HomeMy WebLinkAboutBUSINESS PLANI~ - -
~'~GREENS
® 9550 HAGEM~ ROAD
(HMMP)
~-IAZARDOUS MATERIALS MANAGEMENT PLAN
(UNIFIED F~OGRAM CONSOI (DATED FORM(
APPLJCATION
BUSNESS OWNER/OPERATOR mEMffiCATION FORM
(HA7ARf~nl1R MATFRIAI F z-~.~;1; ??'Y INF(~RMATIt)N1
BAKERSFIELD FIRE DEPT.
-~ Prevention Services
' ~ '~ 900 Truxtun Ave., Suite 210
BP~I~IT n Bakersfield, CA 93301
~wTr ,fir Tel.: (661) 326-3979
"'' "'~ Fax: (661) 852-2171
Page 1 of 2
b~,
~~
I FACILITY tDENTIRCATION
FACILITY ID NO. ~ ear eginn ng /~ Yea Fra ng p
1/25/06 1/25/07
BUSINESS NAME (Same as FACILITY NAME or DBA- Daing Business As) s BUSINESS PHONE toz
Walgreens #6526 661-587-0733
SITE ADDRESS
ia1
9550 Hageman Road
CITY 10 Ip cos
Bakersfi
e
l
d
~,~ CA 93312
p
REET ~ ~~
pj
~
j
~
93~1~3B SIC CODE ray
i
60 (aDipit#> 5912, 7384
COON ~~
Santa Clara
OPERATOR NAME im OPERATOR PHONE tia
Walgreens Corporation (847) 914-3853
II. OW NER~IN FORMATION
OWNER NAME OWNER PHONE rtz
t11
Walgreens Corporation
(847) 914-3853
OWNER MAILING ADDRESS na
200 Wilmot Road
CITY na STATE ns IP ne
Deerfield IL 60015
III. ENVIRONMENTAL CONTACT
_
CONTACT NAME tti~ GONTAGT o-IONE e
Christina Chia etta M.S. 2171 (847) 914-3195
CONTACT MAILING ADDRESS ne
200 Wilmot Road
CITY izo STATE t21 ZIP ~~
Deerfield IL 60015
- PRIMAFi~Y IV. EMERGENCY CONTACTS -SECONDARY-
NAME 123 NAME 126
Ralph Gonzales Agnes Macapagal
TITLE 124 TITLE 129
Store Manager District Photo Supervisor
BUSINESS PHONE 125 BUSINESS PHONE 130
661-587-0733 661-587-0733
24-HOUR PHONE 126 24-HOUR PHONE O ` 131
661-587-0733 559-307-7100 \
PAGER No 127 PAGER No 132
/A N/A
V. CERTi1riCAT10N
Certlflcation Based Dn my Inquiry of those Indlvlduals responsible for obtaining the Information, I certify under penalty of law that I have personally
examined and am familiar with th 'rtformation submitted in this inventory and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR 133 DATE'/3~ /~y 134 NAME OF DOCUMENT PREPARER 135
Mike Ryan, Regulatory Compliance Specialist
NAMES OF OWNER/OPERATOR (pant) 136 7{7LE OF OWNERlOPERATOR 137
Dean Jarrett Divisional Merchandise Manager
FD2089
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,.r-I
ALIFORNIA ANNOTATED SITE MAP BUSINESS NAME: WALGREENS #6526 ~ SITE ADDRESS: 9550 HAGEMAN RD
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ALIFpRNIA ANNOTATED SITE MAP I BUSINESS NAME: WALGREENS #6526 I SITE ADDRESS: 9550 HAGEMAN RD. Map #:2 pF
BAKERSFIELD CA, 93312
A B C D E F G H I
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(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
~`
BUSINESS ACTIVITIES PAGE
(HAZARDOUS MATERIALS INFORMATION)
BAKERSFIELD FIRE DEPT.
d R $ r , ~ Prevention Services
PIR[ 900 Trttxtun Ave., Suite 210
ARTII T Bakersfield, CA 93301 ~~
Tel.: (661) 326-3979 ~~
Fax: (661) 852-217 /~ y~,
Page 1 of 1 ,` ;!+"
I. FACILITY IDENTIFICATION
FACILI fY ID # (For Office use only -please leave blank) 3 EPA ID #
TBD
DBA /FACILITY NAME _~
Walgreens #6526
II. ACTIVITIES DECLARATION
DOES Your Facility ... It Yes, Please Complete .,. zg
A. HAZARDOUS MATERIALS • OES FORM ' ':' ' )Chemical Description Form) i 130
1. Have on site (for any purpose) hazardous ®Yes ^ No • CONSOLIDATED COMPLIANCE PLAN 4
materials at or above 55 gallons for liquids, Minimum required clannino elements: W
~V
500 pounds fOr SOIIdS, Or 200 CU. ft. fOr ®Yes ^ No •
• Emergency Response Plan
Maps
compressed gases (include liquids in ASTs and • Training
USTs)? . Prevention
B. REGULATED SUBSTANCES (RS) 131
1. Have on site RS at greater than the threshold ^Yes ®No • OES FORM ' < )Chemical Description Form)
planning quantities established by the California Risk Management Plan (RMP Submit to USEPA)
Accidental Release Prevention program
•
•
CONSOLIDATED COMPLIANCE PLAN O
o
Incorporating CaIARP Program Elements
(C21ARP)?
C. UNDERGROUND STORAGE TANKS (USTs) /
' 1
1. Own or operate Underground Storage Tanks? ^Yes ®No ) G
n
UST FACILITY FORM
• /
UST TANK FORM (One Per Tank)
2. Intend to upgrade existing or install new USTs? ^Yes ®No • UST FACILITY FORM ) ~ 1331
• UST TANK FORM (One Per Tank) FORM ="£''
• UST INSTALLATION FORM One Per Tank FORM
D. TANK CLOSURE /REMOVAL
2. Need to report closing an UST that hel hazardous ^Yes ®No • UST TANK FORM (Closure section -one per tank)
materials or
3. Need to report the closure /removal of a tank that ^Yes ®No • UST TANK CLOSURE FORM
was classified as hazardous waste and cleaned on-
site?
E. ABOVEGROUND PETROLEUM STORAGE
TANKS CASTS) ^Yes ®No • CONSOLIDATED COMPLIANCE PLAN
1. Own or operate ASTs above these thresholds; • Incorporating Federal Spill Prevention Control and ~
any tank capacity is greater than 660 gallons or the Countermeasure (SPCC) Elements pursuant to 40 CFR Part 112.
total capacity for the facility is greater than 1,320 j
F. HAZARDOUS WASTE EPA ID NUMBER -Provide on this page
1. Generate hazardous waste? ^Yes ®No • To obtain EPA ID Number, please phone (916) 324-1781
2. Recycle more than 100 kg/mo of recyclable ^Yes ®No • RECYCLING FORM
materials at the same location it was generated?
3. Recycle more than 100 kg/mo of recyclable ^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 (DTSC FORM 1772)
• TP UNIT FORM (One per unit)
5. Subject to Financial Assurance requirements?
- ^Yes ®No • CERTIFICATION OF FINANCIAL ASSURANCE
6.
Consolidate Hazardous Waste generated at a
^Yes ®No
• -
REMOTE WASTE ~ CONSOLIDATION SITE NOTIFICATION FORM
remote site?
_ . ~ . ,
FD2088 (Rev. 02/05)
ENT'p ~~e 2 3 Zoos
~~
~`
(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
(UNiF;ED PROGRAM CONSOI (DATED FORM(
APPLJCATION
BUSNESS OWNER/OPERATOR IDEMIRCATION FORM
(HA7ARnC)I lS MATFRIAI R'=~,'',t""E`=.a ?T~{ INF(~RMATIONI
BAKERSFIELD FIRE DEPT.
• Prevention Services
900 Truxtun Ave., Suite 210
H s F ' D Bakersfield, CA 93301
F11ief
;ARtr T Tel.: (661) 326-3979
Fax: (661) 852-2171
Page 1 of 2
I FACILITY IDENTIFlCAT'ION
FACILITY ID NO. ~ ear eginn ng /' Yea Fra ng o
1/25/06 1/25/07
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) s BUSINESS PHONE X02
Walgreens #6526 661-587-0733
SITE ADDRESS
~ oa
9550 Hageman Road
CITY to Ip ios
CA
Bakersfield 93312
UN BR BEET
~
~~~~
p cos SIC CODE rp~
3-1
3-
9 (4 DigitlF) 5912, 7384
COUNT
Santa Clara cos
OPERATOR NAME ioy OPERATOR PHONE rrp
Walgreens Corporation (847) 914-3853
11. OWNER INFORMATION
OWNER NAME OWNER PHONE >>z
nt
Walgreens Corporation
(847) 914-3853
OWNER MAILING ADDRESS »3
200 Wilmot Road
CITY tta STATE X15 IP ns
Deerfield IL 60015
III. ENVIRONMENTAL CONTACT
-
CONTACT NAME 1» GpNTAGT o.{ONE s
Christina Chia etta M.S. 2171 (847) 914-3195
CONTACT MAILING ADDRESS rrs
200 Wilmot Road
CITY rzo STATE ;Zr ZIP r~
Deerfield IL 60015
- PRIMAEiY iV. EMERGENCY CONTACTS -SECONDARY-
NAME 123 NAME 126
Ralph Gonzales Agnes Macapagal
TITLE 124 TITLE 129
Store Manager District Photo Supervisor
BUSINESS PHONE 125 BUSINESS PHONE 130
661-587-0733 661-587-0733
24-HOUR PHONE 126 24•HOUR PHONE 131
661-587-0733 559-307-7100
PAGER No 127 PAGER No 132
NIA N/A
V. CERTt1~iCAT10N
Certlflcation Based Dn my Inquiry of those Indlvlduals responsible for obtaining the Information, I certify under penalty of law that I have personally
examined and am familiar with the
,-. information submitted in this inventory and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOF+ 133 DATE 134 NAME OF DOCUMENT PREPARER 135
11 01/25/2006 Mike Ryan, Regulatory Compliance Specialist
NAMES OF OW NER70PERATOR (print) 136 TITLE OF OWNER/OPERATOR 137
Dean Jarrett Divisional Merchandise Manager
FD2089
c~
(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
APPLICATION
FOR SECTION DISCOVERY AND
NOTIFICATION (FORMS)
_ ~
/4Rl
~~rsnr 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 2
INSTRUCTIONS
1. To avoid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as hriaf anti rnnrisc? as nossihlP_
~ r
+. ,y
BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As)
Walgreens #6526
ADDRESS (Far ~ocar use only)
9550 Hageman Road
FACILITY ID NO. ~
ro
' ~ S 1: C ,=N TI ON ~ ' ~,~~ ~
A. LEAK DCTECTION AND MONITORING PROCEDURES:
tore personnel visually inspect products on a daily basis.
B. EMPLOYEE AND AGENCY NOTIFICATION:
The manager on duty will notify Walgreen's employees and customers of the emergency via the Public Address System and shouting when necessary. Management to various employees will
delegate the responsibility of contacting neighbors. Neighboring facilities will be contacted in person. If an evacuation is needed, after the initial notifcation has been given, Walgree~i s
personnel and customers will be escorted through emergency exits located throughout the facility. The emergency assembly areas are located in the parking lot in front of the store, and in the
rear of the store near receiving. The emergency assembly area will depend on the extent and location of the incident. Walgreen's store management will assist all emergency responders during
a facility incident as needed. All agency notification will be contacted by corporate.
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
To be dispatched by corporate.
D. EMERGENCY MEDICAL PLAN:
Mercy Hospital- 2215 Truxtun Ave, Bakersfield, CA 93301
~~. ~ ~,"' TI NS ~ '~ r
A HAZARD ASSESMENT AND PREVENTION MEASURES'
In order to prevent a release from occurring, all hazardous materials are kept in their original containers and store personnel visually inspect products
on a daily basis.
B. RELEASE CONTAINMENT AND/OR MITIGATION:
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.
C. CLEAN--UP AND RECOVERY PROCEDURES:
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.
f-U"LUtiS (Rev. 02/05)
Page 2 of 2
.. „~ %
~ =~ ~.~ Fes" h : ,-~: L=. ~T10N 11.2: RELEASE RES - "
f=, p r1
UTILITY SHUT-0FFS (LOCATION OF SHUT-OFFS AT YOUR FAG L T Y
NATURAL GAS/PROPANE: Outside Rear of building. Map 1 H-2
ELECTRICAL: Back of store near employee's break room. Map 1 G-6
wATER: Back of store near employee's break room. Map 1 E-1
SPECIAL: N/A
PRIVATE FIRE PROTECTIONANATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION:
Fire extinguishers, automatic fire alarm system and automatic fire sprinkler will affect entire building.
B. WATER AVAILABILITY (FIRE HYDRANT):
Fire Hydrant located on Akers Road.
Water connection outside of Walgreen's.
-5-~,~'-~ ~--,-_ , ---T --,----T -------a-f- ~ ~-;~-~- -~ - -- y -
' ~` ~, ~ SECTION III: TRAINING ~> _ ~~~~.~~„~-~
f- --- 11 ~ . ~,~~. -- -
NUMBER OF EMPLOYEES
26
MATERIAL SAFETY DATA SHEETS ON FILE:
All records are maintained in the store manager's office, as well as at the corporate office and 3E Company.
BRIEF SUMMARY OF TRAINING PROGRAM:
All employees are trained on the proper handling and storage of hazardous materials. Training covers safe handling practices, calling
3E Company to obtain material safety data sheets via fax on demand, emergency response procedures, and other areas. Training is
provided to first time employees upon initial hiring, and to all employees on an annual basis. Training provides employees with skills
and support in order for them to develop safe work practices, to prevent accidents, and to improve their work environment.
~~ ~ ,, _ RTIFICATION ~ ~~ -.~s "- '~"`~
- - -- ~ ~ .~~_ - -- 1 - ~-_-- -
IBased on my mqu~ry of those mdw~duals responsible for obtaining the information I certify under penalty of law that !have personally
examined and am familiar with the information submitted and believe the information is true, accurate, and complete.
OWNER
1/25/06
ass
Dean Jarrett
ivisional Merchandise
FD2085 (Rev. oz~os~
• (HMMP) ' •
HAZARDOUS MATERIALS MANAGEMENT PLAN ~'~ -
• ~Ir~ _
CHEMICAL DESCRIPTION FORM `_ ~~rrr ; r
HAZARDOUS MATERIALS INVENTORY
NEW ^ ADD ~:: DELETE ^ REVISE 200
tSE1lL=K,r'1L''LiJ r'11CL+' LL~'Yl'.
Prevention Services
9001Ytaxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
(€~nx, f~sr?ta g~z rsr~z~a; i~~, ; !~, ~sr ere,;
J?aa~t_01 2
BUSINESS NAML fSame as FACILITY NAME o DBA Dang Business As) 3
Wallareens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Retail Sales Floor (In Refrigeration/Cooler System) CONFIDENTIAL (EPCRA) ; ! Yes~i No
FACILITY ID No. 1 MAP No. (oplionar) 203 GRID NO. (optional) 204
1 G-4, G-S
II HE I AL IN ORMATI N
CHEMICAL NAME 205 ?08
TRADE SECRET 0 Y
s ~ N
Chlorodifluoromethane e
o
If ~ ~t t Pc efe ,° inetructio
COMMON NAME 207
EHS' ^ Yes ~ No
efrigerant (R-22) 208
----- ..
CAS No. 209
°If EHS is °Yes," ell amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
NFG, OHH, IRR
TYPE 211
X
PURE O m MIXTURE O
WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
p
w
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID I LtOUID :i~GAS 214
2S8
21s
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ~3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ~ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM P18 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 258 258 N/A
221222
0 UNITS ^ ga GAL X d CU FT Ib LBS ^ to TONS DAYS ON SITE
"If EHS, amount must be in lbs. 36S
223
STORAGE CONTAINER ^ k BOX p TANK WAGON
(Check ell tner apply) 0 a ABOVEGROUND TANK f CAN
C b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
In refrigeration system
U c TANK INSIDE BUILDING ^ h SILO G SS B TT r
0 d STEEL DRUM ^ i FIBER DRUM ':~ n PLASTIC BOTTLE
^ e PLASi IClNONMETALLIC DRUM ^ j BAG ^ o TOTE BIN
224
STORAGE PRESSURE ^ a AMBIENT ~ as ABOVE AMBIENT 7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 480VE AMBIENT 0 ba BELOW AMBIENT ^ c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 228 227 ^ Yesf7 No 22B 229
2 230 231 ^ Yes fl No 232 233
4 238 239 ^ Yes No 240 241
5 242 243
~-
~ ^ Yes ^ No 244 245
_-_
'
_
- ~~~III. SIGNATURE
PRINT NAME & TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DA7 E 24
Z ~Z2
"~ ~
Dean Jarrett, Divisional Merchandise Mana er
~
f 0
FD2086
t/"~
HAZARDOUS MATERIALS MANAGEMENT PLAN
~, ..,,, ~,.,-~. ,R .... ~~ _, H _ E R 3 p ] ~ D
GIRL
CHEMICAL DESCRIPTION FORM ° ~,~~rr r
HAZARDOUS MATERIALS INVENTORY `
NEW ^ ADD is°: DELETE ^ REVISE 200
li~Atit:K~r'1r;LL r'l1CL~' Ll:Yl'.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
{{.7ne; t~~na far nra:z~riafr ~ - ttr erha.~_j
Paae_t_ol 2
BUSINESS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walereens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Retail Sales Floor CONFIDENTIAL (EPCRA) ; Yey~(i No
FACILITY ID No. 7 MAP No. (optional) 203 GRID NO. (optional) 204
1 G-6
II HE I AL IN ORMATI N
CHEMICAL NAME 205 906
v
TRADE SECRET ^ Yes ,q No
Helium f ct PCRA refer o'nst
COMMON NAME 207
EHS' ^ Yes x No
Helium 208
CAS No. 209
'If EHS is'Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
NFG, OHH
TYPE 211
PURE ^ m MIXTURE ^
WASTE
X 27
RADIOACTIVE: =Yes ~ No CURIES 213
p
w
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID I LIQUID _~GAS 214
220
-
-~ 216
FED HAZARD CATEGORIES ^ 1 FIRE '. 2 REACTIVE ~3 PRESSURE RELEASE ^ 4 ACUTE HEALTH ~ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 277 MAXIMUM P18 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 220 110 N/A
221222
^ UNITS ^ ga GAL ~ cf CU FT Ib LBS ^ to TONS DAYS ON SITE
'If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER
(Cnectr ell roar apply) ^ a ABOVEGROUND TANK - (CAN ^ k BOX p TANK WAGON
^ b UNDERGROUND TANK ^ g CARBOY f~ CYLINDER ^ q RAIL CAR
^ c TANK INSIDE BUILDING ^ h SILO G SS O R
^ d STEEL DRUM ^ i FIBER DRUM n PLASTIC BOTTLE
^ e PLASH IC/NONMETALLIC DRUM ^ j BAG G o TOTE BIN
224
STORAGE PRESSURE ^ a AMBIENT ~ as ABOVE AMBIENT i7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~I a AMBIENT ^ as 4BOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 228 227 ^ Ves ^ No 228 229
2 230 231 C Yes fl No 232 233
4 238 239 ^ Yes ~ No 240 241
5 242 243 ^ Yes ^ No 244 245
` ~'~III. SIGNATURE `
PRINT NAME 8 TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
can Jarrett, Divisional Merchandise Man~er_ ~ ~ ~~ ~ 'Z2 °~~
i ~
FD2086
1
~~
(HMMP) ' - ~
HAZARDOUS MATERIALS MANAGEMENT PLAN '"
,..e'::~°-~sw„.. <..,»,.~~".~.:-, . ..~:...~vu,Fi~;' - s ,.'r M,»~u,. ,:.,,,,,µ ..,...«»~ ...:.......... H V E R S P I , p
• ~1Rt
CHEMICAL DESCRIPTION FORM '._"Rrr , >r
f
HAZARDOUS MATERIALS INVENTORY
~ NEW C ADD DELETE ^ REVISE 200
tfAliLK~r11':LL Jr'iKL' LL''Yl'.
Prevention Services
900 'IYuxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
s: is,»z,~r;,~t, e~riq, tsrar~t3.j
Paa@_1__c2t 2
BUSINESS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walgreens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) Yes~i No
FACILITY ID No. 1 MAP No. (optional) 203 GRID NO. (optionep 204
1 G-7
Ii HE I AL IN ORMATI N
CHEMICAL NAME 205 ~~// 106
TRADE SECRET ^ Yes ,+a No
' ct PCRA refer to instructio
COMMON NAME 207
EHS' ^ Yes ~ No
UJI Developer Starter 206
-.. -- ...
CAS No. 209
'If EHS is °Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
IRR, SENS
TYPE 211
p PURE ~ m MIXTURE ^ w WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIQUID i:; g GAS 214
1
---~~ 216
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ®3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 10 5 N/A
221222
^ UNITS ~ ga GAL ``: cf CU FT Ib LBS ^ to TONS DAYS ON SITE
•If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER ^ k BOX p TANK WAGON
(cneck all roar epplyl ^ a ABOVEGROUND TANK ~ ' f CAN
G b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
^ c TANK INSIDE BUILDING ^ h SILO GLASS BOTT r R
^ d STEEL DRUM ^ i FIBER DRUM - n PLASTIC BOTTLE
~1 a PLASi1C/NONMETALLIC DRUM ^ j BAG G o TOTE BIN
224
STORAGE PRESSURE .~, a AMBIENT ~ as ABOVE AMBIENT i] ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 460VE AMBIENT ^ ba BELOW AMBIENT Q c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 75 226 Water 227 ^ Yes No 226 7732-18-5 22s
2 230 231 C Yes ~No 232 233
15 Potassium Carbonate 584-08-7
a 10 236 Sodium Bicarbonate z3s ^ rea ~( No 2ao 144-55-8 2a1
s 2az
5 Aminocarbox 11c Acid Derivative 243
Y ~ __ ° Yea p; "° 244 gas
140-01-2
___
_
_
` "III. SIGNATURE
PRINT NAME 8 TITLE OF AU f'HORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
. Z~Z~- ~~
can Jarrett, D1v1s1onal Merchandise Manager_____ _ \/ 2'
' "' ~ O
FD2086
1~
(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
CHEMICAL DESCRIPTION FORM
HAZARDOUS MATERIALS INVENTORY
NEW ^ ADD DELETE ^ REVISE 200
BUSINESS NAML ISame as FACILITY NAME o DBA Dang Business As) 3
Walgreens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) Yey~l No
FACILITY ID No. t MAP No. (optional/ 203 GRID NO. (optional/ 200
1 G-7
U EMI AL IN ORMATI N
CHEMICAL NAME 205 ?Og
~~.,//
TRADE SECRET ^ Yes ,o~No
It ct PC A rate o' t ctio
COMMON NAME 207
EHS• ^ Yes ~ N°
FUJI Developer Replenisher tog
__ ....
CAS No.
209
'If EHS is `Yes,' all amounts below must be
iri lbs.
FfRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
IRR, OHH, SENS
TYPE
[~ p PURE ~ m MIXTURE ^ w WASTE 211
RADIOACTIVE:
=Yes ~ No 2t CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIQUID '~ g GAS 21a
3
FED HAZARD CATEGORIES
^ 1 FIRE 2 REACTIVE --~
®3 PRESSURE RELEASE ~j 4 ACUTE HEALTH z1s
~ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM P1B AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 30 15 N/A
2z1z22
^ UNIT3 ~ ga GAL '::; cf CU FT Ib LBS ^ to TONS DAYS ON SITE
~If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER ^ k BOX p TANK WAGON
(cnece ell roar appty) ^ a ABOVEGROUND TANK f CAN
^ b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
U c TANK INSIDE BUILDING ^ h SILO GLAS BOTT r R
^ d STEEL DRUM ^ i FIBER DRUM ~ n PLASTIC BOTTLE
~I a PLAS'i'IClNONMETALLIC DRUM ^ j BAG G o TOTE BIN
STORAGE PRESSURE ~ a AMBIENT ~ as ABOVE AMBIENT
i7 ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~ a AMBIENT ^ as 4BOVE AMBIENT
^ ba BELOW AMBIENT
^ c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
t Sp z2s Water 2z7 ^ Yes)q No 22g 7732-18-5 22a
2 230 231 C Yes ~No 232 233
35 Potassium Carbonate 584-08-7
a 10 238 Para-Phenylenediamine Derivative 23s ^ Yes ~{ No 2ao g020-34-0 2a1
s zaz
5 Aminocarbox he Acid Derivative
Y ~
___
. 2a3 ^ Yea ~ No 2aa
140-01-2 gas
..
__ . VIII. SIGNATU~FIE ~ ---_
PRINT NAME & TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DALE 24
\~
7
2
~
~
can Jarrett, Divisional Merchandise Mana er -
i
. -
-
FD2086
KAIiJ~K~r'1Z:Lli r'11CL~' LL''Yl'.
`_
'~ Prevention Services
B ..,E R s N , ~ n 9001Yuxtun Ave., Ste. 210
flR,t Bakersfield, CA 93301
`:~Al1r ; , ~ Tel.: (661) 326-3979
Fax: (661) 852-2171
ns~tsari~I, i~€ar~ ~3alf?c)trig. ar ~zrc/ta.~
~ a a ~1r...oJ 2
(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
CHEMICAL DESCRIPTION FORM
HAZARDOUS MATERIALS INVENTORY
NEW ^ ADD ! DELETE ^ REVISE 200
BUSINESS NAML (Same as FACILITY NAME o DBA Dwng Business As) 3
Walgreens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) "1 Yey~t No
FACILITY ID No. 1 MAP No. (optionat) 203 GRID NO. (optional) 204
1 G-7
li HE I AL IN ORMATI N
CHEMICAL NAME 205 906
~,/
TRADE SECRET ^ Yes ,q No
If c PCRA refer to instructio
COMMON NAME 207
EHS• ^ veg ~ No
UJI Bleach & Replenisher Zoe
CAS No. 209
'If EHS is °Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
IRR, SENS
TYPE 211
' p PURE ,~ m MIXTURE p w WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
LARGEST CONTAINER 275
PHYSICAL STATE ^ s SOLID X I LIQUID W; g GAS 214
1 _
_
~~ 216
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ®3 PRESSURE RELEASE ~j 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check ell that apply)
ANNUAL WASTE 277 MAXIMUM E18 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 10 5 N/A
zz1222
^ UNITS ~( ga GAL cf CU FT Ib LBS ^ to TONS DAYS ON SITE
°If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER
(Check ell loaf apply) ^ a ABOVEGROUND TANK (CAN ^ k BOX p TANK WAGON
^ b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
U c TANK INSIDE BUILDING ^ h SILO GLASS BOTT r
^ d STEEL DRUM ^ i FIBER DRUM ~ n PLASTIC BOTTLE
e PLAST IClNONMETALLIC DRUM ^ j BAG G o TOTE BIN
224
STORAGE PRESSURE .~ a AMBIENT ~ as ABOVE AMBIENT 7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 4BOVE AMBIENT ^ ba BELOW AMBIENT p c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 65 zze Water 227 ^ reaj3( No zzs 7732-18-5 2za
2 230 231 C Yes ~No 232 233
15 Ferric Ammonium PDTA 111687-36-6
4 10 238 Ammonium Bromide 23s ^ Yea ~ No zoo 12124-97-9 247
5 5 za2 Ammonium Nitrate z43
-_ ^ vas 7f>< N° za4 6484-52-2 z4s
- ~ III. SIGNATt1~RE ___
PRINT NAME 8 TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
1
can Jarrett, Divisional Merchandise Manager _ ~ _~,~-ZZ-t
-,- ~ U
JtiAtitr''K,JN~II:LL 1'~iKL'~ LL''Yl'.
;: .
~ Prevention Services
H E R s P I v 900 TYuxtun Ave., Ste. 210
~ r~Rr Bakersfield, CA 93301
', A~rr ~ ~ Tel.: (661) 326-3979
Fax: (661) 852-2171
a~x ... ~~, c~rare~r.!
-Paoe_t_o1 2
FD2088
r
i
(HMMP) ' tl0.-~ ~
HAZARDOUS MATERIALS MANAGEMENT PLAN
~IRt
CHEMICAL DESCRIPTION FORM ~ ~~~rr s
HAZARDOUS MATERIALS INVENTORY
~I NEW C ADD DELETE ^ REVISE 200
l3AKriK~r'1L''LL P'i1CL~' Lt'iYl'.
Prevention Services
900'IYuxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
~aatit_oS 2
BUSINESS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walgreens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) Yey~{1 No
FACILITY ID No. 1 MAP No. (optional) 203 GRID NO. (optional) 204
1 G-7
Ii HE I AL IN ORMA7'I N
CHEMICAL NAME 205 905
~v/
TRADE SECRET ^ Yes ,ca No
It ct PCRA refer to lost ctio
COMMON NAME 207
EHS• D Yea ~ N°
UJI Fixer & Replenisher tog
CAS No. 209
•If EHS is °Yes," all amounts below must be
iri lbs.
F#RE CODE HAZARD CLASSES (Complete if requested by local fire chiel) 210
IRR, SENS
TYPE 211
" p PURE ~ m MIXTURE ^ w WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIQUID G g GAS 214
3
-
~
~ 216
-
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE 6 3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM P18 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 30 15 N/A
2z12z2
D UNITS ~( ga GAL ':': cf CU FT Ib LBS ^ to TONS DAYS ON SITE
•If EHS, amount must be in lbs.
- 365
223
STORAGE CONTAINER ^ k BOX p TANK WAGON
(cneck all roar apply) D a ABOVEGROUND TANK ..: f CAN
D b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
U c TANK INSIDE BUILDING ^ h SILO - SS BO r
^ d STEEL DRUM ^ i FIBER DRUM (:~ n PLASTIC BOTTLE
e PLAS'1C/NONMETALLIC DRUM ^ j BAG ^ o TOTE BIN
224
STORAGE PRESSURE ~ a AMBIENT ~ as ABOVE AMBIENT 7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~J a AMBIENT ^ as 480VE AMBIENT ^ ba BELOW AMBIENT D c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 50 228 Water 227 ^ Yes)3( No 2zg 7732-18-5 zz9
2 230 231 C Yes ~No 232 233
45 Ammonium Thiosulfate 7783-18-8
a 5 z36 Ammonium Bisulfate 23s D Yea ~ No 2ao 10192-30-0 241
5 5 242 Imidazole 243
~~- ~ ^ Yes ~ No 2aa 288-32-4 245
- ~ III. SIGNATURE _..._..
PRINT NAME 8 TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
--~ r
can Jarrett, Divisional_Merchandise Manager ~~/ ~.~(~-2-
t ~
FD2086
HAZARDOUS MATERIALS MANAGEMENT PLAN
H- E R S P I
. ~IR~
CHEMICAL DESCRIPTION FORM ~-~~ ~rrr : r
HAZARDOUS MATERIALS INVENTORY
~I NEW ^ ADD `" DELETE ^ REVISE 200
KAKt:K~r'l1:LL k'1KL~' 1JL'"Yl'.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax (661) 852-2171
{'d7n~s ~ „ (?,yx n3ra~r=.~1, d~~' t~ulla~ar=g, ,
-~ao~tQi 2
BUSINESS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walgreens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL(EPCRA) ':' Ye~(i No
FACILITY ID No. 1 MAP No. (optional) 203 GRID NO, (optional/ 204
1 G-7
Ii HEMI AL IN ORMATI N
CHEMICAL NAME 205 ?06
TRADE SECRET ^ Yes ~ No
I ct P refer t i 'o
COMMON NAME 207
EHS• ^ vas )7 No
UJI Super Conditioning Tablets Zoe
- .. --- ..
CAS No. 209
`n EHS is'Yes," all amounts beVow must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local Lire chief) 210
IRR
TYPE 211
j p PURE ,~ m MIXTURE ^ w WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ~ s SOLID I LIQUID v g GAS 214
100 tablets/bottle
--~~
216
FED HAZARD CATEGORIES ^ 1 FIRE ':' 2 REACTIVE ®3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM P18 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 200 tablets 200 tablets N/A
z212z2
^ UNITS ~ ga GAL "'; cf CU FT Ib LBS ^ to TONS DAYS ON SITE
'If EHS, amount must be in lbs. 36S
223
STORAGE CONTAINER
~ ^ k BOX p TANK WAGON
(Coach an roar apply/ ^ a ABOVEGROUND TANK
f CAN
G b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
U c TANK INSIDE BUILDING ^ h SILO G S OTT r R
^ d STEEL DRUM ^ i FIBER DRUM Xn PLASTIC BOTTLE
0 e PLASMIC/NONMETALLIC DRUM ^ j BAG ^ o TOTE BIN
224
STORAGE PRESSURE ~ a AMBIENT ~ as ABOVE AMBIENT i7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 4BOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 90 z26 Sodium Sulfate 227 ^ veafQ No 2ze 775 82-6 2z9
2 230 231 C Yes ~No 232 233
1S Sodium Dichloro-s-triazinetrione 2893-78-9
4 S 238 Boric Acid 239 ^ Yes }~, No 240 10043-35-3 241
5 242 243
_ 1 ^ Yes ^ No 244 245
~-_-. _.
__._
` ~ III. SIGNATURE
PRINT NAME & TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
can Jarrett, Divisional Merchandise Manager __ ~ ,~'" ~ "'2i~- ', ~°
~ i v
FD2086
~~
HAZARDOUS MATERIALS MANAGEMENT PLAN
• P/R< -
CHEMICAL DESCRIPTION FORM ,,,r~rr ,. s
HAZARDOUS MATERIALS INVENTORY '~
NEW C ADD `; DELETE ^ REVISE 200
l3AliL~'K,JN1L''L1J !+'iKL~' LL''Yl'.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
~~ae n;~F~ariat, b~r~r t~czitcfir~~, or ~tre:r.~
J?ao~t_g1 2
BUSINCSS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walereens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) Yey~i No
FACILITY ID No. 1 MAP No. (optional) 203 GRID NO. (optional) 204
1 G-7
II HEMI AL IN ORMATI N
CHEMICAL NAME 205 ~/ ?06
TRADE SECRET 0 Yes ,n~No
It ct PCRA referto'nstructio
COMMON NAME 207
EHS• ^ Yee ~ Ne
UJI SUPERFLO & Replenisher Zoe
-
_. ---
CAS No. 209
'If EHS is "Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
IRR, OHH
TYPE 211
p PURE ~ m MIXTURE ^ w WASTE 21
RADIOACTIVE: ~ Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIOUID g GAS 214
3
216
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ®3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ~ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 21e YA
219 WASTE 220
AMOUNT DAILY AMOUNT DAIL
MOUNT CODE
0 30 15 N/A
221222
^ UNITS ~ ga GAL ': cf CU FT Ib LBS ^ to TONS PAYS ON SITE
"If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER
(Cneck sll that apply) ^ a ABOVEGROUND TANK i CAN ^ k BOX 1 p TANK WAGON
^ b UNDERGROUND TANK ^ g CARBOY ^ 1 CYLINDER ^ q RAIL CAR
^ c TANK INSIDE BUILDING ^ h SILO S r R
0 d STEEL DRUM ^ i FIBER DRUM Xn PLASTIC 80TTLE
^ e PLASTICINONMETALLIC DRUM ^ j BAG ~ o TOTE BIN
224
STORAGE PRESSURE .~, a AMBIENT ~ as ABOVE AMBIENT i7 Da BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 460VE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 90 zee Water zz7 ^ Yes No 2ze 7732-18-5 z2s
2 230 231 C Yes ~No 232 233
10 Triazole Derivative 288_88_0
a 10 23e Substituted Triazole 238 ^ Yea ,~ No 2ao N/A 2a1
5 242
5 Di ro lane Gl col 2a3
p PY Y
_-~ -_ ^ Yes ~i; No zaa 2a5
25265-71-8
_
~ III. SIGNATU~FIE -_'-
PRINT NAME 8 TITLE OF AU PHORIZED COMPANY REPRESENTATIVE S GNATURE DATE
24
/
can Jarrett, Divisional Merchandise Manager (~ ~ / ~ '2.2•=-~~
/ Q
FD208e
V
(HMMP) '
HAZARDOUS MATERIALS MANAGEMENT PLAN
CHEMICAL DESCRIPTION FORM
HAZARDOUS MATERIALS INVENTORY
NEW C ADD ": DELETE ^ REVISE 200
t3AtiL'K,P1L''LL r11CL' L2'iYl'.
~~ ~ ~ Prevention Services
B,"~ e R s P, n 9001Yuxtun Ave., Ste. 210
'~~~ Bakersfield, CA 93301
®~~, ~ ~ rr ' ' f Tel.: (661) 326-3979
' Fax: (661) 852-2171
¢C.~Y?fi3 f(3r~zg ~' ;> Y" rz:?'f?.i, f,r'+: ~ <. ~ at'~~Y.j i,
~' a a ~t~.o1 2r
BUSINESS NAML (Same as FACILITY NAME o DBA Dang Business As) 3
Walereens #6526
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) Ye~ No
FACILITY ID No. 1 MAP No. (oprionar) 203 GRID NO. loplionel) 204
1 G-7
It: HE l AL IN ORMATI N
CHEMICAL NAME 205 906
~~,,//
TRADE SECRET ^ Yes ,o~No
f ct PCRA referto'nstructio
COMMON NAME 207
EHS• ^ Yes ~ NO
UJI Bleach 3 Starter Zoe
CAS No. ~ 209
'If EHS is °Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
CORR,SENS
TYPE 211
p PURE ~ m MIXTURE 0 w WASTE 21
RADIOACTIVE; =Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIQUID i. g GAS 214
1
---~ 216
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ®3 PRESSURE RELEASE ~j 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 10 5 N/A
221222
^ UNITS ~.Q ga GAL ": cf CU FT Ib LBS ^ to TON5 DAYS ON SITE
°If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER ^ k BOX ': p TANK WAGON
(cneck ell Cher eppry) ^ a ABOVEGROUND TANK f CAN
^ b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
LI c TANK INSIDE BUILDING ^ h SILO GLASS BOTT r R
^ d STEEL DRUM ^ i FIBER DRUM Xn PLASTIC BOTTLE
^ e PLAS's IClNONMETALLIC DRUM ^ j BAG ~ o TOTE BIN
224
STORAGE PRESSURE ~ a AMBIENT = as ABOVE AMBIENT 7 ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 480VE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 70 228 Potassium Acetate 227 ^ Yes~iQ No 228 127-08-2 229
2 230 231 ^ Yes ~No 232 233
60 Water 7732-18-5
4 15 238 Potassium Hydroxide 239 ^ Yes ~( No 240 1310-58-3 241
5 242 243 ^ Yes ^ No 244 245
` ~ III. SIGNATURE
PRINT NAME & TITLE OF AU fHORIZED COMPANY REPRESENTATIVE '~ S GNATURE DATE 24
can Jarrett, Divisional Merchandise Manager ~~~/ ~.`Z~--~ ~'
~ v
a
FD2086
Moth
(HMMP) t
HAZARDOUS MATERIALS MANAGEMENT PLAN
CHEMICAL DESCRIPTION FORM
HAZARDOUS MATERIALS INVENTORY
NEW ^ ADD i::; DELETE 0 REVISE 200
BUSINCSS NAML ISame as FACILITY NAME o DBA Dang Bus+ness As)
JValereens #6526
KAtiL''K~l''1L''LL 1'1KL'' Ll'iYl'.
.
r ~ ~
~s Prevention Services
' e x s v +
~ n
B 900'IYtixtun Ave., Ste. 210
'~~~ Bakersfield, CA 93301
'A~l/ _ 'T Tel.: (661) 326-3979
' Fax: (661) 852-2171
;'~ir?~~ ?~rnt ~aa : - t~uil~ari~, ~r ~~€r~a. j
-eBQ~I_Q.t 2
{FORMATION
3
CHEMICAL LOCATION 201 CHEMICAL LOCATION 202
Photo Lab CONFIDENTIAL (EPCRA) ', Ys~¢i No
FACILITY ID No. 1 MAP No. (optional) 203 GRID NO. (optione0 204
1 G-7
II: EMI AL IN ORM TI N
CHEMICAL NAME 205 ~,/ 706
TRADE SECRET ^ Yes ,n~No
It ct PC Are er to instructio
COMMON NAME 207
EHS• ^ Yea ~ N°
UJI Stabilizer Startup Kit Zoe
CAS No. 209
•If EHS is °Yes," all amounts below must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete iF requested by local fire chief) 210
IRR, OHH
TYPE 211
p PURE ~ m MIXTURE 0 w WASTE 21
RADIOACTIVE: =Yes ~ No CURIES 213
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLID X I LIQUID ~ g GAS 214
.50 __ _
~
' 216
FED HAZARD CATEGORIES ^ 1 FIRE 2 REACTIVE ®3 PRESSURE RELEASE ~ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH
(Check ell that apply)
ANNUAL WASTE 217 MAXIMUM P1B AVERAGE 219 STATE WASTE 220
AMOUNT DAILY AMOUNT DAILY AMOUNT CODE
0 10 5 N/A
2z1z22
D UNITS ,~ ga GAL cf CU FT Ib LBS ^ to TONS DAYS ON SITE
•If EHS, amount must be in lbs. 365
223
STORAGE CONTAINER
(Cneck alt roar apply) ^ a ABOVEGROUND TANK 1 CAN ^ k BOX `; p TANK WAGON
G b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
U c TANK INSIDE BUILDING ^ h SILO GLASS BO r T R
D d STEEL DRUM ^ i FIBER DRUM Xn PLASTIC BOTTLE
^ e PLASTIC/NONMETALLIC DRUM ^ j BAG G o TOTE BIN
224
STORAGE PRESSURE ~ a AMBIENT ~ as ABOVE AMBIENT i~ ba BELOW AMBIENT
225
STORAGE TEMPERATURE ~ a AMBIENT ^ as 4BOVE AMBIENT ^ ba BELOW AMBIENT q c CRYOGENIC
%WT HAZARDOUS COMPONENT EHS CAS #
1 100 226 Water 227 ° Yeaff( "° 22$ 7732-18-5 229
2 230 231 C Yes ~No 232 233
10 Triazole Derivative 288_gg_p '
a 7 23e Substituted Triazole 239 ^ Yes ,~( No 240 1310-58-3 241
5 5 242
- Glycidol Ether Derivative 243 ^ Yes ~ No 244 245
68072-38-8
^--. "III. SIGNATUF#E -~-__
PRINT NAME & TITLE OF AU fHORIZED COMPANY REPRESENTATIVE S GNATURE DATE 24
can Jarrett, Divisional Merchandise Mana>;er ~ ~ - _ ~'~~~ °-~
v
FD2086
~~ Vv
ALIFORNIA ANNOTATED SITE MAP I BUSINESS NAME: WALGREENS #6526 ~ SITE ADDRESS: 9550 HAGEMAN RD. I Ma #:1 OF 2
BAKERSFIELD CA, 93312 P
A B C D E F G H I
2
3
4
5
6
~'
O ELECTRIC MAIN
OG GAS MAIN
O WATER MAIN
FIRST AID
PC PHOTO CHEMICALS
COMPRESSED GAS
CYLINDERS
(xeuuw)
R-22 REFRIGERANT
Y
X ~
ALIF^RNIA ANN^TATED SITE MAP BUSINESS NAME WALGREENS #6526 SITE ADDRESS 9550 HAGEMAN RD. Ma #~2 ^F 2
BAKERSFIELD CA, 93312 P
A B C D E F G H I
1
2
3
4
5
s
}~
z
0
x
W
Y DR
CAL A
SHOP ING CENT R
OMMER I
r,
.--~
i~ L ~ - - ~_~
~,
COMMER I
L +~>
~~~~
HA EMAN RD
1 SCA E.
3E NOT TO SCALE
SAFE REFUGE AREA
~..i FIRE HYDRANT
i,
r~
Y
X -~
~_-,
;~',-
WALGREENS 6526
~~5~~-
SiteID: 015-021-002409
Manager RALPH GONZALES
Location: 9550 HAGEMAN RD
City BAKERSFIELD
CommCode: KCFD STA 65
EPA Numb:
BusPhone: (661) 587-0733~/_,-r
Map 10 2 CommHaz ~ ~FJW
Grid: 17C FacUnits: 1 AOV:
SIC Code:5912 ~ ~133N
DunnBrad:93-103-6651
Emergency Contact / Title Emergency Contact / Title
RALPH GONZALES / STORE MANAGER AGNES MACAPAGAL / DIST PHOTO SUPR
Business Phone: (661) 587-0733x Business Phone: (559) 307-7100x
24-Hour Phone (661) 587-0733x 24-Hour Phone (559) 307-7100x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: ~ Fire Press React ImmHlth
71,~v) iooZ•-S~7ov
Contact ~Ii~3-S~3~T~-1 ~HrA-FPETTP,~%~~F~y ~a ~~~'ry ~~"• Phone : F8~9-}
Ma i lAddr : ~fr8-W3-i,M6T ~H-MS~2~ 9~ l ~ oS ASTaN kv~ . State : ~b C,~}
City HE'ER~'3~'~ - ~-~~StSAD Zip -b-9-03~- q'Z.OaX
Owner WALGREENS CORP Phone : ( 84 7 ) 914 -~~-3~ 22(~~
Address 200 WILMOT RD M52171 State: IL
City DEERFIELD Zip 60015
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif ' d: RSs : No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT 1~I ~ ~ `
Based on my inquiry of those individualy ENT MAR
onsibie for obtaining the information, I certif y~
e
:
~
007
r
p
p
under penalty of lave that i have personally a
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
Signa ure Date
-1- 02/20/2007
:_ -."
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Hazmat Inventory By Facility Unit ~
~ MCP+DailyMax Order Fixed Containers at Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
~ --&~E~LE~73-SH•ER ,~ e{-e L 10.0 0 GAL Hi
~Hd3-n~L~~ =~ nmT ~TT.'A ~~,.~-~ L 10.0 0 GAL Mod
z'TTr~"T-D-LD ~AN-D3-3'-I-ON3-NG 'I'~ABi,E~SS ~~' S 2 . 0 0 GAL MOd
REFRIGERANT R-22 G 258.00 FT3 Low
-~i-d-I ~ ~~~E~.d3 S~iI;~- aC,e.~ L 3 0. 0 0 GAL Low
-~`H~Y ~ & Id~H£~ ~~x~'e L 3 0 . 0 0 GAL Low
-~J~ L~N~~ ~~,Q~c~, L 3 0. 0 0 GAL Low
~$-J-~ -~OP~R-S'IA~2 -e L 10.0 0 GAL Low
HELIUM F P IH G 220.00 FT3 Min
~ L 10.0 0 GAL Min
~~ n
e.C.~ c R L 5. 0 0 GAL Min
-2- 02/20/2007
-3- 02/20/2007
s
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
FUJI BLEACH & REPLENISHER •-• ~~~I~~ 1~ Days On Site
365
Location within this Facility Unit Map: Grid:
PHOTO LAB CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _
Liquid TMixture~ Ambient ~ Ambient DRUM/BARREL-NONMETAL
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
1.00 GAL 10.00 GAL 5.00 GAL
ne,~r~rcLVUa wi~ir~iv~iv 1
oWt. RS CAS#
65.00 Water No ~ 7732185
15.00 Ferric Ammonium PDTA No 111687366
10.00 Ammonium Bromide No 12124979
5.00 Ammonium Nitrate No 6484522
ti1~Gt1ttL [-la~~aat~l~ly 15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Hi
-4- 02/20/2007
F WALGREENS 6526 ~SiteID: 015-021-002409 ~
~ Inventory Item 0010 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
FUJI BLEACH 3 STARTER •- '~~L-~-~ Days On Site
365
Location within this Facility Unit Map: Grid:
PHOTO LAB CAS#
STATE TYPE _
Liquid TMixture
= PRESSURE TEMPERATURE _
Ambient ~ Ambient
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum
1.00 GAL 10.00 GAL
Daily Average
5.00 GAL
t1HGK[CUVU.7 LV1~lYV1V~1V1J
%Wt. RS CAS#
70.00 Potassium Acetate No 127082
60.00 Water No 7732185
15.00 Potassium Hydroxide No 1310583
t1E~GEiKL AS ~iSJJ1~1t51V 15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Mod
~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
FUJI SUPER CONDITIONING TABLETS "~ b ~(,~~ Days On Site
365
Location within this Facility Unit Map: Grid:
PHOTO LAB CAS#
~SolidE TMixtur~mbRent~E ~ AmbientT~E ~LASTOICTCONTAINERE
AMOUNTS AT THIS LOCATION
Largest Container- Daily Maximum I Daily Average
1.00 GAL 2.00 GAL 2.00 GAL
t1L-1GtiK_UVUJ lrVl"lYV1V~1V 1.7
oWt. RS CAS#
90.00 Sodium Sulfate No 7757826
15.00 Sodium Dichloro-s-triazinetrione No 2893789
5.00 Boric Acid No 10043353
riliGLi[CL 1~J~77.,.7.'~l~lt.,1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Mod
CONTAINER TYPE
PLASTIC CONTAINER
-5- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
REFRIGERANT R-22 Days On Site
365
Location within this Facility Unit Map: Grid:
REF SYS I ~ ~ CAS#
75-45-6
STATE T TYPE PRESSURE TEMPERATURE ~~ CONTAINER TYPE
~GdS I Pure Above Ambient Ambient I OTHER - SPECIFY
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum ~ Daily Average
258.00 FT3 258.00 FT3 258.00 FT3
ntiZARDOU5 COMPONENTS
oWt. RS CAS#
100.00 Chlorodifluoromethane No 75456
riHGEihCL 1-~J ~7~b~1~1r,1V 15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
FUJI DEVELOPER REPLENISHER -- ~ ~~-~-~ Days On Site
365
Location within this Facility Unit Map: Grid:
PHOTO LAB CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixtur~-Ambient ~ Ambient DRUM/BARREL-NONMETAL
AMOUNTS AT THIS LOCATION
--Largest Container -Daily Maximum ( Daily Average
3.00 GAL 30.00 GAL 15.00 GAL
rtnc~tu~lJVV~ l.V!'lr V1V 1'..1V 1.S
owt. Rs cAS#
50.00 Water No 7732185
35.00 Potassium Carbonate No 584087
10.00 Para-Phenylenediamine Derivative No 28020340
5.00 Aminocarboxylic Acid Derivative No 140012
r1tiL~tilCL tii7 ~P.JJ J1"1L~1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
-6- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
~UJI FIXER & REPLENISHER - ~ ~ (~-~~
Location within this Facility Unit
PHOTO LAB
STATE TYPE PRESSURE
Liquid TMixture~Ambient
Largest Container
3.00 GAL
Map
TEMPERATURE
Ambient
AMOUNTS AT THIS LOCATION
Daily Maximum
30.00 GAL
Grid:
Days On Site
365
CAS#
CONTAINER TYPE _
DRUM/BARREL-NONMETAL
Daily Average
15.00 GAL
HAZARDOUS COMPONENTS
$Wt. RS CAS#
50.00 Water No 7732185
45.00 Ammonium Thiosulfate No 7783188
5.00 Ammonium Bisulfite No 10192300
tiHGHKL H5~L5~1°1151V 15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
~UJI SUPERFLOW & REPLENISHER ~" ~~~~
Location within this Facility Unit Map: Grid:
PHOTO LAB
Days On Site
365
CAS#
Liquid TMixtur~mbient~E ~ AmbientT~E ~STICTCONTAINERE
AMOUNTS AT THIS LOCATION
Largest Cont3100rGAL Daily M30100m GAL I Daily A15r00e GAL
I1EiGL~i1CLVU.7 1,V1~lYV1Vr,1V 1.7
oWt. RS CAS#
90.00 Water No 7732185
10.00 Triazole No 288880
5.00 Dipropylene Glycol No 25265718
I1HGti2CL H.7 .7r,.7.71~1~1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
-7- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
FUJI DEVELOPER STARTER ~~D ~~~ Days On Site
365
Location within this Facility Unit Map: Grid:
PHOTO LAB CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _
Liquid TMixture ~-Ambient ~ Ambient DRUM/BARREL-NONMETAL
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
1.00 GAL 10.00 GAL 5.00 GAL
HAZARDOUS COMPONENTS
oWt. RS CAS#
75.00 Water No 7732185
15.00 Potassium Carbonate No 584087
10.00 Sodium Bicarbonate No 144558
5.00 Aminocarboxylic Acid Derivative No 140012
ru~,~EUC~ H~~r~Sari~iv 1
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~
COMMON NAME / CHEMICAL NAME
HELIUM Days On Site
365
Location within this Facility Unit Map: ~ Grid:
RETAIL SALES FLR ~-jp/7 CAS#
7440-59-7
STATE T TYPE T PRESSURE ~~ TEMPERATURE ~~ CONTAINER TYPE ~
~GaS I Pure -I Above Ambient I Ambient I PORT_ PRESS_ CYLINDER I
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
220.00 FT3 220.00 -FT3 110.00 FT3
HAZARDOUS COMPONENTS
oWt. RS CAS#
100.00 Helium No 7440597
ru~a~rcL ti~a~~~ri~lvl~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Min
-8- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~
~ COMMON NAME / CHEMICAL NAME
FUJI STABILIZER STARTUP KIT ~~ ~ ~l.C ~ L Days On Site
365
Location within this Facility Unit
PHOTO LAB
STATE TYPE PRESSURE
Liquid TMixture Ambient
Largest Container
0.50 GAL
Map: Grid:
CAS#
TEMPERATURE CONTAINER TYPE
AmbientPLASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Daily Maximum
10.00 GAL
Daily Average
5.00 GAL
HAZARDOUS COMPONENTS
%Wt. RS CAS#
100.00 Water No 7732185
10.00 Triazole No 288880
t11~GLiKL E~5 5J~J5.71~1L' 1V 1
TSecret RS BioHaz =Radioactive/Amount= =EPA Hazards= =NFPA-~ =USDOT#= =MCP=
No No No No/ Curies / / / Min
~ Inventory Item 0001
COMMON NAME / CHEMICAL NAME
WASTE FIXER --- ~,~l.,~T~
Location within this Facility Unit
PHOTO LAB
Facility Unit: Fixed Containers at Site ~
Days On Site
365
Map: Grid:
CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TWaste -r Ambient- ~ Ambient ~STIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
- 5.00 GAL 5.00 GAL 5.00 GAL
i'1HGHCCLVUb 1,V1~lYV1VL"1V1.>
%Wt. RS CAS#
Silver No 7440224
nt~~tit~cl~ r~aal;a~l~il;ly 1~~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R / / / Min
-9- b2/20/2007
F WALGREENS 6526 SiteID: 015-021-002409
Fast Format
~ Notif./Evacuation/Medical Overall Site
~ Agency Notification
N ~ F"t ~Qv- ~F ~ p z/o~ e+- ~P ;~-t~, vt -fames 'rs -~-~,e r es~v~s ~i bi t~ 1~ ~F ~~-~.e ~ ~-~ i-~ L (- f~
E.~~ 5'~~ iYtRi1~~('~ () f" G1 ~~i i G{ ytGU-p~ vt,~~I~Y~Gi~~ i h. C~ S P 0~ P.tv~,e.r't~`GN Ci~'~ = ~ {'~~~ l~K~
~ ~erc vrs ct-~e i-1a'~1 Fie//d vF -~ ~.Jre se~- ce a~ a.h erv~~~he;~ ~~t n n~ /-euar.~~~c~i b~ b~
VP,i~bal Cl1-nlnt,+.~l c6chun or wj-~ -~-i~,e S~-Fvre c~,l~,rm S~s~~em ;F one eXis-(-s - /~I;~ Ph,a{z ~
e,n.plo~~eu w; U ..P:vo~u,v~-e i m mrecCia-~I l~ Fo ~f o+~y n~ ~-I-~.e w~~~.r r `1 t~+-e~,~re ~tia ~a ~-i ~I
b Grc~1~1S %J1%l(~1 UJdU ~2 •er'FUrm.e~ ~in ~{-~.e I~.dfv ~ ~ rior ~ ,2.~~Gt,GUUT1iJV1
r ~ ~ ~
Employee Notif./Evacuation 03/28/2006
THE MANAGER ON DUTY WILL NOTIFY WALGREENS EMPLOYEES AND CUSTOMERS OF THE
EMERGENCY VIA THE PA SYSTEM AND SHOUTING WHEN NECESSARY. MANAGEMENT TO
VARIOUS EMPLOYEES WILL DELEGATE THE RESPONSIBILITY OF CONTACTING NEIGHBORS.
NEIGHBORING FACILITIES WILL BE CONTACTED IN PERSON. IF AN EVACUATION IS
NEEDED, AFTER THE INITIAL NOTIFICATION HAS BEEN GIVEN, WALGREENS PERSONNEL
AND CUSTOMERS WILL BE ESCORTED THROUGH EMERGENCY EXITS LOCATED THROUGHOUT
THE FACILITY. THE EMERGENCY ASSEMBLY AREAS ARE LOCATED IN THE PARKING LOT
IN FRONT OF THE STORE, AND IN THE REAR OF THE STORE NEAR RECEIVING. THE
EMERGENCY ASSEMBLY AREA WILL DEPEND ON THE EXTENT AND LOCATION OF THE
INCIDENT. WALGREENS STORE MANAGEMENT WILL ASSIST ALL EMERGENCY RESPONDERS
DURING A FACILITY INCIDENT AS NEEDED. ALL AGENCY NOTIFICATION WILL BE
CONTACTED BY CORPORATE.
Public Notif./Evacuation 02/23/2006
TO BE DISPATCHED BY CORPORATE.
9
-10- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409
Fast Format
~ Notif./Evacuation/Medical Overall Site
~ Emergency Medical Plan 08/17/2006
MERCY HOSPITAL, 2215 TRUXTUN AVE
9
9
-11- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 02/23/2006 ~
IN ORDER TO PREVENT A RELEASE FROM OCCURRING, ALL HAZARDOUS MATERIALS ARE
KEPT IN THEIR ORIGINAL CONTAINERS AND STORE PERSONNEL VISUALLY INSPECT
PRODUCTS ON A DAILY BASIS.
Release Containment 08/17/2006
IN THE EVENT OF A SPILL, ALL PRODUCTS WILL BE CLEANED UP USING IN-HOUSE
EQUIPMENT (IE, ABSORBENTS, BROOMS, GLOVES, ETC). PRODUCTS ARE DISPOSED OF
ACCORDING TO STATE AND FEDERAL REGULATIONS.
Clean Up
08/17/2006
IN THE EVENT OF A SPILL, ALL PRODUCTS WILL BE CLEANED UP USING IN-HOUSE
EQUIPMENT (IE, ABSORBENTS, BROOMS, GLOVES, ETC). PRODUCTS ARE DISPOSED OF
ACCORDING TO STATE AND FEDERAL REGULATIONS.
v~.uci itcavui~.c Al..l..1V0.1~1V11
-12- 02/20/2007
F WALGREENS 6526 SiteID: 015-021-002409 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
oNc~ia~. nct~aiu~
Utility Shut-Offs 08/17/2006
NATURAL GAS/PROPANE: OUTSIDE REAR OF BLDG (MAP 1 H-2)
ELECTRICAL: BACK OF STORE NEAR EMPLOYEES BREAK ROOM (MAP 1 G-6)
WATER: BACK OF STORE NEAR EMPLOYEES BREAK ROOM (MAP 1 E-1)
LOCK BOX: NO
Fire Protec./Avail. Water 08/17/2006
PRIVATE FIRE PROTECTION: FIRE EXTINGUISHERS, AUTOMATIC FIRE ALARM SYSTEM,
AND AUTOMATIC FIRE SPRINKLERS.
FIRE HYDRANT: AKERS RD; WATER CONNECTION OUTSIDE OF STORE.
Building Occupancy Level 02/23/2006
26 EMPLOYEES
-13- 02/20/2007
F WALGREENS 6526 SitelD: 015-021-002409 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 08/17/2006 ~
MSDS RECORDS ARE MAINTAINED IN THE STORE MANAGERS OFFICE, AS WELL AS AT THE
CORPORATE OFFICE AND 3E CO.
BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE TRAINED ON THE PROPER
HANDLING AND STORAGE OF HAZARDOUS MATERIALS. TRAINING COVERS SAFE HANDLING
PRACTICES, CALLING 3E CO TO OBTAIN MSDS VIA FAX ON DEMAND, EMERGENCY
RESPONSE PROCEDURES, AND OTHER AREAS. TRAINING IS PROVIDED TO FIRST TIME
EMPLOYEES UPON INITIAL HIRING, AND TO ALL EMPLOYEES ON AN ANNUAL BASIS.
TRAINING PROVIDES EMPLOYEES WITH SKILLS AND SUPPORT IN ORDER FOR THEM TO
DEVELOP SAFE WORK PRACTICES, TO PREVENT ACCIDENTS, AND TO IMPROVE THEIR WORK
rayc ~
nciu i.vt ru~.uic ~~c
nciu ivi r u~.uic vac
-14- 02/20/2007
ALIFORNIA ANN^TATED SITE MAP I BUSINESS NAME: WALGREENS #6526 I SITE ADDRESS: 9550 HAGEMAN RD. I
BAKERSFIELD CA, 93312 Map #:1 ^F 2~
A B C D E F G H I
1
2
3
4
5
6
f'
O EI.ECTRtc MAW
O GAS MAIN
O 'HATER MAW
FIRST AID
COMPRESSED GAS
0 CYLINDERS
1~~)
R-22 REFRIGERANT
Y
X ~
CALIFORNIA ANNOTATED SITE MAP BUSINESS NAME: WALGREENS #6526 SITE ADDRESS: 9550 HAGEMAN RD.
BAKERSFIELD CA 93312 Ma #:2 ^F
P
A B C D E F G H I
1
2
3
4
5
6
~'
I
f
f
E
tU
y,
xi
Y
X --~
SAFE REFUGE AREA
FIRE HYDRANT