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Home My WebLink AboutBUSINESS PLAN usiness Name: Business Address: cus E & NO. - ~/ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ~)~/q-,~--~ NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT 'FINANCE CHARGE i. -- ~ OTHER ADJ CUSTOMER NAME ~-~ ~_Ctr)JD Cr~ ~"~- ~~\ ~ MAILING ADDRESS ~.,~'~ '~'-~Or~ ~ ~ ~ ~ . C,~ ~Er~'t ~¢ STATE O~ ZIP CODE~~~ SITE ADDRESS PARCEL NUMBER ADJUSTMENT' J CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT STATEMENT OF ACCOUNT CITY OF BAKERSFIELD P 0 BOX 2057 BAKERSFIELD, CA ~3303-~057 (661) 326-3979 DATE: 6/01/00 TO: RTB EQUIPMENT REPAIR 2004 ANTONiNO AVE ~AKERSFiELD~ CA Y~u~ CHARQE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT 5/01/00 BEQINNINQ BALANCE .00 HMO09 6/0i/00 HAZ MAT HANDLING FEE I i58.00 BSO0i 6/0i/00 CA STATE SURCHARQE 10.00 FOR QUESTIONS OR CNANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT TNE TOP OF TNiS STATEMENT. ~URR~NT .~gE,, 30 OVER 60 OVER 90 168~0~ DUE DATE: 7/03/00 PAYMENT DUE: 168.00 TOTAL DUE: ~168.00 ~AT~: &/O~/~O 9U~ DAT~: 7/03/00 REMIT AND MA~E CHECK PAYABL~ TO: PO BOX ~057 B~ERSF~ELD C~ 93~03-2057 (66~) 326-3979 OUSTOHER NO: ~i7g~ CU~TOH~R TYPE: TOTAL DUE: $i68.00 R T B EQUIPMENT REPAIR ~1 31~9 SiteID: 215-000-001908 Manager : ~1~ ~, ~/~ ? ~ I BusPhone: (661) 323-9188 ~ __ -- 'IMap: 102 COmmHaz : MOderate Location: 3004 AN'TONINO AVE ] . City : BAKERSFIELD ~ ~ ..... ~J Grid: 23D FacUnits: 1 AOV: CommCode: COUNTY STATION 66 SIC C~ode: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DENNIS BIRKS / BROTHER TERRY BIRKS / SHOP MECHANIC Business Phone: (661) 392-5756x Business Phone: (661) 323-9188x 24-Hour Phone : (661) 391-8654x 24-Hour Phone :. (661) 324-9070x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact : Phone: (661) 323-9188x MailAddr: 3004 ANTONINO AVE State: CA City : BAKERSFIELD Zip :.93308 Owner RONALD R BIRKS Phone: ~661) 324-9070x Address : 3004 ANTONINO AVE State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: ~ Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpe~HazIEpA HaZardsI Frm DailyMax 10nitIMCP ACETYLENE ~F.P IH G 500 GAL Hi AEROSOLS F P L Hi GASOLINE L Mod MOTOR OIL F DH L Min OXYGEN P R G 500 FT3 Low WASTE OIL F DH L 110 GAL Low I, '/"EAR~ ~Z~ Do hereby ce~i~ thru ~ have reviewed ~h® a~ache~ haza~ou$ m~edals mana§~- any correlites co~i~u~e a complete and co~e~ man- -~ R T B EQUIPMENT REPAIR SiteID: 215-000-001908 = Inventory Item 0003. Facility Unit: Fixed Containers at Site ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# ~ C~ OF %~ ~ ~o~ UP ~ooF,, 74-86-2 i = STATE ~ TYPE PRESSURE TEMPERATURE CONTAINERTYPE Gas /Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION { Largest Container I Daily Maximum I Daily. Average 250.00 GAL' 500.00 GAL 250.00 GAL %Wt. ' S CAS# ' 100.00 Acetylene N 74862 HAZARD ASSESSMENTS [ TSecretINO N ~S I BioHazNo Radioactive/AmountNo/ Curies FEPAp HazardsiH /NFPA// I .USDOT# HiMCP = Inventory Item 0005 Facility Unit: Fixed Containers at Site ~ivUVl~ ~Vl~ / ~£ ~.6x...l_~ ~Vl~ AEROSOLS Days On Site 365' Location within this Facility Unit · · ~Map: Grid: ~r CAS#' ~ STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Ambient I Ambient I METAL CONTAINR- NONDRUM I Liquid Mixture · Largest Container Daily Maximum Daily AVerage %Wt. ,RS CAS# 70.00 Isobutane No 75285 10.00 prOpane No 74986 20.00 n-Butane Or Butane Mixture No 106978 I TSoorot RS , BioHaz HAZARD AiSESSMENTS I RadiOactive/Amount EPA Hazards NFPA USDOT# MCP I No No J No No/ Curies F P / / / Hi R T B EQUIPMENT REPAIR SiteID: 215-000-001908 = InVentory Item 0006 Facility Unit: Fixed Containers at Site GASOLINE Days On Site 365 Location within this Facility Unit 'Map: Grid: CAs#. F STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid .{Pure Ambient Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Lar~est~'" ffr~-~ ,C°ntainer [ ~) 6--~t._,Daily Maximum Daily~ (~--.Average HAZARDOUS COMPONRNTS 100.00 Gasoline lq' 800661~ HAZARD AssEsSMENTS' lTSecretl oRSIBioHaz Radioactive/Amount I'EPA Hazards I' NFPA 'USDOT#'I MCP No N No No/ Curies / / /' Mod ---- Inventory Item 0004 Facility Unit: Fixed Containers at 'Site MOTOR OIL. Days On Site 365 LocatiOn within this Facility Unit Map: Grid: .' CAS# J~- ~q3 ~ ~O5Ot_f 8020835 Liquid /Pure- · Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average ' HAZARDOUS COMPONENTS 100.00 Motor Oil, Petroleum Based N . 8020835 HAZARD ASSESSMENTS TSecretI oRSlBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I'MCp No N No No/ Curies F DH / / ./ Min R T B EQUIPMENT REPAIR SiteID: 215-000-001908 = Inventory Item 0002 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: CAS# F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE I IAmbient I Above Ambient . Pure - Gas PORT. PRESS CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 250.00 FT3 500.00 FT3 ~50.00 FT3. HAZARDOUS COMPONENTS 100.00 Oxygen,'Compressed N ' 7782447 HAZARD ASSESSMENTS TSoorOt[RSIBioHazRadioaotivo/AmouBtEPAHazardsNFPAI~USDOT#MCp No No No No/ Curies P R / / / Low = Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site · 365 Locationwithin this Facility Unit Map: Grid: ~.~ CAS# ~U1~31 ~- ~0~, lO~'Er'/~)O~2.-I-iJ O~ ~D~ [~.,p ~_~¥~,,~ 221 STATE ~ TYPE PRESS~E TEMPE~T~E CONTAINER TYPE Li~id ~Waste' I A~ient I A~ient ' [ DR~/B~REL-NO~ET~ ~O~TS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 55.00 G~ 110.00 G~ ~ . 55..00 G~ 100.00 ~as~e Oil, ~e~roleum Based ~ ' ~Z~D ASSESSMENTS ~TSecret~ RS,BioHaz~ Radioactive~AmOunt, EPA Hazards, NFPA USDOT% MCP No~~~~No No No/ Curies F DH / / / Low 08/17/1999 F R T B EQUIPMENT REPAIR SiteID: 215-000-001908 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 08/17/1999 IN CASE OF OIL DRUM SPILLAGE, WE CALL COALS WASTE~ SERVICES. -- Employee Notif./Evacuation 08/17/1999 EXITING N, S & W DOORS, THROUGH THE S GATE MEET ACROSS THE STREET. IN FRONT OF JIMS TOWING FOR HEAD COUNT. Public Notif./Evacuation 08/17/1999 EXITING N, S & W DOORS, WHICH ARE CLEARLY MARKED WITH EXIT SIGNS. Emergency Medical Plan 08/17/1999 TAKE EMPLOYEES TO SAN JOAQUIN OR MEMORIAL HOSPITALS OR CALL LOCAL FIRE DEPT. 5 08/17/!999 F R T B EQUIPMENT REPAIR SiteID: 215-000-001908 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention '08/17/1999 KEEP ALL HAZ MAT IN CLOSED CONTAINERS. GIVE TRAINING ON.HANDLING OF HAZ MAT. ~ Release Containment 08/17/1999 KEEP HAZ MAT IN ONE AREA IE. OIL (OUTSIDE) AEROSOL (IN cABINETS) ETC. KEEp SAND NEAR THOSE LOCATIONS. SURROUND SPILL WITH SAND TO KEEP IT CONTAINED. ~ Clean Up 08/17/1999 CONSULT MSDS ON SPECIFIC HAZ MAT, PUT HAZ MAT INTo CONTAINERS. ~'~SEAL CONTAINERS AND CALL COA~LS WASTE SERVICES. Other Resource Activation -6- 08/17/1999 F R T B EQUIPMENT REPAIR SiteID: 215-000-001908 I Fast Format ~ Site Emergency Factors ~Overall Site Special Hazards --Utility Shut-Offs 08/17/1999 A) GAS - E WALL, OUTSIDE OF BLDG 30FT FROM STREET BEHIND CHAINLINK FENCE B) ELECTRICAL - E WALL, INSIDE & OUTSIDE OF BLDG C) WATER ' SW WALL, OUTSIDE OF BLDG (CORNER) D) SPECIAL - OXYGEN & ACETYLENE TANKS ARE INSIDE ON NW coRNER'OF BLDG E) LOCK BOX - YES, BY SW WALL, FACING ST NEXT TO ROLL UP DOOR · -- Fire Protec./Avail. Water 08/17/1999 PRIVATE FIRE PROTECTION - 2 SMOKE ALARMS IN BLDG, 3 FIRE EXTINGUISHERS INSIDE BLDG AND 1 OUTSIDE BLDG. NEAREST FIRE HYDRANT - APPROXIMATELY 150FT ACROSS THE STREET TO THE E OF FRONT OF BLDG. Building Occupancy Level -7- . 08/17/1999 ~/T B EQUIPMENT REPAIR SiteID: 215.-000-001908 ~ , ,Fast Format I/~ Training Overall Site ~i/-- Employee Training 08/17/1999 WE HAVE 1 EMPLOYEE AT THIS FACILITY. ~o ~o~ =v~ ~o= ~s~s s~s o~ ~i~?????????? ~S GIVE A BRIEF SI1MMARY OF YOUR TRAINING PROGRAM: TERRY BIRKS'HAS SIX YEAR OF TRAINING FROM THE US NAVY AS A FIREFIGHTERAND SAFETY EXPERT. -- ~age 2 ~ Held for Future Use Held for Future Use CITY OF'BAKERSFIELD. OFFICE OF ENVIRONMENTAL SERVICEs 1715 Chester Ave., Bakersfield, CA (805) 326-3979 - : '..~'',~.'~ :'"' ~/ax~ ~' / 1. To avoid ~er a~io~ re~'t~s fo~ ~n 30 days of receipt. '~~ ,. 2. T~E~ ~$~RS m ENGLISH. ': . 4. Be ~ brief ~d concise ~ possible. SECTION 1: BUS.SS ~E~ICATION DATA , '~ ~ D~ & B~S~ET ~~: SiC CODE: SECTION 2: E~RGENCY NoTWICATION CO.ACT TI~E BUS. PHO~ 24 ~. PHO~ HAZARDOUS MATERIALS MANAGEMENT 'PLAN MATERIAL SAFETY DATA SHEETS ON FiT:g-: - BRIEF SUMMAKY OF TRAINING PROGRAM: SECTION 4: EXEMPTIONREOUEST' · ' I CERTIFY UNDER PENALTY OF PER.ffJRY THAT.MY, BUSINESS IS EXEMPT FROM THE REPORTING REQ IKEM S OF C .HApTER 6.95 OF ~ ',C.ALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWlNGREASONS:?' ~ ~ .. WE Do'NOT HANDLE HAZARDOUS MATERIALS:"-· WE DO HANDLE HAZARDOUS MATERIALS, BUT THE rQUANTITIES AT NO TIME EXCEED .THE .MINIMUM REPORTING QUANTITIES. OTb-mR (SPECn r REAsoN) SECTION 5: CERTIFICATION .~ I. 'CERTIFY THAT THE ABOVE INFOKMATION 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.) ~kND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE tlAZARDOUS MATERIALS MANAGZM~NTPLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES ~ -.~-I1~ ~4S~ OF'OI L O£O~ 3Pt Ll~4~E i.Ou~ ¢_~LL. Oj34L,S B. EMPLOYEE NOTIFICATION AND EVACUATION: C. P~LIC EVACUA~ON: ... D. E~RG~CY ~DIC~ PL~:~ .~ -~.~ ._ . . It~ZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN A. . RELEASE PREVENTION STEPS: l/..e-~? ~qt.L /4~,~'r' .. t , ', , · :. !: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN- PROCI;.DURES:.~-.~-_. ___. .... ~s .~.~'~' ' '.-.. ~.~.. .....,., SECTION 8: UTILITY SHUT-OFFS {LOCATION OF SHUT-OFFS AT YOUR ....... . NATURAL'GAS/PROPANE: [('151.~ /,I_),CL[I i Oolitic. O~- bui }dl~n~. · ',,.,,. , I _ - LOCKBOX:- (~C) ....... IF-YES, LOCATION: hi ~"}l~~ ~()~/~, SECTION 9: P~A~ F~ PRO~C~ON~A~R AV~~ITY A. ~A~ ~ PRO~C~ON: ,. ~ .. ".. ~, B. WA~R AVg~IT~~ ~~): n~' o+' bo.ildrn~ . ' . 4 cITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 715 Chester Ave.' Bakersfield, CA (805) ~26-~979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BusINEss IS A FARM [ ] FACILITY NAME CITY %)Ql&~--~-/~l_O STATE ~ ZIP q~'~O~ NATURE OF BUSINESS ~m~L< ~~C ~~/& ~f . SIC CODE DUN & BRADSTREET NUMBER &b l 3 q- 9070 CITY STA~ EMERGENCY CONTACTS BUSINESS PHONE C~(~ [" ~P ~q 24 HOUR PHONE 'BUSINESS PHONE ,i~:~O'-~ "- q / ~ ~ 24 HoUR PHONE - ~_~'~/~ - C] (~717 (~ 1 of CI~E~C~ DESCRIPTION I)INVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check ifchemicai is a NON Trade Secret[ ]TradeSeeret[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: ' AHM [ ] CAS # 4 ) Physical & Health PHYSICAL HEALTH H~rd Categories Fire [ ] Reactive [ ] Sn,ttl~n Release of Pressure [ ] ImrnediateHealth (Acute) [ ] Delayed Health (Clu~ni¢) [ 5) WASTE CLASSIFICATION (3.digit code from DHS Form 8022) USE CODE 6) PHYSICAL STAT~ So~ia [ ] Liquid [ ] Cas [ ] Pure £ ]Mixture £ ] Waste [ ] Radi°active [ 7) Agotnvr A~rD TnVm AT FAc~rrY ~:0iqrrs 0F~gr~s, scrm~ ' '~) ST6RAGit cODEs : ' --- ' Maximum Daily Amount ... Lbs [ ] Gal [ ] fl3 [ ] a) Container:. Average Daily Amount Curies [ ] b) Pressure: Annual Amount e) Temperature Largest Size Container # Days on Site circle Which Months: All Year, $, F, M, A, M, $, $, A, S, O, N, D 9) MIXTURE: List COMFO~ CAS# % WT AHM the three most hazardous l) [ ] chemical components or 2) . [ ] any AHM components 3) [ ] 10)LOCATION I') INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check it'chemical is a NON Trade Secret [ ] Trade Secret 2) Common Name: 3) DOT # (optional) :. Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] S~dd~ Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) $) WASTE CLASSIFICATION (3-digit code from Dm Form 8022) USE CODE 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] ft3 [ ] a) Contsine~. Average Daily Amount Curies [ ] b)'Pressure: Annual Amount c) Temperature Largest Size Container # Days on Site Circle Which Months: All Year, J, F, M, A, M, ~', $, A, S, O, N, D 9) MIXTURE: List ... coMPONENT CAS# % WT AHlVi the three most hazardous I) [ chemical components or ' 2). [ any AHM components 3) [ 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with .the intbrmation on this and all attached documents. I believe the submitted information is ~ue, accurate and complete. PRINT Name & Title of Authorized Company Representative SignatUre Date