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Home My WebLink AboutBUSINESS PLAN 11/01/1998 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ....... ~,,~,;~¢~,,i,;~,,~i~,~?~,~,,~,~,,, ......... This permit is issued for the following: .:~,,¢,,¢iri: i ~!~,,i:~:¢:~:¢:~:'?~:'''%}i!ii!:: .r, iii!!!iiii~: iiii!iii¢~'L;iiiiil;i~i~;Unde[ground Storage of Hazardous Materials LOCATION 801 BRUNDAGE~?',~';*~s~**~:~;~/ U BAK[~:SE[~D ca g330~{?~:¢¢~::'~:~".:~ ~i~."~,. ""41 H ..... ..,~' ,~:'i~,:i~,H'%~'. ~ ,' , , '' ~ '~'l ~ ~'! ....... ~'". "~ .... , ... ,.,~u ~r ..~...,.' ,' , .,' .~ ~,., .~ , . .~ r ,~. ,, ~., "..~ '~;'~ ~..~ ~ ............... :" :ii~,.~ ~!. h~i';::~i¢ ~' ~' ¢;i~i~iE;¢¢~ i~!i~i!~ii~ii~' -'~ ~'" ~ % ~ q;"-....;:4i. '- i,':1. "~¢~i~ ........ ~[iii~i~;~i~i~;~a~j~~ .......... ~ ~'= ~I ~:-¢' _~_.~ ¢. '~---,..-.;;.~ ...,,, ¢,%' ¢, ',.., ,,, ~, Issu~ by: O~ICE OF E~R O~AL S~ ~CES 1715 Chewer Ave., ~rd Floor B~el~ CA Voice {805) 32~979 F~ (805) 32~576 ExpkationDate: June 30, 2000 ITE DIAGI~M [ ! FACII.,ITY DIAG~ [ ! Business Name: Business Address: ITE DIAGRAM ~ ~} ~ FACilITY DIAGRAM Business Name: . ,Jo~.4,u ~ aCc~ ~ ~c.o ,sc-<u~c~' Business Address: ~ t ~o,~oo~C,~ z.~. :~ ~ STATEMENT'OF ACCOUNT CITY OF BAKERSFIELD i50i TRUXTUN AVE BAKERSFIELD, CA 9330i-520i (805) 326-3979 DATE: 11/01/98 TO: JOHN & LEONARDS FIELD SERVICE 801 BRUNDAQE LN MM BAKERSFIELD, CA 93304 CUSTOMER NO: 17057 CUSTOMER TYPE: ES/ 20595 CHARQE DATE DESCRIPTION ' ' REF-NUMBER DUE DATE TOTAL AMOUNT 10/01/98 BEQINNINQ BALANCE 128.50 FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT, PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 DUE DATE' 12/01/~8 PAYMENT DUE' 128.50 TOTAL DUE* $1~8.50 *' CUSTOHER NO: 17057 ' CUSTOMER TYPE~. ES/ ~05c25 TOTAL DUE: $I28. 50 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501TRUXTUN AVE BAKERSFIELD, CA 93301-5201 · ~,, ' DATE: 9/01/98 TO: dOHN & LEONARDS FIELD.SERVICE~ .,: ' 801 BRUNDAOE LN ~M' .~ ',,, BAKERSFIELD, CA 93G04 ' CUSTOMER NO: '17057 CUSTOMER TYPE: ES/ 205~5 CHAROE DATE DESCRIPTION ~. ~ ~ REF~NUMBER DUE DATE TOTAL AMOUNT ~/01/~8 ~EOINNINO B~L~NC'E~ ' 1~. 50 FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUH~ER ~T THE TOP DF THIS STATEHENT. CURRENT OVER 30 OVER 60 OVER 90 DUE DATE: 10/01/98 PAYMENT DUE: 128.50 TOTAL DUE: $128.50 TOTAL DUE: '~ 128. 50 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501TRUXTUN AVE BAKERSFIELD, CA 93301-5~01 (805) · 3~&n3979 , ,~ .... · · DATE: 8/01/c78 TO: JOHN & LEONARDS F,IELD SERVICE ~' '" ~Oi ~RUNDAQE LN ~H· _,,: ~,' ~ i~AKERSFiELD, CA ~G04~ ~ ,, . CUSTDNER NO: 17057 ' CUSTOMER TYPE: ES/ 205~5 FOR OUESTIONS'OR CHANCES TO YOUR ACCOUNT PLEASE C~LL THE NUHBER ~T THE TOP DF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 128.50 DUE DATE: 8/31/98 PAYMENT DUE: 128. 50 TOTAL DUE: ~i28.50 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501TRUXTUN AVE BAKERSFIELD, CA 93301-5~01 (805) 326-3979-- DATE: 6/30/98 TO: JOHN & LEONARDS FIELD SERVICE 801BRUNDAQE LN gM BAKERSFIELD° CA 93304' CUSTOMER NO: 17057 CUSTOMER TYPE: ES/ 20595 CHARGE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT 6111198 BEQINNINQ BALANCE 128.50 FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 1~_OD ..... DUE DATE: 7/30/98 PAYMENT DUE: 128.50 TOTAL DUE: $128.50 ~CusTOMEE~ ,NO:' : I705~.~ :~,~ ,, ~, CUSTOME~R:, TYPE~'¥ES/ 2~0595. ,, ~ ~ · :,; , , ,, TOTAL DUE:' $128. 50 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD i50'i TRUXTUN AVE BAKERSFIELD, CA 9330i-520i TO: dOHN & LEONARDS.F2ELD SERVI'CE .¥;L'. . BAKERSFIELD, ,'CA' 93304,: ': :'¢ : CUSTOMER ND: ;,,~17'057 CUSTOMERTYPE: ES/ 20595 ~ lng BALANCE ' ' ' .00 5/01/98 BE~INN HMO05 6/01/98 HAZ MAT HANDLINQ FEE E ' : 110.00 S8001 6/01/98 CA-STATE SURCHARGE 18.50 FOR ~UESTIONS OR ~HAN~~ '~ TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 128.50 DUE DATE: 7/01/98 PAYMENT DUE: 128.50 TOTAL DUE: $128.50 , John Buford ~ ;g;-,':.. Leon. a. rd---King_ ~--~(80~') 332-7098 ~ ,7~i''. .'~(80~' 839-1094 Corfi~)lete Tractor & Equipment Repair SHOP: 12235 S. UNION AVE. DIESEL P.O. BOX 70561 · BAKERSFIELO, CA 93387 OVER 70 YEARS EXPERIENCE CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester A~ CA (805) 326-3979 IN. STRU___CTIONS.' {'VO ~ 7 ~ C 1. TO avoid further action, remm this form within 30 da~s of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: LOCATION: ~O ~~G ~D~SS: CITY: ~<C~6 DUN & BRADSTREET NUMBER: SiC CODE:~ PRIMARY ACTMTY: '"r-'c,-n<..rorL · ~r3-~u,~r~ qzc..~.o/a, a.._ OWNER: MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. 3o,4~ l'~o~-0'a.o c. xw~---'< %~q-4q%C- %52.- '70q5~ IIAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS 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 INFOKMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES 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: WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 4 · Business Name Address CHEMICAL DESCRIPTION l ) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret 2) Common Name: ~_J~R.O/~ ~'f.f..) ~ t, nd'r'cgL O tr._ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [~ 'Gas [ ] Pure [ ] Mixture,~,] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIIvtE AT FACILITY UNITS OF MEASURE 8) STORAGE CODES ~_~ Maximum Daily Amount __~ 5" Lbs [ ] Gal ~ fi3 [ ] a) Container: Average Daily Amount ~ %~' Curies [ ] b) Pressure: Annual Amount ? ~ ~) c) Temperature Largest Size Container ~ # Days on Site %~ W Circle Which Months: All Year, $, F, M. A, M, I, J, A, S, O, N, D 9) MIXTURE: List COMPONEKr CAS// % WT the three most baTgdous 1) ~ o ~ o ~ [ chemical components or 2) [ any AHM components 3) [ 10)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] CheckffchemicalisaNONTradeSecxet[ ]Tradesocret[ 2) Common Name: ! ~' ~ ~OL ~/C_?.J Y-'-' 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release ofPressure [ ] Immediate Health (Acute) [ 5) WASTE CLASSIFICATION O-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount ~X" Lbs [ ] Gal [ ] fl3 [ ] a) Container: Average Daily Amount C ~'- Curies [ ] b) Pressure: Annual Amount %-'~"' c) Temperature Largest Size Container ~Y~ , # Days on Site '5 6 ~" Circle Which Months: All Year, J, F, M, A, M, $, $, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazaudons 1) ~'T~O~ --~ot-t-/C~'xrr- [ chemical components or 2) [ any AffM components 3) [ ! 0 )LOCATION ! certify under penalty of law, that ! have personally examined and am familiar with the information on this and all atlached documents. I believe thc submitted information is ~ruc, accurate and complete. PRIIqT Name & Title of Authorized Company Representative Signature Date HAZ~ RDOUS MATERIALS INVENTO~ · Page., ,-of Business Name Addre~ CITE1VHCAL DESCRIPTION I )[NVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret 2) Common Name: ~k~'~ O?/-~ 3) DOT # (optional) Chemical Name: AI-IM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH HazardCategofies Fire,S]Reactive[ ]SuddenReleaseofPressure[ ] Immediate Health (Acute) ~] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (a-digit code from DHS Form 8022) USE CODE 6) Pm's~cAL STATE So.a [ ] Liquid [~] Oas [ ] Pu~ [ ] Mixtur~ [ ] Waste~l Raaioactive [ 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount g f' Lbs [ ] Gal [~-ft3 [ ] a) Containe~. Average Daily Amount ~ ~" Curie~ [ ] b) Pressure: Annual Amount ~ ~7' ¢) Temperatu~ # Days on Site '~ & 5' Circle Which Months: All Year, $, F, M, A, M, $, I, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous I) [ chemical components or 2) [ any AHM components 3) [ 10)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] CheckifchemicalisaNONTradeSectet[ ]Trad~[ 2) Conunon Name: "~'-~2'D~C~'Off- /d.~OP-gc, U to. ~--cd ~/5 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ IRe. active[ ]SuddenReleaseofPressure[ ] lmmediateHealth(Acute)[ ]DelayedHealth(Chroni¢)[ 5) WASTE CLASSIFICATION (3-digit code flora DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] LiquidlY] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND ~ AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 12_~' Lbs [ ] Gal ~ ~ [ ] a) Container:. ; O Average Daily Amount ; e_ C" Curies [ ] b) Pressure: Annual Amount ( t. ~" c) Temperature Largest Size Container # Days on Site '7 6 ~'~ Cimle Which Months: All Year, J, F, M, A, M, $, $, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) [ ch~nical components or 2) [ any AHM components 3) [ 0 )LOCATION certify under penalty of law, that I have personally examined and am familiar with the information on this and all a~ti documents. I PRIlqT Name a Title of Authorized Company Representative f /t'' ' - ~i~ffure