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Home My WebLink AboutBUSINESS PLAN ITE DIAGR,~M ~ I~usine~ N~me: ' C~o~: FACILITY DIAGRAM Busine~ Address: For Office Use Only /95- '~. First In Stction: Inspection Station: Area Mcp# of NORT'H usiness Name: "' (-~,~;-'~::~7'" ~ _ Businms Address~ " ~ SANTA FE RAIL EXTENDEDSTAY ~MOT'EL EMPTY LOT CAMELOT PARK ACCESS ROAD ON THE BOARDER RESTAURANT o bURGER KING RESTAURANT JIFFY- LUBE TACO BELL o CALIFORNIA AVE Hazardous Materials/Hazardous Waste Unified Permit -PER ~,*~ :~?.CONDITIONS OF.. MITON REVERSE SIDE Permit ID #:: 015-000-001459 'CAMELOT.PARK ..~ .'~ :,LOCATION: 1251'OXKST~ ·, "' This _~mit is IsSued for the followin_u: El H.~nrdous Materials Plan [3 Underground Storage of Hn-_,.rdous Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment Issuedby: 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: dune 30. 2003 ]$$u¢ Date Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-0214)01459 CAMELOT PARK LOCATION 1251 OAK Issued by: .......... ,,~,~,~,!!~,?,? ~,~,, ,..,~,~ This permit is issued for the following: ..,,~:4!~q~ii%:~i::!i::!~::~'~:~''~:~:::ii ii~i!iJi, iii i~;~,i!iiii:;~:iiiiiii~ili~e[ground Storage of Hazardous Materials ...... .:.. .............. ~:::".-. :~ ~:;~: ~i:':~ ~: ......... .....~ 7=4~=.',. ~ ,~,,.':~i~~ ? ~,~i,.,~,.~,~,.,'..'.~ ~:.~ ~. Bakersfield Fire Department OFFICE OF ENVIRONMENTAL 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 HM~ P y- SITE DIAGRAM Business Name: t t P~ FACILITY DIAGRAM Business Address: For Office Use Only First In Stction: tnsoeotion Station: Area Mi=p # NORT.H of 08/20/2003 13:23 ~OOMERS! ~ J? 3 + ............... ~ ...................... SitelD: 015-021-001459 + Manager : __ %%%% BusPhone: (661) 325-5453 Location: 1251 OAK ST ~%%% Map : 102 CommHaz : bow City : BAKERSFIELD ~- Grid: 25C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title LAMONT LAVERT / GENERAL MANAGER -M~LTCi~ ~u~~%N-- /~~T~ Business Phone: (661) 325-5453x Business Phone: (661) 325-54~3x 24-Hour Phone : (661) 821-6703x 24-Hour Phone : (661) 327-1286x Pager Phone : ( ) - x Pager Phone :..~-S~!) C22=S~A- Hazmat Hazards: Fire Press ImmHlth 'DelHlth Contact : Phone: (661) 325-$453x MailAddr: 1251 OAK ST State= CA City : BAKERSFIELD Zip : 93304 Owner ~4EL~T ~w ~m~ ~ ~ Phone. 661 325-5453x Address : 1251 OAK ST state: CA City : BAKERSFIELD Zip : 93304 Period ~ ~,/~: to TotalASTs: = Gal Preparer~-~'~~-~ TotalUST~: ~ Gal Certif'~ ' RSs: No ParcelN Emergency Directives: 07/30/2003 CAMELOT PARK Manager :: · ~;J~'-' Location 1251 OAK ST ~ City :BAKERSFIELD <~/ CommCode: BAKERSFIELD STATION 03 EPA Numb: BusPhone: Map : 102 Grid: 25C SIC Code: DunnBrad: SiteID: 015-021-001459 (~05) 325-5453 CommHaz : Low FacUnits: 1 AOV: Emergency Contact ~ Title LAMONT LAVERT ~%~.~GENERAL MANAGER Business Phone: 24-Hour Phone : Pager Phone : ( ) - x .Hazmat HazardS: Fire ImmHlth ' DelHlth Contact : Phone: (~&~)~z~ -S~-Sx MailAddr: 1251 OAK ST ~_ State: CA City : BAKERSFIELD ~ ~/~~ Zip : 93304 Owner CAMELOT PARK LTD Phone: ~) 325-5453x Address : 1251 OAK ST '"~'~0~~ State: CA City : BAKERSFIELD Zip : 93304 · Period : to ~gO~ TotalASTs: = Preparer: TotalUSTs: = Certif'd: RSs: No Gal Gal = Hazmat Inventory --As Designated Order Hazmat Common Name... JSpecHaz EPA HazardsI Frm GASOLINE F IH DH L WASTE OIL F DH L 1], ~',,~/~,~,~7". C'/,~,~o hereby certify tha~ I have ~y~ or~p~m ~me) reviewed ~hs a~ach~d ~~s mal~als manage- mere plan ~o~~~F/~nd that il along ~ith (Na~ ~ ~s~) any corremions consti~me a compline and correc~ man- One Unified List All Materials at Site DailyMax Unit MCP 500.00 GAL Mod 55.00 GAL Low agement plan for my facilily. "'Date 09/05/2000 CAMELOT PARK SiteID: 015-021-001459 ---- Inventory Item 0001 Facility Unit: Fixed Containers at Site ~lvuvl~ ~vl~ / ~ ± ~.,q..