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Home My WebLink AboutBUSINESS PLAN ORTH TE/FACI LI T¥ DI RA (CHECK ONE SITE DIAGRA>~ ..... . FACILITY DIAGRAM 5A - t_ .':L.L i. HM~01 Account Number ACCOUNTS RECEIVABLE ADJUSTMENT Jsnuaw 24, 1995 Date Esther Duren From Fire Department- Hazardous Materials Division Department/Division ROBBYS NURSERY & LANDSCAPE SERVICE New Account New Address Close Account Service Chan;le Other Adjustments X Billing Name 3313 S H STREET Billing Address Site Address Parcel # (if Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change <60.11> 1-11-95 Remarks: THIS BUSINESS CLOSED FEBRUARY OF 1994. WE HAVE AGREED TO WRITE OFF THE FINANCE CHARGES. Page: 1 Account Billing/Collection Activity Inquiry SUTL108 Acct : 403901 Cyc St: CL Bill St: FB Cyc: 5 Rt: Seq: SSN : Parcel: .... Svc Cls :e Name : ROBBYS NURSERY & LANDSCAPE SERV Svc Add: 3313 S H ST Amt due: 60.11 Lst Pmt: -453.00 Pmt Dte: 03/30/94 -- Prior Bills -- Date Balance 01/01/95 60.11 02/09/94 0.00 01/01/94 0.00 01/01/93 0.00 01/01/92 0.00 01/01/91 0.00 02/15/90 0.00 Current Period Postings Type Desc Date Amount Receipt # Enter '/' For Bill History,'P' To Print Report, '/C' For Credit and Deposit History or 'XX' To Exit Overall Site with 1 Fac. Unit General Information ,1 Location: 3313 S H ST Map: 124 Hazard: High Community: BAKERSFIELD STATION 05 Grid:. 18A F/U: 1 AOV: 0.0 Contact Name I IHAROLD ROBINSON IKATHY ROBINSON Mail Addrs: 3313 S H ST City: BAKERSFIELD Comm Code: 215-005 BAKERSFIELD STATION 05 Title Business Phone 24-Hour Phone- 1(805) 831-6273 x 1(805) 589-4158 (805) 831-6273 x (805) 832-7420 Administrative Data D&B Number: State: CA Zip: 93304- SIC Code: Owner: ROBBYS NURSERY & LANDSCAPE SERV Address: 3313 S H ST City: BAKERSFIELD Phone: (805) 831-6273 State: CA Zip: 93304- Summary 02/61/94 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 Page -Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-004 BEST 12-12-12 Solid 2300 Extreme · Fire LBS 02-005 BEST TURF SUPREME Solid 450 Extreme · Fire LBS 02-007 CALCIUM NITRATE Solid 680 Extreme · Fire LBS 02-003 KELLOGG KARE. Solid 2500 Moderate · Fire LBS 02-001 UREA sOlid 2200 Moderate · Fire LBS 02-006 KELLOGG GYPSITE Solid 2000 Low · Fire LBS 02-002 ~SULFATE OF AMMONIA Solid 4000 Minimal · Fire LBS 02-008 STEER ,MANURE Solid 5000 Unrated · Fire LBS 02/01/94 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 02 - Fixed Containers on Site Hazmat InventOrY Detail in MCP Order Page 3 02-004 BEST 12-12-12 · Fire SOlid 2300 LBS Extreme CAS #: ~ Trade Secret: No Form:· Solid Type: Mixture Days: 365 Use: FERTILIZER Daily·Max2,300 LBS I Daily Average 250.00 LBS Annual Amount LBS --~ 3,500.00 BAG Storage Press T Temp I Ambient~Ambient I SHED LoCation -- Conc 12.0% 12.0% 12.0% Components IJMm'nonium Phosphate, Dibasic Ammonium Nitrate Potash MCP ---TGuide MinimalI 7 Low ! 60 02-005 BEST TURF SUPREME · Fire Solid 450 Extreme LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: FERTILIZER Daily Max LBS Daily Average LBS 450 I 350.00 Annual Amount LBS 900.00 BAG Storage Press T Temp I Ambient~AmbientlSHED Location -- Conc 12.0% 6.0% 18.0% IAmmonium Nitrate Potash Ammonium Sulfate Components MCP --Iuide High 43 Low 6~ Minimal 02/01/94 ROBBYS NURSERY & LANDSCAPE SERV <215-000-000494 02 ? Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 4 ~02-O07 CALCIUM NITRATE Solid · Fire 680 Extreme LBS CAS #: Trade Secret: No FOrm: Solid Type: Mixture Days: 365 Use: FERTILIZER Daily Max LBS680 I ~ Daily Average 200.00 LBS Annual Amount LBS 8oo.oo BAG Storage Press T Temp 'Ambient/AmbientlSHED Location -- Conc 14.0% Nitrogen 1.0% Ammonium Nitrate Components MCP ---~uide High 02-003 KELLOGG KARE · Fire Solid 2500 Moderate LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: FERTILIZER Daily Max LBS. 2,500 Daily Average LBS 1,300.00 Annual Amount LBS 5,000.00 BAG Storage Press T Temp IAmb i ent/Amb i ent I SHED LoCation -- Conc 8.0% Nitrogen , 8.0% Phosphoric 4.0% Potash Acid Components MCP__TGuide Low ! 21 ModerateI 60 Low / 60 02-001 UREA Solid · Fire 2200 Moderate. LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: FERTILIZER Daily Max LBS Daily Average LBS 2,200 I 250.00 Annual Amount LBS 4,000.00 BAG Storage Press T Temp I Ambi ent/Ambi ent I SHED Location -- Conc 46.0% IUrea Components MCP ---TGuide ModerateI 1 02/01/94 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 02 - Fixed Containers .on Site Hazmat Inventory Detail in MCP Order Page 5 02-006 KELLOGG GYPSITE · Fire Solid 2000 Low LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: FERTILIZER Daily Max LBS 2,000 Daily Average LBS 1,000.00 Annual Amount LBS 8,000.00 BAG Storage Press T Temp Ambient~AmbientlSHED Location -- Conc 75.0% [Gypsum 14.0~ Sulfur Components MCP Gui~e Minimal Low 32 02-002 SULFATEOF AMMONIA · Fire Solid 4000 Minimal LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 use: FERTILIZER Daily Max4,000LBS I Daily Average600.00LBS Annual Amount LBS' 6,000.00 BAG Storage Press I Temp AmbientlAmbientlSHED Location -- conc 21.0% IAmmonium Sulfate Components MCP -~Guide Minimal I 7 02-008 STEER MANURE · Fire Solid 5000 Unrated LBS CAS #: Form:. S'olid Trade Secret: No Type: Mixture Days: 365 Daily Max LBS 5,000 I Storage BAG - Cone Use: FERTILIZER ~Daily Average LBS --q--- Annual Amount LBS -- 2,000.00] 25,000.00 ~Press T Temp Ambient]AmbientlSOUTHEAST Components Location ~ MCP ~uide 02/01/94 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 Page O0 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBALLY NOTIFY THEM OF A PROBLEM AND EVACUATE IF NECESSARY <3> Public Notif /Evacuation ALL OF OUR PRODUCTS ARE INDIVIDUALLY PACKAGED IN SMALL QUANTITIES (IE PINTS, QUARTS, GALS, ETC.) THEREFORE, IF A SPILL OCCURS IT WOULD BE VERY MINOR AND WE COULD EASILY REQUEST OUR CUSTOMERS TO LEAVE IF NECESSARY. <4> Emergency Medical Plan CALL EMERGENCY TREATMENT VEHICLES (AMBULANCE) AND TRANSPORT TO NEAREST HOSPITAL EMERGENCY ROOM. 02/01/94 RoBBYs NURSERY & LANDSCAPE SERV 215-000-000494 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page <1> Release Prevention WE HAVE SEVERAL MATERIAL ON HAND TO CONTAIN AND ABSORB A SPILL <2> Release Containment SWEEP UP AND PLACE IN SUITABLE CONTAINER FOR USE, RECYLE, OR DISPOSAL. <3> Clean Up SWEEP UP AND PLACE IN SUITABLE CONTAINER FOR USE, RECYCLE, OR DISPOSAL. <4> Other Resource Activation 02/01/94 ROBBYS NURSERY,& LANDSCAPE SERV 215-000-000494 00 - Overall Site <F> site Emergency Factors Page <1> Special Hazards <2> Utility Shut-Offs A) GAS - SOUTHEAST CORNER BUILDING B) ELECTRICAL - WEST WALL INSIDE MAIN OFFICE C) WATER - NORTHEAST CORNER PLANZ D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER FIRE HYDRANT - NORTHWEST CORNER OF THE NURSERY. HOSE BIBBS ARE AVAILABLE THROUGHOUT THE NURSERY AND THERE ARE DRAINAGE CANALS ON THE EAST AND SOUTH SIDE OF THE NURSERY <4> Building Occupancy Level 02/01/94 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 Page 00 - Overall Site <G> Training <1> Page 1 WE HAVE 8 - 10 EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? INSTRUCTIONS ARE GIVEN TO EACH EMPLOYEE PRIOR.TO THE HANDLING OF A MATERIAL <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 02/01194 ROBBYS NURSERY & LANDSCAPE SERV 00 - Overall Site <H> RMPP DATA 215-000-000494 Page 10 <1> Release Containment <2> Offsite Consequences <3> In House Capabilities <4> Plant Shutdown Instruction 04/14/92 ROBBYS NURSERY & LANDSCAPE SERV 215-000- Overall Site with 1 Fac. Unit General Information By. 'e I Location: 3313 S H ST .Map: 124 Hazard: High I Community: BAKERSFIELD STATION 05 Grid: 1SA F/U: 1 AOV: 0.0 Contact Name HAROLD ROBINSON KATHY ROBINSON Title Business Phone----T-24-Hour Phone- (805) 831-6273 x ~(805) 589-4158 (805) 831-6273 x.1(805)832-7420 Administrative Data Mail Addrs: 3313 S H ST . City: BAKERSFIELD Comm Code: 215-005 BAKERSFIELD STATION 05 D&B Number: State: CA Zip: 93304- SIC Code: Owner: ROBBYS NURSERY & LANDSCAPE SERV Phone: (805) 831-6273 Address: 3313 S H ST State: CA City: BAKERSFIELD Zip: 93304- Summary 04/~4/92 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 2 02-001 UREA · Fire Solid 2200 Moderate LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Daily Max LBS 2,200 Sto~age BAG -- Conc 46.0% IUrea Days:.365 Use: FERTILIZER Daily Average LBS Annual Amount LBS I / 4,ooo.oo Location Press T Temp ~ / I Ambient/AmbientlSHED / / ' MCP List Components iModeratel 02-002 SULFATE OF AMMONIA b Fire Solid 4000 Minimal / LBS CAS #: Form: Solid BAG Type: Daily Max. LBS 4,000 Storage / Trade Secret: No / Mixture Days: 365 use:. 5ERTILIZER ~ . Daily Averag~ LBS;-/--T---- Annual' Amount LBS , ~::;,~)"- 2, C ~,'~0 O/ , 6,000.00 I A m[T: tTA m;TPent I S.EV Location -- Conc 21.0% IAmmonium Sulfate Components MCP List IMinimal I 02-003 KELLOGG KARE Solid · Fire 2500 Moderate LBS CAS #: Trade Secret: No Form: Solid Type: Mixture. Days: 365 Use: FERTILIZER Daily Max LBS 2,500 Daily Average LBS 1,300.00 BAG Storage Press T Temp Ambient/AmbientlSHED Annual Amount:LBS -- 5,000.00 Location -- Conc 8.0% 8.0% 4.0% INitrogen Phosphoric Aqid Potash Components I MCP iList IMinimal I .IModerate~ IMinimal ~ 04/14/92 .ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 02 - Fixed Containers on Site Hazmat I.nventory Detail in Reference Number Order Page ·02-004 BEST 12-12-12 Solid 2300 ~ FAre~ / LBS Extreme CAS #: Form:'Solid Trade Secret: No Type: Mixture Days: 365 BAG Daily Max LBS 2,300 / Use: FERTILIZER Storage Daily Average~ge LBS/LBS Press T Temp ~, / ' I Ambient[Ambient S~D Annual Amount LBS 3,500.00 Location -- Conc 12.0% 12.0% 12.0% I Ammonium Phosphate, Ammonium Nitrate Potash Components MCP iList Dibasic Minimal Extreme Minimal 02-005 BEST TURF SUPREME ~ Fire Solid 450 Extreme LBS CAS #: Form: Solid BAG Type: Daily Max LBS 450 Storage / Trade Secret: ~No · / Mixture Days: 365 ~Use': FER~LIZER / Daily Average LBS ---n-/--Annual Amount LBS ~ Press T Temp. ~,/ Location I Ambient|Ambient I SHED -- Conc 12.0% 6.0% 18.0% IAmmonium Nitrate Potash Ammonium Sulfate Components MCP Extreme Minimal Minimal iList 04/14/92 ROBBYS NURSERY &.LAND~CAPE SERV 215-000-000494 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 02-006 KELLOGG GYPSITE · Fire Solid 2000 Low LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 'Use: FERTILIZER· Daily Max LBS 2,000 Daily Average LBS 1,000.00 I Annual.Amount·LBS 8,000.00 BAG ,Storage Press T Temp AmbientlAmbientlSHED Location -- conc 75.0% GyPsum 14.0% Sulfur'. Components MCP List I MinimalILow 02-007 CALCIUM NITRATE Solid · Fire 680 Extreme LBS CAS #: Trade Secret: No Form: Solid Press I Temp~ I / BAG Storage i Ambient/Ambien~l ~ED -- Conc Compon~ts 14.0% Nitrogen · 1.0% Ammonium!Nitrate Type: Mixture Days: 365 Use:. FERTILIZER . Daily Max LBS Daily Average LB~ Annual Amount LBS 680 1 800.00 Location MCP List IMinimal I Extreme 04/14/92 ROBBYS NURSERY & LANDSCAPE sERv 215-000-000494 Page 00 - Overall Site <D> Notif./Evacuation/Medical 5 <1> Agency Notification CALL 911 <2> EmPloyee Notif./EvacUation VERBALLY NOTIFY THEM OF A PROBLEM AND EVACUATE IF NECESSARY <3> Public Notif./Evacuation ALL OF ouR PRODUCTS ARE INDIVIDUALLY PACKAGED IN SMALL QUANTITIES'(IE'PINTS QUARTS, GALS, ETC.) THEREFORE, IF A SPILL OCCURS IT WOULD BE VERY MINOR AND WE COULD EASILY REQUEST OUR CUSTOMERS TO LEAVE IF NECESSARY. <4> Emergency Medical Plan CALL EMERGENCY TREATMENT VEHICLES (AMBULANCE) AND TRANSPORT TO NEAREST HOSPITAL EMERGENCY ROOM. 04/14/92 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page <1> Release Prevention WE HAVE SEVERAL MATERIAL ON HAND TO CONTAIN AND ABSORB A SPILL <2> Release Containment <3> Clean Up <4> Ot'her Resource Activation 04/14/92 ROBBYS NURSERY & LANDSCAPE SERV 215-000-000494 00 - Overall Site <F> Site Emergency Factors Page 7 <1> Special Hazards <2> Utility Shut-Offs A) GAS ~ SOUTHEAST CORNER BUILDING B) ELECTRICAL - WEST WALL INSIDE MAIN OFFICE C) WATER - NORTHEAST CORNER PLANZ D) SPECIAL - NONE E) LOCK BOX'- NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER FIRE HYDRANT - NORTHWEST CORNER OF THE NURSERY. HOSE BIBBS ARE AVAILABLE THROUGHOUT THE NURSERY AND THERE ARE DRAINAGE CANALS ON THE EAST AND SOUTH SIDE OF THE NURSERY <4> Building Occupancy Level 04/14/92 215-000-000494 Page ROBBYS NURSERY & LANDSCAPE SERV 00 - Overall Site <G> Training 8 <1> page 1 WE'HAVE 8 - 10 EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? iNSTRUCTIONS ARE GIVEN TO EACH EMPLOYEE PRIOR TO THE HANDLING OF A MATERIAL <2> Page 2 as' needed <3> Held for Future Use <4> Held for Future Use Farm and Agriculture ~ Standard Business !(~i .. ::.. Page, of LOCATION: NON ' TRADE SECRET '- ' ';" . ~D~SS: )~IW ~~'"~~ST~ I~; :C~SS CODE: " REFER TO INSTRUCTIONS FOR PROPER CODES *~ / i 2 3 4 5 · 6 7 8 9 10 11 12 13 · 14 T~ans T~pe" Max Average Annual Measure # Days Cent ' Cent Cent Use Location Where. '. %/by Names of Mix~ure/Cc~ponents Code Co~.e Amt Amt Amt Units on Site Type Press Tem~. Code Stored in Facility . i w~ See Instructions Physical and ]Z lth Hazard · C.A.S. Number Component # I Name '~ (Check all thai: apply) :./ : : Component # 2 Nam~ :; C.~. N;~mber' ~ Fire Hazard ~ Sudden· Release ~ Reactivity ~ I~ediat. [~ Delayed , ~: : ': ' J;!' Component # 3 Name i C.A.S. Number of Pressure (', Health , Health '~ Physical and lt~alth ll~srd C.A.S. lqun~er . Con, on,hr #' 1 N~a~ :t~ C.AoSo ~umbar (Check ali that apply) '" [~] Deiayed '' ~ease Fire Hazard Sudden Reactivity I~ediate of Pressure :. Health Health Component # 3 Name & C.A.S. Number Phlmtcal and Health Hazard C.A.S. Number ~:"' ~- Component # 1 Name & C.A.S. Number (Check all that apply) ?< Component # 2 Name & C.A.S.. Number , of Pressure Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component # I Name & C.A.S. Number (Check all that apply) . . Component # 2 Name & C.A.S. Number of Pressure Health Health : Component # 3 Name & C.A.S. Number EMERGENCY CONTACTS %1 Na~e Title 24 Hr. Phone Name . - :, Title 2~ Hr ~hone ',ertification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) , . .. I certify under peanl~y of law that I hayer.personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those individuals responsible for obtaining the lnformat/on. I believe that the submitted information is true, accurate, and complete. NAME-AND OFFICIAL TITLE OF OWNER/OPERATOR OR OWNER/OPERATOR*S AUTHOR/ZED REPRESEI~fATIVE SIGlqATURE .... ~ . , . %~,,: DAT~ SZONED .,. BAKERSFIELD CITY FIRE DEP~RTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 " (805) 326-3979 RECEIVED JUL 10 1987 Ans'd ............ BUSINESS NAME OFFICIAL USE ONLY ID~ HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCT IONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the bus'iness as a whole, 4. Be as brief and concise as possible. 000494 SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS: SECTION ~: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material-, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS, · J~ / I AFTER BUS. HRS. Ph~ ~ ._~5~::~ - ~ t~--'~ SECTION 3: LOCATION OF UTILITY SHUT~OFFS FOR BUSINESS AS A WHOLE A. NAT .' GAS/PROPANE: ¢')M-C -I:'---~P__Cp,-'r'~ ~50Cl'I'~ct--~Y B. ELECTRICAL:~T ~~ ~n~io~ m~ ~tc~. D. · SPECIAL: ~ E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO MSDSS? YES / NO YES / NO KEYS? YES / NO - 2A - SECTION~'"P~IVATE RESPONSE TERM FOR BUSINESS AS A WHOLE SECTION. 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING'IN THE FOLLOWING AREAS. CIRCS~:'yEs OR NO INITIAL A, METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:.... .......................... ~ ......... ¢f~5) NO B. PROCEDURES FOR cOORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES ~ C~ PROPER USE OF SAFETY EQUIPMENT: .................. YES D. EMERGENCY EVACUATION PROCEDURES: ................. YES E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ........ YES SECTION 7: HAZARDOUS ~3~TERIAL REFRESHER YES YES .YES YES CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... E~ NO I, ~-~3i~ ~-O(_~(AC~-~C>'~ - , certify that the above information is accurate. .~I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95. Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. - 2B ' I.D. 'BAKERSFIELD C'TY FIRE DEPARTMENT t ,4 4A-1 NON--TRADE SECR'ETS MATERI ALS INVENTORY of OFFICIAL ONLY CFIRS CODE ADDRESS: '~'~- ~5/, ~ -..~3~- ' ADDRESS: FACILITY UNIT NAME: CITY, ZIP: ~'/~/~ '-- ' ~~ CITY,ZIP: PHONE ,: '~f- ~ ~R PHONE ~: USE 1 -2 ~ 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE NAME: TITLE: SIGNATURE: ~ DATE: EMERGENCY CONTACT: TITLE: PHONE · BUS HOURS: , AFTER BUS HRS: ~EMERGENCY CONTACT: TITLE: PHONE ~ BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: BUSINESS NAHE: OWNER NAHE: FACILITY UNIT ~: / ADDRESS: ADDRESS: FACILITY UNIT NA~E: ~}[ ~~ C I.TY, ZIP: CITY,ZIP: PHONE ~: PHONE ~: [OFFICIAL USE CFIRS CODE. I ONLY 1, 2 3 4 5 6 7 8 9 10 TYPE .PLAX ANNUAL CONT !USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNITi CODE CODE FACILITY UNIT WT. CHEMIC. AL OR COMMON"NAME CODE GUIDE 'N'APLE~: ' :~ TITLE :~ · SIGNATURE,: " DATE: ' EMERGENCY .,C.ONTACT: .:.:.:%.~,: :..,.'.... ,.. .':.~ .- TITLE:':..,~,'.~:.~-i:,:::::,~.~:~:'.:?.,~':':~ '.' ,.' ~HONE.# BUS HOURS:..-" :':'.-:':'.-" ': ~:.".::~:. '..i BUSINESS NA~E: ~~~ ~J~~J OWNER NA~E: ~~ ~[~c~ FACIn'ITY UNIT ADDRESs:: ',~(.~-,~~/ :~ ,~ / ADDRESS: ~]~. :~ /~ FACILITY UNIT NA~E: ~ C I.TY, Z I P: ~~,~/~~ ~ ~)~ C I TY, Z I P: ~~ '~,~/~ / _ , PHONE ~: ~)~ ~['~.~ PHONE ~: ~ .~~/:~ OFFICIAL USE. CFIRS CODE ONLY I 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT US~ LOCATION IN THIS % BY HAZARD D.O.T ~CODE A~OU~T AMOUNT UUXT:COD~ CODE ~ACZ~ZTV U~XT WT. C~M~A~ OR CO~MO~"~AM~ COD~ o~TNO ~G~o L~ ~oop ~,~. ~1 m~L07' ~ - -:. ~ ,, .. .~ ' .: .:: .., ..:... :.:-::::: ~.~l::co-..,::.::., ' · · . . ~ "' _~,~:~ 4' .~b~:?'~:.5.~F>~'5~,~,:Zw::,.-'.,",?'~ ,::..,,. :: .... ':'..:-:?~H':': ~ ".';::'~::'~':>Z.,~ ;-..?'.":?'x:~'.i~'~'~ .: '~ .~: .: ~:' ~::. ? ~'~:e~ ~ iz ~ '; L, ':'-', 'F' ?""-".-' .../.~,:>,':::" :' ". :'': -','" ' :.,..::.:.,~,..:.:..~.,:.~,,, .:... · ..,¥.,,...?, .: :.: ..:~ . ........ ::,~:..,_,::...:.,....~ ....... ,......,,~..O N~ .,,~.~;D E..{~-,. ~ C..~.~.~ S ....... . .... - .,.. :.. · :.. BUSINESS NA~B: OWNBR.NA~B: FACILITY UNIT ADDRESS:. - ADDRESS: FACILITY UNI.T NA~E: ~ C I.TY, ZIP: CITY,ZIP: PHONE ~: 'PHONE ~: [OFFICIAL USE. CFIRS CODE ~ o~sy ,, 2 3 7 8 9 10 BAX ANNUAL LOCATION IN THIS % BY HAZARD D.O T AHOUNT A~OUNT FACILITY UNIT WT. CHEMICAL OR.CO~BON 'BA~E CODE GUIDE ~'. ~ z~-~ ~ ~OoD /<~~ ~e~y ~' ' ~ ,':':,,::,'...,.:>'::'::'4. '~[~EB~, ~ 8[~B~B~.'. '"":-? :-:.' '~.. : .: B~ PHONE ;m: ~ ,~J,'~l--~-'-]'~'~ PHONE. #: ... _~ ~--C[[5.~"~? [OFFICIAL USE CFIRS CODE I ONLY 2 3 ? 9 10 MAX ANNUAL LOCATION IN THIS HAZARD D.O.T AMOUNT AMOUNT FACILITY UNIT CHEMI AL OR COMMON ~NAME CODE GUIDE NA~E: ON: TITLE: ..':: I-T LTLE SIGNATUI O/-l~C,,oN ,~c~.. Co. C~ ~co ~ cg~_~n ~c~t~c CO, :. "I-q-gq BUS :.HOURS.: ' HA"Z'ARDOU~"' .~ATgRI"A'LS'~::' 'I"NVENTORY BUSINESS NA~E: OWNER NANE: FACILITY UNIT ADDRESS: ADDRESS: FACILITY UNIT NANE: ~/ C I.TY, ZIP: CITY,ZIP: PBONE ~: PHONE ~: [OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE A~OUNT A~OUNT UNIT CODE CODE FACILITY UNIT WT. CHE~IqAL OR CO~ON"NAME CODE ~GUIDE NAME ' TITLE: SIGNATURE: I' ': ' ..... ~ DATE: - ..... ;~,._-.v,...: :.. ..... ¥ ,.~... .... _ :.:~.~,? ..,, ~,,..~+::. , ~..E-:.~,.::.,:~ - .... ? ........ : ........ .. , ..... ...,.,.-,..::,.. ..... .~:~ ~:~,~:. .... ,.:..;.,..~ .... . ~..., AFTER J~US.~ HRS ........ . ......... .,:,. ....... ................... , ........ ... .................. . ....... .. ...... . ...... .~.,:..~.,~,,....,: ,.~.? ,..... ....... ...., .... ................. .,,,~ .,.,~ ....... :>~.?,.~-.,..?~ ~_.~-.. ............... . ............. ...~: ~,'".... - -. .... 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BUSiNESS ACTIVITY: TITLE: PHONE # BUS HOURS: AFTER BUS HRS: PHONE #,BUS.HOURS: .AFTER,Bus HRS: I.D. # FORM 4A-1 Page~ 'NON--TRADE SECRETS HAZARDO'US MATER.IALS INVENTORY BUSINESS NAME: [~O~g ~[,U~.,cD~.Ig-~ OWNER NAME: [~OC.O ~-O~Of-~(/~ FACILITY UNIT ADDRESS:~%~ ~~ ~ ~I, ' ADDRESS: ~'1~ ~ ~'~ FACILITY UNIT NAME: CI.TY, ZIP: ~~~~ ~q CITY,ZIP: ~l~_t~ P~ONE ~: ~ ~~~ [OFFICIAL USE CFIRS COBE I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS -~ BY HAZARD D.0.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIC. AL OR COMMON~ NAME CODE GUIDE NAME: l~~~ t5 ( ~ TITLE: ('"'J{.O~'~"~__ SIGNAT~ ~/~, ~ DATE: '7-c~'-'~..7l EMERGENCY CONTACT: ~C~Ort"~L./~) ~[~ ' TITLE: ~~ ' PHONE ~ BUS HOURS: AFTER BUS HRS: EMERGENCY CONTACT: ~~ ~D~/~ , TITLE: ~~~. ' PHONE ~ BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: ~~ ~,SF~ ~'~O.~F-~/~F_ AFTER BUS HRS: ~B~--~q~ ..' . 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TITLE: SIGNATURE: DATE: PHONE # BUS HOURS: AFTER BUS HRS: PHONE # BUS HOURS: AFTER' BUS 'HRS: I.D. { FORM 4A-1 ~age , NON.--TRA'D'E~..'SECRETS HAZARDOUS MAT E R-I"AL S I N.~VENTORY BUSINESS NAME: ~;~(~/~ /~C~-~"~_.-C/ OWNER NAME: ~~ ~C~/~ FACILITY UNIT ADDRESS: .~.~L~ ,~l.t~'~ ~ I ADDRESS: ~'/~ ~ /~ FACILITY UNIT NAME: C I.TY, Z I P: ~~~,~~ ~.~ C I TV, Z I P: ~~ PHONE ~: ~ ~/-~~ PHONE ~: ~ ~q--~(~ 10FFIClAL USE CFIRS CODE - - I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS .~ BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE GUIDE EMERGENCY CONTACT: ~~ ~G~l~ TITLE: 0~~ PHONE · BUS HOURS: ~%-~ . ~ :' ~l~ ., TITLE: EMERGENCY CONTACT: 'ACTI'q~'viT~ PRINCIPAL BUSINESS' !:'": · . ., ':.'.,,.ff~'4 . · · ' ~.'.':' '- '-,~ ~ '~z ,t~.'~.~ .... , ',' % AFTER BUS HRS: ~-1__~:~. ' . PHONE # BUS HOURS: ~'~--(_,d2.:-~ ~F~VI~ AFTER BUS HRS: . ~--~~ , ,I.D. # -. FORM 4A-1 Page __~of ~.?/Z:- NON--TRADE SECRETS HAZARDOUS 'HATER'r ALS. INVENTORY BUSINESS NAME: OWNER NAME: FACILITY UNIT #: / ADDRESS: ADDRESS: FACILITY UNIT NAME: /~/ CI.TY, ZIP: CITY,ZIP: PHONE ~: PHONE #: [OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIC. AL OR COMMON. NAME CODE GUIDE N~ME: TITLE: S GNATURE: EMERGENCY CONTACT: TITI, E: ~MERGENCY CONTACT: TITLE: 'pRINCIPAL BUSINESS PHONE # BUS HOURS: AFTER BUS HRS: PHONE # BUS HOURS: AFTER BUSH. RS: DATE: I.D. ~ FORM 4A-1 Page ~o~ ~ NON--'TRADE SECRETS HAZARDOUS~ HATERI ALS ,I NVENTORY BUSINESS NAME: ~O.~)~k~_'=~ ~l,[¢_..?-~-kOk~ OWNER NAME: ~)~ -~(~ FACILITY UNIT #: ] ADDRESS:' ~%~ ~~ ~. ' ADDRESS: ~ /~ ~ /~ ~ACILITY UNIT NAME: ~ ~ CITY, ZIP: ~~~~ ~~ CITY,ZIP: ~~ ~,~,~ ' PHONE ~: ~ ~%---~~ PHONE ~: . ~ ~--~[~ [OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MA× ANNUAL CONT USE LOCATION IN THIS .% BY HAZARD D.O.T coDE AMOUNT AMOUNT U.~T CODE CODE EACIL~TY ~~cY CONTACT ' ~~ .~~ . T~T~: ~~~ ~ON~ ~US ~ouRS ~~.~" · BAKERSFIELD CITY FIRE DEPARTMENT · .I.D. # FOR~I 4A-1 Page _ /~ of NON--TRADE' SECRETS HAZARDOUS 'MATERI ALS I NVENTORY BUSINESS NAME: OWNER NAME: FACILITY UNIT #: / ADDRESS: ADDRESS: FACILITY UNIT NAME:~%~ CI-TY, ZIP: " CITY,ZIP: PHONE ~: PHONE #: [OFFICIAL USE CFIRS CODE I ONLY 1 2 3 4 5 6 7 .8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMouNT UNIT_ CODE CODE FACILITY UNIT WT. 'CHEMICAL OR COMMON.,,NAME CODE GUIDE ~/~ O7x l.. :~Z , .NA~.Ej: .': T ITL E: S I ONATURE :, DATE EMERGENCY' CONTACT: TITLE: PHONE # BUS, HOURS: ~.::~:,:-.~:e:~:~:'m,~s;:4.~,;~4: , :,,,~ . ...... . 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AFTER BUS HRS: ~- OWNER NA~IE: ~,~"'~[1~ ~{~t~")/'}. FACILITY UNIT #:__L___' ADDRESS: ~-"~ I~_. [~,OX. ]'[l:~P) FACILITY UNIT NAME: CITY,ZIP: ~:~1~.~--~----~ # FORM 4A-I Page _~of'~- NON--TRADE 'SECRETS HAZARDOUS I~IAT E R 1' ALS 1' NVENTORY BUSINESS NAME: OWNER NAME: FACILITY UNIT'#: ] ADDRESS: ADDRESS: FACILITY UNIT NAME:~ CITY, ZIP: CITY,ZIP: I PHONE #: PHONE #: OFFICIAL USE CFIRS COOE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE NAME: TITLE: SlGNATpRE :., . DATE: 'EMERGENCY CONTACT: TITLE: .. " ! PHONE #.BUS. HOURS: -- '.-:'. .' ' ' ! AFTER BUS HRS: BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Pagel,/or NON--TRAm . S C R .TS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME:~5~'% IOL~-~_f~ 0~NER NAME: ~~ ~t~~ FACILITY UNIT ADDRESS: ~l~ ~A~ ~T. I ADDRESS: ~V ~ ,. ~ ~ FACILITY UNIT NAME: J3~W CI.TY, ZIP: ~~~~ Q~ CITY,ZIP: ~~ Q~I~ ~o~ ~: ~ ~t-~~ ~nON~ ~: ~0~ ~--~t~ Io~.g~C~A~ us~ cg~s CO~E I ONL~ I 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T coo~ A~OU~T A~ouNT U~T CO~ CO~ ~AC~TY U~T WT, C~qAL O~COMSp~.~AS~ CO~E ~UX~n NAME: TITLE: ~)7')~:'_./~_. ' . SIGNATURE~C~)~-'~ ~-.~.~.,,'~ff~-~'NDATE: ~-~-~") EMERGENCY CONTACT: ~ ~1~ TITLE: f~n.~ ' ' PHONE { BUS HOURS: ~%1%~q~ " :". - AFTER BUS HRS: BHERGENCY CONTACT :. ~~ ~O~/n~ -'"'~.~T. LE:' .~~" .. PHONE { BUS .HouRs: pR~N~.!.~,A.~. BU. SINE$~ .6C.%.I{y~.}~::.~,: ~w~D...~M~~ J~~m¢;:..:'~¢V~,. ..... IFI.B~ ;BUS HRS.; ': Vt%..:, :< : ." ': :, :, ' · ~ {-,,' % ¢ :', ~:' :ff,~.¢O'F~:~l ~?,,,.'<: -.'. , - ' v:~&"J:', .' "a? :¢,~vi- ',>lc,,' "a, ~¥"<~v'.~"oV'r;-' >: v..-¢~.~ ,9~., '.'~-,.,., . ,,~,,';'.:~, 3,'. · .:,,?. ;~-k',.'f.:,. · '. "<:' :--r :I.D.'# FORM 4A-1 : _. 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BU'S.'HRS:, .. .-:?. .., '- I.D. # BAKERSFIELD CITY FIRE DEPARTMENT FORM 4A- 1 NoN--TRADE · SECRETS HAZARDOUS MATER1' ALS INVENTORY Page __~__ of ~_.___~ BUSINESS NAME: ~O~:)[:~J~ I'~LX~.~'.l~ OWNER NA~E: '~~ ~n~ FACILITY UNIT ADDRESS: ~l~ ~)(l~~ ~ ~ ~ ADDRESS: ~T ~ ~ ~ FACILITY UNIT NA~E: CI.TY, ZIP: ~~~ ~q CITY,ZIP: ~%~ ~~ ' PHONE ~: ~ ~t--~~ PHONE ~: ~ ~q-~l~ OFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL T CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNI , CODE CODE FACILITY UNIT WT. CHEMIC, AL OR COMMON, NAME CODE GUIDE NAME: ~ ~f~-~ TITLE: ~Y/.,OYI~_.~ Sift ,ATE: EMERGENCY CONTACT: '~O~ ~O~I~ TITLE: ~]~~ ~ PHONE ~ BUS HOURS: ~%~-~~ " A~T~ ~US nRS: ~~~ - EHERGENCY CONTACT: ~ "~O~l~ TITLE: ~~~ .. PHONE [ BUS HOURS: . ~R:~N~P~AL~:B.~NE~~`~:~;~:~~~.`~~~.~c~T~T~v`Tj ~~~_.. ~~...AFTER BUS' HRS.: ~-..~ " · ':-'.,~.' , ':'..'-' .:,'.: ,'3~A?.~. ~`:~;:~f::~`~``~}}~i:~:;~:~`~¢~`~.~`~x~.~ ,..,, ~,.-~ .~w,-'.,Ix~~ ;'. . . 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BUS ,HOURS:, :'.'.:~': ,., . . .,. :',.',.:~,;:.',~ ':' '~":: . ,,'--,;:Ncc::*",t¢,~,'',~-'- ~.~-,:.::-'.~;,'"::,~:~.i.~¢!Lt-:',,':,~"..'~,,~..~..~ '. ,. ' . . . ",' _. '. . .. , : . _: ........... ~:,:.. ....... ~:~:~ .... ~.~,,.. :. :,~.: ....... ~ .... :.... ,:., :,.~ ..... ~:,, ..................... AFTER. BUS HRS. · - '- :. ..~--.::.:c~;',,,-'.,' .:';.,~ ~_-'~: z'¢_~:~4, &.~* ~'..,'.~".~.~.a¢;"::.::~%'''~'~' ~:,~-: ,',-. ". .... " , ,.- ' . .--. ..- ",, · , ,-,.. ¢,",. :-' ' - '-' .- ' ' ' ', NERG:ENC.Y..r~.~ON.T:AC.T;~:,'~:~-'~'~{!;~_'.~::'~::;~,.~;, ' :.. : ~. .'' .".:~:;'TI~.TLE'::;.;.: : .~' :;;' :~' .',:: _' . ".-:~,'"'.~P, HONEe:~. BUS BAKERSFI, ELD CITY F;IRE~DEPARTMENT "#. ,..; · . " . -.. ':" :";.:~,. ,F,0RM ..4A=! :, :". "' .:' ' Page . ':., ";7 '-::' '.' .:. :-.,N°'~,~.;'~=.~:'X,:6~.;'*,~,:,'S ~;'~/i*:~,'T'-q =__..,.._..____~.._..,_... ____,_.___', , · '~'- ' "":' ,-c; '-:. ,, ," · BUSI,NESS NAME: ~O~~ ~r-~c..~-(~.~ OWNER NAME: ~¢3~L.{) r'~t~ · FACILITY. UNIT ADDRESS.:_ ~[~ '.~~. ~ ~. I ADDRESS: ~. ~~ FACILITY UNIT NAME:'~M~~ CI.TY, ZIP: ~~,¢1~ 0~ CITY,ZIP: ..~~ q~l~ · PHONE ~:... ~ ~t~~ PHONE t: ~ ~q--Mt~ [OFFICIALONLY USE CFIRS CODE 1' 2 '¢ 3 '4 5 6 ? 8 9 10, TYPE MAX.. ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT hiT. CHEMICAL OR COMMOI,~ NAME CODE GUIDE BUS~NESS NAME:~ ADDRE. SS:~.:~ ;,~ .'... CI-TY,' ZIP: 'PHONE ~: " OWNER .NAM'E: '' - - ' FACILITY UNIT #: ~.:'.ADDRESS:'..-. '~ 'FAC.I.LITY';UNiT NAME:-. PHONE.-#.:" [OFFICIAL USE CFIRS CODE [ ONLY 1 2 .' 3 4 5 .6 7 :' 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · 'BY HAZARD D.O.T CODE 'AMOUNT AMOUNT UNIT ,CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMOI~ NAME CODE GUIDE 56 ~ ~ J c~o~ O-io-to ~ " , p~p/~2~ ~cl~ ~;~. ~, .ff ~7..~.., ~ ~.c~~,~ · ,~ :.. ,.'~ : ~:: :-;:,..:" .::-;. ,.-. . '.~. . .. ~: , "-,' .... :. ~...~-.. .''". ::: .... , ~. ~: 0~I~:' t ;:'~' . . :-. BAKERSFIEI, I)'.CITY FIRE 'DEPARTI~ENT I.D.-':' .... ' ';~':~ .... ';:' ...'-'-' . .' . .... · ~i": ":.-:' :':')':'.J. :'. :'": ~J.'::i~'/i'FORM:"4A-1 '' .. :": ':%:':.:-- .' '-..' ~ :..- .... :. H A:Z,'A~.R:D'.O':U'S~: :' ~A"T:E R 'I .A L S:f '"~.X~ N'V E~N T O R Y ' ' BUSI, NESS NA~E: ~0~~ ~1~~I~ ' OWNER NA~E: ~~ ~{~~- FACILITY UNIT ~:_ ADDRESS: ~ ~~"~ ~~.T ADDRESS: ~'lZ ~X" [~ - FACILITY UNIT CI.TY; ZIP:~~ q~3~ CITY,ZIP: ~~ - Q3~l~ PHONEi.*: ~ ~~~ PHONE ~: ~ ~-~~ ~OFFICIAL USE CFIRS CODE I ONLY 1 2 3 4 5 -6 ? 8 '- 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY .HAZARD D.O':T CODE AMOUNT Ar4ouNT UNIT CODE CODE FACILITY UNIT WT. CHEI~IqAL OR COWiMON NAME CODE OUIDE ' BUSINESS NAME: '.... ' ',~:.:: ~ ,OWNER'.NAME: FACILITY UNIT #:": ] ADDRESS~: '~ ~ ...... ...ADDRESS: .': '~ FACILI'.TYi. UNI'T.NAME:: "" CI-TY,' ZIP: .~' . ' .'CITY',ZIPs' ~ ~ PHONE ~: : " .-. ~... PHONE #': [OFFICIAL USE' CFIRS '~ODE ONLY 1 2 3 4 5 .6 '7 8 9 10 TYpE MAX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T CODE 'AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COM~iO~ NAME CODE GUIDE r,~'~'R~r. NC¥,".CONTA.~T:",' :: , .V.. :' .:.,- .~ ~.: -:'.,i,-;-~'::"':.~' ~L~.' :,,',~: ..... Yt'?:,'~'.;-%t:'::?:~?¥fi~O~t. ~ ~US HOURS: ". ~'J~= ". ' ADDRESS: OWNER NAME: ~_.O~,(D )~O)~t/q~-.-x~ FACILITY UNIT #:_/ ADDRESS: ~ ~ ~ ~(~O'(~ FACILITY UNIT NAME:Burn, O, CITY,ZIP: ~j~i~..~l:=sk-J ~%~ ' PHONE ~: ~ .~--~{~ OFFICIAL USE CFIRS CODE ONLY 1 2 $ 4 5 '6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMO~INT AMOUNT UNIT CODE CODE FACILITY UNIT WT,. CHEMIqAL OR COMMON, NAME COD.,E GUIDE :', /7 Porns -'NAME: ~-~~ '~Z)/c~//~F~ TITLE: CJL.O'FT.'~_~t~__' .SIGNA' DATE: -~--~-~.~ i, :E~ERGE~c.Y CONTACT: ~~ ~/~%~. TITLE:.. ~ PHONE.¢ BUS HOURS: :.?/ j., ............... j ..... :....::, . v;' -:'.' .- -- ,, -. -.'-. .... '" ... ,..?'::,:.,',,~. .. ' AFTER BUS HRS: ' ~--qt~ :'~ERO. EN:GY.;j. CONT:AOT:J. ~~' ~-~ ...: T.I.TL~:; .::~,~::'~'~~~'.~'-':, :. [HONE: # ..,BUS.: HOURS: ~l~[~atr:':', .'", '.,, ; BUSINESS NAME: : , ~''OWNER NAME: "FACILITY UNIT #: ADDRESS:..,...'. ADDRESS:' FACIL. ITY~UNIT .NAME:, '. CITY, ZIP: : CITY,ZIP: : ' pHONE ~: PHONE,: #: [OFFICIAL'USE CFIRS CODE ! ONLY 1 [ 2 " 3 4 5. 6. 7 8 9 10 YPE["MAX' ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T ODE [AI4OUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR CO~tON NAME CODE GUIDE ' ...... :Page {' of.~.: !.: BUSINESS NAHE: ~O~5~q~ ~S:~_.[2.,~! OWNER NAME: _~c~O~ '~_(7(~ti'"~~ FACILITY UNIT ADDRESS: ~%,'=) ~-,~C~ixT~ ~[- ~'T-, ' ADDRESS: ~"~ [~ P~>~ [{~)L~ FACILITY UNIT NAME:~ CI.TY, ZIP: 3~,_~--~ - ~q CITY,ZIP: ~t--~ PHONE ~: '::~ ' _'c~.-~l--(o~?:~ PHONE #: <~j~>~ ~--'~C]-/.~[,~--~ {OFFICIAL USE CFIRS CODE { ONLY 1 2 · . 3 4 5 6 :7 8 9 1 0 TYPE MAX ANNUAL CUNT USE LOCATION IN THIS ~; BY HAZARD D.O.T CODE A~OUNT A~IOUNT UNIT CODE CODE FACILITY'UNIT WT. CHE~IIqAL OR COMMON NAME CODE~ GUIDE ./ z POT,s ~ 'NAHE:._Jj~3,4~[~IJ~)_ 'I'~Z)~~ TITLE.:.,.~~._ SIGNATU{ DATE: ~-~-~ EMER.GENCY. 2CONTACT::i~,~C,~c.8~ ¢-OZ~t~ ......... TI.TLEi.~~.~l/ PHONE # BUS HOURS:I~Bi-~2]~ "c E"~E,R.O.EN.,CX,,.C.O,N?A.C.? :,.:.'E~~.... 6R....5:.~!~,T .:':.:-i::?W:~,?,~ ~:. r~~~.:.",".. : :'....PHONE .# ~ ,OURS ~: tZ~-~,:Zn~.";::.'>..', :, ; "~'P:';:;%':'-'>si""''e.,~?,<"'~',}~d'"~:'~' :~j~'~cG~'=7-'''''~':'''''-~''':' ~'" ~'";;:"?';:','~." ""':""~"<~ .... .~'"'~"~"-:'~' I'' .... ='* ....'" "~ ,,~.~-=¢-~_-~ ~--~-.,..,'.,7.'~". : :'~ ..... " ..., ,':.." 't~:x..~'-,'-.~..~ ~..~.,'4.-~->.t'-' ,.O,,. , 'v~-=,.-~,,,: CITY of BAKERSFIELD NO N-- ~FRAD E S E C RETS ' ~q,.J._of..~.. BUSINESS NAME: /~0/-'~17'~'_~ ~'~{?,~t~'f OWNER NAME: ~Dr~ ~>(-'~{~lr~ NAME OF T~"~ rACIr-ITY: r'~-~ CITY, ZIP: ~M~5~~ ~ CITY, ZiP: · ~5~ ~}[~ DUN AND BRADSTREET NUMBER ~e C~e Mt Mt Est Units m Site I~ ~l l~ ~ St~ tn F~tllty Wt ~ I~t~ti~ / ........ (C~k ~11 thc a~ly) r--~ r ~ r--~ ~t 12 ~&C.l.S. ~ P~ical ~ ~lth Hl~l~ C.l.S. ~ ~t II h i C.l.S. ~ ~lth of P~ ~lch ......... ~t 13 ~&C.A.S. Mfllth of P~sum ~lth~ Hfllth of Prflsure Hfllth ........- ' ....... Certlfi~atim (Read and sign after colpJetJng aI.I sections) I ctrttfy uflder Nrmlty of lp t~t I ~ve ~rsmallyexami~ ~ la fNiliir with t~ tnf~tt~ suhitt~ tfl this ~ Ill IttKi ~ts, ~ tbt ~ff m W t~t~ of t~e t~tvi~ll m~sible BUSINESS NAME: LOCATION: CfTY, ZIP: PHONE NoN--TRADE OWNER NAME: ADDRESS: CITY, ZIP:- PHONE · : ~ ~ IIr~3'~UC~ZO]~ FOR I~ROF~t COD33 SECR~.TS kAME OF T~'~ FACILITY: ,STANDARD IND. CLASS CODE DUN AND BRADSTRE£T NUMBER -- i 13 NOBel OF Illxturl/Comt! ./ ~e~lth ' of Pressur~ Health II Nmi & C.A.S. ~d~ C~t 12 liell & C.A.S. ~ Cm~wrint I] ~ & C.A.S. nulMr !KERG[#CY CONTACTS I1 12 , C~rti/tc,thm (Read and sikh after coapletln£ all sectl6ns) ' " . i : Business Hfllth of P~s~ ~lth ~ ) ~ & C.A.S. ~ L~~'~ NoN--TRADE SECRETS ' ~,9, ..~__ of .~.. Certi~icstlon (Read. and ~fEn after co~pJetJn£ aJJ sectJons) ,~I~L ~~ 2'~~e~ ..... - *~ ~~ ~~~--~ ~. · - ".'... ~-~q ........ · ..... u .., -. ~,. ,'.~..- -' · .... . I OJ ~~x~L~x''~ ~'~' ' ,' "? ...*. sECRE,ijTS- ,',~.*. . NON--TRADE / NAME: if0WNER NAME: ~ME OF TI~ FACILITY: LOCATION: iADDRESS: STANDARD IND. CLASS CODE. CITY, ZIP: iClTY, ,ZIP: , DUN AND BRADSTREET NUMBB:R p.o.e ,: ~lP.o.z .: I __ - __ _ - C~ C~e ~t ~t Est ~tts m Site I~ ~ Tm ~ St~ In F~ility ~ I~t~ti~ ~lth of P~ ~lth. ..... ~_._.J .... ~ .... L. _ %leal ~ ~lth Naza~ C.a.$. ~, ~t II ~ E C.A.S. ~ ~,,~ o, ~, ,~~ , ................... ; ~t,, ~c.~.s.~ '~0 '., ~T~H ,_~_t_~ ..... L__~__..~ /~ ~1~ i'"~:~ 1 ~ I~.~'1 o:~,~ :: _ '~~ ~T ~ . r--~ · r-~ -~ r--~ ~t ~ .~ & C.I.S. ~ -- -~'- ' H~lth of P~'~ ~lth ' :(C~k .,. ,~, ~,y) , t~ fl - - ~-' '-' ,:~-' :~' '* -':-'"' ~ ~o ~ ~~o~_~ P~-O_ ~lth ' of Pe~sureJ ~alth '~ ' ~ ~aERGENCY C~TACTS II · I; Certificatian (Read and siffn after completing all sections/ ~ cvr.ttfv..undee I~. !ty of lee that [ ~w ~smally e,~tM ~ la f~flJar elth t~ tnf~tJm ~ltt~ Jn this NO N-- T'R'AD E ..... SECRETS' LOCATiON:__..~)iL_~,- ~.~-~j..~ -~..~.--~_~.-..---v% ;D~;ES;; '- ~ %~ .. %~ ~' STANDARD IND. CLASS CODE CITY, ZIP:~~~~ ' ~~-- CITY, ZIP: · ~~~~,, ~ DUN AND BRADSTREET HUMBER PHONE I: ~~~ PRONE ~: ~~1~ __ - ___ - ~ ; 3 4 S i I I ! It II Il 13 14 C~ C~e ~t ~ Est ~ts ~S~te l~ ~ l~ ~ .. St~ i, F~tllty ,~' ~ I~t~ti~ IC~k ell t~t ~ly)~ ........ ~__ -- . [ ~ r ~ r--~ ~t 12 ~&C.A.S.~ FireNazerd a--~ R~t~vtty ~la~ ~--4 ~ hl~ ~--~ I~tltl ~0 i . ~lth of P~ ~lth P~icel -~ r--~ ~--~ ~_~r-- ~--] ~t It ~&C.A.S. ~ ~lth of ~ ~)th ~ ~ ' le H~lth of P~ ~lth n .- ~-l::.a~::l .... ~__.L_.i~._J~.~Xt ~2__~ lq ~_~ [ "~ '0¢~¢_ ' . ~~ ~-8'-~iT~ / H~lth of Pr~sure ~lth ' ' ' ' ~ = HAZARDOUS MATERI ALS ;i I ~T%FENT.ORY' FerB and 14riculturff Stind~rd ~usi~s B~SINESS NAME: '~ 0~ER NAME: ; NAME OF T~ FACILX~: LOCATION: '1 ADDRESS: ~ STANDARD IND. CLASS CODE i CITY, ZIP: - / DUN AND BRADSTREET NUNBER* CITY, ZIP: , PHONE ·: ~ - - PHONE I: ~ 'Jt~e'B~ 2'0 ~lqfSl~ITC2'ZOit~ IrOl~ ~OPER COD~.~ ,~ ..... (~ C~e ~t ~t Est ~its m Site I~ ~s I~ ~ .. St~ In f~tltty~ ~ I~t~tl~ ~ ~ Fire Hazard [-'* r--. r--~ -- mlth of ~m mlth : ~ ' : ~t 13 .&C.A.S. ~--./~~~ ' P~ical ~ ~lth H~lth ' of Pr~sure ~alth ~ERGENCY C~T~TS Cartlficatio~ (Re"d and sikh after coapletJnE all se~ctlons) "' I certify under ~lty of 1~ t~t ~ h~ ffrsmilly e.~i~ ~ N fmtltar with t~ inf~tim ~itt~ tn this ~ ... . . . . . , ,:~-.::,.,._: · : .... ~~ ..~:::~ ~ S i'~ . :..~ ';:L'. Do hereby 4 CITY of BAK_FRSFf£LD tel ~ E C.-t,~E ."ID .~. . ,. ,, . H~. M~T. DIV. certify thet I here reviewed the attached Hazardous Materials business olan RECEIVED '~PR 0 ~ 1959 HAT, MAT. DIV. and'that it along with the attached additions or corrections constitute a complete and'correct Business PLain for my facility. sz~na%ure ' BUSINESS NAME ~ ROBBY'S NURSERY & LANDSCAF~E SERVICE ID N~BER - 215~000-0004~4 LoCATioN - 3313 SOUTH H. STREE'Ii HIGH HAZARD RATING 4 OVERVIEW - JURIS CODE 215=005. JORIS - BAKERSFIELD STATION 05 HAP PAGE 124 GRID 1SA FACILITY UNITS:I. HAZARD RATING 4 RESPONSE SU~gqRY 2A SEC 4~ - NO PRIVATE RESPONSE TEAM EMERGENCY CONTACT~ 2A SEC 2) ~. HAROLD ROBINSON -'831-G273 OR 589'4158 KATHY ROBINSON - 831-6273 0R832-7420 UTILITY SHUTOFFS"2A sEc 3)' A) GAS - SE'CORNER BLDG E) LOCK BOX - NO B) ELECTRICAL - W WALL INSIDE HAIN O~FICE C) WATER~- NE CORNER PLANZ D) SPECIAL -' NONE 2, NOTIFicATION / PUBLIC EVACUATION ALL ·OF oUR PRODUCTS ARE INDIVIDUALLY PACKAGED IN SHALL QUANTITIES (I.E. PINTS, QUARTS, GALS, ETC), THEREFORE, IF A-SPILL OCCURSIT WOULD BE VERY MI~OR AND WE COULD EASILY REQUEST OUR CUSTONERS TO L~E IF NECESSARY. ~ PROBL~ NE WOULD HAVE NOULD PRO~BLY NOT BE Iw~qJOR HOUGH TO ~AC~TE THE NEIGHBORING BUSINESS OR' RESID~CE. 3, HAZ HAT. TRAINING SUHARY ' s 1) NINE TOTAL EMPLOYED - ONLY6 - 7 ARE PRESENT EACH DAY, "3) INSTRUCTIONS AR[.GIVEN To EACH EMPLOYEE PRIOR TO THE HANDLING OF'A MATERIAL. '. LOlL EMERGEWC¥ ~EDI:~L ASSIST~qCE. -. · 2A SEC ~) CALL BHERGENCY ~REATHENT'VEHICLES (AMBULANCE) AND TRANSPORT TO NEAREST HOSPITAL EMERGENCY. ROOH. A.. OVERALL HAZARDOUS HATERIALS-I~ENTORY ~EE ATTACHED SHEETS B. ii' FIRE PROTECTION - A FIRE EXTINGUISHER IS IN THE HAIN STORE. '2) ~TER SUPPLIES - THE FIRE HYDRJ~IT IS LOCATED ON THE't~I COP~ER' OF THE NURSERY. HOSE BIBBS ARE AVAILABLE THROUGHOUT THE NURSERY AND THERE ARE DRAINAGE CANALS ON THE EAST AND SOUTH SIDES OF THE NURSERY. D, EMPLOYEENOTIFICATION / EVACUATION ~ mm "HITH .ONLY' 6 -- 7 EMPLOYEES PRESE]'~T 'EACH D~Y IT HOULD BE UERY EASY TO UERBALLY NOTIFY THEM OF A PROBLEM AND EuACUATE IF NEcEsSARy' E. MITIGATION / PREVENTION / ABATEMENT 'HE HAUE SEUERAL M~T'ERIALS (IE~ pERILITE, VERMICULITE, ETC.) ON HAND TO CONTAIN AND ABSORB A SPILL. necessary revisions. Any tima an administering agency makes any substantial changes to its area plan, it shall forward the changes.to the office within 14 days after the changes have been made. (e) An administering agency shall submit to the office, along with its area plan, both of the following: (1) The basic provisions of a plan to conduct.onsite inspections of businesses subject to this ,:hapter by either the z,~ministering agency or other designated entity. These inspections shall ensure compliance with this chapter and shall identify existing safety bazar:ds that could cause or contribute to a release or suggest preventative meas~re designed to minimize the risk of the release of hazardous material into the workplace or environ- ment. The requirements of thiS!¥aragraph do not alter or affect the immunity provided a public entity pursl~ant to Section 818.6 of :he Government Code. (2) A plan to institute a data management syst~-:m which will assist in the efficient access to and utilization of information Collected u~lder this chapter. This data management system shall be in operation within two years after the business plans are required to be submitted to the adminis- tering agency pursuant to Section 25505. (f) The regulations ado;~ed by the office pursuant to subdivision (a) shall include an optional model reporting form for business and area plans. (Amended by Stats. 1986, Ch. 463.) 25503.5. (a) Any business, except as provided in subdivision (b), which handles a hazardous material or a mixture containing a hazardous material which has a quantit~ at any one time duri?~g the reporting year equal to, or greater than, a ~'~otal weight of 500 pou~%ds, or a total volume of 55. gallons, or 200 cubic feet at standard temper~.~,ture and pressure for compressed gas, shall establish and implement a bus~ness plan for emergency ~-esponse to a release or threatened release of a [~azardous material in accordance with the standard.,?in the regulations adopted pursuant to Section 25503. (b) (1) Hazardous mat~"rial contained ~onsume~ pr~d,,ct~ ~or direct distribution to, ...~md use by, the genera%: public is exempt fro,{.. ~he business plan requirements'of this chapter unless the ad~niStering"~ agency has found, and has provided notice to the business handling the product, that the handling of certain quantities 6~ the product requires the submission of a business ...plan, or any portion thereof, in response to public health, safety, or envf.~nnmental concerns. · (2) In addition to th,~" authority specified in paragraph (4), the administering agency may, in exceptional circumstances, following notice and public hearing, exempt f:om the inventory provisions of this chapter~ any hazardous substance spec..fied in subdivision .(k) of Section 25501, if the administering agency finds that the hazardous substance would not pose a present or potential dangei; to the environment or .to human health and safety if the hazardous substance was released intc.the environment. The administering agency shall .A,:cify in writing the ',.asis for granting any exemption under this paragr~.~h. The administering .agency shall send a / notice to the office within live days of the effective date of any exemption/ granted pursuant to this para'~'aph. ·