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Home My WebLink AboutBUSINESS PLAN CiJy of B~rsfield TRANSMITTAL SLIP For Your: [] Signature ~x,._Action ~'lnformation I"1 File Please:-- [] f~e~urn i-'1 See Me [] Follow Up [] Prepare Answer Copy to: ..................................................................................................... Memo: ................................................................................................... ........ ...~....~.~.~...~.~......'~.~-....~....*...~.;_~L~....~.../..~.~-.~._~.~-.. ..... ,...E..o..~..,.....Z....~..~_.~..¥.....~...o...~.~......~.~.~......~....~.~.~.~. .... DATE ~ ADDRESS ZIP CODE ~)~.~ ~ FEE BUSINESS LICENSE NO. PERMIT REQUIRED PERMIT BUILDING CLASS/TYPE OF occUpANCY BUSINESS NAME BUSINESS PHONE HOME PHONE NO. OF FLOORS ' ~ '" SQUARE FOOTAGE ~ V~OL~T~OW NOT~O~ ~U~ OOOU~A~T LOA~ OTHER DATE OF REINSPECTION (1) (2) {3) May 2, 1991 BAKERSFIELD RECEIVED MAY 1 6 1991 Ans'd ............ AGCT# 4~6701 LACKEY WELDING SERVICE ..6201,SCHIRRA CT #12 BAKERSFIELD CA 93313 Gentlen~n/Ladies: Our records indicate that your hazardous materials account is ninety (90) days or greater past due. It is of utmost importance that said account be brought to current status immediately. Until said account is cleared of the past due balance you are in violation of the Municipal Code and subject to legal action. If you have any questions please call me at 326-3933. Respectfully, Drew Sharples Financial Investigator cc: file cds2 AMOUNT NEEDED TO CLEAR ACCOUNT City of Bakersfield · Treasury Division · P. O. Box 2057 Bakersfield · California · 93303 (805) 326-3757 ADJUSTMENTS TO'ACCOUNTS RECEIVABL'E DATE ~ ~). ~ PROPERTY OWNER !. J..~zw ^CCOUNT ~.~$ ADJUSTMEN' ( ) SERVICE CEA' ( ) KEW ADDRESS ROUTE C/O LACT BiLLiNG AMOUNT CORRE~:-'~ I ADJ. TO N£ZT BiLLiNG AMOUNTIBiLL!];C, - (-) : ECT!V£ DATE Page: 1 Account Billing/Collection Activity Inquiry SUTL108 Acct : 426701 Cyc St: CL Bill St: NO Cyc: 5 Rt: Seq: SSN : Parcel: .... Svc Cls :e Name : LACKEY WELDING SERVICE Svc Add: 6201 SCHIRRA CT - STE 12 Amt due: 142.82 Lst Pmt: -330.03 Pmt Dte: 11/13/90 -- Prior Bills -- Date Balance 01/01/91 125.00 02/15/90 0.00 02/10/89 0.00 Current Period Postings 'Type Desc Date ~ B91 PENALTY 03/01/91 B92 FINANCE CHARGE 03/01/91 B92· FINANCE CHARGE 04/01/91 B92 FINANCE CHARGE 05/01/91 Amount 12.50 2.51 1.40 1.41 Receipt # Enter '/' For Billing History, 'P' To Print Report, 'D' For Detail Page, or ALT-F10 HELP I ADDS VP I FDX I 9600 E71 LOG CLOSED I PRT OFF I CR I CR Business Name: Location: Bakersfield Fire pt. Hazardous Materials Inspection Date Completed Plan ID # 215-O00t~e~ 7t'~ (Top right comer Business Plan) Station No. c] Shift ~ Inspector ~"~' REUEiVED 'OUPI / & 17u~ HAZ. MAT. DIV. Adequate Inadequate Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Verification of MSDS Availability Number of Employees -x~ Verification of Haz Mat Training Comlnents: Verification of Abatement Supplies & Procedures Comments: Emergency Procedures Posted Containers Properly Labeled Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: ~ 0 ~'~_... FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office E,r inn name Do he,,_b..,, certify that i have reviewem the attached Hazardous Materials for name ~ business business Dian RECEIVED HaT~, ~AT. 0~¥, and that it alon~ with the attached additions or corrections constitute a complete and correct Business Plan for my facilit.v. si~n~re'"--~'~ date BUSINESS NAME LACKEILDING SERVICE LOCATION GZOI-12 SCHIRRA CT ID NI~R 21S-~X2~O-O~792 HIGH HAZARD RATING 3 3. HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 05123/88 BY ESTER SEC S) YHITE LANE MEDICAL CLINIC. PAGE 12/14188 16:57 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME LACKEY WELDING SERVICE ID NUMBER 21S-O00-OOO?~Z LOCATION G20~-12 SCHIRRR CT HIGH HAZARD RATING 3 1. OVERVIEW LAST CHANGE 05/23/88 BY ESTER JURIS CODE Z15-009 SURIS BAKERSFIELD STATION 09 M~P PAGE 1Z3 GRID 1SC FACILITY UNITS 1 H~Z~RD R~TING 3 RESPONSE SUMMARY 2R SEC 4) NO PRIVATE RESPONSE TERM EMERGENCY CONTACTS 2R SEC WII_I. IRM R. LACKEY - 832--3443 OR 397-0587 BRET H. LACKEY - B3Z-3443 OR 831-.2347 UTILITY SHUTOFFS 2R SEC R) GAS - NONE B) ELECTRICAL ,- BLDG NW CORNER N SIDE MIDDLE OF LAWN C) WATER - UNKNOWN D) SPECIAL - -NONE E) LOCK BOX - NO Z. NOTIFICATION / PUBLIC EVACUATION LAST CHRNGE / / BY < NO INFORMRTION RECORDED FOR THIS SECTION > PAGE ! 12/14/88 lEiS?' MATERIAL SAFETY DRTR SYSTEMS, INC. (905) G4B-G80~ BUSINESS NAME LACKEY WELDING SERVICE LOCATION GZOl-1Z SCHIRRA CT FACILITY UNIT Ot ID NUMBER 215-OO~-(~88'79Z HIGH HAZARD RATING OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 05/Z~/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT PURE OXYGEN SW .CORNER OF SHOP PORTABLE PRESS, CYL. ID PERCENT COMPONENTS Z359.00 100.0 OXYGEN, COMPRESSED PURE ACETYLENE NW CORNER OF SHOP ID PERCENT COMPONENTS 1Z41.O0 100.0 ACETYLENE PORTABLE PRESS. CYL, MAX RMT UNIT HAZARD USE' ~c~:'r 3 HIGH HEATING HAZARO LIST HIGH f2~ FT3 HERTING EXTREME HAZARD LIST EXTREME PURE ARGON SW CORNER OF SHOP ID PERCENT COMPONENTS 1365,00 1OO.O ARGON PORTABLE PRESS, CYL, MIXTURE CARBON DIOXIDE/ARGON SW CORNER OF SHOP PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 136S.00 ?S.0 ARGON 1~51.00 25.0 CARBON DIOXIDE 200 FT~ NONE WELDING/SOLDERING HAZARD LIST NONE L~FT~ LOW WELDING/SOLOERING HAZARD LIST NONE LOW B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 05123188 BY ESTER SEC 4) PORTABLE FIRE EXTINGUISHER FOR FIRE PROTECTION SEC S) FIRE HYDRANT UNKNOWN PAGE 1Z/14/88 1G:57 MATERIAL. SAFETY DATA SYSTEMS, INC. (805) 648-.680~ EMPLOYEE NOTIFICATION / EVACUATION ID 215-000-00~79Z HiGH HRZ~RD R~TING 3 LAST CHRNGE 05/Z~/B8 BY ESTER SEC Z) VERBAL NOTIFI£~TION OF EMERGENCY ON PREMISES. EVACUATE SPACE THROUGH WEST ROLL UP DOOR. E MITIGRTION / PREVENTION / RBRTEMENT LRST CHRNGE 05/Z3/88 BY ESTER SEC 1) PROPER VALVES ON COMPRESSED GAS BOTTLES. FLAMMABLE GAS SEPERRTED FROM OXYGEN 80TTLES ANO CHAINEO TO 8ULKHEAOS. P~GE 4 IZ/14/88 IG:S? MATERIAL SRFETY D~TR SYSTEMS, INC. (805) B48-G800 CITY of BAKERSFIELD CITY. ZIP:~',.~,~7: q;' ~-~'1-~ CITY, ZIP: ~ ~ ~ ~ DUN AND BRADSTR~T NUMBER (~e C~e Mt ~ Est ~*ts m Site ~lth of P~ ~lth .......... ~t ...... ~-~ -- r--~ r--~ ~ith of ~ ~lth .... P~tc, I ~ ~lth ~ C.A.S. ~ ~ (C~k ell ~t e~iy) ' ' · ~ ~ -- - - r -- ~lth of P~ ~ith ...... t__J Flee Hlz~rd ~--~ ~ttvtty -- ~ ~ll~ ~ ~}~e ~--J I~tetl H~lth of Pr~sure ~lth Certification (Read and s~.en after coepletln£ all sections) I certtfy trader Nflelty of la. t~t ? ~ve ~rs~111y ~.~n~ ~ ~ f. Jlilr vJth t~ Jnf~wtim su~Jtt~ tn thle ~ ell ettK~ ~ts. ~ t~t ~s~ m ~ ~t~ of t~e l~tv~1s m~slble for obtaining t~ Jflf~m. I ~teve t~t t~Jtt~)o~tim ~s t~, accurate, ~d c~letl. N~~~~G[~r ~z~~ ............................. re~ta~ }va S~gna[ure~"~: ....... 2~ .................................................... ~ ~ ~ ~ ..... BAKERSFIELD CITY FIRE DEPARTMENT 2130 "O" STREET BAKERSFIELD, CA 93301 (805) 326-3979 OFFICIAL USE ONLY BUSINESS NAME ID# INSTRUCTIONS: HAZARDOUS MATERI ALS BUS!NESS PLAN AS A WHOLE FORM 2A 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME;.L ~_~-~2 ~_)~/_OZ/~ 5~Z'i~u~r'C~ B. LOCATION / STREET ADDRESS: 6g~)/ ~"~...~'~__..~ C'T'~/Z CITY: ~~~CD ZIP: ~~[~ BUS.PHONE: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT.ELECTRiCAL..~-~-~ ~c~55o~\~' GAS/P~I~_~PANE: ~w)O],~ , ~ s. D. SPECIAL: k~ ~ E. LOCK BOX: YES ~ I~ YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS:...- .................................... YES NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. YES NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES NO YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES NO YES NO SECTION 7: HAZARDOUS ~4ATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS. HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUnDer A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... f,~E,,~ NO I,~T 3~ (_[%Ck2~f , 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 inaccurate information constitutes perjury. 'SIGNATURE~~,~/~ - 2B - BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 'BUSINESS NAME: OFFICIAL USE ONLY ID# BUS I NESS PLAN SINGLE FACILITY UNIT FORM SA INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTION, ABATEMEN~F PROCEDURES SECTION 2: NOTIEICATION AND EVACUATION PROCEDURES AT THIS U:IT ONLY t SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~ NO ",. - If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YE If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATI~0N "oF UTILI~ S~T-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPAN~ ELECTRICAL: D. SPECIAL: E. LOCK BOX: YES /~!F YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO MSDSs? YES / NO YES / NO KEYS? YES / NO - 3B - · BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 Page .. of' NON'--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME:L~'~V [~O~[~k,~ ~0~.,~ OWNER NAME':L~Ii%e'a~,~ ~2~ ~~ FACILITY UNIT AODRESS:~{ ~C~~ ~ ~ I~ ADDRESS:~Oq 3~,~~ FACILITY UNIT NAME: PHONE * ' ~3~ A~ 3 - 7 :ODE ONLY 1 2 $ 4 5 6 ? 8 9 IO TYPE MAX ANNUAL CONT USE LOCATION IN TI{IS % BY HAZARD D.O.T CODE AMOUNT AMouNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE,, N, AME: TITLE: SIGNATURE: DATE EMERGENCY CONTA( TITLE: /~T/.,)~;I~- PHONE # Bi HOURS:--~VV3 ' ' ~T~ AFTER BUS "RS: ~7 05T7 E.EROENCY CONTACT: ~ ~~f TITLE: .. P"ONE ' BUS HOURS:F~ ~V~3 .US .RS: - 4A-1 - I TE/FAC ILI TY FORM NORTH SCALE: BUSINESS N~[E: FLOOR: OF DATE: / / FACILITY N~E: UNIT #: OF (CHECK ONE) SITE DIAGRk~! FACILITY DIAGR.~W (Inspector's Comments): -OFFICIAL USE ONLY- SITE DIAGRAM (Re~d Items) 1. Address: Identify the principle buildings by the Street numbers. 2. Street(s), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. 3. Storm Drains, Culverts, Yard Drains ¢. Drainage Canals, Ditches, Creeks, 5. autldtngs a. Frame construction b. Masonry construction c. Metal construction d. Access Door 6. Utility Controls a. Gas b. Electricity c. Mater ?. Fire Suppression Systems: a. Fire Hydrants b. Fire Sprinkler Connections c. Fica Standpipe Connections d. Water Control Valves for protection systems e. Fire Puftp 8. Fire Department Access 9. Lock (key) Box 10. MSDS Storage Box 11. Railroad Tracks 12. Fence or Barrier a. Wire b, Masonry c. Wood d. Gates 13. Powerllnes 14. Guard Station IS. Storage Tanks: Identify the capacity iff gal. a. Above ground b. Underground 16, Diking or Berm 17. Evacuation Route 18. Evacuation Area: Identify the location where employees will meet. 19. Outside Hazardous Waste Storage ZO. Outside Hazardous Material Storage 21. Outside Hazardous Material Use/Handling ZG. Type of Hazardous Material/Masts Stored or Used (See Below) TyPE OF HAZARDOUS MATERIA~ F - Flammable E - ~xploslva L - Liquid C - Corrosive 0 - Oxidizer O - Gas W - Water Reactive T - Toxic S - Solid O - Waste B - Etiological Example: ilasaable Liquid - FL ~CILIT¥ DIAGRAM, (Required lteis in addition to the above) 1, Risers for Sprinklers 8. 2. Partitions 9. 3. Stairways: Indicate the lO. levels served from highest to lowest. 11. 4. Escalator: Indicate the levels served from 12, highest to lowest. 5. Elevator 13. Attic Access 14. ?. Skylights R - Radiologlcal P · Poison Cryogenic Fire Escapes Air Conditioning Uflltm MlndM Inside Hazardous Waste Storage Inside Hazardous Materials Storsge inside Hazardous /4~terinls Uae/Hm~dllng Se~r Drain inlets