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Home My WebLink AboutHAZ-BUSINESS PLAN 9/7/1994 '~ ~ ~. Bakersfield Fire Dept, ., ~// HAZARDOUS MATERIALS DIVISIC ~ ,, ,~~ ~ DateCompleted~'~ ~ r B~sinessldentificatioj~rN~', ~15-000 ~)0o5~ (Topof Business Plan) / · ~tation No. /-------~ Shift ~:~ Inspector ~ ~E;P-.,/'~>? .~'q~- Vnrif,e~t,nn nf I,~~ ~ ~ ' ~~ Vnr'rfie~tinr ...... . ..,~nm~y-w~er~a~s L__I I~J RECEIVED · ~JO¥ 2 8 1994 Verification Quantities Verification of Location r~ HAZ. MAT. DIV. Proper Segregation of Material // Comments: ~.~j~' Verification of ~ Number of Employees Verification Mat Training ~ Comments: Verification of Abatement S~ ~lies & Procedures ~ Comments: Emergency res Posted ~ Containers ly Labeled ~ Comments: Verification Diagram ~ Special Hazards Associated with this Fac~,ty: / Correction Needed Business Owner/Manager FD 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy 09/07/94 PETROLEUM TESTING SERVICE (90-93) 215-000-000583 Page 0 o Overall Site with 1 Fac. Unit ~.~~[~. General Information Location: 5880 DISTRICT BLVD SU 1 Map:123 Haz:0 Type: 3 City : BAKERSFIELD Grid: 15C F/U: 1 AOV: 0.0 --Contact Name Title Contact Name Title ROY BURLINGAME / TOM HOLLENBECK / Business Phone: ( ) 835-0311x Business Phone: ( ) 835-0311x 24-Hour Phone : ( ) 832-4970x 24-Hour Phone : ( ) 397-5862x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 5880 'DISTRICT BLVD SU 1 D&B Number: City: BAKERSFIELD State,: CA Zip: 93313- Comm Code: 215-086 OUT OF:BUSINESS/HAZ-MATL'S SIC Code: Owner: PETROLEUM TESTING SERVICE INC Phone: ( ) - Address: 12051 RIVERA RD State: CA City: SANTA FE SPRINGS. Zip: 90670- Summary ~Fhe P.T. Schuylers 1737 El Travesia Drive La Habra Heights, California 90631 April 18, 1994 ' ~~~ City of Bakersfield Treasury Division P.O. Box 2057 Bakersfield, Ca. 93303 Att: Drew Sharples Financial Investigator Re: Account # 40501 Dear Mr. Sharpies, As a former owner and officer of Petroleum Testing Service, Inc. a company that went out of business in October of 1992, I write this letter in response to your corresponmdence of April 14,: 1994. Enclosed you will find copies of letters sent to the Fire Department and the Hazardous Materials Division of the City of Bakersfield. It seems incredible to me that you cannot or will not chec~ your records and see that Petroleum Testing Service, !Inc. vacated the premises at 5880 District Blvd. in October of 1992. Certainly th'is should be a matter o£ record. I trust that you will verify the fac. ts and adjust your records accordingly. Anita L. Schuyler hr ~ -encls. B A K E R.S F I E L D APril 14,.1994 A C:C:'T~ 4-0 9., 0 1 PETROLEUM ]'ES]'II',IG SERVICE INC ~'?~v ~t_ T~,,~,vs_s,~ V~,VE FIRST NOTICE LA HABRA CA 906,3'1 Dear Business Owner: Our records indicate your hazardous materialS account ls ninety (90) days or greater past due. It is of paramount importance that said,account either be paid in full or a satisfactory payment schedule.be made with me. Until this account is clearedof the past du® balance you are in violation of the Municipal Code and are subject to 'legal action. If you have any questions or if you wish to make arrangements I can be reached by telephone at the number listed below. '-. Drew Sharpies Financial,Investigator ACCOUNT : PAST DUE : $ AMOUNT DUE: $./~,/~ \CO~\90 City of Bakersfield · Treasury Division · P.O. Box 2057 Bakersfield · California · 93303 (805) 326-3757 I..a I-labra I'lei~hm. California 1994 Esther Ouran Hazar'dou,s Mater~,als D:i, vision 2,10.], H Street Bakersf±eld. Ca. 93301 Re: Hazardous Materials Bi, ll HM409501 [)eat" PIs. Duran, Ne are :in rece.tpl: of your letter dated February Zn your ~e~er you ~ri~e bha~ a portion of ~he enclosed b~ll is for the ~nspect~on done on .I. 2/8/95. The inspeot:,.i, or~ could no~ have been made for Petroleum Testing Serv~oe, s~nce bhat company ~e d~d not: occupy ~he prem~.ses at 5880 b~s~rJ, c~ B~vd. The oompa'ny ~en~ oub o¢ bus~ness and left the area and ~ocat~on ~n Ocbober of ~992. Please ad,~usb your records accord~ng].y. Youn prompt attention to thi. s matter is appreciated. Si ncerely, ~ . ..."~ ~t~ita L. Schuy~,er ,/ April 9, 1994 Fire Department City of Bakersfield P.O. Box 205'7 : Bakersfield, Ca. 93303-2057 Re: llazardous Haterials Fees GL #0110-11..117 Account #t1H409501 This letter ia written in response to a Statement of Account regarding the above. Enclosed please find a letter written Hatch 3rd addressing a previous and similar statement. Aa stated in the March 3rd letter, Petroleum Testing Service, Inc. vacated the premises at 5880 Distri. ct: .. B.tvd. in Bakersfield in October of 1992. The known as Petroleum Testing Service, Inc. we,,l:. business in October of 1992. Therefore, the reco,'ds are in error. , If there is any doubt as to the valldity of the above it should be a simple marker for your department to check City records to verify Ebe information. Please adjust your records accordingly. Sincerely,.~ .,,~ / Anita L. S6huyler ~ ( former Vice-Presiden~, Petroleum Testing Serv:i. ce -. The P.T. Schuylers 1737 El Travesia Drive La Habra Heights, California 90631 (213) 694-6466 April 9, 1994 Fire Department City of Bakersfield P.O. Box 2057 Bakersfield, Ca. 93303-2057 Re: Hazardous Materials Fees GL #0110-11117 Account. #HM409501 This. letter is written in response tO a statement of Account regarding the above. Enclosed please find a letter written March 3rd addressing a previous and similar statement. As stated in the March 3rd letter, Pgtroleum Testing Service, Inc. vacated the premises at 5880 District Blvd. in Bakersfield in October of 1992. The company .known as Petroleum Testing Service, Inc. went out of business in October of 1992. Therefore, .the records are in error. If t,here is any doubt as to the validity of the above it s~hould be a simple matter for your department to check City records to Verify the information. Please adjust your records accordingly. S~cerely,,~ 'Anita L. S6huyler ' (former Vice-President, Petroleum Testing Service) CITY'OF BAKERSFIELD 0 ~i=l~t"l EtvlENT OF ACCOUNT. .. P.O. BOX 2057 ~ .-.. CITY OF BAKERSFIELD BAKERSFIELD, CA 93303-2057 ACCOUNT NO. ~,..~ ...... 0.. '.'. · - -' ....... :' ..... :" . ,; , , ..... '., r .- :' · '.' ,':' -' ;,.,: '- ...... '. iNQUiRiES CONCERNING THIS BILL, PLEASE PHONE: · , - CUSTOMER COP~ ..... .. RETURN PA~'ME'ff, ITS TO ' I "' ' "' ' / '~-'"~' , ';' · ~;,,Ill. ,.~,=" ., '....-. · · , . '":' · C T¥ OF BAKERSF ELD ' ~ ". ' ' . ~ ' ' '-"., ~ ....~" ; . ~"'~' · .-'"' 'CTYOFBAKERSFIELD :' '"'. ' 'P.O BOX 2057 .' - ' / ' ' " ""; ~';;'.,' .... :" '" ";" / ' '"" ' ' '' :' - ~' " ' :, B~ERSF ELD; cA 9~30~]2'057 ~a~','~'dou~' .~.:~a~.'.~t]e~~ ~ NQUIRIES CONCERNING THiS BILL, PLEASE PHONE:' (~ ~D ~ S~ ~" ~9 ~9 , INVOICE UMBEl ' '" ' CUSTOMER- :COPY .. : '~ , ' ' ~' ,:,. ,:..',,': - .t ,:.'? HM409501 Account Number ACCOUNTS RECEIVABLE ADJUSTMENT April 7~ 1994 Date New Account New Address Esther Duran Close Account From Service Chanqe Other Adjustments X Fire-Department- Hazardous Materials Division Department/Division PETROLEUM TESTING SERVICE INC' Billing Name · 5880 DISTRICT BLVD - STE 1 Billing Address Site Address Parcel # (if Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change 139.15 0 < 139.15 > 04-01-94 Remarks: COMPANY INFORMED US THAT THEY LEFT BAKERSFIELD IN OCTOBER OF 1992. WE WILL NOT PURSUE IT. Page: 1 Account Billing/Collection Activity Inquiry SUTL108 Acct : 409501 Cyc St CL Bill St: FB Cyc: 5 Rt: Seq: SSN : Parcel: , - - - Svc Cls :e Name : PETROLEUM TESTING SERVICE INC Svc Add: 5880 DISTRICT BLVD - STE 1 Amt due: 139.15 Current Period Postings Lst Pmt: -76.17 Type Desc Date Amount Receipt Pmt Dte: 06/14/93 Bgl PENALTY 03/01/94 12.30 -- Prior Bills -- B92 FINANCE CHARGE 03/01/94 2.47 Date Balance B92 FINANCE CHARGE 04/01/94 1.38 02/28/94 0.00 01/01/94 123.00 01/01/93 0.00 01/01/92 0.00 01/01/91 0.00 02/15/90 0.00 Enter '/' For Billing History, 'P' To Print Report, 'D'~ For Detail Page, or '/C' For Credit and Deposit History or 'XX' To Exit PTS Laboratories, Inc. .~' 4342 West 12th Street · Houston, TX 7705~ Telephone (713) 680-2291 · Fax (713) 680-0763 Esther Duran Hazardous Materials Division 2101 H Street 8akersfield~ Ca. 9~301 '"~/~ Re: Hazardous Materials Bill HM409501 Dear Ms. Duran~ We are in rsceipt of your letter dated February 28~ 1994. In your letter you write that a portion of the enclosed bill is for the inspection done on 12/8/9~ The inspection could not have been made for Petroleum Testing Service~ Inc. since that company we did not occupy the premises at 5880 District Blvd. The company went out of busi~ness and left the area and location in October of 1992. Please ad3ust your records accordingly. You'r prompt at%ention to this matter is appreciated. February 20, 1994 FIRE DEPARTMENT 2101 H STREEI' S. D. JOHNSON BAKERSFIELD, 93301 FIRE CHIEF 326-391 Petroleum Testing Service Inc. 1737 E. Travesia Dr. La Habra, CA 90631 RE: Hazardous Materials Bill HM409501 Dear Sirs: The above mentioned bill, enclosed, is for the 5880 District Blvd. location in Bakersfield, CA. A portion of that bill is for the inspection that was done on 12-08-93. When the inspection was made there was no mention of the company being closed. The laws clearly require ;that this office be notified within 30 days of any change. The City of Bakersfield does not prorate any of their bills, therefore the bill is still due. Thank you for your prompt attention to this matter. Sincerely, ("l , ..... Esther Duran Hazardous Materials Division /ed RETURN PAYMENTS TO: ? ~' ........~-:..L ,, ' .. PLEASE MAKE CHECKS PAYABLE~T~: CITY OF BAKERSFIELD 'HA ~DOU$ M~ERI ALS ~][¥ jSION , . p.o.~ox205~, CITY OF BAKERSFIELD '-' BAKE~SFIELD, CX9,3303-2057' I ACCOUNT NO. H~ ~095~i :' ::..:~:~ardO~:~ ;~Q:~:e.r.i,~L~: ~;,~,a~d[;i ng Fees ~, ;, ;~, ;.; .' .>:. :...,..- ..' . ;' .,.~,. ' Pr evi oU's '~a~'~'~ INqUIrIES CONCEPNING THIS BILL' PLEASE PHONE' 8 ~S J -- " ' ' ' / ] ' : . ' . ' .( ,- 526 ~979 , , , ~ ' · '' ,., . .," · ,. ':: ", " · PETROLEUU. TESTI~e SERVICE '~ , ', '~ '::, ,':'~..,:,~, ' .",.': ~ ,'- '",,,-" .,"' ."' ". '~'-' ~": ."' :. ',',""~LA"::flA.OfiA. CA 906~I-8003 .' "' -?,' " .~.1 .~ ,,., .... '. :,'.,:, :, :',, ,~',:, Mu~~:flE~u~,.r,is.coPz ~TH. pA~N~;'' ,. <.'.:',,. :," :'_., '..' : ...... 'r , .. r -- l .... PLEASE MAKE CHECKS PAYABLE TO: . RETUI~N PAYMENTS TO: . ',. CITY OF BAKERSFIELD ~A~.ARoouS ,~ArE~I ALS, ~[V tSIoN CITY OF BAKERSFIELD · · ' P.O. BOX 2057. ' , '- ~ BAKERSFIELD, CA 93303-2057 AccoUNT NO. tilt ~, 095~1 - '~' '~,C ~.,,.' ~, .. '.." ' .~azardous ~ateriaLs Handling Fees "- :.... .: .:. .,... ' ~ ' ' ...... ~'~ ' ~ ' " ' ' · - "- ' ...... .' ANNUAL FEE ' ' , CE ~T' 2 H~'~'T~'FRO" THE BIL[ ~ DATE A ~0. AO~ ~..RV'CHG .. · :: . i' AND FXNANCE CHG OF l~ PeR HONT" ~LL BE ASSESS~U-'. ' t ~ ~ - J ' , PETROLEUH TESTIAG SERVICE INEH~09501 INVOICE NUMBER 1757 EL TRAVESIA GRIVE .... .. ' ] LA' H~BRA~ CA 9063~-8005 MU~T RETURN THIS COPY WITH PAYMENT . . . ......... Utilities General Account Maintenance 02/28/94 PUTLS801 Acct Nbr: 409501 Bill Stat: NO Transfer-from: Page 1 of 6 Cyc Stat: CL Acct Cyc Stat: CL Transfer-to: Due: 123.00 1. Customer Name: PETROLEUM TESTING SERVICE INC 2. Social Sec Nbr: 3. Telephone: 805-835-0311 4. Service Address: 5880 DISTRICT BLVD - STE 1 5. Service City: BAKERSFIELD 6. State: CA 7. Zip: 93313 8. Parcel ID: 9. Bill Cycle: 5 20. Water Svc Class: 10. Route Nbr: 11. Comments : 12. Prev Acct: HM00583 23. Misc Services: 23.1F01HAZ MAT HANDLING -13. Service Date: 23.2! Fl7 INSPECTION FEE 14. Fund no: 23.31 15. Billto Ad1:1737 EL TRAVESIA DRIVE 23.41 16. Billto Ad2: ~ 24. iClosing Date: 17. Bill-to City: LA HABRA 18. State: CA 19. Zip: 90631-8003 Enter Save(S), Cancel(XX), Next. Page(/), or Field # to ~Change FINANCE DEPARTMENT Gr~( OF BAKERSFIELD BAKERSFIELD, CALIFORNIA ADDRESS CORRECTION REQUESTED PETROLEUI~ TEST lNG -$ER¥ ICE' IN~ . ~t~'.,..~E :'.~..~ .& , . . . Ill..,lhh.lhdhdh.lh.lh.ih,--Illh"llmlh'l Bakersfield F A) fl .~"~ Hazardous Materials Inspection ~ i' Date Cgmpleted ~z-,~ ~-~ ~ Bus~e~N~e: ~o~ ~ T~~ ~g, '""" ~' '~ .; ~cafion: ~~-I ~~~ ~C~ ~ ~' plan ID ~ 215-000~~(Top right comer Business Pl~) Station No. ~ S~ 5 ~Inspector ~~-~-~ Adequate Inadequate Verification of [nvento~ Materials ~ ~ VeHficafion of Quantities ~ ~ VeHficafion of Location ~ ~ ~oper Se~egafion of MateH~ ~ ~ VeHfication of MSDS Availabfliw ~ ~ Nmber of ~ployees ~ 5 Verification of Haz Mat Trai~ng ~ ~ Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted ~/ [--] Containers Properly Labeled [~/ [--~ Comiuents: Verification of Facility Diagram ~/ [~] Special Hazards Associated with this Facility: Violations: ,.~ FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office '?- ...... CITY of BAKERSFIELD RECEIVED Fare and Aqriculture ~ StandardSusiness -- HAZARDOUS MAX;,' RXAr..S 0 1990 NON--TRADE SECRETS -' HAZ, MAT~DJ.V: of .... LOCATION:~ D{%~te~OO~,Tc ~ [ ADDRESS: 13~ EL ~4~ STANDARD IND.~[~'S~O6E cITY, ZlppJ~.-C~ q~i ~ CITY, Zr~:-L~a ,T~ ~ { DUN AND BRADSTREET NUMBER t 2 ~ 4 6 6 I 8 ~ 10 I1 12 13 lrans Ty~ ~x Avera6l ~nual ~asum I ~ Cmt ~t ~t ~e L~ttm W~e T ~ Nam of Rtxtum/~te C~e C~e ~t ~t Est Units ~~ Tyro Pr~s T~ C~ .. ' Sto~ tn Facility ' Nt ~ Instmctims Ph~ical and H~lth Haze~ C.A.S. ~ Cat II ~ & C.l.S. ~ (C~k all t~t apply) Fire Hazard u--J Reactivity ~--~ ~la~ ~--~ ~m Rel~se u--d Health of P~re H~lth '-~ H~lth of P~su~ ~lth ......... ~---- P~ical ~d HHlth Hazard C.A.S. ~ ~t l1 ~ & C.l.S. ~ (C~k al] t~t apply) d Fire HaZard [ ~ Reactivity ~-- d ~la~ ~ ~ ~dd~ RelHse ~ ~ i~iate Health of Prasur, H. Ith ' '~~ , Cat 13 Nm i C.A.S. ~ Certificati~ (Read and s~Kn after coepJet~nE all sections) ] certify ~der ~alty of la= that I ~ve ~rsmally examn~ and aa faailiar eith t~ infor~tim su~itt~ tn this a~ a11 ~ d~u~ts, and t~t ~s~ m W ~nqui~ of t~e i~ivi~als for obtaining t~ infor~tim. I ~lieve t~t t~ sumitt~ info~ti~ is true, accurate, and cmolete. / ~ ~/ / ~ ""'~ CITY of BAKERSFIELD '--' - HAZARDOUS MATERI ALS I and ~v~cu~tur~ NON-- T RAD E S E C RETS OF F__A_C.I. L I_TY: BUSINESS NAMg:.Y.c~'reLeuv~'e:LY~,~c~$eto~e _~e_, OWNER NAME: LOCATION: ~ ~$~7-iO..'~CU~-u .~c,,7~-~q: I ADDRESS: ~'~ ~-L Vr~-~(,% STANDARD IND. CLASS CODE CITY, ZIP~ E~ (~. C~ ~t~ CITY, ZI~: ~~C~ ~A q O~ ,. ~UN AND BRADSTREET NUMBER ~ ' '~ ~ l~u~lo~ ~ ~oP~ ~o~ C~e C~e ~t ~t Est Un,ts m Site T~ .... ~_l.~._l._~x~.l~_l,~~ ~~~~~~eD_._: __ , ....... ~C~k all t~t I~ly) ' ; ~reaazard =--a R~t~w~ty ~--d ~1~ =--d ~i~ =--~ l~ate .... ' ......... ~lth ef p~ee ~lth P~icll ~ ~ith Hazl~ $~ C.A.S. ~ ~t Il (C~k ell tMt a~ly) .... .... ~ -~ ~lth of ~ ~ith _~.~-~ ~~~~~~.- -- --~ ,~_n~.~~..~~.~~~a t ~.~o~ ~~ ~ . ~ ....... I -- r -. r -- ~ ~t 12 [ ~ F~ Hazaed ~_a R~t%vi~y N~lth of P~u~ ~lth ~t · t ...... L ....... J ' ' ' ' P~i ~ HHIth ~z~ C.A.S. ~ ., r - -- r -- ~ r --. C~t H~lth of Pe~suel ~lth ~t 13 ~3~3t I ....... -- H~F'~I s~aft~r coepJetJnR a~] sect~ ) / ~lty f~11?r obtaining t~ '~"-' HAZARDOUS MATERI ALS I NVENT-ORY' Farl 4nd &~r~lture ~ St~rd Ousm~5 NON-- TI1ADE SECRETS ' P~e .... of .... ~Ie NAME 0F T~S FACILITY: STANDARD IND. ~S~ ~oDE ~C~ C~e Mt Mt Est ~its m Site l~ ~ T~ ~ St~ in F~titty ~ ~ I~t~ti~ ~lth of ~ ~lth !l C~tlficlti~ (Reid and .li~ lfter col~eiJnE ail sectionS) ' . ..-' .'. ' : ' ' RECEIVED BAKERSFIELD CITY FIRE DEPAR 213o "G" S EET JUL 1987 BAKERSFIELD,(805) 326-3979CA 93301 Anid ............ OFFICIAL USE ONLY NAME HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTI ONS: 0 0 0 5 8 3 1. TO avoid further action, retucn 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 A. BUSINESS NAME: Petroleum Testing Service, Inc. B. LOCATION / STREET ADDRESS: 5880 District Boulevard, Suite 1 CIT~,! Bakersfield ZIP: 93313 BUS.PHONE: ( 805 ) 835-0311 SECTION 2: EMERGENCY 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: NAME. AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Roy Burlingame Ph# (805) 835-0311 Ph# (805) 832-4970 B. Tom Hollenbeck Ph# (805) 835-0311 Ph# (805) 397-5862 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: West side yard against concrete wall B. ELECTRICAL: Main is located behind Suite #20, 5880 District Blvd. C. WATER: West side yard asainst concrete wall D. SPECIAL: ~ire shut-off valve on the extreme northwest corner wall of building E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO 'MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE'FOR YOUR BUSINESS AS A WHOLE NON-LIFE THREATENING: SOUTHWEST URGENT CARE CENTER ~i':'.? ~.~?i~ 5397 TRUXTON AVENUE ~. <.~:' ~,,,~ B~ERSFIELD, CA 93309 ,- (805) 322-2273 LIFE THREATENING: AMBULANCE/PARAMEDICS SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...' .................................... YES NO NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: ..........................~YES NO ~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~_~ NO 'YES NO D. EMERGENCY EVACUATION PROCEDURES: .................~ NO YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO ,YES (~ SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO, DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN $00 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ('~YE~NO I, ,/~m-~'~ e~rti~ that the above information is accurate. ~fh-~his infor?.~on will be used to fulfill my firm's obligations under the new a ' 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 BUS I NESS pLAN SINGLE FACILITY UNIT FORM SA 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 UNI'T LISTED BELOW 4. Be as BRIEF and CONCISE as possible. L.~o~.c~A._O~.~./ FACILITY UNIT~ FACILi~ b~IT N~ME 5etmt ' SECTION l: MITIGATION, PRE~NTION, ABATEMENT PROCED~ES. SECTION 2: NOTIFICATION ~ EVACUATION PROCEDIZES AT T~IS UNIT' ONLY SECTION 3: HAZARDOUS MATERIALS FOR 'THIS b~IT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... YES NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES NO If'No,.complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) 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 trade 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-OFFS AT THIS UNIT 0MLV. A. NAT. GAS/PROPAN~ B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES STM PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 3B - BAKERSFIELD CITY FIRE DEPARTMENT ' I.D. # -' FORM 4A-1 .Page 2 of" 2 NON--TRADE SECRETS ',~ HAZARDOUS MATERI ALS I NVENTORY ~- BUSINESS NAME: Petroleum Testing Service, Inc. OWNER NAME; Petroleum Testing Se~ice, Inc. FACILITY UNIT #:~ ADDRESS: 5880 District Blvd, Suite 1 ADDRESS: 12051 Rivera Road FACILITY UNIT NAME: CITY, ZIP: Bakersfield, CA 93313 CITY,ZIP: Santa Fe Springs, CA 90670 -, PHONE #: .... (805) 835-0311 PHONE #: (213) 698-0081 ~OFFICIAL USE CFIR~ CODE ONLY I 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CO'DE CODE FACILITY UNIT . WT. CHEMICAL OR COMMON NAME CODE GUIDE I Southeast corner, center UN1066~ P 220 11440 Ft3 04 09 west, north center lO0 NITROGEN ~~ NFLG P 215 645 Ft3. 04 center .100 HELIUM ~Ck~ NFLG UN1 east center, outside P 600 2400 GAL 05 09 buildins NW corner 100 -LIQUID NITROGEN ~ .~ CRYO UN5197 NAM.E TITLE: S GNATURE: DA~ ~: EMERGENCY CONTACT: ROY BURLINGAME TITLE: LABORATORY MANAGER PRONE # BUS ROURS: (805) 835~0311 AFTER BUS RRS: (805) 832-4970 EMERGENCY CONTACT: TOM HOLLENBECK ~ TITLE' OPERATIONS SUPERVISOR .. PHONE # BUS ROURS: (805) 835-0311 PRINCIPAL BUSINESS ACTIVITY: OIL WET.T. CORF. ANALYSIS AFTER BUS HRS: (805) 397-5862 - 4A-1 - BAKERSFIELD CITY FIRE DEPARTMENT -, I.D. # FORM 4A-1 Page i ,of' 2 NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME: Petroleum Testing ServiCe, Inc. OWNER NAME,.' Petroleum Testing Service, Inc. FACILITY UNIT #: ADDRESS: 5880 District Blvd, Suite 1 ADDRESS: 12051 Rivera Road FACILITY UNIT NAME: CITY, ZIP: Bakersfield, CA 93313 CITY,ZIP:Santa Fe Springs, CA 90670 PHONE #: (805) 835-0311'~ PHONE #: (213) 698-0081 ~OFFICIAL USE CFIRS CODE { ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT , WT. CHEMIqAL OR COMMON NAME CODE GUIDE, ~ bhtside southwest ACETONE (2-PROPANONE),, ~f'~"~ FLLQ 1090-26 ] P 55 55 GAL 06 08 corner lot' 100 110 825 GAL 06 08 corner lot 100 TOLUENE (TOLUOL) ~ I ~ C~fLQ 1294-27 /--- outside southwest ) P 55 165 GAL O6 O8 corner lot 100 MET OL (METH% ALCOHOL100) LLQ 1230-28 t outside southwest 55 55 GAL 06 08 corner lot 100 CHLOROFORM (TRICHLOROMETHANE)/d~¢ ORMS UN-1888 outside southwest ~~, 55 55 GAL 06 08 corner lot 100 DICHLOROMETHANE (METHYLENE CHLORIDE) 1593-74 ORMS outside southwest ;~k~ CMLQ M 55 55 GAL 06 08 corner lot 98 CHEVRON THINNER PARA_FINS - 2 AROMATICS ORMS < 0.1 BENZENE ~O \ CMLQ - i~~ ~utside southwest corner CASTMASTER A M 55 220 GAL 06 07 lot/inside north corner POLYMERIC ISOCYANATE WATR - 30 DIPHENYL METHANE DIISOCYANATE 30 HIGH POLYMERS ORMS - ~-- 40 PETROLEUM SOLVENT-AROMATIC NAPHTHA ORMS - ~utside southwest corner CASTMASTER B 55 220 GAL 06 07 lot/inside north corner POLYMERIC ALCOHOL ORMS - 20 HYDROXAL TERM. POLY ETHER. ORMS 40 AROMATIC SOLVENT BLEND' ORMS - 30 POLYETHER ORMS - NAME TITLE: SIGNATURE: DATE-: EMerGENCY CONTACT: ROY BURLINGAME TITLE: LABORATORY MANAGER PHONE # BUS HOURS: (805) 835-0311 AFTER BUS HRS: (805) 832-4970 EMERGENCY CONTACT: TOM HOLLENBECK TITLE': OPERATIONS SUPERVISOR ,, PHONE # BUS HOURS: (805) 835-0311 PRINCIPAL BUSINESS ACTIVITY: OIL WELL CORE ANALYSIS AFTER BUS HRS: (805) 397-5862 - 4A-1 - ~~ ~[~;i[~[~ 12051 RIVERA RD.'SANTA FE SPRINGS, CA 90670-2289 ~~~ ~~ TELEPHONE (213)698-0081 · PANAFAX (213)693'0947 HAZA~OUS ~TERIALS T~INING I have received and understand the hazards associated with the use and handling of the substances checked. I feel' adequately trained, in the use Of and are knowledgable of the safety devices, procedures and equipment required for such use. ~ ( ~Acetone ( ~)~Methanol ( ~Toluene (~yMethylene Chloride (~'Chloroform ( )Other "WE CARE" ~ FIRE CHIEF OCTOBER 19, 1988 326-3911 PETROLEUM TESTING SERVICE INC. 5880-1 DISTRICT BLVD BAKERSFIELD, CA 93313 DEAR MR. TOM HOLLENBECK: THE ENCLOSED "ACUTELY HAZARDOUS MATERIALS REiGISTRATION FORM" MUST BE COMPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUM REPORTING QUANTITY OF ANY MATERIAL ON THE EPA LIST OF EXTREMELY HAZARDOUS SUBSTANCES. (FED. REGISTER VOL. 52, NO. 77, P. 13397). YOUR COMPANY HAS REPORTED HANDLING THE FOLLOWING ACUTELY HAZARDOUS MATERIALS: : CHLOROFORM (TRICHLOROMETHANE) PLEASE RETURN THE COMPLETED ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM TO: HAZARDOUS MATERIALS DIVISION 2130 G STREET." BAKERSFIELD, CA 93301 IF YOU HAVE. ANY QUESTIONS'n=~^nn~x'~,,~,~x,,~ THIS FORM PLEASE CALL RALPH HUEY AT 326-3979. SINCERELY YOURS, RALPH E. HUEY HAZARDOUS MATERIALS COORDINATOR REH/ed ENCLOSURE R 'EI~ISTRATION ' ACUTELY HAZARDOUS MATERIALS FORM THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERATOR OF EACH BUSINESS IN CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL IN QU ,ANTITIES GREATER THAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT STP: t THIS FORM SHALL BE COMPLETED AND SUBMITTED TO YOUR LOCAL ADMI1NISTERING AGENCY. (§25533 & 25536 Health & Safety Code) Note instructions on reverse NOV 3 1988 Business Name {"~ e.~v,- '["'~_.~ .~PU~,.. _~"~O_ , AI18'~ ............ Business Site Address Business Mailing Address (if different) ~:~"-~ ~ ~ ,,~ Business Phone ~. ~_"~ ~.~"-~t [ Business Plan Submission Date2 Process Designation3 -. A(~t,ITE~.Y HA~;AROOUS MATERIALS HANOi. ED4 -USE ADDITIONAL PAGES IF NECESSARY- CHEMICAL NAME QUANTITY GENERAL DESCRIPTION OF PROCESSES AND PRINCIPAL E~I,IIPMENTS: SIGNATURE.---/' <~~7~4~ PRINTED NAME'- ---~~(.ge ~C (~, DATE California Office of Emergency Services FORM HM 3777 (1-15-88) INSTRUCTIONS: Superscripts: 1. Quantities for RMPP compliance are "equal to or greater than" thc minimum criteria and apply to chemicals handled "at any one time". 2. Businesses handling reportable quantifies of Acutely Bm,~rdous Materials that have not submitted a business plan MUST contact local Administering Agencies. The business plan submission date will assure the Administering Agency that a imsmess plan has been submitted and is on t-fie. This will also immediately identify businesses that have not submitted business plans. 3. "Process Designation" is provided as a reporting option (with the approval of the Administering Agency) for facilities that can most easily report by process. Thus, facility RMPP registration data could be submitted in a similar format to a business plan that is divided by process. "By process" data can initiam an emergency response to a process incident rather than a general emergency response to a major facility. Process designation can simplifY'inspections for major facilities and improve future emergency response. 4. Refer to the EPA list of Exlremely Hazardous Substances from the Federal Register (Volume 52, No. 77, p. 13397 et. seq.. April 22, 1987). Each chemical has a threshold planning quantity. This list may be changed by EPA on an annual basis. Utxtates of this list may be available early in 1988. To comply with this element, you may attach a copy of the inventory submitted to your Administering Agency from your business plan and highlight all Acutely Hazardous Materials. It is recommended that facilities list all extremely lmTardous chemicals handled in quantifies equal to or in excess of 1) 500 pounds, and 2) any EPA threshold planning quantity less than 500 pounds. 5. Do not include Trade Secret information in these descriptions. General: For emergency response pmT~oses, it would be desirable to describe the following to the Administering Agency: 1. Batch Process: ~raw ma~ri~? b. What operating Ixessurc range? c. What operating temperature range? cl. Batch capacity rating? c. Product characteristics? (c.g., chemical state, flammability, toxicity, etc.) f. Critical process points and characteristics? ........ 2:~Co~tiriuous process: (simffar infonnaiibn-as'~bOve~)- ,.NOTE: '~ursuant to §25534, the Administering Agency may ~xtuirc the submission of a Risk Management Prevention Program (RMPP), ff thc Administering Agency determines that thc handler's operation may present an acutely i~zardous materials accident risk. Thc handler shall prepare thc RMPP in accordance with subdivision (c) [of §25534]. Thc RMPP shall be prepared within 12 months following thc request made by thc Administering Agency pursuant to this section." (§ 25534 (a) Health and Safety Code) An amendment to thc RMPP must be submitted to thc Administering Agency within 30 days of: 1. Any additional handling of acutely hazardous materials. 2. Any material or substantial alterations to business activities. 3. Change of address, business ownership, or business name. (§,.25533 (c) Health & Safety Code) · EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP · Califomia Office of Emergency Services FORM HM 3777 (1-15-88)