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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit t CONDITIONS OF PERMIT ON REVERSE SIDE ,i i ~ .......... ~,,~'~'~;"~'~"~ ........ This permit is issued for the following: PERMIT ID~ 015~2100105i ,'.:~*~:~ ~..,~;~.~b _ ~ ~:~?~:::~}~$k:::M~agement Program LOCATION 909 18TH Issu~ by: OB~ersfield Fke Depa~ment Approv~ by: ~~~' 1715 Chewer Ave., 3rd Floor ffi B~emfiel& CA 9~01 Voice (805) ~26-3979 F~ (805)~S76 Expiration Date: ~n~ ~0~ ~000 September 5, 1990 Mr. J.E. Boynton Boynton Bros. Inc. 909 18th Street Bakersfield, Ca. 93301 Dear Mr. Boynton: Enclosed you will find a computer printout of the Hazardous Materials Management Plan that is currently in our computer, we have highlighted the areas that need to be revised. Also due to a change in the law that went into effect January, 1989, we need to have a new inventory form (enclosed/ filled out. These forms must be filled out and returned to our office by September 28, 1990. If you have any questions please don't hesitate to contact us at (805) 326-3979. Sincerely Yours, Ralph E. Huey Hazardous Materials Coordinator REH:vp Enclosures 03/15/96 BOYNTON BROS INC 215-000-001051 Page 1 Overall Site with 1 Fac. Unit General Information Location: 909 18TH ST Map:103 Haz:3 Type: 3 City : BAKERSFIELD Grid: 30C F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title J. E. BOYNTON / ROBERT KISER / Business Phone: (805) 324-4532x Business Phone: (805) 324-4532x 24-Hour Phone : (805) 327-2161x 24-Hour Phone : (805) 871-6512x Pager Phone : ( ) - x I Pager Phone : ( ) - x Administrative Data Mail Addrs: 909 18TH ST D&B Number: 95-153-4095 City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: Owner: J. E. BOYNTON Phone: (805) 832-2465 Address: 305 STARMOUNT DR State: CA City: BAKERSFIELD Zip: 93304- Summary ~\~ ~ I, ~o1~.~'~'7"- ,"~~ Do hereby certify that I have reviewed the a~ached haza~ous mate~als marmge- ~~ ~. ~nd tha~ it alo~ with ment plan for ~ny ~rr~ions constitute a complete and corre~ man- age~nt plan for my 03/15/96 BOYNTON BROS INC 215-000-001051 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-004 ACETYLENE Gas 127 High · Fire, Pressure, Immed Hlth FT3 02-002 CLEANING SOLVENT Liquid 110 Moderate · Fire, Delay Hlth GAL 02-003 OXYGEN Gas 275 Low · Fire, Pressure, Immed Hlth FT3 02-001 MOTOR OIL Liquid 110 Minimal · Fire, Delay Hlth GAL 03/15/96 BOYNTON BROS INC 215-000-001051 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-004 ACETYLENE Gas 127 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 I Daily Average FT3 I Annual Amount FT3 127 ~ 63.00 254.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IAbove ~AmDiontlPORTABLE -- Conc Components MCP ---iGuide 100.0% IAcetylene IHigh / 17 02-002 CLEANING SOLVENT Liquid 110 Moderate · Fire, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: CLEANING Daily Max GALI Daily Average GAL I Annual Amount GAL -. 110 ~ 55.00 240.00 Storage~~Press T Temp Location DRUM/BARREL-METALLIC IAmbientlAmbientlSERVICE DEPT. NW -- Conc[ Components ] MCP ---~uide 100.0% IMineral Spirits IModeratel 27 02-003 OXYGEN Gas 275 Low · Fire, Pressure, Immed Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3I Daily Average FT3 ~ Annual Amount FT3 ... 275 ~ 137.00 550.00 Storage Press T Temp~ Location PORT. PRESS. CYLINDER Above ~AmbientlON CART -- Conc Components MCP Guide 100.0% IOxygen, Compressed ILow I 14 03/15/96 BOYNTON BROS INC 215-000-001051 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 MOTOR OIL Liquid 110 Minimal ~ Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL I Daily Average GAL I Annual Amount GAL 110 ~ 55.00 330.00 Storage Press T Temp Location DRUM/BARREL-METALLIC IAmbient/AmbientlSERVICE DEPARTMENT -- Conc~ Components ~ MCP ---/Guide 100.0% IMotor Oil, Petroleum Based IMinimal I 27 03/15/96 BOYNTON BROS INC 215-000-001051 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation 1) TO NOTIFY ALL PERSONNEL AT THIS LOCATION VERBALLY 2) TO HAVE EMERGENCY NUMBERS OF ALL INVOLVED EMERGENCY NUMBER 911 3) ALL PERSONNEL TO ASSEMBLE IN PARKING LOT TO HAVE HEAD COUNT <3> Public Notif./Evacuation PERSONAL VISIT TO NEIGHBORS AND SIGNS IN AREAS IN QUESTION <4> Emergency Medical Plan MERCY MEDI CENTER 820 34TH ST BAKERSFIELD, CA. (805) 325-6334 MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFEILD, CA 327-3371 MEMORIAL HOSPITAL 420 34TH ST 03/15/96 BOYNTON BROS INC 215-000-001051 Page 6 00 - Overall Site <D> Notif./Evacuation/Medical <4> Emergency Medical Plan (Continued) BAKERSFIELD, CA. 327-1792 03/15/96 BOYNTON BROS INC 215-000-001051 Page 7 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention A) PROPER TRAINING OF ALL PERSONNEL IN HANDLING OF MATERIALS B) FLUIDS ARE USED IN SMALL QUANTITIES SO AS NOT TO SPILL MORE THAN 2 GALLONS C) USE OF PROPER SWEEPING COMPOUNDS USE OF FIRE EQUIPMENT IF NEEDED <2> Release Containment MAINTAIN VENTILATION - ABSORB SPILL ON VERMIEALITE, OIL DRY OR SIMILAR MATERIAL AND PLACE IN A HOOD OR OTHER LOCATION WHERE VAPORS CAN BE EXHAUSTED SAFETY. <3> Clean Up SWEEP UP AND DISPOSE OF IN METAL OR CARDBOARD CONTAINER. <4> Other Resource Activation 03/15/96 BOYNTON BROS INC 215-000-001051 Page 8 00 - Overall Site <F> Site Emergency Factors Special Hazards <2> Utility Shut-Offs A) GAS - SOUTH ALLEY BETWEEN 17TH & 18TH STREETS B) ELECTRICAL - SOUTHEAST CORNER SERVICE DEPT, SOUTHEAST CORNER OF OFFICE, INSIDE WAREHOUSE C) WATER - IN ALLEY BETWEEN 17TH & 18TH STREETS EAST OF O STREET D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - TEL TEC SECURITY FIRE HYDRANT - SOUTHWEST CORNER ALLEY BETWEEN 18TH & 17TH STREETS ON 0 STREET. <4> Building Occupancy Level 03/15/96 BOYNTON BROS INC 215-000-001051 Page 9 00 - Overall Site <G> Training <1> Employee Training WE HAVE 15 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: QUARTERLY SAFETY MEETINGS COVERING MATERIAL HANDLING AND STORAGE PRACTICES. <2> Page <3> Held for Future Use <4> Held for Future Use ~ ~ Overall Site with 1 Fac. Unit I General Information : 909 18TH ST Map: 103 Hazard: Moderate ity: BAKERSFIELD STATION 01 Grid: 30C F/U: 1AOV: 0.0 , Contact Name Title Business Phone ' 24-Hour Phone1 ~'. E. BOYNTON (805)'324-4532 x (805) 327-2161! ERT KISER (805) 324-4532 x (805) 871-6512~ Administrative Data 3Mail Addrs: 909 18TH ST D&B Number: 95-153-4095 City: BAKERSFIELD State: CA Zip: 93301- Code: 215-001 BAKERSFIELD STATION 01 SIC Code: : J. E. BOYNTON Phone: (805) 832-2465 : 305 STARMOUNT DR State: CA City: BAKERSFIELD Zip: 93304- mary RECEIVED 1 5 1992 HAT reviewed the mtached hP~.srdous rnmer~aJs rnarmgeo agement plan for my ~acilit¥, 02/24/92 BOYNTON BROS INC 215-000-001051 Page 2 O ? 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-0~1- MOTOR OIL Liquid 110 Minimal I · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No ~ Form: Liquid Type: Pure Days: 365 Use: LUBRICANT ~ Daily Max GAL Daily Average GAL Annual Amount GAL -- I Storage Press T Temp Location '~~ DRUM/BARREL-METALLIC IAmbient~AmbientlSERVlCE DEPARTMENT - Conc Components MCP List 100.0% IMotor Oil, Petroleum Based Minimal I 02-002 CLEANING SOLVENT Liquid 110 Moderate · Fire, Delay Hlth GAL CAS #: Trade Secret: No~ i Form: Liquid Type: Mixture Days: 365 Use: CLEANING ~~ ~ Daily Max GALll0 I Daily Average 55.00 GAL 1 Annual Amount 240.00 GAL ~ Storage I~Press T Temp Location DRUM/BARREL-METALLIC Iambient~AmbientlSERVICE DEPT. NW -- Conc Components MCP List 100.0% IMineral Spirits IModeratel 02-003 OXYGEN Gas 275 Low · Fire, Pressure, Immed Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 Daily Average FT3 Annual Amount F~3 275 I 137.00 I 550.00 Storage Press I TempI Location PORT. PRESS. CYLINDER Above ~AmbientlON CART -- Conc Components ~ MCP List · 100.0% IOxygen, Compressed ILOw - I 02/24/92 BOYNTON BROS INC 215-000-001051 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02 ACETYLENE Gas 127 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3127I~ Daily Average63.00FT3 I Annual Amount254.00FT3 -- Storage I Press I Temp I Location PORT. PRESS. CYLINDER Above ~Ambient PORTABLE -- Conc Components MCP --~List 100.0% IAcetylene IHigh ') 02/24/92 BOYNTON BROS INC 215-000-001051 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> A~ency Notification cAi 911 <2>?Employee Notif./Evacuation ALL PERSONNEL TO ASSEMBLE IN PARKING LOT TO HAVE HEAD COUNT · ubli Notif./Evacuation PERSONAL VISIT TO NEIGHBORS AND SIGNS IN AREAS IN QUESTION ~ WILLARD D C:IRI~TIANSO.M MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 MEMORIAL HOSPITAL 420 34TH ST 02/24/92 BOYNTON BROS INC 215-000-001051 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention A~,~ROPER TRAINING OF ALL PERSONNEL IN HANDLING OF MATERIALS B,,) FLUIDS ARE USED IN SMALL QUANTITIES SO AS NOT TO SPILL MORE THAN 2 GALLONS ,C) USE OF PROPER SWEEPING COMPOUNDS : USE OF FIRE EQUIPMENT IF NEEDED <2~:~ elease Containment <31~ Clean Up <4> Other Resource Activation 02/24/92 BOYNTON BROS INC 215-000-001051 Page 6 O0 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2}_~Utility Shut-Offs ' A) GAS - SOUTH ALLEY BETWEEN 17TH & 18TH STREETS B) ELECTRICAL - SOUTHEAST CORNER SERVICE DEPT, SOUTHEAST CORNER OF OFFICE, INSIDE. WAREHOUSE /C) WATER - IN ALLEY BETWEEN 17TH & 18TH STREETS EAST OF O STREET D) SPECIAL - NONE E) LOCK BOX - NO <3>~ Fire Protec./Avail. Water PRIVATE FIRE ~PROTECTION - ~ SECURITY FIRE HYDRANT - SOUTHWEST CORNER ALLEY BETWEEN 18TH & 17TH STREETS ON 0 STREET. <4> Building Occupancy Level ." 