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HomeMy WebLinkAboutBUSINESS PLAN 9/2/2005:~ WALGREEN'S #3272 3315 SO. H STREET ~~ UNIFIED PROGRAM INSPECTION CHECKLIST • i~y SECTION 1 Business .Plan and Inventory Program Bakersfield Fire Dept. ' Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: X661)_326 3979 ___ ____ FACILITY NAME WSPECTION DATE INSPECTION TIME CJ ~.~ 62E~rJ s. ~ X72 . ~- ADDRESS P E No. of Empbyees FACILITVCONTACT~~ ~ ~ Business ID Number C~1-2 l s ~1 Er:_.~5 ~ tJ ANA to ~/Z 15 -021- ~ () 19© q Sec~on 1: Business Plan and Inventory Program Routine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection ANY HAZARDOUS WASTE ON SITE?: ~ YES ^ NO ExPLAIN: ~~{o Yo CF~E n.r, L_ l~~~ f ~ 6A L • QUE T S R RDING THIS INSPECTIONS P EASE CALL US AT ~6G')~ 326-3979 ctor (Please Fire Prevention 1st-In/Shift of Site White -Environmental Services Yellow -Station Copy ---- Site Respoh tble arty (Please Print) ~ Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION D TE INSPECTION TIME ADDRESS ~ --~ -- ------- ------.---- - - PHCJNE No. No. of Employees --- 33 /.s" ~ . N ss~ - - --- - - 396 -c~~ _..-~~__.._. FACILITYCONTACT Business ID Number 15-021- Oo Iq o~ Section 1: Business Plan and Inventory Pn~gram Routine ^ Combined ^ Joint Agency ^Mnlti-Agency O Complaint ^ Re-inspection C V \V=V'loationnce~ OPERATION COMMENTS I~ ^ APPROPRIATE PERMIT ON HAND ~g03--- - -----°- ------------------ -- -- I~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~ v ~ -------- ------ ----------- ---- - --- ^ VISIBLE ADDRESS ~I ^ CORRECT OCCUPANCY ~I ^ VERIFICATION OF INVENTORY MATERIALS 1~ ^ VERIFICATION OF QUANTITIES I~ ^ VERIFICATION OF LOCATION Y f a 7 ~T~ r! G.~Q-Q/, ~j/ ~ Q / - ~, ^ PROPER SEGREGATION OF MATERIAL ----- - -- r _l.r-~ ~ ~~~~G~S -~~<~~- -_C~N l ^ - VERIFICATION OF MSDS AVAILABILITYE - ----------- ------- ' ~x~~ ~~ ~c~-4~.~~4 ~ ----- ~`I ^ - VERIFICATION OF HAT MAT TRAINING -----.-..- - -------- ., _1~ J ~~ l~G ~~-r ~4 • l~' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES _ --- ---------------------------- - ^ EMERGENCY PROCEDURES ADEQUATE ------- ~I ^ CONTAINERS PROPERLY LABELED --------------------------------- ------ - ^ -- HOUSEKEEPING ---- ------- ---- - ----- -- --- - ---------------------------- ----- ^ FIRE PROTECTION ~I ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASyT~E~ON~~SDITE~: ~ YES ^ NO EXPLAIN: ~~~/~ (_~~lG°/1~1 ` QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~6F'I ~ 326-3979 n ~/ Inspector - ~ Badge No. Site White -Environmental Services yellow - Station Copy Pink -Business Copy ~ ~~, .~ .,: (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN tw+AEO araocRny coNSamu-T®FnRM1 BUSINESS ACTIVITIES PAGE {HAZARDOUS MATERIALS FACILITY INFORMATION) ~>! ._ s fl~l wRFelr BARERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 /, Tel.: (661) 326-3979 I ~V~ Fax: (661) $52-2171 ~/, ~ 1, ~ ~j t~0 Page 1 of 1. ,~, I. FACILITY IQENTIFICATION FACILITY ID # (For Office use only -please leave blank) 3 EPA 10 # N/A DBA /FACILITY NAME j~ algreens #3272 !~) 11. ACTIVITIES DECLARATION DOES Your Fadtity ... ff Yes, Please Complete ... A. HAZARDOUS MATERIALS • CHEMICAL DESCRIPTION FORM 1 1. Have on sde (for arty purpose) hazardous ®Yes O No • HAZARDOUS MATERUIL3 MANAGEMENT PLAN materials at or above 55 galbns for liquids, • Emergency Response Plan 500 pounds for solids, or 200 cu. fL for l7 Yes ®No Ma compressed gases (include fiquids in ASTs and ~ USTs)? . preve~j~ B. REGULATED SUBSTANCES fRS) 1. Have on site RS at greater than the threshold ^Yes ®No CHEMICAL DESCRIPTION FORM 191 planning quantities established by the California • RISK MANAGEMENT PLAN (RMP Sutxnit to USEPA) Accidental Release Prevention program • CONSOLIDATED COMPLIANCE PLAN rn • Incorporatlng CaIARP Program Elements ! ~ 1 (CaIARP)? V ' C. UNDERGROUND STOR.eGE TANKS (USTs1 1. Own or operate Underground Storage Tanks? ^Yes ®No UST FAGLITY FORM L., i • UST TANK FORM (One Per Tank) ~J 2. Intend to upgrade existing or install new USTs? ^Yes ®No • UST FACILITY FORM • UST TANK FORM (One Per Tank) • D. TANK CLOSURE /REMOVAL 2. Need to report closing an UST that j~ hazardous O Yes M No UST TANK FORM (Closure sectlon -one per tank) materials or 3. Need to repoR the closure % removal of a tank that O Yes ®No UST TANK CLOSURE FORM was classified as hazardous waste and leaned on- sice? E. ABOVEGROUND PETROLEUM STORAGE TANKS (ASTsI ^Yes'® No • HAZARDOUS MATERIALS MANAGEMENT PLAN 1. Own or operate ASTs above these thresholds; Incorporatlng Federal Spiu Preventlon Control and any tank Ca ad p ty is greater than 660 gallons or the Countermeasure (SPCC) Elements pursuant to 40 CFR Part 112. total capaclty for the facility is greater than 1,320 F. HA7eRDOU3 WASTE EPA 10 NUMBER - Provido on this page 1. Generate hazardous waste? ^Yes ®No • To obtah- EPA ID Number, please ptrone (918) 324-1781 2. Recycle more than 100 kg/m0 of recyclable ^Yes ®No • RECYCLING FORM materials at the same location it was generated? 3. Recycle more than 100 kg/m0 Of recyclable O Yes ®No • RECYCLING FORM materials at an off-site location different from the point of generation? 4. Treat Hazardous Waste on site? ^Yes ®No • TP FACILITY FORM • TP UNIT FORM (One per uniq 5. Subject to Financlal Assurance requitemer>ts7 O Yes ®No • CERTIFICATION OF FINANCIAL ASSURANCE 6. ConsoUdate Hazardous Waste generated at a ~ Yes ®No • REMOTE WASTE I CONSOLIDATION SITE NOTIFICATTON FORM remote site? NOTE:. !f you checked YES to any part of Sections 11A -11F above, then in addition to the fortes requested above, please Submit BUSINESS OWNER/OPERATOR IDENTIFICATION FORM (FD2089) FD 2143 (Rev. o9J0'.S) E~'~ ~ ~ B ~ 3 2006 "~ G (HMMP) FIAZA.RDOtJS MATERIALS MANAGEMENT PLAN NNIFIED PROGRAM CONSOLIDATED FORM) APPLICATION BUSNESSaVY1~F3Z/OP9iATORD9~tifICAT10NF+OE~IIA ~~ (HAZARDOUS MATERIALS FACILITY INFORMATION) I-/tL A~ BAKERSFIELD FIRE DEPT. Preveatioa Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 2 L FACILITY IDENTIFICATION ~ FACILITY ID NO. t Year Bapiminp too Year Ertdi tot !~ 02/ 15/2006 02/ 15/207 BUSINESS NAME (Same as FACILnY NAME or OBA- Doing Bualrteaa Aa) s BUSINESS PHONE taz algreens #3272 661-396-0631 sITE ADDRESS ,p, 3315 South H Street akersfield toy CA 3304 ~~ a sTREET 9~~3 ~~ ~ sic coDF~912 7384 707 - , (a oil s) couNTY ,oe Kern --9PERATOR ~~ toff OPERATOR HONE „p Walgreens Corporation 847-914-3853 ,, .... IIc.OtNNER INFORMATION OWNER NAME ttt OWNER PHONE to Walgreens Corporation 847-914-3853 OWNER MAILING ADDRESS tt7 200 Wilmot Road CITY to STATE tts IP na Deerfield IL ' 60015 III. EN1/IRONMENTAL CONTACT CONTACT NAME ttt CONTACT PHONE „a Christina Chiappetta, Safety & Compliance Environmental Supervisor, MS 2171 847-914-3195 CONTACT MAILING ADDRESS tta 200 Wilmot Road CrrY t20 STATE tZt ZIP ~ Deerfield IL 60015 - PRIMARY ! N. EMERGENCY CON TACTS -SECONDARY- NAME 123 NAME 128 Chris Nelson Agnes Macapagal TITLE 124 TRLE 129 Store Manager District Photo Supervisor BUSINESS PHONE 125 BUSINESS PHONE 130 661-396-0631 559-307-7100 24-HOUR PHONE 126 24-HOUR PHONE 131 661-589-0419 559-307-7100 PAGER NO. 127 PAGER NO. 132 N/A N/A 133 . .. .. V. CERTIFICATION Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of taw 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 SIGNER 138 DATE 134 NAME OF DOCUMENT PREPARER 135 02/15/2006 lison Millard, Agent for Walgreens Corporation NAME OF OWNER/OPERATOR (SDIGNATURE 8 PRI 137 TRLE OF OWNER/OPERATOR 138 Dean Jarrett / Divisional Merchandise Manager FD 2142 (Rev. 09105) .