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HomeMy WebLinkAboutHAZ-WASTE REP. 4/23/2012BUSINESS ACTIVITIES KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 FACILITY INFORMATIONBAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 Page I of d I. FACILITY IDENTIFICATION FACILITY ID # (AgencyUse only) I EPA ID # (Hazardous Waste Only) 2 CAL000362304 BUSINESS NAME (Same as Facility Name ofDBA -Doing Business As) 3 Bed Bath and Beyond #407 BUSINESS SITE ADDRESS 5000 Stockdale Hwy 103 BUSINESS SITE CITY Bakersfield 104 CA ZIP CODE 105 93309 H. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, lease submit the Business Owner/Operator Identification page KC Form 2730). Does your facility... IfYes, please com lete these pages ofthe UPCF.... A. HAZARDOUS MATERIALS 4 Have on site (for any purpose) at any one time, hazardous materials at or above HAZARDOUS MATERIALS INVENTORY 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed I YES [K NO CHEMICAL DESCRIPTION gases (include liquids in ASTs and USTs); or the applicable Federal threshold CONSOLIDATED CONTINGENCY PLANquantityforanextremelyhazardoussubstancespecifiedin40CFRPart355, Appendix A or B; or handle radiological materials in quantities for which an SITE MAP emergency Ian is required pursuant to 10 CFR Parts 30 40 or 70? B. REGULATED SUBSTANCES 4a Have Regulated Substances stored onsite in quantities greater than the threshold CalARP — REGULATED SUBSTANCE quantities established by the California Accidental Release prevention Program YES ® NO REGISTRATION (KC Form 2736) CalARP)? C. UNDERGROUND STORAGE TANKS (USTs) 5 UST FACILITY (KC Form A) Own or operate underground storage tanks? YES El NO UST TANK one page per tank) (KC Form B) D. ABOVE GROUND PETROLEUM STORAGE 8 Own or operate ASTs above these thresholds: Store greater than 1,320 gallons ofpetroleum products (new or used) in F-1 YES ® NO NO FORM REQUIRED TO KCEHD aboveground tanks or containers. E. HAZARDOUS WASTE 9 EPA ID NUMBER — provide at the top of Generate hazardous waste? this page YES NO HAZ WASTE GENERATOR FORM Recycle more than 100 kg/month ofexcluded or exempted recyclable 10 YES ®NO RECYCLABLE MATERIALS REPORT materials (per HSC 25143.2)? one per recycler) (KC Form 2732) I I ON -SITE HAZARDOUS WASTE TREATMENT — FACILITY (KC Form 17720 Treat hazardous waste on -site? YES ® NO ON -SITE HAZARDOUS WASTE TREATMENT — UNIT (one page per unit) KC Form 1772u) Treatment subject to financial assurance requirements (for Permit by Rule and YES ® NO Z CERTIFICATION OF FINANCIAL Conditional Authorization)? ASSURANCE (KC Form 1232) Consolidate hazardous waste generated at a remote site? YES ®NO 13 REMOTE WASTE / CONSOLIDATION SITE ANNUAL NOTIFICATION Need to report the closure /removal ofa tank that was classified as 14 HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned on -site? YES ® NO CERTIFICATION Generate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or 14, Obtain federal EPA ID Number, file more of federal RCRA hazardous waste, or generate in any single calendar YES ® NO Biennial Report (EPA Form 8700 - month, or accumulate at any time, 1 kg (2.2 pounds) ofRCRA acute hazardous 13A/B), and satisfy requirements forwaste; or generate or accumulate at any time more than 100 kg (220 pounds) of RCRA Large Quantity Generator. spill cleanup materials contaminated with RCRA acute hazardous waste. Household Hazardous Waste (HHW) Collection site? YES ®NO 14b NO FORM REQUIRED TO KCEHD F. LOCAL REQUIREMENTS ,^u . D 15 A copy ofthe facility's Contingency /Emergency Response Plan is to be included with the original submission ofthe Business Plan. KCEHD is to be informed of any revisions to the plan. Please contact KCEHD at the above number for assistance in completing the plan. APR 2 7 2012 05/2008 revised i KC Form 2729 BUSINESS OWNER/OPERATOR IDENTIFICATION KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 FACILITY INFORMATION BAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 PageJKof I. IDENTIFICATION FACILITY ID# BEGINNING DATE 100 ENDING DATE 101 2012 -04 -23 2013 -04 -23 BUSINESS NAME (Sameas FACILITY NAME or DBA— Doing Business As) 3 BUSINESS PHONE 102 Bed, Bath and Beyond #407 661 - 636 -0717 BUSINESS SITE ADDRESS 103 BUSINESS FAX 102a 5000 Stockdale Hwy BUSINESS SITE CITY 104 ZIP CODE 105 COUNTY 108 Bakersfield CA 93309 KERN DUN & BRADSTREET 106 PRIMARY SIC 107 PRIMARY NAICS 107a 5719 442299 BUSINESS MAILING ADDRESS 108a 5151 San Felipe, Suite 1600 BUSINESS MAILING CITY 108b STATE 108e ZIP CODE 108d Houston TX 77056 BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 110 Bed, Bath and Beyond #407 908 - 688 -0888 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 112 Bed, Bath and Beyond #407 908- 688 -0888 OWNER MAILING ADDRESS 113 650 Liberty Ave OWNER MAILING CITY 114 STATE 115 ZIP CODE 116 Union NJ 070831 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 118 Chris Baker 713 - 625 -7015 CONTACT MAILING ADDRESS 119 CONTACT EMAIL 119. 5151 San Felipe, Suite 1600 chris.baker scnow.com CONTACT MAILING CITY 120 STATE 121 ZIP CODE 122 Houston TX 770561 PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY - NAME 123 NAME 128 Store Manager Scott Simon TITLE 124 TITLE 129 Manager Regional Director of Loss Prevention BUSINESS PHONE 125 BUSINESS PHONE 130 661 -636 -0717 310- 384 -6799 24 -HOUR PHONE 126 24 -HOUR PHONE 131 310 - 384 -6799 310 - 384 -6799 PAGER # 127 PAGER # 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 APN: - - - Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty oflaw that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIG RE OF O R/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134 NAME OF DOCUMENT PREPARER 135 4 Chris Baker NA—ME OF SIGN (print) 136 TITLE OF SIGNER 137 Chris Baker Agent For 05/2008 revised) KC Form 2730 HAZARDOUS WASTE GENERATOR KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Form 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 Page of I. FACILITY INFORMATION FACILITY ID # EPA ID # (Hazardous Waste Only) 2 CAL000362304 BUSINESS NAME (Same as Facility Name ofDBA -Doing Business As) 3 OF EMPLOYEES Bed, Bath and Beyond #407 36 II. TYPE OF GENERATOR PLEASE CHECK THE BOX THAT APPLIES B RCRA GENERATOR NON -RCRA GENERATOR FEDERAL WASTE CALIFORNIA WASTE ONLY LARGE QUANTITY GENERATOR 1000 KG HAZARDOUS WASTE PER MONTH SMALL QUANTITY GENERATOR 100 KG BUT <1000 KG HAZARDOUS WASTE PER MONTH) CONDITIONALLY EXEMPT SMALL QUANTITY GENERATOR 1:3100KGHAZARDOUSWASTEPERMONTH) III. WASTE STREAM IDENTIFICATION PLEASE COMPLETE THE TABLE BELOW. (SEE INSTRUCTIONS ON THE BACK FOR CODES AND EXPLANATIONS) PROCESS C WASTE DESCRIPTION D WASTE ID E AMOUNT F UNITS G STORAGE H DISPOSAL I PER YEAR METHOD METHOD Damaged / Off Spec Product Waste Aerosols 331 120 Pounds C B Damaged / Off S ec Product Corrosive Liquid, Acidic 791 150 Pounds C B Damaged / Off Spec Product Corrosive Liquid, Basic 122 150 Pounds C B Damaged / Off Spec Product Toxic Liquids 331 55 Pounds C B Damaged /Off Spec Product Flammable Liquids 214 200 Pounds C B Damaged / Off Spec Product Oxidizing Liquids 141 100 Pounds C B Damaged / Off Lighters 214 120 C BSecProductPounds I certify that the information provided herein is true and accurate to the best ofmy knowledge. OWNER/OPERATOR NAME J OWNER/OPERATOR TITLE K Chris Baker Agent For OWNER/OPERATOR SIGNATURE DATE L HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661) 862 -8700 Fax (661) 862 -8701 (one pageper materialper building or area) ADD DELETE REVISE 200 Page f 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME orDBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® NO I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1 11. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Aerosols Ifsubject to EPCRA, refer to instructions COMMON NAME zo7 zos EHS` El Yes ® NoVariousAerosols If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Not currently required by KCEHD) 210 2.1 HAZARDOUS MATERIAL 211 TYPE (Check one item only) a. PURE [:1 b. MIXTURE ® c. WASTE 212 RADIOACTIVE Yes 1K] No 213 CURIES PHYSICAL STATE 214 Check one item only) a. SOLID ® b. LIQUID El c. GAS 215 LARGEST CONTAINER 18G FED HAZARD CATEGORIES 216 Check all that apply) ® a. FIRE b. REACTIVE c. PRESSURE RELEASE d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXM DAILY AMOUNT 218IMU ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 331 UNITS* a. GALLONS b. CUBIC FEET ® c. POUNDS d. TONS 221 1 DAYS ON SITE: 222 Check one item only) ` IfEHS, amount must be in pounds. 180 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM h. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE © a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No If more hazardous components arepresent at greater than 1% by weight irnon- carcinogenic, or0.1 % by weight ifcarcinogenic, attach additional sheets ofpaper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Sin Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 (one page per material per building or area) ADD DELETE REVISE 200 Palte 130fa 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business AS) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® No 1 MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 11. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Carbon Dioxide IfSubject to EPCRA, refer to instructions COMMON NAME 207 208 EHS* El Yes ® NoCarbonDioxide If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Not currently required by KCEHD) 210 2.2 HAZARDOUS MATERIAL 211 212 RADIOACTIVE El Yes ® No 213 CURIESTYPE (Check one item only) El a. PURE [:1 b. MIXTURE ® c. WASTE PHYSICAL STATE 214 Check one item only) El a. SOLID [:1 b. LIQUID ® c. GAS 215 LARGEST CONTAINER 18G FED HAZARD CATEGORIES 216 Check all that apply) a. FIRE b. REACTIVE [0 c. PRESSURE RELEASE d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 1 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 UNITS* a. GALLONS b. CUBIC FEET ® c. POUNDS d. TONS 221 DAYS ON SITE: 222 Check one item only) * IfEHS, amount must be in pounds. 180 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM It. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 l Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No Ifmore hazardous components are present at greater than 1% by weight ifnon- carcinogenic, or0.1 % by weight ifcarcinogenic, attach additional sheets ofpaper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 IfEPCRA Please Sign Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTYENVIRONMENTAL HEALTHDIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661) 862 -8700 Fax (661) 862 -8701 (one page per material per building orarea) ADD DELETE REVISE 200 Page 14 of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES N NO I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # I II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Corrosive Liquid, Acidic If Subject to EPCRA, referto instructions COMMON NAME 207 208 Corrosive Liquid, Acidic EHS* Yes ® No If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Notcurrently required by KCEHD) 210 8 HAZARDOUS MATERIAL 211 TYPE (Check one item only) a. PURE b. MIXTURE ® c. WASTE 212 RADIOACTIVE El Yes El No 213 CURIES PHYSICAL STATE 214 Check one item only) a. SOLID ® b. LIQUID c. GAS 215 LARGEST CONTAINER FED HAZARD CATEGORIES 216 Check all that apply) a. FIRE b. REACTIVE c. PRESSURE RELEASE ® d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 2201791 UNITS* a. GALLONS b. CUBIC FEET ®c. POUNDS d. TONS 221 DAYS ON SITE: 222 Check one item only) " If EHS, amount must be in pounds. 1801 STORAGE CONTAINER 223 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 c OTHER c. TANK INSIDE BUILDING g. CARBOY k. BOX ® o. TOTE BIN d. STEEL DRUM h. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No 1fmore hazardous components are present at greeter than 1% by weight if non carcinogenic, or0.1 % by weight ifcarcinogenic, attach additionalsheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Sign Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTYENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 (one page per material perbuilding or area) ADD DELETE REVISE 200 Page Ilof 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® NO 1 MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # I 11. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Corrosive Liquid, Basic IfSubjectto EPCRA, refer to instructions COMMON NAME 207 zos EHS* Yes ® NoCorrosiveLiquid, Basic IfEHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Not currently required by KCEHD) 210 8 HAZARDOUS MATERIAL 211 TYPE (Check one item only) [3 a. PURE b. MIXTURE N c. WASTE 212 RADIOACTIVE Yes No 213 CURIES PHYSICAL STATE 214 Check one item only) a. SOLID ® b. LIQUID c. GAS 215 LARGEST CONTAINER FED HAZARD CATEGORIES 216 Check all that apply) a. FIRE b. REACTIVE c. PRESSURE RELEASE ® d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 1 122 UNITS* a. GALLONS b. CUBIC FEET ® c. POUNDS d. TONS 221 1 DAYS ON SITE: 222 Check one item only) • IfEHS, amount must be in pounds. 180 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM h. SILO I. CYLINDER p. TANK WAGON STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No If more hazardous components are present at greater than I% by weight if non carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheetsof paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 IfEPCRA Please Sign Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTYENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661 ) 862 -8700 Fax (661) 862 -8701 (one pageper materialper building or area) ADD DELETE REVISE zoo Page A of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® No 1 MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Flammable Liquids IfSubject to EPCRA, refer to instructions COMMON NAME 207 208 Flammable Liquids EHS* Yes 91 No If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Notcurrently required by KCEHD) 210 3 HAZARDOUS MATERIAL 211 212 RADIOACTIVE El Yes El No 213 CURIESTYPE (Check one item only) [:1 a. PURE [:1 b. MIXTURE ® c. WASTE PHYSICAL STATE 214 Check one item only) 11 a. SOLID ®b. LIQUID C. GAS LARGEST CONTAINER 215 FED HAZARD CATEGORIES 216 Check all that apply) © a. FIRE b. REACTIVE c. PRESSURE RELEASE d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 2201214 UNITS* a. GALLONS b. CUBIC FEET ®c. POUNDS [I d. TONS 221 DAYS ON SITE: 222 Check one item only) • If EHS, amount must be in pounds. 1801 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM h. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE © a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No If more hazardous components are present at greater than 1% by weight if non - carcinogenic, or0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Sign Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661) 862 -8700 Fax (661) 862 -8701 (one page per materialper building or area) ADD DELETE REVISE 200 Page I lof I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® NO 1 MAP# (optionaq 203 GRID# (optional) 204 FACILITY ID # 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Lighters If Subject to EPCRA, refer to instructions COMMON NAME zo7 208 EHS* Yes iXI NoLighters If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Not currently required by KCEHD) 210 2.1 HAZARDOUS MATERIAL 211 TYPE (Check one item only) a. PURE El b. MIXTURE ® c. WASTE 212 RADIOACTIVE [I Yes ®No 213 CURIES PHYSICAL STATE 214 Check one item only) a. SOLID ® b. LIQUID El c. GAS 215 LARGEST CONTAINER 18G FED HAZARD CATEGORIES 216 Check all thatapply) ® a. FIRE b. REACTIVE c. PRESSURE RELEASE d. ACUTE HEALTH e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT WASTE AMOUNT 219 STATE WASTE CODE 220771_ANNUAL 214 UNITS* a. GALLONS b. CUBIC FEET ® c. POUNDS d. TONS 221 1 DAYS ON SITE: 222 Check one item only) * IfEHS, amount must be in pounds. 180 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM h. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE iKI a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 225 d. CRYOGENIC WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No If more hazardous components are present at greater than 1% by weight ifnon- carcinogenic, or0.1 % by weight if carcinogenic, attach additional sheets ofpaper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Sign Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTYENVIRONMENTAL HEALTHDIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661) 862 -8700 Fax (661) 862 -8701 (one page permaterial per building or area) ADD DELETE REVISE 200 Page At6of Ll 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® NO I MAP# (optional) 203 GRID# (optiomi) 204 FACILITY ID # 11. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Oxidizing Liquids IfSubject to EPCRA, referto instructions COMMON NAME 207 208 Oxidizing Liquids EHS* Yes ® No If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Not currentlyrequired by KCEHD) 210 5.1 HAZARDOUS MATERIAL 211 212 RADIOACTIVE Yes No CURIES 213 TYPE (Check one item only) 1:1 a. PURE El b. MIXTURE ® c. WASTE PHYSICAL STATE 214 Check one item only) a. SOLID R] b. LIQUID E] c. GAS LARGEST CONTAINER 215 FED HAZARD CATEGORIES 216 Check all that apply) a. FIRE b. REACTIVE c. PRESSURE RELEASE d. ACUTE HEALTH ® e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 141 221 UNITS* El a. GALLONS [:1 b. CUBIC FEET ® c. POUNDS d. TONS DAYS ON SITE: 222 Check one item only) * If EHS, amount must be in pounds. 180 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM h. SILO I. CYLINDER p. TANK WAGON STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225 WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No Ifmore hazardous components are present at greater than I% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of papercapturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 IfEPCRA Please Sin Here 5/2008 revised) KC Form 2731 HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION KERN COUNTY ENVIRONMENTAL MEALTBDIVISION Unified Program Consolidated Form (UPCF) 2700 M STREET, SUITE 300 HAZARDOUS MATERIALS BAKERSFIELD, CA 93301 661) 862 -8700 Fax 661) 862 -8701 (one page per material per building or area) ADD DELETE REVISE 200 Pa e of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME orDBA — Doing Business As) 3 Bed, Bath and Beyond #407 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Receiving / Hazardous Waste Storage Area YES ® No I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET Yes ® No 206 Waste Toxic Liquids IfSubject to EPCRA, refer to instructions COMMON NAME 207 208 Toxic Liquids EHS* Yes ®No If EHS is "Yes ", all amounts below must be in lbs. CAS# 209 FIRE CODE HAZARD CLASSES (Notcurrently required by KCEHD) 210 6.1 HAZARDOUS MATERIAL 211 TYPE (Check one item only) a. PURE b. MIXTURE [@ c. WASTE 212 RADIOACTIVE Yes No 213 CURIES PHYSICAL STATE 214 Check one item only) a. SOLID ® b. LIQUID El c. GAS 215 LARGEST CONTAINER FED HAZARD CATEGORIES 216 Check all thatapply) a. FIRE b. REACTIVE c. PRESSURE RELEASE d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 331 UNITS* a. GALLONS b. CUBIC FEET N c. POUNDS d. TONS 221 DAYS ON SITE: 222 Check one item only) * IfEHS, amount must be in pounds. 1801 STORAGE CONTAINER 223 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. TOTE BIN d. STEEL DRUM It. SILO 1. CYLINDER p. TANK WAGON STORAGE PRESSURE © a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224 STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 225 d. CRYOGENIC WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 226 227 228 229 1 Yes No 230 231 232 233 2 Yes No 234 235 236 237 3 Yes No 238 239 240 241 4 Yes No 242 243 244 245 5 Yes No If more hazardous components are present at greater than 1% by weight if non - carcinogenic, or0.1% by weight if carcinogenic, attach additional sheets ofpaper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA Please Sin Here 5/2008 revised) KC Form 2731 CONSOLIDATED CONTINGENCY PLANEMSTREET, Y ENVIRONMENTAL HEALTH DIVISION Unified Program Form SUITE 300 COVER PAGE , CA 93301 Fax 661 862 -8701 Page of ) I. FACILITY IDENTIFICATION FACILITY ID # EPA ID # (Hazardous Waste Only) 2 CAL000362304 BUSINESS NAME (Same as Facility Name ofDBA -Doing Business As) 3 Bed, Bath and Beyond #407 The Consolidated Contingency Plan provides businesses a format to comply with the emergency planning requirements of the following two written hazardous materials emergency response plans required in California: 4 Hazardous Materials Business Plan (HSC Chapter 6.95 Section 25504 (b) and 19 CCR Sections 2729- 2732), and 4 Hazardous Waste Generator Contingency Plan (22 CCR Section 66264.52) This format is designed to reduce duplication in the preparation and use of emergency response plans at the same facility, and to improve the coordination between facility response personnel and local, state and federal emergency responders during an emergency. A copy of the plan shall be submitted to this Division and 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. Describe below where a copy of your Contingency Plan, including the hazardous material inventories, Training Records, and Site Map(s), are located at your business: Binder in Hazardous Material Storage Area We appreciate the effort of local businesses in completing these plans and are available to assist in any manner. If you have any questions, please contact this Division at (661) 862 -8700. PLAN CERTIFICATION I certify under penalty of law that I have personally examined and I am familiar with the information provided by this plan and to the best ofmy knowledge the information is accurate, complete, and true. Printed Name of Owner/ Operator Chris Baker Title ofOwner /Operator Agent For Signature of Owner/ Operator Date We appreciate the effort of local businesses in completing these plans and are available to assist in any manner. If you have any questions, please contact this Division at (661) 862 -8700. ADVISORY Page (+ of 44t The site - specific Contingency Plan is the facility's plan for handling emergencies and shall be implemented immediately whenever there is a fire, explosion, or release of hazardous materials or waste that could threaten human health and /or the environment. The contingency plan shall be reviewed, and immediately amended, if necessary, whenever: I The plan fails in an emergency 4 The facility changes in its design, construction, operation, maintenance, or other circumstances in a way that materially increases the potential for fires, explosions, or releases of hazardous waste or hazardous waste constituents, or changes the response necessary in an emergency List of emergency coordinators changes 4 List of emergency equipment changes Submit a copy of any updates or changes to this Division. II. EMERGENCY CONTACTS PRIMARY SECONDARY NAME 123 NAME 128 Store Manager Scott Simon TITLE 124 TITLE 129 Manager Regional Director of Loss Prevention BUSINESS PHONE 661 - 636 -0717 125 BUSINESS PHONE 130 310 -384 -6799 24 -HOUR PHONE 126 24 -HOUR PHONE 131 310- 384 -6799 310- 384 -6799 PAGER # 127 PAGER # 132 III. EMERGENCY RESPONSE PLANS AND PROCEDURES A. Notifications Your business is required by State Law to provide an immediate verbal report of any release or threatened release of a hazardous material to local fire emergency response personnel, this Division, and the California Emergency Management Agency. If you have a release or threatened release of hazardous materials, immediately call: FIRE /PARAMEDICS /POLICE /SHERIFF PHONE: 911 AFTER the local emergency response personnel are notified, you shall then notify this Division and the California Emergency Management Agency. Kern County Environmental Health Division: (661) 862 -8700 or after hours, call Dispatch at (661) 861 -2521 California Emergency Management Agency: (800) 852 -7550 or (916) 845 -8911 National Response Center: (800) 424 -8802 Information to be provided during notification: 4 Your name and the telephone number from where you are calling. 4 Exact address of the release or threatened release. 4 Date, time, cause, and type of incident (e.g. fire, air release, spill etc.) 4 Material and quantity of the release, to the extent known. 4 Current condition of the facility. 4 Extent of injuries, if any. d Possible hazards to public health and/ or the environment outside ofthe facility. B. Emergency Medical Facility Pa a of List the closest emergency medical facility that will be used by your business in the event of an accident ofinjury caused by a release or threatened release of a hazardous material HOSPITAL /CLINIC: PHONE NO: Mercy Hospital 661- 632 -5000 ADDRESS: 2215 Truxton Ave CITY: ZIP CODE: Bakersfield 93301 C. Private Emergency Response DOES YOUR BUSINESS HAVE A PRIVATE ON -SITE EMERGENCY RESPONSE TEAM? Yes No If yes, provide an attachment that describes what policies and procedures your business will follow to notify your on -site emergency response team in the event of a release or threatened release ofhazardous materials. CLEANUP/DISPOSAL CONTRACTOR List the contractor that will provide cleanup services in the event of a release. NAME OF CONTRACTOR: PHONE NO: PSC Environmental Services 877 - 577 -2669 ADDRESS: 5151 San Felipe, Suite 1600 CITY: ZIP CODE: Houston 77056 D. Arrangements with Emergency Responders 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 arrangements in the space below: E. Evacuation Plan 1. The following alarm signal(s) will be used to begin evacuation ofthe facility (check all which apply): Verbal Telephone (including cellular) Alarm System ® Public Address System Intercom Pagers ® Portable Radio Other (spec): 2. ® Evacuation map is prominently displayed throughout the facility. 3. ® Name of individual(s) responsible for coordinating evacuation including spreading the alarm and confirming the business has been evacuated: Store Manager on Duty F. Earthquake Vulnerability Identify areas of the facility where releases could occur or would require immediate inspection or isolation because of the vulnerability to earthquake related ground motion. Hazardous Waste/ Hazardous Materials Storage Areas Production Floor Process Lines Bench/ Lab Waste Treatment Other: Identify mechanical systems where releases could occur or would require immediate inspection or isolation because ofthe vulnerability to earthquake related ground motion. Utilities Sprinkler Systems Cabinets X Shelves Racks Pressure Vessels Gas Cylinders Tanks Process Piping Shutoff Valves Other: G. Emergency Procedures Page U of Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials /wastes: 1. PREVENTION (prevent the spill /release) - Consider the types of spills /releases associated with the hazardous materials /wastes present at your facility. What actions does your business take to prevent these spills /releases from occurring? You may include a discussion of safety and storage procedures. This site generates due to damaged and un- sellable retail product. The hazardous waste accumulation is inspected on a weekly basis for prompt detection of any possible spills or leaks. 2. MITIGATION (stop the release /spill) - Describe what actions are taken to reduce the harm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? In theevent of a spill, employees will evacuate the immediate area and notify the manager on duty for additional guidance. Management will access the spill and make the determination as to how to proceed with spill clean up by either directing employees on proper spill cleanup procedures or by contacting the emergency response vendor if necessary. 3. ABATEMENT (clean up the spill /release) - Describe what you would do to clean up the spill /release. How do you handle the complete process of cleaning up and disposing of released materials at your facility? In the event of a release, employees will cordon off the immediate area and notify the manager on duty for additional guidance. IV. Emergency Equipment Page —7 of 22 CCR, Section 66265.52(e) [as referenced by Section 66262.34(a)(3)] requires that emergency equipment at the facility be listed. Completion of the following Emergency Equipment Inventory Table meets this requirement. EMERGENCY EQUIPMENT INVENTORY TABLE Equipment CateRory 2. Equipment Type 3. Location 4. Description* Personal Protective, Equipment, Safety Cartridge Respirators Chemical Monitoring Equipment (describe) Chemical Protective Aprons/Coats Chemical Protective Boots Equipment, and First Aid Equipment Chemical Protective Gloves Receiving Single Use Nitrile Gloves Chemical Protective Suits (describe) Face Shields First Aid Kits /Stations (describe) Hard Hats Plumbed Eye Wash Stations Portable Eye Wash Kits (i.e. bottle e) Respirator Cartridges (describe) Safety Glasses/Splash Goggles Receivina NIOSH Approved Splash Goggles Safety Showers Self- Contained Breathing Apparatuses (SCBA) Other describe Fire Automatic Fire Sprinkler Systems Store Wide Automatic Sprinkler System Extinguishing Systems Fire Alarm Boxes /Stations Fire Extinguisher Systems (describe) Other describe Main Support ABC Fire Extinguishers Spill Absorbents (describe) Control Equipment and Berms/Dikes (describe) Decontamination Equipment (describe) Emergency Tanks (describe) Decontamination Exhaust Hoods Equipment Gas Cylinders Leak Repair Kits (describe) Neutralizers (describe) Overpack Drums Receiving Poly Containment Totes Sums (describe) Other (describe) Communications and Chemical Alarms (describe) Intercoms/ PAS stems Service Des Alarm Systems Portable Radios Em to ees Telephones Underground Tank Leak Detection Monitors Other (describe) Additional Equipment Use Additional Pages if Needed.) Describe the equipment and its capabilities. /fapplicable, specify any resting /maintenance procedures /intervals. Attach additionalpages, numbered appropriately, ifneeded. V. EMPLOYEE TRAINING Page S of All facilities which handle hazardous materials must have a current written employee training plan. The items listed below are required per Health and Safety Code Section 25504 (c) and Title 19 Section 2732. Training shall be provided: 4 Initially for all new employees. 4 Methods for Safe Handling ofHazardous Materials. Note: These training programs may take into consideration theposition ofeach employee. Facility personnel are trained as follows: Q Familiarity with all plans and procedures specified in the Contingency Plan. Q Methods for Safe Handling of Hazardous Materials. J Safety procedures in the event of a release or threatened release of a hazardous material. 4 Use ofEmergency Response equipment and supplies under the control ofthe business. Q Procedures for Coordination with local Emergency Response Organizations. Additional training should include: Q Internal alarm /notification procedures. 11 Evacuation/re -entry procedures and assembly point locations Q Material Safety Data Sheet (MSDS) training including specific hazard(s) of each chemical to which employees may be exposed, including routes ofexposure (i.e. inhalation, ingestion, absorption). VI. HAZARDOUS WASTE GENERATOR TRAINING If your business is a hazardous waste generator, you are required to provide training in hazardous waste management for all workers who handle hazardous waste at your site (22 CCR §66265.16). You are also required to document training. The items below are required. EMPLOYEE TRAINING Facility personnel will successfully complete training within six months after the date of their employment or assignment to a facility or to a new position at a facility. Q Employees will not handle hazardous wastes without supervision until trained. TRAINING DOCUMENTATION The owner or operator must maintain the following documents and records at the facility: Q Job title for each position at the facility that is related to hazardous waste management, and the names of the employee(s) filling the position(s). Q Description for each position listed above (must include required skill, education, or other qualifications as well as duties ofemployees assigned to the position. Q Description of type and amount of both introductory and continuing training given to each employee. Q Records that document that the requirements for training or job experience have been met. Q Current employees' training records (to be retained until closure of the facility). Q Former employees' training records (to be retained at least three years after termination of employment). CONSOLIDATED CONTINGENCY PLAN KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Form 2700 M STREET, SUITE 300 SITE MAPBAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 Page of I. FACILITY IDENTIFICATION FACILITY ID # I EPA ID # (Hazardous Waste Only) Z CAL000362304I BUSINESS NAME (Same as Facility Name of DBA -Doing Business As) 3 Bed, Bath and Beyond #407 SITE ADDRESS 103 CITY 104 ZIP CODE 105 5000 Stockdale Hwy Bakersfield1 93309 DATE MAP DRAWN MAP # SUB - FACILITY # (ifneeded) 4/23/2012 1 For Site Map Loading Areas Parking Lots Internal Roads Storm and Sewer Drains Adjacent Property Use Locations and Names of Adjacent Streets and Alleys Entrance and Exit Points and Roads Evacuation Routes For Storage Map Location of Each Storage Area Location of Each Hazardous Material Handling Area Location of Emergency Response Equipment NORTH CONSOLIDATED CONTINGENCY PLAN KERN COUNTY ENVIRONMENTAL HEALTH DIVISION Unified Program Form 2700 M STREET, SUITE 300 SITE MAPBAKERSFIELD, CA 93301 661 862 -8700 Fax 661 862 -8701 L Page 0 of I. FACILITY IDENTIFICATION FACILITY ID # 1. 8S° #407 Main Entranca I Exit 3AKERSFIEt -0, CA, c cN i:aa 2/05%07 REviSED 6/18/200 EPA ID # (Hazardous Waste Only) 2 o ..ar. +e.e. nano[ A wnlw .a.at ..r :.a•..wrm enex.•1 e6Tj ram •ar. lao. s•a+ m.. 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