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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS .OF .PERMIT ON REVERSE SIDE · . , ~. ~ c.~. ! '.~. ',* This _hermit is issued for the followinq: [] H.~rdous Materials Plan [] Underground Storage of HazardOus Mateflals Permit ID #:: 015-000-001832 [] Risk Marmgement Program SAM LYNN ~BALL PARK [] Hmrdou, W,,te Or~SiteTrmr~t · - LOCATION: 3805 CHESTER AVE · OFFICE OF ENVIRONMENTAL SER VICES' ' 1715 Chester Ave., 3rd Floor ^pprovedby: .' Issue Date Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 ExPifationDate:' June 30, 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........ ,,,,~,,~¢,~,~,~,~a~:~:~,,~, .............. This permit is issued for the following: ::,¢,¢¢ii? ;!i~ i::~;~:~"%iiiiiiiiiii!iil;~,~.,~ii!ii ill i;ii;::: i[~iiiU~e:rground Storage of Hazardous Materials PERMIT ID# 015-021 ~)01832 ~i '~i :'~i: i:,~ iiiii:~i !ii!iiiiiiii:'" ...::!!!!:!i!!! i}!i i! !! :!!i!~:::~!?ii,~!?~'~kli~agement Program ' CHESTER ~":=' ::¢ '~¢=~: '¢'¢ ...... ~r"a~'..." ~ =~, ,~' '~:.':~"~,~:~-~ ~ .... :~ ~-'-....~"~ :a~ ..a:~i; ,ea~i!~!ia~i~ .......... .~:' ........ ~i~~'' ~.¢ '~5;= ,~"...".-...'i!i ~. . ~'ff~ ~' ['¢iii'"~'~'i'[~[ff' i~ii~...,i'. :~ ~ ~=' ". '~4'~ '~ '"'" ~ '[ ~. '~'" ~':~P '"'~A~'~-"sl' a~$=¢:' ~7 .~ ,, ',. , J i ~'~.......~$ ~ '~" ..."'~-'%"~ ,lY :~ -, '= ~ "~i~i. ....... :::% ' ir ,~ii~" ~ii~i;'":h4::.; "~'~ ..................... ~;;i,.,,..:';~ ,:,',i~i ~i[!,~ili~a ii,' .¢~(~' ¢" '%:'--.. '=",,,..'"~ ,,~ii~' ,~i~' ;~ii~,~i;: .................... :'"'"%'"",,~i~, '~ii!, '~i}k. 'i~¢ ".,,¢' ', '~ ~.,~i~~' Issu~ by: B~ersfield Fire Depa~ment Approv~ by: ~~~~'~ O~ICE OF E~R O~AL S~ ~CES 1715 Chewer Ave., ~rd Floor ce of ~~ B~e~fiel~ CA 93301 Voice (805) 326-~979 F~ (805),26-0576 Expiation Date: June 30, 2000 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROG~M INSPECTION CHECKLIST 1715 Chester Ave., yd Floor, Bakersfield, CA 93301 FACILITY NAM~ ADD.SS %~O5 G~~ ~ PHONE NO. ~ [ - ~ FACILITY COfiTACT_ gR~&N ~ ~5 BUS.ESS ID NO. 15-210~ ~SPECTION TIME [ ~ ~ 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 X 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 hazardous waste on site?: [~l Yes Explain: Questions regarding this inspection? Please call us at (661)326-3979 Busi ,et~ Sits~Respon~sible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy In CUSTOMER TYPE & ~_~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE .~ -/-0~_- NEW ACCOUNT ADDRESS CHANGE CLOSE ACCOUNT -'-' FINANCE CHARGE OTHER ADJ /- MAILING ADDRESS" - .///~) ~"~/L-~/ ~~L~ ....... CITY /~("~--~_~~ ...... " (3/~Z---.. "ziP coDE ~)~.