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Home My WebLink AboutBUSINESS PLAN 7/18/2007W '1 U i i N ~~ xW ~a ~~~ ~~, ---- ~ I \ / i ~"il 1 r ~~ __~ _- _~__._-i=- _- _-_ ~--.____-___-___-_. ~_~ y^-p~~ l~ 'r~rC~~ [-~' +- MID MACHINE SiteID: 015-021-001704 Manager MARION VAN MIDDENDORP Location: 532 BELLE TERR 2 City BAKERSFIELD BusPhone: (661) 836-2520 Map 124 CommHaz Minimal Grid: 06D FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title M VAN MIDDENDORP / OWNER / Business Phone: (661) 836-2520x Business Phone: ( ) - x 24-Hour Phone (661) 664-4787x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire DelHlth Contact MARION VAN MIDDENDORP Phone: (661) 836-2520x MailAddr: 532 BELLE TERR 2 State: CA City BAKERSFIELD Zip 93307 Owner MARION VAN MIDDENDORP Phone: (661) 664-4787x Address PO BOX 9576 State: CA City BAKERSFIELD Zip 93389 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT Uaed on my inquiry of those individuals responsrbie for obtaining the information; i certify under penalty of faw that I have personally examined and ai?a fam+liar with the information submitted and F~elieve the information is true, accurate, and complete. "/y /~j h Y~ Signature Date -1- 07/12/2007 r F MID MACHINE SitelD: 015-021-001704 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP LUBE OIL F DH L 100.00 GAL Min -2- 07/12/2007 -3- ~ 07/12/2007 F MID MACHINE ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME LUBE OIL Location within this Facility Unit OUTSIDE NE CRNR SHOP STATE - TYPE PRESSURE Liquid Mixtur~ Ambient SiteID: 015-021-001704 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 8020835 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average -55.00 GAL 100.00 GAL 100.00 GAL t1E~GEittLVU~J 1:V1~lYV1Vt;1V15 %Wt. RS CAS# 100.00 Lubricating Oil (Petroleum-Based) No 8020835 riHGt1KL HSJI;JJ1~1~1V1A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -4- 07/12/2007 n , F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/17/1995 ~ TELEPHONES IN FRONT OFFICE AND ONE IN BACK OF SHOP. Employee Notif./Evacuation 10/17/1995 SHOP IS SMALL ENOUGH FOR VERBAL COMMUNICATION. ru~.111~. iVVl.lt . / r,Vdl;Udl.1U11 Emergency Medical Plan 01/24/2001 CONTACT PRIVATE DOCTOR OR USE FIRST AID EQUIPMENT ON HAND. S -5- 07/12/2007 F MID MACHINE. SiteID: 015-021-001704 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/24/2001 ~ ALL MACHINES HAVE CUTTING OIL COLLECTION PANS. Release Containment 04/17/2006 CUTTING OIL IS RECYCLED THROUGH CENTRIFUGE OUTSIDE NE CORNER IN BACK OF BLDG. ABSORBENT READILY AVAILABLE. Clean Up 04/17/2006 ABSORBENT IS SPREAD ON SPILLED OIL. v~iici ncavul..~.c til:l.1VQ{.,1V11 -6- 07/12/2.007 ., . _ ~ F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, oNci.iai naaaiu~ Utility Shut-Offs 12/11/2006 A) NATURAL GAS/PROPANE - E END MAIN BLDG B) ELECTRICAL - ELECT MAIN E END OF SITE PANEL FOR SHOP IN STORAGE ROOM E SIDE OF HALLWAY C) WATER - OUTSIDE S DOOR (SHOP ONLY).MAIN ON W SIDE OF SITE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/05/2007 PRIVATE FIRE PROTECTION - ONE FIRE EXTINGUISHER BY FRONT DOOR AND ONE BY BACK DOOR. FIRE HYDRANT - SW CRNR OF PROP AND SE CRNR OF PROP. Building Occupancy Level 03/09/2006 1 EMPLOYEE -7- 07/12/2007 ;~ ?~ F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/27/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rays ~ Held for Future Use Held for Future Use -8- 07/12/2007 c^^` MID MACHINE SiteID: 015-021-001704 Manager BusPhone: (661) 836-2520 Location: 532 BELLE TERR 2 Map 124 CommHaz Minimal City BAKERSFIELD Grid: 06D FaCUnits: 1 AOV: CommCode: BFD STA~06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title M VAN MIDDENDORP / OWNER / Business Phone: (661) 836-2520x Business Phone: ( ) - x 24-Hour Phone (661) 664-4787x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire DelHlth Contact ; Phone: (661) 836-2520x MailAddr: 532-BELLE`TERR~2 '~~ - State: CA City BAKERSFIELD Zip 93307 Owner MARION VAN MIDDENDORP Phone:. (661) 664-4787x Address PO BOX 9576 State: CA City BAKERSFIELD Zip 93389 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: ~ RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT Based on my in~~~lry nt 3has~? ~,~-di ~ ce tfy 1 ll ~ ~ ni l y ~Ersona av4~ responsible for obpa~ wptha? the ~nformat~on enalty c n r l _ unde P ' examined and a,m frarrrlll~r ~lt ligve the information is true, b o submitted and accurate, and complete. e ~~~~~~ Q~i___---~~--~- ° _. "` --- to Signature -1- 02/05/2007 F MID MACHINE .SiteID: 015-021-001704 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP LUBE OIL F DH L 100.00 GAL Min -2- ~ 02/05/2007 -3- 02/05/2007 7i ~ F MID MACHINE SiteID: 015-021-001704 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME LUBE OIL Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE NE CRNR SHOP CAS# 8020835 = STATE TYPE PRESSURE TEMPERATURE' CONTAINER TYPE Liquid TMixture ~mbient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 100.00 GAL 100.00 GAL - HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Lubricating Oil (Petroleum-Based) No 8020835 t1EjGHKL EiJw7L' J~1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min -4- 02/05/2007 S F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/17/1995 ~ TELEPHONES IN FRONT OFFICE AND ONE IN BACK OF SHOP. Employee Notif./Evacuation 10/17/1995 SHOP IS SMALL ENOUGH FOR VERBAL COMMUNICATION. t'U1J11C: 1VVL11 / P~VdC;Udl.1Ui1 Emergency Medical Plan 01/24/2001 CONTACT PRIVATE DOCTOR OR USE FIRST AID EQUIPMENT ON HAND. -5- 02/05/2007 F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/24/2001 ~ ALL MACHINES HAVE CUTTING OIL COLLECTION PANS. 0 Release Containment 04/17/2006 CUTTING OIL IS RECYCLED THROUGH CENTRIFUGE OUTSIDE NE CORNER IN BACK OF BLDG: ABSORBENT READILY AVAILABLE. Clean Up 04/17/2006 ABSORBENT IS SPREAD ON SPILLED OIL. V1~11C1 iCC~V Ul.LC iiC.: l.1Vdl. l CJil -6- 02/05/2007 F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ w7~JC C:1dl i1d'G di. Ui7' Utility Shut-Offs 12/11/2006 A) NATURAL GAS/PROPANE - E END MAIN BLDG B) ELECTRICAL - ELECT MAIN E END OF SITE PANEL FOR SHOP IN STORAGE ROOM E SIDE OF HALLWAY C) WATER - OUTSIDE S DOOR (SHOP ONLY) MAIN ON W SIDE OF SITE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 02/05/2007 PRIVATE FIRE PROTECTION - ONE FIRE EXTINGUISHER BY FRONT DOOR AND ONE BY BACK DOOR. FIRE HYDRANT - SW CRNR OF PROP AND SE CRNR OF PROP. Building Occupancy Level 03/09/2006 1 EMPLOYEE -7- 02/05/2007 •. F MID MACHINE SiteID: 015-021-001704 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/05/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: rayc c. nclu LV.L rULLLLC V5C i1C 1C,1 1(JL L' UI.Ut~ US ~' -8- 02/05/2007 UNIFIEC~ PROGRAM INSPECTION CHECKLIST:' .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services ~~~~ 900 Truxtun Ave., Suite 210 ~wrr r Bakersfield, CA 93301 ' 326-3979 Tel.: (661) Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE NSPECTION TIME ADDRESS IJ^) 1 I .-~ HONE NO. O OF EMPLOYEES FACILITY CONTACT /'~~--ram-, USINESS ID NUMBER Section 1: Business Plan and Inventory Program ~ ~ / ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V (c=Compliance` OPERATION V=Violation l COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ Business PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS NrrD ~ ~ !"'t~ 1, ^ CORRECT OCCUPANCY ^ ^ ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION V~ ~~~ ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY , - / I~' ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO EDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ~, 1( ~ G yew ANY HAZARDOUS WASTE ON SITE? ^ YES IIYNU EXPLAIN: - _ QUESTIONS REGARDING THIS INSPECTION? P/LEASE CALL US AT (881) 328-3979 nspector (Please Print) Fire Prevention / 1" In / Shift of Sfte/Station k Business Site/School Site esponsible Party (Pte Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD204e (Rev. 02!05) ~~. IDNIFIE6 PROGRAM INSPECTION CHECKLIST "` .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT s p Prevention Services ~~~~ 900 Truxtun Ave., Suite 210 ~R>rM Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME l ~ ,~ ~ ~~~ ~ ~. NSPECTION DATE //-) ~-I - v G INSPECTION TIME ADDRESS ~, 3 2 / HONE NO. 3y-7 s~~ O OF EMPLOYEES ~ . -~ ~. c~- ~ FACILITY CONTACT _ ~ USINESS ID NUMBER ~s-o2~- ~ oZ2z3 e..r L ~ X Section 1: Business Plan and Inventory Program ~ % ~ 1' ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ~ ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS _ ____ _ _ _____ _ _ _ ^ APPROPRIATE PERMIT ON HAND ~~~,® D E ~ ~ ~ 200 ^ BUSiness PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ Ctd PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ' (((/// ^ VERIFICATION OF HAZ MAT TRAINING Lt3' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCE URES D N /~ V ^ ~ / ~G EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ I{Y HOUSEKEEPING S ~ ~~GI ~1CC~ - ^. ^ FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND , , ~- ANY HAZARDOUS WASTE ON SITE? p l!! YES Cj~,~ CC EXPLAIN: _ ~ ~ r1~nt°~ _ T_ ~ b 60~ ~__.I -1-~-J---~~~ ~~~~(/~~ph / _ .~ ~UESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (681) 328-3979 Inspector (Please Print) Fire Prevention / 1`~ In /Shift of Site/Station # Business Site/School ite Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink - Buainese Copy FD2049 (Rw. 02/05) ;, ~; + MID MACHINE _________________________________________ SiteID: 015-021-001704 + Manager Location: 532 BELLE TERR 2 City BAKERSFIELD BusPhone: (661) 836-2520 Map 124 CommHaz Minimal Grid: 06D FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title M VAN MIDDENDORP j OWNER / Business Phone: (661) 836-2520x Business Phone: ( ) - x 24-Hour-Phone (661) 664-4787x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire DelHlth Contact - Phone: (661} 836-2520x MailAddr: 532 BELLE TERR .2 - State: CA City BAKERSFIELD Zip 93307 Owner MARION VAN MIDDENDORP Phone: (661) 664-4787x Address PO BOX 9576 State: CA City BAKERSFIELD Zip 93389 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: .. Emergency Directives: PROG A - HAZMAT Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~~~ Signature ate ENS ~J~ ~~~20 _ 06 -1- 03/09/2006 UNIFIED PROGRAM INSPECTION CHECKLIST U SECTION 1 Business .Plan and Inventory Program Bakers$eld Fire Dept. '. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 ' Tel: (661)_326-3979 --- -- - FACILITY NAME r~ • ~_ WSPECTION DATE INSPECTION TIME ADDRESS PNONE No. No. of Employees FACILITYCONTACT ~ f ~ ~`'~; -~~~ ~ 8uainess ID Number (~ 15-021 - (SO ('~ ~ ~/ Gr~ , ~, o ~- Section 1: Business Plan and Inventory Program outine O Combined D Joint Agency OMulti-Agency O Complaint O Re-inspection ANY HAZARDOUS WASTE ON SITE?: OYES WJ NO EXPLAIN: r QUESTIONS RE~ING THIS INSPECTIONS PLEASE CALL US AT ~GF>'I ~ 326-3979 f~ ~ Inspector (Please Prin Fire Prevention 1st-IMShik of Site White -Environmental Services Yellow -Station Copy 1 G?1_ _ _ _ Site espon PaAy (Please P m '~ g Pink -Business Copy ~~ ~ Bakersfield Fire Dept. UNIFIED PRO~~RAM INSPECTION CHECKLIST Enironmental services 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. ~ No of Employees -- -------- ~ i I ~ - ----~---- --.._ FACILITYCONTACT Business ID Number 15-021- ~, ~D ~ Section 1: Business Plan and Inventory Pn~gram ,:Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V \V=Vioa~lonn~~ OPERATION COMMENTS ^ --- APPROPRIATE PERMIT ON HAND ------- - -- _ ~ - ----- ti0 - --------------------------- ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE `` ~~' ^ VISIBLE ADDRESS ~ -= . ^ .._- CORRECT OCCUPANCY --_-__ -.-__.- ~ ,/ '~~ `/I l~ ~ ~ 1 - _- ~~ T_...-_--.-_._.___~~SG.~~= -L--.-.~. ^ VERIFICATION OF INVENTORY MATERIALS '~ ^ VERIFICATION OF QUANTITIES ~~ - -'' r'" ~ ^ L VERIFICATION OF LOCATION - _.__- - t,::~-a~~~ r E,.[Kr7 L~ ~~-{~----- ----------- -- ^ -= PROPER SEGREGATION OF MATERIAL ~ . -- ^ VERIFICATION OF MSDS AVAILABILITYE _ "~'~~ /1~~ f~: ~ ~',-% ^ VERIFICATION OF FIAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE --- --- - --- - - ~- ^ CONTAINERS PROPERLY LABELED -- `- ,----- ----------- --- --- ---- `------ ----- ^ HOUSEKEEPING !/ ^ FIRE PROTECTION ~' ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES ~ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (66~~ 3Z6-3979 Inspector Badge No. White • Environmental Services Yellow - Statbn Copy usiness Site Responsible Party /~ {/ Pink -Business Copy in '~•~-"'~- , + VALLEY PAINTING _____________________________________ SiteID: 015-021-002223 + Manager BusPhone: (661) 834-7900 Location: 532 BELLE TERR Map 124 CommHaz Moderate City BAKERSFIELD Grid: 06B FacUnits: 1 AOV: CommCode: BFD STA 06 SIC Code: EPA Numb: ~ DunnBrad: Emergency Contact / Title Emergency Contact / Title / / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat .Hazards: - - - - - - ~ - Fire--- --- --- ImmHlth --DelHlth Contact KERRY FELIX i l 4, ~ /1'~hone: (661) 834-7900x o ~ 3 ~ ~h `~'y~~ Ma Addr : ! State : CA City Zip ~3~~ Owner KERRY FELIX Phone: (661) 834-7900x Address State: CA ~ ° City ~ Zip 93309 ~ ~~~ol~ (~ Period to Preparers Certif'd: ParcelNo: TotalASTs: _ TotalUSTs: _ RSs: No Gal Gal Emergency Directives: PROG A - HAZMAT PROG S - SPRAY PAINT BOOTH `~0 - - - Based on my inquiry of those individuals EN i D APR ~ S 006 responsible for obtaining the information, I certify under penalty of law that I have personally Examined and am familiar with the information submitted and believe the information is 4rue, accurate, d c plete. =__. 'y" ~ Sim, ~~ti Da e -1- 03/24/2006 cl _,~~ VALLEY PAINTING SiteID: 015-021-002223 Manager KERRY FELIX Location: 532 BELLE TERR City BAKERSFIELD BusPhone: (661) 834-7900 Map 124 CommHaz Moderate Grid: 06B FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title KERRY FEL IX / OWNER / Business Phone: (661) 834-7900x Business Phone: ( ) - x 24-Hour Phone (661) 345-4045x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact KERRY FELIX Phone: (661) 834-7900x MailAddr: 13502 COPPER CREST DR State: CA City BAKERSFIELD Zip 93306-7756 Owner KERRY FELIX Phone: (661) 834-7900x Address 13502 COPPER CREST DR State: CA City BAKERSFIELD Zip 93306-7756 Period to TotalASTs: = Gal Prepares: TotalUSTs: = Gal Certif'd: RSs: No _ ParcelNo: Emergency Directives: PROG A - HAZMAT A E rpo ~~aa ENfib ~ ~ ~ PROG S - SPRAY PAINT BO U ~ ~~~~' OTH Sased on my ingt.iry of those irsdiuic;ucfs responuible for octair~in3 the info~maion, !certify under penalty of la~~ that I have per~onalfy examined and am familiar with the infarrriation submitted ano beiiEVe the information is true, accurate, area complete. ~` / r Si at- use '_ ~® --~-~ Vim' ^V~ Date -1- 07/16/2007 C ~a jt- F VALLEY PAINTING ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002223 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit. MCP PAINT F IH DH L 55.00 GAL Mod WASTE THINNER F IH DH L 55.00 GAL Mod -2- 07/16/2007 r,~~ -. ~, -3- 07/16/2007 ~:. _ ~~_ F VALLEY PAINTING SiteID: 015-021-002223 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PAINT Days On Site 365 Location within this Facility Unit Map: Grid: CAS# Liquid TMixture ~mbient~E ~ AmbientT~E METALOCONTAINRTNONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 55.00 GAL GAL t11~GHKIJVU.7 1.V1~lYV1VJ~,1V 1.7 %Wt. RS CAS# 25.00 Mineral Spirits No 8030306 15.00 Naphtha No 8030306 5.00 Methyl Ethyl Ketone No 78933 3.00 Ethylene Glycol No 107211 t1AGLll[L A55L' ~J1~1151V'1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT## MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE THINNER Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Waste -Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL .55.00 GAL 55.00 GAL nr~Gr~tcl~vua ~:vlnrvlvr,ly l ~ %Wt. RS CAS# 100.00 Thinner No 8030306 tif1GH2C1J L~.7 ~ 1; ~ J L~11~,1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 07/16/2007 1 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 07/20/2001 ~ PAINT AND SUPPLIES ARE VISUALLY INSPECTED AND SHOULD A PAINT CAN RUPTURE IT WOULD BE IMMEDIATELY NOTICABLE. Employee Notif./Evacuation 07/20/2001 MSDS SHEETS WILL BE ACCESSABLE TO ALL EMPLOYEES AND PLACARDS WILL BE POSTED IN BREAK ROOM OR NEXT TO MSDS SHEETS. Public Notif./Evacuation 07/20/2001 IN THE EVENT OF A SMALL SPILL, WE WILL USE AN ABSORBANT MATERIAL TO CLEAN UP ANY SMALL RELEASE. IN THE EVENT OF A LARGE RELEASE WE WILL CALL 911. Emergency Medical Plan 07/20/2001 ALL EMPLOYEES WILL BE TAKEN TO THE NEAREST HOSPITAL FOR TREATMENT. -5- 07/16/2007 F VALLEY PAINTING SitelD: 015-021-002223 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/20/2001 ~ ALL FLAMMABLES WILL BE SEGREGATED FROM OTHER PAINT MATERIALS. Release Containment 07/20/2001 FLAMMABLES WILL BE SEGREATED FROM OTHER PAINT MATERIALS, SPILLED MATERIALS WILL BE CLEANED UP USING AN ABSORBANT MATERIAL. Clean Up 01/31/2007 SPENT SOLVENTS WILL BE COLLECTED IN ONE CENTRAL 55-GAL DRUM COLLECTION. PAINT MATERIALS WILL BE BOUGHT AND USED AS NEEDED. SUFFICIENT QUANTITIES WILL BE PURCHASED ON A JOB-BY-JOB BASIS. V1.11C1 1<C.7VULl.:C til.:V1VGLV1V11 -6- 07/16/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~yc~:~.al na~,caiu5 Utility Shut-Offs Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - NONE 03/24/2006 Building Occupancy Level 12/11/2006 2 EMPLOYEES -7- 07/16/2007 f - " .. F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 12/11/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SOLE. PROPRIETOR AT THIS TIME, OWNER IS AWARE OF HAZARD COMMUNICATION PROGRAM. rayC ~ nciu tvt 1'UI. U.LC V.7C nc1l.L 1VI L'UI~U.LC USC -8- 07/16/2007 :'~ . ~ ~~~ V~ F VALLEY PAINTING Manager .:- 1~-1r ~' - ~ ~~ ~. Location: 532 BELL