HomeMy WebLinkAboutBUSINESS PLAN 11/8/2000Hazardous Materials/Hazardous Waste Unified Permit
. CONDITIONS OF PERMIT ON REVERSE SIDE
Permit ID #:: 015-000-000610
UNION CEMETERY ASSOCIA
LOCATION: 730 POTOMAC AVE
This _.ermit is Issued for the followinil;
[] Hazardous Materials Plan
[] Underground Storage of H,~-rdOus Materials
[] Risk Management Program
[] Hazardous Waste On-Site Treatment
Issued by:
Bakersfield Fire Department
OFFICE OF ENVIR ONMENTAL SER VICES'
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Approved by:
Exp' ,~tion Date:
' (... Ralpl; .uey,
Office of Eviromaem~Services
Issue Date
June 30. 2003
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
.... ,~, ,~;~,,,. ,,;?,~;,~ ,,,, ~,~,.., This permit is issued for the following:
~i~ $?;'~ f ,i~: ;F ~i~ ,r ;~,' ,~,' ,( /' ,,,,. ? !i~h ..... -- w
...... ~Wi~,"F r ~, ~. ~,:!:,:~:::,,;::,~:::~::~:;,,:;~,~::: ~ ~'.:./;.....'t~l:~Hazardous Materials Plan
,,~/i?~',i'.:~i~,~i!:!i:?:~'~'':~'~::~i ili!! i ill iii;:;'.: ii~ii~::ii~e[ground Storage of Hazardous Materials
......... ~'?~,?/~ ~iiiii,,, ': iii '~ !~:.:: :/.:.il '.:::~.:.;: ~'.:i:~i: ::i~ ~:::~iiiiii/':i;ili?!!i:~iii~a~d~s Waste
UNION CEMETERY A~UISIAHON "~:9:"~"-?~'~''''''''' "" ~ ............. ~,~:::~;':~,~:":~'::;~::;;:~,;~:~
LOCATION 730
Issued by:
Bakersfield Fire Department
OFF[CE OF ENV[R 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
U~_i~N CEMETERY ASSOCIATION
Manager :
Location: 730 POTOMAC AVE
City : BAKERSFIELD
CommCode: BAKERSFIELD STATION 02
EPA Numb:
SiteID: 015-021-000610
BusPhone: (805) 324-9648
Map : 103 CommHaz : Low
Grid: 32A FacUnits: 1 AOV:
SIC Code: 6553
DunnBrad:
Emergency Contact / Title
uNNYZEPEI~A / SUPERVISOR
slness Fnone: (805) 324-9648x
24-Hour Phone : (805) $36_]0-17ix
Pager Phone : ( ) - x
Emergency Contact / Title
RUTH WEST / SUPERINTENDENT
Business Phone: (805) 324-9648x
24-Hour Phone : (805) 325-4194x
Pager Phone : ( ) - x
Hazmat Hazards:
Fire ImmHlth
Contact :
MailAddr: PO BOX 3066
City : BAKERSFIELD
Phone: ( )
State: CA
Zip : 93385
x
Owner
Address :
City :
Period :
Preparer:
Certif'd:
UNION CEMETERY ASSOCIATION ~x~
PO BOX 3066 ~-~~~"~_
BAKERSFIELD
Phone: (805) 324-9648x
State: CA
Zip : 93385
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Emergency Directives:
=Hazmat Inventory
--As Designated Order
Hazmat Common Name...
GASOLINE
One Unified List
Ail Materials at Site
ISpooHazlEPA HazardsI Frm I DailyMax IunitlMCP
F IH L 500.00 GAL Mod
BENNY ZEPEDA DO hOF@~y 0®~i~J" ~
ffy~ or p~nt n~me)
o8/~8/2ooo
F L~.I~N CEMETERY ASSOCIATION
SiteID: 015-021-000610
Fast Format
= Training
-- Employee Training
WE HAVE 1# EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: EMPLOYEES ARE: ALL MADE AWARE OF LOCATION AND
WHAT IS STORED, ALL MADE AWARE OF NON-SMOKINGAREA, ALL MADE AWARE OF POWER
BEING "OFF" AT ALL TIMES WHEN NOT IN USE, WHOT TO NOTIFY IN EVENT OF
ACCIDENT OR EMMINENT DANGER OF EXPLOSION DUE TO FIRE.
Overall Site
03/19/1992
--Held for Future Use
Held for Future Use
6 os/18/2ooo
~{RE DEPARTMENT
M, R. KELLY
ACTING FIRE CHIEF
CITY of BAKERSFIELD
"WE CARE"
1715 CHESTER AVENUE
BAKERSFIELD, 93301
326-3911
April 6, 1994
Mr. Richard Carrete
Union Cemetery Association
P.O. Box 3066
Bakersfield, CA 93385
Dear Mr. Carrete,
Thank you for updating your business plan and informing us of the additions of Motor
Oil and Diesel Fuel. However, you neglected to complete the inventory forms and
therefore I do not know what to update ie: amount, storage codes etc.
I have returned them for your convenience. Please complete the inventory forms and
return them to this office. Thank you.
Sincerely yours,
Hazardous Materials Coordinator
REH/dlm
Date Comp~eted_~~zF~
/
(Top of Business Plan)
Departure Time: ~ 5 d) Inspe~on Time:
Number of Employees:
Inade(
Verificaaor~ of ~SDS Availability
Verification of Haz k~at Training
Comment~:
Verificai~on of Abatement Supplies & Procedures
Comment~:
Emergency Procedures Posted
Containers Propedy Labeled
Comment~: ~
Verificat]or~ of Facility Diagram
Special Hazsrds Associated ~h ~his Facility:
o /
Busi~ ~er~ans~er PRINT
All Items O.K
Correction Needed
White-Haz ~at Div Yellow-Station Copy Pink-Business Copy
In conformity with provisions of pertinent o, rdinanc~es, codes and/or regulations, application is made
by: ~._~ ~/-/-//~b~ /~.~ ~
to display, store, install, u~, o~rate, ~!1 or handle materials or pr~esses involving or creating con-
ditions deemed hazar~us to life or pro~ as follows:
Bakersfield Fire Dept.
Hazardous Materials Division
2130 "G" Street
Bakersfield, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2,
3.
4.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer tine questions below for the business as a whole.
Be Drief and concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS NAME: ~Y~lo¢ ~emeTe~v
LOCATION:
MAILING ADDRESS:
i
CITY' ~ .,,E.E.C.:,CF~F___~.,b,,' '
STATE: (A ZIP: '"¢.~.~,,¢'~'PHONE' .~2~¢/-~ ¢~
DUN & BRADSTREET NUMBER:
SiC CODE: g ~'5~
PRIMARY ACTIVITY: (~', RAY~ ~A~A,T'ENA~c ~
MAILING ADDRESS: ~,~
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE BUS, PHONE
24 HR, PHONE
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAG~:MENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS: !~
MATERIAL SAFETY DATA SHEETS ON FILE' y£$
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
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
I, ~"~2.. ~, ,~,~E.~p,t~? .~',~?~:~ ~r~,~E.~l CERTIFY THAT THE ABOVE INFOR-
MATION IS ACCURATE. IUNDERSTAND 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
FDI$¢
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
RELEASE PREVENTION STEPS: ,
RELEASE CONTAINMENT AND/OR MINIMIZATION:
Co
CLEAN-UP PROCEDURES:
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRICAL:
WATER:
SPECIAL:
LOCK BOX: YES~O~) IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A, PRIVATE FIRE PROTECTION: C~4£~lc, AL ~X-nN~41~FIE~
WATER AVAILABILITY (FIRE HYDRANT)'
,4. FDIS¢O
Bakersfield Fire Dept. ~
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name:
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
AGENCY NOTIFICATION PROCEDURES'
EMPLOYEE NOTIFICATION AND EVACUATION:
PUBLIC EVACUATION'
EMERGENCY MEDICAL PLAN:
CITY of BAKERSFIELD
HAZARDOUS MATERIALS INVENTORY
Farm and ADticulture [-1 Standard Business [] NON--TRADE SECRETS Page
BUSINESS NAME' (.,~J~o~ C~m~'T'~'2 ~$~ OWNER NAME: ~J~r~ ~'~or~7' ~'S~T~o~ NAME 0F THIS FACILITY:
LOCATION; ~ ~ ~Ac ADDRESS: ~ ~ m~'~ STANDARD IND. CLA~S.
CITY. ZIP: ~~4~ . ~o~ CITY. ZIP~ ~_~.~. ~ ~ . DUN AND BRADSTREEI NUMB~H ......
I 2 3 4 5 6 ? 8 9 10 tl 12 %l~y Names of Nixture/ComDonents
Trans !y~e Hex Average Annual Heasure I t~e ~ont Cont Cont Us Location.Whelm.
Code ~ooe Ami Ret Est Un,ts on ~ype Press Temp ColeStored ]n ~acl~cy~t See Instructions
Physical and Health Hazard C.A,S, Number ComoonenL I1 Name t C,A,S. Number
(Check ali that apply) '
Componen[ 12 Name ~ C.A,S. Number
~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~
Health of Pressure
Component 13 Name S C,A,S, Number
Physical Iud Health Hazard C,A.S. Number Component 11 Name t C.A,S. Number
(Check al/ that apply)
Component 12 Name S C.A.S, Number
~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Im~i~
Health of Pressure
Component 13 Name ~ C.A.S, Number
Il ll II
Physical and Health Hazard C,A.S. Number Component II Name I C,A.S, Number
(Check a11 tha: apply)
Component 12 Name S C.A.S, Number
~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Immediate
Health of Pressure Health
Componen[ 13 Name S C,A.S. Number
Physical and Health Hazard C,A,S, Number Component II Name & C,A,S, Number
(Check a/1 :ha[ apply)
Component 12 Name S C,A.S. Number
~ Fire Hazard ~ Reac[ivi[y ~ Oelayed ~ Sudden Release ~
Health of Pressure
Component 13 Name ~ C,A,S, Number
EMERGENCY CONTACTS fll fl2
~me Tltle ~Hr p~one R~e Tltle
ferti[i;atioq,(Re~d a,.n,d.~ign af~.er compl¢tiog,all secti,ons.)
.cer,~t,y .unoer penalty..o~' )a~ cnqc ~ nave pe.rsonal~y, examlnqoeqo ~m tami~]aC.~fitb the j nTormac]pn submitted in this and all
at.c~;nea.oocgmenc.s, eno c.nac oaseo on.my ,nqu,ry 9r.cnose ,na,v,oua,s respons,o,e ,or obca,ning cne ,ntormat,on. I believe~) .C~%
s uomtteo tnt or mac,on ,s true, accurate, eno comp,e ce. ~~ ~~~
FRO~
SUBJ~C?~