~ ~Vl~ GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SW CORNER OF TRACK AREA CAS# 8006-61-9 r STATE I TYPE PRESSURE Liquid Mixture Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest ContainerGAL AMOUNTS AT THIS LOCATION Daily Maximum 500.00 GAL Daily Average 500.00 GAL HAZARDOUS COMPONENTS %Wt. 100.00 Gasoline CAS# 8006619 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA/// I USDOT# Mod Inventory Item 0002 Facility Unit: Fixed Containers at Site WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE RACE CART REPAIR SHOP CAS# 221 F STATE ~ TYPE Liquid I Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE. DRUM/BARREL-METALLIC Largest ContainerGAL i AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Waste Oil, Petroleum Based No CAS# 0 TSecret No SIBioHaz N No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA /// IUSDOT# MCP Low 2 09/05/2000 CAMELOT PARK SiteID: 015-021-001459 Fast Format ~ Notif./Evacuation/Medical --Agency Notification PHONE FOR AGENCY NOTIFICATION INSIDE MANAGERS OFFICE. Overall Site 07/07/1994 -- Employee Notif./Evacuation VOICE INTERCOM THROUGHOUT FACILITY. 07/07/1994 Public Notif./Evacuation PA SYSTEM. 07/07/1994 Emergency Medical Plan FULL FIRST AID KIT IN MANAGERS OFFICE. 07/07/1994 -3- 09/05/2000 CAMELOT PARK SiteID: 015-021-001459 Fast Format ~ Mitigation/Prevent/Abatemt -- Release Prevention CONVAULT TANK. Overall Site 07/07/1994 -- Release Containment ABSORBANT MATERIALS AVAILABLE. 07/07/1994 -- Clean Up Other Resource Activation -4- 09/05/2000 CAMELOT. PARK SiteID: 015-021-001459 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs A) GAS - OUTSIDE SE CORNER OF CASTLE B) ELECTRICAL - E SIDE OF CASTLE BLDG C) WATER - FD~CONNECTION AT NE CORNER OF PARKING LOT D) SPECIAL - NONE E) LOCK BOX - ABOVE W SIDE ENTRANCE 07/07/1994 Fire Protec./Avail. Water 07/07/1994 PRIVATE FIRE PROTECTION - SPRINKLERED BLDG, FIRE EXTINGUISHERS THROUGHOUT NEAREST FIRE HYDRANT - NE CORNER OF PARKING LOT Building Occupancy Level -5- 09/05/2000 CAMELOT PARK SiteID: 015-021-001459 Fast Format Training -- Employee Training WE HAVE 60 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS TRAINING BOOK Overall Site 07/07/1994 -- Page 2 -- Held for Future Use Held for Future Use 6 09/05/2000 CI~E~C~ DESCRIPTION ~)/N~ZNTORY STATUS: New [. ] Addition [ ] Revision {J] Deletion ~ ] Chemical Name: .~ Ch~.k if clmmcai is a NON Trad~ Secret [ t-~I"rmde Secret 3) DOT # (optional). 4) Physical & Health PHYSICAL HEALTH H-~,,'xtCategoti~ Fire["lR~cmive[ ]S,__,,~Rel~aseofPr~ssu~[~rm,,,_~i-,,,I-k~h(Acume)[ ]DelayedH~flih(Chruui¢)[ 5) WASTE CLASS~TION (3-disit ~ a,~... DHS Form 8022) USE CODE 6> PHYSICAL STATE Solid [ ] Liquid [ ] Oas [~ Pu~tJ<l ~ t { W~,~ t { I~ti~i,~ t I 7) A~OUNT AND ~ AT FACR.1T~ ; Lb,[ lO, ii Circle Which Months: 8) STORAGE CODES d~._/~ a) Coumiu~. b)~ ~ · c) T~,,u,~ ,~- , F, M, A, M, $, $, A, S, O, N, D COMPONENT CAS# % ~ ~ [ ] [ ] [. I 1 ) INYENTORY STATUS: N~v [ 2) Common Name: ].Addiliou[ {R~isiou[ ]Del~iou[ ] Check if chemical is a NON T~de Secret [ ]Tra~i ] · 3) DOT # (oplioual) Ch~uicai Name:. Ami[ ] c,,~# 4)Physical & H~alth · Hazard Calories S) wAsTE'cLASSIFICATION (~disit ~ fium DHS Form 8022) 6) PHYSICAL STATE .... Solid [ ]. Liquid [ ] Gas [ ]. Pu~ [ ] 7) AMOUNT AND TIME AT FACILITY UN1TS OF MEAS~ Eke[ ]Reactive[ ]Sudd~Rel~ofPr~m~[ ] Imm~lia~H~flth(Acu~)[ ]Delay~lH~allh(Chmuic)[ USE CODE ~Ua~[ ] Wa.~[ ] {U,aka:~i,~[ ] 8) STORAGE CODES Maximum Daily Amount Av. erage"Dail¥_ Amo~n.. t, # Days on Si~e MIXIIJRE: List ihe ~ mos~ {,--,-'dous I) chemical componen~ or' any AHM compon~uts 3) L~[ lC, ali ]f13[ ] Cu,i. [ I a) Couu~u~r:. b) Pressure: c) Temperatmm~ Ci~le WhichMonths: COMPONENT CAS# % WT [ I [ ! I ~ under p~uaiu/of law, ,~,,t I ~,ve p~'sonally ,.~,,,,i,,~d aud am familiar wi~h fl~ iuf~ auar. h~ d~mm~um I believe the submittal information is true, accurnt~ and ~mpl~. ~ "~ ' h:~'''' ' ;.~ PRIlqT Name & Title of Authorized Company Representative ture ..... / Dht~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME ~'~ ~, e l(& ADDRESS 12 $ i Oq ~'k FACILITY CONTACT k,~ ,.,.,, L- INSPECTION TIME INSPECTION' DATE.. [0 - Iq - ~" PHONE NO. '32~ - 5 "t' BUSINESS IDNO. 15-210- O O NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program. Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate ~ l~ ~' D~' ,~,,e t~-e__- '"' i e~ Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate t/' . Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand ~- C=Compliance V=Violation Any hazardoos waste on site?: ~'Yes [] N° Explain: ~lce O ~ i Questions regarding this inspection? Please call us at (805) 326-39?9 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy s Site Responsible Party Inspector: ~.Z/~ 03/25/96 CAMELOT PARK 215-000-001459 Overall Site with 1 Fac. Unit General Information Location: 1251 OAK ST City : BAKERSFIELD I Map:102 Haz:2 Type: 3 I Grid: 25C F/U: 1 AOV: 0.0 I Contact Name Title LAMENT LAVERT / GENERAL MANAGER Business Phone: (805) 325-5453x 24-Hour Phone : (805) 323-4424x Pager Phone : ( ) - x Contact Name Title IJEAN-PAUL DEMEURE / PROJECT MANAGER Business Phone: (805) 325-5453x 24-Hour Phone : (805) 665-1633x Pager Phone : ( ) - x Administrative Data Mail Addrs: 1251 OAK ST City: BAKERSFIELD Comm Code: 215-003 BAKERSFIELD STATION 03 D&B Number: State: CA Zip: 93304- SIC Code: Owner: CAMELOT PARK LTD Phone: (805) 325-5453 Address: 1251 OAK ST State: CA City: BAKERSFIELD Zip: 93304- Summary (Typ~ o pn '1%' nmn',e) reviewed the attached hazardous ' '~ ment plan for ~z~~~nd tha~. it ~.!on§ with any ~rm~ions constitute a ~mplete and coffe~ man- agement plan for my facili~. 03/25/96 CAMELOT PARK 215-000-001459 Hazmat Inventory List in MCP Order 02 - Fixed Containers at Site Page Pln-Ref Name/Hazards Form Max Qty MCP 02-001 GASOLINE Liquid 500 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 WASTE OIL Liquid 55 Low · Fire, Delay Hlth GAL 2 03/25/96 CAMELOT PARK 215-000-001459 02 - Fixed Containers at Site Hazmat Inventory Detail in MCP Order Page 02-001 GASOLINE ~ Fire, Immed Hlth, Delay Hlth Liquid 500 Moderate GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: FUEL Daily Max GAL500 I Daily Average500.00GAL Annual Amount GAL 500.00 Storage ABOVE GROUND TANK Press T Temp Location IAmbient~AmbientlSW CORNER OF TRACK AREA -- Conc 100.0% IGasoline Components MCP ---~uide ModerateI 27 02-002 WASTE OIL ~ Fire, Delay Hlth Liquid 55 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL55 I Daily Average55.00GAL Annual Amount GAL 55.00 Storage DRUM/BARREL-METALLIC Press T Temp Location IAmbient~AmbientlINSIDE RACE CART REPAIR SHOP -- Conc~ Components 100.0% IWaste Oil, Petroleum Based MCP --TGuide Low ~ 27 03/25/96 CAMELOT PARK 215-000-001459 00 - Overall Site <D> Notif./Evacuation/Medical Page 4 <1> Agency Notification PHONE FOR AGENCY NOTIFICATION INSIDE MANAGERS OFFICE. <2> Employee Notif./Evacuation VOICE INTERCOM THROUGHOUT FACILITY. <3> Public Notif./Evacuation PA SYSTEM. <4> Emergency Medical Plan FULL FIRST AID KIT IN MANAGERS OFFICE. 03/25/96 CAMELOT PARK 215-000-001459 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page 5 <1> Release Prevention CONVAULT TANK. <2> Release Containment ABSORBANT MATERIALS AVAILABLE. <3> Clean Up <4> Other Resource Activation 03/25/96 CAMELOT PARK 215-000-001459 00 - Overall Site <F> Site Emergency Factors Page 6 <1> Special Hazards <2> Utility Shut-Offs A) GAS - OUTSIDE SE CORNER OF CASTLE B) ELECTRICAL - E SIDE OF CASTLE BLDG C) WATER - FD CONNECTION AT NE CORNER OF PARKING LOT D) SPECIAL - NONE E) LOCK BOX - ABOVE W SIDE ENTRANCE <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLERED BLDG, FIRE EXTINGUISHERS THROUGHOUT NEAREST FIRE HYDRANT - NE CORNER OF PARKING LOT <4> Building Occupancy Level 03/25/96 CAMELOT PARK 215-000-001459 00 - Overall Site <G> Training Page 7 <1> Employee Training WE HAVE 60 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS TRAINING BOOK <2> Page 2 <3> Held for Future Use <4> Held for Future Use BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION 1715 ~CHESTER ~.AVE:~ · BAKERSFIELD, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 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 brief and concise as possible. SECTION l' BUSINESS IDENTIFICATION· DATA BUSINESS NAME' LOCATION: MAILING ADDRESS: CITY: STATE:_ ZiP: DUN & BRADSTREET NUMBER: PHONE: SIC CODE: PRIMARY ACTIVITY: OWNER: MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION: CO NTACT TITLE BUS. PHONE 24 HR. PHONE .1. .. i~akersfield Fire Dept. l~I~ardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN 'SECTION 3: TRAINING: NUMBER OF EMPLOYEES: dO MATERIAL SAFETY DATA SHE~S ON FILE: BRIEF SUMMARY oF TRAINING PROGRAM: /IAsDs T-f4 d, SECT[ON 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 OD NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEED THE MINIMUM REPORTING QUANTIZ. IES. SECTION 5: OTHER (SPECIFY REASON) CERTIFICATION: CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. 1. UNDERSTAND ·THAT THIS INFORMATION WILL·BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFET'Y CODE!' ON HAZARDOUS MATERIALS (DIV.. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT ATiO N- CO NSTiTUTES~-~ ,~----_.,PERJURY' ~__~/~ / 2. TITLE DATE. '- Bakers~elcl Fire Dept. PIazardous lVIaterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facilfl7 Unit Name: SECTION 6: NOTiFiCATION AND EVACUATION PROCEDURES: AGENCY NOTIFICATION PROCEDURES: EMPLOYEE NOTIFICATION AND EVACUATION: PUBLIC EVACUATION: EMERGENCY MEDICAL PLAN: · Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN' ko RELEASE PREVENTION STEPS: 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: LOCKBOX: Y~NO iF YES, LOCATION' --'~¢~ 6,.-J ~,O~: ~~~ SECTION 9: PRIVATE FiRE PROTECTION/WATER AVAILABILITY: Ao PRIVATE FiRE PROTECT[ON: WATER AVAEABE[TY (,FIRE HYDRA,N"'0: : HAZARDOUS MATERIALS DIVISION .].715 CHESTER AVE. BAKERSFIELD, CA. 93301 (805) 326-3979 JON 1 4 1994 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME FACILITY NAME SiTE ADDRESS CITY NATURE OF BUSINESS SIC CODE STATE DUN 8, BRADSTREET NUMBER ZiP ~'""~ ~ OWNER/OPERATOR MAILING ADDRESS PHONE CITY STATE ZIP NAME L. ,'a~"~'xN~ BUSINESS PHONE EMERGENCY CONTACTS TITLE ~.7_.