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Home My WebLink AboutBUSINESS PLAN (2) TE/F.~C ILI TY D GRAM SCALE: BUS INESS NAME: FLOOR: 0F (CHECK ONE) SITE DIAGR.~M FACILI~ DIAGR.¢M I(Inspector's Comments): -OFFICIAL USE ONLY- - ~A - SITE DIAGRAM (Requi ) 1. Address: Identify the g. Lock (key) Box principle buildings by the Street numbers. 10. HSDS Storage Box 2. Street(s), Alleys. 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. ~asonry 3. Storm Drains, Culverts, · Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Gates Creeks. 13. Powerllnee S. Buildings a. Frame construction 14. Guard Station b. Masonry construction IS. Storage Tanks: Identify the c. Metal construction capacity in gel. a. Above ~'ound d. Access Door : ...................... · .................. _b. Under~round 6. Utility Controls a, Gas 16. D/Icing or Bern b. Electricity 17. Evacuation Route c. Mater 18. Zvacuation Area: Identify the " 7. Fire Suppression Systems: location where a. Fire Hydrants ' anployean mill b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage o. Fire Standpipe 20. Outside ~azardous Connections Material Storage d. Water Control Valves 21. Outside 8azacdoua for protection systems Waterlal Use/Hand~ln~ e. Fire Pamp 22. Type of Hazardous Waterta//Waate Stored 8. Fire OepartnanC Access or Used (See Below) TYP8 OF RAZARDOUS .~ATERIAL F - Flammable g - Explosive L '- Liquid R - Radiological C - Corrosive 0 - Oxidizer O - Gao P - Poison M - Water Reactive T - Toxic S -' ~o'lid ~-~ - CrYogenic ........ .D - Waste B - Etiological Example: Flammable Liquid - FL FACILITY DIAGRAM (Required items in addition to the abo~e) 1. Risers for Sprinklers 8. Fire+Escapes 2. Partitions 9. A~r Conditioning Units 3. Stairways: Indicate the I0. Windows levels served from highest ~o lowest, ll. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. ~aterials Storage S. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets 7. Skylights ' MATERI~ B~[~rsfield Fire Dept. Haza~l~Us Materials Division Business Name: ~"~,',~'/~/~.y' .,<'-///~ ~-/ Location: / ,~ ~* ~',~ Business Identification No. 215-000 /,7 ~ ~> (Top of Business Plan) Station No. /"/ Shift /0 Inspector ' Arrival Time: Departure Time: Inspection Time: Adequate Inadequate of Inventory Materials of Quantities of Location Comments: Verification of MSDS Number of Employees: Verification of Haz Mat Training ["1 ['1 Comments: Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled ['"1 ['1 Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: ~-/,~,,, ~ / All Items O.K Business Owner/Manager PRINT NAME SIGNATURE Correction Needed White-Haz Mat Div Yellow-Station Copy Pink-Business Copy 02/24/92 BRANTLEY STEEL FABRICATION 215-000-001365 Page 1 Overall Site with 1 Fac. Unit General Information Location: 1306 33RD ST Map: 103 Hazard: Moderate Community: BAKERSFIELD STATION 04 Grid: 19C F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- Administrative Data Mail Addrs: 1306 33RD ST D&B Number: City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-004 BAKERSFIELD STATION 04 SIC Code: Owner: CHARLOTTE BRANTLEY Phone: ( ) - Address: 1306 33RD STREET State: CA City: BAKERSFIELD Zip: 93301- Summary 02/24/92 BRANTLEY STEEL FABRICATION 215-000-001365 page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 OXYGEN Gas 230 Low · Fire, Pressure, Immed Hlth, Delay Hlth FT3 cAs #: 7782-44-7 Trade Secret: No Pure Days: 365 Use: WELDING SOLDERING Form: Gas Type: Daily Max FT3I Daily Average FT3 I Annual Amount FT3 230 ~ 230.00 2,500.00 Storage Press T Temp Location PORT. PRESS. CYLINDER'IAbove ~Ambientl' -- Conc Components MCP List 100.0% IOxygen, Compressed ILow I 02-002 ACETYLENE Gas 330 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3I Daily Average FT3 ----~-- Annual Amount FT3. 330 ~ 330.'00 3,500.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IAbove ~AmbientI -- Conc Components MCP List 100.0% IAcetylene IHigh I 02/24/92 BRANTLEY STEEL FABRICATION 215-000-001365 Page 3 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification <2> Employee Notif./Evacuation , NO EMPLOYEES <3> Public Notif./Evacuation <4> Emergency Medical Plan 02/24/92 BRANTLEY 'STEEL FABRICATION 215-000-001365 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention <2> Release Containment <3> Clean Up <4> Other Resource Activation 02/24/92 BRANTLEY STEEL FABRICATION 215-000-001365 Page 5- 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NORTH SIDE BACK B) ELECTRICAL - NORTH SIDE BACK C) WATER - NORTH SIDE BACK D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - ???????????? FIRE HYDRANT - SOUTH SIDE 33RD STREET DIRECTLY ACROSS STREET <4> Building OccuPancy Level 02/24/92 BRANTLEY STEEL FABRICATION 215-000-001365 Page 6 00 - Overall Site <G> Training <1> Page 1· WE HAVE ?? EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF SUMMARY OF TRAINING: / ,<2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 2130 "G" STREET " BAKERSFIELD, CA 93301 (8o ) RECE,VED DEC '7 1988 io3- c.. 0FFICf:4E USE ONLY Afl~'d ............ iD, 3US INESS NAME HAZARDOUS MATER, ALS FOal~ INS~UCTIONS: 1. TO avoid further action, return this form by ~. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the question~ b~low for the business as a whole. 4. Be as b~ief and concise as possible. SECTION 1: BUSI~SS IDE~IFICATION DATA B. LOCATION / STREET ADDRESS: %'~0~ 5~ g~[ I~D ziP: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-75~0 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. ~S~ TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. B. PhC Ph= SECTION 3: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS A ~OLE A. NAT. GAS/PROPANE: B. ELECTRICAL: ~A~¢ D: SPECIAL: E. 50Ck BOX:, YES /~ IF YES, LOCATION: IF YES, DOES t-T CONTAIN SITE PLANS? YES / N0 MSDSS? YES / NO' FLOOR ~ANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TE~ FOR BUSINESS AS A WHOLE S · o: oCAL ...... ~,-,~,,~="~v~..~. MEDf'CAL ^~srSTANCE FOR YOL~ BUSINESS AS-A ;VIIOL-~ SECTION 8: ~MP~O~ T~[NING ~MPLOY~RS ARE R~QUIRED T0 HAV~ A PROGRAM WHICH PROVIDES EMP~OY~S WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS >~TERIALS:... .................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. ' YES NO YES NO E. DO YOU ~INTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO SECTION ~: ~Z~DOUS ~TERI~ CIRCLE YES - NO - NO~ ' : - ................ DOES YOUR BUSINESS HANDLE HAZARDOUS ~TERIAL IN QUANTITIES LESS THAN 500 PO~~ SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ~YES N0~~~ ~.~t~_ ~~Cy , certify that the above information is accurate. I understand Chat this inf6rmation will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. ~0 Chapter 8.95 Sec. 85500 Et Al.) and that inaccurate information codstitutes perjury. Dear Business Owner: Enclosed please find a cody of your r~s:onse to the Hazardous Material Business Flan reuues:. We have foun~ it necessary :o rejec: y~ur p~an for the following reason(s) as checked below. [--~ Illegible Business Plan (please print or type information in English). Form 2A ~ Missing or F--l Incomplete Form 3A lng orI i Incomplete ~ ~LC cc~ c~ 11 t~c~c'~~4 ,~'-J~y .- Form Site Diagram r'~ Missing or r'~ Incomplete Facilities Diagram I [ Missing or['~ Incomplete This is to be corrected and resubmitted within 30 days to: Bakersfield City Fire Department Hazardous Materials Division 2~30 "G" Street Bakersfield, CA 9330~ If additional cooies of any forms are needed they can be picked uo from the Hazardous Materials Division at 2~30 "G" Street in person. Sincerely Yours,,/ Hazardous Materials Coordinator REH/eg CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Farm and Agriculture n Standard Business NON--TRADE SECRETS Page BUSINESS NAME.'~/~)~N~-/~y"~.-~7~/ ~'~b~T~VOWNER NAME: NAME OF THIS FACILITY: LOCATION:~~/--~ ADDRESS: STANDARD IND CLASS CODE: CITY, ZIP~ CITY. ZIP: DUN AND BRAD~TREET NUMBER PHONE U: PHONE ~: - - REFER TO~N~IHU~')IONS FUN PROPER CODES tYRe Hex Xv~rpge Annual 'Neasure I ~y~ Conk Conk Conk...~e Location?e[e. ~y. Nam of ~ixturelCo,ponents Code code AmC A,c Est Un~ts on 5~[e Type Press Temp Stored ~n Pac~/~y See Componen~ 12 Name I C.A,S, Number ~ Fire Hmrd ~ Reactivity ~ Delayed ~ Sudden Release ~ ]mmedim Health of Pressure Health Component 13 Name I C.A.S. Number Physical and He41Ch 6azard C.A.S. Number Component I1 Name t C.A.S. Number (Check al/ that apply) _ . _ .. . , _ [ . Component 12 Name & C,A,S. Number ~ Fire Hazard ~ Reactivity ~ qHayed ~ SuDDen Helease ~ Heath of Pressure H~81C~ / Componen[ 13 Name I C.A,S, Number I I I I I ~1 I' I Physical and Health [mrd (Check all [ha[appl~} ~: ~C~S. ~er ~J ~ Componen~ 'I Na,e :C,A.S. Number D Fire ,mrd D Remctivity 0 Dela~r~u~den~ 0 Im~.[e P N e H~Ch T/ [f~ssure / - Health ~ ... -- - . ~ll //~onenC 11 Na,e I C.A,S. Number '~ o? Pressure ~/Hea/ch ~ Fire Hazard ~ Reactivity ~ D 1~ ~ Sudd n Release ~ Component 13 Name & C.A,S. Number EHERGENCY CONTACTS fll Name Title 24 Hr PhOne Name Title 241Hr Phone erCifi aCiD Re and f naf r tom 7 C f g a 7 7 l sect lone) ac}acned.d~c~eeAc~: eno cpa[ based o~.my 1Aqulry ~T.c~ose lflO1VIOUl/S responsible rot obcalnifl9 [ne Information. ] believe Chat the SUDmICCeo 1Atormatlofl Is [rue, 8ccurm, AnD comp/e[8. ~e~e end oficial [1tie of mer/ooera[or OH o~fler!operator's aUthOrized representative ~gnature ~T~ced '