HomeMy WebLinkAboutBUSINESS PLAN- , ~2'- :i~ CITY OF BAKERSFIELD
'~ OFF~E OF ENVIRONMENTAL SI~VICES
':;!, 7~5 Chester Ave., CA 93301 (661) 326-3979
.... ~ ~!IUSINESS OWNER I OPE~TOR IDENTIFICATION ·
~ / ~' --'-~l~ FAClLI~ INFORMATION ,~ ~ ,~
;:L. ,:~ ~ Year Begin r Year Ending
BUSINESS NAME (Same as FACILi~ NAME or DBA- Doipg Business ~) 3 j ~SINE~ PHONE
_ ~ ~ CA ZIP
DUN ~ ~o~ ~IC CODE ~o~
B~DSTREET (~ Digi~ ~)
COUN~
OPE~TOR NAME ~ OPE~TOR PHONE n ~o
OWNER
ADDRESS , 113
z,.
r >':~' ', ::": .:;..
CONTACT ~ILI~G
TITLE ~ ~ ~ ~ ~ ~25 TITLE
PAGER ¢ 128 PAGER ¢ 133
- ': ;>~,' L%:':::~::q~':;::,~%> (~,?~::::,:H>; ,N::: ":~x ":::'~:;;;::':~': ~,~:~'t~::~::~,,;,'::,~,:, ,,',', -: , ::::~,;; : ,,~F:~':':,r: -,,. :>.
Ce~ificaUon: Ba~d on my inquiW of ~ose individuals responsible for chaining the information, I ~di~ under penal~ of law ~at I have personally examined
and~m ~miliar with the information submi~ed in this inventow and believe ~e info~ation is tree, accurate, and ~mplete.
:SIG~ ,E OF~OPE~TfR -- DATE ,34 ~E OF DOCUMENT PREPARER
,~ ~OP~TOR (pdnt) 136 TITLE OF OWNE~OPE~TOR 137
UPCF (7~99) S:\CUPAF~OJ~_MS\OES2730.TV4.wpd
~ FME ~
~4~~r 1715 Ch~ter Ave. CA 93301 (~1) 32~3979
CHEMICAL DESCRIPTION
' ~one fo~ per mate~l per bu~ing or ama)
STOOGE CO~AINER ~ a A~GROUND T~K D e P~NONM~C DRUM ~ i FIBER DRUM
(~eck all ~at app.)
Db UNDE~UNDTA~ ~f ~ Dj ~ ~~cso~ D r O~ER
~ c T~K INSIDE BUILDING D g ~oY ~ k BOX ~ o TO~ BIN
~S~ DRUM ~ h SILO ~ I ~LINDER ~ p TANK WA~N
sTO~ P~SSURE ~~ ~ ~ A~VEA~IE~ Dba BELOW~IE~
~ ~. CITY OF BAKERSFIELD~
OFFICE OF ENVIRONMENTAL SiCIly'ICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
NEW' one form per matenal per building or ama)
[] ADD [] DELETE r'"l REVISE 200 Page __ of __
--BU~'iNESS~I~4~E (Same as FACILITY NA~ME or DBA - Doing Bu~inass A~) t, 3
~ t
· I CONFIDENTIAL (EPCRA) . /
2O7
FIRE CODE NAZARD CLASSES (Comp~,e if requasted by k3~al tim o'~d)
210
TYPE []p PURE [] m MIXTURE ~ WASTE 211 I RADIOACTIVE [] Yes /~_.No 212 CURIES 213
PHYSICAL STATE
[] s SOLID ~ __ LIQUID [] g GAS 214
PE~ ~Z~RD CATEGOPJES [] ~ RRE r-! 2 REACrI~ [] ~ PRESSURE ~ ~SE [] 4 ACU~ RE~ ~N~C NEN. TH 2~
(Check a~ ~
* If EHS, amount must be in lbs.
STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223
(Check all t~at apply)
[] b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER
[] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN
STEEL DRUM [] h SILO [] I CYLINDER [] TANK wAGON
P
STORAGE PRESSURE ~a AMBIENT [] aa ABOVE AMBIENT [] ha 8ELOWAMBIENT 224
STORAGE TEMPERATURE
AMBIENT [] aa ABOVE AMBIENT [] ba 8ELOWAMBIENT [] c CRYOGENIC 225
Z I 230 23'1 []Yes ['-INo232 233
3 I 234 235 ~'[Yes[]No 236 237
4 I 238 239 []Yes.[]No 240 241
-5IL 242 243 [] Yes [] No 244
245
PRINT NAME & TITLE OF AUTHOr• CO~ddY REPRESENTATIVE SIC.~ATURE /"~'~ .... DATE 246'
OFFICE OF ENVIRONMENTAL SEI~K~CES
1715 Chester Ave., CA 93301 (661) 326-3979
*"~'" ~' ~'~'"" HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per mater~al per t~uil(ling or ama)
~ [] ADD ~ DELETE l-/REVISE 200 Page __ of __
BUSINESS NAME (Sa~e as FACILITY N~,ME a~ DB~'-- Doing Bu$in.ess As-), ~ 3
CHEMICAL LOCATION ~0 ~ ~ C~l,'7OO~. '~.,~I~CHEIViCALLOCATIONo~.~ ! CONFIDENTIAL(EPCRA) r-] yes/~lo. 202
2o5 I 'mADE SECRET I--I Yes
CHEMICAL NAME
t If Subject to EPCRA, re~e~' to instructions
210
TYPE r-lp PURE [] m MIX'FURE ,~w WASTE 211 ] RADIOACTIVE []Yes ~.No 212 . CURIES 213
(Checka, thatapply) ~ RRE 1--12 RE. ACl'nfE 1'-]3 P~ESSU~Ei~a. EASE FI4 ACUTE HEALTH CHRONICHEJ~TH 216
AMOUNTANNUAL WASTE ZI7 I MAXIMUMDAiLY AMOUNT ~/7~-~ 218 i AVERAGEDAILY AMOUNT /d~.,~ 219 ! S~rE~fTE CODE, 220
DAYS
ON
SITE
/ ' If EHS. amount must be in II)s. ~
STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223
(Check all that apply)
[] b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BO'I'I'LE [] r OTHER
[] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN
~'~STEEL DRUM h SILO I CYLINDER p TANKWAGON
STORAGE
PRESSURE
~ a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT
224
STORAGE
TEMPERATURE
~j~a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [] c
CRYOGENIC
2 i -230 23~ [] Yes I-J ~o 232 233
3 I 234 235 []Yes[]No 236 237
4 i 238 239 I"-] Yes.l--I No 240 241
/
5 i 242 243 [] Yes [] No 244
f
OFFICE OF ENVIRONMENTAL SER~CES
1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
Section I1.1 - DISCOVERY AND NOTIFICATIONS
I. FACILITY IDENTIFICATION
BUSINESS NAME (Same as FACILITY NAME Or DBA - Doing Business As) , ~ 3
ADDRESS (For local use only) _ ~ -- (~ I 4?6.
DISCOVERY
A. LEAK DETECTION AND MOblITORING PROCEDURES:
' ' ~' ':~ ':"";" :'" '" ': "": ' ""'" ' ' ,.~;,?-~..7:
,, : :'.,<~Jc~*~' ,'~'t:i~t.,C,,~.~ 'r , :,7.. ' {~;~Z~B,~''''~ ' '-~, ,'. ~.*. .,,... ~ · ~
B, EMERGENCY AND AGENCY NOTIFICATION PROCEDURES:
.., -~,~,~,.~t.~ :~.~e.:-'~:'~:,?~:.~,' . '.::~,.'~;:'~;~.-~.E~IR~-NMENTAL'~
C. SPECIFIC RESPONSIBILITIES OF EMPLOYEES:
!,::::;:,;':;;~:', ~'.i :iiii ;.":~::'.,":.'"'"' .... . '" "~"'""'" ' : ':"":" ..... '~ ....... :~', .... , .... .:4:.i
· 'EMERGENO~Y MiEDIJ~AB:' J:iJ.AN -.": "': '" ';" ;: "<' ':~, ~::~ ........... '"'-' ..... "-""
D. CLOSEST LOCAL MEDICAL FACILITY:
.
UPCF (7/99) S.~PROCEDURE MANUAL~New HMMP fmm.wp<t
Se~ion 11.2 - RELEASE RESPONSE PL~I
PRELIMINARY ASSESSMENT
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
B. RELEASE CONTAINMENT AND MITIGATION:
O '
C. CLEAN-UP AND RECOVERY PROCEDURES:
UPCF (7/gg) $:~:q~)CEEX, IRE MANLIAL~Iew HMMP fo~'m.wixl
HAZARDOUS MATERIALS MANAGEMENT PLAN
Section II1.1 - FACILITY/~dqD LOCALITY INFORMATION
UTILITY SHUT-OFF8
LOCATION OF SHUT-OFFS AT YOUR FACILITY:
SPECIAL:
LOCK BOX: YES ~O~ IF YES, LOCATION:
PRIVATE FiRE PROTECTION I WATER ""~" ' '
- . ,- ...... AVAILABILi;I'Y '. '. '
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABILITY (FIRE HYDRANT):
.. . :::;:..;.'..'
A.NUMBEROF EMPLOYEES:~
B. MATERIALS DATA SHEETS ON FILE: f.~~
C. BRIEF SUMMARY OF TRAINING PROGRAM:
,, CERTIFICATION · ·
Based on my inquiry of those individuals restx3nsib~ f~' obtaining the Infotmetion, I certify under penally of law that I have personnaly examined and am familiar with the lnfom~tlon submitted and be~le~e the
NAME OF SIGNER (p,'lot) 478. TITLE OF SIGNER 479.
UPCF (7/99) S:~oROC..ED~ MANUN.~Iew HMMP fen~.wl~