HomeMy WebLinkAbout1425 S H STREETUNIFIED PROGRAM INSPECTION CHECKLIST;' ~ Prevention Services
A_A r R S e,, E.„ 900'IYuxtun Ave., Suite 210
~ __.___.___. ^ __ _ _-.-;~ ~ P/RE Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ~€ ~f~'ARTM ~N,T Tel.: (661) 326-3979
~ Fax: (661) 872-2171
FACILITY NAME ~
` ~ ~- ~ ~. INSPECTION DATE
'Z '~ Z~ - Q ~ INSPECTION TIME
ADDRESS ~' /+ ~ S S• l~ ~~ ,
~ / G P~N~ O. ~/ /~ U
~ ~a NO OF~ MPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER
,5-o2,-c~ozae~
Section 1: Business Plan and Inventory Program -
^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( c=comP~iance~ OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND
^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS ~
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
L~ ^ VERIFICATION OF LOCATION ~
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
L7 ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY IABELED .
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS W/A,,STE ON SITE? ~~YES ^ NO
EXPLAIN: ~n,I Gt S 1~C ~i Ilf ~
~ . ; c~ ~ I / ~~ ~. -1--G ,' .,
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
/~I, ~~I~~s~~. ~lC- ~.
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # Bu ' es e/ esponsible Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/OS
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
Manager : MARK MONTANIO BusPhone: (661) 833-1680
Location: 1425 S H ST Map : 124 CommHaz : Moderate
City : BAKERSFIELD Grid: 06C FacUnits: 1 AOV:
CommCode: BFD STA 06 SIC Code:5912
EPA Numb: DunnBrad:
+-------------------------------------
--------------------------------- -----------------------------------------+
----~ s~~h_~ _--- --------------------
+_____________________________________ __+_--__ --___________________________+
Emergency Contact / Title Emergency Contact / Title
MARK MONTANIO / MANAGER A~~r YOURGULEZ / ASST MANAGER
Business Phone: (661) 833-1680x Business Phone: (661) 833-1680x
24-Hour Phone :(661) 869-0912x 24-Hour Phone :(661) 873-1733x
Pager Phone :(661) 805-1136x Pager Phone :( ) - x
+------------------------------------- --+--------------------------------------+
~ Hazmat Hazards: Fire Press React ImmHlth DelHlth ~
+------------------------------------- -----------------------------------------+
Contact : NANCY G MACLEOD Phone: (717) 761-2633x
MailAddr: PO BOX 3165 State: PA
City : HARRISBURG Zip : 17105
+------------------------------------- -----------------------------------------+
Owner RITE AID CORP Phone: (717) 761-2633x
Address : PO BOX 3165 State: PA
City : HARRISBURG Zip : 17105
+------------------------------------- -----------------------------------------+
Period . to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
+------------------------------------------------------------------------------+
~ Emergency Directives: ~
PROG A - HAZMAT
PROG H- HAZ WASTE GEN
t______________________________________________________________________________+
-1- 08/25/2008
+ RITE AID DRUG STORE 5811 ___ ________________________ _ SiteID: 015-021-002029 +
+= Hazmat Inventory __________ ________________________ ______ _ By Facil ity Unit +
+_= MCP+DailyMax Order _______ _______________________ Fixed Containers at Site +
+----------------------------- ---+-------+-----------+-----+---------- +----+---+
~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~
+----------------------------- ---+-------+-----------+-----+---------- +----+---+
PROPANE E F P IH G 144.00 FT3 Hi
PHOTOGRAPHIC DEVELOPERS R IH L 5.00 GAL Mod
PHOTOGRAPHIC DEVELOPERS R IH L 5.00 GAL Mod
PHOTOGR.APHIC BLEACH IH L 5.00 GAL Low
PHOTOGRAPHIC BLEACH IH L 2.00 GAL Low
MOTOR OIL F DH L 270.00 GAL Min
PHOTOGRAPHIC STABILIZER IH L 29.00 GAL Min
PHOTOGRAPHIC STABILIZER IH L 9.00 GAL Min
WASTE FIXER IH DH L 5.00 GAL Min
+______________________________________________________________________________+
-2- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0002 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
PROPANE Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
I CAS# I
74-98-6
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPER.ATURE __+___= CONTAINER TYPE _____+
I Gas ~ Pure ~ Above Ambient ~ Ambient ~ PORT. PRESS. CYLINDER ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
144.00 FT3 144.00 FT3 48.00 FT3
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I 100t00IPropane IYesl ~S# ~4986I
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD•ASSESSMENTS =__+_________+________+_____+
ITSNc~retlN~RSIBNo~Hazl RN~d~oactive/Cu~l'es I FPP HaiHrds I%F~A/ I USDOT# I Hip I
+_______+___+______+____________________+_____________+_______=_+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Defineii ----------------------------------------------------------------+
*______________________________________________________________________________+
-3- 08/25/2008
+ RITE AID DRUG STORE 5811 __________________________ __ SiteID: 015-021-002029 +
+= Inventory Item 0003 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIl~ION NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGRAPHIC DEVELOPERS Days On Site
I
KODAK FLEXICOLOR DEVELOPER REPLINISHER LORR 365
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB CAS#
I I
123-31-9
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 5.00 GAL 4.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
gWt. RS CAS#
5.00 Potassium Carbonate No 584087
1.00 Potassium Sulfite No 10117381
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cu~l'es I EPA RalHrds I%F%A/ I USDOT# I Mod I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-4- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0007 _______________ Facility Unit: Fixed Containers at Site +
+_= CONII~ION NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGRAPHIC DEVELOPERS I Days On Site I
KODAK EXTACOLOR RA DEVELOPER REPLINISHER 365
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB I CAS# I
123-31-9
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
I Liquid ~ Mixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS P,T THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 5.00 GAL 4.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
~Wt. RS CAS#
1.00 Potassium Carbonate No 584087
1.00 Triethanolamine No 102716
1.00 Diethylhydroxylamine No 3710847
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cur1'es I EPA RalHrds I%F~A/ I USDOT# I Mod I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-5- 08/25/2008
+ RITE AID DRUG STORE 5811 __________________________ __ SiteID: 015-021-002029 +
+= Inventory Item 0008 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIMON NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGR.APHIC BLEACH Days On Site
I
KODAK EKTACOLOR RA BLEACH FIX AND REPLINISHER 365
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB I CAS#
I
12124-97-9
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPER.ATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 5.00 GAL 4.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
$Wt. RS CAS#
10.00 Ammonium Thiosulfate No 7783188
5.00 Sodium Bisulfite No 7631905
5.00 Acetic Acid Solution No 64196
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNoHazl RN~d~oactive/Curles I EPA HalHrds I jF~A/ ( USDOT# I Low I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-6- 08/25/2008
+ RITE AID DRUG STORE 5811 __________________________ __ SiteID: 015-021-002029 +
+= Inventory Item 0004 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~fON NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGRAPHIC BLEACH Days On Site
KODAK FLEXICOLOR RA BLEACH REPLINISHER NR 365 I
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB I CAS# I
12124-97-9
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient I Ambient ~ PLASTIC CONTAINER I
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 2.00 GAL 1.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
$Wt. RS CAS#
15.00 Ferric Ammonium Ethylene Diamine Tetraacetic Acid No 0
10.00 Ammonium Bromide No 12124979
8.00 Ammonium Nitrate No 6484522
5.00 Acetic Acid Solution No 64196
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No I No I No/ Curies I IH I/// I I Low I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
*______________________________________________________________________________+
---------------------
-7- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0001 _______________ Facility Unit: Fixed Containers at Site +
+_= CON~ION NAME / CHEMICAL NAME ______________________________+________________+
MOTOR OIL Days On Site
365 I
Location within this Facility Unit ~ Map: Grid: +----------------+
I 8020835 (
+-------------------------------------------------------------+____------------+
------------------ ------------------------ ------------
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER ~
+_________+----------+_______________+_______________+-------------------------+
---------- -------------------------
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contii~ne~rG~ I Daily 2~O100m GAL I Daily AOOr00e GAL I
+--------------------------+---------------___-______+-------------------------+
---------------------- --------------- - -------------------------
+_______+______________ HAZAR.DOUS COMPONENTS =_____________+___+_______________+
I 100t00IMotor Oil, Petroleum Based INosl CAS#8020835I
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~ret N~RSIBN~oHazl RN~d~oactive/Cu~l'es I FPA HazarDH I jF~A/ I USDOT# I Min I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
*______________________________________________________________________________+
-8- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0009 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~ION NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGR.APHIC STABILIZER Days On Site
KODAK EKTACOLOR PRIME STABILIZER AND REPLINISHER 365 I
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient I PLASTIC CONTAINER I
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 29.00 GAL 28.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
$Wt. RS CAS#
1.00 Polyvinylpyrrolidone No 9003398
10.00 Magnesium Nitrate No 10377603
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No I No I No/ Curies I IH I/// I I Min I
+_______+___+______+____________________+_____________+_____-___+--------+-----+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-9- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0006 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIMON NAME / CHEMICAL NAME ______________________________+________________+
PHOTOGR.APHIC STABILIZER Days On Site
KODAK FLEXICOLOR STABILIZER AND REPLINISHER LF 365 I
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ PLASTIC CONTAINER I
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 9.00 GAL 5.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
°sWt. RS CAS#
1.00 Hexamethylenetetramine No 100970
1.00 Sodium Dodecylbenzene Sulfonate No 25155300
1.00 Dipropylene Glycol No 106627
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Curles I EPA HalHrds I%F~A/ I USDOT# I Min I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5:
Ag.Defined6:
Ag.Defined7:
Ag.Defined8:
Ag.Defined9:
Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-10- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0005 _______________ Facility Unit: Fixed Containers at Site +
+_= CON~lON NAME / CHEMICAL NAME ______________________________+________________+
WASTE FIXER Days On Site
SPENT PHOTOGRAPHIC FIXER 365 I
Location within this Facility Unit Map: Grid: +----------------+
PHOTO LAB ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
I Liquid ( Waste ~ Ambient ~ Ambient ~ PLASTIC CONTAINER ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
1.00 GAL 5.00 GAL 4.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I ~~t ISilver INosl CAS#7440224I
+_______+--------------------------------------------------+---+---------------+
--------------------------------------- --- --------------
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No I No/ Curies I IH DH I/// I I Min I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
*______________________________________________________________________________+
-11- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+= Inventory Item 0005 _______________ Facility Unit: Fixed Containers at Site +
+__________________+_________+_____= WASTE DATA =__________+___________________+
I Treated On Site I CA Code I US Code I GAL Generated/Mo.l GAL Generated/Yr.l
No
+------------------+---------++--------+-------------------+-------------------+
~ Treatment UnitID: ~ Unit Type: ~
+-----------------------------+------------------------------------------------+
~ Agency-Defined Text Label ~
+______________________________________________________________________________+
-12- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+_________________________________________________________________ Fast Format +
+= Notif./Evacuation/Medical ____________________________________ Overall Site +
+_= Agency Notification ___________________________________________ 07/12/2000 +
CALL 911.
+______________________________________________________________________________+
+__= Employee Notif./Evacuation ___________________________________ 07/12/2000 +
CLERKS ARE TR.AINED TO EVACUATE THEMSELVES AND CUSTOMERS THROUGH OUR EXIT
DOORS. MANAGER ARE TO NOTIFY FIRE DEPT, TURN OFF AIR VENTS AND EXIT BLDG.
+______________________________________________________________________________+
+___= Public Notif./Evacuation ____________________________________ 07/12/2000 +
WILL EVACUATE BY LOUDSPEAKER SYSTEM AND WALK STORE, TIME PERMITTING.
+______________________________________________________________________________+
+____= Emergency Medical Plan _____________________________________ 07/12/2000 +
MEMORIAL HOSPITAL.
+______________________________________________________________________________+
-13- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+_________________________________________________________________ Fast Format +
+= Mitigation/Prevent/Abatemt ___________________________________ Overall Site +
+_= Release Prevention ____________________________________________ 07/12/2000 +
SINCE THIS IS A RETAIL STORE, WE HAVE ONLY OCCASIONAL MINOR SPILLS OF MOTOR
OIL WHICH ARE WIPED UP, MATERIALS ARE STORED IN SMALL QUANTITIES WHICH ARE
PACKAGED FOR RETAIL.
WE TRY TO PREVENT ACCIDENTS BY HAVING SAFETY TOPICS EACH MONTHLY MEETING
CUSTOMER BREAKAGE OF CONTAINERS OF HAZARDOUS MATERIALS ARE HANDLED BY A
MANAGER OR STOCKMAN USING A MOP.
+______________________________________________________________________________+
+__= Release Containment __________________________________________ 07/12/2000 +
MOTOR OILS ARE IN 1 QUART PLASTIC BOTTLES. SINCLE BOTTLE SPILLS WOULD BE
CONTAINED BY USING PAPER TOWELS. MULTIPLE BOTTLE SPILLS WOULD BE CONTAINED
BY USING KITTY LITTER AS AN ABOSRBENT AND LEAKING PROPANE BOTTLES WOULD BE
TAKEN OUTSIDE TO VENTILATE IN THE OPEN AIR. THESE BOTTLES ONLY HOLD 16 OZ.
+______________________________________________________________________________+
±___= Clean Up ____________________________________________________ 07/12/2000 +
WOULD CONTACT A LICENSED WASTE DISPOSAL COMPANY SPECIALIZING IN HAZARDOUS
MATERIALS.
+______________________________________________________________________________+
+____= Other Resource Activation ______________________________________________+
+______________________________________________________________________________+
-14- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+_________________________________________________________________ Fast Format +
+= Site Emergency Factors _______________________________________ Overall Site +
+_= Special Hazards ___________________________________________________________+
+______________________________________________________________________________+
+__= Utility Shut-Offs ____________________________________________ 10/25/2007 +
GAS - ALLEY BETW STORE AND DINER
ELECTRICAL - BACK HALL BEH OFFICE 15-20FT FROM BACK DOOR
WATER - ALLEY BETW STORE AND DINER
+______________________________________________________________________________+
+___= Fire Protec./Avail: Water ___________________________________ 12/11/2006 +
PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE (HEAT) SENSORS ON CEILING, AND
FIRE EXTINGUISHERS.
FIRE HYDR.ANT - NE CRNR BRUNDAGE & A ST AND S CRNR HUGHES LN & ROBIN RD.
+______________________________________________________________________________+
+____= Building Occupancy Level __________________________________= 12/11/2006 +
18 EMPLOYEES
+______________________________________________________________________________+
-15- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029
+_________________________________________________________________ Fast Format
+= Training _____________________________________________________ Overall Site
+_= Employee Training _____________________________________________ 12/11/2006
MATERIAL SAFETY DATA SHEETS ON FILE.
BRIEF SUNII~lARY OF TRAINING PROGRAM: WILL GO OVER HAZARDOUS MATERIALS
HANDLING BY STORE MEETING ONCE A MONTH. THE STOCKMEN WILL GET ONE ON ONE
+
+
+
~
+______________________________________________________________________________+
+__= Page 2 ___________________________________________________________________+
+______________________________________________________________________________+
+___= Held for Future Use _____________________________________________________+
+______________________________________________________________________________+
+____= Held for Future Use ____________________________________________________+
+______________________________________________________________________________+
-16- 08/25/2008
+ RITE AID DRUG STORE 5811 ____________________________ SiteID: 015-021-002029 +
+_________________________________________________________________ Fast Format +
+= Response/Risk Management _____________________________________ Overall Site +
+_= Operations ________________________________________________________________+
+______________________________________________________________________________+
+__= Planning _________________________________________________________________+
----------------------
+______________________________________________________________________________+
+___= Logistics _______________________________________________________________+
+______________________________________________________________________________+
+____= Finance/Administration _________________________________________________+
+______________________________________________________________________________+
-17- 08/25/2008