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Home My WebLink AboutBUSINESS PLAN 5/22/1996 Hazardous Materials/Hazardous Waste Unified Permit ..... .~. CONDITIONS. OFPERMIT ON REVERSE SIDE This hermit is issued for the followin~_: [] Hm,~rdous I~dals Plan '13 Underground Storage of Hazardous Materials Permit ID #:: 015-000-001698 [3 Risk Management Progmm JUAREZ AUTO REPAIR = Hazardous Waste On-Site Treatment LOCATION: 411 E BRUNDAGE LN OFFICE OF ENVIRONMENTAL SER VICES' * ,'" 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 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 ............... ~,,,,,~,~,~,~,~,,~;~m ............. This permit is issued for the following: ,,¢¢ i'- '~, i :':~i>:':::il ?~i il;iii;':::::i ii:,~ ~e[ground Storage of Hazardous Materials JUAREZ AUTO REPAIR LOCATION 411 E BRUNDAGE":,%?A~m;:::.':):~.;; BAKERSE]E~D ca ~-... ':%,,,....l .. *::h:::.*l ..." ll'~::~':~:::::l'll': .... EIb:: :::~![]: [~]~ ':~[i]]~i~: 2~' ~::s:,:: : i ¢:: .... :~s:~i;;'ll:''' .l' .,." l l'' ...:'']l?:::::?':F':';:::Y :l" :.l :' l: ] "'~:':~::¢:: ..... Issu~ by: 0 B~ersfield Fire Depa~ment Approv~ by: OFFICE OF E~R O~E~AL S~ ~CES 1715 Chewer Ave., 3rd Floor B~e~Eel~ CA 93301 Voice (805) F~ (80S)~6-0S76 Expiration Date: dun~ ~0~ ~OO0 SiTE DIAGRAM FACILITY DIAGRAM C'--'-I For Otfice Use Only F~rst ~n Sta;tan: Area M¢~ # Inscec.~on Stc,'tan: NORTH CUST E & NO. /_.c_.~3 '- ,~0, (~ ~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE L-'"' -~, .-~ '"~:>4 q _ (.~,, L..~ NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT FINANCE CHARGE I OTHER ADJ MAILING ADDRESS L+I( ~' /~('UCk~CL~... ~ CITY ~%J~EE%~ 6~C_~ STATE (~-' ZIP CODE (~%%0'7 SITE ADDRESS PARCEL NUMBER (IF APPLICABLE) ADJUSTMENT i CHG DATE CHARGE CODE j ADJUSTMENT AMOUNT DATE: 5101104 TO: JUAREZ AUTO REPAIR ~-.~.'~ ...... E..-,.-,,.,;"~,'DA-'"E,.. .. .~ LN GU.5TOMER NO: .-q060.--'~060 TYPE: ED - ENVIRONMENTAL ~ERVICES ~ PA OR n=~niv=O IN ERROR P~:~o: CALL ~ ~ n ~ ~'~ PAYMENT DUE: ~0~. O0 ~!0i704 DUE DAT~' ~1~1/04 ,,i~,_.~' :'~' dURREZ AUTO ~EPATR_ AND MAriE CHEC~i PAYABLE TO: 2057 ~,AK~R~,' ~ELD CA ~3303-2057 TOTAL DUE' *~09. 00 JUAREZ AUTO REPAIR SiteID: 015-021-001698 Manager : BusPhone: (661) 324-3846 Location: 411 E BRUNDAGE LN Map : 124 CommHaz : Minimal City : BAKERSFIELD Grid: 05A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad: Emergency Contact / .~-T~tle Emergency Contact / Title ~-~-!~r~T; ~3AD~ / OWNER SIMON GARCIA / Business Phone: (661) 324-3846x Business Phone: (661) 324-3846x 24-Hour Phone : (661)-~m~--~82~_ 24-Hour Phone : (661) Pager Phone : ( )~1 Pager Phone : ( )~ -qG7~x Hazmat Hazards: Fire DelHlth Contact : .- Phone: (661) 324-'3846x MailAddr: 411 E BRUNDAGE LN State: CA City :'BAKERSFIELD Zip :'93307 Owner ~ ~ ~ .... -- ...... ~ ou~U{~Z'~;~~O~ Phone: (661)~--~(~/~~ City BAKERSFIELD O~ ~ Zip :..q~q-3~T~ Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List -- Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm, I DailyMax IUnitIMCP WASTE OIL F DH L ., 150.00 GAL Low h~ve any ~ec~0ns ccnsdtute a c0mp~ele and c0;rec[ -z- o9/o6/2oo~ +.JUAREZ~AUTO REPAIR- ~SiteID:. 