~ ,HAZARDOUS MATERIALS MANAGEMENT PLAN UNIFIED PROGRAM CONSOLIDATED FORMS CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIALS INVENTORY ^ NEW ^ ADD O DELETE ® REVISE 2006 ~/RL ~rrr r BAKER.SFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 (One lorm per material, per build)ng, or area.) Pann1 of 7 BUSINESS MAAAE (Sams as FACILITY NAME or DBA -Doing Buainsss As) algreens #3272 CHfJNICAI. LOCATION 201 CHEMICAL LOCATION etail Sales Floor (In Refrigeration System) CONFB)ENTUIL (EPCRA) ^ Yas~4 FACILITY ID No. 1 MAP No. (optbnu) 203 GRID NO. (optbnaq 1 F-5 CHEMICAL NAME 205 hlorodifluoromethane TRADE sECRET D Yaa 19 No COMMON NAME 207 EHS' ^ Yes ®No efrigerant (R-22) 2 CAS No. 209 'U EHS Is 'Yes; all amounts below moat ba 75-45-6 ~^~ FIRE CODE FIAZARD CLASSES (CompleU A npuestad Dy bcal fin diet) ~ .~: '-~ _: _,-^ , .;..,~~ 21 TYPE 211 - -- -- ~ 21 CURIES 21 ®p PURE O m MU(TURE ^ w WASTE RADIOACTNE: 0 1'ea f9 No _ LARGEST CONTAINER - _ ._.. .. _. . .. __. _.. - 21 PHYSICAL STATE ^ s SOLID ^ 1 UOUID & q GAS 214 - . .. . 58 21 FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTNE ®3 PRESSURE RELEASE ®4 ACUTE H EALTH ®5 CHRONIC HFJILTH (Check aU that apply) ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 22 AMOUNT O DAILY AMOUNT 258 DAIIYAMOUNT 258 CODE N/A 221 rz2 ^ UNRS ^ t>a GAL . 131 d CU FT ^ ro LBS ^ Tn TONS DAYS ON SITE 365 q EHS, amount must tx in Ibs. 22 STORAGE CONTAINER (cn•ur •u m•r .ppty) ^ a ABOVEGROUND TANK 0 t CAN ^ k BOX ^ p TANK WAGON ^ b UNDERGROUND TANK ^ q CARBOY ^ I CYLINDER p q RAIL CAR ^ c TANK INSIDE BUILDING ^ h SILO In Refri eration S stem ^ d STEEL DRUM ^ 1 FIBER DRUM ^ n PLASTIC BOTTLE D a PLASTICMONMETALLIC DRUM ^ j BAG ^ o TOTE BIN u STORAGE PRESSURE ^ a AMBIEN7 ® as A80VE AMBIENT ^ ba BELOW AMBIENT 22 STORAGE TEMPERATURE ® a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT D c CRYOGENIC %WT ~' HAZARDOUS COMPONENT EHS..`~:~ ~~ CAS # . 1 226 227 ^ Yes 0 No 228 22 2 230 231 D Yea ^ No 232 2 3 234 235 ^ Yea ^ No 236 23 4 238 239 ^ Yas ^ No 240 241 5 242 243 ^ Yss D No 244 24 _ - - . ~ ; ;; ~ .... ~ '~ • ~ III. SIGNATURE-:.: _ . PRINT NAME b TITLE OF AUTHORIZED COMPANY liEPRESENTAT SIGNATURE GATE 2 Dean Jarrett/ Divisional Merchandise Manager 02/15/2006 FD 2144 (Rev. 09/05) .~r. ~ . WALGREENS 3272 Manager CHRIS NELSON Location: 3315.5 H ST City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: ~~gDO SiteID: 015-021-001909 BusPhone: (661) 396-0631 Map 123 CommHaz Low Grid: 13B FacUnits: 1 AOV: SIC Code:5912 cu•.d 73,s~'~ DunnBrad : q 3-- jo3 ~- fir) Emergency Contact / Title Emergency Contact / Title CHRIS NELSON / STORE MANAGER AGNES MACAPAGAL / DIST PHOTO SUPR Business Phone: (661) 396-0631x Business Phone: (661) 396-0631x 24-Hour Phone (661) 589-0419x 24-Hour Phone (559) 307-7100x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth w~any Contact : °C~•iR3-S~'3~]A CLH3~i}E'IY'A3~ Co o `/ Rai~,,J abr`J ~• Phone : "~4;~ ~ B2•_ ~~ (-~ ~~) MailAddr: -2b~@-W3~MOT ~D-M:S-2~?~ l`l0s ~}r)-a h Pave . State: I~ City ~ERRi~3~i,D-~Ga.~lsbaG( Zip -~r6.63-5r Owner WALGREENS CORP Phone : ( 84 7 ) 914 ~$5-3x 22(~ ~{ 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 •F; ~ n r.TT nm~ r' Tr7 rrrap-x~rvu,r s (~ L /1\ ~~ ENr~D ~~ R z ~ z~o7 Based on my inquiry of those individual responsible for obtaining the informatian, I certify under penalty of law that I hav© personally examined and am familiar with the information submitted and belie°re the information is true, accurate, and complete. ~'Y1-~,-a~•~.~.~''~ 3 •t2•Zoo 1 Signature Date -1- 02/20/2007 F WALGREENS 3272 SitelD: 015-021-001909 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ~S CHLORODIFLUOROMETHANE G FT3 Low HELIUM F P IH G 22-x' FT3 Min "'~'S'~E F3X~R ~~-e L 3 0. 