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COMPLIANCE INFO_PRE 2019
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1900 - Hazardous Materials Program
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PR0520571
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
5/21/2019 1:18:15 PM
Creation date
6/12/2018 8:52:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0520571
PE
1920
FACILITY_ID
FA0001858
FACILITY_NAME
MY MINI MART
STREET_NUMBER
1756
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11721005
CURRENT_STATUS
Active, billable
SITE_LOCATION
1756 N WILSON WAY
P_LOCATION
01
P_DISTRICT
002
Supplemental fields
FilePath
\MIGRATIONS\W\WILSON\1756\PR0520571\COMPLIANCE INFO 2016 - 2007 .PDF
QuestysFileName
COMPLIANCE INFO 2016 - 2007
QuestysRecordDate
9/6/2017 6:38:32 PM
QuestysRecordID
3306790
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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C£RS Consolidated Emergency Response/ Contingency Plan —Page d of I <br />RECEIVED <br />MAY 21 2018 <br />ENVIRONMENTAL HEALTH <br />PERMIUSERVICES <br />Ree, aaRTltI <br />H. EARTHQUAKE WLNERABpdTY <br />Idemrf) areas of the faabry that arc vulnerable to hv>udous manna 1, releases spills due 1, eariNvako-relsld radon flies, yeas regwrt Immadwe nolnwn and <br />'flineetwo <br />VULNERABLE AREAS (Check all that apply in LOCATIONS (e.g.. shop, outdoor shed forensic Into <br />® I HAZARDOUS MATERIALS WASTE STORAGE AREA Cann! ark:. on weaueada.ana or <br />❑ 2 PROCESS LINES/ PIPING in <br />❑ 3 LABORATORY 11+ <br />❑ 4 WASTE TREATMENT AREA sit <br />d,rtltPo mechanrW wWems vullserv6le to mlems s Tls due W ears foie -Mimed mesion These sleets n wrt ImmeJmlr Isulaoon and oo Ilan. <br />VULNERABLE SYSTEMS. (Check all that applyI Rn LOCATIONS <br />❑ 1. SHELVES, CABINETS AND RACKS ser <br />® 2 TANKS(EMERGENCY SHUTOFF( ion roPsxdranud wvnr,y au usr,e. 4,�.nwr lu <br />❑ 3 PORTABLE GAS CYLINDERS I tee <br />❑ 4 EMERGENCY SHUTOFF ANDiOR UTILITY VALVES til• <br />❑ 5 SPRINKLER SYSTEMS all <br />❑ 6. STATIONARY PRESSURIZED CONTAINERS Ieg., Propane dispemmg tank l til= <br />L EMPLOYEE TRAINING <br />Esphartiaa sr Regdremmc Finplo,, ee vmmng is required for WI errglo)e,s handling haltardulu Iwtrnmm <br />als and hadou,s warms In da)--dam <br />y or cleaup uperaolou <br />including volunteers mid w coonanors. Training must be <br />• Provided wohtn 6 molls lisr sew hirci, <br />• Amerded as neeess in poor to clung, In process or work avrngnlrent, <br />• Given upon mulifiuuon to the En ergcm) Response Comingrw) 1•lan, and updated'refresbed annually for all engdmees <br />Requiredcontent Includes all of the folluwmg <br />• hitswial Safety Iota Sho m • Cammuneation told alarm systems. <br />• Harmd commumcauo r related m hzllb and satin. • Ilei. al prulecuve equtpmem. <br />• Methods for late handling of ha ani.. ]ubslallces. • Llw ofesrergenc) response, egulpmvra I g Fire ewngumhem, reapsrwun, <br />• Fue hurards of malenals processes. em). <br />• Conditions bkel) to None" emergcnrlu. • Dczovirroo canon inmudures. <br />• Coordination ofersurgenc) response, • Evocwliun pnredures: <br />• Notification procedures; • Control ad containment procedures. <br />• Applicable Ima and regulations. • UST wittloring system equipuscro Will procedures Ufapplaablel <br />INDICATE HOW EMPLOYE:L TRAINING PROGRAM IS ADMINISTERED (Click all that apph ) <br />❑ I FORMAL CLASSROOM, ❑ 2 VIDEOS, ® 3 SAFETY, TAILGATE MEETINGS, <br />04 STUDY GUIDES/ MANUALS(Speeifyln <br />915 OTHER (Speed) ). usT dmpusa apraor m,Y ur.lp u <br />❑ 6 NOT APPLICABLE BECAUSE FACILITY HAS NO EMPLOYEES <br />Urge Qlmnll) Gmenner(I.QG) I mining Record.: Large quanllry hazardous NNC g,nelwur] 11 c. Nhr gelewe rrlurc otos .Tp g:lllmu I,UW kdugnms of <br />IlaIDrd0LL1 MY1IC (li! InUnd1) mYTt fClaln Nrlll[n JJ[Ylnvnrwltln til Cmp10\K hLVird0LL5 NaAe IIYRigellCnl lmining aef5lam N61ea IMIWI[a <br />• A Nnnen uwhncagcdo of the I)pe ad amnoo of hath inuoJu:son and continuing training Iht •dl be elven to perons filling each job postcon having <br />respomrhlin for Ili: rtnnagttnaa of hleaNuus Paste le it. late hn&'n ooresun& compliance Nnh accumulution time limos, tie 1. <br />• fTa: lura, lob role, ad dale ofirwmng lot each hvanlwn Nasac nWngcment mining s niton given to an employee filling such slob position. ad <br />• A Nnurniob description for rWch of Ibe above job posiuom that dcwnbes lob dunes ad the skills, eduouun, ordher yunlifiwuons reyund of perwnncl a]Wgned <br />to the position <br />• Cwrenl employ,, "unng records mut be rewired until classic, of the I-V Ilio) <br />• Fonder em lovee training nYrads mull be retained at IC W three ]cars after Ienmnawrn of ctrif,101 mem <br />J. LIST OF ATTACHMENTS <br />tCheck arc of to fullowmgl a' <br />©I NO ATTACHMENTS ARE REQUIRED, ser <br />❑ 2 THE. FOI LOWING DOCUMENTS ARE ATTACHED. I' <br />K. SIGNATURE/ CERTIFICATION <br />Cenllkatba: Based on on in(uln of Nus, individuals responsible for ublaimng the Infonratmn, I ccmfi Inkier pcndn of Lin, that I love pasarWl) eswnined ad <br />M familiar won [be mformnlon wbmmed and believe the information n It actunue, and complete, and dW a copy Is available on Wm. <br />SIGNATURE DOWNER OPERATOR <br />DATE SIGNED <br />L 4v 5 <br />sI <br />I �" <br />ykvu- <br />NAME Of SIGNER I pan <br />TITLEOFSIGNE <br />Ashish Bove'a <br />Operator <br />
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