The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 3/13/2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This hermit is issued for the followinq: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials D Risk Management Program [] Hazardous Waste On-Site Treatment PERMIT ID # 015-021-002169 ,. P E MOTORING ~-'~' ' LOCATION 1625 S :~'~ iC~ " ~~~ OFFICE OFEN~RONMENTAL SER~CES' ~ ~ DEC 1 4 Z000 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 .~ofE~s~i~= ~ . Voice (661) 326-3979 ' F~(661) 326-0576 Exp~tionDate: 'June 30~ 2003. I V V -El~ctri~ ENTRANCE ~ater o~ valve Hydrant S. CHESTER Ave ration ~ 0 ~c~e'~F ~i SITE DIAGRAM IrACU. JTY DIAGRAM Bu~ne~ Nme: Business Add.n: ITE DIAGRAM Business Business Address: i Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave $1::~.'T|ON 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPECTION DATE Section 1: Business Plan and Inventory Program ~l~utine 0 Combined ~ Joint Acjency U! Multi-Agency U! Complaint FI Re-inspection C V ( c=Comptiance '~ OPERATION COMMENTS ~, v=violation ~ ~ APPROPRIATE PERMIT ON HAND /~ [~ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~_~_ ~' ~ CORRECT OCCUPANCY ~' ~ VERIFICATION OF INVENTORY MATERIALS ~ [~ VERIFICATION OF QUANTITIES ~ ~ VERIFICATION OF LOCATION _~' __ [~ PROPER SEGREGATION OF MATERIAL ~ V PROCEDURES ~ EME GENCY ROCEDURES ADEQUATE '" ~ ~ HOUSEKEEPING ~ FIRE PROTECTION ANY H~ARDOUS WASTE ON SITE?: .~YEs ~ NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector Badge No. Business Site Respons~e Party P E MOTORING SiteID: 015-021-002169 Manager : BusPhone: (661) 397-5818 Location: 1625 S CHESTER AVE Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad:77-054-5525 Emergency Contact / Title Emergency Contact / Title Business Phone: (661) 397-5818x Business Phone: (661) 665-0517x 24-Hour Phone : (661) 528-8656x 24-Hour Phone : (661) 201-4062x Pager Phone : ( ) - x Pager Phone : ( ) - x Hanmar Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 397-5818x MailAddr: 1625 S CHESTER AVE State: CA City : BAKERSFIELD Zip : 93304 Owner HECTOR M HERNANDEZ ET AL Phone: (661) 665-0517x Address : 8909 CROWNINGSHIELD DR State: CA City : BAKERSFIELD Zip : 93311-1903 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpeoHazlEPA HazardsI Frm I DailyMax lUnitlMCP FREON F P IH G 3.00 FT3 Min MOTOR OIL F DH L 250.00 GAL Min WASTE OIL F DH L 240.00 LBS Low -1- 07/01/2002 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~).i~. ~,'~-t,~ INSPECTION DATE //- ' ADDRESS ~ b~C $, C~es4~c- A,~ PHONENO. ~61 ,~9~ -$81~ FACILITY CONTACT ~ .s / ,? C'ardo/,., r~ BUSINESS ID NO. 15-210-OO9..[~cl INSPECTION TIME .~o ~3 ~ NUMBER OF EMPLOYEES.. ~ Section 1: Business Plan and Inventory Program '~ Routine [~ Combined [~ Joint Agency [~ Multi-Agency ~ Complaint [~ Re-inspection OPERATION C'V COMMENTS 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 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 Explain:Any hazardous/..,... ~-~'d.-~_waste on site?:o, Y f~Yes {~ No .~---x"~ ~ White - Env. Svcs. Yellow - Station Copy Pink - Business Copy In . P E MOTORING SiteID: 015-021-002169 Manager : BusPhone: (661) 397-5818 Location: 1625 S CHESTER AVE Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad:77-054-5525 Emergency Contact / Title Emergency Contact / Title LUIS S HERNANDEZ / CO OWNER EVELVA HERNANDEZ / SPOUSE Business Phone: (661) 397-5818x Business Phone: (661) 665-0517x 24-Hour Phone : (661) 528-8656x 24-Hour Phone : (661) 201-4062x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 397-5818x MailAddr: 1625 S CHESTER AVE State: CA City : BAKERSFIELD Zip : 93304 Owner HECTOR M HERNANDEZ ET AL Phone: (661) 665-0517x Address : 8909 CROWNINGSHIELD DR State: CA City : BAKERSFIELD Zip : 93311-1903 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hanmar Inventory One Unified List --Alphabetical Order Ail Materials at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax Unit MCP FREON F P IH G ~ FT3 Min MOTOR OIL ~, _ -- I~tl~r'r%~O F DH L ~-~0 GAL Min WASTE OIL L~ ~ ho~b~ oe~i~Fthm ~ hfv~DH n 240.00 LBS Low ~r ~n~ n.~) reviewed ~he a~ached h~ardous materials manage- ment plan ~o nd that i~ alo~ with any corr.[tons ~nsfitu~e a ~mple~s and ~s~ man- agemen~ plan for my ~a~li~. -~- ~o/~6/~oo~ F P E MOTORING SiteID: 015-021-002169 = Inventory Item 0003 Facility Unit: Fixed Containers at Site FREON Days On Site 365 Location within this Facility Unit Map: Grid: 3 CYLINDERS - WHERE ARE THEY LOCATED??~?~? CAS# Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average I HAZARDOUS COMPONENTS 100.00 Dichlorodifluoromethane N 75718 HAZARD ASSESSMENTS TSecretl ~S BioHaz( Radioactive/Amount EPA HazardsI NFPA USDOT# MCP No N No No/ Curies F P IH / / / Min = Inventory Item 0002 Facility Unit: Fixed Containers at Site MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: WHERE IS IT LOCATED????????? ~ CAS# Liquid Pure Ambient Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest 200.00 GAL ~0,~ GAL I Daily Average Container Dail,y Maximum ~"', (,,-(3 GAL HAZARDOUS COMPONENTS %Wt. R{NoRS~ CAS# 100.00 Motor Oil, Petroleum Based 8020835 TSecret NRS BioHaz Radioactive/Amount EPA Hazards NFPA No No No/ Curies F DH / / / Min 2 10/26/2001 P E MOTORING SiteID: 015-021-002169 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~U~ ~ / ~1~ ~v]~ WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 221 STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Waste I Ambient I Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 240.00 LBSI 240.00 LBS 120.00 LBS 100.00 Waste Oil, Petroleum Based N 0 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F DH / / / Low -3- 10/26/2001 F P E MOTORING SiteID: 015-021-002169 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 04/16/2001 THE USED OIL CONTAINER IS MADE FROM STEEL AND DOESNT HAVE ANY AIR PRESSURE, AND IS FAIRLY NEW, SO THERE IS NO CAUSE FOR LEAKS. -- Employee Notif./Evacuation 04/16/2001 IF THERE IS ANY OCCASIONAL OIL SPILL IT WILL BE NON EMERGENCY, SO WE CAN CALL CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES. Public Notif./Evacuation 04/16/2001 OUR USED OIL IS PICKED UP BY ASBURY ENVIRONMENTAL SERVICES, CALIFORNIAS FULL SERVICE HAZARDOUS WASTE RECYCLER. SO EVERY TIME THE CONTINER NEEDS TO BE EMPTIED WE CALL THEM. Emergency Medical Plan 04/16/2001 OUR FIRE AND LIABILITY INSURANCE COVERS FOR ANY EMERGENCY MEDICAL NEED. 4 10/26/2001 P E MOTORING SiteID: 015-021-002169 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 04/16/2001 USED OIL IS DRAINED FROM THE CARS TO A 20 GAL PORTABLE OIL DRAIN. WHEN FULL TO MINIMUM CAPACITY IT IS EMPTIED TO THE MAIN USED OIL CONTAINER. SO THERE IS NEVER ANY USED OIL EXPOSED TO THE ENVIRONMENT. THEN, WHEN FULL IT IS EMPTIED BY WASTE RECYCLER ASBUDY ENRIVONMENTAL SERVICES. -- Release Containment 04/16/2001 WE HAVE THE NECESSARY EQUIPMENT TO COLLECT ALL THE USED OIL TO PREVENT ANY SPILL FROM HAPPENING. -- Clean Up 04/16/2001 WASTE RECYCLER, ASBURY ENVIRONMENTAL SERVICES, IS THE COMPANY THAT REMOVED THE WASTE FROM OUR LOCATION. Other Resource Activation -5- 10/26/2001 E MOTORING SiteID: 015-021-002169 Fast Format Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 04/16/2001 A) GAS - NONE B) ELECTRICAL - INSIDE BLDG C) WATER - IN FRONT OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/16/2001 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. NEAREST FIRE HYDR3LNT - ON THE CORNER OF PROPERTY, 25 YDS FROM THE BLDG. Building Occupancy Level -6- 10/26/2001 P E MOTORING SiteID: 015-021-002169 Fast Format ~ Training Overall Site -- Employee Training 04/16/2001 WE HAVE 2 EMPLOYEES AT THIS FACILITY. DO YOU HAVE MSDS SHEETS ON FILE? N/A - USED OIL ONLY. BRIEF SUMMARY OF YOUR TRAINING PROGRAM: EMPLOYEES RECEIVED TRAINING ON HOW TO PROPERLY HANDLE THE ONLY HAZARDOUS MATERIAL WE WORK WITH WHICH IS USED OIL AND IT HAS BEEN WORKING EXCELLENT, WE HAVE HAD NO SPILL OR ACCIDENT. -- Page 2 Held for Future Use Held for Future Use 7 ~ 10/26/2001 CITY OF BAKERSFIELD ]FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301 FACILITY NAME /"~. ~ /'v~,2~.~,,-,,~ () INSPECTION DATE /,~ -~ ADDRESS /t4 Z. ~ - ~ ~.~_.C./-.e~.~ PHONE NO. '3' '~ "2"- FACILITY CONTACT.~-.4,,.~ ~ d-f/,..,,~ BUSINESS ID NO. 15-210- ~ INSPECTION TIME ,~ ~ .-,,., ...,._. NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program outine ~ Combined [~ Joint Agency [~ Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification ofquantities .__ ~,?-t/dd ~ ~'r~'$ r~.~,~. 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 Site Diagram Adequate & On Hand C=Compliance V=Violation AnYExplain:hazardousz~s:~,L<_waste on site?:~.~./ .~es [~ No ~~y Questions regarding this inspection? Please call us at (661) 326-3979 White- Env. Svcs. Yellow- Station Copy Pink- Business Copy In,spector:, ~ ~ 'c~"~ ~ P ~'M~ORING SiteID: 015-021-002169 Manager : BusPhone: (661) 397-5818 'Location: 1625 S CHESTER AVE Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad:77-054-5525 Emergency Contact / Title Emergency Contact / Title HECTOR M HERNANDEZ / OWNER ADOLFO HERNANDEZ / MANAGER Business Phone: (661) 324-4588x Business Phone: (661) 397-5818x 24-Hour Phone : (661) 201-4062x 24-Hour Phone : (661) 201-6029x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 397-5818x MailAddr: 1625 S CHESTER AVE State: CA City : BAKERSFIELD Zip : 93304 Owner HECTOR M HERNANDEZ ET AL Phone: (661) - 39x75818 Address : 8909 CROWNINGSHIELD DR State: CA City : BAKERSFIELD Zip : 93311-1903 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax IUnitlMcP WASTE OIL F DH L 240.00 LBS Low 1 02/27/2001 May 3, 2001 P. E. Motoring Hector M. Hernandez, et al. 1625 S. Chester Avenue Bakersfield, CA 93304 Dear Mr. Motoring: FIRE CHIEF Enclosed, please find the Site and Facility Diagram Instructions packet. When your RON FRAZE Hazardous Materials Management Plan and Inventory were submitted it was lacking ADMINISTRATIVE SERVICES the diagram portion. Please draw and submit the diagram(s) of your facility by 2101 "H" Street Bakersfield, CA 93301 June 8, 2001. VOICE (661) 326-3941 ~^x (661) 395-1349 The diagram should include the following: SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 1) name of your business; VOICE (661) 326-3941 2) business address; FAX (661) 395-1349 3) indicate which direction is North; PREVENTION SERWCES 4) ' the cross streets neighboring business addresses (within 300 feet) 1715 Chester Ave. Bakersfield, CA 93301 5) entrances and exits VOICE (661) 326-3951 6) location of utility shut-offs; FAX (661) 326-0576 7) location of the nearest fire hydrant; ENVIRONMENTAL SERVICES 8) portions of the building protected by automatic sprinkler system; and most 1715 Chester Ave. Bakersfield, CA 93301 imoortantlv VOICE (661) 326-3979 FAX (661) 326-0576 9) the location of the hazardous material(s). TRAINING DIVISION If you have any questions, please feel free to call me at (661) 326-3658. 5642 Victor Ave, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Thank you for your assistance. Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENTAL SERVICES Esther Duran, Accounting Clerk II Office of Environmental Services ED\db Enclosures P E MOTORING SiteID: 015-021-002169 Manager : ~ ~ BusPhone: (661) 397-5818 Location: 1625 S CHESTER AVE Map : 124 CommHaz : Low City : BAKERSFIELD Grid: 06C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad:77-054-5525 Emergency Contact / Title Emergency Contact / Title HECTOR M HERNANDEZ / OWNER ADOLFO HERNANDEZ / MANAGER Business Phone: (661) 324-4588x Business Phone: (661) 397-5818x 24-Hour Phone : (661) 201-4062x 24-Hour Phone : (661) 201-6029x Pager Phone : ( ) - x Pager Phone : ( ) ~ x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 397-5818x MailAddr: 1625 S CHESTER AVE State: CA City : BAKERSFIELD --Zip : 93304 Owner HECTOR M HERNANDEZ ET AL Phone: (661) - 39x75818 Address : 8909 CROWNINGSHIELD DR State: CA City : BAKERSFIELD Zip : 93311-1903 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ ~J; ~J~-~ = Hazmat Inventory One Unified List --As Designated Order All Materials at Site Hammer Common Name... [SpooHazlEPA HazardsI Frm DailyMax lunit(MCP WASTE OIL F DH L 240.00 LBS Low I, _ Do hereby certify that ! have (Type or print nan{e) -- reviewed the at~ached hazardous materials manage- men~ plan for ~.E~. I,/~-~/ and that it along with ' (Name of Busin®&~ any corrections constitute a complete and correct man- agement plan for my facility. -1- ~ 02/27/2001 Signalure - Oaie .... P E MOTORING SiteID: 015-021-002169 = Inventory Item 0001 Facility Unit: Fixed Containers at Site WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 221 ~ STATE I TYPE I PRESSURE I TEMPERATUREAmbient AmbientDRuM/CONTAINER TYPEBARREL - METALL I C Liquid Waste AMOUNTS AT THIS LOCATION Largest Container / Daily Maximum Daily Average 240.00 LBSL 240.00 LBS 120.00 LBS HAZARDOUS COMPONENTS 100.00 Waste Oil, Petroleum Based N 0 'HAZARD ASSESSMENTS TSeorotlN~SIBioHazI Radioactive/Amount EPA HazardsI NFPA I USDOT# MCP No No No/ Curies F DH / / / Low -2- 02/27/2001 E MOTORING SiteID: 015-021-002169 Fast Format ~ Notif./Evacuation/Medical Overall Site Agency Notification Employee Notif./Evacuation -- Public Notif./Evacuation Emergency Medical Plan 3 02/27/2001 E MOTORING SiteID: 015-021-002169 Fast Format F Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention Release Containment ~ Clean Up Other Resource Activation -4- 02/27/2001 P E MOTORING SiteID: 015-021-002169 Fast Format Site Emergency Factors Overall Site Special Hazards -- Utility Shut-Offs 12/13/2000 A) GAS - B) ELECTRICAL- C) WATER- D) SPECIAL- E) LOCK BOX - Fire Protec./Avail. Water 12/13/2000 PRIVATE FIRE PROTECTION - NEAREST FIRE HYDRANT - Building Occupancy Level -5- 02/27/2001 P E MOTORING SiteID: 015-021-002169 Fast Format = Training Overall Site -~- Employee Training 12/13/2000 NUMBER OF EMPLOYEES? DO YOU HAVE MSDS SHEETS ON FILE? GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM: Page 2 Held for Future Use Held for Future Use I 6 02/27/2001 '", ,_ CITY OF BAKERSFIELD O OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 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. 5. You may also attach Business Owner / Operator Form and Chemica! Description Form(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE 1 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. 1' DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORINGjp~ROCEDURES: B. EMPLOYEE AND AGENCY NOTIFICATION: , , C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT ANI~ PREVENTION MEASURES: B. RELEASE CONTA~ENT A~/OR MITIGATION: C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL OAS/PROPANE: SPECIAL: ............. ~/ .................... LOCK BOX: YES/~ IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: - '~t 'CC ~t~ ~'~l ~ B. WATER AVAILABILITY (FI~E HYDRANT): Loc 4eO CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 INSTRUCTIONS: ? 1% 2. T~E~T ANS~RS ~ ENGLISH. 3. ~swer the questions below for the business as a whole. 4. Be as brief ~d concise as possible. 5. You may also attach Business Omer / Operator Fo~ ~d Chemical Description Fo~(s) to ~e ~ont of ~is pl~ instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA OWNER: MAILING ADDRESS: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE 1 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. 1' DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: B. EMPLOYEE AND AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION 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 PE1LIURY. SIGNATURE TITLE DATE 4 HAZARDOUS MATER/ALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: ELECTRICAL: .V'~-. ~ WATER: ~'~% SPECIAL: LOCKBOX: YES, NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): . ~ s ~ :~ o OF E OF ENVIRONMENTAL IISi CES girt ~ 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER / OPERATOR IDENTIFICATION FACILITY INFORMATION Page Of , · · ·, v ~ ::;, I. FACILITY IDENTIFICATION BUSIN_ESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 i BUSINESS PHONE 102 SITE ADDRESS DUN & ~ ~oe SIC CODE COUNTYt~¢N ~ ~o8 WNER MAILING ~ ~ -- . - CONTACT MAILING ~ ~ ~ . . ~9 TITLE C 0 -- ~ ~ ~ ~ 125 TITLE ~ ,30 BUSINESS PHONE ~/~ ~ ~/-~,~e~ ,26 BUSlNESSPHONE ~q~_ 3-- 9t 8 ,3, Cedification: Based on my inqui~ of ~ose individuals responsible for obtaining the infomation, I ~di~ under penal~ of law ~at I have personally examined and am familiar with the info~ation submi~ed in this invento~ and believe the infomation is t~e, accurate, and ~mplete. TURE O~OWN~PE~TOR DATE ~34 NAME OF DOCUMENT PREPARER -NAMES OF O E~PE~¢~&-(;i;t¢ ,36 TITLE OF OWNE~OPE~TOR - 137 UPCF (7~99) S:\CU PAFORMS\OES2730.TV4.wpd .... /'~~ CITY OF BAKERSFIELI~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mate~fal per building or area) [] NEW [] ADD [] DELETE [] REVISE 200 Page __ of __ BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Busin~ As) 3 , CHEMICAL LOCATION 201!CONFiDENTIALGHEMIGAL LOCATION(EpC~) ~ Y~ ~ No 202 }~ ~AcILI~ ID ~ [~;~:~1 J [ ~;~] [~ [~ IJ I ~P ~ (opt~naO 203 GRID ~ (opt~naO 2~.: "~": ~' ~ ~-': - ,::: ;:F~:::'¥~ ? ~':x;::::;::,::;:: ~ ~';'~>: ¢~ ~77,;::~' '.',} :/'{~ ~;~.;¥ ~ ~::f~:~,4r/;';: ' ~'~ ,: ~;'~;F,: ,~ .;:;~ :. ;~' ~:: ~'?~?.::::: ;, . , ', :~,~ '~ ~J~ ) 205 [ T~DESECRET ~ Y~ ~No 206 '. CHEMICALNAME ~ ~ ~ ~ 207 }, } If Su~j~ to EPC~, refer to instm~ions COM~N NAME ~ I EHS' ~Y~ ~No 208 i: 2aD ~PE ~ p PURE ~ m MIX. RE ~ w WASTE 211 ~DIOACTJVE ~Y~ ~No 212 [ CURIES 213 PHYSICAL STATE ~ s SOLID ~, LIQUID ~g~S 2,4 ~RGEST CONTAINER ~d k~-~ 215 FED H~RD ~TE~RIES ~ 1 FIRE ~ 2 REACTIVE ~ 3 PRESSURE REL~SE ~ 4 ACUTE H~L~ ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ANNUAL WASTE 217 ~IMUM 218 AVENGE 219 STATE WAS~ CODE ~0 A~UNT DALLY A~U~ DAILY A~U~ DAYS ON SITE ~2 UNITS' ~ ga GAL ~ d CU ~ ~ lb LBS ~ tn TONS 221 * If EHS. am~nt must be in lbs. STOOGE CO~AINER ~a ABOVEGROUND TANK ~ e P~STI~NONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR 223 (Check afl that apply) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ n P~STIC BO~LE ~ r OTHER ~ c TANK INSIOE BUILDING ~ g CARBOY ~ k BOX ~ o TOTE BIN ~d S~EL DRUM ~ h SILO ~ I CYLINDER ~ ~ TANK WAGON STOOGE PRESSURE ~ a AMBIE~ ~ aa ABOVE AMBIENT ~ ba BELOWAMBIENT ~4 STOOGE TEMPE~TURE ~ a AMBIENT ~ aa ABOVE AMBIE~ ~ ba BELOWAMBIE~ ~ c CRYOGENIC ~5 :;~¢~"'~""::=::~%~bJ;: :,~:~;~;~':' ~ :=?~ C~,2"J~,~:;~? 2 230 23a ~ Y~ ~ No 232 ~3 3 j 2~ 235 ~Y~No 236 237 4 238 239 ~ Y~ ~ No 240 241 5 242 243 ~ Y~ ~ No 244 245 Z P~INT NAME & TITLE OF AUTHORIZED COMPA~ REPRESENTATIVE 81G~TURE DATE 245 UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd