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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This _~ermit is Issued for the following: [] Hazardous Materials Plan E] Underground Storage of HazardOus Materials [] Risk Management Program ~ cI Hazardous Waste On-Site Treatment PERMIT ID # 015-021-002184 ..~;5' ~ ~ ' DEAR ANNIE ~...~ .? LOCATION 1817 ;~ CAi t301 OFFICE OF ENVIRONMENTAL SER VICES' . ,.a, t.,~]~ ) ~ Bakersfield, CA 9330! OmceorE,,~.~.~s~ic~ ~ Voice (66~) 326-3979 FAX (661) 326-0576 Expiration Date: Ju~e 3~.. 2~3 RA~ [~J/ .~ FACILITY :7~/~ SITE DIAG · ~ Business N~e: % / /~:~' "~ ~l~ Busin~Ad~ess: ~~ /7 ~' ~ ~ ~ DEAR ANNIE SiteID: 015-021-002184 Manager : BusPhone: (661) 633-9874 Location: 1817 EYE ST Map : 103 CommHaz : Minimal City : BA~RSFIELD Grid: 30C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code: EPA Numb: DunnBrad: Emergency Contact / ~itle/ Emergency Contact / Title Business Phone~ (661)~ 63~-~874x /~ Business Phone: (661) 633-9874x 24-Hour Phone ~ i~{~ ~6-8121x ~ 24-Hour Phone : (661) 325-5339x Pager Phone ~:' ( /~/ - x~ Pager Phone : ( ) - x Hazmat Hazards:l~/ ~~ Fire Pre~ ImmHlth Contact : GREG'MCNEILL · ~/ ~ ~hone: (661) 633-9874x MailAddr: 1817 EYE ST -- /7~ ~State: CA City : BA~RSFIELD I~ Zip : 93301 Owner NANCY BRANNON/KIM MCNEILL Phone: (661) 633-9874x Address : 1817 EYE ST ~ / State: CA City : BAKERSFIELD ~~ Zip : 93301 Period : to ~ TotalASTs:. = Gal Preparer:~~ ~ ~ TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives~~'' ~ Hanmar Inventory One Unified List --Alphabetical Order All Materials at Site Hazmat Common Name... ISpocHazlEPA Hazards] Frm DailyMax IUnitlMCP HELIUM F P IH G 438.00 FT3 Min -1- 04/05/2002 DEAR ANNIE SiteID: 015-021-002184 9 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ -- COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: NE CORNER OF SHOP & STOREROOM CAS# 7440-59-7 STATE i TYPE i PRESSURE i TEMPERATURE CONTAINER TYPE I FGas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION , Largest Container I Daily Maximum Daily Average 219.00 FT3I 438.00 FT3 219.00 FT3 HAZARDOUS COMPONENTS I 100.00 Helium N 7440597 HAZARD ASSESSMENTS ITsecretl ~SlBioHaz Radioactive/Amount I EPA Hazards NFPA I USDOT# MCP No N No No/ Curies F P IH / / / Min -2- 04/05/2002 F DEAR ANNIE SiteID: 015-021-002184 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 07/03/2001 EXTRA HELIUM TANKS HAS TIGHTENED CAP ON IT AND HELIUM IN USE HAS TIGHTENED VALVE ON IT. -- Employee Notif./Evacuation 07/03/2001 EMPLOYEES ARE INSTRUCTED TO CALL 911. Public Notif./Evacuation 07/03/2001 GREG MCNEILL AT 633-9874. Emergency Medical Plan 07/03/2001 WOULD GO TO NEAREST HOSPITAL. -3- 04/05/2002 DEAR ANNIE SiteID: 015-021-002184 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 07/03/2001 TANKS CHAINED TO WALLS. -- Release Containment 07/03/2001 1 TANKS CHAINED TO WALL. -- Clean Up 07/03/2001 1 OPEN DOORS AND AIR IT OUT. MAKE SURE ALL CUSTOMERS ARE OUT AND LEAVE STORE. Other Resource Activation -4- 04/05/2002 F DEAR ANNIE SiteID: 015-021-002184 Fast Format F Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 07/03/2001 A) GAS - OUTSIDE SE CORNER OF SIDE B) ELECTRICAL - OUTSIDE SE CORNER OF SIDE BLDG C) WATER - OUTSIDE SE CORNER OF SIDE BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 07/03/2001 PRIVATE FIRE PROTECTION - ALARM SYSTEM AND FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - LOCATED ON THE SW CORNER OF 19TH AND EYE ST. Building Occupancy Level -5- 04/05/2002 DEAR ANNIE SiteID: 015-021-002184 Fast Format ~ Training Overall Site -- Employee Training 07/03/2001 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE THAT WILL BE POSTED ON THE BACK WALL. BRIEF SUMMARY OF TRAINING PROGRAM: ALL EMPLOYEES ARE INSTRUCTED TO LEAVE BLDG AND CALL FIRE DEPT. -- Page 2 --Held for Future Use Held for Future Use 6 04/05/2002 DEAR ANNIE · SiteID: 015-021-002184 Manager :~/~ ~ ,/l~C/l'/~/~---~'~ BusPhone: (661) 633-9874 Location: 1817 EYE ST Map : 103 CommHaz : Minimal City : BAKERSFIELD Grid: 30C FacUnits: 1 AOV:. CommCode: BAKERSFIELD STATION 01 SIC Code: EPA Numb: DunnBrad: Emergency contact / Title Emergency Contact / Title NANCY BtL~N-NON / ~ ~X'~JLT~z-~_L KIM MCNEILL / ~)~-~/~ ~/~ Business Phone: (661) 633-9874x Business Phone: (661) 633-9874x 24-Hour Phone : (~)~A& ~/~fx 24-Hour Phone : (~6/)~'EA--~-~3?x Pager Phone : ( ) - ~ Pager Phon~- ~ ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact : ¢,4/~.~'~. Phone: (661) 633-9874x MailAddr: 1817 EYE ST State: CA City : BAKERSFIELD Zip : 93301 Owner NANCY BRANNON/KIM MCNEILL Phone: (661) 633-9874x Address : 1817 EYE ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List --As Designated Order All Materials at Site Hazmat Common Name... ISpecHazlEPA Hazards rrm DailyMax IUnitlMCP ' HELIUM ~, _ ¢5 CA/C/ 0 hereby ce~i~ thru ~ have Cy~ or pa~t name) reviewed the a~ached h~ardous mate~ats maF~age- ' (Name oi ~sine~) ~ any corremions constitute a complete and ~rrect man- agement plan foamy facili~. -~- o~/o4/2oo~ DEAR ANNIE SiteID: 015-021-002184 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site HELIUM Days On Site 365 Location within this Facility Unit Map: Grid: NE CORNER OF SHOP & STOREROOM CAS# 7440-59-7 Gas {Pure Above Ambient Ambient ' PORT. PRESS. CYLINDER Largest Container I Daily Maximum { Daily Average HAZARDOUS COMPONENTS 100.00 Helium .N 7440597 HAZARD ASSESSMENTS TSecret --RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP NoNO No No/ Curies F P IH / / / Min 2 01/04/2001 OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, retum 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 EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. 1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTIONAND MONITORING PROCEDURES: B. EMPLOYEE AND AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY'/ NATURAL GAS/PROPANE} ~U-'~r ~g: ~" ~. ~O .r, ~4_ ~ ~/~e', ~ SPECIe: LOCK BOX: ~S~ IF ~S, LOCATIOn' PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III:-TRAINING. NUMBER OF EMPLOYEES:,~ BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION -L - ' ' __ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED 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 Tt~ ~ACC~TE INFORMATION CONSTITUTES pERJURY. E_ ' DATE ~ ~ CITY OF BAKERSFIELi~ ~~ OIRRCE OF ENVIRONMENTAL ~'RVICES , l~p_~'~,~t,~y; 1715 Chester Ave., CA 93301 (661)326-3979 ,~ ~:~'~ H~RDOUS MATERIALS IN~NTORY ~3~( ~ CHEMICAl. DESCRIPTION~ ~W OADD ODELETE OREVISE ~ I ~ t ~ ~ Page -- Of -- BUSINESS ~ME (~ma ~ FACILI~ ~E ~ DBA - ~ng Bu~n~ ~) 3 CHEMICAL LO~TION ~NFIDE~IAL (EPC~) · 205 T~E SECRET CHEMI~L ~E ~ t ~ ff Subj~ to E~, ref~ to instm~s FIRE ~DE ~D C~SSES (~plete ~ ~umt~ ~ I~ tim ~ 210 ~PE ~RE ~ m M~RE ~ w WASTE 211 ~DIOA~ ~ Y~ ~ No 212 [ CURIES 213 PHYSI~L STATE ~ s ~u~ ~ ~ UOU~D ~ ~S 2~ ~GEST ~A~ER ~ t~ FED ~RD ~TE~RIES ~P~SSU~ ~E ~ 4 AC~ H~L~ ~ 5 ~RONIC H~ 216 (~ m~ mat apply) ~ 1 FI~ ~ 2 ~U~ DALLY ~U~ ~ DALLY ~U~ UNffS* ~ ga ~L ~ CU ~ ~ 'lb ~S ~ ~ TONS 221 DAYS ON ' ~ EHS. ~nt mus~ be in lbs. STOOGE ~AINER ~ a A~VE~UND T~K ~ e ~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~E ~ q ~IL (Check all ~at app.) D b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE ~ r O~ER ~ C T~K INSIDE BUILDING ~ g ~Y ~ k ~X ~ o TO~ 8IN ~ d S~ DRUM ~ h SILO ~ ~LINDER ~ ~ T~K WA~N STOOGE P~SSU~ ~ a A~IE~ ~. A~VE A~IE~ ~ ba BELOW A~IE~ ~4 STOOGE TE~RE ~A~IE~ ~ aa A~VE ~IE~ ~ ba BELOW A~IE~ ~ c CRYOG~IC 2 ~0 231 ~Y~ ~No 232 ~ ~9 ~Y~ ~No 240 241 242 243 ~ Y~ ~ NO 2~ 245 PRINT NAMI SIGNATURE DATE UPCF (7~99) S:\CUPAFORMS\OES2731.TV4.wpd Dear Annie, 181~ Eye Street Bakersfield, CA 93301 (661) 633-9874 art rubber stamping, scrapbool~ng, cards, balloons, partiesJ and morel Nancy Brannon 9~m McN~ill ~ ~ TL