HomeMy WebLinkAboutBUSINESS PLAN March 30~ 1990
TO~ BUll Descary~ City Treasurer
FROM: Ralph E, HUey~ Hazardous Materials Coordinator
SUBJECT: Service Center
Account.# HM425301~ is no longer in business, The Hsz Mat bill was
returned not forewardable~ they have a previous balance of $75,00.
We feel the previous~balance should be collected, Please turn this
over for collection.
Thanks
May 25~ 1990
TO~ Nina Mayer~ Accounts Receivable
FROM: Ralph E. Huey~ Hazardous Materials CoordinatOr
SUBJECT: Service Center
Nina~ account # HM 425301 is n° longer in business. We have
other forwsrding address. Please stop sending statements~ they
will just continue to come back.
Thsnks
' STA~E N~.NDATEO PROG~AN .... ,~ . ,, ""'?~
RETURN PAYMENTS TO: ~. '. ' PLEASE/V~A'~I~E
CITYOF BAKERSF, IELD HAZ~RDOUS, ~'I~RI~LS '~JVI$iOIN ,
CITY
P.O. BOX 2057 :' :'
BAKERSFIELD CA 93303-2057 ACCOUNT NO. ~, ,, '425]0Z ~-~
~T~TE MANDATEO PROG~A~ .,:~,
:' ,-' ,, ~C,'-' ~',,,,, ". '
Z,.', 'q. ,, ~- , . . ". .' .
INQUIRIES'CONCERNING THIS BILL, PLEASE PHONE: 526--3979
- .- BA~ERSFfELD~ CA'
'-' CUSTOMER C~ "
O Bakersfield Fire Dept.
·. · Hazardous Materials~Inspectio~_
Plan iD # 215-000 0 .. 0Crop 6_§hr corner Busine-'~mo · . ' ............
Station No. t Shift /~) Inspector q"tl/~
~5) ~b3 8- 3z/~/& Adequate Inadequate
Verification of InventOry Materials
Verification of Quantities
Proper Segregation of Material. (L~ "~ "C~0j~j)~f 7-1
Comments:
Verification of MSDS Availabfli~'
..... Number of Employees
Verification of Haz Mat Training ~-~
Comments:
Verification of Abatement Supplies & Procedures [--] [--]
Comments:
Emergency Procedures Posted [~] [-]
Containers Properly Labeled [--] [~
Comments:
Verification of Facility Diagram [--] [-~
Special HazardS Associated with this Facility:
ViolationS:
FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
BAKERSFIELD ~ITY F~IRE OEPAR
~ ->~ 2i30 "S" S'mEET~ RECEIVED
.AKE.SFIELD, CA
(sos) 3~-39z9.,.. 1%~ ~ SEP 8 1987
.. . , Ans'd ............
- HAZAR'DOUS ~TERI ALS
BUS.INESS PLaN AS A WHOLE
1. To avoid furthe~ action, return this form by OCT 2
z. TYPE/PRINT ANSWERS IN ENGLISH. ~8'd..
3. Answer the questions below for the business ~s a whole ...........
4. B6 as brief and concise aS possible.
SECTION 1: BUSI~SS IDE~IFICATION DATA
A. ~usz~Ss NA~: >~W~
B. LOCATION / STREET ADDRESS: ~ ~~
CI~: ~~~'~ ZIP: ~~t BUS.PHONE: (~)
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
EMpLoYEES. TO NOTIFY IN CASE: OF EMERGENCY:
'NAME AND TITLE DURING BUS. HRS., AFTER BUS. ERS.
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A MOLE
C.WATER: ~~ O~
SPEC IAL:
E.
- 2'A -
SECTI6ff,?~'~if~'~E RESPONSE ZS~'~ FOR B,~SIXESS AS A WHOLE
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YO~ BUSINESS AS A WHOLE
SECTION.6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INITIAL REFRESHER
A'. METHODS FOR SAFE HANDLING OF HAZARDOUS
MATERIALS: ....................................... YES N( ~S NO
B..PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES: .......................... YES N( YES NO
C. PROPER USE OF SAFETY EQUIPMENT: .................. YES N( YES N0
D. EMERGENCY EVACUATION PROCEDURES: ................. YES N( YES NO
E. DO Y0U MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ YES NO
SECTION
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS ~TERLAL IN QUANTa. 0.._POL~B~,,~ ....
~~OR-'2-00'-CUB-IC 'FEET OF A COMPRESS~D GAS:... '..~_~~,~~, :
I, ~0'~ ....... ~:f~t~ , cert.ify that the above information is accurate.'
I understand that this information will be' used to fulfill my firm's obligatiohs under
the new California Health and ,Safety .code on Hazardous Materials (Div. ZO Chapter 6.95
Sec. ~5500 Et Al.) and that inaccurate information constitutes perjury.
SIGNATURE TLE ~~~' DATE' ~
- 2B - '
BAKERSFIELD CITY; FiRE ~DEPAR/B~IENT
2130 "G" STREET
BAKERSFIELD, CA 93301
OFFICIAL USE ONLY
· iD~
BUSINESS NAME:
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 8A
INSTRUCTIONS 1. To avoid further action, this form must be returned by:
2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.
3. Answer the questions be!o~v for THE FACILITY UNiT LISTED BELOW
4. Be as BRIEF and CONCISE as possible.
SECTION 1: MITIGATION, PREVE~TrFION, ABATEMENT PROCEDURES
SECTION Z i NOTIFICATION AZD EVACUATION PROCEDL~ES AT THIS L~iT ONLY
BAKERSFIEI, D CITY FIRE DEPARTMENT (Z5
I,D. ~ FORM 4A-1 · Page
NON--TRADE SECRETS
HAZARDOUS MATERI'ALS' I NVENTORY
~" ~ADD.~:~<S.S2~ FACILITY UNIT NA~E:
AUDRESS:
CITY, ZIP: CITY,ZIP:
I-
ONLY
I 2 O 4 5 6 7 8 9 IO
TYPE ~AX ANNUAL CONT UsE LOCATION IN THIS ~ BY ]lAZARD B.O.T
~DE AMOUNT A~OUNT UNIT CODE CODE FACILITY UNIT ,..;[~O~. '~ ' ~[ ~l~ ~ ~~~--~ o, ~ ,'~-- f~,~°~ '~WT' C,EHI~AL OR CO~HON NA~E~o~_~ ~'; '~' ~ ~~~ O~CODE GUIDE
NAHE: TITLE: SIGNATURE: DATE!
EHERBENCY CONTACT:. TITLE: PHONE ~ BUS HOURS:
AFTER BUS
EMERGENCY CONTACT: TITLE: PHONE ~ BUS HOURS:
PRINCIPAL BUSINESS ACTIVITY:__ AFTER BUS. HRS:
- .4A-I -
Dobbs Avco
~ ChesS. er Ave.
I PC Funky's Serv i ce
Center
230
Alley
SERVICE CENTER
Site Diagram
Scale
Sep. 1 ~, 1997 1" = 35'
0
Bathroom
Bathroom
SERVICE CENTER
Site Diagram
Scale
Sep 14, 1987 1" =