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HomeMy WebLinkAboutBUSINESS PLAN 8/8/2007+i --JL ~- C-REATIVE COOPER- - -~- - 3624 BUCK OWENS BLVD Bldg_12_~ - -- . - -_ r--_- =-_----- - - a .; CREATIVE COPPER SitelD: 015-021-002419 Manager JESSICA LATTA Location: 3624 BUCK OWENS BLVD 12 City BAKERSFIELD BusPhone: (661) 325-4506 Map 102 CommHaz High Grid: 23B FacUnits: 1 AOV: CommCode: KCFD STA 66 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DEREL LATTA / OWNER CYRIL ANDRE / LANDLORD Business Phone: (661) 325-4506x Business Phone: (661) 871-5659x 24-Hour Phone (661) 342-2249x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact DEREL LATTA Phone: (661) 325-4506x MailAddr: 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 Owner DEREL & JESSICA LATTA Phone: (661) 325-4506x Address 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT E~~-;~~ on my inquiry pf those individuals rt-%r~.3~~il'~!q far oEJtaining the information, I certify ~-~n~le; p~bnalty of law that I have personall y f3xamined and am familiar with the information w,~_~bmitteci ,end believe the information is true, acturr e, a ~mplete. A ggrr ,~, rlat ~_ -~-- ~ ~ D e ENT'D BUG 0 ~ X007 -1- 07/10/2007 F CREATIVE COPPER SiteID: 015-021-002419 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETELYNE E F P IH G --9~ FT3 Hi OXYGEN F IH DH G "®- FT3 Low ~L~.acl -2- 07/10/2007 -3- 07/10/2007 F CREATIVE COPPER SiteID: 015-021-002419 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ACETELYNE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE N WALL OF SHOP CAS# 74-86-2 ~GasATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum FT3 Daily Average 3 • t1AGH.tCLVUa 1..V1~lYV1VJ;1V1w7 °sWt. RS CAS# 100.00 Acetylene Yes 74862 I1HGHtU.J H.7.7tS.7~1~1J;1V l a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit INSIDE N WALL OF SHOP STATE TYPE PRESSURE _ Gas TPure -Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1~:-A~A FT3 FT3 .9~-9~ FT3 I3HGLi1CLVU.7 1.V1~lYV1VJJIV I ~J %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 riHG1itCL H.7 w7 L" ~Jb1~1L"1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/10/2007 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/21/2002 ~ EMERGENCY WOULD BE A FIRE AND 911 WOULD BE THE PROCEDURE Employee Notif./Evacuation 11/21/2002 CHECK GAUGES TO MAINTAIN SAFE PRESSURE. EVACUATE BUILDING IN CASE OF LEAK (MAJOR) OR NOTIFY OWNER IN CASE OF SMALL LEAK. Public Notif./Evacuation 911 02/27/2007 Emergency Medical Plan 04/11/2006 GOOD SAMARITAN HOSPITAL, AIRPORT DR -5- 07/10/2007 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 11/21/2002 ~ GAS BOTTLES ARE SOAP TESTED WHEN DELIVERED AND LEAK DOWN TESTED EVERY NIGHT Release Containment 02/27/2007 LARGE LEAK REQUIRES EVACUATION AND EMERGENCY CALL. ALL OTHER LEAKS ARE REPAIRED BY MELDS OR OWNER BEFORE EMPLOYEES ARE ALLOWED TO WORK. Clean Up 02/27/2007 MELDS V1.11Ci iCC~UULGC~ ACC:1VdL1OI1 -6- 07/10/2007 :. F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~.JC l:1ca1 nca~aiu5 Utility Shut-Offs CLEARLY MARKED 02/27/2007 Fire Protec./Avail. Water OVERHEAD SPRINKLER SYSTEM 02/27/2007 Building Occupancy Level 04/11/2006 1 EMPLOYEE -7- 07/10/2007 :.' ;t. F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/27/2007 ~ OWNER AND SON. rayc c nC1u tVl rUI.ULC U.5"C riclu ivt r uI.ULC u~C -8- 07/10/2007 ;~ CREATIVE COPPER SiteID: 015-021-002419 Manager .~~~1CA ~~ BusPhone: (661) 325-4506 Location: 3624 BUCK OWENS BLVD 12 Map 102 CommHaz High City BAKERSFIELD Grid: 23B FacUnits: 1 AOV: CommCode: KCFD STA 66 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DEREL LAT TA / OWNER CYRIL ANDRE / LANDLORD Business Phone: (661) 325-4506x Business Phone: (661) 871-5659x 24-Hour Phone (661) 342-2249x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact "~„=_2E~- L~-T"~-~ Phone: (661) 325-4506x MailAddr: 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 ................ Owner DEREL & JESSICA LATTA Phone: (661) 325-4506x Address 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 ............... Period to TotalASTs: = Gal Preparers TotalUSTs: = C3al Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT '~~~ ~ ~ b ~~~~ t 1d ify Ce Based on my inquiry the information! 1 i ng ersonally responsible for obtain nalty of law that I have p tion under pe examined and am familiar with the informa information is true, submitted and believe the c mplete. accura e, a Z D ~ D gig ature -1- 011291007 ~~ I F CREATIVE COPPER SiteID: 015-021-0024]:5 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit 1~CP _.._. ACETELYNE OXYGEN E F P F IH IH DH G G 1980.00 1980.00 FT3 FT3 Hi Lbw -2- 01/29/2007 -3- O1/29/~007 F CREATIVE COPPER ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME ACETELYNE Location within this Facility Unit INSIDE N WALL OF SHOP STATE TYPE PRESSURE _ Gas TPure Above Ambient SiteID: 015-021-002415 ~ Facility Unit: Fixed Containers at Site ~ ............... Days On Site 365 Map: Grid: CAS# 74-86-2 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER,,,,.,,,. AMOUNTS AT THIS LOCATION ~~ Largest Container Daily Maximum Daily Average 1980.00 FT3 1980.00 FT3 1980.00 FT3 nr~~xtclJVUa ~VLnrVlvlJlvla %Wt. RS CAS# 100.00 Acetylene Yes 74852 t11~GE~L[11 1~5 5 L'.5 J1~1L'~1V -1_a TSecret RS BioHaz Radioactive/Amoun-t EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit INSIDE N WALL OF SHOP STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C1980100rFT3 Daily1980100m FT3 I Daily1980r00e FT3.. riEiG1-itCll V U.7 lL Vl~lr V1VL' 1V 1 J $Wt. RS CAS# 100.00 Oxygen, Compressed No 778247 __ rl~~t~rcl.~ t~~a~aal~i~ly t 5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Lava -4- 01/29/2007 F CREATIVE COPPER SiteID: 015-021-002418 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/21/20012 ~ EMERGENCY WOULD BE A FIRE AND 911 WOULD BE THE PROCEDURE Employee.Notif./Evacuation 11/21/2002 CHECK GAUGES TO MAINTAIN SAFE PRESSURE. EVACUATE BUILDING IN CASE OF LEAK (MAJOR) OR NOTIFY OWNER IN CASE OF SMALL LEAK. Public Notif./Evacuation 61` Emergency Medical Plan 04/11/2006 GOOD SAMARITAN HOSPITAL, AIRPORT DR -5- 01/29/2007 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sites ~ ~ Release Prevention 11/21/20012 ~ GAS BOTTLES ARE SOAP TESTED WHEN DELIVERED AND LEAK DOWN TESTED EVERY NIGHT Release Containment 11/21/20072 LARGE LEAK REQUIRES EVACUATION AND EMERGENCY CALL. ALL OTHER LEAKS ARE REPAIRED BY ~~~ OR OWNER BEFORE EMPLOYEES ARE ALLOWED TO WORK. 1..1Cd11 lJY ~~ ~~ 15 vtner xesource ycLlvaLion -6- 01/29/20707 F CREATIVE COPPER SiteID: 015-021-002415 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ especial riazaras UL111Ly SnuL-V=ZS C~~R ~~ i'V~ ~2 k ~~~ r ice rrc~Lec . ~ r~vaii . wage= Building Occupancy Level 04/11/206 1 EMPLOYEE -7- O1/29/~007 F CREATIVE COPPER SiteID: 015-021-002415 ~ Fast Format ~ ~ Training Overall Site ~ _. oyee raining ~uJ ~r ~-sz ~ ~~ rayC ~ aac ~.u a_vt ru~..utG V.7C 11C 1CA 1VI t UI.UIC U5~ -8- 01/29/2607 UNIFIED PROGRAM INSPECT~i®N CHECKLIST`' 'iw-ct: ~....- ..:t .s?tF^",~".C .. .. A"':c ~h'.tY.:.:u....rtt,a;...;_"~.. 7.3. .ei~'s .,,, a. ~..;~w. . r,... ..;.w.J ".:", .s-..-,t.~.. S« £.. < e. .:~n `~ SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a Prevention Services pt~ 9001Yuxtun Ave., Suite 210. ARfM t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872--2171 FACILITY NAME NSPECTION DATE INSPECTION TIME ADDRESS HONE NO. O OF EMPLOYEES ~ 3Z FACILITY CONTACT USINESS ID NUMBER ~ ~~ ~ f5-02f- Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND I~ , ^ BUSIIl13SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS '~ ^ CORRECT OCCUPANCY `~I ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ 14 ~.-- ^ VERIFICATION OF LOCATION '~, ^ PROPER SEGREGATION OF MATERIAL `~° ^ VERIFICATION OF MSDS AVAILABILITY , \ ^ VERIFICATION OF HAZ MAT TRAINING ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~(, ^ EMERGENCY PROCEDURES ADEQUATE `~ ^ CONTAINERS PROPERLY LABELED / ~ ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ~ NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Prtnt) Flre Prevention / i6~ In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink - Business Copy FD2049 (Rev. 02!05) CREATIVE COPPER SiteID: 015-021-002419 Manager Location: 3624 BUCK OWENS BLVD 12 City BAKERSFIELD BusPhone: (661) 325-4506 Map 102 CommHaz Grid: 23B FacUnits: 1 AOV: CommCode: KCFD STA 66 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title DEREL LATTA / OWNER CYRIL ANDRE / LANDLORD .Business Phone: (661) 325-4506x Business Phone: (661) 871-5659x 24-Hour Phone (661) 342-2249xCELL 24-Hour Phone ( ) - x Pager-Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ~ ImmHlth DelHlth Contact ~ Phone: (661) 325-4506x MailAddr: 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 Owner DEREL & JESSIA LATTA Phone: (661) 325-4506x Address 3624 BUCK OWENS BLVD 12 State: CA City BAKERSFIELD Zip 93308 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: -1- 10/03/2005 ., F CREATIVE COPPER SiteID: 015-021-002419 ~. ~ Hazmat Inventory ~ By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETELYNE OXYGEN E F P F IH IH DH G G 1980.00 1980.00 FT3 FT3 Hi Low `r ~' -2- 10/03/2005 F CREATIVE COPPER SiteID: 015-021-002419 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ACETELYNE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE N WALL OF SHOP CAS# 74-86-2 = STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure ~-Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average ,1980.00 FT3 1980.00 FT3 1980.00 FT3 Maximum Stored Maximum Open Use Maximum Closed Use FT3 FT3 FT3 HAGAKllUUS CUMPUNENTS °sWt . RS CAS# 100.00 Acetylene Yes 74862 y, -3- 10/03/2005 F CREATIVE COPPER SiteID: 015-021-002419 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE N WALL OF SHOP CAS# 7782-44-7 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient .PORT. PRESS. CYLINDER Largest Container 1980.00 FT3 Maximum Stored FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1980.00 FT3 Maximum Open Use FT3 Daily Average 1980.00 FT3 Maximum Closed Use FT3 t1HGHKLVU~ 1;V1~lYV1V1';1V1~ oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 -4- 10/03/2005 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 11/21/2002 ~ EMERGENCY WOULD BE A FIRE AND 911 WOULD BE THE PROCEDURE Employee Notif./Evacuation 11/21/2002 CHECK GAUGES TO MAINTAIN SAFE PRESSURE. EVACUATE BUILDING IN CASE OF LEAK (MAJOR) OR NOTIFY OWNER IN CASE OF SMALL LEAK. ruAlic NoLiz.~~vacuaLion Emergency Medical Plan GOOD SAMARITAN HOSPITAL AIRPORT DRIVE 11/21/2002 -5- 10/03/2005 ..~ F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 11/21/2002 ~ GAS BOTTLES. ARE SOAP TESTED WHEN DELIVERED AND LEAK DOWN TESTED EVERY NIGHT Release Containment 11/21/2002 LARGE .LEAK REQUIRES EVACUATION AND EMERGENCY CALL. ALL OTHER LEAKS ARE REPAIRED BY KERN GAS OR OWNER BEFORE ,EMPLOYEES ARE ALLOWED TO WORK. dean up ~zner xesource r~cLivaLion -6- 10/03/2005 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _ ~peclal riazaras UL111Ly ~IIU.L-VIIS Fire Protec./Avail. Water Building Occupancy Level -7- 10/03/2005 ,~ ti F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 11/21/2002 NUMBER OF EMPLOYEES 4 rage Held for Fut U riela =or ruLUre use -8- 10/03/2005 F CREATIVE COPPER SiteID: 015-021-002419 ~ Fast Format ~ ~ Response/Risk Management Overall Site ~ = vperaLions rlanning Logistics Finance/Administration -9- 10/03/2005 :~, F CREATIVE COPPER SiteID: 015-021-002419 ~ ~ Full Format Type+Category+Sub-Category+Date2(ASC) Order ~ One Unified List ~ ---- 11V iJ t'L'1~11V1VJ BUSINESS PLAN PROGRAM- ROUTINE INSPECTION Reference Dates Summary Description Raymond 10/28/2004 Business Plan Inspection OK WINES 10/11/2002 OKAY -10- 10/03/2005 UNIFIED PROGRAM INSPECTION CHECKLIST ~~\~~w~~~.m~¿~:}(~,fff~~:~~(,ft~~^.'\t!J~ SECTION 1 Business Plan and Inventory Program J Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INS~TIO~TE INSPECTION TIME {;:~f!!-~±-- NO~ÈmPloÿãës~,j'\ --~--~:_+---- FACILITY NAME . t' ()-,., _n__~__\'L?;__L£~m______ - -1f¡--- ADDRESS 3~__~_ LI:____ß_u::_\':=:"_~~___~{~~L ______l?:__~_ FACILllYCONTACT Business ID Number 15-021- Section 1: Business Plan and Inventory Program A[ Routine LJ Multi-Agency LJ Complaint LJ Re-inspection LJ Combined LJ Joint Agency C V ( C=Compliance ) V=Violation OPERATION COMMENTS LJ ApPROPRIATE PERMIT ON HAND .~_~___~~___._____~_.___._~__~_____~_~ _.____~________~_________.__.___._._ n...____"___~.. _ __"__" .___ _~____ ___ ___ .- -----------~-----~--.--------_._-- --'- LJ BUSINESS PLAN CONTACT INFORMATION ACCURATE _ ________________._____________________._____.