HomeMy WebLinkAboutBUSINESS PLAN 7/22/2003 Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON ..REVERSE SIDE
'~;..~' ·· ' ~?:. ': ** - "'. : ~ ~':'" '~*'.' This _Dermit is issued for the folloWincj;
:El Hazardous Materials Plan
[3 Underground Storage of Hazardous Materials
[] Risk Management Program
· [3 Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002171
TRUCK DOCTOR
LOCATION 4615 E 93307 .
1715 Chester Ave., 3rd Floor ApProved by: L~[~,-eY. fi~~ .~ss,e ~ate
Bakersfield, CA 93301 OfficeofEvimnmemlffServices ~'
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: June 30, 2003
ITE DIAGRAM [-~] FACILITY DIAGRAM
Business Name: '-""1'~,
Business Address:
ITE DIAGRAM 1. ] FACILITY DIAGRAM 1.__]
TRUCK DOCTOR SiteID: 015-021-002171
Manager : BusPhone: (661) 325-8414
Location: 4615 E BRUNDAGE LN Map : 103 CommHaz : Moderate
City : BAKERSFIELD ~% ~ Grid: 34D FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency C~ / soNTitle
RICHARD W KAY JR / OWNER RICHARD J/K%Y /
Business Phone: (661) 325-8414x Busin~s_~_h_o~e: (661) 325-8414x
24-Hour Phone : (661) ~31~-~?~ ~A3u~,~ncne--: (6~) 29S !.5,~9x~0~
Hanmar Hazards: Fire Press ImmHlth DelHlth
Contact : Phone: (661) 325-8414x
MailAddr: PO BOX 70607 State: CA
City : BAKERSFIELD Zip : 93387
Owner RICHARD W KAY JR Phone: (661) 325-8414x
Address : PO BOX 70607 State: CA
City : BAKERSFIELD Zip : 93387
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: Res: No
ParcelNo:
Emergency Directives:
~ Hazmat Inventory One Unified List
~ Alphabetical Order Ail Materials at Site
HGLANHazmat Common Name... ISpooHaz[EPA Hazards[ Frm I DailyMax IUnitlMCP
ACETYLENE E F P IH G 700 00 FT3 Hi
TIFREEZE L 55 00 GAL Low
EAR OIL F DH L 55 00 GAL Low
YDRAULIC OIL L 55 00 GAL Low
UBE GREASE F DH L 30 00 GAL Min
F DH L 165 00 GAL Min
pOTOR OIL
XYGEN F IH DH G 700 0,0 FT3 Low
ROPANE E F P IH G 800 00 FT3 Hi
I~ SOLVENT F DH L 50 00 GAL Mod
~ASTE OIL F DH L 500 00 GAL Low
1 07/18/2003
F TRUCK DOCTOR SiteID: 015-021-002171
Fast Format
~ Notif./Evacuation/Medical Overall Site
--Agency Notification 12/22/2000
N/A
-- Employee Notif./Evacuation 12/22/2000
IN CASE OF FIRE OR EMERGENCY CALL 911 OR FIRE DEPT.
-- Public Notif./Evacuation 12/22/2000
KERN OIL FILTER RECYCLING.
Emergency Medical Plan 12/22/2000
MERCY HOSPITAL ON TRUXTUN.
I, ~,~,,:e_.. ~/~'~. DO hereby ce.i~ that I have
(Tyl~e or prtn! name) '
reviewed the attached hazardous materials manage-
ment plan foi~rbu~l<2 ~D~-~o~and that it along with
(Name of I~usines~)
any corrections constitute a complete and correct man-
agement plan for my facility.
Da:~
2 07/18/2003
~-~. ~ ~ 0 / ~ Bakersfield Fire Dept.
UNIFIED PROGRAM INSPECTION CHECKLIST Enizonmental Sez~ices
~,,, ' .......,,' , ,, ,,,, ,,, , ,, - - . 1715 Chester Ave
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301
Tel: (661)326-3979
15-021 -
Section 1: Business Plan and Inventory Program
Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint ~ Re-inspection
[ C=Comp~iance '~ OPERATION COMMENTS
~, V=Violation
APPROPRIATE PERMIT ON HAND ·
VISIBLE ADDRESS
VERIFICATION OF INVENTORY MATERIALS
VERIFICATION OF QUANTITIES
VERIFICATION OF LOCATION
PROPER SEGREGATION OF MATERIAL
VERIFICATION OF MSDS AVAILABILITYE
EMERGENCY PROCEDURES ADEQUATE
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: [] YES [] NO
EXPLAIN:
Inspector Badge No..
White - Environmenial Sea, ices Yellow - Station Copy Pink - Business Copy
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATE R MENT
1. To avoid further action, retum this form within 30 days of receipt. ~'X,'°
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.
5. You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 HR. PHONE
.1
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
B. EMPLOYEE AND AGENCY NOTIFICATION:
i~ e.~ o4-~,,~, o~ e~,~~7
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
~a 0,) gI-/~c'~
· D. EMERGENCY MEDICAL PLAN:
2
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
B. RELEASE CONTAINMENT AND/OR MITIGATION:
t,.~,.~-~-/~ o, I -I~ lc. h~ ~~,,ry co,,~4~,~,,-,¢ ~
~ ~ ~ ~d d~, ~ y.
C. CLEAN-UP AND RECOVERY PROCEDURE, S:
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PR.OPANE: ~. t~ s~, I ~f'e~p~ ~
WATER: Ua. I - ~:,~ ~
SPECIe:
LOCK BOX: ~S~ IF ~S, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION:
B. wATER AVAILABILITY (FIRE HYDRANT):
3
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: ~
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
CERTIFICATION
I I.~Ei(SqANI~ 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
.ACCURATE INFORMATION CONSTITUTES PERJURY.
' Sf'~NAT'~"' "' URE /~~- - TITLE- DATE
4
CITY OF BAKERSFIEL ,1~
OF~CE OF ENVIRONMENTAL ;E'RVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER/OPERATOR IDENTIFICATION
FACILITY INFORMATION
Page Of
'i~?; '~, ~: ~ Year Ending ~o~
FACILITY ID # [~;~i~:~:~t~;~: ~i~'~ Year Beginning
BUSINESS NAME (Same as FACI,LITY NAME or DBA- Doing Business As) 3 I BUSINESS PHONE lO2
SITE ADDRESS lO3
DUN & ~o6 SIC CODE ~o?
BRADSTREET (4 Digit #)
COUNTY ~) ~o8
i; ': '~.: ~t.~''yT~'.'":'::~:: ':?~%~ ....... ::5'~: ~,~ ", ","~,~'L,':':~,,'~,~;7,r-'"~":,, i
OWNER NAME ' ~ ~ OWNER PHONE ~ 112
OWNER ~ILING :
, ' ' ' I '
CONTACT ~ILING
,,o
. , . -.~-. , .~.: :,~:~> ~, ~ :,.:.~ .: :?~.~: ~.>::: .,:. :?~:~. :::~:: ~ .:.- ~,,,~ :.~N~%~<~,. ?>~tZ;:~::: ~;:~:<:c< ,:~,-'%~0~<.~,,, ~ ?;: .~ r>: ~'.:-:5.,~;>. :.~.t ..~,' .>:~.3~, ::... :.~ 7 :..,., .).'7 ~ ' .': L.L:, ; .:'~ :~,::~.:~: ':7%;.
. '~" ' ':y::: ~?:'? '::7%~? ~ :}','~ '~.~¢'~ ~":':" ........ '"~ '~'~". ' ..... ?:~:~:~ 6~'~.~,~..u~5?2:T:,;: ~ :::7
Oediflcat~ Based on my inqui~ of ~ose individuals responsible for ob~ining ~e info~ation, I ~i~ under penal~ of law ~at I have personally examined
and ~iar with the information submi~ed in this,i~ento~ and believe the info~ation is tree, accurate, and ~mplete.
"'~AT~ OF OWNE~OP~TO~.~,, ~ ~ DATE 134 I NA~ OF DOCUMENT PREPARER
~A'~'o~E~OPE~T~R (~rint) ~/ ~ ,3~ ?ITLE OF OWNE~O O . ' ,aT
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. ~l~, s ~ i~,.~. O E OF ENVIRONMENTAL SI VICES
tl~nlt~M~l~' 1715 Chester Ave., CA 93301 (661) 326-3979
'~'~"~"~ ~' H~RDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one fo~ per matedal per building or a~a)
~EW ~ ADD ~ DELETE ~ REVISE
2~
Page
BUSINESS ~ME (Same as FACILI~ NAME ~ DBA - D~ng Busin~ ~) 3
CONFIDENTIAL (EPC~) ~ Y~
205 T~DE SECRET ~ Y~o 206
2O7
COM~N ~ME EHS* ~ Y~ ~ No 208
FIRE CODE H~RD C~SSES (C~plete if r~u~t~ by I~1 fire ~i~
210
PHYSICAL STATE ~S SOLID ~'OUID ~g ~S 214 ~RGEST~AINER ~O ~/jOO~ 215
(Ch~ all that apply)
~GAL ~ ~ CU ~ ~ lb LBS ~ tn TONS 221
STOOGE CONTAINER ~ABovEGROUND TANK .~P~STI~NONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR 223
(Check all that apply)
~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ n P~STIC BO~LE ~ r OTHER
~TANK INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE BIN
~S~EL DRUM ~ h SILO ~CYLINDER ~ ~ TANK WAGON
STOOGE PRESSURE ~ a A~IE~ ~ aa A~VEAMBIE~ ~ ba BELOW AMBIE~ 224
STOOGE TEMPE~TURE ~ aAMBIENT ~ aa A~VEA~IENT ~ ba BELOW AMBIE~ ~ c CRYOGENIC 225
' 226 227 [] Yes ['-I No 228 229
230 231 [] Yes [] No 232 233
234 235 [] Yes [] No 236 237
238 239 [] Yes [] No 240 241
242 ~ ~'-- 243 [] Yes [] No 244 245
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE DATE 246
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