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Home My WebLink AboutBUSINESS PLAN CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N° 9 5 2 Location4J~7 ~ ! ~ ~ ~ ~ .~ Sub Div. Blk. Lot You are hereby required to make the following cor~ctions at the above I~ation: Cor. No Completion Date fo,' Corrections Inspector 326-3979 '.-" COR.R. ECTIO.N NOTICE' BAKERSFIELD FIRE DEPARTMENT, Sub Div, Blk Dot. You are hereby required to make the folloWing corrections at'the above location: Coz. NO :: Complet. ion Date for Corrections ...,~. A.~ ~/, '2~..,}9 - Inspector i ..... ~ FLOOR: (CHECK ONE) SITE DIAGRAM FACILITY DIAGR.~ inspector's Comments): -OFFICIAL USE SITE DTAGRAM (Req items) l. Addre,~: Identify the 9. Lock (key) Box principle buihlings by the Street numDers. 10. MSDS Storage Box 2. Street(s), Alleys, 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. Masonry 3, Storm Drains, Culverts, Yard Drains c. Wood 4. Drainage Canals. Ditches, d. Gates Creeks, 13. Powerllnes 5. Buildings a. Frame construction 14. Gnard Station b. Masonry construction 15. Storage Tanks: Identify the c. Metal construction capacity in gal. a. Above ground d. Access Door , b. Underground 6. Utility Controls a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Water 18. Evacuation Area: , . -. Identify the 7, Fire Suppression Systems: location where a. Fi're Hydrants employees will meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage c. Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Water Control Valves 21. Outside Hazardous for protection systems Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored 8. Fire Department Access or Used (See Below) TYPE OF HAZARDOUS MATERIAL F = Flammable g = Explosive L = Liquid R = Radlological C = Corrosive 0 = Oxidizer G = Gas P = Poison W = Water Reactlve T = Toxic S. = solld H = Cryogenic O = Waste B = Etiological Example: Flammable Liquid = FL' FACILITY DIAGRAM (Required items in addition to the. abo~e) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/llandltng 6. Attic Access 14. Sewer Drain Inlets 7. Skylights RETURN PAYMENTS TO: PLEASE MAKE CHECKS PAYABLE TO: G~I~TYOF~AKERSFIELD STATEMENT OF ACCOUNT P.O.'BOX 2057 CITY OF BAKERSFIELD BAKERSFIELD, CA 933.03-2057 ACCOUNT NO. '~ F.]RE..DEpAR.TNENT' ~ _- ...... ::' ...... F~'e'~b~S ~a Lance INQUIRIES CONCERNING THIS BILL, PLEASE PHONE:.' "32 ~1=* 3:979 ' ': ' ' ' ' n~ v BA~ERSF CA 93305 ~ REM~ANCE cOPY" -" I *~C~T~;'" ~:~¢:BAKERSF~ELD '[ STATEMENT OF ACCOUNT P.O. BOX 2057 / BAKERSFIELD, CA 93303-2057 ~ ACCOUNT NO. ¢¢,,..~,_¢ ':~:~ ~, ~/ INQUIRIES C~ERNING THIS BILL PLEASE PHONE: OUS~MER OOPY R & S AUTO ~ ~ SiteID: 215-000-001285 Manager : ~ ~ ~S~ ~"A~C-~f- BusPhone: (661) 327-7381~ Location: ~ ~ 7~ ~ /~ ~T Map : 103 Com~az : Moderate City~ ~ ~~,~, ~"' Grid: 30D,~'FacUnits: '1 AOV: CommCode: BAKERSFIELD STATION 01 SIC code':5531 EPA Nu~: DunnBrad: Emergency Contact~ / Title " Emergency Contact- / ,' Title ~THO~ ~EZ / O~ER. ~ %' ~ / ~AGER Business Phone: (661) 327-7381x Business Phone: (661) 327-7381x' 24-Hour Phone : (661) ~71 1597:[ 24-HoUr Phone : (661)~-~63x Pager Phone : (. ~ - x Pager Phone : ( ) - x Hazmat Hazards: Fire Im~lth DelHlth Contact : ~. Phone: (661) 327-7381x Mai'lAddr: 427 E 18TH ST ~State~ CA City ~: BAKERSFIELD Zip : 93305~ Owner ~Ci~f ~EZ ~.0~-- ~~ Phone: (661) 327-7381x Address : 427 E 18TH ST State: CA City : BAKERSFIELD Zip : 93305 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal' Certif ' d: RSs: No Emergency Directives: /. ~' '-~ ~ Haz~at Inventory " One Unified List ~ As Designated Order All Materials at Site'~: '~' Hazmat Common Name... sPecHaz EPA H~zardsI Frm I Daily~a~"~Unit,,., :,:~,:~."~-~-~ MCP SODI~ HYDROXIDE /dO IH DH S ~ q~~~ Moa ~, ~ ~ ( ~ u ~ ~.~o hereby ceff~ that ~ have reviewed lhe affaohed h~a~dous maieda]s manage- any co~ec~ons oons~Ru~s e oomp~et~ and cormo~ m~n- . ..~,~, .. agement plan ~or my ~acili~. R & S AUTO SUPPLY SiteID: 215-000'-001285 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME SODIUM HYDROXIDE Days On Site 365 Location within this Facility Unit MaP: Grid: HOT TANK BETWEEN STORE & SHOP CAS# 1310-73-2 F STATE T TYPE PRESSURE --~ TEMPERATURE CONTAINER TYPE Solid Pure Ambient Ambient IN MACHINE/EQUIP AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 55.00'GALI 55.00 GAL 55.00 GAL HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Sodium Hydroxide N 1310732 HAZARD ASSESSMENTS TSecretl RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP NoIN° No No/ Curies F IH DH. / / / Mod F 'Inventory Item 0002 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME WASTE OIL ~' Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 221 FSTATE TYPE PRESSURE --~ TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 30.00 GAL 30.00 GAL %Wt. HAZARDOUS COMPONENTS 100.00 Waste Oil Petroleum Based NOSR CAS# , HAZARD ASSESSMENTS TSecret RI RSlBioHaz! Radioactive/Amount EPA Hazards NFPA USDOT# MCP No.INo I ~No No/ Curies F DH / / / Low 05/03/'2000 F R & S A~9~~Y SitelD: 215-000-001285 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 05/03/2000 CALL 911. -- Employee Notif./Evacuation 05/03/2000 VERBAL NOTIFICATION & CALL 911. Public Notif./Evacuation 05/03/2000 FRONT OR REAR DOOR, VERBAL. Emergency Medical Plan 05/03/2000 KERN MEDICAL CENTER - 1830 FLOWER ST - 395-4004 OR SAN JOAQUIN COMMUNITY HOSPITAL - 2615 EYE ST - 395-3000. -3- 05/03/2000 R & S A%~P~=~B~=Y SiteID: 215-000-001285 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 05/03/2000 PRODUCT PACKAGED FOR RESALE IN SMALL CONTAINERS. WHAT ABOUT THE HOT TANK???????????? -- Release Containment 05/03/2000 HOW WOULD YOU CONTAIN A HOT TANK SPILL??????????????? -- Clean Up 05/03/2000 HOW WOULD YOU CLEAN UP THE SPILL AFTER IS HAPPENED?????????? Other Resource Activation -4- 05/03/2000 F R & S AUTO SUPPLY SiteID: 215-000-001285 Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 05/03/2000 A) GAS - E SIDE OF BLDG B) ELECTRICAL - S WALL.REAR, E WALL IN STORE C) WATER - S SIDE OF SHOP BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 05/03/2000 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - NO FIRE HYDRANT IN IMMEDIATE LOCATION. Building Occupancy Level -5- 05/03/'2000 R & S AUTO SUPPLY SiteID: 215-000-001285 Fast Format Training Overall Site -- Employee Training 05/03/2000 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: CALL SAFETY MEETINGS, GO OVER MATERIAL SAFETY DATA SHEETS AND FIRST AID PROCEDURES. -- Page 2 Held for Future Use Held for Future Use 6 05/03/2000 · CITY OF BAKERSFIELi ' O E OF ENVIRONMENTAL ~2.t~,~r~ 1715 Chester Ave., CA 93301 (661)326-3979 ..... '::~;:~:~::~m':~)~g~ :*' :/'~ ' ' ' : I FACILI~ INFORMATION ' ~ ,'= "' :"~-. ~* BUSINESS ~ME (Same ~ FACILI~ NAME ~ DBA - D~ng Busings As) 3 CHEMI~LLO~T~ON ~O~ ~t& gC~~' ~ ~ ~t~p =0~I CHEU~CALLO~TIOn ~Y~ ~no 202 [ CONFIDENTIAL (EPC~) FACILIWlD#I I ~ I I }~~-'"-7~'~ mP~(opt~naO 2031GRIO~(opt~naO ~.- ~...~ , . .. ,. C~EM~c~L ~,,~ORMaTiON .... .:.,.~ 205 T~DESECR~ ~ Y~ ~ No 2~ CHEMI~L ~ME ~O (O~ /~ ~ Xl Oe ff Su~j~ tO EPee. refer to .nst~io,s 207 COM~N ~ EHS* ~ Y~ ~ No 208 ~RE CODE H~RD C~SSES (~plete if ~u~t~ by ~1 fire ~ie0 210 FED H~RD CATE~RIES 1 FIRE ~ REACTIVE ~ 3 PRESSURE RELEASE ~ ACUTE HEALTH ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ANNUAL WASTE 217 3 M~IMUM 218 ~ AVENGE 21~ STA~WASTE~DE A~U~ DAILY A~U~ ~ ~ DAILY A~UNT UNITS* ~a ~L ~ ~ CU ~ ~ lb LBS ~ tn TONS ~1 DAYS ON SITE ' If EHS, am~nt must be in lbs, STOOGE ~NTAINER ~ABOVEGROUND T~K ~ e P~STI~NONMETALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR (Check all ~at apply) ~ b UNDERGROUND TANK ~ f CAN ~ ] BAG ~ n P~STIC BO~LE ~ r O~ER ~ c T~K INSIDE BUILDING ~ g ~RBOY ~ k BOX ~ o TOTE BIN ~ d S~EL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WA~N STOOGE PRESSURE ~ AMBIE~ ~ aa ABOVE AMBIENT ~ ba BELOW AMBIE~ STOOGE TEMPE~TURE a AMBIE~ ~aa ABOVE AMBIENT ~ Da BELOW AMBIENT ~ c CRYOGENIC 2~',~: ~,; 5: :'?', ~,.~' '~ ' ~' ,.: ' ~6 227 ~ Y~ ~ No 228 230 231 ~ Y~ ~ No 232 2~ 235 ~ Y~ ~ No 236 237 238 239 ~ ~y~ ~No 2~ 241 ......... 242 ~ Y~ ~ No 244 245 PRINT NAME & TITLE OF AU~ORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 2~ UPCF (7/99), S:\CUPAFORMS\OES2731 .TV4.wpd HM466801 Account Number ACCOUNTS RECEIVABLE ADJUSTMENT February 16~ 1994 Date New Account New Address Esther Duren Close Account From Service Change Other Adjustments X Fire Department. Hazardous Materials Division De pa rtment/Dlvlalon R & S 'AUTO SUPPLY Billing Name 427 E 18TH ST Billing Address Site Address Parcel # (if Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change 110.00 0 < 110.00> 1-1-94 Remarks: WHEN ANTHONY JUAREZ BOUGHT R & S AUTO SUPPLY HE. REMOVED THE 55 GAL DRUM OF WASTE OIL AND REPLACED IT WITH A 30 GAL DRUM. MAKING HIS HAZARDOUS MATERIAL BELOW THE REPORTABLE QUANTITY. HM466801 Account Number ACCOUNTS RECEIVABLE ADJUSTMEN~ Februsry'16~ 1994 Date Hew Account New Address Esther Duren Close Account From Service Chsn.qe Other Adjustments X Fire Department- Hazardous Materials Division Department/Division R & S AUTO SUPPLY Billing Name 427 E 18TH ST Billing Address Site Address Parcel # (if Applicable) Landlord Name & Address (If'Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change 110.00 0 < 110.00> 1-1-94 Approved By: Remarks: WHEN ANTHONY JUAREZ BOUGHT R & S AUTO SUPPLY HE REMOVED THE 55 GAL DRUM OF WASTE OIL AND REPLACED IT WITH A 30 GAl. DRUM. MAKING HIS HAZARDOUS MATERIAL BELOW THE REPORTABLE QUANTITY. BAKERSFIELD CITY FIRE DEPARTMENT H~ARDOUS MATERIALS MANAGEMENT P~N INSTRUCTIONS: 'F. TO avoid further .action, return '~his form f receipt. '2. TYPE/PRINT ANSWERS IN ENGLISH. · ' ~""- 3. ,Answer the questions below for the business as a who~e. 4. Be brief and concise as possible. LOCATION' ~Zg ~,!~'~ ~ MAILING ADDRESS: %~. ~G CITY: ~fl~~1~) STAT~¢~ Z~P:~ PHONE: ~- DUN & BRADSTRE'ET NUMBER: SIC CODE: ~AILINGA~RESS: ~Z] ~t~~ SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24. HR. PHONE .. ~Bakersfield Fire Dept. .~ ~ ,. HAZARDOUS MATERIALS MANAGEMENT PLAN ' SECTION 3: TRAINING: NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: ~(II .~C_q-'-~x,d'/E C~¢C,( BRIEF SUMMARY oF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT'MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: ~... WE O'O NOT HANDLE HAZARDOUS MATERIALS. .,V// WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEEO THE MINIMUM REPORTING QUANTF[',IES, OTHER (,SPECIFY REASON) SECTION 5: CERTIFICATION: I, ~t~q L)t)_CtP-JZ'-7__ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL, SEUSEDTO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIA~S (DIV., 2'3 CHAPTER 6.95 SEC..'2SEOQ ET AL.) AND TH,iT INA CCU RA.TE iNFO RMATION. CO N STtTUIES PERJURY. SIGNATURE ~ TITLE DATE Bakers~elcl F-be Dept. Hazardous Materisls Division HAZARDOUS. MATERIALS MANAGEMENT PLAN SECTION <5: NOTIFICATION AND EVACUATION PROCEDURES: ^. AGENCY NOT~tCAT~ON Pr~OCEDUr~ES: qll~,~f~CC/ B. EMPLOYEE NOTIFICATION AND EVACUATION: "~~~~/~/~ ~- C. PUBLIC EVACUATION: TO ~'£G°T. ~ .~'2~bl~l~(-~'" " O. EMERGENCY MEDICAL PLAN: (~ RII ~ ~,~~c,( ~ ,, .:~..-- ' : - BakerSfietcLFire Dept. Hazardous iViater~als Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITiGATiON, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: B. RELEASE, CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: -~¢iU;~ -~'iD,~, o ¢ ~. WATER' ~ 'a U t~ -' SPECIAL: LOCK 8ox: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: 4. HAZARDOUS 'MATERIALS DIVISION 2130 "G" STREET BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILFFY DESCRIPTION CHECK iF BUSINESS iS A FARM [ ] FACILt~ NAME '~ ~ ~~ SITE ADDRESS ~ ~% ~, I ~ ~ ~ NATURE OF BUSINESS' A ¢ ~ ~ ~ +%' OWNER/OPERATOR P. HONE MAILING ADDRESS CITY 'STATE ZIP EMERGENCY CONTACTS BUSINESS PHONE '~?~ ?~1 24-HOUR PHONE NAME ) TITLE' BUSINESS PHONE ..~~¢g I 24-HOUR PHONE BAKERS -F LD EPA [ 'M ' CI'EY FIRE. D ENT HAZARDOUS MATERIALS INVENTORY Page__of__ CHEMICAL DESCRIPTION IN~NTORY SIA~S; New. ddition [ ] ~evision elation ( ] Check ff chemic~ chemi~ N~e: AHM [ ] CAS PHYsIcAL & H~L~ n~ PHYSICAL H~L~ H~RD CA.CORtES Fire~ .,~active [ ] Sudden Relate et Pressure [ ] Immedi~e He~h (Acme) PHYSICALSTA~ Solid [ ] Uquid [~G~ [ ] Pure ~ure [ ] W~te' [ ] R~ioad~. [ ] M~mum Daly Amount: [~ [ ] ga ~ ~3 [ ] ~) Contaner: Average D~ly Amount: cudes [ ] b) Pressure: ' AnnuN Amount: c) Tem~r~ure: ~gest Size ~ont~ne'r: ~ Days On Site ~ ~A~ Circle~ichMom~: ~llYe~,)J, F, M, A, M, J, J, A, S, O, N, D 9) MITRE: ~st COMPONENT CAS ~ % ~ AHM the three most h~dous 1) ~ O ~ o~ O ( ~ t ~ ~ [ ] chemi~ com~nen~ or ~y AHM com~nents 2) ~ ~ .~ C~~ ~ 0 C(} ~ S [ ] 3) [ ] CHEmiCAL DE~CRI~ION 1) IN~NTORY STA~S: New [ ]' Add,ion [ ] Revision ~Dele~en [ ] Check E chemi~ is ~ NON ~D~ SECR~ [ ] ~ SECR~ 2) Cemmon N~e: Chemica N~e: AHM 4) PHYSICAL & H~L~ ~HYSICAL H~L~ H~RD CA~GORIES Fire [ ] Rea~ive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) 5) WASTE C~SSIFICA~ON (~digit code from DHS Fo~ 8022) USE COO~ 6) PHYSICALSTA~ Solid [ ] Dquid [ ] G~ [ ] ~ure 7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CQOES M~imum Daly Amount: lbs [ ] g~ [ ] ~3 [ ] a) Contaner: Average D~ly Amounl: cudes [ ] b) Pressure: Annu~ Amount: c) Temper~ure: ~gest Size Contaner: ~ D~W On $~e Gircle~ich Monks: ~1Ye~, J, F, M, A, 9) MITRE: ~st COMPONENT CAS · % ~ AHM the three most h~dous 1 ) ch'emi~ com~nen~ or ~y AHM com~nen~ 2) 3) 1 O) ce~ u~er pen~ of law, ~at I have patently ex~tn~ ~ ~ f~fli~ w~ ~e mfomabon suDmi~ on ~is ~d ~1 a~ch~ ~ocumen~ submi~ in~a~on is ~e, accumm, ~d complain. PRI~ Name & ~Ee of A~odzed .Com~y Represenm~e SignOre 04/23/92 R & S AUTO SUPPLY 215-000-0012 ~ ~ :/Page 1 Overall Site with 1 Fac. Unit ~¥ 27 1992 General Information !¥ ........... -- Location: 427 E 18TH ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 01 Grid: 30D F/U: 1AOV: 0.0 i Contact Name Title I Business Phone 24-Hour Phone JIM MCCOY OWNER (805) 327-7383 x (805) 831-4066~ ANTHONY JUAREZ MANAGER 1(805) 327-7383 x (805) 871-1587 Administrati%e Data Mail Addrs: 427 E 18TH ST D&B Number: City: BAKERSFIELD State: CA Zip: 93305- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 5531 Owner: JIM MCCOY Phone: (805) 327-7383 Address: 1324 WHITE LN . State: CA City: BAKERSFIELD Zip: 93307- Summary i, J ! iv1 I'd ~. ¢ o y_ Do hereby .ceffify that ! have reviewed the ~hed h~ardous ms~er~ls manage- m~t plan for A, ~ ~7~ ~,~,~ and that it aion~ w~th ~y ~rre~ion~ ~ns~tute a complete ~nd corre~ man- ~ement plan for ~y facil~. 04/23/92 R & S AUTO SUPPLY 215-000-001285 Page 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 MOTOR OIL Liquid 75 Minimal ~ Fire, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GALI Daily Average GAL I Annual Amount GAL 75 ~ 24.00 75.00 Storage~~Press T Temp Location PLASTIC CONTAINER IAmbientJAmbientlFRONT OF STORE -- Conc Components MCP ~List 100.0% IMotor Oil, Petroleum Based IMinimal I 02-002 ANTIFREEZE Liquid 66 Low ~ Fire, Delay Hlth o GAL CAS #: 107-21 1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily.Max GALI Daily Average GAL I Annual Amount GAL 66 ~ 18.00 240.00 Storage~ Press T Temp ~ Location ,PLASTIC CONTAINER IAmbientJAmbientlFRONT 'OF STORE -- Conc Components MCP List 100.0% IEthylene Glycol ILow I 04/23/92 R & S AUTO SUPPLY 215-000-001285 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL NOTIFICATION & CALL 911 <3> Public Notif./Evacuation FRONT OR REAR DOOR, VERBAL <4> Emergency Medical Plan KERN MEDICAL CENTER, 1830 FLOWER ST, 395-4004 SAN JOAQUIN COMMUNITY HOSPITAL, 2615 EYE ST, 395-3000 04/23/92 R & $ AUTO SUPPLY 215-000-001285 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention PRODUCT PACKAGED FOR RESALE IN SMALL CONTAINERS <2> Release Containment <3> Clean Up <4> Other Resource Activation 04/23/92 R & S AUTO SUPPLY 215-000-001285 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - EAST SIDE OF BUILDING B) ELECTRICAL - SOUTH WALL REAR, EAST WALL IN STORE C) WATER - SOUTH SIDE OF SHOP BUILDING D) SPECIAL - NONE E) LOCK BOX' - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT -' NO FIRE HYDRANT IN IMMEDIATE LOCATION <4> Building Occupancy Level 04/23/92 R & S AUTO SUPPLY 215-000-001285 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 4 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE CALL SAFETY MEETINGS, GO OVER MATERIAL SAFETY DATA SHEETS AND FIRST AID PROCEDURES. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use and that it alon~ with the attached additions or co.~ections constitute a complete and co-~ect Business Plan for m}.- facilit.v. LOCA'f']' O~x .'-L?'?' L ~ !:~ i'H ST ~'-~i "'~ H~-:~Z?~RO l:~R',r'i;~ i',IG ~:." t.. OVERVIEW LAST CHANGE ]ltZSli:~8 BY JURIS CODE Zt5-~0l JURIS 8RKERSFiE[_D STATION ~)l MfiP PAGE 1~)3 GRID 30D FACiLiTY UNITS I i..tRZF~IRO RATING 2 RESPONSE SUMMARY 2A SEC 4) JIM MCCOY 8ILL STAW FtNTHONY JUAREZ EMERGENCY CONTACTS ZA SEC Z) JIM MCCOY, OWNER - 3£?-?383 OR 831-4068 ANTHONy JURREZ~ MGR - 327-7383 OR 87Z-9118 UTILITY SHUTOFFS ZA SEC 3) ~) GAS.- E SIDE OF BLDG B) ELECTRICAL - S WALL REAR, E WALL IN STORE C) WATER - S SIDE OF SHOP 8LOG D) SPECIAL - NONE E) LOCK 80)( - NO Z, NOTIFICATION / PUBLIC EVACUATION CHfiNGE~--,.~,,.~gU L~ST < NO INFORMATION RECORDED FOR THIS SECTION PRGE 1 1Z/ZZ/88 I?:ZZ MATERIAL SAF'ETY OA'FA SYSTEHS, iNC,, (8~5) G48-iS~0 , L.C)C;:.',T]:ON ~;L'7 E ~i¥i"H ..<,"i ................................... < NO INFORMATION iTECOFIDEB FOR THIS SECTION > 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE I1/Z8/88 BY VAL SEC S> KERN MEDICAL CENTER, 1830 FLOWER ST, SAN JOAQUIN COMMUNITY HOSPITAL, ZGIS EYE ST, 3BS-3000 PAGE 2 i2/ZZ/88 l'7:ZZ MATERIAl.. ~!;AFE',r¥ [)hTh ,'.SYSTEMS, ZNC.. V ID TYPE NAME H~)( ~M'l' UNIT HAZARD LOC~T!ON CONTAINMENT . USE ~ PURE MOTOR OiL '75 GRL UNKNOgN FRONT OF STORE PLASTIC CONTRINER[S] LUBRI(]BNT ID PERCENT COMPONENTS HBZt~RD LIST Z 8¢)8.9¢ ~ ¢~e. ~ HOTOR OIL UNKNOWN Z PURE ~NTIFREEZE B6 GBL UNKNOWN FRONT OF STORE PL¢~STIC EONTRINER[S] COOLING ID PERCENT COMPONENTS H~ZRRO LIST ,ZS~Z.Dt~ le~.~ ETHYLENE GLYCOL UNKNONN 8, FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 11/28/88 BY VAL SEC 4) FIRE EXTINGUISHERS 3A SEC S) FIRE HYDRANT - NO FIRE HYDRANT IN IMMEDIATE LOCATION PAGE HA'FERIRI.. {SAFETY []A"F~ SYSTEHS, Il,lC. (8¢5)848-68¢0 r- ~.Uh HFi7 FifiD ° LOCflTiDN 4.;; ~:' i ~;'TH ~7 ''T" ~ ~,,~'.'~ .... D. EMPLOY'EE NOTIFICPFFiON / EvP, CL~PiTION LP~ST £HF~N(.:)E 11/28/88 E~\; V(:iL SEC Z) VERBAL NOTIFICATION'E CALL E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE ll/Z8/88 BY VAL 3R SEC 1) PRODUCT PACKAGED FOR RESALE IN SMALL CONTAINERS PfiGE 4. I .c,,' z: z. z c%c~ HA, TER]iFIL BF!F'E"F".,' D.P,,TFI Sx,"STE.:MB. ]:NC CITY of BAKERSFIELD N O_ N -- VHo~z ~: ~-,~ -~ P~O~Z ~: ~/~~ - 7 ' - __-__- - _ Ph~icI1 C.A.S. (C~k ~11 t~t a~ly) ~lth of ~ ~lth ................. - r -- ~ ~lth of ~ Mlth .... ~_t .k_, ...... 1 1 I~1 I ! I I .......... . ............. P~tcol ~ Mlth ~z~ C.A.S. (C~k ~11 t~t I~ly) ~-. ~-~ '-~ rtre Haza~ ~--a g~ttv~ty Mlth of P~ Mlth k t , j ~ ~ ........... .~l__t ...... , ....................... 1. [ _.t ....................... P~*c.1 ~ ~lth ~8~ C,A.S. C~t HHlth of P~su~l HHith ~t 13 ~iC.A.S. HE~GENCY ~TACTS I1R~_~ ................................... ~G ....................... ?I-R~'PG ....... ~ ~ ~'~! ....... Cer~f~c.~i~ (Read and s~Kn for~obtainm9 t~ inf~tt~. I ~lieve t~t t~ su~itt~ info. tim August 3, 1992 Mr. Jim McCoy R & S Auto Supply 427 E. 18th Street Bakersfield, Ca. 93305 Dear Mr. McCoy: Enclosed Please find the computer copy of your Hazardous Materials Business Plan that you certified as complete on May 27, 1992. This plan.is not complete. You have failed to complete the highlighted sections E2 (release containment), and E3 (cleanup) on page 4 of your plan. Please complete and return these sections by August 20, 1992. If you have any difficulties please do not hesitate to call our office at 326-3979. Sincerely Yours, Ralph E. Huey Hazardous Materials Coordinator ENCLOSURE O Bakersfield Fire Dept, HAZARDOUS MATERIALS DIVISION Date Completed Business Name: F~ % -~' ~u'TO .~ P .Location: /",/~J-- "7 E, / ~ RECEIVED Business Identification No. 215-000 /,,',3.~ ~" ~l'op of Business Plan) ~tAR 1 2 1992 Station No. ,,3.,.. Shift /~ Inspector ~'Oh/N~-,~, HAZ. MAT. n!V. Adequate Inadequate Verification of Inventory Materials ~ Verification of Quantities I~ Verification of Location ~ Proper Segregation of Material~ Comments: Verification of MSDS Availablity I~] 0 ~----I~umber of Employees /7/' Verification of Haz Mat Training ~ Comments: Verification of Abatement Supplies & Procedures ~ Comments: Emergency Procedures Posted ~ Containers Properly Labeled ~ Comments: Verification of Facility Diagram I~ Special Hazards Associated with this Facility: /V o/,4 ~_. Violations: ~~.,&/,~/,~.~ All Items O oK. Correction Needed B~s~ own~nager / FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy i.D. # ~/ · FORM 4A-1 Page .... NON--TRADE SECRETS " HAZARDOUS MATERI ALS I NVENTORY BUSINESS NAME.: ~ /) ~ OWNER NAME: C /~ ~$~0 ~ FACILITY UNIT ~ ............. ADDRESS: ~k' 7 ~ /~ - ' ' ' ADDRESS: / ~ ~/~/~a L~.FACILITY UNIT NA~E: ........ PHONE ~: ~ ~q~/ P,ONE ~: ~/ ~~ [OFFICIALo~i~y USE CFIRS .... l 2 3 4 5 6 ~ 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN TBIS % BY HAZARD[ ~0DE AMOlj~T AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL 0R COMMON NAME CODE_](;~li!?!~ EMERGENCY CONTACT: /~~ TITLE: ...~~ ff PHONE ~ BUS BOURS:.~2.~~7 ~ AFTER BUS ~RS: ~7/~6 ~ ~~cv co~c~:~h'7o~v .~/u~7~ ~: /~~~_ .. ~.o~ ~ ..s .o.~s: ~Z~/ .- PRINCIPAL BUSINESS'ACTIVITY: ~ //,~9 ~~ ~~. AFTER BUS ~RS: ~--~//~ .... SECTION 3: HAZARDOUS MATERIALS FOR THIS b~iT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... NO If YES, see B. If NO, continue with SECTION 4, B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade ~ecret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION · ,' ..i".. ~.: ....... SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SRo'T-OFFS AT THIS bLNIT ONLY. A NAT. GAS/'PROPANE~ B ELECTRICAL: 'C. WATER: D. SPECIAL: E. LOCK BOX: YES IF ¥_S LOCATION: IF YES. Si~: PLANS? YES ," :,,0 ,~!SDSs9 '_,,:S "XO FI. OOR PLANS? YES / NO KEYS? YES /' NO - 3B - BAKF_.RSEiE£D giT'-," FiRE DE?ARTMENT 2_,o0 STREET BAKERSFIELD, CA 93301 OFFiCiAl. USE ]~US I ~TESS 1="r-AN' SINGLE FACILITY UNIT FORM INSTRUCTIONS 1. To avoid further action, this form must be returned by: '2. 'TYPE,"PRI57T YOUR ANSWERS IN ENGLISH. ,3. Ans~e? .*.he questions below for THE 4. Be as BRz and CONCISE as possible FACILITY UNIT~ ~ FACILITY UNIT NAME: SECTION ~: MIT%GATION~ PREVEN~I'ION~ ABATEMEN'I' PROCEDURES / SECTION' 2: NOTIFICATION .~N~D EVACUATION PROCEDI~ES &T THIS UNiT - 3A - SECTI~7 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR yoUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS .aRE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E>!PEOYEES WITH iNITIAL AND REFRESHER TRAi.YiNG IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~TERIALS:...~ .................................... YES ~0,) YES >lO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES /~.Y~ YES NO C. PROPER USE OF SAFETY EQUIPMENT: .............. · .... ~ NO ~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. - YES 5;0 YES NO E. DO YOU }~AINTAIN EMPLOYEE TRAINING RECORDS: ...... .. YES ~ YES NO SECTION 7: F, AZARDOUS ,~ATERIAL CIRCLE YES -. NO - NONE DOES YOUR BUSINESS HANDLE HAZARDOUS ~TERIAL IN QUANTITIES LESS THAN 500 poUNDs OF A SOLID/'~55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ..... '. '~ NO I, k_/~-~'/~z;-~ ~' ~/%{ , certify that the above information is accurate. I un~t'a~d t~a~ this information will.be used to fulfill my firm's obligations under the/new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CI~f ~[RE DE?AR~fENT · ~ ~" RECEIVED · ~'.o0 S ,.~EET B~ERSFIELD, CA 93301 . (~os) ~e~-~ ~AY 2 5 1988 Ans'd ............ BUSINESS PLAN AS A WHOLE INS~UCTIONS: 1. To avoid further action, return this form by ~. TYPE/PRINT ANSWERS IN ENGLISH. 3. Anser the questions beiow for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSI~SS IDE~IFICATION DATA /' SECTIO~ 2: E~RGE~CY ~OTIFICATIO~S In case o~ an e~ergenc~ involving the release o, threatened rolease o~ a hazardous ~ater~al, calI 01! and 1-800-852-75~0 or 7our local g~re department and the State la~. EMPL0)~EES TO NOTIFY IN CASE OF EMERGENCY: NAME/A~D TITLE_ .~ DURING BUS. HRS. AFTER BUS. HRS. JJ / / SECTION 3: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS A ~OLE S. ELECTRICAL: D. SPECIAL: E. LOCK BOX: 'YES ,/~ IF YES, LOCATION: IF YES, DOES IT CONTAfN SITE PLANS? YES / FLOOR PLANS? YES / NO ~EYS? YES / NO