0 0 GAL Min -2- 02/20/2007 -3- 02/20/2007 F WALGREENS 3272 SiteID: 015-021-001909 ~ ~ Inventory Item 0003 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 IN REF SYS CAS# 75-45-6 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average Zug ' '-~^w-v~ FT3 2,"~ ' ~~B-d-^a FT3 ~S~ '~-o FT3 - HxGL~l[1JVU5 1:V1~lYV1VI;1V 15 %Wt. RS CAS# 100.00 Chlorodifluoromethane No 75456 rlr~~tittl~ tia~~a~ln~iv_15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit INSIDE SE CRNR OF STORE STATE TYPE PRESSURE = Gas TPure Above Ambient 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 Daily Average ~ 2~ ~-6~ FT3 ~ ~j ^' ' ~ ^ . ^ ^ FT3 ~ ( Q --~=~-o o-- FT3 t1KGHKLVUJ l:Vl°lYV1V~1V1J %Wt. RS CAS# 100.00 Helium No 7440597 riEiGl~itC1J L-~~JJ;J~1~11~,1V1J 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 3272 ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE FIXER "' ®~~~ PHOTOGRAPHIC SLUDGE W/SILVER Location within this Facility Unit INSIDE SE CRNR OF STORE SiteID: 015-021-001909 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid I Waste ( Ambient~E ~ AmbientT~E DRUM/BARRELENONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 30.00 GAL 30.00 GAL 15.00 GAL r~~,r~tcLU u a ~:vrir~iv ~i~ l oWt. RS CAS# 0.50 Silver No 7440224 tiL-~GE~tCL ASS~a51~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min -5- ~ 02/20/2007 a F WALGREENS 3272 SiteID: 015-021-001909 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 01/13/1999 NOTIFICATION OF THE PROPER AUTHORITIES IS THE RESPONSIBILITY OF THE PHOTO LAB MANAGER, STORE MANAGER, OR DESIGNATED ALTERNATE IN CASE OF EMERGENCY. PHOTO LAB OPERATORS ARE NOTIFIED OF THE PRESENCE OF AN EMERGENCY REQUIRING EVACUATION BY VERBAL COMMUNICATION OR WITH THE STORE ALARM SYSTEM IF ONE EXISTS. ALL PHOTO LAB EMPLOYEES WILL EVACUATE IMMEDIATELY FOLLOWING THE WARNING. THERE ARE NO CRITICAL OPERATIONS WHICH WILL BE PERFORMED IN THE PHOTO LAB PRIOR TO EVACUATION. 9 Employee Notif./Evacuation 01/13/1999 PHOTO LAB OPERATORS WILL EVACUATE USING THE CLOSEST ACCESSIBLE EXIT (USUALLY THE FRONT DOOR). THE STORE MAY ALSO PROVIDE A FACILITY MAP, SPECIFIC TO THE STORE, THAT DESIGNATES FIRE EXITS. AFTER EVACUATION, PHOTO LAB OPERATORS WILL CONGREGATE IN THE PARKING LOT, A SAFE DISTANCE FROM THE FRONT OF THE STORE. ALTERNATE CONGREGATION POINTS MAY BE SPECIFIED IN THE STORES SITE-SPECIFIC EMERGENCY ACTION PLAN. THE PHOTO LAB MANAGER OR STORE MANAGER WILL BE INFORMED OF PHOTO LAB OPERATORS SAFE EVACUATION. Public Notif./Evacuation ACCOUNTING FOR EVACUEES - PHOTO LAB OPERATORS WILL PHOTO LAB OPERATORS HAVE SAFELY EVACUATED THE BLDG. OR STORE MANAGER WILL BE NOTIFIED OF THE ABSENCE OF 01/13/1999 ENSURE THAT ALL OTHER THE PHOTO LAB MANAGER ANY PHOTO LAB OPERATORS. L~LLIClyGlll..y 1.1C 1111.0.1 x10.11 -6- 02/20/2007 F WALGREENS 3272 SiteID: 015-021-001909 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 02/19/1999 PHOTOPROCESSING CHEMICALS ARE DILUTE SOLUTIONS CONSISTING PRIMARILY OF WATER; THEREFORE, THEY ARE NOT FLAMMABLE. USED RAGS, WASTE PAPERS, AND FLAMMABLE MATERIALS ARE NOT STORED IN THE PHOTO LAB. 9 Release Containment 01/13/1999 TO MINIMIZE SPILLS IN THE PHOTO LAB, OPERATORS PRACTICE GOOD HOUSEKEEPING. PHOTO PROCESSING CHEMICALS ARE TYPICALLY STORED IN DELIVERY CONTAINERS AND KEPT IN THE DELIVERY CONTAINERS PRIOR TO USE TO AVOID ACCIDENTAL SPILLS. PHOTOPROCESSING CHEMICALS ARE STORED AWAY FROM HEAVY TRAFFIC AREAS. SPILLS THAT DO OCCUR IN THE PHOTO LAB ARE USUALLY VERY SMALL IN VOLUME AND CAN BE READILY CLEANED UP. Clean Up 02/19/1999 A MOP OR SPONGE THAT HAS BEEN THOROUGHLY RINSED WITH FRESH WATER IS USED TO ABSORB THE SPILLED PHOTOPROCESSING CHEMICALS. ALL RINSE WATER IS CAREFULLY POURED INTO THE PHOTO LAB WASTE DRUM USING A FUNNEL. THE MOP, SPONGE, AND/OR BUCKET USED FOR CLEAN-UP IS THOROUGHLY RINSED IMMEDIATELY AFTER USE. V1.11Ci LCC .7VUi l:C tiG LlVGt l,.1 V11 -7- 02/20/2007 F WALGREENS 3272 SiteID: 015-021-001909 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~7~JC 1:1d1 tldGdlU~ Utility Shut-Offs 01/12/2007 A} GAS - NONE B) ELECTRICAL - IN STOCKROOM C) WATER - MAIN OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLERS AND FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - 100FT FROM FRONT DOOR CRNR S H & PLANZ. 