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BUSINESS OWNER/ORERATOR IDENTIFIC,ATION FORM ~~ ffl~E ,~~
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(HAZARDOUS MATERIAL FACILITY INFORMATION)
BAKERSFIELD FIRE DEPARTMENT
Prevention Services
1501 Truxtun Avenue, is` Floor
Bakersfieid, CA 93301
Phone:661-326-3979 . Fax:661-852-2171
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U. ?CERTIFICATION'
Certifica ' n: B sed on my inquiry of th os individuals responsible for obtaining the information, I certify under penalty of law that I have persona lly
exami d and familiar with t i form n submitted in this inventory and believe the information is true, accurate, and complete.
51 ,N URE O DOCUMf:iNT FPfiR["'
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FD2142(Rev
O1/DS)
Emergency Response/Contingency Plan ~
(Hazardous Materials Business Plan Module) ,
Authority Cited; HSC~' 25504(b); 19 CCR ~2731; 22 CCR ~66262.34(a)(4) Page of
.
All facilities that handle hazardous materials in.HMBP guantities must haye a wriiten emergency resporise plan. In addition, facilities
that generate 1,000 kilograms or more csf hazardous waste:(or more than 1 kilogram of acutely hazardous waste or 100 kilogxams of
debris resulting from the spill of an acutely hazardous waste) per month, or accumulate more than 6,000 kilograms of hazardous waste
on-site at any one time, must prepare a hazardous waste contingency plan. Because the requirements are similar, they have been
combined in a single document, provided below, for your convenience. This plan is a required module of the Hazardous Materials
Business Plan (HMBP). If you already have a plan that meets these requirements, you should not complete the blank plan,
below, but you must include a copy of your existing plan as part of your IIMBP.
This site-specific Emergenc.y Response/Contingency Plan is the facility's plan for dealing with emergencies and shall be. implemented
immediately whenever there is a fire, explosion; or release of hazardous mafe"rials that could threaten human health and/or fhe
environment. At least one copy of the plan shall be maintained at the facility for use in the event of an emergency and for
inspection by the local agency. A copy of the plan and any revisions must be provided to any contractor, hospital, or agency with
whom special (i.e., contractual) emergency services arrangements have been made (see section 3, below).
1. Evacuation Plan:
a. The following alarm signal(s) will be used to begin evacuation of the facility (check all that apply):
^ Bells; ^ Horns/Sirens; ~ Verbal (i.e., shoutin~; ^ Other (spec~
b. ~ Evacuation map is prominently displayed throughout the facility.
Note: A properly completed HMBP Site Plart satisfies contingency plan map requirements. This drawing (or any other drawing that
shows primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas) must be
prominently posted throughout the facility in locations where it will be visible to employees and visitors.
2. a. Emergency Contacts*:
Fire/Police/Ambulance Phone No.: 911
--------------------------------------------------------
State Office of Emergency Services _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone No.: ($00) 852-7550
b. Post-Incident Contacts*:
Certified Unified Program Agency (CUPA) Phone No.:
---------------------------
Fire Department Hazardous Materials Program Phone No.:
---------------------------
California EPA Department of Toxic Substances Control _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone No.: (510) 540-3739
Cal-OSHA Division of Occupational Safety and Health Phone No.: (408) 452-7288
Air Quality Management District _ _ _ _ _ _ _ _ _ _ _ _ _ Phone No.: (415) 771-6000
Regional Water Quality Control Board Phone No.: (510) 622-2300
* Phone numbers for agencies in Unidocs' Member Agency geographic jurisdictions are available at www.unidocs.org.
c. Emergency Resources:
Poison Control Center* _________________ ______________ phone No.: (800) 876-4766
Nearest HospitaL• Name: B~k@fSfi@Id ~@1110PIa~ 0"~OSplt1~
Ad~-ess: 420 34th Street
Phone No.: (661) 327-1792
city: gakersfield
If you have made special (i.e., contractual) arrangements with any police department, fire department, hospital, contractor, or State or
local emergency response.team to coordinate emergency services, describe those anangements below:
NONE
UN-020UPC~ - 9/15 www.unidocs.org Rev. 07/24/06
Emergency Response/Contingency Plan (Hazardous Materials Business Plan Module) Page of
4. Emergency Procedures:
Emergency Coordinator Responsibilities:
a. Whenever there is an imminent or actual emergency situation such as a explosion, fire, or release, the emergency coordinator (or
his/her designee when the emergency coordin'ator is on call) shall:
i. Identify the character, exact source, amount, and areal extent of any released hazardous materials.
