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Home My WebLink AboutBUSINESS PLAN 1/4/1994 MMP PLAN~: MAP SITE DIAGRAM 8u$ine~ Nome: Business Address: FACILITY DIAGRAM t--'---q For' OffiCe Use Only First In Station: Inspection Station: Area Map Ct ot NORTH ~ Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-021001100 SWIM CHEM LOCATION 4601 Issuedby: ......... ~=~,~.¢~?~,~;~,~,.~,,~, ....... This permit is issued for the following: .... ~,~.~=~ ~..= ~..~..~,,~ .......................... ~ ........ ...==..~..Ha~rdou ate ~als lan GRISSOM ~"~,~..:~r~'-~:_r BA~S LD CA ~ri~'~--_.~¢~.~::'":-.~. '~ ~ =~- -'~,~ = ~,;~ CZ~,,~ ~~ ~. *~;==¢'..,, ~.- ..., =,.../ =.' .... ,, ~ ~ .~' ~, ,..,,i~ ....... ~==~i~L.E. ,(..." ~ ~"~¢'~Z ,,,~,~¢~ ..... Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Approved by: ExpirationDate: June 30, 2000 12/27/94 SWIM CHEM 215-000-001100 Page Overall Site with 1 Fac. Unit General Information Location: 4601 GRISSOM ST Map:123 Haz:3 Type: 3 City : BAKERSFIELD Grid: 15D F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title DUKE DELAPP / BRANCH MANAGER JEREMY GOODMAN / COUNTER SALES Business Phone: (805) 837-8344x Business Phone: (805) 834-9866x 24-Hour Phone : (805) 665-9420x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 4601 GRISSOM ST D&B Number: 09-123-9764 City: BAKERSFIELD -State: CA Zip: 93309- Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code: 5091 Owner: BIO LAB NETWORK Phone: (805) 837-8344 Address: P O BOX 1489 State: GA City: DECATUR Zip: 30031- Summary ?'~ _ Do hereby (~ertify that ,~ have reviewed the attached hazardous mmerials m~,. merit plan f°r--~~aaw~.~_.and th~,~ it along with any corrections constitute a complete and correct man- agement plan for my facility, 12/27/94 Pln-Ref Name/Hazards SWIM CHEM 215-000-001100 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Form Max Qty Page MCP 2 02-005 MURIATIC ACID · Reactive, Immed Hlth Liquid 1000 High GAL 02-006 SODIUM HYPOCHLORITE · Reactive, Immed Hlth Liquid 1000 High GAL 02-001 TRICHLORO-S-TRIAZINETRIONE · Reactive, Immed Hlth Solid 17500 Moderate LBS 02r002_ SODIUM DICHLORO-S-TRIAZINETRIONE · Reactive, Immed Hlth Solid 6500 Moderate LBS 02-003 CALCIUM HYPOCHLORITE · Reactive, Immed Hlth Solid 2200 Moderate LBS 02-004 PVC CEMENT · Fire Liquid 100 Moderate GAL 2522 Grand Canal Blvd., Suite 4 Stockton, CA 95207 Gordon Lindstrom CPA (209) 473-0312 Fax (209) 474-3831 12/27/94 SWIM CHEM 215-000-001100 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-005 MURIATIC ACID · Reactive, Immed Hlth Liquid 1000 High GAL CAS #: 7647-01-1 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: STORAGE/IN STORAGE Daily Max1,000GAL I Daily Average700.00GAL Annual Amount GAL -- 28,000.00 Storage PLASTIC CONTAINER Press T Temp I Ambient~Ambient I OUTSIDE Location -- Conc 31.5% IHydrogen Chloride MCP ---/Guide Components IHigh ~ 15 02-006 SODIUM HYPOCHLORITE · Reactive, Immed Hlth Liquid 1000 High GAL CAS #: 7681-52-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: STORAGE/IN STORAGE Daily Max GAL Daily Average GAL 1,000 I 700.00 I Annual Amount GAL 28,000.00 Storage PLASTIC CONTAINER Press T Temp I AmbientJAmbient I OUTSIDE Location -- Conc 12.5% ISodium Hypochlorite 1.0% Sodium Hydroxide Components MCP ---~uide {High m 45 Moderate { 60 02-001 TRICHLORO-S-TRIAZINETRIONE · Reactive, Immed Hlth Solid 17500 Moderate LBS CAS #: 87-90-1 Trade Secret: No Form: Solid Type: Pure Days: 365 Use: STORAGE/IN STORAGE Daily Max LBS 17,500 Daily Average LBS 12,250.00 Annual Amount LBS 49,000.00 Storage PLASTIC CONTAINER Press T Temp Location I AmbientlAmbientlNORTHWEST CORNER -- Conc Components 99.0% ITrichloro-s-triazinetrione iMCP ---~uide ModerateI 45 12/27/94 SWIM CHEM 215-000-001100 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 4 02-002 SODIUM DICHLORO-S-TRIAZINETRIONE · Reactive, Immed Hlth Solid 6500 Moderate LBS CAS #: 2893-78-989 Trade Secret: No Form: Solid Type: Pure Days: 365 Use: STORAGE/IN STORAGE Daily Max LBS 6,500 Daily Average LBS 4,550.00 Annual Amount LBS 18,200.00 Storage PLASTIC CONTAINER Location Press T Temp Ambient{AmbientlNORTHWEST CORNER -- Conc Components 100.0% ISodium Dichloro-s-triazinetrione MCP Guide IModerate I 45 02-003 CALCIUM HYPOCHLORITE · Reactive, Immed Hlth Solid 2200 Moderate LBS CAS #: 7778-54-3 Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: STORAGE/IN STORAGE Daily Max LBS 2,200 Daily Average LBS 1,540.00 Annual Amount LBS -- 12,000.00 Storage PLASTIC CONTAINER Press T Temp Location Ambient{AmbientlNORTHWEST CORNER -- Conc 65.0% ICalcium Hypochlorite Components MCP ---~Guide IModerateI 45 02-004 PVC CEMENT Liquid 100 Moderate · Fire GAL CAS #: 109-99-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: STORAGE/IN STORAGE Daily Max GAL Daily Average GAL 100 { 70.00 Annual Amount GAL -- 280.00 Storage PLASTIC CONTAINER Press T Temp Location I AmbientJAmbient I AGAINST NORTH WALL -- Conc 0.0% ITetrahydrofuran 0.0% Dimethylformamide 0.0% Polyvinyl Chloride Components MCP ---TGuide ModerateI 26 ModerateI 26 Minimal I 31 12/27/94 SWIM CHEM 215-000-001100 Page 00 - Overall Site <D> Notif./Evacuation/Medical 5 <1> Agency Notification 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 THEN NOTIFY THOSE UP THE CHAIN OF COMMAND WITHIN THE CORPORATION. <2> Employee Notif./Evacuation 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. <3> Public Notif./Evacuation 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. <4> Emergency Medical Plan 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 AUTHORITIES CONTACTED. 12/27/94 SWIM CHEM 215-000-001100 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention 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. <2> Release Containment 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. <3> Clean Up 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. <4> Other Resource Activation 12/27/94 SWIM CHEM 215-000-001100 00 - Overall Site <F> Site Emergency Factors Page <1> Special Hazards <2> Utility Shut-Offs 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 <3> Fire Protec./Avail. Water 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. <4> Building Occupancy Level 12/27/94 SWIM CHEM 215-000-001100 Page 00 - Overall Site <G> Training <1> Employee Training 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. <2> Page 2 <3> Held for Future Use <4> Held for Future Use 12/27/94 SWIM CHEM 215-000-001100 00 - Overall Site <G> Training Page 9 <4> Held for Future Use (Continued) 11/21/94 SWIM CHEM 215-000-001100 Overall Site with 1 Fac. Unit age 1 General Information Location: 4601 GRISSOM ST Map:123 Haz:3 Type: 3 I City : ~~~ Grid: 15D F/U: 1 AOV: 0.0 Contact Name FF DAVIS siness Phone~ -Hour Phone . ger Phone : Title . Contact Name Title (805) 835-9772x ( ) - x I Pager Phone : ( ) - x Administrative Data _Mail Addrs: 4601 GRISSOM ST City: BAKERSFIELD Comm Code: 215-013 BAKERSFIELD STATION 13 D&B Number: 09-123-9764 State: CA Zip: 93309- SIC Code: 5091 /~gwner: B L NETWORK Phone: (805) 837-8344 /~Address: P O BOX 1489 State: GA / City: DECATUR Zip: 30031- Summary D YOUHAVE A BUSINESS NAME CHANGE?????? WHO OR WHAT IS B.L.N.?????? I~'~' ,'~~. _ DO hot, by c'~rti~/that I have review~ the a~h~ h~a~ous m~e~als manage- ment plan fo~,, _~~a~ that it al~ wi~h any ~ffe~ions consatute a ~mplete end ~e~ man- agement plan for my facility. ~-~~ Balrersfield Fire Dept. ~ HAZARDOUS MATERIALS DIVISION Date Completed //_//~"'.--. . Business Name: Business Identification No. 215-000 ~O~/~ ~op of Business Plan) Station No. Adequate Inadequate . ~' ~_~0;~O Verification oflnvento~ Materials ~,}~, .~ ~~y~ Verification ~ Ouantitios Propor 8e~ro~ation Coffimonts: Number of Employees Comments: Verification of MSDS Availablity Verification of Haz Mat Training Verification of Abatement Supplies & Procedures Comments: Comments: " Emergency Procedures Posted Containers Properly Labeled Verification of Facility Diagram Special Hazards Associated with this Facility: ,5 / Violations: /l~si'nes~ O~wner/M anager//')"'/ FD 1652 (Rev, 1-90) All Items O.K. Correction Needed White-Haz Mat Div. Yellow-Station Copy Pink. Business Copy 09/07/94 215-ooo-oollOO Unit with 1 Fac. Overall Site General Information Page Location: 4601 GRISSOM ST Map:123 Ham:3 Type: 3 0.0[ City : Grid: 15D F/U: 1 AOV: ~HW~9 ~.OzwTr' VVContact Name Business Phone: 24-Hour Phone : Title / BRANCH MANAGER (805) 837-8344x (8o5)\c35 ~?:x ( )' ~--~?~ x 7~ Cont'act Name Title ~NN~,. . ...___~.~~v~~ / COUNTER SALES Business Phone: (805) 837-8344x 24-Hour Phone : ~ne : ( )'g3~6~x Administrative Data Mail Addrs: 4601 GRISSOM ST City: BAKERSFIELD Comm Code: 215-013 BAKERSFIELD STATION 13 D&B Number: 09-123-9764 State: CA Zip: 93309- SIC Code: 5091 Owner: B L NETWORK Phone: (805) 837-8344 Address: P O BOX 1489 State: GA City: DECATUR Zip: 30031- Summary Bakersfield: Fire Dept. HazardoUs Materials Division ~I/~/2 2130."G" Street. ~' ! i ~.'4PR 8 1992 _. B~kersfield,' C/L.93301, HAZA.RDO US;. M ATE~-~J~I~S!M:x'0~G EMENT"P LA N:;:'' .... To 'avoid further. action, return this'form within 30 daYs of receipt. 2. 3. 4. SECTION 1' TYPE/PRINT ANSWERS' IN ENGLISH. Answer the questions below for the business'as a whole. Be brief and concise as poSSible. BUSINESS IDENTIFICATION DATA BUSINESS NAME: gWTM £HFM LOCATION: 4601 6rissem Street MAILING ADDRESS: same CITY' Bakersfield· DUN & BRADSTREET NUMBER' STATE: CA 09 12397:64 93309 PHONE' (805) SIC CODE: 5091 837-8344 PRIMARY ACTIVITY: '~holesale Distributio~~ OWNER' B-'L Network''. ' -. MAILING ADDRESS: P,O_ ROY ~4~9, Decatur. GA 30031 SECTION 2: EMERGENCY NOTIFICATION: ' cONI:ACT' ' "-?:' "":"TITLE ..... :'-:'..'"BUS. PHONE. 1. nli'ff nav'i~ "Rwanch U~n~g~- (805) 837-8344 . 24 HR. PHONE (805) 835-9772 (Bo5) ~7~ eg~ Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: 4 MATERIAL SAFETY DATA SHEETS ON FILE: 90~ BRIEF SUMMARY OF TRAINING PROGRAM: O~r~:'em:p.16yee training begins with hazard communication standard including MSDS ~"::'~:,content and location, chemical properties an~t incompatibilities, and exposure t~eatment. To insure proper use of the equipmentused i:n 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 i-¥1~C'~.tFC't them on proper operation of a fire extinguisher. ~l'e'ha'~v6' verY speci·fi·c procedures in our spill containment and clean up program. We emphasize what not to db' as well as what to do in these situations. These chemicals are incompatible and reactive and therefore r~quire certain considerations during clean up. SECTION 4: EXEMPTION REQUEST: I CERTIFY .UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS:. WE DO NOT HANDLE.HAZARDOUS 'MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: MATION IS ACCURATE. I UNDERSTANDTHATTHISINFORMATiONWILLBEUSEDTO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOus MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. TITLE DATE FD1590 Bokersfield Fire Dept. - Hazardous Materials Division HAZARDOUS'MATERIALS MANAGEMENT PLAN Facility unit Name: Swim Chem SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:';::~''' A. AGENCY NOTIFICATION PROCEDURES: In the case of a small spill, One hundr~d'.~ounds or less, the employees w~ll notify the branch manager. Once the spill i~ 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 manag~ who in turn will initiate evacuation and notify'the fire depar~tment'. After 'securing the, area and accounting for personnel the branch mana~er'will notify the s~fet~ coordinator and the area m~na§er. The areama]nagerwill then notify those up the chain of command within the co~poration. B. EMPLOYEE NOTIFICATION AND EVACUATION' Our operation in Bakersfield will only hawe four employees. The branch managerwill have all responsibility of employee notificatqon and evacuation by means of word of mouth. In the event of his absence the second in command assumes .these responsibilities. C. PUBLIC EVACUATION: The customers or.any nonemployees 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. D. EMERGENCY MEDICAL PLAN: An eyewash~hower will be installed for chemical exposure to the eyes or skin. In medical emergencies not requiring immediate transprtation to a hospital we will use the services of Valley MediGal Group.which specializes in occupational medicine. Severe emergencies will have' the proper authorities contacted. Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: Because we are a distribution company, our products, including the hazardous materials are bought and resbtd. The majority of our products are in consumer~commodities. Because of this, our release prevention is based on prgper storage and handling. B. RELEASE CONTAINMENT AND/ORMINIMIZATIONi Becaus~ our products' are in small individual pac'kages, 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. C. CLEAN-UP PROCEDURES: In the case of a small spill~ we have very specific procedures for cl.ean up. They include tra.ining, 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. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: There i~ nnP wlv~ fnr fh~ ~nf~r~ h,,~la~,~ toward the .center of the building. ELECTRICAL: The panel is nn thC ¢a~t wall~ shufh o~ the offices. SPECIAL: 'nnne LOCK BOX: YES/NO IF YES, LOCATION: N/A SECTION. 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITy_: A. PRIVATE FIRE PROTECTION: The building has complete coverage by the sprinkler system. The fire extinguishers are mounted to specifications. B. WATER AVAILABILITY (FIRE HYDRANT)'. There is a fire hydrant located 25 yards southeast of the front door of the building. . /~.~,. ~. FD15~O CITY Farm and Agriculture~ Standard Business BUSINESS NAME:___gwim Ehpm LOCATION: n~nl n~oo~m c+~+ CITY, ZIP: B~r~fi~l~'~ ~ .... 93309 ?Ho~g #: (805)'837_8~q~ , OF BAKERSFIELD HAZARDOUS MATERIALS INVENTORY NON - TRADE SECRET OWNER NAME: R.[ N~t~or~ : ADDRESS: -,P.U.3WQx IgS9 ..; ~. .CITY, ZIP} De'ca%ur~ GA 30031 : P~ONE.#: (~04) 378-1761 R~R ~O I~UC~ONS ~OR PROPER CODES" Page ] of~___ NAME OF THIS 'FACILITY: gwim Chum STANDARD IND. CLASS CODE: 5091 DUN AND BRADSTREET NUMBER/FEDERAL ID # Tress Type Max Average Annual Measure # Dayu Cunt Cunt Cunt Use Location Where % by Names of Mixture/Components Code Cods Amt Amt Amt Units . on. S!~e Type Pres..s Tem~ Code Stored in Fa?ilit~ w~ See .Ins_tructlons N I p I ~7.snnl l??bO I, 4qnnn I ~h. I RRR I1~1 I 1 I 4 I '.2~ NnRTHWFST nn~Fn . Oq TPTEHI nR~/-fi-TRTA7TNF TRTnNF Physical and Health Hazard C.A.S.U.~er 87-90-1 Component # 1 Name '& C.A.S. Number heck all that apply) - Component # 2 Name & C.A.S. N~mber ~--' Fire Hazard ~ Sudden Release'flr-I~ Reactivity~2~ Immediate ~] Delayed of Pressure Health Health Component # 3 Name & C.A.8. Number N I PI65°° I455° I 18200I LBS' I 365 110 I 1 I 1' 1371 N0'RTHWEST'CORNER~ 100 S0'Di, UM 'DICHLOR0-S-TRIAZiNE ~' "TRIONE PhVsl~a~ and Health Hazard c.~.s. Hu~er 2893-78-9 Component # ~ H~ ~ c.~.s. Homher (Check all that apply) Component # 2 Hame & C.A.S. Humber ~ Fire Hazard ~ Sudden Release [] 'Reaotivity '~ Immediate ~ Delayed of Pressure Health Health Component # 3 Name & C.A.S. Humber NIP I 2200 [ 1540 I 120001LBS 'l ,365 1 10 i I I 4 1371 No'RTHWEST CORNER 65 CALCIUM HYPOCHLORITE Fhysioa~ and .ealth Sa~srd C.~.s.'.u~ber 7778-54-3 Componen~ # 1 Ha~ ~ C.A.S. N~er {Cheek all that apply) Component i~ 2 Ham~ & C.A.8. Nu~er of Pressure H~lth Health Component ~ 3 Na~ & C.A.8. N~er i inn I7a i' ~an I sm .... I~ss I ~n I ]'"1"4 [~71 AGATNST NORTH WAll ?~ig gQlUENT CEMENT IU~-~-~ (Check all ~hat apply) 68-12-2 Component 8 2 N~ & C.A.B. N~er ~ Fire .azard ~ Sudden Relea.e ~ Reactivity ~ I~ediate ~ Oelay~ ,,pIMETHYLFORHAMIDE POL~TN~I EHL~RTDE RFSTN '"E~RGENCY CONTACTS tl [liff UaVJS ~anaper (SOb) 8~5-~//,Z ~2 senny Ayde]o~e counter sales -~% 97A_n Nam ~ttle 24 Hr. 'Phone ~e · ~itle ~U~ H~ ~on~ csrtifteation (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I hayer personally examined and am familiar with the information submitted in this ~nd all attache~/~ocuments and that based on my inquiry of those /1 -' - ,, '- ,~-, ~' CITY OF B/~KERS F I ELD ItAZARDOUS MATERIALS INVE~RY Farm and Agriculture ~ Standard Business ,~ NON - TRADE SECRET Page.2' of_~__ BUSINESS NAP[E: Swim Chem OWNER NAME: R-[ Nptwor~ NAME OF THIS'"F~ILITY: SWj~ Chem LOCATION: 4601Griss0m Street ADDRESS: D ~ ~v 1~ ~ STANDARD IND. CLASS CODE:'5091'~ CITY, ZIP: Ra~p~S~]a CA 93309 .CITY, ZIP:"~a~UF~'~ 30031 DUN AND BRADSTREET NUMBER/FEDeRAL ID ~' PHONE #: (805) 837 834~' PHONE.#: (404) 378-1761 a ~ - L ~ ~ - g ~ ~ ~ REFER TO I~TRUCTIONS FOR PROPER CODES Trane Type Max Average Annual Measure [ Days Cent Cent Cent Use Location Where ]' % by Names of Mixture/Components Code Code Amt ~t Amt Units on. Site Type Press Tem~ Code Stored in Fao.~lit~ w~ Bee Instructions Physical and Health Hazard C.A.S..~e~ Component.i 1 "~ % e.~.S..u~er 31. S HYDROGEN CHLORIDE (Cheo~ en that apply) , 007732-18-5 : · Co~onent # ~ .~ ~ C.a.a..~mer 68.~ WATER of Pressure ~alth ~lth ~ Component i 3 Na~ & C.A.B. Nu~er N I~ I ~000 I 70~ '1 ~nnn I GA.L I 36S I !0 I"i-, I 4 1371 OUTSIDE SODIUM HYPOCHL'0RITF t/ , 7681-52-9 Phy. tcal and B. lth .azard C.A.S. Nu~er Co.orient I 1 N~ & C.A.8. N~er 12.~ SODIUN HYPOCHLORITE (Check all that apply) ', 1310-73-2 ' of Pressure ~ealth ~ealth Component ~ 3 Na~ & C.A.S. No.er ~ I ~ I 16 I' 12 I 25 I gAL I 365 1~31~ { 4 i371 ASAINST NORTH WALL, , , , POXOLOH~EPOXY__ COAT!N6 Physical eno ,~lth .azard C.A.S.' No,er Component i ~ .~-- , c.~.e. ,u~.= 2807-3~9 _P Component * 2 Na~ & C.A.a. Nu~er " 6~2:95~" of Pressure Health Health Component i 3 Na~ & C.A.S. Ru~er ~ '~ I 16 I 12 I 25 { GAL { 36~ {13 I 1 I 4 I 37l AGAINST NORTH WALL PARALON 2' COAliNG,, ~ 64742-95-6 (Check all that ~pply) i ' 64742-88-7 of Prea~ure Health Health Component ~ 3 N~ & C.A,~. No,er ~R~NCY cOd%ACTS 4'Z ~2 Na~ Title 24 Hr. Phone N~e · Title 24 H~' Phone Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I hayer personally examined and am familiar with the information submitted in this and all attached docume, nts and that based on my inquiry of those individuals responsible for obtaining the information. I believe that the submitted information is true, accUrate, and complete. NAME AND OFFICIAL TI~E OF O%~/~ER/OPEI~%k~OR OR OWNER/OPF~3~TOR'S AU~ORIZED REPRESENTATIVE SIGNAR"J~ DATE SI~NED