-1178x 24-Hour Phone (661) 322-8565x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Contact ROBERT H LUCACHER, ENV/ENERGY MGR Phone: (510) 727-3237x MailAddr: 22301 FOOTHILL BLVD MS4025 State: CA City HAYWARD Zip 94541-2771 Owner MERVYNS LLC Phone: (510) 727-3000x Address 22301 FOOTHILL BLVD MS4025 State: CA City HAYWARD Zip 94541-2771 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No arcelNo: Emergency Directives: PROG A - HAZMAT ~ PROG T - UNDERGROUND STORAGE TANK ,1J J~ "' U ~ q 1 9 200j Based on my ingc.riry of those individuals cnsible for obtaining the information, i certify sr ~ re under penalty of law that i have personally examined and am familiar with the information submitted and believe the information is true, accurate. ~',~~ complF _7/_/~ - Date Sig , ure -1- 07/12/2007 UNIFIED PROGRAM INSPECTION CHECKLIST; ~~.____ ~ ~____~_m______z~,. P ~e____________-_ _._~_ ___ SECTION 1: Business Plan and Inventory Program ` ~~ J e_ _e_ a s_ F_ i q __ F/RE ARTM T Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ~:~~ j~s ~7 ,z-, ~-o~ ADDRESS u~5o ~,~r~QN)~- ~~. PHONE NO. ~~~-yI~( NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER ~o(,A-N(J~ L~G26 15-021- p0 ~ ('1~ ..,~~_ Section 1: Sus-mess Plan anc~ lrwentory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION u C V (c=compliance OPERATION V=Violation COMMENTS -// l3 ^ APPROPRIATE PERMIT ON HAND L5V ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS l ~/ ^ CORRECT OCCUPANCY - / L7 ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES L"f ^ VERIFICATION OF LOCATION l~ ^ PROPER SEGREGATION OF MATERIAL (~ U Cry-" ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ,_, / L4~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ,.,,/ L4' ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES f~JO ner-outs QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~ - .~~ 3~ Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # s Site / esp s e arty (Ple a Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05