015-02i~001698 + Manager : BusPh0ne: ~(661) 324-3846 Location: 411 E BRUNDAGE LN Map : 124 'CommHaz' : Minimal City · : BAKERSFIELD .Grid: 05A. FacUnits: i~AOV: commc0de: BAKERSFIELD STATION~O6 SIC~Code:7538 EPA NUmb: · DunnBrad~' + Emergency ContaCt / Title ~- ~Emergency Con~ac~;~ ~r~~.itle .M~-~L---0'U'A'R'~' ' / OWNER ~,~X .. · ' ~ A if-~I$-~· ~ '' Business. Phone:' /661) 324-3846x~o~Business'~ Phone:~ (661) 324.-3846x ~4-Hour Phone : (661) E31 13~3x -24-Hour Phone : (661)~ ~r'Phone .. :. ( ~1-~x ' Pager Phone : (~33 + ........ ~ ..................... ~ .... . .................. ~ ......... '__~ ............ + I Hanmar Hazards: Fire· DelHlth Contact : PhOne: (661·) 324-3846X· 'MailAddr:.411 E BRUNDAGE LN .~ State: CA City : BAKERSFIELD Zip : 93307~ + .... ,___L .................................... ~ ............. + owner M~GuBL JUAREZ. ~~0~-~,.l~.~ ~ - Phone: (6'61)$3i-~4~i~-~,, ' Address : 67~0 ~OWREY ST J~/~ O~ ~...~ . Sta~e: Ck ' City · : BAKERSFIELD . Zip : 93307 + ......................................................... .r .... r ..... i__~ ........ + Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal~ Certif'd: RCs: NO ~ ........ ~ ........... ~ .... ~---7--~ ........ ~- ........... .-? ........... ~ .... 7-----~--.T [.Emergency Directives: + ---+ += Hanmar Inventory One Unified List + +== Alphabetical Order All Materials at Site + +~ ....... ' ....... ~ ................ + ....... + + ..... + ......... r+ .... +---+ Hazmat Common Name..' ISpecHazlEPA HazardsI Frm I DailyMax IUnitlMCPI __~ .............................. + .... ~___+ ........... + ..... + .......... + .... +---+ WASTE OIL F DH L 150.00 GAL Low · I, ,J~,~('--~r..~'''L''-' Do hereby ce~ify 'ths~ '~ h'?:ve / GYpe or pdn~ any Corrections r.r,?~,':'~'~'-t¢ a complete and .......... ' . agemen'~p~an~' br my facility. · . ,. 0Z/25/2002 + JU~EZ AUTO REPAIR -- SiteID: 015-021-001698 += Inventory Item 0001 -- - Facility~Unit: Fixed COntainers at Site +== ~COMMON NME / CHEMICAL NME WASTE~OIL ~ I Days On Site · ~' I 365 Location within'this Facility Unit Map: Grid:, + ................ OUTSIDE 'aw COMER OF-SHOP ~1 CAS# 221 += STATE=+= TYPE ===+== pRESSURE ===+ TEMPE~TURE ==+====.CONTAINER I Liquid I' Waste .{ A~ient I A~ient ~ ~ ~O~TS AT THIS LOC~TION I ' ~ -55.00 GALI 150.0'0 GAL 55.00 GAL ,+ ~ ~ + + ~ZARDOUS COMPONENTs . , No' 10'0 00 waste Oil Petroleum Based ..~ +=======4 . P===+--- 4 +===4 4 ~ZARD ASSESSMENTS ===4 +== ~ ..... ITSecret'l, RS[BioHazl Radioactive/Amount I EPA HazardsI NFPA No · No No No/ Curies F DH / / ./ " Low 4 +==='+ t -+===== ........ 4 4 ==+=====+ 01/25/2002 + JUAREZ AUTO REPAIR SiteID: 015-021-001698 + + Fast Format + += Notif./Evacuation/Medica1 __ Overall .Site + +==.Agency Notification 06/06/1996 + TELEPHONE 'AVAILABLE AT.OFFICE ~WINDOW BETWEEN sHop. +' Empl0yee~NOtif./Evacuation _ 01/.18/2001 + VERBAL. + .... Public Notif./Evacuation - · 06/06/1996 + · FROM OFFICE OUT N DOOR. TO N-hi.CORNER OF. LOT. ~Emergency Medical Plan ~ . .... 06/0'6/1996 + .' KERN MEDICAL CENTER. 3 -. ~ 01/25/'2002 + JuAREz AUTO' REPAIR SiteID:~ 015-021-001698 ~ ~ Fast Format :+='Mi'tigation/Prevent/Abatemt Overall Site +== Rel'ease'Prevention . 06/06/1996 WASTE OIL DRUMS STORED IN LOW. TRAFFIC AREA~ +=== 'Release Containment 06/06/1.996 q + .... Clean~UP .06/06/1996~+ WASTE,OiL. COLLECTED BY ENVIROPUR WEST EVERY 90 DAYS.. +. + ..... O~her Resource Activation '~ , .' .... 4- 01/25/2002 +~jUAREZ~,AUTO REPAIR = = SiteID: 015-02i-.001698 + Fast Format + Site Emergency FactOrs Overall Site +. +~=~-Special Hazards ~ +=~=.~tiiity.Shut-Offs - 06/06/1996 + A)' GAS -. NOT.. CONNECTED (GAs PIPING IN FRONT OF BLDG) S') ELECTRICAL - OUTSIDE SE CORNER OF ~SHOP , C) WATER - OUTSIDE SE CORNER OF SHOP BELOW ELECTRICAL METER ' ' D) ~SPECIAL --NONE ' E) LOCK.BOX - NO,' '. .... ~ Fire Protec;/AVail. Water 01/18/2001-+ PRIVATE'FIRE PROTECTION- PORTABLE FIRE EXTINGUISHERS ONE IN OFFICE bAlD 1 BY SINK IN WORK AREA. NEAREST FIRE HYDRg_NT - ?????????? Building Occupancy Level ~ + JUAREZ AUTO REPAIR ~ ~' Fast Format += Training: +=='Employee Training ' = 01/18/2001 W,E HAVE'NO .EMPLOYEES AT THIS FACILITY oNLy HusBAND AND WIFE'WORK HERE DO YOU PUIVE MSDS SHEETs AVAILABLE?'???.???? BRIEF S~RY OF TRAINING PROGR/dVI: + .... Page 2 + + .... Held.for Future Use + .... + Held for Future Use -6- .. 01/25/2002 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CtIECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME t,,J~JCtr'~-'t... /~d~ ~0~ mSPECTIONDATE FACILITY dONTACT ~'-~~ BUSINESS ID NO. 15-210- ~SPECTION TIME ~ ~ NUMBER OF EMPLOYEES Section I: Business Plan and Invento~ Program ~utine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS ' ' Appropriate permit on hand .r:~.~ t/' Business plan contact information accurate- ~/ Visible address ~/ Correct occupancy bt Verification of inventory materials t/ Verification of quantities k/ Verification of location v/ Proper segregation of material vt' Verification of MSDS availability ~ Verification of Haz Mat training ~/ Verification of abatement supplies and procedures V' Emergency procedures adequate b/ Containers properly labeled Vt' Housekeeping Vt Fire Protection ~/ Site Diagram Adequate & On Hand b' C=Compliance . V=Violati0n Any hazardous waste on site?: Ii'Yes (~ No Questions regarding this inspection? Please call us at (661) 326-3979 X~sine~s Site Responsible Party · White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspect CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ADDRESS i.~-II E. ~.-. PHONE NO. % 7.~- "~ gkt6 FACILITY CO}qTACT Pm"*-' '~-;~-'7,,,,,~ BUSINESS IDNO· 15-210- r:9/_/-.? INSPECTION TIME ~ ~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~Routinc ~l Combined ~ Joint Agency ~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand . .;~* . ,r, 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 Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Hou-sekeeping Fire Protection Site Diagram Adequate & On Hand V C=Compliancc V=Violation / Any hazardous waste on site?: ~i~YeS [~ No Questions regarding this inspection? Please call us at (661) 326-3979 t · ' ' Responsible Party White-Env. Svcs. Yellow - Station Copy Pink-Business Copy Inspecto~'~ JUAREZ AUTO REPAIR SiteID: 015-021-001698 Manager : .. BusPhone: (661) 324-3846 Location: 411 E BRUNDAdE LN Map : 124 CommHaz : Minimal City : BAKERSFIELD Grid: 05A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ~__!G?ET= ~T~p~ _ / OWNER SIMON GARCIA / Business Phone: (661) 324-3846x Business Phone: (661) 324-3846x 24-Hour Phone : (661)-~m~-~?~- .24-Hour Phone : (661) ~ Pager Phone : ( ) ~}~ -0~]x Pager Phone : ( ).~2 -~G75x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 324-3846x MailAddr: 411 E BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93307 Owner -4~-~--~Tr~Z~ ~-~.~ Phone: (661) 4~ Address : ~ S/~ F~ State: CA ~3-~7 City : BAKERSFIELD Zip :_9~nJ{~T-"~ ~)my Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ---- Hazmat Inventory One Unified List -- Alphabetical Order Ail Materials at Site Hazmat Common Name... [SpooHazlEPA HazardsI Frm I DailyMax Unit MCP WASTE OIL F DH L 150.00 GAL Low Do hereby certify~that I have I, (TyPe or print name~-'-- reviewed the a~ached hazardous materials mznage- and that it along with ment plan for_ any corrections constitute a complete and correct, man- agement plan for my facility. - I~ate i Signature 1 09/06/2001 JUAREZ,AUTO REPAIR ..... SiteID: 015-021-001698 Manager : BusPhone: (661) 324-3846 Location: 411 E BRUNDAGE LN Map : 124 CommHaz : Minimal City : BAKERSFIELD Grid: 05A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad: Emergency Contact / Ti~e Emergency Contact / Title MIGUEL JUAREZ / OWNER SIMON GARCIA / Business Phone: (661) 324-3846x Business Phone: (661) 324-3846x 24-Hour Phone : (661) 831-1383x 24-Hour Phone : (661) 304-8905x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat,Hazards: Fire DelHith Contact : Phone: (661) 324-3846x MailAddr: 411 E BRUNDAGE LN State: CA City : BAKERSFIELD Zip' : 93307 Owner MIGUEL JUAREZ Phone: (661) 831-8401x Address : 6750 LOWREY ST 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 Ail Materials at Site + + 4 -4 + + .... +- - -+ Hazmat Common Name... ISpecHazlEPA HazardsI Frm I Da.ilyMax lUnitIMCP{ + ....... + ........... + ..... + .......... +-.__+___+ WASTE OIL F DH L 150.00 GAL LOW agem,;n,, p!an for my facility. -1- Ol/25/2ooa JUAREZ AUTO REPAIR ,.~ .~'~ ~ ~.~?. ~ r..~m-7~ ! ~ ~ v~,~_~,I SiteID: 015-021-001698 Manager : · ~N 9 2001 BusPhone: (805) 324-3846 Location: 411 E BRI. JlqDAGE LN IMap : 124 CommHaz : Minimal City : BAKERSFIELD '/B~: ~Grid: 05A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATI~'06 '. SIC Code:7538 EPA Numb: , DunnBrad: ? EmergencyContact / Title Emergency Contact ~L Title MIGUEL JUAREZ / OWNER ~]=--o~dga~rE~ ~ ~n~ BROTHER Business Phone: (805) 324-3846x Business Phone: (805) 324-3846x 24-Hour Phone .: (805) ~3! 13~3x~3/°~0 24-Hour Phone : (805) 8-3-3-=%~8~ >~p~ger Phone : ( ) - x Pager Phone : ( ) ~ ~J x Hazmat Hazards: Fire DelHlth Contact : Phone ~ ($$ / )32~ j~/W x MailAddr: 411 E BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93307 Owner MIGUEL JU~EZ F~/-F~/-~ Phone: (805) ~ Address : 6750 LOWREY ST 3~-~6~ State: CA City : BAKERSFIELD Zip : 93307 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ---- Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site WASTE OIL F DH L 150.00 GAL Low SOLVEN,T ~ ~/C~-- F DH L 'W 30. ~0 GAL Mod o ~ I, A~J A ~-<:~:2. Do hereby certify that I have (Tyl~3 or pdn! name) reviewed the attached hazardous materials manage- ment plan for, ~t.x~c~-z. ~and that it along with (Name of Business) any corrections constitute acomplete and correct man- agement plan for my facility, ~~~.~ //--~_~00 10/30/2000 JUAREZ AUTO REPAIR SiteID: 015-021-001698 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE SW CORNER OF SHOP CAS# 221 Liquid Waste Ambient Ambient DRUM/BARREL-METALLIC I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily~Average jr- GAL 1 o.oo 5 .oo GAL 100,00'Waste Oil, Petroleum Based ~ N 0 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F DH / / / Low = Inventory Item 0002 Facility Unit: Fixed Containers at Site SOLVENT Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE SW STORAGE ROOM CAS# 8030306 F STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient CARBOY AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average i%j~ GALI 30.00 GAL 30.00 GAL HAZARDOUS COMPONENTS oRI %Wt, S CAS# 100,00 Naphtha N 8030306 HAZARD ASSESSMENTS TSecretl oRSlBioHaz Radioactive/Amount I .EPA HazardsI NFPA USDOT# MCP No N No No/ Curies F DH / / / Mod -2- 10/30/2000. F JUAREZ AUTO REPAIR SiteID: 015-021-001698 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 06/06/1996 TELEPHONE AVAILABLE AT OFFICE WINDOW BETWEEN SHOP. Employee Notif./Evacuation 06/06/1996 VERBAL -- Public Notif./Evacuation 06/06/1996 FROM OFFICE OUT N DOOR TO NW CORNER OF LOT. Emergency Medical Plan 06/06/1996 KERN MEDICAL CENTER. -3- 10/30/2000 F JUAREZ AUTO REPAIR SiteID: 015-021-001698 Fast Format ~Mitigation/Prevent/Abatemt Overall Site --Release Prevention 06/06/1996 WASTE OIL DRUMS STORED IN LOW TRAFFIC AREA. --Release Containment 06/06/1996 ABSORBANT MATERIAL USED TO SOAK UP SPILLED OIL. -- Clean Up 06/06/1996 WASTE OIL COLLECTED BY ENVIROPUR WEST EVERY 90 DAYS. Other Resource Activation -4- 10/30/2000 juAREz AUTO REPAIR SiteID: 015-021-001698 F Site Emergency Factors Overall Site Special Hazards Utility Shut-Offs 06/06/1996 A) GAS - NOT CONNECTED (GAS PIPING IN FRONT oF BLDG) B) ELECTRICAL - OUTSIDE SE CORNER OF SHOP C) WATER - ouTSIDE SE CORNER OF SHOP BELOW ELECTRICAL METER D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Availl! Water 06/06/1996 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - ?????????? Building OcCupancy Level -5- 10/30/2000 F.JUAR~z.AUTO REPAIR SiteID: 015-021-001~98 Fast Format ~ Training Overall Site ,/-- Employee Training 06/06/1996 WE HAVE 0 EMPLOYEES AT THIS FACILITY. DO YOU HAVE MSDS SHEETS A~[II_d2d3LE???????? ,BRIEF sUMMARy OF TRAINING PROGRAM: ' iPage 2 I I -- Held for Future Use Held for Future Use MISCELLANEOUS RECEIVABLES ADJUSTMENT · ADDRESS CHANGE; · . CLOSE ACCr · FINANCE CHARGEI. / ' OTHER ADJ CUSTOMER NAME .._] ~)o._c C__T_ ~~C~ ~^,.,.G ^DDRESS '~ ~ G~o~,~ ~e ~ " CITY {~-~_~¢ % ~'; C_~ O~ STATE ~ ZIP CODEC~(~7 SITE ADDRESS PARCEL NUMBER (~F,~PUCAOLE) ADJUSTMENT i CHG DATE CHARGE CODE ADJUSTMENT AMOUNT I I I ' BAKERSFIELD CITY FIRE DE .. ~RTMENT :: HAZARDOUS MATERIALS DIVISION 1715 'CHESTER'AV£~ · BAKERSFIELD, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTEUCT1ONS: i. To Qvoicl tu[tr~er Qction, return mis form within 30 dQys ot receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer me auestions below for the gusiness os a whole. '-.¢. Be iDriet cna concise cs Do&siDle, SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME' M,--,~L:N,.= AC'DR~-:S: ~.~UN, .:~ ~: RACSTR EE- NUMBER: SIC 'CODE: .~WN='.~ ~:~. ~ ~Gu'~ SECTION 2: EMERGENCY NOTIFICATION' ~_ ardous 1V~aterials Division. i -'- ; HAZARDOUS MATERIALS MANAGEMENT PLAN " ] SECTION 3: TRAINING: - NUMBER OF EMPLOYEES: .. MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: ~,J/~ SECT[ON ~: EXEMPTION REQUEST: i mERTiFY UNDER PENALTY OF PERJURY ~' .... - - ,~,A~ MY BUSINESS IS EXEMPT FROM THE ,~E?ORT'ING REQUIREMENTS OF CHAPTER 6.95 OF THE :'CALIFORNIA HEALTH & SAFETY CO .~ FC, RTHErOLLGWINGREASONS: - ~,... NOT HANDLE '" -' ~ ' =A/.-,xOOUS MATERIALS. WE CC' ""' " - ~,~NOL: HAEARCCUS MATERIALS, ~UT ~HE QUANTiTiES AT NO ~,M~-,.x~uzw THE MINIMUM REPORTING QUANTEIES. SECTION 5' CERTIFICATION: i, CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY F!RM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND ~AFE'.-Y CODE" ON HAZARDOUS MATERIALS (DIV. 2.0 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION.CONSTITUTES PERJURY. ~GNAT~RE ~ TITLE DATE HAZARDOUS MATERIALS MANAGEMENT PLAN Facilih/U'nit Name: " SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTiFiCATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. :UBLIC ~"/ACUATIO N' ~ c~-~C~c~- c~' ~ ~)c~ ~ ~ c'/(~,J~ c..kF' ~ '-'. ZMERGE:'"IC'r' MEDICAL ?UZ, N' Hazardous ~aterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: RELEASE-CONTAINMENT AND/OR MINIMIZATION: t~,p> <r~CF~,,.r"r '~,~TC-~ ,~C. ~C'~ ~ 5o~,~ 'u o s P, ,_c,~r3 ~.~ C. CLEAN-UP ?RCCE'DURES: ~ .'._,,.,,,~.--., ~ICN CF SHUT-OFFS AT YOUR FACILITY'): SECTION 8: UTiLtTY SHUT-OFFS ,~AL ',=,~/:..'~QPANE: ~,:.,q"- -iLECTRICAL: ~.A. TrS. ,o G %~ WATER O,./'T-s.,O~ ~ ~: c.J'&,UP.- LOC'<ECv' ' " . .... -' . ,.,.. :'E:,,NO ;F 'TEE, ,,.,,,..,,--, iON. SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: B. WATER AVAILABILITY (FIRE HYDRANT')' : BAKERSa[IELD CITY FIRE DEP ClTMENT'- · .I H DOUS MATERIALS INVENTORY. Page--of__: CHEMI~ DE~RImON· 1) IN~ORYSTA~: N~~[ ] a~n[ ] ~n[ ] Ch~m~aNON~S~ [ ~ - c~ N~: 4) PH~SIC~ & H~ PHYSIC~ H~ H~D CA~RI~ Rte [~Re~ [ ] S~en Re~ of Pre.ute [ ] I~e He~ ~e) [~~ ~ (Ch~) [ ] : 5) WA~ C~SSIRCA~ON ~ ( (~ig~ ~e ~m DHS Fo~ ~) USE CO~ 6) PH~SIC~STA~ ~1~ [ ] Uquid ~ [ ] Pure [ ] M~ [ ] W~te [~' ~ AMOUNT ~D ~ME AT FAClU~ UNITS OF M~SURE a) STOOGE CODES M~mu~~.~: ~ ~ [] e~ [/"~ [] A~ ~N ~um: ,~ ~ cudes [ ] b) Pre.urn: ~n~ A~unt: ~ ~ c) Tempera: ~g~t Size'Con~ · Da~OnS~e ~ Ci~e~ichMomhs: AllYe~. J, F, M, A, M, J, J, A. S, O, N, D 9) MI ,XTURE: List COMPONENT CAS# .,"J~' AHM chemical components or any filM components 2) [ ] [] CHEMICAL DESCRIPTION 1) INV~,NTORY STATUS: New [t.~'Addition [ ] Revision [ ] Deletion [ ] Check if chemicaJ is a NON TRADE SECRET [ ] TRADE SECRET [ ] I . 2) Common Name: ~._)L.t~/~/~/~'-' 3) DOT # (optional) Cher~icaJ Name: .. AHM [ ] CAS # 4) PHY,SICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive ~ ] Sudden Release of Pressure [ ] Immediate HeaLth (Acute) [ ] Delayed HeeJth (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ } Liquid [f,~ Gas [ ] Pure [ ] Mixture ( ] Waste [ ] Radioactive ( ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) .STORAGE CODES Maximum Daily Amount: ~'C~ ihs [ ] gal [c.]""1~3 [ ] a) Container: Average Daily Amount: '~50 cqnes [ ] b) Pressure: Annual Amount: 1'7..C~ c) Temperature: Largest Size Container: # Days On Site 9) MIXTURE: List COMPONENT CAS # % WT AHM the tl~ree most hazardous I) ?~_."'"~'~..)~---L,,_I'~ /~~ [ ] chem~lcaJ components or . any A~HM components 2) [ ] I believe submitted information is true, accurate, and complete. PRINT Name & Ti#e of Auff~orized Comoany Fle~resentative - Sigl~ture ' ~ Date BAKERSFI .D CITY FIRE DEPAFBMENT HAZARDOUS MATERIALS INVENTORY Page_of. usiness Name Address CHEMICAL DESCRIFTION 1) INVF-.NTORYSTATUS: New[ ] Additk~[ ] Revision[ ] Deletion[ ] Check if chemical i~ & NON TRADE SECRET [ ] TRADe-SECRET [ ] 2) Common Name: 3) DOT ~* (OI:X~.-,~').. Chemical Name: AHM [ ] CA~ # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ *'] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] D~ ~ (~) [ ] 5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] liquid [ ] Gas [ ] Pure [ ] Mixture [ ]' Waste [ ] ~ [ ]. 7) AMOUNT AND TIME AT FAClMTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: Ib~ [ ] gal [ ] ~3 [ ] a) Container:. Average Daily Amount: cunas[ ] 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 # % VVl' AHM the three most hazardous 1 ) [ ] chemical components or any AHM components 2) [ ] 3) [ ] 1 0) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New[ ] Addition[ ] Revision[ ] Deletion{ ] Check if chemicel is a NON TRADE SECRET [ ] TI:IADESECRET [ ] 2) Common. Name: . 3) DOT ft (optional) Chemic~ Name: AHM 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactwe [ ] Sudden Release of Pressure [ ] Immediate HeeJth (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION .!3-dicjit code from OHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] L~auid [ ] Gas. [ ] Pure [ ] Mixture [ } Waste [ ] Ra~lioactive [ ] · 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum C~aily Amount: lbs [ ] gaJ [ ] ft3 [ ] a) Contmner: Average Dmly Amount: curies [ ] * b) Pressure: AnnuaJ Amount: c) Temperature: !.m'gest Size ContaJner: # 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 fl % V~' AHM the three most hazardous 1 ) [ ] chemicaJ components or any AHM components 2) [ ] ~) [ ] 10) cer~fy un~er penal~y of law, that I have personally examined eno am familiar with the infometion submitted on this anti all et~ached clocumeng~ I believe th · :bmitted information is Due, accurate ar~ comntete. RINT Name & Title of Authorized Company Re~resentabve Signalure . Date Manager : Location: City JUAREZ AUTO REPAIR Vl\" 411 E BRUNDAGE BAKERSFIELD ,-- /" (- ( L~ SiteID: V¡:: ,(J{)5/IJtS5' BusPhone: LN Nou! /5 Ma~ : 124 Û ·ß'^. ß'A.. r/!' A·· Grld: 05A f'í . Y'1 S ~ ff aM ./ STATION 06 !4¡;1í¡/J¿;SIC Code: 7538 DunnBrad: 015-021-001698 .. ~ (661) 324-3846 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD EPA Numb: Emergency Contact / Title Emergency Contact / Title ANNA GOMEZ / OWNER ESTILA MUNOZ / Business Phone: (661) 324-3846x Business Phone: (661) 324-3846x 24-Hour Phone : (661) 330-9673x .~ 24-Hour Phone : (661) 633-0651x Pager Phone : (661) 831-5581x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : phone: (661) 324-3846x MailAddr: 411 E BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93307 Owner ANNA GOMEZ Phone: (661) 831-5581x Address : 3516 OLIVER ST State: CA City : BAKERSFIELD Zip : 93307 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: SPOKE WITH NEW OWNER, ELIZABETH, 5-24-04 WILL SEND HER NEW FORMS. THEY'VE BEEN THERE OVER A YEAR. One Unified List 1 All Materials at Site 1 f= Hazmat Inventory f== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP WASTE OIL y ~ /' 7J f:., eJ) / CJe~ DH L 150.00 GAL Low -1- 06/28/2004 SiteID: 015-021-001698 ~ Facility Unit: Fixed Containers at Site ~ F JUAREZ AUTO REPAIR p= Inventory Item 0001 == COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility unit OUTSIDE SW CORNER OF SHOP Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 150.00 GAL Daily Average 55.00 GAL E %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPON NTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -2- '06/28/2004 SiteID: 015-021-001698 l Fast Format l Overall Site l 06/06/1996 F JUAREZ AUTO REPAIR I p= Notif./Evacuation/Medical Agency Notification TELEPHONE AVAILABLE AT OFFICE WINDOW BETWEEN SHOP. r=:: Employee Notif./Evacuation VERBAL. 01/18/2001 ] 06/06/1996 Public Notif./Evacuation FROM OFFICE OUT N DOOR TO NW CORNER OF LOT. Emergency Medical Plan 06/06/1996 KERN MEDICAL CENTER. -3- 06/28/2004 SiteID: 015-021-001698 '1 Fast Format '1 Overall Site '1 06/06/1996 F JUAREZ AUTO REPAIR I f= Mitigation/Prevent/Abatemt Release Prevention DRUMS STORED IN LOW TRAFFIC AREA. Release Containment 06/06/1996 ABSORBANT MATERIAL USED TO SOAK UP SPILLED OIL. Clean Up 06/06/1996 WASTE OIL COLLECTED BY ENVIROPUR WEST EVERY 90 DAYS. Other Resource Activation -4- 06/28/2004 , . SiteID: 015-021-001698 ì Fast Format ì Overall Site ì I f JUAREZ AUTO REPAIR I f= Site Emergency Factors [:: Special Hazards Utility Shut-Offs 06/06/1996 A) GAS - NOT CONNECTED (GAS PIPING IN FRONT OF BLDG) B) ELECTRICAL - OUTSIDE SE CORNER OF SHOP C) WATER - OUTSIDE SE CORNER OF SHOP BELOW ELECTRICAL D) SPECIAL - NONE E) LOCK BOX - NO METER Fire Protec./Avail. Water 01/18/2001 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS ONE IN OFFICE AND 1 BY SINK IN WORK AREA. NEAREST FIRE HYDRANT - ?????????? Building Occupancy Level -5- 06/28/2004 , . SiteID: 015-021-001698 ì Fast Format ì Overall Site ì 01/18/2001 F JUAREZ AUTO REPAIR I F Training Employee Training WE HAVE NO EMPLOYEES AT THIS FACILITY ONLY HUSBAND AND WIFE WORK HERE. DO YOU HAVE MSDS SHEETS AVAILABLE???????? BRIEF SUMMARY OF TRAINING PROGRAM: Page 2 [ I I Held for Future Use Held for Future Use -6- 06/28/2004 ,;: .. F JUAREZ AUTO REPAIR F Full Format I SiteID: 015-021-001698 ì Type+category+Sub-Category+Date2(ASC) Order ì One Unified List ì BUSINESS PLAN PROGRAM INSPECTIONS ROUTINE INSPECTION Reference Dates Summary Description STANDRID 12/11/2002 OKAY SNIDER 11/20/2001 OK ANY HAZARDOUS WASTE ON SITE YES WASTE OIL BONNER 10/25/2000 01/09/2001 FOLLOW UP RETURN TO COMPLIANCE 10-25-00 - NO LONGER HAVE SOLVENT AND WASTE OIL CONTAINERS NEED LABELS. 1-9-01 - BP UPDATED TO SHOW NO MORE SOLVENT ON SITE. ED MATTHEWS 08/20/1999 FOLLOW-UP 8-20-99 - NEED MSDS, HAZ MAT TRAINING, ABATEMENT SUPPLIES, LABEL CONTAINERS, AND SITE DIAGRAM. SEND BP. ED HARTLEY 07/28/1998 OK PROVIDE WASTE OIL LABELS. HARTLEY 04/04/1997 OK -7- 06/28/2004