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BUSINESS PLAN 3/1/2007
MA t~A1 ~ t v, ...~~ O a ' ' '`_. ~t Q ~~ ~; ti i .~ ~~ I ' I i I N OO sy A.. W „ V 3 ~~~ -.~1.. ~° ~ ~v ~a ~ - Y1~zr ~~ ~ n P~~~ (I ~n c~~ ~~ ~ ~ - ~~ ~ ~- a a _ ~, e- ~~~~"3 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of ~ L FACILITY IDENTIFICATION FACILITY ID # r EPA ID # (Hazardous Waste Only) - (Agency Use Only) BUSINESS N_-~AiE (Same as Facilitc• Name or DBA -Doing Business as) f'I ~ '- ~ ~~~~ GOLDEN STATE PETERBII.T II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does -our facilitt~... If Yes_. lease com lete these aces of the UPCF... A. HAZARDOUS MATERIALS Have an site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases HAZARDOUS MATERIALS INVENTORY (include liquids in ASTs and USTsj; or the applicable Federal threshold X YES ^ NO a. _ CHEMICAL DESCRIPTION (OES 2731) quantit<~ for an e~-tremely hazardous substance specified iu 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an erueraerrc~~ 1<w is re aired ursuant to 10 CFR Parts 30.40 or 70'? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILTI'Y (Formedy SYVRCB Form A) 1. O~~n or operate undergrotmd storage tanks'? ^ YES X NO 5. UST TANK (one page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ^ YES X NO 6. UST FACILITY UST TANK (one per tank) UST INSTALLATION -CERTIFICATE OF COMPLIANCE (orre page per tank) (Formerly Form e) 3. Need to report closing a UST? ^ YES X NO 7. UST TANK (closure portion -one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) O~rn or operate ASTs above these thresholds: -anv tank capacih- is greater than 1.320 gallons, or X YES ^ NO a. NO FORM REQUIRED TO CUPAs -the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? X YES ^ NO 9. EPA ID NUMBER -provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? ^ YES X NO lo. perr~yoler) 3. Treat hazardous waste on site? ON5ITE HAZARDOUS WASTE ^ YES X NO 11. TREATMENT - FACILTI'Y (Ponnedy DTSC Fom~s 1772) ONSITE HAZARDOUS WASTE TREATMENT -UNIT (one page per amt) (Foanerly 17rSC Forme 1772 r~fl,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by ^ YES X NO CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? 12. ASSURANCE (Fonnedy DTSC Fom~ 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE /CONSOLIDATION ^ YES X NO 13. SITE ANNUAL NOTIFICATION (Fonoerly DTSC Form 119 6. Need to report the closure/removal of a tank that was classified as ^ YES X NO la HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? . CERTIFICATION (Formedy DTSC Form Iza9) E. LOCAL REQUIREMENTS 1' (You may also be required to provide additional information by your CUPA or local agency.) l~ J ~O ` ~ n„~:,.Aee Arti.M;ac onn-r,t,,,. r no., tomF UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Pa a of L L IDENTIFICATION FACILITY ID # t BEGINNING DATE too. ENDING DATE tot. (Agency Use Oxly) 02-01-07 02-28-08 BUSINESS NAME (Same a9 FACILITY NAME w DBA-Doug Business As) 3• BUSINESS PHONE 102. GOLDEN STATE PETERBII.T 661-833-1700 BiTSINESS SITE :1DDRESS 103. 1450 SOUTH UNION AVE CITY lo+• ZIP CODE 1os. CA BAKERSFIELD 93307-14142 DUN & BRADSTREET 1116. SIC CODE (4 digit #) log. 5599 COUNTY 103• KREN BUSINESS OPERATOR NAME 109. BUSINESS OPERATOR PHONE 110. E.M. THARP 559-782-5800 II. BUSINESS OWNER OWNER NAME ul. OWNER PHONE Ilz. MORRIS A THARP 559-782-5800 OWNER MAILING ADDRESS 113• 19243 ROAD 192 CITI' 11+• STATE 115• ZIP CODE 116• PORTERVILLE CA 93257 TIL ENVIRONMENTAL CONTACT CONTACT NAME 117• CONTACT PHONE 113• SCOTT HOBSON 661-833-1700 CONTACT MAH.ING ADDRESS I~• 1450 SOUTH UNION AVE CITY Izo. STATE Izl. ZH' CODE Izz. BAKERSFIELD CA 93307 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123• NAME 123. BRUCE GREER CASEY THARP TITLE 12{• TITLE 129• GENERAL MANAGER VICE PRESIDENT BUSINESS PHONE 12.9• BUSINESS PHONE 130• 59-782-5800 559-782-5800 24HOUR PHONE* 1z6. 24HOUR PHONE* 131• 559-361-9932 559-361-9931 PAGER # 127• PAGER # 13x. ADDITION_•~I. LOC ~I:LI" (.'OLLECTED INFORIILITION: 133. Certifieation: B ed o my inquiry th individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and f ar with the o Lion sabmitted and believe the hnformation is true, acc and complete. SIGNAT OWNERlOP R DESIGNATID REPRESENTATIVE DAT 13~. NAME OF DOCUMENT PREPARER 135• !~ SCOTT HOBSON N_ IGNER (print 136• TTTL OF SIGNER 137. BRUCE GREER GENERAL MANAGER * See lnstractions on next page. UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION Tone page per material per lntilding of areal ^ ADD ^ DELETE X REVISE-' Page .3 of LI L FACILITY INFORMATION BUSINESS NAME (Same as FACII,ITY NAME or DBA-Doing Business As) 3. GOLDEN STATE PETERBII.T CHErIICAL LOCATION '01 CHEMICAL LOCATION CONFIDENTIAL 't'' EPCRA ^ YES Z NO FACILTl'Y ID # 1. AI_~P =-°' GRID # -ua (Agency Use Only) 2 R-14 II. CHEMICAL INFORMATIO N CHEMICAL NAME '-t's TRADE SECRET Pes _l" No '-<'~ if su6iect to FsexA, sew to ms~~~ COMMON NAME ''-o ~. pos. Exs= ^ Yes X No GREASE CAS# '09. 'If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Completeifrequiredbylocatagency) 't~' HAZARDOUS MATERIAL TYPE (Check one item only) ^ a PURE X b. MIXTURE ^ r; WASTE 211. RADIOACTIVE ^ Yes X No 212. CURIES =1; PHYSICAL STATE (Check one item only) ^ a. SOLID X b. LIQUID ^ e GAS 214. LARGEST CONTAINER 1~0 ?15. FED FL-lZ.~RD C.~TEGORIES '_t6. (Check all that apply) X a FIRE ^ b. REACTIVE ^ c PRESSURE RELEASE ^ d ACUTE HEALTH X e. CHRONIC HEALTH A\•-ER_~1GE DaII.l ArIOLTNT '-1? 1`L-1l~AtUI~ID.aILT ArIOLTNI'-1S. _~NNL?~L 1G.~STE AnIOLTNT-19. ST.~1TE «:-~STE CODE -?~. 130 300 71_ n .rs oN srrE --- UNITS' ^ a. GALLONS ^ b. CUBIC FEET ^ c POUNDS ^ d. TONS 365 ( Check one item orilc) • It EHS, amount must bt in otmds. STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e. PLASTIGNONMETALLIC DRUM ^ i. FTBER DRUM ^ m GLASS BOTTLE ^ q. RAII. CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ o. PLASTIC BOTTLE X a OTHER ^ c TANK INSIDE BUII.DING ^ g. CARBOY ^ k BOX ^ o. TOTE BIN X d STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON Yz3. STORAGE PRESSURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIEPTT 224. STORAGE TEMPERATURE X a AMBIFIVT ^ b. ABOVE AMBIENT ^ a BELOW AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 65 zze. REFINED BASE OILS nz. ^ Yes x No zza. 64742-54-7 2z9. 2. 20 2~. INHIBITORS & DYE zs1. ^ Yes x No zsz. N/A ~ 3. 15 ~~ MOLBDENUAL DISULFIDE ~5- ^ Yes x No ~ 1317-33-5 ~~~ q, 23a. z39. ^ Yes ^ No 2ao. za1. g, 2a2. zas. ^ Yes ^ No zaa. zas. if taore hazv~doas eompoaeats are present at greater than 1°/. by n~elgbt g' nos-rarcfo°genir, or 0.1% be weight if carclaogedr, attach addHbnal sheets aF paper ~rpttuiog the regatre8 hdormation. ADDTI'IONAL LOCALLY COLLECTED INFORMATION '-a~ If EPCRA, Please Sign Here. ua,~.,t,.,,~ n,r~4ar;o1 t,,,,A..r,.,,, ~nm.i..,. 5 va., t~m~ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (onr uaee urr matrtial urr biulda~¢ or azral ^ ADD ^ DELETE X REVISE =°0 Page ofZi L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3. GOLDEN STATE PETERBILT CHEZ\IICAL LOCATION '-'?t CHEMICAL LOCATION CONFIDENTIAL '0'-- EPCRA ^ YES l NO FACILITY ID # t. AL-1P -~: '03. GRID # '-C4 (Agency Use Only) Z iT-17 II. CHEMICAL INFORMATIO N CHEMICAL NAME ,t" TRADE SECRET Yes l No '~ If Subject to EPCRA, refer to inshuceons COMMON NAME-°' '°s EHS• ^ Yes X No R13~A CAS# '~ ;If EHS is "Yes," all amounts below must be in Ibs. 811-97-2 FIRE CODE HAZARD CLASSES (Complete ifregmredbylocal agency) >to. HAZARDOUS MATERIAL X a. PURE b. MIXTURE c. WA5TE 211. RADIOACTIVE ^ Yes X No 212. 't3. CURIES TYPE (Check one item only} PHYSICAL STATE 214. fit, ST ER 3~ (Check one item only) a SOLID b. LIQUID X c. GAS LARGE CONTAIN FED IL~1Z.~RD C.aTEGORIES-16. (Check all that appl}.i a. FIRE b. REACTIFE _l' c. PRESStRE RELEASE 1 d. aCLTTE HEALTH _l" e. CHRONIC LLEALTH ALEIL~GED.~II.1 _~fOtTN1' ''_t;. 1`L~1"II~ICTI~tDaILTAhIpUNT ''_IS. ANNi.?-aL\~:~STEAhtOUNr-19. STATE\~:~STECODE -'-o. 2i ~~ -''-1. DAIS ON SITE --- UNITS a GALLONS b. CUBIC FEET X c. POUNDS ^ d. TONS 36S (c'.heck one item oiil~-) * ffEHS, amount must be in ounds. STORAGE CONTAINER s. ABOVEGROUND TANK ^ e. PLASTLC/NONMETALLiC DRUM ^ i. FIBER DRUM ^ m GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG n. PLASTIC BOTTLE c OTHER ^ c TANK INSIDE BUILDING ^ g. CARBOY k BOX ^ o. TOTE BIN d. STEEL DRUM ^ h. SILO X LCYLiNDER p. TANK WAGON 223. STORAGE PRESSURE a. AMBIENT X b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1, 226. 227. ^ Yes No 228. 229. Z, 230. 231. Yes No 232. 233. 3, z3a. z3s. ^ Yes No 236. 23;. 4. ~. ~9• ^ Yes No zao. zat. $, 242. 243. ^ Yev plo 244. 245. If Wrote hazardous rnmpooeuts are present at greater than 1% by n'Hght tf oon-carefoogenie, or 0.1% be w~el¢t d'caremogenie, attach additMaal sheets of paper captoriug the required ioforamdoa ADDITIONAL LOCALLY COLLECTED INFORMATION ''-46 If EPCRA, Please Siglt H No~a~A..+,~ r,TQrA.;~t T„.,n,.t...,, ~nm .t~~ 5 uA., t~m~ IJNIF'IED PROGRAM CONSOLIDATED FORM AA~ARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY --CHEMICAL.DESCRIPTION (nix page per material Ixr buddn~g or area) ^ ADD ^ DELETE X REVISE-°o Page _ of ? 1 L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME ar DBA -Doing Business As) 3. GOLDEN STATE PETERBILT CHEMICAI. LOC~ITION-°t CHEMICAL IACATION CONFIDENTIAL-o= EPCRA ^ 1'ES _1" NO FACILITY ID # t. DI -1P » 'o; GRID # 'oa. (Agency Use Onty) 2 V-10 II. CHEMICAL INFORMATIO N CHEMICAL NAME '0~ TRADE SECRET Yes _l' No '-06 If Subject to EPCRA, refer to insauctions COMMON NAME '-o' '0S EHSs ^ Yes X No ARGON CAS# '-09 *If EHS is "Yes," all amounts below must be in lbs. 7~#-037-1 FIRE CODE HAZARD CLASSES (completeifrequired bylocat agency)_tu. HAZARDOUS MATERIAL TYPE (Check one item only) X a. PURE b. MIXTURE e. WASTE 211. RADIOACTIVE ^ Yes X No 212. _'t 3. CURIES PHYSICAL STATE 214' fit,. LARGEST CONTAINER 336 (Check one item only) a. SOLID b. LIQUID X c. GAS FED K~Z~1RD C.-~TEc30RIES '1G. iCheck all that apph_l a. FIRE b. REACTIVE l c. PRESS[RE RELEASE d. ACUTE HEALTH S e. CHRONIC HEALTH ..~\-ERat?ED~II.TAAfOtrNT '-t% ri~1'II~IUAID?IL1.~fOUNT '-ts ANNUAI.I~=~STE.~fOL1NT_t9. ST.~TER~STECpDE "°. 560 1008 '-=1~ DATSUNSITE ---~ UNITS• a GALLONS X b. CUBIC FEET c POUNDS ^ d. TONS 361 i Check one item . nlcl * If EHS. amount must be in ounds. STORAGE CONTAINER a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAILCAR ^ b. UNDERGROUND TANK f. CAN ^ J. BAG n. PLASTIC BOTTLE r. OTHER ^ e. TANK INSIDE BUILDING ^ g. CARBOY k BOX ^ o. TOTE BIN d. STEEL DRUM ^ h. SII,O X !.CYLINDER p. TANK WAGON 223_ STORAGE PRESSURE a. AMBIENT X b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1, 226. 227. ^ Yes No 228. 229. Z, 230. 231. Yea No 232. 233. 3. ~~ z35. ^ Yes NO 236. 237. 4, z3a. z39. ^ Yes No vw. 24t. $, 242. 243. ^ Yes NO 244. 245. It more hazardous components are present at greater than 1 % be weight H sea-caretaogeWe, or 0.1°/. be n~eN~6t ~ carcinogenic, attach addttieoaf sheets of paper capturing qm regdred istormatfoa. ADDITIONAL LOCALLY COLLECTED INFORMATION '-•16 If EPCRA, Please Sign H uo~q.,t,.,,a r.,t9•P.;9t r...,A..t,.r., ~nm a,.~ 5 nA., t wn~ UNIFIED PROGRAM CONSOLIDATED FORM AA7.ARnOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION lonz page pzr matzriat pzr btuldu~ or aria i ^ ADD ^ DELETE X REVISE ;rro. Page ~ of L l L FACII.ITY INFORMATION BUSINESS NAME (Same as FACILTfY NAME or DBA-Doing Business As) 3- GOLDEN STATE PETERBILT CHE111ICAI. LOCATION '01 CHEMICAL LOCATION CONFIDENTIAL '-°' EPCRA ^ YES l NO FACILTTY ID # t. tit.-;P ~-o; GRID # ~0~ (Agency use only) 2 V-11 II. CHEMICAL INFORMATIO N CHEMICALNAME =i5 TRADE SECRET Tesl' No '-tom If Subject to EPCRA, refer to inshucbons COMMON NAME ~°' pos. EHS* ^ Yes X No CARBON DIOXIDE CAS# ''-U9 " all amounts below must be in lbs. •If EHS is "Yes 12~-38-9 , FIRE CODE HAZARD CLASSES (Campkteifc«~puredbylocalegency)-11 HAZARDOUS MATERIAL TYPE (Check one item only) X a PURE b. MIXTURE c. WAST& 211. RADIOACTIVE ^ Yes X No 212. 21; ('DRIES PHYSICAL STATE 214. X15 RGEST CONT INER 2OO L (Check one item only) a SOLID b. LIQUID X c. GAS A A FED I3_-\ZARD C_-1TEliORIES_l6. (Check all that appl}:i a. FIRE b. REACTIi-E S c. PRES.SLfRE RELEASE d. ACUTE HEALTH S e C'HItONIC HE~II.TI3 A~"ERAGEP~II.Y AAIOUNT_17. I`i~.1"II~ILTAID_~II.1":II~tOtTNT 'ts. ANN[J.-~LI~'_-~STE ~IOLTNT '-19. ST_-~TE~VaSTECODE 2''0. 380 600 '-'_ 1- DAY S ONSITE --- UNITS" a. GALLONS X b. CUBIC FEET c. POUNDS ^ d. TONS 36S (Check ona item onlc i * Tt EHS. amount must bz in ounds. STORAGE CONTAINER a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLICDRUM ^ i FIBER DRUM ^ tn. GLASS BOTTLE ^ q. RAII,CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG n. PLASTIC BOTTLE r. OTHER ^ c TANK INSIDE BUILDING ^ g. CARBOY k BOX ^ o. TOTE BIN d. STEEL DRUM ^ h. SII.O X I. CYLINDER p. TANK WAGON 223, STORAGE PRESSURE a. AMBIENT X b. ABOVE AMBIENT ^ G BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c BELO W AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I. zze. zz7. ^ Yes No 22a. zzs. Z. 230. 231. Yes NO 232. 233. 3, 234. 235. ^ Yes No 236. 237. ¢, 238. 239. ^ Yes NO 240. 241. 5, zaz. 243. ^ Yes No ~. 2as. If more harardoas aomponeats are present at greater than 1% by n~eigbt ff ooo-carciaogeaM, or 0.1% b}' a'el~t N carcinogeafc. attach addltlooat sheets of paper taptoriag [6e rcgdred iaformatloo. ADDTITONAL LOCALLY COLLECTED INFORMATION =a6 If EPCRA, Please Sign H ./ Flgoo..L.»~ TE~t~;ol T.,.,.,..t,.ra.'1(iM ,i.v. 5 Aao 171(1(. UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION tone page per material per biti(ding or uea I ^ ADD ^ DELETE X REVISE '°0 Page L °f Z L L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME ar DBA-Doing Business As} 3. GOLDEN STATE PETERBILT CHEDIIC_-1L LOCATION-01 CHEMICAL LOCATION CONFIDENTIAL-°- EPCRA ^ I'ES _l" NO FACILTtY ID # 1. AI_-1P = 'U; GRID #-0a (Agency Use Only) 2 / 3 T-8/R-11 / P-20 II. CHEMICAL INFORMATIO N CHEMICAL NAME =°' TRADE SECRET 1'es l No-t'6. If Subjectto EPCRA, refer to insWCtions COMMON NAME-°- '-0S EHSg ^ Yes X No ACETYLENE CAS# ''-~g sIf EHS is "Yes," all amounts below must be in lbs. 7~-86-2 FIRE CODE HAZARD CLASSES {Complete ifregrrired by local agency) '-11 HAZARDOUS MATERIAL TYPE (Check one item only) X a. PURE b. MIXTURE c WASTE 211. RADIOACTIVE ^ Yes X No 212. ~ t; CURIES PHYSICAL STATE 2ta. .U. AR CO INE 137 (Check one item only) a SOLID b. LIQUID X c. GAS GEST NTA L R FED H_~.Z.-\RD C.-~TEIiORIES '_16. (Check all that apply) X a. FIRE b. REACTIVE X c PRESSURE RELEASE X d ACUTE IiEALTH X e. CARONIC IIEALTH A~~ER~GE D-~IC.Y AAIOLiNT ''-t i. ILL-1.1~fUAtD.-LILY MOUNT 'IS. ANNL.?~I. \t:YSTE MOUNT ?l9. STATE tV~STE CODE-'-t~- ~tll 822 -'-l D ATS ON SITE--'- UNITS" a GALLONS X b. CUBIC FEET c. POUNDS ^ d TONS 361 (Check one itrm onlc) * IfEHS, amount must br in ounds. STORAGE CONTAINER a ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ tn. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG a. PLASTIC BOTTLE r. OTIIEI2 ^ G TANK INSIDE BUILDING ^ g. CARBOY k BOX ^ o. TOTE BIN d. STEELDRUM ^ h. SII.O X LCYLINDER p. TANK WAGON 7y3. STORAGE PRESSURE a. AMBIENT X b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1, 226. 227. ^ Yes No 228. 229. 2, 230. 231. Yes NO 232. 233. 3, 234. 235. ^ Yes NO 236. 237. 4. 23s. z39. ^ Yes No 2ao. zal. g, zaz. za3. ^ Yes No zaa. gas. U mere hazvdoos compoaeats are present at greater than 1 % be n~elght ff aoa-caretaogenic, or 0.1% b~~ n~etght If carchwgedc, attach addMoaal sheets of paper capuuing the required hdormaUoa. ADDTI'IONAL LOCALLY COLLECTED INFORMATION '~~ If EPCRA, Please Sign Here u4,q.a~„~ re~rP.;at Tr.>P.,,..r., ~nm a,,,. 5 nA., t ~m~ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (.nr page per material per btuldu~g or area) ^ ADD ^ DELETE X REVISE-~ Page ~ of L/ L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3~ GOLDEN STATE PETERBILT CHEAIIC:IL LOC aTION '-01 CHEMICAL LOCATION CONFIDENTIAL '~~' EPCRA ^ 1~S l NO FACILITY ID # t Al AP = =0; GRID # ''ia (Agency Use Only) 2 R-11 / V-l l II. CHEMICAL INFORMATIO N CHEMICAL NAME '-U3 TRADE SECRET Yes _l" No-~ If Subject to EPCRA, infer to instructions COMMON NAME '-0 i '-0S EHS' ^ Yes X No NITROGEN CAS#-~ ;If EHS is "Yes," all amounts below must be in lbs. 7727-37-9 FIRE CODE HAZARD CLASSES (Complete if required bytocelagency) ''-i1 HAZARDOUS MATERIAL TYPE (Check one item only) X a PURE b. MIXTURE c WASTE 211. RADIOACTIVE ^ Yes XNo 212. ,t; CURIES PHYSICAL STATE 214. "t~' RGES NTAINE 336 L (Check one item only) a. SOLID b. LIQUID X c GAS A T CO R FED FL~Z.-\RD CATEGORIES ?t6. (Chick all that apph'1 a. FIRE b. REACTP"E S c. PRESS'i?RE RELE aSE d. ACtrTE HE aI.TH _l' e. (TIItONIC HEALTH A\"ERAGE DAII.T AAfOUNT ''-1 ~. AL~1II~3L~iDaII.1 A2`i0UA3T ''-i8 .~NNL.?~L \\aSTE MOUNT '-19. STATE \4.~STE CODE '-?~. X475 1008 "t DAPS ON SITE '-" UNITS' a. GALLONS X b. CUBIC FEET c. POUNDS ^ d. TONS 361 (Check:. ne item onlc) ' IT EHS, amount must be in ounds. STORAGE CONTAINER s. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG n. PLASTIC BOTTLE r. OTHER ^ c. TANK INSIDE BUII.DING ^ g CARBOY k BOX ^ o. TOTE BIN d STEEL DRUM ^ h. SIIA X {.CYLINDER p. TANK WAGON 223. STORAGE PRESSURE a. AMBIENT X b. ABOVE AMRTF.NT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELO W AMBIENT ^ d CRYOGENIC 223. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I, 226. 227. ^ Yes NO 228. 229. 1, 230. 231. Yes NO 232. 233. 3, 234. 235. ^ Yes No 236. 237. q, z3s. z39. ^ Yes No 2ao. eat. $, 242. 243. ^ Yea NO 244. 245. If omre harardoas eoarpoaents are present at Beater than 1 % by u~elght S aonraMtagedc, or O.IYe by n-e/ght if carclaogeaM, attach additbaal sheets of paper rrpturing the required hdormadoa. ADDTl'IONAL LOCALLY COLLECTED INFORMATION ''-a6 If EPCRA, Please Sign Here_ uQ-,~.,inn~ 1\A~ta:,,l Tn.ront..r..7nM.l..~ 1 Ao,. 17m~ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION lost: yagz yzr matzual pzr btulding of atza) ^ ADD ^ DELETE X REVISE '-0° Page ~ of [! L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3. GOLDEN STATE PETERBIT CHEMICAL LOCATION '-01 CHEMICAL LOCATION CONFIDENTIAL =°'- EPCRA ^ YES l NO FACILTI'Y ID # I. Di -1P ~-°; GRID # -oa (Agency Use only) 1 / 3 K-21 / V-6 IL CHEMICAL INFORMATIO N CHEMICAL NAME '0s TRADE SECRET I'es t No =°~ If Subject to EPCRA, referto a~strnctions COMMON NAME '-0i -°S EHS* ^ Yes X No PROPANE CAS#-°~ sIf EHS is "Yes," all amounts below must be in lbs. 7~-98-6 FIRE CODE HAZARD CLASSES (Cotupteteifrequitedbylocalagertcy) ''1°. HAZARDOUS IvIATERIAL X a. PURE b. MIXTURE c. WASTE 211. RADIOACTIVE ^ Yes X No 212. CURIES '13. TYPE (Check one item only) PHYSICAL STATE 214. GEST ER 1000 NT ~1, (Check one item only) a. SOLID X b. LIQUID c GAS LAR CO AIN FED H.~ ~RD C'_~TEcUORIES _1G. (Check all that apply) X a. FIRE b. REACTIVE X c. PRESSURE RELEASE X d ACUTE HEALTH X e. CHRONIC HEALTH A~BR-Ui'E D-lII.T ArtOLTNT ?t i. I~L~..Z~iCA~t DAILI ArIOLTNT-1S. .~NNCJ_-~I ~l•'ASTE AhIOLTNT '19. STATE 1V.~STE CODE -'-'U. 380 1280 "'t DAIS ON SITE --- i]DtITS" X s. GALLONS b. CUBIC FEET c. POUNDS ^ d. TONS 3GS (Check one itzm onlc'r ' If EHS, amotmt must be in otmds. STORAGE CONTAINER X a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ tn. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG n. PLASTIC BOTTLE r. OTHER ^ a TANK INSIDE BUILDING ^ g. CARBOY k. BOX ^ o. TOTE BIN d STEELDRUM ^ h. SII.O X 1. CYLINDER p. TANK WAGON ~3- STORAGE PRESSURE a. AMBIF,PIT X b. ABOVE AMBIENT ^ C BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225. °lo WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 226. zz~. ^ Yes No 22s. 229. Z, 230• 23t. Yes No 232. 233. 3, 234. 235. ^ Yes No 23G• 237. 4. 235. z39. ^ Yes No 2ao. zat. 5, zaz. za3. ^ Yes No zaa. zas. If amore harardous roaywneats are present at greater Wao 1•/. be n~efght ft aoa-carcinogenic, ar 0.1% be n~efght H eaMaogeaM, attarb additlmal sheets paper capturlag the regWred fatoratatloa ADDITIONAL LOCALLY COLLECTED INFORMATION -~ If EPCRA Please Sign Here. raa,4r,1,.,,~ re~rA.;,t 1,...A..+,..., ~nm ,1.,,. ~ u>., t ~ rn~ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION - forts aga par malarial pat Ixulding of area) ^ ADD ^ DELETE X REVISE ''-0° Page L of G~ L FACII.ITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3. GOLDEN STATE PETERBILT CHEhIIC AL LOC: ATION ''-01 CHEMICAL LOCATION CONFIDENTIAL ''''- EPCRA ^ YES l NO FACILTTY ID # t. 1\i ~P T '-o~. Ogg # zoa. (Agency Use Only) 3 X_20 II. CHEMICAL INFORMATIO N CHEMICAL NAME ''-0{ TRADE SECRET I"es _l" No '°6 If Subject to EPCItA, refer to instructions COMMON NAME-°' '°s EHS= ^ Yes x No GASOLINE CAS# '-°9 •If EHS is "Yes," all amounts below must be in lbs. 8006-61-9 FIRE CODE HAZARD CLASSES (eompteteifrequireabytocstagency) '1° xAZARDOUS MATERIAL X a. PURE b. MIXTURE a WASTE 211. RADIOACTIVE ^ Yes X No 212. ''; CURIES TYPE (Check one item only) PHYSICAL STATE 21a. ?t;. ES 55 NT INE (Check one item only) a. SOLIp X b. LIQUID c GAS LARG T CO R A FED H.-~,Z.aRD C_aTEIiC>RIES ?1G. (Check all thaz apply) X a. F1RE b. REACTIVE c. PRESSURE RELEASE X d. ACUTE HEALTH X e. CHRONIC HEALTH A\'ER~OED•1II.Y.•1AfOLTNT '-i- 1`L~.l'II~ILTAID~II.YArIOtTNT '-ts ?.NNI.?~I.\V.~STE ~iOLTNT 't9. ST.aTE~~:~ISTECODE-?°. 55 110 "l DAYS ON SITE ---- UNITS• X a. GALLONS b. CUBIC FEET c POUNDS ^ d TONS 365 (Check one item on11'1 * IfEHS. amount must be in ounds- STORAGE CONTAINER a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK X f. CAN ^ j. BAG n. PLASTIC BOTTLE c OTHER ^ c TANK INSIDE BUILDING ^ g. CARBOY k BOX ^ o. TOTE BIN X d STEELDRUM ^ h. SILO 1. CYLIlVDER p. TANK WAGON 223- STORAGE PRESSURE X a. AMBIENT b. ABOVE AMBIENT ^ e. BELOW AMBIENT 224. STORAGE TEMPERATURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 226- 227. ^ Peg 1110 228. 229- 2. z3o. 23t. Yes No z32. z33. 3. ~- 235- ^ Yes No 236- 237. q, z3s. z39. ^ Yes No zao. zat. 5, zaz. za3. ^ Yes No 2aa. 2a5. utuore harardoos compoaeats are present at greater than 17. b~ u~efght if ttotrcartiaogeoic, or 0.1 % b~ tt-elght B carciaogeaic, attach additloaal sheets of paper capaoing the required htfortoatba. ADDTI'IONAL LOCALLY COLLECTED INFORMATION If EPCRA, Please Sign Here. ua~~..t...,e A,I..r...:9t r...,A..r,.r., ~nn~ a,.,. 5 ua„ t ~m~ UNIIt~ED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (one page per material per tmildatg or arml ^ ADD ^ DELETE X REVISE '-a' Page ~ of 21 L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3. GOLDEN STATE PETERBILT CHEnIIC AL LOCATION '-ot• CHEMICAL LOCATION CONFIDENTIAL ''-o'-- EPCRA ^ 1"ES _l' NO FACII.ITY ID # 1_ DI_-~P ~ 'o; GRID # '04. ~agerwy use orty~ 2 / 3 R-11 / V-10 / O-7 ~~ II. CHEMICAL INFORMATIO N CHEMICAL NAME '-65 TRADE SECRET ^ Tes t No '-UG If Subject to EPCRA, refer to instructions COMMON NAME 'o% :os- Exs= ^ Yes x No OXYGEN CAS# 't'~ =If EH3 is "Yes," all amounts below must be in lbs. 7782-{~-7 FIRE CODE HAZARD CLASSES (Complete ifretluitea by local agency) '1° IIAZARDOUS MATERIAL TYPE (Check one item only) X a PURE b. MIXTURE c WASTE 211. RADIOACTIVE ^ Yes X No 212. CURIES ,1; PHYSICAL STATE (Check one item only) s. SOLID b. LIQUID X c GAS 214' LARGEST CONTAINER 2g5 ~ h. FED FL~ZARD C'.-\TEGORIES ?16. (Checl: all that applt=l a. FD2E b. REACTIVE T c. PRESSURE RELEASE d. aCi?TE HEaI:TH e. CHRONIC HEALTH A~'EIL3i:E DST MOUNT '-1 % 1\L~1"AICJAf DAII.1 AI\iOUNT '-ls ANNCL~I. \VASTE AMOUNT '19. STATE 1VaSTE CODE '-=o. 1200 2280 -''-1 D_-11 S ON S11'E '-" UNITS• a. GALLONS X b. CUBIC FEET c POUNDS ^ d TONS 36S t Lheck one item only i * It EHS, amount must be in ounds. STORAGE CONTAINER e. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ t FIBER DRUM ^ rn. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG p. PLASTIC BOTTLE r. OTHER ^ c TANK INSIDE BUILDING ^ g. CARBOY k. BOX ^ o. TOTE BIN d STEEL DRUM ^ h SII.O X I.CYLIlVDER p. TANK WAGON q3_ STORAGE PRESSURE a. AMBIENT X b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1, zz6. 227. ^ Yes No 22s. z2v. y, z3o. 23t. Yes No 23z. z33. 3, 234. 23s. ^ Yes No z36. 2s~. 4. 238. z3v. ^ Yes No 240. zal. g. z4z. aas. ^ Yes No z44. zas. If more luiardogs components are present at greater than 1 % be tceight if non-crrelnogenk, or 0.1 % be eAght ff earrhwgente. attaeb addltl~al sbeets of paper captmiog We txgolred brformatba ADDITIONAL LOCALLY COLLECTED INFORMATION '-a6 If EPCRA, Please Sign Here. uA,o.a..nc T,lotn.~isl T,,.,>ntn...7M7.4.~ 5 nP., t~in~ UNIl~ED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (: xie page per mateual per builduig or area) ^ ADD ^ DELETE X REVISE '-t'0 Page Hof Lj L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3~ GOLDEN STATE PETERBILT CHETIICAi. LOCATION 'ot. CHEMICAL LOCATION CONFIDENTIAL '0' EPCRA ^ YES l NO FACILITY ID # t. M_~P m '-0; GRID # ''od. (Agency Use Only) 2 ~7_ig II. CHEMICAL INFORMATIO N CHEMICAL NAME '-0' TRADE SECRET Tes t No =~'~ If Subject to EPCRA, refer to inshuctions COMMON NAME ''-o%. pos. EHS' ^ Yes x No DIESEL FUEL CAS# ''-U~ *If EHS is "Yes," all amounts below must be in lbs. 6833-30-5 FIItE CODE HAZARD CLASSES (Camplateifsegrnredbytocalagency) '-tt' xAZ.ARDOUS MATERIAL X a. PURE b. MIXTURE c. WASTE 271. RADIOACTIVE ^ Yes X No 212. sta. CURIES TYPE (Check one item only) PHYSICAL STATE 214' =ts. T 50~ (Check one item only) a. SOLID X b. LIQUID a GAS LARGEST CON AINER FED fL~Z.°1RD C.~TEC.ORIES '16. (Check all that apply) X a. FIIZE b. REACTIVE c. PRESSURE RELEASE X d ACUTE HEALTH X e. CHRONIC HEALTH Al'ERIGED~.II,1 _~SpLTNT-1% 1`L-~1~IL~iD~ILTAr10UNf 'ls. :aNNi_?-1I.R•~STE.~IOtiNT '-19. ST_~TE\~aSTECi1DE_'_o. 26.5 iS0 ='?t- DaTSONSITE "'- LINITS• X a. GALLONS b. CUBIC FEET c. POUNDS ^ d TONS 36S iCheck ont item onlcl * ffEHS. amount must be in ounds. STORAGE CONTAINER X a ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK X f. CAN ^ j. BAG n. PLASTIC BOTTLE n OTHER ^ a TANK INSIDE BUILDING ^ g. CARBOY k. BOX ^ o. TOTE BIN d STEEL DRUM ^ h. SII.O I. CYLINDER p. TANK WAGON a23. STORAGE PRESSURE X a AMBIENT b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TEMPERATURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT' ^ d CRYOGENIC 225. WT HA7,ARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1, z26. 2z~. ^ Yes No zzs. 229. 2. ~~ 23l• Yes No 232. 233. 3, z3a. z35. ^ Yes No z36. 237. 4, 23ti. 239. ^ Yes No uo. 241. 5. 242. 243. ^ Yes No 244. 245. If more hazvdous components are present at greater ihao 1 % hr ~rdght d aoo-carriaogedc, or 8.1 % by ezlght ff earrlaogeuk, attach addttbual sheets of paper aaptmiog dce required laformatlon ADDITIONAL LOCALLY COLLECTED INFORMATION-~ ff EPCRA, Please Sign Here u4~9.,~..,,~ r,,rgrA.;gi r...,o..r,.,.,~nn~.i,.~ V o,,., »m~ UNH+IED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION f one ogee cer ruaf~ial oer buildi~~ or areal ^ ADD ^ DELETE X REVISE '~' Page [ ~ of L 1 L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3. GOLDEN STATE PETERBILT CHEntICAI. LOCATION-~~ CHEMICAL LOCATION CONFIDENTIAL '~'= EPCRA ^ YES 1 NO FACILITY ID # ( I,L-1P ~ '~; GRID #-~a (Agency Use Only) 2 / 3 K-11/V-17 / F-18 H. CHEMICAL INFORMATIO N CHEMICAL NAME-~{ TRADE SECRET Yes 1 No =t6 If Subject to EPCRA, refer to inshuctions COMMON NAME-u~- ins. EHS* ^ Yes X No AUTOMOTIVE BATTERIES CAS# =~ *If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Compteteifrequiredbylocalagency) ''-1t' HAZARDOUS MATERIAL TYPE (Check one item only) ^ a PURE X b. MUCTURE ^ c WASTE 211. RADIOACTIVE ^ Yes X No 212. ?13. CURIES PHYSICAL STATE (Check one item only) X a. SOLID b. LIQUID ^ c. GAS 214' fit, LARGEST CONTAINER 3300 FED H.~Z.~RD l .~TEC.ORIES_16. (Check all that apple:) a. FIRE l b. RE_aCTTt'E ^ c PRESSURE RELEASE X d ACUTE HEALTH e. CHRONIC HEALTH ~~'ER~GED.~II1 _-1AIOLTNT '1~- rL~l'II~ILR~ID~II.1 AAIOLTNT-1S. _.~ATNU_~I.1V_~STE ~fOLTNT-19. STATE\t".~STECODE "-i1- 80 276 "1 D?,TS ON SITE --- UNITS' ^ a. GALLONS ^ b. CUBIC FEET X c POUNDS ^ d. TONS ' 36.i ( Check one item only 1 * ffEHS, amount must be in ounds. STORAGE CONTAINIIt ^ a ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAII. CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE X r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ a TOTE BIN d STEEL DRUM ^ b. SII.O ^ 1. CYLINDER ^ p. TANK WAGON 223. STORAGE PRESSURE X n. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For miarture or waste only) EHS CAS # I. 34 226. LEAD z2~. ^ Yes x No 2za. 7439-92-1 2zv. 2. 34 ~0- SULFUIC ACID zsl. x Yes No ~- 7664-93-9 za3. 3. 31 ~~ LEAD DIOI~LIDE z3s. ^ Yes x No ~. 1309-60-0 2a~. 4, z3s. z39. No zao. ^ Yes zal. 5, za2- za3. ^ Yes ^ No z4a. zas. U more harazdoas cemponeats are present at greater than 1% by ttetght if aoa-carHaogeok, or O.l % by a~etgbt ii eara~egeak, attach additlooal sheets of paper captariag the regatred iuleraradoa ADDITIONAL LOCALLY COLLECTED INFORMATION =~ If EPCRA, Please Sign Here. V us~o..t,.,.~ A,r~ro.;~t r...,o..r..r., ~nm ,u.~ 5 taA., t ~m~ UNIIfIED PROGRAM CONSOLIDATED FORM AA7.ARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION icyr_ page per mat_rial pet b~ulduyg or area i ^ ADD ^ DELETE X REVISE '-°° Page / of Z L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3• GOLDEN STATE PETERBII.T CHEhiIC -~L LOCATION-°t CHEMICAL LOCATION CONFIDENTIAL-°' EPCRA ^ IES Z NO FACILITY ID # t DI_-1P ~ ~0: GRID # '-oa (Agency Use Only) 2 / 3 U-17 l 7r2 II. CHEMICAL INFORMATIO N CHEMICAL NAME '-0i TRADE SECRET 1'es l No '-t'~ if Subject to EPCRA, refer to instructions COMMON NAME ''c. ~. '°s. EHS= ^ Yes X No AUTOMOTIVE BATTERIES CAS# ''-°9 =If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Campleteifrequiredbylocalagency)-1t HAZARDOUS MATERIAL TYPE (Check one item only) ^ a PURE b. MIXTURE X c WASTE 211. RADIOACTIVE ^ Yes X No 212. fit; CURIES PHYSICAL STATE (Check one item only) X a SOLID b. LIQUID ^ c GAS 214. ,t, LARGEST CONTAINER 3300 FED Ii•12ARD l'_•~TEiiORIES 21G. (Check all that applcl a. FII2E _l" b. REACTIVE ^ c PRESSURE RELEASE X d. ACUTE HEALTH e. CHRONIC HEALTH A~ER~c3E D-1II.Y:IAIUUNT' 't~. 1\L~1'II.IL/AID_~ILY:IAIOLTNT-ts. _~NNL?aL `~•1STE ~IOLTNT-19. ST_-1TE I~=•1STE CODE "-t~ 25 4S 27720 "'-t DAIS ON SITE "' UNITS" ^ s. GALLONS ^ b. CUBIC FEET X a POUNDS ^ d. TON5 36S (Checl. one item onlc) * Jt EHS, amount must be io uunds. STORAGE CONTAiNIIt ^ a ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLICbRUM ^ i. FIBER DRUM ^ tn. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ G CAN ^ j. BAG ^ a. PLASTIC BOTTLE X r. OTHER ^ c TANK INSIDE BUII.DING ^ g. CARBOY X k BOX ^ o. TOTE BIN d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223, STORAGE PRESSURE X a AMBIENT ^ b. ABOVE AMBIENT ^ a BELOW AMBIENT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c. BEI.o W AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only} EHS CAS # 1. 34 22G. LEAD n2• ^ Yes x No ~~ 7439-92-1 z29. 2. 34 230 SULFUIC ACID 23t. X Yes No 23z. 7664-93-9 z33. 3. 31 ~ LEAD DIOXIDE 235. ^ Yes x No ~ 1309-60-0 ~~~ 4, 238. 239. ^ Yes ^ NO 240. 241. $, 242. 243. ^ Yes ^ NO 244. 245. It Dare lurardoos r®rpooents are preseat at greater than 1% b~ w-elght ff oou-carclnogeoic, or O.f % be ~tel8ht if carcinogenk, attach addHional sheets of paper aaphving the regaked IoformatMo. ADDITIONAL LOCALLY COLLECTED INFORMATION--~ If EPCRA, Please Sign Here u~~~..t..,,~ iaara.;at r.,.,A.,t..R, ~nn~.t,.,. ~ nP., t ~~n~ UNIFIED PROGRAM CONSOLIDATED FORM FfA~ARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION onz pagz pzt tuatznal pzr btaldutg of aria) ^ ADD ^ DELETE X REVISE '-°0 Page L of 2 ~ L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3- GOLDEN STATE PETERBILT CHEDiIC_•1L LOC aTION '-t11 CHEMICAL LOCATION CONFIDENTIAL '-f-- EPCRA ^ 1"ES Z NO FACILITY ID # 1. DI_-1P T-°; GRID #-~a (Agency Use Only) 2 ~1_1'~ II. CHEMICAL INFORMATIO N CHEMICAL NAME-°' TRADE SECRET Y es l No-U6 If Subject to EPCRA, refer to instructions COMMON NAME '0' '-r's EHS* ^ Yes X No ANTIFREEZE /COOLANT CAS# =f9 *If EHS is "Yes," all amounts below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete ifrequuedbylocal agatcy) 'lt' HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE b. MIXTURE X e. WASTE 211- RADIOACTIVE ^ Yes X No 212. ?I; CURIES PHYSICAL STATE (Check one item only) a. SOLID X b. LIQUID ^ c. GAS 214. 'ls. LARGEST CONTAINER 55 FED ILA ~RD C_~TEGORIES '16. (Checl: all that appl~;i a. FIRE b. RE aCTI~-E ^ c. PRESSURE RELEASE X d. ACUTE HEALTH X e. CHRONIC HEALTH A~~ER~t;E D_aII.T AhfOL?NT '-1%. 1\L~l~fUI~fDAII.I AI~IOLTNT '-1S :~NNi?aL \~:~STE AMOUNT -19. ST_~TE 1'b'~STE CODE-?u. 3~ 110 723 -''-1 DAI S ON SITE --- UNITS" X a. GALLONS ^ b. CUBIC FEET c. POUNDS ^ d. TONS 36S (Che~:k one item onlc 1 • IT EHS. amount must be in ounds. STORAGE CONTAINER X a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ L FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ a. PLASTIC BOTTLE r. OTHER ^ c TANK INSIDE BUILDING ^ g. CARBOY k. BOX ^ o. TOTE BIN X d. STEEL DRUM ^ h. SII.O ^ L CYLTNDER ^ p. TANK WAGON 223. STORAGE PRESSURE X a. AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIF•NT 224. STORAGE TEMPERATURE X a AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 98 226. ETHYLENE GLYCOL 22~. ^ Yes X No z2s. 107-21-1 zz9. 2. 2 ~~ ADDITIVES vl. Yes x No ~2- MIX 233. 3, z3a. z3s- ^ Yes No z36- 237- 4. z3s. z39. ^ Yes ^ No zoo. zal. 5, 242. 243. ^ Yes ^ NO ~~ 24s- If more hararAous rnmpoaeats are present at greater than 1% by tcelght if uou-careloogeufc, or 0.1% be t~~eight if rrrciuogeoic, attach addttioual sbeets of paper capturlug the requtred intormatioa ADDITIONAL LOCALLY COLLECTED INFORMATION ''-a6 If EPCRA, Please Sign Here. uq~9~,t,.,,o i.~rs*a.:vt t,,..,.m„:., ~nrrt ,~,.~ 5 uo., t~inF UNH+IED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION ienr p~gr txt material yrt btulding or areal ^ ADD ^ DELETE X REVISE '-"t' Page ~ of L / L FACILITY INFORMATION BUSINESS NAME (Same as FACILTIY NAME ar DBA-Doing Business As) 3~ GOLDEN STATE PETERBILT ~' CHEMICAL LOC ATION ''-01 CHEMICAL LOCATION CONFIDENTIAL -~'= EPCRA ^ 1"ES _l" NO FACILITY ID # t. hi_-1P k ''-f1 GRID # ''-0a (Agency Use Only) 2 `77_15 II. CHEMICAL INFORMATIO N CHEMICAL NAME ''-05 TRADE SECRET Yes l No '-t'6 If Subject to EPCR~ refer to instructions COMMON NAME 'o% ?pS. EHS= ^ Yes X No MOTOR OlL cAS# ~°~ sIf EHS is "Yes," all amounts below mtut be in lbs. FIRE CODE HAZARD CLASSES (Complete ifregturedbytocalagency) '_lo. HAZARDOUS MATERIAL ^ a PURE b. MIXTURE X e WASTE 2t1. RADIOACTIVE ^ Yes XNo 212. CURIES 't; TYPE (Check one item only) PHYSICAL STATE (Check one item only) a SOLID X b. LIQUID ^ c. GAS 214. LARGEST CONTAINER 50~ ~t ~ FED Ii~Z.~RD C.aTE~~RIES '_l6. (Check all that applt-l a. FIRE b. REACTI~Z ^ c PRESSURE RELEASE X d ACUTE HEALTH X a CHRONIC HEALTH a~~ER~GED~T~tOUNT '-t% 1`L~~I1TAiD.a1LYAnIOLTNT_1S. _.\NN[L-1L\VASTE:1I~tOUNT '-19 ST.-\TE\VASTE CODE '-'o 250 750 1125 -'-t- DATSONSITE '-" UN1TS• X s. GALLONS ^ b. CUBIC FEET c POUNDS ^ d TONS 365 (Check one item onlt=) * IfEI3S. amount must be in ounds. STORAGE CONTA7[NER X a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ tn. GLASS BOTTLE ^ q. RAII.CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG n. PLASTIC BOTTLE r. OTI-IER ^ c. TANK INSIDE BUILDING ^ g. CARBOY Ic BOX ^ o. TOTE BIN X d STEEL DRUM ^ b. SII.O ^ 1. CYLINDER ^ p. TANK WAGON 223. STORAGE PRESSURE X s. AMBIENT ^ b. ABOVE AMBIENT ^ c BELOW AMBIENT 224. STORAGE TIII4PERATURE X a AMBffiVT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 75 226. REFINED BASE OILS zz~. ^ Yes x No 2~. 64742-55-5 zz9. 2. 10 z3o. ADDITIVES zit. Yes x No x+2. 68649-42-3 233. 3.10 ~~ DIRT /FUELS /WATER z35. ^ Yes x No ~. MIX ~~ 4, 238. 239. ^ Yeq No zao. eat. g, 2az. za3. ^ Yes ^ No zaa. zas. If mole harardous components are present at greater than lYo b~ n-efght ff non-carNnogenic, or 0.1 % by weight if cara~ogenic, athrch additional sheets at paper captmhig the regtdred infora>adon. ADDTI'IONAL LOCALLY COLLECTED INFORMATION '-a6 If EPCRA, Please Sign Here. T.to~o..t..,,c T..t~ta.~:ol 1...,n..r,,.,, 7M'/ .i..~ 5 DA.. 17/!1!. UNIFIED PROGRAM CONSOLIDATED FORM AA7.ARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION lonr pagr per au,ktiil prr fitildii~ of areal ~'~ ^ ADD ^ DELETE X REVISE-a' Page /~ of?/ L FACII.ITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3. GOLDEN STATE PETERBILT CHEI\IIC aL, LOCATION 'ot. CHEMICAL LOCATION CONFIDENTIAL '`'' EPCRA ^ I'ES 1 NO FACILITY ID # t. hI_•1P » ''o; GRID = J-11/G16/R-1S-16 'oa (Agency Use Only) 2 / 3 R 17 / V-1~1 /H-19 II. CHEMICAL INFORMATIO N CHEMICAL NAME '-o' 'TRADE SECRET Yes l No-06. If Subject to EPCRA, refer to instructions COMMON NAME 'o~. 'os. EHS= ^ Yes x No MOTOR OlL CAS# '09. 'If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Completeifrequiredbyla~l agency) '_to. HAZARDOUS MATERIAL TYPE (Check one item only) ^ a PURE X b. MDCTURE ^ c. WASTE 21i. RADIOACTIVE ^ Yes X No 212. 't; CURIES PHYSICAL STATE (Check o>te item only} ^ a SOLID X b. LIQUID ^ c. GAS 214. ~I,. LARGEST CONTAINER I Q~0 FED H.~Z_~RD C.-~TEtiORIES_ ib. (Check all that apply) X a FIRE ^ b. REACTIVE ^ c PRESSURE RELEASE ^ d ACUTE HEALTH X e. CHRONIC HEALTH ?~'ER.~GE DST _~fOLTNT ''-t%. nL1l"II~ILTI~ID_~ILY ?AtOLTNT' '_ts. .~NNIJ_-1L \V:aST'E ArtOLTNT '19. STATE \VASTE CODE ?'o. 700 1800 '_31. D_a1 S pN SITE --- [INPfS• X a. GALLONS ^ b. CUBIC FEET ^ c POUNDS ^ d TONS 365 Check one item onlc) * it EHS. amount must be in ouods STORAGE CONTAINER X a ABOVEGROUND TANK ^ e. PLASTIClNONMETALLIC DRUM ^ L FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ a. PLASTIC BOTTLE X r. OTHER ^ a TANK INSIDE BUILDING ^ g. CARBOY ^ K BOX ^ o. TOTE BIN d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223. STORAGE PRESSURE X a AMBIENT ^ b. ABOVE AMBIENT ^ e BELOW AMBIENT 224. STORAGE TEMPERATURE X s, AMBIENT ^ b. ABOVE AMBIENT ^ c. BELO W AMBIENT ^ d. CRYOGENIC 225. WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1. 85 2z6. REFINE BASE OILS 227- ^ Yes x No 2zs. 64774-58,8 229. a. 15 230. ADDITIVES 23t. ^ Yes x No ~2- 68649-42-3 z3s. 3, 234. z35. ^ Yes No ~. ~7- q, 2315. z39. ^ Yes ^ No zao. eat. 5. 242. 243. ^ Yea ^ No 244. 245. IE tuore haxardovs eaatpoaeats are present at greater Mao 1% 6c,teight K non-caraiBOgeafc, or 0.1 % b~ n'Mg6t if cara~ogeaiG alrrch ad~tMaal sheets of paper captarlag the requtred totmotalioo. ADDITIONAL LOCALLY COLLECTED INFORMATION ''-a6 If EPCRA, Please Sign Here. zto~9.,t,.,.~ n,is.a.:~t r,.,,o,.r...rt. ~nn-r .t„~ V uA,. tornF UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (olte page p~~ matetiai pei Ittti-dvtg of meal ^ ADD ^ DELETE X REVISE 't't' Page/ of~j L FACILITY INFORMATION BUSINESS NAME (Same as FACILdTY NAME or DBA -Doing $usiness As) 3. GOLDEN STATE PETERBILT CHErIICAI: LOCATION ''-01 CHEMICAL LOCATION CONFIDENTIAL '-0-- EPCRA ^ 1"ES l NO FACILITY ID # 1. hL~P = '03 GRID # =04 (Agency use only) 2 W-17 IL CHEMICAL INFORMATIO N CHEMICAL NAME 'Q5 TRADE SECRET ^ Yes l No 't'~ If Subject to EPCRA, refer to ins6uctions COMMON NAME ''-0 % '0S EHS* ^ Yes X No OIL FII:TERS CAS# '09 *If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Compkteifiequiredbylocalagency) "-i~ HAZARDOUS MATERIAL a. PURE b. MIXTURE X c. WASTE 211. TYPE (Check one item only) RADIOACTIVE ^ Yes X No 212. .1?. CURIES PHYSICAL STATE 214. "j5 GES ONT NER 450 L (Check one item only) X a. SOLID 6. LIQUID c GAS AR T C AI FED H,AZ?.RD C:-~TECiORIES _16. (Check all that apply) X e. FIRE b. REACTIVE c. PRESSURE RELEASE X d ACUTE HEALTH X e. CHRONIC HEALTH A~ER~GE D-~II.1 _~ItIOL'NT '1 i. 1\L-L~[C~ID.~1 .~1I~IpUNT ?1S. ANNC?-1L T~'~STE AkfOLTNT_19. STATE \~:-~STE CODE_'0. 600 100 1000 "t DAIS ON SITE --- UNITS• e. GALLONS b. CUBIC FEET X c. POUNDS ^ d. TONS 36$ i Check one item onle) * If EHS, amount must be in owtds STORAGE CONTAINER a. ABOVEGROUND TANK ^ e. PLASTIClNONMETALLiCDRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAILCAR ^ b. UNDERGROUND TANK f. CAN ^ j. BAG n. PLASTIC BOTTLE c OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY k. BOX ^ o. TOTE BIN X d STEELDRUM ^ 6. SII.O X 1. CYLINDER p. TANK WAGON Zz3. STORAGE PRESSURE X a. AMBIENT b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224. STORAGE TEMPERATURE X s. AMBIENT ^ 6. ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225. WT IIA7.ARDOUS COMPONENT (For mixture or waste only) EHS CAS # >t. 2zc. WASTE CRUSHED OIL FILTERS z27. ^ Yes x No zza. 229. Z, 230. 231. i'eg pjp 232. 233. 3. 234. 235. ^ Yes No z36. 237. Q, 238. 239. ^ Yes NO 240. 241. g, 2a2. 243. ^ Yes No 24a. 2a5. If amore 6arardous coatpoaents are present at greater than 1 % 6c nefght O aoa-careiaogeaic, or 0.1 % b~ freight if carchwgenk, attach additlooal sheets of paper crpnaing We required iatora~atba. ADDTfIONAL LOCALLY COLLECTED INFORMATION ''-a6 If EPCRA, Please Sign Her V u~~srt,,,,~ a.t~rA.;,.t r,,.,a„r,„-„ ~nm.a,.,. 5 uA., t~in~ Sitc Address: /~~ SO tanl i ~i.1 ~ V ~ I~,~K~S'~~~ ~A X33 °7 Date Map DraH'n: ~/~/ / O7 Map Scale: Page l of 3 A t3 C D E F G H I J K L M N O P Q R S T U V «' X Y G 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2~ 2b 27 28 UN`IFLED PROGRAM CO'N'SOLIDATED FORM FACILITY INFORMATION ' SITE MAP Instructions are printed on the following page. Site 1~1ap 200?.doc ~ Rev ] x'06 U'T~IFIED PROGRAM CO:~SOLID.ATED FORA4 FACILITY IISFORMATION . ~ SITE MAP :. Site Address: /~sd Sd (~rJ~o~ ~U~ ~,4Kf=2Sl~~~(/~ C~fl x,330 Date Map Dravrn: a / o?i !~ Map Scale: Page ~ of A B C D E F G H I J K L M N O P Q R S T U V «' X Y Z 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 zs 2F 2i zF ---- ~ .~ ; ~ ~ ~ -r- ,---- Instructions are printed on the following page. Sit: A7ap 200?.doc '] Rev) 2;Ob Site Address: / ~cSD SD V N ~ o ..1 19 V C ~A1~~~S ~ 1 ~~~ e,~ ~3~0 7 Date Map Dra~~°n: ~ / 2 / / DZ Map Scale: --__ Page .3 of 3 A IS L ll r; N' (i H 1 J K L M iV U Y t1 K ~ I~ U V ~N X Y G 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2{ 2E 2i Z~ Ul~'IFIED PROGRAM CONSOLIDATED FORM FACll.ITY INFORMATION SITE MAP ~~ r Instructions-are printed on the follo«•ina page. Site Map ZQO?.doc ~ Rev 12,'06 UNIFIED PROGRAM INSPECTION CHECKLIST ~ Prevention Services >z .a F R s r , 0 900 Truxtun Ave., Suite:21.0 - - - I . FiAE Bakersfield, CA 93301- S E C T I O N 1 : BUSICI@SS Plan and- InV@11tOry Program ae ~M Tel.: (661) $26=3979 - - ~ Fax: (661) 872-2171 ~ FACILITY NAME ' INSPECTION DATE - INSPECTION TIME ~. ~-~-r ~ I ! - ~ 2 ~.. I ADDRESS _ - _ PHONE NO. - NO OF EMPLOYEES - FACILITY CONTACT BUSINESS ID NUMBER - I ~~ I 15-021- ~Q'I b5~ ~ Section 1: Business Plan. and Inventory Program __ ~~~ - LN ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( ~'-~ompuance~ OPERATION COMMENTS ~ ~ V=Violation ~ u r~rrrwrr~in~ ~ rurvvu ~ vw nnrvu LY ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE - ` ~ ~ ~ ZOO VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ,, / 6Y ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY - / L]V' VERIFICATION OF HAZ MAT TRAINING '~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ ~ ^ I'ti o ~ ` " +~ ~l ~r C7~ ~/ l~l ^ EMERGENCY PROCEDURES ADEQUATE I ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ~ V ,~ (~ (_ T ^ SITE DIAGRAM ADEQUATE & ON HAND f ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 Inspector (Please Print) .Fire Prevention / 1" In /Shift of Site/Station # YES @' NO A/ - i c ~~ ~~~~ k ~T Uf~~ylo/Y Business Site /Responsible Party (Please Print} - - - - White -Prevention Services - -Yellow -Station Copy - Pink -Business Copy . _ - FD 2755 (Rev. 09105 ' . + GOLDEN STATE PETERBILT _____________________________= SiteID: 015-021-001553 + Manager PATRICK MOTLEY Location: 1450 S UNION AVE City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: BusPhone: (661) 833-1700 Map 124 CommHaz High Grid: 08A FacUnits: 1 AOV: SIC Code:5599 DunnBrad: t====--------------------------------------------------------------------------+ ---------------------- ---- ------------ Emergency Contact / Title Emergency Contact / Title PATRICK MOTLEY j GENERAL MANAGER CLINTON JOHNSON / SERVICE MANAGER Business Phone: (661) 833-1700x Business Phone: (661) 833-1700x 24-Hour Phone (661) - ,39,3-- 24-Hour Phone (661) 392-8343x Pager Phone ( ) - x ~G 99 Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact Phone: (661) 833-1700x MailAddr: 1450 S UNION AVE State: CA City BAKERSFIELD Zip 93307 Owner GOLDEN STATE PETERBILT Phone: (661) 833-1700x Address 1450 S UNION AVE State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN ENT'D MAR 2 4 2006 Based on mysnquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitt n~ believe the information is true, ~' ~ '~© Date -1- 03/07/2006 Bakersfield Fire Dept. UNIFIED PROGRAM INSPECTION CHECKLIST Environmental Services ~_- - ~~`~"""~'~'°"~ ~ 900 Truxtun Ave., Suite 210 SECTION 1 Business .Plan and Inventory Program Bakersfield, CA 93301 Tel: X661) 326-3979 FACILITY NAME WSPECTION GATE INSPECTION TIME ADDRESS PHONE No. No. of Employees 3~ s __ FACILITYC TACT Business 10 Number _ ~.1 n.< ~ ,lP /I/I ~7-f-lcoc~ i 15'U21- ~} O~ J S~ Section 1: Business Plan and Inventory Program ~PRoutine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection • ANY HAZARDOUS WASTE ON SITE?: ^ YES ONO ExPU-IN: ' • QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~F)C)'I ~ 326-3979 I i ~ 1 or (Please~rtnt) ~ Fire Prevention 1st-InlShik of Site - White - Envvonmental Services Yelknv - Stalan Copy Business Site Responsible Party (Please Print} Pink -Business Copy UNIFIED PROGRAM 1..3PECTION CHECKLIST ~ SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. ol` Employees _ t r lit ~ o Vi -- - - - ,.--- - - FACVLITYCONTACT -- --- --- Business ID Number 15-021- o00 X60 Section 1: Business Plan and Inventory Pn~gram ^ Routine ^ Combined O Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection C V ncel OPERATION t t COMMENTS J n o \V=Vioa ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS --- - ----. ------------------- -- ------ --`-- ~ V l_..---- --------- ------- ^ ^ CORRECT OCCUPANCY ~ ~./`~,i /~/ ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ^ ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED I ^ -- ^ --- HOUSEKEEPING ---- -- -------- ---- ---- -------- ---------- ^ ^ FIRE PROTECTION i -~- ---_- ---^--~---- ~.--------_--_------- ----- -- -------- ^ ^ SITE DIAGRAM ADEQUATE Sr ON HAND ~ ANY HAZARDOUS WASTE ON SITE: ^ YES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66~~ 3Z6-3979 I t _._ . - ---- --------- - --._ ....- . ----- -- --------- I Inspector Badge No. i - - White - Environmental Services r Business Site Responsible Party Yellow -Station Copy Pink -Business Copy UNIFIED PROGRAM I..~PECTION CHECKLIST ~ SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME I .INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees _ ~~~ D S, u ~ r ot~t S 3 3- %7~ ____L_ ~~_____ __ __ _ FACILITYCONTACT Business ID Number ~ s-o21- oo r 553 Section 1: Business Plan and Inventory Pn~gram ^ Routine ^ Combined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection C l~ V ^ IV=Vioationn~l OPERATION; ., a; APPROPRIATE PERMIT ON HAND COMMENTS ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY JAI ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES i~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL (~ ^ VERIFICATION OF MSDS AVAILABILITYE (~ ^ VERIFICATION OF FIAT MAT TRAINING ~ ^ ^ -~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE I --- ^ CONTAINERS PROPERLY LABELED --------- ---------- -- -- -- i~. - ^ ^ ^ ------ - --------- - HOUSEKEEPING --- ------ FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND --- _- --j I ---- ----------- / Q _ /O ~ ~ D= D ~ _ ~Z~~ ~~~,CJ i1V } ANY HAZARDOUS WASTE ON SITE?: L~-YES ^ NO ~E~.~~ ~ , 7 EXPLAIN: ~~G (r<<~ ~ l - !°I~ l Lt ~L~e~ / ~GN I ~/1 QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~F)6'I ~ 326-3979 / o/~y ~L~<lG•?_'~ ~L!IE`.~".t~/ -off --------- ------ ----~-~ -- _..~--Irk---------- Inspector Badge No. Wn~te - Environmental Services Vellow - Statbn Copy -- --------'f-~-~-- ~-- ~ _`~--- --- Business Si esponsible Party ~_' i Pink - BUSine55 Copy ~~_.