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Home My WebLink AboutES-BUSINESS PLAN 10/6/2000FACILITY ~ rio/,~~,0 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 t F-.C WEo 2000 INSPECTION DATE PHONE NO. ?--- BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine [~l Combined [~l Joint Agency [~ Multi-Agency [~l Complaint ~l Re-inspection OPERATION C ./V__ - COMMENTS Appropriate permit on hand Business plan contact information accurate ~"" ~'J,~,f~ ~,~/ 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 SUl~plies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous watste~on site?; ,, ]~l Ye~s ~ No Explain: ~t~_ ./'~_! ..;,.~_.~ Questions reg~ding~is inspection? Please c~l us at (66 i) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy E~usiness Site Responsible Party -people RE: Expressly Portraits, Inc. Corporate Name Change Dear Vendor: We are pleased to inform you that, effective January 14, 1999, Expressly Portraits, Inc. is changing its corporate name to The Picture People, Inc. This is only a change of corporate name and is not a result of a change in corporate entity or the sale of assets or shares. The corporation will remain a California corporation. Please adjust your records accordingly. Thank you. Very truly yours, Opal Ferraro Chief Financial Officer 1157 Triton Drive, Suite B · Foster City, California 94404 ° 650.~78.9291 · Fax 650.578.9881 MISCELLANEOUS RECEIVABLES ADJUSTMENT i NEWACCOUNT ~ ADDRESS CHANGE CLOSE ACCT FINANCE CHARGE I CUSTOMER NAME MAILING ADDRESS SITE ADDRESS STATE PARCEL NUMBER (IF AJ=PLICABLE~ ADJUSTMENT i CHG DAiI= CHARGE CODE ADJUSTMENT AMOUNT / APPROVED Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ?:,?'ii¥'*I' j~?:::~.!!::'.':: .............. ~'~iii}i*~iiii!ii:~i~: ~iil}~:~i!ili, i!i~i i~?~ :i:~i:~:!:;~:::~:U~erground Storage of Hazar~bus Materials EXPRESSLY ~;~:.'"....'"'-~i ~-- ~' % ~:~, ..~E~;~]~:]~]~[]~.' '~I~ ~' .L.? ,.'~ :.'" '~? Issued by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 .FAX (805) 326-0576 Approved by: ~Pldlph Hucy~ Office of ~l~en~al Servi&s Expiration Date: June 30, 2000 FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE Section 5: Hazardous Waste Tier Permit Treatment Program [] Routine [] Combined l~Joint Agency [~l Multi-Agency [21 Complaint [] Re-inspection Onsite Treatment Unit Tier: [] PBR [] CA {~ CESW Unit number & name: [] CESQT [] CE[. {~[ CECL OPERATION C V COMMENTS All hazardous wastes treated are generated onsite Onsite treatment notification tbrms available and complete Onsite treatment unit tier and/or count is correct on form Unit number is correct on notification tbrm t,,/ Number of tanks or containers is correct on form Treatment monthly volume is correct on form Waste identification & treatment is correct on form Complies with residual management requirements Properly closed a treatment unit Complies with tank and containment certification Developed and maintains a written inspection log Meets pretreatment standards for waste discharge Developed and maintains a Closure Plan on site IPBRI Developed and maintains a Waste Analysis Plan and Waste Analysis Records [PBRI Maintains Training Records on site [PBRI Obtained local permits for treatment operations IPBRI Identifies and labels Treatment Units IPBRI C=Compliance V=Violation Inspector: (./LJ ( r',/'~ Office of Environmental Services (805) 326-3979 Business Site Responsible Party CA=Conditionally authorized ' CECL=Conditionally exempt commercial laundry CEL=Conditionally exempt limited White - Env. Svcs. CESW=Conditionally exempt specified wastestream CESQT=Conditionally exempt small quantity treatment PBR=Permit by rule Pink - Business Copy FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROG, RAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 4: Hazardous Waste Generator Program INSPECTION DATE / ~'6/cp~- EPA ID [] Routine [] Combined ~ Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous xvaste determination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID#) Authorized lbr waste treatment and/or storage V' release, lire, or explosion within 15 days ofoccurance Reported Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed ~vhen not in use Weekly inspection of storage area located at least 50 feet from property line ~-~ Ignitable/reactive waste Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste of lead acid batteries including labels Proper management of' used oil filters Proper management Transports hazardous waste with completed manifest t-" Sends manifest copies to DTSC Retains manifests fbr 3 years Retains hazardous waste analysis for 3 years Retains copies of'used ()il receipts fbr 3 years Determines if waste is restricted fi'om land disposal C=Compliance V=Violation Inspector: Office of Environmental Services (805) ~_6-~979 Business Site Responsible Party \Vhite - Env. Svcs. Pink - Business Copy ADDRESS ~2-) O / FACILITY CONTAC~ff'¢/~'J~/ INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION D_A~TE /~ - ~(~ PHONE NO. -7- ? BUSINESS ID NO. 15-210- C~tS>lff-/l~_~ NUMBER OF EMPLOYEES '~t.3 ' Section 1: [] Routine Business Plan and Inventory Program ,~ombined [] Joint Agency [21 Multi-Agency 121 Complaint [] Re-inspection OPERATION C ./V__ COMMENTS Appropriate permit on hand Business plan contact intbrmation accurate Visible address J 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?: [i~.e,s o [] No Questions regarding this inspection? Please call us at (805) 326-3979 White- Env. Svcs. Yello,,,- Station Copy ..-:VT: ?? ::~ink'. Business Copy Business Site Responsible Party Inspector: FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE Section 5: Hazardous Waste Tier Permit Treatment Program [] Routine ~ Combined [] Joint Agency [] Multi-Agency [] Complaint Onsite Treatment Unit Tier: []PBR []CA ~CESW Unit number & name: [] CESQT [~] CEL [] Re-inspection []CECL OPERATION C V COMMENTS All hazardous wastes treated are generated onsite Onsite treatment notification forms available and complete Onsite treatment unit tier and/or count is correct on form 'eft Unit number is correct on notification form v Number of tanks or containers is correct on form Treatment monthly volume is correct on form Waste identification & treatment is correct on form Complies with residual management requirements Properly closed a treatment unit with tank and containment certification Complies Developed and maintains a written inspection log v/ ~L~_d~gE' /~,~'~/T~'~'J ON <~.~I"'E Meets pretreatment standards for waste discharge Developed and maintains a Closure Plan on site [PBR] Developed and maintains a Waste Analysis Plan and Waste Analysis Records [PBRI Maintains Training Records on site [PBR] Obtained local permits for treatment operations [PBRI Identifies and labels Treatment Units [PBRi C=Compliance V=Violation Inspector: Office of Environmental Services (805) 326-3979 (.J~usiness Sit~ ~.esponsible Party CA=Conditionally authorized CECL=Conditionally exempt commercial laundry CEL=Conditionaily exempt limited White - Env. Svcs. CESW=Conditionaily exempt specified wastestream CESQT=Conditionally exempt small quantity treatment PBR=Permit by rule Pink - Business Copy FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 ~O(/--7-r~ ,'rs ~ Z_~/ INSPECTION D^TE ///O/5' g Section 4: Hazardous Waste Generator Program EPA ID # ~ ~',ac. OOO6.gq-.5'S-- [] Routine [~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazard°us ~vaste determinati°n has been made k, t~--4:*r ~'V ¢ogP o,~qc~ EPA ID Number (Phone:916-324-1781 to ohtain EPA lD #) Authorized for waste Weatment and/or storage Reported release, fire. or explosion within 15 days ofoccurance Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking ~,/" Containers are compatible with the hazardous waste Containers are kept closed ~vhen not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years //" Retains hazardous waste analysis for 3 years Retains copies of used ()il receipts fbr 3 years Determines if waste is restricted fi'om land disposal C=Compliance V:Violation X"'~~ dff,~ Inspector: /--~r ~'~'~..5" . Off'ice of Environmental Services (805) 326-3979 (.//12usiness Site Responsible Party \Vhite - Env. Svcs. Pink - Business Copy ADDRESS '7-70 {"-'irt;do.. ~ 12..4- PHONE NO. FACILITY CONTACT /.-- ?&~t,/e¢ S~,,,JOC~$ BUSINESS ID NO. 15-210- INSPECTION TIME loc_x},-, (o :- 3.O NUMBER OF EMPLOYEES CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r~ Floor, Bakersfield, CA 93301 Section 1: Business Plan and Inventory Program [] Routine ~{~ Combined [] Joint Agency [] Multi-Agency [] Complaint l~l Re~inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact intbrmation accurate Visible address Ot, J {g0t~,C_~ t.~:~t'& 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?: ~ Yes ~ No Explain: 5tt..~t~'~ ~--~F~MO- OJ}X~T~ Questions regarding this inspection? Please call us at (805) 326-3979 White - Env. Svcs. Yellmv - Station Copy Pink - Business Copy (.2/Business Site Responsible Party Inspector: Business Name: Facility Address: Expressly Portraits # 29 2701 Ming Avenue Bakersfield, CA 93304 Facility Phone #: 605-397-0996 Studio Manager: Renee Bsharah ~O~t"~~ Studio Manager Home Phone #: 605-663-0199,,.~ President / CEO: Peter L. Harris'~'~I Date Open: 29-Jul-89 Nature of Business: Portrait Studio with on site Processing. SIC Code (4digit #): 7221 & 7384 Federal EPA #: CAD983667106 Ctate EPA #: CAL000063455 Corporate Contact: Martin Ritchey, Director of Technical Services Corporate Phone Number: (415) 578 - 9291, Ext. 7631 EMERGENCY CONTACTS Name: Title: Pager: PIN #: Phone: Extension: Primary Brian Parks dOc~ Area Technician ~_~j~.. 1-800-759-7243 r ~~ ,~ 5057406 1~15~78-9291 7632 Name: Title: Secondary Victoria Fleming ~,C..GtlL~I~ ~)~ District Manager ' Pager: PIN #: 5e68e~ Phone: 1~91 Extension: .7.403 Emergency Planning Information The On Site Emergency Coordinator is the Studio Manager listed above. For State/Fed planning: We do not handle extremely hazardous substances listed in 40 CFR 355, Appendix A. There are No School's, Hospital's or Extended Care facilties within 1,000 ft. (Straight line distance) of our facility. CERTIFICATION: I certify under penalty of law that I have personally prepared and examined this document, and am familiar with the information. Signature March 1, 1996 Date EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 0 REV [] TRADE SECRET 0 PAGE 1 OF 12 Business Name: Expressly Portraits ~t29 I Location Street Address: 2701 MIn~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Flexicolor Developer Replenisher LORR I Common %wt. 90-95 1-5 <1 MIXTURE INFO <1 Date: August 1, 1995 CAS #: Film Developer Replenisher Component Water Potassium Carbonate 000584-08-7 4 - (N.~hyI-N-2hydroxyethyl) 2- 25646-77-9 methylphenylenedlamine sulfate Pentetic acid, pentasodlum salt 000140-01-2 N/A MIXTURE UN/DOT #: CAS # 007732-18-6 1760 ~ 8 HAZARD CODES HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION PHYSICAL SOLID 0 UQUID STATE GAS 0 OTHER AMOUNT & TIME STORAGE CODES & LOCATION Max. NFPA 704 HAZARD DIAMOND Fire Health '~V~Peciflc PURE 0 MIXTURE [] RADIOACTIVE O WASTE O Waste Qty./year on Site: 75 Gallons 30 Gallons State Waste # 541 EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 13 REV [] TRADE SECRET 0 PAGE 2 OF 12 Business Name: Expressly Portraits #29 I Location Street Address: 2701 Min~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Flexicolor Developer Starter LORR Common Name: %wt. 70-75 10-15 MIXTURE 5-10 INFO 1-5 1-5 1-5 Film Develo Starter Component Water Potassium bicarbonate Potassium carbonate Date: CAS #: NIA MIXTURE UN/DOT #: CAS # 007732-18-5 000298-14-6 000584-08-7 sulflte 007757-53-7 Pentetlc acid, pentasodlum salt 000140-51-2 Sodium bromide 007647-15-6 not regulated HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID 1:3 LIQUID GAS 13 OTHER Tem NFPA 704 HAZARD DIAMOND Fire ~cttve Health ~pecirm PURE 13 MIXTURE [] RADIOACTIVE 13 WASTE 13 Waste Qty./year OI1 Site: <1 Gallon I quart State Waste # 641 area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD O REV [] TRADE SECRET O PAGE 3 OF 12 Business Name: Location Street Address: Chemical Name: Kodak Flexicolor Bleach III Replenisher NR Common Name: MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION %wt. Expressly Portraits 1/29 2701 Miami Avenue, Bakersfield, CA 93304 I CAS #: Photographic Film Bleach Concentrate UN/DOT #: Component CAS # 80..85 Water 1-5 Ferric ammonium propylendla- minetatra acetic acid 1-5 Acetic acid 1-5 Ammonium acetate 1-5 Ammonium bromide 1-5 Ammonium nitrate HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID O LIQUID GAS O OTHER Max. Daily: 30 Gallone Avg. Daily: 15 Gallons # Da~/s / Year on Site = 36S Container ~ Plastic bottle/jug Pressure ,~ Ambient Pressure 00732-18-5 111687-36-6 000064-19-7 000631-61-5 012124-97-~ 00648452-2 Temperature ,~ Ambient Tem Date: August 17 1995 N/A MIXTURE 1760 18 NFPA 704 F~e ~Reactive HAZARD DIAMOND Healt ~ ~pecific PURE O MIXTURE [] RADIOACTIVE Fl WASTE O Largest container on Site: 30 Gallone Waste Qty./year 75 Gallon8 State Waste # 54t area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 13 REV [] TRADE SECRET [3 PAGE 4 OF 12 Business Name: Expressly Portraits f/29 I Location Street Address: 2701 Min~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Flexicolor Bleach StarterlC-41, C'-41B Common Name: MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION Film Bleach Starter % wt. Component 70-75 Water 25-30 Sodium acetate HMiS LABEL CODES HEALTH FLAMMABIMTY REACTIVITY PERSONAL PROTECTION SOLID 13 LIQUID [] GAS Cl OTHER 13 Max. Daily: <1 quart. Avg. Daily: <1 quart # Days I Year on Site = 3ss Container =~ Plastic bottlerjug Pressure ¢, Ambient Pressure Date: August 1~ 1995 Temperature ¢> Ambient Tem CAS #: N/A MIXTURE UN/DOT #: CAS # 00732-18--5 0001274)9-3 NFPA 704 HAZARD DIAMOND not regulated JLargest container on Site: Gallon Fire ~eaclNe Health ~,Specific PURE O MIXTURE [] RADIOACTIVE 13 WASTE 13 Waste Qty./year < Gallon State Waste # 541 EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 0 REV 13] TRADE SECRET 0 ' Business Name: Expressly Portraits #29 I Location Street Address: 2701 MIn~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Flexicolor Fixer and Replenisher Common Name: MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION )hic Film Fixer and % wt. Component 80-85 Water 10-15 Arnonlum thiosulfate <1 Ammonium sulflte <1 Sodium Bisulflte <1 Ammonium bisulflte ~lenisher PAGE 5 OF 12 Date: August Ir 1995 HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID Fi LIQUID GAS 0 OTHER UN/DOT #: CAS # 007732-18-5 007783-18-8 010196-04-0 007631-90-5 010192-30-0 NFPA 704 HAZARD DIAMOND CAS #: NIA MIXTURE not regulated Fire ~~e Health PURE 0 RADIOACTIVE on Site: 30 Oallon~ MIXTURE [] WASTE 0 EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD I~1 REV [] TRADE SECRET 13 PAGE 6 OF 12 Business Name: Expressly Portraits #29 I Location Street Address: 2701 Min~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Flexicolor Stabilizer and Replenisher LF Common Name: %wt. 95-100 <1 MIX'FURE <1 Date: August 1~ 1995 CAS #: N/A MIXTURE UN/DOT #: not regulated CAS # ~hlcFilm Stabilizer Component Water Hexamethylenetetramine Sodium dodecylbenzene sulfonate 007732-18-5 000100-97-0 025155-30-0 025265-71-9 not available 002634-33-5 INFO HAZARD CODES PHYSICAL STATE <1 Diproplyene glycol <1 <1 Nonionic surfactant Substituted thlazolin - 3 - one HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID Cl LIQUID [] GAS 13 OTHER 13 AMOUNT & TIME STORAGE CODES & LOCATION Max. Daily: NFPA 704 Fire HAZARD DIAMOND PURE El MIXTURE [] RADIOACTIVE 13 WASTE 13 Waste Qty./year on Sit~: 300 Gallon~ 30 Gallon~ State Waste # 641 area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 0 REV [] TRADE SECRET 0 PAGE 7 OF 12 Business Name: Expressly Portraits ~/29 I Location Street Address: 2701 MIn~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Ektacolor RA Developer Replenisher RT Common Name: MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION 95-100 1-5 1-5 <1 <1 Water Develo Component Potassium carbonate Trlethanolamlne N, N - dlethylhydroxylamine 4 - (N - ethyl - N 2 methanesulfonyl - aminoethyl)-2- methylphenylenedlamine sesquisulfate monohydrate Date: August 1, 1995 CAS #: NIA MIXTURE UN/DOT #: CAS # 007732-18-5 OOO584-O8-7 000102-71-6 003710.84-7 025646-71-3 176018 HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID 0 LIQUID GAS 0 OTHER Max. Daily: 30 Gallon. Avg. Daily: 16 Gallona NFPA 704 Fire /~ Reactive HAZARD DIAMOND PURE O MIXTURE [] RADIOACTIVE O WASTE 13 Waste Qty./year orr Site: 300 Oallona 30 Gallon. State Waste # 541 area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD O REV [] TRADE SECRET t'l PAGE 8 OF 12 Business Name: Expressly Portraits f1~29 I Location Street Address: 2701 Min~l Avenue, Bakersfleldl CA 93304 Chemical Name: Kodak Ektacolor RA Developer Starter Date: August 1~ 1995 CAS #: NIA MIXTURE Common Name: MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & Develo % wt. Component 70-80 Water 15-20 Potassium bicarbonate 5-10 Potassium chloride <1 Potassium carbonate <1 Potassium bromide HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID 13 LIQUID [] GAS 13 OTHER 13 Max. Daily: Avg. Daily: # Days / Year on Site = Container <1 quart <1 quart 365 Plastic bottle/~u~l Pressure ~ Ambient Pressure UN/DOT #: CAS # 000732-18-5 000298-14-6 007447..40-7 0005844)8-7 0077584)2-3 not regulated NFPA 704 Fire ,/~ Reactive HAZARD DIAMOND Y~//~,Specilic PURE 13 MIXTURE [] RADIOACTIVE 13 WASTE 13 Largest container Waste Qty./year on Site: <1 Gallon I quart State Waste # 541 Location Description ~ containers in ~. production sree .~-~.~ . .. . ~......~.~.~...~.¥:.~ ........ EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD O REV [] TRADE SECRET 13 PAGE 9 OF 12 Business Name: Expressly Portraits #29 I Location Street Address: 2701 Min~l Avenue, Bakersfleldi CA 93304 ! Chemical Name: Kodak Ektacolor RA Bleach Fix and Replenisher Common Name: ~lenisher %wt. 80-85 5-10 MIXTURE INFO 5-10 1-5 1.5 Water Bleach Fix and Component Ammonium ferric ethylenedlaminetetra- acetic acid Amonlum thiosulfate Sodium bisulflte Acetic acid Date: August 1, 1995 CAS #: N/A MIXTURE UN/DOT#: 176018 CAS # 007732-18-5 021265-50.9 0077830-18-8 007631-90-5 000064-19-7 HAZARD CODES PHYSICAL STATE AMOUNT & TIME HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID I'1 LIQUID [] GAS ~ OTHER I~1 NFPA 704 HAZARD DIAMOND Fire ~ctive Heal ~ ~/~,Specirm PURE I:1 MIXTURE [] RADIOACTIVE I::1 WASTE ~ Waste Qty./year 450 Gallon~ State Waste # 541 EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 13 REV [] TRADE SECRET 13 PAGE 10 OF 12 Business Name: Expressly Portraits ~t~29 I Location Street Address: 2701 MIn~l Avenue, Bakersfield, CA 93304 Chemical Name: Kodak Ektacolor Stabllizer/RePlenishe~;IRA-4NP Common Name: MIXTURE INFO and % wt. Component 95-100 Water <1 Polyvlnylpyrrolldone <1 Oragano silicone <1 Dipropylene glycol <.1 Substituted thlazolin - 3 one HAZARD CODES HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION Date: August 1~ 1995 CAS #: N/A MIXTURE UN/DOT #: CAS # 007732-18.5 oogoo3-3g-8 not available 025265-71-8 002634-33-5 not regulated NFPA 704 HAZARD DIAMOND Fire ~eactive Health ~,Specific PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION SOLID CJ LIQUID [] GAS 13 OTHER 13 Max. Daily: PURE 13 MIXTURE [] RADIOACTIVE 13 WASTE 13 Largest container on Site: 30 Gallon. Waste Qty./year 900 Gallons State Waste # 541 Location Description Idastlc containera in area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD C] REV [] TRADE SECRET 13 PAGE 11 OF 12 Business Name: Expressly Portraits f~29 Location Street Address: 2701 Min~l Avenue, Bakersfield, CA 93304 Chemical Name: Photoprocessi.ng Waste - No Sliver Common Name: Processln~ Effluent I % wt. Component 8 Film Developer 2 Film Bleach 90 Paper Developer MIXTURE INFO HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION Date: August 1~ 1995 CAS #: N/A MIXTURE UN/DOT #: CAS # HMIS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID 13 LIQUID GAS C] OTHER Max. NFPA 704 HAZARD DIAMOND Health PURE {3 MIXTURE RADIOACTIVE ~ WASTE [] Waste Qty./year on Site: lOO Gallone 12 Iltres State Waste # 541 area EXPRESSLY PORTRAITS, INC. HAZARDOUS MATERIAL INVENTORY FORM CHEMICAL INVENTORY ADD 0 REV [] TRADE SECRET 0 PAGE 12 OF 12 Business Name: Expressly Portraits f~29 J Location Street Address: 2701 Ming Avenue, Bakersfield, CA 93304 Chemical Name: Photoprocesslng Waste - Silver Bearing Common Name: Processing Effluent %wt. 4 4 MIXTURE 28 INFO 64 HAZARD CODES PHYSICAL STATE AMOUNT & TIME STORAGE CODES & LOCATION Component Film Fixer Film Stabilizer Paper Bleach Fix Paper Stabilizer HMiS LABEL CODES HEALTH FLAMMABILITY REACTIVITY PERSONAL PROTECTION SOLID 0 LIQUID GAS 0 OTHER Max. Date: August 1~ 1995 CAS #: N~A MIXTURE UN/DOT #: CAS # NFPA 704 Fire /'~ ReactNe HAZARD DIAMOND Health PURE 0 MIXTURE [] RADIOACTIVE 0 WASTE 0 Waste Qty./year 1000 Gallon8 State Waste # 541 area Policy Number: OP-229 Date of Last Revision: 9/95 EMERGENCY PROCEDURES - CHEMICAL SPILLS INTRODUCTION When using the various amounts of photoprocessing chemicals, it is not impossible to encounter a chemical spill. It is necessary to immediately mitigate the chemical spill for the protecl~on of everyone, REQUIRED POLICY In the event of a chemical spill, follow the Required Procedures. REQUIRED PROCEDURES 1. Put on the Personal Protective Equipment, (goggles, rubber gloves and apron). 2. Mitigate the cause of the spill. 3a. Non Silver Bearin,q Chemistry. · Clean up the spill with the mop. · Non-Silver bearing chemistry is flushed to the sewerrsystem with copious amounts of water. 3b. Silver Bearing Chemistry 3C. · Silver bearing chemistry is poured into the silver recovery container. · Rinse the mop and bucket 3 times, each timepouring the fluids into the silver recovery container. Alternative Procedure for Silver Bearin,q Chemistry · Absorb the spill with vermiculite or other inert material, then place in a container for chemical waste. · Clean the surface thoroughly to remove residual contamination. ._.;STAT,E, OF CA.L!FORNI ~A-ENVIRONMENTAL P~TECTION AGENCY DEPARTMENT OF TOXIC SUBSTANCES CONTROL REGION 1-1515 Tollhouse Road Clovis, CA 93612 CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers PETE WILSON, Governor PHYSICAL ADDRESS:' ~?~ /'/%7~? /~vc . ~ Icfr~ ~;~/~f , c/'~, FACILITY CONTACT-NAME: Or~ ~r~'~ PHONE: (~/~ ~7~- SIC CODE(S): e~/ ?$'2// INSPECTION DATE: Local # NOTIFIED UNIT COUNT: PBR CORRECT UNIT COUNT: PBR -- CA__ CESW / CESQT TOTAL / CA__ CESW__ CESQT TOTAL This checklist and inspection report identify violations of state-law regarding onsite treaters of hazardous waste, operating under an onsite permitting tier. This inspection verifies the information provided on form DTSC 1772. It also covers generator requirements, although a separate checklist may be used for those requirements. A checkmark indicates violation of the law, which are explained in more detail on the attached note sheets. The governing laws are the Health and Safety Code (HSC) and Title 22 of the California Code of Regulations (22 CCR). Generator Standards: Each inspection agency may. use their own generator inspection checklist or protocols, which are summarized below. A full evaluation of each item or document is not conducted during the Verification Inspection, unless serious deficiencies are suspected. NO 1. Contingency plan has been prepared (adequately minimize releases, has alarm/communication system, lists emergency equipment and phone numbers for emergency coordinators). 2. Written training documents and records prepared for employees handling hazardous waste. 3. Meet container management standards (storage time limits, closed, labelled, compatibility, ~ inspected weekly, in good condition, with ignitables/reactives 50 feet from property line). 4. Meet tank management standards '(either secondary containment or integrity assessments, plus storage time limits, labelled, compatibility, inspected daily, in good condition, with ignitables/reactives 50 feet from property line). 5. All wastes are properly identified. Treatment Items-Facility Wide: (Facility must submit a revised Form 1772 to correct errors or omissions.) 6. All units under PBR, CA, and CE are properly indicated on Form DTSC 1772. (Add any new units with unit sheets or correct tier on the unit sheet.) 7. All generator identification information on Form DTSC 1772 is correct. 8. The submitted plot plan/map adequately shows the location of all regulated units: 9. There are records documenting compliance with sewer agency Pretreatment standards and industrial waste discharge requirements, where applicable. 105 Generator has prepared/maintained source reduction documents requirements (SB 14/SB 1726). For many wastes, a checklist or plan is required only if annual hazardous waste volume is over 5,000 kilograms (approx 11,000 pounds or 1,350 gallons). HSC 25244.15, 25244.19-.21 For CA or PBR notifiers: 11. The generator has an annual waste minimization certification. (PBR submit with renewals.) Onsite Checklist (A) Page 1 of__ Au=mast 2, 1994 z~STAT~'OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC SUBS'rANcES CONTROL REGION 1-1515 Tollhouse Road Clovis, CA 93612 CHEC~T AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers UNIT SHEET PETE WILSON, Governor Complete one unit sheet for each unit either listed in the notification or identified during the inspection. Unit Number: ~/ ~ Unit Name: ~'~r /~c~r~ z/~;/~ ~ / Notified Tier: C ~s co Correct Tier: Notified Device Count: Correct Device Count: Tanks ~ Containers / Tanks Containers For each Unit: NO 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22 23. All hazardous wastes treated are generated onsite. The unit notification is accurate as to the number of tank(s) and/or container(s). The estimated notification monthly treatment volume is appropriate for the indicated tier. The waste identification/evaluation is appropriate for the tier indicated. The wastestream(s) given on the notification form are appropriate for the tier. The treatment process(es) given on the notification form are appropriate for the tier. The residuals management information on the form is correct and documented for the unit. The indicated basis for not needing a federal permit on the notification form is correct. There are written operating instructions and a record of the dates, volumes, residual management, and types of wastes treated in the unit. There is a written inspection schedule (containers-weekly and tanks-daily). There is ~t written inspection log maintained of the inspections conducted. If the unit has been closed, the generator has notified DTSC and the local agency of the closure. For each CA or PBR unit: 24.- The generator has secondary containment for treatment in containers. For each PBR unit: 25. There is a waste analysis plan 26. There are waste analysis records.. 27. There is a closure plan for the unit. Unit Comments/Observations: (If this is a unit that was not included on the notification form, the violation is operating without a permit-HSC 25201 (a). Also note if the activity is currently ineligible for onsite authorization.) Onsite Checklist (B) Page of August 2, 1994 '~STAT~'OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC SUBSTANCES CONTROL REGION 1-1515 Tollhouse Road Clovis, .CA 93612 CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers SIGNATURE SHEET PETE WILSON, Governor Onsite Recycling: Only answer if this facility recycles more than 100 kilograms/month of hazardous waste onsite. NO 28. The appropriate local agency has been notified. HSC 25143.10 29. Activities claimed under the onsite recycling exemption are appropriate. HSC 25143.2 et sec. Releases: YES 30. 31. If there has been a release, provide the following information: number of releases, date(s), type(s) and quantity of materials/waste, and the cause(s). Use unit sheet or attach additional pages. Within the last three years, were there any Unauthorized or accidental releases .to the environment of hazardous waste or hazardous waste constituents from onsite treatment units? Within the last three years, were there any unauthorized or accidental releases to the environment of hazardous waste or hazardous waste constituents from any location at this facility? For purposes of a Tiered Permitting inspection, an unauthorized and/or accidental release to the environment does not include spills contained within containment systems. This report may identify conditions observed this date that are alleged to be violations of one or more sections at the California Health and Safety Code (HSC) or the California Code of Regulations, Title 22 (22 CCR) relating to the management of hazardous waste. The violations may be described in more detail on the attached note sheets. If any violations are noted, the facility is required to the submit a signed Certification of Return to Compliance within 60 drys, unless otherwise specified. (A certification form is provided.) If any cori'ections are needed to the initial notification, the facility will submit a revised notification within 30 days to the Department of Toxic Substances Control with a copy to the local enforcement agency. Inspector(s): Lead Inspector: Or~er Inspector: Signature: Signature: Print Name: Print Name: Title: Title: Agency: Agency: Phone Number: Phone Number: Facility RePresentative: Your signature acknowledges receipt of this report and does not imply agreement with the findings. Signature: Print Name: Title: Date: Onsite Checklist (C) Page of August 2, 1994 STAT'E OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC SUu;IANCES CONTROL REGION 1-1515 Tollhouse Road Clovis, CA 93612 CHECKLIST AND INITIAL VERIFICATION INSPECTION REPORT FOR Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers NOTE SHEET PETE Wll' SON, Governor This sheet includes inspector observations and expands upon the violations identified on the checklist (by number). In some cases, it indicates how the facility should correct the violations. It also includes the names of any others participating in this inspection. Onsite Checklist (D) Page of August 2, 1994 STA'P~- OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY DEPARTMENT OF TOXIC SUB;3"rANCES CONIKOL PJEGION 1-1515 Tollhouse Road Clovis. CA 93612 TIERED PERMITTING CERTIFICATION OF RETURN TO COMPLIANCE PETE WILSON, Governor For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers In the matter of the Violation cited on · As Identified in the Inspection Report dated Conducted by · (agency(s)) I certify under penalty of law that: Respondent has corrected the violations specified in the notice of violation cited above. I have personally examined any documentation attached to the certification to establish that the violations have been corrected. Based on my examination of the attached documentation and inquiry of the individuals who prepared or obtained it, I believe that the information is true, accurate, and complete. -4. I am authorized to file this certification on behalf of the Respondent. o I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name (Print or Type) Title Signature Date Signed Company Name EPA ID. Number DTSC-RETCOMP.CRT (8/94) ~TATE.__~=~-- ZZP FILE TYPZ OTHER PETE WILSON, Governor STATE OF CALIFORNIA--ENVIRONMENTAL PR{ ~=~ rlON AGENCY ~'--~"DI~"~"PARTM E NT OF TOXIC su~S;TANCES CONTROL 400 P Street, 4th Floor P.O. Box 806 Sacramento, CA 95812-0806 (916) 323-5871 11/16/93 EPA ID: CAL000063455 EXPRESSLY PORTRAITS INC/VALLEY PLAZA CTR MEL ORCHARD 1151 TRITON DRIVE SUITE C FOSTER CITY, CA 94404 For facility located at: 234 VALLEY PL CTR/2701 MING AV BAKERSFIELD, CA 93304 Authorization Date: 11/16/93 Dear Conditionally Authorized and/or Conditionally Exempt Facility: ACKNOWLEDGEMENT OF UNITS OPERATING UNDER CONDITIONAL AUTHORIZATION AND/OR CONDITIONAL EXEMPTION The Department of Toxic Substances Control (DTSC) has received your facility specific notification (fOrm DTSC 1772) and forms for Conditional Authorization and/or Conditional Exemption for Specified Wastestreams (form DTSC 1772B and/or 1772C). Your notifications are administratively complete, but have not been reviewed for technical adequacy. A technical review of your notifications will be conducted when an inspection is performed. At any time, you may be inspected and will be subject to penalty if violations of laws or regulations are found. The Department acknowledges receipt of your completed notification for the treatment unit(s) listed on the last page of this letter. These units operating under Conditional Authorization or Conditional Exemption are authorized by California law without additional Department action, pursuant to Health and Safety Code sections 25200.3 and 25201.5. Your authorization to operate continues until you notify DTSC that you have stopped treating waste and have fully closed the unit(s). You will be charged annual fees calculated on a calendar year basis for each year you operate and have not notified DTSC that the units have been closed. You must notify the DTSC 60 days before first treating hazardous wastes in any new unit. You must also notify the DTSC whenever any of the information you provided in these notifications changes. To revise information, mail a cover letter to the above address explaining the changes, attach only the pages of your notification package that have changed, and re-sign and date at the signature space on page 3 of form 1772. Your status to operate under Conditional Authorization and/or Conditional Exemption is contingent upon the accuracy of information submitted by you. in the notifications mentioned above, and your compliance with all applicable requirements in the Health and Safety Code. Any misrepresentation or any failure to fully disclose all relevant facts shall render your authorization to operate null and void. You are also required to properly close any treatment unit. Additional guidance on closure will be issued and distributed to all authorized onsite facilities later this year. Page 2 EPA ID: CAL000063455 If you have any questions regarding this letter, or have questions on operating requirements for your facility, please contact the nearest DTSC regional office, or this office at the letterhead address or phone number. Enclosure CC: Sincerely, Michael S. Homer, Chief Onsite Hazardous Waste Treatment Unit Permit Streamlining Branch Hazardous Waste Management Program SUSAN LANEY DTSC REGION 1 SURVEILLANCE & ENFORCEMENT BR. 10151 CROYDON WAY, SUITE 3 SACRAMENTO, CA 95827 STEVE MCCALLEY KERN COUNTY ENVIRON. HEALTH SERVICES DEPT 2700 M STREET, SUITE 300 BAKERSFIELD, CA 93301 Page 3 ENCLOSURE 1 Units authorized to operate at this locatiotr' UNDER CONDITIONAL AUTHORIZATION: EPA ID: CAL000063455 UNDER CONDITIONAL EXEMPTION: 1 l~po.r~a~s~ of To~ 5~l~ac~ Coau-~ ?age 1 of.~ ONSITE t-IAhZARDOUS WASTE TREATMENT NOTIFICATION FORM FACILITY SPECIFIC NOTIFICATION For U~ by Hazardou~ Waste Generators Performing Treatment ~ Under Conditional Exemption and Conditional Aut~or/zation.. [] and by Perm. it By Rule Facititie~ IaJtia~ Revised Please refer to the attached Ir. strucrion, r before completing this form. You may notify for more than one permitting tier by using this notification form, DTSC 1/-72. You must attach a separate unit specific notification form for each unit at this location, There are di~erer~ unit specific notification forms for each of the four categories and an aztditional notification form for rranxporlabt~ treatmen~ units (777J's}. You ontv have to submit forrr~ for the tier(s} that cover your unit(si. Discard or recycle tl~ other unused.forms. Number each page of your completed notification package and indicate the total number of pages at the top of each page at the 'Page __ of ~ '. Put your EPA 2D Number on each page. Please provi~ all of the information requested; all hems must be completed ~cept those thai state 'if di~erent' or 'if available'. Please type the information provided on this form and an..' catachments. The notification will not be consid~'red complete without p .ayment of the appropriate fee for each tier uru~r which you are operating. (P~ease note that the fee is per 77EJ~ not per UNIT. For ~.arnPle, if you operate 5 units but they are all Conditionally Authorized, you on~ owe $1 ,j 4.0, NOT5 tirne~ $1,240. If you operate any. Permit by. Rule units and any units uru~r Conditional Authorizatior, you owe $2,2800 Chec~.s should be made payable to the Deparzment of Toxic Substanc~ ~ontrol and be stapl~:l to the top of this form. Please fill in the check number in the box above. I. NOTI>-ICATION CATEGORIES lndic.~, e. the number of units you operate in each tier. ~ be the nurn3er of unit ~pecific notification fornt~ you ~t ~a& F~ ~ Ti~ ~e ~r ~t) A. Con~tio~ly Exempt-S~ll ~~e~o~ DTSC 177~) S 1~ D. Pe~t by Rule ~ (Fora DTSC 1772D) $1,1~ Total Num~ of Uaita GENERATOR IDENTIYlCATION Total F~ Attachaxt $ \ O~),~'~ EPA ID NUMBER NAME (Company or Facility) (DBA-l~ing Bctaix~s Aa) PHYSICAL LOCATION cri-Y COUNTY CONTACT PERSON BOE NqJMBER (if available) H__HQ 32 PHONE NUMBER(*M~' ) ~'-D~ - ¢[ ~.q, k DTSC 1772 (I/93) Page 1 MAILD~'G ADDRESS, 17' Dlq:TEREN-]': COUNTRY CONTACT PERSON STAT~_ F~ Zm qt4qot{__ (only corral:t: if not USA) (Tim Name) (l.att Natty) PHONE NI/MBER6t~ ~ )5_.q.~_-q kq \ III. TYPE OF C05[PANY: STAh'DARD Ih'DUSTRiAL CLASSIFICATION (SIC) CODE: Use eitl~r one or t~o SIC codes tlu~t b~t de.~cribe your company's products, service, or inclu, r~al activity. E. zample: 738~ Phoro(inixb. ing lab 3672 Prinxed cireuix ~ 80ll Media~zl da:n:xo~ offila~/a~t'n.i~ First: pD-'~\ Po~JIN--~'JV ~an3t~c~ Second.'-"/_.~.~q PR/OR PERbflT STATUS: YES NO r-'l El 2. El [] 4. Check ye~ or no to each question: Did you file a PBR Notice of Intent to Operate (DTSC Form g462) ia 1992 for this loc. a6on? Do you now have or have you ever held a state haT=,'dous waste facility full' permit or interim ~,,n,s for any of the..~ treatment units? Do you now have or have you ever held a frill permit or interim sums for any other h.7-,'dous wast~ activities a? this location? Have you ever held a variance issued by the Department of Toxic Substances Control for the ~t you are now notifying for at tki.s location? Has this location ever been ias'pec, ted by the state or any local agency as a l:uu:ardou~ ~ ~. V. FRIOR ENFORCEMENT RrI~rORY: YES NO Within the last three years, has this facility been the mbject of any convictions, judgments, sexde'mems, or final orders resulting from aa action by any local, state, or federal eaviron,-,,~tal or public health enforceme~t'ageacy? (For the purl~ses of th.is form, a notice of violation does not constitute an order and need not be n~ported ua.le~s it was not corrected and became a final order.) If you answered yes, check this box and a.n.a~h a li~tiag of convictions, judgments, settlemeat~, or orders and a copy of the cover sheet from each document. (See the Instructions for mom iaformafioa) DTSC 1772 (1/93) 33 Page 2 VI. ATTACI~ENT$: Page 3 A plot plan/map detailing the location(s) of the covered unit(s) in relation to the facility boundaries. A umt specific notification form for each unit to be covered at tkis location. of(,: VI/. CERTIY'ICATIONS: Taix forrn mart be signed by an authorized corporate officer or any othev'person in :he comparrv who performs decision-rnaking funcrior, s that govern operation of the facili~. (per title 22, California Code of Regulation~ iCCR) section 66270.11). Aid th.n~ copiax rnatrt have originaI Mgnatm-~. Waste Minimization I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degre~ have determined to be e,eonomic, ally practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which mlnimi2.~ the present and future threat to human health and the environment. Tiered Permittin~ Certification I certify that the unit or units described in these documents meet the eligibility and operating requirements of state stat'utes and regulations for the indicatexl permitting tier, including generator and so:oncia_,w requirements. I understand that if any of the units operate under Permit by Rule or Conditional Authorization, I will a~so be required to provide required financial assurances by January 1, 1994, and conduct a Phase I eavironmemal axseasmeat by Januar7 1, 1995. I certify under penalty of law that this document and all attach_meats were prepared under my direction or supervision in ac, corflance with a system designed to assure that qualified personnel properly gather and evaluate the information submittect. Based on my inquiry of the person or persons who manage the system, or those directly reajx>nsible for gathering the ixfformation, the informafif.n is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are substantial penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Name (Print or Type) Signature -- Title Date OPERATING REQUIREbfENTS: Please note that generators treating hazardous waste on. rite are required to comply with a number of operating requirernem, r wPa'ah differ depending on the tier(s) under which one operater. Thee operating requirements are set forth in th~ ~atutes and regulations, some of which are referenced in the Tier-Specific Fac'~rheet& SLrBMISSION PROCEDURE~: You must submit t~o crrpi~ of this completed notification by certified mail, return receipt requ~rted, to: Deparrrnent of Taxic Substancer Control Form 1772 Onsite tta:.ardous Wa. rte Treatment Unit 400 P Street, 4th Floor (walk in only) P.O. BaxS06 Sacramento, CA 95812-0806. You must also subrn~ one c~I~' of the notification and attachments to the local regulatory agency in your jurisdiction a.r li~ted in the irtrrru~ion materials. You must also retain'a copy as part of your opercaing record. All three forrr~ must have original $ignalurer, not copier. 34 DTSC I772 (I/93) Page 3 FLOOR PLAN CON'DITIONALLY EXENfI:rr . SPECIFIED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursuant to Health and Safety Code Section 25201.5(¢)) NU'bfl3ER OF TREATMENT DEVICES: . Tank(s) [ Container(s) Each unit mu. it ~ clearly i~ntified and lab¢l~l on the plot pl~n attach~ to Form J 772. A.rsign a uniqu~ number to tach unit. 7h~ number can be sequ.~ntial (], 2, SJ or using any syst~rn you choose. Check the type(s) of wasttstreo, rn(x) and treatment process(esi. I. WASTESTREAMS A.N'D TREATbfENT PROCESSES: Estimated Monthly Total Volume Treated: poun~ and/or I~'O-~'Ogallons 7he following are the eligibZ~ waxttsrrearns and procers~s. P~aze ch~ck all applicabl~ boxy: 1. Treats resins mixed in accorctanc~ w/th the manufacturer's i~.stmctions. Treat containers of 1 I0 gallons or le~s capacity that contained ha:',rdous waste by ming or physical proc.~-s_ses_~, such as cruslamg, shredding, grinding, or pUncturing. Drying .special waztes, az classified by the department pursurmt to title 22, CCR, section 66261.124, by pressing or by pa&sire or heat-aided evaporation to remove water. Magnetic separation or screen/ng to remove components from special waste, as class/fled by the de:pan:me:at pursuant to title 22, CCR, section 6.6261.124. Neutimlize acidic or a/kaline (basa) wastes from the regeneration of ion exchamge media usexl to ci~rnlrum'al~ ~r. ('I'kis waste camaot contain mom than I0 perr~nt acid or base by weight to be eligible for condit/onal exemption.) Neutralize acidic or alt-:line (b~) wastes from the food proce~ing/ndustry. Recovery of silver from photofitdshiag. The volum~ lirn~t for conditional exempt/on is 500 gaf.Ions ~ generator (at the sa.me location) ia any calendar month. Gravity separatic~ of th~ following, including the use of flocculants ~ d~rnulqfiers if a. The settfing of solids from the waste where the re:mxlting aqueous/liquid stream is not ~. b. The separation of oil/water mixtures and separation sludges, if the average oil recovered Her month is less tt:ma 25 barrels (44 gallons per barrel). Neutralizing acidic or alkaliae (base) mater/al by a state certified laborau:n-y or · laboratory opera_ted_ by an educational institution. (To be eligible for conditional exemption, fi:ds waste ea.maot contain more than 10 percem acid or base by weight.) 4O DTSC 1772B (1/93) Page 9 EP^ ID NUMBER~-~k.L. OOC~ C~'% CONDITIONALLY EX~iM]PT - SPECIYTED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (.pursuaat to Health and Safety Code Section 25201.5(c)) NAR.R. ATI'VE DESCRI2r'TION$: Provide a brief description of'the specific waste treated and the treatment process uaed. RESIDUAL NLMNAGE]'vfENT: Check yes or no to each question as it applies to ail residuals.from this treatmen~ unit. NO [-'[ 1. Do you di~harge noa-ba~'n,'dous aqueous waste to a publicly owned treatment works (POTW)/sewcr? 2. Do you discharge non-ha?ardous aqueous waste under an N'PDES permit? Do you have your residual hazardous waste hauled off$ite by a registered hazardous waste hauler? If you do, where is the waste sent? 'Check all that apply. 1~ a. Offsite r~ycting '-] b. Thermal treatment [~l c. Disposal to land [] d. Further treatment [-'] [] $. Other method of dispo~. Specify: 4. Do you dispose of non-h~?-,-dous solid waste residues at aa off'site locahon? IV. BASIS FOR NOT N~-~DING A FEDERAL PER3irr: In order to demonstrate eligibility for one of tfia~ onxite rrean~ent tieT~, facilities are required to provide the baris for dexerrnining that a ha~arclous waste permit i~ not required under the federal Resourc~ Correct,ion and Reco~,ry Act (RCRA} and the fexiera2 regulation~ adopted under RC'7~A ('J-alt 40, Cotte of Fezieral Regulations (CFRJ). Choose the reason(s) that describe the operation of your or. rite treatment unir~: The ha~a~ous waste being treated is not a h.--,-dous waste under federal law although it is re~,l.¢..~ ~ · hazardous wast~ under California state law. The wase,, is ta'eated ia wa~tewat~r tmatm~t tm.its (tax&s), as cl~fi.ned ha 40 ~ Psat 260.10, sad discharg~ to · publicly owned treatment works (POTW)/seweriag agency or under aa NPDES permit. 40 CFR 264.1(gX6) and 40 CFR 270.2. 41 DTSC 1772B (1/93) Page 10 EPA iD NUMBER~ CONDITIONALLY EXEMI~T. SPECiFYED WASTESTREAMS UNIT SPECIFIC NOTIFICATION (pursum'~t to Health and Safety Code Section 25201.5(c)) BASIS FOR NOT NEEDL-NG A FEDERAL PERMIT: (continued) Page ~ of ~ The waste is treated in elementary neutralization units, as defined m 40 CFR Part 260.10, and discharged to ~ POTW/sewermg agency or under an NPDES permit. 40 CFR 264.1(g)(6) and 4:0 CFR 270.2. The waste is treated in a totally enclosed treatn:~nt facility as defined in 40 CFR Part 260.10; 40 CFR 264.1(g)(5). The company generare~ no more than I00 kg (approximately 27 gallons) of haz~rdo~ waste in a calendar monfl: and is eligible ~ a federal conditionally exempt small quantity generator. 40 CFR 260.10 and 40 CFR 261.5. The waste is treated in an accumulation tank or container within 90 days for over 10Ct) kg/month gemerators and 180 or 270 days for generators of 100 to 1000 kg/month. 40 CFR 22.34:, 40 CFR 270.1(c)(2)(i), and the Preamble to the March 24, 1986 Federal Register. Recyclable materials are reclaimed to recover economically si~ma/ficant amounts of silver or other precious metals. 40 CFR 261.6(a)(2)(iv), 40 CFR 264.1(g)(2), and 40 CFR 266.70. Empty container rinsing and/or treatment. 40 CFR 261.7. Other:. Sl:ecify: V. TRANSPORTABLE TREATMENT UNTF: Please refer to the Instructions for more informmion. YES NO [--'] 1~ Is this umt a Transportable Treatment Unit? If you answered yes, you must also complete and attach Form 1772E to this page. The Tier-Specific Fact.sheets contain a summa.D, of the operating requirmaents for this category. Please review those rt~luir~nents mrffully before completing or submitting this notification package. DTSC 1772B (I/93) 42 Page I 1 Hazardous Materials~azardouS,~WaSte'Unified. permit. CONDITIONS OFPERMIT ONi~REVERSE SIDE Permit ID#:: 015-000-001839 RITZ CAMERA #534 LOCATION: 2701 MING AVE This ~errnit is issued for the followin_~: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program D Hazardous Waste On-Site Treatment IELD .. 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 i Expiration Date: 'June 30; 2003 Issue Date STATEMENT OF ACCOUNT CITY ~ TM ....... P 0 BOX 2057 BAKERSFIELD, CA 93503-~057 PA~E~ TO: RITZ CAMERA q=O! MINQ AVE 671~ =~TZ.,~ WA / .Y~.~ CUSTOMER NO: 3/01/03 ANNUAL .~ ILL iF RECEIVED IN DATE' 4/01/03 ~PE: ES/ / / ~-6/30/~003. LL--(661)3~6-364~. ~6030 123. O0 CURRENT OVER 30 OVER 60 1~3.00 OVER 90 5/01/03 PAYMENT DUE' TOTAL DUE' PLEASE DETACH AND SEND TH!~ COPY WITH ~EMITTANCE DAT~: 4/01/03 DUE DAT~ 0/0t/03 CUSTOMER NO: · 7413 REMIT AND MAKE ~HEC~ PAYABLE TO: CiTY OF ~A~E~FiELD PO ~OX ~057 BAKERSFIELD (661) 886-364~ RITZ CAMERA CUSTOME~ TYPE: ES,/ CA 93303-2057 TOTAL DUE: 123.00 $123.00 26030 $1~3.00 SECTION 1-Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 ADDRESS ~ PHONE No. No. of Employees r<.'.-1 ................ ,,, .... IOAo. e ~(,,.,, ti, m; 1\~.,,,-- 15-021- oo toe',.? ? ,..{':? :.' .:.':.: ,.:' ":" SeCtiOn~l:Business Plan and InventorY. program [3F~outine ~ Combined 1'1 Joint Agency ~1 Multi-Agency ~ Complaint [] Re-inspection ~' c=compliance ~ OPERATION ~, V=Violation APPROPRIATE PERMIT ON HAND [] BUSINESS PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY [] VERIFICATION OF INVENTORY MATERIALS [] VERIFICATION OF QUANTITIES [] VERIFICATION OF LOCATION [] PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITYE [] VERIFICATION OF HAT MAT TRAINING [] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES [] EMERGENCY PROCEDURES ADEQUATE [] CONTAINERS PROPERLY LABELED [] HOUSEKEEPING FIRE PROTECTION [] SITE DIAGRAM ADEQUATE & ON HAND COMMENTS ANY HAZARDOUS WASTE ON SITE?; ~ YES [] No I QUESTIONS REGARDING THIS INSPECTION?_~3 I ~p;c~~ PLEASE CALL US AT (661)Badge~ No. 326-3979 _~. '~~~ White - Environmental Sewices Yellow - ~tion ~py Pink - Business Copy FACILITY NAME ~ ADDRESS g.'70 I FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 INSPECTION DATE ~'-,,q3- PHONENO. (903) _29t0- Cto3 t BUSINESS ID NO. 15-210- OOlg3'~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine [~ Combined I~ Joint Agency ~ Multi-Agency ~1 Complaint [~ Re-inspection OPERATION CIv COMMENTS Appropriate permit on hand Business plan contact information accurate 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 "l~usiness Site Responsible Party Inspector: .. D May 3,2001 Ritz Camera 2701 Ming Avenue Bakersfield, CA 93304 Dear Business Owner: FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 . VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Enclosed, please find the Site and Facility Diagram Instructions packet. When your Hazardous Materials Management Plan and Inventory were submitted it was lacking the diagram portion. Please draw and submit the diagram(s) of your facility by June 8, 2001. The diagram should include the following: 1) 2) 3) 4) 5) 6) 7) 8) 9) name of your business; business address; indicate which direction is North; the cross streets neighboring business addresses (within 300 feet) entrances and exits location of utility shut-offs; location of the nearest fire hydrant; portions of the building protected by automatic sprinkler system; and most importantly the location of the hazardous material(s). If you have any questions, please feel free to call me at (661) 326-3658. Thank you for your assistance. Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENTAL SERVICES Esther Duran, Accounting Clerk II Office of Environmental Services ED\db Enclosures IVendor No. I CLAIMANT'S NAME AND ADDRESS: The Picture People - Expressly 2701 Ming Ave Bakersfield, CA 93304 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) Date: 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 $214.25. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $222.75. Dept. 0000 El / Obit Project # Invoice # 7900 VOUCHER TOTAL Amount Date of Invoice $222.75 $222.75 ISECTION 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 93301-5201 TO: THE PICTURE 270i MiN~ BAKERSFIELD DATE: 4/01/~9 CUSTOMER NO: CHARQE DATE ES/ 26041 TOTAL AMOUNT SSO01 3/01/~ 2126199 3t31/~ adjustm ',~: ~i~Z~-~STATE,,~,, .~' ~i FOR QUESTIONS OR"CHAN~ESu'TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. .00 214.25- 8. 50- CURRENT OVER 30 OVER 60 OVER 8. 50- DUE DATE: 5/03/~ PAYMENT DUE: TOTAL DUE: 222.75-- $222.75- Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-0214)01839 RITZ CAMERA #534 LOCATION 2701 MING Issued by: ~,,~,~,?¢'~ ~%~?~"Y~i:~,s~,~,..~,~ ........ This permit is issued for the following: ~},:'=,:'~¢~L:::'%~' BAKE~SEi~LD ca 933~{~?-' ~,~;::':':.:~'::~1~= [~:,. ".~ ;i~' ~ j .... '"~.:~u~.~. .:.. ~ ~ t~[~l~H~ ~. ~' ~ '- ":".- ~g:'-'"'".:i~ '[':~ ........... ~a~,=. - ............ · ................... ::[/:~i;" ~:']' ~34;X" ~¢..'"-..~'4~~ ~.--...:~ ~=..'~: .¢~[~...)~?~'* ~¢~;~;,.,.,i:,~a~'~,' ,~. ¢ ,=. ~;= '... '~::?"'"'% '~r:'.,. '",... ,- · ~,.," .~¢ :, .. '=~"~('..... ..... "'.:=~['~==,...;': '~;~2¢~' ~ii~. "~¢* :=="...,,~"+¢"~" i' ¢ ] i .i.,~i~ Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Approved by: Office of ~ental Servides Expiration Date: June 30:2000 RITZ CAMERA #534 SiteID: 215-000-001839 Location: 2701 MING AVE City : BAKERSFIELD BusPhone: Map : Grid: (805) 396-9051 CommHaz : FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: CAL000112114 SIC Code:7384 DunnBrad: Emergency Contact Business Phone: 24-Hour Phone : Pager Phone : / Title / ( ) - x ( ) - x ( ) - x Emergency Contact Business Phone: 24-Hour Phone : Pager Phone : / / ( ) ( ) ( ) Title X X X Hazmat Hazards: React Contact : MailAddr: 2701 MING AVE City : BAKERSFIELD Phone: (805) 396-9051x State: CA Zip : 93304 Owner RITZ CAMERA Address : 6711 RITZ WAY City : BELTSVILLE Phone: (805) 396-9051x State: MD Zip : 20705 Period : to TotalASTs: = Preparer: TotalUSTs: = Certif'd: RSs: No Gal Gal Emergency Directives: THIS IS A WASTE TREATMENT SITE WHICH REQUIRES A JOINT INSPECTION. PLEASE CALL ENV SVCS TO SCHEDULE INSPECTION WITH HOWARD WINES. = Hazmat Inventory --As Designated Order Hazmat Common Name... WASTE FIXER One Unified List Ail Materials at Site ISpeoHazlEPA HazardsI Frm DailyMax UnitIMCP R L 5 GAL Min 1 07/23/1998 FACILITY NAME ADDRESS FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ru Floor, Bakersfield, CA 93301 INSPECTION DATE [ l- 6 ~ c~B PHONE NO. q6,- qC ./ BUSINESS ID NO. 15-210- O:5>t'~ NUMBER OF EMPLOYEES Section 1: [] Routine Business Plan and Inventory Program ~Combined [] Joint Agency [] Multi-Agency Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate pem~it on hand Business plan contact intbrmation accurate 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?i~ ~Yes. [] No Questions regarding this inspection? Please call us at (805) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy "l~siness Site Responsible Party 6>,4o0 Inspector. ~d~ ~'- ,~~ FACILITY NAME (~ I ADDRESS '~"70 t /w/ FACILITY CONTACT INSPECTIONTIME Iq'' tO...- ~"oo CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE_ l/~"/~ ,~' PHONE NO. ~q~, - BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1.: Business Plan and Inventory Program [] Routine ~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address /14~.cc '¢Xoo~ DO~¥ '0,$0c.~'¢ 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?: ~ Yes [] No Explain: :~/..O~7~?.. ~-15o~]~ez.¥t Questions regarding this inspection? Please call us at (805) 326-3979 While - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Site Respons)~f/e Party Inspector: t..,O / &r/~q CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: 2. 3. 4. To avoid further action, return this form within 30 da~s of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be as brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: LOCATION: MArt'.lNG ADDRES S: CITY: DUN & BRADSTREET NUMBER: STATE: ziP: c3q- PHONE: SIC CODE: P~Y ACTMTY: OWNER: MAILING ADDRESS: ~o?o~- SECTION 2: EMERGENCY NOTIFICATION CONTACT 'TITLE BUS. PHONE 24 HR. PHONE ~3 £7Z0 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: ~'~ MATERIAL SAFETY DATA SHEETS ON FILE: 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 TIME EXCEED THE ~ REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDF~ THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THA.._,T ~ACCURATE INFORMATION CONSTITUTES PER.RJRY. ' ' '~;IONA~ - ~ ' "T~JLE' ~ 'DATE 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIQATION, PREVENTION AND ABATEMENT PLAN A. RELEASE PKEVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NA~ OAS/PROPANE: ELECTRICAL: WATER: SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDe): i~usincss Name H~RDOUS MATERIALS INVENT~_Y ~1 "fi'Z_ ~ C,-~& ://' g"~4- Address Page .... CHEMICAL DESCRIFIION of, I ) INVENTORY STATUS: New [~q Addition [ ] Revision [ ] Deletion [ 2) Common Name: ~ ~°~"~ T f'MO 'Co6//-,~ ~: ~ c.. f-~ oc CO_ Chemical Name: 4) Physical & Health Hazard Categories 5) WASTE CLASSIFICATION 6) PHYSICAL STATE Solid [ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount PHYSICAL Fire [ ] Reactive{~' ] Sudden Release of Pressure [ (3-digit code from DHS Form 8022) Liquid~ Gas[ ] Pure[ ] UNITS OF MEASURE Lbs[ ] c-ai~4 ~3 [ I ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 3) DOT # (optional) A~M[ ] CAS# ] Immediate Health (Acute)'~ Delayed Health (Chronic) [ ] USE CODE Mixture [ ] Waste [~ Radioactive [ ] 8) STORAGE CODES a) Container. ~. ~-~'t'~ c_ Average Daily Amount Aonuai Amount I000 Largest Size Container # Days on Site Curies [ ] b) Pressure: ~ c) Temperature ~ Circle Which Months: All Year, J, F, M, A, M, $, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % w'r AI-nVl the three most hazardous 1) '~ t C..t//?t,., [ ] chanical components or 2) [ ] any AHM components 3) [ ] 10)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSecret[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION O-digit code from DIaS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] ~[ ] Pure[] Mixture[] Waste[] ~tioactive[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # D~ys on Site UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] Gal [ ] fU [ ] a) Contsin~ Curies [ ] b) Pressure: c) Temperature Circle Which Months: AIl Yeatr, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COM1K)~ CAS# % WT AHM the three most hazardous 1) [ ] chemical components or 2) [ ] any AHM components 3) [ ] 10)LOCATION [ certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. believe the subrmtte~i~ information is true, accurate and complete. PRI}qT N.e & Ti/le of Auk. ed Company R~_.r~mtetive Signature - ~ Business Name [L~RDOUS MATERIALS INVENT~Y Addruss Page of CHEMICAL DES~ON I ) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Ddetion [ ] Check ffchemical is a NON Trad~ ~ [ ] Trad~ Seer~ [ ] 2) Common Name: 3) DOT # (optional) Ch~uical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ ]Reactive[ ]S,_,dd~Releas~ofPressum[ ] lmmediateHealth(Acute)[ ]DdayedHealth(Chwuic)[ 5) WASTE CLASSIFICATION (3-digit cod~ frt~n DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Oas [ ] eur~[ I Mixtu~[ I Waste[ ] l~Uoa~ive[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]Gall ]f13[ ] a) Container: Curi~s [ ] b) Pressure: c) Tempa'ature Circle Which Months: All Ye~u', J, F, M. A, M. $, $, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) [ ] chemical componeuts or 2) [ ] any AHM components 3) [ ] 10)LOCATION 1) INVENTORY STATUS: Ncw [ ]Addition[ ]Revision[ ]Deletion[ ] CheckifchemicalisaNONTrad~Sccret[ ]TradcSccrct[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AI-IM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ ]Reactive[ ]$udd~ReleaseofPressum[ ] lmmediateHealth(Acute)[ ]DelayedHealth(Chroni¢)[ 5) WASTE CLASSIFICATION O-digit code fium DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pm[] Mixtu~[ ] waste[ ] R~lioa~v¢[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] Gal [ ] fl3 [ ] a) Cont~i.e~. Curks [ ] b) Pmssu~: c) Temperature Circle Which Months: AII Year, J,F,M,A,M,J,J,A,S, O,N,D 9) MIXTURE: List the three most hazardous 1) chemical components or 2) any AHM compon~uts 3) COIVlPONENT CAS# % WT [ ] [ ] [ ] 10)LOCATION certify under penalty of law, that I have personally examined and am familiar with thc information on this and all attached documents. I bslicvc thc submiRcd information is lruc, accurate and complete. PRINT Name & Title of Authorized Company Represeniative Sislmtum Date Business Name HA~RDOUS MATERIALS INVENTORY Address Page of CHEMICAL DESCRIPTION I)INVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSecret[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release ofPresmn'e [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION O-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ I G-as [ ] Pur~[ ] Mixture[ ] Wa.~[ ] mqioactive[ ] 7) AMOUNT AND TIME AT FACILrrY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lb~ [ ] Cai [ ] 1%3 [ ] a) Collt-in~. curies [ ] b) Pressure: c) Temperature C/role Which Months: All Year, J, F, M, A, lVl, J, J, A, S, O, N, D 9) MIXTURE: List COM~NENT CAS# % WT AHM the three most hazardous 1) [ ] chemical components or 2) [ ] any ~ components 3) [ ] lO)LOCATION 1) INVENTORY STATUS: New [ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSecret[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH ~Categories Fire[ ]Reactive[ ]Suckh~Relea~ofPressure[ ] lmmediateHealth(Acute)[ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-disit codo from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Cas [ ] Pure [ ] Mixm~ [ ] Waste [ ] Radioa~/ve [ ] 7) AMOUNT AND TIlVlE AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount La~e~ Size Container # Days on Site 9) MIXTURE: List the three most hazardous 1) chemical components or 2) any AHM components 3) UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]Gal[ ]113[ ] a)Contain~r:. Curies [ ] b) Pressure: c) Tcmpmmturc Cii~le Which Months: AIl Year, J, F, M. A, M. J, $, A. S. O, N. D COMPO~ CAS# % WT [ ] [ ] 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I believe thc submitted infommtion is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date H~RDOUS MATERIALS [NVENTI~Y Business Name Address Page of' CHEMICAL DESCRIPTION I) I~VENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchcmical is a NON Trade Secret [ ] Trade ~ [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health Hazard Categories Fire [ 5) WASTE CLASSIFICATION ] Reactive [ PHYSICAL HEALTH ] Su~ad~_~ Release ofPressur~ [ ] Immediate Health (Acute) (3-dilit code from DHS Form 8022) USE CODE ] Delayed Heal~ (Cl~mic) [ ] 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure[ ] Mixture[ ] Waste[ ] Raaioaaive[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daffy Amount Annu~ Amount Largest Size Container # Days on Site UNITS OF MEASURE 8) STORAGE CODES Lbs [ ] C-al [ ] fl3 [ ] a) Contaiuer:. Curies [ ] b) Pressure: c) Temperatur~ Circle Which Months: AIl Year, $, F, M, A, M, $, $, A, S, O, N, D 9) IvlIXTURE: List COMPO~ CAS# % WT AHIvi the three most hazardous 1) [ ] chemical components or 2) [ ] any AHM components 10)LOCATION I)INVEKrORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] Check if chemical is a NON Trade Secret [ ]TradeSec~[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHlVl [ ] CAS # 4) Physical & Health PHYSICAL I-[EALTH Hazard Categories F/re[ ]Reactive[ ]SuddenReleaseofPressu~[ ] lmmediateHealth(Acute)[ ]DelayedHealth(Chroni¢)[ ] 5) WASTE CLASSIFICATION (3-diiit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] Oas[ ] Pure[ ] Mixture[ ] Waste[ ] Radioactive[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Conta/ner # Days on Site 9) MIXTURE: List the three most b,,,urdous 1) chemical components or 2) any AH]Vi components 3) UNITS OF MEASURE 8) STORAGE CODES Lbs[ ]Gal[ ]fl3[ ] a) Container: Curies [ ] b) Pressure: c) Temperature Circle Which Months: All Year, J, F, M, A, M, $, $, A, S, O, N, D COMPONEKr CAS# % WT [ ] [ ] I 0 )LOCATION [ c~rtify under penalty of law, that I have l~rsonally ommimxi and am familiar with the information on this and all attached documants. I bslieve the submitted information is true, accura~ aad complete. PRINT Name & Title of Authorized Company Representative Signature Date Bdsiness Name HA~RDOUS MATERIALs INVENTORY Address Page of CHEMICAL DES~ON 1) INVENTORY STATUS: New [ 1 Addition [ ] Revision [ ] Deletion [ ] Check ii'chemical is a NON Trade Secret [ ] Trad~ Secret [ ] 2) Common Name: 3) DOT # (optional) Chenucal Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire[ ]Reactive[ ]SuddenRdeaseofPressure[ ] rmmediateHealth(Acute)[ ] Delayed Health (Chronic) [ WASTE CLASSIFICATION (3-digit code Gum DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Oas [ ] Pm'e[ ] ~x'tm'e[ I waste[ ] P~uo~dve[ ] 7) AMOUNT AND TIME AT FACILrrY Maximum Daily Amount Averase Daily Amount Annual Amount Largest Size Container # Days on Site uNfrs OF MEASURE 8) STORAGE CODES Lbs[ ]Gall ]ft3[ ] a) Container: Curies [ ] b) Pressure: ¢) Teu~un~ Civic Which Month~: All Ymr, $, F, M. A. M, $, $, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the thr~ most hazardous I ) [ ] chemical compon~n~ or 2) [ ] any AHM components 3) [ ] 10 )LOC ATION I)[NVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletion[ ] CheckifchemicalisaNONTmdeSecret[ ]TradeSec~t[ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHlVi [ ] CAS # 4) Physical & Health PHYSICAL I'IF. ALTH Ha.ardCategories Fire[ ]Reactive[ ]SuddmReleaseofPressure[ ] {'mmediateHealth(Acute)[ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-disit ~xxle from DHS Form 8022) USE CODE PHYSICAL STATE Solid [ ] Liquid [ ] G-as [ ] eur~[ ] Mi~[ ] wut~[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site 9) M~TURE: List the three most hazardous 1) chemical components or 2) any AHM components 3) UNII~ OF MEASURE 8) STORAGE CODES Lbs[ ]Cai[ ]ii3[ ] a)Contain~. Curies [ ] b) Pressure: c) Tempemtu~ Circle Which Mondm: All Year, J, F, ]vi, A. IV{, $, $, A, S, O, N, D COMPONENT CAS# % WT [ I [ ] I O)LOCATION [ ctumify under penalty oflaw, that I have personally examined and am familiar with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. PRINT Name & Tide of Authmized Company Representative Signature Da~ Business Name HAZARDOUS MATERIALS INVENTORY Page of' CI~MICAL Die. SCRIFIION 1 ) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check it'chemical is a NON Trade Secret [ ] Trade Sec~ [ ] Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] S,_,dd_~ Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (chwuic) [ 5) WASTE CLASSIFICATION (3-digit code fi'om DHS Form 8022) USE CODE PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] ru~[ ] Mixture[ ] Waste[ ] tUsdioactive[ ] 7) AMOUNT AND TllklE AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF IVIEASURE 8) STORAGE CODES Lbs[ ]Gall ]it][ ] a)Contemec Cutfes [ ] b) Pressmtre: ¢) Temperatu~ Civic Which Moaths: All Yesr, J, F, M, A, M, $, L A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WI' AItM the three most hazardous 1) [ ] chemical components or 2) [ ] any ~ components 3) [ ] 10)LOCATION I)INVENTORYSTATUS:New[ ]Addition[ ]Revision[ ]Deletiou[ ] Check if chemical is a NON Trade Secret [ ]TradeSeca~t[ ] 2) Common Name: 3) DOT # (optional) Che~cal Name: AHlVi [ ] CAS # 4) Physical & Health PHYSICAL HEALTH HA,~,rdCategofies Fi~e[ ]Reactive[ ]SuddeuReleaseofPtessute[ ] Immediate Health (Acute) [ ]DelayedHealth(Chwuic)[ 5) WASTE CLASSIFICATION (3-digit code flora DI-IS Form 8022) USE CODE PHYSICAL STATE Solid [ ] Liquid [ ] Oas [ ] Puli ] Mixtu~[ ] W~[ ] l~Uo~ve[ ] 7) AMOUNT AND TIME AT FACILITY Maximum Daily Amount Average Daily Amount Annual Amount Largest Size Con~tk~- # Days on Site UN]TS OF MEASURE 8) STORAGE CODES Lbs[ ]Gal[ Iff3[ ] a)Conta/nec. Curies [ ] b) Pressu~: ¢) TemperaUu'e Circle Which Months: AIl Y~r, $, F, lyf, A, IVi, $, $, A, S, O, N, D 9) MIXTURE: List the three most h,~Ardous 1) chemical compononts or 2) a~y AHM components 3) COMPONENT CAS# % WT [ ] [ ] [ ] 10 )LOCATION ! certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents, I believe thc submitted information is Uue, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date SITE DIAGRAM [ Business Name: Business Address: FACILITY DIAGRAM t SPILL RESPONSE PLAN For:. Ritz Camera Center Store NUmber # (.~ - ~ (~,ddres~i .' . Facility Primary Contac~(~fQ.~, r~(~'~! (Name of Store Manager) ~ (Home Telephone Number) (Work Telephone Number) Chemical Spill Reporting and Notification In the event of a spill the following 1-Hour lab personnel will be contacted to determine the best method of spill response and Mitigation. (AssistahI~tore Mana~r ~ (Telephone l(lumber) - ..x ~(T~chnical ServiCe Manager) (Telephone Number) Emergency Assistance For emergency.h'ealth, safety and environmental assistance for Fuji Hunt and the Eastman Kodak Com- pany products Call: Fuji Hunt 1-800-424-9300 Kodak (716) 722-5151 (See RITZ CAMERA EMERGENCY RESPONSE PLAN) Local Fire Department Telephone Number protective Equipment Review the product Material Safety Data Sheet(s) for the proper safety equipment requirements for personnel protection and controls, contact Fuji Hunt at (1-800-424-9300) for Fuji Hunt products Eas~xnan Kodak Company Emergency Health, Safety, and Environmental Hot-Line at (716) 772-5151. Use only the safety gear provided. It is OSHA approved and may nOt be January 1997 One liter or less of a photopr°CeSsing solution would not constitute an emergency. For small spills, the immediate area should be evacuated and the spill should be' mopped-up and/of flushed with cold water to a floor drain connected to an approved or permitted municipal sewer system. If there is no acc. eza to an approved municipal sewer system, the spill should be mopped-up, absorbed and containerized for off-site disposal according to Federal, State, and Local regulations. For large spills, immediately evacuate the affected area and notify the designated. personnel res~nsible for spill response and mitigation. In most cases the procedures listed under 'small spills' apply, however, if you have a spill of a chemical concentrate, the spill may require nentrali~tion (pH adjustment) prior to management of the waste. (sm,)-H Date: I. Business Information Business Name Address Zip Code .27o t ., C(~- Parcel Number Address City Zip Coae Business Phone Home Phone 20-705'r ('5or) qtq .o~oo ,-_ -- onsible rt onsibl or hnlcal Resource Ae On.site Notification (describe the chain of notifications). Decision Ma~t: This person has the authority to ma.Ice decision regarding the classification of the release and dclcrmine the appropriate.response. Depaztment/Telephone '-~q~5~ ~~-"'~ ~: .... VoW;on e Inlcmal HaT~rdous Materials Response Team Notification Procedures: This depends on the ~ of your operation. The response team may range from one l~rson who knows how to clean-up a 'sPill to a fully equipped team. [ ] Alarm [ ] Public Address System [ ,~' ]Telephone [ X ] Voice List procedures for notification of employees who could be exposed to hazardous conditions by release. [ ] Alarm [ ] Public Address System [.-k' ] Telephone '[g ] Voice List procedures for notifying neighboring residence, buSinesses, schools, etc. which can be affected by a release. Document list of those to be nOtified. [ ] Ahrm [ ] Public Address System [,k"] Telephone [ x'] Voice Designate an hud?idual who will perform the.nofifieation- Name Contact ~ c_- e T~,~on~ ¢~ Contact Person Name Address Telephone, Contact Person N~Tle Addres~ Telephone Contact Person N~ne Address Telephone Contact Person F--'MERG~CY: R~PoN.,SE NUMBERS .... Ambulance Sea'v'ice County Ha~axdous Material'(24 hom'S~ ) Fire l:~partment Medical Facility (nearest hospital) Sheriff Department State Highway Patrol 3ge, -t6 6 -vc- STATE AGENCY NUMBER~ State Office of Emergency Services State Department of Toxic SubstanCeS 'Control State Department of Environmental Proteciion Environmental Protection Agency (-EPA) National Response Center ~60..- ,4 hq - '46t, O 1-800-424-8502 OTHER IMPORTANT NUMBERS ]~/IITIGATION FResoonse. Ciean-Uo. Recover),_) List of Emergency Response Equipment [~N] Telephone [~] Broom [X.] Mop and Pail [k] Fire Extinguisher [ ] Absorbent Material (Vermiculite, .Ki'tty Litter, Rice, HuH, Ash, Sand) [ ] Shovel andPail ~] Water Hose [ ] Decontamination Shower .- [~] Eyewash FoUntain [~.] Personnel Protective Equipment [×] Face Shields, Safety Goggles, Glasses [rd Rubber GloVes [ ] Rubber Boots [ ] Respirator D( ] Protoctive Clothing [~ Other B. Containment Procedures ~'] 'Blocking drains [k~] Diking with absorbeniYother [ ] Bern in storag.e/work area(s) [ ] Other .C. Clean-Up Procedures Absorbent lVlaterial Evaporation Dilut~lush (Only those chemical~ acceptable to the Sanitary Sewer.) Lice. ase Hazardous Waste Treatment, Storage, and Disposal Company Recycling Recycling Company Address Zip Code Tclephoac EPA Number List personnel who will give technical advice to off-site emergency responder (fh'e, police) in case of spill. [ ] Owner ['] Manager EVACUATION PLAN List Procedures for Spreading the Alarm , larm Public Address System Telephone Voice Del"me/Post Evacuation Routes On your site diagram draw arrows or u.~ the fire evacuation mutes showing the r~fe way out of the facility. · . Ce Det'me Procedures for Accounting for All Employees and Visitors After Evacuation. On your site map designate a safe collection POint for evacuees. Designate a responsible person to account for them, Ve TRAINING PLANS AND PROCEDI. JR.F~R A written plan outlining the information to be used to train new employees and an annual review course for all employees. In CA this isa mandatory requirement see Chapter 6.95 for the California Health and Safety Code). It is suggested that the Business Emergency Plan be.Used in conjunction with the Material Safety Data Sheets for each chemical as the core of this training. Include proper handling, safety, and personal protective procedures. Proof of training is also required; a sign-off sheet stating the date, the names of the participating employees, and the material covered'On that date will meet the requirements. Please submit a copy of the lesson, and where ~he proof of training can be reviewed with the Business Emergency plan.