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Home My WebLink AboutBUSINESS PLAN 8/28/1996 SITE DIAGRAM ~ FACIL1W DIAGRAM For Offica Use Only Fffsr In Stotion: Are(: MoD # ot Inspection St~:'tion: NORTH No~T I1 SO~T~ ~5 S~*~ oFF ~ 300 ~L, o~ BAKERSFIELD HARRY BENNE~ / Our record show your enwronmental se~ices (hazardous material and/or undergroun~ tank) account, 3688-ES, is nine~ (90) days or greater past due. This account needs to be paid in full immediately. The balance due on the account is $ 330-65. Until this ~ccount is cleared of the pa~ due balance, you ~ violatin~ the ~unicipal Code ~nd ~ subject to legal Please ~11 me at the number listed below if you have any questions regarding your account or if yOU are unable to pay the entire balance due. Sincerely, ITY OF BAKERSFIELD cc' l ...... ~o .. ~ ...... : ........ ~S CORRECTION REQUESTED TO SENDER ' RETURN ToHOT~VE 5 GARAgE-AU :RARRY E RETURN TO SENDER iil,,,ll,,,,,ll,,Ih,lh,,Ih,,ll,,,Ih'""lllh"ll'"lh' BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION [7].5 -CHESTER' AVE; BAKERSFIELD,.CA. 93301 , .. HAZARDOUS S MANAGEMENT PLAN 1. To avoid furlher action, return this form within 30 days of receipt. ~RI~ 24, 1994 2. ~PE/PRINT ANSWERS IN ENGLISH,. 3. AnsWer the Questions below for the ~usiness as o w~oie. 4. Be brief and concise cs oo~ible. SECTION 1' BUSINESS iDENTIFICATION DATA , r-~ ~.: MAILING ADDRE,~. .-,. DUN &BRADSTRE'ETNUMBF-R' SIC CODE: "7d¢~ PRIMARY ACTIVITY' ("~~~ /¢)-0~ ,/¢....~d/d/-//~, .... SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS, PHONE 24 HR. PHONE ... ., . .,-~- -. ~a~ers*neJ. ct ~'u:e Dept. - jazardous Materials Di~sio~ HAZARD~'S MATERIALS MANAGEME~PLAN SECTION 3: TRAINING; NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING pROGRAM: 8P L [CERTIFY UNDER PENALTY OF PERJURY THAT'MY BUSINESS IS EXEMPT FROM THE C~APTER 6.95 OF THE "CALIFORNIA HEALTH a REPORTING REQUIREMENTS OF '" SAFETY CODE" FOR THE FOLLOWING REASONS" ,~Az..AROO US MATERIALS. WE DO NOT HANDLE" -^ WEDO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO 'TiME,XCEED THE MINIMUM REPORTING QUANTFTIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION' 1, 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 SAFETf CODE" ON HAZARDOUS. MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATiON.CONSTiTUTES PERJURY. SIGNATURE TIT[F__ DATE. Bakersfield F_re Dept. ~ ~1~ Hazardous Materials Division~l~ HAZARDOUS. MATERIALS MANAGEMENT PLAN SECTION 6' NOTIFICATION AND EVACUATION PROCEDURES' A. AGENCY NOTIFICATION PROCEDURES: EMPLOYEE NOTIFICATION AND EVACUATION'_. C. PUBLIC F_VACUATION' . Bakersdeld. Fire Dept. v. Hazardous ~ateriats Di~si ...... ~ .' ,9 HAZARDOUS MATERIALS MANAGEMENT PLAN ,. SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RE,,..A,.,c PREVENTION STEPS RELEASE-OONTAtNMENT AND/OR ~INIMIZA~lON: C, CLSAN-UP SECTION 8: UTILI~ SHUT-OFFS (LOCATION OF SHUT-OFFS A~ YOUR FAC~LffY)' S? EC.,IA.L: · · ..-...':' LOC',<' BOX: YES IF YE~, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION' -Fi¢..~- ~ 7... T I /1,/ ~ U I $ ~~--1'2. / ~J -,. 8. WATER AVAILABILITY (FIRE HYDRANT)' BAKE ISFIE'LD CITY FIRE DI I ARTMENT ~ ;~*~~~' HAZARDOUS MATERIALS DIVISION ~'(~'~ '~'~, 17'15 CHESTER AVE. ? ~, ..'~ BAKERSFIELD, CA. 93301 '~ ~i" (805) 326-3979 ~ HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS.A FARM [ ] NATURE OF BUSINESS' ~~~'~ SIC CODE ~ ~ ~ DUN & B~DSTREET NUMBER owNER/OPERATOR 'i[~~(l ~)~/WI}~-T T' PHONE 8't~q MAILING ADDRESS ~/ · L~. ~ST~~~. EMERGENCY CONTACTS BUSINESS PHONE ~'r'7 ~- qgG ~ .24-HOUR PHONE NAME '~~-/~ LL~_ fV~OoF~//~' TITLE BUSINESS PHONE 24,HOUR PHONE S,~no~ 3~. 1~ I:~-GION¥ LEP~ .STA~COA,cID F- .BAKERSFali LD CITY FIRE DEPAR_TMENT HAZAtWDOUS MATERIALS INVEN'i iY Page_oL 9usinessName ~f~il~-~l~yS ~J'L~-~O Address ~/ ~, e~S~l C~[~ICAL [ESC[l~lO[ 1) IN~NTORY STA~S: New [ J Add,ion [ ] Revision [ ] Deletion I ] Check ~ chemi~ is a NON ~DE SECR~ [ ] ~DE SECR~ [ ] 2) Common N~,: 1/~O//~ ~/~ " 3) ~T * (optiona) Chemi~ Name:~ AHM [ ] CAS 4) PHYSICAL & H~L~ PHYSICAL H~L~ H~RD CA~GORIES Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) [ ] ~layed He~h (Chronic) [ ] 5) WAS~ C~SSIFICA~ON it code from DHS Fo~ 8022) USE CODE 6) PHYSICAL STA~ Solid [ ] Uquid G~ [ ] Pure ~ M~ure [ ] W~te [ ] Radio~Ne [ ] .= Con,=n. : Average O~ly Amount: 1~ cudes [ ] b) Pressure: Annu~ Amount: ~O ~~ ~ I I c) Tem~r~ure: ~gest Size Contaner: ~ 0 0 ~' :OawOnSit, / ~,~.? Circle ~J, F, U, A, M, J, J, *, S, O, N, D 9) MITRE: Dst COMPONENT CAS ~ % ~ AHM the three most h~dou: 1) ~ / ~ [ l chemi~ com~nenm or ~y AHM com~'nents 2) { 3) [ ] CHEmiCAL D~SGRI~ION 1 ) IN~NTORY STA~S: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~ [ ] ~DE SECR~ [ 2) Co.mon N..: ~~ ~, ~ 3) ~T' (option.) Chemica Name: ~~ , AHM [ ] ' CAS 4) PHYSICAL & H~L~ PHYSICAL H~L~ H~RD CA~GORIES Fire ~eamive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acme) [ ] ~layed He~h (Chronic) 5) WAS~ C~SSIFICA~ON (~digit code from DHS Form 8022) USE CODE ~~, 6) PHYSICALSTA~ Solid [ ] Uquid [~ [ ] Pure [ ] M~ure [ ] W~te ~ R~ioectNe [ ] 7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE e) STOOGE CODES M~imum Daily Amount: ~ I~ (] g~ [~3 [] a) Contaner: ~ / Average Daly Amount: [ ~ curies [ ] b) Pressure: Annu~ Amount: (. ~ c) Temper~ure: ~gest Size Contmner: ~ ~ · DaysOnSite {~ Circle ~ich Months:~~, F, M, A, M, J, J, A, S, O, N, D 9) MITRE: ~st COMPQNENT CAS ~ % ~ AHM the three most h~dous 1) [ ] chemi~ com~nenm or ~y ~M com~nents 2) [ ] 3) [ ] 10) Lo~ion ' ce~ under pen~ of law, ~at I have pe~onally examln~ ~ ~ f~ili~ wi~ ~e infoma~on suOmi~ on ~is ~d all a~ch~ documenm, I belieVe submi~ info~a~on is ~e, accu~te, ~d complete. PRINT Name & Ti~e ~ A~horized Core.ny Represenab've I Signa~ ' ' ~ Da~ BAKERSEIELD CITY FIRE DEP, I::ITMENT HAZ DOUS MATERIALS INVEN :)RY Page._.of___ Igusin.~ss Name Address CHEMICAL DESCRIPTION . ; 1 ) INVENTORY STATUS: New [ ] Addition [ J Revision [ ] Deletion [ I Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ J 2) Common N~me: 3) DOT # (optional)-, Chemical Name: AHM [ ] CAS # 4,) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure { ] Immediate Health (Acute) { ] Delayed Health (Chronic) [ ] . 5)'WASTE CLASSIFICATION ,(3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILiTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size'Container: # Days On Site Circle Which Months: All Year. J, F. M. A, M, J. J. A. S. O. N. D 9) MIXTURE? List COMPONENT CAS # % WT AHM the three most hazardous 1), [ ] chemic, a] components or any AHM components 2) { ] 3) [ l · . 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New ( ] Addition ( ] Revision [ ] Deletion [ ] Check if chemic, a] is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure { ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION .(3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] ~t3 [ ] .-' a) Container: Average Daily Amount: cunes[ ] b) Pressure: Annuai Amount: c) Temperature: Largest Size Container: ': # Days On Site Circle Which Months: All Yea~, J, F, M, A, M, J, ~J;"Ai S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM ~he three most hazardous · 1). [ ] chemicaJ components or any AHM components '2) [ ] 3) [ ] 10) Locaaon pena~;y of law, ~at I have personally examineo an~ am familiar with the infomar~on suOmiffeo on ~is eno all attacl~eo oocumen~s. I beiieve ~e submitted information is true~ accurate, and complete. Company Representabve PRINT Name & Title/of AuthonZecl Signa~e /' Date / ' BAKERSI' ": CITY FI.RE DEPA.R. TMENT H OUS MATERIALS INVENWRY · Page--of__ 9usiness Name Address ' CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Checkif chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) 'Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4)'PHYSICAL & HEALTH PHYSICAL HEALTH ,HAZARD CATEGORIES Fire { ] Reactive( ]. Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Heaith (Chronic) [ 5) WA,~TE CLASSIFICATION · ',i3-digit code from DHS Form 8022) USE CODE .,~) PHYSICAL STATE Solid [ ]:" Liquid [ ] Gas [ ] Pure [ ] 'Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE ' 8) STORAGE CODES Maximum Daily Amount: lbs [ ] gal [ ] 1t3.[ ] a)'C~ntalner: Ave~'age Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: : # D~y~::On':~Site Circle Which Months: All Year. J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: IJst COMPONENT CAS # % WT AHM the three most hazardous 1'), . [ ] chemical cor:nponentsor . , any AHM components 2) ~' [ ] · 3) : -[ I '~10) Location \' '~:!!~"' - , CHEMICAL DESCRIPTION 1)'iNVENToRy STATUS:. New [ ] Addition [ ] Revision ['] ,Deletion [ ] Check if chemical is a NON TRADE SECRF [ ] TRADE SECRET [ 2) Common Name: 3) DOT # (oPtional) hemical Name: AHM [ ] CAS # 4) P'H~SICAL & HEALTH PHYSICAL HEALTH.:. ' ' HAZ~., B? CATEGQRIES Fire [ ] Rea. iv. [ ] .~ud~l*n Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health 5) WA SSI.FICATION (3-digit code from 'DHS Form 8022) :.' usECODE 6) PHYSl S TE Solid ['] Liqmd [ ] Gas [ ] .,,~ure [ ] Mixtu~'e.[ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 0 lbs [ ] g? [ ] ~3 [ ] a) Container: Average Daily Amount' .curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size container: ~ ,;,'i')' # Days On Site \~..._..~ ~ Circle Which M~ths: Ail Year, J, F, M A. M, J, J, A, S, O, N, D 9) MIXTURE: · List COMPONENT CAS # % WT AHM the three most hazardous 1) [ ] chemicaJ Components or any AHM components '~) [ ] 3) [ l unoer pen~U~l of Is':,' ~at~t t~ave personalTY~XEmineO anti am familiar w~ the mromeoon suDmirteo on this ano ail artact~eO clocurnen~ PRINT Name & Title/of Authorized Company f~epresenta,ve '""J ' ' ..... .% · [..., '-.7!:.