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Home My WebLink AboutBUSINESS PLAN 10/6/2003 Hazardous Materiais Permit ID ~:: 015~00~00320 'EXPRESS FA'BRICATION LOCATION: 320 30TH ST ' ?, :., Issued by: BakersfieldOFFICE OF Fire EN ~R Depa~ment'~ ONMENTAL ~~~ 1715ChesterAve.,.3rdFioor Bakersfield, CA 93301 Voice (661) 326-3979 F~ (661) 326-0576 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF' PERMIT ON REVERSE SIDE · . ....... ,~,~,;~,~,?:~?,~?,~;~=~,~,,,~,~,,,~,;~ ......... This permit is issued for the following: =~i~ ' :'iI?'' ~. ',~r ~il "'~iil[i~: ,~"?~ ~A~D~EI~/~~"*~;;~[ ~;:=~'"" Ii ~ ~ ' ~'~i'~=l~' ~''' ? '~': "' ;'"'"~E' LOCATION 320 30TH ~?~.,'~?'&~¥j.O? ~,~',.~,,~,~ CA ~, ..................... . ..... ~"-" ~ ,i ...... '~ "''-'3~'~.'' . '"~:~'.,~l' ,' ,' , ' · ~ ,' .' ' ~ l~ " ~ '"-- ~-'. '" '] E~'~ ~' '~ ~c ...................... ;~ i~_ ,:,r~/' m, m~;~]~ ~ ~ ~ B~ ~ ~,~ ;...~)]~ f. ,' ~'. ,~..- .......~. .,.?, .,... ,,::~ ..,~...:::;~?m ::., ,~Q . ~.....,, ~, ~: ........ % ~% . ~, ..4 .... ~,;~ ~ .~ ~* '-, ',~. Is~ by: ~ B~erdield Fke D~ment Approv~ by: ~~~~' O~CE OF E~R ONe.AL S~ 1715 Chewer Ave., 3rd Floor B~e~fiel~ CA 9~01 Voice (805) ~6-3979 F~ (80S)~26-0S76 Expiration Date: ~n~ ~0~ ~000 -..,, '~'§ITE/'FACIL...TY DIAGR/~I · ' NORTH SCALE: BUS I NESS NAME: ~ FLOOR: OF . DATE :& /~ FACILITY N~E: UNIT· ~' OF ' · (CHECK ONE) SITE' DIAGRX~I ~. R. L. 14~ ~s*~ co, :,' ~1~,, Inspector's Comments): -OFFICIAL USE ONLY- 1. Address: Identlfy the 9. Lock (key) Box - '~.~"~-- principle buildings. by' the Street numbers. 10. MSDS Storage Box 2.. Street(a), Alleys, 11. Rallro~ld Tracks Driveways, and Parking ,Areas adjacent to the 1.2. 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. Powerllnes 5. Buildings a. Frame construction 14. Guard Station .b.' Masonry construction IS. 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. Mater 18. Evacuation Area: ~ Identify the 7. Fire Suppression Systems: location where a. Fire Hydrants employees will meet. b. Fire Sprinkler 19. Outside Hazardous Connections Maste Storage c. Fire S~andpipe' - 20, Outside Hazardous Connections Material Storage 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 MATER[Az Fl~able B · ~xpAoalve L - Liquid R · Radlolog.lcal Corrosive 0 - Oxidizer G - Oas p · Poison Water Reactive T - Toxic g - SOlid H - Cryogenic D - Waste B - Etiological Example: Flammable Liquid - FL 'FACILITY DIAGRAM (Required. llama In addi[lon to the above) _ ~:.,' 1. Risers for Sprinklers 8. Fire Escapee 2. Partitions g. Air Conditioning Units [3. Stairways: Indicate the 10. Mlndo~ levels se~-ved from higheat to lo. st. Il, Inside Razardoua Waate Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous ~te~iaJs Uae/H~d] 6. Attic Access 14. Se~r Drain 7. Skylights CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME E ~'f£gS:5 F~I~gl6,aTo~ /,",C INSPECTION DATE t/O ADDRESS X'~O .TO"Ca~5'T- PHONENO. FACILIT, Y CONTACT ~ b4-SAts,(-t .~ BUSINESS ID NO. 15-210- INSP~C/TION TIME t/~ /v,~ NUMBER OF EMPLOYEES / ,S~mn 1: Busines~ Plan and Inventory Program [~l Routine [~ Combined I~ 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 Any hazardous waste on site?: Questions regarding this inspection? Please call us I } 326-3979 /~ BuSiness Site Responsible Party~ While -Env. Svcs. Yell0. - Station Copy Pink - Business Copy Inspector: " EXPRESS FABRICATION INI SiteID: 015-021-0 Manager : %3~%BusPhone:~ (661) 322-2678 Location: 320 30TH ST ~\\%% Map : 103 CommHaz : Low City : BAKERSFIELD~' · Grid: 19D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title PAT HUESTIS / LEON HARDCASTLE / Business Phone: (661) 322-2678x Business Phone: (661) 322-2678x 24-Hour Phone : (661) 398-9775x 24-Hour. Phone : (661) 322-9344x