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Home My WebLink AboutBUSINESS PLANHazardous Materials/HazardOus Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID#:: 015-000-000745 GENE DAVENPORT LOCATION: 2113 Q ST Issued by: 'IELD This oermit is issued for the following: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program · 'El Hazardous Waste On-Site Treatment Approved by: Expiration Date: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 · Voice (661) 326-3979 FAX (661) 326-0576- Issue Date June 30; 2003 IT~ DIAGRAM Bu~L, teu Name: Bu~n~ Address: ORTH I TE/FACI LI TY FORM DI AGR~%I~ ,. SCALE: BUSINESS NAME DATE :'?/,q/~7 FACILITY N~ME': (CHECK ONE) SITE DIAGR.~M FLOOR: OF UNIT ~ ~: OF FACILITY DIAGR.&M 'Z.I l(Inspector's Comments): -O~FI,~IAL iUSE ONLY- - SA - SITE DIAGRA~ (Requlr..~lteme) 1. Address: 'Identify the principle buildings by the Street numbers. 2. Street(e), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. 3. Storm Drains, Culverts, Yard Drains 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. Water 7. Fire Suppression Systems: a. Fire Hydrants b. Fire Sprinkler Connections c. Fire Standpipe Connections d. Water Control Valves for protection systems e. Fire Pump 8. Fire Department Access 9. Lock (key) Box 10. MSDS Storage Box 11. Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood d. Gates 13, Powerllnes 14, Guard Station 15, Storage Tanks: Identify the capacity in gal. a. Above ground b. Underground 16. Diking or Berm 17. Evacuation Route 18. Evacuation Area: Identify the location where employees will meet. 19. Outside Hazardous Waste Storage 20. Outside Hazardous Material Storage 21. Outside Hazardous Material Use/Handling 22, Type of Hazardous Material/Waste Stored or Used (See Below) TYPE OF HAZARDOUS RATERIAL F = Flammable E - Explosive L - Liquid C .= Corrosive 0 - Oxidizer O = Gas W = Water Reactive T - Toxic S = Solid D = Waste B = Etiological Example: Flammable Liquid = FL 6. Attic Access. FACILITY DIAGRAM (Required items tn addition to the. abo~e) 1. Risers for Sprinklers 8. 2. Partitions 9. 3. Stairways: Indicate the 10, levels served from highest to lowest. 11. 4. Escalator: Indicate the levels served from 12. highest to lowest. S. Elevator ...... - -'.13.' 14. 7. Skylights R = Radtologlcal P = Poison H = Cryogenic Fire Escapes Air Conditioning Units Windows Inside Hazardous Waste Storage Inside Hazardous Materials Storage Inside Hazardous Materials Use/Handlln~ Sewer Drain Inlets : GENE DAVENPORT AUTOM~VE Manager : Location: 2113 Q ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 04 EPA Numb: siteID: 0'i5 r~021- 000746 BusPhone: (661) 323-9535 Map : 103 CommHaz : Moderate Grid: 30B FacUnits: 1 AOV: SIC Code:7538 DunnBrad: Emergency Contact / Title GENE DAVENPORT / Business Phone: (661) 323-9535x 24-Hour Phone : (661) 589-3310x Pager Phone : ( ) - x Emergency Contact~' / Title CORVIN DAVENPORT / Business Phone: (661) 323-9535x 24-Hour Phone : (661) Pager Phone : ( ) Hazmat Hazards: ImmHlth DelHlth Contact : MailAddr: 2113 Q ST City : BAKERSFIELD Phone: (661) 323-9535x State: CA Zip : 93301 Owner GENE DAVENPORT Address : 32339 AMY City : BAKERSFIELD Phone: (661) 589-3310x State: CA Zip : 93312 Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: i, ~e,~ ~,~ Do hereby certify ~ha! I hays ~ ~ ~i.~ ~,e) " ~v~ed ~he a~ach~d h~ar~gus maiedals m~ni plan for ~,,~ ~o~,~ and fh~i ~f alon~ ~ifh a~m~m Pla~ for rny facility. 1 08/13/2003 GENE DAVENPORT AUTOM~VE = Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME SOLVENT Location within this Facility Unit W OUTSIDE SiteID: 015-021-000746 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 64742-88-7 F STATE -- TYPE Liquid Pure PRESSURE TEMPERATURE Below Ambient I Below Ambient CONTAINER TYPE DRUM/BARREL-NONMETAL Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average I 55.00 GAL HAZARDOUS COMPONENTS I%Wt. I 100.00 Naphtha Solvent TSecret No NoRS BioHazINo Radi°active/Am°untNo/ HAZARD ASSESSMENTS EPA Hazards I NFPA USDOT# MCP Curies IHI / / / Mod -3- 08/13/2003 GENE DAVENPORT AUTOMOTIVE Manager : ' [, ~' MAR 5 1999 Location: 2113 Q ST City : B~ERSFIELD CommCode: B~ERSFIELD STATION 01 EPA Nu~: SiteID: 215-000-000746 BusPhone: (805) 323-9535 Map : 103 CommHaz : Moderate Grid: 30B FacUnits: 1 AOV: SIC Code:7538 DunnBrad: Emergency Contact GENE DAVENPORT Business Phone: 24-Hour Phone : Pager Phone : / Title / (805) 323-9535x (805) 589-3310x ( ) - x EmergenCy Contact / Title CORVIN DAVENPORT / Business Phone: (805) 323-9535x 24-Hour Phone : (805) 397-6143x Pager Phone : ( ) - x Hazmat Hazards: ImmHlth DelHlth Contact : MailAddr: 2113 Q ST City : BAKERSFIELD Phone: ( ) State: CA Zip : 93301 X Owner GENE DAVENPORT Address : 32339 AMY City : BAKERSFIELD Phone: (805) 589-3310x State: CA Zip : 93312 period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory --As Designated Order Hazmat Common Name... USED OIL ' DH L SOLVENT ~, ~z ~v~f,~ O0 hereby ce~i~ ~hm ! i~ave L men~ plan ~,r~ ~~ g~~ I~ along with an~ ~rr~ons ~s~i~ a ~mpl~s and co~s~ man- One Unified List Ail Materials at Site 200 GAL Low 55 GAL Mod agemsn~ p~an ~or my ~li~y. -1- : 02/18/1999 GENE DAVENPORT AUTOMOTIVE ~ Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME USED OIL Location within this Facility Unit SOUTHWEST OUTSIDE SiteID: 215-000-000746 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 221 V STATE ~ TYPE Liquid I Waste PRESSURE TEMPERATURE CONTAINER TYPE I Below Ambient I Below Ambient I DRUM/BARREL-METALLIC Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 200.00 GAL Daily Average 100.00 GAL HAZARDOUS COMPONENTS %Wt. I 100.00 Waste Oil, Petroleum Based CAS# HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies DH NFPA/// I USDOT# Low ---- Inventory Item 0004 -- COMMON NAME / CHEMICAL NAME SOLVENT Location within this Facility Unit SOUTHWEST OUTSIDE Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 64742-88-7 FSTATE ~ TYPE Liquid /Pure PRESSURE TEMPERATURE CONTAINER TYPE I Below Ambient I Below Ambient I DRUM/BARREL-NONMETAL Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55100 GAL HAZARDOUS COMPONENTS %Wt. I 100.00 Naphtha Solvent No 8030306 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies IH NFPA/// I USDOT# Mod 2 02/18/1999 GENE DAVENPORT AUTOMOTIVE SiteID: 215-000-000746 Fast Format = Notif./Evacuation/Medical --Agency Notification CALL 911 Overall Site 01/07/1990 -- Employee Notif./Evacuation CALL BAKERSFIELD CITY FIRE DEPT AND VERBAL EVACUATION. 01/07/1990 -- Public Notif./Evacuation DUE TO SIZE OF SHOP NO EVACUATION IS NEEDED 01/07/1990 Emergency Medical Plan NEAREST HOSPITAL. 01/07/1990 -3- 02/18/1999 GENE DAVENPORT AUTOMOTIVE SiteID: 215-000-000746 Fast Format = Mitigation/PreVent/Abatemt --Release Prevention WE STORE HAZARDOUS MATERIAL IN BARRELS AND PAY CRANES HAZARDOUS WASTE TO GET RID OF IT. IF SPILL SHOULD OCCUR I WOULD CALL THE BAKERSFIELD CITY FIRE DEPT. Overall Site 03/20/1992 --Release Containment 03/20/1992 ACETYLENE/OXYGEN - ATTEMPT TO STOP SOURCE OF RELEASE. EVACUATE ALL PERSONNEL FROM AFFECTED AREA. REMOVE SOURCE OF HEAT OR IGNITION AND VENTILATE AREA. SOLVENT - STOP FLOW AND SHUT OFF ALL SOURCES OF IGNITION. ABSORB WITH DIATOMACEOUS EARTH OR OTHER INERT MATERIAL. WIPE OR MOP UP OR WASTE OIL - AVOID BREATHING OF OIL MIST, REMOVE OIL SOILED CLOTHING, WASH -- Clean Up 03/20/1992 ACETYLENE/OXYGEN - NO DISPOSAL PROBLEM GAS WILL DIFFUSE INTO THE ATMOSPHERE. MOVE CYLINDER TO A'REMOTE OUTDOOR AREA. SOLVENT - WIP OR MOP UP, ABSORB WITH DIATOMACEOUS EARTH OR OTHER INERT MATERIAL. WASTE OIL - MOP OR WIPE UP OR ABSORB WITH CLAY, DIATOMACEOUS EARTH OR OTHER INERT MATERIAL. Other Resource Activation -4- 02/18/1999 GENE DAVENPORT AUTOMOTIVE SiteID: 215-000-000746 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs A) GAS - IN ALLEY NORTHWEST CORNER OF BUILDING B) ELECTRICAL - INSIDE NORTHEWEST CORNER OF BUILDING C) WATER - FRONT SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO 01/07/1990 -- Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 2 FIRE EXTINGUISHERS 01/07/1990 FIRE HYDRANT - CORNER OF 21ST AND Q STREETS Building Occupancy Level -5- 02/18/1999 GENE DAVENPORT AUTOMOTIVE SiteID: 215-000-000746 Fast Format ?raining Employee Training Overall Site 03/20/1992 WE HAVE 1 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. REVIEW ALL MATERIAL SAFETY DATA SHEETS. -- Page 2 --Held for Future Use ~ Held for Future USe -6- /1 - Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ............. ~,,;;,,~;,;¢~;;~;~;.~:;~,,;~;,,,,~;,,,,~,;....,;~ ....... This permit is issued for the following: · ~ a?;i? i; ::iI iii::iil;ii?~i:i:?;;iiiii~;iii;ill !!i?~:!;Hazardous Materials Plan ~ ¢¢i ?i' ?, !:P:"~:;~::;i i!i ii~, ;iiiil;i ii;:;~:, i?~iia:::iiU~e[ground Storage of Hazardous Materials G EN E DAVE N PORT A T '~'"¢='~' U~'~''~ *iii,, '~.iiii~ :~i~!~:!:::=:,~:;~::~:~;i:::::,i= ::;::[: i ;': :.!!:;:i:::;i' ;:'~=;i =' '-:~:!:!i ~!i~a~d~s Waste LOCATION 2113 Q :. · ~.....~ ~ ~..'~,. ,..'~: . ¢ ~, ,. '., ~.r · ~,'"'... , ~ ..... .. ~ , . ..,. ,,.,.. ~.. ,~ . , , ~ ........... -~ E~r 3~..~ ~..-'.:,i ~ .. ' ... ~ ..~ ~." ~- : ~: i~- '% ""...::i~ i ~ ~' ~";J~"='~;.. '""T' "~'~'~ ~,.,~,~' '~ ~ ' ~,~:~ i,~ a~" ' ~" '%". -.- '""::: ,~'~ %~...- Issued by: 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 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 Overall Site with 1 Fac. Unit General Information Page Location: 2113 Q ST Map: 103 Hazard: Moderate Community: BAKERSFIELD STATION 01 Grid: 30B F/U: 1AOV: 0.0 Contact Name GENE DAVENPORT' CORVIN DAVENPORT Title BUsiness Phone (805) 323-9535 x (805)'323-9535 x -- 24-Hour Phone- (805) 589-3310 (805) 397.6143 Administrative Data Mail Addrs: 2113 Q ST City: BAKERSFIELD Comm Code: 215-001 BAKERSFIELD STATION 01 D&B Number: State: CA Zip: 93301- SIC Code: 7538 Owner: GENE DAVENPORT Address:'32339 AMY City: BAKERSFIELD 'Phone: State: CA Zip: 9331~ Summary .RECEIVED 1902, HA7 I~t~T. DIV. reviewed the mt~ched 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 2 02-001 ACETYLENE · Fire, 'Pressure, Immed Hlth Gas 300 High FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3. 300 Daily Average FT3 300.00 Annual Amount FT3 300.00 Storage FIXED PRESS. CYLINDER Press T Temp Location -- Conc 100.0% IAcetylene Components MCP - List 02-002 OXYGEN · Fire, Pressure, Immed Hlth Gas 300'Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3' 300 Daily Average FT3 300.00 Annual Amount FT3 300.00. Storage FIXED PRESS. CYLINDER .Press T Temp IAbove ~Above ISOUTHEAST Location -- Conc 100.0% IOxygen~ Compressed Components MCP ILow iList 02-003 USED OIL · Delay Hlth Liquid 200 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: LUBRICANT Daily Max GAL' 200 Daily Average GAL 100.00 Annual Amount GAL -- 200.00 Storage DRUM/BARREL-METALLIC Press I Temp IBelow ~Below Loc~tion ISOUTHWEST ouTSIDE -- Conc ~ Components 100.0%IWaste Oil, Petroleum Based MCP Low iList 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 .02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 02-004 SOLVENT Liquid- · Immed Hlth 55 GAL Moderate CAS #: 64742-88=7 Trade Secret: No Form: Liquid TYpe: Pure Days:. 365 Use:' LUBRICANT Daily. Max ' GAL Daily Average GAL ---q-- Annual Amount GAL -- 55.00~ 55.00 Storage DRUM/BARREL-NONMETAL Press T Temp IBelow ~Below Location ISOUTHWEST OUTSIDE -- Conc 100.0% INaphtha Solvent Components MCP ----[List IModerateI 02~24/92 'GENE'DAVENPORT AUTOMOTIVE 21~-000-000746 00 - Overall Site <D> Notif./Evacuation/Medical Page <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation CALL BAKERSFIELD CITY FIRE DEPT AND VERBAL EVACUATION. <3> public Notif./Evacuation DUE TO SIZE OF SHOP NO EUACUATION IS NEEDED <4> Emergency Medical Plan NEAREST HOSPITAL. 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 00 - Overall Site <E> Mitigation/Prevent/Abatemt / Page 5 <1> Release Prevention WE STORE HAZARDOUS MATERIAL IN BARRELS AND PAY CRANES HAZARDOUS WASTE TO GET RID OF IT. IF SPILL SHOULD OCCUR I WOULD CALL THE BAKERSFIELD CITY FIRE DEPT. <2> Release Containment <3> Clean U_p~ ~ · ,. ~ /~ ~ ~ . <4> Other Resource Activation 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 00 - Overall Site <F> Site Emergency Factors Page 6 <1> special Hazards <2> Utility Shut-Offs' A) GAS - IN ALLEY, NORTHWEST CORNER OF BUILDING B) ELECTRICAL - INSIDE NORTHEWEST CORNER OF BUILDING C) WATER - FRONT SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water 'PRIVATE FIRE PROTECTION -.2 FIRE EXTINGUISHERS .FIRE HYDRANT - CORNER OF 21ST AND Q STREETS <4> Building OcCupancy Level 02/24/92 GENE DAVENPORT AUTOMOTIVE 215-000-000746 00 - Overall-Site <G> Training Page <l>.Page 1~ WE HAVE ~ EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. REVIEW ALL MATERIAL SAFETY DATA SHEETS. <2> Page 2,as needed <3> Held for Future Use <4> Held for FUture ,Use .I F E ~ 0 ~ 'i~ certi~-- . ~ ' ~?-that I have ~evie~ed the ,S~ ........ :... attached Hazardous Materials business plan (.name of business) and that it along with the attached additions or corrections constitute a complete and'correct Business Plan for my 'facility. _ __ si~na~/urel · th, ~ 0..d [ .,- VE LOCATION E i i :~ (,} ST. LF-IST CHANGE 07IZ8/88 BY ESTER JUR,IS COOE Z1S-001 JUR!S BAKERSFIELO STPF[ION MAP. PAGE i03 GRID 308 FACILITY UNITS t HAZARD RFtTING 3 RESPONSE SUMMARY ZR .:SEC 4) NO PRIVATE RESPONSE SUMMARY EMERGENCY CONTACTS ZA SEC GENE DAVENPORT - ]23-BS3S OR S8B-]]IO' C~RVIN DAVENPORT - 323-BS35 OR 397-G143 UTILITY SHUTOFFS ZA SEC A) G~S - IN ALLEY NW CORNER OF BLBG B)'ELECTRICAL - INSIOE NW CORNER OF BLDG C). WATER - FRONT SIDEWALK D) SPECIAL - NONE E) LOCK BOX -' NO Z. iNOTIFtCATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECOROED FOR THIS SECTION > PA6E ~ z MATERIAL :SAFETY DA'FA SYSTEMS, INC, (@05)' IS48.-GB(~X~ .'' ' I,,f~.~b GENE OR~.;ENPORT I._OCRTiON Z i 1.5 6/ ST HIGH HAZARD RRTtN6 3 3. HRZ MAT TRR[N!~ SUHMRRY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > At.: LOCAL EMERGENCY MEDICAL ASSISTANCE SEC 5> NEAREST HOSPITAL. LAST CHANGE 07/Z8/88 BY ESTER· PAGE 2 MATERtRL SAFETY DRTR SYS'FEMS~ INC. (805) B48-B8(z~ 1Z/ZB/88 1':16' .; ~. OVERFILL H~tZAROOUS MRTERIP, LS INVENTORY L,~ST (]HP~NGE 07/Z8/88 BY ESTER ID TYPE N.qME MAX RMT UNIT .HAZARD LOCAT I ON CONTAINMENT' { c ;Z PURE ACETYLENE, SW INSIDE ID PERCENt COMPONENTS iZ41.00 i00,0 ACETYLENE PORTABLE Nc PRE==, CYL. PURE OXYGEN .SW INSIDE PORTABLE PRESS. CYL' ID PERCENT COMPONENTS Z3S9,00 100.0 OXYGEN, COMPRESSED 300 FT3 EXTREME gELOING/SOLOER!~ HAZARD'LIST EXTREME 300 FT3 HIGH WE[OIN$/SOLOERING HAZARO LIST HIGH, ,4 WASTE USED OIL SW OUTSIDE -' ID PERCENT COMPONENTS ISB8,(Z~ 100,0 WASTE OIL · .~ SOLVENT SW OUTSIDE ID PERCENT COMPONENTS iZ0~.0~ 100.0 NAPHTHA SOLVENT Z~) 8BL UNKNOWN DRUMS OR 8RRR NON MET, LUBRICANT HAZARD LIST UNKNOWN SS BBL EXTREME DRUMS OR BARR NON MET. LUBRICANT 'HAZARD LIST -EXTREME B. FIRE] PROTECTION / WATER SUPPLIES '~ LAST CHGNGE. / / BY < NO INFORMATION RECORDED FOR THIS SECTION Y PaGE MATERIAL S{4FETY. O~T~t SYSTEMS, INC. (80S> B48-68~ fZ/Z~/'88 ff:fG" BUsiNESS NAME GENE OEVENPORT AUTOMOTIVE LOCi~TION 2t13 O ST' O. E~'iPLOYEE NOTIFICATION / EVACUATION HIGH Hf.-iZf~RD RATING ~ LEST CHANGE ,~7/Z8/88 BY ESTER 3R. SEC 2) CALL BAKERSFIELD CITY FIRE OEPT.RND VERBAL EVACU~TION~ E. MITIGRTION/ PREVENTION / RBRTEMENT LAST CHANGE 07/Z8/88 BY ESTER SEC 1) WE STORE HAZARDOUS MATERIAL IN BARREL'S AND PRY CRANES HAZARDOUS ~ASTE TO GET RID'OF IT. IF SPILL SHOULD OCCUR I gOULD CALL THE BAKERSFIELD CITY FIRE DEPT. PR~'E 4 MATERIAL sAFETY ORTR SYSTEMS. INC. (80S) 648'-68~ 1Z/ZB/88 ll:lIS - ~' ~" .~- CITY of BAKERSFIELD. ZIP' ~~'%~ [~t~ ~C~/ CITY, ZXPt · ~,/~~ ~ ~ '~ / ..... rod, Code Amt' ' Ami Est Units o1~ Site lyp~ Prell 1#p Code .. '~~~~'2 ~~ ~ ~Lc ~ ~ .......... ~-~--~ , ~ 1 :~-- J -~-~-: - - ~ · -~ .... ~-~-~ ........ - ..... fr.t~ all that apply) ,.: -- ire Hazard L__ Reactivity L--J ~18yrd L d~ ReIIeII ~ ] 1~latl -'. Health of Presiure H~lth Cm~t *11 Naa I C,A.9, Number (~heck all t~t apply) ': ::; Ca~t It NaN &'C,A,S, Nuahr [ e Hazard u--a Reactivity Health .of Prfflu H~lth ' 'i : (~ck ali that apply) ' ' ' r -? . r - ~ [- q/ r - ~ r-- 1 ' ~t Il NaN & C.A.S. Numar · · . Health at ~rl~surl n~ ~ . ' I . . C~mt I] Nam i C.A.S, Numar (Check all that apply) ' ~ ~ ~/~ ~P--/ I --"l .... ' ' ' -- ' / ' ' /-~ ..... ~ ~. .... ,.,~ ~.,,.,,~_~..,,,.,.~-.,~,~. . · ~ .... ~- ...... ~ ....................................... -4 ....... [ ,~,~,~ co, uc~s .,sa~~'/~,--~ ..... ~Cert~fication (Read and stRn after compJetlnlT all sections) r ~f nd*r e~alt of lam that ! have oersonally examined and ae fselliar vtth the Information su~t~ In this l~lll Ittac~ d~ts, end t~t based ~ ~ inquiry of t~se)ndtvldu~is'res~sible ~ ~ ~ ~' ~_~ .......................... BAKERSFIELD. CITY FIRE DEPARTHENT 21:3o G" 'STREET BAKERSFIELD, CA- 9:3301' .(805) 326,3979 BUSINESS NAME HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 00 746 1..To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION, 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: B. LOCATION / STREET ADDRESS: · 12 I I ~'~ ST'- SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-8S2-7880 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. SECTION 8: LOCATION OF ~ILI~ S~-OFFS FOR BUSI~SS AS A ~OLE AFTER BUS. HRS. Ph# ~4'~z~' ~ ~ 0 A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER:. D. SPEC. IAL: E. LOCK! BOX: YES / NO IF YES, LOCATION: IF YES,, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO YES / NO MSDSS? KEYS? YES / NO YES / NO 2A - · SECTION 4: PRIVATE RESPONSE TEA~4 FOR BUSINESS AS A ~'IOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: Er~PLOYEE TRAINING. 'EMPLOYERg ARE REQUIRED,iTO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITHi:INITIAL AND 'REFRESHER ·TRAINING 'IN THE FOLLOWING AREAS. '- CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS:...- .................. .................. YES B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES~ C. PROPER USE OF SAFETY EQUIPMENT: .................. YES D. EMERGENCY EVACUATION PROCEDURES: ................. YES E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES REFRESHER YES NO YES NO YES NO · YES NO YES NO SECTION 7: HAZARDOUS I~ATERIAL CIRCLE YES OR NO,~ DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUND~-~F A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ~___F~S/NO I,~T. ~,~o~ , certify that theabove information is accurate. I understand that thi~ information will be used.to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. - 2B - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 BUSINESS NAME: OFFICIAL USE ONLY ID# BUSI NESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS :1. To avoid further action, this' form must be returned 1)yi 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Ans~er the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FAC'ILI~ UNIT~ I FACILI~ b~IT N~ME: ~ SECTION 1: MITIGATION, PRE~NTION, ABATEMENT PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS U?~IT ONLY SECTION 3: HAZARDOUS ¥,ATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... If YES, see B. If NO, cpntlnue with SECTION 4. YES NO B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous material~ inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition tn the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGeNcY RE,PONDERS SECTION 6: LocATIoN OF UTILITY SH~3T-OFF~ AT THIS UNIT ONLY. A. NAT. GAS/PROPANE': B. ELECTRICAL: C. WATER: D. sPEcIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO YES / NO MSDSs? KEYS7 YES / YES / BAKERSFIELD cITy FIRE DEPARTMENT FORM 4A-1 'Page ~of NON--TRADE SECRETS HAZARDOUS I~IATERI ALS I NVENTORY .PHONE ~:_~.~~ PHONE *: ¢~~lo · IoFFzClAL USE CFIRS CODE I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE flAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT . WT. CHEMICAL OR COMMON NAIVlE CODE GUIDE fi' NAME: E:~ERGENCY CON1;ACT: ~.~,~,~ ~,.e,,~-'~~- TITLE: ~'~ ~'-~1~ ~ PHONE * 'BUS HOURS: "~:~t ~'~ · ' ' AFTER BUS HRS: ~gt ~ ~ E~ER~ENCY CONTACT: ~eet~~:,~~ TITlE: ~ ~~., PHONE ~ BUS HOURS:.. ~% ~--S~ ~'~NCIP-AL' BUSINESS ACTIVITY: '~ep~,;- ~+-~-~e.3 AFTER BUS HRS: ~e~ ~ ~ U~ - 4h-I -