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BUSINESS PLAN 9/16/2003
Hazardous. Ma Permit ID#:: 0'15-000-000175. ENGINE PARTS WAREHOUS! LOCATION: 410 21ST ST Issued by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTA L' SER VICES B~u~ 1715 Chester Ave., 3rd Floor ~rtttm~ Bakersfield, CA 93301 ~,~mr~rt Voice (661) 326-3979 ,,~i~,, FAX (661) 326-0576 '='. ' :.'- 13 Underground Storage of HazardoUs Materials · :13 Risk Management Program ": '13 HnTnrdous Waste On-Site Treatment ' · ; ' ' ' -- , ~"[ :',~f' i: ',- '" 2. · . OfficeofEviromn~S~wic~ ~ . .Approved by: Expiration Date: "jUne 30. 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ...:~,~;~;::~,?i~. ;,~,, ;~,,,~;~,~,~,~ This permit is issued for the following: ~ ~=~i ?"i' !~; :=?'% iiiii!i{~=. ~,iii!!!iiii~. iiiiiiiii iiiiii::::', ii?~:~ii~Dili~O~emround Storage of Hazardous Materials PERMIT ID# 015-021000175 .' ,..i~'?~i'i:j:,ii~.::iiiii'~!!!~iii!i? il !!!!i~!!!!iiii~=!!!!!'.~!!!![ ! !.~,~ iq ~k ~nagement Program '. G NE PARTS WAREHOUSE~&.MA~HINE'~,.*'' ................... '~'~=..=~='~c.~.¥:?~=::;=~;~:~;~:.~;.~.~.:.~=. *LOCATION 410 21ST Issued by: Bakersfield Fire Department omc£ O£ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice ($05) 326-39?9 FAX (805) 326-0576 Approved by: Expiration Date: June 30, 2000 I TE/FACI LI TY R NORTH. SCALE:.,I.~m.I[ ~O BUSINESS NAME:~z~' ~ r~ FL00R: , 0F (CHECK ONE) SITE DIAGRkM / FACILITY DIAGR ,) 'e~~ Inspector's Comments): -OFFICIAL USE ONLY- SITE DIAGRAm4 1. Address: Identify the 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. Masonry 3. Storm Drains, Culverts, Yard Drains c. Wood 4. Drainage canals, Ditches, d. Gates Creeks, 13. Powerlines 5. Buildings a. Frame construction 14. Guard Station b. ~asonry construction I5. Storage Tanks: Identify the c. Metal construction' capacity in ~nl. 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. Fire Hydrants employees will meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste StOrage c. Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Nater Control Valves 21. Outside Hazardous for protection systems Material Use/Handling e. Fire Pu~p 22, Type of Hazardous Material/Waste Stored B. Fire Department Access or Used (See '~ Below) TYPE OF HAZARDOUS MATERIAL F - Flammable E .= Explosive L = Liquid' R = Radtologtcal C - Corrosive 0 - Oxidizer .O = Gas P = Poison W = Water Reactive T = Toxic S = Solid H = Cryogenic D = Waste. -B = Etiological Example: Flammable Liquid = FL FACILITY DIAGRAN (Required items in addition to the. abo~e) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Alu 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. Haterials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets 7. Skylights ' ' ' ITE/FACI LITY NORTH SCALE: ./,..2D ! BUSINESS ht . [~.... (CHECK ONE) SITE DIAGRk~I ;% , !~..: . '" Inspector's Comments): -OFFICIAL USE ONLY- COI~RECTION NQIrlCE .i 04945 .i BAKERSFIELD FIRE DEPARTMENT Location ~'[/+' ~_( sT iT Name ~--'~'~- pAP_T~ ~sE You ~e hereby required to m~e ~e fo/lo.hq co~ections at ~e above Iocat~on: Cor. No. I' Completion Date for Corre~ 7/S°//0 S Inspector FD 1950 326'3951 p1010045.jpg (1280x960x24b jpeg) p1010046.jpg (1280x960x24b jpeg) p1010048.jpg (1280x960x24b jpeg) i ? p1010047.jpg (1280x960x24b jpeg) B A K E g s F £ E 'L'~ Haz Mat Emerg Spill Complaint Environmental Services ~ ~ ~ Haz Mat Incident / Spill Repo~ / Complaint Follow Up Date ~ /~3//03 Time Repo~g ParW ~ t ~ ~ ~,~a Env~onmen~l se~ices Contact Address (~ Telephone No. ~- ~od ~~ Location of the ~cident A ~ ~ ~( ~ r ~,~ ~ ~ Description of the ~cident ( Chemical name and Quantity ) Responding to Incident ~} N Observations Special Conditions and / or health risks Haz Mat Team Dispatched Y N Van Cellular No. 332-7865 OES Number Required ~Y N Number Poss Exposure viCtims Medical Attention Required or Obtained Probable Hazardous Waste Clean Up Y N Discussion and Disposition Referral CITY OF BAKERSFIELD FIRE DEPARTMENT ~ OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME'--'~'~,~4. ~/4r~5 wA~tJ°~z '~SPECTION DATE ~"/~ -- ~ ADD. SS q{O ZI s~ PHONENO. ~Z~--~3~ FACILITY CONTACT ~j,~ f~D BUSINESS ID NO. 15-210- ~i 7 ~ ~SPECTION TIME [.~ ~ NUMBEROF EMPLOYEES / D Section 1: Business Plan and Invento~ Program ~outine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand V Business plan contact information accurate Visible address V Correct occupancy t/ Verification of inventory materials Verification or quantities / Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection ,/, Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous ,waste on site?: Questions regarding this inspection? Please call us at (661) 326-3979 st S · '~" 'p ,' leParty ENGINE PARTS WARE MACHINE SiteID: 015-021-000175 Manager : BusPhone: (661) 323-7399 Location: 41021ST ST ~ Map : City : BAKERSFIELD %%%~%~ 103 CommHaz : Moderate ~ Grid: 30B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title HELIOS ROBAYO / OWNER~ MAURIS MASITIER / Business Phone: (661) 323-7399x Business Phone: (661) 323-7399x 24-Hour Phone : (661) 588-1122x 24-Hour Phone : (661) 588-3216x Pager Phone : ( ~) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ~!'/~-~th DelHlth Contact : Phone: (6 .~)L~33~72 399x MailAddr: 41021ST ST State: CA City : BAKERSFIELD Zip : 933, Owner HELIOS ROBAYO Phone: (6611~8-1122x Address : 2012 CLASSEN ST State: CA City : BAKERSFIELD Zip : 93312 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: Res: No ParcelNo: Emergency Directives: (T~ ~ ~m name) r~vie~sd th~ ~ttach~d hazardous mmeri~ls man~e- mere p~n fo[~.~~ , ~ ~he~ i~ elong ~i~h (~ ~ ~) ~ny ~ions ~ns~itu~~ ~ ~mpl~e ~n~ ~rm~ man- agement Plan ~r my facility. i 08/05/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3"~ Floor, Bakersfield, CA 93301 4-tq INSPECTION DATE FACILITY NAME bc-WO"q~/7~-e/3' ~~e ~o~ - ADD.SS q/O Z/~r~., _~ PHONENO. 3~-~~ FACILITY CONTACT huet5 BUSINESS IDNO. 15-210- ~SPECTION TIME ~ ~ ~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ,/~Routine ~ Combined [~] Joint Agency [~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address '4 Correct occupancy Verification of inventory materials Verification of quantities Verification of location // . Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled t/ Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation - Explain:any hazardous waste on site?:o { t.., ~jYes [~]No .~~Q~) ~ . .-- Questions regarding this inspection? Please call us at (661) 326-3979 Bu ess S~te R tble White - Env. Svcs. Yellow - Station Copy Pink - Business Copy · ENGINE PDLRTS WAREHOUSE & ~ MAC SiteID: 215-000-000!75 Manager : /~~~{~__~-)~usPhone: (805) 323-7399 Location: 410 21ST ST I f~w,,~ o LUUU IMap : 103 CommHaz : Moderate City· : BAKERSFIELD ~~:/~,__ . /Grid: 30B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATIC__ ~.SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title " Emergency Contact / Title HELIOS ROBAYO (~. OWNER MAURIS MASITIER Business Phone: ~) 323-7399x Business Phone: (,~)323-7399x 24-Hour Phone : (~) 588-1122x 24-Hour Phone : Pager Phone : ( ) - x Pager Phone : ( ) Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr~ 410 21ST ST State: CA City : BAKERSFIELD Zip : 93301 Owner HELIOS ROBAYO Address : ~5~2 ~E~OOD~ ~ ' ~ .... ~2 ~5~~ ~-' State: Phone: CA (805) 323-7399x. City : BAKERSFIELD . Zip : Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List 9 -- As Designated Order Ail Materials at Site ~ ~Unit MCP Hazmat Common Name... I I ISpecHazlEpA Hazards Frm DailyMax . ~ACETYLENE F P G 330.00 FT3 Hi ~"OXYGEN F P G 231.00 FT3 Low MOTOR OIL F L 55.'00 GAL Min ~NAPTHA SOLVENT F L 50.00 GAL, Mod /WASTE OIL F DH L 55.00 GAL Low /ANTIFREEZE F DH~' L 300.00 GAL Low AEROSOL PAINT , F P IH L 240.00 GAL Hi I, ~03~ k/~.oO'~© Do hereby ce~i~ ~hm I have ~y~ ~ p~nt name) ~vie~ed the a~ached haza~ous minerals mar:age- ment plan ~or '~. Q.V~/. and ~hm it along wifh any corrosions con~ute a complete and corre~ man- ~ agement plan ~r my facili~. ? 1 . 06/20/2000 ~g~mre · ~te ' ENGINE PAR~S WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0001 Facility Unit: Fixed Containers on Site ~1~ ~Vl~ / ~1 ~_A~_L, ~vl~ ACETYLENE Days On Site 365 Location within this Facility Unit MaP: Grid: CENTER OF BUILDING CAS# 74-86-2 Gas /Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 330.00 FT3 200.00 FT3 100%Wt'00 Acetylene I-IAZJ~DOUS COMPONENTS YesRS CAS# 74862 HAZARD ASSESSMENTS TSecret'l ~S'BioHaz'i ' Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P / / / Hi = Inventory Item 0002 Facility Unit: Fixed Containers on Site OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: CENTER. OF BUILDING CAS# 7782-44-7 F STATE -- TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT~ PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container [ Daily Maximum Daily Average FT3I 231.00 FT3 175.00 FT3 HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Oxygen, Compressed N 7782447 TSecret I HAZARD' AiSESSMENTS I S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P / / / .Low -2- 06/20/2000 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location Within this Facility unit Map: Grid: FRONT OF BUILDING CAS# STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid 1Pure I Ambient I Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 55.00 GAL 25.00 GAL nZARD0US COMPON .NTS %Wt. oRS CAS# 100.00 Motor Oil, Petroleum Based N 8020835 HAZARD ASSESSMENTS ITSecret NoRS BioHa'zI Radioactive/Amount EPA HazardsI NFPA USDOT# MOP No No No/ Curies F / /, / Min InventOry Item 0004 Facility Unit: Fixed Containers on Site COMMON NAME /~CHEMICAL NAME NAPTHA SOLVENT Days On Site 365 Location within.this Facility Unit Map:. 'Grid: NW OUTSIDE CAS# r STATE -- TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient DRUM/BARREL -METALLIC AMOUNTS AT THIS LOCATION [ Largest C°ntainer I Daily Maximum Daily Average GAL 50.00 GAL 30.00 GAL HAZARDOUS COMPONENTS 100.00 Naphtha Solvent N 8030306 HAZARD ASSESSMENTS TSecretl RSIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No No No No/ Curies F / / / Mod -3-, 06/20/2000 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ~ = Inventory Item 0005 . Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 LoCation within this Facility Unit Map: Grid: NW OUTSIDE CAS# 221 F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid .I~waste I Ambient I Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 55.00 GALI 30.00 GAL HAZARDOUS COMPONENTS 100.00 Waste Oil, Petroleum Based N 0 HAZARD ASSESSMENTS TSecret N~SIBioHaz Radioactive/Amount EPA HazardsI NFPA USDOT# I MCP No 'No No/ Curies F DH / / / Low = Inventory Item 0006 Facility Unit: Fixed Containers on Site 9 -- COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: · FRONT OF BLDG CAS# 107-21-1 Liquid Pure Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS.LOCATION Largest Container Daily Maximum Daily Average GAL 300.00 GAL 120.00 GAL HAZARDOUS COMPONENTS wt.I CAS# 100.'00 Ethylene Glycol N 107211 HAZARD ASSESSMENTS TSecret ~S [ BioHaz I Radioact ive/Amount. EPA HazardsI NFPA USDOT# MOP No N No No/ Curies F DH / / / Low 4 06/20/2000 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site AEROSOL PAINT .Days On Site 365 Location within this Facility Unit Map: 'Grid: NE OUTSIDE CAS# STATE TYPE PRESSURE =--~ TEMPERATURE CONTAINER TYPE Liquid Mixture Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS ,LOCATION Largest Container I Daily Maximum Daily Average GALI 240.00 ~GAL 120.00 GAL HAZARDOUS COMPONENTS 30.00 Acetone N 67641 15.00 Toluene IN° I 108883 25.00 Xylene, Mixed No 1330207 16.00 Propane Yes 74986 HAZARD ASSESSMENTS ' 'I'TSecret oRS BioHaz' Radioactive/Amount, EPA Hazards' NFpA USDOT# MCp No N No No/ Curies F P IH / / / Hi 5 06/2o/2ooo F ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 01/07/1990 CALL 911 Employee Notif./Ev~cuation 01/07/1990 TELEPHONE PUBLIC ADDRESS SYSTEM - EXITS NORTH, SOUTH, EAST, WEST DOORS Public Notif./Evacuation 01/07/1990 TELEPHONE PUBLIC ADDRESS SYSTEM EXITS - NORTH, SOUTH, EAST, WEST DOORS Emergency Medical Plan 05/07/1997 MEMORIAL HOSPITAL - 420 34TH ST - (805) 327-1792. 6 06/20/2000 F ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ MitigatiOn/Prevent/Abatemt Overall Site --Release Prevention 05/07/1997 ACETYLENE AND OXYGEN ARE CHAINED TO A CART. SOLVENTS AND PAINT ARE INSIDE A FIRE PROOF CABINET. Release Containment 03/20/1992 OPEN .VALVES. PIG SOCKS TO ABSORBE SOLUTIONS. --~ Clean Up 03/20/1992 AIR OUT. RECYCLE SOLUTIONS. o /2o/2ooo F ENGINE PARTS wAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ Site Emergency Factors Overall Site 'Special Hazards --Utility Shut-Offs 03/13/1992 A) GAS - RIGHT REAR OF BUILDING - OUTSIDE; B) ELECTRICAL - REAR WALL OF BUILDING - INSIDE C) WATER - RIGHT DRIVE WAY FRONT ON 21ST STREET D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/%3/1992 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - 21ST AND V ST IN THE MIDDLE OF THE BLOCK BETWEEN V AND R. [ Building Occupancy Level 8 ,06/20/2000 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ Training Overall Site -- Employee Training 05/07/1997 WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: OUR EMPLOYEES ARE TRAINED-AS WHAT TO DO IN AN EMERGENCY, LOCATION OF FIRE EXTINGUISHERS, EXITS, 911 NUMBER AND NEAREST HOSPITAL. -- Page 2 Held for-Future Use --Held for Future Use -9- 06/20/2000 CITY OF BAKERSFIELD CLAIM VOUCHER IVendor No. I certify that this claim is correct and valid, and is a proper charge against the City Agency and account indicated. CLAIMANT'S NAME AND ADDRESS: Engine Parts Warehouse & Machine (AUTHORIZED SIGNATURE OF CITY AGENCY) 410 E 21St Street Bakersfield, CA 93301 Date: 04-01-99 Initials of Preparer: CITY DEPARTMENT: FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Contract Number if Applicable) This customer madea duplicate payment on this years Haz Mat bill in the amount of $226.50. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $235.00. Dept. El / Objt Project t Invoice # Amount Date of Invoice 0000 7900 $235.00 vOUCHER TOTAL $235.00 SECTION 72, PENAL CODE FINANCE DEPT. USE ONLY Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to aJlow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, Examined & Approved for Payment Amount or writing, is guilty of a felony. STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD, CA 93301-520i (805) 32~-397~ DATE: TO: ENGINE PARTS WAREHOUSE · MACNI 410 ~IST~ST BAKERSFIELD~ CA ~3301 CUSTOMER NO; 28~0 CUSTOMER TYPE~ ES/ ~840 CHARGE DATE DEBCRIPTiON REF-NUMBER DUE DATE TOTAL AMOUNT 3/01/99 BE~INNIN~ BALANCE ~6.50 2/1~/99 PAYMENT ~/17199 PAYMENT ~&.50-- CA STATE SURCHARGE FOR 8UESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP DF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 8.50- DUE DATE: 5/03/99 PAYMENT DUE: 235.00- TOTAL DUE: ~235.00-- R~IT AND ~KE CH~C~ PAYABL~ TO: PO BOX R087 BAKER SF Z EL~ C~ ~3303-~057 ( 805 ) CUSTOMER NO: ~840 CUSTOMER TYPE: ES/ ~8~0 TOTAL DUE: $R3~.00- MI$CELLANFOU$ RECEIVABLES ADJUSTMENT ADDRESS CHANGE CLOSE ACCT i : .,.~.c~ c.~. I OTHER ADJ ' i MAILING ADDRESS ~ ~(~ ~-_~ ~' SITE ADDRESS PARCEL NUMBER (IF APPUCABLE} ADJUSTMENT CHG DATE CHARGE CODE ADJUSTMENT AMOUNT /-/~-~ ~?? ( '~..~ ~.~ REMARKS: ! APPROVED BY ~~ ENGINE PARTS WAREHOUSE & MAC~_~~[! ~,~i SiteID: 215-000-000175 Manager : ' ~A¥ ~1997 ~3usphone: (805) 323-7399 Location: 410 21ST ST Map : 103 CommHaz : Moderate City : BAKERSFIELD ~ Srid: 30B FacUnits: 1AOV: CommCode: BAKERSFIELD STATI~ ~'~ .................................. SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title HELIOS ROBAYO / OWNER MAURIS MASITIER / Business Phone: (805) 323-7399x Business Phone: (805) 323-7399x 24-Hour Phone : (805) 588-1122x 24-Hour Phone : (805) 832-6583x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title = Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI' Frm DailyMax Iunit MCP ACETYLENE F P G 330 FT3 Hi AEROSOL PAINT F P IH L 240 GAL Hi NAPTHA SOLVENT F L 50 GAL Mod ANTIFREEZE F DH L 300 GAL Low OXYGEN F P G 231FT3 Low WASTE OIL F DH L 55 GAL Low MOTOR OIL F L 55 GAL Min ~, ~ ~,~,(.,~ ~ ~--~,,~¥(~0o hereby csr~i~y th~ I have ~ or ~nt ~) reviewed ~h~. a~ached h~ardous minerals manage- ment plan for~ ~, ~ ~ '~-~ ~and that itq ~lon~ with (~e of Bushe~) any corrections constitute a complete and corrs~ man- agement plan for my facili~, -1- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0001 Facility Unit: Fixed Containers on Site ACETYLENE Days On Site 365 Location within this Facility Unit CENTER OF BUILDING CAS# 74-86-2 STATE -- TYPE PRESSURE TEMPERATURE CONTAINER TYPE I I Gas Pure I Above Ambient I Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 330.00 200.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Acetylene ~ 74862 -2- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0007 Facility Unit: Fixed Containers on Site AEROSOL PAINT Days On Site 365 Location within this Facility Unit NE OUTSIDE CAS# ~ STATE [ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Mixture Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 240.00 120.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL %Wt. EHS CAS# 30.00 Acetone No 67641 15.00 Toluene No 108883 25.00 Xylene, Mixed No 1330207 16.00 Propane No 74986 -3- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0004 Facility Unit: Fixed Containers on Site NAPTHA SOLVENT Days On Site 365~ Location within this Facility Unit NW OUTSIDE CAS# FSTATE -- TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid PureIi Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 50.00 30.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. Naphtha EHS CAS# 100.00 Solvent No 8030306 -4- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit FRONT OF BLDG CAS# 107-21-1 F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure I Ambient I Ambient PLASTIC CONTAINER AMOUNTS STORED AND IN USE Lrgst COLt.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 300.00 120.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS .COMPONENTS EHS CAS# %Wt. 100.00 Ethylene Glycol No 107211 -5- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site OXYGEN Days On Site 365 Location within this Facility Unit CENTER OF BUILDING CAS# 7782-44-7 Gas PureIi Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 231.00 175.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt.Ii EHS CAS# 100.00 Oxygen, Compressed No 7782447 -6- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0005 Facility Unit: Fixed Containers on Site WASTE OIL Days On Site 365 Location within this Facility Unit NW OUTSIDE CAS# 221 D~UM/BARREL-METALLIC Liquid Waste Ambient Ambient AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 55.00 30.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Waste Oil, Petroleum Based No . 0 -7- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 = Inventory Item 0003 Facility Unit: Fixed Containers on Site MOTOR OIL Days On Site 365 Location within this Facility Unit FRONT OF BUILDING CAS# r STATE TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE I Liquid Pure Ambient Ambient PLASTIC CONTAINER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 55.00 25.