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Home My WebLink AboutBUSINESS PLANa UNIFIED PROGRAM INSPECTION CHECKLIST ;,~;,yk,-,~ rarro!e~m~rnvu~u+wm~rwr.,u:~M+ret:w~s+waawaew~v~ SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 FACILITY NAME INSPECTION DATE INSPECTION TIME PHONE No No. of Employees ADDRESS w~ i ~ 3 FACILITYCONTACT Busines D Num 15-021- C''~G' i 7 ~~ Section 1: Business Plan and Inventory Program outine ^ Combined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection C V ~y=v~oatonnce) OPERATION COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ~i ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS i ~' -.._. ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOGATION . __ _. ^ ^ PROPER SEGREGATION Of MATERIAL ~ ~~ " ^ ^ VERIFICATION OF MSDS AVAILABILITYE ~ F~t~' " ^ ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ A „~ -- --._._.__. _..-- --._ ...._..._ _ .---- - ...---- ---- - ----... ___ ..... .__ .... _ ._ . ~ . - - .. (u ~. ^ ^ EMERGENCY PROCEDURES ADEQUATE }~ ^ ^ CONTAINERS PROPERLY LABELED (~ U ^ ^ HOUSEKEEPING ~- ~~ y --_-....._...- ------~_ __._..._.... -- ----"--- _ - ... _i. . _..-_......_... ~ ~.;1 M ^ ^• FIRE PROTECTION ~ , ,-~ ~ ,~~ i ' , LIL ~-, ,_i ------ ----.-- ----- - __.._ _ --- - _._ ...----r- -...._ ._ ;~ ^ ^ SITE DIAGRAM ADECUATE ~ ON HAND `~ ~/ ~ ~~ ~ ) ANY HAZARDOUS WASTE ON SITE7: ^ YES b IVO EXPLAIN: ~ f~~ ~L ~ ~= c~.Si~%~ '~"_- ~'!: i ~~`/ ' ~~~~5/~'%f_.S.S ~~ - %~y`'~ QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~F)G'I ~ 326-3979 ,r furl` ~:/c•~ ' G~ /~L_%~"i';~'f f.-f={ _./`~ Inspector (Please Print) Fire Prevention 1st-In/Shift of Site Business Site Responsible Pally (Please Print) White • Environmental Services Yellow - Station Copy Pmk • 8us~ness Copy m 8 Hazardous Materials/Haz:ardouS Waste Unified.Permit CONDITIONS~.O~F.PERMIT':ON:'R*EVERSE SIDE Permit ID#:: 015-000-000174 COAST APPLIANCE PAl LOCATION: 220 EUREKA ST This _oe~it is issued for the following_: [] H=7-rdous Materials Plan ' [] Underground Storage of HazardOus Materials n Risk Management Program [] H=~rdous Waste On-Site Treatment IELD Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: Issue Date Expiration Date: June, 30. 2003 ¸0, Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-021000174 COAST APPLIANCE LOCATION 220 Issued by: ......... ,~,~.~??~i~'?77m~,>~ ....... This permit is issued for the following: ~,/'?'!?: .~ji~,!::i!;::"i~;"~%i ili!iiii~,, .,~ il iii~ i ili ?':: ili[i!ili~iii~'~ ~e[ground Storage of H~rdous Materials EURE~ i~v:~'':';*~:.~'':'~'' .... ~?'~'::" ~' ~' ""-'~ ~"~ '~"~-~'~ ~'~' ~ [ ~ '[ ~ '~'~E~ ~' i %~r~J~' ~="~.. '"~ ~. "-..'~ ~ ["L ~ ....--.-~.Z~ ' ~ ~ '~ ~ ~=,' ~" ~./.~.~ ~.~ .( ...~ F'~k r '~ ~--. '~,. ~ · ~_. -..~ ~. ~. ~. --...~ ~E~ ~" ~'~; ~:;' ~ ~ ~;; '~"'"'""~' ~E'-.% ,/ ..... ?-- ~ ~_ ~. '.~_..,; ~ ~- ~,,-,,-~, Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., ~rd Floor Bakersfield, CA 93301 '~r_:.. iortr.~_-,.,..iA...~q7cI Approved by: _ June30, 2000 ITE/F,~CILITY FORM NORTH SCALE: BUSINESS NAME: FLOOR: 0F DATE: / / FACILITY NAME: UNIT ~: OF (CHECK ONE) SITE DIAGRAM FACILITY D IAGR.a.Y Inspector's Cpmments): -OFFICIAL USE ONLY- ITE/FACI LI T¥ 3!~ 0 R~I 5 D I .:&GRAM ' NORTH SCALE: DATE: / / BUSINESS NAME: FACILITY FLOOR: UNIT ~ -: OF (CHECK ONE) SITE DIAGR.~%! FACILITY'DIAGR.%Mf,~ l{fnspector's Comments): -OFFICIAL USE ONLY- t I TE/FACI LI TY FORM DI NORTH SCALE: DATE: ./ / BUSINESS NAME: FACILITY NAME: FLOOR: OF UNIT ~ -: OF (CHECK ONE) SITE DIAGRk~I FACILITY DIAGR~%~ ~ liInsPector's Comments): -OFFICIAL USE ONLY- COAST APPLIANCE PARTS~I ST Manager : Location: 220 EUREKA ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 015-021-00017~ BusPhone: (661) 323-3761 Map : 103 CommHaz : Minimal Grid: 29C FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact / Title JOE MARTICH / Business Phone: (661) 324-9891x 24-Hour Phone : (661) 831-0446x Pager Phone : ( ) - x Emergency Contact / Title GARY MILLS / MANAGER Business Phone: (661) 324-9891x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Press ImmHlth Contact : MailAddr: 220 EUREKA ST City : BAKERSFIELD Phone: (661) 324-9891x State: CA Zip : 93305 Owner COAST APPLIANCE PARTS Address : 2606 LEE AVE City : S EL MONTE Phone: (818) 579-1500x State: CA Zip : 91733 Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Emergency Directives: I, ~/?,~//~/~5 __ Do hereby certify that ! have (T,~ge ~' pdnt name) reviewed the a~ached, h~ardous mate~als manage- ment plan for~ ~Z/~c ~hat it along with ~ (~e'of ~) -- ~y ~e~ions ~ns~tute a complete and ~rm~ man- agement plan for my fadlity. Gal Gal -1- 08~04/2003 COAST APPLIANCE PARTS DIST Manager : Location: 220 EUREKA ST City : BAKERSFIELD BusPhone: Map : 103 Grid: 29C CommCode: BAKERSFIELD STATION 02 EPA Numb: SIC Code: DunnBrad: SiteID: 015-021-000174 (805) 324-9891 CommHaz : Minimal FacUnits: 1 AOV: Emergency Contact / Title JOE MARTICH / Business Phone: (805) 324-9891x 24-Hour Phone : (805) 831-0446x Pager Phone : ( ) - x Emergency Contact / Title GARY MILLS / MANAGER Business Phone: (805) 324-9891x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : RECEIVED City : BAKERSFIELD Owner COAST APPLIANCE PART~V~0~. S Address : 2606 LEE AVE ~V~C~ City : s EL MONTE Press ImmHlth Phone: ( ) State: CA Zip : 93305 X Phone: (818) 579-1500x State: CA Zip : 91733 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: = Hazmat Inventory --As Designated Order Hazmat Common Name... REFRIGERANT 22 One Unified List Ail Materials at Site DailyMax IUnit MCP ISpecHazlEPA HazardsI Frm P IH G 2000.00 FT3 Min ~, (~F;~/ /'/'),~.J~ Do hereby ce~ify., that I have ('lype or print name) ' reviewed the aitached hazardous malerials m~ ..:~..qe- rnent plan for~-/-~?~/~o~,~ and lhat it aiong '~ith (Name 03 Business) any corrections constitute a complete and correct man- agement plan for my facility° ~ .*,~ ~ r ,,,. ,, SignatUre - 1 - Date 09/05/2000 COAST APPLIANCE PARTS DIST ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME REFRIGERANT 22 Location within this Facility Unit NORTHWEST CORNER SiteID: 015-021-000174 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 75-45-6 r STATE ~ TYPE Gas ~Pure PRESSURE TEMPERATURE I Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 2000.00 FT3 Daily Average 1000.00 FT3 HAZARDOUS COMPONENTS 100.00 Dichlorodifluoromethane CAS# 75718 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies P IH NFPA/'// I USDOT# Min -2- 09/05/2000 COAST APPLIANCE PARTS DIST SiteID: 015-021-000174 Fast Format = Notif./Evacuation/Medical --Agency Notification CALL 911 Overall Site 07/24/1992 -- Employee Notif./Evacuation PASS THE WORD ON INTERCOM AND GET OUT AND CALL 911. 07/24/1992 Public Notif./Evacuation I PASS THE WORD ON~ INTERCOM AND GET OUT AND CALL 9-1-1. 07/24/1992 -- Emergency Medical Plan CLOSEST HOSPITAL. MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 07/24/1992 3 09/05/2000 COAST APPLIANCE PARTS DIST SiteID: 015-021-000174 Fast Format = Mitigation/P{event/Abatemt -- Release Prevention Overall Site 01/07/1990 COMPRESSED GASSES IN CHAINED MOBILE CART. USE PROPER VALVES AND FITTINGS FREON STORED IN SMALLER QUANTITIES SAFETY PRESSURIZED CYLINDERS -- Release Containment -- Clean Up Other Resource Activation -~- 09/05/2000 COAST APPLIANCE PARTS DIST SiteID: 015-021-000174 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs 09/27/1996 A) GAS - REAR OF BUILDING RIGHT CENTER B) ELECTRICAL - REAR OF BUILDING TO THE RIGHT AT ROLL UP DOOR ON RIGHT C) WATER - REAR OF BUILDING IN ALLEY AT FENCE LINE IN FRONT OF RIGHT ROLL UP DOOR D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS 09/27/1996 FIRE HYDRANT - 18TH AND SONORA Building Occupancy Level -5- 09/05/2000 COAST APPLIANCE PARTS DIST SiteID: 015-021-000174 Fast Format = Training -- Employee Training WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: DATA SHEETS AVALIABLE TO ALL EMPLOYEES, IF THERE SHOULD BE A LEAK EVACUATE THE AREA UNTIL IT IS VENTILATED AND CHECKED TO BE FREON FREE. (USE FREON LEAK DETECTOR). Overall Site 07/24/1992 Page 2 Held for Future Use ~ Held for Future Use -6- 09/05/2000 COAST APPLIANCE PARTS DIST Manager : Location: 220 EUREKA ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: SiteID: 215-000-000174 BusPhone: (805) 324-9891 Map : 103 CommHaz : Minimal Grid: 29C FacUnits: 1 AOV: SIC Code: DunnBrad: Emergency Contact JOE MARTICH Business Phone: 24-Hour Phone : Pager Phone : / Title / (805) 324-9891x (805) 831-0446x ( ) - x Emergency Contact GARY MILLS Business Phone: 24-Hour Phone : Pager Phone : / Title / MANAGER (805) 324-9891x ( ) - x ( ) - x Hazmat Hazards: Press ImmHlth Contact : MailAddr: 220 EUREKA ST City : BAKERSFIELD Phone: ( ) State: CA Zip : 93305 x Owner COAST APPLIANCE PARTS Address : 2606 LEE AVE City : S EL MONTE Phone: (818) 579-1500x State: CA Zip : 91733 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory --As Designated Order Hazmat Common Name... ISpecHaz REFRIGERANT 22 P IH P IH One Unified List Ail Materials at Site EPA HazardsI Frm I DailyMax IUnitlMcP G 2000 FT3 Min G 5000 FT3 Min -1- 06/12/1998 Overall Site with 1 Fac. Unit SEP ~7199~ General Information ~ t Location: 220 EUREKA ST Map:103 Haz:l Type: 3 City : BAKERSFIELD Grid: 29C F/U: 1 AOV: 0.0 Contact Name Title~ Name Title JOE MARTICH / !GARYC°ntact MILLS / MANAGER Business Phone: (805) 324-9891x Business Phone: (805) 324-9891x 24-Hour Phone : (805) 831-0446x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: 220 EUREKA ST D&B Number: City: BAKERSFIELD State: CA Zip: 93305- Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code: Owner: COAST APPLIANCE PARTS Phone: (818) 579-1500 Address: 2606 LEE AV State: CA City: S EL MONTE Zip: 91733- r Summary .~./LJ~ Do hereby certify' that I have reviewed the attached hazardous materials manage- ment plan for~zr~ ~/~/~--~-and that it along with - (Name of Buatness) any corrections constitute a complete and correct man- agement plan for my facility. 09/19196 Pln-Ref COAST APPLIANCE PARTS DIST 215-000-000174 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Name/Hazards Form Max Qty Page MCP 02-001 REFRIGERANT 22 ~ Pressure, Immed Hlth Gas 2000 Minimal FT3 02-004 REFRIGERANT R-12 ~ Pressure, Immed Hlth Gas 5000 Minimal FT3 09/19/96 COAST APPLIANCE PARTS DIST 215-000-000174 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 02-001 REFRIGERANT 22 ~ Pressure, Immed Hlth Gas 2000 Minimal FT3 CAS #: 75-45-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max FT3 2,000 Daily Average FT3 1,000.00 Annual Amount FT3 12,000.00 Storage PORTu PRESS. CYLINDER Press T Temp Location IAbove ~Ambient INORTHWEST CORNER -- Conc Components 100.0% IDichlorodifluoromethane MCP ---7Guide IMinimal I 12 02-004 REFRIGERANT R-12 ~ Pressure, Immed Hlth Gas 5000 Minimal FT3 CAS #: 75-71-8 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max FT3 5,000 Daily Average FT3 2,000.00 Annual Amount FT3 18,000.00 Storage PORT. PRESS. CYLINDER Press T Temp Location IAbove ~AmbientlNORTHWEST CORNER -- Conc Components 100.0% IDichlorodifluoromethane MCP ---~uide Minimal I 12 09/19/96 COAST APPLIANCE PARTS DIST 215-000-000174 00 - Overall Site <D> Notif./Evacuation/Medical Page <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation PASS THE WORD ON INTERCOM AND GET OUT AND CALL 911. <3> Public Notif./Evacuation PASS THE WORD ON INTERCOM AND GET OUT AND CALL 9-1-1. <4> Emergency Medical Plan CLOSEST HOSPITAL. MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 09/19/96 COAST APPLIANCE PARTS DIST 215-000-000174 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt 5 <1> Release Prevention COMPRESSED GASSES IN CHAINED MOBILE CART. USE PROPER VALVES AND FITTINGS FREON STORED IN SMALLER QUANTITIES SAFETY PRESSURIZED CYLINDERS <2> Release Containment <3> Clean Up <4> Other Resource Activation 09/19/96 COAST APPLIANCE PARTS DIST 215-000-000174 Page 00 - Overall Site <F> Site Emergency Factors 6 <1> Special Hazards <2> Utility Shut-Offs A) GAS - REAR OF BUILDING RIGHT CENTER B) ELECTRICAL - REAR OF BUILDING TO THE RIGHT AT ROLL UP DOOR ON RIGHT C) WATER - REAR OF BUILDING IN ALLEY AT FENCE LINE IN FRONT OF RIGHT ROLL UP DOOR D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT -- 18TH AND SONORA <4> Building Occupancy Level 09/19/96 COAST APPLIANCE PARTS DIST 215-000-000174 Page 00 - Overall Site <G> Training <1> Employee Training WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: DATA SHEETS AVALIABLE TO ALL EMPLOYEES, IF THERE SHOULD BE A LEAK EVACUATE THE AREA UNTIL IT IS VENTILATED AND CHECKED TO BE FREON FREE. (USE FREON LEAK DETECTOR). <2> Page 2 <3> Held for Future Use <4> Held for Future Use Business Name: IATERIA~ Bak,~field Fire Dept. Hazar(l~s Materials Division Date Completed ~-//~'/~/7/ Location: Business Identification No. 215-000 Station No. ~ Shift Arrival Time: ,/O~/.~ / ;7 z// (Top of Business Plan) /4/r Inspector Departure Time: ///06j Inspection Time: Adequate Verification of Inventory Materials ~ Verification of Quantities ~ Verification of Location ~ Proper Segregation of Material~ Inadequate i-I RECEIVED HAZ. MAT. DIV. Comments: Number of Employees: Verification of MSDS Availability Verification of Haz Mat Training Comments: Verification of Abatement Supplies & Procedures {~ Comments: .V Emergency Procedures Po{;ted r'l Containers Properly Labeled ~ Comments: . 'Verification of Facili~ Diagram ~ Special Hazard~ Ass~.~ ~s F~:~ ~ ~sin~s ~er/~ger PRINT ~ME ~ ~IGN~URE- ' All Items O.K Correction Needed White-Haz Mat Oiv Yellow-Station Copy Pink. Business Copy 04/20/92 COAST APPLIANCE PARTS DIST 215-000-000174 Page Overall Site with 1 Fac. Unit General Information Location: 220 EUREKA ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 02 Grid: 29C F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- DOUGLA~ R. REANEY Mana§er (805) 324-9891 x (805) 832-4281 Administrative Data Mail Addrs: 220 EUREKA ST D&B Number: City: BAKERSFIELD State: CA Zip: 93305- Comm Code: 215-002 BAKERSFIELD STATION 02 SIC Code: Owner: ................. COAST APPLIANCE PARTS Phone: (818)579 - 1500 Address: 220 EUREKA ST 2606 LEE AVE. State: CA City: BAKERSFIELD SO. EL MONTE, CA 91733 Zip: '93305- Summary ~, __Ro, ger Erickson c','y~o,..,,,.~,.) Do hereby ce~tHy that ! have reviewed the attached hazardous rnaterf, als manage- rnent plan for coast Appliance~t:~ . ~* mat i~ along with any correctiOns constitute a cornpleie and corrsc~ man- a~ement plan for my facility. RECEIVED JUL 2 3 1992' HAZ. M4T. DiV. 04/20/92 COAST-APPLIANCE PARTS DIST 215-000-000174 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 2 02-001 REFRIGERANT 22 · Pressure, Immed Hlth Gas 2000 ' Minimal FT3 CAS #: 75-45-6 Trade Secret: No Form: Gas Type: Pure Daily Max FT3 2,000 I Days: 365 Use: COOLANT/ANTIFREEZE Daily Average FT3 Annual Amount FT3 -- 1,000.00 I 12,000.00 Storage PORT. PRESS. CYLINDER Press T Temp Location I Above /Ambient I NORTHWEST CORNER -- Conc Components 100.0% IDichlorodifiuoromethane MCP ~List IMinimal I 02-0 :ETYLENE · Pressure, Immed Hlth Gas 100 High FT3 Z O O. Z CAS #: 16-2 Trade Secret: No Form: Gas e: Pure Days: 365 Us WELDING SOLDERING Daily Max FT3 100 Storage PORT. PRESS. CYLINDER Daily Average 00 Annual Amount FT3 300.00 Press IAbove Location NORTH INTERIOR WALL CENTER -- Conc 100.0% IAcetylene Co MCP List 02-003 Z Z O Z OXY( ·.Fire essure, Immed Htth Gas Low FT3 CAS #: 7782- Trade ecret: No Form: Gas Days: 365 Use: WELDING SOLDERING Daily Max FT3 200 Storage PORT. PRESS. CYL] )aily Average FT3 60.00 Annual Amount FT3 -- 600.00 Press T Location NORTH INTERIOR WALL CENTER -- Conc 100.0% IOxyge~, Compressed Com~ MCP --~List ILow 04~20/92 COAST APPLIANCE PARTS4DIST 215-000-000174 00 - Overall Site <D> Notif./Evacuation/Medical Page <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation PASS THE WORD ON INTERCOM AND GET OUT AND CALL 911. <3> Public Notif./Evacuati°n' NONE LISTED PASS THE WORD ON INTERCOM AND GET OUT AND CALL 911 <4> Emergency Medical Plan CLOSEST HOSPITAL. MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD, CA. (805) 327-1792 .04~20~92 COAST APPLIANCE PARTS DIST 215-000-000174 00 - Overall Site <G> Training Page <1> Page 1 5 ~ WE HAVE,EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE DATA SHEETS AVALIABLE TO ALL EMPLOYEES, IF THERE SHOULD BE A LEAK EVACUATE THE AREA UNTIL IT IS VENTILATED AND CHECKED TO BE FREON FREE. (USE FREON LEAK DETECTOR <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use CITY of BAKERSFIELD (ty~e or prin; name) Do hereb7 cert~ _.~,,. that I have reviewed J~llS'[~ ............ attached HazardoUs Materials business ~lan for (name of business) and that. it along with the f~Pr~7--$ RECEIVED ' rl~ ~0 1989i HAZ, MAT. DIV. attached additions or corrections constitute a complete and correct Business Plan for ms' facility. date BUSINESS NAME~ APPLIANCE PARTS DIST LOCATION 220 EUREKA ST ID NUMBER 215-000-000174 HIGH HAZARD RATING 2 1 o OV~EI~V I ~EW LAST CHANGE 09/30/88 BY ESTER JURIS CODE 215-002 JURIS BAKERSFIELD STATION 02 MAP PAGE 103 GRID 29C FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM. EMERGENCY CONTACTS 2A SEC 2) ROBERT W. REANEY - 324-9891 OR 832-4218 DOUGLAR R. REANEY - 324-9891 OR 832-4281 UTILITY SHUTOFFS 2A SEC 3) A) GAS - REAR OF BLDG RIGHT CENTER B) ELECTRICAL - REAR OF BLDG TO THE RIGHT AT ROLL UP DOOR ON RIGHT C) WATER - REAR OF BLDG IN ALLEY AT FENCE LINE IN FRONT OF RIGHT ROLL UP DOOR D) SPECIAL - NONE E) LOCK BOX - NO o NOT I F ICATION / PUBL I C EVACUAT ION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/13/88 15:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS LOCATION NAME 'CE,~;'JT~E APPLIANCE PARTS DIST ID NUMBER 215-000-000174 220 EUREKA ST HIGH HAZARD RATING 2 MAT TRA I N I NG SUMMARY LAST CHANGE / / BY EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 09/30/88 BY ESTER 2A SEC 5) CLOSEST HOSPITAL. PAGE 2 12/13/88 15:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ~ APPLIANCE PARTS DIST LOCATION 220 EUREKA ST FACILITY UNIT 01 ID NUMBER 215-000-000174 HIGH HAZARD RATING 2 A e OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 09/30/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE PURE REFRIGERANT 12 & 22 NW CORNER PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 1086.00 100.0 DICHLORODIFLUOROMETHANE PURE ACETYLENE N INTERIOR WALL CENTER ID PERCENT COMPONENTS 1241.00 100.0 ACETYLENE PORTABLE PRESS. CYL. 28000 FT3 LOW COOLANT HAZARD LISTS LOW 100 FT3 EXTREME WELDING/SOLDERING HAZARD LISTS EXTREME PURE OXYGEN N INTERIOR WALL CENTER PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 2359.00 100.0 OXYGEN, COMPRESSED 200 FT3 HIGH WELDING/SOLDERING HAZARD LISTS HIGH PROTE CT I ON / WATER SUPPL I E S LAST CHANGE 09/30/88 BY ESTER 3A SEC 4) FIRE EXTINGUISHERS FOR FIRE PROTECTION. 3A SEC 5~ PAGE 3 12/13/88 15:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ~APPLIANCE PARTS DIST LOCATION 220 EUREKA ST ID NUMBER 215-000-000174 HIGH HAZARD RATING 2 EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 09/30/88 BY ESTER 3A SEC 2) PASS THE WORD ON INTERCOM AND GET OUT AND CALL 911. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 09/30/88 BY ESTER 3A SEC 1) COMPRESSED GASSES IN CHAINED MOBILE CART. USE PROPER VALVES AND FITTINGS. FREON STORED IN SMALLER QUANTITIES SAFETY PRESSURIZED CYLINDERS. PAGE 4 12/13/88 15:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 CITY oJ' BAKERSFIELD LOCATION: -~._L)IO._~_~,~/~ ~-, ADDRESS: '-~ ~-~.,~V~--. STANDARD IND. C~ASS CODE CITY, ZIP:~KE~gF i~L~. e A ~.30~ CITY, ZIP: $, ~L ~fi~ . ~ ~t)~-~ DUN AND BRADSTR~ET NUHBER ' ' ~.", ~ ~. ~ ~1 ~ I ~ Cat ~t ~t ~ t~t~ ~ t~ ~ ~ "s~~~ ' Mlth ' ~t~ ~ & C.A.S. ~ ..... ~1 ~cl ~ ...... ~_1~ I ~ I ¢~ :~ : ~~I~1 ~ ' .... : .............. ~lth of ~_C:.?~L , ff~lth of Pr~surl H~lth ~t ,~ ....... ~__L .... ~_..:_~_ ....... ~.~ ............ (Reed end sJgn after completing ail sections/ BAKERSFIELD CITY FIRE DEPARTME ~-130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 io3( US INESS NAME OFFICIAL USE ONLY ID~ HAZARDOUS lw_3kTERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: ~.~UtA~ jl~l.l~U¢~' ~ll~[~'"l~ B. LOCATION / STREET ADDRESS:~ CZ~:~~ ZIP: ~30~ ~US.PHONE: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME .AND TITLE DURING BUS. HRS. .~FTE~ BUS. HRS. B. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE:, . _ ' · -. ~- ,, A ~ . ~--/-~-r-~-, ~ B ELECTRICAL: C WATER: ~ D. SPECIAL: E. LOCK BOX: YES /'~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SrTE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES ,/ NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION $: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES iMPLOYEES WITH INITIAL AN~ REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIA~ REFRESHER A. METHODS FOR SAFE HANDLING ,0F.HAZ~RDOUS .MATERIALS:...'...,. .................. . ............... ~__~_S~ NO~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES~ C. PROPER USE 0F SAFETY EQUIPMENT: .................. YE~ NO~ D. EMERGENCY EVACUATION PROCEDURES: ................. E. DO YOU ,MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES SECTION ?: HAZARDOUS MA~ERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~4TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:. ...... YESfNO~ I ~ ' ~~l'O~ ~ ~U~/. ,; '~ertify tha~ the above information is accu~at~.- I understa~d~khat 'this information will~be used to fulfill my firm's obliLat'~ons"unGer the new C~t~iforni~ Health'and Safety %bde on H~za~dous Materials ~(Div. 20 Chap%er 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFiCiAL USE ONLY BUSINESS ID# BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACII, ITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as .possible. FACILITY UNIT# FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION .*aND EVACUATION PR0~CEDURES AT THIS UNIT ONLY - 3A - SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YE If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (~,~hite form #4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yei]ow form ~4A-2) ~n addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E~RGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. C. WATER D. SPECIAL: IF YES, S!~P-LANS? YES~gs? FLOOR PLA~/ NO K, EYS? YES / NO YES / NO FACILITY UNIT #: / ... FACILITY UNIT NAtHE: ., · FORM -4A-I Page ~ of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME :'C.~.N(h~ ~oo{,o,~g~ ?o..,-~'~ ~.+ OWNER NAME :~ec~ ADDRESS: ~O ~ur~"S~, ADDRESS: CITY, ZIP:~ker~;et~ . ~ ~33o3- CITY,ZIP: PRONE *: _, ,,~-$~/' PNONE ~: [OFFICIAL USE CFIRS CODE I o~ ! , 2 3 4 $ 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 COMMO~_N_.A~ CODE GUIDE. NAME: TITLE: SIGNATURE: DATE: EMERGENCY EMERGENCY PRINCIPAL CONTACT: /~{~ /3.3, /2, F_.,<IAI6'/ TITLE: Pr-.~'~,~,~ PHONE · BUS HOURS: . AFTER BUS HRS: BUSINESS ACTIVITY: ~' ~~a _ '~ _~ - I~1~ AfpI~ P~+~. b.;~-~ ................... ~TE-~--~.8-~RS: - 4A-1 - -"