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Home My WebLink AboutBUSINESS PLANi ~: _ ~; '~ BKFLD FIRE DEPT - sTa a - - - -- - - - -- II. 130 BERNARD STREET - _ ~, i ~P= ~~ Ib;>> ~~ I~~'; ~~~i ~~ .1~, ~'~~ (~' l BAKERSFIELD FIRE DEPARq~ENT {./~/GO BUREAU OF FIRE PREYENTION Date APPLICATION Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made by: - Nome of ~ 04 to display, stare, install, use, operate, sell or handle materials or processes involving or creating con- ditions deemed hazardous to life or propert"v~as fallows: Authorized Representative .': .. Perm~ ........... ~.//. ~L?.,0_ .................. /,,0::: / ' By ............. /~.: .............................................................. · ,. Date C~'~> Fire Marshal .: ' :-.?., ... .~" .'- ..... ::,.. .~',',i .:-: . · .,'. '.':.;;. · . -.~. -: . .:: ~'-...'.'. - ..'. ! ..'-:... .' :. :.- ..'-":: .' '.... ..... :;..- . . .. :,~:. .'., ... ...... . .... :..... .-. ,. ,...'i.: .: ,. :. ~ ... .. .. ...... ~ ., :~-:.: :..,.:"'i: .:>:'.., ,.':..':..:. ,.,.. ~' .:. :'. '., ._ ,.;..... ,. ~ ....,. .... :. ~.: ',"::i.~ .... ,~:,::...~_. ~. :..:, Age~y Dl~lof B~er~field, CA ~/~L~ ..... ~ Telephone (805) ~CA~LEY RESOURCE ENT AGENCY DEPAR MENTAL ~ER~T FOR PER~NENT CLOSURE ~~~ PERMIT NUMBER A 12~ OF UNDERGRO~D HAZARDOUS SUBSTANCES STORAGE FACILITY FACILITY NA~/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Bakersfield Fire Station ~4 City of Bakersfield Placer Trac~or ~rvic~ 130 Bernard Street 1501 Trux~un Aven~e P.O. Box 170 Bakor~field, CA 93301' Bakersfield, CA 93301 Loom/s, CA 95650 License ~44059I Phone: (805) 326-3724 Phone: (916) 652-5535 PERMIT FOR CLOSURE OF PERMIT EXPIRES . August B0, 1990_ I TANK(S) AT ABOVE APPROVAL DATE May 30, 1990_ Hazardous Materials ~J~pialist ..................................................................................... POST ON PREMISES ............ ;. ..................................................... CONDITIONS AS FOLLOWS; h It ia ThC ccsponsibi|ity of thc Pcrmitt¢~ to obtain permLts which may he reqt~ircd by OCher regulator'7 agencies prior to bcginninS work. (i.~., Fire and Buildin g Depart ments) 2. Pcrmittc~ mu~t ,notify ;he Hazardous Materials Management Program at (80~) 861-i636 two working days ~ to tank removal or abandon in place to arrange tar required inspections(:). 3. Tank clo~ur~ activities must be per Kern County Environmental Health and Fire Department approved methods aa described in Handbook $0. 4. [t is th{: contra{tree's r~pon$ibility to know and adhere to all applicable lawn regarding the handling, tran~portati0n or treatment of materials. · $. The tank removal contractor must have a qualified company employee onsite supervising the tank removal, The employee a;ust have tank cxperiance prior to working u~aupervlsed. 6. [g any contractor~ other than those lhted on permit and per.it application arc to be uxilizad, prior approval m~t be granted by the ~ liatad, on the permit. Deviation fr~m the submitted application is not allowed. 7, Soil Sampling: · :, a. Tnnlt size [~aa Than or equal to 1,000 ~allo~a - a minimum of two sampie~ must be retrieved from bcncath the center of I he tanl~ at of approximately two feet and six feet, b. TavJc size greater than 1,000 to 10,000 salloas - a minimum of fo~r samptc~ must be retrieved one-third of the way in from the each tank at depths of approximately two fcct and iix feet. c, Talfl/tize greater than 10,000 gallons - a minimum o/~ix aampie~ rau~t be retrieved on-fourt~ of the way in from the ends of each and beneath thc ccnler of each Tsar at' depths o/approxima[ety two feet and six feet. $. Soil Sampiir~g (piping area): A minimum of two ~ampiea ent~t be retrieved at dgptl~ of approximately two feet ante six feet for every 13 linear feet of pipe run and dispenser area, Bakersfield Fir ept. Hazardous Materials Inspection Date Completed Location: / Plan ID ~ 215-000//~ (Top right comer Business Plan) Station No. ~ffO~e~ ." ~d M0~~ A ~AT_ ~ ~ ~~dA~~ Verification of Invento~ Materials Verification of Quantities Verification of Location ~oper Se~egafion of Matefi~ Verification of MSDS Availabfli~ Nmber of~ployees Vehficafion of Haz Mat Trai~ng Verification of Abatement Supplies & Procedures ~ [-~ Commel~S: Emergency Procedures Posted Containers Properly Labeled Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: .,~_,~./tdZ)OfcJt~--.Z~ ,~-O CZ_ --/-,,,</'/~d ~ //ZJ ,,~--~,~ FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office G Bakersfield Fire ept. Hazardous Materials Inspection Date Completed Business Name : ~-~ ~'"~ ~'(C~'~ ~3-'~f~. ~:L. t_~ , Location: _1 ~_~ _~ ~.~ ~ i~ ~,j~./~ RECEIVED -7 . NOV 0 6 1989 Plan ID ~ 215-000 ' (Top fight co~er Business Plan) ~ ~ - ~~ -- ~ ~ Adequate Inadequate VeHfica~on of lnvento~ Materials Verification of Quantities Verification of Location ~oper Se~egafion of Matefi~ Verification of ~SDS Availabfli~ Number of Employees Verification of Haz Mat Training [~] [~ Verification of Abatement Supplies & Procedures [~] ~] Comments: Emergency Procedures Posted [~] Containers Properly Labeled [~ [-~ Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office ...~ -~.'. ~,x CITY o~ BAKERSFIELD~ ~,.. .. ' u,.~ ,,, ~__ ~ ~ "~.'E C..qRE" "'.'~..C 'o..:,......:' ~., ' ~z~ (ry~e or erin: name) ~FC~IV~ Do hereby, certify ~hat I have reviewed the attached Hazardous Materials business plan (name of business) and that. it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. ' 'si,~ure ....... date - CITY of BAKERSFIELD NON--TRADE SECRETS LOCATION: I ~O ~~ ADDRESS: ~tO ~ ~, ~, STANDARD IND. CLASS CODE CITY, ZrP: q ~0~, CITY, ZrP: q ~O ~ DUN, AND BRADSTRKET NUMBER C~e C~e Mt Mt Est Units m Site I~ ~s I~ ~ St~ tn F~tlity~- ~ I~t~tt~ fC~k ell t~t a~ly) blth of Pm~ ~lch ........ H~lth of Pr~sure Health q ........... ~t 13 ~&C.A.S. ~r ¢~rttfic.ti~ (Read and sJ~n after co.pJe~ln~ ali sections} I cert?y ~der ~lty of law t~t I ~ve ffrs~ollyexonin~ ~d au f~ilior with t~ tnforMti~ subitt~ tn this ~ oll lttKM for obtaining t~ inf~ti~. I ~lie~ tMt t~ su~i. tt~ info~ti~ is tr~ accurate 4nd cmplece. ~ BAKERSFIELD CITY FIRE DEPARTMENT · 0~ 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-39?9 l OFFICIAL USE ONLY BUSINESS PLAN AS A WHOLE INSTRUCTI 0NS: .... , 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS: ~O ~P--q-~rq-~.O SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 91! and 1-800-852-7550 or 1-916-427-4341. 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 BI/S. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE D. SPECIAL: ~ E. LOCK BOX: YES ,/~__~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MEDES? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOL~R BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING ". EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES' EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A, METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS:.... .................................... ~ NO ~. NO WITH RESPONSE AGENCIES: .......................... ~ NO .~NO C. PROPER USE OF SAFETY EQUIPMENT: .................. NO NO D. EMERGENCY EVACUATION PROCEDURES: ................. · NO NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO NO SECTION 7: FIAZARDOUS MATERIAL CIRCLE(~-,NO - ~o1~ DOES YOUR BUSINESS HANDLE HAZARDOUS ~TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, $$ GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO I, ~%~ ~~' , certify that the above information is accurate. I understand 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. 2S500 Et Al.) and that inaccurate information constitutes perjury. - 2B - BAKERSFIELD CITY FIRE OEPAR'C..IE.XT - 2130 "G" STREET BAKERSFIELD, CA 93301 07S~Ci.4L USE ONLY BUSINESS NAME: BUS I NESS PLAN SINGLE FAC ILI T'f UNIT FORM SA INSTRUCTIONS 1. To avoid further action, t~fis form must be returned by: 2. TYPE/?RINT YOUR ANSWERS IN ENGLISH. 8. Answer tke questions below for THE FACILI~f %~IT LISTE~ BELOW 4. Be as BRIEF and CONCISE as possible. ~ :' FACILI~ ~IT~ FACILI~ ~IT N~: SE~ION 1: MITIGATION, PR~ION~ ABAT~ PROC~L~ES SECTION 2: NOTIFICATION Ah'D EVACUATICN PROCEDL'RES AT THIS L-X'iT O.YLY SECTION 3: HAZARDOUS MATERIALS FOR THIS bLNIT 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 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 secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILI?f SHUT-OFFS AT THIS UNIT ONLY· A .YAT " ~''~ ~ '" · . E. LOCK BOX: YES .'~F YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES ." NO FLOOR PLANS? YES ./ NO KEYS? YES .." NO - 3B - NON--T~AD~ S~OR~TS liAZA~DOUS ~AT~RI ALS' I NV~NTORY __ ~[ ONLY 2 3 7 9 '}1~1; Al, lfJlJt~'l' AHIJlJ~I' FACILITY UHIT CIIEHI(;AL OR COHHON HAHE CODE ~-2'-,~ · ¢ ~c/:~ TITI, EI -: .,~ ~', ....;~:: oNE t Bus IIOlIRS: v AFTER BUS ~_ ,~ ~ ,, TITLE~ ~/~' ~-~, PIIOHE I BUS IIOIIRS: ACTIVITY: ~/~~/~G . AFTER ~IIS.