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HomeMy WebLinkAboutBUSINESS PLAN>~ ., ii ~~~~~, - ~~\ ~~ ~i i WAL-MART #2557 8400 ROSEDALE HWY. igoy ,~~ ~M:~~ WAL-MART 2557 Manager JACK PERSONS Location: 8400 ROSEDALE HWY City BAKERSFIELD SiteID: 015-021-001904 BusPhone: (661) 588-2097 Map 102 CommHaz Extreme Grid: 20D FacUnits: 1 AOV: CommCode: KCFD STA 65 EPA Numb: CAL000195089 SIC Code:5399 DunnBrad:05-195-7769 Emergency Contact / Title Emergency Contact / Title JACK PERSONS / STORE MANAGER MINH NGUYEN / CO-MANAGER Business Phone: (661) 588-2097x Business Phone: (661) 588-2097x 24-Hour Phone (800) 530-9924x 24-Hour Phone (800) 530-9924x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press React ImmHlth DelHlth Contact O J WARD, ENV COMP MGR Phone: (479) 204-8579x MailAddr: 702 SW 8TH ST State: AR City BENTONVILLE Zip 72716-0500 Owner WAL-MART STORES INC Phone: (479) 204-2324x Address 702 SW 8TH ST State: AR City BENTONVILLE Zip 72716-0500 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ~N~~ ~~ ~' ~ ~ ~(~®9 ~_ c~r d ^;^ r`1V Ir'q~'!YV QT Zilp!'? !?i(SIl"' 'i.•+~o if'S!~7,^t,=;lC`~~. fOr O~'a!nlny the l; ~forir•~,~ion, i G'ri_If`~ uncaer ~~cnalty cf laver that i have ~ersanally examined a_nd am fa.mifiar with the information su:emitted and believe the informa?ion is true, accurate, an' ~~ ~~'^'~'•~~ /p -/l -O 7 6 _ ~icr _zeure Date -1- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G 1200.00 FT3 Hi PROPANE E F P IH G 612.00 FT3 Hi WINDSHIELD WASHER SOLVENT DH L 110.00 GAL Hi INSECTICIDE F IH DH S 2520.00 LBS Mod TRICHLORO-S-TRIAZINERTRIONE IH DH S 1400.00 LBS Mod INSECTICIDE F IH DH L 160.00 GAL Mod ALGACIDE IH DH L 100.00 GAL Mod PAINT THINNER F DH L 50.00 GAL Mod WOOD FINISH L 40.00 GAL Mod CHARCOAL LIGHTER FLUID F IH DH L 30.00 GAL Mod LEAD ACID BATTERIES F R IH S 7200.00 LBS Low WASTE MOTOR OIL F DH L 800.00 GAL Low HYDRAULIC FLUID F DH L 250.00 GAL Low WASTE MOTOR OIL F DH L 240.00 GAL Low ANTIFREEZE L 100.00 GAL Low MOTOR OIL F DH L 1000.00 GAL Min HELIUM F P IH G 1000.00 FT3 Min WASTE OIL/WATER MIXTURE F DH L 1000.00 GAL Min CARBON DIOXIDE F P IH G 850.00 FT3 Min WASTE COOKING OIL L 333.00 GAL Min FERTILIZERS IH S 20400.00 LBS UnR WASTE BATTERIES IH S 6750.00 LBS UnR HERBICIDE IH DH L 630.00 GAL UnR WASTE OIL FILTERS F DH S 250.00 LBS UnR -2- 10/05/2007 -3- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR (FRONT-RETAIL) CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 238.70 FT3 1200.00 FT3 600.00 FT3 Y1AZ1H.tCL V U .7 1, V1~lY V1V L" 1V 1 b %Wt. RS CAS# 100.00 Propane Yes 74986 tlE~LlXttL I~S ~~aJ1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 238.70 FT3 612.00 FT3 477.40 FT3 nl'~1L11'~(. LV U 17 l.U1Y1 r. ULV ~11~ 117. %Wt. RS CAS# 100.00 Propane Yes 74986 nsi~ltitcL r~~ arla~i~irlivt~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -4- 10/05/2007 ~GasATE TPureE =AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER F WAL-MART 2557 ~ Inventory Item 0023 COMMON NAME / CHEMICAL NAME WINDSHIELD WASHER SOLVENT Location within this Facility Unit AUTO DEPT Days On Site 365 Map: Grid: CAS# Liquid TMixture ~mbRent~E ~ AmbientT~E ~ PLASTCICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 1.00 GAL 110.00 GAL I` 65.00 GAL tLE~G1~itUVU~ 1:V1~lYV1V C;1V l a oWt. RS CAS# 70.00 Methyl Alcohol No 67561 t1E~GAtCL A5Jt;551~11",1V 1"5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi ~ Inventory Item 0022 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~ Ambient ~ Ambient BAG AMOUNTS AT THIS LOCATION` Largest Con20100rLBS Daily2520100m LBS I Daily1630r00e LBS IlEiGEi2CL V U.7 1. V1~lY V1V J;1V 1 J °sWt. RS CAS# 63.00 Napthalene No 64742956 17.00 o-Xylene, m-Xylene, p-Xylene No 1330207 IIHGHLtL H~J .72S.7J1~1tS1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No Noj Curies F IH DH / / / Mod SiteID: 015-021-001904 ~ Facility Unit: Fixed Containers at Site ~ -5- 10/05/2007 F WAL-MART 2557 ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINERTRIONE POOL CLEANER Location within this Facility Unit GARDEN CTR STATE TYPE PRESSURE Solid TMixture ~ Ambient SiteID: 015-021-001904 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 87901 TEMPERATURE CONTAINER TYPE Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 37.00 LBS 1400.00 LBS 900.00 LBS nt~Gt~tcl~vu5 ~:vrir~lV~iV1~ oWt. RS CAS# 100.00 Trichloro-s-triazinetrione No 87901 t11~G1jKL A5 5~JJ1~1L'1V15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod ~ Inventory Item 0021 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# Liquid TMixture ~mbient~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 160.00 GAL 100.00 GAL i1HG1-]tCLVUD I..VP'lYV1V~1V 1.7 %Wt. RS CAS# 63.00 Napthalene No 64742956 17.00 o-Xylene, m-Xylene, p-Xylene No 1330207 I1HGHttL H. 7.~1;~.'~1~1r,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -6- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ALGACIDE Days On Site POOL - ALGAECIDE 365 Location within this Facility Unit, Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum Daily Average 1.00 GAL 100.00 GAL 50.00 GAL riHGL~KLVUJ ~vrirvlV~1V 15 %Wt. RS CAS# 10.00 Alkyl Dimethylbenzylammonium Chloride No 68424851 1.30 Ethyl Alcohol No 64175 tiL~GHKL ra~a~5al~ll;lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod ~ Inventory Item 0008 COMMON NAME / CHEMICAL NAME PAINT THINNER Location within this Facility Unit PAINT DEPT Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 1.00 GAL 50.00 GAL 30.00 GAL ns~GrucLVU~ ~.v1~1ru1V~1V1~ oWt. RS CAS# 100.00 Mineral Spirits No 64741419 I1L-1GKKL Fia 7JiS.7.71~1LS1V l~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -7- 10/05/2007 ~~ F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0024 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WOOD FINISH Days On Site 365 Location within this Facility Unit Map: Grid: PAINT DEPT CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~mbient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 40.00 GAL 20.00 GAL -- tiL~G1~tCLVU.7 1~V1~lYV1VJ;1V l.`~ %Wt. RS CAS# 55.00 Mineral Spirits No 64742887 5.00 Mineral Spirits No 64741657 9.00 Heavy Naphthenic Petroleum No 64742525 9.00 Highly Refined Base Oil No 64742536 riHGEiKL tiSJI;J.71~1r,1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod ~ Inventory Item 0020 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CHARCOAL LIGHTER FLUID Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# Liquid TMixture ~mbRent~E ~ AmbientT~E ~STOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 0.25 GAL 30.00 GAL 20.00 GAL HAZARDOUS M CO PONENTS %Wt• RS CAS# 100.00 Aliphatic Hydrocarbons No 64742887 I11'1[.ituCL ti~ 7 Jr+~~l"1L'1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -8- 10/05/2007 ~ F WAL-MART 2557 ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME LEAD ACID BATTERIES Location within this Facility Unit AUTO DEPT SiteID: 015-021-001904 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# ~SolidE TMixture ~ Ambient~E ~ A~PeRATURE OTHER NTSPECIFYYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 LBS 7200.00 LBS 3600.0.0 LBS t1AGKCCLVUJ 1~V1~lYV1V~1V1S %Wt. RS CAS# 53.00 Lead No 7439921 10.00 Sulfuric Acid (EPA) No 7664939 26.00 Lead Dioxide No 1309600 4.00 Lead (II) Sulfate and Mixtures thereof No 7446142 t1L~Y,HKL HJ.71;~.71~1L' 1V l a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F R IH / / / Low ~ Inventory Item 0013 COMMON NAME / CHEMICAL NAME WASTE MOTOR OIL Location within this Facility Unit TIRE & LUBE EXPRESS Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# Liquid TWaste ~Ambient~E ~ AmbientT~E ABOVEOGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 800.00 GAL 800.00 GAL 135.00 GAL lll~i/~tiRl/ V V .7 1. VL•lY V1V L' 1V 1 .7 %Wt. RS CAS# 100.00 Petroleum Distillate, Straight Run Middle No 64742650 L1tiLiriCCJJ L-1w 7.7 L~J J1"1L~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -9- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0019 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HYDRAULIC FLUID Days On Site 365 Location within this Facility Unit Map: Grid: AUTO DEPT CAS# Liquid I Mixture AmbRent~E ~ AmbientT~E -I PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 250.00 GAL 160.00 GAL - tll-1GHKLVUJ ~vl~lrvlvl;lvlJ %Wt. RS CAS# 95.00 Heavy Paraffinic Petroleum No 64742547 t1E~Gf1KL 1~. 5.7L' .7.71~11;1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: ENV CAGE CAS# Liquid TWaste -~ Ambient~E ~E~MPeRATURE ~OVEOGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 240.00 GAL 240.00 GAL 65.00 GAL iZHGa`iICLUUJ l.Vl"!t'V1V l:,1V 1.7 %Wt. RS CAS# 100.00 Petroleum Distillate, Straight Run Middle No 64742650 11tiGL-i[CL H J~JGw7.71°11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -10- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: AUTO DEPT CAS# Liquid TMixture ~mbient~E ~ AmbientT~E -~STOCTCONTAINERE AMOUNTS AT THIS LOCATION Largest Contiin00erG~ Daily 100100m GAL I Daily A60r00e GAL r1t~~tu~LVUa ~~1nrV1.V~iv 15 oWt. RS CAS# 94.00 Ethylene Glycol No 107211 5.00 Diethylene Glycol No 111466 1.00 Dipotassium Phosphate No 7758114 riEiGti1CL ti. 7.7J:SJJ1~1tS1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit AUTO DEPT Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 5.00 GAL 1000.00 GAL 570.00 GAL ilL-~GEi2CLVU.7 1.V1~lYV1VJ;1V 1.7 owt. Rs cAS# 100.00 Petroleum Distillate, Straight Run Middle No 64742650 riHGHtCL 1-iJ ~J;.7a1~1r,1VlA TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -11- 10/05/2007 r. F WAL-MART 2557 ~ Inventory Item 0014 COMMON NAME / CHEMICAL NAME HELIUM Location within this Facility Unit LAYAWAY STATE TYPE PRESSURE _ Gas TPure Above Ambient SiteID: 015-021-001904 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7440-59-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 250.00 FT3 1000.00 FT3 500.00 FT3 t1.HGHKLVUJ 1.V1~lYV1VP,1V1~ %Wt. RS CAS# 100.00 Helium No 7440597 t11~GE~tCL E~.7.~L" ~J1~1L" 1V l A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0015 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL/WATER MIXTURE Days On Site 365 Location within this Facility Unit Map: Grid: TIRE & LUBE EXPRESS CAS# STATE TYPE T PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste ~ Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 1000.00 GAL 1000.00 GAL 500.00 GAL I1tiG1-1KLVUJ 1.V1~lYV1V~1V l. J %wt. Rs cAS# 60.00 Petroleum Distillate, Straight Run Middle No r 64742650 I1L-~GHKL Ha Al;J~1~1J~J1V-1w7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -12- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0016 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: MCDONALDS CAS# 124-38-9 ~GdSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Cryogenic INSUL.TANK / CRYOGENIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 425.00 FT3 850.00 FT3 550.00 FT3 t1AGL~iCLV U.7 1:V1~lYV1V I;1V 1.7 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1EiGHtCL L-1~7 .71;.7.71~11;1V 1 .7 - - TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0027 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE COOKING OIL Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE BACK OF STORE, IN REC AREA CAS# Liquid TMixture ~ Ambient~E ~ AmbientT~E ~ ABOVEOGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 333.00 GAL 333.00 GAL 150.00 GAL IlEiGEittLV U.7 1.V1~lYV1V 1~,1V 1 J owt. RS CAS# 85.00 Soy Bean Oil No 8001227 15.00 Nonyl Phenoxy Polyethoxyethanol No IlEiGEi1CL Ei. 7.7~~7.71~1~1V l.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Min -13- 10/05/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0017 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME FERTILIZERS Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# ~SolidE TMixtur~mbient~E ~ AmbientTURE BAG CONTAINER TYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 50.00 LBS 20400.00 LBS 11600.00 LBS HAZARDOUS COMPONENTS oWt. RS CAS# Sulfur No 7704349 Urea No 57136 Ammonium Phosphate, Dibasic No 7783280 Ammonium Phosphate, Monobasic No 7722761 Potassium Chloride No 7447407 I1HGtittL H~ J.7L~J~Jl~1J=,1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -14- 10/05/2007 a ; F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0025 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE BATTERIES Days On Site USED LEAD-ACID CAR BATTERIES 365 Location within this Facility Unit Map: Grid: ENV CAGE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TWaste ~mbient ~ Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 LBS 6750.00 LBS 2550.00 LBS - HAZARDOUS COMPONENTS oWt. RS CAS# 34.00 Lead No 7439921 34.00 Sulfuric Acid (EPA) No 7664939 31.00 Lead Dioxide No 1309600 t1HGL-1KL r~Ja~aal~l~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR ~ Inventory Item 0018 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HERBICIDE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE Liquid TMixture ~ Ambient TEMPERATURE CONTAINER TYPE Ambient ~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 630.00 GAL 410.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Herbicides No 0 I1HGHiCL H. 7.72S.7J1~1tS1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / UnR -15- 10/05/2007 }: h F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0026 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL FILTERS Days On Site 365 Location within this Facility Unit Map: Grid: ENV CAGE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TWaste -~mbient ~ Ambient BIN AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 250.00 LBS 250.00 LBS 68.75 LBS r~~r~tcL~u~ wi~ir~lvr~iv~l~ %Wt. RS CAS# 10.00 Petroleum Distillate, Straight Run Middle No 64742650 titj~.~tcL r~55~~ai~i~iv 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR -16- 10/05/2007 \~ :_ ~j ` (~_ i O"I WAL-MART 2557 SiteID: 015-021=001904 Manager : JACK PERSONS BusPhone: (661) 588-2097 Location: 8400 ROSEDALE HWY Map 102 CommHaz Extreme City BAKERSFIELD Grid: 20D FacUnits: 1 AOV: CommCode: KCFD STA 65 SIC Code: 5399 EPA Numb: GA.L pd p ~ `~ ~p~g DunnBrad: 05-195-7769 Emergency Contact / Title Title Emergency Contact / eQ JACK PERSONS / STORE MANAGER .~WAF4• ~ ~ / -,~~` MANAGER Business Phone: (661) 588-2097x Business Phone: (661) 588-2097x 24 -Hour Phone ~~ _ 24 -Hour Phone ~~'~ Pager Phone ( ) - x/`30~ Pager Phone ( ) - x j~j.2y Hazmat Hazards: RSs Fire Press React ImmHlth DelHlth Contact ~_/~ T.r/f}~jr ,E,t/dlL, Corv~i°G/~7R/~ ~'~ti~• Phone : - MailAddr : 702 $W 8TH ST State : AR ~~~ v~0. - ~~7q City BENTONVILLE Zip 72716-0500 Owner WAL-MART STORES INC Phone: Address 702 SW 8TH ST State: AR ~f7 ,ZO~-z3.Z5( City BENTONVILLE Zip 727 b- 500 Period ,•~j`Zo ,~4 ~ to ~3~t g 7-OD $ TotalASTs : _ ~~ / 73 Gal Preparer : Certif'd: ,5' ~,r/d7L. C. TotalUSTs : ~LLIS ~i~~:S~ ~/~`.' ~if/VTZ-' ~ON~t~l~~3~lC,C.,RSs: _ -Gal Yes ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROD T - ABOVEGROUND STORAGE TANK -~~ rr ~u~ 7tit rZ,E. ~~ -1- 02/20/2007 i ~~o~S ENr~ A PR ~ ~ 2007 -~o F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name._. SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE ~~ E F P IH L ~ j,Z: ~-~rB3 Hi PROPANE ~., E F P IH G , j~p .6.2.00 FT3 Hi WINDSHIELD WASHER SOLVENT DH L 110.00 GAL Hz INSECTICIDE. F IH DH S 2520.00 LBS Mod TRICHLORO-S-TRIAZINERTRIONE -~ IH DH S 1400.00 LBS MOd WOOD FINISH L t~D ~Q.UO GAL Mod INSECTICIDE F IH DH L 160.00 GAL - Mod PAINT THINNER F DH L 5 Q,y8:00 GAL Mod ALGACIDE IH DH L jpD x$.00 GAL Mod CHARCOAL LIGHTER FLUID F IH DH L jtlr6r9".00 GAL Mod LEAD ACID BATTERIES .; F R IH S ~,'tpQ~G9~9.00 LBS Low WASTE MOTOR OIL F DH L 800.00 GAL Low HYDRAULIC FLUID F DH L 250.00 GAL Low WASTE MOTOR OIL F DH L 240.00 GAL Low ANTIFREEZE L /:OV .2~~9'.00 GAL 'Low HELIUM F P IH G j ~ c! .128'0 .00 FT3 Min MOTOR OIL F DH L 1000.00 GAL Min WASTE OIL/WATER MIXTURE F DH L 1000.00 GAL Min CARBON DIOXIDE ~ F P IH G 850.00 FT3 Min FERTILIZERS IH S 20400.00 LBS UnR WASTE BATTERIES- IH S 6750.00 LBS UriR HERBICIDE IH DH L 630.00 GAL UnR WASTE OIL FILTERS F I1H S 250.00 LBS UnR -2- 02/20/2007 ~ WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NANO; / CHEMICAL NAME . PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN .PATIO (',('j~}C~- O~j~l~`~C.~n1~4L~ CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Da ly Average 38'7 ~ ~ ~/a.no - ~77~~~ HAZARDOUS COMPONENTS °sWt. RS CAS# 100.00 Propane ~ Yes 74986 rui~tucu t~ 5n~~r~.iv t ~ --... - - TSecret RS BioHaz Radioactive/Amount -EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 36S Location within this Facility Unit Map: Grid: GARDEN CTR (~i~o,~ ~~ ~ (.) cAS# 74-98-6 STATE TXPE PRESSURE TEMPERATURE CONTAINER TXPE Gas TPure ~~Above Ambient Ambient PORT. PRESS. CYLINDER -- AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 0~3 ~ . `! ~.•1-~r6$' FT3 / aZ- O O -~':'D9 FT3 (~ 0 p -+~98-,-99 FT3 HAZARDOUS COMPONENTS ~Wt_ RS CAS# 100.00 Propane Yes 74986 nta i.aa rrt ~. !'1.7 .7L'.7.71'LG1V 1.~/ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -4- 02/20/2007 F WAL-MART 2557 SiteID: 015-021-OOI904 ~ ~ Inventory Item 0023 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WINDSHIELD WASHER SOLVENT Days On Site 365 Location within this Facility Unit Map: Grid: AUTO DEPT % CAS# STATE TYPE PR.BSSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.0o GAL 11a.oo GAL 65.OO GAL - HAZARDOUS COMPONENTS ~Wt. RS CAS# 70.00 Methyl Alcohol No 67561 ~ Inventory Item 0022 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDE Days On Site 365 . Location within this Facility Unit Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~ Ambient ~ Ambient BAG ~--- AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 20.00 LBS 2520.00 LBS 1630.00 LBS ~-+~~•o!±!~VUS C:VMYVIVlSN'1'S ~Wt. RS CAS# 63.00 Napthaiene No 64742956 17.00 o-Xylene~ m-Xylene, p-Xylene No 1330207 HA7AEZD ASSESSMENTS TSecret RS BioFiaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 02/20/2007 F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site q COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINERTRIONE Days On Site POOL CLEANER 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# 87901 STATE TYPE ''~~ PRESSURE TEMPERATURE ---~ CONTAINER TYPE ~Salid Mixture ~ Ambient ~ Ambient 1 BP.G -~- AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 37.00 LBS 1400.00 LBS 900.00 LBS HAZARDOIIS COMPONENTS ~Wt. RS CAS# 100.00 Trichloro-s-triazinetrione No 87901 riAGAitU AS S~SSMr:1V'1'S TSecret RS BioHaz Radioactive/Amount I3PA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod ~ Inventory Item 0024 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WOOD FINISH Days On Site 365 Location within this Facility Unit Map: Grid: PAINT DEPT CAS# Liquid TMixture ~AmbRent~ ~ AmbPe~T~ METALOCONT IA NR-NONDRUM - AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average s . oo GAL rip ~a--o o GAL ~p ..~e~ : oo cAL riKGAKiJVU.S" C:VMYVIVL'"N'1"r7" $Wt.~ RS CAS# 55.00 Mineral Spirits No 64742887 5.00 Mineral Spirits No 64741657 9.00 Heavy Naphthenic Petroleum No 64742525 9.00 Highly Refined Base Oil No 64742536 t1t!lliK1J H: 7515J5M1'i1V1':i TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Na No No/ Curies / / / Mod -6- ~ WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0021 Facility,Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT TEAS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 160.00 GAL 100.00 GAL i'lE1GL~ttUVVa I:VMYVN151V'A"S ~SWt . RS CAS# 63.00 Napthalene No 64742956 17.00 o-Xylene, m-Xylene, p-Xylene No 1330207 riHGAtf1J L~S StSSSML'1V'1"~ TSecret RS SioHaz Radioactive/Amount EPA Hazards NFPA USDOT## MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME . PAINT THINNER Days On Site ' 3 6.5 L ti ithi thi F ilit i M G id oca on w s n ac y Un t ap: r : PAINT DEPT CAS# ~LSquid TMixture Ambient ~ Ambient~~ -~LASTICTCONTRp,TNERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL ~ .~8-. 00~ GAL ~ ~ ~. 00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Mineral Spirits No 64741419 tiAGHKL A.5 ".5"f5.5'.5'Mt'iiV't'.7" TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -7- 02/20/2007 J F WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ALGACIDE Days On Site POOL - ALGAECIDE 365 Location within this Facility Unit. Map: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~Ambient Ambient ^~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 1. o o GAL f o p ~8-~o GAL J -p ~' o o .GAL tix~Atcuuu~ c;umru~vriv'r~ ~Wt. RS CAS# 10.00 Alkyl Dimethylbenzylammonium Chloride No b8424851 1.30 Ethyl Alcohol No 64175 kiAG.F3K1) LiS Si4'SSmlSN'1'S TSecret RS.BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod ~ Inventory Item 0020 Facility IInit: Fixed Containers at Site ~ COMMON NAME/ CHEMICAL NAME CHARCOAL LIGHTER FLUID Days On Site 365 Location within this Facility Unit Map.: Grid: GARDEN CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~-Ambient ~ AmbientPLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average - 0.2 5 GAL 30 ~$- 0 0 GAL ~ X9':'0 0 GAL HAZARDOUS eoMPONENTs ~Wt. ~ RS CAS# 100.00 Aliphatic Hydrocarbons No 647428$7 t~,z~Htc.u x.~ anaai•~.v-ra TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -8- 02/20/2007 p WAL-MART 2557 SitelD: 015-021-001904 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME LEAD ACID BATTERIES Days On Site 365 Location within this Facility Unit Map: Grid: AUTO DEPT CAS# Solid TMi~cture ~_Ambi~ent~ ~ Ambien~t~ ~OTHERO~SPE IFY PB AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 3 0 . oo Lss ~ ~~ ~.a6a~. oo LBS 3 6 00 ~aa. oo Lss tiAl+AK1JVU5 C:VMYViVi'~'lY1"' $Wt. RS CAS# 53.00 Lead No 7439921 10.00 Sulfuric Acid (EPA) No 7664939 26.00 Lead Dioxide No 1309600 4.00 Lead (II} Sulfate and Mixtures thereof No 7446142 t1fiGH1VJ Elb .7tSb.7l"SELY 1 a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F R IH / / / Low ~ Inventory Item 0013 Facility Unit: Fixed Containers at Site q COMMON NAME / CHEMICAL NA ME WASTE MOTOR OIL Days On Site 365 L ti ithi thi F ili M i d oca on w n s ac ty ap: Gri Un t : TIRE & LUBE EXPRESS CAS# STATE TYPB Liquid Waste PRESSURE Ambient TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUN'T'S AT THIS LOCATION Largest Container Daily Maximum Daily Average 800.00 GAL 800.00 GAL 135.00 GAL HAZARD ASSSSSMSNTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -9- 02/20/2007 ~ WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0019 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME HYDRAULIC FLUID Days On Site 365 Location within this Facility Unit Map: Grid: -AUTO DEPT CAS#" STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 250.00 GAL 160.00 GAL tLHL~KlCi7 A.5"StSJSML~IV"1"S Secret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCF No No No No/ Curies F DH / / / Love ~ Inventory Item 0011 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE MOTOR OIL Days On Site 365 L ti ithi F thi ili U i M id oca on w n s ac ty n ap: t Gr : ENV CAGE CAS# ~LSquid TW ste ~ ~AmbRent~ ~ AmbientT~ ABOVE GROUNDRTANRE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 240.00 GAL 240.00 GAL 65.00 GAL HAZAi2DOUS COMPONENTS $Wt. RB CAS# 100.00 Petroleum Distillate, Straight Run Middle No 64?42650 t'lHGH2tU H5 ~25551~1V1':S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -10- 02/20/2007 ~ WAL-MART 2557 SiteID: 015-021-001904 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site. 365 - Location within this Facility Unit Map: Grid: AUTO DEPT CAS## STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient ~LASTIC CONTAINER {{{` AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.0 0 GAL / C d ~. 0 0 GAL ~ © ~b4 b : 0 0 GAL HAZARDOUS COMPONENTS $Wt. RS CAS# 94.00 Ethylene Glycol No 107211 5.00 Diethylene Glycol No 111466 1.00 Dipotassium Phosphate No 7758114 tiHGay.KAJ E~S~SSM~+N7::i TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / /. Low ~ Inventory Item 0014 Facility Unit: Fixed Containers at Site ~ COMMON NAMfi / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: LAYAWAY CAS# 7440-59-7 ~GasATE TPu~.reE ~~AboveSAmbien~ Ambient~E PORTCONT~ASNBR~LINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average. a-5'0 38'8": 00 FT3 ( Q DO .1.2f}9'. 00 FT3 5--~p .x8"00 FT3 HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Helium No 7440597 11HG4~X Ll l~ ~y r: S ~ Mr:N'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH -11- ~ WAL-MART 2557 SitelD: 015-021 001904 ~ ~ Inventory Item .0005 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 36S Location within this Facility Unit Map: Grid: AUTO DEPT CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture :Ambient Ambient PLASTIC CONTAINER • AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 1000.00 GAL 570.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Petroleum Distillate, Straight Run Middle No 64742650 fLF1Gli.K.l) El~ 7~7Pi.7Jl~1L' LV l.'! TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0015 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL/WATER MIXTURE Days Oil Site • 365 Location within this Facility Unit Map: Grid: TIRE & LUBE EXPRESS CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste -Ambient .Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1ooa.oo GAL 1000.00 GAL 500.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 60.00 Petroleum Distillate, Straight Run. Middle No 64742650 YiHGHiCL a~ 753:~~Mt51V"1'~7' TSecret RS BioHaz Radioactive/Amount SPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min P WAL-MART 2557 SitelD: 015-021-001904 ~ ~ Inventory Item 0016 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE ~ Days On Site 365 Location within this Facility Unit Map: Grid: MCDONALDS CAS# 124-38-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas PureAbove Ambient Cryogenic INSUL.TANR / CRYOGENI~ --~ AMOUNTS AT THIS LOCATION --~ Largest Container _ .Daily Maximum Daily Average 425.00 FT3 850.00. FT3 550.00 FT3 HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1AGE~tClJ Hb .7Ba7.71~1LLV"1-S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min. ~ Inventory Item 0017 Facility IInit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME FERTILIZERS Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# ~SolidE TM xture ~'Ambient~ ~ Ambien~tT~ BAG CONTAINER TYPE AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum Daily Average 50.00 LBS 20400.00 LBS 11600.00 LBS ru~~~wc~ua cvrirvivniv"ra ~Wt. RS CAS# Sulfur No 7704349 Urea Na 57136 Ammonium Phosphate, Dibasic No 7783280 Ammonium Phosphate, Monobasic No 7722761 Potassium Chloride No 7447407 HAL_QK~ AS SjSSSM~N'.L'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -13- 02/20/2007 F WAL-MART 2557 SiteID: 015--021-001904 q ~ Inventory Item 0025 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE BATTERIES Days On Site USED LEAD-ACID CAR BATTERIES 365 Location within this Facility Unit Map: Grid: ENV CAGE CAS# ~SolATdE TYPE T PRESSURE TEMPERATURE ~~ CONTAINER TYPE Twaste I Ambient ~ Ambient I OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 LBS 6750.00 LBS 2550.00 LBS - t~HGfitC11Vl3S L"VPRYViVt:LV~l"S ~Wt_ RS CAS# 34.00 Lead NO 7439921 34.00 Sulfuric Acid (EPA) No 7664939 31.00 Lead Dioxide No 1309600 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR ~ Inventory Item 0018 Facility Unit: Fixed ,Containers at Site ~ COMMON NAME / CHEMICAL NAME HERBICIDE Days On Site 365 Location within this Facility Unit Map: Grid: GARDEN CTR CAS# Liquid TMi~xPture ~Ambient~ ~ AmbientT~ ~LASTOICTCON AINERE -• AMOUNTS AT THIS,LOCATTON Largest Container Daily Maximum Daily Average 1.00 GAL 630.00 GAL 410.00 GAL HA7,ARDOUS COMPONENTS ~Wt. 100.00 Herbicides HAZARD ASSESSMENTS TSecret RS BiaHaz Radioactive/Amount EPA Hazards No No No No/ Curies I IH DH RS) CAS# No 0 NFPA USDOT# MCP / / / UnR -14- 02/20/2007 ~ WAL-MART 2557 SitelD: 015-021-001904 ~ ~ Inventory Item 0026 Facility Onit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL FILTERS Days On Site 365 Location within this Facility Unit Map: Grid: ENV CAGE CAS# ~SolAdE TWaste ~-Ambi~ent~ ~ A~P~RATURE BIN ~~AINER TYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 250.00 LBS 250.00 LBS 68.75 LBS HAZARDOUS COMPONENTS ~Wt. RS CAS# 10.00 Petroleum Distillate, Straight Run Middle No 64742650 t9A%AK1) ASS~SSM2SIVTS TSecret RS BioHa2 Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (oae a materiel 6ui or area) ®ADD ^DELET'E ^REViSE ~ I. FACILITY INFORMATION BUSINESS NAME (Same es FACILITY NAME or DBA -Doing Business As) 3 Wal-Mart Store #2557 CHEMTCAL LOCATION zoI CHEMICAL LOCATION CONFIDENTIAL EPCRA 2oz Inside the back of store in receivin area. ^ YES ® NO 1 MAP# (optiond) 2~ GR1D# (optiond) 204 PACILTTY ID # Ma #1 Fl II. CHEMICAL INFORMATION CHEMICAL NAME zo5 TRADE SECRET Yes No zoa If Subject to 1:PCRA, refer w iastructioas zm COMMON NAME EHS* ^ Yes ®No Used COOkin Oil CAS# 209 *If EHS is "Yes°, all amounts below must be in lbs. FIRE GbDI's HAZARD CLASSES (Complete if required by t.UPA) 210 HAZARDOUS MATERIAL TYPE (Check o~ item aaly) ^ a. PURE ®b. MIXTURE ^ a WASTE 211 RADIOACTNE ^ Yes ®No 2t2 CURIES zt3 PHYSICAL STATE z1a (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS LARGEST CONTAINER 333 gallons 215 FED HAZARD CATEGOR~S 216 (Check all that apply) ®a. EIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ^ e. CHRONIC HEALTH AVERAGE DAII.Y AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 2zo 150 allons 333 allons NA NA zzI DAYS ON SITE: 2az UN1TS* ®a. GALLONS ^ b. CUBIC FEEL' ^ c POUNDS ^ d. TONS 3b5 days Check one item old * If EHS amount must be in cartels. STORAGE CONTAINER ®s. ABOVE GROUND TANK ^ e. PLASTIGNONMETALLIC DRUM ^ i. FIB1$2 DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f CAN ^ j. BAG ^ a PLASTIC BOTTLE ^ r. OTHER ^ G TANK INSIAE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SrLO ^ 1. CYLINDER ^ p. TANK WAGON 2z3 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIT ^ c. BELOW AMBIENT 224 STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONEN'T' (For mixture or waste only) EHS CAS # I 85 zz6 Soybean Ott 2z7 ^ Yes ®No zzs 8001-22-7 229 2 15 . z3fl Nonyl Phenoxy Polyethoxy Ethanol 231 ^ Yes ®No 232 NA 233 3 234 233 ^ Yes ^ NO 236 237 4 z3s z39 ^ Yes ^ No zoo za1 Amore tlaaardous components are present at doter Wan 1 % by wei~ttt it nan-©runogptic, or o.196 by weisht if catxinoge~c, ettadt additional shcets of paper captoeioe tM requirM Infotmatioa. ADDITIONAL LOCALLY COLLECTED INFORMATION 2'~ Used cooking oil is picked up by vendor for recyclieg on a regular basis. If EPCRA Please Si Here Revised: 03/24/2007 16 Emergency Response/Contingency Plan (Hazardous Materials Business Plan Module) Authority Cited: HSC, Section 25504{b); Title 22, Div. 4.5, Ch. 12, Art. 3 CCR All facilities that handle hazardous materials in specified quantities must have a written emergency response plan. In addition, facilities that generate 1,000 kilograms or more of hazardous waste per month, or accumulate more than 6,000 kilograms of hazardous waste on-site at any one time, must prepare a contingency plan. Because the requirements are similar, they have been combined in a single document, provided below, for your convenience. This plan is a required module of the Hazardous Materials Business Plan (HMBP). If you already have a plan that meets these requirements, you should not complete'the blank plan, below, but you must include a copy of yoar existing plan as part of your HMBP. This site-specific Emergency Response/Contingency Plan is the facility's plan for dealing with emergencies and shall be implemented immediately whenever there is a fire, explosion, or release of hazardous materials that could threaten human health and/or the environment. At least one copy of the plan shall be maintained at the facility for use in the event of an emergency and for inspection by the local agency. Within some Counties, hospitals and police agencies have delegated receipt of these plans to the local agencies administering Hazardous Materials Business Plans; so additional copies need not be submitted. However, a copy of the plan and any revisions must be provided to any contractor, hospital, or agency with whom special (i.e. contractual) emergency .- services arrangements have been made (see section 3, below). 1. Evacuation Plan: a. The following alarm signals} will be used to begin evacuation of the facility (check all that apply): ^ Bells; ^ Horns/Sirens; ®Verbal {i. e. shouting); ®Other (speci, fy) Public Address System, Radios, Telephone b. ®Evacuation map is prominently displayed throughout the facility. Note: A properly completed HMBP Site Plan satisfies contingency plan map requirements. Thin drawing (or any other drawing that shows primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas) must be prominently posted throughout the facility in locations where it will be visible to employees and visitors. 2. a. Emergency Contacts*: Fire/Police/Ambulance ......................................... Phone No. 911 State Office of Emergency Services .............................. Phone No. (800) 852-7550 b. Post-Incident Contacts*: Fire Department Hazardous Materials Program ................... Phone No. (661) 326-3911 County of Kern Environmental Health Services Department ...... Phone No. (661) 862-8700 California EPA Department of Toxic Substances Control ............ Phone No. (916) 255-3545 Cal-OSHA Division of Occupational Safety and Health .............. Phone No. (559) 445-5302 San Joaquin Valley Air Quality Management District ............... Phone No. (661) 326-6900 Fresno Regional Water Quality Control Board ......................... Phone No. (559} 445-5116 * These telephone rsrsmbers are provided as a genera! aid to emergerscy rsot4 juntion. Be advised that additional agencies may be required to be not{~ed. c. Emergency Resources: Poison Control Center ....................................... Phone No. (800) 876-0766 Nearest Hospital: Name: San Joaquin Community Hospital Phone No.: (661)385-3000 Address: 2615 Eye St. City: Bakersfield 3. Arrangements With Emergency Responders: If you have made special (i.e. contractual) arrangements with any police department, fire department, hospital, contractor, or State or local emergency response team to coordinate emergency services, describe those arrangements below: Specialty response for an emergency response contractor is coordinated by the Wal-Mart Home Office at (479-204-8453) or 24-hr Alarm Central at (800-530-9924), considering the nature and magnitude of the release. Revised: 03/24/2007 17 Emergency Response/Contingency Plan (IEVIBP Module) 4. Emergency Procedures: Emergency Coordinator Responsibilities: a. Whenever there is an imminent or actual emergency situation such as a explosion, fire, or release, the emergency coordinator (or his/her designee when the emergency coordinator is on call) shall: i. Identify the character, exact source, amount, and areal extent of any released hazardous materials. ii. Assess possible hazards to human health or the environment that may result from the explosion, fire, or release. This assessment must consider both direct and indirect effects (e.g. the effects of any tonic, irritating, or asphyxiating gases that are generated, the effects of any hazardous surface water run-off from water or chemical agents used to control fire, etc.). iii. Activate internal facility alarms or communications systems, where applicable, to notify all facility personnel. iv. Notify appropriate local authorities (i.e. call 971). v. Notify the State Office of Emergency Services at 1-800-852-7550. vi. Monitor for leaks, pressure build-up, gas generation, or ruptures in valves, pipes, or other equipment shut down in response to the incident. vii. Take all reasonable measures necessary to ensure that fires, explosions, and releases do not occur, recto, or spread to other . hazardous materials at the facility. b. Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall: i. Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from a explosion, fire, or release at the facility. ii. Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in azeas of the facility affected by the incident until cleanup procedures are completed. iii. Ensure that all emergency equipment is cleaned, fit for its intended use, and available for use. iv. Notify the California Environmental Protection Agency's Department of Toxic Substances Control, Kern County Environmental Health Services Department and the local fire department's hazardous materials program that the facility is in conrpliance with requirements b-i and b-ii, above. Responsibilities of Other Personnel: On a separate page, list any emergency response functions not covered in the "Emergency Coordinator Responsibilities" section, above. Next to each function, list the job title or name of each person responsible for performing the function. Number the page(s) appropriately. 5. Post-Incident Reporting/Recording: The time, date, and details of any hazardous materials incident that requires implementation of this plan shall be noted in the facility's operating record. Within 15 days of any hazardous materials emergency incident or threatened hazardous materials emergency incident that triggers implementation of this plan, a written Emergency Incident Report, including, but not limited to a description of the incident and the facility's response to the incident, must be submitted to the California Environmental Protection Agency's Department of Toxic Substances Control, Kern County Environmental Health Services Department and the local fire department's hazardous materials program. The report shall include: a. Name, address, and telephone number of the facility's owner/operator; b. Name, address, and telephone number of the facility; c. Date, time, and type of incident (e.g. fire, explosion, etc.); d. Name and quantity of material(s) involved; e. The extent of injuries, if any; f. An assessment of actual ox potential hazards to human health or the environment, where this is applicable; g. Estimated quantity and disposition of recovered material that resulted from the incident; h. Cause(es) of the incident; i. Actions taken in response to the incident; j. Administrative or engineering controls designed to prevent such incidents in the future. 6. Earthquake Vulnerability: [19 txR §2731(e)} Identify any areas of the facility and mechanical or other systems that require immediate inspection or isolation because of their vulnerability to earthquake-related ground motion: Aboveground storage tanks containing oil are located in the TLE, used batteries and used motor oil are located in the locked in the locked environmental cage outside the TLE. Propane tanks are located in the garden patio and front of store. Cylinders of compressed gases are located in McDonalds (cazbon dioxide} and in Layaway (helium). Revised: 03/24/2007 18 Emergency Response/Contingency Plan 7. Emergency Equipment: 22 CCR §66265.52(e) jas referenced by 22 CCR §66262.34{a)(4)J and the Hazazdous Materials Storage Ordinance require that emergency equipment at the facility be listed. Completion of the following Emergency Equipment Inventory Table meets this requirement. EMERGENCY EOLTIPMENT INVENTORY TABLE 1: Equipment Cat or 2. Equipment 'l' 3. Locations * 4. Descri Lion** Personal ^ Caz[rid a Res irators Protective ^ Chemical Monitoring ui ment (describe Equipment, ®Chemical Protective Aprons/Coats B3, Cl, D2, D3 Tire Lube Express (TLE), Safety Station, Hazardous Waste Accumulation Area (HWAC), Photo Safety ^ Chemical Protective Boots Equipment, ®Chemical Protective Gloves B3, Cl, D2, D3 TLE, Safet Station, HWAC, Photo and ^ Chemical Protective Suits (describe) First Aid ^ Face Shields Equipment ®First Aid Kits/Stations (describe) B3, Dl/2, D3, G2, FS TLE, Layaway, Photo, Receiving, Customer Srv. ^ Hard Hats ® Plumbed E e Wash Stations Dl, D3 Maintenance, Photo ^ Portable E e Wash Kits (i. e. bottle e) ^ Res irator Cartrid es (describe) ® Safet GlasseslS lash Go glen B3, Cl, D2, D3 TLE, Safet Station, HWAC> Photo ^ Safet Showers Self-Contained Breathin A aratuses (SCBA) ^ Other (describe) Fire ®Automatic Fire S rinkler S stems Entire Store Ceilin mounted s rinkler s stem Extinguishing ®Fire Alarm Boxes/Stations Entire Store Systems ®Fire Extinguisher Systems (describe) Entire Store Handheld fire extinguishers throughout store; locations marked by red arrow/ta eon columns ^ Other (describe) Spill ® Absorbents describe) Entire Store Sill Kits Control ^ Berms/Dikes (describe} Equipment ^ Decontamination ui ment {describe) and ^ Emer enc Tanks (describe) Decontamination ^ Exhaust Hoods Equipment ^ Gas C linden Leak Re 'r Kits (describe) ^ Neutralizers (describe) ^ Ove ack Drums ^ Su s (describe) ^ Other (describe) Communications ^ Chemical Alarms (describe) and ® Intercoms/ PA S stems Entire Store Alarm ® -Portable Radios Entire Store Man ement Staff Systems ® Tel hones Entire Store ^ Under and Tank Leak Detection Monitors ^ Other {describe) Additional Equipment ®Hazardous Waste Accumulation Area Back of store, D2 Bucket system, fire cabinet, and aerosol drum have been placed in the back of the stare to manage hazardous wastes generated at the store for pick up within 9{I days by a licensed CA transportation hauler for pro r dis sat. Revised: 03/24/2007 19 Employee Training Plan (Hazardous Materials Business Pian Module) Authority Cited: HSC, Section 25504(c),• Title 22, Div. 4.5, Ch. 12, An. 3 CCR Ail facilities that handle hazardous materials must have a written employee training plan. This plan is a required module of the Hazardous Materials Business Plan (HIVIBP). A blank plan has been provided below for you to complete and submit if you do not already have such a plan. If you already have a brief written description of your training program that addresses all subjects covered.below, you are not required to wmplete the blank plan, below, but you must include a copy of your existing document as part of your HMBP. Check all boxes that apply. (Note: Items marked with an asterisk (*) are required.]: 1. Personnel are trained in the following procedures: Internal alazm/notification * ® Evacuation/re-en ocedures & assembi oint locations* ® Emer nc incident ortin External emer enc res onse or anization notification ® Location{s) and contents of Emer enc Res nse/Contin enc Plan ® Facility evacuation drills that are conducted at least {specify) once every month. WM Training Procedures (coot.): Training procedures for new employees is through the Wal-Mart Computer Based Learning Program at the facility, and include on the job training. Training procedures are refreshed annually for hazardous materials storage, labeling, record keeping, and handling requirements; the Hazardous Materials Business Plan is reviewed by applicable new employees, to all applicable employees on an annual basis, and is available for all associates review in the Manager's Office, Environmental Manager's Guide. Material Safety Data Sheets are available online via the Wal-Mart web for review or printed out for onsite reference. Personnel and Claims associates track training records and manifests, respectfully. Training records and manifests are available for review upon request with the store manager. Fire drills are performed monthly to assure evacuation routes and meeting place; and the Automatic Fire Sprinkler System is checked by a licensed vendor quarterly. 2. Chemical Handlers are additionally trained in the following: Safe methods for handlin and stora a of hazardous materials ~` Location(s) and ro er use of fire ands ill wntrol ui meat S ill rocedures/emer enc rocedures Pro er use of ersonal rotective ui ment Specific hazard(s) of each chemical to which they may be exposed, including routes of exposure (i.e. inhalation, ingestion, abso tion) ® Hazardous Waste Handlers/Managers are trained in all aspects of hazardous waste management specific to their job duties {e.g. container accumulation time requirements, labeling requirements, storage area inspection requirements, manifesting requirements, etc.) * Hazardous Waste Accumulation Area with bucket system, fire cabinet, and aerosol drum have been placed in the back of the store to manage hazazdous wastes generated at the store for pickup within 90 days by a licensed CA transportation hauler for proper disposal. Alt applicable employees have been trained in the procedures of the Hazardous Waste Accumulation Area. Training records are available upon request at the store. Small quantity spills -associates are trained to use personal protective equipment, to clear the area, notify management, absorb the spill, place in a labeled and dated self-closing bag, and place in a plastic, color-coded bucket with sealing lids, labeled with type of material and accumulation start date, and placed in the Hazadous Waste Accumulation Area in the back of the store receiving area for 90 days pending pick-up from a licensed CA transportation hauler for proper disposal. Large spills -employees are not trained emergency responders; employees are instructed to ca11911and the store manager for emergency assistance; and the store manager will notify Wal-Mart Home Office at (479-204-8453) or 24-hour Alarm Central (800-530-9924) to uest an Emer nc Res onse Contractor, if necess Revised: 03/24/2007 20 3. Emergency Response Team Members are capable of and engaged in the following: ® Personnel rescue rocedures Shutdown of o erations Liaison with res ndin a encies Use, maintenance, and re lacement of emer enc res nse ui ment Refresher training, which is rovided at least annuall Emergency response drills, which are conducted at least (specify) once every month. Wal-Mart Store emergency coordinators will be available at the staging area to assist emergency responders. Revised: 03/24/2007 21 Record Keeping (Hazardous Materials Business Plan Module) All facilities that handle hazardous materials must maintain records associated with their management. A summary of your recordkeeping procedures is a required module of the Hazardous Materials Business Plan (HMBP). A blank summary has been provided below for you to complete and submit if you do not already have such a document. If you .already have a brief written description of your hazardous materials recordkeeping systems that addresses all subjects covered below, you are not required to complete this gage, but you must include a copy of your existing document as part of your I3NiBP. Check all boxes that apply. The following records are maintained at the facility. (Note: Items marked with an asterisk (*} are required.]: Current em to ees' trainin records to be retained until closure o the acili ® Former em to ees' trainin records (to be retained at least three ears a er termination o em to ent) Trainin Pro am(s i.e. written descri lion o introducto and continuin trainin) ® Current co of this Emer enc Res onse/Contin enc Plan Record of recordable/re rtable hazardous material/waste releases ® Record of hazardous materiallwaste storage area inspections Record of hazardous waste tank daily ins ections Descri lion and documentation of facilit emer ency res onse drills Note: The above list of records does not necessarily ident~ every type of record required to be maintained by the facility. A copy of the Inspection Check Sheet(s) or Log(s) used in conjunction with required routine self- inspections of your facility must be submitted with your Il3VIBP. (Exception: Available from your local agency is a Hazardous Materials/Waste Storage Area Inspection Form that you may use if you do not already have your own form. If you use the example provided, you do not need to attach a copy.) Check the a ro riate box: We will use the Unidocs "Hazardous Materials/Waste Storage Area lnspection Form" to document inspections. ® We will use our own documents to record inspections. (A blank copy of each document used must be attached to this HMBP.) WM Record Keeping (cont.): The Hazardous Materials Business Plan is available for aIl associates review in the Manager's Office, Environmental Manager's Guide_ Material Safety Data Sheets are available online via the Wa1~Mart web for review or printed out for onsite reference. Personnel and Claims associates track training records and manifests, respectfully. Training records are available for review upon request with the store manager. Revised: 03/24/2007 22 Los Angeles County Hazardous Materials Division Business Name: WAL-MART STORES, INC. (STORE #25; g Revision Date: 3122!2007 A B C Annotated Consolidated Storage Mai I Site Address: 8400 Rasedafe Highwa D E F G #'I Hazarclous Materials Plan , NOT TO SCALE GRANITE FALLS DRIVE Legend s 1 ; ® fire exit ~ i 1 USED aL j ~ i wAIX_IN ~ J3~3 WGNAGLp SED~AS7 fi~fm drains ~ / ((7,) 290 CAL FlLTER BINS /~~ ! Sanit sewer f'138Lt¢ j ' w E : ..._._..--- - .._ manno e p USED OIL AST ~ . _...__ _..._-._.................~....-------........- .„ l~ ~~~~~ pppp~---HELWU , LOADING A fire hydregfs~&~ 77Q~, D •AUN YAWAY • DOCK ~nrredtorre ® ~ ~ ~! i ~ ', spRnideraystem ~i Z rnwsrmnRnuo i ~i - I valves .. yu eA~TTERY cA~ lE{0-,YQD CAR aq,GeW' I ~ i • ®~ . i • ? • ! • ® ® elecirtcal stwtoft O (z~eoo cAi.. i ~ ~ { I N aL AST _. ,_ ..._.. _.._. .. , ~ ._._. --- - _ snutofl (1) SS OItL ~ ~ ' .____...._._. ._._.__~ ...----,-•._ _. .__ ...•®__ gas. . _ _ i- ~ ~ ..: ~ ..i... WIPER FLUID ~ ~ ] _ NJ10- - ~__'. -~ .__...... _ ....__.__........._... _._------- ` - ....._..... -~--~-~-----~--~---~~-~---- ~ ~ O . -_ -.-....._ -..__.._ti._.._._... ___..__ ._ . .~~_ ~~irorwxre.wo>-._.~._ ~ _. .. `.._ ._ . ;.. ~ -. water shutoff vr~ ~>~ I ~ E ! j 1 Rre extlngulsher nuo W (2) 29 OAL I ®• ~ • ` + • + MSOS & 3 ~ WBE aL/DR!•isE (f~ cAL i SPORTING i.._ ..... _._._ -_ __ _ --- _!_-. _,.-_ .._._ ..-__--,--------. .. i ~ contingency Plan CP a O i USED l)VL ASf OOOOS ® & ® ~ i • ~ ® • I • i • eyeawashers~e 0 ( I ' reonal protective ~y ~ ...... .. .. ... ._ ~.7 Z ( ~ ~~ 9e~1, _ ii CO TANKS PROPANE I • ~ • • ..__...•- J x GARDEN ~ __..._... __ ~ OPERATIO ...... ~ CENTER f i ~ spfll contalnmen- 8 PATIO • i,.»,.........._...: `., _._.-.._..-_-.-__.._. __._.... .....~ - REFRICERAiED miGgakion equipmAnt GRANULAR FQi1fL1ZF1t~ - - i._ FLOOR CASES HERBKgDESi ` i A CHiwCOAIIJGtrtER I ~.......,t_p__t.~..._.._..:..._,__1.p...~......._-......_..._..._..---....._...---......__.....L._._.._...--------- flrat~atl '! tlJSEGTIdDE4 ~ i ; ~ ~ • ± • , eQu meM *. aooL suPwJCS j ama° a~ ( _ .- • FR'S emergency •~ ~re .-.- ._--- _ OFFlCE essemblyarea ,..- _ ._...---- --~...___ ~.__ . .._ .. __..__ ._I_ _.._-- _ _ _.__ .. _ .. ----- r __ .._. . _.~ ,+ .. . ' __... _ CUSt01~ER _.._.... _ ---- ----- . tlazerdous waste HwAC ----. ~ • SFJtvICE accumulation area PROPANE _ (~TaW i ~ ENTRANCE I i ! ! ~ (JACK IN THE BD~ i ROSEDALE HIGHWAY' N w {' ~ r + WAL MART 2557 _______________________________________ SiteID: 015-021-001904 + Location: 84 OEROSEDALE HWY '~ ~55 ~ MapPho102 CommHaz88 High City BAKERSFIELD Grid: 20D FacUnits: 1 AOV: CommCode: KCFD STA 65 SIC Code:5399 EPA Numb: DunnBrad:05-195-7769 Emergency.Contact / Title Emergency Contact / Title H~E~i`R9~S~ / STORE MANAGER MARTY WALDRAM / ASST MANAGER Business Phone: (661) 588-2097x Business Phone: (661) 588-2097x 24-Hour Phone (501) 273-4600x 24-Hour Phone (661) 747-1180x Pager. Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press React ImmHlth DelHlth Contact Phone: (661) 588-2097x MailAddr: 702 SW 8TH ST State: AR City BENTONVILLE Zip 72716-0500 Owner WAL MART STORES INC Phone: (661) 588-2097x Address 702 SW 8TH ST State: AR City BENTONVILLE Zip 72716-0500 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ENT'D APR 2 7 2006 Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law 4hat I have personally examined and am familiar with the information submitted and believe the information is true, accur e, and complete. ~j,~ _ ~ y~ Sign/ture~ Date -1- 03/22/2006 Igo Annotated Consolidated Storage Map #1 H zardous Materials Plan M, Business Name: WAL MART (STORE #2557) Site Address: 8400 Rosedale Highway, Bakersfield, CA 93312 Submission Date: 8/02/04 Inspection Date: 7/23/04 A B C D E F G legend toazss-Aar 1 USED OIL FILTERS PUBLIC \ USED OIL \\\` USED LEAD-ACI IE \ ENVIRONMENT LACE NEw OIL [ NAPER FLUID W 3 ~ OIL%GREASE UOILD ' Q IV Q J _ _ l1 STORE PROPANE GARDEN Z GARDEN CENTER PATIO ~ GRANULARi fERTIUZER HERBICIDES 4 CHARCOAL LIGHTER FLUID INSECTICIDES ~ G~ANITE FALLS D ~~~ HELIUM 1 •AU TO YOTOR pL Q ANTIFREEZE Q TRANSY1590N FLUIO 0-AGO CAR BATTERIES • ® J ~ • iauo cAR wAz PASTE CAR wAX NDSNIELD VIPER FwIO ®• SPORTING GOODS ! PHOTO - PAINT- NNT THINNER ~~ - wppi€p FINIy1 i • I • • •® • POOL SUPPLIES POOL CLEANER CHLORINE • ALCAEGOE PROPANE (RETAIL) R~SEDALE HIGHWA storm drains ~ sanitary sewer manhole SO USED COOKING OIL fire hydrants & I connections sprinkler system ~( valves ICJ • electrical shutoff O gas shutoff •® ® water shutoff O fire extinguisher MSDS & MSDS & Contingency Plan CP safety showers & Q • eye washers personal protective PP equipment • ® spill containment & mitigation equipment • COpTANKS first aid • equipment McDONALD$ emergency assembly area ® fire exit • • NOT TO SCALE L'EAD'WEIGFTTS D CAR Ei~TTER Hazardous MaterialS/Hazardous Waste Unified Permit . CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID #:: 015-000-001904 WAL MART #2557 LOCATION: 8400 ROSEDALE HWY IELD ~ , This _oerrnit is issued for the followin_o: [] Hazardous Materials Plan E] Underground Storage of Hazardous Materials (~ Risk Management Program [3 Hazardous Waste On-Site Treatment Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Approved by: · Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 ..Expiration Date: Officeof Ev~Services ~ June 30; 2003 Issue Dale SYSTEM LAYOUT DATE: ~' ~- ~ ~ PREPARED BY: ~~~-- ' Comp~ Points ' ~ ~ ; , .: , ~ ~ ~ ~ , ~ ..... ~ ...... ~--~ ........ ~ ........ L--.-4-.--..~- .-L___.~._%_.~._ ~ ~ I i ~ ; ; ~ ~ : ' , ~ ~ ~ . ~ ~ : . ; I ........ :' ; ...... ~ ..... t ...... ~ ..... r .... f ....... i ..... ~ ..... i .... +--+ ..... i---~.--..4 .... 4 ..... i ....... 4----.4 .... ~----L...-~ ......... ,_ u___:_.. ; ; ' ~ ' :' ' ' ' ; " ' ' ~ ' ' ' ' ,- ; 'x,;~ ':' ;. ........... ~_ . ~ .... i .... %~ . ...... ~ ......... : ........ ~ .......... ; ............ ~ ............ ~ ...... 4 4 .... ~ ~ ~ 7~ ~;~ ; ~/ / ~, ~ : : .... ~ ' ' ( ~ _, - - t" - ' ' ' ' '~ CENTRAL RTATIC3N ~OP¥ -- Whit¢~ 2 -d:' o P, OSEDAL~: HIGHWAY 8AKERSFIELD CALIFC.'qNIA *"""-' '~ ITE DIAGRAM-I~-/~i FACILITY DIAGRAM Business Name:~ Business Address: UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 ::::'~~'~W~-1J~5~~ ~i~==~~=~====~~~~'-- FACILITYCONT ACT t- Business ID Number 15-021- Section 1: Business Plan and Inventory Program o Routine þ.( Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection c V ( C=Compliance ) V=Violalion OPERATION COMMENTS f~~:::;~::~~~;~~~n;;;~~~~~ --_~~=~~l2CO~l~6Qf$~--- o VISIBLE ADDRESS -----------,-----------~_..._---_._-----------_.__._--,._~._--- -~-_... )4_ 0 CORRECT OCCUPANCY ¥-;--~RIFICATION- O;~VENTORY :TE~-IAL;---·-----'--·---- ---- t___~~~~ERI~~~~ON_ OF _~~~~~~;~~ ___=~-~_..:_~~_.~_.~~-~:-._.~=_.: -_'_.___~~~~~__.~-~::_~~':__._.-__~~~~:-____. _!__~_.__~~~~~~AT~~ OF _~OC~T!~~_____________._________ _ _____________________ __.____._________-0 _._________ '___n_ ~__~~ROPER SEGR~GA~~_~~~~ERI~~__..______________,__ .,_____________ ____.,__._ __ _ __ ___.._________.________ ___ _u_ o VERIFICATION OF MSDS AVAILABILrTYE ------z..1tD~cyt --~Ù':j~J---~I--- 5t~~~E;---- - -- -...--tibf CÞ~- ffÞ\b¡.n;.~ê7ryl M-J-{I'7S- t~) -.. u_ _.____________._____.____._._____________~_.____ __._ '__~___..<_____..' ...____..__ _ __.........__..__.______._,.. .__ _._..._"_...__._.__....,__.___ ______.______._..._ __h·_____. . __ .___" ____.._____ tJr 0 VERIFICATION OF HA!'MAT TRAINING ~_,__.___~___._.____________._.__.._,____. ____..__.___"__.___ ._._____..____._.___"____.___..____..__ n._.____.__.___.__.__.,.__..."'·_,.._.._ "'.._ ,K( 0 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - ________________ ___________...__..___'_.___.,____ ._,,__., _.__._._~_.____ ·________4·'...·_·__.__·· ._._,_,. __.._._,_ ___" ___,,__,.,_ _., .____..____.___ lr~-~~~~,~~-~:~:~~~:~~A~------+ - ..... --- .__n - . . ··~=O~~;;EE~NG·~-~=-.=~=--=-===-=-:+1~-~~~~~----~~~~-- ~~~~~,______ __.~-~~-__-_~ - ~ 0 FIRE PROTECTION K-a---S,~~D~:~;AM A~~~u~~~ -&-O~ --H~~-;' ---- - ------ -------- -- ------------- ,---- -- - -------- --- -- - -- -- ---------- -- ---- - ------- I .. _. _'.. _ ·_.n_" __._. ANY HAZARDOUS WASTE ON SITE?: )If YES a No EXPLAIN: ~ 0. I / 13.H~ Ý\ ~.5 I ..-B4~~ HIS INSPECTION?:':E ~~US_A~(661) 326-3979~-'ll-±. \1 \~ n.D ,,,...__ Badge No,_ .l!1JL~~~\-arty ¡Ie· Environmenlal Services Yellow . Salion Copy Pink - Business Copy CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 171SChester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME vUt ýVJdt' 1FZEbr INSPECTION DATE IOIz,~/o 4-' EPAID# (l¡jt.- OOO(ql~c¿ Section 4: Hazardous Waste Generator Program o Routine ~ Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS (:) 1)Sc&Otl/~~\~~ Hazardous waste detennination has been made EP A ID Number Authorized for waste treatment and/or storage Reporteclrelease, fire, or explosion within IS days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames 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 SO 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 filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C-Compliance V~tion Inspector: '0 ¡p1fA J-r~ Office 0"/ ~. ,..,¡o(".t 326-3979 White - Env. Svcs. ~ I J ~~^\t00~A"" t BusIness SIte ResponsIble Party Pink - Business Copy ¡ -¡: WAL MART #2557 SiteID: 015-021-001904 Manager : DUANE FERRONE Location: 8400 ROSEDALE HWY City BAKERSFIELD BusPhone: Map : 102 Grid: 20D (661) 588-2097 CommHaz : Moderate FacUnits: 1 AOV: CommCode: KCFD STA 65 EPA Numb: SIC Code:5399 DunnBrad:05-195-7769 Hazmat Hazards: RSs Emergency Contact / Title DOU CIIUI'I1\m~~"\Y AM.. / ASSISTANT MGR Business pn~n~~ \b61) 588-2097x 24-Hour Phone : ~) Â73 4666^ Phone : (m) 7~7 -1I8D x Fire Press React ImmHlth DelHlth Emergency Contact DUANE FERRONE Business Phone: 24-Hour Phone : Pager Phone / Title / STORE MANAGER (661) 588-2097x (501) 273-4600x () x Contact : MailAddr: 8400 ROSEDALE HWY City BAKERSFIELD Phone: (661) 588-2097x State: CA Zip 93312 to Phone: (501) State: AR Zip 72716 TotalASTs: = TotalUSTs: = RSs: Yes 27x34600 Owner Address City WAL MART STORES INC 702 SW 8TH ST BENTONVILLE Period Preparer: Certif'd: Parcel No: Gal Gal Emergency Directives: I, Å"\ Do hereby cs&1ify ~ha~ i have (Ty reviewed the attached hazardous maierials managSD \ ,. I".' ÅÀ _:1 '2.557 ment plan for~and ~ha~ i~ along with (iI!tIIITIG of Business) any corrections eC)nsti~u~e a cömplet~ and oorr®d M(§!n- agemen~ plan ~or my iad!iW· ~ -1- 10/21/2004 'i F WAL MART #2557 f= Hazmat Inventory f== MCP+DailyMax Order SiteID: 015-021-001904 9 By Facility Unit 9 Fixed Containers at Site 9 specHaZ EPA Hazards Frm I DailyMax Unit MCP IH DH L 711. 00 LBS Hi IH DH L 463.00 LBS Hi F R IH S 350.00 GAL Hi F DH L 350.00 GAL Hi DH L 125.00 GAL Hi F P IH G 120.00 LBS Hi L 110.00 GAL Low F DH L 1950.00 GAL Min Hazmat Common Name. . . POOL CHLORINE POOL CHLORINE SULFURIC ACID (BATTERIES) PAINT REMOVER ._ WINDSHIELD WAS~OLVENT PROPANE ---.. ~ ANTIFREEZE MOTOR OIL All c/;d tJ¡/ C6~1C)- ~((Jr ..' -2 - 10/21/2004 " F WAL MART #2557 f= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME POOL CHLORINE CALCIUM HYPOCHLORITE Location within this ~cility Unit SEASONAL - BY TOY DEPT / €:t~J.Ç-/U ,A~ SiteID: 015-021-001904 ì Facility Unit: Fixed Containers at Site 9 Days On Site 365 Map: Grid: CAS# STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 75.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 711.00 LBS Daily Average 75.00 LBS %Wt. RS CAS# 90.00 Calcium Hypochlorite No 7778543 3.00 Sodium Chloride No 7647145 5.00 Calcium Chlorate No 10137243 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Hi HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -3- 10/21/2004 .- SiteID: 015-021-001904 9 Facility Unit: Fixed Containers at Site ì F WAL MART #2557 f= Inventory Item 0002 ~ COMMON NAME / CHEMICAL NAME POOL CHLORINE TRICHLOROISYANURIC ACID Location within this Facility Unit SEASONAL - NEXT TO TOY DEPT 7 ØJ¡N J.~ A<~ Days On Site 365 Map: Grid: Þ'I G1Øi,.1> ~> CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 25.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 463.00 LBS Daily Average 25.00 LBS %Wt. RS CAS # 96.00 Trichloro-s-triazinetrione No 87901 4.00 Dichloroisocyanuric Acid No 2782572 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Hi HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -4- 10/21/2004 SiteID: 015-021-001904 9 Facility Unit: Fixed Containers at Site 9 F WAL MART #2557 f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME SULFURIC ACID (BATTERIES) Days On Site 365 Location within this Facility Unit AUTOMOTIVE DEPT Map: Grid: CAS# 7664-93-9 STATE - TYPE Solid Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE BOX Largest Container 2.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 350.00 GAL Daily Average 250.00 GAL HAZARD US COMPONENTS %Wt. RS CAS# 26.00 Sulfuric Acid ( EPA) No 7664939 o HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F R IH / / / Hi Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined5: - Ag .Define11 -5- 10/21/2004 SiteID: 015-021-001904 , Facility Unit: Fixed Containers at Site, F WAL MART #2557 f= Inventory Item 0008 F== COMMON NAME / CHEMICAL NAME PAINT REMOVER METHYLENE CHLORIDE/PETROLEUM DISTILLATES Location within this Facility Unit PAINT DEPT Days On Site 365 Map: Grid: CAS # 67641 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 1. 00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 350.00 GAL Daily Average 300.00 GAL %Wt. RS CAS # 50.00 Methylene Chloride No 75092 50.00 Petroleum Distillate, Straight Run Middle No 8030306 HAZARDOUS COMPONENTS HAZARD ASSE M S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Hi SS ENT Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined5: Ag.Defined8: - Ag.Define11 -6- 10/21/2004 SiteID: 015-021-001904 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 F WAL MART #2557 p= Inventory Item 0006 === COMMON NAME / CHEMICAL NAME WINDSHIELD WASHER SOLVENT METHANOL SOLUTION Location within this Facility Unit TIRE LUBE EXPRESS Map: Grid: CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 125.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 125.00 GAL Daily Average 60.00 GAL %wt. I 40.00 Methanol HAZARDOUS COMPONENTS ~ CAS# 675611 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Hi HAZARD ASSESSMENTS Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.DefinelO: - Ag.Define11 -7- 10/21/2004 SiteID: 015-021-001904 9 Facility Unit: Fixed Containers at Site 9 F WAL MART #2557 f= Inventory Item 0007 == COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within thï' , Facility Unit Map: Grid: SPORTING GOODS DEPT ~f-.6Ò Îc(~ ~~. k~;.. /'f"~~("PIJ...~ A\~ / A)N CAS# 74-98-6 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 1.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 120.00 LBS Daily Average 80.00 LBS HAZARDOUS COMPONENTS I~ CAS # 749861 I l~~~óolpropane TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS Ag.Defined1: Ag.Defined5: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined8: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Define11 1õ·4 e.ì =- t . 7(+) + 5 \' f)1I\- L? gti~ l~/V +- /1Þ + £!òI<,."t p.;..-~/./l.- l> U4b > J' CtXA-ÁJt f;.a>~I~\~ ~ (1~) -z; ~10 ~ i -8- 10/21/2004 SiteID: 015-021-001904 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 F WAL MART #2557 f= Inventory Item 0004 F= COMMON NAME / CHEMI CAL NAME ANTIFREEZE ETHYLENE GLYCOL Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS Map: Grid: CAS# STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1. 00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 80.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low HAZARD ASSESSMENTS Ag.Defined5: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined1: Ag.Defined8: - Ag. Define11 -9- 10/21/2004 'õ SiteID: 015-021-001904 ì Facility Unit: Fixed Containers at Site ì F WAL MART #2557 f= Inventory Item 0005 F== COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS Map: Grid: CAS# 8020835 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 400.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 1950.00 GAL Daily Average 1600.00 GAL Z OM E %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 HA ARDOUS C PON NTS AR SM S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZ D ASSES ENT Ag.Defined1: Ag.Defined5: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Definel1 -10- 10/21/2004 c,. - .G+-z...:¡- ) 7 ~ > ......,.......... cc.&J r ð<'U / . 9cC/ c: " 3-:J(') WAL MART #2557 Manager : DUANE FERRONE Location: 8400 ROSEDALE City : BAKERSFIELD BusPhone: CommCode: COUNTY STATION 65 EPA Numb: SiteID: 015-021-001904 Map : 102 Grid: 20D (661) 588-2097 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:5399 DunnBrad:05-195-7769 Emergency Contact DUANE FERRONE Business Phone: 24-Hour Phone : Pager Phone : / Title / STORE MANAGER (661) 588-2097x (501) 273-4600x ( ) - x Emergency Contact / Title DON CHUMAN / ASSISTANT MGR Business Phone: (661) 588-2097x 24-Hour Phone : (501) 273-4600x Pager Phone : ( ) - x Hazmat Hazards: RSs Fire Press React ImmHlth DelHlth Contact : MailAddr: 8400 ROSEDALE HWY City : BAKERSFIELD Phone: (661) State: CA Zip : 93312 588-2097x Owner WAL MART STORES INC Address : 702 SW 8TH ST City : BENTONVILLE Phone: (501) State: AR Zip : 72716 27x34600 Period : Preparer: Certif'd: to TotalASTs: = Gal TotalUSTs: = Gal RSs: Yes Emergency Directives: ~ Hazmat Inventory --Alphabetical Order Hazmat Common Name... ANTIFREEZE MOTOR OIL PAINT REMOVER POOL CHLORINE POOL CHLORINE PROPANE SULFURIC ACID (BATTERIES) One Unified List Ail Materials at Site EPA HazardsI Frm [ DailyMax Unit MCP ISpecHazI 110 00 GAL 1950 00 GAL 350 00 GAL 463 00 LBS 711 00 LBS 120 00 LBS 350 00 GAL 125 00 GAL L F DH L F DH L IH DH L IH DH L F P IH G F R IH S (Type or print name) reviewed the attached hazardous materials manage- ment plan for ~3,L'-Oi(~f<T and that it along with (Name of 8usine~s) Low Min Hi Hi Hi Hi H± Hi any corrections constitute a complete and correct man- 05/03/2001 WAL MART #2557 ~ Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME ANTIFREEZE ETHYLENE GLYCOL Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS SiteID: 015-021-001904 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# STATE -- TYPE PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 80.00 GAL HAZARDOUS COMPONENTS %Wt. 100.00 Ethylene Glycol N 107211 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies NFPA I USDOT# I MCP / / / Low = Inventory Item 0005 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 VSTATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 400.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 1950.00 GAL Daily Average 1600.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Motor Oil, Petroleum Based  SI CAS# N 8020835 HAZARD ASSESSMENTS ITSecretNo NoRS BioHazl Radi°active/Amount IEPA Hazards]No No/ Curies F DH NFPA /// USDOT# MCP Min 2 05/03/2001 WAL MART//2557 ~~~8~8~6~6~ SitelD: 015-021-001904 Invento~ Item 0008 ~~6~ Facility Uffit: Fixed Containers at Site i~ COMMON NAME / CHEMICAL NAME PAINT REMOVER o Days On Site METHYLENE CHLO~DE/PETROLEUM DISTILLATES o 365 o Location wi~in this Facility U~t Map: Grid: PAINT DEPT o CASff o o 67641 o STATE ~i~ TYPE ~i~ PRESSURE ~O~i TEMPE~TURE ~i~¢ CONTAINER TYPE Liquid o ~re o Ambient o Ambient o METAL CONTAINR-NONDRUM o i~~~~i AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o 1.00 GAL o 350.00 GAL o 300.00 GAL o ififiEEE~Ei~E~EEfifi~E~fi HAZARDOUS COMPONENTS %Wt. o o RSo CASff o 50.00OMethylene Chloride ONo o 75092° 50.00Opetrolem Distillate, Straight Run Middle ONo o 8030306° i~i~i~i~~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT~ o MCP o No ONoONo o No/ Curies°F DH° /// o OHio Inventory Item 0002 ~~EE~E Facility Unit: Fixed Containers at Site i~ COMMON NAME / CHEMICAL NAME POOL CHLORINE o Days On Site o TRICHLOROISYANURIC ACID ° 365 o Location within this Facility Unit Map: Grid: SEASONAL - NEXT TO TOY DEPT o CAS# o O o STATE ~i~ TYPE ~i~ PRESSURE ~5~i TEMPERATURE ~i~ CONTAINER TYPE Liquid o Mixture o Ambient o Ambient o PLASTIC CONTAINER o i~fi~fi~fi~fi~i AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o 25.00 LBS ° 463.00 LBS o 25.00 LBS o i~i~~ HAZARDOUS COMPONENTS %Wt. o o RSo CAS# o 96.00 °Trichloro-s-triazinetrione o No o 87901 o 4.00°Dichloroisocyanuric Acid ONo o 2782572° i~i~i~i~~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount ° EPA Hazards ° NFPA ° USDOT# ° MCP ° No ONoONo o No/ Curies° IH DH ° /// o OHio -3- 05/03/2001 WAL MART//2557 ~~~~~~ SitelD: 015-021-001904 i~ Inventory Item 0003 ~~~ Facility Unit: Fixed Containers at Site i i~ COMMON NAME / CHEMICAL NAME POOL CHLORINE o Days On Site o CALCIUM HYPOCHLORITE o 365 o Location within this Facility Unit Map: Grid: SEASONAL - BY TOY DEPT o CAS// o o o STATE 5~5 TYPE ~ PRESSURE ~ TEMPERATURE 5~ CONTAINER TYPE Liquid o Mixture o Ambient o Ambient o PLASTIC CONTAINER o i~~5~~5~ AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o 75.00LBS o 711.00 LBS o 75.00 LBS o %Wt. o o RSo CAS# o 90.00OCalcium Hypochlorite ONo o 7778543° 3.00°Sodium Chloride ONo o 7647145° 5.00°Calcium Chlorate ONo o 10137243° i~i~i~i~~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT//o MCP o No ONoONo o No/ Curies° IH DH° /// o OHio Inventory Item 0007 EEEEEEEEEEEEEEE Facility Unit: Fixed Containers at Site i~ COMMON NAME / CHEMICAL NAME PROPANE o Days On Site o o 365 o Location within this Facility Unit Map: Grid: SPORTING GOODS DEPT o CAS// o o 74_98_6° STATE ~i~ TYPE ~i~ PRESSURE ~i TEMPERATURE ~i~ CONTAINER TYPE Gas o Pure o Above Ambient o Ambient o PORT. PRESS. CYLINDER o i~~~~i AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o 1.00LBS o 120.00 LBS o 80.00 LBS o i~iEEEEE~EE5~E~E6 HAZARDOUS COMPONENTS %Wt. o o RSo CAS# o 100.00Opropane OYeso 74986° i~i~i~i~~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT//o MCP o No ONoONo o No/ Curies °FP IH o /// o OHio -4- 05/03/2001 WAL MART//2557 ~~~~~~ SiteID: 015-021-001904 Inventory Item 0001 ~~~ Facility Unit: Fixed Containers at Site i~ COMMON NAME / CHEMICAL NAME SULFURIC ACID (BATTERIES) o Days On Site o o 365 o Location within this Facility Unit Map: Grid: AUTOMOTIVE DEPT o CAS// o o 7664_93_9° i5 STATE ~i~ TYPE ~i~ PRESSURE ~i TEMPERATURE ~i~ CONTAINER TYPE ~i Solid o Pure o Ambient o Ambient o BOX o i~~5~5~i AMOUNTS AT THIS LOCATION ~~~~i Largest Container o Daily Maximum o Daily Average o 2.00 GAL o 350.00 GAL o 250.00 GAL o %Wt. o o RSo CAS// o 26.00oSulfuric Acid (EPA) ONo o 7664939° i~i~i~i~~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT//o MCP o No °Yes°No o No/ Curies °F R IH o /// o OHio Inventory Item 0006 E~EEEEEEE~ Facility Unit: Fixed Containers at Site i~E COMMON NAME / CHEMICAL NAME EEE~EEEEEE~EEEEEEEE~EEEi~E~EEE~E~EEEi WINDSHIELD WASHER SOLVENT o Days On Site o METHANOL SOLUTION o 365 o Location within this Facility Unit Map: Grid: TIRE LUBE EXPRESS o CAS// o o O STATE ~i~ TYPE ~i5~ PRESSURE ~5i TEMPERATURE ~5i~ CONTAINER TYPE Liquid o Mixture o Ambient o Ambient o PLASTIC CONTAINER o i~~~5~~i AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o 125.00 GAL o 125.00 GAL o 60.00 GAL o i~EEEEEEiEEEEEEEE~EEEEE HAZARDOUS COMPONENTS %Wt. o o RSo CAS// o 40.00OMethanol ONo o 67561° i~i~i~i~8~ HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT//o MCP o No ONoONo o No/ Curies° DH° /// o -5- 05/03/2001 MISCELLANEOUS RECEIVABLES ADJUSTMENT NEW ACCOUNT .ADDRESS CHANGE CLOSE ACCT FINANCE CHARGE I., OTHER ADJ CUSTOMER NAME MAILING ADDRESS SITE ADDRESS PARCEL NUMBER (IF APPUCABI..E) STATE ZIP CODE-~'7 } ~coL~[~ ADJUSTMENT } CHG DATE · ' I CHARGE CODE ADJUSTMENT AMOUNT REMARKS' '~~, APPROVED BY Vendor No. J CLAIMANT'S NAME AND ADDRESS: Wal Mart Store Inc #2557 702 SW 8th Street Bentonville, AR 72716-8015 CITY OF BAKERSFIELD CLAIM VOUCHER I certify that this claim is correct and valid, and is a proper charge against the City Agency and account indicated. (AUTHORIZED SIGNATURE OF CITY AGENCY) Date: 04-01-99 Initials of Preparer: ClTY DEPARTMENT:FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Cor~'act Number if Applicable) This customer made a duplicate payment on this years Haz Mat bill in the amount of $176.50. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $185.00. Dept. 0000 El / Objt 7900 Project # Invoice # VOUCHER TOTAL Amount Date of Invoice $185.00 $185.00 SECTION 72, PENAL CODE Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. :INANCE DEPT. USE ONLY Examined & Approved for Payment Amount STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501TRUXTUN AVE BAKERSFIELD, CA 93301-5201 TO: (805) 326-3979 WAL MART STORE INC ~2557 70~ SW 8TH ST BENTONVILLE~ AR 7~716-8015 DATE- 4/01/99 CUSTOMER NO: 20044 CUSTOMER TYPE: ES/ ~5824 CHAROE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT SSOOi 3101199 BEQINNINO BALANCE ~/i7/99 PAYMENT 3/Gi/99 Charge adjustment CA STATE SURCHARQE 4/30/99 · O0 176. 50- 8. 50- FOR OUESTIONS OR CHANOES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 8.50- DUE DATE: 5/03/99 PAYMENT DUE: TOTAL DUE: 185.00- ~185.00- (805) G~6-G979 CUSTOMER NO: CUSTOMER TYPE: ES/ TOTAL DUE: ~5824 9~85.00- WAL MART #2557 Manager : DUANE FERRONE Location: 8400 ROSEDALE City : BAKERSFIELD HWy~P~'Y~IB~T~D / SiteID: 215-000-001904 1 5 7999 ~usPhone: (805) 588-2097 ---~ ~ap : 102 CommHaz : Moderate ~rid: 20D FacUnits: 1 AOV: CommCode: COUNTY STATION 65 EPA Numb: SIC Code:5399 DunnBrad:05-195-7769 Emergency Contact DUANE FERRONE Business Phone: 24-Hour Phone : Pager Phone : / Title / STORE MANAGER (805) 588-2097x (501) 273-4600x ( ) - x Emergency Contact DON CHUMAN Business Phone: 24-Hour Phone : Pager Phone : / Title / ASSISTANT MGR (805) 588-2097x (501) 273-4600x ( ) - x Hazmat Hazards: RSs Fire Press React ImmHlth DelHlth Contact : MailAddr: 8400 ROSEDALE HWY City : BAKERSFIELD Phone: (805) 588-2097x State: CA Zip : 93312 Owner WAL MART STORES INC Address : 702 SW 8TH ST City : BENTONVILLE Phone: (501) State: AR Zip : 72716 27x34600 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: Yes Emergency Directives: ~ Hazmat Inventory --As Designated Order Hazmat Common Name... SULFURIC ACID (BATTERIES) POOL CHLORINE POOL CHLORINE ANTIFREEZE MOTOR OIL WINDSHIELD WASHER SOLVENT ISpecHazI One Unified List Ail Materials at Site EPA HazardsI Frm I DailyMax Unit MOP E PROPANE r~ / F P IH G PAINT REMOVER ~, ~ ~o~~ D0 hereby %ertify ~hat P~ave L rewis~ ~h~ a~ch~d h~ardous materials manage- wi~h any corm~ion~ ~nsfi~ute a comple~ and ~rr~c~ man- F R IH S 350 GAL Hi IH DH L 463 LBS Hi IH DH L 711 LBS Hi L 110 GAL 'Low F DH L 1950 GAL .__Min DH L 125 GAL Hi 120 LBS Hi 350 GAL Hi 02/25/1999 WAL MART #2557 = Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME SULFURIC ACID (BATTERIES) , Location within this Facility Unit AUTOMOTIVE DEPT SiteID: 215-000-001904 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 7664-93-9 F STATE ~ TYPE sOlid /Pure PRESSURE Ambient TEMPERATURE Ambient BOX CONTAINER TYPE Largest Container 2.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 350.00 GAL Daily Average 250.00 GAL HAZARDOUS COMPONENTS %Wt. I 26.00 Sulfuric Acid (EPA) yeRsS CAS#7664939 TSecretINo YesRS]Bi°HaZNo HAZARD ASSESSMENTS I Radioactive/Amount I EPA Hazards I NFPA No/ Curies F R IH / / / USDOT# MCP Hi = Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME POOL CHLORINE TRICHLOROISYANURIC ACID Location within this Facility Unit SEASONAL - NEXT TO TOY DEPT Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# STATE TYPE PRESSURE Ambient Mixture Liquid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 25.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 463.00 LBS Daily Average I 25.00 LBS %Wt. 96.00 4.00 HAZARDOUS COMPONENTS Trichloro-s-triazinetrione Dichloroisocyanuric Acid  S CAS# N 87901 No 2782572 TSecret No I RSiBioHaz No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies IH DH NFPA I USDOT# IMCP/// Hi -2- 02/25/1999 WAL MART #2557 ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME POOL CHLORINE CALCIUM HYPOCHLORITE Location within this Facility Unit SEASONAL - BY TOY DEPT SiteID: 215-000-001904 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# STATE ? TYPE PRESSURE Ambient Mixture Liquid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 75.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 711.00 LBS Daily Average 75.00 LBS HAZARDOUS COMPONENTS %Wt. I 90.00 Calcium Hypochlorite 3.00 Sodium Chloride 5.00 Calcium Chlorate N 7778543 INo I 7647145 No 10137243 TSecret No HAZARD ASSESSMENTS N~S BioHazI Radioactive/Amount EPA Hazards No No/ Curies IH DH NFPA/// I USDOT# ~ Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME ANTIFREEZE ETHYLENE GLYCOL Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# rSTATE ~ TYPE Liquid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 80.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS, Ethylene Glycol N~S CAS# 107211 TSecret No I RSiBioHaz No No HAZARD ASSESSMENTS I Radioactive/Amount I EPA Hazards I No/ Curies NFPA/// I USDOT# MCP Low -3- 02/25/1999 WAL MART #2557 ~ Inventory Item 0005 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit AUTO DEPT & TIRE LUBE EXPRESS SiteID: 215-000-001904 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 STATE -- TYPE PRESSURE Ambient Liquid Pure TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 400.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 1950.00 GAL Daily Average 1600.00 GAL HAZARDOUS COMPONENTS %Wt. I 100.00 Motor Oil, Petroleum Based N 8020835 TSecretINo NoRSIBi°HaZNo HAZARD ASSESSMENTS Radioactive/Amount' EPA Hazards No/ Curies F DH NFPA /// USDOT# MCP Min = Inventory Item 0006 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WINDSHIELD WASHER SOLVENT Days On Site METHANOL SOLUTION 365 Location within this Facility Unit Map: Grid: TIRE LUBE EXPRESS CAS# VSTATE ~ TYPE Liquid/Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 125.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 125.00 GAL Daily Average 60.00 GAL %Wt. 40.00 Methanol HAZARDOUS COMPONENTS No S CAS 6 s611 HAZARD.ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies DH NFPA/// I USDOT# MCP Hi -4- 02/25/1999 WAL MART #2557 = Inventory Item 0007 -- COMMON NAME / CHEMICAL NAME PROPANE Location within this Facility Unit SPORTING GOODS DEPT SiteID: 215-000-001904 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 74-98-6 F STATE ~ TYPE Gas /Pure PRES SURE TEMPERATURE I Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 1.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 120.00 LBS Daily Average 80.00 LBS %Wt. 100.00 Propane HAZARDOUS COMPONENTS CAS# N 74986 HAZARD ASSESSMENTS Radi°active/Am°untNo/ Curies I EPAF P HazardsiH NFPA /// USDOT# MCP Hi ~ Inventory Item 0008 -- COMMON NAME / CHEMICAL NAME PAINT REMOVER METHYLENE CHLORIDE/PETROLEUM DISTILLATES Location within this Facility Unit PAINT DEPT Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 67641 STATE I TYPE - PRESSURE Ambient Pure Liquid -- TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 350.00 GAL Daily Average 300.00 GAL %Wt. 50.00 50.00 HAZARDOUS COMPONENTS Methylene Chloride Petroleum Distillate, Straight Run Middle CAS# N 75092 No 8030306 TSecret No HAZARD ASSESSMENTS I RS BioHazI Radioactive/AmOunt EpA Hazards No No No/ Curies F DH NFPA/// I USDOT# -5- 02/25/1999 F WAL MART 92557 SiteID: 215-000-00'1904 Fast Format ~ BUSINESS PLAN PROGRAM Overall Site --Agency Notification 12/04/1998 STORE MANAGER (OR MANAGER ON DUTY) ACTS AS EMERGENCY COORDINATOR: FIRE DEPT - 911 LOCAL OFFICE OF ENVIRONMENTAL SERVICES - 326-3979 STATE OFFICE OF ENVIRONMENTAL SERVICES - 800-852-7550 OR 916-262-1621 Employee Notif./Evacuation -- Public Notif./Evacuation -- Emergency Medical Plan 12/04/1998 EACH STORE H_AS A MEDICAL PROVIDER (DETERMINED BY STORE Mg2XlAGEMENT) THAT IS AFFILIATED WITH A LOCAL HOSPITAL. VALLEY INDUSTRIAL MEDICAL GROUP - 2501 G ST - 327-2225 OR MEMORIAL HOSPITAL - 420 34TH ST - 327-1792. F WAL MART #2557 SiteID: 215-000-001904 Fast Format BUSINESS PLAN PROGRAM -- Release Prevention Overall Site 12/04/1998 SPILL PREVENTION IS LARGELY A MATTER OF MONITORING BY STORE ASSOCIATED; ~ MAINTENANCE OF GOOD STOCKING & HOUSEKEEPING PROCEDURES IS PRACTICED, ACCORDING TO PROCEDURES SET OUT IN THE RISK MANAGEMENT RESOURCE MANUAL TAB 5: FLOOR SAFETY; TAB 23; HAZARD COMMUNICATION. BULK OIL STORAGE IN THE TIRE & LUBE EXPRESS IS ADDRESSED BY A SEPERATE SPILL PREVENTION PLAN. -- Release Containment 12/04/1998 IMMEDIATE RESPONSE PROCEDURES ARE DESCRIBED IN THE RISK MANAGEMENT RESOURCE MANUAL TAB 23: HAZARD COMMUNICATION & INCLUDE SPILL ISOLATION, CONTAINMENT, CLEANUP & DISPOSAL PROCEDURES. ALSO INCLUDED ARE EMERGENCY RESPONSE CONTACTS, PERSONAL PROTECTIVE EQUIPMENT, REQUIREMENTS & RELATED TOPICS. -- Clean Up 12/04/1998 CLEANUP & DISPOSAL OF RELEASED MATERIALS IS ADDRESSED IN THE RISK MANAGEMENT RESOURCE MANUAL TAB 23 HAZARD COMMUNICATION. SPILL CLEANUP KITS ARE LOCATED IN SEVERAL LOCATIONS AND PROCEDURES ARE PRESENTED ON THE KIT. DISPOSAL OF HAZARDOUS MATERIALS IS ACCOMPLISHED THROUGH 1. STABILIZATION & RETURN OF pRODUCT TO RETURN CENTER FOR ROUTING TO VENDOR OR INCENERATION TRAILOR; 2. PICKUP BY LICENSED WASTE HAULER FOR OFFSITE DISPOSITION; OR 3. IF THE PRODUCT IS BIODEGRADABLE & IN SMALL QUANTITY, ARRANGE WITH LOCAL WASTE TREATMENT PLANT FOR INCLUSION WITH SANITARY SEWAGE. Other Resource Activation F WAL MART #2557 SiteID: 215-000-001904 Fast Format F BUSINESS PLAN PROGRAM Special Hazards Overall Site --Utility Shut-Offs A) GAS - W END OF BLDG B) ELECTRICAL - N SIDE OF BLDG, REAR C) WATER - N SIDE OF BLDG, REAR D) SPECIAL - NONE E) LOCK BOX - NO 12/04/1998 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLERS. 12/04/1998 NEAREST FIRE HYDRANT - THEY ARE ALL OVER. Building Occupancy Level F WAL MART #2557 SiteID: 215-000-001904 Fast Format BUSINESS PLAN PROGRAM -- Employee Training WE HAVE 280 EMPLOYEES AT THIS FACILITY. Overall Site 12/04/1998 WE HAVE ALL MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFE OPERATING & EMERGENCY PROCEDURES ARE FOUND IN OUR RISK MANAGEMENT RESOURCE MANUAL IN TAB 15: EMERGENCY PROCEDURES & TAB 23: HAZARD COMMUNICATION. NEW EMPLOYEE TRAINING, RETRAINING ON REASSIGNMENT, ANNUAL REFRESHER TRAINING & ANY SPECIAL TRAINING DOCUMENTAITON IS RETAINED BY THE TRAINING COORDINATOR & IN EACH ASSOCIATES PERSONNEL FILE. Page 2 Held for Future Use Held for Future Use ' CITY OF BAKERSFIELD -. OFFICE' OF ENVIRONMENTAL.SIgI~..,~~S~, 1715 Chester Ave., Bakersfield, CA (805) 326'3979 1. ' To avoid further action, return this form within 30 days of receipt. ~,/34~~ 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: iA&/-k~¢+ 540 c¢% LOCATION: }/{oJ- lt]to.c ~- '~ ~5'5 '7 MAIL~G ADDRESS: ~'~ ~ CITY: ~<,5 -'~; ~ STATE: ZIP: J-~f//-" PHONE:' DL,W & BRADSTREETNUMBER: 05~ IC?5- 77(a~ PRLX~Y ACTIVITY: 'Pxt~_o2 I ~o_[eS · SiC CODE: 5'3 99 OWNER: NO-I-/~ct %4oces, :F,~tc. ' ~LMLINGADDRESS: '70;l. co.~d g~/' .S~- ~,~.,~d~¥,'/le ,4~ 72,.71& SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE ._:/f- 24 HR. PHONE ~o t- ,a 75-q o0o -i HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: -'~. - ~ ~ · MATERIAL SAFETY DATA SHEETS ON FILE: A l { BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEN[PTION REOUEST I CERTIFY U~'W'DER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM REpORTINGREQUIRE~NTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH THE ...& SAFETY'CODE'' FOR THE FOLLOWING REASONS: "4' WE DO NOT HANDLE I-L4ZARDOUS MATERLM. S. WE DO I-L4MDLE HAZARDOUS NLATERIALS, BUT THE QUANTITIES AT. NO TDdE EXCEED THE M]-X~.WI REPORTEqG QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I. ~,~..a~z ,/~.~_o-~,~ff~ CERTIFY THAT THE ABOVE INFORMATION 'IS ACCURATE. I U~q:)ERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL ~fY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAF/~Y CODE'~ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.V'AND THAT/JNACCURATE INFORMATION CONSTITUTES PERJURY. ' : ' -SIGNA~rRE ' TITLE DATE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES AGENCY NOTtFICATION PROCEDURES: EMPLOYEE NOTIFICATION AuN'D :EVACUATION: PL~LIC E\.'ACUATION: HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: 5 B. ~LEASE CO~~~T X~OR ~ATIO~; ~~fi~b Z S' ~aza cd ~c~~ ~(~4~ ¢oc ~clo5,'o~ )~,~k W~,~c5 ~e~. SECTION 8: LT~ITY S~-O~S (LOCATI. ON OF S~-O~S AT YO~ FAC~I~ NATLq:bU.., GAS/PROP,~NE: '-U B, A. SPECIAL: LOCK BOX: ~ IF YES, LOCATION: 77. g,/L. SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY mo PRIVATE FIRE PROTECTION: VT,, ~_ Tx+- ~ ~(oC~ &k..f B. WATER AVA1J.,ABILITY (FIRE I--Dq)tLkNT): 4 EMERGENCY PROCEDURES COVER THIS MATERIAL WITH ALL ASSOCIATES, EVENING, PEAK-TIME, WEEKEND AND FULL TIME. The safety of customers and associates is the number one priority in any emergency situation. Evacuation procedures must be started immediately when the safety of customers or associates is threatened. Fire (Code Red), Bomb Threat (Code Blue), Shootings (Code Brown) require the evacuation of the building. Associate/customer injury (Code White), severe weather (Code Black), Hostage Situations (Code Green), or Missing Child (Code Adam) do not necessarily require evacuation of the building. We use color codes for emergency procedures: [] Code Red Fire [] Code Blue Bomb Threat [] Code Black Weather [] Code White Customer or Associate Injury [] Code Green Hostage Situations [] Code Brown Shootings [] Code Adam Missing Child [] Code Orange Chemical Spill Response FIRE CODE RED: FIRE EVACUATION PLAN Remain calm. Your signal to evacuate is a Code Red announcement over the public address system, fire alarm or a fellow associate. Proceed to the nearest exit assisting customers/associates along the way in an orderly fashion. WALK DO NOT RUN Unlock doors as you leave your area. Close all doors (bm do not lock them) as you exit. Watch for customers and fellow associates who may need extra help exiting the building. Go to your designated meeting area Outside the building. Wait there for further instructions. Please familiarize yourself with the evacuation procedure and the most direct rome om of the facility from your work area along with one alternative route in case the first is blocked by smoke etc. Keep the Wal-Mart Emergency Procedure Flip Chart in a common place for fast reference in the event of an emergency. If you are the first to observe a fire, notify the service desk, management, or use of the fire pull boxes located throughout the facility. Never try to extinguish the fire prior to notifying the service desk or fire department. Secure high dollar merchandise before leaving an area that is not in danger. Wal-Mart associates: Refer to your Store Manual, Code: LP-13. Sam's ~ssociates, refer to your Club Manual, Code LP3. 15-6 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326,3979 SITE AND FACILITY DIAGRAM INSTRUCTIONS FOR HAZARDOUS MATERIALS MANAGEMENT PLANS These instructions explain the use of the site diagram and the facility diagram. Normally, small and medium size businesses will only have to submit a site diagram. If you have subdivided your business into smaller areas because of the complexity or size, then you will be completing and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business it it is in a remote location. SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following information: Check the box on the top lef~ comer of the form provided that indicated "Site Diagram". Print the name of your business, as shown in your HMMP, on the top of the diagram. Label the location of the hazardous materials and identLry them by name and type of hazard (ie. Flammable liquid, corrosive solid). .~~-Label the location of utility shutoff points for gas, electric and water services. .~5~. Labei' the' location of fire hydrants. ~6~ Label portions of the building protected by automatic sprinkler systems. ~bel the direction representing north on the diagram. (The diagram form provided includes a north arrow). Map labeling must be leijble~d easily understandable. Try to avoid t~ symbols. If you must use them, pr~ovide a legend explaining your system. use of abbreviations or Maps may be returned ,for correction ifyo~ fail to follow these instruction. FACILITY DIAGRAM INSTRUCTIONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. Check the box in the upper right hand corner of the form provided that indicated "Facility Diagram". Print the name of your business as shown on your I-IMMP. Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. Indicate which area the diagram represents and the total number of facility diagrams that you are including. If a map represented the first of four areas, it would be labeled//1 of 4. Follow instruction (3 -7) for site diagrams regarding the specific details to be included on each facility dias~m. 2 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME FACILITY NAME ~SITE ADDRESS CITY 'NATURE or BUSINESS SIC CODE JVc. I- # STATE DUN & BRADSTREET NUMBER O5 -/O5 - '7 '7 /o q OWNER/OPERATOR MAILING ADDRESS CITY PHONE 6©/- P-73- 4/0~9 STATE ~/~ ZIP EMERGENCY CONTACTS BUSINESS PHONE NAME BUSINESS PHO~ 24 HOUR PHONE TITLE A-'s~. ~ 24 HOUR. PHONE Business Name HAZARDOUS MATERIALS INVENTORY / ClIEMICAL DESCRIPTION 1) INVENTORY STATUS: New [~ Addition [ ]Revision[ ]Deletion[ ] Ch Name: 3oI{:oC C Ac;d= Check if chemical-is a NON Trade Secret [5~] Trade Secret [ 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ ] Reactive [X] Sudden Release ofPressure [ ] lmmediateHealth (Acute) l~>,q Delayed Health (Chronic) [ 5) WASTE CLASSWiCATION O-digit code fi:om DHS Form 8022) USE CODE , . .. ~ 6) PHYSICAL STATE Solid [ ] Liquid [-~/] Gas [ ] Pure [ ] Mixture D~q Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILrrY Maximum Daily Amount . ~O Average Daily Amount ~. 50 Annual Amount ----' Largest Size Container ' ~ ~c~ # Days on Site $(o°_5 9) MIXTURE: List the three most hazardous 1) chemical components or 2) any AHM components 3) 10)LOCATION UNITS OF MEASURE Lbs[ ]C,-al D~] ft3 [ . Curies [ ] Circle Which Months: 5vl~',.,c,c Actd , 8) STORAGE CODES a) Container: II b) Pressure: I ' c) Temperature fit- OJ, F, M, A, M, J, J, A, S, O, N, D [ ] 1) INVENTORY STATUS: New [34 Additibn [ ] Revision [ ] Deletion [ ] 2) Common Name: PcK)I (.hi Oi~ Che= Name: Acid 4) Physical & Health PHYSICAL Hazard Categories Fire [ 5) WASTE CLASSIFICATION ] Reactive [><'] Sudden Release of Pressure [ (3-digit code from DHS Form 8022) Check if chemical is a NON Trade Secret [3~] Trade Secret [ ] 3) DOT # (optional) ~ q O ~ .~m ~ I cas# ¢3 '-I ~ 0/ ] Immediate Health (Acute) ~ Delayed Health (Chronic) [ ] use CODE /4 6) PHYSICAL STATE Solid [~Z] Liquid [ ] Gas [ ] Pure[ ] M_ixtureD<] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FACIL1TY UNITS OF MEASURE Daily Amoun[ ~ ~o ~ Lbs [5<] Gal [ I ft3 [ ] Maximum Average Daily Amount ~: '~ Curies [ ] Annual Amount -. --'--- Largest Size Container ,~'~ lb # Days on Site [ qsO Circle Which Months: .. 9) MIXTURE: List COMPONENT the three most hazardous 1) Tc 0~q ' ' ' - ' chemical components or 2) g),'chloct:,[ =%o.~loc;c o-c_,d any AI-IM components 3 ) 8) STORAGE CODES a) Contain~ / 0 b) Pressure: I c) Temperature All Year, J, F, M,~,~N., n. CAS# % WT otto -/~c93 [ ] [ ] [ I. 10)LOCATION I ~ U~ ~ of law, ~t I ~ve ~ly ~min~ ~d m f~ m~ ~e ~mfion on ~ md ~1 a~ ~m~. I ~lieve ~e sub~R~ ~o~fion is ~e, a~ate ~d ~mple~.. P~ Nme & Title bfAu~o~ Comfy R~e~mfive - Si~ Da~ Business Name OUS MATERIALS INVENT(~ CHEMICAL DESCRIPTION Page ~k offS__ 2) Common Name: Chemical Name: 4) Physical & Health Ha?ard Categories 1) INVENTORY STATUS: New [M] Addition [ ] Revision [ PHYSICAL Fire [ 5) WASTE CLASSWICATION ] Deletion [ ] ] Reactive DC] Sudd~ Release of Pressure [ (3-digit c.4xte flora DHS Form 8022) Check if chemical is a NON Trade Secret [5~ Trade Secret [ 3) DOT # (optional) 1 '7 q~3 A~t ~ CAS# -7 V 'V ~'¢¢3 ] Immediate Health (Acute) D<'] Delayed Health (Chronic) [ USE CODE q-~ 6) PHYSICAL STATE Solid D4] Liquid [ ] Gas [ ] Pure [ ] ~;fixtureI'~] Waste [ ] RacUo~tive [ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount --/ Average Daily Amount Annual Amount Largest Size Containe~ # Days on Site I ~ O Lbs[ ]Gal[ Iff3[ Curies [ ] Cimle Which Months: 8) STORAGE CODES a) Container:. I O b) Pressure: I c) Temperature ~L All Year, J, F, M,~ M, J, J, A, S-~O, N, D 9) MIXTURE: List the three most ba?ardous chemical components or any AHM components CAS# % WT AHM 77 '7~ 5~3 ~- ~o~.~ [ ] '76::, z4 '-v i¢ ~ o- 3 ro [ ] to t %--/7q5 0-5 ~, [ ] 10)LOCATION 1) INVENTORY SI^TUS: New [S~] A~fion [ 4) Physical & Health Hmard Categories Fire ~ Reactive [ WASTE CLASSn~CA'no~ 3 q 3 ] Revision [ ] Deletion [ ] Check ffchemical is a NON Trade Secret [->4 Trade Secret [ I'~ col PHYSICAL Sudden Release of Pressure [ O-digit cod~ from DHS Form 8022) 3) DOT # (optional) 30 ~'~ ~-- Am, i[ ] cas# ] Immediate Health (Acute) D<] Delayed Health (Chronic) [ 6) PHYSICAL STATE Solid [ ] Liquid D<] Gas { ] Pure[] Mixture~] Waste[ ] aadioa~ve[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount i I O e~d-. Average Daily Amotmt Annual Amount Lamest Size Container" # Days on Site UN'frs OF MEASURE 8) STORAGE CODES Lb~[ ]Gall><]fl3[ ] a) Container:. I0' Curies [ ] b) Pressure: c) Temperature Cimle Which Months: ~'~J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List the three most hmardous chemical components or any AHM components COMPONENT CAS# % WT 2) C>,eC,~,lo^te. c-.M,~col t1! qeLo 0-5 3) ~; Po+&.'~,o~4 'Phe. s.~a,~e 775c~11q I-Z g [ ] [ ] [ 1. 10)LOCATION . ', , - ./X, u4~o:L,~ ~,p4.~ "-U,'~F_ Lob E~pce~s ' I certify under penalty of law, that I have personally examined and am familiar with the int~ma~on on this and all attached documents. I believe the submitted information is tree, accurate and complete. . ~ ~__, PRINT Name & Title of Authorized Company Representative " Date Business Name HAZARDOUS MATERIALS INVENTORY CKEM~CAL DESCRIPTION I) INVENTORY STATUS: New D<] Addition [ ]Revision[ ]Deletion[ ] 2) Common Name: /x404rOf C)i[ Check if chemical:is a NON TradeSeeret D~] Tmd~ Sea'et [ 3) DOT ii/(op~onal) I ~ 7 ~ c s# (o¥7¥2 4) Physical & Health PHYSICAL HEALTH I-lmsrdCategofies Fire[2~]Reactive[ ]SuddenReleaseofPmssure[ ] lmmediateHealth(Acut~)[ ]DelayedHealth(Clm~¢)[ ] 5 ) WASTE CLASSIFICA_.TION ,2.,~. ] (3-digit ced~ from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [X'q Gas [ ] Pure [ ] Mixtu~ UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] cai I>4fo [ ] a) Conain~. lC)., Curies [ ] b) Pressure: ~ c) T~m~m~a-atum66 . ~J, F, M_, A, M, .l, J, A, S, O, N, D 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount I q Average Daily Amount 1 6¢ Annual Amount ---- Largest Size Container z-iD& # Days on Site 3~ Circle Which Months: CAS# % WT .---. d - l,O, 97 [ ] [ ] [ ] 9) MIXTURE: List the three most ha:~ardous chemical components or any AHM components COIVlPONENT 2) A IK cxt~.~ Isocc t'.,tt ,'a4 ,'de d ,'~?,- s a~t 3) 10)LOCATION __ __ , l) INVENTORY STATUS: New [,)<] Addition [ ] Revision [ ] Deletion [ ] ChemicalNam¢: ~t~e.-~o-M0 I $olo-Ka4 4) Physical & Health Hazard Categories Fire [~] Reactive [ Check if chemical is a NON Trade Secret [ ] Trade Secret [ 3) DOT # (opUon~) 1 Z 3 0 5) WASTE CLA~$~CA~ON PHYSICAL HEALTH ] Sudd~ Relea~ of Pressure [ ] lmm~liat~ Health (Acute) ~ Dehyed Health (Chronic) [ (3-digit code from DH8 Form 8022) USE CODE {Q[ - 6) PHYSICAL STATE Solid [ ] Liquid [.~ Gas [ ] eur~[ ] Mixtu~ Waste[ ] ~ti~-tive[ ] UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]CralD<]fl3[ ] a)Contain~ I0 Curies [ ] b) Pr~: t c) Temperature q AIl Year, J, F, M, A, M, J, J, A, 8, O, N, D ' 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amouat Average Daily Amount Annual Amount Largest Size Container ~ ~. # Days on Site ~q~5 Circle Which Months: COMPONENT CAS# % WT 2) Na-~c~-c [ ] [ ] [ l- 9) MIXTURE: List the three most hazardous chemical components or 3) 10)LOCATION I certify under penalty o~'law, that I have personally examined and am familiar with the infom~tion on this and all attached ~ts. I behe_ve the submitted information is true, accurate and complete. P o Date MATERIALS INVENT~Y t~RDOUS CHEMICAL DESCRIPTION Page I ) INVENTORY STATUS: New DQ Addition[ ]Revision[ ]Deletion[ ] Cheek if chemical is a NON Trade Secret [ ]TradeSeeret[ ] 2) Common Name: DOT # (optiot~l) AHM[ ] CAS# 4) Physical & Health Hazard Categories Fire [5(] Reactive [ PHYSICAL I-mAI. TH Sudden Release of Pressure [~] Immediate Health (Acute) ['~ Delayed Health (Chronic) (3-digit code flora DHS Form 8022) USE CODE ~ ~' 5) WASTE CLASSIFICATION 6) PHYSICAL STATE Solid [ ] Liquid [ ] Oas De.] Mixture[ ] Waste[ ] m~ioa~ve[ ] 7) AMOUNT AND TIME AT FACILITY Mmdmum Daily Amount Average Daily Amount Annual Amount Ian'gest Size Container ~ i bs~ # Days on Site LbslS<4C, al[. ]fO[ Curies [ ] Circle Which Months: 8) STORAGE CODES a) conmin~ O~- b) h-esm~: ~ c) Temperature ~ J, F, M, A, M, J, J, A, S, O, N, D 9) IVlIXTURE: List COMPONENT the three most hazardous I) chemical components or 2) any AHM components 3) CAS# % WT AHM 'Tqq'g6 I00 [ ] [ ] [ ] l 0)LOCATION 1) INVENTORY STATUS: New [ ] Addition [ 2)commonmme: '"~o3 ~a-~ '"~xe ~,t~',, e a / T6 ,'~x~e e ChemicalName: JolA 4-hc~ l exto C k l o~ ,'cl e /' Pe 4c dw~ 4) Physical & Health Hazard Categories Fire ['t< ] Reactive [ 5) WASTE CLASSIFICATION ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ . ] Trade Secret [ 3) DOT # (optional) Ama[ ] CAS# PHYSICAL HEALTH ] Sudden Release of Pressure [ ] Tmmediate Health (Acute) D<] Delayed Health (Chronic) [ (3-digit code fao,,, DH8 Form 8022) USE CODE f-/ 6) PHYSICAL STATE Solid [ ] Liquid [~] Gas [ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount 15 Average Daily Amount 3o Annual Amount ~ Largest Size Container i e, # Days cz Site 'b(~ Pure[] Mi~p/-.] Wam[] Radioactive[ ] Lbs[ ] Gal [Nc] ft3 [ C~[ ] Circle Which Months: 8) STORAGE CODES a) Contains. i 3 b) Pressure: I c) Temperatu~ ~ j~ j, F, M, A, M, J, J, A, S, O, N, D COlVlPONENT 9) MEK'TURE: List the three most hazardous 1) chemical components or 2) any AHM components 3) 10)LOCATION I certify under penalty of law, that I have Ixa~mally examined and am familiar with the information on this and all attached doctmaents. I be~ve the submitted information is true, accurate and complete. ~ture PRIAFF klame & Title of Authorized Comtmnv Reoresentative ' Date