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Home My WebLink AboutBUSINESS PLANHazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF .PERMIT ON REVERSE SIDE Permit ID #:: 015-000-001849 SOUTH KERN MACHINERY This ~ermit is Issued for the followin0: [] Hazardous Materials Plan [] Underground Storage of HazardOus Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment LOCATION: 520 S MT VERNON AVE 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: Expiration Date: Ralpg Huey, D~! Ot~ce of Ev~Sc'rvices ' June 30. 2003 Issue Date Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE Issu~ by: G Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Approved by: Expiration Date: June 30. 2000 ITE DIAGRAM [ Business Name: Business Address: :_.] FACILITY DIAGRAM 520 S-. Nit. Vernon Avenue Bakersfield, CA 93307 x ! * * * * * SEE ATTACHED DIAGRAM * * * * * Inventory Legend: 0001 Hydraulic Oil 0002 Waste Oil 0003 Waste Antifreeze 0004 Diesel 0005 Propane 0006 Sulfuric Acid 0007 Acetylene 0008 Oxygen 0009 Argon/Carbon Dioxide 0010 Acetylene 0011 Oxygen 0012 Motor Oil 0013 Hydraulic Fluid 0014 Motor Oil 0015 Batteries w/Sulfuric Acid N ecured Storage Covered Storage DRIVE ~Y Facility Diagram South KernMachinery, Inc. 520 S. Mt. Vernon Avenue Bakersfield, CA 93307 :~ ~-Water Sh.ut off! 0095 '~- ~Pr~ne' ~-?Shut Of~f 0010 0001,0002, 0003,0004 0014 0013-.~ . ,--'-'-~, BUILDING FLOOR PLAN ' 0012 T '+ ~*Natural Gas Shut GATEWAY DRIVE ? ! 5zo S. Me. Vr.~n~ . ~.. I FACILITY NAME LOCATION ~ o/? CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE 3/z No. of Tanks >10,000 gallons Section 6: [] Routine Spill Prevention Control & Countermeasure (SPCC) Plan [] Combined J~]~. Joint Agency [] Multi-Agency [] Complaint [] Re-inspection SPILL PREVENTION CONTROL AND C V COMMENTS COUNTERMEASURE PLAN 112.7 Guidelines for preparation and implementation of SPCC: (a) Spill History (b) Discharge Scenarios (c) Containment and/or Diversionary Structures (d) Strong Spill Contingency Plan and Written Commitment (e) Spill Prevention and Containment Procedures (1) Facility drainage (2) Bulk storage .tanks (3) Facility transfer operations (4) Tank car and truck loading rack operations (5) Oil production facilities (onshore) (6) Oil drilling and workover facilities (onshore) (7) Oil drilling and workover facilities (offshore) (8) Inspections and records (9) Security (excluding oil production facilities) (10) Personnel, training and spill prevention procedures (i) Proper instruction (ii) Designated person for spill prevention (iii) Spill prevention briefings Age of Tanks ~ Aggregate Storage Capacity [ flOC) gallons C=Compliance V=Violation Inspector: Office of Environmental Services (661) 326-3979 White - Env. Svcs. Pink - Business Copy Cc: Shelton Gray, RWQCB, 3614 East Ashlan Ave., Fresno, CA 93726 Business Site Responsible Party D April 13, 2000 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICE.8 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 FAX (8O5) 326-O576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3979 FAX (805) 326-0576 TRAINING DMSION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 Joe Canas, Program Manager Kern County Environmental Health Department 2700 "M" Street Bakersfield, CA 93301 Unified Hazardous Materials / Waste Facility Permit for South Kern Machinery, 520 South Mount Vernon Avenue Dear Joe: I recently inspected the above referenced facility and noticed a Kern County Unified Hazardous Materials / Waste Facility Permit posted on site, in addition to the City's legitimate permit for the same. The problem is, this facility was built new there in 1997 in an area which has been City since 1986. I imagine what may have happened was that the previous location of South Kern Machinery used to be in the County at 250 Washington Street and that it's new location wasn't correctly discerned by your staff to now be within the City of Bakersfield. I informed the business manager at the time of my inspection that his facility is in the City, and has been since the move in1997, and that any fees paid to the County since that time, have been in error. You may want to take the initiative to help refund these fees back to the business. Sincerely, Howard H. Wines, III Hazardous Materials Specialist Office of Environmental Services cc: Steve Rengers, South Kern Machinery FACILITY NAME ADDRESS C~.o CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~ Floor, Bakersfield, CA 93301 FACILITY CONTACT ~'~-/~ ~C-,~ga-a-s INSPECTION TIME INSPECTION DATE PHONE NO. ~a'-5'-s -~qoo BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program 1~ Routine J~ Combined I~l Joint Agency [~l Multi-Agency 1~ Complaint I~l Re-inspection OPERATION C V COMMENTS Appropriate permit on hand C~ ~a2r~,~- ~_.y~/ Business plan contact information accurate Visible address Correct occupancy Ver/tication of inventory materials Verification of quantities Verification of location Proper segregation of material RON r. AUBUS, Service Manager Verification of MSDS availability II Mobile (661)978-6599 Verification of Haz Mat training ~~~JTH ~ Verification of abatement supplies and procedures ~ K E R N W ~E Emergency procedures adequate MACHINERY www'kernmachinery, com ..~ Containers properly labeled ~ 520 S. Mt. Vernon Avenue (661) 833-9900 Mt. Vernon Ave. South of Hwg. 58 (800) 244-6424 Housekeeping -~-~ Bakersfield, CA93307.2858 Fax (661) 833-9911 Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [~Yes [~l No Explain: ~1"~' C3'~ t.. ~r ~.~r.t_rt..~,~..,~& Questions regarding this inspection? Please call us at (805) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Site Responsible Party Inspector: ~LJ(~E--~ FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE "~ (zz'''5/eve-) Section 2: Underground Storage Tanks Program [] Routine [~Combined Type of Tank Type of Monitoring [] Joint Agency [] Multi-Agency Number of Tanks Type of Piping [] Complaint [] Re-inspection OPERATION C V CO.9~$k~TS Proper tank data on file ~ Proper owner/operator data on file ~ Permit fees current j Certification of Financial Responsibility ~..~e~~'~ Monitoring record adequate and current Maintenance records adequate anoint Failure to correct prior~'~olations Has there b~~n unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) t ooo/~-$-0 / 3~-O AGGREGATE CAPACITY Type of Tank ct ~ t d 2- Number of Tanks -'~ OPERATION Y N COMMENTS SPCC available SPCC on file with OES /,/ Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy ~u}iness Stite Responsible Party CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N_ 50. i~'~-e..,J Location ~'~'~) Sub Div, Blk. Lot You are hereby required to make the following corrections at the above location: 946 Cot. No Completion Date for Corrections Date Inspector 326-3979 FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # [] Routine j~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous xvaste determination has been made EPA lD Number (Phone:916-324-1781 to obtain EPA ID #) Authorized tbr waste treatment and/or storage Reported release. |]l'e. or explosion within 15 days of occurance Establishcd or maintains a contingency plan and training Hazardous waste accumulation time fi'ames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed ,vhen not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Propel- management of' used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests tbr 3 years Retains hazardous waste analysis lbr 3 years Retains copies of used {)il receipts tbr 3 years Determines if waste is restricted fi'om land disposal -// C=C°mpliance V=Vi°lati°n Omce of Environmental Services (805) 326-3979 BU~in~'~ffSite Responsible Party \Vhite - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME SO~TH KERN MACHINERY, INC. FACILITY NAME SOUTH KERN MACHINERY, INC. SITE ADDRESS 520 S. MT.VERNON AVENUE CITY BAKERSFIELD NATURE OF BUSINESS SIC CODE Retail & STATE CA ZIP 93307 Service Farm& Turf Equipment DUN & BRADSTREET NUMBER 05-389-3491 OWNER/OPERATOR MAILING ADDRESS CITY Bakersfield Don Camp, Jr. P.O. Box 70520 PHONE (805)833-9900 STATE CA ZIP 93387-0520 EMERGENCY CONTACTS BUSINESS PHONE (805) 833-9900 Ext. 106 NA~[E Steve Renqers Ext. 110 BUSINESS PHONE (805) 833-990Q Ext. 110 NAME: Ron Faubus l BUSINESS PHONE: (805) 833-9900 Ext. 112 TITLE President, General Manager (805)664-0546 24HOURPHONE Cellular (805)829-7890 TITLE Parts Manaqer 24 HOUR PHONE (805) 391-8757 Pager (805) 329-4944 TITLE: Service Manager 24HOUR PHONE: (805) 399-9501 PAGER: (805)335-4741 or 335-3524 ZARDOUS MATERIALS INVEN~RY Business Name Address Page CIIEMICAL DESCRIPTION I) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudd_~ Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code flora DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TnvIE AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] Gal [ ] ft3 [ ] a) Container:. Curies [ ] b) Pressure: c) Temperature Circle Which Months: AIl Year, J, F, M, A, M, $, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AI-'IM the three most hazardous 1 ) [ ] chemical components or 2) [ ] any AHM components 3) [ ] 10)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSecret[ ] 2) Common Name: 3) DOT # (optional) Ch~n'aical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudd~ Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Clmmic) [ 5) WASTE CLASSIFICATION (3-digit code from DH8 Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure[ ] Mixture[ ] waste[] Radioactive[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UN1TS OF MEASURE 8) STORAGE CODES Lbs [ ] Gal [ ] ft3 [ ] a) ConUfiner: Curies [ ] b) Presstm:: c) Temperature Circle Which Months: AIl YeaL J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List the three most b~-rdous 1) chemical components or 2) any AHM components 3) COMPONENT CAS# % WT [ ] [ ] [ ] 10)LOCATION I certify under penalty of law, that I have personally examined and am familim' with thc information on this and all attached documents. I believe the submitted information is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date SOUTH KERN MACHINERY Location: 520 S MT VERNON AVE City : BAKERSFIELD BusPhone: Map : 103 Grid: 04B CommCode: COUNTY STATION 41 EPA Numb: - SIC Code: DunnBrad: SiteID: '215-000-001849 (805) 833-9900 CommHaz : Moderate FacUnits: 1 AOV: Emergency Contact / Title DONALD CAMP JR / OWNER Business Phone: (805) 833-9900x/O~ 24-Hour Phone : (805) 664-0546x ~~~f~F Phone : (~) ~ -~g$Ox Hazmat Hazards: RSs Emergency Contact / Title STEVEN RENGERS / PARTS MANAGER Business Phone: (805) 833-9900x/~ 24-Hour Phone : (805) 391-9757x Emergency Directives: Fire Press ImmHlth DelHlth = Hazmat Inventory --MCP+DailyMax Order Hazmat Common Name... ISpecHazI PROPANE ACETYLENE BATTERIES E SULFURIC ACID ACETYLENE OXYGEN DIESEL OXYGEN HYDRAULIC FLUID HYDRAULIC OIL WASTE OIL WASTE ANTIFREEZE ~ EPA HazardsI Frm F P IH F P IH F IH IH F P IH F IH DH F IH DH F DH F DH F DH F DH MOTOR OIL ARGON/CARBOI~, IO (~,or~r~m~_~.,~ ~-- DO hereby r®vi~d ~he ~t~ached h~a~0us ~a~a~ m~nag~- ~ ~la~..~o~~d ~ha~ ~ a~o~ with (Name of Busine~} One Unified List Ail Materials at Site IDailyMax Unit MCP G 18000 FT3 Hi G 1000 FT3 Hi S, 500 LBS Hi L 330 GAL Hi G 300 FT3 Hi G 1500 FT3 Low L' 1000 GAL Low G 700 FT3 Low L 550 GAL Low L 350 GAL Low L 300 GAL Low L 200 GAL Low L 1000 GAL Min L 550 GAL Min .G 330 FT3 Min -1- 02/20/1998 S, OUTH' KERN MACHINERY SiteID: 215-000-001849 Inventory Item 0005 Facility Unit: Fixed Containers at Site PROPANE Days On Site 365 Location Within this Facility Unit Map: Grid: S FENCE LINE IN YARD CAS# -, 74-98-6 = STATE ~ TYPE Gas' /Pure PRESSURE TEMPERATURE I Above Ambient I Ambient CONTAINER TYPE FIXED PRESS. CYLINDER Largest Container 18000.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 18000.00 FT3 Daily Average 18000.00 FT3 .%Wt~ 100.00 Propane HAZARDOUS COMPONENTS N 74986 TSecretNo N~S BioHazNo HAZARD ASSESSMENTS Radi°active/Am°unt I EPA HazardsINo/ Curies F P IH NFPA /// USDOT# I MCPHi --Inventory Item 0007/ Facility Unit: Fixed Containers at Site ~ff~vl~~ ~vl~ / ~ ~_,o,_~ ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE FABRICATION SHOP CAS# 74-86-2 STATE TYPE Gas I Pure PRESSURE TEMPERATURE Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 330.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 FT3 Daily Average 1000.00 FT3 %Wt. 100.00 Acetylene HAZARDOUS COMPONENTS INo CAS# 74862 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F P IH NFPA /// IUSDOT# 2 02/20/1998 S~OUTH KERN MACHINERY SiteID: 215-000-001849 Inventory Item 0015 Facility Unit: Fixed Containers at Site ~Uivuvl~ ~Vl~ /. ~1~./*'*~ ~Vl~ BATTERIES Days On Site sULFURIC ACID 365 Location within this Facility Unit Map: Grid: INSIDE S SIDE OF PARTS DEPT CAS# TEMPERATURE Ambient CONTAINER TYPE OTHER - SPECIFY Largest Container 1.00 LBS AMOUNTS AT THIS LOCATION Daily~ Maximumsee~0 LBS Daily Average IJ_/~X_b[UUU~ ~U~U~'I'~ %Wt. RS CAS# 35.00 Battery Acid Yes 7664939 10.00 Nickel Oxide No 1313991 5.00 Cadmium Oxide (EPA) Yes 1306190 TSecretNo yeRsS BioHazNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH NFPA/// I USDOT# MCP Hi -- Inventory Item 0006 Facility Unit: Fixed Containers at Site ~:UJ. vllvJ. Ul~ 1%/.Z**.~lt"; / t.:l-J.J~lVl.L t.;~X-,L~ 1%l_,~.J.V1J~ SLrLFURIC ACID Days On Site 365 Location within this Facility. Unit Map: Grid: ENCLOSURE AT SE CORNER OF BLDG~0~/D~ oF~i.O~ ~ CAS# f~ r~TO~ A ~)~/~,~)/~L3 7664-93-9 r STATE ~ TYPE Liquid /pure. PRESSURE IAmbient TEMPERATURE ' IAmbient CONTAINER TYPE ABOVE GROUND TANK Largest Container 330.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 330.00 GAL Daily Average 330.00 GAL HAZARDOUS COMPONENTS %Wt. I 100.00 Sulfuric Acid, Spent SI CAS# N 7664939 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies IH NFPA /// USDOT# -3- 02/20/1998 SOUT~ KERN MACHINERY = Inventory Item 0010 ~ COMMON NAME / CHEMICAL NAME ACETYLENE Location within this Facility Unit INSIDE SW CORNER OF SHOP SiteID: 215-000-001849 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 74-86-2 STATE TYPE Gas ] Pure PRESSURE , TEMPERATURE Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 88.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 300.00 FT3 Daily Average 300.00 FT3 I%Wt. I 100.00 Acetylene HAZARDOUS COMPONENTS CAS# 74862 ITSecretI RSIBioHaz No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F P IH NFPA/// I USDOT# = Inventory Item 0008 -- COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit INSIDE NE CORNER OF FABRICATION SHOP Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 7782-44-7 STATE TYPE Pure Gas PRESSUREr TEMPERATURE Ambient ! Ambient Above CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 249.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1500.00 FT3 Daily Average 1500.00 FT3 %Wt. 100.00 HAZARDOUS COMPONENTS Oxygen, Compressed N 7782447 No No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA/// [ USDOT# Low -4- 02/20/1998 F S. OUTH KERN MACHINERY SiteID: 215-000-001849 ---- Inventory Item 0004 Facility Unit: Fixed Containers at Site DIESEL Days On Site 365 Location within this~Facility Unit _ · ~Map: Grid: S~DE OF SHOP BLDG S. ~/. dOr~ ~ ~? CAS# Liquid Pure Ambient Ambient ABOVE GROUND TANK Largest Container 1000.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum HAZARDOUS COMPONENTS I % Wt. Diesel 100.00 .Fuel No. 2 Daily Average [ N 68476302 ITSecret ~S BioHaz No N No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies NFPA /// USDOT# MCP Low ~ Inventory Item 0011 -- COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit INSIDE SW CORNER OF SHOP Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 7782-44-7 FSTATE ~ TYPE Gas [Pure PRESSURE TEMPERATURE { Above Ambient [ Ambient { CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 249.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 700.00 FT3 Daily Average 700.00 FT3 %Wt. 100.00 HAZARDOUS COMPONENTS Oxygen, Compressed S[ CAS# N 7782447 TSecret No RN~oRSBi°HazNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# MCP Low -5- 02/20/1998 ---- Inventory Item 0013 -- COMMON NAME / CHEMICAL NAME HYDRAULIC FLUID Location within this Facility Unit SW CORNER OF S STORAGE BLDG SiteID: 215-000-001849 Facility Unit: Fixed Containers at Site Days On Site 365 CAS# Map: Grid: 0 F STATE -- TYPE Liquid Pure PRESSUREr TEMPERATURE Above Ambient ! Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION I Daily Maximum sAL Daily Average HAZARDOUS COMPONENTS 100.00 Brake Fluid, Hydraulic (Diethylene Glycol Monob... N CAS# 112345 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH I NFPA I USDOT# I MCP / / / Low = Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME HYDRAULIC OIL Facility Unit: Fixed Containers at Site Location within this /acility Unit _~ Map: SIDE OF SHOP BLDG TEMPERATURE Ambient STATE TYPE PRESSURE Ambient Pure Liquid Grid: Days On Site 365 CAS# CONTAINER TYPE ABOVE GROUND TANK Largest Container 350.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 350.00 GAL Daily Average 350.00 GAL HAZARDOUS COMPONENTS 100.00 Hydraulic Brake Fluid (Diethylene Glycol Monobu... N CAS# 112345 TSecretINo NoRSIBi°HaZNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies NFPA /// USDOT# MCP Low -6- 02/20/1998 SOUT~ KERN.MACHINERY SiteID: 215-000-001849 Inventory Item 0002 Facility Unit: Fixed Containers at Site ~lV~Vl~ ~vl~ / ~lVli ~Z.-~.I~ ~Vl~ WASTE OIL Days On Site 365 Location within this_.Facil~ty Unit~, k Map: Grid: S SIDE OF.SHOP BLDG /~,~,~f~4A0~ ~'~D~ CAS# Liquid Waste Ambient Ambient ABOVE GROUND TANK Largest Container 300.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum I 300.00 GAL Daily Average 300.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Waste Oil, Petroleum Based CAS# HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA/// I USDOT# Low Inventory Item 0003 Facility Unit: Fixed Containers at Site ~jUIVUV. I.U.L%I D4.~--%lVll"; / ~l"ll";lV!.L ~:~,1..~ WASTE ANTIFREEZE Days On Site Location within this, Facility Unit . , Map: Grid: FSTATE ~ TYPE Liquid I Waste ~--~URE IAmbient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 550.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 200.00 GAL Daily Average 150.00 GAL %Wt. 30.00 HAZARDOUS COMPONENTS Ethylene Glycol I ~s CAS# N 107211 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA /// USDOT# MCP Low -7- 02/20/1998 M~CHINERY = Inventory Item 0012 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit INSIDE SE CORNER OF S STORAGE BLDG SiteID: 215-000-001849 Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 STATE -- TYPE PRESSURE Ambient Pure Liquid -- TEMPERATURE TAmbient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum Daily Average HAZARDOUS COMPONENTS I%Wt. I 100.00 Motor Oil, Petroleum Based CAS# 8020835 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA /// USDOT# ] MCP Min = Inventory Item 0014 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit S RACK OF S STORAGE BLDG Facility Unit: Fixed Containers at Site Map: Grid: Days On Site 365 CAS# 8020835 STATE TYPE PRESSURE Ambient Pure Liquid TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container 5.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 550.00 GAL Daily Average 550.00 GAL HAZARDOUS COMPONENTS %Wt. I 100.00 Motor Oil, Petroleum Based I ~s CAS# N 8020835 TSecretNo R~NoRS~Bi°HazNo HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA /// USDOT# MCP Min 8 02/20/1998 ~ SOUTH KERN M~CHINERY ~ Inventory Item 0009 -- COMMON NAME / CHEMICJkL NAME ARGON/CARBON DIOXIDE Location within this Facility Unit INSIDE SW CORNER OF FABRICATION SHOP SiteID: 215-000-001849 Facility Unit: Fixed Containers at Site Map:· Grid: Days On Site 365 CAS# 7440-37-1 FSTATE ~ TYPE Gas I Mixture PRESSURE TEMPERATURE CONTAINER TYPE I Above Ambient I Below Ambient I PORT. PRESS. CYLINDER Largest Container 330.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 330.00 FT3 Daily Average 330.00 FT3 %Wt. 25.00 75.00 Argon Carbon Dioxide HAZARDOUS COMPONENTS S CAS# N 7440371 No 124389 TSecret No I RSiBioHaz No No. HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F P IH NFPA/// I USDOT# MCP Min -9- 02/20/1998 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: 2. 3. 4. To avoid further action, return this form within 30 days of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: SOUTH KERN MACHINERY, INC. LOCATION: 520 S. MT. VERNON AVENGE P.O. BOX 70520 MAILING ADDRESS: CITY: BAKERSFIEI.D DUN & BRADSTREET NUMBER: PRIMARY ACTMTY: Retail STATE: 05-389-3491 CA ZIp:93387 & Service Farm & Turf Equipment Don Camp, Jr. PHONE: (805) 833-9900 SIC CODE: 3523 OWNER: MAII.INGADDRESS: P.O. Box 70520 Bakersfield: CA 93387-0520 SECTION 2: EMERGENCY NOTIFICATION CONTACT Don Camp TITLE President/General Mgr. BUS. PHONE (805) 833-9900 2. Steve Rengers Parts ~2naqer 3. Ron Faubus Service Manager Trans-West Security (Rudy or Tom Burns) (after hours security) 1 (805) 833-9900 ' (805) 833-9900 or (805) 834-0711 24 HR. PHONE (805) 664-0546 (~03) ~z~-/~go Cellular (805) 391'-,9757 (805) 329-4944 Pager (805) 399-9501 (805) 335-4741 Pager (805) 335-3524 Pager (805) 834-0711 HAZARDOUS MATERIALS MANAGEMENT PLAN / SECTION 3: TRAINING NUMBER OF EMPLOYEES: 50 1 set on file in Administration Office MATERIAL SAFETY DATA SHEETS ON FILE: 1 set on file in Parts Managers Office 1 set on file in Shop Foreman's Office BRIEF SUMMARY OF TRAINING PROGRAM: All employees receive training regarding materials they work with or which are present in their areas. Training is on-going with additional training presented as new substances are introduced or the current MSDS changes. Initial training-upon implementation of the IPP program Annual re-training Newly hired employees immediately upon starting work Specific training for non-routine tasks. All training is documented and is conducted under the direction of managment. Employees receive training as a work group, except for new hires, and will be as interactive as possible. Training is lecture-discussion type with hand-out information, visual aids and hands on SECTION 4: EXEMPTION REQUEST instruction. I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, Don Camp, Jr. CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.)AND THAT INAEC..URATE INFORMATION CONSTITUTES PERJURY. res en enera 3/24/98 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SEC,T.,ION 6; NOTIFICATION.AND, EVACUATION PROCEDURES AGENCY NOTIFICATION PROCEDURES: Emergency actions shall be taken under the direct supervision and coordination of the supervisor on site. Employees will be trained in emergency responses for which they are capable of performing. All other emergency responses will be handled by dialing 911 and notifying the proper emergency response team. Bo EMPLOYEE NOTIFICATION AND EVACUATION: All employees will be notified to evacuate the facility thru the use of the P.A. System. Employees are to proceed to the nearest exit reporting to the open area north of the building. (See attached evacuation route) Depa~-h~ental supervisors will be responsible to account for the employees in their depar~-~nts. Custc~ers in the facility, at~.time_of announcment to,evacuate, will be escorted to the open area north of the building by the departmental managers. PUBLIC EVACUATION: See Above D. EMERGENCY MEDICAL PLAN: Basic Emergency First Aid will be administered by trained employees for eyeinjuries, burns, bleeding, and basic life support (CPR).%. For life threating emergencies, 911 will be called and the injured will be transportated to the nearest medical faclility equipped to handle that type of emergency. (this'determination will be made by the emergency response team) 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, pREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: Employees are trained in general safe operating rules and are charqed with the responsibility to work in a safe manner to protect their own fiealth as well as others. Employees are provided with and instructed on the use of personal protective ecLDt. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Secondary containment systems, protective equipment, on site fire extinguishers located throughout the buildings, sprinkler, system in main building - two storage buildings are not equipped with sprinklers, fire alarm system monitored thru Tel Tec Security C. CLEAN-UP PROCEDURES: Waste oil and anti-freeze are picked up by Asbury Spent batteries are picked up by Exide Corporation Used oil filters picked up by Kern Oil Filter Recycling Rags are recycled by AmeriPride Laundry SECTION 8: UTII.!TY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)_ PT.W. ASE REFER TO FACILITY DIAGRAM NATURAL GAS/PROPANE: Shutoff at T0nks- ,q~. w~.~ c~ o~ Y~""d WATER: Outside door of Office on North East side of buildinq SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: r__~_~ Box is !~c=_t~ at electric Cate on the Gateway Drive entrance SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY ao B° PRIVATE FIRE PROTECTION: Main building equipped with' sprinkler system, monitored fire alarm system thru Tel-Tee Security WATER AVAILABILITY (FIRE HYDRANT): Fire Hydrant located on South Mt. Vernon by the North East Gate, Fire Hydrant located ~ North West of the main building by the North Storage sheds. 4 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: 2. 3. 4. To avoid further action, return this form within 30 days of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be as brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: ~T~4 LOCATION: ~20 ~. MAILING ADDRESS: CITY: STATE: __ ZIP: PHONE: ~ '"5~ - ~ ~ oo DUN & BRADSTRR~.T NUMBER: PRIMARY ACTMTY: ~ OWNER: ~_~o~ ~ u~ C~,~-,? .30,_ SIC CODE:.~ MAIl.lNG ADDRESS: SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE 1. Dc~A.~c~ ~'~c,~e ,.to._.. ~~n.... BUS. PHONE 24 HR. PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAJNING NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTWY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: Do EMERGENCY MEDICAL PLAN: ST~VEN RENGERS, Parts Manager KERN 520 S. Mt. Vernon Avenue (805) 833-9900 Mt. Vemon Ave. SOuth of Hwjz 58 (800) 244-6424 Bakersfield, CA 93307-2858 Fax (805) 833-9977 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIOATION. pREVENT[ON AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: ELECTRICAL: WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 4 Business Name HAZARDOUS MATERIALS INVENTORY Addrcss Page ..... of CHEMICAL DESC~ON I) INVENTORY STATUS: New [ ] Addition [ 2) Common ~ame: Chemical Name: Revision [ ] Deletion [ ] Cheek ifchcmicai is a NON Trade Secret [ 07 /--- 3) DOT # (optional) AHM[ ] CAS# ] Tra~ ~ [ ] 4) Physical & Health Hazard Categories Fire [~ Reactive [ 5) WASTE CLASSIFICATION PHYSICAL HEALTH ] Sudd~ Release of Prepare [ ] Immediate Health (Acute) [ (3-digit code fi-om DHS Form 8022) USE CODE ] Delayed Health (Chronic) [ ] 6) PHYSICAL STATE Solid [ ] Liquid [~ Oas [ ] Pur~[ I ~ix'mre[ I Wasu:[ ] msdioa~ive[ 7) AMOUNT AND TIME AT FACILITY __._. Maximum Daily Amount ~ q C) Average Daily Amount "5 ~ Annual Amount # Days on Site ~. O UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] eaj~-] aa [ ] a) conutm~ C~es[ ] b) Pressure: c) Temperature C/role Which Months: AU Year, $, F, M, A, M, $, $, A, S, O, N, D 9) MIXTURE: List the three most hazardous 1) chemicai components or 2) any AHM compongnt~ 3) COMPONENT CASt/ % WT [ ] [ l [ ] I 0 )LOCATION 1) INVENTORY STATUS: N~v [ ] Addition [ ] Revision [ ] Deletion [ ] Cheek ffchemical is a NON Tra~ Secret [ ] Trade ~ [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health Hazard Categories Fi~ [~] Reactive [ 5) WASTE CLASS]FICA]ION PHYSICAL HEALTH ]St_~_enRcleaseofPressure[ ] Immediate Health (Acute) [ (3-digit code fi, om DHS Form 8022) USE CODE ] Delayed Health (Chronic),[~ ~-o 6) PHYSICAL STATE Solid [ ] Liquid ~] Cas [ ] Puxe[ ] ~xmre[ ] waste~t ~oacUve[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF IVlE~ 8) STORAGE CODES Lbs [ ] Gal ~ it3 [ ] a) Conta/ne~. "Z_ Curies [ ] b) Pressure: S c) Tcmpensturc ~ Circle Which Monfl~s: AIl Year, $, F, M, A, M, $, J, A, S, O, N, D 9) MIXTURE: List thc three most hazardous 1) chemical components or 2) any AHM components 3) COMPONENT CAS# % WI' [ ] [ ] [ ] 10)LOCATION certify under penalty of law, that I havc personally examined and am familiar with the information on this and all attached documents. I belicvc thc submitted information is true, accurate and complete. PRINT Name & Title of Authorized Company Repres~tstive Signature Date Business Name HAZARDOUS MATERIALS INVENTORY Addruss Page of CHEMICAL DESCRH'TION iNVENTORY STATUS: New [ ] Addition { ] Revision [ ] Deletion { ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] common ~ame: tY ~f'~ Y~,-rwt~--r~c-~-~- 3) DOT # (opUonal) Chemical Name: AI-[M [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Suddun Release of Pressure [~r]' lp,,.,.a,_',-,, Health (AonU~) [ ] Delayed Health (Chroui¢)~;r] 5) WASTE CLASSH;'ICATION 6) PHYSICAL STATE Solid [ (3-digit code Gum DHS Form 8022) ] Liquid 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Averase Daily Amount Annual Amount Largest Size Container # Days on Si~e USE CODE 9) MIXTURE: List the three most hazardous 1) chemical components or 2) any AI-[M components 3) Civic Whic~ IViontl~ AIl Y~, $, F, M, A, M, $, $, A, S, O, N, D COMPONENT CAS# % WT [ ] [ ] 10)LOCATION I)INVENTORYSTATUS:N~v[ ]Aad,_'~ion[ ]Revisiun[ ]Deletion[ ] Common 7)'- Chemical Name: Check ifehnuical is a NON Trad~ Secret [ 3) DOT # (optional) AI-uvi[ ] cas# ] Trad~ ~ [ ] 4) Physical & Health Hazard Categories Fire~,'] Reactive [ 5) WasTE CLASSIFICATION PHYSICAL HE.~TH ]SuddonReleas~ofPress~{ ] Immedia~Heaith(Acute)[ ]DeiayedHealth(Chruni¢)[ (3-digit code Bum DHS Form 8022) PHYSICAL STATE Solid [ ] Liquid ~ Cam [ ] 7) AMOUNT AND TI:ME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container / # Days on Site "~ & ~'~ 9) IViIXTURE: List ~e three most hazardous l) chemical components or 2) any AH]vi components USE CODE Pu~ ~axtu~[ ] w~[] z~aio~v~[ ] UN1TS OF MEASURE 8) STORAGE CODES Lbs[ ]GaI~]R3[ ] a)Cuntainec ~-- Curies [ ] b) Pressure: l c) Temparatu~ ~' Circle Which Months: AIl Year, $, F, M, A, M, $, $, A, S, O, N, D COMPONENT CAS# % WI' [ ] [ ] [ ] 10)LOCATION [ ceftin/under penalty of law, that I have personally exantined and am familiar with the infommtion on this ond all attached do~ummts. I believe [he subnutted iuformation is true, accurate and complete. PRI1VT Name & Title of Authorized Company Representative Sisnature Date [~ttsln~ss Na/n~ HAZARDOUS MATERIALS 12qVENTORY Address Page., of, CHI~ MICAL DESCRIFrlON I ) INVENTORY STATUS: New [ ] Addit/on [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trad~ Secret ( 2) Common Name: ~3Nt>~-~ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health HaTard Categories Fire [ ] Re, active [ 5) WASTE CLASSIFICATION PHYSICAL HEALTH ] St__~k'n_ Rel~as~ of Pressu~ [ ] lmm(~llate Health (Acu~) [ O-digit c(x~ from DH8 Form 8022) USE CODE ] Delayed Health (Cltroui¢) [ d) PI-[YSIC~uL STATE Solid [ ] Liquid [ ] Gas [4f~ Purcell' Mixt~[ ] was~[ ] P.~Uomive[ ] 7) AMOUNT AND TIME AT FACILITY S~tn-m Daily Amount I ~0 Average Daily Amount l.-/'-LmOO Annual Amount # Days on Site ~ 6~' L~[ lOal[ Curies 8) STORAGE CODES a) Contain~ b) 1~: ¢) Temlx~aU~ Circle Which Months: All Year, .{', F, Ivi, A, lVi. $, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WI' AHM the tiu'ee most hazardous 1 ) [ ] chemical components or 2) [ ] any AI-IM components 3) [ ] I)INVtflqTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check ifchemical is a NON Trade Secret [ ]TradeSecret[ 2) Common Name: '~ cYl_ ~-,ov~) ~... ~_d~ 3) DOT # (optional) Ch~uicai Nme: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH HazaniCatego~es Fh'e[ ]React/ve{~SuddenReleaseofPressure[ ] ImmediateHeaith(Acute)[/~DelayedHesRh(Clmmi¢)[ 5) WASTE CLASSIFICATION (3-digit cod~ fxum DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ I Liquid~ Gain [ I Pure[] ~tur~[9] was~[ ] P.~Uomive[ ] 7) AMOUNT AND TI]ViE AT FACILn~ .,.j.~3 Maximum Daily Amount Average Daily Amount ~ > O Annual Amount Larsest Size Container ~o # Days on Site '~- UNITS OF IVIEASURE 8) STORAGE CODES Lbs [ ] Gal [~!{~{ R3 [ ] a) ContaLu~. Curies [ ] b) Pressure: ¢) Temlxu'atur~ Ci~le Which Months: AIl Yeatr, J, F, M, A, M, $, .~, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# thc three most hazardous I) ~ ~- ~-~'~-, c .,~,~ chemical components or 2) any AHM compononts 3) [ ] [ l [ I I certify under i~ty of law, that I have {x~m~mally ~ aud mu familiar with the iaformation on this and ail attached docum~uts. I believe thc submitted information is trtm, accuratg and complct~. PRINT Name & Title of Authorized Company Representative Signature Date H~RDOUS MATERIALS [NVENTt~Y Business Name Addr~,s Pase of CHEMICAL DESCRIPTION [NVENTORy STATUS: N~w [ ! Addition [ I Revision [ I D~letion [ I Che~k if chemical is a NON Trade Secret [ ] Trade Se:mt [ Common Name: ~c~.~'-~q..~'-,~F~ 3) DOT # (optional) Ch~nical Name: AI-IM [ ] CAS # 4) Physical & Health Hazard Categorie~ Fire,[s~] Reactive [ 5) WASTE CLASSIFICATION PHYSICAL HEALTH ] S,~,d_d~ Release of~ [~] Immediate Health (Acute) [ (3-digit code ~om DHS Form 8022) USE CODE ] Delayed Heaith (Chronic) [ 6) PHYSICAL STATE Solid [ ] Liquid [ ] Crasxf~] Mixture[ I W. te[ 7) AMOUNT AND TIME AT FACILITY ~,ximum Daily Amount Average Daily Amount / Annual Amount Largest Size Container # Days on Site ~&~'" UNITS OF MEASURE 8) STORAGE CODES Lt~[ lC. al ]tu[~ a)ConUaner Curi~ [ ] b) Pressure: c) Temperatore Circle Which Month~: All Year, $, F, M, A, M, $, J, A, S, O, N, D 9) lVIIX'I~: List COMIR)NENT CAS# % WT AHM the three most hn,,,rdous 1) [ ] chemical components or 2) [ ] any AHlVi c~mponems 3) [ ] lO)LOCATION I)INVENTORY~ATUS:New[ ]Addition[ ]Revisiou[ ]Deletion[ ] Check ifchemical is a NON Trade Secret [ ]TradeSecret[ 2) Common Name: (~-"'~'~-~'J 3) DOT # (optioual) Chemical Name: AHlVi [ ] CAS # 4) Physical & Health PHYSI~ HazardCatesories Fire[ ]Reactive[~SuddenRelemeofPressum~I~] tmmediateHealth(Acute)[ ]DelayedHeaith(Chrunic)[ ] 5) WASTE CLASSIFICATION O-digit code from DI-I~ Form 8022) 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [~-~,] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amomt / ~ Average Daily Amount ( ~'-~o Annual Amount Largest Size Container ~t~ # Days on Site % co ~-- 9) MIXTURE: List the three most hazardous I) chemical component~ or 2) any AHM components 3) USE CODE Pure[ ] ~xture[ ] w.~[ ] P,~dio~ve£ ] UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]Gall ]fl3[1~J a) Container: ~ Curies [ ] b) Pressure: 'z. c) Temperature /--/ Circle Which Months: All Year, $, F, M, A, [vi, $, $, A, S, O, N, D COMPONENT CAS# % Wi' [ I [ ] 10)LOCATION [ c~rtity under penalty of law. that I have personally exaunined and am familiar with the infornuttion on this and ali attached documents. I believe the submitted information is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date 8AZARDOUS ~/ATE~S I~vENToRY Addr~s Page CgEM~CAL DESCRIPTION [) E'PVE~ORY STATUS: New [ ] Addition [ ] Revision [ Chemical Name: ] Delcuou [ ] Check if chemical is a NON Trade 9ec~et [ ] Trad~ ~ [ ] 3) DOT # (optiouai) AtU~[ 1 CASa 4) Physical & Health Hazard Categories Fire [ ] Reactive [ 5) WASTE CLASSIHCATION PHYSICAL HEALTH ] Suddm Release of Pressure ~ Immediate Health (Acute) [ (3-disit code fi,.~ DHS Form 8022) 6) PF[YSIC~L STATE Solid [ ] Liquid 7) AlViOUNT AND TnVIE AT FACILITY Maximum Daily Amount Average Daily Amount % Annual Amount Largest Size CoaXer '~ '50 # Days on Site 9) MIXTUKE: List the three most haz~dous chexmcal compoumts USE CODE ] DeJay~ Hearth (ch-~ic) [ UNITS OF lVlEASURE 8) STORAGE CODES LI~[ ]Gal[ ]R3~ a) Container. Curia [ ] b) c) Temperature Cimle Which Meatl~: All Yesr, L F, M, A, M, $, $, A, S, O, N, D 1) ~c~Olv~O~ CAS# [ ] [ ] 3) [ ] 10)LOCATION 1) II~ORY STATU~: New [ 2) Common Name: Chemical Name: 4) Physical & Health ~ Categories ] Addition [ ]Revision[ ]~el~ion[ ] Check if chemical is a NON Trade Sea~m [ DOT # (opUon~) At~[ ] CAS# ] Trade Secret [ ] Fke{~;~Reactive[ ]$uddenRelesseof~[~] Inuuediat~Health(Acute)[ 5) WASTE CLASSIFICATION O-digit cod~ f~um DHB Form 8022) USE CODE ] Delax,~l Health (Ch.,uui¢)[. ] PHYSICAL STATE Solid [ ] Liquid [ ] Gas [~ ~i~ ~[ I w~s~[ ] ~o~d.[ I 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount '] UNITS OF MEASURE 8) STORAGE CODES Lbs[ lGal[ lft3[~] a)Contaktec Curie~ [ ] b) ~: c) T~mix~tu~ Avemse Daily Amount Annual Amount # Days on Site ~, 9) MIXTURE: List the three most h,,Tnrdous 1) chemical components or 2) any AH]Vi components Circle Which Montl~: All Year, $, F, lyf, A, M, $, I, A, S, O, N, D COMPONENT CAS# % WT [ l [ I [ I )LOCATION c~i~ ~ ~ of law, ~t I ~ ~ly ~ ~ ~ f~ ~ ~ ~fion on ~s ~d ~1 ~ ~m~. I believe the submitted information is Uue., accurate and complete. PRINT Name & Title of Authorized Compmmy R~tative Signature Date HAZARi~OUS bIATERLAL$ LNVENTORY - Addr~s CI~-MICAL D~SCRIFrlON Page 'of~ ' l ) INVE~ORY STA'['US: New [ ] Addition { ] ReVision [ ] Deletion [ ] Check if chemical is a NON Trade Secret { ] Trade Secret [ 2) Common Name: <~C~-{-g 3) DOT # (optional) Chemical Name: AF[M [ ] CAS # 4) Physical & Health H~:,~,xi Categories WASTE CLASSIFICATION PHYSICAL HEALTH ] Reactive {~-~ S,,~-_ Release of Pressure [~1 r,-,-ediat~ Health (Acute) (3-digit code from DHS Form 8022) USE CODE l De~yed He, U, (Chrome) [ ] 6) PHYSICAL STATE ,Solid[ ] Liquid[ I GasifY] 7) AMOUNT AND ~ AT FACILI~.~. Maximum Daily Amount Average D~ily Amouat Annual Amount Largest Siz~ cont~, tt Days on Sit~ UNITS OF ME,a.~URE 8) STORAGE CODES Lbe[ ]Cml[ ]lt3{~] a)ConMin~-. Cuzie~ [ ] b) Pressure: c) Temperature Circle Which Montha: AIl Year, $, F, M, & M, $, L A, S, O, N, D 9) MIXTURE: List COMPO~ CAS# % WT ~ the three most hazardous 1 ) [ ] chemical components or 2) [ ] any AEM components 3) [ ] I)n, cqENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSeoret[ 2) Common Name: /~ff..) ~-O~=. ~ ! t=..- 3) DOT # (optional) Chemical Name: AH~ [ ] CAS # 4) Physical & Health PHYSICAL HEALTH PammiC~_t~ori~n Fim,[~R~x~iv~[ ]Suddml~_e!_,~of~[ ] rmm~!-t~Health(Acut~)[ ]DelayedHeal~(Clmmic)[ ] 5) WASTE CLASSIFICATION (~di~it ~ from DH~ Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid Pullet4 z~tttre[ ] w~[] ~tio~ctive[ ] 7) AMOUNT AND TIME AT FACILITY. _ lVhximum Daily Amount Averse Daily Amount Annual Amount Largest Siz~ Container # Days on Site L~[ ] C.a ~t~l tO [ C~-i~ [ ] Cimle Which Months: 8) STORAGE CODES a) Contains. b) Pressure: c) T~mp(mstu~ AIl Year, .1', F, M, A. M, $, 1, A, S, O, N, D 9) MIXTURE: List the three most h~o-,'do~ 1) chemical components or 2) any AZ-fly{ componamts 3) COIvlPONENT CAS# % WT [ ! [ l [ I I certify under penalty of law, that I have personally examined and am familiar with thc information on this and all attached docmnents. I believe the submitted information is true, accurate and complem. PRINT Name & Title of Authoriz~l Company Representative Sil~ature Date Business Name H~RDOUS MATERIALS EVVENTO~Y Address Page of, CHEMICAL DESCRIPTION I ) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret 2) Common Name: i~t)'~,C~ ["~L ~' ,.m~ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health Hazard Categories Fire,~ Reactive [ 5) WASTE CLASSIFICATION PHYSICAL I-~TH ] Suddeu Releas~ of Pressure [ ] L, um~diate Health (AcuUO [ (3-digit code fi-om DHS Form 8022) USE CODE ] Delayed Health (Chronic) [ 6) PHYSICAL STATE Solid[ I Liquid[ ] Gas[ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount 5'TO Annual ,amount Larsest Size Contniner # Days on Site UNITS OF lVIEASURE 8) STORAGE CODES Lbs[ ]Oal[~)]fl3[ ] a)Containe~. Cu~e~ [ ] b) Pressure: c) Temperature Civic Which Months: AIl Year, J, F, M, A, M, J', .l, A, S, O, N, D 9) MIXTURE: List COIvIPO~ CASt/ % WT AHM the three most h,onrdous 1) [ ] chemical components or 2) [ ] any AHM components 3) [ ] I)IN'VENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check ifchemical is a NON Trade Secret [ ]TradeSec~[ ] 2) Conu~on Name: 3) DOT # (optional) ChcmJcal Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL I-I~T~ I-~dCategories Fh'c[~p]Rcactive[ ]SuddenRelcascofPrcssurc[ ] ImmediateHealth(Aeute)[ ]DelayedHcalth(Chwuic)[ ] 5) WASTE CLASSIFICATION (3-digit code fxom DI-B Form 8022) USE CODE 6) PFIYSIC~J., STA'I]3 Solid [ ] Liquid [~2{~} Gas [ ] ~[~1 Mixtm [ ] ware 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] Gal ~ fl3 [ ] a) Contain~ Curies [ ] b) Pressure: c) Temperature Circle Which Months: AIl Year, J, F, M, A, M, $, .l, A, S, O, N, D 9) MIXTURE: List the three most hazardous 1) chemical components or 2) any AffM components 3) COMPONEKr CAS# % WT [ ] [ ] [ ] [ certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documenis. I believe the submiRcd information is ~rue, accurate and complete. PRINT Name & Title of Authorized Compony Representative Signature Date HAZARDOUS MATERIALS 13{VENTORY Addln~,s Page of CHEMICAL DESCRIPTION I ) 12qVE~ORY STATUS: New [ ] Addition [ ] Revision [ l Deletion [ ] Ch~ck il'chemical ia a NON Trad~ Secret [ ] Trade Sec~t [ 2) Common Name: ~~'T''~-'~ ~ ~'''~ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEAL~ Hazard Categories Fire ( ] Reactive [4~ Sudden Rele~.~ of Pressure ( ] lmm,.diate Health (Acute) ( ] Delayed Health (Chnmi¢) [ 5) WASTE CLASSIFICATION (3-digit code Gu,,, DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ I Liquid [~] Gas ( ] Pure[] Mixture(,~ waste[] Radioa~ve[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount ~-~ Average Daffy Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lba[,~,Gal[ ]R3[ ] a) Container: c~ [ ] b) ¢) Temperam Civic Which Months: Afl Y~a~, $, F, 1~ A, 1~ $, $, A, S, O, N, D 9) MIXTUI~: List the three most hn~,nrdous chemical c~anponems or COMPONENT CAS# ~oWT AHM 1) ~uF-u~c.. A~-,/% [ ] 2) [ ] 3) [ ] lO)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] CheckifchemicalisaNONTrad~Secret[ ]Trad~Seozt[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH HazardCategofies Fire[ ]Reactive[ ]$,_,dc~__ReleaseofPresmure[ ] fmmediateHesJth(Acute)[ ]DelayedHealth(Chroui¢)[ 5) WASTE CLASSI~CATION (3-digit cod~ fi,.-m DHS Form ~22) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure[ ] Mixture[ ] Waste[ ] Radion~iv¢[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daffy Amount Average Daily Amount Annual Amount Largest Siz~ Container # Days on Site 9) MIXTURE: List the three most I~ardous 1) chemical components or 2) any AHM compon~t~ 3) UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]Gal[ Irt3[ ] a)Contain= Curies [ ] b) Pressure: ¢) Temperature Circle Which Months: All Year. J, F, M, A, M, I, I, A, S, O. N, D COMPONE2~ CAS# % WT [ I 10)LOCATION I c~.rtify under penalty of law. that I have personally examined and am familiar with tim iui'ormation on this and all attached documonts. I believe the submitted iuformatiou is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date ITE DIAGRAM Business Name: Business Address: FACII~IAGRAM ! N