HomeMy WebLinkAboutBUSINESS PLAN ~ S I TE / F _~C I L I T¥ D I z&G l"{z,-~IV~'
i : FORM 5
/
(CHECK ONE) SiTE
i nspecto~mments): -0F~tCIAL USE
SITE DIAGRAM (Ref ~'r'°~?~'~'~
1. Address: Identify the 9. Luck (key) Box
principle buildings
by the Street numbers. 10. MSDS Storage Box ~
2. Street(s), Alleys. 11. Railroad Tracks
Driveways, and Parking
Areas adjacent to the 12. Fence or Harrier
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. Buildings
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
....................... ~ ....... ................................... mee t.
~ ......... -::.;:. ........ ~--~_~-- .... ~_.._.z_ .................. :: L_L.5. ' .........
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 = Radtological
C = Corrosive 0 = Oxidizer G = Gas P = Poison
W = Water Reactive T = Toxic S = Solid Il = Cryogenic
D = Waste B = Etiological
Example: Flammable Liquid = FL
FACILITY DIAGRA~ (Required Items la 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. 11. Inside Hazardous Waste
Storage "
4. Escalator: Indicate the
levels served from 12. Inside Hazardous
highest to lowest. Materials Storage
5. Elevator 13. Inside tlazardous
Materials Use/Handling
6. Attic Access
14. Sewer Drain Inlets
7. Skylights
sfield Fire'Dept.
Hazardous Materials Inspection
Date Completed c/v'- /'7- P O
Business Name: ~T/(],'~2~'-~
Location: &O~
AU~ ~ ? i9%
PI~ ID ~ ~]5-000/Z~O (Top dS~[ come~ B~si~ess Ph~) HA~ ~4AT, DIV.
~b ~~ ~ t~ ~rv~ Z~c~3 o~ 8&~dequate Inadequate
Ve~ficafion of [nvento~ Materials
vefifica6on of Quan~ties
vefifica6on of Location
~oper Se~ega6on of Matefi~
Verification of MSDS Availability [--] [-~
Number of Employees
Verification of Haz Mat Training
Comments:
Verification of^batement Supplies & Procedures [-~ [--]
ColTLments:
Emergency Procedures Posted [~] [~
Containers Properly Labeled [~] []
Verification of Facility Diagram [-~
Special Hazards Associated with this Facility:
Violations:
FD 1652 (Rev. 3.89) ~Vhite-Haz Mat Div. Yellow-Station Copy Pink-Business Office
BAKERSFIELD FIRE DEPARTMENT
/~/~'r~ BUREAU OF FIRE PREVENTION _~/~_ ~,~/~,
Date .APPLICATION Application No.
In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made
by:
Name of Company / / ' ~Address
to display, store, install, use, operate, sell or handle materials or processes involving or creating con- .
ditions deemed hazardous to life or property as follows:
issued '
GARY J. WICKS 2700 M Street. Sutte 300
Agency Olrector Bakersfield, CA 93301
(805) 861-3502 (/.f~~.. Telephone (805) 861-3,636
STEVE McCALLEY ~,~~,~.~ Teiecopier (805) 861-3429
O~,ecto, RESOURCE ENT AGENCY
PERMIT FOR PERML,&NENT ~ --~_<~-"-~'~.-'..' PERMIT NUMBER A 1236-15
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR:
James Card Lock Ace Financial Corp. Groundwater Resources Inc.
601 Golden State Hwy. 315 E. 18tl~ Street 5400 Aldrin Ct.
Bakersfield, CA Bakersfield, CA 93305 Bakersfield, CA 93313
License #520768
Phone: (805) 325-5722 Phone: (805) 835-7700
PERMIT FOR CLOSURE OF PERMIT EXPIRES September 4, I990
5 TANK(S) AT ABOVE AP]?ROVAL DATE June 4. 1990
LOCATION APPROVED BY
Hazardous Materials
............................................................................... POST ON PREMISES ................................................................................
CONDITIONS AS FOLLOWS:
1. It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City
Fire and Building Departments).
