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HomeMy WebLinkAboutBUSINESS PLAN (2) SITE/FACILITY DI AGR~M NORTH SCALE:~/q,,= I'0' BUSINESS NAME: q FLOOR: OF DATE:~ / / FACILITY N~hME: UNIT #: OF Bo ~'1 (CHECK ONE) SITE DIAGRAM ~ FACILITY DIAGRAM (Inspector's Comments): ' -OFFICIAL USE ONLY- 1. Address: IdentlfyW~q~'e 9. Lock (ke~ principle buildings by the Street uulbers, lO, MSDS Sto~age Box .... '2. Street(s), Alleys, 11. Railroad Tracks Driveways, Gad Parking ** *Areas adjacent to the 12. Fence or Barrier property. Include the a, Wire street names. b. Masonry 3. Store Drains, Culverts, Yard Drains c. Wood 4. Drainage Canals, Ditches. d. Gates Creeks, 13. Pomerllnes 5. Buildings a. Frame construction 14. Guard Station b. Masonry construction lB. Storage Tm{ks: Identify the c. Metal construction capacity la gal, a. Above ground d. Acce~s Door - · b. Underground Utility Controls a. Gas 16. Diking or Berm b. Electricity I~. Evacuation Route c. Water 18. Evacuation Area: - Identify the ?. Fire Suppression Systems: location where a. Fire Hydrants employees will b. Fire Sprinkler 19. Outside Hazardous Connections MasSe Storage c. Fire Standpipe lO. Outmide Hazardous Connections Material Storage d. Watdr Cont;,ol Valves ~1. Outside Hazardous for protection systems Material U~e/Handling e. Fire Pu~p 22. Type of Hazardous #atorlai/Waste Stored 8. Fire Department Access or Used (See ~ielow) F -Flsanable g = lixploeive. L - L/quid {~ - Hadioloi/lcai C - Corrosive 0 - O~ldlz~r ' G = Gas P - Poison Water Reactivo T = Toxic S o Solid 'H - Cryogenic D - Waste B - Etiological Example: Flat. able ~lquld = FL FACILITY DIAI]RA~ (Required items in addition to the. 1. R/sera ~or Sprinklers 8. F{re gacapea 2. Partitions O. Air Conditioning Unite 3. S~alrways: Indicate the 10. Windows levels served fron highest to lowest. 11. Inside Hazardous Waste 3toraga 4. Escalator: Indicate the levels served ~roa Ii. Inside Hazardous highest to lo,eat. Waterials Stora~ $. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14, sewer Drain Inlets 7. Skylights BAKERSFIELD CITY FIRE-DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 JUN 2 1987 Ans'd ............ 080201 USINESS N~E HAZARDOUS MATERI ALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 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 m. BUSINESS NAME: ~Lu~q ~RC~i~ ~o~ B. LOCATION / STREET ADDRESS: ~0~ \6~ ~eeZ CITY:'.~*~O ZIP: qS~O~ BUS.PHONE: ( .) ~-~mO SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7560 or 1-916-427-4341. This will notify 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. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A ~IOLE A. NAT. GAS/PROPANE: qo~ B. ELECTRICAL: ~ ~x Co~ 0~ ~b,~ 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 - SECTION 4: PRI'~TE 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 A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...- .................................... ~ NO O NO B. PROCEDURES FOR COORDINATING ACTIVITIES C. PROPER USE OF SAFETY EQUIPMENT: .................. NO NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO NO - -SECTION -7 :' F3/ZARDOUS-I~TERI~J] ............ CIRCLE YES OR NO 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 t I, ~o~ ~-~ , certify that the above information is accurate. I und~-rstand 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 6.98 Sec. 25800 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CIT~ FIRE DEPARTMENT. 2130 "G" STREET .BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUS I NESS 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. $. Answer the questions belo~ for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and C0NCISE as possible. FACILITY UNIT# F~ClLI~ ~SIT S~E: , SECTIO~ 1: ~ITIGATIOS~ PRE~STIO~ ABATEr4EN~ .SECTION 2: NOTIFICATION A/%q] EVACUATION PROCED5qlES AT THIS b~7IT ONLY - 3A - 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, c~mplete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-Z) in addition to the nonq~ra___de_ -- secret-form. List~ only the trade ~cre{s-on'form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 8: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPANE~ B. ELECTRICAL C. WATER: D. SPECIAL: E. LOCK BOX: YES /~ tF YE~, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - VALLEY M HINE SHOP 8915 Rosedal¢ Highway -~rsfield, California 93312 Ph: 805-589-952~.:.,:.~: 805-589-9603 February 6, 1996 City of Bakersfield Fire Department Mr. Ralph E. Huey 1715 Chester Ave. Bakersfield, CA 93301 Dear Mr. Huey: Valley Machine Shop was sold on 6-1-95. The New General Information is as follows: LOCATION: 8915 Rosedale Highway /0 ~- ~q~q- C~ CITY: Bakersfield CONTACT NAME: Douglas W. Pmett 24 HOUR BUSINESS PHONE: 805 589-2768 CONTACT NAME: Phillip E. Pmett 24 HOUR BUSINESS PHONE: 805 589-2768 MAILING ADDRESS: As above (tyoe or prin~ name) RECEIVED Do hereby ce:ti~y that ~ h~ve :eviewed the JAN I~ lgB9 ,, , Ans'd ............ attache6 ~aza:6ous. Mate~kals bus~ess (namW of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. . sitgna~ur-e - -~ · - date BUSINESS NAME VALLEY MACHINE SHOP ID NUMBER 215-000-000201 LOCATION 903 18TH ST HIGH HAZARD RATING 2 1 . OVEI~V I EW LAST CHANGE 06/10/88 BY ESTER JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30C FACILITY UNITS 1 'HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) JOHN HARRER OR WILLIAM E. HARRER 345 REXLAND DR 2825 CHRISTMAS TREE LN 834-9280 871-8515 EMERGENCY CONTACTS 2A SEC 2) BILL HARRER - 327-1866 OR 871-8515 JOHN HARRER - 327-1866 OR 834-9280 UTILITY SHUTOFFS 2A SEC 3) A) GAS - NONE B) ELECTRICAL - SOUTHEAST CORNER OF BLDG C) WATER - ALLEY SOUTHWEST CORNER OF PROPERTY D) SPECIAL - NONE E) LOCK BOX - NO 2 . NOTIFICATION / PUBLIC EVACUAT I O.N LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/14/88 09:37 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME VALLEY MACHINE SHOP LOCATION 903 18TH ST ID NUMBER 215-000-000201 HIGH HAZARD RATING 2 HAZ ~VlAT TRAINING S U~IMAt{Y LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > 4 . LOCAL E~4EIiGENCY MEDICAL ASSISTANCE LAST CHANGE 06/10/88 BY ESTER 2A SEC 5) MEMORIAL HOSPITAL 420 34TH ST 327-1792 PAGE 2 12/14/88 09:37 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME VALLEY MACHINE SHOP ID NUMBER 215-000-000201 LOCATION 903 18TH ST HIGH HAZARD RATING 2 FACILITY UNIT 01 A . OVERALL HAZAt~DOUS MATERIALS INVENTORY LAST CHANGE 06/10/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 PURE ACETYLENE 172 FT3 EXTREME SOUTH WALL PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 1241.00 100.0 ACETYLENE EXTREME 2 PURE OXYGEN 2000 FT3 HIGH SOUTH WALL PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 2359.00 100.0 OXYGEN, COMPRESSED HIGH B . F I I:~E PROTECTION / WATER SUPPLIES LAST CHANGE 06/10/88 BY ESTER 3A SEC 4) 1 6LB FIRE EXTINGUISHER FOR FIRE PROTECTION. 3A SEC 5) FIRE HYDRANT SE CORNER OF 18TH & Q ST. \ PAGE 3 12/14/88 09:37 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ./ BUSINESS NAME VALLEY MACHINE SHOP ID NUMBER 215-000-000201 LOCATION 903 18TH ST HIGH HAZARD RATING 2 D . EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 06/10/88 BY ESTER 3A SEC 2) CALL FIRE DEPT. AND EXIT BLDG. E . MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 06/10/88 BY ESTER 3A SEC 1) SECURE ALL GAS CYLINDERS TO WALLS - KEEP ALL MATERIALS IN COVERED, SEALED CONTAINERS. PAGE 4 12/14/88 09:37 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 VALLEY MACHINE SHOP 903 - 18th STREET ,^,-~,-~. c^ ,~o, CITY of BAKERSFIELD CITY, ZIP: ....... tn~'"'""~v_~ .... ~t CITY, ZIP: ~~ , ~'5o~ DUN AND BRADSTREET t 2 ) 4 S S T I I 10 11 12 13 la (~e C~e · kt ~ / Est ~ttl m Site l~ ~ 1~ ~ .. St~ In F~ility ~ :_~ Fire Natlrd ~- a ~ttvlty ~- J hl~ . -- i him u- J I~ilte ' ~lth of Prom ~lth --- .... [ ................ 1..~ ........... 1~ooo ..... ' ...... .__ (C~k ~11 t~t a~ly) ........ /~ .., g,~ ................... ~lth of ~m ~lth '' ' .... L_I L ......... 1 I I t ~ ! ! !_ I ................ I~k ell t~t e~ly} ~lth of Pm~m ~lth ...... ~__t_,, .... L, ......... L.:, .... ]. ~__~ .... J_~J ~ ....... , .......... ~lth of Pr~surl ~l~h .... . ~-~ .~-~, ...... CgrttfiC4tt~ (Read and s~En after co.pletInE all sectXons) ................. ....... ., ,. ....................... BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page NON--TRADE SECRETS ' HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME: ~u~-~\ ~C~¢ ~ OWNER NAME: ~.u~ ~ FAC'ILITY UNIT ADDRESS:~ ~ ~ ADDRESS:~ C~ ~. ~ FACILITY UNIT NAME: CITY, ZIP: ~~&) ~ CITY,ZIP: ~~ ~ ~o~ PHONE ~:,,,,,,~'~o~-~-]~ PHONE ~: ~-~ {OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE ~AX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T .CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL 0R COMMON NAME CODE OUIDE ' ;~¢. //~ DATE: NA~E: TITLE: ~ S'GNATURE: E~EROENCY CONTACT: ~/~ ,~N~ TITLE: ~, ~/ ' PHONE · BUS HOURS: AFTER BUS HRS: ?~I- E~EROE~CY CONTACT: ~--~4~ T~TUE: d~ , PHONE m BUS HOURS: ~,R~NUIPAL BUSINESS ACTIVITY: ~4/~/e~ AFTER BUS HRS: - 4A-1 -