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Home My WebLink AboutBUSINESS PLAN UTILITY BUILDING EQUIE WOMENS ~ MENS.. .... I0 ~ ~ UTILI' --, TY- ROOM ~EST~OOM- ~EST~OOM SCALE I"= ~' .. ~' .... ELECTRICA'L ' ' II I0 I~UTILITY BUILDING CONT, ED[DE] / ALLEY. -- NOT, ES I .RESERV. PICNIC AREAS- 2.PICNIC NOOKS :5. SERVING SHELTER -. 4LPLAY AREAS - SHELTERS 5 .SHELTER 6,TENNIS COURTS- 2 7.BASKETBALL COURT 8 .SWIMMING POOL 9 ,SOFTBALL DIAMOND I0 .RESTROOMS I I.POOL UTIL STORAGE 12. PUMP HOUSE .... 13 .PARKING LOTS I WATER METER~I EL TORO DRIVE rm PERMANENT TRASH RECEPT. -c- WATER FOUNTAIN ~ BBQ 06/2~/~3 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 Page Overall Site with 1 Fac. Unit General Information Location: MING AV\EL TORO ST. Map: 124 Hazard: High I Community: BAKERSFIELD STATION 06 Grid: 06C F/U: 1AOV:~ 0.0 1 Contact Name ~ Title Business Phone 24-Hour Phone] LINDA ROBINSON ISUPERVISOR I (805) 326-3701 x (805) 837-1388! JERRY DE LAURIE CRAFTWORKER~I (805) 326-3701 x (805) 323-0685! Administrative Data Mail Addrs: 1501TRUXTUN AV D&B Number: City: BAKERSFIELD State: 'CA Zip: 93301- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 7999 Owner: CITY OF BAKERSFI. ELD Phone: (805) 326-3701 Address: 1501 TRUXTUN AV State: CA· City: BAKERSFIELD Zip: 93301- Summary 06/2~/93 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 2 02-001 CHLORINE- Ga~-~j 3000 Extreme ~ Fire, Pres~,eT--~mme~--~thT--D/~lay Hlth~~ FT3 CAS ~: 7782-50-5~Trad~ret: No Form. Gas Type: %Pqu~e ' Days: 100 Use: WATER TREATMENT -- Daily Max FT3// ~. Daily Average FT3 ~. Annual Amount FT3 3,0~ ,~ 1,500.00 ! ' 4,500.00 ~ Storage~ I Press T Temp I Location PORT. PRESS. CXLINDER IAbov~ [AmbientlE WALL AND S WALL --1~nc ' I // ~Components MCP ~Guide .0% IQhlorine (EPA) IExtreme ! 20 02-002 · SODA ASH-- c--P~% Solid ~ Fire, ~d_H hl~h~ /~~' ' ' -- Form: Solid ~pe:~m,~y~]:~65 Use: -- Daily M/~ax LBS~ I Daily Avera~0~ ~a~ge ~]~~~~tT~T~.nt I E WALL --.~onc ' Component~ 100.0% ISodium Carbonate 900 Low LBS WATER TREATMENT Annual Amount LBS 1,800.00 Location M~CP ----TGuide Low ! 60 06~29~93 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 00 - Overall Site <D> Notif./Evacuation/Medical Page <1> Agency Notification CALL 911 ALL RELASES WILL BE REPORTED TO BAKERSFIELD FIRE, HAZARDOUS 'MATERIALS DIVISION 326-3979 AND CALIFORNIA OFFICE OF EMERGENCY SERVICES 1-800-852-7550 <2> Employee Notif./Evacuation NOTIFY FIRE DEPARTMENT CLEAR PERSONNEL FROM AREA <3> Public Notif./Evacuation VERBAL, EMERGENCY EXITS ARE UNLOCKED DURING POOL OPERATION HOURS, LIFEGUARDS WILL CONDUCT .THE EVACUATION OF THE FACILITY. <4> Emergency Medical Plan NEAREST HOSPITAL BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 00 - Overall Site " <E> Mitigation/Prevent/Abatemt Page 4 <1> Release Prevention SAFETY CLOTHING AND EQUIPMENT ADHERENCE TO MANUFACTURES INSTRUCTION ON LABLE ISOLATE SPILLS - CONTAIN FoR PROPER REMOVAL GAS.CYLINDERS CHAINED TO THE WALL <2> Release Containment <3> Clean Up <4> Other Resource Activation BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 00 - Overall Site <F> Site Emergency Factors Page <l>.Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - TOOL SHED EAST OF MENS ROOM C) WATER - NORTH END OF PARK, PUMP ROOM D) SPECIAL ~ NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - CITY FIRE HYDRANT - SOUTHWEST CORNER EL TORO DR. AND LA FRANCE <4> Building Occupancy Level BAKERSFIELD WAYSIDE PARK SWIMMING 00 - Overall Site <G> Training 215-000-001317 Page <1> Page 1 WE HAVE 4 EMPLOYEES AT THIS .FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE LIFEGUARDS RECIEVE TRAINING. JERRY DELAURIE HAS BASIC TRAINING IN SCBA TO WORK AROUND CHLORINE GAS. IN CASE OF EMERGENCY WILL TURN OFF EQUIPMENT BRING TO SHUT DOWN THEN ASSESS NEED FOR ADDITIONAL CONTRACT HELP. <2> Page 2 as needed <3> Held fOr Future Use <4> Held for Future Use FACILITY INFORMATION FORM Please answer each of the following questions by circling Y (yes) or N (no). ~s any acutely hazardous material (AHM) manufactured or used in a chemical reaction ? / N Is any other flammable gas, flammable liquid or explosive material manufactured or used in a chemical reaction ? Is any reaction in question 1 or 2 a moderately or highly exothermic reaction ( e.g'. alkylation esterfication, oxidation, nitration, polymerization or condensation) or one involving electrolysis v Can any unplanned'release of a AHM to the atmosphere result from the malfunction of any scrubbing, treatment or neutralization system or the discharge of a ~-1 pressure relief system ? ~/ N Does any physical or chemical process in which an AHM is produced or used involve a batch process Does any physical or chemical process involve the production or use of any AHM at a pressure in excess of 15 psig v 7. In excess of 275 psig ~ ~/N Does any physical or chemical process involve the production or use of an AHM ~at a temperature above 125 degrees F ~ 9. In excess of 250 degrees Y/® 10. Can any explosive dust be present in any closed container within 100 feet of an AHM or otherwise be present in the same building as an AHM 9 11. Is'there any ignition source or open flame within 100 ft. of any process, storage or transfer area where a flammable or explosive AHM is present , except where there is a firewall providing protection ~ 12. Is any lined or non-metallic pipe used in the transfer of any AHM ? 13. Is any equipment or piping handling any AHM more 10 years old ~ PLEASE PROVIDE THE FOLLOWING INFORMATION : ( Attach additional pages,if necessary) Your company's current workers compensation ~ experience modification factor. ~_ How many people occupy the building in which AHM's are used or stored ? .~' Give details of all accidents which involved any '~O6~diC~a_~ hazardous material and all other instances when the'fire department has been summoned in an emergency. Briefly described the operations process at your plant and the specific processes utilizing AHM's~ including storage proceedures. -2- '5. Briefly describe the equipment being used in the processes involving AHMs. Report quantity of AHM(s), referenced in the cover letter, that this business handles. a) Maximum amount on hand at any one time. ~ ~ b) Please attach a Material Safety Data Sheet for any material that is a mixture. Do not include MSDS for pure substances. DEMOGRAPHIC DATA: State the straight line distance in feet between the business property line and each of the following. 1. Nearest school. ~~ ,.~t:"~ 2. Nearest daycare center, hospital, nursing home or similar facility. 3. Nearest residence/motel etc. 4. Nearest occupied building. ! I certify that the ..foregoing information is true and correct to the best of my knowledge. 0!/24/91 BAKERSF Page WAYSIDE PARK SWIMMING 2~000-001517 Overall Site with 1 Fao. Unit General Information LooatLon: MING AV\EL TORO ST Map: 124 Hazard: High Ident Number: 215-000-001517 Grid: 060 Area of Vul: 0.0 V ~' ~ '- ,' Administrative Data Mail Addrs: 1501 TRUXTUN AV D&8 Numbec: City: BAKERSFIELD State: CA Zip: 9~O1- comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 7999 Owner: OITY OF BAKERSFIELD PhoRe: (805) Address: 1501 TRUXTUN AV State: CA City: BAKERSFIELD Zip: Summary , ................................................................. I, ~/;,~0/~_ ,g~¢;,~Jo/~ Do hereby certify that I have (Type or prim reviewed the attached hazardous materials mar:age- ment plan for ~ ,~c/~¥/~ ~nd that it ~dong with any corrections constitute a complete and correct man- agement plan for my facility. 01/24/91 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001317 Hazmat Inventory List in MOP Order 02 - Fixed Containers on Site Pln-Ref 02-001 Name/Hazards CHLORiNE~'~ ~ Fire, Pressure, lmmed Hlth~/D'elay Hlth Form Quantity MOP Gas FT3 Extreme 2 02-002 SODA ASH Fire, Immed Hlth Solid 900 Low LBS 01/24/~1 BAKERSFIE~ WAYSIDE PARK SWIMMING 2i~te000-001;517 02 - Fixed Containers on S Hazmat Inventory Detail in MOP Order 3 02-001 CHLORINE Fire, Pressure, Immed Hlth, Delay Hlth. Gas ;5369 Extreme FT3 CAS ~: 7782-50-5 Trade Secret: No Form: Gas Type: Pure Days: /-~~ Use: WATER TREATMENT Daily Max -- Storage PORT. PRESS. CYLINDER .... Daily Av~T5 ~ Annual Amount FT5 : .¢.r.'"7./'e I q j Press Z Temp .... I Loo~tLon ~bove j~mbsen~ E N~LL ~ND 8 N~LL -- Cone 100.0~o Chlorine (EPA) Components MOp ..... FList Extreme JEPA 02-002 SODA ASH Fire, Immed Hlth Solid 900 Low LBS CAS ~: 497-19-8 Trade Secret: No Form: Solid Type: Pure Days: ;565 Use: WATER TREATMENT Daily Max LBS 900.00 ..... Daily Average LBS ---T---- A 600.00 nnual Amount LBS -- 1,800.00 BAG Storage Press T Temp AmbientJAmbientJE WALL Location -- Cone - loo.o~ JSodium Carbonate Components .... MOP ----~ist jLow 01/24/91 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001517 Page 4 O0 - Overall Site <D> Notif./Evaouation/Medioal <1> Agency Notification , <2> Employee Notif./Evacuation NOTIFY FIRE DEPARTMENT CLEAR PERSONNEL FROM AREA <5> Public Notif./Evaouation <4> Emergency Medical Plan NEAREST HOSPITAL 01/24/91 BAKERSFI WAYSIDE PARK SWIMMING O0 - Overall Site 20000-001317 <E> Mitigation/Prevent/Abatemt Page 5 <1> Release Prevention SAFETY CLOTHING AND EQUIPMENT ADHERENCE TO MANUFACTURES INSTRUCTION ON LABLE ISOLATE' SPILLS - CONTAIN FOR PROPER REMOVAL <2> Release Containment <3> Clean Up <4> Othem Resource Activation 01/24/91 Page 6 BAKERSFIELD WAYSIDE PARK SWIMMING 215-000-001517 O0 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - TOOL SHED EAST OF MENS ROOhi D) SPECIAL- NONE - ' ~ El) LOCK SOX - NO <5> Fire Protec./Avail. Water P~ FIRE PROTECTION - CITY FIRE HYDRANT - SOUTHWEST CORNER EL TORO DR. AND LA FRANCE <4> Held for Future use 01/24/91 BAKER~ WAYSIDE PARK SWIMMING 2~000-001517 Page 7 O0 - Overall Site <G> Training <1> Page 1 WE HAVE ,~ EMPLOYEES AT THIS FACILITY LIFEGUARDS RECIEVE TRAINING.' JERRY DE LY~ HAS BASIC TRAINING IN SCBA TO WORK AROUND CHLORINE GAS. IN OASE OF EMERGENOY WILL TURN OFF EQUIPMENT - BRING TO SHUT DOWN THEN ASSESS NEED FOR ADDITIONAL CONTRAOT HELP. <2> Page 2 as needed <5> Held got Future use <4> Held for Future Use May l, 1990 Dear Business Manage~: The following questior~r, aire is a supplement to the Acutely Hazardous Materials Regist~-ation Form previously submitted by your business as required under Section 25534 of the California Health & Sa~ ~C~?de. This registration i nd i cat es t hat ~e~fi~I~_~y_s-i-d~]~ hand 1 es ~~)]~ ~gas,~-an acutely haza~dous material ( AHM ), in an amount greater than the plar~r~ing quantity for this chemical. Additional informati.z,n is necessary in order tn complete the risk management planning functions of this agency. This questionnaire should be completed by an office, er of the compar~y or other person having substantial management control over all operations at the facility. If there is any doubt as to whether or not the ar~swer to a question is yes or rio, the answer "yes" shall be given. With in two weeks of receipt, complete and return the questionnai~e to: The Bakersfield Fire Department Haza~dous Materials Division 2130 G Street Bakersfield, CA 93301 If you need additional info~mation, please call 326-3979. Sincerely, Barbara B~enner Hazardous Mate~ials Planning Technician CITY of BAKERSFIELD HAZARDOUS MATERIALS INVENT.ORY' NON--TRADE SECRETS tUSINESS NAME (]it', of Bakersfield sane HAME OP TI~$ FACILITY: Wa?id~ Pml LOCATION: .., Minq and EI Toro ADDRESS: 4101 Truxtun Avenue STANDARD IND. CLASS CODE[- CITY, ZIP: CITY. ZIP: 93309 DUN AND BRADSTREET NUMBER PHONE #: PHONE #: (~5~ 326-3117 __ - - ~ TO .TWS2'~UCTZOlrS POlt PROPI~ CODI~ 1 ~ 3 I S t ? I ! 10 II I~ 13 Irons T~ Nix Av~Mll /~fl~i Miu~ I Oys Cmt Cat C~nt Use tocittan ~ ~ ~ of Ntxt~/~ts C~e C~e Mt Mt Est Un*ts m Stte T~ ~ I~ ~ .. St~ tn FKtltty ~ I~t~ti~ .N_I.LJ._3~e__] 1~9 I. 67~ [~3:! m :1 m I 2 I 4 1__4~._! E w)]]/~:~!] .............. I~ .... Ph~icll ~ Hmlth ~ZIH C.A.S. ~ 7782-50-5 ~t ~ ~ &c.A.s. ~ IC~k ,11 t~C a~ly) ..... Chlorine [ ire Hezird ~--a R~tivity -- hi'th[[] ~of P~mh]~ -- IMilte~lth ..... ' ' ..... Wt 13 ~ & C.A.S'. (C~k .11 t~t apply) . : ~da Ash _ ~lth of ~ ~lth ~t 13 ~&C.A.S. ~ ..... L_L L,L,2,I [ I I ! I' I I ::' P~Ic~l ~ ~lth b~lH C.A.S. ~ It Il h I C.A.a. ~ (C~k ~ll t~t Ipply) ...................... [ ~ Fire Hazaed [-~-~ Rflctivity [ ] ~14~ ~- J ~ Relme ~- a I~tate ...... · ~lth of P~su~ NNIth P~icll ~ H~lth ~tlN C.A.S. ~ It II ~ I C.A.5. W (c~k ail t~t INly) ~-._ _ --- . ....... H~l~h of 9r~su~e Health ........... N~,GENCY C~TACTS I1 Neil Tier~ SU~rvisor i~ ' ~5-336~ I~Jerry ~a~ie Maintenance Craft~rker I 323-~5 ,~a-i ................................ m~i ....................... .-,F,~i ........ ~ Tm~ .m~-~ ........ Certification (Read and sign after coapJetJng ali sectJons) [ cert~fy under penalty of law that I have oersonallyexamined and ii feliliar Pith the tnfor.~tJon submitted tn this and Ill at~Khed docueents, end that based on ay inquiey of thole individuals ee~ponsible for oL~.aining the infoeMtton. I believe that the submitted inforlation is true, accurate, and cmiplete. _//7 . j ix ,.. ,, .... ....... ...... ,- '~'.- 'm ....... ~?~, ......................... *~,~-~ .... r ................. ~ ............... · BUSINESS NAME BAKERSFIELD WAYSIDE PARK SWIMMING ID NUMBER LOCATION MING AV ANO EL TORO NIGH HAZARD RATING ,l. OVERVIEW JURIS CODE MAP PAGE 1Z4 ..... LAST CHANGE 01/03/8B BY VAL ZlS-006 JURIS 8AKERSFIELO STATION 06 GRID OGC FACILITY UNITS 1 HAZARD RATING 4 RESPONSE SUMMARY CITY SEC 4) EMERGENCY CQNTRCTS ZR SEC 2) , _~,..R .~-.E-K~N11ER - 326-31 I? OR UTILITY SHUTOFFS 2R SEC 3) A) GAS - NONE B) ELECTRICAL - TOOL SHE~'E OF MENS ROOM C) WATER SHUT OFF'.- ? D) SPECIAL - NONE E) LOCK BOX -'NO NOTIFICATION / PUBLIC EVRCURTION LAST CHANGE / / BY < NO INFORMRTION RECORDED FOR THIS SECTION > 0I/'05/8B TT: MR'rERIRL SAFETY DATA' SYSTEMS~ INC. '(80B) BUSINESS NRME BAKERSFIELD WRYSIDE PARK SWIMMING ID NUMBER Z15-000-001317 LOCATION MING AV AND EL TORO HIGH HRZARD RBTING 4. MBT TRAINING SUMM~RY LRST CHRNGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICBL ASSISTANCE 9-/'/ LBST CHBNGE 01/03/89 BY VBL SEC S> NEAREST HOSPITAl_ PBGE.Z 01/0S/89 17:38 MATERIBL SAFETY DR'fA SYSTEMS, INC. (805) 648-.6800 BUSINESS NAME BAKERSFIELD WAYSIDE PARK SWIMMING ID NUMBER ZIS-080-001317 LOCATION MING AV AND EL TORO HIGH HAZARD RATING 4 FACILITY UNIT 01 OVERALL HAZARDOUS MATERIALS INVENTORY ' LAST CHANGE 01103189 BY VRL ID TYPE NAME LOCATION' CONTAINMENT PURE CHLORINE NORTH WALL PORTABLE PRESS,. CYL. ID PERCENT COMPONENTS 1028.00 1~.0 CHLORINE (EPA) MAX AMT UNIT HAZARD USE ..~FT3 EXTREME WATER TREATMENT HAZARD LIST EXTREME EP PURE SODA ASH N END E WALL BAG[S] ID PERCENT COMPONENTS 1Z88.00 100.0 SODIUM CARBONATE 900 LBS UNKNOWN WATER TREATMENT HAZARD LIST UNKNOWN B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 01103189 BY VRL SEC 4) CITY 3fl SEC S) FIRE HYDRANT - SW CORNEA'EL TORO DR. AND L.R FRANCE PAGE '01/0S/89 1'7:38 MATERIAL SAFETY DATR'SYST1Sr~',' I'NC',. (895') G48~G800 BUSINESS NAME BAKERSFIELD WAYSIDE PARK SWIMMING ID NUMBER ZlS-000-001~17 LOCATION MING Ag AND EL TORO HIGH HAZARD RATING 4 EMPLOYEE NOTIFICATION / EVA£UATION 3A SEC Z) NOTIFY FIRE DEPARTMENT CLEAR PERSONNEL FROM AREA LAST CHANGE 01103/8B 8Y VAL E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 01/03/89 BY VA[. SEC 1> SAFETY CLOTHING AND EQUIPMENT ADHERENCE TO MANUFACTURES INSTRUCTION ON LASLE ISOLATE SPILLS - CONTAIN FOR PROPER REMOVAL PAGE 4 01/05/89 MATERIAl. SAFETY DATA SYSTEMS, INC. (805> 648-6800 FIRE DEPARTMENT D.S. NEEDHAM FIRE CHIEF CITY of BAKERSFIELD "WE CARE" OCTOBER 13, 1988 2101 H STREET BAKERSFILED, 93301 326-3911 PARKS"DIVISION 4101TRUXTUN AVE. BAKERSFIELD, CA 93309 DEAR MR. PAUL DOW: THE ~NCLOSED "ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM" MUST BE COMPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUM REPORTING QUANTITY OF ANY MATERIAL ON THE EPA LIST OF EXTREMELY HAZARDOUS SUBSTANCES. (FED. REGISTER VOL. 52, NO. 77, P. 13397). THE PARKS (SEE ATTACHED LIST) ARE REPORTED HANDLING THE FOLLOWING ACUTELY HAZARDOUS MATERIAL: CHLORINE 'PLEASE RETURN THE COMPLETED ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM TO: HAZARDOUS MATERIALS DIVISION 2130 G STREET BAKERSFIELD, CA 93301 IF YOU 'HAVE ANY QUESTIONS REGARDING'THIS FORM PLEASE CALL RALPH HUEY AT 326-3979. SINCERELY YOURS, RALPH E. HUEY HAZARDOUS MATERIALS COORDINATOR REH/ed ENCLOSURE BEALE PARK POOL CENTRAL PARK POOL JASTRO PARK POOL JEFFERSON PARK PO PLANZ PARK POOL SAUNDERS PARK POOL SIEMON PARK POOL OLEANDER & DRACENA 19TH & R ST MYRTLE & TRUXTUN BERNARD & KING H & PLANZ PALM & OAKDALE PASADENA & REDLAND THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERATOR OF EACH BUSINESS IN CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL IN QU ~ArNTITIES GREATER THAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS' AT STP.~ t ~._rr~THiS FORM SHALL BE COMPLETED AND SUBMI'ITED TO YOUR LOCAL ADMINISTERING AGENCY. (§25533 & 25536 Health & Safety Code) Note instructions on rever~e Business Name City of Bakersfield Business Site Address Min~] & E1 Toro - Wayside Park Pool Business Mailing Address (if different) 4101 Truxtun Ave., - c/o Neil Tierney Business Phone (F~05~ 326-3117 Business Plan Submission Date2 Jan. 1988 Process Designation3 Swimminq Pool Water Disinfectant ACUTELY HAZARDOUS MATERIAL~; HANDLED4 -USE ADDITIONAL PAGES IF NECESSARY- CHEMICAL NAME QUANTITY (C12) Chlorine - liquified §as under pressure Approx, 4-6 150 lbs c¥1. GENERAL DESCRIPTION OF PROCES~E~ AND PRINCIPAL E~UIPMEN'I'5: Approximately 4-6 (150) lbs. chlorine cylinders. Chlorine gas is injected through a Wallace & Tiernan V-75 control board. It is injected directly to the return line of ~he pool. The cylinders are not manifolded, but used as individuals, with one on line and one connected for standby. Isolated individually with their own double shut off valves. (See attached sheet) SIGNATURE ~'7,/~7 / ~' PRINTED NAME Nei 1 Tierney/ TITLE California Office of Emergency Services FORM HM 37-/7 (1-15-88) Park Supervisor DATE 10/21/88 INSTRUCTION : Superscripts: 1. Quantities for RMPP compliance are "equal to or greater than" the minimum criteria and apply to chemicals handled at any one tune. Businesses handling reportable quantities of Acutely HaTardous Materials that have not submitted a business plan MUST contact local Administering Agencies. The business plan submission date will assure the Administering Agency that a business plan has been submitted and is on file. This will also immediately identify businesses that have not submitted business plans. 3. "Process Designation" is provided as a reporting option (with the approval of the Administering Agency) for facilities that can most easily report by 17to.ss. Thus, facility RMPP registration data could be submitted in a similar format to a business plan that is divided by ~. "By process" data can initiate an emergency response to a process incident rather titan a general emergency response to a major facility. Process designation can simplify inspections for major facilities anti improve future emergency response. 4. Refer to the EPA list of Extremely Hazardous Substances from the Federal Register (Volume 52, No. 77, p. 13397 et. seq_.. April 22, 1987). Each chemical has a threshold planning quantity. This list may be changed by EPA on an annual basis. Upda~ of this list may be available early in 1988. To comply with this element, you may attach a copy of the inventory submitted to your Administering Agency fi'om your business plan and highlight all Acutely Hazardous Materials. It is recommended that facilities list all extremely bsTardous chemicals handled in quantifies equal to or in excess of 1) 500 pounds, and 2) any EPA threshold planning quantity less than 500 pounds. 5. Do not include Trade Secret information in these descriptions. General: For emergency response pm'poses, it would be desirable to describe the following to the Administering Agency: 1. Batch Process: a. ~raw ~? b. What operating pressure range? c. What ~g temperature range? d. Batch capacity rating? e. Product characteristics? (e.g., chemical state, flammability, toxicity, etc.) f. Critical process points and characteristics? 2. Continuous process: (s'unilar infonnalion as above.) "Pursuant to §25534, the Administering Agency may require the submission of a Risk Management Prevention Program (RMPP), ff the Administering Agency dettxmiB, es that the handler's operation may present an acutely ha?~rdous materials accident risk. The handler shall prepare the RMPP in accordance with subdivision (c) [of §25534]. The RMPP shall be prepared within 12 months following the request made by the Administering Agency pursuant to this section." (§ 25534 (a) Health and Safety Code) An amendment to the RMPP must be submit~exl to the Administering Agency within 30 days of: 1. Any additional handling of acutely I~-~rdous materials. 2. Any material or substantial alterations to business activities. 3. Change of address, business ownership, or business name. '(§ 25533 (c) Health &Safe. ty Code) · EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP · California Office of Emergency Services FORM HM 3777 (1-15-88) ~j ~i"$AFETY VENT LINE. RUN ON COI'IIlNHOUS GRAI)ILN1 TO OUJ*~IDE AIMOSPItEHE WITH OUTER FOINIED DOWN. (?.~)5UPPONJ IN CONDUI [ OR JflOUGH. [] IJ 49~-5/i~ OD FL EXI~I E CONNECTION 4FT ~]S/4'S()iUII('~N I,I~CIIAli(~J' LItII/ lillll 10 PuIIIT OF ,/// ............. AI'PLICAItDll ('~)~lJl'l'ulil lit COIID[Jll IJll IIIOHJ~II, ~-~-~/; Cl.[AIIANC[ I101L I'()11 Ii, l" M(JlIJ1III,J~ / [] AUXILIARY CHLORIN£ CYLINDER VALVES U'I24~--UNION I'YPE P -24 'TG --GAS~.£1 (~) (.IiI_ORINE CYL IND[ N5 ($1Z£ MAr VAgr) CullE ~OiUIN)N I,~t".CIIAIIG£ Lille lO IIl,lL'CIOll .... ~ 5/,~ INJ£C'IOR WAIl~il SUPPLY R£COMMEt,IDED I~'J Accl.-$5o/ir /IEM £u/1~1/5/1~0 Ii'Ir// C//LOli/IVAI~Jtl, ELEVATION INSTALLATION REQUIREMENTS BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 0FFIC[AL USE ONLY BUSINESS NAME ID:~ lVl~XT E R I AL HAZARD O US BUS I NESS PLAN AS FORM 2A INS/RUCTIONS: 1. To avoid further action, return this 'fo,m 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 ! B. LOCATION / STREET ADDRESS: /g~g~' CITY: E/~K~~/~'~"/Z~ ZIP: f330y BUS.PHONE: ( ) 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: TITLE B. Ph# DURING BUS. HRS. AFTER BUS. HRS. Ph:~ SECTION 3: LOCATION OF UTILI/~f SHUT-OFFS FOR BUSINESS AS A Wll0LE A. NAT. GAS/PROPANE: ////~ D. SPECIAL: E. Lock BOX: YES ," NO IF YES, LOCATION: IF YES. DOES IT CONTAIN SITE PLANS? ~/ NO FL00~ PLANS?~./ -NO MSDSS? ...~./ NO KEYS? YES ./.~ SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A NHOLE 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 ~TERIALS:.... .............. ~'. .................... ~.(~ESJ NO., YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES . WITH RESPONSE AGENCIES: .......................... C. PROPER USE OF SAFETY EQUIPMENT: ................. D. EMERGENCY EVACUATION PROCEDURES:.' .... ............ E. DO YOU .MAINTAIN EMPLOYEE TRAINING RECORDS: ....... SECTION ?: HAZARDOUS .WATERIAL ~i NO YES NO -NO YES NO NO YES NO NO YES NO cIRCLE YEs. :- NO - NONS 'DOES YOUR BUSINESS., HANDLE HAZARDOus M_~TERIAL.' IN QUANT~.T!ES.LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID. OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... ','ES :MO I, , Certif~"that the above information is accurate. r und~stand that this 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 con'stitutes perjury. SIGNATURE E . DATE BAKERSFIE£D CITY. FIRE OEPARWIEXT 2130 "G" STREET BAKERSFIELD, CA 93S01 BUSINESS NAME: OFFiCiAL USE ONLY BUS I NESS PLAN SINGLE FAC ILI T'xz UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.' 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as .possible. SE~ION I: MITIGATION~ PR~!0N~ ABA~ PROC~ES SECTION 2: NOT!F!CATION AN~ EVACUATION PROCEDL~ES AT T~IS I~'iT 05~Y SECTION 3: I{AZARDOI;.~ .WaT%RIALS FOR TNIS I;:{iT O,,Y[.y · A. Does ti~{s Facility Unit contain Hazardous .Haterinl..-'? ..... If YES, see B. If NO, continue with SECTION 4, !. " 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 {~hite form If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yello~ form ~a., , .~.~--} in addition to the non-trade secr~)t form. List only the trade secrets on form 4A-~_. SECTIOM 4: PRrVATE~ FIRE PROTECTiOX SECTIO~ S: LOCATION OF WATE~ SU?PLY FOR ~SE BY EME'RG~'~IC~ RESPO,~}ERS SECTION ~: tOCATION' OF ~rILI?f SHUT-OFFS AT THIS Ui%IT ONLY· ! C. WATER: O. SPECTAL: E. r...OCK Bn.N. !'~$ ' 5:0 l'E YES, SiTE Pr_.ANg? rt...OOR Pr..'Cff~'.' U.S. DEPARTMENT OF, LABOR OccupalionM Safely and Health Adl'ninislration Fo,r- Requhed under USDL Salet¥ and Health Regulation!, for Ship Repair;rig, i Shipbuilding, and Shipbreaking (29 CFR 1915. 1916, 19171 ".- 'i SECTION I t';2~NUF AC I U RE R"~ IN; A tw4 E _ Jones ~e~c~!s, Inc. " ',~8-6383 or ~5-'2887 ADD ~ t SS [,¥,mhrt. Yt~etl. Cir)'. S:~le. end ZIP / SECTIONI'I - HAZARDOUS INGREDIENTS - PAINTS-~'~ESERVATIVES. & SOLVENTS % {Units} ALLOYS AND h~ETALLIC COATINGS % IUni.) C~ALYST ; - ALLOYS - ;.. · METALLIC COATI~OS ' ': ¥~HICL~ ........ FILLEfl METAL ,- 50LVENTS PLUS COATING OR CO~[ FLUX ~ DDIT Iv~S O~H[ R5 TLV ~; HAZARDOUS f,gIXTURES OF OTHER LIOUIDS. SOLIDS, OR GASE~ SECTION i11-- PHYSICAL DATA / EVA~ RATION RATE.. I:'E_ RCEr,~T, VOLATILE '. BY VOLUM. E (%) ' SECTIONIV - FIRE AND EXPLOSION HAZARD DATA :....': -:.' u,,,_,su,.u r,.£ ~,,D t_.:-,_o=,o~ .~Zr. RDS Qill suppdr% .co:%ustion of cez%ain ma%erimls. c~rr,.=nics reaz'k with CrQorJ~e, sc~._et~.mes with ek~__~ ~=:t~e.= SEC~IONV - HEALTH t~AZARD DATA Acu;e resoirator~ irritation .... . ~~ONDi]-iO.~, l'O AvOiD SECTION VI REACTIVITy DATA I SECTIONVII SPILL OR LEAK pROCEDURES ...... ~_c!ose ~a!ves ~.o iso!~te le~. Cont~mt suppler ~eai~tely, D'o SECTION Vlll - SPECIAL PROTECTION INFORMATION: __------ .. .........~ ...... ~ . . . ~-l~S~o .- SECTION !x'' SpECIAl- PRECAUTIONS ' CO~ -__..~ ...... ~ ............ stored 5_n dz~ area out of direct ~;u~]i~t. ~a aw~ fz~ heat so~.~ce. i" · . /.z>aa ~,~ht .~rr~ta,~o~ to e- ~5 fi' - ..... Zes, ~kin and ~u~ .... ~-' ~ · ,':~ve ~o fresh air. L'~TABLE COt~DITIONs TO AVOID 15 mtnute~. OCCU HAZARDous ?OLYMERI. ZATIoN -. WILL ~ Occu~ · Htgh .humIdity: causes ca~tng. . '£P~ TO BE TAKEN IN CASE L,ATERiA~ELEASED o~ ep .... ~~ mac.al t~nsfer to a contaf~er and enera] trash. Residue ~ be %'ashed'a%,a~ w~th ~'ater. ~~ han~.~ng .~s required. Residue , - :' uanti %'~r~ . - ....... ~~ qu~ ties can be r ~ ct. L~.t ...... *%'ashed away w~ t ~ ..... F~y coQEalners may 5e ~ncin=rat_~ ~ h~ ~ ~-~--_~_- ......... ~u or discarded as 'Saneral ;L ..... y~rea - ax'old contact wtth acid8 ' special h~]dl~ng procedure. OT~a~EC~UT~ONS X 872'_ Cree~ ~e SAFETy ~o2.,plY 82935 SHEET FED.:TD. /-'0. 313 PI~ONE NO. 80' t PAINTS. Pr: ST 0 0 HOpper 0 RD ALLoYs A~"O J~ETALLic COATi.,,,~ ~-'e'~E ~'ETAL ALLoyS OTHERs CLUx AIk. ,ll,,ll';; ,hie oc:%,E I.D. # ' BAKERSFIELD CITY FIRE DEPARTMENT ~. .~-' FORM 4A-1 Page of' NON--TRADE SECRETS - ;i .... HAZARDOUS MATERI ALS INVENTORY . ~"' ? s ER NAME: .-' - ~uumm~ :~lWf( ~ ~- l~l~~~ ~ R FACILITY UNIT ~ :_ C .... ~ ---- ~~ DD ESS: _/~-~/~ ~~~ 'F~CI~TY UNIT NAME: ~, ~o~ ~:~ ~/~ ~o~ ~: ~-~11~ o~i"c~affos~.c~t~s COD: ~ ONLY ! 2 3, 4 5 6 7 8 9 I0 TYPE MAX. ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T .CODE AMOUNT AM_O_I~NT UNIT CODE CODE FACILITY UNIT WT. CHEMIqAL OR COMMON NAME CODE GUIDE ~AME: T rTr.~ · o IGNATURE: DATE: EMERGENCY CONTACT: TITLE: PHONE ~ BUS HOURS: AFTER BUS HRS:' {MERGENCY CONTACT: TITLE: PHONE ~ BUS HOURS: 'RINCIPAL BUSINESS ACTIVITY: AFTER BUS HRS: - 4A-1 -