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HomeMy WebLinkAboutBUSINESS PLAN SITE/FACILITY D I AG R.Zkl~i NORTH SCALE: DATE:,~ / / FACILITY N~ME: .. ~ ' D UNIT ~: 0F .. ,. Inspector'~ Comments): -OFFICIAL USE ONLY-' 1. Address: Identffy the 9. Lock (key) Bo~ principle buildings ~. Street(s), Alleys, 11. Railroad Track= :Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. Masonry 3. Storw Drains, Culverts, Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Gates Creeks, 13, Powerllnes 5, Buildings a. Frame construction 14. Guard Station b. Masonry construction 15. Storage Tanks: ~ Identify the C. Metal construction capacity in gal. m. Above ground · d. Access Door b. Underground 6. Utility Controls a. Gas 16. Diking or Berm b. Electricity 17. £vacuation Route c. Water 18. Evacuation Area: Identify the ?. Fire Suppression Systems: location where a, Fire Hydrants employees mill meet. b. Fire Sprinkler 19. Outside Hazardous Connections Waste Storage c. Fica Standpipe 20. Outside Hazardous Connections M=tsrial Storage d. Water Control Valves 21. Outside Hazardous for protection systems Material Use/~andling e. Fire Pump 22..Type of Hazardous Material/Waste Stored 8. Fire Department Access or Used (See Below) TyPE oF HAZARDOUS NATERIAL F - Flammable E - gxplosive L - Liquid R - Radiological C = Corrosive' 0 - Oxidizer O - Oas P - Poison M - Water Reactlve T - Toxic S - Solid ~ . Cryogenic D - Waste B - Etiological Example: Fla~ab/e Liquid - FL FACILITY O£AGRAN (Required Items la addition to the above) 1. Risers for Sprinklers 8. Fire Escapes Partitions 9. Air Conditioning Unite 3. Stairways: Indicate the 10. Wlndow~ levels'served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12; Inside Hazardous highest to lomest. Ma:erials Storage 5. Elevator 13. Inside Hazardous .. Materials Use/Handling 6, Attic Access 14. Sewer Drain Inlets ?. Skylights 08/18/92 BLACKWELL PAINTING 215-000-000220 Page 1 Overall Site with 1 Fac. Unit General Information Location: 5650 DISTRICT BLVD 103 Map: 123 Hazard: Moderate Community: BAKERSFIELD STATION 13 Grid: 15D F/U: 1 AOV: 0.0 iContact NameI Title i Business Phone' i 24-Hour Phone~ CURTIS BLACKWELL (805) 836-7153 x (805) 834-3969! TOM HINES' (805) 845-2471 x ( ) ' ~ / Administrative Data Mail Addrs: 5650 DISTRICT'BLVD 103. D&B Number: '19-241-7988 City: BAKERSFIELD State: CA Zip: 93313- Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code: 1721 Owner: CURTIS BLACKWELL Phone: (805) 399-6658 --Add~es~ :-59'0'0--VALLEY-BROOK ............ St~t-e-:'-CA~-- City: BAKERSFIELD Zip: 93308- Summary RECEIVED SEP 2 2 1992 HAZ,:~A~ DI~ ~ieby cer~if~ ~h~ ~ have plan for and ~h~ i~ ~long ~i~h !0/30/90 BLACKWELL PAINTING 215-000-000220 HA~ MAT. DIVPage Overall Site with 1 Fac. Unit General Information Location: 5650 DISTRICT BLVD 103 Map: 123 Hazard: Moderate Ident Number: 215-000-000220 Grid: 15D Area of Vul: 0.0 Contact Name Title Busin%ss Phone 24 Hour Phoneq Administrative Data Mail Addrs: 5650 DISTRICT BLVD SU 103 -D&B Number: CitT: BAKERSFIELD State: CA Zip: 93313- Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code: Owner: CURTIS BLACKWELL Phone: { ) - Address: 3g08 KENNEDY WY State: CA City: BAKERSFIELD Zip: - Summary hereb~ that ! have ... ~ -y~~ £(~ ~A.~ r~v!ewed the attached hazardous materials manage- ~pDr~ ~c~ any corre~,ons ~n~itute a ~mptete and ~rre~ man- ~ ~, o · agement plan for my facili~.~ 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Quantity MCP 02-001 LACQUOR THINNER ? 