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 -8- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 01/07/1990 CALL 911 -- Employee Notif./Evacuation 01/07/1990 TELEPHONE PUBLIC ADDRESS SYSTEM - EXITS NORTH, SOUTH, EAST, WEST DOORS Public Notif./Evacuation 01/07/1990 ~TELEPHONE PUBLIC ADDRESS SYSTEM EXITS - NORTH, SOUTH, EAST, WEST DOORS Emergency Medical Plan 01/07/1990 MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 -9- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 03/20/1992 ACETYLENE AND OXYGEN ARE CHAINED TO A CART. SIKVEBTS AND PAINT ARE INSIDE A FIRE PROOF CABINET. Release Containment 03/20/1992 OPEN VALVES. PIG SOCKS TO ABSORBE SOLUTIONS. -- Clean Up 03/20/1992 AIR OUT. RECYCLE SOLUTIONS. Other Resource Activation -10- 04/25/1997 ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 Fast Format ~ Site Emergency Factors Overall Site speCial Hazards -- Utility Shut-Offs 03/13/1992 A) GAS - RIGHT REAR OF BUILDING - OUTSIDE; B) ELECTRICAL - REAR WALL OF BUILDING - INSIDE C) WATER - RIGHT DRIVE WAY FRONT ON 21ST STREET D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/13/1992 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - 21ST AND V ST IN THE MIDDLE OF THE BLOCK BETWEEN V AND R. Building Occupancy Level -11- 04/25/1997 F ENGINE PARTS WAREHOUSE & MACHINE SiteID: 215-000-000175 ? Fast Format ----/Training Overall Site -- Employee Training 06/18/1990 WE HAVE 12 EMPLOYEES WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE OUR EMPLOYEES ARE TRAINED AS WHAT TO DO IN AN EMERGENCY, LOCATION OF FIRE EXTINGUISHERS, EXITS, 911 NUMBER AND NEAREST HOSPITAL. -- Page 2 Held for Future Use Held for Future Use -12- 04/25/1997 02/24/92 ENGINE PARTS WAREHOUSE & MACHINE 215-000-000175~ECEi'q~QPage 1 Overall Site with 1 Fac. Unit General In=formation Location: 41~ 21ST ST Map: 103 Hazard: Moderate Community: BAKERSFIELD STATION 01 Grid: 30B F/U: 1 AOV: 0.0 Contact Name 'Title Business Phone 24-Hour Phone- HELIOS ROBAYO Ou3~3~_~_ (805) 323-~7~_399 x (805) 831-1912 Administrative Data Mail Addrs: 412~ 21ST ST D&B NUmber: City: BAKERSFIELD State: CA Zip: 93301- Comm Cbde: 215-001 BAKERSFIELD STATION 0.1 SIC Code: Owner: HEi~IOS ROBAYO_ Pho'ne: (805) 323->'7~399 Address: 20.1j~':C~asseh2St.~? State: CA City:-BAK-E-RS°FTELD, CA~ 93312 Zip: 93309- Summary l~ 19 1992 02/24/92 ENGINE PARTS WAREHOUSE & MACHINE 215-000-000175 Page 2 02 - Fixed Containers on Site Hazmat I~nventory Detail i~n Reference Number Order 02-001 ACETYLENE I Gas 330 High · Fire, Pressure FT3 CAS #: 74-86-2! Trade Secret: No Form: Gas Type: Pure Days: 365 use:'WELDING SOLDERING Daily Ma~ FT3 Daily Average FT3' Annual Amount FT3 Storag Press T Temp Location PORT. PRESS. CYLINDER IAbove ..1AmbiontlC'ENTER OF BUILDING ---Conc Components MCP List 100.0% .IAcet~'lene IHigh --~ 02-002 OXYGEN Gas 231 Low · Fire, PressUre FT3 CAS #: 7782-44-7 Trade Secret: No FOrm: Gas -~ Type: Pure Days: 365 Use: WELDING SOLDERING Daily M FT3 Daily Average FT3 Annual Amount FT3 Storag Press T Temp ~' Location PORT. PRESS. CYLINDER Iabove [AmDiontlCENTER OF.BUILDING -- Conc Components MCP List 100.0% IoxygE~n, CompresSed ILow I 02-003 MOTOR OIL Liquid 55 Minimal · Fire GAL CAS #: . Trade. Secret: No Form: Liquid Type: Pure. Days: 365 Use: LUBRICANT Daily Max GAL Daily Average GAL Annual Amount GAL . 55 I 25.00 I 200.00 st°rag9 IIPress T~Temp Location ~ PLASTIC CONTAINER IAmbient~AmbientlFRONT OF BUILDING -- Conc I Components. I MCP, List 100.0% IMoto~ Oil, Petroleum Based IMinimal I' 02/24/92 ENGINE ~ARTS WAREHOUSE & MACHINE 215-000-000175 Page 3 02.- Fixed Containers'on Site Hazmat I~nventory Detail ~n Reference Number Order 02-004 NAPTHA SOLVENT Liquid 50 Moderate · Fire ~GAL CAS #:. Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Mar GAL Daily Average GAL Annual Amount GAL -- 50 I 30.00 I 200.00 Storage Press T Temp Location DRUM/BARREL-METALLIC Ambient/AmbientlNW ouTSIDE -- Conc Components MCP iList 100.0%' INaph~ha Solvent Moderate ' 02-005 WASTE OIL Liquid 55 Low. · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 36'5 Use: WASTE · Daily Mai GAL I ' Daily Average GAL I Annual Amount GAL 55 30.00 300.00 Location Storag9 Press T Temp DRUM/BARREL-METALLIC IAmbient~AmbientlNw OUTSIDE -- Conc Components MCP ~List 100.0% IWast~ Oil, Petroleum Based ILowI' 02-006 ANTIFREEZE Liquid 300 Low · Fire, Delay Hlth GAL CAS #: 107-21~1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Mai ~ I Daily AVerage. GAL ] Annual Amount GAL i 120.00 600.00 Storag~ Press T Temp Location PLASTIC CONTAINER Ambient~AmbientlFRONT OF BLDG -- Conc Components MCP List 100.0% I Ethylene GlycoI 02/24/92 ENGINE ~ARTS WAREHOUSE & MACHINE 215-000-000175 Page 4 02 - Fixed Cont'ainers on Site Hazmat nventory Detail i~n Reference Number Order. 02-007 AEROSOL PAINT ~ Liquid 240~ High · Fire, Pressure, Immed Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: PAINTING Daily Mar GAL Daily Average GAL Annual Amount GAL -- i 240 I 120.00 I 240.00 S~orag Press T TempI] Location' PORT. PRESS."CYLINDER Above |AmbientlNE OUTSIDE - conc Components MCP ~List 30.0% IAcetOne ModerateI 15.0% Toluene Moderate[ 25.0% Xyle~e, Mixed ModerateI 16.0% Propane Extreme I 02/24/92 ENGINE PARTS WAREHOUSE & MACHINE 215-000-000175 . Page 5 00'- Overall Site <D> Norif./Evao~uation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation TELEPHONE,PUBLIC ADDRESS sySTEM - EXITS NORTH, SOUTH, EAST, WEST DOORS <3> Public Notif./Evacuation TELEPHONE PUBLIC ADDRESS SYSTEM EXITS - NORTH, SOUTH, EAST, WEST DooRs <4> Emergency Medical Plan MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 02/24/92 ENGINE pARTS WAREHOUSE & MACHINE 215-000-000175 Page 6 00 - Overall Site <E> Mitigation~Prevent/Abatemt <1> Release Prevention ACETYLENE AND OXYGEN ARE CHAINED TO A CART. <2> Release Containment <3> Clean Up A~R OUT <4> Other Resource Activation 02/24/92 ENGINE PARTS WAREHOUSE & MACHINE 215-000-000175 Page '7 O0 - Overall Site <F> Site Emer..'gency Factors <1> Special' Hazards <2> Utility Shut-Offs A) GAS - RIGHT REAR OF BUILDING - OUTSIDE; B) ELECTRICAL -.REAR. WALL OF BUILDING - INSIDE C) WATER - RIGHT DRIVE WAY FRONT ON 21ST STREET D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE.FIRE PROTECTION - NONE FIRE EXTI~GUISHS;R FIRE HYDRANT - ? 21' & .V MIDDLE OF BLOCK BETWEEN V & R <4> Building Occupancy Level 02/24/92 ENGINE PARTS WAREHOUSE & MACHINE 215-000-000175 Page 8 00 - Overall Site <G> T~aining <1> Page 1 WE HAVE 12 EMPLOYEES WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE OUR EMPLOYEES ARE TRAINED AS WHAT TO DO IN AN EMERGENCY, LOCATION OF FIRE EXTINGUISHERS, EXITS, 911 NUMBER AND NEAREST HOSPITAL. <2> Page 2 as needed <3> Held for Future Use <4> Hold for Futuro Uso CITY of BAKERSFIELD ETS . ~j~HAZAR DOUS MATERIALS INVENTORY Farm andAgticulture n Standard Business NON--TRADE SECR , ~~AME: ~¢~e-~ ~¥, NAME OF THIS FACILITY: · BUSINESS NAME: ~L:~ ~k~ STANDARD IND. CLASS LOCATION; ~o ~t~5+ - AUU~; 4~ ~ CITY. ZIP: %m~ ~o[ CITY. ZIPi ' _ DUN AND BRADSTR~ET NUMB? ..... PHONE fl: ~zq- 1~ )DES PHONE ~( ]li -- I 2 3 4 5 6 I ' 8 9 10 11 12 ' ~i!y Names0fHixtu?/C0mp0nen[s frans !y~e Hex Avgrpge Annual Measure I Qy~ Cont Cont Cont Us Location?ace. Stored in Pacl/icy · Code come 133gt Amc Est Units on 51ce Type Press .~emp cole see InstructIons ~h~sical mod ,ellthi~llrd C.~.S. Number ~-~-~ Component tl Na~e I C.i.S. Humber (Check all that ap,ly) '' -- ~Fire Hazard ~ Reactivity ~ 0elayed ~Sudden Release ~ Im~ediateC°mp°nent 12 Na~e I C.A.S. Number - Health of Pressure ~ealth Component 13 la~e t C.~.S. Number ' ' Physical and HealthBazard C.A.S. Number ~ ~-~-~ Component II Name & C,A,S. Number lOC O~G~'~ (Check'al/ that Heal[h Component 13 Name ~ C.A.S, Number Physical and HealthUazard C.A.S. Number Component II Male I C.A.S. Number lOC ~.~ (Check all that apply} ~Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Immediate Component 12 Name I C.A,S, Number Health of Pressure Health Component 13 Name ~ ~,A,~. Number Physical Iod HealthUaTard C,A,S. Number Component I1 Name &C,A.S. Number '10, ~r~+~ (Check al/ that apply) - ~Fire Hazard g Reactivity ~ Oelayed ~ SuddenRelease ~ lm~i~c°mp°nen[ 12 Name t C.k.S. Number Health of Pressure Component 13 Name I C.A.S, Number ;ertifi atio ' Re and i naf r corn 1 ting all sectfons) . ~er ,fy unter pertain', o~ that ]~av~7person;~.exam,n,~aqf ~m familIar.,it~ Lb, information submitted in this and all Lt~acled.dgc~ment~, an~ t~ac oasea on.my inquiry ¢.cnose Inolvlaua~s responsible for obtaining the information. I believe that the ;uomitteo imormatton IS crum, accurate, ann complete. (~¢~~ Ne~e e~d oficiai title et o~n~rfooera~or u, owfler!opeTator S authorized renresentatlve 5~at-~ ~ ~ CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Farm andAgticulture t1 Standard Business [] NON--TRADE SECRETS Pa~e BUSINESS NAME: ,,_,,~& /%..-<;~. ,- ~' ~ ~L, OWNER NAME: ~.~-~r---t_ ~--oi--- -r~ NAME OF THIS FACILITY: ~.C~,TI~.N;. /-/1~3 mi~- 5+--'~-'t '~,~ ADDRESS; · ST NDARD IND. CLASS CODE~.' ~,x~. ~': ~t- ~ ,q ~ ~ o t CITY. ZIP: ~ c>.-,-,~q (' DU~ AND BRADSTREET NUMBER ....................... PHONE : ~;c~ ..?~,~ - PHONE #: - .;: - - - - - ~ FR T~ OPER 2ODES ............... ~ ' IqEi-I-I~ IU llV~II~UblILIIVO l~,,un rn~r:n Trans tYRe Nax Avgr~ge Annual Neasure I ~y~ Con[ Cont Con[ Us Location?ace. Code cooe AmC Amc Est Units on 51ce Type Press Temp Co~eStored ~n ~aclliCy Physical and Health~Hazard C.A,S. Number Component I1 Name I C,A,S, Number (Check ali that apply) ire Hazard ~ Reactivity elayed ~ Sudden Release . ~ lm~i~ Component 12 Name I C.A,S, Number ~eaKh of Pressure Componen[ 13 ~a~e I CA.S. Number PhvsicH a~d ~ealth Uazard C.A.S, Nu~ber Co~ponen[ It Naae ~ C.A,S. Number [Check al/ that apply) ' Health of Pressure Componenk 13 ~a~e t CA.S, Nuaber PhysicH and Health Uazard C.A.S. Number Component II Name ~ C,A.S, Number (Check all that apply) Health of Pressure Component 13 Name I C,A,S. Number Physical lod Health UaTard C,A,S, Number Component II Name I C,A,S, Number (Ch~ck al/ that appIy/ : F Component I~ Name & C,A,S, Number ire Hazard ~ Reactivity ~ Oelayed ~ Sudden Release Health of Pressure Component 13 Name I C,A,S, Number EHERGENCY CONTACTS fllNa~S{~ ~g--;" llti~~'w~ · 'erti.f' ati0 , Re an.d.~ign aft~pr compl~Cipg,all, secCi.ons.) 'certllv unler nenal~'y o~aw that I nave personal~y, examlnqOaq(] ~m Tamillat'.vlt~ theL.l_nt..o.r..~a.t!~.n aul~mittecI in this and all ~~;~-fiAd'dA~-umAn[~{ afl~1 thai; based OA my inQuiry ot T, nose iflOlV1OUa/S responsible TOt OOLallllltk3 ~, u Ifltormatlon, ! believe that the /~_ .. i~G~[~d'~i~[lon Ts true, accurate; and complete, ~ . ~ame eno pfictal Title of o~ner/ooera~or u, o~ner/operator:s autnorizee reoresentative signatu CITY of BAKERSFIELD 0HAZARDOUS MATERIALS INVENTORY Farm andkgticulture D Standard Business NON--TRADE SECRETS P~e of__ BUSINESS NAME: OWNER NAME: NAME OF THIS FACILITY: · C TI N' AODRESS; - STANDARD IND CLASS CODE: ~T~. ~I~: CITY. ZIP: DUN AND BRAD§TREE' NUMBER PHONE #: PHONE #: -' - - - - REFER TO-INsiHuciioN~--FOR--PROPER CODES '1 2 3 4 5 6 1 8 9 10 11 12 ~/~y Trans !yfle Hax Avfr.Bge Annual Measure I .Oy.s Cont Cont Cont Us Location?eH. Code coca kmt Amc EsL UflICS on 51[e Type Press Temp Co3e~t See Instructions Stored In racl/ICy/ "' ,,.,, c.,.s. ,,.,, Physical ADd Health, Hmrd C.A.S. Humber ComponenC II Hame ~ C.A.S. Number (Check ~/I that Apply} 0 Fire Hazard ~ Reactivity 0 Delayed O Sudden Release 0 Immediate ~ Healt~ of Pressure Component 13 ~=ie t C.~.S. ~micH ~ H~I[~ ~mrd C.i.S. ~um~~ Co~po,~,t I1 Na~e t C.A.S. ~umr p ooo ComponenC Name ~ C.A.S. Number Cite Hazard 0 Re,ctivity 0 Delayed 0 Sudden Release Health of Pressure Component 13 Name I C,A,S, Number PhyHcal and Health 6mrd c,A,s. Number Component II Name I C,A,S, Number (Check ali Chat APP]H Co~poflenC Na~e C,X,S, Numr 0 Fire Hmrd D Reactivity 0 Delayed 0 Sudden Release 0 Immediate · Health of Pressure HealthComponent 13 Nam8 t C,A,S. Number PhYsical lcd Health Umrd C,A,S, Number Component II Name I C,A,S, Number (Check Al/ that apply) : ' Component I~ Name I C,X,S, Number 0 Fire Hazard ~ Reactivity ~ Oelayed ~ Sudden Release D ]m~i~ Health of Pressure Componefl~ 13 Name I C.X,S, Number EMERGENCY CONTACTS ~1 fl2 me ' title ~~-- Name Tltle ierti[i~;atioq ,(Rep~ an.d.~ign af~f~r compl~tT,ng,a17 sectipns.) ~.,ceqclu.unoer penalt'X ~;]8W that i nave personH~y, examln~Qqo ~m Tamil~a[.~it~ the inTormmon ~u~mitte~ in this 8nd all lt~acneo,o~c~menc~, An~ cpAc DAseo on.my inquiry ~.Lnose iflOlViOUa/S responsible Tot ebCalnin9 the lflTormmon. [ believe Chat the GUDmlLteo iAtormAtlon IS true, Accurate, AnD comp/Ace. ~e e~o pfIciai titie, ot ounerlooerator oH ounef!operator's authorized representative signature [1~ r.