TERR City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: Map 124 Grid: 06B SIC Code: DunnBrad: SiteID: 015-021-002223 (661) 834-7900 CommHaz Moderate FacUnits: 1 AOV: Emergency Contact /~- __Ti.tle Emergency Contact / Title KERRY FEL IX /,, / Business .Phone: (661) -7900x ~ 83~ Business Phone: ( ) - x 2 4 -Hour Phone ( -~0-1 ) J r ~~7- ~`~Jrx _ 2 4 -Hour Phone ( ) - x Pager Phone (' - ) _ _ - _ x ~~ Pager Phone ( ) - x Hazmat_.Hazards :- _ -- .. Fire - - ImmHltYh DelHlth Contact KERRY FELIX Phone: (661) 834-7900x MailAddr: 13502 COPPER CREST DR State: CA City BAKERSFIELD Zip 93306-7756 Owner KERRY FELIX Phone: (661) 834-7900x Address 13502 COPPER CREST DR State: CA City BAKERSFIELD Zip 93306-7756 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A _ HAZMAT ~ PROG H - HAZ WASTE GEN ~, PROG S - SPRAY PAINT BOOTH ~N~~'pM~Y' ® 3 ~9®~ tasad on my inquiry of those individuals btaining the information, I certify f or o respcnsible law that I have personatiy under penalty of examined a am familiar with the information lieve the information is true, d b _ e submitted a accu ate, d co p ete. y~ ~-~;'V Signature -- Date -1- 05/18/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PAINT F IH DH L 55.00 GAL Mod WASTE THINNER F IH DH L 55.00 GAL Mod -2- 05/18/2007 _3_ 05/18/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PAINT Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 55.00 GAL GAL t1[-1GHtCUVUJ ~:V1~1rVlvr,lvla %Wt. RS CAS# 25.00 Mineral Spirits No 8030306 15.00 Naphtha No 8030306 5.00 Methyl Ethyl Ketone No 78933 3.00 Ethylene Glycol No 107211 t1AGL~tCL 1~5b~.751~1L"i1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME WASTE THINNER Location within this Facility Unit STATE TYPE PRESSURE Liquid TWaste -T Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE _ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL ru~c~HtcLVU~ ~Vl~irvlvr~ivi~ %Wt. RS CAS# 100.00 Thinner No 8030306 tit1G[ittL ti5a~a~rll;LV la TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 05/18/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 07/20/2001 ~ PAINT AND SUPPLIES ARE VISUALLY INSPECTED AND SHOULD A PAINT CAN RUPTURE IT WOULD BE IMMEDIATELY NOTICABLE. Employee Notif./Evacuation 07/20/2001 MSDS SHEETS WILL BE ACCESSABLE TO ALL EMPLOYEES AND PLACARDS WILL BE POSTED IN BREAK ROOM OR NEXT TO MSDS SHEETS. Public Notif./Evacuation 07/20/2001 IN THE EVENT OF A SMALL SPILL, WE WILL USE AN ABSORBANT MATERIAL TO CLEAN UP ANY SMALL RELEASE. IN THE EVENT OF A LARGE RELEASE WE WILL CALL 911. Emergency Medical Plan 07/20/2001 ALL EMPLOYEES WILL BE TAKEN TO THE NEAREST HOSPITAL FOR TREATMENT. -5- 05/18/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 07/20/2001 ~ ALL FLAMMABLES WILL BE SEGREGATED FROM OTHER PAINT MATERIALS. Release Containment 07/20/2001 FLAMMABLES WILL BE SEGREATED FROM OTHER PAINT MATERIALS, SPILLED MATERIALS WILL BE CLEANED UP USING AN ABSORBANT MATERIAL. Clean Up 01/31/2007 SPENT SOLVENTS WILL BE COLLECTED IN ONE CENTRAL 55-GAL DRUM COLLECTION. PAINT MATERIALS WILL BE BOUGHT AND USED AS NEEDED. SUFFICIENT QUANTITIES WILL BE PURCHASED ON A JOB-BY-JOB BASIS. ~,_ V l~i1Gl 1\G w7VU1l..G llt. l.lV0.l.l Vll -6- ~ 05/18/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ iJLJCC:1d1 ridGdIUwS' 'Utility ~-Shut-Of-f s Fire Protec./Avail. Water 03/24/2006 PRIVATE FIRE PROTECTION - NONE Building Occupancy Level 2 EMPLOYEES 12/11/2006 -7- 05/1$/2007 F VALLEY PAINTING SiteID: 015-021-002223 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 12/11/2006 I MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SOLE PROPRIETOR AT THIS TIME, OWNER IS AWARE OF HAZARD COMMUNICATION PROGRAM. rayC ~ nciu ivi ru~.utc ~~c _~ , r_ aiciu ivi ru~.uic vac -$- o5/ls/2oo~ Hazardous Materials/Hazardous Waste Unified Permit · ., .CONDITIONSOF· ~?~ :PERMIT~.i.~,.i~ .~:~,~-~i.~ ON REVERSE SIDE ' · -~ ~ H~ous ~ P~ Permit ID~:: 015~00~01704 ; . .. , ..- D Risk~~P~ -'' MID,.,~Ua~.,..~~-: = ~.." ~... a · *' LOCATION:~. 532 BELLETER~CE ~2 ' ' ]EED ...... . .... *?.? *, ... .: .. OFFICE OF EN~R ONMENTAL SER ~CES- ' ' ' 1715 .Chester Ave., 3rd Floor Approv~by: Bakersfield, CA 93301 'r~s~'Wu~/ 326-3979 -:: ..~?'./...5,,'~:, · ..... · Voice ' :' .,. ,"~ ~"5.--. '' F~(661) 326-0576 ':~':E~P~fi6g'Dit~f ' June 30~ 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ....... ,~,,?.?.~??;?~Ei~",? ~,~ ,~,~, This permit is issued for the following: ,~F~ '~ L~~ ~[~' "~ ~:~' .F .