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Home My WebLink AboutBUSINESS PLAN 8/6/1991 BULK TRANSFER (Business) BUSINESS NAME ~;Z Iv-~- 'SITE LOCATION ~ ~O OLD OWNER N~E ~m~ NEW O~ER N~E ~~ NEW O~ER ADD. ~O ACCOST N~BERS INVOLVED APPROX. DA~ OF TRANSFER ~ - 2. P THIS INFORMATION IS TAKEN FROM THE DAILY REPORT AND SHOULD BE VERIFIED PRIOR TO ANY CHANGES. DISTRIBUTION: Sanitation Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street BakerSfield, CA. 03301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: *' 1. To avoid further action, return this form within 30 days of receipt. ~ _2 .... _T~PE/PRINT ANSWERS. IN ENGL SH. 3, Answer the questions below for the business as a whole. .. 4. Be brief and concise as possible. . -. ~ .. SEcTION~ BUSINESS IDENTIFICATION DATA DUN & BRADSTREET NUMBER: SIC CODE' PRIMARY ACTIVITY: MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS, PHONE 24 HR. PHONE FD1590 Bakersfield Fire Dept. · - Hazardous Materials Division ' HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION, $: ~, TRAINING: NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIE~ SUMMARY OF TRAINING 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. __W.E_DO.~IANDLE _HAZARDOUS MATERIAL , BU,.tH_E_ Q_'_LJ__AN_~_ITI.ES~AT. NO ...... ~.. TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION~"~ CERTIFICATION: I, ._~.~J~),~ Z. //~¢--~6~'-,~/-Xj CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTANDTHATTHISINFORMATIONWILLBEUSEDTO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS N ATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFO MATION CONSTITUTES PERJURY. ~ /. TITLE DATE 2. F~RE DEPARTMENT 2101 H STREET S. D. JOHNSON July 3 1, 19 9 1 BAKERSFIELD, 93301 FIRE CHIEF 326-3911 Ms. Brenda McClean Odorite Janitor Supply, Inc. 420 E. California Ave. Bakersfield, CA 93307 Ms. McClean: Based on our conversation today, I understand that Odorite no longer owns any chemical inventory~having sold it to Bakersfield Supply. Because Odorite Inc. still exists, for legal purposes and owns vehicles only, it will be necessary to 'file a request for exemption from hazardous materials reporting requirements. Complete sections 1, 4 and '5 of the attached form to request exemption. Ii I can be of any assistance, please call me at 326-3979. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc: Ralph Huey RECEIVED PlAY 1 1991 ,)5/0'7/91 ODORI'TE JANIf'OR SUPPLIES INC 215-000~000254 Page .1 OveFall :Site with 1 Fao, Unit A~8'~ ............ ~ne~l Information i [ Looa'ti~n 420 E CALIFORNIA AV tdap: ~03 HazaFd: i"iode~ate Ideo'b Numbe~: 215-000-000234 Grid: 32~ Area of Vul~ 0.0 r .... Contact Name Title Business Phone ~'-F 24 HOLIP Phone-' ...... s" "'~ / (805) 836-80'72 BREi',ID~ M~CLEAN (805) 5~.5-_81a x 30E ~R~VSA .' (805) 325-5815 x ~(805) Mail Addrs: '420 E CALIFORNIA AV D&B Number': 95,-312-675'4 Cl,ty: BktI<~RSFIELD Stake: CA Zip: 9550-7- Corem Code: 2i5-002 BAKERSFIELD STATZON 02 SIC Code; 5087 OwneF: ODORZTE JANITOR SUPPLY ZNC Phone;: {805) 525-5815 Addness: 420 E CALIFORNIA AV State; CA City: BAKERSFIELD Zip:; 95307- S ,J ~ m a F y 05/01/91 'ODORZT'E JANITOR SUPPLIES INC 215-000-000234 Page 2 Hazmat Inventory List in MOP Order. 02 - Fixed Colntainers on P~n-Ref Nan'le/Hazards Form Quanti ty HOP 02-006 oO oE¢OND.~ BOWL CLEAI,I 'L, iquJd -LTb- Fire,. lamed Hi'th,. Delay, Hitb~~ ........ ' ~ ..... ~ GAL 02-019 BOWL CLEAi4ER~ ,~~-~ ¢~~ Liquid ~ Extreme Fire, lamed Hlth, Delay. Hlth ~ / GAL 02-.001 CARPET MAINTAINER ,Liquid ~ ~ Extreme Fire, lamed Hlth, D~i~y Hitl] GAL 02-028 BEHOLD FURNITURE POLISH , Liquid ~ ~ High .Fire, Pcessuce, Delay Hith GAL 02-020 DRAIN OPENER Liquid 17E- ~¢. H:igh Fire', lamed Hlth, Delay Hlth GAL 02-014 HEAVY DUTY POWDERED BLEACH Solid .!,OOg~ ~¢~ Hi,~h Ia-reed Ptlth, Delay Hltiq LBS -013 HOUSEHOLD BLeacH Liquid 160 Hiqh Fire,' Immed Hlth, Delay Hlth GAL 02-026 MR IdUSCLE OVEN (;LEAN Liquid ~ ~ High ' Fire, Pressure, Immed Hlth~ Delay Hlth GAt_ 02-Q05 ODOR CONTROL F Liquid ~ ~ High lamed Hith, Delay Hlth GAL E2-,327 ODORiTE GLASS CLEANER Liquid -~ ~' High F~re, "Pressure, tamed Hlth~ Delay Hlth GAL 02-029 RENUZIT DEOD ROOM SPRAY Liquid ~OCm ~ Higl] Fire Pcessur'e Delay Hlth GAL 02-007 SAP'TY FOAM 8~WL CLEAN ~iquid E,O ~ High Flee, Z-meed H1bh, Delay Hi'th GAL 02-008 SHOWERS N STUFF BATHROOM CLEANER Liqwid' c~cu Higl] Fire, Imn'led Hlth, Delay Hlth ~ GAL 02-002 WAX STRIPPER , Liquid ~ ~¢ High Fire, Delay Hlth GAL 02-025 WINDEX GLASS' CLEANER Liquid ~d ~¢ High Fire, .immed Hl~h, Delay Hlti~ GAL. 02-021 ALL IN ONE BATHROOM CLEANER ~ Liquid 170 Hoderate Fire, Immed Hlth, Delay Htth ~ GAL 02-023 8-26 AMidONIA L~quid ,. Fi're, Immed Hltt~, Delay Hi'kln GAL 05/0"2'/91 ODOR'ITE JAi'qI]~OR SUPPLIES ih. lO 2t5-000-0002,54 Page Hazmat Inventor'y List in MOP Order 02 - Fixed Oontainers on Site Pln-Ref Name/Hazacds Fol-m Quantity i'10[~' 02-012 OLEAN GUAR~ Liquid ~ ~ ~ Moderate Fire, Immed Htth, Delay Hith GAL 02-015 HEAVY DUTY DEGRE~SER Liquid ~ ~0 Pioderate Fire, Delay Hlth G~L 0=-00, HOUSEHOLD AMiqOiqi~ Liquid ~ bO Moderata Fire, Immed Hlttn', Delay Hlth GAL 02-024 ISP'ROPYL ALOOHOL Liquid ~ b~le~e i*ioderate F~re~ Immed Hltl~, Delay Hlth GAL 02-010 id[DIOIDE Liquid ~ &O Moderate Fire~ Pressure GAL 02-022 SAND BRITE BATHROOM CLEANER' Lzquid ~ /~ Moderake Fire, Immed Hlth.) Delay Hlth GAL , 02-018 SOLVENT LAUNDRY DEGREASER Liquid ~ .~/e~W, Moderate F'ice, Delay Hlth' GAL 02-01~ SPRAY' OLEAN Liquid ~ /6~ Moderate Fire, Delay Hlkh' GAL / 02-017 SPRAY OUT SPOTTER Liquid !SO ~0 i~loderat~ Fire, Pressure, Immed Hl'tl~ D~lay Hlth 'GAL 02-011 WALL/VINYL CLEANER .Liquid ~ ~e~ Moderate _Fire. rim]ay Hlttn .... ~ GAL ].02-003 'WET FLOOR 23 Lzqu/d ~ ~ Moder~ ~mmed HZ~h~ ~eZay HI.~I~ ~AL 02-004 UNDERCOAT ~EAL_R Liquid ".~ ~ cow h ~ re GAL 05/07/91 ODoRITE JANITOR SUPPLIES !h!O 215-000-000254 Page O0 - Overall Site <D> i4otif. ,/Evacuation/i~edioai <1> Agency Noti'f'ioation OALL 9i I <2> Employee i',.Io'gi~./Evaouatior~ EVACOATION ROU~ -IE'o-": FRONT DOOR, SIDE DOOR,, REAR DOOR~, AND VERBAL NOTIFICATION AND CALL 911 <5> Public No'ti~P./Evaouation NOTIFY FIRE DESAR"EMEI',IT IF FIRE OR EXTREME LARGE SPILL. EITHER MYSEL~~ OR EMPLOYEE WOULD BE SENT TO NEIGHBORING BUILDING OF TOXIC SPILL, FIRE, ANY DANGER '1"0 HEALTH OR SAFETY 'TO NEIGHBORING BUILDING, IF IT WERE WORSE 'THE FIRE DEAPRTidENT WOULD HAVE ISSUED THE ENI'IRE AREA 'FO BE EVACUATED. '<4> Emerq!enoy Medical Plan LOCAL HOSPITAL OR C¢'~LL 05/.0'7/'91 ODORI]~E JANITOR SUPPLIES INC {~15.-000-0002154 Page 5 O0 -Overaii Site <E> ~iti~ation/Prevent/Abatemt <1> Release Preven'tion HAVE QUICK SORB FOR SPILL PICK-UP AL.L PRJDU(.,],:~ PACKAGED FOR r.. .... <I> Relea,:~ O'ontainrnent <3> Olean Up AS FAR AS 'THE DISPOSAL OF-' ~-~BidORBA, i t4ATERIAL I WOULD ASK "i"F.tE FiRE DEPAR'Fi~iENT OR THE HEALTH DEAPRTI':iENT OR THE HAZARDOUS I','iATERIALS DEPARTI"iENT FOR ADVISE OF DISPOS'ITIOlxl; iF THE SP'ILL WERE OF: A "TOXIC I~iATERIAL THE ABOVE DEPAR'T'NENTS WOULD BE THE ONLY PEOPLE Z WOULD KNOW TO OONTACT. <4> Other Resource AotiQation 05/0'7/91 ODORITE JANITOR 'SUPPLIES INC 215-000-000254 PAge ~ O0 - Over'all Site <F> Site ~me~genoy Faotor-s <1> op~wlal Hazards <.2. Utility Shut-Offs ~} G~S- NORTHNFIS'T (.BAOK) OORNFIR OUTSIDFI B} ELECTRICal - NORTH~4EST CORNER INSIDE O.) N~TER - SOUTHNEST CORNER OUTSIDE D) SPECIAL -. NONE E.) LOCK BOX - NO <3> Fire Proteo./Avail. {4a'ter PRIVAITE FIRE PROTECTION - FIRE EXFItqGUI~Hb_R~ FIRE HYDRANT - FiAS"F SIT2FI' Ui",!ION ¢aVE <4> Held for Future use 05/0'7/91- ODORITE JANITOR SUPPLIES iNO 215-000-0002;54 ,r0a,~e '7 O0 - OveFali Site <G> Trainin9 < 1 > Page 1 AlE H~,VE 4 EMPLOYEES AT THIS FACILITY WE HAVE id{:~TERIAL SAFETY DATA SHEETS ON FILE EMPLOYEES THAT ARE PUTTING MERCHANDISE AWAY O'R DELtVER'ING MERCHANDISE OF THE HAZARDS ARE-TOLD' OF THE HAZARD SIGNS THAT ARE ON THE CASES AND THEY ARE TD BE STORED UPRIGHT THE EMPLOYEES DO NOT WORK.WI'TH 'f'HE CHEidZCALS FOR RE~SONS OTHER THAN DELIVERY TO END-USER CUSTOidERS AND TO PUT IN STORAGE. bHEY ARE iNSTRUCTED blOT TO STAOK HIGH DUE "FO BREAKING DOWN OF C&tsES,, ALL CASES ARE FROid idANUFACTOR DIRECT IN SAFE CASES.. BUT AlE DO NOT OVERSTACK THESE ITEM.'3 FOR OUR OAIN SAFETY. THE DELIVERY PERSON HAS BEEN INSTRUCTED FOR STORAGE AND SALES PERSONEL ARE AAlARE OF IdSDS REPORTS ON FILE AND DO I<NOAI HOFJ TO READ THEM. Page 2 as needed <3> Held for Future Use <4> Held for' Future Use "WE CARE" FIRE DEPARTMENT 2101 H STREET D. S. NEEDHAM ?,; U. x'~, L~() · BAKERSFIELD, 93301 FIRE CHIEF 326-3911 Dear Business Owner: The enclosed "Acutely Hazardous Materials Registration Form" must be completed by any business, handling above the minimum reporting quantity of any material on the EPA list of extremely hazardous substances. (Federal Register Volume 52, No. 77, P. 13397). Your company has reported handling the following acutely hazardous material: Sulfuric Acid Please return the completed Acutely Hazardous Materials Registration Form to: Hazardous Materials Division 2130 G Street Bakersfield, CA 93301 If you have any questions regarding this form please call Barbara Brenner at 326-3979. Sincerely, Barbara Brenner Hazardous Materials Planning Technician BB/ed Encl. Bakersfield Fire Dept. CHECK LIST 2. A.H.M. RECEIVED 3. R.M.r.P. REQUESTED 4. R.M. P. P..REVIEWED 5. R.MoP.P. APPROVED 6. R.M.P.P. INSPECTION COMMENTS: BUSINESS NAME I. DNUMBER FIRE DEPARTMENT May ?, 1991 2101 H STREET D. S. NEEDHAM BAKERSFIELD. 93301 FIRE CHIEF 326,3911. _ ..,~. Ms. Brenda McClean Odorite Janitor Supply Inc. 420 £. California Ave. Bakersfield, CA 93307 Ms~ McClean, Thank you for promptly completing and returning the Acutely' Hazardous Materials(AHM) Registration form. The quantities .of materials which you reported on the AHM .registration reflect reductions in the amounts of materials stored. It is important that you update your hazardous materials management plan sc that it is accurate. £nclosed is a copy of Odcrite's current plan. It has been two years since any revisions have been made. Please mark any changes in the text on the printout. Use the enclosed ~inventory form to make changes, additions and deletions in the hazardous materials pounds (solid) or 200 cubic~ feet {gas) must be reported. Be sure to properly delete any materials whose quantities have been reduced so that they never exceed the reporting quantities. If several products have similar chemical composition but individually do not exceed the reporting quant£ty they should be grouped together. An example of this generic reporting follows. 60 Seconds Cleaner - 10% Hydrofluoric Acid - 25 6al Bowl Cleaner - 2% Hydrofluoric Acid - 40 Gal Report 'these together as Bowl Cleane~ -' 2-10% Hydrofluoric Acid - 65 Gal -. Similarly report other products which share primary ingredients but which indiVidually are less than 55 gal, 500 lbs or 200 cubic feet. If you have any questions or need assistance with this inventory revision, please call me at 326-39?9. The revised plan is due June 7, 1991. Sincerely, Barbara Brenner cc: Ralph Huey May :~ 1990 Dear Business Manager: The following questionnaire is a suppler~ent to the Acutely Hazardous Materials Registration Forr~l previously subr,~itted by your business as required under Sect ior~ 25534 of the California Health & Safety Code. This registration indicates t~~t~e_J~a~,~~~les drain ~~ ~~a~/~, an acutely hazardous ~aterial ( AHM ), in an a~ount greater than the planning quantity for this che~ical. Additional information is necessary in order to co~plete the risk ~anage~er~t plar~ning fur~ctions of this agency. This questionnaire should be co~pleted by ar~ officer of the co~pany or other person having substantial ~anagement control over all operations at the facility. If there is any doubt as to whether c,r not the answer to a question is yes or no, the answer "yes" shall be given. With in two weeks of receipt, co~plete and return the questionnaire to: The Bakersfield Fire Depart~ent Hazardous Materials Division ~130 G Street Bakersfield~ CA 9~01 If you r~eed additional infor~ation, please call G26-G979. Sincerely, Barbara Bret, her Hazardous Materials Plar, nir, g Techniciar, ACUTELY !ARDOUS MATERIALS REgiSTRATION FORM THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERATOR OF EACH BUSINESS IN CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACLrrELY HAZARDOUS MATERIAL IN QU ,ANTITIES GREATER THAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT STP. I THIS FORM SHALL BE COMPLETED AND SUBMTFI~D TO YOUR LOCAL ADMINISTERING AGENCY. (§25533 & 25536 Health & Safety Code) Note Instructions on revers~ Business Mailing Address (if different) Business Phone ~:,~,~-'--;~"-~o¢ OIp Business Plan Submission Date2 Process Designation3 ACUTELY HAZARDOUS MATERIALS HANDLED4 -USE ADDITIONAL PAGES IF NECESSARY- CHEMICAL NAME OUANTITY GENERAL DESCRIPTION OF PROCESSES AND PRINCIPAL EQUIPMENTS: California Office of Emergency Services FORM HM 3777 (1-15-88) INSTRUCTIONS: Superscripts: 1. Quantities for RMPP compliance are "equal to or greater than" the minimum criteria and apply to chemicals handled "at any one time". 2. Businesses handling reportable quantifies of Acutely Hazardous Materials that have not submitted a business plan MUST ~6nh~Ct ~ Admhiis~4ng Agencies. The business plan submissi°n date will aSsure the Administering Agency that a business plan has been submitted and is on file. This will also immediately identify businesses that have not submitted business plans. 3. "Process Designation" is provided as a reporting option (with the approval of the Administering Agency) for facilities that can most easily report by process. Thus, facility RMPP registration data could be submitted in a similar format to a business plan that is divided by process. "By process" dam can initiate an emergency response to a process incident rather than a general emergency response to a major facility. Process designation can simplify inspections for major facilities and improve future emergency response. 4. Refer to the EPA list of Extremely Hazardous Substances from the Federal Register (Volume 52, No. 77, p. 13397 et. se.o_.. April 22, 1987). Each chemical has a threshold planning quantity. This list may be changed by EPA on an annual basis. Up,~_a_!es of this list may be available early in 1988. To comply wis this element, you may attach a copy of the inventory submitted to your Administering Agency from your business plan and highlight all Acutely Hazardous Materials. It is recommended that facilities list all extremely haTardous chemicals handled in quantifies equal to or in excess of 1) 500 pounds, and 2) any EPA threshold planning quantity less than 500 pounds. 5. Do not include Trade Secret information in these descriptions. General: For emergency response purposes, it would be desirable to describe the following to the Administering Agency: 1. Batch Process: a. What.raw mauxials? b. What operating lxessure range? c. What operating tempemure range? d. Batch capacity rating? e. Product characteristics? (e.g., chemical state, flammability, toxicity, etc.) f. Critical process points and characteristics? 2. Continuous process: ( 'similm information as above.) NOTEt "Pursuant to §25534, Ibe Administering Agency may require the submission of a Risk Management Prevention Program (RMPP), if the Aflminislm~ Agency determines that the handler's operation may present an acutely hazardous materials accident risk. The handler shall prepare the RMPP in accordance with subdivision (c) [of §25534]. The RMPP shall be prepared within 12 months following the request made by the Administea'ing Agency pursuant to this section." (§ 25534 (a) Heath and Safety Code) An amendment to the RMPP must be submiUed to the Adminis~g Agency within 30 days of: 1. Any additional handling of acutely hazardous materials. 2. Any material or substantial alterations to business activities. 3. Change of address, business ownership, or business name. (§ 25533 (c) Health & Safety Code) · EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP · California Office of Emergency Sewices FORM HM 3777 (1-15-88) x... ~ / 'WE CARE" April 19, 1991 FIRE DEPARTMENT 2101 H STREET D. S, NEEDHAM BAKERSFIELD, 93301 FIRE CHIEF 326-3911 . . Ms. Brenda McClean Odorite Janitorial Service 420 E. California Ave. Bakersfield, ~CA 93307 Dear Ms. McClean, The enclosed "Acutely HazardoU~ Materials Registration Form" must be completed by any business, handling above the minimum reporting quantity of any material on the EPA list of Extremely Hazardous Substances. (Fed. Register Vol. 52~ No 77, P. 13397). Your company has reported handling the following Acutely Hazardous Materials: 110 GAL, 6% FORMALDEHYDE - ODOR CONTROL F 175 GAL~ 10% HYDROFLUORIC ACID - 60 SECONDS BOWL CLEAN 170 GA'L, 2% SULFURIC ACID - SAFETY FOAM BOWL CLEAN & SHOWERS N STUFF BATH CLEANER' 175 GAL, 2% HYDROFLOURIC ACID - BOWL CLEANER 175 GAL~ 50% SULFURIC~ACID - DRAIN OPENER List these material on the green form in the same manner that they are listed above. You have spoken with me in the past regarding the need to ~update your inventory due to reductions in quantities of materials stored. I am sending you another inventory form to use to update your hazardous materials inventory. It is important~that you accurately report these materials in order to avoid confusion and additional reporting requirements. The attached Facility Risk Index must also be completed. Please return the completed Acutely Hazardous Materials Registration Form, Facility Risk Index and Haz Mat inventory by May 24, 1991 to: Bakersfield City Fire Department Hazardous Materials Division 2130 G Street Bakersfield, Ca. 93301 The Facility Risk Index is designed to distinguish those facilities that use acutely hazardous materials in chemical processes from those who are involved in limited processes or storage. If you have any questions, please call Barbara Brenner at 326-3979. Sincerely Yours, Barbara Brenner Hazardous Material Planning Tech~nician ~\~. ~'- 'i;~ ACUTELY HAZARDOUS MATERIALS REGISTRATION RISKMANAGEMENT AND PREVENTION PROGRAM CHECK LIST 3. R.M.P.P. REQUESTED 4. R.M.P.P. REVIEWED 5. R.M.P.P. APPROVED 6. R.M.P.P. INSPECTION COMMENTS: BUSINESS NAME I. DNUMBER Plaea~se ,'.a.~,e ~:tne er',ci,:ssed '?oma- of' dr'a'i:n open<sl~ (S~ '}>; ~suJfur'ic ,sc$~s) pr"oduc'~ ~q"~:Lch you {,he dr'aLn opener' e.t. any Lisa ~ho inw~n'~or-y f:onm ~:o dele'[',c ~hl~, :]r'oduei: ~:pom your" rOep an ~ r,~a~"~'t: .i.n~pec ~ or'~ ~i :L l j. nspecl: your' 'F~c :~. i i. ~ y P].e~.~e cc~mp].c~'~,e and r'etur"n '~:,i'"~i~ kr'lven~'.or"y for'm .F-J s r' b ~s r' ,!:.~ FJ r'e rme;r' Bakersfield Fire l t. Hazardous Materials Inspection Date Completed Bus~e~ N~e: ~ORI~ ~ ~o ~ Location: ~ ~0 f, C ~kl ~. Plan ID · 215-000 ~ (Top right comer Business Plan) Station No. ~ S~fi ~ Inspector Adequate Inadequate Verification of Inventory Materials ~' [~] Verification of Quantities Verification of Location ~ ~fl~roper/Segregation of Material [~ [--] Verification of MSDS Availability [] [] Number of Employees Verification of Haz Mat Training Verification of Abatement Supplies & Procedures [~ [~ COmln~lT,: Emergency Procedures Posted [~ [-~ Containers Properly Labeled Comments' Verification of Facilivy Diagram Spec4a~~ed with this Facility: Violations: NO.P_ . FD t652 (Roy. 3-80) White-Haz Mat Div. Yellow-Station CoDy Pink-Business Office ~OUTELY HAZAROOUS MATERIALS REGISTRATION AND RISK M~NAGEMENT AND PREVENTION PROGR6M GHEOK LIST 2, A.H.M, RECEIUEO ..5~ q'~l ~. RoM.~,P. REQUESTEO ...... 4, R.M.P,'P. REVtEWEO 5. R.M.P,P, APPROVEO 6, R.M,P.P, INSPECTION COMMENTS: FIRE DEPARTMENT 2101 H STREET O. S. NEEDHAM BAKERSFIELD, 93301 FIRE CHIEF 326-39'i 1 April 12, 1989 Odorite Janitor Supplies Inc. 420 E. California Ave. Bakersfield, Ca. 93307 Dear Business Owner: The enclosed "Acutely Hazardous Materials Registration Form" must be completed by any business, handling above the minimum reporting quantity' of any material on the EPA~list of Extremely Hazardous Substances. (Fed. Register Vol. 62, No 77, P. 13397). Your company has reported handling the following Acutely Hazardous Materials: SULFURIC ACID (Drain Opener) Please return the completed Acutely Hazardous Materials Registration Form to: Bakersfield City Fire Department Hazardous Materials Division 2130 G STreet Bakersfield, Ca. 93301 If you have any questions regarding this form please call Duane Meadows or Ralph Huey at 326-3979. Sincerely Yours, Hazardous Material Planning Technician DJM/ed AHMREG.FOR (t3~e ~r ~r~n~ name) RECEIVED Do ~ereb: eertif3' that I have revie~ced the j~ attached Hazardous Haterialg business clan RECEIVED (name of business) HAT..~AAT. DIV' RECEiVeD ~PR 0 5 1989( or corrections constitute a complete and cor~.~AT.O~, Business Plan ~lity. BOSINESS~NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCA~ION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 1 . OVI~i:~V I EW LAST CHANGE 11/17/88 BY VAL JURIS CODE 215-002 JURIS BAKERSFIELD STATION 02 MAP PAGE 103 GRID 32A FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS 2A SEC 2) BRENDA MCCLEAN - 325-5813 OR 836-8072 UTILITY SHUTOFFS 2A SEC 3) - A) GAS - NONE B) ELECTRICAL - NW CORNER INSIDE C) WATER - SW CORNER OUTSIDE D) SPECIAL - NONE E) LOCK BOX - NO NOTIFICATION / PUBLIC E VACUAT I ()1'~? < NO INFORMATION RECORDED FOR THIS SECTION > ', PAGE 1 12/14/88 10:02 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BOSINESS-~NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOC&TION ~' 420 E CALIFORNIA AV HIGH HAZARD RATING 3 BAST GHANGE 11/17/88 BY VAB PAGE 2 12/14/88 10:02 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 FACILITY UNIT O1 A . OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 11/17/88 BY VAL ID TYPE NAME MAX AMT UNIT HAZARD ~ LOCATION CONTAINMENT USE 2 MIXTURE' CARPET MAINTAINER 100 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 3 MIXTURE MOP ON STRIPPER 100 GAL HIGH SE CORNER SIDE PLASTIC CONTAINER[S] STRIPPER ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0~ 2-BUTOXYETHANOL MODERATE 1560.00 6.0 SODIUM HYDROXIDE, SOLUTION HIGH 1103.00 5.0 ETHANOLAMINE HIGH 4 MIXTURE HEAVY DUTY STRIPPER 100 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] STRIPPER ID PERCENT COMPONENTS HAZARD LISTS 5 MIXTURE UNDERCOAT SEALER 100 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] SEALER ID PERCENT COMPONENTS HAZARD LISTS 2802.00 3.0 ETHYLENE GLYCOL UNKNOWN 6 MIXTURE PINE ODOR CLEANER 300 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 7 MIXTURE 60 SECONDS BOWL CLEAN 50 GAL EXTREME SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1030.00 10.0 HYDROFLUORIC ACID EXTREME EPA 1078.00 2.0 HYDROCHLORIC ACID HIGH 8 MIXTURE SAFTY FOAM BOWL CLEAN 50 GAL HIGH SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1220.00 8.0 PHOSPHORIC ACID HIGH 1078.00 7.0 HYDROCHLORIC ACID HIGH 2158.00 3.0 OXALIC ACID MODERATE 1076.00 2.0 SULFURIC ACID (EPA) HIGH EPA 9 MIXTURE SHOWERS N STUFF BATHROOM CLEANER 50 GAL HIGH SE CORNER SIDE PLASTIC CONTAINER[SI CLEANING ID PERCENT COMPONENTS HAZARD LISTS PAGE 3 12/14/88 10:02 - .. MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS~,NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 FACILITY UNIT O1 A . OVERALL H.~ZARDOUS MATERIALS IN~rENTORY ( * CONTINUED * ) LAST CHANGE 11/17/88 BY VAL ID TYPE NAME , MAX ANT UNIT HAZARD LOCATION CONTAINMENT USE 9 MIXTURE SHOWERS N STUFF BATHROOM CLEANER 50 GAL HIGH ( * CONTINUED * ) ID PERCENT COMPONENTS HAZARD LISTS 1220.00 6.0 PHOSPHORIC ACID HIGH 1076.00 2.0 SULFURIC ACID (EPA) HIGH EPA 10 -- MIXTURE HOUSEHOLD AMMONIA 600 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1024.00 5.0 AMMONIA (EPA) MODERATE EPA 11 MIXTURE DEFOAMER 100 GAL UNKNOWN ~ SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 12 MIXTURE FOLEX SPOTTER 100 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 13 MIXTURE WALL CLEANER 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 14 ~ MIXTURE VINYL AND UPHOLSTERY CLEANER 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 15 MIXTURE CLEAN GUARD 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING .ID PERCENT COMPONENTS HAZARD LISTS 1852.00 8.0 2-BUTOXYETHANOL MODERATE 16 PURE HOUSEHOLD BLEACH 600 GAL HIGH SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1165.00 12.0 SODIUM HYPOCHLORITE UNKNOWN 1560.00 8.0 SODIUM HYDROXIDE, SOLUTION HIGH PAGE 4 12/14/88 10:02 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 FACILITY UNIT 01 A . OVERALL HAZARDOUS MATERIALS INVENTORY ( . CONTINUED ~ ) LAST CHANGE 11/17/88 BY VAL ID TYPE NAME MAX ANT UNIT HAZARD LOCATION CONTAINMENT USE 17 MIXTURE HEAVY DUTY POWDERED BLEACH 1000 LBS UNKNOWN SE CORNER SIDE BOX[ES] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1165.00 70.0 SODIUM HYPOCHLORITE UNKNOWN 18 MIXTUR~ KNOTAC CARBURATOR CLEANER 100 GAL HIGH SE CORNER SIDE METAL CONTAINERS CLEANING ID PERCENT COMPONENTS HAZARD LISTS 2234.00 75.0 METHYLENE CHLORIDE MODERATE 1061.00 10.0 CRESOL, MIXED HIGH 1118.00 10.0 XYLENE, MIXED HIGH 19 - MIXTURE.HEAVY DUTY DEGREASER 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 20 MIXTURE SPRAY CLEAN 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 21 MIXTURE SPRAY OUT SPOTTER 100 GAL MODERATE SE CORNER PLASTIC CONTAINER[S] CLEANING ID PERCENT'COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 22 MIXTURE SOLVENT LAUNDRY DEGREASER 50 GAL HIGH SE CORNER SIDE METAL CONTAINERS CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1446.04 100.0 * * NAME NOT FOUND IN MSDS DICTIONARY * * 23 MIXTURE BOWL CLEANER 100 GAL EXTREME SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1220.00 8.0 PHOSPHORIC ACID HIGH 1078.00 3.0 HYDROCHLORIC ACID HIGH 1030.00 2.0 HYDROFLUORIC ACID EXTREME EPA 24 - MIXTURE DRAIN OPENER 100 GAL HIGH SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS PAGE 5 12/14/88 10:02 , MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS.NAME ODORITE JANITOR SUPPLIES INC .ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 FACILITY UNIT 01 A . OVERALL HAZARDOUS MATERIALS INVENTORY ( . CONTINUED * ) LAST CHANGE 11/17/88 BY VAL ID TYPE NAME MAX ANT UNIT HAZARD LOCATION CONTAINMENT USE 24 . MIXTURE DRAIN OPENER 100 GAL HIGH ( * CONTINUED * ) ID PERCENT COMPONENTS HAZARD LISTS 1076.00 50.0 SULFURIC ACID (EPA) HIGH EPA 25 MIXTURE ALL-IN ONE 100 GAL MODERATE SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1852.00 6.0 2-BUTOXYETHANOL MODERATE 26 MIXTURE SAND BRITE BATHROOM CLEANER 50 GAL UNKNOWN SE CORNER SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 27 MIXTURE B-26. AMMONIA 55 GAL MODERATE N WALL DRUMS OR BARR NON MET. CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1024.00 30.0 AMMONIA (EPAI MODERATE EPA 28 PURE ISPROPYL ALCOHOL 55 GAL HIGH N WALL DRUMS OR BARR NON MET. CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1160.00 100.0 ISOPROPANOL HIGH 29 MIXTURE WINDEX GLASS CLEANER 75 GAL EXTREME NE ROOM SIDE PORTABLE PRESS. CYL. AEROSOL ID PERCENT COMPONENTS HAZARD LISTS 1852.00 10.0 2-BUTOXYETHANOL MODERATE 1160.00 10.0 ISOPROPANOL HIGH 1047.00 3.0 ISOBUTANOL HIGH 1155.02. 3.0 PROPANE EXTREME 30 MIXTURE MR MUSCLE OVEN CLEAN 75 GAL EXTREME NE ROOM SIDE PORTABLE PRESS. CYL. AEROSOL ID PERCENT COMPONENTS HAZARD LISTS 1560.00 10.0 SODIUM HYDROXIDE, SOLUTION HIGH 2066.00 10.0 ISOBUTANE EXTREME 1103.00 10.0 ETHANOLAMINE HIGH 31 MIXTURE RENUZIT AIR FRESHNER 20 GAL HIGH NE SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS PAGE 6 12/14/88 10:02 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 FACILITY UNIT 01 A . OVERALL HAZARDOUS MATERIALS INVENTORY ( * CONTINUED * ) LAST CHANGE 11/17/88 BY VAL ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 31 MIXTURE RENUZIT AIR FRESHNER 20 GAL HIGH ( * CONTINUED * ) ID PERCENT COMPONENTS HAZARD LISTS 1218.00 30.0 ETHYL ALCOHOL 'HIGH 32 MIXTURE WINDEX GLASS CLEANER 50'GAL HIGH NE SIDE PLASTIC CONTAINER[S] CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1160.00 30.0 ISOPROPANOL HIGH 1852.00 8.0 2-BUTOXYETHANOL MODERATE 33 MIXTURE BEHOLD FURNITURE POLISH 75 GAL EXTREME NE ROOM SIDE PORTABLE PRESS. CYL. AEROSOL ID PERCENT COMPONENTS HAZARD LISTS 1203.00 3.0 NAPHTHA EXTREME 1155.02 2.0 PROPANE EXTREME 34 MIXTURE RENUZIT DEOD ROOM SPRAY 93 GAL EXTREME NE ROOM SIDE PORTABLE PRESS. CYL. AEROSOL ID PERCENT COMPONENTS HAZARD LISTS 1155.02 3.0 PROPANE EXTREME 2066.00 2.0 ISOBUTANE EXTREME PAGE 7 12/14/88 10:02 " MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS'NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION " 420 E CALIFORNIA AV HIGH HAZARD RATING 3 B . FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 11/17/88 BY VAL 3A SEC 5) FIRE HYDRANT - EAST SIDE UNION AVE D . E~4PLOYEE NOTIFICATION / EVACUATION LAST CHANGE 11/17/88 BY VAL 3A SEC 2) EVACUATION ROUTES: FRONT DOOR SIDE DOOR REAR DOOR VERBAL NOTIFICATION AND CALL 911 PAGE 8 12/14/88 10:02 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ODORITE JANITOR SUPPLIES INC ID NUMBER 215-000-000234 LOCATION 420 E CALIFORNIA AV HIGH HAZARD RATING 3 E . M I T I GAT I ON /2PB'-EVEN~T I ON / LAST--'cHANGE'-11'/'17-/88 BY VAL 3A SEC 1) HAVE QUICK SORB FOR SPILL PICK-UP ALL PRODUCTS PACKAGED FOR RESALE PAGE 9 12/14/88 10:02 ~" ~. MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 CITY of BAKERSFIELD '~___~ .~HAZARDOUS MATERI AL~; I NVENT.ORY' Far~, end Aq~icu}ture Standard Code Code Art I~t Est Units ~ Site ly~ Press l~p C~e .. Stored in Fa~ Nt See Instru~ Physicalc~fi end Health Hazard ~ C.A.S.' Nua~r C~nent II Na~ & C.l.5. Nunbe. m Physical And Health Hazard ' · C.A.S. Numar ~t 11 la~ & C.A.~: Numar ._~ ~ ~ .... Health of Pressure Health ~Fine Hazard k--o Reactivity ~_a OolayeO ~dd. Rel.se u--J I~tate /~0, O0 Health of ~relsure Health - . ..... Certification (Read and slRn after completing a11 sections) . ~ certJ~V under p~alty of law that I have. 0erspnally examined end am f~e{ltar' ~tth t~ {nfO~~tlt~ $n th{~ a~ ~!]~ d~u~t~,~t ba~ed ~ mV inquiry of t~e lnd{vidual~ resp~ib}e CITY of BAKERSFIELD '7___~ ~. ~AZARDOUS MATERI Ar-~I I NVENT.O RY' Farm and Agriculture Standard Business i Trans lyoe Max Average Annual Measure I ~s C~t C~t C~t Use L~ati~ Where % by Na~s of Nixture/C~ts Code Code let let Est Units m Site Ty~ Press l~p C~e .. Stored In Facility Wt See Instructi~s u--J Fire Hazard u--~ Reactivity u~ley~ u--d ~dd~ Release Hca 1th of Prll~url H~lth ........................................................ C~p~t I1 Name & ~,4.S. Number u--J Fire Hazard Reactiv{ty lay~ u--~ ~dd~ Release u--J la. late ....... · Health · of ~n~ure H~lth [ ~ Fire Hazard [ ~ Reactivity [ ~dd~ Release u--J {~tatg . of Pr~sure Health Ca,et 13 NaN I C.l.S. Numar I Physical and Health Hazard C.A.S. Numar C~t II NaN & C.A.5. Numar L __~ Fire Hazard ~--J Reactivity ~ hL-u ~dd~ Release I~tate ................... ~ ............................................ ; .... of Pressure Health ~ERGEHCY COHTACT5 I1 ;~tff~catien (Read and s~n after compJetJn~ a]] sections) certtfy under p~elty of law that I have personally examined end am famtltar vtth t~ tnfo~hitt~ In t~il ~ I~ I~C~ d~um~ts, and~t ~sed ~ W inquiry of t~se tndlvtduals resp~sible C e *", C~ ' ~t - .Amt. Est ..-Units- ~.~t*e ..-T~ . ~ · Health.. of Pr~e With :l,~ i ~--.:. i:~ ~:~. 1. re. '~k I ~~ · ,,.,................. ,, ,,.,,,:'-:,,,.,,-~ ................ .. ...... : .... =---;:,.,:-~.- ... ,.: ~.~ ,,_,,-,~.,.,... ~ :~ ~_:~:~~'-~.:.' -. _~- ....... · t~il ~ ,~--. · " ' - ~ ~,- ~ ..... ' ' ' .. ...... . . . - . . .. -~.-... ,.. , -,. ~ . '. . . - ;'-,~.','~. ~. ,.", .- .,,. ,., . ~ :...'.~". ,. . . ,.. , >. : . (C~k all--t~t a~tyi. '. .'. ':, .... L'-::. . .-::.~,'1--./?:::- ': '. -. '- . ,:'- . -,: . .......... : ........ . .......... . ........ ~ ".- B~iERSFIELD CITY FIRE DEPARTME~FF · ' '~ 2130 "G" STREET ~ BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATE Ri ALS BUSINESS PLAN AS A WHOL~ FORM ~ 1. To avoid further action, return th~s foum b7 '' 2. TYPE/PRINT ANSWERS IN E);GLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSI~SS IDE~IFICATION DATA SECTION 2: EMERGENCY NOTIFICATIONS In case of an emeryency involvinM the release or threatened release of a hazardous material, call 911 and 1-800-8S2-7580 or 1-918-427-4341. This will notify your local fire department and the State 0ffice of Emeryency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: A.NAM-~'~f~_ AND TITLEt~ ~C ~ ~ ~~ P he ~--~/~DDR ING BUS. HRS. PhC AFTERF ~BUS'-- ~HRS'7 SECTION 3: LOCATION OF LTT.,.LITi SH~u%-OFFS FOR BUSINESS .iS A A. NAT. GAS/PROPA~[: ' ~/'"'"A ' B. ELECTRICAL: ~¢~¢~ /~C%~ ~4~,~ D. SPECIAL: E. 5OC~ BOX: YES ,/~ IF YES, LOCATION: IF YES DOES IT COXTA[X SITE PLANS? YES / x'0 ZSDSS? TES ../ FLOOR PLANS? YES ,/ NO , - o KEVS. YES / - 2A - SECTION 4: PRIVATE RESPONSE TE.~ FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YO%~ BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING aA?~O~a~S ARE REQUIRED TO HAVE A ?ROGRA}I WHICH PROVIDES EMPLOYEES WITH i)~ITIAL AXD REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO iNITiAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS >~TERIALS: ....................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES .~ WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. - YES NO YES NO E, DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO SECTION 7: HAZARDOUS ~MATERIAL CIRCLE YES - NO - NONE ' ~ IN QUANTITIES LESS THAN 500 ~ '~' DOES YOUR BUSINESS HANDLE HAZARDOUS AA~RIAL ~0E.,DS OF A SOLID, U5 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO I, , certify that the above information is accurate. I understand that this information wi!l be used to fulfill my ~irm s obtisat!ons under the new California Health and Safety code on Hazardous Zaterials (Div. 20 Chapter Sec. 2SS00 Et Al.) and that inaccurate information constitutes perjury. 'SIGNATURE TITLE DATE - 2B - ,/" '~~ " BAKERSFIELD CITY FIRE DEPARTNENT 2130 "G" S~EET /' B~RSFIELD, CA 9330~ / (805) 326-3979 OFFICIAL USE ONLY HAZARDOUS MATERI ALS BUSINESS PLAN AS A WHOLE FORM 2A INS~CTIONS~~ ~ 1. To avold ~uether actlon, ~etuen th~s foe~ b~ 3. Ah~er the questlons belo~ fo~ the buslness as a 4. Be~brie~ and conclse as possible. SECTIO~ 1: I~$S IDE~I~IC~TIO~ B. LOCATION / ADDRESS: /0~- I ~ ~ ~ ~:i/¢ITY ~Rg~ ~ ZIP: BUS.PHONE: SECTIO~ 2: E~RGE~C~ ~OTI~I In case of an emergenc~ the eelease oe threatened release of a hazardous ~aterial, call 011 and or 1-010-427-4341. This ~ill no~if~ ~our local fire depart~ent'and ate Office of Emergenc~ Services as la~. E~PLOYEES TO ~OTIFY I~ C~ OF NA~E AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF ~ILI~~-OFFS FOR BU S A ~OLE C. WATER: O_u~~l'v~ ~~ ~ ~~ D. SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO ~SDSS? YES / NO FLOOR PLANS~ YES / NO KEYS9 YES / NO 2A - 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 PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A,. METHODS FOR SAFE HANDLING OF HAZARDOUS ,MATERIALS ' Y~ N0 ~ N0 B. PROCEDURES FOR COORDINATING ACTIVITIES , ., · WITH RESPONSE AGENCIES: .............. ~...././~ YES NO YES NO C. PROPER USE OF SAFETY EQUIPMENT.:.. ................ --'~ ~ N0 y~s NO D. EMERGENCY EVACUATION PROCEDURES ~ N~ E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES SECTION ?: RAZ~aRDOUS ~4ATERIAL CIRCLE YES OR NO DOES YOUR .BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A-COMPRESSED GAS: ...... ~ NO I, ~'(~;'P;O~ ~7~,/~¢~c~/~;/~/ ~",~ , 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 (Div. 20 Chapter 6.95 Sec. 28500 Et Al.) and that inaccurate information constitutes perjury. - 2B - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUSINESS 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. 3. Ans~er the questions belolw for THE FACIL.?TY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# / FACILITY UNIT N~ME:~/~ SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS U?~IT ONLY ;ECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... YES NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YE~ NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes,""complete a hazardous materials inventory for~ marked: TRADE SECRETS'ONLY (yellow form ~4A-2) in addition to the non-trade " secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION ~' SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RE,PONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY.--- A~ NAT. G~$./PROPANE~ B. ELECTRICAL: 'E. LOCK BOX: YES /<~ LF YES-~- LOCATION: .............. IF YES, SITE PLANS? YES / NO MSD.q.s? 5'ES / ~0 FLOOR PLANS? YES / NO KEYS? YES ," ¥0 ' · BAKERSFIELD CITY FIRE DEPARTMEN _ ,,/ °~ - f':%l,~ i=,:;,.. :..~'::...>::::/ ::,,!::'~ ;'..:~,~.~..!:.'.: .-'-: . ....' ,,-,~,u ,~^ .~ ' page · ' ~ ~ ~ I ?-.;- ~. ':::'.,'(~ ;i.L.: ~ ;;.~",~. '.-%'~:;~':--~ ?-'---::' ,~: ..... ' ~o~o~/o~ ~ ..... "":, .?.7 :.':b, :,.,::-., . ,.~:~..~¢~ :.. ,. · GODE A~OUNT A~OONT FAGI~ITY O~IT ~ - ~ ~ : :-~: :"::':.~ , '- I~ I ~z ~'~ ~r~; ~ ~ ': "' ':: .......... "" .~ ~~. " ' .-. " :. ....~ .: ...:,.. -...¥?...~,.,. ... :.:: . .. , .. . .... :~.~.: - ~... j: ~ '. ...,..: . .,,~.-,.'~- ' . E~ERGENCY CONTACT: ~ou~~~ :6 TITLE: PHONE ~ [ [OURS: ~:~ j:~.:: . EMERGENCY CONTACT: ~ ~[~O TITLE: ~~ PHONE { BUS HOURS: '~-&-~ ~, ' .,: ":":': ..... ; ....-': .... ' · '.:'.'~ ~ ..' ..' ,:i," ~-.:' b :" .' ,,. I [::~ :.;.."~.' -: ..... :-- . , ...; . ': prt'~c]pAt, nustNEss ACTIVITY: ' ~ce~ ~ ~zJe ff~z~ ~e~a[~ AFTER BUS HRS: .... _ , .- ~,. I ' -" ; ': · ...... 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" '~'"' ' "~'~ ' ' :":"~">'"" " . . ~'" -'-:,:'~,~: 3:~; ~~*' :"' ~'~'- ~ -~L2~:~: :.:; ODORll JANITOR SUP 420 ~ CAL~F,, AV:' ur~r~ 93307 CA ......... ., : 21 2O 19 18 17 16 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 I ~ CITY of BAKERSFIELD CALIFORNIA FIRE DEPARTMENT ~ 2101 H STREET D. S. NEEDHAM ~ BAKERSFIELD, 93301 FIRE CHIEF 861-2911 MEMORANDUM HAZARDOUS MATERIALS INSPECTION ~..,~o.: /00 /9 ~ -~'~ VIOLATIONS: