HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/HaZardous. wasteUnified~ Permit
CONDITIONSOF .PERMIT'.ON',' RE-VERSE.~SIDE ~-.-. ~
.... , ::. : . * .. * This _oermit is issued for the followin_~:'
· ., [] Hazardous Materials Plan
[] Underground Storage of Hazardous Materials
Permit ID #:: 015-000-000589 ~ . · ~. [] Risk Management Program .1:
'*' ** [] Hazardous Waste'On-Site Treatment
ONE HOUR MARTINIZING ~' ,~.~-~' *."
LOCATION: 2221 BRUNDAGE LN 'IELD .- -,
,~ * ~ .........*~-,, · , . ;::, ,,,:. :. -.. . .'- . -*;.
Issued by: Bakersfield Fire Department ~:. **' ' . ' ' . "*~ ~ · ~ ..
1715 Chester Ave., 3rd Floor Approved by:
Issue Date
Bakersfield, CA 93301 OffgeofEv~Services ~
Voice (661) 326-3979
FAX (661) 326-0576 ExpirationOate: june 30.. 2003
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
...... ~???'?~'%?;E?!?';~'~;,~ d .... This permit is issued for the following:
I~" ..~,~,¢?"/?: ?:/?, ~::;~:~Zd~22;2:2'.?.:.;;IEl~!Hazardous Materials Plan
, ?i~]"i.j:~!::i!::;:?:::;i [ii!i i!i ill ii;;;: iii',iiii:,~::i~e[ground Storage of Hazardous Materials
PERMIT ID# 015-0214300589 ¢ =~!"~; ' i~, ~iii:ii ~? ...:?( ~: ~ ~,?~ :: ~]~[~,~k[~.agement Program
......... ~?C,..'¢~.q'"'"':~i¢;,~':?'' ~';~:;~:~r"~;;;X... ~,?~r '~.1~?~,.. ~,'~ ....... :::~.
LOCATION 2221 U~UNUA~",,
:~. '*.. '~' ' ~ :~ .... .'" "..~.,,.-.:27=,,,,?~?~,F"'' ~¢. ~¢ ~ i. i~ ~ ~ 'r"?~=:,. =;..~ ~?'""- ~ ~= '...."'~j
'~'. "'.. ~ ~'" .~ ........... :tl ' ~ ?~'.,~%* . '.r;~.'d ¢.~ ' ' ~'~ ~" · "'-'"~
'~." '" :~
% ....... :-~ ~' '~¥. *="~',,':...;.~ ~. * {:~ ,?~-" ,¢~ '~ ,, ~,~4.
"~[::: ...
.....
]ssu~ by:
1715 Chewer Ave., 3rd Floor
B~enfiel& CA 93301
Voice (805) ~2~979
F~ (805) 326~576 Expiration Date: June 30, 2000
'SCALE:]~ /~Oi BUSINESS NAME: ....
~ORT}I F~OOR: . OF
(C}IECK ONE) SITE DIAGR~
(Inspector's Comments):- ,-OFFICIAL USE ONLY-
- SA -
NORTH . .SCALE:~
"'/~ BUSINESS N~E: ,' FLOOR: OF
~. .
'. .:. o,~:~¢~7.. ~,c~ N~: ·.....-.~:. ,: o~
. (CHECK 0~) SITE DIAG~ FACILI~ DIAG[~ / '
l(Inspector's Comments): -OFFICIAL USE ONLY- ...
- SA -
FDATE ADDRESS ~ZIP. - CO ~ ~'~ B'I:OCK NO.
2:' ~ '-'-wO
BUS ~,S LICENSE NO. ~~ ' ~lZ~'~i~:~; ~j~Z~:::~-~RMI~.-
.' ~ ~.. .... ~~-, ~,, ~ '- ~o ~ ~_ o ~ .
BUILDING CLASS/TYPE OF OCCUPANCY ~~ "0SINESS NAME '
,
BUSINESS PHONE HOME PHONE
~o. OF FLOORS SaU~RE FOOTagE Z~
-- O~E~
~TE OF ~E~PEOT~ON ~ ~2) (~
~ Bakersfield Fire Dept.
UNIFIED PROGRAM IN E,CTION CHECKLIS Enironmental Services
Business~i~lan and inventorY program
SE' CTION 1- ' ! 715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME INSPECTION DATE INSPECTION TIME
ADDRESS ...................... PHONE N~. No. of Employees
FACILITYCONTACT Business ID Number
: ' ' .. ' Section 1. Business Plan and InventorY Program
~.--'~Routine ~ Combined ~ Joint Agency [] Multi-Agency [] Complaint ~ Re-inspection
C V ('C=Compliance~ OPERATION %~O COMMENTS
~,. V=Violation ./ .
~' ~ APPROPRIATE PERMIT ON HAND
~ [~ BUSINESS PLAN CONTACT INFORMATION ACCURATE
"~ [] VISIBLE ADDRESS
~ [] VERIFICATION OF QUANTITIES__ ___~.~)_ ~.~___~..~_.__~
~ [] VERIFICATION OF LOCATION
"~ [~ PROPER SEGREGATION OF MATERIAL
~ [] VERIFICATION OF MSDS AVAtLABILITYE
~ ~'1 VERIFICATION OF HAT MAT TRAINING
~ [] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~ [] CONTAINERS PROPERLY LABELED
~ [] HOUSEKEEPING
[] ~1 FIRE PROTECTION
~ r'l SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: ~ YES
Inspector Badg~ 'No.
White - Environmental Services Yellow - Station Copy Pink ~ Business Copy
ONE HOUR MARTINIZING SiteID: 015-021-000589
Manager : DEE GILLION ~% BusPhone:
(661)
325-3374
Location: 2221 BRUNDAGE LN
Map : 102 CommHaz : Moderate
City : BAKERSFIELD Grid: 36D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 sIC Code:1541
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
DON DOERKSEN / GENERAL MANAGER NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (661) 325-3374x Business Phone: (661) 325-3374x
24-Hour Phone : (661) 831-9393x 24-Hour Phone : (661) 834-7784x
Pager Phone : (661) 332-1274x Pager Phone : (661) 345-5329x
Hazmat Hazards: React
Contact :-~4~6%~6~ ~ Phone: (661) 588-9353x
MailAddr: ~8~v - ~ ~~ State: CA
City : BA/4~R~FIELD ~--~ Zip : 93312
Owner JTCH INC Phone: (661) 588-9353x
Address : 3876 ALLEN RD State: CA
City : BAKERSFIELD Zip : 93312
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: Res: No
Emergency Directives:
=Hazmat Inventory One Unified List
--Alphabetical Order Ail Materials at Site
Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax IUnitlMCP
PERCHLOROETHYLENE DRY CLEANING R L 150.00 GAL Low
WASTE PERCHLOROETHYLENE R L 25.00 GAL Low
1 01/13/2003
:~[-ONE ~OUR MARTINIZING SiteID: ~-'~021-000589
Manager : DEE GILLION BusPhone: (661) 325-3374
Location: 2221 BRUNDAGE LN
Map : 102 CommHaz : Moderate
BAKERSFIELD %%~ Grid: 36D FacUnits: 1 AOV:
City
:
CommCode: BAKERSFIELD STATION 06 SIC Code:1541
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
DON DOERKSEN / GENERAL MANAGER NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (661) 325-3374x Business Phone: (661) 325-3374x
24-Hour Phone : (661) 831-9393x 24-Hour Phone : (661) 834-7784x
Pager Phone : (661) 332-1274x Pager Phone : (661) 345-5329x
Hazmat Hazards: React
Contact : C.u_~2~.LES ~~EP2~ .~ ~'/~ Phone: (661) 588-~3~x
MailAddr: 3876 ALLEN RD State: CA
City : BAKERSFIELD Zip : 933~
Owner JTCH INC Phone: (661) 588-9J3~-3~
Address : 3876 ALLEN RD State: CA
City : BAKERSFIELD Zip : 933L~
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
I,'-~)m ~'~o~..>/2..~-e3'A Do hereby certify that I h~e
ffy~ ~ ~nt ~me)
~ie~ed the a~ached h~ardous materials manage-
mere plan fo~ ~~/~ ~ ~ ~nd t~t it ~ong with
(N~ ~ 8~) '
any ~ions constitute a complete and ~rr~ man-
agement plan for my facility.
