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Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This oermlt Is Issued for the following:
~ Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002136
B AND B PRINTING
LOCATION:
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Issued by:
CA
93313
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Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SERVICES'
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date:
AlJG 1 S
Issue Date
. June 30, 2003
-~ -`~`' ~ Prevention Services
UNIFIED PROGRAM LNSPECTION CHECKLIST a E R S F , 9ooTruxtun Ave., suite 210
FIRE Bakersfield, CE193301
SECTION 1: Business Plan and Inventory. Program gtarM r Tel:: (661) 326-3979
- Fax: (661).872-2171- -
FACILITY NAME - ~ ON- ATE
INSPE TI INSPECTION TIME
j~ n L
ADDRESS PHONE NO. NO OF EMPLOYEES
FACILITY CONTACT BUSINESS ID NUMBER -
Qdlvc~~' SN>'1"G1 15-021-CJIS-C)21-~ 00
~--.
Section 1: Business Plan and Inventory Program
^ ROUTINE `~ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ .RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON-HAND -
^ - BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS ~'N~r~ /~ ~~
/~
~.[] ^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^
VERIFICATION OF MSDS AVAILABILITY p
~J, -} y
lJ~. a ~-- 1`1 S DS ~ a.- G i..e.~f ~s
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY.PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION (~ w0 a-~ ~~~~1~ ~ Ca /~ ~ ~~
^ SITE DIAGRAM ADEQUATE & ON HAND ~.../-~ rp
{~ i /' w' r v ~ ~ / r
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN: ~d5{`~' Sb~~~^^~
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
G ~~~~ -~
Inspector (Please Print) Fire Prevention / 1s' In /Shift of Site/Station #
AYES ^ NO'
)3~ ~
- - White-Prevention Services- Yellow-Station Copy Pink-Business Copy FD2155 (Rev. 09/05
~4`'`- -'tc~'`~ CITY OF BAKERSFIELD FIRE DEPARTMENT
~~ ~~ OFFICE OF ENVIRONMENTAL SERVICES
~° .y UNIFIED PROGRAM INSPECTION CHECKLIST
'k•E'~gti ~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301
FACILITY NAME ~: ~ ~'~~ NTi N 6 INSPECTION DATE ~ [ ~' I
Section 4: Hazardous Waste Generator Program EPA ID # ~~ ~- ~~~ ~-~ `~ ° 9 Z
^ Routine ~ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number C"%~ ~ ~c~ Z-~ji Q ~ °l ~_
Authorized for waste treatment and/or storage
Reported release, fire, or explosion within 15 days of occurrence
Established or maintains a contingency plan and training
Hazardous waste accumulation time frames
Containers in good condition and not leaking
Containers are compatible with tote hazardous waste
Containers are kept closed when not in use
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line ~ ,y
Secondary containment provided
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste N /~
Proper management of lead acid batteries including labels f11
Proper management of used oil filters 1~1 ~
Transports hazazdous waste with completed manifest
Sends manifest copies to DTSC ~ r-g a imp a ~
Retains manifests for 3 years },~,~~
Retains hazazdous waste analysis for 3 years ~ ~,~~. ~ `~
Retains copies of used oil receipts for 3 years N ~
Determines if waste is restricted from land disposal
~=~,ompuance v=vto[aaon
Inspector: ~ ~ ~~--~
Office of Environmental Services (661) 326-3979
White -Env. Svcs.
Pink -Business Copy
Business Site Responsible Party
~~-~lo
B & B PRINTING ~SiteID: 015-021-002136
Manager ROBERT F SMITH
Location: 4300 STINE RD 607
City BAKERSFIELD
BusPhone: (661) 834-1235
Map 123 CommHaz Moderate
Grid: 15D FacUnits: °1 AOV:
CommCode: BFD STA 13
EPA Numb: CAL000249092
SIC Code:
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
ROBERT F SMITH / OWNER /
Business Phone: (661) 834-1235x Business Phone: ( ) - x
24-Hour Phone (661) 831-4930x 24-Hour Phone ( ) - x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire DelHlth
Contact ROBERT F SMITH Phone: (661) 834-1235x
MailAddr: 4300 STINE RD 607 State: CA
City BAKERSFIELD Zip 93313-2352
Owner ROBERT F SMITH Phone: (661) 834-1235x
Address 4300 STINE RD 607 State: CA
City BAKERSFIELD Zip 93313-2352 ,
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG H - HAZ WASTE GEN EfV~`~ MA'Y
11! ~
f v' ~ ~ 4oQ~
U ~
I yIII
used on my inquiry of those fncii,~iclua;5
responsibie for obt
i
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a
n
ng the information, I Certify
un er penalty of ladv that f t
•
so;~dlly
,ave pe±
a fined and am familiar ~roith the information
sub fitted and believe the inf
ormation is true,
ccu te, and c mplet~.
Signature """' - p
' ~ ~`
ate
-1- 05/21/2007
F B & B PRINTING SiteID: 015-021-002136 ~ I
~ Hazmat Inventory By Facility Unit ~• 'i
~ MCP+DailyMax Order Fixed Containers at Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
WASTE SOLVENT F DH L 15.00 GAL Mod
-2- 05/21/2007
-3- 05/21/2007
F B & B PRINTING
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
WASTE SOLVENT
Location within this Facility Unit
E WALL PRINT SHOP
STATE TYPE
Liquid ~aste
SiteID: 015-021-002136 ~
Facility Unit: Fixed Containers at Site ~
Days On Site
365
Map: Grid:
CAS#
= PRESSURE TEMPERATURE CONTAINER TYPE _
Ambient ~ Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
30.00 GAL 15.00 GAL 15.00 GAL
r~~r~xliuu~ uui~iruiv~iv'r~
~Wt. RS CAS#
100.00 Cleaning Solvent No 8030306
riAGKK1J HSS~S~1~1r;1V'1'S
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Mod
-4- 05/21/2007
F B & B PRINTING SiteID: 015-021-002136 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 04/06/2007 ~
911
Employee Notif./Evacuation 04/06/2007
VERBAL/EVACUATION OUT FRONT OR BACK DOORS
Public Notif./Evacuation ~ 04/06/2007
VERBAL/EVACUATION OUT FRONT DOOR
Emergency Medical Plan 04/06/2007.
911, AMBULANCE, HOSPITAL
-5- 05/21/2007
F B & B PRINTING SiteID: 015-021-002136 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 04/06/2007 ~
SECONDARY CONTAINMENT
Release Containment 04/06/2007
SECONDARY CONTAINMENT
Clean Up 04/06/2007
RAGS
v~iici iccwuiuC tit,l.,lVdl.lVil
-6- 05/21/2007
F B & B PRINTING SiteID: 015-021-002136 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
.7~JCC:1cl1 nd'GdIUS
Utility Shut-Offs
GAS: E SIDE OF BLDG
ELECTRICAL: PANEL INSIDE SHOP
WATER: E SIDE OF BLDG
04/06/2007
Fire Protec./Avail. Water
FIRE EXTINGUISHERS
04/06/2007
DU11Ullll~. VC:L U~Jd11C: ~/ LCVC1
-7- 05/21/2007
F B & B PRINTING SiteID: 015-021-002136 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 04/06/2007 ~
BRIEF SUMMARY OF TRAINING PROGRAM: IN-HOUSE TRAINING
Y dt~. C G
RClll lV1 r u~uic U.7C
I1C1U 1V1. rUI.UIC U.7~C
-8-
05/21/2007
PRINT G
COMPANY
Sheila R. S.rith
,Owner V
(661) 834-1235
(661) 834-9815 Fax
e-mail: Smith2001@earthlink.net
. 4300 Stine Road, Suite 607
Bakersfield, CA 93313-2352
(Located in the Presidio Complex)
"Quality & Service is Our Business"
/
PRINT G
COMPANY
Robert F. S]'Y'ith
Owner 0
(661) 834-1235
(661) 834-9815 Fax
e-mail: Smith2001@earthlink.net
4300 Stine Road, Suite 607
Bakersfield. CA 93313-2352
(Located in the Presidio Complex)
"Quality & Service is Our Business"
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CITY OF BAKERSFIELD FIRE MENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
F ACILITY NAME~ ß f'l-tlv'nAf&.
ADDRESS3~C)C Sn~ (2.D ~,~,
F ACILITY CONTACT ~ev- ~~'f 4"\4-
INSPECTION TIME
INSPECTION DATE
PHONE NO.
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
Section 1:
Business Plan and Inventory Program
~ Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION C V COMMENTS
Appropriate penn it on hand /VC-c.J PC~"", I r 10 ~G 15$U'6C)
Business plan contact infonnation accurate F'~kSG ~f'LGrc;: ~ 'R~
Visible address (~I-fC""'¡ ((€c./I) II\J ~ ç .&-W. f(.., )
Correct occupancy
Verification of inventory materials
,
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand Pt~ç ~c..C-rr: f:( ¡<:.é1 V(l¡\./
C=Compliance
V=Violation
Any hazardous waste on site?: ~ ~es 0' No
Explain: ~ Œ ~C)L...J'GV í C"1)( C-fL
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
~~l?ðwvH/
Business Site Responsible Party
uJ7 N'CS
Inspector:
Questions regarding this inspection? Please call us at (661) 326-3979
e
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
Section 4:
Hazardous Waste Generator Program
INSPECTION DATE tI1 ( 7 ( Oú
EP A ID #
FACILITY NAMEß ~ ß ?<Zu-fT7,J&
S-- Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Hazardous waste detennination has been made
EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #)
Authorized for waste treatment and/or storage
Reported release, fire, or explosion within 15 days of occurrence
Established or maintains a contingency plan and training
Hazardous waste accumulation time frames
Containers in good condition and not leaking
Containers are compatible with the hazardous waste
Containers are kept closed when not in use
Weekly inspection of storage area
Ignitable/reactive waste located at least 50 feet from property line
Secondary containment provided V ft~ ('/2ðVIf)f3- 'fTf2ð.-~ 67
Conducts daily inspection of tanks
Used oil not contaminated with other hazardous waste
Proper management of lead acid batteries including labels
Proper management of used oil filters
Transports hazardous waste with completed manifest
Sends manifest copies to DTSC
Retains manifests for 3 years
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years
Detennines if waste is restricted ftom land disposal
C=Compliance
V=Violation
¡I I I _ ^-::::-<
Inspector: V\.)"" C /
Office of Environmental Services (661) 326-3979
White - Env. Svcs.
