HomeMy WebLinkAboutBUSINESS PLAN 5/19/1998 Hazardous Materials/Hazardous Waste unified Permit
. CONDITIONS OF PERMIT ON REVERSE SIDE
This hermit is issued for the following;
[] Hazardous Materials Plan
I~ Underground Storage of HazardOus Materials
Permit ID.#:: 015-000-O01883 E] Risk Management Program ·
ALL PRO AUTOMOTIVE [] Hazardous Waste On-SlteTreatment
LOCATION: 509 BRuNDAGE LN
· y..,~i',.i', ~ ::,':?:,,,
OFFICE OF ENVIRONMENTAL SER VICES
Bakersfield, CA 93301 .,
VoiCe` (661) 326-3979 , ~.
FAX(661) 326-0576 '_. ,,:'.i i:iExpiration Date:
'~,A~I~; AREA
AUTO LIFT
. DRI VB WA ~,, [ ~1. .
VALVE
MISCELLANEOUS RECEIVABLES ADJUSTMENT ,
DATE ~" //::)-'~ .~^ccoum' ;
ADDRESS CHANGE
CLOSE ACCT j
· I='NANCE CHARGE I ,,~/J
OTHER ADJ
MAILING ADDRESS ~C.._~ _~C',._)c~ckoLc~ ~ ~
CITY ~2-'~~_~-%~,-C~C~ STATE ~ ZIP CODE
SITE ADDRESS
PARCEL NUMBER
OF APPUCABLE)
ADJUSTMENT
~ CHG DATE CHARGF CODE ADJUSTMENT AMOUNT
i '
! .
APPROVED BY
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ~ -f)t'2-e3 ,~A,/~'~ INSPECTION DATE "K'~/"t~
ADDRESS ~'~ 1~-.~"Mk6~__ ~ PHONE NO. ~ 'Z-_~ ~
FACILITY CONTACT ~ -~J$~"') BUSINESS ID NO. 15-210-
INSPECTION TIME ~4~) NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
I~l Routine ~'Combined [21 Joint Agency 1~1 Multi-Agency [~l Complaint W___l Re-inspection
OPERATION C'V COMMENTS
Appropriate pemfit on hand
Business plan contact intbnnation accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location v
Proper segregation of material
Verification of MSDS availability -~'
Verification of Haz Mat training
Verification of abatement supplies and procedures ~/ ·
Emergency procedures adequate t.~
Containers properly labeled
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?: ~es [21No ~'..
Explain: ~)'1'~ (~-~t.. ~
Questions regarding this inspection? Please call us at (805)326-3979 ' l~usiness Site l~l~c~ns~l~'le Party
While- Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector:
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ~ ~O~e-) .~d3'a"Orv-oVq~ INSPECTION DATE
Section 4: Hazardous Waste Generator Program EPA ID # - /V~'-~
[] Routine ~ Combined [] Joint Agency [] Multi-Agency [] Complaint [2] Re-inspection
OPERATION C V COMMENTS
Hazardous xvaste determination has been rnade
EPA 1D Number (Phoue: 916-324-1781to obtain EPA ID #)
Authorized for waste treatment and/or storage
Reported release, fire. or explosion xvi'thin 15 days ofoccurance
Established or maintains a contingency plan and training
Hazardous waste accumulation time frames
Contaiuers in good condition and not leaking '6/'
Containers are compatible witl~ the hazardous waste
Containers are kept closed tvhen not in use b/'
/
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line
Secondary containment provided
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste
Proper management of lead acid batteries including labels
Proper management of used oil filters
Transports hazardous waste with completed manifest
Sends manifest copies to DTSC
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used ()il receipts for 3 years
Determines if waste is restricted fi-om land disposal
C:Compliance V:Violation
Inspector: <:Z~t/-
Office of Environmental Services (805) 326-3979 Businessz:~e Rksponsible Party
\Vhite - Env. Svcs. Pink - Business Copy
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
· 1715 Chester Ave., BakerSfield, CA (805) 326-3979
INSTRUCTIONS: ID~ ~[~9~,~ ~(~" 'i~
1. To avoid ~nher actio~ re~ tbs fora ~thn 30 days of re~ipt.
2. T~E~ ~S~S ~ ENGLISH.
3. ~swer the que~ons below for the bus,ess ~ a whole.
4. Be ~ briefed concise ~ possible.
SECTION 1: BUS,SS ~~ICATION DATA
LOCATION: -~'~) ~7 ~Fd4J,'0 D ~
MAILING ADDRESS:
DUN & BRADSTREET NUMBER: SIC CODE:
PRIMARY ACTIVITY:
MARLING ADDm~SS:
SECTION 2: EMERGENCY NOTIFICATION
CONTACT · TITLE BUS. PHONE 24 HR. PHONE
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SI-IF~ETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
SECTION 4: EXEMPTION REQUEST
I CERTIFY UNDER PENALTY OF PERJURY 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 INFO~TION CONSTITUTES PERJURY.
SIGNATI~X'-~' TITL"F~ DATE
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURE.~
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 CONTAINMENT AND/OR MINIMIZATION:
C. CLEAN-UP PROCEDURES:
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRICAL: l~05, O~
WA~R: ~, o ~
~OCK BOX: ~0 ~
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABILITY (FIRE HYDRANT):
/
4
Page of
Business Name Address
CHEMICAL. DESCRIPTION
l ) INVENTORY STATUS: New [ ] Addition [ ] Rev/sion [ ] Deletion [ ] check if them/cai is a NON Trade Secret [ ] Trade Secret
2) Common Name: (/'$~..~ t/~]'x7-//"'-(~/~E~ 3)DOT#(opfional)
Chemical Name:' ', AHM [ ] . CAS #
4) Physical & Health PHYSICAL HEALTH ·
Hazard.Categories Fire[ ]Reactive[ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ]DelayedHealth(Clux~fie)[
5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid[ ] Liquid~4 ' Gas[ ] Pure[ ] Mixture[ ] Waste~ Radioactive[ ]
7) AMOUNT AND TIME AT FACILrrY~...q._. UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount ~ Lbs[ ]Gal[ Iff3[ ] a) Container:
Average Daily Amount 3 ~'~ Curies [ ] b) Pressure:
Annual Amount ~'~"~ c) Temperature 4--
Largest Size Container
# Days on Site ~"~ Circle Wh/ch Months: All year, j, F, M, A,' M, J, $, A, S, O, N, D
9) MIX'IXJRE: List COMPONENT CAS// % WT AHM
the three most hazardous l) [
chemical components or 2) · [
any AHM components 3) ' [
I) INVENTORY STATUS: New [ ]Add/tion[ ]Revision[ ]Deletion[ ] Check ifchemical is a NON Trade Secret [ ]TradeSeeret[
2) Common Name: [-J ~ ~'~ 6_) ! l__ 3) DOT # (optional)
Chemical Name: 'AHM [ ] CAS #
4) Physical & Health PHYSICAL HEALTH
Hazard Categories Fire [ ] Reactive.[ ] Sudden Release of PreSSUre [ ] lmmed/ate Health (Acute) [ ] Delayed Health (Chronic) [
5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Sol/d [ ] Liquid {~e'] C-~ [ ] Pure [ ] Mixture [ ] Waste.Ira
7) AMOUNT AND TIME AT FACILrrY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount g~ff~ Lbe[ ]Gal[~,]fl3[ ] a) Container:
Average Daily Amount ~ ~ Cur/es [ ] b) Pressure:
Annual Amount ~5'- c) Temperature 4-
Largest Size Container Y '~
# Days on Site ~ ~ Circle Which Months: All Year, $, F, M, A, M, I, I, A, S, O, N, D
9) MIXTURE: List COMPO~ ' CAS# % WT
the three most hazardous 1) [
chemical components or 2) [
any AHM components 3) [
10)LOCATION
[ ~rtify under penalty of law, that I have persormlly ex&mined ~ud am familiar with the ~fformafiun on this aa~l ~11 atV, ched documents. I
believe the submitted information is'true, accurate and complete. -. . ~,/) iff/
PRINT Name & ffAuthorized Company.Representative S~ Date
i~RDOUS MATERIALS INVENT~Y .
Business Name ff~SL(~' )C::)ff-/D /~]TO)~Ci'B,/~ Address ~ C7 ~,.~j~j~~ Pase of
CHEMICAL DESCRII~I'ION
1)[NVENTORYSTA~S:N~[ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade socret [ ]TradeSecret[
2) Common Name: ,~ ~'~AJ//_. 3) DOT # (optional)
Chemical Name: AHM [ ] CAS #
4) Physical & Health . PHYSICAL HEALTH
Hazard Categories Fire[ ]Reactive~]Sudd~ReleaseofPressure[ ] Immediate Health (Acute)J~] Delayed Health (Chronio) [
s) WAS'm CLASSIFtC^TIO~ ia-digit code a,~,, Dm ~onn S0::) USE CODE
6) PHYSICAL STATE .Solid [ ] Liquid ~ Gas [ ] Pur~ [ ] Mixtureffi~~ Waste [ ] Radioactive [ , ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES ~-~
Maximum Daily Amount ~ ~ Lbs [ ] Gal ~] fl3 [ ] a) Container:,
Average Daily Amount /dZ9 Curies[ ] b) Pressure:
Annual Amount [~ c) T .emperamre
Largest Siz~ Comaiaer t ~
# Days on Site 755S'~ Circle Which Months: AIl Year, $, F, M, A, M, $, $, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS# % WT AHlVl
the ttu-ee most tmardous ~) ~,C:~- ~ ~ a. OX, O ~ [ ]
chemical components or 2)
any AI-IM components 3) [ ]
1) INVENTORY STA~S: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Seeret [ . ]TradeSec~[ ]
2) Common Name: 3) DOT # (optional)
Chemical Name: AHM [ ] CAS #
4) Physical & Health PHYSICAL HEALTH
HazardCategorie$ Fire[ ]Reactive[ ]S~dd~R¢lea.s~ofPressure[ ] lmmediateHealth(Aolte)[ ]DelayedHealth(Chro~i¢)[ ]
~) WASTE CL~ sn~c^~o~ (a-digit code from ~aS F°rm S0::) USE CODE
6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radi~oactive[ ]
7) AMOUNT AND TIME AT FAC]LgTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount Lbs [ ] C, al[ ] ft3 [ ] a) Container:.
Average Daily Amount Curies [ ] b) Pressure:
Annual Amount c) Temperatu~
Largest Size Container
-- # Days on Site Circle Which Months: All Year, $, F, M, A, M, $, $, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS#' % WT AHM
the three most Mzardous 1) [ ]
chemical components or 2) [ ]
any AH/vi components 3) [ ]
10)LOCATION
believe the mlanRted infom~tion i~ tr~ ~w.~umte ~md complY.
PRINT Name & '14ifle of Authorize! ComPany Repre,~tat/v~ .kJ x,~...~il~hne Date
i~RDOUS MATERIALS INVEN~
Business Name Address
CHEMICAL DESCRIFrlON
I) INVENTORY' STATUS~ New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemicai iS a NON Trad~ Secret [ ] Trade Sec~ [ ]
2)'Comm0n Name: 3) DOT # (optional)
Chemical Name: · AHM [. ] CAS #
4) Physieai & Health PHYSICAL HEAL'IH
Hazard Categories Fire[ ]Reactive[ ] Sudden Release of Pressure [ ] lmmediateHeslth(Acute)[ ]DelayedHeaith(Chronie)[ ]
5) w^s~ ci.,cssn~c^Tiou o-aiVt ~ ~ Dm Vo~m S02~) USE CODE
6) PHYSICAL STATE Solidi .l Liquid[ ] C~s[ I Pure[ I Mixture[ ] Waste[ ] Radioactive[ l
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount Lbs [ ] C-al [ ] fl3 [ ] a) Containec.
Average Daily Amount Curies [ ] b) Pressure:
Annual Amount ¢) Temperature
Largest Size Container
# Days on Site Circle Which Months: All Year, $, F, M, A, M, $, $, A, S, O, lq, D
9) MIXTURE: List COMPONENT CAS# % WT AHM
the three most hRT~rdous 1) [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10)LOCATION
1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemieai is a NON Trade Secret [ ]TnuieSeo'et[ ]
2) Common Name: 3) DOT # (optional)
Chemical Name: AHM [ ] CAS #
4) Physical & Health PHYSICAL HEALTH
H~nrdCategories Fire[ ]Reactive[ ]S~_,/d__,mReleaseofPres,sure[ ] lmmediateHeaith(Acute)[ ]DelayedHealth(Chroni¢).[ ]
5) WASTE CLASSn~CAT~O~ (3~it code from DHS Form S022)USE CODE
6) PHYSICAL STATE Solid [ ] Liqu/d [ ] C-as [ ] Pure [ ] Mixture [ ] - Waste [ ] Rad/oactive [ ]
7) AMOUNT AND TIME AT FACIL1TY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount Lbs [ ] Gal [ ] fl3 [ ] a) Container:.
Average Daily Amount Cur/es [ ] b) Pressure:
Annual Amount ¢) Temperature
Largest Size Container
# Days on Site Circle Wh/ch Months: All Year, $, F, ~ A, M, $, $, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS# % WT AHM
the three most hazardous 1) [ ]
chemical components or 2) [ ]
any AHM components 3) [ ]
10 )LOCATION
[ certify uader penaity of law, that I have pet~nally examined and am familiar with the information on this and all attached documents. I
believe the submitted information i~ true, accurate and complete.
PRINT Name & Title of Authorized Company Representative Signature Date.