~'L~- ? .. -' SITE ADDRESS ~,5" (~/~ff'oc~ ~~{4 ~ PARCEL NUMBER (IF APPLICABLE) ADJUSTMENT CHG DATE CHARGE CODE ADJUSTMENT AMOUNT REMARKS: '02 13:09 ~661 326 0576 BFD HAZ MAT DIV __~002 SAM LYN~ ~%LL PARK ~=~== ........ = ..... ==~==== ....... SitelD: 015-021-00$B32 + Manager : BusPhone: (805) 861-2502 Location: 3805 CHESTER AVE Map : 103 Comndtaz : UnRated City : BAKERSFIELD Grid: 1gA FacUnits: i AOV: CommCode: OUT OF:BUSINESS/HAZ-MATL'S SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title -~A't=,K.-J.I~A~K~RTJ~.~pF~ AREA PARK SUPER GHORG~ LOPEZ / PARK SUPER Business Phone'S-'(805) 861-2502x Business Phone: (805) 861-2502x 24-Hour Phone : (805~ 24-Hour Phone : (805) 393-6808x Pager Phone : ( ) ~ x Pager Phone : ( ) - x Hazmat Hazards: ESs Fire ImmHlth DelHlth Contact : Phone: (805) 861-2502x MailAddr: 3805 CHESTER AV~ State: CA City : BAK]~RSFIELD Zip : 93301 Owner SAM LYNN BALL PARK Phone: (805) 861-2502x Address : 3805 CHESTER AVE State: CA City : BAKERSFIELD Zip : 93101 Period : to TotalASTs: = Gal Preparer: TotalUSTS: = Gal Certif'd: ESs: Yes ~mer~ency Directives~ += Hazmat Inventory =~=~=~ ..... ~ .............. ~=~= ..... One Unified ~ist + +== Alphabetical Order ........ ~=-== .................... All Materials at Site + ................................ + ....... + ........... + ..... + .......... + .... +__.+ .az at co.on Name... }speeaazl~Pa Hazards} Frm I DailyMax IUnit}MCPJ ................................ + ....... + ........... + ..... + .......... + .... ~---+ ALKYD RESIN BASE PAINT F IH DH .L k\ 100.00 ~ Hi ANTIFRF.~ZE L ~250.00 (]AL Low BORMACIL IH DH S \ 150.00 LBS Mod COPPER SULFATE IH DH S ~00.00 LBS DIPHACINONE IH D~ S ~00.00 LBS DIQUAT DIBROMIDE IH DH L 3~0.00 GAL Hi DIURON IH DH S !0%. 00 LBS Mod ~LANCO SURFLAN L 250~00 GAL Min MONSANTO ROUNDUP L 250. ~0 C, AL Low ORTHO DIQUAT L 310.0~ GAL Hi ORYZALIN IH DH L 250.00\8AL ROUNDUP IH DH L ~ 8~00~ Low SIMAZINE IH DH S ~20.00 LBS SPRAY OIL F L 1~. 00 GAL Low SURYLAN L 60.~0 C4%L UnR -1- 01/30/2002 13:10 '~661 326 0576 BF3) HAZ MAT DIV 0003 + SAM LYNN BALL PARK ~'====~='~ .......... ===~=~== SiteID: 015-021-001832 ............... ~=~ ........ --==-==--=- One Unified List +'~ Alphabetical Order ............................ ................................ + ....... . ........... + ..... + .......... + .... +~__+ Mazmat Common Name,.. ................................ + ....... I, ~,,,,~T _ff~, £/-' ? Do hereby certify that i have ~lype of* p~et reviewed the attached hazamous materials manage* . . ~e~O merit plan mr_K~,~ ce~,,~,, ?.~/~,, and tha~ i! aloflo with any corrections const;,tute a complete and correct man- agement p~n for my faculty. -2- 0i/30/2002 /30/02 1:}:09 '~661 326 0576 BFD IIAZ ~[AT DIV.. ~001 B A K E R S r I £ L D COVER SHEET .~ .~'A~TM~T PRI~VI!INTION SRRVICF.,S 1 ? 15 Chester Ave. · Bakersfield, CA 93301 Bttsincss Phone (661) 326-3951 · FAX [661) 326-0576 TO: ~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ¢-//~ -0 / NEWACCOUNT ' ADDRESS CHANGE CLOSE 'ACCT ) ' FINANCE CHARGE ' ~ OTHER ADJ i MAILING ADDRESS SITE ADDRESS p~CEL NUMBER OF APPUC~ "' ADJUSTMENT I CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT I /-o~-o r ....5~¢¢ I ~, (0 I ! 09/18/2001 12:02 ~518987001 ~:,~.. -' YEArLINg, AVENUE MR430107 ~ CITY OF BAKERSFIELD ~ 9/18/01 ~cellaneous Receivables In~J~ry 08:25:34 Customer ID . . . : 16226 Name: K C PARKS DEPT Last statement : 9/01/01 Addr: REFERENCE: SAM LYNN BALL PARK Last invoice : 0/00/00 1110 GOLDEN STATE AVE Current balance : 722.00 BAKERSFIELD, CA 93301 Pending ..... : .00 A ACTIVE ENVIRONMENTAL SERVICES Type options, press Enter. Combined Detail 5=Display Chg Bnk G Opt Trans Date Code Description Amount Balance Typ Cd L 2/02/01 stmrn Statements Processed 00 1384 50 N - 1/01/01 stmrn Statements Processed 00 1384 50 N - 1/01/01 SS001 CA STATE SURCHARGE 10 00 1384 50 A 00 - 1/01/01 HM017 HAZ MAT ANNUAL INSPE 53 00 1374 50 A 00 - 1/01/01 HM010 HAZ MAT HANDLING FEE 307 00 1321 50 A 00 - 12/01/00 stmrn Statements Processed 00 1014 50 N - 11/01/00 stmrn Statements Processed 00 1014 50 N - 10/01/00 stmrn Statements Processed 00 1014 50 N - More... F3=Exit F12=Cancel * = Pending STATEMENT OF ACCOUNT CITY OF BA½ERSF!ELD ? 0 BOX 2057 ,~303 BAKERSFIELD, CA =~ DATE: 2/02/01 TO: SAM LYNN BALL 2805 ~N~ER ~AKERSFIELD,~ CUSTOMER NO: 1~7'57~ CHAROE DATE ~CRIPT~ION ............... : ......... .... ~ R,EF: NUMB.ER O TOTAL AMOUNT !/O1/O1 BE~INNIN~ BA~A~6E ~ ,,~,~,~,~:~:: 1 384. 50 FOR ~UESTIONS OR CHAN~ES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER &O OVER ~0 370.00 1014.50 3/05/0~ PAYMENT DUE' 1,384.50 $1,384.50 STATEMENT OF ACCOUNT CITY OF BAKERSFIELD P 0 BOX -°057 BAKERSFIELD, CA 93903-2057 DATE: 4/01/00 TO: SAM LYNN BALL PAR½ 3805 OH~STER AVE BAKERSFIELD, C~ ~3301 CUSTOMER NO: ~&2~& CUSTQMER TYPE: ES/ 1957~ CHARQE DATE DES'CR{PTION;~' ~._ REF~NUMBER DUE~DATE TOTAL AMOUNT 3/01/00 B~I~NNIN~ BALANCE 662. 50 FOR GUESTIONS OR CHANGES TO 'YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 662.50 DUE DATE: 5/01/00 PAYMENT DUE: 662.50 TOTAL DUE: $662.50 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES, 1715 Chester Ave., Bakersfield, CA (805) 326-3979 . ~.-, x~~'. . · ........ · . ~STRUCTIONS: ~ 1: ~o a~oid~er:a~o~ r~ ~s fom.~ffin. 30 days ofre~ipt. ,,. -~- 3. ~er ~e questiom below for ~e buS~~ ~ a Whole. ". 4.. Be ~ bfi~ ~d ~nci~ ~ possible.' ' cITY: ~ ' ~ ~b STA~:'C& Zm.:97~ / pHo~ ' ' ~, '~. ~ . . D~ & B~S~T ~~ SIC CODE:~ ~ x . ~ ~ f s~c~o~-2: ~~nNC~ N0~C~ION CO,ACT ~E BUS. PHO~ 24 ~ PHO~ -2.. . 1 HAZARDOUS MATERIALS MANAGEMENT PLAN /SECTION 3:~.~(~ /' NUMBER. OF EMPLOYEES: / / MATERIAL SAFETY DATA'SHI~.I:;-TS ON FILE: BRIEF SLrMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REOUEST '~ I CEKTIFY UNDEK PENALTY OF PER/UKY.THAT MY-BUSINESS IS EXEMPT FROM THE RI~.PORTING REQUIREMHNTS'OF CHAPTER,6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOI.LOWlNO REASONS: -.~ WE DO NOT HANDLE HAZARDOUS MATERIALS. ,'" WE DO HANDLE HAZARDOUS MATERIALS, BUT ~ QUANTFrlES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. '. · OTHER (SPECIFY.REASON) 'SECtiON 5: n,a*o~~oK~s ACCU~TE: Itn, mEaSTa~,rD ~T mS n,r~o~oN w~ SE USm TO ~m m~ FaU~'S O~.IGATIONSta,r~m ~ "cAL~om, a~ }mAL~ a_~'D samTy CODE" ON ~azam~Ous MA~ma~.s ~r~. 2o clm,'r~ ~.~5 SEC. 255OO ET AL.) AND'THAT INACCURATE INFORMATION CONSTITUTES PERJURY. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES Al AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NoTIFIcATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: 3 MISCELLANEOUS RECEIVABLES ADJUSTMENT CUSTOMER NAME _~:)..~ ~.~ p~ ~"~, ~ [. ~-~'"' ~___ MAILING ADDRESS ~~:)~ ~.~C_~%-~('-- ~ ~ SI~ ADDRESS PARCEL NUMBER (w N'PUCAa. L=) ADJUSTMENT l CHG DATE I CHARGECODE I ADJUSTMENT.AMOUNT ' REMARKS: ~~, ~~' ! APPROVED BY ~ 03/28/96 SA,~ NN 8ALL PARK 015-01.0-- Page Locat:fion: 3805 ~t-.~Eo~ER AV ~ap:102 r.,~z::0 Type: Cfft:y : oAkERSF'~Et..O Gt~ffd: 24 : I AOV: 0.0 .... Contact Name ........... Tfft]e ~ ~ .... Contact Name T'~"e~,.~ ........... ~-~:Z PARK ~"PERVISC)R JA~.~ .-EARD / AREA PARK ~H,)v,~. "'~'E '""' / o0.)) 861-2502x 24-Hour Phone : (805) 392-8330x ~ ~ 24-Hour ,~'nu:~e : (805) 393-68n~' woX PageP Phone : ( ) x II PageP Phoi]e : PARK MA ~' ~ ~'~ FAC L~TY FOR ~ ~ ~n~'~ .... ~' ~' ABOvEuRuUND TANKS PESTICI' ~ STORED IN ' ~ .... ' ~Ei.¢ b~D¢ ,'~ITE IS SHARED BY KCFD & 8LM (AS OF 3/17/93). : 02 Ffixed ~ "~- ORTHO D~QUAT 310 GAL High ~.r'~:~ c~OmAG~: DLDG RM ......... ~ I~ 100 GAL }"I i g h ALr~hu REo~,,I 8Ao,:: PAINT F ~' VALSPAR 80 [3 ¢' '"' ~,", 150 LBS Mode, Pate ROUNBUP IH DH 80 GAL Low STORE::~'~LDG N END OF '¢A'",,u MONSANTO ROUNDU2 250 GAL. Low CHEMICAL ~TORA~:,E BLOG RM A,~, IFREc;¢_E F ~},~ DH 250 ,~*'A'L Low SPRAY OIL. F 112 GAL Low CO~PER L. FATE IH ou ~¢,..~ 4000 LBS Mfi'n~maq STORAGE DLDG N OF YARD ELANCO .:,,J,,~"~_AN 250 GAL. O~,Y~AL. ZN ~1--1 ~¢~'b 250 GAL DIPF, A,..Ii~ONE Ir, DH 200 L.o,'~ M'fiaima] SU RFL. AN 60 GAL Unrat~d STORE 8LOG N END OF YARD · ~"1 D~QUAT D]BROM]DE ¥' DH 310 GAL Unr'ated DZURON Z}.I DH 100 LBS UnPaced SIMAZINE ]}-.I DH 120 LDo Unrated