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Home My WebLink AboutBUSINESS PLAN cus~ & No. _ - ~'~ CELLANEOUS RECEIVABLES ADJUSTMENT DATE ~--"~- c:~/-.(~ NC=W ACCOUNT ADDRESS CHANGE CLOSE ACCT ' F,~CE C~GEI ~ O~ER ~J PARCEL NUMBER (iF APmJCABU~ ADJUSTMENT I CHG DATE CHARGE CODE I ADJUSTMENT AMOUNT j ,~- I-~PO ~ ~, ~(-7.~_ .~c~ ! APPRO~D BY GOLDEN EMPIRE AMBUI,ANCE 2700 F. STREET - 93301. P. O. BOX 918 - 93302 · BAKERSFIELD, CALIFORNIA BUSINESS (805) 325-9011 · ADMINISTRATION (805) 325-9141 FAX (805) 325-1820 FAX (805) 325-1524 "WE SERVE SO OTHERS MAY LIVE" STATEMENT OF AC( CITY OF BAKERSFIELD ~'.~~/~ P 0 BOX .o057 DATE: 6/01/00 TO: QOLDEN EMPIRE~ AHBULANOE ~-~ v~ BAKERSFIELD, CA ~330i CHARGE DATE:DEScRIPTZON REF-NUMBER DUE DATE TOTAL AMOUNT 5/01/00 ~EQINNINe BALANCE 8. 50- HMO05 8/OZ/O0 HAZ MAT HANDLINQ FEE E , 110. O0 HMOI7 b/Ol/O0 HAZ MAT ANNUAL INSPECTION ~~/~ 50.00 SSO01 b/O1/O0 CA',.:STATE SURCHAReE 10. O0 FOR OUESTIONS OR CHANQES TO 'fOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT OVER 30 OVER 60 OVER 90 ;,;: i;2~i"i;"-':' CUS.TOMER' 'No:': ': 2943 ; ...................... CUSTOMER'--'' *'"TYPE: ..... ...... :~ TOTAL DUE: ~1/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Overall Site with 1 Fac. Unit General Information ~ Location: -~--~gq%f-ST ~TDO ~'Fn 5T~T Map:103 Haz:2 Type: 3 i City : Grid: 30D F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title ~gmA~--f~n%K~ ~ ~u~/~J PETER BRANDON / Business Phone: (805) 325-9011x Business Phone: (805) 325-9011x 24-Hour Phone : (805) 78-3-~-~x~~a~ 24-Hour Phone : (805) 327-9000x Pager Phone : (~,~)&Sa -7¥~x Pager Phone : ( ) - x __ Administrative Data Mail Addrs: ~ 'l~O"~" 5~- D&B Number: 04-166-7460 City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 4119 Owner: MOSESIAN Phone: (805) 325-9011 Address: ~ ~7~ ~ ~T~F State: CA City: BAKERSFIELD Zip: 93301- Summary I, ~n,~ (',~ ~,~. d ~a/Do hereby certify that I here r~i~ t~ a~hed h~ardous materials m~.a~e- ment plan for ~mb.l~ ~ ~ a~ th~ it a~ng ~th any ~ions con~ute a ~mplete and ~e~ man- ageme~ p~n ~or my ~ci~. 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-001 OXYGEN Gas 2500 Low · Fire, Pressure, Immed Hlth FT3 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-001 OXYGEN Gas 2500 Low · Fire, Pressure, Immed Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 I Daily Average FT3 I Annual Amount FT3 2,500. I 1,500.00 24,000.00 Storage ; Press T Temp; Location PORT. PRESS. CYLINDER Iabove IAmbientlSOUTH STORAGE ROOM &-W~-SIDE O 5~. £~ ~ -- Conc Components MCP Guide 100.0% IOxygen, Compressed ILow I 14 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation %eu~&~ o0~ THE OXYGEN BOTTLES ARE IN A SEPERATE ROOM TO THE REAR (SOUTH) OF THE BUILDING. IF THERE IS AN EMERGENCY CONCERNING THE OXYGEN ROOM ALL EMERGENCY AGENCY'S ARE TO BE CONTANCTED INCLUDING,~4%OXYGEN. IF NEEDED EVACUATION WILL TAKE PLACE IN AN ORDERLY FASHION AWAY\FROM INCIDENT SITE. <3> Public Notif./Evacuation IN THE EVENT OF A RELEASE OR SPILL INVOLVING A HAZARDOUS MATERIAL, THE ON-DUTY SUPERVISOR AND THE DIRECTOR OF OPERATIONS WILL BE NOTIFIED. CONCURRENTLY, ALL STAFF AND VISITORS WILL IMMEDIATELY BE DIRECTED TO LEAVE THE VICINITY OF THE SPILL AND ASSEMBLE IN A SECURE AREA, LOCATED UPWIND AND OUTSIDE OF THE HAZARD RADIUS OF THE SPILLED MATERIALS. THIS AREA WILL BE IDENTIFIED BY THE SUPERVISOR OR ADMINISTRATOR. THE ON-DUTY COMMUNICATIONS STAFF WILL BE DIRECTED TO NOTIFY THE FIRE DEPARTMENT OF THE EMERGENCY BY DIALING 911 <4> Emergency Medical Plan IF A MEDICAL EMERGENCY AROSE AT THIS BUSINESS WE WOULD DISPATCH POLICE AND FIRE DEPT. ON OUR DIRECT LINE. WE WOULD ALSO HAVE AN AMBULANCE DISPATCHED FROM OUR COMPANY IF ONE WAS NOT AVAILABLE WE WOULD DISPATCH HALL AMBULANCE. ALL OF THE MAJOR HOSPITALS ARE CAPABLE OF HANDLING EMERGENCIES INVOLVING HAZARDOUS MATERIALS. IF NUMEROUS PEOPLE ARE INVOLVED THEY WOULD BE SENT TO SEVERAL HOSPITALS NOT TO OVERLOAD 1 IN PARTICULAR. 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention OXYGEN BOTTLES ARE UPRIGHT AND CHAINED AGAINST A WALL. <2> Release Containment IN THE EVENT OF A RELEASE, THE ON DUTY SUPERVISOR AND ADMINISTRATIVE PERSONNEL AND FIRE DEPARTMENT ARE IMMEDIATELY NOTIFIED. THE IMMEDIATE AREA AND MAIN BUILDING IS EVACUATED AND ALL PERSONS ARE MOVED TO SAFE STAGING AREA UPWIND AND OUTSIDE THE HAZARDOUS RADIUS OF THE SPILL LEAK. <3> Clean Up -~%~R OXYGEN SUPPLY COMPANY WILL BE CONTACTED AND PLACED IN CHARGE OF CLEAN ~ DUTIES AND REQUIREMENTS REGARDING ANY OXYGEN INCIDENTS. <4> Other Resource Activation 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS uv WALKWAY ~ OWVmWN WnmM_ f%TT~_~TnW Ow Cm??r~IT_T ?:ALL ~= ~a~TT~G~O B) ELECTRICAL - ~RTH & SOUTIi UALL$ OIYCEN ROOM, HALL%:AY BY T~INING Ruff4~ - .O.Z E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - AT PRESENT TIME WE DO NOT HAVE A SPRINKLER SYSTEM OR AN ALARM SYSTEM. WE DO HAVE A D~R~CT DIAL TO BAKERSFIELD POLICE DEPT. AND KERN COUNTY FIRE DEPT. WE HAVE,FIRE EXTINGUISHERS ON THE PREMISIS. WE ALSO HAVE SOMEONE AT THIS LOCATIOn, 24 HOURS 7 DAYS A WEEK. FIRE HYDRANT --~4)Um~4~EAST~GR~ER OF !8~2H. ~ND Q~£TREET£ <4> Building Occupancy Level 01/17/95 GOLDEN EMPIRE AMBULANCE 215-000-000458 Page 7 00 - Overall Site <G> Training <1> Employee Training WE HAVE 85 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. ALL EMPLOYEES WHO MAY BE EXPOSED TO HAZARDOUS SUBSTANCES WILL RECEIVE TRAINING ON POTENTIAL HAZARDS AND HOW THESE SUBSTANCES CAN BE SAFELY USED AND HANDLED IN THE WORKPLACE. EMPLOYEES WILL ALSO BE INSTRUCTED ON THE CORRECT ACTION TO BE TANKEN IN CASE OF A PROBLEM. THIS TRAINING WILL BE ~GIVEN AT THE TIME OF INITIAL ASSIGNMENT, AND WHENEVER A NEW HAZARD IS INTRODUCED INTO THE WORK AREA. <2> Page 2 <3> Held for Future Use <4> Held for Future Use