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Home My WebLink AboutBUSINESS PLAN · " ' "' ~ RECEIVED · ' -- HAZ. MAT. DIV.' CITY OF BAKERSFIELD ' " BAKERSFIELD FIRE DEPARTMENT Date APPLICATION Application No. In conformity, with provisions of pertinent ordinances, codes and/or regulations, application is made by: " I ' Nome of C~mpany ' ) . A_. ) Address to display, store, install, use, operate, sell or handle materials or processes involving or creating con- ditions deemed .hazardous to life or property as follows: ~uth~d ~~ ........ !.~?~.Z.~.~ ...................... 8v ....... ~ ............. ~ ............................................... RANDALL L. ABBOTT 2700 M Street, Suite 300 Agency Director Bakersfield, CA 93301 (805} 861-3502 Telephone (805) 861-3636 .... Telecopier (805} 861-3429 STEVE Mc CALLE¥ Oirec, o, RESOURCE MANAGEMENT AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH SERVICES PERMIT FOR PERMANENT L"L"OS-Id4~ PERMIT NUMBER A 1301-19 OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: John Mayne Bright Family Trust Crisp Construction, Inc. 1629 California Ave. P.O. Box 801 P.O. Box 1066 Bakersfield, CA 93301 Newhall, CA 91322 Visalia, CA 93279 License #567429 Phone: 805-259-5919 Phone: 209-734-6381 PERMIT FOR CLOSURE OF PERMIT EXPIRES . December I0~ 1990 1 TANK(S)AT ABOVE September I0, 1990 -- / c/t~ .~_,0Ok/~x APPROVAL DATE LOCATION .~Aju_~t~ O.. APPROVED BY .~.~,zJr~Laurel Funk ' Hazardous Materials Specialist ............................................................................... POST ON PREMISES ................................................................................ CONDITIONS AS FOLLOWS: 1. It is the responsibility of the Permiztee zo obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments). 2. Permittee must notify the Hazardous Materials Management Program at (805) 861-3636 two working days prior to tank removal or abandonment in place to arrange for required inspections(s). 3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-30. 4. It is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation or treatment of hazardous materials. 5. The tank removal conlractor must have a qualified company employee on site supervising the tank removal. The employee must have tank removal experience prior to working unsupervised. 6. ff any contractors other than those listed on permit and permit application are to be utilized, prior approval must be granted by the specialist listed on the permit. Deviation from the submitted application is not allowed. 7. Soil Sampling: a. Tank size less than or equal lo 1,000 gallons - a minimum of two samples must be retrieved from beneath the'center of the tank at deplhs of approximately two feet and six feet. b. Tank size greater than 1,000 to 10,000 gallons - a minimum of four samples must be retrieved one-third of the way in from the ends of each tank at depths of approximately two feet and six feet. c. Tank size greater than I0,000 gallons - a minimum of six samples must be retrieved one-fourth of the way in from the ends of each tank and beneath the center of each tank at depths of approximately two feet and six feet. 8. Soil Sampling (piping area): A minimum of two samples must be retrieved at deplhs of approximately two feet and six feet for every 15 linear feet of pipe run and under Ihe dispenser area. .-<MIT FOR PERMANENT ~ PERMIT NUMBER A 1301-19 .~F UNDERGROUND HAZARDOUS ADDENDUM SUBSTANCES STORAGE FACILITY 9. Soil Sample analysis: a. Ail soil samples retrieved from beneaI h gasoline (leaded/unleaded) tanks and appurtenances must be analyzed for benzene, toluene, xylene, and total petroleum hydrocarbons (for gasoline). b. All soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel) and benzene. ¢. All soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total organic halides, lead, oil and grease. d. All soil samples relricved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease. e. All soil samples retrieved from beneath tanks and appurtenances that contain unknown substances must be analyzed for a full range of substances that may have been slored wilhin the tank. 10. The following timetable lists pre- and post-tank removal requirements: ACTIVITY DEADLINE Complete permit application submitted Al least two weeks prior Io closure to Hazardous Materials Management Program Notification lo inspector listed on permit of date Two working days and time of closure and soil sampling Transportation and tracking forms sent to Hazardous No later than 5 working days for transportation and 14 working Materials Management Program. Ail hazardous waste days for the tracking form after tank removal manigests must be signed by the receiver of the ' hazardous waste Sample analysis to Hazardous Materials Management No later than 3 working days after completion of analysis Program 11. Purging/Inerting Conditions: a. Liquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid remain in tank. (CSH&SC 41700) b. Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) c. No emission shall result in odors detectable at or beyond property line. (Rule 419) d. No emission shall endanger the health, safety, comfort or repose of any person. (CSH&SC 41700) e. Vent lines shall remain attached to tank until the inspeclor arrives to authorize removal. RECOMMENDATIONS/GUIDELINES FOR REMOVAL OF UNDERGROUND STORAGE TANKS This department is responsible for enforcing the Kern County Ordinance Code, Division 8 and state regulations pertaining to underground storage tanks. Representatives from this department respond to job sites during tank removals to ensure that the tanks are safe to remove/close and that the overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered Io clarify the interests and expectations for this department. 1. Job site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by CAL-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rule, worker~ are not permitted in improperly sloped excavations or when unsafe conditions exist in the bole. Tools and equipment are to be used only for their designed function. For example, backhoe buckets are never substituted for ladders. 2. Properly licensed contractors are assumed to understand the requirements of the permit issued. The job foreman is responsible for knowing and abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. Individual contractors will be held responsible for their post-removal paperwork. Tracking [oims, hazardous waste manifests and analyses documentation .are necessary for each sile in order to close a case file or move it into mitigation. When contractors do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new closures wilt increase. OWNER OR~G-Efi~ DATE LF:ch [unk\1301-19.pta March 22, 1990 ~J~_Joseph Yandel~ ~---~utomotlve Semite Center 1629 California Avenue Bakersfield, Ca. 93304 Mr. Yandeil: £nclosed you will find a copy of a revised statement, with you owing only the current balance of $75.00. Also enclosed you will find a copy of the business plan. You will need to revise the plan to be correct, fill cut new inventory sheets, and draw a new map. This must be returned to this office {2130 G Street} within 15 days from the date of this letter. Sincerely, /M~zardous Materials Division March 22, 1990 TO: Nina Mayer, Accounts Receivable FROM: Ralph E. Hue¥, Hazardous Materials Coordinator SUBJECT: Automotive Service Center Nina, account # HM406301 has a previous balance of ~150.00, which I have turned over to Bill Descary for collection, .this business has a new owner and this new owner will only be responsible for the current charges of $75.00. I don't know how you will want to handle this. The account won't be closed, the ~150.00 previous balance won't be written off, and the new owner will only be responsible for for the current charges. Thanks March 22~ 1990 70~ Bill Descary~ City Treasurer FROM~ Ralph E, Huey~ Hazardous Materials Coordinator SUBJ£CT: Automotive Service Center Account # HM406301~ has a previous balance of ~150.00 and current balance of ~75.00. The previous balsnce of $150~00 should go in for collection because there is a new owner and he will be responsible for the current balance of $?5.00. The previous owner is LaRoyce Savage~ I may have a mailing address of P.O. Box 41536~ also a home address of 3700 Thoreson Ave.~ Bakersfield~ Ca. 93309. Whatever can be done. Thanks~ RETURN PAYMENTS TO: PLEASE MAKE CHECKS PAYABLE TO.' CITY OF BAKERSFIELD Hazardous Materials Division P.O. BOX 2057 CITY OF BAKERSFIELD BAKERSFIELD, CA 93303-2057 ACCOUNT NO. HM 40630 ] Hazardous Materials Handling Fees for 001-I1117,., Hazardous Materials Handling Fee State Mandated Program ,~ ~ . Current Charges $75.00 Billing Date 02/15/90 ...... '~. Total Balance Due $75.00 This Bill is Due Upon Receipt ~,~::~, :,,~.~, · INQUIRIESCONCERNINGTHISBILL, PLEASEPHONE: 326-3979 Automotive Service Center HM406301 1629 California Av OITYOOP¥ Bakersfield, Ca. 93304 + + Bakersfield Fire De'pt. Hazardous Materials Inspection Date Completed Location: /~ Z q ~= Plan ID g 215-00~ff~(Top fight comer Business Plan) Station No. 5 S~" ~ Inspector ~, Adequate Inadequate Verification of Invento~ Materials Verification of Quantities Verification of Location ~oper Se~egafion of Matefi~ Co~m: Verification of MSDS AvailabfliW Nmber of Employees Verification of Haz Mat Trai~ng Co~m: Ve~cafion of Abatement Supplies & Procedures Co~: ~e~ency Pr~ed~es Posted Containers Properly Labeled Co~: Ve~cafion of FaciHw Dia~m Speci~ Hazers ~sociated ~th tMs Fac~W: FD 1652 (aev. ~1 White-H~ Mat Div. Yellow-Station Copy Pink-Business Office ..~ . -*'" ~,~ CITY ..~,,~ ~' BAKERSFIELD ' "~" , ~y~e or przn~ name) RECEIVED Do hereby certify that I have revie~ed the attached Hazardous ~Jaterials business plan (name of bu~ine~ and that it along with the attached additions or corrections constitute a complete and correct Business Plan for m,v facilit.v. BUSINESS NAME AUTOMOTIVE SERVICE CENTER ID NUMBER 215-000-000524 LOCATION 1629 CALIFORNIA AV HIGH HAZARD RATING 2 1 . OVERVIEW LAST CHANGE 09/02/87 BY ESTER JURIS CODE 215-006 JURIS BAKERSFIELD STATION 06 MAP PAGE 103 GRID 3lA FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) WE HAVE TRAINED ON WHAT TO DO IN CASE OF FIRE & WHERE ALL CHEMICALS ARE AND WHERE GAS AND ELECTRICAL SHUT OFFS ARE. EMERGENCY CONTACTS 2A SEC 2) LA ROYCE SAVAGE - OWNER - 325-6958 OR 834-4731 ROYCE SAVAGE - 325-6958 OR 834-4731 UTILITY SHUTOFFS 2A SEC 3) A) GAS - REAR OF BLDG B) ELECTRICAL - INSIDE WALL BY STOCK ROOM C) WATER - REAR CENTER OF PARKING LOT D) SPECIAL - NONE E) LOCK BOX - NO 2 . NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/27/88 10:41 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~US~INESS NAME AUTOMOTIVE VICE CENTER ID N ER 215-000-000524 LOCATION 1629 CALIFORNIA AV HIGH HAZARD RATING 2 3 . HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION 4 . LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 09/02/87 BY ESTER 2A SEC 5) ANY HOSPITAL PAGE 2 12/27/88 10:41 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME AUTOMOTIVE SERVICE CENTER ID NUMBER 215-000-000524 LOCATION 1629 CALIFORNIA AV HIGH HAZARD RATING 2 FACILITY UNIT 01 A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 01/19/88 BY EVAMC ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 WASTE WASTE OIL 250 GAL UNKNOWN OUTSIDE EAST SIDE UNDERGROUND TANKS WASTE ID PERCENT COMPONENTS HAZARD LISTS 1598.00 0.0 WASTE OIL UNKNOWN B . FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 09/27/88 BY ESTER 3A SEC 4) WATER & FIRE EXTINGUISHERS FOR FIRE PROTECTION. 3A SEC 5) FIRE HYDRANT AT NORTHWEST CORNER OF CALIFORNIA & H STREET. PAGE 3 12/27/88 10:41 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~US.INESS NAME AUTOMOTIVE VICE CENTER ID N ER 215-000-000524 LOCATION 1629 CALIFORNIA AV HIGH HAZARD RATING 2 D . EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 09/27/88 BY ESTER 3A SEC 2) VOICE & NEAREST DOOR THEN CALL 911 E . MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 09/27/88 BY ESTER 3A SEC 1) OUR SPILLS ARE ONLY GASOLINE, OIL & SOLVENT WHICH WE KEEP QUICK SORB TO CLEAN UP WITH. PAGE 4 12/27/88 10:41 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~/' CITY of BAKERSFIELD ~-7 RECEIVEQ '.r..naAqr,C.'tur. ~ Sta,,d.,-de~,.,,,... ~ HAZARDOUS ~ATgRIALS Z~'~g~.ORY'JAN1 6 1989 BUSINESS NAME:. -- O~NER NAME: ~~ ~ ~~ ~ NAME OF T~ FACILITY: all t~t a~ly) H~lth of P~.u~l Health Cert~i~ (Read and sigfl after ColpJetJflg ali sectJofls) I certt[y under ~)ty of 1~ t~t I ~ve ~rsmollyaxomin~ ~d om f~ilior eith t~ Jnfor~tim su~itt~.t~ ell Itt~ ~~ t~t ~smJ ~ ~ i~t~ of t~l t~tvi~ls r~siblo for. obtamJ~ t~ info. tim. I ~Tieve t~t t~ su~Jtt~ Jnfo~tJm Js t~, accurate, ~d cmaiete. Bakersfield Fire Dept. Hazardous Materials Inspection Date Completed G:~- [9o - ~,~c~ Location: I ~/L~ C~ (. t-C Plan ID ~ 215-000, 6 ~q (Top right comer Business Plan) 'JU~ 1 6 1989 Station No. ~ SM~ ~ Inspector ~. o 4'4~ay. ~Z OIV Adequate Inadequate Verification of Invento~ Materials Verification of Quantities Verification of Location ~oper Se~egafion of Matefifl Corrmlents: Verification of MSDS Availability ~ [--~ Number of Employees _.~ Verification of Haz Mat Training [~] [~ Comments: Verification of Abatement Supplies & Procedures Conlments: Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram ~f/ [--] Special Hazards Associated with this Facility: ~. ~-,% C-c~,4~ ~ 4'~'~e~. Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office .~~,,~' ~X'~RSFI~.L~ CIW FIR~.' ~.e~~ RECEIVED '~ 2130 "G" STREET BAKERSFIELD, CA 93301 JUL ]~r ]987 (8o5) 326-3979 ~ ~ ~h Ans'd ............ OFFICIAL USE 0NLYID~ ~~~ ~ ~SI~SS P~ ~S ~ ~HO~ 1. To avoid further action, return this for~ by 2. TYPE/PRIST ANSWERS IS ESGLISH. 3. Answer the questSons belo~ for the business as a ~hole. ~. Be as brie~ and concise as possible. SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAM~AND~TITLE DURING BUS. ~R~. AFTER BUS. HRS. SECTION 3: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS A ~OLE D. SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSSP YES / NO FLOOR PLANSP YES / NO KEYS~ YES / NO - 2A - tSECTION 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:...' .................................... (~ NO ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~YE__S) NO YE(,~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ N~ ~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. ~S~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUN~.q~QF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ......tv~;~ NO I, /(~ g~/ ¢C~'(~/~y~. ~ , 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. 25500 Et Al.) and that inaccurate information constitutes perjury. " BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUS I NESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS L~.'IT ONLY SECTION 3: HAZARDOUS MATERIALS FOR THiS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES 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 form marked: TRADE SECRETS ONLY (yellow form ¢4A-2) in addition to tile non-trade secret form. List only tile trade secrets on form 4A-2. SECTION4: PRIVATE FIRE PROTECTION t?ECTION 5.: LOCATION OF WATER SUPPLY FOR USE BY E:4ERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. ~' / ' ~'~ ,~AS.,PROPANE. B. ELECTriCAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES ,/~0~ IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES ," NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page NON--TRADE SECRETS ,.~, HAZARDOUS I~IATER I ALS I NVENTORY USE CFIRS 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T CODE A~OUNT A~OUNT UNIT CODE CODE FACILITY UNIT , WT. CHEMICAL OR COMMON NAME .COD~ GUIDE ~-R~cuUN'rY FIRE DEP~d~TI~NT ..~-~4, VICTOR"'STR~r OFFICIAL USE ONLY AU~ MOTI~ ~ER. CENTER ID¢ O00~ RECEIVE ~ ............. HAZARDOUS MATERI ALS BUSINESS PLAN AS A WHOLE 4' Be'as b,lef and concise as fpZ~s::;ebusiness a's a w12];¢.' ~~-- ,~ SECTION 1: BUSINESS IDE~IFICATION DATA SECTION 2: EI~RGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 91! and !-800-852-7550 or !-916-427-434!. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY iN CASE OF EMERGENCY: NAME A~D ~LE, .~ DURING BUS. ~S ArqUeBUS. SECTION $: LOCATION OF UTILITY SffUT-0FFS FOR BUSINESS AS A WI{0LE A. NAT. GAS/PROPANE: . B. ELECTRICAL: C. WATER: 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 -Over- HMCU-4 SECTION 4: PRi~E,~RESP,ONSE TEAM FOR BUSINESS AS A WHOLE ""['r~ : ' ,. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ' /%/ "7 "' i SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPL0¥EES 'WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~ MATERIALS: ' NO NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... EE~y_~J NO ~_~S) NO C. PROPER USE OF SAFETY EQUIPMENT: ..................~ NO~ NO D. EMERGENCY EVACUATION PROCEDURES: ............... ~. ~ N/0.~ (Y~.~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YESfN~.~.~ . YES NO I underst~d that this infor2~ation 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-inaccurate information constitutes perjury. HMCU-4 ~ ~ KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD, CA 93308 OFFICIAL USE ONLY ID# B~SINESS NA~E: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by'JUl 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT'LISTED BELOW 4. Be as BRIEF and CONCISE as possible. -' SECTION 1: ~ITIGATION~ PRE'VENTION~ ABATEI~NT PROCEDI~tES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT TI{IS UNIT ONLY \ i HMCU-6 SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... . NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the h~zardous materials a bona fide Trade Secret as defined by Section 6254.7 of the Government Code? ......... YES If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form 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 ENERGENCY RESPONDERS · SECTION 6: LOCATION OF UTILITY SIt, T-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES /& IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO HNCU-6 KERN COUNTY FIRE DEPARTMENT I.D. # FORM 4A-1 ' page__=., of~ NON--TRADE SECRETS HAZARDOUS lVIATER I ALS I NVENTORY BUSINESS NAME: OWNER NAME: ...... ~' ~," FACILITY UNIT #: ADDRESS: ADDRESS: ,. FACILITY UNIT NAME: CITY, ZIP: CITY,ZIP: ,'. ~ PHONE #: PHONE #: {OFFICIAL USE CFIRS CODE ..../ ON,Ly .. 1 2 3 4 5 6 ? 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN ,THIS ~; BY HAZARD D.O.T COD,E. AMOUNT AMOUNT UNIT CODE .C,O.D.E FACIL..IT¥ UN,IT WT: CH.,.E. MICAL O.R. CO.,M. MON NAME CODE GUIDE NAME: __ TITLE: ~~ SIGNATURE: - AFTER BUS HRS: $~ ~ - ~' ? 3 / AFTER BUS HRS: PRINCIPAL HMCU -9 CITY of BAKERSFIELD FIRE DEPARTMENT ~~~.,~ 2101 H SrREEr D. S. NEEDHAM ~ BAKERSFIELD, RRE CHIEF 326-3911 Dear Business Owner: Enclosed please find a copy of your response to the Hazardous Material Business Plan request. We have found it necessary to reject your plan for the following reason(s) as checked below. ~--I Illegible Business Plan (please print or type information in English). Form 2A F--) Missing or F--) Incomplete Form 3A F'~ Missing or~'~ Incomplete Form 4A ~'~ Missing or F~~co~;lete Form SA Site Diagram [~Missing or F-~ Incomplete Facilities Diagram [~-~issing or F-l Incomplete This is. to be corrected and resubmitted within 30 days to: Bakersfield City Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, CA 93301 If additional copies of any forms are needed they can be picked up from the Hazardous Materials Division at 2130 "G" Street in person. Sincerely Yours, Hazardous Materials Coordinator REH/eg