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HomeMy WebLinkAboutBUSINESS PLAN 'P.O. BOX 2057 BAKERSFIELD, CALIFORNIA 93303-2057 ADDRESS CORRECTION REQUESTED DO NOT FORWARD BAKERSFIELD.- CA 9330~ .I + + RETURN PAYMENTS TO: CITY OF BAKERSFIELD HAZARDOUS MATERIALs DIVISION P.O. BOX 2057 BAKERSFIELD, CA 93303-2037 ACCOUNT NO. tim ~i:388902 HAZARDOUS MATERIALS HANDLING FEES SITE ADDRESS: 919 34TH STREET #B FUND.ii SERVICE FOR FISCAL YEAR 7/01/92 PAYMENTS AFTER 12/31/92 NOT ON THI~ !!BILL:7:?i, ~ HAZ MAT HANDLING FEE :iii?::::'? ,,,~¥::~i,i~ '142~00 BILLING DATE 1/1/93 ANNUAL FEE THIS BILL IS DUE UPON RECEIPT. 2 MONTHS FROM THE BILLING DATE A 1 FINANCE CHARGE OF 1% PER MONTH WILL BE ASSESSED. PLEASE MAKE CHECKS PAYABLE TO: CITY OF BAKERSFIELD CURRENT CHARGES 142.00 TOTAL BALANCE DUE 142.00 I% ADMINISTRATIVE SERVICE CHARGE AND INQUIRIES CONCERNING THIS BILL, PLEASE PHONE: (805) 326-3979 CITY COPY CALLAWAYS AUTOMOTIVE MACHINE 919 34TH STREET BAKERSFIELD, CA. 93301-2101 lin 388902 + CITY OF'BAKERSFIELD P.o. BOX 2057 BAKERSFIELD, CALIFORNIA 93303-2057 ADDRESS CORRECTION REQUESTED DO NOT FORWARD CALLA~AYS AUTO~TIVE'~IACHI~E 919 34TH STREET BAKERSFIELD, CA. 93301-2101 I C~TY oF BAKERSFUE'LD P.O. BOX 2057 BAKERSFIELD, CAUFORN~A 93303-2057 ITE H5 t 5'IP DIAGRAM P L...~.N- ~IAP F A ~-l~'h.I TY, 'Bt. AG, RAM i., ORTH : SCALE: '~TE/FACILITY FORM DATE: / / FACILITY NA~ME: FLOOR: UNIT ' ~: OF (CHECK ONE) SITE DIAGRAM FAC I L I TY D IAGR.~M f( Inspector's Comments): -OFFICIAL USE ONLY- - 5A - SiT~ OtAGR___=__~ (Re,ii, ed items) 1. Address: Ident'~sJ'~ the principle buildings by the Street numbers. 9. Lock Box 10. MSDS Storage Box Street(a}, Alleys. Driveways. and Parking Areas adjacent to the property. Include ,the street names. 3. Store Drains. Culverts, Yard Dralns Il. Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood .~,4. Drainage Canals, Ditches, Creeks, .' 5. Buildings a. Frame construction b. Masonry construction c. Metal construction d. Access Door 6. Utility Controls a. Gas b. Electricity -- · c. Hater ?. Fire Suppression Systems: ........ a. Fire Hydrants b. Fire Sprinkler Connections c. Fire S~andpipe. _. .,-.Connections d. Water Control Valves for protection systems d. Gates 13. Powerllnes 14. Guard Station 15. Storage Tanks: Identify the capacity in gal. a. Above ground b. Underground 16. Diking or Berm ' l?. Evacuation Route Evacuation Area: Identify the location where employeea will seat. 19. Outside Hazardous Masts Storage ; -~"' 20. Outside Hazardous. '' Material Storage 21. Outsi~e.Haza~dous Materiai' . Use/Handling e. Fire Pimp f . 8. Fire oeP~-tment Access F - Flnnnable E ' C - Corrosive 0 ~2. Type of Hazardous Material/Waste Stored or Used (See Below) TyPE OF EAZARDOUS {~TERIAL Explosive L - Llquid R - Radl~logicai Oxidizer O - Gao P - Poison Water Reactlve T - Toxic Solid ~ - Cryogenic D - Waste B - Etiological Example: Flassable Liquid · FL FACILITY DIAGRAM (Required Items in addition to the above) .g. 1. Risers tqr Sprinklers · ." '2. Part'ltl°ns ~ 3. Stairways: Indicate the levels served frae highest to lo~eat, 4. Escalator: Indicate the levels served from · highest to lowest. 5... Elevator 6. Attic Access "- 8. Flee gicapea Air Condttl?nlng ~nlt. 11, Inside Xazardous Waste Storage i2. Inside Ha;ardoue Materials Storage 13. Inside Hazardous Materials Uae/Handling ', 7. Skylights 14. Se~er Drain Inlets HM388902 Account Number ACCOUNTS RECEIVABLE ADJUSTMENT February 18~ 1993 Date Esther Duran From Fire Department- Hazardous Materials Division Department/Division CALLAWAYS AUTOMOTIVE MACHINE New Account New Address Close Account Service Change Other Adjustments X Billing Name 204 SANDY MUSH RD., MERCED, CA Billing Address 2216 N ST. Site Address Parcel # (If Applicable) Landlord Name & Addres. s (If ApPlicable) ADJUSTMENT. Last Billed Correct Billing'. Adjustment to Effective Date of Billing Change 01-01-93 0 01-01-93 Approved By: Remarks: BUSINESS CLOSED PER INSPECTION BY RALPH. BUSINESS BILLED IN ERROR. Utilities 'General Account Maintenance PUTLS801 ACct Nbr: 388902 Bill Stat: NO Transfer-from. P~age 1 of 6 Cyc Stat: CL Acct Cyc Stat: CL Transfer-to: ~D~1_42.00~ 1. Customer Name: CALLAWAYS AUTOMOTIVE MACHINE 2. Social Sec Nbr: 3. Telephone: 805-327-8222 4. Service Address: 2216 N ST 5. Service City: BAKERSFIELD 6. State: CA 7. Zip: 93301 8. Parcel ID: 9. Bill Cycle: 5 10. Route Nbr: 11. Comments : 12. Prev Acct: HM00209 23. 13. Service Date: 12/16/92 14. Fund no: 15. Bill-to Addressl: DAVID JONES 16. Bill-to Address2:204 SANDY MUSH RD 17. Bill-to City: MERCED 20. Water Svc Class: Misc Services: 23.1 F09 HAZ MAT HANDLING 23.2 24. Closing Date: 18. State: CA 19. Zip: Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change ALT-F10 HELP I ADDS VP FDX I '9600 E71 I LOG CLOSED I PRT OFF CR I CR CALLAWAYS AUTOMOTIVE NE SHOP Locatior;: 22i6 N ST Coml~;~ur~ity: BAKERSFIELD STATION 01 Number: 215-000-000209 VALERIE i0/14/92 Map: 103 Hazard: Moderate Gr-id: 30C F/U: 1 AOV: 0.0 ..... Corrbact Name Su~mary Title Business Phor~e---T'(24-~H/ . ~ c-~¥ Phor;e- (805) 327-8222 x ~ - (805) ~,_7 8 ..... x ~ ) - BUSINESS MOVED, CHANGED OWNERSHIP AND CHANGED ITS NAME 'TO BARNES CUSTOM ENGINES. MADE NLIB 9/14/92. OPENED NEW ACCOUNT UNDER BARNES CUSTOM ENGINES. REOPENED ACCOUNT 10/14/92, FOUND THAT' BARNES HAD MOVED AND CALLAWAYS HAD REOPENED. SENT BUSINESS PLAN FOR REVISION 10/14/92. <A> Hazmat <B> Scrr~ 1 <F> Site Facts <G> Trair~ing <K> Held Aside <L> Incidents <P> Prir~t <R> Delete <C> Fac. Ur~its <D> Notif/Evac <E> Mitigatior~ <H> RMPP Data <I> Not Used <J> Not Used <M> Ir~spectior; <N> Admn <Esc> Exit TO: FROM: SUBJECT: M.EMORANDUM DECEMBER 11, 1992 DREW SHARPLES, FINANCIAL INVESTIGATOR/~/ - HAZARDOUS MATERIALS HM479601 HM388901 L1oyds Garage, 1440 2nd Street Judgment received on 10/28/92. Close 01 Account and open 02 Account if applicable. Callaways Crankshaft Grinding, 2216 N Street Judgment received on 10/22/92. Close 01 Account and open 02 account if applicable. nrc MDS.113 Utilities General Account Maintenance PUTLS801 Acct Nbr: 479601 Bill Stat: NO Cyc Stat: CL Acct Cyc Stat: CL Transfer-from: Transfer-to: Page 1 of 6 Due:. 160.51 1. ~Customer Name GARAGE 2. Social Sec Nbr: 4. Service Address: 1440 ST 5. Service City: BAKER 8. Parcel ID: 9. Bill Cycle: 5 10. ~Route Nbr: 11. Comments : S.C. JUDGMENT 12. Prev Acct: HM01436 . 13. Service Date: 14. Fund no: 15. Bill-to Addres 1440 2ND ST 16. Bill-to Add] : 17. Bill City: BAKERSFIELD ~7 3. Te State: CA 20. Wa Svc Class: 805-324-1516 7. Zip: 93301 $160.~!-~40.00 COURT COSTS Misc serVices~ F09 HAZ MAT HANDLING 24. Cl, o~~ate. 18. State: CA 19.· Zip: 93301 Enter Save , Cancel(XX), Next Page(/), or Field # to Change ALT-F10 HELP I ADDS VP I FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR I CR Utilities General ACcount Maintenance PUTLS801 Acct Nbr: 388901 Bill Stat: NO Transfer-from: Page 1 of 6 Cyc Stat: CL Acct Cyc Stat: CL Transfer=to: Due: 160.51 1. Customer Name: CALLAWAYS CRANKSHAFT GRINDING 2. Social Sec Nbr: 3. Telephone: 805-327-3231 4. Service Address: 2216 N ST 5. Service City: BAKERSFIELD ~~ 6. State: CA 7. Zip: 93301 8. Parcel ID: ~-- ; 9. Bill Cycle: 5 20. Water Svc Class: 10. Route Nbr: 11. Comments : S.C. JUDGMENT 10-22-92 $160.51 + 40.00 COURT COSTS 12. Prev Acct: HM00209 23. Misc Services: 23.1 F09 HAZ MAT HANDLING 13. Service Date: 10/14/92 23.2 14. Fund no: 24. Closing Date: 09/15/92 15. Bill-to Address1: C/O JAMES & PATSY BARNES 16. Bill-to Address2:919 34TH STREET STE B 17. Bill-to City: BAKERSFIELD 18. State: CA 19. Zip: 93301 Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change ALT-F10 .HELP I ADDS VP I FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR I CR ,'2o~ ~ OCT 1 7 1991 Business Identification No. 215-000 -t (Top of Business Plan)' ,,~ ~ HA7 MAT. D~r Station No. q Shift ~ Inspector ~ ~" 7~ Adequate Inadequate ~ C., Verification of Inventory Materials I~] I~ _ _ ~ Verification of Quantities I~ ~] ~' . ,~) ~., Verification of Location I~ ~] ~; , ~,~,v of Material I~] ~ ~ /)~ Comments: ~, ,/~-'~ Veri MSDS Availablity I~ I~ U~,\" \ Number of Employees Verification of Haz Training comments: Verification of Abatement Supplies & Procedu Comments: Comments: Emergency Procedures Posted Containers Properly Labeled Verification of Facility Diagram Special Hazards Associated with this Facility: Business Owner/Manager FD 1652 (Rev. 1-90) All Items O.K. Correction Needed White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy 04/03/91 ~/~ CALL~ S CRANKSHAFT GRINDING Z>00-000209 ~~J Overall Site with 1 Fac. Unit .. ~ ~~~ General Ir~formatior~ [Lc, catior,: 2216 N ST Ident Nurnber: 215-000-0002o9 Page 1 Map: 103 Hazard: Moderate ~ Grid: 30C Area of Vul: 0.0 ~ C~nt act Name !.~JA~,IiES- ~'?ATSY Mail Addrs: 2216 N ST City: BAKERSFIELD Comm Code: ~l~-JO1 BAKERSFIELD STATION 01 Title i Business Phc, r,e ......... r 24 Hour' Phc, r,e] LESSEE (805) 327-~231 x Administrative Data D&B Number: State: CA Zip: 93301- SIC Cc, de: Owner: DAVID JONES Phone: ( ) - Address: 204 SANDY MUSH RD State: CA City: MERCED Zip: - Summary RECEIVED HA7 MAT. DIV. 04 / 03 / 91 p a g e 2 P 1 n-Ref CALLAWAYS cRANKSHAFT~ GRINDING 215-(')(')(')-(')(')(')2(')9 Hazmat Irsventory List irs MCP Order 02 - Fixed Corstainers on Site Name/Hazards Forrn Quarst i t y MCP ACETYLENE Fire, Pressure, Immed Hlth Gas 200 FT3 Hi gh (i)2-(')(i)4 CLEANING SOLVENT Fire, Irs~med Hlth, Delay Hlth Liquid GAL Moderate 02-003 SODIUM HYDROXIDE Fire, Immed Hlth' Liquid 150 LBS Moderate 02-001 OXYGEN Fire, Pressure, Ir~med Hlth Gas ' . 200 FT3 Low 00 - Overall Site (D) Not.if. /EvacuatiorJ/Medical Page <1> Agenc~~ NotificatiorJ CALL 911 <2.> Employee Not i f. /Evacuat ior~ ANYONE IN'THE FRONT OF~SHOP WOULD EXIST THE WEST DOOR, IF IN THE MIDDLE OF THE SHOP THEY WOULD EXIST THE NORTH' DOOR TO THE PARKING LOT, IN THE BACK OF SHOP THEY WOULD EXIST THE EAT DOOR. <3> Public Notif./Evacuatior, ~ ON THE SOUTH SIDE OF BUILDING'IS A VACANT LOT, ON NORTH SIDE E~F BUILDING IS 23RD STREET. ADVANCE MUFFLER IS BUSINESS APPROXIMATELY 1 BLOCK AWAY. WESTSIDE IS A RESIDENCE.' ~EASTSIDE IS THE ALLEY. <4> Emerger, cy Medical Plar, 04/03/91 Page 4 CALLAWAYS CRANKSHAFT GRINDING OO - Overall Si <E> Mi t i gat i o~r,/Prever, t/Abat emt <1> Release Prever, tion ~ OXYGEN & ACETYLENE CAHINED UP ON CART. SODIUM HYDROXIDE IN SEALED CONTAINER. _CLEANING SOLVENT IN SEALED CONTAINER. <2> Release Cor, tair, mer, t TWO EIGHTY GALLON SUMPS <3> Clear, Up FLUSH WITH WATER, NEUTRALIZE, SWEEP OR SCOOP UP AND REMOVE, PREVENT SPREAD OF SPILL ~' <4> Othe~ Resource Act i vat i or, 04/03/91 CALl CRANKSHAFT GR I ND I NG 21~000-000209 00 - Overall Site <F> Site Er~lergerfcy Factors Page 5 Special Hazards <2> Utility Shut-Offs A) GAS - NORTH SIDE OF BUILDING B) ELECTRICAL - INSIDE SOUTH WALL REAR C) WATER - REAR ALLEY D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECTION - 5 FIRE EXTINGUISHERS FIRE HYDRANT - IN ALLEY ON CORNER OF 23RD ST. <4> Held for Future use 04/03/91 CALLAWAYS CRANKSHAFT GRINDING 2.15-00,:].000209 00 - Overall Site <G> Trair, ir, g Pa g e 6 <1> Page 1 WE HAVE 2 EMPLOYEES AT THIS FACILITY WE~ HAVE MATERIAL SAFETY DATA SHEETS .ON FILE BRIEF SUMMARY OF TRAINING: WE WEAR RUBBER BOOTS, RUBBER APRONS, FACE SHIELD, DUST N[ASK, SYNTHETIC ROBBER GLOVES ' <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use :! CT'i'Y of BAKEH FI ELD ,i HAZARDOUS MATERIALS INVENTORY Farm andAgticulture Fl' 5taddard Business [] NON--TRADE SECRETS ~' PaDe of ..... .,--,.o ,,,,'ut. i 0AT,LA?tA~ 'S MACHINE OWNER NAME:J~ES B~RNES NAMEsTANDARDOF T~ISiND FACILI-TY:cLASS CODEf LOCATION:~-LO~ x~ .o'.L'n,-'.~'~' ADDRESS; 627~.R(lE~O(3~ ~r~ . CITY. ZIP:_gA~g~T~T.B~ oqqAq . CITY. ZIP4~Zm~~IELUV~'IUb DUN AND B~AD~TREET_ NUMBER_ PHONE fl: 9~'/-:~--~ ~-- REFER PHONE fl:T ~-~ 9P~ CODES ~,~ - ~ ' - - ' ~ 13 14 ;]relns !YIn' Hax A¥1~r.aDe',; Annual Heasure '~)[ Cont Cont Cont Us toc,tion. Whe'[e. eCode [Doe AmC Amc ~ Est Un~ts on e Type Press Temp Co~e y- Ha.s of'Nixture/Coeoonents Stored In ~aciIICy ~: See ]flsLruct~ons · ~hvsical and Health Hazard C.A.S. Number ~07~2 Component II Hame I C.A,S. Number ~ ' .. (Check ali tha~ apply) ~ . , ~ Component '2 Name I C.A,S, Number ~ FireHazar~ .;~Reactivity~ ~ Delayed ~ Sudden Release ~ Immediate {~n~w~te~) ~. Health of Pressure Health Comp~onent 13 Name I C,A.S, Number :' GENERATES] ~AT ~: ~ ' Physical mod HemlLh)Hmzmrd C,A,S, Number 1310723 Compon'ent II Name I C.A.S. Number ICheck al/ that a~l/I ~ Coe~onent t~ Naee I C.R.S. Nueber ~'~ ~ Fire ,azard :~ aeactivitl ~ Oelayed ' ~ Sudden Release ~ Im~i~ Health of Pressure [ Component I~ Naee I C.~.S. Nueber ~;. C.k.S, Number Component Il Name t C,A.S. ~ber PhysicAl 8nd HeAlth Hazsrd ;;' (Check all th,t '?Iv) . j ~n ~~'~ Reactivity ~ Delayed .Release ~ ]m~i~ Component 12 Namb ~ C.A.S. Number Hazard . Health eT Pressure~. Component 13 Name ~ C.A.S. Number Physical'lod Healt~UaTard ~ C.A.S, Nuebe[ Component II Haae i C.A,~, N~ber (Chec~ al/ ~hat a~p/H ~ ~'e Hazard ~ Remctivit~ ~ Delayed · ~ Hem/Ch ~ , Component 13 Name & C.A,S, Number ~,, ' _ EMERGENCY CONTACTS fll J~ES BARNES TTT~*~T~R ~~6t: fl2 fe[[~[l~:t~ler oena!l~R~f~a, ?hat ]~av~ person[tf~ examlnq~Peq~ em famil,ar. ~it~ ~lle.!nfor. mat!pn aul~mitt.ed in ~4,.;;-~ed'd.c.man[s 'an~ that basee on my inquiry of those I~OIVIQUI/S responsible ~or oocaln~ng [ne tntormacton. ]belteve that s~tt~rmatlOn IS tr~e~cUrate, and cokp/e e. - July 26~ 199Q Mr. Chris Duncan Callaways Crankshaft Grinding 2216 N Street Dear Mr. Duncan: Enclosed you will find ~ computer printout of the Hazardous Msteri~ls Management Plan that we h~ve in the computer~ please update and address any highlighted areas. Due to a change in the laws that went into effect January, 1989, we need to have a new inventory form (enclosed} filled out. These forms must be filled out and returned to our office by August 10, 1990. If you have any questions please don't hesitate to contact us at (805) 326-39?9. Sincerely Yours, Ralph E. Huey Hazardous Materials Coordinator FIRE DEPARTMENT D S. NEEDHAM FiRE CHIEF CITY of BAKERSFIELD "WE C,4RE" 2- 3 ql 2101 H STREET BAKERSFIELD, 93301 326-391 ~ Dear Business Owner: This notice is meant to act as a reminder that the California Health and Safety Code, ChaDter 6.95, requires any handler of hazardous materials to revise their hazardous materials business plan within 30 days of any one of the following events: (1) A 100 per cent or more increase in the quantity of a previously-disclosed material. (2) Any h~ndling of a previously-undisclosed hazardous material, subject to the inventory requirements of Chapter 6.95. (3) Change in business ownership. (4) Change in business address. (5) Change of business name. Any questions regarding these required revisions, please call the Hazardous Materials Division at (805) 326-3979. Sincerely yours, alph E. ~~ Cdous Materials Coordinator REH/d BAKERSFIELD CITY FIRE' DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 _ (805) 326-$979 S~NESS NAME RECEIVED JUN ! 2 lgl)7 Ans'd ............ HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. '- 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS: ZIP: q~O/ BUS.PHONE: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving'the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME A DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: /kJ~PiZT'/-f' B. ELECTRICAL: _ /~/~./~1~, C. WATER: ~ ~'~'~[.~ - - '- SPECIAL-: ~ A D.E. LOCK BOX: YES /~ IF ~s,-LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO YES / NO MsDsS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: L~CAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING,. EMPLOYERS ARE REQUIRED TO-HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. '~ ~. CIRCLE YES OR NO ' , INitIAL' REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . .~ .................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. ~PROPER USE OF SAFETY EQUIPMENT: .................. YES NO 'YES NO D. EMERGENCY EVACUATION PROCEDURES: ................ ~. YES NO YES NO ~E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO SECTION 7: HAZARDOUS MATERIAL ,'~'.L.iji.~= CIRCLE.YES OR NO HAZ%kD6U~'. ~TER IAL DOES YOUR BUSINESS IN QUANTITIES LESS THAN 500 PbUND$_.QF A HANDLE SOLID, 55 GAL~0NS OF A LIQUID, OR.20Q CUBIC FEET OF A COMPRESSED.GAS:., .... .,:..~VES'/NO.~~~ I, -~' (~ I)t,.l(..l~Ct,'/ , certify that the above information is accurate. I-hnderstand;that this ~nformation will be used to fulfill my f~rm'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. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 BUS'INESS NAME: OFFICIAL USE ONLY ID# BUSINESS ' PLAN SINGLE 'FACILITY UNIT' FORM SA INSTRUCTIONS 1. To avoid further action, th~s form must 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# FACILITY UNIT NAME: '' SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEbURES 'AT THIS b%TIT 'ONLY SECTION 3:-..HAZARDOUS MATERIALS FOR THIS UNIT' ONLY .A. Does this Facility Unit contain Hazardous Materi ~'-~ E~ a~o: ...... NO If YES, see B. If NO, continue with SECTION 4',,:. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ If No, complete a .separate hazardous materials inventory form marked: NON-TRADE SECRETS O~LY (white form #4A-1) If Yes, complete.a hazardous materials~inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-t~ade secret 'form List .only the trade ~o · secre~, on form 4A-2. SECTION 4:,PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY ~ESPON~ERS SECTION 6: ' LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. ' ' "~" GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPEC[AL: ' E. LOCK BOX: YES ,,; IF YES, LOCATION: tF YES, SITE PLANS? FLOOR PLANS? YES / NO MSDSs? YES / YES / NO KEYS.'?- YES / NO - 3B - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY ADDRESS: PHONE #: OWNER NAME: c i TI, Z I P: FACILITY UNIT NAME: UNIT #: -~Z?- ~ ~(- ' PHONE #: '~ff-7~.~-7~_.<-' IOFFICIAL USE CFIRS CODE - { ONLY 1 2 3 ':::' 4 5 6 7 8 9 1 0 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 NAM~E: TITLE: , SIGNATURE: {~/.,., . d''J-~,,,...-__ DATE: '~"-~HOI~--# BUS HOURS: EMEI~OENCY CONTACT:~ EMERGENCY CONTACT: FR~INC~IPAL,: BUSINESS AFTER BUS HRS: PHONE # BUS HOURS: AFTER BUS HRS: RES. PHONE BUS. DHONE (80~1-0831 (805) 832-3508 "'-':?~ ".-~ ~ '-~'. ~"' NOEL CHAMBLESS ~ ...~ 47OI WIBLE RD., BAKERSFIELD, CA 93309 WHOLESALE FUELS MATERIAL SAFETY DATA SHEET PRODUCT/MATERIAL:, ~',JPC 140 SAFETY SOLVENT MANUFACTURER.' WHOLESALE FUELS ADDRESS: 2200 E. Brundage Lane Bakersfield California 93307-2806 EMERGENCY PHONE NOS. MEDICAL:: 213/~;64-2121 (L.A. POISON CENTER 24 HR NO.) CHEMTREC: 800/42~;-9300 BUSINESS: 805/327-4900 SECTION I - MATERIAL IDENTIFICATION TRADE NAME: JPC 140 SAFETY SOLVENT PRODUCT CODE NO.: GENERIC NAME:,_ Orga?ic so~lyent CHEMICAL NAME: Mixture of Petroleum hydrocarbons SYNONYMS: Mid-distillate mixture. CHEMICAL FAMILY.'. Aliphatic, aromatic .hydrocarbons ' MSO$ CODE_.I'IO.: MMD00030~0AC CAS REGISTRY NO.: Not registered. NIOSH REGISTRY NO.: Not registered. CHEMICAL FORMULA: Mixture of petroleum hydrocarbons. SECTION II - HAZARD IDENTIFICATION HEALTH HAZARDS PHYSICAL HAZARDS ASPIRATION HAZARD SKIN DEFATTING AGENT COMBUSTIBLE LIQUID MISUSE OF EMPTY CONTAINERS CAN BE HAZARDOUS AND LEAD TO SERIOUS INJURY. READ SECTIONS V, VIII, X, & XI. D.O.T. HAZARD CLASS: Combustible Liquid UN HAZARD CLASS NO: None NFPA RATING: HEALTH 2 FLAMMA8ILITY 2 REACTIVITY 0 OTHER: Consumer Product Safety Commission requires a label warning for "Petroleum distillates". SECTION Ill - HAZARDOUS INGREDIENTS AND RECOMMENDED EXPOSURE LIMITS HAZARDOUS INGREDIENTS RECOMMENDED EXPOSURE LIMITS LIMIT TYPE AMOUNT AGENCY 1) Petroleum distillates None established. PRODUCT/MATERIAL: OPC 140 SAFETY SOLVENT MSDS CODE NO.: MMD0003030AC SECTION IV - HEALTH HAZARD INFORMATION GENERAL: This material is an aspiration hazard.' OCULAR/EYE: This material may cause eye irritation. Contact with the liquid may cause burning, tearing, and redness. DERMAL/SKIN: This material may cause skin irritation. Prolonged or repeated contact may cause burning, redness, drying and cracking of the skin, and dermatitis. INHALATION/BREATHING: Exposure to mists or to excessive vapor concentrations may cause irritation of the nose, throat and respiratory tract; signs of central nervous system depression; i.e., headache, nausea, drowsiness and dizziness. INGEST[ON/SWALLOWING: Accidentally swallowing this material can cause irritation of the stomach and digestive tract; Larger. ingestions may cause signs of central nervous system depression; i.~., :he_a. dache, nausea, .dro~wsin~Ss and dizziness,.. This material is an aspiration hazard and may enter the lungs when swallowing or vomitin9 and cause serious lung damage. CHRONIC/OTHER: No known additional effects. SECTION V - SPECIAL HAZARDS AND PRECAUTIONS HAZARDS DURING NON-ROUTINE OPERATIONS: vapors. Heating may generate irritating and toxic SPECIAL PRECAUTIONS AND COMMENTS: Empty containers retain material residue which may generate hazardous vapors. Do no.t pressurize, cut, weld or expose empty containers to any source of heat or flames. MEDICAL CONDITION AGGRAVATED BY EXPOSURE: pulmonary disease. Pre-existing skin disease. Chronic SECTION V! - EMERGENCY AND FIRST AID PROCEDURES ATTENTION: IF VICTIM IS NOT BREATHING OR IF BREATHING DIFFICULTIES DEVELOP ARTIFICIAL RESPIRATION OR OXYGEN SHOULD BE ADMINISTERED BY QUALIFIED PERSONNEL. ' OCULAR/EYE CONTACT: Flush the affected eye(s) with water. If irritation develops, seek medical assistance. DERMAL/SKIN CONTACT: Remove contaminated clothing and flush contact areas with water and then thoroughly cleanse contact by washing with soap and water. If irritation or redness devel, op and persist, seek medical assistance. INHALATION/BREATHING: If symptoms of exposure develop, move away from source of exposure to vapors or mists. If symptoms persist, seek medical assistance. INGESTION/SWALLOWING: DO NOT INDUCE VOMITING/ASPIRATION HAZARD. If victim is conscious and alert, give milk or water to drink. Seek immediate medical assistance. COMMENTS/PHYSICIAN INFORMATION: This material is a moderately volatile, low viscosity mixture of petroleum hydrOcarbons with a low order of acute toxicity. It is an aspiration hazard. PRODUCT/MATERIAL: JPC lZ;0 SAFETY SOLVENT MSDS CODE NO. MMD000]}030AC SECTION VII - CHEMICAL REACTIVITY INFORMATION STABILITY: Stable under normal conditions of storage and handling. REACTIVITY: Reacts vigorously with strong oxidizing agents. INCOMPATABILITY: Incompatible with strong oxidizing agents. HAZARDOUS REACTION/DECOMPOSITION PRODUCTS: Thermal decomposition yields carbon dioxide and carbon monoxide. .. CONDITIONS CONTRIBUTING TO HAZARDOUS POLYMERIZATION: This material does not polymerize. SECTION VIII - FIRE AND EXPLOSION HAZARD INFORMATION NFPA RATING: HEALTH 2 FLAMMABILITY 2 REACTIVITY 0 FLASH POINT (METHOD): 63°C/TCC; 69°C/TOC FIRE POINT/AUTOIGNITION TEMP: z;90°F FLAMMABLE LIMITS (% BY VOLUME/AIR): LOWER: 0.9% UPPER: 4.9% FIRE/EXPLOSION HAZARDS: This material is a moderate fire and explosiOn hazard and may be ignited by any ignition source above its flash point. Vapors may travel to ignition source and flash back. Containers may explode in fire. Vapor explosion hazard indoors, outdoors or in sewers. Empty Containers retain material residue and may generate vapors which may ignite and explode. COMBUSTION PRODUCTS: Carbon dioxide, carbon monoxide and water vapor. EXTINGUISHING MEDIA: Carbon dioxide, dry chemical, foam, and water spray. FIRE FIGHTING PROCEDURES: Wear protective equipment and clothing when fighting fb'es, including a self-contained breathing apparatus for fires in enclosed spaces. Use water spray to cool fire-exposed containers, to dilute and disperse vapors, protect personnel, and to flush unignited spills from fire area. ........ SECTION--I-X .... PERSONAL -PROTECTION AND ENGINEERING- CONTROLSt- . ___: EYE AND FACIAL PROTECTION: Chemical goggles are recOmmended to prevent eye contact. SKIN PROTECTION: Protective gloves and clothing are recommended when prolonged contact with the concentrated material may occur. RESPIRATORY PROTECTION: Respiratory protection may be required to minimize exposure to vapors. Wear an approved organic vapor cartridge or supplied air respirator as necessary. VENTILATION: General mechanical ventilation or explosion-proof local exhaust recommended to minimize exposure to vapors. OTHER: An eye wash and a source of running water should be available to flush or wash eyes and skin. PRODUCT/MATERIAL: 3PC 140 ~AFETY SOLVENT MSDS CODE NO.: MMD0003030AC SECTION X - SHIPPING, STORAGE AND HANDLING, PROCEDURES SHIPPING INFORMATION: D.O.T. SHIPPING NAME: Petroleum distillate D.O.T. ID NUMBER: UN 12~;8 D.O.T. HAZARD CLASSIFICATION: Combustibl~ liquid.' SHIPPING REGULATIONS: No label required. See DOT regulatio'ns 49CFR 173.118a for packaging requirements. STORAGE: Store in closed containers in a cool well-ventilated area away from all heat and ignition and strong oxidizing agents. Containers should be electrically bonded and grounded when transferring materials. HANDLING: Use in a well-ventilated area and. wear recommended protective equipment and eloi~hing. Use explosion-proof tools and equipment. Avoid breathing vapors or mists and prolonged or repeated skin contact. MISUSE OF EMPTY CONTAINERS CAN BE HAZARDOUS. COMPLETELY DRAIN AND HAVE .... -(gOMMERGIALI.:Y-Ct:E~'ANED~B~FORE--A'NY-REUSE.- '-KEEP 'CONTAINERS-CLOSED AND DO-NOT--- USE TO STORE ANY OTHER MATERIALS BEFORE THEY HAVE BEEN COMMERCIALLY CLEANED. DO NOT CUT, WELD, DRILL OR SUB3ECT CONTAINERS TO HEAT OR FLAMES. VAPORS MAY IGNITE AND EXPLODE. SECTION Xl - SPILL, LEAK AND DISPOSAL PROCEDURES SPILL OR LEAK PROCEDURES= Evacuate area for large spills. Remove all ignition sources and provide explosion-proof ventilation. Wear recommended protective clothing and equipment, Do not allow spills to enter sewers, streams or surface waters. Dike and contain spills. Use inert absorbent to reduce fumes and to pick up spill. Collect for later disposal. DISPOSAL PROCEDURES; DISPOSE OF IN ACCORDANCE WITH FEDERAL, STATE AND LOCAL REGULATIONS. Empty containers should be commercially cleaned and reconditioned for reuse. SECTION XII - PHYSICAL DESCRIPTION AND PROPERTIES DESCRIPTION: A clear water-white liquid with a characteristic petroleum hydrocarbon odor. MELTING POINT: NA BOILING POINT/RANGE: 184-210°F OVERPOINT: NA VAPOR PRESSURE: lmm of Hg 0 77°F %-VOl--A-TILE -BY-~VE)EUME: -t.00% ....... -- VAPOR DENSITY; (Air=l) 5.4 EVAPORATION RATE: (BuAc=l) 0.06 SOLUBILITY. (WATER): Negligible pm: NA SPECIFIC GRAVITY: 0.80 API GRAVITY: No data. VISCOSITY: 1.3:3 cSt-~-37~8qc POUR POINT.' NA OTHER= None MSDS CODE NO: MMD0003030AC NEW/REVISION DATE: 4-27-86 REPLACES MSDA CODE NO: New ORIGINAL DATE= New PREPARED BY: David C. Markie DATE-' 5-10-86 ************************************************************************************** © Copyright, 1986. Health & Hazard Systems, 415 W. Foothill, Claremont, CA ~1711 THIS MATERIAL SAFETY DATA SHEET WAS PREPARED HEALTH& HAZARD SYSTEFLS UNDER CONTRACT TO HEALTH & HAZARD SYSTEMS ~ N15 W. FOOTHILL BLVD. WHO ASSUMES LIABILITY FOR THE INFORHATION ~ CLAREMONT, CA9~711 CONTAINED HEREIN. ANY QUESTIONS OR COMMENTS PHONE NO: ?lN/G2_1-998G REGARDING THIS INFORHATION SHOULD BE DIRECTED TO: Do hereb5~ attached certify that I have Hazardous Materials reviewed the~,~ business ~lan for and that it along with the attached additions or Busi~ess~ my · ~ - ' ~ ~ --~na'' ' - corrections consti~ ~ ~u~e a comDlete and date correct BUSINESS NAME CALLAWAYS CRANKSHAFT GRINDING LOCATION 2216 N ST ID NUMBER 215-000-000209 -'~'"HIGH HAZARD RATING 3 1 . OVERVIEW LAST CHANGE 06/30/88 BY ESTER JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30C FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM. EMERGENCY CONTACTS 2A SEC 2) LEE DAVIS - 327-3231 OR 832-5952 CHRIS DUNCAN - 327-3231 OR 393-8174 UTILITY SHUTOFFS 2A SEC 3) A) GAS - N SIDE OF BLDG B) ELECTRICAL - INSIDE S WALL REAR C) WATER - REAR ALLEY D) SPECIAL - NONE E) LOCK BOX - NO - 2 . NOTt F ICATION / PUBL I C EVACUAT I ON LAST C ANGE ! / ZY BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 12/14/88 09:48 BUSINESS NAME CALLAWAYS CRANKSHAFT GRINDING ID NUMBER 215-000-000209 LOCATION 2216 N ST HIGH HAZARD RATING 3 3 . HAZ MAT TRAINING SUMMARY LAST CHANGE I / ~/ g~ BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 06/30/88 BY ESTER 3A SEC NO EMPLOYEES. PAGE MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 12/14/88 09:48 BUSINESS NAME CALLAWAYS CRANKSHAFT GRINDING LOCATION 2216 N ST FACILITY UNIT 01 ID NUMBER 215-000-000209 HIGH HAZARD RATING 3 OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 06/30/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE PURE OXYGEN REAR OF SHOP PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 2359.00 100.0 OXYGEN, COMPRESSED 200 FT3 HIGH WELDING/SOLDERING HAZARD LISTS HIGH PURE ACETYLENE REAR OF SHOP ID PERCENT COMPONENTS 1241.00 100.0 ACETYLENE PORTABLE PRESS. CYL. 200 FT3 EXTREME WELDING/SOLDERING HAZARD LISTS EXTREME 3 PURE SODIUM HYDROXIDE 150 LBS REAR OF SHOP DRUMS OR BARR NON MET. STRIPPER ID PERCENT COMPONENTS 1560.00 100.0 SODIUM HYDROXIDE, SOLUTION HIGH HAZARD LISTS HIGH 4 PURE CLEANING SOLVENT 55 GAL OUTSIDE IN REAR DRUMS OR BARRELS MET.. WASHING ID PERCENT COMPONENTS 1203.01 100.0 PETROLEUM NAPHTHA EXTREME HAZARD LISTS EXTREME PROTECTION / WATER SUPPLIES LAST CHANGE 06/30/88 BY ESTER 3A SEC 4) 5 FIRE EXTINGUISHERS FOR FIRE PROTECTION. 3A SEC 5) FIRE PLUG IN ALLEY ON CORNER OF 23RD ST. PAGE 3 12/14/88 09:48 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME CALLAWAYS CRANKSHAFT GRINDING LOCATION 2216 N ST ID NUMBER 215-000-000209 HIGH HAZARD RATING 3 EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 06/30/88 BY ESTER 3A SEC 2) N/A NO EMPLOYEES. MITIGATION / PREVENT ION / ABATEMENT LA'ST CHANGE 06/30/88 BY ESTER 3A SEC 11 OXYGEN & ACETYLENE CAHINED UP ON CART. SODIUM HYDROXIDE IN SEALED CONTAINER. CLEANING SOLVENT IN SEALED CONTAINER. PAGE 4 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 12/14/88 09'48 BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY GENERAL INFORMATION: Important: if you require more inventory forms than the one provided, you should make photocopies of the forms prior to entering any information on them. The additional copies must be on the same color paper as the original. Information must be typed/mrinted in English. Make a cody for your records. Complete business name and address information. If the>' have been required, the number of separate facility un[ts wi.l[ be determined by the Bakersfield City Fire Department. Give each facility ,]nit a common name, and a one or two digit number. NOTE: An inventory form must be made for each separate facility unit. The top of the form must be completed for each facility - showing Business name and location as well as owner name and mailin~ address. Also include "SIC" Standard Industrial Classification and ii' available Dun and Bradstreet Number. Non-Trade Secrets (White Form). one facility unit. Non-Trade Secret Materials in Trade Secrets (Yellow Form). facility unit. Trade Secret Materials in one TRANSACTION CODE: Is this inventory sheet new, an addition, deletion or update to your hazardous materials business plan. A = Addition D = Deletion U = Update N = New TYPE/CODE: For the purpose of'this entry, there are three types of hazardous materials: P = Pure M = Mixtures of pure substances W = Wastes. (Also add appropriate waste code) MAXIMUM A~NT: This sh(~ld represent the maximum number of units of this material present at any one time. (Refer to the "UNIT" section of these instructions) AVERAGE AMOUNT: This should represent the average amount, usually on hand at any one time. ANNUAL AMOUNT: This should represent the anticipated annual (thru put) number of units of the material. MEASURE UNITS: LBS = Pounds, for materials stored as solids GAL = Gallons, for materials stored as liquids FT3 = Cubic Feet at S.T.P., for materials stored as gases CU9 : Curies, for radioactive materials DAYS ON SITE: Days anticipated that this material ~i!£ be at this site, for the calendar year reporting. CONTAINER TYPE: (Use appropriate code) 0l. Under.:round Tank 02. Above:round Tank 0:~. Fixed Pressurized Tank (.)4. Portable Pressurized Cylinders 05. Insulated Tank (includes cryogenics) 06. Drums or Barrels - Metallic 07. Drums or Barrels - Non-Metallic 08. Corboy(s) 09. Glass Container(s 10. Plastic Container s) ll. Box(es) 12. Bag(s) 13. Metal Containers not drums) 14. In Machinery or Drocessin~ ecuiDment 15. Bin(s) 99. Other - specify 10. 11. CONTAINER PRESSURE (Use appropriate code) 1 = Ambient Pressure (1-Atmosphere) 2 = Greater than Ambient Pressure 3 = Less than Ambient Pressure CONTAINER TEMPERATURE (Use appropriate code) 4 : Ambient Temperature $ : Greater than Ambient Temperature 6 = Less than Ambient .Temperature 7 = Cryogenic Conditions USE CODE (Use appropriate code) 01. Additive 02 Adhesive 03 04 05 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Aerosol Anesthetic Blasting CatalYst Cle_~m~ing Coo~a'nt Cooiing Drilling Drying Emulsifier/Demulsifier Etching Experimental Fabrication Fertilizer Formulation Fuel Fungicide Grinding Heating Herbicide 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 99 Insecticide Instructional Lubricant Medical Aid or Process Neutralizer Painting Pesticide Plating Preservative Refining Sealer Spraying Sterilizer Storage Stripping Washing Waste Water Treatment Welding'Solderin~ Well Injection Oil Treatment Other - Specify 12. LOCATION WHERE STORED IN THIS FACILITY Briefly indicate the location of the material within the building/facility unit using compass points and obvious landmarks. 13. PERCENT BY WEIGHT Indicate the concentration of each pure substance as a percentage of total weight. In the case of mi×tures and wastes enter the ma×imum expected concentration of the three most Hazardous Components. Round off %. 14. NAMES OF MIXTURE/COMPONENTS EMERGENCY CONTACTS: Enter the name, title and phone numbers of two Dersons who are knowledgeab[e about this facility. PLEASE BE CERTAIN THAT FORMS ARE PROPERLY SIGNED AND DATED AT THE BOTTOM CITY of BAKERSFIELD NON--'tRADE SECRETS ' P~e .... of LOCATION: '~ c'~-~-~l/~ : ~T" : ADDRESS: /~.5~.-~ f/: '~., t' ~-' STANDARD IND. CL~S$ CODE PHoNECITY' ~:ZIP: ~ ~.~g~ ~ %~ ~. % ~.,~) ~ ~ ~'/~ e~[?[~ ~" ~ ~;' PHoNECITY' ~:ZIP: ~[~.~['9~/~r~ r? ~. ~r ~ ~,~, ~c~ ~; ..... [6"~ ~- ~ DUN AND BRADSTREET_ NUHBER_ ~ ~ Z~U~O~ ~ ~OP~ COD~ - - (~ C~e ~t ~t Est Units m Stta l~ ~s I~ ~ St~ tn FKtlity '~' ~ I~t~ti~ .9_1 .... 1 ........... 1~ I ~ ) ) ). ~ ) . ~ ...... Ph~ic~l ~ HNlth [~ r--~ -- r--~ r--~ ~t 12 ~EC.A.S. ire Hazird u- a R~tivity [ n ~1~ ~ a ~ hi~ ~ J I~tmte ~lth of Pm~ ~lth P~*cll ~ ~lth (C~k 4ll t~t 4ppJy) - r--~ -- [ ] Ft~ ~zArd L--J ~ctivtty ~lth of P~ ~lth ..... L_L ...... ~C~k ~11 t~t ~ly) - [ ~ Fire Hazard Hfllth of P~fu~ ~lth ~t 13 ~&C.A.S.~ l, J ~ t J ~ I ,~ ................. ...... t ........ P~ical ~ HNlth (C~k ill t~t a~iy) - -- ~ ~ Flee Hazard H~lth of Pr~sure Health '~-- - ...... ~t ~NERGENCY C~TACTS I1 H~': ................................... ~(Ii ....................... ~rR~-P~i ...... ~ TltlT ~-~ ...... Certification (Read and sikh after comp/arlene al] sections) I cer~fy under 114~altv of law that ! have ~ersmallyexamined and la familiar with t~ tnforNti~ subitt~ in this ~ ell IttK~ ~ts, ~ t~t ~s~ ~ ~ iGi~ of t~e t~tvt~ls mGliblm for ob~ainin~ t~ iflf~tim. I ~lieve t~t t~ su~itt~ info.tim is t~, accurate, ~d cmpiete. N~-S~[~G)HEi~I-HEI;'GT'~&~iGF'O~'~7G~FSIG~'~'SGE~Fi)~'~;GF~lSHGG SiQRS[GFG ............................. ' ....................... ~i'Si~ ............................ CITY of BAKERSFIELD q'RADE SECRETS ' P~9~ .... of LOCATION: __ ADDRESS: STANDARD IND. CLASS CODE CITY, ZIP: CITY, ZIP: DUN AND BRADSTREET NUMBER PHONE #: PHONE #: - - C~e C~e it ~t Est Un,ts m Site ]y~ ~l T~ ~ St~ in F~Jlf~yBt' ~ I~t~ti~ Physical ~d Health H~za~ C.A.S. ~ ~t II ~ i C.I.$. ~ (C.~k all t~t e~ly) fleaith of P~ ~ith P~ic,] ~ Hfllth Hazlrd C.A.S. ~ ~t II M & C.A.S. ~ - r--~ -- -- -- Wt 12 M&C.A.S. ~ Health of Pr~sure Health , ............. NERGENCY C~TACTS I1 Certification (Read and sJKn after coapJetin£ aZ] sections) I cerLify under penalty of lee that I ~ve ~rs~ally examin~ and am familiar .ith t~ infor~ti~ suMitt~ tn this ~ all IttK~ ~ts. ~ t~t ~s~ ~ W in~i~ of t~e t~tvt~ls r~sible for O~ainin~ t~ in(~ti~, ~ ~lieve t~t t~ su~itt~ iflfoe~ti~ is t~, accurate, and cmplete. fl~- ~a-~TTiEi~I-TiII~'GT'~TGF-O~-~FZ~F~EG;'T'~GE~FiT~';GGF~T)EiGi Si)E)TG~G ................................................... ~li'Si)~ ................... 7~ ...... OES CALIFORNIA * Hazardous ~ Mateti~d Califomia Otf'~ee at ~,~ Division To Report all significant releases or potential releases of hazardous materials, F~ C~ 9-1-1 (or the local emergency response agency) Then Ca~ the Governor's Office of : Emergency Services (OES) Warning Center 1~2~7550 (only in California) or call the public number (916) 262.1621 [t's the taw! June 1992