HomeMy WebLinkAboutBUSINESS PLAN .///-~ SITE/FACILITYFORM $ DIAGR~2~[
NORTH SCALE: BUSINESS NAME: ' , , FLOOR: [ 0F j
, O7l~~ ~ ~l~o~,~
" (CHECK ONE) ~ DIAG · FACILI~ DIAG~
Inspector's Comments): -OFFICIAL USE 0NLY-
HMCU- 13
l~,. IM~.I~T.A~NT MES~I~GE . [
I DATE P.'I~I.'
,F
PHONE NO.
CALLED TO SEE yOU WILL CALL AGAIN
WANTS TO SEE YOU RUSH
SIGNED
ASSOCIATED L1-A2334
'~ PTN OF SWV4 OF SEC. 20 T. 2OS. R.27E. 70-1
I
I
~ I F
CONDUCTOR PIPE~ · CELLARS
RATHOLE: · MOU~EHOLI~ DRILLING
Scare Lic. # 381787
NORD P.O. BOX 1288
BO,.~-39f~-55~) BAKERSFIELD. CA
SITE DIAGRAM ~ FACILITY DIAGRAM Business Nome: G./4/ ~ .~_~ ..~/.L,~/,-: ~OC. · ..
For Office U~e Only
First In Station: Area Mop # of
Insi~ection Station: NORTH ~"'~
. - FLOOR:
NORTH SCALE:i,, '- /o~ , BUSINESS NAME:
~ DATE:~/&7/~FACILI~ N~E: UNIT *: OF
(c~cK o~) ~-~ ' ~AC~CZ~
VLA
SITE DIAGRAM
Business Name: I~,,.,..r'c--~er~t~'e
Business Address: ?__.
FOr Office Use Only
First In Station: __ Area Map # 'li of
Inspection Station: NORTH ~/"~
BAKERSFIELD CITY FIRE DEPARTMENT
~ HAZARDOUS MATERIALS DIVISION
1715 ~CHESTER'-~A,V£~
· BAKERSFIELD, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
1. To avoid further action, return this form within 30 days of receipt. AUG B 1994
· 2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole. By
4. Be brief and concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS NAME: GU H fl~TI-{OI.-P__. DP-.~L.,L,i~jG;
MAILING ADDRESS: P~O. Pox
DUN & BRADSTREET NUMBER' ~ ~:~G~_~_.,~'.5- ~'~ SIC CODE:
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT . TITLE BUS. PHONE 24 HR. PHONE
.:-. - .. ' ~kersfie!d Fire Dept. " '.
H'a"~rdous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE: ~ P--5
BRIEF SUMMARY oF TRAINING PROGRAM:
s
SECTION 4: EXEMPTION REQUEST: "
I CERTIFY UNDER PENALTY OF PERJURY THAT'MY BUSINESS IS EXEMPT FROM THE
REPORTING 2E~UIREMENTS OF CHAPTER ~.95 OF 7HE "CALIFORNIA HEALTH '&
SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT HANDLE. HA~..R~O'US MATERIAES.' '"
WE DO' HANDLE HAZARDOOS MATERIALS, BUT THE QUANTITIES AT NO
TIMEEXCEEO 'THE MINIMUM REPORTING Q.L.J,~NTrT. IES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION'
I, CERTIFY THAT THE ABOVE INFOR-
MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION 'WIbL,,BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "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 DATE. · ....:;
, .. 3: .... B~t~ers~..etcl Fize Dept.~j
" Hazardous Materials Divis[o~
HAZARDOUS MAIERIALS MANAGEMENT PLAN
Facilify Unit Name: ~'~/4 i~/gt'~/~L~ j)~'/I,~ '.t~C, f~.-
SECTION 6: NOTIFICATION AND E,..V..AC, OATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
, F~-~ ~~t~.~-/~c~.-/-~ oN G~ne~. Ph~ ~b..
B,' EMPLOYEE NOTIFICATION AND EVACUATION'~
C. PUBLIC EVACUATION'
O. EMERGENCY MEDICAL PLAN'
.~ 'x -' : -~ Bakersfielc~F~eDept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS'
8. RELEASE-CONTAINmENT AND/O~ MINIMIZATION: ~ ' '-
~ -
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)'
SPECIAL:
LOCK BOX: YES/O tF YES, LOCATION:
SECTIQN 9:. PRWATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABIL[~ (FIRE HYDRAND' :
t..~----J-'-~*- ~ BA RSFIELDITY FIREPARTMENT
': HAZARDOUS1715MATERIALScHESTER AVE. DIVISION
BAKERSFIELD,(805) 326-3979CA' 93301 r' AUG g 1994 L~
H.~.ARDOUS MATERIALS INVENTO',
FACILITY DESCRIPTION
CHECK IF BUSINESS IS A FARM [ ]
SiC CODE · 1 ~ ~ ~ DUN & B~DSTREET NUMBER
OWNER/OPERATOR '~¢,hn St~ I_~_ ~_d~tO PHONE fl~- 71"~-- _~
MAILING ADDRESS ~ ~iP~:, I~ ~ .
EMERGENCY CONTACTS
BUSINESS PHONE _~O~" 3~3'~ 1 ~ 24-HOUR PHONE ~O~ 3~ 7 1 ~'~
BUSINESS PHONE <~¢~"- ~"~'~ "TL~.,~"' 24-HOUR PHONE
BAKERSFIEI CITY FIRE DEPART tENT
HAZARDO' jS MATERIALS INVENTOR?
usinessName ~.~ %~0~ ~,~ A~dress.~ ~~~ ] ~~.~,. ~,~
CHEMICAL DESCRI~ION
1) IN~NTORYSTA~S: New[ ] Addition{ ] Revision~ Deletion{ ] Checkifchemic~isaNON~DESEC~ ~DESECR~
4) PHYSICAL & H~L~ ,. PHYSICAL H~L~
H~RD CA~GORIES Fire [~' Reactive [ ] Sudden Rele~e of Pressure [ ] lmmeOiMe He~h (Ac~e) [ ] Delayed He~h (Chronic)
~) WAS~ C~SS~mCA~ON ~ ~ I (3-digit.coU. ~o~ BHS Fo~ sO~m use CoDe
6) PHYSICALSTA~ Solid [ ]" Uquid [~ G~ [ ] Pure [~M~ure [ ] W~te [ ] R.ioa~we [ ]
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE B) STOOGE CODES
M~mum Daly Amount:
Average Daly Amount: ~1'' ~ curies '[ ] 5) Pressure:'
/.
Annua Amount: ~~ c) Temper~ure:
~gest Size'Container: ~
· Daw On Site _ _ ~ Circte~i~h Months: ~llYe~,)J, F, M, A, M, J, J, A,, S, O, 'N,
9) MI~URE: Ust COMPONENT ~~ % ~ AHM
chemica com~nen~ or
any AHM com~nents ~) ZI~)C ~/~ ~'~ ~ ~ ~ ~ ~
1 O) Location
.. CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New [ ] Add,ion [ ] Re,sion { ] Deletion [ ] Check E chemi~ is a NON ~DE S~R~ [ ] ~DE SECR~
2) Common N~e: 3) ~T ~ (opaona)
Chemica N~e: AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Read{ye [ ] Sudden Rele~e of Pressure [ ] Immedi~e Heath (Ac~e) [ ] ~layed He~th (Chronic)
5) WAS~ ~S~IFICATION (~igit code ~om DHS Fo~ 80~2) USE CODE
6) PHYSlCAL STA~ Solid [ ] ~uid [ ] G~ [ ] Pure [ ] Minute [ ] W~te [ ] Radioa~ive { ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Omly Amount: lbs [ ] g~ [ ] fi3 [ ] ~) Contaner:
Average ~mJy Amount: cudes [ ] b) Pressure:
Annu~ Amount c) Temper~ure:
~gest Size Contaner:
~ Days On Site Circle ~ich Months: AllYe~, J, F, M, A, M, J, J, A, S, O, N,
9) MITRE: ~st COMPONENT CAS · % ~ AHM
the three most h~aous 1 ) ' '
chemi~ com~nen~ or
~y AHM com~nents
-,
3)
!0) Lo'~on
, ce~ unoer ~en~ oi Jaw, mar i have ~emonaliy ex~tn~ ~o ~ f~tii~ wl~ me mtomaoon suDmt~ on ~is ~ ~l a~cn~ Oocumen~. I Deiieve
subm~ in~a~on is ~e, accumm, ~d complete.
PRINT Name & 77tie of AuthonZeO Com~any Represenrative Signature Date
OSxO1x94 1~06 ~ $05 ~92 8165 SULLIU~5
Material Safety Data Sheet
1. CH~HIC[L PRODUCg AND CO~PAN~ IDENTIFICA?ION
C~SVRO~ ~hO &00 Mvltioraae SA~ 15~-~0
PRODUCT NUMBER(S)1 CPS235101 CPg23B0t9
COHPAN¥ IDEN?IFiCATION ~M~RGENC¥ ?BL~PHONE NUMBg~$
Chevron USA Produc~s Company HSALTH (24 hr): (800)231-[623 or
Bnvtronmental~ Safety, and Health (5i0)231-0623 (lnternat~.or.al)
$7~ Market St.', Room 2900 TRANSpORTATiON (2~ hr): Ci[gM?R~C
San Francisco, CA 9¢10~-2856 (8~0)42~-9300 or (202)483-i7616
PRODUCT INFORNAT1ON: MSDS Requests: (800) 228-3500
~nvi~onmental~ Safety, & Health In~o: (¢15) 894-1899
Product Information: (800) $82-3835 :'
2. COMPOSITION/IN~ORMA?ION ON INGRZDI~NTS
100.0 % CHEVRON DELO 400 Multi'fade 5AB 15W-40
CON?AININ~
COMPONE#?8 M4OUN? LI~IT/~?Y AGKNC¥/~!¥Pg
LUBRICATIN0 BASB Olb J
8~VER~L¥ R~FZNED P~TROLBUM DIS?ILLAT~
> ~0.0% 5 m~/m3 (m~t) ACGI~ T~A
10 m~/~3 (mist) ACGIH ~T~L
~ ~9/m3 (mist) OS~A
The BASB OIL may be a mixture of any of the following: CAS 6474188~,
CAS 647¢1895, CAS 647~1964, CAS 64741975, CAS 64742014, CAS 647426~5,
CAS 647~2516, CAS 64?42547, CAS 6¢742627, CAS 6~742650, or CAS
~DDITIVgS INCLUDING THE FOLLOWIN~
< 3o.0% ,
R~vI$1o~ H~mber:-~ - Revision Date= og/oa/9a HSD'S-Number! 00~602
NDA - No Data Available #A - ~ot Applicable
~%epare~ accor01ng t° t~e OsP. A Ratar~ Communication
(29 CFR 1910.1200} an~ th% ARS! ~SDS Stanaard (z400.l) by the Toxicology
a~ ~%&ith ~iSk AOSe$8~flt U~it, CRTC, P.O. BOX 4054, ~ohmon~, CA 94804
CHEVRON DgLO 400 #u grade 8Ag iS#-40 Page '2 St 7
~I~C ALKyL DITflIOPflOSPHATE I ·
Chemical Name: PHOSPHORODITHIolC ACID,O,O-DI-ci-14-ALKYL ESTERS, ZI!NC SALT
CAS68649423 ( ~,5%
Chemical Name: HSXkNE .
CA$110543 ~ 0.1% 50 ppm ACOIH
3500 mg/m~ ACGZH
1800 mg/m3 OgHA PE[
1 LBS CERCLA 02.4
CONPOSI?ION COI414EN?: '
All the components of this material are on the Toxic Substances Cortro~
Act Chemical Substance~ inventory.
This product fits the ACOIH definition for mineral oil mist. The
T~V is 5 mg/m$, the OSHA P~L is 5 mp/m3,
TLV - Threshold Limit Value TWA , Time Wei~hted Average
STEb - Short-term Exposure Limit TPQ - Threshold Planning
~Q - Reportable Quantity PEt, Permissible Exposure Limit
C - Ceiling Limit CAS chemical Abstract Servicl Number
A1-5 - Appendix A CategOries () - Change Has Been Proposed
~. HAZARDS IDENTIFICATION
pOTENTIAh H~ASTH
This substance is not expected to cause prolonged or a'ipnificant
irritation. This hazard evaluation is based on the data ~rom slmilar
materials.
This substance is not expected to caus~ prolonged or significant s"~in
irritation. The systemic toxicity of this substance has not been
determined. However, it should be practically non-toxic to internal
organs if it 9eta on' the skin. This hazard evaluation is based on data
from slmila~ materials.
The systemic toxicity of this substance has not been determined. ~owever,
it should be p~actically non-toxic to internal organs if swallowed. This
hazard evaluation is based on data £rom similar material~.
The systendc [~xJc[ty o~ this substance has not bee~ determined,
it should be practically non-toxic to [nternal organs i~ inhaled.
hazard evaluation is based on data [~om s~m[[ar material~.
4. FIRST AID ~ASURBS
'-~tston Numb° z Revision Date: 00/03/93 HSDS Number~: 0ossa2
NDA - No Oats Available HA - Not Applicable
X-DOS021
t
~o fir~st aid procedures ere required, llowever, as a precaution £1u~h eyes
with fresh water for 15 minutes, hemove contact lenses if worn.
SKIN~
No first aid procedures ere required. As a ,precaution, wash skin
thoroughlF with soap and water. Remove and wash contaminated cloth:!ng.
ING~STION~
1[ swallowed, give water or milk to drink end telephone for medical;
advice. Consult medical personnel before inducing vomiting. If medical
advice cant~ot be obtained, thet~ take the person a,d product cotttalm r to
the nearest medical emergency treatment center or hospital.
IN~ALATION~
since this material is not expected to be an it~ediate inhalation p:roblem,
no first aid proceaures ere requireO.
5, FIRE FIGHTING MEASURES
FLM4MABLE PROPERT I ES
I~LA~H POINT** (COC) 399F (204C) Min.
AUTOIGNITION~ NDh
FL~ABILITY LINITS (~ by volume in air): Lower: NA Upper: NA
EKTIN~U1SHIN~ MEDIA:
CO2, Dry Chemical, Foam and Water Fog.
NFPA ~TIN~St Health ~ ~lammability 1; Reactivity O.
FI~ FIGHTING INSTRUCTION6~
For fires invo~vln9 this meterie3, ~o not enter any enclose~ or con~ine~
fire spa~e wi{hou~ proper protective equipment, i.cluding self. contained
breathing apparatus~
~BU6T ION ~OD~O~g, , '
Normal co. bastion forms c~rbon dioxide, w~ter v~por and m~y produce~oxides
of sulfur, nitrogen and phosphorous. Zncomplete combustion can pro luce
caren monoxide.
~. ACCIDEN~A~
CHEMTREC EMERGENCY NUMBER (24 hr): (800)424-9300 or (202)483-7616
A¢CIDgN?AL R~L~A$~ MgABUNE$~
8tOp the source of the leak or release. Clee~ up release~ as soon ~s
possible. Contain ~iqui~ to prevent further contamination of soil,
surfaco water or groundwater. Clean up small spill~ using appropriate
techniques such as sorbeht materials or pumping. Where ~eas~ble and
appropriate, remove conCaminated soil. Follow prescribed procedure~ for
reporting and responding to larger releases.
7. BANDLIN~ AND
HANDLING AND STORAOE:
DO NOT we~d, heat or drill container. Residue may ignite with exp~sive
violence if heated sufficiently. CAUTION! Do not use pressure %o e~pty
Reveals. N.mbe~t 1 Revision Date: 09/03/93 MsDSN~ber:;O05602
NDA ~ No Da~a Available NA - Not AppliCable
CX~VROH DELO 400 ~istade SAE 15W-40 PaSe 4 of 7
drum or drum may rupture with explo~iw ~orce.
8. ~XPOSUR~ CON~ROLS/P~RSON~L PRO~CTION
PERSOHAL PROTE¢?IVK ~QUiPNENT
~o special exe protection ~s ~aua~y ncccs~aryo
8KIH PRO?EC?IOH:
No special skin protect[on is usually necessary, Avoid prolonged hr,
{requently repeated skin contact with this material. Skin contactlc~n be
minimized by wearing protective clothing.
No special respiratory protection is normally required. However, if
operat[n§ cond~tions create airborne concentrations which exceed the
recommended exposure standards, the use of an approved respirator Ss
required.
