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HomeMy WebLinkAboutBUSINESS PLAN (3)-__. -r--- --- ---~_ -- -- -- - -- - _ - ;, ~~ I i _ -\ _„~ i BROOKSIDE MARKET & DELI B'~' 4700 COFFEE ROAD ~~~ ; ~~ JuL ~ l , ~~~r ~= _ Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST~i B_ E R S_F ~ __ 900TruxtunAve., Suite 210 ~---~-- -- - - - ` FIRE _D Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~ ART, r Tel.: (661) 326-3979 ~~ ~ Fax: (661) 872-2171 FACILITY ME ~/~ ~ ,.~/. - ~~ ~7 ~ LC. INSPE 10 DATE © INSPECTION TIME ADDRESS ~ ~ r PHO ENO. ~ ~ NO OF EMBL.OYEES ~ ~ ~ ~ s" V ^ ~ 3 l I/ FACILITY CONTACT BUSINESS ID NUMBER 15-021-, l ~ ~~ Section 1: Business Plan and Inventory Program. ^ ROUTINE OMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ~ APPROPRIATE PERMIT ON HAND l:~t~lND-~- ~~ ~V~ (O ~ `,~-. ,., , / L4~ ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS LEI/ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES I~-~~ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ ~ VERIFICATION OF MSDS AVAILABILITY S~` ,j S r ~~ C~„ J• ~~C: ~ /~- ^ LW VERIFICATION OF HAZ MAT TRAINING cS ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES LAY ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION r V~. ~~ efrsF^~ r C~S lkt9J~Y ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES `~NO EXPLAIN: QUESTIO~ REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White -Prevention Services Yeltow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 „-. INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~~St~c . ~_ BAKERSFIELD FIRE DEPT. Prevention Services e ~~ E R S F I -, n 900 Truxtun Ave., Ste. 210 F/RE Bakersfield, CA 93301 ABTM T Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 INSPECTION DATE: _1~ Section 2: Underground Storage Tanks Program ^ Routine ~mbined ^ Joint Agency ^ Multi-Agency Type of Tank Number of Tanks Type of Monitoring Type of Piping ^ Complaint ^ Re-Inspection 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 ~~ IMoV~t ~ C S 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 White -Prevention Services Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT 0 015 4 2 PREVENTION SERVICES DIVISION 1600 TRUXTUN AVENUE, SUITE 401 (661) 326-3979 / Location: ~ 7~® ~0 ~cc.` ~ ~ ~tb~s(dc, Ad Y,~ou `are hereby required to take the following action at the above location; l]VCORRECT & CALL FOR REINSPECTION ^ CORRECT & PROCEED 3 Received by: ~~----- Inspector: Steve Underw0 d_ . nitial- - Date: ~ /~ /~ --_~--- ~-Be hane: (661) 326-3190 (from B:OOam to 8:30am) KBF-9229 c~.Uticc~C~c~ f~~c°c~~Utrc~ ~`~ ~fo ~M.S ~~ S~~s ~o~ Completion Date for Corre ti s:,,,~ /~ /~ ,. + BROOKSIDE MARKET & DELI _____________________________ SiteID: 015-021-001756 + Manager NIMI BRAR BusPhone: (661) 588-1338 Location: 4700 COFFEE RD Map 102 CommHaz Moderate City BAKERSFIELD Grid: 16C FacUnits: 1 AOV: CommCode: KCFD STA 61 SIC Code:5541 EPA Numb: DunnBrad:048479646 Emergency Contact / Title Emergency Contact / Title NIMI BRAR / MANAGER RUPINDER JHAJ / OWNER Business Phone: (661) 588-1338x Business Phone: (661) 587-8959x 24-Hour Phone (661) 303-5442x 24-Hour Phone (661) 703-5368x Pager Phone (661) 496-4049x Pager Phone (661) 204-4210x Hazmat Hazards: Fire ImmHlth DelHlth --------------------------------- -- --------------------- ----- --+ Contact RUPINDER JHAJ ,rn~ ~ MailAddr: 8049 ENDS LN `~' ~~ Phone: IU Gb State: (661) 587-895.9x CA City BAKERSFIELD ~Q_~j,~ (~ ~~ Zip 93312 Owner RUPINDER JHAJ Phone: (661) 587-8959x Address 8049 ENDS LN State: CA City BAKERSFIELD Zip 93312 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~IW PROG A HAZMAT 1 PROG U - UST ~ V ~ l b` Based on my inquiry of those individuals responsible for obtaining the fnfarmatlon, I certify exam ned and am famll as with ache 1n Por~aQOn submitted and believe the information is true, accurate, and complete. ~~ ~1~ ~ Date ~°o~~ ~ ~ ~~ s5~,~~~ a ~~~ ~~~ 1~ ~®~6 -1- 05/30/2006 UNIFIED PROGRAM INSPECTION CHECKLIST=, ~~~~ ......:. ,.. a ...z ~Rrr .SECTION 1: Business Plan and Inventory Program ~'' BAHERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAM ~ T t~D NSP INSPECTION TIME ~ ~ (~'J i ADDRESS HO ~ G~~ ~ 3 O OF~MPL~ S ~ lFJ1 i Q G 3 FACILITY CONTACT ~ USINESS ID NUM81.5-021 ~ ~~/n S~ / --- __ __ ___ ~ 5 ~ ~J~~- Section 1: Business Plan and Inventory Program ~ J ^ ROUTINE BINED ^ JOINT AGENCY ^ MULTI•AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compiiance~ OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~~G~ ~g~ BUSIr1BSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS D 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 ^ PRO ^ VERIFICATION OF ABATEMENT SUPPLIES AND DURES EMERGENCY PROCEDURES ADEQUATE ^ CONTAINENS PROPERLY LABELED HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE $ ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: _ - PLEA8E CALL US AT (881) 328-3879 (Please Print) Fire Prevention / 1" In / Shift of Site/Station # -~ Business Site/School Ite Responsible Parry (Please Pritt) White -Prevention Services Yellow -Station Copy Pink - Bueinese Copy FD20~8 (Rev. 02105) "s .b ,4 . .a.LD ~~' ~~w ~ ~ ~~ ~~ ~~ ~W y'1 ~~ .~ ~ _•" '~ ~' SwF ~ARi~I FACILITY NAME~`~Q~~~ CITY OF BAKERSFIEI~U FIRE DEPARTMENT OFFICE OF ENVIRONI~'IEN1'AL SERV(t:ES iJNIF1ED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'`' Floor, Bakersfield, CA 93301 lam. _ INSPECTION DATE ~ $ ~-C Section Z: Underground Storage Tanks Program ^ Routine ~~mbined ^ Joint Agency ^Mu1ti-Agency , / ^ Complaint ^ Re-inspection Type of Tank ~tiJ~F~ Number of Tanks "T Type of Monitoring _ d.c.~~lti- Type of Piping ~~ 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: Office of Environmental Services (661) 3 -3979 White -Env. Svcs. Business Site Responsible Party Pink -Business Ci~ry \ ~. ,~~ _ a JatT - UNIFIED PROGRAM INSPECTION CHECKLIST .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a Prevention Sesvices ,>r>>R~ 900 Truxtun Ave., Suite 210 ~~sn Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE INSPECTION TIME ADDRESS HONE NO. O OF EMPLOYEES 7 FACILITY ONTACT ~ USINESS ID NUMBER ~ ~ / 15-021- '~(/~j Section 1: Business Plan and Inventory Program ~U " ~OUTINE OMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (e=Conip1i~) OPERATION V=Violation COMMENTS APPROPRIATE PERMIT ON HAND ^ BUSIfI@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 - - - ---- ,Iq ~ ~--- /~- -- ZUD6 /~ ^ V VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE _ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ~j ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: OU TIONS}IEGARDING THIS INSPECTION? PIEABE CALL U8 AT (881) 328-3979 Inspector (Please Print) Fire Prevention / 1 In ! Shift of Site/Station q usiness Site/School Site esponsibls Party (Please Print) White -Prevention Serviees Yellow -Station Copy pink -Business Copy FD2049 (Rw. 02/0ti) ... ~' ?~ ~ C[TY OF BAKERSFIELU FIRE DEPARTMENT ~~ OFFICE OF ENVIRONMENTAL SERVICES • ~~~` UNIFIED PROGRAM INSPECTION CHECKLIST ,~ ~g~;,~!' 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME '#~ ~S` F /~1.4/~~'E 7- INSPECTION DATE I ~ lc9 -~~ Section 2: Underground Storage Tanks Program outine ^ Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type of Tank ~a ubjg^~~/11l Number of "fanks ~ ~y ~ ~ Type of Monitoring Type of Piping --~,,f`L~ ~~~( OPERATION C V COMMENTS Proper tank data on the ~ ~' ~ ~. Proper owner/operator data un the d ~< < < fS ~~ ~~~! - Permit fees current `/ D~ Q t Certification of Financial Responsibility Monitoring record adequate and current ~'v I ~O'~ ~Q.vJB /L££>~S rd 6ti G'~t9 ' `SS !~- k. Maintenance records adequate and current ~ .vd Failure to correct prior UST violations Has there been an unauthorized release? YeS NU '~~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) _ Type of Tank J,,~~- ~~~ ~~v- > i .v OPERATION Y N COMMENTS SPCC available SPCC on the 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: ~i4i'1'I~N ~,~~ ~~ Office of Environmental Services (661) 326-3979 white - Fnv. Svcs. AGGREGATE CAPACITY Number of Tanks Pink -Business Cnl,y Business Site Responsible Party Y~. ~- y'~ .aV ,.~-z ~ ar'Oii _~i~F'FE )tL:~ liril~:Ek::~ll ~ I F.L,D i.`Fi .+: ~:;i ~~' o THh~ 111. '~'UI:IE~ ~= 1':., I'i'1 ;11'l=,"fl:h'1 ~TA`1'LI 1:'EiI"~>)::"I' riL.L }=UI'Ji"f11'I'~l°. h1?}k'f°1tiL - ~, Iii:>LUNIE - .!`1.=c! GF1L LIL.L.i`iGE: ~~ 1 ~~!~ Gi~l_S 90%o ULL~;~";i-:= gal ~ ~_riL TG Vc~LUI°1F' _ ~19~~'? ~F;L.3 HEIGHT = a'r . I i 1 l fdCHES Wr~TER 'ti~~L = 1 ~:;;~L,~ l.,Ir~TER = IJ . ?', 1 hJCt-IE ; TEI°IP = 6c~ ~.. LiEG F `f - : I_IPJI..EHI.!F:0 :'~ I`I'I- - . 1 _ yLl"/'„ I-Il.t.i-i!.:f: _'~lLl t>i-tl_:_: TC '~.~s;LIJI°I}'. = 6f~'=~6 Gr;L:: I-IEI~=;II'1' = 5..'=:+,' IhJ~'t1Ft3 laIFiTER ~.~i:+L. = la Gr~L.}3 6J,q'1'ER = Ia . 00 1 1di~:Hk:~: T 3 : UIVI..EHI)ED NiIRTH 1.+C1L.1_II°lE = 5~i50 i~r1I.S LILL~GE _ ~ B 0'~ Gr~L. 91 1° ll1_Li-1GE= 3?36 (~r1L: TC: liul_Uh•lE = 5350 GHL,:.; HEIGHT = X19.90 I NL'HE: I.JATER 's?UL = 0 GrL.ti 6J€~TER = U . OLl I t~1C'HE ,, TEt°iP = 59.3 I!EG F 7' 4 : ~,UPR'Eh1E +dC;LLII^'1F. = 5914 i;AL,, LIL.L(~i;E = 4~~1i=, i;rtLS, y0:?;, LIL.Li~uE= ,3'=':;' i=,NL;; Tt' ~.'ULLII°lE = 5900 GriL.~ ,, HEIGHT = 54.0:? Itd~'HE 1.^Ir`1TER IrUL = 1 '~ i :HL WATER = 0 . ` '~ I PJi~ HE°, :R: :k ::ti t ;t EtVD ?f * 4 3E 2 t ~`4. {1 BROOKSIDE MARKET & DELI Manager NIMI BRAR Location: 4700 COFFEE-RD City BAKERSFIELD SiteID: 015-021-001755 BusPhone: (661) 588-1338 Map 102 CommHaz Moderate Grid: 16C FacUnits: 1 AOV: CommCode: KCFD STA 61 EPA Numb: SIC Code:5541 DunnBrad:048479646 Emergency Contact / Title Emergency Contact / Title NIMI BRAR / MANAGER RUPINDER JHAJ / OWNER Business Phone: (661) 588-1338x Business Phone: (661) 587-8959x 24-Hour Phone (661) 303-5442x 24-Hour Phone (661) 703-5368x Pager Phone (661) 496-4049x Pager Phone (661) 204-4210x Hazmat Hazards: Fire ImmHlth DelHlt ................. Contact- RUPINDER JHAJ Phone: (661) 587-8959x MailAddr: PO BOX 640 State: CA City WASCO Zip 93280 Owner RUPINDER JHAJ Phone: (661) 587-8959x Address PO BOX 640 State: CA City WASCO Zip 93280 _. Period to TotalASTs: = Coal Preparers TotalUSTs: = C3al Certif'd: RSs: No ParcelNo: ............... Emergency Directives: PROG A - HAZMAT PROG U - UST ENT'D ~ ~B 2 2 2007 used on my inquiry of thASe indlVl~u~ls {nformatlnn, I e~rtifY th , e responsible for obta~ning that I have personally under penalty of law miliar with the information f a examined and am submitted and believe the information is true, accurate, and mplete. ~z -ter o? - i t Date -1- Ol/26/2n07 r S F BROOKSIDE MARKET & DELI SiteID: 015-021-001756 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BROOKSIDE MARKET & DELI Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper RONALD ROGERS ICC Nbr: 5246218-UC PROPERTY OWNER INFORMATION Name RUPINDER JHAJ Phone: (661) 587-8959x Address: City Type CORPORATION State: Zip: TANK OWNER INFORMATION Name RUPINDER JHAJ Phone,: (661) 587-8959x Address: City State: Zip: Type CORPORATION BOE UST Fee# UNKNOWN Financ'1 Resp: INSURANCE Legal Notif Business Mailing Address Date:04/28/2000 Phone: (426) 659- x Name:DON JEFFRIES Ttl:PRESIDENT State UST # TYMT 44-040810 1998 Upg Cert#: 00865 -2- Ol/2,6/2~07 r F BROOKSIDE MARKET & DELI SiteID: 015-021-001756 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit 1~+tCP ................ REGULAR UNLEADED L 10000.00 GAL Ntt~d PLUS UNLEADED GASOLINE L 10000.00 GAL Nlbd PREMIUM UNLEADED L 10000.00 GAL Nlod DIESEL #2 F IH DH L 10000.00 GAL Lew -3- Ol/26/~b07 -4- O1/26/Z007 F BROOKSIDE MARKET & DELI SiteID: 015-021-001756 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF FAC CAS# 8006-61-9 Liquid TMixture~ Ambient~E ~ TAE~MPeRATURE ~EROGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 4000.00 GAL t1HGH2CLV U.7 1..V1~lYV1V~1V 1 J oWt. RS CAS# 100..00 Gasoline No 8006619 t1HGHKL Hb.7J;~J1~1~1V l TSecret RS BioHaz Radioactive/Amount 'EPA Hazards NFPA USDOT# MC1 No No No No/ Curies / / / Mod ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME PLUS UNLEADED GASOLINE Location within this Facility Unit SW CRNR OF FAC STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers at 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 Daily Average 10000.00 GAL 10000.00 GAL 4000.00 GAL IIL-~GHCCLVU.7 1..V1~lYV1V~1V 1.7 %Wt. RS CAS# 100.00 Gasoline No .8006619 I1t~GL-1[CL L~~JJ;A.71~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC$ No No No No/ Curies / / / Mod -5- O1/26/~007 F BROOKSIDE MARKET & DELI SiteID: 015-021-001755 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF FAC 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 10000.00 GAL 10000.00 GAL 4000.00 GAL HAZARDOUS COMPONENTS %Wt• RS CAS# 100.00 Gasoline No 8006519 t1HGtitCL HJ JL~.7~J1~1.C.1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MC1 No No No No/ Curies / / / Mod ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF FAC CAS# 68476-3~-6 STATE TYPE PRESSURE ~ TAmEbMPeRATURE ~ CONTAINER TYPE Liquid TMixture~Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL I 4000.00 GAL rirauru~tiVVw7 L.vl•1rV1VAlVl.7 °sWt . RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 riri[~tiiCL H Ja7 L'+.7 J1~1L'1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Lot+v -6- O1/26/~007 F BROOKSIDE MARKET & DELI. SiteID: 015-021-001756 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Sites ~ ~ Agency Notification 01/24/199`7 ~ EMERGENCY PHONE NUMBERS LISTED. Employee Notif./Evacuation MAP IN OFFICE AND EMPLOYEES NOTIFIED. 12/08/1999 Public Notif./Evacuation 01/24/199`7 AS INSTRUCTED BY STORE OPERATORS. Emergency Medical Plan 12/08/1999 911. -7- 01/26/007 F BROOKSIDE MARKET & DELI SiteID: 015-021-001755 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/30/20(75 ~ AUTO SHUT-OFFS AT PUMP AND TANKS, EMERGENCY BREAKAWAYS ON ALL HOSES AND OVER-SPILL BOXES AT EACH TANK. Release Containment 04/04/2005 DRIVER TRAINING IN PLACE NOW, TRAINING OF STORE EMPLOYEES AND SHUT-OFF MECHANISM AT CONSOLE. Clean Up HAVE LIST OF EMERGENCY COMPANIES AND PHONE NUMBERS. 01/24/1997 V1.11C1 1CCSVULUC liULlVdl.1CJII -8- O1/26/~007 F BROOKSIDE MARKET & DELI SiteID: 015-021-001755 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special riazaras Utility Shut-Offs 05/30/2006 A) GAS - SE CRNR OF STORE B) ELECTRICAL - UG VAULT S END BY HAGEMAN; MAIN IN OFFICE C) WATER - NE CRNR OF STORE D) SPECIAL - EMER SHUT-OFF TO GASOLINE OUTSIDE & INSIDE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - CALL-ACTIVATED ALARM INSIDE STORE - KERN SECURITIES. NEAREST FIRE HYDRANT - SE CRNR OF SITE COFFEE & HAGEMAN. 01/26/2007 Building Occupancy Level 12 EMPLOYEES 04/04/2005 -9- Ol/26/~007 i~ a F BROOKSIDE MARKET & DELI SiteID: 015-021-001755 ~ Fast Format ~ ~ Training Overall Sites ~ ~ Employee Training 05/30/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SHEETS. ONGOING FOR NEW EMPLOYEES USING MSDS rage ~ Held for Future Use Held for Future Use -lo- 0l/26/~007