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Home My WebLink AboutBUSINESS PLAN 2/21/2001 CUST & NO. ~'_..~ ~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ,~'")~'-((.~{ NEW'ACCOUNT ADDRESS CHANGE CLOSE ACCT · FINANCE CHARGE I OTHER ADJ I ~,// CUSTOMER NAME -___~C~,C~e_.% '~-:('-(:l~qXC :: .~)~',/ %~0C~ MAILING ADDRESS ~~ ~C~¢~~ ~~. CI~ ~~ %5 C~¢ STATE (~' ZIP CODE SITE ADDRESS PARCEL NUMBER ADJUSTMENT I CHG DATE CHARGE CODE ADJUSTMENT AMOUNT i /-~/-~/~L~/ Y/~ - APPRO~D BY ~...( /c ~- JAIME FRAME & BODY SHOP AJ~,__~~) SiteID: 015-021-002055 Manager : ~3/t~~BusPhone: (661) 321-9624 Location: 332 BRUNDAGE LN ~, ~'~ Map : 103 Com~az : Minimal City : B~ERSFIELD ~" Grid: 31D FacUnits: 1 AOV: CommCode: B~ERSFIELD STATION 06 SIC Code: EPA Nu~: DunnBrad: Emergency Contact / Title Emergency Contact / Title JAIME PEREZ / OWNER / Business Phone: (661) 321-9624x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (661) 321-9624x MailAddr: 332 BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93304 Owner JAIME PEREZ Phone: (661) 321-9624x Address : 332 BRUNDAGE LN State: gA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: INVENTORY OBTAINED ON INSPECTION - NEED TO COMPLETE A HAZARDOUS MATERIALS MANAGEMENT PLAN AND SITE/FACILITY DIAGRAM. BILLED RETURNED WITH CHANGE OF ADDRESS FROM THE POST OFFICE. CALLED TO VERIFY, PHONE HAS BEEN DISCONNECTED. WILL FORWARD TO THAT ADDRESS. 1-31-01 WIFE, HERLINDA, CALLED JAIME WAS DIAGNOSED WITH CANCER LAST YEAR. SHOP HAS BEEN CLOSED SINCE THEN. SHE WILL SEND US A COPY OF HIS DISABILITY PAPERS. ---- Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm I DailyMax IUnitlMCP OXYGEN F IH DH G 249.00 FT3 Low JAIME FRAME & BODY SHOP SiteID: 015-021-002055 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~UIVUVlU~ ~Vl~ / ~ ~./--~.L~ ~Vl~ OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: CENTER OF SHOP CAS# 7782-44-7 F STATE ~ TYPE i PRESSURE, TEMPERATUREI CONTAINER TYPE Gas /Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 249.00 FT3I 249.00 FT3I 249.00 FT3 I HAZARDOUS COMPONENTS ~ %Wt. S CAS# 100.00 Oxygen, Compressed N 7782447 HAZARD ASSESSMENTS ITSecret[ ~S BioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No N No No/ Curies F IH DH / / / Low -2- 01/31/2001 D~TE: 1101/01 DUE ~EM~T AND CITY PO ~OX 2057 CUSTOMER NO: 330&4 CUSTOMER TYPE: E~/ 40187 TOTAL DUE: ~i40.00 FRESNO DZSABZLZTY OFF Serving tee People of California FRESNO, CA ~3707-00:~ ---NOTICE OF COMPUTATION--- T-T~+l.eph¢,~l~. N-'~..$00r~l,gO-3~.7 · ..~-~-~ z, -- ' This rfotice does not establish your rJ§ht ':~t6 b~'~fitsr. Di~-alSility Insurance is'paid.to: ,, you only when you meet ali the conditions of eligibili~, Youe Social Seour~ty Nu~er: ~, , ' ~Gs-04- 4~ .. ~ . j, AD. C~FCK~; IF OUE,/,~ MAILED SEPA~TELY~ Your maximum Benefit amount is $ --, ..... '-> Your weekly Benefit amount is $ 161.00 < ....... Your daily Benefit a~unt is S 23.00~p Your ~laim'e{~eottve date is 11/02/00 RDGR~ R ';~rU PER~Z' [ SEPT 99 I 6EC g9 ~ i MAR 00'.. ; UUNE ~0 ./:" NAME l~CT ._ 380i.52 ~I ... '"' .PO , ..~ .00 , IMATTS PAZNI~O00001000]O.,~ ~R .~OTAL 3801 .~2 ..00 :.qO · T ~00 .. !TOTAL NAGES t. See'that y~ Social seCu~f~Y Nu~er (SSN) is co~eec~ly s~wn.' ' :~ 2. C~ck any o* the wages 1 is:~ w~t~ you did not earn. 3. Check {or any wages subject to t~ Califoenia Une~loy~nt lnsurance UNIFIED PROG~M3rd INSPECTION CHEC~IST 1715 Chester Ave., Floor, Bakersfield, CA 93301 FACILITY NAME .~,~C0 ~ ~ ~o~ 5~ ~SPECTION DA~E ~1 ADD'SS ~3~ ~~E ~ PHONENO. FACILITY CONTACT 3~,~ g~ BUS'ESS ID NO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program {~__Routine [~ Combined l~l Joint Agency [~ Multi-Agency [~1 Complaint [~l Re-inspection OPERATION C'V COMMENTS Appropriate permit on hand ~f~.~j ~/.Jx~ ~,~'..-~ Business plan contact information accurate ~Og~ (~t.~ "IZ) ~ Visible address Correct occupancy Verification of inventory materials Verification of quantities ~__dl~ ~ ~' O,~/tlE. tO Verification of location ~----~~ ~ Proper segregation of material Verification of MSDS availability I '~ - ~ Se hab~)spafiol Verification of Haz Mat training Jaime's Body Shop Verification of abatement supplies and procedures Bodywork & Paint Emergency procedures adequate Containers properly labeled I (661) 321-9624 Housekeeping I 332Brundage Lane · Bakersfield, CA, 93304 Fire Protection ~ : Site Diagram Adequate & On Hand t~,'t.:c- ~.-,~0' ' ~.~'30~ C--Compliance V=Violation Any hazardous waste on site?: [~l Yes ~No Explain: ~gl/]I~,k(' I,'O ~ 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: