HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/HazardouS Waste, Unified Permit
CONDITIONSOF~PE. RMIT :ON:REVERSE SIDE
' ~ ' . ' : r : . This _~ern~t is issu~ for ~ follo~ng;
~ H~ous Materials Plan
~ermit I~:: 0~$~00-000~0
S H E RATO N F O U R P O I N TS
LOCATION: 5101 CALIFORNIA AVE IELD
-~.'...~. ~!'
Is su ed by: B a kc rs field Fi re Depa~ment
OFFICE OF EN~R ONMENTAL
1715 Chester Ave., 3rd Floor Approv~by:
Bakersfield, CA 93301
Voice (661) 326-3979
~~~, F~ (661) 326-0576 Expmdon Date:
I
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
:.. ~ ~,,;,?~7~???'?':~,,,~ ........ This permit is issued for the following:
~,??~!~".i.:,~,ilj:?:?%iiiii!i !ii iiiiiii?iiiiiii~iiU~erground Storage of Ha~rdous Materials
PERMIT ID~ 015~21~00160 ??'~ ~, ~ ~ ~:;~;" ?~;~;~:~5:~J5~:~ ~ ~ ~'~k~agement Program
SHE~TON FOUR POINTS
LOCATION 5101 CALIFORNI ':" ¥,'~ ~ B~S~i~LD CA ~'0'%_" ~'' ~...:'"'~.
~"--'"
~::~
~--.-
[s~ b~:
B~e~eld Fke D~mment Approv~ by:
0~ OFE~O~AL S~ ~CES
1715 Cheuer Ave., 3rd Floor
B~e~el~ CA 93301
Voice (805) 32~3979
F~ (~05)3~57~ Exp=tionDate: ~Un~ ~0~ ~000
m~~,~AL~~~~ II II1111111111111111111 !!11111
~~~ Valleylnn ' /// ~~~~~. ~'~
5101 ~LIFORNIA AVENUE ~ / _ l_ I I I I I I / I I I J ~ I
~KERSFIELD,~UFORNIA 9~ ~ / -- / [J I ~ I
· ' ~5/32~97~ .~ ~ ~ ~o216o416o616o8161ol61216u16161618162o1 ~! J
.... -
EXITFITNESS ROOM
/
~ I ~ m m I MEETING ROOMS: RMS A-I 1st FLOOR ~
~ I THE BISTRO ENTRANCE ~ LOBBY ~ = ~"~ RM 3 2nd FLOOR I ~ ~ ]
ENTRANCE ~ TODD'S I~ II ~ ~ I I . J ~ ~
_ ENTRANCE ~ ~
-- ~ ~ 352 354 356 358 360 362 364 366 368
_ ~~U .~11 I I11 I I~
I ~ I I ~ ~ I~J L; ~ ~
A CALIFORNIA F MIDWAY-SUNS~ - EXIT
B SAN 30AQUIN ~ STOCKDALE
C GRAPEVINE G YOSEMITE
O BELRIDGE H SEQUOIA PARKING
E ELK HILLS I KINGS CANYON
SHERATON FOUR POINTS HOTEL Sit : 015-021-000160
Manager : BusPhone: (661) 325-9700
Location: 5101 CALIFORNIA AVE %% Map :
102
CommHaz
Low
:
City : BAKERSFIELD ~ Grid: 34B FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 11 SIC Code:7011
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
BILL MURRAY / GENERAL MANAGER BOB ANTONE / CHIEF ENGINEER
Business Phone: (661) 325-9700x Business Phone: (661) 325-9700x
24-Hour Phone : (661) 832-7610x 24-Hour Phone : (661) 633-9457x
Pager Phone : J~,'__~. ~3C_~w- Pager Phone ........ ~
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact : Phone: (661) 325-9700x
MailAddr: 5101 CALIFORNIA AVE State: CA
City : BAKERSFIELD Zip : 93309
Owner RFS HOTEL INVESTORS INC Phone: (661) 325-9700x
Address : 850 RIDGELAKE BLVD 220 State: TN
City : MEMPHIS Zip : 38120
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
~ ' I, ~',tl Ivtoaz,~¥ Do hereby certify thru I have
~~~ iType or p~im n--,
reviewed the attached hazardous materials rnanage-
rnent plan for~-cua.~,,,n~~d that it along with
~ ~?'~/)") 0 49~ (Nm of Busine,8)
any corrections constitute a complete and corre~ man-
agement plan-for my facility.
SHERATON FOUR POINTS HOTEL SiteID: 015-021-000160
~azmat Inventory By Facility Unit
-- MCP+DailyMax Order Fixed Containers on Site
Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax IUnitlMcP
FREON 22 F P IH G ~0 i~9~-~FT3 Low
LIQUID SCALE INHIBITOR DH L ~00 ~ GAL Low
FREON 12 F P IH G 64.00 FT3 Min
-2- 10/21/2003
SHERATON FOUR POINTS HOTEL SiteID: 015-021-000160
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
~U~U~ ~vl~ / ~£ ~ ~vl~
FREON 22 Days On Site
365
Location within this Facility Unit Map: Grid:
NE CORNER CAS#
75-45-6
F STATE TYPE I PRESSURE i TEMPERATURE CONTAINER TYPE
Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
~argest Container I Daily Maximum Daily Average
100.00 Chlorodifluoromethane N 75456
TSecret RS BioHazI HAZARD AiSESSMENTS I
Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Low
~ Inventory Item 0002 Facility Unit: Fixed Containers on Site
~~ ~Vl~ / ~i~ ~Vl~
LIQUID SCALE INHIBITOR Days On Site
365
Location within this Facility Unit Map: Grid:
NE CORNER CAS#
FSTATE ~ TYPE PRESSURE -- TEMPERATURE CONTAINER TYPE
Liquid I Mixture I Ambient [Ambient I DRUM / BARREL - NONMETAL
AMOUNTS AT THIS LOCATION
Largest Container ] Daily Maximum I Daily Average
7, C~6; -~' GAL[ 7, O0 ~ GALI '7,O0 ~ GAL
HAZARDOUS COMPONENTS
%Wt. CAS#
13.00 Ethylene Glycol 107211
HAZARD ASSESSMENTS
TSecret[ oRSIBioHazl Radioactive/Amount EPA HazardsI NFPA USDOT# [ MCP
No N No No/ Curies DH / / / Low
-4- 10/21/2003
i.~. Bakersfield Fire Dept.
UNIFIED PROGRAMi'~oPECTION CHECKLIST ~i-~: Enironmental Set,rices
, ,,' , ,, ' ,'"' -- -- 1715 Chester Ave
SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME{,.,~ '~-"~~ j' ~.~ '~ ,~----'"~'~. ~/~J ~~ ~~~IN~E~ION ~AT~
ADDRESS ~/~/ ~~~ ~~ ~__~ NO. o~es
15-021
~ ~ ' ,g ' [~; ~ ~ ~ %~' ' '~ ~ ~ ~ ~ ~ E~ ': ' ~ ~ r~ '~ SeCtion ~1: BdsinesS Plan,and InVentory program ".
,~outine ~ Combined ~ Joint Agency [] Multi-Agency [] Complaint [] Re-inspection
C V ('C=Compliance'~ OPERATION COMMENTS
%. V=Violation ./
~l [] APPROPRIATE PERMIT ON HAND
~ [] BUSINESS PLAN CONTACT INFORMATION ACCURATE
~ [] VISIBLE ADDRESS
'~ [] CORRECT OCCUPANCY
'~ [] VERIFICATION OF INVENTORY MATERIALS
'~ [] VERIFICATION OF QUANTITIES
'~ ~ VERIFICATION OF LOCATION
'~ [] PROPER SEGREGATION OF MATERIAL
~[~ [] VERIFICATION OF MSDS AVAILABILITYE
'~ [~ VERIFICATION OF HAT MAT TRAINING
~ [] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
'~ [~ EMERGENCY PROCEDURES ADEQUATE
~ [~ CONTAINERS PROPERLY LABELED
'~ [] HOUSEKEEPING
[] FIRE PROTECTION
~ SITE O~AGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: [] YES ~ No
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
Inspector Badge No. Business Site Responsible Party
White- Environmental Sero'ices Yellow- S~ation Copy Pink-Business Copy //~'~
SHERATON FOUR POINTS HOTEL SiteID: 215-000-000160
Manager : -- · BusPhone: .(805) 325-9700
Location: 5101 CALIFORNIA A~E MAR "~ 2000 ~ Map : 102 CommHaz : Low
City : BAKERSFIELD ~' . ...... ! Grid: .34B FacUnits: 1 AOV:
CommCode: BAKERSFIELD ST~;~Y'~i'~j' -I SIC Code:7011
EPA Numb: DunnBrad:
er~.ency Contact / Title Emergency Contact / Title
Business Phone: (~() 325-9700x Business Phone: (~-~) 325-9700x
24-Hour Phone : (~l') ~Z-,'7~lOx 24-Hour Phone : (~[.) ~5~'-.~,~7x
Pager Phone : (~) &~-~x Pager Phone : (~l)G~-~x
Hazmat Hazards: Fire Press Im~lth DelHlth
Contact : Phone: ( ) - x
MailAddr: 5101 ~IFO~IA AVE State: ~
City : B~ERSFIELD Zip : 93309
O~er '"'~L ~'~:~ ~ v ~ ~'=- '~ ·
............... X ~ ~o~~, ~. Phone: (<.~.~:.) .).-~.~7 -."~%?.l ,..~
Address : ~O ~C~ D.q ~SO~ ~q6 ~z~ State: '~c TM
City : S~{ P~:CISCO ~%~ ~. ~ Zip : ~ ~
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
-1- 01/20/2000
SHERATON FOUR POINTS HOTEL SiteID: 215-000-000160
-- Hazmat Inventory By Facility Unit
-- Alphabetical Order Fixed Containers on Site
Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax IUnitlMCP
FREON 12 F P IH G ~D~ 9~3~U0 GAL Min
FREON 22 F P IH G ~ ~
FT3
Low
F~RODR-- DH L ~ GAL Hi
2 01/20/2000
SHERATON FOUR POINTS HOTEL SiteID: 215-000-000160
---- Inventory Item 0001 Facility Unit: Fixed Containers on Site
%JUiV. U.vIUN N./.kivii,.,; / UHl";lvllt..f./-'~--{~
FREON 12 Days On Site
365
Location within this Facility Unit Map: Grid:
NE CORNER CAS#
75-71-8
Gas {Pure Above Ambient Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container { Daily Maximum I Daily Average
GAL{ .2c,,m- GALI GAL
HAZARDOUS COMPONENTS
100.00 Dichlorodifluoromethane N 75718
HAZARD ASSESSMENTS
TSecretI oRSIBioHazI Radioactive/Amount EPA HazardsI NFPA USDOT# MCP
No N No No/ Curies F P IH / / / Min
= Inventory Item 0003 Facility Unit: Fixed Containers on Site
FREON 22 Days On Site
365
Location within this Facility Unit Map: Grid:
NE COP~ER CAS#
75 -45-6
F STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Gas Pure {Above Ambient {Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container { .Daily Maximum Daily Average
~O' FT3L ~ ~7~z-r~gf) FT3 4S~ .~ FT3
HAZARDOUS COMPONENTS
%Wt. { RS I CAS#
100.00 Chlorodi f luoromethane No 75456
HAZARD ASSESSMENTS
TSecretl oRSIBioHaz Radioactive/Amount I EPA Hazards NFPA I USDOT# I MCP
No N No No/ Curies F P IH / / / .Low
-3- 01/20/2000
SHERATON FOUR POINTS HOTEL ~~~~ SiteID: 215-000-000160
i~ Inventou Item 0002 ~~~ Facili~ U~t: Fixed Contahers on Site
i~ COMMON NAME/CHEMICAL NAME
~ ~ ~~ o Days On Site o
~~ ~ ~~. ~ o 365 o
~cation wi~in this Facility Unit Map: Grid:
NE CORNER o CAS~ o
o 79-10-7
iE STATE ~i~ TYPE ~i~ P~SSURE ~i TEMPE~TU~ ~i~ CONTAINER TYPE
Liquid o Mixture o Ambient o Ambient o DRUM/BA~EL-NONMETAL o
i~8~8~8~8~888~8~i AMOUNTS AT T~S LOCATION
Largest Container o D~ily Maximum o Daily Average
GAL o ~~AL o 55.00 GAL o
i~~~~ ~ZARDOUS COMPONENTS
%~ o RSo CAS~ o
0.2~~ic ~id ~ ONo o 79107°
0~~hyde ~PA) ~ °Yes° 50000°
T o o o o o o ~ o MCP o
No ONoONo o No/ Curies° DH° /// o OHio
-4- 01/20/2000
SHERATON FOUR POINTS HOTEL ~6~~/~/~/~/~ SiteID: 215-000-000160
i/~ Notif./Evacuation/Medical ~~/~~/~~ Overall Site
iiSi~ Agency Notification i~i5~~5~i5~~~i~ 02/07/1990 i
o
CALL 911
O
i~ Employee Notif./Evacuation ~/~/~/~/~/~~~ 02/07/1990
o
FIRE PROCEDURES ARE KEPT POSTED IN ALL EMPLOYEE WORK AREAS. ALL PERSONNEL o
ARE TRAINED ON HOW TO HANDLE AN EMERGENCY SITUATION. PERIODIC RE-TRAINING IS o
CONDUCTED BY DEPARTMENT HEAD. ALL GUEST ROOM DOORS'HAVE EMERGENCY o
EVACUATION PROCEDURES POSTED. o
O
i~ Public Notif./Evacuation ~~~g~~/~ 02/07/1990
O
ALL DEPARTMENT HEADS NOTIFY OUR FIRE BRIGADE WHICH HAS BEEN TRAINED TO °
EVACUATE THE BUILDING AND DIRECT GUESTS TO SAFE AREAS.
o
i~ Emergency Medical Plan EE~E~EEEE~EEEE~EE~E~E~E~EE~gEE 02/07/1990
O
CONTACT 911 WE SEND ALL PEOPLE TO MEMORIAL HOSPITAL OR MERCY. WE ALSO SEND o
PEOPLE TO VALLEY INDUSTRAIL MEDICAL GROUP. o
O
MEMORIAL HOSPITAL MERCY HOSPITAL VALLEY INDUSTRIAL GROUP °
420 34TH STREET 2215 TRUXTUN AV 2501 G STREET o
BAKERSFIELD, CA BAKERSFIELD, CA BAKERSFIELD, CA. o
(805) 327-1792 (805) 327-3371 °
o
-5- 01/20/2000
SHERATON FOUR POINTS HOTEL
i~ Mitigatio~Prevent/Abatemt ~~~~~ Overall Site i
i~ Release Prevention
O
ALL ~ZA~OUS ~TE~ALS ARE ~PT IN LOC~D STOOGE. LIMITED ACCESS TO o
HAZARDOUS ~TE~ALS BY DEPARTMENT HEADS ONLY. ALL ~TE~AL DATA SHEETS ARE
~PT POSTED WITH HAZA~OUS SUBSTANCES. ALL PERSONNEL ARE T~INED ON THE o
PROPER,USE OF MATE~ALS BEFORE PER~TTED TO USE. ROUTINE ~-T~INING IS o
PROVIDED BY DEPARTMENT HEADS. LOC~D STOOGE A~AS A~ CHEC~D DAILY. o
O
iOO~ Release Contaiment
O
O
o
o
0
o
-6- 01/20/2000
SHERATON FOUR POINTS HOTEL ~EE~g~i~b~b~E~ SitelD: 215-000-000160
i~ Site Emergency Factors ~~~~~~ Overall Site i
i~ Special Hazards
o
o
i~6~ Utility Shut-Offs g6E6666E6~E6E~6666~66666~666~EE~6666 02/07/1990
A) GAS - IN P~NG LOT OFF MO~ NORTH SIDE ~WNEX~ RGG~,2 - o
B) ELECT~CAL - IN UTILITY ROOM BE~ND ~- ~e~.~
C WATER - AT STREET ON MO~WK BY GUEST ~GIST~TION PA~NG
D) SPECIAL - NONE o
E) LOCK BOX - NO
O
i~ Fire Protec./Avail. Water ~~~~~ 02/07/1990
o
P~VATE FI~ PROTECTION - _ALL GUEST ROOMS, STOOGE. AREAS, AND PUBLIC SPACE
A~ EQUIPPED WITH SMO~ ALARMS, SP~N~ERS, AND FI~ EXTINGUISHERS. o
o
O
o
o
FI~ HYD~NT - ON MO~WK, IN PA~NG LOT NEXT TO FITNESS ROOM, IN PA~NG
LOT BEHIND BUILDING 4, IN PA~NG LOT BEHIND RESTA~NT, ON CALIFO~IA AV
O
i~ Build~g Occupancy ~vel
o
o
-7- - 01/20/2000
SHERATON FOUR POINTS HOTEL ~E~i~i~i~EEEEEiSiS~E~ SiteID: 215-000-000160
i~ Tra~ng ~~e~e~~~e~eee~e~e~e~ Overall Site
lee Employee Trai~ng eeeeeeeeeee~e~ee~~~eeeeeeee 03/02/1992 i
0
WE ~VE 80 EMPLOYEES AT THIS FACILITY o
O
WE ~VE MATE~AL SAFETY DATA SHEETS ON FILE o
o
B~EF SUMMARY OF T~INING: ALL NEW EMPLOYEES ARE T~INED TO USE CHEMICALS.
ALL UPDATES ARE POSTED DAILY.
O
O
o
i~ Held for Fumre Use
o
0
-8- 01/20/2000
MATERIAL SAFETY DATA SF~T
I - PRODUCT IDENTIFICATION
COmPANy ~%ME: Nu-Calgon Wholesaler. Inc.
Tel No: (314) 994-1010
ADDRESS: 2451 Schuetz Road (800)554-5499
Maryland Heights, MO 63043 .CH~tTREC: (800)424-9300
PRODUCT NAME: No.340 Liquid Scale Inhibitor Product No.: 43'40 __
Synonyms: Phosphonate Glycol Mixture
II - HAZARDOUS ING-~KED~az~TS OF MIX~)R~S
MATERIAL: (CAS#) (ORAL LDS0) % Bv Wt, TLV PEL
#Ethylene Glycol (107-21-1) (Rat 8540rog/kg) 13 50.p~m , 50p~m
....... . ............. _ .................................. (ceil~.ng). ceil~.ng) .........
#Ingredient subject to reporting under Section
313 of Title III (SARA) and 40 CFR 372.
III- PHYSICS'. DATA
Vapor Pressure, .n~n Hg: Like Water Vapor Density (Air=l)60-90F: Like H20
Evaporation Rate (ether=l): N/A % Volatile by wt @70
Solubility in H20: C. omplete pH @ Solution N/A
Freezing Point F: N/A pH as Distributed :. 8.5'
Boiling Point F: >212 . Appearance: Clear, colorless liquid
Specific Gravity ~20=1 @25C: 1.25 Odor: Chemical odor
~v - FI~E AND ~-.~LOS~Q~
Flash Point F: Not flammable Flammable Limits: N/A
Extinguishing Media: Product is not flammable.
Special Fire Fighting Procedures: Always use suitable equipment for
,fighti.ng chemical fires. A self-contained breathing apparatus and
zmpervlous clothing.
Unusual Fire and Explosion Hazards: None known.
V - REAUrZVITY DATA
Stability - Conditions to avoid: None known.
Incompatibility: Strong oxidizers.
Hazardous Decomposition Products: Unkn°~.
Conditions Contributing to Hazardous Polymerization: None known.
(Cont'd on Page 2)
No.340 Liquid Scale Inhibitor
VI - HEALTH HAZARD DATA
EFFECFS OF OVEREXPOSURE (Medical Conditions Aggravated/Target Organ Effects),
A. ACUTE (PrimaryRoute of Exposure) EYES & SKIN: Causes irritation to
both eyes and skin= INGESTION: Harmful if swallowed. Large quantities
will cause upset to stomach.
