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HomeMy WebLinkAboutBUSINESS PLAN 6/5/2007i i. i ~~ ~ u ~ LESLIE'S POOL SUPPLIES II 9901 HAGEMAN ROAD, SUITE_500 1- - 11__ -_ _-=--= - - - - --- - UNIFIED PROGRAM INSPECTION-CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services n . F R s r _, ; „ 900 Truxtun Ave., Suite 210 F~R-E Bakersfield, CA 93301 D ARTM Tel.: (661) 326-3979 l@ahni Fax: (661) 872-2171 FACILITY NAME ~ Lc SCI Es ~~~~ ~ S7~ INSPECTION DATE ~;~~7 INSPECTION TIME ADDRESS O I A!c E MA N PHONE NO. Z°1 '~ NO OF EMP OYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021- a'p~~},S'~ Section 1: Btasiness Plan and Inventory Program '~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND .. a i, G ~ ~ ~rr2 M ~ -r /J" a ~ PE ~,~~,6 ~' ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ~ ~ r ^ VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY p, ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~N~4 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ ~ HOUSEKEEPING ~ /k~.~ ~s/~ ~~i.~ ~'., ~~k ~o ^ ~ FIRE PROTECTION ~ ~cfv~C..~ .rte ~~n~ -. , ~~~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # ^ YES ENO White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 T:. FIRE PREVENTION INSPECTION i!~• B E R S F I L D F/RE ARTM T BAKERSFIELD FIRE DEPT. y~ Prevention Services 900 Truxtun Ave., Ste. 210 ~~, I Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ Fax: (661) 2-2171 DISTRICT BLOCK NO. DATE ~_ r"~ ~~ p j EE ' f ~ .~~ FACILITY ADDRESS ~ ~ ~, f ` ~U p / CITY, STA T E, 21P f n~ r, t, ~,/ ~ ~ ~ ~/~ /r .L' FACILITY NAME F HO MANAGER'S NAME BUSINESS OWNER'S NAME AND ADDRESS ~ ~ CITY, STATE, ZIP O R' PHONE O. BILL TO: (IF DIF ERENT F M ABOV NAME, D ESS r ~Iti C STA E, ZIP, ~~ ~ BILLING PHONE NO. C OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE ^ YES ^ NO CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS CHECKED BELOW No. Y 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.) COMBUSTIBLE WASTE I DR VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its safe disposal. (U.F.C.) COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.) 4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10) ExTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) __________________ portable fire extinguisher to be immediately accessible for use in (area) _____________________________ (U.F.C.) g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use, by a person having a valid license or certificate. (U.F.C.) 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (doorlwindow) to SIGNS fire escape. (U. F.C.) g Provide and maintain appropriate numbers on tr tq~l~,t~ „kground and visible from the street to indicate the correct address of the building. (B.M.C.) (U.F.C.) /~~/,.~ c g Repair all (cracks/holes/openings) in plaster in (location) _____________ ~____________________. Plastering FIREDOORSI shall return the surface to its original fire resistive condition. (U.B.C.) FIRE SEPARATIONS 10 Remove/repair (item & location) _________________________________________________________. Self-closing doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the closing device. (U.F.C.) EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.) 12 Provide a contrasting colored and permanently installed electric light over or near required exit (location) ______________________________ to clearly indicate it as an exit. (U.F.C.) STORAGE 13 Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.) 14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets ELECTRICAL APPLIANCES where needed. (N.E.C.) (U. F. C.) 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N.E.C.) (U.F.C.) OUTDOOR BURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C. FIREwoRKS 17 Violations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 18 ~ / y _ ~ ~ ~ ~ ~-'~>~ I o L+ ~ r_`~ ,` / ~°.'P i/ i'`) ~ ~ .r9 ~ r l <.• G~e~ F--F .~/ ~ .ll, ice!' C'7.rt i .7 7 .S'rr c~ CUSTOMER: ~ > ,~--.,~.--- S rv,h~ ~T"oR~ ~~} _ LEGEND: _ t (Signature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE U.B.C. UNIFORM BUILDING CODE /~ B.M.C. BAKERSFIELD MUNICIPAL CODE _ INSPECTOR: i„L,~ ,.y AP NO.: "/ N.F.P.A. NATIONAL FIRE PROTECTION (Signature) T ASSOCIATION N.E.C. NATIONAL ELECTRIC CODE White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (ReV. 09/05) ' C~~R1~EC~'I®N N®1"ICE ~~~~52 "BAKERSFIELD FIRE DEPARTMEPlT Location /,?/ ~Al_~ ~~~ k~ ~`©~ Name ~~' ~ ! ; ,~ ~ ~~~~ S t~~l ,~f s You are hereby required to make the following corrections at the above location: ~~~ ~~,6;' ~ ~ ~~ irr~ ~,~~.~ ~~f . i~~,L, ~~I ~t L. Cor. No. a ~ /UI ~ ~~~~ ~®iLJ .( J ! 4``~ ~ 71 S. r 1 c A r~o~ ~ S r S f~ ~`- ~~ Completion Date for Corrections ~?~`(1 Date ,~- ~ ~ ~ ~-,, inspector Fo,~ 326-3951 L` _~ F LESLIES POOL SUPPLIES 570-HAGEMAN Manager JAMES COWAN Location: 9901 HAGEMAN RD 500 City BAKERSFIELD CommCode: KCFD STA 65 EPA Numb: ~- s,~ SiteID: 015-021-003455 BusPhone: (661) 829-2302 Map 102 CommHaz High Grid: 18D FacUnits: 1 AOV: SIC Code:5999 DunnBrad:05-O10-6095 Emergency Contact / Title Emergency Contact / Title GREG CANFIELD / DISTRICT MGR M IKE JENNINGS / MGR REG AFFAIRS Business Phone: (661) 835-7568x Business Phone: (602) 366-3946x 24-Hour Phone (559) 307-9815x 24-Hour Phone (480) 227-9249x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth DelHlth Contact : MIKE JENNINGS Phone: (602) 366-3946x MailAddr: 3925 E BROADWAY RD 100 State: AZ City PHOENIX Zip 85040 Owner LESLIES POOLMART Phone: (602) 366-3999x Address 3925 E BROADWAY RD 100 State: AZ City PHOENIX Zip 85040 Period .to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT Qased on my inquiry of those individuals responsible for obtaining the information !c tif ~N~~~ ~ ~ ~ ~ ~Q~7 , er y under penalty of taw that I hav e personally examined and am familiar with the information submitted and believe the information is true , accurate, and complete. Date -1- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-003455 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP MURIATIC ACID E R IH L 300.00 GAL Hi TRICHLORO-S-TRIAZINERTRIONE IH DH S 8000.00 LBS Mod CALCIUM HYPOCHLORITE S 2100.00 LBS Mod SODIUM CARBONATE S 3100.00 LBS LOw SODIUM BICARBONATE R IH S 1690.00 LBS Min DICHLORO-S-TRIAZINE 2,4,6 (1H,3 S 4500.00 LBS UnR FRESH AND CLEAR S 1000.00 LBS UnR HYPOCHLORITE SOLUTIONS L 300.00 GAL UnR -2- 02/02/2007 -3- 02j02j2007 F LESLIES POOL SUPPLIES 570-HAGEMAN = ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME MURIATIC ACID Location within this Facility Unit RETAIL FLR/STORAGE AREA STATE TYPE PRESSURE Liquid TMixture ~ Ambient SiteID: 015-021-003455 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7647-O1-1 TEMPERATURE CONTAINER TYPE Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 15.00 GAL 300.00 GAL 200.00 GAL rlr~~~lcu~u~ wl~irvivl;lvl~ %Wt. RS CAS# 36.00 Hydrochloric Acid Yes 7647010 t11~GAtt.L L~SJI;J~1~11;1V1a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINERTRIONE Location within this Facility Unit RETAIL FLR/STORAGE AREA STATE T TYPE ~ PRESSURE Solid I Mixture I Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 87901 TEMPERATURE CONTAINER TYPE Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 8000.00 LBS 5300.00 LBS ti1~GEitCLVU~ lLV1~lYV1VL"1V1J %Wt. RS CAS# 100.00 Trichloro-s-triazinetrione No 87901 tiEjGHKL L~~~~551~11;1V 1 A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod -4- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN = ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME CALCIUM HYPOCHLORITE Location within this Facility Unit RETAIL FLR/STORAGE AREA STATE TYPE PRESSURE Solid Mixtur~mbient SiteID: 015-021-003455 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7778-54-3 TEMPERATURE CONTAINER TYPE Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Co100100rLBS Daily2M00100m LBS I Daily1400r00e LBS nt~ay,.tcLUUJ ~.urirvlv~iv 1 ~ %Wt. RS CAS# 70.00 Calcium Hypochlorite No 7778543 ntiGH1KL HJ J~JJ1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM CARBONATE Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 497-19-8 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~ Ambient ~ Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 3100.00 LBS 2100.00 LBS nrauruci~vVJ \.V1•lr V1V 81V1J $Wt. ~ RS CAS# 100.00 Sodium Carbonate No 497198 1'1tiGriiCL ti J JP~J J1"1P~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -5- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM BICARBONATE Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 144-55-8 STATE T TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE ~SOlld I Mixture I Ambient ~ AmhiPnt_ ~ nTUFR - ~PFrTFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 1690.00 LBS 1150.00 LBS - HAZARDOUS COMPONENTS °sWt. RS CAS# 100.00 Sodium Bicarbonate No 144558 riti[~.tiCCL H~ 7 w7 L~~w71°1LilV 1.J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Min ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DICHLORO-S-TRIAZINE 2,4,6 (1H,3H,5H) TRIONE, SODIUM SALT Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 51580-86-0 ~SolidE TMixture ~mbient~E ~ AmbientT~E OTHERONTSPECIFYYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 LBS 4500.00 LBS 3000.00 LBS HAZARDOUS COMPONENTS %Wt. RSA CAS# HAZAR D AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR v -6- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME FRESH AND CLEAR Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 70693-62-8 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~ Ambient ~ Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 LBS 1000.00 LBS 670.00 LBS -' H1-~GEIKLVUJ 1.:V1~lYV1VL'1V1~ °sWt. RS CAS# 43.00 Potassium Peroxymonosulfate No 10058238 23.00 Potassium Bisulfate No 7646937 29.00 Potassium Sulfate No 7778805 3.00 POTASSIUM PEROXYDISULFATE No 7727-21-1 2.00 Sodium Carbonate No 497198 riAY,1iK1J AS~J;SS1~1L"~1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME HYPOCHLORITE SOLUTIONS Location within this Facility Unit RETAIL FLR/STORAGE AREA STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7681-52-9 TEMPERATURE CONTAINER TYPE Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 40.00 GAL 300.00 GAL 200.00 GAL t1HGE~tC1/VUA 1:V1~lYV1V~1V7~ %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 tiHGF1KL A~.7J~,.7.71~1L"1V1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -7- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 08/15/2006 PER ESTABLISHED PROCEDURES, EMPLOYEES TRAINED TO IMMEDIATELY CONTACT LESLIES REGULATORY AFFAIRS/SAFETY DEPT AND LOCAL EMERGENCY RESPONSE PERSONNEL IF SITUATION PRESENTS AN IMMEDIATE THREAT TO PEOPLE, PROPERTY, AND/OR ENVIRONMENT. ,_ P~lll~JlVyCC 1VV1.11 / L~VdI.:UdI..LV11 ~~r~a-1 Public Notif./Evacuation e.1' ~ G/\ Emergency Medical Plan 08/15/2006 IN THE EVENT OF A MEDICAL EMERGENCY, LOCAL EMERGENCY RESPONSE PERSONNEL WOULD BE CONTACTED. PERSONS NEEDING MEDICAL TREATMENT WOULD BE DIRECTED TO BAKERSFIELD OCCUPATIONAL MEDICINE. -8- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 08/15/2006 ~ EMPLOYEES TRAINED ON PROPER STORAGE/HANDLING OF CHEMICALS, INCLUDING SEPARATION OF INCOMPATIBLE MATERIALS. ALL PRODUCT STORED IN FINAL CONSUMER PACKAGING. NO PACKAGING OF CHEMICALS OCCURS ON SITE. Release Containment 08/15/2006 SMALL SPILLS/RELEASES WILL BE HANDLED BY STORE PERSONNEL ACCORDING TO ESTABLISHED, POSTED PROCEDURES. LARGER SPILLS/RELEASES OR SPILLS/RELEASES THAT POSE AN IMMEDIATE DANGER TO PEOPLE, PROPERTY, OR THE ENVIRONMENT WILL BE HANDLED BY LOCAL EMERGENCY RESPONSE PERSONNEL AND/OR AN EMERGENCY RESPONSE CONTRACTOR. Clean Up 08/15/2006 ALL SPILLS MUST BE ADDRESSED IMMEDIATELY BY PERSONNEL ON SITE. SPILLS/RELEASES REQUIRING LOCAL EMERGENCY RESPONSE PERSONNEL AND/OR AN EMERGENCY RESPONSE CONTRACTOR MUST BE CONTAINED IMMEDIATELY AS WELL. V1.11C 1_ 1CC~7VUll.:C til: l.lVdl.1 V11 -9- 02/02/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ w7j.lC 1..10.1 iZaaaiua Utility Shut-Offs 12/14/2006 ELECTRICAL: INSIDE BACK DOOR OF BLDG W OF REAR ENTR WATER: OUTSIDE BACK DOOR OF BLDG NEAR ENTR LOCK BOX: NO Fire Protec./Avail. Water 08/15/2006 PRIVATE FIRE PROTECTION: AUTOMATIC SPRINKLER SYSTEM, FIRE ALARM SYSTEM, AND WATER & ABC FIRE EXTINGUISHERS. FIRE HYDRANT: N OF BLDG NEAR FRONT ENT. Building Occupancy Level 12/14/2006 2-7 SEASONAL EMPLOYEES -10- 02/02/2007 .i ~ F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast. Format ~ ~ Training Overall Site ~ ~ Employee Training 08/15/2006 ~ MSDS ON FILE IN STORE OFFICE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE TRAINED CONCERNING THE PROPERTIES AND PROPER HANDLING PROCEDURES FOR ALL HAZMAT SOLD IN THE STORE. IN ADDITION TO MANDATED TRAINING CONDUCTED FOR ALL NEW HIRES AND AT REQUIRED INTERVALS FOR CONTINUING EMPLOYEES, LESLIES CONDUCTS MONTHLY SAFETY MEETINS THAT COVER TOPICS SUCH AS UNDERSTANDING MSDS, CHEMICAL HANDLING PROCEDURES, SPILL RESPONSE, PERSONAL PROTECTIVE EQUIPMENT, ETC. rdye ~ nci.u ivi r u~uic vac .1 J L ___ aiciu i.vi i' ui.uic ~~c -11- 02/02/2007 ~' ,~-~ (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN (UNIFIED PROGRAM CONSOLIDATED FORM) APPLICATION BUSINESS OVMER I OPERATOR IDEMIFlCATION FORM (HAZARDOUS MATERIALS ~=>"a;lL ? ~ "t' INFORMATION) ,~ BAKERSFIELD FIRE DEPT. Prevention Services /~~ r3 1p ~ ~ ~ , H 900 Truxtun Ave., Suite 210 ~ (~ I ` SIR! Bakersfield, CA 93301 ,/ otP~~~w~NS Tel.: (661) 326-3979 ~/ Fax: (661) 852-2171 Page 1 of 2 r `~~ '1 I. FACILITY IDENTIFICATION FACILITY ID N0. ear eginning too Year Ending to BUSINESS NAME (Same as FACILITY NAME or DBA- Dping Business As) a ~~j e~ ~S`wiYhwlih Pol Su ~ ~ D BUSINESS P ONE to ~GI ~a ~~~~. SITE ADDRESS n/~ ~ ~ d 770 ^~ tq (' i~ ~ ^ a J CITY /~ ~`~~ +q'+ IP `331 ~ t0 DUNN 8 BRAD`TROE~ O~ ~ /~1-rJ /\[~ ~ (~ II`" /l ENT'D A U G 1 ~~ ~OO~ IC CODE~~ to 4 Digit #) COUNTY D ~ u I , 10 OPERATOR NAME~ tq8 OPERA OR Pr E ~~ ~~ tt ~~ / ~ ~ I G i I I. OWNER INFORMATION OWNERNAME i~ ~ w,a~~" t++ OWNER HONE t+ Boa ~~-3999 OWNER MAILING ADDRESS >-7 ^~ ^ ~~ ~~ / I~ tt 5 !?(J Ci t~flT`b/- CITY ~~o ^ tt4 STATE ^~ tt5 Ip ~~~ tt /f'~ III. ENVIRONMENTAL CONTACT CONTACT NAME ~ ---~^ /yllk~~~hhlh tt7 CON ACT PHONE tt ~aa ~~ 3q CONTACT MAILING ADDRESS ^ ~ (a`J ~~~ ~r ( ~~ tt I,rf}~yi~ I CITY ~~0~ i t2o STATE ~~ tz+ ZIP ~~~ tz -PRIMARY NAME /~ n ~~~ 1 'v^ /L,{r~( (/~~ IV. EMERGENCY CONTACTS -SECONDA.. RY-_ ~ 12 NAME ~j~.~ I~ 12~ \I • ,Yl rn T17LE c~ aha ~ `~ ` .'r l ,2 ITLE ~h ~ u ,., , BUSINESS PHONE ~~ ('~ n 125 BUSINESS PHON ~ „^ ~ 13 24-HOUR PHONE - ~ r ~ ~~ 12 4-HOUR PHONE ~/ r~ A _ ~r ~ ` / ~y 131 PAGER No ~ _ 12 U PAGER No ~ ~ ~ ~ 13 13 ~_ V. CERTIFICATION Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted in this inventory and believe the information is true, accurate, and complete. SIGNATURE OF 0 ER/OPERATOR full pr' e) 13 DAT 13 NAME OF DOC MENT PP=PARE ~ a ~ r ~ (ful printed name) 13 ~ ~ z SIGN U OF 0 NER/OPERAT OR DESIGNATED i REPRESENTATIVE ~' hi 13 TIT E OF OW NER/OPERATOR/OR D REPRESENTATIVE (SIGNER) ~ SIGNATED n ~/M~ 13 a~a~~' KDAr1~t,r1 /YfT~1v(~ U .i ~ / ru z~ trtev. vaiua~ (HMMP) - HAZAPtPS MATERIALS MANAGEMENT PLAN x SITE & FACILITY DIAGRAM Page 2,of 2 .. BAKERSFIELD FIRE-DEP'~. Prevention Services _ a e ~ s F z ~~ 900 Truxtun Ave.,. Suite 210 F-RE Bakersfield, CA 93301- ~~r~r r Tel.: 661-326-3979 _ Fax:; 661-852-21.71 - - ~~,/~ SITE DIAGRAM - - FACILITY DIAGRAM .,: - ~ n Business Name: ~~~„$ ~I,tJI~{.yt ~Q~ ~ j ~ ~ ~ ---- . Business-Address: - I 1 ~~ ~. ,1 ~u~~~/Y°~ l I (~1~-W_._.. - -- - - ~ . ~ - ~_ HOIIS~NG . - ~ - - - - - ALLEY TOLET q p .... _.. __ - ._. - -/ 8 s~ _ _ _ g 1 cr~~_ g ~~ ~ ~ ~ 593 EMPTY .LOT - - tE3 E'S ~. PARKING 6, eA (xC 2001 - C~3C 2WI ~,,r HAGEMAN ROAD Chemical Listing .1• 1 - Chlor Brite 2 - Chlor Tabs (Trichlor) 3 -Fresh `N Clear 4 - Muriatic Acid 5 -Power Powder 6 -Chlorinating Liquid 7 - Soda.Ash - ~ 8 -Alkalinity Up I - I NORT.H~ ~ ~~ ndicate direction-of North Fr) ?'i 7f1 rRo„ namK~ ,~ z:i LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 Manager JAMES COWAN Location: 9901 HAGEMAN RD 500 City BAKERSFIELD BusPhone: (661) 829-2302 Map 102 CommHaz High Grid: 18D FacUnits: 1 AOV: CommCode: KCFD STA 65 EPA Numb: SIC Code:5999 DunnBrad:05-O10-6095 Emergency Contact / Title Emergency Contact / Title GREG CANFIELD / DISTRICT MGR MIKE JENNINGS~ / REG AFFAIRS MGR Business Phone: (559) 307-9815x Business Phone: (602) 366-3946x 24-Hour Phone (559) 307-9815x 24-Hour Phone (480) 227-9249x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth DelHlth Contact MIKE JENNINGS Phone: (602) 366-3946x MailAddr: 3925 E BROADWAY RD 100 State: AZ City PHOENIX Zip 85040 Owner LESLIES POOLMART Phone: (602) 366-3999x Address 3925 E BROADWAY RD 100 State: AZ City PHOENIX Zip 85040 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENrp oc r ~ ~ ~~~ -- C~a.sed on - respcnsit~;A f,~ c~~q~irv-of those individuals under nin~ng the inform W ally of ia~r th exarrrined a-~.famiiia submitted ation, A certify at i have personalEy r wrih th and e information accurate ; bz;~eve fhe information is nd complete. true, ~'' Date ® °e- -1- 07/12/2007 ~- F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP MURIATIC ACID E R IH L 300.00 GAL Hi TRICHLORO-S-TRIAZINERTRIONE IH DH S 8000.00 LBS Mod CALCIUM HYPOCHLORITE S 2100.00 LBS Mod SODIUM CARBONATE S 3100.00 LBS Low SODIUM BICARBONATE R IH S 1690.00 LBS Min DICHLORO-S-TRIAZINE 2,4,6 (1H,3 S 4500.00 LBS UnR FRESH AND CLEAR S 1000.00 LBS UnR HYPOCHLORITE SOLUTIONS L 300.00 GAL UnR -2- 07/12/2007 -3- 07/12/2007 5 I, F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MURIATIC ACID Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 7647-O1-1 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 15.00 GAL 300.00 GAL 200.00 GAL - HAZARDOUS COMPONENTS oWt. RS CAS# 36,00 Hydrochloric Acid - _ Yes 7647010 TSecret RS BioHaz r1CiL~tiLCL 1"1J Radioactive/Amount JLi~7.71.1P~1V 1 a EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINERTRIONE Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 87901 STATE T TYPE -~-- PRESSURE TEMPERATURE '~~ CONTAINER TYPE Solid I Mixture I Ambient ~ Ambient I C)THF.R - GPF.C''TFV AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 8000.00 LBS I 5300.00 LBS ZARDO US COMPONENTS ~Wt• RS CAS# 100.00 Trichloro-s-triazinetrione No 87901 I1t~GL~iLCL H~ JJ L' .7.71~1L' 1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod -4- 07/12/2007 r, F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CALCIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 7778-54-3 ~SolidE I Mixtures PRESSURE TEMPERATURE CONTAINER TYPE I Ambient ~ Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 100.00 LBS 2100.00 LBS 1400.00 LBS tiHGKKLVUA 1:V1~lYV1V1r1V1a %Wt. RS CAS# 70.00 Calcium Hypochlorite - No 7778543 tiL-~GXKL 1'~55r;~~1~1~1~ 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME SODIUM CARBONATE Location within this Facility Unit RETAIL FLR/STORAGE AREA Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 497-19-8 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid Mixture Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Con50100rLBS Daily31j00100m LBS I Daily2100r00e LBS tit~GtittLVU~7 L.v1~lrVlvl~,lv1a %Wt. RS CAS# 100.00 Sodium Carbonate No 497198 riEiGl-~KL E~.7 J L" .7 51~1L' 1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -5- 07/12/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM BICARBONATE Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 144-55-8 STATE T TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE Solid I Mixture I Ambient ~ Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 50.00 LBS 1690.00 LBS 1150.00 LBS - t1t~~r~xLwa ~~l~ir~iv~iv 1 %Wt. RS CAS# 100.00 Sodium Bicarbonate - No 144558 t1E1GE~KL A5 J~551~1L;1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Min ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DICHLORO-S-TRIAZINE 2,4,6 (1H,3H,5H) TRIONE, SODIUM SALT Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 51580-86-0 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid Mixture Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 LBS 4500.00 LBS 3000.00 LBS ~--~ HAZARDOUS COMPONENTS %Wt. RS{ CAS# I11-~GHt<L 1-~.7.7L' .7.71~1~1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -6- 07/12/2007 t, ~ F LESLIES POOL SUPPLIES 570-HAGEMAN = ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME FRESH AND CLEAR Location within this Facility Unit RETAIL FLR/STORAGE AREA STATE T TYPE --~- PRESSURE Solid I Mixture I Ambient SiteID: 015-021-003455 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 70693-62-8 TEMPERATURE CONTAINER TYPE Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 LBS 1000.00 LBS 670.00 LBS tiE~Gl-~tcL V U 7 ~vinrviV niV 1 J sWt. RS CAS# 43.00 Potassium Peroxymonosulfate - No 10058238 23.00 Potassium Bisulfate No 7646937 29.00 Potassium Sulfate No 7778805 3.00 POTASSIUM PEROXYDISULFATE No 7727-21-1 2.00 Sodium Carbonate No 497198 t1AGHKL F~a5~~J1~1L"1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HYPOCHLORITE SOLUTIONS Days On Site 365 Location within this Facility Unit Map: Grid: RETAIL FLR/STORAGE AREA CAS# 7681-52-9 Liquid TMixture ~Ambient~E ~ AmbientT~E OTHER NTSPECIFYYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 40.00 GAL 300.00 GAL 200.00 GAL ruiGHtCLVUD 1..V1~lYV1Vr~1V1b %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 rues-a.ecL .y~ ar,a~i~i~ivl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -7- 07/12/2007 S ~ F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/15/2006 ~ PER ESTABLISHED PROCEDURES, EMPLOYEES TRAINED TO IMMEDIATELY CONTACT LESLIES REGULATORY AFFAIRS/SAFETY DEPT AND LOCAL EMERGENCY RESPONSE PERSONNEL IF SITUATION PRESENTS AN IMMEDIATE THREAT TO PEOPLE, PROPERTY, AND/OR ENVIRONMENT. Employee Notif./Evacuation 02/23/2007 VERBAL- _ _ -- Public Notif./Evacuation VERBAL 02/23/2007 Emergency Medical Plan 08/15/2006 IN THE EVENT OF A MEDICAL EMERGENCY, LOCAL EMERGENCY RESPONSE PERSONNEL WOULD BE CONTACTED. PERSONS NEEDING MEDICAL TREATMENT WOULD BE DIRECTED TO BAKERSFIELD OCCUPATIONAL MEDICINE. -8- 07/12/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 08/15/2006 ~ EMPLOYEES TRAINED ON PROPER STORAGE/HANDLING OF CHEMICALS, INCLUDING SEPARATION OF INCOMPATIBLE MATERIALS. ALL PRODUCT STORED IN FINAL CONSUMER PACKAGING. NO PACKAGING OF CHEMICALS OCCURS ON SITE. Release Containment 08/15j2006 SMALL SPILLS/RELEASES WILL BE HANDLED BY STORE PERSONNEL ACCORDING TO ESTABLISHED, POSTED PROCEDURES. LARGER SPILLS/RELEASES OR SPILLS/RELEASES THAT POSE AN IMMEDIATE DANGER TO PEOPLE, PROPERTY, OR THE ENVIRONMENT WILL BE HANDLED BY LOCAL EMERGENCY RESPONSE PERSONNEL AND/OR AN EMERGENCY RESPONSE CONTRACTOR. Clean Up 08/15/2006 ALL SPILLS MUST BE ADDRESSED IMMEDIATELY BY PERSONNEL ON SITE. SPILLS/RELEASES REQUIRING LOCAL EMERGENCY RESPONSE PERSONNEL AND/OR AN EMERGENCY RESPONSE CONTRACTOR MUST BE CONTAINED IMMEDIATELY AS WELL. v~.iici iccovui~.c r~~~.i.va~.ivit -9- 07/12/2007 F LESLIES POOL SUPPLIES 570-HAGEMAN SiteID: 015-021-003455 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ O~JC l.:1Q1 na~aiu~ Utility Shut-Offs 12/14/2006 ELECTRICAL: INSIDE BACK DOOR OF BLDG W OF REAR ENTR WATER: OUTSIDE BACK DOOR OF-BLDG NEAR ENTR LOCK BOX: NO Fire Protec./Avail. Water 08/15/2006 PRIVATE FIRE PROTECTION: AUTOMATIC SPRINKLER SYSTEM, FIRE ALARM SYSTEM, AND WATER & ABC FIRE EXTINGUISHERS. FIRE HYDRANT: N OF BLDG NEAR FRONT ENT. Building Occupancy Level 12/14/2006 2-7 SEASONAL EMPLOYEES -10- 07/12/2007 ___ _ __,~ .'•-' ~ F LESLIES POOL SUPPLIES 570-HAGEMAN SitelD: 015-021-003455 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08j15/2006 ~ MSDS ON FILE IN STORE OFFICE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE TRAINED CONCERNING THE PROPERTIES AND PROPER HANDLING PROCEDURES FOR ALL HAZMAT SOLD IN THE STORE. IN ADDITION TO MANDATED TRAINING CONDUCTED FOR ALL NEW HIRES AND AT REQUIRED INTERVALS FOR CONTINUING EMPLOYEES, LESLIES CONDUCTS MONTHLY SAFETY MEETINS THAT COVER TOPICS SUCH AS UNDERSTANDING MSDS, CHEMICAL HANDLING PROCEDURES, SPILL RESPONSE, PERSONAL PROTECTIVE EQUIPMENT, ETC. Page 2 Held for Future Use Held for Future Use -11- 07/12/2007