ii. Assess possible hazards to human health or the environment that may result from the explosion, fire, or release. This
assessment must consider botli direct and indirect effects (e.g., the effects of any toxic, irritating, or asphyxiating gases that
are generdted, the effects of any hazardous surface wdter run-offfrom, water or eherriical agents use. d to control fre, etc.):
w. Activate internal factlity alarms ori communications systerris, where applicable, to notify all facility personnel.
iv. ~ Notify appropriate local aut}iorities (i.e., cd11911).
v. Notify the State Office of Emergency Services at l-800-852-7550.
vi. Monitor for leaks, pressure build-up, gas generation, or ruptures in valves, pipes, or other equipment shut down in response to
the incident.
vii. Take all reasonable measures necessary to ensure that fires, explosions, and releases do not occur, recur, or spread to other
hazardous materials at the facility.
Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall:
i. Provide for proper storage arid disposal qf recovered waste, contaminated soil or surface water, or any other material that
results from a explosion; fire, or release at.the facility.
ii. Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the
facility affected by the incident until cleanup procedures are completed.
iii. Ensure that all emergency equipment is cleaned, fit for its intended use, and available for use.
iv. Notify the California Environmental Protection Agency's Department of Toxic Substances Control, the local CUPA, and the
local fire department's hazardous materials program that the facility is in compliance with requirements b-i and b-ii, above.
Responsibilities of Other Personnel:
On a separate page, list any emergency response functions not covered in the "Emergency Coordinator Responsibilities" section,
above. Next to each function, list the job title or name of each person responsible for performing the function. Number the page(s)
appropriately.
5. Post-Incident Reporting/Recording:
The time, date, and details of any hazardous materials incident that requires implementation of this plan shall be noted in the facility's
operating record.
Within 15 days of any hazardous materials emergency incident or threatened hazardous materials emergency incident that triggers
implementatio^ of this plan, a written Emergency Incident Report, including, but not limited to a description of the incident and the
facility's response to the incident, must be submitted to the California Environmental Protection Agency's Department of Toxic
Substances Control, the local CUPA, and the local fire department's hazardous materials program. The report shall include:
a. Name, address, and telephone number of the facility's owner/operator;
b. Name, address, and telephone number of the facility;
c. Date, time, and type of incident (e.g., fire, explosion, etc.);
d. Name and quantity of material(s) involved;
e. The extent of injuries, if any;
f. An assessment of actual or potential hazards to human health or the environment, where this is applicable;
g. Estimated quantity and disposition of recovered material that resulted from the incident;
h. Cause(es) of the incident; ,
i. Actions taken in response to the incident;
j. Administrative or engineering controls designed to prevent such incidents in the future.
6. Earthquake Vulnerability: ~19 CCR §2731(e)~
As an attachment to this plan, you must identify any areas of the facility and mechanical or other systems that require immediate
inspection or isolation because of their vulnerability to earthquake-related ground motion.
7. Hazard Mitigation/Prevention/Abatement ~i9 CCx §z~3t(e)~
As an attachment to this plan, you must include procedures that provide for mitigation, prevention, or abatement of hazards to persons,
property, or the environment. These procedures must be scaled appropriately for the size and nature of the business, the nature of the
damage potentia] of the hazardous materials handled, and the proximity of the business to residential areas and other populations.
UN-U20UPCF - 10/15 www.unidocs.org Rev. U7/24/OG
Emergency Response/Contingency Plan (Hazardous Materials Business Plan Module) Page of
8. Emergency Equipment:
22 CCR §66265.52(e) [as referenced by 22 CCR §6626234(a)(4)] requires that emergency equipment at the facility be listed.
Completion of the following Emergency Equipment Inventory Table meets this requirement.
EMERGENCY EQ~JIPMENT INVENTORY TABLE
1.
Equipment
Cate or 2.
Equipment
T e 3.
LocationS * 4,
.
Descri tion**
Personal ^ Cartrid e Res irators
Protective ^ Chemical Monitoring E ui ment (describe)
Equipment, ~ Chemical Protective A rons/Coats Batte char ACid a ron
Safety ^ Chemical Protective Boots
Equipment, ~ Chemical Protective Gloves Batte char 2 Fair Rubber Gloves
and ^ Chemical Protective Suit"s describe)
First Aid ~ ^ Face Shields
Equipment ^ First Aid Kits/Stations (describe) Rest Room One lar e first aid kit
^ Hard Hats
^ Plumbed E e Wash Stations
~ Portable E e Wash Kits (i.e., bottle e Batte char Two 32oz e e wash bottles
^ Res irator Cartridges describe)
~ Safet Glasses/S lash Go les Batte char S ash o 1es
^ Safety Showers
^ Self-Contained Breathing A aratuses (SCBA
^ Other (describe)
Fire ^ Automatic Fire S rinkler Systems
Extinguishing ^ Fire Alarm Boxes/Stations
Systems ^ Fire Extinguisher S stems (describe)
^ Fire Extinguishers (describe)
^ Other (describe
Spill ~ Absorbents (describe SaleS fI00r 8-10 Fort Ib ba S
Control ^ Berms/Dikes describe
Equipment ^ Decontamination E ui ment (describe)
and ^ Emergency Tanks (describe)
Decontamination ^ Exhaust Hoods
Equipment ^ Gas Cylinder Leak Re air Kits (describe)
~ Neutralizers (describe Batte Chaf 301b bUCket SOdB ASh
^ Ove ack Drums
^ Sum s (describe)
^ Other (describe) ~
Communications ^ Chemical Alarms (describe) ~
and ^ Intercoms/ PA Systems
Alarm ^ Portable Radios
Systems ~ Tele hones Counter 5-6 Hard Line Phones
^ Tank Leak Detection S stems
^ Other (describe
Additional ~ 55 Gallon Steel Drum Stock room
Equipment ~ Mo s, brooms, mo bucket Stock room
(Use Addirional ~ Trash Ba s, Sales ba s
Pnges if Needed.) ^
^
^
* Use the map and grid numbers from the Storage Map prepared earlier for your HMBP.
** Describe the equipment and its capabilities. If applicable, specify any testing/maintenance procedures/intervals. Attach
additiona! pages, numbered appropriately, if needed.
UN-020UPCF - 11/15 wrvw.unidocs.org Rev. 07R4/06
~ Employee Training Plan
(Hazardous Materials Business Plan Module)
Authority Cited: HSC, Section 25.504(c); 22 CCR ,¢66262.34(a)(4) Page of
All facilities that handle hazardous materials in HMBP quantities must have a written employee training plan.
This plan is a required module of the Hazardous Materials Business Plan (HMBP). A blank plan has been
provided below for you to complete and submit if you do not already have such a plan. If you already have a
brief written description of your training program that addresses all subjects covered below, you are not
required to complete the blank plan, below, but you must include a copy of your existing document as
part of your HMBP.
Check all boxes that apply. [Note: Items marked with an asterisk (*) are required.J:
1. Personnel are trained in the following procedures:
~ Internal alarm/notification *
~ Evacuation/re-entry rocedwes & assembly oint locations*
^ Emer enc incident re ortin
^ External emer enc res onse or anization notification
^ Location(s) and contents of Emer enc Res onse/ContinQenc Plan
^ Facility evacuation drills, that are conducted at least (spec~): (e.g., "Quarterly", etc.)
2. Chemical Handlers are additionally trained in the following:
~ Safe methods for handling and storage of hazardous materials *
^ Location(s) and ro er use of fire and s il] control e ui ment
^ S ill rocedures/emer enc rocedures
~ Pro er use of ersonal rotective e ui ment *
~ Specific hazard(s) of each chemical to which they may be exposed, including routes of exposure (i.e., inhalation, ingestion,
absor tion) * '
~ Hazardous Waste Handlers/Managers are trained in all aspects of hazardous waste management specific to their job duties
(e.g., container accumulation time reguirements, labeling requirements, storage area inspection reguirements, manifesting
re uirements, etc.) * '
3. Emergency Response Team Members are capable of and engaged in the following:
Com letethis section onl i ou have an in-house emer enc res onse team
^ Personnel rescue rocedures
^ Shutdown of o erations ,
^ Liaison with res onding agencies
^ Use, maintenance, and re lacement of emergenc res onse e ui ment
~ Refresher training, which is rovided at least annually *
^ Emergency response drills, which are conducted at least (specify): (e.g., "Quarterly", etc.)
UN-020UPCF - 12/IS www.unidocs.org Rcv. 07/24/06
Record Keeping
(Hazardous Materials Business Flan Module) Page of
All facilities that handle liazardous materials must maintain r.ecords associated with their managernerit. A
summary of your record keeping procedures is a required module of the Unidocs Hazardous Materials Business
Plan (HMBP). A blank summary has been provided below for you to complete and submit if you do not
already have such a document: If you already have a brief written description of your hazardous materials
record keeping systems that addresses all subjects covered below, you are not required to complete this
page, but you must include a copy of your existing document as part of your HIVIBP.
Check all boxes that apply. The following records are maintained at the facility. [Note: Items marked with an
asterisk (*) are required. J:
~ _ Current em loyees' training records, (to be retained until closure of the facility) *
~ Former em lo ees' training. records (to be retained at least three years a ter termination of em loyment) *
~ Trainin Program(s) (i:e„ written descri tion of introductory and continuing traini,n~ *
~ Current co ,y of this Emergency Res onse/Contingency Plan *
~ Record of recordable/re ortable hazardous materiaUwaste releases *
~ Record of hazardous material/waste storage area ins ections *
~ Record of hazardous waste tank daily inspections *
^ Descri tion and documentation of facility emer ency res onse drills
Note: The above list oJrecords does not necessarily ident~ every type of record required to be maintained by the facility.
Note: Tlze following section applies where local agencies require facility owners/operators to perform and
document routine facility self-inspections: ,
A copy of the Inspection Check Sheet(s) or Log(s) ~rsed in conjunction with required routine self-
inspectaons of your facility must be submitted with your HIVIBP. ~Exception: Unidocs provides a
Hazardous Materials/Waste Storage Area Inspection Form that you may use if you do not already have your
own form. If you use the Unidocs form (available at www.unidocs.org~, you do not need to attach a copy.J
Check the appropriate box:
^ We will use the Unidocs "Hazardous Materials/Waste Storage Area Inspection Form" to document inspections.
^ We will use our own documents to record inspections. (A blank copy of eac/i document used must be attacl:ed to this HMBP.)
UN-020lIPCF - 13/15 www.unidocs.org Rev. 07/24/06
Facility Site Plan and Storage Map Instructions
(Hazardous Materials Business Plan Module)
A Site Plan (public docurrient) and Storage Map (confideritial document) must be included with your HIVIBP.
For relatively small facilities, these documents rnay be combined into one drawing. However, if combined, the
combined Site Plan/Storage Map will become a public document. If you are concerned about displaying the
storage locations of hazardous materials to the public, you.must provide a separate facility Storage Map. Since
these drawings are intended for use in emergency response situations, larger facilities (generally those with
complex and/or multiple buildings) should provide an overall site plan and a separate storage map for each
building/storage area. A blaiik Facility Site Plan/Storage Map sheet has been provided on the previous page.
You may complete that page or attach any other drawing(s) that contain(s) the iriformation required below:
1. Site Plan (public document): This drawing shall contain, at a minimum, the following information:
a. An indication of North Direction;
b. Approximate scale (e,g., "1 inch = IOfeet".);
c. Date the map was drawn;
d. All streets bordering the facility;
e. Locations of all buildings and other structures;
f. Parking lots and internal roads;
g. Hazardous materials loading/unloading areas;
h. Outside hazardous materials storage or use areas;
i. Storm drain and sanitary sewer drain inlets;
j. Wells for monitoring of underground tank systems;
k. Primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas.
2. Storage Map (confidential): The map(s) shall contain, at a minimum, the following information:
a. General purpose of each section/area within each building (e.g., "O~ce Area ", "Manufacturing Area ",
etc.);
b. Location of each hazardous material/waste storage, dispensing, use, or handling area (e.g., individual
underground tanks, aboveground tanks, storage rooms, paint booths, etc.). Each area shall be
identifiable by a Grid Number, to be used in item 204 on the Hazardous Materials Inventory - Chemical
Description pages of the Business Plan;
c. For tanks, the capacity limit in gallons and common name of the hazardous material contained in each
tank; ~
d. Entrances to and exits from each building and hazardous material/waste room/area;
e. Location of each utility emergency shut-off point (i. e., gas, water, electric.);
f. Location of each monitoring system control panel (e.g., underground tank monitoring, toxic gas
monitoring, etc.).
UN-020UPCF - 15/15 www.unidocs.org Rev. 07/24/OG
_~
CONSOLfDATED CONTlNGENCY PL~41V
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT Unified Program Form
2700 M STREET, SUITE 300 SITE MAP
BAKERSFIELD, CA 93301,
j6B7 862a8700 Fax(667)862=8701
_. __ _ _ _ ___
' , Page of
1. FACILITY IDENTIFICATION
FACILITY ID # ~ EPA ID #(Hazardous Waste Only) z
CAL a 2~ `~
BUSINESS NAME (Same a§ Facility Name of DBA-Doing Business As) s
AUTOZONE. ~ : ~ ._ •
_
SITE ADDRESS 103
~ L( I ~-~1eS~l~ ~ CITY 104
~.~er ~ ZIP CODE 105
c~
DATE MAP DRAWN MAP # SUB-FACILITY #(if needed)
6-7-2004
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For Site Map
• Loading Areas
• Parking Lots
• Internal Roads
• Storm and Sewer
Drains
• Adjacent Property Use
• . Locations and Names
of Adjacent Streets and
Al leys
• Entrance and Exit
Points and Roads
• Evacuation Routes
For Storage Map
• Location of Each
Storage Area
• Location of Each
Fiazardous Material
Handling Area
• Location of Emergency
Response Equipment
N~~ S~~
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gIAZAR'DO~JS 1VIAT~+ RIALS INV~+ 1oT`I'~RY - CHEIVIICAL DESCRIPTION
KERN COUNTY ENVIRONIVIENTAL HEALTH SERVICES DEPARTMENT Unified Program Consolidated Form (UFCF)
2700 M STREET, SUI'rE 300. I3AZARDOUS MATERIALS
I
BAKERSF
ELD, CA 93301
(661 862-8700 F8X (661 ~ HGZ-H7O1 (one page per material per building or area)
^ADD ^DELETE ~REVISE 200 Page 1 of 3
I. FACILITY INFORMATION ' ~
BUSINESS NAME ($ame as FACILITY NAME or DBA -: Doing Business As) 3.:
AUTOZONE
_ _ _
__
CHEMICAL LOCATION Zo~ CHEMICAL LOCATION CONFIDENTIAL EPCRA 202
STOCK ROOM ^ YES ~ tvo
FACILITY ID # ~ MAP# ~°pt'°"eq 203 GRID# (optioneq 2~
II. CHEMICAL INFORMATION
CHEMICAL NAME zos TRqDE SECRET ^ Yes ~ No z~
WASTE ABSORBENT ~rs~n;~coErcw~; ~~n~;,~c~~~t;o,~
GOMMON NAME zo~ 20e
WASTE ABSORBENT EHS* ^ Yes ~ No
CA$# . 209 *If EHS if "Yes", all amounu below must be in pounds
8002-OS-9
FIRE CODE HAZARD CLASSES (Not wrrently required by KCEHSn) Z~p
FLAM
HAZARDOUS MATERIAL ~ 213
TYPE (Check one item only) ^ a. PURE ^ b. MIXTURE ~ c: WASTE Z>> Kt1DI0ACTIVE ^ Yes ~ No 212 CURIES 0
PHYSICAL STATE z~s
Check one item onl Z~4
~ Y) ~ a. SOLID ^ b. LIQUID ^ c. GAS LARGEST CONTAINER 440
FED HAZARD CATEGORfES 2~6
(Check all that apply) ~ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ^ d. ACU7'E HEALTH
^ e. CHRONIC HEALTH
AVERAGE DAILY AMOUN'C Z~~ MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT ~19 STATE WASTE CODE ZZa
220 440 1340 221
u~
UNITS' ^ a. GALLONS ^ b, CUBIC FEET ~ c. POUNDS ^ d. TONS DAYS ON SITE: ~
Check one item onl • If EHS, amount must be in ounds. 365
STORAGE
CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR
, ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ a PLASTIC BOTTLE ^ r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
~ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDEA ^ p. TANK WAGON 223
STORAGE PRESSURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ZZy
STORAGE TEMPERATURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c• BELOW AMBIENT ^ d. CRYOGENiC 225
%WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1 50% ZZe PETROLEUM OIL zn ^ Yes ~ No us
8002-OS-9 zz9
2
230 Z3~
^ Yes ^ NO 232
- 233
3
234
235
^ Yes ^ NO 236
Z;~
4
238
z39
^ Yes ^ No zao '
24~
5
242 243
^ Yes ^ No zaa Zqs
If morc haznrdous componenfs xre preaent a[ prcater than 1% by weight if nomcarcinogenic, or 0.1 % by weight i( tarcinogenic, attath additional 8heels of paper cep[uring [he required informntion.
ADDITIONAL LOCALLY COLLECTED INFORMATION WASTE zab
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If EPC Please Si n Here
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~AZARD~US 1VIATER~AI:cu IlW~+ l~T~'~~Y - C~IEMICAL DESCRIPTION F
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KERN COUNTY ENVIRONMENTAL HEALTH SERVIdES DEPARTMENT Uni6ed Program Consolidated Eorm (UPCF)
'
2700 M STREET, SU1
rE 30o HAZARDOUS MATERIALS
BAKERSFIELD, CA 93301 '
(661 862-8700 Fax(661)862-8701
(ane page pu mnterial per building or area)
^ADD ^DELETE ~REVISE Zo~ Page 2 of3
I. FACILITY INFORIVIATION
BUSINESS NAME (Same as FACILITY NAME or DBA = Doing Business As) 3
AUTOZONE
_ _ .
GHEMICAL LOCATION 201 GHEMIGAL LOCATION CONFIDENTIAL EPCRA Zoz
STOCK ROOM ^ YES ~ tvo
FACILITY ID #
r ~ MAP# (opcional) 203
~ GRID# (opcionel) 2~
II. CHEMICAL INFORMATION
CHEMICAL NAME zos TItADE SECRET 206
^ Yes ~ No
SULRURIC ACID
~ ~If Subjea to EPCRA; refer ro instrvctionv
COMMON NAME Zo~
208
BATTERY FLUID-ACID ~ EHS*
~ Yes ^ No
CAS# 209 *lf EHS if "Yes", all emounts 6elow must be in pounds
7664-93-9
FIRE CODE HAZARD CLASSES (Not currentty required by KCExsn) Z~a
CORR '
HAZARDOUS MATERIAL z~3
TYPE (Check one item only) ^ a. PURE ^ b. MIXTURE ~ c. WAS7'E 21 ~ ~IOACTIVE ^ Yes ~ No 2~z CURIES 0
PHYSICAL STATE 215
(Check one item only) ^ a. SOLID ~ b. LIQUID ^ c. GAS 214 LARGEST CONTAINER 4
FED HAZARD CATEGORIES
2~6
(Check all that apply) ^ a, FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE
~ d. ACUTE HEALTH ^ e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT z1~ MAXIMUM DAILY AMOUN'C Z~B ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220
~~ 140 3640 791
UNITS• ^ a• GALLONS ^ b. CUBIC FEET ~ c. POUNDS ^ d. TONS u~ DAYS ON SITE: ~
Check one item onl • If EHS amoun[ must be in ounds. 36S
STORAGE
CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q• RAIL CAR
^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ~ r, OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOT'E BIN
^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON zz3
STORAGE PRESSURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ~ ZZq
STORAGE TEMPERATURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC z25
%WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1 34% 226 SULFURIC ACID n~ ~ Yes ^ No zze
7664-93-9 zz9
2
230 231
^ Yes ^ NO 232
233
3
z~a
zss
^ Yes ^ No z36
237
4
238
239
^ Yes ^ No zao
Za~
5
zaz
z43 ^ Yes ^ No zaa Z45
I( more hazardow components ere preemt at grealer thnn 1% by weight if non-careinogenic, or 01 % by weight if exrcinopmic, attach additionnl aheets o( paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION WASTE zav
If EPCRA Please Si n Here
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2700 M STREET, SUi
rE 300 .
HAZARDOUS MATERIALS
BAKERSFIELD, CA 93301
(661 862-8700 Fax 661 862-8701 • (one pa8e pe~ material
per buiiding or erea)
^ADD ^DELETE ~REVISE 20° Page 3 of3
I, FAGILITY INFORMATION
BUSINESS NAME (3ame as FACILITY NAME or DBA -. Doing Business As)
3
AUTOZONE
CHEMICAL LOCATION zoi CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2
STOCK ROOIVI ^ YES ~ 1vo '
FACILITY ID #
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MAP# ~o~~o~q zos
GRID# (o~~o~q zoa
Il. CHEMICAL INFORMATION
CHEMICAL NAME zos 1-RppE SECRET Zob
^ Yes ~ No
FETROLEUM OIL tt's~b~~c to ePCxn, ret'u w~~wa~o~
COMMON NAME , zo~ zos
WASTE OIL EHS* ^ Yes ~ No
Cf~$# ~ 209 •If EHS if "Yes", all amounts below must be in pounds
8002-OS-9
FIRE CODE HAZARD CLASSES (t~ot currenuy required by KCEHSn) Z~p
FLAM
HAZARDOUS MATERIAL 2t3
TYPE (Check one item only) ^ a. PURE ^ b. MIXTURE ~ c. WASTE 21 ~ RADIOACTIV E^ Yes ~ No 212 CURIES 0
PHYSICAL STATE 2i5
(Check one item only) ^ a. SOLID ~ b. LIQUID ^ c. GAS 214 LARGEST CONTAINER 220
FED HAZARD CATEGORIES 2~6
(Check all that epply) ^ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ^ d. ACUTE HEALTH
^ e. CHRONIC HEALTH
AVERAGE DAILY AMOUNS 217 MAXIMUM DAII.Y AMOUNT Z~8 ANNUAL WASTE AMOUN7' 219 STA7'E WASTE CODE 220
11~ 22~ 5~2~ 221
u~
UNITS• ~ a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS DAYS ON SITE: Z2z
Check one item onl • If EHS, amount must be in o~,as. 365
STORAGE
CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIG/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS B07"fLE ^ q. RqIL CAR
^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ h. SILO ^ L CYLINDER ~ p. TANK WAGON 223
STORAGE PRESSURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT y,q
STORAGE TEMPERATURE ~ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225
%WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1 99% zzb PETROLEUM OIL Zn ^ Yes ~ No zzs
8002-OS-9 u9
2
'`30 231
^ Yes ^ No 232
Z33
3
234
235
^ Yes ~ NO 236
~ 237
4
~s
239
^ Yes ^ No zao
241
5
242 243
^ Yes ^ No zaa 245
If more hnznrdoue components are present at grea~er than 1% by weight if non-carcinogenic, or 0.1 % by weigh~ if carcinogenic, attath additional sheets of pnper capmring the requircd information.
ADDITIONAL LOCALLY COLLECTED INFORMATION WASTE zae
If EPCRA Please Si n Here