B. SUBCHRONIC, CHRONIC, OTHER: No available information was found'
VII - EME~!~CY~/qD FIRST,Tn
EYES & SKIN: In case of contact, in~nediately flush eyes with plenty of
water for at least 15 minutes. Call a physician. Flush skin with water.
INGESTION: If swallowed, induce vomiting i~ediately by g%ving two
· glasses of water and sticking finger down throat. Never give anything
by mouth to an unconscious person. Call a physician.
RemOve any remaining material by abSOrbing on vermlcu±lue or o~ner
suitable material and place in ~ sealed metal container for disposal.
Waste Disposal Methods: r~ndfill or mix with a flammable solvent and
incinerate in accordance with local, state and· federal regulations.
IX - PROTEcT~ONINFORMA'.~ION/C~'~OL~A~u~ES
Respiratory: Not required unleSs the TLV Eye: Goggles or IGlove: Rubber
for ethylene glycol is exceeded, safety glasses
Other Clothing and Equipment: Not required.
VentilatiOn: Mechanical exhaust is reco~nended.
~ - sPEcIAL PRECAUTIONS
Precautions robe taken in Handling and Storing: Avoid contact~with
eyes, skin and clothing. Keep container closed. Wash thoroughly after
handling. Use with adequate ventilation.
Additional Information: Read and observe all labeled precautions.
Revision Date: 07/06/94
Seller makes no warranty, expressed or implied, conce~ing the use of this
product other than indicated on the label. Buyer assumes all risk of use
and/or handling of this material when such use and/or handling is contrary
to label instructions.
While Seller believes that the information Contained herein is accurate, such
information is offered solely for its customers' consideration and verification
under their specific use conditions. This information is not to be deemed a
warranty or representation of any kind for which Seller assumes legal responsi-
bility.
· . PAGE 2
FourPoints'
HOTELS
Sheraton
February 29, 2000
Ms. Esther Duran
Office of Environmental Services
Bakersfield Fire Department
2101 "H" Street
Bakersfield, CA. 93301
Dear Ms. Duran,
Thank you for taking the time with me to discuss the Hazardous Materials Business Plan document, which
your office forwarded to us for review.
Upon following your instructions, I have made the necessary hand written changes to this document to
update our business plan. This includes the change of contact names, telephone numbers, property
ownership and the corrected quantity of chemicals that are currently on site. I have also reported in this
plan a new!chemical;.which replaced Sanacor, which was used in our cooling tower. The chemical now
used to treat, our'cooling tower is a product by Calgon called "Liquid Scale Inhibitor". I have included a
copy of the MSDS sheet for this product for your review. Please note that we do not use Sanacor on
property.
Should you have any questions, please feel free to contact me. My direct line is 661-862-7428.
Thank you,
,/~~TG~roalurM~?ina tgse~otel b~Sheraton
Bakersfield,. CA, ~ :: · . ..: ' ......
Four Points Hotel Bakersfield
5101 California Avenue, Bakersfield, CA 93309, Telephone: (661) 325-9700, Fax: (661) 323-3508
THE FOUR POINTS HOTEL BA,~ERSFIELD IS OWNED BY RFS INC. HOTEL INVESTORS AND OPERATED UNDER A UCENSE ISSUED BY FOUR FOINTS HOTEL BY SHERATON.
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FA C I L ITY N A M E ~/( r~/~' ~/~'fl'/'(-&''~A/ INSPECTION DATE
ADDRESS ,.~'/P/tC~'~/~'/~rt~JA,~'' PHONE NO.
FACILITY CONTACT ,,~////']~Z4'/"/'~ rd' BUSINESS ID NO.
INSPECTION TIME /-,5"-~ t NUMBEROF EMPLOYEES
Section 1: Business Plan and Inventory Program
[outine[221 Combined [~ Joint Agency [21 Multi-Agency [21 Complaint ~.J Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact intbrmation accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
·
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazard°us waste °n site?: [~ Yes 3° /2~9. 0t,c,,l
Explain:
Questions regarding this inspection? Please call us at (805) 326-3979 gusi~' Party
White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspecto~
' ,",,.-. ~'.. ~:.>- ' : Bob Anto~~ 5
Chief Engin(r~.,/
O Four Points Hotel Bakersfield
FourPoints 5101 California A~enue
Bakersfield, CA 93309
H 0 T E t S Telephone: (805)325-9700
Direct Line: (805) 862-7457
~ Fax: (805) 323-3508
Bill Mur ',, C.H.A.
General ~r
O Four Points Hotel Bakersfield
F0ur Point s 5101 California Avenue
®
Bakersfield, CA 93309
H o T E L S Telephone: (661) 325-9700
Fax: (661) 323-3508
Sheraton Direct: (661)862-7428
Email: wkmurray@aol.com
~.,
[0/31/95 SHERATON VALLEY'¥iNN 215-000-000 6~/
Overall Site with 1 Fac. Unit
General Information
Location: 5101 CALIFORNIA AV Map:102 Haz:2 Type: 3
City : BAKERSFIELD Grid: 34B F/U: 1 AOV: 0.0
Contact Name Title Contact Name Title
JOHN LLOYD / DARREN WOOD /
Business Phone: (805) 325-9700x Business Phone: (805) 325-9700x
24-Hour Phone : (805) 664-1111x 24-Hour Phone : (805) 323-3547x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Administrative Data
Mail Addrs: 5101 CALIFORNIA AV D&B Number:
City: BAKERSFIELD State: CA Zip: 93309-
Comm Code: 215-011 BAKERSFIELD STATION 11 SIC Code: 7011
Owner: GUS ENTERPRISES X Phone: (805) 325-9700
Address: 180 HARBOR DR State: CA
City: SAN FRANCISCO Zip: 94965-
Summary
!, T~.~ ~ _ Do hereby certify that ! have
reviewed the attached hazardous materials ma;;age-
ment plan for~Z-~ ~ and that it along w'~h
~ ' (Na,..~ a.~,~') '"
any corrections constitute a complete and correct man-
agement plan for my facility.
10/31/95 SHERATON VALLEY~INN 215-000-000160 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-002 SANACOR Liquid 55 High
· Delay Hlth GAL
02-003 FREON 22 Gas 134 Low
· Fire, Pressure, Immed Hlth FT3
02-001 FREON 12 Gas 95 Minimal
· Fire, Pressure, Immed Hlth GAL
10/31/95 SHERATON VALLEY INN 215-000-000160 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-002 SANACOR '~ Liquid 55 High
· Delay Hlth GAL
CAS #: 79-10-7 Trade Secret: No
Form: Liquid Type: Mixture Days: 365 Use: WATER TREATMENT
Daily Max GAL55 I Daily Average55.00GAL ~ Annual Amount100.00GAL
Location
Storage Press T Temp
DRUM/BARREL-NONMETAL IAmbient/AmbientlNE CORNER
- Conc Components ~ MCP -~Guide
0.2% IAcrylic Acid IHigh ~ 29
0.5% IFormaldehyde (EPA) IHigh 29
02-003 FREON 22 Gas 134 Low
· Fire, Pressure, Immed Hlth' FT3
CAS #: 75-45-6 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: HEATING
Daily Max FT3134 I Daily Average68.00FT3 I Annual Amount134.00FT3
StorageI~Press T Temp Location
PORT. PRESS. CYLINDER IAbove~AmbientlNE CORNER
-- Conc
I'Chlorodiflu°r°methane Components I MCP -~Guide
· 0% ILow ! 12
100
02-001 FREON 12 Gas 95 Minimal
· Fire, Pressure, Immed Hlth GAL
CAS #: 75-71-8 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: CLEANING
Daily Max GAL95 I Daily Average63.00GAL 1 Annual Amount95.00GAL
Storage Press T Temp Location
PORT. PRESS. CYLINDER IAbove~ ~AmbientlNE CORNER
-- Conc Components ! MCP ---TGuide
100.0% IDichlorodifluoromethane ~Minimal I 12
10/31/95 SHERATON VALLEY INN 215-000-000160 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
FIRE PROCEDURES ARE KEPT POSTED IN ALL EMPLOYEE WORK AREAS. ALL PERSONNEL
ARE TRAINED ON HOW TO HANDLE AN EMERGENCY SITUATION. PERIODIC RE-TRAINING IS
CONDUCTED BY DEPARTMENT HEAD. ALL GUEST ROOM DOORS HAVE EMERGENCY
EVACUATION PROCEDURES POSTED.
<3> Public Notif./Evacuation
ALL DEPARTMENT HEADS NOTIFY OUR FIRE BRIGADE WHICH HAS BEEN TRAINED TO
EVACUATE THE BUILDING AND DIRECT GUESTS TO SAFE AREAS.
<4> Emergency Medical Plan
CONTACT 911 WE SEND ALL PEOPLE TO MEMORIAL HOSPITAL OR MERCY. WE ALSO SEND
PEOPLE TO VALLEY INDUSTRAIL MEDICAL GROUP.
MEMORIAL HOSPITAL MERCY HOSPITAL VALLEY INDUSTRIAL GROUP
420 34TH STREET 2215 TRUXTUN AV 2501 G STREET
BAKERSFIELD, CA BAKERSFIELD,.~A. BAKERSFIELD, CA.
(805) 327-1792 (805) 327-3371
10/31/95 SHERATON VALLEY.INN 215-000-000160 Page 5
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ALL HAZARDOUS MATERIALS ARE KEPT IN LOCKED STORAGE. LIMITED ACCESS TO
HAZARDOUS MATERIALS BY DEPARTMENT HEADS ONLY. ALL MATERIAL DATA SHEETS ARE
KEPT POSTED WITH HAZARDOUS SUBSTANCES. ALL PERSONNEL ARE TRAINED ON THE
PROPER USE OF MATERIALS BEFORE PERMITTED TO USE. ROUTINE RE-TRAINING IS
PROVIDED BY DEPARTMENT HEADS. LOCKED STORAGE AREAS ARE CHECKED DAILY.
<2> Release Containment
<3> Clean Up
<4> Other Resource Activation
10/31/95 SHERATON VALLEY INN 215-000-000160 Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - IN PARKING LOT OFF MOHAWK NORTH SIDE FITNESS ROOM
B) ELECTRICAL - IN UTILITY ROOM BEHIND MAIN DESK
C WATER - AT STREET ON MOHAWK BY GUEST REGISTRATION PARKING
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - ALL GUEST ROOMS, STORAGE AREAS, AND PUBLIC SPACE
ARE EQUIPPED WITH SMOKE ALARMS, SPRINKLERS, AND FIRE EXTINGUISHERS.
FIRE HYDRANT - ON MOHAWK, IN PARKING LOT NEXT, TO FITNESS ROOM, IN PARKING
LOT BEHIND BUILDING 4, IN PARKING LOT BEHIND RESTAURANT, ON CALIFORNIA AV
<4> Building Occupancy Level
10/31/95 SHERATON VALLEY INN 215-000-000160 Page 7
00 - Overall Site
<G> Training
<1> Employee Training
WE HAVE 80 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: ALL NEW EMPLOYEES ARE TRAINED TO USE CHEMICALS.
ALL UPDATES ARE POSTED DAILY.
<2> Page
<3> Held for Future Use
<4> Held for Future Use
Ag~ount Number
ACCOUI~ ECEIVABLE ADJUSTMENT' ~.. ~. .~..,,.. .,.
March 21~ 1995
Date New Ac=ount
New Address
Esther Duren Close Account
From Service Charms
Other Adjustments X
Fire Department- Hazardous Materials Division
Department/Division
SHERATON VALLL=Y INN
Billing Name
5101 CALIFORNIA AVE.
Billing Address
Site Address
Parcel # (If Applicable)
Landlord Name & Address (If Applicable)
ADJUSTMENT
Last Billed Correct Billing Adjustment to Effective Date of
Billing Change
< 19.22 · 03-01-95
Remarks: PAYMENT WAS POSTED ON MARCH 2ND AFTER FINANCE CHARGES HAD BEEN
ADDED. WE WILL WRITE OFF THE FINANCE CHARGES.
Page: 1 Account Billing/Collection Activity Inquiry SUTL108
Acct : 385801 C¥c St CL Bill St: NO Cyc: 5 Rt: Seq:
SSN : Parcel: .... Svc Cls :e
Name : SHERATON VALLEY INN
Svc Add: 5101 CALIFORNIA AVE
Amt due: 19.22 Current Period Postings
Lst Pmt: -160.00 Type Desc Date Amount Receipt #
Pmt Dte: 03/02/95 Bgl PENALTY 03/01/95 16.00
-- Prior Bills -- B92 FINANCE CHARGE 03/01/95 3.22
Date Balance 99 PAYMENT 03/02/95 -160.00 104189
01/01/95 0.00
01/01/94 0.00
01/01/93 0.00
01/01/92 0.00
01/01/91 0.00
02/15/90 0.00
Enter '/' For Billing History, 'P' To Print Report, 'D' For Detail Page, or
'/C' For Credit and Deposit History or 'XX' To Exit
· f~ ' RECEIVE.r!.
(ty~e or ~rin~ name) .