01/12/2007 Building Occupancy Level 03/07/2006 31 EMPLOYEES -8- 02/20/2007 F WALGREENS 3272 SiteID: 015-021-001909 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/12/2007 ~ MSDS SHEETS ON FILE. BRIEF SUNIlKARY OF TRAINING PROGRAM: THIS EMERGENCY BY ALL PHOTO LAB OPERATORS UPON INITIAL ASSIGNMENT ADDITION, THE PLAN IS REVIEWED BY OPERATORS IF THE CHANGE, OR IF ANY CHANGES ARE MADE TO THE PLAN. A EMERGENCY ACTION PLAN IS KEPT IN THE PHOTO LAB FOR OPERATORS. ACTION PLAN IS REVIEWED TO THE PHOTO LAB. IN LR DUTIES UNDER THE PLAN WRITTEN COPY OF THIS REVIEW BY ALL PHOTO LAB rayc ~ Held for Future Use Held for Future Use -9- 02/20%2007 CALIFORNIA ANNNTATED SITE MAP (BUSINESS NAME~WALGREENS #3272 (SITE ADDRESS~BAKERSFIELD, CA 93304 I Map #.1 EF 2 I A B 1 2 3 4 O ELECTRIC MAIN OG GAS MAIN O PATER MAIN FIRST AID SK SPILL KIT R-22 REFRIGERANT ® FLOOR DRAIN FIRE EXTINGUISHER Q COMPRESSED GAS CYLINDERS (~~) 5 6 7 Y C D E F G H I 0 4 d i F ( ^ ~ :nn G W __ ~ _ __ _ ____ NFG _0 _ V _ O„__. _.__. ~ LPG OHH Offii! IRR X -~ ALIF^RNIA ANN^TATED SITE MAP BUSINESS NAME: SITE ADDRESS:3315 S, H ST. Map #.2 OF 2 WALGREENS #3272 BAKERSFIELD, CA 93304 ., A B C D E F G H I `' 1 2 3 4 5 6 ~° ,. ~_ _ -- -,- 1 3E E J W z ~z ~Q U ® STORM DRAIN FIRE HYDRANT SAFE REFUGE AREA Y X -~ -, ~~, . BUSINESS ACTIVITIES KERP~ COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT 27UQ M STREET, SUITE J00 Ifnified Prot?ram Consolidated Form (l1pCF) BAKERSFIEI,D, CA 93301 FACILITY INFORMATION 661 862=8700 Fax 661 862-8701 Pa e 1 of 4 I. FACILITY IDENTIFICATION FACILITY ID # ! ! t EPA ID # (Hazardous Waste Only) ' ~ _ N/A BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) 3 Walgreens # 3272 II. ACTIVITIES DECLARATION ~0~~ 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 fete these a es of [he 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 (xc Fnrm 273t) 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 materials in quantities for which an emergency plan is SITE MAP (xc Form z73a) 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) (xc Fnm, o) 2. Intend to upgrade existing or install new USTS? ^YES ®NO 6 UST FACILITY UST TANK (one per tank) UST INSTALLATION - CER 1"IFICATE OF COMPLIANCE (one page per tank) (KC Form C) 3. Need to report closing a UST? ^YES ®No 7 UST TANK (closureporcion-oncpagcpcrtank) 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 KCEI-ISD D. HAZARDOUS WASTE ~~ 1. Generate hazardous waste? ~N~ ~ ®YES ^ NO 9 EPA ID NUMBER provide at the top of this page WASTE GENERATOR FORM (KC Form 2735) 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 recycler) (KC Form 2772) 3. Treat hazardous waste on site'? ^YES ®NO I 1 ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (KC Form U72t) ONSITE HAZARDOUS WASTE TREATMENT -UNIT lone page per unit) (KC Form 1772u) 4. Treatment subject to financial assurance requirements (for ^YES ®NO 12 CERTIFICATION OF FINANCIAL Permit by Rule and Conditional Authorization)? ASSURANCE (KC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ^YES ®NO l3 REMOTE WASTE /CONSOLIDATION SITE ANNUAL NOTIFICATION (KC Form t tva) 6. Need to report the closure/removal of a tank that was classified as hazardous waste and cleaned onsite? ~ yES ®NO i4 HAZARDOUS WASTE TANK CLOSURE CER'1'IFICATiON (KC Forth t2a9) E. LOCAL REQUIREMENTS 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 IZS is any substance listed in Section 2770.5 of CCR Title 19, Division 2, Chapter 4.5. RISK MANAGEMENT PLAN (when required) F~ BUSINESS OWNER/OPERATOR IDENTIFICATION KERN COUNTY ENVIRONMENTAL HEALTH SEKVIC;EJ U>;NAKI'MENT 2700 M STREET, SUITE 300 Unified Program Consolidated Form (UPCF) BAKERSFIELD, CA 93301 FACILITY INFORMATION 661 862-8700 Fax 661 862-8701 ® NEW BUSINI=.SS ^ OUT OF BUSINESS ^ REVISE/UPDATE (EFFECTIVE / / ) Page? of 4 I. IDENTIFICATION FACILITY [D# I BEGINNING DATE loo ENDING DATE 101 9/23/05 9/23/06 BUSINESS NAME (Sara as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE loz Walgreens # 3272 (661) 396-0631 BUSINESS SITE ADDRESS ~°3 3315 South H Street CITY 104 ZIP CODE los C`~ Bakersfield 93304 DUN & BRADSTREET lob S[C CODE (4 digit #) io7 93-103-6651 5912, 7384 COUNTY log Kern Count BUSINESS OPERATOR NAME u>9 BUSINESS OPERATOR PHONE ' to Walgreens Corporation (847) 914-3853 II. BUSINESS OWNER OWNER NAME ~ ~ ~ OWNER PHONE 112 Walgreens Corporation (847) 914-3853 OWNER MAILING AUDRESS I1! 200 Wilmot Road CITY 114 STATE ~ IS ZIP CODE 116 Deerfield IL 60015 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE llg Christina Chiappetta (847) 914-3195 CONTACT MAILING ADDRESS ~ 19 200 Wilmot Road, MS 2171 CITY 120 STATE 121 ZIP CODE X22 Deerfield IL 60015 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME 12g Chris Nelson Agnes Macapagel TITLE I'-4 TITLE 129 Store Manager Photo Supervisor BUSINESS PHONE Izs BUSINESS PHONE 13° (661) 396-0631 (661) 396-0631 24-HOUR PHONE 126 24-HOUR PHONE 131 661-589-0419 559-307-7100 PAGER # 127 PAGER # 132 N/A N/A ADllIT[ONAL LOCALLY COLLECTED INFORMATION: 133 APN: 4 0 5_ 2 1 0_ 1 9_ 0 0_ g 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 OFOWNER/OPERATOR OR DESIGNAT D E RESENTATIVE DATE X34 ~ ~~ ~ NAME OF DOCUMENT PREPARER 135 ~` ` 0 Brian Vernetti, Agent for Walgreens Corporation NAME OF SIGNER (print) l36 TTTLE OF SIGNER 137 Dean Jarret Divisional Merchandise Manager ~ HAZARDOUS WASTE GENERATOR KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT C nified 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 # I_ ~ ~ EE'A ID # (Hazardous Waste Only) N/A BUSLNESS NAME (Same as Facility Name of DBA-Doing Business As) 3 Walgreens # 3272 # OF EMPLOYEES A 25 II. TYPE OF GENERATOR PLEASE CHECK THE BOX THAT APPLIES B RCRA GENERATOR FEDERAL WASTE NON-RCRA GENERATOR CALIFORNIA WASTE ONLY LARGE QUANTITY GENERATOR (>[000 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) !certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR NAME J Dean Jarret OWNER/OPERATOR TITLE K Divisional Merchandise Manager OWNER/OPERATOR SIGNATURE DATE L HAZARDOUS MATERIALS INVENTORY - cxEM><caL nESC>~PTioN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (U PCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELU, CA 93301 661 862-8700 FaX 661 862-8701 (onc page per mtterial per building or area) ®ADD ^ DELETE ^ REV 1SE zoo Page ~ of ~ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DI3A -Doing Business As) 3 Walgreens # 3272 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zoz Retail Sales Floor ^ YES ® NO j ~ i MAP# (optional) 203 GRID# (optionaq 204 FACILITY lD # 1 E-2 II. CHEMICAL INFORMATION CHEMICAL NAME 'z05 TRADE SECRET Yes No ''-06 Helium If Subject to EPCRA, refer to instructions COMMON NAME zo7 2os 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) zlo NFG, OHH HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^ b. MIXTURE ^ c. WASTE 2n RADIOACTIVE ^ Yes ®No 212 CURIES 13 PHYSICAL STATE (Check one item only) ^ a. SOLID ^ b. LIQUID 18 c. GAS 214 LARGEST CONTAINER 21,360 215 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 2l8 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE -'-0 21,360 21,360 0 N/A 221 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 STORAGE 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. OTHER ^ 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 2z4 STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I z26 2z7 ^ Yes ^ No zzs z29 2 230 237 ^ Yes ^ No 232 233 j 234 235 ^ Yes ^ NO 236 237 Q 238 239 ^ Yes ^ NO 240 241 5 zaz za3 ^ Yes ^ No z4a gas If more hazardous components are present et greater than 1 •/, by weight if non-catrinogenic, or 0.1°/. by weight it wrdnogeniq attach addffional sheets of paper capturing the requtrcd information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Si Here HAZARDOUS MATERIALS INVENTORY - c~~cAL nESCx~rTioN KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862-8700 Fax 661 862-8701 (onc pagc per nuterial prr building or urea) ®ADD ^ DELETE ^ REV ISE Y0U Page 3 of ~ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or UBA -Doing Business As) 3 Walgreens # 3272 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2 Retail Sales Floor (In Refrigeration System) ^ YES ®No ~ - -` t MAP# (optional) 203 GRID# (optionaq 20a FACILITY lD # 1 F-5 II. CHEMICAL INFORMATION CHEMICAL NAME ''-os TRADE SECRET ^ Yes ®No 206 Chlorodifluoromethane !(Subject to EPCRA, refer to instructions COMMON NAME zoo 2os EHS* ^ Yes ®No Refrigerant (R-22) CAS# 209 "lf EHS If "Yes", all amounts below must be in pounds 75-45-6 FIRE CODE HAZARD CLASSES (Notcu:ventlyrequiredby KCEHSU) zio NFG, OHH, IRR HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^ b. MIXTURE ^ c. WASTE 21 t RADIOACTIVE ^ Yes ®No 2t2 -13 CURIES PHYSICAL STATE (Check one item only) ^ a. SOLID ^ b. LIQUID ®c. GAS Zia 2t5 LARGEST CONTAINER 1708 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 219 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE '--° 1708 1708 0 N/A z21 DAYS ON SITE: '-'-2 UNITS' ^ a. GALLONS ®b. CUBIC FEET ^ c. POUNDS ^ d. TONS Check one item onl " 1 f EHS, amount must be in ands. 365 S"FORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONME"GALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f CAN ^ j. BAG ^ n. PLASTIC BOTTLE ® r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN In Refrigeration System ^ 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 22s %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I zzb zn ^ Yes ^ No na z29 2 230 231 ^ Yes ^ NO 232 233 3 23a z3s ^ Yes ^ No z36 z3~ 4 23a 239 ^ Yes ^ No 2ao zat 5 zaz 243 ^ Yes ^ No 2aa gas If more hazardous components are present at greater than 1% by weight if non-carcinogenla ar 0.1 % by weight [f carclnoganlc, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION za6 If EPCRA Please Si Isere 'f ~ 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 Chris Nelson Agnes Macapagel TITLE 124 TITLE 129 Store Manager Photo Supervisor BUSINESS PHONE 125 BUSINESS PHONE 130 (661) 396-0631 (661) 396-0631 24-HOUR PHONE 126 24-HOUR PHONE 131 661-589-0419 559-307-7100 PAGER # 127 PAGER # 132 N/A N/A III. 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: 4 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. 4 Current condition of the facility. a Extent of injuries, if any. d Possible hazards to public health and! or the environment outside of the facility. B. Emer enc Medical Facilit 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. CLEANUP/DISPOSAL 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 all 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 or manager on duty F. Earth uake Vulnerabilit 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 occumng 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 lete 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. In cases where a HazMat spill exceeds the capabilities of on-site resources, capabilities or training, and/or poses a special or unique hazard to life, safety or the environment, management will ca11911 and, if applicable, the Office of Emergency Services at (800) 852-7550. In conjunction with this notification, an external contractor, capable of safely cleaning up the spill, will be summoned to the site. IV. Emergency Equipment 22 CCR, Section 66265.52(e) [as referenced by Section 66262.34(x)(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 1 Hour Photo Apron Safety ^ Chemical Protective Boots Equipment, ®Chemical Protective Gloves 1 Hour Photo Ru er and ^ Chemical Protective Suits (describe) First Aid ^Face Shields Equipment ®First Aid Kits/Stations (describe) officeBreak Room 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) ® 5afet Glasses/Splash Goggles 1 Hour Photo goggles ^ Safety Showers ^ Self-Contained Breathing Apparatuses (SCBA) ^ Other (describe) Fire ®Automatic Fire S tinkler Systems Throughout Alarms Extinguishing ^ Fire Alarm Boxes/Stations SyStemS ® Fire Extinguisher Systems (describe) Throughout ABC rated ^ Other (describe) Spill ®Absorbents (describe) 1 Hour Photo Rags Control ^ Berms/Dikes (describe) Equipment ^ Decontamination Equi ment (describe and ^ Emergenc 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 Throug out Alarm ^ Portable Radios SyStemS ®Telephones Throughout ^ 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 proceduresrnterva/s. Attach additional pages, numbered appropriately, ifneeded. 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. 4 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: 4 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 Emer enc Response Organizations. Additional training should include: 4 Internal alarm/notification procedures. 4 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 ex osed, including routes of ex osure (i.e. inhalation, in estion, absorption . 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 a 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 ervision 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). 4 Description for each position listed above (must include required skill, education, or other qualifications as well as duties of employees assigned to the position. 4 Description of type and amount of both introductory and continuing training given to each employee. 4 Records that document that the requirements for training or job 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). ALIFORNIA ANNOTATED SITE MAP ~ BUSINESS NAME: Walgreens #3272 I SITE ADDRESS: 3315 South H St. Bakersfield, CA 93 A B C D E F G H 1 2 3 4 5 6 f' Map #:1 I a, 3E NORT UNDEFI Y X -~ ~ .~ HELIUM TANK FIRST AID KIT O ELECTRIC PANEL O WATER MA[N O GAS MAIN FIRE EXTINGUISHER FLOOR DRAIN R-22 REFRIGERANT EMERGENCY EQUIPMENT ALIFORNIA ANN^TATED SITE MAP BUSINESS NAME: Walgreens #3272 SITE ADDRESS: 3315 South H St. Map #:2 Bakersfield, CA 93304 A B C D E F G H 2 3 4 5 6 f° LAUNDR^ AT NORT H&R BL^C i I" SBC ~ ~ J Q I I~. Z A o! U ~ e IV L_i~~ Z a ... J S^U H H ST. 1 SCA E~ 3E NOT TO SCALE m. .;• , EVACUATION AREA FIRE HYDRANT ® STORM DRAIN Y X -~ • UNIFIED PROGRAM INSPECTION CFIECKLIST .SECTION 1: Susiness~Plan and Inventory Program ~ Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME 'f NSPECTION DATE NSPECTION TIME ADDRESS Gd HONE NO. O OFEMPIOYEES 331 S "~ ~~ ,/,/ •• s /, ~ `~~, - ~~ ~ / ?....~';' • ~- ..`~ FACILITY CONTACT • ~ ~ ~ a ~ /~~" f~5 6 USINESS ID NUMBER 15-021- ~GO/ ~ O ~ Section 1: Business Plan and Inventory Program ~` OW ~'~ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ C PI'" APPROPRIATE PERMIT ON HAND ~ / L3~, ^ BUS1ileSS PLAN CONTACT iNFORMAT{ON ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS r! ~^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ® ^ ~^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY (tT'~^ VERIFICATION OF HAZ MAT TRAINING ~,/ L7 ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES l!~' ^ EMERGENCY PROCEDURES ADEQUATE ~^ CONTAINERS PROPERLY LABELED ~ ^ HOUSEKEEPING ~ / tl~l' ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~~~ EXPLAIN:' __ - .Q~yU~ESTIONS RE/GARDIfNG THUS INSPECTION? PLE,A/~SE CALL US AT (881) 328-3979 Ins°pector (Please Print) /ire Prevention / 1`~ In / Shift of SBe/Station Y BAKERSFIELD FIRE DEPT a p Prevention Services ~i1r*~ 900 Truxtun Ave., Suite 210 ~s'r/ ~ BakersSeld, CA 93301 White -Prevention Services Yeilow -Station Copy Pink - Business Gopy FD2048 (Rw. ORI05)