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Home My WebLink AboutBUSINESS PLAN Y ~ field '0ffi e o~:Envi mental -':' "' ""' .... :' ' -': .. ~. Cit of Ba rs / c' - '"-' '- . _ . - ..... ron Serwces ' - .... ' - - . :- .. 171'5 CheSted'Ave.- .... - ake :.~-_.,::: :,~.- . -. . ,, .. : --.' . : , ~, -'. . .-- ~ -.. -- , . - .. -'. - - : : --'?': -. - . " ':" :.-. :, .'.. :T0 Wh0m'It MaY COhc~rn: ' .... . . ....... -~- :: .-~ ,::.', c....:.': ..... . ....... -., : ,:.:--. , :. _ :.:.'..:': ,:~ .'--..:.:::,"..if. adYtbing:.e,se.iSr~,~ed:;Pl~a~'.le}':Us:~)~:: .~, . : '5 ,, ':, - . .-,~ ~.. .... :- -~ ,.-_ . - . ~ , ........ .-. _.:- .,. . ..,- _. ~. , ..~-.:..: .- . _ ... . .'-:_ ; : :. : - . ,. -- .,;, .- : .- . -- _.. - .... ,~. · , ~ ... _ .,,, , ,:....' '~- · ;~ - , . . , · .. .. : ' ,,_=: .,',.- : .-._ ~. . . - :-, ..... . .- ... ,, :- . -:. .: ...: ..: : ,' .. -...-- :;S'. '~'. ~ . ...2 . .. ',......:~'. ,. . _ ~ ' , .... - .... , ':,...-,:: , -,.- -- _ - . . ,-.. - ~, . . : , , .. :.:' . . _- .- . ... - : , . : , - ~-.T:~7-. ,, -' ' -' - - ' ' 7' 2-- :. - ' "--' : . ¥: '& · :"2 - - - -2 . ' ' ' = s · :' j - . .- ' '-- ' ' '' '.' 145'm COlUmbus'-'-.::- Bakersfield,. CalifOrnia :~aao¢. '- , . . - ., '-: .: ~ ~ _ . .. ' '.':--~+ .~ ~-~'' , : ~ ':.~, ' .~ - CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 2t26-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, remm 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 Chemical Description Form(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA MA~LINO ADDRESS: '73eT QembCe~k'e, EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR: PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. 1' DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: B.' -EMPLOYEE -AND- ia/GENCY'NOTIFICATION.; .................... - .... C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 -~ -' - ~ CITY OF BAKERSF[ELD,~, OFPI~E OF ENVIRONMENTAL SIal'VICES 1715 Chester Ave., CA 93301 (661) 326-3979 '~"~~~-" BUSINESS OWNER / OPERATOR IDENTIFICATION FACILI'~ INFORMATION Page "': ~,, , t ~.~ , i~,~O'?.~'"~..'i.~.:' ',;?;?2~.X?/':~i¥.~i~"<~%'~'~:!~>:':q~;w;.-,:.. .;:~0.'; ~ ?~ '¥:~ ;:~:¢~'~. ~'~:?..', :)' ~;?;~.~<'?~:,~..; ;': ,~,~". : ':,.~ f ~ ~ ' , :~.~ ' FACIL'' ID · g' g ........ , y~gg;ning" 1. Year Ending BUSINESS NAME (Same as FACILI~ NAME or DaA- Doing Busings ~) 3 BUSINESS PHONE SITE ADDRESS COUN~ O~ER ~ILIN~ CONTACT NAME ~tck ~dthook ,,, CONTACT PHONE CONTACT ~ILING CI~ ~ ~ ~' ~ ~ ~ ~2o STATE ~ ~2~ ZIP '; .~,'; ~:: :; ¢;S~.~ ~.'~:i ,~ ~.T.~. ~ ~,~,~ i-~ ;.'~' ,~<~ '~ ~" ~-,9~ ~~;~~ ~ ~ e. *. ~j~:~ ~:~¢.~;~ .';~* ,*: * ~(~ ~.~; ~ ' ~ BUSINESS PHONE 3 ~H - 7 ,~ ~W ,*~ BUSINESS PHONE ~ ~H -~ ~ ~ ~ ~,-HOU~ ~HON~ ~ ~ ~ ~*~ a4-*OU~*HON* ~ ~ ~ ~ SIGNATURE ~ OWNE~O~TOR ~ DATE ~ ~ NAME OF D~UMENT PREPARER 5 15 ,nc NAMES ~ OWNE~OP6~T~ (pdnt) ~ TITLE OF OWNE~OP~TOR UPCF (7~99) S:\CUPAFORMS\OES2730.TV4,wpd " ~ CITY OF BAKERSFiELI~ OFFTCE OF ENVIRONMENTAL SERVICES ~ "tl a.rm 'r 1715 Chester Ave., CA 93301 (661) 326-3979 H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one ~ per mate~al per building or ama) ~ NEW D ADD ETE ~ REVISE ~ . Page ~ of BUSINESS ~ME (~me ~ FAOILI~ ~E ~ DBA - ~ng Busin~ ~} 3 205 T~DE SECRET ~ Y~ ~o ~6 CHEMICAL ~ME If Subj~ to EPC~, r~ to instm~ions 207 FIRE ~DE H~D C~SSES (~pl~e if ~u~t~ by 1~1 tim ~i~ 210 ~PE D p PURE ~ ~RE ~ w WASTE 21( ~DIOACTIVE ~Y~ ~No' 212 CURIES 213 PHYSI~L STA~ ~ s SOLID ~ I LIQUID ~ ~S 214 ~RGEST ~AINER 215 FED ~ ~TE~RIES ~ 1 FIRE ~ 2 ~ACT~ ~ 3 PRESSURE RE~SE ~ 4 ACU~ H~L~ ~ 5 CHRONIC H~TH 216 (~ all ~at apply) ANNUAL WASTE 217 [ ~I~M 218 AVENGE 219 STA~WAS~CODE A~U~ [ DAILY A~U~ DAILY A~U~ DAYS ON SffE UN.S* ~ ga ~L ~ ~ CU ~ ~ lb LBS ~ m TONS * ~ EHS, am~nt mu~ be in lbs. STOOGE ~AINER ~A~VEGROUND T~K ~ e P~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL (Check afl ~at apply) ~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE ~ r O~ER ~ c TANK INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE BIN ~ d S~EL DRUM D h SILO ~YLINDER ~ p TANK WA~N STOOGE PRESSURE ~ AMBIE~ ~ aa A~VE A~IE~ ~ ba BELOW AMBIE~ ~4 STOOGE TEMPE~RE ~A~IE~ ~ aa A~VE AMBIE~ Dba BELOW AMBIE~ ~ c CRYOGENIC ~5 226 227 [] Yes [~o 228 229 230 231 [] Yes [] No 232 233 234 235 [] Yes [] No 236 237 238 239 [] Yes [] No 240 242 243 [] Yes [] No 244 245 PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE DATE 246 UPCF (7/99) S:~CUPAFORMS\OES2731.TV4.wpd CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME JM~Z... ida EC./-IA~,c~ c INspEcTION DATE ADDRESS t(/-4~ t,~, ~ot_~r~tgU.g PHONE NO. FACILITY CONTACT ~~' ~ BUS,ESS IDNO. 15-210- ~SPECTION TIME · NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [] Routine [] Combined [~ Joint Agency ~ Multi-Agency l~l Complaint [~ Re-inspection CV OPERATION COMMENTS hand t~ t t_ c. 5g,~qO Appropriate permit on Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities ~'~ / Verification of location Proper segregation of material O LHOOK Verification of MSDS availability FCHAN[CAL, INC. 1 Verification of Haz Mat training uc ~, 693939 Air Conditioning Specialists - Verification of abatement supplies and procedures 1145 W. Columbus _ Bakersfield. CA 93301 Emergency procedures adequate Phone: (805} 324-7524 Nick Molhook Fax: (805) 3;~4-1306 Pre$idenl; -- Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V--ViOlation Any hazardous waste on site?: ~ Yes ~ . . Questions regarding this inspection? Please call us at (661) 326-3979 ~'~siness Site Responsible p.arty · - . ~ Whife- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: ~ CITY OF BAKERSFIELi~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 **'~"~~"~'~*~'* HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one ~ per mate~l per bu~ or ama) ~EW ~ A~ ~ DElE ~ REVISE ~ Page ~ of 8UStNESS ~E (~e ~ FACIL~ ~E ~ O~ - ~ng B~ ~) 3 CHEMI~L LO~TION CHERYL ~E ~ ~ Subj~ to EPC~ r¢~ to ins~¢~s ~0 PHYSI~L ST A~ ~, "LID D I L--UID ~S 214 j ~RGEST~AINER ~U~ BILY A~U~ DAILY ~U~ UN'S* D ~ ~L ~ CU~ ~ · ~S ~ ~ TONS STOOGE ~AINER ~ a ~GROU~ T~K ~ · ~TI~NM~IC ~UM * D i FIBER DRUM (Check afl ~at app.) ~ b UNDER~UND T~K D f ~ ~ j ~G ~ n ~TIC BO~ D r O~ER ~ c T~K INSIDE BUI~ING ~ g ~Y ~ k ~X ~ o TO~ BIN ~ d S~EL DRUM ~ h SILO ~UNDER ~ p T~K WA~N STOOGE ~ · ~IE~ ~ A~VE A~IE~ ~ ba BELOW A~IE~ ~4 STOOGE ~~ ~ · ~IE~ ~ ~ A~VE ~1~ D ~ BELOW A~IE~ ~ ~9 UPCF (7199) S:\CUPAFORMS\OES2731.TV4.wIxI ~ CITY OF BAKERSFIELD~ OFFICE OF ENVIRONMENTAL SE"RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 '*'*~*"'"~~"" ~"--" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mate~al /~er t~uilc/ing or ama) .EW I-I [] ['-] 200 Page of ADD DELETE REVISE BUSINESS ~E (~e ~ FACIL~ ~ME ~ D~ - ~nG B~nm ~) 3 CHEMI~L LO~TION ~T I ~ ~ ~ ~L ~'~ ~ CONFIDE~IAL (EPC~) CHE~I~L ~E ~ Subj~ ~o EPC~ r~ to insets ~7 FIRE CODE H~ C~ES (~pl~e ~ ~ by I~ tim ~ ~0 ~PE ~~ ~ m ~ ~ w WAS~ 211 ~D~A~ ~Y. ~ 212 i CURIES ~3 PHYSI~L STA~ ~ s ~LID ~1 L~UID ~g ~S 214 ~GEST~AINER FED ~ ~RIES ~ 1 FI~ ~ 2 ~ ~ ~ ~E ~ 4 AC~ H~L~ ~ 5 ~RONIC H~ ~6 (~ mi mat ~) · UN.S* ~ ~ ~ ~ ~ ~ ~lb ~S ~ ~ TONS DAYS ON S~ · ~ EHS, ~nt m~ ~ in I~. STOOGE ~AINER ~ a ~G~UND T~K ~ e P~N~IC ~UM ~ i FIBER DRUM {Chec~ a// ~at app/y) ~ b UNDERG~UND TANK ~ f ~ ~ j ~G ~ n ~TIC BO~LE ~ r O~ER ~ C T~K I~IDE BUILDING ~ g ~Y ~ k BOX ~ o TO~ BIN ~ d ~ ~UM ~ h SILO ~1 CYLINDER ~ p T~K WA~N a ~IE~ ~ ~VE ~IE~ ~ ba BELOW A~IE~ ~4 STOOGE P~SSU~ STOOGE ~e~l~ ~ M ~1~ ~ ~ B~OWA~IE~ ~ ~9 242 243 PRINT NAME & TITLE OF AUTHORIZED COIVlPANY REPRESENTATIVE ./.t~IGNATURE ~1 [' ~' DATE Z4~ UPCF (7~99) S:\CUPAFORMS\OES2731 .'l%/4.wpd