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HomeMy WebLinkAboutBUSINESS PLAN 10/31/2006,,~, ~~ ~. i I~ ~ ~~ MIKES FOOD & LIQUOR #3 ~, !i 2300 PANAMA LN '~ ' a • UNIFIED PROGRAM INSPL~CT~I~ON CHECKLIST1 a E R S F, o Prevention Services _ __ 900'IYuxtun Ave., Suite 210 ~~ . ____.~~~ _ _ _.__ __ V _ _ __.__._._- _.. _.mm :~ ~ -_ FIRE Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ~' "'~rM ' Tel.: (661) 326-3979 U ~ Fax: (661) 872-2171 FACILITY NAME 1N1\~QS 'oo~ ~ I QU.O~ ~''~ INSPECTION DATE 'Q 31 Oso INSPECTIQN TIME ~~~ ADDRESS ,/~ HONE NO, NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUM615-U2~- ~~ , / " -;Section 1: Easiness P~aa and Inventory Progrsm ^ ROUTWE ~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT _ ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS APPROPRIATE PERMIT ON HAND ~~ ~e~, ~-f'e ' ~w ~aJ[ WU~~- ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~ } .>' . .~ ^ VERIFICATION OF INVENTORY MATERIALS ~ ~^ ' U ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ ~- VERIFICATION OF MSDS AVAILABILITY Q _ Q y~ F~Ci ~^ ~ T S u ` 1, ` 3/ ~V ~ 9 ,_ ^ ~ VERIFICATION OF HAZ MAT TRAINING ~ ~~ ra\h~n ~~cQ >-~) ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND • ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~~~~~ Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) ^ YES - ~ NO White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 A ~. INSPECTIONS B E R S F I L D S BUSINESS PLAN & ~RrM r INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST • FACILITY NAME: rn~ ~E S 'FdO~ °- ~-I 4`" ~~~'~ Section 2: Underground Storage Tanks Program INSPECTION DATE: ~ 3~ ~ ~ ^ Routine Combined ^ Joint Figency ^ Multi-Agency Co plaint ^ Re-Inspection Type of Tank ~ ~ ~°~I C1e~l Number of Tanks Type of Monitoring !~C G yJ Type of Piping Dsz.ESS K 2c :D ~ OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current L"~-.~~ ~/-+~'rs~ Certification of Financial Responsibility 1~[~-1 i .~ 1~~ l` 1 h ~-Lk- ~"- Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations ~o Has there been an unauthorized release? ^ Yes ~iOniO 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 /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: ~ ~rG~-~-~'~'~T ~' ~_ Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services 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 Business Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) t}, ,;, + MIKES FOOD & LIQUOR 3 _______________________________ SiteID: 015-021-001141 + Manager Location: 2300 PANAMA LN City BAKERSFIELD BusPhone: (661) 836-3362 • Map 123 CommHaz High Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 13 SIC Code:5541 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DALJINDER CHAUHAN / OWNER / Business Phone: (661 )836-3362x Business Phone: ( ) - x 24-Hour Phone (661) 836-3362x 24-Hour Phone ( ) - x Pager Phone (661) 203-8050x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : DALJINDER CHAUHAN Phone: (661) 836-3362x MailAddr: 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Owner DALJINDER CHAUHAN Phone: (661) 836-3362x Address 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: ~ Emergency Directives: ~ ~ PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK ` PROG U - UST Based on my inquiry of those individuals responsible for obtaining the information, 1 certify ENT,D n under penalty of law that I have personally H h~ ~ O examined and am familiar with the information 1" ~~OC submitted and believe the information is true, U accurate, and complete, ~~ d;fi"IA ~~~C.l~ Si ature Date -1- 04/03/2006 ._I11-Ir~IC11 ~~AA~AwA 11-IZ'~C~TIAfII ~`L~Cf~I[1 f@T SECT9~N 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAM INS CTI N DATE INSPECTION TIME _~~~~ ~~ ~d _~_~_~ o ~_______ ___- _-___ __ ______.,-_ _--_ --_- -_ . -__ _ _ ~a~~~~ __ __ __ __ -____ ___ ADDRESS PHO E No. of Employees ------- ~ 3 0 ~ --~ur~c~ ~~__~.K~ --- .------ ---- ---------- --- ---- --- - _ _- - ----- - -- -- FACILITYCONTACT Business ID Number I5-021- Section 1: Business Plan and Inventory Pn~gram ^ Routine ombined D Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection C V \V=Vioarilonnce~ OPERATION COMMENTS ~ ^ APPROPRIATE PERMIT ON HAND ~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ------------- ~^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ V I ERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ---- ^ VERIFICATION OF LOCATION LW L^ PROPER SEGREGATION OF MATERIAL t!~ ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF FIAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES C>I/ ^ EMERGENCY PROCEDURES ADEQUATE ILJI/ ^ C.ONTAINERS PROPERLY LABELED ---- -.. _ ...-- - -- - -...-- _ -- ----_ .- ---- -- ^ C~Y/ 1'10USEKEEPING t ~ x c ~ ~- ~ ---- ---~---~----_-_----_------- --_---------- ----- ----- ^ L11/ TIRE PROTECTION . - -- ---- _ -_ _ ----_----_--- - -_----- -_ ---___ 1r / ++ ~^ SITE DIAGRAM ADEQUATE 8c ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTIONS ARDING IS SPECTION? PLEASE CALL US AT (66~~ 3ZG-3979 f Inspector Ba a No., White -Environmental Services Vallow -Station Copy Business Site Responsible Party Pink -Business Copy ~~iw4~' ~ "~~~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT , ;6 ~; OFFICE OF ENVIRONMENTAL SERVICES ~`A \= y~~ ~~ UNIFIED PROGRAM INSPECTION CHECKLIST _w ~gti,,~' ,~~~'~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME~/l.i1 Ce~ S I'P'-~~ ( ~" [ ~t1~~ INSPECTION DATE S Section 2: Underground Storage Tanks Program ^ Routine ~mbined~ ^ Joint Agency ^Multi-Agency ~ ^ Complaint ^ Re-inspection Typc of Tank U.1 K Numycr of Tanks Type of Monitoring ~ L/Ll. Type of Piping ~CUF OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit tees 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 SIZES 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 overfill/overspill protection? C=Compliance =Violation Y=Yes N=NO Inspector: Oftice of Environmental Services (805) 326-3979 White -Env. Svcs. Pink -Business Copy Business Site Responsible Party ®RRECTION NOTICE 0125 BAKERSFIELD FIRE DEPARTMENT Location I~ ~~ s r~ ~1 ~ ~ t c(~ ~}~ ~ Name X30© ~la r~.~,.~ti You are hereby required to make the following corrections at the above location: Cor. No. 0 ( a-` C / r `r ~ GL~2L { . C-_J c. o ~ rcc~~o -~ ~ 1 B ~. -1 ___- ~' ~ Completion Date for Corrections Date (~- ~S Inspector FD 1950 326-3951 ~, . -~ ~ MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 Manager DALJINDER CHAUHAN Location: 2300 PANAMA LN City : BAKERSFIELD BusPhone: (661) 836-3362 Map 123. CommHaz Extreme Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5541 DunnBrad: Emergency Contact / Title Emergency Contact / Title DALJINDER CHAUHAN / OWNER / Business Phone: (661) 836-3362x Business Phone: ( ) - x 24-Hour Phone (661) 836-3362x 24-Hour Phone ( ) - x Pager Phone (661) 203-8050x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact DALJINDER CHAUHAN Phone: (661) 836-3362x MailAddr: 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Owner DALJINDER CHAUHAN Phone: (661) 836-3362x Address 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - PROG T - HAZMAT ABOVEGROUND STORAGE TANK ep' c~ ENT'D J U L c) O ZOO7 PROG U - UST Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar wish the information submitted and believe the infiormation is true, accurate, and complete. ~~ Signature Date -1- 07/12/2007 :r F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ ---- STORAGE CONTAINER DATA (UST FORM A) - Last Action Type: FACILITY/SITE INFORMATION Business Name: MIKES FOOD & IQUOR 3 Cross Street Cot-~~'y S'~7~ Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper ICC Nbr: PROPERTY OWNER INFORMATION Name .~191.~1i"iJGiZ C11~1+~~~9,N Phone: ((6)) ~~3 -~~J~x Address: F71~7 JtdLl~H~9MP-ro 9R. City (S A KER.PF>Ey-~ State : C/9L Zip : X33/3 Type INDIVIDUAL TANK OWNER INFORMATION Name JAS /~ ~30v C Phone : ( ) - x Address: City State: Zip: Type INDIVIDUAL BOE UST Fee# UNKNOWN Financ'1 Resp: STATE FUND Legal Notif Business Mailing Address Date:06/08/1999 Phone: (816) 662- x Name:DALJINDER S CHAUNHAN Ttl:OWNER State UST # 1998 Upg Cert#: 00816 -2- 07/12/2007 F MIKES FOOD & LIQUOR 3 ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001141 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name..., SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 18000.00 FT3 Hi UNLEADED GASOLINE F IH DH L 10000.00 GAL UnR DIESEL F IH DH L 5000.00 GAL UnR UNLEADED PREMIUM GASOLINE' F IH DH L 5000.00 GAL UnR -3- 07/12/2007 -4- 07/12/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE ~ Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF PROP CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 18000.00 FT3 18000.00 FT3 18000.00 FT3 rit~c~xtcLUU~ ~uinr~lv~lvl~ oWt. RS CAS# 100.00 Propane ~ Yes 74986 ntic~s-u~cL xa ar~aari~lyl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE STORE, CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~•Ambient ~ Ambient -~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 6000.00 GAL ru~uruu~v~a ~.vi•trvtvnlVtS %Wt. RS CAS# 100.00 Gasoline No 8006619 rlti[~ti1CL ri JJL~~7.71.1P~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR -5- 07/12/2007 ~ F MIKES FOOD & LIQUOR 3 ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME DIESEL Location within this Facility Unit E SIDE STORE SPLIT TANK STATE TYPE PRESSURE Liquid TMixtur~mbient SiteID: 015-021-001141 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: , CAS# 68476-34-6 TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5000.00 GAL 5000.00 GAL 3800.00 GAL ritiGliCCLVUJ 1,V1~lYV1V~1V1J %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 I1tiGri2CL riJ JP~JJl"1L~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED PREMIUM GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE STORE SPLIT TANK CAS# 8006-61-9 STATE TYPE PRESSURE" TEMPERATURE ~~ CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient I UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5000.00 GAL 5000.00 GAL 3000.00 GAL rariuruu~vvo I.VPlr V1V 1=,1V1J -- %wt• Rs cAS# 100.00 Gasoline No 8006619 r11i[.irilCL riJ JI;JJl"11;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR -6- 07/12/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 06/14/1999 CALL 911. ,._ P~lll~JllJyCC 1VVl.1l / P~VdC:Udl.1Ul1 Public Notif./Evacuation YELL AT THEM TO LEAVE. 06/14/1999 Emergency Medical Plan 11/27/2000 NEAREST HOSPITAL OR CALL 911. -7- 07/12/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/03/2006 ~ STICK UNDERGROUND STORAGE TANK, AUTOMATIC SHUT-OFFS. Release Containment 04/20/2006 USE ABSORBENT MATERIAL, MOP AND BUCKET, SHOVEL ABSORBENT MATERIAL INTO DRUM. Clean Up 04/03/2006 WITH SMALL SPILL USE KITTY LITTER. WITH LARGE SPILL CALL FIRE DEPARTMENT. PLACE MATERIAL INTO DRUM AND HAVE HAULED OFF. v~.itci iccavui~c til:l,lVCtl.1V11 -8- 07/12/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ orc ~ i a i na ~ ai u~ Utility Shut-Offs GAS - NONE ELECTRICAL - BEH ICE CREAM REF N WALL STORE WATER - UNDER S SIDE GLASS WINDOW SPECIAL - NONE LOCK BOX - NO 02/28%2007 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER L SIDE OF ENTR. FIRE HYDRANT - SE CRNR OF PROP. 12/29/2006 Building Occupancy Level _ 04/03/2006 1 EMPLOYEE -9- 07/12/2007 ~, F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 12/29/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: NO SMOKING IN THE AREA OF THE GASOLINE PUMP; AVOID PROLONGED AND/OR REPEATED SKIN CONTACT; PREPARE.ABSORBENT MATERIAL FOR SMALL SPILLS; IN CASE OF LARGE SPILL OF GASOLINE, POWER OFF, EVACUATE PREMISES, NOTIFY 911. rayc c Held for Future Use nciu ivi ru~uiC u5~ -10- 07/12/2007 .,i. MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 Manager '~~l~-~1 ~eJ~)Z C~1~U'~i~~ BusPhone: (661) 836-3362 Location: 2300 PANAMA LN Map 123 CommHaz Extreme City BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5541 DunnBrad: Emergency Contact / Title Emergency Contact / Title DALJINDER CHAUHAN / OWNER / Business Phone: (661) 836-3362x Business Phone: ( ) - x 24-Hour Phone (661) 836-3362x 24-Hour Phone ( ) - x Pager Phone (661) 203-8050x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact DALJINDER CHAUHAN Phone: (661) 836-3362x MailAddr: 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Owner DALJINDER CHAUHAN Phone: (661) 836-3362x Address 2300 PANAMA LN State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK PROG U - UST ~~ in airy of those individuals i ~ FED 2 6 y ~,`~n, ~~ ~r o~,ata;ning the information. I cert have personalty X007 . ;~-,lea penalty of law that I m fam~Uar with the information e , axamined and a the information is tru d n~ a edand o npteiP MC -i~14' G f,,r,. ~~ ~ Date ~~ i ~~iy~;ture -1- 02/05/2007 t 1 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: MIKES FOOD & LIQUOR 3 Cross Street Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper ICC Nbr: PROPERTY OWNER INFORMATION Name Phone: Address: City State: Zip: Type INDIVIDUAL TANK OWNER INFORMATION Name Phone: Address: City State: Zip: Type INDIVIDUAL - x - x BOE UST Fee# UNKNOWN Financ'1 Resp: STATE FUND Legal Notif Business Mailing Address Date:06/08/1999 ~ Phone: (816) 662- x Name:DALJINDER S CHAUNHAN Ttl:OWNER State UST # 1998 Upg Cert#: 00816 -2- 02/05/2007 F MIKES FOOD & LIQUOR 3 ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001141 ~ By Facility Unit ~ Fixed Containers on Site ~ .Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 18000.00 FT3 Hi UNLEADED GASOLINE F IH DH L 10000.00 GAL UnR DIESEL F IH DH L 5000.00 GAL UnR UNLEADED PREMIUM GASOLINE F IH DH L 5000.00 GAL UnR -3- 02/05/2007 -4- 02/05/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF PROP CAS# 74-98-6 ~GaSATE TYPE PRESSURE ~ TEMPERATURE ~~ CONTAINER TYPE TPure Above Ambient i Ambient I ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest 18000100rFT3 Dai118000100m FT3 I Dai118000r00e FT3 nti~r-ucL~ua ~:vinrvlv~lv~l~ $Wt. RS CAS# 100.00 Propane Yes 74986 ru~~~ucL r~aa~aain~lvlJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE STORE CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~mbient ~ Ambient ~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 6000.00 GAL r111[.~t1RLVVw7 l.Vl•lr V1V P~1V 1 $Wt. RS CAS# 100.00 Gasoline No n 8006619 rrCiL~tiiCL tiJ J1'.~J J1"1LilV1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR -5- 02/05/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE STORE SPLIT TANK CAS# 68476-34-6 Liquid TMixture ~ Ambient~E ~ AmbientT~E ~ UNDER GROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5000.00 GAL 5000.00 GAL 3800.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 riAGKKL L~~~L'~~51~1L"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED PREMIUM GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E SIDE STORE SPLIT TANK CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5000.00 GAL 5000.00 GAL 3000.00 GAL P1HGt3CCLVU~J 1.V1~lYUlV~1V 1.7 %Wt. RS CAS# 100.00 Gasoline No 8006619 ritiGtitCL ti. 7.7P~.771°1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / UnR -6- 02/05/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/14/1999 ~ CALL 911. ,_ Ldll~JlVyCC _1VV 111 ~ L' VCII: UCLL1V11 Public Notif./Evacuation YELL AT THEM TO LEAVE. 06/14/1999 Emergency Medical Plan 11/27/2000 NEAREST HOSPITAL OR CALL 911. -7- 02/05/2007 F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/03/2006 ~ STICK UNDERGROUND STORAGE TANK, AUTOMATIC SHUT-OFFS. Release Containment 04/20/2006 USE ABSORBENT MATERIAL, MOP AND BUCKET, SHOVEL ABSORBENT MATERIAL INTO DRUM. Clean Up 04/03/2006 WITH SMALL SPILL USE KITTY LITTER. WITH LARGE SPILL CALL FIRE DEPARTMENT. PLACE MATERIAL INTO DRUM AND HAVE HAULED OFF. V1.11C1 iCC5VLL1.l:C til:l.lVdl..LV11 -8- 02/05/2007 P MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JiJCC:1d1 ridGdLC,lS Utility Shut-Offs 12/29/2006 A) GAS - NONE B) ELECTRICAL - BEH ICE CREAM REF N WALL STORE C) WATER - UNDER S SIDE GLASS WINDOW D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER L SIDE OF ENTR. FIRE HYDRANT - SE CRNR OF PROP. 12/29/2006 Building Occupancy Level 04/03/2006 1 EMPLOYEE -9- 02/05/2007 ., :, F MIKES FOOD & LIQUOR 3 SiteID: 015-021-001141 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 12/29/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SL7NIMARY OF TRAINING PROGRAM: NO SMOKING IN THE AREA OF THE GASOLINE PUMP; AVOID PROLONGED AND/OR REPEATED SKIN CONTACT; PREPARE ABSORBENT MATERIAL FOR SMALL SPILLS; IN CASE OF LARGE SPILL OF GASOLINE, POWER OFF, EVACUATE PREMISES, NOTIFY 911. rayc ~ nciu tvt ru~.uic vac nci~.a tvi ru~ul.c ~5c -10- 02/05/2007