J A N 2 z~
Do hereby certify that I have reviewed the Afls'(i ............
attached Hazardous Materials business Dian
(name of bus
and that it along, with the attached additions
or corrections constitute a comDlete and correct
Business Plan[ ,,,fo///ity.
~'~, sBfJSINEiSS N~blE SHE N VALLEY INN ID BER Z]S~(~-OB~)IB(~
' LOCATION 5101 CALIFORNIA F~V HIGH HF-)ZARD RATING
!. OVERVIEW
LAST CHANGE 03/18/88 BY EVAMC
JURIS COOE 21S-011 SURIS BAKERSFIELD STATION II
M~P PAGE lO2 GRID 34B 'FA~T¥"ONITS'I" f~AZ~R~ RATING Z
RESPONSE SUMMARY 2A SEC 4) NO PRIVATE'TEAM ....
EMERGENCY CONTACTS 2A SEC Z)
C .... '"'""'"' ]~Z B- 9'"m0 - . OYG o~m.
~ bb. LLERS iq,'ilml, b.i~iGR.~ '..
UTILITY SHUTOFFS ER SEC 3)
Et) GAS - SEE SITE DIAGRAM ATTACHEO B) ELECTRICAL - SEE SITE DIAGRAM ATTRCHEO
C ~ATER - SEE SITE OIAGRAM RTI'FICHED D) sPECIAl..'- NONE E) LOCK 80X -
Z. NOI'IFICRTION / PUBLIC EVACUATION
~0'+~ LRSI' ~'CH~NGE / / BY
< NO jNFOR~TIOB ~FBBR~O FOR 'THIB SEOTION >
PP, GE 1 :'" "'" I"ZI"~O'/8'8-"FF:~'~,~
' I"tATER! IBL' SBT'ElY 'DATA 'S¥Sq'Et"IB, ' INC. ' ('BO."S) B4'8-;BB00
~ ?:~-~ BUSINESS NAME VfiLLEY INN IO~I~MBER
~" ' LOCRTION SlSl CALIFORNIA RV HISH HAZARD RRTING
3. HAZ M~T TRSINI~ SUMM~RY
[~ST~ C'FIF~ E / / BY
-.. NO INFO~RTION'~'CO~ED'FOR'~[S"SECTION >
LOCAL EMERGENCY MEDICAL ASSISTANCE
....... L~S~ CHANGE 03/10/88 BY EVAMC
SEC 5) CONTACT 911 ..........
PAGE 2 t7__/Z0/88 ll:SIS
MATERIAL SFIFETY DP!IrA' SYST£MS;" 'INC'. 'I"BOS) B48-GBS~)
BUSINESS NAME SHE N V~LLEY INN ID BER 215-O(~-OOOiBO
LOC~TION 5tO1 C~L, IFORNIB RV HIGH HRZBRD R~TING 2
FRCILITY UNIT O1
~ OVERRLL HRZRROOUS M~TERIRLS'IN~C~TOR¥
.... ' ..... [~'5T'CH'~&qSE"O~/T~/BB BY EVRMC
ID TYPE NAME ~' M~X AMI' UNIT H~ZARO
LOCATION CO~KFR'~NMET~ USE '
1 MIXTURE SCUM CLERN '~$ GRL UNKNOWN
HOUSEKEEPING DRUMS OR'BRRRELS ~ET,. CLERNI~
ID PERCENT COMPONENTS ...... HRZRRB LIST
2 MIXTURE SRNRCOR 55 GRL UNXNOYN
UTILITY ROOM DRUMS OR B~R NON HET. YRTER TRERTMENT
iD PERCENT COMPONENTS ...... HAZRRO LIST
FIRE PROTECTION / Y~TER SUPPLIES
L~ST CHANGE O~/10/B8 BY EV~MC
3A SEC 4) ~LL GUEST ROOMS, STORAGE '~RE~S,"~I~O"BUBLIC"'SPACE ARE EQUIPPED WITH
SMOKE ~L~RMS, SPRINKLERS, HNO'~FIR~"E~TINGOI'SFIERS'~
M~TERI~L SAFETY'DAT~"SYSTEMS~'SNC% (80'S'Y'B~B=G'8~ .....
" BUSINESS NAME SHE )N VRLLEY INN ID BER ZiS~~-~lGO
z " ; LocATION 5101 CALIFORNIA AV HIGH HAZARD ~ATING Z
O. EMPLOYEE NOTIFICATION / EVACUATION
LMST CHANGE 03/t0/88 BY EVRMC
3R SEC Z) FIRE PROCEOURES"RRE'KEPT"P'O~TErD"iN ALL EMPLOYEE WORE PREPS.
ALL PERSONNEL' RRE"'TR~rNEO"O~HO~"TO"~RNBE:E'~'~ EMERGENCY SITUA~FION.
PERIODIC RE-TRAINING IS"CONO~IETI'ED'~Y.'.'D~PARTMENT HE~D.
RLL GUEST ROOM BOORS HAVE EMERGENCY EVACUATION PROCEDURES POSTEO,
E. MI'FIGRTION / PREVENTION / ABATEMENT
LRST CHRNGE 03/10/B8 BY EVRMC
SEC 1) ALL HA7RRDOUS MATERIALS ARE KEPT IN LOCKED STORAGE.
LIMITED RCCES~,i TO HRZRRDOUS MATERIALS BY DEPRRTMENT HERDS ONLY.
RI, L MRTERIRL DRTR SHEETS PRE KEPT POSTED IJITH HAZARDOUS SUBST(qNCES.
RLL PERSONNEL ¢~RE TRRINEi] ON THE PROPER. USE OF MATERIALS BEFORE
PERMITTED TO USE
ROUTINE RE-TRRINING IS PROVIDEB BY DEPARTMENT HEADS.
LOCKED STORAGE ¢tREAS PRE ~CHEC~(ED'~DRI'EY
PAGE 4 12/20/8'8
MRTERIRL SAFE"fY DRTR SYSTEMS, INC~ (805) G48-~8¢~
· CITY of BAKERSFIELD
Far, an~ Agriculture ', , Sta,dar~ Husioess ~' I-[J~.7-J~./~,:DOTJS ~~~ ~~ ~ ~V~~-O~'
' ,.~e/_. of
BUSINESS NAME:~~~~ /~ OWNER NAMe: ~ ~~/~ ~ , NAME OF T~ FACILITY:
LOCATION: 5-/0/ ~~ ~~. ADDRESS: ~3~0 ~/~3~/; ~d~~ F/O STANDAnD IND. CLASS CODE '~
CITY, ZIP: ~~~_~ ~ F~~ CIT~, ZIPt~_C~,/~O d~- ~~- DUN AND BRADSTREET NUMBER
~ ~0 XNS~C~XONS ~OR ERO~
I ? ~ 4 S S 7 g g lO I1 1~ 1) II
Code Code Amt A~t Est ~nlts ~ Site Ty~ Prell ]~ C~e .. Stored In Facility See Instructt~s
(C~k all that apply)
: Health ' ~ of Pressure flMlth
P~ysical end Health Hazard C.A.S. Numbr C~t 11 No~ & C.A.S. Num~r
,~,.~ .,, ,~, ...,,~ ~ 7~-/a - 7 :J~'~.K~ ~ ~ ~ / ~
Health -of Pe~sure H~Jth ' ' ......
~Pm~t I] Na~ & C.A.S. Numar
Physical and Health Hazard C.A.S. Numar ~Mt II NoN & C.A.S. Numar
[ ~ ~tre H~z4cd [ ~ Reoctivtty [ ~ Deiay~ [--~ Sudd~ Reielse [ ~
Health of Pressure Health ' ' .....
i~ Fire Hazard ~-J Reactivity Delayed ~dd~ Release I~late .
~ Hea Ith of Pressure Health .............
,~,~,~,~;,~,~-,, '~ ~ --- · , ~,~ ~ (/(~ ',, ~oa. ~o~~- ..... '~,~~,~'~Z~--'-~V~o~
....0 ~ ..... ~_~_A ......... ~.~e ................................................................ ~..==~==.== .... ~--__=.~_
Certification (Read and sJEn afte
~ certtfy under ~alty of la. that { have t based ~ my inquiry ef t~se individuals
CITY of BAKERSFIELD
Farm and Agricu)ture ~ Standard Business
LOCATION: ~/0/ ~6/F ~W3 ADDRESS: ~30 ~/~SH/~ ~dV ~ )[0 STANDARD IND. CLASS CODE
CITY, ZIP:~F/~.O ~ ~~ CITY, ZIP: 5~h~hO~O . ~- '~9~- DUN AND BRADSTREET NUMBER
~ ~o z~s~uc~zo~s ~o~ wov~ COD~S
Code Code Amt lmt Est Units ~ Site Ty~ Prell Cap C~e .. Stored In Facility See Instructtms
r ~ ~ C~mt 12 ll~ I C.I.S. Number
Be~lth of Pressure H~lth
C~t l] Name & C.A.S. Number
Health - of Pr~sure H~Jth ............
~am~t 13 Nam & C.I,$. Numar
Physical and Health Hazard C.l.S. Numar b~t Il NaN i C.A.S. Numar
(C~k all ~t apply)
Health of Fr~sure Health
~mt I~ Na~ & C.LS. Numar
Physical end Health Hazard C.A.S. Num~r C~t II NaN & C.l.S. lum~r
(Check ail that apply)
r -- ~ r -- n r -- n r -- ~ r -- ~ C~t 12 NaN & C.A.S. Ndmber
~--a Fire Hazard c--a ~eactivity ~--a Oelayed ~--a ~dd~ ~elease ~--J I~fate .
~ealth of Pressure Health .............
Ca.et Il N8~ & C.J.S.
MERGENCY CONTACTS l1
Certification (Read and sign after compJetJnE aJ/ sections)
I ~erttfy under ~alty of law that I have oersonally examined and aa faetBav ~tth t~ tnforaattm su~ttt~ tn thtl u d t~t ~sed ~ ~ inquiry of t~se Individuals res~sible
,,_,,,,, ............................
2i30 "G" STREET RECEIVED
BAKERSFIELD, CA 93301 ~
(805) 326-3979 JUL 7 1987
Ans'd ............
OFFICIAL USE ONLY
000160
BUSINESS NAME
HAZARDOUS MATER I ALS
BUSINESS PLAN AS A WHOLE
FORM 2 A
INSTRUCTIONS:
1, To avoid further action, return this form by
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
A. BUSINESS NAME: SHERATON VA]],FY INN
B. LOCATION / STREET ADDRESS: 5101 California Avenue
CITY: Bakersfield ZIP: 93309 BUS.PHONE: (805
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:
NAME AND TITLE '"~-~/~' DURING BUS. HRS. AFTER BUS. HRS.
A. Gary Hageman Gen. Mgr. Ph# 325-9700 Ph# 398-8487
B, Tom Sellers Maint. Eng. Ph# 325-9700 Ph# 871-2535
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: ~ ~it~ dim~rmm
B. ELECTRICAL: "
C. WATER: "
D. SPECIAL:
E. LOCK BOX: YES / NO IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO
FLOOR PLANS? YES / NO KEYS? YES / NO
~/tm.~.- W~_-2A _
SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A ~fl-IOLE
Upon notification of a hazardous or potentially hazardous situation, Maintenance
Engineer and General Manager are immediately contacted. Emergency vehicles are
~_8o~t~.~ged if needed.
SECTION 5: LOCAL EMERGENCY ~EDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
Contact 911.
SECTION 6: E~PLOYEE 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: ' . 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 ?: HAZ~d%DOUS MATERIAL
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: ...... YE~.. NO
I, Gary Hageman , 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.
SIGNATURE / ~/~,,~ TITLE Gen. Mgr. DATE 6-2-87
.//' /
BAKERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET
BAKERSFIELD, CA 93301
OFFICIAL USE ONLY ID# 000160
BUSINESS NAME: Sheraton Valley Inn'
BU$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. ~ ......... . : -
FACILITY UNIT~ FACILITY UNIT NAME:
SECTION 1: MITIGATION, PREVENTION~ ABATEMENT PROCEDURES .,
1. All, i.hazardous materials are .kept. in locked..s,'.tor..ag~: .
2. Limited--access .to hazardous materials by-depar--tment,~h~ds
3. Ail material data sheets are kept posted 'with hazardous substances..
4. Ail personnel are trained on the proper use of materials before permittedto use.
5. Routine re-training is provided'by department heads. , .
6,, Locked storage areas are checked daily.
SECTION 2: NOTIFICATION AA~D EVACUATION PROCEDS-RES 'AT THIS ~'IT
1. Fire procedures are kept posted in all employee work areas. (see attached sheet)
2. Ail personnel are t~ained on how to handle an emergency situation.
3. P~riodic re-training is conducted by department heads.
4. Ail guest room doors have emergency evacuation procedures posted.
SECT!OM 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY
A. Does this Facilit¥ Unit contain Hazardous Mater~a!s? ...... YES NO
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES 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 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
Ail guest r~ms, storage areas, and public s~ce are equipped ~m"'Smoke' ale, s,
sprinklers, ~d fire extinquishers. "~'.~. ....I' ,' '~ ?-'.:.
SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E~RGENCY RESPO~ERS
See site diagram
SECTION 6: LOCATION OF UTiLiTY SHUT-OFFS AT THIS b~IT ONLY. ..
A. NAT. GAS..,"PROPANE'~
See site diagram
B. ELECTRICAL:
See site diagram
WATER:
See site daigram
D SPECIr
E ..... LOCK BOX: vt~s .." NO tF YES, LOCATION:
iF YES S~""? PLANS? YES / .YO MSDgs? YES"
FLOOR Pr.A.YS? YES / ~0 TEEYS? Y~S / ¥O
3~
EMERGENCY FIRE PROCEDURES
Should the fire alarm panel "sound" in the back office area or if a
guest should call to report a fire, please follow these important
emergency procedures:
1 .) If the alarm sounds, check the fire panel to determine where the fire is
located. Investigate quickly in the case of a false alarm.
2.) If a guest reports a fire, inquire as to where the fire is,located.
3.) Using the automatic dialing telephone (telecredit phone) at the front
desk, immediately call the Fire Department. Telephone number
~324-4542.
4.) Assign a houseperson or security officer to meet the emergency
vehicles at the entrance to the hotel to direct the firemen to the
proper location.
5.) Notify the maintenance engineer if not on property.
6.) Notify the general manager.
7.) Call all rooms in close proximity of the fire and advise the guest of the
emergency situation and to proceed to the nearest exit.
8.) If the fire is contained in a hallway, guests on the Iowerfloor should be
instructed to use the window exit. Guests occupying the upper floor
should be advised to feel the door for excessive heat before
attempting to exit through the hallway.
9.) If a guest is not accessible by phone, direct contact should be
attempted.
10.) Other emergency vehicles such as ambulance, paramedics, and
police should be contacted if necessary.
REMEMBER! THE MOST IMPORTANT THING IS
NOT TO PANIC IN AN EMERGENCY SITUATION.
BAKERSFIELD CITY FIRE DEPARTMENT
I.D. # FORM 4A-! Page
NON--TRADE SECRETS
HAZARDOUS lWXATER I ALS I NVENTORY
BUSINESS NAME: Sheraton Valley Inn OWNER NAME: GUS Enterprises X FACILITY UNIT #:
ADDRESS: 5101 California Avenue ADDRESS: 180 Harbor Drive FACILITY UNIT NAME:
CITY, ZIP: Bakersfield 93309 CITY,ZIP: San Francisco~ 94965
PHONE ~: 805-325-9700 PHONE #: 415-332-7940 .IOFFICIAL USE CFIRS CODE
ONLY
! 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT -USE LOCATION IN THIS % BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT, CHEMIqAL OR COMMON NAME CODE GUIDE
M ' 4 6 gal gal 10 08 lower 600 bldg. RDH Lime Solvent CRMT
M 9 48 gal gal 10 36 lower 600 bldg. Household Bleach CRMT
M 15 30 gal gal 10 08 Housekeeping D-Fen ORMA
~M '51~?' 220 gal J'gai 06 08 Housekeeping Scum Clean ORMA
M 5 5 lbs lbs 10 30 Housekeeping ~ Mop-Up PSNB
M 2 6 gal gal 10 20 Housekeeping MSR Mildew Stain Remover ORMA
M 5 30 gal gal 10 05 Housekeeping Rim Bowl Cleaner~ CRMT
M 3 18 gal gal 13 03 Housekeeping Orange Twist CMLQ
M 5 2~al gal 10 08 Housekeeping Chemtrol Glass & Mirror Cleaner FLLQ
M 5 5 gal gal 10 38 Lower 600 bldg. No Rinse Half Time Wax Stripper FLLQ
M 5 36 gal gal 10 08 Housekeeping Spray Wipe ORMA
M 5 30 gal gal 10 08 lower 600 bldg. Dazzle Neutral Floor Cleaner ORMA
M 1 25 gal ,b, bl 06 08 Housekeeping Liqui-Terge Detergent ORMA
M 5 5 gal gal 10 08 lower 600 bldg. One Coat High Solids F16or Finish ORMA
M 5 5 gal gal 10 34 lower 600 bldg. Acrathane Resilient Floor Sealer oRMs
NAME: Gary Hageman ' -:~. TITLE: Gen. Mgr. S GNATU'RE'! DATE :.
EMERGENCY CONTACT: Gary Hageman TITLE: Gen. Mgr. PHONE # BUS HOURS: 325-9/00
AFTER BUS HRS: 398-8487
E~ERGENCY CONTACT: Tom Sellers TITLE: Maintenance Engineer ~. PHONE # BUS HOURS: 325-9700
· PRINCIPAL BUSINESS ACTIVITY: Hotei AFTER BUS HRS: 8/1-2333
- 4A-1 -
BAKERSFIELD CITY FIRE DEPARTMENT
I.D. ~ / FORM 4A-1 Page 2 ':6'f :2',
i NON--TRADE SECRETS \
HAZAR. DOUS HATERI ALS I NVENTORY .~ .~'.
BUSINESS NAME: Sheraton Valley Inn OWNER NAME: GUS Enterprises X FACILITY UNIT #:
ADDRESS: 5101 California Avenue ADDRESS: 180 Hartx~r Drive FACILITY UNIT NAME:
CITY, Z I P: Bakersfield 93309 CITY, Z I P: San Francisco 94965 "
PHONE ~: 805-325-9700 PHONE #: 415-332-7940 IOFFICIALONLY USE CFIRS CODE
1 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CeNT 'USE LOCATION IN THIS % BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. .CHEMICAL OR COMMON NAME CODE GUIDE
M 5 5 gal: gal 10 08 Housekeeping Skin It Kleen CRMF
M 5 30 gal gal 10 08 Housekeeping Chemtrol Non-Acid Bowl Cleaner OR~
M 100 500 lbs lbs 07 41 UTILIT~ ROOM Pool Chlorinating Tablets 0XID
M 50 250 lbs lbs 07 41 UTILITY ROOM Chlorinated Granules 0XID
M 10 30 gal:: gal 10 41 UTILITY ROOM ~ HASA Muriatic Acid CRMT
M 5 30 gal,~ gal ~0 41 UTILITY ROOM HASA Pool Chlorine OXID
. 55 80 gal ~ 07 41 UTILITY ROOM Sanacor CRMT
NAME: Gary_ Hageman TITLE: Gen. Mgr. SIGNATURE: DATE:
EMERGENCY CONTACT: Gary Hageman TITLE: Gen. M~r. PHONE # BUS HOURS: 325-9700
AFTER BUS HRS: 398-8487
EMERGENCY CONTACT: Tom Sellers TITLE: Maintenance Engineer., PHONE # BUS HOURS: 325-9700
PRINCIPAL BUSINESS ACTIVITY: Hotel AFTER BUS HRS: 871-2535
- 4~-1 -