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Home My WebLink AboutBUSINESS PLANi~~~ i ~~ tai 6d `~ ~~;: NLIB "'~-.~,:';'""' Commen.ts ): Inspector' s ,:':~,- USE ONLY- /. - ~ - SITE DIAGR~ (Required Items) ddress: Identlfy the ck (key) Box . ~rlnotple buildings by the Street numbers. ~MSDS Storage Box ~'~Street(s),Alleys, ~1~RallroadTracks-- ~iveways, and Parking Areas adjacent to the , '~ Fence or Barrier property. Include the ~'; ~a. Wire ' .' '~street names. . X ~Storm Drains, Culverts, ~ard Drains ~ c. Wood ~Ovalnage Canals, Ditches, d. 6ares Creeks, ~~p B owerltnes utldlngs a. Frame construction l~uard Station b. ~asonry construction ./ 15. Storage Tanks: c. Metal construction capacity In gal. -.' a. Above ~round d. Access Door 6~llty ConCrol~ ~as tktng or Berm ~dentlfy the 7.~re Suppression Systems: location where tre Hydrants ~ e~ployees, will b. Fire Sprinkler tslde Hazardous "~ Connections ~ W~ste Storage Connections ,'. d. ~a~ec Control Valves 21% Outside ~azardous for protection systems ~ ~Materlal .~ use/ffandlin~ e. Fire P~p 22~i ~pe of Hazardous . ~atertal/Waste S~ored 1 Depart~en~ Access . or (See Used TYPE OF ~Z~DOUS ~TERIAL '' C - Corrosive . .: 0 ,:Oxidizer .' 0.: :- Oas .. P - Poison .~'~:. ' ~ = Water Reactive T - Toxic' ", ~;~.- 9oI1i / H - Cryogenic D = Waste B - Etiological Example: Flammable Liquid = FACILI~ DIAG~ (Required items In addition to the. abo~e) ' j~ 1. Ri?ers for Sprinklers..' .. 8, Fire Escapes 2,:p~t. ilions 9, Air Conditioning Units 3, StairWays: Indicate the levels'.served from highest to lowest, 11. In~lde Hazardous Waste Storage 4, Escalator: Indicate the levels served from 12, Inside Hazardous highest to lowest. -. Materials Storage 5, EleVator 13, Inside Hazardous Materials Use/Handling '6, Attic Access *' 14, Sewer Drain Inlets 7. Skylights STATEMENT OF ACCOUNT CITY OF BAKERSFIELD BAKERSFIELD, CA 93301-0000 (805) 32~-3979 DATE: 1/01/97 TO: MORRISON AUTOMOTIVE SERVICE ATTN: RICHARD STEPHENSON lOiO ALTA VISTA DRIVE BAKERSFIELD, CA 93305 CUSTOMER NO: 3137 CUSTOMER TYPE: ES/ 3137 i'. .... C~AR~E .... ~~t~T~ N- R E F~- NUMBER-I~UE-~n AT~ .... -TOT AI..~ AMOUNT .... 12/0I/~& BEQINNINQ BALANCE .00 HMO09 1/01/97 HAZ MAT HANDLiNQ FEE I 158.00 HMO17 1/01/97 HAZ MAT ANNUAL iNSPECTION ~I'~J-Oi~ 50.00 FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL 'THE NUMBER AT THE TOP DF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 208.00 DUE DATE: 1/01/97 PAYMENT DUE: 208.00 DATE:: l/O1/~7 DUE D&TE: 1/01/~7 REMIT A~D I~A~ CHEC~ PAYgSLE TO: CITY OF BAAERSFIELD P.O. BOX 2057 BAKERSFIELD CA 93303-2057 CUSTOMER NO: 3137 CUSTOMER TYPE: ES/ 3!37 TOTAL DUE: ~208.00 MR430101 CITY OF BAKERSFIELD 2/18/97 Miscellaneous Receivables Inquiry 9:33:16 Customer ID . . . : 3137 Name: MORRISON AUTOMOTIVE SERVICE Last statement : 2/01/97 Addr: ATTN: RICHARD STEPHENSON Last invoice : 0/00/00 1010 ALTA VISTA DRIVE 'Current balance : 208.00 BAKERSFIELD, CA 93305 Pending ..... : .00 A ACTIVE ENVIRONMENTAL SERVICES Previous balance : 231.08 Deposit balance : .00 Type options, press Enter. Open Activity l=Select Opt Code Description Current Overdue Total due HM009 HAZ MAT HANDLING FEE I .00 158.00 158.00 HM017 HAZ MAT ANNUAL INSPECTION .00 50.00 50.00 F3=Exit F7=Pending activity F8=Charge hsty F9=Payment hsty F10=Combined detail Fll=Invoice inquiry F12=Cancel F13=Auto charges F14=Deposit detail F21=Other tasks · MISCELLANEOUS RECEIVABLES ADJUSTMENT'- DATE c~- [~-~ '-~ NEWACCOUNT ADDRESS CHANGE · ~' -'~ ' CLOSE ACCT · 'FINANCE CHARGE i ' SITE ADDRESS pARCEL NUMBER (IF APPLICABLE) ' ,.'. .. ADJUSTMENT CHG DATE i CHARGE CODE ADJUSTMENT AMOUNT REMARKS: APPROVED BY JlllJjllljjlllJJjjllll~ljjllljjlll'jjllljjlljjltjjllllljjllljJj 0 ~ ~ ~ · · NOSNBH~BiS/O~H3! B .Nii~ NOSZaUOW :oi I 05/06;~~ -~ MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 1 Overall Site with 1 Fac. Unit General Information Location: 1010 ALTA VISTA DR Map:103 H~z:3 Type: 3 City : BAKERSFIELD Grid: 29A F/U: 1 AOV: 0.0 Contact Name Title .' Contact Name Title r ~ARY STEPHENSON / OWNER / Business Phone: (805) 324-6461x ~,/ Business Phone: (805) 324-6461x 24-Hour Phone : (805)~ 24-Hour Phone : (805)~ Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 1010 ALTA VISTA DR D&B Number: City: BAKERSFIELD ' ~ ............ .S_t_a_t_e:_._C~A_~ Zip: 93305,. Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code: Owner: RICHARD STEPHENSON / Phone: (805) Address: ...... -C3-''m- - ~/.~ ~LL ~~ State: CA City: BAKERSFIELD - Zip: 93306-~ Summary RECEIVED HAZ. MAT. DIV, i~,~,,? ~j~,e-~e~mO Do hereby certify that ! have m~ewed the a~ached h~ardou~ m~terials~manage plan for ~sm ~ ~,o~and that i~ along w~h ~.e~ions ~i~~mp~e and ~rr~ man- ~eme~ plan ~~ · ~gnam~ 05/06~6 ' MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-0 gh 02-0 02-001 WASTE OIL Liquid 150 Low · Fire, Delay Hlth GAL 02-003 FREON Gas 697 Minimal · Fire, Pressure, Immed Hlth ............. FT3 02-002 NEW OIL Liquid 60 Minimal ~ Fire, Delay Hlth GAL 05/06/~6 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-005 :NE Gas 330 High · Immed Hlth FT3 CAS #: 74-: Secret: 'No Form: Gas Type: 55~ Use: WELDING NG FT3. r-- Daily Amount FT3 -- Daily Max 3~/ ~ 165. 330.00 L. Storage ~ r Press PORT. PRESS. CYLINDER IAbo~ MOBILE STORED PARTS -- Conc Components ~--MCP ---/Gu[de 10, IHigh~ 17 02 ;EN Gas 281 Low , Pressure, Immed Hlth FT3 CAS Trade Secret: No Form: Gas Days: 365 Use: WELDING ~ Dai~ Max FT3 e FT3 L Amount FT3 -- //Qr~, 281 281.00 / Storage -- Press Location PORT/ PRESS. CYLINDER MOBILE ~RTS RM -- Conc Components ide ~n, Compressed 14 02-001 WASTE OIL Liquid 150 Low · Fire, Delay Rlth .............. GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL I Daily Average GAL I Annual Amount GAL 150 ~ 75.00 450.00 Storage Press T~Temp .~ Location DRUM/BARREL-METALLIC Ambient~AmbientlREAR OF BLDG OUTSIDE -- Conc Components MCP Guide 100.0% IWaste Oil, Petroleum Based ILOw I 27 05/06~6 ~ MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 FREON Gas 697 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: Trade Secret: No Form: Gas Type: Pure Days: 365 Use: COOLING Daily Max FT3 I Daily Average FT3 I Annual Amount FT3 697 I 346.00 3,485.00 Storage Press T Temp Location PORT. PRESS. CYLINDER IAbove [AmbientlVaRIOUS IN SHOP Conc IMinimal I 12 I~Dichl°rodifluor°methaneC°mp°nents MCP ---~uide 100.0% 02-002 NEW OIL Liquid 60 Minimal · Fire, Delay Hlth GAL CAS #: Trade Secret: No FOrm: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GALI Daily Average GAL 1 Annual Amount GAL 60 ~ 30.00 450.00 StorageIIPress T Temp Location DRUM/BARREL-METALLIC Iambient~AmbientlPaRTS ROOM CENTER -- Conc components MCP Guide 100.0% IMotor Oil, Petroleum Based IMinimal I 27 05/06~6 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation CALL 911 AND EVACUATE. <3> Public Notif./Evacuation NOTIFY ALL CUSTOMERS AND EVACUATE. <4> Emergency Medical Plan SAN JOAQUIN HOSPITAL - 2615 EYE ST - 327-1711. 05/06~6 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 6 O0 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention SECURED CONTAINERS, SEALED AND IN SMALL QUANTITY. CALL RUTHERFORD PACIFIC FOR VACUUM. <2> Release Containment KITTY LITTER TO ABSORB SPILLS. <3> Clean Up DEGREASERS AND SOAPS TO CLEAN SPILL <4> Other Resource Activation 05/06~6' MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 7 O0 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - INSIDE NORTH WALL C) WATER - ALLEY NORTH SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FOUR FIRE EXTINGUISHERS FIRE HYDRANT - ALLEY NORTH OF BUILDING <4> Building Occupancy Level 05/06796 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 8 00 - Overall Site <G> Training <1> Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: EMPLOYEES READ SAFETY DATA SHEETS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use 04/23/92 MORRISON 'AUTOMOTIVE SERVICE 215-000-00( ~2~Ay 4:1992e 1 Overall Site with 1 Fac. unit General Information By Location: 1010 ALTA VISTA DR Map: 103 Hazard: Moderate Community: BAKERSFIELD· STATION 02 Grid: 29A F/U: 1 AOV: -.0.0, Contact Name Titke Bus ~ e 24-HoUr Phone] X[k~S~~~' em~ (805) 324-6461 x (805) Administrative Data Mail Addrs: 1010 ALTA VISTA DR D&B Number: . City: BAKERSFIELD State: CA Zip: 93305- Co~ Code: 215-002 BAKERSFIELD STATION 02 SIC Code: Owner: RICHARD STEPHENSON ~ ...,Phone- .( address:~01O A~.~.A V~S~ ~O{ ~0~~5~ ~State[ CA Sugary r®vi~sd ~h® ~ached hazardous ma~er}a~ manags- _,, and ~ha~'i~ alon~ with plan for ~rre~ons ~ns~tu~e a complete and ~rre~ man- ....., 04/23/92 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 2 02 - Fixed Containers on Site ~ Hazmat Inventory Detail in Reference Number Order· 02-001 WASTE OIL Liquid 150 Low · Fire, Delay Hl~th GAL CAS #: 221 Trade SeCret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL Daily Average GAL --'Annua1 Amount' ~AL~ _ 150 [ 75.00 I ' 4'50.00 Storage~lPress T Temp Location DRUM/BARREL-METALLIC Iambient]AmbientlREaR OF BLDG OUTSIDE -- Conc Components MCp List 100.0% IWaste Oil, Petroleum Based ILOw I 02-002 NEW OIL Liquid 60 Minimal · Fire, Delay Hlth GAL CAS #: Trade Secret: No Form: LiqUid Type: Pure Days: 365 Use: LUBRICANT Daily Max GALI Daily Average GAL 1 Annual Amount GAL 60 ~ 30.00 450.00 StoragellPress T Temp Location DRUM/BARREL-METALLIC IAmbient[AmbientlPaRTS ROOM CENTER -- Conc Components MCP List 100.0% IMoto'r Oil, Petroleum Based IMinimal I 02-003 FREON Gas 697 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: Trade Secret:.No Form: Gas Type: Pure Days: 365 Use: COOLING Daily Max FT3 Daily Average FT3 Annual Amount FT3 697 [ 346.00 I 3,485.00 Storage Press T Temp LOcation PORT. PRESS'. CYLINDER Above [Ambient. VARIOUS IN SHOP -- Conc ~ Components ~ MCP List. 100.0% IDichlorodifluoromethane ]Minimal [ 04/23/92 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 3 02 - Fixed Containers on Site· Hazmat Inventory Detail in Reference Number Order 02-004 OXYGEN ·. Gas 281 Low · Fire~ Pressure, Immed Hlth -~ FT3 CAS #: 77'82-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365. Use: WELDING SOLDERING Daily Max281FT3 I Daily Average140.00FT3·--~---- Annual. Amount281.00.FT3 Storage Press T'Temp Location PORT. PRESS. CYLINDER Above IAmbientlMOBILE STORED PARTS RM -- Conc Components MCP List 100.0% Ioxygen, Compressed Low 02-005 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 FT3330 I Daily .Average165.00FT3 I Annual Amount330.00FT3 Storage ~ Press I Temp Location PORT. PRESS. CYLINDER IaboVe /AmbientlMOBInE sTORED PARTS ~RM -- Conc Components · MCP List 100.0% IAcetylene High I 0~/23/92 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation CALL 911 AND EVACUATE. <3> Public Notif./Evacuation NONE LISTED <4> Emergency Medical Plan SAN JOAQUIN HosPITAL - 2615 EYE ST - 327-1711. 04/23/92 MORRISON AUTOMOTIVE SERVICE 21,5-000-000832 Page 5 00- Overall Site ~ <E> Mitigation/Prevent/Abatemt <1> Release Prevention SECURED CONTAINERS, SEALED AND IN SMALL QUANTITY. CALL RUTHERFORD PACIFIC " FOR VACUUM. <2> .Release Containment t/.,~,4,.. C, Tie'fL' To <3> Clean Up E:::~-~-~s~'~'z.s- 4, ..%~e~ 'To C~'~''~ <4> Other ResoUrce ActiVation 04/23/92 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 6 00 - Overall Site · <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut2Offs A) GAS - NONE B) ELECTRICAL - INSIDE NORTH WALL C) WATER - ALLEY NORTH SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FOuR FIRE EXTINGUISHERS FIRE HYDRANT - ALLEY NORTH OF BUILDING <4> Building Occupancy Level 04/23/92 MORRISON AUTOMOTIVE SERVICE 215-000-000832 Page 7 / 00 - Overall Site <G> Training <1> Page 1, . ~y<~~~ ~o ~o~ .~v~ =~~ s~ ~ s==s o~ ~=? -~ BRIEF. SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use ,,"~, -*,! 'e,\ CITY' Of BAKERSFIELD , . ,.' .- ~:: .~ ~.. "I, VE C,4RE" ~ .~, ,,~ "O-...e ........ .' ~t~ :,.-~ ~,.',,'~ (t~'~e or prin~ name) ,~ ~ ..... ~ ...... Do hereby cert~ _z., that I have reviewed the attached Hazardous Materials business ~lan for ~d or/:~ so~ ~ ~*o~o~,0~' (name of businessl and that it along with the attached additions or corrections constitute a comDlete and correct Busin=ss ~v facilit.v. s'o'n~ur-ez~ date LOCATION 1010 ALTA vISTA DR HIGH HAZARD RATING 1. OVERVIEW LAST CHANGE 11/07t88 BY ESl'ER JURIS CODE Z1S-~X~Z JURIS BAKERSFIELD STATION 02 MAP PAGE 103 GRID'.ZBA FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY zR SEC. Z) EVACUATE, FIRE EXTINGUISHERS, CALL AND HAVE SPILL. CLEANED'BY .QUALIFIED PEOPLE. EMERGENCY CONTACTS ZA SEC Z) RICHARD STEpHENSON - 393-G945 OR 8~4-4ZG8 KEITH STEWRRT - 3Z4-6461 OR.399-'960B UTIL'ITYSHUTOFFS ZA.SEC 3) A) GAS =' NONE 8) ELECTRICAL - INSIOE N WALL C) WATER - ALLEY N S10E O) SPECIAL - NONE E) LOCK BO)( -.NO NOTIFICATION / PUBLIC EVACUATION LAST CHANGE < NO INFORMATION RECORDED FOR THIS SECTION > PAGE I 12/15/88 09:37 MATERIAL SAFETY DATA. SYSTEMS, INC. (805) 848-8800 BUSINESS NRME"MORRISON AUTOMOTIYE SERVICE ID NUMBER LOCATION i010' ~Ll'R VISTA DR HIGH HAZARD RATING ~. HAZ'MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED ,FOR THIS SEC'TION > 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 1t/07/88 BY ESl'ER SEC 4) SAN'JOAQUIN HOSPITAL - ZG1S EYE ST -- ~Z7-1711. PAGE Z 1Z/15/88 09:5? MATERIAL SAFETY DATA SYSTEMS,' INC. (805> 648-8800 ~AUSINESS NAME MORRI AuTOMoTIVE SERVICE LOCATION 1010 ALTA'VISTA OR HIGH HAZARD RATING 3 FACILITY UNIT ~. OVERALL HAZARDOUS MATERIALS INVENTORy LAST CHANGE 11/07/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 WASTE WASTE OIL 150 GAL UNKNOWN REAR OF BLDG OUTSIDE ORUMS OR BARRELS MET.. W~STE IO PERCENT COMPONENTS HAZARD.LIST 1598,00 100,0 WASTE OIL UNKNOWN Z , PURE 'NEW OIL. 60 GAl_ UNKNOWN PARTS ROOM CENTER ORUMS OR BARRELS MET., LUBRICANT I0 PERCENT COMPONENTS HAZARO LIST ~808,~ 1(~4~.0 MOTOR OIL UNKNOWN 3 PURE 'FREON 697 FT3 LOW VARIOUS IN'SHOP PORTABLE PRESS, CYL, COOLING ID pERCENT.COMPONENTS HAZARD LIST, 108G,00 100.0 DICHLOROOIFLUOROMETHANE LOW 4. PURE OXYGEN 281 FT3 HIGH MOBILE STOREO PARTS RM PORTABLE PRESS, CYL, WELDING/SOLOERING I0 PERCENTCOMPONENTS HAZARO LISI ~3S9.00 10~,0 OXYGEN, COMPRESSED HIGH S PURE ACETYLENE 330 FT3 EXTREME MQBt.LE STORED PARTS RM PORTABLE PRESS, CYL. WELOING/SOLDERING I0 PERCENT COMPONENTS HAZARD LIST ~Z4i,O<~ ~.0 ACETYLENE EXTREME PAGE 3 lZ/15/88 09:~2 MATERIAL SAFETY DaTA SYSTEMS, INC. (805) 648-6800 :? .;:..?: · BusINESS NRME.~MORRISON AUTOMOTIVE SERVICE ID NUMBER'Z1S-OOO-OOOB~Z LOCATION 1010 RLTR VISTA 'DR HIGH HAZARD RATING B, FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 11/07/88-BY ESTER 3A SEC 4) FOUR FIRE EXTINGUISHERS FOR FIRE .PROTECTION, 3R SEC 5) FIRE HYDRANT IN ALLEY NORTH OF BLDG~ D. EMPLOYEE NOTIFICRTION / EVACUATION LAST CHANGE 1~/~?/88 BY ESTER SEC Z) CALL, 911 AN[} EVACUATE. PAGE 4 1Z/15/88'09:37 .. MATERIAL SAFETY OR. TR SYSTEMS,,tNC. (805) B48~6800 BUSINESS N~ME MORAl AUTOMOTIVE SERVICE ID ZlS-000-0008~ LOCATION 10i0 ALTA VISTA DR HIGH' HAZARD RATING E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 11/O?/B8 BY ESTER ~A SEC 1) SECURED CONTAINERS, SEALED AND IN SMALL QUANTITY. CALL RUTHERFORD PACIFIC FOR VACUUM~ PAGE S lZ/15/88 MA'TERIAL SAFETY DATA SYSTEMS, INC. (805) BAKERSFIELD CITY FIRE DEPARTMENT ' ,2130 "G" STREET . BAKERSFIELD, CA 93301 (805) 326-3979 OFFICIAl, ONLY / .... BUS INESS .~AME . HAZARDOUS i~ZkTERI AL S BUSINESS PLAN' AS a WHOLE F O ml~X -.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 B. LOCATION / STREET ADDRESS: SECTION 2: EMERGENCY NOTIFIcATIoNs In case of an emergency involving the release or threatened release of a. hazardous material, call 911 and 1-SOO-SSa-~SSO:or 1-91~-42~-4041. This will notify' your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAMEAND TITLE DURING BUS. HRS. AFTER BUS. H~_. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: it2~,t3~ B. ELECTRICAL:--7-,~r~ob-' a3o,'z~ Lw~t-g. ". C. WATER: ~cr_~-W ,Oo~.v~ 5,O6~-- D. SPECIAL: i E. LOCK BOX: YES ,I NO IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE.PLANS? YES / NO MSDSS? YES / NO ~. FLOOR PLANS? YES /'NO KEYS?. YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR' Y0b~ BUSINESS ASA WHOLE ~ .......... :, ...:~...... . , .......... :.' SECTION O: EMPLOSrI~E TRAINING ". EMPLOYERS ARE REQUIRED 'TO HAVE A PROGRAM WHICH PROVIDES"EMPL0~EES%~ITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. ,.--:~ CIRCLE'YES'OR NO INITIAL REFRESHER ~ ~ETHODS FOR SAFE HANDLING OF HAZARDOUS .' ~__V____~'sO"' .MATERIALS:....·. .................. . ........ ..,- ...... ~ NO WiT. RESPONSE AGENCIES: ......................... i ~ ~0 c PROPER uSE OF SAFETY EQUIPMENT: .............. ..... ~ NO '~I> NO D EMERGENCy EVACUATION PROCEDURES: ................. -(~). NO (~ NO E DO YOU MAINTAIN EMPLOYEE TRAINIMG RECORDS:...:... YES ~. YES SECTION 7: I~ZARDOUS I~TERIAL CIRCLE YES ~.,NO.,- NONE DOES YOUR'BUSINESS HANDLE ~AZARDOUS ~TERIAL IN QUANTITIES LESS.THAN 30'0 P~F-A SOLID, 55 GALLONS OF A LIQUID', OR 200' CUBIC FEET OF A CoMpREsSED GAS:.'.'i'i::,.. ~Y~. NO I, ~c_~O ~q-~o~ c-n~ , certify that the above information is accurate. I understand that this information ~ill'be used to fulfill my firm's obligations under the ne~.California Health and Safety code on, Hazardous Materials (Div. 20 Chapter .Sec .25500 Et Al.) an~curate informati'0n~co~stitutes .perjury. - · - 2B ~ " BAKERSFIELD CITYFIRE,DEPART~ENT 2130 "G" STREET' BAKERSFIELD, CA 93301 (8o5) 3~6-3979 105~q/~ -' OFFICIAL USE ONLY ID# · · BUSINESS NAME HAZARDOUS lvI3%TE R I ALS ' BUSINESS PLAN AS' A WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below fop the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS': (0 'O' ~[~.. ~~, ~ ..... SECTION 2: EI~tERGENCY NOTIFICATIONS In case of.an emergency involving the release O~ threatened release of a hazardous mateFial, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Sevvices as requi~ed by '""~P5OYEES TONOTIFY IN CASE OF EMERGENCY: ~A~E A~DTITLE DURING BUS. HRS. ^~TER BUS. HRS. S~CTION 3: LOCATION OF UTILITY Sh'UT-OFFS FOR BUSINESS AS A A. NAT. GAS/PROPANE: D. SPECIAL. ' BOX: YES /~IF YES, LOCATION: E. LOCK IF YES, DOES IT CONTAIN· SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL ENERGENCY 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 (~, NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO ("-YES) NO C. PROPER USE OF SAFETY EQUIPMENT:.. ................ ~NO ~ NO ' NO c-'Y E~) NO E. DO YOU MAINTAIN EMPLOYEE TRAIN-ING RECORDS: ....... YES~ SECTION 7_: HAZARDOUS NATERIAL CIRCLE YES OR NO. DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUN~F A SOLID, 55~GALLONS OF A LIQUID, OR .200 CUBIC FEET OF A COMPRESSED GAS: .... .£ YES] NO I,.~~ '_~, certify that the above information is~accurate. I understana-t~hat this i_~ion will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. S IGNATUR~ C-'~~.~ITLE F~~' DATE .BAKERSFiELD.CITY,FIRE DEPARTMENT ~2130 "G"~STREET BAKERSFIELD, CA 93301 OFFICZAL USE ONLY ID# BUSINESS NAME: BusI NESS PLAN SINGLE FACILITY UNIT FORM 8A INSTRUCTIONS 1. To avoid further actibn, tb~.s form must be retuz'ned by: 2.' TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer' the questions be!o~.for THE FACILITY UNIT .LISTED BELOW · 4. 'Be as BRI'EF and CONCISE as possible. FACILITY UNIT# FACILITY UNIT N~ME: .. .SECTION 1: MITIGATION, PREVENTION, ABATEMEN~r PROCEDURES SECTION 2: NOTIFICATION ~ND EVACUATION PROCEDURES AT THIS UNIT ONLY SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY · A,.Does this Facility Unit contain Hazardous Materials? .... NO · ' If YES, see B If NO, continue with SECTION 4. B. Are any of. the hazardous materials 'a bona fide. Trade Secret Y If No, complete a separa%e hazardous materials inventory form marked: NON-TRADE SECRETS 0NLY.(white'form.#4A-1) If Yes, complete a h~zardous material~ inventory form marked: TRADE SECRETS.0NLY (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: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT 0NLY. A. NAT. G:aS/'PROPAN~'T D. SPECIAL: " E. LOCK BOX: YES. C~IFI YES, 'LOCATION ' ':~F YES, SITE PLA~S? YES / NO MSDSs? YES / NO ' FLOOR PLANS? YES /' NO KEYS? YES / NO t ..... 3B - " I BAKERSFIELD CITY 'FIRE DEPARTI~ENT .D. # FOR~I 4A-1 Page ~of NON--TRADE SECRETS HAZARDOUS MATERT ALS' t NvENTORY ° OI~NER NaM~..-~- ...... ~.-.- ~ ~" ~ ' FACILITY UNIT BUSINESS NAHE: ~O~t~ ~ ~ ~~ ADDRESS:/e/e~I~'~ d~. FACILITY UNIT NA~E: CITY, ZIP: ~ ~q~~ CITY,ZIP: ~ ~ PHONE ~: ~~/ PHONE ~: ~q~f ]OFFICIAL USE CFIRS CODE I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE~ ~AX ANNUAL CONT USE LOCATION IN T.IS · BY .AZARD D.O.T ~ A~OUNT A~OUNT UNIT CODE COOE FACI ~¢ CHEmiCAL OR CO~ON NA~ CODE GUI~ .~.' LITY UNiT / ~ ~T. !, ~ '1 I' '~t~: -' 5 ~ ~ ~' TITLE-~ SI6NATURE' DATE: ,,EHERGENCY CONTACT: ~ .TITLe: ~ P~ON~ ~OURS: , ~lq ~, _ ~ ~ · AFTER BUS HRS: ~ ,~, ~ ,~.. '~'~ERBENCY CONTACT:~ TIT~E :~-~' PHONE ~ ~s HOurs: 3m~ . P~IN,~F~A~ BUSINESS' ACTIVITY: ~] ~ ~ · ~ a~T~r BUS HRS: ~?~ ~' "'~ %'~ - 4A- 1' -