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Home My WebLink AboutBUSINESS PLAN'~ ii I{ ~, WALGREEN'S #3222 i _ __ C ~, 40 CHESTER AVENUE If -- - ---- - - - - -- _ ~~LI -, - - i ~_ :-~~ WAI;GREENS 3 2 2 2 Manager MICHAEL HART Location: 40 CHESTER AVE City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: I°1b~° SiteID: 015-021-001854 BusPhone: (661) 631-2810 Map 103 CommHaz Low Grid: 31C FacUnits: 1 AOV: SIC Code: 5912 ~ "Z3g~ DunnBrad:93-103-6651 Emergency Contact / Title Emergency Contact / Title MICHAEL HART / STORE MANAGER AGNES MACAPAGAL / DIST PHOTO SUPR Business Phone: (661) 631-2810x Business Phone: (559) 307-7100x 24-Hour Phone (661) 340-3376x 24-Hour Phone (559) 307-7100x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth. Contact C~ii~-i~'i'I~.3-A E~H3~'rP~E~T'~r3~'~3 ~f~ Q 1-av ~. r''`F'~''~ ~ Y fit' Phone : (ov ioo -FS'7Gv '~1-4-37~'SX" MailAddr : 2-0~6-~3~M ~ jab5 /3's~'av. ~ State : ~- ~ City BE~`R~'3~D'CGw(S~i~' Zip -fs6.03~ ~'7ST0~ Owner WALGREENS CORP Phone: (847) 914 221~~Q Address 200 WILMOT RD MS2171 State: IL City DEERFIELD Zip 60015 Period to TotalASTs: = Gal Preparers TotalUSTs: _ ,Gal Certif ~ d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT TM~ Tn eT r'S~.'hs. *i ~ Y ~~ ; ry~v l E~~~sed on my inquiry of those indiv+duals ~IY I`® IVI~~ ~ ~ ~4~~ resr~onrsl~le for sabiGining the information, I certify ersonally ve I h p a under panalty of law that d am familiar with the information examined an submitted and believe the information is true, accurate, and complete. rY1~ ,,0...,aL.~..~ 3_ ~ 7 Signature Date -1- 02/20/2007 F WALGREENS 3222 ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-001854 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpeCHaz EPA Hazards Frm DailyMax Unit MCP CHLORODIFLUOROMETHANE G 258.00 FT3 Low HELIUM F P IH G 220.00 FT3 Min --WAS ~-~X~R ~~~ R L 9 0. 0 0 GAL Min -2- 02/20/2007 _3_ 02f20f2007 F WALGREENS 3222 SiteID: 015-021-001854 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CHLORODIFLUOROMETHANE Days On Site REFRIGERANT (R-22) 365 Location within this Facility Unit Map: Grid: RETAIL SALES FLR REF SYS ~ ~-S j(~ CAS# 75-45-6 ~GdSATE TYPE ~''~ PRESSURE TEMPERATURE CONTAINER TYPE TMixture I Above Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Co258100rFT3 Daily 258100m FT3 I Daily 258r00e FT3 riHGFit'C1JVUb l..Vl°lYV1VL'1V1S owt. Rs cAS# 100.00 Chlorodifluoromethane No 75456 ri1~GFiK11 HJJL".5JLv1~1V15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit RETAIL SALES FLR STATE TYPE PRESSURE _ Gas TPure -Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: C._(Q CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 220.00 FT3 220.00 FT3 220.00 FT3 t1AGEjtC1JVUJ 1:V1~lYV1Vl~,1V1J %Wt. RS CAS# 100.00 Helium No 7440597 rit,atalcl.~ t~~ ar.~al~l~lvt~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 02/20/2007 F WALGREENS 3222 SiteID: 015-021-001854 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE FIXER ' D,~' i Days On Site 365 Location within this Facility Unit Map: Grid: PHOTO LAB CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 90.00 GAL 45.00 GAL HAZARDOUS COMPONENTS °sWt. RS CAS# Silver No 7440224 riHGHKL HJ w7~.7~1~1L"1V1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -5- 02/20/2007 ~ F WALGREENS 3222 SiteID: 015-021-001854 ~ Fast Format ~ _~ Notif./Evacuation/Medical_ Overall Site ~ ~ Agency Notification 02/23/1998 ~ CALL 911 AND NOTIFY LOCAL FIRE DEPT OF ANY HAZARDOUS MATERIAL PROBLEMS. GET ALL PERSONS OUT OF THE BLDG BY CHECKING ALL POSSIBLE LOCATIONS TO BEING PRESENT DURING A PROBLEM. Employee Notif./Evacuation 02/23/1998 WE WILL USE OUR PA SYSTEM TO ALERT ALL PERSONS IN THE STORE TO LEAVE. CHECK ALL POSSIBLE LOCATIONS SO EVERYONE IS OUT. Public Notif./Evacuation 02/23/1998 WE WILL USE OUR PA SYSTEM TO ALERT ALL PERSONS IN THE STORE TO LEAVE. CHECK ALL POSSIBLE LOCATIONS SO EVERYONE IS OUT OF THE BLDG. Emergency Medical Plan 02/23/1998 WE HAVE A FIRST AID KIT THAT WE CAN USE IN CASE OF AN EMERGENCY. WE WILL CALL 911 AND GET INSTRUCTIONS BEFORE THE FIRE DEPT IS ON SCENE. -6- 02/20/2007 r F WALGREENS 3222. SiteID: 015-021-001854 ~ Fast Format ~ ~ Mi.tigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 02/23/1998 ~ WE TRAIN ALL EMPLOYEES ON THE PROPER WAY TO HANDLE HAZARDOUS MATERIALS. WE ALSO REINFORCE BY REPEATING THE READING OF THE BOOKLETS ONE TIME PER YEAR AND RETAKE THE WRITTEN TEST. Release Containment 02/23/1998 WE WILL CALL THE FIRE DEPT FIRST ON ANY HAZARDOUS MATERIAL WE MUST RELEASE. Clean Up 04/19/2006 FOR MOST CLEAN-UP IT WILL MEAN TO MOP UP SPILL THEN RINSE WITH WATER. Other Resource Activation -7- 02/20/2007 F WALGREENS 3222 SiteID: 015-021-001854 ~ Fast Format ~ ~ Site Emergency Factors- Overall Site ~ a7~JC ~.1Q1 nCl~al ua7 Utility Shut-Offs 04/19/2006 A) GAS - BACK OF STORE BY RESTROOMS B) ELECTRICAL - PANELS BY OFFICE C) WATER - SHUT-OFF VALVE BACK OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - SW CRNR & NW CRNR OF BLDG OUTSIDE. 01/12/2007 Building Occupancy Level 03/08/2006 19 EMPLOYEES -8- 02/20/2007 F WALGREENS 3222 SiteID: 015-021-001854 Fast Format Training.. _ __ Overall Site ~ Employee Training 03/08/2006 BRIEF SUNIMARY OF TRAINING PROGRAM: ALL EMPLOYEES READ A TRAINING MANUAL AND ARE TESTED ON STORING AND MANAGING HAZARDOUS MATERIALS. ALL MANAGEMENT STAFF MEMBERS AND RECEIVING STAFF READS A MANUAL ON TRANSPORTING HAZARDOUS MATERIALS AND ARE TESTED. ALL MANAGEMENT STAFF READS A MANAGEMENT VERSION AND AGAIN ARE TESTED ON TRANSPORTING HAZARDOUS MATERIALS. 9 rayc c. Held for Future Use Held for Future Use -9- 02/20/2007 ALIFORNIA ANNETATED SITE MAP (BUSINESS NAME WALGREENS #3222 1 2 3 4 5 6 __. _ ..._~__ ._ _ _. ~...~ ~ _._~__A_92. ? .__._~___ _.... .`.__.~_ __...._ ~._ ... ._ ___. ... ~._ _.. FrNIIG _ II~.. ___._. ww -~- NFG OHH _ _ LPG_. _ ~ ~ YRR _ _ _ : OHH }° A B C D E (SITE ADDRESS~40 CHESTER AVE. BAKERSFIELD, CA 93301 F G H Map #.1 ~F 2 I O ELECTRIC MAIN OG GAS MAIN O RATER MAIN FIRST AID g-22 REFRIGERANT COMPRESSED GAS O CYLINDERS (satttra) Y X -~ ALIFORNIA ANN^TATED SITE MAP BUSINESS NAMES WALGREENS #3222 SITE ADDRESS~40 CHESTER AVE. BAKERSFIELD, CA 93301 Map #~2 ^F 2 2 3 4 5 6 ,, 7 A B C D E F G H I SAFE REFUGE AREA ® STORM DRAIN ~..i FIRE HYDRANT Y X -~ ,~~-, j' Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST A a. 'ERs,, ,~:. ,, 9ooTruxtun Ave., suite 210 FIRE Bakersfield, CA 93301 SECTLON 1.: Business Plan and Inventory Program. ~ ",~~ T Tel.: (661) 326-3979 • - .. ~ - - "` N~ax: (b61 J is /G-L 1 ~ 1 FACILITY NAME ~~~ ~ ~~/YS ~ ~ INSPECTION DATE '~/ ~~ INS/PE~CjTjIO~N TIME L VO/ ADDRESS PHONE NO. NO OF EMPLOYEES FACILITY CONTACT - B SINESS ID NUMBER 15-021- eol P'.S `f ~/~ GyG' ~~~'x ..Section 1: Business Plan and Lnventory Program I" ~~D ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS - / ^ C~ APPROPRIATE PERMIT ON HAND l~ ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY 1 ~~~ S ~ [~ 1~ Q~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES --// L~l ^ VERIFICATION OF LOCATION L'7 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~ y y~ 1".LJ ~ /' L~ ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ln~ ~ Ti 4 ~ ~~. v ~-C~~~° ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUSO~/W,A/S~TE ON SITE,?~ EXPLAIN: /r~'V r~~~ ' ~ ^ NO TIN? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # White -Prevention Services Yellovi =Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 HAZARDOUS MATERIALS MANAGEMENT PLAN (UNIFIED PROGRAM CONSOLlDiATED FORbq APPLICATION Bl1$N~S OVN~t/OPBiATiORDB~t1Fif.A110N POFZIIA (HAZARDOUS MAATERWLS FACILITY INFORMATION) D ~-~~r ~irr BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Suite 210 Bakers5eld, CA 9330] Tel.: (661) 326-3979 Fax: (661)852-2171 Page 1 of 2 ~~s~ L .FACILITY IDENTIFICATION FACILnY1DN0. t 02/18eQ_ut!ti06 tao ~~~ ~ _ 0215 ~~,~ tot s BUSINESS NAME (Same as FACILITY NAME or DBA- Ooinp Btdnew As) BUSINESS PHONE taz algreens#3222 661-631-2810 srTE ADDRESS tp, 0 Chester Avenue akersfield tw CA 3301 ,os 9~~~~~`B~1~TREET ~ a~~i#E5912, 7384 107 Kemp t~ PERATOR E V~algreens corporation too OPERATOR HONE 847-914-3853 tto ~. ;:: . ... .. .. IL:OWNERINFORMATION OWNER NAME ttt OWNER PHONE ttz Walgreens Corporation 847-914-3853 OWNER MAILING ADDRESS tt3 200 Wilmot Road CnY to STATE tts IP tta Deerfield IL 60015 III. EN7,/IRONMENTAL CONTACT CONTACT NAME Intl (AmP~~an~ tt7 CONTACT PHONE tte Christina Chiappetta, Safety & 1 Supervisor, MS 2171 847-914-3195 CONTACT MAILING ADDRESS tte 200 Wilmot Road CITY tao STATE ut ZlP to Dee~eld IL 60015 - PRIMARY Iv. EMeRGENCY coN Tacrs -SECONDARY- NAME 123 NAME 128 Michael Hart gees Macapagal ~ TITLE 124 Tn'LE 129 Store Manager District Photo Supervisor BUSINESS PHONE 725 BUSINESS PHONE 130 661-631-2810 559-307-7100 O 24-HOUR PHONE 126 24HOUR PHONE ' 131 661-340-3376 ~ 559-307-7100 PAGER NO. 127 PAGER NO. 132 N/A N/A 133 . .. - .. , v ,. ..V. CERTIFICATION 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 in this inventory and believe the information is We, accurate, and complete. SIGNATURE OF SIGNER 136 DATE 734 ~;f1'~rp~AA~414~;~~i~d~~Ralgreens 1~ (9867~31~OL Corporation NAME OF OWNER/OPERATOR (SDIGNATU E RINT) 137 TRLE OF OWNERlOPERATOR 138 Dean Jarrett Divisional Merchandise Manager FD 2142 (Rev. Q9/05j 'rv :T. + WALGREENS 3222 ______________________________________ SiteID: 015-021-001854 + Manager MICHAEL HART BusPhone: (661) 631-2810 Location: 40 CHESTER AVE Map 103 CommHaz Moderate City BAKERSFIELD Grid: 31C FacUnits: 1 AOV: CommCode: BFD STA 06 SIC Code:5912 EPA Numb: DunnBrad: +______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Title MIKE HART / STORE MANAGER AGNES MACAPAGAL / DIST PHOTO SUPR Business Phone: (661) 631-2810x Business Phone: (559) 307-7100x 24-Hour Phone (661) 340-3376x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact CHRISTINA CHIAPPETTA Phone: (847) 914-3195x MailAddr: 200 WILMOT RD State: IL City DEERFIELD Zip 60015 Owner WALGREENS CORP Phone: (847) 914-3853x Address 200 WILMOT RD State: IL City DEERFIELD Zip 60015 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ENS Ap ~~9~0 06 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, acc rate, and complete. ~-~~~~ Signature Date -1- 03/08/2006 0~-2~-n~ ()~~ ~ ~; RCVD BUSINESS ACTIVITIES KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT 2711U M STREET, 5U[TE 300 Unified Program Consolidated Form (l1pCF) BAKERSFIELD, CA 93301 FACILITY INFORMATION 661 862-8700 Fax 661 862-8701 Pa elofs I. FACILITY IDENTIFICATION FACILITY ID # ~ I EPA ID # (Hazardous Waste Only) 2 TBD BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) ~ 3 Walgreens # 3222 II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (KC Form 2730). Does our facilit .. If Yes, lease com lete these a es of the UPCF.... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 HAZARDOUS MATERIALS INVENTORY - gallons for liquids, 500 pounds for solids, or 200 cubic feet for CHEMICAL DESCRIPTION txc Form 2731) compressed gases (include liquids in ASTs and USTs); or the ®yES ^ NO 4 CONSOLIDATED CONTINGENCY PLAN applicable Federal threshold quantity for an extremely hazardous (KC Form 2733) substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological matcrials in quantities for which an emergency plan is SITE MAP (KC Form273a) required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTS) UST FACILITY (KC Form A) 1. Own or operate underground storage tanks? ^YES ®NO 5 UST TANK (one page pcr tank) (KC Fom, n) 2. Intend to upgrade existing or install new USTS? ^YES ®NO 6 UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (KC Form C) 3. Need t0 report closing a UST? ^YES ® NO 7 UST TANK (clns~reportion-oncpagepertank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above a total capacity for the facility of greater than 1,320 gallons? ^YES ®NO 8 NO FORM REQUIRED TO KCEHSD D. HAZARDOUS WASTE 1. Generate hazardous waste? ®YES ^ NO 9 EPA ID NUMBER -provide at the top of this page WASTE GENERATOR FORM (KC Form 2736) 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC 25143.2)? ^YES ®NO 10 RECYCLABLE MATERIALS REPORT (one per recyder) (KC Form 2732) 3. Treat hazardous waste on site'? ^YES ®NO 11 ONSITE HAZARDOUS WASTE 1 6 ~oo^ b TREATMENT- FACILITY (KC Form 1772f) Q 0.'