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Home My WebLink AboutBUSINESS PLAN 2/15/1994i~DOUS'*MAT L.S INSPECTION Hazardous Materials Division · . .'Date Completed !/2..%/~'~"~ .. Business Name: ~[.~,~, ~--~ ~ ~ ~,~,J ~ ~ ~ Location: ~o~ C~. Business Identification No. 215-000 H~ (Top of Business Plan) S~fion No. ~ ~W~ Shift ~ Inspe~or , / ~al Time: ~; o ~ Depa~re Time: ~ ~' ~O Inspe~on Time: ~ ~ ¢~ '~- Adequate Inadequate Verification of Invento~ Mate~als ~ VeHficafi°n of Quakes ' ~ Ve~ficafion of Location ~ Proper Segregation of MateHal '~ Commen~: Verification of MSDS Availabili~ ~ Number of Employees: Ve~ficafion of Haz Mat Training ~ Commen~: Verification of ~atement Supplies & Procedures ~ Commen~: Emergency procedures Posted ~ Containers ProperN Labeled '~ Commen~: / · Verification of Facili~ Diagram ~ special Hazards Associated ~ ~is Facile: 'Business Owner/Manager PRINT NAME ' SIG'~AfURE Correction Needed 0 ', White-Haz Mat Div Yellow-Station Copy Pink-BusineSs CoPY ~.. ' 02/1~0/g4~: CHARLES SUTTON CHEVRON /INC 215-000-000468 Page 1 ? ~ Overall Site~with 1 Fac. Unit General Information Location: 3624 CALIFORNIA AV Map: 102 Hazard: Low I Community: BAKERSFIELD S~ATION 03 Grid: 35B F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone] cHARLES SUTTON (805) 325-1'642 x ~ (805) 832-5310! CHARLES SUTTON JR ASST..MANAGER (805) 398-9117 x (805) 664.9572/ AdminiStrative:Data Mall Addrs: 3624 CALIFORNIA AV D&B Number: City: BAKERSFIELD State: CA Zip:'~93309- Comm Code: 215'003 BAKERSFIELD STATION 03 SIC Code: 5541 Owner: CHARLES SUTTON Phone: (805) 832-5310 Address: 5708 CARDIFF CT State: CA City: BAKERSFIELD Zip: 93309- iSummary , attached hazardous materials manage- ~'~.. ,1,/~ r O/R ~ions~nsfitute a,~mplet, and ~rr~ man- p~an ~or m~ tacilit~. Date -- 02/~70/94~ CHARLES SUTTON CHEVRON INC 215-000-000468 Page 2 ~ - ? Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Form Max Qt¥ MCP Pl~n-Ref Name/Hazards .~ 02-001 UNLEADED PLUS GAsoLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 REGULAR UNLEADED GASOLINE ' Liquid 10000 Moderate · Fire, Immed Hlth, Delay-Hlth GAL 02-003 SUPER UNLEADED GASOLINE Gas 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-004 USED MOTOR OIL Liquid 1000 Low · Fire, Delay Hlth ~ GAL 02/~0/94= CHARLES SUTTON'CHEVRON INC 215-000-000468 Page 3 ~ ? 02 - Fixed Containers on Site . Hazmat Inventory Detail in MCP Order 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No ~ Form: LiqUid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL Annual Amount GAL .- 10,000 I 3,000.00 ----~ 144,000.00 Storage Press T Temp Location UNDER GROUND TANK Ambien~AmbientlSOUTHWEST OF PUMP ISLAND -- Conc Components MCP ---~uide 100.0% IGasoline IModeratel 27 02-002 REGULAR UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #:'8006-61-9 Trade Secret: N0 Form: Liquid Type: Pure ,Days: 365 Use: FUEL Dally Max GAL Daily Average GAL I Annual Amount GAL 10,000 I 5,000.00 648,000.00 , Storage PressT Temp Location UNDER GROUND TANK Ambient~AmbientlSOUTHWEST