__._u___"...._______._._...,.______.___ ....__________..__. __. . _.______.__._..___._ u ._.______~____________._ .__._.._. LJ VISIBLE ADDRESS --,-----,.._.__..__.__._--~._._-_._._----_.._~.--_.--....- --.-.-.-- ----....---.----...-.....-.-- .- .----------.--- ---.. - ----.-- ........._._.._....__...__..._.___ ..__ _._.....___.____ u LJ CORRECT OCCUPANCY _______ ....__________.__.___.___._.._..._..___________.______._..___.______.._____________._n___ m..__...._ __ __. _...______ _. ..____...___ _.... _ ._._ __.. - ---.---.-- ._-~---~-..._-_.. ... .----- .--- - LJ - VERIFICATION OF INVENTORY MATERIALS -.-"----.-------- ....------- - - -.- ----------~----.---_._-_._------ .------.. .. .........---.-.. -- _._---,~_.__._._-----_._--_.- ---- LJ VERIFICATION OF QUANTITIES ___._.._.____________._________...____~_____~_________._.____." _. .__._....h____._.__.__~_.....____ _. .._ ._._______.... ._. ...._.n_ __..__. _____.___._ n_ ____._ _ ._ -- .-- _._-,-.-._~-------...__....---- LJ VERIFICATION OF LOCATION _·_____.___.._________.___._.________n _______.__... ..__ _. _.. _.,,____..___.____________________...__~.. ___._______ _._._________. _________ ._._ m.. .___ . .._ . .__m__. -.- ---.--- ----.--------------...- LJ PROPER SEGREGATION OF MATERIAL --....--.--- ----_._---~-~--------_.._-------._-- - --------.----.-... ---..-.--..----.----....- -.----..---.-..-- .,_____.._ ___.__ _.._._.__._ _.___.__ _..__..._. ___ . ________ _ ._.u___.___.__n ___~_~~~IFIC~~~~_~~~~~_~~~~~~~'='~~_________________ ----f------------------ __ __ ._____m__ _________________________ LJ VERIFICATION OF HAT MAT TRAINING ' ______....._____.__.___._____.___________._.____ ._.._u___.___ _____.._.._..___..__._ ... _u_._._ _.___ .._..___.... n._ _ __ _________.._..._.__ .._ __.. ._.._._____ ___. .. __.. _.__._ -- ---. ---------.. .-- --~------_.- LJ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES -_.-_..~----_._.._...__.._-_.._.._._~ ------~-~_... --~---~---_..- -- ,,"- --- --....--..-- --..-...-. .--.------. _...._~_.._-- -.-. ----.._- .-----.--.- - -.. .----.-... ..-.-- ....._.__..._~----_.---_.._-+----_.--...- LJ EMERGENCY PROCEDURES ADEQUATE --_._------_._---_._._._---_._-------_._---------~-_.----~..~-- . --_...._--_..._-~-_._---- ___________ ___. ..._____.___._ _. __ _.__. _.__ __ un .._.. ...____. _.._,. ._~. ___.__ ____..__~..._____.. ..__ _.____ ____.~.__ o CONTAINERS PROPERLY LABELED ---------------~------------..-------.------ ---- --.----------------~---- - -----i--·--·- -------.--.- -------- --- --- .-...------ -- --------- -. -- ---- ------ --------- .--------.--------.------------ ___~__~O~S~~==_~~~______________________________ ________(__________ ___ ___________._ _. ,_ .__.. _ .. ________________________ -~ ::~~~~~~E;,_~~;.-&O~HAND - ... --- ---rum-nun - __mm - - ---.-- -- .--------.--------------.. ANY HAZARDOUS WASTE ON SITE?: ~NO LJ YES EXPLAIN: 0> ;g ~ THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~_ __________~___n___________.__.______._._._. ____ Gc.._ ~_ Fire Prevention 1st-In/Shift of Site White - Environmental Services Yeliow - Station Copy ~- - -- ------------- B In s Site Responsible Party (Please Print) Pink - Business Copy ~ Fí Ý6t "XAJ :. -- ¿ 'CREATIVE COPPER SiteID: 015-021-002419 Manager : Location: 3624 BUCK OWENS BLVD 12 City BAKERSFIELD BusPhone: Map : 102 Grid: 23B (661) 325-4506 CommHaz : FacUnits: 1 AOV: CommCode: KCFD STA 66 EPA Numb: SIC Code: DunnBrad: Emergency Contact DEREL LATTA Business Phone: 24-Hour Phone : Pager Phone : / Title / OWNER (661) 325-4506x (661) ~B2ð~^ ~ (661) 342-2249xCELL Emergency Contact / Title CYRIL ANDRE / LANDLORD Business Phone: (661) 871-5659x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Period : Preparer: Certif1d: Parcel No: to Phone: (661) 325-4506x State: CA Zip : 93308 Phone: (661) 325-4506x State: CA Zip : 93308 TotalASTs: = Gal TotalUSTs: = Gal RSs: No Contact : MailAddr: 3624 BUCK OWENS BLVD 12 City : BAKERSFIELD Owner Address City DEREL & JESSIA LATTA : 3624 BUCK OWENS BLVD 12 : BAKERSFIELD Emergency Directives: ~~~~~ D (TVfJ&O!' 1Mtname) Do hereby CI9i1ify thB1~ ~ havs reviewed t~e ~ached hazardous matsria!$ m~l1agiS- ment plan rofeg(~"f:-~nd ~ha~ i~ tæJJ '. ¡;., (NlMT1e of Business) ©ng Wit., anycormd8@&'DS ccmstituts a compl~ft~ @lnd ~©B'V'®©I mBlf'U- agemenft p¡~Bìn for my iacimy. C);{w ~ {,/ SignslUre ID/i!'/ O'j -1- 10/25/2004 .. SiteID: 015-021-002419 9 By Facility Unit 9 Fixed Containers at Site 9 specHazlEPA Hazards Frm I DailyMax IUnit MCP E F P IH G 1980.00 FT3 Hi F IH DH G 1980.00 FT3 Low rCREATIVE COPPER f= Hazmat Inventory f== MCP+DailyMax Order Hazmat Common Name... ACETELYNE OXYGEN -2- 10/25/2004 .. SiteID: 015-021-002419 1 Facility Unit: Fixed Containers at Site 1 F,'CREATIVE COPPER p= Inventory Item 0002 === COMMON NAME / CHEMICAL NAME ACETELYNE Days On Site 365 Location within this Facility Unit INSIDE N WALL OF SHOP Map: Grid: CAS # 74-86-2 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 1980.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1980.00 FT3 Daily Average 1980.00 FT3 %Wt. I 100.00 Acetylene HAZARDOUS COMPONENTS ~ CAS# 748621 HAZARD S E EN S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi A S SSM T Ag.Defined1: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: - Ag.Define11 -3- 10/25/2004 '# ;: SiteID: 015-021-002419 ì Facility Unit: Fixed Containers at Site ì F CREATIVE COPPER f= Inventory Item 0001 == COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit INSIDE N WALL OF SHOP Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 1980.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1980.00 FT3 Daily Average 1980.00 FT3 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS HA D A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ZAR SSESSMENTS Ag.Defined8: MISC. LOCAL AGENCY DATA Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined6: Ag.Defined7: Ag.Defined9: Ag.Define10: Ag.Defined1: Ag.Defined5: r- Ag. Define11 -4- 10/25/2004 01mlers/Arlists: Derel ff_~ Jesa~ca Latta 3624 B~& 661-325-4506 Fax ~ or l - 3 2 5-4 5 2 6 - w~m~. cr ea liv ecopJ~er, com CREATIVE COOPER SiteID: 015-021-002419 Manager : BusPhone: (661) 325-4506 Location: 3624 BUCK OWENS BLVD 12 Map : 102 CommHaz : City : BAKERSFIELD Grid: 23B FacUnits: 1 AOV: CommCode: COUNTY STATION 66 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title DEREL LATTA / OWNER CYRIL ANDRE / LANDLORD Business Phone: (661) 325-4506x Business Phone: (661) 871-5659x 24-Hour Phone : (661) 665-8202x 24-Hour Phone : ( ) - x Pager Phone : (661) 342-2249xCELL Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 325-4506x MailAddr: 3624 BUCK OWENS BLVD 12 State: CA City : BAKERSFIELD Zip : 93308 Owner DEREL & JESSIA LATTA Phone: (661) 325-4506x Address : 3624 BUCK OWENS BLVD 12 State: CA City : BAKERSFIELD' Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~eviewed the a~ach~d h~ardous mere plan for ~~qe~nd ~ha~ i~ ~¢n~ w~h -1- 08/04/2003 .' OFI~EE OF ENVIRONMENTAL S~II~VICES ~ tIRE ~ - 1715 Chester Ave., CA 93301 (661) 326-3979 '"~'"~~'~'~ ~ ~..~,',.~ BUSINESS OWNER/OPE~TOR IDENTIFICATION I~ ~ u 7 FACILI~ INFORMATION ~ ~ ~. FnC~U~ tOENT~F~CATiON ~ ~c,u~o, i ~3 I~t I ~ , '~earBeginning ~00 i YearEnding BUSINESS NAME (Same as FAClU~ NAUE or DBA- Doing Business ~) 3 ~ BUSINESS PHONE ~02 ' SITE ADDRESS m3 ..... DUN & ~o~ ~ SIC CODE ~oz : COUN~ ~o~ ' :~::~ ' ""' %'?:~' il;~::0WNER, iNFOR~TION::~:~?:''~ : ~ ~', '? '~" OWNER ~ILING BONTAOT NAME ~z ~ BONTABT PHONE OONTAOT ~ILINB ~ ~ ~ ADD~ESS OlW ~2o STATE ~2~ ZIP ~ ','. ~..: ,~ ~.:~.;~4-: : :. ?(~,~ ~%~ ~*'~ ;:2 '.~:~-'.C ';L~:~ ~,' . ' .; ,~' , .~,~.~ ,~. ~' .r ,.. - . .. :, .· ~,t :..... TITLE ~M~ ,~s TITLE ~~ ~b BUSINESS PHONE %~q~O~ ,2~ BUSINESS PHONE ~! -- ~~ 24-HOUR PHONE ~-- ~O ~ ,27 24-HOUR PHONE PAGER ~ ~ -~ ~-- ~ ~ G 133 ': "'. '~,~ ~ ~::~ ;~;;~. ~:~::: :'::~";~ '. 2~' ,,,/;,-:',,:, ~ ~ ~: ~,:::~.,'~ ~ '~,,;.:; :,~.'*~.Y, ,, ~ 772;';~; q. 7:~:~:Y:~ :' , :?~ '5,'~ ' :.r:~: ,,, .- ~.~; ,. Ce~ifica~on: Based on my inqui~ of ~ose individuals responsible for obtaining the info~ation, I ~.i~ under penal~ of law ~at I have pe~onally examined and am familiar ~lfl the information submi~ed in this invento~ and believe [he info~ation is t~e, accu~te, and ~mplete. SIGNATUR~7~R /DATE/,,/0 7/0' ~1~ NAME OF DOCUMENT PREPARER~; 135 ~AMES OK~WN~E~TO~ (print) ~3e TITLE ~F OWNE~OPE~TOR 137 _ ~ ~~ ~TT~ d~ UPCF (7~99) S:\CUPAFORMS\OES2730.TV4.wpd OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS SECTION I. - BUSINESS IDENTIFICATION DATA: The Business Owner / Operator Form, Chemical Description Form(s) and other Forms (e.g.: underground storage tank information, hazardous waste treatment, etc., as needed) may be submitted as the first section of the Hazardous Materials Management Plan in order to avoid duplication of information for initial submissions. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 11.1 - DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Describe the procedures and equipment used to detect any release or threatened release of a hazardous material from any storage container, tank, or vessel at your business. Please provide a written explanation that also includes the make and model number of any automated or electronic leak detection equipment in use at your facility. B. EMPLOYEE AND AGENCY NOTIFICATION: What agencies and or corporate officials are notified in case of a hazardous materials spill or emergency -- What procedures are used to notify these parties? At a minimum, you must call 9-1-1 and the Office of Emergency Services at 1-800- 852-7550 to report any spills that are a threat to life, safety or the environment, or for other non-emergency spill reporting, please call our office at (661) 326-3979. C. ENVIRONMENTAL RESPONSE MANAGEMENT: Please describe who will be responsible for what activities (notifying authorities, clean-up companies, etc.), and what the chain-of-command is at your facility for making sure these activities are carded out. D. EMERGENCY MEDICAL PLAN: Summarize your plan for handling medical emergencies occurring at your business. List the local medical facility capable of handling an accident involving Hazardous Materials used at your business. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION Il,2- RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: Explain the procedures that you have developed and implemented to help prevent an incident from occurring. These steps could include, but are not limited to, storage methods, container types, segregation, safety equipment, and/or procedures used. B. RELEASE CONTAINMENT AND/OR MITIGATION: Explain the procedures that you have developed and implemented to assist in keeping a hazardous materials incident at your business as small or confined as possible. C. CLEAN-UP AND RECOVERY PROCEDURES: Explain what clean up procedures will be implemented in case of a release at your business. This should address small spills, as well as a major release of material once the material is contained. Hazardous Waste: Please provide the name of the hazardous waste company that regularly removes the wastes from your business, and how often that waste is removed. Please keep all disposal receipts for the last three years available on site for inspection. UTILITY SHUT-OFFS List locations of shut offs using compass points and known or obvious landmarks. If you have a lock box containing keys and maps of the facility for the Fire Department to use, please list its location also. PRIVATE FIRE PROTECTION/WATER AVAILABII JTY A. Private Fire Protection: Describe on-site fire protection for your business or facility unit, including sprinklers, fire extinguishers, alarm systems and private response teams. B. Water Availability (Fire Hydrant): Give the location of the closest water supply or fire hydrant to be used by the Fire Department in case of an emergency. SECTION Ill - TRAINING List the number of employees that are working in the area of the hazardous materials, use or storage. Include all employees who have any occasion to be in those areas. Give the location where Material Safety Data Sheets (MSDS) are kept on file. The MSDS must be readily available on site in a place where employees can access them. Give a brief summary of your Hazardous Materials Training Program. Employees are reqoired by State law to have a pro_re'am which provides employees with initial and refresher training in the following areas: 1) Methods for safe handling of the hazardous materials used by your business. 2) The Cal OSHA Hazard Communication Standard. 3) Correct use of emergency response equipment and supplies available at your business. 4) The prevention, minimizing and clean up procedures you have developed for your business. 5) The emergency evacuation plans you have developed, as well as, your notification procedure and medical plan. 6) Procedure to coordinate with and assist the 'local emergencY personnel that may respond to your business 7) Who and how to call for immediate assistance in the event of an accident involving hazardous materials. CERTIFICATION Please fill in your name, title, and sign and date on the signature line. IMPORTANT You must return this plan, inventory forms, and map within 30 days of receipt. If you have any questions please cal1 us at (661) 326-3979 Thank you for helping to keep our All America City cleaner and safer. CITY OF BAKERSFIELD~ OFFI~ OF ENVIRONMENTAL SEI~VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HAZARDOUS MATERIALS MANAGI=MENT PLAN Section Il.1 - DISCOVERY AND NOTIFICATIONS I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ADDRESS (For local use only) 476. FACILITY ID # I i ' DISCOVERY A. LEAK DETECTION AND MONITORING PROCEDURES: ' ~'.i..'; . ;..., :~';,.. ~. ~,.~ . .; . . B. EMERGENCY AND AGENCY NOTIFICATION PROCEDURES: UPCF {7/99) S:~PROCEDURE MANUAL~Iew HMMP fo~n.wpd HAZ~)se)US MATERIALS MANAGEME~ PLAN ction 11.2 - RELEASE RESPONSE PLAN PRELIMINARY ASSESSMENT A. HAZARD ASSESSMENT AND PREVENTION MEASURES: ~:~0~"~- RESPONSE ACTIONS .... B. RELEASE CONTAINMENT AND MITIGATION: * '- FoLLow-uP ACTIONS C. GLEAN-UPAND RECOVERY PROCEDURES: UPCF (7/99) S:~r~ROCEOURE MANUAL,~,Mw HMMP fmm.wpd Section II1.1 - FACILITY AND LOCALITY INFORMATION UTILITY SHUT-OFFS LOCATION OF SHUT-OFFS AT YOUR FACILITY: NATURAL GAS/PROPANE: I ELECTRICAL: 1 '5'lO SPECIAL: LOCK BOX: YES / NO IF YES, LOCATION: PRIVATE FIRE PROTECTION I WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): ,.: .... .:., ',TRAiNiN A. NUMBER OF EMPLOYEES: q B. MATERIALS DATA SHEETS ON FILE: C. BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION Based on my inquiry of Ihose individuals responsible for obtaining the infom~alion, I certify under penally of law that I have personnaly examined and am familiar with the information submitted and believe the infom*,,aUon is true, accurate, and complete. SIGNATURE OF OWNER I OPERATOR OR DESIGNATED REPRESENTATIVE DATE 477. NAME OF SIGNER (p.dnt) 478. TITLE OF SIGNER 479. UPCF (7/99) S:Ur~ROCEDURE MANUAL~'M~w HMMP fmm.wpd CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS INVENTORY INSTRUCTIONS CHEMICAL DESCRIPTION FORM Make as many copies of the chemical description form as necessary to report your entire inventory of hazardous materials. Report every hazardous material handled in quantities equal to or exceeding 55 gallons of a liquid, 500 pounds ora solid or 200 cubic feet ora gas. Report any amount of any hazardous waste being generated or handled on site. I. FACILITY INFORMATION: Check the appropriate box for a new inventory or for additions, revisions or deletions to an existing inventory. Enter the business name at the top of the form. Enter the page number in the fight hand corner. Describe the exact location of the hazardous waste or material being reported. NOTE: Chemical location information is considered confidential unless you check "no." Ifa site map is being submitted, you may refer to the map number and grid coordinates for the approximate location of the material, as shown on the map. II. CHEMICAL INFORMATION: Each of the instructions below correspond to the entry field with the same number on the chemical description form. CHEMICAL NAME 205 Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the International Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture or a hazardous waste, do not complete this field; complete the "common name" field instead. TRADE SECRET 206 Check "Y" for yes if the information in this section is declared a trade secret, or "N" for no, if it is not. State requirement: If yes, and business is not subject to EPCRA, disclosure of the designated trade secret information is bound by Health and Safety Code, Section 25511. Federal Requirement: If yes, and business is subject to EPCRA, disclosure of the designated Trade Secret information is bound by Title 40 Code of Federal Regulations (CFR) and the business must submit a "Substantiation to Accompany Claims of Trade Secrecy" form (40 CFR 350.27) to USEPA. COMMON NAME 207 Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. EHS 208 Check "Y" for yes if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CFR, Part 355, Appendix A. If the material is a mixture containing an EHS, leave this section blank and complete the section on hazardous components below. CAS # t 209 e azardous material. For mixtures, enter the Enter the Chemical Abstract Service (CAS) number for th h CAS number of the mixture if it has been assigned a number distinct from its components. If the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous components in the section below. FIRE CODE HAZARD CLASSES (Please leave blank) 210 HAZARDOUS MATERIAL TYPE 211 Check the one box that best describes the type of hazardous material: pure, mixture or waste. If waste material, check only that box. If mixture or waste, complete hazardous components section. RADIOACTIVE 212 Check "Y" for yes if the hazardous material is radioactive or "N" for no, if it is not. CURIES 213 If the hazardous mater/al is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. PHYSICAL STATE 214 Check the one box that best describes the state in which the hazardous material is handled: solid, liquid or gaseous (gas). LARGEST CONTAINER 215 Enter the total capacity of the largest container in which the material is stored. FEDERAL HAZARD CATEGORIES 216 Check all the physical and health hazards associated with the hazardous material: PHYSICAL HAZARDS: Fire: Flammable Liquids and Solids, Combustible Liquids, Pyrophories, Oxidizers Reactive: Unstable Reactive, Organic Peroxides, Water Reactive, Radioactive Pressure Release: Explosives, Compressed Gases, Blasting Agents HEALTH HAZARDS: Acute Itealth (Immediate): Highly Toxic, Toxic, Irritants, Sensitizers, Corrosives, other hazardous chemicals with an adverse effect with short term exposure. Chronic Health (Delayed): Carcinogens, other hazardous chemicals with an adverse effect with long term exposure. ANNUAL WASTE AMOUNT 217 If the hazardous material being inventoried is a waste, provide an estimate of the annual amount handled. MAXIMUM DAILY AMOUNT 218 Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacent/outside area at any one time over the course of the year. This amount must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions, deletions, or revisions projected for the current year. This amount should be consistent with the units reported in box 221. AVERAGE DAILY AMOUNT 219 Calculate the average daily amount of the hazardous material or mixture containing a hazardous material, in each building or adjacent/outside area. Calculations shall be based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the number of days the chemical will be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. STATE WASTE CODE 220 If the hazardous material is a waste, enter the appropriate California 3-digit hazardous waste code as listed on the back of the Uniform Hazardous Waste Manifest. A list of common State Waste Codes are included on page 4 of these instructions. UNITS 221 Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that the material is stored in (gallons, pounds, cubic feet, or tons). DAYS ON SITE 222 List the total number of days during the year that the material is on site. STORAGE CONTAINER 223 Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one. STORAGE PRESSURE 224 Check the one box that best describes the pressure at which the hazardous material is stored. STORAGE TEMPERATURE 225 Check the one box that best describes the temperature at which the hazardous material is stored. HAZARDOUS COMPONENT 1 - 5 (% by weight) 226, 230, 234, 238, 242 Ifa range of percentages is available, report the highest percentage in that range. HAZARDOUS COMPONENT 1 - 5 Name 227, 231,235,239, 243 When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that mixture by percent weight (refer to MSDS or, in the ease of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater than 1% by weight if non- carcinogenic, or 0.1% by weight if carcinogenic, should be reported. If more than five hazardous components are present above these percentages, you may attach an additional sheet of paper to capture the required information. When reporting waste mixtures, mineral and chemical composition should be listed. HAZARDOUS COMPONENT 1 - 5 EHS 228, 232, 236, 240, 244 Check "Y" for yes if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "N" for no, if it is not. HAZARDOUS COMPONENT 1 - 5 CAS 229, 233,237, 241,245 List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. III. SIGNATURE: 246 Please print name, title, sign and date each chemical description form. If you have any questions please call us at (661) 326-3979 CALIFORNIA WASTE CODES Code Description .Co. de Description Inorganics 241 Tank bottom waste I I l Acid solution 2 < pH < 7 with metals 251 Still bottoms with halogenated organics (antimony, arsenic, barium, beryllium, 252 Other still bottom waste cadmium, chromium, cobalt, copper, lead, 261 PCB's and material containing PCB's mercury, molybdenum, nickel, selenium, silver, 271 Organic monomer waste (includes unreacted thallium, vanadium and zinc) resins) 112 Acid solution without metals 272 Polymeric resin waste 113 Unspecified acid solution 281 Adhesives 121 Alkaline solution pH >12.5 with metals (see 291 Latex waste 111) 311 Pharmaceutical waste 122 Alkaline solution without metals 321 Sewage sludge 123 Unspecified alkaline solution 322 Biological waste other than sewage sludge 131 Aqueous solution (2 < pH < 12.5) containing 331 Off-spec, aged or surplus organics ' reactive anoins (azide, bromate, chlorate, 341 Organic liquids (nonsolvents) with halogens cyanide, fluoride, hypochlorite, nitrite, 343 Unspecified organic liquid mixture perchlorate and sulfide anions) 351 Organic solids with halogens 132 Aqueous solution with metals (see 11 I) 133 Aqueous solution with total organic residues Sludges 10% or more 411 Alum and gypsum sludge 134 Aqueous solution with total organic residues 421 Lime sludge less than 10% 431 Phosphate sludge 135 Unspecified aqueous solution 441 Sulfur sludge 141 Off-spec, aged, or surplus inorganics 451 Degreasing sludge 151 Asbestos containing waste 461 Paint sludge 161 FCC Waste 471 Paper sludge/pulp 162 Other spent catalyst 481 Tetraethyl lead sludge 171 Metal sludge (see 111) 491 Unspecified sludge waste 172 Metal dust and machining waste (see 111) 181 Other inorganic solid waste Miscellaneous 511 Empty pesticide containers 30 gal or more Organics 512 Other empty container 30 gal or more 211 Halogenated solvents (methylene chloride, 513 Empty containers less than 30 gal chloroform, TCE, TCA) 521 Drilling mud ~ 212 Oxygenated solvents (acetone, butanol, MEK) 531 Chemical toilet waste 213 Hydrocarbon solvents (stoddard solvent, 541 Photo chemical/photo processing waste xylene) 551 Laboratory waste chemicals 214 Unspecified solvent mixture 561 Detergent and soap 221 Waste oil and mixed oil 571 Fly ash, bottom ash, and retort ash 222 Oil/water separation sludge 581 Gas scrubber waste 223 Unspecified oil - containing waste 591 Baghouse waste 231 Pesticide rinse water 611 Contaminated soil from site clean-ups 232 Pesticide and other waste associated with 612 Household wastes pesticide production 4 ,"~"~-s~-~-'~ 6 OFFI~ CITY OF BAKERSFIELD _. OF ENVIRONMENTAL SEI~ICES t~n~ r~r 1715 Chester Ave., CA 93301 (661) 326-3979 ' '~' ~" ~' H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fo~ ~er mate~al per building or ama) ~ NEW ~ ADO ~ OELETE ~ REVISE ~ Page ~ of ....' I. FACI~ INFOR~N BUSINESS ~ME (~e ~ FACILI~ME ~ O~- ~ng Busin~ ~) 3 201~ CHEMICAL LO~TION ~ Y~ ~ No ~2 CHEMI~L LO~TION ~ C~FIDENTIAL (EPC~) .... ' ' ?~' { (~ /." ~ ¢} ~'::~ ~:ILcHEMiC~INFORMA~oN ~""}~ CHEMICAL ~ME FIRE CODE H~RO C~SSES (~pl~e if ~[~ by I~l ~re ~ 210 ~PE ~p PURI= ~ m MITRE ~ w WASTE 211 ~D~ACTIVE ~ Y~ ~0 212 CURIES 213 PHYSICAL STATE ~ s SOL(O ~l LIQUID ~g ~S 214 ~GEST CO~AINER 2~5 FED H~RD ~RIES ~ FIRE ~ 2 R~CT~ ~ 3 PRESSURE REL~E ~ 4 ACU~ H~L~ ~ 5 CHRONIC H~LTH 216 (Ch~ ~l thal apply) ANNUAL WASTE 217 { ~I~M 218 ~ A~GE 219 STA~W~DE A~UNT ~ DALLY A~U~ ~i OAILY ~U~ STOOGE CO~AINER ~ a A~VEGROUND TANK ~ · P~STI~ONM~ALLIC ORUM ~ i FIBER ORUM ~ m G~SS 80~LE ~ q ~IL ~R (Check all ~at apply) ~ b UNOERGROUNO TANK ~ f ~N ~ j ~G ~ n P~STIC BO~LE ~ r OTHER ~ c T~K INSIDE BU~LOtNG ~ g ~Y ~k~X ~ 0 TO~ BIN ~ d STEEL DRUM ~ h SILO ~1 CYMNOER ~ = T~K WA~N STOOGE PRESSURE ~a ~IE~ ~ ~ ABOVE A~IE~ ~ ba BELOWA~IENT STOOGE TEM~TURE ~ A~IENT ~ ~ A~VEA~IE~ ~ ba BELOWAMBIE~ ~ c CRYOGENIC 2 230 ~ 231 DY. Q~232 3 234 ~ 235 ~Y~ 236 ~7 4 , ~ ~ 239 ~ Y~ ~ NO 2~ 241 5 ~ 242 243 ~ ~ 245 Y~ 2~ ~.. ;; , , ~ ,~: ,.'~,~: ~. ',",~,'.:: , *, ..:.: .~.'.': '.::!:: ,::.:~. ? ?::'. *',...:':.'~?¢:~:' ~ :~ · ".~4:-:?::. ;:;.x .. .., · ' : :.: .:..~:~ :, ' ..,. PRINT ~ME A TITLE OF AU~ORIZEO COMPA~ REPRESE~ATIVE SIG~TUR/ II ~ / I ~ , DATE UPCF (7/99) S:~.CUPAFORMS~,OES2731 .T¥4.wpd OFFICE OF ENVIRONMENTAL SEll,ICES t ntr rm? rr 1715 Chester Ave., CA 93301 (661) 326-3979 CHEMICAL DESCRIPTION (one fon'n per maten~l per t~utlding or ama) [] NEW ~ ADD ~ DELETE ~ REVISE ~ Pa~ ~ , ' . I. FACI~ INFORMA~N BUSINESS ~ME ~me ~ FACILI~ME ~ O~ - ~usifl~ ~) ' -- ~ 3 CHEMICAL LO~TION 201~ CHERYL LO~TION CHEMICAL ~. COM~N ~ME EHS' FlEE CODE H~D C~SSES (~ol~e it ~t~ ~y I~ r~e ~ 210 ~PE ~ PU~ ~ m ~RE ~ w WASTE 211 ~IOACTIVE ~ Y~ ~ ~ 212 CURIES 213 PHYSICAL STATE ~ s SOLID ~ I LIQUID ~S 214 ~ST ~AINER 215 FED ~RD ~TE~RIES ~ FIRE ~ 2 ~C~ ~ 3 PRESSURE REdE ~ 4 ACU~ H~LTH ~ 5 CHRONIC H~L~ 216 (Ch~ all lhat ap~y) ANNUAL WASTE 217 . ~I~M 218 ~ A~GE 219 STATE W~TE A~UNT DAILY A~U~ } DALLY A~U~ UNITS* ~ ga ~L ~d CU ~ ~ lb LBS ~ ~ TONS 1 DAYS ON S~E (C~k all mat ~ b UNDERGROUND TANK ~ f ~N ~ j ~G ~ n P~TIC BO~LE ~ r OTHER ~ c T~K INSIDE SUILDING ~ g ~Y ~ k BOX ~ o TO~ BIN ~ d S~EL DRUM ~ h SILO ~YLINDER ~ p TANK WA~N STOOGE P~SSURE ~a ~IE~ ~ ~ A~VE A~IE~ ~ ba BELOW AMBIENT STOOGE TEM~TURE ~A~IENT ~ ~ A~VEA~IE~ ~ be BELOWA~IE~ ~ c CRYOGENIC ~ 242 243 ~Y~ ~NO 2~ 245 2~ UPCF (7/99) S:\CUPAFORMS'tOES2731.TV4.wpd CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 171S CHESTER AVE,, BAKERSFIELD, CA (661) 326-3979 SITE AND FACILITY DIAGRAM INSTRUCTIONS FOR HAZARDOUS MATERIALS MANAGEMENT PLANS These instructions explain the use of the site diagram and the facility diagram. Normally. small and medium size businesses will only have to submit a site diagram. If you have subdis'. ~d yc .' business into smaller areas because of the complexity or size, then you will be completivg and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business if it is in a remote location. All diagrams must be on 8 ~A x 11 paper and drawn using a straight edge tool. SITE D/AGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following information: 1. Check the box on the top left comer of the form provided that indicated "Site Diagram". 2. Print the'name of your business, as shown in your HMMP, on the top of the diagram. 3. Label the location of the hazardous materials and identi~ them by name and type of hazard (ie. Flammable liquid, corrosive solid). 4. Label the location of utility shutoff points for gas, electric and water services. 5. Label the location of fire hydrants. ..~ 6. Label portions of the building protected by automatic sprinkler systems. 7. Label the direction representing north on the diagram. (The diagram form provided includes a north arrow). Map labelin8 must be ies~and easily understandable. Try to a~l the use of abbreviations or symbols. If'you must useTlrem, provide a lesend explaiaia8 your system. Maps may be returned for correction if'you fail to follow these instruction. FACII,Ir['Y DIAGRAM I~$TRUCTION$ Facility diagrams are supplements to the site diagram. Use them to show the subdivision details ora larse business. 1. Check the box ia the upper fight hand comer of the form provided that indicated "Facility Diasram". 2. Print the name ofyour business as shown on your ttMMP. Print the name of the area that this map represents. This name should be the same name that you used on this area's invemory report. 3. Indicate wbi~ area the diasmm represem and the total number offluility diasra=s that you are including. Ifa map represented the first o£four are~ it would be labeled #1 4. Follow instruction (3 -7) for site diasrams regarding the specific details to be included on each fi~ih'ty diasram. 2 ITE DIAGRAM Business Name: l SIT~ DIAGBAM ~ FACILITY DIAGRAM ,~ a,mix~ Nm,:' ...... Dear Business Owner: This packet contains important information regarding your business and the F~E CHIEF requirements of Hazardous Materials Inventory Regulations. Both State and Federal laws RON FRAZE may require that your business complete a Hazardous Materials Management Plan (HMMP). ADMINISTRATIVE SERVICES Please read all the enclosed information carefully~ failure to comply with any portion of 2101 "H' Street the Business Plan requirements may result in Civil Liabilities of up to $2,000 for each day in Bakersfield, CA 93301 which the violation occurs. VOICE (661) 326-3941 FAX (661) 395-1349 WHAT BUSINESSES MUST COMPLY SUPPRESSION SERVICES 2101 "H" Street If you handle, use, store or dispose of Hazardous Substances at any time during the Bakersfield, CA 93301 VOICE (661) 326-3941 year in excess of the minimum reporting quantities you must submit a Plan. FAX (661) 395-1349 Typical everyday Hazardous Material you may find in your facility may include, but PREVENTION SERVICES are not limited to: compressed gasses; fuels - all types including propane; solvents - most FIRE S~:ETY SERVICES · E~MEI{TAL SERVICES 1715 ChesterAve. solvents would be Hazardous materials; oils - new and waste; thinners; caustic or corrosive Bakersfield, CA 93301 materials; poisonous or toxic materials, and radioactive materials. VOICE (661) 326-3979 FAX (661) 326-0576 Minimum State Reporting quantities are any quantity of explosives and any quandty PUBLIC EDUCATION of hazardous waste. For all other hazardous materials they are: 1715 Chester Ave. Bakersfield, CA 93301 55 gallons for liquids VOICE (661) 326-3696 FAX (661) 326-0576 500 pounds for solids 200 cubic feet (at standard temperature and pressure, for FIRE INVESTIGATION gasses) 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 For all acutely Hazardous Materials thc minimum reporting quantities are found on FAX (661) 326-0576 the list of Extremely Hazardous Substances on the current EPA List (Vol. 52 No. 77 of the Federal Register.) This list is available at the Office of Environmental Services of the TRAINING DIVISION Bakersfield Fire Department, 1715 Chester Avenue, Bakersfield, CA 93301 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 Your reporting requirements are either thc State quantities or thc Federal (threshold FAX (661) 399-5763 planning quantity) - WHICHEVER IS LOWER! WHATBUSINESSES ARE EXEMPT If you do not handle Hazardous Materials or if the quantities of Hazardous Materials are below the minimum reporting quantities at all times during the year, you are exempt. Hazardous Materials which are stored in transit or temporarily maintained in a fixed facility for less than (30) thirty days during the course of transportation are exempt from the inventory requirements of the law. --NOTE- (Hazardous Materials contained solely in a consumer product for direct distribution to, and use by, the general public are NOT exempt from the reporting requirements of the law per this Administering Agency.) HOW DO BUSINESSES COMPLY Businesses that are required to comply with requirements of Chapter 6.95 Of California health and Safety Code must submit a Plan. This Business Plan consists of: , 1. Emergency Response Plans and Procedures. 2. Inventory of Hazardous Materials. 3. Training Program for Employees. The forms for completing the Hazardous Materials Management Plan are attached to this letter. By correctly filing this Business Plan in, you satisfy both the Federal Requirements (Tier I and Tier II Inventory Requirements of SARA Tire Ill) as well as the California Requirements of Chapter 6.95 of the California Health and Safety Code. Business owners are urged to read and become familiar with Chapter 6.95 of the California Health and Safety Code. Copies are available at the Office of Environmental Services of the Bakersfield Fire Department, 1715 Chester Avenue, Bakersfield, CA 93301 (661) 326-3979. The completed Business Plans are required to be submitted within 30 Days of receipt of this letter. On-site inspections are required to insure compliance with the law. If you have any questions or need assistance with completing the Business Plan please call (661) 326-3979. Sincerely, Ralph E. Huey Director, Office of Environmental Services REH:baw CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS FACILITY INFORMATION INSTRUCTIONS BUSINESS OWNER / OPERATOR FORM I. FACILITY IDENTIFICATION: Enter the reporting period (year beginning and ending) for the facility information. Enter the business name and site address and phone number of your business. Do not use P.O. box numbers. Enter the Dun & Bradstreet or federal tax identification number for your business. Enter the Standard Industrial Classification (SIC) number for your business. Each type of business has a Standard Industrial Classification code number. Some common SIC codes are listed on the back of this page. Other SIC codes may be obtained from your worker's compensation insurance forms, the State of California Employment Development Department, or by calling our office at (661) 326-3979. Enter the name and phone number of the person responsible for operating the business. II. OWNER INFORMATION: List the legal business owner or corporation name and provide the headquarter address or residential address if owned by an individual and phone number. III. ENVIRONMENTAL CONTACT: Identify the person who is primarily responsible for environmental compliance at the business. This person may be either the business owner, one of the emergency contacts, an environmental manager, or consultant. IV. EMERGENCY CONTACTS: List the name, title, and phone numbers of two people at the business who can respond if the Bakersfield Fire Department requires additional information or other assistance. These contact persons must have keys or access to all areas of the facility, be available for emergency call-outs, and have decision-making authority to call on other resources (such as hazardous waste clean-up companies) as necessary. V. CERTIFICATION: The business owner or operator must sign, date, and also identify the document preparer. COMMON STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODES 0111 Wheat production 0724 Cotton ginning 5821 Eating places 0115 Corn production 0541 Grocery store 5813 Drinking places (Alcohol service) 0131 Cotton production 1541 Dry cleaners 5983 Fuel oil dealers 0139 Field crops, except cash 2911 Oil refineries grains 5984 LPG dealers 3441 Welding/fabrication- 0161 Vegetables & melons 7342 Pest control structural 0172 Grapes 7532 Auto top, body, 3443 Welding/fabrication - upholstery repair 0173 Tree nuts boiler Auto paint shops 0174 Citrus fruits 3569 Machine shop 7533 Auto exhaust repair 0175 Deciduous tree fruits 4222 Cold Storage 7536 Auto glass replacement 0179 Other tree fruits & nuts 4925 Compressed gas supplier 7537 Auto transmission 0192 General farms, primarily 5093 Automobile salvage repair crop 5169 Chemical supply 7538 General auto repair 0241 Dairy farms 5511 Motor vehicle dealers 7542 Car washes 0252 Chicken eggs. (new & used) 8071 Chemical laboratory 0253 Turkey eggs 5521 Motor vehicle (used only) 2851 Paint manufacture 5531 Auto & home supply stores 0291 General farm, primarily livestock & animal 5541 Gasoline service stations specialties CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROG~M INSPECTION CHECKLIST 1715 Chester Ave., 3~" Floor, Bakersfield, CA 93301 FACILITY NAME ~~ ~P~ ~SPECTION DATE l o ADD.SS ~4 g~ ~ ~ ~ PHONENO. FACILITY CONTACT ~~ ~m BUSINESS ID NO. 15-210- ~SPECTION TIME NUMBER OF EMPLOYEES Section I: Business Plan and Inventory Program ~ Routine [~ Combined ~] Joint Agency I~ Multi-Agency ~l Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~ ~-~"o-,.-t ~ ~ ~. Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials ~/~1 X fo ~xe.a~ Verification of quantities ~._.,~rd 'i~ jLC.C-Tc~ Verification of location I~$~a~ ~O c,o~cc ~ .~.~o Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~] Yes ~No us~inesn~~R~ Explain: Questions regarding this inspection? Please call us at (661) 326-3979 ite Responsible Party White - Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: {,~ l~.~