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Home My WebLink AboutBUSINESS PLAN 1/18/1988 E/FACI LI TY FORM NORTH SC~~J/~d'Lk/-~BUS INE~ NAME: FLOOR: 0F DATE:./ / FACILITY NAME: UNIT ~": OF (CHECK ONE) SITE'DIAGRAM FACILITY DIAGR.~M t::X, IT l( Inspector's Comments): -OFFICIAL USE ONLY- SITE DIAGRA~ (Reid items) 1. Address: Identify the principle buildings by the Street numbers. 2. Street(s), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. Storm Drains, Culverts, Yard Drains 4. Drainage Canals, Ditches, Creeks, $. Buildings a. Frame construction b. Masonry construction c. Retal construction d. Access Door 6. Utility Controls a. Gas b. Electricity c. Water 7. Fire Suppression Systems: a. Fire Hydrants b. Fire Sprinkler Connections c. Fire Standpipe Connections d. Water Control Valves for protection systems e, Fire Pu~p 8. Fire Department Access 9. Lock (key) Box 10. MSDS Storage Box 11. Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood d. Gates 13. Powerlines 14. Guard Station 15. Storage Tanks: Identify 'the capacity in gal. a. Above ground b. Underground 16. Diking or Berm 17. Evacuation Route 18. Evacuation Area: Identify the location where employees will meet. 19. Outside Hazardous Waste Storage 20. Outside Hazardous Material Storage 21. Outside Hazardous Material Use/Handling 22. Type of Hazardous Material/Waste Stored or Used (See Below) T~E OF HAZARDOUS MATERIAL F '= Flammable E .- Explosive L * Liquid C ~ Corrosive 0 - Oxidizer' O - Gas ~ ~ Water Reactive T - Toxic 9 - Solid D = Waste' i - Etiological Example: Flammable Llquld - FL FACILITY DIAGRAM (Required Items In addition to the. abo~e) 1. Risers for Sprinklers 2. Partitions 3. Stairways: Indicate the levels served from highest to lowest. 4. Escalator: Indicate the levels served from highest to lowest. 5. Elevator 6. Attic Access 7. Skylights R = Radtological P - Poison H * Cryogenic 8. Fire Escapes 9. Air Conditioning Units 10. Windows 11. Inside Hazardous Waste Storage 12. Inside Hazardous Materials Storage 13. Inside Hazardous Materials Use/Handling 14. Sewer Drain Inlets Utilities General Account Maintenance PUTLS801 Acct Nbr: 411201 Bill Stat: FB Cyc Stat: CL Acct Cyc Stat: CL Transfer-from: Transfer-to: Page 1 of 6 Due: 256.43 1. Customer Name: POOL CIRCUS 2. Social Sec Nbr: 3. Telephone: 4. Service Address: 1725 GOLDEN STATE AVE 5. Service City: BAKERSFIELD 6. State: CA 8. Parcel ID: 9. Bill Cycle: 5 20. Water Svc Class: 10. Route Nbr: 11. Comments : 12. Prey Acct: HM00603 23. 13. service Date: 14. Fund 'no: 15. Bill-to Addressl: C/O WOODY BRYANT 16. Bill-to Address2:119 WESTBLUFF 17. Bill-to City: BAKERSFIELD 7. Zip: 93301 Misc Services: 23.1 F99 NOT IN BUSINESS 23.2 24. Closing Date: 02/20/90 18. State: CA 19. Zip: 93305 Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change ALT-F10 HELP I ADDS VP I FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR I CR POOLS · SPORTING GOODS · HOBBIES · DOLLS JANUARY 12, 1988 RECEIVED JAN 1 [R 1988 A,s'd ............ CITY OF BAKERSFIELD P.O. Box 2057 BAKERSFIELD, CA 93303-2057 DEAR SIR: L<U.~:~_JU.S~:.~_E.C.E_I~E.~.~R_B_I_LLL.LN~__EO.R ACCOU.NT N~.~BER_H.McC0_6O.3 FOR OUR [100 24TH ST., BAKERSFIELD, CA 93301 LOCATION. WE VACATED THE PREMISES LAST AUGUST, THEREFORE, WE DO NOT UNDERSTAND WHY YOU ARE BICLING US. IF THERE IS A PROBCEM,' PLEASE LET ME KNOW SO WE MAY CORRECT THE SITUATION. T~ou, ABLE INCL. 4818 E. Tulere · Fresno, CA 93727 · (209) 252-9365 IRETURI~I PAYMENTS TO: ' ' .,CI]yyOF BAKERSFIELD . '0 m ~ ~ ~@ i~,~¢~T~'~,~O""' · AKERSFIELD, CA 93303-2057 ACCOUNT NO. ( INQUIRIES CONCERNING THIS BILL, PLEASE INVOICE NUMBER ~ 0 g ~ 3 0 0 REMI~ANOE OOPY PLEASE/~KE CHECKS PAYABLE TI: cITy OF BAKERSFIEL[~ O. OO April 4~ 1990 TO: FROM~ SUBJECT: Bill Descary, City Treasurer Ralph E. Huey, Hazardous Materials Coorinator Pool Circus Account # HM 411201 has a previous balance of $400.00. They have made no attempt to pay and there is no forwarding address that I am aware of. This business was previously owned by Woody Bryant. At this time I have no idea how to find Mr. Bryant. This account should be turned over for collection. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 RCEIVED JUL 13 1987 Ans'd ............ OFFICIAL USE ONLY BUSINESS NAME ID# INSTRUCTIONS: HAZARDOUS lW~ATERIALS BUSINESS PLAN AS A WHOLE FORM 2A 000603 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 brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: Pool Circus B. LOCATION / STREET ADDRESS: 1100 24th Street CITY: Bakersfield ZIP: 93301 BUS.PHONE: (805) 323-2383 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. A. Cleta Lanq Ph#323-2383 AFTER BUS. HRS. Ph# 831-8022 B. Mary Godfrey ph~323-2383 Ph# 831-594.4 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PL~MS? - 2A - YES / NO YES / NO MSDSS? YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSINESS AS A WHOLE Cleta Lang- Manager Mary Godfrey- 1st assr or in the event the above listed people listed are not available at the time. The manager on duty at the time will be available. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE Cleta Lan~- Store Man~ger 1. Memg~:,ial-~9~pital on 34th Street 2. Sout~We~:U~%ent Care Center 322-2273 3. or any nearby facility that is authorized to handle an emergency 4. San Joaquin hospital 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 A. METHODS FOR SAFE HANDLING OF HAZARDOUS .................................... [YE~ NO MATERIALS:...~ B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES C. PROPER USE OF SAFETY EQUIPMENT: .................. ~)NO D. EMERGENCY EVACUATION PROCEDURES: ................. E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... ,FES~ NO SECTION ?: HAZARDOUS NATERIAL REFRESHER YES NO YES YES NO Russ Fire Ext · YES NO Company YES NO CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES NO I, Woody Bryant , certify that the above information is accurate. I understand 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 6.98 Sec. 25500 Et Al.) .and that inaccurate information constitutes perjury. SIGNATURE TITLE t/~ DATE - 2B - SECTION 3: ~ZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain H~zardous Materials? ...... ~ NO If YES, see B. If NO, continue with §ECTiON 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) 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 ~: PRIVATE F~IRE PROTECTION SECTION 5: LOCATION OF WATER suPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A, NAT. B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES .,/~ IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO YES / NO - 3B - MSDSs? KEYS2 YES / NO YES / NO BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFiCiAL USE ONLY BUSINESS NAME: ID# BUSI NESS PLAN SINGLE FACILITY UNIT FORM SA INSTRUCTIONS 1. To avoid further actlon, th~s form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4, Be as BRIEF and CONCISE as .possible. FACILITY UNIT~ FACILITY UNIT NAME: SECTION I: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES 'AT THIS UNIT ONLY BAKERSFIELD CITY FIRE DEPARTMENT FORM 4A-1 Page ____of.~' NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME: Pool Circus ~e~AME:Cleta Lang FACILITY UNIT°#: ADDRESS: 1100 24th Street ADDRESS: ~100 24th Street FACILITY UNIT NAME: CITY, ZIP: Baker~fi.eld~ CA 93301 CITY,ZIP: Bakersfeld~ CA 93301 ICI USE CFIRS PHONE ~: 322-2383 PHONE #: 322-2383 {OFF CODE { ONLY 1 2 3 4" 5 6 7 8 9" ' 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT, WT. CHEMICAL OR COMMON NAME CODE GUIDE P 25 75 Gal 10 99 North wall Liquid Sodium Hypochloride CMLQ '~P 500 1000 Lbs t0 99 " " Calcium Hyypochlorite i~ ~ CM$~ ~P 2500 750 Lbs t0 99 " " -~ Dichlorisocyanurate 55-65% CM~ P 2500 750 Lbs IQ 99 " " Trichlorisocyanurate 80-90%-' ~S~L P i0 25 Gal ,~ 99 " " Muriat ic Acid CMLQ p 13 25 Lbs ]0 99 .... Sodium Bisulfate CMSL p 1 1 LBS ]0 99 " " Calcium Chloride CaC12 CMSL p i 1 Gal ]O 99 ,,. ,, Cyanuric Acid CMLQ p 25 ,25 Gal ] 0 99 " " Quaterhary, A~nonium CMLQ p 1 1 Gal ] O 99 " " SodiumThiosulfate NAME Darla Carr TITLE: Agent SIONATURE: k fJ~Jc ~- DATE: '//~, EMERGENCY CONTACT: Cleta Lane TITLE~anager PHONE # BUS HOURS: 322-23~3 AFTER BUS HRS: 831-8022 EMERGENCY CONTACT: TITLE: .... PHONE # BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: - 4A-1 - MEMORANDUM . r ~ October 24, 1990 TO Ralph~..E_...._.H..u..e_.y, Hazardous Materials Coordinator FROM M~_i_.e.._.Dais, Accounting 'Supervis0r- Treasury . ~ Pool Circus moved from 1100 24th Street to 1725 Golden State Avenue sometime in August 1987, per correspondence in your files. Arthur's Toys located at 1725 Golden State was billed under HM411301 for the FY 88/89. It appears that Pool Circus -~HM411201 was billed in'error for FY 88/89 ($200). If you agree, please authorize Accounts Receivable to adjust off ~he 88/89 billing for Pool CircuJ HM411201.