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Home My WebLink AboutBUSINESS PLANCUST ~ & ,0. (~ MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT 'FINANCE CHARGE 'OTHER ADJ CUSTOMER NAME MAILING ADDRESS STATE ZIP CODE SITE ADDRESS PARCEL NUMBER (IF APPLICABLE) ADJUSTMENT DATE CHARGE CODE ADJUSTMENT AMOUNT REMARKS' APPROVED BY ~ /~(~.~-'- CITY OF _P,, .... P,._,F'I ? O =":× itJ: ~LUE ...... - n~w~il AUTO REPAIR 2i3i R STREET BAKERSFIELD, CA 93301 DATE' 3/15/04 CUSTOMER NO- 47275/56872 TYPE: ES --ENVIRONMENTAL SERVICES REFi-NUMBER DUE DATE TOTAL AMOUNT SSO0i 31011~* BEg ............... ~ 5/i5/04 HAZ MAT FEE gROUP 9 i8i.00 3!1=,n~ ~,~ SN QUANTITY HAZ WASTE gEN 58.00 THis P~ IS FOR SMALL ~UANTITY gENERATORS OF HAZARDOUS WASTE. 3/15/04 CA STATE SURCHARGE 24.00 A~kii ' :&~--'''-- ~Ti ' - ~ ~-- .... A_ n.._ MAI -,--LiN~ .UN FISCAL YEAR 7/01/03 THROUGH &/30/O4-iF RECEIVED iN ERROR CALL 32&-3&58 CURRENT 263.00 uV=n ...... '~'o~. OVER ~0' OVER 90 DUE DATE: 4/14/04 PAYMENT DUE: 263.00 TOTAL DUE: $263.00 DATE: 3/15,04 DUE DATE: 4/i4,04 ' NAME: .BLUE HAWAII AUTO REPAIR CUSTOMER NO' 47=75/5687~ TYPE: REMIT AND MAEE CHECK PAYABLE TO: =CITY OF BAKERSFIELD PO =nv ~ ~AKERSFI ELD CA 93303-2057 TOTAL DUE: $263.00 CITY OF ICE OF ENVIRONMENTA RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER/OPERATOR IDENTIFICATION FACILITY INFORMATION /0.~-~/~ / P. o, FACILITY ID #li~;!ii;i;~ l~i1¢~:~ i iii ,I i 1 Year Beginning BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) SITE ADDRESS ~oo Year Ending ,o~ 3 102 BUSINESS PHONE 103 DUN & BRADSTREET i,CA ZIP 106 107 SiC CODE (4Digit#) -7~38 108 COUNTY oPE~ToRNAME "~,¢~.¢ ¢- ~ ~.r~v S~', ,,go OPERATORP."?N~(~ OWNER MAILING CONTACT m~L~NG ~2o STATE ~. ~2~ Cl~ NAME S ¢" ,2a NAME TITLE 125 'ITLE 131 BUSINESS PHONE 132 ?4-HOUR PHONE ~:2 ~ ( ,? ff .~/~- 0(~'~---0 ( 127 PAGER # 128 ~ PAGER ¢ 133 Cedifica~on: Based on my inquiw of ~ose individuals respensible for ob~ining the info~atien, I ~di~ under penal~ of law ~at I have personally examine and am ~miliar with ~e information submi~ed in this inventow and believe ~e informatien is tree. accurate, and ~mplete. ¢ NAME ~--OFy EPJOP ERATOR\(pdnt)~ i~I 136 DATE 134 NAME OF DOCUMENT PREPARER TITLE OF OWNER/OPERATOR 137 UPCF (7/99) S:\CUPAFORMS\OES2730.TV4-wpd CITY OF BAKERSFIE~R O IEE OF ENVIRONMENTAL VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN Section I1.1 - DISCOVERY AND NOTIFICATIONS I. FACILITY IDENTIFICATION · ... BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ADDRESS (For local use o~ly) 476. DISCOVERY Ao LEAK DETECTION AND MONITORING PROCEDURES: B. EMERGENCY AND AGENCY NOTIFICATION PROCEDURES: · ,. ....... . .....-' , -.- ': ~ ? EMERGENCY MEDICAL PLAN UPCF (7/99) S:~PROCEDURE MANUAL~Iew HMMP fon*n.wpd Section 11.2 - RELEASE RESPONSE PLAN PRELIMINARY ASSESSMENT A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND MITIGATION: : ~ :-'-~:': "' · ?i: !,;" :.': :'?~ .Up AcTI C. CLEAN-UP AND RECOVERY PROCEDURES: UPCF (7/99) 8N=ROCEDURE MANUAL~"4ew HMMP fonn.wl~d HAZARDOUS MATERIALS MANAGEMENT PLAN Section II1.1 - FACILITY AND LOCALITY INFORMATION · UTILITY SHUT-OFFS LOCATION OF SHUT-OFFS AT YOUR FACILITY: NATURAL GAS / PROPANE: ELECTRICAL: WATER: SPECIAL: LOCK BOX: YES / NO IF YES, LOCATION: · ,...- "' pRi~/~.TE.Fii~i~+ECTioN I' wATER:A~'~.BiLiTY : A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): Co NUMBER OF EMPLOYEES: ~ MATERIALS DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: ..cERTIFICATION *' Based on my lnqut~ of those individuals responsible for obtaining the Info.nation, I ce~ under penalty of law that I have personnaly examined and am familiar with the infoiTnaUon submitted end beileve the information is true, acx:urate, and complete. DATE 478. TITLE OF SIGNER 477. 479. UPCF (7/99) S:~=:~ROCEDURE MANUAL~iew HMMP form.wlxl O~FFICE OF ENVIRONMENTAL~ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form ~er matenal per t~uSd~g or area) NEW r"l ADD I-1 DELETE [-] REVISE 200 Page __ of ~ - BUSINESS NAME (Same as FACILITY NAME oi' DBA - Doing Business A~) 3 , 'ZJ CHE.CALLOCAT'O" d/x.7*..5'/,~ , CHEM~CALLOCAT'O" e d~' ~ 2o'~i [] v~ [] No 2o2 14 U &l:' F TRADE SECRET [] Yes [] No 206 ff Subject to EPCRA, tefra' to instructions COMMON NAME EHS' [] Yes [] No 208 :"'" ::" ' ~'"';':~"? "' CAS # 20~ ':'UE.~ ~'r(=,' -" ~'~'~"m~'i"'~.:?' i FIRE CODE HAZARD CLASSES (Complete if requested by local fire ct~ie0 210 TYPE [] p PURE [] m' MIX'~RE [] w WASTE 211 I RADIOACTIVE [] yes [] No 212 CURIES 213 PHYSICAL STATE [] $ SOLID []1 LIQUID [] g GAS 214 I LARGEST CONTAINER 215. FED HAZARD CATEGORIES [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (C. hec~ a~l that apply) AMOUNT OAILY AMOUNT DAILY AMOUNT 219 i STATE WASTE CODE 220 UNITS* [] ga C~L [] d CU FT [] lb LBS [] tn TONS 221 i DAYS ON SITE. 222 · if EHS, amount must be in lbs. STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALUC DRUM [] i FIBER DRUM [] m GLASS BOTTLE · [] q RAIL CAR 223 (Check all that apply) I"'1 b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] as ABOVE AMBIENT [] ba BELOW AMBIENT 224 i STORAGE TEMPERATURE [] aAMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 : ~3 ~0 ~1 ~Y~ ~No~2 : ~7 ~8 ~9 OY~ ~ 2~ 241 242 243 ] ~y~ ~No 2~ 245 I S:\CUPAFORMS\OES2731 .TV4.wpd UPCF (7~99) .. O~F CITY OF BAKERSFIF~ ICE OF ENVIRONMENTAL'~ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 [] NEW [] ADD [] DELETE [] REVISE HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION 20O (one form per matedal per building or ama) Page __ of __ BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) CHEMICALLOCATION ~,~,,,~4~1~ d~, al~t~ 2011CHEMICALLOCATIONI CONFIDENTIAL (EPC~) ~Y~ ~No 202 ~AClLI~ ID ~ ~j~ ~] ~~P ~ (op~naO 203 ~ GRID ~ (op~naO 2~ ' T~DE SECRET CHEMICAL ~ME CAS ~ FIRE CODE H~RD C~SSES (C~plete if ~u~t~ by I~1 fire ~i~ 210 ~PE ~ p PURE ~ m MITRE ~ w WASTE 211 ~ ~DIOACTIVE ~ Y~ ~ No 212 ~ CURIES 213 PHYSICAL STATE ~ s SOLID ~1 LIQUID ~ g ~S 214 ~RGEST ~AINER 215, F~D H~RD CATE~RIE5 ~ 1 FIRE ~ 2 R~CTIVE ~ 3 PRESSURE REL~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216 (Ch~ ali that apply) []Yes []No 206 if Subject to EPCRA, refer to instructions ANNUAL WASTE 217 MAXIMUM /a~,,, ~' 218 AVERAGE 219 i STATE WASTE CODE 220 AMOUNT DALLY AMOUNT DALLY AMOUNT UNITS* [] ga GAL [] cf CU FT [] lb LBS [] tn TONS 221 { DAYS ON SITE 222 * If EHS, amount must be in lbs. STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE . [] q RAIL CAR 223 (Check all that apply) [] b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224 ] STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [] c CRYOGENIC 225 1 ~ Y~ ~ No 232 233 i 3 2~ 235 ~ Y~ ~.No 236 237 ~ 4 238 239 ~ Y~ ~ No 240 241 { 5 242 243 ~ ~ 2~ 245 Y~ NO )~;~T"NA~ ~T~+L~'5~ Xb~'6~5~a.px~ ,~,~sENT,T~VE S~TU,E ~*TE UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd ~ CITY OF BAKERSFII~) OFFICE OF ENVIRONMENTAL-SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 '"'"" ~" ~ HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fonw per material per Ou#(~ing or ama) [] NEW f'l ADO i~ DELETE [] REVISE 200 Page __ of ~ BUSINESS NAME (Same as FACILITY NAME ~ DBA - Deing Business As) 3 CHEMICAL LOCATION ~ ~., ~1~ I CONFIDENTIAL (EPCR.A) FACILITY,D# j ~]~, ~ i =:#(Dp.ne/) 203 i GRlO#(op--na/)f 204 .' ~ ~.~:'.~¥?.!~,~::-'--:~.:',~..~.::;:?.~;.?'-'~L'.'.'~. '~'~:?':~ :~.'.:i'.'~*'~,:;' ?" ':. ; ~'~'~'~'":"' ":i.~ ' ' * ' ;';"~' ~'~ ' · ' .... .~ .............. '~:'~.~ ,'~ ..... ~'~'~:~ ' '~ ' :,~¥,.;..'m: !~:7:~-~*.~:?11. CHEMICAUINFORMATIO,-· ,L':'-:','¥~'?. :*':.. ¥. ":::~::'~':~:.'~ 2O5 ! TRUE'SECRET CHEMICAL NAME []Yes []No 2o6 2O7 COMMON NAME t EHS* [] Yes [] No 208 FIRE CODE HAZARD CLASSES (Complete if requested by local fire chie0 210 TYPE I-'1 p PURE r-] m MIXTURE [] w WASTE 211 i RADIOACTIVE [] Yes [] No 212 CURIES 213 PHYSICAL STATE []s SOLID [], LIQUID [] g GAS 214 LARGEST CONTAINER ,~/~/.~_.... 215. FED HAZARD CATEGORIES [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (C~ec~ a~ that AMOUNT DALLY AMOUNT DAILY AMOUNT * If EHS. amount must be in lbs. ~219 I STATE WASTE CODE 220 DAYS ON SITE. 221 STORAGE CONTAINER (Check all 81at apply) [] a ABOVEGROUND TANK [] b UNDERGROUND TANK [] c TANK INSIDE BUILDING I'-I d STEEL DRUM [] e PLASTIC/NONMETALLIC DRUM [] t FIBER DRUM [] m GLASS B~TTLE [] f CAN [] j BAG [] n PLASTIC BOTrLE [] g CARBOY [] k BOX [] o TOTE BIN [] h SILO [] I CYMNOER D p TANK WAGON •q RAIL CAR 223 [] r OTHER STORAGE PRESSURE [] a AIr. lENT [] as ABOVE AM]~IENT [] ha BELOWAMBIENT 224 STORAGE TEMPERATURE [] e AMBIENT [] aa ABOVE AMBIENT [] be BELOW AMBIENT [] c CRYOGENIC 225 ' 2 i ~0 ~1 [ ~y~ D~2 ~3 3 ; ~ ~s ~Y~No ~ ~7 241 4 ~ ~9 ~ Y~ ~ ~ 2~ ~5 242 243 ~ Y~ D No 2~ 245 S:\CUPAFORMS\OES2731.TV4.wpd UPCF (7/99) ,. ~ CITY OF BAKERSFII~ O'~FICE OF ENVIRONMENTAL-SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 *"-" ~" ~" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fon'n per material l~er budclmg or ama) [] NEW [] ADO [] DELETE [] REVISE 200 Page ~ ol' ~ BUSINESS NAME (Same as F~CILIT~ NAME o~ OBA- Oong Business As) cHEMICALLOCATIO" t~,~""~/~'~;~ 4~,~ ~:~1~ 201] CHEMIC, ALLOCATION 1 I CONFIDENTIAL (EPCRA) 'I~AC LITY ID # ~ m [ I :~ MAP # (opik)na/) 203 i GRID # (op'tionaO . ':' ='..~'!j:i: ?:;!;;~,~!~:~,??~:~'~'~:~':':~i!ii? :.,,".'-":.:';'-,'::,:;~iii~',!i.i~'"~*i, CHEMiC~'~Ii~'FORMATION i~t:.:i:; ,i:: '*"' :':'":~::::"" '" ': CHEMICAL NAME COMMON NAME I"] yas r--INo 202 205 ! TRADE SECRET I'-] Yes [] No 206 I ff Subjec~ to EPCRA. reft' to instructions 207 ! t EHS* []Yes [] NO 208 FIRE CODE HAZARD CLA,~ES (C~plate if requested by local fire ~ 210 CURIES 213 TYPE [] p 'PURE [] m MIX"RJRE [] w WASTE 211 i RADIOACTIVE I-Iyas []No 212 P.Ys, STA []. OUD RGESTCONTAI.E. [] 3 PRESSURE RELEASE [] 4 ACUT~ HEALTH [] S CHRONIC HEALTH 216 FED HAZARD CATEGORIES E] 1 FIRE (c,'-.~ a~ mat apply) ANNUAL WASTE AIVlOUNT I--]2 REACTIVE 2t7 I MAXlMUM ~ 218 I AVERAGE 219 DAILY AMOUNT a~ DAILY AMOUNT UNITS* [] ga GAL [] d CU FT [] lb LBS [] tn TONS 221 * If EHS. amount must be in lbs. STATE WASTE CODE 220 DAYS ON S~TE. 222 STORAGE CONTAINER (Check all ~at apply) [] a ABOVEGROUND TANK [] b UNDERGROUND TANK [] c TANK INSIDE BUILDING r-I d STEEL DRUM D · PLASTIC/NONMETALUC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] r ~ [] j ~ [] n PLAs'nc BOTrLE [] g CARBOY [] k BOX [] o TOTE BIN [] h SILO [] I CYLINDER [] p TANK WAGON E]q RAIL CAR 223 [] r OTHER STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224 STORAGE TEMPERATURE [] .,AMBIENT [] aa ABOVE AMBIENT [] bs BELOWAMBIENT [] c CRYOGENIC 225 1 226 227 [] Yes [] No 228 2 230 231 [] Yes [] No 232 233 3 234 . 235 [] Yes El. NO 236 237 241 238 239 [] Yes E] No 240 245 242 243 [] Yes I-'1 No 244 '" '-~:~ ~* :*.,' ..,-. ,,~. ,, ~':" ~ .~* .'~,~l,:~:~.,~=:.~'~,~-.-::,:,-,~'.'~:~t;~';' ~ ' , ,~:~,~7',~'.~ .,*~.',, .,.:.~=.. ~.,~.~:,~-,,: ~'.' ~ ,...* , ~¢. ~ t~:,;'-,. :~.~=,~,:~.~ , PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE ~IUNA U UPCF (7/99) S:\CUPAFORMS\OES2731.TV4-wpd ITE DIAG FACILITY DIAGRAM ITE DIAGRAM ...._._ BusineuName:, , Busifu~ Address: ~ FACU, FI'Y DJAGRA~