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HomeMy WebLinkAboutHAZ-BUSINESS PLAN 10/25/2007 ) MESA MARIN FOOD MART Manager : MOHAMED M MUTHANA III Location: 11101 HWY 178 City BAKERSFIELD SiteID: IlL BusPhone: Map : 104 Grid: 20D (661) 366-4886 CommHaz : Moderate FacUnits: 1 AOV: " CommCode: KCFD STA 45 EPA Numb: SIC Code:5541 DunnBrad: Emergency Contact / Title MOHAMAND M MUTHANA / MANAGER/PARTNER Business Phone: (661) 366-4886x 24-Hour Phone (661) 978-9283x Pager Phone () x Period Preparer: Certif'd: ParcelNo: to Emergency Contact / Title DAHHAN M MUTHANA / PARTNER Business Phone: (661) 366-4886x 24-Hour Phone (661) 978-8092x Pager Phone ( ) x Fire Press ImmHlth DelHlth Phone: (661) 366-4886x State: CA Zip 93306 Phone: (661) 978-0115x State: CA Zip 93305 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Hazmat Hazards: Contact : MOHAMED M MUTHANA III MailAddr: 11101 HWY 178 City BAKERSFIELD Owner Address City MOHAMED M MUTHANA II 430 BAKER ST BAKERSFIELD Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG U - UST [: ;7'i '"; .-"<:-) on r:lV j nq! : 1"\1 o~. 1 hnsp ~ '("; ,. , ":,' j nd i\i; c) :Je!s I LJ'j(i : (of'-rl i)+- Date " ~y.~ ) ; ") -1- '\~~~ 07/12/2007 F-MESA MARIN PIT STOP SiteID: 015-021-001211 9 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: ", FACILITY/SITE INFORMATION Business Name: MESA MARIN FOOD MART Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: Dsg Own/Oper : DOUGLAS M YOUNG II I ICC Nbr: 0878646-UC PROPERTY OWNER INFORMATION Name : MOHAMED MUTHANA II Phone: 366-4886x Address: 430 BAKER ST. State:CA Zip 93305 City : BAKERSFIELD Type : INDIVIDUAL TANK OWNER INFORMATION Name : Phone: Address: City : State: Zip: '~ Type : INDIVIDUAL BOE UST Fee# : Financ'l Resp: SELF INSURED Legal Notif : Date:01/27/2004 Phone: (661) 978-9283 Name:MOHAMED M MUTHANA III Ttl:BUSINESS MGR b6( Q7'8 "283 State UST # : 1998 Upg Cert#: -2- 07/12/2007