2. Permittee must notify the Hazardous Materials Management Program at (805) 861-3636 two working days prior to tank removal or abandonment
in place to arrange for required inspections(s).
3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-30.
4. I1 is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation or treatment of hazardous
materials.
5. The tank removal contractor must have a qualified company employee on site supervising thc tank removal. The employee must have tank removal
experience prior to working unsupervised.
6. ff any contractors other than those listed on permit and permit application are to be utilized, prior approval must be granted by the specialist
listed on the permit. Deviation from the submitted application is not allowed.
7. Soil Sampling:
a. Tank size leas than or equal to 1,000 gallons - a minimum of two samples must be retrieved from beneath the center of the tank at depths
o~ approximately two feet and six feet.
b. Tank size greater than 1,000 to 10,000 gallons - a minimum of four samples must be retrieved one-third of thc way in from the ends of
each tank at depths of approximately two feet and six feet.
c. Tank size greater than 10,000 gallons - a minimum of six samples must be retrieved one-fourth of the way in from the ends of each tank
and beneath the center of each tank: at depths of approximately two feet and six feet.
8. Soil Sampling (piping area):
A minimum of two samples must be retrieved at depths of approximately two feet and six feet for every 15 linear feet of pipe run and under the
dispenser area. . .
C,,,., la_
PERMIT FOR PERMANENT'~5'L-O~S'UI~ PERMIT NUMBER A 1Z36-15
OF UNDERGROUND HAZARDOUS ADDENDUM
SUBSTANCES STORAGE FACILITY
9. Soil Sample analysis:
a. All soil samples retrieved from behest h gasoline (leaded ! unleaded) tanks and appurtenances must be analyzed for benzene, toluene, xylene,
and total pelroleum hydrocarbons (for gasoline).
b. All soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel)
and benzene.
e. All soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total organic halides, lead, oil and grease.
d. All soil samples retrieved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease.
e. All soil sample~ retrieved from beneath tanks and appurtenance~ that contain unknown substances must be analyzed for a full range o~
substances that may have been stored within the tank.
f. All soil samples retrieved from beneath tanks and appurtenances that contained furfuryl alcohol resin must be analyzed for phenols,
formaldehyde and furfuryl alcohol.
10.' -Tile following timetable lists pre- and post-tank removal requirements:
ACTIVITY DEADLINE
Complete permit application submitted At least two weetcs prior to closure
· to Hazardous Materials Management Program
Notification to inspector listed on permit of date Two working days
and time of closure and soil sampling
Transportation and tracking forms sent to Hazardous No later than $ working days for transportation and 14 working
.Materials Management Program. All hazardous waste days for the tracking form after tank removal
manifests must be signed by the receiver of the
hazardous waste
Sample analysis to Hazardous Materials Management No later than 3 working days after completion of analysis
Program
11. Purging/Inerting Conditions:
a. Liquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid remain in tank. (CSH&SC 41700)
b. Tank shall be purged through vent pipe dischar~ng at least 10 fe~t above ground level. (CSH&SC 41700)
c. No emission shall result in odors detectable at or beyond property line. (Rule 419)
d. No emission shall endanger the health, safety, comfort or repose of any person. (CSH&SC 41700)
e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal.
RECOMMENDATIONS/GUIDELLNE$ FOR REMOVAL OF UNDERGROUND STORAGE TANKS
This department is responsible for enforcing the Kern County Ordi~ance Code, Division 8 and state r~gulations pertaining to underground storage tanks.
Representatives from tiffs department respond to job sites during rank removals to ensure that the tank:; are safe to remove/close and that the overall
job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interests
and expectations for this department.
1. ~Iob site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by
C.&L.-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rule, workers are not
permitted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designed
function. For example, bacleho~ buckets are never substituted for ladders.
2. Properly licensed contractors are assumed to understand th,.' requirements of the permit issued. The job foreman is responsible for knowing and
abiding by the conditions of the permit. Deviation from tht: permit conditions may result in a stop-work order.
3. Individual contractors will be held responsible for their post-removal paperwork. Tracking forms, hazardous waste manifests and analyses
documentation are necessary for each site in order to close a case file or move it into mitigation. When contractors do not follow through on
necessary paperwork, an unmanageable backlog of incomplete cases results. [f this continues, processing time for completing new closures wil~
increase.
MD:ca~
\a1236~ 15. ptc
Bakersfield Fire Dept.
. Hazardous Materials Division~ E C E I ¥ E 0
2130 "G" Street APR I 0 1990
, Bakersfield, CA. 93301
Ans'd ............
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
1. To ovoid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business os o whole.
4. - Be brief and concise os possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS NAME' ,.J/~,,,,, ~'~- ,,~_,¢,~! ~coc~: .~C'~,~,~-~,,,~
LOCATION' ~ ~~' ~~
MAILING ADDRESS: ~. ~x ~
CITY: ~~~ STATE' ~ ZIP: ~$~HONE:
DUN & BRADSTREET NUMBER: 0~,1~'' ~, SIC CODE'
PRIMARY ACTIVITY' _(_~,9~z~ L~,c,~ /~'~, ~ c~ ~ ~~ .~
MAILING ADDRESS: ~0. ~ ~ ~ ~~/~c~
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR. PHONE
1.
~1~' Z-H~ F,~,~,~y .
FO15'30
~Bakersf[eld Fire Dept.
Hazardous Mal:erials Division
HAZARDOUS MATER, IALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS:
MATERIAL SAFETY DATA SHEETS ON FILE'
BRIEF SUMMARY OF TRAINING PROGItAM:
SECTION 4: EXEMPTION REQUEST:
I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE
REPORTING REQUIREMENTS OF CHAP'rER 6.95 OF THE "CALIFORNIA HE:ALTH &
SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT HANDLE HAZARDOUS MATERIALS.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REA*SON)
SECTION 5: CERTIFICATION:
I, ~J£~'~,£ ~-- ~ ~-/~ ~"~. ~- CERTIFY THAT THE ABOVE INFOR-
MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FU LF.IL.L 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
INACCURATE INFORMATION CONSTITUTES PERJURY.
,,-~'IG ~ A TURE TITLE D ATE
FD1590
[)3/29/9[) CARDLOCK SYSTEM 215-00£~01250 Page 1
Overall Site with 1 Fac. Unit
General I~-~format ion
i Location: 6(:)2 GOLDEN STATE Map: 103 Hazard: Low I
Ident Number: 215-000-001250 Grid: 30B Area of Vul: 0.0
Contact Name Title ... Business Phone ~.24 Hour Phone-
ROY LA'J~DERDA~ ( ) ~q~-~:~ ~~ ) 32'; ~52
Mail Addrs: 602 GOLDEN STATE D~-B Number:
City: BAKERSFIELD State: CA Zip: 93301-
Comm Code: 215-004 BAKERSFIELD STATION 04 SIC Code:
Owner: D~N .~S Jg~ ~. ~~ Phone: ( ) -
Address: P 0 BX ~ ~ State: CA
City: BAKERSFIELD Zip: 93302-
Sure, mary
03/29/90 JAMES CARDLOCK SYSTEM 215-000-00125(') Page 2
Hazr~at Inver~tor¥ List irJ Reference Nu~ber Order
02 - Fixed Cord;ainers c,r~ Site
Pln-Ref Name/Hazards Forr~ Quar~t ity MCP
02-001 GASOLINE/DIESEL ? 30,000 Low
GAL
03/29/90 CARDLOCK SYSTEM 215-000W.~) 1250 Page 3
02 - Fixed Con'~ainers on Site
Hazmat Inventory Detail in Reference Nu~ber Order
02-001 GASOLINE/DIESEL ? 30000 Low
GAL
CAS ~: Trade Secret: No
For~: Unknown Type: Pure Days: Use: FUEL
Daily Max GAL ~ Daily Average GAL ~ Annual A~ount GAL
30~ 000 ~ 0 - 99 ~ 650,000
Storage ~ Press T Temp '! Location
UNDER GROUND TANK : REAR OF BLDG
-- Conc ~ Components ~ MCP ~ist
100.0% ~Range Oil ILow
JAMES CARDLOCK SYSTEM 215-(~[)0-001250 Page 4
£)¢~ - Over,_~l 1 Site
<D> Notif~ /Evacuation/Medical
<1> Agency Notification
<2> Employee Notifo-/EVacuat-ior, ..........
3A SEC 2) TURN OFF EMERGENCY TURN OFF SWITCH FRONT CENTER OF BUILDING
<3> Public Notif./Evacuatior,
<4> Emergency Medical Plar,
2A SEC 5) - NO EMPLOYEES AT LOCATION
~ d/~9/90 JA CARDLOCK SYSTEM 215-C)£)C )125() Page 5
0() - Ove~.-all Site
<E> Mit igat ion/Prevent/Abater~t
<1> Release Prevention
3A SEC 1) STANDARD GASOLINE STATION SAFETY EQUIPMENT - AUTOMATIC SHUT OFF/
SHEER OFF VALVE - VAPOR HOOD
<2> Release Containr~ent
<3> Clean Up
<4> Other Resource Activation
03/29/9[) JAMES CARDLOCK SYSTEM~-~'15-000-001250 Page 6
0[) - Ove'rall Site
<F> Site Er~ergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
2A SEC 3)
A) GAS - S REAR OF BLDS B) ELECTRICAL - I/S REAR WALL C) WATER - S CURB -
24TH STREET D) SPECIAL - NONE E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
3A SEC 4) FIRE EXTINGUISHERS - FRONT & REAR OF
BLDG
3A SEC 5) FIRE HYDRANT - ACCROSS THE STREET
<4> Held for Future use
03/2_9/9[) CARDLOCK SYSTEM 215-DO[~O 1250 Page 7
(')0 - Overall Site
<G> Trai~Jing
<1> Page 1
<2> Page 2'~as needed'
<3> Held for Future Use
<4> Held for Future Use
March :29, 1990
TO: Nina Mayer, Accounts Receivable
FROM: Ralph E. Huey, Hazardous Materials Coordinator
SUBJ£CT: James Cardlock System
Nina, account # HM463801 should ihave a mailing address of P.O. Box
387, Bakersfield, Ca. 93302 witlh a location address of 602 Golden
State Highway.
Thanks
~ /. BAK/ ERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET
SA ERSFIE ,S, CA RECEIVED
(805)326-3079 APR 28 1988
/ Ans'd... ......
~ ~D~ I
~ . ~ ~A% BUSINESS PLAN AS A WHOLE
1. To avoid ~u~he~ action, ~eturn th~s fo['~ by
3. Answer t~e questions be!ow ~or the bus,ness as ~ whoie.
4. Be as brief and concise as possible.
SECTION 1: BUSI~SS IDE~IFICATION DATA
SECTION 2: E~ERGENCY 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.
SECTION 3: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS A ~OLE
B. ELECTRICAL: ~,.~,~ ~)~
C. WATER: ,~./~ ~~ -- ~z/F~
D. SPECIAL:
E. LOC~ BOX: YES ,/~ ~F YES, LOCATION:
IF YES, 00ES tT C0:,:TAI% S~TE PLANS? YES / ~0 ~4SDSS? YES /
FLOOR PgANS? YES / ~0 KE?S. YES /
- 2A -
SECTION 4: PRIVATE RESPONSE TE.~ FOR BUSINESS AS A WHOLE
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
SECTION 6: EMPLOYEE TRAINING
EMPLCYERS ARE REQUIRED TO HAVE A ?ROGRAM WHICH PROVIDES EMPLOYEES WiTH iNiTIAL AND
REFRESHER TRAIXING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INITIAL REFRESHER
A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~-~
MATERIALS: ........................................ ~S NO YES NO
B. PROCEDURES FOR COORDINATING ACTIVITIES~~-~'-~' .Y.~_O
WITH RESPONSE AGENCIES: ........................... NO YES NO
C PROPER USE OF SAFETY EQUIPMENT: .................. NO YES NO
D EMERGENCY EVACUATION PROCEDURES: ........ ". ......... - YES NO
E 'DO YOU ,MAINTAIN EMPLOYEE TRAINING RECORDS: ........ YES~__~ YES NO
SECTION ?: ~AZARDOUS MATERIAL
CIRCLE YES - NO - NONE
DOES YOUR BUSINESS HANDLE HAZARDOUS .,~.~RIAL IN QUANTITIES ~SS~_ '~.A.~ ~' o~ ?05.,DS OF A
SOLID, 5~G~NS OF A LIQUID, OR 200 CUBIC FEET OF ~ COMPRESSED GAS: ...... YES NO
, certify that the above information is accurate.
I~u~de~s(tf/~hat this informanion wi!]. be .used to fulfill my firm'~ obligations under
the new 7,a'!ifornia Health and Safety code on Hazardous ?,!a~erials (Div. 20 Chapter 6.95
Sec. 25500 Et Al.) and that inaccurate information constitutes perjury.
2B -
BAKERSFIELD CITY FiRE DEPART:~IE.%T
217,0 "G" STREET
8AKERSF!ELD , CA 93501
Cc: ~,.~.A~ USE
ID#
BUSINESS XA>.~:
BUSINESS PLA~
SINGLE F~CILIT~ UNIT
FO~ ~A
INSTRUCT IONS I. To avoid further action, t]his form must be re-~uz'ned
2. TYPE/PRINT YOUR AS'SWERS IN E~GLISH.
$. Answer the questions betow fer THE TACII, ITY UNIT LISTED BELOW
~. Be a~ BRIEF and CDNCZSE as possible.
SECTION !: ~ITIGAT!0%, PR~%ION~ ABATEME%% PROCEDb~ES
SECTION 2: NOTIFICATION A?~'D ~"''"'"'~'av.~u~,,~, ~,,., P~OCEDL-RES AT T'rIIS L~."iT O.~LY
SECTION 3: HA%ARDOI;S MATERIALS FOR THIS L.'NIT ONlY
A. Does :.his Facility Unit con'~.ain Hazardous 5[ateria!s? ......
if YES, see B.
If NO, continue with SECT'iOX 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES~'
form marked: NON-T?ADE SECRETS ONLY (white form
~f Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (ye;iow_ form -~=-=) in addition to ~he non-trade
secret form. Elst only the trade secrets on form
SECTION $: LOCATION OF WATER SUPPL'? FOR USE BY EMERGENCY .RESPONDERS
SECTION 6: LOCATION OF UTiL!?f SH'b'T-OF?S .iT ~--RIS hR'IT
B. ELECTRICAL:
C. WATER:
O. SPEC!AL:
~. COCK BOX: YES .' ? YES, L~,C:,TI ....
i BAKERSFIEI, D CITY FIRE DEPARTMENT
I.D. # FORM 4A-I Page / of
i NON--TRADE SECRETS
i HAZARDOUS MATERI ALS I NVENTORY
BUS S NAME:5_ __
INES ~ R NAME: ~ ~-~ ~~'~c~=~__< FACILITY
PHONE ~: .~ PHONE ~: ~/Z~ ~OFFICIALo~y USE CFIRS ...... CODE
1 2 3 ~ 4 5 6 7 8 9 10
TYPE ~AX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT ~T. CHEMIqAL OR COMMON NA~E CODE GUIDE
I
NAME TITLE: ~~~ S GNATURE: ,~ ~ ~~ DATE:(~~
EHERGENCY CONTACT: ~ TITLE: ~ ~ BUS HOURS:
~ AFTER BUS HRS:
~'E~ERGENCV CONTACT:.~ TITLE: PHONE ~ BUS HOURS:
PRINCIPAL BIJSINESS ~ACTIVITV: ~~~~ ~ ~ AFTER BUS HRS:
-- 4n--1 -