HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This _Dermit is issued for the followiltq;
[] Hazardous Materials Plan
[] Underground Storage of Hazardous Materials
Permit ID #:: 015-000-001834 [] Risk Management Program
SAN MARCOS CARBU [] Hazardous Waste On-Site Treatment
LOCATION: 407 E BRUNDAGE LN
OFFICE OF ENVIRONMENTAL SER VICES' .
1715 Chester Ave., 3rd Floor .Appmvedby: .L~lPi/tlueY, l~--'~ ~ Iss-e Date
Bakersfield, CA 93301 OfliceofEvimnmenl~Services
Voice (661) 326-3979
FAX (661) 326-0576 , Expiration Date: Jun~} 30.= 2003
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
........... ,,,,~,,=.~,?~?~,,~,~,~,~, ................ This permit is issued for the following:
,~,~,?' ~?i :~,! Pr?::iii '~i}i!! ii~ ii i~i!i!!iii?:ii?,iilDiiiiU~e!:ground storage of Hazardous Materials
SAN MARCOS CARBU
LOCATION 407 E
~.:::::::-:::~
'~ · *
Issu~ by:
O B~er~field Fke Depa~ment Approv~ by: ~~~'
OFFICE OF E~R O~E~AL
1715 Chewer Ave., ~rd Floor
B~e~fiel~ CA 93301
Voice (805) ~26-~979
F~ (80S)~26-0576 Expiration Date: dun~ ~O~ ~OOO
MISCELLANEOUS RECEIVABLES ADJUSTMENT
DATE .._..~-i~-Of' NEWACCOUNT
ADDRESS CHANGE
CLOSE ACCT
'FINANCE CHARGE,
OTHER ADJ
SITE ADDRESS
PARCEL NUMBER
(~F AP~'UCA~LE)
ADJUSTMENT
i CHG DATE CHARGE CODEADJUSTMENT AMOUNT
, I-O/-oi /v/4fp'/q ,~ ~3.0o
SAN MARCOS CARBURETORS SiteID: 015-021-001834
Manager : BusPhone: (805) 861-8606
Location: 407 E BRUNDAGE LN Map : 103 CommHaz : Minimal
City : BAKERSFIELD Grid: 32C FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
GERARDO LOPEZ / OWNER /
Business Phone: (805) 861-8606x Business Phone: ( ) - x
24-Hour Phone : (805) 363-6333x 24-Hour Phone : ( ) - x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire DelHlth
Contact : Phone: (805) 861-8606x
MailAddr: 407 E BRUNDAGE LN State: CA
City : BAKERSFIELD Zip : 93307
Owner GERARDO LOPEZ Phone: (805) 363-6333x
Address : 3860 WEEDPATCH HWY State: CA
City : BAKERSFIELD Zip : 93307
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
: Hazmat Inventory One Unified List
-- Alphabetical Order All Materials at Site
Hazmat Common/~ame... ISpecHaz EPA Hazards Frm I DailyMax UnitlMCP
CARBURATOR CLEANER F DH L 15.00 GAL Hi
SAFETY KLEEN"SOLVENT L 15 . 00 GAL Mod
~, Oo hereby csr~ify that ~ have
(T~pa or pdnl neme)
reviewed ~he a%tached hazardous materials manage-
ment plan for and that it along with
(Nam~ of Busine&s)
any corrections constitute a cornple~e and correct man-
agernent plan for my ~acili~y.
-1 - 03/15/2001
Signature Date
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301
FACILITY NAME ,-~'~-~ ~"~.~,tO.a' d,,'-~,g,-~o,~,~PECTIOS DATE
ADD'SS ~J~ 2 ' ~' ~~ ~ ~ PHONE NO. ~/-
FACILITY cONTACT_ ~ ~-a ~ ~'~ BUSINESS ID NO. 15-210-
~SPECTION TIME /~ NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
~(ff.~outine {~l Combined ~ Joint Agency [~1 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 L4t
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate I~__~
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
. !
