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Home My WebLink AboutBUSINESS PLAN 10/23/2003 Hazardous Materials/Hazardous Waste Unified Permit ~ CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID#:: 015-000-000946 RICKERT TRUCKING LOCATION: 400 OLD YARD RD This oermit is Issued for the followina: El Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment Issued by: Bakersfield Fire Department OFFIC£ OF ENVIR ONbI£NTAL SER VICES' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: Officeof Evironmerrtff[Services ' Expiration Date: June 30:~ 2003 Issue Date Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-0214)00946 RICKERT TRUCKING LOCATION 400 This permit is issued for the following: ..... ~,~,:"?~?:i~':~.;'??,~,,. !! ,,: ~ :: :i ::i~;~;:~i ::i; ;:;i;:: ~ ~::::;;i;:i'~?]:~,:.5:5!El:! Hazardo us ~ * Materials Plan OLD YARD ~,:~",~?]~i~[~:]?~/' BA~ERSE.i~LD ca ~i~-- "~ '~: ~, ..~:~i;~;. ~i~;~,..,,~, ,~;~,~'"-,'., ,.,~F=' ~'~' ~;.":" ~i.'.. %~..'""'"[:L ~;...% =, ~ · ' ' . ,.~rf ~ ':. '- Issued by: 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 IVendorNo. CLAIMANT'S NAME AND ADDRESS: Rickert Trucking Company 400 Old Yard Rd Bakersfield, CA 93307 CITY OF BAKERSFIELD CLAIM VOUCHER I certify that this claim is correct and valid, and is a proper charge against the City Agency and account indicated. AUTHORIZED SIGNATURE OF CITY AGENCY) )ate: 04-01-99 Initials of Preparer: CITY DEPARTMENT:FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Contract Number if Applicable) This customer made a duplicate payment on this years Haz Mat bill in the amount of $226.50. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $235.00. Dept. 0000 El / Obit 7900 Project # Invoice # VOUCHER TOTAL Amount $235.00 $235.00 Date of Invoice SECTION 72, PENAL CODE Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill account, voucher, or writing, is guilty of a felony. FINANCE DEPT. USE ONLY Examined & Approved for Payment Amount STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501TRUXTUN AVE BAKERSFIELD, CA ~3301-5201 TO: (805) 326-397? RICKERT TRUCKINO COMPANY 400 OLD YARD DR BAKERSFIELD, CA ?3307 DATE: 41011?? CUSTOMER NO: 3578 CUSTOMER TYPE: ES/ 3578 CHARGE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT SSO01 3/01/?? BEOINNIN~ BALANCE 2/04/?? PAYMENT 3/31/79 Chaege adjustment CA STATE SURCHARGE 4/30/~ .00 226.50-- 8. 50-- FOR QUESTIONS OR CHANQES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. CURRENT 8.50- DUE DATE: 5/03/?? OVER 30 OVER 60 OVER PAYMENT DUE: TOTAL DUE: 235.00- 9235.00- DAT~: ~/0~/~ ~JE DATE: ~/03/~ RE~IZT AND MAKE CHECK PAYABLE TO: C~TY OF ~AAERSFIEL~ PO ~OX 2057 BA½ERSF~ELD CA ~3G03-2057 (805) 326-3979 CUSTOMER NO: 3578 CUSTOMER TYPE: ES/ TOTAL DUE: 3578 MISCELLANEOUS RECEIVABLES ADJUSTMENT CUSTOMER NAME MAILING ADDRESS NEWACCOUNT i ADDRE$S CHANGE CLOSEACCT · FINANCE CHARGE OTHER ADJ ZIP CODE ~"~_~(~ "~ SITE ADDRESS PARCEL NUMBER O~= ADJUSTMENT i CHG DATE I I CHARGE CODE ADJUSTMENT AMOUNT ,, ! M~VI P PLAN' MAP SITE DIAGRAM Business Name: Business Address: FACILITY DIAGRAM For Office Use Only First In Station: Inspection Station: Area Map # of NORTH '- % RICKERT TRUCKING Manager : Location: 400 OLD YARD RD City : BAKERSFIELD CommCode: BAKERSFIELD STATION 0~~ EPA Numb: SitelD'~15-021-000946 BusPhone: (661) 832-2246 Map : 124 CommHaz : Moderate Grid: 08A FacUnits: 1 AOV: SIC Code:3711 DunnBrad:95-352-9438 Emergency Contact / Title GLEN RICKERT / OWNER Business Phone: (661) 832-2246x 24-Hour Phone : (661) 393-0392x Pager Phone : (661)~ ~0 Hazmat Hazards: Emergency Contact / Title CHRIS PHILLIPS / OPERATIONS MANA Business Phone: (661) 832-2246x 24-Hour Phone : (661) ~ Pager Phone : (661).3j; Fire Press ImmHlth DelHlth Contact MailAddr: 400 OLD YARD DR City : BAKERSFIELD phone: (661) 832-2246x State: CA Zip : 93307 Owner GLEN M RICKERT Address : 400 OLD YARD DR City : BAKERSFIELD Phone: (661) 832-2246x State: CA Zip : 93307 Period : Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: I, ~H.R,15 . ~HIU-.IP~ Do hereby certify that I have (Type o~ 13dnt name) reviewed the a~ached hazardous materials manage- rnent plan for~cl~e'~r '~c~,,J(,,and that i~ along ~i~h (Name of Business) a~ny corrections constitute a complete and correc~ man- agemem plan for my ~'acility. 10/17/2003 ~ RICKERT TRUCKING Hazmat Inventory -- MCP+DailyMax Order Hazmat Common Name... ACETYLENE WASTE OIL OXYGEN MOTOR OIL ISpecHazI SiteID: 015-021-000946 By Facility Unit Fixed Containers on Site EPA HazardsI Frm DailyMax IUnitlMCP F P. IH G 275.00 FT3 Hi F DH L~ 500 '. 00 GAL Low F IH DH G 275.00 FT3 Low F DH L 220.00 GAL Min -2- 10/17/2003 RICKERT TRUCKING Manager : Location: 400 OLD. YARD RD .City : BAKERSFIELD commcode: BAKERSFIELD STATION.05 EPA Numb: SiteID: 215-000-000946 BUsPhone: (805) 832-2246 Map : 124 CommHaz : Moderate Grid: 08A FacUnitS: .1 AOV: .SIC Code:3711 DUnnBrad:95-352-9438 'EmergencyContact / Title GLEN RICKERT A~i/ OWNER ' Business Phone: ~) 832-2246x 24-Hour Phone : (~3) ~ ~ Phone : ( 3~3 ' Emergency contact CHRIS PHILLIPS Business Phone: 24-Hour Phone : ~~Phone : / Title (~/) Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : MailAddr: 400 OLD YARD DR City : BAKERSFIELD Phone: ( ) State: CA Zip : 93307 X Owner GLEN M. RICKERT Address : 400 OLD YARD DR City : BAKERSFIELD Phone: (805) 832-2246x State: CA Zip : 93307 Period : Preparer: Certif'd: to TotalASTs: = Gal TotalUSTs: = Gal RSs: No Emergency Directives: = Hazmat Inventory --Alphabetical Order Hazmat Common Name... ACETYLENE MOTOR OIL OXYGEN WASTE OIL One Unified List Ail Materials at Site ISpooHazlEPA Hazardsl Frm DailyMax IunitlMcP F P IH F · DH F IH DH reviewed the a~ached .haZardous ma~rials manage- ment plan ~or ~t~<~-r' /~uc~/~nd that it along with (Name el 13usi.e~s) any corrections constitute a complete and correc~ man- agemem plan for my f'acili~. G L G L 275 FT3 Hi 220 GAL Min 275 FT3 Low 500 GAL Low 08/24/1999 RICKERT TRUCKING ~ Inventory Item 0004' -- COMMON NAME / CHEMICAL NAME ACETYLENE Location.within this Facility Unit PORTABLE CARTS SiteID: '215-000-000946 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 74-86-2 STATE ~ TYPE ~Gas. '1. Pure' PRESSURE TEMPERATURE Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 275.00 FT3 Daily Average 150.00 FT3 %Wt. 100.00 Acetylene HAZARDOUS COMPONENTS 74862 I NoTSecretI~ NoRS IBi°Haz No HAZARD ASSESSMENTS I Radi°active/Am°unt IEPA HazardsNO/ Curies F P IH NFPA /// USDOT# MCP Hi ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME MOTOR OIL Location within this Facility Unit NORTH WALL OF SHOP Facility Unit: Fixed Containers on Site · Map: Grid: Days On Site 365 CAS# 8020835 STATE TYPE PRESSURE Pure 1Liquid ~ Ambient TEMPERATURE Ambient CONTAINER TyPE DRUM/BARREL-METALLIC -Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 220.00 GAL Daily Average '1 75.00 GAL %Wt 100.00 HAZARDOUS COMPONENTS Motor Oil, Petroleum Based CAs# 8020835 TSecret No I RSIBioHaz No No HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F DH NFPA /// USDOT# I MCP Min -2- 08/24/1999 RICKERT TRUCKING = Inventory Item 0003 -- COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit PORTABLE CARTS SiteID: 215-000-000946 Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 cAS# 7782-44-7 · rSTATE ~ TYPE Gas /Pure PRESSURE TEMPERATURE I Above Ambient I Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum I 275.00 FT3 Daily Average 150'00 FT3 HAZARDOUS COMPONENTS %Wt. I 100.00.Oxygen,. Compressed-~ .... .7782447 HAZARD ASSESSMENTS Radioactive/Amount I EPA HazardsI No/ Curies F IH DH. NFPA /// USDOT# I MCP Low' ---- Inventory Item 0002 -- COMMON NAME / CHEMICAL NAME WASTE OIL LoCation within this Facility UnitI 40PT EAST OF CENTER OF SHOP Facility Unit: Fixed Containers on Site Map: Grid: Days On Site 365 CAS# 221 STATE ~ TYPE Liquid I Waste PRESSURE Ambient TEMPERATURE IAmbient CONTAINER TYPE ABOVE GROUND TANK. Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 500.00 GAL Daily AVerage 200.00 GAL %Wt. 100.00 HAZARDOUS COMPONENTS Waste Oil, petroleum Based cAS# 0 TSecret No HAZARD ASSESSMENTS RadioaCtive/AmoUnt EPA Hazards No/ Curies F DH NFPA '1.'11 USDOT# MCP Low 3 08124/1999 O o BY PHONE - 911 TO PEOPER AGENCY (B.F.D.) O O o VERBAL NOTIFICATION - WE ARE AVERY sMALL COMPANY WITH USUALLY NO MORE THAN o FIVE EMPLOYEES HERE AT' ONE TIME. O O o INDUSTRIAL AREA - BUT IF NEEDED CONTACT WOIJLD BE VERBAL; O o FIRST STEP WOIJLD BE TO ~I~J.~L 911 AS THEY SHOULD BE kBLE TO COORDINATE THE °'~ICKEST RESPONSE TO J~I' EMERGENCY. -4- 08/24/1999 RICKERT TRUCKING ~~~~'~~~~ SiteID: 215-000-000946 Mitigation/Prevent/Abatemt ~~~~~~~ Overall Site i~ Release Prevention ~~~~~~~~~..05/05/1992 O.ALL MATERIALS ARE STORED PROPERLY IN CONTAINERS. PRESSURIZED GASES ARE ALL LOCKED IN CARTS, OILS ARE IN SUPPLIERS DRUMS, ETC. NO MATERIALS ARE STORED IN I.d~GE QU/~TITIES. ~I-IOP AREA IS EQUIPED WITH ABSORBING MATERIAL FOR LIQUID SPILLS. MATERIAL WOULD BE CLEANED UP AND CONTAINERIZED TO BE PICKED UP BY A LICENSED cARRIER_ ~O DISPOSE ~OF PROPERLY ............. i~ Other Resource Activation -5- 08/24/1999 RICKERT TRUCKING ~&~~~~~~ SiteID: 215-000-000946 i& Site Emergency Factors ~~~~~~~~&~ Overall Site ~i~ Special HaZards ~~~~~~~~~~~~i ' i~ Utility Shut-Offs ~~~~~~~$~~ 05/05/1992 A) GAS - EAST'SIDE OF BLDG - 25FT NORTH OF SE CORNER . B)' EhECTRICkL - ~%ST SIDE OF BBDG - 25FT ~ORTH OF SE CORNER C) WATER -' SW CORNER OF ~ROPERT¥ ~EJ~R SIDEWJ~K . D) SPECI~ - NONE .. ~.