~}~[~;~}~L.,. ~ ~ d[ % :~ '~[g"" .~ ~'"' --.-..=.~. LOCATION 532 BELLE T E ~:~*~;~::??:?' ~?-.. "...!~ =~:[~" ~;.~ ..... [,~!~[~=:,... ~.'-':'"':~:~;'::~:.~;~i~j¢~'~ji~[k~F~' Ji ~ ~'"~i"~ ..... ~, .~ 'E~[~[~?.~ '~'..""..~::~ ,?... ~ ., ..., : ...... ~ ~ . ~ ,', . . . "%'"' ..--- ]ss.~ by: 1715 Chewer Ave., 3rd Floor fi/ ~ph Hucy~ O~ce of ~enml S~id~ B~e~fiel~ CA 93301 " Voice (805) 326-3979 F~ (805)326-0576 Expiration Date: June 30, 2000 MID-MACHINE 532 Belle Terrace #2 Bakersfield, Ca. 93307 (805) 836-252O Marion Van Middendorp ITE DIAGRAM I ! FACILITY DIAGRAM Bustne~ Nome: ~tC) -- m4C~,~c .. For Office Use Only First In Station: Arec~ Mca # af lnsoe¢:ion St¢~on: NORTH Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 IFACILITY NAME , I INSPECTION DATE I INSPECTION TIME · , .,, BusineSs Plan and Inventory progmm· ,,: ',' ~ ., - , · ~ - /,~l~Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection C V (C=C°r"P"a"cel OPERATION COMMENTS \ V=Violation /J~ [] APPROPRIATE PERMIT ON HAND "~[]VISIBLE ADDRESS ~:[]CORRECT OOC.PANCY _,_~_ .................. ~ ...... ~_r~_._¢_~_._/_ / "'~[] VERIFICATION OF INVENTORY MATERIALS & [] VER,F,CAT,ON OF Q.ANT,T,ES .... ~ ~ PROPER SEeREeATIO. OF .*TERIAL _,~%~ -2_.~_~__~_~ ............ ~ ~ VERIFICATION OF MSDS AVAILABILI~E VER~F~C~O~ OF H~ MAT T~N~NG PROPERLY ~BELED ~ FIRE PROTECTION ~ ~ SITE DtAGRAM ADEQUATE & ON HAlO ANY H~ARDOUS WASTE ON SITE?: ~ YES ~No EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector Badge No. ~ 'Business Site Responsible Party White - Environmenta~ Services Yellow - Station Copy Pink - Business Copy MID MACHINE SiteID: 015-021-001704 Manager : BusPhone: (661) 836-2520 Location: 532 BELLE TERRACE #2 ~%~%%%% Map : 124 CommHaz : Moderate City : BAKERSFIELD Grid: 06D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title M VAN MIDDENDORP / OWNER / Business Phone: (661) 836-2520x Business Phone: ( ) - x 24-Hour Phone : (661) 664-4787x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact- : - - Phone: (661) 836-2520x MailAddr: 532 BELLE TERRACE #2 State: CA City : BAKERSFIELD Zip : 93307 Owner MARION VAN MIDDENDORP Phone: (661) 664-4787x Address : PO BOX 9576 State: CA City : BAKERSFIELD Zip : 93389 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No" ParcelNo: Emergency Directives: m~nt p~n for ~r~ that it ~l~ng ~ith (i~no of eny ~0~i0ns ~n~itut~ a ~p~t~ and ~rr~ ~'~- 09/09/2003 MID MACHINE SiteID: 015-021-001704 Manager : BusPhone: (805) 836-2520 Location:, 532 BELLE TERRACE #2 Map : 124 CommHaz : Moderate City :, BAKERSFIELD Grid: 06D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ~~ / M. VAN MIDDENDORP / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone : -~05~ ~l ~2~ 24-Hour Phone : (805) 664-4787x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: ( ) - x MailAddr: 532 BELLE TERR3tCE #2 State: CA City : BAKERSFIELD Zip : 93307 Owner MARION VAN MIDDENDORP ~ECEIV~D Phone: (805) 664-4787x Address : PO BOX 9576 State: CA City : BAKERSFIELD JAN ~ 9 20~ zip : 93389 Period : t° ~NW~0~,~0~S TotalaSTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List ~ AS Designated Order Ail Materials at Site Hazmat Common Name... ISpocHazlEPA HazardsI Frm I DailyMax IUnitlMCP LUBE OIL /~/6A/ F DH L 100.00 G~L Min I, I/~/~/'~D~./VpO,~/3Do hereby certify ~hat i have (Type or print name) reviewed the at~ached hazardous materials rnm~age- mere plan fo r /')f! /7- /~,~d thru it along with (Name of Business) any corrections constitute a cornple~e and correct man- agemem plan ;or my ~acili~j. ~igna~ure i~' Dar4 ~ - / -1- 01/03/2001 MID ~CHINE SiteID: 015-021-001704 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site L~E OIL Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE NORTHEAST COMER OF SHOP CAS# 8020835 STATE TYPE PRESS~E TEMPE~T~E CONTAINER TYPE Liquid Pure A~ient{{ A~ient{{ DR~/B~REL-MET~LIC ~O~TS AT THIS LOCATION ] Largest Container I Daily Maximum I Daily Average ~Z~DOUS COMPONENTS %Wt. I ~S CAS# 100.00 Lubricating Oil (Petroleum-Based) N 8020835 ~Z~D ASSESSMENTS TSecretR~NoR~BioHazlRadioactive/AmountEPAHazards NFPA USDOT#MCP No No No/ Curies F DH / / / Min -2- 01/03/2001 F MID MACHINE SiteID: 015-021-001704 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 10/17/1995 TELEPHONES IN FRONT OFFICE AND ONE IN BACK OF SHOP. -- Employee Notif./Evacuation 10/17/1995 SHOP IS SMALL ENOUGH FOR VERBAL COMMUNICATION. Public Notifo/Evacuation 10/17/1995 YES Emergency Medical Plan 10/17/1995 CONTACT PRIVATE DOCTOR SOME FIRST AID EQUIPMENT -3- 01/03/2001 MID MACHINE SiteID: 015-021-001704 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 10/17/1995 ALL MACHINES HAVE CUTTING OIL COLLECTION PANS -- Release Containment 10/17/1995 CUTTING OIL IS RECYCLED THROUGH CENTERFUGE IN BACK OF BUILDING (OUTSIDE NORTH EAST CORNER) ABSORBANT READILY AVAILABLE. -- Clean Up 10/17/1995 ABSORBANT IS SPREAD ON SPILLED OIL. Other Resource Activation -4- 01/03/2001 MID MACHINE SiteID: 015-021-001704 Fast Format ~ Site Emergency Factors Overall Site 9 Special Hazards --Utility Shut-Offs 07/23/1997 A) NATURAL GAS/PROPANE - E END OF MAIN STRUCTURE B) ELECTRICAL - ELECTRICAL MAIN IS LOCATED AT E END OF STRUCTURE PANEL FOR SHOP LOCATED IN STORAGE ROOM E SIDE OF HALLWAY C) WATER - OUTSIDE S DOOR (SHOP ONLY) MAIN IS LOCATED ON W SIDE OF STRUCTURE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 07/23/1997 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, ONE BY FRONT DOOR AND ONE BY BACK DOOR. FIRE HYDRANT - ONE AT SW CORNER OF PROPERTY. ONE AT SE CORNER OF PROPERTY. Building Occupancy Level -5- 01/03/2001 MID MACHINE SiteID: 015-021-001704 Fast Format = Training Overall Site -- Employee Training 10/17/1995 NUMBER OF EMPLOYEES: 1 MATERIAL SAFETY DATA SHEETS ON FILE: YES BRIEF 'SUMMARY OF TRAINING PROGRAM: YES Page 2 Held for Future Use -- Held for Future Use -6- 01/03/2001 JUL !? 1997 Iii, Manager : B~ ,Phone: (805) 836-2520 Location: 532 BELLE TERRACE #2 8y.~ Ma : 124 CommHaz : Moderate City : BAKERSFIELD ........... ~-~ id: 06D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title NORM CORTEZ / M. VAN MIDDENDORP / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone : (805) 833-6820x 24-Hour Phone : (805) 664-4787x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Agency-Defined Topic Title = Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpecHaz EPA HazardsI Frm DailyMax Unit MCP LUBE OIL F DH L 100 GAL Min 1 06/23/1997 MID MACHINE SiteID: 215-000-001704 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site LUBE OIL Days On Site 365 Location within this Facility Unit OUTSIDE NORTHEAST CORNER OF SHOP CAS# 8020835 STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 100.00 100.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Lubricating Oil (Petroleum-Based) No 8020835 -2- 06/23/1997 MID MACHINE SiteID: 215-000-001704 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 10/17/1995 TELEPHONES IN FRONT OFFICE AND ONE IN BACK OF SHOP. -- Employee Notif./Evacuation 10/17/1995 SHOP IS SMALL ENOUGH FOR VERBAL COMMUNICATION. -- Public Notif./Evacuation 10/17/1995 YES Emergency Medical Plan 10/17/1995 CONTACT PRIVATE DOCTOR SOME FIRST AID EQUIPMENT -3- 06/23/1997 MID MACHINE SiteID: 215-000-001704 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 10/17/1995 ALL MACHINES HAVE CUTTING OIL COLLECTION PANS -- Release Con'tainment 10/17/1995 CUTTING OIL IS RECYCLED THROUGH CENTERFUGE IN BACK OF BUILDING (OUTSIDE NORTH EAST CORNER) ABSORBANT READILY AVAILABLE. -- Clean Up 10/17/1995 ABSORBANT IS SPREAD ON SPILLED OIL. Other Resource Activation -4- 06/23/1997 MID MACHINE SiteID: 215-000-001704 Fast Format = Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 10/17/1995 NATURAL GAS/PROPANE: EAST END OF MAIN STRUCTURE. ELECTRICAL: ELECTRICAL MAIN IS LOCATED AT EAST END OF STRUCTURE PANEL FOR SHOP LOCATED IN STORAGE ROOM EAST SIDE OF HALLWAY. WATER: OUTSIDE SOUTH DOOR (SHOP ONLY) MAIN IS LOCATED ON WEST.SIDE OF STRUCTURE. SPECIAL: NONE LOCK BOX: NO ---- Fire Protec./Avail. Water 10/17/1995 PRIVATE FIRE PROTECTION: FIRE EXTINGUISHERS, ONE BY FRONT DOOR AND ONE BY BACK DOOR. FIRE HYDRANT: ONE AT SOUTHWEST CORNER OF PROPERTY. ONE AT SOUTHEAST CORNER OF PROPERTY. Building Occupancy Level -5- 06/23/1997 MID MACHINE SiteID: 215-000-001704 Fast Format = Training Overall Site -- Employee Training 10/17/1995 NUMBER OF EMPLOYEES: 1 MATERIAL SAFETY DATA SHEETS ON FILE: YES BRIEF SUMMARY OF TRAINING PROGRAM: YES ------ Page 2 Held for Future Use Held for Future Use 6 06/23/1997 BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION ~ ×,.~ 1715 ;CHESTER '. AV-F-'" /'~, ~)'~~-~ BAKERSFIELD, CA. 93301 0 HAZARDOUS MATERIALS MANAGEMENT PLAN 1. To avoid further action, return this form within 30 days of receipt. · 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the auestions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA MAILING ADDRESS: ~'4~ DUN &BRADSTRE'ETNUMBER: ~ SIC CODE: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE / .: ' .. Bakersfield Fire Dept. .... ]~ardous ~aterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: / MATER~AL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: SECT[ON 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 TIMEEXCEEO THE MINIMUM REPORTING QUANTff. tES. ...OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION' I. CERTIFY THAT THE ABOVE INFOR- MATION 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. 2(3 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION.CONSTITUTES PERJURY. SIGNATURE ~' TITLE DATE Bakersfield: Fire Dept. ~ Hazardous Materials Divisio~' HAZARDOUS ~4AIER~Ak$ MANAGEMENT PhAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: ,,V~Y O. EMERGENCY MEDICAL PLAN: _ zo~' ,~i,7-.~;d ?~,'x Bak~ lclFi~ pt · rsfie e De Hazardous Materials Division ....... HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS' VCJ' - SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' · / · SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: .-- .., BAKER IELD CITY FIRE DEP FITMENT HAZARDOUS MATERIALS INVENTORY Page_/of CHEMICAL DESCRIPTION 1) INVENTORY STATUS: l~lew [] Addition [ ] Revision [ ] Deletion [ ] Check if chemicalis a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) CommonName: X i i ) 3) DOT · Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire j~ Reactive [ ] Sudden Release of Pressure [ ] Immediate HeaJth (Acute) J~ Delayed HeaJth (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code from DHS Form S022) USE CODE 6) PHYSICAL STATE Solid [] Uquid ~]~ Gas [ ] Pure .,~ Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY //I/3_ / UNITS OF MEASURE e) STORAGE CODES Maximum Daily Amount: ,~ ~'~'~E - lbs [ ] gal ~[~ ft3 [ ] a) Container: ¢~., ~//v//J , Average Dally Amount: ~ cudes [ ] b) Pressure: ~.~ ~ ~'F~ "~' Annual Amount: ~ . c) Temperature: ,~,./44~/'F~/'/7- Largest Size*Container: __ # Days On Site Circle Which Months: ~e_~.~J, F, M, A, M, J, J, A, S, O, N, D · 9) MIXTURE: IJst · /~ COMPONENT CAS # % WT AHM the three most hazardous 1) --( .~2_. C.~, / [ ] chemical components or any AHM components 2) [ ] 3) [ ] 'CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if 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 [ ] Sudden Release Of Pressure [ ] Immediate Health (AcUte) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACIUTY ~ UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ~t3 [ ] a) Container: Average Dally Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT' AHM the three most hazardous 1). [ ] chemical components or any AHM components 2) "~ [ ] 3) [ l 10) Location certify under penalty of law, that I have personally examined and am familiar with the infoma~on submitted on this and all attached documents. I believe th~ submitted information is b'u/e, accurate, and complete. PRINT Name & Title of ~t~lori~ed comp~ny Representab've - ~. Signature ~ Date BAKERSF I..D CITY FIRE DEPAIF MENT ' HAZARDOUS MATERIALS INVENTORY Page_of__ 0usiness Name Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision[ ] Deletion[ ] Check if 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 [ I Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION ,(3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ft3 [ ] a) Container: , Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperat,ure: Largest Size Container: # Days On Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: Ust COMPONENT CAS # % W'I' AHM the three most hazardous 1) [ ] chemical components or any AHM components 2) [ ] 3) [ ]. 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision [ ] Deletion[ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common N~.'ne: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FAClUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site CimleWhich Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1), [ chemicaJ components or any AHM components 2). "" [ ] 3) [ 10) Location ~ cer~fy under penalty of law, that I have personally examined and am familiar with the infometion submitted on this and all attached documents. I believe th~ submitted information is ~ue, accurate, and complete. PRINT Name & Title of Authorized Company Representative Signature Date