~ T~c ed ~,, ,:~x~ ~ /~_ Bakersfi t. -- :. Hazardous Materials Inspection ' Date Completed plan ID ~ 21S~000 j ~(Top '~ght come~ Business Plan) ..... ~ ,. Adequate Inadequate Venficauon of. Invento~ Materials ~o~' Ve~cation of MSDS-- Availab~i~ ' ~" hficafi°n °f Haz Mat Trai~ng , Co~B: Ve~cafion of Abatement Supples & Procedures Co--mm: Emergency Procedures Posted [--I [--] · Containers Properly Labeled ~ [~ Comments: Special Hazards Associated with this Facility:., -:: FD 1652 (Rev. 3-89) White-Haz Mat Divl Yellow-Station Copy Pink-Business Office ,/-~: CITY o.f BAKERSFIELD ~,,,~ T~'~ ~1 "I'VE' C,4RE" , ~_. .~ :!. (ty~e or ~rin~ name Do hereby c=rt ~ ~-' . ~. _~. that~have revie~em the attached Hazar.dous Fiaterials business plan (name of business) and that it along ~,ith' the attached additions or corrections constitute a complete and correct Business Plan forum?- facility. CITY of BAKERSFIELD NO N-- '17 RAD E S E C R E TS .... · ~ ~ ~ NAME OF T~S FACILITY: ~~ ' CITY, ZZP:'~~~ ~/ CZTY, ZZP:~~~O ~ff~/ _ DUN AND BRADSTREET NUHBER q ~lth of P~ ~lth ((~k ~11 tbt a~ly). ~lth of ~ ~lth HHIEh of Pr~sure ~lth R(RGENCY . ~lle ..................................... ~11 ' (Read and siKn after coJplettnK all sections) ~flder ~lty of lp t~t ) ~ve ~rs~ally~xami.nff.~ aI fNitiar vith t~ tflf~Mti~ ~u~itt~ in thie ~ all mttK~.~s.~t hs~ m W i~t~ of t~e (~ivt~ts m~sibtl Farm and Aqriculture ~ Standard Business BUSINESS NAME: CITY of BAKERSFIELD HAZARDOUS MATERI ALS q'RADE sECRETS OWNER NAME: ' Page .... of .... NAME OF T~ FACILITY: LOCATION: ADDRESS: STANDARD IND. CLASS CODE CITY, ZIP: CITY, ZIP: DUN AND BRADSTREET NUMBER PHONE #: PHONE ~: - - ~ 2'0 IWSTI~UCTZONS ~'OH PI~OP~R ~OD~ I rahs Ty~ ~x A~age ' ~l ~msu~ I C~e C~e bt ~t Est Units m Site l~ ~ T~ ~ St~ tn F~tlity~' ~ Inlt~ti~ .... 1 ..... 1 ............. 1 ........... 1. [_.l_~l~_J. ..... Physical ~d Health HIZe~ C.A.S. ~ ~ Fire Hazard u--J R~ctivity [ ~ hlm~ ~--J ~ Am)Nsc ~--J I~tmtm He, ith of P~ ~lth ............ ~t m3 .... ~ .... ~1 ............. 1 ............. L ....... LI ..... L._',L,-~_~5.. ~ I~ ............... ~ .... P~ical ~d Health *Nazl~ C.A.S. (~k ail t~t app)y) [-] FieeHazard [--] ~cttvity [--] hla~ [--] Hfllth .... Z .... t. l ............ 1 I I [~.~1 ..... !i .......................... P~ical ~ Hfllth HIZ4~ C.A.S. (C~k all t~t apply) .... Health of Prflsuee HNIth ~t 13 ~&CA~.~ P~ical ~ Hfllth hli~ C.A.S: (C~k 411 t~t enly) ..................... ~--~ r--~ [--~ ~--~ ~--~ C~t ~-,d Ftee Hezaed c--~ bctivity NIo~ ~--d ~de Relme u--~ le~te Health of Prflsuve Health ..... - ...... FMEaGENCY C~TACTS I1 ~ ..................................... . Titli ....................... ~I'RF'P~i ....................... Nam ' .............. frill ..................... ~-M)'P~) ........ Certificatiee (Read and sign after compJetJng alJ sections) I certify undee ~lty of law that I have oersonally examined and am familiar with the information submitted tfl this and al1 mttmehed documants, end that Msed on ~y inquiry of the*e individuals r~sible for obtaining the information. I believe that the submitted infonmatio~ is true. accurate, and complete. Si~RSEG;; ...................................................... ~ti'$1)~i(1 ............................. BUSINESS. NAME ENGINE PARTS WAREHOUSE & MACHINE ID NUMBER 215-000-000175 LOCATION 410 21ST ST HIGH HAZARD RATING 3 1 .' OVEi~VIEW LAST CHANGE 05/17/88 BY TERRY JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30B FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4: NONE. EMERGENCY CONTACTS 2A SEC 2: HELIOS ROBAYO - 323-7399 OR 831-1912 PARSIFAL ROBAYO - 323-7399 OR 397-5280 UTILITY SHUTOFFS 2A SEC 3: A) GAS - RIGHT REAR OF BUILDING - OUTSIDE; B) ELECTRICAL - REAR WALL OF BUILDING - INSIDE; C) RIGHT DRIVE WAY FRONT ON 21ST STREET; D) SPECIAL - NONE; E) LOCK BOX - NONE. 2 . NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION 'RECORDED FOR THIS SECTION > PAGE 1 12/13/88 15:15 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS~ NAME ENGINE PARTS WAREHOUSE & MACHINE ID NUMBER 2.15-000-000175 LOCATION 410 21ST ST HIGH HAZARD RATING 3 3 . HAZ- MAT TRAINING suMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > 4 . LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 05/17/88 BY TERRY 2A SEC 5: NEAREST HOSPITAL' PAGE 2 12/13/88 15:15 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ENGINE PARTS WAREHOUSE & MACHINE ID NUMBER 215-000-000175 LOCATION 410 21ST ST HIGH HAZARD RATING 3 FACILITY UNIT 01 A . OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 05/17/88 BY TERRY ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 PURE ACETYLENE 330 FT3 EXTREME CENTER OF BUILDING PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 1241.00 100.0 ACETYLENE EXTREME 2 PURE OXYGEN 231FT3 HIGH CENTER OF BUILDING PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 2359.00 100.0 OXYGEN, COMPRESSED HIGH 3 PURE NEW OIL 10 GAL UNKNOWN FRONT OF BUILDING PLASTIC CONTAINER[S] LUBRICANT ID PERCENT COMPONENTS HAZARD LISTS 2808.00 100.0 MOTOR OIL . UNKNOWN 4 PURE SOLVENT 50 GAL EXTREME NW OUTSIDE DRUMS OR BARRELS MET.. CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1203.02 100.0 NAPHTHA SOLVENT EXTREME B . FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 05/17/88 BY TERRY 3A SEC 4: NONE 3A SEC 5: NONE PAGE 3 12/13/88 ~5:15 MATERIAL SAFETY DATA SYSTEMS, INC. (~05) 648-6800 BUSINF~SS NAME ENGINE PARTS WAREHOUSE & MACHINE ID NUMBER 215-000-000175 LOCATION 410 21ST ST HIGH HAZARD RATING 3 / n ~ EMPLOYEE NOTI FI CATION / EVACUATION LAST CHANGE 05/17/88 BY TERRY 3A SEC 3: CALL' 911. E . MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 05/17/88 BY TERRY 3A SEC 1: ACETYLENE AND OXYGEN ARE CHAINED TO A CART. PAGE 4 12/13/88 1'5:15 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~,,~- ....~ Hazardous Materials Dii~ion TO: BUILDING DEPT. LOCATION z//O ~9/x::~ ~ ~__..~-. ~ . STATUS OF HAZ MAT REGULATIONS I. uired to complete a Hazardous Materials Business Plan [] Hazardous Materials Business Plan Complete {--I Risk Management & Prevention Program Required [-q Risk Management & Prevention Program Requirements are being met - OK to issue permit ['] 'Risk Management and Prevention Program bas been approved. OK to issue Certificate of Occupancy. III, E] No Hazardous Material Requirements. IV. F~ All Hazardous Materials Reporting Requirements ' Complete. MOTE' ' ' Comments: ..~/Jux(j. ~J~tCz¢,~,. ~ '~~ ~ ~ Hazardous Materials Oivi~oh . . Date · FDI~5 Rev 1/90 Bakersfield Fire t. Hazardous Materials DI~ion RECEIVED HAZARDOUS MATERIALS COMPLIANCE STATEME~[~ 0 {~ 1990 (To be completed by Building Permit Applicant and/or Site Plan Review Applicant) HAZ. MAT. DIV. BUSINESS NAME ENGINE PARTS WAREHOUSE & MACHINE SHOP LOCATION 410 21st;' Street.Bakersfield, California, 93301 PLEASE READ ALL OF THE INFORMATON CAREFULLY, FAILURE TO COMPLY WITH THE HAZARDOUS MATERIALS REGULATIONS MAY RESULT IN CIVIL LIABILITIES OF UP TO $2000.00 FOR EACH DAY IN WHICH THE VIOLATION OCCURS. YES NO Will the Applicant or future building occupant be required to complete a Hazardous Materials Business Plan? [-~ r-'l (NOTE) If you handle, store, use or dispose of, reportable qL;~3ntities of any hazardous substance, you are required by California Law to complete a Hazardous Materials Business Plan. Forms can be obtained from the Bakersfield Fire Department, Hazardous Materials Division, 2130 G Street. Typical every day hazardous materials you may find in your facilities may include, but not limited to: compressed gases; fuels - all types; solvents; oils (new and waste); thinners', caustic or corrosive materials; poisonous or toxic materials; and radioactive materials. Will the applicant or future building occupant be required to complete a Risk Manage- YES NO ment and Prevention Program? F-~ r-1 (NOTE) If you handle, store, use or dispose of reportable quantities of any extremely hazardous substance you must develop a Risk Management and Prevention Program. THIS PLAN MUST BE APPROVED BY THE LOCAL ADMINISTERING AGENCY BEFORE YOU COMMENCE OPERATIONS AT THIS FACILITY. The list ofregulated chemicals is contained in Appendix A of part 355 of Subchapter J of Chapter I of Title 40 of the code of Federal Regulations. This list of chemicals isavailable at the Bakersfield Fire Department, Hazardous Materials Division, 2130 G Street. Will the applicant or furture building occupant be required to obtain a permit from the YES NO K~rn County Air Polution Control District? ['-'] Location within 1,000 feet of outer boundry of the following: YES NO School -(any school, public or private used for the purposes of education of E~] [] children Kindergarten or any of grade 1 to 12, inclusive) Hospital- F-1 F-~ Long Term Care Facility- E~ E~] Check here if none of the above apply to this project, r'-I F-1 ~ner, Priniple or Officer of B HAZARDOUS MATERIALS COMPLIANCE STATEMENT ATTACHED. FD 1654 akersfield Fire Dep Hazardous Materials Division HAZARDOUS MATERIALS INFORMATION GUIDE The following are guidelines to help the building permit applicant determine whether they wiil need to. comply with the hazardous materials'reporting requirements of Chapter 6.95 of the California Health and Safety Code. Chapter 6.95 requires businesses that handle hazardous materials, at the California Threshold Reporting Quantities, file a "Hazardous Materials Response Business Plan and Inventow" With the Local Administering Agency, which is the City of Bakersfield Fire Department, Hazardous Materials DiviSion, 2130 G Street, (805) 326-3979. Businesses that handle. "Acutely Hazardous Materials" must also file an "Acutely Hazardous Materials Registration Form" and complete a "Risk Management and Prevention Program".. The California,Government Code Section 65850.2 prohibits a city or county from issuing a final certificate of occupancy unless these reporting requirements are being or have been met. Please read the statement below to determine if any of the materials handled by your business or by a future occupant of your site, fall under the hazardous materials reporting requirements. PLEASE INDICATE WITH A CHECK IN THE "YES" BOX ON THE BUILDING PERMIT APPLICATION IF THE APPLICANT OR FUTURE BUILDING OCCUPANT WILL HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL: A. In a quantity at any one time equal to or greater than a total weight of 500 pounds or a total volume of 55 gallons, or 200 cubic feet at standard temperature and pressure for compressed gas. (See Appendix I for Hazardous Material definitions.) B. Or any quantity of the Acutely Hazardous Materials listed in Vol 52 No. 77 of the Federal Register (List available at the Hazardous Materials Division Office, 2130 G Street.) *NOTE: A mixture that contains one percent (1%) or more of a hazardous ingredient is a hazardous material. A mixture that contains one tenth of one percent (0.1%) or more of a carcinogen is a hazardous material. If your proposed business is going to handle any acutely hazardous material or will be within 1000 feet of the outer boundary of a school, you may be required to complete and implement a Risk Management and Prevention Program as per Section 65850.2 of the California State Government Code. A school is defined in the Health and Safety Code, Section 42301.9(a), as any school used for the purposes of education of children in kindergarten or any of grades 1 to 12 inclusive. IF FUTURE OCCUPANT IS UNKNOWN AT THIS TIME THE FACT THAT THE BUILDING FOR WHICH THIS PERMIT IS BEING APPLIED DOES NOT HAVE A TENANT AT THIS TIME, DOES NOT RELIEVE THE OWNER OR HIS AUTHORIZED AGENT FROM THE RESPONSIBILITY UNDER CALIFORNIA LAW TO INDICATE WHETHER FUTURE OCCUPANTS WILL NEED TO COMPLY WITH THE REPORTING REQUIREMENTS FOR THE HANDLING OF ANY HAZARDOUS MATERIALS. IF AT A LATER DATE YOU DETERMINE THAT A TENANT WILL BE HANDLING HAZARDOUS MATERIALS AS DESCRIBED IN THIS GUIDE SHEET YOU MUST INFORM THE CITY OF BAKERSFIELD, HAZARDOUS MATERIALS DIVISION AT (805) 326-3979. . FD 1653 attached Hazardous Haterials business plan (name of business) and that it along with the at%ached additions er corrections consti~ ' - ~u~e a complete and cor. ect Business Plan for~?- facility. C ~ -- .~u~' -- ! ~ date ~ ~ ~IrS~'ROCTZOI~S POJ~ PROPAR CODg~ IrAflf TyI~ Ret Av~q'14~ ln,~41 ~ I ~ Cant Cmt Cent ~ Location ~ % by k of Ilxtd/C41111clllntl d re Niz.rd ~ .~ II~act(vlty u---' Oml.wd -- h1.4~ ~--~ I..ediete Ne4 Ith of PPI~S~ ~.~/ C4=eoflmt l! n... & C.A.S. mumm, (~heck ~11 t~t ep~ly) Health of Pfl~Sml Nee Ith C41llmeat ii ~ & C.A.S. (C~k iii t~t a~ly} __ ~k~ t~t ~ly) = , ............... flfllth of Prflsure ~lth :~lrttficltiQ~ (Read and siRn after co.pletin£ ail sections) I certify under ~lty of 1~ t~t li~ ~rs~11y e.~i~ ~ ~ f~ililr ,tth t~ tflf~tim su~itt~ In this ~ .11 Itt~ ~s. ~t ~ m W i~tw of t~e I~lv4~ll ~tble ' · BU~NESS NAME ENGINE WAREHOUSE &.MACHINE ID 215-000-000175 ~LOCATION . 410 21ST HAZARD RATING 3 1 . OVERVIEW' LAST CHANGE 05/17/88'BY TERRY JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30B FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4: NONE. EMERGENCY CONTACTS 2A SEC 2: HELIOS ROBAYO - 323-7399 OR 831-1912 ' PARSIFAL ROBAYO - 323-7399 ~' OR 397-5280 UTILITY SHUTOFFS 2A SEC 3: A) GAS - RIGHT REAR OF BUILDING - OUTSIDE; B) ELECTRICAL - REAR WALL OF BUILDING - INSIDE; C) RIGHT DRIVE WAY FRONT'ON 21ST..,STREET; D) SPECIAL - NONE; E) LOCK BOX - NONE. 2 . NOT I F I CAT [[ LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 I~/!3/88 15:!5 MATERIAL SAFETY DATA SYSTE?IS INC. (805 BUSIb. IESS NAME ENGINE WAREHOUSE &.MACHINE IDI [BER 215-000-000175 ~LOCATION 410 21ST HAZARD RATING 3 3 . t~AZ MAT T~-~AINING ~UMMARY LAST CHANGE / / BY // 4 I~ocAL EME']-~GEN£'.\r Mt!I~)IC/\L ---%$S I STANCE LAST CHANGE 05/17/88 BY TERRY ZA SEC 5: NEAREST HOSPITAL /~/...--,,~ ~,,e'/~ c /..¢,~, ,E,,~/'~--',,~ Z-.. PAGE 2 12/13/88 1'5:15 MATERIAL SAFETY DATA SYSTEMS, INC. 805) 648-6800 ~; ,~0C~T'ION 410 21ST IGH'HAZARD RATING 3 FACILITY UNIT 01 A · OV .~ERALL IqAZARDC)L;S MATERIALS INVENTORY LAST CHANGE 05/17/88 BY TERRY ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 PURE ACETYLENE 330 FT3 EXTREME CENTER OF BUILDING PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISt 1241.00 100.0 ACETYLENE EXTREME 231FT3 HIGH 2. PURE OXYGEN .. CENTER OF BUILDING PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT'COMPONENTS .' HAZARD LIS~ 2359.00 100.0 OXYGEN, COMPRESSED '": HIGH 3 PURE NEW OIL '10 'GAL UNKNOWN .~ FRONT OF BUILDING PLASTIC CONTAINER[S] LUBRICANT ID PERCENT COMPONENTS HAZARD LIS% 2808.00 100.0 MOTOR OIL UNKNOWN 4 PURE SOLVENT 50 GAL EXTREME NW OUTSIDE DRUMS OR BARRELS MET.. CLEANING · ' ID PERCENT COMPONENTS HAZARD LIS' 1203.02 100.0 NAPHTHA SOLVENT EXTREME LAST CHANGE 05/17/88 Bt' TERRY '3A SEC 4: NONE PAGE 3 12/13/28 1'5:'[5 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~ Bus~'~ESS .~AME ENGINE WAREHOUSE &.MACHINE ID iBER 215-000-000175 ~OCATION 410 21ST HAZARD gATING 3 D . EMPLOYEE NOTIFICATION / E VA¢2IJATION -. LAST CttANGE 05/17/88 BY TERRY 3A'SEC 3: CALL 91'1. E . MITIGATION / PI{E\;EN 7' I ON / A t:] z-% IF IE ME N T LAST CHANGE 05/17/88 BY TERRY 3A SEC 1: ACETYLENE AND OXYGEN ARE CHAINED TO A CART. PAGE 4 12/13/88 1'5:15 MATERIAL SAFETY DATA S¥S'['EMS INC (805 648-68 'BAKERSFIELD CITY FiRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY · BUSINESS NAME: · · .BUSINESS PLAN SINGLE FACILITY UNIT FORM 8A 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# FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDbnRES AT THIS UNIT ONLY SECTION 3:,;,,HAZARDOUS'MATERIAL$ FOR THIS UNIT ONLY ' A. Does this .Facility Unit contain Hazardous Materials? ...... NO If YES, §ee 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 inventory form marked: NON'TRADE SECRETS oNLY (white form #4A---I) If Yes, complete a hazardousmateriaIs inventory form marked: TRADE SECRETS ONLY (yellow,form ~4A-2) in addition to the non-trade secret'form. List 0nly the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER suPPLY FOR USE BY ~MERGENCY RESPONDERS SECTION 6: ,,LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS,/PROPAN~"i B. ELECTRICAL: C. WATER: D. SPECIAL: ' NO IF YES LOCATION: E. LOCK BOX: YES / , IF YES, SITE PLANS? YES / NO MSDSs9 YES /' NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - (805) 326-3979 OFFICIAL USE ONLY 3USINESS NAME HAZARDOUS MATER I ALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCT IONS: 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 1: BUSINESS IDENTIFICATION DATA~~~--~'~ - A. BUSINESS NAME: ENGINE PARTS WAREHOUSE i & MACHINE SHOP B. LOCATION / STREET ADDRESS: 410- 21st STREET ' BAKERSFIELD, CA 933~01. i .... CITY: ZIP:': 1 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify yo_ur 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. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE C. WATER: ~ ~~'~V~ ~ ~D~k~ m/~ ~/~. ~ D. sPECIAL: ~~ / ' . E. LOCK BOX: YES /~ IF YES, LOCATION: ... - IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO 2A - PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION.-5:._ LOCAL EMEROENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS ASA WHOLE SECTION 6: EMPLOYEE T~INING. EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER'TRAINING IN THE FOLLOWING AREAS. CIRCLE YESOR NO INITIAL REFRESHER A. METHODS F0R SAFE HANDLING 0F HAZARDOUS ~ ~TERIALS:...· ..................................... NO NO B', PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~S NO ~ NO C. PR9.PER USE OF SAFETY EQUIPMENT:... ................ NO NO ' D. EMERGENCY EVACUATION PROCEDURES: ................. · NO NO E. DO YOU ~INTAIN EMPLOYEE TRAINING RECORDS: ....... YES YES SE~ION ~: ~ZARDOUS NA~RI~ CIRCLE ~S OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~%ERIAL IN QUANTITIES LESS THAN 500 POUN~F A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:..~.... ~ NO ~'~I,~/~'L/Of ~4~ ': ' , 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 1.) and at inaccurate information constitutes perjury. · BAKERSFIELD CITY FIRE DEPARTMENT I.D. FORM 4A-1 Page NON--TRADE SEcRETs HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME:~J~/I/~_~//~f~--~ ~4.'~/"7'~' i/~".o~ ~~NER NAME: ~~/~ ~~ FACILITY UNIT ~:......, ADDRESS: ~ ~'-~ ADDRESS: ,f~14 ~t~ ~~--FACILITY UNIT NA~E: CITY, ZIP:~~~Y~d ~,.~d [ CITY,ZIP:~~4'~d PHONE ~: ~- ~~ PHONE ~: ~/~ /~ [OFFICIAL USE CFIRS CODE I ONLY 1 2 3 4 5 6 7 8 9 10 'TYPE MAX ANNUAL CONT USE LOCATION IN THIS ~; BY HAZARD D.O.T CO0EA AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT . WT. CHEMICAL OR COMMON NAME CODE GUIDE , / NAHE :_~¢ TITLE: ~ ~/~ SIONATURE: ': ' DATE :~5~2-- ~/ EMERGENCY CONTACT: TITLE: ~ - ZZ>t,'v",'v~,~_. ~ "BUS HOURS: .- FTER BUS HRS: EMERGENCY CONTACT :~,?,'~-,~.,f'//'~OZ.- ~4,,O5/~.~ TITLE: ~F.> '- ~>c,q~'/l~'Z:~,~ .. PHONE # BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: '_,~_,,4~'~_/~/qr~ ~)/~-'_/~./Z.,/) /.,~-- AFTER BUS HRS: - 4A-1 -