|
5HY3DJHRI
<br />&$/,)251,$(19,5210(17$/5(3257,1*6<67(0 &(56
<br />&2162/,'$7('(0(5*(1&<5(63216(&217,1*(1&<3/$1
<br />Prior to completing this Plan, please refer to the INSTRUCTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLAN
<br />$)$&,/,7<,'(17,),&$7,21$1'23(5$7,21629(59,(:
<br />)$&,/,7<,'$
<br />%86,1(661$0( (Same as Facility Name or DBA - Doing Business As)$
<br />%86,1(666,7($''5(66 $
<br />%86,1(666,7(&,7<$=,3&2'($
<br />&$
<br />7<3(2)%86,1(66 HJ3DLQWLQJ&RQWUDFWRU $,1&,'(17$/23(5$7,216 HJ)OHHW0DLQWHQDQFH $
<br />7+,63/$1&29(56&+(0,&$/63,//6),5(6$1'($57+48$.(6,192/9,1* &KHFNDOOWKDWDSSO\ $
<br />+$=$5'2860$7(5,$/6 +$=$5'286:$67(6
<br />%,17(51$/5(63216(
<br />,17(51$/)$&,/,7<(0(5*(1&<5(63216(:,//2&&85%< &KHFNDOOWKDWDSSO\
<br />&$//,1*38%/,&(0(5*(1&<5(6321'(56 HJ
<br />&$//,1*+$=$5'286:$67(&2175$&725
<br />$&7,9$7,1*,1+286((0(5*(1&<5(63216(7($0
<br />%
<br />&(0(5*(1&<&20081,&$7,2163+21(180%(56$1'127,),&$7,216
<br />,QWKHHYHQWRIDQHPHUJHQF\LQYROYLQJKD]DUGRXVPDWHULDOVDQGRUKD]DUGRXVZDVWHDOOIDFLOLWLHVPXVW,00(',$7(/<
<br /> 1RWLI\IDFLOLW\SHUVRQQHODQGHYDFXDWHLIQHFHVVDU\LQDFFRUGDQFHZLWKWKH(PHUJHQF\$FWLRQ3ODQ 7LWOH&DOLIRUQLD&RGHRI5HJXODWLRQV
<br />1RWLI\ORFDOHPHUJHQF\UHVSRQGHUVE\FDOOLQJ
<br /> 1RWLI\WKHORFDO8QLILHG3URJUDP$JHQF\ 83$ DWWKHSKRQHQXPEHUEHORZ DQG
<br /> 1RWLI\WKH6WDWH:DUQLQJ&HQWHUDW
<br />)DFLOLWLHVWKDWJHQHUDWHWUHDWVWRUHRUGLVSRVHRIKD]DUGRXVZDVWHKDYHDGGLWLRQDOUHVSRQVLELOLWLHVWRQRWLI\DQGFRRUGLQDWHZLWKRWKHUUHVSRQVHDJHQFLHV:KHQHYHUWKHUH
<br />LVDQLPPLQHQWRUDFWXDOHPHUJHQF\VLWXDWLRQVXFKDVDQH[SORVLRQILUHRUUHOHDVHWKH(PHUJHQF\&RRUGLQDWRUPXVWIROORZWKHDSSURSULDWHUHTXLUHPHQWVIRUWKHFDWHJRU\
<br />RIIDFLOLW\DQGW\SHRIUHOHDVHLQYROYHG
<br /> 7LWOH&DOLIRUQLD&RGHRI5HJXODWLRQV(PHUJHQF\3URFHGXUHVIRUJHQHUDWRUVRINLORJUDPVRUPRUHRIKD]DUGRXVZDVWHLQDQ\FDOHQGDUPRQWK
<br /> 7LWOH&DOLIRUQLD&RGHRI5HJXODWLRQV 5HVSRQVHWR/HDNVRU6SLOOVDQG'LVSRVLWLRQRI/HDNLQJRU8QILWIRU8VH7DQN6\VWHPV
