The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 1/28/1992 " SITE/FACILITY D I ~%GRAM ~ FORM FLOOR: NORTH SCALE: BUSINESS N~E: ~ 2' DATE:'~.,~/?V FACILITY N~E: ~ ~'~t~ UNIT ~: (CHECK ONE) SITE DIAGRA.~! FACILITY DIAGR.~I l(Inspector's Comments): -0FF!CIAL USE ONLY- 1. Address: Identify the 9. Lock (key) Box ~'~ ~ principle buildings by the Street numbers. 10. MSDS Storage Box 2. Street(s), Alleys, 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. Masonry 3. Storm Drains, Culverts, Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Gates Creeks, 13. Powerllnes 5. Buildings a. Frame construction 14. Guard Station ' ..... b. Ma~or~y'-constFu~l~ ............ 1'5. StoriEe Tanks?' -- Identify the c. Metal construction ....... capacity in gal. . ..... . ..... .... - - -~ .... ' a. Above ground d. Access Door : b. Underground 6. Utility Controls , ,~ a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Water 18: Evacuation Area: Identify the 7. Fire Suppression Systems: location where a. Fire Hydrants employees will meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage c. Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Water Control Valves 21. Outside Hazardous for protection systems Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored 8. Fire Department Access or Used (See ...... Below) TYPE OF HAZARDOUS MATER~AL F - Flammable E .- Explosive L - Liquid R = Radlologlcal Corrosive 0 - Oxidizer O = Gas P = Poison Water Reactive T - Toxic 9 = Solid H - Cryogenic D - Waste B - Etiological Example: Flammable Liquid = FL FACILI~ DIAGRAM (Required items in addition to the, abo~e) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. $iairways: Indicate 'the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets 7. $k?ltghts Bakersfield Fire Dept.~ HAZARDOUS MATERIALS DIVISION Date Completed // -,Z d-~7'- ~',Z Business Name: /c~"/~'"'7-~7 '~/x~'/' Location: ,Z, ~0 "~ /~.~M,,~_/~z~ ~-.J,-/ Business Identification No. 215-000 ~'? (Top of Business Plan) All$'d ............ Station No. --~ Shift ~ Inspector Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Verification of MSDS Availablity Number of Employees ~-/" Verification of Haz Mat Training ~-~ comments: ~___~ Verification of Abatement Supplies & Procedures Comments: ~~ Emergency Procedures Posted ~, Containers Properly Labeled '~omments: __ ~ Verification of Facility Diagram Sp.,~'ie.~H~,azards Associated with this Facility: ~ All Items O.K. ~ Correction Needed I~ Business Owner/Manager FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy RETURN PA~MEN~$ TO: -..L,..,, ,. CITY OF BAKERSF ELD" ,.' : P.o. BOX 2057 ": '. ' CITY OF BAKERSFIELD ~ BAKERSFIEL;D, CA 93303-2057', ACCOUNT NO. H'~ '&2 ~t, ' RETURN THIS COPY WITH PAYMENT ' ' ' : . ' " · '~NVO~Ce NU~e~ "' :"' "' "' 'l ~OZ eRu~oA~e c~, ' ' , ,,', ,.' ,'.-' P.O. BOX 2057 BAKERSFIELD, CALIFORNIA 93303-2057 ADDRESS CORRECTION REQUESTED DO NOT FORWARD FRED SttA~S t~HEEL AL~[GN]NG 8RAHH426&OZ 2907 BRtINDAGE LN 8,R~ERS'FIELD. CA 93.304 CITY of BAKF_RSFIELD "~",~ii~ RECEIVED . (~.~e o~ ~n~ n~e) ~S ........... Do herebT.¢ certify that-I have reviewed the RECEIVED attached Hazardous Materials business plan JAN 1 g 1989 ~.o~. p',.---~J .x6 ,,v.,..,~ ¢X~,,_-.( -,-- ~,..-,.~ ~"'"~ ............ (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for mF facility. s i~naLure u= ~= - i .~CITY Of BAKERSFIELD ' Fare and ~qriculture ~ Stanoard eusiness ~ ~-IJ~k~Z J~.2:~.~)O T..TS ~~~ ~'~ ~ ~~~0 ~Y' P~e of . , · . .?~~.-- LOCATION:_~q /(~~ ~~ ADDRESS: ~ ~o~~Y, STANDARD IND. CLASS CODE CITY. ZIP:~~f~. ~ ~~ CITY, ZXP: ~~~, ~. ~O~ DUN AND BRADSTREET NUMBER PHONE ~: ~~--~ ' 'pHON~ ~: ~---J~d--~ ,',. _ _ - _ _ _ -' ,~Z - ~-~ ~ ~o ~s~uc~xo~s ~o~ ~oP~ co~s " I · ~ 3 4 S i ? I :1 IG '11 12 13 ' Frans Type ~x Average ~i ~a~ I ~ ~t '~t ~c Use LKittm ~e ~ ~ i~ of fftxcure/C~cs I. Cooe ~e ~c :~t Est Units m I ty~ ~s Tub t~e ., St~ in Ficitl~ Nt See lnst~ti~s Physical led H.alth Hazlrd .C.A.S..~ ~[ 81 ~N & C.I.S. ~" (C~k all t~t'apply) · ''- ' ' - ' I ~ ~ r-- ~ r-- ~ r-- ~ r -- ~ ~ ~ i~N & C.A.S. Health ol Prlssutl HMIch. - ' Heaith of Pr~sure Heeich ~ut 13 Nlm & C.A.S. ~M ~hys~cal ~d Health Hazard" C.A.S. Numar ~c I1 NIN A C.A,S. (C~Kk 011 [~[ apply) ' -- :~ire Hazi~d ~--~ Reactivity ~--~ hllYK r--~ ~dK RIIIISt -- L--J ~--~ CM~t 12 NlM & C.A.S. "'""' """' ,,-, -- .............. ................. ' ....................... Ph~ical ~d Health Hazard C.A.S. Nuihr ~mt II NaN I C.A.5. ~r (Chitchat apply) . , ~ ~Flre Hazard ~-J Reactivity hlayH ~ Release Health aL Pressure Health ............. ~ .......................................... · ~mC 13 Nm&C.A.S. ~ · ~~ g 'r~_~ ................ .,~,,~, ~, ...... ~ .... , ~ .... ~ D .... ' - .- ~-~-~ % x~~ .~%¢~~~;~--:..; ,:ertificaci~ (Read and SiKh after completjnE al] sections) . . . · . - - ..~ . . : . - . .,- · .. - .' :' . . ; . - :- - . .: . ' .. . . . : :'. -. ';. . ., . -: · ~.~: . : .... . . . F~ BAKERSFIELD CITY F IRE' DEPART~4ENT B~ERSFIELD, CA 93301 (805) 326-3979 USINESS N~E HAZARDOUS ~ATERI ALS ~USINESS P~AN AS A ~HO~E INS~UCTIONS: 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 ~hole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA SECTION 2: E~RGENCY NOTIFICATIONS In case of an emeegenc~ involving the release ov threatened release h~zavdous mateeial, call 911 and 1-800-852-7550 oe 1-916-427-43.41. This ~ill not/fy your loom fiee dep~vtment and the State Office of Emergency Sevv~ces ~s eequived by E~PLOYEES TO NOT~FY IN CASE O~ NAME AND TI~E DURING BUS. HRS. AFTER BUS. HRS. E LOCK BOX: YES / NO IF YE{, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - sEcTIoN 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 TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...~ .................................... YES~iO) YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES N~O~ YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES~ 'YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES YES NO -E, DO--YOU MAINtAIN_EMPLOyEE TRAINING ~E~ORDS: ....... YES YES NO SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS~0F A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... I, ~-~L.,,o-~ I~w~o~ , certify that the above information is accurate. I understand that this information will be used to fulfill my firm's obligations 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. BAKERSFIELD CITY FIRE DEPARTMENT 21BO "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY 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/PRINT YOUR ANSWERS IN ENGLISH. ,q. Answer the questions beloN for THE FACII,!TY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. flSECTION 1: MITIGATION, PRE~NTION, ABATEMEN~ PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... YES NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade .......... . .... s~.~.pe~t~f~m.,=~Ll.st.o.n.l~ the:,~ad~..se_cr_ets_.on fo~m_~A=2 ...................... SECTION 4: PRIVATE FIRE PROTECTION SECTION $: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION S: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. XAT. GAS./PROPANE% B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCI< BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? YES / NO ~ISDSs? YES /' NO FLOOR PLANS? YES / NO KEYS? YES / ~0 - 3B -. BAKERSFIELD CITY FIRE DEPARTMENT " I.D. # FORM 4A-1 Page ._~__of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NA~IE:Fy'~--~/ -~ ~m~ ~(~~.NER NANE: ~ ~ ~~ FACILITY ~~: AO~ESS' ~q ~7 ~~&~ ~ ADURESS: ~Z~ ~,~ FACILITY UNIT NA~E: P~o~ ~: ~~~ ~.ON~ ~: ~Z/~ ~-~ [O~C~A~ US~ C~S COOE ' ,.,. ~ - -i 'ONLY 1 2 3 4 5 6 7 8 9' 10 TYPE ~AX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T ~ AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL 0R COMMON NAME CODE GUIDE E;~ERGENCY CONTACT: ~~ ~a~ TITLE: ~~ P~ONE ~ BUS ~OgRS: P~INCIPAB BUSINESS ACTIVITY:~,~~~'~ ~[~ ~ AFTER BUS - 4g-1 -