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HomeMy WebLinkAboutBUSINESS PLAN (3)VOWS #2033 4500 COFFEE ROAD , - ~ ~ - - -- ~~ i.^o ~i- - hr __ j.. + VONS 2033 ___________________________________________ SiteID: 015-021-002005 + Manager ~-V e- co~~ Location: 4500 COFFEE RD City BAKERSFIELD BusPhone: (661) 589-0316 Map 102 CommHaz High Grid: 16C FacUnits: 1 AOV: CommCode: KCFD STA 61 SIC Code:5411 EPA Numb: (~p-(~~ DunnBrad:00-132-5034 Emergency Contact / Title Emergency Contact / Title / MANAGER / LOSS PREVENTION Business Phone: (661) 589-0316x Business Phone: (626) 8.21-7545x 24-Hour Phone (626) 821-7545x 24-Hour Phone (626) 821-7545x Pager Phone (~q ) - x Pager Phone (u~q ) - x Hazmat Hazards--------------------------Fire Press ImmHlth +------------ ----------------~a{p -~~~•~'-~~----+ Contact Vr, n5 f oo~ S 4 f~6~y C ~ r-e e t l a T. ~e (man , phone MailAddr: PO BOX 513338 rn~•~•~~ State: CA City LOS ANGELES Zip 90051-1338 Owner VONS A DIVISION OF SAFEWAY Phone: (626) 821-5601x Address PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Period o~~O ~ to ~ ~~~ TotalASTs • = Gal Preparer : -~,en ; ~~; ~ r }-- JUG h TotalUSTs : = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT fNT~ ~~~ ~ ~ 2p~g Based on my inquiry of those individuals responsible for obtaining the information, 1 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 Date ~°~~ 55~ -1- 05/08/2006 h ~.y .' :;.`` ire • Call9-1-1. • Remain calm and identify yourser. • Give the bcation and nature of the emergency • W am others in the immediate area. • Use an extinguisher only'rf it is a sma0 fire. • Folbw evacuation instructions. • If smoke is present, stay bw, crawl on your hands and knees to the nearest exit. • Walkto the nearest emergency exit. Cbse au doors as you go. Do not use elevators Earthquake • Duck and Cover. • Stay clear of tall objects and windows. • Once the initial shocks have subsided, stay under cover. • Assist the injured. • Checkfor hazards. • Evacuate the building only H instructed to do so. Use stairs only. • Be prepared for aftershocks. Evacuation Procedures • Remain calm • Your signal to evacuate is either the fire alarm, an announcement over the public address system or a feDow empbyee. • Unbckdoors as you leave your area. • Cbse aY doors as you exit. • Move in an orclerty fashion toward the stairs and/or exBs of the building. Wail there for f urther instructions I 1 WAREHOUSE ~~ ,>p,5'}r~; ('S PRODUCE MEAT SEAFOOD BOX SERVICE DELI '~ W BAKERY FROZEN FOOD R.R. ® I~ DAIRY BOX BREAK ® ROOM KIDS CLUB CHECKSTANDS ~~ 1-}tt t'Jm ~ FLORAL PHARMACY CUSTOMER MG ~T~I 1 SERVICE ~--N - EVACUATION MAP (Not To Scale) WELLS R.R. FARGO RELOCATION AREA VONS #2033 4500 COFFEE RD. BAKERSFIELD, CA 93308 Fire Extinguishers To operate a fire extinguisher: P -Pull the pin A - Aim at the base of the fire S -Squeeze the trigger handle S -Sweep from side to side Be sure to report all fires. recardless of their size. Medical • Stay calm and gather the information. • Cad 9-1-i. • Identify yourseH and give your bcation. • Describe the emergency situation. • Advise felbw enpbyees of the emergency and ask for assistance. • Assist the victim to the degree that you are trained. Hazardous Material • Notify your supervisor. • Identify materials involved, 'rf known. • If required, evacuate the immediate area and keep others out. Assist those who cannot leave on their own. • Retrain fromsmoking, eating, drinking and applying cosmetics. Civil Disorder • Notiy your supervisor. • Remain within the building. • Do not become a spectator. • Do nothing to antagonize the demonstrators. • AwaR further instructions from your supervisor. Bomb Threat • Do not panic. • Notify your supervisor. • Your supervisor will notify the security department and the police. • Await instructions. e e ds: Primary Emergency Exits -~ Fire Extinguishers Water Main/SprinklerRi Gas Meter Shut Off Valve Relocation Area SEPT. 98 111iu" rr,•, ~f s, E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 Manager SHANNON BALLENGEE Location: 4550 COFFEE RD H City BAKERSFIELD BusPhone: (661) 587-0700 Map 102 CommHaz Minimal Grid: 16C FacUnits: 1 AOV: CommCode: KCFD STA 65 EPA Numb: SIC Code:8041 DunnBrad: Emergency Contact / Title Emergency Contact / Title E SWIDA-SKILLEN / OWNER SHANNON BALLENGEE / MANAGER Business Phone: (661 ) 587-0700x Business Phone: (661) 587-0700x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React Contact ELIZABETH SWIDA-SKILLEN Phone: (661) 587-0700x MailAddr: 4550 COFFEE RD H State: CA City BAKERSFIELD Zip 93308 Owner ELIZABETH SWIDA-SKILLEN DC Phone: (661) 587-0700x Address 4550 COFFEE RD H State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN EIVT'p 11 I ~ ~ v ~nn~ Based on my inquiry of those indiv;~i~~als " responsibie for obtaining the information, I certify under penalty of law that I have person~~h~ examined and am familiar with the informatir submitted and believe '.he r' ~t d information is t :~.=; ~om , F. accura e, an ~ ~ ~-~ ,~ Signature Date -1- 07/11/2007 ~ ,, F E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... ISpecHazIEPA Hazards) Frm I DailyMax IUnitIMCPI WASTE FIXER R L 5.00 GAL Minl -2- 07/11/2007 -3- 07/11/2007 F' =~ F E SWIDA-SKILLEN DC CHIRO CORP ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER Location within this Facility Unit DARKROOM STATE TYPE PRESSURE Liquid TWaste ~ Ambient SiteID: 015-021-002201 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 25.00 GAL 5.00 GAL 5.00 GAL t1HGf~KLVUS lLV1~lYV1VL",1V 1 a oWt. RS CAS# Silver No 7440224 t11~GHKL L~~~JJJ51~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R / / / Min -4- 07/11/2007 r , F E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/17/2006 ~ CONSTANT MONITORING OF RECLAIMING TANK; NEVER TO EXCEDE HALF FULL. Employee Notif./Evacuation 03/28/2006 911, OFFICE OF EMERGENCY SERVICES 800-852-7550, LOCAL 326-3979 AND/OR MID-STATE X-RAY SERVICE 559-441-7750. Public Notif./Evacuation 04/17/2006 GEOFF FESSLERCy{~,`J•~~ E/RIC~-TR~GGEETAD~, ~~AND AGE/`N\CY NOTIFICATION. Emergency Medical Plan 04/17/2006 FLUSH, MOP UP, TAKE PERSON TO 34TH ST MEDI CENTER. WILL NOT HAPPEN DUE TO CLOSED RECLAIMING SYSTEM. -5- 07/11/2007 F E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 03/07/2001 ~ CLOSED RECLAIMING SYSTEM. Release Containment 03/07/2001 CLOSED RECLAIMING SYSTEM. Clean Up CLOSED RECLAIMING SYSTEM. 03/07/2001 v~.iict 1ZCDV6l1 l:C tiC: l.lVdl.1 V11 -6- 07/11/2007 F E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs ELECTRICAL - BREAKER BOXES W END OF SUITE WATER - OUTSIDE W WALL 04/26/2007 Fire Protec./Avail. Water 01/11/2007 PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE EXTINGUISHERS, AND ALARM SYSTEM. NEAREST FIRE HYDRANT - N ON HAGEMAN RD. Building Occupancy Level 03/28/2006 EMPLOYEES ~~ -7- 07/11/2007 I, ~ ... 'i F E SWIDA-SKILLEN DC CHIRO CORP SiteID: 015-021-002201 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/11/2007 ~ MSDS SHEETS ON FILE IN DARKROOM. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE INSTRUCTED TO MONITOR LEVEL OF RECLAIMING SYSTEM TANK. rayc a Held for Future Use aiciu ivi ru~.utc vac -8- 07/11/2007 _. ~ VONS 2033 SiteID: 015-021-002005 Manager.: DAVE CODD Location: 4500 COFFEE RD City BAKERSFIELD BusPhone: (661) 589-0316 Map 102 CommHaz High Grid: 16C FacUnits: 1 AOV: CommCode: KCFD STA 61 EPA Numb: SIC Code:5411 DunnBrad:00-132-5034 Emergency Contact / Title Emergency Contact / Title DAVE CODD / MANAGER LOSS PREVENTION / MANAGER Business Phone: (661) 589-0316x Business Phone: (626) 821-7545x 24-Hour Phone (626) 821-7545x 24-Hour. Phone (626) 821-7545x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact MARCELLA T GELMAN MSRD Phone: (626) 821-5608x MailAddr: PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Owner VONS A DIVISION OF SAFEWAY Phone: (626) 821-5601x Address PO BOX 513338 State: CA City LOS ANGELES Zip 90051-1338 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ,n PROG A - HAZMAT ~ \ ~ ~~~7 ENT's BAR Based on my inquiry of those in~iivi~d~a€~I~ responsible for obtainh~g the 4nfo-'~atigr, 1 certify under penalty of law ingt I have p~;rsor~aliy examined and am familiar with the inf©rmation . s ., fitted and believe the information is true, ccu s nd complete. ~7 ignature Date -1- 02/20/2007 ~: F VONS 2033 ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002005 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP BLEACH IH L 80.00 GAL Hi FREON R-22 P IH G 4650.00 LBS Low HELIUM F P IH G 500.00 FT3 Min CARBON DIOXIDE F P IH G 500.00 FT3 Min -2- 02/20/2007 -3- 02/20/2007 F VONS 2033 SiteID: 015-021-002005 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at•Site.~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 12 CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~Ambient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 80.00 GAL I 40.00 GAL - tiL~GA.tt.LVU~ ~Vlnr~ivr~ivlJ °sWt. RS CAS# 100.00 Bleach No 7681529 riAGF~tCL A5~1";~51~11";1V"1"5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA- USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME FREON R-22 ~ Days On Site 365 Location within this Facility Unit Map: Grid: MOTOR RM CAS# STATE - TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure. Above Ambient Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 4650.00 LBS 4650.00 LBS ( 4650.00 LBS nsic~rucLVU~ 1.V1~1rV1V~1V1~ oWt. RS CAS# 100.00 Chlorodifluoromethane No 75456 riliGEitCL Ei.7a1;.>.71~1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P IH / / / Low -4- 02/20/2007 F VONS 2033 ~~Inventory Item 0001 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit FLORAL DEPT STATE TYPE PRESSURE _ Gas TPure Above Ambient SiteID: 015-021-002005 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE - Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 291.00 FT3 500.00 FT3 500.00 FT3 nt~~tircl~vu~ ~vl~ir~lv~lvl~ %Wt. RS CAS# 100.00 Helium No 7440597 rlt~~t~tcl~ t~aa~~~l~i~ly l a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# -MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: SERVICE DELI CAS# 124-38-9 ~GasATE T TYPE PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE ~ I Pure Above Ambient I Crvocrenic I INSUL.TANK / CRYOGENIC I AMOUNTS AT THIS LOCATION Largest Co250100rFT3 Daily 500100m FT3 I Daily 250r00e FT3 I1t~Gti[CLV U.7 l.Vl"lYV1VL" 1V 1 J %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 ntic~tuc.u r~ ~~1,~ar11;1V1a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -5- 02/20/2007 F VONS 2033 SiteID: 015-021-002005 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 05/08/2006 MANAGER WILL COORDINATE EVACUATION UTILIZING THE PUBLIC ADDRESS SYSTEM. EMPLOYEES WILL ASSIST CUSTOMERS TO THE NEAREST EXIT. PERSONNEL WILL IMMEDIATELY NOTIFY APPROPRIATE EMERGENCY RESPONSE UNITS. 9 9 Employee Notif./Evacuation 05/08/2006 MANAGER WILL COORDINATE EVACUATION UTILIZING THE PUBLIC ADDRESS SYSTEM. EMPLOYEES WILL ASSIST CUSTOMERS TO THE NEAREST EXIT. PERSONNEL WILL IMMEDIATELY NOTIFY APPROPRIATE EMERGENCY RESPONSE UNITS. Public Notif./Evacuation 05/08/2006 IN THE EVENT OF AN INCIDENT, THE AREA WILL BE IMMEDIATELY EVACUATED OF CUSTOMERS AND UNTRAINED PERSONNEL. TRAINED MANAGERS WILL MITIGATE, IF POSSIBLE, OR CONTACT LOCAL OFFICIALS FOR ASSISTANCE. Emergency Medical Plan 03/27/2000 CALL 911. -6- 02/20/2007 F VONS 2033 SiteID: 015-021-002005 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 05/08/2006 PRODUCTS CONTAINING HAZARDOUS CHEMICALS ARE MERCHANDISED ON SHELVES IN SUCH A MANNER AS TO PREVENT DAMAGE, BREAKAGE, OR SPILLAGE OF THE PRODUCT. INCOMPATIBLE CHEMICALS ARE SEPARATED BY DISTANCE AND/OR PARTITIONS TO AVOID ACCIDENTAL MIXTURE. 9 9 Release Containment 07/06/2006 SMALL RELEASES WILL BE HANDLED BY TRAINED PERSONNEL. CHEMICALS WILL BE ABSORBED, PLACED IN AN APPROPRIATE CONTAINER AND HANDLED BY A PROFESSIONAL CONTRACTOR AND STORES WILL CONTACT CENTRAL DISPATCH 623-869-3110, OR AFTER HOURS 714-736-7212, AND/OR LOCAL AUTHORITIES. Clean Up 07/06/2006 CLEAN-UP WILL BE HANDLED BY A PROFESSIONAL CONTRACTOR. STORES WILL CONTACT CENTRAL DISPATCH 622-869-3110, OR AFTER HOURS 714-736-7212, AND/OR LOCAL AUTHORITIES. Other Resource Activation -7- 02/20/2007 ~, F VONS 2033 SiteID: 015-021-002005 ~ _ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~JiJCC:1d1 11dGdL US Utility Shut-Offs 05/08/2006 A) GAS - NE REAR STORE B) ELECTRICAL - C) WATER - N REAR STORE D) SPECIAL - N/A E) LOCK BOX - NO ,F~i~ ,rye Prot~/ec . /Av~a~i,.l . Water . ~ ~,~ ~ /~ 5p~.l~~I~-~~~[~.(/j/~ l~z~v U~~1L ~~D/'i/t ~~1u'~"' (~Gl~~l~ ~ l ~ y 2~~ ~~~ i Building Occupancy Level 07/06/2006 96 EMPLOYEES -8- 02/20/2007 t. i 1 i~ F VONS 2033 SiteID: 015-021-002005 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/08/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: IN THE EVENT OF AN INCIDENT, THE AREA WILL BE IMMEDIATELY EVACUATED OF CUSTOMERS AND UNTRAINED PERSONNEL. TRAINED MANAGERS WILL MITIGATE, IF POSSIBLE, OR CONTACT LOCAL OFFICIALS FOR ASSISTANCE. rctyC ~ nvlu tai r u~.uiC vSC Held for Future Use -9- 02/20/2007 UNIFIED PROGRAM INSPECTION CHECKLIST~~; ory ogram SECTION~1~. ~~Business~Plan and Invent - Pr~,~ ~: BAKERSFIELD FIRE DEPT Prevention Services ~~~~ 9001Yuxtun Ave., Suite 210 ~r*>r~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME v NSPECTION DATE 3i2 INSPECTION TIME ®NS ADDRESS 2d '-t S oa C HONE NO. s~~ ~o~ i 6~ O OF EMPLOYEES o c FACILITY CONTACT ~ USINESS ID NUMBER 15-021- ~~ ,~ C 6 Section 1: Business Plan and Inventory Program ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance OPERATION V=Violation _ ____ COMMENTS ________ _ ^ ~ APPROPRIATE PERMIT ON HAND £~ ~ ~ .. ~ P® ~,.. ~'~ ^ BUSIrI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY '~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING t ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~UO/ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING j$B ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~lO EXPLAIN: _. QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 326-3979 ~~~~~~)~ ~r~ Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # Business Site/School SHe Responsble PaAy (Please Print) White -Prevention Sarvicea Yellow -Station Copy Pink - Buaineas Copy FD2048 (Rw. 02/05)