HomeMy WebLinkAboutBUSINESS PLAN SITE/FACILITY D I AG R~d~I
FORM
NORT~ SCALE ~ BUSINESS NAME: FLOOR: OF
DATE: / / FACILITY NAME: UNIT #: OF
(CHECR ONE) SITE DIAGRAM FACILITY DIAGRAM
HMCU-13
~'~ Bakersfield Fire Dept. RECEIVED
-~ Hazardous Materials Division [NOV,, 2 1 1990
2130 "G" Street
HAZ. MAT. DIV.
Bakersfield, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
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 b~siness as a whole.
4. Be brief and concise as possible.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: d"/~]]/c~ )~ /
MAILING ADDRESS:
~:~6 Tx,~ z.~.~ ~--2~'~ ~1
DUN · BRADSTREET NUMBER: SIC CODE:
PRIMARY ACTIVITY: ~/ ~ .~
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR. PHONE
FD15c'
Bakersfield Fire Dept.
0~iV~,-3~'~;~¢~, Hazardous Materials Division
0~!¥! t ~ ¥~,h~ HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REQUEST:
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
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
~ATION ~S ACCURATE." I' UNDERSTAND.THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HA~RDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC.. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
FDI59,-
November 21, 1990
Mr. Ben Fitzgerald
Chaparral Petroleum Inc. (Apache Lease)
4125 Ming Ave.
Bakersfield, Ca. 93309
Dear Mr. Fitzgerald~
In reviewing the paperwork you submitted regarding the
Hazardous Materisls Handling Fees, we find that you will be
responsible for the bills already billed. However, we will exempt
you for the 1900 - 1091 fiscal year forward and a follow uD
inspection to verify its inactive status will follow at some future
date.
If in the future you make the Titus Lease inactive please
notify us immediately so we can mske you'exempt for that well also.
Sincerely,
Valerie Penderg~ass
Hazardous Materisls Division
Page: 1 Accour, t Billing/Collection Activity Inquiry SUTL108
Acct : 419601 Cyc St CL Bill St: NO Cyc: 5 Rt: ~ Seq:
SSN : Parcel: .... Svc Cls :e
Nar~e : CHAPARRAL PETROLEUM INC(APACHE)
Svc Add: .SE SEC7' 18 T29S R29E KERN BLUFF
Amt due: 503.72 Current Period Postings
Lst Pmt: Type Des[ Date Ar,~ount Receipt
Prat Dte: B91 PENALTY 05/01/90 22.50
-- Pri6r Bills -- B92 FINANCE CHARGE 05/01/90 6.7'7
Date Balance B92 FINANCE CHARGE 06/30/90 4.79
02/15/90 225.00 B92 FINANCE CHARGE 08/01/90 4.84
02/10/89 225.00 B92 FINANCE CHARGE 09/01/9[) 4.89
B92 FINANCE CHARGE 10/01/90 4.94
B92 FINANCE CHARGE 11/01/90 4.99
Enter '/' For Billing Hist,z, ry, 'P' To Prir~t Report, 'D' F,z,r Detail Page, ,z,r
ALT-F10 HELPI ADDS VP IFDX I 1200 E71 J LOG CI_OSED I PRT OF'F' J CR I CR
Page: 2 Accc, ur, t Billing/Collectior, Activity Ir, quiry SUTL108
Acct : 419601 Cyc St CL Bill St: NO Cyc: 5 Rt: Seq:
SSN : Parcel.: .... Svc Cls :e
Nar,~e : CHAPARRAL PETROLEUM INC(APACHE)
Svc Add: .SE SEC'[ 18 T29S R29E KERN BLUFF
Readings Cons Prey Rdg Curr Rdg Cons
02/15/90 Arnour, t Misc Transact ions
Fwd: $225.00 Type Des[ Date Amount Receipt
Water:' $0.00 FFG ** Not on File ** 02/15/90 225.00
Sewer: $0.00
Misc: $225.00
Cred: $0.00
"rc, t a 1: $450.00
Enter '/' For More Billing History, 'D' F,-,r Detail Postir, gs, '/C' fc, r Credit an
ALT-F10 HELP I ADDS VP IFDX I 1200 E71 I LOG CLOSED I PRT OFF' I CR I CR
BAKERSFIELD, CA 93301
(805) 326-3979 ~--~7
OFFICIAL USE ONLY
ID#
BUSINESS NAME
HAZARDOUS MATERI ALS
BUSINESS PLAN AS A WHOLE
F ORM 2'A
I. To avoid further action, return this form b~
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. ~
~ f '""-'""~l, ]
SECTION 1: BUSINESS IDENTIFICATION DATA
A. BUSINESS NAME: £haDarral Petroleum Inc. Apache Lease .
B, LOCATION / S-T~..~.S.%,~S.E. ~ sec. 18 T~95 R2~,.E Ker~ Bluff Field
CITY: aa~rsfield: Ca. ZIP:none qc"~O~ BUS.PHONE: ( 805 ) 834 5234
SECTION 2: EI~ERGENCY NOTIFICATIONS
In case of ah emergency involving the ~elease or threatened release of a
hazardous material, call 911 and 1-800-852-7550 or 1-916-427-434]. 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:
NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS.
A. Dan a. Marrintt Fnrman of 0perationsPh#805 834 5234 Ph~ same
B. a~n M Fit?g~rald Pres. Ph# 805 834 5234 Ph# same
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: Nome
B. ELECTRICAL: "main" 75 ft. s.w. of storaqe tea ks
c. WATER: Nome
D. SPECIAL: Nome
E. LOCK BOX: YES /~_,,)IF 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 WHOLE
Any crude Oil spills shall be cleaned up by contract equipment and
personal, All fires shall be turned o~er to the fire Dept.
SECTION 5: LOCAL' EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
Closest HoPital LEmergency Room
SECTION 6: EMPLOYEE TRAINING
EMPLOYERS.ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
m. METHODS FOR SAFE HANDLING OF HAZARDOUS
WITH RESPONSE AGENCIES: .......................... ,~F~E~/ NO ~ 50
C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ SO ~ NO
D. EMERGENCY EVACUATION PROCEDURES: ................. NO NO
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ YES ~
SECTION 7: HAZARDOUS ~ATERIAL
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN S00 POUNDS OF A
SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO
I, ;')~ ~. A,f~,~-~ , certify that the above information is accurate.
I understand that this information will be used to fulfill my firm's obliMations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
Sec. 25500 Et A].) and that inaccurate information constitutes perjury.
- 2B ~
BAKERSFIELD CITY FIRE DEPARTMENT
2130 "G' STREET
BAKERSFIELD, CA 93301
OFFICIAL USE ONLY
ID#
BUSINESS NAME:
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM SA
INSTRUCTIONS 1. TO avoid further action, thts form must be returned
2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.
3. Answer the questions below for THE FACILITY UNIT LISTED BELOW
4. Be as BRIEF and CONCISE as possible.
FACILITY UNIT# None~ . FACILITY UNIT NAME: ADache ]ease
.SECTION 1: MITIGATION, PREVENTION, ABATEMEN~r PROCEDURES
The tank farm is enclosed in a dirt berm,
Any spill shall be pumped up and the surface c]eamed acc,o~d,i~ogt~o county regulations.
SECTION 2: NOTIFICATION Al%~ EVACUATIO~ PROCEDb~ES AT THIS L~IT ONLY
Th~§ facility is in the open, and all employee's have two way
radio's for contact with supervisor
.~u, continue w~ta SE 7'fOX 4.
Are any of '-~-
.,'?,- r, ~. marked: NON-TRADE ( 0:,'~'?''.r,~) ONLY ~ .
TRA')E SECRETS ONLY ' · J.;: -,-
. ,,~,e ?,: f.: '~ *'~" '
s?'-'_?,. .0. ,,. ,.is: cn],V' ',:~? ,.)'~e. :~ecre1..'z- oll form 4:-~.--~
4' ~';x~A~5 FIRE PROTECTCO7
None '
'::. "" ") .LC_;.L::".;''t~', OF UTILITY? ': ',?.. :"v,- ':,' ...... S
.... ,-:;.; .................. ~ ,.:. .... : ...... : _ % .~ .'. UXTT Oh'[."/'.
propane: none
~:~' "~;"' "Main" 75 ft. sw of tank battery
none
none
BAKERSFIELD CITY FIRE DEPARTMENT
I.D. ~ FORM 4A-1 Page ] of
NON--TRADE SECRETS
HAZARDOUS MATERI ALS INVENTORY
BUSINESS NAME: Apache lease OWNER NAME: Chaparral Petroleum Inc. FACILITY UNIT #:__
ADDRESS: ~c. IR T29S R29E Kern LBluff Field ADDRESS: 4600 W. Americam Ave/ FACILITY UNIT NAME:
CITY, ~[,?: /Bakersfield CITY,ZIP: Bako~rsfield. Ca. 93'309
PHONE ~: 805 S3d 5234 PHONE #: 805 834 5234 [OFFICIAL USE CFIRS CODE
! ONLY
I 2 3 4 5 6 7 8 9 10
'YPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T
?DE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE
P 500 350 b. bls 02 37 entire facility 100 15 gravity crude oil ~"73~ FLLQ
NAME __[lnn Ft. Marriott TITLE:FormaL of Op.erationsSlONATUR(~: ,~ Jrt,., C/Lff' ~z.//~,-~,~C] DATE:
~ME~GEN(~Y CONTACT: Don H. Marniott TITLE:FormaL of 0peratXfon~ PHONE'# -BUS HouRS: 805 8345234 -
AFTER BUS HRS: same
EM~E~RGENCY CONTACT: Ben M. Fitzgerald TITLE: Pres. PHONE m BUS HOURS: 805 834 5234
PRINCIPAL BUSINESS ACTIVITY:__ crude oil production AFTER BUS HRS: same
SI TE/FACZ LI TY D T AG R~I
INor"'.tt I SCALE:,, ._,USINESS NAME: .SLOOR: OF
DATE: / / FACIf,[TY NAME: UNIT #: OF
(CHECK ONE) SITE DIAGRAM .~ FACILITY DIAGRAM
lnspectoc's Comments): -OFFICIAL USE ONLY-
HMCU-13