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+ FLEET CARD FUELS 55 _________________________________ SiteID: 015-021-001348 +
Manager BusPhone: (661) 589-5772
Location: 7030 SCHIRRA CT Map 123 CommHaz Moderate
City BAKERSFIELD Grid: 16D FacUnits: 1 AOV:
CommCode: BFD STA 09 SIC Code:
EPA Numb: DunnBrad:
G
°
I
em{
Emergency Contact / Title
~~ Emergency Contact / Title
- ~al.n t}~aveh5}`" / ,., ~4gAo~tr HIGHT / DIR RETAIL SALE
Business Phone: (661) x ~~,1 Uwtle~ Business Phone: (661) 321-9961x
24-Hour Phone (661) lx 24-Hour Phone (661) 9'00-2214x
Pager Phone ( ) 3Z?'g3~~ Pager Phone ( ) - x
+--------------=----------971 =°-~~?-----+ ----------------- ---------------------+
Hazmat Hazards: Fire ImmHlth DelHlth
Contact Phone: (661) 321-9961x
MailAddr: PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Owner FLEET CARD FUELS Phone: (661) 321-9961x
Address PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of law tha4 I have personally
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
`, ~, ~ /~
%~
ature Date
ENT°D ~, pR 17 2006
-1- 03/22/2006
~~b [ -
.Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST >, , F R $ r , 0 900Truxtun Ave., suite 210
_ - F~~E Bakersfield; CA 93301
SECTION 1: Business Plan and Inventory Program ° aRtM Tel-.:- (661) 326-3979
_ _ - ~ Fax: (661) 872-2171
FACILITY NAME- /
~^ 5 INSP CTION ATE INSPECTION TIME
ADDRESS PHO ENO. NO OF EMPLOYEES
~ - -
FACILITY CONTACT BUSINESS ID NUMBER
/
~ Ce.. ~~ (~
~i(l
15-021- 1 ~~[ O
_ - - -- -
---
- -
- Section 1: Business Plan and Inventory Program
- - ~ / - - - - -
-" LV/ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
~, /
LW ^ APPROPRIATE PERMIT ON HAND -
m~^ BUSIr1eSS PLAN CONTACT INFORMATION ACCURATE
L~ ^ VISIBLE ADDRESS
is/^ CORRECT OCCUPANCY ~4JV/
0~ ^ VERIFICATION OF INVENTORY MATERIALS
I~l~^ VERIFICATION OF QUANTITIES -
L
St/
^ VERIFICATION OF LOCATION
~
/
(S.I/ ^ PROPER SEGREGATION OF MATERIAL
~^ VERIFICATION OF MSDS AVAILABILITY
~^ VERIFICATION OF HAZ MAT TRAINING
^ -VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
~,~, /
try ^ FIRE PROTECTION
~~
r
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO
EXPLAIN:
/~
QU
INSPECTION? PLEASE CALL US AT (661) 326-3979
Inspector (f~lease Print) Fire Preve~on / 1" In /Shift of Site/Station #
- - ~ ~ White -Prevention Services Yellow -Station Copy
Bus( eSS S~ Re/ s Bible Party (Please Print)
- Pink -Business Copy - - FD 2155 (Rev. 09/05
~~nl
FLEET CARD/~F~UELS 55 SiteID: 015-021-001348
Manager.: lacy C~?~-P~~-.n ' BusPhone: (661) 589-5772
Location: 7030 SCHIRRA CT Map 123 CommHaz Moderate
City BAKERSFIELD Grid: 16D FacUnits: 1 AOV:
CommCode: BFD STA 09
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
JOHN HAVE RSTOCK / GEN MGR CAL VLY BERK HIGHT / DIR RETAIL SALE
Business Phone: (661) 327-9341x Business Phone: (661) 321-9961x
24-Hour Phone (661) 979-0947x 24-Hour Phone (661) 900-2214x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire ImmHlth DelHlth
Contact JOHN HAVERSTOCK Phone: (661) 321-9961x
MailAddr: PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Owner FLEET CARD FUELS Phone: (661) 321-9961x
Address PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif~d: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT ~M ~ Q
~
PROG T - ABOVEGROUND STORAGE TANK ~
~N~'D A R~ ~ ~ ~.~~~
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under pen ': of law that I have personally
'
exam
ne and m familiar with the information
sub. i t a believe the information is true
,
accur , a c plete. ~.
~-
r
~~
Signatur Date
i
-1- 04/24/2007
F FLEET CARD FUELS 55
Last Action Type:
SiteID: 015-021-001348 ~
STORAGE CONTAINER DATA (UST FORM A)
FACILITY/SITE INFORMATION
Business Name: FLEET CARD FUELS 55
Cross Street
Business Type: Org Type:
Total Tanks 3 IndnRes/Trust: No PA Contact:
Dsg Own/Oper
PROPERTY OWNER INFORMATION
Name - T ~~ ~~~j~ ~u~~ Phone
Address:
City State: Zip:
Type CORPORATION
(661) 321-9961x
TANK OWNER INFORMATION
Name ~- J C~~ ~~E~ Phone: (661) 321-9961x
Address:
City State: Zip:
Type
BOE UST Fee# : UNKNOWN
Financ'1 Resp: STATE FUND
Legal Notif
Date: Phone: (1 ) - x
Name: Ttl:
State UST # - 1998 Upg Cert#: 00713
ICC Nbr:
-2- 04/24/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
~ Hazmat Inventory By Facility Unit ~
~ MCP+DailyMax Order Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
REGULAR UNLEADED F IH DH L 13500.00 GAL Mod
PREMIUM UNLEADED F IH DH L 13500.00 GAL MOd
DIESEL FUEL F IH DH L 13500.00 GAL Low
-3- 04/24/2007
-4- 04/24/2007
F FLEET CARD FUELS 55
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
REGULAR UNLEADED
Location within this Facility Unit
BELOW GRADE VAULT
STATE TYPE PRESSURE
Liquid TMixture ~ Ambient
SiteID: 015-021-001348 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
8006-61-9
TEMPERATURE CONTAINER TYPE
Ambient ~ UNDER GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
15000.00 GAL 13500.00 GAL 2333.00 GAL
riA7,1-1tt1JV U 7 1:V1~lYV1V L' 1V 1 J
owt. Rs CAS#
100.00 Gasoline No 8006619
t1AGHtC1J .°.J J1' JJl~lt'~1V 1_J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
PREMIUM UNLEADED Days On Site
365
Location within this Facility Unit Map: Grid:
BELOW GRADE VAULT CAS#
8006-61-9
Liquid TMixture ~AmbRent~E ~ AmbientT~E I UNDEROGROUNDRTANKE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
15000.00 GAL 13500.00 GAL 533.00 GAL
HAZARDOUS CGl~lrvlv~ly 1 J
$Wt. RS CAS#
100.00 Gasoline No 8006619
11HGt~t'C1J Ha 7.7 L' .7.71"1P~1V 1 b
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
-5- 04/24/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
DIESEL FUEL Days On Site
365
Location within this Facility Unit Map: Grid:
BELOW GRADE VAULT CAS#
68476-34-6
STATE
Liquid TYPE PRESSURE
TMixture ~mbient
~ TEMPERATURE
Ambient CONTAINER TYPE
UNDER GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
15000.00 GAL 13500.00 GAL 2432.00 GAL
- r1r~~.~ucLUU~ wlnrvlv~lv~t~5
%Wt. RS CAS#
100.00 Diesel Fuel No. 1 No 70892103
t1HGHKL L~~ 5t;5~1~1L'1V1J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Low
-6- 04/24/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 04/17/2006 ~
CALL 911, BAKERSFIELD FIRE DEPT.
Employee Notif./Evacuation
11/27/2000
ALL CARDLOCK USERS ARE INSTRUCTED IN EMERGENCY PROCEDURES. THE PROCEDURE IS
TO TURN THE EMERGENCY SWITCH OFF AND GO TO THE PAY TELEPHONE AND DIAL 911
AND ADVISE EMERGENCY PERSONNEL OF THE SITUATION. THERE ARE THREE EXITS FOR
EASY EVACUATION.
_ , ,,,
r LLAJ111. 1YV V11 ~ l~ V0.1.. (.L0. L1V11
Emergency Medical Plan
LOCAL URGENT CARE AND EMERGENCY FACILITIES.
11/27/2000
-7- 04/24/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 04/17/2006 ~
ALL DISPENSER PUMPS ARE EQUIPPED WITH AUTOMATIC FILL SHUT-OFF NOZZLES. ALL
DISPENSERS ARE EQUIPPED WITH IMPACT SHEAR VALVES IN THE EVENT OF EARTHQUAKE
OR IF DISPENSER IS ACCIDENTLLY HIT. ALL DISPENSER HOSES ARE EQUIPPED WITH
BREAKAWAY FITTINGS WHICH WILL STOP FLOW IN THE EVENT CUSTOMER FORGETS TO
REMOVE NOZZLE FROM FUEL TANK BEFORE DRIVING AWAY. ALL DISPENSER SUMPS ARE
EQUIPPED WITH POSITIVE SHUT-DOWN SENSORS. EACH VAULT IS EQUIPPED WITH BOTH
VAPOR AND LIQUID SENSORS TO ENSURE POSITIVE SHUT-DOWN IN THE EVENT OF A
LEAK. SITE FAX REMOTE ALERT WILL PAGE AUTHROIAZED PERSONNEL IN CASE OF
ALARM.
