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Home My WebLink AboutBUSINESS PLAN MISCELLANEOUS. RECEIVABLES ADJUSTMENT DATE ~-/~-~ NEW ACCOUNT ADDRESS CHANGE CLOSE Acc'r · FINANCE CHARGEI / OTHER ADJ I ~__ PARCEL NUMBER ADJUSTMENT I CHG DATE [ CHARGE CODE [ ADJUSTMENT AMOUNT } . REMARKS: APPROVEDBY~~ RETURN PAYMENTS TO!' .,',-... -' '~1" ' ..' ' ' ' ' ' ' ' ~r'": ' ' ' C,T¥ OFB*~E.S~,d'LD' :;/ '1 STATEMENT C~' A~-' COUNT "' ' PLEASE MAKE OHEOKS RAYABLE TO: "P.O. BOX"205~"~"" .:',' ~": I' ' -.~. ~-'" "., ' ' CITY OF BAKERSFIELD '' '." BAKERSFIELD, CA 93303-~0'57 ~ ACCOUNT NO. M~~ · '. '.~ '~ % '' ': . .... ;..'.. ~ '.. .. ~- . . . . ~ /,_ ... . · .~ : . , .,.- ~ ; ,, . ..~ . ... .... ,, . .... :,¢~. · . .... INQUIRIES CONCERNING THIS BILL, PLEASE P~ONE:. ~--~* 7' ,~ '~' ~' ~X~%( COTY OF BAKERSF~E'"- - ,- , . ' P.O. 9OX 2057 ROUTIN - REQUEST Please -' ~ HANDLE ~ APPROVE and " ~ FORWARD " ~ RETURN ~ ~EEP OR D~SCARD ~ REVIEW WITH ME ~?-~O PIERCE ,, BA~ER~F [ElD CLASS VICE TOOLS .- PR'OI~CTION PACKERS & ACCESSORIES · TUBING ANCHORS/CATCHERS - DRILLABLE PLUGS DRILLABLE CEMENT RETAINERS RETRIEVABLE CEMEN:I' RETAINERS .~:'·.. CASING SCRAPERS ' WASH TOOLS ~ ........ ~-~ ATI PACKER SYSTEMS ! SALES OFFICE ' ~ P.O. Box 41747 BAKERSFIELD, CA 93384 ~ ~ (805) 631-0661 (OFFICE) -~ (805) 631-0634 (FAx) P.E. "BUDDY" COX, SENIOR EQUIPMENT SPECIALIST ............................... :' .......................... : ..... ........... i-"':" .. . .- '.:.. ~.: .: :-,:,' . .= ' ::':'"' '::;"'~ ::' '":' '"::':' -: .. ~ ....!,. ~-~:..., ':":' ": i:.- , .~.:,.:...: . ,-:: '.> -,· ....... '::' '!': ~' ~ .- ::::; .... ~ . :'""~'; ~ ' '"' "::" '"!" '" '": :'.,:i:::. .. ',.." ': ' ' ' :.:.::: '>. '":~:" :::~:i' - ":' ':.,:~i,:~: ' '"'::: · ','-' :.' -',',.' "i:.- i..:::.?: - ?'""'~' ..?,'i ~::~ i.:.":': ' .... .. >...::: -.,:','" ..... :; . . . -. .:.:, ~::.: ... · .:~!:-.. _ :. ..... .?~. ..... -- : --..,.:.: .:. , _ AMERICAN TECHNICAL INDUSTRIES 631-0632 BAKERSFIELD RECEIVED Bakersfield Fire Dept. MAY o 5 1992 Hazardous Materials Division 2130 "G" Street HAZ. MAT. DiV. B~kersfield, CA. 93301 · HAZARDOUS MATERIA~ENT PLAN INSTRUCTIONS: '" ; · i. To avoid furthei action, return' this form within 30 days of receiPt. 3. Answer the questions below for the business as a whole. / 4. Be brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA MAILING ADDRESS: DUN & BEADSTEEET NUMBEE: ~-~' ~~ SIC CODE: OWNER: ~'~G ~. ~8~E~ '" SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE '24 HR. PHONE Dept. Bakersfield Fire " ': Hazardous Materials Division ',~.~:~.~ HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: ~ MATERIAL SAFETY DATA SHEETS ON FILE: ~{~__.,.~ BRIEF SUMMARY OF TRAINING PROGRAM' I 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 DC) NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: ~, "~~~ f, C~ ~ c~r~¥ ~A~ ~'~ A~OV~ ~O~- MATIO. N IS ACCURATE, I UNDERSTANDTHATTHISINFORMATIONWILLBEUSEDTO 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 fNACCURAT5 INFORMATION CONSTITUTES .PERJURY. SIGNATURE TITLE DATE 2. FD15~ Bakersfield ~'~_re Dept. HazardOus Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION' Do EMERGENCY MEDICAL PLAN: Bakersfield Fire Dept. Hazardous Materials Division HAZAJ~DOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVEIqTION STEPS: ' B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAn-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: ELECTRICAL: WATER' ~'~ SPECIAL: LOCK BOX: YES~ IF YES, LOCAIION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: B. WATER AVAILABILITY (FIRE HYDR~ANT): 4, FD1590 . ---'. -'$1T.a DIAGRAM..(r---q FACILITY' DIAGRAM " ~'~' 'Susine~ Ncme:i.. :;'~T-~:' gCP_....._~'~l-,~m.~ · "v ' BUsine~ Addre~:- .... ' "' '- ."::i: '.~ :' ' -,-'.. - - - For Office Use Only First In Statlom - . -Am~ Map ~ .. ' of · ": '" . i~p~Ctlo, O Stgt on: NORTH .._: ~: SITE DIAGRAM ~ FACILITY DIAGRAM i-----I Business Name: /~T~' '/~r-.e P_. ! . Business Address: ¢.~.5-'C) '?,'EAc.¢ '~-.~..~ .... ' FOr' Office Use OnlY First In Station: Area Map # of Inspection Station: " NORTH ~ CITY OF BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Farm and Agricult~re'~Standard Business : Page. of__~ NON - TRADE SECRET BUSINESS NAME:i AT/- OWNER NAME: C~I~ C ~*'~,'%*7-7-- NAME OF THIs FACILITY: /~'['~ ~3~F'3W-~ ~R ~ INS~U~IONS ~R PROPER ~DES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Tr~s ~e ~ Average ~nual Measure ~ Days Cent Cent Cent Use Location ~ere % by N~s of M~ture/C~nents Code C~e ~t ' ~ ~t Units on Site ~ Press Temp Code Stored ~n Facility ~ See Instructions (Check all that· apply) Component ~ 2 Na~ & C.A.S. N~er ~ F're Hazed ~ Sudden Release '~ ~¢tiVity ~ Im~i~te ~ D.lay~ of Pressure H~lth H~lth Component ~ 3 N~ & C.A.S. N~er M J? J I0 J ~ J ~0 J~35 J3~ I~,DI i J q JosJS~..6,~e o~ ~o~.. ,~ ~v¢~r mOPH'T~ (Check all that apply) ~ Co~onent ~ 2 Na~ & C.A.S. N~er ~ Fire Hazed ~ Sudden Release ~ Reactivity ~ Im~iat. ~ Delay~ of Pressure H~lth Health Component ~ 3 N~ & C.A.a. Nu~er ~~~ Physical and H~lth Hazard C.A.S. N~er Component ~ 1 Na~ & C.A.a. Nu~er (Check all that apply) .'.>% . Component ~ 2 Na~ & C.A.S. Nu~er ~ ~ F~re Hazed ~ Sudden Release ~ R~ctivity ~ I~iate ~ Delay~ of Pressure H~lth Health Component ~ 3 Na~ & C.A.S. Nu~er / Physical and H,lth ..zard C.A.S. N~e: 1~''~--/ Component ~ I Na~ & C.A.S. N~er (Check all t~t apply) Compon~t ~ 2 N~ & C.A.S. N~er ~ Fire Haz=d ~ Sudden Release ~ R--ctivity ~ I.~iate ~ Delayed of Pressure H~lth H~lth Component ~ 3 N~ & C.A.S. N~er E~RGENCY CONTACTS %1 ~ Up~ ~.~X ~N~ &~ ~i- 06~ ~2 Na~ / Title 24 ~. Phone N~e T~tle ' 24 Hr Phone C~t~fication (~ ~D SIGN AFTER COMPLETING ~L SECTIONS) certify ~er p~nl~y of law that I hayer ~rsonally ~in~ and ~ f~ili~ with the ~nfo~ation submitted ~n this ~d all attached d~ents ~d that ~sed on ~ in~i~ of those ind~v~d~ls res~nsible for obtaining the info~tion. I believe that the submitted info~ation is t~e, acc~ate, and complete. ~ Farm and AgricultUre ~-] Standard Business : LOCATION: :, ~ 9 .~I ~1 ~ ~}, ~ ' CITY, Z I P : ] A~ ~ q Fm ~ 9 I ' DuNAND BRADSTREET NUMBER/FEDERAL/ID I~..~R TO INSTRUC~TION$ 'FOR PROPI~ OODES Tra.~ Type Max Average Annual Measure 8 Days Cent Cent Con% Use ~x)cation'Where I: {:: N ~ s of Mlxture~om[~Onents Code C,ae Amt An= Amt Units on Sits Type Press Temp .Code Stored in Facility See Instructions · and a~al~h Eazard C.A.S. 'Nuaber .... Component' # I Nam~ & C.A.S. NU~b~ (Check ail that ~pply] Component # 2 N~ & C.A--~-. of Pr~aure Itealt~' ' Heali;h Component ~ 3 Nam~ & C.A.S. (Cheek ail thor- apply) ' Co~0n~t ~ 2 Nam & of Pressure ; . ~ ~ j . -' C.A.S~ N~ber Com~onen~ ~ I Na~ &, . - . '~. ~.:.~ ..... :: l:~...~....? :} ~,. I l..':. ,~?~,..:.,: . I -... , .- I . .... :".~ I · I ..