° E) BOCK BOX - NO PRIVATE~F!RE_PRQ~E~IO~VARIO~Us_EIRE_EXTINGUISHERS .. NEAREST FIRE HYDRANT - ACROSS THE STREET TO THE SOUTH · aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeef £~&~ Buildin~ Occupancy ~evel ~~~~$~$~~~$~$~~~i -6- os/24/1999 RICKERT TRUCKING.~~&~~~~~~ SiteID: 215-000-000946 i~ Training ~~~~~~~~~~~ Overall Site i~ Employee Training ~~~~~~~~~05/05/1992.i WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MSDS SHEETS ON FILE. ' BRIEF SUMMARY OF TRAINING PROGRAM: BI-MONTHLY MEETINGS WILL ALL PERSONNEL, WITH SAFETY STRESSED EVERY DAY TO THOSE EMPLOYEES MOST IN CONTACT WITH HAZARDOUS MATERIALS. . . 08/24/1999 RICKERT TRUCKING 215-000-00_~ / ~/9)3 Page Overall Site with ,1 Fac. Unit-'~O/~ General Information I Location: 400 OLD YARD RD Map:124 Haz:3 Type: 3 I City : Bakersfield Grid: 08A F/U: 1 AOV: 0.0 Contact Name Title GLEN RICKERT / OWNER Business Phone: (805) 832-2246x 24-Hour Phone : (805) 832-1206x Pager Phone : ( ) - x Contact'Name Title · CHRIS PHILLIPS / OPERATIONS MANA Business Phone:. (805) 832-2246x 24-Hour Phone : (805) 366-8311x Pager Phone : ( ) - x Administrative Data Mail Addrs: 400 OLD YARD DR City: BAKERSFIELD Comm Code: 215-005 BAKERSFIELD STATION 05 D&B Number: 95-352-9438 State: CA Zip: 93307- SIC Code: 3711 Owner: GLEN M. RICKERT Phone: (805) 832-2246 Address: 400 OLD YARD DR State: CA City: BAKERSFIELD Zip: 93307- Summary I, _.~AL~ ~ILClP, J DO hereby certify that I have (Type er print name) reviewed the attached hazardous materials manage- ment plan for_~~/i~t/.~/ftt~&and that it along,with (Name of Busi~ss) any corrections constitute a complete and correct man- agement plan for my facility. Date 03/07/9~ RICKERT TRUCKING 215-000-000946 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-004 ACETYLENE · Fire, Pressure, Immed Hlth Gas 275 High FT3 02-002 WASTE OIL · Fire, Delay Hlth Liquid 500 Low GAL 02-003 OXYGEN · Fire, Immed Hlth, Delay Hlth Gas 275 Low FT3 02-001 MOTOR OIL · Fire, Delay Hlth Liquid 220 Minimal GAL oz/o7 9 4 RICKERT TRUCKING 215-000-000946 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-004 ACETYLENE · Fire, Pressure, Immed Hlth Gas 275 High FT3 CAS #: 74-86-2 Form: Gas Type: Pure Daily Max FT3 275 Storage PORT. PRESS. CYLINDER -- Conc 100.0% IAcetylene Trade Secret: No Days: 365 Use: WELDING SOLDERING Daily Average FT3 I Annual Amount FT3 I 150.00 1,000.00 Press T Temp Location IAbove [AmbiontlPoRTABLE CARTS Components MCP -~Guide I IHigh ! 17 02-002 WASTE OIL · Fire, Delay Hlth Liquid 500 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL500 I Daily Average200.00GAL Annual Amount GAL 700.00 Storage ABOVE GROUND TANK Press T Temp Location IAmbientlAmbientl40FT EAST OF CENTER OF SHOP -- Conc~ Components. 100.0% IWaste Oil, Petroleum Based MCP ---/Guide ILow ~ 27 02-003 OXYGEN · Fire, Immed Hlth, Delay Hlth Gas 275 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 275 Daily Average FT3 T 150.00 Annual Amount FT3 1,000.00 Storage PORT. PRESS. CYLINDER Press T Temp Location I Above ~Ambient I PORTABLE CARTS - Conc 100.0% IOxygen, Compressed Components MCP -~Guide ILow ~ 14 o3/o7 ' RICKERT TRUCKING 215-000-000946 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-001 MOTOR OIL ,'Fire, Delay Hlth Liquid 220 GAL Minimal CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL 220 I Daily Average GAL 75.00 Annual Amount GAL 700.00 Storage DRUM/BARREL-METALLIC Location ~~Press T Temp Iamb{ent/Amb~entlNORTH WALL OF SHOP I---'---- /---' -- I---- -- Conc, Components 100.0% IMotor Oil, Petroleum Based MCP ----~uide IMinimal I 27 RICKERT TRUCKING 215-000-000946 00 - Overall Site <D> Notif./Evacuati°n/Medical Page 5 <1> Agency Notification 'BY PHONE - 911 TO PEOPER AGENCY (B.F.D.) <2> Employee Notif./Evacuation VERBAL NOTIFICATION - WE ARE A VERY SMALL COMPANY WITH USUALLY NO MORE THAN FIVE EMPLOYEES HERE AT ONE TIME. <3> Public Notif./Evacuation INDUSTRIAL AREA - BUT IF NEEDED CONTACT WOULD BE VERBAL. <4> Emergency Medical Plan FIRST STEP WOULD BE TO CALL 911 AS THEY SHOULD BE ABLE TO COORDINATE THE QUICKEST RESPONSE TO AN EMERGENCY. RICKERT TRUCKING 215-000-000946 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page <1> Release PreventiOn ALL MATERIALS ARE STORED PROPERLY IN CONTAINERS. LOCKED IN CARTS, OILS ARE IN SUPPLIERS DRUMS, ETC. PRESSURIZED GASES ARE ALL <2> Release Containment NO MATERIALS ARE STORED IN LARGE QUANTITIES. ABSORBING MATERIAL FOR LIQUID SPILLS. WHOP AREA IS EQUIPED WITH <3> Clean Up MATERIAL WOULD BE CLEANED UP AND CONTAINERIZED TO BE PICKED UP BY A LICENSED CARRIER TO DISPOSE OF PROPERLY. <4> Other Resource Activation RICKERT TRUCKING 215-.000-000946 00 - Overall Site Site Emergency Factors Page <1> Special Hazards <2> Utility Shut-Offs A) GAS - EAST SIDE OF BLDG - 25FT NORTH OF SE CORNER B) ELECTRICAL - EAST SIDE OF BLDG - 25FT NORTH OF SE CORNER C) WATER - SW CORNER OF PROPERTY NEAR SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO ~3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - VARIOUS FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - ACROSS THE STREET TO THE SOUTH <4> Building Occupancy Level 03~07/95 RICKERT TRUCKING 215-000-000946 00 - Overall Site <G> Training Page 8 <1> Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY. WE HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: BI-MONTHLY MEETINGS .WILL ALL PERSONNEL, WITH SAFETY STRESSED EVERY DAY TO THOSE EMPLOYEES MOST IN CONTACT WITH HAZARDOUS MATERIALS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 HAZARDOUS MAT GEMENT PLAN 1992 L~ 1. : To avoid further action, return this form Withi~ 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: LOCATION: '~f/fl · MAILING ADDRE§S: CITY' STATE: ~'~ ZIP' .~._~0'7 PHONE:(~'~',') ~,2 ',3,~"/(4 DUN & BRADSTREET NUMBER: ~'._q'-,~',,~'~z3F sic CODE: ..~711 .. PRIMARY ACTIVITY' ,/'~'~ ,/~/,4'~- .~-~U~_X'//~'~-.- OWN : .'. MAILING ADDRESS" ~V ~ZP 'F~ ~. - ~X¢~/¢Z~; ~, SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE 1. ~--------~ /~ ~'AJ /'~, l~ e:.~T' BUS. PHONE ":~4 H'I~. 'PHONE FD15~ Bakei~sfield Fire DePt. ' Hazardous Materials DivisiOn HAZARDOUS MATERIALS MANAGEMENT PLAN' SECTION 3: TRAINING: NUMBER 'OF EMPLOYEES: /,,2 MATERIAL SAFETY DATA SHEETS ON FILE:- BRIEF SUMMARY OF TRAINING PROGRAM: /._~y 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 TIMEEXCEED THE MINIMUM REPORTING QUAN'TITIES, OTHER (SPECIFY REASON) SECTION 5: 'CERTIFICATION: I, ~----/~/-/~ //-~/Z C/I:~ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFIL.I_ 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 PER. JUR. Y. ~ SIG'~ATUI~ TITLE DATE FD1590 Bakersfield Fire Dep~ Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SEC:~ION'6: NOTIFICATION AND EVACUATION PROCEDURES: --A. · AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: ~/~--,,~/~L PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN' Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PRE/~'ENTION STEPS:",~:ZL~--' B. RELEASE CONTAINMENT AND/OR MINIMIZATION: ,/~0 ,/~'/~T'E',~/~/...-~ SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT yOUR FACILITY)' NATURAL GAS/PROPANE: ~-~3T' 5ID-e-. ELECTRICAL: .~h/~' ~'. /l~ou~: '~"'-~ .... ::-~ '-~ WATER'. SPECIAL' LOCK BOX: IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITy: A. PRIVATE FIRE PROTECTION: WATER AVAILABILITY (FIRE HYDRANT): 4. FD1590 Farm and Agriculture~standard Business OF' BAKERSF I EL1t HAZARDOUS HATERIALS INVENTORY NON - TRADE sECRET ADDRESS: ~6;~ ~U/~/~/~96~- ~. CITY, ZIP: ~~/~. ~ · Page,./ of,__~ NAME OF THIS4FAcILITY: STANDARD IND. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL ID REFER TO INSTRUCTIONS FOR PROPER CODES: i 2 3 4 5 6 7 : 8 9 10 11 12 13 14 Trane T~pe Max Average· Annual Measure # Days -COnt., Cont Cont Uae Location Where % by Names of Mix~ure/c~ponents _~_e Code Amt Am~ Am~ Units on Site 'Ty~ Press ~Tem~ ~n Stored in Facilit]~ w~ See Instructions _ PhysiCal and He~I~h Hazard C.A:S. Number - ~ ' Component # I Name ~. C~A.S. Number (Ch.~ ''ll u~t apply) ' ~., Co~°nent ! 2 Nm '~ C.A.S. ~mm= ; ' .~ Component ~ 3 Name & C.A.S. Number of Pressure .. 'Health ~' Health ..; Ph~cal ,,nd Health ~azard C.~..q. Number ' Co~ponen~ ~ I N~e & C.&.8. Nu~:~er (Check -11 ~.tm~: Component '~-2 N~ & C.A.~. Number [] F,re Hazard [] Sudden Release 'j~ Reactivity [] I-~ed*at-. ~ Delayed of Pressure - Health Health Component ~ 3 Name & C.A.S. Number Physicaland Health Hazard C.A.S..u~= 77/'4,' CZ--/ ' 7 Compo..nt,, .am., C.A.S. ,u.ber (Check all that apply) , ~ ~re H.,ard [] Sudaen Rele..e FI H~cti~it~ E~ ~edi.te ~elaY~ · of Pressure ~ Health Health Component # 3 Name & C.A.S. NUmber ~hm~o~ and Health ~zard C.A,S. ,,,~er ?~ -/m --~ Component ~ ~ ,~ ~ C.~.S..~er . (Check all t~ apply) . Co~on~t ~ 2 N~ $ C.A.S. N~ of Pressure · ~ H~lth H~lth Co~on~t 9 3 N~ & C.A.S..N~ N~ T~tle 24 ~. Phone N~e Title 24 ~ Phone Cert~fication (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I hayer personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of-those true, accura ~ corn e. individuals responsible for obtaining the information. I believe that the submitted information is N~ M~D. O~:r~IAL ~T~LE OF O~a~gR/OPERA.TOR OR OWNgR/OPI~RA~OR'-~ AU~HOI~ZED AgPRgaI~TA~IVE ~I(A~I'AT~I~ ~'~ '- .:. DATE