-1- 09/15/2003
ONE HOUR MARTINIZING SiteID: 015-021-000589
Fast Format
= Training Overall Site
-- Employee Training 12/07/1999
WE HAVE 4 EMPLOYEES AT THIS FACILITY.
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE.
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
T24E USE'~U-PERCHLOR{~B~Kq=n~-A~~ CL~-HR__P~OCEDUP. ES-TO USE iN
~-CHEMIEAL PROCEDURE ~OOK~
Page 2 1
Held f°r Future Use I
Held for Future Use I
-8- 09/15/2003
'~ONE HOUR MARTINIZING == SiteID: 015-021-000589 +
Manager : ~ ~ll/,~ BusPhone: (661) 325-3374
Location: 2221 BRUNDAGE LN Map : 102 CommHaz : Moderate
City : BAKERSFIELD Grid: 36D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:1541
EPA Numb: DunnBrad:
------4 +
Emergency Contact / Title Emergency Contact / Title
DON DOERKSEN / _~___~£~N~f~ NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (661) 3~-~ ~?~ Business Phone: (661) '~-~7~
24-Hour Phone : (661) 831-9393x 24-Hour Phone : (661) 834-7784x
Pager Phone : (661) 35~2~?g Pager Phone : (661)~3~--_~~
Hazmat Hazards: React I
I Contact : ~~ ~/~.~ Phone: (661)~-~_~'~
MailAddr: ~?& /~L~~ State: CA
city : BAKERSFIELD Zip : 933~2.
.................... ~ ......................................................... +
Owner ~-~ ~ Phone: (661) 5-~ ~ ~-~
Address : 5~?'~ ~LL~A/~J State: CA
City : BAKERSF%ELD Zip : 933/~--
........... +
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: Res: No
Emergency Directives:
+= Hazmat Inventory One Unified List +
+== Alphabetical Order == All Materials at Site +
................................ + ....... + ........... + ..... + .......... + .... +_- -+
Hazmat Common Name... ISpecHazlEPA HazardsI Frm I DailyMax IUnitlMCPI
................................ + ....... + ........... + ..... + .......... + .... +- - -+
e ',CHLOROETHYLENE R L 150.00 GAL Low
-1- 01/24/2002
+bONE HOUR MARTINIZING --- SiteID: 015-021-000589
+= Inventory Item 0001 Facility Unit: Fixed Containers on Site
+== COMMON NAME / CHEMICAL NAME ~
TETRACHLOROETHYLENE Days On Site
365
Location within this Facility Unit Map: Grid: + ................
W WALL BACK (WORKING AREA) OF STORE I CAS#127_18_4
+= STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER TYPE .....
I Liquid I Pure I Ambient I Ambient I IN MACHINE/EQUIP
4 ==q + + ----~=
4 ~ AMOUNTS AT THIS LOCATION =
Largest Container Daily Maximum I Daily Average
150.00 GAL 150.00 GAL I 150.00 GAL
+ ~ ~==========
+ ~ HAZARDOUS COMPONENTS ~---+===4
100.00 Tetrachloroethylene No 127184
+ ~ +===4
+ ~===4 ~ HAZARD ASSESSMENTS ===4 =4 + .....
{TSecretINo NoRSIBi°Hazl'Radi°active/Am°unt IEPANo No/ Curies HazardsR NFPA/// I USDOT# I MCP ILow
+ ~===4 ~ +=============4 =+== ~=====+
+= Inventory Item 0002 Facility Unit: Fixed Containers on Site
+== COMMON NAME / CHEMICAL NAME +---
WASTE PERCHLOROETHYLENE I Days On Site 1365
Location within this Facility Unit Map: Grid: + ................
INSIDE SW CORNER OF STORE I CAS#
127-18-4
+= STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+ .... CONTAINER TYPE
I Liquid I Pure I Ambient I Ambient I IN MACHINE/EQUIP
+--~ ~ ---- ~===============+ ~
4 ~ AMOUNTS AT THIS LOCATION
I Largest Container I Daily Maximum I Daily Average
15.00 GAL ~-~,D~ GAL 15.00 GAL
4 , HAZARDOUS COMPONENTS +===+
. I
4 + ~ +
4 +===4 ~ = HAZARD ASSESSMENTS ===4 ~ ~ .....
I TSecret INo NoRS I Bi°HasINo Radio'active/AmountNo/ Curies EPA RHazards I NF~A/// USDOT# I MOP
4 =+===+======4 ~ + ~ +=====+
2 01/24/2002
+ ONE HOUR MARTINIZING SiteID: 015-021-000589 +
+ Fast Format +
+= Notif./Evacuation/Medical Overall Site +
+== Agency Notification 12/07/1999 +
CALL 911.
+=== Employee Notif./Evacuation -- 12/07/1999 +
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUAL.
THEY WILL ALSO CALL 911 FOR FIRE DEPT AND 1-800-852-7550 STATE OFFICE OF
EMERGENCY SERVICES.
+== _--+
+ .... Public Notif./Evacuation 11/22/1996 +
IF THERE IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO
IMMEDIATELY EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP
PROCEDURE.
~ Emergency Medical Plan 02/14/1990 +
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
3 01/24/2002
+ ~ONE HOUR MARTINIZING siteID: 015-021-000589 +
4 .... Fast Format +
+= Mitigation/Prevent/Abatemt Overall Site +
+== Release Prevention 05/11/1992 +
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
+=== Release Containment ........ 05/11/1992 +
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
+
..... Clean Up -- 11/22/1996 +
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
RECLAIMED.
+
Other Resource Activation +
-4- 01/24/2002
+'~ONE HOUR MARTINIZING SiteID: 015-021-000589 +
~ -- = Fast Format +
+= Site Emergency Factors Overall Site +
+== Special Hazards +
+=== Utility Shut-Offs 12/07/1999 +
A) GAS - S WALL OF BLDG
B) ELECTRICAL - S WALL OF BLDG
C) WATER - S OF BLDG IN GROUND
D) SPECIAL - NONE
E) LOCK BOX - NO
+ .... Fire Protec./Avail. Water 12/07/1999 +
FIRE EXTINGUISHERS - NO SPRINKLERS.
