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Hazardous Materials/Hazardous Waste Unified Permit
Permit ID #:: 015-000-001799
~ CONDITIONS .OF ,PERMIT }ON REVERSE SIDE
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, i This permit Is Issued for the following:
, ItI Hazardous Materials Plan
· 0 Underground Storage of Hazardous Materials
, 0 Risk Management Program
o Hazardous Waste On-Site Treatment
, COLDMEN OF: CALIFORNIA,
,LOCATION: 4708 STINERD
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Issµed by:
Approved by:
Issue Date
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"t~xp~~i~~~pa!~:, -:, " "June 30, 2003
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PerDl.it
to
Operate
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This permit is issued for the following:
zardous Materials Plan
round Storage of Hazardous Materials
",;~gement Program
m' ,Waste
4708
PERMIT ID# 01S-D21.o01799
COLDMEN OF CALIFORNIA
lOCATION
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Issued by:
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STINE
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (805) 326-3979
FAX (805)326-0576
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ph Huey,
ffice of ental Servi es
June 30, 2000
Approved by:
Expiration Date:
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F ACILlTY NA E
ADDRESS
F ACILlTY CONTACT
INSPECTION TIME
CITY OF BAKERSFIELD FIRE DEP ARTMIENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd I;loor, Bakersfield, CA 93301
. ~
INSPECTION DATE \ \ ,..... b .~,... o?/
PHONE NO. fiB 2. - C¡S-/Io
BUSINESS ID NO. 15-210- \'1 OJ '1
NUMBER OF EMPLOYEES .s-
Section I:
.~ Routine
Business Plan and Inventory Program
D Combined
D Joint Agency
o Multi-Agency 0 Complaint
D Re-inspection
OPERA TION C V COMMENTS
Appropriate pennit on hand Iv !J ^(\I\~
Business plan contact infonnation accurate I~ ~~~ ~ \l ~
Visible address V
Correct occupancy Iv
Verification of inventory materials IJ
Verification of quantities V
Verification of location ¡
Proper segregation of material j
Verification of MSDS availability II·
Verification ofHaz Mat training 11 /
Verification of abatement supplies and procedures ./
Emergency procedures adequate J
Containers properly labeled V V
Housèkeeping j ~
Fire Protection J, ~
Site Diagram Adequate & On Hand IJ
C=Compliance
V=Violation
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
Any hazardous waste on site?:
Explain:
DYes ~o
Questions regarding this inspection? Please call us at(661) 326-3979
COLDMEN OF
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CALIFORNIA-
SiteID: 015-021-001799
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Manager TRACI STAMPS
Location: 4708 STINE RD
City BAKERSFIELD
BusPhone:
Map : 123
Grid: 14C
(661) 832 - 9516
CommHaz : Moderate
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 13
EPA Numb:
SIC Code:
DunnBrad:94-224-2777
Emergency Contact
TRACI STAMPS
Business Phone:
24-Hour Phone
Pager Phone
/ Title
/ BRANCH MANAGER
(661) 832-9516x
() x
() x
Emergency Contact
PAUL JORDAN
Business Phone:
24-Hour Phone
Pager Phone
/ Title
/ OWNER FRESNO
(559) 275-1146x
() x
() x
Hazmat Hazards:
Fire Press
ImmHlth
Contact :
MailAddr: 4708 STINE RD
City BAKERSFIELD
Phone: (661) 832-9516x
State: CA
Zip 93313
Owner
Address
City
PAUL JORDAN
1. 70 8 81'INE RB 5(.,..,;;.3 w. 8A£S7DW
Rl\.KEROFIELD r£e5tJO
Phone: (559) 275-1146x
State: CA
Zip 93313- 93?Zz..
Period
Preparer:
Certif'd:
. 'PârcêTNo: . ",..-,,-..--~--,
to
I~~
- ---~
TotalASTs: =
TotalUSTs: =
RSs: No
_/ ~ -.-..-~~-------:- ""']
Gal
Gal
- - ,r --~_ .
'-'I
Emergency Directives:
I ,~ E;mm¡1S" Do hereby certify thai J hæfS
'. (Typa elf print name)
r~viewed the attached hazardous materials manags-
ment plan forß4:tf?Júd~&I:~~ that ~ ;¡Iong with
(NameO~
any corrections constitute a complsts and corrset man-
agement plan ior my facility.
c¡/; JIo 3
/ 08((1
·r~~·
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08/04/2003
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-
-
c¡r-'
COLDMEN
OF CALIFORNIA
..)
RI3U GROCCP'fl\NN .12!/I~~)
4708 STINE RD l~
BAKERSFIELD
Manager
Location:
City
BusPhone:
Map : 123
Grid: 14C
SiteID: 015-021-001799
(i-tvl
(lJ"OS.k 8 3 2 - 9 516
CommHaz : Moderate
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 13
EPA Numb:
SIC Code:
DunnBrad:94-224-2777
Emergency Contact / Title
REN aRODOr-J:M~'t- / BRANCH MANAGER
Business Phone :~'(.s-e-57 832-9516x
24-Hour Phone :"'-'(805) 832-9516x
Pager Phone () x
Emergency Contact d¡wJ Title
FRESNO OFFICE PA~~D r owµß£
Business Phone: (..2-&97 275-1146x
24-HourPhone ~~1 275-1146x
Pager Phone : () X
Hazmat Hazards:
Period
Preparer:
Certif'd:
to
Fire Press ImmHlth
Phone: (~~ 832-9516x
State: CA
Zip 93313
Phone:
State: CA
Zip 93313
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Contact :
MailAddr: 4708 STINE RD
City BAKERSFIELD
Owner
Address
City
PAUL JORD&
4708 STINE RD
BAKERSFIELD
Emergency Directives:
~-2.. ~ ~r.A:
~ erf>L(rfõ dÁ~' fJ1tr¿ .
p= Hazmat Inventory
f== Alphabetical Order
One Unified List ~
All Materials at Site ~
Hazmat Common Name...
SpecHaz EPA Hazards
DailyMax
MCP
FREON
PROPANE
I,~ ?)779n1fÖ
(Type or print name)
F P IH G
F P IH G
Do hereby certify that I have
937.00 FT3 Min
727.00 FT3 Hi
reviewed the attached hazardou5 materials manage- .
ment plan for/~~A--' n./~~nd that it along with
~USIFIOSS) ,
any corrections constitute a complete and correct man-
agement plan for my' facility.
C#~~/
-1-
03/16/2001
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F COLDMEN OF CALIFORNIA
p= Inventory Item 0001
= COMMON NAME / CHEMICAL NAME
FREON
R22
Location within this Facility Unit
MIDDLE-OF WAREHOUSE S WALL
BM)(
SiteID: 015-021-001799 1
Facility Unit: Fixed Containers at Site 1
Days On Site
365
Map: Grid:
CAS #
75-71-8
STATE - TYPE
Gas Pure
PRESSURE ~ TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
140.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
937.00 FT3
Daily Average
937.00 FT3
%Wt. RS CAS #
100.00 Dichlorodifluoromethane No 75718
HAZARDOUS COMPONENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Min
HAZARD ASSESSMENTS
p= Inventory Item 0002
F== COMMON NAME / CHEMICAL NAME
PROPANE
Facility Unit: Fixed Containers at Site 1
Days On Site
365
Location within this Facility Unit
ON FORKLIFT
Map:
Grid:
CAS #
74-98-6
- TYPE
Pure
PRESSURE ---- TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
727.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
727.00 FT3
Daily Average
727.00 FT3
%Wt. I
100.00 Propane
HAZARDOUS COMPONENTS
~
CAS #
749861
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
HAZARD ASSESSMENTS
-2-
03/16/2001
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o B) ELECTRICAL - NW CORNER
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COLDMEN OF CALIFORNIA
SiteID: 215-000-001799
Manager m·p...'kU ....:,..:,BLMlD .l?p..¡
Location: 4708 STINE RD
City BAKERSFIELD
Phone:
123
Grid: 14C
(805) 832 - 9516
CommHaz : Moderate
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 13
EPA Numb:
SIC Code:
DunnBrad:94-224-2777
30-----
Emergency Contact / Title Emergency Contact / Title
REN GROSSMANN / BM Œ:fìfM:r H:'·':'.lJ~ / ~ ijii--'f .k:=;r;i:-"'.... ~~
Business Phone: (805) 832-9516x Business Phone: (805) 832-9516x
24-Hour Phone : (805) 832-9516x 24-Hour Phone : (805) 329-0889x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire Press ImmHlth
.- . .- - ,- , , -, - -- ~-
Contact : Phone: (805) 832-9516x
MailAddr: 4708 STINE RD State: CA
City : BAKERSFIELD Zip : 93313
Owner PAUL JORDON Phone: (805) 832-9516x
Address : 4708 STINE RD State: CA
City : BAKERSFIELD Zip : 93313
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
Hazmat Common Name...
One Unified List l
All Materials at Site l
p= Hazmat Inventory
~ As Designated Order
DailyMax
FREON
PROPANE
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!,-fit-,ð' (JT42J~/l~ go hersby certify \1i'¡af I hat'U
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~s\;'iewoo fths a¡tlaChoo haæardous ma.terials manage-
ment pl~n 108' ~~æ--alOO that it along with
Slny cOi'U'~io~$ œnsîiìuts Sl comlQ)leì~ ~iîd com~ct man-
agem~~mt ¡plan ~Oi' my ~mty.
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11/23/1998
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C&@~amen of ~iìQCD ¡nla
HEATING. AIR CONDITIONING . ~L MBING
Sales. Service · Installation
REN GROSSMANN
Branch Manager
4708 Stine Road
Bakersfield, CA 93313
805-832-9516
Fax: 832-0446
5623 W. Barstow
Fresno, CA 93722
209-275-1146
Fax: 275-7196
Lic# 347989
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
.' 1715 Chester Ave., Bakersfield,. ,~9~~J~Ji:.~2.72·
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INSTRUCTIONS:
1. To avoid further action, return this form within 30 days of receipt. ~'¥ .:llo( I qq 7
2. TVPEIPRINT 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
BUSINESS NAME: Coc;D 1'0\C,~ c peA ( I F
LOCATION: 4-7oð' s¡ (I\:J~
MAILING ADDRESS: ~~
ÇITy:~~Ç7 D
. "ST ATE:Cti' ZIP:73Y3HONE: ð':J2. -1...v Þ
DUN & BRADSTREET NUMBER: 2::0' 7~-:2.2...~2-777 SIC CODE:'
PRIMARY ACTIVITY: 1/ !/ ~ c' / /l-ß Ó7
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OWNER: ---ÝAtA L -:SO~A to
MAILING ADDRESS: S~~
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SECTION 2: EMERGENCY NOTIFICATION
CONTACT
1. ~L.~ ' 6R..ûSS¡nAN~
2. Ç)1~)\/6rf\ ,..{ J10dlrx rid
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TITLE
BUS. PHONE
24 HR. PHONE
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HAZARDOUS MATEmALS MANAGEMENT PLAN
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. SECTION 3: TRAINING
NUMBER OF EMPLOYEES: ç'
MATERIAL SAFETY DATA SHEETS o~:;i~:' eJt'rì '. ; ~q~~~+:.'(
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BRIEF SUMMARY OF TRAINING PROGRAM:
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SECTION 4: EXEMPTION REOUEST .
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: f' '.
, ..
v WE DO HANDLE HAzARDOUS MATERIALS, BUT THE QUANTITIES AT
. NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5~ION . .
~_~'~n~1 NI~ ACC~~UNDERST~~T~~ =O~~ONWILLBE
USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH
AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500
ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY.
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. IGNATURE
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TITLE "
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DATE
2
Coldmen ö~ ~~~CílúD[fDDÖ,~,
HEATING - AIR CONDITIONING- PLUMBI~
Sales - Service - Installation
LEIF LOGAN
Plumbing Manager
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4708 Stine Road
Bakersfield, CA 93313
805,832-9516
Fax: 832-0446
Lic# 347989
5623 W, Barstow
Fresno, CA 93722
209-275-1146
Fax: 275-7196
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HAZARDOUS MATEmALS MANAGEMŒNTPLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
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A.
AGENCY NOTIFICATION PROCEDURES:
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B. EMPLOYEE NOTIFICATION AND EVACUATION:
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PUBLIC EVACUATION: ' ,
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D. EMERGENCY MEDICAL PLAN:
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SECTION 7: MITIGATION. PREVENTION AND ABATErvŒNT PLAN '
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A. ",,:'RELEASEPREVENTIONSTEPS: " ' .' .'" ." , '
R'o~e..~ ~"CU\~~ 5-1-0(1"0\ Ûf{'¡~~+-
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B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
C.
CLEAN-UP PROCEDURES:
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SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
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NATURAL GAS/PROPANE:
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ELECTRICAL:
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LOCK BOX: YES~ IF YES, LOCATION:
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SECTION 9: PRIVATE FIRE PROTECTIONIW ATER AVAILABILITY
A.
PRIVATE FIRE PROTECTION: I_I F-ï're.., ¡;:y+
h'¡?e S¡;r"111f.er J-fir()~'jÁo"'1-.
B. WATER AVAILABILITY (FIRE HYDRANT):
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., B~kersfield,_CA'(~05)326-3979
HAZARDOUS MATERlALS UNVENTORY
FACILITY DESCRIPTION
CHECK IF BUSINESS IS A FARM [ ]
BUSINESS NAME CDCD ~ '. ().ç C-A I J P
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FACILITYNAME ...~
SITE ADDRESS ,4,7oí! S7/ N~
CITy0Æpu' STATECÁJ ZIP ?ß/J
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SIC CODE .,
DUN & BRADSTREET NUMBER
OWNERlOPERATOR~¡tJ G-/áJK/ZJ4-/V/'I PHONE R 3 L tJ 57 b
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MAILING ADDRESS ~ 70? .577 /LIe- ~.fl
CIT~~~) , STATEGA ZIP '.33/'3
EMERGENCY CONTACTS
N~µ (ÝZ!ðS>ßA/V/'o./
BUSINESS PHONE £73 ¿ Yc..57r6
NAME ,(L VQA'\ GJocol \Qr\.J
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BUSINESS PHONE ~~ ';). ~gS-fb
TITLE ~cII' 4?oMð~
24HOURPHONE ff52-'YS7~
TITLE Servr~~ (Ylqr"
24 HOUR PHONE 3 ;J. q - O~() o¡ fYl;'
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&ARDOUS MATERIALS INVENTly
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CHEMICAL DESCRIPTION
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Page -L of 1..-
I) INVENTORY STATIJS:New [ÝJ Addition [ .] Revision [ ] Deletion [ ]. Check if èhemical is a NON Tràde Secret [ ,] Trade Secret [
J),çoIIlI11onName:..,,'F?IV1~ _. '~LA )"
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--ARM[ ] CAS#
4) Physical & Health
Hazard Categories
. / PHYSICAL . ~ HEALTII
Fire [L..-tReactive [ ] Sudden Release of Pressure [V'] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION
6) PHYSICAL STATE Solid [
(3-digit code from DHS Fonn 8022) USE CODE
Liquid [ Gas [ vi Pure[,,,r Mixture [ ] Waste [ ] Radioactive [
7) AMOUNT AND TIME AT FACILTIX UNITS OF MEASURE . . 8) STORAGE CODES ,
, MaxiIIJ.wo,pailY ÄI!tQwlt ~/~ 7 ." Lbs [~,Gal[j ] ft3 [v(:" . _" ~a)Container,"__, ~" ,t) ":1-'. . ~
Average Daily Amount ", _ ........=- . Curies [ ] b) Pressure: ð . ~
Annual Amount S,.'5 '1~ c) Temperature
Largest Size Container ~O Le> \ ~ <1. ~ <t ~ _
# Days on Site ,3'- s- Circle Which Months: 1 Year, ,~, M, A, M, J, J, A, S, 0, N, D
9)~11nRE: Li&
the three most hazardous I)
chemical components or 2)
any ARM components 3) ,
r. COMPONENT
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CAS#
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ARM
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lO)LOCATION
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· I) INVENTORY STATUS::NèW,~ditionT'!lRèviSion [-
2) Comm.on Name: Pf~(\... ~.
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3) DOT # (optional)
Chemical Name:
AHM[ ] CAS#
'FHYSICAL ./"' ," HEALTII
Fire VfReactive [ ¡{Sudden Release ofPressur~ ["'1 fuunediate Health (Acute) [ ] Delayed Health (Chronic) [
4) Physical & Healfl!
Hazard Categones
5) WASTE CLASSIFICATION
(3-digit code from DHS Fonn 8022) USE CODE
Liquid [ ] Gas [ vf Pure [~MixtureJ ] \\:"aste [
~-~- -.~-...:...~- --~---~- -"- -- -- "",:,- ~- --- -~
6) PHYSICAL STATE . Solid [
... ...,..........,...
~-..,..-~ .--~--=-- ------....-------~--~-., -_.-..,....
7) AMOUNT AND TIME AT FACILITY ....,
Maximwo Daily Amount ., ë;t ,
Average Daily Amount 7 ;;;>... -,
Annual Amount
Largest Size Container
# Days on Site
Radioactive [ ]
-......... --.-",-" _.~-::,; ------- ~-~ ~-....,. -~=--.. -
UNITS OF MEASURE
Lbs [ ] Gal [ ] ft3 [ \1""'-
Curies [ ]
8) STORAGE CODES
a) Container:
b) Pressure:
c) Temperature
~1-
~b~
\.
4-
Circle Which Months:
All Year, J, F, M, A, M, J, J, A, S, 0, N, D
9) ~11nRE: List
the three most hazardous. I)
chCßJ.Ícal components òr, 2)
any ARM components. " 3)
a COMPONENT
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CAS#
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lO)LOCATION () i\. ~()(k í: .pt
, I cèî:tify unqerpenalty of law; ' that lhave pèrsonally examined and am familiar with the ÍIÛonoation on this and all attached docwnents. I : .
believe _th, e "'bmitt~ ;mannation ¡, -, """""" ond oomplete. ~ ~;':'A
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