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DATE ZIP COD: , FEE I BLOCK u~ ~,,,.,, ~ ~ ~ ~ . ~USlNESS MGR./R ESPONSlB LE ~ BgSINESS PHONE , NO. OF FLOO~S sQuArE FOOTAGE I V'iOLATION NOTICE ISSUED? /M~ OCCUPANT LOAD OTHER DATE OF REINSPECTION (1) (2) (3) Pr eue r~"J'l o'rl PAP, K,im,~ Lc~'r' -- -. C ADDRE~ PARCEL No.(OPTIONAL) ClIY NAME ~' BOX TO INDICATE Q INDIVIDUAL Q PARTNERSHIP ~ AGENCY 1YPE OF BUSINESS GAS STATION ~ 2 DI~.TRIBUTOR FARM ~ 4 PROC ESSOR ~ 5 OTHER EMERGENCY CONTACT PE DA · E ( · FIRS AGENCY ~ FEDERAL AGENCY KERN COUN1Y PERMff TO OPERATE No. ' ' ! EMERGENCY CONTACT PERSON (SECONDARY~ optional CODE DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE NIGH~: NAME (LAd, FIRST) PHONE NO. WITH AREA CODE II. PROPERTY OWNF~R I~EORMATION_(MUST BE.COMPLETED) · $~, ~ ~ ~1 ~l ' [ TO INO CATE ~ ~ PA~NEESHIP III. TAI KOWl (I BE ) NAME CA~ OF ADDE~ INFOEMA~ION LOCAL AGENCY [~ STATE AGENCY [~ COUN"iY AGENCY (~ FEDERAL AGENCY PHONE No. WITH AREA CODE J~ INDIVIDUAL ATE LOCAL AGENCY C~ STATE AGENCY ~COUNW AGENCY ~FEDERAL AGENCY PHONE No. WITH AREA CODE OW TANK No. SERVICE YIN YIN YIN YIN YIN YIN DO YOU HAVE FINANCIAL RESPONSIBILITY? YIN !:.~.TANK OESCRIPTION OWNER'S TANK C, DATE INSTALLED (MO/DAY/YEAR) III. TANK CONSTRUCTION UARK( 'INBOXSS~S A. TYPE OF [] i DOUBLE WALL SINGLE WA. LL SYSTEM [] 2 SINGLE WALL [~ 4 ECONOARY · 8.. TANK [] 1 [] 2 STEEL MATERIAL (Primary Tankl IN SOX D LINER ] 95 UNKNOWN ] 99 o'rlqER ] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC 8 100% METHANOL COMPATIBLEWIFRP [] 9g OTHER E~ 2 ALKYO [--'~' 3 EPOXY LINING [] 4 PHENOLIC LINING C. INTERIOR UN~NG ' [] [] , ,, UN'OW. [] . DinER IS · YES__ O. CORROSION [] 1 [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION, [] 5 [] 9s UNKNOWN [] 99 OTHER IV. PIPING INFORMATIC cmcLE A EOT. ~ A~mLmAaZ A. SYSTEM TYPE A U 2 PRESSURE A U 3 GRAVITY k U 99 OTHER B. CONSTRUCTION A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U STAINIrE. SS STEEl. A U 3 POLYVINYL CHLORIDE (PVC)A U 4 FIBERGLASS PiPE A U 6 CONCRETE A O 7 STEEL WI COATING A U. S 100~ ME31-IANOL COMPATIBLEW/FRP A U '1o CATHOOIc PROTECTION A U 9~ UNKNOWN A U 99 OTHER D. LEAK DETECTION [:::] I AUTOMAI'ICLJNELEAKDETECTOR [] 2 LINE I")GNTNESS TESTING ~'~ 3 INTERSllTIIq. MONITORING [] 9g OTHER V. TANK LEAK DETECTION [] 6 TANK TESTING [] , I.~Tm~L.O.ITO.ING '[] ,, .o.E [] ,, UN~OWN []" OTHE. I. TANK DESCRIPTION couPL~m ALL ~Tm~S- SPECIFY ~ UNKNOWN _ I A. OWNER'S TANK I. D. # ' B. MANUFACTURED BY: C. MATERIAL AND CORROSION PROTECTION C. DATE tNSTALLED (MO/DAY/YEAR) III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN D. TANK CN3ACITY IN GALLONS: AND ALL THAT APPLIES IN SOX O A. TYPE OF [] 1 i:X)UBLE WALL [] 3 LINER [] g5 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SECOIN CONTAINMI~,~,(VAULTEDTANK) [] 99 OTHER B. TANK [] , [] 2 STEEL [] '~I,ERGLAS, [] MATERIAL [] 5 [] ~ --- ~ C. INTERIOR lINING IS D. CORROSION [] PROTECTION [] IV. PIPING A. SYSTEM TYPE El. CONSTRUCTION C. MATERIAL AND A U 1 STEEL CORROSION A U 5 ALL NUM PROTECTION A U g LEAK DETECTION 4 STEEL CLAD W/FIE)ERGLASS REINFORCED FLASTIC 0 100% METHANOL COMPATIBLEW/FRP 99 OTHER 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC [] gl NONE [] g5 UNKNOWN [] gg OTHER U IF UNDERGROUND. BOTH IF APPLICAOLE PRESSURE A U 3 GRAVITY A U 99 OTHER DOUBLE WALL A tJ 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U'~2 STAINLESS STEEL A U 3 POLYVINYL CHLORIOE{PVC)A U 4 FIBERGLASS PiPE A U 6 CONCRETE A U 7 STEEL WI coA~NG A U 8 1~. ME~ANQL COMPATIBLEWIFRP S~ A U 10 CA~OOICPRO~CTiON A U g5 UN~OWN A U g90~ER D~CTOR ~ 2 LINET~H~ESS~S~NG ~ 3 INI~S~L ~Nff0RING ~ ~ O~ER V. TANK LEAK DETECTION I~ , ~,S.AL ~.ECK [] = ,.V~.TOR. RECONC.,ATIO. []. VAPOR.O.,TOR,NG []. *.TO.ATIC TANK O*.GING [] . GROUND WATE.~,.ONITOR,NG ' ~, ~ ~ANK TEST,NG [] ~ '"TERST'T'AL~O.,TOR'NG [] .' NO"E [] .. ~.~OW. [] ~ O~"ER . I.~ANK D ESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UN~;~r~A~. & ~Ltj,/~,c~-~...~-~--:----~- A. OWNER'S TANK ~. o., ~a~'~z~, c~ ~ i C. DATE iNSTALLED (MO/DAY/YEAR) I .... GALLONS: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. Pt, AND C. AND AI~L THAT APr'.lES IN aOX O A. 'fYPE OF [] ~ DOUBLE WALL [] 3 SING,~ WALL W,TH EX'r~.IOR LINER ~ 95 u.~owN SYSTEM ~ 2 SINGLE W~L ~ 4 SE~ND~Y ~NTAINME~ (VAUL~D'TAN~ ~ ~ O~ER 8. TAtlK ~ 1 ~RE STEEL ~ 2 STA~ESS S~ · ~ 3 FIBERG~S ~ 4 STEEL C~O WI FIBERG~ REINFORCEO P~C ~ s ~ L, ,,~ ~ ~ ~.L~, ~ ~ ~ u.~w. ~ . O~R A, SYSTEM TYPE PRESSURE A_tl 3 G~V~ A U.. 9~ OTHER 8. CONSTRUCTION U 2 I:X3UBLE WALL A U 3 LINED TRENCH A [/ g5 UNKNOWN A U C. MATERIAL AND A U U. 2 STAINLESS STEEL A U 3 POLYVINYt. CHLORIOE (PVC)A U ~t FIBERGLASS PIPE.. CORROSION A {J 5 6 CONCRETE A {J 7 STEEL WI COATING A U a 100"/. METHANOL COMPATIBLEW/FRP PROTECTION A U g A U. '1o CATHOOIC PROTECT~QN A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 [] 2 LINE TIGHTNESS TESTING [] 3 INTF..qSTI'TIAL MONITORING [] 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNO WATER MONITORING I [] TA. TESTING [] . ,.TE.ST. , .MO.ITOR,NG [] .O.E [] [] O ER I I. TANK DESCRIPTION coaPL~rs ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # -, n. MANUFACTURED BY: C. DATE .INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: III. TANK CONSTRUCTION ~. AN0 c, AND ALL THAT APPLIES IN BOX D A. TYPE OF [] 1 DOUBLE WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] (VAULTED TANk3 [] 99 OTHER . B. TANK [] MATERIAL (Primary Tank) C. INTERIOR ~ 5 LINING · IS UNING D. CORROSION [] ~ PROTECTION [] s IV. PIPING INFORMATION A. SYSTEM TYPE A U 1 B. CONSTRUCTION A u ~ s gl LINING M ETHANOL ? 3 FIBERGLASS [] 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC 7 [] 8 10~"o METHANOL COMPAT~BLEW/FRP NKNOWN ~ g9 OTHER [] 3 EPOXY LINING [] 4 PHENOLIC LINING [] 95 UNKNOWN [] 99 OTHER YES~ NO~ [] 3 VINYL WRAP [] 4. FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN [] ~g oTHER ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A U 2 PRESSURE A U 3 GRAVITY A U 9g OTHER C. MATERIAL AND ' CORROSION PROTECTION O. LEAK DETECTION V. TANK LEAK DETECTION A U 2 DOUBLE WALL A U 3 LINED TRENCH A U g5 UNKNOWN A U 99 O3'HER A U I SARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC1A U 4 FIBERGLASS PIPE A U 5 ALUMINUM k U 6 CONCRETE A U 7 STEEL WI COATING A [J 8 100% METHANOL COMPA~BLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECT[ON A U 95 UNKNOWN A U g9 OTHER [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 ttiT~J~$T~TtAL MONrrORING [] ~ Oll-tER I~.~ 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION []3 VAPOR MONITORING [] a, AUTOMATIC TANK GAUGING [] 5 GROUND WATE~ MONITORING · ~ 6 TANK TESTING [] 7 INTERSTITIAL MONITORING [] g, NONE [] 95 UNKNOWN [] 99 OTHER H~,zABakerSfield Fire Dept. ~i RECE)VED~ ~ RDOUS MATERI..ALS DIVI~II3N 2130 G Street, Bakersfield, CA 93301JU! 8 ,§gt~k~~f~ (805) 326-3970 ~ A,~d ............ ~ QUESTIONNAIRE NAME ~ ~E ~ / ~ BUSINE~ ~ ] GAS STATION f~ 2 DISTRIBUTOR ~ KERN COUN~ PERMIT ~3FAEM ~ 4 PRaEtOR ~ 5 OTHER ~ TO OPE~TE ~. ~ EMERGENCY CONTACT PERSON (PRIMARY) DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE No. WITH AREA CODE EMERGENCY CONTACT PERSON (SECONDARY) optional DAYS: NAME (LAST. FIRST) PHONE No, WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE No. WITH AREA CODE II. PROPJ~TY OWNER iNFO~I~,AT~ON/(MUST BE COMPLETED) NAME l ~L~TRE~ A DDRES~ ~ ~BOX ~DI IDUAL ~ LOCAL AGENCY ~ STATE AGENCY TO INDICATE ~ PARTNERSHIP ~ COUN~ AGENCY ~ FEDERAL AGENCY CI~ NAME STATE ZIP CODE ~ PHONE No. WITH AR~ CODE OWNER'S TANK No. DATE INSTALLED //~ VOLUME PRODUCT STORED DO YOU HAVE FINANCIAL RESPONSIBILITY? Y/N TYPE IN SERVICE Y/N Y/N Y/N YIN Y/N YIN Fill one segment out constructed of th~ame materials, style and ie one segment out. ~Fleas~id~i~tanks by owf~ I. TANK DESCRIPTION COMPLETE A~kmTEM~ -. SPEC,Fi ,Fj,~5~pWN / / III. TANK CONSTRUCTION MARK ONE ITEM ~Y IN ~0XES A, B, ANDC,~DALLTHATAPPLIESINBOXO for each tank, unless all tanks and piping are , then only fill ID #. A. TYPE OF SYSTEM B. TANK MATERIAL (Primary Tank) C. INTERIOR . LINING 1 DOUBLE WALL ~. / ~ [] 95 UNKNOWN [] 3 SINGLE WALL WITH EXTERIOR ~ 2 SINGLE WALL [] 4 SECON~RY CONTA~..INMENT (/~ULT~TANK) [] 99 OTHER [],B*RESTEEL []'STEELC 'DW'F'BERG .RE,N.ORCEDP .ST,C D. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 3 VINYL WRN3 [] 4 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN [] 99 OTHER IV. PIPING INFORMATION C~RCL~yA IFAROVEGROUNDOR U IFUNDERGROU'ND, BOTHIFAPPLICABLE A. SYSTEM TYPE A U 1 SUCTIONI% . A ti 2 PRESSURE _ A U 3 GRAVITY A U 99 OTHER C. ~ATER'ALA"O A U , BARES/~i' ~1 U r STAINLESSS~EL A U 3 ~LWINYL CHLORIDE,PVO, A U 4 FIBERG~S PIPE CORROSION A U 5 ALUMI~MF "A U 6 CONCRE~ A U 7 STEELWlCOATING A U 8 1~ ME~ANOL COMPAT~BLEW~RP PROTECTION A U 9 ~LVANIZED S~EL A U 10 CATHODIC PROTECTION A U g5 UNKNOWN A U ~ O~ER D. LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONITORING [] 99 OTHER V, TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING [] 6 TANK TESTING [] 7 INTERSTiTIAL MONITORiNG [] 91 NONE [] 95 UNKNOWN [] 99 OTHER I. TANK DESCRIPTION COMPLETE ALL ITEI~IS -- SPECIFY IF UNKNOWN III. TANK CONSTRUCTION MARK~EITEMONLYINBOXES&~,ANDC, mDALLTHATAPPLIESINBOXD A. TYPEOF [] 95 UNKNOWN SYSTEM [] 99 OTHER [~ 1 DOUBLE WALL [] 3 SINGLE WAL~i~WITH EXTERIOR LINER [] 2 SINGLE WALL .~ ~--~4 SECONDARYIO~ONTAINME~ULTED./T4~ ] 1 BARE STEEL AINLESS S R.MATERIALTANK [~ , CONCRETE ' ~ ~L~ 6~OLYVINYL C.~IDE'~,~/~UMINI~/ ~ 4 STEEL C~D W/FIBERG~SS REINFORCED P~STIC8 1~. ~E~,NOk CO~P,TI,,E W/FR, 9 8RON~ ~LVANI k UNKNOW~ ~ 99 O~ER IS LINING ~ATERIAL COMPATIBLE WITH 1~ ~ANO~ ? YES__ NO__ [] 4 PHENOLIC LINING C. iNTER[OR [] ~ OTHER LINING D. CORROSION [~ I POLYETHYLENE WRAP [] 2 COATING PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC [] ~6 U""NOWN [] "OTHER IV, PIPING INFORMATION CIRCLE A IFABOVE 3ROUNDOR U BOTH IF APPLICABLE A. SYSTEMTYPE A U I SUCTION ~ U 2 PRESS/RE~ / , U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION AU 1 SINGLE WALLdX /, 'NcH ,u ,, ....ow. ~. MATERIAL AND A U I ~RESTEEL ';~/ST'rNLESS~iE~ ~~IDE(PVC)A U 4 FIBERGL~SPIPE CORROSION A U 5 ALUMINUM ~AI 61~OtlC,ET~ r( A, ~TEEL~COATIN~ A U 8 ,~,. ~E~ANOL PROTECTION A U 9 GALVANI~D S' EEL A I ~ CAFH~C~'OTECT'~ A U 95 UNKNO'N ~A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE .EAKDETECTOR INET ESS TESTING ~N~ORING ~ -- -- V. TANK LEAK DETECTION TANK TESTING [] 2 INVENTORY RECONCILIATION [~ 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING ~'~ 7 INTERST,TIALMONITORING ~ 91 NONE [] 95 UNKNOWN ~ 99 OTHER / - - (Primary Tank) C. JN~"~O~ ~. 5 ~ L~I~ ~ 8 UNLINED ~ ~ UN~OWN ~ . O~ER MNING iS UNING MATE~ ( M ~ E ~ 1~ ME~ANOL? YES~ NO~ ~ , ~LYE~LE~ W~P ~ 2 ~A~NG ~ 3 VI~L ~ ~ 4 FIBERG~S REINFORCED ~STIC D. CORROSION PROTEC~ON ~ s CATHOD~ rECTION ~ 9~ NONE ~ ~ UN~OWN ~ ~ O~ER IV. PIPING INFORMATION C~RCm ,. s,s,~.,~ , ~ , s~c,,o, ~ ~ = ~ss~.~/~ ~=~ % ~u . o~. - B. CONSTRUCTION A U 1 SINGLE WALL ~ ~AIU I~BLE~ ~U~LINED TREN~ AU 95 UN~OWN AU ' O~ER ' CORROSION A U 5 ~UMINUM ~ ~ ~ ~ ~CRE~ .... A' ~ 7 STOL W/~NG A U 8 1~ MEdrOL ~MPATIBLE W~RP PROTE~ION A D. LEAK DETE~ION ~NffORING ~ 99 O~ER 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC 8 100% METHANOL COMPATIBLEW.,'FRP 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC.TANK GAUGING [] 5 GROUND WATER MONITORING [] 6 TANK TESTING [] 7 iNTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER C. DATE iNSTALLED ( O/ ) t D. TANK CAP ITY IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B. AND O~ ~ID AL,I./~AT AP~/~I, BOX D · ,,'STEM [], S,N,LE WALL ~,,,SE,~RY CO~ ~MM~ULTEDTA¥ [] ' OTHER__ . . · [] ,BARESTEEL ~,, STA,'~SS~ I'~ ~F,BERGLASS~ '.STEELCLADW, F'BERGLASSRE,NFORCEDPLAST,C (PdmaryTank) ~ , BRONZE C. INTERIOR ~ 5 G~SS LINING ~ 6 UNLINED ~ 95 UNKNOWN ~ ~ O~ER DNING IS LINING MATERIAL COMPATIBLE WITH 1~. ME~ANOL ? YES ~ NO~ O. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE IV. PIPING INFORMATION A. SYSTEM TYPE ] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION ]95 UNKNOWN [] 99 OTHER AUTOMATIC LINE LEA~ DETECTOR ~ 2 LINET~TNESSTESTING A U 8 100"1o METHANOL COMPATIBLEW/FRP A U gg OTHER [--'-~ 3 tNTERSTITtAL MON~'ORING [~ g9 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] 4 AUTOMATIC TANK GAUGING [] 5 GROUNDWATER MONITORING [] 6 TANK TESTING [] 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER Msrch 29, 19BO TO: FROM: SUBJECT: Nina Mayer, Accounts Receivable Ralph E. Huey, Hazardous Materials Division H. Russell Taylor Fire Prevention Nina, account # HM410501 is no longer in business, however they are still responsible for the $200.00 fee for the current year. The account should be closed. N 0 N-- '17 P. AIi) [E S E C R E']? S ' P*ge j__of.~._ CITY, gI~: ~*~5'~1'~i~ ,OE. ~'3~ CITY, ZlP:~qvb~ejO. O~. 93J0~ DUN AND BRADSTREET NUMBER Certification (Read and sign after completing aiJ sections) for obca ~n~ng ~. ~...', .... - -~Z ...... ~o~. ~.._~._, .>I~_~5~.,, .................... "; · STANDARD IND. "-0L~,ss CO~E ~? [~ ,~::w9 ~ '7~ ?~ rtification (Read and sign after coepleting all sections) certify trader ~enelty of lp that I ~ve ~rs~ollyexauin~ ~ ~ f~ilior vith t~ tnfor~tim su~itt~ in this ~ 811 ottK~ ~tl, ~ t~t ~sK m ~ i~t~ of t~e t~tvihols ~siblo r obtain)~' t~ iflf~ti~. I ~Iieve t~c t~ su~itt~ info. tim t~ t~accurate, ~ c~ CITY of B.4KERSFIELD }IAZARDOUS MATERIALS INVENTORY' N O N -- 'J' I~ A ID E S E C R E 'I' S ,., 3__ of .5.. DUN AND BRADSTREET NUMBER S~m I~truct i~ '-FF · tlficatie~ freed and =iKn after compJetlnE all sections/ · obta,fl,mq t~ ~nt~t~, I ~l~e t~t t~ su~itt~ mto~ti~ ~s t~eccure[e, ~d.c~te._ ~ [ ~ '~- ~,,,,,-~.~-~,~. ~,,~,.,-~,,,~,~..~,.,,., ,,,.,,~,,---~ ............... , ................. my inquiry of tho~e t~dlvid~als responsible ,,,.,¢,;./_.e..:.~.z ............. CITY of BAKERSFIELD -;,'tfficetio~ (Reed and $~gn aftcr coepJ~tJnE all or obta~pmg t~ inf~tl~. I ~lieve t~t t~ ~u~itt~ ~nt~ti~ , CITY of BAKERSFIELD . ,o ~ . -_ ~.,O,~.C,,~o,N~,.N^.~.. /4. ~.0~.~/ C~e C~e ~t ~t [st Units ~ Sit. ly~ ~l ........... ~ x - ~ ~/o~~--"1~ ~ :'t _ ~'~t~C ~o~o~) ,i[,yttffn~ ~ ,'-I1, , -- ,, ..... . .... :_:~::t::::5-.:..:_..~__,_%~[ , ':,' .',_ ::~:._:.:: .... ::: :::::, ~ [C~k all t~t e~iy) ~ ~ ~-~ ~t~.zl~--~ ~vt~y ~--~ ~la~ ~--~ ~dd~ ~el~se ~--~ I~J~te ~ / ' ffeaJth of Pr~sure Health _ : . ..i ..... ~:~,.e~,~ .... W:,~;,~:,_e.s I ~or ob~a~n~ t~ iflt~MCt~. I ~lieve t~t t~ su~itt~ inf~ti~ is t~eccu~ote. ~ c~tl._ ~ [ ~ _ - ~,0., - ' ~ ' - '- ~ ~ ,~,~~,"~ ' ,,,.g~.z~.:r~ ............. ~ ~~,,,~,-~-~,~~,~,.~,~,gp~;?~ .~.~..~., .................... POST CONSPICUOUSLY NON-TRANSFERABLE CI T 1' of BAKER SFIEL D CERTIFICATE MUST BE REF~'EWED v,qT!-':~-,, 3c'. DAYS AFTER z~X?i~ATFC!-,i ' BUSINESS TYPE .'.~::'- >. " ' - '':" ,'· ~) (~ BUSINESS TAX PAID . : FIRE EXTINgUiSHER SERVICE J J YES PENALTY TOTAL TAX NONE PAiD BUSINESS TAX CERTIFICATE IS HEREBY GRANTED. LICENSEE IS TO COMPLY WITH ALL LAWS AND ORDINANCES. ISSUANCE OF THIS LICENSE DOES NOT CONSTITUTE AUTHORIZATION TO CONDUC~T BUSINESS IF LICENSEE HAS NOT COMPLIED WITH ALL APPLICABLE LAWS AND ORDINANCES. THIS LICENSE IS ISSUED WITHOUT VERIFICATION THAT THE LICENSEE IS SUBJECT TO OR EXEMPT FROM LICENSING BY THE STATE OF CALIFORNIA. TO BUSINESS H RcUSSELL TAYLORS FIRE PREV P 0 BOX 2056 BAKERSFIELD CA 9~,~03 BUSINESS H. RUSSELL TAYLOR PRES. OWNERS d_nHN H. TAYLOR, V. P. MARO-ERY F. TAYLOR, SEC-TRES. .c~-x" ,4 .p.-',,.,:/ '/' / ..,~<-:>.~.,-,./ ,..y ,.,-,,' .?'.".. FINANCE DIRECTOR BUSINESS LOCATION-IF OTHER THAN MAILING ADDRESS: 1831 QOLDEN STATE HWY DAT,...E ADDRESS ZIP CODE FEE [ BLOCK NO. BUSINESS LICENSE NO. PERMIT REQUIRED PERMIT NO.' · BUiLDiNG CLASS/TYPE OF OCCUPANCY BusINEss NAME BUSINESS OWNER BUSINESS MGR./RESPONSIBLE i'BUSINESSPHONE HOME PHONE NO. OF FLOORS SQUARE FOOTAGE VIOLATION NOT~CE ISSUED? /~ - OCCUPANT LOAD - oTH E R , DATE OF REINSPECTION (1) (2) (3) INSPECTOR STATION/SHIFT/STATION PHONE ~ -) -/ 19 ~..~ Auto Tire Rebuilding Plants Auto Wrecking .lunk Yard !.taste Handling Bowling Alley. Cci lulose Nitrate Combustible Fibres Compre s.sed Gas Dust ~xplosion Hazard Exp 1 os i 9e s BAKERSFIELD FIRE DE PARI7, ,ff. NT BUREAU OF FIRE PREVENTION Amanuni t ion Flammable Finishes Spray Finishing Flammable Liquids Fumigation Garage Hazardous Chemicals -] Liquefied Pet Gas Lumber Yard F[agnesium PERHIT NO: /%/~--,-' blatches Place of Asembly Tent fl~/Welding & Cutting Hotion Pic Project Airport tleliport Organic Coating High Piled Stock This card is to remaia in a conspic~'.,~s place near the installation until final inspection is made and approved. Final In~l,ection: 19 Inspectc~r: H. RUSSELL TAYLOR le ~ e ~-~ · '~re re~entto~ ._)ervtce HAZ. ALL ~PES OF FIRE FIGHTING EQUIPMENT - POTABLES - SYSTEMS - FIRE A~RMS - SAFETY EQUIPMENT - McCULLOCH CHAIN SAWS-PUMPS-GENERATORS P.O. BOX 2056 AREA CODE 805-321-0704 BAKERSFIELD, CALIFORNIA 1131 GOLDEN STATE HWY, I1 ~ Jn:i: r._.c t t e,,r S ~-~:~ni at'~i~mo,'o,~:F~a~a~'F,,~m~ ;i~,,,~,~i s~4~i .... ~ ........... ~ ........................... ~i-s,~a~-: .......................... '%~ .,~ . MEMORANDUM "WE CARE" January 24, 1990 TO: Jack Highfield, Building Inspector i FROM: Tim Capehart, Inspector, Fire Safety Control ~UBJECT: Inspection of 1831 Golden State Hwy. During a recent inspection requested by Mr..Jack Highfield, at 1831 Golden State Hwy. (H. Russell Taylor Fire Prevention), the below items were noted. 1. Open flame heater was being used in an area where Class I liquids were present, per Uniform Fire Code 79.110 and Sec. 79.114. This is unacceptable. 2. Warning signs were not posted as required per Uniform Fire Code 79.108. 3. A large amount of spilled, petroleum products have been spilled on the ground from a pile of gas powered chain saws. This product has leaked up and into the wood structural members of the building. Per Uniform Fire Code 79.113, flammable or combustible liquids can not be spilled onto the ground, the contaminated structural members must be removed and replaced and the spill properly cleaned up. 4. A tank used for cleaning purposes of engine parts is not approved for this application. Its use must be discontinued until an approved device is supplied. 5. In my opinion, this occupancy could be a B-1 if the use of Class I, II or III-A liquids were discontinued. If not, it is an H-4. 6. In either case of occupancy classification, a one-hour fire separation wall must be provided between a B-2 office portion and a B-1 or H-4. 7. If he does not want to remove the flammables, it, then, becomes an H-4. Other code requirements would have to be met. Tim ~ector Fire Safety Control TC/d GARY J. WICKS Agency Director (805) 861-3502 STEVE McCALLEY Director c;~ .r,r,., · -. c'...-o .?' ' F. RESOURCE ~;ENT D E PA RT~~. ~,I~.~,~,.~:N M E NTAL January 31, 1990 2700 M Street, Suite 300 Baker,,field, CA 93301 Telephone (805) 861-3638 Telecopler (805) 861.3429 AGENCY Russ Taylor P.O. Box 2056 Bakersfield, CA 93303 Re: Referral Inspection at the H. Russel Taylor Fire Prevention Service Facility Dear Mr. Taylor: This Department recently performed an inspection at your facility located at 1831 Golden State Highway on the 22nd of January 1990, to determine the health threat of reported unauthorized hazardous substance releases. Our inspection discovered a release of oil and gasoline on a cement floor within a small room. These substances were in the process of being absorbed with an agent and did not appear to be seeping into the cement or through cracks. In the back yard, obvious waste oil stains were observed near the vehicle maintenance lift rack. In addition to the oil stains in the back yard, several drums on pallets were found toward the rear of the fenced property. They appeared to be in good condition and labeled appropriately. Based on our inspection findings, we have determined that the use and management of hazardous substances does not present a significant or.imminent health threat. As advised during the inspection in accordance with California Code of Regulations, Title 22 you must dispose of waste substances within 90 days after beginning accumulation. Should you have any questions regarding this Departments findings I may be contacted at {805} 861-3636. Sincerely,' e Canas zardous Materials Specialist II Hazardous Materials Management Program JC:cd cc: Jack Highfiel City of Bakersfield Building Dept. Richard Harger City of Bakersfield Fire Dept. canas\taylor, let -Oq RECEIVED FI8 1 ~ ~9~9 HAZ MAT. DI[ I Melayne T. Mills, Haz-Mat Coordinator ~ " (type or print name) Do hereby certify that I have reviewed the attached Hazardous Materials business plan for H. Russell Taylor Fire Prevention Services (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. date BUSINESS NAME H RUSSELL TAYLOR FIRE PREVENTION TD NUMBER 215-000-000596 LOCATION 1831 GOLDEN STATE HIGH HAZARD RATING 3 1. OVERVIEW LAST CHANGE 05/31/88 BY ESTER JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 102 GRID 24B FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) ALL EMPLOYEES HAVE BEEN TRAINED IN USE OF ALL TYPE EXTINGUISHER'S. ALL EMPLOYEES KNOW THE LOCATION OF PROTECTIVE EQUIPMENT (INCLUDING SCBA'S), FIRE HOSES, FIRE NOZZLES AND WATER SOURCES, AND SEVERAL HAVE BEEN TRAINED IN THEIR USE IN FIGHTING INCIPIENT FIRES, AND PROTECTING PERSONNEL AND SURROUNDING PROPERTIES. ~LL EMPLOYE~'S KNOW LOCATION OF GAS AND ELECTRICAL SHUTOFF'S. EMERGENCY CONTACTS 2A SEC 2) H RUSSELL TAYLOR - 325-0704 OR 399-0984 SHERMAN ROOKS - 325-0704 OR 399-7271, & MELAYNE MILLS - 398-9030 OR 325-0704 UTILITy SHUTOFFS 2A SEC 3) A) GAS - NW CORNER MAIN BLDG B) ELECTRICAL - IN SEC C OF CHAIN SAW PART (3) OF MAIN BLDG C) WATER - SW CORNER PROPERTY D) SPECIAL - NONE E) LOCK BOX - NO NOTIFICATION / PUBLIC EVACUATION L,AST CHANGE 2/10/89 BY MELAYNE MILLS BY 911 AND VERBAL NOTIFICATION WITH PUBLIC (CUSTOMER) EVACUATION THROUGH MAIN EXIT, NE SIDE, AREAS 2 OF MAIN BUILDING. iF~THIS EXIT IS NON-FEASIBLE, EXIT THROUGH THE NEAREST DOOR, AWAY FROM THE FIRE OR UP-WIND FROM A SPILL (OR RELEASE), INTO SAFE PERIMETER AREA. PAGE 1 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 12/27/88 15:33 BUSINESS NAME H RUSSELL TAYLOR FIRE PREVENTION ID NUMBER 215-000-000596 LOCATION 1831 GOLDEN STATE HIGH HAZARD RATING 3 3. HAZ MAT TRAINING SUMMARY LAST CHANGE 02/10/89 BY MELAYNE MILLS WE HAVE A FORMALIZED HAZ-MAT ~TRAINING~(~^~" FILE IN OUR SAFETY OFFICE. TRAINING HAS INCLUDED EMPLOYEE 1 ON 1 SESSIONS-OVERVIEW OF MSDS, THEIR LOCATION AND INTERPRETATION. WE HAVE USED SEVERAL PREPARED HANDBOOKS AND VIDEOS TO COMPLIMENT UNDERSTANDING MSDS AND RIGHT-TO-KNOW ISSUES, AND VERSED EMPLOYEES OF HAZARDOUS MATERIALS ON LOCATION, AND LABELING SYSTEMS. WE MEET QUARTERLY WITH EMPLOYEES TO UPDATE AND REVIEW, RETRAIN ANNUALLY, AND TRAIN NEW EMPLOYEES WITHIN THEIR FIRST 90 DAYS ON-SITE. WE HAVE MSDS AND HAZARD COMMUNICATION DATA IN BOOKLETS AVAILABLE TO ALL EMPLOYEES OR PUBLIC OR FIRE PERSONNEL, ADJACENT TO THE SAFETY OFFICE, AND WE ARE VERY WILLING TO DISCUSS ANY PERTINENT ISSUE AT ANYTIME. EMPLOYEES ARE ALSO TRAINED IN DETECTION PROCEDURES OF HAZARDOUS MATERIALS RELEASED OF SPILLED ON-SITE, AND PROPER NOTIFICATION PROCEDURES. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 05/31/88 BY ESTER 2A SEC 5) ALL EMPLOYEES ARE AWARE OF "911" ASSISTANCE AND EVACUATION PLANS. SEVERAL EMPLOYEES ARE CERTIFIED IN CPR, FIRST AID, AND EMT CARE. ALL EMPLOYEES HAVE BEEN ADVISED OF MERCY HOSPITAL' S DECONTAMINATION UNIT, AND THE NEARNESS OF SAN JOAQUIN HOSPITAL AND HELIPORT. ~ PAGE 2 ~2/27/BB %5:33 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME H RUSSELL TAYLOR FIRE PREVENTION ID NUMBER 215-000-000596 LOCATION 1831 GOLDEN STATE HIGH HAZARD RATING 3 FACILITY UNIT 01 ae OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 06/08/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 PURE KEROSENE 110 GAL MODERATE DRUMS OR BARRELS MET...FUEL ID PERCENT COMPONENTS DOT ID#1223 100.0 KEROSENE W-SIDE BLDG #8 (OUTSIDE) HAZARD LISTS EXTREME 2 PURE GLYCERINE ID DOT ID#2402 55 GAL LOW DRUMS OR BARRELS MET...OTHER PERCENT COMPONENTS HAZARD LISTS 96% GLYCERINE W-SIDE BETWEEN BLDG. 7&8 (OUTSIDE)LOW MIXTURE GASOLINE 640 GAL HIGH ABOVE GROUND TANK FUEL ID PERCENT COMPONENTS (NOTE: WAITING FOR NEW MSDS) DOT ID#1203 GASOLINE W-SIDE BETWEEN BLDG. 7&8 (OUTSIDE) HIGH PURE DIESEL ID DOT ID#1993 MIXTURE~2 CYCLE OILS/AND SMALL AMOUNT OF GASOLINE 110 METAL CONTAINERS WASTE ID PERCENT COMPONENTS SE BLDG. #8 (OUTSIDE) DOT ID#1071 MOTOR 0IL ~ 110 GAL MODERATE DRUMS OR BARRELS MET .... FUEL PERCENT cOMPONENTS (NOTE: WAITING FOR NEWMSDS)HAZARD LISTS 100.0 DIESEL FUEL NO.'2 MODERATE GAL UNKNOWN HAZARD LISTS UNKNOWN MIXTURE TRICHLOROTRIFLUOROETHANE DOT DRUMS OR BARRELS MET .... OTHER ID ? 100 PERCENT COMPONENTS TRICHLOROTRIFLUOROETHANE 55 GAL LOW HAZARb LISTS LOW PURE OXYGEN STORAGE AREA 3 & 9 PORTABLE PRESS. CYL. ID PERCENT COMPONENTS DOT ID#1072 99.5 856 FT3 HIGH WELDING/SOLDERING HAZARD LISTS HIGH PURE ACETYLENE AREA 3 PORTABLE PRESS. CYL. ID 100 PERCENT COMPONENTS DOT ID#1001 250 FT3 WELDING/SOLDERING EXTREME HAZARD LISTS PAGE 3 12/27/88 15:33 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME H RUSSELL'TAYLOR FIRE PREVENTION ID NUMBER 215-000-000596 LOCATION 1831 GOLDEN STATE HIGH HAZARD RATING 3 FACILITY UNIT 01 no OVERALL HAZARDOUS MATERIALS INVENTORY ( * CONTINUED * ) LAST CHANGE 06/08/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 9 PURE NITROGEN AREA 9 PORTABLE PRESS. CYL. ID PERCENT COMPONENTS DOT ID #1066 99.9 NITROGEN 1824 FT3 MODERATE USE CODE 99 OTHER MODERATE 10 PURE CARBON DIOXIDE 3490 FT3 LOW AREA 9 PORTABLE PRESS. CYL. USE CODE 99 OTHER ID PERCENT COMPONENTS HAZARD LISTS DOT ID # 1013 99.5 CARBON DIOXIDE LOW 11 PURE HALON 1301 267 FT3 LOW AREA 9 FIXED PRESS. TANKS OTHER ID PERCENT COMPONENTS HAZARD LISTS DOT ID#1009 100.0 MONOBROMOTRIFLUOROMETHANE LOW 12 PURE HALON 1211 300 FT3 LOW AREA 9 PORTABLE PRESS. CYL. OTHER ID PERCENT COMPONENTS HAZARD LISTS DOT ID#1974 100.0 BROMOCHLORODIFLUOROMETHANE LOW 13 14 ADDITION MIXTURE 2 CYCLE OIL 55 GAL AREAS 6-2 PLASTIC CONTAINERS ID PERCENT COMPONENTS ~ DOT ID#1071 (UNKNOWN PERCENT, WAITING FOR NEW MSDS, 'UNKNOWN IF ANY M C.A.S. #) ADDITION MIXTURE "TRPLEX" ABC AREA 9 METAL CONTAINERS DOT ID? PERCENT COMPONENTS MONOAMMONIUM PHOPHATE (UNKNOWN C.A.S.#, NOT AVAILABLE PERCENT) M 1000 LBS NO HAZARD 15 MIXTURE PURPLE K POWDER AREAS 9 & 10 METAL CONTAINERS DOT ID? PERCENT COMPONENTS (UNKNOWN C.A.S.#, PERCENT NOT AVAILABLE) 1000 LBS NO HAZARD OTHER PAGE 4 12/27/88 15:33 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~ BUSINESS NAME H RUSSELL TAYLOR FIRE PREVENTION ID NUMBER 215-000-000596 LOCATION 1821 GOLDEN STATE HIGH HAZARD RATING 3 FACILITY UNIT 01 ao OVERALL HAZARDOUS MATERIALS INVENTORY ( * CONTINUED * ) LAST CHANGE 06/08/88 BY ESTER 16 MIXTURE DRY CHEMICAL - BC POWDER AREAS 9 & 10 METAL CONTAINERS DOT ID? PERCENT COMPONENTS (UNKNOWN C.A.S#, PERCENT NOT AVAILABLE) 1000 LBS OTHER Be 3A SEC 4 ) FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 05/31/88 BY ESTER MANY TYPES OF FIRE EXTINGUISHERS ARE AVAILABLE FOR USE ON INCIPIENT FIRES, AND FIRE HOZES AND FIRE NOZZLES ARE AVAILABLE FOR USE IF NECESSARY. HYDRANT WRENCHES AND TWO COUNTY (KCFD) FIREMEN TRAINED IN FIRE SUPPRESSION ARE PART- TIME EMPLOYEES. HOWEVER, THERE IS NO CENTRAL ALARM OR EXTINGUISHMENT SYSTEM INSTALLED ON-SITE~- FIRE EXTINGUISHERS FOR SUPPRESSION OF CLASS A,B,OR C FIRES ARE LOCATED IN EVERY ROOM, IN VERY BUILDING. 3A SEC 2) EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 05/31/88 BY ESTER VERBAL NOTIFICATION ALL EMPLOYEES HAVE BEEN ADVISED OF EVACUATION PROCEDURES, I.E., EVACUATION FROM CLOSEST EXIT, AWAY FROM INCIDENT SITE, OR UP-WIND IF POSSIBLE, AND INTO A "SAFE" PERIMETER AREA. NOTIFICATION OF APPROPRIATE AGENCY(S) IF POSSIBLE, THRU "911" OR RELEVANT NUMBERS. (~HAZ-MAT DIV. OF BFD 326-3979 AND OES 800-852-7550~ ~ C¼e~Tr~ PAGE 5 12/27/88 15:33 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800' BUSINESS NAME H RUSSELL TAYLOR FIRE PREVENTION ID NUMBER 215-000-000596 LOCATION 1821 GOLDEN STATE HIGH HAZARD RATING 3 FACILITY UNIT 01 MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 05/31/88 BY ESTER 3A SEC 1) ALL ~EMPLOYEES HAVE RECEIVED TRAINING IN SAFETY PROCEDURES REGARDING ALL HAZARDOUS OR POTENTIALLY HAZARDOUS EQUIPMENT OR MATERIALS. ALL HAZARDOUS OR POTENTIALLY HAZARDOUS MATERIALS HAVE BEEN PROPERLY CONTAINED, LABELED, AND STORED. THE FIRST AID/SAFETY AND FIRE PREVENTION AND HAZ-MAT STAFF KEEP CURRENT OF EDUCATIONAL AND COMPLIANCE DATA. ALL EMPLOYEES HAVE BEEN ADVISED AND TRAINED IN EMERGENCY PROCEDURES IN CASE OF ACCIDENTAL SPILLS OR LEAKS. WE HAVE TRIED TO SEGREGATE ALL POTENTIALLY HAZARDOUS MATERIALS .INTO "NON-REACTIVE" AREAS. ALL CYLINDERS ARE UPRIGHT AND CHAINED, VALVES MAINTAINED; THE ABOVE-GROUND GASOLINE STORAGE TANK IS 15 FEET FROM THE FENCE LINE AND NEAREST BUILDING WITH A THREE FOOT HIGH CINDER BLOCK RETAINING WALL SURROUNDING IT, CONNECTING CONCRETE SLAB AS THE BASE AND THE TANK HAS A VAPOR NOZZLE; THE CHAIN SAW WASH DOWN TANK IS ENCLOSED WITH A "DRIP-DRUM" FOR WASTE OIL/GAS (OUTSIDE) AREA 3 OF MAIN BUILDING; ALL VALVES AND GAUGES REGULARLY MONITORED ON EXTINGUISHER AND HYDRO-TESTING EQUIPMENT; WE HAVE KITTY LITTER AND HAZ-ZORB ON-SITE FOR SMALL SPILLS - EMPTY DRUMS WE CAN SEAL FOR TRANSPORT, AND COOPERATION FROM I.T. IN BUTTONWILLOW FOR CLEAN-UP; ALL MATERIALS ARE PROPERLY LABELED AND EMPLOYEES WHO SMOKE ARE CONSTANTLY REMINDED OF THEIR CLEARANCE AREAS. ALL HALLWAYS AND EXITS ARE KEPT CLEAR FOR USE AND GAS/ELECTRICAL SHUTOFFS ARE FREE FROM DEBRIS AND MATERIALS. SMALL AMOUNTS OF HAZARDOUS MATERIALS NOT IN DRUMS, ARE IN THE COOLEST, MOST WELL VENTILATED, YET COVERED AREA, BUILDING #7. A GERMAN SHEPARD IS ON PREMISES AT ALL TIMES AS WATCHDOG (DOGHOUSE & DOG RUN) ADJACENT TO GAS SHUTOFF NW CORNER OF MAIN BUILDING. ALL WASTE OIL DRUMS ARE PROPERLY LABELED AND ARE HAULED AWAY OR CLEANED BY A LICENSE~ WASTE HAULER WHEN FULL., PAGE 6 1~2/27/88. 15:33 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 WRITTEN HAZARD COMMUNICATION PROGRAM H. Russell Taylor's FIRE PREVENTION SERVICE, INC. 1831 Golden State Hwy. P.O. Box 541 (805) 325-0704 Bakersfield, Calif. INTRODUCTION: Our Haz-Mat Dept. has developed a Hazard Communication Program to enhance our employees health and safety. As a company we intend to provide information about chemical hazards and other hazardous substances, and the control of hazards via our comprehensive Hazard Communication Program which includes container labeling, Material Safety Data Sheets (MSDS) and training. The following program outlines how we will accomplish this objective. CONTAINER LABELING It is the policy of this company that no container of hazardous substances will be released for use until the following label information is verified: Containers are clearly labeled as to the contents Appropriate hazard warnings are noted The name and address of the manufacturer 'are listed The responsibility has been assigned to Haz-Mat Coordinator. To further ensure that employees are aware of the hazards of materials used in their work areas, it is our policy to label all secondary containers. The supervisor of Haz-Mat Dept. will ensure that all secondary containers are labeled with either an extra copy of the original manufacturer's label or with generic labels which have a block for identity and blocks for the hazard warning. MATERIAL SAFETY DATA SHEETS (MSDS) Copies of MSDS for all hazardous substances to which employees of this company may be exposed are kept in Haz- Mat/First Aid/Safety Office. They will be responsible for obtaining and maintaining the data sheet system for the company. The Haz-Mat Coordinator will review incoming data sheets for new and significant health/safety information. He/she will see that any new information is passed on to the affected employees. (If alternatives to actual data sheets are used, provide a description of the system.) MSDS will be reviewed for completeness by Haz-Mat/Safety Office. If an MSDS is missing or obviously incomplete, a new MSDS will be requested from the manufacturer. Cal/OSHA (or Fed-OSHA) will be notified if a complete MSDS is not received. MSDS are available to all employees in their work area for review during each work shift. If MSDS are not available for new hazardous substances(s) in use do not have MSDS, please contact the Haz-Mat Coordinator immediately. EMPLOYEE INFORMATION AND TRAINING Employees are to attend a health and safety orientation set up by Haz-Mat Safety Office prior to starting work for information and training on the following: An overview of the requirements contained in the Hazard Communication Regulation, including their rights under the regulation. Inform employees of any operations in their work area where hazardous substances are present. Location and availability of the written hazard communication program. Physical and health effects of the hazardous substances. Methods and observation techniques used to determine the present or release of hazardous substances in the work area. How to lessen or prevent exposure to these hazardous substances through usage of engineering controls, work practices, and/or the use of personal protective equipment. Steps the company has taken to lessen or prevent exposure to these substances. Emergency and first aid procedures to follow if employees are exposed to hazardous substance(s). How to real labels and review MSDS to obtain appropriate hazard information. NOTE: It is critically important that all of our employees understand the training, If you have any additional questions, please contact: Haz-Mat/First Aid/Safety Office. When new hazardous substances are introduced, Haz- Mat/Safety Office will review the above items as they are related to the new material in your work area safety meeting. e LIST OF HAZARDOUS SUBSTANCES The following is a list of all known hazardous substances present in this business. Specific information on each noted hazardous substance(s) can be obtained by reviewing the Material Safety Data Sheets. EXAMPLES: Hazardous Substances (ie) Olin Fuses Kerosene LIST Work Area or Process (ie) Resale/Safety Flares Use As Solvent/Fuel Se HAZARDOUS NON-ROUTINE .TASKS Periodically, employees are required to perform hazardous non-routine tasks. Prior to starting work on such projects, each affected employee will be given information by their supervisor about hazards to which they may be exposed during such an activity. This information will include: Specific hazards. Protective/safety measures which must be utilized. 'Measures the company has taken to lessen the hazards including ventilation, respirators, presence of another employee and emergency procedures. Examples of non-routine tasks performed by employees of this company: Task Hazardous Substance Wash Down of Chain Saws or Chain Saw Parts Gasoline or Solvent (Site Drawing NW-3) HAZARDOUS SUBSTANCES IN UNLABELED PIPES To ensure that our employees who work on unlabeled pipes have been informed as to the h~zardous substances contained within, the following policy has been established: Prior to starting work on unlabeled pipes our employees are to contact Haz-Mat Safety Office for the following information: > The hazardous substance in the pipe. > Potential hazards. > Safety precautions which shall be taken. INFORMATION CONTRACTORS. To ensure that outside contractors who safely in our plant, it is the responsibility of the Safety First Aid Office to provide contractors the following information: Hazardous substances to which they may be exposed while on the jobsite. Precautions the employees may take to lessen the possibility of exposure by usage of appropriate protective measures. If anyone has questions about this plan contact: Safety and First Aid Office· Our plan will be monitored by Safety Office to ensure that the policies are carried out and that the plan is effective· (Signature) F AX~~~~. ~ >Haz-Mat Coordinator/Fire and Fire and Safety Assistant BAKERSFIELD CITY FIRE DEPARTMENT · 2130 "G" STREET JUL 13 1987 BAKERSFIELD, CA 93301 BUSINESS N~ME OFFICIAL USE ONLY ID# ~ HAZ~%I~DOUS lvI~kTERI ALS z ' ~p..~ \ · ' BI. TS 'i" N~-$S ~I:>oL~A~2AAS A T~HOL ~-~/'7 ~'~--d;7 ~ ' · ::-~" ,,', ,: ': ', i.'. ,':,:., :' ,'.",-:;.-:,?,'."':,'"':,:; :?~i'.':::' '.~ !,:,:..,:, .~-:,~ .:,:~-..:'~,' ..... i:.L:i!',>:,":':?":,::?, :.:,':::,.:~::? !,~, J !', ~'": " ' '""'W~ :' ', .., '." .-.':' ~ ,' -, ':,-"'F ~:' .::~:"V~' "': "L' ~:'~ >TM '~":: '.~:': '"'::'+":"~::,:: : .: ~ :'::' ': ;. :':>:~':':'::': ¥~:~:~:~:~:T:t :.~F:~[.~:~Ff:~f.~`:~t[4`~`~:~`~[~`~:~.~. ~ · "' "-~ 3. Answer the questions belo~ for the business"'AA' a' · , ~:, ~'-4 Be as brief and concise as possible ':.:'..:.: ;.:::~,.~.~'..~_:.v,~.,,':g~.',:,:~.~'.:,:~,~.:~'.~?,e~g"~f~A~G~zz:: ::.~,,',':~ ..... '' 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 wilI'n°ttf¥ ..: your local fire department and the Sta.t~ 'Office of Emergency Services as required by law. .. .EMPLOYEES' TO NOTIFY IN CASE OF EMERGENCY: ' " '' ": ', '- ....... ' '-' A.~.NAME AND TITLE 'T~'"O '.'::'..... .... D~ING BUS, ~RS. 'AFTER BUS. ~S. , . . C. WATER: .~'L~} D. SPECIAL: ' E. LOCK BO~: YES /~ IF YES, LOCATION: . , . IF YES, DOES IT CONTAIN SITE PLANS?' YES / NO MSDSS? FLOOR PLANS? YES / NO KEYS? ri '') YES / NO YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SE~ION' 5: LOCAL EMERGENCY MEDICAL ASSIST.~N'CE FOR YOL~ BUSINESS AS A WHOLE ..'. - :. :'..::L~y~:~:~:~-~:, .:~.~:.,:~: ,..~.~?t:t4~O~':.;.;~.x~;'-~: ~-',"::-~..,::'.~-::.:::u'~':..r:.%~i.~:f::~-/~:q-~::;~q:~'~:~'~;:~ - : ~ .',. ~.~'~F" ' ' ::," ' " :-~'~ ..... ~-~-'~'~ ........... ~?~.'-~-..~- ~,, '-~i.~.,. ~"*~,.~..-;:'-';-~ ,'%,~'~,;~r~'¢~d~T~.~(~' rZ~ .~,;,~*.~.::-~; . :'EMPLO~RS ARE REQUIRED TO ~VE A PROO~M ~HICH PROVIDES ~PLOYEES WITH INITIAL . ~ ~,~ .--;,,.... . . - · ' ...... ',..t-.?~t,5~:/~.::,*..v. · ' V ~":, .-.: '." ' '~' "~ ' ~' ..: :~.. ~r~s: .... · ...... ' .... :,.: ...... ~ ........................... :~5~}. _~0 ...... ~ ~o B. PROCEDURES fOR COORDINATING ACT[V[TrES __ ~'" ... ':' '. · - ~z~ ~s~o~s~ A~cz~s: ........................""'~ ~o ~s ~o ~o~ ~s~ o~ s~ ~~: ...... '. .... - ....... ~ ~o .' ~s .C.. tEMERGENC~ EVACUATION PROCEDUR" S:... ~ .'~ ............ '-~:~ NO '.x YES -NO E DO YOU ~INTAIN EMPLO~E TRAINING RECORDS:...,,..'..:' ~ NO '"". YES NO - ME.ION 7: ~Z~OUS ~RI~ ' · · . . '~-.:... ::.. ~ ;'.L :~..~:..'..~:.~=x".. -. .... .- .~..~. ..*~ ROB OR ~O :' : '~"~ ':~' ..... '~ " ..... '~:-DOES ~O~R B~SI~ESS'~E ~X~RDO~S ~WERI~L. I~ q~ITI~S hESS T~ ~00 POB~OF "..I~J~[~ ~ ~/~ff-. (, ~'~ ,~erttf~ th~ the aaove. ~nror~a~ion ~s aeeueare~ '"I Understand that ~h~a Infor~atio~ ~11 be used to ful~fll ~ 'f~e~'s obligation -..:.th~ ne~ California ~ealth and Safer7 Code on ~azardoua ~ateeial8 {B~.'~O Cha~ter '~ Seo. g~O0?t~, ~1.) and that tnaceu~ate.tnfo,~ation constitutes pe~ju~ -%~..~..:-: ..... ~. ~U,S=t[ ~[Oa'S.2::: .. ' ...:.d: .~ ',~: '.... ~ ..... ' ::..-/~ ~.2:..:-7'~'_ (j~ :':~ .'~. :~ .- "'~'~';; .~'. . ~..' -'i{~ , ~',.:' '-' ' ' ' ' ., ~* ~ .' : "'~'7. - . . ..... .. · . BAKERSFIELD CITY FIRE DEP.~RTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 BUSINESS NAME: OFFICIAL USE ONLY ID# SINGLE FACILITY UNIT F ORlV~ v ' ' "': ' . ' - :-. 1. To avoid further . "-.. 2. TYPE/PRINT YOUR ANSWERS' IN ENGLISH. ., ',-.~,-)~: .'~ 1',,:.::':~;~ .,,'.~ ',..3. Answer the questions below for THE FACILITY. b~IT LISTED' ':.-7'z'- -' . .Tjx.'., ~,~..'::-.. · t':"~· ., , - . ~l~ I- r · .. :.'... u-' - ................. '- SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS L~!T ONLY' . m~ef5. " ~.' :'" SECTION 3: HAZARDOUS MATERi.a..LS FQR THIS U%riT O.Y. LY .A. Does this Facility Unit contain Hazardous Materials? ...... ~~O If NO, continue with SECTION 4. L 6r~e~ ~%~OU~l~ B. Are anF of the hazardous ~aterials a bona fide Trade Secret · If No, 'complete a'separate hazardous ~teriais inventory form ~arked:'NON-T~AOE SECRETS ONLY (whi~e for~ If Yes, complete a hazardous materials inventory form -k T~DE SECRETS ONLY (yeliow form g4A-2) in addition to the non-trade :.secret form. ·"·List 'only the trade secrets on form 4A-2 .... "......~. .... · [ .... ~?:=:i::I/.SECTION -5: - LOCATION' -OF WA~R SD~PLV FOR USE BY E:~GEN~ RESPO~ERS- · B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: SITE PLANS?~ ~,' NO MSDSs? I ~~ . Jl' ~ 0 FLOOR PLANS? YES /' NO KEYS? YES / NO NORTH SCALE: DATE: / / BUSINESS NAME: FLOOR: OF FACILITY N~ME: UNIT ~: OF · . (CHECK ONE) SITE DIAGR.%M FACILITY DIAGR.~M Inspector's Comments): -OFFICIAL USE ONLY- I.D. BAKERSFIELD CITY" FIRE DEPARTMENT. ,. ,FORM 4A-1 NON--TRADE',:. SECRETS '. " HAZARDOUS MATERI ALS BUSINESS NA~,E:ti,~':~II 7~)~laI? F~,~ 2~n~.~ o.~. s~.~:-~, t~eil ADDRESS :/~'.~i ~Oi~',f'~' ~'f~ ~. ADDRESS: CITY, ZIP:, 13~Fer,si~gia . Oa, "~'3>3a'3 CITY,ZIP; NVENTORY FACILITY UNIT NAME: UNIT #: FFICIAL USE CFIRS CODE ONLY i 8' 9 ...... '1'0 1 2 3 4 5 6 ,7 . TYPE MAX ANNUAL CONT USE LOCATION' IN THIS '~ · BY '.':i. ' '.- ,': HAZARD D,0, CODE AMO.UI~T~.;AMOUNT UNIT CODE CODE ' FACILITY_UNIT . :'i: ,~.l~. '"CHEMI(~A~OR COMMON NAME , CODE GUI[ :"~/. ../.'t' h.~¢ ; ' ,..:- 'i~:~c Pk~ ~"'.-):'~2raOo,~..'~ · , ,... ........ / NA~E: ' TITLE: $IONATURB ~? DATE: E~ERo~NCy cONTACT-: .TITLE{ , '..- .... ,~ .... ~-~': PHONE # BUS, HOURS: EMEROENC¥ CONTACTi'""':.' "" :. -.. , . ,: iTLE.~:..,,.:':.-:f'[.-&?:,i.L~,' :~i ~,:::::~/.. AFTER BUS HRS: ................ ? = ~_ ~'~:':"-: .... ~ ; :'=':::':i','"FHONE # BUS HOURS; PRINCIPAL BUSINESS~ACT'IVITV; :. AFTER BUS HRS;~ BAKERSFIELD CITY FIRE DEPARTMENT I.D. # -~ FORM 4A-1 Page -~ f¢ NON--TRADE SECRETS BUSINESS NAME: ~{- ~ --f'~~ ~ NER NAME.' FACILITY UNIT #:~ ADDRESS: ~ ADDRESS: FACILITY UNIT NAME: CITY, ZIP: CITY,ZIP: PHONE ~: PHONE #: [OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 ? 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS ~; BY HAZARD D.O.' CODE AMOUNT AMOUNT UNIT CODE CODE .FACILITY UNIT {~T. CHEMI(~AL OR COMMON NAME CODE NAME TITLE: SIGNATURE: .. ~ EMERGENCY CONTACT: TITLE: -' '..:':~ ,. EMERGENCY CONTACT: TITLE: ~': :';?!:':~::(:'' PRINCIPAL BUSINESS ACTIVITY: - 4A-1 .- PHONE # BUS HOURS: AFTER BUS HRS: PHONE # BUS HOURS: AFTER BUS HRS: DATE: I, !) · # : .... .'.'. 2':: ~[1 ';".' :t;':ii.".";"':'""~:'i";'!~';:i'.'~"~ F 0RI~" 4 A ~- 1. _ .. :,~. ... ... : "' '-' ......,.~/1,~[4 ' ''''_. ':': (" :",.~ .:,,?.. ". . .':.,:'; .: page : ":"(;" "':':- ' .:':':NON~"TR'ADI~-'t' 8 ECRE~ . ' " · OWNER NAME: - FACILITY.UNIT .#: ADDRESS: /?..'-F/ ¢c ~-~4/ ' ~/'/¢-'~,~' :'~.~/~"!"?'"'":>~"{A!)DR~.SS:~'" '~' := FACILITY UNIT NA~E:' PHONE #: ~r'O,~-,_~&~.;~--~)¢~/ '-' ' '.""""' '' '.' !'~"PHONE #: " [OFFICIAL USE C~IRS coDE ~.. · ' ': ' "~',"~ ' ~ ' '"" ,,:."?'~:'%~ .... ':: [ ONLY ' 1 TYPE MAX ANNUAL CONT USE:::; -?:LOCATION'~i-IN '.THIS ii BY ' : .-.' - :HAZARD D.O. lODE AMOUNT A~OUNT UNIT CODE CO.DE ~ FACII'.ITY.:UNIT' ,WT. CltEI~ICAL' OR-CO~O~ ~E ..CODE GUID ~'~ :'~ ~ .~ ;:-- 1: . ..... ~;';~,'-. ' · . . . : ..,, v, ~:: . . ..< ',. '.[ : .-;':,..~..?';'.- '~ "' ........ '.:J ' :' .. " ':~ :, :~ :x ."~ .:: ''.' . · : .-¢ ,,.~ k:. .; ....... ~? :'.~. · . :: t: '.- , · · ,; ~% '. . : · -, ~ :,: : [' · ... .:-..::, - ,. .. ,:: ,~ >-~ ·,:: . ;:., . ..... :,.:. ....... .: ::-> . .,,, ~.....::'..:: :'::>,~-:~, .:- .. ./ - O roT~ I H. l~sselt Tayler's . FIRE PREVENTION SERVICE , INC. communication Program to enhance our ' ,As a company we intend to pr. ovide information· about chemical hazards and other hazardous substances, and the cont. rol of hazards via our comprehensive Hazard Communication Program which includes container labeling, Material · ~?e,~y 0"" ,-, c~ta Sheets (MSDS) and training.." ~ne {oflowing pzogram eu~'hnes ' ' 4. - CONTAINER LABEL}NG It is the policy of this company that no cont.ainer of hazardous substances will be released for use until the following label information is verified: ~. Containers are clearly labeled as to the contents ~.. Appropriate hazard warnings are noted .. >. The name and address of the manufacturer are li.,*..?~,d~ .. ' This resconsibility has been assigned to ~J'~~. ' :-'.' ; ",',': , ..... .:..::.:~ " To further ensure that employees am a~are of the hazgrds of :- .,:" ... materials used in their work areas, it is our policy to label all ". . secondary contain~r~, .... . . ' - ' : ' · ": ': .':":~:-'::-:.':'?:?':~';?':'::;'.- -"- -'-' - :..'. 't."~ '::.". ?'...'.The supervisor ~:';[~1 ensure that all '.::, .}..: :~. : .-' secondary cont~i~rs ar~ la~led with either an extra copy of the original manufacturer's label or with generic labels which ,' -." -' ' , have a block tot denbty and'olocks for the hazard warnm~ -"t:: .t; ' ': .... . .' · ' ' ' ' -" ' '" ~ ' '. :-,' , ' ' --"~ '-- '::-'~';'~5:' :'~r-:::~': --':'~%~¥;:" -- .. -, . (~SDS) : -...-:..... :,,, .:-..;-. ¢, =.:-. .:.:- .,.~ Copies of :MSDS for sll hazsrdous subst'ance~ t5 ,;~h'icS'Z:L;Z.:- ............ :._L:'' , ........ '.:,. · .- ; · ema~oyees of this company may b,e:,exposed are kept in .' . ~6 . ~- will be ' -. responsible ,or obtain[ng ~ .m. ai~taining the dat~ shee~ ............... : ............ .-7 .... system ~or the company. - . .. 0:~~¢~wi'l review i~comi~g dat~ sheets for ~ew ~nd significant heath/safety information. He/she will' see that ' " :' ":":':':""}:' any new informstion is passed on to the affected employees. ...., (If alternatives to actual da[a sheets are used, provide a :;.. , -'..., ',~.-.':" description of the system.) . _' .. ....: · .... If an MSDS is missing or obviously incomplete, a new MSDS ... will 6e requested from the manufacturer. Cai/OSHA will be ~ ~ · .': nod,l.d ~, a ~omvlete MSDS is not received. ~ .... MSDS are available [o all employees in their work area for review during each work shift. If MSDS are no( 8v~i~¢,.".' or · new hazardous substance(s) in use do not have MSDS. 3. EMPLOYEE INFORMATION AND TRAINING Emp_loy,ees ale ~o~?attend a health and safety orientation set up by ~-'~_~_ O_~L/CJO, prior to startihg v, ork for. infor'mation and tr~inlng on the following: An overview of the requirements contained in the Hazard ' Communicatio'n Regulation, including their rights under Inform employees of any operations in their work area where hazardous substances are present. ' .. Location and availability o'f the written hazard .¢~ Physical and hea'ith effects of the hazardous -, '~' Methods and'observatiOn techniques usedto determine'~--¢~'~ '- the presence or release of hazardous substances in the ' How to lessen or pre~)ent exposure to these h~ardous sub- -.-;;:..: '. stances through usage of engineering controls, w~rk practices, and/or the use of personal prote6tive equipment. '" Steps the.compa'nY'hss taken to--lessen-or Prevent ............. ::: ......... ' ' "" eXPosure tb the~'~'subs~nE~s: .......... 7--7~-~'--~:.' .......... Emergency sn'd ~,first aid procedures to follow if employees are exposed [o h~zardous substance(s). .: · ... How to read labels and review MSDS to obtain appropriste hazard information. NOTE: 1[ is c~iti'cs.liy important thai all of our employees understand the training. I~ you have any a'ddi[ional ...... When new.hazardous substances are introduced, relate~o the new material ~n your work 2rea ssfety meeting. 4. LIST OF HAZARDOUS SUBSTANCFS The following is a list of all known hazardous substances present ~,n'E/,x. cL.~t,~t,.;~;~. Specific information on each noted hazardous substance(s) can be obtained by reviewing the Material Safety Data Sheets. ---- about hazards to which_they may be expOsed during such an activity ................. ............................... This !nformation will include: Specific hazards. Protactive/sa/ety measures which must be utilized. >- Measures the company has ~aken to lessen the hazards including ventilation, respirat, o_rs, presence of another employee and emergency procedures. ' ,¢~ampl~l of non.routine tasks performed b'/ employees cf this "comTany: TASK HAZARDOUS SU3STANCE LIST HazardauS Substances·(ie) Work Area or ?rocass ,'ia affected employee will be given information by their supervisor 8. HAZARDOUS SUBSTA?.ICF_.S IN UNLABELED PIPES To ensure that our employees who work on unlabeled pipes have been informed as to the hazardous substances contained within, the following, policy has been established: Prior to star.ting ,,vor. k on un abeled pipes our emoloye,',s are to- contact g (~ ,,for the following information: >- The hazardous substancs in the pipe. . ,. ::-;~ >' Potential hazards. >- Safety precautions '-'~.i~'-'.::.; :~ '.: , which sh~ll be taken. ~:--' .' :-... ' ' - ' ',-.. ', -. ." · ":-~' ~ ~ N ~ ~ "· ~' ' :' ~ .': , .. ;'~ t'. ' '~' ':,~0~* ' .'~ '":.'?,'~ INFOR~v]h4G CO,Il RAC ~ ORS ..: ........... ' : .- '... ...... ?.;-,..,.,."-~ -'-..-' ..... ~.?.~..~,~,.:,'~..~,:.,,~..:~,':~ ,.. ,:,- ~:..-,~ ~t-, :, ';,' ,: . ' . -. ' .. , '.' ' ' . .,':,'¢ ; '. :' ' .. ' '-'. ~ , .~.. '%.'-.,t:Lt~i::~. ,;.~- - t:' ,,.,,:,¢ ?, ~t~,' ~., . ' To ensure that outside contractCrs work safely ~n~ug~l'ant, it'is" =.the responsibility of ~"~-~l~'~/l~,~:2/~ /~ '. ..... , .... v.:-:_:. __ :.._~_2= :'L'. prov~d~ contrac,ors ,he ,ollowi~g iMormation: ~ ' .~ t.:t.. - .... ..7... ~ Hazardous' sBbs(~Ces ~o ,z/hic,~ they~y._be exposed-while on the/obsite. .. · ·" '~' :'~" >" Precautions the ,.mploye,,s may take to lessen the possibility :..-.~ · ~::. . .. · ... of exposure by usage of appropriate protective measures. ' ' ~. . - ..'::.::.::?' Our plain ,,ill be m,.,nit, ored by..~,ld-~..¢~/~¢_..~ 'to ensu-,'~ the: FIRE DEPARTMENT O.S. NEEOHAM FIRE CHIEF CITY of BAKERSFIELD "WE CARE" OCTOBER 13, 1988 2101 H STREET BAKERSFILED, 93301 326-3911 . H..RUSSEL TAYLOR FIRE PREVENTION CO. ~ , 1831 GOLDEN STATE HWY. "~. BAKERSFIELD, CA 93301 ...... · '~':~.:~.' DEAR ~R. 'RUSSEL TAYLOR: :,~'~': ' :;'-'..: ~ :':~ '- '~ TH~ ENCLOSED "ACUTELY HAZARDOUS MATERIALS .'-.'~"i?MUST BE COMPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUM QUANTITY OF ANY MATERIAL ON THE EPA LIST'OF:..t~.,:,7,&.:t,~:L'~'/!~?:C:..~i -''.::.:,iEXTREMELY HAZARDOUS SUBSTANCES, '-'{FED, REGISTER ...... :: ??, P, 13397), .... YOUR COMPANY FAS REPORTED HANDLING T~E . .. -- ."'.FOLLOWING ACUTELY HAZARDOUS MATERIALS: SULFURIC ACID :'. PI~EASE RETURN THE COMPLETED ACUTELY HAZARDOUS MATERIALS -'4;:: REGISTRATION FORM TO: .. HAZARDOUS MATERIALS DIVISION 2130 G STREET BAKERSFIELD, Ck 93301 IF YOU HAVE ANY QUESTIONS REGARDING THIS FORM PLEASE CALL RALPH HUEY AT 326-3979. SINCERELY YOURS, RALPH E. HUEY HAZARDOUS MATERIALS COORDINATOR REH/ed ENCLOSURE ': Business Name ,'. Business Site Address I ~ · .: : .:.,i~.. Business Mailing'Address .: :**: THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERATOR OF EACH BUSINESS IN CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL IN QU ,ANTiTIES GREATER THAN ~00 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT STP. · TI{IS FORM SHALL BE COMPLETED AND SUBMITTED TO YOUR LOCAL ADMINISTERING AGENCY. (§25533 & 25536 Health & Safety Code) ,,~ ' NOte instructions on rover, e ~ ..4r~:,~::-x.,~,~,:-.:?~,.C ' ' _ :' different) GENERAL DESCRIP~0~~ OF PROCESSES AND PRINCIPA~ EOUIPMEN~: '~:.5~:3~??' :/{',/-{<~ "?~-/"::;:.:}?:.~.}?~:?.~: :' California Office of Emergency Services FORM HM 3777 (1-15-88),. ADDRESS (INK) OCCUPANCY 'ZIP CODE BLOCK NUMBER PERMIT REQUIRED YES [] NO [] MULTIPLE OCCUPANCY YES ~ NO [] CONTACT ! TITLE PHON E--EIUSI NESS~'EMERGENCY BUILDING OWNER AODRESS PHONE--BUSINESS--EMERGENCY ,?i ~'' *~ *- _ .,c . DATE 'INSPECTED DATE RE--INSP. DATE COMPLETED INSPECTOR HAZARDS FOUND 07/10/91 H RUSSELL TAYLOR FIRE PRE~_NTION Site as a Whole General Information Page 001 Location: 1851 Golden State Ident Number: 21.5-000-000.596 Map: 102 Hazard: Moderate Grid:248 Area of Vul: Administrative Data Mail Addr$: 1851 GOLDEN STATE City: BAKERSFIELD GeoSubdiv: BAKERSFIELD STATION 01' D&B Number: State: CA Zip: 93501- SIC Code: Owner: H. RUSSELL TAYLOR Addrs: 1831 GOLDEN STATE HWY City: BAKERSFIELD Title Phone: (805) 525-0'704 State: CA Zip: 93501- Contact H RJooELL TAYLOR SHERMAN ROOKS Business Phone ( ) 325-0704 ( ) 32,5-0704 Hour* Phone ) 3,~ ,q-ocs4 ) 399-7271 8UolN_oo HAS BEEN CLOo_D BY THE BUILDING Summary: AS OF 8-11-89 THIS ~ F°° °F DEPARTMENT, CITY OF BAKERSFIELD 07/10/91 Page 002 H RUooE_L TAYLOR FIRE PREVENTION <D> Notif./Evaouation/Medioal Yon: 00 - Site as a Whole <1> Agency Notification <2> Employee Notif./Evaouation 5A SEC 2) ALL EMPLOYEES HAVE BEEN ADVISED OF EVACUATION PROCEDURES, IE~, EVAOUATION FROM CLOSEST EXIT, AWAY FROM INOIDENT SITE, IT POSSIBLE. NOTIFIOATION OF APPROPRIATE AGENCY(S) IF POSSIBLE, THRU "gii" OR RELEVENT NUMBERS. <5> Public Notif./Evaouation 07/lO/gl H RUSSELL TAYLOR FIRE PREVENTION <D> Noti¢./Evaouatlon/Medioal Cot: O0 - Site a.s a Whole Pa~e 00~ <4> Emergency Medloal Plan 2A SEC 5) ALL EMPLOYEES ARE AWARE OF "911" ASSISTANCE AND EVACUATION PLANS. SEVERAL EMPLOYEES ARE CERTIFIED IN CPR, FIRST AID., AND EMT CARE~ ALL EMPLOYEES HAVE BEEN ADVISED OF MEROY HOSPITAL'S DEOONTAMINATION UNIT, AND THE NEARNESS OF SAN JOAQUIN HOSPITAL AND HELIPORT. 07/iO/~i H RUSSELL TAYLOR FIRE PREVENTION <E> Mitigation/Prevent/Abatemt for: OO - Site as a Whole Page 004 <l> Release Prevention 5A SEC l) ALL EMPLOYEES HAVE RECEIVED TRAINING IN SAFETY PROCEDURES REGARDING ALL HAZARDOUS OR POTENTIALLY HAZARDOUS EQUIPMENT OR MATERIALS. ALL HAZARDOUS OR POTENTIALLY HAZARDOUS MATERIALS HAVE BEEN PROPERLY OONTAINED~ LABELED~ AND STORED. THE FIRST AID/SAFETY AND FIRE PREVENTION STAFF KEEP OURRENT OF EDUOATIONAL AND OOMPLIANOE DATA. ALL EMPLOYEES HAVE BEEN ADVISED AND TRAINED IN EMERGENOY PROOEDURES IN OASE OF AOOIDENTAL SPILLS OR LEAKS. <2> Release Containment <3> Clean Up 07/10/91 Page 005 <4> Other Resource Activation 07/10/91 H RUSSELL TAYLOR FIRE PREVENTION Paqe 006 <F> Site Emergency FaotoFs fol~: O0 -Slte as a Whole <1> Special Hazards <2> Utilitw Shut-Offs 2A SEO 5') A) GAS - NW CORNER MAIN 8LDG B) ELEOTRIOAL - IN SEO 0 OF OHAIN SAW PART (3) OF MAIN BLDG O) WATER - SW OORNER PROPERTY D) SPEOIAL - NONE E) LOCK BOX - NO <5> Fire Protect/Avail. Water 5A SEC 4) MANY TYPES OF FIRE EXTINGUISHERS FOR USE ON INCIPIENT FIRES OR RESALE. EXTINGUISHMENT SYSTEMS FORE RESALE. 3A SEC 5) WATER SHUTOFF SW CORNER OF PROPERTY (ALLEY) CITY (SILVER/GREEN - 4."/ 2 1/2") HYDRANTS NE AND NW SIDE OF PROPERTY. 07/10/91 H RUSSELL TAYLOR FIRE PREVENTION <F> Site Emergenoy Faotors for: O0 - Site as a Whole Paqe 007 <4> Held Cot Future use 07/i0/91 H RUSSELL 'TAYLOR FIRE PREVENTION <M> Inspeotions for: O0-Site as a Whole Page 008 I !No.! ID Number Date ! Description 1 12~4 08/11/89 BUSINESS C_OoED BY THE BUILDING DEPARTP1ENT =~ 125456789012 07/06/88 OK BUSINESS NfuME ' RECEIVED BAKERSFIELD CITY FIRE DEPARTMENT ~{) 2130 "G" STREET JUl. 1'3 1987 BAKERSFIELD, CA 9330! 8' o~c~ us~ o~ '~ ~'~ - HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A 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 brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME:H. B. LOCATION / sTREET ADDRESS:j~i~ 000596. ZIP: q~/ BUS.PHONE: (~(}5)~'~.ii~-,)-""" OVOf-/ . 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 StaI~ Office of Emergency Services as required by law. EMPLOYEES' TO NOTIFY IN CASE OF EMERGENCY: DURING BUS~. ~tRS. AFTER BUS. HRS. NAMEA..~. AND~u.~.~i ~ ! ITITLE 'T~ SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: /~]Lt~ {~Or[l~/~ B. ELECTRICAL: ~ IV D. SPECIAL: E. LOCK BOX: YES /~ IF YES, IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? FLOOR PLANS? YES / NO KEYS? YES I NO YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION' 5: LOCAL EMERGENCY MEDICAL ASSIST.~NCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHIOH PROVIDES EMPLOYEES WITH INITIAL ~L'REFRESHER.:-TRAIN!NG_.INTHE FOLLOW!.NG-AREAS ' ......... CIRCLE YES OR NO INITIAL .REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~ATERIALS - ~_$).NQ ..... YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: ..... . ...... ' ....... NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO YES 'NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO YES NO sEcTIoN 7: HAZARDOUS MATERIAL CIRCL~ OR NO DOES YOUR BUSINESS ~HANDLE HAZARDOUS ~TERIAL IN QUANTITIES LESS THAN 500 POUND./~OF A " SOLID', 55 GALLONS OF A. LIQUID, OR 200,CUBIC FEF~T OF A COMPRESSED GAS: ..... .. t~$!.~ NO xx the new California Health and Safety Code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. .-, .... H. ~[JS55;.,L TAYLOR'S ... ~ / . . ' .~::, ~.. ,~ ,,.,.:,.. .. · · , BARERSFIELD CITY FIRE DEPART)lENT 2130 "G" STREET BAKERSFIELD, CA 93301 ,BUSINESS NA)IE: OFFICIAL USE ONLY ID# " BUSI NESS PLAN SINGLE FACILITY UNIT FORM ' SA 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 BELOW '~. 4. Be as BRIEF ~nd CONCISE as possible. - " ' ..... SECTION 1: MITIGATION, PRE~NTION, ABATEMENT PROCEDURE~'. SBCTIO~ 2: NOTIFICATION M~ EVACUATION PROCEDD~ES AT THIS E~IT' ONBY' 'RI~ enlistees h~'~ b~en --aou'~3.e.ta 'o4~ SECTION $: HAZARDOUS ~ATERiALS FOR THIS U,NiT ONLY 'A. Does ti, is Facility Unit contain Hazardous Materials? ...... B. Are any of the hazardous materJa]s a bona fide Trade Secret YES If No, ·complete a,sepa~ate hazardous materiais inventory form marked:'NON-TRAE:E SECRETS ONLY (white form ff Yes, complete a hazardous materials inventory for~: marked: TRADE SECRETS ONLY (yellow for~ ~4A-2) in additian to ~he nan-~rade ..secret form. List ·only ~he trade secrets on form 4A-2. SE~T[O~ 5':-LOCATION O~ ~ATER SUPPLY FOR USE BY E[4ER6ENGY RESPO~ERS SECTION 6: LOCATION OF UTIL[~ S~T-OF~S AT THIS UNIT ONLY. A. NAT. .GAS/'PROPAN~;,'] . ;: .' D. SPECIAl,: E. LOCK BOX: YES / NO IF YES, LOCATION: SITE PLANS.'? ('%'E~,S7 / NO FLOOR PL:-,×o. YES NO MSDSs? KEYS? TE/FACILITY 'D FORM 5 NORTH· SCALE: BUSINESS NAME: FLOOR: 0F DATE: / / .FACILITY ~'~ME: UNIT ~' .-.: OF . (CHECK ONE) SITE DIAGRA)! FACILITY DIAGR.~ l( Inspector's Comments): -OFFICIA'L USE ONLY- FACILITY BAKERSFIELD CITY FIRE DEPARTMENT~ S I.D. # ' ' 'FORM 4A-1 Page o-~,d' · NON--TRADE SECRETS ~j~--~, HAZARDOUS MAT~:RI ALS · PHONE ~: ,.),.~,.~ L, OFFICIAL USE CFIRS CODE ONLY ! 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION' IN THIS % BY HAZARD D.0.T CODE,,. AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT . ~LT ' CHEMIQA~ OR COMMON NAME , CODE GUIDE i -'":" '",."""..':' ~'. ''~'~, '-'. ~,,,~,-,,~,,,-,~. ....... ,~//7~ 0/, ::?_L_ 0 ~I~i'~_ ....... .. ~ ..,. .. ' :'/~ ":.,~'CO~/~ .... /:1.~ 1 './ ~' c2/~_, o:.,,::,,~,~ .>_':',. -' cr,~.,.:_<.~:Z,C.'~,, :~:~ O, a o:~ / ~ :zo... :i:t "':~.CZ~: :( ~o:o: ., ,0.... &. :,t:,? q ~u..o~u:.,.,,.."' :r' ,,., .,:<..:,,~....,.,,.. ....., .,,.____,: ~ NAME: TITLE: ~' _ SIGNATURE'. ~1 ,',, DATE: EMERGENCY.CONTACT: .... TITLE: PHONE ~ BUS. HOURS: _ : '~ AFTER BUS HRS: ' PHONE ~ BUS }{OURS: EMERSENCY CONTACT: TITLE; ~ _ ,.. ' PRINCIPAn BUSlNESS-ACT'IVITY: ._: _ -- ___- .... . .... AFTER BUS HRS~ ...... ' ~_~ _ . ., ~ ~ I.D. BUSINESS NAME: ADDRESS: CITY, ZIP: PHONE ~: NER NAME: FACILITY UNIT #: ADDRESS: FACILITY UNIT NAME: CITY,ZIP: PHONE #: [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 AMOUNT AMOUNT, UNIT CODE CODE FACILITY UNIT WT. CHEMIC, AL OR COMMON NAME CODE GUIDE, NAME: TITLE: SIGNATURE: DATE: EMERGENCY CONTACT: TITLE: PHONE # BUS HOURS: AFTER BUS HRS: EMERGENCY CONTACT: TITLE: PHONE # BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: - 4A-1 - / f ( _/ ~ r u"""'"'~ v" _ C ,,-v:" J V ~'.,..~,~ ;;,..' ;' '.' ~ ~1 L,~ I ':~:', ? ;~'~ tt:i": ToTal ~ro~erl~ pap, K, h~ Lo'l- :f H. Russelt Tayler's · FIRE PREVENTION SERVICE , INC. ]831 GOLDEN STATE HWY. - P. O. BOX 541 J05 - 825-0704 i~AKEP,,SI:IELD, CALIF. · )NTRODtJCT!ON' . Communication Program to enhance our emplo%.~.s ..h~.al.,h and._saTety. - As a company we intend to pr. ovide information about chemical hazards and other hazardous substances, and the control of hazards via our comprehensive Hazard Communication Program which includes container labeling, Material Safety Data Sheets (MSDS) and training. 1. CONTAINER LABELING It is the policy of this company that no container of hazardous substances will be released for uSe until the following label information is verified: >- Containers are clearly labeled as to the contents ~- Appropriate hazard warnings are noted >- The name and address of the manufacturer are li.~.',~,dt /\ This responsibility has been assi§ned ~.o ~-L,'i,~:L, CO To further ensure that employees arc, av~are of the hazards of materials used in their work areas, it is our policy to label all secondary containc, r~o ' I he supervisor "'t, OU-~';~ll ensure that all secondary con't~i,~ers ar~ la[~L~led with either an extra copy of the original manufacturer's label or with generic labels which have a block for identity and 'blocks for the hazard warning. 4', 2. MATF_RIAL SAFETy DATA SHEETS (MsDs) Copies of:MSDS for .-211 hazardous substances ~o Which emp!oyees of this comoany ma..y, becxposed are kept in respons~ole .for ob. raining ~u~a .m_a-i~taining the dat~ shee,~ system for the company. ,/~11 review incoming data sheets for new and significant hea'~h/safety information. He/she will' see that any new information is passed on to the affected employees. (If alternatives to actual data sheets are used, provide a description of the system.) · MSDS '.',,ill be reviewed for completeness by. I~ an MSDS is missing or obviously incomplete, a new MSDS will 5e requested from the manufacturer. Cai/OSHA will be ,, ~- noti¢ied'i~ a complete MSDS is not received. (~ ~-~,G MSDS are available to all employees in their work area for re,dew during each work shift. If MSDS are no( avail:,.'.' ',ar n,:,,v~, hazardous substance(s) in use do not have MSDS. , 3. EMPLOYEE INFORMATION AND TRAINING Employ.ees'are to. attend a health and safety orientation .s. et up by ~(j. O.~b"60. prior to starti'ng v, ork for. informa,ion and tr~imng on the following: > An overview of the requirements contained in 'the Hazard ' Communicatio'n Regulation, including their rights under :>- inform employees of any operations in their work area where hazardous substances are present. >'- Location and availability of the written hazard communication program. >- Physical and iiealth affects of the hazardous substances. ' ' Methods and Observation techniques Used to determine the presence or release of hazardous substances in the work 'area. Ho,,,/ to lessen or pre',)ent exposure to these hazardous sub- stances through usage ot' engineering controls, ,,v(~rk practices, and/or the use of personal protective equipment. Steps the-company has.taken to lessen-or prevent · - " =m~rg~ncy and'first aid procedures to follow if employees are. exposed [o hazardous substance(s). How to read labels and review MSDS to obtain appropriate hazard information. ~u~ =: tt is criti'caliy important that all of our emo oyees understand the training. I~ you have any ,_dd,tional questiqns, plea~e"co, nt¢,cL When new. hazardous substances are introduced, , .. ,.,,,ill review the above items as the,/ are related'to the new material in ycur work area safety meeting. 4. LIST OF HAZARDOUS SUBSTANCES The following is a list of all knoWn hazardous substances present ~,~T,.~oL.~I.LO~,';'E~..'), Specific information on.each noted hazardous substance(s) can be obtained by reviewing the Material Safety Data Sheets. Hazardous Substances (ie) LIST Work Area ,3r 2roc3ss (i~') P,.r,._,c,cally, employees are required to-perform hazardous-non- rou.?.ine tasks. Prior to starting-work on such proje~ctis, 6act~ affected employee will be given information by their supervisor about hazards to v,,hich_.they may be exposed during such an activity This information will include: Specific hazards. Protective/safety measures wh/ch must be utilized. >- Measures t,be company haS taken to lessen ~' ~ ,ny hszards including ventilation, respirat, o~r_s, presence of another employee and emergency procedures. ~xample¢ of non.routine tasks performed by employees of this ' c. ompany: TASK HAZARDOUS SU3STANC2 HAZARDOUS SUBSTANCES IN UNLABELED PIPES To ensure that our employees who work on unlabeled pipes have been informed as to the hazardous substances contained within, the following policy has been established: Prior to star.ting ,,vo~,k on unlabeled pipes our employees are to- ,..~"~'t. ' "~,'(~,,,for the following in.ormation' :> The haza. rdous substance in the pipe. >- Potential hazards. Safety precautions which shall be ' ' taKon. 7. }NFORMING CONTRACTORS To ensure that outside contractors work safely in ou~,r}lant, it is ~.~;..~ ,~s~o,~,~,,,~,~. o~ ~. ~~ /,~.- ~ ~{~. ~o.. erovide contractors the ~ollowing i~ormation: ~' ~ Hazardous' substances tO ?h/ch they.may_be exposed..while on the/obsite. >- Precautions the employees may take to lessen the possibility of exposure by usage of appropriate protective measures. Our pl.n will be monitored by-~~ ~C~ 'to ens,~ tha~ me - ' - · ' l ~~~,~. ~~~,~ FIRE DEPARTMENT D. S, NEEDHAM FIRE CHIEF CITY of BAKERSFIELD "WE CARE" OCTOBER 13, 1988 2101 H STREET BAKERSFiLED, 93301 326-3911 H. RUSSEL TAYLOR FIRE PREVENTION CO. 1831 GOLDEN STATE HWY. BAKERSFIELD, CA 93301 .. DEAR MR. RUSSEL TAYLOR: THE ENCLOSED "ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM" MUST BE COMPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUM REPORTING QUANTITY OF ANY MATERIAL ON THE EPA LIST OF EXTREMELY HAZARDOUS SUBSTANCES. (FED. REGISTER VOL. 52, NO. 77, P. 13397). YOUR COMPANY HAS REPORTED HANDLING THE FOLLOWING ACUTELY HAZARDOUS MATERIALS: SULFURIC ACID PLEASE RETURN THE COMPLETED ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM TO: HAZARDOUS MATERIALS DIVISION 2130 G STREET BAKERSFIELD, Ck 93301 IF YOU HAVE ANY QUESTIONS REGARDING THIS FORM PLEASE CALL RALPH HUEY AT 326-3979. SINCERELY YOURS, RALPH E. HUEY HAZARDOUS MATERIALS COORDINATOR REH/ed ENCLOSURE MATERIAL O~EAN® Network SAFETY DATA EMERGENCY PHONE 1-800'OLIN-911 " SECTION I - IDENTIFICATION CHEMICAL NAME & SYNONYMS ~ Railway or Highway Safety Flare ' C,I'~MICAL FAMILY I FORMULA Not applicable 1' Mixture DESCRIPTION Elongated paper tube containing a yellow powder with fuel oil odor SECTION II - NORMAL HANDLING PROCEDURES TRADE NAME Not applicable CAS NO. Not assigned/mixture PRECAUTIONS TO BE TAKEN IN HANDLING AND STORAGE PROTECTIVE EQUIPMENT Eyes- Gloves Other Store in a cool, well-ventilated place away from all sources of ignition. If tube is broken, do not get contents in eyes, on skin or on clothing. Do. not take internally. Avoid breathing dust. Upon contact with skin or eyes, wash off with water. Exercise caution when using this product since molten flecks may be emitted. Do not use product near any flammable or combustible materials. Follow directions on paekage~ Do not point an ignited flare toward face or body. VENTILATION REQUIREMENTS. This product should be used only outdoors. If used indoors, local mechanical exhaust ventilation is recommended to minimize exposure. sECTION III - HAZARDOUS INGREDIENTS BASIC MATERIAL OSHA LD 50 LC 50 SIGNIFICANT EFFECTS PEL None 2750 mg/kg No Irritant to skin, eyes Strontium nitrate established (rat) data and mucous membranes· None No No Irritant to skin, eyes Potassium perchlorate established data data and mucous membranes i' i None. , No No May cause eye and 'Sulfur .. ,~ established data data mucous membrane zrrltatlon ' SECTION ,IV - FIRE AND EXPLOSION HAZARD DATA METHOD, Contents 350° Flammable solid LIMITS ND ND EXTINGUISHING MEDIA Water, sand SPECIAL FIRE HAZARD & FIRE FIGHTING PROCEDURES Use NIOSH/MSHA approved self-contained breathing apparatus where this material is involved in a fire. SECTION V- HEALTH HAZARD DATA THRESHOLD LIMIT VAI'UE , ' None'established for mixture. SYMPTOMS OF OVER E£POSURE Tube contents are corrosive to the eYes and irritating to respiratory tract. I~I~ER~EN,CY FmS[-~D P~OC~DIJRES Flush with water for SKIN Flush with water for 15 minutes, call a physician. O Z O IINGESTION INHALATION If contents are ingested: ~Drink la,rge quantities of water. Induce vomiting by sticking finger down' throat. Call a physician. Re'move victim to fresh air. Call a physician. ACUTE ORAL L~.~'~50 ray or HighwaY CHEMICAL NAME Safety Flare ~ SECTION VI- TOXICOLOGY (Product) Approx 3 g/kg (rat) CARCINOGENIClTY NOt known to be carmnogeme ACUTE DERMAL LD 50 ACUTE INHALATION LC 50 >2 g/kg (rabbit) Not established MUTAGENICITY Not known to be mutagenic EYE IRRITATION Corrosive PRIMARY SKIN IRRITATION Not an irritant PRINCIPAL ROUTES OF ABSORPTION Inhalation, dermal EFFECTS OF ACUTE EXPOSURE , Tube . · . ( . Contents are corrosive to the eyes and irritating to respiratory~ tract. Inhalation of combustion products will irritate eyes: mneous memb~nes: lungs. EFFECTS OF CHRONIC EXPOSURE ' ' None expected from Proper use. SECTION VII- 'SPILL AND LEAKAGE PROCEDURES (Control Procedures) ACTION-FOR MATERIAL-RELEASE OR SPILL ............................. In large quantity, remove all sources of ignition. Wear NIOSH/MSHA approved dust respirator. Follow OSHA regulations for respirator use. (See 29 CFR 1910.134). Wear goggles, coveralls, impervious gloves and boots. Clean up in a manner to minimize contamination with organic material. Do not return material to original container. Place in a fresh container and isolate. Do not seal the container. In the event of a large spill use the emergency telephone number shown on the front of this sheet. TRANSPORTATION EMERGENCY, CONTACT CHEMTREC 800-424-9300 WASTE DISPOSAL METHOD Dispose of Contaminated product and materials used in cleaning up spills or leaks in a manner approved for this material. Consult appropriate federal, state and local regulatory agencies to ascertain proper disposal procedures. SECTION VIII - SHIPPING DATA iD.O.T: CLASS Fusee (Railway or Highway) Flammable Solid, NA 1325 SECTION IX- REACTIVITY DATA STABLE X UNSTABLE AT °C OF I HAZARDOUS POLYMERIZATION CONDITIONS TO AVOID .......... ' High heat, ignition sources of any kind· INCOMPATIBILITM (Material to Avoid) Strong oxidizers HAZARDOUS DECOMPOSITION PRODUCTS IMAY OCCUR WILL NOT OCCUR Sulfur dioxide, nitrogen oxides, carbon monoxide X SECTION X- PHYSICAL DATA MELTING PO. INT NO data IBOIL=NG POINT NO data (1%0 ' I) NO SPECIFIC G RAVI. T~ data IVAPOR PRESSURE SOLUBILITY IN WATER pH NO data No data N6-d~ta VOLATILES NO data EVAPORATION RATE No data VAPOR DENSITY (Air ' 1) NO data INFORMATION FURNISHED BY: 737 Environmental Hygiene and DATE Toxicology Department (203) 789-5436 February 10, 1986 Depa~men~ of Environmental Hygiene and Toxicolog (203) 789-543b~{~' Olin CORPORATION 120 Long Ridge Road, Stamford, Connecticut 06904 OCEAN® Network EMERGENCY PHONE 1-800-OLIN-911 I.D. KERN COUNTY FIRE DEPARTMENT ],-- ' FORM 4A-1 - E~,~ NON--TRADE .S ~.CR HAZARDOUS MATERI ALS ~; z~. .... /}OWNER NAME: ADDRESS :- ' /~/ ~OL~/ ~/~ ?]/~,.f~ ADDRESS: C~TY, Z~p: ~.j~(}~/~) ~, ~3~~ C~TY,Z~P: -INVENTORY page /of/ FACILITY FACILITY,UNIT UNIT NAME: · AFTER BUS HRS: ,~,-~FC/-/ PHONE # BUS HO~RS: AFTER BUS HRS: 3~- '~b/ .HMCU-9 EMERGENCY C 0 N T A C T: ~'~k ~7Y% ~ [~b PRINCIPAL BUSINESS ACTIVITY: ~[~.6/ ~"~ ~'~ NAME:~_~O.f]~ P. '-ff/l~W0C/,k' ' TITLE: SIGNATURE DATE:~./~--, EMERGENCYV'~'ONTACT:~d/~ TITLE:~6~?{~r'/tOF~$iO~g/'7 # BUS HOURS: ,~r~.:~drGoy~/ 1 2. 3 '' 4 5 6 : 7 8 9 TYPE MAX ANNUAL CONT USE LOCATION IN ,TH'IS · BY HAZARD" D..O.T .CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME .CODE GUIDE ~lC~-c'~¢r PHONE #: [OFFICIAL USE CFIRS CODE PHONE #: ~O,T- "'~ '/ ~ ONLy ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUI~ LABORATORIES, INC. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CITY OF BAKERSFIELD HAZARDOUS MATERIALS 2130 G ST BAKERSFI~TD, CA 93301 Attn.: RALPH E HUEY 326-3979 Sample Description: UNKNOWN RT-1 8-29-89 Date Reported: Date Received: Laboratory No.: 09/01/89 08/29/89 6676-1 Page 1 Constituents. TOTAL CONTAMINANTS (Title 22, Article II, California Administrative Code) .Sample Results Method P.Q.L. Units Method Pensky-Martens Flash Point Reactive Cyanide Reactive Sulfide 4.74 0.01 pHUnits 9040 1 ?8F 1. F 1010 1 None Detected 1.0 mg/L 733.2 1 Nons Detected 1.0 mg/L 733.2 1 (See Last Page for Comments, Definitions, Regulatory Criteria, and References) Constituents Recoulator~ Criteria S.TLC, mg/L ~3, mq/kg pH 2-12.5 2-12.5 Comment: Ail constituents reported above are in mg/kg (unless otherwise stated) on an as received (wet) sample basis. Results reported represent totals (TTLC) as sample sub3ected to appropriate techniques to determine total levels. P.Q.L. = N.D. = I.S. = Practical Quantitation Limit (refers to the least amount of analyte detectable based on sample size used and analytical technique employed. None Detected (Constituent, if present, would be less than the method P.Q.L.). Insufficient Sample STLC TTLC = Soluble Threshold Limit Concentration = Total Threshold Limit Concentration REFERENCES: (1) "Test Methods for Evaluating Solid Wastes", SW 846, July, 1982. (2) "Methods for Chemical Analysis of Water and Wastes", EPA-600, 14-79-020. // J.~J. Eg~n ENW~ONMENTAL CHEMICAL ANALYSIS PETROLEUM LABO RATO RIFS, INC. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CITY OFBAKERSFIELD Date Reported: 09/01/89 HAZARDOUS MATERIALS Date Received: 08/29/89 2130 G ST Laboratory No.: 6676-2 BAKERSFIRT,D, CA 93301 Attn.: RALPH E HUEY 326-3979 Sample Description: UNKNOWN RT-2 8-29-89 Page i (Titl~~ 22, TOTAL CONTAMINANTS Article If, California Administrative Code) Method Constituents Sample Results P.Q.L. Units Method Ref. Oil & Grease 8257. 20. mg/kg 413.1 2 (See Last Page for Comments, Definitions, Regulatory Criteria, and References) Constituents Regulatory Criteria STLC, m~/L TTLC, m~3/k~ Comment: All constituents reported above are in mg/kg (unless otherwise stated) on an as received (wet) sample basis. Results reported represent totals (TTLC) as sample sub3ected to appropriate techniques to determine total levels. P.Q.L. = N.D. = I.S. = Practical Quantitation Limit (refers to the least amount of analyte detectable based onsample sizeusedandanalytical technique employed. None Detected (Constituent, if present, would be less than the method P.Q.L.). Insufficient Sample STLC = Soluble Threshold Limit Concentration = Total Threshold Limit Concentration REFERENCES: (1) "Test Methods for Evaluating Solid Wastes", SW 846, July, 1982. (2) "Methods_ for Chemical Analysis of Water and Wastes", EPA-600, 14-79-020. ~ j. [6~'. Eg l(-fn CHEMICAL ANALYSIS PETROLEUM LABORATORIES, INO. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CITY OF BAKERSFIELD HAZARDOUS MATERIALS 2130 G ST BAKERSFIRT.n, CA 93301 Attn.: RALPH E HUEY 326-3979 Sample Description: UNKNOWN RT 8-29-89 Date Reported: 09/01/89 Date Received: 08/29/89 Laboratory No.: 6676-3 Page 1 TOTAL CONTAMINANTS -(T~tle'22, ~A~ticle II, California Admin~strati~e ~ode) Method Constituents Sample Results P.Q,L, Units Method Ref. Oil & Grease 134129. 20. m~/kg 413.1 (See Last Page for Comments, Definitions, Regulatory Criteria, and References) Constituents R~ecjulatoryCriteria STLC, m~/L TTLC, n~3/kG Comment: All constituents reported above are in m~/kg (unless otherwise stated) on an as received (wet) sample basis. Results reported represent totals (TTLC) as sample subjected to appropriate techniques to determine total levels. P.Q.L. = N.D. = I.S. = Practical Quantitation Limit (refers to the least amount of analyte detectable based onsample size usedandanalytical technique employed. None Detected (Constituent, if present, would be less than the method P.Q.L.). Insufficient Sample STLC = Soluble Threshold Limit Concentration = Total Threshold Limit Concentration REFERENCES: (1) "Test Methods for Evaluating Solid Wastes", SW 846, July, 1982. (2) "Methods for Chemical Analysis of Water and Wastes", EPA-600, 14-79-020. May 21, 1986 Dear Distributor: ICI Americas has complied with the OSHA regulations and has provided a Halon 1211 MSDS for many years. The Material Safety Data Sheets are distributed to equipment manufacturers and end-users as well as distributors. Enclosed is the most recent ICI Americas' MSDS dated January 8, 1986. The information provided is for use by your company and also that of your customers. In event an emergency arises whereby information needs to be obtained on Halon 1211, call (302) 575-3000 (24 hours) and tell them the nature of the inquiry as it refers to BCF® Halon 1211. If we can be of any assistance in the matter concerning Halon 1211, please contact us at (302) 575-3536. Si/n~ely, /{a~mes H.. Davis' pales Development Manager ~Fire Fighting Chemicals JHD :ih (~ICI Americas Inc. ~ATERIAL SAFETY DATA SHEE~ Wilmington, Delaware 19897 000310 Form No.: 3620h(D) Phone (302) 575-3000 (24 hours) Date: 01/08/86 S[~'TIO~ I NAME S HAZARD S~ Material name: ' BCFe (Ha!on 1211) Hazard sun~ary (as defined by OSHA Hazard Communication Standard, 29 CFR 1910.1200): Physical hazards: Compressed gas Health hazards: Harmful (central nervoussystem depression, cardiac arrhythmias) Read the entire I~DS for a more thorouqh evaluation of the hazards. SI3CI'IOIq 2 II~({Ri{DI~ I % [ , TLV Brc~ochloro~ifluor~nethane (CAS 353-59-3) I 100 I I I I I I ! I I I I ! I Ingredients not precisely identified are proprietary or nonhazardous. ingredients appear on the EPA ~SCA Inventory. Values are not product specifications, gt = greater than, It = less than, ca = approximately Hot listed- All SECTION 3 PHY$ICAL DATA Boiling point: 26°F Vapor pressure: 15 pstg at 15.6°C Vapor density (air = 1): 5.7 Solubility in water: Insoluble pH: No data Specific gravity: 1.83 (11quid) % Volatile by volume: 100 Appearance and odor: Colorless gas or colorless volatile liquid with very faint sweet odor SECTION 4 FIRE AND EXPLOSION HAZARD DATA Flash point (and method): Does not flash Autotgnition temp.: ~one Flammable ]imits (~P): Wo~e Extinguishing media: Not applicable; product is an extinguishing agent. Use wa[er to cool fire-exposed cylinders or other containers. Special fire fighting protective equipment: Self-contained breathing apparatus with fu]! facepiece an~ protective clothing when re-entering unventilated fire areas where product has been used. MATERIAL SRFE'r~ DATA SHEET (continued) BCFe _(Halon 1211)' SECTION 4 F~R~ AND ~X~L~ION ~0 DATA (continued). Unusual fire and explosion hazards: When BCF is discharged onto a fire, It decoeposes above 900°F, releasing brc~ide tons, the extinguishing agent. However, halogen cc~pounds, such as halogen acids, are also for~ed. ~hese bypreducts, although harmful if inhaled, are easily detected; only a few parts per million create an unpleasant, acrid odor, which serves as a warning to the user. Rfter the extinguisher is discharged, the area should be vacated until ventilation clears the atJaosphere. 5 Stabiltty: Stable under noraal conditions. Decc~aposes.under. fire conditions (above Inc~patiblltty ~matertals to avoid): Actlve metals such as lx~dered alu~lnu~ and ma~neslu~, and flres of metal hydrides. Hazardous decoeposltton products: Thermal decc~aposltton: BCF begins decc~aposlng at teeperatures above 900aP to give free halogens, halogen acids, and s~all a~ounts of carbonyl haltdes. Tests simulating fire conditions could not detect phosgene in amounts as lOw as 0.04 ppm. Hazardous polymerization: Will not occur. SECTION 6 HEJ%LTHHAZARD General: The' health hazard assessment ts based on a combination of available toxlclty Information and human experience. Ingestion: Ingestion is not likely to occur since this material is a gas at rocca temperature. ~e contact: The liquid form of thls ~aterial can produce chilling sensations and dIscc~fort. Skin contact: Evaporation of i~gutd fr~ the skin can produce chilling sensations. Skin injury does not result. Skin absorption: Systemically toxic concentrations are unlikely to be absorbed through the skin In Inhalation: Exposures to concentrations of this material above 4% for longer than one minute can cause toxic side effects. Other effects of overexposure: Prolonged exposures can cause dizziness, headache, nausea, ~Japatred coordination ,progressing to unconsciousness. In susceptible Individuals, cardiac sensitization to circulating epinephrine c~pounds can result tn potentially fatal heart arryth~ias. MATERIAL SAFETy DATA SHEET (continued) BCPe {Malon 1211) SECTION 6 HEALTH HAZARD ASSES~IENT (continued} , . First aid procedures: Skin: Wash material off the skin with copious amounts of soap and water. If redness, itching or a burning sensation develops, get medical attention. Byes: Immediately flush with copious amounts of water for at least 15 minutes. If redness, Itching or a burning sensation develops, have eyes examined and treated by medical personnel. Ingestion: Give I or 2 glasses of warm water to drink and get ~edical attention. DO~a3T Induce vomiting. Have vtctLe lie down and keep warm. (~ever give anything by mouth to an unconscious person.) Inhalation: Remove victim to fresh air. If cough or other respiratory slmptoms develop, consult medical personnel. If not breathing, gt~ artificial respiration, preferably mouth-to-mouth. If breathing Is difficult, give oxygen. Co~sult medical personnel. Note to Physician: Product can Induce cardiac muscle sensitization to circulating epinephrine-like co~pounds. Do ~OT give adrenalin or similar sl0apat~tmetic drugs. Do NOT allow a victim to exercise until 24 hours following specific exposures-. Freeze burns of mucosal tissue can develop following contact with liquid form of this material. SECTION 7 SPILL OR LEAK PROCEIXIRE~S Steps to be taken in case material is released or spilled: Ventilate spill area and recover any liquid. Protect against frostbite frc~ evaporating liquid. Disposal method: Not applicable. Container disposal: Not applicable. SECTION 8 SPECIAL PROTECTION INFORMATION TLV~ or suggested control value: No TLV assigned by RCGIH. ICll operates its facilities such that employee exposure to this material is kept below 1000 ppm as an 8-hour l'arA. Ventilation: Ventilate low-lying areas, such as, sumps or pits where dense vapors may collect. Use local exhaust to control exposures. Respiratory protection (specify type): Not normally needed if controls are adequate. If ~ed, u~ ~ti/NIOf~ approved respirator for organic vapors. For high concentrations ar~ oxygen-~eftctent atmospheres, use positive pressure air-supplied respirator. Protective clothing: Impervious gloves and apron to protect against liquid exposure. Eye protection: Chemical tight 9oggles; full faceshteld in addition if splashing ts possible. ~TER][AL 5AFET~ DATA SHEET (continued) BCP~ (Halon 1211) SECTIOH 8 SPECIAL PROTECTIONIN~TION (continued) ., ,,,. Other protective equttxnent: Eye-wash station and safety shc~er in ~ork area ~hen working with ltqutfted product. SECTfON 9 S.P~'CIAL PRi!~.A~I'OH5 OR OTHER ~ Precautions to be taken in handling Or stotinki: Store in a cool area with good venttlat!o~. Keep vapors away fr(aa high temperature surfaces to avoid toxic and corrOSive decc~aposition products. ~nforce "NO SPK)KI~' rules in areas of use. Rev. of ~I3334(C) The Information herein ls given in good faith but mo warranty, expressed or Implied, Is made. IDENTIFICATION MATERIAL SAFETY DATA SHEET Name: Halon 1301 Fire Extinguishant Chemical Family: Halogenated Hydrocarbon SynonMns: Monob ~ no t r i fl uorom e thane CAS Name: Methane, Br(~notrifluoro . nufacturer/Dlstributor: E.I. du Pont de Nemours & Co. (Inc.) - 1o70 Formula: CBrF3 CAS Registry No. 75-63-8 Medical Mnergency Phone: (800) 441-3637 ,~ddress: Freon~ Products Division Transportation Mmergency Phone: CHI~4TREC (800) 424-9300 PHYSICAL DATA Boiling Point (°F): -71.95 Density: 1.538 g/cc @77°F Vapor Density (Air=-1): 5.14 Form: Liquefied gas Color: Colorless Percent Volatile by Volume: 100 Vapor Pressure: 220 psig @ 77°F Solubility in ~20: 0.03 wt. % @ 77°F Appearance: Clear ' Odor: Slight ethereal odor HAZARDOUS C(IMPflqENTS Material: Monob ~o,ot r i fluoromethane Approxhnate %: 100 HAZARDOUS REACTIVITY Stability: Material is stable. However, exposure to flames or hot surfaces above 1000°F will cause dec(~nposition. Inc~npatibility: Alkali or alkaline earth metals - powdered Al, Zn, Be, etc. Decomposition: Halm~ 1301 may be decomposed by high temperatures (open flames, glowing metal surfaces, etc.) forming hydrogen fluorides, hydrogen bromide, free bromine - possible carbonyl halides. PolMnerization: Will not occur. The doll in thil Mallrill $1fety DOll Sheet relltel only lo the lpecific mnllrinl d®iignnlld AND EXPLOSION DATA Flash Point: None Method: TOC Autoignition Temperature: Not determined ~ Autodecomposition Temperature: Flanmable Limits in Air, % by Vol. lower: Nonflanmable Upper: Nonflanmable Not determined Fire and Explosion: Containers are equipped with t~nperature and pressure relief devices but may still rupture under fire conditions. Deco~position may occur. Extinguishing Media: Nonflm~nable Special Fire Fighting Instructions: Self-contained breathing apparatus (SCBA) may be required if cylinders rupture or release under fire conditions. HEALTH HAZARD INFORMATION Principal Health Hazards: Inhalation: Vapor is heavier than air and can cause suffocation by reducing oxygen available for breathing. Breathing very high concentrations of vapor can cause light-headedness, giddiness, shortness of breath, and may lead to. narcosis, cardiac irregularities, unconsciousness, or death. LC 50 Rats >800,000 ppm( v/v)/4 hr. Note: In screening tests with experimental animals, exposure at approximately 75,000 ~ap~s (v/v) and above, followed by a large intravenous epinephrine challenge, induced serious cardiac irregularities. Skin: Contact with liquid can cat,se frostbite. Eye: Contact with liquid can cause frostbite. Exposure Limits: PE~ (OSHA): lO00 ppm TLV® (ACGIH): 1000 ppm (see note under additional information section). Safety Precautions: Avoid liquid contact with skin and eyes and unnecessary breathing of vapors. -3- Fi rs t Aid: inhalation: Remove to fresh air, call a physician. arti ficiaI respiration, preferably mouth-to-~nouth. oxygen. Do not give ephlephrine or similar drugs. If not' breathing give If breathing is difficult, give ~)te to Physicians: Because of a possible increased risk of eliciting cardiac dysryt~nias, catecholamines, such as epinephrine, should be considered only as a last resort in life threatening emergencies. Eye: Flush with water. Call a physician if frostbite occurs. Skin: Fl~sh with water. Treat for frostbite if necessary. Medical Conditions ..Possibly Aggravated by Exposure: Cardiovascular Disease: See Principal Health Hazards: Inhalation Section. Other Health Hazards: Halon ]30] is not classified as carcinogenic by IARC, NTP, or OSHA. Based on animal studies and human experiences this product poses no hazard to man relative to syst~nic toxicity, carciaogenicity, mutagenicity, or teratogenicity when occupational exposures are below its 'i~V~. PROTECTION INFORMATION Generally Applicable Control Measures: Normal ventilatio~ for standard manufacturing procedures is generally adequate.~ P~cal exhaust should be used when large ~nounts are released. Mechanical ventilation should be used in low places. ~ Personal Protective Equi~nent: Lined Butyl gloves should be used when handling liquid, Chemical splash goggles should be ~orn when handling liquid. Under normal manufacturing conditions, no respiratory protectio~ is required when using this product. Self-contained breathing · apparatus (SCBA) is required if a large spill occurs in a confined area. DISPOSAL INFORMATION Spill, ~ak, or Release: Ventilate area--especially low places where heavy vapors ,n[gt~t collect. Remove hot metal surfaces or source of non-extinguished flames. Waste Disl~psal: C~mply witl~ ali. federal, state, and local regulations. s:~i. tal>!e vapor ceco~ery equipnent. Reclaim in -4- SHIPPING INFO~TI~ Domestic - Other Than Air (DOT 49 CFR ]72.10]) Proper Shipping Name Hazard Class bT! No. DOT Label(s) DOT Placard Monobromotrifluoromethane Nonflammable gas ]009 Nonflammable gas Nonflammable'gas International Water or Air(DOT/IMO 49 CFR ]72.102) Proper Shipping Name Hazard Class '~'~ No. DOT/P-D Label Bromo t r i f luorome thane Nonfl~table gas ]009 Nonflsnmable gas Other Information Shipping Containers Cylinders, ton tanks, tank trucks, tank cars. Storage Conditions Clean, d~y area. Do not heat above ]25°F. ADDITIONAL INFORMATION It is considered good practice to avoid all unnecessary exposure to Halon ]30]. In ~nergency (fire extinguishing system actuation), exposure should be limited to the following: Up to 7 percent - ]5 minutes 7 to ]0 percent - ] minute ]0 to ]5 percent - 30 seconds over ]5 percent - prevent exposure Small concentrations (approx. 5%) of Halon ]30] extinguishes flame by chemically interrupting the combUStion process - not by replacing oxygen. However as with any gaseous product, vaporization of excessive amounts of Halon ]30] can deplete or replace oxygen necessary for breathing. In confined/enclosed spaces or areas with little ventilation, this may be hazardous to health. Date Revised: ]2/85 Person Responsible: T. D. Armstrong, C&P Dept., Freon® Products Lab., Chestnut Run, Bldg. 7]],-Wilmington, DE ]9898 (302) 999-3847 or (302) 999-4338. E-77509-3 D5/Jll ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERATOR OF EACH BUSINESS IN CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL lin QUANTITIES GREATER THAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT STP. 1 THIS FORM SHALL BE COMPLETED AND SUBMTITED TO YOUR LOCAL ADMINISTERING AGENCY. (§25533 & 25536 Health & Safety Code) ,,'3 Note instructions on reverse Busin.s Site Address ~/ C~ ~ ~0,~ :3~ ~¢ Business Plan Submission Date Business Phone Process ~ignation~ ACUTELY HAZARDOUS MATERIALS HANDLED4 -USE ADDITIONAL PAGES IF NECESSARY- CHEMICAL NAME QUANTITY (~ENERAL DE$CRIPTIQN OF PROCESSE~; AND PRINCIPAL EQUIPMENTS: PRINTED NAME I~g© {~), DATE California Office of Emergency Services FORM HM 3777 (1-15-88) INSTRUCTIONS: Superscripts: 1. Quantities for RMPP compliance are "equal to or greater than" the minimum criteria and apply to chemicals handled "at any one time". 2. Businesses handling reportable quantities of Acutely Hazardous Materials that have not submitted a business plan MUST contact local Administering Agencies. The business plan submission date will assure the Administering Agency that a business plan has been submitted and is on t-fie. This will also immediately identify businesses that have not submitted business plans. 3. "Process Designation" is provided as a reporting option (with the approval O~the A~lmi~is-tefing Agency) for- facilities that can most easily report by process. Thus, facility RMPP registration data could be submitted in a similar format to a business plan that is divided by process. "By process" data can initiate an emergency response to a process incident rather than a general emergency response to a major facility. Process designation 4. Refer to the EPA list of F_,xtr~mely HsT~rdous Substances from the F~ Register (Volume 52, No. 77, p. 13397 et. sea., April 22, 1987). Each chemical has a threshold planning quantity. This list may be changed by EPA on an annual basis. Updates of this list may be available early in 1988. To comply with this element, you may attach a copy of the inventory submiued to your Aclminist~-ing Agency from your business plan and highlight all Acutely I-la?m'dous Materials. It is recommended that facilities list all extremely h~ardous chemicals handled in quantifies equal to or in excess of 1) 500 pounds, and 2) any EPA threshold planning quantity less than 500 pounds. 5. Do not include Trade Secret information in these descriptions. General: For emergency response purposes, it would be desirable to describe the following to the Administering Agency.'- 1. Batch Process: a. What raw materials? b. What operating ~ range? c. What operating mmperaua-e range? d. Batch capacity rating? e. Product chamctea'istics? (e.g., chemical state, flammability, toxicity, etc.) Critical process points and characteristics? 2. Continuous process: (similar information as above.) NOTE: "Pursuant to §25534, the Administering Agency may require the submission of a Risk Management Prevention Program (RMPP), if the Administering Agency determines that the handler's operation may present an acutely hazardous materials accident risk. The handler shall prepare the RMPP in accordance with subdivision (c) [of §25534]. The RMPP shall be prepared within 12 months following the request made by the Administering Agency pursuant to this section." (§ 25534 (a) Health and Safety Code) An amendment to the RMPP musk be submitted to the Administering Agency within 30 days of: 1. Any additional handling of acutely hazardous materials. 2. Any material or substantial alterations to business activities. 3. Change of address, business ownership, or business name. (§ 25533 (c) Health & Safety Code) · EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP · California Office of Emergency Services FORM HM 3777 (1-15-88) FOR COATINGS, RESINS AND ~E~ ATED MATEFHALS V^'~o~CTu"£~S~'~ Schotle Corporation s:~t A~ss 200'W. Nozth Avenue ,:^r~c~ February, 1985 c:~ ss~.~z-~soet Northtake, Illincis 60164 (312) 562-7290 .~oo~c~c:~.~sa Su!furi~. Acid · Sulfur Trioxide Approx. 76 Water :. ~ Appro=.-,.2-4 .... , OSHA Corros ,i~e~Liquij__ DOT ~cLujJ~ UN1830 2-EM:CAL Open containers will release SO~ gas; which is readily converted to sulfuric acid mis~ in air. Will react violently with water. Can ignite some combustibles and organics. Heat incr=ases pressure and may explode container. The use of self-contained breathing appa- agus is recommended for fire fighters. Keep work areas free of hot metal surfaces and other sources of ignition.. Water may be helpful in keeping adjacent containers cool; however, avoid spreading burning liquid with water used for cooling purposes. It~ ~A L/~ T~O~t ~'~ ~' Inhol~tion of fum~ or ~id m~ ~ ~ ~rr~t~i~ or corr~ive bums ~o ~ u~ ~r~o~ .~, :n~ ~, ~u~. and thro~. Lung irr~[a~ion e~ ~l~ ~a ~ ~ ~r. Can corrosive ~rns to ~u~, th~, ~ ~. ~n ~ rata if ~~. t'Can caus~ sovore burns or irritation, EYES Liauid cont.'ct c~n c~us9 irritation, cort~al bums, ~ c~njunr.,~ivitis. Blindll~ may r~u:t, or ~c~e or 13~rmat~n! injury. Mist con!9L't may irri~to or burn. ~EPlMIE~SI[~LE CONCENTRATION: AIR ~SEE $~CT~o~ J) 1 n~cu.m. {~ 1(:~5 H~-~.~O~) {OSHA) TLV: ~am~ (ACGIH) INUSUAL CHflO~lC TO,~ICITY (1} Ero~on of tc~th, (2) Iofio~ of ttto ~in, (3) ~r~chiti~, (~) mouth infl~ntrn~?J~. -Refer~n.c~ A~ n~ ~m~ra~r~. sut~r t~o~i~ ~ is ~. Thi~ is ~lera~ -- UNSTAaLE ~ $TA~LE o j ~ hi~r ~ra~r~. This g~ is toxic. ~rr~. ~ en o~di~r. Nitro COml~OUndS, carbJdc~, dianes, water, alcohoI~ chlorazes end pormang~nat~3: cau~e fires and 13o~ib~o c~ocaon~. AIl¥1'compour~$ end t~V~3: un,oreo 13oiyrn~riza~ion. possibly violont--Ref. (h), (continued. Section ~AZARDOU$ DECOMPOStTION PI~OOUCT$ Sulfur trioxide gns: scm obovo. Also this is a fire ri$,t~, if h'l Con~'t with Or~iC matarial$. ~AZAR00(J~ POLYMERIZATION CONQi~tO~¢5 T(J AVOIO MAY OCCUR :~ WILL NOT OCCUR ~'~,L~ o.~E~. ...... · ..................... ' ' ' If the rc~ulting stint, ring and violent ~ion ~ ~ ~ain~, dilute small spills or le~s ~uti~sly, from a distance, w~th ' plow of wamr. N~ralize r~idue wi~ ~l~ali ~ ~ ~s ~ ~r lim~. Adequate v~t~{at~on is r~ir~ wi~h ~da ash due to rele~ of ca.on dioxide g~. Othe~i~. u~ an ine~ ~nt. Per~nnel ~ouJd wear full pro't~tive e~u~pmen[. '(~e ~ct~on I for w~z~ ~is~l ~th~s.) A~emgt to kind ~t o~ ~r. Any rele~ to ~e ~vironm~t of ~s Dmduct may ~ subie~ to F~rsI ~/or ~tato ro~Jn9 r~uir~. C~ ~i~ ~i~o ~c~s. EYES ANO.FACE As a minimum. ~Ye~r hard hca, chemical safety ~,cj~, m~d ~ll-f~ pla~ic sh{~id. Do no~ w~ar c~t~ len~s. For incre~ As a minimum, ~uocr ccid-ro~ist~n~ sgron, 13rotc~'~ivo ch3~ing, boots end ~untlet glovet for routine product u~. For incre~d 9ro'~cti~, incluc~ c~-refi~t trO~ and j~et. c)T~ CLOT~dG ~D EOU~PM'ENT Eve~'~3h C~)d Ouic'~-c:/rench shOwer farilit;ee -,,~,o,-*^,~ *---- ~ .... :-- -~- ........ $gflon IX--SP~[CIAL P~ECAUTIOi~ for fir~ ~'~cljecont To non.le~im3 tanks or ott~er cont~?ner~ of O~eum. F~E ExTINGuISHING AGE~TS TO ~VOIO Po not u~3 solid w~' strocri~ near ruptur~:t tanks or spills of Pleura. Acid re~:t~ vh3ie~tf¥ with wamr and can spatter ~cid onto SPECIAL FiRE ~G~TIPeG PIa{-~CAu?IO~$ At. high tomD=tature~, sulfuric ~cid mist Or sulfur triox~ele g;es can b3 rele~-,d from 9ente,~1 or rulotur~l containers. If water ~s add<~ to Pleura, violent spattering can ecx3ar, and considerable ,~e~t may :3e evolved. Wear NIOSN-aOgrovecl sari-contained bre~ing al;~atua ~ith full fcml3icco ~ hall ~rot~Ctie~ clothin~J. Cco~ non-leaking ~ire~oasc~ c~tainers with water sorer. VENTILATION S~.~c~n.~ to.;cdu~ ~.~g~c~ ~ cci:~ mb:tz ~o o~,T,{s~ibie ,.%el~. ;~c&egi~,~ cr~ unioczting =ret3., oan~L~processing ecluipment mw rc~qUire m~ct~enic~ e~h~uot systems. Corrosion-proo~ (~nstrucxion Keel:) sourc~ of i(~nition away. Do not ~t in eve~, on skin, on clothing. DO not breathe vapor or mist. Uso wi~ aC~ClUat~ ventil&- tion and u~ protective ec~uiDmont a= outlined ~n Section E. Procedunr~ sro dotaled in r~'~ferenc~s listc-d in ~ction J {Allied). Never mi~ watc~ ~nd Pleura. = a violent m,:~--tion STORAGC~ Store in cool, woll.vcn~ila~ e~e cw~ from ~busti~ ~ ro~ivo ~ V~t ~ ~n~ ~ly ~ moro SPECIAL. PRECAuTION~PROC~R~/~B~C iNSTrUCTIONS C~ ~ ~mo. Vo~ 0ntr~V' hazards-irritating to eV~ ~ ~r~ tr~. ~ unlo~in~ ~t on ~11 Orotamive TOXICITY ~TANOL;WAT~R P~.~TITI~ C~ ~ ICIENT ~PA~ZAnooussuBSTANC~ ~ C~ ,:SOLn~PonVAo~Ar~l'iVg: 1{3OO " I 1~-117 . ..~ ?~O. .:~ . .' . ' -, '," . ' Consult [uo~i~, ~ dilution ~ neut~lizat~on can ~ v~ hazardous. If t~ reciting violet ~'e~tion can ~ contained, waste ol~m should ~ ~utiouslV dilut~ ~i~ ~a~o~ end ~u~cliz~ with an alkali. Neutrahz~J ~sto must ~ dis~s~ of ~n ~cord- an~ with a~licablo dis~l r~l~ions. Waste may have to ~ diso~ of 3v an a~rov~wasm dis~sal contractor. {Unneutrahz~ matenat ~s EPA corrosive w~o-DO~). R CRA STATUS 01= "JNU$~: O MA TERIAL- 40CFR , Hazardous Wmto No. OOO2-Con'~ive and O003~Recc~ive if discarded 2e~ .22. 23. (2) TLV from ~o ACGIH 19~I lis~, :'Three. old Limi~ V~luc~ for Chemical Substance.. "Am. Conf. of Gov0mmental IndustrirJ Hygienics, Cinonn-..Tti REGULATORY STANOARO~ ILO O.T. CLAS$tFICAT*O~ Corr 3sire m,3{:er~al DOT.lID Number: NA 1§31 (a) Ooc~mc~tc~ion of tho Threshold L~m~t Value, 4th Edition, 1g~1, Am. Conf. of Gov~nm~t~l Hygienistz, Cincinnati 452~, ~: "~l~nc Acid". (b) Alli~ ~r~ration wsll che~. (c) Alli~ Cor~rati~ ~u~ information bulletin. l'he~.e general, rul. es are ~,e basis su~.furic acid: '' First aid mu$: be scar:ca immediately, since delay c~,n resul~ in 'serious injumy2 Call a physician as soon am possible, no m~tter hca' stigh~ ~he injury appears ~o be. All con,amino,ed clothing ~.~st: be re~vad im~a~ia{~ly. Flush affee~e4 areas of ~he body wi~h copious quan.~i~ie~ of wa~er until all ~races of sulfuric acid are remove~. ~, .,. ~ ~ nau~ra%iz~ ~ aci~ wt~h ~I~ al~line molu~,ons un~i~ all ;.'~.r'ea~ of.c~n~mct have b~n ~oroUghly yashe~.~..~ plentiful ~ounts I~ case of severe or 'ez~en~ive burns, shock s~cons -- rapi~ pulse, swaacin~, co~lapse -- ~hc appear ac amy ~lm~. %~e~ ~hay do, plata ~ke pa~zea: on his back and keep hi~ ~, no~ ho~., un:il a physiciam arrive~. Do no~ give any~Kin~'b~ ~ ~o ~ patient. . ~n case of eye con~ac~ wi:h sulfurt~ acid: Wash ~hu eyes wi~ copious quan~l~i~S of ~nnin~ wa%:er for tissues'of ~ha surface of ~h'e eyes and [ids. Do no~ use ho~ wacar. .. A physician, prefarably an eys specialis~ ~.~s~ be callz~.~dia=al If he does no~ arrive wi:his !5 minuses, ey~ irrisa~i~ ~houid be resumed for a second 15-~nu'Ce pe~iodl ':After '~h~'"~irs~'irri'~at~on.;...':.. '.~....'" '.. f~rs: 'az~':r,~,,~::Do""noc.;.u~o any o~~~ o~ oi~nt; .... · -'. ...... If sulfuric acid .bas .been ~aken.incernally, calP a physiaian-i~e- :, : din:ely. Do no~ induce roaring. Do no= give anything by ~uch aq unconscious If the patient is conscious, have him wash out his m~uth with copious quanti~ies of water. Then have him drink milk, preferably mixed wi[h the whi-~cs of eggs. If milk and egg whites are not availabl~, have thc pa~ien~ drink as much wa~ar as possible. Any accidental contact with sulfuric acid, ~d~echer external or in~ernal , should be d~c:~be~ ~o rme physician in de~ail..ac ch~ cimo ~hac' he called. Itc shoul~ ba given the exact rocor.ion of the patient. _ ........... Remove Co fresh air. Avoid repeated concac~ with skin and repcaccd breaching of vapors,