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Home My WebLink AboutBUSINESS PLAN ~j U A ~ , ALANIZ BODY WORKS o .' 3406 GETTY STREET Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF ,PERMIT ON REVERSE SIDE ': · · '~ This ~ermit is Issued for the followin~_: , E] Hazardous Materials Plan [3 Underground Storage of HazardOus Materials Permit ID #:: 015-000-001349 . [3 Risk Management Progmm ALANIZ BODY WORKS a Hazardous Waste On-Site Treatment LOCATION: 3406 GETTY ST OFFICE OF ENVIRONMENTAL SER VICES ",'" .; ~ 1715 Chester Ave., 3rd Floor . Approved by : C'Ralpil/HucT'D~i issue Date Bakersfield, CA 93301 OfficeofEvironmen~Scrvices ~' Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: "JUI~I~ 30. Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: Materials Plan PERMIT ID# 015-0214)01349 ..,,,,~,~' Iround Storage of Hazardous Materials .~,~ ~ agement Program ALAN IZ BODY WORKS .:,'?,- ii~;~iiiii"' Waste LOCATION 3406 GETTY [~-.._.. -'...~ ~(,.;-..:~ ,.. ........... '~:'::2¥~ ,~,? 4;~' ~.'.....-.,j[~' I~ by: ~ B~ersfield F~e D~mment O~CE OFE~RO~AL S~ ~CES Approved by: . 1715 Chewer Ave., 3rd Floor B~enfiel~ CA 93301 Voice (805) 32~3979 F~ (S0S)326-0576 Expiration Date: ~n~ $O ~000 SITE/FACILITY DIAGRA~I ' -; f FOI~M ~ /~? ~?. ~.~. NORTH SCALE: BUSINESS NAMe: FLOOR: OF (CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM J Inspector's Comments) -OFFICIAL USE ONLY- SITE DIAGRAM (R, ~ed Items) ~ 1. Address: Idel the 9. Loc y) Box principle buildings by the Street numbers, 10. MSDS Storage Box 2. Street(s), Alleys, 11. Railroad Tracks 'Driveways, and Packing Areas adjacent to the 12. Fence or Harrler property. Include the a. Wire street names. b. Masonry 3. Storm Drains, Culverts. Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Gates Creeks, 13. Powerlines 5. Bnildings a. Frame construction 14. Guard Station b. Masonry construction 15. Storage Tanks: Identify the c. Metal construction capacity in gal. a. Above ground d. Access Door b. Underground, 6 Utility Controls a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Water 18. Evacuation Area: Identify the Fire Suppression Systems: location where a. Fire Hydrants employees will meet. b. Fire Sprinkler 19, Outside Hazardous Connections Waste Storage c, Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Water Control Valves 21. Outside Hazardous for protection systems Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored 8. Fire Department Access or Used (See Below) TYPE OF HAZARDOUS MATERIAL F = Flammable E = Explosive L = Liquid R = Radlologlcal C = Corrosive 0 = Oxidizer G = Gas P = Poison Water Reactive T = Toxic: S = Solid H = Cryogenic O = Waste B = Etiological Example: Flammable Liquid = FL FACILITY DIAORA~ (Required items in addition to the above) 1. Risers for Sprinklers 8. Fire Escapes -2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest, ll. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served from 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets ALANIZ BODY WORKS SiteID: 015-021-001349 Manager : BusPhone: (661) 323-0525 Location: 3406 GETTY ST Map : 102 CommHaz : Moderate City : BAKERSFIELD Grid: 23D FacUnits: 1 AOV: CommCode: COUNTY STATION 65 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title ROEL ALANIZ / OWNER / Business Phone: (661) 323-0525x Business Phone: ( ) - x 24-Hour Phone : (661) 871-1256x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ~ Press ImmHlth Contact : Phone: (661) 323-0525x MailAddr: 3406 GETTY ST State: CA City : BAKERSFIELD Zip : 93308 Owner ROEL ALANIZ Phone: (661) 323-0525x Address : 3513 HARVARD DR State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ---- Hazmat Inventory One Unified List --Alphabetical Order Ail Materials at Site Hanmar Common Name... ISpocHazlEPA HazardsI Frm DailyMax UnitlMCP ARGON F P IH G 340.00 FT3 Min OXYGEN F P IH G 280.00 FT3 Low I, .......... Do hereby certify that I have (Type or print name) I~evie?~ed the attached h~ardo,,s mmerials manage- ~en~ plafl for .... ~ and ~hat it ~lon~ w~h ~ny.~e~iOns mnsti~ule a complete and corre~ man- ~eme~ plan ~r my facili~. 3/2003 F ALANIZ BODY WORKS SiteID: 015-021-001349 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 07/24/2000 CALL 911. -- Employee Notif./Evacuation 07/24/2000 VERBAL NOTIFICATION AND EXIT OUT FRONT DOORS. Public Notif./Evacuation Emergency Medical Plan 07/24/2000 MERCY HOSPITAL - 2215 TRUXTUN AV - 327-3371. 2 07/18/2003 F ALANIZ BODY WORKS SiteID: 015-021-001349 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 07/30/1990 GASES ARE IN APPROVED PRESSURIZED CYLINDERS STORED PROPERLY AND USE PROPER VALVES AND FITTINGS. --Release Containment 07/24/2000 CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING. -- Clean Up 07/30/1990 CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING. Other Resource Activation -3- 07/18/2003 ~ ALANIZ BODY WORKS SiteID: 015-021-001349 Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 07/24/2000 A) GAS - MOBILE B) ELECTRICAL - N REAR OF BLDG C) WATER - E SIDE OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 07/24/2000 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ON PREMISES. FIRE HYDRANT - CORNER OF PIERCE & GETTY. Building Occupancy Level -4- 07/18/2003 ALANIZ BODY WORKS SiteID: 015-021-001349 Fast Format ~ Training Overall Site -- Employee Training 07/24/2000 WE HAVE ?? EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE?????????? BRIEF SUMMARY OF TRAINING: -- Page 2 -- Held for Future Use Held for Future Use -5- 07/18/2003 ALANIZ BODY WORKS SiteID: 215-000-001349 Rw'.c~E~VED2 _, Manager : ',% ~us~none: (805) 323-0525 Location: 3406 GETTY ST JH,~/20 ~ p : 102 CommHaz : Moderate City : BAKERSFIELD ~/ ?rid: 23D FacUnits': 1 AOV: CommCode: COUNTY STATION 65 ~ '~IC Code-. EPA Numb: ~ DunnBrad: Emergency Contact / Title Emergency Contact / Title ROEL ALANIZ / OWNER / Business Phone: (805) 323-0525x Business Phone: ( ) - x 24-Hour Phone : (805) 871-1256x 24~Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact : Phone: ( ) - x MailAddr: 3406 GETTY ST State: CA City : BAKERSFIELD Zip' : 93308 Owner ROEL ALANIZ Phone: (805) 323-0525x Address : 3513 HARVARD DR State: CA City : BAKERSFIELD Zip : 93308 Period : to TotalASTs: = Gal Preparer: TotalUSTs = Gal Certif'd: RSs: No Emergency Directives: ~- Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hazmat Common Name... ISpocHazlEPA Hazardsl Frm DailyMa× UnitlMCP OXYGEN~0/~ '''~c~'/ F P IH G 280.00 FT3 Low ~ ~ t-~'herebycer~ifyih:~t~hav~H G 340.00 FT3 Min ~GON [' ~' ~ U~~er ~) -- ' reviewed ihs a~ached h~ous ma~fi~ls manags- -- -~ ' (Na~ el ~ne~) '/'" any corre~ions cons~Ru~e a complete and correc~ man- agement plan ~or my facili~. --~- o~/~z/~ooo F ALANIZ BODY WORKS SiteID: 215-000-001349 = Inventory Item 0001 Facility Unit: Mobile Containers on Site ~U~V~v~u~ ~vl~ / ~ £ ~.~ ~Vl~ OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: MOBILE CAS# 7782-44-7 Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS ~ THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 280.00 FT3 140.00 FT3 HAZARDOUS COMPONENTS 100.00 Oxygen, Compressed N 7782447 RS BioHazI HAZARD AiSESSMENTS TSecret Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low = Inventory Item 0002 Facility Unit: Mobile Containers on Site ~ ARGON Days On Site 365 Location within this Facility Unit Map: Grid: MOB I LE CAS # 7440-37-1 F STATE I TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Gas Pure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 340.00 FT3 170.00 FT3 HAZARDOUS COMPONENTS 100.00 Argon N 7440371 HAZARD ASSESSMENTS TSecretl oRSIBioHazNo N No Radioactive/Am°unt I EPA HazardsINo/ Curies F P IH NFPA/// USDOT# MiaMCP' -.2- 06/21/2000 ALANIZ BODY WORKS ~i5i~i5~6~6i5~6/~i~6i5~5/~6~6~6~6 SitelD: 215-0~-001349 i Notif./Evacuatio~Medical ~~~~:~~ Overall Site i i~ Agency Notification ~~~~~~~ 01/07/1990 i O CALL 911 o o i88~ Employee Notif./Evacuation ~8~88~8~8~i~8~8~8~8~ 01/07/1990 ~ O VENAL NOTIFICATION AND EXIT OUT FRONT DOORS o i~88 ~blic Notif./Evacuation o o i~88~ Emergency Medical Plan ~E~EE~EE~EEE~ES~8~E88~EE~SE~E O1/07/1990 i o MERCY HOSPITAL o 2215 TRUXTUN AV BA~RSFIELD, CA. (805) 327-3371 o o ALANIZ BODY WORKS ~~~~~ SitelD: 215-000-001349 Mitigation/Prevent/Abatemt ~~~~i~~ Overall Site i~ Release Prevention ~~~~~,,~~ 07/30/1990 o GASES ARE IN APPROVED PRESSURIZED CYLINDERS STORED PROPERLY AND USE PROPER ° VALVES AND FITTINGS.. o O i~ Release Containment ~~~~~~ 07/30/1990 o CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING o o i~ Clean Up ~~~~~~!~~~ 07/30/1990 O CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING. o o i~g~ Other Resource Activation O O -4- 06/21/2000 ALANIZ BODY WORKS ~/~6~/~6/~/~/~/~~¢~ SiteID: 215-000-001349 Site Emergency Factors ~~~~i~~ Overall Site i i~ Special Hazards O o i~E Utility Shut-Offs ~EE~E~EE~E~E~EE~EEEEE~EE~E~ 07/30/1990 o A) GAS - MOBILE B) ELECT~CAL - NORTH REAR OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE o E) LOCK BOX - NO o i~ Fire Protec./Avail. Water ~~~i5~~ 07/30/1990 o P~VATE FIRE PROTECTION - FI~ EXTINGUISHERS ON PREMISES O o o FI~ HYD~NT - CORNER OF PIERCE & GETTY o aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee~f. i~ Building Occupancy Level -5- 06/21/2000 i ALANIZ BODY WORKS ~~~6~6~6~ SiteID: 215-000-001349 i~ Trai~ng ~~~~~~i!~~ Overall Site i~ Employee Training ~~~~~~~ 07/30/1990 i o o o WE HAVE ?? EMPLOYEES AT THIS FACILITY O O o DO YOU HAVE MATE~AL SAFETY DATA SHEETS ON FILE? O o o B~EF SUMMARY OF T~INING: o O O O O o o O o O O o o o o -6- 06/21/2000 ~6/25/9J ALANIZ BODY WORKS 215-000-001349 Page Overall Site with 1 Fac. Unit General Information Location: 3406 GETTY ST Map: 102 Hazard: Moderate Community: COUNTY STATION 65 Grid: 23D F/U: 1AOV: 0.0 Contact Name Title Business Phone ~ 24-Hour Phone] ROEL ALANIZ OWNER (805) 323-0525 x/ Administrative Data Mail. Addrs: 3406 GETTY ST D&B Number: City: BAKERSFIELD State: CA Zip: 93308- Comm Code: 215-065 COUNTY STATION 65 SIC Code:. Owner: ROEL ALANIZ. - .... Phone: (805) 323~0525 Address: 3513 HARVARD DR State: CA City: BAKERSFIELD Zip: 93308- Summary JUL 0 2 ~99i HAZ. MAT. DIV. I,_ .~/~,~'F'~'Do hereby certify that i have · · O'yl~o~t~) reviewed the a~ached h~a~ous materials manage- me., plan for~/~J~-/s.~Y/~t~at 'I along with any mrr~ons constitute a ~mplete and coffe~ man- agement plan for~ fadli~. 06/25/93 ALANIZ BODY WORKS 215-000-001349 Page 2 Hazmat Inventory List in MCP Order 01 - Mobile Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 01-001 OXYGEN Gas 280 Low · Fire, Pressure, Immed Hlth FT3 01-002 ARGON Gas 340 Minimal · Fire, Pressure, Immed Hlth FT3 06/25/93 ALANIZ BODY WORKS 2152000-001349 Page 01 - Mobile Containers on Site Hazmat Inventory Detail in MCP Order 01-001 OXYGEN Gas 280 Low · Fire, Pressure, Immed Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3280If Daily Average140.00FT3 I Annual Amount2.80.00FT3 Storage Press T Temp~ Location PORT. PRESS. CYLINDER Above ~AmbientlMOBILE -- Conc .... Components , MCP ---TGuide 100.0% IOxygen, Compressed ILow ~ 14 01-002 ARGON Gas 340 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 7440-37-1 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3340 I Daily Average170.00FT3 I Annual Amount340.00FT3 -- Storage Press I Temp Location -- Conc Components MCP ---~uide 100.0% IArgon IMinimal I 12 06/25/93 ALANIZ BODY WORKS 215-000-001349 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL NOTIFICATION AND EXIT OUT FRONIT DOORS <3> Public Notif./Evacuation <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFIELD, CA. (805) 327-3371 06/25/93 ALANIZ BODY WORKS 215-000-001349 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention GASES ARE IN APPROVED PRESSURIZED CYLINDERS STORED PROPERLY AND USE PROPER VALVES AND FITTINGS. <2> Release Containment CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING <3> Clean Up CALL AND HAVE THEM REPLACED IF THEY ARE LEAKING. <4> Other Resource Activation 06/25/93 ALANIZ BODY WORKS 215-000-001349 Page 6 00 - Ow~rall Site <F> Site Emergency Factors <1> Special Hazards ~) GaS - MOBIL~ c) ~T~- ~s~ SID~ O~ BUI~DI.G <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ON PREMISES FIRE HYDRANT - CORNER OF PIERCE & GETTY <4> Building Occupancy Level 06/25/93 ALANIZ BODY WORKS 215-000-001349 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? BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use · , ~-.. '~ ../ ~ '~, ..x ~:., ~ .,,~ tF~e or prin% name} Do hereb~ eerti~- , HAZ. MAT. DIV. ~ ~ that I have revie~cem the attached Hazardous Mal-~erials business plan (ri&me o£ bus±ness) and that it along with the attached additions or corrections constitute a complete and correct 06/50/89 ALANIZ BODY WORKS Page 001 Site as a Whole General Information Location: 5406 Getty St Map: 102 Hazard: Moderate Ident Number: 215-000-001549 Grid:25D Area of Vul: Administrative Data Mail Addrs: 5406 GETTY ST D&8 Number: City: BAKERSFIELD State: CA Zip: 95508- GeoSubdiv: COUNTY STATION 65 SIC Code: Owner: ROEL ALANIZ Phone: (805) 523-0525 Addrs: 5515 HARVARD DR State: CA City: BAKERSFIELD Zip: 95508- Contact Title Business Phone !24 Hour Phone ROEL ALANIZ ~ ~j ~ ~. (;805) 523-0525 x !(805) 589-958.5 × ! Summary: NO PRIVATE RESPONSE TEAM 06/50/89 ALANIZ BODY WORKS Page 002 Overall Site HAZMAT INVENTORY - LIST 01-001 Oxygen 249 Low > FT5 Ol-O02 Argon 556 Minimal > FT5 06/50/89 ALANIZ BODY WORKS Page 005 Overall Site HAZMAT INVENTORY - DETAILS Oi-OOi Oxygen 249 Low > FT5 Form: Unknown Type: PUre Days in use: Use: WELDING SOLDERING -- Daily Max Amt .... I .... Daily Average Amt ~ Annual Amount .... ~tJnit -- .~. Container ,-PressTTemp ., Location PORT. PRESS.'CYL~NDER ! I IMOBZLE -- COHO..T Components , · MCP iList-- 100.0~,lOxygen. , Oompressed ,iL°w 01-002 Argon 556 Minimal > FT5 Form: Unknown Type: Pure Days in use: Use: ......... Daily Max Amt 'i Daily Average Amt ~ Annual Amount ,Unit -- ......... Container ipressTTemp 'i Location PORT. P~ESS. CYLINDER I I IMOe~LE -- Coho.i Components i .... MOP --TLiSt- 100.0~ !Argon !Minimal 06/50/89 ALANI2! BODY WORKS Page 004 <D> Notif./Evaouation/Medioal for: - <1> Agency Notification CALL 911 <2> Employee Notif./Evaouation VERBAL NOTIFICATION AND EXIT OUT FRONT DOORS <S> Publio Notif./Evaouation 06/50/89 ALANIZ BODY WORKS Page 005 <D> Notif./Evaouation/Medioal for= - <4> Emergency Medical Plan MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFIELD, CA. (805) 327-3371 08/30/89 ALANIZ BODY WORKS Page 008 <E> Mitigation/Prevent/Abatemt for= - <1> Release Prevention GASES ARE IN APPROVED PRESSURIZED CYLINDERS STORED PROPERLY AND USE PROPER VALVES AND FITTINGS. <2> Release Containment <3> Clean Up 06/50/89 ALANIZ BODY WORKS Plge OOT (E> Mitigation/Prevent/Abatemt for: - <4> Other Resource Activation 06/50/89 ALANIZ BODY WORKS Page 008 <F> Site Emergency Factors for: - <1> Special Hazards <2> Utility Shut-Offs A) GAS - MOBILE B) ELECTRICAL - NORTH REAR OF BUILDING C) WATER - EAST SIDE OF BUILDING D') SPECIAL - NONE E) LOCK BOX - NO <5> Fire Proteo./Avail. Water PRIVATE FIRE PROTECTION - FIRE HYDRANT - 06/~0/89 ALANIZ BODY WORKS Page 009 <F> Site Emergenoy Faotors for: - <4> Held for Future use 06/50/89 ALANIZ BODY WORKS Page 010 <G> Training for: - Page 1 NONE <2> Page 2 as needed <3> Held for Future Use 06/30/89 ALANIZ 80DY WORKS Page 0i1 <G> Tra, ining for= - <4> Held for Future Use CZ-FY of' BAKERSFIELD , HAZARDOUS MATERTALS TNVENTORY Farm and Agticulture ~ Standard 0usiness FI NON--TRADE SECRETS Pa~e __/__ STANDARD IND. CLASS CODE: U Y Pp~,,~ ~I ~~,_. ....., _ ~0~ - ~.~, ~IP~ ~~k~~~ q~ DUN AND BRADSTREEI NUMBER u~c : · ~-~ -- PHONE ~: -- ; - - - / Code coco Amt Amt Est Units on 7ype Press ..romp. Co~e, Stored ~n ~ac~tty Sa~..tnstruct~ons Physical and Health Hazard C.A,S, Number Component I1 ~ame I C,A,S. ~umber (Check ail that apply) Component ¢3 Name ~ C.A,a, Number Physics1 snd ~eal~hYazard C.A.S. Humber Co~onenL I1 ~a ! C.~.S. ~u~b~r ~re Yazard ~ R~ac[ivi[~ ~ Oelayed ~udd~n,~elease Componen[ ~a~e C.~.S. Number .~a,~,, el rressure Health , Component 13 ~a~) I (,~,S, ~u~ber Physical and Health Hazard C,A,a, Number Component Il Name I C,A,S, Number (Check all thmt Component 12 Name ~ C,A,S, Number ~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Immediate Heal[h of Pressure Health Component 13 Name S C,A,S, Number Physical mhd Health ~aTard C,A,S, Number Component II Name t C,A,S, Number (Check 811 thmt mpp/y) Component 12 Name I C.A.S. Number ~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Im~i~ Health of Pressure Component 13 Hame i C.A.S. Humber ,, ,, EMERGENCY CONTACTS I ~)qAi ~ A~ 3~-~ fl2 m ~ TI 2~,r Phone N~e " Title certify unoer penalty ol)a~ tnqc I navepeEsonajpl, examlnqoaqoQm famillaLyitb the information submitted in~his 8nd all at~ached.d~ments, mn~ tpmc ~mseo on.my inquiry ~r.cnose lnOlvlouaps responsiDme tek obtaining the information, I believe that th suDm~tteo~n/ormatlon Is c~ue, accurate, aha complete. ~~ of own~t/o~rator u~ owner/dpe-r~tot s aut~oriieo repreSEntative ' . BAKERSFIELD CITY FIRE DEPART1WENT 2130 "G" STREET ~[C~!~/~D BAKERSFIELD, CA 9330~ ~ (805) 326-3979 OC'r ~ {988 /0'~ ~ ~~ ~vlq Anf d ............ p ~5~f OFFI'C[,~L .AZARDOUS ~AT~.RIALS ~ ~ 3 · 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 buief and concise as possible. SECTION 2: E~4ERGENCY 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 ~ill notify your loca! fire department and the State Office of Emergency Services as required by la~. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: B. Ph# Ph# SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A MNOLE A' NAT._~AS/PROPANE:~ ./~ ~/z/~'-- ~ C WATER: -~:~.~'~ ~ (B.e__ "'~-~8---',~ ~Z ? V D. SPECIAL: 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 SECTION 4: PRIVATE RESPONSE TE~dW FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRA~ 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 ~ATERIALS: ....................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES NO YES NO / E. DO YOU AINTAIN EMPLOYEE TRAINING ECORDS: ....... YES YES< SECTION ?: HAZARJ)OUS 1WA~RI~J, CTRCLE YES OR NO OR NONE .,/~~, DOES Y~R BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS~,~AN~,500~OFz~ SOLID~/55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSE~GAS:~ .~.... [ YE~ ; [ ~n~erstand'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/~ and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY BUSINESS NAME: _..~//~ ] BUS I] NESS PLAN SINGLE ]FACILITY UNIT ]?ORM 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 BELOH 4. Be as BRIEF and CONCISE as possible. FACILI~ ~IT¢ FACILI~ ~IT N~: SECTION 1:' MITIGATION, ~E~ISN,, ABATE~ PROCED~ES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY - SA - SECTION 3: HAZAJ{I)OUS NATERIALS FOR THIS UNIT 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 ENERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFPS AT THIS UNIT ONLY. A. NAT. GAS/'PROPANi?.' B. 'ELECTRICAL C. WATER: D. SPECIAL: E, LOCK BOX: YES / NO IF YES, LOCATION: 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'__of NON--TRADE SECRETS HAZARDOUS MATERI ALS I NVENTORY BUSINESS NA.M~: ~ ~ .5 OWNER NAME: .,~,,-'/,3x.- FACILITY UNIT #: AUDnESS: 7qa(~ ~~/ ff~ / ADDRESS: ?f~3 ff~f~D {/~, FACILITY UNIT NAME: PHONE {: ?~3- m'~f PHONE {: ~/~/~f~' ti f~--fff~f [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 A~OUNT A~OUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE OUIDE' AFTER BUS HRS: ~/. /2,>' {3MEROENCV CONTACT: TITLE: .. PHONE { BUS HOURS: {PRINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: 4A-I