Pager Phone : ( ) - x ~Pager Phone : ( ) - x Hazmat Hazards: Fire Press Contact : PAT HUESTIS Phone: (661) 322-2678x MailAddr: 320' 30TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner PATRICK HUESTIS Phone: (661) 398-9775x Address : 2400 MOFFITT WY State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: 1 08/05/2003 ~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~/~flZ¥.C FrABP-lr.A'rl3Otd INSPECTION DATE ADDRESS '~20 ~0'''r~ ~'"ff PHONE NO. FACILITYCONTACT~- ~./-tt/J'~qT"/_$ BUSINESS ID NO. 15-210- INSPECTION TIME ,/_/9 a,4'./;~,, 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 d -~ E.a~4t~ ~nn~r~ it4 p~.~ ~- Business plan contact information accurate Visible address I/ Pn'o,a~- ~ ct 7 c~_ 6 :~ 6.5 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 site?: [~Yes /~No Explain: White- Env. Svcs. Yellow- Station Copy EXPRESS FABRICATION INC siteID: 215-000-000320 .... 'Q BusPhone: (805) 322-2678 · Manager : ' ~ ~ Map : 103 CommHaz : Low Location: 320 30 TH ST ~-~ I~9~ Grid: 19D F acUnits: 1 AOV: City : BAKERSFIELD commcode: BAKERSFIELD STATI~~'Q~'!' '~:~/~C~$ SIC Code: EPA' Nu~: DunnBrad: Emergency Contact / Title Emergency Contact / Title PAT HUESTIS / LEON HARDCASTLE Business Phone: (805) 322-2678x Business Phone: ( 322-2678x 24-Hour Phone : (805) 398-9775x 24-Hour Phone : (~1Y5-) 322-9344x Pager Phone : (_ ) - x Pager Phone : (~1) - x Hazmat Hazards: Fire Press Contact : ~ Q~]-/5 Phone: MailAddr: 320 30TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner PATRICK HUESTIS Phone: (~)'~~-- Address : 2,.~_,~C& CLE~CR~K Pn-~O0 mO~,~y State: CA Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: mare plan for Expr~ ~%r,~d ~. i~ a~ ~h any corre~ions consli~u~e a ~mpls~e and ~e~ man- agement plan for my ~clli~. -1- 11/01/1999 EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers on Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm . DailyMax Unit MCP ACETYLENE F P G 150.00 FT3 Hi OXYGEN F P G 500.00 FT3 Low FREON F P G 3400..00 FT3 Min ARGON/CARBON DIOXIDE F P G 1200.00 FT3 Min CUTTING OIL F L 200.00 GAL Min -2- 11/01/1999 EXPRESS FABRICATION INC siteID: 215-000-000320 = Inventory Item ~0002 Facility Unit: Fixed.Containers on Site ~lVUVl~ ~Vl~ / ~£ ~.*kl~ ~Vl~ ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: NE WALL WELDING ROOM CAS# 74-86-2 FSTATE TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Below Ambient PORT.. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average FT3 150 . 00 FT3 100 . 00 FT3 %Wt. HAZARDOUS COMPONENTS IYeaRS CAS# 100.00 Acetylene 74862 HAZARD ASSESSMENTS TSecretNO N oRS I Bi°HaZNo Radioactive/AmountNo/ Curies FEPA HazardsIP NFPA/'// uSDOT# HiMOP = Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this.Facility Unit Map: Grid: NE WALL WELDING ROOM CAS# 7782-44-7 ~ STATE ~ TYPE/Pure , PRESSURE , , i TEMPERATUREI CONTAINER TYPE /Gas I Above Ambient Below Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average FT3 500.00 FT3I 250.00, FT3 HAZARDOUS COMPONENTS I 100.00 Oxygen, Compressed N 7782447 HAZARD ASSESSMENTS I TSecret I ~S BioHaz Radioactive/Amount EPA HazardsI NFPA USDOT# MCP No N No No/ Curies F P / / / Low -3- 11/01/1999 EXPRESS FABRICATION INC siteID: 215-000-000320 = Inventory Item 0004 Facility Unit: Fixed.Containers on Site ~UlV~Vl~l~ ~Vl~ / ~ ~_.U,_L~ ~Vl~ FREON Days On Site 365 Location within this Facility Unit Map: Grid: NE WALL WELDING ROOM CAS# 75-71-8 F STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER'TYPE Gas /Pure I Above Ambient I Below Ambient I PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 3400.00 FT3 1700.00 FT3 HAZARDOUS COMPONENTS 100.00 Dichlorodifluoromethane N 75718 HAZARD ASSESSMENTS TSecretl ~SIBioHazNo N No Radioactive/Am°unt I EPA HazardsINo/ Curies F P NFPA/// USDOT# MinMOP = Inventory Item 0003 Facility Unit: Fixed Containers on Site L~UIvuvK3N NAIVI~: / t;~lvl.l.t;_~kh ARGON/CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: NE WALL WELDING ROOM CAS# 7440-37-1 Gas ' /Mixture Above Ambient Below Ambient PORT.. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average FT3 1200.00 FT3I 600.00 FT3 HAZARDOUS COMPONENTS %Wt. I RS CAS# 75.00 Argon IN° 7440371 ~': 25.00 Carbon Dioxide .No 124389 HAZARD ASSESSMENTS TSoorot I oRS Bi°HaZNo N No Radioactive/AmountNo/ Curies EPA HazardsIF P NFPA/// USDOT# MinMCP -4- 11/01/1999 EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME CUTTING OIL Days On Site 365 Location within this Facility Unit Map: Grid:- WEST OUTSIDE WALL OF WELDING ROOM CAS# FSTATE TYPE PRESSURE I TEMPERATURE I CONTAINER TYPE I Amb i e nt DRUM/BARREL - ME TALL I C Ambient Licluid Pure I I AMOUNTS AT THIS LOCATIONI Largest Container Daily Maximum Daily Average GAL 200.00 GAL 100.00 GAL HAZARDOUS COMPONENTS 100.00 Cutting Oil 0 HAZARD ASSESSMENTS TSecretINO NoRS I Bi°HaZNo Radioactive/AmountNo/ Curies EPAF Hazards NFPA/// USDOT# I MCPMin -5- 11/01/1999 F EXPRESS FABRICATION INC SiteID: '215-000-000320 Fast Format = Notif./EvacuatiOn/Medical Overall Site --Agency Notification 01/07/1990 CALL 911 -- Employee Notif./Evacuation 01/07/1990 VERBAL WARNING "FIRE" AND EVACUATION. CALL 911. -- Public Notif./Evacuation 01/07/1990 IN THE EVENT OF AN EMERGENCY OR FIRE THERE WILL BE VERBAL NOTIFICATION OF EXPRESS FABRICATION EMPLOYEES AND ANYVISITORS ON THE PREMISES THE ONLY BUSINESS NEIGHBOR WE HAVE IS GIFFORD ELECTRIC AND WE WILL NOTIFY THEM BY PHONE AT 325-2428 OR VERBALLY IN PERSON Emergency Medical Plan 05/29/I997 MEMORIAL HOSPITAL - 420 34TH ST - (805) 327-1792. -6- 11/01/1999 F EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 03/23/1992 HAZARDOUS GASES ARE CHAINED TO A WALL PER CAL OSHA REQUIREMENT. ALL BOTTLES ARE EQUIPPED WITH PROPER FITTINGS. --Release Containment 03/23/1992 ALL GASES ARE STORED IN APPROVED PRESSURIZED CYLINDERS. IN THE EVENT OF RELEASE WE HAVE NO MEANS FOR CONTAINMENT OF GASES. CUTTING OIL IS STORED IN 55 GALLON DRUMS PROVIDED BY SUPPLIER. -- Clean Up 03/23/1992 CUTTING OIL SPILLS WILL BE CLEANED UP USING A GRANULAR ABSORBANT THAT IS A STOCK ITEM IN MY SHOP. Other Resource Activation -7- 11/01/1999 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format F Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 03/23/1992 A) GAS - SOUTH WEST CORNER OF OFFICE BUILDING B) ELECTRICAL - CENTER OF EAST PROPERTY LINE C) WATER - SIDE ON FENCE 20FT EAST OF GATE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 05/29/1997 SHOP AND OFFICE TRAILER ARE EQUIPED WITH AUTOMATIC FIRE SPRINKLERS, SHOP HAS 5 FIRE EXTINGUISHERS LOCATED THROUGHOUT THE BUILDING. THE OFFICE HAS 1 FIRE EXTINGUISHER. FIRE HYDRANT - 30 FEET WEST OF THE FRONT GATE ON 30TH ST. Building Occupancy Level 8 11/01/1999 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format ~ Training Overall Site -- Employee Training' 05/29/1997 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE NOTIFIED OF ALL HAZARDOUS MATERIALS AND TRAINED IN THE USE OF THESE MATERIALS AT OUR QUARTERLY SAFETY MEETINGS. -- Page 2 --Held for Future Use Held for Future Use -9- 11/01/1999 Manager : ~?, BusPhone: (805) 322-2678 Location: 320 30TH ST I~ /~ ~ Map : 103 CommHaz : Low City : BAKERSFIELD I~y~_/.___ i Grid: 19D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title PAT HUESTIS / LEON HARDCASTLE / Business Phone: (805) 322-2678x Business Phone: (805) 322-2678x 24-Hour Phone : (805)~23-053~_~ ~24-HoUr Phone : (805) 322-9344x Pager Phone : ( )~ - '- x ~ Pager Phone : ( ) - x Hazmat Hazards: ~%%~'~ ~ ~.~% 7 Fire Press Agency-Defined Topic Title ~ Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm DailyMax IUnit MCP ACETYLENE F P G 150 FT3 Hi OXYGEN F P G 500 FT3 Low FREON F P G 3400 FT3 Min ARGON/CARBON DIOXIDE F P G 1200 FT3 Min CUTTING OIL F L 200 GAL Min ~, ~,~'r,,,, oK.. ~-~.~-r-'~ ~ Do hereby cerU~y ~ha~ ~ have reviewed ~he a~;.ched,~.~.-...~"~',~' ~'--~'.'~,~,~,,~, ~: n',a~erie~s manage- men~ plan for F_~p.~ rr-~-~c~.~'nd that it along wi~h any corre~ions ~s~e a ~mple~e an~ ~e~ man- 1 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 = Inventory Item 0002 Facility Unit: Fixed Containers on Site ACETYLENE Days On Site 365 Location within this Facility Unit NE WALL WELDING ROOM CAS# 74-86-2 F STATE TYPE PRESSURE ~ TEMPERATUREI CONTAINER TYPE Gas PureIi Above Ambient Below Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 150.00 100.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Acetylene No 74862 -2- 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit NE WALL WELDING ROOM CAS# 7782-44-7 VSTATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas · PureI~ Above AmbientIi Below Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 500.00 250.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHSI CAS# 100.00 Oxygen, Compressed ~ 7782447 -3- 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME FREON Days On Site 365 Location within this Facility Unit NE WALL WELDING ROOM CAS# 75-71-8 Gas fPure Above Ambient Below Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 3400.00 1700.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Dichlorodifluoromethane No 75718 -4- 05/16/1997 F EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ARGON/CARBON DIOXIDE Days On Site 365 Location within this Facility Unit NE WALL WELDING ROOM CAS# 7440-37-1 STATE [ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Gas Mixture Above Ambient Below Ambient PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3 1200.00 600.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 %Wt. EHS CAS# 75.00 Argon No 7440371 25.00 Carbon Dioxide No 124389 -5- 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site CUTTING OIL Days On Site 365 Location within this Facility Unit WEST OUTSIDE WALL OF WELDING ROOM CAS# .STATE TYPE PRES$URE -- TEMPERATURE CONTAINER TYPE Liquid Pure I Ambient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS STORED AND IN USE Lrgst Cent.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 200.00 100.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS EHS CAS# %Wt. 100.00 Cutting Oil No 0 6 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 01/07/1990 CALL 911 -- Employee Notif./Evacuation 01/07/1990 VERBAL WARNING "FIRE" AND EVACUATION. CALL 911. -- Public Notif./Evacuation 01/07/1990 IN THE EVENT OF AN EMERGENCY OR FIRE THERE WILL BE VERBAL NOTIFICATION OF EXPRESS FABRICATION EMPLOYEES AND ANY VISITORS ON THE PREMISES THE ONLY BUSINESS NEIGHBOR WE HAVE IS GIFFORD ELECTRIC AND WE WILL NOTIFY THEM BY PHONE AT 325-2428 OR VERBALLY IN PERSON Emergency Medical Plan 01/07/1990 MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 -7- 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 03/23/1992 HAZARDOUS GASES ARE CHAINED TO A WALL PER CAL OSHA REQUIREMENT. ALL BOTTLES ARE EQUIPPED WITH PROPER FIT, TINGS. -- Release Containment 03/23/1992 ALL GASES ARE STORED IN APPROVED PRESSURIZED ~CYLINDERS. IN THE EVENT OF RELEASE WE HAVE NO MEANS FOR CONTAINMENT OF GASES. CUTTING OIL IS STORED IN 55 GALLON DRUMS PROVIDED BY SUPPLIER. -- Clean Up 03/23/1992 CUTTING OIL, SPILLS WILL BE CLEANED UP USING A GRANULAR ABSORBANT THAT IS A STOCK ITEM IN MY SHOP. Other Resource Activation 8 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 03/23/1992 A) GAS - SOUTH WEST CORNER OF OFFICE BUILDING B) ELECTRICAL - CENTER OF EAST PROPERTY LINE C) WATER - SIDE ON FENCE 20FT EAST OF GATE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/23/1992 SHOP AND OFFICE TRAILER ARE EQUIPED WITH AUTOMATIC FIRE SPRINKLERS, SHOP HAS 5 FIRE EXTINGUISHERS LOCATED THROUGHOUT THE BUILDING. THE OFFICE HAS 1 FIRE EXTINGUISHER. FIRE HYDRANT - 30 FEET WEST OF THE FRONT GATE ON 30TH STREET Building Occupancy Level -9- 05/16/1997 EXPRESS FABRICATION INC SiteID: 215-000-000320 Fast Format ~ Training Overall Site -- Employee Training 09/30/1991 WE HAVE 4 EMPLOYEES AT THIS FACILITY WE HAVE MATERIALS SAFETY DATA SHEETS ON FiLE EMPLOYEES ARE NOTIFIED OF ALL HAZARDOUS MATERIALS AND TRAINED IN THE USE OF THESE MATERIALS AT OUR QUARTERLY SAFETY MEETINGS. Page 2 Held for Future Use Held for Future Use -10- 05/16/1997 -~ '~ .... .-. t}' ' ~) ' "ECEIVED 02/~.4/92~// PRESS ~S~IC~IO~ I.C 2Z5-000-0003~0 FEB 281992Page 1 ~ Overall Site with 1 Fac. Unit Ans'd ............ Location: 320 30TH ST 'Map: 103 Hazard: Low Community: BAKERSFIELD STATION 04 Grid: 19D F/U: 1 AOV: 0.0 Contact Name Title Business Phone ~24-Hour Phone- PAT HUESTIS (805) 322-2678'x (805) LEON HARDCASTLE ~ (805) 322-2678 x (805) 322-9344 Administrative Data ('~o~'~ ~1.~.~$b Mail Addrs: 320. 30TH ST D&B Number: City: BAKERSFIELD State.: CA Zip': 93301- Comm Code: 215-004 BAKERSFIELD STATION 04 SIC Code: Owner: PATRICK H~ESTI~ ~.~TI~ Phone: (~')~ -~'3~ Address: ~_ ~ ~o C~w~WCCD ~_~. ~ ~~r~J(~ .~. State: CA Summary 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 2 02 -~Fixed Containers on Site Hazmat Inventory Detail in Refer'ence Number order 02-001 OXYGEN Gas 500 Low · Fire, Pressure . FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily. Max FT3 I Daily AVerage FT3 I Annual.Amount FT3 500 ~ 250.00 _ 12,000.00 Storage Press TTemp Location PORT. PRESS. CYLINDER IAbove ~Below INE WALL WELDING ROOM Conc Components MCP List 100.0% Ioxygen, Compressed ILow I 02-002 ACETYLENE Gas 150 High · Fire, Pressure FT3 CAS #: 74-86-2 Trade Secret: No ~ Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING -- Daily Max FT3I Daily AVerage FT3 I Annual.Amount FT3 .150 ~ 100.00 2,000.00 Storage I Press T Temp I Location PORT. PRE-SS. CYLINDER Above ~Below NE WALL WELDING ROOM -- Conc Components MCP~ List 100.0% IAcetylene IHigh I 02-003 ARGON/CARBON DIOXIDE Gas 1200 Minimal · Fire, Pressure FT3 CAS #: 7440-37-1 Trade Secret: No Form: Gas' Type: Mixture Days: 365 Use: WELDING SOLDERING Daily Max FT3 I Daily Average FT3 ~ Annual Amount FT3 -- 1,200I 600.00~ 2,0,800.00 Storage Press T Temp LOcation PORT. PRESS. CYLINDER Above JBelow NE WALL WELDING ROOM --ConsI Components I MCP /List 75.0% Argon IMinimal ~ 25.0% Carbon DioXide ~Minimal 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 3 02 - Fixed Containers on Site Hazmat InVentory Detail in Reference Number Order 02-004, FREON ~ Gas 3400 ~Minimal · Fire., Pressure , FT3 CAS #: 75-71-8 Trade Secret: No ~ ~ Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 Daily ~verage FT3 I Annual Amount FT3 -- 3,400 I 1,700.00 6,800.'00 Sto~age Press T Temp Location PORT. PRESS. CYLINDER Above . ~Below INE WALL WELDING ROOM -- Conc . Components MCP --TList 100.0% IDichlorodifluoromethane ~1Minimal I 02-005 CUTTING OIL Liquid 200 Minimal · Fire GAL · CAS #: Trade Secret: No ~ Form: ~iquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max GALI Daily Average GAL 1 Annual Amount GAL 200 ~ 100.00_ 1,500.00 Storage·IIPress T Temp Location DRUM/BARREL-METALLIC Iambient~AmbientlWEST OUTSIDE WALL OF-WELDING BOO -- Conc · Components· 'MCP LiSt '100.0% ICutting Oil IMinimal I 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 4 00 - Overall Site . <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL WARNING "FIRE" AND EVACUATION. CALL 911. <3> Public Notif./Evacuation IN THE EVENT OF AN EMERGENCY OR FIRE THERE WILL BE VERBAL NOTIFICATION OF EXPRESS FABRICATION EMPLOYEES AND ANY VISITORS ON THE PREMISES THE ONLY BUSINESS NEIGHBOR WE HAVE IS GIFFORD ELECTRIC AND WE WILL NOTIFY THEM BY PHONE AT 325-2428 OR VERBALLY IN PERSON <4> Emergency Medical Plan MEMORIAL HosPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 5 ~00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention HAZARDOUS GASES ARE CHAINED~TO A WALL PER CAL OSHA REQUIREMENT. ALL BOTTLES ARE EQUIPPED WITH PROPER FITTINGS. <2> Release Containment <3> .Clean Up <4>. Other Resource Activation 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - SOUTH WEST CORNER OF OFFICE BUILDING B) ELECTRICAL - CENTER OF EAST PROPERTY LINE C) WATER - SIDE ~ON FENCE 20FT EAST OF GATE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water. SHOP AND OFFICE TRAILER ARE EQUIPED WITH AUTOMATIC FIRE'SPRINKLERS, SHOP HAS 5 FIRE EXTINGUISHERS LOCATED THROUGHOUT THE BUILDING. THE OFFICE HAS 1 FIRE EXTINGUISHER. .FIRE HYDRANT - 30 FEET WEST OF THE FRONT GATE ON 30TH STREET <4> Building Occupancy Level 02/24/92 EXPRESS FABRICATION INC 215-000-000320 Page 7 00 - Overall Site <G> Training ,~ <1> Page 1 WE HAVE 4 .EMPLOYEES AT THIS FACILITy WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE EMPLOYEES ARE NOTIFIED OF ALL HAZARDOUS MATERIALS AND TRAINED IN THE USE OF THESE MATERIALS AT OUR QUARTERLY SAFETY MEETINGS. <2> Page 2 as needed ? <3> Held for Future Use <4> Held for Future Use Bakersfield Fire Dept. HazardoUs Materials Inspection Date Completed ' BUsiness Name: "~"~~ ,t~-~'~5~gc,~ff-~ro · Location: ~.~2.4~ ¢,.~0 ~ ~-r-. plan ID # 215-000..~ZO (Top right comer Business Plan) .. Adequate Inadequate RECEIVED. verification of Inventory Materials SEP 1 2 1989 Verification of Quantities [--] HAg. MAT. DIV. · 'Verification of Location Proper Segregation of Material ,~ [~] ,,[,/~ 7 o Verification of MSDS Availability ~' Number of Employees Verification of Haz Mat Training Verifcafion of Abatemem Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram ¢ [-~ Special Hazards Associated with this Facility: Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy, Pink-Business office .,'.~.'--'. '~ CITY of BAKERSFIELD (*,vge or Drinc name) RECEIVED Do hereby certify that. I have reviewed the Al~$'d ............ attached Hazardous Materials business plan (name of business) and that it along with the attached additions or corrections constitute a comDlete and correct Business Plan for my facility. s ~gna~ur.e date ' ~USINESS ~AME EXPRESS FABRICATION INC 'ID NUMBER 215-000-000320 !,OCATION 320 30TH ST HIGH HAZARD RATING 2 LAST CHANGE 07/01/88 BY ESTER [URIS CODE 215-004 JURIS BAKERSFIELD STATION 04 iIAP PAGE 103 GRID 19D FACILITY UNITS 1 HAZARD RATING 2 ~ESPONSE SUMMARY 2A SEC 4! NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS 2A'SEC PAT HUESTIS - 322-2678'OR LEON HARDCASTLE - ~-~'~'~~32-9092~..~ UTILITY SHUTOFFS 2A SEC 3) iA) GAS - SW CORNER OF OFFICE BLDG B) ELECTRICAL - CENTER OF E PROPERTY LINE 'C) WATER - SIDE ON FENCE 20FT E OF GATE D) SPECIAL -~NONE E ) LOCK BOX - NO NOT I F I CAT ION / PUBL I C EVACUAT ION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > kGE 1 12/16/88 12:48 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ! USINESS NAME EXPRESS FABRICATION INC .ID NUMBER 21!5-000'000320 OCATION 320 30TH ST HIGH HAZARD RATING 2 3 . .HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS 'SECTION >. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 07/01/88 BY ESTER 2A SEC 5) MEMORIAL HOSPITAL - 420 34TH ST - 327-1792 !'AGE 2 12/16/88 12:48 MATERIAL SAFETY DATA SYSTEMS, INC (805) 648-6800 ~USINESS'~NAME EXPRESS FABRICATION'~ INC ID NUMBER 215-000-0'00320 ~oCATION 320 30TH ST HIGH HAZARD.RATING 2 ~ACILITY UNIT 01 t. ' OVERA'LL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 09/2?/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 PURE OXYGEN 500 FT3 HIGH -NE WALL WELDING ROOM PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 2359.00 100.0 OXYGEN, COMPRESSED HIGH .. 2 PURE ACETYLENE 150 FT3 EXTREME NE.WALL WELDING ROOM PORTABLE PRESS. CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS · 1241.00 100.0 ACETYLENE EXTREME 3 MIXTURE ARGON/CO2 1200 FT3 LOW NE WALL WELDING ROOM PORTABLE PRESS. CYL. WELDING/SOLDERING ' ID PERCENT COMPONENTS HAZARD LISTS 1365.00 75.0 ARGON NONE 1251.00 25.0 CARBON DIOXIDE LOW 4 PURE FREON 3400 FT3 LOW NE WALL WELDING ROOM PORTABLE PRESs· CYL. WELDING/SOLDERING ID PERCENT COMPONENTS HAZARD LISTS 1086.00 100.0 DICHLORODIFLUOROMETHANE LOW 5 PURE CUTTING OIL 100 GAL UNKNOWN W SIDE FAB AREA DRUMS OR BARRELS MET.. COOLANT ID PERCENT COMPONENTS· HAZARD·LISTS 1688.02 100.0 CUTTING OIL ~ 'AGE 3 12/16/88 12:48 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~USINESS ~NAME EXPRESS FABRICATION'-- INC ID NUMBER 215-000-000320 ,0CATION 320 30TH ST ' HIGH HAZARD' RATING 2 FIRE PROTECTION / WATER' SUPPLIES LAST ' CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > EMPLOYEE NOT I F I CA.T I ON / EVACUAT I ON LAST CHANGE 07/01/88 BY ESTERs' 3A SEC 2) VERBAL WARNING "FIRE" AND EVACUATION. CALL 911. AGE 4. 12/16/88 12:48 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 USINESS 'NAME EXPRESS FABRICATION INC · ID NUMBER 215-000-0003.20 IJOCATION 320 30TH ST HIGH HAZARD RATING 2 MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 07/01/88 BY ESTER 3A SEC 11 HAZARDOUS GASES ARE CHAINED TO A WALL PER CAL osHA REQUIREMENT. ALL BOTTLES ARE EQUIPPED WITH PROPER FITTINGS ~AGE 5 12/16/88 12:48 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ..... CITY of BAKERSFIELD "-' Fa,.- ~.d Agric. lt~r, ~ st~.~a e~.... ~ ~~~0~ ~~~ ~~ ~ ~~~.0~' NO N-- T R AD E ~ E C RE TS ' ' P,g, ~.__ :" ~ ........ ADDRESS: ~lOq ~~0~ m. STANDARD IND. CLASS CODE CITY, ZIP: ~~~ ~. q~}~ CITY, ZIP: ~~tO~ C~, ~76~ DUN AND BRADS~EET NUffiBER -- I ~ 3' 4' S i ' 7 I ~ I0 11 Il 13 lrmnS Ty~ ~x l~rmge ~1 ~su~ I ~ CmS ~t ~t ~ L~tt~ ~ ~ ~ ~ llxt~/~tl C~e C~e kt ~t Est Units m Site l~ ~l. TW ' ~ ., St~ in FKtlity ~ IC~k all t~t I~)y) ~_: [~] Fire Haztrd u--J l~tivlty' hl~t ~ hi~ u_J I~(Ite ~ ,'; .... ~..~ h of P~ ~lth ...... / . too - - r~ ~'" ~ ~ c.,.,. ~ [~] Fi~z4rd ~--u Mcttvity hl~ ~ ~1~ ~lth of Pmm ~lt~ " · ~t 63 ~&C.A.S. ~ ~,~ ~t,b,,~ c.~ ~qqO-~7-'l., ~t. ~&c.A.s. ~ .~ (~i ~ll t~t ~l~) · ' ..... -I · ~ 13 ~&~.A.S. ~ (~ .,, ,~, .,y~ ~ ~r~ ~ .......... fl~lth of Pr~sune Health Certt~icati~' (Read and siffn after cowpJettng all sections) )?certify ~deP ~lty of ),, t~t I ~ve ~rs~mlly examinff ~d mm fmmilimr with t~ infor~u~itt~ t~ thl, ~ ~11 mttK~ ~t,. ~ t~t ~,~.m W i~t~ of t~, tKtvt~ls ~! ~ ,. CITY of BAKERSFIELD ~ . TRADE sECRETS d ~CAT~O~: %~_~ ~ ~, .... ~DR~S: ~'~ -~,~ ~ ST~D ~. C~S CODe ' M ~ ~itk I I ..... ;_! _ I i I 1 .... J t.I ! ............ ~--~ r--~ r--~ r--~ r--~ ~ ~&~. ~ With ~ W klW ' l ~ blth ~z~ C.A.S. ~ ~t II b & CJ.S. i ~11 tMt r--~ ~-~ r--~ r--q ~t ~ ~&C.LS.~ ~bl~ Mlth ~ C.A.S. ~ ~ IJ b &C~. ~ ~n ~ & ~.A.s. ~ ~ ' . ':~f TO:' CITY OF BAKERSFIELD'; FIRE DEPARTMENT . . . HAZARDOUS MATERIALS DIVISION 2130 "G" STREET : BAKERSFIELD, CA 93301 FROM: '~EXPRESS FABRICATION INC. 320 30TH STREET BAKERSFIELD,. CA'93301 RE.: UPDATE TO HAZARDOUS M~TERIALS~REPORT TEXT: PLEASE MAKE THE FOLLOWING ADDITIONS TO OUR HAZARDOUS · MATERIALS REPORT. ID NUMBER 215-000-000320' PAGE'1 PARAGRAPH 2. NOTiFICATION/PUBLIC EVACUATION ' · ." A. IN TH~ EVENT OF AN ENCY-OR FIRE THERE WILL ~ BE VERBAL NOTIFICATION O~ EXPRESS F~BRICATION o. . EMPLOYEES AND ~NYj~ISITORS ON THE PREMISES. . . B. THE ONLY BUSINESS NEIGHBOR WE HAVE IS GIFFORD. ~LECTRIC AND ~E WIEL'NOTIFY THEM BY PHONE AT .. . ~25-2428 OR ~IERBALLY IN F'ERSON. F'AGE 2 PARAGRAPH 3. HAZ MAT TRAINING SUMMARY .- A. EMPLOYEES ARE NOTIFIED OF ALL HAZARDOUS MATERIALS AND TRAINED IN THE USE OF THESE' MATERIALS AT OUR QUARTERLY S~FETY MEETINGS. · PAGE 4 PARAGRAPH 3 FIRE PROTECTION/WATER SUPPLIES · A. SHOP & OFFICE TRAILE~ARE EQUIPED WITH AUTOMATIC FIRE sPRIN~iLERS.· .. ' B. SH~P HAS 5 FIRE E~X~INGUISHERS LOCATED - THROUGHOUT THE~UlLDING. THE OFFICE HAS -C. THERE'IS A F~,RE I:-IYE~RANT LOCATED ~0 FT WEST OF THE FRON~ GATE ON '30TH STREET. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 lOFFICIAL USE ONLY /(530 USINESS NME HAZARDOUS MATER%ALS BUSINESS P-LAN AS A WHOLE. F'ORM 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: ~ 9V~S_~: B. LOCATION / STREET ADDRESS: SECTION 2: E~RGENCY 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 ygur 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 A. NAT. GAS/PROPANE: 5U3 CO~CC O~, O~,c~ ~C. 5~ b,~a~ :~ ~ S. ELECTRICAL:~6~~ C~ ?~~~ta~ ~e~ ~,c,~ ~ ~ C. WATER: 5T~ %~O~ ~ ~ ~ ~ ~ O~ ~T~ D. SPECIAl: E. LOCK BOX: YEs ~I~ YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO . KEYS? YES / NO - 2A - SECTION 4:.PRIVATE RESPONSE TE~ FOR BUSINESS AS A ~OLE O~ 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 YE~. NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: YES ~ 'YES(~ C. PROPER USE OF SAFETY EQUIPMENT: ................ -.. NO ~__~NO D EMERGENCY EVACUATION PROCEDURES: ................. NO (~NO~ E DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES (~) YES~____~ SECTION.~: HAZARDOUS MATERIAL CIRCLE YES OR NO, DOES YOUR BUSINESS HANDLE HAZARDOUS ~ATERIAL IN QUANTITIES LESS THAN $00 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ' YES Q I, ~{~v--~ ]c~t~--~5-[-'1~' , 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 6.98 Sec. 25500 'Et Al.) and that inaccurate information constitutes-perjury. :BAKERSFIELD CITY FiRE DEP~RTMENT 2130 "6" STREET .BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# · '~BUSINESS NAME: BUSI NESS PLAN SINGLE FACILITY UNIT FORM 8A INSTRUCTIONS 1. To avoid further.action, this form must be returned by: 2. TYRE/PRINT YOUR ANSWERS tN ENGLISH. 3. Answer the questions'~below for THE FACILI'~TY 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 PROCEDURES AT THIS UNiT ONLY SECTION 3:'HAZARDOUS MATERIALS FOR THIS b~IT'ONLY ~A. Does this Facility Unit contain Hazardous Materials? ...... YES NO I'f YES see B If NO, continue with SECTION 4. B. Are.any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a ··separate hazardous materials inventory . form marked: NON-TRADE SECRETS 0NL? (white form #4A-l) If Yes, complete a hazar.dous 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 SECTION 6:.~'LOC~TION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPAN~' B. ELECTRICAL: WATER D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? YES ~ NO MSDSs? YES / NO FLOOR PLA~S? YES / NO KEYS? YES / NO - 8B - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORt4 4A-1 Page 'N'ON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NA~IE: ~-~o~s¢ ~%c~,~ ~c . OWNER NA~E: x~X< ~g~)~ FACILITY UNIT ADDRESS: ~ ~o~ ~~ ADDRESS:. []o~ ~~ ~ FACILITY UNIT NA~E: PHONE {: ~- ~ ~~ PHONE ~: ~ '~ ~ [OFFICIAL USE CFIRS { ONLY 1 2 3 4 5 6 7 8 9 10 TYPE NAX ANNUAl. CONT USE LOCATION IN THIS , BY HAZARD D.O.T ~CODE AMOUNT A~OUNT UNIT 'CODE CODE FACILITY UNIT WT. CHEMICAL OR.CO~ON NAME CODE GUIDE NA~E: ~. ~~ TITLE: SlONATURE: DATE: AFTER BUS HRS: ~OO ~ '~ '" HAZARDOUS MATERIALS INSPECTION ~TION:~ ~O ~ O~ ~- f ~IFI~TION OF ~U~ITI~