FIRE HYDRANT - NE CORNER BRUNDAGE LANE & HUGHES AND NW CORERN HUGHES AND
FREEWAY 58 OVERPASS.
Building Occupancy Level
-5- 01/24/2002
+ ONE HOUR MARTINIZING SiteID: 015-021-000589 +
+ = Fast Format +
+= Training Overall Site +
+== Employee Training == 12/07/1999 +
WE HAVE 4 EMPLOYEES AT THIS FACILITY.
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE.
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS BEEN HERE A FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGAIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
+=== Page 2 ---
+ .... Held for Future Use --
Held for Future Use =
-6- 01/24/2002
ONE HOUR MARTINIZING SiteID: 215-000-000589
./.:f;. BusPhone: (805) 325-3374
Manager : ~/ ~. 2 19;e~ Map : 102 CommHaz : Moderate
Location: 2221 BRUNDAGE LN
City : BAKERSFIELD ii Grid: 36D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code: 1541
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
DON DOERKSEN / VICE PRESIDENT NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (805) 327-8326x Business Phone: (805) 327-8326x
24-Hour Phone : (805) ~-7-~-~.5~.~~ 24-Hour Phone : (805) 834-7784x
'~ ~ Phone : ( .~J~.. ~37 2 ~!2~g~/~;~ ~ Phone ~/ (~) ~.~-7-~-~-~-~, ~
Hazmat Hazards: React
Contact : Phone: ( ) - x
MailAddr: 2221 BRUNDAGE LN State: CA
City : BAKERSFIELD Zip : 93304
Owner DAN LANDON ENT INC Phone: (805) 325-3374x
Address : 2025 ALTA VISTA State: CA
City : BAKERSFIELD Zip : 93305
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
any corrosions cons~ul, a compl,~ and ~,~ man-
-1- 11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
---- Hazmat Inventory By Facility Unit
-- MCP+DailyMax Order Fixed Containers on Site
Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax IUnitIMCP
TETRACHLOROETHYLENE R L 150.00 GAL Low
-2- 11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
= Inventory Item 0001 Facility Unit: Fixed Containers on Site
~UiV~VlU~ ~Vl~ / ~± ~Y'k~ ~Vl~
TETRACHLOROETHYLENE Days On Site
365
Location within this Facility Unit Map: Grid:
WEST WALL BACK (WORKING AREA) OF STORE CAS#
127-18-4
F STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER'TYPE
Liquid /Pure I Ambient I Ambient I IN MACHINE/EQUIP
AMOUNTS AT THIS LOCATION ~
Largest Container [ Daily Maximum I Daily Average
150.00 GALI 150.00 GALI 150.00 GAL
HAZARDOUS COMPONENTS
100.00 Tetrachloroethylene N 127184
HAZARD ASSESSMENTS
TSoorotl ~S BioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP
No N No No/ Curies R / / / Low
-3- 11/01/1999
F ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
~ Notif./Evacuation/Medical Overall Site
--Agency Notification 02/14/1990
CALL 911
-- Employee Notif./Evacuation 02/14/1990
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUEL. THEY
WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550 STATE OFFICE OF EMERGENCY
SERVICES.
-- Public Notif./Evacuation 11/22/1996
IF THERE IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO
IMMEDIATELY EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP
PROCEDURE.
Emergency Medical Plan 02/14/1990
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
---- Mitigation/Prevent/Abatemt Overall Site
-- Release Prevention 05/11/1992
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
-- Release Containment 05/11/1992
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
-- Clean Up 11/22/1996
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
RECLAIMED.
Other Resource Activation
-5- 11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
F Site Emergency Factors Overall Site
Special Hazards
--Utility Shut-Offs 08/24/1994
A) GAS - SOUTH WALL OF BUILDING
B) ELECTRICAL - SOUTH WALL OF BUILDING
C) WATER - SOUTH OF BUILDING IN GROUND
D) SPECIAL - NONE
E) LOCK BOX - NO
-- Fire Protec./Avail. Water 08/24/1994
FIRE EXTINGUISHERS. NO SPRINKLERS.
FIRE HYDRANT - NORTHEAST CORNER BRUNDAGE LANE & HUGHES
NORTHWEST CORERN HUGHES AND FREEWAY 58 OVERPASS
Building Occupancy Level
-6- 11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
Past Format
~ TraininH Overall Site
-- Employee TraininH 07/17/1990
WE HAVE 4 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS BEEN HERE A FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
-- Page 2
-- Held for Future Use
Held for Future Use
-7- 11/01/1999
ONE HOUR MARTINIZING SiteID: 215-000-000589
Manager : BusPhone: (805) 325-3374
Location: 2221 BRUNDAGE LN Map : 102 CommHaz : Moderate
City : BAKERSFIELD Grid: 36D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:1541
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
DON DOERKSEN / VICE PRESIDENT NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (805) 327-8326x Business Phone: (805) 327-8326x
24-Hour Phone : (805) 871-3511x 24-Hour Phone : (805) 834-7784x
Pager Phone : (805) ~ Pager Phone : (805) ~
Hazmat Hazards: ~ 57- ~/3--- React ~7-- ~/
Emergency Directives:
= Hazmat Inventory One Unified List
-- MCP+DailyMax Order Ail Materials at Site
Hazmat Common Name... ISpecHazlEPA Hazards[ Frm DailyMax Unit MCP
TETRACHLOROETHYLENE R L 150 GAL Low
!~ Do hereby certify tha~ ~ have
r~vi~w~ ~h® a~ached hazardous ~da~
any corre~ions ~s~u~ ~ c~p~
1 10/24/1997
ONE HOUR MARTINIZING SiteID: 215-000-000589
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site
TETRACHLOROETHYLENE Days On Site
365
Location within this Facility Unit Map: Grid:
WEST WALL BACK (WORKING AREA) OF STORE CAS#
127-18-4
Liquid Pure Ambient Ambient IN MACHINE/EQUIP
AMOUNTS AT THIS LOCATION
Largest Container I Daily Maximum Daily Average
150.00 GALI 150.00 GAL 150.00 GAL
HAZARDOUS COMPONENTS
%Wt. EHS CAS#
100.00.Tetrachloroethylene No 127184
HAZARD ASSESSMENTS
TSecret EHS BioHazI Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R / / / Low
2 10/24/1997
F ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
~ Notif./Evacuation/Medical Overall Site
--Agency Notification 02/14/1990
CALL 911
-- Employee Notif./Evacuation 02/14/1990
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUEL. THEY
WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550 STATE OFFICE OF EMERGENCY
SERVICES.
-- Public Notif./Evacuation 11/22/1996
IF THERE IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO
IMMEDIATELY EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP
PROCEDURE.
Emergency Medical Plan 02/14/1990
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
-3- 10/24/1997
F ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
~ Mitigation/Prevent/Abatemt Overall Site
--Release Prevention 05/11/1992
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
-- Release Containment 05/11/1992
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
-- Clean Up 11/22/1996
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
RECLAIMED.
Other Resource Activation
4 10/24/1997
ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
F Site EmerHency Factors Overall Site
Special Hazards
~ Utility Shut-Offs 08/24/1994
A) GAS - SOUTH WALL OF BUILDING
B) ELECTRICAL - SOUTH WALL OF BUILDING
C) WATER - SOUTH OF BUILDING IN GROUND
D) SPECIAL - NONE
E) LOCK BOX - NO
Fire Protec./Avail. Water 08/24/1994
FIRE EXTINGUISHERS. NO SPRINKLERS.
FIRE HYDRANT - NORTHEAST CORNER BRUNDAGE LANE & HUGHES
NORTHWEST CORERN HUGHES AND FREEWAY 58 OVERPASS
BuildinH Occupancy Level
5 10/24/1997
ONE HOUR MARTINIZING SiteID: 215-000-000589
Fast Format
= Training Overall Site
-- Employee Training 07/17/1990
WE HAVE 4 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS BEEN HERE A FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
-- Page 2
Held for Future Use
Held for Future Use
6 10/24/1997
10/21/96 ONE HOUR MARTINIZING 215-000-000589 ,__Page 1
Overall Site with 1 Fac. Unit / %~l'q~
General Information
Location: 2221 BRUNDAGE LN Map:102 Haz:3 Type: 3
City : BAKERSFIELD Grid: 36D F/U: 1 AOV: 0.0
Contact Name Title Contact Name Title
DON DOERKSEN / VICE PRESIDENT NEELEY HOOPIIAINA / MAINTENANCE
Business Phone: (805) 327-8326x Business Phone: (805) 327-8326x
24-Hour Phone : (805) 871-3511x 24-Hour Phone : (805) 834-7784x
Pager Phone : (805) 329-7968x Pager Phone : (805) 329-4219x
Administrative Data
Mail Addrs: 2221 BRUNDAGE LN D&B Number:
City: BAKERSFIELD State: CA Zip: 93304-
Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 1541
Owner: DAN LANDON ENT INC Phone: (805) 325-3374
Address: 2025 ALTA VISTA State: CA
City: BAKERSFIELD Zip: 93305-
Summary ..
(TyPe or p~int name)
reviewed the a~ached h~ardous
ment plan for~
any corrections consti~ute a comp!ete and correct man-
a~ement plan ~or my facili~.
10/21/96 ONE HOUR MARTINIZlNG 215-000-000589 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-001 TETRACHLOROETHYLENE Liquid 240 Low
~ Reactive GAL
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-001 TETRACHLOROETHYLENE Liquid 240 Low
~ Reactive GAL
CAS #: 127-18-4 Trade Secret: No
Form: Liquid Type: Pure Days: 365 Use: CLEANING
Daily Max GAL ~ Daily Average GAL T Annual Amount GAL .
Storage · Press -. Temp, Location
IN MACHINE/EQUIP Ambient AmbientlWEST WALL BACK (WORKING AREA) OF
Ambient AmbientI STORE
-- Conc Components ~ MCP ---TGuide
100.0% ITetrachloroethylene ILow ! 74
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUEL. THEY
WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550 STATE OFFICE OF EMERGENCY
SERVICES.
<3> Public Notif./Evacuation
IF THER IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO IMMEDIATELY
EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP PROCEDURE.
<4> Emergency Medical Plan
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
OCCUR.
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 5
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
<2> Release Containment
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
RECLAIMED.
<3> Clean Up
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVEN WILL BE
RECLAIMED.
<4> Other Resource Activation
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - SOUTH WALL OF BUILDING
B) ELECTRICAL - SOUTH WALL OF BUILDING
C) WATER - SOUTH OF BUILDING IN GROUND
D) SPECIAL - NONE
E) .LOCK BOX - NO
<3> Fire Protec./Avail. Water
FIRE EXTINGUISHERS. NO SPRINKLERS.
FIRE HYDRANT - NORTHEAST CORNER BRUNDAGE LANE & HUGHES
NORTHWEST CORERN HUGHES AND FREEWAY 58 OVERPASS
<4> Building Occupancy Level
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 7
00 - Overall Site
<G> Training
<1> Employee Training
WE HAVE 4 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS BEEN HERE A FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
<2> Page 2
<3> Held for Future Use
<4> Held for Future Use
10/21/96 ONE HOUR MARTINIZING 215-000-000589 Page 8
00 - Overall Site
<G> Training
<4> Held for Future Use (Continued)
ONE HOUR MARTINIZING
DON DOERKSEN VICE-PRESIDENT
DAN LANDON ENT. INC.
2025 ALTA VISTA DRIVE
BAKERSFIELD, CA. 93305
Telephone 805 327-8326
Fax 805 327-3001
Bakersfield Fire Dept. //~l~-~~~
Hazardous Materials Division
1715 CheSter
Bakersfield, Ca.
I After the inspection, I talked to inspecter Germanetti
and he told me I needed a copy of the facility diagram at
my facility, which I have done.
~, He also stated that I needed sponges to absorb the
solvent instead of cotton drape material. I have no way to
reclaim solvent loaded sponge material bUt I am able to
reclaim solvent out of the cotton material in the event of
a spill.
BAKERSFIELD
FIRE DEPARTMENT
October 21, 1996
FIRE CHIEF
MICHAEL R. KELLY
ADMINISTRATIVE SERVICES
210t 'H' Street
Bakersfield, CA 93301 Don Doerksefl
(8O5) 326-3941
FAX (~) ags-1349 One Hour Martinizing
2221 Brundage Lane
SUPPRESSION SERVICES Bakersfield, CA 93304
2101 'H' Streot
Bakersflold, CA 93301
(808> a26-a~, Dear Mr. Doerksen:
FAX (805) 395-1349
P~VE.TIO. SERV,CES During a recent fire inspection (9-20-96, copy attached) the fire department found
1715 Choster Ave. several items inadequate.
Bakersfield, CA 93301
(805) 326-3951
FAX (~)3264~76 1) Verification of Abatement Supplies and Procedures. Please check your
ENVIRONMENTAL $1:RVICE$ abatement supplies and make sure that all employees are aware of their
m5 Chostor Avo. location as well as how to use them.
Bakersfiold, CA 93301
(805) 326-3979
F~X (~) a26~76 2) Verification of Facility Diagram. Please review the copy of your Facility
1RAINING DIVISION Diagram for accuracy.
56~2 Victor Street
Bakersfield, CA 93308
(~ a99-~6~7 At this time we would also ask that you take the time to reivew your current
FAX (805)399-$7&3 Hazardous Materials Business Plan and make any necessary changes within 30
days. Thank you for your attention to these matters.
Esther Duran
Hazardous Materials Division
/ed
~ ~...~tDOUS MATERIAS INSPECTION ~i t~akerstieid b=ire Dept.
. ,~
~ ..... --..~ ~~:.~ Haz~i)us
.;~~ Da~ Completed
B~iness Name:~
Lo.~on: ~ ~ [ ~~ ~ ~ ~ ~.
8~ne~ [den~ca~on ~. ~5~00 ~ ~ ~op of 8~e~ P~an)
S~on No. G C ~ Shift 0 Inspe~or
/
~al~me: /~ /~ Depa~reTime: /~/~ Impe~on~me:
Adequate Inadequate
Ve~fica~on of I~ento~ Mate~als
VeHfica~on of QuartZes
VeHfica~on of Loca~on
Proper Segregation of Material
Commen~:
Verification of MSDS Availabil~
Number of Employees:
Verification of Haz Mat Training
Commenm:
Common~:
fim~r~on~ Proeodure~ Posted
8pocial Hazards ~s~ociat~d ~ ~i~
Violations:
~m~~___~')l/'c~rL/ /,,// ' ' ( All Items O.K
eus~ness Owner/Manager PRINT ~ME - ~ ~TU~E Cone~on Needed
Wh~ ~t ~ Yel~w~n ~ Pink-B~ ~
Inspector's Comments):' -OFFICIAL USE ONLY-
- 5A -
(Inspector's Comments): -OFFICIAL USE ONLY-
- 5A -
HAZARDOUS MATE! .S INSPECTION ]~ersfield Fire Dept.
Haz'a~'~ous Materials Division
Date Completed
Bu{inessName: ~)t,J~ {~{3U~ /~t~~
Location: ~ 7,.. 7_. ~ ~'~~ ~ ~.--7-' ~ ~..-,.
Business Identification No. 215-000 (DO0 ~'-.~'-~ (Top of Business Plan)
Station No. ~ ~' ~ Shift ~ Inspector ~...~~~ //~. ~J.
/
Arrival Time: / (~ /'~ Departure Time: //,,2 / ~ Inspection Time: ~>-*~/x.~, ,..~.,-
Adequate Inadequate
Verification of Inventory Materials ~
Verification of Quantities {~
Verification of Location ~
Proper Segregation of Material~ r"l
Comments:
Verification of MSDS Availability ~
Number of Employees: /--'[
Verification of Haz Mat Training {~ I"1
Comments:
Verification of Abatement Supplies & Procedures I'1
Comments:
Emergency Procedures Posted ~
Containers Properly Labeled ~
Comments:
Verification of Facility Diagram I"l
Special Hazards Associated with this Facility:.
Violations:
All Items O.K
Owner/Manager PRINT NAME - ~--~-~AtU~E - C0rrec~on Needed
Wh~H~ Mat D~ Yellow~on ~py Pink-Busings ~py
~7/22/94 ONE HOUR MARTINIZING 215-000-00051
tge
Overall Site with 1 Fac. Unit '~ AUG 8 1994 3
General Information ,~
Location: 2221BRUNDAGE LN Map:102 Haz:3 Type: 3
City : Grid: 36D F/U: 1 AOV: 0.0
o~p I ~cc.I ~
Contact Name Title --Contact Name - Title
DON DOERKSEN / VICE PRESIDENT E / MAINTENANCE
Business Phone: (805) 327-8326x Business Phone: (805) 327-8326x ~4 '
24-Hour Phone : (805) 871-3511x 24-Hour Phone : (805) 8~-~-4~x~%
Pager Phone : (~-)~ -~?6~x Pager Phone : (~3-) ~q -~;~ x
Administrative Data
Mail Addrs: 2221BRUNDAGE'LN D&B Number:
City: BAKERSFIELD State: CA Zip: 93304-
Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 1541
Owner: DAN LANDON ENT INC Phone: (805) 325-3374
Address: 2025 ALTA VISTA State: CA
City: BAKERSFIELD Zip: 93305-
i Summary
· ~'~J'~r~~ Do hereby csrtify that ~ hav~
' (Type or print name)
reviewed the .a~ached__ h~ardous mater~ls manag~
mant pJan f~p~~/~ that ~t
a~OR~
~ith
07/22/94 ONE HOUR MARTINIZING 215-000-000589 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-001 TETRACHLOROETHYLENE Liquid 240 Low
· Reactive GAL
07/22/94 ONE HOUR MARTINIZING 215-000-000589 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-001 TETRACHLOROETHYLENE Liquid 240 Low
~ Reactive GAL
CAS #: 127-18-4 Trade Secret: No
Form: Liquid Type: Pure Days: 365 Use: CLEANING
Daily Max GAL Daily Average GAL Annual Amount GAL
240 I 210.00 I 420.00
Storage , Press T Temp Location
IN MACHINE/EQUIP AmbientlAmbient WEST WALL BACK (WORKING AREA) OF
AmbientlAmbient STORE
-- Conc Components MCP --[Guide
100.0% ITetrachloroethylene ILow ~ 74
07~22/94 ONE HOUR MARTINIZING 215-000-000589 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUEL. THEY
WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550 STATE OFFICE OF EMERGENCY
SERVICES.
<3> Public Notif./Evacuation
IF THER IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO IMMEDIATELY
EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP PROCEDURE.
<4> Emergency Medical Plan
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
OCCUR.
07~22/94 ONE HOUR MARTINIZING 215-000-000589 Page 5
O0 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT.LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
<2> Release Containment
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVENT WILL BE
RECLAIMED.
<3> Clean Up
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. tHIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVEN WILL BE
RECLAIMED.
<4> Other Resource Activation
07~22/94 ONE HOUR MARTINIZING 215-000-000589 Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - SOUTH WALL OF BUILDING
B) ELECTRICAL - SOUTH WALL OF BUILDING
C) WATER - SOUTH OF BUILDING IN GROUND
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - ????????
(DO YOU HAVE FIRE EXTINGUISHERS? WHAT ABOUT FIRE SPRINKLERS?)
NORTHWEST CORERN HUGHES AND FREEWAY 58 OVERPASS
<4> Building Occupancy Level
07~22/94 ONE HOUR MARTINIZING 215-000-000589 Page 7
00 - Overall Site
<G> Training
<1> Page 1
WE HAVE 4 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
ALL EMPLOYEES UPON HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR'PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS BEEN HERE A'FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for FUture Use
07}22/94 ONE HOUR MARTINIZING 215-000-000589 Page 8
00 - Overall Site
<G> Training
<4> Held for Future Use (Continued)
'.'x "~< -"~. '''/ . "'~l'~ ~'-':'---,'.-."'~. ,.. ," ':~
',."-..0-' '0 .-, :f ~,. - ' ,
(t~e or ~rin~ name)
JAN I 7 198~
Do herebs, cert~
_~ that I have reviewed the A~;'~ ............
attached Hazardous Haterials business plan
(name of business
and that it along with the attached additions
or corrections constitute a complete and correct
Business Plan for m,v facility.
~/~//~Z~ur.e date/
%
BUSINESS NAME ONE HOUR MARTINIZING ID NUMBER 215-000-000589
LOCATION 2221 BRUNDAGE LN HIGH HAZARD.RATING
1 . OVERVIEW ~
LAST CHANGE 05/24/88 BY ESTER
JURIS CODE 215-006 JURIS BAKERSFIELD' STATION 06
MAP PAGE 102 GRID 36D' FACILITY UNITS 1 HAZARD RATING 3
RESPONSE SUMMARY
2A SEC 4) TWO EMPLOYEES ARE ON PAGERS AND CAN RESPOND TO CALLS. ALSO SEVERAL'
EMPLOYEES AT THE STORE HAVE BEEN TRAINED TO TAKE CARE OF MINOR
PROBLEMS. .
EMERGENCY CONTACTS 2A SEC 2)
DON DOERKSEN - 327-8326 OR 871-3511
RALPH BARBEE - 327-8326 OR ~98-~6 ~/-~k
UTILITY SHUTOFFS.. 2A SEC 3)
A) GAS - S WALL OF BLDG B) ELECTRICAL - S WALL OF BLDG
C) WATER - S OF BLDG IN GROUND D) SPECIAL - NONE
E) LOCK BOX - NO
2 . NOT I F I CAT I ON / PUBL I C EVACUAT I ON
LAST CHANGE t /~ /~$ BY
If there is any spillage of Chemicals, The person in
charge is. to immediately evacuate the customer area,
before starting the Clean-up procedure.
PAGE 1 12/27/88 15:18
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
BUSINESS~NAME ONE HOUR MARTINIZING ID NUMBER 215-000-000589
LOCATION 2221BRUNDAGE LN HIGH HAZARD RATING 3
3 . HAZ MAT TRAINING SUMMARY
LAST CHANGE / / ~/~ BY
. All employees upon hiring are informed that. we use
Hazardous Materials and generate Hazardous Waste. New
employees are shown and informed in the use of the Material
Safety Data Sheets, New employees are also shown where and
how to use our Hazardous Chemical Procedure Book,.which
lists all of the Chemicals used. It also.gives important
information and clean-up procedures' for.Perchloroethylene.
After an employee has been here a few weeks, they
are.shown a Safety Film on the use of Perehloroethylene
and the Clean-up procedures to use in the event of a
s'pillage. They are again shown and informed on the use
of the MSDS and The Hazardous C~emicalProcedure Book.
4 . LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 05/24/88 BY ESTER
2A SEC 5) EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY
ROOM OR THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN
MAJOR INJURIES OCCUR.
PAGE 2 12/27/88 15:18
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
BUS~NESS NAME ONE HOUR MARTINIZING ID NUMBER 215-000-000589-
LOCATION 2221 BRUNDAGE LN .HIGH HAZARD RATING 3
FACILITY UNIT 01
A. OVERALL HAZARDOUS MATERIALS INVENTORY
LAST CHANGE 05/24/88 BY ESTER
ID TYPE NAME MAX AMT UNIT HAZARD
LOCATION CONTAINMENT USE
1 PURE TETRACHLOROETHYLENE 200 GAL HIGH
SW WALL (CONT #06) IN PROC. MACHINERY CLEANING
ID PERCENT COMPONENTS HAZARD LISTS
2580.01 100.0 TETRACHLOROETHYLENE HIGH
2 WASTE TETRACHLOROETHYLENE 15 GAL HIGH
SW WALL BY BOILER ROOM ', DRUMS OR BARRELS MET.. WASTE
ID PERCENT COMPONENTS HAZARD LISTS
2580.01 t4~.0 TETRACHLOROETHYLENE HIGH
B . FIRE PROTECTION / WATER SUPPLIES
LAST CHANGE / / ~/~BY
FIRE HYDRANTS
1. NE corner Brundage Lane and Hughes.
2. NW corner Hughes and Freeway 58 Overpass.
PAGE 3 12/27/88 15:18
MATERIAL sAFETY DATA SYSTEMS, INC~ (805) 648-6800
BUSINESS NAME ONE HOUR MARTINIZING ID NUMBER 215-000-0005'89
LOCATION 2221 BRUNDAGE LN HIGH HAZARD RATING 3
n . EMPLOYEE NOTIFICATION / EVACUATION
LAST CHANGE 05/24/88 BY ESTER
3A SEC 2) IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL. TRAINED IN CLEAN-UP PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY
MANUEL. THEY WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550
STATE OFFICE OF EMERGENCY SERVICES.
E . MITIGATION / PREVENTION / ABATEMENT
LAST CHANGE 05/24/88 BY ESTER
3A SEC 1) ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS
EXCEPT FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS
KEPT SEALED TO PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY
INSPECTED TO BE SURE THEY ARE WORKING CORRECTLY AND SAFELY.
PAGE 4 12/27/88 15:18
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
CITY of BAKERSFIELD
NON--'I?RAI-)E SEC RE]?S
' ~ge of
BUSINESS
CITY, ZIP: ~l~ ~t~/~ ~ ~0~ CZTY, ZIP: ~o}~l~ld ~ ~0~-- , DUN AND BRADSTREET NUMBER
~(~e C~e ~t ~t Est Unfts m Site T~ ~ 1~ ~ .. St~ In F~tltty ~ ~ I~t~ti~
Fire Hazard ~e~ct~v~ty [ ~ ~le~ ~ ] ~ hi.se ~--~
IC~k all t~t apply) - ' '
~lth of P~ ~lth ..............
(C~k ~11 t~t apply) --
Heo Ith of Pmsure Nfllth
{C~k al1 t~t ~wly) ....................... ._ _
- ~ Cat
Health of Prflsurl Health .............
Certificatim (Read and sign after completing aJ] sections)
I earthy ~der ~lty Of la. t~t I ~ve ~rsmallye.a.in~ end aa feeiliar .tth t~ tnfor~tim ~tt~ In th~ ell att~ ~ts. ~ t~t ~s~ m ~ ~t~ of t~e t~tvi~ls ~sible
for,~taining t~ info. tim. I ~lieve t~t t~ su~itt~ infor~tim is t~. accurate, and cmal~te.)
DR~-~ CLERRIR~'
DAN LANDON ENTERPRISES
2415 E. ASHLAN · FRESNO, CA 93726 · (209) 224-2996
July 7,1989
oo. OOE.KS~. Mr. Ralph Huey RECEIVED
V,cePres,denl Bakersfield Fire Dept
2025 A,la v,s,a ' JUL 1 11989
Bakershefd Cahforma 2130 O st.
1805~ 325-55~2 Bakersfield, Ca. H~Z. MAT. DIV.
Mr. Ralph Huey
Please add to the Hazardous Business Plan under
OTHER LOCATIONS "E" Mitigation/Prevention/Abatement for the following
2513 So. H Stree!
,n Benton Park locations,
~.~21 ~r.n~age La~e ONE HOUR MARTINIZING
in Brundage Square
5630 StocKdale H.ghway 251 3 So H st. ID 21 5-000-000590
.~ Sloo*aa,e v.,age 2221 Brundage 21 5-000-000589 ~
2232 N,les Street
Cot.er o, Ash S,reel .3801 Auburn 21 5-000-000593 ..
3~01 AuOurn Streel 5630 Stoekdale Hwy. 21 5-000-000591
~orner O! Oswell
1601 McDonald Way 21 5-000-000600~'
1601 McDonald Way
JuSt off Ming3200 Stine Rd. 21 5-000-000599L.,--
2507N C~es,erAve. 8200 B4 Stockdale Hwy. 21 5-000-000592
at Ch,na Grade Loop
3200 St,ne
~,P,aoz ~ '_-~f a spillage occurs, a trained employee following
8200 Stockdale Highway company policy will evacuate the area, turn on all
in Town & Country Village
coolers and exhaust fan, and mop up solvent with
absorbant cotton material. This material when
saturated with solvent will be placed into the dry
Granny's Walh
2234N,lesSIreet cleaning machine where the solvent will be reclaimed.
3805 Auburn Street
1601 McDonald Way ~ ~,/~
2505 N. Chester Ave.
3200 Stme
Eldon Draf~ery Cleaner~ /
2025 Alta V,s~a
04/14/92 ONE HOUR MARTINIZING 215-000-000589 Page 1
Overall Site with 1 Fac. Unit
General Information
Location: 2221 BRUNDAGE LN Map: 102 Hazard: Moderate
Community: BAKERSFIELD STATION 06 Grid: 36D F/U:' 1 AOV: 0.0
Contact Name Title Business Phone~ 24-~Hour Phone-
DON DOERKSEN VICE PRESIDENT (805) 327-8326 x ~(805) 871-3511
RALPH BARBEE MAINTENANCE (805) 327-8326 x/(805) 861-0632
.Administrative Data
Mail Addrs: 2221 BRUNDAGE LN D&B Number:
City: BAKERSFIELD State: CA Zip: 93304-
Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 1541
Owner: DAN LANDON ENT INC Phone: (805) 325-3374
Address: 2025 ALTA VISTA State: CA
City: BAKERSFIELD Zip: 93305-
Summary
RECEIVED
~Y 0 8 1992
H~? ~T. DIV.
I,~--~'~.?~?.~~'''-- Do hereby ~ that I have
r~ed the atached h~a~ous materials manage-
m~t plan for~/~/~ .and that it along with
(~e ~ ~) /
~ ~ffe~ions ~ns~tute a compile and corre~ man-
~eme~ plan for my fadl~.
04/14/92 ONE HOUR MARTINIZING 215-000-000589 Page 2
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
02-001 TETRACHLOROETHYLENE Liquid 240 Low.
· Reactive GAL
CAS #: 127-18-4 Trade Secret: No
Form: Liquid Type: Pure Days: 365 Use: CLEANING
Daily Max GALI Daily Average. GAL 'I Annual Amount GAL
240 ~ 210.00 420.00
Storage i Press T Tempi Location
IN MACHINE/EQUIP Ambient~Ambient E WALL IN BACK
DRUM/BARREL-METALLIC Ambient~Ambient SE CORNER
-- Conc Components MCP List
100.0% I Tetrachloroeth, rlene ILow --~
04/14/92 ONE HOUR MARTINIZING 215-000-000589 Page 3
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./EvaCuation
IN THE EVENT OF A SPILLAGE OR POTENTIAL SPILLAGE, THE AREA IS TO BE
IMMEDIATELY EVACUATED. PERSONNEL TRAINED IN CLEAN-UP.PROCEDURE WILL
IMMEDIATELY PROCEED TO CLEAN-UP SPILLAGE AS OUTLINED IN COMPANY MANUEL. THEY
WILL ALSO CALL 911 FOR FIRE DEPT. 1-800-852-7550 STATE OFFICE OF EMERGENCY
SERVICES.
<3> Public Notif./Evacuation
IF THER IS ANY SPILLAGE OF CHEMICALS, THE PERSON IN CHARGE IS TO IMMEDIATELY
EVACUATE THE CUSTOMER AREA, BEFORE STARTING THE CLEAN-UP PROCEDURE.
<4> Emergency Medical Plan
EMPLOYEES WITH MINOR INJURIES ARE TO GO TO THE NEAREST EMERGENCY ROOM OR
THEIR OWN DOCTOR. EMPLOYEES ARE REQUIRED TO CALL 911 WHEN MAJOR INJURIES
OCCUR.
04/14/92 ONE HOUR MARTINIZING 215-000-000589 Page 4
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAINERS EXCEPT
FOR SMALL QUANTITIES USED IN SPOTTING CLOTHES. MACHINERY IS KEPT SEALED TO
PREVENT LEAKAGE OF CHEMICALS. MACHINERY IS ROUTINELY INSPECTED TO BE SURE
THEY ARE WORKING CORRECTLY AND SAFELY.
<2> Release Containment
/ALL CHEMICALS ARE KEPT SEALED AND STORED IN THEIR PROPER CONTAI~ERS
EXCEPT FOR SMALL .QUANTITIES USED IN SPOTTIN~ CLOTHES. MACHINERY
KEPT SEALED TO PREVENT LEAKAGE OF CHEMICALS.. MACHINERY IS ROUTINELY
INSPECTED TO BE SURE THEY ARE WORKING CORRECTLY AND SAFELY.
IF SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
/
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP /
SOLVENT WITH ABSORBANT COTTON MATERIAL. THIS MATERIAL WIIEN SATURATED
NITFI SOLVENT WILL BE PLACED INTO THE DR~ CLEANING MACHINE WIIERE TH~
SOLVENT WILL BE RECLAIMED. . /
<3> Clean Up
IF A SPILLAGE OCCURS, A TRAINED EMPLOYEE FOLLOWING COMPANY POLICY WILL
EVACUATE THE AREA, TURN ON ALL COOLERS AND EXHAUST FAN, AND MOP UP SOLVENT
WITH ABSORBANT COTTON MATERIAL. tHIS MATERIAL WHEN SATURATED WITH SOLVENT
WILL BE PLACED INTO THE DRY CLEANING MACHINE WHERE THE SOLVEN WILL BE
RECLAIMED.
<4> Other Resource Activation
04/14~92 ONE HOUR MARTINIZING 215-000-000589 Page 5
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - SOUTH WALL OF BUILDING
B) ELECTRICAL - SOUTH WALL OF BUILDING
C) WATER - SOUTH OF BUILDING IN GROUND
D). SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - ????????
NONE
FIRE HYDRANT - NORTHEAST CORNER BRUNDAGE LANE & HUGHES
NORTHWEST CORERN HUGHES AND FREEWAY 58 OVERPASS
<4> Building Occupancy Level
04/14/92 ONE HOUR MARTINIZING 215-000-000589 Page 6
O0 - Overall Site
<G> Training
<1> Page 1
WE HAVE 4 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
ALL EMPLOYEES UPON'HIRING ARE INFORMED THAT WE USE HAZARDOUS MATERIALS AND
GENERATE HAZARDOUS WASTE. NEW EMPLOYEES ARE SHOWN AND INFORMED IN .THE USE
OF THE MATERIAL SAFETY DATA SHEETS. NEW EMPLOYEES ARE ALSO SHOWN WHERE AND
HOW TO USE OUR HAZARDOUS CHEMICAL PROCEDURE BOOK, WHICH LISTS ALL OF THE
CHEMICALS USED. IT ALSO GIVES IMPORTANT INFORMATION AND CLEAN-UP PROCEDURES
FOR PERCHLOROETHYLENE.
AFTER AN EMPLOYEE HAS' BEEN HERE A FEW WEEKS, THEY ARE SHOWN A SAFETY FILM ON
THE USE OF PERCHLOROETHYLENE AND THE CLEAN-UP PROCEDURES TO USE IN THE EVENT
OF A SPILLAGE. THEY ARE AGIN SHOWN AND INFORMED ON THE USE OF THE MSDS AND
THE HAZARDOUS CHEMICAL PROCEDURE BOOK.
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for Future Use
BAKERSFIELD C-ITY FIRE DEPARTMENT
,2130 "~" ST~E~.T RECEIVED
BAKERSFIELD, CA 93301 JUN I91987
(805) 326-3979 A[IS'[~ ............
0FFICIAL USE 0NLY
ID~
BUSINESS NAME
HAZARDOUS MA.TE R I ALS
BUSINESS PLAN AS A WHOLE
FORM 2A
f)00589
INSTRUCTIONS:
1. To avoid further action, return this form by
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
A. BUSINESS NAME: ~ Fie ~uP' ~c2p-L/~/2 /n~
B. LOCATION / STREET ADDRESS: ~; l~U~ ~
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or threatened release of a
hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify
your local fire department and the State 0ffice of Emergency Services as required by
law.
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: ·
NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS.
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: $ ~q/t ~ ~Z~
B. ELECTRICAL: S ~'a~l ~ '~D~
c. WATER: ~'~-~ ~. ~r~ ;~ ?c~u~
D. SPECIAL:
E. LOCK BOX: YES /~ IF YES; LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO' MSDSS? YES '/ NO
FLOOR PLANS? YES / NO KEYS? YES / NO
2A -
sEc'TION 4: PRIVATE RESPONSE TEAM FOR BUSINESS' AS.A WHOLE
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
SECTION 6': EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAIXING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INITIAL REFRESHER
A. METHODS FOR SAFE HANDLING OF HAZARDOUS.~ /f~
.MATERIALS Y~ NO~. NO
,.,
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: .......................... YES ~---~_~YES ~_~
C. PROPER USE.OF SAFETY EQUIPMENT: .................. ~ NO ~ NO
D. EMERGENCY EVACUATION PROCEDURES: .................~ NO~ NO
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO NO
SECTION ?: HAZARDOUS MATERIAL
CIRCLE YES OR NO
DOES YOUR BUSIN.E, SS .HANDLE HAZARDOUS MATERIAL IX QUANTITIES LESS THAN 500 POUNDS OF.~h
SOLID, 55 GALLONS OF A LIQU.ID, OR 200 CUBIC FEET O.F A COMPRESSED GAS: ...... YES (NO_~/
I, ~¢3~y~ k~_ O~m/~9ov'\ , cert'ffy that the above informat'ion is accurate.
I understand that this information will be used to fulfill my firm's obIigations under
the new California Health and Safety code on Hazardous Materials (Div: 20 Chapter 6.95.
Sec. 25500' Et Al.) and that inaccurate information constitutes perjury.
2B -
.BAKERSFIELD CiTY FiRE DEPARTMENT
2:130 "G" STREET
BAKERSFIELD, CA 93301
OFFiCL,~L USE OXHY'
ID#
BUSINESS NAME: ·,
BUSI NESS PLAN
SINGLE FACILITY UNIT
- FORM 3A
INSTRUCTIONS 1. To avoid further action, this form must be returned by:
2. TYPE/PRIS'T YOUR ANSWERS IN ENGLISH.
3. Answer tke questions belm~, for THE ~ACII. ITY UNIT'.LISTED BELOW
,4. Be as BRIEF and CONCISE as possible.
FACILI~ g~IT~ FACILI~ G~I.T N~:
SECTi'ON 1: MITIGATION, PRE~NTION, ABATEMENT PROCEDg~ES
SECTION 2: NOTIFICATION AND EVACUATIOTT PROCEDURES AT THIS UNIT ONLY
S '~'1o~ .l~,,.~,~rz7 ~u~cu~-~, Pm~ ,~L ~,~a ~'~
...... BAKERSFIELD CITY FIRE DEPARTMENT ''
I.D. # FORM 4A-1 Page / of
NON--TRADE SECRETS
HAZARDOUS 'MATERI ALS I NVENTORY
BUSINESS NAME: (D,v)~ /~/oo~. ~')?a~Z;/~;zJ~m OWNER NAME: '-~oTM ~d~ ~ '~. FACILITY UNIT ~:~
ADDRESS: ~1 ~~9~ ' ADDRESS: ~o~ ~ ~a ~ FACILITY UNIT NAME:
CITY, ZIP: ~o/~;~/~ ~~ CITY,ZIP: ~lC~,e~
PHONE ~: ~--~ PIIONE ~: ~o_~ ~?~M~ OFFICIAL USE CFIRS COOi
ONLY
1 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CIIEMI~AL OR COMMON NAME CODE GUID
"9 ] .,, lo o8
i
I1 ~d~o f L~o~L ~/~
NAME ~~~oe m/C se~ TITLE: ~i:'~'.:' SIGNATURE: ~
' . ~ / ~ DATE: ~-/6--U7 .
g~gR6gNCY CONTACT: ~ ~ ~eb/tS~ TITLg: o~ PllO~g · ~$ HOUR~:
AFTER nUS HRS:
~RINCI~A~ ~SlNg~ ACTiViTY: ~ ~ ~ ~ ~ l~ ~ AF'I'gR
- d~-I -
BAKERSFIELD CITY FIRE DEPARTMENT -
b+:D. # FORM 4A-1 Page ~r.. of
NON--TRADE SECRETS
HAZARDOUS MATERIALS INVENTORY
BUSINESS NAME: O}9~ ~oc~k- YT'ld~--C~lY~/7_;w~q OWNER NAME: ~ ~o~ ~, ~, FACILITY UNIT ~:~
ADDRESS: ~ ~A~~ ' ADDRESS: ~O ~' ~m ~5~ FACILITY UNIT, NAME:
PHONE ~: M~C-~9 ~, PHONE ~: 3~y-.~~ ~OFFICIAL USE CFIRS CODE
ONLY
1 2 3 4 5 6 7 8 9 10
EMERGENCY CONTACT: ~ ~/dsc~ TITI, E: O~ ~, PHONE ~ BUS HOURS:.. ~-~
· '.EMERGENCY CONTACT: TITLE: PHONE ~ BUS HOURS:
'~RINCIPAL BUSINESS ACTIVITY: ~ ~_l~a~q ~n~ Am.o~A~ AFTER BUS HRS:
~ - '4A-1 -
BAKERSFIELD CITY FIRE DEPARTMENT
NON--IRAn'S SECRETS
HAZARDOUS MATERI ALS INVENTORY ·
BUSINESS NAME: (DTOC ~oc,~- f)'l~Xhr/',';Iz Im~ OWNER NAME: '-~'~':io'~c],~ ~"r,-~, ~C, FACILITY UNIT
ADDRESS: ~1 ~.~~ ADDRESS: ~O~_<. ~Ta b~ FACILITY UNIT NAME:
PIIONE *: ~%~-~2~ PIIONE ~: 3~3-~3a~ IOFFICIAL USE CFIRS CODE
I
ONLY ..
1 2 3 4 5 6 7 8 9 10
AME: ~o~ ~0,9P/~%~ TITLE: ~'F' :" SIGNATURE: k~ q~ DATE:
MERGENCY CONTACT: ~ ~o~-/~e~ TITLE: u,P, PIIONE ~ BUS HOURS.:
AFTER BUS tIRS: ~7/-~5
M~RGENCY CONTACT: TITLE: . PHONE * BUS HOURS:
RIN, CIPAL BUSINESS ACTIVITY: ~A~ ~k~a~,~ ~g ~auw d~ AFTER BUS HRS: