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Home My WebLink AboutBUSINESS PLANS 2/16/2007 -L 5' EZ LUBE 108 '. SiteID: 015-021-003438 Manager MIKE DODSON 1'l-U.6o UAUI\,.ju Location: 3901 WIBLE RD 8 City BAKERSFIELD CommCode: BFD STA 07 EPA Numb: BusPhone: Map : 123 Grid: 14B (661) 332-4799 CommHaz : Low FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact /.-0 Ti tIe .MIKEl :El~D~cm t\-u(;o LVf."~7 e~lI,,~-o\bT l"rIN6,R . h -f6) '~ILf - BUSlness Pone:" 61 033 1995x 5S C4-,~IZ. 24-Hour Phone : ~61) 3ee-925~~~-6~~ Pager Phone ~l) ~32 A7q~~ Hazmat Hazards: Contact : .g.TEVE RA1VlIREZ ttlA.b 0 U"tt.llA;;-.!o MailAddr: 3506 W LAKE CENTER DR B City SANTA ANA Owner Address City Period Preparer: Certif'd: ParcelNo: EZ LUBE LLC 3506 W LAKE CENTER DR B SANTA ANA to Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK Signature 10~~ Date Emergency Contac5 / Title ~~~~R S'n!:V1;!:~ ....~HIREZ $)'AL.l.f:.rJ / .JTIR OF 'flF TTJU9:6 Business Phone: (714) 556-1312x 1-<'1 24-Hour Phone (714) ~5 ~~7~S~-&H~ Pager Phone () x Fire DelHlth Phone: State: Zip 3"tl.:> - 7...(..P f.p (714) S8S-667Qx CA 92704 Phone: (714) 556-1312x State: CA Zip 92704 TotalASTs: = TotalUSTs: = RSs: No Gal Gal ENT'Q F ~ &2 3 2007 -1- 01/31/2007 l' SiteID: 015-021-003438 9 By Facility Unit "I Fixed Containers at Site 9 IspecHazlEPA Hazards I Frm I DailyMax IUnitlMCP F EZ LUBE 108 f= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name. . . ~L \Nlo'T()i2... 0\ '-- ~ F DH L 200.00 GAL Low L 135.00 GAL Low F DH L 2880.00 GAL Min _F DH L 970.00 ~AL Win 5-~. t:.. ~cwt:.b. WASTE ~rIFREEZE ANTIFREEZE MOTOR OIL ' -MOTOR OlL P E'l..0.-'\'L -2- 01/31/2007 -3- 01/31/2a07 SiteID: 015-021-003438 "I Facility Unit: Fixed Containers at Site "I Days On Site 365 F EZ LUBE 108 f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME WASTE ANTIFREEZE Location within this Facility Unit BASEMENT Map: Grid: CAS # STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 200.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 200.00 GAL Daily Average 100.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # 55.00 Ethylene Glycol No 107211 7.50 Diethylene Glycol No 111466 7.50 1,2-Propylene Glycol No 57556 5.00 Sodium No PROPRIETY 50.00 Water No 7732185 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSMENTS -4- 01/31/2007 ',' SiteID: 015-021-003438 "I Facility Unit: Fixed Containers at Site 9 F EZ LUBE 108 F Inventory Item 0004 = COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit BASEMENT Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 135.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 135.00 GAL Daily Average 75.00 GAL %Wt. RS CAS # 55.00 Ethylene Glycol No 107211 7.50 Diethylene Glycol No 111466 7.50 1,2-Propylene Glycol No 57556 5.00 Sodium No PROPRIETY 50.00 Water No 7732185 HAZARDOUS COMPONENTS ZARD SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low HA AS -5- 01/31/2007 " SiteID: 015-021-003438 9 Facility Unit: Fixed Containers at Site 9 f EZ LUBE 108 p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit BASEMENT Map: Grid: CAS # 8020835 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK La~gest Container 960.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 2880.00 GAL Daily Average 1600.00 GAL E %Wt. RS CAS # 99.00 Motor Oil, Petroleum Based No 8020835 0.12 zinc No 7440666 HAZARDOUS COMPON NTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESSMENTS p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME MOTOR OIL Facility Unit: Fixed Containers at Site 9 Days On Site 365 Loc?tion within this Facility Unit BASEMENT Map: Grid: CAS # 8020835 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 970.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 970.00 GAL Daily Average 475.00 GAL HA US MPONENTS %Wt. RS CAS # 99.00 Motor Oil, Petroleum Based No '8020835 0.12 zinc No 7440666 ZARDO CO HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -6- 01/31/2007 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (one oaoe oer material oer buildino or area) DADD DDELETE DREVISE 200 I Page _ of - I. FACILITY INFORMATION BUSINESS NAMEjSame as FACILITY NAME or DBA - Doing Business As) 3 EZ Lube #1 oil CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 Basement EPCRA ~ YES D NO I I I I I I II I I I I I I 1 I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET DYes 1:81 No 206 If Subject to EPCRA, refer to instructions COMMON NAME 207 208 Waste Motor Oil EHS' DYes t8I No CAS# 209 'If EHS is "Yes", all amounts below must be in Ibs, FIRE CODE HAZARD CLASSES (Complete ij required by CUPA) 210 HAZARDOUS MATERIAL 212 I CURIES N/A 213 TYPE (Check one item only) D a. PURE D b. MIXTURE ~ c, WASTE 211 RADIOACTIVE DYes ~ No PHYSICAL STATE 215 (Check one item only) D a, SOLID ~ b. LIQUID D c.GAS 214 LARGEST CONTAINER 970 FED HAZARD CATEGORIES 216 (Check all that apply) ~ a. FIRE o b, REACTIVE o c, PRESSURE RELEASE ~ d. ACUTE HEALTH o e, CHRONIC HEALTH AVERAGE DAILY AMOUNT 2171 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 475 970 11,000 221 221 I DAYS ON SITE: 222 UNITS' ~ a. GALLONS o b. CUBIC FEET o c. POUNDS o d, TONS 365 (Check one item only) . If EHS, amount must be in pounds. STORAGE CONTAINER ~ a, ABOVE GROUND TANK De, PLASTIC/NONMETALLIC DRUM D i. FIBER DRUM D m. GLASS BOTTLE D q. RAIL CAR Db. UNDERGROUND TANK D f. CAN D j,BAG D n, PLASTIC BOTTLE D r. OTHER DC. TANK INSIDE BUILDING o g. CARBOY D k, BOX D o. TOTE BIN D d. STEEL DRUM D h. SILO D I. CYLINDER D p. TANK WAGON 223 STORAGE PRESSURE ~ a, AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~ a. AMBIENT D b. ABOVE AMBIENT D c. BELOW AMBIENT D d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 <.12 226 Zinc 227 DYes D No 228 7440-66-6 229 2 230 I 231 o Ves 0 No 232 233 3 234 235 DYes 0 No 236 237 4 238 239 o Ves D No 240 241 5 242 243 DYes D No 244 245 If more hazardous components are present at greater than 1 % by weight If non-carcinogenic, or 0.1 % by weight If carcinogenic, attach additional sheets of paper capturing the required ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) OES Form 2731 7. Records +Describe where you keep other records required by this plan, such as employee training records (including drills), release report records, maintenance/safety records, and emergency phone lists. (Please note: records of drills shall be maintained for a period of three (3) years and shall be available for review by Fire Department personnel. The records shall include the facilitators name, title, facility location, date of drill and signature of the facilitator). File cabinet in manaqers office. I Section B -Employee ;Training Program ,'I Describe the training your business conducts for all employees in safety procedures in the event of a release or threatened release of hazardous materials. By law, this training shall include, but not be limited to, the following: new employee training, annual training, periodic refresher courses, and familiarization with Section B (Emergency Plans and Procedures) of this Business Emergency Plan. An example "Chemical Training Record" is attached to assist you in employee training (you may use this example or an alternative if you prefer). Traininq takes place at our corporate office in Santa Ana absorbent socks & clean UP are materials displayed. Video & overhead photos are used to show how to use these items. Store manaqers conduct refresher courses at the store durinq their monthly store meetinq. All safety issues are discussed and reviewed. OFFICIAL USE ONL Y: Insp. # Issued: Reviewed By: Date Received: Correction Required: 3. Mitigation (reduce the hazard) -+Describe what is done to lessen the harm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a spill, fire, explosion, or airborne release from your business? Tanks are in the basement where there is no public access. Tanks are closed systems where there is no manual fillina or emptina. All done via remote pipe system. Immediate response - contain hazard and call the Fire Department then move to safety. 4, Abatement (remove the hazard)-+Describe what you would do to stop and remove the hazard. How would you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? What aspects of the response are beyond your ability and need to be handled by others? All spills are contained usinq absorbent socks. Clean up is done with towels that are sent for disposal or cleaned UP by our Recyclinq Co Asbury Environmental. 5. Facility Notification and Evacuation -+Describe how you will immediately notify and evacuate your facility. What communications or alarms are used? How will you operate this equipment during power failures? Specify emergency exits, alternatives, and staging areas you have identified. Our Business has open pits to the basements. Emerqency notification is done verbally from employees in basement to upstairs. 6, Your business is required to keep a copy of this Business Plan, including your site maps, and your Hazardous Materials Inventory Disclosure. Describe where copies will be located at your business and where other copies will be maintained. Office file cabinets. EZ Lube Corporate office for Spills and Emerqencies. 4. A business shall appoint an Emergency Coordinator and alternates to assist in initiating emergency response and evacuations in the event of a release. The Emergency Coordinator will be responsible for initiating actions of the business to respond to a release, or threatened release of a hazardous material to include mitigation, control, evacuation of all facility personnel, and meeting with emergency response personnel upon arrival. An example Emergency Coordinator Task Completion Sheet is attached to assist you. List your facility's Emergency Coordinator and alternates. Emergency Coordinator's Name Title Jose Herrera Director of Training Alternate #1 Name Title Hugo Luevano District Manager Alternate #2 Name Title John Allen Area Manager , . Prevention (preventing' hazards) 1. Briefly describe your business's standard operating procedures in the event of a released or threatened release of hazardous materials: Describe the kinds of hazards associated with the materials present at your facility. Possible hazards include oil spill or antifreeze spill. All containers are closed systems that are filed and emptied usinq remote connections. Spills are minimized. Spills are contained usina absorbent socks or other materials and then recvcled. 2. What preventative actions have been initiated by your business to abate or prevent hazards relating to hazardous materials handling, use, and storage (Place a "..i" in the boxes below that apply). Drum storaQe and/or aboveQround tank storaQe areas: ~ Isolation and separation of incompatible materials. ~ Berms or diked areas to contain spills. ~ Storage on non-combustible, concrete, or paved ground. Compressed and/or crvoQenic Qas storaQe areas: Q. Cylinders stored upright and secured. Q. Isolation and/or separation of incompatible gas cylinders (oxygen and flammable gases, etc). General: Q. Hazardous Materials Data Storage Cabinet and/or lock box installed at a Fire Department approved location. Q. Information in Data Storage Cabinet is updated after each disclosure and/or as necessary. ~ Materials Safety Data Sheets (MSDS) are readily available for each hazardous material on the premises. ~ Labeling of all materials and storage areas with the product name and associated hazards. ~ Separation between outside hazardous materials storage or tanks and combustible materials (wood. brush, etc). Q. Posting of "NO SMOKING" signs where appropriate. Q Posting of NFPA 704 Placard in a Fire Department approved location. ,~ " Business Emergency Plan (BEP) ISection A - Emergency Response Plan and. Procedures, State law requires your business to complete all sections of the Emergency Response Plan Procedure listed below, "N/A" is not acceptable. 1. Your business is required by State Law to provide immediate notification of any release or threatened release of a hazardous materials to 1) local fire emergency response personnel, 2) the Office of Emergency Services (OES), and 3) the Local Administering Agency. Businesses within Costa Mesa fulfill the Administering Agency notification requirement by calling 9-1-1. If you have a release or threatened release of hazardous materials, immediately call: Fire/Paramedics/Police Phone: 9-1-1 Individual responsible for calling 9-1-1: Store Manager After the local emergency response personnel are notified, you shall then Emergency Service (24 hours/day): State Office of Emergency Services: Individual responsible for calling State OES: notify the Office of (800) 852...7550 -or- (916) 262-1621 Store