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Consolidated Con envy Plan <br /> Hazardous Materials Division for Hazardous Materials,Hazardous Waste- �.Underground Storage Tanks <br /> FACILITY IDENTIFICATION / OPERATIONS OVERVIEW <br /> BUSINESS NAME FACILITY ID# DATE <br /> Jiffy Lube Store #2322 1/20/2014 <br /> BUSINESS ADDRESS <br /> 500 E. Kettleman Ln. <br /> -" Check elements covered by this consolidated <br /> plan, Hazardous Materials ® Hazardous Waste ® Underground Storage Tanks ❑ <br /> Supplemental elements submitted: UST Written Monitoring Plan ❑ <br /> TYPE OF BUSINESS(e.g.painting contractor) INCIDENTAL OPERATIONS (e.g.fleet maintenance) <br /> Automotive Quick Lube Facility <br /> HAZARDS/EVENTS COVERED BY PLAN(e.g.chemical spills,fire,earthquake,etc) <br /> Chemical Spills, Fire, Flood, Earthquake <br /> EMERGENCY COORDINATOR & ON-SITE TECH ADVISORS / INTERNAL RESPONSE <br /> Identify your Emergency Coordinator&On-site Technical <br /> Advisors: <br /> Name/Position: Ti ffy Ville gas <br /> I........_._...—..._..----._... -._........... .................................._... <br /> _._ ..._..._..._.— _ _ <br /> Emergency Coordinator: Address: 500 E. Kettleman Ln. <br /> Must have the authority to classify the -- <br /> release,make management decisions, & Phone#s: Day:209-339-0900 I After hours: <br /> determine appropriate response Responsible for: spill prevention ® contacting facility responders <br /> emergency assessment J <br /> (check all that apply) management ® authorizing spill response work ❑ <br /> Person is: ® on-site or ❑ on-call .._....._......_......_........._..........._..._.....___.._._ <br /> interfacing with public emergency <br /> initiating alarms ® responders _ ❑ <br /> agency notification ❑ other: ❑ <br /> Alternate#1 Alternate#2 <br /> Name/Position: Justin Kydd Herman _ _Glen Ganotis —� <br /> Address: 1471 Shore St. 1471 Shore St. _-- <br /> Alternate Emergency Coordinators: City: West Sacramento West Sacramento <br /> List In order of responsibility. Zip: 9569195691 <br /> ___._..--- _ --.--._-__-.-.._.__.._ <br /> Day phone: 916-375-1155 916-375-1155 <br /> After hours phone: 91 6-267-3663 209-298-5373 <br /> ................................................—................................_....__..._............_............;._....._........_....._.........................-.........----..._................ <br /> - <br /> Person is: ❑ on-site or ®on-call ❑on-site or ®on-call <br /> " On-Site Technical Advisors <br /> Available to provide site-specific technical Owner: Supervisor: <br /> advice to off-site emergency responders) Manager: General Manager I Other: <br /> Identify type of internal response: <br /> Team Members(name or position): Responsibilities: <br /> ❑ Internal facility General Manager <br /> response team g Spill Prevention, Control &Cleanup <br /> 2. Regional Manager Emergency AssessmenVMgmt <br /> (attach additional pages it needed: <br /> Options: ............................-...-_............................ --._..........__.._.__....._.-.._.......__... _— <br /> i indicate an Attachment by Assistant Manager Serve in place during GM absence <br /> checking this box ) -�-_ <br /> (check 3. HSSE Coordinator Guidance for spill response <br /> one or Name:Asbury Environmental Services Describe role/responsibilities <br /> more) _address: 300 E.Oaks Street.Compton,CA.90221 Used Oil,Filters,Antifreeze,Transporter& <br /> ® Contractor �_._..._._ Recycler. <br /> phone#:800-727-2879 Can Provide response for oil Spills. <br /> ® Call public emergency responders 1911 <br /> .............................................................................................................................. <br /> Page CP 1: Facility Identification, Emergency coordinator&Tech Advisors, Internal response <br />