400 High GAL 02-002 PAINT THINNER ~ 55 High GAL 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP O~der  400 High 02-001 LACQUOR THINNER ?~ GAL CAS #: Trade Secret: No Form: Unknown Type: Pure Days: Use: PAINTING Daily Max GAL [ Daily Average GAL ] Annual Amount GAL. 400 ~ 0 _ 1,200 Storage Press Temp Location METAL CONTAI NR-NONDRUM I T INORTH WALL -- Conc Components MCP List 0.0% Acetone Moderate 0.0% Toluene Moderate 0.0% n-Propanol Moderate 0.0% n-Butyl Acetate Moderate 0.0% Xylene, Mixed Moderate 0.0% Methanol High 02-002 PAINT THINNER 9 55 High~ GAL CAS #: Trade Secret: No Form: Unknown Type: Pure Days: Use: PAINTING Daily Max GALI Daily Average GAL I Annual Amount GAL 55 ~ 0_ 200 Storage Press T Temp Location METAL CONTAINR- NONDRUMI_ iNORTH WALL -- Conc Components MCP List 0.0% Acetone Moderate 0.0% Toluene Moderate 0.0% n-Propanol Moderate 0.0% n-Butyl Acetate Moderate 0.0% Xylene, Mixed Moderate 0.0% Methanol High 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 4 O0 - Overall Site <D> Notif./Evacuation/Medical ~"~<1> Agency Notification <2> Employee Notif./Evacuation VERBALLY AND CALL 911 Public Notif,/Evacuation <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention CLEAN UP WITH RAGS AND THROW AWAY IN METAL BUCKET WITH LID. THINNER KEPT IN CLOSED SAFETY CONTAINERS ~2> Release Containment <4> Other Resource Activation 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special' Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - 30FT EAST OF FRONT DOOR C) WATER - SOUTHWEST OF FRONT DOOR D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER FIRE HYDRANT - IN FRONT OF OUR BUILDING <4> Held for Future use 10/30/90 BLACKWELL PAINTING 215-000-000220 Page 7 00 - Overall Site <G> Training <1> Page 1 WE HAVE ?? EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY Farm and Agriculture [1 Standard Business [] NON--TRADE SECRETS I 2 ] 4 5 6 ~ 8 9 I0 II 12 irons Code c~oe AmC Ami EsL Un~ts on Iype Press tamp Stored ~n racially Physical and Health HAzard C.A.S, Number < ~ ~ ~ V~ - ~-~ Component II Name I C.A.S. Number (Check all Ch4L apply) Heal~h of Pressure Health Component 13 Name I C,A,S, Number Physical Ipd PealCh Hazard C.A.S, Number ~ CY Y¢~ - ~- ? Component I1 Name I C,A,S. Number ~ire Hazard U Reactivity U DelayedHe,lth ~Oen. of Pressure Release U ]m[~Si~~ Component 12 Hame, C.A.S. Number C~mponenL 13 Na;e I C.A.S, Number Physical and Health Hazard C.A,S. Number 44r~ - Component I! Name A C,A.S, Number (Che:k all th8: applyJ (Check 411 thmt Apply) Component 13 Na~e I.C,A.S, Number erti[j;8ioq ,(Rep~ ~.nd.$ign after compl~tiog,all, sec~i~n~) a~acned.docgmenc~, anO t~ac oaseo on.my Inqu~r~ ~Lcnose Inolvloul/s respoflslD/e tot ob&aln~ng ~he Inlormaclofl, I believe Ch~ suOmltLeo lntOrma~lO~ IS true, accurate, ano co~p/ece. g,~fi:JlJ tit1, of o~net/operator u, oNner/operator's authorized represen[ativ, ~S,~ ~September 5, 1990 Mr. Curtis Blackweli Blackwell Painting 5650 District Blvd., Suite 103 Bakersfield, Ca. 93313 Dear Mr. Blsckwell: Enclosed you will find a computer printout of the Hazardous Msterisls Management Plan that is currently in our computer, we hsve highlighted the areas that need to be revised. Also due to a chsnge in the lsw that went into effect January, 1989, we need to hsve s new inventory form (enclosed) filled out. These forms must be filled out and returned to our office by September 28, 1990. If you have any questions please don't hesitate to contact us at (805) 326-39?9. Sincerely Yours, Rslph E. Huey Hazardous Materials Coordinator REH:vp Enclosures BAKERSFIELD CITY FIRE· DEPARTMENT ' 2130 "G" STREET' RECE[VED BaKerSFIELD, CA 933O! (805)326-3979 JUN ! $ ~87 A~ ............. OFFICIAL ~SE ONLY ID# 000220. BUSINESS NAME INSTRUCTIONS: 1. To avoid further action, return this form by 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. SECTION 1: BUSINESS IDENTIFICATION DATA SECTION 2: EI~ERGENCY 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 law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: 6~ee~e~ NAME_AND TITLE.,;; .~ ~ DURING BUS. HRS. AFTER BUS. HRS. A. {/o~.',~ /T/~c~'~e/l Ph~ ~ . ~ ,,~ b/,'~ e ~ Ph# /4 ob' ~ Ph# ~ ~° ~ ¢ P / SECTION 3: LOCATION OF UTILITY SBUT-OFFS FOR BUSINESS AS A tltOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: ~ ~ C. ~ATER: /~ ~ D. SPECIAL: E. LOCK BOX: YES / N~_0~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO 2A - RESPONSE TEAM.FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY,MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TWINING EMPLOYERS ARE R~UIRED TO HAVE A PROd'RAM WHI'qH PROV~DE~'iEMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLEOWING AREAS,,,_% CIRCLE YES 04 NO INITIAL REFRESHER A. METHODS'FOR SAFE HANDLING OF HAZARDOUS "' ~TERIALS E~NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... E~.S NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO YES NO E. DO YOU ~INTAIN EMPLOYEE TRAINING RECORDS: ....... - NO YES NO SECTION 7: ~Z~RI)OUS ~TERI~ CIRCLE YES OR NO DOES YOUR BUSINESS, HANDLE;HAZARDOUS ~TERIAL IN QUANTITIES ~ESS THAN 500 POUNDS OF~ sonIb, 55 GALSONS~OF A LIQUid; OR 200'dUBIC FEET OF A COMPRESSED'GAS , certify that the above inf'orma~ion is~accurate. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY BUSINESS NAME: ~[ r/ (l BUS I NESS PLAN SINGLE FACILITY UNIT F 0 RlV~ 3A INSTRUCTIONS '~ 1. To avoid further action, this form must be returned by: 2. TYPE/.PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as .possible.. ~. SECTION 1: MITIGATION, PREIrENTION,' ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS b~.'IT ONLY ~ECTION 3: HAZARDOUS MATERIALS FOR~THIS UNIT-ONLY .A. Does this Facility Unit contain Hazardous Materials? ...... NO If YES, see'B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES Q If No, complete a separate hazardous materials inventory form marked: NON=TRADE 'SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in. addition to the non-trade secret ~form. List only the tnade secrets on form 4A-2. ,SECTION 4: PRIVATE FIRE PROTECTION .SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY .EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OF_.FS,AT,_THIS UNIT ONLY.. B. ELECTRf6AL: C. WATER: D. SPECIAL: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES /' NO - 3B - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page ,,g~of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME: BLACKWELL PAINTING OWNER NAME: Curtis W. Blackwell FACILITY UNIT #: /~)_~ ' ADDRESS: "5650 Dictrict Blvd ADDRESS: 3208 Kennedy way FACILITY UNIT NAME:~/~c~e~7~' CITY, ZiP: Bakcrcfield CA. CITY,ZIP: Bakersfeild CA. PHONE ~: ~ ~o~ PHONE ~: 834-3969 OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE ~AX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE ~:&~ ~ ~00 ..... .{ 1200 GAL-::)6/13 29 North Wall 100% Lacquor Thinner //~p ""~ ~ 200 GAL~)6/13 29 Nor th Wall 100% Paint Thinner~ ~~/ P ~0 /~ GAL 29 North Wall 100%. /' Oil' base paint NAME: ' /' '/ Off~ / TITLE: ; Z~ (~ ~ONGTURE: ~ E'M'ERGENCY CONTACT:~ ~ _ e-~ _ = TITLE: ..;~~ . PHONE * BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: ~,'~ '' AFTER BUS. HRS: