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Home My WebLink AboutBUSINESS PLAN 10/15/2008~~ ~~~ ~~ ~~~: ra^` ~,y~~.: ~y ~~ LINCARE ,, 4300 STINE RD X603 ___ ~__ I~ ,~ , (~~ SEP 2 6 2QQ3 ~~ .~~ ~ {t~ Ir S I f Per . . ~- .' ',' -.:. . . ,.; :.-, . it·· tò ··Oper-ftte Hazardous Materials/Hazardous Waste Unified Permit ~ ~ CONDITIONS OF PERMIT ON REVERSE SIDE · Permit ID #:: 015-000..000127 LINCARE LOCATION: 4300 STINE RD 603 Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave.) 3rd Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: This permit is issued for the following: It! Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment "', Issue Date . June 30, 2003 -..-. .- -...._-.. ------ - - __~____o - -<--_. --. _.- _h_____.__ Per.u.it to Operil.te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ;:¡"ª,~ardous Materials Plan . '~[9round Storage of Hazardous Materials ... ····agement Program Waste 4300 LINCARE PERMIT ID# 015-021'()00127 LOCATION Issued by: STINE Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (80S) 326-3979 FAX (80S) 326-0576 *~ ph Huey, ffice of ental Servi es .June 30, 2000 Approved by: Expiration Date: . HMVP PLAN. lV.lAt' " t;. SITE DIAGRAM FACIL.ITY DIAGRAM 1>< Business Name: I \I ITA \A ,,?_~) Business Address: 430ð Stine.. eO Ste. ~03 fuK€.rõf'teJd Cf 933/3 For Office Use Only First In S tction: Area Mcp it inspection Station: of NORTH 0 \1 5 "~.....,,..;:=~~l!:rf.,~ 03 ~" ....~',~.~~.. ,.~I"~~~ ',."" "_.:.- , fY'I~·~·.t,,~~.:::,,~H~" · ......:.c~;C;\lT~~::;6; .' '. :.: ~ ',' .:,;:~~';./~{~~:'~ ;-\".';':::'::'- -, ~JII>p6&1lR. . .·7.... O».fqcN .; a~" ·2 ,. :/- '.~.:.:\:~:. ~~'~ WAREHOUSE . -... .-_. .~ W OFFiCe: "UW"ØI?' .< E j 0 ~ . ¡ ... v V / OlSPLAY '/ .AREA './ / -~ N ...,.,... '~ ~ _~ e ..z. ~^;. LINCARE INC ADELlNA- ~vU~2(~tJE~. Manager F~T.~ rrTVV~T r_ Location: 4300 STINE RD 603 City BAKERSFIELD CommCode: BFD STA 13 EPA Numb: SiteID: 015-021-000127 BusPhone: (661) 833-3333 Map 123 CommHaz Low Grid: 14C FaCUnits: 1 AOV: SIC Code:5169 DunnBrad:94-297-2885 Emergency ' Contact / Title ID~~ INa" Emergency Contact / Title ~rN~--~_ =;~ i~t~i-rPr- / MANAGER f ~ / ~ Business Phone: (661) 833-3333x ~u~~ Business Phone: ( ) - x 24-Hour Phone (661) 833-3333x 24-Hour Phone ( ) - x •P~ , ( 661) - - 8 ~l 1~,~5 ~ Pager Phone ( ) - x I ( u Hazmat Hazards: Fire ImmHlth DelHlth Contact ;~LE/VE JUNES Phone: (727) 530-7700x MailAddr: PO BOX 9004 State: FL City CLEARWATER Zip 33758-9004 Owner LINCARE INC Phone: (727) 530-7700x8446 Address PO BOX 9004 State: FL City CLEARWATER Zip 33758-9004 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT'D Q ~ ~° 5 2QQ7 (3asPCl on my inq~.~iry of those individuals responsiwl~ 'ror ob~~aining the information, Irertify under penalty of la~rr that ! have personally - Examined and any familiar with the information submitted and heiieve the information is true, accurate, and complete. Signature Date -1- 07/12/2007 r, "<' _- ? F LINCARE INC ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-000127 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F IH DH G 6000.00 FT3 Low -2- 07/12/2007 ? ., ~: , P -3- 07/12/2007 F LINCARE INC ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit E SIDE OF BLDG 601 STATE T TYPE PRESSURE _ Gas I Pure Above Ambient SiteID: 015-021-000127 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest C6000100rFT3 Daily6000100m FT3 I Daily3000r00e FT3 -• tu~~r~tcLVUa uuriruiv~lvla oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 r~~Hx.l~ ~aa~~~ri~iv 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low a -4- 07/12/2007 •-~ F LINCARE INC SiteID: 015-021-000127 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/28/2006 ~ CALL FIRE DEPT. CONTACT LINCARE SUPERVISOR. NOTIFY INTERNAL SAFETY DEPT. Employee Notif./Evacuation 08/28/2006 VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE SPILL. Public Notif./Evacuation 08/28/2006 VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE LEAK OR SPILL. Emergency Medical Plan 08/28/2006 EMPLOYEES INSTRUCTED TO CONTACT SUPERVISOR. GO TO MERCY MEDI CENTER. GO TO CLOSEST HOSPITAL IF SERVER PROBLEM. -5- 07/12/2007 r F LINCARE INC SiteID: 015-021-000127 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 08/28/2006 ~ CYLINDERS CHAINED OR IN HOLDING BASE. CYLINDERS PLACED IN AREA OUT OF WAY OR NORMAL FLOW OF TRAFFIC. STAFF INSERVICED ON CORRECT HANDLING PROCEDURES. Release Containment 08/28/2006 SHUT OFF OXYGEN VALVES OR PUT ON CONTINUOUS FLOW TO EMPTY CYLINDER. Clean Up 08/28/2006 AERATE PREMISES. V1.11C1 1CC.7-Vl.L1.l:C HC:L1VdL1Vil -6- 07/12/200'7 `- "., F LINCARE INC SiteID: 015-021-000127 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a~c~:lc~l na~cxLUS Utility Shut-Offs 1) GAS - OUTSIDE W WALL S CRNR 2) ELECTRICAL - OUTSIDE W WALL S CRNR 3) WATER - OUTSIDE W WALL N CRNR 4) SPECIAL - NONE 5) LOCK BOX - NO 08/28/2006 Fire Protec./Avail. Water 12/14/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. STE 603: OFFICE AREA HALL E SIDE DOOR ENTERING WHSE AND WHSE AREA E WALL BY ROLL-UP DOOR. STE 601: OFFICE AREA W SIDE WALL NEXT TO DOOR BEFORE ENTERING WHSE AND WHSE AREA W SIDE WALL NEXT TO SINKS. NEAREST FIRE HYDRANT - ACROSS ST S CRNR UNION AVE & ESPEE. Building Occupancy Level 14 EMPLOYEES 03/13/2006 -7- 07/12/2007 F LINCARE INC SiteID: 015-021-000127 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08/28/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS ON OXYGEN GIVEN TO EACH EMPLOYEE ALONG WITH INSERVICE TRAINING. rctyc L Held for Future Use iiciu i.vi ru~.utc vac -8- 07/12/2007 LINCARE INC SiteID: 015-021-000127 Manager ~~~~ ~C ~ ~~ ~J ~ ~, BusPhone: (661) 833-3333 Location: 4300 STINE RD 603- Map 123 CommHaz Low City BAKERSFIELD Grid: 14C FacUnits: 1 AOV: CommCode: BFD STA 13 SIC Code:5169 EPA Numb: DunnBrad:94-297-2885 Em rgency ~r~~, C ntact / Title ~ ~w~/0~~/ ~~-/t-~S~r Emergency Contact FRANK GURROLA / Title / SR SERVICE REP Business Phone: ((06/) g~3 3 33~ ~ Business Phone: (661) 833-3333x 24-Hour Phone ( ) ?~n-~. x 24-Hour Phone (661) 833-3333x Pager Phone ( ) S~Y~-P~c Pager Phone (661) 398-7848x Hazmat Hazards: Fire ImmHlth DelHlth Contact c _LINDA KINNER --~~_"'~ ~~ ~ --'-- "- _ _~ ~~~Phone: (727) 530-7700x8446- MailAddr: PO BOX .9004 State: FL City CLEARWATER Zip 33758-9004 Owner LINCARE INC Phone: (727) 530-7700x8446 Address PO BOX 9004 State: FL City CLEARWATER Zip 33758-9004 Period to TotalASTs: _ - Gal Prepares : - --_ = - - TotalUSTs : - = Gal Certif'd: RSs: No ParcelNo: - - - Emergency Directives: PROG A - HAZMAT ENT'a MAR ~ Ofl7' ------ ~- in ui.r o-f:-those, ind•sviduats Bayed' on my Q btaining the information, I certify --_ - - - - - - -- - - - _ - _ __--- - = responsible tar o nder penalty of law that I have personally n ti u o xamined and am familiar with the infiorma t e rue, the information is submitted and beli lete• accurate, nd omp { a te D Si ature -1- 02/02/2007 ESYS SiteID: 015-021-001137 Manager ~~-1~ ~~ « ~ /~l . ~~ S Sbh~ e.,ll u Location: 4520 STINE RD 7 City BAKERSFIELD CommCode: BFD STA 13 EPA Numb: BusPhone: (661) 833-1902 Map 123 CommHaz High Grid: 15D FacUnits: 1 AOV: SIC Code: DunnBrad:14-868-2933 Emergency Contact / Title Emergency Contact / Title FABIO M RUSSONIELL / OWNER KRIS HENSON / ~C~-iC.P ~~i~~~~~e"~- Business Phone: (661) 833-1902x101 Business Phone: (661) 833-1902x121 24-Hour Phone (661) 398-6160x 24-Hour Phone (661) 809-1340x Pager Phone (661) 809-1340x Pager Phone ( ) - x Hazmat Hazards: Fire Press. ImmHlth Contact ~LZ.~IXZ /J'1.~l~SSL'hJ]~Cv Phone: (661) 833-1902x MailAddr: 4520 STINE RD 7 State: CA City BAKERSFIELD Zip 93313 Owner FABIO M RUSSONIELLO Phone: (661) 833-1902x Address 3200 CLEARWATER DR State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~N~`'~ M~ ~ ~ ~OQ7 r~'~;~f° ^il Iil'V .^tC{!liy OI '~;`;it~it) Ii~u:SifU;1%~:~ !:: ~. . ~ , i,r^,~~. .: t'tIA trl: 1'=;I")'' '[4C: irl ii t;"~![. t!f_li~ i (:, c~~il~ ~stlt~l~,t j.3"r~aii~,: ,-. y, ~•l:?: s"f8' Jllallii ~'?'ui~l!41°.C~ v;~l;~ :i.il~ !"r':'1II4~:C' VJ';C~! 't'C;2 if"?`Ciii~"1-^.~iCii"; ,! ;.(_'.` f'E i;'ul+ Pii~? i~~:O~`i!'liilif'l ,_ tCiJG-~; i i C SI.iFJ1~ ~t ? y w ° ~ ~ ! ~w~~LtI C3. ~t~ ;.'C~ r'1~i -... r ~j ri~t 4G~~1 ~!~l~W ~ ~ 6J Ch!F -1- 01/30/2007 UNIFIED PROGRAM INSPECTION CHECKLIST; .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services ~~~~ 900 Truxtun Ave., Suite 210 ~R>rr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTION DATE _ NSPECTION TIME z~ .a ~,u. ADDRESS HONE NO. O OF EMPLOYEES O D ~ ~o S' 3~ 3 3 r °~ FACILITY CONTACT USINESS ID NUMBER 15-021- 000 l a."~ 1< ~~ o ~ A Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION V-Violation COMMENTS INS ^ APPROPRIATE PERMIT ON HAND / 6~' . ^ BUSir1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ~'' t !,/ ~~~° ~j Aa ~fi ^ 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 ^ CONTAINEHS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ~ NO ~~~~~ /_ .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 32t3-3979 L~ . ~~'~ 17iAr- e Inspector (Please Print) Fire Prevention / 1" In / Shift of SNe/Station / areas Site) ool She R y (Please Print) White -Prevention Sarviees Yetlow -Station Copy Pink -Business Copy FD2048 (Rw. 02/05) FHB ~ ~ ~~~~ ~~ ..~ STATEMENT QF ACCQUNT PAGE CITY flF BAKERSFIELD P fl BClX 2G57 BAKERSFIEt_L}: CA ~~~3fl3-2t~57 t66i} 326-3658 TCI: L I NCARE I NC C..t..soR.~ I~-cs~c_ncr~ ,fE,"~~~=~~-::~,~~~, SAFETY DEPT P Cl i~fl~ 9t~L74 CLEARWATEh, F'L 33758-d3Dt74 DATE: 2fG1 /C~5 CUSTOMER P~tt7: 3588i358t3 TYRE: ES -- ENUIRuNMENTAL SERVICES -_____-___ -__ - _.~..~,.._~.....~~.w__..~.._.~ -- -- _~.Y..~_.. ~:HARGE C}~tTE G~ESCRIPTI~l~( REF-DUMBER DUE DATE TOTAL ,4t'tl~Uts(T i/4~1/G5 BEGIC~NING BALAC~CE .OG Hh1Di?5 2/{?i!'t)5 HAZ MAT F'EE Gf~DUP 5 152. D4 SSC+{?1 2!'{)1 f~C-5 CA STATE SURCHARGE 24. ©O ANNUAL_ BILL FQR THE FISCAL YEAR 7-~ f -04 Tip 6-34-OS IF RECEIVED IN ERRUR PLEASE CALL 0661} 326-365$ CURREhdT ~3VER D flUER 6(3 AVER ~G 176. GD --I3U aD3i' AYMENT DUE: i7E~.4© TOTAL DUE : ~ i 76. 0© ~r / LINCARE INC. 19387 U.S. 19 NORTH CLEARWATER, FL 33764 TEL: 727.530.7700 ext. 8446 FAX: 727.530.0203 Linda Kintner ,Licensing Administrator City of Bakersfie] Hazmat Division PO Box 2057 Bakersfield, CA S .Dear Renewal Prop ~__~=`-~ - ---- -Enclosed= with--thi $176.00 to cover t] Lincare Inc. 4300 Stine Rd. Bakersfield, CA ~ Customer #3588 Permit ID#015-000 Please adjust your Dept., Attn: Linda __....,_.,., _ ~ Y,.w , ,...., ..._. ............. _ ~ .... , .,,.. ,,., .. Thank you, Linda Kintner Licensing Administrator 800-284-2006 Ext. 8446 727-530-0203 Fax UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME / , Al INSPECTION DATE INSPECTION TIME ---------~-~-1'-C ~-R--~---------------- _..-------- - ---------- -- ------ --------- ~~~-~6~--- -- -~~3d~------- _. .4DDRESS ~ PHONE No. ~o. of Employees FACILITYCONTAC7 ~--- -----~---~-- -- --- ------ Business ID Number- -- -- c~Tu ot. 15-021- o~sld-? Section 1: Business Plan and Inventory Pn~gram Routine ^ Combined ^ Joint Agency OMulti-Agency ^ Complaint ^ Re-inspection yC~ V lV=Vioaponnce~ OPERATION COMMENTS L_l ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY 1 -,,,J- - ~ -------------------- ----------.. _... __. U ^ VERIFICATION OF INVENTORY MATERIALS -J----------- - -------- ----------------------._ ...---~.---- _ ------- ------- --- -----..._..__.. _ - -_ _ _ _._._.. _ ..._ ..._. _._. D ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION .. _ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES ANO PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED © ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO EXPLAIN: n ~l QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66'I ~ 326-3979 ------~~.. ------__ _.~.~~y -------- ~e----- Inspector Badge No.; Business Site Responsible Party White -Environmental Services Vellow -Station Copy Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental .Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME L IN CA2~ -------------- INSPECTION DATE ~?~-I ~-~ INSPECTION TIME ~.~~-- ---- ADDRESS ~ 3 a o s-~ N ~ ~ ~ ~ ~ -- -- HO No. ~;J 93~ 33 No. of Employees _~y _ --- --- FACILITYCONTACT ~ Business ID Number 15-021- bOa~l ~ ~ r // 1N t C~ ,. Secfion 1: Business Plan.and Inventory Program ,Routine ^ Combined ~ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection ncel OPERATION C V p COMMENTS \V=Vioa on __ Crl' ^ APPROPRIATE PERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE L~ ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY '~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL IJ~ ^ VERIFICATION OF MSDS AVAILABILITYE ® ^ VERIFICATION OF HAT MAT TRAINING L`f ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - -------------- - --- -- ^ EMERGENCY PROCEDURES ADEQUATE ------- --------------------------------------- r --- - -- ---------- ---- CJ ^ CONTAINERS PROPERLY LABELED ---- ------------------ --------- -- ------------ ~^ HOUSEKEEPING ---- ---------------- --- - ^ FIRE PROTECTION - - ---------- ---------- ------------ ~^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: EXPLAIN: ^ YES l~'No QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT (661) 326-3979 -- ~ Inspector ~ --------------Badge No . White -Environmental Services Yellow -Station Copy ~ Business Site Responsible Party Pink -Business Copy ~ 3 UNIFIED PROGRAM INSPECTION CHECKLIST :~-. SECTION 1 Business Plan and Inventory Program C Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661)-326-3979 __ Section 1: Business Plan and Inventory Program ~outine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection r1 L J FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees FACILITYCONTACT Business 10 Number c L v ~ 15-021- ooa /a'7 ANY HAZARDOUS WASTE ON SITE?: OYES ^ NO EXPLA{N: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT ~66~~ 326-3979 ___L_-~~,,~.~~~s __~~.1va~--------1.~ ~~D _------------- ---- _- ----- Inspector (Please Print) Fire Prevention 1st-InlShifl of Site White -Environmental Services Yellow -Station Copy --~p,~L1.1t ulP~dc~-- B siness Site Response le Party (Please Print) rn g Pink • Business Copy · . /, ~ , LINCARE SiteID: 015-021-000127 Manager Location: 4300 STINE RD 603 City BAKERSFIELD CommCode: BAKERSFIELD STATION 13 EPA Numb: ~~"') ~'\) ~~ , BusPhone: Map : 123 Grid: 14C (661) 833-3333 CommHaz : Low FacUnits: 1 AOV: SIC Code:5169 DunnBrad:94-297-2885 Emergencv_Conta~t MICHAEL SIMMIEN Business Phone: 24-Hour Phone Pager Phone / Title / CENTER MANAGER (661) 833-3333x (661) 833 - 3333 x (661 ) 398 -7840 x Rmpra~n~v Contact FRANK GURROLA Business Phone: 24-Hour Phone Pager Phone / Title / SR 8ER REP (661) 833-3333x ( 661) 833 - 3333x ( 661) 398 - 7848x Hazmat Hazards: Fire ImmHlth DelHlth Contact : :4JNCARE SAFEl'Y DEPT. /LINDA KINI'NER MailAddr: PO BOX 9004 City CLEARWATER Owner Address City LINCARE INC PO BOX 9004 CLEARWATER Phone: (727) 530-7700x8446 State: FL Zip 33758-9004 Phone: (727, ) 530- 7700x8446 State: FL Zip 33758-9004 Period Preparer: Certif'd: ParcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: I Michael Simnien , (Type or print nama) reviewed the attached hazardous materials manage- and that it along with Do hereby certify that i have ment plan for Lincare Ir:C. (Name 01 BuaiItOSS) any corrections constitute a complete and correct man- agement pian for my facility. f~¥/D3 -1- 08/22/2003 ,. . SiteID: 015-021-000127 ì By Facility Unit ì Fixed Containers on Site ì speCHazEPA Hazards Frm I DailyMax unitlMCP F IH DH G ()OOO.OO FT3 Low . F LINCARE f= Hazmat Inventory f== MCP+DailyMax Order Hazmat Common Name... OXYGEN -2 - 08/22/2003 F LINCARE f= Inventory Item = COMMON NAME / OXYGEN . ~ SiteID: 015-021-000127 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 €' 0001 CHEMICAL NAME Location within this Facility Unit E SIDE OF BLDG STE 601 Map: Grid: CAS# 7782-44-7 STATE - TYPE Gas Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 6000.00 FT3 Daily Averane 3000.00 I. FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS HA D TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ZAR ASSESSMENTS -4- 08/22/2003 F LINCARE I f= Notif./Evacuation/Medical Agency Notification . L SiteID: 015-021-000127 9 Fast Format 9 Overall Site ì 1-'2/03/1937- 9/22/03 1. CALL FIRE DEPT. 2. CONTACT LINCARE SUPERVISOR. A. NOTIFY INTERNAL SAFETY DEPT. Employee Notif./Evacuation 0-9/1:;/1~93- 9/22/03 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE SPILL. Emergency Medical Plan 12/0,jil.'::J<:J7 9/22/03 Public Notif./Evacuation ~/1~/2~/~~~ 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE LEAK OR SPILL. 1. EMPLOYEES INSTRUCTED TO CONTACT SUPERVISOR. 2. GO TO MERCY MEDI CENTER. 3. GO TO CLOSEST HOSPITAL IF SEVERE PROBLEM (BURN). -5- 08/22/2003 ~ . e SiteID: 015-021-000127 ì Fast Format ì Overall Site ì 09/1:;/199J. 9/22/03 F LINCARE I f= Mitigation/Prevent/Abatemt Release Prevention 1. CYLINDERS CHAINED OR IN HOLDING BASE. 2. CYLINDERS PLACED IN AREA OUT OF WAY OR NORMAL FLOW OF TRAFFIC. 3. STAFF INSERVICED ON CORRECT HANDLING PROCEDURES. Release Containment 12/03/199"1· 9/22/03 1. SHUT OFF OXYGEN VALVES OR PUT ON CONTINUOUS FLOW TO EMPTY CYLINDER. Clean Up O~Ji/¡~;'3- ] 1. ~TE PREMISES. Other Resource Activation -6- 08/22/2003 F LINCARE I f= Site Emergency Factors r== Special Hazards . . SiteID: 015-021-000127 9 Fast Format 9 Overall Site 9 I Utility Shut-Offs 0~fl~/2ðO~ 9/22/03 1) GAS - OUTSIDE W WALL TOWARDS SCORNER 2) ELECTRICAL - OUTSIDE W WALL TOWARDS SCORNER 3) WATER - OUTSIDE W WALL N CORNER 4) SPECIAL - NONE 5) LOCK BOX - NO Fire Protec./Avail. Water 0~/l~/2ðð6 9/22/03 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS SUITE 1. OFFICE AREA HALL E SIDE DOOR BEFORE ENTERING WAREHOUSE. 603 2. WAREHOUSE AREA E WALL BY ROLLUP DOOR. SUITE 1. OFFICE AREA W SIDE WALL NEXT TO DOOR BEFORE ENTERING WAREHOUSE. 601 2. WAREHOUSE AREA W SIDE WALL NEXT TO SINKS. NEAREST FIRE HYDRANT - ACROSS THE ST ON THE S CORNER OF UNION AVE AND ESPEE. Building Occupancy Level -7- 08/22/2003 F LINCARE I F Training Employee Training . . SiteID: 015-021-000127 9 Fast Format 9 Overall Site 9 1z/03/199~ 9/22/03 ~ WE HAVE1~ EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS ON OXYGEN GIVEN TO EACH EMPLOYEE ALONG WITH INSERVICE TRAINING. Page 2 [ I I Held for Future Use Held for Future Use -8- 08/22/2003 LINCARE Safety Dept. SAFETY DEPARTMENT 19387 US 19 NORTH CLEARWATER, FLORIDA 33764 . LIAcARE#Jti TEL: 727, 530-7700 FAX: 727,530-0203 september 23, 2003 Bakersfield Fire Dept. Prevention Services Attn: Karen Crawford 1715 Chester Avenue Bakersfield, CA 93301 ï..~~~ ~ ~~ c¡. Dear Ms. Crawford: Enclosed with this letter please find our upjated Hazardous Materials Business Plan as requested. All revisions have been highli<jJ.hted for your convenience. This business plan is for our location listed below: Lincare Inc. 4300 Stine Rd., SteM 603 Bakersfield, CA 93313 Site ID#015-021-000127 If there are any questions regarding this information sutmitted, please contact the Center Manager, Michael Simmien, at 661-833-3333, or myself at the telephone number listed below. Sincerely, µ~ Linda Kintner Licensing Administrator 800-284-2006 Ext. 8446 727-530-0203 Fax ) I ~ - ø LINtARE~~ T~ LlNCARE INC. 19387 U,S. 19 NORTH CLEARWATER, FL 33764 TEL: 727.530.7700 ex!. 8446 FAX: 727,530,0203 Linda Kintner Licensing Administrator 01/15/03 City of Bakersfield Hazmat Division PO Box 2057 Bakersfield, CA 93303-2057 Dear Renewal Processor: Enclosed with this letter please find the Hazmat, Invoice and check #11742000 for ~_____-.--;:...-..-:-_ -_----- -~-__..:;_....._~~. \Õ-.- ~ .._____ ~_______~~_ .0- ~__ ~~_ ..- ~ _ . -0::=- _____. .-.__ _ $186.00 to cover the required fee for the Lincare location listed below: ' Lincare Inc. 4300 Stine Rd. Bakersfield, CA 93313 Customer #3588 Permit ID#015-000-000127 Please adjust your records to have our mailing address read as follows: Lincare Safety Dept., AUn: Linda Kintner, PO Box 9004, Clearwater, FL 33758-9004. Thank you, tJf:JL~ o? ~~ 1\' Qt /} Linda Kintner Licensing Administrator 800-284-2006 Ext. 8446 ,___----1n-~30-Q£Ql.F~~~-,~-----~--_-~.--.,.~,~- __, ___ ___ ____~____~-_-, .- - -------~- ' Tom' CITY OF BAKERSFIELD FIRE DEPARTMENT b~ OFFICE OF ENVIRONIVIF.NTAL SERVICES ~p UNIFIED PROGRAM INSPECTION CHECKLIST ~ ~gtii~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME !~I ~G~.~ ADDRESS 3tx~ 577 N~ Q~Q • ~ a~ FACILITY CONTACT 1Mtt ~~-",~ S t r1.~r... t ~pw) INSPECTION TIME ~ O l~ e` +.i INSPECTION DATE N o~ S ~ ZOG z- PHONE NO. ,~- 3 3 -~ '~ 3 3 3 BUSINESS ID NO. 15-21 U- OD 127 Nt1MBER OF EMPLOYEES ( S Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Multt-Agency ^ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address '~ 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 C=Compliance V=Violation Any hazardous waste on site?: Explain: Questions regarding this inspection`! Please call us at (661) 326-3979 [~ Yes 'No White -Env. Svcs. Yellow -Station Copy Pink -Business Copy Business Site Responsible Party Inspector: ~~ /~~i-~,~ 13f~ ~f ~~ ì "" \ .- ~ - -' ., LlNCARE INC. 19337 U,S. 19 NORTH SUITE 500 CLEARWATER, FLORIDA 33764 LINt/IRE~t; TEL: 727,530.7700 ex!. 446 FAX: 727.530.0203 Jennifer Wefers Licensing Administrator 01117/01 City of Bakersfield PO Box 2057 Bakersfield, CA 93303-2057 Dear City of Bakersfield, -~- ------- _..:-...--,......---~--~ -....--- ---..:...--- - Please find the enclosed Hazmat handling and inspection invoice and fee in the amount of$179.00 for the following for the following Lincare Inc location: Lincare Inc. 4300 STINE ROAD BAKERSFIELD, CA 93313 Customer #3588 Please send any future correspondence to my attention at the Lincare corporate headquarters addressed below: Jennifer Wefers, Safety Dept. Lincare Inc. P.O. Box 9004 Clearwater, FL 33758-9004 Telephone No.: 727-530-7700 Fax No. 727-530-0203 If you should have any questions, I can be reached at 727-530-7700 ext. 446. .. - LI#cIlREf£~ LlNCARE INC. 19337 U,S, 19 NORTH SUITE 500 CLEARWATER, FLORIDA 33764 TEL: 727.530,7700 ex!. 441 FAX: 727.530,0203 lincaresafetv@yahoo,com Larry Reit Licensing Administrator 12/28/99 City of Bakersfield 1501 Truxton Ave Bakersfield, CA 93301-5201 10943-000 Dear City of Bakersfield, Please find the enclosed Hazmat Management Plan for the following Lincare Inc location: 90 1082 1500 Lincare Inc. 4300 STINE ROAD BAKERSFIELD, CA 93313 Please send any future correspondence to my attention at the Lincare corporate headquarters addressed below: Larry Reit, Safety Dept. Lincare Inc. P.O. Box 9004 Clearwater, FL 33758-9004 Telephone No.: 727-530-7700 Fax No. 727-530-0203 If you should have any questions, I can be reached at 727-530-7700 ext. 441. Thank you, Larry Reit Licensing Administrator " ~ - ...... e \ e LINCARE SiteID: 215-000-000127 / / BusPhone: Map : 123 Grid: 14C (805) 833-3333 ComrnHaz : Low FacUnits: 1 AOV: Manager Location: 4300 STINE RD 603 City BAKERSFIELD / CommCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code:5169 DunnBrad:94-297-2885 Emergency Contact / Title Emergency Contact / Title ....-.. .1. .c. l:" H..l.J1V1ER / ~U.1. '"'~" CARMELLA GONZALES / RCP Business Phone: (OO~) 833 3333.h. - Business Phone: (805) 833-3333x 24-Hour Phone : (805) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImrnHlth DelHlth Contact : Phone: ( ) - x MailAddr: 4300 STINE RD 603 State: CA City : BAKERSFIELD Zip : 93313 Owner ~v~n.'ALAIRE CORP Lincare Inc Phone: U~ðS) a~~ ~~33.h. Address : 2121 U ~IFOI\NIÅ Kv~E . PO Box 9004 State.. ~ FL City : HALNU'f CREER , Clearwater Zip : 94.S9G 33758-9004 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ;,ì:Jeb \; C L~kI; S lDo h<ereby certify that I have (rWJEJ@1 LMiI'li 00Il'1O) r!9\fiewed th~ attached hoo::amou~ ma!~t1als manage- ment pian for ~ '" c.. ~e.... {- L.. and that it along with (NQIiwfl~) any COfi1"ed~@~$ oon$tôtute a complete and oorred man- agem®ßi!t pla~ f@g' fii1Y fadliiy. ~~ ! '¿,1",17 IS/gnOOIN 0. -1- 10/18/1999 '~ - .:¡ I I' e e SiteID: 215-000-000127 1 By Facility Unit 1 Fixed Containers on Site 1 specHazEPA Hazards Frm I DailyMax IUnitlMCP F LINCARE p= Hazmat Inventory f== As Designated Order Hazmat Common Name... OXYGEN F IH DH G 4500 FT3 Low -2- 10/18/1999 ,.. e e SiteID: 215-000-000127 1 Facility Unit: Fixed Containers on Site 1 F LINCARE f= Inventory Item 0001 F= COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit EAST SIDE OF BLDG SUITE 601 Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 4500.00 FT3 Daily Average 2200.00 FT3 %-Wt. - - RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -3- 10/18/1999 ~ r... e e SiteID: 215-000-000127 ì Fast Format ì Overall Site ì 12/03/1997 F LINCARE I p= Notif./Evacuation/Medical Agency Notification 1. CALL FIRE DEPT. 2. CONTACT LINCARE SUPERVISOR. A. NOTIFY INTERNAL SAFETY DEPT. Employee Notif./Evacuation 09/15/1993 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE SPILL. Public Notif./Evacuation 09/15/1993 1. VERBAL NOTIFICATION TO EVACUATE PREMISES INCASE OF SEVERE LEAK. OR SPILL. Emergency Medical Plan 12/03/1997 1. EMPLOYEES INSTRUCTED TO CONTACT SUPERVISOR. 2. GO TO MERCY MEDI CENTER. 3. GO TO CLOSEST HOSPITAL IF SERVERE PROBLEM (BURN). -4- 10/18/1999 :.4 _... e e SiteID: 215-000-000127 ì Fast Format ì Overall Site ì 09/15/1993 F LINCARE I p= Mitigation/Prevent/Abatemt Release Prevention 1. CYLINDERS CHAINED OR IN HOLDING BASE. 2. CYLINDERS PLACED IN AREA OUT OF WAY OR NORMAL FLOW OF TRAFFIC. 3. STAFF INSERVICED ON CORRECT HANDLING PROCEDURES. Release Containment 12/03/1997 1. SHUT OFF OXYGEN VALVES OR PUT ON CONTINUOUS FLOW TO EMPTY CYLINDER. Clean Up 09/15/19931 I 1. ~¡RRATE PREMISES. Other Resource Activation -5- 10/18/1999 ~ ~q e e SiteID: 215-000-000127 ~ Fast Format ~ Overall Site ~ I F LINCARE I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs 12/03/1997 1) GAS - OUTSIDE W WALL TOWARDS SCORNER 2) ELECTRICAL - OUTSIDE W WALL TOWARDS SCORNER 3) WATER - OUTSIDE W WALL NORTH CORNER 4) SPECIAL - NONE 5) LOCK BOX - NO Fire Protec./Avail. Water 12/03/1997 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS SUITE 1. OFFICE AREA HALL E SIDE DOOR BEFORE ENTERING WAREHOUSE. 603 2. WAREHOUSE AREA E WALL BY ROLLUP DOOR. SUITE 1. OFFICE AREA W SIDE WALL NEXT TO DOOR BEFORE ENTERING WAREHOUSE. 601 2. WAREHOUSE AREA W SIDE WALL NEXT TO SINKS. NEAREST FIRE HYDRANT - ACROSS THE ST ON THE S CORNER OF UNION AVE AND ESPEE. Building Occupancy Level -6- 10/18/1999 ');;. , ..r.. I I I e e SiteID: 215-000-000127 ì Fast Format ì Overall Site ì 12/03/1997 F L INCARE I F Training Employee Training WE HAVE 5 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS ON OXYGEN GIVEN TO EACH EMPLOYEE ALONG WITH INSERVICE TRAINING. r Page 2 -ReId for Futur_e_Use_ ,-I I - -. --"- Held for Future Use -7- 10/18/1999 ~ FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAJ( (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 - e October 18, 1999 Larry Reit Safety Department, Lincare, Inc. P. O. Box 9004 Clearwater, FL 33758-9004 Dear Mr. Reit: In reply to your letter dated September 27, 1999 regarding your application for 4300 Stine Road. If the application you are referring to is the Hazardous Materials Management Plan, it was never received. The last certification we have is dated November 26, 1997 signed by a Ms. Bernadette Palmer. In regards to your receipt for payment made, we do not send out receipts your cancelled check should be your receipt. However, I have enclosed a copy of your account history showing that a payment of $128.50 was received on February 10, 1999 and a copy of the current Permit to Operate that expires June 30, 2000 and should be posted at 4300 Stine Road #603. Please note that California Law requires that businesses review their business plan annually to determine if revisions are needed, and to certify that the review and necessary changes were made. To facilitate this we have enclosed a computer print-out of the plan you submitted in 1997. Please review this plan in its entirety and make any necessary revisions on the print-out. When the review and revisions are completed sign the first page of the plan and return it to our office within 30 days. If you have any questions or if we can be of further assistance please do not hesitate to call (661) 326-3979. Sincerely, Esther Duran Office of Environmental Services ,,~ 7~ de Wt'VnnV/Ao/ ..97'OP J~0P6 .r~ L/~ WIo/lAI'~Y''''' -. \ LlNCARE INC. 19337 U,S, 19 NORTH SUITE 500 CLEARWATER, FLORIDA 33764 TEL: 727,530.7700 ex!. 441 FAX: 727,530,0203 lincaresafetv@yahoo,com e ")ì ; e LINCIIREffl~ Larry Reit Licensing Administrator Bakersfield, City of P.O. Box 2057 Bakersfield, CA 93303 9/27/99 "--- ...."_-, --.-___ _ __ _____ --0__ __ .____ __ -=---__:__._ -- -~. - --_ __ _.-0::=---- ___ ~. __ -------- Dear Bakersfield, City of, On 2/4/99 an application was made for Bakersfield Hazmat Fee for Center located at 4300 STINE ROAD BAKERSFIELD, CA. To date, no certificate or receipt has been received. Please indicate the current disposition of this application as soon as possible. You may mail your written response to: Safety Department, Lincare Inc. P.O. Box 9004 Clearwater, FL 33758-9004. Thank You for Your Prompt Response, " Larry Reit Licensing Administrator , MR4""":3 Ö"I;n Customer ID . . Last statement Last invoice Current balance Pending . . . Type options, S=Display Opt Trans Date 2/10/99 2/01/99 1/15/99 1/15/99 1/15/99 1/01/99 12/01/98 11/01/98 10/01/98 . . CITY OF BAKERSFIELD 4IÞscellaneous Receivables I~iry 3588 10/01/99 0/00/00 8.50- .00 10/12/99 13:18:32 Name: LINCARE INC Addr: LARRY REIT, SAFETY DEPT POBOX 9004 CLEARWATER, FL 337589004 A ACTIVE ENVIRONMENTAL SERVICES press Enter. Combined Detail F3=Exit Code stmrn stmrn SSOOl HM005 stmrn stmrn stmrn stmrn F12=Cancel Description PAYMENT Statements Processed Statements Processed CA STATE SURCHARGE HAZ MAT HANDLING FEE Statements Processed Statements Processed Statements Processed Statements Processed Amount 128.50- .00 .00 18.50 110.00 .00 .00 .00 .00 Balance .00 128.50 128.50 128.50 110.00 .00 .00 .00 .00 * = Pending Chg Bnk G Typ Cd L 00 Y A A + .i.... , ~ LlNCARE INC. 19337 U,S. 19 NORTH SUITE 500 CLEARWATER, FLORIDA 33764 TEL: 727.530.7700 ext. 441 FAX: 727.530.0203 lincaresafetv@vahoo.com e . 0 LI¡fCARE~!f Larry Reit Licensing Administrator 2/04/99 City of Bakersfield 1501 Truxton Ave Bakersfield, CA 93301-5201 10943-000 ~, DearCity'öfBãketslielâ~--'-~ '- ----.,---,._~- - --~- - -. - ~ .- - "'" -- A _. ._ ._ Please find the enclosed Hazmat Handling fee (check # 10800024) of$128.50 for the following Lincare Inc location: 90 10 82 15 00 Lincare Inc. 4300 STINE ROAD BAKERSFIELD, CA 93313 Please send any future correspondence to my attention at the Lincare corporate headquarters addressed below: Larry Reit, Safety Dept. Lincare Inc. P.O. Box 9004 Clearwater, FL 33758-9004 Telephone No.: 727-530-7700 Fax No. : 727-530-0203 If you should have any questions, I Gan be ~eached at 727-530-7700 ext. 441. Thank you, Larry Reit Licensing Administrator ~ T" ~ e STATEMENT OF ACCOUNT 4IÞ JAN 2 8 1999 CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD, CA 93301-5201 '", / ,. 'y (805) 326-3979~ c'" ~ DATE: 1/15/99 TO: LINCARE INC LARRY REIT, SAFETY DEPT POBOX 9004 CLEARWATER, FL 33758-9004 ~ ~ " ~-:--,~'µ$.:~:,C!I!II;R ~O~ê~__~ _ ~,- -.. CtJ~f!E:-ESI 3588--~ -------------------~--------------------~--~-------------------------------- CHARGE DATE DESCRIPTION REF~NUMBER DUE DAT~' TOTAL AMOUNT ------ -------- ------------------~------ ~-~-~---~- --------, -------------- HM005 SS001 1/01/99 BEGINNING BALANCE 1/15/99 HAZ MAT HANDLING FEE E 1/15/99 CA STATE SURCHARGE .00 110. 00 18. 50 FOR QUESTIONS OR CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. -------------- -------------- -------------- -------------- CURRENT OVER 30 OVER 60 OVER 90 -------------- -------------- -------------- -------------- - 128.50=-- -,;-~~,',-". /,~ ~ - '"->.",1 _'O.~~ __~--:;;,..;.- ~~~ " -~~ -.'_~_---T .. DUE DATE: 2/15/99 PAYMENT DUE: TOT AL DUE: 128. 50 $128. 50 ". ...,. e e LIIVC~l!:qg~ June 24, 1998 City of Bakersfield P.O. Box 2057 Bakersfield, CA 93303 Dear City of Bakersfield, Enclosed is payment (check #10693640) of $178.50 for the Hazardous Materials Handling Fee and Inspection for the following Lincare Inc locations: Lincare Inc --- ? 4300 Stine Rd # 603 Bakersfield, CA 93313 I would like to take this opportunity to request that any future renewals and correspondence be sent to my attention at the Lincare corporate headquarters addressed below: Larry Reit, Safety Dept. Lincare Inc. P.O. Box 9004 Clearwater, FL 33758-9004 Telephone No.: 813-530-7700 Fax No. : 813-530-0203 If you should have any questions, I can be reached at 813-530-7700 ext. 441. Sincerely, Larry Reit Administrative Assistant AUG 7.1998 Gp .~. e 8T A TEI"fENT OF ACCOLJNT e .. CITY OF BAKERSFIELD i5üi TRUXTUN AVE BAKERSFIELD, CA 933üi-52üi ( BO~n326~3~7~ / , " '-".:* . / i < ~ ,> TO: LINCARE 4300 STINE RDb03 BAKERSFIELD, ,Ç~ 93313 , ,,..c' DATE: 6/01/98 CUSTOMER NO: ,<3588 CUSTOMER TYPE: ESI 3588 ----------------~,-;...-,-~--....._--!-.:...._--,-~.;;....:-.-..................------------':--.----....;..------------------ ! ,''': "\.,-,~¡ , (" --,_' <! ~> _ "'>'_ "_ : , '_ ~ ,,' __~ ':~~:- 7... _ , . _ - - - CHARGE-'-'- U~\TE'IJÈ;;SC:RW:TTON"""'"' ,<0 , ",~:~~~~'-cE:f;:7\fUMBER;DUE, DA:fr--TÕTAL AMO-UNT-'- ______ ________ .....___.__..-:~__.;.;....;...::....-__......:......._;:..:,.....__..:.....;...'....;, ":"'_":",;,~",;,_.:o..-___ ______~_ ______________ -, '! ¡', ' . , ~ " :: ;, , M, ~ d ~. HM005 HM017 88001 5/01./98 6/01/98 B~GINNrMG BALANCE HAZ MAT'HANDL¡NG fEE E LJA7' MAT....Nr.¡¡ 111.1 l"'op-cCTTON J t, .f.. \' J J M ."tvron.... f~\oiJ ~. .I. J CA STATE'8URCHARGE .00 11 O. 00 50. 00 18. 50 6/01/98 6/01/98 , '10,-/0 . ~~ ' \.5" fJ! t f ~ W{Jß¡~ " , FOR GUESTfdNS-O~ CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. -------------- -------------- -------------- -------------- CURRENT OVER 30 OVER 60 OVER 90 -------------- -------------- -------------- -------------- 178.50 DUE DATE: 7/01/98 PAYMENT DUE: TOT AL DUE: 178.50 $178.50 ,- VITALAIRE LINCARE WEST -- - - -.. -. - .--..----'-.- .. ...~-.__.. -..,--..-- ~001 11/26/97 WED 11:55 FAX -.... .....;"; -.- ..-- ---..- .- LINCARE BAKERSFIELD 'f!'EST 4300 Stine Road, Suite 603, Bal'ersfiel~ ('''A 93313 FAX Date: Nurnber oj" 1... 10: -Wk}4-ui?~ ¡'ì."",: LlNCARE BAKE'RSFlh'LD WEST Pllone: Ji'ax phone: dc: l'hone: Fn pllonø: 805-833..3333 805..s39·o3334 lUiJIIAUB: o Urgent o Føl'yourlrwiøw 0 ReplyASAP [I Please comment ~o\( ~Ð"'- 1 Jf f:~ f(.f, EVE ~14 LftztR. \' " 11/26/97 WED 11:55 FAX 141002 ARE CHIEF MICHAEl. R. ICillV ~MIHIS1RAtIVE SEtVlCES 2101 "H- street Bakel1field, CA 93301 (80S) 326-3941 FAX (805) 395-1349 SUPPR&$SION SEIt1'ICES 210\ "W SlTeet Bakemleld. CA 93301 (80S) J2Q03941 FAX(ao5)J95-1349 PQMH110,. $EIMCES 1715 Chesler Ave. BakersfJØla, CA 93301 (805) 3~3951 FAX (805) 32bœ76 ENVlI!O'MENTAL S~ICE$ 1715 Che.srer Ave. Bakersfteld. CA 93301 (805) 32lÑ979 FAX (805) 32600576 lRAl,ING DMSION ~2 V\c1Or street Bckersrleld. CA 9330S (805) 3~7 FAX (81)5) 399-5763 VITALAIRE LINCARE WEST ~ e D ~ ~. 057(t:; ----==> . - BAKERSFIELD FIRE DEPARTMENT dJJ-~ èl9s¡ qq 7 IMPORTANT DO DISCARD NOT Dear Busiøess Owner: 0ÆJ ~~é9ð1~ '/l~ þ#l- ~ 6~ ~2 California Law requires that all Businesses, which at any time during the year handle reportable quantities of hazardous materials. file a Hazardous Materials Business Plan, including inventory of hazardous materials, with the local administering agency. Your business has filed such a plan. This same regulation requires that these businesses review the business plan submitted to determine if revisions are needed, and to certüÿ to the administering agencies that the review was made and that any necessary changes were made to the plan. To facilitate this review we have enclosed a computer print-out ofthe plan you have submitted. Please review this plan in its entirety and make any necessary revisions on the print-out. When the review and revisions are completed sign the :tirst page of the plan in the appropriate space certifying that the plan is complete and correct. Return the business plan along with any revisions to this office within 30 days of receiving these forms. If you have any questions or if we can be of any assistance please do not hesitate to c.all326-3979. ~. ~~ \ I ¡q <1 ') "'-::"":;'" ~ /0. ') --¡-. - / Sincerely yours, ~ ~~~ Aa¥~-' l)Jad. ~9ò (jðH.<. ~ 9-/6:-97~ r ~ f~phE.HUey1 . . ~-I t:t-Þ- 11 ¿¡;f /U..-! W1. J1.Il ~ r ~ ,--,-Hazardous Materials Coordmator ~,,.u JI. '1~ çI~ ~aA\¿;;l 3.éJ cJa.~:. - p.ed~/'~q.~~ i..f ¿X' ,k.r;l/V-Z ~'f'~' ~ 1<r , ~ a ca..flj i w~-,~ 6..e, .~d-J' Jfi J»J a - - ~d- (a:J~~ t 1.._ ,- ~'C " ¡. j .-rW ]~ , _ ~,Ao-.9k...A W~ 11/26/97 WED 11:56 FAX VITALAIRE LINCARE WEST ~003 " . e e 1 . ¿ ,(JI1CQré:- .. ¥f .L'.A..u .A..LR:E 1- J tJ W-i- SiteID: 215-000-000127 Manager : JS~Il.J ~bE'I"t€- ÞA-LhE'rt Location: 4300 STINE RD 603 City BAKERSFIELD BusPhone: Map : 123 Grid: 14C (805) 833-3333 CommHaz : LoW' FacUnits: 1 AOV: ComrnCode: BAKERSFIELD STATION 09 EPA Numb: SIC Code:5169 DunnBrad:94-297-2885 Emergency Contact I Titl~eNíE~\ Emergency Contact I Title BERNADETTE PALMER / ,~ MANAGER CARMELLA GONZALES I RCP Business Phone: (805) 833-333 xl Business Phone: {80S} 833-3333x 24-Hour Phone : (805) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Emergency Directives: One Unified List ì All Materials at Site ì SpecHaz EPA Hazards DailyMax MCP F IH DH G 4500 FT3 Low F Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... OXYGEN !, ¥-Gtt1~~lÌft~~Et. Do helreby certify th~ U have reviewed the attached hazardous ma.~elials manage- mên~ pian for LJ,J l!~~ and tha1 it along w~lIo. (I\!t'!msoV ¡;~M) mil ;E,ny corrections constitufe a complete and correct man- aºement plan for my facility. 1 ., :L-J~ f~ ;c:na1WO "(~~1 -1- 10/28/1997 11/26/97 WED 11:56 FAX VITALAIRE LINCARE WEST @004 " e e 0001 CHEMICAL NAME SiteID: 215-000-000127 9 Facility Unit: Fixed Containers on Site ì F VITAL AIRE F Inventory Item = COMMON NAME / OXYGEN Days On Site 365 Location within this Facility Unit EAST SIDE OF BLDG SUITE 601 Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE PORT. PRESS. CYI,INDER OUNTS A: S CATION Largest Container Daily Maximum Daily Average FT3 4500.00 FT3 2200.00 FT3 AM T THl LO HAZ OUS COMPONENTS %Wt. EHS CAS # 100.00 Oxygen, Compressed No 7782447 AIm HAZARD ASS SSMENTS TSecret EHS BioHaz Radioactive/Amount BPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DR / / / Low E -2- 10/28/1997 11/26/97 WED 11:57 FAX VITALAIRE LINCARE WEST 141 005 , e e SiteID: 215-000-000127 ì Fast Format ::¡ - Overall Site ì 09/15/1993 F VITAL AIRE I ~ Notif./Evacuation/Medical ~ Agency Notification 1. CALL FIRE DEPT. L ~ a~ 2. CONTACT ~TALAIRE SUPERVISOR. A. NOTIFY INTERNAL SAFETY DEPT. Employee Notif./Evacuation 09/15/1993 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE SPILL. Public Notif./Evacuation 09/15/1993 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE LEAK OR SPILL. Emergency Medical Plan 09/15/1993 1. EMPLOYEES INSTRUCTED TO CONTACT SUPERVISOR. 2. GO TO MERCY MEDI CENTER. 3. GO TO CLOSEST HOSPITAL IF SERVERE PROBLEM (BURN) . -3- 10/28/1997 11/26/97 WED 11:57 FAX VITALAIRE LINCARE WEST 141 006 e e SiteID; 215-000-000127 9 Fast Format =¡ Overall Site ì 09/15/1993 f VITAL AlRE I p= Mitigation/Prevent/Abatemt Release Prevention 1. CYLINDERS CHAINED OR IN HOLDING BASE. 2. CYLINDERS PLACED IN AREA OUT OF WAY OR NORMAL FLOW OF TRAFFIC. 3_ STAFF INSERVICED ON CORRECT' HANDLING PROCEDURES. Release Containment 09/15/1993 1. SHUT OFF OXYGEN VALVES OR PUT ON CONTlNUOUR FLOW TO EMPTY CYLINDER. Clean Up 09/lS/l993 ] I 1. AIRRATE PREMISES. Other Resource Activation -4- 10/28/1.997 11/26/97 WED 11:57 FAX VITALAIRE LINCARE WEST 141007 ". e e SiteID: 2~5-000-000127 ì Fast Format ì Overall Site "I I F VITAL AIRE I F Site Emergency Factors ~ Special Hazards Utility Shut-Offs 1) GAS - OUTS IDE WEST WALL TOWARDS SOUTH CORNER 2} ELECTRICAL - OUTSIDE WEST WALL TOWARDS WOUTH 3} WATER - OUTSIDE WEST WALL NORTH CORNER 4} SPECIAL - NONE 5) LOCK BOX - NO 06/16/1995 CORNER Fire Protee./Avail. Water 06/16/1995 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS SUITE ~. OFFICE AREA HALL E SIDE DOOR BEFORE ENTERING WAREHOUSE. 603 2. WAREHOUSE AREA E WALL BY ROLLUP DOOR. SUITE 1. OFFICE AREA W SIDE WALL NEXT TO DOOR BEFORE ENTERING WAREHOUSE. 60~ 2. WAREHOUSE AREA W SIDE WALL NEXT TO SINKS. NEAREST FIRE HYDRANT - ACROSS THE STREET ON THE SOUTH CORNER OF UNION AVE AND ESPEE. Building Occupancy Level I -5- 10/28/1997 11/26/97 WED 11:57 FAX VITALAIRE LINCARE WEST 141 008 ,~ e e ... ." .. SiteID: 215-000-000127 ì Fast Format ï Overall Site ì 06/16/1995 f VITAL AIRE I F Training Employee Training G WE HAVE ' I EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS ON OXYGEN GIVEN TO EACH EMPLOYEE ALONG WITH INSERVICE TRAINING. Page 2 Held for Future Use I J I r r [ Held for Future Use -6- 10/28/1997 'i ~ ~ I~ -- . ~Œ£(Çœ{ãWŒ£~V 1 i 06/07/95 VITAL AIRE 215-000-000127 JUN 1 5 1995 I ~e Overall Site with 1 Fac. Unit :; General Information By ::: -'~-.-..---...........,... - Location: 4300 STINE RD 603 Map:123 Haz:2 Type: 3 City . BAKERSFIELD Grid: 14C FlU: 1 AOV: 0.0 . ~ Contact Name Title ~ Contact Name Title CARLA WEISS I GENERAL MANAGER RUTH BUSTAMANTE I RESP THERAPIST Business Phone: (805) 833-3333x Business Phone: (805) 833-3333x 24-Hour Phone · (805) 366-5189x 24-Hour Phone · (805) 399-3987x · · Pager Phone · ( ) - x Pager Phone · ( ) - x · · Administrative Data Mail Addrs: 4300 STINE RD 603 D&B Number: 94-297-2885 City: BAKERSFIELD State: CA Zip: 93313- Comm Code: 215-009 BAKERSFIELD STATION 09 SIC Code: 5169 Owner: VITALAIRE CORP Phone: (805) 833-3333 Address: 2121 N CALIFORNIA AV State: CA City: WALNUT CREEK Zip: 94596- Summary I, LA ~~r;i:~ Do hereby certify that t have reviewed the attached hazardous materials manage- ment plan for V'Tetªi'7' _and that it along with (f-'.eme C ,II1tJ$S) any corrections constitute a complete and correct man- agement plan for my facitity. Cm,QaLJJLLJ Signa.... 1.P-/2.-qs De» i l' _ 'ii; 06107/95 PIn-Ref Name/Hazards -- e VITAL AIRE 215-000-000127 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Form 02-001 OXYGEN ~ Fire, Immed H1th, Delay H1th Gas Page 2 Max Qty MCP 4500 Low FT3 "1 ~ . e e 06/07/95 VITAL AIRE 215-000-000127 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 OXYGEN . Fire, Immed Hlth, Delay Hlth Gas 4500 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 4,500 I 2,200.00 I 4,500.00 Storage r Press T Temp -:ì Location PORT. PRESS. CYLINDER Ambient Ambient/WEST SIDE END OF BLDG Sum~ ~ol ê:a.5-r :51 Oi: 0 J:" ß l.D G. - Conc l Components I~ MCP ~uide 100.0% Oxygen, Compressed I Low I 14 1 ~ '" e e 06/07/95 VITAL AIRE 215-000-000127 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification 1. CALL FIRE DEPT. 2. CONTACT VITALAIRE SUPERVISOR. A. NOTIFY INTERNAL SAFETY DEPT. <2> Employee Notif./Evacuation 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE SPILL. <3> Public Notif./Evacuation 1. VERBAL NOTIFICATION TO EVACUATE PREMISES IN CASE OF SEVERE LEAK OR SPILL. <4> Emergency Medical Plan 1. EMPLOYEES INSTRUCTED TO CONTACT SUPERVISOR. 2. GO TO MERCY MEDI CENTER. 3. GO TO CLOSEST HOSPITAL IF SERVERE PROBLEM (BURN) . ~ = e e I 06/07/95 VITAL AIRE 215-000-000127 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention 1. CYLINDERS CHAINED OR IN HOLDING BASE. 2. CYLINDERS PLACED IN AREA OUT OF WAY OR NORMAL FLOW OF TRAFFIC. 3. STAFF INSERVICED ON CORRECT HANDLING PROCEDURES. <2> Release Containment 1. SHUT OFF OXYGEN VALVES OR PUT ON CONTINUOUR FLOW TO EMPTY CYLINDER. <3> Clean Up 1. AIRRATE PREMISES. <4> Other Resource Activation 1. " e e 06/07/95 VITAL AIRE 215-000-000127 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs 1) GAS - OUTSIDE WEST WALL TOWARDS SOUTH CORNER 2) ELECTRICAL - OUTSIDE WEST WALL TOWARDS WOUTH CORNER 3) WATER - OUTSIDE WEST WALL NORTH CORNER 4) SPECIAL - NONE 5) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS SùITE 1. OFFICE AREA HALL E SIDE DOOR BEFORE ENTERING WAREHOUSE. ~o3 2. WAREHOUSE AREA E WALL BY ROLLUP DOOR. 50116' I. Of"FIC£ Ae.EA W SiDE' WAU- nexT 10 lXDr' ßO..Fo(,e2 en'reV"l~ ~0.JS.S2.' /pD I :2., u..}a..æY'ÐùSE Ä(Qú..... vJ S I 0 E. uJO.L(... ~T 'TO .$/ kJ kS NEAREST FIRE HYDRANT - ACROSS THE STREET ON THE SOUTH CORNER OF UNION AVE AND ESPEE. <4> Building Occupancy Level ~.... . ~ I e e 06/07/95 VITAL AIRE 215-000-000127 00 - Overall Site Page 7 <G> Training <1> Employee Training WE HAVE~~MPLOYEES AT THIS FACILITY. 'Cp WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MSDS ON OXYGEN GIVEN TO EACH EMPLOYEE ALONG WITH INSERVICE TRAINING. <2> Page 2 <3> Held for Future Use <4> Held for Future Use --, , '. It Bakersfield Fir~ePt. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 iJ 7 ..~~ HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. 2. 3. 4. To avoid further action, return this form withIn 30 days of receipt. ~ ~ (Ç [§~ ¡ I \\11 :~~ TYPE/PRINT ANSWERS IN ENGLISH. ... ..I" LS~ Answer the questions below for the business as a whole. SEP Be brief and concise as possible. 14 1993 By SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: VITAl-Alr"e,., ') 'H£DIUtl STO"e. lOCATION: _' LfBOO st\n€- e.d <:Gte (p 0'6 &.Ke.r6nel J Ot- ,/ MAILING ADI.JI<t~~: CITY: _BAt'-.E.f"sfìeJd STATE:~ ZIP: '7!0l3 PHONE: 1?>_3-3333_ Ç'ep:I:Þ .... DUN & BRADSTREET NUMBER: ~,-\.. 2."- '2..ß'8'.5 SIC CODE: ;PRIMARY ACTIVITY: -HEDIQQ\ 6uppl~ OWNER:' V'TAIAire.... COR-p. MAILING ADDRESS: .:t121 k1p. Ca1.i:ö...nla... (,t~ uJalt1\Jí Cree (. q'-tS~" SECTION 2: EMERGENGY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR~_P.HONE_ . '--~\O\( .Q . 1. CAr"IA uJ~'&S GQr1Qfa! rY\a.na.~ ' ,533-3333 : 5foG,-5IBQ 2. Rùth ~LJSTa(('\(lrn-e.. Re~p. Jher-llpLST 833-3333 91'1-3GJ (1 , ~ 1. ---, -, \ \ '.- " .. Bakersfield Fire Dept. e Hazardous Materials D'-ion HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: ..5 . MATERIAL SAFETY DATA SHEETS ON FILE: yes.. BRIEF SUMMARY OF TRAINING PROGRAM: HS'DS 9J'\ o}(.q..a.n .3IvQ...n 10' roc+! e.mp'-O\.<e... 0..(0"3 c: I rn6erlJI~ . "'irO-tn 1(\5 ..' 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. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO . TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: ~ I, CQl_fa.... WI.-J ~ .1) CERTIFY THAT THE ABOVE INFOR-I 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 C~APTER 6.95 SEC. 25500 ET Al.) AND THAT I INACCURATE INFORMATION CONSTITUTES PERJURY. I Cada SIGNA TURE (~Ù.lil<4-- 4-Û\.Uafl.f77an~ 1!~. TITLE 0 I OÁTE' 2. ---, ,t[,_,~ -., / ~ ...-.... '; -'.\ m' , e . Bakersfield Fire De. Hazardous Materials Division "'"'" ~ ..., " HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Vl'Tfrl AIl!feJ SECTION 6: NOTIFICATION ANDEV ACUATION PROCEDURES: A. B. AGENCY NOTIFICATION PROCEDURES: I, CfJ /I Fir¿~ 0 EfJT · .,' :z.. êð/JTflQ..:r Vtm/ fI/¡¿eJ SUperVISO eJ f7: a:. , /IIOT! F</ II(/l1VéWaJ úa. FeI9 CÚfJ . EMPLOYEE NOTIFICATION AND EVACUATION: I, V'ee.ßa.P /JOr/F/(!A-'t7Ch:} 70 (¿VCl(!(J/f~ ¡:ilðmi6£:5 ¡IV (!~ ¿;-P -:SEl/tT/l..é. ..5p/Lf..., C. PUBLIC EVACUATION: I I / &:ZI /J M"'TI r / C!.:I1-'itC/YJ 70 6VC:¿W,4-,J .. . v t...r..o At.. , v v ':::¡:::' I ~ PUP716 ES, ¡Ill (!./L5-e, of ~ . D, EMERGENCY MEDICAL PLAN: _~I .-4 ~ AT ð{1ÓJer(/¡:!i ðiJ . ~ TlJ (!lJlU'IC-(..JLJ 'r /. £l??pJex.¡éØ!> flU' . ðu1 TúI . ~ .l. t.o 7OffJ<2/lt!.Lf_ /l'I.tÞ /."J JF> ~ r 3. (Jo TO dð ~ ï rlo¥ l~~ 3, F01 ¡/e::'i ¡¡ e Bakersfield Fire Dept. e Hazardous Materials Division <.... ~ ;';,' (~ ~ ¡.. -> HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS:. ¡; - ~f../L..II()t:Jt.Æ.êj. MII/AJed o~ J1Ù J:iOu:JIN 9 ~ or=- - eL¡LI N fU.A.,S f! La.t?«J I JÙ tU.Il..Aw ð ~v- ¿rf <r ~ ¡:¥4JUt o-f' 17lå:-FIí (!) . . - ...5Ta-ff //l1~/t1:£d0'17 (!LJ~ HdALd !/NJ ¡.u.()~ B. RELEASE CONTAINMENT AND/OR MINIMIZATION: - ..5HUT 0 * ¿Jz. vQ./v~s...- ' OIL IJLrr em (]Ò/UTINz/OU.:s FLOlV TO &m. pn¡ (1.<¡/I~. C. CLEAN-UP PROCEDURES: 11/ .e.1/..tl.--IC- ¡OMm / ~ ~ SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: ~£-Fa..ClU":J V'Cl.<flLm /. Fðs:.:T Qr)d COl'Y1p!eX ELECTRICAL: Se-e- -f'a.CU...'T~ 1))~~ /6outh E;Q,Ç'ï é'o.-npJeX WATER: ùnd~12.. .s1~k:.S· .. '." SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY: A. PRIVATE FIRE PROTEÇTION: AR..L é56T1NQUlj tlL/LS /Ù a.,¿...ftuz- ~ ~' lJl1iœ- /rliA #/1"// ~ $~~/ /~ R.ot/up 0Íð:Í) - lU~ Cl-ll.;i: l:A-s:r~ --I WATER A ABILITY (FIRE HYDRANT): B. 4. fD1690 ~'i'" ~,'t. e Bakersfield ~e D~~t: e Hazardous MaterIals DIVlslon HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: . , ' lJ ' _ ~'Ii....IItJæ.R;j. (]J-I1I/AJtd Oil IN JiOC-D1 N 9 - ~ o~ - et.¡i../ N /UA.,5 f! 1t:!..ce:::J I ~ ~ ð ~T õT uJ <f Al~ ¡ø/t!IlUt 0+'" ~à.# C!.) . - .sTaR /1I1~/a£d0"r7 C!LJ~ j-ICiALd I/AlJ ¡u.1J~:::' B, RELEASE CONTAINMENT AND/OR MINIMIZATION: - ..51-1u¡ 0 -it 61- valve..S,...- O~ pUT em (JOA.JT/N¡)OU.:s FLCJ'<J ~ .{o é.n1 P7Zf (1<';/ I~ . C. CLEAN-UP PROCEDURES: ill 1(!..I!..4..IC.. ¡or~ I;§ ¿<;- SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE:-5Et -Fa..ClU ~ V 'ú~m / R!l5::T t2X1d COfY1pteX? ELECTRICAL: 56"E" f"'a.CiL.lítj VI4..~ /.soUt-h r=Q~ r"tJry")P'ºX WATER: ,)(\d~-e... ~t.-IK.s.. SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: AR.L GKTlNqOi:j ttéA..S /Ù B..L--Itu- êf7v~ &11Jf1i¿c /1££A #11-/1 cÐ 5/d..2- ~ R.Dlll.IfJ at%/) , . I.U~ ä/. í! d. ¿p...:s.r u.Þ-LL- &..f WATER A ABILITY (FIRE HYDRANT): B. 4, FD1590 o Farm and· Agriculture 181 Standard Business CITY OF BAKERSFI~LD HAZARDOUS MATERIALS INVENTORY ~: ,....,: . . ~..._. ~ ,A - r.: Page_of ~: ,\, ~ NON - TRADE SECRET BUSINESS NAME: '\JITAI AIR <õ ) ~~I~~;, ~~tJi:q; ~ ~. ~~3 PHONE #: Z e - ~ ð 33 OWNER NAME: y ITAIA\V"~ Cðr'"p ADDRESS: ..:LI::L\ IVl), (iA\\R1I'Y\ICL Blvd CITY, ZIP: '^/a Ind. (1j"....~L <!A q'ihq,,' PHONE ,#:(.5lðì C:¡-n-G.~o REFER TO INSTRUCTIONS FOR PROPER CODES ' 8 10 11 12 Cont Cont Use Location Where Code Stored in Facility NAME OF THIS"'FACILITY: YfTaJAI~- STANDARD IND. CLASS CODE: DUN AND BRADSTREET NUMBER/FEDERAL q~-~qQ-J.,ffffß ID # 1 Trans Code 'N 13 14 , by Names of Mixture/Components wt See Instructions C.A.S. Number "'1 '78"l- i./'-t - '7 Number ox qQ.f"\ t"'J'ì8 2-4~-7 Sudden Release 0 Reactivity D 'Imediate 0 Delayed of Pressure Health Health Component # 2 Name , C.A.S. NUmber Component # 3 Name , C.A.S. Number Physical and Health Hazard (Check all that apply) o Fire Hazard 0 Sudden ReleaseD of Pressure " C.A.S. Number Component ,. 1 Name:' C.A.S. Number Reactivity 0 IDDI1ediate 0 De{aYed Health Health .¡ .Component # 2 Name , C.A.S. Number Component' 3 Name & C.A.S. Number Physical and Health Hazard (Check all that apply) D Fire Hazard 0 Sudden Release 0 Reactivity 0 Immediate 0 Delayed of Pressure Health Health C.A.S. Number Component' 1 Name , C.A.S. Number ':,' Component # 2 Name , C.A.S. Number Component' 3 Name , C.A.S. Number Physical and Health Hazard C.A.S. Number (Check all that apply) o Fire Hazard 0 Sudden Release 0 Reactivity 0 Immediate 0 Delayed of Pressure Health Health Component , 1 Name , C.A.S. Number Component It 2 Name , C.A.S. Number Component It 3 Name , C.A.S. Number EMERGENCY CONTACTS #1 níE..- (J,PJ'1ØHJG. !17r,/11Q..ar¿ 933 -.3.333 #2 Title 'T' .24 Hr. Phone HorrK!- ~{¡;,..,..5t'f{' 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 in this and all attached documents and that based on my inquiry of those individuals responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete. C A lufi We-IS '.:5 (}p AJ.2.{~ ti(> f)()9 t:A. ' . NAME' AND OFFICIAL TITLE OF OWNER/OPERATOR OR OWNER/OPBRATOR' S AUTHORIZED REPRESEN':MTIVE (IIJ¡ ia L1l h10 SIGNATURE . tt £~p DATE ISI .,