HomeMy WebLinkAbout1612 BRUNDAGE LANEUNIFIED PROGRAM INSPECTION CHECKLIST~j~
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SECTION 1: Business Plan and Inventory Program ~;
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RA r:esr~e n
F/RE
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Prevention Services
900 'IYuxtun Ave., Suite 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME
S~Q~.fc s/''lo.~s _~, lJ~sl-, INSPECTION DATE
1-~2-~ INSPECTION TIME
3-Y~
ADDRESS R
~ ~o ~ Z /~rv" ` "C_ ~v1 , PHONE NO.
GU/ ' 3Zj -2Y2 O OF EMPLOYEES
FACILITY CO~T •
~~ ~ ~
~ v ~. ^-~ ~ BUSINESS ID NUMBER
15-021- O v 3 ~q S ~
~ ~
~.
Section 4: Business Plan and inventory Program
^ ROUTINE ^ COMBINED ^ JOINTAGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( c=comP~iance~ OPERATION
V=Violation COMMENTS
Ild' ^ APPROPRIATE PERMIT ON HAND
^ BUSIII@SS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
Q~ ^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
~ ^ VERIFICATION OF MSDS AVAILABILITY
Id ^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
C~ ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
^ YES GVNO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
/~'y ~ kc-J v h~. s ~--- (~ /(~- X ~
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # ' ess Site / Responsible Party (Please Print)
White -~Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
.,:
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
Manager :
Location: 1612 BRUNDAGE LN
City : BAKERSFIELD
BusPhone: (661) 323-2422
Map : 103 CommHaz :.Moderate
Grid: 31C FacUnits: 1 AOV:
CommCode: BFD STA 06
EPA Numb:
SIC Code:7542
DunnBrad:02-0694770
+______________________________________________________________________________+
+_______________________________________+______________________________________+
Emergency Contact / Title Emergency Contact / Title
JOSEPH ELLER / PROJECT MANAGER JONATHAN RANKIN / CONTRACTOR
Business Phone: (661) ~?-~~x 3z3lz~~S gusiness Phone: (661) ~'~~x~3~ ~s'
24-Hour Phone :(661) 809-0031x 24-Hour Phone :(661) 809-7305x
Pager Phone : ( ) - x Pager Phone : ( ) - x
+---------------------------------------+--------------------------------------+
~ Hazmat Hazards: I
+------------------------------------------------------------------------------+
Contact : JOSEPH ELLER Phone: (661) 323-2422x
MailAddr: 2314 Q ST State: CA
City : BAKERSFIELD Zip : 93301
+--------------------------------------- ---------------------------------------+
Owner RED TOP CAR WASH LLC Phone: (661) 323-2422x
Address : 2314 Q ST State: CA
City : BAKERSFIELD Zip : 93301
+--------------------------------------- ---------------------------------------+
Period . to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
+--------------------------------------- -='-------------------------------------+
~ Emergency Directives: ~
PROG A - HAZMAT
~~~ --------- ~
+______________________________________________________________________________+
-1- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH __________________ _________ SiteID: 015-021-003451 +
+= Hazmat Inventory __________________________ ______________ = By Facility Unit +
+_= MCP+DailyMax Order _______________________ _______ Fixed Containers at Site +
+--------------------------------+-------+-----------+-----+----------+----+---+
~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~
+--------------------------------+-------+-----------+-----+----------+----+---+
FrI . ed
LIQUID SURFAXCTANT L 5.00 GAL Mod
LIQUID SURFACTANT L 5.00 GAL Mod
ALKALINE DETERGENT BUILDER L 55.00 GAL Low
LIQUID ALKALINE DETERGENT MIXTU L 30.00 GAL Low
QUATERNARY AMINE/MINER.AL OIL L 30.00 GAL UnR
LIQUID DETERGENT MIXTURE L 30.00 GAL UnR
FOAMING SURFACTANT MIXTURE L 15.00 GAL UnR
QUATERNARY AMINE/MINERAL OIL L 10.00 GAL UnR
LIQUID DETERGENT MIXTURE . L 10.00 GAL UnR
ALKALINE WALL CLEANER L 5.00 GAL UnR
+______________________________________________________________________________+
-2- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0009 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID ALKALINE DETERGENT MIX I Days On Site I
FOAM-N-KLEAN 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient I DRUM/BARREL-NONMETAL I
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
30.00 GAL 30.00 GAL 15.00 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
gWt. RS CAS#
5.00 Sodium Metasilicate No 6834920
10.00 2-Butoxyethanol No 111762
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cu~l'es I EPA Hazards I 2~0/0/ 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 ----------------------------------------------------------------+
+______________________________________________________________________________+
-3- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0002 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~lON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID SURFAXCTANT I Days On Site I
SUPERSAT PURPLE BUG 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
5.00 GAL 5.00 GAL 2.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I~Wt. I I RS CAS# I
10.00 Ethylene Glycol Monobutyl Ether No 111762
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cu~les I EPA Hazards I 2~1/1/ 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 ----------------------------------------------------------------+
*______________________________________________________________________________+
-4- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0003 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID SURFACTANT I Days On Site I
SUPERSAT TIRE & WHEEL 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
5.00 GAL 5.00 GAL 2.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
°sWt. RS CAS#
60.OOIEthylene Glycol Monobutyl Ether INo I 111762I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSecretl RSIBioHazl Radioactive/Amount ( EPA Hazards I NFPA I USDOT# I MCP I
No No No No/ Curies 2/1/1/ Mod
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ 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
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0001 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIMON NAME / CHEMICAL NAME ______________________________+________________+
ALKALINE DETERGENT BUILDER Days On Site I
SUPERSAT MPH POWDER 11-11 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient I Ambient I DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con55100rG~ I Daily M55100m G~ I Daily A~SrOOe G~ I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I gWt. I I RSI CAS# I
25.00 Sodium Metasilicate No 6834920
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~ret NR~SIBNo~Hazl RN~d~oactive/Cu~l'es EPA Hazards 2~0/1/C I 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.Defineii ----------------------------------------------------------------+
t______________________________________________________________________________+
-6- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0011 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIMON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID ALKALINE DETERGENT MIXTURE I Days On Site I
ONE STEP PLUS 365
Location within this Facility Unit Map: Grid: +----------------.+
EQUIPMENT ROOM ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_____=_________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con30100rG~ I Daily M30100m G~ I Daily A15r00e GAL I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
~Wt. RS CAS#
5.00 EDTA No 64028
10.00 Sodium Silicate No 1344098
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz =Radioactive/Amount= =EPA Hazards= ==NFPA==+ =USDOT#= =MCP-
No No I No I No/ Curies I 2/0/0/ 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
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0007 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIl~ION NAME / CHEMICAL NAME ______________________________+________________+
QUATERNARY AMINE/MINERAL OIL Days On Site
PEARL SEALANT & DRYING AGENT 365 I
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
I Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con30100rG~ I Daily M30100m G~ I Daily A15r00e GAL I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I ~5t0012-Butoxyethanol INosl CAS# 111762I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoS BNoHazl RN~d~oactive/Cu~ies I EPA Hazards 2j~F~A~/ I USDOT# I U~C~P 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 ----------------------------------------------------------------+
+______________________________________________________________________________+
-8- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0008 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID DETERGENT MIXTURE I Days On Site I
SPECTRUM FOAMING BRUSH DETERGENT 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM ° ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient I Ambient I DRUM/BAR.REL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con30100rG~ I Daily M30100m G~ I Daily A15r00e GAL I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I~Wt. ~ ~ RS~ CAS# I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Curies I EPA Hazards I 2jo/p/ I USDOT# I UCnPR 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
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0006 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~ION NAME / CHEMICAL NAME ______________________________+________________+
FOAMING SURFACTANT MIXTURE Days On Site
LUSTRA FOAMING CONDITIONER 365 I
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
5.00 GAL 15.00 GAL 7.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I g~^1t • I ~ RS ~ CAS# I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No INo I No I No/ Curies I I 2/0/0/ I I UnR 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
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0004 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~ION NAME / CHEMICAL NAME ______________________________+________________+
QUATERNARY AMINE/MINERAL OIL Days On Site
SPECTRUM CLEAR COAT SEALANT 365 I
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container ( Daily Maximum I Daily Average I
5.00 GAL 10.00 GAL 2.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I~Wt• I I RS~ CAS# I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz =Radioactive/Amount= =EPA Hazards= ==NFPA==+ =USDOT#= =MCP=
No INo I No I No/ Curies I I 2/0/0/ I I UnR 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
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0005 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
LIQUID DETERGENT MIXTURE ( Days On Site I
SPECTRUM HIGH PRESSURE DETERGENT 365
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM ~ CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
I Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
5.00 GAL 10.00 GAL 2.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I ~inlt • I I RS I CAS# I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cu~l'es EPA Hazards I 2jo/0/ I USDOT# I UnCP~ 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 ----------------------------------------------------------------+
+______________________________________________________________________________+
-12- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+= Inventory Item 0010 _______________ Facility Unit: Fixed Containers at Site +
+_= CON~ION NAME / CHEMICAL NAME ______________________________+________________+
ALKALINE WALL CLEANER Days On Site
OFF-THE-WALL 365 I
Location within this Facility Unit Map: Grid: +----------------+
EQUIPMENT ROOM I CAS# I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid I Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL I
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Container I Daily Maximum I Daily Average I
5.00 GAL 5.00 GAL 2.50 GAL
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I ~~n1t • I ~ RS ~ CAS# I
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSecretl RSIBioHazl=Radioactive/Amount=l=EPA Hazards=l==NFPA==+I=USDOT#=I=MCP=I
No No No No/ Curies 2/0/0/ UnR
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ 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 ----------------------------------------------------------------+
+______________________________________________________________________________+
-13- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+_________________________________________________________________ Fast Format +
+= Notif./Evacuation/Medical ____________________________________ Overall Site +
+_= Agency Notification _______________________________________________________+
+______________________________________________________________________________+
+__= Employee Notif./Evacuation ___________________________________ 08/14/2006 +
CONTACT OFFICE OF EMERGENCY SERVICES 800-852-7550 AND/OR BFD 326-3979.
+______________________________________________________________________________+
+___= Public Notif./Evacuation ____________________________________ 09/18/2007 +
CHAIN-OF-COMMAND: JOSEPH ELLER; JONATHAN RANKIN; SCOTT STEPHENS. THE
PERSON IN CHARGE WILL START THE RESPONSE.
+______________________________________________________________________________+
+____= Emergency Medical Plan _____________________________________ 08/14/2006 +
MERCY HOSPITAL, 2215 TRUXTUN AVE, 332-5000.
+______________________________________________________________________________+
-14- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+_________________________________________________________________ Fast Format +
+= Mitigation/Prevent/Abatemt ___________________________________ Overall Site +
+_= Release Prevention ____________________________________________ 08/14/2006 +
ALL CHEMICALS ARE STORED IN SEPARATE PLASTIC CONTAINERS. HANDLING THE
CHEMICALS IS LIMITED TO PLACING THE CONTAINER AND OPENING A LID. EYE
PROTECTION AND GLOVES ARE WORN.
+______________________________________________________________________________+
+__= Release Containment __________________________________________ 08/14/2006 +
PRODUCTS ARE STORED IN 5/30-GAL PLASTIC CONTAINERS. THESE CONTAINERS ARE
REPLACED ROUGHLY EVERY 3 TO 6 MONTHS WITH NEW CONTAINERS.
+______________________________________________________________________________+
+___= Clean Up ____________________________________________________ 08/14/2006 +
ALL SPILLS WOULD FLOW TO A DRAIN IN WHICH THE CHEMICALS COULD BE RECOVERED
FROM A SERIES OF CATCH TROUGHS.
+______________________________________________________________________________+
+____= Other Resource Activation ______________________________________________+
+______________________________________________________________________________+
-15- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+_________________________________________________________________ Fast Format +
+= Site Emergency Factors _______________________________________ Overall Site +
+_= Special Hazards ___________________________________________________________+
+______________________________________________________________________________+
+__= Utility Shut-Offs ____________________________________________ 08/14/2006 +
NATUR.AL GAS/PROPANE: INSIDE GATE TO EQUIPMENT ROOM
ELECTRICAL: INSIDE GATE TO EQUIPMENT ROOM
WATER: INSIDE EQUIPMENT ROOM AND ON BRUNDAGE LN
+______________________________________________________________________________+
+___= Fire Protec./Avail. Water ___________________________________ 08/14/2006 +
PRIVATE FIRE PROTECTION: FIRE EXTINGUISHERS
FIRE HYDRANT: CRNR BRUNDAGE & EYE
+------------------------------------------------------------------------------+
---------------- -----------------------------------
+____= Building Occupancy Level ___________________________________ 08/14/2006 +
3 EMPLOYEES
+______________________________________________________________________________+
-16- 08/25/2008
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+_________________________________________________________________ Fast Forma~t~+•;
+= Training _____________________________________________________ Overall Site +~~'
+_= Employee Training ____________________________________________= 09/18/2007 +
MSDS IN EQUIPMENT ROOM FILES.
BRIEF SUI~IlKARY OF TRAINING PROGRAM: EDUCATION OF CHEMICALS USED; HANDLING
PROCEDURES; ACTION PL1~N IN CASE OF SPILL/EMERGENCY; AND CONTACT LIST FOR
EMERGENCY.
+______________________________________________________________________________+
+__= Page 2 ___________________________________________________________________+
+______________________________________________________________________________+
+___= Held for Future Use _____________________________________________________+
+______________________________________________________________________________+
+____= Held for Future Use ____________________________________________________+
+______________________________________________________________________________+
-17- os/25/2oos
+ SQUEEKYS MONSTER CAR WASH ___________________________ SiteID: 015-021-003451 +
+_________________________________________________________________ Fast Format +
+= Response/Risk Management _____________________________________ Overall Site +
+_= Operations ________________________________________________________________+
+______________________________________________________________________________+
+__= Planning _________________________________ -___+
+______________________________________________________________________________+
+___= Logistics _______________________________________________________________+
+______________________________________________________________________________+
+____= Finance/Administration _________________________________________________+
+______________________________________________________________________________+
-18- 08/25/2008