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Home My WebLink AboutBUSINESS PLAN I TE/FAC ILI TY FORM D'I AG RJ%l~ WORTH SCALE:i'=~ BUSINESS ~'~,~E: ~.~ ~r~ C~· FLOOR: (CHECK ONE) SITE DIAGRAM FACILI'TY DIAGRA~M I~L L I ! Inspector's Comments): -OFFICIAL USE ONLY- ECEIVED SITE/FACILITY DIAGRA2~ AUg I 0'1989" NORTH I-Znspecto-:,, 8~Comment8~: oo ~ -OFFIGIAG, USE O~LY- 0./' Bz-IK£R$SIF_LD "I~"£ C,-t RE" (~yue or ~rin~ name) Do hereb.-.c certify that I have reviewed the attached-Hazardous Materials business plan t~£0£1V£13 ~'~... (name of business) and that. ±t alon~ with the attached additions or ,~orrect.ions~ oonsti~u~be a complete and correct Business Plan for my facility. .. sl,~nanure date BUSINESS NAME FRANK CO INC LOCATION 39S1-D S Ft ST IO NUMB0215-000-800~70 HIGH H~2~RD RATING 1. OVERVIEW LAST CHANGE 10/09/87 8Y ESTER JURIS coDE Zt5-00S JURIS 8AKERSFIELO STATION 0S MAP PAGE IZ4' GRID ]8A FflCILITY UNITS ! HAZARD RATING 2 RESPONSE SUMMARY ZA SEC 4) WE HAVE FIRE EXTINGUISHERS AND WATER HOSES AVAILABLE. OUR MAIN BUSINESS RT PRESENT IS PROVIOING TESTING OF ENGINE'AND TRANSMISSION SELLING OF SPECIAL P~RTS. THERE IS ONLY MY WIFE ANO I EMPLOYEO. EMEF~ENCY CONTRCTS 2R SEC 2) RRLEN F. KURTIS - 833-848G CAROL L. KURTIS'- 8,33-848G UTILITY SHUTOFFS ZR SEC R) GAS - NONE IN 8LDG UNIT O 8) ELECTRICAL - INSIDE DOOR TO THE RIGHT CORNER C) WATER -.NONE IN BLD6 UNIT O D) SPECIBL - NONE E) LOCK 80X ~ NO 2. NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / ,BY < NO INFORMATION RECOROED FOR THIS SECTION > P~tGE ~ 12/28/88 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS N~ME FRANK K~S CO INC LOCATION 3951.-D S H ST 3. HAZ M~T TRAINING SUMMARY ID NUMBO2 ! 5~OOO-(~OO770 HIGH HAZARD RATING Z LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL. EMERGENCY. MEDICAL ASSISTANCE [_RST CHANGE !0/09/87 BY ESTER SEC S) WHITE LANE MEDICAL CENTER 540! UHITE LN (805) 83Z-ZO~ PF)GE 2 12/Z8/88 lZ:OB MATERIAL SAFETY DRTA SYSTEMS, iNC, (805) G48-B800 BUSINESS NAME FRANK KUtS CO INC LOCATION 39'Sl-O S'~ ST FACILITY UNIT O! ID NUMB~Z1S-O~O-O~?70 HIGH HAZARO RATING Z OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANOE 05/04/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION.. CONTAINMENT USE. ! WASTE ENGINE DRAIN OIL/WASTE OIL 55 GAL OUTSIOE ORUMS oR BARRELS MEI'., WASTE I0 PERCENT COMPONEN[S tS98.00 l(~,0 WASTE Oil. UNi<NOWN HAZARD LIST UNKNOWN B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 10109/87 BY ESTER 3A SEC 4) FIRE EXTINGUISHERS 3R SEC S) HYDRANT - RT SIDEWALK PRGE 3 1ZIZB/88 1Z:06 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-G8~0 BUSINESS NAME FRANK K~S CO INC LOCATION 3951-D S H ST EMPLOYEE NOTIFI£ATION / EVACUATION ID N 15-000-~770 HIOH HAZARD RATING LAST CHANGE 10109187 BY ESTER SEC 2) VERBAL AND CALL 911 E. MITIGATION / PREVENTION / ABATEMENT 'LAST CHANGE 10/O9/87 BY ESTER SEC 1).CLEAN UP BY ~IPINO glTH PRPER TOgELS OF RRGS. OIL IS IN SEALED METAL CONTRiNERS. 1Z/ZB/BB 1'2:0B MATERIAL SAFETY DATA SYSTEMS, INC. (805> B4B-GB00 CIT}' of BAKERSFIELD hr, ~nd A~ricul~ure ~ Standard e~s~ness ~ }?A~--ARDOLT$ MAT~'-]~.T A~S Z gV~gT.O~ NON--TRADE SECRETS ' Pa~ .... of .... BUSINESS NAME: ~1~ ~(~,f ~ ['~ OWNER NAHE: ~CC~ /~j NA~E OF T~ FACILITY: ~O~ LOCATION: _~C~f~/-"~'- ~ ~ ~-- ADDRESS: ~'~ /~(/~--"~.g,~odC"" STANDARD IND. CLASS CODE CITY, ZIP: ~~1~ ~_~. ~o~ CITY, ZIP: ~l~l~ ~ ~ DUN AND BRADSTREET NUMBER PHONE ~: ~ ~ --~ ~ PHONE ~: ~ O~ ~ ~ - - ~ ~ ~U~O~ ~R ~OP~ COD~ C~e C~e ~t ~t Est Un*. ~ Stte T~ ~s T~ ~ .. St~ ~n F~tltty~ ~ I~t~t~ _~ _._1 ........ Phil ~ HNIth r--. ~ Fire Hazird of .~_[ 1 .... ............ ] .............. 1 ~lth of P~ ~lth .... ~__[ I i ! I I i ! I ! .................... P~tcll ~ Mlth (C~k all t~t ao~ly) :~--~ H~ith of P~su~.e HNIth ......... A r:~t 13---" & LA.S. ~ .... (C~k ~11 t~t Hfllth of Pr~sure H~lth ~t 13 Certification (Read and sJKn after coepJet~JnE all sections) l.,cerflfy under penalty of la# that I have personallyexarned and am f.iliar with the information subiitted in this and ell attached docueonts, and that based on By inquiry of those tndtvtcluels rlSlxms~ble for obtaining the inforMtion. I believe that the submitted infoe, tion is true. accurate, ond complete. ~ /~ L / ~ /~. ,~. ,-~- ~ ~T~,-~~· -;~-;~;~ s~-~; ..-s~; ........... ( - ~ 'c'a 't O g ..................... ' ................ BAKERSFIELD CITY FIREDEPARTMENT 2130"0" STREET BAKERSFIELD, CA 93301 (805) 326-3979 OFFICIAL USE ONLY 1/DC., · ID# RECEIVED JUL 16 1987 Ans°d ............ HAZARDOUS MATERI ALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: , 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 000770 RECEIVED 4. Be as brief and concise as possible. , ,~-$~':~[~.~. AUG 2 0 1987 SECTION 1: BUSINESS IDENTIFICATION DATA -- /,~n~D~ Ans'd ............ I). LOCATION / STREET ADDRESS: -~'q$7 '~ ~ ~ ~/~ ~ SECTION'g: E~RGENOY NOTIDICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 011 and 1-800-852-7550 or 1-g16-427-4S41. This will notify yQue IDeal fire department and the State Office of Emergency Services as required by law. EMPL6yEEs TO NOTIFY IN cAsE OF' EMERGENcy: NAME AND TITLE DURING BUS. HRS. AFTER BUS. }iRS. SECTION 3: LOCATION OF UTILITY SItUT-0FFS FOR BUSINESS AS A WItOLE A.~AT. G~/PROPANE: ,~]d,,Jd'- FXd ~4~¢. &~/r F- B. 'ELECTRICAL: C. WATER: D. SPECIAL: A/~/~'- E. LOCK BOX: YES /(~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO YES / NO MSDSS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ,,4-Yf/f SECTION-i~:~: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: · YES ~ YES ~ B. PROCEDURES FOR COORDINATING ACTIVITIES C. PROPER USE OF SAFETY EQUIPMENT:: ................. YES YES D. EMERGENCY EVACUATION PROCEDURES: ................. YES YES E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES YES REFRESHER SECTION 7: HAZARDOUS MATERIAL 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: ...... ~S~ NO I, /~'/~ ~ :, /k~/~.~ , 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. SIGNATURE '~:~ ~ ~':' ~ ' ' . ~' '~ /~,'~.; "~, TITLE . C ~.~o DATE - 2B - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 BUSINESS NAME: OFFICIAL USE ONLY ID# BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A ' INSTRUCTIONS ~. To avoid further action, this fO~-m m~st be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# b FACILITY UNIT N~E: /t/o~"'- ,~$ECTION 1: ~ITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS U?~IT ONLY '" S~A OX ,, OX /" $~ - 88 - OK / 6$XV'Id ~00'I3 aSNVqd 3£1S '$3X ~I :NOI£VOOq '$~A -aI~/ $-qA :X08 >lgOq '3 :~VIOMd$ 'fl : qVOI~I£O2~/2 '8 ' h~NVd0Md/$V9 '£VX 'V "ATN0 ilN~ S~H.I. iV S~l~0-.l.aH$ AiI~Iifl ~tO NOI£V007 :9 NOIJ,02$. SH2(LMOdS2H AON-q0~12tK~t A8 2tSfl 80.4 A~IddnS (I-V~# maoJ'o%Iq~)'A~NO '$£~MOES 3OVH£-NON :pa~a~m'~aoj Kaoluoau! SlU!ao%mu snopquz~q o%~a~dos ~ o%oIdmoo 'ON'JI I .U. # ~.~ /~/~,rDtQ/.~.,~ BAKERSFIELDFORM CITY 44-1 FIRE DEPARTMENT NON--TRADE SECRETS HAZARDOUS MATERI ALS I NVENTORY ADDRESS: ~..~.~o ~/ CITY,ZIP: FACILITY UNIT FACILITY UNIT NAME: PHONE #: IOFFIClAL 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. CHEMIqAL OR COMMON NAME CODE GUIDE NAM~ TITLE: FIF~ SIONATDRE: ~~~ ~ DATE: ~MERG~NCY CON~AC~: ~c~ ...... YI~n~: --PHONE , BUS HOURS: AFTER BUS HRS: ~rO~,,b,['~ SITE/FACILITY DIAGR~ FOR~I 5 ' ~~/ ,~. /4' ~. 0~-~ NORTH SCALE: /" =/0t BUSINESS NAME: DATE: 7/?/~)?FACILITY NAME: (CHECK ONE) SITE DIAGRAM FAC IL ITY D IAGR.a~M Inspector's Comments): -OFFICIAL USE ONLY-