02/24/92 BOYNTON BROS INC 215-000-001051 Page 7 00 - Overall Site <G> Training <1> Page 1 WE HAVE 15 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON PILE BRIEF SUMMARY OF TRAINING: QUARTERLY SAFETY MEETINGS COVERING MATERIAL ~ANDLING AND STORAGE PRACTICES. \ <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use Bakersfield Fir '~' / HAZARD, OUSMATERIALS DIVISION Date Completed,)--- clr/'~i' ~ Business Name: ~OyF'~/,,J ~, Ii, dE-, Location: QO~ [~'~.,~-- ~'(-' RECEIVED Business ldentification No. 215-000 /C~-/ (T'opof Business Plan/) 2 Station No. [ Shift ~' inspector ~,/,'/g)OA-P'/j. //-///'~ ,AZ. MAT. DIV, Adequate Inadequate Verification of Inventory Materials ~ ~ Verification of Quantities ~ ~] Verification of Location ~ ~ Proper Segregation of Material~ ~ Verification of MSDS Availablity ~ ~ Number of Employees [ ~ 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: Violations: 'n~s~OOw~ A llltemsO.K. ~~] B~us Correction Needed i ger FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy -- CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Farm AndAgt. iculture FI Standard Business [] NON--TRADE SECRETS BUSINESS NAME: Bo~ BROS I~C OWNER NAME: .T ~ ~n~ NAME OF THIS FACILITY: LOCATION; 909 18~B s~ ADDRESS: 30~"s~o~ DR STANDARD IND CLASS CODE: CITY. ZIP: BAKERSFI~~ 93301 CITY. ZIP: BA~RSF!ED, CA 93304 DUN AND BRAD~TREET NUMBER PHONE fl: ~-324-453~ PHONE ~; (805; u~z-z~b CODES ' REFER TO~NSTRUU~ONS~ROP~ CodeTrans cooe[Y~e Amt~ax AvfraDeAmc AnnUalEsc NfiasUreun~ts CAI~ ~[e Con[ Gont ~on[-ColeUs Locakion.~he[e. Hames See°f Press lump ~ype Stored In Pa~cy ~Y Physic~l And,ellLhHAzard C,A,S, Humber Componen~ II Nlme I C,A,S, Number (Check all that apply) Component I~ Name I C.A.S. Number Hazard ~ Reactivity ~ Sudden Release ~ Immediate of Pressure Health Component 13 Name I C.A.S. Number ~hysic~l 8nd Health HAzard C,A,S, Number Componen[ II Name t C,A,S, Number v ICheck al/ Chat Component I~ Name t C.A.S, Number U Fire Hazard ~ Reactivity U Belayed U Sudden Release U Hea/th of Pressure Component 13 Name I C.A.S. Number Physical and Health Hazard C.A.S, Number ' ~7~'P-¢~- F Component II Name I C.A,S, Number tCheck 811 that apply) ~ ~u~~ ~2~ Component I~ Name l C,A,S. Number re Hazard ~ Reactivity ~ Belayed Health Component 13 Name I C,A.S. Number Physical and Health ~aiard C.A,S, Number. ~-~'~-~ Component II Name I C,A,S. Number ICheck a11 Chat applll ~re Hazard ~ Reactivity' ~ Delayed ~d~npReleaSeot ressure ~di~ea~ Component C.A.S. Humber Health Component 13 Name I C.A,S. Number EMERGENCY CONTACTS fll at~a~hed.doc~ment~, ~n~ ~ oaseo om:my ~nqu~ry g~.~nose ~no~v~oum~s respons~D~e for obtaining ~he ~ntorma~on, I be~eve thaL Lhe ~~f~tl~ of o~nertooer~tor UH o~fler/operators ~horlzeo representatlve~ - ~'ure Bakersfield Fire Dept. v// HAZARDOUS MATERIALS DIVISION Location: .4,s'd ............ Business Identification No. 215-000 ~ ~ ~"' ~ (Top of Business Plan) Station No. [ Shift ~-~. Inspector Adequate Inadequate Verification of Inventory Maerials I~ ~ ~_____~ ,,~ Verification of Quantities Verification of Loc,ion Proper Segregation of Material Comments: ~ .~ ' Verification of MSDS Availablity Number of Employees ~ ~, Verification of Haz Mat Training Comments: Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Special Hazards J~ssociated with this Facility: '~ L_ , ~) ~'~ Correction Needed I~ bw~'~lana r- '~-- '~-'- ~ , FD 1652 (Rev. 1-90) ~i~-H~ ~t Div. Yellow-S~tion ~py Pink-Busine~ ~y ogxosxgo 'FON ROS INC 21 S_¢,O0_OOil l RECEIVED ~:~ Overall Site with 1 Fao. U~,it OCT 2 ~ 1990 General Informat ior, Location: 909 18TH ST Map: 10~ Hazapd: Modepate Ident Number: 215-000-001051 Grid: 30C Area of Vul: 0.0 Contact Name Title Business Phone ~-24 Hour Phone- J. E. BOYNTON (805) 324-4532 x (805) ROBERT KISER (805) 324-4532 x (805) 871-6512 Administrative Data ,,, Mail Addrs: 909 18TH SI' D&B Number:~5x~d~ City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION O1 SIC Code: / ~ Owr~er: J. E. BOYNTON ~ Phone: Address: 305 STARMOUNT DR~ State: CA City: BAKERSFIELD Zip: 93304- ~ Summary tl, ,d' .-o.~ Dc~ hereby cedJ(y/hat I hays msn~ pi~.n for ~ ;.nd ';:hst it ~Ior~ with agemsnt pla~ for my facllily, 09/05/90 B~ ITON BROS INC 215'000-001~1 Page 2 Hazrnat Inver, tor¥ List itl Reference Number Order % 02 - Fixed Cor~tai~ers o~ Site Plr~-Ref Nar~e/Hazards Forr~ Quant ity MCP 02-001 MOTOR OIL ? 110 Mi~ir~al GAL 02-002 CLEANING SOLVENT ? 110 Moderate 02-003 OXYGEN ? 275 Low FT3 02-004 ACETYLENE ? 127 H i gh FT3 09/05/90 B~I~TON BROS INC 215-000-0( Page 3 O0 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation 1) TO NOTIFY ALL PERSONNEL AT THIS LOCATION VERBALLY 2) TO HAVE EMERGENCY NUMBERS OF ALL INVOLVED EMERGENCY NUMBER 911 3) ALL PERSONNEL TO ASSEMBLE IN PARKING LOT TO HAVE HEAD COUNT <3> Public Notif./Evacuation <4> Emergency Medical Plan DR. WILLARD B CHRISTIANSON 2021 22ND ST 327-9617 MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 MEMORIAL HOSPITAL 420 34TH ST 327-1792 09/05/90 ~TON BROS INC 215-000-001~ Page 4 O0 - Overall Site <E> Mit i gat i on/Prevent/Abat e~t <1> Release Prevention A) PROPER TRAINING OF ALL PERSONNEL IN HANDLING OF MATERIALS B) FLUIDS ARE USED IN SMALL QUANTITIES SO AS NO]' TO SPILL MORE THAN 2 GALLONS C) USE OF PROPER SWEEPING COMPOUNDS USE OF FIRE EQUIPMENT IF NEEDED <2> Release Contain~ent~ <3> Clean Up <4> Other Resource Activation 09/05/90 ~ B~TON BROS INC ~15-000-00] Page 5 ~ O0 - Overall Site <F> Site Er~ergency Factors <1> 'Bpecial Hazards <2> Utility Shut-Offs A) GAS - SOUTH ALLEY BETWEEN i?TH & 18TH STREETS B) ELECTRICAL - SOUTHEAST CORNER SERVICE DEPT, SOUTHEAST CORNER OF OFFICE, INSIDE WAREHOUSE C) WATER - IN ALLEY-BETWEEN i?TH & 18TH STREETS EAST OF 0 STREET D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SONITROL SECURITY FIRE HYDRANT - SOUTHWEST CORNER ALLEY BETWEEN 18TH & 17TH STREETS ON 0 STREET. <4> Held for Future use 09/05/90 ×' ~TON BROS INC 215-000-00~ Page 6 ~ O0 - Overall Site <G> Training <l.>/Page ~ WE HAVE ??-.EMPLOYEES AT '[HIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use HAZARDOUS ~TERI ALS BUSINESS PLAN AS A WHOLE FORM 2a INS~UCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION ~: BUSI~SS IDE~IFICATION DATA A. BUSINESS NAME: s. LOC~TZON / STRSE~ A~RESS: z P: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7580 or 1-916-427-4341. This will not~fy your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A.._~'-~. ~r-.~,~~' Ph# ~Z~'?-- Ph# B. '--~..~ ~ ~<~ 5 ~ (~- Ph# ~t Ph~ ~ 7/ -~/~'- SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: ~-~.~. ~-~C? ,~ce_ ~%%[~j ~£~,-~ ~ I~'~k~ ~"~kL~s-- ~. B. ELECTRICAL: C. WATER: ~,~ All r~ ~,~.~ ~'*~ ~ l%'v ~.~m~ og"~" ~"~'' D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES ,/ NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 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 EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~NO (~ NO C. PROPER USE OF SAFETY EQUIPMENT: ................... ~ NO '~-~> NO D. EMERGENCY EVACUATION PROCEDURES: ................. f~N0 (~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... ~NO ~"~S-~NO SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ,MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES ~ I,' .'~_F~x,~c> ~ ~_,4i~/~~- , certify that the above information is accurate. I understand that 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. SIGNATURE,, 7 ITLE c~/f./f~>~ ,~.<,~rXec'.'3'~ DATE 7-,/0 .~ 7 BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFiCiAL USE ONLY ID# BUSINESS NAME: ~)~_~ ~ ~¢c~ ~'~ BUS I NESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT.~ '~-~J~)~ FACILITY b'NIT NB34E: ~~ %CF ~~ SECTION 1: MITIGATION, PRE~5~ION, ABATEMEN~ PROCED~ES SECTION 2: NOTIFICATION .~ND EVACUATION PROCEDURES .AT THIS L%'IT ONLY - 3A - SECTION 3: HAZARDOUS MATERIALS FOR THIS U~.'IT ONLY A, Does this Facility Unit contain Hazardous :,~:.~v~,,~,,~?._~..~ ...... ~ NO If YES, see B. If NO, continue wit~ SECTION 4, B. Are any of the hazardous materials a bona fide Trade Secret YES (~ If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous ~aterials inventory form marked: TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade secret form List only the trade ~ · secre~ on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E,~,~RGENCY RESPONDERS Oat CD" '~--,- SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS bQTIT ONLY. B. ELECTRICAL~: C. WATER: O. SPECIAL: £. !,OCK BOX: YES .,"~rF VES, .r..OCATION: BAKERSFIELD CITY FIRE DEPARTMENT I.D. { FORM 4A-1 Page ~of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY ..t PHONE ~: 2~q-q~,'{ ~ PHONE ~: ~3~-'~ ~ IOFFICIAL USE CFIRS CODE I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE HAX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T CODE AHOUNT AHOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE OUIDE F~iEROENCY CONTACT: t~ " TI~I,E: ,t PHONE g BUS HOURS: AFTER BUS HRS: E,ERGENCY CONTACT: '~..~,'~'~ /<, S [/C TITLE: ~'y/q,~ .. PHONE { BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: ''~/gt' ~ ~r 5~gL//c'~' AFTER BUS HRS: