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HomeMy WebLinkAboutBUSINESS PLANi~ T MRB BI1 SERVICE 5650 DISTRICT BLVD. #128 Hazardous Materials/'I-IaZardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit ia issued for the followin._: Hazardous Materials Plan Underground Storage of H=7;,rdous Materials Risk Management Program Hazardous Waste On-Site Treatment PERMIT ID # 015-021-002065 MRB BIT SERVICE LOCATION 5650 #128 C~ ;313 OFFICE OF ENVIRONMENTAL SER VICES'' · 1715 Chester Ave., 3rd Floor Approved by: (..Ralpl{Huey..l~--/~! Issue Date Bakersfield, CA 93301 omc¢orE,,i.~.,~s~,ic~s Voice (661) 326-3979 FAX(661) 326-0576 Expiration Date: June 30., ITE DIAGRAM UNIFIED PROGRAM INSPECTION CHECKLIST<<' ~~~~ .SECTION 1: Business Plan and Inventory Program ~ • BAHERSFIELD FIRE DEPT Prevention Services 900 'IYuxtun Ave., Suite 210 ~~Bakersfield, CA 93301 Tel.: (661) 326-3979 " Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE NSPECTION TIME ADDRESS -~-- ~ 2~ HONE NO. ~ Z ~ O OF EMPLOYEES ~ ~ ~s ~ l FACILITY CONTACT USINESS ID NUM9ER 15-021- ~b2.d(~S. Section 1: Business Plan and Inventory Program _ ~~ ~Iy~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE•INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ENT` LJ ^ BUSlfll?SS PLAN CONTACT INFORMATION ACCURATE ~ ~,~'" N ~ cs ^ VISIBLE ADDRESS D CORRECT OCCUPANCY ^ -/ LK ^ VERIFICATION OF INVENTORY MATERIALS _ VERIFICATION OF QUANTITIES ~-~~ v v " ~~ ^ VERIFICATION OF LOCATION ^ ^ PAOPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~~ O~ ^ VERIFICATION OF HAZ MAT TRAINING PRO ^ VERIFICATION OF ABATEMENT SUPPLIES AND DURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HANG ~ ' ANY HAZARDOUS WASTE ON SITES EXPLAIN: - - •~UESTI S REGARDING HIS INSPECTION? VLEABE CALL US AT (881) 528-3979 a->r~v ~' l3 ~ Ins or Please Print) Fire Prevention / 1p In / Shift of Sile/Station k ^ YES ®' NO White -Prevention Services Yellow - Station Copy Pink - 8uaineea Copy F02049 (Rw. 02105) UNIFIED PROGRAM INSPECTION CHECKLIST SECTIOIy '! Business Plan and Inventory Program .~ Bakersfield Fire Dept. ' Environmental Services 900 Truxtun Ave., Suit~,210 Bakersfield, CA 93~ 2 3 ~nn~ Tel: (661) 326-3979 FACILITY NAME INSPE~N OAT INSPECTION TIME ADDRESS PN E No. No. of Employees ~O~Z~ --~i--~~c:.__--~LV_0.--~--1 ~~--.. _.._ __ _ _ .---_ - --_ _- _ ------ -_ _ .---- _----------- FACILITYCONTACT Business ID Number / 15-021- ~ 2~ (~ Dr- Section 1: Business Plan and Inventory Program Routine O Combined ^ Joint Agency ^ntulti-Agency ^ Complaint ^ Re-inspection C V \V=Vioatioo Cel OPERATION COMMENTS ^ L~9 APPROPRIATE PERMIT ON HAND ~~ L+7 ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ V ISIBLE ADDRESS ^ C ORRECT OCCUPANCY ^ ~ VERIFICATION OF INVENTORY MATERIALS --- _ ~ S~ ~,~~ _ _ ^ i~vERIFICATION OF QUANTITIES ) I I r t --- - -- _ ..._..._ _._._ . l --I - -- . ...__.... __.. -- -- _ .. _ ._ _..._ _ .. ... ._ - .. ...__....._ ^ .VERIFICATION OF LOCATION I( I l l~^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ~~~ ~ ~ s ~ ^ VERIFICATION OF HAT MAT TRAINING ~ ^ VERIFICATION OF ABATEMENt SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE ~ l ^ CONTAINERS PROPERLY LABELED H OUSEKEEPING ^. FIRE PROTECTION ^ S ~ - ` ITE DIAGRAM ADEOUATE & ON HAND !~ ~ ©~ S 17~ ANY HAZARDOUS WASTE ON SITE?: ^ YES L}J IVO EXPLAIN: QUESTIONS REG RDING THIS INSPECTION? PLEASE CALL US AT (66~~ 3Z6-3979 I or (Please Print) Fire Prevention 1st-INShiff of Site White -Environmental Services Yellow -Station Copy Pink -Business Copy + MRB BIT SERVICE ....... = .--- --- SiteID: 015-021-002065 Manager : BusPhone: (661) 831-1376 Location: 5650 DISTRICT BLVD 128 Map : 123 CommHaz : Moderate City : BAKERSFIELD Grid: 15C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 13 SIC Code: EPA Numb: DunnBrad: +============ Emergency Contact / Title Emergency Contact / Ti~e LINDA BOWEN / MOM LISA BOWEN / WIFE Business Phone: (940) 855-4303x Business Phone: (661) 631-5420x 24-Hour Phone : (940) 525-4590x 24-Hour Phone : (661) 831-1376x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth +- Contact : Phone: ( ) - x MailAddr: 5650 DISTRICT BLVD 128 State: CA City : BAKERSFIELD Zip : 93313 Owner MERLE BOWEN Phone: (661) 631-5420x Address : 2500 EL PORTAL State: CA City : BAKERSFIELD Zip. : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No +- -+ Emergency Directives: += Hazmat Inventory One Unified List +== Alphabetical Order = = All Materials at Site -+ ....... +- -+ ..... + .......... + .... +- - -+ Hazmat Common Name... ISpeoHazlEPA HazardsI Frm I DailyMax IUnitlMCPI ................................ + ....... + ........... + ..... + .......... + .... +_-_+ ACETYLENE E F P IH G 300.00 FT3 Hi OXYGEN F IH DH G 300.00 FT3 Low (Ty~ ~r ~/~ .....' O0 hereby "~'~ ~ · .... u that I have reviewed ti)e ~.~., , ment Plan for ~,~c,:ed hazardous m~er!als ~and 'th.a~ it a~o~g with any corrections COnstitute a Complete am~ agement plan ~r my 01/25/2002 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ./~. eb /~'~'~'~ ~--~./t'C~ INSPECTION DATE /Z'-' 7-.-'7,-0 ADDRESS 5~b-~ O[~'77~E.~ '/~ / 2-~ PHONE NO. FACILITY CONTACT//'7~ ]'~)WOx'9 BUSINESS ID NO. 15-210- INSPECTION TIME /D/17 tn./ NUMBER OF EMPLOYEES / Section 1: Business Plan and Inventory Program 9 Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand k)O"l" O ~ ~' Business plan contact information accurate /t¥'~f) '-'/0 I kJ Visible address Correct occupancy Verification of inventory materials /t:~) Verification of quantities ~" Verification of location Proper segregation of material t.. /- Verification of MSDS availability h/~'E).~' ~ O ~'~'~ Verification of Haz Mat training ~ /' Verification of abatement supplies and procedures b f' Emergency procedures adequate 1~~' Containers properly labeled Housekeeping ~ f Fire Protection t. Site Diagram Adequate & On Hand t- C=Compliance V=Violation Any hazardous waste on site?: []Yes ~No ../ Questions regarding this inspection? Please call us at (661) 326-3979 'l~"~usi~s~tel 5~s~1 i Y White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: 1715 CheSter Ave., Bakersfield, CA (661) 326-3979. / HAZ. ARDOUS MATERIALS MANAGEMENT 1. To avoid further action, return t' ' ' ays of receipt. 23: TZwEe/~r ~R~Ne qTu cas tNioSns~e~oSwINfoEr NthGe ~IuS?i~;ss asa w hole. 4. Be as brief and concise as possible. \'~-"~ 5; You may also attach Business Owner / Operator Form and Chemical Description FoY~(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA LOCATION: CITY:~<~,~~ ' STATE: (~ ZIP:~Y)/3PHO~: X)/-/3fl~ 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-AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: t C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: AT SPECIAL: LOCK BOX: YESff~y IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: .~ ~"'¥/"'7'~70'k~N:~'r~' B. WATER AVAILABILITY (FIRE HYDRANT):~j~/,.~O,,q_~ ~ o<.,d4.od~,~~ 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: M~T~PaAL S,~PETY DATi SHEETS BmEF S~Y OF T~G PROG~: · CERTIFicATiON I, ~ ~.d'x L~~' /'~ ~,J ~ CERTIFY THAT THE ABOVE INFORMATION ~s ^CCiTt. x U~P. ST.~a:, T~T TInS ~OR~TIOS Wn~L B~ US~ TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INA~CUI~TE. INFORMA .T~I0.N/C.0NSTITUTES PER,FLTRY. 4 CITY OF BAKERSFIELD~ OF E OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 "**~""'~~"'~*'"*' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mate#a! per building or ama) ~ NEW ~ ADD ~ DELVE ~ REVISE ~ Page ~ of BUSINESS ~ME (Same ~ClL~ ~ME ~ O~ - ~ing Busin~ ~) 3 ~5 T~OE SECRET ~ Y~ If Subj~ to EPC~, ref~ to instm~i~s ~7 FIRE ~DE H~D 6~SSES (~pl~e ~ r~u~t~ by I~1 fire ~i~ 210 ~PE ~ p PURE D m MITRE B w WASTE 211 ~DIOACTIVE BY~ ~No 212 [ CURIES 213 PHYSI~L STA~ aS SOLID ~, LIQUID ~ g ~S 214 ~RGESTCO~AINER ~~ 215 FEO ~RO ~TE~EIES ~ 1 FIRE ~ 2 ~1~ ~ 3 PRESSURE ~L~SE ~ 4 ACU~ H~LTH ~ 5 CHRONIC H~TH 216 (Ch~ all that apply) ANNUAL WASTE 217. ~I~M 218 AVENGE 219 [ STATE WASTE CODE A~U~ DAlLy A~U~ , DALLY A~U~ I UN~S' ~ ga ~L - ~ ~ CU~ ~ lb LBS ~ ~ TONS 221 DAYSONSITE o ' STOOGE CO~AINER ~ a A~VEGROUND T~K ~ e P~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~ ~ q ~IL ~R (Check all ~at apply) ~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~C BO~LE ~ r OTHER ~ c TANK 1~81BE BUILDING ~ g ~R~Y ~ k BOX ~ o TO~ BIN ~ d S~EL DRUM ~ h SILO ~ ~ I CYLINDER ~ p T~K WA~N STOOGE PRESSURE ~ a A~IE~ ~ aa A~VE AMBIE~ ~ ba BELOW AMBIE~ STOOGE TEMPE~TURE ~ aAMBIE~ ~ ~ A~VEA~IE~ ~ ba BELOW AMBIE~ ~ c CRYOGENIC ..... 230 231 ~ Y~ ~ NO 232 ~3 2~ 235 ~ Y~ ~ NO 236 238 239 ~ Y~ ~ NO 240 241 242 243 ~ Y~ ~ No 244 245 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE DATE 246 UPCF (7~99) S:\CUPAFORMS\OES2731.TV4.wpd