HomeMy WebLinkAboutBUSINESS PLAN ITE DIAGRAM FACII3TY DIAGRAM
Business Ad.ess: ~ ~0~ ~ ~ ~ ~0 ~ ~
~ ~'I~.~'
Baker's Welding supply In' .
~O~ 3 -°D-7 - 4580 State Rd.
Bakersfield, CA 93308
Phone 661-387-6800
Fax 661-387-6807
March 05, 2000
City of Bakersfield
Office of Environmental Services ! MfiR 7 Z000 /I
1715 Chester Ave
/
Bakersfield Ca. iBY'
This note is to advise your office that we no longer have the products listed in our
business plan at 3000 Antonino Ave. We have relocated our business to 4580 State
Rd.
I have been advised that we are now in the County so we will be notifying the
County regarding our products and their inventory.
If anything further is required of our company please feel fi:ee to call us at the
number listed above.
. S'~rely,
K[l~l~ ~ David Melo
FOR SALES AND SERVICE
DAVID MELO
661-325~9353(WELD) 3000 Antonino Ave
Fax 661-326-7816 Bakersfield, CA 93308
CITY OF BAKERSFIELDi
OFFICE OF ENVIRONMENTAL SERVICES
1715 chester Ave., Bakersfield, CA (805) 326-3979
1. To avoid further action, return this form within 30 days of receipt.
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
MAILING ADDRESS: ~,~.,rq ~- .....
DUN & BI~.DSTREET NUMBER.: SIC CODE:
SECTION 2: EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 I-IR. PHONE
1
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING
NUMBER OF EMPLOYEES: ~
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REOUEST
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 DO NOT HANDLE HAZARDOUS MATERIALS: '
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT
NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES.
OTHEK (SPECIFY REASON)
SECTION 5: CERTIFICATION
INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE
USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH
AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500
ET AL.) AND THAT INACCURATE INFORMATION. CONSTITUTES PERJUKY.
SIGNATORE ~" TITLE ~ DXTE-
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
A. AGENCY NOTIFICATION PROCEDURES:
B. EMPLOYRR NoTIFIcATION AND EVACUATION:
.~ ' ~ ..~,~xf,..:~. ----... ~ .,'
Ci ....PUBLIC EVACUATION': ' - ............... · ' , , '1~
D. EMERGENCY ,MEDICAL PLAN:
ILs, ZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION. PREVENTION AND ABATEMENT pLAN
B. _ RELEASE CONTENT ANI~/~R lVlINIM~ATIO~N: . ~ .__/ ~ ~/~
C. CT.~AN-UP PROCEDURES: ... '
SECTION 8: UTILITY SHUT-OFFS _('LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELEC~C~: ~~
WA~R: ~ 0~~ ~'
SPEC~:-
LOCK. BOX: ~S~ ·
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY
B. WATER AVAIl.ABILITY (FIRE HYDRANT):
g ous ,v T msLS v oR¥ · Pas
~C~ ~~0~
1 ) ~ORY STA~S: N~ ~A~ [ ] Re~ [ ] ~le~ [ ] C~k ~ch~ is a NON T~ S~ ~] T~ S~ [ ]
2) Co~o. N~e: ~ ~/~~ ' 3) ~T ~ (op~o~)
4) Ph~i~ ~ H~ ~SIC~
5) ~AS~ C~S~CA~ON (3~t ~ ~ D~ Fo~ 80~) USE CODE
6)P~SIC~STA~ ~Ud[ ] Liq~d[ ] ~[~] ~[~] ~e[ ] W~[ ] ~ve[
7) ~O~ ~ ~ AT FAC~ ~ OF ~~ 8) STOOGE COD~
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Av~e ~y ~t ~/~* O Cm~ [ ] b) ~:
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I)~ORYSTA~S:N~[ ]A~fi~[ ]R~[ ]~lcfi~[ ] Ch~~~aNONT~~~T~~[
~)c~me: ~ ~d ~ ~)~T~(~e~)
4) Ph~i~ ~ H~ P~IC~
~.,*~ Ca~g~ F~ [ ] R~dve [ ] S~ ReI~ of~ [ ~ ~ H~ (A~m) [ ] ~la~ H~ (C~c) [ ]
S) W~ C~S~CA~ON (a~¢t ~ ~ D~ F~ 80~) USE CODE
7) ~O~ ~ ~ AT FAC~ ~ OF ~~ 8) STOOGE CODES
Av~eD~y~o~t /~C9 C~[ ] b)~:
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IO)L~A~ON ~ ~ ~ / ~ ' - l "~ ~
P~ N~e ~ Title of Au~o~ Comfy R~mfiv, '~- / / Da~ '
,!
~AZARDOUS MATERIALS ~NV~ORY
Page Y-~-of 7
~C~ DES~ON
4) Physi~ & H~ ~SIC~
~ Ca~o~ F~ [ ] ~ [ ] S~ ~1~ of~ ~ ~ ~ (A~u~) [ ] ~lsy~ a~ (C~O [ ]
5) W~S~ C~S~CA~O~ (3~t ~ ~ D~ F~ 8022) ~SE CODE ~ ~
7) ~O~ ~ ~ AT FAC~ ~ OF ~~ 8) STOOGE COD~
L~[ ]~[ ]~ a)Con~
Av~. ~y ~o~t / D ~O C~ [ ] b) ~: ,
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ch~ ~~u ~ 2) [ ]
4) Ph~i~ A H~ ~SIC~
5) w~= c~smcA~o~ O~$t ~ ~ ~m ~ ~m) use corn Y ~'
7) ~0~ ~ ~ AT FAC~ ~ OF ~~ 8) STOOGE CODES
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Av~e D~y ~o~t ~ g C~ [ '] b) ~:
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~ Days on Site C~le ~ch M~: ~ I, F, ~ ~ ~ I, l, & S, O, N, D
9) ~: Li~ CO~~ C~ % ~
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P~ N~e & Tifl~ of Au~o~ Comfy a~five 8i~ - ' Da~
~Ih-kZARDOUS MATERIALS LNVI~ORY
~ ' PascO_. of
CKEMICAL DI~.SCRIPTION
I)INVENTORYSTATUS:New~/~.^ddition[ ]Revision[ lDeletion[ ] Check ffch~cal is a NON Trade Secret~
2) Common Name: ~ ~I-O~I,.L) 3) DOT# (optional) U ~
Chem/cai Name: t/~-c~ (y-~J AHM[ ] CA~#
4) Physical & Health PHYSICAL HEALTH
Categori=F~ [ l Reactive [ l Suad~ ~e~as~ ofPressu~ 0Q r~,ediate H~th (^~ute) [ l D~ayed ~th
s) w^sTE ct.~ssn~c^r~o~ (3.aisit ~ r~ Dm rom 8022) USE CODE
6) PHYSICAL ST^TE Solid [ ] Liquid [ I O~s ~ Pur~j~] Mixture [ ] Waste [ I Radio~ive
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily.amount ~oO 0 Lbs [ ] Cral [ l fl3 ~l a) Contain=
Av~e Daily.amount /200 0 Curies [ ] b) Pr~ssu~: 2..,...
