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HomeMy WebLinkAboutBUSINESS PLAN (3) ~. ~~ \ \. NAJDAWI CHEVRON ~ X525 WHITE LN ~,~~~~ ,~, ~~, ~J ~~ s~~~ , SEP 2 6 2003 ~~ ,. ~. UNIFIED PROGR~4M INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironniental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ~ INSPE ION DATE INSPECTION TIME ~ ~ ~~ ADDRESS PH N No. of Employees --- Business ID Number FACILITYCONTACT 15-021- Section 1: Business Plan and Inventory Pn~gram ^ Routine ombined ^ Joint Agency DMulti-Agency ^ Complaint ^ Re-inspection V C tl ncel OPERATION J ~ y ~ L~/ L^ on V=Voa PERMIT ON HAND APPROPRIATE ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ V ISIBLE ADDRESS l(J/ LEI CORRECT OCCUPANCY -- - - - ^ VERIFICATION OF INVENTORY MATERIALS ----------------- --------------------------------------- (~ ~^ VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION -~--J-------------------------------- ----------- - LRY U 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 LW U HOUSEKEEPING ----- FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8t ON HAND COMMENTS ANY HAZARDOUS WASTE ON SITE: ^ YES 'i7~N0 EXPLAIN: tUESTIONS CARDING IS PECTION~ PLEASE CALL US AT (66~) 326-3979 Inspector Badge No., White -Environmental Services Yellow - Statbn Copy Ite Responsible Parry Pink -Business Copy } ~a.LD p`,• ~~~w4e' T~ \ CITY OF BAKERSFIELD FIRE DEPARTMENT d ~ ~ b OFFICE OF ENVIRONMENTAL SERVICES ~~' '~~` UNIFIED PROGRAM INSPECTION CHECKLIST \`~w ~gti,,i'~~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ..,.~~ FACILITY NAME ~ ~Q(~3l ~`R)nt INSPECTION DATE~g Section 2: Underground Storage Tanks Program ^ Routine ~mbined ^ Joint Agency ^MultI-Agency ^ Complaint ^ Re-inspection Type of Tank ~Q(1J ~C~ Number of Tanks Type of Monitoring ~LI~ Type of Piping f~(ll?~ OPERATION C V COMMENTS Proper tank data nn the Proper owner/operator data on the Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? YeS No ~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Viola ion Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 Business ite Responsible Party White - 1?nv. Svcs. Pink -Business Copy :ti aa' + NAJDAWI CHEVRON _____________________________________ SitelD: 015-021-00043? ~ Manager Location: 2525 WHITE LN City BAKERSFIELD BusPhone: (661) 832-9781 Map 123 CommHaz Moderate Grid: 13C FacUnits: 1 AOV: CommCode: BFD STA 05 SIC Code:5541 EPA Numb: DunnBrad:02-787-5673 ' Emergency Contact / Title Emergency Contact / Title RAGHDA NAJDAWI / OWNER BASHAAR NAJDAWI / Business Phone: (661) 588-7445x Business Phone: (661) 832-9781x 24-Hour Phone (661) 703-9673x 24-Hour Phone (661) 706-9676x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact DENISE ROSS - - Phone: (661) -832-9781x- - -- -- MailAddr: 2525 WHITE LN State: CA City BAKERSFIELD - Zip 93304 Owner RAGHDA NAJDAWI C;~ ~ Phone: (661) 832-9781x ? ~ ~ 6 Address 15830 BLACK HAWK AVE ~,~ , j State: CA City BAKERSFIELD Zip 93314 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST - - ~ i3ased `an my inquiry 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 submitted and believe the information is true accurate, and complete. 5i nature Date ANT ~ ~ PR .~ -1- 03/30/2006 ~5 3 + NAJDAinII CHEVRON _____________________________________ SiteID: 015-021-000437 + Manager BusPhone: (661) 832-9781 Location: 2525 WHITE LN Map 123 CommHaz Moderate City BAKERSFIELD Grid: 13C FacUnits: 1 AOV: CommCode: BFD STA 05 -SIC Code:5541 EPA Numb: DunnBrad:02-787-5673 Emergency Contact / Title Emergency Contact / Title RAGHDA NAJDAWI / OWNER BASHAAR NAJDAWI / Business Phone: (661) 588-7445x Business Phone: (661) 832-9781x 24-Hour Phone (661) 703-9673x 24-Hour Phone (661) 706-9676x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact DENISE ROSS Phone: (661) 832-9781x MailAddr: 2525 WHITE LN State: CA City BAKERSFIELD Zip 93304 Owner RAGHDA NAJDAWI Phone: (661) 832-9781x Address 15830 BLACK HAWK AVE State: CA City BAKERSFIELD Zip 93314 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG U - UST ENT'D O C T 2 4 -2006 ~~~~H art rr+y int}uiry of those individuals ra~p~rl~ibie for obtalning the information, I certify urrd~tr penalty pf law tha4 I have personally exar~-inrod and am famlllar with the Information submitted and. bolleve a Information is true, accurate, and com " Signature ~"~°m' Date -1- 03/30/2006 ~~~ ~ 2~ NAJDAWI CHEVRON SiteID: 015-021-000437 ,Manager :_~~-~~S'~ ~`~S BusPhonec (661) 832-9781 Location: 2525 WHITE LN Map 123 CommHaz Moderate City BAKERSFIELD Grid: 13C FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code:5541 DunnBrad:02-787-5673 Emergency Contact / Title Emergency Contact / Title RAGHDA NAJDAWI / OWNER BASHAAR NAJDAWI /, S ©~'1 Business Phone: (661) 588-7445x Business Phone: (661) 832-97$lx 24-Hour Phone (661) 703-9673x 24-Hour Phone (661) 706-9676x Pager Phone (661) 717-3896x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact DENISE ROSS Phone : ( 661) ff~z'~9"7'8~~x ~" MailAddr: 2525 WHITE LN State: CA :z6 S -~ 7 S , 7 City BAKERSFIELD Zip 93304 Owner RAGHDA NAJDAWI Phone: (661) 832-9781x Address 15830 BLACK HAWK AVE State: CA City BAKERSFIELD Zip 93314 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT '(~~~ ~ PROG U - UST ~ I f3dsod on my inquiry of those individuals tif I AI ~ M~~' ~ ~ ~OQ, ~N~ ~ w! y cer responsible for obtaining the information, under penalty of laver that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~~~G S - 2 (). ~G ~ Signature Date -1- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: NAJDAWI CHEVRON Cross Street Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper AARON KOOP ICC Nbr: 5246167-UC PROPERTY OWNER INFORMATION Name BASHAAR NAJDAWI Phone: (661) 832-9781x Address: City State: Zip: Type TANK OWNER INFORMATION Name BASHAAR NAJDAWI Phone: (661) 832-9781x Address: City State: Zip: Type BOE UST Fee# Financ'1 Resp: SELF INSURED Legal Notif Date:07/02/2001 Phone: (366) 145-51 x Name:BASHAAR NAJDAWI Ttl:OWNER State UST # 1998 Upg Cert#: 28503 -2- 05/16/2007 F NAJDAWI CHEVRON ~'Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-000437 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP UNLEADED PLUS GASOLINE F R IH DH L 12000.00 GAL Mod UNLEADED GASOLINE F R IH DH L 12000.00 GAL Mod SUPREME UNLEADED F R IH DH L 12000.00 GAL Mod COOLANT - ANTI FREEZE R L 10.00 GAL Low MOTOR OIL F DH L 150.00 GAL Min -3- 05/16/2007 -4- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ 'Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST SW CRNR CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture ~mbient ~ Ambient ~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12.000.00 GAL 12000.00 GAL 500000.00 GAL riL~L,HKLVUJ ~.vlnrviVrlV1~ %Wt. RS CAS# 100.00 Gasoline No 8006619 _- - riHGHKL H~ ~1;~51~11;1V la TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UST SW CRNR CAS# 8006-61-9 Liquid TMixture ~mbRient~E ~ AmbientT~E ~EROGRODNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 600000.00 GAL HAZARDOUS COMPONENTS r %Wt. 100.00 Gasoline RSI CAS# No 8006619 11AG,t]itL t]~ 7 JP.~~7 J1.1LilV 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod -5- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ `Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME SUPREME UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: UST SW CRNR CAS# 8006-61-9 Liquid TMixture ~mbRient~E ~ AmbientT~E UNDER GROUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 500000.00 GAL t1AGEitCLVUJ 1.V1~lYV1V~1V 1.7 -- %Wt. RS CAS# 100.00 Gasoline No 8006619 17.E-1GEdC1J E1.7w71",~7J1~1L'1V1.J _- TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME COOLANT - ANTI FREEZE Location within this Facility Unit SW WALL STORE STATE TYPE PRESSURE Liquid TMixture T Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 107-21-1 TEMPERATURE CONTAINER TYPE Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 10.00 GAL 10.00 GAL nti[~ti.tC1JVU~J l.Vl~lt'V1VP~1V 1.7 %Wt. RS CAS# 75.00 Ethylene Glycol No 107211 1ZEiE~Ei1SL Li~J iJ.GJJI•IL~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT#$ MCP No No No No/ Curies R / / / Low -6- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ ~~'Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: NW CRNR BLDG OUTSIDE SW WALL INSIDE CAS# 8020835 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 150.00 GAL I 50.00 GAL t1t~Gxrcl~~u~ ~ul~lr~lv~lv~1~5 ~Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 riE~GtitCL HJ~l;JJ1~11J1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -7- 05/16/2007 ~ F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/20/2006 ~ IN THE EVENT OF SPILL THE FOLLOWING AGENCIES ARE NOTIFIED: BAKERSFIELD FIRE DEPT HAZARDOUS MATERIALS DIVISION 326-3979, STATE OFFICE OF EMERGENCY SERVICES 800-852-7550, CHEVRON USA INC, THESE AGENCIES ARE CONTACTED BY PHONE, AND CALL 911. Employee Notif./Evacuation 04/20/2006 IN CASE OF A SPILL OF HAZARDOUS MATERIALS OR A FIRE, ALL EMPLOYEES ARE INSTRUCTED TO TURN OFF PUMPS WITH EMERGENCY SWITCH AND CALL THE BAKERSFIELD FIRE DEPT OR 911. ALL CUSTOMERS WILL BE EVACUATED FROM THE STATION AND DRIVEWAYS CLOSED, EXCEPT FOR THE FIRE DEPT AND EMERGENCY VEHICLES. EMPLOYEES ARE NOTIFIED IN PERSON IF THEY ARE ON DUTY AND A HAZARDOUS MATERIAL EMERGENCY ARISES. EMPLOYEES NOT ON DUTY ARE NOTIFED BY PHONE. Public Notif.jEvacuation 04/20/2006 IN CASE OF EMERGENCY, LARGE GAS SPILL, FIRE, OR EXPLOSION I AND THE MEN ON THE EMERGENCY CONTACT SHEET WILL BE CALLED IMMEDIATELY, AS WELL AS 911 AND THE FIRE DEPT. EVACUATE ALL CUSTOMERS FROM STATION LOT AND CLOSE ALL ENTRANCES TO STATION, EXCEPT FOR EMERGENCY VEHICLES. IN THE EVENT OF A HAZARDOUS MATERIAL EMERGENCY, ALL DRIVEWAYS ARE TO BE BLOCKED AND ALL PEOPLE ON THE PREMISES ARE TO BE EVACUATED WITH THE HELP OF LOCAL POLICE DEPT. Emergency Medical Plan 04/20/2006 IN THE EVENT OF AN ACCIDENT REQUIRING MEDICAL ATTENTION CALL: HALL AMBULANCE 327-4111, CITY POLICE 327-7111, TRANSPORT INJURED PERSON TO SAN JOAQUIN HOSPITAL, 2615 EYE ST, 395-3000 OR MERCY HOSPITAL, 2215 TRUXTUN AVE, 327-3371. -8- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/19/2006 ~ ALL EMPLOYEES ARE INSTRUCTED IN THE PROPER USE OF GASOLINE PUMPS, USE OF GASOLINE PUMPS, ALL HOSES AND NOZZLES ARE INSPECTED REGULARLY FOR ANY SIGNS OF LEAKING OR MALFUNCTION OF NOZZLES AND AUTOMATIC SHUT-OFF DEVICES. ALL EMPLOYEES ARE INSTRUCTED NOT TO SMOKE OR ALLOW CUSTOMERS TO SMOKE IN RESTRICTED AREAS. GASOLINE IS NOT TO BE USED FOR CLEANING. ALL PUMPS, HOSES, AND NOZZLES ARE CHECKED PERIODICALLY FOR LEAKS. NOZZLES ARE. CHECKED DAILY TO BE SURE SHUT-OFF MECHANISM IS WORKING PROPERLY. Release Containment 04/20/2006 IN THE EVENT OF A SPILL OF GASOLINE OR OTHER MATERIALS, ALL EMPLOYEES ARE FAMILIAR WITH THE DANGER OF FIRE OR CONTAMINATION OF THE GROUND OR WATER AND HAVE BEEN INSTRUCTED ON THE IMPORTANCE OF IMMEDIATE CLEAN-UP. Clean Up 04/20/2006 IN CASE OF SMALL SPILL, WIPE UP AND LET EVAPORATE. IN CASE OF LARGE SPILLS WHICH CONTAMINATE GROUND, PLACE CONTAMINATED MATERIAL IN DISPOSABLE CARTONS AND CONTACT LOCAL HEALTH DEPT FOR PROPER DISPOSAL OF MATERIAL. IN CASE OF A GASOLINE SPILL, SHUT OFF ALL POWER AT STATION AND CALL THE LOCAL FIRE DEPT. v~.iic.L iccavuttrc til:l.lVQl.1V11 -9- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ oNc~:iai nac~ai.u~ Utility Shut-Offs 04/20/2006 A) GAS - NONE B) ELECTRICAL - ELECT PANEL S END STORE C) WATER - WHITE LN N OF PUMPS BY POLE ON SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/05/2007 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN CASHIER AREA AND STOREROOM BEH DOOR. FIRE HYDRANT - NW CRNR WHITE LN & EL POTERO BY SHELL STATION, S SIDE OF WHITE LN BET TEXACO STATION & MCDONALDS N SIDE OF WHITE LN FRONT OF COMFORT INN MOTEL. Building Occupancy Level 03/30/2006 6 EMPLOYEES -10- 05/16/2007 F NAJDAWI CHEVRON SiteID: 015-021-000437 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/24/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE REQUIRED TO READ MSDS SHEETS, READ WARNING LABELS ON PRODUCTS, BE AWARE OF ANY LEAKS OR SPILLS OF GASOLINE OR OTHER CHEMICALS, AND TO USE PROTECTIVE EQUIPMENT IF A JOB _ REQUIRES IT. ra.yc ~ Held for Future Use nciu ivi. ru~ul.c ~5c -11- 05/16/2007