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Home My WebLink AboutBUSINESS PLAN I TE/FAC ILI TY FORM SCALE:/~/O BUSINESS NAME: FLOOR:/ 0F/ UNIT ~:/ OF/ (CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - principle buildings by the Street numbers. Street(s), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. Storm Drains, Culverts, Yard Drains 4. Drainage Canals, Ditches, Creeks, 5. Buildings a. Frame construction b. Nasonry construction c. Metal construction d. Access Door 6. Utility Controls a. Gal b. Electricity c. Water Fire Suppression Systems: a. Fire Mydrauts b. Fire Sprird<ler Connections c. Fire Standpipe Connections d. Water Control Valves for protection systems e. Fire Pimp J 8. Fire Department Access .f 9. Lock (ke 10. MSDS Storage Box II, Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood d. Gates 13. PowerJlnes 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. lg. Outside Hazardous Masts Storage 30. Outside Hazardous H~tsrial Storage 21. Outside Ha=ardous Material Use/Handling 22. Type of Hazardous Naterial/Waate Stored or Used (See klow) F = Flammable E - Explosive L - Liquid R = Radlologicsl. C - Corrosive 0 - Oxidizer O - Oas P - Poison W - Mater Reactive T = Toxic 9 - Solid 'H - Cryogenic O - Masts B - Etiological Example: Flaaaable Liquid - FL FACILITY DIAGRAN (Required items tn addltioe to the above) i. Rlsor. for Spr/nkler~ 8. Fire Escapee 2. Partitions $. Air Conditioning Units 3. Stairways: indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste 8~urage 4. Escalator: ~ndlca~e levelm ae~ed ~rom 1~, In~lde Hazardous higheet ~o lowest. ~t~rial, S~orage 5. Elevator 13, In,ide Hazardoum ~tarlal~ Uae/Handling ~. AtZlc Access 14. 9e~r Drain Inlets 7. Skyligh~ 03/3~/~4 ~ ACME POOL SUPPLY 215-000-000299 Page Overall Site with 1 Fac. Unit General Information Location: 2030 L ST Map:103 Haz:3 Type: 1 Community: BAKERSFIELD STATION 01 Grid: 30A F/U: 1 AOV: 0.0 Contact Name WILLIAM M ~AYLYi/ VERNON ALLEN IOWNER Mail Addrs: 2030 L ST City: BAKERSFIELD ,Comm Code: 215-001 BAKERSFIELD STATION 01 Title Business Phone 24-Hour Phone- (805) 327-8955 x 805)~~( Administrative Data D&B Number: State: CA Zip: 93301- SIC Code: Owner: WILLIAM M. ~AYLY/ Phone: (805) 334-6664 Address: 1900 ALTA VISTA State: CA /~;~'~-~, City: BAKERSFIELD Zip: 93305- Summary ~'-r~F? ~ Do hereby certify that ~ have ~Y~ ~ ~t ~~ reviewed ~he a~ached h~ardous mmeHals manag~ ~ p~a~ ~o~~-~/and ~ha~ i~ along wi~h (~e of Busi~} ~Y ~~ons ~ns~i~u~e a ~mp~e and ~rr~ man- 03/3~-/94 ~ ACME POOL SUPPLY 215-000-000299 Page Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards ~ Form Max Qty MCP 02-006 BROMINE TABLETS Solid 60 Extreme · Fire, Reactive, Immed Hlth LBS 02-001 DRY CHLORINE Solid 1000 High · LBS 02-003 LIQUID CHLORINE - HYDROCHLORIC ACID Liquid 100 High · GAL 02-004 SODIUM HYPOCHLORITE Liquid 100 High · GAL 02-010 CALCIUM.HYPOCHLORITE Solid 200 Moderate · LBS 02-002 CONDITIONER - CYANURIC CHLORIDE Solid 300 Moderate · LBS 02-011 SODIUM DICHLOR Solid 300 Moderate · LBS 02-007 SODIUM CARBONATE Solid 400 Low · LBS 02-005 SODIUM BISULFATE Solid 100 Minimal · LBS 02-009 SIMAZINE-2 CHLORO-4 Solid 40 Unrated · LBS 2 03/3~/94 ', ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-006 BROMINE TABLETS · Fire, Reactive, Immed Hlth Solid 60 Extreme LBS CAS #: Form: Solid Daily Max LBS 60 Trade Secret: No Type: Mixture Days: 365 Use: STORAGE/IN STORAGE ~ Daily Average LBS I Annual Amount LBS -- 30.00I 200.00 Location Storage PLASTIC CONTAINER Press T Temp I Ambi ent[Ambi ent I SHOWROOM -- Conc ~ Components 92.5%[ 3-Bromo-l-chloro-5,5-dimethylhydantoin MCP ---TGuide ILow ! 35 02-001 DRY CHLORINE Solid 1000 High · LBS CAS #: Trade Secret: No FOrm: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS Storage PLASTIC CONTAINER Daily Average LBS 400.00 [ Annual Amount LBS 8,000.00 Press T Temp Location IAmbient[AmbientlSHOWROOM & ~ -- Conc 90.0% ITrichlorosilane Components MCP --[Guide IHigh ! 38 02-003 LIQUID CHLORINE - HYDROCHLORIC ACID · Liquid 100 High GAL CAS #: Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max GAL 100 Storage PLASTIC CONTAINER Daily Average GAL I Annual Amount GAL 40.00 400.00 Press T Temp Locatio~ [Ambient[Ambient [ -- Conc 12.5% IHydrochloric Acid MCP --[Guide Components IHigh ! 15 03/3~/94 ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 4 02-004 SODIUM HYPOCHLORITE · Liquid 100 High GAL cAs #: 7681529 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: WATER TREATMENT Daily Max GAL 100 I Daily Average GAL 40.00 Annual Amount GAL -- 500.00 Storage PLASTIC CONTAINER Press T Temp AmbientlAmbientI '-- Conc 12.5% ISodium Hypochlorite Components Location MCP ---~uide High ! 45 02-010 CALCIUM HYPOCHLORITE Solid 200 Moderate · LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: COOLING Daily Max LBS Daily Average LBS Annual Amount LBS 200 I 100.00 1 800.00 Storage PLASTIC CONTAINER Press T Temp IAmbient IAmbient I -- Conc 65.0% ICalcium Hypochlorite Components Location MCP ---~uide IModerateI 45 02-002 CONDITIONER - CYANURIC CHLORIDE · Solid 300 Moderate LBS CAS #: Trade Secret: No Form: Solid Type: Pure Days: 365 Use: WATER TREATMENT Daily Max LBS 300 I Daily Average LBS 150.00 Annual Amount LBS 600.00 Storage PLASTIC CONTAINER Press I Temp Location AmbientlAmbientlSHOWROOM &~~ -- Conc 100.0% ICyanuric Chloride Components MCP ----~uide IModerateI 60 03/3~/94' ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 5 02-011 SODIUM DICHLOR Solid 300 Moderate LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS Daily Average LBS I 300 150.00 I Annual Amount LBS -- 1,000.00 Storage PLASTIC CONTAINER Press T Temp IAmbient{Ambientl -- Conc Components 65.0% ISodium Dichloroisocyanurate Location MCP ---iGuide Moderate I 42 02-007 SODIUM CARBONATE · Solid 400 Low LBS CAS #: Trade Secret: No Form: Solid Type: Pure Days: 365 Use: WATER TREATMENT Daily Max LBS 400 I Daily Average LBS 200.00 Annual Amount LBS 1,500.00 Storage PLASTIC CONTAINER Press T Temp Ambient I Ambient I -- Conc 100.0% {Sodium Carbonate Components Location MCP ---TGuide {Low ! 60 02-005 SODIUM BISULFATE Solid · 100 Minimal LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS Daily Average LBS I 100 50.00 I Annual Amount LBS 200.00 Storage PLASTIC CONTAINER Press T Temp AmbientlAmbientI -- Conc 91.0% ISodium Bisulfate Components Location '~_~..~.~-! !." ~C~ ---=~u~de IMinimal { 60 o3/3Q/94' ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 6 02-009 SIMAZINE-2 CHLORO-4 Solid 40 Unrated · LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS40 I Daily Average 20.00 LBS Annual Amount LBS 60.00 BAG -- Conc Storage Press T Temp I Ambi entlAmb i ent I Components Location ~ MCP ---TGuide 03/3Q/94~ ACME POOL SUPPLY 215-000-000299 Page 00 - Overall Site <D> Notif./Evacuation/Medical 7 <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation WE HAVE ONE EMPLOYEE - TRAINED IN BASIC HAZ MAT PROCEDURES. ON DAYS WHEN MY FATHER IS IN IF WE HAD A PROBLEM WE WOULD VERBALLY NOTIFY EACH OTHER AND EXIT THE BEST POSSIBLE WAY. <3> Public Notif./Evacuation WOULD VERBALLY NOTIFY ANY NEIGHBORS IF A PROBLEM OCCURRED. <4> Emergency Medical Plan HALL AMBULANCE SERVICE - 1001 21ST ST MERCY HOSPITAL - 2215 TRUXTUN AV SAN JOAQUIN HOSPITAL - 2615 EYE ST 03/3Q/94~ ACME POOL SUPPLY 215-000-000299 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention / ~TT ~T~L om~ T~, ST~P~CE ~ ~ SPRIN~LERED INulASE OF FIRE~:~ LIQUID CHEMICALS ARE IN SECONDARY PLASTIC CASES. ALWAYS KEEP 100 LBS OF SODA ASH CONTAINER OPEN TO PUT' ON ANY ACID SPILLS AND FIRE EXTINGUISHERS AT DOOR ENTERING STORAGE ROOM. wATER HOSE & BIB READY TO FLOOD ROOM. ALL DRY CHEMICALS ON PALLETS ABOVE ANY LIQUID SPILL IN ROOM. <2> Release Containment STORAGE ROOM MASONARY WALLS WITH CEMENT FLOOR, WITH EARTH PIT 3' BY 3' FOR DRAINAGE IF NECESSARY. <3> Clean Up WOULD CLEAN UP WITH LICENSED ENVIRONMENTAL CONTRACTOR. <4> Other Resource Activation 03/3Q/94 % ACME POOL SUPPLY 215-000-000299 00 - Overall Site <F> Site Emergency Factors Page 9 <1> Special Hazards <2> Utility Shut-Offs A) GAS - SOUTHWEST CORNER OF BUILDING B) ELECTRICAL - INSIDE NORTHEAST ROOM OF BUILDING C) WATER - NORTH SIDE OF BUILDING AT SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water .... FIRE EXTINGUISHERS IN PLACE AND SPRINKLERS IN THE CHEMICAL STORAGE ROOM FIRE HYDRANT - NORTHWEST CORNER OF BUILDING <4> Building Occupancy Level 03/3Q/94~ ACME POOL SUPPLY 215-000-000299 Page 00 - Overall Site <G> Training 10 <1> Page 1 WE HAVE 2 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: BASIC TRAINING GIVEN IN WHICH CHEMICALS WILL NEUTRALIZE EACH OTHER AND SOME FIRE DEPARTMENT SEMINARS ATTENED AND NSPI TRAINING FOR SWIMMING HANDLING PROCEDURES. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use ~ Farm 'and Agriculture~Standard Business / ~!. LOCATION: "2.O "~D ~ ~ ~.C~T~, Z~P: ~~-~ ~o~ PHONE ~: ~- -~ ~ TY OF HAZARDOUS MATERIALS INVENTORY NON - TRADE SECRET OWNER NAME: ADDRESS: CITY,-ZIP: PHONE BAKE RS F I ELD Ni~E OF THIS'~¢FACILITY: STANDARD IND. CLASS CODE: DUN I~ID BRADST~ET NUI~ER/FEDERJ~ ID ~ :<~ i 2 3 4 5 6 7 8 9 10 11 12 13 14 Trans Type Max Average Annual Measure # Days Cont Cont Cont Use Location Where I ~ % by Names of Mixture/Components Code· Code Amt Amt Amt Units on Site Type Press Temp Code Stored in Facility wt See Instructions " C.A.S.' NUmber Component # I Name ~ C.A.S. Number ph~sical and Health Hazard ,~.ck all that apply) Component # 2 Name & C.A.S. N{~mber ~,~ Physical and Health Hazard C.A.S. Number "~'q ~'0'5 ~..P b~'-~'~ & C.A.S. Number '~ g Fire Hazard [] SuddenRelease I ~Reactivity [] Immediate [] Delayed COp. r~D~/ l~6t{~4iU~ .. , & C.A.S. Number I I I I I I I I I I I Physical and Health Hazard C.A.S. Number Component # I Name & C.A.S. Number ~,,, (Check all that apply) ~ Component # 2 Name & C.A.S. Number of Pressure Health Health Component # 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component # i Name & C.A.S. Number i~'i (Check. all that apply) Component # 2 Name & C.A.S. Number ~ Fire Hazard ~ Sudden Release ~ Reactivity ~ I~ediate ~ Delayed I (., of Pressure Health Health component # 3 Name & C.&.S. Number ~4 EMERGENCY CONTACTS 81 82 ':~:~l:' N] Title 24 Hr. Phone Name Title 24 Hr Phone (READ AND SIGN AFTER COMPLETING ALL SECTIONS) ~ l 'I certify under peanlty of law that I hayer personally examined and am familiar with the inf0rmatio.n submitted in this a~.d all.a.ttanhed docum~/~d that based on my inquiry of those :~:ndividuals respormibl, for obtaining the information. I believe that the submitted information ,s true, accurate, a:u ORIZ~D ~EP IVE FIRE DEPARTMENT S. O. JOHNSON FIRE CHIEF CITY of BAKERSFIELD "WE CARE" July 1, 1992 2101 H STREET BAKERSFIELD, 93301 326-3911 Donna Bayly Acme Pool Supply 2030 L Street Bakersfield, CA 93301 Donna: As we discussed on the phone, it is necessary to correct the chemical name of the bromine tablets on Acme's hazardous materials inventory. Please complete the highlighted sections on the enclosed inventory form.' Check fields 3-5 to make sure that the maximum, average and annual poundage is correct. White out and change any information which is incorrect. Please return the completed inventory form by 7-17-92. Call me at 326-3979 if you have any questions. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc: Ralph Huey Farm and Agriculture~Standard Business 'LOCATION: 'ZO ~9 ~- ~C CITY OF ~ BAKERsFIELD HAZARDOUS MATERIALS INVENTORY NON - TRADE SECRET OWNER NAME: ADDRESS: . CITY, - ZIP: PHONE ,.#: ' · ' REFER TO I"STRUCTIONS FOR PROPER CODESi I 2 3 4 5 6 Trane Type Max Average Annual Measure Code· Code Amt Amt Amt Units Physical and Health Hazard C.A.S. Number of Pressure 7 8 9 10 11 Days Cont Cont Cont Use on Site Type Press Temp Code 3eSl I t I I~mediate '~ Delayed Health Health 12 LocationWhsre Stored in Facility Page/ of_/ NAME OF THIS"~FACILITY: STANDARD IND. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL ID Component # 1 Name & C.A.S. Number Component # 2 Name & C.A.S. N~mber Component # 3 Name & C.A.S. Number % Names of Mixture/Components See Instructions I I I I Physical and Health Hazard (Check all that apply) ~ Fire Hazard ~ Sudden Release '~ Reactivity of Pressure I I I physical and Health Hazard C.A.S. Number i.i' (Check all that apply) C.A.S. Number [] I~ediate ~ Delayed Health Health ~ Fire Hazed [] Sudden ~lease ~ Reactivity [] I~iate ~ Delay~ of Pressure Health Health Ph~ical and Health ~zard C.A.S. Number · :(Check all that apply) ~ Fire Hazed ~ Sudden Release ~ Reactivity ~ I~.diate ~ Delay~ of Pressure Health Health Component # i Name & C.A.S. Number Component # 2 Name & C.A.S. Number Component # 3 Name & C.A.S. Number Component ~ i Name & C.A.S. Number Component # 2 Name & C.A.S. Number Component # 3 Name & C.A.S. Number Component # 1 Name & C.A.S. Number Component # 2 Name & C.A.S. Number Component #.3 Name & C.A.S. Number ',RGENCY CONTACTS #1 #2 Name Title 24 Hr. Phone Name Title 24 Hr Phone !;i Certification (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 !i?i~'iduals responsible for obtaining the information- I believe that the submitted information is true, accurate, and complete. · ~3%%:-~ '~ ;.,. · . . ;-'~.! . . ,i DATE ST~D "~/~ID OFFICIAL TITLE OF O~IER/OPYP, A~H OH O~IER/OPERATOR*S Atn.'aO~I ZED K~PKESENTATIVE 02~20/92 ACME POOL SUPPLY 215-000-000299 .Overall Site with 1 Fac. Unit HAR ~} 1992page Ans'd ............ General Information Location: 2030 L ST Map: 103 Hazard: Moderate Community: BAKERSFIELD STATION 01 Grid: 30A F/U: 1AOV: 0.0 Contact Name Mail Addrs: 2030 L ST City: BAKERSFIELD Comm Code: 215-001 BAKERSFIELD STATION 01 Title Business Phone, 24-Hour Phone- ~c~J (805) 327-8955 x 1(805) 322-8828 (805) 327-8955 x Administrative Data D&B Number: State: CA Zip: 93301- SIC Code: Owner: WILLIAM M. RAYLY ~Z?0! /~'~ phone: ( )_~/ Address: 1900 ALTA VISTA State: CA City: BAKERSFIELD Zip: 93305- Summary ,~~~~z~Do hereby c®~O~/~ha~ J hav~ reviewed the attached hazardous mmerial~ manage. corrections constitute a complete and ~rr~ man- ag~mem plan ~or my fa~lJ~y. 02/20/92 02-001 ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number/~D~ DRY CHLORINE S~F~d 1600 High CAS~ ~ Trade Secret: No .../ ~c~/q/~f-/ / For~: S0~id T~e: Mixture Days: 365 Use: ~]~ ~TM~NT ~ Daily Max L__B_~ Daily Averag~e~LBS ~Annual Amount LBS ( ~Z~z3~'{~ ' / 400 .':'1~0---~{ 8,000.00 ~ Storage /~ Press T Te~p Location -- ~ PLA~CONT~ER IAmbient I A~ient I SHOWROOM & S OF BLDG -- Conc ~X /Components I MCP ~List 90.0% Trichlorosilane ~// I Hlgh I 02-002 CONDITIONER - CYANURIC CHLORIDE · Solid 300 Moderate LBS CAS #: Form: Solid Daily Max LBS 300 Storage PLASTIC CONTAINER Type: Pure -- Conc Components 100.0% ICyanuric Chloride Trade Secret: No Days: 365 Use: WATER TREATMENT i Daily Average LBS Annual Amount LBS -- 150~00 ----~ 600.00 Press I TempI Location Ambient[AmbientlSHOWROOM & S SIDE BLDG MCP iList Moderate 02-003 LIQUID CHLORINE - HYDROCHLORIC ACID CAS #1~ ~ Trade Secret: N~ Form: ~quid Type!/ Mixture Day/.' 365 Use: -- Da~ly Max GA~/ Dail~ Average GAL ~ P~e's''~ i Temp PLASTIC CO~NTAINER Ambient[Ambient SOUTH Liquid 80 High GAL WATER TREATMENT Annual Amount GAL 400.00 Location SIDE OF BLDG -- Conc 12.5% IHydrochloric Acid Components MCP iList High 02/20/92 ACME POOL SUPPLY 215-000-000299 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-004 SODIUM HYPOCHLORITE Liquid 80 High · GAL CAS #: / ~ade Secret: No Form: L~lq/uid Type: Pu~e Days: 365 Use: WATER TREATMENT -- Daily Max GAL ~ Daily Average GAL ~~nnual Amount GAL __ . I/ 40.00 I / 500.00 ~rage /Press Temp /% /Location f. / PLASTIC~TAINER ~AmbientTAmbient \/ -- ~/ -- cons I'~""'~_.~..-/' Components~// MCP List ~~~dium Hypochlorite J High 02-O"05~DIUM/~SULFATE Solid 100 Minimal. ' · ~ LBS CAS #: Trade Secret: No Form:Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS Daily Average LBS Annual Amount LBS 200.00 Storage PLASTIC CONTAINER Press T Temp JAmbientJAmbient J Location -- Cons 91.0% Jsodium Bisulfate Components MCP jList JMinimal 02-006 BROMINE Solid 60 Extreme LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS60 J Daily Average 30.00 LBS j Annual Amount LBS 200.00 Storage PLASTIC CONTAINER Press T Temp IAmbient/A~bient I Location -- Conc 61.0% IBromine (EPA)-- 27.0% Chlorine (EPA)-- Components MCP IExtreme Extreme --iLiSt JEPA JEPA 02/20/92 ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 4 02-007 SODIUM CARBONATE Solid · 400 Low LBS CAS #: Trade Secret: No Form: Solid Type: Pure Days: 365 Use: WATER TREATMENT Daily Max LBS 400 I Daily Average LBS 200.00 Annual Amount LBS -- 1,500.00 Storage PLASTIC CONTAINER Press I Temp Ambient/AmbientI Location -- Conc 100.0% ISodium Carbonate MCP List Components iLow 02-008 PHENOL ~ Liquid 1 Moderate ~'///~qu~l.d~~~ Days: ~3/~5/ Use: OTHER ~~~ax GAL ~ ~~-~e GAL Annual ~ount GAL -- ~<~~ss T T~p I Location---- ~L~C ~TAI~~ I ~bi~im~ lents MCP L~t -- 0.0% lPhe~ (EPA) Modera~[E 02-009 SIMAZINE-2 CHLORO-4 ~ Solid 40 Unrated ~ LBS CAS #: Trade Secret: No Form: Solid Type: Mixture Days: 365 Use: WATER TREATMENT Daily Max LBS40 I Daily Average 20.00 LBS Annual Amount LBS 60.00 BAG Press T Temp Location Storage iAmbient/AmbientI -- Conc ~ Components ~ MCP ~List .02/20/92 ACME POOL SUPPLY 215-000-000299 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 5 02-010 CALCIUM HYPOCHLORITE Solid 200 Moderate LBS CAS #: Form: Solid Daily Max LBS 200 Trade Secret: No Type: Mixture Days: 365 Use: COOLING i Daily Average LBS Annual Amount LBS -- 100.00 I 800.00 Location Storage PLASTIC CONTAINER Press T Temp Ambient{AmbientI -- Conc 65.0% ICalcium Hypochlorite Components MCP List Moderate 02-011 SODIUM DICHLOR Solid 300 Moderate LBS CAS #: Form: Solid Daily Max LBS 300 Trade Secret: No Type: Mixture Days: 365 Use: WATER TREATMENT Daily Average LBS I Annual Amount LBS -- I 150.00 1,000.00 Location Storage PLASTIC CONTAINER Press T Temp I Ambient~Ambient I - Conc Components 65.0% ISodium Dichloroisocyanurate MCP ~List IModerateI 02/20/92 . ACME POOL SUPPLY 215-000-000299 Page 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation ~:E Lnv= i~G Ei4PLGYE~. ON DAYS WHEN MY FATHER IS IN IF WE HAD A PROBLEM WE WOULD VERBALLY NOTIFY EACH OTHER AND EXIT THE BEST POSSIBLE WAY. <3> Public Notif./Evacuation ~. WOULD VERBALLY NOTIFY ANY NEIGHBORS IF A PROBLEM OCCURRED. <4> Emergency Medical Plan HALL AMBULANCE SERVICE - 1001 21ST ST MERCY HOSPITAL - 2215 TRUXTUN AV SAN JOAQUIN HOSPITAL - 2615 EYE ST 02~20/92 ACME POOL SUPPLY 215-000-000299 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page <1> Release Prevention ALL CHEMICAL STORED IN STORAGE ROOM ARE SPRINKLERED IN CASE OF FIRE. LIQUID CHEMICALS ARE IN SECONDARY PLASTIC CASES. ALWAYS KEEP 100 LBS OF SODA ASH CONTAINER OPEN TO PUT ON ANY ACID SPILLS AND FIRE EXTINGUISHERS AT DOOR ENTERING STORAGE ROOM. wATER HOSE & BIB READY TO FLOOD ROOM. ALL DRY CHEMICALS ON PALLETS ABOVE ANY LIQUID SPILL IN ROOM. <2> Release Containment <3> Clean Up <4> Other Resource Activation 02~20/92 ACME POOL SUPPLY 215-000-000299 00 - Overall Site <F> Site Emergency Factors Page" 8 <1> Special Hazards <2> Utility Shut-Offs A) GAS - SOUTHWEST CORNER OF BUILDING B) ELECTRICAL - INSIDE NORTHEAST ROOM OF BUILDING C) WATER - NORTH SIDE OF BUILDING AT SIDEWALK D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN PLACE AND SPRINKLERS IN THE CHEMICAL STORAGE ROOM FIRE HYDRANT - NORTHWEST CORNER OF BUILDING <4> Building Occupancy Level 02/20/92 ACME POOL SUPPLY 215-000-000299 Page 9 00 - Overall Site <G> Training <1> Page 1 WE HAVE 2 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE z ~age z as ~e~ded <3> Held for Future Use <4> Held for Future Use CITY o.,t' BAKER SFTELD "I I:E C.4 R E" ! ~yee or Drin~ name RECEIVED F E B 0 2 i989 Do hereby c=~t~'' reviewed ~he . ~ _~., that i have ,- /k~'~ ............ attached Hazardous Flaterials business plan for (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business~//~//Plan for:~mv fza~ ility..,, ' ~ ~ Z~nasuF~ LoCATIO~: ~~:~2-~ ~/ DUN AND BRADSTREET NUMBER C~e ~t ~t Est Units ~lth of P~ ~lth P~ical ~ ~lth Hazl~ C.A.S. (C~k 411 t~t ~pply) P~icol ~ ~Jth ~za~ C.A.S. (C~k oil t~t opp~y) ..... Fire Hazard ~--~ RHct,v4ty ~le~ ~ ~ ~ Reline -- Health of P~ical ~ H~lth ~a~ C.A.S. ~-_ .................... ~t (C~k oll t~t ~ly) , ' _ ~ .......... Flee Hazaed ~--~ ~ct~v~y ~--- ~la~ ~--~ ~e blme ~--d I~ate ........... H~lth of Prflsure Health ~t 13 h &C.A.S. ~r - Certtficatio~ (Reed end sign after coapJetJng ali sections) under penalty of 1~ t~t I ~ve ~rs~allv e.amin~ end la f~iliar vtth t~ i.forMtim.su~itt~ obta~nina t~ inf~ti~. I ~lieve t~t T~ su~itt~ info.tim is t~, accurate, end c~plete. ................. my inquiry of tho~e tn~tvtdmmis ~Pe~sible ............... LOCATION: ~)L~'/9 ~ /;~'~/ " ADDRESS: · STANDARD IND. CLASS CODE CrTY ZIP: ~-~.~:?~-_t~/~,~_/_/.~/ ~'~,~ ~W~/ CITY. ZIP: ~~~J~ ~/ DUN AND BRADSTREET NUMBER PHONE ~: ~ .~ PHONE e: /~_:-__~ '' - ~~ ~,-~ _ _ -/ - ; ~ ~-x~~x~ ~ ~oP~ con~ C~ C~e ~t ~t Est Un,ts m Site .~I~J_.Z~._] ~ I ~ Vg~.lx~l/~1 / I ~ WXI ~'~ ~/ ~~ ~' ~//~ -- f~-~ Fireaazaed ~--a R~tJvJty ~--d ~1~ ~--] ~ ~i~ ~--~ ~lth . el P~m ~lth : -~-L~I...&~___L~.~_,I ~ ~1~~~ (~k oll t~t apply) _ ~-~_ ~-~ :-~_ ~_~-~ '~t, ~ ~ C.A.S. ~- ~ ~ FI~ ~za~d ~ J ~ttv~ty ~le~ J ~:blm I~tote ~lth of P~ ~lth P~tcol ~ ~lth ~ze~ C.l.S. ~ (C~k all t~t o~ly) ~ H. Ith of P~ blth ~t I P~icol ~ H~lth ~le~ C.A.a. ~- t[~ -- , r--~ r-- r--~ C~t B2 ~&C.A.S. ~ flee Hazard ~-] ~tivity ~--~ ~le~ ~-] ~ ~lme fl~lth of Pr~suee Hea)th ~', Tli - ' ............ tl~li' ~F'~" ' Certificatfo~ (Reed and sign after coepJetJng ali sections) ~'c~'rtify under aenaity of le~ that I ~ve ~rsmollye,amin~ ~d om faJliar etth t~ tnf~ti~,su~itt~ ~or obtaining t~ inf~t~.~l ~lieve. t~t t~ su~tt~ info~ti~ is t~. accurate, efta c~atete.~. ~.::. :~'~- .... . . inquiry of tho~e tndtviduola e~lXmsJble .............. LocATION: (C~k ell t~t o~ly) ~lth Of P~ ~lth (C~k all t~t R~ct~vity -- N~lth of P~sure N~lth H~lth of :~ Certification (Read and sJKn after coapJetJnE a11 sections) ~o;ttfy under I~elty of lee that I ~ve ~rsmallye~aein~.and aa f~iliar etth t~ tnfor~ti~ls~itt~ ~or obtaining t~ interim. I ~lieve t~t t~ sumitt~ in;o~tim is tr~. accurate, :. ,~_ />~ ~ ~,,~ ~~~ inquiry of tlw~e individuals responsible · CITY ' .. '-~ ~HAZARDOUS~] MATERIALS INVENT'ORY fo~ and A~ricul~v~e ~ S~nd~d Busings ' NON--}, TRAOE SECRETS ' ~.f_of ~_ C~e ~t ~t Est Units ~ Site l~ ~ l~ ~ f St~ tn F~tlity ~ ~ Iqt~ti~ (C~k ell t~t apply) ~lth of P~ ~ith (C~k all t~t Fire Hazard =- ~ R~tiv~ty ~la~ ~-- ~ ~elme I~ete . , · ...... Health of P~su~ NHlth ~t 13 ~&C.A.S. ~ ~lth of Pr~sure Health Certification (Read and sign after co~p]etJng all sections) ~c'~r'ttfv under Oenalty of le~ that I have eersonally exan~ned and aa familiar with tho throe ,netion,subaitted in this and all attechad~doe~/, end that ~s~ ~ ~ ~t~ of t~e i~tvi~ls ~sible BUSINESS NAME ACME PO~SUPPLY LOCATION 2030 L ST IOUMBER 215-000-000299 HIGH HAZARD RATING 3 1 . OVEI:{$~IEW LAST CHANGE 11/06/87 BY ESTER JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30A FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) B & C FIRE EXTINGUISHERS IN PLACE. ROOM. SPRINKLERS IN CHEMICAL STORAGE .EMERGENCY CONTACTS 2A SEC 2) ~UN 0 8 1989 WILLIAM M RAYLY - 327-8955 OR 322-8828 SAL DEL RIO - 327-8955 OR 833-4633 UTILITY SHUTOFFS 2A SEC 3t A/ GAS - SOUTHWEST CORNER OF BLDG BI ELECTRICAL - INSIDE NORTHEAST ROOM OF BLDG Cl WATER - NORTH SIDE OF BLDG AT SIDEWALK DI SPECIAL - NONE E) LOCK BOX - NO NOTIFICATION < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 MATERIAL SAFETY DATA SYSTEMS, INC. 12/16/88 1'2:10 805) 64.8-6800 BUSINESS NAME ACME POOL SUPPLY LOCATION 2030 L ST ID NUMBER 215-000-000299 HIGH HAZARD RATING 3 3 HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > iOo E Fr,,gLoyEES '--- EMERGENCY MI~DICAI_, ASSISTANCE LAST CHANGE 11/06/87 BY ESTER 2A SEC 5) HALL AMBULANCE SERVICE - 1001 21ST ST MERCY HOSPITAL - 2215 TRUXTUN AV SAN JOAQUIN HOSPITAL - 2615 EYE ST PAGE 2 12/16/88 1'~ ~:10 MATERIAL SAFETY DATA SYSTEMS, INCl. (805) 648-6800 BUSINESS NAME ACME PO~ LOCATION 2030 L ST FACILITY UNIT 01 SUPPLY' 215-000-000299 HIGH HAZARD RATING 3 A o OVERALL HAZARDOUS MATERI~-I_ LS IN\fENTOt{Iz LAST CHANGE 11/06/87 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE 1 MIXTURE DRY CHLORINE 2000 LBS SHOWROOM & S OF BLDG PLASTIC CONTAINER[S] BACTERICIDE ID PERCENT COMPONENTS 2633.00 90.0 TRICHLOROSILANE EXTREME HAZARD LIS~ EXTREME 2 PURE CONDITIONER - CYANURIC CHLORIDE 100 LBS SHOWROOM & S SIDE BLDG PLASTIC CONTAINER[S] ADDITIVE ID PERCENT COMPONENTS 1658.00 100.0 CYANURIC CHLORIDE HIGH HAZARD LIS~[ HIGH 3 MIXTURE LIQUID CHLORINE - HYDROCHLORIC ACID 25 GAL SOUTH SIDE OF BLDG PLASTIC CONTAINER[S] BACTERICIDE ID PERCENT COMPONENTS 1078.00 12.5 HYDROCHLORIC ACID HIGH HAZARD LISq! HIGH FIRE PROTECTION / WATER SllPPLI~JS LAST CHANGE / / BY < NO INFORMATION RECORDED FOR TItlS SEC, TION > PAGE 3 12/16/88 12:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME ACME POOL SUPPLY LOCATION 2030 L ST ID NUMBER 215-000-000299 HIGH HAZARD RATING 3 EMPLOYEE NOT I F I CAT ION / LAST CHANGE EVACUAT ION / / BY < NO INFORMATION RECOR, DED FOR THIS SECTION > E . MITIGATION / PREV-ENT I ON / ABATEMENI" LAST CHANGE / / BY <' NO INFORMATION RECORDED FOR THIS SECTION PAGE 4 12116/88 12:10 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BAKERSFIELD CITY FIRE DEPARTMENT I.D. # ~:-~%-~~ FORM 4A-1 Page / of / NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY ADDRESS: ~',~ 't2~* -~'2z- ADDRESS: FACILITY UNIT NAME: CITY, ZIP: ;~/~-._~. ~ '~/~,~ ,O .~, ~,,~>? ~ CITY,ZIP: PHONE ~:~ ~-~~_ PHONE ~: OFFICIAL USE CFIRS CODE [ ONLY 1 2 3 4 5 US6E 7 8 9 10 D TYPE MAX ANNUAL CONT LOCATION IN THIS ~ BY HAZARD .O.T CODE A.OUNT AMOUNT UNIT CODE CODE FACILITY : TITL~.~ gS)t,~.( SlONATURE: DATE: EMERGENCY CONTACT: ~-~,/~y TITI. E: t~W~/ PHONE # BUS AFTER BUS HRS: E"EROENCY CONTACT: --~'~/ z~/r'~_./. . ~J'~ TITLE: P"ONE ~ BUS HOURS: PRINCIPAL BUSINESS ACTIVITY: ~J~~ ~/ ~~ AFTER BUS HRS: - 4A-1 - iZ io BAKERSFIELD CITY FIRE DEPARTMENT 2130 "O" STREET BAKERSFIELD, CA 93301 (805) 326-3979 RECEIVED JUN 3 0 1987 Ans'd ............ IUSINESS NAME OFFICIAL USE ONLY ID# HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 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 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 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~ ,T, Ij~LE ~j~ DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B ELECTRICAL: ~ ~;>/~ ~/~h D. SPECIAL: E. LOCK BOX: YES / N0 IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / NO MSDSS? YES / NO YES / NO KEYS? YES / NO - 2A - SECTION. 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...· ........................ ; ......... ~ NO Y~_~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~NO ~NO C. PROPER USE OF SAFETY EQUIPMENT: .................. NO NO D. EMERGENCY EVACUATION PROCEDURES: ................. ~ ' ~.~ E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES YES SECTION 7: HAZARDOUS MATERIAL CIRCL~OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUND~F A SOLID, 55 GALLONS OF A LIQUID, j~j~200 CUBIC FEET OF A COMPRESSED GAS: ...... ~ NO I, /~//b~ ~ /~ , certify that the above information is accurate. // I understand that this iJ~o~ion 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. SIGNATURE SI TE/FAC ILI TY FORM DIAGRAM SCALE:/_-~ BUSINESS NAME: (CHECK ONE) SITE DIAG~ FACILI~ DIAGR.~ . l-aP l( Inspector's Comments): -OFFICIAL USE ONLY- - SA - Hazardous Materials Inspection Date Completed Ans'd ............ Plan ID # 215-000 o2,.~ (Top right comer Business Plan) Station No. / Shift ~(~ I ns p e c tor C~-~o~,,, ~.~f~ Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material ColTLrncnts: Verification of MsDs Availability Number of Employees Verification of Haz Mat Training CornlTlents: Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Comments: Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: FO 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy, Pink-Business Office