Release Containment 11/27/2000
UNDERGROUND STORAGE TANKS.
Clean Up 04/17/2006
SMALL SPILLS WILL BE ABSORBED AND DISPOSED OF. LARGE SPILLS WILL REQUIRE A
LOAD OF SAND FOR CONTAINMENT AND ABSORBTION.
v~iici ncavut~c t-~~~.1vat,ivll
-8- 04/24/2007
.!
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
~ Special Hazards
Utility Shut-Offs 11/17/2006
A) GAS - NONE
B) ELECTRICAL - INSIDE BLDG
C) WATER - DRIVEWAY NEAR DMV LOT.
D) SPECIAL - EMER POWER SHUT-OFF ON BLDG NEAR DOOR
E) LOCK BOX - NO
Fire Protec./Avail. Water 01/31/2007
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER ON ISLAND AND ON BLDG.
FIRE HYDRANT - AT EACH DRIVEWAY ENTR ON SCHIRRA CT.
Building Occupancy Level 03/22/2006
L:TNMANNED SITE
-9- 04/24/2007
c.
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 11/17/2006 ~
MSDS SHEETS ON FILE IN THE OFFICE.
Page 2'
Held for Future Use
i
ncl.u ~ Lv.[. r u~.uic vac
I
-10- 04/24/2007
~S~
FLEET CARD FUELS 55
Manager GARY CHAPMAN
Location: 7030 SCHIRRA CT
City BAKERSFIELD
CommCode: BFD STA 09
EPA Numb:
BusPhone:
Map 123
Grid: 16D
SIC Code:
DunnBrad:
SiteID: 015-021-001348
(661) 589-5772
CommHaz Moderate
FacUnits: 1 AOV:
o c ~~.
Emergency Contact / Title r
Emergency Conta t / Title
JOHN HAVERSTOCK / GEN MGR CAL VLY ~~/
Business Phone: (661) 327-9341x Business Phone: (661) 321-9961x ld~@
24-Hour Phone (661) 979-0947x 24-Hour Phone (661) 900-2214x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire ImmHlth DelHlth
Contact JOHN HAVERSTOCK Phone: (661) "-~-~~ln
MailAddr: PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Owner FLEET CARD FUELS Phone: (661) 321-9961x
Address PO BOX 81685 State: CA
City BAKERSFIELD Zip 93380
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
F3ased on my inquiry of those individuais
responsible for obtaining the information, I certify
under penalty of lavtit that I have personally
®x ', erg and am familiar with the information
s b ittE d and believe the information is true,
a rat ,and complete. ~ ~,~ ~ /~~
~ not ~ Date
EN~'~
-1-
07/11/2007
F FLEET CARD FUELS 55
Last Action Type:
SiteID: 015-021-001348 ~
STORAGE CONTAINER DATA (UST FORM A)
FACILITY/SITE INFORMATION
Business Name: FLEET CARD FUELS 55
Cross Street
Business Type: Org Type:
Total Tanks 3 IndnRes/Trust: No PA Contact:
Dsg Own/Oper
ICC Nbr:
PROPERTY OWNER INFORMATION
Name F1 ec k ~~~ ~vel S Phone : ( 6 61) 3 21- 9 9 61x
Address: 42UO R~KcK o~eng C31~d,
City $~ke~s~;~1c1.~ ~ State: e~ Zip: Q33o8
Type CORPORATION
TANK OWNER INFORMATION
Name ~lee~- G~.~tC-v.c~s Phone: (661) 321-9961x
Address: y2oo ANC/C awes 61vc1
City Pj~ke~s~;olc~ State : C'Y~ Zip : 9 3 ~ ~ ~'
Type ~ or poss. }~ o n
BOE UST Fee# UNKNOWN
FinanC'1 Resp: STATE FUND
Legal Notif
Date: Phone: ( 1 } - x
Name: Ttl:
State US T # 1998 Upg Cert#: 00713
-2- 07/11/2007
F FLEET CARD FUELS 55
~ Hazmat Inventory =
~ MCP+DailyMax Order
= SiteID: 015-021-001348 ~
By Facility Unit ~
Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
REGULAR UNLEADED F IH DH L 13500.00 GAL Mod
PREMIUM UNLEADED F IH DH L 13500.00 GAL Mod
DIESEL FUEL F IH DH L 13500.00 GAL Low
-3- 07/11/2007
-4- 07/11/2007
Y 'i
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
REGULAR UNLEADED Days On Site
365
Location within this Facility Unit Map: Grid:
BELOW GRADE VAULT CAS#
8006-61-9
Liquid TMixtur~mbient~E ~ AmbientT~E ~UNDEROGROIINDRTANKE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
15000.00 GAL 13500.00 GAL 2333.00 GAL
..- rlH~t~utl.l~u~ ~vl~lrvlvl~,1v1~
%Wt. RS CAS#
100.00 Gasoline No 8006619
tiHG1~tCL AJ ~ L' ~ ~1~1L' 1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
~ Inventory Item 0003
COMMON NAME / CHEMICAL NAME
PREMIUM UNLEADED
Location within this Facility Unit
BELOW GRADE VAULT
STATE TYPE PRESSURE
Liquid Mixture~A_mbient
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
8006-61-9
TEMPERATURE CONTAINER TYPE
Ambient ~ UNDER GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
15000.00 GAL 135.00.00 GAL 533.00 GAL
ntiGtlttu V U 7 l.. Vl"lt' V1V P~1V 1 S
%Wt. RS CAS#
100.00 Gasoline No 8006619
l1L-1G1-1iCL ri. 7.7 P~J.71"1P~1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
-5- 07/11/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
DIESEL FUEL Days On Site
365
Location within this Facility Unit Map: Grid:
BELOW GRADE VAULT CAS#
68476-34-6
Liquid TMixture ~ AmbRent~E ~ A~PeRATURE TEROGROIINDRTANKE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
15000.00 GAL 13500.00 GAL 2432.00 GAL
- - HAZARDOUS COMPONENTS
%Wt. RS CAS#
100.00 Diesel Fuel No. 1 No 70892103
t1HGHt<L H.5 5J;551~1J;1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Low
-6- 07/11/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 04/17/2006 ~
CALL 911, BAKERSFIELD FIRE DEPT.
Employee Notif./Evacuation 11/27/2000
ALL CARDLOCK USERS ARE INSTRUCTED IN EMERGENCY PROCEDURES. THE PROCEDURE IS
TO TURN THE EMERGENCY SWITCH OFF AND GO TO THE PAY TELEPHONE AND DIAL 911
AND ADVISE EMERGENCY PERSONNEL OF THE SITUATION. THERE ARE THREE EXITS FOR
EASY EVACUATION.
,~
tUiJ 1.1 l: 1VV 1.11. ~ ~VCLl: 11QL1Vli
Emergency Medical Plan 11/27/2000
LOCAL URGENT CARE AND EMERGENCY FACILITIES.
-7- 07/11/2007
F FLEET CARD FUELS 55 SiteID: 015-021-001348
Fast Format
~ Mitigation/Prevent/Abatemt Overall Site
~ Release Prevention 04/17/2006
ALL DISPENSER PUMPS ARE EQUIPPED WITH AUTOMATIC FILL SHUT-OFF NOZZLES. ALL
DISPENSERS ARE EQUIPPED WITH IMPACT SHEAR VALVES IN THE EVENT OF EARTHQUAKE
OR IF DISPENSER IS ACCIDENTLLY HIT. ALL DISPENSER HOSES ARE EQUIPPED WITH
BREAKAWAY FITTINGS WHICH WILL STOP FLOW IN THE EVENT CUSTOMER FORGETS TO
REMOVE NOZZLE FROM FUEL TANK BEFORE DRIVING AWAY. ALL DISPENSER SUMPS ARE
EQUIPPED WITH POSITIVE SHUT-DOWN SENSORS. EACH VAULT IS EQUIPPED WITH BOTH
VAPOR AND LIQUID SENSORS TO ENSURE POSITIVE SHUT-DOWN IN THE EVENT OF A
LEAK. SITE FAX REMOTE ALERT WILL PAGE AUTHROIAZED PERSONNEL IN CASE OF
ALARM.
Release Containment 11/27/2000
UNDERGROUND STORAGE TANKS.
Clean Up 04/17/2006
SMALL SPILLS WILL BE ABSORBED AND DISPOSED OF. LARGE SPILLS WILL REQUIRE A
LOAD OF SAND FOR CONTAINMENT AND ABSORBTION.
V1.11CL iCC.7-Vl1Ll.:C 1"Ll:l.lVdl.1U11
-8- 07/11/2007
•1 r
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
~rC~:lal na~uiu~
Utility Shut-Offs
ELECTRICAL - INSIDE BLDG
WATER - DRIVEWAY NEAR DMV LOT
SPECIAL - EMER POWER SHUT-OFF ON BLDG NEAR DOOR
04/30/2007
Fire Protec./Avail. Water 01/31/2007
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER ON ISLAND AND ON BLDG.
FIRE HYDRANT - AT EACH DRIVEWAY ENTR ON SCHIRRA CT.
Building Occupancy Level 03/22/2006
UNMANNED SITE
-9- 07/11/2007
~~
~~ -.
F FLEET CARD FUELS 55 SiteID: 015-021-001348 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 11/17/2006 ~
MSDS SHEETS ON FILE IN THE OFFICE.
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nclu tvi rUI.UIC U.7'C
-10- 07/11/2007