HomeMy WebLinkAboutUNDERGROUND TANK
KBF-7171
CORRECTION NOTICE
BAKERSFIELD FIRE DEPARTMENT N°
Location../..~/dC' ~
Sub Div,__ Blk. . Lot,
You are hereby required to make the following corrections
at the above location:
Cot, l~o
0~73
Completion Date fo/' Corrections_
Inspector
326-3979
" BAKERSFIELD CITY FIRE.DEPARTME~
HAZARDOUS MATERIALS DIVISION
2130 "G" STREET
BAKERSFIELD, CA. 93301
'~~ HAZARDOUS MATERIALS MANAGEM
INSTRUCTIONS:
To avoid further .action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be bdef and concise as po~ibie.
SECTION l' BUSINESS IDENTIFICATION DATA
BuSiNESS NAME:
LOCATION:
MAILING ADDRESS:
CITY' I~_r CA"~,'e/_~ STATE:
DUN & BRADSTRE'ET NUMBER:
PRIMARY ACTIVITY'
OWNER:
ZIP: ~ PHONE:~'~:~S-_'~..~,2- ~5'?.~'
s~c CODE: "-/
MAILING ADDRESS'
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE
~,~ _~e,~,,cCm . ~:.~ ._¢~'-2,~
.~,,..~,.,,.. ¢~ ~ ~z - ~S"~ ,'3'
BUS. PHONE 24 HR. PHONE
.1.
-. Bakersfield Fire Dept.
.zardous l~s[terials Division
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 EX~E'MPT FROM THE
REPORTING REQUIREMENTS OF CHAPTER 6~95 OF TFtE "cALiFORNIA HEALTH ~
SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT_HANDLE HAZARDOUS MATERIALS.
~ __WE DO HANDLE HAZARDOUS MATERIALS, 8UTTHE QUANTITIES AT NO
TIMEEXCEEO 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.
DATE
akersf~etd Fire Dept.
ardous ~aterials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name:
SECTION 6: NOTIFICATION AND EVACUATION iROCEDURE$:
A. AGENCY NOTfFICAT[ON PROCEDURES:
b,,',',_~ N.~,,_,r_,:..,./.
EMPLOYEE NOTIFICATION AND EVACUATION:
No'l- Eno,.t¢~k l_t~r~,¢l~d %o ~,"~rr',~nT7
PUBLIC EVACUATION:
EMERGENCY MEDICAL PLAN:
3;
· B ~k~rs~elcl Fire D
Hazardous iVlgterials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
AD
RELEASE PREVENTION STEPS:
RELEASE.-c'ONtAI'NMENT AND/OR MINIMIZATION'
CLEAN-UP PROCEDURES:
lo:cc t4,,,'e c_.l,,,.~,,-~lo O~,~l~Y ~ .0-.o~,-,'," vcO,..
SECTION 8: UIILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY'):
NATURAL GAS/PROPANE:
ELECTRICAL:
WATER:
SPECtAL'
LOCK BOX: YES/NO IF YES, LOCATION'
SECTION 9: PRIVATE FIRE PROi~CTION/WATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION'
WATER AVAILABILtTY (FIRE HYDRANT):