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HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/HazardouS Waste Unified Permit . ,.CONDITIONS' OFPER~MIT ON REVERSE SIDE This hermit is Issued for the following: 'El Hazardous Materials Plan. 13 Underground Storage of HazardOus Materials permit ID #:: 015-000-001452 13 Risk Management Program 13 Hazardous Waste On-Site Treatment SECURITY ROOFING , LOCATION: 721 BUTTE:ST Issued by: Bake rsfield Fire De pa rtme nt OFFICE OF ENVIRONMENTAL SER VICES' i'1~ 1715 Chester Ave., 3rd Floor : Approved by: ' re · ' Issue Date Bakersfield, CA 93301 :' oecmof£vi,~,,~s~,ic~ - Voice (66'1) 326-3979 ' v~ (~) ~2~-0sz~ ' ~xp~t~o..v~t~:"~un~ 30=. 200~ .. ., :.. *~.'..': ~15 ~"~ .'.' usiness Name: SECURITY ROOFING'C %~%~ SiteID: 015-021-001452 ~x~ BusPhone: (661) 872-2819 Manager : Location: 721 BUTTE ST ~v Map : 103 CommHaz : Moderate City : BAKERSFIELD Grid: 29C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code:1761 EPA Numb: DunnBrad: Emergency Contact / Title I Emergency Contact / Title SAM ALVAREZ / OWNERI PAUL MARTON / Business Phone: (661) 872-2819x Business Phone: ( ) - x 24-Hour Phone : (661) 872-3378x 24-Hour Phone : ( ) - x Pager Phone : (661) 331-9058xCELL Pager Phone : (661) 809-9778x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 809-7~36x MailAddr: 1430 GRACE ST State: CA City : BAKERSFIELD Zip : 93306 Owner SAM ALVAREZ Phone: (661) 331-9058x Address : 1430 GRACE ST State: CA City : BAKERSFIELD Zip : 93306 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ' '(Type iFpdnt name) 2 reviewed ~he at~acL~d h~Azardj~.us materials ma,~age- mere plan for / along wi~h (~ of any corre~ions cons~i~u~e a compile and corr..man- agement plan, for my f~cility. -1- 10/21/2003 · F SECURITY ROOFING SiteID: 015-021-001452 [ Fast Format F Site Emergency Factors Overall Site  Special Hazards --Utility Shut-Offs 03/14/2001 A) GAS - NONE B) ELECTRICAL - NE SIDE OF BLDG C) 'WATER - ????????~NO~ D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/14/2001 .... TION~~.?~~???? ~ (FIRE EXTI~GUISHERS~OR ~PRINKLERED~LDG????????????????????) FIRE HYDRANT - ???????????? (WHERE IS THE NE~ES~,~IRE H%DRANT LOCATED?????????????????) Bflilding Occupancy Level -8- 10/21/2003 F SECURITY ROOFING coM SiteID: 015-021-001452 Fast Format ~ Training Overall Site --Employee Training 03/14/2001 WE I-LIVE 4 EMPLOYEES ~T THIS F~CILITY. __ 0 o e¢ ~E rmVE ~TCR¢~n S~¢ST¢ ~T~ SaEETS ON FCnE. ~¢~ BRIEF SUMMARY OF TRAINING: WE HOLD TRAINING SESSIONS ON I-I~Z~RDOUS MATERI~S. ~ Page 2 --Held for Future Use Held for Future Use -9- 10/21/2003 SECURITY ROOFING COMPANY · SiteID: 015-021-001452 Manager : BusPhone: (661) 872-2819 Location: 721 BUTTE ST Map : 103 CommHaz : Moderate City : BAKERSFIELD Grid: 29C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: 1761 EPA Numb: DunnBrad: Contact / Title-~3 ,E,~m~rgency Co, act/ ~/,~ T;t_le Emergency .H C 'BUD LOPET,' / OWNER' ~,~q LO~.~z,' r~-~; Business Phone: (661) 872-2819x Business Phone: 24-Hour Phone : (661) 872-3378x 24-Hour Phone : (661) - x Pager Phone : (661)3~ Pager Phone : Hanmar Hazards: Fire Press Im~lth DelHlth con~ac~ : ;~ ~a.~ 3~ ~hone: (~) S0~-~x MailAddr: ~3701 C~LEWOOD DR State: CA City : BAKERSFIELD ~~ Zip : 93306 Owner ~~ ~ ~V~W,-~~ Phone: ',f~)~OD 7:Zg~ - Address :~ l~d ~wa~ State: CA City : BA~RSFIELD ~d~ Zip : 93306 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = .' Gal Certif 'd: Res: No Emergency Directives: ---- Hanmar Inventory One Unified List -- Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpooHazIEPA Hazards[ Frm DailyMax IUnitIMCP ALUMINUM PAINT ' F IH DH L 55.00 GAL UnR ASPHALT F S 10000.00 LBS Min PROPANE F P IH G 2911.00 FT3 Hi reviewed ~he at~hed h~a~do~ mmerials ment plan f~U ~,~' g~~ha~ ~ ~,ong wi~ any ~rr~ions ~emem plan for, .... ~.-,:,~:~.'~,. 01/10/2003 SECURITY ROOFING COMPANY SiteID: 015-021-001452 = Inventory Item 0004 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ALUMINUM PAINT· Days On·Site 365 Location within this Facility Unit Map: Grid: N ENTRANCE 1/3 WAY BACK CAS# STATE --]-- TYPE PRESSURE .... TEMPERATURE CONTAINER TYPE Liquid I Mixture Ambient I Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 55o00 GAL I 20.00 GAL HAZARD ASSESSMENTS TSecretI RSlBioHaz Radioactive/Amount EPA HazardsI NFPA USDOT# [ MOP N© No No No/ Curies F IH DH / / / UnR = Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME ASPHALT Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF PROPERTY E SIDE .CAS# 8052424 STATE TYPE .... PRESSURE TEMPERATURE CONTAINER TYPE FSolid Pure I Ambient I Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average LBS I 10000.00 LBS I 3000.00 LBS %Wt. S CAS# 100.00 Asphalt N 8052424 HAZARD ASSESSMENTS [TSecretl ~SIBioHaz[ Radioactive/Amount EPA Hazards NFPA USDOT# I MOP No N No ·No/ Curies F / / / Min -2- 01/10/2003· SECURITY ROOFING COMPANY SiteID: 015-021-001452 ~ = Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: ON TRUCK CAS# 74-98-6 Gas /Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average FT3I 2911.00 FT3I 1500.00 FT3 HAZARDOUS COMPONENTS 100.00 Propane Yes 74986 HAZARD ASSESSMENTS ITSecretl ~SIBi°HazI Radi°active/Amount I EPA Hazards INo N No No/ Curies F P IH NFPA/// ] USDOT# HiMCP 3 01/101/.2003 F SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 03/14/2001 CALL 911 AND OFFICE OF EMERGENCY SERVICES 1-800-852-7550. -- Employee Notif./Evacuation 03/14/2001 CALL 911 AND SEND EMPLOYEE TO STREET GATE. -- Public Notif./Evacuation 03/14/2001 NOTIFY BUSINESS NEXT DOOR. Emergency Medical Plan 03/14/2001 KERN MEDICAL CENTER OR MEMORIAL HOSPITAL. -4- 01/10/2003 SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format = Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 03/14/2001 POST HAZARDOUS DATA SHEETS AND HOLD THAINING COURSE ON HAZARDOUS MATERIALS FOR ALL EMPLOYEES. --Release Containment 03/14/2001 DAM ALL SPILLS WITH SAND. -- Clean Up 03/14/2001 USE CLEAN UP IV ABSORBENT MATERIAL. Other Resource Activation -5- ol/10/ 0o3 F SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format F Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 03/14/2001 A) GAS - NONE D) SPECIAL - NONE E) LOCK BOX - NO Fire Pr°tec../Avail. Water 03/14/2001 PRIVATE FIRE PROTECTION - ????????????? (FIRE EXTINGUISHERS OR SPRINKLERED BLDG????????????????????) FIRE HYDRANT - ???????????? (WHERE IS THE NEAREST FIRE HYDRANT LOCATED?????????????????) Building Occupancy Level 6 01/10/2003 SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format ~ Training Overall Site -- Employee Training 03/14/2001 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: WE HOLD TRAINING SESSIONS ON HAZARDOUS MATERIALS. i P age 2 I i' Held for Future Use I Held for Future Use -?- 01/ 0/h603 SECURITY ROOFING COMPANY ~~_~ SiteID: %15-021-001452 Manager· / ~?~u · / -,,~ 7 ~ <~ ~ ~sPhone: (805) 872-2819 Location: 721 BUTTE ST /~ a ~ Pn^ ~'M&p : 103 CommHaz : Moderate City : BAKERSFIELD !~. ~ug/ ~rid: 29C FacUnits: 1 AOV: · /s/ CommCode: BAKERSFIELD. STATION 0 IC Code:1761 EPA Numb: ~/ DunnBrad: Emergency Contact / Title Emergency Contact / Title Business Phone: (~) 872-2819x Business Phone: 24-Hour Phone : ~) 872-3378x 24-Hour Phone : (~)-~ ~ Phone : (~) ~?-~3~x Pager Phone : ('- ) Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr:' 3701 CANDLEWOOD DR State: CA City : BAKERSFIELD Zip : 93306 Owner H C BUD LOPEZ Phone: ( ) - x Address : 3701 CANDLEWOOD DR State: CA City : BAKERSFIELD Zip : 93306 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = ~ Gal Certif 'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List ~ -- As Designated Order Ail Materials at Site ~ Hazmat Common Name... ISpeoHaz[EPA HazardsI Frm I DailyMax Unit MCP ASPHALT F ~ S 10000.00 LBS Min PROPANE ~ F P IH G 2911.00 FT3 Hi ALUMINUM PAINT ~1 F IH DH L 55.00 GAL UnR /'"----r D° hereby certify that I have reviewe~the a.~achedtl'/azardous materials manage- ment plan ~or r,,~c~-F~,9 ~and that i~ along with (Name of Busine~) any corrections constitute a complete and correct man- agement plan for my facili~j. ',~ -1- 02/01/2001 ~ k ~ .~., $igna~re Date SEC~ITY ROOFING COMPANY SiteID: 015-021-001452 Inventory Item 0001 Facility Unit: Fixed Containers on Site ~lvUvlU~ ~vl~ / ~1 ~ ~Vl~ ~PHALT Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF PROPERTY E SIDE CAS# 8052424 STATE -- TYPE' PRESSURE TEMPERATURE CONTAINER TYPE A~ient I A~ient I DR~/BARREL-NO~ET~ Pure Solid AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average' LBSI 10000.00 LBSI 3000.00 LBS HAZARDOUS COMPONENTS 100.00 Asphalt N 8052424 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F / / / Min ---- Inventory Item 0002 Facility Unit: Fixed Containers on Site I.:l.)lvUV1%.)l%{ I~{Z-klVlJ:5 / I:l'/J:SiVl.L t~k/J l~JZ-UVlJ:5 PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: ON TRUCK CAS# 74-98-6 F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Pure Above Ambient I Ambient I PORT. PRESS CYLINDER. Gas . AMOUNTS AT THIS LOCATION Largest Container '[ Daily Maximum I Daily Average FT3I 2911.00 FT3I 1500.00 FT3 HAZARDOUS COMPONENTS 100.00 Propane 74986 HAZARD ASSESSMENTS [TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPANo No No No/ Curies F P IH / / / USDOT# I MCPHi -2- 02/01/2001 SECURITY ROOFING COMPANY SiteID: 015-021-001452 = Inventory Item 0004 Facility Unit: Fixed Containers on Site ~~ ~Vl~ / ~£~1~ ~Vl~ ALUMINUM PAINT Days On Site 365 Location within this Facility Unit Map: Grid: N ENTRANCE 1/3 WAY BACK CAS# ~ STATE I TYPE PRESSURE --i TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average GALI 55.00 GAL 20.00 GAL i %Wt' HAZARDOUS COMPONENTS RS CAS# HAZARD ASSESSMENTS TSecret ~S I BioHazI Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No N No No/ Curies F IH DH / / / UnR -3- 02/01/2001 f SECURITY ROOFING COMPANY SiteID: 015-021-001452 I Fast Format ~Notif./Evacuation/Medical Overall Site --Agency Notification 04/25/1991 CALL 911 OFFICE OF EMERGENCY SERVICES 1-800-852-7550 -- Employee' Notif./Evacuation ,04/25/1991 CALL 911 SEND EMPLOYEE TO STREET GATE  Public Notif./Evacuation 04/25/1991 IFY BUSINESS NEXT DOOR Emergency Medical Plan 04/25/1991 KERN MEDICAL CENTER MEMORIAL HOSPITAL -4- 02/01/2001 SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/25/1991 POST HAZARDOUS DATA SHEETS HOLD TRAINING COURSE ON HAZARDOUS MATERIALS FOR ALL EMPLOYEES 04/2 /i991 Release Containment DAM ALL SPILLS WITH SAND · Clean Up 04/25/1991 USE CLEAN UP IV ABSORBENT MATERIAL Other Resource Activation 5 02/01/2001 SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format F Site Emergency Factors Overall Site SpeCial Hazards ~ Utility Shut-Offs 04/25/1991 A)· GAs'- NONE B) ELECTRICAL - NORTHEAST SIDE OF BUILDING C) WATER - ???????? D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/25/1991 PRIVATE FIRE PROTECTION - ????????????? FIRE HYDRANT - ???????????? Building Occupancy Level -6- 02/01/2001 SECURITY ROOFING COMPANY SiteID: 015-021-001452 Fast Format ~ Training Overall Site ~ Employee Training 06/13/1991 WE HAVE 4 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA.SHEETS ON FILE BRIEF SUMMARY OF TRAINING: WE HOLD TRAINING SESSIONS ON HAZARDOUS MATERIALS Page 2 Held for Future Use Held for Future Use -7- 02/01/2001 CITY OF BAKERSFIELD CLAIM VOUCHER I Vendor No. I I certify that this claim is correct and valid, and isa proper charge against the City Agency and account indicated. CLAIMANT'S NAME AND ADDRESS: Security Roofing Company (AUTHORIZED SIGNATURE OF CITY AGENCY) 3701 Candlewood Dr Bakersfield, CA 93306 Date: 04-01-99 Initials of Preparer: "~o~ [ ,~.~(_O_~ ~*~*-* CITY DEPARTMENT: FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Contract Number if Applicable) This customer made a duplicate payment of this years Haz Mat bill in the amount of $310.50. We have since made an adjustment to the California State surcharge in the amount of $8,50 leaving them with a credit of $319.00. Dept. Invoice # 'Amount Date of Invoice 0000 7900 $319.00 VOUCHER TOTAL $319.00 SECTION 72, PENAL CODE FINANCE DEPT. USE ONLY Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, Examined & Approved for Payment Amount or writing, is guilty of a felony. STATEMENT OF ACCOUNT. CITY OF BAKERSFIELD 150i TRUXTUN AVE BAKERSFIELD° CA 93301-520i -~ :~'~ DATE: 4/01/99 TO: SECURITY ROOFINg COMPANY 3701 CANDLEWOOD ~DR BAKERSFIELD, C'A 93306 CUSTOMER NO: 34&1 CUSTOMER ~TYPE: ES/ 3461 CHARGE DATE DESCRIPTION ,REF-NUMBER DUE DA~E TOTAL AMOUNT ~- O0 3/01/99 BEgINNINg BALANCE ,-_~ · ~/0~/99 PAYMENT 310.50- SSO01 3/31/99 Charge adjustment 4/30799 8.50- CA STATE SURCHARGE : FOR ~UESTIONS OR CHAN~ES~-TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 8.50- DUE DATE: 5/03/99 PAYMENT DUE: 319.00- TOTAL DUE: $319.00-- __.. MISCELLANEOUS RECEIVABLES ADJUSTMENT ADDRESS CHANGE CLOSe^CCT i ~ ~....c.c...~. i ' OTHER AOJ ,, ~ SITE ADDRESS ~~[ ~¢25~ ~ PARCEL NUMBER OF APPLICABLE) ADJUSTMENT CHG DATE CHARGE CODE , ADJUSTMENT AMOUNT APPROVED BY~~:~ I Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ......... ~,~,~,~¢~,~,~,~,,~v~,~ .............. This permit is issued for the following: · ~¢¢ ¢:'i' ?~?~'>~::'~iii i!L. ~iii!!!iii~. iiiiii~iii;:} iiii~iBili~$emround Storage of e~rdous Materials : '~,¢~H.~'i= :t '~ .... "~**~a~8¢i~ ..... ...... . '~];;::::::.~ ":~;%:. ,,.......:: '~. "**-'"::::~." *:iiiir :~ii~: :~:*"~*:'~&.;:'?"~-F'r'x'~'¢%%.M%b '~ Bakersfield Fke Depa~ment Approved by: OFFICE OF E~R ONe.AL S~ ~CES 1715 Chewer Ave., ~rd Floor B~emfiel~ CA 9~01 Voice (805) ~26-~979 F~ (S05),264576 ExpimtionDate: June 30.. 2000 Utilities General Account Maintenance 12/29/94 PUTLS801 Acct Nbr: 481101 Bill Stat: NO Transfer-from: Page 1 of 6 Cyc Stat: CL Acct Cyc Stat: CL Transfer-to: Due: 0.00 1. Customer Name: SECURITY ROOFING COMPANY 2. Social Sec Nbr: 3. Telephone: 805-872-2819 4. Service Address: 721 BUTTE 5. Service City: BAKERSFIELD 6. State: CA 7. Zip: 93305 8. Parcel ID: 9. Bill Cycle: 5 20. Water Svc Class: 10. Route Nbr: 11. Comments : 12. Prev Acct: HM01452 23. Misc Services: 23.1 Fl0 HAZ MAT HANDLING 13. Service Date: 23.2 Fl7 INSPECTION FEE 14. Fund no: 23.3 15. Billto Ad1:3701CANDLEWOOD DR 23.4 16. Billto Ad2: 24. Closing Date: 17. Bill-to City: BAKERSFIELD 18. State: CA 19. Zip: 93306 Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change ROUTING PERMIT APPLICATION Please process immediately! Cross out your department and forward to the next. CITY of BAKERSFIELD "WE CARE" 'FIRE DEPARTMENT April 4, 1990 2101 H STREET D. S. NEEDHAM BAKERSFIELD, 93301 FIRE CHIEF 326-3911 Mr. H.C. Lopez Security Roofing 3701Candlewood Dr. Bakersfield, Ca. 93306 Mr. Lopez: You hsve a Hazardous Materials Business Plsn filed with the City of Bakersfield dated May 25, 1989 that shows an address of 721 Butte St. I believe that this address is no longer vslid. Current California Law requires that you revise your business within 30 days of a move. This business plan does need to be revised and returned to this office no lster than April 13, 1990. If we can be of any assistance please do not hesitate to call. ~a~pn .~nuey .... Hazardous Materisls Coordinator CITY of BAKERSFIELD d~( . NO g ' SECRETS* , CITY, ZIP:[~9///~fl~,~/~ / "~,A/, CITY, ZIP:~g~d;.~",~./~ [lg/. ~.~ DUN AND BRADSTREET NUHBgR ' - PHONE 1:__~77 - Xi/~ PHONE ~: ~77 ~ 7~ / ' - - frans Ty~ ~x ' Average ~nual ~asure I ~ Cmt ~t Cmt hs L~ett~ ~re ~ff~, H~ of l~xtu~/C~tl C~e C~e ~t ~t Est Units m Site Ty~ Prfls I~ C~E .. St~ In Facility ~ Inst~tims Physical and Health Hazard C.A.S. ~ C~t I1 ~ & C.A.S. ~ I~k all t~t ~pply) r-~ ~ ~ r--~ r-~ ~t It ~iC.A.S.~ azard L--J Reactivity ~le~ L--~ ~ Rel~se ~--a I~iatl Health of Pe~ure ~lth [ e Hazard [ ~ Reactivity ~--J hla~ ~- Rllflff' ~ ~ I~tlte H~lth of P~u~ ~lth ....... ~t 13 ~&C.A.S. ~ P~tcal ~d ff~lth Hazard C.A.S. ~ at 11 h i C.A.a. ~ (C~k ,Il t~t ,~ply)T~~--~r -- - ~, ' -- r --a -- :~t 12 N~ & C.A.S. ~ ~ Hazard ~ ~ R,eactivity ~d ~lay~ ~--d ~d~ Relflse ~ ~ I~tate . Health of Prflsure Health ; C~t 13 Nm & C.A.S. b~ (Ch~k all t~t a~ly) ...................... ,~,, ..... L_ Hazard [ J Reactivity ~ [ ~ ~dd~ Release I Health of Pr~sure Health ...... Cm~t 13 Nm i C.a.S. N~r , HEPGENCY C~TACTS I~ HSi~-: .................................. ~[li ....................... 21-RF'P~i ........ Nib T1~1~' ~'H~'P~ ....... Certificatim (Read and sign afte~ compJetJng all sections/ '~ . [ cffrt~fy under ~alty of law that I ~ve ~rs~allyexamin~ and am fauiliar ,lth t~ tnfor~tim su~}~tt~/ In this I~ a11 Ittlc~ d~ts. ~ t~t ~s~ m~ Anqui~ of t~e t~tvi~als r~sible for obtaining t~ tnforNt~. I ~lteve t~t t~ su~ttt~ intor~tt~ *s true, accurate, and cmalet~ ~ ~ /) / , . // ,, BAKi~;~ri~LD CITY FiRE DE~HilVt~NI 2130 'G' STREETI BAKERSFIELD, CA. 93301 ~~'L~ (805) 326-3979 .... ~ ~ ~ HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A It1~ INSTRUCTIONS; ~AZ, MAT, DIV, 1. To avoid further action, return this from w~thin 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 4.3' Answefas brief thequestions below for the business as a whole. Be and concise as possible. ~...~,~ SECTION t; BUS~N~S ~oENTIFICAT[ON OATA ~ ~~-- SECTION 2: ENERGENCY NQT~F}CATIoN8 ~n case of an emergency involving ~he release or threatened release of a hazardous material, call ~11 and 1-800-852-7550 or 1-916-427-4341. Th~s w~ll no%~fy your local fire depar%men% and the S%a%e Off~ce of Emergency Services as required by law. ENPLOYEES TO NOTIFY IN CASE OF ENERGENCY: NAHE AND T~TLE DURING BUS. HRS. AFTER BUS. HRS. 8,,~CT~ON 3; LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS A8 A WMOLE A. NATURAL GAS/PROPANE: ,~O~ ~ - B. ELECTRICAL: ~St&~ ~ C. WATER: ~ N P . D. SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION' IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY ~ - B. 'DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS MATERIAL YOU HANDLE ~ ~ ~ C. GIVE A BRIEF SUMMARY OF Y~R HAZARDOUS MATERIALS TRAINING PROGRAM' ' SECTION 7: EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER §.95 OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE FOLLOWING. REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION,8: CERTIFICATION I, ~,~, ~J L-~ ~~---- , certify that the above inf°rmati°n is accurate. I un~erstan~ that this information will be used to fulfill' my firm's obligations under the new California Health and Safety code on 'Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that ~naccura~t in~°rmati°n c°nstitutes perjury'' ' SIGNATUR'E~,, TITLE - / " BAKERSFIELD CITY FiRE DEPARTMENT '~-, 2130 "G' STREET ,: BAKERSFIELD, ,CA. 93301 ,, (805) 326-3979 ~ ID# II BUSINESS (NAME ' HAZARDOUS MATERIALS "' BUSINESS PLAN AS A WHOLE FORM 3^ ];NSTRUCT~:ONS 1. To avoid further action, ~his form mus~ be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH, '-' 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW ~. Be as BRIEF and CONCISE as possible, SECT[ON I: HIT[GAT[ON, PREVENT[ON, ABATENENT PROCEDUR[S SECT];ON ~; NOT[F[CAT][ON 'ANO EVACUATION PROCEDURES AT THE UNIT ONLY SECTION~3:~~~HAZARDOUS .ATERIALS FO,~R THIS UNIT ONLY ~ " B. Are a~y~f the hazardous material.s ~na fide Trade, et? YES NO If NO. coh~lete .a separate Hazardous ma~ee, rials inventory~ form marked.~NON-TRADE SECRETS ONLY (.white.form #4A-1) ~ Zf YES, complete a hazardous materials inve.i~.~ry form marke~: TRADE SECRETS O%LLY (Yellow form #4a-2) in addYt;ion to the noh~-trade secret form. Lis only the trade secrets on f°~..4A-2, BY (Fire Hydrant) SECTION 6: UTI iHUT-OI A. NATURAL )ROPANE- B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: / NO IF YES, gOCAT IF YES, SITE PLANS? YES / NO MSDSs YES / FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - CITY of BAKERSFIELD  NON--TRADE SECRETS _. CITY, NUMBER frans Ty~ ~x Average ~nual ~asu~ I ~ Cmt ~t ~t ~e L~tt~ N~e ~ ~ N~ of Ntxtu~/~ts C~e C~e Mt ~t Est Un,ts ~ Site Ty~ P~I T~ ~e Stoe~ tn Facility Nt Ph~ical and H~lth Hazard C.l.$. i Cat Il h i C.l.S. ~ IC~k all t~t aaply) .......... r--n r--~ ~t 12 MiC.A.S. ~ Health of P~sure ~lth (~k ell t~t a;ply) -- L e Hazard ~--J ~cttvlty hla~ -- RII~ ~--J i~tat. H~lth of P~su~ ~]th P~ical ~d 8Nlth Naza~ C.A.S. ~ ~t Il h S C.i.S. ~ (C~k all t~t apply) Health of PP~suee H~lth (Ch~k all t~t a~ly) ....................... [-- Hazard [ -~ R~ctivity [ [r_--'~ ~dd~ Release C~t 12 Nm ~ c.l.S. Mr Health of Pr~sure Health ....... EMERGENCY CffiTACTS I1 Cercificati~ (Read and sign after completing all sections/ . ~ : · [ certt{ of 1~ t~t ] ~ve rs~al] f i y ~der ~alty ~ y examin~ and am amiliar with t~ nfor~tiffi su~tt~ in this a~ all mttae~ dffi~ts. ~d t~t ~s~ ~ for obtaining t~ infor~tim. I ~lieve t~t t~ su~itt~ infor~ti~ is true, accurate, and c~plet,~/ ~ ~ /) SITE/FACILITY DIAGRAM FORM 5 (CHECK ONE) SITE DIAGRASI-: ~UYY~ C ~o~ ~ " CI~LI E (Inspector's Comments) -OFFICIAL USE ONLY- SiTE DIAGRAM .tems) ' 1. Address: Identify the 9. Lock (key) Box principle buildings ~.: by the Street numbers. 10. MSDS Storage Box 2. Street(s), Alleys, 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire s~reet names. b, Masonry 3. Storm Drains, Culverts, Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Oates Creeks, 13. Powerllnes 5. Buildings a. Frame construction 14. Guard Station b. Masonry construction 15. Storage Tanks: Identify the c. Hetal construction capacity in gal. a. Above ground .~:_}. Access Door b. Underground 6. Util'lty Controls a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Water 18. Evacuation Area: Identify the 7. Fire Suppression Systems: location where a. Fire Hydrants employees will ,~. meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage c. Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Water Control Valves 21. Outside Hazardous for protection systems Material ~. Use/Handling e, Fire Pump 22. Type of Hazardous ;~' ~atertal/Waste Stored 8. Fire Department Access~ or Used (See Below) TYPE OF HAZARDOUS MATERIAL F = Flammable E = Explosive L = Liquid R = Radlologlcal C = Corrosive 0 = Oxidizer G = Gas P ~ Poison ~ ~ Water Reactive T ~ Toxic S = Solid H ~ Cryogenic D = Waste B = Etiological Example: Flammable Liquid = FL FACILITY DIAGRAM (Required Items in addition to the above) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest, il. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. Materials Storage 5, Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets April 4, 1990 TO: Ninm Mmyer, Accounts ReceiVmble FROM: Ralph E. Huey, Hmzardous Materials Coordinstor SUBJECT: Security Roofing Co. Nina, account # HM 481101 should have an sddress of 3701Candlewood Drive, Bmkersfield, Cm. 93306. Thmnks April 4~ 1990 Mr. H.C. Lopez Security Roofing 3701Candlewood Dr. Bakersfield~ Ca. 93306 Mr. Lopem: You have ~ Hazardous Materials Business Plan filed with the City of Bakersfield dated May 25~ ~989 that shows an address of 721 Butte St. I believe that this address is no longer valid. Current California Law requires that you revise your business within 30 days of a move. This business plan does need to be revised and returned to this office no later than April 13~ 1990. If we can be of any assistance please do not hesitate to call. a~ardous Materials Coordinator