JidÅ/ xkd
Business Site Responsible Party
Pink - Business Copy
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
.. CITY OF BAKERSFIELia
OFI'ttE OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
CHEMICAL LOCATION
200
(one form per material per building or area)
Page 01
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''':;/~J~I;'f:ACILrrt INfØRMA 1'ION¿!>~..^,j~,,~:~' :,
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2011
o Yes 0 No 202
204
CHEMICAL NAME
W~re
~Ç'd
, - t' x. c.t<
o Yes 0 No 206
It Subjeà to EPCRA, refer to instructions
207
o Yes 0 No 208
COMMON NAME
CAS #
209
i FIRE CODE HAZARD ClASSES (Complete if requested by locaf fire chief)
210
TYPE
o P PURE
o m MIXTURE o w WASTE 211 RADIOACTIVE DYes ONo 212 CURIES
o I LIQUID OgGAS 214 LARGEST CONTAINER '2.0
o 2 REACTIVE o 3 PRESSURE RELEASE o 4 ACUTE HEALTH 05 CHRONIC HEALTH
213
PHYSICAL STATE
o s SOLID
215
FED HAZARD CATEGORIES
(Check all that apply)
ANNUAL WASTE
AMOUNT
01 FIRE
216
217
I'D
218 AVERAGE
DAILY AMOUNT
ç-
219 STATE WASTE CODE 220
UNITS·
GAL OdCUFT
. If EHS, amount must be in Ibs.
~PlASTICINONMETALLlC DRUM
Of CAN
o 9 CARBOY
o h SILO
o Ib LBS
o In TONS
221
DAYS ON SITE
222
STORAGE CONTAINER
(Check all thaI appty)
o a ABOVEGROUND TANK
o b UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
o i FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o P TANK WAGON
o q RAIL CAR
o r OTHER
223
STORAGE PRESSURE
o aa ABOVE AMBIENT
o ba 8ELOW AMBIENT
224
STORAGE TEMPERATURE
o Yes 0 No 228
2 i 230 231 DYes 0 No 232 233
3 234 235 DYes 0 No 236 237
4 238 239 o Yes 0 No 240 241
5 242 243 o Yes 0 No 244 245
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIELÇa
OFPK:E OF ENVIRONMENTAL SBVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
DADD
D REVISE
200
D DELETE
(one form per material per building or area)
Page or
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/.~~I;'FACILITY:INFORMATION "
3
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BUSINESS NAME (Same as FACILITY NAME or DBA· Doing 8us1ness As)
~ ~ ß ~Q{ ,.J'Í'-&-
CHEMICAL LOCATION IN S I Oé ot=- pf?.¡pJr '5 #ðP
2011
CHEMICAL NAME
WÆ'S T E
$'ò'LV6J"(
o Yes 0 No 202
204
o Yes 0 No 206
If Subject to EPCRA. refer to instructions
207
o Yes 0 No 208
COMMON NAME
CAS #
209
! FIRE CODE HAZARD ClASSES (Complete if requested by local lite chief)
TYPE o p PURE o m MIXTURE
PHYSICAL STATE o s SOLID ~IQUID
FED HAZARD CATEGORIES ~RE o 2 REACTIVE
(Check all thaI apply)
ANNUAL WASTE 217 MAXIMUM
AMOUNT OAll Y AMOUNT
IS-
WASTE
211
RADIOACTIVE
o Yes 0 No
OgGAS
214
LARGEST CONTAINER
:sa
o 3 PRESSURE RELEASE
o 4 ACUTE HEALTH
05 CHRONIC HEALTH
218 AVERAGE
CAlLY AMOUNT
I~
OgaGAL OdCUFT
. If EHS, amount must be in Ibs.
o Ib LaS
o In TONS
UNITS·
STORAGE CONTAINER
(Check all l11al apply)
o a ABOVEGROUND TANK
o b UNDERGROUND TANK
o c TANK INSIDE 8UILDING
~ STEEL DRUM
o e PLASTlCINONMETALLlC DRUM
01 CAN
o g CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o p TANK WAGON
STORAGE PRESSURE
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
IB4..AMBIENT
STORAGE TEMPERATURE
o 88 ABOVE AMBIENT
o be BELOW AMBIENT
J2Kà AMBIENT
210
212
CURIES
213
215
216
219 STATE WASTE CODE 220 i
I
221
DAYS ON SITE
222
o q RAIL CAR
o r OTHER
223
224
o c CRYOGENIC
225
DYes 0 No 228
230 231 DYes 0 No 232 233
I 3 234 235 OYesONo 236 237
4 238 239 o Yes 0 No 240 241
5 242 243 o Yes 0 No 244 245
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd