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HomeMy WebLinkAboutBUSINESS PLAN (2)1 ~. ~. ' ~~ CIRCLE K CORD #2708606 ,,. a~~ ~ - ~ ~ ~~ 1030 OAK STR ~ '~~- - - -- - _ - =- EET ~~ ~ _ ~~ +y A ,~o fi J.. ~z;~~` • ~~ ,~~~;~, 1 ~~ _ -Prevention Services ~1`NIFLED PROGRAM.-fNSPECTlON CHECKLIST' A ~ R s F ; . ,; goo"Truxtun Ave., suite 210 - FIRE - ~ Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° AerM Tel.: (661) 326-3979 - _ _ - ~ `' " " Fax: (661)872-2171 FACILITY NAME " ~ ~~~~ INSPEC ION DA ~ f ) INSPECTION TIME ~ ~ © ` '7 ADDRESS 4 3 0 ~a(c. T ~ PHONE NO. - ~ ~ NO OF EMPLO EES ' FACILITY CONTACT . BUSINESS ID NUMBER 15-021- ! f Section 1: Business Plan and Inventory Program --- ^ ROUTINE LF~COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance .OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS " ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF"LOCATION ^ PROPER SEGREGATION OF MATERIAL EN~~ A ~ (~ l,e VERIFICATION OF MSDS AVAILABILITY VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION 4~ -t- ~ cr~T~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIOI)(~ REGAI~I~i'(.a THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 (Please Print) Fire~vention / 1s` In /Shift of Site/Station # B siness Site / Responsi Party (P se Print)' White -Prevention Services Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev. 09/05 ^ YES ^ NO ~. INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: C(r~c, (~ __ B i~-~F~ P/RE ~Rr~- r INSPECTION DATE: G Section 2: Underground Storage Tanks Program ^ Routine ~bined ^ Joint Agency ^ Multi-Agency Complaint ^ Re-Inspection Type of Tank ,nLt} Number of Tanks Type of Monitoring ~ ~0 [,Q}~ Type of Piping r~ )~ OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overFll /overspill protection? C =Compliance V =Violation Y =Yes N = No i Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 KBF-7335 FD 2156 (Rev. 09/05) ~~ ~ 3'1°~ __' . ~' ~~ CIRCLE K STORE 2708606 SiteID: 015-021-00126 Manager DONNA GREGORY BusPhone: (661) 861-8048 Location: 1030 OAK ST Map 102 CommHaz Extreme City BAKERSFIELD Grid: 36A FacUnits: 1 AOV: CommCode: BFD STA 03 SIC Code:5541 EPA Numb: DunnBrad:10-5457662 Emergency Contact / Title Emergency Contact / Title SERVICE CONTACT CTR / 24 HOURS KEVIN QUINN / DISTRICT MGR Business Phone: (866.) $05-4357x Business Phone: (559) 647-6910x 24-Hour Phone (866) 805-4357x 24-Hour Phone (~S'~) 63 Y' -4'zLflx Pager Phone ( ) - x Pager Phone ( ) - x . _ ... Hazmat Hazards: Fire Press ImmHlth DelHlt~i Contact LORRAINE SOFFE Phone: (951) 270-5183x MailAddr: 495 E RINCON 150 State: CA City CORONA 5r, zip 92879 Owner CIRCLE K STORES INC Phone: (951) 270-5193x Address 495 E RINCON 4~-8150 State: CA City CORONA ~.~ Zip 92879 .............. Period to TotalASTs: = Coal Preparers TotalUSTs: = Coal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD SYS PROG H - HAZ WASTE GEN PROG U - UST ~ ~ ~ z o zoos Based on my inquiry of those individuals respansibie for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate nd com'~/l~ete ? /,/' ~~~/ WC../ 'mil % J ~~ ignature ate -1- 01/29/2007 F CIRCLE K STORE 2708606 SiteID: 015-021-001296 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: CIRCLE K STORE 2708606 Cross street dark Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper C irC~--~- 5'~'Of~,$ ,~.2, ICC Nbr: PEKO0020 PROPERTY OWNER INFORMATION Name ~~ ~G ~ e- ~L S+o ~~S , ~-C - Phone : c ~ ~ a ~ ~ ~ ~ ~ a ~ n cddress : ~{q S'' ~ , (?.j nLO v~ Sfira.~F ~ ~-}e . l 5 ~ State Zi ~ 9 ~~ ~ 2 ~ v - S~ ~ 3 Type CORPOR~P,~TION • C~ P . ~ Z $ ~9 TANK OWNER INFORMATION Name ~i rc ~ ~ ~ S"~"oe~¢. J .Sv-C . Phone : ( ~ ~._.~-o-- Address: ' cit ~rS~ ~ • 2-'~c°'^ S-l-~e~- s~f'e - (~'~State zi 4 a~7q~ ~ ~ o - ~'/ 9 3 T e C~~PORATION / • ~ P • q Z~ ~' t YP BOE UST Fee# 032073 Financ'1 Resp: GUARANTEE Legal Notif Date:01/02/2004 Phone: (239) 093- x Name:MICHELLE WILSON Ttl:REGIONAL COMPLIANCE SPEC State UST # 1998 Upg Cert#: 00834 -2- O1/29/~007 F CIRCLE K STORE 2708606 ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001255 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... ~SpecHaz~EPA Hazards Frm ~ DailyMax ~UnitIMCPI PROPANE E F P IH G~ b0 ~~ 0 0 ~3--~~ GASOLINE - REGULAR UNLEADED F IH DH L 10000.00 GAL Mod GASOLINE, PREMIUM UNLEADED n F ~ IH DH T L 10000.00 r ^ GAL Mod TT""1Ti~. 1111"17 CARBON DIOXIDE REFRIGERATED LIQ = F P J.7I' IH ~ L ~ 2610.00 l7Al..! FT3 Min CARBON DIOXIDE P IH G 350.00 FT3 Min GASOLINE, UNLEADED PLUS F IH DH L 10 000.00 GAL Ur1R WASTE FILTERS S __ S .x--60 ~r 7iR ~jS . -3- Ol/29/~007 -4- O1/29/~007 F CIRCLE K STORE 2708606 SiteID: 015-021-001295 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF ENTR DOOR CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Large/spt~ Container ,/Daily Maximum /' ^Daily Average S ls/y'l_ , Q n, n n z~m-L / C•. ~9'P-*'~ ~' 3v G,4L ~ n n n n n ~mZ !'lEiGlitCLV U .7 l.. V1~1r V1V ~1V l ~ sWt. RS CAS# 100.00 Propane Yes 74986 t11~GHKL 1-~J .>~~J1~1r,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MGR No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME GASOLINE - REGULAR UNLEADED Location within this Facility Unit W SIDE OF LOT STATE TYPE PRESSURE Liquid Mixtur~Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient -~ER GROUND TANK ' AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3500.00 GAL ru-~~t~.x.LVU~ ~VinrVtv~ivla °sWt. RS CAS# 100.00 Gasoline No 80066].9 tii-~GHKL 1-~J w7l"iJ,J1~1L"1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- O1/29/~007 F CIRCLE K STORE 2708606 ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME GASOLINE, PREMIUM UNLEADED Location within this Facility Unit W SIDE OF LOT STATE TYPE PRESSURE Liquid Mixture Ambient SiteID: 015-021-001296 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 10000.00 GAL 10000.00 GAL 3500.00 GAL r~~tucL~u~ ~:vrirvlvnlvl~ -- oWt. RS CAS# 100.00 Gasoline No 8006].9 tlHGE~YCL 1~~ Jw7~~~71~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MAP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE L ~ ~ ~-- Days O e 65 Locatio within this Facilit Unit Map: Grid: CAS# STATE TYPE RESSURE TEMPERATUR CONTAINER TYPE Liquid Waste Ambi t Ambient DRUM/BARREL-METALLIC ............. AMO AT IS LOCATION Largest Container D y~Maximum Daily Average 55.00 GAL 55:0.0 GAL 55.00 GAL ~ _ _. Gt1tcLVU.7 L.vl"1rv1v.C,lvlb ~ %Wt. ~ RS CAS# 100.00 Waste Oi Petroleum Based No~~ 0 r1HGtitCL [i~ a~.7.71~tt',tv1.7 TSecret S BioHaz Radioactive/Amount EPA Hazards. NFPA USDOT# MC1~ No No No No/ Curies F DH / / / Low -6- 01/29/2007 .F CIRCLE K STORE 2708606 ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE REFRIGERATED LIQUID Location within this Facility Unit STOREROOM/FOODMART STATE TYPE PRESSURE _ Liquid TPure ~-Above Ambient Largest Container 2610.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 2610.00 FT3 Daily Average 1605.00 FT3 riE~GH.KLV U5 1.:V1~lYV1V.C~1V 15 %Wt. RS CAS# 10.0.00 Carbon Dioxide No 124389 nx~ritcl~ r~~ ~~~~in~ly t~a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies F P IH / / / Mitt ~ Inventory Item 0004 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Location within this Facility Unit STOREROOM/FOODMART STATE - TYPE Gas Pure = PRESSURE _ Above Ambient Days On Site 365 Map: Grid: _. CAS# 124-38-9 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER_ AMOUNTS AT THIS LOCATION Largest Co175100rFT3 Daily 350100m FT3 I Daily 175r00e FT3 riliGH,KLVU.7 ~.VrirVlv~ly-1D %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 I11-'~GLiKL t]~ .7 ~~.71~1~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P IH j / / Mini SiteID: 015-021-001296 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 124-3F3-9 TEMPERATURE CONTAINER TYPE Cryogenic INSUL.TANK / CRYOGENIC... Facility Unit: Fixed Containers on Site ~ -7- 01/29/2007 <F CIRCLE K STORE 2708606 ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME GASOLINE, UNLEADED PLUS Location within this Facility Unit N SIDE OF LOT STATE TYPE PRESSURE Liquid TMixtur~Ambient SiteID: 015-021-001296 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006619 = TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container ~ Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3500.00 GAL nt~~tuc~wa wi~irv~vr,ly l ~ %Wt. RS CAS# 100.00 Gasoline No 8006619 t1AGKKL A~ J~JJ1~1r,1VTJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UriR ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FILTERS ~ Days On Site 365 Location within this Facility Unit Map: Grid: -- TRASH ENCL CAS# 8006619 STATE TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE Solid Waste I Ambient ~ Ambient DRUM/BARREL-METALLIC I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 02 Q 0 ( b s • -~-`_~ $~ (~S ~ 3 (b,s' . 10.0 0 GAL ru~c~t-~tcLUUa lrV1~lYV1V~1V 1J %Wt. RS CAS# 5.00 Gasoline No 8006619 I1t~GEiCCL L•i.7 JP~.7.71~1L~1V 1.J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Un:R -8- Ol/29/~007 F CIRCLE K STORE 2708606 SiteID: 015-021-001296 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/23/2006 ~ IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND, WITHIN 24 HRS, STATE OFFICE OF EMERGENCY SERVICES 800-852-7550. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAM HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT 911; BAKERSFIELD POLICE DEPT 911; BAKERSFIEI,D CITY HAZARDOUS MATERIALS DIV 911; STATE OFFICE OF EMERGENCY SERVICES 800-852-7550 OR 916-262-1621. Employee Notif./Evacuation ,04/18/2006 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUT-DOWN OF HIS/HER AREA OF RESPONSIBILITY BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION. WILL FOLLOW THE DISIGNATED ROUTES AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUTE BY VERBAL METHOD TO A PREDETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTEL7 FOR. Public Notif./Evacuation 10/23/2006 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED: JOHNS BURGERS, 1000 OAK ST, 324-8131; QUALITY INN, 1011 OAK ST, 325-0772; AND YEN CHING REST, 1021 OAK ST, 324-3185. -9- Ol/29/~007 ~F CIRCLE K STORE 2708606 SiteID: 015-021-001295 Fast Form~:t ~ Notif./EvacuationJMedical Overall Site ~ Emergency Medical Plan 04/18/20015 MERCY SOUTHWEST HOSPITAL, 2215 TRUXTUN AVE, 632-5281 OR KERN MEDICAL CENTER 1830 FLOWER ST, 326-2000. -10- Ol/29/~b07 ~F CIRCLE K STORE 2708606 SiteID: 015-021-00126 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/18/2006 ~ 1. STORE TANK AND/OR CYLINDERS WITH VALVE PROTECTION CAPS INSTALLED. 2. TANK AND CYLINDERS SHOULD BE STORED UPRIGHT AND FIRMLY SECURED TO PREVE1Vfi FALLING OR BEING KNOCKED OVER. 3 CONTAINERS SHOULD BE STORED IN A COOL, DRY, WELL VENTILATED AREA AWAY. FROM SOURCES OF HEAT OR IGNITION AND DIRECT SUN LIGHT 4. IF YOU SUSPECT ANY PROBLEMS WITH THE TANK NOTIFY THE SUPPLIER IMMEDIATELY TO HAVE THE SYSTEM INSPECTED Release Containment 04/03/2006 ~l. DIAL 911 - INFORM EMERGENCY PERSONNEL THAT THERE IS A RELEASE FROM THE REFRIGERATED 2. EVACUATE EMPLOYEES AND CUSTOMERS FROM THE SITE AND DENY ENTRY TO UNAUTHORIZED 3. STAY UPWIND OF THE SPILL AND OUT OF LOW-LYING AREAS. 4. DO NOT TOUCH OR WALK THROUGH SPILLED MATERIAL. 5. AVOID BREATHING GASES. 6. DO NOT ENTER THE BUILDING UNTIL EMERGENCY PERSONNEL HAVE NOTIFIED YOU THAT IT IS SAFE. 7. CONTACT MANAGEMENT USING THE EMERGENCY PHONE LIST PROCEDURE. Clean Up 04/03/2006 NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR 602-530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. CARBON DIOXIDE: A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS/VENTILATE. C. CLEAN-UP PROCEDURES:. VENTILATE ARE IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. -11- O1/29/Z007 F CIRCLE K STORE 2708606 SiteID: 015-021-001296 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~Lner xesource r-~czivaLion -12- O1/29/~007 `F CIRCLE K STORE 2708606 SiteID: 015-021-001296 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special riazaras Utility Shut-Offs 04/18/20076 A) GAS - S WALL OF BLDG E END OUTSIDE B) ELECTRICAL - INSIDE BACK RM OF STORE (BREAKERS) & E WALL OF BLDG (METER) C) WATER - S WALL OF BLDG (MAIN LINE GATE VALVE) & SW CRNR OF SITE (METER) D) SPECIAL - EMER GAS SHUT-OFF SWITCH AT CASHIER STATION CONSOLE; N WALL 0) BLDG AT E END OUTSIDE E) LOCK BOX - NO Fire Protec./Avail. Water 10/23/2006 ~SE-4~t~~- A-2EX~ PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS: 1 NEXT TO 1 BY FRONT DOOR, AND 1 AT PUMP ISLAND. FIRE HYDRANT - SW OF SITE ACROSS OAK ST Building Occupancy Level 04/03/200)5 EMPLOYEES -13- 01/29/2007 'F CIRCLE K STORE 2708606 SiteID: 015-021-001296 ~ Fast Form~:t ~. ~ Training Overall Site ~ ~ Employee Training 01/29/20U7 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE SHOW OUR EMPLOYEES WHERE MSDS ARE, WHERE SHUT-OFF SWITCHES ARE AND INSTRUCT THEM WHEN TO USE THEM. SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIALS IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT; USE OF KITTY LITTER FOR SMALL SPILLS; EMPLOYEES ARE INSTRUCTED PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL, AND CIRCLE I ENVIRONMENTAL DEPARTMENT; AND EACH CIRCLE K GASOLINE STORE HAS A COMPANY-SUPPLIED GASOLINE MANUAL WITH MSDS FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY USAGE TRAINING WILL PROVIDE FAMILIARIZATION WITH THE rage ~ I1C1U LVL L'UI.ULC VSC -14- Ol/29/~007 'F CIRCLE K STORE 2708606 SiteID: 015-021-001296 Fast Format ~ Training Overall Site ~ Held for Future Use -15- 01/29/2007 270:}606 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page of I. FACILITY IDENTIFICATION ',FACILITY ID# ' i 1 EPA ID# (Hazardous Waste Only) 2 ', CAt_000278511 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS 3 Circle K Store #2708606 I. ACTIVITIES DECLARATION NOTE: tf you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the l l d ©YES • NO 4 HAZARDOUS MATERIALS INVENTORY - icabte Federal threshold quantity for an extreme y hazar ous app ~/ CHEMICAL DESCRIPTION (OES 2731) substance specified in 40 CFR Part 355, Aappendix A or 8; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) ~ YES NO 5 / UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? YES ©NO 6 ~ UST FACILITY UST TANK (One per tank UST INSTALLATION -CERTIFICATE OF COMPLIANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? YES ©NO 7 ~ UST TANK (olosure portion-one page per tank C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or YES ©NO 6 / NO FORM REQUIRED TO CUPAS ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? `YES NO 9 ~ EPA ID NUMBER--Provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted YES ©N01o / RECYCLABLE MATERIALS REPORT recyclable materials (per HSC § 25143.2)? (one per recycler) 3. Treat hazardous waste on site? YES ©N011 ~ ONSITE HAZARDOUS WASTE TREATMENT -FACILITY / (Formerly DTSC Form 1772) ~// ~ ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B.C,D, and L 4. Treatment subject to financial assurance requirements (for Permit •YES ©NO 12 J CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE (Formerly DISC Form 1232) 5. Consolidate hazardous waste generated at a remote site? YES ©N013 / REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as YES ©NO 1a / HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2708606 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION r - ------ --- -------- -- -- --------- -------------------- _ _ __ _ _ I. I_DENTIFICA_TI_O jFACILITY ID# i ~ ~ ~ _.1--1-- ~---i_---L-- !BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) j Circle K Store #2708606 USINESS SITE ADDRESS I iCITY UN_BRADSTREET Page of T TENDING DATE 101 ' 1 BEGINNING DATE 100 12/_31___12_0_07 01/01/2007 3 (BUSINESS PHONE 102 661-861-8048 103 1030 Oak Street ------- -------- - - -------- - - ---- - - - - - - - - I-- -, --- - - -- - - _ - __ 1041 CA .ZIP CODE 105 Bakersfield ~ 93304 _ ---- - -- -- ----------------- __----- - - --- --- - - - 107 106 SIC CODE (4 digit tt) 10-5457662 5541 iCOUNTY 106 Kern BUSINESS OPERATOR NAME 109 ;BUSINESS OPERATOR PHONE 110 ~ -- -- - _------ - --- Circle-K Stores, Inc.- - --- _ -- _._._ - ! (951), 270-5183 II. BUSINESS OWNER OWNERNAME - --- --- --- - - -- ----- - ---- - -----_ _ -- - -. i . - 111 ;OWNER PHONE - 112 ~ Circle K Stores, Inc. (951) 270-5193 ----- --- - - - -- ----- -...------- - (OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 CITY 114 - - - ---------- - ----- ---- jSTATE 115 ZIP CODE - - _ _ -~ 116 ( Corona 1 92879 CA I ---- -- --------- --------- - ------- - --- - --- ------- ------ - - - ------ --- -- ----- - - - -- - ------- -- __ ------- -- _- _ __ -- _ _ , ! III. ENVIRONMENTAL CONTACT tCONTACT NAME 117 jCON'fACT PHONE 118 Lorraine Soffe ' 951-270-5183 F --- ~CONTACT MAILING ADDRESS 119 495 E. Rincon, Suite 150 I CITY - - ---- ---^ --- --- 120 iSTAI~E 121 IZ.1P CODE 122 Corona ~ CA 92879 PRI MARY IV. EMERGENCY CONTACTS SECONDARY ;NAME -_ 123 iNAME 126 Service Contact Center Kevin Quinn 'TITLE 124 ;TITLE - - - 129 24 Hours i District Manager jBUSINESS PHONE 125 jBUSINESS PHONE 130 I 866-805-4357 I 559-647-6910 i24-HOUR PHONE - _ - _. _ . 126 •24-HOUR PI10NE 131 866-805-4357 559-639-9228 !PAGERS i r---------------- 127 IpAGERi! - - _'i -------- - -- ~- ------ --- -- --.. - _ . ..-- _ __ _ --- --- ----- ---- ..-...__ -- -.... 132 -._ .. DDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that 1 have personally examined and am (familiar with the information submitted and belie ~he info tion is true, accurate, and complete. _.__ _ -- - - SIGNATU O R/ P R 0 iD 4 iNAME OF DOCUMENT PREPARER 135 _ ~j~~~HL DESIGN GROUP, INC ENVIRONMENTAL DEPT. 136 'NAME O E print) (TITLE OF SIGNER 137 ! Lorraine Soffe I ~ Com liance Mana er -_ --- ----- --- - - -- - -_. _ ..- -- - -- 9_---- UPCF (1/99 revised) ~( OES FORM 2730 (I/9 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEM ICAL DESCRIPTION One page per material per building or area) i ADD i DELETE _ i REVISE 200 --- -- _ Page of - ___ _ _ _ I. FACILITY INFORMATION -- ---- -- - ---- ----- -- - - --- - -- --- ---- - - _ - - _ - (BUSINESS NAME 3 l Circle K Store #2708606 z~oasos - - - CHEMICAL LOCATION CFIEMICAL LOCATION CONFIDENTIAL 202 ~ WEST SIDE OF LOT (EPCRA ~ _ ~yES _xJ No FAC[LITY ID# _ -_ ~ ~ ~ !' - r~ ~ i I ` _ - ' _ L I I 1 rMAP# (optional) ~ 203 ~ GRID# (optional) 204 I ~. ~ , k 1 i C4 II. CHEMICAL INFORMATION __ __ 'CHEMICAL NAME 205 ;TRADE S ~ _ _ _ - - - --,Yes _I X !No ECRET ~ ~ i I i l - 206 GASOLINE I _._ _ __._ _ If Subject to EPCRA, refer _to instructions COMMON NAME 207 ; EHS _~ Yes j-xi No 208 REGULAR UNLEADED GASOLINE 't - ---- ------ - --------------------------- -- -- -- - --- - ICAS# 209 8006-61-9 ~, If EHS is " Yes", all amounts below must be in lbs. .FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 8 FLAMMABLE LIQUID I 210 - , HAZARD MATERIAL _ 211 ,- ~-TYPE (Check one nem ~ I ~ RADIOACTIVE, . ~ Yes a. PURE ~ X~ b MIXT'URF c WASTE '- ' ' - - ' ~ ~ 212 ~ ; X'~No ;CURIES I 213 _ _ _ -- - - - - - - - ~ II J c. GAS. _ . - PHYSICAL STATE - I j ---- 214 i - , a. SOLID ~ LARGEST CONTAINER X1 b. LIQUID L 000 215 _ - . ((Check one item only) ~ (FED HAZARD CATEGORIES ! r -- X1 a. FIRE ~ ~ b. REACTIVE ~ ~ c.PRESSURE RELEASE ; X ; d. ACU"fE HEAI: I ~ fH ' X ~ e.CHRONIC HEAL"fH 216 ' - !(Check all that apply) ---J . -- jAVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUN f 2181ANNUAL WASTE AMOUN"1' - - - 219 ~STAI'E WASTE CODE 220 - _.. _.. ._. -I- - _ _ 3500_---- ----._ I 10000 _- -- _ - -- ... -- --- _ . - - -- -. _ _ _ ____ !UNPFS* ~X ~ a. GALLONS ~ b. CUBIC FEET I I c. POUNDS ~ I, d. "EONS ' ' 221 ;DAYS ON SITE: 222 . ---- ~ --' - (Check one item only) I,______.-_______ ____-_.