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HomeMy WebLinkAboutBUSINESS PLAN 10/15/2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF .PERMIT ON REVERSE SIDE Thf~ =ermit is issued for the following: I;I H=~-~rdous Materials Plan E] Underground Storage of Hn~,rdOUS Materials Permit ID #:: 015-000-001720 [] Riak Management Program DARRELLS AUTOMOTIVE n H~r~o.. w.m o.-s.,, LOCATION: 927 BRUNDAGE LN OFFICE OF ENVIRONMENTAL SER VICES' " ' "'" 1715 Chester Ave., 3rd Floor Approved by: (~R~a"~'_D~i ~,~ D~¢ Bakersfield, CA 93301 i: Oftic¢ofEvimnmenllffServices ~ 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 .............. ,~,~,~,,~,,,~,~?~?,,~,~,,, ............... This permit is issued for the following: PERMIT ID# 015-0214)01720 :, ?~i :'~i: ;,,, ii i ii! iiii:" ...:::!!!i!:~!!iiiii~ ?~::?!':~.:~':i!!:~!%¢iii~iii[,,~i!}~Sk:MA0agement Program LOCATION 927 B r U N BAG ~?,;:'?,~;;~;,,,.:,: ?:'.r? B . ~.:............:;:..,. ~,....---.. Issu~ by: 1715 Chewer Ave., ~rd Floor B~e~fiel~ CA 93301 Voice (805) 326-3979 F~ (80S) ~26-0S76 Expkation Date: Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave SECTION 1. Business Plan and Inventory Program Bakersfield, CA 9330l Tel: (661)326-3979 FACILITY NAME INSPECTION DATE iNSPECTION TIME .............................. ADDRESS PHONE No. No. of Employees FACILITYCONTACT Business ID Number -"~-~,.,..-..-, ,. ~,,,,.,.c:, / ~, ~' 15-021- bO~ "7 7.0 , , . :.: ' Section 1' BUsiness Plan, and InventorY progmm ~outine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection C V [ C=C°mpliance'~ OPERATION COMMENTS K V=Violation ...... ~ [] APPROPRIATE PERMIT ON HAND .......... ~?j .............................................................................. ~ [] BUSINESS PLAN CONTACT INFORMATION ACCURATE "~' [] VISIBLE ADDRESS ~ [] CORRECT OCCUPANCY ____-~ ~ ........ .-~?}~.-_~- ~-~(~_.d_~ ...... ~-~ ~-_-?..-~ .............. :L ..... '~ i'1 VERIFICATION OF INVENTORY MATERIALS __./ _.~_ _.~/f~_.. _. ~_,~_.~_~_ '-_ _~-~_,~_~Z_~_: . J  [] VERIFICATION OF QUANTITIES ............. ~ .............................. / "~ ~ VERIFICATION OF LOCATION l ....... ~'~ [] PROPER SEGREGATION OF MATERIAL I c,~.~Y-~__~'_.~ .... ~_~__..~±~ ~_O___Z X ................... ~ ~ VERIFICATION OF MSDS AVAILABILITYE " '~ [~ VERIFICATION OF HAT MAT TRAINING '~ ~ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES  [~ EMERGENCY PROCEDURES ADEQUATE _~ ~-~ CONTAINERS PROPERLY LABELED ~L' HOUSEKEEPING -'----'---':::~ ...... ~;~ [~ FIRE PROTECTION ~ [] SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: .~YEs [] NO EXPLAIN: .~1~ ~)'~ ~ ~ , Inspector Badge No. ~ y White - Environmenta~ Services Yellow - Station Copy Pink - Susines~. ~,opy DARRELLS AUTOMOTIVE SiteID: 015-021-001720 Manager : BusPhone: (661) 327-3589 Location: 927 BRUNDAGE LN Map : 103 CommHaz : Low City : BAKERSFIELD Grid: 31C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DARRELL MONSIBAIS / OWNER DAVID MONSIBAIS / FATHER Business Phone: (661) 327-3589x Business Phone: (661) .327-3589x 24-Hour Phone : (661) ~~=5~ 24-Hour Phone : (661) 872-1771x Pager Phone : ( ~/ -~6-% Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (661) 327-3589x MailAddr: 927 BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93304 Owner CARRELL MONSIBAIS Phone: (661) 327-3589x Address : 927 BRUNDAGE LN State: CA City : BAKERSFIELD Zip : 93304 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 DailyMax [UnitlMCP ANTIFREEZE/COOLANT F IH DH L 80.00 FT3 Low AUTOMATIC TRANSMISSION FLUID F DH L 70.00 GAL Low MOTOR OIL F DH L 120.00 GAL Min OXYGEN F IH DH G 282.00 FT3 Low WASTE OIL F DH L 165.00 GAL Low 1 07/01/2002 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3"~ Floor, Bakersfield, CA 93301 FACILITY NAME~)ctt~-¢I~ t~i~x~,a'~'0~ INSPECTION DATE o__-/_ Z.-g, -Z) 7_..., ADDRESS q~3~ ~ro,.~.l~,_.~ (.-n,~q .PHONENO. 6qbt L'3R9-358'q FACILITY CONTAC _T~~ r~m~,/be,3BUSINESS ID NO. 15-210-ol5tRo INSPECTION TIME. / ~ ~ f ~ NUMBEROF EMPLOYEES d~. Section 1: Business Plan and Inventory Program ~,.-:~4?~outine [~ Combined [~ Joint Agency [~ Multi-Agency [...-I Complaint I~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventeD, 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 t..-' Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation ,~~ ,~ ( Any hazardous waste on site?: .~lTYes Questions regarding this inspection? Please call us at (661) 326-3979 Bu~ness~nsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: t ' n--, · r - ~ - IZZ] ' Posteq;le $ ° .rl,~ Certified Fee ,]-. 90 Return Receipt Fee 1.50 Here~ r-~ (Endorsement Required) IZ2 Restricted Delivery Fee · r"-t(Endorsement Required) · cu m~,.~ Po~0o a ~,. $ 3.74 · Ltl ~ Reclp!ent°e Name 'Ptea,e Print Ctea. rl¥){To be completed by:melter) · r-1 IStreet, Apt. No.; ct PO Boa No. · Complete items 1, 2, and 3. Aisc complete A. item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. Il c. Signatur_.,...~e .~_,_.__~~ ~ ~'~ ~ [] Agent · Attach this card to the back of the mailpiece, X ~ or on the fr.o.~.t if space permits. 'E] Addressee 1. Article AddiCted to: D. is.de,yeW_, a__d. dress different from item 17 [] Yes = If YES. enter delivery address below: :3~ No ~ DARRELLS AUTOMOTIVE "' ~ 927 BRUI~AGE LAlqE BAKERSFIELD, CA 93304 3. Service Type I~ Certified Mail [] Express Mail { [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Copy from service label) 7000 0520 0021 9610 7622 PS Form 381 1, July 1999 Domestic Return Receipt 102595-99-M-1789 May 15, 2001 Darrells Automotive 927 Bmndage Lane Bakersfield, CA 93304 vIA CERTIFIgl) lqAIL '~ Subject: Revocation of Darrells Automotive; Permit to Operate ~, FIRE CHIEF RON FRAZE Dear Business Owner: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 Y'our "Permit to Operate" at 927 Brundage Lane, known as Darrclls ^utomotivc is VOICE (661) 326-3941 FAX (661) 395-1349 being revoked effective Monday, May 28, 2001, at 5:00 p.m. This "Permit to Operate" is being revoked due to failure to pay current as well as past due fees. SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 This action can be avoided by bringing your account current prior to that time. If you ,VOICE (661) 326-3941 FAX (661)395-1349 have any questions, please call me at (661) 326-3979. PREVENTION SERVICES Sincerely, 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661} 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Ralph E. Huey, Director VOICE (661) 326-3979 FAX (661)326-0576 Office of Environmental Services TRAINING DIVISION RH\db 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661)399-4697 FAX (661) 399-5763 CC: Walter Porr, Jr., City Attorneys Office Steve Underwood, Environmental Services Esther Duran, Environmental Services Drew Sharpies, Treasury DARRELLS AUTOMOTIVE' SiteID: 015-021-001720 Manager :. LN '~Y~' V BusPhone: (805) 327-3589 Location: 927 BRUNDAGE ' ~ ~~~~~~ap : 103 CommHaz : Low City : BAKERSFIELD rid: 31C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION ~SIC Code: EPA Numb: F/ DunnBrad: Emergency Contact / Title Emergency Contact / Title DARRELL MONSIBAIS / OWNER DAVID MONSIBAIS . / FATHER Business Phone: (805) 327-3589x Business Phone: (805) 327-3589x 24-Hour Phone : (805) 829-6150x 24-Hour Phone : (805) 872-1771x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat 'Hazards: Fire ImmHlth. DelHlth Contact : Phone: ( ) - x MailAddr: 3114 JEWETT 9'R~ ,~r~2~F_ ~ state: ~ city : B~ERSFIELD Zip : 9330~ O~er D~ELL MONSIBAIS Phone: (805) 829-6150x Address : 311~ JE~TT 9~ ~u~~ ~ State: ~ ., City ': B~ERSFIELD W Zip : 9330 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = 'Gal Certif ' d: RSs: No Emergency~irective~: ~ ~, ~~'~ ~~ ~ ~~. ' ~ Hazmat 'Invento~ '~ One Unified List I' As Designated Order All Materials at Site '~,. Hazmat CommOh Name... ~SpocHaz~EPA Hazards~ Frm ~ DailYMax'~Unit~MC~ OXYGEN F IH DH G 282.00 FT3 Lo~ MOTOR OIL F DH L 120.00 A~O~TIC T~SMISSION FLUID F DH L 70.00 G~ Lo~ WASTE OIL F DH L 165.00 G~ Lo~ ~TIFREEZE/COO~ F IH DH L 80.00 FT3 Lo~ i, ~ ~ ~,~. Do here~y ce~i~ thru i have ~'Or .~., n~~) ,reviewed the a~ached h~a~ouS materials manage- .... (Namb 6f BuSt~) any corrections constitute a complete and correct man- agement plan fo~y facili~. a~r~ DARRELLS AUTOMOTIVE SiteID: 015-021-001720 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site m COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: CAS# INSIDE SHOP~ SOUTH WALL. ~ ~ 7782-44-7 F STATE _T= TYPE i. PRESSIIRE i TEMPERATUREI CONTAINER TYPE Gas /PUre Above Ambient Ambient PORT. PRESS. CYLINDER AMOIINTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 282.00 FT3 141.00 FT3 .... I"I..~~U~ ~F~N'l'~ ','~ %wt. RS CAS# 100.00 Oxygen,. Compressed 'N© 778244' .... HAZARD ASSESSMENTS TSecret ] ~S.I BioHaz Radioactive/Amount EPA HazardsI NFPA USDOT~ MOP No N© .No/ Curies F IH DH / / / Low = Inventory Irem 0002 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: ~ STAT~. =-r-- TYPE ! AmbientPRESSURE ~ TEMPERATURE / : i U Ambient i AJBOVE GROUND TANK lLiquid_~ PureI CONTAINER TYPE - ~ AMOUNTS AT THIS LOCATION Largest Container / Daily Maximum, Daily Average GALL___ ' 120.00 GAL 100 00 GAL HAZARDOUS COMPONENTS %wt. RNo~ CAS# 100.00 Motor Oil, Petroleum Based 8020835 TSecret B'io~az Radioactive/Amount EPA Hazards--~ NFPA USDOT# MCP No No ~ No/ Curies F 'DH I / / / Min -2- 02/27/200 DARRELLS AUTOMOTIVE SiteID: 015-021-001720 -- Inventory Item 0003 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME AUTOMATIC TRANSMISSION FLUID Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE EAST END OF ~,.OP CAS~ STA.TE TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Liquid 1 Pure ]Ambient ~ Ambient I DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average GALI 70.00 GAL 50.00 GAL HAZARDOUS COMPONENTS 100.00 Transmission Fluid (Petroleum-Based) N HAZARD ASSESSMENTS TSecret'l oRSIBioHaz Radioactive/Amount EPA HazardsI NFPA USDOT# I MCP No N No No/ Curies F DH . / / / Low = Inventory Item 0004 Facility Unit': Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE OIL / Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE EAST END OF YARD. "CAS# 221 ~ STATE ~ TYPE ... ~---=- P.RESSURE --~ TEMPERATURE . CONTAINER TYPE Liquid ~ ~ Ambient ~ Ambie~t_~___~ DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Daily Maximum Daily Average 165.00GAL__~ 165.00 GAL il, Petroleum Based RS CAS# -  ~- HAZARD ASSESSMENTS ~ ~_ No [I Radi°active/Am°unt' EPA HazardsINO/ ~ Curies~ F DH NFPA~, USDOT# I MCPLow -3- 02/27/20( DARRELLS AUTOMOTIVE SiteID: 015-021-001720 ~ Inventory Item 0005 i Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE/COOLANT ! Days On Site i 365 Location within this FacilityiUnit Map: Grid: INSIDE SHOP, ~ WALL i CAS~ F STATE TYPE PRESSURE!-----~ TEMPERATURE CONTAINER TYPE Ambient . CYLINDER Mixture PORT. Liquid Above Ambient I PRESS AMOUNTS AT THIS LOCATION Largest Container I--l'IDaily Maximum Daily Average FT3I ' i 80.00 FT3 60.00 PT3 HAZARDOUS iCOMPONENTS Ethylene Glycol I N 107213 H~ZARDASSESSMENTS TSecretl RSIBioHaz Radioactive/A~ount I EPA Hazards I NFPA I usDoT# I MCP No ,No No No/ Curies F IH DH / / / Low -4- 02/27/20C DARRELLS AUTOMOTIVE SiteID: 015-021-001720 Fast Format ~ Notif./Evacuation/Medical OverallSite Agency Notification 01/26/1996 LISTED ~ Employee Notif./Evacuation 01/26/1996 TO THE FRONT OF THE BUILDING. -- Public Notif./Evac~''-, '~ 01/26/1996 Emergency Medical Plan 01/26/1996 911 TO BE CALLED 02/27/200 DARRELLS AUTOMOTIVE SiteID: 015-021-001720 Fast Format ~MitiHation/Prevent/Abatemt Overall Site --~.Release Prevention 01/26/1996 GAS CYLINDERS KEPT cHAINED TO CAR~ OIL~, TANKS LOCATED B~N~ - - ~AY~_ ~ NOT IN THE WAY OF TRAFFIC. ~? _ .... ~ Release Containment 01/26/1996 ABSORBANT AND MOPS TO PICK UP SPILLS. Clean Up 01/26/1996 WASTE OIL PICKED UP BY CRANE,S OR COLES. Other Resource Activation -6- 02/27/200] F DARRELLS AUTOMOTIVE SiteID: 015-021-001720 Fast Format ~ Site Emergency Factors Overall Site -- Special Hazards --Utility Shut-Offs 01/26/1996 NATURAL GAS/PROPANE: WEST'OF BUILDING. ELECTRICAL: INSIDE OFFICE. WATER: BY THE FRONT DOOR. SPECIAL: GUARD DOGS IN YARD. LOCK BOX: NO Fire Protec./Avail. Water 01/26/1996 FIRE EXTINGUISHERS IN SHOP.~ 0~C~¢~ FIRE HYDRANT ACROSS THE STREET. Building Occupancy Level -7- 02/27/200 DARRELLS AUTOMOTIVE SiteID:'015-021-001720 Fast Format ~ Training Overall Site ~ Employee Training 01/26/1996 MATERIAL SAFETY DATA SHEETS ON FILE: YES BRIEF SUMMARY OF TRAINING PROGRAM: FIRST MONDAY OF EVERY MONTH. ----- Page 2 i,, ,,~,, Held for Future Use Held for Future Use -8- 02/27/2001 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES . UNIFIED PROGRAM INSPECTION CHECKLIST ~ 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~,.~tq~?_~.~ AZ,TD INSPECTION DATE 10'"17_.-97 ADDRESS ~e~ $~l~..XXtld0/~'6~ PHONE NO. '~ 52"7- 2a ~ gq FACILITY CONTACTT~. ~v fi/lotOSi ~e41X BUSINESS IDNO. 15-210- Q~S- 060-00 ["/20 INSPECTION TIME 'i ~/rd t~,3 NUMBER OF EMPLOYEES q S' - o 36 section 1: Business Plan and Inventory Program ~l Routine ~ Combined [] Joint Agency [] Multi-Agency .[] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand t..~- Business plan contact information accurate t./f Visible address t..- Correct occupancy l~'- Verification of inventory materials L~' rt~ ~>[ tt]~ ~ Z~"~O Verification of quantities ~.../ 130 Verification of location l~ Proper segregation of material L' Verification of MSDS availability 1~ ~' Verification of Haz Mat training l/ ~ Verification of abatement supplies and procedures ~ f Emergency procedures adequate ~ f Containers properly labeled L.. Housekeeping b/ Fire Protection Site Diagram Adequate & On Hand }/ C=Compliance V=Violation Any hazardou, s waste 9¥ site?: ~Yes []No~k/ ~/( Explain: ~ tt~.~?~ O/L. Questions regarding this inspection.'? Please call us at (805) 326-3979 '~l~siness Site e/RAgsp~ble Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ~'-/~-~ NLm/i/ACCOUNT i ADDRESS CHANGEi CLOSE ACCT j 'FINANCE CHARGE!. ~ · OTHER ADJ I i/~_ ~ MAILING ADDRESS q2W '~F'©c~do, }C__. ~~ " CITY {~O~C~i C_[C~ STATE ~'~.~ ' ZIP CODE ~_~-~ SITE ADDRESS PARCEL NUMBER ADJUSTMENT I CHG DATE I CHARGECODE I ADJUSTMENT.AMOUNT : REMARKS: APPROVED, B'~?~~ . BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 1715 '~CHE STE R::. A.V~ BAKERSFIELD, CA. 93801 HAZARDOUS MATERIALS MANAGEMENT PLAN 1. TO avoid further action, return this focm within 30 days of Feceil::)t, ~-~ -2. TYPE/PRINT ANSWERS IN ENGLISH. . 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: ~--~.¢cc~ ~ ~ ¢~, u,,"~'-''~ ~,,,,,,:¥', V~ . LOCATION: r--4,3.'/ ~2'~_/- ~,n. ,,¢/~' ~ .,,. ! MAILING ADDRESS' .'/'~_'..n,~.~. ' CITY.~--~'~'.-~,~//~// STATE: L~,4 ZIP: .~..~$6"-/PHONE: ?'ZL-5--,.3,~'7 DUN & BRADSTRE'ET NUMBER: SIC CODE: PRIMARY ACTIVITY: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE .: .. Bakersfield Fire Dept. " ~zardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: q MATERIAL SAFETY DATA SHEETS ON FILE: \/j~ ~ BRIEF SUMMARY oF TRAINING PROGRAM: F;¢.6~.IR/V'~tJc'u~ o(Z SECT[ON 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT' MY BUSINESS 1S EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALtFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: ,/WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HA. NDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEED THE MINIMUM RE:PORTING O. UANTFfiES. OTHER (SPECIFY REASON) SSCT, O, 1, ~"~'"~//~'~// CERTIFY THAT THE ABOVE INFOR- MATiC)N IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL'BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" I~~~URAIE INFORMAIION.CONSrITUTES PERJURY. ~ SIGNATURE ' TITLE ' DATE ..... Bakersfield Fire Dept. - Hazardous ~aterials Divisio~ HAZARDOUS MAISR~AkS MANAGE~SNT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTiFiCATION PROCEDURES: ~5 ~e~ B. EMPLOYEE NOTIFICATION AND EVACUATION'--'"~'O ~ ''~'-(- ~'~ ~ C. PUBLIC EVACUATION: B M ~dFL~ D pt ' Hazardous Materials Division ....... 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' ~-g-"r~' ~/~ ~c~-jo SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' S ? EC IA L:~--r~'~'d> L,~)6-¢¢ /-,) LOCKBOX: YES/~ !FYES, OCATION: SECTION 9.: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: /"~<~- /..~x ,"",,,/0-d;,¢4,~_~ ,,',J ~'zgor~ BAKF-_~SFtELD CITY FIRE Dij=ARTMENT HAZARDOUS MATERIALS DIVISION ].7].5 CHESTER AVE. BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAM~~ '.~ ,~~ FAC[LJTY NAME NATURE OF 3USINESS . SiC CCDE DUN & B~DSTREET NUMBER EMERGENCY CONTACTS NAME' ~/'"~'~_.~/,/'~'.-// ~¢.4 ¢,',/~/¢'-',.¢' TITLE (2.~,_,,.,.-, ~ =U,..4NESS PHONE 24-HOUR PHONE ~¢,,-:.27-¢'/::F'""~ BAKERSFIF D CI'Pf FIRE DEPART MENT HAZARDOUS MATERIALS INVENTOII Pa~e~oL' CHEMICAL DESCRI~ION ) iN.TORY $TA~S: New [~ Addition [ ] Re,stun [ ] ~let~n [ ] Chec~ ~ chem~ ~ a NON ~E S~R~' [ '] ' ~ 8~R~ [ ] Chem~ N~e: AHM [ ] CAS 4) PHYSICAL & H~L~ PHYSICAL H~ H~D CA~GORIES Fire [ ] Reecho ~ Sudden Rele~e o1 Pressure ~ Immeai~e He~ (Ac~e) { ] ~ He~ (Chmnm) [ ] WAS~ C~SSlFICA~ON ,{3~igit code from DHS Fo~ 8022) USE CODE ~ PHYSICAL STA~ Solid [ ] ~u~ [ ] G~ ~ Pure ~ M~ure [ ] W~te [ ] R~ [ ] AMOUNT AND ~ME AT FAClU~ ~ UNITS OF M~SURE 8) STOOGE CODES M~mum Daly Amount: ;~ ( ] g~ { ] ~3 ~ a) Conta~ Average Oa~ Amount: ~ ~{ cunes [] b) Pressure: Annu~ Amount: ~~ c) Tem~r~m: ~ Oa~ On Site '~ Circle~ich Momhs: AllYe~. J, F, M, A. M, J, J. A. S. O. N, D' MITRE: Ust ~ ~OMPON~ CAS e % cnem~c~ com~nen~ or any AHM com~nen~ 2) [ ] 3) [ ] CHEMICAL DESCRI~ION IN~NTORY STA~S: New ~ ~dd~ion ( ~ Re.sion { ] Oeletion { ] Chec~ ~ chemi~ is a NON ~DE S~R~ Common N~e: /~'~ ~ 1 ~ 3) ~T · Chemic~ N~e: AHM [ ] CAS PHYSICAL & H~L~ PHYSICAL H~L~ N~RD CA~GORIES F~re ~ ~ea~ive ( ] Sudden Retake of Pressure [ ] ImmeOi~e He~h (Ac~e) [ ] ~laye~ He~ (Chron.) [ WAS~ C~SSIFICA~ON (~iglt code from DHS Fo~ 8022) USE CCDE PHYSICAL STA~ Solid [ ] ~Quid ~ G~ [ ] Pure ~ M~ure [ ] W~te [ ] Radioa~ [ ] AMOUNT AND TIME AT FACiU~ UNITS CF M~SURE 8) STOOGE CODES M~mum Oaly Amount: / ~0 'bs [ ] ga ~ ~3 [ [ al Cont~ne~ Average Oaly Amount: i ~ curies [ ] b) Pressure: Annua Amount: ~ G~ c) Temprite: ~gest Size Contaner: ~ ~ ~ Days On Site "~ ~ C:,rcie ~ich Months: All Ye~, J, F, M, A. M, J, J, A. S, O, N. D MITRE: Dst COMPONE~ CAS · % ~ ' AHM the three most h~aous 1) ~~ ~1 ~ [ ] c~em~ com~nen~ or ~y AHM core.nones 2} [ ce~ under pen~ ot law, ~a~ i nave pemonmly ex~n~ ~o ~ t~m~ w~m ~e ~n~omanon sunmt~ on ~ia ~ ~I ~ ~umen~ 'aDm~ in~a~on is ~e, accumm, ~ com~le~. RINT Name & TTtle of Au~onze(~ Com!~any Re~resenra~ve Signature Date · HAZARDOUS MATERIALS INVE ORY Page.of_. ; usiness ~i~me'-- Address CHEMICAL DESCRIPTION ) INVENTORY STATUS: New.~J Addition [ ]ReVtSion [ ] Deletion [ ] Chec~ if chemical i~ a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: ,~/.~"~-).,'u'lJ'~'l ~ '/"l~A-~.J;~t~, .,~ / ,c~'~. ~"~C/, ,"~ 3) DOT # (Ol~On~). Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [~ Reactive ( ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayeel HeaJltt (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code fi'om OHS Form 8022) USE CODE e~-.6 6) PHYSICAL STATE Solid [ ] L~quid {~ Gas [ ] Pure [~ Mixture [ ] Waste [ ] Radioactive 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES MaXimum Dally Amount: '7~1 lbs [ ] gal [ ] ,'t3 [ ] a) Container. Average Dally Amount: ..~-'C~ cunes [ ] b) Pressure: Annual Amount: ~ c) Temperature: L~rgest Size'Contasner: # Days On Site "~-~ Circte Which Months: All Year, J. F, M, A, M, J, J, A. S, O, N. O 9) MIXTURE: LIst COMPONENT CAS ,9 % WT AHM chemical coml:)onents or any AHM components 2) [ ] CHEMICAL DESCRIPTION =NVENTORY STATUS; New ~ ~'dc~itlon ( ] Revision { ) ~etetion ( ] Check ff chemical is a NON TRADE SECRET [ Common Name: /,.~7"~ ~ ( ~ 3) DQT # (optional) C.,hem~caJ Name: AHM [ ] CAS ,9 PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive { ] Sudden Release of Pressure [ ] immediate Health (Acute) [ ] Delayed Healltt (Chronic) WASTE CLASSIFICATION '~Z-"'L'~[ (3-digit code from OHS Form 8022) USE CODE 4 PHYSICAL STATE Soiid [ ] Liquid ~ Gas [ ] Pure [ ] Mixture { ] Waste ~J Radioactive { ] .AMOUNT AND T;ME AT F~CI~T'./ ~£NITS CF MEASURE 8) STORAGE CODES Averaqe i~aity Amount: tunes [ ] b) Pressure: Annual Amount: ~._~ (~t...') c) Temperature: ~L La. rc3es! Size Container: ~ Days On Site Circle Wl~cn Months: .Ail Year. J, F. M. A, M. J, J, A, S, O, N, D MIXTIJRE: List CCMPONENT CAS # % w'r AHM the three most hazardous ~ ) (.~ ~ c"T-~' (~. ¢'-' ee ~ [ ] c~emicai comoonents or any AHM components 2) [ ] [] O) Looa.tio n ~_j't.Y~'"'~ i cere/y uncler peneJty o//aw, ~a~ I nave ~ersona~ly examined ancz am ~arnmar w~m the ~ntomanon suDrn~ttea on ~is gna ali arlacftea ~tOCUmenm '~Dmirted inforrnabon is ~'ue, accurate, and complete. RINT Name & Title of Au~honzeo Company Representative Signature Date BAKERSFIIF D CITY FIRE DEPARtS/lENT HAZARO )US MATERIALS INVENTOWY P~age_%o~_..: usiness Name Addr~s CHEMICAL DESCRI~ION 1) IN~RYSTA~S: N~{ ] ~n( ] Re~n[ ] ~n{ ] Ch~m~aNON~S~'[ ] ~S~ [ 2) 3) · C~m~ N~e: ~M [ ] C~ ~ ' 4) PHYSICAL & H~ PHYSICAL H~ H~D CARRIES ~m [ ] Re~ [ ] Su~en Re~ of Pressure [ ] Im~di~e He~ ~e) ~ 5) WAS~ C~SSIRCA~ON .(3~ig~ ~e ~m OHS Fo~ 8022~ USE CODE S) PHYSIC~STA~ Sol~ [ I ~qu~ ~ ~ [ ] Pure ~ M~ [ ] W~te [ ] R~ [ ~ AMOUNT AND ~ME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES M~mumDaNA~um: ~ ~ [ ] ga ~ ~3 [ ] a) Co~ Average DaN A~um: ~ cunes[ ] b) Pressure: Annu~ Amount: ~ c) Tempera: ~gest Size Contane~ ~ Da~ On S~e ~ Circle~ich Momhs: All Ye~. J. F. M. A. M. J. J. A. S. O. N. D 9) MITRE: ~st COMPON~T CAS · % cbem~ com~nen~ or ~y AHM com~nen~ 2} [ CHEMICAL DESCRI~ION ~) ~N~NTORY STA~S: New [ ] Add,ion { ] Revision ( ] Deletion ( ] Check ~ cheml~ is a NON ~DE SECR~ [ Chemica Name: AHM [ ] CAS ~ 4) PHYSICAL & H~L~ PHYSICAL H~L~ H~RD CA~GORIES Fire ~ Rea~ve [ ] Suaden Rete~eof Pressure ~ imme~i~eHe~ (Acme) [ ] ~l~a He~ (Chronic) [ ] 5) WAS~ C~SSIFtCA~ON .(~digit code from DHS Fo~ 8022~ USE CODE 5) PHYSICALSTA~ Solid [ ] U~uid [ ) G~ ~ Pure ~ M~ure [ ] W~te [ ] R~io~e [ ] 7) AMOUNT AND ~ME AT FACI~ ~NITS CF M~SURE 8) STOOGE CODES M~mum Oaiiy Amount: ~ ihs { ] ~a ( ] ~3 ~ a) Contaner: Average ~aiy Amount: ~ cunes[ ] b) Pressure: Annu~ Amount: ~ c) Tempe~um: ~gest Size Cont~ner: ~ Days On Site ~ Circle~ich Months: All Ye~. J. F. M. A. M. J. J. A. S. O. N. D 9) MITRE: ~,t ~'~ ~ ~~'~'~~ONENT CAS~ % the three most h~ous 1) [ ] c~em~ com~nenm or ~y AHM com~nenm 2) [ 3) e~ under ~en~ of ~aw. ~at t nave ~e~onaiiy ex~m~ ~o ~ f~,i~ w~m ~e infomaeOn suDm~ on ~iS ~d ~1 a~c~ ~mi~ info~a~on is ~e. accumm. ~d INT Name & Title of Authonzeo Company RepresentaOve Signa=re Date I !-,,AN...~!fi .... >..>)iON I!.!,<L,,-!AN~,I:: 015.-010.-.00 ! 668 G~ner'a'l ~in!"or'mat'i on t...o¢;~.~t:fi on: 927 BI~UNI)A(-;I:.! I..N flap', !"{~za.~-d: Unt-~t:ed C'ity : (-~AKERSi::;(E~L.() G~'id ,, ; 1 AOV ', ......... Cont:a(;t: Name ..................... "f'! t'~ e .................. ~ ......... C;o~t:act Name ..................... "f"i t:'i e .................. / I / 24.-.Hour Phone : ( ) .-. x [ 24-...Hour Phone : ( ) .... x Pager' Phone : ( ) ..- x i Pager Phone : ( ) .-. Adm'Jnistpatfive Data .................................................................................... tvte~i'l Addl-s,, 92? Bt~UNI)AGE L.N D&B Numbep: (:omm Code: 0'i5...-905 (:OUNTY/[{~F:D.-..STA 5 I~I~SPONSE S:(C Code: ()NneP ,, JOHN P:(KEi~ Phone: (805) 631 Add~'ess: 92'7 E~RUNDAC;E~ I,,.N St:ate: CA (':ity~ I(~AKE!~SF::(ELD Zfip: 93::-104 .... Summa r'y .................................................................................................................................................................................................................................................. -I"i?ANSI~t:(SS:( ON I~!>((::!flANGI.-:! 0 ! .'.~-.-. 010..-001 O0 .-. Ove.~'l'! SJte <D> Not fi ~:,/Evacu~tfi on/!~ledfi caq <1> Agency Not fi f fi cat i on Public Not fi ~',/Ew~cuatfi on <4> Emengencs* t~edfica}'I P'ian <2> Re'l e4.~se Act: 'i v~ ,'z. 'i or~ <3> F:'ir'e Pr, ot:ec,/Av~'i'l, tibiae:er* <4> t!!art:hqu,:~ke Vu'lner'abi'l'it:~./ <2> [)e.,~¢;r'i b~.,. Tmai,min,o, Pr'ogr'am <3> .:::met,. 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