<br /> 7LWOH&RGHRI)HGHUDO5HJXODWLRQV1RWLILFDWLRQUHTXLUHPHQWVIRUDUHOHDVHRIDKD]DUGRXVVXEVWDQFHHTXDOWRRUJUHDWHUWKDQWKHUHSRUWDEOHTXDQWLW\
<br />7LWOH&DOLIRUQLD&RGHRI5HJXODWLRQV G DQG7LWOH&RGHRI)HGHUDO5HJXODWLRQV G LL IRUJHQHUDWRUVRIOHVVWKDQNLORJUDPVRI
<br />KD]DUGRXVZDVWHLQDQ\FDOHQGDUPRQWK
<br />)ROORZLQJQRWLILFDWLRQDQGEHIRUHIDFLOLW\RSHUDWLRQVDUHUHVXPHGLQDUHDVRIWKHIDFLOLW\DIIHFWHGE\WKHLQFLGHQWWKH(PHUJHQF\&RRUGLQDWRUVKDOOQRWLI\WKHORFDO83$
<br />DQGWKHORFDOILUHGHSDUWPHQW¶VKD]DUGRXVPDWHULDOVSURJUDPLIQHFHVVDU\WKDWWKHIDFLOLW\LVLQFRPSOLDQFHZLWKUHTXLUHPHQWVWR
<br /> 3URYLGHIRUSURSHUVWRUDJHDQGGLVSRVDORIUHFRYHUHGZDVWHFRQWDPLQDWHGVRLORUVXUIDFHZDWHURUDQ\RWKHUPDWHULDOWKDWUHVXOWVIURPDQH[SORVLRQILUHRUUHOHDVHDW
<br />WKHIDFLOLW\ DQG
<br /> (QVXUHWKDWQRPDWHULDOWKDWLVLQFRPSDWLEOHZLWKWKHUHOHDVHGPDWHULDOLVWUDQVIHUUHGVWRUHGRUGLVSRVHGRILQDUHDVRIWKHIDFLOLW\DIIHFWHGE\WKHLQFLGHQWXQWLOFOHDQXS
<br />SURFHGXUHVDUHFRPSOHWHG
<br />(0(5*(1&<5(63216(
<br />3+21(180%(56
<br />$0%8/$1&(),5(32/,&($1'&+3
<br />&$/,)251,$67$7(:$51,1*&(17(5 &6:& &$/2(6
<br />1$7,21$/5(63216(&(17(5 15&
<br />32,621&21752/&(17(5
<br />/2&$/81,),('352*5$0$*(1&< 83$ &
<br />27+(5 6SHFLI\ &&
<br />1($5(670(',&$/)$&,/,7<+263,7$/1$0( &&
<br />$*(1&<127,),&$7,213+21(180%(56 &$/,)251,$'(372)72;,&68%67$1&(6&21752/ '76&
<br />5(*,21$/:$7(548$/,7<&21752/%2$5' 5:4&% &
<br />86(19,5210(17$/3527(&7,21$*(1&< 86(3$
<br />&$/,)251,$'(372)),6+$1':,/'/,)( &'):
<br />86&2$67*8$5' 86&*
<br />&$/26+$
<br />&$/),5(2)),&(2)7+(67$7(),5(0$56+$/ 26)0
<br />27+(5 6SHFLI\ &&
<br />27+(5 6SHFLI\ & &
<br />$&(56,'$'$7(2)3/$135(3$5$7,215(9,6,21²² ..%%::::<br />10851091 11/25/2020
<br />7-Eleven Inc. #38877
<br />1515 E. Main St
<br />Stockton 95205
<br />Gasoline Retail Store c-store
<br />■■
<br />■
<br />■
<br />(209) 468-3420
<br />San Joaquin General Hospital (209) 835-4934
<br />(916) 464-3291
<br />Dispatch 1
<br />(800) 828-0711
|