HomeMy WebLinkAboutBUSINESS PLAN 7/19/1997 Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
....... ,~,,,,,;~,??'?'?Y:?'~=!~,i~??~:,~,,, ....... This permit is issued for the following:
,,~??:ii%" ,%,~.,.',:,, ::k2:Z~5;::?,: ?.~:::;Et~Hazardous Materials Plan
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LOCATION ' 532 BELLE TER~
Issu~ by:
Bakersfield Fire Depa~ment Approved by: F gP)e~;~~ '
OFFICE OF EN~R O~AL
1715 Cheaer Ave., 3rd Floor
B~ersfiel~ CA 93301
Voice {805) ~26-~979
F~ (805)~26-0S76 Expiration Date: ~n~ ~0~ ~0OO
IT~ DIAGraM ~ ~ FACILI~ DIAGRAM
Bus~ne~ Name: ~~ ~ ~&
For Office Use Only
First In Station: Area Moo # of
Insoeation Station: NORT.H .~/~
a) CCNTAINE.=t'CCOE$
01.' Un(=ergmunO tank cg. Glass cOntainer(s)
02. Ab~vegrounO rant< ".0. P!astic container(s)
0:3. Fixe~ Pressunzeci ta. nt~ 1 ~. acxles)
04. ~ortaole oressunzett cylinders ~2. gag(s)
05. Insu~a[eo tank 13. Me~al conminem (not drums)
(inc=uOee cryogenics) 34. In machinery or processing
C6. Crums or i3arre~s, metallic
07. Orums or ~arrms. nan-metallic
08. C4r~oy(s) gg. Cruet-specfiy
~) P~E$SURE CQOE$
1 - The material is stored at ambient (normai atmosoneric) pressure.
;2 - The matenai is stmreo at greater than amoient pressure.
3 - The materials is storeo at less U'lan ammient pressure.
c) T--,MPE.=ATURE CCCE=,
,~. The matenat is storeci at amOient (surrounoinc_) terncerature.
5, - ;';ne matenai Js store(3 at greater than amoient ~emoera[ure.
5 - The matenai is s:ore~3 at tess than amoient term:er~ture.
7 - The material is szoreQ unQer cryogenic ccncitJcns
USE CCCE$
01. AaCitive ~0. Fungici. ce 39. Washing
,32. A(31~es~ve 21. Gdnoing 40. Wasm
~,3. Aerosol 22. Heating ~1 .. Water Trident
24. Anes[ne~ic 23. Heroic:ce · '~2. Weioing/soldenng
05. Bac:enciOe 2~. Ins~ac:ce ' ~. Well ini~en
C~. ~lasun~ 25. [ns~c:onal ~. Oil trea~ent
07. C4[~ys[ 25. Lu~n~n~ ~5. Re~Je
.08. C:eanm~ 27. ~e~i~ ~tcicrocess ~. Aircm~ sy~ems
39. Ccctan[ 2~. Neu~,zsr ~7. Ba~e~ etude
:0. C;c,ng 29. P~mung ~. Breathing a~r
I 1. Cdlling 30. PesUc:ce
~ 2. C~m~ 31, Fiaung EO. ~nisn~ ~ro~uct
13. Emuisitieri~emulsifier 32. ~rese~a~e
I~. E~c~mg 33. Aefinin~ 52. HyOmuiic ~uioment
15. ~xoenmental 2~. ~eater 53. ~olH~ m~[ntenance
16. Fzcn~t~on 35. S~ymg
1 7. Femtiza[ion 38. Steniizer 55. ~oie~ie c:eml~ts
~8. Fcrmuisucn 37. S~m~e .,, g9. O~er - soect~,
~g. Fue~ 38.
Manager : sPhone- (805) 366-9416
Location: 532 BELLE TERRACE #~.By-~' ' M+p : 12~ CommHaz : Minimal
City : BAKERSFIELD "'~ ..... =:~Grid: 06D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
RAY ELAM / OWNER MARION VANMIDDENDOR / LESSOR
Business Phone: (805) 838-3368x Business Phone: (805) 836-2520x
24-Hour Phone : (805) 366-9416x 24-Hour Phone : (805) 664-4787x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire
Agency-Defined Topic Title
= Hazmat Inventory One Unified List
-- MCP+DailyMax Order Ail Materials at Site
Hazmat Common Name... ISpeoHazlEPA HazardsI Frm DailyMax Unit MCP
GREASE F S 660 GAL UnR
-1- 06/23/1997
ELAM MANUFACTURING SiteID: 215-000-001727
~ Inventory Item 0001 Facility Unit: Fixed Containers at Site
GREASE Days On Site
365
Location within this Facility Unit
OUTSIDE NORTHWEST CORNER OF SHOP. CAS#
0
~ STATE r TYPE PRESSURE , TEMPERATURE CONTAINER TYPE
DRUM/BARREL-METALLIC
Solid Pure Ambient Ambient
AMOUNTS STORED AND IN USE
Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
660.00 300.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
%Wt. HAZARDOUS COMPONENTS IEHSI CAS#
-2- 06/23/1997
ELAM MANUFACTURING SiteID: 215-000-001727
Fast Format
~ Notif./Evacuation/Medical Overall Site
-- Agency Notification 01/31/1996
EMPLOYEES OF MID-MACHINE SHOP WILL NOTIFY EMERGENCY RESPONDERS BY CALLING
9-1-1 IN CASE OF INCIDENT INVOLVING GREASE OWNED BY ELAM MFG.
-- Employee Notif./Evacuation 01/31/1996
EMPLOYEES OF MID-MACHINE SHOP WOULD FOLLOW PROCEDURES FOR NOTIFICATION AND
EVACUATION AS LISTED IN THE BUSINESS PLAN FOR THEIR OWN CO-LOCATED BUDINESS.
Public Notif./Evacuation 01/31/1996
CUSTOMERS AND NEIGHBORING BUSINESSES WILL BE NOTIFIED IF EVACUATION IS
NECESSARY DURING INCIDENT.
Emergency Medical Plan 01/31/1996
SOME FIRST AID EQUIPMENT ON SITE OR WILL TRANSPORT TO NEAREST HOSPITAL.
-3- 06/23/1997
ELAM MANUFACTURING SiteID: 215-000-001727
Fast Format
Mitigation/Prevent/Abatemt Overall Site
-- Release Prevention 01/31/1996
DRUMS ARE STORED OUT OF THE WAY OF EQUIPMENT BEING USED AT THE MACHINE SHOP.
-- Release Containment 01/31/1996
ABSORBANT IS AVAILABLE ON SITE.
-- Clean Up 01/31/1996
WILL ABSORB AND DISPOSE OF PROPERLY USING LICENSED HAULER.
Other Resource Activation
-4- 06/23/1997
ELAM MANUFACTURING SiteID: 215-000-001727
Fast Format
~ Site Emergency Factors Overall Site
Special Hazards
-- Utility Shut-Offs 01/31/1996
NATURAL GAS/PROPANE: EAST END OF MAIN BUILDING.
ELECTRICAL: SOUTHEAST STORAGE ROOM OF SHOP.
WATER: MAIN AT WEST SIDE OF BUILDING.
Fire Protec./Avail. Water 01/31/1996
FIRE EXTINGUSIHERS. FIRE HYDRANT AT SW & SE CORNERS OF PROPERTY.
Building Occupancy Level
-5- 06/23/1997
ELAM MANUFACTURING SiteID: 215-000-001727
Fast Format
~ Training Overall Site
-- Employee Training 01/31/1996
NUMBER OF EMPLOYEES: 0
MATERIAL SAFETY DATA SHEETS ON FILE: YES, ON FILE WITH/MID MACHINE.
-- Page 2
-- Held for Future Use
Held for Future Use
6 06/23/1997
Bakersfield Fire Dept.
~FFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
Date Completed i O- ~ - ~, b,
Business Namei ~"l~
"-----
Location:W _% Z.. ~ ~ ! I _n"' ~e..r~ ~z¢ ~ -
Business IdentificaUon No. 215-000C)O I '-I 7. "'t (Top of Business Plan)
StationNo. ~ Shift C- Inspector ~-~e-~o"::'q'-I'
??~r.~:i~l Time: / c//~C>'- Departure Time: / 5'"/'¢0 Inspection Time: i ~'"' ,//4/4./.
Adequate Inadequate Adequate Inadequate
Address Visable 13~ [] Emergency Procedures Posted g ,1~.'
Correct Occupancy ~- [] Containers Propedy Labled []
Verification of Inventory Materials '~'_ I'1 Comments:
Verification of Quantities ~ []
Location ~ [] Verification of Facility Diagram [] z~
Velification
of
Proper Segregation of Matedal 13/ [] Housekeeping ~1 []
Fire Protection '1~ I'1
Comments: Electrical [] ~
Comments:
Verification of MSDS Availablity '1~ []
Number of Employees: ]' ~ UST Monitoring Program [] []
Comments:
Verification of Haz Mat Training [] []
Permits ff'l []
Comments: Spill Control [] []
Hold Open Device [] El
Verification of / Hazardous Waste EPA No.
Abbatement Supplies and Procedures ,Dr []
Proper Waste Disposal [] []
Comments: Secondary Containment [] []
Secudty [] []
Special Hazards Associated with this Facility:_ ~o '
Viola~ons:
Businests Owner/Manager PRINT NAME q:~31GN~,'I:URE - Correction Needed
White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy
HAZARDOUS MATERIALS DIVISION
1715-CHESTER A.V_E~
BAKERSFIELD, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
1. To avoid further action, return this form within 30 days of receipt.
-2. i'YPE/PRINT ANSWERS IN ENGLISH.
3. Answer the auestions below for the business as a whole.
4. Be brief and conc,se cs .Doss,hie. I.T~ %
SECTION 1' BUSINESS IDENTIFICATION DATA ~ ~
BUSINESS NAME: ~¢~
F~
MAILING ADDREss.
CITY: STATE: ZIP' ~3~ PHONE:
DUN & 5R~DS~RE~7 NUMBER' SIC CODE:
PRIMARY ~ ~V1TY.
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE /".~,:~. PHONE 24 HR. PHONE
/
.. SaKers~eld Fire Dept. ~o
I~ardous 1V~aterials Division .....
HAZARDOUS MAIER~AL$ MANAGEM~:NI PlAN ' ~ .~
SECTION 3'. TRAININ(~:
NUMBER OF. EMPLOYEES'
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REQ. UEST: ·
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 OD NOT HANDLE HAZARDOUS MATERIALS.
WEDO HANDLE HAZARDOUS MATERIALS, BUT THE C3UANTITIES AT NO
IME:XCc=O THE MINIMUM RE?ORTING ~UANTrTIES.
,_C~FY REASON)
OTHER (SP
SECTION 5: CERTIFICATION:
t, 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. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION. CONSTITUTES PERJURY.
SIGNATURE TITLE DATE
, .... Bakers~..eld F~e Dept. ~
Hazardous Mater~ab Div~sio~
HAIRDO US MATERIALS MANAGEMENT PLAN
FacJliW Unit Name: ~~ ~- "
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
B, EMPLOYEE NOTiFiCATiON AND EVACUATION:
C. PUBLIC EVACUATION:
O. EMERGENCY MEDICAL PLAN'
~ ~'-,..rcS? A-, o ~c, Eo,P,~c--u~ 6~d $,~-E ~..
Bskers~elcL Fize Dept.
Hazardous Materials D[visien ......
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7' MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS:
8. RELEASE-CONTAINMENT AND/OR MINIMIZATION:
C. CLEAN-UP PROCEDURES:
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE:
...CTRICAL.
WATER: ~/~..,j ~ uo
~"' ~C'AL""
LOC','< BOX: YES/NO iF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABIUTY (FIRE HYDRANT)' '
BAKER i IELD CITY FIRE DEP iRTMENT
HAZ31 RDOUS MATERIALS INVEI t'ORY
Page~of~
3usiness Name Address _~ 7_. ,~ ~-.((.~' ~--~r-~'r~c ~ 1~ -~.._.
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [¢"J TRADE SECRET [ ]
2) Common Nam,: 3) DOT #
ChemiceJ Name: AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ellJ 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 ~ 1t3 [ ] a) Container:
Average Daily Amount: ~ cudes [ ] b) Pressure:
AnnuaJ Amount: /~'7..c~0 c) Temperature:
Largest Size Container: ~'.~--'
# Days On Site ~'~-"' Circle Which Months: //~ J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % WT AHM
the three most hazardous 1) [ ]
cl~emicai components or
any AHM components 2) [ ]
3).
10) Location 0 t~T-%, ~ ~ f~J~ C' (~.~J ~9.~ ~
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 FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: lbs [ ] gal [ ] 1t3 [ ] a) Container:
Average Daily Amount: cudes [ ] 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) [ ]
10) Location
cer~ly under penalty of law, that I have personally examined and am familiar with the infomat~on submitted on this and all attached documents. I believe th~
suDmitted information is ~ue, accurate, and complete.
PRINT Name & Title of Authorized Company Reprasentatlve Signature Date
BAKERSFIi .D CITY FIRE DEPAFiVIENT
HAZARDOUS MATERIALS INVENTORY Page_of__
Business 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 [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE
6) PHYSlCAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FAClMTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Dally Amount: lbs [ ] gal [ ] 1~3 [ ] a) Container:
Average Dally Amount: cudes [ ] 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) [ ]
10) Location
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 Dally Amount: lbs [ ] gal [ ] fi3 [ ] 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: Ust COMPONENT CAS # % Wl' AHM
the three most hazardous 1) [ ]
chemic, e] components or
any AHM components 2) [ ]
3) [ ]
10) Location
certify under penalty of/aw, that I have personally examined and am familiar with the infomaSon submitted on this and all at~ached documents. I believe the
submitted informa#on is ~'ue, accurate, and comp~eta.
PRINT Name & Title of Authorized Company Representatlve Signature Date