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BUSINESS PLAN 10/29/2003
MODERN LABORATORY SERVICES ~ ~' 4300 STINE ROAD #209 Per I' I I', I k , , It to·' -'Dpe'r,ia:te' Hazardous Materials/Hazardous Wª.ste' Unified Permit CONDITIONS OF ,PERMIT ON REVERSE. SIDE Issued by: I i ¡ ,.,. . -'''' - . ,This permit Is Issued for the following: ItJ Hazardous Materials Plan o Underground Storage of Hazardous Materials , 0 Risk Management Program o Hazardous Waste O~1te Treatment " .' " " , ' ; , .' .... ~, .,o'!...._ '. 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: Issue Date 'June 30, 2003 · ~.. -_. -.-..-.---- ~ -,--..----.---^------------- - I' I: PerDllt Operate , , to Hazardous Materials/Hazardous W aste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ":ti,~ardous Materials Plan " ""'!tground Storage of Hazardous Materials " agement Program Waste 4300 PERMIT ID# 015-021'()00523 MODERN LABORATORY SER LOCATION Issued by: STINE Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 *~ ph Huey, ffice of ental Servi es "une 30, 2000 Approved by: Expiration Date: '~, HMMP PLAN- MAP SITE DIAGRAM I fY1 rJ f>'¿ ~Ñ FACILITY DIAGRAM L..-A ß¡J{<AjO~ Y se P-U I C€ ~ ¡ , tJC . $, t µf P.J'.) ; * ~D 5" ~ 2- ¿K.;1 I ~ Business Name: Business Address: 4- ?> 00 For Office Use Only First In Station: Inspection Station: Area Map # of NORTH 0 D 0- H '~---~'-'9r- ,~,,- - R'I î l 6 I n:>:JQ l 8 35 OH3 'tJM qLO ì,!nS U '-, 1;:1 ~\r~~I;¡\~:t' AJ.n, :J1::J,j /~\,~~ I. f " ~\, .' ~ 3:>WO ' '~....,.=~ 01.;,'(;) :>,,~o Á!J N3 IT '-....1 I I~ I ~I I~~I I ' I ~1 II 1- - I LJ I I .. , ~ c==-=J8 · ,"'"'''' ~ "'"'2 3:>N3!J3.!NOJ " I ' t I ~ \I d :, ," I 'I~ i I '- =- -t 1-i;::::~~Q':';~;'~~~;) _.__1 _J ~h OIO'-"~- r .--. / "'" ,~ æ ''''',;' f ""j'; N:3,"OM .-,-- \ \ I " I ,J., 'x' "'--.r-fj'f"", _/ j - --, '¡ ,'",,,-, ""--'. G--J ., L ~__ ,_ 1"'\ / . '. ., ., "..·L =..·....11-- ,...... - .,---, "'3~ 'vo:/( <10 .-naU./ .\v.t.:>;T\'J I w1vú'Q:) .Lf)::' ;I.EI/.)) l I l: OOII:HWJ I i I¡: r1---1 .1:--." <$1. í-\ ~r: (;;~ttN ~V\ .sl-\E~ +, F {#..~"ì lTi tJ \<.. II -~I-t I ~O~ vi> booR \ -=,:,=~:c:o=-=:=~c::''':'F'':'"'':+1: IT ?( "0 1-",,\ -f~' -- '::,,\~~'..c:c:-__~, ~t-==-,,----: . . c=... ~- ..-C~I, ' F:~nV0 T,.., "-,_JI, - - u r i lU ¡ ~ ~~~ ~~ Ñ(JI ~ Ii ~~ arr coo, - J I - I - J- 1\ P - ---' '+--T +--+--1" r-- -+ II i I. L WARE HOljlSE - D 7,D /It / ntH..A- ~ I.) ~ ~A. f~:~=~~"~,"·'-~:···"::I'-=-~' 1 ¡ n I I I (5SU i2tr D7b [(COJ c,~cPr=-:;:!~Io'=====- \ ' ,-, - J ~ J -,) ,."., C( DOR .... ~t/> ,tty- """ "'.... L.OUNGE STORAGE - þTION ,_, C EN RY FL~( -. ---- Pf\-c. l L \ TY '"þ\A& I I I "Ø v [1 rQ +-- CONFERENCE 8 :' ç:(A~ ~xr'ÑlI\"lf . Et\. +:; RAt!')'"" Itl b ~Ir e' e OFFIC OFFI CE ~ N ,;¿\6 ~AICe~F'ec.b CPr Q'J'513 N\ODERf\} LA-ß '<;.e-P.V\c..E"S, Lot: "SDO S:rUve- RO. ~ ~o'S - 2..0'} f H l\9M P pLMf MAP ~.. SITE DIAGRAM I X I FACILITY DIAGRAM Business Name: tv\Of)~RÑ \..:ftßÐ~ATf>P.Y .~tlt\l\c.~5' 'I' NC. . Business Address: tÇ. "300 S,t IJé R'>. ~ 2DS'- 2-cA For Office Use Only Inspection Station: Area Map # of NORTH 0- First In Station: ~I :: \..u ~ \ T~ LPtN.r N l \} ,1 t.. vc.-~'f \~ ~ I II ,.~ ~F'AE' ~'fÞ"A""'-S ~ <t ~ 1. L . ~ ~ fR¡r¿\¿./,,¡,. /...df"' 2 ç VI øl£- I ,,! \11 . off"" ¡.\OIJ \"( I \. ~ ( NE.W H"f\\ ~ /: ""'-~.. .y...JI . CJSITE/FACILITV D4ÞAGRAM FORM 5 t SC·\f::-. I ' 'f''r ~ 2.«; D,HE:(p /q/&Ot ~ORTH (CHECK ONE) SITE DTAGRA~! FLOOR: OF l I L;~IT:t: OF l I V /' , " / J I I .- ,,- -- """'1"- \ \ "r ...." .. \ :' 'I' \ ,...~ : ~' . .-,' '-::n, :1' '. , 1/ ""'~, (;1 t. '1 ., - ,_"'_ I (Inspector's Comments): -' __.;.,..~O"'~ 1,1__.I'1,~9I1tP(,,1 -OFFICIAL USE ONLY- - 5A - S¡TE DIAGRAM (Req~ Items) 1. Aùd¡'ess: I den t i~he principle buildings by the Street numbers. ( ~J 9. Lock (key) Box 10. MSDS Storage Box 2. Street(s), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. 11. Railroad Tracks 12. Fence or Barrier a. Wire i...·¡·' ." 1,1.' b. Masonry 3, Storm Drains, Culverts, Yard Drains ; ! ' ( ,', c. Wood ., , , 4. Droinage Canals. Ditches, Creeks, d. Gates 13. Power lines 5. Buildings a. Frame construction 14. Guard Station b. Masonry construction 15. Storage Tanks: Identify the capacity in gal. a. Above ground c. Metal construction d. Access Door b. Underground 6. Utility Controls a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Witter 18. Evacuation Area: I den ti fy the loca tion where employees will meet. 7. Fire Suppression Systems: a. Fire Hydrants b. Fire Sprinkler Connections 19. Outside Hazardous Waste Storage c. Fire Standpipe Connections . 20. Outside Hazardous Material Storage d. Water Control Valves for protection systems 21. Outside Hazardous Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored or Used (See Below) 8. Fire Department Access TYPE OF HAZARDOUS MATERIAL F Flammable E = Explosive L = Liquid R = Radiological C . Corrosive 0 . Oxidizer G = Gas P Poison W = Water Reactive T = Toxic S = Solid H Cryogenic D = Waste B . Etiological Example: Flammable Liquid· FL FACILITY DIAGRAM (Required items in addition to the above) 1- Risers for Sprinklers 8. Fire Escapes 2. Parti t ions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served froll 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Ha7.ardous Materials Use/Handling 6. Attic Al:'cess 14. Sewer Drain Inlets '-. , . I \,., ..'0. 1"... .-.:--... ~ORTH (jSITE/FACILITV D~GRAM FORM 5 1 SC·\f ::,. , ,.. -(.. I ';! , FLOOR: \ OF C~IT ~: I OF (CHECK ONE) SITE DIAGRA~ \ ¡ '\ \" \I~ \ " : ~~ 'y ~ 1l ~ ~ t '.1 '0' I ~1 >{ .., (00'5' t J ,\, ,," ,,' ¡: ",,\' \ì7ij,.'\ ///, ~ ~ " ~/ f( <~:"" "". " , /,/- ..- , -' ~~':l'--:~--:::": . \' .~.~< f ~ . ¡i; . ~l .\',f. ~.~:. . ~ ::,~ ~ ':--"" j , , .:: '~.:,""" '/'.,' ~ \~~":.::"~.~. '. (, .... f;' - po 1- \ q S't - r<. -OFFICIAL CSE ONLY- (Inspector's Comments): - 5A - SITE DIAGRAM (Req~ Items) 1. Address: Identify the principle buildings by the Street numbers. (.J --. 9. Lock (key) Box 10. MSDS Storage Box 2. Street(s), Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. 11. Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry 3, Storm Drains, Culverts, Yare! Drains c. Wood 4. Droinage Canals. Ditches, Creeks, d. Gates c. Metal construction 13, Power lines 14. Guard Station 15. Storage Tanks: Identify the capacl ty in gol. a. Above gx;ound b. Underground 16. Diking or Berm 17. Evacuation Route 5, Buildings a. Frame construction b. Masonry construction d. Access Door 6. Utility Controls a. Gas b. Eiectricity c. Wnter 18. Evacuation Area: Identify the location where employees will meet. 7. Fire Suppression Systems: a. fire Hydrants b. Fire Sprinkler Connections 19. Outside Hazardous Waste Storage c. Fire Standpipe Connections . 20. Outside Hazardous Material Storage d. Water Control Valves for protection systems 21. Outside Hazardous, Material Use/Handling e. Fire Pump 22. Type of Hazardous Material/Waste Stored or Used (See Below) 8. Fire Department Access TYPE OF HAZARDOUS MATERIAL F - Flamllable E · Explosive L . Liquid C . Corrosive 0 · Oxidizer G . Gas W a Water Reactive T · Toxic S a Solid R . Radiological P . Poison H = Cryogenic D . Waste B . Etiological Exa.ple: Flammable LiquId· FL FACILITY DIAGRAM (Required items in addition to the above) 1. Risers for Sprinklers 8. Fire Escapes 2. Partitions 9. Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served frolll 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Ha7.ardous Materials Use/Handling 6. Attic Al!cess 14. Sewer Drain Inlets ~ -¡. î . . MODERN LABORATORY SERVICES INC , / ,/ . CommCode: EPA Numb: EDWINA G HARLANDER 4300 STINE RD 209 ~ BAKERSFIELD ~~ ~ BAKERSFIELD STATION 13 4It SiteID: 015-021-000523 / BusPhone: (661) 835-~OOO Map : 123 ComrnHaz Y. Low Grid: 14C FacUnits: 1 AOV: SIC Code:8071 ~ DunnBrad:60-3~-8453 Manager : Location: City Emergency Contact ROBERT WARD Business Phone: 24-Hour Phone : Pager Phone / Title / OWNER (661) 835-9000x22 (661) 589-4279x () x Emergency Cont / Title STAN SHERRILL / VICE PRES Business Ph e: (661) 835-9000x20 24-Hour Ph ne : (661) 664-7718x Pager Pho e : () X Hazmat Hazards: React Owner Address City ROBERT WARD 1416360 FENWICK DR BAKERSFIELD Phone: (661) 835-9000x State: CA Zip 933132352 Phone: (661) 589-4279x State: CA Zip 93312 Contact : MailAddr: 4300 STINE RD 209 City BAKERSFIELD Period Preparer: Certif'd: parcelNo: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: //)éLL-fr"¿}0 Lee. (~"J< Do hereby certify that I have (Tvpe or pont name, &viewed the attached hazardous materials manage- ment pian for W\ø~ ""'" LQ~ and that it along with (Name of Business) any corrections constitute a complete and correct man- agement plan for my facility. 7~ /øher r~1 ~~, DItI' -1- 09/12/2003 , / --. '1 ¡., / e F MODERN LABORATORY SERVICES INC f= Hazmat Inventory f== MCP+DailyMax Order · SiteID: 015-021-000523 9 By Facility Unit ì Fixed Containers on Site ì R DailyMax 400.00 GAL Mod Hazmat Common Name... SpecHaz EPA Hazards \N .e> "" 4 ) 6rt(;,þ J C J~ I {1'1 't''J L ~ ab~\l-e. ;·h~k.\S \}JQ do ,^o'\- hCt~d. ~ (t."f(¡Ao.l:7Je ~'IA4"".\-'\-\~ of ' ~C\ 2þ.ý'ð()",~ ~G\1'"V';,,\.5 W-f" eYe:) ~"'..; t" .. - A r!J:I- ALf~L-1x I 1-, te- (' . »"'Z--c A~ l5~scì>e. 5' l-- jJ,¡. or- $;1-(:. A (;f- W1\~'\)í>e J [... ,t~Y" g;'l-C P, Y!>f. BØI<W\~ "'bj~ i Lj~~", $ 'l.~ '11 ~ <I Chff MCP ( S~ 5~\\ØV\.. .(I ~w.", f~) d'&..\ðf$~\.\~ C1o,....,J... d. Þ3 % f1iJ(oc;h)~"',t. 1}c.',J o· OZ5% I'h..h~\\c... A~iJ 0 . ð'f f7;b f~1r..J~w._ C'JG.~-4e (J. (S3~ ¡1ðo7G5S;\\~ C1~ñ'rk <S~ j'}\5PS IS C\('f: q~~v~ t>\. -2- :s- 0 l:rfers 100 L:~ 8 Li>re r 2 Lf ¡:;,~ 09/12/2003 I ~ Larr~ Pa~ne 706 321-9956 p.3 SAFETY DA'TA ABX ALPHALYSE 1L 31/01/00 1. Product and comJ)any identification : Product Name: ABX ALPHAL YSE 1 L Product Code: ABX Ref. lL == > 0902010 Supplier: ABX - Rue du Caducée - Pare Euromédecine - 34184 MONTPELLIER CEDEX 4 ( 33 .04.67.14.15.16 FAX ==> 33 .04.67.14.15.17 2. Composition / Component data Preparation: Chemical Nature: Potassium Cyanide 0.03 % Components involvin2 danEers or impurities: Potassium Cyanide 0.03 % 3. Identification of daneers Main dan2ers Specific risks : Hannful if inhaled. swaHowed or in contact with the skin. Extremely toxic fumes are given offwhen in contact with an acid. 4. Emereencv first aid Inhalation: Contact with skin : Contact with eves: InEestion : Breathe in fresh air deeply Rinse abundantly with soapy water Rinse abundantly with water. Artificial respiration with added oxygen as in the case of intoxication by cyanidric acid. 5. Fire - fiehtin!! Means of ro a ation: This roduct is non-inflammable 6. Necessarv steps to be taken in case ofleaka2e Individual precantions : Wear laboratory gloves and protective goggles Precautions for environmental protection : Neutralise with sodium hypochlorite solution. Cleaninf! procedure : After neutralisation, soak up but do not throw down the sink {incineration . 7. Handlin2 and stora2e Handling Tecbnical recommendations: Precautions : Advice to users : Storaee Technical recommendations: Stora2e conditions: Incomnatible snbstances : , ' Avoid còrÌtact with the eyes, skin and respiratory tract Laboratory gloves and protective goggles. Always handle in a well ventilated area. As applied to all toxic liquids Packa in materials: Store in an airtight recipient. Store at 18 to 25°C and away tram the light Avoid all contact with acids or aqueous acid environments as extremely toxic cyanide vapour may be formed. Wra in 01 eth lene or other lastic. 8. Exposure control/ Individual protection Technical recommendations: Equipment for individual protection: Eye wash, safety shower Laboratory gloves, protective goggles in case of prolonged hat:løling. In Larr~ Pa~ne ?06 321-9956 p.4 SAFETY DATA fl!HEET ABX ALPHALYSE 1L 31/01/00 9. Phvsico - chemical properties: Phvsical Status : Liquid ~: Colorless Odour : Smells of cyanide J!!!: 10 ± 0,5 Combustion point: Non-inflammable Volumetric mass : Exolosible characteristics : Solubilitv : Aqueous solution miscible with water 10. Stabilitv and Reactivitv Stability : Expiry date A void all contact with the next reagents: BASOL YSE, BASOL YSE II Substances to be avoided: A void all contact with acids or aqueous acid environments as highly toxic cyanide acid vapours may be fonned. Dan2erous products from decomnosition : Cyanide acid vapours formed upon contact with acids. 11. Toxicolollical information Acute toxicity : The danger of serious intoxication exists in case of absorption or inhalation LD 50 Potassium Cyanide: 10 mglkg (oral, rat) 12. Ecolollicallnformation Mobility : Tht: product is dangerous in water, and toxic to fish and plancton. KCN in its pure state is extremely toxic to fish LC 50 leuciscus idus "fonna orfus" : 0.07 - 1 mg/l 13. Problems concernin1! waste disposal Residual waste: Neutralise the product (see procedure as described) before discarding Soiled packuiD2 : Incineration 14. Information concernin1! transportation: International re2Ulations By land: Not classified according to E.E.C. instructions 91/325 By river : Not classified aq;q~ding to E.E.C. instructions 91/325 By air : Not classified according to E.E.C. instructions 91/325 D,,,oOoClto 9 ~Tot oloDo;'¡;od a.GOo..dme *00 I::.&.C. .nøtrv..i.onø !)1,t~:\S' 15. Re1!ulations Community ret!UlatioDs Not classified according to E.E.C. instructions 91/325 16. Rellu/ations This sheet is complementary to the user's technical notes but does not replace them. Infonnation contained herewith is based on our current knowledge of the product. at the date shown. and is correct to the best of our knowledge. Furthermore the user's attention is drawn to the dangers of using this product for anything other than its intended use. In no way does this infonnation exempt the user trom knowing about or applying all the rules relating to its funC?tion. The user must accept the sole responsability and take precautions accordingly for the use of this product. .. -- J' Larr~ Pa~ne . SAFETY DA,TA ABX BASOLYSE 5L 706 321-9956 p.9 .' 31/01/00 1. Product and company identification : Product Name: ABX BASOL YSE 5L Product Code: Réf. ABX == > 02 04 050 Supplier : ABX - Rue du Caducée - Pare Euromédecine - 34184 MONTPELLIER CEDEX 4 ( 33 .04.67.14.15.16 FAX ==> 33 .04.67.14.15.17 2. ComDosition / ComDonent data Preparation : Chemical Nature: Hydrochloric acid: 0.025 % Phtalic acid: 0.09 % Dodecylhydrogenosulfat : 0.02 % Components invoJvinf! danf!ers or impurities; The concentratration at which these products are used does not necessitate their classification accordin to E.E.C. instructions ref. 91/325 3. Identification of dangers Main dane:ers : Specific risks : Harmful if inhaled, swallowed or in contact with the skin. Irritates the eyes 4. Emergencv first aid Inhalation : Contact with skin : Contact with eves : In estion: Breathe ftesh air deeply Rinse abundantly with soapy water Rinse abundantly with water whilst holding open the eyelids C:::: 15 mins.). Rinse mouth out with water if the victim is conscious, otherwise call a doctor. This roduct is non-inflammable 6. Necessary steps to be taken in case of leaka2;e Individual' precautions: Wear gloves and protective goggles Precautioos for enviroomeotal protection: Neutra1ise product before discarding Cleaoio2 procedure : After neutralisation, absorb th eproduct and rinse the whole area with water. 7. Handlin! and stora!e Handlinf[ Technical recommeodations: Precautions : Advice to users : Avoid all ~ontact with the skin, eyes and respiratory tract Wear glov~ and protective goggles Always handle the product in a well-ventilated area As for all toxic liquids Storage Technical recommendatioos: Stora2e conditions: ' Incomoatible substaoces : Store in an airtight recipient Store at 18 to 25°C Avoid all contact with acids or aqueous acid environments as extremely toxic cyanide vapour may be formed. Wra in 01 eth lene or other lastic. Paekin materials 8. Exposure control I Individual protection Tecbnical recommeodatioDS : Eouiomeot for individual orotection : Eye wash, safety shower Laboratory gloves, goggles in case of prolonged contact > . Larr~ Pa~ne 706 321-SS56 p.10 0 bB SAFETY DATA .EET X BASOLYSE 5L 31/01/00 . 9. Phvsico - chemical properties: Physical Status: Liquid Color : Colorless Odour : Odourless l!!!: 2.7 ± 0.2 l2nitioD ooint : Non-inflammable V olumemc mass: Eml08ible characteristics : Solubilitv : Aqueous solution miscible with water 10. Stabilitv and Reactivitv Stability : Expiry date A void all contact with the next reagents: MINOL YSE - MINIL YSE - MINOL YSE LMG - MINIL YSE LMG - ALPHAL YSE Dane:erous products from decomposition : Not classified 11. Toxicological information Acute toxicity : Not classified according to E.E.C. instructions 91/325 Local effects : Not classified according to E.E.C. instructions 91/325 12. Ecolo/!Ìcal Information Mobility : Biodegradable> 90% 13. Problems concernin1! waste disposal Soiled Dackal!Înl! : Incineration 14. Information concerninfl transportation: International re1!Ulations By land: Not classified according to E.E.C. instructions 91/325 By river : Not classified according to E.E.C. instructions 91/325 By air : Not classified according to E.E.C. instructions 91/325 i I. By sea: Not classified according to E.E.C. instructions 91/325 15. Reflulations Community re2Ulations Not classified according to E.E.C. instructions 91/325 16. Reflulations This sheet is complementary to the user's technical notes but does not replace them. Information contained herewith is based on our cutTent knowledge of the product. at the date shown. and is correct to the best of our knowledge. Furthermore the user's attention is drawn to the dangers of using this product for anything other than its intended use. In no way does this information exempt the user from knowing about or applying all the rules relating to its function. The user must accept the sole responsability and take precautions accordingly for the use of this product. " . > , Larr~ Pa~ne 70S 321-9956 p.15 I SAFETY DAT HEET /ABX MI1VILYSE LMG lL 31/01/00 1. Product and company identification: Product Name: ABX MIN[L YSE LMG IL Product Code: Réf. ABX u> 0702010 Supplier: ABX - Rue du Cadueée - Pare Euromédecine - 34184 MONTPELLlER CEDEX 4 ( (33).04.67.14.15.16 FAX ==> (33).04.67.14.15.17 2. Composition / Component data Prepanttioo : Chemical Nature : Potassium Cyanide 0.03 % Components inVOMn1!: dsnt!:ers or impurities : Potassium Cyanide 0.03 % 3. Identification of dan!!ers Main dan1!:ers : Hannful if inhaled, swallowed or in contact with the skin. Specific risks : Extremely toxic gas given off upon contact with an acid 4. EmerJ!encv first aid Inhalation : Breathe fresh air deeply Contact with skin: Rinse abundantly with soapy water Contact with eyes: Rinse abundantly with water Io!!:estioo : Artificial respiration with added oxygen as in the case of intoxication by cyanide acid. 5. Fire - fi!!htinJ! Means of propa2atiOD : This product is non-inflammable 6. Necessary steps to be taken in case of leakage Individual precautions: Wear gloves and protective goggles Precautioos for eoVÍronmeotal protection: Neutralise with sodium hydrochlorite solution. CIeanin2 procedure: After neutralisation, absorb the product but do not throw down the sink (incineration). 7. Handling and storage i \i Handlin!! , Avoid all contact with the skin, eyes and respiratory tract Technical recommendations: Wear gloves and protective goggles Individual precautions: Always handle in a well-ventilated area Advice to users : Same as applies to all toxic liquids Stora!!e Technical recommendations: Store in an airtight recipient Stor3ee conditions: Store at 18 to 25°C Incompatible substances : Avoid all contact with acids or aqueous acid envirorunents as extremely toxic cyanide vapour may be fonned. Packine materials Wrap in pOl)'ethylene or other pl~tic. 8. Exposure control/ Individual protection Technical recommendations: Eye wash, safety shower Eauipment for individual protection : Laboratory gloves, protective goggles. . . ;; . Larr~ Pa~ne 706 321-9956 p. 16 I SAFETY DATA 'BEET ABX MINILYSE LMG 1L 31/01/00 9. Physico - chemical properties .- Physical Status: Liquid Color: Coloriess Odour : Smells of cyanide !!!;!: LO,O ± 0,5 Combustiou point: Non-inflammable V olumetric mu~~ : Exol05ible characteristics :. SolubiJitv : Aqueous solution miscible with water 10. Stability and Reactivity Stability : Expiry date Avoid all contact with the next reagents: BASOL YSE, BASOL YSE II Substauces to be avoided : A void all contact with acids or aqueous acid environments as highly toxic cyanide acid vapours may be formed. Dan1!:erous products from decomU05itioo : Cyanide acid vapours upon contact with acids 11. Toxicolo.!!ical information Acute toxicity : The danger of serious intoxication exists in case of absorption or inhalation LD 50 Potassium Cyanide: 10 mg/kg (oral, rat) 12. Ecolof!ical Information Acute toxicitvity : The product is dangerous in water, and toxic to fish and plancton. KCN in its pure state is extremely toxic to fish LC 50 leuc1scus idus "forma orfus" : 0.07 - I mg/l 13. Problems concerninf! waste disposal Residual waste: Neutralise the produçt (as previously described) before discarding Soiled P3cka!!int! : Incineration 14. Information concerning transportation: International r~atioQs By land: Not classified according to E.E.C. instructions 91/325 By river : Not classified acèò!ÛÙ1g to E_E.C. instructions 911325 By air : Not classified according to E.E.C. instructions 91/325 By sea : Not classified according to E.E.C. instructions 91/325 15. Regulations Community reIDÙatious Not classified according to E.E.C. instructions 91/325 16. R81!ulations This sheet is complementary to the user's technical notes but does not replace them. Information contained herewith is based on our current knowledge of the product, at the date shown, and is correct to the best of our knowledge. Furthermore the user's attention is drawn to the dangers of using this product for anything other than its intend~ use. In no way does this information exempt the user Erom knowing about or applying an the rules relating to its function. The user must accept the sole responsability and take precautions accordingly for the use of this producl . , ~~P-18-2002 ~9:22 .. . lVlA.l.ß&l.ðLJ pr1.a:.J.'I.a..... -..--.- . Haema-Lyse 9100 Diff Part # COIA490187600S0 P.01 . MODERN LABORATORY SERVICES : ABX Diagnostics 34 Bunsen Drive Irvine Ca 92618-4210 Chemtrec Emergency # - (800) 424-9300 Technical Service # - (888) 903-5001 ***~***************.******************~ ~PA~TUN(iS ************************-********* 4C}ð) lß'l~60 Health: 3 Fire: 1 Reactivity; 2 Speci6c Hazard: No Data SECTION I : PRODUCT IDENTITY ProductlTrade Name (8) : Haema-Lysc 9100 Düf Part Number: COIA490187600S0 MSDS Date: In/O'}. CAS # : N/A Category: Hematology Reagent Distributor: ABX Diagnostics Chemical Name: ßaema-Lyse 9100 Diff Formula: Not given Brief Description : Clear liquid SECTION II HAZARDOUS INGREDIENTS & EXPOSURE LIMITS CJlEMICAL NAME CAS# % LIMIT VALUES POTA.sSlUM CYANIDE DEIONIZ)1:D WATER QUATERNAR.Y AMMONIUM COMPOUNOS, ALKYBENZYLDIMETIJYL 151-50-8 <5% >90% <5% PEL 5 mg/m3 (TL vrrw A) N/A N/A SECTION III : PHYSICAL/CHEMICAL CHARACTERISTICS Boiling Point: Not Detern1Ìned Vapor Pressure (mm Hg.) : Not Determined Vapor Density (AIR;; 1) : Not Determined Solubility in Water: 100% % Volatile / Volume: 0% Appearance and Odor: Clear liquid with a strong chemical odor PH : Reference only Specific Gravity (H20'" 1) : Not Determiped ,,,./ Miscellaneous Information: No InformJtion SECTION IV : FIRE AND EXPLOSION HAZARD DATA Flash Point: 1510 F Flammable Limits: N/A Lower Explosivc Limit (LEL) : N/A t? PIN: 300308001.02 SEP-1B-2002 09:22 r~ P.02 . Haema-Lyse 9100 Diff . Part # COtA49018760050 FIRE AND EXPLOSION HAZARD DATA (cont.) , SECTION IV Upper E%plosive Limit (VEL) : Extinguishing Media : Special Fire Fighting Proeedu:res : Unusual Fire and Explosion Elazards : N/A Use extinguishing media such as C02 or a dry chemical fire extingubher. Use water to keep fire-exposed containers cool Fire fighters should wear self contained breathing apparatus with fuJl face shield. Closed containers may explode. Vapors may be f1ammable. SECTION V : REACTIVITY DATA Stable: Huardou$ Polymerization May Occur: Conditions to Avoid: Incompatibility (Material to Avoid) : Hazardous Decomposition or Byproduets : t~"'\ < Yes No Avoid exposure to direct sunlight and ex:cessive heat and cold. Avoid. contact with acids, strong oxidizing agents and ammonia. Carbon Monoxide, Carbon Dio;dde, Nitrogen Oxides and Hydrogen Chloride. SECTION VI: HEALTH HAZARD DATA Effects on Eyes : Effects on Skin: Effects Due to Ingestion: Effects Due to Inhalation: First Aid Procedures for Eyes: First Aid Procedures for Skin: First Aid Procedures for Ingestion: First Aid Procedures for inhalation: Irritant. May cause burns and severe eye damage. l'rolonged exposure roay cause severe irritationt redness and swe1ling. May cause headaches, nausea, vomiting, diz¡r;iness and weakness. Irritant. May cause headaches, nausea, dizziness and drowsiness. Wash eyes with large amounts ofwl\ter or normal saline for 15 mioutes, occasionally lifting upper and lower lids. If symptoms persist seek medical attention. Wash affccted area with large amounts of soap aDd watcl' for 15 minutes. If symptoms persist seek medical attention. Drink water, give cyanide antidote, induce vomiting and contact a physician. Move to fresh air and give oxygen if needed. SECTION vn: PRECAUTIONS FOR SAFE HANDLING AND USE Steps to be Taken in Case Material is Released or Spilled : Waste Disposal Method: Precautions to Be Taken in RandHng and Storing: Other Precautions: ) Mop up with plenty of soap and water and dispose of down tbe drain. If not in It ventilated area, wear appropriate breathing appttatus. Methods of waste disposal must comply with Federa], State and Local eó~¡ronmental regulations. Keep out of ground water or surface waters due to toxicity to fish. Store at room temperature and avoid excess sunlight. No Data. + PIN: 300308001.02 SEP-18-2002 09:22 '" ~., ," ..-.. P.03 . Haema-Lyse 9100 Diff Part # COIA490187600S0 . SECTION VIII CONTROL MEASURES J Local Exbaùst : Mechanical (General) : Special VentiJation ; Other Ventilatiou : Protective Gloves : Eye Proteelion : Other Protective Ctothing or Equipment: Work! Hygienic Practices: Respiratory Proteètion (Specify Type) : It meets iL V requirements. It meets TLV requirements. N/A Normal ventilation. Use rubber,latex, neoprene (recommended) gloves. Safety goggles. Lab coat or apron. N/A Not required for nonnal use. SECTION IX : ADDITIONAL INFORMATION Indiscriminate mixing of this reagent with other chemicals may produce a hazardous substance. The inforDIlltton contained in this Material Safety Datil Sheet meets tbe req\lfrements of the United States Occupational Safety And Health Act 811d regulations promul~a[cd thefeundea- (29 CFR 191G.12GO ef. $I!Cf.). Aldloogb the stlltenlent$ and tceom¡nendatic>ds contained in this document J1re be1ieyed to be accurate, they arc intended only lIS II guide by a person traiDed in chemical hKndJing using appropriate preca\ltions. Trained pl:r$OltS mlut determine tÞe precautions required for their specific appUc:ations. ABX Diagnos'ies dlsçl.aims any other warranties, expressed or implied to the produ<:t supplied with this document, its fitness for a particular purpose with respect hereto ¡¡ad discll1lms allliabilily from rcJiauce thereon. ) >< PIN: 300308001.02 TOTAL P.03 ',\ .. - ;. ... :i' \ / -- e MODERN LABORATORY SERVICES INC Manager : £i;WttVA¡ G. H¡t:J-r¿i-AND eK..- Location: 4300 STINE RD 209 City BAKERSFIELD / / CommCode: BAKERSFIELD STATION 1~ EPA Numb: .. , ,_ "I /'--:.J / ,. ~-~ .~ I vi::;¡,) 11-:-' ¿,:¡ . /) "" :. ;-» ~."'\~"'I ~ u~ J:/ BusPhone: Map : 123 Grid: 14C SiteID: 215-000~000523 0(P F35-t:jDOQ- (ß..8"S) 664 0444 "Ekf: II CommHaz : Low FacUnits: 1 AOV: SIC Code:8071 DunnBrad:60-389-8453 Emergency Contact / Title Pres;¡)~"¡' Emergency Contact / Title VI'c..e- ~ ROBERT WARD ~ OWNER STAN SHERRILL ~I/ OWNER r:?éd Business Phone: 835-9000x22~ Lr..v.... Business Phone: (~) 835-9000x20 24-Hour Phone : (-e0~) á64 9~46)( (¡" 24-Hour Phone EJ,IC~8"51 664 7718~ R Pager Phone : ( ) &wl)-~"-fff;¡''7 Pager Phone : ( ) ~.l.ott:J.f-q,~ I Ð rvr Hazmat Hazards: React Contact : ' ;.0 q Phone: ( ) - x MailAddr: 4300 STINE RD ~ State: CA City : BAKERSFIELD Zip : 933132352 Owner ROBERT WARD I J-/ I (¡; P" e.n f.,(,/ ,. c.k. De Phone: (-805) GGi 9SiGx Address : 3(;00 rOE Ul State: CA ~(Pl) 5F9 - J.j,;;. 7 'j City : BAKERSFIELD Zip : 9--J3r1 Q3:3' I a. Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: f= Hazmat Inventory One Unified List ì p== MCP+DailyMax Order All Materials at Site ì Hazmat Common Name.. . SpecHaz EPA Hazards DailyMax MCP DILVENT 900 R L 480.00 GAL Mod DETERGENT & HGB REFERENCE 900 R L 300.00 GAL Mod DILVENT 1600 R L 480.00 GAL DETERGENT & HGB REFERENCE 1600 R L 300.00 GAL ~ ~9P IAJA- ¿;. ~I.-A¡.)~~ lDo ~rs"s1gy cøü1i1y ~hal~ ~ have , (Tv~@fp¡jntV\ß\mo) reviswslct too raltla\©h®d h~ardoos ma~ijS manage- r! Jic.es . h (\ rnl~n ~«:»fi" r&Q<2ft\ lM')QIlMbÆ.v1 ':>~fld ~fr1¡a\i it along Wit msrh ... (~~ of !&ußlnoœ) alny oofrsctio¡nS COVlstßtutø a œm~ist~ and OOITsd Mallìt- agsmsnt plan i©r my ~cmty. ¿;~..)/¡¡jA~ ~ ~.;t, l'iqc¡ ( . lUte )ate 12/20/1999 e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 ¡ íë Inventory Item 0004 ëëëëëëëëëëëëëëë Facility Unit: Fixed Containers on Site i íëë COMMON NAME / CHEMICAL NAME ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëîëëëëëëëëëëëëëëëë¡ o DIL VENT 900 0 Days On Site 0 o 0 365 0 o Location within this Facility Unit Map: Grid: ûááááááááááááááááÇ o No Location Given ° CAS# ° ° ° 122-99-6 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëj íë STATE ëîë TYPE ëëëîëë PRESSURE ëëëî TEMPERATURE ëëîëëëë CONTAINER TYPE ëëëëëj ° Liquid 0 Mixture 0 Ambient ° Ambient ° PLASTIC CONTAINER 0 åëëëëëëëëëüëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëëëëëëëëëëëëëëëëëëëëî AMOUNTS AT THIS LOCATION ëëëëëëëëëëëëëëëëëëëëëëëëë¡ o Largest Container ° Daily Maximum 0 Daily Average 0 ° GAL 0 480.00 GAL ° 200.00 GAL 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëîëëëëëëëëëëëëëë HAZARDOUS COMPONENTS ëëëëëëëëëëëëëëîëëëîëëëëëëëëëëëëëëë¡ ° %Wt. 0 ° RSo CAS# ° ° 0.3002-Phenoxyethanol °No 0 122996° o 0.400Sodium Fluoride °No ° 76814940 åëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëüëëëëëëëëëëëëëëëj íëëëëëëëîëëëîëëëëëëîëëëëëëëëëëë HAZARD ASSESSMENTS ëëëîëëëëëëëëëîëëëëëëëëîëëëëë j °TSecretO RSoBioHazo Radioactive/Amount 0 EPA Hazards 0 NFPA ° USDOT# 0 MCP ° o No °No 0 No ° No/ Curies 0 R 0 / / / 0 ° Mod 0 åëëëëëëëüëëëüëëëëëëüëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëüëëëëëëëëëüëëëëëëëëüëëëëëj .. e · e e íë Inventory Item 0002 ëëëëëëëëëëëëëëë Facility Unit: Fixed Containers on Site j íëë COMMON NAME / CHEMICAL NAME ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëîëëëëëëëëëëëëëëëëj o DETERGENT & HGB REFERENCE 900 0 Days On Site 0 o o 365 ° Grid: ûááááááááááááááááÇ o CAS# 0 ° Location within this Facility Unit ° SOUTH ROOM Map: o ° 122-99-6 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëj íë STATE ëîë TYPE ëëëîëë PRESSURE ëëëî TEMPERATURE ëëîëëëë CONTAINER TYPE ëëëëëj o Liquid 0 Mixture 0 Ambient 0 Ambient 0 PLASTIC CONTAINER 0 åëëëëëëëëëüëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëëëëëëëëëëëëëëëëëëëëî AMOUNTS AT THIS LOCATION ëëëëëëëëëëëëëëëëëëëëëëëëëj ° Largest Container 0 Daily Maximum 0 Daily Average 0 ° GAL ° 300.00 GAL ° 150.00 GAL ° åëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëëëëîëëëëëëëëëëëëëë HAZARDOUS COMPONENTS ëëëëëëëëëëëëëëîëëëîëëëëëëëëëëëëëëëj o %Wt. 0 ° RSo CAS# 0 ° 0.400Sodium Fluoride °No ° 76814940 åëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëüëëëëëëëëëëëëëëëj íëëëëëëëîëëëîëëëëëëîëëëëëëëëëëë HAZARD ASSESSMENTS ëëëîëëëëëëëëëîëëëëëëëëîëëëëë j °TSecretO RSoBioHazo Radioactive/Amount 0 EPA Hazards 0 NFPA 0 USDOT# 0 MCP 0 o No °No ° No ° No/ Curies 0 R ° / / / 0 ° Mod ° åëëëëëëëüëëëüëëëëëëüëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëüëëëëëëëëëüëëëëëëëëüëëëëëf -2- 12/20/1999 e e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 j íë Inventory Item 0003 ëëëëëëëëëëëëëëë Facility Unit: Fixed Containers on Site ¡ íëë COMMON NAME / CHEMICAL NAME ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëîëëëëëëëëëëëëëëëë¡ o DILVENT 1600 ° Days On Site 0 o ° 365 ° o Location within this Facility Unit Map: Grid: ûááááááááááááááááÇ o 0 CAS# 0 o ° 122-99-6 ° åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëj íë STATE ëîë TYPE ëëëîëë PRESSURE ëëëî TEMPERATURE ëëîëëëë CONTAINER TYPE ëëëëë¡ o Liquid 0 Mixture ° 0 0 ° åëëëëëëëëëüëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëëëëëëëëëëëëëëëëëëëëî AMOUNTS AT THIS LOCATION ëëëëëëëëëëëëëëëëëëëëëëëëë¡ o Largest Container 0 Daily Maximum, 0 Daily Average 0 ° GAL ° 480.00 GAL 0 200.00 GAL 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëîëëëëëëëëëëëëëë HAZARDOUS COMPONENTS ëëëëëëëëëëëëëëîëëëîëëëëëëëëëëëëëëë¡ ° %Wt. ° ° RSo CAS# ° åëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëüëëëëëëëëëëëëëëëj íëëëëëëëîëëëîëëëëëëîëëëëëëëëëëë HAZARD ASSESSMENTS ëëëîëëëëëëëëëîëëëëëëëëîëëëëë¡ °TSecretO RSoBioHazo Radioactive/Amount ° EPA Hazards ° NFPA ° USDOT# 0 MCP 0 o No °No 0 No 0 No/ Curies 0 R 0 / / / 0 0 ° åëëëëëëëüëëëüëëëëëëüëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëüëëëëëëëëëüëëëëëëëëüëëëëëj íë Inventory Item 0001 ëëëëëëëëëëëëëëë Facility Unit: Fixed Containers on Site ¡ íëë COMMON NAME / CHEMICAL NAME ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëîëëëëëëëëëëëëëëëë¡ o DETERGENT & HGB REFERENCE 1600 0 Days On Site 0 o o 365 0 Grid: .ûááááááááááááááááÇ ° CAS# 0 ° Location within this Facility Unit ° SOUTH ROOM Map: o ° 9016-45-9 ° åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëj íë STATE ëîë TYPE ëëëîëë PRESSURE ëëëî TEMPERATURE ëëîëëëë CONTAINER TYPE ëëëëë¡ o Liquid 0 Mixture 0 Ambient ° Ambient ° PLASTIC CONTAINER 0 åëëëëëëëëëüëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëëëëëëëëëëëëëëëëëëëëî AMOUNTS AT THIS LOCATION ëëëëëëëëëëëëëëëëëëëëëëëëë¡ o Largest Container 0 Daily Maximum 0 Daily Average 0 ° GAL 0 300.00 GAL 0 150.00 GAL ° åëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëj íëëëëëëëîëëëëëëëëëëëëëë HAZARDOUS COMPONENTS ëëëëëëëëëëëëëëîëëëîëëëëëëëëëëëëëëëj o %Wt. 0 ° RSo CAS# 0 åëëëëëëëüëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëüëëëüëëëëëëëëëëëëëëëj íëëëëëëëîëëëîëëëëëëîëëëëëëëeëëë HAZARD ASSESSMENTS ëëëîëëëëëëëëëîëëëëëëëëîëëëëë¡ °TSecretO RSoBioHazo Radioactive/Amount ° EPA Hàzards ° NFPA ° USDOT# 0 MCP 0 o No °No 0 No 0 No/ Curies 0 R 0 / / / 0 0 ° åëëëëëëëüëëëüëëëëëëüëëëëëëëëëëëëëëëëëëëëüëëëëëëëëëëëëëüëëëëëëëëëüëëëëëëëëüëëëëëj -3- 12/20/1999 e e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 i íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Fornaat j íë Notif./EvacuationlMedical ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Agency N otification ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Employee Notif./Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01107/1990 j o 0 o THE EMPLOYEE ON SITE WILL OPEN DOORS TO VENTILATE ROOM AND CALL 0 o STAN SHERRILL OR BOB WARD TO NOTIFY THEM THAT A SPILL HAS OCCURED. IF THE 0 o EMPLOYEE NOTICES A FEELING OF DIZZINESS THEY SHOULD GO OUTSIDE FOR FRESH 0 o AIR - PROTECTIVE GEAR IS NOT REQUIRED. 0 o 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Public N otif. /Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Emergency Medical Plan ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01107/1990 j o 0 o MEDICAL EMERGENCIES THAT DO NOT REQUIRE "ON SITE" TREATMENT WILL BE o TRANSPORTED VIA PERSONAL VEHICLES TO 0 o SAN JOAQUIN HOSPITAL 0 o 2615 EYE STREET 0 o BAKERSFIELD, CA. o (805) 395-3000 o o o o o o ON SITE EMERGENCIES WILL BE INITIATED BY CALL 911 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -4- 12/20/1999 e e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Mitigation/Prevent/ Abatemt ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site i íëë Release Prevention ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01/07/1990 j o 0 o ACIDS, CAUSTICS, ETC ARE TO BE STORED IN A METAL CABINET 0 o CARBOYS OF DETERGENT AND DILUENT ARE NOT TO STORED OVER 5 CASES HIGH o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Release Containment ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01/07/1990 i o 0 o SHOULD ANY CARBOYS RUPTURE, SPILL, OR LEAK AN ASSESSMENT OF THE AMOUNT o OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5 GALLONS WILL BE CLEANED 0 o WITH ABSORBANT MATERIALS THAT WILL BE PLACE IN BIOHAZARD BAGS - SPILLS '0 o OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED o UNTIL CARPET/FLOORING DRYS. ' 0 o o o o äëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Clean Up ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01/07/1990 j o 0 o SHOULD ANY CARBOYS R'UPTURE, SPILL OR LEAK AN ASSESSMENT OF THE AMOUNT o OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5GALLONS WILL BE CLEANED o WITH ABSORBANT MATERIALS THAT WILL BE PLACED IN BIOHAZARD BAGS - SPILLS o OVER 5 GALLONS WILL BE VACUUMED WITH A WET - V AC - ROOM WILL BE VENTI LA TED o UNTIL CARPET/FLOORING DRYS 0 o o o o o o äëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Other Resource Activation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -5- 12/20/1999 e e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 i íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format i íë Site Emergency' Factors ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Special IIazards ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Utility Shut-Offs ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01107/1990 j o 0 o A) GAS - ALLEY ON SOUTII SIDE OF FACILITY TO LEFT OF FREIGIIT DOOR o B) ELECTRICAL - ALLEY ENTRANCE DIRECTLY INSIDE FREIGIIT DOOR. o C) WATER - ALLEY BEIIIND FACILITY TO LEFT OF FREIGIIT DOOR 0 o D) SPECIAL - FILE CABINET AT FRONT OF SIIOP EAST WALL CONTAINS SITE PLANS o FLOOR PLANS AND MSDS 0 o E) LOCK BOX _ NO 0 o 0 o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Fire Protec.l A vail. Water ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01107/1990 i o 0 o PRIVATE FIRE PROTECTION - FIRE EXTINGUISIIER ARE LOCATED WITIIIN TIlE FACILITY 0 o AS MARKED ON TIlE FACILITY PLAN 0 o o o o o o o FIRE IIYDRANT - 0 STREET AND TIlE ALLEY BEIIIND TIlE FACILITY o 0 STREET IS WEST OF OUR FREIGIIT DOOR o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Building Occupancy Level ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -6- 12/20/1999 ,. . . :... , ... e e í MODERN LABORATORY SERVICES INC ëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000523 i íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 01/07/1990 j o 4 0 o WE HA VE~ EMPLOYEES AT THIS FACILITY ~ () ~ U)Ov('eJ-,ovse- 04- ú. +-O-t-o..t o 0 o WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE o o o of- lq~p(O~e6 a-l-- W.5 Aome5S . o OUR EMPLOYEE'S ARE INSTRUCTED ON SAFE HANDLING OF MATERIALS, USE OF SPILL o KITS, EVACUATION AND REPORTING PROCEDURES. 0 o 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf o ,..,. .' ì .. It e o ~~~~~~rr\\ ,~4::B 4 1993 P~ 1 ~ 01/25/93 MODERN LABORATORY SERVICES INC 215-000-0 Overall Site with 1 Fac. Unit General Information By Contact Name ROBERT WARD STAN SHERRILL Map: 103 Hazard: Low Grid: 30D F/U: 1 AOV: 0.0 Location: t}31 19TH -S'fIo DO S"t11.:E" Rb *-2.0" Community: BAKERSFIELD ~TATION 01 Title 24-Hour Phone (805) 664-9546 (805) OWNER 1\ ~.., Administrative Data S Mail Addrs: -631 l~"fIl S'F- 'i"3l:oS.,..,A,.)1E RO'l1l..bCf e,¡..J ~ Number: 77-009-7088 City: BAKERSFIELD State: CA Zip:~1JJ3 Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 8071 Owner: ROBERT WARD Address: 3600 POE LN City: BAKERSFIELD Phone: (805) 664-9546 State: CA Zip: 93311- Summary THIS BUSINES~~CATED BEHI~VALLEY FOR APPOINTME~ORE INSPE~G. OF THE DOLL~YOU MAY WANT TO CALL ~-s-q3. ~ ./)11 A,. 1-. I I, _ /JA I .-: \.Y'/~) U~ . IutlL a.., /J2&U I, ~ Dbe~ J3. íA)3~ £ 'It Do hereby certitJ that J have yps C1' ptInt nwne reviewed ~he attacm>,: ":,,,,:í~":'CUS materials manage- ment plan forMD()Ç:'ß~_~~~II. ~ï:d that it along with (NM1.a :;t Bt)!l1I1~...») any corrections cons'muta a c(;inplete and correct man- agement plan for my facility. <:' j~J:ðt~11993 ·- . " -- e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 Hazmat Inventory List in Reference Number Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Quantity MCP 02-001 DETERGENT & HGB REFERENCE 1600 Liquid 300 Unrated ~ Reactive GAL 02-002 DETERGENT & HGB REFERENCE 900 Liquid 300 Moderate ~ Reactive GAL 02-003 DILVENT 1600 Liquid 480 Unrated ~ Reactive GAL 02-004 DILVENT 900 Liquid 480 Moderate ~ Reactive GAL '\. .. . e e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in Reference Number Order 02-001 DETERGENT & HGB REFERENCE 1600 ~ Reactive Liquid 300 Unrated GAL CAS #: 9016-45-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL 300 I 150.00 I 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:I Ambient Ambient I SOUTH ROOM Location - Conc Components MCP ---p;uide 02-002 DETERGENT & HGB REFERENCE 900 ~ Reactive Liquid 300 Moderate GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL 300 I 150.00 I 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:I Ambient Ambient I SOUTH ROOM Location - Conc l 0.4% Sodium Fluoride Components 1-; MCP ----rGuide Moderate 54 02-003 DILVENT 1600 ~ Reactive Liquid 480 Unrated GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL 480 I 200.00 I 600.00 Storage Press T Temp C·omponents Location - Conc MCP ---p;uide '0 e e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in Reference Number Order 02-004 DILVENT 900 ~ Reactive Liquid 480 Moderate GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL 480 I 200.00 I 1,600.00 Storage PLASTIC CONTAINER r Press T Temp ~I Location Ambient AmbientlNo Location Given Components I~ MCP ~. uide Unrated 0 Moderate 54 Conc 0.3% 2-phenoxyethanol 0.4% Sodium Fluoride !\, e e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site <D> Notif./Evacuation/Medical Page 5 <1> Agency Notification <2> Employee Notif./Evacuation THE EMPLOYEE ON SITE WILL OPEN DOORS TO VENTILATE ROOM AND CALL STAN SHERRILL OR BOB WARD TO NOTIFY THEM THAT A SPILL HAS OCCURED. IF THE EMPLOYEE NOTICES A FEELING OF DIZZINESS THEY SHOULD GO OUTSIDE FOR FRESH AIR - PROTECTIVE GEAR IS NOT REQUIRED. <3> Public Notif./Evacuation <4> Emergency Medical Plan MEDICAL EMERGENCIES THAT DO NOT REQUIRE "ON SITE" TREATMENT WILL BE TRANSPORTED VIA PERSONAL VEHICLES TO SAN JOAQUIN HOSPITAL 2615 EYE STREET BAKERSFIELD, CA. (805) 395-3000 ON SITE EMERGENCIES WILL BE INITIATED BY CALL 911 t - e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention ACIDS, CAUSTICS, ETC ARE TO BE STORED IN A METAL CABINET CARBOYS OF DETERGENT AND DILUENT ARE NOT TO STORED OVER 5 CASES HIGH <2> Release Containment SHOULD ANY CARBOYS RUPTURE, SPILL, OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5 GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACE IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS. <3> Clean Up SHOULD ANY CARBOYS REUPTURE, SPILL OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACED IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS <4> Other Resource Activation · '\, \ - e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ALLEY ON SOUTH SIDE OF FACILITY TO LEFT OF FREIGHT DOOR B) ELECTRICAL - ALLEY ENTRANCE DIRECTLY INSIDE FREIGHT DOOR. C) WATER - ALLEY BEHIND FACILITY TO LEFT OF FREIGHT DOOR D) SPECIAL - FILE CABINET AT FRONT OF SHOP EAST WALL CONTAINS SITE PLANS FLOOR PLANS AND MSDS E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER ARE LOCATED WITHIN THE FACILITY AS MARKED ON THE FACILITY PLAN FIRE HYDRANT - 0 STREET AND THE ALLEY BEHIND THE FACILITY o STREET IS WEST OF OUR FREIGHT DOOR <4> Building Occupancy Level -'r , ,. ~~e . e 01/25/93 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 8 <G> Training " <1>, Page 1 WE HAVE 2 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE OUR EMPLOYEE'S ARE INSTRUCTED ON SAFE HANDLING OF MATERIALS, USE OF SPILL KITS, EVACUATION AND REPORTING PROCEDURES. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use '\ \ '. e CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D JOHNSON FIRE CHIEF 2101 H STREET BAKERSFIELD, 93301 326,3911 Dear Business Owner: This notice is meant to act as a reminder that the California Health and Safety Code, Chapter 6.95, requires any handler of hazardous materials to revise their hazardous materials business plan within 30 days of anyone of the following events: (1) A 100 per cent or more increase in the quantity of a previously-disclosed material. (2) Any handling of a previously-undisclosed hazardous material, subject to the inveliltory requirements of Chapter 6.95, (3) Change in business ownership. (4) Change in business address. (5) Change of business name. Any questions regarding these required revisions, please call the Hazardous Materials Division at (805) 326-3979. , Sincerely yours, ! .' ~~ ~ ~~_hu~' Huey Hazardous Materials Coordinator '--~ ~ ~~l ~~~~'r ~ ~t~ ~ ~, 1:, ~. \. ~ ~~ ~. 1 1'\ I e CITY OF 'BAKERSFIELD P.O. BOX 2057 BAKERSFI Ð,-cA[)foRNIA93303..2 57 'e ~' .. lit '... Z '.= ,z ~~a: -~ ~~ ~~ m~ ..." 0.0 ¡;~ z::c o~· ~o !tz ~ø =~ . , ::c to: ... 'lit ::) -,,-~ } Á' -...:-;:.:;.~ , . I ! ,a. Q. ,~.' .. r~ ~~f ~ -tßWt(s M,:"if": r'SAJ<ptn;:9iÞ :.t "'J..'1'r ~Fr ~:"'iA'n -....... ADDRESS CORRECTION REQUESTED DO NOT FORWARD .' : " ,j /¡;13 " . ,'J iJL" 1_!,..:I. ø' ~. - (¡ ',\ .1..1" !,~" . '1'13\ ).1.,';1) ",'" 'Ùqq,Í;.l\~·N· iû ~y~~~~th, CE?,~~',r'Io f"\:. \ Jf'. t I \ AD -r.;,"'1\: ....¥ 1 .:Ikr.! "t'\üOE.~· ;~'i';:H~ RO,' i"",~,:~-?' .1,0 o o'! '. 0 .:r 1.ì· n C/~ "'"1,":1.-:\ 4- .;¡íJ -~ ·r. ~\..I../ ,. "'0' t:!e.i . \-<C'0....,- ..... "'El<.t J¡'; r~ .., :,~ . -""... "'0 r-., I" - ·d..., \'~H \ - R~1 oJ \\\\l\t\\t1l\\1I1\ \ \\ \\I\lIIt \,,\\111\ \11 III,., .... \\\11 1\\ II tl1\\ 1\\ '.-..-- MAIL TO '~:~r:j~¡\~!'n,::j ~ \ It, .... ',: , ;.j. ·"·~.-,º.I)~.·// (~. " ·--'·::.~l.~.,.._...._ _'_'''~H'''.'' ~ '., . _. ..--... .-.. -~ SERvICES INHM4062ûl II.IIIIIIIIIIIIIIIIIIIIIU 1111111111 Ultillll.llllll ,..-....__.~. '-"-"'_.'-~- I RETURN PAY~ i ~ OF BAKERSFIELD P.O. BOX 2057 . BAKERSFIELD, CA 93303-2057 '--- PLEASE MAKE CHECKS PAYABLE TO: 5 MATERIALS ÞIVIßION CITY OF BAKERSFIELD o. ìi~ 406.2tÞJ, ....~:::..~...:... 'í..>. ~. .' ~ . ..'-,.;...-........,......"'_ '.~' .~...: !rta~arQ\():¡JSi'#ôterials Hiindling f'<'!H~$ \ . rr"f:"iÇluS~iillanc~ ·~4...eO ¡!'t~-'Á:d ~;~ ;1: . 191:iI .~. ·.~~~~~t~¡r83fIT~;.·· .... :.--.;:.T7::~:.':~.~:-:-:::"=-::-::-.":-' ,SER!jU,C,,",j~DA.'.!JJ,l.óttI9J., ."",~~t'l,f41"f,~~.,~":.",,':.'~¿µ;",'0,,:';'·":"~':'¡",,",',',' ,..... ·~ttt~'192 P 3y~~nt ,94.,00 . PA \1~E~TS ø\fTEW 12/311'9¡ !iOT Ot't,{tól:..s·~"aU.,lc"';'¡;;"J':~:"~:":""'" ....".'," . "'..." ,.' ,.". ...,.".,;';'..".,'.......:,..,;;'.' tJAZ Ð1Af ~Å~ij)ll~~fEŒ', ' "\,>'94.0tJ . ,. ,t.. ", ,_ F_ ,..- _ ., . " . -:-:':":"-'¡k'~~, \';;~~;Lr~~;~ . ~.o!i)ERN '-::þA!.'HH~Å tQ~! 1t,rwST ..,. IAleIS~IELD_ CA'9JIOl INVOICE NUMBER MUST' RETURN THIS COPY WITH PAYMENT E3 RETURN PAYMENTS TO: CITY OF BAKERSFIELD HAZARDOUS MATERIALS DIVISION P.O. BOX 2057 BAKERSFIELD, CA 93303-2057 ACCOUNT NO. HM 406201 HAZARDOUS MATERIALS HANDLING FEES SITE ADDRESS; 4300 STINE RD. 1307 FUND 011-11117 SERVICE FOR FISCAL YEAR 7/1/92 - 6/30/93 PAYMENTS ~FTER 12/31/92 NOT ON THIS BILL HAl MAT HANDLING FEE PLEASE MAKE CHECKS PAYABLE TO: CITY OF BAKERSFIELD PREVIOUS BALANCE 01/29/92 PAYMENT 94.00 -94.00 99.00 TOTAL CURRENT CHARGES 99.00 CURRENT CHARGES 99.00 BILLING DATE 1/1/93 TOTAL BALANCE DUE 99.00 ANNUAL FEE THIS BILL IS DUE UPON RECEIPT. 2 MONTHS FROM THE BIL[ING DATE A 10 ADMINISTRATIVE SERVICE CHARGE AND FINANCE CHARGE OF 1% PER MONTH WILL BE ASSESSED. INQUIRIES CONCERNING THIS BILL, PLEASE PHONE: (805) 326;3979 INVOICE NUMBER MODERN LABORATORY SERVICES INC. HM 406201 4300 STINE RD. STE 307 BAKERSFIELD, CA. 93313-2352 CITY COpy p~/ ) ~~16d! fS>' ~ ~6(?ft~K ¡i'sP.s r..Þ tb~;';:qOO . ~ 47JUVqtP)'V -¡: ,~' '\ e ./ RECEIVED MAR 1 3 1992ge ARs'd............ 1 ~ 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 Overall Site with 1 Fac. Unit General Information Location: 83'1 19TH ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 01 Grid: 30D F/U: 1 . AOV : 0.0 - Contact Name Title Business Phone - 24-Hour Phone ROBERT WARD OWNER (805) 664-0444 x (805) 664-9546 STAN SHERRILL (805) 664-0444 x (805) 871-2433 Administrative Data Mail Addrs: 831 19TH ST D&B Number: 77-009-7088 City: BAKERSFIELD State: CA Zip: 93301- Comm Code: 215-001 BAKERSFIELD STATION 01 SIC Code: 8071 Owner: ROBERT WARD Phone: (BoÇ") '604 - 'lS'% Address: 3600 POE LN State: CA City: BAKERSFIELD Zip: 93311- Summary THIS BUSINESS IS LOCATED BEHIND VALLEY OF THE DOLLS, YOU MAY WANT TO CALL FOR APPOINTMENT BEFORE INSPECTING. I, \<"U~'ß. ~1>1I:- Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ~nt plan forfV'lOl)~#J l:;1 &e~vlt~ and that it along with (Ni;mG 01 uainooG) any corredsons constitute a comp~me and correct man- agement plan for my faci1ity. .~' ~ .~ . ..". ' "f\<···' .;, ".' '<,," 'Ma.vr.Q \I I ,~~ V Date . ~L'f¡:,. '1'. ," ',' ,. '... ,.. O~ .. e e 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 DETERGENT & HGB REFERENCE 1600 ~ Reactive Liquid 300 Unrated GAL CAS #: 9016-45-9 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL 300 . 150.00 I 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:I Ambient Ambient SOUTH ROOM Location - Conc Components MCP ~List 02-002 DETERGENT & HGB REFERENCE 900 ~ Reactive Liquid 300 Moderate GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL 300 I ' 150.00 I 1,000.00 Storage PLASTIC CONTAINER r Press T Temp -:I Ambient Affibient SOUTH ROOM Location - Conc l 0.4% Sodium Fluoride Components MCP ~List I-;oderate 02-003 DILVENT 1600 ~ Reactive Liquid 480 Unrated GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL 480 I 200.00 600.00 Storage Press T Temp Location - Conc Components MCP ~List .. e e 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in Reference Number Order 02-004 DILVENT 900 ~ Reactive Liquid 480 Moderate GAL CAS #: 122-99-6 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL 480 I 200.00 1,600.00 Storage PLASTIC CONTAINER r Press T Temp ~ Location Ambient Ambient No Location Given Components ~ MCP WList Unrated Moderate Cone 0.3% 2-phenoxyethanol 0.4% Sodium Fluoride .. e e 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 4 <D> Notif./Evacµation/Medical <1> Agency Notification <2> Employee Notif./Evacuation THE EMPLOYEE ON SITE WILL OPEN DOORS TO VENTILATE ROOM AND CALL STAN SHERRILL OR BOB WARD TO NOTIFY THEM THAT A SPILL HAS OCCURED. IF THE EMPLOYEE NOTICES A FEELING OF DIZZINESS THEY SHOULD GO OUTSIDE FOR FRESH AIR - PROTECTIVE GEAR IS NOT REQUIRED. () <4> Emergency Medical Plan MEDICAL EMERGENCIES THAT DO NOT REQUIRE "ON SITE" TREATMENT WILL BE TRANSPORTED VIA PERSONAL VEHICLES TO SAN JOAQUIN HOSPITAL 2615 EYE STREET BAKERSFIELD, CA. (805) 395-3000 ON SITE EMERGENCIES WILL BE INITIATED BY CALL 911 '.... e e d 02/27/92 MODERN LABORATORY SERVICES ,INC 215-000-000523 00 - Overall Site Page 5 <E> Mitigation/prevent/Abatemt <1> Release Prevention ACIDS, CAUSTICS, ETC ARE TO BE STORED IN A METAL CABINET CARBOYS OF DETERGENT AND DILUENT ARE NOT TO STORED OVER 5 CASES HIGH <2> Release Containment SHOULD ANY CARBOYS RUPTURE, SPILL, OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5 GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACE IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS. <3> Clean Up SHOULD ANY CARBOYS REUPTURE, SPILL OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACED IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS <4> Other Resource Activation I oi " '\, e e 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ALLEY ON SOUTH SIDE OF FACILITY TO LEFT OF FREIGHT DOOR B) ELECTRICAL - ALLEY ENTRANCE DIRECTLY INSIDE FREIGHT DOOR. C) WATER - ALLEY BEHIND FACILITY TO LEFT OF FREIGHT DOOR D) SPECIAL - FILE CABINET AT FRONT OF SHOP EAST WALL CONTAINS SITE PLANS FLOOR PLANS AND MSDS E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER ARE LOCATED WITHIN THE FACILITY AS, MARKED ON THE FACILITY PLAN FIRE HYDRANT - 0 STREET AND THE ALLEY BEHIND THE FACILITY o STREET IS WEST OF OUR FREIGHT DOOR <4> Building Occupancy Level . ,:oJ P" ~ e e 02/27/92 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Ovèrall Site Page 7 <G> Training <1> Page 1 WE HAVE 2 EMPLOYEES AT THIS FACILITY " WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE OUR EMPLOYEE'S ARE INSTRUCTED ON SAFE HANDLING OF MATERIALS, USE OF SPILL KITS, EVACUATION AND REPORTING PROCEDURES. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 04/02/92 1'r1ODEF<NeIBORATORY SEHVICES INC 21.000--000523 Overall Site with 1 Fac. Unit Page 1 General InforMation '-- ..-----..-..------- .....------.-- . ----------------------------------.- ~ Map: 103 Hazard: Low Grid: 30D FlU: 1 AOV: 0.0 ....-----.........-.....-..---.-- Location: 831 19TH ST COMMunity: BAKERSFIELD STATION 01 .---..---- ~ Co«t;ad Name T ROBERT WARD OWNER STAN SHERRILL ------.---..------ Ti t 1e - T Bus;«es" Phoy,e _1 24-Hc'u¡-~ Pho)'",e'l (805) 664-0444 x (805) 664-9546 : 8~5 )_~61~.=04~~_~_____. _~_~~~~_~~_~2_~3~ Ad m i )'"1 i s t rat i \/ e D a t a ---.----------------------- Mail Addrs: 831 19TH ST City: BAKERSFIELD Owner: ROBERT WARD Address: 3600 POE LN City: BAKERSFIELD -..-..---.... STATION 01 D&B Number: 77-009-7088 State: CA Zip: 93301- SIC Code: 8071 ..----...----------. ..---....-......------..-..- Phone: (805) 664-9546 State: C~i Zip: 93311- -------- - Sumflla¡-~y -.-----..------ ..-----....------.---. ....-.-..............---..--..-- THIS BUSINESS IS LOCATED BEHIND VALLEY OF THE DOLLS, YOU FOR APPOINTMENT BEFORE INSPECTING. r~AY I.>JANT TO RECEIVED iAPR 2 Î 1992 ------------ -"7---M AT. -Õ1V:---'-- ___________---HA_-'-_________._____.__ CALL ~ 04/02/'3;::~ MODERN LABORATORY SERVICES INC 215-000-000523 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site PIn-Ref Name/Hazards F 01'~rll Pê.'ige 2 Quarlt it Y J't1CP 02-002 DETERGENT & HGB REFERENCE 900 Reactive Liquid --..----.---.-.---------..- 300 Mode1'~ate GAL --- ..----..--.. 02-004 DILVENT '300 Reactive Liquid ----- ---------- 02-001 DETERGENT & HGB REFERENCE IS00 Reactive Liquid ----., Lt80 'Iklde1'~at e GAL --------- 300 U·...IY'·ated GAL 02-003 DILVENT IS00 Reactive Liquid ...---.----..----.----------....-......---..----..-.--..---.. 480 U'n1'~ated GAL -..---.--..-----..-----......--.-- . e 0'+/02/92 MODERN eBORATORY SER'·nCES INC 21.)00-0005i.7:3 02 - Fixed Containers on Site Page -~ .:, Hazmat Inventory Detail in MCP Order 02-002 DETERGENT & HGB REFERENCE 900 Reactive Liquid 300 Ylode¡-~at e GAL ------ ..--- CAS #: 122-99-6 T¡--'ade SecTet: No F o¡-~m : L i qui d Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS ---- Dai ly 'I'lax GAL -'f- Dai ly Ave¡--·age GAL T- A....ö'H.lal Amount GAL 300 150,00 1,000.00 ------ Sto¡-~age PLASTIC CONTAINER '-r P¡--'ess T Temp :1------- Locatio...., Ambient Ambient ¡SOUTH ROOM ------- - Co....'c --r;:--- 0.4% ¡Sodium Fluoride Cclmpo·ne....'t s - --T- MCP --rL i s t I 'I·lode¡-~ate I --------.---. ...-----....-..-..----------.. 02-004 DILVENT 900 Reactive Liql.lid 480 I'''!c,de¡-~¿'\t e GAL ----.-.. CAS *~: 1.::2-99-6 T¡-~ade Sec¡--'et: NCI F on'l: L i qui d Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS -- Dai ly Max GAL -----..¡- Dai ly (-¡ve¡--'age GAL --1-- A....mual Amol.mt GAL 480 I 200,00 1,600.00 -.-- Sto¡-~age -----T P¡--'ess T Temp :-r ------ Locat io...., PLASTIC CONTAINER Ambient Ambient/No Location Given ------- CCI.... C - -----..----- Compo....'ent s --·--------1-- MCP ---IL i st U.... ¡--·ated MClde¡--'ate c). 3~<' 2-phenoxyethanol SCld i tlrll F 1 u.:.¡-~ i de o. L.% ..-.--- 02-001 DETERGENT & HGB REFERENCE 1600 Reactive Liquid 300 U....'¡-~ated GAL .-.-..---------- CAS #: 9016-45-9 T¡-~ade Sec¡--'et: No Fo¡-~m: Liquid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS --- Dai ly Max GAL -T Dai ly Ave¡-~age GAL ----r- A....mual Amc'l.mt Gr-¡L 300 150.00 I 1,000.00 -- Stcl¡-~age PLASTIC CONTAINER I A~~~:~t T A~~~7~n~ SOUT~-'R~-~ Locat i c....., - Co....'c . CC'UI po....'e....'t s -------------r MCP ---T-L i s t 04/02/9;:~ MODERN LABORATORY SERVICES INC 215-000-000523 02 - Fixed Containers on Site Pa~1e 4 Hazmat Inventory Detail in MCP Order ...--..---..--- .-.......------......---------..------..-..........------.-..... 02-003 DILVENT 1600 Reactive Liquid '+80 U·¡,-.r~ated G(:~L -----------.--..-....----...---.--....------..---------..---......----....-....----..--......-........-----..------ UiS t~: 122-'39--6 Tr~ade SE?C'r'I:?t: No Fonll: Li quid Type: Mixture Days: 365 Use: MEDICAL AID OR PROCESS ---- Daily Max GAL '+80 ,-- Dai ly Aver~age GAL -··T- A'¡,w'lual Amc.uYït GAL I 200.00 600.00 ---- Stc'r~age -·-·-T Pr~ess T Temp -,---.----- LClcat il:I)", ---...---..----- '- CO)"IC -~_.. ----....-..- CClm pc.ne)",t~:; ·------···-----r- MCP ....,.L i s t . e 04/02/9f~ tr10DERN eBORATORY SERVICES INC 21.100-000523 00 - Overall Site Page <::' ..J (D) Notif./Evacuation/Medical ...-----....-- ::: ~:;r':~~: i :i:a;~:~~;: ->r";R:,:::r :C~~ß"H::::~:þM:~~~:~~I~:'LL- /' l- 6DO- i?s'2- - 7 S <:;D. A t>þt II oIVA u..y t:.MeR~~¡vcy:tt:-~ II w:t.u... 'ge- c A-LLE D IfIVO 0\>1\ A-l:>D(¿E:t! aM T~e- NAr.::>RE: l>f= THE' tE"M~Rb.eNcr \,V\I.\.. Be- có......"..U' IVI<' I9TE:b. (2) Employee Notif./Evacuation ---.. ",,~.._-_.. THE EMPLOYEE ON SITE WILL OPEN DOORS TO VENTILATE ROOM AND CALL STAN SHERRILL OR BOB WARD TO NOTIFY THEM THAT A SPILL HAS OCCURED. IF THE EMPLOYEE NOTICES A FEELING OF DIZZINESS THEY SHOULD GO OUTSIDE FOR FRESH AIR - PROTECTIVE GEAR IS NOT REQUIRED. (3) Public Notif./Evacuation (4) Emergency Medical Plan MED I CAL EME RGENC I ES THAT DO NOT REQU I RE II ON SITE II TREATMENT L-JI LL BE TRANSPORTED VIA PERSONAL VEHICLES TO SAN JOAQUIN HOSPITAL 2615 EYE STREET BAKERSFIELD, CA. (805) 395-:3000 ON SITE EMERGENCIES WILL BE INITIATED BY CALL 911 04/02/92 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page IS (E) Mitigation/Prevent/Abatemt ---- --------..----..----- Cl} Release Prevention ------.. ACIDS, CAUSTICS, ETC ARE TO BE STORED IN A METAL CABINET CARBOYS OF DETERGENT AND DILUENT ARE NOT TO STORED OVER 5 CASES HIGH C2} Release Containment SHOULD ANY CARBOYS RUPTURE, SPILL, OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5 GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACE IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS. C3} Cleay/ Up SHOULD ANY CARBOYS REUPTURE, SPILL OR LEAK AN ASSESSMENT OF THE AMOUNT OF SPILLAGE WILL BE MADE. LESS THAN 1 CARBOY OR 5GALLONS WILL BE CLEANED WITH ABSORBANT MATERIALS THAT WILL BE PLACED IN BIOHAZARD BAGS - SPILLS OVER 5 GALLONS WILL BE VACUUMED WITH A WET-VAC - ROOM WILL BE VENTILATED UNTIL CARPET/FLOORING DRYS (4) Other Resource Activation . e 04/02/9;;:: MODERN .BORATORY SERVICES INC 21.)00-000523 00 - Overall Site Page 7 <F) Site Emergency Factors ..-------.-------..-- -------............-.......--.-------...---..- <1) Special Hazards (2) Utility Shut-Offs A) GAS - ALLEY ON SOUTH SIDE OF FACILITY TO LEFT OF FREIGHT DOOR B) ELECTRICAL - ALLEY ENTRANCE DIRECTLY INSIDE FREIGHT DOOR. C) WATER - ALLEY BEHIND FACILITY TO LEFT OF FREIGHT DOOR D) SPECIAL - FILE CABINET AT FRONT OF SHOP EAST WALL CONTAINS SITE PLANS FLOOR PLANS AND MSDS E) LOCI" BOX - NO C3} Fire Protec./Avail. Water ------- .------.--- PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER ARE LOCATED WITHIN THE FACILITY AS MARKED ON THE FACILITY PLAN FIRE HYDRANT - 0 STREET AND THE ALLEY BEHIND THE FACILITY o STREET IS WEST OF OUR FREIGHT DOOR (4) Building Occupancy Level ....---------...-.-----..- 04/02/92 MODERN LABORATORY SERVICES INC 215-000-000523 00 - Overall Site Page 8 <G} T¡-~a i )"sl )",g --..-----------...-..-----...-----..--. . ..-------...--- < 1} Pag~? 1 ---- WE HAVE 2 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE OUR EMPLOYEE'S ARE INSTRUCTED ON SAFE HANDLING OF MATERIALS, USE OF SPILL KITS, EVACUATION AND REPORTING PROCEDURES. <2} Page 2 as needed <3} Held for Future Use ----.---. <4} Held for Future Use ---..-...------- . e . . CITY of BAKERSFIELD "WE CARE" March 27, 1992 2101 H STREET BAKERSFIELD, 93301 326,3911 FIRE DEPARTMENT S, D, JOHNSON FIRE CHIEF Robert B. Ward II Modern Laboratory Service, Inc. 831 19Th Street Bakersfield, CA 93301 Dear Mr. Ward: Enclosed please find the computer copy of your Hazardous Materials Business Plan that you certified as complete on March 11, 1992. This plan is not complete. You have failed to complete the highlighted section D1 on page 4 of your plan. Please complete and return by April 1 0, 1992. If you have any difficulties please do not hesitate to call our office at 326-3979. Please send copies of MSDS sheets for HGB reference 1600, Dilvent 1600, HGB Reference 900 and Dilvent 900. Sincerely yours, ~~ Ralph E. Huey Hazardous Materials Coordinator REH/ed Enc!. ¡' ..-:¡ BAKERSFIELD CITY FIRE DEPARTMENT e 2130 -G· STREET e BAKERSFIELD, CA. 93301 (805) 326-3979 ~ ~~ ~f~vu V ~.GJ I ~ 7, ;õ OFFICIAL USE ONLY I D # Cù05d~ BUSINESS NAME I , ,HAZARDOUS MATERIALS BUSINESS PLAN' AS A W~OLE FORM 2'A RECEIVED ~JUN 2 0 '989 H ~l. M.A T. D,V. INSTRUCTIONS: 1. To avoid further action, return this from within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 1~-30 0 ~ SECTION 1: BUSINESS IDENTIFICATION DATA (~~~ A. BUSINESS NAME: MODER!\) LI\ßORijTO£'( SE,ev\c£'S, \NC-. B. LOCATION / STREET ADDRESS: 83 \ \q~ ~-\-ree:t CITY:, '"ß~kers.-P\e\& ZIP: Q1'30\, BUS. PHONE: (fJc>$) G:,l;,q-ðL.\-Lty.. SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your loCal fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE A. (¿o6fRr WAAD PHI DURING BUS. HRS. AFTER BUS. HRS. "(-,4 .-D'f~t &lo4-04'-t~ PHt ""4-qS~~ PHI ¡ l' - 2. 433 STRÑ 5'-\G«p.\L.~ B. PHI A. B. c. D. E. NATURAL GAS/PROPANE: A\ e DtJDR, ELECTRICAL: e ~ V\<!i- WA TER : i it SPECIAL: LOCK BOX: YES /® I F YES, LOCATION: f\LE C'Aß\t-J~'" A-ì .ÇRÐtJf ~ J»Pf œ~r WALL IF YES, DOES IT CONTAIN SITE PLANS?~ NO MSDSS?~~ ; FLOOR PLANS?~/ NO KEYS? YES ~ SECTION 3: e e ¡ '; '" " ., ~ < , SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE , t=}c(';d.et'\t~ <;~\\\5 CðV'\ b~ ltïan&leJ \v)1-ert1~tl~ ~~ u~e of- a~~or-bam- M.~Ter·q~llð ~ \\ ~~\LL. \(;..\-.3 rI ~"t av-e. on s;+e... WC\.~-te Mater;eJ 'Nf)\)\!1 be.. p~cd, \tI\ REO 'B\D~=èðartf \0 dtf orrJ pi c.1ç~ t) f ~y ~ \ l c.OMdl~ ot, ~~v~er ~ SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE . tn;ew~íxR';¡~eW\ergeAcì e1 4ðtt ~o t1Dt re,,\-vì re- \'on .s\4« It +'re~tMg~t w)\\ ~ ?~a~.~rte1. V~ê\ per SDV'la\ ve""\c-(e~ -to ~V7 Jr>AINIV\ ~SP'+~ E.R~. On ~:ri~u~~~~IÇ¡~e(l)cte.! wd\ be \",\-\~a{eJ by C'~l\î I\~ \\ 9l\ (. SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A TRAINING PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. A. NUMBER OF EMPLOYEES AT THIS FACILITY ~ B. -DO 'YOU HAVE MSDS (MATERIAL SAFETY DATA SHEETS) FOR EACH HAZARDOUS MATERIAL YOU HANDLE? 'ES . C. GIVE A BRIEF SUMMARY OF YOUR HAZARDOUS MATERIALS' TRAINING PROGRAM: ð0fl.. Ef()~lOYE~~ ~t€. ··'''J.nroc.-1e'JJ 011\ .s~ hðt.~\;"'~ o~ ñ?ð'I-{er¡~J V~~ 'Ð+ ~p'\\ \<.t.s J ev~ )a-\1o'^l íep~r--\ìV\~ f'f"l)C~~~.s. SECTION 7: 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 AND SAFETY CODE FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION I,1:o'oert -::E- \jJf'rf.b .::u:. , certify that the above information is accuràte. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on H~zardo4~ Material$ (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that ìnaccur~e ìnformati~n· const~rjury. SIGNATURE \~~~'~~lJ1-- DATEb-N~&~_ ----, ..i BAIRSFJELD CITY FIRE D¡fARTMENT 2130 wG- STREET BAKERSFiELD. CA. 93301 (805) 326-3919 " ., BUSIN:SS NAMë I D # II Ü iI I: " !i II OFFICIAL USE ONLY HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible " FACILITY UNIT. \ FACILITY UNÌT NAME: /Y}DDERÑ Lí\ßoR.itTVP-y SERVICE.S. \~. , SECTION 1: MITIGATION. PREVENTION. ABATEMENT PROCEDURES ," "" CD " '., ..', . ..'" f~ ~ I\t\'"\ OