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HomeMy WebLinkAboutBUSINESS PLAN Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE Permit 10 #:: 015-000-000302 BIZZY BEE CLEANERS LOCATION: 3364 NEW STINE RD A3 Issued by: I Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor . Approvedby: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: ~,. .' This permit is issued for the following: '¿:f1~rrilIJ1;~", IiI Hazardous Materials Plan .d17 f ra~<;;::>~'ft' 0 Underground Storage of Hazardous Materials, ;:tf(l i~~ \9,) 1)[, !~>:.__, ,0 Risk Management Program Iff \ j)¿!I;<f: ~) 0"~'" 0 Hazardous Waste On-Site Treatment AY~Þ,t~~~{~,~-::J~~~;~~~:,;-,..,<., ~ç, ,'¡ -?~~~' ~', '\:.... tt¿'~..r'.{> ..<t_J....: . :: \. ~..~" t ~:4.'1 l-¡, ...~' ,"r-~~"'''/.ft ' --.-,~-- ¡f' '. ''I.~ BAl<ERSFIELD ·lD'Á"·: ".=~ i.'A. ... 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PerDl.it to Operftte Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE Issued by: This permit is issued for the following: ,llthil~rdous Materials Plan ":,I;"~[9round Storage of Hazardous Materials ., "... agement Program Waste PERMIT ID# 015-021.000302 BIZZV BEE CLEANERS LOCATION 3364 .- I 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: *~ ph Huey, ffice of ental SClVi es June 30, 2000 Expiration Date: -:t ". t'_ i I . H M~¡r P PLAN -' MAP SITE DIAGRAM FACILITY DIAGRAM 'ßusY í.SE6 ¢; 8usiness Name: Business Address: 'S""3b4 S"i,^'é ol2.D For Office Use Only FirST In Station: Area Mcp # of NORTH V Inspection Station: <p L. ~¡;...J' L.. <2- \) ---- ? AI?-i<.lN& ~C.J\.l. TY v->o(l....Q CI-\ IIIIA. GM.()GVs ?Df> ~'t's ß:>~ ßEE ~ !~'~ () ~ ~--,-~~_I ~ ~ ¡ Iò (:' lQC {i.oÞ-í£æ ¡,.{YCJRAfJr S'/.lu'WFF r ~'<é , (> ~YDf1#lT JON <? lU < ~ V> --1 I , I , I APA£.T~C--VT ~P(2~ 1 I J ! : , I ! i ¡ I '~ a) CCNTAINERCCDES /'~ÂIII 01. Underground tank 02. Aboveground tank 03. Fixed Pressurized tank 04. Portable pressunzed cylinders OS. Insulatec tanl< (includes cryogenics) OS. Drums or carrels - metallic 07. Drums or barrels - non-metallic 08. Carcoy(s) b) PRESSURE CODES e "\ . I 09. Grass container(s) ¡a. Plastic container(s) 11. 80x(es) i 2. 8ag(s) i 3. Metal containers (not drums) 14. In machinery or processing equipment ; 5. 8in(s) 99. Cther - specify . , , - ïhe material is stored at ambient (normal atmoscheric) pressure. 2 - The materral is storeo at greater than amcient pressure. 3 - The materials is stereo at less than ambient pressure. c) TcMP=~A TURE C8DES 4 - ïhe material is stored at ambient (surrounaing) temceratur~. 5 - ïhe materiai is scared at greater than amoienc ,emoerature. 6 . ïne matenal is s;:ered at less than amoienc temcerature. 7 . ïhe' materral is storeo under cryogenic ::onc:tions 01. Additive 02. Adhesive 03. Aerosoi 04. Anesthetic as. Bac:erlcide 06. 81astrng 87. Catalyst 08. C:eanlng eg. C~oianr 1 O. C~oling 1 1. Drilling 12. Drying , 3. Emutsitier/demulsítier 1 4, E:~ching 1 5. ;'xoerimental i 6. Facncatlon 17. Fertilization 18. ¡::ormuiatlcn 19. Fuel ~;JQ. 1- -- ----- - USE CODES 20. Fungicide 2'. Grinding 22. Heating 23. Herolclde ' 24. InsecClclde 25. !nsuuctlonai 26. L'Joricam 27. Medical ata/process 28. Neutra¡jzsr 29. Painting 30. Pesticide 3'. Plating 32. Preservative 33. Relining 34. Sealer 35. SpraYIng 36. Slenlizer 37. Storage 38. Stnoper 39. Washing 40. Waste 41. Water Treatment '42. Welding/soldering 43. Well injection 44. Oil treatment 45. Resale 46. Aircraft systems 47. Battery electrolyte 48. Breathing air 49. Drafting aid 50. Finisned product 51. Fire protectIon 52. Hydraulic eouipment 53. Roao/Hwy maintenance 54. T esttng 55. Wholesale chemicals 99. Other· specify 2, RI!GICN" I.!i'C ST ANOAAO OO1Ir.. ~~.. .... '... H'~MP p~ MAp· SITE DIAGRAM FACILITY DIAGRAM I >< Business Name: Business Address: For Office Use Only Inspection Station: Area Map # of NORTH 0 First In Station: (1' tl Gœs /:: If>cl (/0 nn_ L f uÀJ+er sNtðtT5 -,- r-.-'--J.----.-----------:- &;\€r e. : . Roo '" :'-- J Fore ExT tb ß -- . / (a ve I AqenC'-i JOf)~ r::::::r -ðp t=J L-J IT c",,"-\e,'V Fr<X\+ Uccr ßrb~ Ì--ù+ e - (!) CITY OF BAKlER§IF'llIER.JD) IF'llJRŒ IJ}!E!JD AJPtIrlW!EN1I' OFFICE O!F JENVll~ONMIIENlI'A!L §!E1R!.Vll<CIE§ UNIFIED ¡PUMJìGMM llN§JP!EC1I'll((»N <ClHIIECOCll..ll§1I' ins ClJne§~<e!/" Av<e'9 Jrd IF~ol[ )!î9 !Bì2l&<e!/"$ffôe~¡¡j]9 <CA ~JJ( ])n fACILITY NAME ßly~ ~ clU/Il/'s ADDRESS 330'f -S \ (\ e... ec\ A - 3. FACILITY CONTACCUU &0 c..þ i e p .p"'ttVl^ JINSPECnON TIME I ')0 t;;) rNSPECnON DATE 10- ;;~-o;;" PHONE NO. 3 C¡7 -- 70# ! BUSINESS KD NO. 15-210- NUMBER Of EMPLOYEES ::J §ednmll n: 1B5un§nU1le§§ JP>llæ:lU1l æ:IU1l(iJJ ll!JBVæU1l~l[ )ry !JDI1'I[ )~I1'2IU1l1l ~outine OJ Combined o Joint Agency OJ Multi-Agency OJ Complaint OJ Re-inspection OPERA nON c v COMMENTS Appropriate pennit on hand Iv v Business plan contact infonnation accurate Iv v Visible address Iv Correct occupancy !v ..- Verification of inventory materials Iv ,.. Verification of quantities :// ,. V '" V erification of location Proper segregation of material 1/ - Verification of MSDS availability V ..-' Verification of Haz Mat training 11/ V Verification of abatement supplies and procedures 1£/ I..-- Emergency procedures adequate Iv v Containers properly labeled !/ V' Housekeeping &"V' Fire Protection V V fî ('Go e ~ ~. ' . l ^ .« k" ~ .?' ,t()\ .r J? ,! ¡VI.- '-" U u Site Diagram Adequate &. On Hand C=Compliance V=Vìolatìon White - Env, Svcs. Yellow· Station Copy Pink - Business Copy 5?>~ 76 AU1lY ~~anI1'¡¡j]qlUt§ 'Wan§~~ 1[ )U1l §llde?: ~ ,,§ OJ ~I[ ) Explam: "\(~~ð~11t"M..,-Vs~2: -\:: ~b.^,- c\A ~ Questions regmrding this inspection? Plels(/) can us It (15M) 326-3979 .' e e BIZZY BEE CLEANERS SiteID: 015-021-000302 Manager : Location: 3364 STINE RD A3 City BAKERSFIELD CommCode: BAKERSFIELD STATION 07 EPA Numb: BusPhone: Map : 123 Grid: 14A (661) 397-7011 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:2842 DunnBrad:560-47-8657 Emergency Contact / Title Emergency Contact / Title J;;IÞMU} \oj Broc..QfCf fftA~ / OWNER R}\¿Jl\.D ALl 8HARI3ATI / Ñ~æ~fE r p ~H Business Phone: (661) 397-7011x Business Phone: (661) 397-7011x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (661) 397-7011x MailAddr: 3364 STINE RD A3 State: CA City : BAKERSFIELD Zip : 93309 Owner ~ALI OIlARBA'I'I ~\~oc..Qléf PM A-fV Phone: (661) 397-7011x Address : 3364 STINE RD A3 State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Pre parer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì f= Hazmat Inventory f== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP PERCHLORETHELYENE F IH DH L 60.00 GAL Low -1- 09/30/2002 e e F BIZZY BEE CLEANERS p= Inventory Item 0007 F== COMMON NAME / CHEMICAL NAME PERCHLORETHELYENE SiteID: 015-021-000302 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit BACK END OF STORE Map: Grid: CAS# 127184 STATE - TYPE Liquid Pure PRESSURE Above Ambient TEMPERATURE Above Ambient CONTAINER TYPE IN MACHINE/EQUIP Largest Container 60.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 60.00 GAL Daily Average 30.00 GAL %Wt. RS CAS# 100.00 Perchloroethylene No 127184 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -2- 09/30/2002 e e SiteID: 015-021-000302 9 Fast Format 9 Overall Site 9 12/01/1999 F BIZZY BEE CLEANERS I f= Notif./Evacuation/Medical Agency Notification CALL FIRE DEPT 9-1-1 AND CALL HAZARDOUS MATERIALS DIVISION 326-3979. Public Notif./Evacuation 12/01/1999 12/01/1999 ] 1 [: Employee VERBAL. Notif./Evacuation N/A. Emergency Medical Plan 12/01/1999 ] NEAREST HOSPITAL. -3- 09/30/2002 e e SiteID: 015-021-000302 9 Fast Format 9 Overall Site 9 11/13/1991 F BIZZY BEE CLEANERS I f= Mitigation/Prevent/Abatemt Release Prevention PERCH STORED ONLY INSIDE DRY CLEANING MACHINES. NO RESERVE STOCK ON HAND. 12/01/1999 12/01/1999 1 1 I r=:: Release Containment LE. I Clean Up NONE NEEDED. I Other Resource Activation -4- 09/30/2002 e e SiteID: 015-021-000302 ì Fast Format ì Overall Site ì I F BIZZY BEE CLEANERS I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs 11/13/1991 A) GAS - BACK CENTER WALL B) ELECTRICAL - BACK CENTER C) WATER - BACK CENTER WALL D) SPECIAL - NONE E) LOCK BOX - NO WALL Fire Protec./Avail. Water 12/01/1999 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - IN THE VONS SHOPPING CENTER. Building Occupancy Level -5- 09/30/2002 e e SiteID: 015-021-000302 ì Fast Format ì Overall Site ì 12/01/1999 F BIZZY BEE CLEANERS I F Training Employee Training WE HAVE 2 EMPLOYEES AT THIS FACILITY. MSDS SHEETS ARE ON FILE AT THIS FACILITY. BRIEF SUMMARY OF TRAINING PROGRAM: ONE TIME TRAINING ON USE AND DRY CLEANING PROCEDURES. EMPLOYEES KNOW WHERE MSDS SHEETS ARE LOCATED. Page 2 r I I Held for Future Use Held for Future Use -6- 09/30/2002 (' . 'II' e e IRONSIDE TRUCK BODY MFG & SLS SiteID: 015-021-001523 Manager : Location: 605 WILLIAMS ST City BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: BusPhone: Map : 103 Grid: 28C (661) 322-7361 CommHaz : Low FacUnits: 1 AOV: SIC Code:3713 DunnBrad: Emergency Contact / Title Emergency Contact / Title ELWOOD CHAMPNESS / LANDLORD MINH LAI / OWNER Business Phone: (661) 327-0228x Business Phone: (661) 322-7361x 24-Hour Phone : ( ) - x 24-Hour Phone : (661) 833-6592xHM Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press , ImmHlth DelHlth Contact : Phone: (661) 322-7361x MailAddr: 605 WILLIAMS ST State: CA City : BAKERSFIELD Zip : 93305 Owner MINH LAI Phone: (661) "834 Ss38x Address : 5901 LUG ENE AVE State: CA ~ 3ð-ioS9 ~ City : BAKERSFIELD Zip : 93313 Period : to TotalASTs: = Gal Pre parer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ~ All Materials at Site ~ f= Hazmat Inventory f== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP CLEANING AND PRIMER THINNER OXYGEN STARGON THINNER F P F P F IH IH L G G L 1. 00 GAL 281.00 FT3 1200.00 FT3 55.00 GAL UnR Low Low Hi DH ~p $-\-- ~\I -e. .~ ~ (¥y~ or print narm» [D@ Û'i®U'®~lf ©®fiii~ afììJ®tí ö . ._J~ r®'\Pi~w~d ~h~ @lt~ch®(Q] Û1lâŒtIDmJ@iL!J@ UïrutID~®fi'ÜtID~~ Uïru®fíiJ®@®~ --.' f) 0 à"~S men~ p!tiìJl1 ~(QJú' .l..ro\,-S .~e. Ttrlle-I..:. p ®oo ~Ûi1®~ !~ ®~@~ ~QÛi1 (WmiIDCV 1B'IDb1~) 0 ~ralf OOfi'[j'®©í1¡@fíiJ~ OOfíiJ®~!QiL!JQ® ® oom[QJ~®~® ®fíiJ(QJ OOfi'[j'~ Uïru®frù~ fà~Sml8fíiJ~ ¡gil§ìfíiJ ~©ú' rFëJlf ~@©~~if(¡¡? ~~ , i!1ro It ("5"/0;)., iQ'2::) 10/31/2002 · - e BIZZY BEE CLEANERS SiteID: 215-000-000302 Manager : Location: 3364 NEW STINE RD A3 City BAKERSFIELD ¡ L ;:: " .'/ BusPhone: Map : 123 Grid: 14A (805) 397-7011 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 05 EPA Numb: SIC Code:2842 DunnBrad:560-47-8657 Emergency Contact / Title Emergency Contact / Title HAMID / OWNER RAJAB ALI SHARBATI / Business Phone: (805) 397-7011x Business Phone: (805) 397-7011x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: 3364 NEW STINE RD A3 City : BAKERSFIELD Phone: ( ) State: CA Zip : 93313 - x Owner Address City RAJAB ALI SHARBATI : 3364 NEW STINE RD A3 : BAKERSFIELD Phone: (805) 397-7011x State: CA Zip : 93313 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: ~,It ¡; l,tæl!;~} (Dì© ÛlŒJr®fÞ>l1 ©®~åti1J ~UiJ®il ~ ~~~® ~(dVi~W01ô1 tM<e @\t~t'aI©Û"!®©1IhJ~m@í)J~ m®~®úîi~ij~ !iVù®n~~®~ m®ú1~ p!Sl!1 ~({jfJ' If, dl:;~~C" ®úW1 ßIhJ®~ W ®~@~ ~Jij~fFü 81B'ìJY roúT®©\íÛ@[ñ)~ @©)~~Ü~ß,ßa® ® ©©mruLª~a® @ú'iJCQ1 @þ)w®©li lñíiJ®[ñ)~ á1~®m®ú"3~ (QJ~t;1ú"3 ~@r? ml1 ~©~~jfi11. ~k;l-- ;¿ / < A?¡ ~v? ~o ~, -1- 10/11/1999 .. F BIZZY BEE CLEANERS p= Hazmat Inventory p== As Designated Order SiteID: 215-000-000302 By Facility Unit Fixed Containers on Site e e ì 1 1 DailyMax unitlMCP Hazmat Common Name... PERCHLORETHELYENE specHazlEPA Hazards I Frm I F IH DH L 60 GAL Low -2- 10/11/1999 e - SiteID: 215-000-000302 1 Facility Unit: Fixed Containers on Site 9 F BIZZY BEE CLEANERS p= Inventory Item 0007 = COMMON NAME / CHEMI CAL NAME PERCHLORETHELYENE Days On Site 365 Location within this Facility Unit BACK END OF STORE Map: Grid: CAS # 127184 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Above Ambient Above Ambient CONTAINER TYPE IN MACHINE/EQUIP Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 60.00 GAL Daily Average 30.00 GAL HAZ U ENT %Wt. RS CAS # 100.00 Perchloroethylene No 127184 ARDO S COMPON S HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -3- 10/11/1999 e e SiteID: 215-000-000302 ì Fast Format =¡ Overall Site =¡ 11/13/1991 F BIZZY BEE CLEANERS I f= Notif./Evacuation/Medical Agency Notification CALL FIRE DEPT 9-1-1 CALL HAZARDOUS MATERIALS DIVISION 326-3979 r=:: Employee Notif./Evacuation CRBAL I Public Notif./Evacuation . N/A I Emergency Medical Plan . NEAREST HOSPITAL 11/13/1991 11/13/1991 ] 1 11/13/1991 1 -4- 10/11/1999 e e SiteID: 215-000-000302 ì Fast Format ì Overall Site ì 11/13/1991 F BIZZY BEE CLEANERS I p= Mitigation/Prevent/Abatemt Release Prevention PERCH STORED ONLY INSIDE DRY CLEANING MACHINES. NO RESERVE STOCK ON HAND. 11/13/1991 11/13/1991 ] 1 I ~:elease Containment I Clean Up NONE NEEDED I Other Resource Activation -5- 10/11/1999 e e SiteID: 215-000-000302 ì Fast Format 1 Overall Site ì I F BIZZY BEE CLEANERS I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs 11/13/1991 A) GAS - BACK CENTER WALL B) ELECTRICAL - BACK CENTER WALL C) WATER - BACK CENTER WALL D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/13/1991 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLER SYSTEM. NEAREST FIRE HYDRANT - IN THE VONS SHOPPING CENTER Building Occupancy Level -6- 10/11/1999 "t .. e e í BIZZY BEE CLEANERS ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000302 íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 11/13/1991 ¡ o 0 o WE HAVE 2 EMPLOYEES. o o o o MSDS SHEETS ARE ON FILE AT THIS FACILITY. o o o o ONE TIME TRAINING ON USE AND DRY CLEANING PROCEDURES. EMPLOYEES KNOW WHERE 0 o MSDS SHEETS ARE LOCATED. 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj e e Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 ~Erc!E PfE[] StEP 2. 1 ~~~~ A~s'd.aaaaaoooaoo ()rL 'l~ufIO~ HAZARDOUS MATE. R . " ANAGEMENT PLAN p.+-:::= f?~O~ ~ ~3 INSTRUCTIONS: .J au, 1. To avoid further action, return this form within 30 days of receipt. ~ W- c¡ 2. TYPE/PRINT ANSWERS IN ENGLISH. A ~: :~s~:f t~~dq~~~t~~s~ ~:~:ssf~~e~he business as a whole. \ ~ 3 - \ 4 7 ~ l/J clG8YG-R.{" LOCATION: -"3 3 b,/ 1/ 6" t¿¿ ~ /7;ve, ¡e 0 ' ;9-3 MAILING ADDRESS: '3 "3 ~ ~ f1 Gr-f¿t .f"/;:";v'é /ZV':)' /{;) "3 CITY: B£J/-<'RST7é¿o STATE:6Ç-ZIP: ~PHONE:"3q77d/ DUN & BRADSTREET NUMBER: SbO- 4l-~bS7 SIC CODE: a~~~. PRIMARY ACTIVITY: OrV{ rv leQ r1ers OWNER: .. RiJj&ß-øl/ S"ij'61æS6ì7- MAILING ADDRESS: SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: e /7;2 YB fiG SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR, PHONE 1. 1I~/i1/ "D ~ ~q77o!¡ 2, 1 , FD1590 e Bakersfield Fire Dept. . Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN , -~. '.~ SECTION 3: TRAINING: NUMBER OF EMPLOYEES: :;;L MATERIAL SAFETY DATA SHEETS ON FILE: ~. BRIEF SUMMARY OF TRAINING PROGRAM: O~~~~ ð1èukJL~ ~dì~q, . 9^&&~' ~~~ k~ ~ (\{\~ ~ ()WL j¿~cd:~J ; SECTION 4: EXEMPTION REQUEST: 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. 1:'-" _ WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QcUANTITIES AT NO TlMEEXCEED THE MINIMUM REPORTING QUANTITIES, OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, ~ ~ \-, ,\~.\', 5~cÌ;g-\-" CERTlFYTHATTHE ABOVE INFOR- . MATlON IS ACCURATE. I 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, -R-~~ RE ~'(\e.'b TITLE C1-~(-q ¡ DATE 2. FD1590 s.-'t\. "..¡ ~ 'w ~ . Bakersfield Fire Dept.4I Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: ß, LL~ ßeç_ C\'E(.!I,\P''G SECTION 6: NOTIFICATION AND EV ACUAI10N PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: CC\\\ fì\€- D~ - g \ \ (0.\\ ~Q.L4rð()0~ \\\o.\e.fìo.\~ CY\0\~\ö\\ ~6-8C\l~ B. EMPLOYEE NOTIFICATION AND EVACUATION: Ver~ \ C, PUBLIC EVACUATION: uA D, EMERGENCY MEDICAL PLAN: l)~C\íes-\ ~'\-\4 \ 3. FDl~ · Bakersfield Fire Dept. . Hazardous Materials Division ."....... ~ . ~ '"'>.. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: ?erc-"" .J;()\e.d Oí\ ~ í f\""0Î de cl.\'1 e\eQ /\-\ <1J ffiQclÜ 1\6 . Do r~rv€- ~-\oc1... Df\ kf\~. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: S:tme. C. CLEAN-UP PROCEDURES: Do(\~ (\e.edeo\ SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ~î:~ Le.C\-ter Ll1 ì \ Pnrl Cp f\-\f\ ~Jo.\ \ ~Gl Ce(\-\er u.1\ 1 It\\e ELECTRICAL: WATER: SPECIAL: LOCK BOX: YESÐ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAilABILITY: A. PRIVATE FIRE PROTECTION: rire.. lc)<.-\-ìC\~v\~~ef-s OJ~ ~f~C\l\er ~~1em . B. WATER AVAILABILITY (FIRE HYDRANT): ::IP, ~ Joo~ S~-\~ Œ(\-\er 4. FD 1590 C I <rL"Y OF .BAKER.SFIELD HAZARDOUS MATERIALS INVENTORY ,I I IÍ.- '-- "'", I o Farm and Agr ieul ture 0 Standard Business NON - TRADE SECRET ea'J~'o-~\\ S~arM', page_of j ) BUSINESS NAME. ~ e\~(~ ~ I ~E~I:~;. ~ : -_~.. - -'~cfß5 . -5 OWNER NAME: ADDRESS: CITY, ZIP: PHONE t: ID # NAME OF THIS FACILITY: STANDARD IND. CLASS CODE: éY64 Ò\. DUN AND 51U}D5~EL N~BJ1R~~DERAL JQ _ _7_7 .15_ _ -:¡ 'ñ ì \- ~'SS INSTRUCTIONS FOR PROPBR CODBS 13 " by wt Physical and Health Hazard C.A.S. Number component II 1 Name & C.A.S. Number (Check all that apply) ~Fire Hazard r:J Sudden Release D Reactivity ~Immediate ~elaYed Component II 2 Name & C.A.S. Number of Pressure Health Health Component II 3 Name & 'C.A.S. Number Physical and Health Hazard C.A.S. Number component II 1 Name & C.A.S. Number (Check all that apply) 0 0 0 o Delayed Component II 2 Name & C.A.S. Number D Fire Hazard Sudden Release Reactivity Immediate of Pressure Health Health Component II 3 Name & C.A.S. Number Physical and Health Hazard C.A.S. Number Component 1/ 1 Name & C.A.S. Number (Check all that apply) 0 0. Reactivity 0 Immediate 0 Component /I 2 Name & C.A.S. Number CI Fire Hazard Sudden Release Delayed of Pressure Health Health Component II 3 Name & C.A.S. Number EMERGENCY CONTACTS #1 Component II 1 Name & C.A.S. Number Component /I 2 Name & C.A.S. Number Component It 3 Name & C.A.S. Number #2 Name Title 24 Hr Phone Physical and Health Hazard C.A.S. Number (Check all that apply) o Fire Hazard 0 Sudden Release 0 Reactivity C1 Immediate 0 Delayed of Pressure Health Health Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I certify under peanlty of law that I haver personally examined and am familiar with the information submitted individuals responsible for obtaining the information. I believe that the submitted information is true, ace (2J/lß./I NAME AND OFFICIAL TITLE OF OWNER/OPERM'OR OR OWNE1VOPBRATOR'S AUTHORIZED REPRESENTATIVE q -<97-or I DATE SIGNED Ir I .. - I ¡ " ' BAKERSFIELD CITY FIRE DEPARTMENT ~ HAZARDOUS MATERIALS DIVISION »\'ÎQ ~ 1715 ,CHESTER A.v.E.~ BAKERSFIELD, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: {!Pc;tL.M rTj;¿ç¿ C/ (f)T 3563 1. To avoid further action. return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUS1NESS NAME: ~..sy '6éE -:/;k ( LOCATION: 3.'S(ô¿¡ STr AlE (ê.Ç) MAILING ADDRESS: <;;-. ~ CITY: STATE: _ ZIP: 0"lfI PHONE: 3.77 - ìð (I DUN & BRADSTREET NUMBER: SIC CODE: PRIMARY ACTIVITY: 1)lLY Gu:.~^' ()L. OWNER: 11- <2.AJ A'ß A L ( S.¡.£Ar2.. ßAT, MAILING ADDRESS: ð4'25" S'tvA¡2.T c..r- ~ 1s ( ( SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE l. RA.~A.ß A. Sf(A~ßA TI ~6fl- 3. c; 7-70 I( 6 2:2.. - (( 0 '7...- 2. M (ILl AM 5 f-{A({fSA T I vJ \ r.:£,. 3 C, 7 - 70 I ( ( ( ,1. , ' , ' Bakersfield Fire Dept. eazardous Materials Division e HAZARDOUS MATERIALS MANAGEMENT PLAN ~ <I. or , SECTION 3: TRAINING: NUMBER OF EMPLOYEES: 2- MATERIAL SAFETY DATA SHEETS ON FILE,: f,J $AeJL &Ç S~ BRIEF SUMMARY OF TRAINING PROGRAM:, ~fl()YG£$ JJ.æb GnJ(7J IN(llt!L,. ~ AAlNUt1t-- TTVlr..v,"'"'G- ,AJ µ,ß·:ZJYlJ)s o-t=. ?B2L¡..tl6¡Q.CSì14Yl-&.J~ ~ ~6J0t-/ DI'\JLCyJ 11-{-E DL-JN G t"è.- C>P£IèA'T£ S -nf£ CLCA'\J£Q.. (TS,€<.,1= SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE IICAUFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, SUT THE QUANTfTlES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTmES. OTHER (SPECIFY RE.A.SON) SECTION 5: CERTIFICATION: I. CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILLSE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFEïY CODE" ON HAZARDOUS MATERIALS (DlV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THÁT INACCU IE INFORMATtONCONSTlTUTES PERJURY. TITLE DATE ') .~ .'", . ....- ..-...... Bakersfi~ld Fire Dept. 'e Hazardous Materials Division e ,¡ HAZARDOUS. MATERIALS MANAGEMENT PLAN Facility Unit Name: ~JSV g E:E- fi: I SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: "fW"c AJt>rJ é <;. ,¡J ~ {O(~E ( DN'tE I ~ FrltsrJT / (}I\fé r.J ß.~L ~. ßE u~GD ,u--J CAS~ ðF ~œc£.....JC. ,./ B. EMPLOYEE NOTIFICATION AND EVACUATION: WoaJ'> 6f-:: ~ l <; So r-+:, <:'IÇ/V r îD æDISR.... GfGfê..JlorJ ~ Ov'l oC:: DL Db '11t£òu&lJ. G«.c>I\Yf D::b12.. C. PUBLIC EV ACUAT¡ON: ?ußUc... (~ ¡.SC>T AUÞv.J0 ArJt.!wµGlé- &cGP'( R'Gc.GPpù.J A!<-GA' (~8)'/~,:rEL.Y It?\fÇ,,>t '~A1Î ùot>lè-(' D. EMERGENCY MEDICAL PLAN: ¡vLL--'<..LP , ~~0G:::.5 r ~ {It '\0..l....- 1 ;:o,~ " e Bakersfield Fire Dept. e Hazardous Materials Division '-- " "..... .. i . HAZARDO'US MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: DI2Y t:....L~,,.J6- !MLsÓC(.J,vJé (s ~Ec...C= -CorJTD.IvV6f)- B. RELEASE'CONTAINMENT AND/OR M!NIMIZATlON: @uull1'GfL f'é::fZ...f 0 Þ;c AL-L Y ~(;:;PI-"1ð1J&:; Ç. W4ST 6' <hIWM. fL1AC-4,t\JE INiO S- - GA' ~ _ '~()C.(I(~" 5bLV'G--r) ,.- ¿fO (S I<C-P-í ON -r(~HT W~ i I ~ 'f ~ -.....u A S--r£ I 5 I'" .$"Tò Iù1.G E: . C. CLEAN-UP PROCEDURES: ~ T6 !f6'2..c....? Ç\ <- TEnS gCwl. ~ /I /f' ogY AA'i) D (SfòS;.1L I A LICC-NC.GJ), +J,A,-Z.A/lDtJJ~ W-A~~TE 4.AU1.,e:!~, SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ßt;H,"';O CU,Alé66 ~'rnVW,Jr A'r fí(:cAr¿ c»: CCN~ ELECTRICAL: Å-"t"- ~ 0.1= ~ WATER: I~I) [2.C-AtL E)cT't::f2(ol2.. ð-l= ßb~& SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABlllTY: A. PRIVATE FIRE PROTECTION: IfSL.O& ¡~ SP(2.u·.lKccft6!) l ~R.G &.. T< fVE,-\Jf s; U8't- f/'"1ØutúTf.D Dr-1 ~C"""l-\dL c.J AU- 8. WATER AVAILA81LlTY (FIRE HYDRANT): .k\ PLMJ"Z.. f ~T'Né öa- 4 LSõ f?£ö-I".¡o.)D CD.....P.~6x. ". '- ----'\í ' _"'"'"111:7' l ,) Business Name BAKERS~LD CITY FIRE DEP,ðATMENT HAZA'1fDOUS MATERIALS INVENì'5RY gJS V ß>C£ ::t± I Page_of_ Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New47) Addition [ ) Revision [ ) Deletion [ ) Check if chemical is a NON TRADE SECRET [ ) TRADE SECRET I ) 2) Common Name: ?EQ..c..~e.~~-JëS 3) DOT # (optional) Chemical Name: AHM [ ) CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ) Reactive [ J Sudden Release of Pressure [ ) Immediate Health (Acute) [ ) Delayed Health (Chronic) [<'1 5) WASTE CLASSIFICATION (3·digit code from DHS Form 8022) USE CODE 1$ 6) PHYSICAL STATE Solid [ ) Uquid [d> Gas [ ) Pure [ ] Mixture ~ Waste [ ) Radioactive [ ) CHfCKALL THAT APPt.Y 7) AMOUNT AND TIME AT FACiliTY UNITS OF MEASURE 8) STORAGE CODES ¡4- Maximum Daily Amount: 1t9ð 100 [ ) gal rrJ ft3 [ J a) Container: Average Daily Amount: C¡O curies [ ) b) Pressure: I Annual Amount: "2-0 c) Temperature: <! Largest Size Container: toO # Days On Site ~G:.. <" Circle Which Months: All Year, J, F, M, A, M. J, J, A, S, 0, N, D 9) MIXTURE: Ust rp COMPONENT CAS # %WT AHM the three most hazardous 1) CJ2..CJ.(L0f2...~&Je: [ ) chemical components or any AHM components 2) [ ) 3) [ ) 10) Location l~ DRV c..L~rJINc..... fVi.fJ£.{4 >'If G A'I 6èf:;¡AfL t>F- ~T~E CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ) Addition [ ) Revision [ ) Deletion [ ) Check if chemical is a NON TRADE SECRET [ ) TRADE SECRET [ ) 2) Common Name: WA-~(é ?Grl...L4~ 3) DOT # (optional) Chemical Name: AHM [ J CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ) Reactive [ J Sudden Release'of Pressure [ J Immediate Health (Acute) [ ) Delayed Health (Chronic) tJ 5) WASTE CLASSIFICATION 2.. 5 '- (3-digit code from DHS Form 8022) USE CODE 40 6) PHYSICAL STATE Solid [ ) Liquid [ ) Gas [ J Pure [ ) Mixture [ ) Waste .téa Radioactive [ ) CHECK All. THAT APPt.Y 7) AMOUNT AND TIME AT FACiliTY ID UNITS OF MEASURE 8) STORAGE CODES I~ Maximum Daily Amount: 100 [ J gal W ft3 [ ) a) Container: Average Daily Amount: ç curies [ ) b) Pressure: ( Annual Amount: '2-0 c) Temperature: 4- Largest Size Container: S- # Days On Site 'J.t. Š Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) lJ..ÞO<~-rE P C-l2-U{¿of.è.C~L. ~ [ ) chemical components or any AHM components 2) ,. [ ) 3) [ J 10) Location 86~rJD ()a..~ - c.(c-4.¡VrA.lG- f'l-'tALµ'.,,[£ ,.rtify Und~ of ~w, .,." "",. ¡.~'O/ ~ned ~. em ,emmw wåh th. m"mar;on 'ub""""" on this and ." .ttaohed .ooum.nts. I fJelieve the SUbm~in~ I ~S ACU~ J ._...,../ete. PRINT Name & II T ny Representative Signature Date 9ø.."t>er3Q, 19¡n REGlCN V LEPC 9TNt4OAAD FCfU,. , \') ~-- ~ BAKERS~LD CITY FIRE DEPJWTMENT HAZARDOUS MATERIALS INVENTORY Page_of_ Address " I I Business Name CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: WA'>TE F(L..~S 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid ~ Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] CHECX N..l. THAT APPlY 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES b Maximum Daily Amount: [0 Ibs {!ç1 gal [ ] ft3 [ ] a) Container: Average Daily Amount: to curies [ ] b) Pressure: , Annual Amount: (0 c) Temperature: t1.. Largest Size'Container: # Days On Site 3~S-' Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: Ust f='( L'TC-R.. COMPONENT CAS # %WT AHM the three most hazardous 1) ~";I [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] CHECK ALl. THAT APPtY 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: Ibs [ ] gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: Ust COMPONENT CAS # %WT AHM the three most hazardous 1) [ ] chemical components or ··r· any AHM components . 2) [ ] 3) [ ] 10) Location certify unaer penalty of law, that I have personally exammea ana am familiar with the mfomation submlttea on this ana all attachea aocuments. I belt eve the , \ submitted information is true, accurate, and complete. PRINT Name & Title of Authorized Company Representative Signature Date Seøt""bDr3Q1~ REGIOIIY LEPCSTANDMCFæM