HomeMy WebLinkAboutBUSINESS PLAN SITE/FACI LITY AGRAM -
FORM $
NORTH SCALE: C/-~'/~/F~'BUSINESS ~A.ME :~/;fx)a4~.~ /~7/~/9 /~'~' FLOOR:/ OF /
(CHECK ONE) S~TE D[AGR.~ ~ ~ FACIL~ o~AGR~
,, , /.
(Inspector's Comments): -OFFICIAL USE ONLY-
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i .' '1
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BUSINE~ N~ME -.
II
HAZARDOUs MATEAIALS ~
BUSINESS'PLAN:Ag A WHOLE RECEIVED
' FORM 2A. ~g 1 5.1~9
, '-' I ~'a~ ~ HAL M~T. DIV.
I.. To avoid further action, mm~urn %hi= from within ~ days of
2. ~PE/PEINT ANSWER~ IN
'~. 6ns~er [he questions beloW~for [he business as a whole.
4. Be as b~imf and concise a~ 'possibl~. -' .'~'
SECTION ~.: ...BUSINESS ~D~MT[F~h%ION ~RTa .....
~ECTTON 2: EHERG/N~Y NOTIF~C~TION~ ~.
In case of an em~r~amc,t involvin~ the r~laase or threatened
a ha=ardou= mm.~erial call ~I and 1-8ee-aSZ-?~E~ or 1-~1~-427-4~4t
~ill no~[f,/'your local fir~ d~ar~men~ and [he ~[ata Office of E~rgsnc7
~,/ice~ as raouir~d by law. ' "'
E~PLOYEES TO NOTIFY [N C~SE ~F E~SENCY:
NA~E ~ND TITLE ' '~: ' ' BUR[NO BU~. HR~. ~FTER
8. _PH~ PHS
SECTION 3: LOC8T~ON OF UTTLI~ ~HUT-O~F~. FOR.SU. STN~ .R~ ~ WHOLE
B. ELECTRZC,~L: ~:,~
C. WATE~: ~ ~
O. SPECIAL: ][l
[F.'(E~, OOE~ IT CONTAIM 3!TE PL~NS~ '(E~ M~S? ';E~
FLO0~ PLRNS? YEE KEY?
SECTION .t: ~.c.!U~T~ RESPONSE TE,~M FOR BUSINESS ~S ~ ~H,3LE
' '"'""COPY
EMPLOYERS ~RE RE'3UIREQ TO H~VE A TRAINING PROGRAM WHICH PROVIDE~ EMPLOYEES
WITH INITIAL ANO REFRESHER TRAINING IN THE S~FE HANDLING OF HAZAROOUS
M~TER!6LS.. : :'~ .~ .;,_.../ : ..
· . ~ ~.~ _
A. NUMBER OF EMPLOYEES AT THIS FACILITY -~
MATERI~L YOU H~NQLE ?
C. GIVE A GRIEF ~UMM~RY OF YOUR H6Z~ROOUS MATERIALS TRaiNING PROGRAM:
.. ,- ,,.~ . f.
I CERTIFY UNQER PENALTY OF PERJURY THaT MY B:JS!MES~ !S EXEMPT FROM THE
REPORTING REQUIREMENTS OF CHAPTER ~.~S OF THE C~LIFOR'NiE HEELTH 6NO SAFETY
COOE FOR THE FQLLQ~4ING EERSONS.C'
' -- ;'Z:,. :.' - ; '
WE O0 NOT H~NDLE H~'ZER~'ou's' MATER!~LS.
14E O0 HANOLE HAZEEOOUS.MATER!~LS, BUT THE OUMNT!TIES AT NO
TIME EXCEED THE MINIMUMeREPORTING QUANTITIES.
OTHER (SPECIFY RERSON).,
SECTION 8: CERTIFICATION
I, ~ ¢~rtify that the above information
accurate. I understand t~atL~his"inforMation will b~ used
s ~= .h and ~aCsty cod~ on
firm' obligations under the n~ C~!i~orni~ H.-I+ '
H~z~rdous Hat~ri~l~ (Oiv. 2~'gHa~{er'8.gS Sec. 2EE.~ Et ~!.) mhd that
in~c~urs~inforM~tion gonstitu~s'
~" .. BAKERSFIELD CITY FIRE DEPARTMENT
NON--TRADE SECRETS
HAZARDOUS MATERI ALS INVENTORY
f, USINESS NAME: ~C~V~C~~eC ~u tr,~WNER NAME: ~m~ FACILITY UNII'
PIIONE fi: ~-~-~/~ PflONE' ~: OFFICIAL USE
ONLY
; 2 3 4 5' 6 7 8 9 10
%'PE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD
~DE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COM,.ON NAME CODE GI;IDE
AME: TITLE: SIGNATURE: DATE: ~-/~- ~ff_.
7,1ERGENCY CONTACT: ~~ TITLE: ~~ PHONE $ BUS. HOURS:~~g~_.
~ AFTER BUS HRS:
;,IE~ENCY CONTACT: _ TITLE: PHONE ~ BUS }{OURS:
~: ·~ citY'of Bakersfield jab!. .... '"~ " " ,
' · ~'17 ~,' 19'91
Bakersfield~ Ca. 93303r2057
Re:Hazardous Materials Handling Fee
Acct. 9 389901
Dear Sirs,
This letter is to inform your office that Creative Consumer
Products is no longer doing business in the state of
California. The company relocated out of state on Aug. 1,
1990.
Please remove our name and registration from your records.
~tcarter j~
CREATIVE CONSUMER PRODUCTS, INC. P.O. Box 4997, Las Cruces, NM 88003
' (505) 527-0018 ...... FAX (505) 527-0227 ......
P.O. BOX
2057
B
BAKERSFIELD,'. ,, C~LIFO~NIA 935
L ~ADDREs~ CORRECTION ~EG
DO
HOT
*:*'- ~ ?' , ~ ........ * 2000~'AVON AV
*: ,~; ,~. .LEAKERS.FInD.' CA' 93304
. . . . .. . :.- :..'~" .-:. .: -.
:... ,~."..- :~ . '.. ....