Any hazardous waste on site?: [~1 Yes ~]No
Explain:~ _
Questions regarding this inspection? Please ¢ali us at (661) 326-3979 - Business ~R~o~le Party-
White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector:
· CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
UNDERGROUND STORAGE TANK PROGRAM
1715 Chester Ave., Bakersfield, CA ($05) 326-3979
INSTRUCTIONS:
1. To avoid further action, remm this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole. %~:x- ,~\~_~_~
4. Be as brief and concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA C--Pa
BUSINESS NAME: ~"'J /VLA-~'~dO <~ C/&/e_%O/z
LOCATION: z~0-/ ~.
~MAILING ADDRESS:
CITY: STATE: __ ZIP: __ PHONE:
DUN & BRADSTREET NUMBER: SIC CODE:
PRLMARY ACTIVITY:
OWNER:
MAIL~'G ADDRESS: ~6'~ ~%6C3 6o~--o~P/x-rca,
SECTION 2: EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 I-[K PHONE
2.
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON F~E:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REQUEST
I CERTIFY L~-DER PENALTY OF PEtLIL-RY THAT MY BUSINESS IS EXEMPT FROM
THE REPORTING REQUIRE~MENTS OF CI-DkPTER 6.95 OF TH2E "CALIFORNIA HEALTH
& SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT HANDLE t-L-~Z.~d3OUS MATERIALS.
WE DO HANDLE HAZ)d~DOUS MATERIALS, BUT THE QUANTITIES AT
NO TiME EXCEED THE .MTNDILWI REPORTING QUANTITIES.
OTH2ER (SPECIFY REASON')
SECTION 5: CERTIFICATION
I. CERTIFY THAT THE ABOVE
INFO1LMA/ION IS ACCURATE. I L.'NDERSTAND THAT TI-~S INFORMATION WILL BE
USED TO FULFILL ,MY FIRM' S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH
AND SAFETY CODE" ON HAZARDOUS .\L-XTERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500
ET .~L.) AND THAT INACCURATE INTOtLMATION CONSTITUTES PERJURY.
SIGNATURE TITLE DATE
2
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
A. AGENCY NOTIFICATION PROCEDUKES:
B. EMPLOYEE NOTIFICATION AND EVACUATION:
C. PUBLIC EVACUATION: .....
SAN MARCOS Fore,~ ')omestic
CARBURETORS Carburot,~_~pocialist***
: Especialista en
, .:~ Carburadores
-" ~ Inportados y del Pais
GERARDO LOPEZ
407 BRUNDAGE LN. (805) 861-8606
D. EMERGENCY MEDICAL PL.&N-:
HAZARDOUS MATERIALS MANAGEMENT PLAN '
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN
A. KELEASE PREVENTION STEPS:
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
C. CLEAN-UP PROCEDURES:
SECTION 8: L'T[LITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATL'R.AL GAS/PROPANE:
ELECTRICAL:
WATER:
SPECIAJ_,:
LOCK BOX: YES/NO IF YES. LOCATION:
SECTION 9: PR. IVATE FIRE PROTECTION.WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABILITY (Fl:RE I-~'DRANT):
;~ness Name Aclaress
CHEMICAL DESCRIPTION
I IN~RYSTA'I1J$: New( ! Am~aal I ~i ! De~i i -,[
C,hem~.aJ Name: ~M [ ] C~
~DCA~RIES Fim~ Re~( ] Sud~enRe~ofPressure [ ~ Im~He~(~e)
WAS~ C~SSIFICA~ON (~ig~ ~e ~m OHS Fo~ SO=} USE CODE
P~ICALSTA~ ~1~ [ ] ~au~ ~ G~ [ ] Pure [ ] M~ [ ] W~tl
AMOUNT AND ~ME AT FACI~ ;NITS CF M~SURE 8) STOOGE CODE$
Average ~ A~un~: c~nes [ ~
Annu~ A~unt: c) Tempera:
~est Size Comanec ~ ~
= Oa~ On S~e ~;~=e ~cn Months: All Ye~. J. F. M. A. M. J. J. A,
MITRE: ~st COMPONENT CAS
'-e mree most n~=o~ ~ )
;~em~ com~nen~ or
~V AHM com~nen~ Z~
CHEMICAL DESCRI~ION
'~NTCRY STA~S. ~ew { ) A~cmen f ] =ews~on ( ~ Ce~et~on Chec~ ~ cnem~ is a NON ~DE SECR~
: nem~cm Name: AHM
:~vsICAL & H~L:~ =HYSICAL H~
-~D CA~GCR~E5 Fire ~ ' ;eam~ve { ~ Su~en ~e,e~e c~ P'~ss~re : ' ,mmeo~e ~e~
.','AS~ C~SSIFICA~ON ~a~g~t co~e ~om OHS Fc~ 8C22) USE CC~E
;,MOUNT AND T;ME ~T F~C:U~ _NITS 2; L{~SURE 8) STOOGE CODES
Average O~N Amount: :Pries [ ; ~) Pressure:
Annum Amount: c) Tem~re:
~ges: S~ze C~ntmner: / ~
=Davs On ~;te C,:c:e v~;cn ~.~ontns: All Ye~... ~. M. A. M. J. J, A,
~e
I ~em~ com~nen~ or ~j~ ~
i nY A~M com~nen~
y u~er De~ or/aw, ~at I n~e oe~on~ly ex~ln~ ~o ~ t~t/t~ wl~ ~e _
~ in~aDon ts ~e, accu~. ~ complete.
' N~e & TiEe of ~cnz~ Com~ Re~en~e
:zness Name Address
CHEMICAL DE$¢RIP'I1ON
~ Common Neme: 3) DOT ·
~e~_ ~ Name: AHM.{ ~ CASe
~AZARO CATEGORIES F~m ; ] Rem::Uve~ ] Sudclen ~eleaseot P~ess~e i ! Imme~l~teHeeWl (Acute)
, WASTE CLASS!FICA'nON (3-d_ig.,t __e~_e eom OHS Form S0221 USE CODE
PHYSICAL STATE Solk:l [ ] Liqu~fl [ ] Gas [ ] Pure [ ] Mi~um [ ] Waste [ ]
AMOUNT AND TIME AT FACIUTY ;JNITS CF MEASURE 8) STORAGE CODES
Average OmW Amoum: curies ( ] b) Prea~um:
Annual Amount: c) Temoereture:
L~rgest Size Container:
# Oars On S~te C;rcleWh~cn Morons: All Year. J. F. M. A. M. J. J. A. S. O. N. D
:~e three most nazamous 1 ) [
;~emlcaJ COmDonellt$ or
~J1¥ AHM comOonents ,?.] [
[i
;~ Location
CHEMICAL DESCRIPTION
r~VE_NTCRY STAT'~S: New ( ] Aclc,~!an ( ] ~ewston { ] Ce~et~on ' . Check if cnemlcat is a NON TRADE SECRET [ ] TRA~E SECRET
Common Name: 3) DOT #
,'.;emlca] Name: AHM [ ] CAS #
=~.Y$1CAL & hlE..AL~-: =HY$1CAL HEALTH
-AZARD CATEGOR!E$ Fire [ ' ,Reac:~ve j ] SuclOen ~e~ea.~e cf P'~ssure : i ~mmecliate Healttl ~Acutel [
,','ASTE CLASSIFICATION '3-a~g~t cooe mom OHS Fc,'~ 8~22! USE CODE
=HYSICAL STATE Solid [ I =~u~ct [ ] Gas [ ] Fure ( ] Mixture [ ] Waste [ ] Raglwa~ve [ ]
;MGUNT AND TiME :,T F,~CIL: ,TY _NITS C= ~,~=_ASL~F,E 8) STORAGE CODES
Ma, x~mum Ca,v Amounl: :s i ' --~: ' ' ~3 [ ] at Container.
Average Oran Amount: :;nes [ ] b) Pressure:
L.a,-gest S~ze Conta;ner:
# Oavs On S~e ;~rc:e wl~:cn ~,~onms: Ail Yee~. J. F. M. A. M. J. J. A. S. O, N. O
MIXq'URE: Ust COMPONEnTs; ~ ..
'~e three most nazaraous 13 [ ]
my AHM components 2.1 [ ]
3~ [ l
LoCa~on
ry unoer f~erMuty or ~aw, in,~t t nave oersoneJl¥ examlneo eno am t~llllt~ wilT1 D'le ;nro~on SUD,¥,,~ on D~ anti aJI
~rteO informaeon ts ~ue. accurate, eno complete.
r Name & Title ot A~c."rzeO Comoany Reoresenm~ve Signature Ogle
e
ne.,~ Name Adoress
CHEMICAL DF~CRIPTION
~~~m ~t ! mi I ~l ! ~1'1 c~t~~-.~~~;~:~~ I
'~AS~ C~SSI~ON ~ig~ ~e ~m OHS Fo~ a~ USE CODE
;MOUNT AND ~ME AT FACI~ ;NITS CF M~SURE 8) STOOGE CODES
~um O~ ~um:
Annum A~m:
~l Size Comm~
~ Oa~ On S,te ~:~=e ~cn Morons: All Yem. J. F. M. A. M. J. J. A. 5. O. N. D
· e mine most n~o~
~em~ com~ne~ or
~v ~HM ¢am~nen~ :', [ ]
:mmon ~e' 3) ~T ~ (o~)
em~c~ Name ~HM [ ] CAS
'vS~CAL & H~L~- °~YSICAL H~
~YS~CAL STA~ Soho { ~ _:u,a [ ~ G~ { ) :.~re ( ] M,~u~ { ] W~te ( ]
)OUNT ANC ~ME ~T 7~C;~ ..',IT~ ~F '.~Sb~E ~) STOOGE
Average O~N Amount: tunes ~ ' b) Pressure:
Annu~ Amount: cl Tem~re:
~gesl S~ze Confiner:
~RE: ~st CCMPCNENT CAS ·
~nree mos: m-~ous ~ ~ [
~ne & Title o! A~,.-c.~zea Comoany Reom~enraDve $ignalum O~e
C~D~RI~ON
c~~: 3) ~T · (m-
WAS~ C~~N (~ ~ ~ OHS Fo~ ~ USE CODE
AMOUNT ANO ~ME AT FACI~ ~NITS CF M~SURE 8) STOOGE CODES
Ann~ A~[: c) Te~: ,I
~e mine m~t n~ ~) [ ]
· ~em~ com~ne~ or
L~n
.J
~NTC~Y STA~S. ~ew ~ ] A~¢mcn ~ ] ~ev~s~on { ] ~em~on' ~hec~ ~ cnem~ i= a NON ~DE $~ [ ] ~E SEC~ [ '
;~mmon N~e: 3) ~T ~ (o~
-,em~cm Name: AHM [ ] CAS =
"YSICAL & H~L:~ =HYSICAL H~
~RD CA~GCR~ES F~re ; ' =ca.we { ] Su~aen Re,e~e c~ ='essure ' ' ~m~o~eMe~ (Ac~e) [ ~
,'A~ C~IFICA~CN ~o~t co~e ~om OHS Fc~ 8C23~ USE CC~E
MOUNT ANO ~ME ~T ~C:U~ _:,iT~ ~ ~,~Sb~E 8) STOOGE CC~E~
M~mmumCa.vAmoum: :s : : ;~ : : ~3 [ alCon:mnec
Averaqe Oran Amount: :;~es ( ' ~) Pressu~:
Annu~ Amount: c) Tempera:
~est S;Ze Confiner:
~ Da~ On S~e C.rc:e ~',c~ Months: ~Jl Ye~. J. ;. M. A. M. J. J, A. S. 0, N. O
I~RE: ~sC CCMPONENT CAS · %
~ mine mos[ n~ous 1 ~ [
v AHM ~m~nen~ :~ [
Vame& 77tie of Au~ c.'~zeO Comoanv Reoresenra~ve Signature Date
SITE DIAGRAM [ 1 FACIL1TY DIAGRAM
Bmin~ N~n~: