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HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit . CONDITIONS OF .PERMIT ON REVERSE SIDE This ~ermit is issued for the followin_=: [] Hazardous Materials Plan [3 Unde~round Storage of Hm,~rdous M~t~als Permit ID #:: 015-000-001881 [3 Risk Management Progmm BRU N DAGE AUTOMOTIVE = Hazardous Waste On-Site Treatment LOCATION: 1301 BRUNDAGE LN IELD 'i '" OFFICE OF ENVIRONMENTAL SER VICES'. App~vedby: " c~ 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 '~"' ~Co~mV~Ho~7~"~~i ~"~ Voice (661) 326-3979 ) !:': ~,'~i~'~ '?~ ''~' F~ (661) 326-0576 Ek~ti0nDate: . June 30. 2003. usiness Name: ' Business Address: MISCELLANEOUS RECEIVABLES ADJUSTMENT =ATE ~-2/~ ~ .~^ccou., ADDRESS CHANGE CLOSE ACCT ' FINANCE CHARGE j , OT.E. ADJ MAILING ADDRESS ~[ ~~ ~:> (J~ bP~ cA~ ~ ( ~ C'~ ~~~[ C [~ STATE ~ ZIP CODE P~CEL NUMBER ADJUSTMENT I CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT ~' ~ I- ©C~ ~%~; \ ~/~ - ~ ! STATEMENT OF ACCOUNT · T, OF BAKERSFIELD P 0 BOX 2057 BAKERSFIELD, CA 93303-2057 (661) 326-3979 DATE~ 6/01/00 TO: BRUNDAQE AUTOMOTIVE ATTN: CHUCK OWNEN 2i35 9 UNION AVE BAKERgFiELD, CA 93507 ! CHARQE DATE DESCR~P,ION REF-NUMBER DUE DATE TOTAL AMOUNT 5/0i/00 BEQINNINQ BALANCE 170. O0 HMO05 6/0i/00 HAZ MAT WANDLiNQ FEE E l iO. O0 SBOOi 6/0i/00 CA BTA~ ~URCHARgE iO. O0 FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL. THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 126~-640 .170;00 DUE DATE: 7/03/00 PAYMENT DUE: TOTAL DUE: $290.00 / CUSTOMER NO: 1~201 CUSTOMER TYPE: ES/ 2319~ STATEMENT OF ACCOUNT CITY OF BAKERSFIELD P 0 BOX 2057 BAKERSFIELD, CA 93303-2057 (661) 326-3979 DATE: 5/01/00 TO: BRUNDA~E AUTOMOTIVE ATTNc CHUCK OWNEN 2135 S UNION AVE BAKERSFIELD, CA 93307 CUSTOMER NO: 19201 CUSTOMER TYPE' ES/ 23199 --~CI~FA~RQE 'UATE-DESCW~ REF=N~MBER~-:D~TOT~-AMO~N~ 4/01/00 BEQINNINQ BALANCE 170.00 FOR GUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 170.00 DUE DATE: 5/31/00 PAYMENT DUE: 170.00 TOTAL DUE' $I70,00 CUSTOMER NO: tc~201 CUSTOMER TYPE: ES/ TOTAL DUE: $170. O0 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD P 0 BOX 2057 BAKERSFIELD, CA ~3303-2057 (6~1) 32&-3~7~ DATE: 4/01/00 TO: BRUNDASE AUTOMOTIVE ATTN: CHUCK OWNEN 2i35 S UNION AVE BAKERSFIELD, CA ~3307 CUSTOMER NO: 19201 CUSTOMER TYPE: ES/ 231~ CHARQE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT G/O1/O0 BESINNIN~ BALANCE 170.00 FOR GUESTIONS OR CHANOES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 170.00 DUE DATE: 5/01/00 PAYMENT DUE: 170.00 TOTAL DUE: ~170.00 ~ii:~:CIT¥OF BAKERSFIELD Po sox BAKERSFIELD CA ~3303-~057 (6~i) 32&-3~7~ CusTOMER NO: I~01 CUSTOMER TYPE: ES/ ~31~ . TOTAL DUE: $170.00 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD P 0 BOX 2057 BAKERSFIELD, CA V~03-=05, (661) 3~6-3V7~ DATE: TD: BRUNDAQE AUTDHDTiUE ATTN: CHUCK DWNEN BAEERSFiELD, CA CUS'iOMER NOl i9~I)~1- CUSTOMER TYPE: ES/ 23199 CHARGE DATE DESCRIPTION REF-NUMBER DUE,DATE TOTAL AMOUNT 2/01/00 BEQINNINQ BALANCE 170.00 FOR (~UESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER VO DUE DATE: 4/02/00 PAYMENT DUE: 170. O0 TOTAL DUE: $170. O0 ~o ~ox ~o~? ~ BAKERSFIELD CA ~3303-'~057 (66i) 3~&'~97 CUSTOMER NO: t9~01 CUSTOMER TYPE: TOTAL DUE ~ STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD~ CA ~3301-5~01 (805) 326-397~ DATE: 1/15/9~ TO: BRUNDAGE AUTOMOTIVE 1301BRUNDA~E LN BAKERSFIELD, CA 93304 CHARGE DATE DEBCRIPTiON REF-NUMBER DUE DATE TOTAL AMOUNT 1/01/99 BEGINNING BALANCE .00 HMO05 1/15/99 HAZ MAT HANDLING FEE E 110.00 HMOI7 1/15/9~ HAZ MAT ANNUAL INSPECTION 50.00 SSO01 1/15/9~ CA STATE SURCHARGE 18.50 FOR QUESTIONS OR CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER c20 17~. 50 DUE DATE: 2/15/~ PAYMENT DUE: 178. 50 TOTAL DUE: ~i78. 50 D~TE: 1/15/~ DUE D~TE: 2/15/99 '; REMIT AND MAKE CHECK PAYABLE TO: ? ........ CITY OF BAKERSFIELD PO BOX ~057 BAKERSF [ELD CA ~3303-~057 (805) 3~&-3~7~ CUSTOMER NO: 19201 CUSTOMER TYPE: ES/ 231~ TOTAL DUE: $I78.50 MISCELLANEOUS RECEIVABLES ADJUSTMENT ADDRESS CHANGI~ CLOSE ACCT SITE ADDRESS [ ~ ~ P~CEL NUMBER ADJUSTMENT I CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT REMARKS: / CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME '~..d~/~r)~,-~ ~ INSPECTION DATE ADDRESS I'~o l ~t-,,.~a.~. PHONE NO. ~ ~ 4- FACILITY CONTACT ~__.q-k. Jo4. O-ujOO BUSINESS ID NO. 15-210- INSPECTION TIME ?~l-,g:~,~-- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine ~ Combined [21 Joint Agency [] Multi-Agency [] Complaint 1~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~---" ~-- Business plan contact intbrmation accurate Visible address Correct occupancy Verification of inventory materials t/ Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability ..~ Verification of Haz Mat training 9 Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?:Explain: t..J<of-~r~ ~;>{t_..- "J~ Yes [~lNo _~.. /'~ {~~~ Questions regarding this inspection.'? Please call us at (805} 326-3979 Business Site Responsible Party While- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: /%~ ~ {-~' ,,.t~--~ BOB, CHUCK (805) 634-0920 Or MIKE Brundage Automotive ~ And Transmission Repair 1301 Brundage Lane Cheapest Price Bakersfield, CA 93304 In Town CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: iC~' (~ ~ 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: ~ MAILING ADDRESS: CITY: STATE: ZIP: F__.)~ PHONE: DUN & BRADSTREET NUMBER: SIC CODE:~ PRIMARY ACTIVITY: OWNER: MAILING ADDRESS: 2 ! '~ ~- ~ O,'q to tO ~ t/ C)"~ SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE HAZARDOUS 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 TI-frS 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 INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 HAZARDOUS MATERIALs MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIYICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: ~'~ a~'~ /~, ~ .,'3 ~T' 3 · . HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIQATION. 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: ~J/A~- ELECTRICAL: t~$t c~ ~ ~ ~-~'J'~ d~ ~ ~ WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAIl.ABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 4 H~RDOUS MATERIALS INVENTO Page of Business Name Address CHEMICAL DESCRllrI~ON 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret 2) Common Name: ~CJ~ .~OPfL~t~ /~o~"'(2g~ O) t._ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard.Categories Fire/~.'.~-]'Reactive[ ] Sudden Release of Pressure [ ] ImmediatcHealth(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 TIME AT FACILITY UNITS OF lVIEASURE 8) STORAGE CODES Maximum Daily Amount 7~'~ Lbs [ ] C-al ~. fl3 [ ] a) Container: Average Daily Amount z40 Curi~s [ ] b) Pressure: Annual Amount ~OO c) Temperature Larsest Size Container "~ # Days on Site ~5". 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 hazardous 1) ~'t o~or~ ~:~ I ~- [ chemical components or 2) [ any AHM components 3) [ 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSecret[ 2) Common Ueme: 7 3) rOT # (o tio a) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ ]Reactive[ ]S,_,dd~nReleaseofPressure[ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) ?HYSICAL ST^rS So~ia [ I I.iquia [e,3 c~ [ I P~ [ I Mixture [ ] Wastej~] m~tio~tive [ ] ?) AMOUNT AND TIME AT FACILrrY UNITS OF MEASURE $) STORAGE CODES Maximum Daily Amount ~-5'" Lbs[ ]Gai[~,]fl3[ ] a) Container: Average Daily Amount ~ O Curies [ ] b) Pressure: Annual Amount !r. aO c) Temlx:rature dO Largest Size Container # Days on Site '~g ~" Circle Which Months: All Year, .~, F, M, A, M, $, 1, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % w'r AHM the three most h~,rdous 1) [ chemical components or 2) [ any AHM components 3) [ 0)rOCATIO dZZ /fZ I certify under penalty oflaw, that I have personally examined and am familim' with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. ~'/'~ PRINT Name & Title of ~,uthori~ed Company Repre~n~ativ. Signa~tu~e ~ ~Date CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakerstield, CA 93301 FACILITY NAME ~2.OMf)~. g~~~ INSPECTION DATE ~' Section 4: Hazardous Waste Generator Program EPA ID # [] Routine [] Combined [~] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous xvaste detennination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID#) Authorized fi~r waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurance Established or maintains a contingency plan and training Hazardous waste accumulation time frames i,,/ Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed xvhen not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Mt? ~,-. Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels 4 Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests tbr 3 years b(~W--.-x~ ~,A,t~/5 Retains hazardous waste analysis fi)r 3 years 1 Retains copies of used ()il receipts tbr 3 years ~ Determines if waste is restricted fi'om land disposal C:Complian,e<~ /.4),V=Vi°lati°n Office of Environmental Services (805) 326-3979 Business Site Responsible Party-~'' White - Env. Svcs. Pink - Bus/ness Copy