__ tf EHS, amountmust be in_pounds. _._ _-_ 365 -.I T A ' a. ABOVE GROUND TANK f e. PLASTICMONMETALLIC DRUM li. FIBER DRUM ~ m.GLASS BOTTLE o. RAIL CAR ICON INER ', f _X b. UNDERGROUND TANK ~ -- E CAN I Ij. BAG ~ , j n. PLASTIC BOTTLE ! Ip. O"fHER c. TANK INSIDE BU[LDING _ g. CARBOY 'I ik. BOX ~ io. TOTE BIN ~ ~ d. STEEL DRUM ~ h. S[LO ~ ~I. CYLINDER I p. TANK WAGON _ i - 223 STORAGE PRESSURE X I a• AMBIENT ~ b. ABOVE AMBIENT lc. BELOW AMBIENT 224 I, STORAGE TEMPERATURE ~ a. AMBIENT I ~b. ABOVE AMBIENT j_ ~c. BELOW AMBIENT - jd. CRYOGENIC 225 I- --------- ----i -------- --- --------- --_. --- - ---- _ -- - --- -- ---- - _ __ - ..- -- - - -. - -- .. _ .. - - . _ _ .. %WT i HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# I 100 226 Gasoline 227 ! Yes ! X No 228 '; 8006-61-9 22s ' !2 1-9 230 I TOLUENE 231 ycs 'X'No I 232 ~ 108-88-3 233 3 1-14 234 , XYLENES 235 ! ;Yes X;No 236 i 1330-20-7 237 ' ~j4 1-5 238 ~ 1,2,4-TRIMETHYLBENZENE 239 ,Yes ~XiNo 240: 95-63-6 241 j5 1-5 242 Ethyl Benzene 243 ;Yes X;No 244 ~ 100-41-4 245 L-...- _ _ _ __ _ _. __ _ _ _ _ ___ _ _ _ ___ _ ___ _ ___ _ _ If more hazardous components are present at greater than I% by weight if non-carcinogenic, or 0, I % by weight if carcinogenic, attach additional sheets of paper capturing the requir ed information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here ' UPCF (1/99) 169 OES Form 2731 = UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ADD __ DELETE X~ REV[SE 200 i Page of I. FACILITY INFORMATION (BUSINESS NAME Circle K Store #2708606 2708606 3 .CHEMICAL LOCATION ,CHEMICA L LOCATION CONFIDENTIAL. 202 WEST SIDE OF LOT 'EPCRA ;YES ; x i No ,_. -, ~ I FACILITY lDaY ~ -~ I. ~~ I - _ - ' 1 (optional) I MAP# I GRIDS (optio nal) 203 204 ! I i I I 1 t C4 _. -- - -_. _ I1. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ,Yes X INo ~ 206 , GASOLINE i --~ -- ~, ~ If Subject to EPCRA, refer to instructions ' iCOMMON NAME 207 -, - - --- _ --- - ------ - -- - --.... -._- - ~ ' PLUS UNLEADED GASOLINE ' E"S ~ ~ Yes fix] No zoa , t ~AS# " 209 I 8006-61-9 i If EHS is " Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID f - - - --- - - - - -- FIAZARD MATERIAL _ _ ~ 211 I RADIOACTIVE ~. _! Yes (TYPE (Check one item ~ ) a. PURE ~ X ~ b. M IXTURL ~ c. WASTE .. ,... -- - - - - -- _ _ - 212 !X ~,No ~ CURIES i 213 ' ~ ~_ i _ -- - ----- ------ r ---Q - - -- - -J--------- ------- -- - _ __ - - -.. PHYSICAL STATE - - - --1---------- -- - - ~ 214 a. SOLID ~ X b. LI UID c GAS I LARGEST CONTAINER L ~ 00~~ 215 _ (Check one item only) ~ --_--_-! _~ ----- ---- -- --- _ (FED HAZARD CATEGORIES i ~ ~ i (-~ a. FIRE ~ ~ b. REACTIVE c.PRESSURF. RELEASE X d. ACUTE -iEAL i X r- -~ TFI ; X ' e.CHRONIC HEALTH 216 ) ~ ,(Check all that apply) AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 (ANNUAL WASTE AMOUNT j 219 ~S fA"fE WASTE CODE ~~ 220 - - -- 3.500 ------- - ~-- --- 10000-- - -------- -- -- _--! - - - _ _ J r-, --' UNITS* I X a GALLONS ~ ~ b. CUBIC FEET ~ ~ c. POUNDS I ; d. TONS I ~ 221 ', DAYS ON SITE: 222 _ _ __. ;(Check one item only) - ------------------------__--- --------_-_-- _-------_-_if EHS-, amount must.be in.pounds. - 365 ~S-FORAGE ia. ABOVE GROUND "TANK r Vie. PLASTIC/NONMETALLIC DRUM ~'~,i. FIBER DRUM '. m.GLASS BOT"fLE ;o. RAIL CAR iCONTAINER t--- ~ ~ i i X ~:b. UNDERGROUND TANK ~ ~f. CAN ~j. BAG n. PLASTIC BOTTLE p. OTHER ~~c. TANK INSIDE BUILDING ~ ~Ig. CARBOY k. BOX ~o. TO-fE BlN id. STEEL DRUM 1h. SILO ~ ~I. CYLINDER ~ , , p. TANK WAGON __. _ ~ __. - 223 r-- ~ i, STORAGE PRESSURE ~X_~ a• AMBIENT I ib. ABOVE AMBIENT ~c. BFLOW AMBIENT i -------------------------------- - - - 224 ------ -- --- --. ... r ---- - '. r~ ~ ~ r---, STORAGE TEMPERATURE ~X 1 a. AMBIENT ~__,b. ABOVE AMBIENT ~ _ Ic. BELOW AMBIEN-f __ - -_ .... - - -- . ___ .. r---~'d. CRYOGENIC ~ __'I 225 %WT HAZARDOUS COMPONENT For mixture or waste onl j EHS j CAS# ~I 100 226 GASOLINE 227: i Yes iX'No 228 ~ 8006-61-9 229 2 1-9 230 TOLUENE 231 i Yes ~X'No ' - -- 232 ~ 108-88-3 233 ~3 1-14 234 i _ __ - - - - - -- ,X XYLENES 235 j--..':,yes ' ~INo ---- -~_ - - _ - --._ 236 ! 1330-20-7 I 237 ~4 1-5 238 ~ 1,2,4-TRIMETHYLBENZENE 239 j - Yes jXNo 240 .. 95-63-6 241 ~ 242 243 5 1-5 i Ethyl Benzene i :Yes X No _ t- 244 100-41-4 ; 245 -- _ --- -- --- --- ---- -- ------- -- ---- - - -- -- --- -- i~ If more haiardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets °f paper captu f --------.-._..__---------------------- -----...__.-_ _.__-------- --~ --- ---._. _- _.. - _ - .._- ... - - .- .. - ring the required informati°n. . ' __ i ADDITIONAL LOCALLY COLLECTED INFORMATION _ -. .. _ .. .. __ _ 246 If EPCRA. Please Sign Herc L ------ - --------------- --- -- -- - - -- _ . - . .. UPCF (1/99) 169 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ~ ~ ADD I DELETE jX~ REVISE 200 ! Page of I. FACILITY INFORMATION BUSINESS NAME Circle K Store #2708606 z7o8sos 3 ~CHF,MICAL LOCATION ,CHEMICA L LOCATION CONFIDENTIAL 202 ~ WEST SIDE OF LOT iEPCRA jYES x j No r ----I -- - -- _ - ~FACILITY IDit ~ ~ I I ~ ; 1j ~I ~ 1 ~ MAP# (optional) : ' _ -- 203 ~ GRIDH (optional) ~ 204 , 1 ~ ~ C,D4 - I i i L- ----- ----- -- --- --- --I--- . ----._ ~- ~ ~ 1-- ~-' -- ---._ I T .-- II. CHEMICAL INFORMATION ----___------ ---- - - - --- ------ - --- I----- -- ---- ICHEMICAL NAME 205 TRADE SECRET ~ Yes : X No ~ ~ 206 GASOLINE - ~ ~' If Subject to pPCRA, refer to instructions '',COMMON NAME 207 208 PREMIUM UNLEADED GASOLINE E"s ~, Yes Xi No ICAStt 209 . 8006-61-9 If EHS is " Yes", all amounts below muss be in Ihs. (FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID - --- - ---- -- - -- --- - --- _~ I_ .J ~ - _ - _ - _ - HAZARD MATERIAL j-- r 211 I - ! RADIOAC'T'IVE i_; Yes ASTE 1-YPE(Check one item t~ ~ RE - - - - - --- _ _ --- -- - - 212 I iXNo !CURIES I 213 _I -- -- __ - -------- ----- l 214 1 -- - - - - --- - -- - (PHYSICAL STATE a. SOLID X b. LIQUID a GAS LARGEST CON-fAINER C ~ -- -- - _.-- - - -- - -- - - - - ~ ~~~~ 215 i - (Check one item only) 'TEED HAZARD CATEGORIES X a. FIRE b. REACTIVE f c.PRESSURL' RELEASE `X~' d. ACUTE HEAL ~ ~ ~ ~ TH ! X ~ e.CHRONIC HEALTH 216 ((Check all that aPPIY) _ L-- L-- -- -. r ----- ----- - ---- ---- I _ - -- -- - AVERAGE DAILY AMOUNT 2171MAXIMUM DAILY AMOUNT 2181ANNUAL WASTE AMOUNT - r - . - ..__ .. _ _. _ . _ . - . _ - .. . 219 iS"I-ATE WASTE CODE _ 220 -- - - ---3500 ----- -- '---- ---10000--- - -- ------ ------~ - -- - -- - - - _ ._!_ . _.. - - _ _ _ _ - --- , -- , -- UNITS* ; X ~ a. GALLONS j b. CUBIC FEET i c. POUNDS i i d. 'I'ONS DAYS ON SITE: (Check one item only) _.-_-____tf EHS,_amount_must be in.pounds.-___. - ---365 ~___ _ . ....... ... . .. i - ;- , STORAGE ~~ ~ a. ABOVE GROUND TANK ~ 'e. PLASTIC/NONME-fALLIC DRUM ,i. FIBER DRUM j m.GLASS BOTTLE ' ~o. RA(L CAR - iCONTAINER I- - ~ ~ ~ I X~b. UNDERGROUND TANK If. CAN I ~j. BAG ; in. PLASTIC BOT'T'LE ~ Ip. OTHER c. TANK INSIDE BUILDING ~g. CARBOY ~ ~.k. BOX ~ !o. 'T'OTE BIN t j ~d. STEEL DRUM ! Ih. SILO ;I. CYLINDER , ' .p. TANK WAGON - - -.-: ~- - 223 STORAGE PRESSURE LX J a. AMBIENT -_ ~Ib. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~X_I a• AMBIENT ~~b. ABOVE AMBIENT _;c. BELOW AMBIENT , Id. CRYOGENIC 225 %WT I HAZARDOUS COMPONENT (For mixture or waste only) EMS - ._.-.._..-I----- -- - CASt~ i ---- -- -- - ---- _ _. - . -- ' I 100 226 ~ GASOLINE 227 Yes ' X )No - _ . .. _ .- . _ - .. _ . . - 228 i 8006-61-9 . 229 __ ---- j--------- _ 2 1-9 230 TOLUENE 231 ! Yes ~ X'No 232 ' 108-88-3 233 I- ------------ -- _ -- -------- ------ --- ----__ _- -- - - ---- - ---- -- - - -- - - I- ~ _, f X~Q ~ 234 235 I 3 1-14 XYLENES Yes - - - - I - - _ - - - - - - ._ _ . .. _ 236 I 1330-20-7 237 238 ! _ --- 239 ~ i- j4 1-5 ! 1,2,4-TRIMETHYLBENZENE j IYes ~XNo 240 i I 95-63-6 241 ' 1XNo j5 1-5 242 243 ~ Ethyl Benzene (-IYes ~ I ~--- ----. -!- -- - - - --..- 244 i 100-41-4 I 245 If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper captu ring the required information I ADDITIONAL LOCALLY COLLECTED fNFORMATION 246 if EPCRA, Please Sign Here UPCF (] /99) 169 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material peg huilding or area) -ADD _--__-- _~_ DELETE_-_ __--_----------IXi REVISE 200 Pa e of -- --- - - - --- -- - ..-- _..- - - ~ - - _ _ _--- - -_ g - _..-..------- ---- -. - ..: - I. FACILITY INFORMATION BUSINESS NAME 3 Circle K Store #2708606 z7osso6 , I C}iEMICAL LOCATION iCl1EMICAL LOCATION CONFIDENTIAL 202 ' IEPCRA NORTH SIDE OF ENTRANCE DOOR [ IYES , X NO __~ I ~ --------- FACILITY 1D# ~ - ~ 1---I----r - -- ~ - -L- -- - --~ - --f- 1 MAP# (optional) i I ~ -- -- -- GRID# (optional) 203 I 204 ' i .. , I I L I ~ I I 1 1 E4 ' - - ` _ --- -- - - -- - - - - - - -- -- - - -- i II. CHEMICAL INFORMA T I O N -- _ - - -- , _ _ _ _ _ _ _ iCHEM1CAL NAME 205 'TRADE S ECRET ! IYes j X ;No 206 Propane -- ' i If Subject to 6PCRA, refer to instructions COMMON NAME 207 i EHS f X j 208 , PROPANE _ Yes [ No ; ',CAS# 209 ' 74-98-6 I tf EHS is " Yes", all amounts below must be in lbs. 1 ----°- - - -- ---__-- ---- - --- ----- ---------- ---- - - --- - --- --- - - - - - - - __ FIRE CODE FlA-LARD CLASSES (Complete if required by CUPA) _ 210 , Flammable Gas - - - ----- ---- - ------- - - -- -_ _ - 211 ' -- -. .. -. ~t1AZARD MATERIAL I i RADIOACI IVE I Yes iTYI'E (Check one nem ~ ~ a. PURE X I b MIXTURE c. WASTF _ ._.-_._.__-__._._.--__-._-.---_-....._.__-L_J__-_-___-_L.-___ I ----- _. - -- _ --- -- - - _ 212 ; X No ~ CURIES , 213 , ;' L PHYSICAL STATE ~- a. SOLID ' X ~ I b. LIQUID ~ ~ c GAS 214 i LARGEST CONTAINER L ~ 5 215 Y !(Check one item onl) -~ - ~ _ _"-- - - - -- - - - - '-X I a. FIRE ~ b. REACTIVE X - I,FED HAZARD CAl'EGORIES , ~ I i -~ I c.PRESSURE RELF..ASE ! X d. ACUTF. HEAL" I ! ' fhl ' e.CHRONIC HEALTH 216 ~_ ._.., _ ,(Check all that apply) -....- _ _-- - --- -.. --- ---- --- _- --- - _..- - I --- . - . - .AVERAGE DAILY AMOUNT 217IMAXIMUM DAILY AMOUNT 2191ANNUAL WASTE AMOUN"f - - 219 STA"fE WASTE CODE 220 ~ ---- --30 -I ----- 60 --------------_- ---I-- _ _ __- - --- ----- - -- -- -- - - - -- ~ - - - -- - -- ' ' * I----' ~ -l, X a. GALLONS b. CUBIC FEET L ~ c. POUNDS d. fONS i ' I 221 ~ DAYS ON SITE: ! 222 ' _ (Check one item only) -if_EHS.amount-mustbe_in_pounds.----!.-- -------------------`----- - ------------ 365 -- --- ---------- - -__ - - -- - , STORAGE ! ) a. ABOVE GROUND TANK r e. PLASTIC/NONMETALLIC DRUM i ~i. FIBER DRUM ~ InI.GLASS BOTTLE ~ io. RAIL CAR !CONTAINER ', -- b. UNDERGROUND TANK ~ r -- I Ij. BAG j f CAN ~ - , jn. PLASTIC BOl''FLE ~ Ip. OTHER ~ c. TANK INSIDE BUILDING ._ .CARBOY g I ~k. BOX ~ Rio. TOTE BIN _ I I ~i ~ d. STEEL DRUM ~ ~- - h. SILO ~ X I. CYLINDER ~ ~p. TANK WAGON _ _ 223 STORAGE PRESSURE ~ ~ a• AMBIENT . X ;b. ABOVE AMBIENT I ~,c. BELOW AMBIENT L __ _ _-. 224 STORAGE TEMPERATURE rX1 a. AMBIENT ~ _~b. ABOVE AMBIENT ~ _ ,Ic. BELOW AMBIENT ~ !d. CRYOGENIC 225 , ' %WT ~'i HAZARDOUS COMPONENT (For mixture or waste only) EFIS I CAS# - -- ---- --- ----- --- - -~------- --------- - - -- -- - - - -- - - - -- - -- --. -.. . - . - II >65 22s i PROPANE 227 ' ~ ;Yes ~X~No _ - - - 22s II 74-98-6 229 - - - - - -- - - - . -.- t .. 12 <35 230. Propylene 231 Yes X ~No ; ,.. _ .. _ - _ 232 i 115-07-1 233 . _r---- ------ ----------- -- ------ - --- ...- - -- -- ..... _... _ 13 <g 234 Ethane 235 Yes ! X Wo -' - -- - -.. 236 74-84-0 ; 237 ja <5 23a ~ Total Butanes 239 ~ .- Yes X iNo 2ao 78-28-5 2a1 j5 <0.1 2a2 i Ethyle Mercaptan 2a3 ; l;Yes 'X;No zaa ' 75-08-1 245 , i If more haurdous components are present at greater than I % by weight if non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper capturing the required information. j ADDITIONAL LOCALLY COLLECTED INFORMATION I 246 I If EPCRA, Please Sign Here UPCF (1 /99) 169 OES Form 2731 • UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ~ i j ADD ~ ~ DELETE ~X~ REVISE 200 ', Page of i I. FACILITY INFORMATION (BUSINESS NAME Circle K Store #2708606 2708606 3 'iCHEMICAL LOCATION .CHEMICA L LOCATION CONFIDEN1lA1. 202 ~ STORE ROOM/ FOOD MART 'EPCRA ' wes x ' No _ _. _. __ . - -- r I i ----- i I I r _ „ , 1 MAP# (optional) -- - l-- i ' iFACILITY !D# ~~~ 1 _. _ . _ _ _ _ - _ 203 GRID# (optional) F4 _ 204 -_ J-- I ---- I N II. CHEMICAL INFORM A T O _ __ _ __ _ ___ _ __ __ --- 'CHEMICAL NAME 205 ~ TRADE S ----r- , -- ---- ECRET ~ !Yes ~ X ;No 206 CARBON DIOXIDE - I If Sub ect to EPCRA, refer to instructions __ - ---------- -- rCOMMON NAME 207 i - i EHS CARBON DIOXIDE GAS ~ I-------------- - --- - ------------------ --- -------- -- -I ----- - - - r ~ ;__ j Yes ~Xj No - - ------ -- ----_. - ------------ . .. . ~CASft 209 ! " " i It EHS is 124-38-9 Yes , all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 NON-FLAMMABLE GAS i ------ ' c. WASTE 211-i --------- ------ 1 -- ----- iHALARD MATERIAL PURE ~ _- ~ b MIXTURE ~ - RADIOACTIVb ~--_i Yes -- --_--- ~X ~ a I'1'YPE Ch k d f.__ 212: X INo ----- -- - - - _ ~ CURIES 213 . ec one em '--- (PHYSICAL STATE 1 214 X 1 c. GAS I LARGEST CONTAINER , a. SOLID [ I b. LIQUID ~ ( 2610 215 - _ - _ (Check one item only) FED HAZARD.CATEGORIES a. FIRE ( ~ b. REACTIVE ~ X~ c.PRESSURE RELEASE ~X i d. ACUTE HEAL I !- - TH I ~ e.CHRONIC HEALTH 216 ___ i ,(Check all that apply) ~._ __ ';AVERAGE DAILY AMOUNT 217 !MAXIMUM DAILY AMOUNT 2181ANNUAL WASTE AMOUNT 218 STATE WASTE CODE 220 __ -- - _._ _ ... _ 16.05- --- -- -- - --!----- -----29.60... - _ _ - --- _ ': -i ---'' UNffS* ~ ~ a. GALLONS ; X b. CUBIC FEET ' c. POUNDS ' d. TONS 221 DAYS ON SI"I'E; 222 I ~ --, _ ,(Check one item only) ~ ~ - ,_ _-_____-_-________________. ___-__.____-. ___-_if EHS, amount must be_in.pounds. __.._ _ 365 --- --- STORAGE ~ i a. ABOVE GROUND TANK ~ 'e. PLASTICMONMETALLIC DRUM i ~i. P1BF'R DRUM m.GLASS BOTTLE o. RAIL. CAR CONTAINER -- r - ~ ~ - ' i ~b. UNDERGROUND TANK i, ~f. CAN 'j. BAG 'n. PLAS'T'IC BOTTLE .p. OTHER i i X lc. TANK INSIDE BUILDING ~ (g. CARBOY !k. BOX ~ io. TO"fE BIN ~_.. ; I-- - d. STEEL DRUM ~ Jlh. SILO ~I. CYl.1NDER i gip. TANK WAGON ~ 223 j STORAGE PRESSURE ~ 1 a• AMBIENT ~ X lb. ABOVE AMBIENT . c. BELOW AMBIENT ~ ---- 224 --- --- --- -- --------------- --- - ---- - - -- - - STORAGE TEMPERATURE ~~ a• AMBIENT ~ib. ABOVE AMBIENT ~ jc. BELOW AMBIENT --- __ T---- -------- --------- -------- - - - __ -- - - - - -- -- ---.- 1 ~ d. CRYOGENIC - ---_ --...----- - _- .. .._ --- 225 I i %WT ~ HAZARDOUS COMPONENT (For mixture or waste only) ! EHS i I CAS# _ ---------------- ---- --- I- ---- ----- - -- -- ----- - -~- - -- -- - - - ---- _ _- - - - - __ II 100% 226 ! CARBON DIOXIDE 227 'i ~ Yes jX_No --..: 228 ~ 124-38-9 229 ' __ r ----------t--- -- --- - - --- - --- - - - ----~ - --- - ~2 230 ~ 231 (Yes ~ X ~No i ~ L -: -- -- - ~ ---- -- - _ .. _ . 232 ~ 233 _ _ - !3 234 235 ~-~ ;Yes ~X ~No ' - 236 ~ 237 . r - ---- --- ---^- ---------~---- -- _ .- - - !4 238 ~ 239 ~ sYes ~ X No ... .. -_ _.... -- . - - . _...._.. ..... _ _ 240 i _. 241 ' 242 I -- ------ - - _....-------... _ -. .243... _.. ~5 Yes X'No --i -- -- --- ._ .. _... 244 ; 245 I If more hazardous components are presem at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper captu ring the required information, j ADDITIONAL LOCALLY COLLECTED INFORMATION i 246 i 1 If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 • UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - ADD I DELETE REVISE I. FACILITY INFORMATION USINESS NAME Circle K Store #2708606 CHEMICAL DESCRIPTION I One page per material per building or area) 200 ; Page of 3 2708606 ;CHEMICAL LOCATION iCl-IEMICAL LOCATION CONFIDENTIAL 202 j I,EPCRA TRASH ENCLOSURE ~ YES ~ X ~ NO -_~ !-_~ - - - FACILIPY ID# I i ptional) r i 20 # (optional) 3 GRID F4 204 -- ---- - - -.. ,-- - - -- - ----- - - - II. CHEMIC AL INFORMATION - - - --- -.._.-..- ---- --- -- ... _ __ _ _ _ _ jCHEMICALNAME 205 1RADE S LCREiT ,Yes i X No 206 , I If Subject to EPCRA, refer to instructions !COMMON NAME 207 , EHS __, _ 208 USED GASOLINE FILTERS ; I ~ 'Yes ~x; No - ------ -------------------------- -----___----- ~CAS# 209 8006-61-9 If EHS is " Yes", all amounts below must be in lbs. r -- - - --- ------------ - -------- - --.. _.-- ---- ----- - -__ -- - - --- -- --_ _ - - - - - - - - - - _ ,FIRF. CODE HAZARD CLASSES (Complete if required by CUPAI - 210 I-B FLAMMABLE LIQUID IIHAZARD MATERIAL _ _ 211 I ~ I I RADIOACTIVE ~~ Yes ITYPL' (Check one item j ~ a. PURE ~~ b. MIXTURE ~ X_I c. WASTE i - --- 212 ~~ X INo ~ CURIES __, j 213 ; i r PHYSICAL STATE f--- 214 I(Check one item only) ~ a. SOLIDI J b. LIQUID ~ ~ c. GAS LARGEST CONTAINER ..----------- ---------_---- -------------- 200 .-..-. - -, 215 FED HAZARD CATEGORIES X1 a. FIRE n b. REACTIVE ~ f c.PRESSURE RELEASE f X~ d. ACUTE HEAL L ~ J t TH I X i e.CHRONIC HEALTH 216 PP y) i(Check all that a I ~---, - ~-- ---- __ . . -- -- - ---- -r- - - -- - - ----- - - - AVERAGE DAILY AMOUNT 217 MAXIMUM DA[LY AMOUNT 218ANNUAL WASTE AMOUNT __. _ - --- - - - .... 219'ISTATE WASTE CODE . 220 i j 200 S I -- --- - ----- - - 5 ---- ---- ._ _ _ - - _ ---- -- --- -- -_ . _ - . _ . r_~ _ ' b. CUBIC FEET X i c. PO a. GALLONS r UNDS ~ ' d fONS ~ * ~ I AYS O D N SITE: 222 ) - - (Check one item only i 365 I p - - , _ _ ___-_if EHS, amount_must be.-in ounds. . _ STORAGE Via. ABOVL•' GROUND TANK rr e. PLASTIC/NONMETALLIC DRUM ! i. F16ER DRUM I i I ';m.GLASS BO"I'TLE !o. RAIL CAR _.. !CONTAINER I - - I ' l - , ~ ~b. UNDERGROUND TANK ~f. CAN jj, BAG in, PLASTIC BOTTLE !p. OTHER 'c. TANK INSIDE BUILDING j ~g. CARBOY jk. BOX ~ ~ 'o. TOTF•, BIN --- r -I -- ; X ~d. STEEL DRUM j jh. SILO jl. CYLINDER ~ ` p. 'TANK WAGON 223 ~' STORAGE PRESSURE X ~ a. AMBIENT j b. ABOVE AMBIL-'NT ~- ;c. BELOW AMBIENT 224 _.. .STORAGE TEMPERATURE ~ a. AMBIENT ~ ib. ABOVE AMBIENT 'c. BIiLOW AMBIENT' i _ _ _. ~'; !d. CRYOGENIC 225 j %WT ~ HAZARDOUS COMPONENT (For mixture or waste only) EHS - -- -- -- --- CAS# i, 5 226 GASOLINE - - - 227 _ I - I ,Yes LX INo 228 i 8006-61-9 - , 229 z 23o I FUEL FILTER 231. IYes X ~No 232 i 233 j3 234 235 I--' r ~ ~ I IYes I X No i `-- - -' 236 , _ ' i -237 ' - -------• -------------------------- ----- - ---- - 4 238 239 ~ IYes j X,INo _.._. _.. - - - _ _- --- -. - -- 240 i 41 I - -_ _ - --. IS 242 243 -'jYes i X ~l0 , 244 i 245 ' ' If more harzrdous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper captu I---- -------------~------------------------------------------ -----------'---- - ---- --.. __._ ..-- ring the required information. ---~ ---- - - ----_.-.- _ -.. _.-... - .--. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 I If EPCRA, Please Sign Herc UPCF (1 /99) 169 OES ForTn 2731 AP# BUSINESS BUSINESS 1 CALIFORNIA ANNOTATED SITE NAME _CIRCLE K STORE #2708606 ADDRESS 1030 OAK STREET BAKERSFIELD MAP DATE 03/16/2004 ZIP CODE 93304 PREPARED BY: IGN GROUP VNC.I DRAWING SCALE a e c ~ E F G H MAP SYMBOLS ELECTRONIC MONITORING POINTS AM~PM MINI MART NORTH O ELECTRICAL PANEL SHUT-OFF OS SUMP SENSOR O NATURAL GAS 1 ® ANNULAR SENSOR O SHUT-OFF WATER SHUT-OFF AUTOMATIC TANK GAUGE PARK WAY O SHUTGOFFY PUMP /~ TMA ~~ TANK MONITORING ALARM ^T TELEPHONE ~ FIRST AID KIT 2 - - - - - - - - - - ~ ~ ® FIRE EXTINGUISHER STORM DRAIN SANITARY SEWER STAGING AREA EVACUATION/ X D MSDS MSDS LOCATION `3 I a Q ~, FIRE HYDRANT ~ x--x- FENCE z W ERE EMERGENCY RESPONSE EQUIPMENT/ABSORBENTS a 12 X 5 GALLON , I PROPANE ~ ~ O ABOVEGROUND I L~ STORAGE TANK w ~~~~ S T ~O ~ I~ ~I `--~ UNDERGROUND T R E T K 4 W ~ S ,o \ o O r ~ I /w ctA l AG AN S O ~ ~ A \~ ~ ~ ~ ~ A L v J O GASOLINE ( ~ ~j ~ G ~ ~ ~ RJR (FLAMMABLE LIQUIDS) ~ ~ ~ ~ ,p~. ~O \ CASHIER I O DIESEL FUEL Q O C ~ J ~~ .O~ ~O ~ ~ l ~ HMMP P CD I O (COMBUSTIBLE LIQUIDS) MOTOR OILS & LUBRICANTS (COMBUSTIBLE LIQUIDS) \ O MSDS E Z O TMA O CD CARBON DIOXIDE 5 z (COMPRESSED GAS) - ~ ~ ERE O PROPANE (FLAMMABLE LIQUID) J I ~ X OA ANTIFREEZE/COOLANTS Q ~ ~ O WASTE OIL ~ (FLAMMABLE LIQUID) CW CAR WASH PRODUCTS 6 O - - - - - ALLEY ~ T7r7 ~ ~- -l JOHN'S BURGERS RESIDENTIAL SECTION I z~ossos BUSINESS EMERGENCY PLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. 1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL 911 (Fire, paramedics, police, or sheriff) STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-891 1 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 661-326-3979 PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A HAZARDOUS MATERIALS INCIDENT: Name: Servic-e_C~ntact Center Telephone:_86.6-8.0.5-_435Z_______..___. Name: -Kevin_Q.uinn.__ ._ .___.._..._ __.._ ____. Telephone:. 559-64.7_-691.0_ ... _ B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: MERCY SOUTHWEST HOSPITAL ADDRESS: 2215 TRUXTON AVE CITY: BAKERSFIELD PHONE: _6.61=.632..-52.8.1_ __..- __-- .__ -- ._-- _ ._.-- _ _ .... - __. _._ 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide information on the steps taken at your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazards at this business are fire and spills„associated with gasoline dispensing...... _ _ Gasoline_dispensing is_supervised by trained personnel. Additional hazardous materials are stored in minimum quantities and stored in small,. unbreakable containers.. All underground storage tanks are monitored using an approved monitoring method. 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill fire, explosion or airborne release at your facility? Small incidents: For leaks and spills, isolate, the area and.contain with. absorbent material. Clean up the spill immediately to_prevent_~reading. For_fires, turnoff pumps, use fire _ _ _ extinguisher if it can be done safely___________ ________ __ _ _ _ __ _ _ Larger incidents;_Turn off pumps using emergency pump shut-off, call 9-1-1 evacuate to emergency assembly. area, wait for emergency personnel to_respond. Immediately contact the District Manager and the Service Contact Center. 4. ABATEMENT Describe what you would do to stop and remove each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the relase? Small incidents will be handled with the on-site.clean-up_equipment,_(i.e„.brooms .shovel,.... absorbent material, mops,. etc )__ For larger mcidents,_the_on site manager will turn off the pumps call 9-I_l,_and the Service Contact_Center ~_1-86.6_-805-4357,._The Conta_ct____..__._ Center will dispatc__h a_maintenance contractor.to_assist._in.abating_the hazard. .For suspected leaks the_operator_will_notify_t_he__Service_Contact_Center. and his/her District Manager who will inyest~.gate__the incident,__If a UST, leak. is confirmed,_then .reporting_wi.ll _ _ _. be done_by Circl_e_K,_which_complies with UST__regulations,_ ___ _ Circle_K will.coordinate_with__any__contractors reguired_to stop a.re.lease, clean ___ up_a_release and/or_dispose.of materials. AlJ_materials will be.disposed of_i_n__. _.,_ __ _ _ accordance with._state, federal and_local laws and regulations,. S. EVACUATION and RE-ENTRY Describe the procedures to be followed for immediate notification and evacuation of your facility and the re-entry procedures after evacuation has occurred. If warranted evacuate to the designated assembly located at: SOUTH AT ALLEY ACROSS OAK STREET The manager or lead employee will take a head count to veri all employees have evacuated safely. The mana er or e ~loyee will confer the responding agencies to indicate the magnitude of the emergency. Re-Entry into the facility will onlhake place after the dealer or manager verifies with the responding agencypersonnel and Circle K Stores, inc. to ensure it is safe. 6. EARTHQUAKES Identify the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The typical waste that is generated at this business is Waste Fuel Filters from the fueling dispensers. This item will be handled in the same manner as used absorbent. Use absorbent material or rags to clean up spills and place in a container for proper disposal or recycling. 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized releases from an underground storage tank (UST). The plan must address a release from a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underground Storage Tank Monitoring and Response plan provided by Circle K Stores, Inc. If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up from the secondary containment within 8 hours, or deteriorates the secondary containment, then the local agency will be notified IMMEDIATELY 3 SECTION II BUSINESS EMERGENCY TRAINING Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum include: A Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards; B. Procedures for coordination with local emergency response organizations: C Correct use of emergency response equipment and supplies under the control of the business; D. The Cal OSHA Hazard Communication Standards; E. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan; p The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care; G. Procedures to coordinate with and assist the local emergency personnel that may respond to your facility; H. Who and how to call for immediate assistance in the event of an accident involving hazardous materials; I. Procedure for ensuring the appropriate personnel receives initial and refresher training. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY. Use the attached employee training log or similar form 1'or record keeping. EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK 2708606 MINOR INCIDENT: (less than 5 gallons) 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2• SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5• NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Call 9-I-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 1030 Oak Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Kevin Quinn 559-647-6910 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805-4357 Secondary: Kevin Ouinn District Manager Day: 559-647-6910 24-hour: 559-639-9228 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response b the agencies in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-891 1 c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) SpilURelease Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added for fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Shill or Release: In the event of a release from the propane tank/cylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\Circle K Stores\zForms\Propane-Spill Plan.doc SpilURelease Response Procedures for Carbon Dioxide (C02) Carbon Dioxide in the form of compressed gas, liquefied gas or refrigerated liquid used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause burns, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dia1911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: I . Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. Training• 1. Employees shall be trained on the above hazards associated with carbon dioxide gas and the preventative measures to prevent a release. 2. Training shall include evacuation procedures in the event of a release. 3. If compressed gas cylinders are present, employees shall be training on the handling of the cylinders and the use of the valve caps to prevent accidental damage to the valve. I:\HAZMAT\Circle K Stores\zForms\co2-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS ~c PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: 1-CAHSERI, I-NORTH SIDE OF BUILDING ~c TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: STORAGE AREA ~c ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: STORAGE AREA * WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: SOUTH SIDE OF LOT * NATURAL GAS SHUT-OFF: If your facility has natural gas, it may be necessary to shut-off the flow in case of an emergency. Location: SOUTH SIDE OF BUILDING ~k PROPANE/LPG SHUT-OFF: if your facility has propane or liquefied petroleum gas, be sure to turn off the -nanual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dial 9-1-1 as necessary. EMERGENCY EQUIPMENT * FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: 1-PUMP ISLANDS, 1-FRONT DOOR, 1-CASHIER ~r SPILL/ CLEAN UP KIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: SPILL KIT fN STORAGE AREA ~c RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE AREA Shovel: STORAGE AREA Gloves: STORAGE AREA Goggles: STORAGE AREA ~c FIRST AID KIT: Use for minor incidents and treatment. Location: SAFETY ZONE * EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: SOUTH AT ALLEY ACROSS OAK STREET ~e ENVIRONMENTAL DOCUMENTS / HMMP _.MSDS SHEETS: Location: STORAGE AREA EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: MERCY SOUTHWEST HOSPITAL 2215 TRUXTON AVE BAKERSFIELD 661-632-5281 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel): For further information, refer to the MSDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION (Breathing): Remove victim from source of exposure and into fresh air. if victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by: Environmental Staff, RHL Design Group, lnc., 800-765-1025 Last Updated: 12-Feb-07 _. Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan _.Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: * An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. f: ~ ~+` ~ 8501 N. MoPac Expressway, Suite 400 Austin, Texas 78759 Phone: (512) 451-6334 Fax: (512) 459-1459 Date Printed and Mailed: 02/05/2007 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 900 TRUXTUN AVE., STE. 210 BAKERSFIELD, CA. 93301 Test Date: 01/26/2007 Order Number: 3150657 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CIRCLE K#2708606, CO. 123 1030 OAK ST. BAKERSFIELD, CA. 93304 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, Dawn Kohlmeyer 0 Manager, Field Reporting T , ~ - ~ TANKNOLOGY CERTIFICATE OF TESTING ~ h 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 01/26/07 WORK ORDER NUMBER: 3150657 CUSTOMER PO: 100899 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708606, CO. 123 495 E. RINCON, STE. 150 1030 OAK ST. CORONA, CA 92879 BAKERSFIELD, CA 93304 LORRAINE SOFFE MANAGER -DONNA (951)270-5193 (661)861-8048 Prnrlnet Pina Tinhtnacc Tact Rasults IMPACT LINE LINE LINE DELIVERY TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL -~.pE A B C d= A B C D FUNCTIO . lOk 1 REG UNLEAD DW FIBERG PRESSURE Y lOk 2 PLUS DW FIBERG PRESSURE Y 10k 3 SUPER DW FIBERG PRESSURE Y FYistinn I inP 1 Pak I~Ptnr_tnr Test EXISTING LEAK DETECTOR #1 EXIST ING LEAK DETECTOR #2 LINE ID MANUFACTURER MODEL # SERIAL # RESULT "MANUFACTURER MODEL # SERIAL # RESULT. lOk 1 VAPORLESS LD2000 16476 P lOk 2 VAPORLESS LD2000 unreadable P lOk 3 VAPORLESS LD2000 16478 P Naw Ranlaramant I Ina I aalc Ilatartnr Tact REP LACED LEAK dETEC O 1 "' REP "' GED E DET C O # LINE ID MANUFACTURER 'MODEL # SERIAL # RESULT MANUFACTURER- MODEL # SERIAL # RESUL rur uwucr ueraucu ropun mwrr^auon, v~sn www.ranKnoiogy.com ana select vn-r.me rceports-wrcfu-, or con[act your local i anKnoiogy ort~ce. Tester Name: TIMOTHY COULTER Technician Certification Number: '---'_ .~ Printed 02/05!2007 08:16 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS .~ i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/26/07 WORK ORDER NUMBER: 3150657 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708606, CO. 123 TANKINFORMATION Tank ID: 1ok 1 Tank manifolded: No Bottom to top fill in inches: PfodUCt: REG UNLEAD Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, s16 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 . o Length in inches: 353 Overspill protection: YES Stage I vapor recovery: DUaL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS ,. TANK TEST RESULTS Test Meth©d. LEAK DETECTOR TEST RESULTS Test method: PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: vaPORLSSs Fluid volume in gallons: Model: Lnzooo Tank water level in inches: S/N; ie„6 Test time: NOT Open time in sec: 6. o0 Number of thermisters: TESTED Holding psi: 22 NOT Specific gravity: Resiliency cc: 1so TESTED Water table depth in inches: est leak rate ml/m: is9. o Determined by (method): Metering psi: i6 Leak rate in gph: Calib. leak in gph: a.oo Result: Results: Pass COMMENTS COMMENTS ULLAGE TEST RESULTS Test Methpd: LINE TEST RESULTS Test type: LINE ~ B r_ Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 120. o Results: Test psi: Bleedback cc: Test time (min): DATA FOR UTS-4T ONLY: Test 1: Start time: Time of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT Vol Change CC: TESTED TESTED TESTED TESTED Test 2: Start time: FIOw fate Cfh : T ( ) ESTED Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cftt): Vot change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRo COMMENTS Impact Valves Operational: YES Printed 02/05/2007 08:16 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER: 3150657 TEST DATE: 01/26/07 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708606, CO. 123 TANKINF..ORMATI ON Tank ID: iok 2 Tank manifolded: No Bottom to top fill in inches: Product: PLUS Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . o o Overfill protection: YES Fill pipe diameter in inches: 4 . o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DvaL Material: Dw FIBERG Installed: aTG Stage II vapor recovery: BazarrcE CP installed on: / / COMMENTS TANK TEST RESULTS Test Method: LEAK DETECTOR TEST RESULTS Test method: PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: vaPORLESs Fluid volume in gallons: Model: LD2ooo Tank water level in inches: S/N: „are,a~le Test time: NOT Open time in sec: 7 . o0 Number of themlisters: TESTED Holding psi: 27 NOT' Specific gravity: Resiliency cc: lss TESTED Water table depth in inches: est leak rate ml/m: le 9 . o Determined by (method): Metering psi: 17 Leak rate in gph: Calib. leak in gph: a.oo Result: Results: Pass COMMENTS COMMENTS ULLAGE TEST RESULTSTest Method: LINE TEST RESULTS Test type: c Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 120.0 Results: Test psi: Bleedback cc: Test time (min): DATA FOR UTS~T ONLY: Test 1: Start time: Time of test 1: Finish psi: NoT NOT NOT NOT Temperature: NOT VOI Change CC: TESTED TESTED TESTED TESTED Test 2: Start time: FIOW fate (Cfh): TESTED Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YEs Printed 02/05/2007 08:16 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS Tanlv~obgy 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/26/07 WORK ORDER NUMBER: 3150657 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708606, CO. 123 TANKL.NFQRMATFON Tank ID: iok 3 Tank manifolded: No Bottom to top fill in inches: Product: suPER Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS' Test Method: LEAK DETECTOR TEST RESULTS Test method: PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: varoRLESs Fluid volume in gallons: Model: LD2ooo Tank water level in inches: S/N: iea~s Test.time: NoT Open time in sec: 9.00 Number of thermisters: TESTED Holding psi: 21 NoT Specific gravity: Resiliency cc: 17o TESTED Water table depth in inches: est leak rate ml/m: 1a9. o Determined by (method): Metering psi: 15 Leak rate in gph: Calib. leak in gph: 3. o0 Result: Results: Pass COMMENTS COMMENTS ULLAGE TEST RESULTS Test Method: LINE'TEST`RESt9CT5 Test pe: c - Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 120.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time (min): Test 1: Start time: Time Of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT v01 Change CC: TESTED TESTED TESTED TESTED Test 2: Start time: FIOw fate Cfh : TESTED ( ) Finish psi: Time of test 2: vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 02/05/2007 08:16 KOHLMEYER Work Order: 3150657 9. SP~LLlOVE~,L Cp~~~;y~ BOXLS ~'ge -'cf , Facility is Not Equipped With SpilUOverfill Conta~r,nxnt boxes SloilllOve~fill Cantainmeat Boxes are Presttst, but wen Mot Tested Test Method P?cvelvped By: 5pi11$ucket Manufacturer ndustry Standard Professional Engineer Other {Specify) Test Method Used: Pressure ~ Yacuum Hydrostatic Other (S~cifY1 Test Equiprnent Used: ~5.~ L Bgwipmeat Rcsalution_ Spill Boa # - Spill 13oY # f ~" .r~ Spill Box # 5pi1; Sox # Bucket Diameter: lp l D Bucket Depth: Wait time between -• applying piessin+rlvacuumlwater ~p /~-~ ~V.S t!o et Y ~5 (p .~-,Z ti 5 and starting test: Test Stan Time: (~ ll 3 ~ ~ Initial Reading (R~: 7 - -7 TestTindTime: Final Reading {Rr}: 1~Oe, -~ ( a 7 '- /~o~ ~ ~ TcstDuration: 3~. r1~vs JGNrx,uS ~or-7~ Change in Reading (R~ ~~ • Pass/Fail Threshold or Criteria: "' Cotnmeutr - tinclade iajormarion an riepairs made prior to testing, and recomrxeruled fallaw.up forfailed lasts) '4 'l- .._-..._ _. ~.._. Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS TEST DATE:Ol/26/2007 ~~ 7~d~"ilk/~t~1®~ WORK ORDER NO.: 3150657 CLIENT: CIRCLER STORES SITE: CIRCLE R#2708606, CO. 123 495 E. RINCON, STE. 150 1030 OAK ST. CORONA CA 92879 BARERSFIELD CA LORRAINE SOFFE 951-270-5193 Tank Interstital Tests Piping Interstital Tests TANK' PRODUCT MANUFACTURER RESULTS REG UNLEAD PLUS SUPER 93304 LINE PRODUCT MANUFACTURER RESULTS SUmD &Under-Dispenser Containment Tests Sump/ DISP.# MANUFACTURER P/F 87 FILL OPW Pass 89 FILL OPW Pass 91 FILL OPW Pass Tanknology representative: BRIAN DERGE Services conducted by: TIMOTHY COULTER UMP TESTS t~ ~~ SECONDARY CONTAINMENT TEST RESULTS Test Date: Work Order: 01/26/2007 3150657 Type Tank or Disp # Manufacturer Model or Material Diam./Width/Length ~ ~~) Depth ~ °) Test Method Start Time Initial Level Level Change Finish Time Final Result Pass/ Fail Spill Container 87 FILL OPW Plastic 10 8 1130 7 0 1200 7 Pass Spill Container 89 FILL OPW Plastic 10 8 1130 7 0 1200 7 Pass Spill Container 91 FILL OPW Plastic 10 8 1130 7 0 1200 7 Pass Comments: SPILL CONTAINERS WERE TESTED USING A THIRTY MINUTE VISUAL. MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring svstem control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CIRCLE K#2708606, CO. 123 Site Address: 1030 OAK ST. Facility Contact Person: MANAGER -DONNA Make/Model of Monitoring System:TLS-350 City: BAKERSFIELD CA Zip: 93304 Contact Phone No: 861-8048 Date of Testing/Service: 01/26/2007 Work Order Number: 3150657 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced TanklD: 87 TanklD: 89 X In-Tank Gauging Probe. Model: MAG 1 X In-Tank Gauging Probe. Model: MAG 1 X Annular Space or Vault Sensor. Model: V/R 409 Annular Space or Vault Sensor. Model: V/R 409 X Piping SumpfTrench Sensor(s). Model: V/R 102 Piping Sumplfrench Sensor(s). Model: V/R 102 X Fill Sump Sensor(s). Model: V/R 208 Fill Sump Sensor(s). V/R 208' Model: ~( Mechanical Line Leak Detector. Model: VAPORLESS LD 2000 X Mechanical Line Leak Detector. VAPORLESS LD 2000 Model: Electronic Line Leak Detector. Model: Electronic Line leak Detector. Model: ~( Tank Overfill/High-Level Sensor. Model: FLAPPER Tank Overfill/High-Level Sensor. Model: FLAPPER Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Tank ID: Tank ID: In-Tank Gauging Probe. Model: MAG 1 In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: V/R 409 Annular Space or Vault Sensor. Model: X Piping Sumplfrench Sensor(s). Model: V/R 102 Piping Sump/Trench Sensor(s). Model: " X Fill Sump Sensor(s). Model: V/R 208 Fill Sump Sensor(s). Model: X Mechanical Line Leak Detector. Model: VAPORLESS LD 2000 Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: FLAPPER Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Ispenser 1-2 DispenserlD: 3-4 Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s) Model: XO Shear Valve(s). X Shear Valve(s) OX Dispenser Containment Float(s) and Chain(s). X Dispenser Containment Float(s) and Chain(s). DispenserlD: DispenserlD: Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). DispenserlD: DispenserlD: Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, 1 have also attached a copy of the (Check all that apply): ~ System set-up X^ Alarm history report Technician Name (print): TIMOTHY COULTER Certification No.: B34132 ~'~~~ -- Signature: License. No.: Testing Company Name: Tanknology Phone No.: (800) 800-4633 Site Address: 8501 N. MoPac Expressway, suite 400, Austin, TX 78759 Date of Testing/Servicing: 01/26/2007 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 1030 OAK ST. Date of Testing/Service: 01 /26/2007 D. Results of Testing/Servicing Software Version Installed: 324.01 Complete the following checklist: 0 Yes ^ No' Is the audible alarm operational? 0 Yes ~ No" Is the visual alarm operational? ^Q Yes ~ No' Were all sensors visually inspected, functionally tested, and confirmed operational? 0 Yes ^ No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No' X N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? ~x Yes ~ No' ~ N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) ^X Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Q Yes ^ No Yes ~ No' ~ N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical ovefill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? Yes' ~X No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes' ~X No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) ^ Product; ^ Water. ,If yes, describe causes in Section E, below. ~x Yes ~ No * Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. QX Yes ~ No * Is all monitoring equipment operational per manufacturers' specifications? * In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: 1030 OAK ST. Date of Testing/Service: 01 /26/2007 F. In-Tank Gauging /SIR Equipment Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ^ Yes ^ No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 0 Yes ^ No • Were all tank gauging probes visually inspected for damage and residue buildup? ^x Yes ^ No' Was accuracy of system product level readings tested? Q Yes ^ No * Was accuracy of system water level readings tested? ^ Yes ^ No * Were all probes reinstalled properly? 0 Yes ^ No' Were all items on the equipment manufacturers' maintenance checklist completed? ' In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) : ^ Check this box if LLDs are not installed. Complete the following checklist: 0 Yes ^ No' ^ N/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: x^ 3 g.p.h ~ 0.1 g.p.h ~0.2 g.p.h ^X Yes ^ No' Were all LLDs confirmed operational and accurate within regulatory requirements? ^x Yes ^ No " Was the testing apparatus properly calibrated? ~x Yes ^ No' ^ N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ Yes ^No' ^Q N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes ^No' 0 N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes ^No • ^x N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes ^No' ^x N/A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes ^No • Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 Based on CA form dated 03/01 ~ '7sd/7 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:Ol/26/07 WORK ORDER NUMBER3150657 CLIENT:CIRCLE R STORES SITE:CIRCLE R#2708606, CO. 123 COMMENTS Monitor Certification, Leak Detector Testing, & Spill Bucket Testing. All tests passed. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM`PINPOINT LEAK TEST RESULTS Printed 02/05/2007 08:16 KOHLMEYER ITE DIAGRAM - Tankn~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/26/07 CLIENT:CIRCLS R STORES WORK ORDER NUMBER3150657 SITE: CIRCLE R#2708606, CO. 123 Printed 02/05/2007 08:16 KOHLMEYER r Work Order: 3150657 T 1 : UNLEHDI:D 87 HIGH IdATER ALARM T 2:UNLEADI:D 139 JAN 26, 2007 12:46 PM T ;1:uNLEADED 51 FE8 4. 20Db 12:09 PM HIGH WATER ALAR11 NIGH WrtTER ALARM MAR 1. 2005 1:59 PM JAN 26, 20D7 12:40 pM FI:B 9 JAN 26. 2047 12:43 PM °~~p~~~~~~'~pM~is k~ . 2006 12:D:1 Ph} MAR 1. 2005 1:51 PM FEB 9. 200b 11:58 Aft MAR 1. 2045 1:53 PM Lau Dmp UCT aLA191M JAN 26. 2007 12:34 PI.1 UVERF I LL ALARM F)LL ALARN UV£P NOV 24, ?OD6 8:47 P19 JAN 26. 2007 12:36 PM . JAN 26. 2007 12:36 PM OGT 21, 2006 7:29 PM FEB 9. 2006 12:4a PM FEH 9. 2006 1:S'3 PM MAR 1, 20D5 2:19 FM FEH 9. 2006 1:09 PM H[GH PRODUCT ALARM JAN 26. 2007 12:37 PM LOW PRODUCT HLARM LOW PRODUCT wLARM D1:C t2, 2DD6 3:15 PM JAfJ 26. 2007 12:33 pM JAN ?6. 2007 -2:33 PM FI:B 9, 2DD6 12:45 pM JAN 25, 2007 2:17 PM ry0V 16. 2006 12:50 PM FEH 9. 2006 i:I7 PM JUL 20. 2706 10:4li FM ShvMLIA lIJEL LEVEL ~aN es, evo4 s e ~ o~ w+ JAN 26. 20D7 12:35 PM HIGH PkODl1C'I' ALARM HIGH PRODIk'T ALARM FEH 9. 2006 12:51 PM JAN ~6, 2DD7 12:37 PM JA~~ 26. 2D07 12:37 pM FEB 9. 2004 12:45 PM FEB 9, 2006 1:5a PM PROBE OUT FEB 9, 2D06 I:DB PM JAN 26. 2007 12:59 PM )NVALID FUEL LEVEL JAN 26. 200'! 12:24 PM JAN 26, 20D7 1:f12 PM INVALID FUEL LEVEL FI3B 9. 2DD6 1:42 PM JAN 26. 2007 12:33 pM JAN 26. 2007 12:33 FM JAN 26. 2007 12:29 PM FEE 9, 2006 l:ll PM H I GH LIATER WARNING PROBE: OuT F>r9 9. 2006 1 1:51 AM 3AN 26. 2007 12:46 PM FEB 9. 2006 12:b9 PM JAN 26, 2007 1:01 PM iRn ze z o: PROBE OUT MAR 1. 2005 1:59 PM . . Sx:ss an ran ~• rgoo -~r~ rn JAN ~6, ?.007 1:03 PM 12:31 PM JAN 26. 2DD7 HIGH WATER WATaNING FEH 5, 2DD6 1:55 PM DELIVERY NET=I/ED JAN 26. 2007 12:43 PM F1±E 9. 2006 12:03 PM H1GH 1,IPtTER WARNING FEE 9. 2006 12:51 PM 21305 2:55 PM Mi4R 1 1'~R 1. 2005 1 :51 PM JHN 26. 240'7 12:43 FM M . F£E 9, 2DD6 11:56 A MAR 1. 2005 1:53 PM MAX PRDDUCT ALARM DELIVER`! NEEDEA JAN 26, 2007 12:37 PM FEB 9, 2006 1:l? FM FEB 9. 20Db 12:45 pM MAR 1. 2005 2:52 PM NEEll£D DELIVERY _ FEE 9, 2006 1:11 PM LOW TEMP WARNING ~1A?{ PRODUCT ALARM MnR 1. 2005 4:02 pM JAN 26, 2007 1:00 PM JAN 26. 2007 12:37 pM F);B 9. 2006 12:45 PM f1FiK PRODUCT ALARM FEH 9. 2006 1:43 PM 3AN 2b. 2007 12:37 PM f1PtR 1. 2005 1 :46 PM FEE g, 2006 t :50. PM LOW 'TEMP WARNING - ' " FI:B 9. 2006 1 :48 PM LOW TEMP WARNITIG _ _ -- SENSOR HLARM ----~ MAR 1. 2005 3:16 PM JAN 26. 2007 1:05 PM L 1:11NLEADEU k17 ANNULAR MAR 1, 2005 1:48 PM FgE 9, 2DD6 1:56 ~ flP+tNULAR SPACE 6ENSOR OUT ALARM _ _ _ _ _ _ _ - - JAN 26. 2007 11:52 AM _ ___~Ept5012 ALARM ----' _ _____ Hg~ypR ALARM -'---- L 3:UNLFADED 91 HNNULAR L g:UNLEADED 13g FILL FUEL HLARM 3AN 26. 2007 11:14 AM ANNU}.AR SPACE 3I:N50R OtlT HLARM pTµER SENSORS SENSOR 4UT ALAI~11 JAN 25, 2007 11 :5t AM JAN 26. 2pD7 11:52 AM pT;NFOR OIiT ALARM FEH 9. 2006 lt:33 AM FUEL ALARM FUEL ALARMI JAN 26, 2DD7 11:36 AM JHN 26. 2007 11:49 AM -_ gEN£,OR ALARM ----- + FUEL ALARM 2007 11:31 flM JAN 26 gENSbR OUT AL.AkT} FEg g, 4006 11:33 AM ?:UNL)rHDED 69 ANNULAR L . ANNULAR SF•ACE ggNSDR OUT ALARM QOp'l 11:52 FB't - - - + r A £A r __ _ AFILL A~U JNN 26. FILL DED 47 7:i1NL L ED 51 }, 9:U11I... OT-iER SENSORS - OTt1ER SEN50R° FUEL ALARM 2fl47 11:27 ~ ?6 LARN51 ~ j S O JANS2n.02D0?LiRM51 AM . JAN 2007 AN 26. SENSOR Ol1T ALARM33 A1K 2906 l1: FUEL ALARIM1 1:4u AM FUEL ALARM JAM 26. 2DD7 }}:49 rwM gEg 9, 3AN 26. 2007 1 gEN50R OuT ALARf1 AM FEHSO`3.OP006LARht33 AM Mpg ~, 2006 11 33 Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 ?, ~ ~ Work Order: 3150657 --- ~i`1t~RT6ENSUK ALARM -- s 1:UNLEADED 87 TUKBINE INSTALL ALARM JtiN 26, 20D7 12:D8 PM CQMMUNICATION ALARM JAN 26. 2007 11:52 AM WATI+R WARNING JAN 26. 2D07 11:43 AM -- __ SMARTS~NSVK HLHKM -- 5 2 :13NLEADI:D 89 TURK 1 N£ i iv3TkLL ALARe•1 JAK 26. 1407 12:12 PM COMMUNICATION ALARM JAN 26. 2007 11:52 AM WHT£R WflRNiNG JAt~ 26. 200. 11 :44 AM -- 3wWRTSENSOR ALARM -~ s 3:UPiLTrADRD gt TURBINE ~;,711MUNICATION ALARM JAN ?(,, 2D07 11:52 AM WATER WARNING JAN 26, 2007 11:45 A1M1 pU£L ALA2DQ7 ll:a5 AM JAN 26• r..1RCL>~ K 8605 t 030 ~~ ~T ~{£RgFIELD.CA•93304 56t-96~-gaa5 3RN Z(„ 2007 1:58 PM 5,~ca-Q~'I BTHT1~i+R£P4RT - A].L FUNCTIONS NOR~I- Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 .' ~; UNIFIED PROGRAM INSPECTION CHECKLIST ,. ~_ _ ._~..._____. _ .. _ _ _ __________ _ _ _______ _ _ _ _____ .~_ M _ _ _ _ SECTION 1: Business Plan and Inventory Program Prevention Services B__ _E a„_5_F___,_ _D 900 Trtixtun Ave., Suite 210 F/RE Bakersfield, CA 93301 ~/rtM r Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME a~~ goo INSPECT ON D TE ~ INSPECTIOr1TIME 3 i 2C~L+~ ~ ry ~ cz ~ ADDRESS Id~ d ®A+~- S't' HQNi NO.~~~o NO OF EI~QPLOYEES (V~ FACILITY CONTACT BUSINESS ID NUMBER i 1 15-021- ~~R~ ~~~ Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ..~.., r1Cl` l ~9 /UUU a~/ll .~ C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE ~ ~°~ °"~ ~~ q' ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY r / ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES D ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING s-~~ ~+a''~ ~~~/ ~''~ 1~ ti V t e7 n .,..,., ~ ~ q d •cv t ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ~~- V~-C~~~ Ce~v..1~-t~ M,q'~'~-~~ 4 ~ Cl'6' ~, ..-r, ~v~'. ~~ o,,,-, r ^ SITE DIAGRAM ADEQUATE & ON HAND ~.7`_ ANY HAZARDOUS WASTE ON SITE? ~9 E1~NOJ (~ ^6r-oV'J EXPLAIN: `~ ~S-'~"~ a ~ ~ ~ ~ C.--ti ~~ G O C C~'~~ tlC t ~ ~ Q ~s'~ D~ ~, i- W~ ... L~ c ~-~R ~-,~-t~,s , QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 .` /~~4~s- '~~ `~ CITY OF BAKER5FIELD FIRE DEPARTMENT c ~~ ~8CA FACILITY NAME C t RLLE K INSPECTION DATE j~- ~ ~ ~' Sectaon 4: Hazardous Waste Generator Program EPA ID # C'~4L.. d CS 2~~.j /~ ^ Routine ~~, Combined ^ Joint Agency ^Mulli-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number ~v ~ ~-/-. ~ ;,,,, Authorized for waste treatment an or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames ~ ~ $~ ~~ ~ ~ S Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided ~ .~ Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste Proper management of lead acid batteries including labels ~ Proper management of used oil fillets ~ Transports hazardous waste with completed manifest Sends manifest copies to DTSC, Retains manifests for 3 years ~~-~; 5~~~~ b Retains hazardous waste analysis for 3 years o ~ ,~-~-~ ~~,~ Retains copies of used oil receipts for 3 years >v ~ o~ ~ ~. Determines if waste is restricted from land disposal ~"`~. =~ompltance v=vtolatton Inspector:_,_~ C=Q-~- ^^~-S ~ - ~/ Office of Environmental Services (661) 326-3979 White -Env. Svcs. ~ OFFICE OF ENVIRONMENTAL SERVICES •y UNIFIED PROGRAM INSPECTION CHECKLIST W ~"gti ~ 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 ~v e e !i ~ ~ Business Site Respo le y Pink -Business Copy. I ., • G I k'LE }: 8606 i U3u ;=?H}; ;;T FhF:ER~F I ELLi , Ch . 9:x;304 , 66:-8t1-8048 L~EC: 14 . ?006 9: ~8 r(°1 ~': ~:TEf°t S'I'riT11 ~ 1'EF'CikT HLL Fi if.Ji-:~T I t_,hd ~ Pd+_~ kNtti1. IfJ`~?EP~JT~~+k'~r' RE:E'tiIRT . I' I : I_I(•JLE~L~ED I~t 1 - I `~JGLUf"lE = 5`IOII GriL~~ IJLLrGE = 41 1 6 ijriLE~ , yu?a ULI_r;~_~E- _ V 1 ~:;4 GhL J . T'.' .'~>Llll',t: = 56':±0 Gtil.fi LIF t ~~H'I 51 .0:~ I P~J~:HE:a h1~`I'1_:hi = f1. 8F~ I PJC'HE~J r'il..!Jf'lE = 74dE• i~riL:~ ULl h~_aE _ ~.3:~i i ~a~L`~ 9~i`: I_ILL~=iiE= 1:.348 GtiL T'= '+i~~+I.uPiE = 7~J4'? GNL HE I GH'I' = 64 . ,3'? I PJt'HE:=~ UJtyTER '~+'~,-I-. -= 15 ~:aHLS I:Jr"il'EI*` = 0.94 I ('JC'HE= T 3: LJPJLEHIiELi '~1 ItULLINIE = t'-.7 GHL Ti ~ t,rr LLQ"lE = 64"CI ::r;I. HEIGHT = 56.96 i r~JCFJE:~~ I,JtiTF.R ,.?C>L = 1 ? GAL. wtiTEk = 0.79 I PJi ~HE~ TEf°1F = 70 .5 L~Ei; .F M ~ T J 1 INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~ i ~-GLE ~~ B E R S F I L D F/IrE AIPTM T Section 2: Underground Storage Tanks Program INSPECTION DATE: 1Z'' ~ ~l b~ ^ Routine ~ Combined Joint Agency ^ Multi-Agency ~ Complaint ^ Re-Inspection Type of Tank ~ W ~~~r (ss s Number of Tanks Type of Monitoring era ..r.>F;` Type of Piping QR~sbw~ „~~ 1~..,~1..<< OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility -Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ^.~ Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill I overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: ~ ~"'^ ~ . `"/ Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 KBF-7335 FD 2156 (Rev. 09/05) i°3° ~; SM 495 East Rincon St Suite 150 Corona, CA 92879 December 21, 2006 Bakersfield Fire Department 2130 G. Street Bakersfield, CA 93301 UPS: K054 558 389 7 RE: Circle K Stores Inc. Submittal of Certificate of Financial Responsibility Attached is the Certificate of Insurance for Circle K Stores Inc., effective December 17, 2006 through December 17, 2007. Pease call me at (951) 270-5183 if you have questions. Sincerely, Lorraine Soffe West Coast Environmental Compliance Specialist Attachments NAME: ADDRESS: POLICY NUMBER: CERTIFICATE OF_INSURANCE SEE SCHEDULE BELOW 5EE SCHEDULE BELOW ST8089599 ENDORSEMENT: Not applicable PERIOD OF COVERAGE: 12/17/06 - 12/17/07 .NAME OF INSURER: AMERICAN Ii~1rERNATIONAL SPECIALTY LINES-INSURANCE . COMPANY ADDRESS OF INSURER: 70 PINE STREiEI' - - - - - ' NEW YORK, NY 10270 NAME OF INSURED: Coucfie-Yard, Inc., Circfe K Stores Inc., and Mac's Convenience Stares, LLC ADDRESS OF INSURED: 1130 West Warner, Building B Tempe, AZ 85284 CERTIFICATION: 1. AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tanks}: See "item 5. Covered Storage Tank Systems}" on policy referenced above, for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases in accordance with and subject to the limits of liability, exclusions, conditions and other terms of the policy arising from operating the underground storage tank(s) identified above. The limits of liability are 51,000,000 each occurrence and S2,000,000 annual aggregate, exclusive of legal defense costs, which are subject to a separate limit under the policy. This coverage is provided under ST8089699. The effective date of said policy is December 17, 2006. 2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: a. Bankruptcy or insolvency of the insured shall not relieve the Insurer of its obligations ' under the policy to which this certificate applies. b. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or damaged third party, with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible for which coverage is C12567 demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95-280.102. c. Whenever requested by a Director of an implementing agency, the Insurer agrees to furnish to the Director a signed duplicate original of the policy and all endorsements. d. Cancellation or any o"they termination of the insurance by the Insurer, except for non- payment of premium or misrepresentation by the insured, will be effective only upon . written notice and only after the expiration of 60 days after a copy of such written ' ~ ',~Y notice is received by YFie innsured. Cancellation fof nan-payment of premium ~ or misrepresentation by thi3 insured will be effective only upon written notice and only ''~ after expiration of a minimum ofi 10 days after a copy of such written notice is received by the insured. e. The insurance covers claims otherwise covered by the policy that are reported to the Insurer within six months of the effective date of cancellation or non-renewal of the policy except where the new or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior policy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97 {b) (2) and that the Insurer is eligible to provide insurance as an excess or surplus lines insurer in one or more states. J rued Representative of Insurer Authorized Representative of American International Specialty Lines Insurance Company 777 South Figueroa Street, 13'" Floor, Los Angeles, CA 90017 CI2567 2 Circle K Tank Schedule 12/17/06-07 __ West Coast Region _ __ as of 12/13/06 _ ____ _ CAPACITY INSTALL RETRO LOC. # Region - ADDRESS CITY STATE UST # GALLONS DATE DATE ~.M.___._.e ...._,. 2708691 WC _.._ 270869 1 WC ~ ; ...____-_-. ~,...._ ...._,..__,...._...._.._.._.~..~.~. __. _ 766 S MAIN ST SAN LUIS AZ 01! __ ._ m,,.~ M__~._. ~.._.._...... ~_._,r.... ____.__..._. ____. . _., . _.__...~..___ 766 S MAIN ST ISAN LUIS PAZ ~ 02 ,_ ~ ~ 1 45 t ___ ~ 30 I __ 20029'S FG _.._ .__ 98161S FG I _,_.._..._ 1-Jun-88 1-Jun 88 ..~..._.._.~...._,~,._ 17-Dec-03 17-Dec-03 _ ...~. 27 1 ~ ~... ~._.._._..m..._.~ w_rv_,. _____~ ____...~.______~. W. ...~ _ _.. _ ~ ~ _,~_.~___..- ._.. ~ ~ ~ W ~ ~_~ ._ ;WC . 0869 766 S MAIN ST _u_~SAN LUIS ;AZ 03 1 05 ~ 9816~S FG 1-Jun-88~ 17-Dec-03 2708691 WC 2701939 IWC 766 S MAIN ST :SAN LUIS PAZ i 04~ 121 E MAIN ST SOMERTON PAZ 01 ~ 05 ~ 9816S FG , ~~ 98161 1-Jun-883 1 17-Dec-03 , S FG -Mar-86 ~ 17-Dec-03 2701939 €WC 121 E MAIN ST 7SOMERTON ?AZ ~ 02 ~ 05 I 9816~S FG 1-Mar-86~ 17-Dec-03 2701939 WC 9 2705709 IWC -__,._--- 121 E MAIN ST ____..~._ ~ gSOMERTON ~~~~ ~ AZ ~~ >.-.. 03 1415E 16TH ST !YUMA PAZ 01` .M.-~. .~..___~_______ ~ j U 330 30 ~ ~ 9_816 S FG ~ 120233D'SF _......_._._.~_ ,1-Mar-86 1-Jan-93 . 17-Dec-03 17-Dec-03 2705709 1WC _..... __ ._ 2701849 WC i _,._,._.,..__ __ 1415E 16TH ST (YUMA iAZ ` 02 __ _.__..~..~..._..__...._.-,.a._.......-.., _____-_., .~_.__m~,e. _._ ~_.._..~ . 1798 4TH AVE YUMA PAZ ? 01 _~_ ~........_._.._., ~...~..._ ~ ...g...~.._.. U 9 __ U i w..__..- 05 { 20 ' 12023LD'SF ~__.._ _. _ 9 9728S~ 1 FG .....~.__. __-~ ,~..._ .. _ 1-Jan-93 ~._._ ~ 1 Ju1,85 ...~.~ ._,_...... 17-Dec-03 .._._,~_.,._.. ~ 17-Dec-03 .-_....,..._....~_ 2701849 aWC ; W ~ 1798 4TH AVE n IYUMA _ ~ ~~AZ 02• U 30 ~ 9728 S'FG ~rn 1 Jul-85 17-Dec 03 2701849 ~ C 1 1798 4TH AVE YUMA „ (AZ 03 U 05 9728~S ~FG 1 Jul 85E 17 Dec-03 2700684 IWC ; .._.,, ~~. ~..._..o 2089 AVE A IYUMA Z 01= _ __ n.. _,_..~ ._ -.~,._. ~.. ~. _._ . .- U 1 05 9728 S FG ° ~ 1 Apr 84 17 Dec-03 2700684 ?WC 2700684 W0 . . . ~ ... W. _. , . 2089 AVE A ,YUMA iAZ ~ 02 2089 AVE A 'YUMA AZ 03 w___.. U U r ~. 30 ! 20 ~m ~_ 9728 S IFG 9816S IFG M~..1 Apr-841 1 A 84; 17-Dec 03 17 D 03 2701847 WC 1 µ _ 2090 E 32ND ST ~~MA ~ ~~ ~ AZ 01 „ U I 20~ 9816 S iFG; ~ - r, ~~1-Jul-85 - ec- 17-Dec-03 _____ s 2701847 WC 1 _.~__._ _ ....a 2701847 WC ( -- ._.__.. ___-_-______. ~ -~. _ , _ ~.. ~. . a _ 2090E 32ND ST .YUMA PAZ 02, ,..~ ...._>....._....,._.._.__m__-_....~.. ~.w.. _,.. ,. ..,._, 2090 E 32ND ST __ YUMA PAZ 03 ~ ~ ...... U U 30 05 v____ - 9816;S FG ,..~A ___ 9816 S ~FG ~ > 1 Jul-85 -._.,._m_. 1 Jul-85 17-Dec-03 ....____..~~..,____. 17-Dec-03 2701800 WC 2~3~9 AVE B 8 YUMA ~ Z 01 U ' 30 9816 S ;FG 1-Nov-85 17-Dec-03 2701800 2701800 ~ WC WC~ ~ ~ ~~ ~ ~ ~'~~' 2398 AVE B IYUMA -~ AZ 02 _...._~.. _._...r-.._..~._._.. ~. ~..-.~ 2398 AVE B ~~~ YUMA IAZ i 03 U ....~... U 1 05 20 a 9816 S IFG ~,.~... ,_._ 9816 S~FG" 1-Nov-851 m.~ - ~ __ 1-Nov-85 17-Dec-03 __ ~_ 17-Dec-03 2701756 270175~~~ IWC , w 2400 S ARIZONA 2400 S ARIZONA AVE YUMA gAZ ~~01 AVE ,YUMA ':,AZ I 02 ~. ~~ ___w_. ~ U X U 20 ~ 30 9816 S ,FG 9728fS~F 1yMay~85 ~~May-85 _ 17 Dec-03 17MDec~03 _.~... 2701756 ._.w_ _ 2701394 ___.~. WC i_..~ ..._..... IWC ~. 2400 S ARIZONA AVE IYUMA S 03i sAZ q_.~-._......._. ..-_. _._~ ___,~ __ ~...._._,_ {2409 8TH AVE _ _ YUMA ~~~~ ~AZ 01 ~_._ ae. - ~ ~- _ U ~ U ~ ~ ~ 05 30 . ~ 97281S.{FG j ~ 9684 D~ IFG _ ~ : ' 1-May-85 17-Dec-03 __~. ...._ 9 Jun-04 17-Dec-03 ..,_._. __._~..._ ~__ 2701394 #WC ~ 2409 8TH AVE YUMA AZ 02 .-..._ _.._ ~ -._._.-.:M-.._.._.._._...._..-_____. . - ~v ~U ~ 05 ~ 9584 D~FG~ ~ ~9-Jun-04" 17-Dec-03 2701394 WC 7 . .. r.. , ~_-_ _ '2409 8TH AVE YUMA iAZ I 03s . ` ' ...___-_ U ~..._~ ._ 20~ ..w... 9684 D. FG ~ 29 Ju 0 17-Dec-03 __..........µ..-._... . 27084 2708475 ~ {WC = _ _. 2505 W 8TH ST IYUMA ~AZ~ 01 2505 W 8TH ST 4YUMA ~_"~~ -~~-~~~~-~ AZ 02 ,-. _ - , _ .~..,,.~_ _.-., w___u~ _.._ ~.~ ~. a U ~ U . .~.. 20 i 05 _ .~ 98'16;S E ~ 9816. S~FG ma~.._ _._. . 4 Nov=87( 17-Dec-03 ~~ 'l Nov 87 P ~ 17 ~° __ _..,,~ ___, . 2708475 ~ WC 2505 W 8TH ST IYUMA AZ 039 ......................._..,.....,......._.,. -.-...3 ,.._.._ P U 30 ' ~ "9816 S FG 1 Nov-87 17-Dec-03 __~.. __•~~ 2700212 " ? WC , 3650 8TH ST IYUMA AZ 01 ~U 20 ~' 9816;S IFG ~1 Nov-85~ 17-Dec-03 ~ W _ _ __-__ ~ ^ ~ 2700212 __~._..____ C .,___...__ -- 3650 8TH STYUMA AZ ~ 1 02 ~ ~U 105 1 9816!S'FG ~ 1 Nov 851 17 Dec-03 ~ 2700212 : ~_..... _..w_ 2701930 D _ WC ... _....._..,-~ WG 1 .. .~._ _ 3650 8TH ST iYUMA [AZ 031 , ~._. _...._.__ .. _ ~ mm~ -_,~~ _~,~ . „ .._ __~_______- __._~_... m__- 379 W 1ST ST IYUMA AZ 01 U 1,_..-.. U 30 20 ._. _. ~ 9816 S FG ~ ...~ 9816 S FG ,_._.n 1 Nov 85( 17 Dec 03 ... ~ ~. ~ .~ ....... 1 Nov=86~ 17-Dec-03 2701930. W _ 2701930 WC 1 ______..,..-_.....~ _____._.. _ .. 379 W 1ST ST ~ YUMA AZ_ ~ 02 379 W 1ST ST YUMA AZ ~-~.~ 0 3 ~ ~~~~ ~ (U U 30 05 ..._. -.1-_._. ~ 9816 S _FG 9816 S FG r . 1 .Nov-86 17-Dec-03 ~:.86~.......17-Dec-03 1-Nav 2701923 WC~ _ __ ._..,_~.._.,__~.. .~ _ _ __..__ ~..... -... ......__~W 637E 32ND ST 1YU AZm _ 01 ____..~. ..~__. q.. .~---M._.__ eee~...~ ,~..__. ~ - . ....~ .._ U .._~.. ~ X05 -. ~ I + "g816~S iFG ... ..__ ,.~ __ .w.-_... ec=851 17-Dec-03 _...~.-_.._._.__ ._._ 2701923 IWC ~_. ~.,.- 2701923 IWC 637E 32ND ST iYUMA iAZ 02 ~,~.~.,_.~_.._~~ ~_,_, [637 E 32ND ST YUMA U i '30 9816'S "FG ~ , ' ' 1 Dec=85 ~ 17-Dec-03 __. _.~. - 2701948 IWC . AZ 03 ~ ~~v_ .. 6544 E OLD HWY 80 YUMA U X ,20 9816 S ,FG ~ ' I 1-Dec-85 17-Dec-03 _.__.._. ._ ..._s .~.~ 2701948 WC ~_ _-__ __. .~ 2701948~WCp ~_._..._._ ._~..~ EAZ ~ 01 _.., ___..___._ m.~...._ ~ _ __.._ w___ ~ 6544 E OLD HWY 80 YUMA AZ 02 _ ~. _._._ -....~ _ ~.. ~..~.._, _....~_ ~~... - _...W . .__._____ -_ _m.._. __._.~.. ;6544 E OLD HWY 80 iYUMA .AZ 03 ..__µ._..~_.,.~._..__.__-_-._~..._ .._._~..~...._.~ _..~... _._._. U _-. 90 ~._-,.._..~ !U .._ 45 1_._. 30 ... 05 20029;S FG 1 L...-_... _ ..~._. ' ` 9816:S iFG 9816'S :FG W_ _.. . 1-Jul-87; 17-Dec-03 _____..._.. __._.,_ 1-Jul-87j 17-Dec 03 _-._.,. _.w.... 1-Jul-87 17-Dec-03 m ._..~_______________ 2_701948, ~~WC 2701736 ~ _---- 6544 E OLDHWY 80 YUMA_ AZ , 04` 695 S 4TH AVE ~~ YUMA _ m_. 'AZ ~~ 01 ~..__ .. . _.-,M_.__~ .._ _ ~ U U 20 05 9 9_816'S FG ~~~ 9816 S FG , 1-Jul-87 17-Dec-03 .~.,..m...~.. ~_..._..~.._ 1-Apr-851 17-Dec-03 2701736 !WC _. _. _r__._ _.~ (695 S 4TH AVE YUMA ~ 02 9 .~...._ ___..~ ._._ .~ . _ U I30 ~ 9816•S FG __ -1-Apr-85~ 17~Dec 03 2701736 WC _ _ ~ a. ~_._ ._..._ ________ _..~. . _.___ _ ~ - _..,.m 695 S 4TH AVE IYUMA PAZ ? 03 ...._ U _._ 20 ~ ~.._m_ .._._ 9816 S IFG N _ 1-A r-85 17-Dec 03 2701356~WC 2 0 3 7110 E HWY 95 "~W~Y-UMA 1AZ 01 ...~...~..._m..__....._ _..~. U X20 i I I 9728 S ~ FG ' p 1-Dec-86! 17-Dec-03 7 1356 ,WC .____._ _._., - 7110 E HWY 95 >YUMA AZ ~ 02 ...____._.. _.~..__ .__......__._~.w__.__~~ _..... U ~ 05 ~,_..... 9728iS FG ~d___~._.._ _ . , 1-Dec-86 17-Dec-03 . 2701356 ¢WC . 2701754 ;WC 2701754 jWC~~ 7110 E HWY 95 IYUMA PAZ 03 .___.__.__._.___...._.~. _,.___ __E.__._ __....._._~ _____. _. __._. 820 W 32ND ST IYUMA ,AZ 01 820 W 32ND ST YUMA U ~._. 1U 30 L.-.. 05 _ i 9728 S FG ~_._..___ _ _ 97281S FG " „~1rv-Dec-86 17-Dec-03 ~.._..._._._.-.._...~..__~_.__._.__ ~ 1-Apr-85E 17-Dec-03 7 270 1754 ;WC _ i AZ ~ 02 820 W 32ND ST ~ YUMA ~~ ~ AZ iU _ 30 ; 972_8 S 4FG 3 1-Apr-85 -Dec-03 _ 2700990 !WC ~ j _ _I _ P ~ O~ 29105 HWY 80 ~~WELLTON ~~ ~~ IAZ W01 ~ ~ U 0 2__0 45 ~ 9816S FG ~~ 9728cS FG ~ 1-Apr-85{_17-Dec 03 1-Apr-85 17-Dec-03 2700990 IWC IAZ ~ 02 29105 HWY 80 ~~WELLTON ..~ . O 30 9728`S FG 1-Apr-85f 17-Dec-03 2700990 iWC 29105 HWY 80 ~WELLTON PAZ 03 O .._......__ X05 _ 9728"S F_G ~.._. 1-A r 85 17 Dec-03 _~ .._._-___w_ .... _ _...__. 2705008 (WC ~~ ! 11424 CHAMBERLAINE AVE ~ADELANTO ~ ICA ~ 01 . _________.. U ._..._ 05 - ..~ ~ 9816~D IFG .._m..._ _ .~ ~ 1-Nov-88~ 17-Dec-03 .~_~___~_-__.~._ 2705008 WC j 11424 CHAMBERLAINE AVE jADELANTO 'CA 02 ~U 20 ! 9816?D #FG t 1-Nov-881 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _ _ _ _ __ 12/17/06_-07 _ West Coast Region ,__ as of 12/13/06 _ _ ` _ _ _ ^ _ ~_ __ __' ___ _ _ _ ______ _ __ LOC. # Region ADDRESS _ CITY _ STATE UST # CAPACITY _ GALLONS INSTALL DATE RETRO DATE 2705008 WC j 11424 CHAMBERLAINE AVE +ADELANTO ' CA ~ 03`U ~30 98161 D `FG 1-Nov-88 17-Dec-03 2708644 I WC 11724 AIRBASE RD ADELANTO ~~._ CA ._.. € 01 U X30 i 9816 D FG 1-Jun-88 17-Dec-03 2708644 g __„ WC '11724 AIRBASE RD __.. . _ _..,. _. _a. _ ~ADELANTO .~........__ .~. _. ___..,. I .w____ CA~~ 0210 X05 i 98161 --- _ _...__ ._... ~ ~ ,. ~.. u~,___. - D MFG ~ _.~ 1-Jun-88 __.._.,._,_ ____;; 17-Dec-03 _ __.._ _.w._ ~ __. 2708644 27007~~ WC 11724 AIRBASE RD 1ADELANTO [56621 STATE HWY 371 ANZA ~ ~ I ~ CA ° 03~U 20 ~ 9816 CA _0110 ~5~ 14976 ~ D (FG D FG _ 1-Jun-88 15-Jun-98 17-Dec-03 17-Dec-03 2700736 2700858 WC WC !56621 STATE HWY 371 .~,_.-.._____-.____ !18465 US HWY 18 1ANZA .. ~,...N.__-__ APPLE VALLEY I ~__,._____, j 02 U X30 11849 CA ~ _ _._ CA ~ 0~{20 9816 ~ D FG D FG ~ 15-Jun-98 1-May-88 17-Dec-03 -~--v- 17-Dec-03 w..,........-___. 2700858 ~,....__ WC _.i__~.~__ __-____..__._~__..e_~ 18465 US HWY 18 .____.. .___.________..._._..~_ ~ APPLE_VALLEY ! .m...~ ~ _..........,........~_._~~_. _______I_~.~._...__ -- CA 02~U 105 1 _ 98161 ...._.._.._. ;~.w.w._....~. ~~µ ,_._~ D gFG A_._._.. 1-May-88' ~_-__~ ..~ ____.._._..... 17-Dec-03 __...__.._._..._. 2700858 . 2701232 ; WC 1_8465 US HWY 18 WC ;4381 EL CAMINO REAL APPLE VALLEY_ AT_ASCADERO ~~ _ ~ ~ CA CA 9816 ` 03~ °30 I ~ 01 U 105 1 14976 ~~ D FG D FG 1-May-88 20 Oct-98' ~ . 17-Dec-03 17-Dec-03 ~ 2701232 I WC '4381 ELCAMINOREAL ATASCADERO ~~ ; CA 11849 ; 02 U i30~ D;FG 20-Oct-98 17-Dec-03 -.__._.....__. 2701197. 2701197 ~..~,.______-z~ _._ __._._._._.~ WC {6930 MORRO RD ATASCADERO WC 16930 MORRO RD ~~ ATASCADERO _....._ A __,_ ~..._ ~. ~._._...._.. -..~ .___ CA ~ 01U 20 j 98'16~ s CA ° 02 U X30 98161 D FG __ . , D:IFG ...-._._....-.___ 1-Jan-85 .~..., 1-Jan-85 17-Dec-03 17-Dec-03 2701197 2705018 WC WC 6930 MORRO RD ... 11021 SHAFFER RD 1ATASCADERO ~~.~~_~ ATW ATER ._~ ~._ iCA 03n'U °0~ E g816~ t_.~.... __ ~ t CA 011~U D'tFG _~. D F_G a1-Jan-851 _ 1 Nov 88 - 17-Dec-03 17-Dec-03 2705018 ' d 2705018, ! 2701178 WC WC ~C .1021 SHAFFER RD .~.~ `1_021 SHAFFERRD 428 SKYLINE BLVD . s _ ATWATER ~~ATWATER~ ___._, AVENAL ~~ ~ ~~ C CA ICA ~ A _021U Oo 9816s .r-__.~.-~.-.--,~ i __ 03~U 30 9816 01 sU 05 1'1849 ~D FG~ :-- D FG D FG 1 Nov-88 1-Nov-88 `10-Dec-98 17-Dec-03 37-Dec 03 : 17-Dec-03 _..._._. 2701178 ... ... .w._.___._..~_~.~ .__~,_~.m_.. WC 1428 SKYLINE BLVD ~. ..___ ~~ _~ .-.~. _..-,.~ AV_ENAL _ _.. _~..~ ICA _ _.. 02~U 30 11849 v_ - _ ..-. D IFG ..-~~... g "10-Dec-98 ~ 17-Dec_03 2708606 ~'~ 2708606 fi WC . _1030 OAK ST ~ N~ BAKERSFIELD WC ' 1_030 OAK ST BAKERSFIELD ___...~~...~.,_v_____.:_. ~~ __..1 ICA CA ,._.._.__ I 01 U rt05 ~ 98164 ~02'U~ 30 9816 ..~, __. ~' 6 ~ ~ D,4FG D ;FG ~ 1-May-88 1-May-88 ~.,_. ~ 17-Dec-03 ~17-Dec-03 270860 ~. WG ~.... 1030 OAK ST _ ~ ~.. _... BAKERSFIELD ~~...,w _,~.~.._ -.~--. w..~. ~ CA ;20 ~ :;98 O U ~FG 1-May-88~ ._..._._ 17-Dec-03 ~,-.-.._.._ 2708825 ~_.~ ~.__... 2708825 WC __ _... WC 2222 F ST ~ .... .~.. _____-__..~ 12222 F ST BAKERSFIELD ~--.-.___..__.~..r...._ BAKERSFIELD CA ~~ _ CA 01~U 20 9816 D FG wa.___ _s, a.~. _ _. _...1.--~ _-.m 02 U 05 9816ED F 1 Mar-871 .~....._....._.._.~ 1-Mar-87 17-Dec-03 --~_.__.~m__-,... 17-Dec-03 __.~... ' .-,.~._......._..._ ~~~~ ~ ~ . ..__ . ._.w .. ~ ' _ _. ~ 2708825 2708605. WC WC ;2222 F ST 5600 AUBURN ST >B SFIELD [BAKERSFIELD ICA ACA 03 U 30 .. 98161.D MFG 01 U 30 98161D FG € 1-Mar-87 -Mar-88 17-Dec-03 17-Dec-03 5 ` ~ G ; ~ 270860 270860 5 . 5600 AUBURN ST IWC ,5600AUBURN ST BAKERSFIELD BAKERSFIELD CA ACA 02 U 20 98161D F = 03 U 05 +. 9816~D,FG A . 1 Mar-88 1-Mar-88~ 17-D_ec-03 17-Dec-03 _ 2701270 ~WC _ J5634 STINE RD ~ _ 1BAKERSFIELD~~ _ ~ ~CA ~ J _ 01 U ~05 ~14976iD G 24-Aug-98 17-Dec-03 ~ ~_ _.. ~m,~_W.._.~...._.~..~,W_ { _._,-_ B _____w______ ___ ..~..__._ __~.----. ..,.__. ~ ~-.~.____-.-. 1 ~.~._..~.. ~_.__.~ 2701270 ;WC 5634 STINE RD :.~ AKERSFIELD __. _~ ACA ..~... ~ _w 02,U 30 ; T1849 .--- -~ .~. .D;1FG ~. 24-Aug-98 ~ ..~ 17-Dec-03 _~_..._. 2705731. _..~_.._._...~, WC .. ;1501 E MAIN ST _ ..:. _._~. __ ..m ~ BARSTOW s ._ _..__~--~~.~ CA ...~__.. _ s 01 U 05 15.154 w_... _ ,.._ _._~ ;D rF_G ._ 1 Nov 9 µ....__ 617-Dec-03 _~_,_...__~ ~ 2705731 WC ~ 1501 E MAIN ST. BARST_O_W ~ CA I 02BU ;30 ~ 15154 .D #EG ~ 1-Nov-96 17-Dec-03 ~ ~-~m-~~ 270109 ~C =500 RIMR_OC_KRD `BARSTOW ___.,__._.._.__...~_.._..._.-.~ ~ CA ...__.W_.. g 01 U '30 E __ _ 11849 .. _w_.~.~ _ ~D 1FG 22 Jan-99 17 Dec-03 ~ 2701096, WC :500 RIMROCK RD ~BARSTOW yCA 02'U 105 ; 11849 D,FG ~ 22 Jan-99 17-Dec-03 2700358 C .~..~._ _...~.._~ 540 W BIG BEAR BL\/D ,~V._-q-~_.~.___._._..._._..~. 9BiG BEAR CITY ._~ _ ;CA ___ __. 01 U 09~~ 11 49 ,. ' D FG N 8 17 D 03 : ~.__....~., 2700358 ;W X _ ___-._____W_.:_.,..~__.~....~..._.._._...r__....._~_._,_._.. WC 540 W BIG BEAR BL\/D, BIG BEAR CITY W ~~ .____.. ,m_. CA __~.__. § __ _ 02iU X : 8 ~_.. ~ 30 € 11849 ~ , ~ _~ ~.D FG ov-9 30 1.._.. .,._ _ : 30 Nov-98 ~~ _ - ec - _..-_., 17-Dec-03 2700951; ~ I ~____M. ' 5809 MANZANITA AVE .~..1__ __~ CARMICHAEL .~~____..__-___._._____.._.___~..... CA __~~__ 01g~U 05 ~ ~ 14976 _-____ r 1.D.'FG 10-Apr98 ~ 1 ~ 2700951 2705728. WC WC 5809 MANZANITA AVE CARMICHAEL 14200 CHINO HILLS PKWY CHINO HILLS CA FCA ~ 02~U 30 1 11849 ° 01 U 05 12037 D MFG ~D °SF ~ 10 Apr-98 1 Jan-91 17-Dec-03 1 17-Dec-03 2705728 WC ~ `4200 CHINO HILLS PK --~------ _ ..~.~_,_.w.. WY gCHINO HILLS ..,..~..__ ~..___._-_-~----.--w _.~_ ICA ..~ 1._. . ~. 1 02 U ;30 E , 12037 _ ,~ ._.._ 1DSF~ w 1-Jan-91 ~ 17-Dec-03 2702964 2702964 WC WC '60 BROADWAY ~60 BROADWAY ~ _ ... ICHULA VISTA ~~~CHULA VISTA -__ _ _ CA _ CA ___._.._ ~ ...._~ --~---_ _ _q__. ~ _ 01 fU 05 ~ 994_2 02 U ~. 30 •~ 9942 !S:IS_F S SF ~_ ~ 1-Apr-81 _ q 1-A r-81 ~..~._._. ~ 1 ~3 ; 17-Dec-03 2705708 . r---..,_~.._. .._...-.-._ IWC 98 BONITA RD 'CHULA VISTA _u~ .~.... ~CA 01 U ~5 15154 DSF _ 1-Jan-96 _.~.. 17-Dec-03 2705708 ~WC 98 B_ONITA_RD_ ICHULA VISTA ;CA ~; m 02 U X30 15154 D SF ; 1-Jan-96 17-Dec-03 2705423 WC .7796 SUNRISE BLVD gCITRUS HEIGHTS ~CA ~ 011U ~105~ 11682 ~D FG ~ 1-Jan-95~ 17-D ec-03 2705423 27054 23 iWC (WC `7796 SUNRISE BLVD 17796 SUNRISE BLVD CITRUS HEIGHTS 1CITRUS H EIGHTS (CA ACA `~ 02U 05 E 11682~ ~~ 03 U a20 ~ 11682 D fF_ D FG ~-Ja_n-95 1-Jan-95 _ 17-Dec-03 17-Dec-03 _ 2705423 WC _ _ 7796 SUNRISE BLVD CITRUS HEIGHTS ~ ~ U ~ ._.. ~~ _ 1 ~~ CA ~ ~ _ , 04g ;30 i 11682 __._ -~ ~D FG ~ 1-Jan-95 _ 1 17-Dec-03 2701922 2701922 !WC WC ~ 11_3120 MAGNOLIAAVE ';13120 MAGNOLIA AVE CORONA CORONA ACA _.__._~ ACA 01 U 20 € 9816 ~ 02 U +05 9816 ~ ~ D_? FG D 1FG ~~ 1-Jan-87 I 1-Jan-87 ~~ ~ 17-Dec-03 17-Dec-03 ~ .____...~.._._ 2701922 ~... ._.__.._.~.__ ..~.__...~.._ IWC 13120 MAGNOLIA AVE sCO_RONA_ ~..._ . _.._.._.__ _ ~ ~ ~ ~ ~ ._~..~._ iCA ~ . _.,.w _._____-. _ 031U °30 I 9816 ______ .~...~ _.__~__,____~ D IFG ._ _. __ : 1-Jan-87 h_ _,._ _~.._a_ .._..~.. 17-Dec-03 ~_.___.~~._.~.,... 2705705 ~WC 304 S MAIN ST _ CORONA _ ACA ~ 01U 30 , 15154 ~ -~ %D~SF # 1-Jan-95 1 17-Dec-03 2705705 1 WC ~ 304 S MAIN ST CORONA ' CA ~ ~ ~ E 02iU `05 _ 15154 ~ D SF ~ - 1-Jan 95 ~~~~~ 1 17-Dec-03 2701914 (WC ~?1930~LAKE BLVD ~ DAVIS ~ ~ CA ~ ~w ~ 01tU 05 ~ 9816 1D ~FG ( 1-May-87 1 17-Dec-03 ___.--.__ ...____ _. ______.~w____._ . ___-__.. ~ __.._ ~...~____n_.___..~. _._ _-~ -_- 2701914 'WC 1193 0 LAKE BLV D IDAVIS ACA ° 02SU 30 9816 D •FG 1-May-87 17-Dec-03 2701914 _ _ _ _ {WC '1930 LAKE BLVD ~ ~ ~ ~#DAVIS ~ ~~~--_.~___ _-_____. 'CA _ _ 03 U 20 ~ 7950 ~D FG ? TM1-Ma -8 7 17-Dec-03 2705017 WC 12549 BLOSSOM _ ;DOS PALOS !CA 01 `U ;30 9816 1D fFG ~ 1 1-Dec-88 j 17-Dec-03 2705017 ''WC ,2549 B L OSSOM _ DOS PALO S ~ ~ iCA 02 U ~ ~ , ;05 j 9816 ~ ~D ?FG _-- i 1-Dec-88 17-Dec-03~ 2705017 WC _ _ _ _ 12549 BLOSSOM ~ _ __ 1DOS PALOS _ ~ ~ CA ~ _ _ y ~03 U~ 120 ~ 9816 D FG _ ~~ 1 D 88 __ 1 17 D 03 ; _ 1 - ec- - ec- G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _ 12/17/06-07 West Coast Region __ _ ___ as of 12/13/06 _ CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2708545 i WC ~ (1161 E VALLEY PKWY ESCONDIDO ICA 01 U 20 I 9816 D IFG 1-Oct-87 17-Dec-03 2708545 i 2708545 WC ,1161EVALLEYPKWY WC 11161 E VALLEY PKWY ESCONDIDO ' ESCONDIDO CA ~ ._ CA 02 ; ~._ 03 1U#05! U~30 9816 ~~ 9816 ~D iD ;FG IFG 1-Oct-87 1-Oct-87 1 17-Dec-03 17-Dec-03 ,__._~,_ 2701527 __..__,._-, __ _-- _. _-_._ _. WC j685 PARKER RD .__._..._-...n~_. _..w.w ~ 9 ~ m __....__._.... __.m_..w_~__._ 2701527 __~ WC 685 P FAIRFIELD ;CA .~._- 01 ~...-w______. U 30 €_.~_ ~ ~ 9816 ...~~...~µ_______a~ ~D „~ IFG ~. _1-Mar-87 ' _ 17-Dec-03 1 ._~ 2701527 =. 2700489 ARKER RD i __.._____~.._._..._.___~.__._ .... WC 685 PARKER RD _ WC~14906 VALLEY BLVD FAIRFIELD _ ~FAIRFIELD ~ _____ FONTANA CA CA ~ ; 02 __~_ 03 U ~05 ~ ~, ~U i20 ! 9816 _ ~ 9816 ~ ~D 1~_ D ~ FG ~_.~ ,FG 1-Mar-87 ..__..__.~ 1-Mar-87 ....._. 17-Dec-03 .._.. , 17-Dec-03 ..._......., 2700489 _. _~._._...~_.._.__~~..,.-._.u WC ~ _ ~~~~ CA ....__ ~. 01 ..~ 05 U _.._ 9684 __.M___. D ~._~- FG __.._ 1-May-95 17-D_ec-03 _ _ 2705802. €14906 VALLEY BLVD WC ~~16900 FOOTHILL BLVD ~ FONTANA FONTANA ~ CA ~ (CA ~ 02 ~ 01 U ~30 I IU~ z05~ 9684 ` X11783 JD S FG SF 1-May-95 1-Jan-83 17-De_c-03 17-Dec-03 2705802 -_-_._.._ 2708734 .....-~..v_- 2708734 WC 16900 FOOTHILL BLVD _ _ ~a_. ~ __..~., .__. WC T 247 E OLIVE AVE -- WC j247 E OLIVE AVE FONTANA _. ._..__.~.~...-._,. FRESNO ~ ~~ IFRESNO CA CA _.._-.. CA 02~U 30 : 11.783 - ._._. __. 01 ~U 05 I 9816 .~ . ~~02#U ~20 j 9816 S D jD SF FG~ FG 1 Jan 83 1 Aug 88 ~. ~...~._ ` ' .1=Aug-88 17-Dec-03 17-Dec-03 ___.___.___. s' 97-Dec-03 2708734: 2705063 2705063 WC "1.247 E OLIVE AVE WC 18190'MISSION BLVD ~ ~ WC IFRESNO _ GLEN AVON _-~ N ~ €CA CA ~ 03 U _ 30 9816 ~ 01 U 2 e 9816 D ..~ D .FG __~. IFG 1=Aug-88 1 Jun-89 17-Dec-03 17 Dec-03 . 2705063 8190 MISSION BLVD WC X8190 MISSION BLVD GLEN AVO GLEN AVON CA ICA 02 U 1059816 03 U ~i30 ~ 9816~ D D FG FG 1 Jun-89 = 1 Jun-89 1 17 Dec-03 ~ 17-Dec-03 2701028 .I WC ,1665 W'HANFORD ARMONA R D HANFORD CA ~ ~ 011U 05 14976 D ~FG~ -' 10 J l 98~ 17 D 2701028- 2705_619 I _ WC -1665 W HANFORD ARMONA RD ._-____M..__ WC X1150 W PACIFIC C OAST HWY~ HANFORD _._ __..~.____ HARBOR CITY ' CA ~ .__ CA . 02~30~ 11.849 ~__M___-.__ . ~-~ . ~ 01~U '05 I 12023 _ D D F~ ~.. NSF u - 10 Jal-98 ,~ 1-Jan-88 - ec-03 ~ 17-Dec-03 __.W__-______ 17-Dec-03 2705619 ~ _ _ WC j1150 WPACIFIC COAST HWY ~~ HARBOR CITY A CA ~mv 021U '30 I 12023 D ?SF 1-Jan-88; 17-Dec-03 2705057, _ 2705057 2705057 WC 81971 ST WC 8197 f ST ~WC ,81971ST 'HESPERIA ~ HESPERIA ~ A iHESPERIA CA CA CA 011U ~,30 ~ ~9816i ____ ~02 U 05 98164 03 U 20 9816' ~ .D• D D ~ LF~ FG FG ~ ~ 1-Nov=88 ~ 1-Nov-88 1 Nov 88 ° ~ 17-D_ec-03 17-Dec-03 17 D 03 .~. , _~-_Mm____-_ _ ~~_. r__~ ___._ ~ ~_,~...___.,. a..-...... _...~~.a- _-_._ _ _a____ _~._~ • . - - ,- ~ - ec- _ __ 2705242 € 2705242 27 WC 3405 E HIGHLAND.AVE WC 13405 E HIGHLAND AVE 4 HIGHLAND : ~ ~~. HIGHLAND ~ CA ~ CA~ ~ 01 U 30 11849I ~ 02IU X05 11849~ ~ D D.. FG FG 18-A 18-Aug-98 17-Dec-03 ,.17 00538 2700538 . WC ~ 955 CLINTON ST WC ;43955 CLINTON ST ~ ~ INDIO ~ ~ aINDlO } CA ~ CA 01 ~U 105 g X14947 02 U 30 ~ 11849 D FG ~ FG 2 Nov 981 2 N " 17 Dec 03 27057~~ ,.5793 ALT_ON PKWY. IRVINE ~ C A , 01 EU 05 14976 4D -- IFG ov 98 - g ~ 1 Nov-01 17 Dec 03 17-Dec-O 3 2705786 WC 15793ALTON PKWY` =IRVINE ~~~ CA 02?~U 30 -14976 ~D j FG~ ' ~ _ 1 2705911~ ~WC ':78364 US HWY 111 •. ---------~ -~ pLA QUINTA ~ CA E ..-- .-,WH.- . .--~~'-" 013U 05 14976P D G 1 Nov-01 -__.._ _____ l _14 Jan 02 7-Dec-03 17-Dec 03 2705911 _a _, 2705911 : WC }78364 US HWY 111 ,n_ _. _.. __~ ..~~w IWC '78364 US HWY 111 -~----• _-_, LA QUINTA ~~-~ __..,.._.._._,..~.,._ ,...a~ LA QUINTA ___w. ~ ~ 3 _ CA ._.~ m .- °C~A~~ ._......,._...021U 30 .14976 ~_ t ._. ... ~ 03~ 45 ~ 14976 ~.. ~ D I D I _ FG I _~ FG ~ 14 Jan 0 a,._ .._-__.._ 14-Jan-02 217-Dec 03 ~.M_.. 17-Dec-03 ~~ 2700837 2700837 ' € ~WC X17671 GRAND AVE. WC '17671 GRAND AVE ~. ~.- SLAKE ELSINORE LAKEELSINORE M~~ CA CA ; ~ mm01 #U ~~.30 I X11849 02~U 05 ~ 11849 4 D I D~i FG FG X _,.. 13 Jul 98~ 13-JUI-98 17 Dec-03 17,Dec-03 ...~m.._ ~ 6470 CAMBRIDGE .. .,...._.e LATHROP , ~ _._._ ~.. M~~. ..~ CA ~...m_ 01 U 105 . 11849 -_._... ._._ ~ ,. U D FG ~ 2-Jan-98= 17-D ec-03 2701205 4 € WC 1 _ 6470 CAMBRIDGE - ILATHROP ~ CA ._ ~30 # 02 ,,~ 118491 5 ~ D _m._ FG G _ __. 2-Jan-98 _ ~ 17-D_ec-03 ~ µµ~~~ ~~ OMPOC ~. q ~ O~U X0 11849= D F ~ 1-Feb-99 17-Dec-03 2701215' ~ 2709200_ I ~.. WC 1421 OCEAN ~.~ rn~ ~_ ~ WC 1400 N HST- ~..... ~.._ ._. _~ ._- ~ ~ L OMPOC LOMPOC .._._ _ : ~ CA CA , 02. 01 ° U 30 1..1849 05 ~ 9684. D D FG FG # 1-Feb-99 14 Jun-05. . 17-Dec-03 17-Dec-03 2709200. I . . a WC 1400 N HST : . ~_~..~.m. ...-_._._..._m.w_.__-___-. LOMPOC _. . C i ....m._,_. ' _ _ _ __..._,_,_x __ m .__._.~ ._~.r._._.m_..-_~ 2709_200 2709200 WC £1400 N. H ST' WC~ µA400 N. H ST _ ~~~~~ LOMPOC ~~ ~-'~ LOMPOC~~ ___._---~ A Cq -CA-__..~ 02 03 ~ p4 05 9684 ~ 30~ 9684 ~ 1 45~ ~ 9684 D D D FG ; FG_= FG ~ ~:14-Jun-05 1'4.=Jun-05 _ .1<t-Jun-051 17-Dec-03 17-Dec-03 '17-D ec-03 2703621 2703621 2703621 WC ~ ~~1704 E PACHECO~~~i WC ;1704 E PACHECO WC ' 1704 E PACHECO LOS BANGS ~~ i LOS BANGS I LOS BANGS CA CA CA 011 02 03 0 05 } 9684 U 30 ` 9684 U ~45 `{ 9684 ~` D D D ; EG ~FG i FG 14-Jun-95 14 Jun 95' 14-Jun-95 _ 17-Dec-03 17-Dec-03 17 D 03 2703614 WC 403 MERCY SPRGS RD~~ LOS BANGS ~ ~ A ~ j ~~01 ~ _ U 05 ~ 9684 D FG 13-Feb-96 - ec- 17-Dec-03 2703614 , WC 403 MERCY SPRGS RD : LOS BANGS CA ` 0 €€ ~ _~_._._--.-.~ 2703614 ._.,-.~.~~-...___._.-._ _w.__ WC _1403 MERCY SPRGS RD {__,.._ _~, NOS ~~ ~ LOS BA ~ CA 02# _u.~~_- 03# U 2 96841 ~-. ~ _.._.._..., U € 30 # 9684, D ~._ D i FG ...~. FG 13-Feb-96 _...... __.__ 13 Feb-961 17-Dec-03 #._..-..__..__._._. 17-Dec-03 2705431 2705431 ~ WC 830 E ST ' ~~.__._~~__,_____ _~ WC 1830 E T _ _~ ~__- MARYSVILLE A ~~~ ` ---.~_,~_ CA j 01~ ~.--~~~~~~M ~"` U 120: ~ 9816~ . ~'-' D , ~ FG ~ ~" ~ 1-Jan-86 ""`"~"-'"" 17Dec-03 2705431 __.~. 2708735 S WC 1830 E ST _,_,.~._. .~...~.._._,_ WC 2097 MENTONE BLVD MARYSVILLE MARYSVILLE } , MENTONE CA ~ CA 2i '-'~ 03~ 0 U X05 9816 ---'-~w-- ~U 30 F 981~ X D D , FG FG " 1-Jan-861 1-Jan-86 ~ 17-Dec-03 .~..._w_____._ 17-Dec-03 2708735 WCi2097 MENTONE BLVD _ _am__..__......._~ ~ ~ _~ MENTONE I ~~ ~~ ~ CA Cq'~ 1 ~'~~~ ~~.~~~~ 02 [ U 05 ( 9816; ~ ~ ~ ~ U = 20 9816 D D j FG FG ~ 1 Dec-88 1 Dec-88 f 17-Dec-03 17-Dec-03 2708735 2700337 i WC 2097 MENTONE BLVD ....... ? _~~ ___._ WC 110597 JURUPA RD MENTONE I ~ ~__ MIRA LOMA CA _ # CA ° 031 ~ 01 _ U 30_1 9816 U 130 11849 D D M FG F ~ 1 Dec 88 7 Dec 98 17-Dec-03 _~-. ~__ 17-Dec-03 2700337 WC 10597 JURUP 8 1 A RD _ I MIRA LO_MA_ ~ ~ CA ____. 02I U 105 i 11849 D~ FG ~ 17 D ec-98 17-Dec-03 2708 ~ 2708843 1 11640 N CARPENTER RD ----.-- _#.__ _ ~.~._...__a WC !1640 N_ CARPENTER RD ' _.~ ~ SMODESTO -----.__.._.W_.m__.___~_~..._._._. MODESTO ...._~..~.._._..._ CA ~ ~..~._._._ CA 01' _.._~ 02~ U #05 9816` ____.-.._. U ~20 € 9816I D ~.~ D FG ~ _____.~ FG _ 1 Oct-87 .____~__W..------.-. 1-Oct-871 17-Dec-03 ~._ _. 17 Dec-03 2708843 I WC ;1640 N. CARPENTER RD # ..~____. "_.'__ MODESTO -----~- CA -.._._.~ 03g ~_._.. . ___.__..._.._ U 130 ; 9816 D , " FG 3 __~ ..._.. 1-Oct-871 _,_._.___. 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule _________ _ _ 12/17/06-07 _ West Coast Region ______ __ as_of 12/13/06 CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2705432 1 ___- ____ WC 899 HAWTHORNE ST ; ,. . .. ~ --...~ MONTEREY j CA ! 01 1U 8 05 9816 tD FG L 1-Jan-90 ! 17-Dec-03 2705432 , _ ~ . _..__._...~.., . _._. .. WC I899 HAWTHORNE ST _ aMONTEREY ; ~ ~~...~...I___..._.~ CA f 02 ~ ~U 8 ...~.~ 20 ._....._... _.~..~ p 9816 ..__. [D __..~ 77 FG .._. 1-Jan-90 ( 17-Dec-03 2705432 pWC 8I 99 HAWTHORNE ST MONTEREY CA ~ 03 v U 1 30 ~~9816 1D, $j]FG 1-Jan-90 ; 17-Dec-03 2705432 ~ , WC I899 HAWTHO R NE ST MONTEREY ~ CA ~ ~ 04 ~ U 45 € 9816 iD }FG I 1-Jan-90 17 De 03 _ 2700872 _ _ ~ ~~ ~ . __ WC P D ' -~m §_ ~ . mm _. . - [ c- 3261 ERRIS BLV !MORENO VALLEY ~ CA 01 , ~~ 1U € 30 ~ 11849 D F_G 31-Jul-98 17-Dec-03 2700872 2701775 _.. WC 13261 PERRIS BLVD_ R NO VALLEY WC `24051 JOHN F KENNEDY DR lMORENO VALLEY ~ __...._.._. __ ~ ,.. - ___ CA __ 02 C l 01 U 1 U 05 30 ~ 14976D FG ' 31-Jul-98 ( 9816~D .FG ~ 1 Jun-88~~~ , 17-Dec-03 D -03 2701775_ . . _ a .__._..-,_,..-_._._ _.,.mm-____-_ WC 24051 JOHN F KENNEDY DR MORENO VALLEY ` ' ~ CA 02 'U 3. 05 _....._ _m.__._, 981E D ;FG 1 Jun-88 .~.a._2..0...~._...._. 17-Dec-03 2701775 WC ;24051 JOHN F KENNEDY DR MORENO VALLEY I rn~ CA 03 8U ! 20 ! 951~~ D ~FG_ 1 Jun_-881 17-Dec-03 2700770 WC 149594 29 PALMS HWY MORONGO UALLEY CA 8 01 U X 30 1 11849 ~D FG 1-May-98` ~~ ~ 17-Dec-03 2700770 .__..,_m_.-.M €WC '49594 29 PALMS HWY MORONGO VALLEY CA 02 i.._. ___. .______ ~..__ .._ w __~ _,~_ - U 1 05 14976'D 'FG 1'Ma -9 ~ ~ Y ~ ~c-03 2701045 . N_..~ ~,, 1 WC ~j 11408 VENTURA AVE I OJAI CA I 01 i ... U ~ X05 . .. 8 9816: D FG 1 Aug 87~ 17- Dec-03 2701045 ~ ~ 1WC ~1~9.1408 VENTURA AVE OJAI ~ _ _ CA € 02 .. t ~€ 05 _ ~ .9816',D FG ' ~ 1=Aug-87 _ .17-Dec-03 2701045 __--._-_ "WC ~ 11408 VENTURA AVE OJAI '-~~~ CA 031 ~ - ~_~_~ U .. 30 _..-., 9816°D FG ° s 1-Aug-87 17-Dec03 2705230 2705230 ~ WC ;16408 ORANGE PARAMOUNT ,C ~ A 01 1WC 16408 ORANGE PARAMOUNT ~ CA ~ 028 - ~~~ ~ U ~~ U 20 05 9816 S FG 1-Jul-83 ~ 9816 S FG 1 Jul-83 17-Dec-03 ~ 17-Dec-03 2705230 iW C 16408 ORANGE . PARAMOUNT =CA 03 U 30 _ ~~9816"S iFG 1-Jul-83 71 Dec-03 2705245~ WC 6105 CLAY PEDLEY 'C 01 U 20 9816D FG 1 N 87 2705245 ~ _ ~ ~ f WC 6105 CLAY _ PEDLEY ~ _~ CA ~ ov- g h ~ 7 17-Dec-03 2705245 2705659 1 3 02 WC~6105 CLAY ~PEDLEY ~ CA ~ 03 WC 8451 SL AUSON AVE PICO RIVERA fCA ~1 U € U U 1 30 05 05 9816tD 3FG 1 Nov-8 9816~D 1FG i 1-Nov-87 ~__~~~ '° 19703 S G 3 D 01 17-Dec 03 17-Dec-03 17 D 03 ~ ~ _ ~_~ .,_-~-...._..__~..__.._.~.... ..~.,,.._ ' ` : F - ec- -mm- - ec- ..._.. 2705659 ----- 2705659 WC _ 8451 SLAUSON AVE PICO RIVERA __ _ CA { 02~ __~~ ~ ___--.__°-- 1NC 8451 SLAUSON AVE _ PICO RIVERA CA 03 _~____._ ~ Nf~~ U 0 U_ ~~ 3 i 45 d 11863~S =FG 3-Dec-01 10369 S F_G 3 D _ c-01 ~ ~ 9 17-Dec-03 ________.w__.__ 17-Dec-03 _ _ ~ 2702970 2702970 WC ~7 ~ CAT 01~ 04 MMAIN STS w.~._..r_~M _ RAMONA_ WC Y~ ,704.MAIN ST ~RAMONA CA ~02i U~ u 05 30 '~28_p LL_1184 D~FG ~ of-98 f > 1T849D ?FG . '28 - Oct-98 17_-_Dec-03 17-Dec-03 .._ ___.. _ ..~.._~,_..-........_..._._.~._.__._~_. .~.._,~.._..~.._._..f 8 _ _ ..._...--g~ _ 2705020 27 WC I 951 N ORANGE R_E_DLANDS CA~ 1 01 ` V rn~ ~ U X05 9816~D FG 1-Oct-89€ 17-Dec-03 05020 -.-..__.__.. WC 1.598 N ORANGE REDLANDS CA . ~ 02 .,..._ ... .._._~._._..~_.. ~ ~'20 9816 D FG . 1 Oct=89 .~._. 17-Dec-03 ~ 2705020 2705214. IWC r~1598 N ORANGE, REDLANDS CA i 03 .~..-._..- '€WC '765 W REDLANDS BLVD REDLANDS CA 018 '~_ _._r,,~ ~ _ ~ W..._ . a30 98161D FG 1-Oct-89 U 0 30 11682 D FG ; 12 Dec-01 .._.._-__.-,_.. ~17-Dec-03 17-Dec-03 2705~ .... -_______- C ' ~ X765 W REDLANDS BLVD REDLANDS ACA s 02 .."`""""'" - - U ,20 11682'D FG € 12 Dec-01 ""`"~" 17-Dec-03 2705214 ---______~.~._~m WC 76 W R - ' , _ 5 EDLANDSBLVD REDLANDS ( CA 031 U 05 14976'D FG 12 Dec-01~ 17 Dec-03 2705252' _ 518 W FOOTHILL R__.~__m ~_-, ___._._ ~,......~~...._...-._... WC _ IALTO ;CA 01 `.-- ~ ~~.__.._w.. ~~ _ ~e __. __~ U q20 . 9728'D FG 1-Nov-88 ~ ` t .,.._.w.___..__ 17-Dec-03 2705252 iWC '518 W FOOTHILLRIALTO CA 02 ~ U 30 9728'D FG , 1-Nov-88 'x 17=,Dec-03 2705252 ; 2700801 , _...._._.._w_._ WC ;518 W FOOTHILL iRIALTO ~~ €CA 03 WC [18965 VAN BUREN-BLVD RIVERSIDE iCA E 01~ ._ _._.._,_.. _._.._._ _.~._ _._.._.._ ..___---.... . ~._ . _ U 105 9728 D'FG 1-Nov-88 U X30 11849 D FG ~ ., 8-Sep-98 1.7-Dec-03 . 1 7-Dec-03 2700801 . . _. _ ___.__,..__..._~_ WC • 148965 VAN BUREN BLVD_ RIVERSIDE CA ~ 02 ..__._~-...._._ ~ ~ ~U ~~05 ~ .14976xD FG 8 Sep-9& , ~ :~ 17-Dec-03 2705221 WC 8609 GARVEY AVE aRO AD CA 0 U ;20 10310 D FG 31-Oct-90f 17-Dec-03 2705221 ~ WC 8609 GARVEY AVE IROSEMEAD ACA ~ ~ 02 U 05 10370 F D G . 2705221 1 WC j8609 GARVEY AVE ~ _ ~ ~ _ t 31-Oct-90 R SO EMEAD ~C ~ ~~ 1Z-Dec-03 2705733 ~WC ~~€998 SUNRISE BLVD A 03 U 30 10310ID FG 3t Oct-90 JROSEVILLE CA 01 U 805 151 4€D '17-Dec-03 2705733 -.-~-~-..--..., 2705247 2705247 ~.....____ ~..~________.._....._.m_.._____..~.~._ WCf998 SUNRISE BLVD „€ WC '5804 MISSION BLVD ~ ~.. WC ,5804 MISSION BLVD _.._._...~.,..__....___.. _..~.. _..._ 5 SF 1 Jan-96 ~_.__..____ ROSEVILLE CA~~ 021U 30 15154^D SF 1-Jan-96 M,,. _______~__._.__._.a ._.~... _ ._.. ,_ _.~ ~BIDOUX 3CA ~~01 U 05 9728D FG ; 1-Mayy-88- ~....___-_._____-.__~ .~. __-,m__m__-~ F.. --.--.- _.~ ~RUBIDOUX ICA 028U X30 96951D FG 9 Jun 03P .~ 8 " 17-Dec-03 17-De_c-03 ~~1-7-Dec-03 ..._.__..._~...__.._ 17-Dec-03 2705247 WC '5804 MISSION BLVD ..~.~_.____._w___-__..._..__..~ mm ~,~_-___.._. _, ._._.__._.._ .____ e~.-~ RUBIDOUX ~CA € 03°U `20 97283D FG ~~ 1 Ma 88 ... p _. ~ . Y ~m~-~ ~ 17-Dec-03 2705203 --.--~.--.--._._. 2705203 WC 6290 MISSION ~..~~._~.__~. _ WC 6290 MISSION ~ _. RUBIDOUX CA ~ 01 U !05 98 S MFG ~ 1 Jan-82~ .~. .-. ~.~._.. ...~_______...~ ._ M..._... RUBIDOUX CA 8 02 U~20 98168S FG 1-Jan-82 _ _.~._ 17-Dec-03 .~.~.___._.~...~ 17-Dec-03 2705203 ' WC 6290 MISSION RUBIDOUX CA ~~ 03 U C30 98166S 8 ..__._.m.._.,....._ ,-._w___._. _~a FG 8 1-Jan-82! 17-Dec-03 2701057 2701057 2 WC 15555 HEMLOCK SACRAMENTO CA 014U ?30 11849D WC '5555 HEMLOCK _ _ SACRAMENTO }CA 0280 X05 14976 D~ ._ ~ ~ ~ FG 8 Apr-98` FG 8-Apr-98 17-Dec-03 17-Dec-03 701212 WC 600 RIOTIERRAAVE =SACRAMENTO :CA _ I_ 011U'05 14976€D FG : 1-Apr-98€ 17-Dec-03 2701212 2705439 € WC X600 RIO TIERRA AVE SACRAMENTO ACA 0 U 30 11849D I WC (1240 N MAIN ST SALINAS !CA 0130 30 9816 D FG~ 1 Apr-98{ jFG 1 Jan 89~ 17 Dec-03 17 D 03 - ec- 2705439 ; 2705439 WC '1240 N_ MAIN ST SALINAS_ CA € 02tU €20 9816 D_I W ~~1240 N MAIN ST SALINAS ~~m ~CA ~ 03 U ;05 I 9816=D 1 FG~ 1Jan-8 FG 8 1-Jan-89 917-Dec-03 17-Dec-03 2705439 € WC ;1240 N MAIN ST ~ SALINAS __ _ ICA _ q04 U 05 9816'D FG ~ 1-Jan-89 ~ 17 Dec 03 2705239 _ ~~~2734 DEL ROSA SANgERNARDINO~~ ~CA ~ 02~ ~05 11849iD MFG ~ 18-Au 98 17-Dec 03 2705239 rv g WC 2734 DEL ROSA :SAN BERNARDINO CA 03 U 30 118493D €FG 18-Au 98 .,....,•, 1 17-Dec 031 27086_41 27086 ~ ~ ~ WC 295 N WATERMAN AVE,_ ;SAN BERNARDINO ACA V ~~ ~ 01~U ~20 ' 9816$D FG 1~Mar_88 _ W ~ , 17-Dec 03' 41 C 295 N WATERMAN AVE SAN BERNARDINO CA 1 02fU 05 , 98168D'FG 8 1-Mar-88 17-Dec-031 G:\datalWCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circfe K WC Region Tank Schedule 2006 12 13 Circle K T ank Sch edule 12/17/ 06-07 ~ ~ West Coas t Regio _ n _ _ as of 12/13/06 ~ _ _ __ _ ____ __ __ CAPACITY __ _ ___ INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2708641 1 WC 295 N WATERMAN AVE SAN BERNARDINO A ~~ CA 03I U 1 30 1 9816 D S FG 1 Mar-881 17-Dec-03 2708688 WC 1 10520 CAMINO RUIZ SA IDN EGO i CA , 01 ~U 30 I 9816; D , FG + 1 May-891 17-Dec-03 2708688 L WC ; _._ 10520 CAMINO RUIZ ... _ ..~ _ _~.. .....~.,. _..._..~, SAN DIEGO ,. _ _ ._ _....,_,_.~~..__., ~ CA ...~...._.....,~ 02 .,._...w,~.. U = _._ ~ 20 98161 D I FG I 1 May 891 ~... ~ _ ..., ' 17-Dec-03 2708688 ; ~ WC 10520 CAMINO RUIZ SAN DIEGO CA ~ _03 U+ 0~ ~ 9816I D ~ FG~1 May-8 917-Dec-03 2705095 ~ 27050 WC 4360 GENESEE AVE 4360 GENESEE AVE ISAN DIEGO_ SAN DIEGO ~~ CA CA ~~ 01 E 02 U 1 : U 30 ! 05 __ 9684 ~9684~ D G 1. 1-Nov-89 `FG~ 1-Nov-89 17-Dec-03 17 TD ec-03 2705095 ....._.__..~. WC 1 .. ___ __-_. - 4360 GENESEE AVE ___.__~___ __._._._ ~....._.,~_ . ..~_ ~ SAN DIEGO _ ` ._.._._.______.___.._....._.____ .~. CA~ w..~. _..~ t ~031 _.._.___. ~ U _ .__ 20 , _.. _ 9684 ._.., -~ D ,_.. sFG _ 1-Nov-89 _£ ._.__~._..m._ f Y , ! 17-Dec-03 ~___~._ .__.._ . 2703608 . WC ~6 . . 21998.COLORADO . ISAN JOAQUIN 1 w._. ~.._._._.. . CA ( _ .___._. 01 ._.__ ___a U p ____._ 05~ 149766 . .D ~--- FG ~ 15-Sep-97 -_..~.....__._...____, 17-Dec-03 __. 2703608 WC ~µ ......r~ 21998 COLORADO ~ . ~ 3AN JOAQUIN ! , _____ CA __ ~ 021 U ~ 30 ~ 11849" ~ D~~ FG 15 Sepw 97~ 17-Dec-03 2705784 WC 98'1 FRANCISCO.BLVD SAN RAFAEL CA 01I U ' 05 10058 .D ~ 3SF 1 San 94 17-Dec-03 2705784. i WC , 981 FRANCISCO BLVD 'SAN RAFAEL CA 02[ U 05 1A058 _. D S~.~.m YJan 94 I .._ 17 Dec 03 2705784 WC j 981 FRANCISCO BLVD 1SAN RAFAEL s ______._~ CA ~ -r 03~ - U 30 s ~12079 D SF~~1~ Jan 94 17 Dec-03 2705238 WC X 765 W HARVARD BLVD x SANTA PAULA CA 01 i U 105 ~ 9816 D FG 25 Feb=85 r 17-Dec,03 2705238 .~ 2708755 .765 W HARVARD BLVD SANTA PAULA ~ WC WC 2790 WHITSON RD SECMA _ CA CA I 03 01 U $30 I 9816 D ;FG ~ 25 Feb'85~ 17 Dec-03 U X05 9816~D iFG~ 1 Apr 88~ 17 Dec-03 _. 2708755 ~ _- _m... __ _._ _. .~...~.._-._. _... WC ~~2790 WHITSON RD 'SECMA ~ _ ___ _.._._._.~..,_.~_._._.. _ ---µ-:-..-.~..-. ._. ~ - _.. .. CA ~ ~ ~ 02 ~-.s,._ _ _. _ _ __. _._. U X20 ; 9816_D IFG 1 ~ 1 Apr-88¥ 17 Dec-03 _. ,~ _.. _ ---->~- - 2708755 . - WC 2790 WHITSON RD !SECMA i CA H03 ~ 9816~D FG ; 1-Apr=88[ 17 Dec-03 U 30 ~ 2705684 - _~,. {WC j27180 MCCALL BLVD ~~ SUN CITY I __~_.__w___-__. ..._...~ ~_ .~ _._ CA ? ____ 01 ....-..~ ~ U 105 92023 D 4SF 15 Apr-87.17 Dec-03 _ __ _„_ .. __. 2705684_ WC "27180 MCCALL BLVD ~ wSUN CITY ~~~ .-.„~r,.~~t___..~.-....,.._~.~_,._.m_...~~ CA ~ ' 02 U 30 1202_3 _D 1SF 15_A_pr-871 17 Dec-03 `~. .~...-M..._....e.~__ ~'' 2700010. ! 2700010 t TEHACHAPI I WC 1302 E TEHACHAPI BLVD r < ~ ~ WC 302 E TEHACHAPI BLVD _ -'TEHACHAPI _ E CA ~ ~ CA 011 ~ 02 =30 118491D,FG € ~29-Jul-981 "17-Dec-03 _ _ _ U I05 ~ 14976'D FG 29 Jul-98 17-Dec-03 U .,.~ - _-rv , ~ ,. 2700564 ¢ WC `7301'0 RAMON RD THOUSAND PALMS ! CA 0 IU ;30 l 14976°D FG 29 Jul 98 17 Dec-03 2700564 ~.._.._-..._---~ WC73010 RAMON RD °THOUSAND PALMS I . ~_~~._ mv,._ .... ...,-......~ -.- - ~.~_...-.._.~.~ ~_., ~. ._ CA -. ~ 1 02 --~ " 6U 10~ 14976 D IFG 29 Jul 98 17 Dec-03 (.._.. i _ . ~.. _ . .. 2701940 ' . . , _ WC 1600 W MAIN ST TURLOCK I CA ~ N~01 _ . . [U~a20 I 9816 D FG ~ ' 1 Ju1.8~ 17 Dec-03 ` 2701940 : 2701940 WC !1600 W MAIN ST rTURLOCK __ I -- WC 1600'W MAIN ST ___W_ TURLOCK ~ ~~ s CA CA~ 02 03 .D FG 1 Jul-87 17-Dec-03 U 405 9816 U 30 4 9816 D FG 1 Jul-E 17-pec-03 I _~..~ 2700348. 2700348 2700743 _ ._._-_~..__~._ WC ,5681 ADOBE RD ~TWENTYNINE PALMS ._...~ 1NC ,5681 ADOBE RD' ~TWENTYNINE PALMS 1 .W _ $WC 73 943 29 PALMS HWY 1TWENTYNINE PALMS . .. CA _.._,~....-~ CA ...m....._.. CA 01 .._.__.. , I~02 01 _.~_ _-_.~.~... _. _ _~._~. U 30 11849 D 'FG 15 Dec 98' 17 Dec-03 ...~..._..t.e _._ ~_, ~U 05 ~ 11849.D FG 15 Deo-9b~17-Dec-03 .,.~...._.. . _. __ 7U 30 11849 D FG 1 Jul-98 17-Dec-03 ..__ 2700743: WC 73 94329 PALM&HWY TWENTYNINE PALMS ~.~ ..~ _. w. - r. ___ . CA _________ 02 _ U 105 _. .._ 11849 D FG 1-Jul-98 17-Dec-03 2701984 WC 795 SHADOW RIDGE DR . VISTA I CA 01 =U 30 98161D FG 1 Apr-87 17-Dec 03 2701984 _.r._-__.-..__._._._,..., _.~._....A......~_u_._..._...._.._. WC 1795 SHADOW RIDGE DR VISTA I -...__,_« CA ~ 02 _. _. .. .. .,. jU 20 9816'D FG 1-Apr-87 17=Dec 03 2701984 ___.__-_.___~ .~. _ w WC 1795 SHADOW -RIDGE DR 'VISTA C ~ A ~ ~ 03 ._.~. _.. U =05 i 9816' D FG 1 Apr 87 1T Dec 03 ~ ~ 2701161! ~....._ WC X1395 PALM AVE . ?WASCO ~ _._..~....~,~ .~._ .____~__....... ~. _..__.~...~.,..,.. CA ~.... _, ,.__ ~01 _~ ~U ~05 i 14976 D FG 12 Jun 98~ 17-Dec 03 _._. a.... _ , .... ... __~,, 2701161 ~_ ~~.. ~ WC `13_95 PALM AVE ~ ~ ~ . ~WASCO I _.,. ._.._._., _.~.. _ -_ __...~.~___ ~,~.._.._..W.~~-....a ~ CA -.~ I _ ~_02 ~ ~ . 'U 130 11849 D FG 12 Jun 98,~ 1~7 Dec-03 2701391 WC 123 E MAIN ST gWESTMORLAND I i CA 01 U 30 9684~D FG 1 Sepm91 p 17-Dec-03 2701391 .. W 123 EMAIN ST.m ~WESTMORLAND~ ~ _ CA ~ 02 i .~_ ~U ~ .. 05 9684 .D FG 1 Se -91I 17-Dec-03 ~ P ~ 2701391 C~ _,~ WC 123E MAIN ST WESTMORLAND f ~ CA ~ 03 ~ gU ~ 20 ~ 1 E p, _.. ~ 9684~D FG 1 Se -91 17 Dec-03 2701156 ._._.._...~.. 2701156 WC 11263 FRANKLIN AVE YUBA CITY ~CA ~.. ~.___._.___ .._~ _-.._~ ~_____....___ _. a..._..~..~._....,....w,-... ~ .-._.~. WC I1263 FRANKLIN AVE YUBA CITY CA rN 01 1 02 U U 05 X30 14976D FG > 17-Feb-983 1 D7 ec 03 _._ _.-,_.-._....._.y._ $ ._...-....,_~, 118491D FG I 1"7-Feb-98s 17-Dec-03 2700902 2700902 WG I6940 OLD WOMAN SPRG 'YUCCA VALLEY ICA ._.~ WC 6940 OLD WOMAN SPRG IYUCCA VALLEY CA ~01 02 U U 30 405 9816 D ;FG 1-Oct-87E 17-Dec-03 9816!D FG 1 O 87 17 03 t D ..~... 2700902 ~ , " ______ ___ _. ______w w.. ._ WC 6940 OLD WOMAN SPRG YUCCA VALLEY_ CA ._.. ~ ~~~ ~ ~ 03 U 20 I - ec- c - t ..__._._ _ ...~...._._v ~ 9816 D jFG 1-Oct-87~ 17-Dec-03 ~ s 2700686 2700686 ~~ _ _. _ am uw ~.. w.._ -- iWC10000 GIBBON SW _ ALBUQUERQUE NM WC ~~10000 GIBBON SW ~s,ALBUQUEROUE _____ ~M ~ ___ _ ~ ~,m_ ~. ~ 01 ~ _ 02 ~ _ U tU 30 05 _ ._.._ _ _ _. ~ _. 11849ID~FG ~ 5 Mar-99~ 17-Dec-03 ___.g____ ___...., ~__......_~__.. 11849~iD E~FG ~ 5 Mar-99~17MDec-03 ~ 27003 2700379 11200 SAN PEDRO DR SE 1ALBUQUEROUE ~ ~NM WC _ ~120~EDR0 DR SE ALBUQUERQUE NM 01 € 02 U ¢U X05 30 9816IS FG 12-Mar-96~ 17-Deo-03 > 9816S FG ~ 12 Mar 96~ 17 Dec 03 _~.._ 2701255 W. _.~ ~_.~..__.-_....__._.__..._._-___._~_..._. _.___~~_, _._..__._.__,~.~........_,._. _._____,._ WC '12900 INDIAN SCHOOL RD NE ALBUQUERQUE ~NM _.___...~.7_..___._._ _. _~_ ... ~.~,...m.._~~~.~._~_~__....... _..-__ 01 T -,.___ eU _ ,m.. ~05 _ __._ _.~~.. ___._.__ ~ -._. _.-_._ ~ ~~10152'S SI ~ 1-Mar-79? 17-Dec-03 .,... a ---~-.. ~,.._. _ .____.._~ ~ ~ 2701255 °WC 1129001NDIAN SCHOOL RD NEIALBUQUERQUE INM 02 jU 2~ 10152;S S1 x 1-Mar-79 17-Dec-03 ____~ .._.. ~....I..__...___.._-._m_-....______.____..W,~_._. __...~._.._.w....~._.~_____- __ ~.. a 2701255 WC 112900 INDIAN SCHOOL RD NE ALBUQUERQUE ~ NM 03 jU 30 10152;S ISI 1-Mar-79 17-Dec-03 2701313 ._ _ -__ WC j1316 YALE SE ALBUQUERQUE --_ s !NM ~ 01~ _ U ~'20 10152`S !SI ~1-Mar-79E 17- Dec 03 C _ ___ - 2701313 2701313 ~.. ~ ~--_.., ,_ ~......m_~~.- _____,-..~._,e .-,,. ~WC 1316 YALE SE ALBUQUERQUE ___-_ __ m_______w_....._. _. WC ~i1316 YALE SE jALBUQUERQUE ~ ~ INM NM _- ~._-. _ 02 I 03 .--_. w._. _ _ R __ _ _... _.__ „ iU X05 10152~S ISI ~1 Mar-79 17 Dec 03 _______ .~. __ ..~ _______w...._. 9U 130 p 10152aS ;SI 3 1 Mar-79 17 Dec 03 ~__..._~_-__ ~ ~ m 2708779 ~. WC I1401 WYOMING NE ALBUQUERQUE ~.w.~~..~.„_... _. __-~____u__ _._...._..~_..~.._._._ ~~ INM ~ ~ 01 . __ U 120 ° 9816,S I~ 1-Jan-891 17-Dec-03 ~._._. ~-_. ~..... '' 2708779 jWC 1401 WYOMING NE ALBUQUERQUE NM 02 IU 05 ' 9816 °S IFG = 1 Jan 89F 17-Dec-03 2708779 1WC F1401 WYOMING NE =ALBUQUERQUE INM 03 ~U ;30 I 9816=S IFG , 1 Jan-89( 17-Dec-03 2701777 WC (2001 MENAUL BLVD NE _ ALBUQUERQUE ~ INM 01 {U 130 ; 9816yS fFG ~ 1-Nov-86 17-Dec-03 I ~ __. 2701777 ~.~_,.__w___,~__._._.... ~...~, ~,~._..,_._...w_ IWC :2001 MENAUL BLVD NE +ALBUQUERQUE ~.. ~ W ~_ ~__.~_._ ._ -...._ ._...~.~, ~NM ._ 0 .~_ _ _,... _._._.....__.y~ _.~..-.~.m..__ 2 X05 ~ ~ 9816'S FG `s 1-Nov -86I 17-Dec-03 2701777 ,_ . ~ . _._ lWC ;2001 MENAUL BLVD NE xALBUQUERQUE ~ jNM i 0~3 _ _ _ _._. _ _ ___ U~ X20 I ~ 9816S IFG 3 ~1-Nov-86 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 .Circle K Tank Schedule 12/17/06-07 ~ _ __ ___ __ _ West Coast Region ~ as of 12/13/06 _ __ __ _ __ CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2708748 ~WC 42019 CARLISLE NE I 2708748 r~WC ;2019 CARLISLE NE ° _.~..~~..~~ .. ~__-~___w~-___.._~..-.__~ _.~.~~~__. 2708748 (WC ;2019 CARLISLE NE ALBUQUERQUE ' ALBUQUERQUE ..~,...~,.~..._.. ALBUQUERQUE i NM __._ NM ~ NM 01 02 _. 03 U I05 i 9816` U '20 ¢ 9816 _.. ~ ~, U 30 9816 S ;FG S FG S ~ G 1-Oct-881 1 Oct 88 1 Oct 88[ 17-Dec-03 17-Dec-03 17-Dec-03 .__...._....__~u.._.__..-..~._~.__._.,.~ __ __w..._,._, _._....._._..___,~..._ w ,__.~...._.....~ _~_.._. _..,~,._• ' ~. __ ~......... .__._ ~..,___._. S FG _... -_..~~ 88 1 J ._ ._e. 17 D 03 2708551 iWC 2934 E_UBA_NKS NE W ~3 ~ ALBUQUERQUE I ~ NM 01 U 30 ~ _ 9816 ~ j S _ an- =88 - ec- 17 03 2934 EUBANKS NE 2708551 C 2708551 ,W 2934 EUBANKS NE --._._._., w_._._ 2700376 IWC3343 WYOMING BLVD NE 2700376 PWC 1343 WYOMING BLVD NE ALBUQUERQUE ALBUQUERQUE m ALBUQUERQUE I ALBUQUERQUE I NM NM ~ { NM NM ~ 02 ~ 03 01 02 U 05 9816. U 220 ____. 9816 U j05~ 9816 U X30 98163 IFG g S ;FG S FG S IFG t, 1-Jan I _...~....,~... 1-Jan-88 10-Feb-96 ~10 Feb-96 -Dec- 17-Dec-03 17-_Dec-03 17-Dec-03 _ ~ - 27014 72 jWC !397 AL:AMEDA NE ~ I ALBUQUERQUE NM 01, 10143~ 05 @ .. - U S SI ! 1~Mar,83 .17-Dec-03 _ 2701472 WC ;397ALAMEDA'NE ~~ 1 _ 1 LALA BUQUERQUE ~ ' `NM 02 03 U ~ 30-~~~ 0 10143 U = _ 5 SI S SI B 1 Mar,83~ ~ 1 M 83 17 Dec 03 17 Dec 03 2701472 WC 397 ALAMEDA NE ,~._ .__,___..u.., _~_ _ ALBUQUERQUE -_,__ w___.__ .~. ~_. ..~ NM w...,-..._~_ ~..: ~.. ~ .__ .. ~ ~.~ ...,~.~. .__ ~ ar _. ._.. _... _.... ~ 2700403~IWC 4212 COAL AVE SE _~_ ' 2700403 ~WC ;4212 COAL AVE SE ~ qL BUQUERQUE IALBUQUERQUE _ _~- ~~~~ 4NM ~ NM _ ~ 01j 02 ~ ^ U _ 30 ` ~ 9816~ °U '05 ~6 S FG ~T FG ~ 16 May-96 X16-May-961 17-Dec-03 17-.Dec-03 2700610 (WC 4400GOORSBLVDSW -._. 2700610 i1NC 14400 COORS BLVD SW . ,~n._ --~ ;ALBUQUERQUE ALBUQUERQUE .---_---~.___~,.._.._..,__.V._~.- NM € INM ,....m .__~-__. 01 ~02 ..n U 105 1 9816; U ;20~~9816 .... ~ ~ S IFG 'S FG ~ ~ ", 1.Feb= 6 ~ 1-Feb-96 .__ ' 17-Dec-03 17 Dec-03 270061.0..__~WC ?4400 COORS BLVD SW IALBUQUERQUE xNM ~ 03 U 30 98161 FG 1 Feb-96 17-Dec-03 2707962~WC X5101 SAN MATED NE IALBUQUERQUE jNM ~ 01 U X05 11682E ~ S IFG ~ 4 Apr 94 17 Dec-03 2707962 IWC 15101 SAN MATEO_NE ~ ~_ ~_~ ~._.~ 2707962 WC ;5101 SAN MATED NE ~ ...r. ~ "ALBUQUERQUE ~ _ _____. ALBUQUERQUE ._~..__. ~ NM 1 .__..._.....,, tNM ~I 02 .-...~ 03 9816~ ,U~~ _20~ ..._ ..._.._.~ U 30 9816 I ~ ~ S G ~ m- S IFG --tom S G ~ ~ 4 Apr 94 ~-_~.-.. 4 Apr-94 ~ . I 16 F 96 b ]7 Dec=03 ~__w_.. 17-Dec-03 ~__~~_,_m.~ 17 D 03 _ 2700741 WC5501 ACADEMY NE ALBUQUERQUE ~~ ;NM 01 ~ U 130 . 9816 _... - Ir ; e - ec- - 2700741 WC 501 ACADEMY NE ALBUQUERQUE NM 02 ~ ~ U ~2 9816a S IFG I 16 Feb?961 17-Dec-03 2700741 IWC -;5501 ACADEMY NE IALBUQUERQUE 4NM 03 U 105 p 9816 S IFG P 16 Feb-961 ?7-Dec-03 2701428 ~WC j6130 EDITH BLVD NE ALBUQUERQUE NM i 01 ._.~..__._..~ .~_~ _,._.~_~e_. .T_..,m._ 270142-.,8+.~WC ~ 6130 EDITH BLVD NE IALBUQUERQUE NM 02 U i20 , 10152I;S 'SI 1 Mar 811 .~._. .~... _.... U x05 ~ ? 10152~S SI 1 Mar 81 'IZ Dec-03 17 Dec-03 2701428 "WC 6130 EDITH BLVD NE IALBUQUERQUE =NM 03 270874W~~~ W '6300 CENTRAL AVE SE ALBUQUERQUE NM 1 01 } 5 U X45 10152 S BSI 1 Mar 81 U ,~30 9816IS `FG 1 Oct-88 ' ° 0 '17-Dec-03 1Z-Dec-03 27087 WC~63000ENTRALAVESE ALBUQUERQUE ~ ~~ NM E ~ 02 S 2708745 WC 36300 CENTRAL AVE SE ALBUQUERQUE 1 NM 03 ~ Y_ 9816 S FG 1 Oct88 U ~1 .~~. U 0 ~ 9816 S FG ' 1 Oct-88 17 Dec-03 17=Dec-03 p _._._....m_.._.....~._.. ....._....___ __ _.__. ~ ~ ~ _~..~,. ._. , ~ 2708934: ;WC' '1535 COORS BLVDNW ALBUQUERQUE ,NM 01 1 s 10000 I 1 May 90, 14 Dec•05 2708934 IWC 1535 COORS BLVD NW IALBUQUERQUE 3NM 02 ~.. C 3 1 10000 I _ ~ 1 May 901 ~ ~ 14 Dec-05 .__ - 270893 1535 COORS BLVD NW ALBUQUERQUE NM 03 __.._ .. __~__.. .M .___. _ ~._ _ _._ ~...___m_._.N__.~_.._ ....~,.~..__ . ~ 1 May 90 10000- x___. _ _ :.,.,. .... 14 .Dec 05 ._._ 2708935 IWC =5311' QUAIL AVE NW •.ALBUQUERQUE 9NM €1 01 _ w__________ __.~ .._ _ _ 20000x. ? I 1 D_ec-96 ~-~~ ~ , _ _ . M 3 14 Dec-05 ~~~ 2708935 :.WC '5311 QUAIGAVE NW ~ ;ALBUQUERQUE 3NM 02 2708936 WC 5210 CENTRAL AVE SE IALBUQUERQUE INM x 01 ` 10000 1 Dec-96 ; 12000/8000 1 Jul-98 1. 14 Dec-05 I- 14-Dec-05 ~..__.~.~....,~._..~.._ _._. __W___ ~ .~~....._.~.,~._____._ ~ _..__._ ~._..,~ 2708936 3WC 52'10 CENTRAL AVE SE IALBUQUERQUE NM 02 ~._._. ~_~_ .. _.._.. .._ ._.._. -~- _._..w ,_ .__,. ___. 2708937~WC 4701 PASEO DEL NORTE ALBUQUERQUE NM ~01 ;..~__~___. _ _ ._ k. rc. 6000= 1 Jul-98 _ ~. ~ ~ 200 00 1 May 99 ~ _ 1. '14 Dec-05 j 14 Dec.05 ____...._.,I_, ~,._ ___. _.. __... __..~...._ .-.._._.____ ... ~.._. ___ . _..._._ 2_708937 !WC .~ ,4701 PASEO DEL NORTE IALBUQUERQUE- NM 02 _ _ _ 2708937 'WC 34701 PASEO DEL NORTEALBUQUERQUE w~.. ~ NM ~ t 03 1 . . . ~~ 1 ~ ~ ~ = 10000 1 May-99 10000; _ 1 May-99 1 14-Dec-05 ~ __ 14-Dec-05 _~.. ...__ -, __ _ .... ~ _NM 01 2708940 WC -8601 CENTRAL AVE NE IALBUQUERQUE __ __ ~ _.r _ 2000~~ 1Feb-0 T 014-Dec-05. _...__~ _ 2708940 WC 8601 CENTRAL AVE NE ALBUQUERQUE NM 02 ~ 1 10000 1 Feb-00 ; 14- Dec-05 ~ .~ .._..~_ 2708940 WC 8601 CENTRAL AVE NE~ 9ALBUQUERQUE~ ~~3NMmm ~~ _ 3 ~.~ , ~._.._.~10000 __~~ x 1 Feb-00 d ~~~ ` ! -__.~_~..., _ 14- Dec=05 ~ 2708941 IWC ,4 03 0 OSUNA RD NE ~ "IALBUQUERQUE INM __._._-_w__~_,g ~._...___......_ .~_ __ _~..... 2708941 pWC [4300 OSUNA RD NE ALBUQUERQUE ,NM __.., - _. _... r .... 1 s _ __. ~ I 01 ~ 02 ' ~ 20000 ~_~_._.4. ~~~ 1 2000/8000 ~ 1 _Sep-00 ~ 1 Sep-0 ; 14-Dec-05 .~______~._ 014 Dec-05 ~_ .-. -._ ~. .. rm . ~ ,._....._. _m_ . _ .~.~..--.-.- _._ ,_ . ~.._ ____. _ ___ 2708942 WC 38181 HARPER NE ALBUQUERQUE INM ,.._.-~.~ 01 . .e___.. 20000 ~ ~__ ~ ; 1 Jul-98 ,_..._.._._. ~ 14-De c-05 _ _~. -...-. W__. __ ..___ ._._~ 2708942 WC 8181 HARPER NE ~ALBUQUERQUE~ INM ~ 02 ` _~. 10000 ~ 1 Jul-98 _ 14-Dec-05 ~ _ __.. ....._._.._...w_..__ ___M__ 2708943 ,WC _ 1300 LOMAS BLVD NE ~~ =ALBUQUERQUE ~ INM ~~ ~_._._ .. ~ ~~~y-~_ 01 ~ ~~~~~ - 20000 ~_...~......-. ~'~~ ` I 1 Dec 00 ~ .~ ~~~ 14-Dec-05 1.__...,__--_ 2708943 WC ~300 LOMAS BLVD NE 'ALBUQUERQUE NM ~ ~ 02 ..~~a ~ 1 10000 _._,. ° 1 Dec-00 ; 14-Dec-05 2708944 IWC 11400 MONTANO NE ALBUQUERQUE ~~~NM ~ _.,_._. ___...._,__. _____~......u,. _..,~ 01 ..~_,~ ~~1 I ~ 20000 0 I W 1 Aug 02 14-Dec-05 m..-....._._.. 2708944 WC 1400 MONTANO NE =ALBUQUERQUE INM 02 , ` ~ 12000/8000 ~ ~ 1 r 1 Aug-02 ~ 14-Dec-05 _.~...._. _.~~,.....~.,,. _ .,_.._.~..___.~_-____-___~._..V._,~ 2708946 WC 19320 COORS BLVD NW ALBUQUERQUE `NM ,~,__.._ 3 01 _ ..,..w_ ~ r 20000 _ ! € 1 Dec-03 14 Dec-05 ___._ .-...~H_______~_~_...._.__._... __ e. 2708946 IWC ;9320 COORS BLVD NW IALBUQUERQUE ~NM ~~ 02 .~. ~,~ ( = 12000/8000 ~ ~. _. 1-Dec-03 1 ~ ~-___.__ 14 Dec-05 ~~ m - ~~ _ ~ 2708698 IWC 16600 2ND ST NW_ _ IALBUQUERQUE ~NM ` t 708698~ 2 WC 6600 2ND STNW ALBU QUERQU E ~ jNM 01 ~ 1 02 320 ; U 9816 5 9816 U S FG T 1-Jun-87 S FG ~ ~ 1-Ju n-87 ~ 17 Dec-03 1 17 Dec-03 _ _ _ _ ~ . 1 270869~mm t3 EWC 6 00 2ND ST NW A E ~~ ~ ~ _ -? _ E ~ 6 LBUQUERQU NM ' ~ 03 U 30 9816 - S FG 1-Jun-87 ~ , 17-Dec-03 2701041 WC 7_660 LOUISIANA BLVD NE ALBUQUERQUE NM 01 IU 305 ( 9816 116 11 ' ' G 7-A r-96 1 17-Dec-03 2701041 WC ~j7660 LOUISIA_N_A BLVD NE IALBUQUERQUE INM ~ ~~ ! 02 iU 130 1 9816 ~ IS jFG I 7-A_pr-96 ~ 17 Dec-03 270_1447 WC j7817 CENTRAL A_VE NE LALA BUQUERQUE INM_ _ ~ ~ ~ 0101 ~ U i30~~~ 8060 1S ;SI i 1-Mar-82 z 17 Dec-03 2701447 jWC 7817 CENTRAL AVE NE ~ALBUQUERQUE }NM _ ~ 1 02 U ~_ 20 ? 8060 _ 'S (SI s 1-Mar-82 mm , 17-Dec-03 2701447 9WC 37817 CENTRAL AVE NE IALBUQUERQUE NM ~ 03 05 8060 U 1S 'SI ~ 1-Mar-82 1 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Sc hedule 12/17/06-07 _ __ ~ _ _ __ ____ _ _ ____ _ _ West Coast Region ~ _ as of 12/13/06 ~ __ _____ _ ___ __ ___ _ __ _ _ _ __ _ J _ _ CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STA TE UST # GA LLONS DATE DATE 2705323 I _~ 2705323 WC = _._._~ WC 8311 GOLF COURSE RD NW ,ALBUQUERQUE ~.•.._..._._._.._ ~. ._v 8311 GOLF COURSE RD NW 'ALBUQUERQUE NM .w...-........_ . ~.. ___. iNM 01 ~ 021 U 30 ` .--._____ U ;20 9816 S I ..__ 98164S } FG ' fG 22-Jun-96~ 17-Dec-03 ~..mm-.~. 22 Jun 96= 17-Dec-03 _~ - _...-..~__w__ M..-1~__..._~...._._..~..~_ ..~.~-_._~-~ . .. _._ ~.~_ .,. ~.. ~. .~.. ~ ..,._.._.. 2705323 WC 8311 GOLF COURSE RD NW ALBUQUERQUE ~ NM ~ . ~ 03 _- U 405 ; ~ e 9816 S I g ~.~. FG .., _. 22 Jun 96# 17-Dec-03 ._.. __... __ -. ~. . ~.._._.. .-___.._.. 2700810 ! 2700810 ,.__ _.-~ WC j WC 1 ~._. . _~ _. -._ _~_..~.._~.. -.,.~ . ~ 712 W MAIN ST 712 W MAIN ST ~~ ~ _~ ~ARTESIA IARTESIA ~~ . 4NM ~~ 4NM .. 101 02 U 445 i ~~~30 ~ _98164S 9816 S FG d~ 4-Jun-96 17-Dec-03 ~ 4-Jun-96 17 Dec-03 I ; ~ .,.~ 2700810 WC 712 W MAIN ST ~~ ARTESIA NM mm~ ~ 03~ I U 05 I 3 ~ 98164S I 5960 S $ FG $ SA~ 4-Jun-9617 Dec-03 96 17 D 03 ~28 M 270_02_89 2700289 ' WC i WC 700 N MAIN ST w...-_._.a_.~. _,._. _ AIN ST ~ 700 N BELEN ~...~. _~ (BELEN .u NM _ _ ~ ~ NM 01 I ~ 02 0 U t U 05 ~ ~-.. 5960£ S S 9 SA ec- - ay- r~._.__._.__._. -96 17-Dec-03 28-Ma m 1 C M 'mm- ~ , ~ ~ _ ~m . ' FG ' y 88' 17 03 1 M D 2700699 W '. 115W HWY 44 ~~ BERNALILLO 4 PNM j 2 ~ ._ ~. 9816 S I ar- - ec- - 2700699 ._..._..._...._...~ 2700699 ? WC ~.:..~ WG ~ 115 W HWY 44 .... ~m 115 W HWY44 BERNALILLO ___...._.~..._._.._. BERNALILLO NM . __-__ iNM ~ 02 _.. ~. `. 03 U 05 _ _ ..~_ . U '430' ' 9816 S. ~._ 98 6 FG i ~- IFG 1 Mar 88E .17-Dec-03 .~ ~1 Mar 88s 17 Dec-03 P ~....._... .-..b 2700561 : WC € .~....... HWY 550 GEN L DELIVERY SCUBA 1NM 01 U X05 9684!D IFG _......». 21 Nov-951 17-Dec 03 2700561. , _d WC .~., _~ . HWY 550 GEN L DELIVERY ..k______...~._... ...~. ~ CUBA _~ .__.-. INM 02• _ _.l u U 120 1 :; _._._ ~-' 9684 D _ ' FG _w.. 21 Nov-95€ 17-Dec-03 .~...~.. ~.,~.. ~- 2700561 ,__._.. WC _ 1 ~ HWY 550 GEN'L DELIVERY ___,e__.v. .._ CUBA _._.______ INM 4 031 U 93 9684 D ! FG ~ 21 Nov-95; 17-Dec-03 2708945 ._.__M- 2708945 IWC ! ~._~ 4 WC ! 6401. HWY 550 ._~_._.,____- __._._ _ 6401 HWY 550 CUBA NM __ .w__..___..~_. _. _.m # CUBA !NM 4 01 __ 02 ~ d 20000 ; mm [ 12000/8000 s I 1 Jun 03~ 14 Dec-05 1 Jun-031 14 Dec-05 1 ` _.. 1 ' ~ _ ~ mm ° 2701436 IWC 844 HIGHWAY 516 FLORA VISTA 1NM 01 _.~.. X45 ~ U 9816 S FG~ ~ _ 16 Oct 95~ 1Z Dec-03 __.______Y_,. _. 2701436 _..._. 'WC 8 I _._...~._..~. 44 HIGHWAY 516 __ _.~___w__.~_ FLORA VISTA '. 4NM _ 02 _~... U X20 i _-.._. 9816 S sFG 1 ~'-16 Oct-95~ 17 Dec-03 ~.. _~.... ~.._~- 2701436 ,._.. ---,... WC 1 ~ _ .~_ _ _ _ 844 HIGHWAY 516 _.._w~.~_ _._._._. _ ..-..._mw_ ~ _ (FLORA VISTA . ~.-. ~.._ NM _ .~...~ __ __ 03; __ .._._ _. U 905 ~ _.__.~____~~ 9816=S FG~m 16 Oct 951. 17 Dec-03 .m .. 2700278 WC 617 W PICACHO.AVE LAS CRUCES - 1NM 01[ U 30 9816tS~FG I 24 Feb-95 17-Dec-03 2700278 ~_~...-._ jWC ' _ _ 617 W PICACHO'AVE ___. ..,__ 'LAS CRUCES ~ ._..W-_._-__~-________w_. µ ~ ~ 4NM ~ 02i M ~ ~~ U =05 i __. ~ 1 4 9816S IFG 24 Feb=951..17-Dec-03 ~.. _._ 03 aFG 24 F 95 17 D 2700278 2708938 WC WC 617 W PICAGHO AVE 1860 MAIN STREET NW ALAS CRUCES LOS LUNAS N __ NM 03 ___ l _ 01 20 U ~' 4 ec- - -. 9816~S eb- 1 Aug 9Q 14-Dec-05 20000' ...__. _ .. . , . __ ~_. ..____..,.________. . _.._---W____-_. __._ ~ _.... ~ .._._,.._..~.._. ~_....~. . _w ..__ T ~- ,.~_...... .~._ . 2708938 _...- ._.._.. ~ WC ' ._._. ..~ 1860 MAIN STREET NW __-._.__.__._..~..~ ___..._ LOS LUNAS ,Y.._____ _-~_~__. __ NM ~. _ 02 __a___~ li 11000 -- . -~_.. ~.3 0/10000 9-Aug-99 14 Dec-05 2708939~ 2708939 WC-~-~'' WCµ -;1-100 NM HWY 52$ __m~ 1100 NM HWY 528 itRlO RANCHO RI0 RANCHO INM NM "" 01 t 02 ' .' ' '20000 1-Apr-00 14-Dec-05 ' r-00 14-Dec-05 1 A 000/10000x 10 .~._......_._~. 2701481 1 ~.... ~ IWC , ..,-~....~ ~_._._. _-..~ 3213 N MAIN 4 ~__... __~,._...._.~.W ,ROSWELL _ !NM ~~ 01 ~ . U ;45 ' . - p 9994jS S{ 1-Mar-83 17 Dec 03 2701481 1WC 1 .3213 NMAIN ROSWELL - SNM 02j U1 ~30~ 99941S SI 1 Mar=831 17-Dec-03 2701481 4WC ; 3213 NMAIN ROSWELL INM 4 03 U 105 ~ ~~~ ~.SI 1 Mar-83;:_17~Dec03 2701481 WC 1 3213 N MAIN ROSWELL ,NM ; 04 ~ U 20 i _ 9994!S SI .1 Mar-83 17-Dec-03 2701341 WC { HWY 70 PO BOX 907 RUIDOSO DOWNS NM 01 ~ ~ U 20 ~ 10152jSSI 1 Mar-79 ' 17-Dec-03 __... _ 2701341 WC ~ ~"_ _ ~_._..._ _..,- .HWY 70 PO BOX 907 ~ .,.,_._..__M __._.,_ .. __....... RUIDOSO DOWNS NM ~.. 9 __.. 02 ~ U ~U X30 I r ~ i _, ~_ _ _ ~_-- 101524S ISI 1-Mar-79 17=Dec-03 9 7 ~ 0 " 2 2701341 IWC 2708933; $WC H WY 70 PO BOX 907 IR IDOSO DOWNS 11315 E WILL ROGERS DR BANTA ROSA NM ~ NM rv 03 01 ~ 05 : U ~! I 1015 SI~ 1-Mar 7 1 -Dec- 3 10000_ ~ 1 Jul 92, 14 Dec 05 - mm~ ~ 2708933. WC ~,. __ 1315 E WILL ROGERS DR .-.~ m SANTA ROSA ..._..._. ___ ...._.- NM _ __. 02 __.. _~_._ s I 1 Jul 92fr 14 Dec 05 10000£ __.__ ___ .-..4_ ._.__ _, ~..-___.. , .. ~~ 2708933 IWC ~ 1315 E WILL ROGERS DR BANTA ROSA ~ NM ~ 03 ~ ~4 1 Jul-92= ~14-Dec-05 10000: ~ 1 2700515 IWC 918 N DATE ST ~ ~iTRUTH OR CONSEQUENCES NM ; _.. 01 1U X30 ! 9816`BFG 1 Nov-88 17 Dec-03 2700515 [WC ` --•~ DATE ST '. ~91 < #TRUTH OR CONSEQUENCES NM I 02~ U i05 1 2 ~ ' : 9816;S iFG 1 Nav-88; ~ 17-D_ec-03 Fm~ G~ 8 2700515 WC ._____ _ ..-. ._.___..___ 2700839 WC _..,-~_~_ 8 N DATEST TRUTH OR CONSE ._.._.._._.---.-. __a m_m__... ~_ ~ ..__,~. _.-..r.__ ~.__ 601 E TUCUMCARI BLVD (TUCUMCARI ~ ~.__________.. QUENCES NM ._ _... ~~ NM _ i 03 ~ _. ! 01~ 0 " - U __. ~ 130 . _ 9816S ( 8 17-Dec 03 ...~.~. _ .. _~._,__-__~ ....,_...w~..M,...., ..__.. 9816 S FG 1-Mar-87` '17-Dec-03 _...._.____,..~.~Y.._.~.. 2700839 IWC ._~~__~ __._. 2708931 IWC .. 1601 E TUCUMCARI BLVD- _._, __._m.-.._._ ~ 2624 SOUTH 1ST STREET .~ ~ M._ ~ .~.....-.__ _ TUCUMCARI -_m_-___..._....~. __ TUCUMCARI . . ,NM ___w.w_.~ . ,NM ._. 02 ~ _ 01 . . . 'U i05 __. 981615 ~FG 4 1-Mar-8717-Dec-03 _._._______~.~... 10000 I 4 1-Jul-7914-Dec 05 ._.~...~ ,_._ _ 2708931 WC .._..-.. ~~~.m_-.. 2708_931 WC 2708931 ,W ~ . . .~ ~ ___ j2624 SOUTH 1ST STREET (TUCUMCARI _.~.___-.,... ~_a,_.,_.-_-__m__.~...... ...~_____.._ m2,._., 2624 SOUTH 1ST STREET TUCUMCARI 2624 SOUTH 1ST STREET~TUCUMCARI ~~ ..__._...._. . ._._ • INM 02 ..__._-_~....~._. ,~_ _ `NM 033 _~.__~.._ ~ INM 04 _. ~_ 1 ~ . ,......~ _ r __-_~_ f -.- 10000 , 1-Jul-7914-Dec 05 ....._.__.. _...i-.-..., .__.__ ~..-..-. ___ 10000 ( ~ 1-Jul-79 14-Dec-05 _ .._..~..._.~__._.-.~_,~.f_-_ 100000 1 1-Jan-90 1 14-Dec-05 2708932 IWC 201 E TUCUMCARI BLVD g"TUCUMCARI _.__..~u_.... INM ___.......~._ 01 ,._.... 1 [j ~ _ ...~.__w_W_W.... ~..~......_..~.~..~ 75001 . 1-Jan-86~ 14-Dec-05 2708932 !WC ___.. - __ _...-.~ 1201 E TUCUMCARI BLVD .1~.._ ._.,~ .............~.-..- __...~~, TUCUMCARI -._... _.~,_~.w.w.... 1NM _,m....~. - 4 02 _~.-..~___ ~ € ~.,.....,._:.._._. _ 75004, 1-Jan-864 14 Dec-05 _.~..__~. ___ .._-... ` 2708932 WC 2701641 IWC 1201 E TUCUMCARI BLVD ;601 S MAIN TUCUMCARI ANTHONY NM ~TX I 03 01 U 130 ; 7500 1-Jan-86~ 14 Dec 05 1015 r-85~ 17 D IFG 1 M c-03 2701641 IWC 1601 S MAIN ANTHONY TX ~ 02 U 105 ` 23 - a e 10152'3 'FG 1 M 85 17 D 03 _.w_._.._._.._ 2701641 ~WC X .._....__...........__ ____ 601 S MAIN . _... _~_ ANTHONY TX W_ i 03 .~.....__ U 20 I ar ec ,._ _ .. 10152 S FG ' 1 Mar 85 17-Dec 03 2706104 WC 10100 MONTANA . =EL PASO TX '€ 01 U (05 ~ 120321S SSA 1 Feb-87i 17 Dec 03 __._.- 2706104_ 1WC _ 2706104 IWC __.._~~,._.,... ~_._ 10_100 MONTANA 10100-MONTANA _ ......._ ~...___ EL PASO TX ~y02 EL PASO ~ ~~ TX 03 w._..1_ __. _ _ ,_,... ~. U;20 ( 101521S SA 1 Feb-87! 17-Dec-03 ~_____}__.._._._...~.... I ~ ~.~.. U 130 12032iS SA 1F b-87 m17 Dec-03 ___._._ 2701257 1WC 2701257 iWC ..~._____ _._ 10567 RUSHING RD 10567 RUSHING RD _._..._ ;EL PASO !EL PASO _ .__._ ___._ TX TX ,~_..~,4._______--- 01 02 ~--___ ~-- U 20 I U (30' ; < e - .------.~.b-_-~-..~...._.__. _.._,...~.___ m----w 101521S iSl 1-Mar-781 17-Dec-03 10152S'SI 1 M 78 17 03 ~._._.___.__.......__.._.~ ______._. _ ,....... .m,,..__.._.__ ____--___~...M ~ -_,.,~_ ...._ _ - ar- -Dec- ..,. ..._ .~...~.... w,___ __._._.__..-._. 2701257 ?WC 10567 RUSHING RD IEL PASO TX 03 ~ ~ U 05 10152~S SI 1 1Mar-788_17-Dec-03 2700481 1WC E '106_16 MCCOMB_S ST _ °EL PASO TX 1 01 ~ ~ ~ _tu 05 ; 1.1682 S 4FG ~ 1-May-94_17-Dec-03 ' 0 ~ ~ 2700481 WC ;10616 MCCOMBS ST EL PASO TX ~ 02 U 98161S IFG 1-May-94( 17-Dec-03 ~,a.. G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule ________ 12117/06-07 ___ West Coast Region _ as of 12/13/06 _ __ ____ __ CAPACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2700481 WC 10616 MCCOMBS ST _....~._ EL PASO TX w 03 ~U X30 ~ ~ 7950y S ~ FG ~ ~1May-94 17-Dec~03 2708515 ~W-C 1073 COUNTRY CLUB RD ~, EL PASO _ TX ? 0_1 ~ ~U 05 10152 °S iFG 1-Jan-87 j 17-Dec-03 2708515 i _..____._.~ , WC E ~..,~ ~._.._.{ 1073 COUNTRY CLUB RD ....___.__._.~ .._..~._ .__. EL PASO ~___~_.....__.___-_.._._...___ ._~.,_...~ TX _-._.. ~ ~ 02 ~_._.._._. U .~ U 120 t_._.. I~ ...__,.__.W___ , FG _ 1-Jan-87 17-Dec-03 2708515 WC ; 1073 COUNTRY CLUB RD EL PASO TX ~ 03 X30 10152 S S FG ~1-Jan-87 17-Dec-03 2700020 ~ 2700020 ' _,j WC ; WC ,._____ 10744 VISTA DEL SOL 10744 VISTA DEL SOL t _ EL PASO ~... ~ x EL PASO ~ l'X TX ~ 01 i 02 U (U 05 20 ~ 11682 ~~~~~ 9816 ~ ,S FG FG 25-Nov-93 i 25-Nov-9 17-Dec-03 317 Dec-03 2700020 WC ~ ; 10744 VISTA DEL SOL ; EL PASO ~~ TX 03 U 30 ~ 7950 1S FG , 25-Nov-93 ~ 17 D e c-03 2701674 WC~ = .10770-DYER ST I EL PASO TX' ~ 01 U 130 s 9728 S sFG ~ 1-Mar-85 ~~ _ _ 17-Dec-03 2701674 2_701674 WC , WC~ 10770 DYER ST. 01 770 DYER ST': ~~~ _ ' EL PASO EL PASO µ TX TX .02 03 1U U 105 i20 1 ;:. .9728 ~9728 ~S ~S. MFG FG ' h=Mar-85 M r-85 ` 1~7-Dec-03 17-Dec-03 2700213 .WC ~ 11096"PEBBCE'HILLS BLVD ~ EL.PASO TX 01 U 05 ~~ 9816 S FG 4 Aug 94 ~ 17 Dec-03 2700213 WC 11096~.PEBBCE HILLS BLVD EL PASO "CX 02 U 20 98.16 S . FG " ~ ~ 4-Aug-94 17~Dec-03 2700213: WC 11096 PEBBLE.:H6LLS BLVD EL PASO - TX 03 U 30 ' : ,..9816 :5• FG ~ 4iAugW 94 17- Dec-03 2700890 WC - :: 11101 .MONTWOOD DR EL PASO TX 01 U 30 :x9728 5 FG ' - ~1-Jan-B~ _ ~m 17-Dec-03 2700890. WC 11101 MONTWOOD DR EL PASO __ l`X." 02 _ U 05 9728 S FG :.1-Jan-86 i 1 2700890' WC :. 1.1101 MONTWOOD DR ~ EL.PASO TX : 03 U 20 9728 S` FG ~ 1-Jan-86 ~ 17-Dec-03 2706309 WC 11390'M0NT\N0OD DRNE. EL PASO ~ _ TX _ 01 U 05 ' .1.1682 .S FG 8-Jan 17-Dec-03 2706309 WC 11390 MONTWOOD DRIVE. EL PASO TX '02 U 20 9816 S~ FG _ ~ ''8-Jan-99 _ ? 17-Dec-03 2706309 WC 11390~M0NTWOOD DRIVE EL PASO TX 03 U 30 "' 9816 S FG ~ 8-Jan-99 ` '17-Dec-03 2706309 WC . 11390 MONTWOOD DRIVE~•~ EL.-PASO TX 04 U 45 -, 7950 S FG-i ._._.__ 8-Jan-99 ~._...._.____ ~ 17-Dec-03 2705312 2705312 1NC WC ~ 11701'M0NTW00D DR' 1'170'1 MONTWOOD DR' EL PASO EL PASO TX 01 U 30 9816 S FG ~~ 1-Nov-94 ~ 17-Dec=03 4 . TX 02 U 20 9816~ S jFG 1.Nov-9 .17=Dec-03 2705312 WG 11701 MONTWOOD: DR" EL PASO TX 03 U 05 ::11682 S Fr G 1 Nov-94 g~17 Dec=03 2706308: WC. 1320 GEORGE DIETER EL PASO' ` TX 01 U 05 ' ' 11682 S r FG" : 5-MaP-98 ~ ~1Z-Dec=03 2706308 , WC 1320 GEORGE: DIETER EL PASO ; : TX ` 02 U 20 `:' :. 11682 ,S FG i 5-Mar-98 ~ .17=Dec=03 2706308 WC 1320 GEORGE DIETER EL PASO TX: 03 U 30 9816 S _. _ . FG 5 Ma 98 ¢ ._., 17 Dec 03 2706454: WC 1400'LEE TREVINO :' EL PASO TX ~ 01 U 05 ~(' 20055 S~ FG 2 Aug 01 17 Dec 03 2706454 WC 1400`LEE TREVINO - EL' PASO TX 02 UC1 30 - : (12068 S FG . 2-Aug=01 F 17=Dec-03 2706454 WC 1400 LEE TREVINO EL PASO TX 03 UC2 45 7981 S FG 2 Aug-01 1 17-Dec-03 2701227 . WC 1400 W YARDELL DR + EL PASO ~ TX 01 U 30 9728 S FG . Y Apr-84 '17-Dec-03 2701227 2701227 WC W 1400 WYARDELL DR EC PASO. _ TX 02 U 05 _ ;9728 S FG ~ '1 Apr 84 - ~ 97=Dec-03 ; C 1400 W YARDELL DR EL' PASO ' _ TX 03 U 20 9728 S FG E 1 Apr-84 ~ 17=Dec-03 2705305 .WC ' 1471 N ZARAGOSA _ EL PASO TX. 01 U 30 .:.9816 ,S FG ~ .- 1.May~96 ~ 17-Dec-03 2705305. WP ' 1471 N ZARAGOSA. _ EL PASO TX 02 __ U 20 ;:;'9816 S; 'FG~ ~ • 1=May-96y ~1~7-Dec-03 2705305 2 WC '; 1471 N ZARAGOSA "° : EL'PASO" ~ TX 03 U 05 `;-11682 S. FG ` ~ 1 May 96 -......M 17=Dec-03 ~ .~_.- 701506 . 2701 WC . 1500 GEORGEDIETER DR: ' EL PASO - TX~. ___ 01 U 20 , ,~ 10152 S- FG ~ TM 1-Jan-87 .17-Dec-03 506 WC 1500 GEORGE DIETER DR EL^:PASO TX 02 U 30 0152 .S FG ~ ~1-Jan-87 17-Dec-03' 2701506 . .WC ' 1500 GEORGE DIETER DR. EL PASO • . :' ;_ TX - 03 U 05 :10T52 S' :FG = __ _..... ~ 1-Jan=87 .._.,.._....W.. "1Z=Dec-03 2708775 WC 1520 LEE'fREVINO : ELPASO' ' TX ' >01 U 20 re .9728 S FG 1-Sep~88 ~ 17=Dec-03 2708775:. WC 1520 LEE TREVLNO EL PASO TX 02 U 05 ' 9728 .S FG 1 1-Sep-88 17-Dec-03 2708775 WC 1520 LEE TREVINO EL PASO ~ ~ TX 03 U 30 ~- 9728 S FG " ~1-Sep-88 17-Dec-03 2706307 WC 1 1600 ZARAGOSA EL PASO TX 01 U 05 11682 S FG 19-Mar-98 17-Dec-03 2706307 WC 1600 ZARAGOSA EL PASO TX 02 U 20 11682 S FG 19-Mar-98 17-De c-03 2706307 I WC _ - 1600 ZARAGOSA EL PASO TX 03 U 30 9816 S FG _ 19-M ar-98 _ ~ 17-Dec-03 2701482 270148 WC ' ' 1798 GEORGE DIETER DR EL PASO TX 01 U 20 9816 S FG _ _ 1-Mar-84 _ 17-Dec-03 2 WC 1798 GEORGE DIETER DR EL PASO TX 02 U 05 9816 S FG i 1-Mar-84 17-Dec-03 2701482 I WCm~ ; 1798 GEORGE DIETER DR EL PASO TX 03 U 30 9816 S FG E 1- Mar--84 17-Dec-03 2706130 WC 2200 N MESA EL PASO TX 01 U 05 11682 S _ FG ' ~25- Mar-99 17-Dec-03 2706130 WC { 2200 N MESA EL PASO TX 02 U 20 9816 S _ FG i 25-Mar-99E, 17-Dec-03 2706130 1 WC _ ; 2200 N MESA EL PASO TX 03 U 30 9816 S FG 25-Mar-99 ~ ~ .._ 17-Dec-03 2700026 WC ~ 3101 MCRAE BLVD EL PASO TX 01 U 05 10152 S _ u_w-__.._._ . SI ~ 1 -Apr-79~ . 17-Dec-0 3 2700026 WC 13101 MCRAE BLVD EL PASO TX 02 ~ U 20 _ ~.. 10152>S _ SI i 1-Apr-79 _ 17-Dec-03 2700026 WCd3101 MCRAE BLVD EL PASO TX s 03 9 3~ mm 10152'S SI 1-Apr-79 17-D ec 03 2701418 ~ WC 13910 A DYER ST EL PASO TX 01 U ~ ~ 20 ~ ~.m._ 10152 S f? _ SI 1-A r-81 _ 17-Dec-03 ~ 2701418 WC ,3910 A DYER ST EL PASO TX ( _ 02i - U -- X05 10152aS _ SI ~ 1-Apr-81 { 17-Dec-03 2701418 t 2708516 WC j3910 A DYER ST WC 94101 N PIEDRAS EL PASO TX ~ ~ ' 031 ~ U 1 - 30 101521S ~~~'- SI 1-Apr-81 ~`~`~~~~ ~~'"" ~ 17-Dec-03 ! ____ EL_PASO _ _ __ __ g 01 U _, 05 ~ ~ __ 9816 S FG a 1-Apr-87 17-Dec-03 2708516 ~ 2708516 ~ _ WC .4101 N PIEDRAS_ WC 4101 N PIEDRAS EL PASO i E ~ TX ~ m 02 U ' ~ 20~ , 9816 S ~ FG ~_ 1 Apr-87 17-Dec-03 7 L PASO TX 03? U 30 i 9816;S FG ( 1-Apr-87 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule_ ___ _______________ West Coast Region __ _ LOC. # Region ADDRESS 12/17/06-07 as of 12/13/0_6 _ CITY TATE ST # CAPACITY GALLONS INSTALL DATE RETRO DATE Z7D5313 J__,_....,. 2705313 I ._~........__~ 2705313 I 2706288 ~ WC 14501 WODDROW BEAN-TRANSMOUNTAIN - -- WC j4501 WOODROW BEAN-TRANSMOUNTAIN ____...____ - WC ~j4501 WOODROW BEAN-TRANSMOUNTAIN WC _ j5665 DESERT SOUTH BL _ EL PASO -- EL PASO , EL PASO { EL PASO TX ~ TX TX TX~ 01 ~ ~ 02j _ ~ 03~ 01 U a U -- U U 30 20 ~ 05 ¢ 05 ? 9816S 9816 S -.~.._,_ 11682:S ~~11 682S FG FG FG FG 23-Nov-94~ _...~.. 23-Nov-941 _.-- 23-Nov-94~ X25-Ju n-99; 17-Dec-03 _ ~........ 17-Dec-03 ~--M,__,._._ 17-_Dec-03 17-Dec-03 2706288 I _ WC 15665 DESERT SOUTH BL EL PASO TX 02 U 20 _ ~ 9816IS FG _ ° ~ 25-Jun-991 17-Dec-03 2706288 . W~ C •;5665 DESERT SOUTH BL EL PASO TX 03 U 30 ~ 9816?S FG ` 25-Jun-99 ~ 17-Dec-03 2706288 2705306• WC ;5665 DESERT SOUTH BL _ WC ~-,6095 MONTANA AVE EL PASO EL-PASO TX TX 04 01 U U 45 45 ._m.-.._ 9816S ~;~7950 S FG FG ____..._..~, 25-Jun-993 12-Sep~95E ____,._. 17-Dec-03 w 17-Dec-03 2705306 .W_G . ;6095 MONTANA AVE EC PASO TX 02 U 30 ~ 9816~S FG 12-Sep=95~ 17-Dec-03 2705306 I WC _ 6095 MONTANA AVE __. _ EL PASO .. TX 03 U 20 ~~~ 9816'S FG i ;4.2-Sep-951 17-Dec-03 2705306 _ WC 6095 MONTANA AVE EL PASO TX 04 U _ 11682~S 05 ~ ~ FG ~ ~: 12 Sep 9 ~~~_ 517 Dec-03 2706126 •I WC 16148 GATEWAY.E EL PASO TX 01 U 05 12032~S SF - ; T-Nov=85' . 17-Dec-03 2706126 WC j5148 GATEWAY E - EL PASO .: TX 02 U 20 12032iS;: SF 1-Nov-85 -17-Dec-03 2706126 'I WC 16148 GATEWAY E: EL PASO" TX `. 03 U 30 ~ ,~•v . 8068~S" SF ' .' 1=Nov-85 . "17-Dec-03 2706098 t 2706098 I 2706098 1 WC;6200 N MESA -._ WC X6200 ~N MESA' ~ WC :6200N MESA EL PASO ~EL PASO . EL PASO TX TX - TX 01 ~ ~ 02 03 U U U 05 i 11682~S _ __,_.. 20 ; _ 9816~S 30 ~ ~ ~. 9816S •FG "s. FG FG " ~25-Feb-991 _ ~ 25-Feb-99 25-Feb~ ~17-Dec-03 _ 17-Dec-03 17-Dec-03 2706098 WC :6200 N MESA EL PASO ' TX 04 U 45 ! ' 7950~S`. FG . 25-Feb-99~ 17-Dec-03 2700616 tWC :6398 DONIPHAN DR '' - EC PASO ` TX 01 U 05 '' 11682 S FG 1 Nov=93 17-Dec-03 2700616 WC mm~6398 DONIPHAN DR . ~ EL PASO •~ - TX 02 U -.~ _... 20 9684 S FG _.. _ww 1-Nov-93 _.._ ~..._._ 17-Dec-03 2700616 . IWC~~~ ~~6398 DONIPHAN ~DR~~ ~ _,. EL PASO ~ ~ ~ ~ TX 03 U 30 3 -~~~~7950~& FG~' ~ ~~1=No 3 ~:~17-De'c-03 2701534 IWC . "(650 N RESLER-DR : ...... __ -- EL PASO TX 01 U 30~~ 9816?S FG " 1-Feb-86 1Z-Dec-03 ~ 2701.534 WC X650 N RESLER DR' - EL PASO' TX 02 U ..~.. 05 ~ 9816'S`. FG _ 1~Feb-86s ,..__w.__..,._. 17-Dec-03 2701534 WC ?..16'50 N RESLERDR ` EL PASO ~ TX 03 U 20 3 9816 S" FG . 1 Feb'-86~ ~ 17-Dec-03 2~70531~5 _W C_ 680E REDD'RD `• EL PASO _ ' ' TX 01 U 30 } : 9816'S FG 5-Feb-96= 1:7-Dec -03 2705315 WC ~ :680 E REDD RD EL PASO TX 02 U 20 > ~~9816!S _ FG S-Feb -96; 17-Dec-03 2705315. 2701190 WC 680~EREDD RD - WC '6996'ESCONDIDO EL PASO EL PASO .: '~ TX ` TX " 03 01 _ U U 05 ' 9816'S 05 ~ 11682`S _ FG ~ 5 Feb-96 17 Dec-03 m_ .._..~ FG 1 A r 94 17 Dec-03 2701190. WC '6996 ESCONDIDO. EL PASO - TX 02 U . • 20 , 9816`S. p - FG I 1-Apr-94 17-Dec-03 2701190 WC ;6996 ESCONDIDO _. ~ EL PASO ' - : TX 03 U 30 7950rS FG ~ 1-Apr-94 17-Dec-03 2706333 .WC ,700~AMERICAS'AVE . N...-_ `EL PASO . - TX 01 U "' 05 _ • 1"1682~S' . ;FG ~ • 7-Oct-99, 1.7-Dec-03 2706333 1WC 700'AMERICAS:AVE ' ; .._ EL PASO " `• . -' ~ . TX 02 U 20 ~ 9816S ~ FG ; 7-Oct=991 1Z-Dec-03 2706333 IWC .700 AMERICAS AVE: - _ EL PASO : ~ TX -- 03 U _ _,.._...vY._.~_ 30 # ' • 9816'S _....._ ~___- ...._~, FG 7-Oct-991: 17=Dec-03 2706333 WC 7OO AMERICAS AVE EL PASO : TX 04 U 45 1 9816 S FG 7 Oct=99t 17-Dec-03 2700450. IWC '7100 N LOOP RD ~~ ' -_ - EL PASO - TX 01 U ._.m. _. _ 30 ! 7950 S __ . _ FG , -7-Apr-94 17= Dec-03 2700450 : WC ~7100'N LOOP RD. _ ~ • :::: EL PASO - TX 02 U . 05 , 11682 `.S __ _ FG ? -Apr-94~ 17-Dec-03 2700450 ' WC X7100 N LOOP RD : ~ .;: EL PASO .; TX: 03 _ U 20 _ 9816'S FG 7-Apr-941 17-Dec-03 2701429 c 2701429. 2701429 WC 17300 N MESA ST. ' . WC :7300 N MESA ST __ 'WC7300 N MESA ST__ EL PASO EL PASO EL PASO TX TX TX 01 02 03 U U_ U 30 i 1D152'~S - 05 ~ 1015_2 S 20 ' 10152~S ` ~~~.. SI ~ 1-Mar-821. 47=Dec-03 "- "~`"~ SI 1 Mar 82( 17-D_ec-03 SI ~ 1 Mar-82~ 17-Dec-03 _ 2706112 WC 17800 GATEWAY E EC PASO TX 01 U OS ' 11682~S FG i 17-Jun-98.17-Dec-03 2706112 WC j7800 GATEWAY E EL PASO TX 02 U 20 9816 S FG 17-Jun-98 17-Dec-03 2706112 :WC7800 GATEWAY E EL PASO TX 03 _ U 30 9816iS _ FG 17-Jun-98 17-Dec-03 ___ ___ _ 2706112 2701508 WC X7800 GATEWAY E IWC__ !8726 MONTANA AVE X EL PASO EL PASO TX TX 04 01 U U 45~ 9816' 20 , 9816 _ S ;5 FG FG 17-Jun-981 17-Dec-03 1-Febb-86~ 17-Dec-03 ~ 2701508 ?WC 8726 MONTANA AVE EL PASO TX 02 U 05 ( 9816 S FG ~ 1-Feb-861 17-Dec-03 2701508 WC ,8726 MONTANA AVE w._..._ _: _ EL PASO TX 03 U 30 9816 S FG I 1-Feb-861 17-Dec-03 2708743 _ 2708743 WC ;8855 N LOOP ..~ WC 8855 N LOOP _ EL PASO EL PASO TX TX -- 01 02 U U -_._-_....-...~~._...._ 30 d 9816 _______~„_ 05 9816 1S , 1S FG FG _,_._,_._...__.-...-,__.~.,..._...__..._ ' 1-Aug-88{ 17-Dec-03 __..._..~....M._- -._.. 1-Aug-88 17-Dec03 2708743 2706089 €WC ;8855 N LOOP ~WC !9497 DYER EL PASO EL PASO TX TX 03 01 ,U U 20 9816 05 ~ 12032i S S FG SA 1-Aug-88~ 17-Dec-03 1-Aug-88! 17-Dec-03 2706089 2706089 2701136 2701136 2701136 WC 19497 DYER___ ____ WC~ 19497 DYER __ WC x,204 S_MAIN _ _ V\fC~~~~ 1204 S MAiN __u WC ?204 S MAIN _ ------- EL PASO __ EL PASO ELLENSBURG __ ELLENSBURG __ ELLENSBURG TX TX WA WA WA 02 03 01 02 03 U_ U_ U ___ U U ~ 20 ~ 12032' 30 1 101281 05 ~ mm _9816 20 ~ ~ _9816 30 ! ~ 9816 S S S S !S SA SA FG p FG z FG 1-Aug-88` 17-Dec 03 1-Aug-88~ 17-Dec-03 30-Apr-95't 17-Dec-03 _30-A_pr-95 ~17-Dec-03 30-Apr-951 17-Dec-03 2701452 i 2701452 1 '2701452 WC 12415 GRIFFIN AVE WC 2415 GRIFFIN AVE __, ----- ------- -- WC :2415 GRIFFIN AVE ENUMCLAW ENUMCLAW _ - ENUMCLAW WA WA WA 01 02 -- 03 U U - - U { __ 30 3 9816 20 9816 ___-- 05 ; 9816 S iS S FG FG FG 21-A r-95 17-Dec-03 ~ 21-Apr-951 17-Dec-03 _w..~._ . _.... .___ _ 21-Apr-95; 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule ` 12/17/06-07 ~ __ _ West Coast Region _ as of 12/13/06 _ ___ LOC. # Region ADDRESS ____ ~ CITY STATE UST # CAPACITY GALLONS INSTALL DATE RETRO DATE 2701546 2701546 3 WC X WC X 10255 SE 240TH ST _______ 10255 SE 240TH ST KENT _ __ KENT WA WA 01 02 U U 30 i ~ 05 w 9728 _._.~ ~y._._ 9728 S 'S FG_I 1-Mar-85 FG ~ 1-Mar-85 e 17-Dec-03 .__.r_-..._ , 17-Dec-03 2701546 WC 10255 SE 240TH ST KENT WA 03 U 20 I ~ 9728 tS FG . 1-Mar- 5 _ 17-Dec-03 2701602 . 2701602 2701602 = WC 1 WC ~ WC ~ 20727 108TH AVE SE ___ 20727 108TH AVE SE 20727 108TH AVE SE KENT KENT KENT _ WA WA WA 01 02 03 U U U 05 30 ' 20 9728 _. 9728 ~~ 9728o FS S S FG 4 _1 Apr 85 FG 1-Apr-85 p FG 1-A r-85 + 17-Deo-03 ~ 17-Dec-03 ~__________~ 17-Dec-03 2708878 WC _____. ~_, 8007 STATE AVE MARYSVILLE WA 01 U 20 , v~~98161 S ~ _ FG k 1 TSep-87~ 17-Dec-03 ~ 2708878 i WC~~( 8007 STATE AVE MARYSVILLE WA 02 U 05 ! m 9816~ S FG ~ 1-Sep 87 _.e _,_ = 17-Dec-03 2708878 ' WC 8007 STATE AVE MARYSVILLE WA 03 U 30 ' ~.~ 981tiI S FG ; 1=Sep-87~ 17-Dec-03 2708567 - WC ~ 1700 132 ST SE ~ MILL CREEK , : WA 01 U 20 9816 S FG 1-Oct 88 17- Dec-03 2708567 " 2708567, WC ; ~WC 1700 132 ST SE . <> 1700 132 ST SE MILL CREEK MILL CREEK . _ WA WA 02 03 U U 05 ~ 30 € : v~ 9816 98,16` ~S .S. FG 1„Oct 8 FG x 1-Oct 88 _ 17 Dec-03 97-Dec-03 2705925 ~ WC ( 9061 DELRIDGE WAY SW. SEATTLE ~ WA 01 U 20 80251 D SF 1-Jan-91 1..1:7-Dec-03 2705925 ~ W C ; 9061 DECRIDGE WAY SW ~ SEATTLE WA 02 U 05 i "10058 dD ~"'"-"~"`~'""""" SF + . ~1-Jan-91 ;17-Dec-03 2705925 WC ; ,~.m__.. 9061 DELRIDGE WAY SW SEATTLE.'. _ WA 03 U 30 r 8025 ~ D SF 1 1 Jan 91 17-Dec-03 2705925 2708795 WC i ~WC 9061 DELRIDGE WAY SW 4704 OAKES ST,_SUITE 100 SEATTLE TACOMA- WA WA 04 01 U - U 45 ¢ 30 . ,. __ 6048 98161 D :D. ,_ ~.._ _,,...-,_____~ SF ; 1 Jan 91 17-Dec-03 FG 1-Apr-89; 17-Dec-03 2708795 WC 14704 OAKES ST, SUITE 100 TACOMA WA 02 U 05 , ,; 9816; :D FG ~ 1-Apr-89„ 17-Dec=03 2708795 WC , 4704~OAKES ST, SUITE 100' TACOMA WA 03 U 20 # ~ 9816 ~ ~D FG 1 1 Apr 891 17 Dec-03 2706000 WC 924 S HWY 85 : ~ SOCORRO NM 01 U 05 ~ .~ 12000 S FG ~ 1-Oct-96; 17-Dec-05 2706000 WC 924 S HWY 85 SOCORRO NM 02 U 30 8000 S FG ' 1-Oct-96'' 17-Dec-05 2706000 WC _ 924 S HWY 85 _ 6000RR0 NM 03 D 45 ~ 10000 S FG 1-Oct-96y 17-Dec-05 2706001 WC __ 801 E THORPE RD " ' LAS CRUCES NM 01 U 05 .- -12000 S __ FG ~. 1-Jan-00 17-Dec-05 2706001 WC _ ~ 801 E THORPE RD' LAS CRUDES ': NM ' 02A U 05 _ 15000 S FG '1-Jan-00 - 17-.Dec-05 2706001 WC _ 801 E THORPE RD' ~_ : LAS.CRUCES NM 02B D 30 ~ ;;6000 S' FG 1-Jan-00 17-Dec-05 2706001 VVC _ _ 801E THORPE.RD , ~ LAS CRUCES NM 03 U 45 8000 S FG .' 1-Jan-00 17-Dec-05 '2706003' WC _ 29955 HAUN`ROAD ~_ SUN CITY CA 01 U 05 20000 .Dr SF 1'-Feb-02 1:7-Dec-05 2706003 WG' 29955 HAUN'ROAD SUN CITY- ... CA 02A U 30 ~ '15000 D SF `.1=Feb-.02 1 D 2706003' WC ` 29955 HAUN ROAD :: I SUN CITY. CA 026 D 45 _ "~5000 D SF ~ 1=Feb-02 1 7- ec-05 7-Dec-05 G:\datalWCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 UNIFIED PROGRAM INSPECTION CHION CHECKLIST ,: ~ ~:.~ r~~ v.~,,~~ ,~ ,., ~.... . ,r ... ,, ... H ._ .~ .. ... ... .SECTION 1: Business Plan and Inventory Program ~. BARERSFIELD FIRE DEPT s p Prevention Services ~~ta 900 Truxtun Ave., Suite 210 ARtI Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NA E NSPECTION DATE NSPECTION TIME ADDRESS HONE NO. O OF EMPLOYEES / ~ ~ FACILITY CONTACT USINESS ID NUMBER ~ ~ n 15-021- (i[J Section 1: Business Plan and Inventory Program ^ ROUTINE ED ^ 'JOINT AGENCY ^ MULTI-AGENCY ~ ^ COMPLAINT ^ RE-INSPECTION C V (c_c°'nPl1efCS) OPERATION V=Violation COMMENTS "° APPROPRIATE PERMIT ON HAND ~'' . ^ BUSInBSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ENT'D ,~ A ~ ~. ~~ 2006 ~+ ^ CORRECT OCCUPANCY ~'' ^ VERIFICATION OF INVENTORY MATERIALS ~v ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ 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 ~/^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ,,~~PtO' EXPLAIN: _ ___ G -~z-~=~'---- ------ DU TI/O~NS~ REGARDING/THIS INSPECTI~O7N? PLEASE CALL U8 AT (881) 528-3979 Inspector (Please Print) Fire Prevention / 1'~ In / Shift of Site/Station # White -Prevention Services Yellow - Station Copy Pink -Business Copy FD20~9 (Rw. 02!05) ,',f~4~'. '~~~; CITY OF BAKERSFIEL.U FIRF~ DEPARTMENT ~~ ~ ~ M~ OFFICE OF ENVIRONMEN'CAL SERVICES "~ .y.' UNIFIED PROGRAM INSPECTION CHECKLIST \~~_w ~R/,II'~1 1715 Chester Ave., 3r`' F'loor, Bakersfield, CA 93301 .~~ii FACILITY NAME ~ 1e.~1~ /~ INSPECTION DATE~~/I ~~ Section 2: Underground Storage Tanks Program ^ Routine ~'ombined ^ Joint Agency Type of Tank lea wlol~ u~ Act Type of Monitoring _ ^ Multi-Agency ^ Complaint ^ Re-inspection Number of Tanks 3 Type of Piping ~r~bl~t~.4i OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on tilt ~~~ ~~ ~' Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No . Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on the with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overtill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: ~jQ~~,7.Q- Office of Environmental Services (661) 326-3979 white -I=nv. Svcs. Pink - F3usiness Ci~ry z~ossos UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION HAZARDOUS MATERIALS BUSINESS PLAN f CERTIFICATION FORM 2006 Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials Business Plan (HMBP) certification described below is hereby submitted for the following facility: Facility Name: Circle K Store #2708606 Facility Street Address 1030 Oak Street City: Bakersfield Zip: 93304 I have personally reviewed the Hazardous Materials Business Plan currently on file with the CUPA dated 3/18/2004 and certify that: (Check one.) © The Hazardous Materials Business Plan is complete and accurate and no revisions are necessary* (See below for details); or Revisions to the Hazardous Materials Business Plan are necessary. The following new or revised form(s) and/or information are enclosed to reflect the necessary changes: Business Activities form Business Owner/Operator Identification form Hazardous Materials Inventory form(s) ~f V~ A p~ Site Map form 1 8 2046 Emergency Response Plans and Procedures Employee Training Program *By checking the top box on this form, you are certifying that: a) The information contained in the annual inventory forms most recently submitted to the administering agency is complete, accurate, and up-to-date; and b) There has been no change in the quantity of any hazardous material as reported in the most recently submitted annual inventory forms; and c) No hazardous materials subject to the inventory requirements are being handled that are not listed on the most recently submitted annual inventory forms; and d) There have been no substantial changes in the facility's hazardous materials operations which would require revision of the current HMBP; and e) The most recently submitted annual inventory forms contain the information required by Section 11022 of Title 42 of the United States Code. OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my inquiry of those individuals responsible for obtaining the information reported above, I believe that the submitted information is true, accurate, and complete. I understand that a revised HMBP must be submitted within 30 days of any change in this facility's storage or handling of hazardous materials which would require u _,d ing of the Signature of Owner/Operator: Ti Name of Owner/Operator (prin Date - Return all forms to: Bakersfield Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield CA 93301 661-326-3979 Business Plan Certification 2006 27osso6 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page ~ of ~i I. FACILITY IDENTIFICATION FACILITY ID# 1 EPA ID# (Hazardous Waste Only) 2 CAL000278511 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Store #2708606 1. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator;ldentification page (OES Form';2730). Does your facility.:. If Yes; please complete these pages of the UPCF.:. A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the li h ld d l f ©YES ^ NO 4 ~ HAZARDOUS MATERIALS INVENTORY - e Federal thres quantity or an extremely hazar app cab o ous CHEMICAL DESCRIPTION(OES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) ~ES ^ NO 5 ~ UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ~ YES ©NO 6 ~ UST FACILITY UST TANK (One per tank UST INSTALLATION -CERTIFICATE OF COMPLIANCE(one page per tank)(Formedy Form C) 3. Need to report closing a UST? ~ YES ©NO 7 ~ UST TANK (closure portion-0ne page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ~ YES ©NO 8 ~ NO FORM REQUIRED TO CUPAS ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ~ES ~ NO 9 ~ EPA ID NUMBER-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted ~ YES ©N010 ~ RECYCLABLE MATERIALS REPORT recyclable materials (per HSC § 25143.2)? (one per recycler) 3. Treat hazardous waste on site? ~ YES ©N011 J ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L) 4. Treatment subject to financial assurance requirements (for Permit ~ YES ©N012 ~ CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE(FormerlyDTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ~ YES ©N013 ~ REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION(Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ~ YES ©N014 ~ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2708606 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page ~~f ~ I. IDENTIFICATION 1 BEGINNING DATE 100 ENDING DATE FACILITY ID# 101 ~ 01 /01 /2006 12/31 /2006 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE 102 Circle K Store #2708606 661-861-8048 BUSINESS SITE ADDRESS 103 ' 1030 Oak Street CITY 104 CA ZIP CODE 105 Bakersfield i 93304 DUN BRADSTREET 106 SIC CODE (4 digit #) 107 10-5457662 5541 !COUNTY 108 Kem BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 110 Circle K Stores, Inc. 866-805-4357 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 112 Circle K Stores, Inc. (951) 270-5193 OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 CITY 114 STATE 115 ZIP CODE 116 Corona CA 92879 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 118 Lorranie Soffe 951-270-5183 CONTACT MAILING ADDRESS 119 495 E. Rincon, Suite 150 CITY 120 STATE 121 ZIP CODE 122 Corona CA 92879 PRIMARY IV. EMERGENCY CONTACTS SECONDARY NAME 123 NAME 128 Service Contact Center Justin Peterson TITLE 124 TITLE 129 24 Hours District Manager BUSINESS PHONE 125 BUSINESS PHONE 130 866-805-4357 661-978-4822 24-HOUR PHONE 126 24-HOUR PHONE 131 866-805-4357 661-978-4822 PAGER# 127 PAGER# 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of those individuals responsible for obtaining the information, 1 certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OP RAT D E 1 NAME OF DOCUMENT PREPARER 135 RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. E OF SIG (pri t) 136 TITLE OF SIGNER 137 Lorraine Soffe Compliance Manager UPCF (1/99 revised) 167 OES FORM 2730 (1/9 APS 1 CALIFORNIA ANNOTATED SITE BUSINESS NAME CIRCLE K STORE #2708606 BUSINESS ADDRESS 1030 OAK STREET BAKERSFIELD MAP DATE 03/16/2004 ZIP CODE 93304 PREPARED BY: ~~s~~x GROUP &NG DRAWING SCALE 1 "= 30'- 0"f A B C D E F G H MAP SYMBOLS ELECTRONIC MONITORING POINTS AM/PM MINI MART O ELECTRICAL PANEL SHUT-OFF SUMP SENSOR NORTH 1 AO ANNULAR SENSOR G NATURAL GAS O AUTOMATIC TANK GAUGE OW WATER SHUT-OFF PARK WAY P O EMERGENCY PUMP SHUT-OFF TMA ~~ TANK MONITORING ALARM TELEPHONE 2 ~ ~ FIRST AID KIT ' - - - - - - - - - ~ FIRE EXTINGUISHER ® STORM DRAIN SANITARY SEWER STAGING AREA EVACUATION/ I X HMMP HMMP, AND MSDS I MSDS LOCATION 3 , J ~ ~ FIRE HYDRANT -x~-~c- FENCE ~ 12 X 5 GALLON ~ z ~ ERE O EMERGENCY RESPONSE EQUIPMENT/ABSORBENTS ~ PROPANE ~ ~ O ABOVEGROUND f- W I ~~~~ S T W ~ I~ JI STORAGE TANK UNDERGROUND 4 7Q ~ S ~~ ~\ ~ OQ ~ OP _ STORAGE TANK ~~~ lQ ~ Cq~~ A Q L-J O GASOLINE (n I ~ ~ Q ~\ ~ ~ ~ R/R ~ (FLAMMABLE LIQUIDS) ~ I ~OQ~ C"9( O O \ CASHIER I O DIESEL FUEL O ~ ` ~ /~ \~ C~~ O l~ \ ~ ~7 { ~~.1 CO ~ O (COMBUSTIBLE LIQUIDS) MOTOR OILS & LUBRICANTS O ~~ G MSDS UP (COMBUSTIBLE LIQUIDS) O Z TMA O CO ( 5 z COMPRESSED GAS) } A `~J' ERE O PROPANE (FLAMMABLE LIQUID) ~ J I ~ ~ X OA ANTIFREEZE/COOLANTS Q ~ I ~ I O WASTE OIL (FLAMMABLE LIQUID) CW CAR WASH PRODUCTS 6 O - - - - v O ALLEY 7 JOHN'S BURGERS RESIDENTIAL EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK MINOR INCIDENT: (less than 5 gallons 2708606 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2• SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5• NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Ca119-1-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 1030 Oak Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who maybe injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Justin Peterson 951-270-5163 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACII~ITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805 -43 57 Secondary: Justin Peterson District Manager Day: 661-978-4822 24-hour: 661-978-4822 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by the a encies in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-8911 c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours} SpilURelease Response Procedures for Carbon Dioxide (C02) The refrigerated liquid COZ used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without waxning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause burns, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dia1911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\Tosco\zFORMS\co2-Spill Plan.doc Spill/Release Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added for fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Spill or Release: In the event of a release from the propane tank/cylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\ConocoPhillips\zFORMS\Propane-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS ~c PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: 1-CAHSERI, 1-NORTH SIDE OF BUII.DING ~c TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: STORAGE AREA qtr ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: STORAGE AREA ~k WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: SOUTH SIDE OF LOT ~c NATURAL GAS SHUT-OFF: If your facility has natural gas, it maybe necessary to shut-off the flow in case of an emergency. Location: SOUTH SIDE OF BUILDING ~c PROPANE/LPG SHUT-OFF: If your facility has propane or liquefied petroleum gas, be sure to turn off the manual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dial 9-1-1 as necessary. EMERGENCY EQUIPMENT ~c FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: 1-PUMP ISLANDS, 1-FRONT DOOR, 1-CASHIER ~-c SPILL/ CLEAN UP KIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: SPILL KIT IN STORAGE AREA ~c RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE AREA Shovel: STORAGE AREA Gloves: STORAGE AREA Goggles: STORAGE AREA * FIRST AID KIT: Use for minor incidents and treatment. Location: STORAGE AREA * EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: SOUTH AT ALLEY ACROSS OAK STREET ~c ENVIRONMENTAL DOCUMENTS / HMMP MSDS SHEETS: Location: STORAGE AREA EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: MERCY SOUTHWEST HOSPITAL 2215 TRUXTON AVE BAKERSFIELD 661-632-5281 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel): For further information, refer to the MSDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION Breathing): Remove victim from source of exposure and into fresh air. If victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIIZST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by.• Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last Updated: 28-Mar-06 Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan _Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: * An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. 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