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Home My WebLink AboutBUSINESS 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 w ,.r-I ALIFORNIA ANNOTATED SITE MAP BUSINESS NAME: WALGREENS #6526 ~ SITE ADDRESS: 9550 HAGEMAN RD BAKERSFIELD CA,_ A B C D E F G H 2 3 4 5 s f° Map #:I OF 2 t ~ ; ""1 ~ ~ ~ l._ 1 ~......... . ~. ., ___. a..__. s O ~l_.._. 1. . ,` ~.,~ ..~ ~ : I i ., : -: __ _. __ __ ._. ,~ ~. _ ~ , 1 ~...~.._iz t ~ ,.~ ~ PHARI~tAC] .. 7 ~ ~ =.I u~ t~ 3-' ~ ~ r -t t ~ _ _~ _. ; - ~. ~ ~ ~ ~I @ S ~., y } ...~ I j i f t ~. _... .._ _ _... _ _. ~ ._ ~ ~ £ . ,.: ~ - . T € F 3 ~ ~; ; _ r. , ~~ ~ R-~ - F, ; <: ...: _~ q, "/O , ! ~ ~ t Y -:~, ' : : : B ~ _ . ... : PHOTO LA ~__J ` *~ ' .:: ~ ~ ~~ ~n ~ '~ x ~ -_ i r?-r_ - - I 3E T TO SCALE O ELECTRIC MAIN ..~ OG GAS MAIN O WATER MAIN FIRST AID pC PHOTO CHEMICALS COMPRESSED GAS CYLINDERS (xeuuM) R-22 REFRIGERANT Y X --~ 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 2 3 4 5 s ~' z O y x DR W CAL AY SHOP ING CENT R OMMER I .~ i` L ~ ~°"M~'~` `~ .;• ~~ ~£ ~- m ~: ; COMMER I L ~ ~, . ~~:~ ~~ ~, HA EMAN RD 1 SCA E~ 3E NOT T^ SCALE ~, ~>> ~~ SAFE REFUGE AREA a ~..i FIRE HYDRANT Y X -~- ~ ~_ (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