Loading...
HomeMy WebLinkAboutBUSINESS PLAN (3)Hazardous Materials/Hazardous Waste Unified Permit ~ ~CONDITIONS~OFPEI~! IX~-,(~N ~REVERSE SIDE Permit ID #:: 015-000-001457 ?iLOOP ELECTRIC This =ermit is issued fOr the foil°Win-e: E] Hazardous Materials Plan ' [] Underground Storage of Hazardous Materials [] Risk Management Program 13 Hazardous Waste on'site Treatment Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 .Chester Ave. 3rd Floor Bakersfield, CA 93301 · Voice '(661) 326-3979 FAX~(661) 326-0576 . Issuc Date ~-" LOOP ELECTR{.GL) .~-~ Electrical Contractor Specializing in Street Lighting & Traffic.Signals 1516 E. 19th St. ANDY KITSCH Bakersfield, CA 93305 (805) 327-0963 Lic. 496032 Fax (805) 327-9519 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME L~O-D~ ~-~_ L ~.__c..~ f~ t"c-~ INSPECTION DATE ADDRESS ]~-[(a ~-~ ,. icj TM FACILITY CONTACT 4~/ /( tTscH BUSINESS ID NO. 15-210- INSPECTION TIME~! ~ ~¥,J 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 Correct occupancy Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping t/ Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~es [~] No Questions regarding this inspection? Please call us at (661) 326-3979 ' B~siness Sit~ sp~}n[esp sible Party LOOP ELECTRIC SiteID: 015-021-001457 Manager : BusPhone: (661) _327-0963 Location: 1516 E 19TH ST Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 28C FacUnits: 1 AOV: ~CommCode: BAKERSFIELD STATION 02 SIC Code: > EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact /~ Title ANDY KITSCH / OWNER BRIAN ~c~L.aF~/ / OWNER Business phOne:' (661) 327-0963x Business Phone://(661) 327-0963x 24-Hour Phone : (661) 327-0963x 24-Hour Phon~/: (661) 588-2514x Pager Phone : (661) 392-0442xHM Pager Phone : ( ) '- x Hazmat'Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 327-0963x MailAddr: 1516 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs:-. = Gal Certif'd:' RSs: No Emergency Directives: F Hazmat Inventory One Unified List ~ Alphabetical Order Ail Materials at.Site Hazmat Common Name... ISpeoHazlEPA Hazards Frm DailyMax IunitlMCP ACETYLENE E F P IH G Hi ASPFLALT LOOP FILLER F L 100.00 GAL Min OXYGEN F IH DH G Low WASTE OIL F DH L 55.00 GAL Low 0%/07/2003 LOOP ELECTRIC ,._ SiteID: 015-0'21-001457 Manager : %%%~ BusPhone: (661) 327-0963 Location: 1516 E 19TH ST Map : 103 CommHaz : Low City : BAKERSFIELD ~° Grid: 28C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ANDY KITSCH / OWNER BRIAN / OWNER Business Phone: (661) 327-0963x/ Business Phone: (661) 327-0963x 24-Hour Phone : (661) 327-0963x 24-Hour Phone : (661) 588-2514x Pager Phone : (661) 392-0442xHM Pager Phone ~ ( ) - x Hazmat Hazards: Fire Press '~ ImmHlth DelHlth Contact : Ph~he: (661) 327-0963x MailAddr: 1516 E I·9TH ST State: CA . . City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: ~CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: reviewsd ~h~ a~ached hazardous mmerials mana~e- (~e of ~) any colophons ~ns~ilu~s a ~mple~o and ~rr~ man- agemen~ plan for my facility. 1 09/09/2003 LOOP ELECTRIC = SiteID: 015-021-001457 Manager : BusPhone: (661) 327-0963 Location: 1516 E 19TH ST Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 28C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ANDY KITSCH / OWNER BRIAN / OWNER Business Phone:' (661) 327-0963x Business Phone: (661) 327-0963x 24-Hour Phone : (661) 327-0963x 24-Hour Phone : (661) 588-2514x Pager Phone : (661) 392-0442xHM Pager Phone : .( ) - x ........ - ............................ + ...................................... Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 327-0963x MailAddr: 1516 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: += Hazmat Inventory ....... One Unified'List + +== Alphabetical Order All Materials at Site + ................................ + ....... + ........... + ..... + .......... + .... +_ _ _+ Hazmat Common Name... ISpeoHazlEPA HazardsI Frm I DailyMax IUnitlMCPI ................................ + ....... + ........... + ..... + .......... +_ _._ _+_ _ _+ ASPHALT LOOP FILLER F L 100.00 GAL Min WASTE OIL F DH L 55.00 GAL Low 1 03/27/2002 CITY OF BAKERSFIELD FIRE.DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME {-.-.¢3t%{~ ~ I---~--C--TO'ir-'~ INSPECTION DATE / [ / ADDRESS I $-[ ~' ~, I ~ 'r~__ 5 T" PHONE NO. ~:g2 ~/ -Oc/0 FACILITY CONTACT t~,,,t~'',-] ]<'l'WC~C~ BUSINESS ID NO. 15-210-rN3/~/6'7 INSPECTION TIME t~. ~- ' o-q,~ 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 '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 Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous w~a. ste on site?: ~]~es [~] No . ~ , Questions regarding this inspection.'? Please call us at (661)326-3979 Buainess Sit~ I~e?o~sible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy . Inspector: · I Hazmat Hazards,:. Fire... DelHlth'l + ........ ¥ .............. 2 ..................................... a ................ + Contact : Phone: (661) 327r0963x MailAddr: .1516 E 19TH ST State{ .CA City :'BAKERSFIELD .Zip : 93305 Owner ANDY KITSCH Phone:· (661) 327-.0963x Address :-6312 MIGNONETTE ST State: CA City : BAKERSFIELD· Zip : 93308 +.' ........... ~ ....... ~__-'-% ........... ~ ...................................... ~_--+ ' Period ': to T0taZASTS: = Gal Preparer: -. TotalUSTs: = Gal i!· Certif'd: RSs: No + .................................................. ~ ....... . ...... + ' Emergency Directives: + + ~: += Hazmat Inventory ........................... · ................ °n~Un~fi~d LiSt' + +==.Alphabetical Order. All Materials at site + +-' .................... r ......... + ....... + ........... + -+ .......... +~---+---+ I Hazmat Comm0n~Name... {SpeoHaZlEPA Hazardsl 'Frm I DailyMax lUnitlMCp{ +~_ ............................. +_- ....... +~ .......... + ..... + .......... + .... +---+. ASPHALT LOOP FILLER F L 100.00 GAL Min WASTE OIL F DH L' 55.00 GAL Low . (T~'pe or pdn~. name). . . reviewed the .attached hazardOUs materials ment plan foi; J~Oo/¢ ~-~£~//'f-~nd that it along with ¢/.;,,m. e of. [~u~iness) " · any corrections constitute a complete and correc['rnan, agement plan for my facility. LOOP ELECTRIC SiteID:~ '015'-021-001457 += InventorY Item 0001. Facility Unit: Fixed Containers at Site +== COMMON NAME / CHEMICAL NAME - ~ ASPHALT LOOP FILLER ~ Days On Site .: ' 365 Location within this Facility Unit Map' '"Gr'id~ .+ ................. SHOP IN WAREHOUSE OUT BACK- "· . I CAS#.~ += STATE'=+= TYPE'S==+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER iTyPE ..... Liquid ' I Mixture 'l Ambient I Ambient I DRUM/BARREL-NONMETAL + ~ 4 ~ ==+ AMOUNTS AT THIS LOCATION =+ Largest Container '1 Daily Maximum Daily Average GAL .100.00 GAL 100.00 GAL +==== =.=+ ~------ ~ == HAZARDOUS COMPONENTS ==+===+-- 22.00 Asphalt No 8052424 ~ 4-===+ 4-=='=4 + HAZARD ASSESSMENTS ===+ ~ +=====+ ~ TSecretINo NoRS I Bi°HazINo Radioactive/AmountNo/ Curies EPAF Hazards· NFPA/// USDOT# MinMCP 4, === q + ~ + ~ +=====+ += Inventory Item 0002 - Facility Unit: Fixed Containers at Site + · +== COMMON NAME / CHEMICAL NAME =~ 4, '1 WASTE OIL Days On Site 365 · Location within' this Facility Unit .. Map: Grid: + ................ +. YARD 'OUT BACK UNDER PARKING FRAME ~ '1 cAs# 0 + ~ + +.= STATE + TYPE ===+== PRESSURE + TEMPERATURE ==+ .... CONTAINER TYPE + I Liquid I Pure I .Ambient I Ambient I DRUM/BARREL-METALLIC I + + ~ ~ k--- .4 + AMOUNTS AT THIS LOCATION ==+ Largest Container· ] Daily Maximum I 'Daily Average I .GAL 5·5.00 GAL 25.. 00 GAL += . + -=4 4- +.= ~ HAZARDOUS COMPONENTS 4,===+ 100.00 Waste Oil, Petroleum Based · No 0 .4 '1 4-===+ 4 4,===.4 + HAZARD ASSESSMENTS ===+ t ~ ..... + ITSecretl RSIBioHazI Radioactive/Amount EPA Hazards I NFPA USDOT# MCPI : No .'.. No No. No/ Curies F DH . / / / Low · 4 4-===+ + ~ + ~ ~-=====+ -- 2 01/25/2002 LOOP ELECTRIC = siteID: 015-021-001457 + Fast Format + .+=.Notif /Evacuation/Medical Overall Site + +== Agency Notification 06/14./1999 + 911 · -+ +=== Employee Notif./Evacuation 06/14/1999 + VERBAL .... Public Notif./Evacuation 06/14/1999 + VERBAL Emergency Medica!...Pl~ .................... 06/14/1999 + 911 IF LIFE THREATENING OR WB CHRISTIANSEN MD .- 327-9617.FOR woRKERS COMP. '. 3 '01/25/2002 +~LOOP ELECTRIC --' " SiteID: 015-021-001457 Fast Format +=~ Mitigation/Prevent/Abatemt == Overall Site ' ~= Reiease Prevention 06/14/1999 BOTH. LOOP FILLER AND' WASTE OIL'ARE STORED IN SEALED CONTAINERS T° pREVENT SPI'LLS. / = Release Containment 06 14/1999 .USE DIRT TO STOP.FLOW-AND cONTAIN. .... · clean Up = : 07/07-/1994 SWEEP. IT UP.. ..... other-~es0urce' Activation -- ~- ==+ -4- 01/25/2002 '.+ LOOP ELECTRIC SiteID: 015-021-001457 .~ · ~ Fast Format + += ,Site Emergency Factors Overall Site + +== Special Hazards =+ + =+ +==~ ~tility .Shut-O££s = 07/07/199~ + A) GAS - NONE ' B) ELECTRICAL· - METER·IN BAcK C) WATER - VALVE ON LEFT HAND SIDE D) .SPECIAL - NONE E) LOCK BOX - NO + + + .... Fire Protec./Avail Water 06/·14/1999 + PRIVATE FIRE PROTECTION '- W.E..HAyE FIRE _EXTINGUISHERs. NEAREST FIRE-HYDRANT - ACROSS THE ST AT 1519 E-19TH ST. + Building Occupancy Level + -5- 01/25/2002 + LOOP ELECTRIC - == SiteID: 015-021~001457 · '~ Fast Format += Training Overall'Site +== Employee Training ~ 07/07/1994 WE, HAVE 5 EMPLOYEES'AT THiS FACILITY.' WE DO HAVE MSDS SHEETS ON FILE.' BRIEF SUMMARY OF TRAINING PROGRAM: .WE HAVE A SAFETY MEETING ONCE A WEEK EACH WEEK'VARIOUS TOPICS ARE DISCUSSED'' EACH EMPLOYEE HAS BEEN. GIVEN A MATERIAL SAFETY DATA SHEET ON THIS LOOP FILLER WHEN THEy ARE HIRED. ... CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 FACILITY NAME I-~, ~- Ic-_c-tcd c_ INSPECTION DATE I ~- / t 2. /O ! ADDRESS I~-I~,, U- .~q -t~ PHONENO..~-27-oci6~ FACILITy CONTACT fl,.ab,--/ ~,(.t'7-~Cid BUSINESS IDNO. 15-210- INSPECTION TIME J ~ v,..,.~' vJ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~]/'~outine [~ Combined I~ Joint Agency {~ Multi,Agency {~ Complaint I~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy .... .Verification: Of inventory materials· ' " ~ ex,,~ ~'. Verification of quantities ... ,~ ~" Verification of location . I/' ......... Proper segregation of material v/ Verification of MSDS availability Verification of Haz Mat training ~J I/~ Verification of abatement supplies and procedures Containers properly labeled Housekeeping '/ Fire Protection Site Diagram Adequate & On Hand ~/' ..... / C=Comp!i~!nce .. y=Violati6n AnYhaZarclo~swaSte'~n:aite?:'-' fives I~No' ''. : _ ,' : ' ' ': .... . Questions regarding this insPeCtion? Please Call us at (661) 326-3979 BJusiness ~i~ Resp]onsible Party CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 · FACILITY NAME ~_.-O7~ ~lG_C_-'f~'C._ INSPECTION DATE 12.-/IZ /0! ADDRESS } ~- I Lo ~ ~c~ -r...~.~ PHONE NO...~ ~ 7 - oq ~ FACILITY CONTACT ~,4.~.,)(_ ~.~"I-SC..M BUSINESS IDNO. 15-210- INSPECTION TIME ]'~ql' v,.... ~ rd NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~outine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate t. Visible address 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 -,/ Housekeeping ~" Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on siite?: ffYes [] No ' _ ~ Questions regarding this inspection? Please call us at (661) 326-3979 ~ ~.~ R~e~.d ,,ns~_bl~ Party White-Env. Svcs. '~ellow - Station Copy Pink-Business Copy Inspector: ,~. ~~ I Hazmat'Hazards: 'Fire D'elHlth I Contact : Phone: .(661) 327-0963x MailAddr: 1516 E 19TH ST State: CA City. : BA_KERSFIELD ...... Zip _:. 93305 9 + Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to T°talASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd' - RSs: No +- + Emergency Directives: += Hazmat Inventory One Unified List + +== Alphabetical Order=-' Ail Materials at Site + -+ -+- -~---~-+- -+ .... +---+ Hazmat Common Name... ISpecHazlEPa HazardsI Frm I DailyMax IUnitIMCPI F ....... + ........... + ..... + .......... + .... +- - -+ ASPHALT LOOP FILLER F L 100.00 GAL Min WASTE OIL F DH L 55.00 GAL Low - t,,a,~ I have I, Do hereby codify (Type or print name) reviewed the a~ached h~a~ous matsdais m~,nt *" p.,~n for any corrections constitute a complete s~d ~Fect m~n- agement plan for my facility. -z- oz/25/2oo2 LOOP ELECTRIC " SiteID: 015-021-0.01457 Manager : BusPhone: (661) 327-0963 Location: 1516 E 19TH ST Map : 103 CommHaz : Low City : BAKERSFIELD. Grid: 28C FacUnits: 1 AOV: CommCode: BJ~KERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / .Title ANDY KITSCH / OWNER BRIAN / OWNER Business Phone: .(661) 327-0963x Business Phone: (661) 327-0963x '24-Hour Phone : (661). 327-0963x 24-Hour Phone :. (661) 588-2514x Pager Phone : (661) 392-0442xHM Pager Phone : (. ) - x 'Hazmat Hazards: Fire DelHlth Contact : Phone: (661)' 327-0963x MailAddr: 1516 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List ~--- Alphabetical Order All Materials at 'Site-~ Hazmat Common Name... ISpocHazlEPA HazardsI Frm I DailyMax lUnitlMCP ASPHALT LOOP FILLER F L 100.00 GAL Min WASTE OIL F DH L 55.00 GAL Low any corrections coastitute a com~ieto" ,, ' agement plan for my facili~. 0 ? / 0 6 / 2 0 0 ~ Signa~m , Dste LOOP ELECTRIC SiteID: 015-021.-001457 Manager : BusPhone: (661) 327-0963 Location: 1516 E 19TH ST Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 28C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title EmergencY Contact / Title ANDY KITSCH / OWNER BRI.AN / OWNER Business Phone: (661) 327-0963x Business Phone: (661) 327-0963x 24-Hour Phone : (661) 327-0963x 24-Hour phOne : (661) 588-2514x ~3~ Phone~: (661) 392-0442x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 327-0963x MailAddr: 1516 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (661) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: F Hazmat Inventory One Unified List ~---As Designated Order Ail Materials at Site Hazmat Common Name... SpecHazlEPA Hazards Frm DailyMax IUnitlMCP ASPHALT LOOP FILLER F L 100.00 GAL Min WASTE OIL F DH L 55.00 GAL Low 1 07/19/2000 LOOP ELECTRIC SiteID: 215-000-001~57 JUN 0 3 1999 BusPhone: (805) 327-0963 Manager : Location: 1516 E 19TH ST ...... ~=~,~.~,~ ~:~.;~ Map : 103 CommHaz : Low -~ ' ...... ~:~ Grid: 28C FacUnits: 1 AOV: City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ANDY KITSCH / OWNER KIM KITSCH / OWNER Business Phone: (805) 327-0963x Business Phone: (805) 327-0963x 24-Hour Phone : (805) 327-0963x 24-Hour Phone : (805) 327-0963x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth ,'ki Contact : Phone: ( ) - x MailAddr: 1516 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner ANDY KITSCH Phone: (805) 327-0963x Address : 6312 MIGNONETTE ST State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List ~ [--- As Designated Order Ail Materials at Site ~ Hazmat Common Name... IspecHazlEPA HazardsI Frm ~DailyMax IUnit MCP ASPHALT LOOP ~ FILLER F L 100 ~GAL Min WASTE OIL~ ~~/~'/, / / F D~ L 55 GAL LOW ~, Qo h~reby certify ~hat I have r®vi~$~ ~he ~chs~ h~rdo~s rnm~ri~ls manage- any corrscfions c~ns~s ~ complete and corrsc~ man- =gernen~ plan ~or my ~cifi~. -1- 11/23/1998 LOOP ELECTRIC SiteID: 215-000-001457 F Inventory Item 0001 Facility Unit: Fixed Containers at Site COMMON NAME / CHEMICAL NAME ASPHALT LOOP FILLER Days On Site 365 Location within this Facility Unit Map: Grid: SHOP IN WAREHOUSE OUT BACK CAS# STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Mixture I Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 100.00 GAL 100.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 22.00 Asphalt No 8052424 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Min ~ Inventory Item 0002 Facility Unit{ Fixed Containers at Site COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: YARD OUT BACK UNDER PARKING FRAME CAS# 0 ~ STATE I TYPE AmbientPRESSURE I TEMPERATUREAmbient · DRUM/BARRELCONTAINER TYPE_METALLiC Liquid Pure AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 55.00 GAL 25.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low 2 11/23/1998 LOOP ELECTRIC SiteID: 215-000-'001457 Fast Format F Notif./Evacuation/Medical Overall Site -- Agency Notification Employee Notif./Evacuation Public Notif./Evacuation Emerge~cy_Me~cal P. lan -3- 11/23/1998 LOOP ELECTRIC SiteID: 215-000-001457 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site :~elease Preven,t//~.n . . ., Release Containment Clean Up 07/07/1994 SWEEP IT UP. Other Resource Activation -4- 11/23/1998 LOOP ELECTRIC SiteID: 215-000-001457 Fast Format F Site Emergency Factors Overall Site Special Hazards Utility Shut-Offs 07/07/1994 A) GAS - NONE B) ELECTRICAL - METER IN BACK C) WATER - VALVE ON LEFT HAND SIDE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 07/07/1994 PRIVATE FIRE PROTECTION - WE HAVE FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - ACROSS THE STREET AT 1519 E 19TH ST. Building Occupancy Level 5 11/23/.1998 LOOP ELECTRIC SiteID: 215-000-001457 Fast Format ~ Training Overall Site -- Employee Training 07/07/1994 WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE A SAFETY MEETING ONCE A WEEK EACH WEEK VARIOUS TOPICS ARE DISCUSSED. EACH EMPLOYEE HAS BEEN GIVEN A MATERIAL SAFETY DATA SHEET ON THIS LOOP FILLER WHEN THEY ARE HIRED. Page 2 Held for Future Use Held for Future Use 6 11/23/1998 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT~ON REVERSE SIDE PERMIT ID# 015-021001457 LOOP ELECTRIC LOCATION 1516 E 19TH Issued by: This permit is issued for the following: Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice .(805) 326-3979 FAX (805) 326-0576 Approved by: Expiration Date: June 30, 2000 MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE z~,../~l-~ NEWAOCOUNT ADORES8 CHANGE " CLOSE ACCT · FINANCE CHARGEI -- OTHER ADJ !,~ CUSTOMER NAME "~,~o (~ -~ ~c_~--C '~ C MAILING ADDRESS \%\.(,~ ~ i ~, -kV,,~ ~,,~.~, . CITY ~--~c~C-e._C~-~, ~,0~ STATE ~'~,~ ZIP CODE~'~' SITE ADDRESS PARCEL NUMBER ADJUSTMENT I ~ CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT i - ! . " I ~ j. ~\y ~e~ ~ ~ APPROVED BY ~ ._ LOOP ELECTRIC SiteID: 215-000-001457 Manager : BusPhone: (805) 327-0963 Location: 1516 E 19TH ST j ~.~ j tMap : 103 CommHaz : Low ~ D~ City : BAKERSFIELD \j ~' ..... ~Grid: 28C FacUnits: 1AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ANDY KITSCH ,/ OWNER KIM KITSCH / OWNER Business Phone: (805) 327-0963x Business Phone: (805) 327-0963x 24-Hour Phone : (805) 327-0963x 24-Hour Phone : (805) 327-0963x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Agency-Defined Topic Title F Hazmat Inventory One Unified List ~-- MCP+DailyMax Order. Ail Materials at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm I DailyMax IUnitlMcP WASTE OIL F DH L 55 GAL Low ASPHALT LOOP FILLER F L 100 GAL Min [ i~fl~e or p~lnt name) reviewed the at~ached hazardous materials manage- ment plan for Z4:2~ ~Z"'/~d'/~/,~-frd that it along .ith any corre~ions ~nsti~u~e a ~mple~e and ~rre~ man- agement plan ~or m~ ~acili~. LOOP ELECTRIC SiteID: 215-000-001457 F Inventory Item 0002 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit YARD OUT BACK UNDER PARKING FRAME CAS# 0 ~ STATEPure TYPE Ambient PRESSURE TEMPERATURE I CONTAINER TYPE Liquid Ambient DRUM/BARREL-METALLIC 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 Waste Oil, Petroleum Based No 0 -2- LOOP ELECTRIC SiteID: 215-000-001457 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME ASPHALT LOOP FILLER Days On Site 365 Location within this Facility Unit SHOP IN WAREHOUSE OUT BACK CAS# FSTATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid /Mixture Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 100.00 100.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 22.00 Asphalt No 8052424 -3- LOOP ELECTRIC SiteID: 215-000-001457 Fast Format F Notif./Evacuation/Medical Overall Site Agency Notification Employee Notif./Evacuation Public Notif./Evacuation Emergency Medical Plan LOOP ELECTRIC SiteID: 215-000-001457 Fast Format F Mitigation/Prevent/Abatemt Overall Site Release Prevention Release Containment Clean Up 07/07/1994 SWEEP IT UP. Other Resource Activation -5- LOOP ELECTRIC SiteID: 215-000-001457 Fast Format F Site Emergency Factors Overall Site Special Hazards Utility Shut-Offs 07/07/1994 A) GAS - NONE B) ELECTRICAL - METER IN BACK C) WATER - VALVE ON LEFT HAND SIDE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 07/07/1994 PRIVATE FIRE PROTECTION - WE HAVE FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - ACROSS THE STREET AT 1519 E 19TH ST. Building Occupancy Level LOOP ELECTRIC SiteID: 215-000-001457 Fast Format ~ Training Overall Site -- Employee Training 07/07/1994 WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE A SAFETY MEETING ONCE A WEEK EACH WEEK VARIOUS TOPICS ARE DISCUSSED. EACH EMPLOYEE HAS BEEN GIVEN A MATERIAL SAFETY DATA SHEET ON THIS LOOP FILLER WHEN THEY ARE HIRED. Page 2 Held for Future Use Held for Future Use -7- $ - . DEC g 01994 ~ 12/14/94 hOOP EBECTRIC 215-000-001457 ge 1 . ~ Overall Site with 1 Fac. Unit By General Information Location: 1516 E 19TH ST Map:103 Haz:2 Type: 3 City : BAKERSFIELD Grid: 28C F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title ANDY KITSCH / OWNER KIM KITSCH / OWNER Business Phone: (805). 327-0963x Business Phone: (805) 327-0963x 24-Hour Phone : (805) 327-0963x 24-Hour Phone : (805) 327-0963x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 1516 E 19TH ST D&B Number: City: BAKERSFIELD State: CA Zip: 93305- Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code: Owner: ANDY KITSCH Phone: (805) 327-0963 Address: 6312 MIGNONETTE ST State: CA City: BAKERSFIELD Zip: 93308- - Summary (Type or print name) reviewed the attached hazardous materials manage- ment plan forLOCI3_ ~_.~\~_~.~(..and that it along with (l~ame of Business) any co~,~ions.con$fitute a complote and correct man- agoment plan for rny facility. :i 12/14/94 LOOP ELECTRIC 215-000-001457 Page 2 ~ Hazmat Inventory List in MCP Order 02 - Fixed Containers at Site Pln-Ref Name/Hazards Form Max Qty MCP 02-002 WASTE OIL Liquid 55 Low ~ Fire, Delay Hlth GAL 02-001 ASPHALT LOOP FILLER Liquid 55 Minimal ~ Fire GAL. 12/14/94 LOOP ELECTRIC 215-000-001457 Page 3 ~ 02 - Fixed Containers at Site Hazmat Inventory Detail in MCP Order 02-002 WASTE OIL Liquid 55 Low · Fire, Delay Hlth GAL CAS #: 0 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: WASTE Daily Max GAL Daily Average GAL Annual Amount GAL 55 I 25.00 I 55.00 Storage IIPress T Temp Location DRUM/BARREL-METALLIC Iambient~ambientlYaRD OUT BACK UNDER PARKING FRAM -- Conc~ Components I MCP ---~uide 100.0% IWaste Oil, Petroleum Based ILow ~ 27 02-001 ASPHALT LOOP FILLER Liquid 55 Minimal · Fire GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: SEALER Daily Max GAL Daily Average GAL Annual Amount GAL Storage IIPress T Temp Location DRUM/BARREL-NONMETAL IAmbientlAmbientlSHOP IN WAREHOUSE OUT BACK -- Conc Components MCP ---~uide 2'2.0% IAsphalt IMinimal I 27 12/14/94~ LOOP ELECTRIC 215-000-001457 Page 4 00 - Overall Site <D> Notif./EVacuation/Medical <1> Agency Notification <2> Employee Notif./Evacuation <3> Public Notif./Evacuation <4> Emergency Medical Plan 12/14/94 LOOP ELECTRIC 215-000-001457 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention <2> Release Containment <3> Clean Up SWEEP IT UP. <4> Other Resource Activation 12/14/94 LOOP ELECTRIC 215-000-001457 Page 6 ~,~' 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - METER IN BACK C) WATER - VALVE ON LEFT HAND SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - WE HAVE FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - ACROSS THE STREET AT 1519 E 19TH ST. <4> Building Occupancy Level 12/14/94 LOOP ELECTRIC 215-000-001457 Page 7 " -00 - Overall Site <G> Training <1> Employee Training WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE A SAFETY MEETING ONCE A WEEK EACH WEEK VARIOUS TOPICS ARE DISCUSSED. EACH EMPLOYEE HAS BEEN GIVEN A .MATERIAL SAFETY DATA SHEET ON THIS LOOP FILLER WHEN THEY ARE HIRED. <2> Page 2 <3> Held for Future Use <4> Held for Future Use BAKERSI ELD CITY FIRE DEP/ TMENT HAZARDOUS MATERIALS INVENTORY Page__of 5usiness Name Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: NeW [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET 2) Common Name: .3) DOT # (optional) Chemical Name: AHM [ i CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive{ ]. Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from ~DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid ['] Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive ( ] i 7) AMOUNT AND T1ME AT FACILITY UNITS OF MEASURE 8) S~ORAGE CODES _Maximum Daily Amount: lbs [ I ga [ ] f~3 [ ] a) ContaJner: Average OaJiv Amount: cunes[ ] b) Pressure: ,' c) Tempera~ture: Annual Amount: Largest Size'Container: # Days On Site Circle Which Months: All Year. J. F. M, A. M. J. J, A. S. O, N. D 9) MIXTURE: Ust COMPONENT CAS # % WT AHM t,~e three most hazardous 1 ) [ ] c~emica~ comDonents or ~y AHM components 2) [ ] 3) [ ] 1 0) Loca~on CHEMICAL DESCRIPTION 1) INVENTORY STATUS:. New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL . HEALTH HAZARD CATEGORIES Fire [ ] Reactive{ ] Sudden Release of Pressure [ ] ImmedialeHealth (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSiFICATiON (3-ci~g~t code from DHS Form 8022) USE CODE i'l ~,) PHYSICALST,'~'Ii: Solid [. ] Liquid [ ~ Ga~ [. ] Pure [ ] Mixture [ ] Waste [ ] Radio~-t~ve [ ] 7) AMOUNT AND T1ME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] ga~ [ ] ft3 [ ] a) Contaner: Average Oa~ly Amount: cunes[ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Conteflner: # Days On Site Circle Which Months: All Year. J. F. M. A. M, J, J. A, S, O, N, O 9) MIXTURE' IJst COMPONENT CAS # % WT' AHM the three most haze~'clous 1 ) [ chem~c,,~ components or a~y AHM components 2) [ 31 [ 10) Loch,on t cer~ry unaer penamil or law, [nat i nave oersonally examlrleo 8.rla art1 /arntllal' wID'l I~le m{oma~on submitted on mis aha afl attached oocumen~s, t believe suDrnir~ea informel~on ~s Due, accurate, an~ corn~lere. PRINT Name & Title of Au~onZeo Company F~eoresentatlve Signature Date BAKERSOELD CITY FIRE DEP. ITMENT ' ._ HAZARDOUS MATERIALS INVENTORY Page_of_ 3usinessName L(~)¢ ~r---~/~--~U Address [~(0 ~ ~ . CHEMICAL DESCRI~ION NTORY STA~S: New [ ] Add,ion [ ] Revision [ ] Deletion [ ] Chec~ ~ chemi~ is a NON ~DE SECR ~DE SECR~ [ ] Chemi~ N~e: AHM [ ] CAS 4) PHYSICAL & H~L~ ~HYSICAL H~L~ H~RD CA~GORtES Fire ~ Reactive ( ] Su~en Rele~eof Pressure [ ] Immobile He~ (Ac~e) [ ] Delayee He~h (Chromc) [ ] 5) WAS~ C~SSIFICA~ON (3-digit co~e from DHS Fo~ 8022) USE CODE ~ , 6) PHYSICALSTA~ Solid [ ] Uquid [~ G~ [ ] Pure [ ] Mi=ute ~ W~te [ ] R~ioam~e ..imumDaiyAmount: ~~ ,. [ ] ::;~ .3 [ ] ~)Contaner: Average ~iy Amount: c ] b) Pressure: · Annu~ Amount: c) Temper~ure: ~gest Size'Cont~ner: ¢ Days On Site Circle ~ich Months: All Ye~. J, F, M, A. M. J. J, A. S, O, N. D the three most h~aous 1) ~ { ] chem~ comDonen~ or ~y AHM com~nen~ 2) [ ] 3) [ ] CHEMICAL DESORI~ION 1) INVENTORY STA~S: New { ] Addition [ ] Revision ( ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR ~DE SECR~ [ ] 2) Common N~e: 4) PHYSICAL & H~L~ ~ PHYSICAL H~L~ H~RD CA~GORIES Fire { ~ Rea~lve [ ] Suaden Relate of Pressure [ ] Immedi~e He~h (Ac~e) [ ] ~laye~ He~h (Chronic) [ l ~) ~svs~c;caI~ Solid [ ] Ci~uid [ ] G~ [ ] ~ur~ ~ ] Mi~ur~ [ I W~m [ l 7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~S~ 8) STOOGE CODES Average 8ely Amount: ~, ~ . curies [ ] ~ b) Pressure: ~ges~ Size Contmne.: ~+~ ~ ' ~ ~ {~ ~ Oeys On Site .~ C[rcte ~ich Months: All Ye~. J, F, M. A, M. J. J, A. S. O, N. D 9) MITRE: ~st ~ COM~N~N~ CAS ~ % ~ ~M cnemlm com~nen~ ~r my AHM com~nents '2) [ ] 3) [ ] co~ unaer .Dens.lei law, ~af I ~sve oe~o~811y exsmln~ ~a ~ t~lll~ Wl~ ~e in{omaDo~ suDmt~ on~ ~a ~t a~cn~ aocumen~ J believe suDmi~ info.aDen is ~e. accu~te, ~ complete. ~ PRI~ Nome & Tige of Au~onzeO Company ~e~resenmDve Signa~re I ?</ BAKERSiELD CITY FIRE DEP/!TMENT HAZARDOUS MATERIALS INVENTORY Page_of_ .; u'siness Name Address CHEMICAL DESCRIPTION 1 ) INVENTORY STATUS: New { ] Addition [ ] Revision [ ] Deletion [ ] · Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ I CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immeaiate Health (Acute) [ 5) WASTE CLASSIFICATION - (3-digit code from OHS Form 8022) USE CODE ' 6)PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] · 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE. , 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ,~3;[ ] a) Container: Average Daily Amount: cune~'~ [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year, J, F, M, A, M, J. J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % VVT AHM the three most haza~clous 1) [ ] chemical components or any AHM components 2) [ ] 31 [ ] 1 0) Location CHEMICAL DESCRIPTION 1) tNVENTORYSTATUS: New[ ] Addition[ ] Revision[ ] Deletion[ ]' Check if chemicaJ is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optionaJ) ChemicaJ Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES' Fire [ ] Reactive{ ] Sudden Release of Pressure { ] ImmediateHeaJth (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code fi.om OHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Lfiquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste_ [.] Radioactive [.] 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] 1~3 [ ] a) Container: Average Daly Amount: curies [ ] b) Pressure: AnnueJ Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: Ail Year. J. F. M, A, M, J, 0, A. S. O, N. D 9) MIXTURE: list COMPONENT CAS # % WT AHM the three most hazardous 1 ) [ chem~c..al components or any AHM components 2) [ ] 3) . [ ] · "/0) Location ce~fy under l~enairy or law, ma! 1 have l~ersonally examined and am famdiar wi[h me mfoma~on submitted on mis eno ali altachea docurnenrs, believe d~e P RII~T Name & Title of IAuthorizeci Company F~epresentalive · Date BAKE FIELD 'CITY FIRE RTMENT -1715 CHESTER AVE. '"" '"'- BAKERSFIELD, CA. 93301 '~-.. '.~.~"~_...._~.,., [,~'(805) 326-3979  HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHE,:~ ~ ~USiNESS ~S ^ ~^RM [ ] ~usNESS N^ME LOOt' P___~LF-- .O. WPIc---b- FAC:LITY' NAME SiC CODE DUN & BRADSTREET NUMBER EMERGENCY CONTACTS BUSINESS PHONE 24-HOUR PHONE NAME ~~ ~~- T~TL5 ~e~ BUSINESS PHONE 24-HOUR PHONE Ba~rsfietC~Fire Dept " ~ ' Hazardous Materials Division ....... HAZARDOUS MATERIALS MANAGEMENT'PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: B. RELEASE-CONTAINMENT AND/OR MINIMIZATION' SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: LOC',,( BOX: YES/NO iF YES, LOCATION' SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. ?RIVATEFiREPROTECT[ON' ~OL9~- ~,kJo-.~ ~ t3oZ~~~ Bi WATER AVAILABILITY (FIRE HYORANT~: A(7~r~ ~- OhLre~__~- Bakersfield Fire Dept. Hazardous Materials IDivisio_~: HAZARDOUS MAIERIAL$ MANAG~MENI PLAN SECTION a: NOTIFICATION AND EVACUATION PROCEDURES' A. AGENCY N©TIF[CAT[ON PROCEOURES: B. :_MPLOYEE NOTIFICATION AND E',/ACUATION: c. ?,u~ulc ~v,,cu^TIO~' ~ ~ ._ ~ O. EMERGENCY MEDICAL PLAN: .: .. akersfield Fire Dept. .... Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: ~ MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY oF TRAINING PROGRAM: '" ~--- V ' -- ' ..... SECT[ON 4: 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 & SAFETY CODE" FOR THE FOLLOWING REASONS: " WE OD NOT HANDLE HAZARDOUS MATERIALS. WE OD HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEEO THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, ~'Y~_ _. /L/ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNOERSTANO THAT THIS INFORMATION WILLSE USED TO FULFILL MY FIRM'S OBLiGATiONS UNDER THE "CAUFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION.CONSTITUTES PERJURY. : NATURE TITLE DATE .... I' 2. BAKERSFI'ELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 1715 ~CHESTER" A.V_E~ BAKERSFIELD, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN i,¢ c~ 7 1. :o ovoid further oction, return this form within 30 do'Cs of receipt. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as po~ible. SECTION ]' 8USINESS1DENT1FICATION DATA BUSINESS NAME: 'L~P DUN & 8RADSTREET NUMBER: SIC CODE: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE