HomeMy WebLinkAboutBUSINESS PLAN TO: Nina Mayer~ Accounts Receivable
FROM: Ralph E, Huey~ Hazardous Materials Division
SUBJ£CT~ Rucker's Mortuary
Nina~ account # HM 467101 has a charge for the 1989-1990
fiscal year. They went below the minimum quantities in May~ 1989
therefore making them exempt from this billing. They are~ however
still responsible for 87-88 and 88-89 billings. This account
.should be closed with only a bslance for 2 years on. the books.
If you have any questions please don't hesitate to call.
Thanks
JOEL DEL. RUCKERi CONSULTANT
~,,~. S. DEL. RUCKER, OWNER
· DUCKI I 'S MODIUADY
a Friendly and Courteous Service
12460 VAN NU¥S BOULEVARD 30! BAKER STREET
PACOIMA, CALIFORNIA 91335 BAKERSFIELD, CALIFORNIA 93305
PHONE; 899-1138
PHONE 322-2001
MARCH 17, ].985) RECEIVED
HAZ. MA3'. DIV.
HAZARDOUS MATERIALS DIVISION
CITY OF BAKERSFIELD
P.O. BOX 2057
. B~KER~SFEILD,' ._C~_~L.I_Fp__RNI~ .93303-2057
GENTELMAN:
FOR SOMETIME YOU HAVE BEEN BILLING ME FOR HAZARDOUS MATERIALS HANDLING FEE.
YOUR INSPECTOR WAS OUT HERE AT THE BEGINNING OF THE PROGRAM WHO SAID THAT
IN ORDER TO BE CONSIDER ON THIS PROGRAM YOU WOULD HAVE TO HAD SIXTY GALLON
OF HAZARDOUS MATERIALS. WE ARE SMALL OPERATE IN FUNERAL INDUSTRY AND WE
NEVER CARRY THAT MUCH OF HAZARDOUS MATERIALS AT ONE TIME.
I CONTACT THE BONDOL LABORATORIES, INC. AND THEY SUBMITTED A MATERIAL SAFETY
DATA SHEET, A COPY OF WHICH WE ARE SUBMITTING TO YOU FOR YOUR INFORMATION.
THANKS FOR YOUR ASSISTANCE IN THIS MATTER.
SDR/eg
RETURN PAYMENTS TO: PLEASE MAKE CHECKS PAYABLE TO..
i CITY OF BAKERSFI'ELD H~Z~D~U-~ ~.~TER~L~ ]D~[~ '~ :'
P.O. BOX 2o~7 < CITY OF BAKERSFIELD
HAZARDOUS. ~,TER. IALS ~AN~Li~N~ FEE P~v~o'u~ Bmlar~c~ .' O. .
""' ' .<" .4' 0-~'-Al1171 ''
ANNUAL F'EE ~. ' : , '. :', ,-
~00.
O0
:, '. : , --,~,- ;."/,. to~l .Cu~rer,<"~ ~ 1I .1OO. O0
s',r~LL ~S DUE-UPON'RECEIPT(:-~ ~ ' , :
~ .... " .;;,,: , f..' . . i ?, ,',' , ..
....,-.-;':'.;4;':.'.;:' , : . .,.. ..... . : ,
INQUIRIES ~NCERNING THIS BILL, PLEASE PHONE: 32~,~3.~7~ ' '.
~ 2210E3 R.UC'.4E~ ~R TUARY'
INVOICE NUMBER ~0~ ~KE~ ST
REMI~ANCE CoPY
RETU.RN PAYMENTS TO- '-/
· ~ ~ITY OF BAKERSFIELD '~" . ' "
~P.0. BOX 2057 HAZA. RDClUS ' PIAT£RIALI~ J~VZSZON' PL~SE ~KE CHE~KS PAYABLE TO: '
.BAKERSFIELD, CA 93303-2057 ACCOUNT NO. H~-OI~ ' CITY OF BAKERSFIELD
'HAZARDOUS MA~ERI~S HAN~i.N~ FEE
.TOTAL. NON, DUE . x... ~. I00, 00~".
F~ATERIAL SAFETY OATA SHEET
Bondol Laboratories, Inc.
P. O. Box t90
~fiadison, AB 723'59
501.-633-2231
PRODUCT ~O_.ESI 8NATI ON:
TYPE: Cavitv Embalming Fluid
Chemical Oescriotion Cas.~
Aldehyde:Formalin 50-00-0 ) lpp~
Alcohol:lYlethanol 67-56-1 200 ppn
PHYSICAL DATA:
Boiling--(OF): 189-212 Specific Gravity - I ,06
Vapor Pressure Unk Volatile..~/~ 100
Vapor Density
~]ater Solubility 100% p-~'. 5,7-6.8
Odor, Appearance: Light green, sharp odol
I
media for E×tin ~ate~ s~rav, dr chemical"
......................... ~C~'' ..................... : ...... .~_ . ~ ~ . ~_~..~...,,q u i s h i n q ...........
Fire F~qh~i~ Procedures ~_~~r~gn~ained'brea~hinq q~ar,
IN C~se oF Fire: Ume ~~~hemical f~r smail fires.
b~ mashLnn ~nd..,.~_lo~dLno
,~seful Eo~ doino a~ay m~_~.b__~o_~.].)~.. Do'a~i~h ~eakinO containers.
Ne utraliz~.~.~b ammo n ~ ~._.D.y~.I ..... .
HEALTH HAZARO OATA
ACUTE EFFECTS OF EXPOSURE:
Inge.~tion: Causes severe burns of mouth, throat and stomach, pale-
ness, ~eakness, ringing of ears, and headache ~ith possible loss of
consciousness; blindness or death may occur.
INHALATION: Irritating to upper respiratory tract.
SKIN: Contact causes burning, drying, cracking, scaling, and bleaching.
Eyes: High vapor concentrations or contact causes tearing and severe
irritation. May cause severe damage and b'lindness.
FIRST AIO PROCEOURES:-
INGESTION: Induce vomiting of conscious patient immediately by giving
2 glasses of water and pressing finger down throat. Contact a physician
immediately.
INHALATION: Remove to fresh air.
Skin': Remove contaminated clothing and ~ash ~ith large amounts oF soap
and ~ater.
EYES: Flush eyes ~ith ~ater 15 minutes. Contact a physician immediately~
5PILL ANO LEAK PROCEOURES: Absorb on paper or absorbent material
(Hardening Compounds) and place in fume hood or closed pail.
~ASTE OISPOSAL ~IETHOO: Incinerate or use with hardening compound in
abdominal cavities. Rinse empty bottles 3 times with 2 ounces of' water.
SPECIAL PROTECTION INFORMATION: NIOSH-~lSHA' approved fromaldeh~de
respirator for respiratory pro~ection.
VENTILATION: Required to keep formaldehyde vapor concentration below 1 ppm.
PROTECTIVE GLOVES: Neoprene, polyeLhylene.
EYE PROTECTIOI,I: Use chemical sp!ash goggles.'
SPE C.I AL PREC-AUT I O~S
PBECAUSIONS TO E.E TAKEN IN HANDLING AND STORING: Do not store for pro-
longed periods bblqm. 50"'F or above 120~F. Keep awa~ from heat, sparks,
and flame~. . ·
REP, iEP, iBER: "THE LIFE YOU SAVE ~AYBE YOUR'O[~JN! "
~flATER!AL SAFETY DATA 'SHEET
Bondo! Laboratories, !nc, I
P. O. 8ox
rfiadison, AR 72359
PROOltCT D_E S I G N&.T.J~_B_.Nj__
TYPEs Artemimi F_mba]ming .F1ui. d. ...........
SPE£TFIFt N~_.5_. T.
Chemical Description Cas # mt % Exp. Limits
Phenol 1 08-95-2 2-3 5ppm
Formaldehyde 50-00 30 ! 1 ppm
r~ethy! Alcohol 67-56-1 5-20~ 200 pp (skin)
Physical Data:
Water solubility: 100%
Odor and Appearance: Clear/orange red, piinchint odor '
Vapor Density: I Evaporation Rate: s io~er ban ?~qethanol
Vapor Pressure: 65 .at 70k
v~,,m_~ v~!~?_~b~ ~%5~99- .~/ .......... .. ~, . .........
?
8oi~ino_ Point: 150-21~°~ ~pecif~c mravit. ,, .~y_ l ,05
Fire and E. xplosion Oa_t~ ................................. : .......................................
Flash poSn.~: 119°F (pe_ns~ ma~ns'.
Flamabl,g Limit: lomer that m~.~O[ ~ ...... :?. .
Fxt~O..~h~pq ~fiedia~ mate ~[~y,_ carbon dioxide
Fq~ F~tioc~ Prec~rall pro[e~i~'.ga=men[s, including
boots, hel~nk, .and breathino aopara[us~.~[x~psi:~O~ [s doubtful.
~*~ctivStv ~-~ be c ~ ~
.... u~a: au~_ous abou[ ~ rsn'o acids o~ kaliesL_
ro'rmaldehvce cas and cnlorides. .
HEALTH HAZARD OATA '
ACUTE EFFECTS OF EXPOSURE:
IngeStion: Causes severe burns of mouth, throat and~stomach, pale-
ness, meakness, ringing of ears, and headache mith possible loss of
consciousness; blindness or death may occur.
INHALATION: Irritating to upper respiratory tract.
SKINs Contact causes burning, drying~ cracking, scaling, and bleaching.
Eyes~ High vapor concentrations or contact causes tearing and severe
irritation. May cause severe damage and blindness.
FIRST AIO PROCEDURES:
INGESTION: Induce vomiting of conscious patient immediately by giving
2 glasses of water and pressing finger domn throat. Contact a physician
immediately.
INHALATION: Remove to fresh air.
Skin: Remove contaminated clothing ,and mash mith large amounts of soap
and water.
EYES: Flush eyes with water 15 minutes. Contact a physician immediately.
SPILL ANO LEAK PROCEOURES: Absorb on paper DC absocb~ent material
(Hardening Compounds) and place in fume hood or closed pail.
~ASTE OISPOSAL R1ETHOD: Incinerate or use with hardening compound 'in
abdominal cavities. Rinse empty bottles 3 t-imes with 2 ounces of mater.
SPECIAL PROTECTION INFOR~ATION~ NIOSH-~SHA' approved fromaldeh~de~.
respirator for respiratory protection.
VENTILATION: Required to keep. formaldehyde vapor concentration belom ] ppm.
~PRO-T-E-CT'IVE GL-RVES:--N~eop-r'e-ne', po'iyeL-hylene.
EYE PROTECTIOI~: Use chemical splash goggles.~ .~.
S F'E£.I AL PREGAiJTI ONS
PRECAUSION5 TO EE TAKEN ~N HANDLING AND STORING: Do not stor'e for pro-
longed periods below 50"~F DC above 120~F. Keep ama~. from heaL, spacks,
and f lan...es.
REI~.iEP, iBER: "THE LIFE YOU SAVE ~fiAYBE YOUR O~JN! "
CITYc BAKERSFiE£D
RRE DEP~R~E~ 2101
0. S. NE~M ~~.
FIRE CRI~ ~1
Enclosed I~lease find a copy of your response to the Hazardous Material Business
Plan ~request. We have found it necessary to reject your plan for the following
reason(s) as checked below.
~ Ill~ible Business Plan (please print or t~e infomation in English).
Fora 2A ~ Missing or~comolete ~~_
Form 3A ~ Missing or ~ Incomplete .
Fo~ 4A ~ Missing or.Incomplete
This is to be cor~cted a~esubmitted within 30 days to:
Bakersfield City Fire Department
Hazardous MaCe~ials v~k
2130 "G" Street
Bakersfield, CA g3301
If additional copies of any fo~s are needed they can be picked up from the
Hazardous Materials Division at 2130. "G" Street in person.
Sincerely Yours, y
Hazardous Materials Coordinator
INSTRUCT! ONS:
1.. To avoid further action, return this foCm by
2. TYPE/PRIS~r ~%SWERS IN ~GLISH.
3. ~'~e~ the questions below fo~ the business as a whole.
4. Be as b~ief and concise as possible.
SECTION t: BUSI.N'ESS !DE~fTIY!CATION DATA
A. BUSINESS NAME: RUCKER'S HORTUARY
B. LOCATION / STREET ADDRESS: 301 BAKER STREET
CITY: BAEERSFIELD ZIP: 93305 BUS.PHONE: (805) 322-2003
SECTION 2: EMERGEN¢! YOTIF!CAT!0NS
In case of an emergency involvin~ the uelease oF threatened r~iease of a.
hazurdous material, cull 9~1 and !-800-852-7~0 ou 1-916-427-4341. This will notify
your Ioc~! fire depur%men~ and ~he Stu~e Office of Emeusency Services as required by
law.
EMPLOYEES TO NOTIFY IN CASE OF ~tEROENCY:
N~E AN13 TITLE DURING BUS. h~RS. AFTER B~S. ERS.
A. 3ESSE STEPHE~S0~ Ph~ 322-2001 Ph~ 325-9154
B. ROBERT BROWN PhC 322-2001 PhC 324-5189
SECTION 3: LOCATION OF UTILIT? S~I]T-OF~S FOR BUSINESS AS A W~OLE
A. NAT. GAS/PROPANE: ~NEXT TO GARAGE DOOR.~ ~HE NORT~/~AST STDF
B. ~LECTRICAL: GARAGE
C. WATER: ACROSS THE STREET ON CORNER OF BAKER & OHICO STRERT
g. SPECIAL :NONE ,/
IF YES. DOES IT CO)'TA[:.; SrTE PLANS? YES ,,/'.~.~. :4SDSS? YES ./
NONE
SECTION ~: LOC,IL EMERGE.~TCV .~.E'DIC.'~L .~SSISTANC2 FOR YO%'R ~USi.YESS .IS .l WHOLE
NO>TE
SECTION S: 574PLOYEE TRAINING
E:,.'.Pr_G'.,'~.~RS ARE REQUIRED TO HAVE A ?ROGRA,',I ~HiCH ?ROVi.DES
RE~'RESHER TRA£XiNG IN THE FOLLg, WI:;G AREAS.
CIRCLE YES OR .YO iNiTiAL REFRESHER
A. ZETHODS FOR SAFE HANDLING OF HAZARDOUS ,~~
.~5~T~R !ALS: .......................................
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: ..........................
.Y0
C PROPER USE OF SAFE?f ~ ' u ~-- YES~ YES NO
· ~QL Ir: .E., ~: ..................
. .,~,'~XJ.~: ................. '-~
-' D0 YOU "* ~"~ ~? -'mr ~,,=- ~=~ rvr-,~. RECORDS: ....... Y
~. .'u~ ~.., ~.-~ ~ ,~ C.;.'.,'- -- ~ C Lr' ~ ~x.~, ~.,~
SECTION 7: ~Z~DOUS
SOLID, SS GALLONS 0F A LIQUID. 0R 200 CUBIC FEET OF A COZPRESSED GAS: ...... YES,~0~
[. S. DEL. RUCKER certify that the above informaEion is accurate.
I un~erst~d tha~ ~his information will be used to fulfill my~,,m~:- 's obl~yaE!ons. . under
the new California ~eaith and Safety code on Hazardous Zaterials (Div. ~0 Chapter 6.98
Sec. Z~00 Et Ai.) and fha5 inaccurate informa¢ion constitutes perjury.
BAK£RSTTE'_LD CiT':' T'ET-. DE?AET:iE:,TT
2!50 ",q"
BAKEP. ST~ELD, ,q..'\ 9,-3301
OFFiCiAL ifFE
iD= 95-153-8089
BUS i>~ESS .YA?~E: RUCKER'S MORTUAIEC
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS
1. To avoid further action, this form must be returned by:
2. 'TYPE,'PRINT YOUR ANSWERS IN ENGLISH.
S. Ans,~',z,- the questions below for THE FACILITY UNiT LISTED EELOW
4. Be as BRIE? and CONCISE as possible.
FACILITY UNITe FACILITY UNIT NAME: RUCKER'S MORTUARY
SECTION 1: ~ITIGATION~ PREVEWFION, ABATEME~-F PROCED%~ES
NONE
" SECTION -~'_..YOTIFiCAT!ON A:Nq] 'v,~C'''"'r~''r_,.~.~._,~.~ P.P, OCEDL,~ES .~,"" T'~rS ...... Ux:i? 0:TLY
NONE
SECTION 3: HAZARDOUS MATERIALS FOR THIS I~iT ONLY
A. Does this Facility Unit contain Hazardous Materials?. ~ E~. NO ~.~
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trude Secret YES NO
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form =4A-l)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (yellow form ~4A-Z) in addition to the non-trade
secret form. List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION
~70NE
SECTION $: LOCATION OF WATER SL~PLY FOR USE BY EMERGENCY RESPONDERS
IN FRONT OF BUILDING, FIRE PLUG IS ACROSS TIlE S.TREET ON CORNER
OF BAKER & CHICO,
SECTION 6: LOCATION OF UTILITY SEro'F-OFFS AT THIS b~IT O~Y.
A. NAT. GAS,PROPANE] NEXT TO BACK DOOR IN GARAGE,(NORTH EAST SIDE)
ELECTRICAL: IN GARAGE
I
'C. WATER: FRONT OF MORTUARY ACROSS THE STREET, CORNER OF BAKER/CHICO
D. SPECIAL: NONE
LOCK BO.Y: YES YES, LOCATIOk':
IS '..'ES 2,[T..E P:LA,',:S,? v:S ',-r, ,. .... .,. -.-~ · .-,-.
..... '. ';'-.-4 .'~S,-;:-'": '~
~ 2 3 4 5 6 7 8 9 10
YPE MAX ANNUAL CONT USE I, OCATION IN THIS ~ BY IIAZAR
ODE A~I()HN~_~MOUNT UNIT CODE ~.~.I~_AC[LITY UNIT NT. ClIE~I_(~A~ OR CO~ON NA~IE CODE
t:HERBENCY CONTAET: ~~ TITI, E: ~ PllONE g ~US'
I:.H:~RBENCY CONTACT: 0}~ '~~ TITLE: ~V~P PHONE t BUS HOURS:
I'RiNCIPAI, BUSINES9 ACTIVITV:~ AFTER BIJ9 HRS:
RECEIVED
E.RSFTETD', . *. CI~f FIRE DEPARTM
z~o "~" s~z MAY 2 5 1988
B~ERSFIELD, CA 9330~
(805) 326-39?9 ~8'~ ......... ;..
IR O~FIC:AL USE ONLY /o~-~Tqd~
UCKER'S MORTUARY ID~ 95-153-8089
001288' |
USINESS
FORM 2A ,
INS~UCTIONS:
1.. To avoid further action, return this form by
2. ~PE/PRINT ANSWERS IN ENGLISH.
3. ~er the questions beto~ for the business as a ~hole.
4..Be as brief ~d concise as possible.
SECTION 1: BUSI~SS IDE~IFICATION DATA
A. BUSI~SS NA~: RUCKER'S MORTUARY
B. LOCATION / STREET ADDRESS: 301 BAKER, STReET
CI~: B~DERSFIELD ZIP: 93305 BUS.PHONE: (805)
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or threatened release of a "
hazardous material, call gl! and 1-800-8~2-?~0 or 1-g16-42~-4341. 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. JESSE ST~PHENSO~ Ph~ 322~200!
B. ROBERT BROWN Ph~ 32~.~2001 Ph~ 324-5189
SECTION 3: LOCATION OF UTILITY St{UT-OFFS FOR BUSINESS AS A WROLE
A. NAT. GAS/PROPANE: /NEXT TO GARAGE DOOR.%N"~~ NORTH/EAST RTD~
B. ELECTRICAL: GARAGE
C. WATER: ACROSS THE STREET ON CORNER~OF BA.KE~& ,CH~CO sTREET
D.
SPECIAL:NONE
(NO~ YES LOCATION:
E. LOCK BOX: YES
2A -
SECTION-~: PRIVATE RESPeNSE T~AM FOR BUSI~ESS AS A WHO£F~
NONE
SECT!OM 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YO~YR BUSINESS AS A WHOLE
NONE
SECTION 8: EMPLOYEE TRAINING
E}!PL01~-SRS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH r¥~,r..,~.~ AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR N0 INITIAL REFRESHER
A. METHODS F0R SAFE HANDLING OF HAZARDOUS
~TERIALS: ....................................... Y~ YES NO
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES.: .......................... YES,_~ YES
C. PROPER USE OF SAFETY EQUIPMENT: · YES~ YES NO
D. E>!ERGE)~CY EVACUATION PROCEDURES: ................. - YES ,-r~
E. DO YOU >~INTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ NO
SECTION ?: Fu~ZARDOUS .MATERIAL
CIRCLE YES ~_.~~- ONE ,
DOES YOUR BU~ESS HANDLE HAZARDOUS )~TERIAL tN QUANTI~iES ~ESS THA~
SOLID, 55 GALLONS OF A LIQUID, OR ~00 CUBIC FEET OF A COMPRESSED GAS: ...... Y:S~,
I, S. DEL. RUCKER , certify that the above information is accurnte.
I understaad that this information will. be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.98
Sec. Z~500 Et Al.) and that inaccurate information constitutes perjury.
TITLE MORTICIAN/OWNER DATE 5-24-1988
BAKERSFIELD CIT:f FiRE DEPARTSiENT
2!30 "G" STREET
BAKERSFIELD, CA 95301
0FFiCL%/ USE 0?~LY
ID~ 95-153-8089
BUSINESS NAME: RUCKER'S MORTUAI~-
BUS I NESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS
1. To avoid further action, this form must be returned by:
2. 'TYPE/PRINT YOUR .ANSWERS IN ENGLISH.
3, Answe? the questions be!o~, for THE FACILITY UNiT LISTED BELOW
4. Be as BRIEF and CONCISE .as possible.
FACILITY UNIT~ FACILITY D~NIT NAME: RUCKER'S MORTUARY
SECTION 1: MITIGATION, PREVE~'FION, ABATEME57 PROCEDD~ES
NONE
SECTION 2: NOTIFICATION AND EVACUATION PROCEDI~ES AT THIS U~iT
NONE
SECTION 3: HAZARDOUS MATERIALS FOR THIS L~iT ONLY
A. Does this Facility Unit contain Hazardous Materials? ......
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of'the hazardous materials a bona fide Trade Secret YES NO
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form ~4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (yellow form ~4A-2) in addition to the non-trade
~ecret form. List only tile trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION
NONE
SECTION 5: LOCATION OF WATER Sb~PLY FOR USE BY EMERGENCY RESPONDERS
IN FRONT OF BUILDING,. FIRE PLUG IS ACROSS THE STREET ON CORNER
OF BAKER & CHICO.
SECTION 6: LOCATION OF UTILITY SHb~r-OFFS AT THIS bW. IT ONLY.
A. NAT. GAS/'PROPANE% NEXT TO BACK DOOR~IN GARAGE,(NORTH EAST SIDE)
B. ELECTRICAL: IN GARAGE
C. WATER: FRONT OF MORTUARY ACROSS THE STREET, CORNER OF BAKER/CHICO
D. SPECIAL: NONE
E. LOCK BOX: YES YES, LOCATION:
, ~ :,: P~ANS: YES MSDSs? :'-"ES
FLOOR PLANS? ~'~S /, KEVS? YES
- 3B -
NON--TRADE SECRETS
'-' HAZARDOUS MATERI ALS I NVEN~ORY /
BUSINESS NAME:_ ~ ~~~OWNER NAME: ~~~
ADDRESS: ~ ~~~ ~~ / ADDRESS: ~ ~~ ~, F~[~ITY UNIT NA~E:
ONLY
1 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARi~
!~.0DE A~OUNT A~OUNT UNIT CODE CODE FACILITY UNIT ~T. CHEMICAL OR CO~ON NAME COD~_
A ~ ~ ~
EMERGENCY CONTACT: ~G~ TITLE: PHONE ~ BU~ :
~'- ~ B AFTER BUS HRS:
EhERGENCY CONTACT: O~ '~~ TITLE:'-~~~ . PHONE ~ BUS HOURS:~o
t?~I~NC~P~[, BUSINESS ACTIVITY: AFTER BUS HRS: ,~~~.
CITY off,BAKERSFIELD
RRE DEPARTMENT · .. 2101 H STREET
Dear Business Owner:
Enclosed please find a copy of your response to the Hazardous Material Business
Plan request. We have found it necessary to reject your plan for the following
reason(s) as checked below,
F-'[ [ll~ible Business Plan (please print or t~e infomatlon in English). "Fom 2A ~ Missing or--complete ~ ~
Form 4A ~ Missing or.Incomplete _~
This is ~o be cor~ed~esubai~ed within 30 days
Bakersfield 6~ty Ff~e
Hazardous Na~er~als
2~30 "G" S~ree~
Bakersfield, CA 9330Z
If add~iona] co~ies of any fo~as are needed ~hey can be p~cked up from ~he
Hazardous ~a~e~als B~v~s~on a~ 2Z30 "G" S~ee~ in person.
Sincerely Yours,
/Ralph E. Hu~
H
azardous ~aLer~als Coordinato~
REH/eg