~NGIHEERIH~ CO~?RO~S~
Use adequate venLi~aLion to keep the airborne concentrations
material below the recommended exposure standard.
9. PHYSICAL AND CHEMICAL PROPERTIES
PHYSICAL DESCRIPTION:
Dark brown liquid.
DH: NDA
VAPOR PRBSSURB~ HA
VAPOR DSNSITY
(AIR-1)~ NA
FREEZING POINT~ NDA
M~LTIN~ POINT= NA
SOLUBILITYI Soluble in hydrocarbon so~ven%s; ~nsoluble in whter.
SPECIFIC ORAVIT¥: 0.89 @ 15,6/15.6C
DBNSIT¥I NDA
SVAPORATION RA?~ NA
VISCOSITY: 14.6 cst @ 100C (Min.)
P~RC~NT VOLATILE
(VO~)~ NA
10. STABILITY AND RRACTIVITY
HAZARDOUS DECOMPOSITION PRODUCTS:
NDA.
CHEMICAL
Stable.
CONDITIONS TO AVOID:
Ho data available.
IHCOMLaATIBI~,IT¥ WITH O?it~R MATERIAL5=
Revision Numbor~ 1 Revision Date: 09/03/93 MSDS Humber: 005602
MOA - No Data Available NA - Hot Applicable
08xO1x94 i$: 12 ~ 805 $92 0165 SULLIUAN$ PET.
C~EVRON D~O ~00 Nulttgrads SA~ 1§#-~0 ~age 6 oE ?
~ ,= ............... , , ..... ,
~ay r~act with strong oxidizing agents, such as chloratee, nitrates
I
peroxides, etc.
HAZARDOUS POLYMERIZATION: :
Polymerization wil~ not occur.
11. TOXICOLOGICAL INFORMATION
EYE EFFECTS:
No product toxicology data available. The hazard evaluation was b~sed on
data from similar materials.
SKIN EFFECTS:
'No pro, ucC Loxicolog¥ ~ata available. The hazard evaluation was ~esed on
data from similar m~terial~.
ACUTE ORAL
No product toxicology data available. The hazard evaluation was based on
data from similar materials.
ACUTE INa&~&TION
No product toxicology data available, ~he hazard evaluation was based on
data from similar materials.
ADDITIONA~ TOXICOLOGY INFOIU4ATION:
This product cat, talkie zinc alkyl dithiopllosphatos (ZDDPS). Several ZDDPs
have been reported to have weak mutagenic acti2ity in cultured marn~alian
cells but only at concentrations that were toxic to the test cells.I He do
not believe that there is any mutagenic risk ~o workers exposed tolZDDPa.
This product contains petroleum base oils which may be refined by various
processes including severe solvent extraction, severe hydrocracki~ or
Severe by, retreating. None of the oils requires a cancer warning ~der
the OSMA Hazard Communication Standard (29 CFR 1910.1200). These oils
have not been listed in.the Natiollal Toxicology Program (NTP) Annuil
Report nor have they been classified by the Internationa3 Agency
Research on Cancer (ZARC) as~ carcinogenic to humans (Group l), prpbably
carcinogenic to humans (Group 2A), or possibly carcinogenic to humlns
(Group 2~).
During use in engines, contamination of oil with ]ow levels of
ca,car-causing combustion products occurs. Used motor oils have been
shown to cause eklb cancer in mice following repeated application and
continuous exposure. ~rie£ or intermittent skin contact with used ~otor
oil is not expected to have serious effects in humans ii the oil is
thoroughly removed by washln~ with soap and water. See Chevron Material
Safety Data Sheet No. 1793 for additional information on used motor oil.
12. iICOLO6ICAL INFORMATION
I~COTOXICIT¥.*
No dat~ &vaiisbie.
ID/V/RONMENTAb
This matorlal tm not eX~ecLod LO ~re~ent. an~ onvit-onmontal' problom~ other
Revision Number~ I Revision Date: 09/03/93 MSDS Number: 006602
NDA = No Data Available NA - Not ApPlicable
than ~hose associated ~i%h oil sp$11~.
13 DISPOSAL CONSIDERATIONS
DIaPOSAn CONSIDERA?IONS:
Place contaminated materials in disposable containers and dispose o~ in a
maN, er consistent with applicable regulations. Contact local
environmental or health authorities for approved disposal of thio
material.
14, TRANSPORT INFORMATION
The description shown may not apply to all shippi2g situations,
Consult 49¢FR, or approp~'iete Dangerous Ooods Regulations, ~or
additional description requirements (e,g,, technical name) and
mode-specific or quantity-specific shippln9 requirements, .
DO? SHIPPING N~EI NOT DESI~ATED AS A HAZARDOUS MATERIAL BY THE
FEDEKAL DOT ' :
DOT HAZARD CLASS~' NOT APPLICABLE I
DOT IDENTIFICATION NUMBER~ NOT APPLICABLE
DOT PACKING GROUP~ NOT APPLICABLE
15 · R~GU~ATORY INFO~ATI ON
SARA 311 CATEDORIES: 1. ~ediate (Acute) Health Effec~st NO
2. Delayed (chronic) Health Sf~ect~s NO
3. Fire ~Hazard: NO
4. Sudden Release of ~ressure Ha~ardt NO
5, Reactivity Ha~ard~ NO
REgUlATORY LI~TS ~EARC~D=
01-SARA ~ 11-N~ ~TK ~i~TSCA Sect 4(e~
0~=MASS RTK 12=CERCLA 302.4 22-TSCA Sect 5(8}(e)(f)
03-NTP Carcinogen 13m~ RTK 23-TSCA Sect 6
04-CA p~op 65-Ca~cin ]4=ACG~H TWA 24-TSCA Sec~ 12(~)
05-CA Prop 65-Repro Tox 15=ACO~H STSh 25-TSCA Sect 8(a'.
06-IARC G~ovp 1 16-ACGIH Calc TLV 26-TSCA Sect
08-IARC Oroup 2B 19-Chevron TWA 29-OSHA CSILI~G
09-SARA 302/304 20-SPA Ce~clnogen 30=Chev~on STBL
10-PA RTK
The following components of this material are found on the
lists indicated, "
HEX~E m
Revision Number: 1 Revision Date~ 09/0~/~ NSDB Number 005602
NBA - No Data Available NA - Not Applicabl~
X-DOS~I
08xOlY94 '15:12 ~ 805 ~92 0165 ~ULLIV~N~ PET. P.O~
CHEVnOH DELO &O0 #ultigrade SAN 15#-40 Pogo ! ? Of ?
. is f'bu~d on lists:
PHOSPHORODITHIOIC ACID,O,O-DI-Ci-14-ALKYL BST~RS, ZINC SALTS
ia found on lists:
SEVBRELY RBFXN~D PETROLEUM DISTILLATE
is found on lists: 14,i5,i?,
15. OTHRR INFORMATION ~x
N~Pl RATINGS: Health l; Flammability t; Reactivity O;
(~east-0, Slight-i, Moderate-2, High-3, Extreme-d.). These values are
obtained using the guidelines or publishe~ evaluations prepares
National Fire Protection Association (NYPA) Or the Natiohal. Paint
Coatin9 Association (for }~I; ratings).
REVISION STATEMENT:
~evised for indexing purposes on~y,
The above information is based on the data of which we are aware
believed to be correct as st the data hereof. Since this information ma~
be applied under conditions beyond our control and with which ye m~y be
unfamiliar and since data made available subsequent to the do~e hereof may
suggest modtticatton of tho information, we do not assume any resp~nsibll-
lay for tho results of its use. This information is furnished upo~
condition that ~he person receiving it shall make his own determine,eisa
of the suitability o! the material for his particulac purpose.
Revision Numberz 1 Revision Date: 09/03/93 MBDS Number: 005602
NDA - No Data Available NA - Not Applicable
I...0~727/9,¢ Rtght--to.-..K~ow/F:ul'i List/b'y ConraC:ode. ariS/or Site ]i[) Page
? G & H i:;'.A"f'I-'IOLi!!! i}i:~]iI...LLNG ;[NC 0'15....0'10..--00'1:?~41
Overall Site with 1
General ]information
I..ocation: 2816 CALLONAY I)R Hap: 10'2. Hazard: llnrated
(';ity : Grid: 200 : '! AOV: 0,0
........... Contact Name ........................... 'T'it'le ...................... I ........... Contact Name .......................... '/"it'le ......................
J A H E S HOG G / P R E S ][ D E N'T' I J OH N S U L. L I V A N / S I",'l [;' "1 .... F R E A SU R I!!! R
Business Phone: (805) 32.3-,.?'142× I Business Phone: (805) 32.:3--.?'142x
:24-.-,Houn Phone : (805) 589...,0100x I 24-Houp Phone : (805) 83'1....8't60x
Pagem Pho,r)e : ( ) .... × ! Pager Phone ; ( ) .... ×
.................................................................................................... Administnative Data .......................................................................................................
Mail Addrs,, 2816 CALI.,.O~AY DR f.)&8 Number:
................... i .....................................................................................................................
Addpes~: 28'16 CAL. LCI~AY OR State: CA
City:8AKERSF:]I:EI...D Zip: 9:3308 ....
s,.~ ~,~, y .............................................................. ~......~ ...................................................................................... ~e~l~; :" ........................................................
~, ~Anpype or~O~LiPRPPrint Name) . do hereby ce~i~ that ~ ha~ -~r 5 I 1~4 /
~eviewedG ~ ~the attached hazardous~ materials managemeat ple~ KCFD H~CU
m ole
~or,,
~t~ _ and that it, along with a,~
(Name 0f Business)
~rrections. constitutes a complete and corre~ managsm~
plan for my facility.
ure ' Date
04,~/'.)..'t/94 IRfight....to....Kn'~w/t:::ull List/by CommCode en~r/on Site ]:D Page
G & H RA"f'HOLE DR]:LL:[NG ]:.NC 0t5...-010--..001341
02 -.- t:::Ixed Containers a~ Site
Hazmat Inventory Detai~ fin Reeerence Number Order
t:,A,:>t.~l... ]: N E I...i qufi d '1 '100 Ivloderat e
02..-00 i R E ()LiI...AI~ '" ~ ....
> Pine, l:)e'iay I"llth GAL
Form: Lfiquid Type: Pure ~1:)~: ~65 Use: I::UEI ....
............... ':,~]~ ~,~ ,:;*-. · ............... I'---~ ~::'~Y~ A~~ ,:;;,~.... ............... A~,,.,a~ Amo,.,~ ,:;*~...
" ' 1,100.00 j ~ 2v ~93.00 J 5,953.00
....................... Storage ....................... ~/Press~ j "f'emp .... J ........................................ !...ocation ...................................
ABOVI-:~ (~;I~OUND TANK ~ ~A~tent J Ambfient j
.... (':onc ................................... '..- .-%" ) ........................................ Components ................................................. j-.. IvlCP .......jGuide
1(~0,0~ JGasoq ine~ J ~vloderate
02.--.002 D:[ ESEI... FUEL I...fi qufi d 550 Low
> i::ire, De'lay H1th GAl...
CAS ~: 80088'19 Trade Secret: No
Form: [..fi quid Type: Pupe Da~'s: 365 ]lse: F:UEL
550.00 j ~2'- '----'7~0 i 3,3~0.00
I ocation
.... ~:::o~ .... t .................................................... ~O'"'¢'~:::°~P°~e~ ............................................... t .... t'J':::~' ........
de
100,0~ JDiesel i:::uel No,~~ jl~odepatej"
0472't/~4 IRdght...-to....Know/l::ult I_d~t/bM CommC:od~ and/oP S~t~ ];D
G & H I:~A"f't.~OI...E DI~];I..LING INC 015----010..--00'1:3~1
<D> Notif,/IEvacuation/l~dical
<~> Agency Notification
S I N C E "f' H E S E "1" A N KS A R N O T N E A R B L D G T H E G R O U N D I S C L E A R E [) "t"H
TO BE I...IT'I"L!~ NEE[~ OF EVACUAT]]ONr.- ~(i~EV;~R' ANY POPUI..ATE[~ AREAS HAVE
,
iii ~llvl E D i AT E '"c' '" c, e
A~ ...... I:::..:>..:> 'T'O F: R O N T G A"i" E. I ~
<2> E!mp'ioye~ No~'it:,/Evscua'cion
]:N I.~!I~'IP.I~GENCIES ALL OUR PE!RSONNEL ARE T() REPORT A'l .... I'HE FRONT GATES, 'I"HIS
Ivti!!!E"r':[NG F'I..AC:E :IS SAf::E AN[) AN AC:(::C~UN'I"]:NG 0!::: F'[!!RSC)NN!:!!i... (::AN SE! CC]N[)UC'I"[:":[],
<3> Public Not. if , /Evacuation
NI!':.:IGI"IBOI~S ON 130"I"H S][I)ES ()1: OUR YARI} NOULD 131!:] N()'T']] F'][ED ]IN CASE Ol:: AN
E Ivl I.'".'! R G !!!! N C Y,
<4> Emergency Ivledica! Plan
ANY L. OCAL I~EDICAL F:AC][L. ZTY CAN ("_:[E USED TO 'I"REAT CALISUALTIE!S [)LIE TO THE! ONL. Y
H. A Z A R [)0 U S Ivl A 'T' I!!! f.~. :i: A I... :1: S ~ (() ]: !!.:.' S !.!! L. A N !:) G A S 01... :1: N i!!! ) S H 0 P H A S ~!¢ A S :i: C I::: ]: R S"f' A ]:
IVtA"l" E F~ :[ A I .... O I L,
tv! 1.'.-'.' RcY H OS P :1: TA !...
2. 2 '1 ..5 'f' R U X'l" U N A V
[!~ A K E RS F: :[ I!!! I... D, C A
(805) 32. "t .- :'-} :.'-) ? 1
t 04"/27/94 Rqght-to--.Kno~/F:u'l'l I...J~t/b~ CommC°d~ anal/or~ SJte IO Pag~ 4
G & H f',~IH]L.E OR]] NG NC
<,~'" () L.I... ]] I 01~....0 '10-.001:341
00 .... Ovenal 1 Site
<E> Pnev,/Mini mization/C1 eanup
<1> Release Pnevention
THESE ARE OVEi:(HEAD FUEL TANKS, 'T'HE I])]]S~I]E~UTER tvlAKES SURE AL.I.. N()ZZL. ES ARE
SECURI~ 8~F:()t:~ I...C~A[~]]N(~; TANKS, USERS ~~.JRE N()ZZL.[:~S AI:~]~ liN TANKS
U,.>.I.N(.,. AI, t_A 1..> KL.P I t,L.I...AK UI Nt..I...I.)¢~t} '~}EBI~.i...~. [.:,A...>UI_.I. NL EVAPOI~A'T'ES QU ];CKI...Y
:[ l::: SP :!; L I... E [), N() SP ]] t... L.S HAVE ()C:C;L~RE~ ~
<2> Release Containment
IN CASE FUI!";L NOZZLES E~ECOIVlE I::AUL. TY A SAFETY SHUI::: OI:::F VAI_VE ON TANK CAN BI!!!
UT]]L];ZED 8Y THE USER,
<3> (;:lean Lip
]:N CASI!!! ()IF A SP]:L.I... TIqI!!RE ];S EQUIPIvlEN'T' ON SI-f'E "1'0. CONTA:[N ANY I_EAKAGE,
<4> ()thet- Re..m. ounce Ac'tivation
b
G & H RAI"H()LE [;R][LL]ZNG INC 015-..-010--.-001341
O0 --. Ovenall Site
<F':> Site Emerg~nc~ Factors
<1> Speci~l Hazards
<2> U~.i 1 i~...V
A) GAS .... APPROX;[IvlATI!!!L.Y 10 I:::T N OF EN"f'I~ANCE (;;ATE ;IN UNI:)I~I~(;;I~OUNI:) VAUL'I"
PROPANE .... S F:ENC:E 8I..UE "i"ANK
B) EI..EC:"I"R]:CAI....... ~ I::ENCE A"i" ENTI~ANCIE OF: YAR[) A"[' U"f']:I...]:"I"Y POI._E
C) ~A'TER .... ~ I:::ENCE A'T' ENTRANCE Of: YARD E CJi::: U"I"I!...I'T'Y POL. E
D) SPEC]:AL. -.. NC)NE
E) I...OCK 80)( .... NO
<3> F:ire Protec,/Avail , Water
PI~IVA'I"E FIRE PROTECTION .... WATER OU'f'I...E:TS AT FUI!::'I_ TANKS, ON AI...I... S~[I)ES OF
13 L D G
<4> Earthquake Vulnerability
G & H RAI"H()L!!!! i)R]iL.L]iNG ZNC 0'15-.0't 0..--00'1 :)4'1
O0 .... Overall Site
<G> "l"maini ng
<'1> 'l"naining Recopd Location
~ J'~ H AV t!!! ~ E ~1P L. OY E t!!!.<.3 A "i .... I"lq i .<.5 I::: A()]] L. I ;TY
N E H A V I.:.: t~ A "1" E R I A L. S A F E "1" Y I) A 'T' A .<5 H E E "I".S O N I: ]1] I.. E
lvlON 'T'H L. Y S A F: E 'i" Y Ivi E E '1~ I N (i;S C:O V I!!! R ]] N G VA R ]] OU.!3 'T'O P ]t] C~3,
Describe Training Program
<3> E{mer, Agency ('.:oordination
<4> L:!mer. Response IEq~.~ipment ,
I -, ---- .. . ' · -'" · "" . · -. 'I 1 List/by Comm.(;;ode a or Site ID Page
G & H RA-f'HOI...E DRILLING iNC 0'15....0'10-...001:;.)41
00 .... Overall Site
<H> SCHOOLS V~;['T'HIN 1/2 ~lIt..E!
<1> High Schools
<2> ,Jrt, High
<:3> I:!!lemer~tary Schools
<4> Private & Pre Schoo'is
SITE/FACILITY D I AGRA~
F O l~l~I ~5
· - FLOOR: ! OF ;
NORTH SCALE:i'/ --- /oZ) , BUSINESS NAME: ~,& ~ ~-T4+DL~ ~)~;-~&C~/~ ~
¢ "
DATE:~/&7/9~FAClLITY N~E: ~o~ UNIT *: OF
(CHECK ONE) ~'I~'~G~ FACILITY DIAG~
IInspector's Comments): -OFFICIAL USE ONLY-
HMCU-13
Account Number
ACCOUNTS RECEIVABLE ADJUSTMENT.
Januar7 23, 1992 NewAccount
Date .. New Address
~' valerie Pendergrass Close Account
From:· Service Change
Fire Department.- Haz Mat Division Other Adj.
· Department/Division. .. . ·
'2816 Callowa7 Rd..m Sakersfiel.d,'Ca. 93312
Site Address
Parcel # (If Applicable)
Landlord Name &Address f Applicable
ADJUSTMENT
I Last Correct : !Adjustment Effective Date
·. .{Billed'- Billing ' {To Billing Of Change
i '*$250.00 'J' 1-2-92
'
~
Approved By:
Remarks: They got rid of their haz mat before the figcal year. We just didn't get .it done in the computer. Billed in error.
Page: 2 Account Billing/Collection Activity Inquiry 'suTL108
Acct : 477401 Cyc St CL Bill St: CO Cyc: 5 Rt: Seq:
SSN : Parcel: .... Svc Cls :e
Name : G & H RATHOLD DRILLING INC
Svc Add: 2816 CALLOWAY RD
Readings Cons Prev Rdg Curr Rdg Cons
01/01/92 Amount Misc Transactions
Fwd: $231.84 Type Desc Date Amount Receipt #
Water: $0.00 B92 FINANCE CHARGE 02/01/91 0.01
Sewer: $0.00 99 .PAYMENT 02/21/91 -231.84
Misc: $250.01 OC OTHER CREDIT 04/30/91 -0.01
Cred: $-231.85 Fl0 HAZ MAT HANDLING FEE 01/01/92 250.00
Total:' $250.00
Enter '/' For More Billing History, 'D' For Detail Postings, '/C' for Credit an
ALT-F10 HELP I ADDS VP FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR I CR
H RATHOLE DRILLING, INC
P. O. BOX 1288
BAKERSFIELD, CA 93302
JANUARY 13, 1992
CITY OF BAKERSFIELD
HAZARDOUS MATERIALS DIVISION
P O BOX 2057
BAKERSFIELD, CA 93303-2057
TO WHOM IT MAY CONCERN:
ON 9/1/90 G & H RATHOLE DRILLING QUIT LEASING 90% OF THE AREA AT
2816 CALLOWAY RD. ON THIS PROPERTY WERE OVERHEAD GASOLINE AND DIESEL
TANKS. THEY WERE HAULED AWAY TO A FARM SOMETIME LATE IN 1990 UNDER
THE DIRECTION OF THE LANDOWNER, MR. JAMES V. HOGG. SINCE 9/1/90
G & H RATHOLE DRILLING HAS LEASED ONLY A ENOUGH LAND TO SUPPORT A
SMALL OFFICE AND THE PARKING OF 4 OR 5 VEHICLES. THE REMAINDER OF
THE LAND IS LEASED TO ENTERPRISE DRILLING FLUIDS, THE ENTIRE PARCEL
IS OWNED BY JAMES V. HOGG.
G & H RATHOLE HAS NOT STORED ANY HAZARADOUS MATERIALS AT THIS OR
ANY OTHER LOCATION SINCE 9/1/90 AND WISH TO CLAIM EXEMPT FROM TMIS
FEE.
ROBERT NORD, PRESIDENT
Bakersfield Fire t.
Hazardous Materials Division RECEIVED
2130 "G" Street '~U~ 0 1 990
Bakersfield, CA. 93301 HAZ. MAT, DIV.
INSTRUCTIONS:
1. To avoicl further action, return this form within 30 clays of receipt.
2, TYPE/PRINT ANSWERS IN ENGLISH,
3. Answer the Questions below for the business as a whole.
'4. Be brief ancl concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS NAME: G&H RATHOLE DRILLING, INC.
LOC-A'TION: 2816 CAT,T,C)WA¥ T~R.
MAILING ADDRESS: P.O. Box 1288 BAKERSFIELD,CA 93302
CITY: BAKERSFIELD STATE: CA ZiP: 93302 PHONE: 325-71fl2 or~9'O100
DUN & BRADSTREET NUMBER: 95-3308102 SiC CODE:
PRIMARY ACTIVITY: OILFIELD CONSTRUCTION
OWNER'. JAMES V. HOGG
MAILING ADDRESS: P.O. BOX 1288 DAf4. CA. 933oP
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR, PHONE
1, ROBERT NORD 323-7142 393-5536
JOHN SULLIVAN 323-7142 831-8760
2.
Bakersfi-eid Fire Dept.
~{azardous Materials Division
,. ~ HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION. 3: TRAINING:
NUMBER O1: EMPLOYESS: (7)
MATERIAL SAFETY DATA SHEETS ON FILE'. MSD - DTESET, FUEL - ACEr~¥LENE
BRIEF SUMMARY OF TRAINING PROGRAM:
Monthly safety meetings covering various topics
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.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION $: CERTIFICATION:
,, /~e,~,.. ,' 7'- ,'"V/o ,"c:/' CERTIFY THAT THE ABOVE INFOR-
MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
2.
Bakersfield Fire Dept~
Hazardous Materials Divi~
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name: G&H RATHOLE DRILLI~G, INC,
/
SECTION ~: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES'
HAZARDOUS MATERIAL SPILL DIAL 1-800-852-7550
FIRE DIAL - 911 GIVE LOCATION
B, EMPLOYEE NOTIFICATION AND EVACUATION:
IN/'~IEI~ERGENCZE$ ALL OUR PERSONNAL ARE T0 REPORT AT THE
FRONT GATE. THIS MEETING PLACE IS SAFE AND AN ACCOUNTING
OF~PERSON~AL CAN ~ CO~UCT~.
C, PUBLIC EVACUATION: NEIGHBORS ON BOTH SIDES OF OUR YARD
WOULD BE NOTIFIED IN CASE OF AN EMERGENCY.
/
D. EMERGENCY MEDICALPLAN:
CA~SUALTIES.
ME~CY ~OSPITAL - 327-337~
HA~LS AMBULANCE - 327-4111
GOIDEN EMPIRE - 327-9000
OUR SHOP HAS BASIC FIRST AID MATERIAL AND SOME OF
OUB EMPLOYEES HAVE FIRST AID AND ADULT CPR TRAINING
-- {~ersaeia FUre Dept. ~j
Hazardous ~[aterials D~vision ~ _ ..~ ~
HA~RDOUS MATERIALS MANAGEMENT ~N ;
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS: MAKE SURE NOZZLES ARE IN TANKS BEFORE
TURNING ON TANK. ALL NOZZLES ARE SECURE BEFORE LOADING TANKS.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
IN CASE FUEL NOZZLES BECOME FAULTY A SAFETY SHUT OFF
VALVE ON TANK CAN BE UTILIZEB BY THE USER.
