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Home My WebLink AboutHAZ-BUSINESS PLAN 5/28/1989 1 ~l b1fi ~/ 6 `~° ~~ +ci ,+ ,u y i ~~ ~ RETURN PAYMENTS TO: CITY QF BAKERSFIELD P.O. BOX 2057 BAKERSFIELD, CA 93303-2057 SYAT~M~N¥ OF AGOOUN¥ ACCOUNT NO. f,,MaZ-~a~. PLEASE MAKE CHECKS PAYABLE TO: iNQUIRIES CONCERNING THIS BILL, PLEASE PHONE: CUSTOMER COPY j~192,9! RETURN PAYMENTS TO: CITY OF BAKERSFIELD P.O. BOX 2057 BAKERSFIELD, CA 93303-2057 STATEMENT OF ACCOUNT ACCOUNT NO. " PLEASE MAKE CHECKS PAYABLE TO: CITY OF BAKERSFIELD INQUIRIES CONCERNING THIS BILL, PLEASE PHONE: REMITTANCE COPY gAi~(E~:SL:]EL~ C,A 93313 2130 'G' STREET ~KE-R'SFIELD CA 93~ (805) 326- 3979 R'ECEIVED HAY 2 8 1989 Ans'd ............ OFFICIAL USE ONLY BUSINESS NAME ID# HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS; 1. To avoid further action, return this from within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: A. B. BUSINESS IDENTIFICATION DATA BUSINESS NAME: C~/~1£~-~ ~.~.0~/~O~K~ ~"~, ~- LOCATION / STREET ADDRESS: ~Ot .~/Z~ ~o0~7 ~,~ CITY:'&~E~SF~EL~ ZIP: ~33/3 aus. PHONE: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE B. 0_.,~, Fte-e. DURING BUS. HRS. SECTION 3: AFTER BUS. HRS. LQQAT[QN OF UTILITy SHUT-OFFS FOR BUSINESS AS A WHOLE A. NATURAL GAS/~ROPANE.: B. ELECTRICAL: C. WATER: D. SPECIAL: LOCK BOX: YES / NO IF YES, LOCATION: ~l~ IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSS? KEYS? YES / NO YES / NO e SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHO[,~ ,, This facility has only two employees; together they comprise our private response team as regards hazardous materials handling/hazardous waste handling, etc. SECTION 5: LOCAL EMERGENCY MEDICAl, ASSISTANCE FOR YOUR BUSINESS AS A WHOLE For medical emergencies, we utilize HALL'S AMUBLANCE SERVICE, which is located in the same office complex~; 6201 Shirra C6urt, Suite #1. Additionally, we are able to utilize the 911 emergency ca.l. 1 system. SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY 2 B. DO YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS MATERIAL YOU HANDLE ~ Yes~ located in the Manager'~ desk C. GIVE A BRIEF SUMMARY OF YOUR HAZARDOUS MATERIALS TRAINING PROGRAM: We provide on-site training in the OSHA Hazard Communication Standard and our own production of Hazardous Waste Hanagement training. Both of these training modules are on video tape for review by our employees subsequent to the training as a refresher as individually required. The training is scheduled annually and training documentation is maintained at our Corporate Health, Safety & Environmental Services Department, Houston, Texas. The training is approximately 4 hours in length. SECTION 7: 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 AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. X WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION I, Frank H. P~rrv. CSP ,.certify that.the above information is accurate. I understand that this information will be used to fulfill, my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that tutes perjury. inaccurate i~rm~a~nst i TITLE Hanager, HSqE DATE 6/2~d'8 9 CITY of BAKERSFIELD Farm and Agriculture Standard Business NON--~FRADE SECRETS CrTY, ZrP: ~~,~ ~1~ ~ -- CITY, ZIP: ~~. ~X ~7~-~ DUN AND BRADSTREET NUMBER _ ~ ~0 ~S~UC~O~ ~OR PROP~ ~OD~ I ~ { 4 5 S 7 8 g 10 II 12 13 li {rahs ly~ ~x Average ~nuai ~asure I ~ Cmt ~t ~t ~e L~tim N~e { ~ Nam of C~e C~e ~t ~t Est Unfts ~ Site Ty~ Prig Trna CMa .. Stoe~ in Facfitty Nt ~ Inst~tfm~ ~_l_~_l..!).~___l u ~ {s~ ~1~ !~_~___1~! ~ i~J.e~,~~ .... ~ ~C~e~ __. Health of P~suee ~lth ~, ~ ~.~th ~,~,~ c.~.s. ~~-~ ~ ,~ ,. ~ c.~.s. ~ ~lth et ~ ~lth .... k._t. " L ..... iL..l I I L_D .... I 1_ l~ ' , ..................... P~ical ~d HNlth Hazard C.A.S. ~ at I1 h i C.i.S. ~ (C~k a11 t~t apply) [-Z - ~-~ - Free Hazard ~ ~ Reactivity ~--~ ~la~ ~ ~ ~dd~ Release ~_d I~ate Health of Pr~suee H~lth ' ' ~t 13 ~&C.A.S. ~ 2 ~ .......... ~__~__t ........ ~ ........ ..m ...... i.~. ~ .t-_~ .... m_~ ..... ~ ....... P~ical ~ H~lth Hazard C.l.S. Numar Ca,mt I1 Nm i C.l.S. i~ (C~k all t~t aluly) ...................... -- -- -- r--~ C~t 12 Nm i C.A.S. Health of Pe~sure Health ~ .... - ..... [ ............................................ [ ....... ..,--~ ............. ,.,.., ....... Certification (Read and siKn after completin~ all sections) I certify under ~analty of law that I have ~ersonal]y examined and am familiar with the information submitted in this~ettech~ documents, and that based on my inquiry of those individuals rm~sible June 6, 1989 Frank Perry Cameron Iron Works USA Inc. P.O. Box 1212 Houston~ Tx 77251 Dear Mr. Perry: Per the request of David Perry of your Bakersfield Office, I have enclosed the forms for the Hazardous Materials Business Plan~ that must be filed with the City of Bakersfield. This plan also meets the Federal inventory reporting requirements as explained in the OES memo also enclosed. To complete the packet I have included a copy of Chapter 6.95 for your review. This business was required within 30 days of your business start up to have a Hazardous Materials Business plan on file~ however I have extended the due date until June 22, 1989. If you have any questions please feel free to call. Sincerely Yours, Ralph E. Huey· Hazardous Materials Coordinator REH:vp REFERRAL TO FINANCE DEPARTMENT FOR COLLECTION ReferriNg Department/Section Account Number Name(Business Name of Commercial Account) Person Making Referral Type of Billing Site Address Mailing Address Owner's Name, Address and Telephone Number Billing Period: From 7-~9 To ~'~O Month/Year Month/Year Amount Due List Collection Efforts by Department Prior to Referral: Co~nents THIS BILLING HAS BEEN VERIFIED AS ACCURATE AND VALID Authorized Signature (Orig'ingl to Cash Management, copy to Accounts Receivable) NM 6~8/90 HER TWO :'MERGENCY ~,ND · tAZARDOUS :HEMICAL NVENTORY ;PECIFIC . qFORMATION ~Y CHEMICAL ,AU~_ CAHERON IRON WQ~KS _USA. INC, ..... STREE, ADO,=SS 6201 Schirra Court.;_ .S. te. #4_ c,,y... B.ak.e?sfie!d s,~,~ CA z,,93315 ,,m,,.. Kerq,. [~ount~ .......... ..UA~0aEss6.20..1.,Sc.hirra Ct~. Ste. 41.Bakersfield, CA 93313 'CAME. David 'M_ PetTy T,nE Facil $t,,y ,' Manager, . _ ~ .~ P.ONE ..!805 t 852-0191 , ,,, , TffLE ...... . . , , , PHO~ ! I 24 HR. PHONE -,M~6nr^Nn .EAD ALL INSTRUCTIONS BEFORE COMPLETING FORM. REPORTING ~Ri6~" .J~JJAR~' I TO DECEMBER 31 19 RR . PHYSICAL INVENTORY ' STORAGE CODES AND LOCATIONS . AdqdO HEALTH 'MAX. AVG. NO. OF CHEMICAL DESCRIPTION HAZARDS DAILY DAILY DAYS (NON-CONFIDENTIAL} . . See Attached Computer Facsimile AMOUNT AMOUNT ON-SITE sTORAGE ' C~ECK &tt mat APPt~ (CODE} KOD~ ~A~S) CODE STORAGE LOCATION CAS SECRET S~DEN RELEASE : -~" ' '" ' ..... ' ~ NAME ,. , · , OF PRESSURE ,,, ~ , , ,, IMMEDIATE t~ CODE D~AYED (CHRONI~ THA~ APPL~ · · - .' ' , , .... ~~ PURE MiX SO,lO : LI~U~O ~AS, [ [ [ ~ I[ [[ [ [ [ [ ~ ,, , ,, ,, , ..... ,,, ,, - ?~Og :F~ .. CAS SECRET ~ SUDDEN RELEME ' ' ' ....... " ' ' ' ' CH~M. RAME OF PRESSURE t~ CODE DELAYED (CHROHI~ CHEC~ ALL CAS SECRET -- F~ . · ~HE~ NAME CERllrY U~DER ~t~tlY O~ t~W ~At t ~g~ P~ONATtY ~XA~EO A~ R~ ~AM~R Wl~ ta~ ~aFOR~ATION S~i~D I~ ~1~ A~D ~t AT1AC~O ~OCU~ENT~. A~O ~T RASED F.H. Perry ~' CSPj, Manager;, HS~~ ' ' · "'"" "' ~, SAVE aVlAC,ltO A Ual OF Record _CHEM_NAME 2-ETHOXYETHANDL TRADE_NAME I,LAC CAMERON GREEN QD EN 2-4371 MANUFACTURER INTERNATIONAL PAINT CO. INC. CAS 110-80-5- PURE MIX X SOLID LIQUID X STATE_CODE Fire X P~essure Reactivity Immediate X Delayed Storagel Fl4 Storage2 St or ag e3 St or ag e4 St or age5 Storage6 DAILY_MAX 00 COMMENTS DAILY_AVG O0 Locl Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record #2 _CHEM_NAME 2-PROPANOL TRADE_NAME I,LAC CAMERON GREEN QD EN 2-4371 MANUFACTURER INTERNATIONAL PAINT CO. INC. CAS 67-63-0 PuRE MIX X SOLID LIQUID X STATE_CODE Fire X Pr essur e React ivity Immediate X Del ayed Storage1 F14 Storage2 St or ag e3 Storage4 St or a g e5 Storage6 DAILY_MAX 00 COMMENTS DAILY_AVG 00 Loc 1 Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record ~3 _CHEM_NAME ACETYLENE TRADE_NAME ACETYLENE MANUFACTURER UNION CARBIDE CAS 74-86-2 PURE X MI X SOLID STATE_CODE Fire X Pressure X Reactivity Immediate X Delayed DAILY_MAX 00 COMMENTS LIQUID Storagel L24 Storage2 St or age3 St nr ag e4 St or a g e5 St or ag e6 DAILY_AVG 00 Loc1 Loc2 Loc3 Loc4 Loc5 Loc6 GAS X DAYS_ONSITE 365 Record ~4 _CHEM_NAME ASBESTOS TRADE_NAME ROCKWELL 196 SEALANT MANUFACTURER ROCKWELL INTERNATIONAL CAS NA PURE MIX X SOLID LIQUID X STATE_CODE Fire Pr essur e Reactivity Immediate Delayed DAILY MAX O0 COMMENTS Stor age1 F14 St or ag e2 St or ag e3 St or ag e4 St or ag e5 Storage6 DAILY_AVG 00 Loc 1 Loc2 Loc3 Loc 4 Loc5 Loc 6 GAS DAYS_ONSITE 365 Record #5 _CHEM_NAME BENZENE' TRADE_NAME LEADED REGULAR GASOLINE MANUFACTURER CONOCO INC. CAS 71-43-2~ PURE MIX X SOLID LIQUID X STATE_CODE Fire X PressUre Reactivity Immediate X Delayed X DAILY_MAX COMMENTS Storage1 F14 St or ag e2 Storage3 Storage4 Storage5 St c,r ag e6 DAILY_AVG 00 Loc1 Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record #6 _CHEM_NAME DIMETHYLBENZENE TRADE_NAME I,LAC CAMERON GREEN QD EN 2-4371 MANUFACTURER INTERNATIONAL PAINT CO. INC. CAS 1330-20-7 PURE STATE~CODE Fire X Pressure Reactivity Immediate X Delayed MIX X SOLID LIQUID X Stor agel Fl4 St or ag e2 St or age3 St or ag e4 St or age5 Storage6 DAILY_MAX 00 COMMENTS DAILY_AVG O0 Loci Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record #7 _CHEM_NAME DYE TRADE_NAME SAFETY-KLEEN 105 SOLVENT-MS N0.6617 MANUFACTURER SAFETY-KLEEN CORP. CAS NA PURE MIX X SOLID LIQUID X STATE_CODE Fire X Pr essur e Reactivity Immediate X Del ayed Storagel D14 Storage2 St or ag e3 Storage4 St or a g e5 Storage6 DAILY_MAX 00 COMMENTS DAILY_AVG O0 Loc 1 Loc 2 Loc 3 Loc 4 Loc 5 Loc 6 GAS DAYS_ONSITE 365 Record ~8 _CHEM_NAME ETHYLENE DIBROMIDE TRADE_NAME LEADED REGULAR GASOLINE MANUFACTURER CONOCO INC. CAS 106-93-4 PURE MIX X SOLID LIQUID X STATE_CODE Fire X Pressure Rea,z t i vi ty Immediate X Del ayed X Stor age1 F14 Storage2 St or age3 St or ag e4 St or age5 St or ag e6 DAILY_MAX 00 COMMENTS DAILY_AVG O0 Loc1 Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record #9 _CHEM_NAME ETHYLENE DICHLORIDE TRADE_NAME LEADED REGULAR GASOLINE~ MANUFACTURER CONOCO INC. CAS 107-06-2 PURE MIX X SOLID LIQUID STATE_CODE Fire X Pressure Reactivity Immediate X Delayed X St or ag e 1 Storage2 Storage3 Storage4 St or age5 St or ag e6 F14 DAILY_MAX COMMENTS 00 DAILY_AVG O0 X GAS Loc1' Loc2 Loc3 Loc4 Loc5 Loc6 DAYS_ONSITE 365 · Record PlO _CHEM_NAME LIGROINE TRADE_NAME I,LAC CAMERON GREEN QD EN 2-4371 MANUFACTURER INTERNATIONAL'PAINT CO. INC. CAS 8032-32-4 PURE MIX X SOLID LIQUID X STATE_CODE Fire X Pr essur e Reactivity Immediate X Delayed Storagel Fl4 St or ag e2 St or ag e3 Storage4 St nr age5 St or ag e6 DAILY_MAX O0 COMMENTS DA I LY_ AVG O0 Loc 1 ' Loc2 Loc 3 Loc4 Loc5 Loc 6 GAS DAYS_ONSITE 365 Record ~1 1 ,CHEM_NAME LIGROINE VM&P NAPHTHA TRADE_NAME I,LAC CAMERON GREEN QD EN 2-4371 MANUFACTURER INTERNATIONAL PAINT CO. INC. CAS. 8032-32-4 PURE MIX X SO~ID LIQUID X STATE_CODE Fire X Pressure Reactivity Immediate X Delayed Storage1 ~F14 Storage2 St or age3 St or ag e4 St or age5 Storage6 DAILY_MAX 00 COMMENTS DAILY_AVG O0 Loc 1 Loc 2 Loc 3 Loc4 Loc 5 Loc6 GAS DAYS_ONSITE 365 Record ~12 _CHEM_NAME MINERAL SPIRITS TRADE_NAME SAFETY-KLEEN 105 SOLVENT-MS N0.6617 MANUFACTURER SAFETY-KLEEN CORP. CAS 8032-32-4 PURE MIX X SO~ID LIQUID X STATE_CODE Fire X Pressure Reactivity Immediate X· Del ayed Storage1 D14 St or ag e2 St or ag e3 St or ag e4 St or age5 St or ag e6 D~ ILY_MAX O0 COMMENTS DAILY_AVG O0 Loc1, Loc2 Loc3 Loc4 Loc5 Loc6 GAS DAYS_ONSITE 365 Record ~13 _CHEM_NAME OXYGEN TRADE_NAME OXYGEN MANUFAC:TURER UNION CARBIDE CAS 7782-44-7 PURE X MIX SOLID LIQUID STATE_CODE Fire X Pressure X Reactivity Immediate X Delayed St or age1 L24 Storage2 St or ag e3 St or ag e4 St or age5 . St or ag e6 DAILY_MAX O1 COMMENTS DAILY_AVG O1 'SAS X Loc1. Loc2 Loc3 Loc4 Loc5 Loc6 DAYS_ONSITE 365 Record #14 _CHEM_NAME TETRAETHYL LEAD TRADE_NAME LEADED REGULAR MANUFACTURER CONOCO INC. CAS 78-00-2 GASOLINE PURE MIX X STATE_CODE Fire X Pr essur e React ivi ty Immediate X Del ayed X SOLID LIQUID Storagel Fl4 St or ag e2 St or ag e3 Storage4 St or age5 Storage6 DAILY_MAX COMMENTS 00 DAILY,AVG 00 X Loc 1 Loc 2 Loc3 Loc4 Loc 5 Loc6 DAYS_ONSITE 365