HomeMy WebLinkAbout645 Tank Farm #FCity of San Luis Obispo Fire Department
tnspection- I nformation
ld_number
Address 645-F Tank Farm Road
Assignment KerrY BoYle
Business Star Automotive
Business Phone 543-7827
Business type
Time spent lnspection Frequency
Responsible party Brian Wampler
Phone 5$-7BZl
Emergency phone
Property owner
Address
City, State, Zip
No Lock Box Location
Last clear date Next lnspection
Hood test
Sprinklers Location
No Alarm Location
No Clean Agent Location
No Stand pipes FDC Location
Self-inspection cycle
Manager )Empl€{ee
Last inspection date
Gas Shutoff: Side
lnspector 1B
NFIRS Code
Not specified
# of buildings
# of units
0
0
FDC loc
Fire flow
Construction type
Stories
Building Area
Occupancy area
Occupancy load
Occupancy
UFC Year
Critical locations Main Elecrrical Shurof f : Side
Preplan hazard
N6tes Repair Garage - /d /hrr;t
ouNA' fuX7utf$fa lw^a^ ^) ,' r''fu -"'l'"(t)
F'ORM S - SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED
BUSINESS OWNER/OPERATOR IDENTIFICATION
PROGRAM AGENCY
I. IDENTIFICATION
ENDINGDATE/?'3t'o?
1011BEGINNING DATE
7-tz"o?
100FACILITY ID#
BUSINESS PHONE
fo 5, sl;zfe 7/9u
BUSINESS NAME (same os
'70 o
NAME or DBA - Doing Business As)
BUSINESS SITE ADDRESS
7 So Fpn nlers 4lr 103
CA
ZTPCODE
73qo t
105
sn"l /us 0815/0
104CITY
SIC CODE (a digit #)107
DUN & BRADSTREET t06
108
COUNTY
110B USINESS OPERATOR PHON EA^/
(
BUSINESS OPERATOR NAME /'brtu,tl h/rrrn fc rrc 109
II. BUSINESS OWNER
Bn ui^ h,/.r"-lct7q
111OWNER NAME
STATE lt5
C/+
t"to?3 ro z-1t6
OWNERPHONE
tlt
I
ADDRESSOWNER
CITY
,
LOS o.fas
III. ENVIRONMENTAL CONTACT
illtCONTACTPHONESnar ns d f t17CONTACTNAME
ll9
CONTACT MAILING ADDRESS
ZIP CODE121STATEt20CITY
ry. EMERGENCY CONTACTS -SECONDARY--PRIMARY-
{r1r/t' Ur/lt*fzZa
128NAMEBrt*, d,Jn-/r t t r23NAME
TITLE I cJruev-
r29
TITLE /ctftruts Pc/tJr-Z
124
BUSINESS PHONE
Yo t" tY"7 .'7/) 7
130
BUSINESS PHONE
lo f, f13, '7 F) 7
125
13124-HOUR PHONE'ta524-HOUR PHONE 126
/
PAGER # / CELL PHONFI #
L
t32
PAGER # / CELL PHONE #t2'1
ADDITIONAL LOCALLY COLLECTED INFORMATION
t33
penalty of law that I have examined andIinformation,the certifyindithosevidualsonBasedresponsibleCertification:my
andandsubmittedthebelieveaccurate,rs true,informationfamiliaralnthewithinformation complete.
t34DATEvlrz/al NAME OF DOCUMENT PREPARER 135
SnrOR DESIGNATEDSIGNATURE
NAME OF SIGNER (prirtr
tsri,^t
t36
f,7\
7
Paoe
C:\l]*{1LJfu'lf;- 1 ,ki:;::;rl*'rlr}*Ai,.l}- 1 ,."i'*r*p\-l*fi'lFi}ritiy illilecl*ry 5 i#r *lJ FA l-il* -Perci'l**eril l.;iiicrrp*'rfoi'**\FRM-$. tlqx) i]?i'I I'109
FORM I - SAN LIIIS OBISPO COLNTY CERTIFIED UNIHED PROGRAM AGENCY (CIJPA)
CHEMICAL IIWENTORY
ormaterial
Page _ of _!ner-nre EnevIsn
K ,flaru,'t I. FACILITY INFORMATION
(Same as
,4"
3
vlE
BusinessorNAMEDBA As)FACILITY DoingNAMEINESSBUS
CHEMICAL LOCATION CONFIDENTIAL
EPCRA
NOYES
CHEMICAL
GRID# (optiooat)MAP#
FACILMY ID #
tr. CIMMICAL INFORMATION
TRADE SECRET
If Subject to EPCRA, refer to instructions
206Yes
GLYCOL + OTHER GLYCOLS
245
CHEMICAL NAME
fl Yes Ft'to
208
EHS*
20't
COMMON NAME
*If EHS is (Y€s", all amounts below must tle in lbs'cAs#
210
FIRE CODE HAZARD CLASSES (Crmplete if required by CUPA)
2t3
CURIES
212
RADIOACTIVE EYCS EINOHAZARDOUS MATERIAL TYPE
(Check one item only)E a. PURE E u. t'llxrunE El c. WASTE
{O Grtzza,,/fLARGEST CONTAINER
215
PHYSTCAL STATE
(Check one item only)E a. SOLID EI b. LIQUID E C. GAS
FED HAZARD CATEGORIES
(Check all that aPPIY)
Ea.FIREfIb.REACTIVEEc.PRESSURERELEASEEd.ACUTEHEALTHEe.CHRONICHEALTH
216
STATE WASTE CODE 220ANNUAL WASTE AMOUNT
/oo 64L/a'u,
219
{o Gnuo^rs
AMOUNTMAXIMUMAVERAGE DAILY ) S 6ftuoo'5 222DAys oN tnu'7
6 SUNITS+
(Check ore item only)
fl d. roNSEI a. GALLONS
EHS, amotnt must be in
Eu. custcFEsr Ec. FOUNDS
Dtrn
b. UNDERGROUND TANK
c. TANK INSIDE BUILDING
d. STEEL DRUM
utrtr
f. CAN
g. CARBOY
h. SILO
tri.
Ek.
trr.
n. PLASTIC BOTTLE
o. TOTE BIN
p. TANKWAGON
m. GI-ASSTANKa. ABOVE
CONTAINER
DRUM
CYLINDER
BAG
BOX
r. OTHER
q. RAIL CAR
E A. AMBIENT E b. ESOVE EMSIENT E C. BELOW AMBIENT
STOMGE PRESSURE
224
STORAGETEMPERATURE El A. AMBIENT Eb. ABOVEAMBIENT E C. BETOW AMBIENT E d. CRYOGENIC
225
CAS #EHSIIAZARDOUS COMPONENT (For mixture or waste only)%wr
t072Llflvo EINo
224
ETHYLENE GLYCOL
2TI
150
x26
flvo flNo
232
2t0
n
237
fl ves flNo
236zy
3 24t
flvo nNo
2&
218
4
245241
Evo ElNo242
5
ot prpcr aptul4 tte
wlghr lf@poeoaf r Prsl la gMacr thrq ritrciorreightmc
ADDITIONAL LOCALLY COLLECTED INFORMATION
A:\WASTANTI.DOC 1 1-Feb-00
COLINTY CERTIFTED TJNIFIED PROGRAM AGENCY (CTJPA)
or
FORM I - SAN LT'IS OBISPO
C HEMICAL ITWENTORY
materisl
Pagc _ of *[]REVISE
2m
IDELETE
I. FACILITY INFORMATION
NAME or DBA - Doing Business As)
BUSINESS NAME (Same as FACILITY
frnn LOCATIO N CONFIDENTTALCHEMICAL
EPCP.A
YESca
201
CHEMICAL LOCATION
GRID# (optionllMAPfI
FACILITY ID /
II. CHEMICAI- INFORMATION
TRADE SECRET
If Subject to
!Yo
refer to instructions
206205
CHEMICAL NAME
HYD ROCARBON 208
EHS*f]vo XttoCOMMON NAME
*tf EHS is "Yes"r all a-mounG below must be in lbs'2l)9
cAs#
2r0
CLASSES (complck if rcquircd bv CUPA)FIRE CODE HAZARD
2l
CURIFJMDTOACTIyE ! Yes q*"
HAZARDOUS MATERTAL TYPE
(Chcck onc itcm only)
fI a. PURE EI b. MIXTURE EI C. WASTE
ztl
25o GntryntfLd.RGEST CONTAINER
7t5
PHYSICAL STATE
(Ctrcct orc item only)
(,. totto El b. LIQUID U c. GAS
zt4
FED HAZARD CATEGORIES
(Chcck alt dra( aPPIY)
I C. PRESSURE RELEASE EI A' EbUTE HEALTH 8 C' CHRONIC HEALTH
2t6
EI a. FIRE E U. RpecrtvE
L o/rJ|
ANNUAL WASTE AMOUNT
t/o o
218
)9o tntt ,
MAXIMUM DAILY AMOUNT211AVERAGEDAILY AMOUNT
00 E d. ToNS
El a. GALLONS
22t
.IfElIS, emount musl be tn Pouir&.UNMS+
oe i(cm only)
Et b. CUBICFEET E C. POUNDS
EHS
HAZARDOUS COMPONENT (For mixture or waste only)%wr
flYc" EI No
PETROLEUM T{YDROCARBO N
xr1
I 100
E Y.s fl uo
232131
2.n
2
flvo I No
735
231
3
[Ycs ENo
214139
236
4
Evcs fl No
24211
212
5
e. ABOVE TANK DRUMc.
f. CAN
g. CARSOY
FIBER
BAG
BOX
STATE WASTE CODE
11
DAYS ON
m. GTASS
E n. PTASTICBOTTLE
E o. TOTEBIN
E p. TANKWAGON
CAS #
b5
trfl r. OTHER i
q. RAILC.{R '
@NTAINER b. UNDERCROUNDTANK
E C. TANK INSIDEBUILDING
f] d. STEEL DRUM E h. sIL
STORAGE PRESSURE EI a. AMBIENT [f u. ,tsovE A'uslENt E c. BEIIW AMBIENT
STOMGETEMPERATURE 8l A. AMBIENT E u. ,tsovE rtl'{B[Et'l-f E c. BELOW AMBIENT E a' cnvocs'Ntc
o( Fpa dp{s{rr
gn @fc.dr cFq.daf l€(dit4 d3!.
fIu
tri.Ekfl r.CYLINDER
A.DDMONAL I'CALLY @LLECTED INFORMATION
q i4t{rtuct
A\WASTOIL.DOC 1 l-Feb4O
FORM T - SAN LIJIS OBISPO COI.'NTY CERTIFIED TJNIFIED PROGRAM AGENCY (C[JPA)
material orCHEMICAL IIWENTORY
Page _ of _
EDELETE []nrvlsE 200
I. FACILITY INFORMATION
3
As)BusinessorNAMEDBAFACILITYDoing
202LOCATIONCONFIDENTIALCHEMICAL
EPCRA
NOYES
LOCATION
201
/
CHEM
GRID# (optional)203MAP#
FACILITY ID #
tr. CHEMICAL INT'ORMATION
TRADE SECRET
If Subject to EPCRA, refer to instructions
206NoYes2n5
CHEMICAL NAME
ASTE SOLVENT
fI Yes F*"EHS*COMMON NAME
*If EHS is {'Yes", all amounts below must be in lbs209
cAs#
N/
FIRE CODE HAZARD CLASSES (Cotrplerc if rcquircd bv CUPA)
2t3
CURIES
212
MDIOACTIVE fI YCS 8 NO
ztl
c. WASTEHAZARDOUS MATERIAL TYPE
(Check one item only)E A. PURE 8 b. MIXTURE
r 5 Gnu-o^t5
2t5
LARGEST CONTAINERPHYSICAL STATE
(Check one item only)E a. SOLID El b. LIQUID EI C. GAS
214
E b. REACTIVE E C. PRESSURE RELEASE El d. ACUTE HEALTH 8 C' CHRONIC HEALTH
[l a. FIRE
zt6
FED HAZARD CATEGORIES
(Check all tlut aPPIY)STATE WASTE CODE 220WASTEAMOUNT219
+I G,**to,.6
2t8
/
DAILY AMOUNTA
6n
2lYDAILAMOUNT
_foLLLI DAYs oN tot,36g aa1
UNITST
(Check one item
E d. ToNsI a. GALLONS
*If ETIS,amount EUst be itr Pounds.
E b. cuBlc FEE-[ E c. PouNDs
223
fl r. oTHER
! q. RAILCAR
i. FIBERDRUMe.
COI.{TAINER trtrtru
m. GT ASS BOTTLE
E f. cAN E N. PLASTIC BOTTLEJ. BAG
K. BOX
I, CYLINDER
o. TOTE BIN
p. TANKWAGONg. CARBOY
h. sll-o
a. ABOVE GROUND TANK
b. UNDERGROUND TANK
TANK INSIDE BUILDING
STEEL DRUM
E b. ABOVE AMBIENT E C. BELOW AMBIENTI a. AMBIENTSTORAGE PRESSURE
224
STORAGE TEMPEMTURE El A. AMBIENT E b. ABOVE AMBIENT EI C. BELOWAMBIENT Dd. CRYOGENIC
ZE
CAS #EHSI{AZARDOUS COMPONENT (For mixture or waste only)%wr
N/Aflvo 8no
224
WASTE SOLVENT190
T26
N/AlYes 8No
232
PETROLEUM HYDROCARBON
211
210
! Yes flNo
2J5
3
Evo Eno
239
4 245
I Yes f] No
244213
242
5
or 0.1% byl% br wl8!t@poeDls rrc P@a ra 3stc(ettrctlfm
EbcG of p.pcr optulrg ahc
ADDITIONAL TOCALLY COLLECTED INFORMATION
A:\WASTESOL.DOC 1 1'Feb-00
FORM E
SAN LIIIS OBISPO COI.INTY CERTIFIED TINIFIED
PROGRAM AGENCY (CllPA)
EMERGENCY RESPONSE PLAN
Or Hazardous Waste Contingency Plan
(see instruction Page vii)Date: Zltz/4
SECTION I.A: BUSINESS IDENTIFICATION DATA
SrrfA &rnrroT/t/€
BUSINESS NAME
7 5o F4rrrlers l/y'E '
CITY ZtrCODESTTE ADDRESS
Snn/ /.rrrs agrs/a /1,4 ('37a t
TELEPHONE NUMBERFACILITY UNIT
Snas
BUSINESS MAILING ADDRESS CITY ZIP CODE
Ifyour business has a license or permit front any of the folloting agencies, please indicate the document number
L Hazardous Materials
Unclergound Storage # ll4
'#rfi*5*"'" (iL dpo gr>/
3. Ail Pollution Control
District #
4. Responding Fire Dept
& Permit#
,t/n
please provide the following information as it pertains to your business and its location. You are not required to notify these companies in the
event of an emergency. This information is provided for your reference and to assist emergency response personnel in responding to a
hazardous materials emergency at your facility. List the name and phone number of the utility company'
Etectricservice /A t Telephone #
Gas Service lU/*Telephone #
Saniration S /O Gtmtnfie Telephone #
Water District Sco Telephone #
SECTION I-B: OWNER CERTIFICATION OF DATA (Certify either I or 2)
l. This l, udwpW plan IUpDATED Existing PIan. I have personally examined the information it contains and am familiar with the
operation ofiht plan. (If you check either of the above two options, continue to complete the remained of the Emergency Response /
Contingency Plan).
Z. ! itrls ptan requires no change and is on file with San Luis Obispo County Hazardous Materials Unified Progam Agency and does
not need any change. (If you check this section, please proceed directly to Form T, the Training Program.)
I celtify under law that the above information is true and accurate.
6n ",,t
ltrzz 7
DATEPRINT NAME OF OWNER OR OPERATORSrr
DOCUMENTS PREPARED BY
Paoe Of
SIGNATURE DATE
s
SECTIONII: EMERGENCY RESPONSE PLANS AND PROCEDURES
Note: Complete all sections of this Emergency Response Procedure below. Use of tetms such as "N/A" (lllot Applicable) will not be accepted.
A. FIRE, SPILL OR RELEASE: The fire code requires immediate notification through dialing 9L1, by whoeYer first sights the
incident. In the event of release or spill of hazardous materials, you must also notify:
1. San Luis Obispo County Hazardous Materials Unified Program Agency during business hours @ 805-781-5544. After
business hours dial 911.
2. The State Office of Emergency Services - (800) 852'7550 or (9L6) 262'1621,
List the individuals responsible for verifying that these calls have been made and also indicate their position in your company
FOR VERIFYING THE DIALING OF 911
6nrn^ lr,/n rrs<Oa/tt/f r<
NAME POSIIION
Unified Program Agency and the State Office of
a h/r./€A
NAME POSIT1ON
B. List the local emergency medical facilities that will be used by your business in the event of an accident or injury caused by a release
of hazardous materials.
/olo $,/htrs ad1rfo 3ot-t/6 -26n
NAME ADDRESS CITY PHONE
frr"alett /klrrnc /?tt S,a/ htgalsPo 80-r,.fuy"{7sJ
NAME ADDRESS CITY PHONE
C. List the Emergency
Primary: /nrnA
Coordinator(s) at your facility.
u/tmrur au0/&gor.f lj,.lfJ)L)(r'>, ,
NAMF,TITLE BIJSINESS PHONE ZHRPHONE PAGER#
, t,+\ n ^^DSecondary:Gni lr/rrufzsp oJ,/;r< go f, frg . t27 L,- -
NAME TITI-E BUSINESS PHONE 24 HRPHONE PAGER#
D.Does your business have an on-site emergency response team? [Yes {No Describe procedures your business will follow in
the event of a release or threatened releass of hazardous materials
(*tz q // . tt/tfcqrt4E ,4/L Olsrarl't&s /A/D /oreto^luu,
bttznil gttz
Page_
E.Ifyou have acutely hazardous materials above threshold ptanning quantities, list (by name and address) adjacent neighboring
businesses and residences, schools, hospitals, etc. Include sensitive facilities (schools, hospitals and rest homes) within L'000 feet
(straight,line distance from your property tine). List telephone numbers for all businesses; for apartment buildings, list manager's
phone. Do not list telephone numbers for private residences.
Al/,4
F Briefly describe your standard operating procedures in the event of a release or threatened release of hazardous materials.
Emergency response procedures must comply with all federal, state and local regulations. Existing emergency response procedures
may be referenced and attached to this document.
L.Preyention -- Describe the accident potentials associated with the hazardous materials present at your facility. What actions
would your business take to reduce accident potentials? Include description of safety, storage and containment procedures'
Hn zr+reaans /A/44rr t/t /.t ,rm/?;A /^)H htma-r,/rtzzct /hsru- T/A/k.
h/rfie Ektza ts .Cmtrt9 //.4 /tmzze Ftuls 4/a
2. Equipment -- List the emergency response equipment at your facility (e.g. fire extinguishing systems, spill control equipment,
decontamination equipment).
Item Maintenance Procedure
/1//A
fitr EXr ,4al^turtt /Ar,ffrc 74&
1/,Et /rek ul
3.Evacuation -- Describe how you will immediately evacuate your facility. What communications or alarms are used? How will
you operate these during power failure?
LocationUse
Slttts 8n ils
FIPa onrr'/aFrtoE
B)us dz ,tgfl9ilffit
I
TO /9.1/O gfla4A
OF
42e l4eaouttEa FDrt.
a
7
Page_
*;\**sul?1il*l\kuilyl*'rL*ilAl$-1\'f $rrrpiilorrp*r;*{y Llirucir:ry ? f*r $IJPA l:ji*.. Ir*ckactlll i.zip\cupat{aans\l::H1$-*.1}*C *7/i ?d}tl
4. Shutdown -- Describe the shutdown for each site or facility
/eflL ta/lz
5a.Response -- Describe what is done to lessen or mitigate the harm or damage to person(s), property, or the environment, and
prevent the event from getting worse or spreading. What is your immediate response to:
Spill
Fire:
Explosion:
Earthquake:
Major Power Failure:
Flood:
L
b. Is this f'acility located on a 100-year flood plain? lYes XN"
c. Earthquake - Identify facility areas and list mechanical or other systems that require immediate inspection or isolation because of
their vulnerability to earthquake related ground motion.
6. Ctean-Up (Remove the Hazard) -- How do you handle the complete process of cleaning up, and disposing of related materials at your
facility? Note: Notify the Hazardous Materials Unified Program Agency when clean up is complete.
G. Location -- Your business is required to keep a copy of the Business Plan and related MSDS sheets on-site. Describe where this
information is located.
Drsrt7v7'
*Page- of-
FORM T
SAN LIIS OBISPO COIINTY CERTIFIED LINIFIED
PROGRAM AGENCY (CIIPA)
EMPLOYEE TRAINING PROGRAM
A.Describe the safety training for all employees in the event of a release or threatened release of hazardous materials. This
training shall inctude, but not be limited to, the following: new employee training, annual training, periodic refresher courses,
and familiarizationwith Emergency Plans and Procedures of this Business Plan/ Contingency PIan.
Summarize the training for all employees that work with or come in contact with hazardous materials/hazardous waste. Describe
how these employees are trained to avoid exposure.
1
f/o /t GlUf,/ A ,,/,il
T#F loc,rnzoJ aF //t zrtnaorts
A/',/0 ,PE thnlnt*,/G.
2.Summarize training speciflc to those employees that would respond to a release or threatened release of hazardous materials or
hazardous waste.
I fPeso'tr rcs
c
ii?ii ,)iit!i
Page-
3. Indicate frequency and duration of training for employees that work with or come into contact with hazardous materials/hazardous
waste.
4 trft< 4f / //7 u)t.rnu/ kt .
E "r"
4. Describe how your employees access training materials. (E.g., bulletin board, employee newsletter, staff meetings, etc.)
S/ilq r ls frK EtttPzo EE
/h
B. List person(s) in charge of training and indicate their qualifications to conduct the training.
3 3't nru
C Indicate where training records are kept. (Records must document the type of training, duration, completion dates, names and
positions of employees receiving training and the name(s) of instructors / trainer.)
t/?4P/ETZ_
Page-
tl:iD{1*lJl,.i** i\kir<.;v1*:'rL**AL$-1i. J exnp\'}'*rriForary iJii'{;cl(}r1: {i ftit flJPA....l"iio....Fnck;*i,;+11.1 .;ip!:rrpa'**tlt*',1"Fiful-'1. il()C ii?,' i Tril$
IIAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION FORM
For (Jse by Unidocs Member Agencies or where approved by your Local Jurisdiction
Authority Cited: Health and Safety Code $25503.3(c); I9 CCR 52729'5(c)
To: Agency Name: San Luis Obispo County Environmental Health Seryices
Agency Mailing Address: PO Box 1489 San Luis O 943406
FAX 805-7814211
pursuant to Section 25503.3(c) of California Health and Safety Code (HSC)' the Hazardous Materials
Business plan (1IMBP) certification described below is hereby submitted for the following facility:
Facility Name:sTrtA- ,4urcrut'nvE
Facility Street Address:
Date of Current HMBP:
tqE -' r w,Jk ffiA,u /onn Crty:9t/ / t//s ed$t)
/o t'),,eo L (/ r',}06
I certifu that: (Check the appropriate box.)
H I have personally reviewed the Hazardous Materials Business Plan currently on file with your agency and
certifl that the tttr4gp is complete and accurate . (See bottom of page for details.) If this facility is subject
to Federal Emergency Planning and Community Right to Know Act (EPCRA) reporting requirements, I
have submittea tfre following documents with this Certification Form: Unified Program Consolidated Form
(UpCF) Business Activities page; UPCF Business Owner/Operator Identification page with current
signaru*re and date; Hazardous Materials Inventory Statement page(s) with an original signature, photocopy
oiul original signature, or signature stamp on each page for all Extremely Hazardous Substances (EHS)
handled at or ab&e their Federal Threshold Planning Quantity (TPQ) or 500 pounds, whichever is less.
or
I ilvisions to the Hazardous Materials Business Plan are necessary. The HMBP as revised is complete and
accurate and is being implemented. A copy of the revisions has been electronically submitted or is
enclosed with this Certifiiation along with a signed UPCF Business Owner/Operator Identification page
and UpCF Business Activities page if the HMBP revision include changes to the Hazardous Materials
Inventory Statement.
OWI\ER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my
inquiry of those individuals responsible for obtaining the information reported aboveo I believe that the
r,rb-iit"d information is true, accurate, and complete. I understand that a revised HMBP must be
submitted within 30 days of any change in this facility's storage or handling of hazardous materials that
would require updating of the HMBP.
nd,r/i;rt I tr A,$p,/.;tJTitleName of Owner/Operator (Print):
Phone: 8o:{, {1t,7 Y;n Signature Date:
, The information contained in the HMBP most recently submitted is complete, accurate, and up-to-date; and
. There has been no change in the quantity of any hazardous material as reported in the most recently submitted Hazardous Materials
Inventory forms; and
, The facility has not begun handling any hazardous material in a HMBP reportable quantity that is not currently listed in the
By checking the upper box on this form, you are certifying that;
Inventory;Materials andHazardous
andIIof02242TitletheofUnitedStatesinformationtheSectionCode;HMBPsubmitted contalnsmostThe byrequiredrecently
theof HMBPcurrentrevlslonwouldthatthenshaveTherenobeensubstantial
uN-039 - 1/l www.unidocs.org Rev. 10i09/07 \$
3ta-
\\S - SAN LU,COUNTY CERTIFIED UNIFIED
l\x,c BUSINESS OWNER/OPERATOR IDENTIFICATION
AGENCY
IDENTIF'ICATIONI.
BEGINNING DATE
tfl /'n/06
100 l0lENDING DATE€FACILITY ID#
t02
-2BUSINESS NAME (same as TACILITY NAME or DBA - Doing Business As)
sfAR A,t ronAoflr/E
3
BIJSINESS SITE ADDRESS ^ A
[" rl S* r f/+^lK hrTu4t toftr:
103
ZIP CODE
?JY,t t
105"''3,J Lu $ CIR{s,o
104
CA
DUN & BRADSTREET t06 SIC CODE (4 digit #)1ss I |J]
'ou*'" SAa/ Lurs o\6pa
I Ott
BI.JSINESS OPERATOR NAME
BRtrtn'l tt/*rl4fu 6n
109 il0BUSINESS OPERATOR PHONE
ErsS- Slt-f?ts
II. BUSINESS OWNER
112O\AAIER PHONEilLOWNERNAME
il5t orc e/t ff:Wq-,v?ta
lt6'"" Srtnl /,ttts og/ffi ll4
III. ENVIRONMENTAL CONTACT
ll8CONTACT PHONEShvr *s d -r t\1CONTACTNAME
l19CONTACT MAILING ADDRESS
STATE t21 ZIP CODE r22120CITY
IV. EMERGENCY CONTACTS _SECONDARY_-PRIMARY-
'Tnni i,t/*rr"Pt,ry
128NAME
BR ut ^-t t1//17"-t P LEnNAME
4*r{ E{(
129TITLE
Qu,l{(a
124TITLE
BIJSINESS PHONE"'"'"
8o 5* q,{9 " }oof r30BUSTNESSlf ";? - &t z -7 f L-)
125
24.HOUR PHONE24-HOUR PHE{E -126
132P#PAGER#/CELLPHONE
133ADDITIONAL LOCALLY COLLECTED INFORMATION:
aA /=,^t
Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certi! under penalty of law that I have personally examined anp
am familiar with the information submitted and believe the information is true, accurate, and complete. I
)i/NER/OPERAJ9F OR DESIGNATED REPRESENTATIVE I DATE t . t345"d/n-- I /o /zo/oL
NAME OFDOCLWIENT PREPARER I35
Bn,^l L'tlt-nYUrt
SIGNATURE OF
OUrrldz
TITLE.OF SIGNER t37NAME OF SIGNER (orintl
Brdia f/rawPtcr\136a/
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C
FORM I _ SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
one material or
K.v
Page ofIDELETEEREVISE
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
s'ay/4 t"x-/ tLPq" rat/'P /oar9rr+r< A,trcmort {€
3
CHEMICAL LOCATION CONFIDENTIAL EPCRA
[J vrs pNo
202CHEMICAL LOCATION
6,4i-F'ml y' fppn /?an-a 1to ?s,ru t
201
FACII,ITY ID #
I MAP# (optional)203 204GRID# (ootional)A8
II. CHEMICAL INFORMATION
PETROLEUM HYDROCARBON
CHEMICALNAME 205 TRADESECRET flYes ENo
If Subject fo EPCRA, refer to instructions
206
COMMONNAME
WASTE OIL/OIL FILTERS
207
EHS*
208
EYes XNo
*If EHS is "Yes", all amounts below must be in lbs,
CAS#
N/A
209
FIRE CODE HAZARD CLASSES (complete if required by cuPA)210
HAZARDOUS MATERIAI TYPE
(Check one itern only)E A. PURE 8 b. MIXTURE X C. WASTE
2tt 212
RADIOACTIVE [ves [No
213
CURIES
PHYSICAL STATE
(Check one itern only)E A. SOLID X b. LIQUID E C. GAS
2t4 215
LARGEST CONTAINER
FED HAZARD CATEGORIES
(Check all that apply)X A. FIRE E b. REACTIVE I C. PRESSURE RELEASE X d, NCUTE HEAITU El C. CHRONIC HEAITH
216
2t<)ANNTJAL WASTE AMOIJNT
/ 0 o Grhoo)
S'I'A'I.E WASTE CODE
221
22t)211AVF,RAGE DAII,Y AMOIJNTilz G'tw,J
214MAXIM{JM DAILY AMOI]NT2 Grn uJ
UNITS*
(Check one itern only)
E b. CUBIC FEET fI C. POUNDS
*If EHS, amount must be in pounds.
EI a. GALLONS E a. roNs 221 DAys oN rttrl
FO
222
I e. PLASTICNONMETALLIC DRUM
Etcan
l-l c CARBOY
E h. stlo
E i. FIBERDRUM
EJ BAG
! k. Box
I I. CYLINDER
! rn. GLASS BOTTLE
I n. PLASTIC BOTTLE
! o. TOTE BIN
! p. TANK WAGON
223
n r. OTHER
n q. RAILCAREc.
Sa.
STORAGE
CONTAINER
E a. ABOVE GROUND TANK
E b. UNDERGROUND TANK
TANK INSIDE BUILDING
STEEL DRUM
X a. AMBIENT E b. ABOVE AMBIENTSTORAGE PRESSIJRE ! c. BELOW AMBIENT
STORAGE TEMPERATURE E A. AMBIENT E b. ABOVE AMBIENT I c. BELOW AMBIENT E d. CRYOGENIC
225
VoWT HAZARDOTIS COMPONENT (For mixture or rvaste only)FJHS CAS #
I 100
226
PETROLEUM HYDROCARBON
221
[Yes XNo
229
230
2
231
[Yes ENo
232 233
234
-t
235 236
[Yes DNo
23'1
238
4
239 240
[Yes ENo
241
5
243 244
lYes lNo
245
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA. Please Sisn Herc
246
l-.1Mffi*1\$crver\LOCAL$*1\l"emp\T*mporary ilirectory 1S for CUPA File Packagelll.zip\cupa\examples\WA$T*lL.l]OC 13-
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!nevtsE 200E(noo EDELETE Page of
I. F'ACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
Srtn fturarrtu*flli
3
CHEMICAL LQCATION'u:iY:'F viiSt< FltfrM Paro ftto 7380 t 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA
E YES Q1r.ro
202
FACILITY ID #f':I MAP# (optional)203 GRID# (optional) 204
A8
II. CHEMICAL INFORMATION
ETHYLENE GLYCOL + OTHER GLYCOLS
CHEMICALNAME 205 TRADE SECRET IJ Yes DfNo
If Subject to EPCRA, refer to instructions
206
EHS*
208nYes ENoCOMMONNAME
WASTE ANTIFREEZE
207
*If EHS is "Yes", all amounts below must be in lbs.
CAS#
107211
209
FIRE CODE HAZARD CLASSES (complete if required by cuPA)2to
2t3
CURIESE A. PURE I b. MIXTTIRE X C. WASTE
2tt
HAZARDOUS MATERIAL TYPE
(Check one itern only)RADIOACTIVE Dves XNo
I A. SOLID E b. LIQUID D C. GAS
214
PHYSICAL STATE
(Check one itern only)
2t5
LARGEST CONTAINER
! a. FIRE E U. NPECTIVP I c. PRESSURE RELEASE X d. ACUTE HEALTH E e. CHRONIC HEALTH
216
FED HAZARD CATEGORIES
(Check all that apply)
AVERAGE DAILY AMOUNT
I ktttta 'J
218MAXIMUM DAILY AMOUNT
3 ttt-c', J
219ANNUAL WASTE AMOUNT
9o o Ga'uu ^)
STATE WASTE CODE 220
DAYS ON SITE:lr0! b, CUBIC FEET ! C. POUNDS
*If EHS, amount must be in pounds.
X a. GATLONS E d. TONS
(Check one itern only)
221UN]TS*
E a. ABOVE GROUND TANK
! b. UNDERGROUND TANK
I c. TANK INSIDE BUILDING
Sa sretr. lnuv
!i!j
nk.!t.
FIBER DRUM
BAG
BOX
CYLINDER
I rn. GLASS BOTTLE
I n. PLASTIC BOTTLE
E o. TOTE BIN
I p. TANKWAGON
223
! r. OTHER
! q. RAIL CAR
STORAGE
CONTAINER
! e, PLASTIC/NONMETALLIC DRUM
I t cntt
g. CARBOY
h. stLo
X A, AMBIENT E U. AEOVB AMBIENT E c. BELOW AMBIENTSTORAGE PRESSURE
224
STORAGE TEMPERATURE X a, AMBIENT ! b, ABOVE AMBIENT I c. BELOW AMBIENT n d. cRYocENIC
225
HAZARDOUS COMPONEN'I (F'or mixture or waste only)EHS CAS #Y"WT
ETHYLENE GLYCOL
227
EYes XNo
228
107211
229
150
226
231
EYes ENo
232 2332Jt)
2
235
[Yes lNo
236 237234
3
238
4
239
I Yes E l.lo
240 24t
243
EYes ENo
244 245242
5
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA. Please Sisn Herc
246
FORM I - SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
material or
1\$*rvcr\t-Of;Al$-1\T*mp\Temp*rary ilir*ctory I for CUPA I ils Fasksselll.uip\cupa\examplee\WASTANTI.DOC 13-C:\llCICUMtu -*-\s
.'-.) FORM E
SAN LUIS OBISPO COLINTY CERTIFIED LINIFIED
PROGRAM AGENCY (CUPA)
EMERGENCY RESPONSE PLAN
Or Hazardous Waste Contingency Plan
(see instruction page vii)Datez I 0 2 0
SECTION I-A: BUSINESS IDENTIFICATION DATA
Sztrc ,furorwozzra
BUSINESS NAME
645-F T/+/k frtntt /ow .Gil lwrs etsl,-rfo fefa I
SITEADDRESS
P ftos^-rrs - 7f)7CITYZIP CODE
FACILITYTINIT 3i/o
fn hp 3?b CJ /uzt o&rffo fsYal - 32 /o
TELEPHONE NIIMBER
BUSINESS MAILING ADDRESS CITY ZIP CODE
Ifyour business has a license or permitfrom any ofthefollowing agencies, pleose iwlicale the document numher.
l. Hazardous Materials
Underground Storage #,'//r+
2 Flazardous waste tr+ t moa
3. Air Pollution Control
District #
4. Responding
& Permit #
Fire Dept
z/rE
3
Please provide the following information as it pertains to your business and its location. You are not required to noti$ these companies in the
event of an emergency, This information is provided for your reference and to assist emergency response personnel in responding to a
hazardous materials emergency at your facility. List the name and phone number of the utility company.
PG+g'8oo - 7rs-soooElectric Service
Gas Service
Sanitation
Water District
So
Sn"l lu ts €ntw
8m- Ta>- e 00c
8oS- E// 3 -@9';r
{os - {Vr ,- // 33
Telephone #
Telephone #
Telephone #
Telephone #
SECTION I-B: OWNER CERTIFICATION OF DATA (Certiff either 1 or 2)
l. This is uSnnw nlan [utnATED Existing Plan. I have personally examined the information it contains and am familiar with the
operation ofthe plan. (If you check either of the above two options, continue to complete the remained of the Emergency Response /
Contingency Plan).
Z. I fnis plan requires no change and is on file with San Luis Obispo County Hazardous Materials Unified Program Agency and does
not need any change. (If you check this section, please proceed directly to Form T, the Training Program.)
I certi$ under penalty of law that the above information is true and accurate.
/4)u{*rrt*/7
PRINT NAME OF OWNER OR OPERATOR DATE
2a d 6
DOCTJMENTS PREPARED BY DATE
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SECTION EMERGENCY RESPONSE PLANS ANP
Note: Complete all sections of this Emergency Response Procedure below. Use of terms such as "N/A" (Not Applicable) will not be accepted.
A. FIRE, SPILL OR RELEASE: The fire code requires immediate notification through dialing 911, by whoever first sights the
incident. In the event of release or spill of hazardous materials, you must also notify:
l. San Luis Obispo County Hazardous Materials Unified Program Agency during business hours @ 805-781-5544. After
business hours dial 911.
2. The State Office of Emergency Services - (800) 852-7550 or (916) 262-1621.
List the individuals responsible for verifying that these calls have been made and also indicate their position in your company.
FOR VERIFYING THE DIALING OF 911:
[k rtA Otfrt"nfrcrt palz/rr(
POSITION
Individual..ro"::[:. for calling San Luis obispo County Hazardous Materials Unified Program Agency and the State office of
Emergency Services: (N
Barrt J
ormally the Emergency Coordinator of your business.)
NAME POSITION
B. List the local emergency medical facilities that will be used by your business in the event of an accident or injury caused by a release
or threatened release ofhazardous materials.
S/drsni /a
NAME ADDRESS CITY PHONE
fnzztet hbspoaz- /f// W^/,td^/ 4/E ,9n/ l.u ts lt?nIfa 8o{* Sy?* sJS3
NAME ADDRESS CITY PHONE
C. List the Emergency Coordinator(s) at your facility
Primary:rlr?^ ahorrtrrz nukfuY-ry3-'vfiz
NAME TITLE BUSINESS PHONE 24 HR PHONE PAGER#
Secondary: {nn r ) l$fru€trfa {7aJ^W? /pS-v{?4mI
NAME TITLE BUSINESS PHONE 24 HR PHONE PAGER #
D.Does your business have an on-site emergency response team?
the event ofa release or threatened release ofhazardous materials.
lYes pNo Describe procedures your business will follow in
c
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E. Ifyou have acutely hazardous threshold planning quantities, ,name and address) adjacent neighboring
businesses and residences, schools, hospitals, etc. Include sensitive facilities (schoolso hospitals and rest homes) within I
'000
feet
(straightJine distance from your property line). List telephone numbers for all businesses; for apartment buildings, list manager's
phone. Do not list telephone numbers for private residences.
ilrr ,SPPue'rBtE.
F'Briefly describe your standard operating procedures in the event ofa release or threatened release ofhazardous materials.
Emergency response procedures must comply with all federal, state and local regulations. Existing emergency response procedures
may be referenced and attached to this document.
1 Prevention -- Describe the accident potentials associated with the hazardous materials present at your facility. What actions
would your business take to reduce accident potentials? Include description ofsafety, storage and containment procedures.
fr /* r"t*s
Mu;r-tl
ra/g otx d4aft k ,tZeZ
ts
,,Equipment - List the emergency response equipment at your facility (e.g. fire extinguishing systems, spill control equipment,
decontamination equipment).
Use Location
z t />)*r-4ac fiars h/gsr wqt/L
Saz#l u./m"tfi6a 6rtr-s
ABP firtos f:i'S/- ir/+(/
s7a1!5fr't /il,f"'rl. "#&
Item Maintenance Procedure
*-,kpnaa
/o/
loi
r/
A
t,tl u
Pr16
Evacuation -- Describe how you will immediately evacuate your facility. What communications or alarms are used? How will
you operate these during power failure?
3.
t 7-S 0/1fE / S 66
Doore "Pr.nrt*r,A,,+"u/ b2aL CIAl FfrS7 u/A42.- 19 /svc/? lctc/&a hon- //vr/z'i:,
/,r UNLaekto r
t€ntrt trts Eut 7-7et^-A /fu0u, f>r7 tVfn*er rE ft r.
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Page
4. Shutdown - Describe the shutdown for each site or facility
fWJ 0F E rtu'PcZs /r1/ l/Lq'z'v?/a4 d& hvrT * -bum .vir (*e{Gn ,
LUrtzra /'ln^l /< Fkzz.flrad 0F /wnrzb fi- ilazrt W&n"rt z
A'ftf-ro, /rttltz- i-g o^/ ffi {'/rranrro) 47- ftazrt ffi cldrz-,
5a.
/tT dts tltt rT -'u/'ut
Response -- Describe what is done to lessen or mitigate the harm or damage to person(s), property, or the environment, and
prevent the event from getting worse or spreading. What is your immediate response to:
Fire:7J fi*tm t-y
fra /ErfieD /tFrJ .pr*A (u41f/.r-'slcta- ,4/t' 9*vTZiEa ffirtrAta[rt€
Exprosion: b).f EuA r-4 . APt* frftc ep7 n r€rt /n,./feaz-a,
Spilr: futof c/P 7dl7rt Shap ,€r+€S
Earthquake 7 o uJ/T/*
*/1/A /Vl:rfu /ailDt t7-.
Major Power Failure:
Flood: f4p gg fuAS " /t/ulP V- SnUfdc" /t/4p.4 FZcnz L/rV t >
b. Is this facility located on a 100-year flood plain? [Yes K*oc. Earthquake - Identiff facility areas and list mechanical or other systems that require immediate inspection or isolation because of
their to related ground motion.
_t I
6. Clean-Up (Remove the Hazard) -- How do you handle the complete process of cleaning up, and disposing of related materials at your
faci Note: Notify the Hazardous Materials Unified Program Agency when clean up is complete.
(un-rzre7- C u / n 2f-tr e€
WfiJ 7E LI/LL &r Ar,4-rcfl;-o 4rua Dslostra Otr off,n7T ,
G. Location -- Your business is required to keep a copy of the Business Plan and related MSDS sheets on-site. Describe where this
information is located.frtr4 Cr8nucr - r4e'rzza.J tzat
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F'il oc'
I
I
JI
lt
7(,
NO
YES
NO
NO
NO
NO
YES
YES
Under penalty of law, I declare
that I have followed the
flowchart and checked the
boxes that are Appropriate for
this business'sloperations. I
also understand that the SLO
County CUPA must be notified
if our operations or procedures
change and make the above
statement inaccurate.
Strl,,o dnmfttx
Wis4)uffl/ro' ,r
Business Name
6ct s-trr/ilk ffrfln
|to, Cn ciJva t
/o
Date
YES
YES
YES
YES
NO
NO
YES
Sign and submit
you need not
submit a business
plan or pay a fee
ls your facilitY:
A): a r€mote site (a remote site is defined
as an unstaffed facility located in an
isolated, sparsely populated area. The
faeility is secured and not accessible to
the general public) and
B): is the inventory less lhan: 500 cubic
feet cor$pressed inert ga6, 500 gallons
combustible liquid fuel, 200 gallons
electrolytes in closed containers, 500
gallons lubricating and hydraulic fluids,
and 1,2Oi gallons of flammable gas used
as fuel (propane)?
x
All otber ctties and unincornoratetl areas:
time fee.
Submit a business plan and pay an annual
fee to:
san Luis county cuPA, Po Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
Aqrbullura1 bua,heoses j
San Luis County D€pt of Agriculture
2'156 Sier,ra Way, Suite A
San Luis Obispo, CA 93401
Ph: (305) 781-5910
Submit a otre time
business plan,
complete
exemption form R
and pay a one
Sign this document -
you need not submit
a business plan or
I PaY afee
Do you store ONLY
motor or lubricating oil
and is the total volume
less than 275 gallons?
(Does not include
waste oil)
Submit Forat S,
Fonn l, and Fonn M
one time only and
pay a one time fee.
Other
Business I
Within San Luis Obispo citv timits.
SLO City Fire Oept, 2150 Santa Barbara Ave
San Luis Obispo, CA 93401-5240
-Ph: (805) 781-7380 I
NO
}u,rn"N r ${Pr.ir/t, PDATE t",, .)*
r{I1
tl
tl
I]
I]
t1
I]
CREATE NEW RECORD (App. attached)
CHANGE CURRENT RECORD
CHANGE OF OWNERSHIP (App. attached)
TEMPORARILY INACTIVATE FACILITY
CLOSE FACILITY
FAclLlrY # -7 iq'z
PROGRAM# //LIOU
pE //eb
€ HruTdiorui.,;
CHANGE CURRENT INFORMATION TO:
e^kn U\"4.(":l ..t-t.t,i ) \
hIAZARDOUS MATERIALS SPECIFIG:
Number of Materials
Number of Waste Streams t-5
Number of Tanks
LABEL INFO: lufttew [ ] Conected
site Address: b,l"s € f,,^k Qrr^ l7-t.*l City:t^,t^-o
Site Name:4-I-,/ A.^k)vl
Reviewed by linitiall:
Supervisor t l
Requested by:
Date:
lnput Entered by:
Date:
Copy to:
4
tzjul
Other IL
finu* \a\ra.\ "
q c"€/-'
C:'CCCULlEiiTFcrrns',GEi'!E3ALiiiFqFiL:.:CC ::-F*!-i:
Environment'o JalthServices oryG
srnufis(805) 781-5544
P.O.Box 1489
2156 Siena Way
gan Luis Obisoo. CA 93406
BPOT
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
AT02
oHspo
Fire Deoartment (80il 781-7380
Date: 04102/200'l
? I 60 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIF'IED I]NIF'IED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
BUSINESS PLAN
Business plan is complete, current, available during inspection (IISC 25503.5, Title 19 CCR2729)
Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)
Site layouUfacility maps are accurite (HSC 25504, Title 19 CCR2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CC8,2732 & 22 CCR 66265.f6)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR)
66265,16
EMERGENGY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (IISC 255M, Title 19 CCR273I &22
ccR s 626s.s3t54'
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment. Maintains all required or appropriate
equipment including an alarm and communications system (Title 19 CCR 2731& 22 CCR
ABOVE GROUND PETROLEUM STORAGE TANKACT
SPCC Plan is reviewed and certified by a registered enginecr within last 5 yrs. (40 CfR 112.5(b))
SPCC Plan is maintained on site or neare$t field offrce. (HSC 25270)
YES NO N/A
8trtr
EUtr
Ettrtr
tr
tr
tr
n
E
EI
COMMENTS Go to ttttptlf* *,slapublichc.lth.oryy'enyironmontslheatthrhazaftloua-matedal3.htm to obtain fonrl3 to comply with BPOI€PGI, fRot and EROI
GPS Coordinates: Latitude: GPS Goordinates: Longtitude:
Facility Name: STAR AUTOMOTIVE Aqencv
trEHS
trclw FIRE
lnsoection Tvpe
tlRoutine
trReinspection
trComplaintSite Address: 645 TANK FARM #F
SAN LUIS OBISPO, CA 93401
Phone: (805)543-7827
Facility lD: FA0007392
PROGRAMS INSPEGTED:trHazmat EHW Generator trUST trAGT UCaIARP trTPE
REINSPECTION REQUIRED:trHazmat trHW Generator trUST trAGT trCalARP I]TPE
PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying
records, and determining compliance with adopted codes.
GRANTED BY (NAMEiTITLE): Title: OWNER Name:
INSPECTOR: PETER HAGUE FACILITY REP: BRIAN WAMPLER
FACILITY NAME: STAR AUTOMOTIVE ADDRESS: 645 TAffi( FARM #F
,,\ sAN LUIS OBISPO, CA 93401--)
)
HAZARDOUS WASTE GENERATOR
EPA ID
NTJMBER:
cAL0309381 Total generated/month:
Waste Oil:
Antifreoze:
Lbs or gals (average)
Solvents:
Others:
YES NO N/A8trtr vrol. #
GTOI
EPA ID NO/PERMITS
Generator has an EPA ID number to treaf, storer dispose, transport or transfer hazardous
waste (Title 22CCR$66262.12) If not' Call (8{Xl) 6184942 to obtain your CAL EPA ID
number
HAZARDOUS WASTE DETER]T,IINATION
Ilazardous waste determination conducted (Title 22 CCR $66262.1f)
Elown knowledge Elanalysis Eother
Hazardous waste analysis/test records aro kept for at least 3 years(Title 22 CCR $66262.40.(c)
DISPOSAL/TRAI\SPORTATION
Htzardous wastes werc trrmported and/or disposed to a facility with an EPA ID NO. and permit or
authorizaiion from DTSC (HSC $25189.5' Title 22 CCR $66262.f2)Emilkrufu l-1 ^er ^-
Hazardous wastes are shipped with manifcst (Title 22 CCR $66262.20)
Manifcsts and/or receipts are properly complcted/rcteined by gencrator for 3 yctrr (fide 22 CCIi
96626,..nt 66262.23'
STORAGE AND MANAGEMENT OT' CONTAINERS/TAIIKS
Hazardous wastes sre accumulated on site as follows (Title22 CCR S66262.34)
tr90 days if waste generated per month is greater than or equal to l(X) kg. (220 lbs.)
tr180 days if waste generated per month is less than lfi) kg (see note)
tr2?0 days ifwaste generated per month is less than 100 kg and transported more than 200
miles (see note)
Note: Applies onty if hazardous wa$te accumulated on site never exceeds 600kg(13"200 lbs)
and noacutely/extremely hazardous waste over l.kgQ.zlbs.) is held on site for ovcr 90 days.
Hazardous waste I'satellite" collection is managed properly (complete labeling/accumulation
time/S5-gal or l-qt limit) (Title 22 CCR $66262.34(c))
Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22
ccR $6626s.17O
Containers of hazardous waste are properly labeled (includes appropriate
dater"IIAZARIlOUS WASTE," wsste composition/physical state, hazardous properties'
name/address of generator) (Title 22 CCR $66262.31, ffi262.34)
Containers/tanks containing hazardous wastes are in good condition/handled to rrinimize the
release or reactlon (Title 22 ccR $66265.1710.191,66265.177(c)
Containers/tanks/liners are compatible with waste stored or transferred (Title 22 CCR
s66265.172)
Containers storing hazardous wastes are closed/sealed (Title22 CCR S66265.f73)
Weekly inspection of areas where hazardous waste container$ are stored is conducted (Title 22
ccRs6626s.174)
Daily inspection of all tank systems is conducted and documented (fifle 22 CCR S66265.f 95)
Empty containers or inner liners greater than 5 gal has date when emptied and are managed
properly within one year of date emptied (TitleZz CCR $66261.7 (D)
RECYCLABLE WASTE
Used oil is managed as hrzardous waste until recycled (includes proper lebeling storage' etc)
(HSC $2s250.4)
Used oil lilters for recycting are managed properly (drained of free llowing liquid' stored in
closed rainproof container, labeled *drained used oil filters," and transferred for metal
reclamation) (Title 22 CCR$ 66266.f 30)
Spent lead-acid batteries are being properly stored and transferred offsite under manifest or
bill of lading for recycling, reuse' or reclamation (Title22 CCR S66266.E1)
Solvents/other recyclablo materials are managed as hazardous wsstes until recycled (Title 22
ccR $66266.3)
tr
tr
B
E
tr
E
rl
tr
tr
tr
tr
tr
tr GT03
N GTO4
tr GTOs
tr GT06
tr GT07
tr croS
tr
E
tr
ts
tr
tr
E
E
tr
E
E
E
E
tr
tr
E
tr
tr
tr
B
tr
tr
u
tr
tr
tr
tr
tr
tr
tr
tr
GTO9
GTIO
GTlI
GTT2
GT13
GTI4
GT15
tr GT16
E GTIT
El GTIS
tr GT19
tr GT2O
tr GT21
INSPECTED BY: PETER HAGUE DATE:04/02/2007
Y.ES
tr
tr
FAGILITV NAME: STAR NUT,)OTVE noonf)645 TANK FARM #F
SAN LUIS OBISPO, CA 93401
HAZARDOUS WASTE GEI\IERATOR
NO N/A\ VrOL. # EPA rD NO/PERMITS
SOIIRCE REDUCTION:For facilities generating >12,000 kg./yr. of hazardous waste on site.
tl E GT22 Generator is subject to SBl4 and has prepared and retained current source reduction
documents or is able make them available to the inspector within (5) days. @SC 525244.19,
El tr GT23 Source Reduction Evaluation and Plan contains the following five elements:certification'
amounts of wastes generated, process description, block diagrams, and implementationschedule
ofselected source reduction measures. (HSC S25244.19)
INSPECTED BY: PETER HAGUE DATE: o4to2t2oo7
FACILITY NAME: STAR AUTpMOTTVE ADDR-E\S:
l
645 TANK FARM #F
SAN LUIS OBISPO, CA 93401
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E
ST]MMARY OF OBSERVATIONS/VIOLATIONS
No violations of underground storage tanlq hazardous materials, or hazardous waste laws/regulations were discovered.
SLO CTIPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
Violations were observed/discovered as listed below. All violations must bo corrected by implementing the corrective action
listed by each violation, Ifyou disagree with any ofthe violations or corrective actions required, please inform the CIJPA
in writing.
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA MuSt bE iNfOTMEd iN
writing with a certificfltion that compliance has been achieved. A falso statement that compliance has been achieved ls a
violation of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility
may be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective
actions. The issuance of this Summary of Violations does not preclude the CIIPA from taking administrative, civil, or
criminal action.
FACILITY NAME: STAR AUTOMOTIVE ADDRESS: 645 TANK FARM#F
SAN LUIS OBISPO, CA 93401
PE NO
1126
vtol+ATloNs
VIOL. NO VIOL. TYPE
GT11
CORRECTIVE ACTION RESUIRED
IMMEDIATELY BEGIN TO PROPERLY LABELALL CONTA]NERS OF
HAZARDOUS WASTE, IMPLEMENT APROCEDURE TO ENSURE
THAT ALL CONTAINERS OF HAZARDOUS WASTE ARE
PROPERLY LABELED. THE FINE FOR THIS VIOLATION IS AN
INITIAL PENALW OF UPTO $25,000, AND THEN AN ADDIT]ONAL
TWO PERCENT OF THE INITIAL PENALW PER DAY
THEREAFTER.
PLEASE LABEL DRUITIS OF WASTE OIL AND ANTIFREEZE.
INSPECTION COMMENTS:
INSPECTED BY: PETER HAGUE
DATE: o4to2/zw7
NAME OF FACILITY REP: BRIAN WAMPLER
SIGNATURE OF FACILITY REP:
I certify under penalty of perjury that this facitity has complied with the corrective actions listed on this
form.
of Owner/Operator:Title: Date: