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Home My WebLink AboutBUSINESS PLAN 2/3/2003Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID #:: 015-000-001100 SOUTH CENTRAL POOL SUP LOCATION: 4601 GRISSOM ST Issued by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTA L SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Thi~ ~mit is issued for the followin_m [] Hazardous Materials Plan El Underground Storage of Hazardous Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment June 30, 2003 Expiration Date: Issue Date SCP DISTRIBUTORS, LLC Manager : VAL ESTRADA Location: 4601 GRISSOM ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: S~teID: 015-021-001100 BusPhone: Map : 123 Grid: 15D (661) 837-8344 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:5091 DunnBrad:87-296-5363 Emergency Contact VAL ESTRADA Business Phone: 24-Hour Phone : Pager Phone : / Title / BRANCH MANAGER (661) 837-8344x (661) 872-7050x (661) 201-7223xCELL Emergency contact THOMAS FLAKE Business Phone: 24-Hour Phone : Pager Phone : / Title / MANAGER GOV COM (985) 801-5128x (877) 821-9166x (877) 821-9166x Hazmat Hazards: Fire React ImmHlth DelHlth Contact : MailAddr: 4601 GRISSOM ST City : BAKERSFIELD Phone: (661) 837-8344x State: CA Zip : 93313 Owner SCP DISTRIBUTORS, LLC Address : 109 NORTHPARK BLVD 400 City : COVINGTON Phone: (985) 801-5128x State: LA Zip : 70433 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory --Alphabetical Order One Unified List Ail Materials at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax Unit MCP ALGAEZONE PLUS BROMINE TABLETS CALCIUM CHLORINE CALCIUM HYPOCHLORITE DIATOMACEOUS EARTH HYDROCHLORIC ACID LITHIUM HYPOCHLORITE ) METHYL ETHYL KETONE ~MURIATIC ACID -POOL ACID POTASSIUM PERM.~q'GJ~N'ATE PVC CEMENT ISILICON DIOXIDE SODIUM BISULFATE SODIUM DICHLORO-S-TRIAZINETRION E E E L F R IH S R IH S DH S R IH L R IH S R IH R IH R IH F F DH R IH 90.00 GAL Hi 5~ 6~8~00 LBS Ext 5~ ~ LBS UnR ~0 44~8~.00 LBS Mod l~ ~ LBS Min 500.00 GAL .Hi Hi Mod L Hi S Hi L Hi L Mod S ~ 29000..00 LBS Low S 1000.00 LBS Min S ~o,~ ~Q~.00 LBS Mod 1000.00 LBS !~c~U- GAL ~ 0 GAL 800 0,,00 LBS ~.00 LBS 100.00 GAL -1- 02/03/2003 F SCP DISTRIBUTORS, LLC = Hazmat Inventory --Alphabetical Order Hazmat Common Name... ISpecHazl ~SODIUM HYPOCHLORITE TRICHLORO-S-TRIAZINETRIONE SiteID: 015-021-001100 One Unified List Ail Materials at Site EPA HazardsI Frm I DailyMax UnitlMCP L ~D.I~9~-00 GAL Hi R IH R IH ~8~00 LBS Mod .... 2 .......... " 02/03/2003 SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Inventory Item 0016 Facility Unit: Fixed Containers on Site ALGAEZONE PLUS Days On Site 365 Location within this Facility Unit Map: Grid: WAREHOUSE AREA CAS# STATE . TYPE PRESSURE TEMPERATURE Liquid I Mixture I Ambient I Ambient I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 90.00 GAL 90.00 GAL CONTAINER TYPE Plastic Bottles/Jugs Daily Average 60.00 GAL %Wt. RS CAS# 71.00 Cooper Triethanolamine Complex No 82027596 25.00 Alkyl Dimethylbenzylammonium Chloride No 8001545 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ Curies NFPA /// USDOT# IHiMCP Inventory Item 0013 Facility Unit: Fixed Containers on Site ~Uiviiviu~ ~vl~ / ~1~ £ ~ ~vi~ BROMINE TABLETS Days On Site 365 Location within this Facility Unit Map: Grid: WAREHOUSE AREA CAS# STATE ~ TYPE Solid /Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 50.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 600.00 LBS Daily Average 100.00 LBS %Wt. HAZARDOUS COMPONENTS Bromochlorodimethylhydantoin RN~oRS CAS# 126067 TSecret No HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI F R IH NFPA /// USDOT# { MCPExt 3 02/03/2003 SCP DISTRIBUTORS, LLC = Inventory Item 0017 -- COMMON NAME / CHEMICAL NAME CALCIUM CHLORINE Location within this Facility Unit WAREHOUSE AREA SiteID: 015-021-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# STATE I TYPE Pure PRESSURE TEMPERATURE CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 2000.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 2000.00 LBS Daily Average I 2000.00 LBS I%Wt. I HAZARDOUS COMPONENTS HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ Curies NFPA /// USDOT# [ MCP UnR = Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME CALCIUM HYPOCHLORITE Location within this Facility Unit NW CORNER Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 7778-54-3 STATE T TYPE PRESSURE Ambient Mixture Solid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 100.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 4000.00 LBS Daily Average I 125.00 LBS HAZARDOUS COMPONENTS %Wt. I 65.00 Calcium Hypochlorite 7778543 ITSecretI ~S BioHaz No N No HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI R IH NFPA/// I USDOT# MCP Mod 4 02/03/2003 SCP DISTRIBUTORS, LLC = Inventory Item 0008 -- COMMON NAME / CHEMICAL NAME DIATOMACEOUS ~EARTH Location within this Facility Unit WAREHOUSE AREA SiteID: 015-021-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On .Site 365 CAS# 68855-54-9 STATE ~TYPE PRESSURE Ambient Pure Solid TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container I 25.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 2000.00 LBS Daily Average 800.00 LBS HAZARDOUS COMPONENTS I%Wt. I 100.00 Diatomaceous Earth I ~S CAS# N 68855549 TSecretNo N~SlBi°HaZNo HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI DH NFPA I USDOT# I MCP / '/ / Min = Inventory Item 0012 -- COMMON NAME / CHEMICAL NAME HYDROCHLORIC ACID Facility Unit: Fixed Containers on Site Location within this Facility Unit WAREHOUSE AREA Map: Grid: Days On Site 365 CAS# 7647-01-0 STATE I TYPE PRESSURE Ambient Pure ILiquid -- TEMPERATURE [Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION I Daily Maximum I 500.00 GAL Daily Average 500.00 GAL %Wt. 35.00 HAZARDOUS COMPONENTS Hydrochloric Acid RSI CAS# Yes 7647010 TSecret No I ~S BioHaz N No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH. NFPA /// USDOT# -5- 02/03/2003 SCP DISTRIBUTORS, LLC ~ Inventory Item 0015 -- COMMON NAME / CHEMICAL NAME LITHIUM HYPOCHLORITE Location within this Facility Unit WAREHOUSE AREA SiteID: 015-021-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 87-90-1 STATE T TYPE PRESSURE Ambient Pure Solid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 200.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 LBS Daily Average 200.00 LBS HAZARDOUS COMPONENTS %Wt. 29.00 Lithium Hypochlorite N 13840330 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA /// USDOT# IMCPHi = Inventory Item 0010 -- COMMON NAME / CHEMICAL NAME METHYL ETHYL KETONE Location within this Facility Unit WAREHOUSE AREA Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# STATE TYPE Mixture 'PRESSURE TEMPERATURE CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 1.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 150.00 GAL Daily Average [ 5.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Methyl Ethyl Ketone INoRSI CAS# 78933 TSecret No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies NFPA /// USDOT# I MCP Mod -6- 02/03/2003 SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Inventory Item 0005 Facility Unit: Fixed Containers on Site MURIATIC ACID Days On Site HYDROCHLORIC ACID SOLUTION 365 Location within this Facility Unit Map: Grid: OUTSIDE CAS# 7647-01-1 F'STATE T TYPE PRESSURE Ambient Mixture Liquid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 GAL Daily Average 700.00 GAL %Wt. 31.50 HAZARDOUS COMPONENTS Hydrogen Chloride RS[ CAS# Yes 7647010 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH I N FPA I USDOT# /// Inventory Item 0014 Facility Unit: Fixed Containers on Site ~U~ ~Vl~ / ~£~ ~Vl~ POOL ACID Days On Site 365 Location within this Facility Unit Map: Grid: WAREHOUSE AREA CAS# F STATE TYPE PRESSURE Solid Pure Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 100.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 8000.00 LBS Daily Average. 3000.00 LBS I%Wt.° 100.0 Muriatic Acid HAZARDOUS COMPONENTS RS[ CAS# Yes 7647010 TSecret ~SIBioHaz No N No HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI R IH NFPA/// I USDOT# MCP Hi -7- 02/03/2003 SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Inventory Item 0011 Facility Unit: Fixed Containers on Site ~U~U~ ~Vl~ / ~M~£~b N~Vl~ POTASSIUM PERMANGANATE Days On Site 365 Location within thi~ Facility Unit Map: Grid: WAREHOUSE AREA CAS# 7722-64-7 F STATE TYPE Liquid Pure' PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 50.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 650.00 LBS Daily Average 110.00 LBS HAZARDOUS COMPONENTS %Wt. [ 98.00 Potassium Permanganate N 7722647 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI R IH NFPA /// USDOT# I MCPHi -- Inventory Item 0004 Facility Unit: Fixed Containers on Site ~U~ ~vl~ / ~~ ~Vl~ PVC CEMENT Days On Site 365 Location within this Facility Unit Map: Grid: AGAINST N WALL CAS# 109-99-9 FSTATE ~ TYPE Liquid /Mixture PRESSURE Ambient -- TEMPERATURE lAmbient CONTAINER TYPE PLASTIC CONTAINER Largest Container 100.00 GAL AMOUNTS AT THIS LOCATION Daily MaXimum 100.00 GAL Daily Average 70.00 GAL %Wt. RS CAS# Tetrahydrofuran No 109999 Dimethylformamide No 68122 PolYVinyl Chloride No 9002862 TSecretINo N~S BioHazNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F NFPA /// USDOT~ I MCP Mod 8 02/03/2003 SCP DISTRIBUTORS, LLC Inventory Item 0007 -- COMMON NAME / CHEMICAL NAME SILICON DIOXIDE Location within this Facility Unit WAREHOUSE AREA SiteID: 015-021-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 14808-60-7 STATE --U- TYPE Solid /Mixture PRESSURE Ambient TEMPERATURE Ambient BAG CONTAINER TYPE Largest Container 10000.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 20000.00 LBS Daily Average I 10000.00 LBS %Wt. 50.00 50.00 HAZARDOUS COMPONENTS Silicon Dioxide Sulfur N 7631869 INo I 7704349 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI F DH NFPA/// I USDOT# MCP Low = Inventory Item 0009 -- COMMON NAME / CHEMICAL NAME SODIUM BISULFATE Location within this Facility Unit WAREHOUSE AREA Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# STATE I TYPE PRESSURE Ambient Mixture Solid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1000.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 LBS Daily Average 1000.00 LBS HAZARDOUS COMPONENTS %Wt. I 91.00 Sodium Bisulfate HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies NFPA/// I USDOT# Min -9- 02/03/2003 SCP DISTRIBUTORS, LLC siteID: 015-021-001100 Inventory Item 0002 Facility Unit: Fixed Containers on Site SODIUM DICHLORO-S-TRIAZINETRIONE Days On Site 365 Location within this Facility Unit Map: Grid: NW CORNER CAS# 2893-78-989 STATE T TYPE PRESSURE Ambient Pure Solid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 3000.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 3000.00 LBS Daily Average 500.00 LBS I I HAZARDOUS COMPONENTS %Wt. 100.00 Sodium Dichloro-s-triazinetrione N 2893789 ITSecret No HAZARD ASSESSMENTS No [ NoRSi --IBi°HaZl Radioactive/Amount No/Curies EPA RHazardslH~ I N FPA I USDOT# /// Mod Inventory Item 0006 Facility Unit: Fixed Containers on Site ~U~U~ ~vl~ / ~£~ SODIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE CAS# 7681-52-9 F STATE TYPE PRESSURE Liquid Mixture Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 1000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 10000.00 GAL Daily Average 2000.00 GAL %Wt. RS CAS# 12.50 Sodium Hypoch!orite No 7681529 1.00 Sodium Hydroxide No 1310732 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI R IH NFPA/// I USDOT# MCP Hi '-10- 02/03/2003 SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Inventory Item 0001 Facility Unit: Fixed Containers on Site ~UlVllVl~ ~Vl~ / ~l ~ ~vl~ TRICHLORO-S-TRIAZINETRIONE Days On Site 365 Location within this Facility Unit Map: Grid: NW CORNER CAS# '87-90-1 F STATE TYPE PRESSURE Solid Pure Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 17500.00 LBS AMOUNTS AT THIS LOCATION Daily Maximum 30000.00 LBS Daily Average 1000.00 LBS HAZARDOUS COMPONENTS %Wt. I 99.00 Trichloro-s-triazinetrione I CAS# 87901 HAZARD ASSESSMENTS Radioactive/Amount I EPA Hazards No/ CuriesI R IH NFPA /// IUSDOT# MCP Mod -ii- 02/03/2003 fi SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Fast Format ~ Notif./Evacuation/Medical --Agency Notification Overall Site 05/05/1992 IN THE CASE OF A SMALL SPILL, ONE HUNDRED POUNDS OR LESS, THE EMPLOYEES WILL NOTIFY THE BRANCH MANAGER. ONCE THE SPILL IS CONTAINED THE BRANCH MANAGER WILL NOTIFY THE SAFETY COORDINATOR FOR CONFIRMATION OF PROPER DISPOSAL PROCEDURE. IN THE CASE OF A LARGE SPILL, THE EMPLOYEE WILL NOTIFY THE BRANCH MANAGER WHO IN TURN WILL INITIATE EVACUATION AND NOTIFY THE FIRE DEPARTMENT. AFTER SECURING THE AREA AND~ACCOUNTING FOR PERSONNEL THE BRANCH MANAGER WILL NOTIFY THE SAFETY COORDINATOR AND THE AREA MANAGER. THE AREA MANAGER WILL -- Employee Notif./Evacuation 05/05/1992 OUR OPERATION IN BAKERSFIELD WILL ONLY HAVE FOUR EMPLOYEES. THE BRANCH MANAGER WILL HAVE ALL RESPONSIBILITY OF EMPLOYEE NOTIFICATION AND EVACUATION BY MEANS OF WORD OF MOUTH. IN THE EVENT OF HIS ABSENCE THE SECOND IN COMMAND ASSUMES THESE RESPONSIBILITIES. -- Public Notif./Evacuation 03/28/2000 THE CUSTOMERS OR ANY NON EMPLOYEES ARE RESTRICTED TO THE COUNTER AREA. EVACUATION OF THESE PEOPLE WOULD BE EASILY ACCOMPLISHED AND WOULD FALL ON THE BRANCH MANAGER OR HIS SECOND IN COMMAND. WE WOULD RELY ON THE FIRE DEPT OR OTHER EXTERNAL AGENCIES FOR THE EVACUATION OF THE GENERAL PUBLIC. Emergency Medical Plan 02/03/2003 EYEWASH STATIONS HAVE BEEN SET UP AT W END OF BLDG AND AT E END OF BLDG. IN MEDICAL EMERGENCIES NOT REQUIRING IMMEDIATE TRANSPORTATION TO A HOSPITAL WE WILL USE THE SERVICES OF BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET OCCUPATIONAL MEDICINE. SEVERE EMERGENCIES WILL HAVE THE PROPER AUTHORITIES CONTACTED. -12- 02/03/2003 F SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Fast Format Mitigation/Prevent/Abatemt Release Prevention Overall Site 05/05/1992 BECAUSE WE ARE A DISTRIBUTION COMPANY, OUR PRODUCTS, INCLUDING THE HAZARDOUS MATERIALS ARE BOUGHT AND RESOLD. THE MAJORITY OF OUR PRODUCTS ARE IN CONSUMER COMMODITIES. BECAUSE OF THIS, OUR RELEASE PREVENTION IS BASED ON PROPER STORAGE AND HANDLING. -- Release Containment 05/05/1992 BECAUSE OUR PRODUCTS ARE IN SMALL INDIVIDUAL PACKAGES, THE CHANCE OF A LARGE SPILL IS MINIMAL. IF A LARGE SPILL DID OCCUR, WE WOULD RELY ON. THE FIRE DEPARTMENT TO CONTAIN THE RELEASE DUE TO THE SMALL NUMBER OF EMPLOYEES. -- Clean Up 03/28/2000 IN THE CASE OF A SMALL SPILL, WE HAVE VERY SPECIFIC PROCEDURES FOR CLEAN UP. THEY INCLUDE TRAINING, PERSONAL PROTECTION (IE GLOVES, GOGGLES, AND RESPIRATORS), AND CLEAN UP EQUIPMENT (IE SHOVELS, CONTAINERS AND BROOMS). WE ALSO HAVE STRINGENT PROCEDURES FOR DISPOSAL, WHICH ARE CLOSELY SUPERVISED AND RECORDED. Other ResoUrce Activation -13- 02/03/2003 f SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 03/28/2000 A) GAS - ONE VALVE FOR THE ENTIRE BLDG, LOCATED TOWARD CENTER OF BLDG B) ELECTRICAL - PANEL IS ON THE E WALL, S OF OFFICES C) WATER - VALVE IS IN MANAGERS OFFICE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/10/1998 PRIVATE FIRE PROTECTION - THE BLDGHAS COMPLETE COVERAGE BY THE SPRINKLER SYSTEM. THE FIRE EXTINGUISHERS ARE MOUNTED TO SPECIFICATIONS. NEAREST FIRE HYDRANT - .THERE IS A FIRE HYDRANT LOCATED 25 YDS SE OF THE FRONT DOOR OF THE BLDG. Building Occupancy Level -14- 02/03/2003 F SCP DISTRIBUTORS, LLC SiteID: 015-021-001100 Fast Format Training -- Employee Training Overall Site 03/10/1998 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE 90 MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: OUR EMPLOYEE TRAINING BEGINS WITH HAZARD COMMUNICATION STANDARD INCLUDING MSDS CONTENT AND LOCATION, CHEMICAL PROPERTIES AND INCOMPATIBILITIES, AND EXPOSURE TREATMENT. TO INSURE PROPER USE OF THE EQUIPMENT USED IN HANDLING AND STORING THE CHEMICALS, WE HAVE A FULL RESPIRATOR PROGRAM INCLUDING A PULMONARY FUNCTION TEST AND INSTRUCTION ON THE USE AND CARE OF OUR RESPIRATORS. WE ALSO HAVE OUR EMPLOYEES FORKLIFT CERTIFIED AND INSTRUCT THEM ON PROPER OPERATION OF A FIRE EXTINGUISHER. WE HAVE VERY SPECIFIC PROCEDURES IN OUR SPILL CONTAINMENT AND CLEAN UP PROGRAM. WE EMPHASIZE WHAT NOT TO DO AS WELL AS WHAT TO DO IN THESE SITUATIONS. THESE CHEMICALS ARE INCOMPATIBLE AND REACTIVE AND THEREFORE REQUIRE CERTAIN CONSIDERATIONS DURING CLEAN UP. -- Page 2 --Held for Future Use Held for Future Use -i5- 02/03/2003 ,f UNIFIED PROGRAM CONSOLIDATED FORM BUSINESS ACTIVITIES FACILITY INFORMATION ~ ~FACILITYID# ! : : ~ i i , ! '-.EPAID#(HazardousWast¢( D LUUL ' ~ H. A~TI~ DEC~TION ~ NOTE: If you check YES to any pa~ ofth~ Hs~ ~ please submit the Business Owner/Operator Identification page (OES Form 2730). ; ; If Yes, ple~e complete these pages of ~e UPCF... I ~ ......................... Does your facility... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquid, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTsand USTs); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for B. UNDERGROUND STORAGE TANKS (UST) I. Own or operate underground storage tanlcs? 2. Intend to upgrade existing or install new USTs? 3. Need to report closing a UST? C. ABOVE GROUND PETROLEUM STORAGE TANKS (AST) Own or operate ASTs above these thresholds: · any tank capacity is greater than 660 gallons, or ~ t!~e t?~9! ~pac!ty for ~h~ ~a~!!ity is.g~'v~,.a,,.t,~r ~h~E.!,,~0 D. HAZARDOUS WASTE l. Generate hazardous waste? 2. Recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC Section 25143.2)? 3. Treat hazardous waste on site? 4. Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? 5. Consolidate hazardous waste generated at a remote site? 6. Need to report the closure/removal of a tank that was classified as hazardous waste and cleaned onsite? LOCAL REQUIREMENTS P'~ES · 'NO4. · YES ;~'~'NO s. ,t' YES '/"NO,, 6. YES :iCe' NO ?. YES : ~O s. YES :i~,/j~o 9. YES 'i/~NOi0. YES · ,:: YES ~'NO~2. i ~ YES YES ~NOl4. HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION (0~ 2231) UST FACILITY (Formerly SWRCB Form A) UST TANK (one page per tank)(Formerly Form'B) UST FACILITY UST TANK (o,~ pe~ tank} UST INSTALLATION - CERTIFICATION OF COMPLIANCE (one page per tank)(Formerly Form C} UST TANK (closure portion - on page per tank) NO FORM REQUIRED TO CUPAS EPA ID NUMBER - provide at the top ofthis t~ge RECYCLABLE MATERIALS REPORT (one per recycler) ONSITE HAZARDOUS WASTE TREATMENT - FACILITY (Formeay D~sc For~ ~772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit)(Forrnerly D'I~oC Forms 1772A. B, C D, and L) CERTIFICATION OF FINANCIAL ASSURANCE (Formerly D'I'SC Form 1232I REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFIACTION (For-ear iasc vom~ n96) HAZARDOUS WASTE TANK CLOSURE 15. (You may also be required to provide additional information by your CUPA or local agency.) UPCF(I~9) 9 02/29/00 us,. s .......................... ~: OWNER/OPERATOR;ATION Page __ of __ I. IDENTIFICATION ~"~ii::'i'~'" 6d''''''~ .......... : ', i ....... "' '!"" ............ !' ';': :'~: "'~iE~ 'i~ 'N~"6;K~= '": ~"I 'E'~'Ei'~'~'6:~YE ' ':' ~6'~:'''''~ .............. ~.C...~ ..O..~...~+c.,..b.>~4~ ~.~ ~.....~ .......... ~ ;~ BUSINESS SITE A~RESS ............. ~1~.~~ ....... ~"~. ~ ~ ~...~ c,~ ~.~:~, ,~:~ z,~oo~ 733/3 DUN & B~OSTREET 1~ SIC CODE .................................................................................................................................................................................................................................................................... ~'~ ...... COUN~ ~F~ II. BUSINESS'OWN~R ':~: '. .": ' ~ .¢;~ · .............. .< ~..:... ................. ~ ¢' ............ :.......;~....~ OWNER ~AILING ~.~s~.../..~. ~<~.~......6.!~ %~..q .............. III. ENVIRONMENTAL CONTACT 117 CONTACT PHONE CONTACT MAILING . .,'PRIMARy- · .' ..:.?iVf::EMEB~:ENCy:CONy~S ============================ ..... 124 I 129 TITLE ~ / ~ ~ TITLE ¢r~ BUS,NESSPHO.E 6*(, W .~ i BUS,NESSP"ON ........ ,._(¢.._¢ _..~.7,.,_-_,,~&_.~ ..... +. ..... L~?¢, ......... ~ :__~_~__ ,~-HOUR P,~.E (G(,,~ ?'~ - 036 ~ .._ _'~ j. ZZ-~.O.?R 'd'~'~"R";' ...... : :~ i PAGER # '50q ~,"-/ ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete~ Si'Gl~,~l~.~"(~/~lE~0~l~'~,"~'t~'~ O'E~i~N~,¥'E~E~EN~:~:iV~ i'"~TE :~4 ! NAME OF DOCUMENT PREPARER 135 ~NAME OF SIGNER 0)n'nf)'- 1~--~ TITLE OF SIGNER !..... ~ ~ ~...... ~..~,~ ,,:... o~ .~ ~,,:,~ ~....... ~..!..;_ ~,. 10 02/29/00 DES FORM 2730 (1/99) OU~V~ ~ HA7_ARDOUS MATERIALS ~ HAZARD ATERIALS INVENTORY- c ICAL DESCRIPTION (one form per material per building or area) [] ADD [] DELETE I~'REVISE 20o Page __ of__ I.. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Busir~ess As) 3 C :~ CONFIDENTIAL- / i EPCRA ~ ~ L ........ ~ :"~?;~,~ : 7i~':~ii ' ~;'~ i~o~io.aa 2o3 GR e # (op~'onaO FACILITY ID #~ ~ !',.!,:! ~ :!!:/J :: i ¢-i ~:,:: ' - - II. CHEMICAL INFORMATION ...................................................................................................................................... ~- .... ~5~.-.~[~ CHEMICAL NAME ~ ~S ~NO COMMON N~E ~7 EHS* ~ FI~E CODE H~RD C~SSES (~te I~byCUPA) 210 PHYSICAL STATE ~. SOUD D b. U~lD B ....................... FED H~RD CATEGORIES 216 (c~*,u~o~,~¢~) 0 a. FI~ O b. ~A~IVE O c P~SSU~ ~L~SE O d. AC~ H~ ~ ~R~IC H~ ;'"~(~'~ n~.v ~ 217 ]M~IMUM 218 [~NNUAL WASTE ; 219 [STATE WASTE AMOUNT /O O~ .......... ~ ~DAILYAUOUNT ~OOO j ~AMOUNT ~ ~ I ~CODE UNITS' ;0 a GAL B b CU ~ ~c. LBS O d. TONS ~ ~ i u~ STOOGE CONTAINER (Ch~kall~t appl~) ~ a. ABOVEGROUNDT~K ~ e. P~STI~ONM~LIC DRUM ~ i, RBEED~ ~ m. GLASS BO~LE ~ q. ~ILCAE ~ b, ~DEEGEO~D TANK ~ [. CAN ~. BAG ~ n. P~S~C BO~LE ~ r. OTH~ ~ c. TANK INSIDE BUILDING ~ G. C~OY ~ ~ BOX ~ ~. TOTE BIN ~ d. STEEL DE~ ~ h. SI~ ~ I. CYL~DEE ~ p.T~KWAGON STOOGE PRESSURE ~. ~BI~ ~ b. ABOVE A~[E~ O c. BELOW AMBIENT STORAGE TEMPERATURE [~a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC · HAZARDOUS COMBO ,NE~ NT: (f,;?~,~;~ ~,,~,,~)' ..,; :..',,;.::'.'.';:?.:.: ,.~ ;:~.:: ..:,. :-. :.~.:¥¢,,:~:.~ ~.,,?.,;, 226 227 I 228 !OYES ONO .2 ~ IOYES 0 NO --'""- ........... 234 !' ~ 235 236 237 i3 . iOYES [] NO ,' '""'~ ................ 2~ '~ ......................................................................................................................................... ~ 'tl ~,,~ ................. ~ 241 o YEs ONO ~ ~ 242 ~ , ~5 ~ ; i OYES 0 NO ! If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogenic attach addilional sheets of paper capturing the required '~ ADDITIONAL LOCALLY COLLECTED i INFORMATION: 246 If EPCRA please sign here OES FORM 2731 (1/99) 11 02/29/00 INVENTORY DADO O ~ O REVlSE ~o HAZARDOUS MATERIALS ICAL DESCRIPTION (one form per material per building or area) Page of BUSINESS NAME (Same as FACILITY NAIVIE o~ DgA-O~ng Business As) CHEMIC~ LO~ON .............. 7 ~ ~NF oe~- ~ · ~ ~. II II. CHEMICAL~INFORMATION : ............. ~....: ........... .:.. : ,:..........:L.=....:.....S ............................ : ............... [ CHEMIC~ NAME ~ T~DE SECRET ~ COMMON ~E ~7 EHS' 55- Sq-- FIRE CODE ~RD C~SSES (~e ~g~byOUPA) 210 1WPE (Check one lorn on/y) ' * { i PHYSICAL STATE OAS I ~ I ~ FED ~RD CATEGORIES O & R~ O b. ~A~I~ 0 c P~S~ ~SE O d. A~ A~ ~. ~IC ~ ~6 alt that apply) 8TO.GE CO~AINER 0 b. ~DERGRO~D TANK 0 [ C~ ~. BAG 0 O ~. lgr ~SlDE BUILDING O G. ~Y 0 ~ BOX O 0 · S~L DR~ 0 k S[~ 0 L ~DER 0 p. T~ W~N 219 ...... STATE WASTE , 223 [] [] ~. o~E~ STORAGE PRESSURE [~a. AMBIENT O b. ABOVE AMBIENT O c. BELOW AMBIENT ~24 I STORAGE TEMPERATURE 225 i la'~. AMBIENT O b. ABOVE AMBIENT [] C. BELOW AMBIENT O d. CRYOGENIC . ~{ -. [ '-- ' '"' ''~--- '~'";'; '-'"'~- ----- ' '---"%',';.,--' :' ::~" · ;~,S~' 9:. ,~ "' ., ',~ik";rk.g" ,:i.,,'..~ ..,:<,~' :,',~ :; ~'!i':':. ::~ ,) <':.~5.~'5'ZT,!~?;/;ig:~':';,~;'~:,~~~:,?:,',T,'2.~,~S~,,';";i .,<,.':' ~?::~"' ". ;'F '~" · ' '. o · :~ '/::: .', " ' ........ ~;~ ~4.'¢:¥44<,,::.~?~:.:C:~,¢',&?,-~';:,*~.:,:;'~:*:< ,::r%. ,,-,~ *.,':-,(g~F~, ~ ' ,, _.-< 2:t2 OYES ONO OYES 0 2~5 OYES 2~ 2~ 'O~S If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogemc, attach additional sheets of paper capturing the required ADDITIONAL LOCALLY COLLECTED INFORMATION: if EPCRA please sign here 237 241 245 246 OES' FORM 2731 (1/99) 11 02729100 HAZARDOUS MATERIALS : IALS INVENTORY- c ICAL DESCRIPTION i (one form per material per buildin~ or area) 0 ADD 0 DELETE I~ REVISE ~oo Page __ of__ · 1, FAClLI~ INF'ORMA~ION BUSINESS NAME (Sa~ as FACI~ ~ME ~ O~ Busine~ ~) 3 FAC LI~ ID ~ ~ ~ ?~::.~ ~ ~ ~ [ .( :~ ~ ~ (optionaO ~ ~ GRID ~ (opaonao ~ II. CHEMICAL.INFORMATION CHEMIC~ NAME ~ T~DE SECRET ~ ~S ~ ~ COMMON NAME ~7 EHS* ~"Fi~'E'~bDE H~ARD CLAssES'~;e'~;~P~ 210 ~ " ............................... ~'1~ CURIES ........ 2'~' ~ H~RDOUS MATERIAL ~ a. ~ ~b. M~ ~ c. WAST~ 211 ~DIOACTIVE ~ ~S ~O ' ~PE (~ ~ ~em ~) (Chec~ on i~em only) (C~alltSatapp/y} O a. R~ 0 b.~A~IVE ~ c P~SS~L~SE ~ d.A~H~ ~. ~R~IC~ ~UOUNT /~'~'~"~ ~ bA~LYaUOUNT ,~ ~ ............. ~ ~UOUUT ~: ~ [CODE STOOGE CONTAINER (Cb~ all ~(~ply) ~ a. ~OVEGROUND T~K ~ e. P~TI~ONM~IC DRUM ~ L RBER D~ ~ m. GL~S BO~LE ~ q. ~[L CA~ Q b. ~DERGKOUND TANK Q C CAN Q j. aaa ~ P~S~C BO~LE O r. OTHER ~ c. TANK INSIDE BUILDING ~ G. CA~OY ~ K. BOX ~ o. TOTE BIN ~d. STEELDR~ ~ h. S[~ ~ I. CYLINDER ~ p,T~KWAGON STOOGE PRESSURE ~, ~BIE~ ~ b. ABOVE A~IE~ ~ c. BELOW AMBIENT ~4 STOOGE TEMPE~TURE ~. ~BIE~ ~ b. ABOVE A~IE~ ~ c. BELOW AMBIENT ~ d. CEYOGEN[C %WT H~OUS cO~o~' "" ~ ' ¢o,:,~t,~)~ - ' : ::~::~::EHS "~': ,:, ~ ' :..::CAS: ¥.~:,::'::,~:.~.? !3 , ,OYES 0 NO :.. ~ ~ ~"]' ~, ~ ~-- ~4~ ~O~S ~0~S ADDITION~ LOCALLY COLLECTEO INFORMATION: [(B~C~ please si~n 11 02/29/0O OES FORM 2731 (1/99) HAZARDO S HAZARDOUS MATER,ALS MATERIALS INVENTORY- MICAL DESCRIPTION L~~.~. (one form per material per building or area) ADO D DELETE ~"REVISE 2oo Page. of__ BUSINESS NAME (Same as FACILITY NAME o~ DBA-Doing Business As) CHEMICAL LOCATION CHEMICAL LOCATION FKCILITY ID #~ ~"': [ ~¢!i/! )::: MAP # (optional) ~t~[u ~ [opuo aq CAS~ ~ :. "t'.':t:. ..... :.~:.:. : ...... FIRE CODE HAZARD CLASSES (Comp~e ifmqu~redbyCUPA) TYPE (Ct~:~ oao ~om oa/~ ' (c~c~o.. .... 9) D a. ~UD ~ U~ID D c. GAS 2~4 FED H~RD CAT~GOR~S ~ R~ D b. ~A~i~ D c P~S~ (Che~ all tha~ apply) AMOUNT C~ .............~ iDAILY AMOUNT 150[ ..... ] ~MOUNT [~. GAL ~ b. CU~ Oc. LBS UNITS' D d. TONS STOOGE CONTAINER (~[ ~11 ~t ~ply) ~ a. ABOVEGROUND TANK [] ¢. PLASTIC/NONMETALLIC DRUM [] b. UNDERGROUND TANK ~. CAN ~ c. TANK INSIDE BUILDING [] G. CARBOY [] ~ STOic 0~4 [] ~. sma 0 L l~I]~J~. DRUM 0 m. GLASS BOT'IlJ~ [] q. RAIL CAR [] j. u^o [] ~ ru,~c uovrtz O ,. o~ ~ ~ aox ~ o. TO~ Bm ~ L ~DER ~ p.T~WA~N 216 STORAGE PRESSURE ~ AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT STORAGE TEMPERATURE [~"~. AMBIENT nb. ABO'CE AMBIENT C]c. BELOW AMBIENT 0 d. CRYOGENIC 11 t I~"YES [] NO OYES 237 i4 .... ~.,~_i __~0 YES [] NO 244 ~ 245 !5 iOYES ONOI ~lfmorehazardouscompo e arepresentatg eatet a 1~ y 'g ~ ' g ', · ~ Y .... · '' ' ~DITION~ LOC~LY COLLECTED INFORMATION: 2~ If EPC~ plc~e sign here OE$ FORM 273~ (~) l I 0~9/~ C~M HAZARDOUS MATERIALS i ICAL DESCRIPTION (one form per material per building or area) ADO 1-1 DELETE I~' REVISE ~oo Page of .,. · .,' ·· i , .:...;: HAZARDO~ MATERIALS INVENTORY - BUSINESS NAME (Same as FAC~t.r~f NAME o~ OSAq3o~ng Business As) CHEMI~ LOCATION ml ~EMI~ L~TION II..OHEMICALINFORMATION~ ~ ' · ~ CHEMIC~ NAME ~ T~DE SECRET 210 ;'-~'~-~0'~×~i×c ....... 'EiT'~' ...... ~.~'~ 6"Z'""~'~" '~;;i'''~x~i'~ ...... 6"'~'~'~'6'''~ ....... ~'"-~- ..................... ~PE (~ ~ ~m ~ FED HAZARD CATEGORIES (c~,,~d,~,w~,~) O a. FiRE ~ b. REACT[VE ~c PR. ESSURERELEASE I~.ACt.rI-EHEALTH ~ .... i OUNT .A_U_0qNT- ........................ / !. O777].'.'... [i~A, LY AMOUNT UNITS' (Ch~k ~e item only} STORAGE CONTAINER (Check all O a. AEIOVEGROUNO TANK ~ PLASTIC~IONMETALLIC DRUM [] b. DNDERGROUND TAJ'qK 0 f. OAN [] c. TANK INSIDE BU[LD[NG O O. CARBOY 0 · STEELDRUM [] h. 0 c. CHRONIC HEALTH 219 ]- TATE WASTE I IOAYS ON ' O L FH3ER DRUM Om. GLASS BOTTLE O q. R.A[L CAR [] j. ~AO ~ e~c.orrt~ O ,. o~a~ O I~ BOX O o. TOTE BIN 0 L CYLTHDER 0 p. TANKWAGON 216 STORAGE PRESSURE [~a. AMBIENT 0 b. ABOVE AMBIENT O c. BELOW AMBIENT STORAGE TEMPERATURE 225 ! ~a. AMBIENT 0 b. ABOVE AMBIENT O c. BELOW AMBIENT 0 (L CRYOGENIC .... ' ' · *':'"":- "! 2~;' :" ' · ~' ': "~:: :' .~ ~:;%¢~ ""~:' ~"~ .':' .!x -' , ':,::":'~>':/,;:~i~:.~,''~ ;' ;'.- ,:x.,:-.':~ ,; ~i ::yi. ' ,~..;;>~: ~3 ~ : O~S ...... ! ............ ~-'-~ ~"- ~ ~4~ ~4 ~ ~ Q~S D~ ~5i ~ o~s o~ ~ ~DITIO~ LOC~LY CO~ECTED ~ INFORMATION: 2~ If EPO~ plcasc si~ bcrc OES FORM 2731 (1/99) 1 ! 02/29/00 i HAZARDOUS MATERIALS ~ HAZARDO~ MATERIALS INVENTORY- C~MICAL DESCRIPTION ... i. · (one form per material per building or area) I-I ADO [] DELEIE [] REVISE 20o Page __ of [· .'::~. I.;FACi:LITY. INFORMATION~ ,,',·''~'~' ,, ~,.: . . ..: ':{' :) :~:: :~._'.:;il;;i: BUSINESS NAME (Same as FACIUTY NAME or DBA-OOng Business CHEMICAL LO~rlON 2Ol CHEMICAL LOC. ATION 202 CONFIOEI',~FIAL - O YES CHEMICAL NAME 205 TRADE SECRET [] YES L3'-~NO 206 207 EHS' 2O6 · ~ ^ oYEs ~m FIRE CODE HAZARD CLASSES (Comp~e ifmquiredbyCUPA) 210 FEO H~D CATEGORIES STORAGE CONTAINER (Check MI tl~t apply) [] a. ABOVEGROUNO TANK [] ¢. PLASTIC/NONMETALLIC DRUM [] b. UNDERGROUND TANK [] f. CAN 0 ¢. TANK INSIDE BUILDING [] G. CARBOY [] L FI~ER DRUM Om. GLASS BOTTLE [] j..^~ ~ namc ~orru~ [] lC BOX ~ o. TOTE B~ ~ L CY~DER ~ p.T~WA~N TAlE WASTE I I ..... k~XYS ON ' ~- 223 STORAGE PRESSURE ~a. AMBIENT [] b. ABOVE AMBIENT El c. BELOW AMBIENT 224 STORAGE TEMPERATURE 225 I~'a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] & CRYOGENIC i 1 3 5 ...... ta or.;.3·~. [] YEs 7'm i - OI - o 3 O~S O ~ :;4 ~ ~O~S 0~ ~ fmore hazardous components are present at grealer than 1% by weight Cnon4arcinogenic or O. 1% by weight ¢carcinogentc, attach additional sheets o/paper capturing the required ~ ~DITION~ LOC~LY COLLECTED ~ INFORMATION: [f EPC~ plebe sign hem OES FORM 2731 (1/99) 11 02/29/00 ;: HAZARDO~ ~ C~ HAZARDOUS MATERIALS L._.__._.._.__VIATERIALS INVENTORY - ICAL DESCRIPTION (one form per material per building or area) [] ADO D DELETE REVISE 20o Page__ of__ .: L::FACiLi~:,:iNFO~MATiON. !.,< ~:i];::: ':,% BUSINESS NA~E (Same as FACILITY NAME (~ OSA-E~ng Business As) CHEMICAL LOCATION i CONFIDENTIAL- ! EPCRA [] '¥1~S ~UO .................... ......... ...... ''''''':. .-171.-- .'. CO~ON N~E ~1 EHS' ~ ~S FI~ COD~ H~D C~SS~S (~te ~byCUPA) .... ~'~'~-~'~'~ .......... ~'i'"'~'~ ~5~ 6'L ~h~'"'""'~v;'~'~'~ ............ 6~'~'-'~ ......... ~'"-~ .......... .... 216 j FED HAZARD CATEGORIES ~}~ RRE ~. REACTIVE [] c PRESSURE RELEASE i~/a. ACUTE HEALTH (Ckec~ all that i0~ ~'OAI~AMOU.T ~00~ ~ ....... i FMOU"T AMOUNT UNITS' j[] a. GAL [] b. CU FT ~c.--J~BS [] d. TONS (C~¢¢k oa¢ item oo1¥) ! [] c. CHRONIC HEALTH 219 I'-I'"JSTATE WASTE J~j L.IC?.OE .J' _j /p'~ 3(.51 STORAGE CONTAINER 223 (c~cckallll~(R~ply) [] a. ABOVEGROUND TANK ~c. PLASTIC/NONMETALLIC ORUM ~ L ~ERDR~ ~ ~ G~S BO~ ~ q.~L~ 0 c. T~K INSIDE BULLDOG ~ O. ~Y ~ ~ BOX ~ o. TO~ ~ ~ · S~L DR~ 0 h. SI~ ~ L ~DER ~ p, T~WA~N STORAGE PRESSURE ~'a. AMBIENT I-1 b. ABOVE AMBIENT Fl c. BELOW AMBIENT 224 STORAGE TEMPERATURE [~ AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC ..... oyEs 243 ~ OYES 237 [] YES 240 241 OYES ONO 244 245 i If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogenic, attach additional sheets of paper capturing the required . ~ AOOITIONAL LOCALLY COLLECTED i INFORMATION: 246 If EPCRA please sign here OES FORM 2731 (1/99) 11 02/29/00 ; ~ ~ HAZARDOUS MATERIALS i (, e f p te ial per building or area) 0 ~ 0 ~ ~ ~SE ~ Page ~ of__ BUSINESS NAME (Same as FAClU'TY NAME ~ DBA-Doing Business As) 3 CHEMICAL LOCATION 201 j CHEMICAL LOCATION 2Q2 i CONFIDENTIAL- i EPCRA [] Y~S FAc LITY ID #i : !: i ! !(: :'i ! ~ }~::?~ MAP # (op~io.aO .......................... ~" '"~'~i[J'~-i~'t)~ ~ .... · , ) ~ i:: -~, ~ : ' , ~ ! ~,::::::; '~-'HFMII2AI___...._ _·INFORMATION : "' '. ' ' II. i"a:iE~'ia~'~iX~[ :~ T~DE SECRET ~ ..... OYES CAS# 209 ~ .: ..' ...",.,,:., .:: FIRE CODE HAZARD CLASSES [~e lmquiredbyCUPA) 210 HAZARDOUS MATERIAL [] a. PUREE l[>%. MIXTURE [] c. WASTE 211 RADIOACTIVE [] YES [] NO 212 CURIES 213 TYPE lC, hock o~e .~em PHYSICAL STATE 214 LARGEST CONTAINER 215 ~"a. SCUD [] b. UQUID [] c. GAS (Ct, e~tatt,~,~,,~p~) ~'~. FIRE [~.REACTIVE Cc PRESSURE RELEASE t~.AOLITEHEALTH AMOUNT ............ i iDAiLYAMOUNT ~.~1~i ............... ! IAMOUNT UNITS' Fl a. GAL [] b. CUFF I;}"¢. LBS O d. TONS 22~ (Check one item only) STORAGE CONTAINER 223 (Cl~ck all fl~at apply) [] a. ABOVEGROUND TANK [] e. PLASTICtNONMETALLIC DRUM [] b. UNDERGROUND TANK 0 f. CAN [] c_ TANK INSIDE BUILDING O G. CARBOY 0 L FIBER DRUM [] r~ ~ox ~ I. CYLINDER [] e. CHRONIC HEALTH I'""t"I TATE I pAYS ON ~ P~C BOI'TL~ ~ r. O~ ~ o. TO~ B~ STORAGE PRESSURE ~a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [~"a. AMBIENq' O b. ABOVE AMBIENT [] c. BELOW AMBIENT O d. CRYOGENIC 225 · '- -' ' ' . . · ' :-:3' , · :::j , : .: ~;. · :,~ j., :L,'-:~!; ::.;:..,.'!~.;k'i.:,'. ~" I . .. ,, . : , .:r .. ..... ,: '~ "' Y ',' ,', L' ,~ .,', ',~ r,.,~ ~x~-.~'~'''~-W~ 233 [] ,ms ~NO 231 !2 ~ i [] YES 234 ! i3 ~ [] YES 238 ~ 235 i4 i , [] YES 242 ~ 243 ~5 i [] YES 236 237 240 241 244 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogentc, attach additional sheets of paper capturing the required ADDITIONAL LOCALLY COB ECTEO INFORMATION: {f EPCRA please sign here 246 OES FORM 2731 (1,/99) I ! 02/29/00 HAZARDOJ~J~j ATERIALS INVEN1 c~ HAZARDOUS MATERIALS MATERIALS INVENTORY - MICAL DESCRIPTION ADD D DELETE [~'REV1SE 2oo Page of__ I..;:FAciLITY INFORMATION [.': ~ : ::_ : =: ::: . .... BUSINESS NAME (Same ~ FACILITY NAME DC DBA-Doing .201 i CHEMICAL LOCATION CHEMICAL LOCATION 292 J i CONFIDENTIAL- C] Y~S FACILITY ID Iii ! !i!?.[ ~ ?.i~ !i i ', i ~ j' '.?i1' MAP # (optional) 203 ! GRID # (optional) 204 CHEMICAL NAME 205 TRADE SECRET [] YES J~O 206 COMMON--NAME 2o7 EHS' O YES ~'""NO 2o8 FIRE CODE HAZARD CLASSES (Comptetei[mq~/redbyCUPA) 210 PHYSICAL STATE ~5/a. SOLID [] b. LIQUID [] c. GAS ~14 i LARGEST CONTAINER FED HAZARD CATEGORIES 216 (c~ttt~tqo~t~,) [] a. FIRE g b. REACTIVE [] c PRESSURE RELEASE g d. ACUTE HEALTH ~e. CHRONIGHEALTH I UNITS !C] a. GAL [] b. CU FT '~>~' LBS [] d. TONS ~21 (Ch~ck o11¢ item on]Z) ! STORAGE CONTAINER (C~eck all tha~ apply) ~ a. ~O~GR~ND T~K ~ P~ONM~IC DRUM ~ b. ~DERGROUND T~K ~ f. ~ g c. T~K INSIDE BUILD~G ~ G. ~Y .... TATE WASTE / JDAYS ON 223 O L FH3ER DRUM [] m. GLASS BOTTLE I-] q. RAiL C.,~R ~. BAG ~PLASTICBO'I-I-L~ [] t. OTHER [] lC BOX [] o. TOTE BIN 0 L cyLrNDER 0 p. TANK WAGON STORAGE PRESSURE J~a. AMBIENT [] b. ABOVE AMBIENT [] c. ,BELOW AMBIENT m4 STORAGE TEMPERATURE ~a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] cL CRYOGENIC ms OES FORM 2731 (1/99) 11 02/29/00 ? i HAZARDO MATERIALS INVENTORY o o HAZARDOUS MATERIA~_S - C~MICAL DESCRIPTION (one form per material per building or area) Page of __ ~-0SlNES~ NAME (Sa~ne as FACILITY NAME o~ OBA-Ooin~ Bus, ness As) CHEMICAL LOCATION 2Ol CHEMICAL LOCATION 332 i CONFIDENTIAL- ~ ~ L) / i EPCRA U ]fl:~ ................................... ........................................................................................................................ i .................................................................. · II.,CHEMICALINFORMATION · '" ' ' ' CHEMICAL NAME 205 TRADE SECRET [] Y~S ~NO 206 COMMON NAME 337 EHS' f%ll. , , ~1 [] YES ~OUS MATERIAL ~ & ~ ~b. M~ B c. WASTE 211 ~ ~DIOACTIVE ~ ~S ~ 212 CURIES 213 PHYSICAL STATE 214 LARGEST CONTAINER [i/a. SCUD [] b. UQUID [] c. GAS (Ckect o. i~¢r~ o.ly) FED HAZARD CATEGORIES (C~ec~alltfiatapply) O & RRE [] b. REACTIVE Dc PRESSUtLERELEASE O d. ACUTE HEALTH AMOUNT C~,J'3,~k~ ........ i IDAILYAMOUNT ~.~a¢~.~ .............. i JAMOUNT STORAGE CONTAINER (Cbec[ tll t~ ~p@l¥) O a. ABOVE[GROUND TANK O c. PLASTIC~NONMETALLIC DRUM O L FH~F~. DRDM [] m. O c. TANK [NS[DE BUILD[NO [] O. C/d~OY O i~ aox O e. TOTE BIN 0 4 STEEL DRU~ 0 h. SILO 0 L CYLINDER 0 p. TANK WAGON STORAGE PRESSURE 'J~ AMBIENT-- [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 215 219 ..... STATE WASTE i ID~vs ON '- [] q. ~JLC~ O r. O~ 216 STORAGE TEMPERATURE Fa. AMBIENT 0 b. ABOVE AM;BlENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 O1'40 [] YES 237 3 i i OYES ....... 1 ................ Z~'"i ~-- ~4~ i4 i i OYES f5 { i ~OYES ADDITIONAL LOCALLY COLLECTED INFORMATION: 246 If EPCRA please sign here DES FORM 2731 (1/99) 1 i 02/29/O0 ~ HAZARDO~ MATERIALS INVENTORY OADD [] D~ [~SE 2~o HAZARDOUS MATERIALS - ~MICAL DESCRIPTION (one form per material per building or area) Page 'of__ ~ BUSINESS NAME (Same as FACILITY NAME o( DBA-Do/rog Business As) 3 CHEMICAL LOCATION 201 i CHEMICAL LOCATION 2(12 FACIL TY D# ::=: f ! ~i!i i~ MAP # (optional) 203 GRID # (optional) 204 :.':; :' :11. CHEMICAL INFORMATION ~':' CHEMICAL NAME 205 TRADE SECRET [] YES (~qO 206 · i~ma:tion~ /- 445_'._~ ............ OC610,C;_3~' COMMON NmE [] YES £:4&',~. Pool Sb~ ~.......+ ,"'~/~' ~ / FIRE CODE ~RD CLASSES (Co~r~o~to tfmquimdbyCUPA) 210 HAZARDOUS MATERIAL [] a. PURE g~b. MIXTURE [] c. WASTE 211 [ RADIOACTIVE [] YES O NO TYPE PHYSICAL STATE 214 ~i~ LARGEST CONTAINER 2~5 ~a. SOLID [] b. UQUID [] c. GAS i FED HAZARD CATEGORIES 216 ~ FIRE I~b. R~ACTIV~ O c ~RESSUR~ RELF~SE i~d. ACLrrE HEALTH O ¢. CHRONIC HEALTH (CI, ec~ att ~,~ apply) .... ~'~'~'~xi,~ ...................... ~'~',~~ , i )~ ~'~ VF~N"UALWASTE ~OUNT 000 ........... ~ jDAILY AMOUNT /apo - ' i ~UOUNT ~ a. GAL 0 b. CU ~ ~. LBS 0 d. TONS UNITS' (~cck o~c item only) i ............................................................................................... (~k ~1 ~t ~ply) 21g T"'F TATE WASTE ........... ODE 0 a. ABOVEGROUND TANK [] e. PLA~TIC, J/qONMETALLIC DRUM [] b. UNDERGROUND TANK [] f, CAN [] c. TANKINS[DEBU[LDiNG [] G. CARBOY 0 · STEEL oP. ut,~ [] ~ SILO [] L FIBER DRU~ 0 tn. GLASS BOTTLE O q. RAIL CAR 0 ~ BOX 0 o. TO~B~ 0 L ~DER 0 p. T~ WA~N STORAGE PRESSURE Ya. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~'~a~ AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 .:, · . , : .. . , ..... ~ =, , ...... ~, ......... . . . =.,, , ~.,~¥, [ 226 ! 227 228 229 ! L;g,;,_..~_ ,';/-so oYEs ~NO t_agqo-~'O !2 :,.~ [] YEs ~"NO'7 ') ~ 7- ~'5 - ~ 2~ ? ......... ~3s z~s ' 237 !31 6, i_ [] YEs V'-'~. ......... ~"~ .............................. as ,4j i OYES UNO ~ i OYES [] NO If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or O. 1% by weight if carcinogemc, attach additional ~heets of paper capturing the required I ADDITIONAL LOCALLY COLLECTED INFORMATION: 246 [£ EPCRA please sign hcrc OES FORM 2731 (1/99) ! 1 02/29/00 ~ C41~M HAZARDOUS MATERIALS HAZARDO MATERIALS INVENTORY - ICAL DESCRIPTION (one form per material per buildin:~ or area) Fi ADO O DELETE E~'REVlSE 20o Page __ of__ I : I ,I : ' I II I I :II:,~:: ~ I : I: : ;I ,I I I II II I ( ' I::III ~:{::I ': ~:~ ~ ,: I ,~'II ; : III ::I::: B-L~INESS NAME (Same as FACIUTY NAME o~ DBA-Doing Business As) 3 CHEMICAL LOCATION 201 i CHEMICAL LOCATION 2Q2 i CONFIDENTIAL- '~ ~ L i EPC~ [] YEs [] NO __ ..t-~.. c~..j.~._.~ ~, ............. _ ................................................................................................................... /I..CHEMIOALiNFORMATION ~ .... "':, ' .".'.. · :...:,.._,.:. ~.. ::::. :L ..,..: _=.._ .: :.:......:....: -... .............. L:..... ~ ~.: ............................................................................... : ......... : ..................... .................................. CHEMICAL NAME ~ T~DE SECRET ~ ~S ~ ~ ~ D~S ~ FIRE CODE H~RD C~SSE~ ~ ~g~bxCUPA) 210 HAZARDOUS MATERIAL [] a. PURE limb. MIXTURE D c. WASTE 2~ i RADIOACTIVE [] YES [;~NO 212 CURIES 213 TYPE (r_.mm~ o.e ~em o~ ' (c~¢/,,.u,,,.o,/~,) u a. SOUD l]~b. UQUID [] c. GAS FED HAZARD CATEGORIES ~ 216 (C/,,*Y<at/t~w,/,/y) D a. RRE [} b. REACTIVE []c PRESSURE RELEASE . ACUTE HEALTH [] c. CHRONIC HEALTH i'--- l L.*MOUNT .................................... GO "'::::::.':.i I~.~!.~vAMouNT V~ ..... ~ ~ ~OU.T__ ' ............. :_LFODE (C~¢ck o.¢ item only) L ................................................................ I STORAGE CONTAINER (Cl,~k ~11 ~at apply) [] s. ABOVEGROUNO TANK [] ¢. PLASTICJNONMETALUC DRUM ]-I i. F~EE DP, U~ [] m. GLASS BO'iTLE Db. UNDEP. GROUNDT^NK []f. (:AN Dj. BAG ~'/..PL~ST[CBOTT]~ •r. OTHEA [] ~. ~ANK [~SmE BU~LDn~ [] ~. C~,P, BOY [] r,. BOX [] o. TOTE Bm [] d. STE,ELDRUM [] I~. SILO [} I. CYLINDER [] p. TANKWAGON STORAGE PRESSURE ~] AMBIF_NT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE ! 225 I~'a. AMBIENT 0 b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC "7. I [] YEs 13 , E] YES i4 ; I 0 YES '~', ..................................................................................................................... t 242 --~'-- 15! 'oYEs 240 ! 241 244 i: 245 DNOi If more hazardous components are present at greater than 1% by weight if non-carcinogenic or O. 1% by weight if carcinogemc, attach additional sheets of paper capturing the required ADDITIONAL LOGALLY COLLEGTED INFORMATION: 246 If EPCRA please sign here DES FORM 2731 (1/99) 11 02/29/00 BUSINESS NAME (Saree as FACILITY NAME or OBA-Oo~ng 8us{ness As) CHEMICAL LOCATION 201 i CHEMICAL LOCATION 332 i CONFIDENTIAL- ! EPCRA [] YES FIRE CODE HAZARD CLASSES (Complete ifmqui~dbyCUPA) 210 HAZARDOUS MATERIAL [] a PUP~ . TYPE (C~eck one ~em ony) 214 i LARGEST CONTAINER 215 PHYSICAL STATE [~a. SOUD [] b. UQUID [] c. GAS FED HAZARD CATEGORIES ~ ~ ~b. ~A~I~ 0 c P~S~ ~L~SE ~d. A~ H~ (C~ ~ ~ ~p~ A~GE DA LY , { 217 ~ I~IMUM ~ ~ ~'~]'-~NNUAL WASTE AMOUNT /~ ......... ~ jDAILYAMOUNT ~.~ ......... ~ ~MOUNT UNITS Jg n. GAL g b. CU ~ ~c. LBS g d. TONS ~ j (Check e.c i*cm only) ~ ................................................................ ' O ¢. CHRONIC HEALTH 219 0 L FIBER DRUM 0 m. GL.~SS BOTFLE [] j..^o ~ [] K. Box ~ e. TOrE BrN [] I. CYLINDER D p. TANKWAGON 216 I IDAYS ON ~ ~-- 223 [] r. OTHF~ STORAGE CONTAINER (Check mil t~*(a~ply) [] a. ABOVEGROUNO TANK ~r¢. PlASTIC/NONMETALLIC DRUM O b. UNDERGROUND TANK [] f. CAN O c. TANK INSIDE BUILDING [] G. CARBOY STORAGE PRESSURE i~a. AMBIENT O b. ABOVE AMBIENT O c. BELOW AMBIENT 224 : STORAGE TEMPERATURE ~/a. AMBIENT 0 b. ABOVE AMBIENT [] c. BELOW AMBIENT 0 (L CRYOGENIC 225 ~ ...................... ~ .... 241 J5 ~ ; ;O~S O~ rtno entc or O I% b wet At ~ carcmogentc attach addtttonal ~heetx of paper capturmg the requir~ ~ If more hazardous components are present al greater than I ~ by weight if honda C' g ' . . o ~ tg ~ ' · ' , . If EPCRA please sign here I 1 02/29/00 246 ADDITIONAL LOCALLY COLLECTED INFORMATION: OES FORM 2731 (1/99) HAZARD• MATERI LS INVENTORY- CI~MICAL DESCRIPTION . (one form per material per building or area) ..... ' ........ ' .............. ax) Page __ of__ BUSINESS NAME (Same as FACILITY NAME or OSA4)oing Business As) 3 CHEMICAL LOCATION 2ol ~ i EPCRA U Yt:: ~ IXlO COMMON NAME 2o7 EHS' CAS # 2o9 iooq 3 - 50- cJ FIRE CODE HAZARD CLASSES (Comp~e ifmquimdbyCUPA) 210 TYPE (C~ooe~omoo~HAZARDOUS MATERIAL 0 [. ~nr-r~c ~/tO. ~O~lUY~2' .... r- urn c. w/~big ....... 211 ~ RADIOACTIVE ~ YES ~UO 212. ~ CURIES 213 -}i (c~c~o.. .... z~j ~ a. SOUD [] b. UQUID [] c. GAS I LARGEST CONTAINER FED HAZARD CATEGORIES (ct,~,,ttt~,uqo~) [] ~L FIRE O b. REACTIVE [] c PRESSURE RELEASE [] d. ACtYFE HEALTH ...... ~"~:~,~'i~ '6~i'i~ ............... ~ .......... -~- -[ ,T']MAXIMUM i t 218 ~i--~N NUAL WASTE ?ouNT ......... d~ coo ............. ..L.IOA'~AMOUNT ~Ob '5~-- "i J~MOUNT u~, .~ tD a. GAL [] b. CU----~ ~"~c LBS [] d. TONS (Ch¢¢[ one item only) .......................................................... '.'. ..................................... STORAGE CONTAINER (ci~:k all Ihat ~ly) [] a. ABOVEGROUNDTANK [] ¢. PLASTIC/NONMETALLIC DRUM ~ i. }:IBEIUDRUM [] rm GLASS BOTTLE [] u. mDE~OU~D T~K 13 t C~N tS'j. ~AO ~ ~'~C aorru~ [] c. TANK INSIDE BUILDING [] G. CARBOY Fl IC BOX [] o. TOTE BIN [] & STEEL DRUM [] I~ SILO ~ L CYI-ENDEE [] p. TANK WAGON 215 ] ~. CHRONIC HEALTH 216 j 1 ICODE I JDAYS ON .... ~ i is, It=r 223 ~ ~. OmE~ STORAGE PRESSURE ~'& AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~a. AMBIENT 0 b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC ~25 · ;"' "': ":~/~*g~trl":"" ' "" :' 1gla ,9's.or~t~r,To ~r~.'a-n~rm,~" "' '"": :~'~ ':::;:: ;~"..::, ': C~: :~5~:~ :5,'.: :~!?. :: ' !".. :: ?~:" ~.., __~~ ~r ~~ %':' ;'~;: ~'< ~:~::2;,%:~ :;;4 :';~:~ ~(~r~-~'~%.' .'q '"' i2 ~ ~ 238 ~ 242i 243 oYEs 240 244 i "OYES ONO i 237 241 245 ~ ADOITIONAL LOCALLY COLLECTED i INFORMATION: 246 I If EPCRA please sign here •ES FORM 2731 (1~9) ! 1 02/29/00 L..H VIATERIALS INVENTORY- ICAL DESCRIPTION (one form per material per building or area) O ADD O DELETE {~REVISE 20o Page of__ BUSINESS NAME (Same as FACILITY NAME o~ DSA-Ooing Business As) 3 · '~'I~MICAL LOCATION -- 201 i CHEMiCALLOCATiON i CONFIDENTIAL- [] YES ~NO ! EPCRA II.' CHEMICAL:INFORMATION '":- ,' "' CHEMICAL NAME 205 TRADE SECRET [] YES [~O 2o6 COMMON NAME 2o7 EHS' [] YES FIRE CODE H~RD CLASSES (~te E~byCUPA) 210 HAZARDOUS MATERIAL [] ~ PURE ~ b. MIXTURE [] c. WASTE 211 i RADIOACTIVE E] YES ~/NO 212 CURIES "'-":' ~-'-~ '~ "'~/: ::':"'~''"'°: '~"~'"---- ~"P~'S,CAL STATE ................................................................................. -- ~" ~' LARGEST CONTAINER t~'a. SOUO 0 b. UQUID [] c. OAS i FEO HAZARD CATEGORIES [~ra. RRE ~b. REACTIVE []c PRESSURE RELEASE (C~ec~ alt that apply) ..... ,,~,~'i~,-GE 'D~iL~ i'~"~'-! ';~ TMAXIMUM ~' I 218 i kNNUAL WASTE AMOUNT ~O~ ............. i !DAILY AMOUNT 3~8C) ............... ~VIOUNT ............. > ........... ~ ~ ~;.,J~,~ .......... ~ INITS' ~E] a. GAL El b. CU FT I~ c. LBS [] d. TONS Check •ac item o.ly) ! ........................................................................ STORAGE CONTAINER (C~cck all ~l ~1¥) [] L ABOVEGROUND TANK [] e. PLASTICJNONMETALUC DRUM O b. UNDEP. GROL~ND TANK [] f. CAN [] c. TANK INSIDE BUILDING [] G. CAI~OY [~ d. STEEL DRUM [] I~ SILO [] L FIBER DRUM [] j. ~A~ [] ~ BOX O I. CYLINDER 216 [] e. CHRONIC HEALTH .......... I. Ic°°E I IDAYS ON 11 , 22~ 1--1 m. (;LASS BOTTLE El q. RAIL CAR ~ p. T~ WA~N STORAGE PRESSURE ~/[ AMBIENT D b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE ~ffa. AMBIENT [] b. ABOVE AMBIENT O c. BELOW AMBIENT O (L CRYOGENIC ~, ] - iL-,-i .... ....... 232 233 231 23O :'"'--; ......... ~4 235 236 237 3 []YES [] NO ~ .............................................................................................................................. T::~-- 24o ~ 238 i4 'OYES [] NO )s! ,oYEs [:NO o w I hit n carclno' entc' orOl%bo wetighttifcarclnogenlc' ' attachoddittonalsheetsofpapercaplurtnglhercquircd' ' ' i lfmorehazardouscomponentsarepresentatgreaterthan I%by e~g if no - g , . Y , ADDITIONAL LOCALLY COLLECTED INFORMATION: If EPCRA please sign here ! 1 02/29/00 246 DES FORM 2731 (1/99) ; ~ I HAZARDOUS MATERIALS i HAZARDO~MATERIALS INVENTORY- CI~ICAL DESCRIPTION (one form per material per building or area) BUSINESS NAME (Same as FAC4LITY NAME or OSA-.O~ng Business As) 3 CHEMICAL LOCATION 201 i CHEMIC.ALLOCATION CONFIDENTIAL - [] YES I~'NO ,ill. CHEMICALilNFORMATION?;·' :it, ' l j . I I I I l I l ........................................................ : ............... . : ....... ..,.... :. ........ :..: :. L LY_::...: .:. L:.L'.;...L ................ :_.1 .................. ~ ................... :...~: ............ · ............................ ............... : ............ CUEMICAL NAME z~,i TRADE SECRET [] YES COMMON NAME 207 EHS' OYES ~"/"NO 20~ cas # = i: ....... FIRE CODE HAZARD CLASSES (~to tfrequiredbyCt..IpA) 210 HAZARDOUS MATERIAL [] a. PURE [~b. MIXIURE [] c. WASTE TYPE (Checkor~emm/y) [] ~S ~ ~ CURIES 211 ~DIOACTIVE 212 . FED ~O CATEGORIES UNITS' ~'~. GAL STOOGE CONTAINER (Q~k all ~t ~HY) O a. ~O~GR~ND T~K 0 c. P~ONM~IC DRUM 0 L ~ER DE~ 0 m. G~S BO~ 0 q. ~L C~ O O & S~ELDE~ O ~ S[~ O L ~L~DER O p.T~WA~N STORAGE PRESSURE ~]'/a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE J 225 ~'a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC ,U,.- i .:' .' · . . ............. , . ~, .,~ ..... o YEs l [] YEs 'NO ,I ...........................235' -' ! 240 238 241 4 i QYES QNO ! 242 243 244 245 .5 i OYES ONO If more hazardous components are present at greater than I% by weight if non-carcinogenic, or O. 1% by weight if carcinogenic, attach additional sheets of paper capturing the required ADDITIONAL LOCALLY COLLECTED INFORMATION: 246 If EPCRA please sign here DES FORM 2731 (1/99) I 1 02/29/00 SECTION III BUSINESS EMERGENCY PLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to develop plans and procedures for your business, you will avoid complications resulting from inaction or misguided action during an emergency. Once the plans and procedures are developed, your employees will have an informative guide to follow in the event of an emergency. You must address each of the following items, however, the amount of detail you provide will depend upon the size and nature of the business, the damage potential of the hazardous materials handled, and the location of the business with respect to residential or other populated areas. 1. EMERGENCY RESPONSE PLANS AND PROCEDURES Your business is required by State Law to provide immediate notification of any release or threatened release of a hazardous material to: 1. Local fire emergency response personnel; 2. The Office of Emergency Services (OES); 3. The Hazardous Materials Management Division. If you have a release or threatened release of hazardous materials, immediately call: FIRE/PARAMEDICS/POLICE/SHERIFF PHONE: STATE OFFICE OF EMERGENCY SERVICES: THE COUNTY OF KERN HAZARDOUS MATERIALS MANAGEMENT DIVISION: OR 911 (800) 852-7550 (916) 262-1621 (661) 391-7000 INDIVIDUAL RESPONSIBLE FOR CALLING THE HAZARDOUS MATERIALS MANAGEMENT DIVISION AND THE OFFICE OF EMERGENCY SERVICES: Val Estrada IDENTIFICATION OF THE CLOSEST APPROPRIATE EMERGENCY MEDICAL FACILITY AVAILABLE TO YOUR BUSINESS: NAME: Mercy Southwest ADDRESS: 400 Old River Road CITY: Bakersfield, CA 93312 PHONE: (661) 666-6000 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide information of the steps taken at your facility, or the policies or procedures now in place, to help PREVENT an accidental release of hazardous material. Issues for discussion may include safety, storage, and containment procedures. Please be specific for each type of Hazardous Material at your business. NEW HIRE ORIENTATION, ONGO1NG DOCUMENTED SAFETY MEETING, ANNUAL HAZ COM REFRESHER TRAINING COURSE. TRAINING GIVEN IN PROPER SEGREGATION AND STACKING OF CHEMICALS. 3. MITIGATION Describe the procedures to be followed to REDUCE THE SEVERITY of a release or threatened release ora hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill, fire explosion or airborne release at your business? Do not write procedures that exceed the capabilities of employees or equipment at your business or that violate any workers safety laws. DOCUMENTED MONTHLY SAFETY MEETINGS AND FACILITY INSPECTIONS ARE DESIGNED TO IDENTIFY POTENTIAL HAZARDS. IN CASES OF A RELEASE, ALL EMPLOYEES ARE TRAINED TO IMMEDIATELY NOTIFY THE MANAGER. IN OUR WAREHOUSE, A HAZARDOUS SPILL WOULD PROBABLY BE A SMALL LIQUID SPILL. ALL EMPLOYEES HAVE BEEN TRAINED IN USING ABSORBANT TO CONTROL A SPILL. A SMALL HAZARDOUS CHEMICAL SPILL CLEAN UP KIT IS PROVIDED AT THE BRANCH. THE CHEMICAL SPILL KIT CONSISTS OF A NONPOROUS CONTAINER, PLASTIC SHOVEL, GOGGLES, RUBBER BOOTS, CHEMICAL RESISTANT GLOVES, AND AN APRON. THE BRANCH MANAGER IS TRAINED TO IDENTIFY THE SPILL AND IN CASES OF A LARGE SPILL TO CALL THE FIRE DEPT. "911". 4. ABATEMENT Describe what you would do to STOP and REMOVE each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the release? ALL EMPLOYEES HAVE BEEN TRAINED IN USING ABSORBANT TO CONTROL A SPILL. A SMALL HAZARDOUS CHEMICAL SPILL CLEAN UP KIT IS PROVIDED AT THE BRANCH. THE CHEMICAL SPILL KIT CONSISTS OF A NON-POROUS CONTAINER, PLASTIC SHOVEL, GOGGLES, RUBBER BOOTS, CHEMICAL RESISTANT GLOVES, AND AN APRON. THE BRANCH MANAGER IS TRAINED TO IDENTIFY THE SPILL AND IN CASES OF A LARGE SPILL TO CALL THE FIRE DEPT. "911". 5. EARTHQUAKES Identify the areas and equipment in your business which would require immediate attention following an earthquake. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation. THE AREAS IN THE WAREHOUSE THAT WOULD BE OF CONCERN WOULD BE THE LIQUID CHEMICALS BREAKING IF THEY WERE TO FALL. ALL CHEMICALS ARE IN PLASTIC BOTTLES THAT RESIST SHATTERING UPON IMPACT. HAZARDOUS WASTE CONTINGENCY Specific procedure for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. 7. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized release from an underground storage tank (UST). The plan must address a release from a single wall or a double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. SECTION IV BUS1NESS EMERGENCY TRAINING Employers are required by State law to have a program which provides employees with initial and refresher training in the following areas: A. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material (MSDS's) and measures employees can take to protect themselves from chemical hazards; B. The CAL OSHA Hazardous Communication Standards; C. Correct use of emergency response equipment and supplies available at your facility; D. The prevention, abatement and mitigation procedures you have developed for your business and explained on the business plan forms; E. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care; F. Procedures to coordinate with and assist the local emergency personnel that may respond to your business; G. Who and how to call for immediate assistance in the event of an accident involving hazardous materials. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY 1. Personnel Are there any specially trained hazardous materials emergency response personnel at your business? ~-~ NO If yes, how many personnel and what are their levels of training or capabilities? EACH PERSON IS TRA1NED TO USE HAZ MAT SPILL KITS IF A SMALL SPILL, LARGE SPILLS REQUIRE A CALL TO THE FIRE DEPARTMENT. Bo Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? ~-~ NO If yes, what type of decontamination can be performed at you business? SHOWER AND EYE WASH STATION Do you have personnel that will provide site security at your business during and after a hazardous materials incident? ~ NO Equipment mo List the type and location of equipment that can or will be used for response to hazardous materials incidents at your facility. (Examples of equipment types: personal protective equipment, fire extinguishers, spill containment material, etc.) TYPE OF EQUIPMENT P.PE FIRE EXTINGUISHERS HAZMAT CONTAINMENT KIT LOCATION HAZ MAT DRUM THROUGHOUT WAREHOUSE IN CHEMICAL STORAGE WAREHOUSE POST FOR EMPLOYEES BUSINESS EMERGENCY PLAN: EMERGENCY NOTIFICATION During an emergency involving a release or a threatened release of a hazardous material you MUST notify appropriate agencies. Information you should be prepared to supply includes: 1. Name and telephone number of reporter; 2. Name and address of business; 3. Time and type of release (e.g., damaged containers, malfunctioning equipment, etc.); 4. Name and quantity of material(s) involved; 5. Extent and number of injuries; 6. Actions taken or being taken to mitigate or reduce emergency; 7. Potential hazards to human health or the environment surrounding the business. TELEPHONE ROSTER AGENCY TELEPHONE NUMBER FIRE DEPARTMENT AMBULANCE/PARAMEDIC POLICE/SHERIFF HOSPITAL Mercy Southwest PRIMARY FACILITY EMERGENCY CONTACT PERSON: Val Estrada, Branch Manager HAZARDOUS MATERIALS MANAGEMENT DIVISION Kern County CALIFORNIA OFFICE OF EMERGENCY SERVICES NATIONAL RESPONSE CENTER POISON CONTROL CENTER HAZARDOUS MATERIALS CLEAN UP CONTRACTOR ChemTrec Other Contacts Thomas Flake 911 911 9ll (661) 666-6000 (661) 837-8344 (661) 391-7000 (800) 852-7550 (800) 424-8802 (800) 876-4766 (800) 424-9300 (985) 892-5521 OR (985) 867-2346 SECTION V HAZARDOUS MATERIAL INVENTORY PACKET Date: 3/3/01 Business Name: Business Address: SCP Distributors, LLC 4601 Grissom Street Bakersfield, CA 93313 Total # of Pages: New Inventory: [] Annual Update: X Please complete the following inventory pages for each chemical in reportable quantities and record the number of pages above. A "~- , -" ':- ,'"C~ _ Sl~e~--__J~-~ Zip , B C D E N 'I .$ S i T E M A P NOT TO SCALE HAZARDOUS MATERIAL LEGEND Common Chemical Name Legend Symb. ' Trade for use on Site Name Map Trichlor Trichloroisocyanuric acid, (~ · tablets dry Dy-chlor Dichloroisocyanuric acid, dry Litho Shock Lithium hypochlorite, dry (~) Bromine 1-bromo-3-chloro-5,5-. (~) Tablets dimethyl-hydantoin Cai-hypo, Caldum hypochlorite, shock hydrated · 02 Shock Potassium peroxymonosulfate Metal Out 1-Hydroxyethylidene-1,1- diphosphonic PVC Methyl ethyl ketone, Cement Tetrahydrofuran Epoxy Epoxy resin, (~) XCene Solvents, Aromatic naphtha light, (~) Primers Propoxy propanol Common Chemical Name Legend Symb. Trade for use on Site Name blap Colorseal, Propolene glycol, Z Primers Butoxy dipropanol Y Bleach Sodium hypochlorile Calcium Calcium chlodde S Increaser Stabilizer Cyanuric add R Alkalinity Sodium hydrogen P Plus carbonate pH Sodium bisulfate N Decreaser Algae Plus Copper-Triethanolamine M comple× Sand Silicon dioxide Si02 H D.E. Diatomaceous eadh B Vermiculite Vermiculite 'A · OTHER EQUIPMENT/NON-HAZARDOUS ITEMS legend use these symbols in composing your s!tc map:. .Symbo(~ 1 ~ Fir¢c~r~uieh~r~ --~ Air r_.onA~o~irg shul;-off 51:~nldcr s.yst.~n valves Emergency ehut,-off ( i.¢. ~ja5 pum~. Follow these steps to complet'e your map. Step Action 1 Indicate your map direction 2 Choose and list your map legend. You may us~ the optional legend on the back of this p..age.. ....... 3 Draw your building outline. 4 Usi.ng your legend symbols, indicate general building information such as: loading areas knox boxes sumps, storm and sewer drains parking lots and internal roads fire hydrants/sprinklers 5 Using your legend, indicate locations of: hazardous material and hazardous waste storage areas undergroun,d,,stor,age ta, nks and hazardous material p~ping systems. 6 Show locations of emergency shut off switches for: ,, gas water electrical 7 Show locations of emergency equipment such as: fire extinguishers protective/first aid equipment ..... mitigation/clean-up equipment 8 Show locations of: Material Safety Data Sheets Emergency Response Plan ,., emergency,.assembly area .... 9 Show locations of adjacent streets and 'identify neighboring properties. · If neighbors are businesses, indicate location by name. · If neighbors are residential, indicate t~at. Sample map This is an example of a completed map. Januhr~'l-5, 2002 D SOUTH CENTRAL POOL SUPPLY, INC. 4601 GRISSOM STREET BAKERSFIELD CA 93309 Dear Business Owner: This notice is meant to act as a reminder that the California Health and Safety Code, Chapter 6.95, requires any handler of hazardous materials to revise their materials business plan within 30 days of any one of the following events: A 10 per cent or more increase in the quantity of a previously- disclosed material. Any handling of a previously-undisclosed hazardous material, subject to the inventory requirements of Chapter 6.95. 3. Change in business ownership. 4. Change in business, address. 5. Change of business name. Any questions regarding these required revisions, please call the Hazardous Materials Division at (661) 326-3979. Sincerely yours, Director, Office of Environmental Services ADDRESS FACILITY CONTACT_V/~,...- INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE PHONE NO. BUSINESS ID NO. 15-210- O i!O' NUMBER OF EMPLOYEES '-] Section 1: Business Plan and Inventory Program Routine {~ Combined [~ Joint Agency [~l Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation ~'~~"~ (Z ~'~--~M} hazardous waste on site?: ~ Yes ~o Any Explain: Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Colby Pink - Business Copy Inspector:,._fr. SOUTH CENTRAL POOL SUPPLY INC Manager : ~\ ~-5'~~ Location: 4601 GRISSOM ST City : BAKERSFIELD IRW.~.EIV~I%q SiteID: 215- 000- 001100 MAR 2 7 ~OD~ B~sPhone- (~f~ 837-8344 By' '~ M~p : 12~ Com~az : Moderate · ~id: 15D FacUnits: 1 AOV: CommCOde: BAKERSFIELD STATION 13 EPA Numb: SIC Code:5091 DunnBrad:87-296-5363 Emergency Contact / Title VAL ESTRADA / BRANCH MANAGER Business Phone: (805) 837-8344x 24 -Hour Phone : (~1.) ~ ~-~' Pager Phone : ( ) - x Emergency Contact / Title -'~._~r~~i'~ / OPERATIONS MGR Business Phone: (805) 837-8344x 24-Hour Phone : (G~) ~--~O{ Pager Phone : ( ) - x Hazmat Hazards: Fire React ImmHlth Contact : MailAddr: 4601 GRISSOM ST City : BAKERSFIELD Phone: (~ ~) 837-8344x State: CA Zip : 93309 Owner SOUTH CENTRAL POOL SUPPLY INC Address : 109 NORTHPARK BLVD 400 City : COVINGTON Phone: (504) 892-5521x128 State: LA Zip : 70433 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~, f~___o~ ~C~i'~ Do her~b~ cer~if~ ~ha~ { hays (Typa ~r pdn~ n~) reviewed ihs a~ached h~a~s mals~als ma~mge- mere plan for ~'~ ~ and that i~ alon~ with ~a~ ef ~ine~) any corre~ions cons~i~u~s a ~mple~s and corre~ ma.- agemem plan for my facility. 1 02/29/2000 ~ SOUTH CENTRAL POOL SUPPLY INC = Hazmat Inventory --Alphabetical Order Hazmat Common Name... I SpecHaz I EPA HazardsI CALCIUM HYPOCHLORITE MURIATIC ACID PVC CEMENT SODIUM DICHLORO-S-TRIAZINETRION SODIUM HYPOCHLORITE TRICHLORO-S-TRIAZINETRIONE F R IH R IH R IH R IH R IH SiteID: 215-000-001100 By Facility Unit Fixed Containers on Site Frm DailyMax IUnitlMCP S 2200.00 LBS Mod L 1000.00 GAL Hi L 100.00 GAL Mod S 6500.00 LBS Mod L 1000.00 GAL Hi S 17500.00 LBS Mod -2- 02/29/2000 SOUTH CENTRAL POOL SUPPLY INC ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME CALCIUM HYPOCHLORITE Location within this Facility Unit NORTHWEST CORNER SiteID: 215-000-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 7778-54-3 rSTATE ~ TYPE Solid /Mixture PRESSURE Ambient TEMPERJkTURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerLBS AMOUNTS AT THIS LOCATION Daily Maximum 2200.00 LBS Daily Average 1 1540.00 LBS HAZARDOUS COMPONENTS %Wt. I 65.00 Calcium Hypochlorite N 7778543 ITSecretI ~S BioHaz No N No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA /// USDOT# MCP Mod Inventory Item 0005 Facility Unit: Fixed Containers on Site MI/RIATIC ACID Days On Site HYDROCHLORIC ACID SOLUTION 365 Location within this Facility Unit Map: Grid: OUTSIDE CAS# 7647-01-1 F STATE TYPE PRESSURE Liquid Mixture Ambient -- TEMPER3kTURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 GAL Daily Average 700.00 GAL HAZARDOUS COMPONENTS %Wt. I 31.50 Hydrogen Chloride RSI CAS# Yes 7647010 lTSecret No HAZARD ASSESSMENTS RS BioHazI Radioactive/Amount EPA Hazards No NoI No/ Curies R IH NFPA /// USDOT# MCP Hi 3 02/29/2000 SOUTH CENTRAL POOL SUPPLY INC SiteID: 215-000-001100 Inventory Item 0004 Facility Unit: Fixed Containers on Site PVC CEMENT Days On Site 365 Location within this Facility Unit Map: Grid: AGAINST NORTH WALL CAS# 109-99-9 FSTATE ~ TYPE Liquid I Mixture PRESSURE Ambient TEMPEP~ATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 100.00 GAL Daily Average 70.00 GAL l-l~UU~ ~U~U~'~'~ %Wt. RS CAS# Tetrahydrofuran No 109999 Dimethylformamide No 68122 Polyvinyl Chloride No 9002862 TSecret No HAZARD ASSESSMENTS RS BioHazI Radioactive/Amount EPA Hazards No NoI No/ Curies F NFPA /// USDOT# MCP Mod Inventory Item 0002 Facility Unit: Fixed Containers on Site ~U~IU~ ~vl~ / ~£~-~J_l . ~vl~ SODIUM DICHLORO-S-TRIAZINETRIONE Days On Site 365 Location within this Facility Unit Map: Grid: NORTHWEST CORNER CAS# 2893-78-989 STATE -- TYPE PRESSURE Ambient Pure Solid TEMPERATURE IAmbient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerLBS AMOUNTS AT THIS LOCATION Daily Maximum 6500.00 LBS Daily Average 4550.00 LBS l%Wt. 100.00 HAZARDOUS COMPONENTS Sodium Dichloro-s-triazinetrione N 2893789 HAZARD ASSESSMENTS I Radioactive/Am°unt I EPA Hazards INo/ CuriesR IH NFPA /// USDOT# MCP Mod 4 02/29/2000 SOUTH CENTRAL POOL SUPPLY INC ~~~~ SitelD: 215-000-001100 i~ Inventory Item 0006 ~aa~a~a~a Facility Unit: Fixed Containers on Site i i~ COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE o Days On Site o o 365 ° Location within this Facility Unit Map: Grid: OUTSIDE o CAS# o o 7681-52-9 o i~ STATE ~iE TYPE EE~iEE PRESSURE 6EEl TEMPERATURE E~iSE~ CONTAINER TYPE Liquid o Mixture o Ambient o Ambiem o PLASTIC CONTAINER o ~~~~ AMOUNTS AT THIS LOCATION Largest Container o Daily Maximum o Daily Average o GAL o 1000.00 GAL o 700.00 GAL o i~i~~ HAZARDOUS COMPONENTS %Wt. o o RSo CAS# o 12.50OSodium Hypochlorite ONo o 7681529° 1.00°Sodium Hydroxide ONo o 1310732° i8EEEEEEi888iE8EEEEiE8EEE~E88~E HAZARD ASSESSMENTS °TSecret° RS°BioHaz° Radioactive/Amount o EPA Hazards o NFPA o USDOT# o MCP o No ONoONo o No/ Curies° RIH o /// o OHio Inventory Item 0001 ~~~ Facility Unit: Fixed Containers on Site i~ COMMON NAME / CHEMICAL NAME ~~~~~i~~~ T~CHLORO-S-T~AZINET~ONE o Days On Site o 365 o Location within this Facility U~t Map: Grid: NORTHWEST CO~ER o CAS~ o 87-90-1 STATE Ei~ TYPE ~EEi~E PRESSURE ~EEi TEMPE~TU~ ~Ei~EE~ CONTAINER TYPE Solid o ~re o Ambient o Ambient o PLASTIC CONTAINER o i~~~fi~i AMOUNTS AT THIS LOCATION Largest Container o Daily Maximin o Daily Average o LBS o 17500.00 LBS o 12250.00 LBS %Wt. o o RSo CAS~ 99. ~ o Trichloro_s_triazinetrione ONo o 87901 °TSecret° RS°BioHaz° ~dioactive/Amount o EPA Hazards o NFPA o USDOT~ No ONoONo o No/ Curies° RIH o /// o -5- 02/29/2000 i SOUTH CENTRAL POOL SUPPLY INC ~~~~ SiteID: 215-000-001100 i i~ Notif./Evacuation/Medical ~~~~~~ Overall Site i i~ Agency Notification ~~~~~~~ 05/05/1992 i O O o IN THE CASE OF A SMALL SPILL, ONE HUNDRED POUNDS OR LESS, THE EMPLOYEES WILL o ° NOTIFY THE BRANCH MANAGER. ONCE THE SPILL IS CONTAINED THE BRANCH MANAGER ° o WILL NOTIFY THE SAFETY COORDINATOR FOR CONFIRMATION OF PROPER DISPOSAL ° ° PROCEDURE. ° O o o IN THE CASE OF A LARGE SPILL, THE EMPLOYEE WILL NOTIFY THE BRANCH MANAGER ° o WHO IN TURN WILL INITIATE EVACUATION AND NOTIFY THE FIRE DEPARTMENT. AFTER ° o SECURING THE AREA AND ACCOUNTING FOR PERSONNEL THE BRANCH MANAGER WILL ° o NOTIFY THE SAFETY COORDINATOR AND THE AREA MANAGER. THE AREA MANAGER WILL ° O O i~ Employee Notif./Evacuation ~~~~~ 05/05/1992 i O O o OUR OPERATION IN BAKERSFIELD WILL ONLY HAVE FOUR EMPLOYEES. THE BRANCH ° ° MANAGER WILL HAVE ALL RESPONSIBILITY OF EMPLOYEE NOTIFICATION AND EVACUATION o ° BY MEANS OF WORD OF MOUTH. IN THE EVENT OF HIS ABSENCE THE SECOND IN ° ° COMMAND ASSUMES THESE RESPONSIBILITIES. ° o o i~ Public Notif./Evacuation ~~~~~~ 05/05/1992 i O O o THE CUSTOMERS OR ANY NON-EMPLOYEES ARE RESTRICTED TO THE COUNTER AREA. o ° EVACUATION OF THESE PEOPLE WOULD BE EASILY ACCOMPLISHED AND WOULD FALL ON ° o THE BRANCH MANAGER OR HIS SECOND IN COMMAND. o o o ° WE WOULD RELY ON THE FIRE DEPARTMENT OR OTHER EXTERNAL AGENCIES FOR THE o o EVACUATION OF THE GENERAL PUBLIC. o O o i~ Emergency Medical Plan ~~~~~~ 05/05/1992 i O o ° AN EYEWASH/SHOWER WILL BE INSTALLED FOR CHEMICAL EXPOSURE TO THE EYES OR ° ° SKIN. IN MEDICAL EMERGENCIES NOT REQUIRING IMMEDIATE TRANSPORTATION TO A ° ° HOSPITAL WE WILL USE THE SERVICES OF VALLEY MEDICAL GROUP WHICH SPECIALIZES ° o IN OCCUPATIONAL MEDICINE. SEVERE EMERGENCIES WILL HAVE THE PROPER o O O -6- 02/29/2000 i SOUTH CENTRAL POOL SUPPLY INC i~ Mitigation/Prevent/Abatemt ~~~~~ Overall Site i~ Release Prevention ~~~~~~~ 05/05/1992 O o o BECAUSE WE ARE A DISTRIBUTION COMPANY, OUR PRODUCTS, INCLUDING THE HAZARDOUS ° o MATERIALS ARE BOUGHT AND RESOLD. THE MAJORITY OF OUR PRODUCTS ARE IN o ° CONSUMER COMMODITIES. BECAUSE OF THIS, OUR RELEASE PREVENTION IS BASED ON ° o PROPER STORAGE AND HANDLING. ° O O i~E~ Release Containment E~EEOEEOEEEEEEEEEEEEEE~EE~EE~EE~E~EEEE~EE 05/05/1992 O o ° BECAUSE OUR PRODUCTS ARE IN SMALL INDIVIDUAL PACKAGES, THE CHANCE OF A LARGE ° ° SPILL IS MINIMAL. IF A LARGE SPILL DID OCCUR, WE WOULD RELY ON THE FIRE ° o DEPARTMENT TO CONTAIN THE RELEASE DUE TO THE SMALL NUMBER OF EMPLOYEES. ° O O i~ Clean Up ~~~~~~~~ 03/10/1998 i o O ° IN THE CASE OF A SMALL SPILL, WE HAVE VERY SPECIFIC PROCEDURES FOR CLEAN UP. ° o THEY INCLUDE TRAINING, PERSONAL PROTECTION (IE. GLOVES, GOGGLES, AND ° ° RESPIRATORS), AND CLEAN UP EQUIPMENT (IE. SHOVELS, CONTAINERS AND BROOMS). o ° WE ALSO HAVE STRINGENT PROCEDURES FOR DISPOSAL, WHICH ARE CLOSELY SUPERVISED ° ° AND RECORDED. ° O o i~ Other Resource Activation O 0~ O O o -7- 02/29/2000 SOUTH CENTRAL POOL SUPPLY INC ~~~~ SitelD: 215-000-001100 i~ Site Emergency Factors ~~~~~~ Overall Site i i~ Special Hazards o O i~ Utility Shut-Offs ~~~~~~~ 03/10/1998 i o A) GAS - ONE VALVE FOR THE ENTIRE BLDG, LOCATED TOWARD THE CENTER OF BLDG B) ELECT~CAL - THE PANEL IS ON THE E WALL, S OF THE OFFICES C) WATER - THE VALVE IS IN THE ~NAGERS OFFICE o D) SPECIAL - NONE E) LOCK BOX - NO o o i~ Fire Protec./Avail. Water ~~~~6~~ 03/10/1998 i O P~VATE FIRE PROTECTION - THE BLDG HAS COMPLETE COVE~GE BY THE SP~N~ER SYSTEM. THE FI~ EXTINGUISHERS ARE MOUNTED TO SPECIFICATIONS. O O O NEA~ST FI~ HYD~NT - THE~ IS A FI~ HYD~NT LOCATED 25 YDS SE OF THE o FRONT DOOR OF THE BLDG. O i~ Building Occupancy Level o o -8- 02/29/2000 SOUTH CENTRAL POOL SUPPLY INC ~/5~/~/~/~/~/~/~ SiteID: 215-000-001100 i i~ Training ~~~~~~~~ Overall Site i i~ Employee Trai~ng ~~~~~~~ 03/10/1998 i 0 0 0 o 0 0 o 0 0 0 0 0 0 o 0 0 0 o 0 0 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE 90 MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: o o o 0 0 OUR EMPLOYEE TRAINING BEGINS WITH HAZARD o COMMUNICATION STANDARD INCLUDING MSDS CONTENT AND LOCATION, CHEMICAL o PROPERTIES AND INCOMPATIBILITIES, AND EXPOSURE TREATMENT. o O TO INSURE PROPER USE OF THE EQUIPMENT USED IN HANDLING AND STORING THE o CHEMICALS, WE HAVE A FULL RESPIRATOR PROGRAM INCLUDING A PULMONARY FUNCTION ° TEST AND INSTRUCTION ON THE USE AND CARE OF OUR RESPIRATORS. WE ALSO HAVE o OUR EMPLOYEES FORKLIFT CERTIFIED AND INSTRUCT THEM ON PROPER OPERATION OF A ° FIRE EXTINGUISHER. ° O WE HAVE VERY SPECIFIC PROCEDURES IN OUR SPILL CONTAINMENT AND CLEAN UP o PROGRAM. WE EMPHASIZE WHAT NOT TO DO AS WELL AS WHAT TO DO IN THESE o SITUATIONS. THESE CHEMICALS ARE INCOMPATIBLE AND REACTIVE AND THEREFORE ° REQUIRE CERTAIN CONSIDERATIONS DURING CLEAN UP. o O -9- 02/29/2000 CITY OF BAKERSFIELD CLAIM VOUCHER Vendor No. CLAIMANT'S NAME AND ADDRESS: South Central Pool Supply Inc 4601 Grissom St Bakersfield, CA 93309 I certify that this claim is correct a,nd valid, and is a proper charge against the City Agency and account indicated. (AUTHORIZED SIGNATURE OF CITY AGENCY) Date: 3-11-99 Initials of Preparer: CITY DEPARTMENT: FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Contract Number if Applicable) This customer made several payments on their Hazardous Materials bill, customer #ES-3577. The first payment in the amount of $352 was made on 2-09-99 and then the second payment of $360.50 was made on 2-17-99. A charge adjustment to correct the CA State Surcharge of $8.50 was made leaving the total credit due in the amount of $360.50. Dept. 0000 Project # Invoice # Amount' VOUCHER TOT~,L $360.50 $360.50 Date of Invoice SECTION 72, PENAL CODE Section 72, Presenting False Claims. Every person who with Intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same If genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. FINANCE DEPT. USE ONLY Examined & Approved for Payment Amount ffoa / CEIVED [ : -g o%g 11oo · ~,h~-.~ SiteID Location: 4601 GRISSOM ST [BY: yap : 123 CommHaz : Moderate City : BAKERSFIELD ~rid: 15D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 13 EPA Numb: SIC Code:5091 DunnBrad ~ '~, - ~2~ ~ --__ ~ Emergency Contact VAL ESTRADA Business Phone: 24-Hour Phone : Pager Phone : / Title / BRANCH MANAGER (805) 837-8344x (805) 765-6379x ( ) - x Emergency Contact DAVID LUHM Business Phone: 24-Hour Phone : Pager Phone : / Title / OPERATIONS MGR (805) 837-8344x (805) 397-8511x ( ) - x Hazmat Hazards: Fire React ImmHlth Emergency Directives: ...~,DZ/-~9~-,.~/ SOUTH CENTRAL POOL SUPPLY. CHANGE IN BUSINESS NAME & OWNE~__.__R NOW /~ /~n~p~r~ ~ Hazmat Inventory One Unified List -- MCP+DailyMax Order All Materials at Site Hazmat Common Name... [SpecHazIEPA Hazards[ Frm DailyMax Unit MOP I I I MURIATIC ACID SODIUM HYPOCHLORITE TRICHLORO-S-TRIAZINETRIONE SODIUM DICHLORO-S-TRIAZINETRIONE CALCIUM HYPOCHLORITE PVC CEMENT F R IH L 1000 GAL Hi R IH L 1000 GAL Hi R IH S 17500 LBS Mod R IH S 6500 LBS Mod R IH S 2200 LBS Mod L 100 GAL Mod m~n~ p~an ~or ~/ ~p~zy~ ~and ~hai ~ a~ng ~h agemeni p~an ior my ~acili~y. 1 12/17/1997 ~'SWIM CHEM SiteID: 215-000-001100 Inventory Item 0005 . Facility Unit: Fixed Containers on Site ~UIVHVlU~ ~Vl~ / ~ ~..1~ ~Vl~ , mmZATZC ACZD Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE CAS# 7647-01-1 FSTATE ~ TYPE Liquid /Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum I 1000.00 GAL Daily Average 1 700.00 GAL %Wt. 31.50 HAZARDOUS COMPONENTS Hydrogen Chloride EHS CAS# No 7647010 TSecret EHS BioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA/// I USDOT# MCP Hi Inventory Item 0006 Facility Unit: Fixed Containers on Site ~lVUVl~ ~Vl~ / ~1 ~Z-'LI_~ N~Vl~ SODIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE CASS 7681-52-9 STATE ~ TYPE Liquid I Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 GAL Daily Average 700.00 GAL I"I./-~.~./A_.L'(.UUU~ ~U~U~N'I'~ %Wt. EHS CAS# 12.50 Sodium Hypochlorite No 7681529 1.00 Sodium Hydroxide No 1310732 TSecret EHS BioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA/// I USDOT# MCP Hi 2 12/17/1997 SWIM CHEM SiteID: 215-000-001100 Inventory Item 0001 Facility Unit: Fixed Containers on Site TRICHLORO-S-TRIAZINETRIONE Days On Site 365 Location within this Facility Unit Map: Grid: NORTHWEST CORNER CAS# 87-90-1 STATE ~ TYPE PRESSURE Solid /Pure I Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerLBS AMOUNTS AT THIS LOCATION Daily Maximum 17500.00 LBS Daily Average 12250.00 LBS %Wt. 99.00 HAZARDOUS COMPONENTS Trichloro-s-triazinetrione EHS No CAS# 87901 TSecret EHS BioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA/// I USDOT# MCP Mod Inventory Item 0002 Facility Unit: Fixed Containers on Site ~UtvuvIu~ ~Vl~ / ~1 ~.Z-.~ ~Vl~ SODIUM DICHLORO-S-TRIAZINETRIONE Days On Site 365 Location within this Facility Unit Map: Grid: NORTHWEST CORNER CAS# 2893-78-989 F STATE ~ TYPE Solid /Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerLBS AMOUNTS AT THIS LOCATION Daily Maximum Daily Average 6500.00 LBS 4550.00 LBS HAZARDOUS COMPONENTS %Wt. I 100.00 Sodium Dichloro-s-triazinetrione EHS CAS# No 2893789 TSecret EHS BioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA /// USDOT# MCP Mod -3- 12/17/1997 SWIM CHEM ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME CALCIUM HYPOCHLORITE Location within this Facility Unit NORTHWEST CORNER SiteID: 215-000-001100 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 7778-54-3 STATE -- TYPE PRESSURE Ambient Mixture Solid -- TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest ContainerLBS AMOUNTS AT THIS LOCATION Daily Maximum 2200.00 LBS Daily Average 1540.00 LBS HAZARDOUS COMPONENTS %Wt. I 65.00 Calcium Hypochlorite EHS CAS# No 7778543 TSecretlEHSIBi°HaZNo No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies R IH NFPA /// USDOT# MCP Mod Inventory Item 0004 COMMON NAME / CHEMICAL NAME PVC CEMENT Location within this Facility Unit AGAINST NORTH WALL Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 109-99-9 STATE ~ TYPE Liquid/Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 'GAL AMOUNTS AT THIS LOCATION Daily Maximum 100.00 GAL Daily Average 70.00 GAL %Wt. HAZARDOUS COMPONENTS Tetrahydrofuran Dimethylformamide Polyvinyl Chloride EHS CAS # INsI 109999 No 68122 No 9002862 TSecret No EHS BioHaz No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F NFPA/// I USDOT# Mod -4- 12/17/1997 SWIM CHEM SiteID: 215-000-001100 Fast Format ~ Notif./Evacuation/Medical --Agency Notification Overall Site 05/05/1992 IN THE CASE OF A SMALL'SPILL, ONE HUNDRED POUNDS OR LESS, THE EMPLOYEES WILL NOTIFY THE BRANCH MANAGER. ONCE THE SPILL IS CONTAINED THE BRANCH MANAGER WILL NOTIFY THE SAFETY COORDINATOR FOR CONFIRMATION OF PROPER DISPOSAL PROCEDURE. IN THE CASE OF A LARGE SPILL, THE EMPLOYEE WILL NOTIFY THE BRANCH MANAGER WHO IN TURN WILL INITIATE EVACUATION AND NOTIFY THE FIRE DEPARTMENT. AFTER SECURING THE AREA AND ACCOUNTING FOR PERSONNEL THE BRANCH MANAGER WILL NOTIFY THE SAFETY COORDINATOR AND THE AREA MANAGER. THE AREA MANAGER WILL -- Employee Notif./Evacuation 05/05/1992 OUR OPERATION IN BAKERSFIELD WILL ONLY HAVE FOUR EMPLOYEES. THE BRANCH MANAGER WILL HAVE ALL RESPONSIBILITY OF EMPLOYEE NOTIFICATION AND EVACUATION BY MEANS OF WORD OF MOUTH. IN THE EVENT OF HIS ABSENCE THE SECOND IN COMMAND ASSUMES THESE RESPONSIBILITIES. -- Public Notif./Evacuation 05/05/1992 THE CUSTOMERS OR ANY NON-EMPLOYEES ARE RESTRICTED TO THE COUNTER AREA. EVACUATION OF THESE PEOPLE WOULD BE EASILY ACCOMPLISHED AND WOULD FALL ON THE BRANCH MANAGER OR HIS SECOND IN COMMAND. WE WOULD RELY ON THE FIRE DEPARTMENT OR OTHER EXTERNAL AGENCIES FOR THE EVACUATION OF THE GENERAL PUBLIC. Emergency Medical Plan 05/05/1992 AN EYEWASH/SHOWER WILL BE INSTALLED FOR CHEMICAL EXPOSURE TO THE EYES OR SKIN. IN MEDICAL EMERGENCIES NOT REQUIRING IMMEDIATE TRANSPORTATION TO A HOSPITAL WE WILL USE THE SERVICES OF VALLEY MEDICAL GROUP WHICH SPECIALIZES IN OCCUPATIONAL MEDICINE. SEVERE EMERGENCIES WILL HAVE THE PROPER 5 12/17/1997 SWIM CHEM SiteID: 215-000-001100 Fast Format Mitigation/Prevent/Abatemt Release Prevention Overall Site 05/05/1992 BECAUSE WE ARE A DISTRIBUTION COMPANY, OUR PRODUCTS, INCLUDING THE HAZARDOUS MATERIALS ARE BOUGHT AND RESOLD. THE MAJORITY OF OUR PRODUCTS ARE IN CONSUMER COMMODITIES. BECAUSE OF THIS, OUR RELEASE PREVENTION IS BASED ON PROPER STORAGE AND HANDLING. -- Release Containment 05/05/1992 BECAUSE OUR PRODUCTS ARE IN SMALL INDIVIDUAL PACKAGES, THE CHANCE OF A LARGE SPILL IS MINIMAL. IF A LARGE SPILL DID OCCUR, WE WOULD RELY ON THE FIRE DEPARTMENT TO CONTAIN THE RELEASE DUE TO THE SMALL NUMBER OF EMPLOYEES. Clean Up 05/05/1992 IN THE CASE OF A SMALL SPILL, WE HAVE VERY SPECIFIC PROCEDURES FOR CLEAN UP. THEY INCLUDE TRAINING, PERSONAL PROTECTION (IE. GLOVES, GOGGLES, AND RESPIRATORS), AND CLEAN UP EQUIPMENT (IE SHOVELS, CONTAINERS AND BROOMS). WE ALSO HAVE STRINGENT PROCEDURES FOR DISPOSAL, WHICH ARE CLOSELY SUPERVISED AND RECORDED. Other Resource Activation 6 12/17/1997 SWIM CHEM SiteID: 215-000-001100 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 05/05/1992 A) GAS - THERE IS ONE VALVE FOR THE ENTIRE BUILDING, LOCATED TOWARD THE CENTER OF THE BUILDING. B) ELECTRICAL - THE PANEL IS ON THE EAST WALL, SOUTH OF THE OFFICES C) WATER - THE VALVE IS IN THE MANAGERS OFFICE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 05/05/1992 PRIVATE FIRE PROTECTION - THE BUILDING HAS COMPLETE COVERAGE BY THE SPRINKLER SYSTEM. THE FIRE EXTINGUISHERS ARE MOUNTED TO SPECIFICATIONS. NEAREST FIRE HYDRANT - THERE IS A FIRE HYDRANT LOCATED 25 YARDS SOUTHEAST OF THE FRONT DOOR OF THE BUILDING. Building Occupancy Level -7- 12/17/1997 SWIM CHEM SiteID: 215-000-001100 Fast Format Training -- Employee Training Overall Site 05/05/1992 WE HAVE 4 EMPLOYEES AT THIS FACILITY. WE HAVE 90 MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: OUR EMPLOYEE TRAINING BEGINS WITH HAZARD COMMUNICATION STANDARD INCLUDING MSDS CONTENT AND LOCATION, CHEMICAL PROPERTIES AND INCOMPATIBILITIES, AND EXPOSURE TREATMENT. TO INSURE PROPER USE OF THE EQUIPMENT USED IN HANDLING AND STORING THE CHEMICALS, WE HAVE A FULL RESPIRATOR PROGRAM INCLUDING A PULMONARY FUNCTION TEST AND INSTRUCTION ON THE USE AND CARE OF OUR RESPIRATORS. WE ALSO HAVE OUR EMPLOYEES FORKLIFT CERTIFIED AND INSTRUCT THEM ON PROPER OPERATION OF A FIRE EXTINGUISHER. WE HAVE VERY SPECIFIC PROCEDURES IN OUR SPILL CONTAINMENT AND CLEAN UP PROGRAM. WE EMPHASIZE WHAT NOT TO DO AS WELL AS WHAT TO DO IN THESE SITUATIONS. THESE CHEMICALS ARE INCOMPATIBLE AND REACTIVE AND THEREFORE REQUIRE CERTAIN CONSIDERATIONS DURING CLEAN UP. -- Page 2 --Held for Future Use Held for Future Use -8- 12/17/1997