Aunmfl Amount z:~& 00 0 ¢)
Largest Siz~ Contai~ ' ~' d
Days on Site C/xcle Months: ~ J, F, M, A, M, J, J, A, S, O, N,
9) IvflXTURE: List COMPONI/NT CASt/ % WT AHM
the thr~ most hazardous 1)
chemical componmts or 2) [ ]
any AHld comport=ars 3) [ ]
I)INVENTOR¥STATUS:N'~w[ ]Addition[ ]Revision[ ]Dd¢fion[ ] Ch~kifchemimlisaNONTrad~[~Trad~8~',~[
4) Physical & Health PHYSICAL HEALTH
Hazard¢ategori~ Fim[~Reaaive[ ]Sudd~R¢le~s~ofPressum~ lmm,~i,t, Health(^mte)[ ]DdayedHealth(elmmi¢)[
5) WASTE CLASSIHCATION O-digit codg fxom Dm Form 8022) USE CODE ,~~
6) PHYsicAL stare soua [ ] Liquid [ ] C-ssl~ ] ?ute [ ] Mixt~ [ ] Waste [ ] ~aiomive [ ]
7) AMOUNT AND TIME AT FACII,IT~' UNTrS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount ~ Lbs [ ] Gal [ ] ft3 D~] a) Con[miner: ' ~/
Av~ase Daily Amount /2_o O Curies [ ] b) Pressm~:
Annual Amount /~ OD (53 ¢) T~ml~ratur~
Larsest Siz~ Couudu~r :2O O
# Days on Site Cimle Whidm Months: ~.~, J, F, M, A, M, I, .~, A, S, O, N,
D
9) MIXTURE: List COMPONENT CAS# % ~ AHM
the thr~ most iumudous I) [ ]
chemicai compon~uts or 2) [
any AHM comlxm~ts 3) [ ]
I certify under penalty of law. th~ l~te l~rsonally ~tin~d and a~miliar with the mbmati~ on this and all ,,ttada~i domm~. I
.believe the submiRed information is true, accurate and complete.
PRINT Name & Title of Authoriz~ Company Representative Si~ature -- 'Daie
ZARDOUS MATERILALS 12q~ORY
c-' Page fi__ of
Clt~MICAL DI~SCRIPTION
I ) iNVENTORY STATUS: New Addition [ ] Revision [ ] Deletion { ] Check if chemical is a NON Trade Secret ~].Trade
:) Common H,me: C: t y 3) # (opuo )
4) Physical & Health PHYSICAL HEALTH
Hazard Categori~ Fir, [ ] Re. active [ ] S,~tt_,~ Rel~a$~ of~~J lmmcdiat~ Health (Acute) [ ] I~lay~d H~alth
[
5) WASTE CLASSIFICATION O-disit code from DHS Form 80~.) USE CODE
6) PHYSICAL STATE Solid [ I Liquid [ ] C,~ [~ Pu~ [ ] Mixture [ ] W~St~ [ I Radio~ai~
[
7) AMOUNT AND ~ AT FACILITY ~ OF MEASURE 8) STORAGE CODES&/
Maximum Daffy Amount /2 ~ Lb, iX] cna [ ] ~ [ ] a) Contain=
^v=a~ Daily Amou-t 'e-5-OO Curiea [ ] b) Prenu~:
Annual Amount / ~ oo 0 c) Temperature
Largest Size Contai-= ~"-O
Days'on Site Cixcle Which Months: ~ J, F, M, A, lVl.
D
9) MIXTURE: List COMPONENT CAS#' % WT AHM
thc three most h,,.*,xtous 1) [ ]
chemical eomponenu or 2) [
any AHM components 3) [ ]
DINVENTORYSTA I~Addition[ IRe~i~ion[ ]mietion[ ] Ch~Irif~miealiaaNONTra~S~r~t~Trad~S~a~[ ]
4) Physical & Health PHYSICAL HEALTH
HazardCategofiea Fire[ lReactive[ ]SuddenReleas~ofPreasureD(~ lmmediateHealth(Acute)[ ]DehyedHealth(Clmmi¢)[
5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas ~ Pur~ [)~,. Mixture [ ] Wast~ [ ] Radi~ve [ ]
7) AMOUNT AND ~ AT FACILI~. UNT~ OF MEASURE 8) STORAGE CODES
mxim~ Dai~y amount ~/O:)O Lb, [ ] C~ [ ]tU [KI a) Contain=
Average Daily Amount ~fOO2) Curies [ ] b) ~:
Annual Amount ~DOOO c) T~ml~ratum
Largest S~ Con~-=' ~
# Days on Site Circle Which Months: ~, F, M, A. M, $, $, A. 8, O. N, D
9) MIXTURE: List COMPONENT CAS// % WT AHM
the three most hazardous 1) [ ]
chemical components or 2) [ ]
any AffM components 3) [
ify penaltyfla ~m ~ y ' a~ ' '" .... this and ali at't~hed documents.
PRINT Name & Title of Authorized Company Representative Signature / Date
[tAZA~OUS MATERIALS I~VENTORY
CI:I~.MICAL DgSCRI~FION
I ) INVENTORY STATUS: New tion[ ]Revision[ ]Deletion[ ] CheckffchemicalisaNONTradeSecretJ)~.]Trad~secr~[ .1
4) Physical & Health PHYSICAL HEALTH
Hazard Categori~ Fix~.[~R~ve [ ] Sudden Rel~ of Pressur~ D~- Immediate Heaflth (Acute) [ ] Delayed Health (Clmmic) [
5) WASTE CLASSWICATION (3-digit code from DHS Form 8022) USE CODE
6) ?HYS~CAL STATE So~i~ { ] ~.iqu/d ~I C~s { ] Pur~{ I Mixture { ] W~.e { I Pa~io~-tiv~ { ]
7) AMoom' a~) ~ Ar l:Acmrrr tn4n~ o~ ~wa~s~ a) STO~OE CODES
Average Daily Amount ~ Curia { ] b) Pre. urn: ~ ,
~a~ Amoum / ~ ,m Q ¢) Tenanmtur~
La~e~t Siz~ ¢ont~i~r //O
D
Days
on Sit~ Civic Which Montlzs: ~Y~, $, F, M, A, M. 1, $, A. S, O, lq,
9) MIXTURE: List COMPONENT CASit % WT AHM
the thre~ most hazardous 1) , [
chemical componems or 2) ~ [
any AH:M components 3), ~ [
I)INVENTORYSTATU$:N'cw{ ]Addition{ ]Revision[ ]Deletion[ ] Ch~kif~ic~li~aNONTmd~~Tr~l~[
4) Physical & Health PttYSICAL
Haz~Cat~ories Fi.re~I. Rea~tiv~[ ]Sndd,-~_ReI~s~ofPres~[~ Immediat~ti~Ith{Aeut~}[ ]DelayedI-I~Ith{Chnmi¢}[
s) wasTE ct. assn~cA'nO~ 0-,tisit ~ .%,, Dm Vorm SO:P) USE CODE' .d-/S-'--
S) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [N Pur~ [)(! .M~ [ I wast~ { I P,a, tioactiv~ [ 1
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE $) STORAGE CODES
Maximum Daily Amount i~O::r3 Lbs{ lC-ali ]f13~,] aJContainer:.
Average Daily Amount 'P ~OO Curies [ ] b) Pressure:
Annual Amount ..ioo: oO O ¢) Temperatur~ fir/
it Days on Site Cimle Which Months:~ Ji F; M, A, M, $, $, A, S, O, N, D
9) MIXTURE: List COMPONENT CA.SIt % WT
the three most hazardous I) ,' [ ]
chemical components or 2) [ ] .
any AH:M components 3) [ ]
10)LOCATION / ' /ri
· I c~'rtify under ponalty of law,~t I haw p~a'm~y ~mined t~1 ~m ftmfih'~- with thc '~fion on this ~md ~11 atlach~d do~mm~ts. I
PI{IN~ Natal& Title of'Authorized Company' Represenlative : . Signa'tur~ ~)a~
HAZARDOUS MATERIALS UVVE$ORY ~oc~age ._~ of ~
CI~MICAL DI~.SCR/PTION
I ) INVENTORY STATUS: New [XAddition [ ] Revisiou [ ] Deletiou { ] Check ii'chemical is a NON Trad~ Secr~{ Trad~ Secrut [ ]
2)CommonName: ~--~' '~/]~(¥,, ~ 3)DOT#(opfional) C
4) Physical & Health PHYSICAL ~2 ~ f,~b,,_~ HEALTH
Hm, a~d Caiegori~s ' Fire [ ] Reactive [ ] Suddgu Relms~ of Pressure [/~/mmediatg H,ealth (Acu~) [ ] Delayed Health (Chrouic) { ]
WASTE CLASSIFICATION (3.digit code fr~n DHS Form 8022) USE CODE
6> PHYSICAL STATE Solid [ ] Liquid [ ] Oas [/~Q.. Pure [ ] Mixture [~,~ W~tg [ ] Radioactive
7) AMOUNT AND TIME AT FACILITY UNITS OF ~URE 8) STORAGE CODES
Max~numDailyAmotmt '~OC30 Lbs[ ]Gall ]R3X] ; a) Contain=
Avgrase Daily Amouut ~ Curia [
Annual Amount ,,~ c~..90 c~33 : c) T~utxtatum ~'
I~.~ s~ co,~ ~ /.--~.
# Days on Sim Circle Which IViouths: Y~,. $, F, M, A, M, L $, A, S, O, N, D
I)INVENTORYSTATUS:New[AAddition[ ]Revisiou[ ]Deletion[ ] Checkifchemical'isaNONTradeSecr~t~Trad~[ ]
4) Physical & Health PHYSICAL HEALTH
t-hzardCat~ori~ Fiji ]Re~:tiw[ ]Sudd~R~ot'~,l~,,,~iia~tt~h(A~t~)[ ].D~la~iH~ai,h(Cmuni~)[ ]
~) WASTE c~ssn~c^uo~ O-~i~,,~ r,~ D~ ~o~ ~0n) US~- COD~. zf ~
6) PHYSICAL STA'rE Solid [ ] Liquid [ ] C,~ DQ ~ [ ] Mixu~'~ [ ~{~ W~ [ ] l~i~vc [ ']
7) AMOUNT AI~ TIME AT FACII/TY UNITS OF MEASURE 8;) STORAGE CODES
Averase Daily Amount .~.~OO-O Curies[ ] b)Pmssum:
Annual Amount ~0 c) Temperature
Largest Size Container .~ ~ 0
# Days on Site Circle Which Mou~hs: (~$! F, M, A, M, I. $, A, S, O. N. D
9) MIXTURE: List
a~y AHM ~mpou~ms 3)
i cgnify under penalU~f law, tha~ 'I have ix:monally ~ammm~/aud m,, tkmiliar with thc ~'om~tion on this and all attached docummts. I
PRINT N~,ne & Tide of Authorized Company Representative Sismture
a,tz, ous , u Emx S Page -7- or 7
CI~C~ DESCRIPTION
{
~-~Ca~go~ F~[ ]R~ve[ ]S~Rel~of~[~~H~(Acu~)[ ]~lay~H~(C~c)[ ]
Av~e ~y~omt
t Da~ on Si~ C~le ~ch M~: , F, ~ & ~ L L & S, O, N, D
[ ']
1 ) ~ORY SYA~S: N~ [ ] A~fi~ [ ] R~ [ ] ~l~fi~ [ ] Ch~ ff~ ~ a NON T~ ~ [ ] T~ ~ [ ]
2) C~on N~e: 3) ~T
Ch~ N~e:
~Ca~ F~[ ]R~five[ ]S~R~of~[
5) W~ C~8~CA~ON (S~t ~ ~ D~ F~ ~022) USE CODE
7) ~O~ ~ ~ AT FAC~ ~ OF ~~ 8) STOOGE CODES
~~D~ly~o~t L~[ ]~[ ]~[ ] a) C~
Av~e D~y ~o~t C~ [ ] b)
~ ~o~t c) T~~
~e~ 8~ Con~
ae ~ mo~ ~ 1) [ ]
ch~ ~m~n~ ~ 2).
~y ~ ~m~m 3) [ ]
[0)L~AHON