Manager 2. List the local emergency medical facility that will be used by your business in the event of an accident or injury caused by a release or threatened release of hazardous materials. Hospital/Clinic US Health Works Address City 1800 Westwind Drive, Bakersfield, CA 93301 Zip Code Phone Number 661-327-9617 3, Does your business have a private on-site emergency response team? DIYes 01No If yes, describe what policies and procedures your business will follow to notify your on-site emergency response team in the event of a release or threatened release of hazardous materials. (Attach additional pages if necessary) All of the employees are trained in procedures to react to a spill or other emerqency event notify store manaqer or assistant. Use spill manaqement kit. absorbent socks to contain spill. Clean UP with raqs/towels and dispose of the materials with Recyclinq Company. ~ t1\oJtr~ ~e~~ uUDeJ - 1f a--- BUSINESS OWNER/OPERATOR IDENTIFICATION KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT 2700 M STREET, SUITE 300 ' BAKERSFIELD, CA 93301 'r-- (661) 862-8700 Fax (661) 862-8701 Unified Program Consolidated Form (UPCF) FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doiog Business As) t::'l:. Lu...6t.. R \05. BUSINESS SITE ADDRESS ~ (), W \ \D LL ~C)A-\::> I. IDENTIFICATION 1 BEGINNING DATE FACILITY ID# CA ZIP CODE <1~~o9 - <16'\ lo 106 SIC CODE (4 digit #) 105 CITY ~f\--~ U~~ ~ ~ L \) DUN & BRADSTREET. 104 107 COUNTY ~~R-N BUSINESS OPERA TOR NAME ~.OS~ ~t>'r"\ PA 108 109 BUSINESS OPERATOR PHONE La. ~ l. 3~2-- ~q-O,C) 110 II. BUSINESS OWNER OWNER NAME . E.1- l-llfl> L LLL OWNER MAILING ADDRESS VSOL. W. LA \<(( t.t.NTE$. \;,;)R. STL ~ III OWNER PHONE ~tL{ - C6'6~' 13/7., 112 113 CITY 'S~~TA 114 STATE 115 ZIP CODE 116 v'-\NA l2.A, L1'l 1-0-/ III. ENVIRONMENTAL CONTACT CONTACT NAME \ --J () 'S E.. r-\ ~ g QtRR 117 CONTACT PHONE 1- t,-/ -CO'5to-/317- 118 CONTACT MAILING ADDRESS ?:> S 0 lp W. LA'K t. C- ~NI't:R. ~~T c.. ~ CITY SA~'\"f\ f\'N'R 119 120 STATE tA 121 ZIP CODE '12 l-(y-( -SECONDARY - 122 -PRIMARY- IV. EMERGENCY CONTACTS . NAME 123 NAME 128 5. Ii.. \J 'L IZ.-A M 1 ?-E--C: ,J.()~E. TITLE 0\ 5~' C-T vv\'f\~A-GL.e BUSINESS PHONE --=t-. ,4: - -S.s (0- I:;;' I z., 24-HOURPHONE --::to (L{- 6t?S - (0 & 1-0 PAGER # 124 TITLE V \ 1\ E.c.. \() R () F '--M<. q ,lJ \ r-JS 125 BUSINESS PHONE -Jr\~ -'56(0, \'>\ L . . 126 24-HOUR PHONE --:rl'-\ - -50>'5 . ~ -:rl lo 127 PAGER # 129 130 131 ... ... ... .. --- --- -- -- - I 132 ADDITIONAL LOCALLY COLLECTED INFORMATION:. APN: 133 Environmental Contact E-Mail Address: Certification: ed on 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 t informati\ n submitted and believe the information is true, accurate, and complete. . TOR OR DESIGNATED REPRESENTATIVE DATE (p ,1- - O\..Q 134 135 "'-. 136 TITLE OF SIGNER 137 (11/02 revised) ~ t:) it 1~1 C-(-o p(i \ I ,_ -:r.. ~ - I' UNIFIED PROGRAM INSPECTION CHECKLlSTll ~~_:.~~''''--. - -~--~_._~---------_._--- --41 SECTION 1: Business Plan and Inventory Program ~ Prevention Services 900 TruxtunAve., Suite 210 Bakersfield. CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 ,I INSPECTION DATE 10' 2.-,. 0 <., INSPECTION TIME D ROUTINE Section 1: Business Plan and Inventory Program D COMBINED D JOINT AGENCY D MULTI-AGENCY D COMPLAINT 61 3<10\ FACILITY CONTACT s~ \Ie Q"1r- ' ORE-INSPECTION C V ( c-complianCe) OPERATION V=Violation ~ D ApPROPRIATE PERMITON HAND fJ D Business PLAN CONTACT INFORMATION ACCURATE D ijl VISIBLE ADDRESS (g] D CORRECT OCCUPANCY ~ D VERIFICATION OF INVENTORY MATERIALS 0 D VERIFICATION OF QUANTITIES . Ia D VERIFICATION OF LOCATION B D PROPER SEGREGATION OF MATERIAL I;;? D VERIFICATION OF MSDS AVAILABILITY .E:J D VERIFICATION OF HAZ MAT TRAINING EI D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EI D EMERGENCY PROCEDURES ADEQUATE e,l D CONTAINERS PROPERLY LABELED a D HOUSEKEEPING ~ D FIRE PROTECTION (j D SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARD~US WlE O,N SITE? J2i YES D NO EXPLAIN, 0:.-1- ~ i ) . D- COMMENTS KBF-6013 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 e;. Oc.cL/l co ~T~ I B Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # White' - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05