~'11 ~A" 1' ONSITE HAZARDOUS WASTE E ,~D V TREATMENT -UNIT (one page per unit) (KC Form 1772u) 4. Treatment subject to financial assurance requirements (for ^YES ®NO 12 CERT[F[CA"I'(ON OF FINANCIAL Permit by Rule and Conditional Authorization)? ASSURANCE (KC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ^YES ®NO 13 REMOTE WASTE /CONSOLIDATION SITE ANNUAL NOTIFICATION (KC Form 1196) 6. Need to report the closure/removal of a tank that was classified as ' ^yES ®NO 14 HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite ? CERTIFICATION (KC Form t2a9) E. LOCAL REOUfREMENTS is Have Regulated Substances (RS) stored on site at greater than the threshold REGULATED SUBSTANCES quantities established by the California Accidental Release Program ^YES ®NO 15 REGISTRATION (KC Form 2736) (Cal ARP)? A RS is any substance listed in Section 2770.5 of CCR Title 19, Division 2, Chapter 4.5. RISK MANAGEMENT PLAN (when required) BUSINESS OWNER/OPERATOR IDENTIFICATION KERN COUNTY ENVIRONMENTAL HEALTH SN:KVIC;ES UEPAK"1'Mk:N'1' 2700 M STREET, SUITE 300 Unified Program Consolidated Form (UPCF) BAKERSFIELD, CA 93301 FACILITY INFORMATION 661 862-8700 Fax 661 862-8701 ® NEW BUSINESS ^ OUT OF BUSINESS ^ REVISE/UPDATE (EFFECTIVE / / ) Page? of S I. IDENTIFICATION FACILITY [D# I BEGINNING DATE 100 ENDING DATE 101 8/3/05 8/3/06 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE 102 Walgreens # 3222 (661) 631-2810 BUSINESS SITE ADDRESS Io3 40 Chester Avenue CITY 104 ZiP CODE los C`~ Bakersfield 93301 DUN & BRADSTREET 106 SIC CODE (4 digit #) 107 93-103-6651 5912 COUNTY 108 Kern Count BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PFIONE 110 Walgreens Corporate (847) 914-3853 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 1 ~= Walgreens Corporation (847) 914-3853 OWNER MAILING ADDRESS 113 200 Wilmot Road CITY 114 STATE I is ZIP CODE 116 Deerfield IL 60015 III. ENVIRONMENTAL CONTACT CON"CAGY NAME 117 CONTACT PHONE lls Walgreens Corporation (847 914-3195 CONTACT MAILING ADDRESS 119 200 Wilmot Road , MS # 2171 CITY 12° STATE 121 ZIP CODE 122 Deerfield IL 60015 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME ~''8 Manuel Garcia Kimberly Jantz TITLE 124 TITLE lz9 Store Manager Photo Su ervisor BUSINESS PHONE t25 BUSINESS PHONE 130 (661)631-2810 (714)225-0674 24-HOUR PHONE 126 24-HOUR PHONE 13t (661)213-7940 (714)225-0674 PAGER # 127 PAGER # 132 N/A N/A ADllIT[ONAL LOCALLY COLLECTED INFORMATION: 133 APN: 0 1 0_ 3 1 2_ 1 7_ 1 Environmental Contact E-Mail Address: Christina.chiappetta@walgreens.com 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. SIGNATURE OF O WNER/OPERATOR OR DESIGNA ED E RESENT TIVE DA E 34 ~~'°~ NAME OF DOCUMENT PREPARER I35 • Eli Fonseca - 3E Company Regulatory NAME OF SIGNER (print) 136 TITLE OF SIGNER 137 Dean Jarret Divisional Merchandise Manager HAZARDOUS MATERIALS INVENTORY - c~Micat, nESCxirTroN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (U PCF) 2700 M STREET, S[JITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862-8700 FaX 661 862-8701 (one page per material per building ur area) ®ADD ^ DELETE ^ REV 1SE 20o Page _ of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or llBA-Doing Business As) 3 Walgreens # 3222 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2 Photo Lab ^ ves ®No t MAP# (optional) 203 GRID# (optional) ''-oa FACILITY ID # ~ 1 F-7 II. CHEMICAL INFORMATION CHEMICAL NAME zos TRADE SECRET ^ Yes No ''-ob If Subject to EPCRA, refer to inswctiuns COMMON NAME zoz zos EHS• ^ Yes ®No Spent Photo Solutions Containing Silver CAS# 209 'If EHS if "Yes', all amounts below must be in pounds FIRE CODE HAZARD CLASSES (Notcurrrntlyrequiredby KCHHSD) 210 IRR HAZARDOUS MATERIAL TYPE (Check one itentonly) ^ a. PURE ^ b. MIXTURE ®c. WASTE 211 RADIOACTIVE ^ Yes ®No 212 CURIES -13 PHYSICAL STATE eta (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS LARGEST CONTAINER 30 2t5 FED HAZARD CATEGORIES ne (Check all that apply) ^ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE $f d. ACUTE HEALTH ^ e. CHRONIC HEALTH AVERAGE DAILY AMOUNT zt7 MAXIMUM DAILY AMOUNT zia ANNUAL WASTE AMOUNT z19 STATE WASTE CODE 2zo 45 90 360 541 z2I DAYS ON SITE: -''-z UNITS* ®a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS Check one item onl " If EHS, amount must be in ands. 365 S"FORAGE CONTAINER ^ a. ABOVE GROUND TANK ® e. PLASTIC/NONME"fALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTH ER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # ~ 1 zze zz7 ^ Yes ^ No zza ~ zz9 2 230 231 ^ Yes ^ NO 232 233 j 234 235 [] Yes ^ NO 236 237 4 23s 239 ^ Yes ^ No zoo zat 5 zoz za3 ^ Yes ^ No zaa zas If more hazardous components are present at greater than t% by weight if non-carcinogenic or O.l % by weight if carclnogeniq attach additional shttts of paper capturing the requ(red information. AUDITIUNAL LOCALLY COLLECTED INFORMATION zae If EPCRA Please Si Isere HAZARDOUS MATERIALS INVENTORY - cHElvucAt, vESCx><rTloN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (U PCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862-8700 Fax 661 862-8701 (one page per rtuterial per building or area) ®ADD ^ DELETE ^ REV ISE zoo Page - of _ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 Walgreens # 3222 CHEMICAL LOCATION 20l CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2 Retail Sales Floor (In Refrigeration System) ^ YES ® NO 1 MAP# (optional) 203 GRID# (optional) 204 FACILITY [D # ~ 1 F-5 II. CHEMICAL INFORMATION CHEMICAL NAME ''-os TRADE SECRET ^ Yes No V06 Chlorodifluoromethane ICSubject to EPCRA, refer to iretructions COMMON NAME zoz zos EHS" ^ Yes ®No Refrigerant (R-22) CAS# 209 'lf EHS iC"Yes", all amounts below must be in pounds 75-45-6 FIRE CODE HAZARD CLASSES (Not currently required by KCEHSU) 210 NFG, OHH, IRR HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^ b. MIXTURE ^ c. WASTE 21 I RADIOACTIVE ^ Yes ®No 212 CURIES -13 PHYSICAL STATE (Check one item only) ^ a. SOLID ^ b. LIQUID ®c. GAS 21a LARGEST CONTAINER 396 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE $~ c. PRESSURE RELEASE $~ d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE z2o 396 396 0 N/A 2z1 DAYS ON SITE: -'22 UNITS' ^ a. GALLONS ®b. CUBIC FEET ^ c. POUNDS ^ d. TONS Check one item onl ' If EHS, amount must be in ands. 365 STORAG E CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ® r. OTH ER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN In Refrigeration Sy stem ^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ^ a. AMBIENT ®b. ABOVE AMBIENT ^ c. BELOW AMBIENT z2a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I zzb zn ^ Yes ^ No 2za 2z9 2 230 231 ^ Yes ^ NO 232 233 j 234 235 ^ Yes ^ NO 236 237 Q z3g 239 ^ Yes ^ NO 240 241 5 zoz 7A3 ^ Yes ^ No 2aa gas If more hazardous components are present at greater than 1 % by weight if non-careinageniu or 0.1 % by weight It carcinogenic, attach additional sheets o(paper capturing the requ[red information. ADDITIONAL LOCALLY COLLECTED INFORMATION zab If EPCRA Please Si Here HAZARDOUS MATERIALS INVENTORY - cHElvucai, vESCRirTioN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unif-ed Program Consolidated Form (U PCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862-8701) FaX 661 862-8701 (one page per mtterial prr building ur area) ®ADD ^ DELETE ^ REV 1SE 2W Page - of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3 Walgreens # 3222 CHEMICAL LOCATION tot CHEMICAL LOCATION CONFIDENTIAL EPCRA 207 Retail Sales Floor ^ YES ® NO I MAP# (optional) 203 GRID# (optionaq 2oa FACILITY ID # ~ ~ 1 E-2 II. CHEMICAL INFORMATION CHEMICAL NAME ''-05 TRADE SECRET Yes No zoe Helium If Subject to EPCR4, refer to instructions COMMON NAME zo7 zos EHS" ^ Yes ®No Helium CA$# 209 'If EHS if"Yes', all amounts below must be in pounds 7440-59-7 FIRE CODE HAZARD CLASSES (Not currently required by KCEHSD) 210 NFG,OHH HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^ b. MIXTURE ^ c. WASTE 21 t RADIOACTIVE ^ Yes ®No 2t2 CURIES .i3 PHYSICAL STATE 2t4 (Check one item only) ^ a. SOLID ^ b. LIQUID ®c. GAS LARGEST CONTAINER 220 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE $f c. PRESSURE RELEASE $~ d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT zI9 STATE WASTE CODE '--° 220 220 0 N/A zzI DAYS ON SITE: zz2 UNITS' ^ a. GALLONS ®b. CUBIC FEET ^ c. POUNDS ^ d. TONS Check one item onl * If EHS, amount must be in ands. 365 STORAGE CONTAINER ^ a. ABOVE GRUUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f CAN ^ j. HAG ^ n. PLASTIC BOTTLE ^ r. OTH ER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ® 1. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ^ a. AMBIENT ®b. ABOVE AMBIENT ^ c. BELOW AMBIENT z2a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 2zs %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I zze zz7 ^ Yes ^ No zza zz9 2 230 231 ^ Yes ^ No 232 233 j 234 235 ^ Yes ^ NO 236 237 4 23s 239 ^ Yes ^ No 2ao eat 5 zaz za3 ^ Yes ^ No zaa zas If more hazardous components are present at greater than 1% by weight if noo-carcinogenic, or 0.1°/. by weight if carcinogenic, attach additional sheets of paper capturing the required information. AUDPCIONAL LOCALLY COLLECTED INFORMATION zae If EPCRA Please Si Here CONSOLIDATED CONTINGENCY PLAN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Form 2700 M STREET, SUITE 300 COVER PAGE BAKERSFIELD, CA 93301 661 862-8700 Fax 661)862-8701 Pa a of 1 I. FACILITY IDENTIFICATION FACILITY ID # i ~ EPA ID # (Hazardous Waste Only) z BUSINESS NAME (Same as Facility Name of DBA Domg Business As) 3 Walgreens # 3222 The Consolidated Contingency Plan provides businesses a format to comply with the emergency planning requirements of the following two written hazardous materials emergency response plans required in California: 4 4 Hazardous Materials Business Plan (HSC Chapter 6.95 Section 25504 (b) and 19 CCR Sections 2729-2732), 4 Hazardous Waste Generator Contingency Plan (22 CCR Section 66264.52), and, This format is designed to reduce duplication in the preparation and use of emergency response plans at the same facility, and to improve the coordination between facility response personnel and local, state and federal emergency responders during an emergency. A copy of the plan shall be submitted to-this Department and at least one copy of the plan shall be maintained at the facility for use in the event of an emergency and for inspection by the local agency. Describe below where a copy of your Contingency Plan, including the hazardous material inventories, Training Records, and Site Map(s), are located at your business: Manager's Office PLAN CERTIFICATION 1 certify under penalty of law that I have personally examined and I am familiar with the information provided by this plan and to the best of my knowledge the information is accurate, complete, and true. Printed Name of Owner/ Operator Title of Owner/Operator Dean Jarret Divisional Merchandise Manager Signature of Owner/ Operator Date ~ Z-~ -i b We appreciate the effort of local businesses in completing these plans and are available to assist in any manner. If you have any questions, please contact this Department at (661) 862-8700. ADVISORY The site-specific Contingency Plan is the facility's plan for handling emergencies and shall be implemented immediately whenever there is a fire, explosion, or release of hazardous materials or waste that could threaten human health and/or the environment. The contingency plan shall be reviewed, and immediately amended,. if necessary, whenever: 4 The plan fails in an emergency 4 The facility changes in its design, construction, operation, maintenance, or other circumstances in a way that materially increases the potential for fires, explosions, or releases of hazardous waste or hazardous waste constituents, or changes the response necessary in an emergency 4 List of emergency coordinators changes 4 List of emergency equipment changes Submit a copy of any updates or changes to this Department. II. EMERGE NCY CONTACTS PRIMARY SECONDARY NAME 123 NAME 128 Manuel Garcia Kimberly Jantz TITLE 124 TITLE 129 Store Manager Photo Su ervisor BUSINESS PHONE 125 BUSINESS PHONE 130 (661)631-2810 (661)631-2810 24-HOUR PHONE 126 24-HOUR PHONE 131 (661)213-7940 (714)225-0674 PAGER # 127 PAGER # 132 N/A N/A II1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. Notifications ° Your business is required by State Law to provide an immediate verbal report of any release or threatened release of a hazardous material to local fire emergency response personnel, this Department, and the Office of Emergency Services. If you have a release or threatened release of hazardous materials, immediately call: FIRE/PARAMEDICS/POLICE/SHERIFF PHONE: 911 AFTER the local emergency response personnel are notified, you shall then notify this Department and the Office of Emergency Services. Kern County Environmental Health Department: (661) 862-8700 or after hours, call Dispatch at (661) 861-2521 State Office of Emergency Service: (800) 852-7550 or (916) 262-1621 National Response Center: (800) 424-8802 Information to be provided during Notification: d Your Name and the Telephone Number from where you are calling. d Exact address of the release or threatened release. d Date, time, cause, and type of incident (e.g. fire, air release, spill etc.) d Material and quantity of the release, to the extent known. d Current condition of the facility. d Extent of injuries, if any. d Possible hazards to public health and/ or the environment outside of the facility. B. Emer enc Medical Facilit 'i List the closest emergency medical facility that will be used by your business in the event of an accident of injury caused b a release or threatened release of a hazardous material ~ HOSPITAL/CLINIC: PHONE NO: Mercy Southwest Medical Center 661 663-0977 ADDRESS: 500 Old River Rd Ste 125 CITY: ZIP CODE: Bakersfield 93311-9509 C. Private Emer enc Res onse DOES YOUR BUSINESS HAVE A PRIVATE ON-SITE EMERGENCY RESPONSE TEAM? ^ Yes ®No If yes, provide an attachment that describes what policies and procedures your business will follow to notify your on-site emer enc res onse team in the event of a release or threatened release of hazardous materials. CLEANUPlDISPOSAL CONTRACTOR List the contractor that will provide cleanup services in the event of a release. NAME OF CONTRACTOR: PHONE NO: Waste contractors will be dispatched by Walgreens Corporate. - - ADDRESS: CITY: ZIP CODE: D. Arran ements with Emer enc Res onders If you have made special (i.e. contractual) arrangements with any police department, fire department, hospital, contractor, or State or local emergency response team to coordinate emergency services, describe those arrangements in the space below: No special arrangements have been made with local agencies. E. Evacuation Plan 1. The following alarm signal(s) will be used to begin evacuation of the facility (check a!I which apply): ®Verbal ®Telephone (including cellular) ^ Alarm System ®Public Address System ^ Intercom ^ Pagers ^. Portable Radio ^ Other (specify): 2. ®Evacuation map is prominently displayed throughout the facility. 3. ®Name of individual(s) responsible for coordinating evacuation including spreading the alarm and confirming the business has been evacuated: Store Manager F. Earth uake Vulnerabifit Identify areas of the facility where releases could occur or would require immediate inspection or isolation because of the vulnerability to earthquake related ground motion. ® Hazardous Waste/ Hazardous Materials Storage Areas ^ Production Floor ^ Process Lines ^ Bench/ Lab ^ Waste Treatment ® Other: Sales Floor Identify mechanical systems where releases could occur or would require immediate inspection or isolation because of the vulnerability to earthquake related ground motion. ® Utilities ^ Sprinkler Systems ^ Cabinets ® Shelves ® Racks ^ Pressure Vessels ® Gas Cylinders ^ Tanks ^ Process Piping ® Shutoff Valves ^ Other: G. Emer enc Procedures Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials/wastes: 1. PREVENTION (prevent the spill/release) -Consider the types of spills/releases associated with the hazardous materials/wastes present at your facility. What actions does your business take to prevent these spills/releases from occurrin ?You ma include a discussion of safet and stora a rocedures. In order to prevent a release from occurring all hazardous materials are kept in their original containers and store personnel visually inspect products on a daily basis. 2. MITIGATION (stop the release/spill) -Describe what actions are taken to reduce the harm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate res onse to a leak, s ill, fire, ex losion, or airborne release at our business? In the event of a spill, all products will be cleaned up using in-house equipment (e.g. Absorbents, Brooms, Gloves, etc.). Products are disposed of according to state and federal regulations. If it is safe to do so employees will attempt to extinguish fires with fire extinguishers in the facility. The manager on duty will be responsible for contacting 9-1-1 if the fire is uncontainable or out of control. 3. ABATEMENT (clean up the spill/release) -Describe what you would do to clean up the spill/release. How do you handle the com fete rocess of cleanin u and dis osin of released materials at our facilit ? In the event of a spill, all products will be cleaned up using in-house equipment (e.g. Absorbents, Brooms, Gloves, etc.). Products are disposed of according to state and federal regulations. IV. Emergency Equipment '~ 22 CCR, Section 66265.52(e) [as referenced by Section 66262.34(a)(3)] requires that emergency equipment at the facility be listed. Completion of the following Emergency Equipment Inventory Table meets this requirement. EMERGENCY EQUIPMENT INVENTOR Y TABLE 1. Equipment Cate or 2. Equipment T e 3. Location 4. Descri tion* Personal ^ Cartridge Respirators Protective, ^Chemical Monitoring Equipment (describe) Equipment, ^ Chemical Protective Aprons/Coats Safety ^ Chemical Protective Boots Equipment, ®Chemicat Protective Gloves 1 Hour Photo Rubber and ^ Chemical Protective Suits (describe) First Aid ^Face Shields Equipment ®First Aid Kits/Stations (describe) O££ceBreakRoom Basic First Aid Supplies ^ Hard Hats ^Plumbed Eye Wash Stations ® Portable Eye Wash Kits (i.e. bottle e) 1 Hour Photo Bottle Type ^ Respirator Cartridges (describe) ^ Safe Glasses/Splash Goggles ^ Safety Showers ^ Self-Contained Breathing Apparatuses (SCBA) ^ Other (describe) Fire ®Automatic Fire S tinkler S stems Throughout Alarms Extinguishing ^ Fire Alarm Boxes/Stations Systems ® Fire Extinguisher Systems (describe) Throughout ABC rated ^ Other (describe) Spill ®Absorbents (describe) 1 Hour Photo Rags COntr01 ^ Berms/Dikes (describe) Equipment ^DecontaminationEqui ment(describe) and ^ Emergent Tanks (describe) Decontamination ^ Exhaust Hoods Equipment ^ Gas C tinders Leak Repair Kits (describe) ^ Neutralizers (describe) ^ Overpack Drums ^ Sum s (describe) ^ Other (describe) Communications ^ Chemical Alarms (describe) and ®Intercoms/ PAS stems Throughout Alarm ^ Portable Radios Systems ^ Telephones ^ Under round Tank Leak Detection Monitors ^ Other (describe) Additional Equipment (Use Additional Pages if Needed.) Describe the equipment and its capabilities. If applicable, specify any testing/maintenance proceduresfntervals. Attach additional pages, numbered appropriately, if needed. V. EMPLOYEE TRAINING All facilities which handle hazardous materials must have a current written employee training plan. The items listed below are required per Health and Safety Code Section 25504 (c) and Title 19 Section 2732. Training shall be provided: 4 Initially for all new employees. d Methods for Safe Handling of Hazardous Materials. Note: These training programs may take into consideration the position of each employee. Facility personnel are trained as follows: Q Familiarity with all plans and procedures specified in the Contingency Plan. 4 Methods for Safe Handling of Hazardous Materials. 4 Safety procedures in the event of a release or threatened release of a hazardous material. 4 Use of Emergency Response equipment and supplies under the control of the business. 4 Procedures for Coordination with local Emergenc Response Organizations. Additional training should include: 4 Internal alarm/notification procedures. d Evacuation/re-entry procedures and assembly point locations 4 Material Safety Data Sheet (MSDS) training including specific hazard(s) of each chemical to which em to ees ma be exposed, includin routes of ex osure i. e. inhalation, in estion, absor tion . VI. HAZARDOUS WASTE GENERATOR TRAINING If your business is a hazardous waste generator, you are required to provide training in hazardous waste management for all workers who handle hazardous waste at your site (22 CCR §66265.16). You are also required to document training. The items below are required. EMPLOYEE TRAINING 4 Facility personnel will successfully complete training within six months after the date of their employment or assignment to a facility or to a new position at a facility. 4 Em to ees will not handle hazardous wastes without su envision until trained. TRAINING DOCUMENTATION The owner or operator must maintain the following documents and records at the facility: 4 Job title for each position at the facility that is related to hazardous waste management, and the names of the employee(s) filling the position(s). d Description for each position listed above (must include required skill, education, or other qualifications as well as duties of employees assigned to the position. a Description of type and amount of both introductory and continuing training given to each employee. 4 Records that document that the requirements for training orjob experience have been met. 4 Current employees' training records (to be retained until closure of the facility). 4 Former emplo ees' trainin records (to be retained at least three ears after termination of emplo ment . HAZARDOUS WASTE GENERATOR KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Form 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 661 862-8700 Fax 661 862-8701 Pa e 1 of 1 I. FACILITY INFORMATION FACILITY ID # _ ~ EPA ID # (Hazardous Waste Only) TBD BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) s Walgreens # 3222 # OF EMPLOYEES A 30 II. TYPE OF GENERATOR PLEASE CHECK THE BOX THAT APPLIES B RCRA GENERATOR FEDERAL WASTE NON-RCRA GENERATOR CALIFORNIA WASTE ONLY LARGE QUANTITY GENERATOR (>1000 KG HAZARDOUS WASTE PER MONTH ~ - SMALL QUANTITY GENERATOR (>]00 KG BUT <1000 KG HAZARDOUS WASTE PER MONTH) CONDITIONALLY EXEMPT SMALL QUANTITY GENERATOR (<100 KG HAZARDOUS WASTE PER MONTH) ~ ~ III. WASTE STREAM IDENTIFICATION PLEASE COMPLETE THE TABLE BELOW. (SEE INSTRUCTIONS ON THE BACK FOR CODES AND EXPLANATIONS) PROCESS C WASTE DESCRIPTION D WASTE ID E AMOUNT F PER YEAR UNITS G STORAGE H METHOD D15POSAL 1 METHOD Photo Processing Spent Photo Solutions Containing Silver 541 (CA) 360 Gallons C B I certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR NAME ~ Dean Jarret OWNER/OPERATOR TITLE K Divisional Merchandise Manager OWNER/OPERATOR SIGNATU _ DATE L ~,~~_~ `~ / V CALIFORNIA ANNOTATED SITE MAP I BUSINESS NAME: WALGREENS #3222 (SITE ADDRESS BA ERSFIELDA CA I Map #:1 I A B C D E F G H I 1 2 3 4 5 6 f' PHOTO WASTE HELIUM TANK O ELECTRIC MAIN O CAS MAIN O WATER MAIN FIRST AID R-22 REFRIGERANT (R-22) Y X -~ ALIFORNIA ANN^TATED SITE MAP I A B C 2 3 4 5 6 f' BUSINESS NAME: WALGREENS #3222 SITE ADDRESS: 40 CHESTER AVE. Map #:2 BAKERSFIELD, CA D E F G H I NORTH 2 LANE W W ~ W Z ~ ~ Q ~ L EASE ~ PA - ~- BU STER ~ ~ V DEO ~ (Y Q z LL ~ ® P LON PA KING S GN PAR ING .~ CHESTE R AVE UE 1 SCA E. 3E NOT TO SCALE Y X -~ SAFE REFUGE AREA ® STORM DRAIN FIRE HYDRANT ALIFC]RNIA ANNGTATED SITE MAP f A B C 2 3 4 5 6 ~' BUSINESS NAME WALGREENS #3222 D E (SITE ADDRESS 40 CHESTER AVE. BAKERSFIELD, CA F G H Map #:1 I Y X -~ HELIUM TANK O ELECTRIC MAIN O GAS MAIN O WATER MAIN FIRST AID R-22 REFRIGERANT (R-22) HAZARDOUS MATERIALS INVENTORY - c~M1cAL nESCUirTION KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (U PCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKER5FIELD, CA 93301 661 862-8700 Fax 661 862-8701 (one page per rtnterial prr building or area) ^ADD ®DELETE ^ REV 1SE 20U Page _ of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3 Walgreens # 3222 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zoz Photo Lab ^ YES ® No ~ 1 MAP# (optional) 203 GRID# (optionaq '204 FACILITY [D # j 1 F-7 II. CHEMICAL INFORMATION CHEMICAL NAME ''-05 TRADE SECRET ^ Yes ®No zob If Subject to EPCAA, refer to iretructiore COMMON NAME zoo 2os EHS• ^ Yes ®No Spent Photo Solutions Containing Silver CAS# 209 •IfEHS if"Yes", all amounts below must be in pounds FIRE CODE HAZARD CLASSES (Notcurrrntlyrequiredby KCEHSO) zio IRR HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ^ b. MIXTURE ®c. WASTE 211 RADIOACTIVE ^ Yes ®No 212 CURIES -13 PHYSICAL STATE 2I5 (Check One item only) ^ a. SOLID ®b. LLQUID ^ c, GAS Zia LARGEST CONTAINER 30 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE $~ d. ACUTE HEALTH ^ e. CHRONIC HEALTH AVERAGE DAILY AMOUNT z17 MAXIMUM DAILY AMOUNT zla ANNUAL WASTE AMOUNT zl9 STATE WASTE CODE 2'-0 45 90 360 541 z'-1 DAYS ON SITE: -''-z UNITS• ®a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS Check one item onl • If EHS, amount must be in ands. 365 S"FORAGE CONTAINER ^ a. ABOVE GRUUND TANK ® e. PLASTIC/NONME'CALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTH ER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC zz5 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 zzb zz~ ^ Yes ^ No zza zz9 2 230 231 ^ Yes ^ NO 232 233 3 z3a z3s ^ Yes ^ No z36 z3i 4z3s z39 ^ Yes ^ No zao zai 5 zaz za3 ^ Yes ^ No zaa gas If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, ar 0.1% by wetght if carcinogenic attach additional sheets of paper capturing the requ(red information. AUDITIUNAL LOCALLY COLLECTED INFURMAT[ON zab If EPCRA Please Si Here HAZARDOUS WASTE GENERATOR KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Form 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 661) 862-8700 Fax (661 862-8701 Pa e 1 of 1 I. FACILITY INFORMATION FACILITY ID # r _ ~ EPA 1D # (Hazardous Waste Only) TBD BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) S Walgreens # 3222 # OF EMPLOYEES A 30 II. TYPE OF GENERATOR PLEASE CHECK THE BOX THAT APPLIES B RCRA GENERATOR FEDERAL WASTE NON-RCRA GENERATOR CALIFORNIA WASTE ONLY LARGE QUANTITY GENERATOR (>1000 KG HAZARDOUS WASTE PER MONTH ~ ~ SMAL[, QUANTITY GENERATOR (>100 KG BUT <1000 KG HAZARDOUS WASTE PER MONTH) ~ ~ CONDITIONALLY EXEMPT SMALL QUANTITY GENERATOR (<] 00 KG HAZARDOUS WASTE PER MONTH) ~ III. WASTE STREAM IDENTIFICATION PLEASE COMPLETE THE TABLE BELOW. (SEE INSTRUCTIONS ON THE BACK FOR CODES AND EXPLANATIONS) PROCESS C WASTE DESCRIPTION D WASTE ID E AMOUNT F PER YEAR UNITS G STORAGE H METHOD DISPOSAL I METHOD Silver Recovery From Photo Processing 541 (CA) 1 cert~ that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR NAME ~ Dean Jarret OWNER/OPERATOR T[TLE K Divisional Merchandise Manager OWNER/OPERATOR SIGNATURE., L DATE v ~~" ~ J/ v UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan *and Inventory Program • Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: ~661~ 326-3979 _ FACILITY NAME WSPECTION GATE INSPECTION TIME ADDRESS'yLJ~/, /~ /~ f~/f ~}~J/~ PHONE No. No. of Empl ees FACILITYCONTACT usiness ID Number I ,~,~ /~//f!~ ~i~~ 15-021-~/~.J / Section 1: Business Plan and Inventory Program k~outine ^ Combined ^ Joint Agency ^hulti-Agency ^ Complaint ^ Re-inspection C C V \V=Vwlation ~~ OPERATION COMMENTS - / LH' ^ APPROPRIATE PERMIT ON HAND C~@" BUSINESS PLAN CONTACT INFORMATION ACCURATE /,(Q J~~~~ LJ ^ VISIBLE ADDRESS C3 ^ CORRECT OCCUPANCY ^ rL'Y VERIFICATION OF INVENTORY MATERIALS f ~ ~~',~`' _ ~//7/ I~ ~j/~~~ ^ VERIFICATION OF QUANTITIES ~ CeY ^ .VERIFICATION OF LOCATION ~^ PROPER SEGREGATION OF MATERIAL ~/ ^ L~l VERIFICATION OF MSDS AVAILABILITYE _._. -- ~f ~/' L~J ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEOUATE ~ ------- ~ ^ --..--_..._,_._-----------------_.------_.._.....------- -------- ... CONTAINERS PROPERLY LABELED I ... } l~ ^ FIOUSEKEEPING l~^• FIRE PROTECTION ~ <tY ^ SITE DIAGRAM ADEQUATE 8t ON HAND ANY HAZARDOUS WASTE ON SITE?: BYES ^ NO EXPLAIN: /,l/,o~rs~ ~/X ~~ • QUESTI REGARDING THIS INSPECTIO L E CALL US AT ~F)6') ~ 326-3979 Inspector (Please Print) Fire Prevention 1 nlShik of Site White -Environmental Services Yellow -Station Copy ~. Business Site Responsible Pa (Please Print) 8 Pink -Business Copy T ~~ a~ - !,' (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN (uwa<o PF1oGwW OONSOUOAT®FORMi BUSINESS ACTIVITIES PAGE (HAZARDOUS MATERIALS FACILITY INFORMATION) ilJLB.. Elul w~ BA3~ERSFIELD FIRE DEPT. Prevention Services 900 Tnixtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) $52-2171 Page 1 of 1. ~~ 1. FACILITY IDENTIFICATION FACILITY ID # (For Office use only -please Leave blank) 3 EPA ID # N/A DBA /FACILITY NAME ~ algreens #3222 II. ACTIVITIES DECLARATION ~' - . DOES Your Facility ... if Yes, Please Complete ... 12 A. j~)jDOUS MATERIALS • CHEMK:AL DESCRIPTION FORM ~ 1. Have on site (for any purpose) hazardous ®Yes O No • HAZARDOUS MATERIALS MANAGEMENT PLAN materials at or above 55 galons for liquids, • Emergency Response Plan 500 pounds for solids, or 200 cu. fL for O Yes ®No compressed gases (ndude I'iquids in ASTs and ~ ~~ ~ USTs)? • Preven tlon B. REGULATED SUBSTANCES [RS- 1. Have on site RS at greater than the threshold O Yes ®No CHEMICAL DESCRIPTION FORM ~ 31 planning quantities established by the California • RISK MANAGEMENT PLAN (RMP SutxnR to U5EPA) Accidental Release Prevention program • CONSOLIDATED COMPLLANCE PLAN Incorporating CaL4RP Program Elements • (CaIARP)? C. UNDERGROUND STORAGE TANKS (USTs{ 13 1. Own or operate Underground Storage Tanks? ~ Yes IO No • UST FACILITY FORM • UST TANK FORM (One Per Tank) 2. Intend to upgrade existing or install new USTs? ^ Yes ®No • UST FACILfTY FORM 13 • UST TANK FORM (One Per Tank) • D. TANK CLOSURE / t?MOVAL 2. Need to report dosing an UST that 11~ hazardous O Yes ~ No UST TANK FORM (Cbsure sedbn -one per tank) (,e " materials or \ 3. Need to report the closure /removal of a tank that O Yes ®No • UST TANK CLOSURE FORM was classified as hazardous waste and cleaned on- site? E. ABOVEGROUND PETROLEUM STORAGE o TANKS (ASTs{ ^ Yes'® No • HAZARDOUS MATERIALS MANAGEMENT PLAN 1. Own or Operate ASTs above these thresholds; • Incorporating Federal SpiN Preventbn Control and any tank capadty is greater than 660 gallons or the Countermeasure (SPCC) Elements pursuant to 40 CFR 112. total capaaty for the facility is greater than 1,320 F. HAZARDOUS WASTE EPA IDNUMBER - Provide on this page 1. Generate hazardous waste? l3 Yes ®No • To obtain EPA ID Number, please phone (918) 324-1781 2. Recycle more than 100 kg/mo of recyclable ~ Yes I9 No • RECYCLING FORM materials at the same location it was generated? 3. Recycle more than 100 kg/mo of recyclable ~ Yes Id1 No • RECYCLING FORM materials at an off-site location different from the point of generation? 4. Treat Hazardous Waste on site? O Yes ®No • TP FACILITY FORM • TP UNIT FORM (One per uniq 5. Subject t0 Finandal Assurance requirements? ^ Yes ~ No • CERTIFICATION OF FINANCIAL. ASSURANCE 6. Consolidate Hazardous Waste generated at a ~ Yes ®No • REMOTE WASTE l CONSOLIDATION SITE NOTIFICATION FORM remote slt@? NOTE: If you checked YES to any part of Sections l1A - IIF above, then in addition to the fortes requested above, please Submit BUSINESS OWNER/OPERATOR IDENTIFICATION FORM (FD2089) ~ ENY,D ~ ~ t.y ~ ~ ryoo~ FD 2143 (Rev. OSoO~ G' ~ %%~~ (HMMP) ..HAZARDOUS MATERIALS MANAGEMENT PLAN G (UNIFIED PROGRAM CONSOLIOiA'TED FORb~ /~ APPLICATION f3~ESSOVM6Z/OP9iATORDBYrF1rAT10N POI~IIA (HAZARDOUS MATERIALS FACILITY INFORMATION) I-/tt w~ BAKERSFIELD FIRE DEPT. Prevention Services 900 Trtaxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (66I) 326-3979 Fax: (661) 852-2171 Page 1 of 2 L .FACILITY IDENTIFlCATION ~ FACILRY tD NO. t Year 700 02/ 156 Year Ertdi 02/ 15/2007 ~ BUSINESS NAME (Same as FAC~rTY NAME or DBA-Doing Buslrost As) s BUSINESS PHONE tpt algreens #3222 661-631-2810 SREADDRESS toy 0 Chester Avenue ak re sfield t~ CA 3301 ~ 94UMN$B1i/1DSTREET bbb~~ 11 ~ gD~~pj $912, 7384 107 Kern t~ PERATORt~- E Vl~algreens Corporation too OPERATOR HONE 847-914-3853 tto ,. , IL ;OWNER INFORMATION OWNER NAME ttt OWNER PHONE to Walgreens Corporation 847-914-3853 OWNER MAILING ADDRESS tts 200 Wilmot Road CITY 114 STATE tt5 IP tta Deerfield IL 60015 III. ENVIRONMENTAL CONTACT . CONTACT NAME ti7 CONTACT PHONE tta Christina Chiappetta, Safety & Compliance Environmental Supervisor, MS 2171 847-914-3195 CONTACT MAILING ADDRESS tt0 200 Wilmot Road CnY t7o STATE ttt Zlp t7Y Deerfield IL 60015 = PRIMARY Iv. EMERGENCY coN TACrs -SECONDARY- NAME 123 NAME 128 Michael Hart gees Macapagal TRLE 124 TRLE 129 Store Manager District Photo Supervisor BUSINESS PHONE 125 BUSINESS PHONE 130 661-631-2810 559-307-7100 24HOUR PHONE 126 24-HOUR PHONE 131 661-340-3376 559-307-7100 PAGER NO. 127 PAGER N0. 132 N/A N/A t33 r. , __..:. V. CERTIFICATION 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 in this Inventory and believe the information is true, accurate, and complete. SIGNATURE OF 31GNER 136 DATE 134 ~AA~aI{9'!~~i~~~algreens 13s 02/15/2006 Corporation NAME OF OWNERIOPERATOR (SDIG LIRE 8 RINT) 137 TRLE OF OWNERIOPERATOR 1~6 Dean Jarrett Divisional Merchandise Manager FD 2142 (Rev. Q9/05) `!~ BAKERSFIELD FIRE DEPT. (HMMP) '3` Prevention Services ~ ~ HAZARDOUS MATERIALS MANAGEMENT PLAN UNIFIED PROGRAM CONSOL~ATED FORMS tt s r 900 Tl"L17Ct1111 Ave., Ste. 210 ' ~~tt Bakersfield, CA 93301 CHEMICAL DESCRIPTION FORM wrrr ~ Tel.: (661) 326-3979 HAZARDOUS MATERIALS INVENTORY ~ Fax: (661) 852-2171 ^ NEW ^ ADD ^ DELETE ® REVISE 2006 (One form per material, per building, or area.) BUSINESS NAME (Sams as FACILITY NAME or DBA - Ooinp Business As) algreens #3222 CHEMICAL LOCATION 201 CHEMICAL. LOCATION 2 etail Sales Floor (In Refrigeration System) CONFIDENTIAL (EPCRA) ^ Yss ^ FACILITY ID No. 1 MAP No. (optronu) 203 GRID N0. (optkin•r) 1 F-5 CHEMICAL NAME 205 hlorodifluoromethane TRADE SECRET ^ Yea ^ No COMMON NAME 207 EHS' 0 Yes ^ No efrigerant (R-22) CAS No. 75-45-6 FIRE CODE HAZARD CLASSES (Complete it reQuestad by kcal fin Gist) FG, OHH, IRR TYPE ®p PURE ^ m MU(7URE ^ w WASTE PHYSICAL STATE ^ s SOLID ^ I LIOUID & tl GAS FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTNE ®3 PRE (Check all tlmt apply) ANNUAL WASTE 217 MAXIMUM AMOUNT O DAtLYAM0UNT2SH ^ UNRS ^ pa GAL ~ d CU !T ^ ro LI3S ^ to TONS a EHS, amount mud be in Ibs. 209 I 'U EHS is 'Yss; all anwints below must ba In Tbs. 211 I ~i~ CURIES RADIOACTIVE: ^ Yes R No 214 258 SSURE RELEASE ®4 ACUTE HEALTH f9 5 CHRONIC HEALTH 218 AVERAGE DA11Y AMOUNT 2 S S CODE _/A DAYS ON SITE STORAGE CONTAINER Icn.ck •rr tn•r •ppry) ^ a ABOVEGROUND TANK ^ t CAN ^ k BOX ^ p TANK WAGON ^ b UNDERGROUND TANK ^ p CARBOY ^ I CYLINDER ^ Q RAIL CAR In Refrigeration Syste ^ e TANK INSIDE BUILDING ^ h SILO O d STEEL DRUM ^ i FIBER DRUM ^ n PLASTIC BOTTLE ^ e PLASTICMONMETALLIC DRUM ^ j BAG ^ o TOTE BIN STORAGE PRESSURE ^ a AMBIENT » as ABOVE AMBIENT ^ ba BELOW AMBIENT STORAGE TEMPERATURE ® a AMBIENT O as ABOVE AMBIENT ^ ba BELOW AMBIENT O e CRYOGENIC %WT ~ HAZARDOUS COMPONENT EHS ' ` •• CAS #. 1 228 227 ^ Yes ^ No 228 2 230 231 ^ Yas ^ No 232 3 234 235 ^ Yes ^ No 238 4 238 239 ^ Yas O No 240 5 242 243 ^ Yes 0 44 .. , . •... ~ III. SIGNATURE . .. PRINT NAME b TITLE OF AUTHORIZED COMPANY REPRESENTATNE SIGNATURE DATE Dean Jarrett/Divisional Merchandise Manager 02/15/2006 Ftl 99dd lRov ncrnsl WALGREENS 3222 .Manager MICHAEL HART Location: 40 CHESTER AVE City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: SiteID: 015-021-001854 BusPhone: (661) 631-2810 Map 103 CommHaz Low Grid: 31C FacUnits: 1 AOV: SIC Code:5912 DunnBrad:93-103-6651 Emergency Contact / Title Emergency Contact / Title MICHAEL HART / STORE MANAGER AGNES MACAPAGAL / DIST PHOTO SUPR Business Phone: (661) 631-2810x Business Phone: (559) 307-7100x 24-Hour Phone (661) 340-3376x 24-Hour Phone (559) 307-7100x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact 3E CO s REGULATORY DEPT Phone: (760) 602-8700x MailAddr: 1905 ASTON AVE State: CA City CARLSBAD Zip 92008 Owner WALGREENS CORP Phone: (847) 914-2264x Address 200 WILMOT RD MS2171 State: IL City DEERFIELD Zip 60015 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT'D J U L 2 3 200? ~a~~ed on my inquiry of those individu2ls respc;nsib'e for obtain'sng the information, I certify under pAna.lty of 12.~r that I Nava personally er..amined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~~ ~~ ~ - ~ 5- a ~ Signature Date -1- 07/16/2007 T C` F WALGREENS 3222 ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-001854 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP CHLORODIFLUOROMETHANE G 258.00 FT3 Low HELIUM F P IH G 220.00 FT3 Min -2- 0~/16/200~ -3- 07/16/2007 F WALGREENS 3222 SiteID: 015-021-001854 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CHLORODIFLUOROMETHANE Days On Site REFRIGERANT (R-22) 365 Location within this Facility Unit Map:l Grid:C56 RETAIL SALES FLR REF SYS CAS# 75-45-6 STATE T TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE ~GaS I Mixture I Above Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Co258100rFT3 Daily 258100m FT3 I Daily 258r00e FT3 ru~~t~xL~ u ~ ~:vlnrvly ~lv i a $Wt. RS CAS# 100.00 Chlorodifluoromethane No 75456 t1HG1~KL 1'i55~~J1~11;1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP •No No No No/ Curies / / / Low ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit RETAIL SALES FLR STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map:l Grid:C-6 CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 220.00 FT3 220.00 FT3 220.00 FT3 ril~GHtC1JVU5 LV1~lYV1V~1V15 oWt. RS CAS# 100.00 Helium No 7440597 t11~G1-]tC1J H~~1;J~1~11:,1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 07/16/200.7 F WALGREENS 3222 SiteID: 015-021-001854 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 02/23/1998 ~ CALL 911 AND NOTIFY LOCAL FIRE DEPT OF ANY HAZARDOUS MATERIAL PROBLEMS. GET ALL PERSONS OUT OF THE BLDG BY CHECKING ALL POSSIBLE LOCATIONS TO BEING PRESENT DURING A PROBLEM. Employee Notif./Evacuation 02/23/1998 WE WILL USE OUR PA SYSTEM TO ALERT ALL PERSONS IN THE STORE TO LEAVE. CHECK ALL POSSIBLE LOCATIONS SO EVERYONE IS OUT. Public Notif./Evacuation 02/23/1998 WE WILL USE OUR PA SYSTEM TO ALERT ALL PERSONS IN THE STORE TO LEAVE. CHECK ALL POSSIBLE LOCATIONS SO EVERYONE IS OUT OF THE BLDG. Emergency Medical Plan 02/23/1998 WE HAVE A FIRST AID KIT THAT WE CAN USE IN CASE OF AN EMERGENCY. WE WILL CALL 911 AND GET INSTRUCTIONS BEFORE THE FIRE DEPT IS ON SCENE. -5- 07/16/2007 F WALGREENS 3222 SitelD: 015-021-001854 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 02/23/1998 ~ WE TRAIN ALL EMPLOYEES ON THE PROPER WAY TO HANDLE HAZARDOUS MATERIALS. WE ALSO REINFORCE BY REPEATING THE READING OF THE BOOKLETS ONE TIME PER YEAR AND RETAKE THE WRITTEN TEST. Release Containment 02/23/1998 WE WILL CALL THE FIRE DEPT FIRST ON ANY HAZARDOUS MATERIAL WE MUST RELEASE. Clean Up 04/19/2006 FOR MOST CLEAN-UP IT WILL MEAN TO MOP UP SPILL THEN RINSE WITH WATER. ~,_ v L11G1 i\G~Vl,L1 VG ril..L1VQL1V11 -6- 07/16/2007 ' , F WALGREENS 3222 SiteID: 015-021-001854 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JCC:1d1 I1d'Gdl U.S' Utility Shut-Offs GAS - BACK OF STORE BY RESTROOMS ELECTRICAL - PANELS BY OFFICE WATER - SHUT-OFF VALVE BACK OF BLDG 03/27/2007 Fire Protec./Avail. Water 01/12/2007 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - SW CRNR & NW CRNR OF BLDG OUTSIDE. Building Occupancy Level 03/08/2006 19 EMPLOYEES -7- 07/16/2007 F WALGREENS 3222 SiteID: 015-021-001854 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 03/08/2006 ~ BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES READ A TRAINING MANUAL AND ARE TESTED ON STORING AND MANAGING HAZARDOUS MATERIALS. ALL MANAGEMENT STAFF MEMBERS AND RECEIVING STAFF READS A MANUAL ON TRANSPORTING HAZARDOUS MATERIALS AND ARE TESTED. ALL MANAGEMENT STAFF READS A MANAGEMENT VERSION AND AGAIN ARE TESTED ON TRANSPORTING HAZARDOUS MATERIALS. rayc c. 17C 11.L LVL rUI.ULC Ue7~C I1C1U LVL rUI.ULC U.`~'C -8- 07/16/2007