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HomeMy WebLinkAboutBUSINESS PLAN *USINESS NAME 'JO' i,i'sl CH c NU BER 215-ooo-ooo86o LOCATION 1109 E 19TH ST :~5 HIGH HAZARD RATING 4 1 . OlzEB~~IEW LAST CHANGE 06/07/88 BY ESTER JURIS CODE 215-002 JURIS BAKERSFIELD STATION 02 MAP PAGE 103 GRID 29D FACILITY UNITS 1 tIAZARD RATING 4 RESPONSE SU~IMARY 2A SEC 4) ONE MAN OPERATION (NO EMPLOYEES WORK AT THIS ADDRESS ON A REGULAR BASIS). EMERGENCY CONTACTS 2A SEC 2) ELMER P JOHNSON - 325-0113 OR 325-0204 UTILITY SHUTOFFS 2A SEC 3) A) GAS - AT HOUSE IN FRONT B) ELECTRICAL - AT HOUSE IN FRONT C) WATER - AT HOUSE IN FRONT D) SPECIAL - NONE E) LOCK BOX - NO 4 . LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 06/07/88 BY ESTER · 2A SEC 5) MEMORIAL HOSPITAL 420 34TH ST 327-1792 PAGE 1 06/07/88 09:55 MATERIAL SAFETY DATA SYSTE~tS, INC. {805) 64.8-6800 BUSINESS NAME JOHNSON CHEMICALS ID NUMBER 215-000-000860 LOCATION 1109 E 19TH ST HIGH HAZARD RATING 4 FACILITY UNIT 01 A . OVIElqlALL H.iZ.iRDOUS ~IATElq~IALS I N~TENTORI~ LAST CHANGE 06/07/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION. CONTAINMENT USE 1 PURE CHLORINE 34362 FT3 EXTREME W SIDE OF YARD PORTABLE PRESS. CYL. PESTICIDE ID PERCENT COMPONENTS HAZARD LISTS 1028 00 100 0 CHLORINE · · EXTREME EPA 2 MIXTURE CAUSTIC SOLUTION 600 GAL HIGH CENTER OF YARD ABOVE GROUND TANKS NEUTRALIZER ID PERCENT COMPONENTS HAZARD LISTS 1560.00 30.0 SODIUM HYDROXIDE, SOLUTION HIGH FIRE PROTECTION / $~AT E !~ SUPPLIES LAST CHANGE 06/07/88 BY ESTER 3A sEc 4) ONE DRY FIRE EXTINGUISHER AND GARDEN HOSE(S) FOR FIRE PROTECTION. 3A SEC 5) FIRE HYDRANT AT E TRUXTUN AVE AT ROBINSON ST (NORTH SIDE OF STREET). PAGE 2 06/07/88 09:55 MATERIAL SAFETY DATA SYSTEMS, INC, (805) 648-6800 BUSINESS NAME JOHNS~ CHEMICALS ~D NUMBER 215-000-000860 LOCATION 1109 E 19TH ST HIGH HAZARD RATING 4 FACILITY UNIT 01 D . E ivII:)LOYEE NOTIFICATION / E$~ACUA?ION LAST CHANGE 06/07/88 BY ESTER 3A SEC 2t 911 & VERBAL NOTIFICATION. E . MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 06/07/88 BY ESTER 3A SEC 1) CHLORINE IN VENDOR'S APPROVED CONTAINER AND VALVES, FITTINGS, ETC. ARE INDUSTRY STANDARD AND OUR TANKS ARE ALL TESTED AND CERTIFIED PER INDUSTRY STANDARDS. APPROXIMATELY 30% CAUSTIC SOLUTION IS IN A CLOSED CIRCULATION SYSTEM MADE OF SCHED 80 PVC WHICH HAS TWO LARGE SUMPS TO PREVENT ACCIDENTAL SPILLS. THIS SYSTEM IS ONLY OPERATED WHILE A QUALIFIED OPERATOR IS ACTUALLY USING IT. POWER IS DISCONNECTED (UNPLUGGED) WHEN NOT IN USE. PAGE 3 06/07/88 09:55 MATERIAL SAFETY DATA SYSTEMS, INC. {805) 648-6800 .. SITE/FACILITY DIAGRIL~I' · .DATE: ./ / FACILITY N~ME: ' UNIT =:' OF (CHECK ONE) ' SITE DIAGR.%M FACILfTY DfAGR.%M (.Inspector's Comments): -OFFICIAL USE'ONLY- - 8A -. · '1 SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT 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 ' ' If No, complete a separate hazardous materials invento'ry 'form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) tf Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List ·only the trade secrets on form 4A-2 SECTION 4:'PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY F~R' USE BY EMERGENCY RESPO~ERS .' E LOCK BOX: YES / No rF YES, LOCATIOS: FLOOR PLANS? YES KEYS? YES - 3B - · BAKERSFIELD CiTY·FiRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUS I NE-SS PLAN SINGLE FACILITY UNI.T FORM 3A INSTRUCTIONS 1. To..av. oid further action, this form must be ...returned by: 2. TYPE/'PRtNT YOUR'ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED EEl. OW · .4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# FACILITY UNIT NB.ME: ,. SECTION 1: MITIGATION, PRE~NTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AN~ EVACUATION PROCEDURES AT THIS UNIT ONLY SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE S~CTION 5: LOCAL E~ERGENCY ~EDICAL ASSIST~CE FOR YOUR BUSINESS AS A ~HOLE · SECTION 6: EMPLOYEE T~INING. EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM'WHICH PROVIDES EMPLOYEES WITH INITIAL AND. REFRESHER' TRAINING.IN THE FO'LLOWIN~-'AREASi.. CIRCLE YES.OR NO .. .~ '~' INITIAL'.. REFRESHER". A.'METHODS"FOR sAFE'HANDLING OF HAZARDOUS ' ':' ' ~TERIALS':...- .................................... ~ NO (~ NO' B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .... : ..................... YES ~ YES (~ c.'PROPER use OF SAFETY EQUIPMENT: .................. No NO D EMERGENCY EVACUATION PROCEDURES: .................YES (~ YES ~ E DO YOU ~INTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ YES N(~ SECTION 7: ~ZARDOUS ~TERI~ CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~4TERIAL IN. QUANTITIES LESS THAN,500 POUNDS. 0.~ SOLID, 55 GALLONS-OF A LIQUIb?tOR 200 CUBIC FEET OF A COMPRESSED GAS:.' ..... I, ~-/~4~ ~, .J~~O~ , certify that the above information is accurate. I understand-that this information ~ill be used to fulfil't my firm's obligations under the new California Health and Safety code on Hazardous Materials" (Div. 20 Chapter 6.98 Sec. 2§§00 Et Al.) and that inaccurate information constitutes perjury. SIGNATURE TITLE DATE ' ' .. Oq.j BAKERSFIELD CITY FIRE DEPARTMENT "~? 2130 "G" STREET RECEIVEr] (8os) 326-39?9 JUL 2 ~ 1987 oTbS? ~ ~ a,s'd ............ OFFICIAL USE ONLY BUSINESS NAME HAZARDOUS MATERIALS .... BUS:I. NESS- PLAN AS A WHOLE FOR~ 2A 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 1 :. 'BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: dob kl SON C~eiq// , C~ SECTION 2: E~RGENCY NOTIFICATIONS In case of an emergency involving the release ov threatened release of a hazardous material, call 911 and 1-800-852-7550 o~ 1-916-427-4341. Thls will uotify you~ local fi~e department and the State Office of Emergency Services as ~equlred by law. E~PL0 NOTIFY IN CASE 0F E~ERGENCY: SA~E, ASD TITLE~/ - -- DURING BUS. HRS. AFTER BUS. HRS. SECTION 8: LOCATION. 0F ~ILI~ S~-0FFS' FOR BUSI~SS AS A ~0LE E. LOC~ BOX: YES ~XO IF YES, LOCATION: ' ~F YSS, DO~S IT CO~TA~ S~T~ PLA~S? FLOOR PLANS? YES / ~0 KEYS? YES / ~0 BAKERSFIELD CITY FIRE DEPARTMENT I,D. # FORM 4A-1 Page" of NON--TRADE SEC~ HAZARDOUS' MATERI ALS '~/ ~' f~ ,.? .-'BUSINESS NAME: .. w ~°~7 ~(C~- O~ER NA~E: ~/~r ~ ~'~ FACILITY ~IT. e: PHONE ~: $~5---Of[~ PHONE ~: ~K~--OLO~ [OFFICIAL USE CFIRS CODE ONLY 1 · 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS '~; BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE O ~; ~_~~~ xr~ °~~o ~.~;~, ~~, 'too c~/~,'~ ~ F~ - I ,, ~ ~ ~ ~ / ~/ FURE ,~ DATE: 7 -f EMERGENCY CONTACT: TITLE: PHONIC# BUS HOURS: ~Z~--OII~ AFTER LBUS HRS: ~Z ~-OZo ~ EMERGENCY CONTACT: TITLE: PHONE # BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS:~ - 4A-i - SITE/FACILITY D I AG RD~Pl FORM $' DATE: / / FACILITY N~ME: ' UNIT ~: OF (CHECR ONE) SITE DIAGRAM FACILITY DIAGRAM . . - ~ . ,,,% (~ ~ · ~.Z__-~' ]~,'.~...~ f'~ 1~<,, ',',., , ./~~"~" , . , . · ' ~'i~- '~_~ ",.~"~ .. ' ' . ~.... " ~ -...:..... ',~',3 ~_/ · ~~..x.~ · ' '- " (Inspector's Comments): -OFFICIAL USE ONLY- S[T£ DfAGRA~ (Re~ it~ 1. Address: identify Lhe '9. Lock(key) Box ~ principle buildings ' by the Street numbers. 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. ~a~onry 3. Storm Drains, Culverts. Yard Drains c. Mood 4. Drainage Canals~ Ditches, d. Gates. Creeks, i3. Powerlines a. Frame construction 14. Guard Station b. Masonry construction 15. S~orage Tanks: Identify ~he c. Metal construction capacity tn ~1. a. Above ground ~ d. Access Door 6. Utility Controi8 ~dO~ ~'_~ b. Underground , OF m. Oas ~T P-rO~'~ ]6. DJking or 8ers /v b. Electricity ~A --~ 17. Evacuation Route . gvacuatlon c Mater 18. ' Identify the 7. Fire Suppression Systems: '~ lo~atloa where ~{~ b. Fire Sprinkler '~0 d' / If. Outmide Hazardous Co~ectiona ~ Malt~ Storage ~ Connections / Material Storage. d. ~ater Control Valves ~~ ~ 21. Outside ~azardous fo~ pro~ec~lon systeas ?atertal 22, Ty~o~ ~azardoue Material/Waste Stored 8. Fire Department Access o~ Used (See TYPE OF ~'~US ~TERIA~ F - Fl~able [ - ~ploeiv~ L - Liquid R - Radiologtcal C - Corrosive 0 -.Oxidizer G -- Gas '~ P - Poison g - ~ate~ Reactlve T - Toxic 9 - Solid H - Cryogenic D - Waste B - Etiological Example: Fishable L/quid - ~L FAC[LITY D[AG~ (Required l~ess~:a~'l~on to ~he I. Risers for Sprinklers /.// ~ ' ~ 8. Fire Escapes 9. AI~ Coadltlodln~ 3. S~alrways: Indicate the ~ / 10. Mind.s levels served from ~ .... / .. hlghes~ to lowest. ~ ll. Inside Hazardous Waste Storage 4. E~cala~or: l~dlca~e' the levels served rroe 12. Inside Razardous hlShes~ ~o loees~. ~a~erlals S~oraee ~. E1evetor 13. Inalde Hazardous ~erlals ~se/aandlln~ 6. i~tlc Access 7. Skylights