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+ PEP BOYS 677 =__________~____________________________ SiteID: 015-021-000926 +
Manager AL GONZALEZ BusPhone: (661) 834-6858
Location: .4605 PLANZ RD Map 123 CommHaz High
City BAKERSFIELD Grid: O1C FacUnits: 1 AOV:
CommCode: BFD STA 07 SIC Code:5531
EPA Numb: CAL000024620 DunnBrad:
Emergency Contact- / Title / Emergency Contact / Title
KEITH CASH / MANAGER BILL WATERS / DIST MANAGER ~
Business Phone: (661) 834-6859x Business Phone: (661) 834-6858x
24-Hour Phone (661) 664-4739x 24-Hour Phone (877) 344-3779x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire Press React ImmHlth DelHlth
Contact ENVIRONMENTAL DEPT Phone: (215) 430-9017x
MailAddr: 3111 W ALLEGHENY AVE State: PA
City PHILADELPHIA Zip 19132
Owner PEP BOYS MANNY MOE & JACK Phone: (215) 430-9017x
Address 3111 W ALLEYHENY AVE State: PA
City PHILADELPHIA Zip 19132
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ABOVEGROUND STORAGE TANK
ENT'D AUG 1 l 2006
gd9Q~ on ^'Y Inquiry of those individuals
respgnpl~lo igr abtaining the information, I certify
under pen®lty Qf law that I have personally
examined anr~ am famllier with th® Information
submitted aryl bellQve the Information is true,
accurate, and complete.
Signature Date
~° ~b~~
~y~~
-1- 03/09/2006
_ __ ___
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Unified Program (UP) Form
CONSOLIDATED CONTINGENCY PLAN
SITE MAP
A site plan and storage map must be included with your Contingency Plan. For relatively small facilities, these documents
may be combined into one drawing. Since these drawings are intended for use in emergency response situations, larger
facilities (generally those with complex and/or multiple buildings) should provide an overall site plan and a separate
storage map for each building/storage area. A blank Facility Site Map has been provided on the reverse side of this page.
You may complete that page or attach any other drawing(s) which contain(s) the information required below.
Site Plan: This drawing shall contain, at a minimum, the following information:
a. Site Orientation (north, south, etc.);
b. Approximate scale (e.g. "1 inch = 10 feet".);
c. Date the map was drawn;
d. Locations of all buildings and other structures;
e. Parking lots and internal roads;
f. Hazardous materials loading/unloading areas;
g. Outside hazardous materials storage or use areas;
h. Storm drain and sanitary sewer drain inlets;
i. Wells for monitoring of underground tank systems;
j. Primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas;
k. Adjacent property use;
I. Locations and names of adjacent streets and alleys;
m. Access and egress points and roads.
Storage Map(s): The map(s) shall contain, at a minimum, the following information:
a. General purpose of each section/area within each building (e.g. "Office Area'; "Manufacturing Area'; etc.);
b. Location of each hazardous material/waste storage, dispensing, use, or handling area (e.g. individual
underground tanks, aboveground tanks, storage rooms, paint booths, etc.). Each area shall be identified by a
unique location code number, letter, or name (e.g. "1'; "2'; "3'; "A'; "8'; "C'; etc.);
c. Entrances to and exits from each building and hazardous material/waste room/area;
d. Location of each utility emergency shut-off point (i. e. gas, water, electric.);
e. Location of each monitoring system control panel (e.g. underground tank monitoring, toxic gas monitoring, etc.).
3. Map Legend
Item and/or Descri tion Location Code LC
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CUPA FORM (01/2000 Version) 11
mo, 'V
Unified Program (UP) Form
CONSOLIDATED CONTINGENCY PLAN
SITE MAP
BUSINESS NAME 3
Pe Bo s #677
SITE ADDRESS 103 CITY 104 ZIP CODE 105
aso5 PiANZ RD SAKERSFIELO 93309
GATE MAP DRAWN MAP # FACILITY ID # 1
03-17-2006
p R r n ~ ~ [; H I ~ For Site Map
i ~ a ~{
5 ~ ~ Seale of Map
A ~p • Loading Areas
- • Parlung Lots
2 ® Internal Roads
• Storm and Sewer
__ 3 -" - - - prams
• Adjacent Property Use
3 € .~ ~ • Locations and Names
of Adjacent Streets and
'Q Alleys
4 " ~ • Access and Egress
I -- Points and Roads
~ ' i ~ + • Primary and Alternate
i I Evacuation Routes
5 oQ _ ~ s
~~ ~~Q ~ lD ~ ®~ Fvr Sub-Ste Map
-- ELY "
~ - • Scale of Map
6 I • Location of Each
° ~ ® ® Q ® ~ I Storage Area
` • Location of Each
r , € € ~ , ® i t I '~ Hazardous Material
7 ~ ® ' ~ , € ~ ~ , ~ Handling Area
S ~ I € ~ ~ ® ~ • Locatron of Emergency
~ ® J t ~ I Response Equipment
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OFFICIAL USE ONLY DATE RECEIVED REVIEWED BY
DN liN STA 'OTHER DISTRICT CUPA PA
CUPA FORM (0112000 Version) ~ 2
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmentai Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
fACILITV NAME ;INSPECTION DATE I INSPECTION TIME
ADDRESS ;PHONE No. i No. of Employees
FACILITYCONTACT ( Business ID Number
~O•r~r t~L ~ r / ~-- "'r2. 2..h i 15-021- oooy a rp
Section 1: Business Plan and Inventory Program
^ Routine ®Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint O Re-inspection
C V \V=~oaPoinncel OPERATION
J DES COMMENTS
1 200
~ 3
^ APPROPRIATE PERMIT ON HAND
^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~o.~~ Q~ -
^ VISIBLE ADDRESS
^
- CORRECT OCCUPANCY
----- -
----- _ -J ~~~~ Q ; ~ ~ ~j~ Q J~
-------------------- -----
,~
------- ----
^ VERIFICATION OF INVENTORY MATERIALS ` l/
;~1~""~ ~~ ~..I
^ VERIFICATION OF QUANTITIES
^
L'
~ VERIFICATION OF LOCATION
-
/
I.S~ - ^ PROPER SEGREGATION OF MATERIAL
^ ~ VERIFICATION OF MSDS AVAILABILITYE ~
'
- t7 ~ ~~,- ~ ~r o vim. ~
-- ----C~~~~.S~~Y'~Y -----
-----
-------
----
^ - - ----------
VERIFICATION OF HAT MAT TRAINING ------ r
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^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
I
L~J ^ HOUSEKEEPING ~ c-1e~., o • ~ e.~. Q-~-S ~ w yt~ a''~cl S-,'~ Qw ,~ ~C
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FIRE PROTECTION -- --- ~ 1------ -
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L~J ^ SITE DIAGRAM ADEQUATE 8c ON HAND I
ANY HAZARDOUS WASTE ON SITE: ~ YES ^ NO
EXPLAIN: ~ c.S ~ e- y ~ I
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W 0.S ~-~ /~
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QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT tss'I ~ 3X)-3979
Inspect r Badge No
Business Site Responsible Party
White -Environmental Services Yellow • Station Copy Pink -Business Copy
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