--,J - 24-HOUR PHONE 442-4 BUSINESS PHONE TITLE 24-HOUR PHONE P,E. GK~N¥ LEP~ STA,NOAP, O F. BAKERSFII D Ci'i' FIRE DEPAR i IENT HAZARETOUS MATERIALS INVENTOI"F¢ usiness Name Address Page- of CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ) Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET 2) Common Name:,~ A<~.,rCJ ~/LZ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate HeaJth (Acute) [ ] Delayed HeaJth (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSlCALSTATE Solid [ ] Uquid ~ Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACIUTY Maximum Daily Amount: Average Daily Amount: Annual Amount: Largest Size'Container: # Days On Site '"~6~' UNITS OF ME~SURE lbs [] gal curies 8) STORAGE CODES a) Container: b) Pressure: c) Temperature: Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: Ust the three most hazardous chemical componen[s or any AHM components COMPONENT CAS # % W'l' AHM 4) [] 2), [ ] 3) [ ] CHEMICAL DESCRIPTION INVENTORY STATUS: New[ ] Addition[ ] Revision[ ] Deletion[ ] Check if chemical is aNON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: ,3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD'¢'~CEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) V~/ASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid ~ Gas [ ] Pure [ ] Mixture [ I Waste [ ] Radioactive 7) AMOUNT AND TIME AT FACIU'r~ Maximum Daily Amount: ~'".-~" Average Daily Amount: Annual Amount: L~rgest Size Container: -~ ~' # Days On Site ~--'"~'~ UNITS OF MEASURE 8) STORAGE CODES lbs [ ] gal [ ] fi3 [ ] a) ContaJner: cudes [ ] b) Pressure: c) Temperature: Circle Which Months: All Year. J, F, M, A, M, J, J, A, S. O. N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) [ ] chemicat components or any AHM components 2) [ ] 3) [ 1 10) LocaJon //'~5,/'3~" ~,~E.E ~_..~'T' ~(~, ~ .574-(C,7(~ submitted.information is ~.~e, ac.curate, and complete, PRINT Name & Title of Authorized Company RepresentatJ've ' ' Date CAMELOT P 05 325 4158 P.01 Fuel Handling Procedures, August 25,1994 Go Karts 1, Must be_ 18 ye~_~o_r_older_to_fuel Karts ~aKe-th_e_-hos'e~frem-thegas-tank. and_put it in the gas boy~.. · % o~,. ~'~--g~ boys while any Karts are on the tr~l~~n-~-°peration 4, Only use_ two furthest lanes, away from customers ( 15 feet ) 5. All Karts must be fumed off dudng fueling 6. No customers ~re allowed in the pets 7, :r,J~-st~e the gas boy next to the car Shop at least ( 40 feet ) from the customers 8, The Material Safety Data Sheets are available in the front office 9. The employee training manual is located in the front office __10. Any questions ask a manager~ · Boat~ 1. Must be 18 years or older to fuel Boats ~_~_~_~.?~t you take the hose_~m- t~_he ga_s_ t..a.9 .k. and put [t in the gas bo~.~) 3. Do not use gas boys while any Karts are running 5. Only truel boats tn res~cted area ~ ~ ;J '7 6, All boats must~be off during fueling 7, Keep gas boy stored in the restricted fence area, away from the customers (10 I~e~)'? 8. The Material Safety Data Sheets are available In the front office 9, The employee training manual is located in the front o~fice ~ · - 10. Any questions ask a manager CAMELOT PARK BAKERSFIELD FUEL HANDLING PROCEDURES SEPTEMBER 8, 1994 GO KARTS 2. 3. 4. o 6. 7. 8. 9. 10. 11. Any employee's fueling the Karts must be 18 years or older. Fill the gas boy from the above ground fuel tank located at the southwest corner of the Go Kart track. Do not use gas boys while any Karts are on the track or in running operation. Only use two furthest lanes, away from customers, to fuel Karts (15 feet) the three lanes closest to the customers are never to be used for fueling. All Karts must be turned off during fueling. Never allow any customers in the pits during fueling, they must wait behind the railing. Then store the gas boy next to the car shop at least (40 feet) from the customers. The Materials Safety Data Sheets are available in the front office. The employee training manual is located in the front office. Any questions concerning these fuel handling procedures, contact a manager. Once Kart is full, reverse direction of hand pump to suck fuel out of fill hose. BOATS 2. 3. 4 6. 7. 8. 9. 10. 11, Any employee's fueling the Boats must be 18 years or older. Fill the gas boy from the above ground fuel tank located at the southwest corner of the Go Kart track. Do not use gas boys while any Karts are running on the track. Only transport gas boy to the Boat area when the park is free of customers (Before or after operating hours). Only fuel boats in the restricted area. All boats must be off during fueling. Keep gas boy stored in the restricted fence area, away from the customers (10 feet). The Material Safety Data Sheets are available in the front office. The employee training manual is located in the front office. Any questions concerning these fuel handling procedures, contact a manager. Once Boat is full, reverse direction of hand pump to suck fuel out of fill hose. Signed by: Date: CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT i'd~'~ 0068 Sub Div. Blk. . Lot You are hereby required to make the following corrections at the above location: Cot. lqo i Completion Date fo,' Corrections Date__~,/~ q,,/~,~. -/9~g/~ ~~_ Inspector 326-3979 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT i'~J~ ' 0069 Location Sub Div. Blk LOt You are hereby required to make the following corrections at the above location: Cot. No Completion Date fo,' Corrections Dato ~/~-~//G' ~f "~' 326-3979 Business Name; Contact Name: ~, Business Phone: Inspector's Name: Time of Call: Date: Type of Call: Incoming RECORD OF TELEPHONE CONVERSATION ID# Time: Outgoing ~ ~0 # Min: t [] Actions Required: Time Required to Complete Activity # Min: Coro No CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT 0068 Sub Div ..... Blk. . Lot. You are hereby required to ~nake the following corrections at the above location: Completion Date for Corrections I~spectot 326-3979 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT i',J2 0069 Location Sub Div. Blk. . Lot You are hereby required to make the following corrections at the above location: Cor. No c,) ~,-, t~ Completion Dale for Corrections Date ~/P":~//'~(/' /~"t'¢-~..-~_f.. (~./lfi~L. _. Inspector 326-3979 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT 'OO6D Sub Div. Blk Lot You are hereby required to make the following corrections at the above location: Cot. No - ~? Completion Date for Correetions ~at~ 7/~/~V ' ~~ ~¢~ 'Inspector ':~, .~.... 326-397.9 CORRECTION NO'TICE' BAKERSFIELD.FIRE DEPARTMENT' Location O. Awxo_.\~"k /~t~70~. Sub Div. Blk.. Lot You are hereby required to make the following corrections at the above location: Cot. ~o [ Of Phone Phone Number Area Code Phone Number Telephoned I ~ Returned Cell I ~i~ Left Packege ;leesoC.. I~.1 Wesln I IP'ees'Se'Mei w,,,~.,,,.,g.,n I I W,,,R.t.,rn I I ,m,,o...t Messege ~ AV~I~Y Signed REORDERNO. 5~226 Made With Recycled Pal:mr