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Home My WebLink AboutBUSINESS PLAN (2)~. 11 ~ ~~` ~~'Q ~.,~~ ~c ~ 'ice 1 i ~ ~ _~ ~ o~ FASTRIP FOOD STORE #6 (FAC #562) ', _ it 1640 S. CHESTER AVENUE ~ ~~~ ~ \~ usT#~1ac~c~ol \l it ~-ate-a~ ~°~" ~~ ~~ ~~ ~ ~- ~~ -~ ~~ 1-~~-~t1 ~i -----, ~~ -_____, r I i ^~ i ~ '° i r _ - --- " ~ I/-~ ~ A~ ~ ~ ~ ;~ ~ ~~ -. ~, FASTRIP 562 SiteID: 015-021-000414 Manager GHALEB JOUDA BusPhone: (661) 397-8606 Location: 1640 S CHESTER AVE Map 124 CommHaz Moderate City j BAKERSFIELD Grid: 06C FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code:5541 DunnBrad:08-109-5747 Emergency Contact / Title Emergency Contact / Title GHALEB JOUDA / MANAGER R CRAIG LINCOLN / OPS MANAGER Business Phone: (661) 397-8606x Business Phone: (661) 393-7000x 24-Hour Phone (661) 393-7000x 24-Hour Phone (661) 393-7000x PageriPhone (661) 205-9090x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact R CRAIG LINCOLN Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380-2515 Owner) JACO HILL Phone: (661) 393-7000x Addres s PO BOX 82515 State: CA City BAKERSFIELD Zip 93380-2515 Perio to TotalASTs: = Gal Prepar ers TotalUSTs: = Gal Certif y d: RSs : No Parcel No: Emerge ncy Directives: PROG A - HAZMAT PROG U - UST ~ i ~M~ d Based on my inquiry of those individuals responsible for obtaining the information, I certify ~ ~~~7 ENT'D APR under penalty of law that I have personally examined and am familiar with the information submitted and 'eve the information is true , accurate comp) ~.~ 7~ Signature Date -1- 03/22/2007 r \ G t ~ _ '~ F FASTRIP 562 Last Action Type: SiteID: 015-021-000414 ~ STORAGE CONTAINER DATA (UST FORM A) FACILITY/SITE INFORMATION Business Name: FASTRIP 562 Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper DOUGLASS M YOUNG III ICC Nbr: 0878646-UC PROPERTY OWNER INFORMATION Name R CRAIG LINCOLN Phone: (661) 393-7000x Address: City State: Zip: Type CORPORATION TANK OWNER INFORMATION Name R CRAIG LINCOLN Address: City Type CORPORATION Phone: (661) 393-7000x State: Zip: BOE UST Fee# 019753 Financ'1 Resp: SELF INSURED Legal Notif Tank Owner Mailing Address Date:04/19/2000 Phone: (366) 170-00 x Name:R CRAIG LINCOLN Tt1:VP State UST # 1998 Upg Cert#: 00734 -2- 03/22/2007 ~ ~ / F FASTRIP 562 SiteID: 015-021-000414 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name.... SpecHaz EPA Hazards Frm DailyMax Unit MCP .~ ~gctla r~ ll~,.~/'•~ce.~~rl ~'-x~scr~ i~G F IH DH L 12 0 0 0 . 0 0 GAL Mod ~~e9l~.lcx.r- LCa~I ~-e-cT-~~a5oloa~ ~ F IH DH L 12 0 0 0.0 0 GAL Mod PREMIUM UNLEADED C~,~l;is,c~.. F IH DH L 12 0 0 0 . 0 0 GAL Mod DIESEL F IH DH L 12000.00 GAL Mod -3- 03/22/2007 ,. r r -4- 03/22/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ~~~cRlc~.~ ~cd~d (~~1~-~ Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~mbient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL I 7000.00 GAL riHGHKLV U 5 1.:V1~lY V1V I;1V 1 J %Wt. RS CAS# 100.00 Gasoline No 8006619 riAGE1KL 1'~5J1'~JJ1~1L1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 COMMON NAME / CHEMI/`CAL ~~1NAME ~~L,Lld~ta'' C.~~Z.~~LG~lKC°~ ~.sit.1'..SO~i'it,~ '~ Location within this Facility Unit UST Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 STATE TYPE PRESSURE Liquid TMixture ~ Ambient TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL I12iL1-1CCLVU.7 l.Vl~lYV1VI;1V 1.7 %Wt. RS CAS# 100.00 Gasoline No 8006619 1'1L-~GL-~1CL 1-1b JL' ~.71~1L' 1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 03/22/2007 r r, F FASTRIP 562 SiteID: 015-021-000414 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED ~l~C7~J~'~' Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 Liquid TYPE PRESSURE TEMPERATURE CONTAINER TYPE TMixtur~ Ambient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL nti~xtcL~u~ ~:vi~irvlvrJlvt~ %Wt. RS CAS# 100.00 Gasoline No 8006619 ___ ns-~~rucL ti aa~aai~i~iv1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME DIESEL Location within this Facility Unit UST STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE ~~ CONTAINER TYPE Ambient I UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL rr~uruu~v~o ~.v1.1rv1v1J1ViS oWt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 11[-~uCiRL H JJP~J Jl•1P.~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -6- 03/22/2007 'F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 07/26/2006 ~ CALL 911 FOR EMERGENCY, IF NEED, CALL STATE EMERGENCY OFFICE 800-852-7550 OR 619-262-1621. Employee Notif./Evacuation 07/26/2006 EXIT THRU WEST DOOR AND CALL 911. ALL EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY SITUATION, THEY ARE TO FOLLOW THESE PROCEDURES: A. SHUT-OFF (IF POSSIBLE) MAIN POWER BREAKER. B. EVACUATE THEMSELVES AND ANYBODY IN OR AROUND THE PREMISES. C. NOTIFY CLOSE NEIGHBORS TO EVACUATE, IF NECESSARY. Public Notif./Evacuation 07/26/2006 EMPLOYEES ARE TRAINED TO EVACUATE ALL CUSTOMERS AND CALL 911. ALSO, TO NOTIFY NEARBY RESIDENTS AND SURROUNDING FACILITIES. Emergency Medical Plan 10/30/2000 CALL 911 EMERGENCY OR MERCY HOSPITAL, 2215 TRUXTUN AVE, 327-3371. -7- 03/22/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/26/2006 ~ ALL AREAS ARE KEPT CLEAR OF COMUSTIBLE PRODUCTS. PUMPS HAVE EMERGENCY SHUT-OFF SWITCH. ABSORBENT MATERIALS STORED NEAR GAS ISLANDS. Release Containment 07/26/2006 IN THE EVENT OF SPILLAGE, EMPLOYEE WOULD SHUT OFF MAIN SWITCH IMMEDIATELY, WASH DOWN AREA OR USE ABSORBENT, DISPOSE OF MATERIALS AS DESCRIBED BY HAZARD RESPONSE PROCEDURES. IN THE EVENT OF A MAJOR SPILLAGE, EMPLOYEE WOULD NOTIFY FIRE DEPT FOR BACK-UP. Clean Up 07/26/2006 OVERFILLS RESULTING IN SMALL SPILLAGE: HOSE AREA. DRIVE OFF RESULTING IN SUBSTANTIAL SPILLAGE: SHUT DOWN ENTIRE SYSTEM. VEHICLE DAMAGE TO PUMP RESULTING IN LEAK: SHUT DOWN POWER DAMAGED PUMP ONLY. ADJACENT BLDG FIRE: SHUT DOWN ENTIRE GAS ISLAND AND EMERGENCY CONTROL SHUT-OFF. FIRE DEPT WILL ADVISE WHEN TO RESUME NORMAL OPERATIONS. CALL Other Resource Activation 10/30/2000 NOTIFY DISTRICT (OPERATIONS) MGR TO CALL OUT EMERGENCY RESPONSE PERSONNEL. -8- 03/22/2007 i:_ . •. F FASTRIP.562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 I1dGdi U.7~ Utility Shut-Offs 01/31/2007 A) GAS - NE REAR CRNR OF BLDG OUTSIDE B) ELECTRICAL - NW CTR INSIDE BLDG BACK RM C) WATER - SE PROP LINE MING & ALLEY WY D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/16/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS INSIDE STORE & ON GAS ISLANDS. FIRE HYDRANT - NW CRNR S CHESTER & MING AVE. Building Occupancy Level 03/30/2006 7 EMPLOYEES -9- 03/22/2007 I d `~1 ter .6 ~F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 07/26/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rciyC G nciu iv.a. ru~.utc vac nciu ivl.. r u~uLC vac -10- 03/22/2007 ~, ~\ ~:, . .: FASTRIP 562 Manager GHALEB JOUDA Location: 1640 S CHESTER AVE City BAKERSFIELD SiteID: 015-021-000414 BusPhone: (661) 397-8606 Map 124 CommHaz Moderate Grid: 06C FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code:5541 DunnBrad:08-109-5747 Emergency Contact / Title Emergency Contact / Title GHALEB JOUDA / MANAGER R CRAIG LINCOLN / OPS MANAGER Business Phone: (661) 397-8606x Business Phone: (661) 393-7000x 24-Hour Phone (661) 393-7000x 24-Hour Phone (661) 393-7000x Pager Phone (661) 205-9090x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact R CRAIG LINCOLN Phone: (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380-2515 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSFIELD Zip 93380-2515 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST the ir~formatiodnl I~cde'rt fy i3 ~ r a n ng ok^t, s ~ e fo respo t lave that I have personally under penalty a examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ture Date , Si ~~U gna / -1- 07/11/2007 F FASTRIP 562 Last Action Type: SiteID: 015-021-000414 ~ STORAGE CONTAINER DATA (UST FORM A) FACILITY/SITE INFORMATION Business Name: FASTRIP 562 Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper DOUGLASS M YOUNG III ICC Nbr: 0878646-UC PROPERTY OWNER INFORMATION - Name R CRAIG LINCOLN Phone: Address: City State: Zip: Type CORPORATION (661) 393-7000x Name R CRAIG LINCOLN Address: City Type : CORPORATION TANK OWNER INFORMATION Phone: (661) 393-7000x State: Zip: BOE UST Fee# 019753 Financ'1 Resp: SELF INSURED Legal Notif Tank Owner Mailing Address Date:04/19/2000 Phone: (366) 170-00 x Name:R CRAIG LINCOLN Ttl:VP State UST # 1998 Upg Cert#: 00734 -2- 07/11/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP REGULAR UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod REGULAR UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod PREMIUM UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod DIESEL F IH DH L 12000.00 GAL Mod -3- 07/11/2007 -4- 07/11/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME /CHEMICAL NAME REGULAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL • nt~~tucLUUa ~~rir~tv~ivt~ °sWt. RS CAS# 100.00 Gasoline No 8006619 nt~~titcL t~~~~a~i~ir.ly t a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE Location within this Facility Unit UST Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 Liquid TMixture ~mbient~E ~ AmbientT~E ~UNDEROGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL ilti[~tilSLVIJ~ l.Vl"lt'V1VP~LVl~J %Wt• RS CAS# 100.00 Gasoline No 8006619 I1tiGEitGL HJ .7 P.~J J1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 07/11/2007 F FASTRIP 562 ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Location within this Facility Unit UST STATE TYPE PRESSURE Liquid TMixture Ambient SiteID: 015-021-000414 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL t1[-iGt~1.KL V U .5 l=vl~lrvly r,lv 1.7 %Wt. RS CAS# 100.00 Gasoline No 8006619 t'LHG1iCtL H~ Jar,~JJ1~lAlV 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 7000.00 GAL nrauruc.vv ~ o L.vl•irvLV r,1v 1 S oWt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 1zr~aru~L r~a ar~~~riaivt~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -6- 07/11/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 07/26/2006 ~ CALL 911 FOR EMERGENCY, IF NEED, CALL STATE EMERGENCY OFFICE 800-852-7550 OR 619-262-1621. Employee Notif./Evacuation 04/11/2007 EXIT THRU WEST DOOR AND CALL 911. ALL EMPLOYEES ARE TRAINED AND AWARE THAT IN THE EVENT OF AN EMERGENCY SITUATION, THEY ARE TO FOLLOW THESE PROCEDURES: SHUT-OFF (IF POSSIBLE) MAIN POWER BREAKER; EVACUATE THEMSELVES AND ANYONE IN OR AROUND THE PREMISES; AND NOTIFY CLOSE NEIGHBORS TO EVACUATE, IF NECESSARY. Public Notif./Evacuation 07/26/2006 EMPLOYEES ARE TRAINED TO EVACUATE ALL CUSTOMERS AND CALL 911. ALSO, TO NOTIFY NEARBY RESIDENTS AND SURROUNDING FACILITIES. Emergency Medical Plan 10/30/2000 CALL 911 EMERGENCY OR MERCY HOSPITAL, 2215 TRUXTUN AVE, 327-3371. -7- 07/11/2007 F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/11/2007 ~ ALL AREAS ARE KEPT CLEAR OF COMBUSTIBLE PRODUCTS. PUMPS HAVE EMERGENCY SHUT-OFF SWITCH. ABSORBANT MATERIALS STORED NEAR GAS ISLANDS. Release Containment 04/11/2007 IN THE EVENT OF A SPILL, EMPLOYEE WOULD SHUT OFF MAIN SWITCH IMMEDIATELY, WASH DOWN AREA OR USE ABSORBANT, DISPOSE OF MATERIALS AS DESCRIBED BY HAZARD RESPONSE PROCEDURES. IN THE EVENT OF A MAJOR SPILL, EMPLOYEE WOULD NOTIFY FIRE DEPT FOR BACK-UP. Clean Up 04/11/2007 OVER-FILLS RESULTING IN A SMALL SPILL: HOSE AREA. DRIVE-OFF RESULTING IN A SUBSTANTIAL SPILL: SHUT DOWN ENTIRE SYSTEM. VEHICLE DAMAGE TO PUMP RESULTING IN A LEAK: SHUT DOWN POWER TO DAMAGED PUMP ONLY. ADJACENT BLDG FIRE: SHUT DOWN ENTIRE GAS ISLAND AND EMERGENCY CONTROL SHUT-OFF. FIRE DEPT WILL ADVISE WHEN TO RESUME NORMAL OPERATIONS. CALL OPERATIONS MANAGER 393-7000. Other Resource Activation 10/30/2000 NOTIFY DISTRICT (OPERATIONS) MGR TO CALL OUT EMERGENCY RESPONSE PERSONNEL. -8- 07/11/2007 -, ~. F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ -~ -,- ~N~~~a~ ~~a~a~~.~ Utility Shut-Offs 04/11/2007 GAS - NE REAR CRNR OF BLDG OUTSIDE ELECTRICAL - NW CTR INSIDE BLDG BACK RM WATER - SE PROP LINE MING & ALLEY WY Fire Protec./Avail. Water 11/16/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS INSIDE STORE & ON GAS ISLANDS. FIRE HYDRANT - NW CRNR S CHESTER & MING AVE. Building Occupancy Level 03/30/2006 7 EMPLOYEES -9- 07/11/2007 V~ ~ s ~~ F FASTRIP 562 SiteID: 015-021-000414 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 07/26/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rayc ~ Held for Future Use nclu ic~i ruuui~ u5~ -10- 07/11/2007 ~+ Prevention Services ~JNI~IED~ PROGRAM INSPECTION CHECKLIST. e F R s r, _n 9oo'IYuxfun Ave., Suite 210 FiaF Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° aRrM Tel.: (661) 326-3979 Fax: (661) 872-2171 - - FACILITY NAME - ~ 'w}- ~ INSPECT ON ATE INSPECTION~TIME ,.., j~ Y' O ADDRESS PHONE NO. NO OF E PLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021= " r Section 1: Business Plan and Inventory Program ^ ROUTINE LYCOMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C ~ ~ c=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL R ^ VERIFICATION OF MSDS AVAILABILITY ~ `. ,~ ~~~~ J LS ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION 0 ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTION EGARDING THIS INSPECTION? PLEASE CALL VS AT (661) 326-3979 ~--_.- {' Inspector (Please rint) Fire Preve ~ n / 1~` In /Shift of Site/Station # Busin s Site / espo Ile Party (PI ase Print) - White.- Prevention Services - ~ Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev. 09105 . __'~ .. _ - _._ __ , _ _. -. - - ~ - ~ - I - ~' _ ^ YES ~~ _. . ~~ INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST B ICI E R S F I L D F/BE ~RrM r BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 FACILITY NAME: ~(.~5~'~,~(j INSPECTION DATE: -~~- Section 2: U//nderground Storage Tanks Program ^ Routine Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank R-.?!=~° ~ Number of Tanks Type of Monitoring Cc,iln Type of Piping 14tt1~ OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ^ No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 s~_.. Busin s Si esponsible Pa ~ .i White -Prevention Services Pink -Business Copy KBF-7335 FD 2156 (Rev. 09105) Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: Fastrip #6 (Exxon) Facility ID #: 2928 Facility Address: 1640 So. Chester Avenue, Bakersfield, CA 93304 (City) Reason for Submitting this Form (Check One) X Addition of Designated Operator Facility Phone #: 661-397-8606 ^ Update Certificate Expiration Date . __. Designated UST Operator(s) for this Facility ALTERNATE 3 O bona! Designated Operator's Name: Jessica L. Meyers Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5313857-UC Expiration Date: June 30, 2009 ALTERNATE 4 (Optional) Designated Operator's Name: Relation to UST Facility (Check One) Business Name (If different from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: ^ Service Technician ^ Third-Party International Code Council Certification #: Expiration Date: ALTERNATE 5 (Optional) Designated Operator's Name: Relation to UST Facility (Check One) Business Name (If different from above): ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: ^ Service Technician ^ Third-Party International Code Council Certification #: Expiration Date: I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (f). Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. NAME OF TANK OWNER (Please Print): .Taco Oil CO. SIGNATURE OF TANK OWNER: DATE: August 9, 2007 OWNER'S PHONE #: 661-393-7000 NOTE: I) SUBMIT THIS COMPLETED FORM TO THE LOCAL AGENCY (NOT THE STATE WATER RESOURCES CONTROL BOARD) BY JANUARY 1, 2005. THE LOCAL AGENCY LIST IS AVAILABLE AT: www.waterboards.caca~ov/ust/contacts/cu a a/ust/contacts/cu~agys.html. 2) NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WTTHIN 30 DAYS OF THE CHANGE. November 2004 ,, r ~~ Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: Fastrip #6 (Exxon) Facility ID #: 2928 Facility Address: 1640 So. Chester Avenue, Bakersfield, CA 93304 (City) Reason for Submitting this Form (Check One) ^ Change of Designated Operator Facility Phone #: 661-397-8606 X Update Certificate Expiration Date Designated UST Oaerator(s1 for this Facility Designated Operator's Name: Douglas M. Young III Relation to UST Facility (Check One) Business Name (If different from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 0878646-UC E~cpiration Date: September 22, 2008 PRIMARY ALTERNATE 1(Optlonol) Designated Operator's Name: Jennifer Davis Relation to UST Facility (Check One) Business Name (If different from above): Co~dence UST Services, Inc. ^ Owner D Operator ^ Employee Designated Operator's Phone #: 800-339-9930 D Service Technician x Thud-Party International Code Council Certification #: 5252886-UC Expiration Date: March 1 S, 2009 ALTERNATE 2 (Optional) Designated Operator's Name: Edward Mitcheil Relation to UST Facility (Check One) Business Name (If d~erent from above): Confidence UST Services, Inc. ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 800-339-9930 ^ Service Technician x Third-Party International Code Council Certification #: 5258845-UC Expiration Date: May 15, 2008 I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training, in accordance with California Code of Regulations, title 23, section 2715(c) - (fj. Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. NAME OF TANK OWNER (Please Print): SIGNATURE OF TANK OWNER: DATE: 1VIarCh 23, ZOOM UWN>~x's YHV1vE #: 001-3Y3- /UW NOTE: 1) SUBMIT THLS COMPLETED FORM TO THE LOCAL AGENCY (NOT TAE STATE WATER RESOURCES CONTROL BOARD) BY JANUARY 1, 2005. TAE LOCAL AGENCY LLST IS AVAILABLE AT: www.waterboards.ca.gov/ustlcontacts/cupa a y~tmt. 2) NOTIFY THE LOCAL AGENCY OF ANY CHANGES TO THIS INFORMATION WITHIN 30 DAYS OF THE CHANGE. November 2004 ~. UNIFIED PROGRAM INSPECTION CHECKLIST : ~~i~ - ,~ :.r: ARfN .SECTION 1: Business Plan and Inventory Program . ~r BAKERSFIELD ~ FIRE DEPT Prevention Services 900 TYuxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~~' NSPECTION DATE NSPECTION TIME ADDRESS / ~ HONE N0. O OF EMPLOYEES a ? / 3 ~~ ~~, ~ FACILITY CONTACT USINESS ID NUMBER 15-021- Section 1: Business Plan and Inventory Program tT ------ ^ ROUTINE ~,pMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION V=Violation COMMENTS ~- ^ APPROPRIATE PERMIT ON HAND ~'fl BUSIf1ASS PLAN CONTACT INFORMATION ACCURATE ~~ ^ VISIBLE ADDRESS ~^ CORRECT OCCUPANCY -- ~t~^ / - VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~~^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~^ VERIFICATION OF HAZ MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND CEDURES 200 ^ EMERGENCY PROCEDURES ADEQUATE ^~' CONTAINERS PROPERLY LABELED L ^ ~. HOUSEKEEPING rz- - A F s 2. ^~ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ,, f ,, ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: (~ / f 1 l /~ /c r ~ ~~)l tl ~--_,/~?~~~~__ 7~! OU TIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (681) 328-3979 Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Stetion # White -Prevention Services Yellow -Station Copy pink -Business Copy FD204e (Rw. OZ/05) ~. ~ i - r . ~ C ~t!~~` '~~~~ CITY OF BAKERSFIEi,D FIRE DEPARTMENT d ~ ~~ OFFICE OF ENVIRONNIEN'fAL SERVICES y~' UNIFIED PROGRAM INSPECTION CHECKLIST =w ~gti,0`A 1715 Chester Ave., 3~~ Floor, Bakersfield, CA 93301 FACILITY NAME ~'f~ S 711TH .S'~ C~.~ S7ftL INSPECTION DATE~~ ~_ Section 2: tinderground Storage Tanks Program ^ Routine Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type ofi Tank z~u~~_u,A/( Number of Tanks Type of Monitoring Type of Piping ~.~6( OPERATION C V COMMENTS Proper tank data on file Proper owner'operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes ~~` No Section 3: Aboveground Storage Tanks Program TANK SIZES} _ Type of Tank OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: Z Office of Environmental Services (661) 326-3979 hl~hitc - f-nv. Svcs. AGGREGATE CAPACITY Number of Tanks __ Pink -Business Cony . mess Site Responsible Party ~ r ..r + FASTRIP 562 _________________________________________ SiteID: 015-021-000414 + Manager GHALEB JOUDA Location: 1640 S CHESTER AVE City BAKERSFIELD CommCode: BFD STA 0 EPA Numb: BusPhone: (661) 397-8606 Map 124 CommHaz Moderate Grid: 06C .FacUnits: 1 AOV: SIC Code:5541 DunnBrad:08-109-5747 +______________________________________________________________________________t Emergency Contact / Title Emergency C t t / Title GHALEB JOUDA / -$~r~' `~~`'t9/ OPS MANAGER ~~uC_°®l~ Business Phone: (661) 397-8606x Business Phone: (661) 393-7000x 24-Hour Phone (661) 393-7000x 24-Hour Phone (661) 393-7000x Pager Phone (661) 205-9090x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact ~i. ~~ !~~ ~, ~~ Phone- (661) 393-7000x MailAddr: PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Owner JACO HILL Phone: (661) 393-7000x Address PO BOX 82515 State: CA City BAKERSFIELD Zip 93380 Period to TotalASTs: = Gal Preparers TotalUSTs: _ Gal Certif'd: RSs: No ParcelNo: Emergency Directives : ~ ~~ /~ PROG A - HAZMAT PROG U - UST ~'N I ,~ J U L ~ ~ 2006 E5. ~a ~ Based on my inquiry of those individuais respanslble for obtaining the information, I certify under penalty of iaw that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. s ~/~ Signatu ~~ Date `'~1V~VV \ ~`~ ~~~ ~\~~ ~!"` -1- 03/30/2006