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Home My WebLink AboutBUSINESS PLAN SI TE/F.~C'I LI T¥ DIAGRAM FORM $ [ NOR~ SCA ~/_/~/ BUSI~SS NA~ME: ,. FLOOR: '~ OF ~ DATE.>/~_/& /~f FACILITY NXME: UNIT ~: f~F f ~[ (CHECK ONE) SITE DIAGR.~M FACILI~ DIAGR.~I '~ Inspector s Comments): -OFFICIAL USE ONLY- AMERICAN TIRE & SERVICE COMPANY A DIVISION OF BRIDGESTONE/FIRESTONE INC.BROOK PARK,OHIO 0 4 1 4 9 i 0 3 ..... : .... .: -......~ . · ...:r ..:-~: e~I<ERSF2.O$:' ~ARCH~ I~1993 ..:':?:~: ~ ..... ': '':':'~:: ': . ' · ~E~' :' ...... :":' ' · - ' ~ :~':L. ~:f? :.:: '.' ' - ': ? .'. - BA~ ~ ~N~ :' ""': :' '""' '"" .:::~ .. · ~ . ~:".' :'.. ' ' ~. Oh~'~'.:" ' ~:'~. ::~':~'.~,': "'"" ' · ~'" S~. ~V;. ~ ' .;. :.:'.'. '.::... EXACTLY'..&~e*~95 DOLLAE$' AND $5 C~NTS' ~' -~.sr~[o c~ or - ::::.'. ,, .......... :., ...... ..... .. ::"..: B KERS ELD CA 93303 ':".: · : ~E~LA~NT 'G ':. .:..'. ':."... .'.'.'. : .......... ::~': :' .'"~'¢~:~;~:}: .... ' ' ". :... :.:.{ 7: ~:~: ~' . ... .... : ' ' ' ". ~ ' :"': U''~'fi~ '::Q'b · ~D 8~fi 0~'..~0~'-.'. ~AG£ 1 C,F' 1 ~ A N K C 0 D ~UM~I~ BAKF'_,SF20.% lt,V A~O~NT r.IEY AMCUNT INE DATE INVOICE OAT. SSUEO, 03/01/93 CHECK' NO. 0¢,14,9103 · O3:SCOUNT REP' IlO- FOR OPERATING PURPOSES THE NAIVE OF OUR OPERATZ(~N .HAS. CHANGED $ ,',o, ,. ,,Es ./~'~. To. FIPESTONE INC. AHTS IS NOT A SEPARATE LEGAL ENTITY, - ~~- ~ Bakersfield Fire Dept. · ' Hazardous Materials Division 2130 "G" Street :/.:.Bakersfield, CA. 93301 ~' ~l~. ~¥. .. ~' H~ZARDOUS MATERIALS MANAGEMENT PLAN ./ INSTRUCTIONS: ' 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. ' .... 3. Answer the questions below for the bu. siness as a whole. 4. Be brief and concise as possible. SECTION ~: BUSINESS IDENTIFICATION DATA BUSINESS NAME: ~.t~,~ .,. . ' MAILING ADDRESS --~ CITY: ~'~5" /~;/M STATE: . PHONE: ' DUN ~ BRADSTREET NUMBER' ',~' DOD-D~. - ~ ~. SiC CODE: MAILING"~DDRESS: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYESS: -.~ MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAIN~ING 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 TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. ~ (4'~m,. ~-,,.O-~ CERTIFYTHATTHEABOVEINFOR- MATION IS ACCURATE. I UNDERSTANDTHATTHISINFORMATION 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. SlGNATURE TITLE DATE Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: ~.{,~,c'..,/t<"r~,,~ ~ .bf '.' SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY N~O_IJEI~AIJO~ p~O_CFntlF~ES: ......... CALL 911 - ASK FOR CITY FTRE DEPT. 'F UNSAFE TO USE SHOP OR OFFTCE PHONES CALL FROM A NEIGH2.ORING BUSINESS. (SECRETARY) B. EMPLOYEE NOTIFICATION AND EVACUATION: EVACUATE ]~UILDINGS AND PARKING LOT° OHNER'AND/OR HANAGER ARE TO SEE THAT ALL EMPLOYEES AND CUSTOFiERS ARE EVACUATED UPWIND OF EVACUATED AREA TO A SAFE DISTANCE IN CASE {'.iF EXPLOSION. C. PUBLIC EVACUATIO'N: EVACUATE ]~UILDINGS AND PARKING LOT. OWNER'AND/OR MANAGER ARE TO SEE THAT ALL EMPLOYEES AND CUSTOHERS ARE EVACUATED UPI.4IND OF EVACUATED AREA TO A SAFE DISTANCE IN CASE OF EXPLOSIC)N. O. EMERGENCY MEDICAL PLAN: ~,1~1..~ ~l( ~P ~ ~ZDtc/,'t~.. b}c. lp · INJURIES OR EXPOSURE - CHECK MSDS REPOR'rs, <TAI<EN FROM OFFICE WITH FIRST AID KIT BY SECRETARY ON EVACUATION), FOR PROPER FIRST AID PROCEDURES. ADMINISTERED BY MANAGER OR OWNER. Bakersti¢ld Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A.' RELEASE p[~EVENTION STEPS: ' , B I~EI_EASE CONTAINMENT ANl~/nil MINIMI7ATIm~' LIQUID SPILL - USE ABSARBENT PELLETS (FIRST ONE DISCOVERING SPILL) a. COMPLETELY COVER SPILL b. BUILD DIt<E AROUND SPILL FOR CONTAINNMENT GAS OR VAPOR LEAD< - IF POSSIBLE SHUT OFF MAIN VALVES OR PObJER SOURCE ( OWNER ) ..... ~ .- C. CLE~N-UP PROCEDURES: CALL ~11 - ASK FOR ,:':ITY FIRE: I)EPT. !1::' UNSAFE TO USE S?'iOP OR OFFICE PHONES CALL FROM A NEIGHBORING BL!SINESS. (=EuF. E~A,,,.r'." SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: CITY of BAKERSFIELD Farm and Agriculture Fi SLendard Business~-IC].>.AZARDOUS HATERTALS TNVENTORY NON--TRADE SECRETS JSINESS NAME: )ta~c,'iC.', .... / ~.~. '~"~.¢', OWNER NAME'. ~F/,~v~ ~.o-.,~ NAME OF THIS FACILITY: )CATION: 53o~ (~..~-~ ~ ADDRESS: .'.%~ '= ~7:.~ ~'~'~ STANDARD ~ND._C~6~S. ~ __ :TY. ZIP: ~-:~.5-~ ,<.Y CITY. ZIP: ~,,krr~i~l~ )'~o~ DUN AND BRADSTREEI NUMBbH- I'rqns lyre Hax Average Annual ~ea~ure I ys .~ont ~ont ~ont ~e Loc~tion.~hece. ':cae ~ooe Amc Amc EsL UflltS on ICe /ype Press /omo Store,.In PacI/ICy. See ]nstructlofls ~hysical and Health ~aTard C.A,S. HumOr ~ Co=portent II Name I'C.X,S. NuAber (Check all that applyl ~¢ ~j~.~.. ? Pressure -- Component 13 NAme I C.A.S, Number F'hysic,l(check 4//~PdthatHealthapp/ylUaTard C.~.S. Nu,ber //~, ~-- . -~? Component I1 Name t C,A,S. ,umber /~ ~/%~. ~re Hazard 0 Re,ctivity 0 Delayed ~gden Release 0 Component Name I C,A,S. Number Hem lth of Pressure Health .Component 13 N~me I C.A,S. Number (Check ~11 that apply) ' Componen~ 12 Name ~ C,X,S, NuLber ~e Hazard 0 Reac,iYi,y ~¢~ ~dden Release 0 -' of,Pressure Component 13 Name I C,A.S, Number ~Physical and Health Hazard C.A.S. ~uaber Co~onent II H~e I C,I,S. Humber (Check ail that apply) ~e Hazard O Reactivity ~~ O Sudden Release O l.mediatec°mp°nent Number ' of Pressure Health Component 13 Name ~ ~,A.S. Number ~rCi,[i;]tioq .(Re~ ~p~.~ign after compleCf(]g.all secCfpn~) cerutr under penalty o))a~ tnqc i navepe[sonally, examlnqOeqolm ~amim~mc. iitb the inlormaclon ~u~mitted in this end all :~ached.docveenc), anO t~ac cased on.my ~nqu~ry 9T.cnose ~nalv~oua)s responsIo~e (or obtaining the Information, I b.el~eve that the ...? JOmltteo inlor~mcion is crum, accurate, a~o c~mp/ece. CITY of BAKERSFIELD ~,' nHAZARDOUS MATERIALS INVENTORY -' -': .................... Pqe ~2_ of'~- ~ar~ and Xgticulture [-1 Standard Business BUSINESS NAHE: owNER NAHE: NAME OF THIS FACILITY: LOCATION: ADDRESS: STANDARD IND. CLASS CODEr ....... PHOUE ~: ~u i~uu ~ z~vo r~n rn~P~ CODES ..... - lrans ly~, ~ax Average Annual ~ea~ure I~[e Cont Cont Cont Us tocation?e~ty 5eelnstruct~ons Code Loam Aa: Act Est Un,ts on lype Press lemp Co~e Stored in fac1 Physical mod ~e~lth Hazard C.X.S. Hum~er ' Component II Name I C.X.S. Number (Check al/ that apply) Component I~ Name I C.X.S. Humber ~e Hazard 0 Reac[i,it, ~[~ 0 Sudden Release 0 ,,,edia,e of Pressure HealLh Co~o,o,t 13 Haea I C.A.S. Humber '~'. -. I I I I I I- I I I I I P~Ysical l~d ~eal:h ~Hard C.A.5. Hueber Coi~onenC II Haee & C.A.S. Nueber (Check all th~: L. CoAponent 12 Hame I C.A.S. Hu~ber ~ Fire Hazard ~ Reactivity ~ Belayed ~ Sudden Release ~: ~ Immediate Health of Pressure ~ Health ~ Component 13 Name i C.A.S. Huzber I I I I I, I I t I I Physical and Health Ualard C.A.S. Number ~_~. Component II Ha~e I C.X.S. Humber [Check 411 that apply) ; Component 12 Hame I C.A.5. Number ~ ~ireHazard ~ Reactivity ~ Delayed ~ Sudden Release Health of Pressure Health Componen: 13 NAao t C.X.S. Huober Phvsicil ind H,Ith Ual~rd C.X.S. Humber Componen: II Hame t C.X.S. Number (Check 411. that app/yl Component 12 Hame I C.X.S. Humber 0 Fire Hazard 0 Reactivity 0 Belayed 0 Sudden Release ' Hem/Ch of Pressure ComponenL 13 Hane I C.A,5. Hunber , '~,~ EHERGEHCY CONTACTS ~1 ~'(,~C~. r,~S ~ Certif' atio .Re p~.~ign af~pr comp1~tipg.all secCi~n~) I cerk[~v un'er oenal~v o~ tn~[ l n~ve personal~y, exaHn~oaqo {a lamillaC.Vitb thejn~{~c}~ ~u~eitt~ iA this.and al1 ..,~ .. , . ~'.- ~"~' "I[.'E CARE (tF~e or Drin~ name) Do hereb3' certify that I have reviewed thejg~j~ attached Hazardous Materials business ~lan for (name of business) and that it along with the attached additions or corrections constitute a comDlete and correct Business Plan for my facility. ~~:~-3~_ /Zs~m~._ ~___ '~ date I CITY of BAKERSFIELD '-- ~ HAZARDOUS MATERI ALS INVENTORY' Fare and *qriculture ~ Standa.d 6us,.ess NO ~-- TRAD ~ S E C R ~T~ ~qe. of .)1~ t,'t["~' OWNER NAME: 7--{('{D[,X ~> nAME OF T~S FACILITY: gOCATION: ~04 Pt;~'('e ~ ADDRESS: /~,[~Sr Z,n~_~[( ~ STANDARD ' -- DUN AND BRADSTREET NUHBgR ~ ~ Z~u~zo~ ~ ~OP~ COD~ Item ly~ ~X iwraqe ~1 ~asu~ I ~ C~e C~e bt ~t Est Un*ts m Site )~ ~s I~ ~ St~ In FKJltty ~ ~ I~t~tJ~ ~ Fire Nezeed ~- ~ttvtty -- ~elth of P~. hlth ~t 13 ~ & C.A.S~ ~ - -- -- r~ r--~ ~t fl N~& C.A.S. ~ A ~t 13 ~& C.A.$. ~ ~(ee Hazard ~ -~ ~tivity ~ ~ ~la~ ~dd~ Relflse S~ete ...... HHlth of Prflsure Health .... . irttficati~ (Reid and sign after CoepJe:Jng all sections) CITY of BAKERSFIELD CITY, ZIP: ~NTCe~/~+/~'C~ A';- ~-~q(}~< CITY, ZIP: · ~{<~-~'+'~{ C'f C~;5~'~ < DUN AND BRADSTREET NUMBER ~- ~ ' ~' ~ ~ TO Z~RUCTZO~S FOR PROP~ CODE~ Stored tn Facility See [nstructt~s 'Co~e Code Amc Amt Est Untts ~ Site ly~ Press l~p C~e .. ~k ,11 t~C aPP y) Fire Hazard ~- ~ Reactivity ~lay~ ~dd~ Release i~tate ~ Health of Pressure HMIth Cmp~t ~3 Name & C.&.S. Numbe~ , .. . ~ ~~~,/~ ' '~ ....... , . . . ...... ..~~_~ -- ~ r--~ r--q C.~mt 12 NaM i C.A.S. Health of Pr~sure H~ICh C~c 13 N,~ ~ C.A.S. ,~ .... L, ....... ,.L.: ......... ,L.-, .... ~ ~ ,L,~~t.-~ ..... . ....... Ph~tcal end Health Hazard C.A.S. Rui~r_ ~t II Nam & C.A.S. Nuigr (C~k ail trot apply) ~ ~ Hre Hazard u--J Reactivity u--~ Delayed ~dd~ Release -- l~ate ...... - ...... Health of 'Pr~sure Health C~t I~ ia~ & C.A.S~ ~ ...... L ............ J .............. ~ ........... J ..... -~ .L__J .... ~ .~ ..... L ..... - ....... Physical and Health Hazard C.A.S. Nue~P C~t II NaN i C.A.S. (Ch~k a11 that apply) ..... '" ...... ~ ~ Fire Hazard u--~ Reactivity u--J Odayed ~dd~ Rel,se u--~ ...... ....... Health of Pressure Health · _ ~t .13 No~ & C.A.S. NUm~P * . , .' , ~/~//~ ~ (~ ~:_. ~ ~-:-~ ~ _---: ................................. ~-?.--~-, C~rtification (Read and si~n after completinE all sections) I certify unde~ ~aity of ~a. that [ have oersona]}y examined and a~ fa=i~iar uith t~ tnfor~ti~,su~ttt~ tn this a~ attac~ d~ua~s, and t~t based ~ ay ~nqu~ry of t~se individuals resp~sib]e EMERGENCY RESPONSE PLAN 1. CALL 911 - ASK FAR CITY FIRE DEPT. tF UNSAFE TO USE SHOP OR OFFICE PHONES CALL FROM A NEIGHBORING BUSINESS. (SECRETARY) 2. EVACUATE BUILDINGS AND PARKING LOT. OWNER AND/OR MANAGER ARE TO SEE THAT ALL EMPLOYEES AND CUSTOMERS ARE EVACUATED UPWIND OF EVACUATED AREA TO A SAFE DISTANCE iN CASE OF EXPLOSION. 5. /_I(~UID SPILL - USE ABSORBENT PEI-LETS (FIRST ONE DISCOVERING SPILl_) a. COMPLETELY COVER SPILL b. BUILD DIKE AROUND SPILL FOR CONTAINNMENT 4~ GAS AR VAPOR LEAK - IF POSSIBLE SHUT OFF MAIN VALVES OR POWER SOURCE ( OWNER ) a. PROPANE - BOTTAM OF TANK ; ELECTRIC SHUT-OFF SOUTHWEST CORNER OF TIRE SHOP BETWEEN TIRE TRUER AND WATER FOUNTAIN b. ELECTRICAL FOR TIRE REPAIR SHOP - SAME AS ABOVE c. FRONT END SHOP - NORTHEAST CORNER NEAR SIDE DOOR 5. INJURIES OR EXPOSURE - CHECI< MSDS REPORTS, (TAKEN FROM OFFICE WITH FIRST AID KIT BY SECRETARY ON EVACUATION), FOR PROPER FIRST AID PROCEDURES. ADMINISTERED BY MANAGER OR OWNER. BUSINESS NttME AMERI TIRE SERVICE iD 21S-000-001171 LOCATION 2BOB PIERCE RD HiGH HAZARD RATING OVERVIEW LAST CHANGE 1Z/Z3/8? BY EVAMC JURIS CODE Z15-OO! JURIS B~KERSFIELD STRTION OI P~GE 10Z GRID Z30 FACILITY UNITS I H~ZARI} RATING 3 RESPONSE SUMMARY Z~ SEC 4) SHUT OFF ALL UTILITtES'AND'E×t'T TO STREET EMERGENCY CONTACTS ZA SEC ELDON ROSS 325-1017 OR 393-044S/329.-Z703 ROY ROSS 86t-70(B~ OR 399-.~801 UTILITY SHUTOFFS 2A SEC 3) A) PROPANE - SW CORNER OF TIRE RERPIR SHOP B) ELECTRICAL - TIRE REPAIR SHOP C) W~TER - NORTH WALL OF TIRE SHOP D) SPECIAL - NONE E) LOCK BOX - NO NOTIFICATION / PUBLIC EVACUATION < NO INFOR~tATION RECOROED"FOR THIS SECTION > PFIGE 1 lZtZO/88 1Z:iO MATERIAL SEFETY'DFtTf'.I SYSTEMS, INC. (DOS) 848-8808 BUSINESS NAME ~HERICRN TIRE SERVICE I0 NUMBER LOCATION Z909 PIERCE RD HIGH HAZARD R~TING 3 FIRE PROTECTION / WATER SUPPLIES L. RST {:H~NGE' i'Z£'Z"3/8? BY EVAMC SEC 4) 4. FIRE EXTINGUISHERS - RT PROPANE TANK SOUTFt OF PROPERTY LINE TIRE SHOP NE CORNER ON W~LL (ROOi~ I ) BRRKE SHOP iN ~ILIGNHENT PIT (ROOM Z) BRAKE SHOP MIDi]I_E OF NORTH WALL (ROOM Z) SEC El) ~4CROSS THE STREET ON SILLECI' & PIERCE' RD - SE CORNER EMPLOYEE NOTIFICATION / EVR~CURTiON' LAST CHANGE lZ/Z3/8? BY EVetMC SEC 2) VOCAL NOTIFICATION OF RtL EMPCOYEES TO EVACUATE TO THE STREET OR ACROSS I'HE STREET ' PAGE 4 MATERIAL SAFETY'DATA SYSTE~iS,'INC. (~05~"B4B~G800 BUSINESS NRME RMERItw TIRE SERVICE ID 2iS-~O-OOit?1 LOCRTION Z909 PIERCE RD HIGH FRCILITY UNIT R. OVERRLL HRZRRDOUS MRTERIRLS INVENTOR~ LRST CHRNGE 0~/01/88 BY TERRY ID TYPE NRME MRX RMT UNIT HRZRRD LOCRTION CO~RIf~[I~T' USE I PURE MOTOR OIL 55 GRL UNKNOgN MIDDLE gEST ~RLL ORUMS' OR BRRRELS ME'T°. LUBRICRNT ID PERCENT CO~-~ON£NTS HRZRRD LIST Z808.00 100.0 MOTOR OIL UNKNOWN 2 PURE OXYGEN ~40 FT3 HIGH ERST URLL BETWEEN bOORS PORTRBLE PRESS. CYL. UELDING/SOLDERIN(~ ID PERCENT COMPONENTS HRZRRD LIST Z35S.00 100.0 OXYGEN. COMPRESSEO HIGH 3 PURE RCETYLENE 320 FT3 EXTREME ERST URLL BETUEEN DOORS PORTRBLE PRESS. CYL. ~ELDING/SOLOERING ID PERCENT COMPONENTS HRZRRE) LIST 1Z41.00 100o0 RCETYLEF~ EXTREME 4 PURE PROPANE ~0 GRL EXTREME SOUTH EDGE OF PROPERTY FIXED PRESS.T~(S FUEL ID PERCENT COMPONENTS H~Z~ L~ST 1155.¢~ 1~.~ LIQUEF~EU PETROLEUM GRS EXTREME S PURE MOTOR OIL. 11~ GRL UNKNOYN NY OUTSIDE CORNER gRL~'S' OR BR~ELS MET,, LilBRIC~NT ID PERCENT COMPONENTS H~Z~RD LIST Z8~8.~ 1~.~ MOTOR OiL UNKNOWN PR~E $ 1~/20/88 tZ:lO MRTERIRL SAFETYO~TR $¥STEi~S, INC. (80~1 8¢8-B800 BUSINESS N~FtE AMERICAN TIRE SERVICE IO NUMBER ZtS-C~J¢~-~t.I?t LOCAI'ION Z9~9 PIERCE RD HIGH H~ZRRD R~'¥ING 3 3. H~Z H~T TRAINING SUMi~RY < NO INFORMATION 'RECORDED'FOR THIS SECTION LOCAL Et'~ERGENCY i'IEDICflL ASSISTANCE LAST CHANGE IZ/ES/8? BY EVEHC SEC S) REMOVE INJURED FROM HAZARDOUS AREA IF POSSIBLE AOMINISTER FIRST AID UNTIL MEDICAL ASSISTCiNCE ARRIVES PAGE Z 1Z/~0/88 12:1~ MATERIAL SAFETY' DRT~' SYSTEMS',' iNC. (80S) E'48-G8~O' " I BUSINESS NAME ~HERIC TIRE SERVICE ID NO ~1S-.(~0-001;71 LOC~TION Zg~ PIERCE RD HIGH H~ZRRD R~TIN6 3 E~ ~IT!G~TION / PREVENTION / ~BA'FEMENT L. RST C'HFI~E ~Z/Z~/'8~ BY EVRHC SEC 1) ONE SS GAL DRUM OIL KEPT OUT OF' DAY OF ~NY SHOP TRAFFIC ONE PORTABLE O)(YGEt~/P}C~TYLENE' ¢_,UTT]~NG' TORCH - VALVES I(~T SHUT OFF TIGHT WHEN NOT IN USE PB~SE S 1Z/~0/88 tZ: MATERIAL SCIFE'TY OF~T~Y SYSTEMS,' I NC. · (805) G48- AMERICAN TIRE SERVICE 2EHE~GEN~'Y P~ $~K~N SE PB~N See page 1 section 2 All employees have been notified to check all areas of shop,(office, tire shop, alignment shop, back yard, both parking areas on sides), before they leave the premises. They will inform anyone in those areas of the danger and direct them to a safe area, (if safe - across the street to grassy area). Employees are to maintain verbal contact with each other during evacuation to verify that all areas all clear. See page 2 section 3 Once a month, between the 1st and the 7th, there will be an owner/emp~6ygee meeting to discuss Material Safety Data Sheets and Emergency Evacuation Plan. Any employee not in attendance will be required to review all information discussed with owner or secretary before the 10th of the month. Bakersfield Fire Del~ HAZARDOUS MATERIALS DIVISION Date CompletedJ///c//c~ Business Name: //~ /~'] ~' /~l c, /41v ~/ ~ ,; Location: .~ D ~ ~ ~ ~// Business ldentification No. 215-000 ~//?/ Fopof ~inessPla~ Station No. / Shi~ ~ ~nspector _~/~/~ ~ ~ ~ Adequate Inadequate Verification of ~nvento~ Materials Verification of Qu~tities Verification of Locaion Proper Segregaion of Material Commenis: Verification of MSDS Availabli~ Number of Employees Verification of H~ Mat Training Comments: Verificaion of Abaement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Verificaion of Fscility Diagram Special H~ards Associated with this Fscility: r~ All ltems O.K. ~ Correction Needed ~ Business Owner/Manager FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy BAKERSFIELD CITY FIRE DEPARTMENT '~ 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 _~'~ BUSINESS HAZARDOUS MATERI ALS 1. To avoid further action, return .:his 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: AMERICAN TIRE SERVICE B. LOCATION / STREET ADDRESS: 2909 PIERCE CITY: BAKERSFIELD ZIP:~93308 BUS.PHONE: (805 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-?$~0 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. .. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A ,?,~;ELDON ROSS Ph.~ 325- 1017 Ph~393-0445/329-2703 (Pgr) B. ROY ROSS Ph~ ~1-70~ Ph~ qQ0_qRml SECTION 3: LOCATION OF ~ILI~ S~-OFF~: FOR BUSI~SS AS A ~OLE A. NAT. GAS SOU~ST CORNER OF TIRE R ~ g~aP- RU.~.~M TIfF T~IIUP . water f~. B. ELECTRICAL:m~ Repair ~ ' [~ ....... / Front C. WATER: .... g ..1 ..... x~ wall of ti~/Lkop D. SPECIAL: E. LOCK 8OX: YES:,/~ IF YES, LqCATION: 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 B~:SINESS AS A WHOLE SHUT OFF ALL UTILITIES EXIT TO STREET SECTION'S: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOb~ BUSINESS AS A WHOLE RENOVE INJURED FROM HAZARDOUS AREA,!.~_IF~?OSSIBLE ADNINISTER FIRST 'AID UNTIL MEDICAL ASSISTAN8g ARRIVES SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WIrE INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AW.AS. CIRCLE YES OR~ INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDTUS .MATERIALS:... .................................... YES ~ YES(N~ B. PROCEDURES FOR COORDINATING ACTIVIT'ES E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES SECTION ?: HAZARDOUS MATERIAL CIRCL~'Y-~ -~ NO - NONE DOES YOUR~BUSINESS HANDLE HAZARDOUS ~ERIAL IN QUANTITIES LESS THA~~ $00 POUNDS OF A SOLID, $$ GALLONS OF ALIQUID, OR Z00 CUBIC FEET OF A COMPRESSED GA~J: ...... ~ES NO I, ~/Z~/~/ ~f%~, 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 (D!%'.' ~0 Chapter 8.g§ Sec. 25800 Et Al.) and that inaccurate Information constitutes perjr~¥,~ - ?q - BAKERSFIELD C'£TY FIRE DEPARTMENT 2130 "G" STREET ~AKERSFIELD, CA 93301 " 0FFiC~.AL USE ONLY ID~ BUSINESS NAME: BUS I 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. 8. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as .possible. . . 'w. FACILITY I~IT~ ,/ FACILITY UNIT NAME.~ ~/O/3 SECTION 1: MITIGATION, PR~ION, ABATEMES~ PROC~E~ SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT,.THIS b%'IT ONLY SECTION 3: ltAZARDOUS MtTERIALS FOR TUIS UNIT ONLY A. Does ti~is Facility Unit conta' ~ llazardous Materials? ...... NO ~f YES, see B. If NO, continue with SECTIOY ~. B. Are any of the hazardous mate~.ials a bona fide Trade Secret' YES If No, complete a separate hazardous materials Inventory form marked: NON-TRADE SECRETS .ONLY (~vh!te form ~4A-1) If Yes, complete a hazardous m~tertals Inventory form marked: TRADE SECRETS ONLY (yellow for~ ¢4A-2) in addition to the nDe-trade secret for~. List OhiO' the trade secrets on' form 4A-2. SECTION 4: PRIVA~ FIRE PROTECT!0~, - SE~ION ~: LOCATION OF W~R S~PLY FOR ~SE SECTION 6: LOCATION OF UTILITY SHb~r--OFFS AT THIS UNIT ONLY. A. XAT. C. WATER: ,. O. SPECIAL: E. LOCK BOX: YES .' .~ IF YES, LOcATIOK: IF YES, SrTE P~.AN.q: '..'ES I YO MqO.qs: ~..:., .,, FLOOR P.r. AXS? ;:ES ,' NC) .KEYS? YES XO -33 - I~ ~ FORH 4A-I Page //, "f .~'~. IIAZARDOUS MATHRI ALS' INVENTORY' ',I)I)HESS: ~0~ ~C~ ~ AUIIflEgSl~~~/ FACILITY UNIT HAME: ,.,,_' .... IIv~ryE e: ~o~ ~--/~/~ PIIOflE I~ 3F~-d~ OFFICIAl, USE CFIRS ' - ONLY ~ i:OHTiiiSK LOCATION iN Tiii6 , ny r-lAX ANNIIAI, __ COI,~ICO~ FACILITY UHIT NT. CIIEHIQAL OR CUHNOH HAHE CODE. A M {~ Il ~:{'_. AMOUNT rlI:Rf;EII(:Y COrI'FAf:T: .~~ TITI,E t AFTER flUS IIRS: 3~~-~?~%_ .~,I~f;F. HVY r:titiTACT: ~ ~ ,,TITLEI.~/~ PIIOHE I BUS llOURS:~/-7~a ?-~-~ . . .... NON--TRADIE SECRETS //// IIAZARDOU5 .ATERI ALS' I NVENTOI1Y ~ ON _~_ f:ONT II~E LOCATION IN TIII8 % BY UNIT COIIE COq~__FACILITY UNIT NT~ CHENIGAL OR COMMON NANE CODE 4~-~ - HAZARDOUS N%TERIALS INSPECTION VERIFICATION OF INVENTORY MATF_.kIALS VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL COMMENTS: VERIFICATION OF HAZ MAT TRAINING VERIFICATION OF MSDS AVAILABLE VERIFICATION OF ABATEMENT SUPPLIES & PRO~RnURES ~ COMMENTS: EMERGENCY PROCEDURES POSTED ~ CONTAINERS PROPERLY L~R'~:~r.~ E~ VERIFICATION OF FACIM~ D~ ~ SPEC~ ~S ~~ ~ ~IS FACI~: VTO~,=O"S: L Jr)/ ~-/s- ?~. _NOT!Of{ 0.~ Vi'-S.:_2T!Oi'{ AND (i~i }},s',~s a>-c sc:a{rses cf ?.,Ia chexicai em';]_: OyeF alU?.~ ; az ma--..:s~L cilh the coil:]si;.}eo '~her'F~n~ ahd alternative :lathed identifies the contelner-a to w:.Tioh it c~ thi .... _, ~ - written materials shall be readily accessible to the i.~-t. employees in their work area throughout each work sh {'TIThe employer shall not remove of deface .~'~-~._.~_~.~n~ labels on incoming containers of hazardous chemicals, unless the container is immediately marked with the required information. (8)The em~toyer shall ensure that labels or other forms of warnings are legible, in English, and prominently displayed on the container, or readily available in the work area throughout each work shift. Employers having employees who speak other languages may add the information in their language to the material presented, as long as the information is presented in English as well, ~1 OXYGEN UNDERSTATED ON YOUR HAZARDOUS MATERIALS BUSINESS PLAN. IREVISE INVENTORY PORTION OF YOUR BUSINESS PLAN. I VIOLATION OF CH, 6.96 CALIFORNIA HEALTH & SAFETY CODE 25509(A)(1-4) The annual inventory form shall include, but shall not be limited to, information on all of the following which are handled in ~uantities e~ual to or greater than the ~uantities specified in subdivision fa)of Section 25503.5: (1)A listing of the chemical name and common names of every hazardous substance or chemical product handled by the business. (2)The category of waste, including the general chemical and mineral composition of the waste listed by probable maximum and minimum concentrations, of every hazardous waste handled by the business. (3)A listing of the chemical name and common names of every other hazardous material or mixture containing a hazardous material handled by the business which is not otherwise listed pursuant to DaragraDh (1) or (2). (4)The maximum amount of each hazardous material or mixture containing a hazardous material disclosed in paragraphs (1),(2), and (3) which is ~. handled at any one time by the business over the ...... course of the_year 3) SAFETY TRAINING FOR EMPLOYEES INADEQUATE. VIOLATION OF OSHA 1910.1200(H) (2)Training. Employee training shall include at least: (i)Methods and observations that ~nay be used t.o detect, the presence or reie:~se cf a hazardous chemical in the ~ork area (s~lcn as monitoring conducted b5~ the emDioyer, continuous monitoring devices? visual appearance or o~cr of hazardous chemicals when being released, etc.)' {ii)The physical and health hazards ,of the chemicals in the ~ork area: (iii)The measures employees can take to protect themselves from these hazards, includin~ specific procedures the employer has implemented to protect emD!oyees from exposure to hazardous chemicals, such as appropriate ~ork practices, emergency procedures, and personal protective equipment to be used; and, {iv)The details of the hazard communication program develoQed by the employer, including an explanation of the labeling system and the material safety data sheet, and how employees can obtain and use the appropriate hazard information. 4) MATERIAL SAFETY DATA SHEETS NOT AVAILABLE. VIOLATION OF OSHA 1910.1200 (g)The employer shall maintain copies of the required material safety data sheets for each hazardous chemical in the workplace, and shall ensure that they are readily accessible during each work shift to employees when they are in their work area(s) (h)(1) INFORMATION. Employees shall be informed of: (i)The requirements of this section (ii)Anw operations in their work area where hazardous chemicals are present; and, {iii)The location and availability of the written hazard communication program, including the required list(s) of hazardous chemicals, and material safet~~ data sheets required by this section. 5) NO E~ERGENCY PLAN AVAILABLE. VIOLATION OF CALIFORNIA HEALTH AND SAFETY ............. ~ ~. ..... CODE CHAPTER 6.95, 25504(B1~ -. Business plans shall include all of the follow, lng: Emergency response plans and procedures in the event of a reportable of threatened release of a hazar~o~s material, includi, ng, but not limited to, ali of the follo~ving: Immediate notification to the acminis~arin~ agency and to appropriate ~ocai emer~enc~- rescue personnel_ and the office. Procedures for the mi'ii,anion of a ueiease or threatened release to minimize any potential harm or damaSe to persons, property, or the environment. Evacuation plans and procedures, including immediate notice, for the business site. The above violations must be corrected by MAY 15, 1988. The department will schedule a re-inspection of your facility to verify compliance. If you have any ~uestions regarding this notice, please contact Ralph Huey at 326-3979. Sincerely, Ralph E.Huey Hazardous Materials Coordinator APRIL !5, 1988 Dear Mr. ROSS NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE IN THE INSPECTION OF YOUR BUSINESS AMERICAN TIRE SERVICE LOCATED AT 2909 PIERCE ROAD BAKERSFIELD, CA 93308 ON 4/5/88 THE FOLLOWING HAZARDOUS MATERIALS REGULATION VIOLATIONS WERE IDENTIFIED.: 1) WASTE OIL CONTAINERS UNLABLED. VIOLATION OF OSHA 1910.1200 (1)The chemical manufacturer, importer, or distributor shall ensure that each container of hazardous chemicals leaving the workplace is labeled, tagged or marked with the following information: (i)Identity of the hazardous chemicalls)o (ii)Appropriate hazard warnings; and (iii)Name and address of the chemical manufacturer, importer, or other responsible party. (4)Except as provided in paragraphs (3) and (4) the employer shall ensure that each container of hazardous chemicals in the workplace is labeled, tagged, or marked with the following information: (i)Identity of the hazardous chemical(s) contained therein; and (5)The employer may use signs, placards, process sheets, batch tickets, operating procedures, or other such written materials in lieu of affixing labels to individual stationary process containers, as long as the alternative method identifies the containers to which it is applicable and conveys the information .required by paragraph (2) of this section to be on label. The writnen materials shall be readily accessible to the employees in their work area througaout each work shirt. ('?)The employer shall not remove of deface e~:zsting labels on incoming containers of hazardous chemicals, unless the container is immediately marked with the required information. (8)The emDloyer shall ensure that labels or other forms of warnings are legible, in English, and Drominently disDlayed on the container, or readily available in the work area throughout each work shift. EmDloyers having emDloyees who sDeak other languages may add the information in their language to the material Qresented, as long as the information is Dresented in English as well. OXYGEN UNDERSTATED ON YOUR HAZARDOUS MATERIALS BUSINESS PLAN. (REVISE INVENTORY PORTION OF YOUR BUSINESS PLAN.) VIOLATION OF CH. 6.96 CALIFORNIA HEALTH & SAFETY CODE 25509(A)(1-4) The annual inventory form shall include, but shall not be limited to, information on all of the following which are handled in ~uantities e~ual to or greater than the ~uantities sDecified in subdivision (a)of Section 25503.5: (1)A listing of the chemical name and common names of every hazardous substance or chemical Droduct handled by the business. (2)The category of waste, including the general chemical and mineral comDosition of the waste listed by Drobable maximum and minimum concentrations, of every hazardous waste handled by the business. (3)A listing of the chemical name and common names of every other hazardous material or mixture containing a hazardous material handled by the business which is not otherwise listed Dursuant to ~aragraDh (1) or (2). (4)The maximum amount of each hazardous material or mixture containing a hazardous material disclosed in Daragraphs (!),(Z), and (3) which is handled at any one time by the business over the SAFETY TRAINING FOR EMPLOYEES INADEQUATE. VIOLATION OF OSHA 1910.1200(H) (2)Training. Emoloyee training shall include at least: (i)Methods and observations that may be used to detect the presence or release cf a hazardous chemical in the work area ~s~cn as monitoring conducted by the employer, continuous monitorin~ devices, visual appearance or oaor of hazardous chemicals when being released, etc. /' iii)The physical and health hazards of the chemicals in the ~ork area; liii)The measures employees can take to protect themselves from these hazards, inc~'~~~ specific procedures the employer has implemented to protect employees from exposure to hazardous chemicals, such as appropriate work practices, emergency procedures, and personal protective eGuipment to be used; and, (iv)The details of the hazard communication program developed by the employer, including an explanation of the labeling system and the material safety data sheet, and how employees can obtain and use the appropriate hazard information. 4) M~T~IAL SAFETY DATA SHEETS NOT AVAILABLE. // VIOLATION OF OSHA 1910.1200 (g)The employer shall maintain copies of the required material safety data sheets for each hazardous chemical in the workplace, and shall ensure that they are readily accessible during each work shift to employees when they are in their work area{s) (h)(1) INFORMATION. Employees shall be informed of: (i)The requirements of this section (ii)Any operations in their work area where hazardous chemicals are present; and, (iii)The location and availability of the written hazard communication program, including the required list(s) of hazardous chemicals, and material safety data sheets required by this section. 5) NO EMERGENCY PLAN AVAILABLE. ~. VIOLATION OF CALIFORNIA HEALTH AND SAFETY ........ --~ODE-CHAPTE-R=-~6.95,. 25504(B) Business plans shall include all of the following: Emergency response plans and procedures in the event of a reportable of threatened release of ~ hazardo~s material, including, but not limited to, ali of the following: Immediate notification to the administerin~ agency and to aDDrouri~'te Local emerSenc~- rescue personnel and the office. Procedures for the m%ti~ation of a release threatened release to minimize any motential harm or damage to Dersons, DroDerty, or the environment. ~vacuation plans and orocedures, includin~ immediate notice, for the business site. The above violations must be corrected by MAY 15, 1988. The deDartment will schedule a re-insDection of your facility to verify eomDliance. If you have any ~uestions regarding this notice, Dlease contact Ralph Huey at 326-3979. Sincerely, Ralph E.Hue¥ Hazardous Materials Coordinator ' ~,~.~ Bakersfield Fire Dept. ~ Hazardous Materials Inspection Location: Plan ID # 215-000. (Top right comer Business Plan) Station No. Shift Inspector~?~ Adequate Inadequate Verification of Inventory Materials Verification of Quantities [~ [] Verification of Location Proper Segregation of Material ~ [] Comm n : Verification of MSDS Availability Number of Employees / Verification of Haz Mat Training Verification of Abatement Supplies & Procedures Conunfints: Emergency Procedures Posted Containers Properly Labeled Verification of Facility Diagram Special Hazards Associated w/th this Facility: Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office