OF PUMP ISLAND -- Conc Components MCP ---TGuide 100.0% IGasoline IModeratel 27 02-003 SUPER UNLEADED GASOLINE Gas 10000~ Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Gas Type: Pure DayS: 365 Use: FUEL -- Daily Max GAL Daily Average-GAL I 'Annual Amount GAL 10,000 I 4,000.00_ 558,000.00 Storage Press T Temp~ · ,Location UNDER GROUND TANK Ambient~AmbientlSOUTHWEST OF PUMP ISLAND -- Conc Components' MCP Guide 100.0% IGasoline IModeratel~ 27 02/~0/94~ CHARLES SUTTON CHEVRON INC 215-000r000468 Page 4 ~ ? 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-004 USED MOTOR OIL Liquid 1000 Low '~ · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No .' Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL Daily Average GAL [ Annual Amount GAL ~ 1,000 I. 200.00 1,600.00 Storage ~~Press T Temp Location UNDER GROUND TANK IAmbient~AmbientlSOUTH OF BACK BUILDING -- Conc Components ~ MCP ---~uide 100.0% IWaste Oil, Petroleum Based ILow ! 27 02/~0~94~' CHARLES SUTTON CHEVRON INC 2157000-000468 Page 5 ~ 00 - Overall Site <D> Notif./Evacuation/Medical. ) <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation SHUT OFF EMERGENCY PUMP SWITCH, LEAVE STATION IMMEDIATELY., TO AN AREA AWAY FROM DANGER, CALL FIRE DEPARTMENT <3> pUblic Notif./Evacuation AFTER EMPLOYEE AND CUSTOMER EVACUATION - CALL 911 <4> Emergency'Medical Pl~an MERCY.HOSPITAL ' 2215 TRUXTUN AV 327-3371 02/~0/94~ CHARLES SUTTON CHEVRON INC 215-'000-000468 Page 6 00 - Overall Site <E> ~t~at£on/Prevent/Abatemt <1> Release Prevention ALL EMPLOYEES KNOW THE LOCATION OF PUMP CUT OFF SWITCH. <2> Release Containment UNDERGROUND STORAGE TANKS <3> Clean Up SMALL GASOLINE SPILLS ARE TO BE WASHED WITH WATER AND CLEANED UP AT ONCE. MAJOR SPILLS ARE TO BE WASHED. WITH WATER UNTIL FIRE DEPARTMENT ARRIVES. <4> Other Resource Activation ~02/i0/9~ CHARLES SUTTON CHEVRON INC 215-000-000468 Page 7 ~ 00'- Overall Site · <F> Site'Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - STORAGE ROOM OFF OF LUBE BAY B) ELECTRICAL , HALL OF LUBE BAY C) WATER - FRONT OF STATION BUILDING LEFT SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION -~ TWO FIRE EXTINGUISHERS ONE INSIDE CASHIER'S BOOTH, ONE INSIDE LUBE AREA. WATER OUTLETS ARE LOCATED BY'CASHIER'S BOOTH AND SOUTH OF STATION BUILDING FIRE HYDARNT - CORNER OF EASTON~& CALIFORNIA <4> Building Occupancy Level 02/~0J9~ CHARLES SUTTON CHEVRON.INC 215-000-000468 Page 8 ' ~' ~' O0 - Overall Site <G> Training <1> Page 1 WE HAVE 9 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE MEET WITH ALL EMPLOYEES,. AT LEAST ONCE A MONTH - DISCUSS SAFETY AND HANDLING OF HAZARDS AROUND STATION. DISCUSS WITH EMPLOYEES SAFETY BULLETINS .RECEIVED FROM CoMpANy. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 02/f~0'194s~ CHARLES SUTTON CHEVRON INC 215-000-000468 Page 9 ~ :~ 00 - Overall Site <H> RMPP DATA <1> Release Containment · <2> Offsite Consequences <3> In House 'Capabilities <4> Plant Shutdown Instruction D7/27Y92'. CHARLES SUTTON ,CHEVRON INC 215-000~00 11 P: !ge 1992 Overall Site with 1 Fac. Unit L General Information Location: 3624 CALIFORNIA AV Map: 102 Hazard: Low Community: BAKERSFIELD STATION 03 ,. Grid: 35B F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phonel CHARLES SUTTON · (805) 325-1642 x (~05) .83~-5_310] Administrative Data Mail Addrs: 3624 CALIFORNIA AV D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Con Code: 215-003 BAKERSFIELD STATION 03 SIC Code? 5541 Address: 5708 CARDIFF CT Sta City: BAKERSFIELD Zi~f: 93309- , Sugary mv~s~d ~s ~achsd h~ardous mmerials m~nt p~n ~or~~ ~.~ that it elon~ with any ~rr~)ons constitute a complete and coFrect agems~ plan tot m~ iadlity. 07/27/92 CHARLES suTTONCHEVRON INC 215-000-000468 Page- 2 02 - Fixed Containers on Site . Hazmat Inventory Detail in Reference Number Order 02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS ~: 8006-61-9 ' Trade Secret: No Form: Liquid Type: Pure. Days: 365 Use: FUEL -- Daily Max GAL Daily Average GAL I Annual AmoUnt GAL 10,000 I ~ .3,000.00 ' i44,000.00 Storage ~ Press T Temp Location UNDER GROUND TANK i Ambient~Ambientl~SOUTHWEST OF PUMP ISLAND· -- Conc ~ Components .' MCP List IModerate I 100.0% IGasoline 02-002 REGULARUNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay'Hlth .GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ ~ -DailyAverage GAL I Annual Amount GAL 10,000 I 5,000.00 648,000.00 Storage Press~T Temp Location UNDER GROUND TANK IAmbient~AmbientlSOUTHWEST OF. PUMP ISLAND -- Conc Components MCP List 100.0% I Gasoline I M°derate I 02-003 SUPER UNLEADED GASOLINE Gas 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL I Annual Amount GAL 10,000 I 4,000.00 558,'000.00 Storage press T Temp Location UNDER GROUND TANK IAmbient|AmbientlSOUTHWEST OF PUMP ISLAND -- Conc Components '1 MCP List 100.0% ]Gasoline I M°derate I .. 07/27/92 CHARLES SUTTON CHEVRON INC 2'i5-000-000468 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order. 02-0~04 USED MOTOR OIL Liquid 1000' Low · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL Daily Average GAL I Annual Amount GAL 1~,000 I 200.00 1,600.00 Storage Press T Temp i Location UNDER GROUND TANK IAmbient~Ambient SOUTH OF BACK BUILDING -- Conc ' Components MCP List 100.0% IWaste OiI, petroleum Based Low --~ 07/27/92 CHARLES SUTTON CHEVRON INC 215-000-000468 · Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency .Notification CALL 911 <2> Employee Notif./Evacuation SHUT OFF EMERGENCY PUMP SWITCH, LEAVE STATION IMMEDIATELY, TO AN AREA AWAY FROM DANGER, CALL FIRE DEPARTMENT <3> Public Notif./Evacuation AFTER EMPLOYEE ,AND CUSTOMER EVACUATION - CALL 911 <4> Emergency Medical Plan MERCY HosPITAL 2215 TRUXTUN AV 327-3371 07/27/92 CHARLES SUTTONCHEVRON INC 215-000-000468 -.Page 5 00 - Overall Site <E>~Mitigation/Prevent/Abatemt <1> Release Prevention 'ALL EMPLOYEES KNOW THE LOCATION OF PUMP CUT OFF SWITCH. <2> Release Containment <3> Clean Up SMALL GASOLINE SPILLS ARE TO BE WASHED WITH WATER AND CLEANED UP AT ONCE. MAJOR SPILLS ARE TO BE WASHED WITH WATER UNTIL FIRE DEPARTMENT ARRIVES. <4> Other Resource Activation 07/27/92 CHARLES SUTTON CHEVRON INC 215-000-000468 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A).GAS - STORAGE ROOM OFF OF LUBE BAY B) ELECTRICAL - HALL OF LUBE BAY C) WATER - FRONT OF STATION BUILDING LEFT SIDE D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVAT$ FIRE PROTECTION - TWO FIRE EXTINGUISHERS ONE INSIDE CASHIER'S BOOTH, ONE INSIDE LU~E AREA. WATER-OUTLETS ARE LOCATED BY CASHIER'S BOOTH AND SOUTH OF STATION BUILDING F I RE HYDARNT - ? ? ? ? / <4> Building Occupancy Level 07/27/92 CHARLEStSUTTON CHEVRON INC 215~000-000468 Page 7 00 - Overall Site <G> Training · <1> Page 1 ~ WE-HAVE 9 EMPLOYEES AT THIS FACILITY W~_HAV~MAT~RIAL SAFETY DATA SHEETS~ON FILE · MEET WITH ALL EMPLOYEES,. AT LEAST ONCE A MONTH - DISCUSS SAFET~ AND HANDLINGOF HAZARDS AROUND STATION. DISCUSS WITH EMPLOYEES SAFETY BULLETINS RECEIVED FROM COMPANY. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use CITY of BAKERSFIELD "I, VE CA RE" . 2101 - STREET FIRE DEPARTMENT BAKERSFIELD 93301 D S NEED~AM ' ' 326-3911 FIR~ CHIEF Charles Suitor"Chevron Irc' 362&' California Eve. 8akersqi'eio, Ch 95~0B Bear S~r: Charles Sutton Chevron needs to revise the site diagram portion of it's Hezardous Material5 Management Plan. THe updated map .which you 5en~ ~n ~hi~ summer is illeg~ble and will not reproduce well enough to be of use ~o Flee Service First Resoonders. The diagrams must be ~mple and neat. Please follow ~he instructions enclosed ~nd avoid the use of symools and extr'a, unrelated information. 'Please file updated site~ diagrams with ,~this office by OctbOer 1S~ lgBO. Call me ~t528-~B?B if you have· any further questions. Barbara Brenner " Hazardou~ Materials Planning Technician · ...~ ...... ,,' ..'./. . -JAN09 1989 attached Hazardous F~aterials business plan ~~: ~,,.~ ............ (n~me off 'business~' and that it along with the'attached additions or corrections constitute a complete and correct Business Plan fo~f~ility. . ~ si,~n~e~- - ' date : :~8{J~SINESS NAME CHARLES SUTTON CHEVRON INC ID NUMBER ZIS- .~-0004G8 ~.%~ -~ LiOCATION gG24 CALIFORNIA AV HIGH HATARD RATING Z 1, OVERVIEW LAST CHANGE 01/%S/88.8Y EVAMC JURIS CODE Z15-003 JURIS BAKERSFIELD STATION MAP PAGE 10Z. GRID .3SB FACILITY UNITS 1 HAZARD RATING RESPONSE SUMMARY ZA SEC 4) ALL EMPLOYEES KNOW EMERGENCY CUT OFF SWITCH FOR GASOLINE. · SELF SERVE ISLANDS ARE SUPERVISED 8Y SALESMEN OR CASHIER ANY GASOLINE SPILLS ARE WASHEO AND CLEANED UP AT ONCE. WE HAVE WORKING FIRE EXTINGUISHERS AVAILABLE AT ALL TIMES FOR PUMP ISLANDS AND SERVICE AREA 'EMERGENCY CONTACTS ~A SEC 2) CHARLES SUTTON 3ZS-lG4Z 83Z-S310 KEII'H COPELAND 398-9117 -UTILITY SHUTOFFS ZA SEC 3) --- ~ ........ A)'GAS - STORAGE ROOM OFF OF LUBE BAY B> ELECTRICAL - HALL OF LUBE BAY' C) WATER - FRONT OF STATION BUILDING LEFT SIDE D) SPECIAL - NONE E> LOCK BOX -'NO NOTIFICATION / PUBLIC EV~ICUATIONLAST CHANGE '< NO INFORMATION RECORDED FOR TillS SECTION > PAGE 1 lZ/Z3/88 1S:SB MATERIAL SAFETY DATA SYSTEMS, INC. ('80S) G48-G8~D :,:~BUStNESS NAME CHARLES SUTTON CHEVRON INC tO NUMBER ZlS-~O0-OOO468 ~OCATION 3GZ4 CALIFORNIA AV HIGH HRZ.ARD RATING Z 'FACILITY UNIT 01 OVERAL~ HAZARDOUS. MATERIALS INVENTORY '/ LAST CHANGE'Ot/25/88 BY EVAMC TYPE NAME MA>( AM'F UNITHAZARD LOC'RTION cONTAINMENT USE PURE REGULAR LEADED GASOLINE. 10000 GAL HIGH SW OF PUMP ISLAND .UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LIST 118Z.00 100.0 GASOLINE, ' HIGH PURE REGULAR UNLEADED GASOLINE 10000 GAL HIGH SW'OFPUMP ISLAND UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LIST 118Z-.0~) 100.0 GASOLINE HIGH PURE SUPER UNLEADED GASOLINE 10000 GAL HIGH SW OF PUMP ISLAND UNDERGROUND TRNKS FUEL ID PERCENT COMPONENTS -HAZARD LIST 118Z.00 100.0 GASOLINE HIGH WASTE USED MOTOR OIL 10~X~ GAL UNKNOWN BACK OF BUILDING SOUTH UNDERGROUND TANKS OIL TREATMENT iD PERCENT COMPONENTS HAZARO LIST 1S98.~ 1~.0 WASTE OIL UNKNOWN 8. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 0B/Z9/88 BY ESTER 3A SEC 4) TWO FIRE EXTINGUISHERS ONE INSIDE CASHIER'S BOOTH, ONE INSIDE LUBE AREA. WATER.OUTLE'FS ARE LOCATED BY CASHIER'S BOOTH 'AND SOUTH OF STATION BUILDING 'SEd'S-)T'WRTER OUTLET LOCATED IN B-ACK OF CASHIER'S' BOOTH AND ON SOUTH SIDE OF MAIN STATION BUILDING PAGE .3 1Z/Z~/88 15:59 MATERIAL SAFETY OA'TA SYSTEMS, iNC. (809)'G48-G800 BUSINESS NAME CHARLES SUTTON CHEVRON INC ID NUMBER 21S-0~0-~04G8 LOCATION 3624 CALIFORNIA AV HIGH HAZARD RATING 3. HRZ MAT TRaINING.SUMMARY LAST CHANGE / / BY < NO_INFORMRTION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANOE 011Z5/88 BY EVRMC SEC S> MERCY HOSPITAL ZZIS TRUXTUN AV PAGE Z 1Z/Z3/88 1,5:59 MATERIAL SAFETY DATA sYsTEMs, INC. (805) 64B-~B00 BUSINESS NAME CHARLES SUTTON CHEVRON INC ID NUMBER ZIS-~-000468 LOCATION 36Z4 CALIFORNIA RV HIGH HRZRRD RATING Z D. EMPLOYEE NOTIFICATION / EVACUATION L.~ST CHRNGE 01/2S/88 BY EVRMC JR SEC Z) SHUT OFF EMERGENCY PUMP SWITCH, LEAVE STATION IMMED'IATEL'Y,~ TO AN AREA AWAY FROM DANGER, CALL FIRE DEPARTMENT E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE O1/ZS/BB BY EVAMC SEC l) ALl_ EMPLOYEES KNOW THE LOCATION OF PUMP CUT OFF SWITCH. SMALl. GASOLINE SPILLS'ARE TO BE WASHED WITH WATER ANO CLEANEO UP AT ONCE. MAJOR SPILLS ARE TO 8E WASHED WII'H WATER UNTIL FIRE DEPARTMENT ARRIVES. Trans Type Hex Average Annual Heasure ~ I ~s Cmt Cmt C~t Use L~atl~ Hhere T by Na~s of Nixture/C~ts · Stor~ in'Facility Ht See Instructi~s '' lode Code Amt' Amt · Est Units -. ~ Site )y~ 'Press l~ C~e .. .~i~ (C~k all that a~Hy) : ' ~ ' Hazard ~--a Reactivity ~-- ~]ay~ -- . ....... ~eaith of Pressure H~lth ..~ C~t t3 Name & C.A.S. Number ~ ,. ~ . ~ealth , · or,vr~sure .~mtn ~pm~t 83 Na~ & C.l.S. Number ,~ .......... tph~ical and Health Hazard ' ?' C.l.S. Numar (C~k all t~t app)y) ' , . Fire Hazard ~--~ Reactivity =-J Oelayed ~--J 5udd~ Releaseu~l~tate Health. of.' Pressure Health ~),' '~--- " (Ch~k all that a~ply} · ' ~ ..... ....... Health of Pressure Health C~t 13 Na~ & C.A.S. Numar ~, Certification (Read and si~n after completinE all'sections) ' [ eertif~unde~alty of law that I have ~ersonally examined and am familiar with t~ infor.ti~_)ubmitt~thi' ~11 ,~.c~.ts. and t~t based ~ .~ inqui.y of t~se individuals .USINESS NAME HAZARDOUS MATERI ALS BUS'INESS PLAN AS A WHOLE FORM ~-A INSTRUCTIONS: 1. To--avoid'further action, ~eturn this form ~Y 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below, for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-8S2-?§50 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: NAME3~N~ TITLE' DURING BUS. HRS. AFTER BUS. HRS. S~CTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE E. LOCK BOX: YES /'NO IF YES, ~OCATION: IF YES, DOES IT CONTAIN SITE PLANS~ YES / NO ~SDSS? YES I NO FLOOR PLANS? YES / NO' KEYS~ YES / NO SECTIO.N. 4__: PRIVATE R_ESPONSE TEA){ FOR BUSINESS AS A WHOLE~;. SECTION. 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE q//- ,..- / SECTION 6: EMPLOYEE TRAININ6 , 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 ~_,~ ~V~kTERIALS ~ NO YES NO B. PROCEDURES FOR COORDINATING .ACTIVITIES ~ITH RESPONSE AGENCIES SO' YES NO C. PROPER USE OF SAFETY EQUIPMENT:..~ ................ NO YES NO D EMERGENCY EVACUATION PROCEDURES: ................. NO · YES NO. E DO YOU ~iAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO YES NO SECTION ?: HAZARDOUS ~4ATERIAL CIRCLE YES OR NO. ' .. .DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES_~LESS. THAN 500 POUNDS ~0~ I'D--,' %5 G~'LL0~S '~)F"~: -L i QU I~, 0----~-~60'-~U~B-~ C -FEET-'0F A ' C0~'PR~ESSED GAS!?-.' fi:-.~--- YES '~~ I, - , certify that the.above information is accurate. I und~'rstahd that this in~%r-mation will be used to fulfill my firm s obligations under the new California Health and Safety code on Hazardous Materials (Div. 2~0.chapter 6.95 Sec. 28800 Et Al.) and that inaccurate information constitutes perjury. S i GNATUR TL DATE BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET ~:BAKERSFIELD,' CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUSI NESS PLAN .... "SING~LE .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 b~IT ONLY ~~_~ SECTION 3: HAZARDOUS *'4ATERIALS FOR THIS 'UNIT ONLY A.. Does. this~Facility Unit contain Haza?dous ~aterials 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 ~A-1) · !f-Yes, complete a hazardous materlals inventory form marked: TRADE SECRETS ONLY (yello~ form.~-2) in addStSon to the non-reade secret form. List onl~ the~ trade secrets on form 4A-2. SECTION, $: LOCATION OF WATER SUPPLY FOR USE BY E~RGENCY RESPOh~ERS-- SECTION 6: LOCATION OF UTILI~ S~T-OFFS AT THIS UNIT ONLY. A. GAS/PROP ~XN~~: D. SPECIAl,: E. LOCK BOX: YES. IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs9 YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - SB - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORlVi 4A-1 Page ....... of NON'--TRADE SE CR"ETS HAZ AR.DOUS MATERI ALS INVENTORY PHONE {: :~ff--.?~~C~ ' ' .~ . PHONE ~: ~~-~ {OFFICIAL USE CFIRS CODE { ONLY 1 2 3 4 ~ 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.0.T E~E!~GENCY CONTACT TITLE: PH0~ ~ BUS PR,'INCIPA,L BUSINESS ACTIVITY: ~~5~ ~~ ~~. -. AFTER BUS HRS: