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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OFPERMIT ON REVERSE SIDE · - : ? '~ ::~ ':' * ":';'"' This _~ermit is Issued for the following; [] Hazardous Materials Plan [] Unde~round Storage o! H~rdOus I~ateri~ls Permit ID #:: 015-000-001820 * [] Risk Management Progmm COFFEY. MFG SPECIALTIES [] Hazardous Waste On-SiteTreatment - LOCATION: 644 BELLE, TERRACE 10 / Issued by: Bakersfield Fire Department ~. : , ~ ~ Bakersfield, CA 93301 :. ' OfficeorEvironmmtlWServices ~" Voice (661) 326-3979 ' FAX (661).326-0576 Expiration Date: 'June 30= 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........ ,,,~.~?.¢~??,~?,,?~,,~,,,,~, ............... This permit is issued for the following: .,~¢¢i~:~'i"'.i'.:~:; !:;?::::Ri i~i!i }i i*i;::i?i;,i~;iU~erground Storage of Hazardous Mateflals COFFEY MFG SPECIALTIES .~?~.~,,'~?,,ili, ..... ,:?' '~" ,, ..... LOCATION ~4 BELLE TER~;~:::::::: '~ ?~ ' .............. ~'~?'~%:' ~ ~' / 3'~:~::: ~: ~.~:~:~':.:.~:~:-~ 10 BAKERSE]~LD ca 93 ~?..... ?=~ ..:.... "=~[~' ~:'.~' >~,,~ .......... ::;::,...."'"':,~;;:2:g~ .~q.:~!~, , u ~ t ...................... ;=~i'.~i .:'-.~ ' ' ~ r"'~ · ...... ',~ .....:~,~'~r",~ ~ ¢" .:?',~,u::::!~¥' ................... .........--.,,~"%'. ~,?~4~ ':'~ ................ %. ',~i !' , F [[?' ~,;;;;:;:~'.::=,~.;.Li;...[.J...;,..,i,,..~,,,~ ::",~ '"?"' ..--'" .;'~,,,,.' 4!i~ ;ii~i''''~' i!ili ~ii!i ~i~~' ~!, '=~f[ii!!~ [ssu~ by: B~er~field Fke Depa~ment Approved by: 1715 Cheaer Ave., ~rd Floor e of~~ B~e~fiel~ CA 93301 Voice (805) 326-3979 F~ (80S)~26-0S76 Expiration Date: ~n~ ~0. ~000 IT~ DIAGRAM FACILITY DIAGRAM Businm Nme: ~ o/~,.~ /,~¥~ ~-~ ~!/~ Business Aclclress: ~ -/-~' ~/£/'t,~.. ?-,~,d,~,,~/,~ ~ ~. ?.~c~ ? · ~~% Bere.r~.sen ., Cr.~r-~ ~ ~ ~ ~ ~-]-~[~ P~-~-e OV[R S0 LOCATIONS TNROUGHOUT NORTH AMERICA TO BE~ER SERVE OUR CUSTOMERS COFFEY MFG SPECIALTIES SiteID: 015-021-001820 Manager : BusPhone: (661) 837-4272 Location: 644 BELLE TERRACE 10 Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7692 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title GEORGE COFFEY / OWNER EDNA COFFEY / WIFE Business Phone: (661) 837-4272x Business Phone: (661) 837-4272x 24-Hour Phone : (661) 393-3024x 24-Hour Phone : (661) 393-3024x Pager Phone : ( ) - x Pager Phone : (661) 399-7995xFAX Hanmar Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 837-4272x MailAddr: 5200 COLONIAL DR State: CA City : BAKERSFIELD Zip : 93308 Owner GEORGE COFFEY Phone: (661) 837-4272x Address : 5200 COLONIAL DR State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: 'TotalUSTs: = Gal Certif'd: Res: No Emergency Directives: ~ Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax lunitlMCP ACETYLENE F P IH G 129.00 FT3 Hi ARGON/CARBON DIOXIDE F P IH G 381.00 FT3 Min HYDRAULIC OIL L 55.00 GAL Low OXYGEN F IH DH G 249.00 FT3 Low -1- 07/01/2002 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 NAMECo~a~ MIe(y .~fec~,~ INSPECTION DATE. /t9- "5 t -- O-'c.. FACILITY ADDRESS (~qq 'igc, lie, ~']~r~',~ce '~' to PHONE NO. 6~1 g39 FACILITY CONTACT :Lt./~ BUSINESS ID NO. 15-210-o~2o INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~ Routine ~ Combined ~ Joint Agency [~ Multi-Agency [..] Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy ~~---~ Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~] Yes [~] No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party White - Env. Svcs. Yellow - Station Copy Pink- Business Copy Inspector: COFFEY MFG SPECIALTIES " ~ SiteID: 015-021-001 Manager : '~ BusPhone: (~ ~ Location: 644 BELLE TERRACE 10 Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7692 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title GEORGE COFFEY / OWNER EDNA COFFEY Business Phone: (805) 837-4272x Business Phone: (.~) 24-Hour Phone : (805) 393-3024x 24-Hour Phone : (805) 393-3024x Pager Phone : ( ) - x ~?one : (~f) Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (~) MailAddr: 5200 COLONIAL DR State: CA City : BAKERSFIELD Zip : 93308 Owner GEORGE COFFEY ~C~v~ Phone: (805) 837-4272x State: CA AddressCity :: BAKERSFIELD 5200 COLONIAL DR ~ ~ ~ ~ Zip : 93308 ~NV~0~ TotalASTs: = Gal Period : to · Preparer: TotalUSTs: = Gal Certif' d: RSs: No Emergency Directives: = Hazmat Inven ry One Unified List -- As Designated Order All Materials at Site Hazmat Common Name... IspecHaz EPA Hazards] Frm DailyMax lUnitlMCP OXYGEN F IH DH G 249.00 FT3 Low HYDRAULIC OIL L 55.00 GAL Low ACETYLENE F P IH G 129.00 FT3 Hi ARGON/CARBON DIOXIDE F P IH G 381.00 FT3 Min ~, ~Zd/?~ ~- ,~- ~'~£Fz'Y Do hereby cortify ~ha~ ~ hav~ (Type or p~tn! name) reviewed the attached hazardous materials rna~age- men~ plan for ~,~/~z-~ m?~. and ~hat it along with (i~me of Bus ness) any corrections constitute a complete and cormc~ rnan- agernem plan for my facili~j. ,~.,. : ~g~mre -1- ~,e 09/05/2000 COFFEY MFG SPECIALTIES SiteID: 015-021-001820 ~ Inventory Item 0001 Facility Unit: Mobile Containers at Site -- COMMON NAME / CHEMICAL NAME ! OXYGEN I Days On Site 365 Location within this Facility Unit Map: Grid: ON PORTABLE WELDING CART CAS# 7782-44-7 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 249.00 FT3 200.00 FT3 HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Oxygen. Compressed N 7782447 HAZARD ASSESSMENTS TSecretl RSIBioHazl Radioactive/Amount I EPA Hazards[ NFPA USDOT# I MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME HYDRAULIC OIL Days On Site 365 Location within this Facility Unit Map: Grid: IN SW CORNER OF SHOP CAS# F STATE i TYPE PRESSURE i TEMPERATUREI CONTAINER TYPE Ambient DRUM/BARREL-METALLIC Ambient Licluid Pure AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 20.00 GAL HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Hydraulic Brake Fluid (Diethylene Glycol Monobu... N 112345 HAZARD ASSESSMENTS TSecret RS BioHaz, Radioactive/Amount, EPA Hazards, NFPA USDOT# MCP No N°l][No No/ Curies / / / Low -2- 09/05/2000 COFFEY MFG SPECIALTIES SiteID: 015-021-001820 ~ Inventory Item 0002 Facility Unit: Mobile Containers at Site ~UIVUVIU~ ~Vl~ / ~± ~ZA_~ ~Vl~ ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: ON PORTABLE WELDING CART CAS# 74-86-2 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 129.00 FT3 129.00 FT3 100.00 FT3 HAZARDOUS COMPONENTS %Wt. y~ CAS# 100.00 Acetylene . 74862 HAZARD ASSESSMENTS TSecret RS BioHaz, Radioactive/Amount , EPA Hazards NFPA USDOT# MCP No N°llNo No/ Curies F P IH / / / Hi ~ Inventory Item 0003 Facility Unit: Mobile Containers at Site 9 ARGON/CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: ON WIRE FEED M.I.G. WELDER CART (PORTABLE) CAS# 7440-37-1 F STATE ~ TYPE PRESSURE i TEMPER3ITURE CONTAINER TYPE Gas /Mixture Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 381.00 FT3 381.00 FT3I 300.00 FT3 %Wt. RS CAS# 75.00 Argon No 7440371 25.00 Carbon Dioxide No 124389 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards I NFPA USDOT# MCP No N° No No/ Curies F P IHI / / / Min 3 09/05/2000 F COFFEY MFG SPECIALTIES SiteID: 015-021-001820 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 10/27/1997 PHONE IN OFFICE AND SHOP USED TO CALL 911 IN THE EVENT OF AN EMERGENCY. -- Employee Notif./Evacuation 10/27/1997 VERBAL. Public Notif./Evacuation 10/27/1997 N/A Emergency Medical Plan 10/27/1997 CLOSEST HOSPITAL - MERCY. -4- 09/05/2000 F COFFEY MFG SPECIALTIES SiteID: 015-021-001820 ~ Fast Format = Mitigation/Prevent/Abatemt Overall Site --Release Prevention 10/27/1997 CYLINDERS KEPT CHAINED TO CART.' OIL DRUM LOCATED OUT OF WAY OF WORK AREA. Release Containment 10/27/1997 N/A -- Cl'ean Up 10/27/1997 SHOP RAGS FOR OIL SPILLS. Other Resource Activation -5- 09/05/2000 F COFFEY MFG SPECIALTIES SiteID: 015-021-001820 I Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 10/27/1997 A) GAS - S END OF BLDG B) ELECTRICAL - S END OF BLDG C) WATER - D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 10/27/1997 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - E SIDE OF BLDG COMPLEX. -- Building Occupancy Level 6 09/05/2000 COFFEY MFG SPECIALTIES SiteID: 015-021-001820 Fast Format ~ Training Overall Site -- Employee Training 10/27/1997 WE HAVE~ EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGPJIM: HAZARD COMMUNICATION AND MSDS. Page 2 Held for Future Use Held for Future Use -7- 09/05/2000 MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ~..-~-~' NEWACCOUNT ADDRESS CHANGE CLOSE ACCT 'FINANCE CHARGE I · OTHER ADJ /, PARCEL NUMBER (~F AP~'UCAat. E) ADJUSTMENT CHG DATE CHARGE CODE ADJUSTMENT AMOUNT APPROVED BY CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA ($05) 326-3979 INSTRUCTIONS: 1. To avoid further action, return this form within 30 days o receipt. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: LOCATION: CITY: STA~: Z~: D~ & B~S~ET ~ER: SIC CODE: P~Y AC~TY: O~R: ~C~ ~H.~G ~D~SS: SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE · ~- 4zVt I]AZA~OUS MATERIALS MANAGEMENT PLAN '. SECTION 3: TRAINING NUMBER OF EMPLOYEES: ~ MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TR.MNING PROGRAM: SECTION 4: EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PEKIURY 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 TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION 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 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: B. RELEASE CONTAD,TME~ AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTII.ITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)_ NATURAL GAS/PROPANE: .~ ELECTRICAL: 5 c--~ WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER, AVAILABILITY (FIRE HYDRANT): 4 ~OUS MATERIALS L-NVENT~ Page of ~C~ DES~ON 1)~ORYSTA~S:N~[ ]A~fion[ IReful{ ]~1~[ ] Ch~kffch~,~aNONT~S~{ ]T~S~{ ] Ch~N~: ~[ ] C~ 4) Ph~i~ & H~ P~SlC~ 5) WAS~ C~S~CA~ON (3~t ~ ~ D~ F~ 80~) USE CODE 6)P~SIC~STA~ ~d[ ] Liq~d[ ] ~] ~] ~e[ ] W~[ ] ~ve[ ] 7) ~o~ ~ ~ AT ~acm~ ~ ov ~~ s) STO~OU COD~ ~m V~y ~omt ~ L~ [ ] ~ [ ] ~l a) C~ Av~e D~y ~omt ~ C~ [] c- b) ~: ~ ~o~t ~ c) T~~ ~ S~ Con~= 9) ~: Lira CO~~ C~ % ~ · e ~ mo~ ~ 1) [ ] ch~ m~ or 2) [ ] ~y ~ ~~ 3) [ ] 1)~ORYSTA~S:New[ ]A~fion[ ]Rehhm[ ]~lefion[ ] Ch~kffch~isaNON 7~~[ ]T~~[ ] ChrONic: ~[ ] C~ 4) Physi~ & H~ P~SIC~ 5) WAS~ C~S~CA~ON (~t ~ ~ D~ F~ 8022) HSE CODI 6) P~SIC~STA~ ~hd[ ] Liqmd[ I ~ ~e~] ~[ ] W~[ ] ~ve[ ] 7) ~O~ ~ ~ AT FAC~ ~ OF ~~ 8) STO~G COD~ Av~c D~y ~o=t ~ ~ Cm~ [ ] b) ~m: ~ ~o=t ~ c) Tm~ m ~ Days on Si~ ~ ~ Cmle ~ch Mon~: ~ Y~, J, F, ~ & J, J, & S, O, N, D 9) ~: Lia CO~~ C~ % ~ · e ~ mo~ ~o~ I) [ ] ch~ mm~n~u or 2) [ ] ~y ~ mm~m~ 3) [ ]. IO)L~A~ON I ~ ~ ~ of law, ~t I Mve ~ly em~ ~d m t'~ m~ ~e ~mam on ~s ~d fll a~ m~. I ~hcve ~e ~b~R~ ~b~ is ~, ~mm ~d ~mplcm. CHEMICAL DESCRII)TION I)INVENTORYSTATUS:New[ ]Addition( ]Re,sion( ]Deletion[ ] Check if chemical is a NON Trad~ S(~-et [ ]Trad~Secret[ ] 2) Common Nam¢: ~_~ / ~) ~ 3)DOT#(optioual) Cheamcal Name: AHM [ ] CAS # 4) Physic. al & Health PHYSICAL HEALTH HazardCategones Fire[ ]Reactive[ ]SuddenReleaseofPressure[ ] lmmediateHealth(A~)[ ]DelayedHealth(Clmmi¢)[ 5) WASTE CLASSIFICATION (3-digit cod~ fly-, DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas~ Pure [~"] Mixtm'e [ ] Wast~ [ I Radioamive [ ] 7) AMOUNT AND TnV~ aT F^cmrrv uNrrs oF MF_~SURE 8) STORAGE CODm Maximum Daily Amount 'T=,~ ~ Lbs [ ] Gal [ ] ft3 [ I a) Container.. Average Daily Amount 3c, r_D Curies [ ] b) ~: Annual Amount ~ c) T ,~-~,erature # Days on Site B ~ ~'- Cimle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, lq, D O) MIXTURE: List ~)lV~ONENT CAS# 4~13/T AHM the three most h~ardous 1) [ chemical compments or 2) c~f-) ~ ~ [ ] any AH/VI c~nponents 3) [ 10)LOCATION OM ~ ,/z_~ C~-~_.~ ~:) x~q. ~. ~. c.O'~_ci~'--~_ ~_-.~'~-'T- 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] ChcckifchmnicalisaNONTradeS(s:z~t[ ]Trad~Sccrm[ 2) Common Narn¢: .~{-d~C)C.- C~t ~ 3)DOT# (optional) Chmnical Name: AHM [ ] CAS # 4) Fhysical & Health FHY$ICAL HEALTH FT~srdCategories Fire[~]Reactiv¢[ ]$-da_~nRcleaseo£Pressure[ ] Imm~li-t~Hmdth(Acmc)[ ] Delayed Health (Chronic) [ ] ~) WASTE CLASSIFICATION (3=digit code from DHS Form 8022} USE CODE 6) PHYSICAL STATE SoUd [ ] Liqttid [~'] Gas [ ] Pure ~ Mixtare [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEAS~ 8) STORAGE CODF~ Maximum Daily Amount ~-'~-'- Lbs [ ] Gal ~ ] ~ [ ] a) Coatam~ Averas¢ Daffy Amount ~7_-(~;) Curies [ ] b) Pre~mre: ( Annual Amount '2-~ c) Tmxtpm'atu~ Largest Size Container ~'""~"~ # Days on Site ~3 G'x~ Circle Which Months: All Year, J, F, M, A, M, $, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most h~ardous 1) [ ] chemical components or 2) [ ] any AH/vi components 3) [ ~o)r.oc^TIo~ I tO 5ot2r~5-r &r~.rjox ~ j I certify under penal~ of law, that I have personally examined and am familiar with the information on ~ and all atteda~ do~am~nt~ I believe the submitted information is true., accurate and complete. .~., SITE DIAGRAM FACILITY DIAGRAM Business Nc:me: ~.4~)_~'~(-/. '/g4F®.._-~?~C,~tLT,.'~ ~ " Busine~ ACUfex: ~ ~~ ~~ ~ ~O For Office Use Only First ~n Stctian: Are<3 McD# of Insc~ec:ian Stolon: NORTH z~