C. CLEAN-UP PROCEDURES: IN CASE OF A SPILL THERE IS EQUIPMENT
ON SITE TO CONTAIN ANY LEAKAGE.
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)'
NATURALGAS/PROPANE:'Propane shut off -South fence Blue tank
ELECTRICAL: West fence at entrance of yard at Utility pole
WATER' " " " " " " East of Utility pole.
SPECIAL:
LOCK BOX: YES/(N-'~ IF
YES,
LOCATION'
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIREPROTECTION: Water outlets, at fuel tanks, on all
sides of the building.
B, WATER AVAILABILITY (FIRE HYDRANT):
CI'I'Y of BAKERSFIELD
HAZARDOUS HATER-rAgs T NVENTORY
Farm and Agriculture D Standard Business [] NON--TRADE SECRETS Page ___ of
BUSINESS NAME: (~ ~ ~~ z~.l~.-~ OWNER NAME: ~e~-- /~r ,, NAME OF THIS FACILITY: ~4~.~
LOCATION: ~~ ~2~:~. - , ADDRESS; ~,~ c;//~ ~. STANDARD IND CLASS CODE~ ....
CITY. ZIP: ~.~.~+. ~ - ' CITY. ZIP~ ~3v~/ -- - DUN AND BRAnd,FEI BUHBER~ ..... ~-'-
PHONE ~: ~- ~ PHONE ¢:
REFER TO~S'TRUCTXONS~~ROP~ CODES ~ ~ - ~ ~ ~- ~/ o ~.
Trans ly,, Hax Average Annual Measure ' ~e Cont Cont Cont ~g~e Location. WheEe. ,w~y Names of,ixture/CcmDonents
Code gooe Amt Amt Est Units on Type Press Tem~ Stored in ~ac}/ity See Instructions
Physical and Health Hazard C.A,S, Number ~Oo~-~1 - ~ Component II Name I C.A,S. Number
Componen~ 12 Name ~ C.A.S. Number
~Fire Hazard ~ Reactivity ~elayed ~ Sudden Release ~ Immediate
Health of Pressure HealCh
:~ Component 13 Name I C,A.S. Number
'Physical lcd Health Hazard C,A.S. Number Component II Name & C,k.S, Number
(Check al1 ~hat a~pll) . _ _
Component 12 Name I ~,~,~, Number
~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~
Health of Pressure
Component 13 Name & C.A.S. Number
Physical 8ndHealthHazard C,A,S, Number ~~-']~1-~ Component ii ~a~e I C,~,S, Number
(Check a11 thmt apply) - ' ~/~L
Component 12 Name & C.A,S, Number
~ire Hazard ~ Reac~ivit~ ~~ U Suddenef PressureRelease U [m~i~.
Component 13 Name ~ C,A,S, Number
('rsic'1 and Health Hazard C,A,S, Number ~.&-- ~/- ~ ComponenL" Name SC,A,S, Number~n~,,/,--.~ ,~L
:heck a/1 that apply)
Component 12 Name & C,A.S. Number
~ire Hazard D Reactivity ~qelayed D Sudden Release D Im~i~ -,
Health of Pressure
Component 13 Name ! C,A,S, Number
Name ~:le Phone ~e- / - ~ T~tle
erti[igatioq ,{Re~ ~.nd.~ign after compl~tiDg,all secti~n~)
.cer~]u.unoer penat[x g~)aW that ~ navepe[sonaHLexamlnqoeqo~m tami~la{.~it~ the.~nto{$aUpn ~u~ittf~ in this ~nd all
atvcneo.oocg~ents, an~ tBat oaseo on.my ]nqutry ¢.cnose ~no~v~oua~s respons}o/e tor ooca~n]ng tne ~nrormauon, I believe that the
suo,,,tLeo In~Z I% cru~ra,e, aha comp,ere. ~ .
SITE/FACILITY DIAGRAM
FORM
NORTH SCALE: BUSINESS NAME:~ FLOOR: [ OF ~
DATE: / / FACILITY NAME: '~ UNIT #: OF
· (CHECK ONE) ~. FACILITY DIAGRAM
(Inspector's Comments): -OFFICIAL USE ONLY-
HMCU-13
AUG 1 6' 198e (8os)
JUL 2 ? 1987
0F¥ICIAL USE ONLY
HAZARDOUS MATERI ALS
BUS I NESS PLAN AS A WHOLE RECEIVE
FOR]VI
, tWAY 2 4 1989
INSTRUCTIONS:
HAZ. MAT. DIV.
~. To avoid further aotio., retur, this form by JUL 2 5 IBB?
2. TYPE/PRINT ANSWERS ZN ENGLISH.
3. Answer the questions be]o~ ~or the business as a whole.
4. Be as brJe~ and concise as possible.
SECTION ]: BUSINESS IDENTIFICATION DATA
A. BUSINESS NAMI: G & H RATHOLE DRILLING INC
B. LOCATION / STREET ADDRESS: 2816 GALLOWAY RD
CITY: BAKERSFIELD ZIP: 93309 BUS.PHONE: (805) 323 7~42
SECTION 2: EHERGENCY 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. 3AMES HOGG PRESIDENT Ph# 323 7142 Ph# 589 0100
B. JOHN SULLIVAN SEC'T TREASURER Ph# 323 .7142 Ph# 831 8760
SECTION 3: LOCATION OF UTILITY SIIUT-OFFS FOR BUSINESS AS A W~OLE
A. NAT. GAS/PROPANE: APROX. 10 ft NORTH OF ENTRANCE GATE IN UNDERGROUND VAULT
B. ELECTRICAL: APROX. 15 ft NORTH OF ENTRANCE GATE ON ELECTRIC POLE
C. WATER: SAME LOCATION AS GAS LINE
D. SPECIAL: NONE
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 4m..~I~A~E RESPONSE TEAM FOR BUSINESS AS A WHOLE .
,~.'~,.~ ~,0~? CAN PROVIDE MINOR EMERGENCY MEDICAL TREA~EN~ ' FU'~ EXPOSURE ~D OTHER S~L~ EMERGENCY' S
" COHPAN~ CAN PROVIDE ~INOR FIRE PROTECTION WITH THE USE OF
FIRE EXTINGUISHERS AND S~LL WATER HOSE
LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
~3~' [~ '~ LOCAL MEDICAL FACILITY CAN BE USED TO TREAT CAUSUALTIES
DUE TO THE ONLY HAZARDOUS MATERIAL IS FUEL ( DIESEL & GASOLINE )
· ~ ~S~ HAS BASIC FIRST AID MATERIAL
SECTION 6: EI~PLOYEE TRAINING
E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EHPLOYEES 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: .......................... ~ NO ~NO
C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO NO
D. EMER6ENCY EVACUATION PROCEDURES: ................. ~ NO df~g~NO
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES
I, ~,O~ ~ ~'-~ R~-~--/ , certify that the above information is accurate.
I understand that this information ~ill 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.
S76NATURE c~3m~f ~,,_¢~-~-'TITLE SEC T TREASURER DATE 7/24/87
HMCU-4
· c, py
KERN COUNTY FIRE DEPARTMENT
5642 VICTOR STREET
BAKERSFIELD, CA 93308
OFFICIAL USE ONLY
ID#
BUSI NESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCT IONS !. 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 ~ossible.
SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES
SE~ION 2: NOTIFICATION
HMCU-6
SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY
A. Does this Facility Unit contain Hazardous Materials? ...... ~N0
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the'hazardous material~ a bona fide Trade Secret as
defined by Section 6254.? of the Government Code? ......... 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 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,RESPONDERS
SECTION 6': 'LOCATION OF UTILITY SHUTkOFFS AT'THIS UNIT ONLY,
A. NAT. GAS/PROPANE:
~/IE~' ~., ~.r' % ?~o ¢ ~*/,,, '~. C ~..tb~ ~ ~ ~c~.
B. ELECTRICAL: . .
C. WATER:
D. SPECIAL: j .... ..
E. LOCK BOX: YES ~ IF YES, LOCATION
IF YES. SITE PLANS? YES / NO MSDSs? YES / NO
FLOOR PLANS? YES / NO KEYS? YES / NO
~CU-6
KERN COUNTY FIRE DEPARTMENT
I.D. # FORM 4A-1 page 1 of 1
NON--TRAD.E SECRETS
~{~ HAZARDOUS MATER]' ALS INVENTORY
BUSINE'SS NAME: G & H RATHOLE DRILLING INC OWNER NAME: JAMES HOGG FACILITY UNIT
ADDRESS: 2816 CALLOWAY RD ADDRESS: 2816 CALLOWAY RD FACILITY UNIT NAME: CALLOW__A_y_ YARD
CITY, ZIP: BAKERSFIELD 93309 CITY,ZIP: BAKERSFIELD 93309
PHONE #: 805 323 7142 PHONE #: 805 589 01OO {O'FFICIAL USE CFIRS CODE
{
O,N. Y ....
1 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT USE LOCATION IN ,THIS N; BY IIAZARD i).O.T
CODE AMOUNT AMOUNT U.N. IT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE
LOCATED IN ABOVE CROON]
P ~00 ~ ~gOO ~[.~ 0~, I~ STOAGE TANKS ALONG /~O Ra~,/~g;~ ~o~yM;~
· NORTH FENCE, 400ft FROI
NAME: JOHN SULLIVAN TITLE:, SEC~T TREASURER SIGNATURE: ' ' ~ DATE:_7
EMERGENCY CONTACT: JAMES HOGC TITLE: PRESIDENT (J' ~HONE # BUS HOURS:.___3_23_lL_~2
:~i~.ERGENCY CONTACT: JOHN SULI,IVAN TITLE: .q~..T T{~.q.P~ PHONE # BUS HOURS: 323 7142 ......
.. ~ BUSINESS ACTIVITY: RATHOLE DRILLING .... ' AFTER BUS HRS: 831 8760
COt~AINER CODES TYPE CODES ~ ~ ,,
01 Underground Tank P = Pure
02 Aboveground Tank M = Eixtures of pure
03 Fixed Pressurized Tank substances
04 Portable Pressurized Cylinders W = Wastes (Also add
05 Insulated Tank (Includes Cryogenics) appropriate waste
06 Drums or Barrels - Metallic code)
07 Drums or Barrels - Non-Metallic
08 Carboy(s)
09. Glass Container(s)
10. Plastic Container(s)
1]. Box(es) UNIT CODES
12. Bag(s)
13. Metal Containers (Not Drum~) LBS : Pounds
14. In Machinery or processing equipment TON = Tons (2,000 lbs)
15. Bin(s) GAL : Gallons
99. OTHER - Specify on separate sheet, BBL = Barrels (42 gals)
Ft3 = Cubic Feet
CUR : Curies
USE CODES .. .~
01. Additive 23. Herbicide
02. Adhesive 24. Insecticide
03. Aerosol 25. Instructional
04. Anesthetic 26. Lubricant
05. Bactericide 27. Eedicat Aid or Process
06. Blasting 28. Neutralizer
07. Catalyst 29. Painting
08. Cleaning 30. Pesticide
09. Coolant 31. Plating
10. Cooling 32. Preservative
11. Drilling 33. Refining
12. Drying 34..~Sealer
13. Emulsifter/Demulsifier 35. Spraying
14. Etching 36. Sterilizer
15 Experimental 3?. Storage
16 Fabrication 38. Stripper
17 Fertilizer 39. Washing
18 Formulation 40. Waste
-19 Fuel "41. Water Treatment
20 Fungicide 42. Welding Soldering
21 Grinding 43. Well Injection
22 Heating 44. 0il Treatment
99. 'OTHER-Specify on ~
HAZARD CODES
EXPL - Explosive OPJ~A - Anesthetic, Irritant
CMLQ - Combustible Liquid ORME - Hazardous Waste
CMSL - Combustible Solid ORES - Other regulated
Material B,C,and D
CR~4T - Corrosive Material PSNA - Poison A (Gas)
FLGS - F]ammabJe Gas PRNB - Poison B (Liquid or Solid)
FLLQ - Flammable Liquid RADI - Radioactive
FLS!. - Flammable So]id WATR - Water Reactive
NFLG - Non-Flammable Gas ETI0 - Etiological AgenZ
OGFX - Organic Peroxide PYRO - Pyrophoric, Hypergolic or
spontaneously combustible
OXID - Oxidizer
CRY0 - Cryogenics
Farm and Agriculture ~--~ I~ COUNTY FI~E DEPAR~ENT ~ '4
HAZARDOUS MATERI ALS I NVENTO ~Y ~ '
Standard Business ~ DUN AND 8RAOSIRE,k'~
STANDARD
IND. CLASS CODE:___/~. NAME OF THIS FACILITY:
REFER TO INSTRUCTIONS FOR PROPER CODES~
1 2 3 4 5 6 ? 8 9 10 ]1
T~ans '[y0e Max ' Aveeage Annual; Measure Cont Cone Cont Use % by Names of M~x~uee/Componen~s
Code Code Amt Amt Es~ ~ ....... ~n_j~]ype Peess ]emp Code Wt See Instructions
Hea]th ~
[~ Fire ~] Oelayed Hea]th C.A.S. Numbep ~0 ~ -- ~/~ ~
~'-~ Reactivfcy ~--J Sudden Release of Ppessupe; on S~te
Health
L--~ Reactivity ~---~ Sudden Release o{ PPessuPe on S~te
Health
L--J Reactivity L ~ Sudden Release of PPessuPe on Site ......
Cep~j~atfon (Read and si~n a/'~er co~gJetin~ all sections) .'
[ cePt~fy undeP pe~a~y o peesonally examined and am familiae ~ith the infoPmation sub~[ted fn this and ell a~tached documents, and that based on my
inquipy of those individuals pesponsfb]e fop obtaining the information, I believe that the submitted fnfopmatio~ fs ~ue, accupate, and complete.
~=-~m~.
INVENTORY CODE SHEET
Trans Code (Column 1) Use Codes (Column '.i0)
A = Add This Item 01 Additive .:
D = Delete This item 02 Adhesive
R = Revised Information 03 Aerosol/Inflation
04 Anesthetic
05 Bactericide
Type Code (Column 2) 06 Blasting
07 Catalyst
P = Pure Material 08 Cleaning
M = Mixture of Substances 09 Coolant/Antifreeze
W = Waste (Must Also: Add 10 Cooling
Appropriate Waste Code from i1 Drilling
"Waste Code Sheet") 12 Drying
13 Emulsifier/Demulsifier
14 Etching
Measure Units (Column 6) 15 Experimental/Analytical
LBS = Pounds 17 Fertilizer
TON = Tons (2,000 lbs) 18 Formulation/Manufacturing
GAL = Gallons 19 Fuel
BBL = Barrels (42 gals) 20 Fungicide
Ft3 = Cubic Feet 21 Grinding
CUR = Curies 22 Heating
23 Herbicide
24 Insecticide
Container Type (Column 7) 25 Instructional
26 Lubricant
01. Underground Tank 27 Medical Aid or Process
02. Aboveground Tank 28 Neutralizer
03. Fixed Pressurized Cylinders 29 Painting
04. Portable Pressured Cylinders 30 Pesticide
05. Insulated Tank (Includes 31 Plating
Cryogenics) 32 Preservation
06. Drums or Barrels - Metallic 33 Refining
07. Drums or Barrels - Non- 34 Sealer
Metallic 35 Spraying
08. Carboy(s) 36 Sterilizer
09. Glass Container(s) 37 Storage/In Storage
10. Plastic Container(s) 38 Stripper
--~r~--=-B=o~f(~%-) ....... - ........ ~-9-~---W~s-h-i~'g -
12. Bag(s) 40 Waste
13, Metal Containers (Not Drums) 41 Water Treatment
14. In Machinery or Processing 42 Welding Soldering
Equipment 43 Well Injection or Service
15. Bin(s) 44 Oil Treatment
16. Unlined Sumps 45 Resale
46 Aircraft Systems
47 Battery/Electrolyte
Container Pressure (Column 8) 48 Breathing Air
49 Drafting Aid
1 = Ambient Pressure 50 Finished Product
2 = Greater Than Ambient Press 51 Fire Protection
3 = Less than Ambient Press 52 Hydraulic Equipment
53 Road/Hwy Maintenance
'Container Temperature (Column 9) 54 Testing
4 =. Ambient Temperature 55 Wholesale Chemicals
5 = Greater than Ambient 99 OTHER-Specify on
6 = Less than Ambient Temp but not another page
Cryogenic
? = Cryogenic Condigns
HA~RDOUS MATERI $ BUREAU
., INSPECTION FORM
INSPECTION SUMMARY: ANNUAL INSPECTION EXEMPTION RE-INSPECTION ~ COMPLAINT__
ALL ITEMS OK: [.~ VIOLATIONS NOTED: [ ]
0 - Does Not Apply 1 - In Compliance 2 - Correction Needed 3 - Verbally Warned
4 - N.O.V 5 - Citation 6 - Referred To (Specify)
EMERGENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731)
A. Agency Notification Plan (O.E.S., FD) L. Work Area Safety
B. Employee Notificatio~'~ Evac. Plan M. Clean-up Materials Placement/Availability
C. Emergency Responder Nu~fication N. Clean-up Equipment
D. Medical Assistance ~ O. Fire Prot~__'
E. Private Response Team Procedur~ P. Was~~ andling_& Storage ~)
uipment
TRAINING REQUIREMENTS (CCR TITLE 19-~,~ INV. & DIAGR~a~I VERIFICATION (CCR TITLE 19-2729)
F. Training Records / R. Inventory Quantities
G. MSDS Available to Employ~ S. Storage, Container Cond., & Labeling
H. Employees Familiar wi~MSDS T. Location in Facility Unit
I. Use of Personal Pr~ctive Equipment U. Emergency Water Supply
J. Waste Materlal~p,e'rmlts & License V. Evacuation Plan & Area ..
K. Employees Fag/~/iar with Evacuation W. Surrounding Exposures
Plan. ~ X. Utility Shut-offs
Y. Other
Comments:
Clearance Granted ~] Re-Inspection Required
/
Start_ed t5:30 Completed /~_~: ~/-_~ Total 'me__: ~_~ Miles on Insp
In~pec-{o-r - -- Owner/Manage~-- '
Fire 580 2415 HMCU 41~[ (Revised 1/89)
HA~~DOUS MATERI S BUREAU
~'- I NSPEOTI ON FO~M
INSPECTION SUMM3%RY: ANNUAL INSPECTION __ EXEMPTION RE-INSPECTION ~ COMPLAINT__
ALL ITEMS OK: [~f~ VIOLATIONS NOTED: [ ]
0 - Does Not Apply 1 - In Compliance 2 - Correction Needed 3 - Verbally Warned 4 - N.O.V 5 - Citation 6 - Referred To (Specify)
EMERGENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731)
A. Agency Notification Plan (O.E.S., FD) L. Work Area Safety __
B. Employee Notification~& Evac. Plan M. Clean-up Materials Placement/Availability
C. Emergency Responder Notification N. Clean-up Equipment
D. Medical Assistance ~'~.._:.__ O. Fire ~r~?on.-S~:s~ ....... .
E. Private Response Team Procedures-~_~.~ P. W~te Handling & g ~
~-~..~_v_~ailability of Protec_~t~e~Equipment
TRAINING REQUIREMENTS (CCR TITLE 19-~2)~INV a DIAOR~ ~I~I-~A~ION (CCR TITLE 19-2729)
F. Training Records // R. Inventory Quantities
G. MSDS Available to Employees' S. Storage, Container Cond., & Labeling
H. Employees Familiar wi~h/MSDS T. Location in Facility Unit
I..Use of Personal Pro~ctive Equipment .... U. Emergency Water Supply
J. Waste Material Rermits & License V. Evacuation Plan & Area
K. Employees Fami'l~ar with Evacuation W. Surrounding Exposures
Plan. '/ X. Utility Shut-offs
Y. Other
Comments:
Clearance Granted [~__] Re-Inspection Required [ ] On__/ / D.E.
started t5:.,_~) Completed /,.,~: ~ Total~me : /~_~ Miles on Insp,
In:~pector - Owner/Manage?,?
Fire 580 2415 HMCU 4~~, (Revised 1/89)
MATERI -m~l~ I~{JI~EAU ~//~L/.-~
INSPECTION S~RY: ~UAL INSPECTION ~ EXEMPTION RE-INSPECTION COMPLAINT
ALL ITEMS OK: ~ ] VIOLATIONS NOTED~
0 - Does not Apply I - In Compliance 2 - Correction Needed 3 - Verbally ~arned
4 - N.O.V 5 - Citation 6 - Refevved to (Specify)
EMERGENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731
A. Agency Notification Plan (O.E.S., FD) _~_ L. Work Area Safety
B. Employee Notification & Evac. Plan -~ M. Clean-up Materials placement/availability
C. Emergency Responder Notification }-L- N. Clean-up Equipment _~_
D. Medical Assistance O. Fire Protection Systems
E. Private Response Team Procedures j~ P. Waste Handling & Storage
O. Availability of Protective Equipment
TRAININ6 REQUIREMENTS (CCR TITLE 19-2732) INV. & DIAGRAM VERIFICATION (CCH TITLE 19-2729)
F. Training Records 2~_ R. Inventory Quantities
G. MSDS Available to Employees I S. Storage, Container Cond., & Labeling
H. Employees Familiar with MSDS ] T. Location in Facility Unit
I. Use of Personal Protective Equipment ~ U. Emergency Water Supply __J
J. Waste Material Permits & License _L~ V. Evacuation Plan & Area
K. Employees familiar with evacuation W. Surrounding Exposures
plan. I X. Utility Shut-offs
Y. Other
Started ~ : \('-~ Co.pleted It'J~ : ,.~b Total Time__: ~) Miles on l'nsp
Iaspector z
~. ~-~'~; ., .~'A''~ ~
'INSPECTION S~RY: ~UAL INSPECTION ~ EXEMPTION RE-INSPECTION CO~PL~INT
ALL ITENS OK: [ ] VIOLATIONS NOTED~-]
. .. . ./'. -' .:.
'0 - Does not apply 1 - In Cospltance 2 - Correct-ion Needed 3 - Verbally ~arned
4 - N.O.V 5 - Citation 8 - Re[erred to (Specify)
EMEROENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731
A. Agency Notification Plan (O.E.S., FD) L. Work Area Safety
B. Employee Notification & Evac. plan M. Clean-up Materials placement/availability
C. Emergency Responder Notification } N. Clean-up Equipment
D. Medical Assistance ,,{ O. Fire Protection Systems /
'E. Private Response Team Procedures ~ P. Waste Handling & Storage'
Q. Availability of Protective Equipment
TRAININO REQUIREMENTS (CCR TITLE 19-2732) INV. & DIAGR~ VERIFICATION (CCR TITLE 19-2729)
P. Training Records ~ R. Inventory Quantities
O. MSDS Available to Employees I S..Storage, Container Cond., & Labeling
H. Employees Familiar with MSD$ { T. Location in Facility Unit
I, Use of Personal Protective Equipment I U.'Emergency Water Supply ' , .
J. Waste Material Permits & License (0 V. Evacuation Plan & Area
K. Employees familiar with evacuation W. Surrounding Exposures
plan. I X. Utility Shut-offs
y. Other
Clearance Granted [ ] Re-'inspection Required ~<~] on
Start'ed /~ :~ Completed Jq : ~/~ Total Time :~-'O Miles on Insp
Inspector ' Own~anager t / r HMCU 14
KERN COUNTY FIRE DEPARTMENT
5642 VICTOR STREET
BAKERSFIELD, CA 93308
IBUSlNESS NA E
INSPECTOR QUESTIONNAIRE
BUSINESS PL;%%~ AS A WHOLE
FOR USE WITH THOSE BUSINESSES COMPLETING A BUSINESS PLAN (2A).
INSTRUCTIONS: 1. Complete this form only once for each occupancy.
2. Attach this form to BUSINESS PLAN (2A) and forward to Data Entry.
BUSINESS PLAN VERIFIED ON:
SECTION 1: RESPONSE S1B~ARY (Limit to 4-5 lines)
SECTION 2: NOTIFICATION / EVACUATION OF AFFECTED PUBLIC (Limit to 13 lines~)~k
HMCU~5_