HomeMy WebLinkAboutBUSINESS PLANHazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF..PERMIT ON REVERSE SIDE
This ~'mit is issu~l for the follow~ng:
[] Hazardous Materials Plan
E! Underground Storage of HazardOus Materials
[] Risk Management Program
El Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002173
PIONEER NURSERY
LOCATION
715
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:
' Exi~iration Date:
Office of Evironm~aff[ Services -
Issue Date
June 30; 2003
Name. o · ~-~,
ITE DIAGRAM
Bu~ine~ Name: ~ ~ ~'~
Business Address:
.- J
PIONEER NURSERY
SiteID: 015-021-002173
Manager :
Location: 715 L ST
City : BAKERSFIELD
CommCode: BAKERSFIELD STATION 04
EPA Numb:
BusPhone: (661) 322-4748
Map : 103 CommHaz : Minimal
Grid: 31C FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / Title
MIKE MARTINI / MANAGER
Business Phone: (661) 322-4748x
24-Hour Phone : (661) 399-7700x
Pager Phone : ( ) - x
Emergency Contact / Title
NINA MARTINI / AUNT
Business Phone: (661) - x
24-Hour Phone : (661) 322-6397xHM
Pager Phone : ( ) - x
Hazmat Hazards:
Fire Press
ImmHlth
Contact :
MailAddr: 715 L ST
City : BAKERSFIELD
Phone: (661) 322-4748x
State: CA
Zip : 93304
Owner PIONEER NURSERY - NELLIE COFFEE
Address : 715 L ST
City : BAKERSFIELD
Phone: (661) 322-4748x
State: CA
Zip : 93304
Period :
Preparer:
Certif'd:
ParcelNo:
to
TotalASTs: =
TotalUSTs: =
RSs: No
Gal
Gal
Emergency Directives:
' ' UVpe'ar I~'im name)
r~vi®~ed the aAached hazardous maC,dais ~n~ge-
~o~and ~i i~ ~ong wi~h
men~
p~an
any ~e~ions ~ns~i~u~ ~ comp~e~ $~ ~rr~ man-
ag~m~ni plan for my ~acility.
-1- 09/26/2003
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILITY NAME T_~/~]//~
Al)DRESS "/!~ L- '~
FACILITY CONTACT ~[~/~-~ I,~MOI~
INSPECTION TIME _~0 b/.l~/~
INSPECTION DATE /
PHONE NO.
BUSINESS ID NO. ~-
NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
j//Routi.n~ [~ Combined [~ Joint Agency [~ Multi-Agency [~ Complaint [~ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand ,/
Business plan contact information accurate
Visible address V/ ~,-'[- ~>~0~,~' 0q4 ~
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
Containers properly labeled
Housekeeping /
Fire Protection / /
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Explain:
Yes ~
Questions regarding this inspection? Please call us at (66 i) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
' 'Bu~ne~ite Responsible Party
Inspector: ~. b'~ ~0 ~
PIONEER NURSERY
Manager :.
Location: 715 L ST
City : BAKERSFIELD
CommCode: BAKERSFIELD STATION 04
EPA Numb:
SiteID: 015-021-002173
BusPhone: (661) 322-4748
Map : 103 CommHaz : Minimal
Grid: 31C FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / Title
MIKE MARTINI /
Business Phone: (661) 322-4748x
24-Hour Phone : ( ) - x
Pager Phone : ( ) - x
Emergency Contact
Business Phone: (
24-Hour Phone : (
Pager Phone : (
/ Title
/
) - x
) - x
) - x
Hazmat Hazards:
Fire Press
ImmHlth
Contact :
MailAddr: 715 L ST
City : BAKERSFIELD
Phone: (661) 322-4748x
State: CA
Zip : 93304
Owner PIONEER NURSERY
Address : 715 L ST
City : BAKERSFIELD
RECEiVeD
Period :
Preparer:
Certif'd:
to
Phone: (661) 322-4748x
State: CA
Zip : 93304
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Emergency Directives:
= Hazmat Inventory
--As Designated Order
Hazmat Common Name...
HELIUM
One Unified List
Ail Materials at Site
ISpooHaz EPA Hazardsl Frm
F P IH
I,~,1~<~,_ lq,,~F,I~/_L~/Do hereby certify that I have
Hype or'pnn!
reviewed the attached h~a~ous
ment plan fo~.~s~ /~~and ~ha~ it a~ong with
any corrections constitute a complete and correc~ man~
G
DailyMax Unit MCP
244.00 FT3 Min
agement plan for my facilib/.
1 01/04/2001
PIONEER NURSERY SiteID: 015-021-002173
Inventory Item 0001 Facility Unit: Fixed Containers at Site
~tV~Vl~ ~Vl~ / ~ 1 ~_/A_IJ ~vl~
HELIUM Days On Site
365
Location within this Facility Unit Map: Grid:
INSIDE W WALL OF FLOWER ROOM CAS#
7440-59-7
FSTATE ~ TYPE
Gas /Pure
PRESSURE TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container I
244.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
244.00 FT3
Daily Average
244.00 FT3
%Wt.
100.00 Helium
HAZARDOUS COMPONENTS
S CAS#
N 7440597
TSecretNo N~S BioHazNo
HAZARD ASSESSMENTS
Radioactive/Amount EPA Hazards
No/ Curies F P IH
NFPA/// I USDOT#
Min
2 01/04/2001
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., BakerSfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
2.
3.
4.
5.
To avoid further action, retum 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.
You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUS.SS
LOCATION:
MAILING ADDRESS: -'~/'
CITY: ,~ ]~ ~ ~,~/O~--'~?h
_/- L 'Tz i 5?"
STATE:~_'J~ ZIP:
PRIMARY ACTIVITY:
OWNER: £dd/d-
MAILING ADDRESS:
PHONE~-27 -CL./") C/~2~--'
EMERGENCY NOTIFICATION
CONTACT
x,,,,,,.,--,q-
TITLE
BUS. PHONE
24 HR. PHONE
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
LEAK DETECTION AND MONITORING PROCEDURES:
Bo
EMPLOYEE AND AGENCY NOTIFICATION:
Co
ENVIRONMENTAL RESPONSE MANAGEMENT:
Do
EMERGENCY MEDICAL PLAN:
2
HAZA~RDOUS
MATERIALS MANAGEMEgT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
B. RELEASE CONTAINMENT AND/OR MITIGATION:
Co
CLEAN-UPANDRECOVERY PROCEDURES:
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRICAL:
WATER: ~ ,~ LC tS,/
SPECIAL:
LOCK BOX: YESO IF YES, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION: J~'t 're(= ~- ~O'~/t76~o
Bo
WATER AVAILABILITY (FIRE HYDRANT):
3
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: o,)
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
CERTIFICATION
M^
IS ACCURATE. I UNDERSTAND THAT THIS I~ORM~TION 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
.;
?
FACILITY NAME qZ>~oxtc"c:~cc t, Jofcsa--tq
ADDRESS '7 t S-- t._ 5"r'
FACILITY CONTACT tMr~,~: /[,t~e'c~l,,O'
INSPECTION TIME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
INSPECTION DATE
PHONE NO. .3 2.2._
BUSINESS ID NO.
NUMBER OF EMPLOYEES
15-210-
Section 1: Business Plan and Inventory Program
6~l~Routine l~ Combined [21 Joint Agency [21 Multi-Agency [~1 Complaint [~ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials ~'~ ~ O ~
Verification of quantities ~' ~ 4 Co' ~'ff'
Verification of location ffq<,~O~r" {,,d td'zk.t.C r_,,ff
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Explain:
Yes ~No
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
usiness Site Res~ble Party
Inspector: (.~
FACILITY NAME
ADDRESS .-}~
FACILITY CONTACT
INSPECTION TIME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE
PHONE NO. .322..
BUSINESS ID NO.
NUMBER OF EMPLOYEES
1 '7.//-t
zC9 48'
15-210-
Section 1: Business Plan and Inventory Program
~Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [21 Re-inspection
OPERATION ' C V COMMENTS
Appropriate permit on hand
Business plan contact information hccurate
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 '
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Explain:
[] Yes ~No
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
"~B~us~td~,b~''
Inspector: