HomeMy WebLinkAboutBUSINESS PLAN ITE DIAGRAM
~--- ~, FACILI'I)~DIAGRAM
For Office Use Only
First In Station:
Inspection Station:
Area Map # of
NORTH
ITE DIAGRAM
Business Name:
Business Address:
For OffiCe Use Only
First In Station:
Inspection Station:
Area Map # of
NORTH
Utilities General Account Maintenance PUTLS801
Acct Nbr: 724001 Bill Stat: FB
Cyc Stat: CL Acct Cyc Stat: CL
Transfer-from:
Transfer-to:
Page 1 of 6
Due: 0.00
2.
4. Service Address: 6000 SCHIRRA CT - STE C
5. Service'City: BAKERSFIELD 6. State: CA
Customer Name: SPECIALTY CONNECTORS INC
Social Sec Nbr: 3. Telephone: 805-832-5006
20. Water Svc Class:
8. Parcel ID:
9. Bill Cycle: 5
10. Route Nbr: 1
11. Comments.:
12. Prev Acct: HM00148 23.
13. Service Date: 12/13/91
14. Fund no:
15. Bill-to Addressl: P 0 BOX 40397
16. Bill-to Address2:
17. Bill-to City: BAKERSFIELD
7. Zip: 93313
Misc Services: 23.1 F99 NOT IN BUSINESS
23.2
24. Closing Date: 12/10/92
18. State: CA 19. Zip: 93384-0397
Enter Save(S), Cancel(XX), Next Page(/), or Field # to Change
ALT-F10 HELP I ADDS VP I FDX I 9600 E71 I LOG CLOSED I PRT OFF I CR I CR
08/18/92 SPECIALTY CONNECTORS 215-000-000148 ' ~ Page
Overall Site with 1 Fac. Unit
General Information
Location ....
Community: BAKERSFIELD STATION 09
Map: 123 Hazard: Moderate
Grid: 15C F/U: 1 AOV: 0.0
Contact Name Title / Business Phone ~ 24-Hour Phone-
DAN HARGIS PRESIDENT 1(805) 832-5006 x 1(805) 833-1998
PRESTON HOWARD VICE PRESIDENT (805) 832-5006 x 1(805) 836-0605
Administrative Data
Mail Addrs: 6000 SCHIRRA CT C D&B Number:
City: BAKERSFIELD State: CA Zip: 93313-
Comm Code: 215-009 BAKERSFIELD STATION 09 SIC Code:
Owner: DON HARGIS Phone: (805) 832-5006
Address: 2108 ORIOLE ST State: CA
City: BAKERSFIELD Zip: 93309-
Summary RECEIVED
'SEP 2 2 1992
HAZ. MAT. DIV.
I,/-.~i~~/~, Do hereby certify
~Ty~ that I have
reviewed the attached hazardous materials manage-
' (.=,,~ alon
any corrections constitute a comp~e and correct m~n-
agemem plan for my;taci,ty. ~~~X ~y
08/18/92
SPECIALTY CONNECTORS 215-000-000148
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
Page 2
02-001 ARGON/CARBON DIOXIDE
· Fire, Pressure, Immed Hlth
Gas
3429
FT3
Minimal
CAS #: 7440-37-1
Trade Secret: No
Form: Gas
Type: Pure
Days: 365 Use: WELDING SOLDERING
Daily Max FT3
3,429
Daily Average FT3
3,429.00
Annual Amount FT3'--
41,148.00
Storage Press T Temp '
PORT. PRESS. CYLINDER Above I AmbientlNW CORNER
Location
-- Conc
75.0% IArgon
25.0% Carbon Dioxide
Components
MCP ----[List
Minimal I
Minimal I
02-002
OXYGEN
· Fire, Immed Hlth, Delay Hlth
Gas 1992 Low
FT3
CAS #: 7782~44-7
Form: Gas Type: Pure
Daily Max FT3 Daily Average FT3
1,992 I 1,992.00
Storage I Press T Temp
PORT. PRESS. CYLINDER IAbove JAmbientlNW CORNER
-- Conc Components
100.0% Ioxygen, Compressed
Trade Secret: No
Days: 365 Use: WELDING SOLDERING
Annual Amount FT3 --
23,900.00
Location
MCP iList
Low
02-003 ACETYLENE
· Fire, Pressure, Immed Hlth
Gas 3429 High
FT3
CAS #: 74-86-2
Trade Secret: No
Form: Gas
Type: Pure
Days: 365 Use: WELDING SOLDERING
Daily Max FT3
3,429
Daily Average FT3
3,429.00
Annual Amount FT3
41,148.00
Storage
PORT. PRESS. CYLINDER
Press T Temp
I Above JAmbient I. NW CORNER
Location
-- Conc
100.0% IAcetylene
Components
MCP --~List
High
08/18/92
SPECIALTY CONNECTORS 215-000-000148
02 - Fixed Containers on Site
Hazmat Inventory Detail in Reference Number Order
Page
02-004 PROPANE
· Fire, Pressure, Immed Hlth
Gas
60 High
GAL
CAS #: 74-98-6
Trade secret: No
Form: Gas
Type: Pure
Days: 365 Use: FUEL
Daily Max GAL
60
Daily Average GAL
60.00
Annual Amount GAL
600.00
Storage
PORT. PRESS.-CYLINDER
Press T Temp
IAbove ~Below
Location
ISE CORNER BY DOOR
-- Conc
100.0% IPropane
Components
MCP
IExtreme I
List
08/18/92
SPECIALTY CONNECTORS 215-000-000148
00 - Overall Site
<D> Notif./Evacuat~on/Medical
Page
4
<1> Agency Notification
FIRE/POLICE - 9-1-1
HAZARDOUS MATERIALS.- 326-3979
<2> Employee Notif./Evacuation
A INTERCOM PAGING SYSTEM WOULD BE USED IN CASE OF EMERGENCY.
WOULD MEET IN STREET IN FRONT OF BUSINESS.
ALL EMPLOYEES
<3> Public Notif./Evacuation
EITHER NOTIFICATION BY PHONE OR DOOR TO DOOR NOTIFICATION.
<4> Emergency Medical Plan
HALL'AMBULANCE IS 1/4 MILE FROM OUR LOCATION. MERCY SOUTHWEST FACILITY AND
WHITE LANE MEDICAL CENTER ARE LESS THAN 1 MILE AWAY.
08/.18/92
SPECIALTY CONNECTORS 215-000-000148
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
Page
<1> Release Prevention
ALL MATERIALS ARE STORED AND SECURED IN SEPERATE AREAS.
ARE READILY AVAILABLE.
FIRE EXTINGUISHERS
<2> Release Containment
THE ONLY MATERIAL THAT COULD BE CONTAINED WOULD BE PAINT OR HYDRAULIC OIL.
SURROUND SPILL WITH EITHER RAGS OR DIRT FOR CLEAN-UP.
<3> Clean Up
OF THE SPILLS THAT WE FEEL WE COULD HAVE, WE WOULD VACUUM THE SPILL INTO
METAL CONTAINERS, THE BALANCE WOULD BE REMOVED BY A HAZARDOUS WASTE REMOVAL
SERVICE.
<4> Other Resource Activation
08/18/92
SPECIALTY CONNECTORS 215-000-000148
00 - Overall Site
<F> Site Emergency Factors
Page
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - SW SIDE OF BLDG IN FRONT
B) ELECTRICAL - SW WALL OF SHOP AREA
C) WATER - SW SIDE OF BLDG JUST BEHIND FENCE
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - NONE
NEAREST FIRE HYDRANT - 150FT SOUTH OF ENTRANCE TO BLDG.
<4> Building Occupancy Level
08/18/92 SPECIALTY CONNECTORS 215-000-000148 Page
00 - Overall Site
<G> Training
7
<1> Page '1
WE HAVE 8 EMPLOYEES AT THIS FACILITY.
WE HAVE MSDS SHEETS ON FILE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TRAINED IN THE SAFE
OPERATION OF WELDING MACHINES, ACETYLENE CUTTING TORCHES. ALL CYLINDERS ARE
STORED IN SAFE LOCATIONS AND ARE CHAINED TO PREVENT FALLING. EMPLOYEES HAVE
BEEN NOTIFIED OF THE 911 EMERGENCY PHONE NUMBER.
<2> Page 2 as needed
<3> Held for Future Use
<4> Held for Future Use
I ARDOUS MATERIALS MANAGEMENT PLAN
INVENTORY INSTRUCTIONs
GENERAL INFORMATION:
Important: If you require more inventory forms than the one
provided, you should make p~otocopies of the forms prior to
entering any information on them· The additional copies must be on
the same color paper as the original·
Information must be typed/printed in English. Make a copy for your
records. Complete business name and address informaAion. If t hey have
been required, the number.of separate facility units will be determined
by the Bakersfield City Fire Department. Give each facility unit a
common name, and a one or two digit number. NOTE: An inventory
form must be made for each separate facility unit.
The top of the form must be completed for eaph facility - s h owi n g
Business name and location as well as owner name and mailing address.
Also include "SIC" Standard Industrial Classification Code and if
available Dun and Bradstreet Number.
Non-Trade Secrets (White Form).
one facility unit.
Non-Trade Secret Materials in
Trade Secrets (Yellow Form).
facility unit.
Trade Secret Materials in one
TRANSACTION CODE:
Is this inventory sheet new, an addition, deletion or update to your
hazardous materials business plan~ -
A '= Addition'
D = Deletion
U = Update
N = New
TYPE/CODE:
For the purpose of this entry,' there are three types of haZardous
materials:
P = Pure
M = Mixtures of pure substances
W = Wastes. (Also add appropriate waste code)
MAXIMUM AMOUNT:
This should represent the maximum number of units of this material
present at any one time. (Refer to the "UNIT" section of these
instructions)
4. AVERAGE AMOUNT:
This should represent the average amount, usually on hand at any
one time.
INVENTORY INSTRUCTIONS
ANNUAL 'AMOUNT:
This should represent the anticipated annual (thru put) number of units
of the material.
MEASURE UNITS:
LBS = Pounds, for materials stored as solids
GAL = Gallons,.for materials stored as liquids
· FT3 = Cubic Feet at S.T.P., for materials stored as gases
CUR = Curies, for radioactive materials
DAYS ON SITE:
Days anticipated that this material will
calendar year reporting.
be at this site, for the
CONTAINER TYPE: (Use appropriate code)
01. Underground Tank
02. Aboveground Tank
03. Fixed Pressurized Tank
04. Portable Pressurized Cylinders
05. Insulated Tank (includes
cryogenics)
06. Drums or Barrels - Metallic
07. Drums or Barrels - Non-Metallic
08. Corboy(s)
09. Glass Container(s)
10. Plastic Container(s)
11. Box(es)
12. Bag(s)
13. Metal Containers (not
drums)
14. In Machinery or processing
equipment
15. Bin(s)
99. Other - specify
®
10.
CONTAINER PRESSURE (Use appropriate' code) 1 = Ambient Pressure (1-Atmosphere)
2 = Greater than-Ambient Pressure ~
3 = Less than Ambient Pressure
CONTAINER TEMPERATURE (Use' appropriate code) 4 = Ambient Temperature
5 = Greater than Ambient Temperature
6 = Less than Ambient Temperature
7 = Cryogenic Conditions
11. USE CODES: (Use appropriate code)
01. Additive
02. Adhesive
03. Aerosol
04. Anesthetic
05. Bactericide
06. Blasting
07. Catalyst
08. Cleaning
09. Coolant
10. Cooling
11.
12.
13.
14.
15.
16.
17.
'18.
19.
20.
Drilling
Drying
Emulsifier/Demulsifier
Etching
Experimental
Fabrication
Fertilizer
Formulation
Fuel
Fungicide
2
11. USE CODES: (Continued)
21. Grinding 34. Sealer
22. Heating 35. Spraying
23. Herbicide 36. Sterilizer
24. Insecticide 37, 'Storage
25. Instructional 38. Stripping
26. Lubricant 39. Washing
27. Medical Aid or Process 40. Waste
28. Neutralizer 41. Water Treatment
29. Painting 42. Welding Soldering
30. Pesticide 43. Well Injection
31. Plating 44. Oil Treatment
32. Preservative 99. Other - Specify
33. Refining
12.
LOCATION WHERE STORED IN THIS FACILITY
Briefly indicate the location of the material within
building/facility unit using compass points and obvious landmarks.
the
13.
PERCENT BY WEIGHT
Indicate the concentration of each pure substance as a percentage of
total weight. In the case of mixtures and wastes enter the maximum
expected concentration of the three most Hazardous Components. Round
off %.
14. NAMES OF MIXTURE/COMPONENTS
EMERGENCY CONTACTS: Enter the name, title and phone numbers of two persons
who are knowledgeable about this facility.-
PLEASE BE CERTAIN THAT FORMS ARE PROPERLY SIGNED AND DATED AT THE BOTTOM
ii~"~. Farm and Agriculture~Standard Business
BUSINESS NAME:
LOCATION:
CITY, ZIP:
PHONE #:
CITY OF BAKERSFIELD
HAZARDOUS ~I~TERIALS INVENTORY
NON - TRADE SECRET
OWNER NAME:
ADDRESS:
CITY, ZIP:
PHONE,.#:'
Page.__
of ;
NAME OF THIS<FACILITY:
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL ID
REFER TO INSTRUCTIONS FOR PROPER CODES
i 2 3 4 5 6 7 8 9 10 11 12 %1~y 14
Trane Type Max Average Annual Measure # Days Cunt Cunt Cunt Use Location Where Names of Mixture/Components
Code Code Amt Amt Ami; Units on Site Type Press Temp code Stored in Facility w~ See Instructions
Physical and Health Hazard C.A.S. Number Component # i Name & C.A.S. Number
(Check all that apply} Component # 2 Name & C.A.S. NUmber
~ Fire Hazard ~ Sudden Release ~ Reactivity ~ Ilm;ediat. '[~ Delayed
of Pressure Health Health ,' Component # 3 Name & C.A.S. Number
Physical and Health Hazard C.A.S. Number Component # I Name & C.A.S. Number
(Check all that apply). Component # 2 Name & C.A.S. Number
i,' o!~ Pressure ' Health Health Component # 3 Name & C.A.S. Number
ph~ioal and Health Hazard C.A.S. Number Component # i Name & C.A.S. Number
'!,d-(Check all that apply) ''
. Component # 2 Name & C.A.S. Number
' ire Re,ard Sudden Relea,. .otivity [] I=ediat. De ayed __
,,~,, of Pressure Health Health Component # 3 Name & C.A.S. Number
physical and Health Hazard C.A.S. Number Component # I Name & C.A.S. Number
(Check all that apply)
Component # 2 Name & C.A.S. Number
"~ Fi' Hazard ~ Sudden Release ~ Reactivity ~ Immediate ~ Delayed
:, of Pressure Health Health Component # 3 Name & C.A.S. Number
EMERGENCY CONTACTS #1 #2
Name Title 24 Hr. Phone Name Title 24 Hr Phone
c~rtifi~ation (READ AND SIGN AFTER COMPLETING ALL SECTIONS)
certify under peanlty of law that I haver personally examined and am familiar with the information submitted in this and all attached documents and that based on my inquiry of those
.1 Jindividuale responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete.
NI%ME.AND OFFICIAL TITLE OF OWNER/OPERATOR OR (Y~NER/OPERATOR'S AUTHOI~IZED K~RES~'~ATIVE SIGNATURE DATE SIGNED
G Bakersfield Fire Dept. ~
HAZARDOUS MATERIALS DIVISION
Date Completed
Business Name: ~D ~---l~l.~'~ (~ ~c~d ~5
Business Identificaion No. 21~000 ~ [ ~ ~op of Business Plan)
Station No. ? ,, Shi" ~ I~sp~
/:? ~ A~te Inadequate
~/ Verification o~v~nto~~s ~
~ ~ ~ V?~i~ation of ~~ /~
~~ /.Proper ~on~eri~ ~
Comments: // ~
/'
~ // VerificaJ o~S Availabli~ ~
/
s
_~~ of H~ Mat ~ni~ ~
Commer s' X~~
~ of A~ent & Procedures ~
Commer s:
' Procedures Posted ~
RECEtVED
DEC 0 5 1992,
HAT. t~AAT. DIV.
Containers Properly Labeled
Verification of Facility Diagram
Hazards Associated with this Facility:
Violations:
Business Owner/Manager
FD 1652 {Rev. 1.90)
All Items O.K.
Correction Needed
White-Haz Mat Div. Yellow-Station Copy
Pink-Business Copy
Bakersfield Fire Dept.
Hazardous Materials Division
2130 "G" Street
RECEIVED
DEl; 2 1991
Bakersfield, CA. 9~. ~1--~ /~ns'd ............
HAZARDOUS MATERIALS MANAGEMENT PLAN
,..,..:.,o..: --'tnxq
1. To avOid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business os a whole.
4. B~ brief and concise as possible.
SECTION 1' BUSINESS IDENTIFICATION DATA
BUSINESS~NAME: SPECIALTY CONNECTORS INC.
LOCATION'
6000 SCHIRRA CT, SUITE C
MAILING ADDRESS:
6000 SCHIRRA CT, SUITE C
CITY: BAKERSFIELD
STATE' CA ZIP: 93313 PHONE: 805-832-5006
DUN & BRADSTREET NUMBER:
SIC CODE:
PRIMARY ACTIVITY' STRUCTURAL STEEL FABRICATION
OWNER: PRESIDENT-DAN HARGIS
MAILING ADDRESS: 2108 ORIOLE STREET
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR, PHONE
DAN HARGIS PRESIDENT 832-5006 833-1998
PRESTON HOWARD VICE-PRES. 832-5006 836-0605
FD1590
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYEES: 8
MATERIAL SAFETY DATA SHEETS ON FILE: YES
BRIEF SUMMARY OF TRAINING PROGRAM' EMPLOYEES ARE TRAINED IN THE SAFE
OPERATION OF WELDING MACHINES, ACETYLENE CUTTING TORCHES. ALL CYLINDERS ARE
STORED IN SAFE LOCATIONS AND ARE CHAINED TO PREVENT FALLING. EMPLOYEES HAVE
BEEN NOTIFIED OF THE "911" EMERGENCY PHONE NUMBER.
SECTION 4: EXEMPTION REQUEST:
I CERTIFY UNDER PENALTY OF PERJURY THAT My BUSINESS IS EXEMPT FROM THE
REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH &
SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT HANDLE HAZARDOUS MATERIALS.
WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
I, CERTIFY THAT THE ABOVE INFOR-
· MATION IS ACCURATE. '1 UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
SIGNATURE TITLE DATE
F D 1590
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facilify Unit Name: SPECIALTY CONNECTORS TNC.
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
HAZARDOUS MATERIALS-326-3979
326-3033
FiRE/POLICE -911
AGENCY NOTIFICATION PROCEDURES:
B. EMPLOYEE NOTIFICATION AND EVACUATION:
A INTERCOM PAGING SYSTEM WOULD BE USED IN CASE OF EMERGENCY. ALL EMPLOYEES
WOULD MEET IN STREET IN FRONT OF BUSINESS.
C. PUBLIC EVACUATION:
EITHER NOTIFICATION BY PHONE OR DOOR TO DOOR NOTIFICATION
D. EMERGENCY MEDICAL PLAN'
HALL AMBULANCE IS 1/4 MILE FROM OUR LOCATION. MERCY SOUTHWEST FACILITY AND
WHITE LANE MEDICAL CENTER ARE LESS THAN I MILE AWAY,
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS 'MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
RELEASE PREVENTION STEPS:
ALL MATERIALS ARE STORED AND SECURED' IN SEPERATE AREAS.
ARE READILY AVAILABLE
FIRE EXTINGUISHERS
RELEASE CONTAINMENT AND/ORMINIMIZATION:
THE ONLY MATERIAL THAT COULD BE CONTAINED WOULD BE PAINT OR HYDRAULIC OIL.
SURROUND SPILL WITH EITHER RAGS OR DIRT FOR CLEAN-UP.
C. CLEAN-UP PROCEDURES:
OF THE SPILLS THAT WE FEEL WE COULD HAVE, WE WOULD VACUUM THE SPILL INTO
METAL CONTAINERS, THE BALANCE WOULD BE REMOVED BY A HAZARDOUS WASTE RE-
MOVAL SERVICE.
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)'
NATURAL GAS/PROPANE: sw SIDE OF BUTLDTNG IN FRONT.
ELECTRICAL: Sb/ b/ALL 0[: SHOP AREA
WATER:
SIDE OF BUILDING JUST BEHIND FENCE
SPECIAL: NO
LOCK BOX: YES~
IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION: NONE
WATER AVAILABILITY (FIRE HYDRANT)'
150 FT SOUTH OF ENTRANCE TO BUILDING
4. FD1590
i . HAZARDOUS MATERIALS INVENTORY
Farm and Agriculture ~ Standard Business ,~ '
NON - TRADE SECRET
BUSINESS N~-~E: Specialty COnnectors Inc. O~ER N~: Dan Hargis-President
LOCATION: 6000 Schirra Ct, Suite C ~DD~SS: 2108 Oriole Street
CITY, ZIP: Bakersfield. Ca. 93313- ~ CITY, ZIP: R~ker~fie]d. £~_
PHONE #: B05-832-5006' .PHONE.,t: 805-833-1998
REFER TO I~TRUCTIONS FOR PROPER CODES'
Page 1 of 2~
'NAME OF THIS ·FACILITY: Same STANDARD IND. CLASS CODE:
__ DUN AND BRADSTREET NUMBER/FEDERAL'ID
~3_ - 043 -3944
1 2 3 ' 4 ' ' 5 6 7 8 9 10 11 12 13 14
TranS Ty~e Max Average Annual Measure ~ Days Cent Cent Cent Use Location Where ;% by Names of M~xture/Co~ponents
Code Code. Amt a.~_ Amt Units on Site T~pe Press Tem~ Code Stored in Facilit~[ w~ See Instruc~tions
N I MI 3429'1 3429 141148 I FT3 I 365 1041214 1421 NW CORNER
and Health Hazard c.A.a.-Number Component # ~ N~ ~ C.A.S. Nu~er 75 ARGO.N
P~eCk~al all that apply)
Component # 2 Wam~ { C.Aoa. Nhmber
[] Fire Hazard [~ Sudden Release ~ Reactivity [[~ I~ediate ~] Delayed 25 CARBON DIOXIDE
of Pressure Health Health Component # 3 Nam~ ~ ~.A.a. Number
~ I P J 1992 I 1992 I 23900 I FT3 I 3R5 I'.n~l ~ I ~ I~?1 ,~^, ~n.~.~
,Physical and Health Hazard C.A.a. Number · Component ~ 1 s,~ · C.A.a. su~er 100'. OXYGEN
(Check all that apply)
v Component # 2 Nan~ & C.A.a. Number
~ Fire H~zard [] Sudden l~lease ~-~ "Reacti ity ~-- Innnediete [] Delayed '"
of Pressure Health Health Component I 3 Name & C.A.S. Number
Physical and Health Hazard C.A.a.' Number ' Component # i Na~ ~ C.A.a. Number 1001 ACETYLENE
(Check all that apply)
Component # 2 Na~e & C.Ao'S. Number
_i Fire Hazard ~ Sudden Release ~[[ Reactivity [] Tmed:~ste ~ Delayed
of Pressure Health Health Component # 3 Name & C.A.a. Number
N I ~ I :i5 -i is I 30 I GAL J_~3e5, I 061 1 I 4 1261 NE MIDDLE OF NALL
~, Fire Hazard [~ Sudden Release [-J Reactivity Immediate ~ Delayed '"~--~. - .
of Pressure' Health . Health Componen~ 9 3 Na~ &.C.A.B. Number
EMERGENCY CONTACTS Il 0AN HARGIS PRESIDENY 833-199'8 t2 PRESYON HOWAR0 VICE-PRESIOENY 836-060
Name Title 24 Hr. Phone [ Name Title 24 Hr Phone
certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS)
[ certify under peanlty of law that I hayer personally examined end am familiar with the information s~bmitte4 ~n ~his and el! attached documents end that based ca ~ ~quiry of those
ind~vidusls rms~onsible for obtaining the infozmat~on. I believe that the mubmit~ed information im true, accurate, and cool, lets.
DAN HARGIS-PRESIDENT ': . . .. . .'.. . 11/26/91
~AME ANb OFFICIAL TITL~ OF OW1~R/OP~%XOR OR OWNEI~OP]~%~OR'8 A~r--uORIZ~D ~TATI%~ aI~ATUlqB DATE HIGI~D
CITY
OF' BAKERSFIELD
Farm and Agriculture ~ Standard
HAZARDOUS MATERIALS INVENTORY
NON - TRADE SECRET.
BUSINESS N~/~E: ·sPECIALTY CONNECTORS INC,
LOCATION: 6000 SCHIRRA CT, SIITTF £
CITY, ZIP: BAKERSFIELD. CA 9331~
PHONE #: 805-832-5006'
OWNER NAME{ DAN HARGIS
ADDRESS:'?~nR OqT~IF ST '~
CITY, ZIP: RAKFRSFTFID_ CA 9330§
PHONE,.#: 805-833-1998 "
REFERee) IN'~UCTIONS P~R PROP~CODES
Page. 2 of 2~-.
NAME OF THIS .FACILITY: SANE
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL ID ~
33_ - 043 - 3944
1 2 3 4 5 6 7 8 9 10 Il 12 13 14
Trans Type Max Average Annual Measure # Days Cont Cont Con~ Use Location Where % by Names of Mix,ute/Components
Code Code Amt Anfc Ami: Units on Site Ty~e Press Tem~ Code Stored in Facilit~ w~ See Instructions
N I M I 10 ] l0 I 50 { GAL, I ¢6~ I 0Gl ~ i 4 1291 NE IN CABINET
j P I azard ' C.A.S: Number . . Component , I N~-~ i C.A.S. Nu~er ~,
Of ~res~ure
u I p I ~n I ~a I, 6oo I SaLI SSS I 041 2 I ~ 1~91 SE CORNE~ BY DOOR ,,
Physical and H~lth Raza~ C.A.S. N~er Co~on~C I ~ s~ · c.a.s, s~er 100',~ PROPANE
(Check all t~ apply)
. Co.orient { 2 Nm t C'.A.8. N{er
Ph~tcal and H~lth Haza~ C.A.8. N~r Component'~ I Nm & C.A.S. N~er
(Check all that apply)
Co~onent 9 2 N~ & C.A.S. N~er
~l Fl~. Hazed ~ Sudden ~loas. ~ R~ctivity ~ ]m~iat. ~ Delay~
of Pressure H~lth H~i~h Co~onen~ J 3 N~ & C.A.B. N~
(Check all t~ apply)
Co~on~t ~ 2 N~ E C.A.a. N~
~ Fire aaz=d ~ 8udd.. ~leaa. ~ R,ctivlty ~ ]=~tat. ~ Delay~
of Pressure H~lth H~lth Co~on~t ~ ~ ~ i C.A.a. N~
E~RGENCY CONTACTS 91 0AN HAaGIS PaESIDENT 833-1998 ~2 PaESTON HOWA~O VIDE-PaESIOENT
N~ Title 24 ~. Ph~e N~e Title 24 ~ Phone
Cer:ification (READ AND SIGN AFTER COMPLETING ALL SECTIONS)
certify under peanlty of law tha~ I ~aver personally examined and am familiar with tho info,~nation submitted in this and &11 a~tached documents ~nd ~hat baaed on m~ inquiry of those
ind.%viduala responsible 'for obtaining the information. I believe that the submitted information is true, accurate, and complete.- "
DAN HARGIS-PRESIDENT
"
~AME A~ OFFICIAL TITL~ OF
Business Name:
Bakersfield Fire DeI~
HAZARDOUS MATERIALS DIVISION
Date Completed
RECFIVED
Location: ~'~'C~ ~-~/3'?-r~"T-/~/-- ~ ~ ~ ~ ~= ~ "0 1991,
Business Identification No. 21~000 000~1~ ~op of Bu~ss Plan,~ ~pp~. MAT. DIV.
Station No. / ~ Shift ~ Inspe~or ~'~ _ '
/
~~~ ~ ~ Adequate Inadequate
~~ ~ Ver~icatioa of Invento~ Uaterials ~ ~
Vorification ~ Ou~titios ~ ~
Vor~ication of koc~ion ~ ~
Propor 8o~r~ation of Matori~ ~ ~
Verification of MSDS Availablity
Number of Employees
Verification of Haz Mat Training
Comments:
Verification of Abatement Supplies & Procedures
Comments:
Emergency Procedures Posted
Containers Properly Labeled
Comments:
Verification of Facility Diagram
Special Hazards Associated with this Facility:
Business Owner/Manager
Correction Needed
FO 1652 (Rev. 1-90) White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy
· CITY of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT
S. D. JOHNSON
FIRE CHIEF
November 7, 1991
2101H STREET
BAKERSFIELD, 93301
326-3911
Mr. Don Hargis
Specialty Connectors
6000 Shirra Court, Suite #C
Bakersfield, Ca. 93313
Dear Mr. Hargis:
Per our phone conversation of November 7, 1991, I am enclosing
the necessary forms for you to complete and return to The
Bakersfield Fire Department, Hazardous Materials Division, 2130 G
Street, Bakersfield, Ca. 93301 by November 27, 1991.
· If you have any questions or if we can be of any assistance
please feel free to call 326-3979.
Sincerely,
Valerie Pendergrass
Hazardous Materials Division
CITY. of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT 2101 H STREET
D. S. NEEDHAM BAKERSFIELD, 93301
FIRE CHIEF F~bl~u~l:y 21,~ 19~1 326-3911
Deem Business Ownem:
Enclosed you will find a computer printout of the Hazarddus
Materials Management Plan that is currently in our computer, we
have highlighted the areas that need to be revised. Also enclosed
you Will find a blank inventory sheet, this should be used to
update or make any necessary changes t° your inventory. The
printout along with any inven~ory changes should be returned to
thi~ office by March 15, 1991.
If you have any questions please don't hesitate to contac~ us
at 326-3979.
Sincerely Yours,
Valerie Pendergrass
Hazardous Materials Divlsion
Enclosures
February 7, 1991
CitY of Bakersfield
P~O. Box 2057
Bakersfield, Ca. 93303-2057
Re:
Cal State Construction Fasten 405901
5880 District Blvd ~20
Bakersfield, Ca. 93313
HM405901
Dear Sirs,
cai State Construction Fasteners is no longer in business as of
October 12, 1990.
DH/ci
Thank You, !
Cai State Construction
Fasteners
February 7, 1991
?~ CitY of Bakersfield
· P.O. Box 2057
Bakersfield, Ca. 93303-205?
Cal State Construction Fasten 405901
· 5880 District Blvd ~20
Bakersfield, Ca. 93313
HM405901
Dear Sirs,
Ca1 ·State Construction Fasteners is no longer in business as of
October 12, 1990.
Thank_YoM, / '
Cal State Construction
Fasteners
DH/cl