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Home My WebLink AboutBUSINESS PLAN 9/30/1997 d ~~ Q~s ~~-tlJ- u \* ,_ I;) ø~~ .£:V' IN ._- - i'!I "þJ141p::L )'V'?\'9qb ,/~"'Jtttlh "iC'lroo ~1 C\,-,,:('\~ ffl?:' ~» Q:? b-t1;;> ("'/ o~ ç êla.I?I(t'I\!~s 0J-fJ ~ o 0' 2> b þj.. 0 'þýL.. rz !It j. 1#6 (!Ó51 iI ø?P)3cYJ Q,3.~ 3(P}ø> b~)t1 ..--!.-' ()/ n - '''.1 J? )~ en ""'3 ìI (~ J..-p~ t:. (1'ê> ] h-l.:'i:>:J1I1 O'b b }-d·v ] f~cIL~IAGRAM [ ~t~~ 12-~ e V1 1/" Q! q ~ \I' j ",) ~' .. 4. ~ ,.} d t ~~ \)'J¡ N I~~j-Vm )(!UD}~~C'>-'p SITE DIAGRAM r ~ Business Name: ~ ,.... t --r--t Business Address: ~ I(-C) g - ~ ~ ~ J, It rJ .. r 4 ;~ 3 u\J IB i ('2 ----'~ PerDl.it to Operftte Hazardous Materials/Hazardous Wast~ Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This p()rrnit is issued for the following: zardous Materials Plan rcund Storage of Hazardous Materials gement Program Waste 4808 PERMIT ID# 015-O21.()01800 QUALITY FRAME LOCATION Issued by: 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 Approved by: Expiration Date: June 30, 2000 " .--- 'e e ~ K,:Jtl~"lF Õò :;........ .. ,,;:"" CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 ~ k' t ,)'-, -.I-':.-' .t... \~ ~_ ,:ì t'~ ' ~ ::-~:.. <::- ~~,/' .,..--- 1. )'0<:' ,;' INSTRUCq:IONS: lA" .<~, I S [3 ~1 ~d- t<.t \ ., - 1. To avoiá further action, return this form within 30 days of receipt. 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: Q ( i J'1 1 - '~i _ 'f ¿4-f14 ~ LOCATION: L(8(J8 ~T/IÁJL R ~ MAILING ADDRESS: ~ A-rvl ~ CITY: ~A~z-~~~(~ ,C~ STATE: MZIP: QPHONE: ,C¡803~7- DUN & BRADSTREET NUMBER: SIC CODE: ( PRIMARY ACTIVITY: #1 <-iTC.J r~l<L ~~U\{L OWNER: l. <i GU { C's ~ ~CA4-( iA-- Û ~ MAILING ADDRESS: 1£08 'CS1i~~ ¡¿Ò I SECTION 2: EMERGENCY NOTIFICATION CONTACT eoses TITLE BUS. PHONE 24 HR. PHONE 1. ~IÄ U~Ù~cJ~cr /L 2. 1 e e "--.. ...._~ < HAZARDOUSMATE~SMANAGEMENTPLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: " Û MATERIAL SAFETY DATA SHEETS ON FILE: ~--, BRIEF SUMMARY OF TRAINING PROGRAM: ,,; 4 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. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TIllS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND S TY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AL ) AND INACC RMATION CONSTITUTES PERJURY. 2 QUALITY FRAME \ Lewis Escalante \..398-0337 4808 Stine Rd. Bakersfield, CA 93313 2;&1 ¡ÇD >~ - - - - --- cF oxY~ u=- ~&Jè c.J:: A«- 6o,J . .. ~ ~ ð-dd-Cf7 ·.;----. e . ...--- '~-~ HAZARDOUSMATEWALSMANAGEMENTPLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GASIPROP ANE: ÙC\ l ') CZ- ELECTRICAL: ÓQ « ~~ ~ l-. ; l.. ') ~ M Or~ v JIY1 ¡l\ ~ A' ( . ~t&J'tJJ (ê:';'F =ev rL ~ (~ WATER: -----' 7'Tp '27 J SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTIONIW ATER AVAILABILITY o ~ , A. PRIVATE FIRE PROTECTION: ~ Pre. I 0'/. k-<T ~S ~(~£. Z-\.{TÏ'wC¡ uf 7'«<2/-5 "' B. WATER AVAILABILITY (FIRE HYDRANT): ~~~dV~ Ø~B cJ I L~ t~~ 4 .......-..." 11 -... . e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: 3 LARDOUS MATERIALS INVENIRY C?()'/tL, ~( ~ ~ Address tfftJ~ 45;rl V$ CHEMICAL DESCRIPTION ~ . . Business Name c_........,~... ~ò p~ge-l-of-Í 1) INVENTORY STAl1JS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: ----# ('. <? ìl L Ç.a.) ~ 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL . HEALTH, ./. Hazard Categories Fire [ ~tive [ ] Sudden Release ofPressuren Immediate Health (Acute) [ VJ Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION 6) PHYSICAL STATE Solid [ Liquid [ 7) AMOUNT AND TIME AT FACILITY Maximwn Daily Amount I ~ 0 Average Daily Amount J 5() X _Annual Amount Largest Size Container # Days on Site ($0 9)1{C(11ntE: Li~ the three most hazardous chemical components or any AHM components 1) 2) 3) (3-digit code from DHS Form 8022) USE CODE Gas [0 Pure [ ~ Mixture [ ] Waste [ ] Radioactive [ UNITS OF MEASURE 8) STORAGE CODESO Lf- Lbs [ ] Gal [ ] ft3 [ ~ a) Container: ~ Curies [ ] b) Pressure: ~ 1/ c) Temperature *- Circle W1ùchMonths: ~Y~ F, M, A. M, J, J, A. S, 0, N, D CAS# % Wf COMPONENT ARM [ ] [ ] [ ] ..... 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret[ ] Trade Secret[ ] 2) Common Name: G -( ~ 1 2- 0 3) DOT # (optional) Chemical Name: 4) Physical & Health Hazard Categories AHM [ ] CAS # PHYSICAL HEALTH L Fire [4eactive [ ] Sudden Release of Pressure [ ~Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION 6) PHYSICAL STATE Solid [ Liquid [ 7) AMOUNT ANDTIMEATFACILra~ 0 Maxirnwn Daily Amount -:...2 c:::,. v '"""") Average Daily Amount .;;J. '1S D ,. ~Annual Amount --- Largest Size Container Uo # Days on Site 1) 2) 3) (3-digit code from DHS Form 8022) USE CODE Gas [ t.-f Pure [v( Mixture [ ] Waste [ ] Radioactive [ UNITS OF MEASURE Lbs[ ] Gal [ ]ft3[ ~ Curies [ ] 8) STORAGE CODES ~ a) Container: b) Pressure: 1.¡ c ) Temperature Circle W1ùch Months: AIl Year, J, F, M, A. M, J, J, A. S, 0, N, D COMPONENT CASH %Wf ARM [ ] [ ] [ ] c¡ - -?ð -7' 7 Date ' '" --, -. ...~ . e - . .,.............. CITY OF BAKERSF][ELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERlALS UNVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME (((>ù y\.,,:, ~ ~~C(Q.. FACILITY NAME SITE ADDRESS 'iß <sf) <;,,/ ~ ~ ~'ò CITY ~~..J(R~~{~ ~ {\ STATE r~\ , NATURE OF BUSINESS A-uro ~t« <2 ZIP <is ~ (~ " r¿Çf64(fJ_ SIC CODE DUN & BRADSTREET NUMBER OWNER/OPERATOR ^ £uJ6 55CJf4.( f1\-µ~ PHONE -rsTJ ¡)ç ~ I 57P f') 3~-T- 11' C a.. MAILING ADDRESS -( IE ./P'JC' CITY ~ eJ¿ R- sF(<¡ k ~ 8T ATE ~íIr-( ZIP f ~~ (3 EMERGENCY CONTACTS CO µ C-IA ~ C-û NAME þ~cs~ 1¿1ä l \ "lU~u~ TÇ.2- TITLE (!)cvJ...J9;,¿ ", , (5)F ?U(k. ~l~ BUSINESS PHONE 24 HOUR PHONE NAME TITLE BUSINESS PHONE 24 HOUR PHONE 1 J..' ,~ euRDOUS MATERIALS INVEN4áRY Business Name QV-6\/'-; '7 ~ f.. Address 1f~I(j~a, <7 Tf ;., "<- CHEMICAL DESCRIPTION I) INVENTORY STATU}jNew [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret[ ] 2)CommooName'~&r //ot 3)DOT#(_) Chemical Name: '0/ ..Q.S. AHM [ ] CAS # 4) Physical & Health PHYSICAL HEAL TII Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code ftom DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] Pure [ 7) AMOUNT AND TIME AT FACILITY Maximwn Daily Amount Average Daily Amount Annual Amount Largest Size Container ~ 0 # Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ ] Curies [ ] Circle Which Months: 9)~: List the three most hazardous I) chemical components or 2) any AHM components 3) 18, COMPONENT ~--... _.. Page ¿ of ?- USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) C<mtainer: b) Pressure: c) Temperature All Year, I, F, M, A. M, I, It A. S, 0, N, D CAS# % Wf AHM [ ] [ ] [ ] ........ f!)T S> fief c... q &0, ~ c2 -7 Ë$' :t>(64î~'l I) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret [ 2) Common Name: Chemical Name: 4) Physical & Health Hazard Categories 3) DOT # (optional) AHM [ ] CAS # PHYSICAL HEALTII Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code ftom DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] Pure [ 7) AMOUNT AND TIME AT FACILITY Maximwn Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ Curies [ ] Circle Which Months: 9)~: List the three most hazardous I) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, I, F, M, A. M, I, It A, S, 0, Nt D CAS# %Wf AHM [ ] [ ] [ ] IO)LOCATION I certify lUlder penalty of law, that I have personally examined and am familiar with the . believe the submitted infonnation is true, accurate and complete. ~ c;. &( ) ~ S S s C#J. (J!/-~7? PRINT Name & Title of Authorized Company Representative 9-~ ~>/ Date ( ... . ti S '.... ¿RDOUS MATERIALS INVENT&. -- , . Business Name Address Page_of_ CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret[ ] Trade Secret [ ] 2) Conunon Name: 3) DOT # (optional) Chemical Name: ARM [ ] CAS # 4) Physical & Health PHYSICAL HEAL 1H Hazard Categories Fire [ ] Reactive [ ] Sudden Release ofPreSSW'e [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code ftom DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] Pure [ 7) AMOUNT AND TIME AT FACILITY Maximwn Daily Amount Average Daily Amount Annual Amount Largest Size Container # Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ Curies [ ] Circle Which Months: 9)~: Li~ the three mo~ hazardous 1) chemical components or 2) any AHM components 3) COMPONENT IO)LOCATION USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M, A, M., J, J, A, S, 0, N, D CAS# %Wf ARM [ ] [ ] [ ] 1) INVENfORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Conunon Name: 3) DOT # (optional) Chemical Name: ARM [ ] CAS # 4) Physical & Health PHYSICAL HEAL 1H Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ 5) WASTE CLASSIFICATION (3-digit code &om DHS Fonn 8022) 6) PHYSICAL STATE Solid [ Liquid [ Gas [ ] Pure [ 7) AMOUNT AND TIME AT FACILITY Maximwn Daily Amount Average Daily Amount Annual Amount Large~ Size Container # Days on Site UNITS OF MEASURE Lbs [ ] Gal [ ] ft3 [ Curies [ ] Circle Which Months: 9)~: List the three mo~ hazardous I) chemical components or 2) any AHM components 3) COMPONENT USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperature All Year, J, F, M., A, M., J, J, A, S, 0, N, D CAS# %Wf ARM [ ] [ ] [ ] IO)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the infonnation on this and all attached documents. I believe the submitted infonnation is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date