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HomeMy WebLinkAboutBUSINESS PLAN 9/26/2003 Hazardous Materials/Hazardous Waste Unified Permit .:~ CONDITIONS OF-PERMIT~ · ON REVERSE SIDE :' This =ermit is Issued for the followin_.: El Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-001993 [] Risk Management Program OSCARS ROAD SERVICE [3 Hazardous WasteOn-Site Treatment LOCATION: 728 1/2 E 19TH'ST OFFICE OF ENVIRONMENTAL SER VICES' · ' 1715 Chester Ave., 3rd Floor i Appros, edby: Bakersfield, CA 93301 ' Offi¢¢of£v~Scrvi¢cs '" Voice (661) 326-3979 FAX (661) 326-0576 'ExPimtionDate: 'June 30:2003 . ~" ' $1'T~ DIAGRAM [ ~ ! lrAOT.rry DIAGRAM Bu.slm~ Name:' " ........... · Busimms CORRECTION ,NOTICE BAKERSFIELD FIRE DEPARTMENT N° 9 3 6 Sub Div. Blk Lot You are hereby required to make the following corrections at the above location: Cot. No Completion Date for Corrections. InspectOr 325-39?9 OSCARS ROAD SERVICE ..- SiteID:/~5-021-001993 / Manager : BusPhone: Location: 728 1/2 E 19TH ST %--- (661) 325-1400  Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 29C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DOLORES GUERRERO / MAINTENANCE DANNY ULLOA / MAINTENANCE Business Phone: (661) 325-1400x Business Phone: (661) 325-1400x 24-Hour Phone : (661) 631-4600x 24-Hour Phone : (661) 871-3313x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : OSCAR LEON Phone: (661) 325-1400x MailAddr: 5409 MONITOR ST ~.. State: CA City : BAKERSFIELD Zip : 93307-6335 Owner OSCAR LEON Phone: (661) 325-1400x Address : 5409 MONITOR ST State: CA City : BAKERSFIELD Zip : 93307-6335 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I'~ C/~/'/'rry~, er ~,~.~-~0 J Do hereby certify tha~~ , nave reviewed the attached hazardous materials manage- ment plan' fo~~ ~,~6/ ~'~__~ ! ~nd that it along with (Ha'neofB~tnes~) - any corrections constitute a complete and correct man- agement plan ~or my ¢ilit¥. 'Date -1- 09/15/2003 F OSCARS ROAD SERVICE SiteID: 015-021-001993 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 10/19/1999 WHEN FILTERS ARE DISCARDED AND/OR IF THERE IS AN OIL LEAK IT WILL BE NOTICED AND TAKEN CARE OF. -- Employee Notif./Evacuation 10/19/1999 COLES SERVICE 322-8258. Public Notif./Evacuation Emergency Medical Plan 10/19/1999 IF YOU WERE TO BE INJURED WHAT MEDICAL FACILITY WOULD YOU GO TO?????????? -7- 09/15/2003 10/14/1999 ~1;06 8053:2.~i5 B.C.$.D. PAGE 03 ~~~ 171.~ Che,ter Ave., Baker, flel~ CA (661),26-,979 I. To avoid ~--action,--~ ~s *--wi~ 30 days °fr~'ipt' .'~ , ~~¢ ~~~ ~S~RS ~ ENGLISH. ~ ~ ~ 2.3. ' ~swer*equesdonsbelowfor*ebus~ess~awh°le'. , , , . ~ ~ I~ ~ 4, B~ ~ bfief~d.concfle ~ possible. · SECTION .I..1: BUSINESS IDENTIi~ICAT/ON DATA BUSINESS NAME.,:... O~car's Road Service LocATION: 728 , ~~G~D~SS:' . ,5409 Moni%or S,,~ (93307-6335~ C~: Bakersfield' STA~: c~ Z~:~~HO~: 651-325-1400 ',P~YA~: ' Car repair OWNER: Oscar-Leon l~/L.~G~D~SS:.54,09 M0n!,tor St BakeK~;ield 93307~6335 .... .S~CTION i.2: EMERGENCY. NOTIFICATION , ::" coNTAcT TITLE BUS~ PHONE 24 H1L'PHoNE. ' 1.' Dolores Guerr,ero ~alnt~e .... ,-,,.'.' ~1-46n0 '6_n~_ 4~00 HAZARDous MATERIALS MANAGEMENT PLAN SECTION II. 1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION'AND MONITORING PROCEDURES: When come bacK'to discard filters and/or oil if there i's a leak'it 'will be noticed then and taken care 'of. B, 'EMPLOYEE AND AGENCY NOTWICATION: Cole's ServiCe 661-322-8258 C. , ENVIRONMENTAL RESPONSE MANAGEMENT: -' If a leak was detected, an immediate cleanup would be done, .. and 'if there was .'an overflow we would call Cole's Service %o remove ~he waste. D. EMERGENCY MEDICAL PLAN: Oil.' and fiite'r's'.are stored for waste recovery only. No medical :tr'ea%m~nt necessary- 2 ii: 06 @053261485 B.C.S.D. PAGE 05 HAzARDoUs' MATERIALS MANAGEMENT PLAN SECTION fi:2: RELEASE RESEONSE PLAN "' A. .HAZARD ASSESSM~NT'AND PREVENTION MEASURES: The °nly hazard would be if the. barrel sprung a leak or overflowed. T~is ~s .usually not a problem. I have Cole:~' Service come in on a regular basis. B:. ' REL~SE CONTAIlqME~ AND/OR M1TIOATION: CLEAN-UP ,AND RECOVERY PROCI~DUR~S: ' 'Cole..!.s.~ Service 661-322-8258 · '.". .I~i!~L]'TY'SHUT*OFFS (LOCATION OF SHUT~FFS AT .YOUR FACFLITY) NATURAL OASfPROPANE~ N o n e ELECTRICAL; N'ort,h~est' Cqrner 0.n.the...~north wall. %VATER: . ApProximately.'3 feet east of the covered patio on the north of the orive, up gate. SPECIAL: 'LOC. I~ BOX:, YES/No IF YES, LOCATION: pRI3/ATE FIRE PROTECTION/WATER AVAILABILITY Have 5' fire, extinguishers, state approved. A. PRIVATE FIRE pRoTEcTION: .~- Have 5 fire extinguishers, state approved. B. WATER AVAILABILITY (FIR~ HYDRANT): .. ,. Approximately 100 feet from drive in gate,,on King street. 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III:' TRAINING NUMBER OF EM?LOYEES: 2 MATERIAL SAFETY DATA SHEETS ON FILE: Emergency numbers on file in office. BPdEF SUMMARY OF TRAINING PROGRAM: Have "shown employe~s how to operate fire extintuishers, where ~he fire .extinguishers' are located, where waste Containers are, the emergency ..shut-offs are for the power and. where the emergency contac't numbers are located. CERTIFICATION I, ' Oscar Le. on · ·. , CERTIFY THAT THE ABOVE INFORMATION Is,AccuR-ATE. "I UNDERSTAND THAT TIiIS INFORMATION WILL BE USED TO FULFILL.~ FIRM's 'OBLIGATIONS UNDER THE "cALWORNIA HEALTH AND sAFETY CODE" ON HAZARDOUs MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ,ET AL.) AND THAT INACCURAT]~ iNFORMATION CONSTITUTES PERJURY. SIGNATURE . " TITLE DA~iE le/i4/i999 11:e6 8e5326148s B.C.S.D. PAGE el · ,*B ersfleld cirri School District 'Kent0n A. Weir, Jr,, President Education Center U,,,.. ,afo,a. C,.rk ,. .. ' Karen A. DeWalt 1300 Baker Street Al Gufierrez Bakersfield, CA 93305-4399' Jerry C. Tale Phone (661) 631-4600 Dr. Jean Fuller Fax (661) 326-1485 ~ul=eHntendent Web Site (htlp:/Iwww, bcsd.k¶ 2,ca,us) · The Bakemfield, City School, District is the largest elementary achooi district in California. 'Date' · The District has more than 27,000 0~. /~ ~:~L~/~/~ ;/Z~ students 'hr°lied thr°u'h°ut' ita . 42 schools. ¢0 ~ square miles and It Is indepen- h . dent of the Bakersfield city limits. FAX; , ,%~~ ,-,[.~--~~) -We encour, ge .nd support . ,_... ........... parent Involvement, In 1998-99, ~(~' ~'~' ' d~l~' rl ji~__..~ over 20,000 voluntser'hours were .' ' ~" ' generated collectively by ,41 From. . r Parent Volunteer of the Year recipients. Co'm p a n y :. Bake.rsfieid City Schp,O,! ,District · Our Parent University program .. began in 1990 and has over 1,S00 P h o n ·: ', ...... graduates. The program offers various training workshops FAX: (661) 326-1485 geared to enhance parenting · , skills, We are listed in the United ,' States Department of Education Office of Elementary and ' 'NUmber of pages ,. I ,._J.._..~ Secondary Education as a model (includlng.c0verT' sheet): "~/. ' parenting program. · O CE OF ENVIRON~NTAL ~CES 1715 Chester Ave., CA 93301 (661)326-3979 BUSINESS OWNER / OPERATOR IDENTIFICATION FACILITY INFORMATION Page Of .,.., ~:~..,,..,. ,.~ ~ :~;,.:;~;~¥~;,: · :. :~ n.:;;.~.,~;~.~i~:~~ ...,:~ ~,~.~.. ~ ~;~,., :~ ~, ? ~ .... ? , ~ .~ ~ ;~,,~?., FACtLI~ID ~ ~ ~ .' Year S~lnnlng ,~ Year Ending BUSINESS NAME (Same as FAClLI~ ~E or OeA- Dol~ emi~s ~) 3 BUSINESS PHONE ~02 lO3 DUN & ~ SIC CODE ~07 B~DSTREET (4 Digit ~) COUN~ ' OPE~TOR ~ME ~ ~ 1~ OPE~TOR PHONE 11o OWNER ~E ~~ ~ 111 OWNE~ PHONE 112 O~ER ~ILING ADDRESS ~ ~ ~, ~ ~3 CI~ 114 STATE 115 ZIP ~ ~~ 116 CONTACT NAME 117 CONTACT PHONE 1~8 119 CONTACT MAILING .~--,~-~ ~_.0~ /~ ~c~) ~ ADDRESS CITY ,20 STATE ,2, ZIP 122 ~ME '~ NAME ~(~~ ~~0 TITLE '~ TITLE ~t~ ~ ~~ BUSINESS PHONE ~Z~ / 1 q~O '~ BUSINESS PHONE ,3, 24-HOURPHONE ~ _ ~/~ 127 24-HOURPHONE ~ ~ ~ [~ 132 ~~'C ~ _ ~(~ . 12e PAGERO 133 Ce~tion~as~ on my inqui~ of ~ose individuals responsible for obaining ~e info~aaon, I ce~i~ under penal~ of law that I have pemonally examin~ and am f~ with ~e info~aaon submiE~ in ~is invento~ and believe ~e info~ation is tree, accurate, and ~mplete. S IG~W~~ DATE ,~ NAME OF DOCUME NT PREPARER 135 NAM~O~ OWNE~OPE~T~R (p~) ~3s TITLE OF OWNE~OPE~TOR ~3~ ~_ , . ~7 , ~,' ~ ,.' ~ ~; ~ ' ~ ~ S:~CUPAFORMS~OES2730.~4.wpd UPCF (7~99) ~-~ ~. ~;,.~;~. [.7~ L~,., ~ ~ ~ ~ ~' ~c~ /,.~ ~ ~lmm ~ OFFICE OF ENVIRONMENTAL SERVICES ~mA~r r~r 1715 Chester Ave., CA 93301 (661) 326-3979 '*~*""~~"~'"" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per matetYal per bu#ding or ama) I-I ADD [] DELETE [] REVISE 200 Page of CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 COMMON NAME 207 EHS* []Yes []No 208 CAS # 209 FIRE CODE HAZARD CLASSES (C~-~p~ete if requested by local fire c~ie0 210 TYPE ~'p PURE [] m MIXTURE [] w WASTE 211 RADIOACTIVE [] Yes [] No 212 I CURIES 213 PHYS,C~L STATE D, SOUD ~', LIQUID O g eS 214 ~GEST CONTA,NER/'~_C.~ 218 FED HAZARD CATEGORIES ~_~ (Check all that apply) FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 AMOUNT DAILY AMOUNT DAILY AMOUNT UNITS* ~"ga GAL [] cf CUFT [] lb LBS [] tn TONS 221 DAYSON SITE 222 ° If EHS, amount must be in lbs. STORAGE CONTAINER (Check all that apply) ~a ABOVEGROUNDTANK De PLASTIC/NONMETALLIC DRUM []i FIBERDRUM F"lm GLASS BOTTLE [~q RAILCAR 223 [] b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER D c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE ~a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224 STORAGE TEMPERATURE [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 226 227 [] Yes [] No 228 229 230 231 [] Yes [] No 232 233 235 [] Yes [] No 236 237 / 23S []Yes [] No 240 241 1 242 [] Yes [] NO 244 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRE. SF-NTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd CITY OF BAKERSFIEL OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mategal per building or area) NEW r-I ADD r-] DELETE r-I REVISE × -- -- 20O Page of BUSINESS NAME (Same as FACILITY NAME o~ DBA - Doing Business As) ........... 3 CHEMICAL LOCATION J~J ~'" ~ ~ 5~ 201CONFIDENTIALCHEMICAL LOCATION(EPCRA) [] Yes [] No 202 FACILITY ID # I ! '...,:1, MAP # (optional) 203 GRID # (op~onal) . 204 205 TRADE SECRET [] Yes [] No 206 CHEMICAL NAME 4~j.~.~~. ~~. '~$ {c.,.--.~ ~"'"'(~")' 0 If Subject to EPCRA. refer to i,structions 207 COMMON NAME EHS* [] Yes [] No 208 FIRE CODE HAZARD CLASSES (Complete if requested by local fire cfliet) 210 TYPE 4~ PURE [] m MIXTURE [] w WASTE 211 RADIOACTIVE aYes •No 212 I CURIES 213 [] s SOLID zE~" LIQUID [] g GAS 214 LARGEST CONTAINER ~ PHYSICAL STATE 215 FED HAZARD CATEGORIES (Check all that apply) I FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 ANNUAL WASTE 217 I MAXIMUM ~ 218 AVERAGE 219 STATE WASTE CODE 220 UNITS* ~ ga GAL [] cf CU FT [] lb LBS [] tn TONS 221 DAYS ON SITE 222 * If ENS, amount must be in lbs. STORAGE CONTAINER ~ ABOVEGROUND TANK [] · PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all that apply) [] b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANKWAGON STORAGE PRESSURE I~ a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224] STORAGE TEMPERATURE l~ a AMBIENT [] aa ABO. YE AMBIENT [] ba BELOW AMBIENT [] c CRYOGENIC 225 226 227 [] Yes [] No 228 22g t 230 231 [] Yes [] No 232 233 []Yes[]No 236 237 / 235 238 239 [] Yes [] No 240 241 242 [] Yes [] No 244 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd OFFICE OF ENVIRONMENTAL SERVICES ~nRrm~r 1715 Chester Ave., CA 93301 (661)326-3979 "'-"'-'~'-'""'" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per matedal per building or ama) "~NEW l-1 ADD r-] DELETE r'l REVISE 200 Page BUSINE~ P~%~ (~e m FACILI~ ~E m O~ - ~ng ~s;.~ ~) 3 ~EMI~ L~N CONFIDE~IAL (E~) rAc~.l ] I I ] i ] I~P'(opt~no0 ~GRID,(op~na~ ~N ~ 20Z 2~0 ~1~ STA~ ~ g ~LID ~ LIQUID ~ g ~S 214 ~GEST ~AINER 215 ~D ~ ~RIES ~1 FIRE ~ 2 R~CT~ ~ 3 ~ESSURE REL~SE ~ 4 AC~E H~L~ ~ 5 CHRONIC H~LTH (~ ~ ~ ~) 21 ~ ] DALLY ~U~ [ DAILY A~U~ UNffS' ~ ~ ~L ~ d CU ~ ~ lb LBS D ~ TONS ~1 DAYS ON ' ~ EHS. em~nl must ~ In STO~ ~AI~R ~ a A~G~UND T~K ~ · P~STI~NM~ALLIC DRUM ~ I FIBER DRUM ~ m G~SS ~LE ~ q ~IL ~t~) ~ b UNDEr--UNO ~A~ ~ ~ ~N ~ J ~G ~ n ~S~C ~CE ~ r O~HE~ ~ c T~ INSIDE BUI~ING ~ ~ ~R~Y ~ k BOX ~ o TOTE ~~~ ~ ~IE~ ~ ~ A~IE~ ~ b~ BELOW~BIE~ ~ c CR~EN~C 1 [ ~ ~7 ~Ym ~No 228 I 2 ] ~ ~1 ~Y~ ~ 232 ~3 I 3 J ~ ~5 ~Y~No 236 4 ~ ~ ~g ~Ym ~No 240 24~ S 242 ~Y~ ~No 2~ ~ 245 ~ ~ & ~ OF ~ U~R~D ~A~ RE~E~AT~E glG~TURE ~ - / DATE 2~ UPCF (7/9g) S:\CUPAFORMS\OES2731 .'l'V4.wpd  CITY OF BAKERSFIELO OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 *'~'-'"--~'"*'**~"" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fomt per mateffal per building or area) [] NEW [] ADO [] DELETE I'"] REVISE 200 Page of OUOl~COO r~Mc [oame as PAL~ILI I Y ~]- Or UI~ - u~ng ~n~ As) ' ' 3 C. EM~C~'LOC~TIO. 4:~.~'~ ~© ~ <.~ A '4..LC.. ....... 20~1 CHEM,C,~.'OC~T~ON [] { -~ ~ ~ S ~={~"~ J CONFIDENTIAL(EPCRA) 202 FACIUTYIO# ! I "-1 MAP#(opt/ona/) 203 GRlO#(opt/ona/) 204 _ _ ...... -~ ~.,~ ......~:~.,~,~..:~ ..... :~:~ ~ ~ ~, ~-.~:~ ~ ~ II CHEMIC ~FOR ~0 ~ '~ ~ ~ ~ ?:~ ~ Subj~ to E~, r~ to instm~ ~M~N ~E ~7 EHS* CAS ~ FI~ ~DE ~ C~SSES (~pl~e ~ r~u~t~ by I~ tim ~i~ 210 ~PE ~ p ~RE ~ m M~RE ~w WASTE 211 ~IOA~E ~ Y~ D No 2~2 CURIES PHYSI~L STATE ~ s SOLID ~ LIQUID D g ~S 214 ~GEST ~AINER ~ 215 FED H~D ~TE~RIES ~ 1 FIRE ~ 2 ~1~ ~ 3 PRESSU~ ~L~E ~ACUTE H~L~ ~ 5 CH~N~ H~LTH (~ all that apply) 216 ANNU~ WASTE 217 ~M ~ 218 A~GE ~ 219 STA~ WASTE ~DE A~U~ DAILY ~U~ DAILY ~U~ ~~ ~ ~ d CU ~ ~ lb ~S ~ m TONS ~1 DAYS ON SffE * If EHS, am~nt must ~ in lbs. STOOGE ~AINER (Check al~ ~at app/y) ~ a ABOVEGROUND TANK ~ e ~STI~ONM~LIC DRUM D i FIBER DRUM ~ m G~SS ~ ~ q ~IL ~ b UNDERGROUND T~K ~ f ~ D j ~G ~ n P~STIC ~LE ~ r OTHER D c T~K INSIDE BUILDING ~ g ~Y ~ k BOX D o TO~ BIN ~d STEEL DRUM D h SILO D I C~INDER ~ p TANK WA~N STOOGE ~ESSURE ~ a ~IE~ ~ ~ ~OVE~BIE~ ~ ba BELOWAMBIE~ ~4 STOOGE ~MPE~TURE ~ a ~BIE~ ~ ~ A~VE ~BIE~ ~ ba BELOW~BIE~ ~ c CRYOGENIC 226 227 [] Yes [] No 228 229 230 231 [] Yes [] No 232 233 234 235 [] Yes [] No 236 237 238 239 [] Yes [] No 240 241 [] Yes [] No 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .'TV4.wpd  CITY OF BAKERSFIEL~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 '*'~-'~'~'~'**"" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mate~fal per building or ama) ~I[NEW [] ADD [] DELETE [] REVISE 200 Page of C"EM,~LLO~T,O. ~5~O~ ~ ' ~ ~ __~ 20.I ~EM,~LLO~T,O. CONFIDENTIAL (EPCRA) [] Yes E] No 202 205 T~DE $ECR~ COMMON ~E EHS* FIRE ~DE ~ ~SSES (~plete if ~u~t~ by I~1 tim ~i~ .... ' 210 ~PE ~ p ~ ~ m MI~U~ - ~w WASTE 211 ~IOA~ ~ Y~ ~ NO 212 J CURIES 213 PHYSIC~STATE ~ s ~LID ~1 LIQUID ~ g ~S 214 ~GEST~AINER ~ 215 FED H~RD ~TE~RIES (~ all that apply) ~ FIRE ~ 2 ~ ~ 3 PRESSU~ REL~SE ~ 4 ACUTE H~ ~ 5 CHRONIC H~ 216 ~U~ D~LY ~U~ DAILY ~U~ ~ga ~ ~ d CU ~ ~ lb LBS ~ m TONS ~1 DAYS ON S~ * E EHS, ~nt must be In lbs, (CheckSTO~GEall ~atCO~AINERap~) ~ a A~VEGROUND T~K ~ · P~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS ~LE ~ q ~IL ~b UNDERGROUNDT~K ~f ~ ~j ~G ~n P~STIC~LE ~r OTHER D c TANK INSIDE BUILDING ~ g ~Y ~ k ~X ~ o TOTE BIN ~d S~ELDRUM D h SILO ~1 C%INDER ~ p T~KWA~N STOOGE PRESSU~ ~ ~BIE~ D ~ ~OVE~BI~ ~ ba BELOW~BIE~ ~4 STOOGE TEMPE~ ~a ~BIE~ ~ ~ A~VE ~BIE~ ~ ba BELOW~BIE~ ~ C CRYOGENIC 226 227 [] Yes [] No 228 229 230 231 [] Yes [] No 232 233 235 [] Yes [] No 236 237 238 239 [] Yes [] No 241 242 [] Yes [] No 244 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .'l'V4.wpd ~~~,~,--,..,~n. ~..~, CITY OF BAKERSFIEL~ OFFICE OF ENVIRONMENTAL SERVICES t~,Ai~rmi~r 1715 Chester Ave., CA 93301 (661) 326-3979 -.~.,..a~~.~.,~....- HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one ~ per mate~al per buildi~ or a~) ~ N~ ~ ADD ~ DELVE ~ R~ISE ~ P~e ~ of BUSINESS ~E (~me ~ FACIM~ ~E ~ O~ - ~ng Bu~n~ ~) 3 ~ ~EMI~LLO~TION ~ Y~ ~ ~ ~2 FACIL~ ID ~ ~ 1 ~ ~ (op~na~ 203 GRID ~ (op~na~ CHEMI~L ~ME ~ ~M~N ~ EHS* D Y~ FIRE ~DE ~ ~ES (~plete ~ r~ by I~1 tim ~i~ 210 ~PE ~ PU~ D m M~ D w WAS~ 211 ~IOA~E DY~ D~ 212 ~ CURIES ~3 PHYSI~ STATE ~ s ~LID ~1 LIQUID ~g ~S 214 ~GEST ~AINER ~ FED ~D ~TE~RIES ~ 1 FI~ ~ 2 ~NE ~ PRE~U~ ~E ~ 4 AC~ H~ ~ 5 CHRONIC H~LTH ~6 (~ ~1 ~at apply) ~NU~ WAS~ 217 I ~IMUM ~ 218 ~ A~GE 219 STATE WA~E ~DE A~U~ DAILY ~U~ DAILY ~U~ UNffS* ~ ga ~ ~d CU ~ ~ lb LBS ~ ~ TONS ~1 DAYS ON SITE * If EHS, ~nt must be in lbs. STOOGE CO~AINER ~ a A~GROUND T~K ~ e ~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~ ~LE ~ q ~IL ~R (Check all ~at ap~) Db UNDERGROUNDT~K ~f ~ ~j ~G ' ~n P~IC~LE ~r OTHER ~ c T~K INSIDE BUI~ING ~ g ~Y ~ k ~X ~ o TO~ BIN ~ d STEEL DRUM D h SILO ~ C~INDER ~ p T~K WA~N STOOGE PRESSURE ~ a ~BIE~ D ~ ABOVE ~BI~ ~ ba BELOW~BIE~ ~4 STOOGE TEM~ ~ a ~BIE~ D ~ ~ ~BIE~ Dba BELOW ~BIE~ ~ c CRYOGENIC 226 227 [] Yes [] No 228 229 230 231 [] Yes [] No 232 233 234 235 [] Yes [] No 236 237 238 239 [] No 240 241 ! 242 [] Yes [] No 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd