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Home My WebLink AboutBUSINESS PLAN (2) Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE [s~ by: B~er,field Fke Dma~m, nt Approv~ by: ff ~ 1715 Chewer Ave., Md Floor ce of ~~ B~ersfiel~ CA 93301 Voice (805) 32~3979 F~ (805)326~576 Expiration Date: dun~ ~0, ~000 SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE.: BUS il.NESS NAME F'~.OOR: OF (CHECI< ONE SITE DIAGRAM FACILITY DIAGR.~'4 Inspector's Comments): -OFFICIAL USE ONLY- - SA - SITE/FACILITY DIAGRAM FORM NORTH SCALE: BUSINESS NAME: FiOOR: OF DATE: FACILITY NAME: UNIT ~t: OF (CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM 5 - ~ l (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - SITE DIAGRAM (Reqt items) 1. Address: Identlf~ the 9. Lock (key) Box principle buildings by the Street numbers. 10. MSDS Storage 2. Street(s), Alleys, 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include tile 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. Masonry construction 15, Storage Tanks: Identify the -' c. Metal construction capacity In gal. a. Above ground d. Access Door b. Underground 6. Utility Controls a. Gas 16. Diking or Berm b. Electricity 17, Evacuation Route c. Water 18. Evacuation Area: Identify the Fire Suppression Systems: location where a. Fire Hydrants employees will meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage ................. -. -~-~-~-~-~-~r-~ .... - _ 20. Outside Hazardous Connections ........ ~tb--fflal-S~o-ra~e - ' ~ - - ..... -- d. Water Control Valves 21. Outside Hazardous for protection systems Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored 8. Fire Department Access or Used (See Below) TYPE OF HAZARDOUS M,~TERIAL F = Flammable E = Explosive L = Liquid R = Radlologlcal C = Corrosive 0 = Oxidizer G = Gas P = Poison W = Water Reactive T = Toxic S = Solid H = Cryogenic - ------- ~ D = Waste B = Etiological ~ ~ - ~--~L~ ~ ~ ..... ?'<' ; '-~'~ ~l~-." ~-Y~'ui~. ~u fd~~ ~ ~ ~:~; '-'~'~'~-"~'~ '- ....... ~' ....... -"-' FACILITY DIAG~ (Required items tn addition to the above) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12, Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets .J 01/12/96 BAKERSFIELD FLORAL SUPPLY 215-000-'0013{ ~ I,i}' ~ / General Information I Location: 1100 18TH ST Map:103 Haz:l Type: 3 City : BAKERSFIELD Grid: 30C F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title ALAN WIENER / STAN WIENER / Business Phone: (805) 327-4841x Business Phone: (805) 327-4841x 24-Hour Phone : (805) 832-1376x 24-Hour Phone : (805) 397-9381x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 1100 18TH ST D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 2~5-001 BAKERSFIELD STATION 01 SIC Code: 5999 Owner: ALAN WIENER Phone: (805) 327-4841 Address: 1410 LA PUENTE DR State: CA City: BAKERSFIELD Zip: 93309- Summary I,/"/(~,~'~- ~.U'/~,~'~,.J~. DO hereby ce.i~ fha I have review~ the a~a~heU ment plan for a~ mat ~ along ~th any ~rr~ions ~n~itute a complete and ~rre~ ~n- ageme~ plan for my faci, l~,,, , RECEIVED 02/20/92 BAKERSFIELD FLORAL SUPPLY 215-000-001389 FIB 2 ? ~9~ Page 1 Overall Site with.1 Fac. Unit A,~ ............ General Information Location: 1100 18TH ST Map: 103 Hazard: Minimal Community: BAKERSFIELD STATION 01 Grid: 30C F/U: 1 AOV: 0.0 Contact Name I Title Business Phone 24-Hour Phoneq ALAN WIENER (805) 327-4841 x (805) 832-1376J STAN WIENER I (805) 327-4841 x (805) 397-9381/ Administrative Data Mail Addrs: 1100 18TH ST D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 5999 Owner: ALAN WIENER Phone: (~-) .3.q7 - ~/F~// Address: 1410 LA PUENTE DR State: CA City: BAKERSFIELD · Zip: 93309- Summary / "' (Ty~ ~ ~ ~) reviewed the ~ached h~ardous materials manage- ~]AKERSFIELD FLORAL ment plan for ~:~ , suPp~at it ~ong w~h ~ny corr~tions constitute a ~mplete and corre~ man- ~ement plan for my facility, 02/20/92 'BAKERSFIELD FLORAL SUPPLY 215-000-001389 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 HELIUM Gas 244 Minimal · Fire, Pressure FT3 CAS #: Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER ~Daily Max FT3I Daily Average FT3 I Annual Amount FT3 -- 244 ~ 180.00_ 732.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IABovo /AmbientlSOUTH WALL REGISTER -- Conc Components MCP List 100.0% IHelium IMinimal I 02/20/92 BAKERSFIELD FLORAL SUPPLY 215-000-001389 'Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification <2> Employee Notif./Evacuation EXIT FRONT DOOR <3> Public Notif./Evacuation <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFIELD, 'CA. (805) 327-3371 02/20/92 BAKERSFIELD FLORAL SUPPLY 215-000-001389 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention HELIUM TANK HAS SHUT OFF VALVE TO FILL BALLOONS <2> Release Containment app~¢~d~ p~o~$.fe~.~.e,~ cy/,~J~ . <3> Clean Up , <4> Other Resource Activation 02/20/92 BAKERSFIELD FLORAL SUPPLY 215-000-001389 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ALLEY B) ELECTRICAL - REAR OF STORE C) WATER - ALLEY D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water FIRE PROTECTION - WATER - FIRE EXTINGUISHERS FIRE HYDRANT - 18TH AND M STREET <4> Building Occupancy Level 02/20/92 BAKERSFIELD FLORAL SUPPLY 215-000-001389 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 10 'EMPLOYEES WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE EMPLOYEES READ MATERIAL, UNDERSTAND MATERIALS AND SAFETY REGULATIONS <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use · ,"" '""~ . 2130 'G' STREET ~I ~t.~x_//~--'~' BAKERSFIELD, CA. 9330 Z~/~. (805) 326-3979 OFFICIAL USE ONLY Il)# BUSINESS NAME HAZARDOUS MATERIALS RECF. IVED .' BUSINESS PLAN AS lA WHOLE ;~Pr~ 0 51989 FORM 2A HAT. M~T. DIV. INSTRUCTIONS; .1. To avoid further action, return this from within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer ~he ques%~ons be3ow for %he bus,ness as a who~e. 4. Be as brief and concise as possible. SECTION 1: BUSINESS ~DENTZF[CAT~ON DATA B. LOCATION / STREET ADDRESS: ./.~OO /~ ~' C ~ TY ~?2J ~-~/~/' ZIP: 9~/ BUS. PHONE: SECTION 2: EMERGENCY NOTiFiCATiON8 In case of an emergency involving the release or threatened release of a hazardous material, ~a33 ~11 and 1-8OO-852-7550 or 1-916-427-4341. This wi~3 notify your ~ocal fire depar:men: and :he S~a:e Office o¢ Emergency Services as required by ~aw. ENPLOYEES TO NOTIFY ZN CASE OF EHERGENCY-: NAHE AND TITLE DURING BUS. HRS. AFTER BUS. HRS. S~CT[ON 3: kQCAT~ON OF UTILITY SHUT-OFFS FOR BUSINESS AG A WHOLE A. NATURAL GAS/P~NE: B. ELECTRICAL:, ~~ ~ ~;~ ~ c. w A T E ~ :.,~/2~Y D. SPECIAL: / E. LOCK BOX: YES / NO ~F YES, LOCATION: IF YES, DOES ~T CONTAIN SITE PLANS? YES / NO HSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO SECTION 4- PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE No, SECTI'ON'v~'.:..'LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE "ti~i i'i ~ .~ ' :. .' , ...¥. SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS HATERIALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY B. 'DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHGETS) FOR EACH HAZARDOUS MATERIAL YOU HANDLE ~ C. GIVE A BRIEF SUMMARY OF Y06R HAZARDous MATERIALS TRAINING PROGRAM: SECTION 7' EXEMPTZON REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROH THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO ........ TIME. EXCEED -THE..MINIMUM 'REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION above information is ate. 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 tha= inaccurate infor~m~tion constitutes perjury, SIGNATURE ~~~' TITLE/~/}~-~, BAKERSFIELD CiTY FiRE D RTMENT 2130 'G' STREET BAKERSFIELD. CA. 93301 (805} 326-3979 OFFICIAL USE ONLY ..... ID# "' BUSINESS NAME HAZARDOUS MATERIALS BUSINESS' 'FLAN "AS ' A'"'WHOLE ...... FORM 3A ~NSTRUCT~ON~ 1. To avo d 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 ~c,~,,~ ,.~T ·~c,,,~ ,.~ .~.E: ,//~n~ SECTION 1: .MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECT~[ON 2: ' NOT[F[CAT[o'N''AND'EVA'CUATT-ON PROCEDURE~ AT, T,.HE~IJL~T~T~.~_J..~ .------ ./ ,ECTION 3: HAZARDOUS HATER[ALS FOR THIS UNIT ONLY .----~, A Does %his Facility Unit contain hazardous Materials'? ...... S/ 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..separateHazardous .materi.a]s inventory form marked' NON-TRADE SECRETS ONLY (white'form ~4A-I) If 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 F~RE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RE,PONDERS (Fire Hydrant) SECTION 6: LOCATION CF UTILITY ~HUT-OFF8 AT TH~S UNIT ONLY. A. NATURAL GAS/PROPANE: B. ELECTRICAL: C. WATER' D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - '-i---- CITY BAKERSFIELD Fare and Aq~iculture c_~ Standard Hush.ess X'XAZARX:)OUS ~JAT I~-RT A~S Z gV~TORY NON--TRADE SECRETS ' Psge .... of .... BUSINESS NAME: crrY, ZIP:~. ff(~. ~ ~)/ CITY, ZIP: :~' ~t~. ~~ DUN AND BRADSTREET au.sea lrans Iy~ ~x Average ~nual ~asu~ I ~ C~t ~t ~t hi L~ltt~ ~e ~N~[ Nam of C~e C~e ~t ~t Est Units m Site Iy~ Pr~g Tie C~l .. Stoe~ in Factllty ~ Inst~cttms Ph~cil and Helith Hazard ~ / f F ............................ [--~ Fire Hazard c_~ Raactivity c_d ~ie~ ~--~ ~m All.se ~--J I~tltl ' Hep I t h of Pr.sure ~ Ith .... Health of Pr~sum HNIth '--' , P~ica) ~d HNIth Hazard C.l.S. ~ ~t II h i C.A.S. ~ (C~k 411 t~t apply} ~ ~ F~re Hazard ~ ~ Reactivity c- a ~la~ ~ ~ ~dd~ eel.se [ ~ I~at, ' Health of Prflsure Health ~'~ Cat 13 Nm i C.A.S. b~ ~ ~ ~ Fire Hazard ~--~ R~ctivity ~--~ ~la~ ~--~ ~ddm Release ~--~ I~tete Health of Pr~suee Health ............. ~ .... ~ ........................................ (ertifice~i~ (Read and sign after coepJet~nE all sections) · certify ~der ~alty of la~ t~t I ~v~ ~rs~eilyexe~in~ and aa faei]iar etth t~ tnfor~ti~ ~~ tht~ ~ll~tt~g~ ~ts. ~d t~t ~s~ m ~ in~ui~ of t~e t~tviduMs r~sible Dear Business Owner: Enclosed please find a cony of your response to the Hazardous Material Business Plan request. We have found it necessary to rejec: your pian for the foilowing reason(s) as checked below. Illegible Business Plan (please print or type infomation in ~glish). Form 3A Missing or ~ Incomplete Site Oiagr~ ~ Missing or ~ [ncomDlete Facilities Diagr~ Missing or ~ Inc~mlete This is to be corrected an, resubmitted ~ithin 30 days to: ~~q Bakersfield City Fire De~ar~ent Hazardous Materials Division 2!30 "G" Street BaZersfield, ~ g33D1 If additional co~ies of any fo~s are needed they c~n be picked u~ from the Hazardous Materials Division at 2~30 "G" Street in person. S i ncere I y Yours, '~ Hazardous Materials Coordinator BAKEB~rt-:.'LD CITY FIRE DEPAR/MENT ~ 2130 'G' STREET ~ BAKERSFIELD, CA. 93301 (805) 326-3979 oF~c~^~ USE O.~ I ~ I~, ,' U013~9 ' ID8 BUSINESS NAME HAZARDOUS MATERIALS RECEWEO B'J-SINES-S-P L-AN-AS--A--WHOi;Ef --'~-~-PR-05-I98-9- - -- FORM 2A HAZ..~AT, reV. INSTRUCTIONS; 1. To avoid further action, return th~s from within 30 days of receipt. 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 S. LOCATION / STREET ADDRESSY.~/OO SECTION 2; EMERGENCY NQTIFICATIONS In case of an emergency involving the release a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire depar~men~ and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTZFY [N CASE OF EMERGENCY: NAHE AND TITLE DURING BUS. HRS. AFTER BUS. HRS. j~-/~ SECT~0N 3; kO~AT~ON OF UTiLiTY SHUT-OFF8 FOR ~U~NE~ A~ A ~HOLE ~. .~,u.:~ ~:/.~o.~.~: ~//~% D. SPECIAL: / E. LOCK BOX: YES ] NO ~F YE~, LOCATION: ~F YES, DOE~ ~T CONTAIN S~TE PLANS? YE~ ] NO N~D~? YES ] NO FLOOR PLAN~? YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE EMERGENCY MEDICAL ASS];STANCE FOR YOUR BUSINESS AS A WHOLE SECT[ON 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATER[ALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY B. 'DO YOU HAVE MSDS (MATER[AL SAFETY DATA SHEETS) FOR EACH HAZARDOUS MATER[AL YOU HANDLE ~ C. G[VE A BRIEF SUMMARY OF YOUR HAZARDOUS MATER[ALS TRAINING PROGRAM: SECTION 7: EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS, WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION I, , 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 TITLE DATE ' BAKERSFIELD CITY FIRE. DEPARTMENT ~ ..rtl 2130 'G' STREET BAKERSFIELD, CA. 93301 (805) 326-3979 ~ OFFICIAL USE ONLY ~ ID# II BUSINESS NAIVE HAZARDOUS MATERIALS ......... ~--~__.BUSi NE-SSz-~pL~-,~N ~A~~--~ A~W-HO-L ~~-~''-. ..... ~, ......... 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 ~ ,FACILITY UNZT NANE: ~ }/4~ SECT[ON 1: H[T~GAT[ON~ PREVENT[ON~ ABATENENT PROCEDURES ,~ECT];ON ;~ NO~I'IF[C,~T[SN-'AND' EVAC~'AT[ON.~ mo.'~"=mlRr:--~ AT .,THE I,I,N_J..T~._~N_[,.,y, ---""- / ,ECTION 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 inventory form marked' NON-TRADE SECRETS ONLY (White form ¢4A-I) Zf 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 FOR USE BY EMERGENCY RESPONDERS (Fire Hydrant) SECTION §' LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NATURAL GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - CITY of BAKERSFIELD NO N-- TRADE S E C RE T~ -' , p,ge LOCATZON://~~ ~/'2~ ' ' ADDRESS: /~FO ,~~~' STANDARD IND. CLASS CODE t ~ 3 4 S 6 ? 6 9 10 11 12 13 ~ 14 C~e C~e Mt bt Est Units ~ Site TyM P~I T~ C~e Stor~ tn Faci)lty Nt ( ~ Jnst~tims E ~ Fire Hazard ~--~ Reactivity E ~ ~la~ ~--~ ~ RelNse ~--~ Health of P~re ~lth .... ~ P~ical. ~nd H~lth H~zard C.A.S. ~ ~,mt II NM & C.A.S. ~ (C~k ell t~t apply) ~ ] Fire Hazard [ ] ~activtty u--~ hle~ u--~ ~m ReiN~ u--u H~lth of P~m ~lth ~ ........ P~ical ~d H~lth Hazard C.A.S. ~ ~t I1 h i C.A.S. ~ (C~k ail t~t apply) Health of Pr~sure H~lth ....... P~co~ ~ Hfl]th HizaPd C.A.S. N~r Cm~t ll Nm & C.A.S. N~ (c~ an t~t apply) u ~ Fire Hazard u_~ R~ctivity-- ~la~ u_~ ~dd~ Release u--J I~tete ], . Health of PrKsune Health ............ ~ ............................................. Certificati~ (Read and s~Kn after compJetJnE ail sectJons) ] for obcai~ ~ infomart. I ~ljeve/t~t t~ sumitted infor~ti~ is true, accurate, and c~te.~]/] ///~ / m, t~tviduals r~sible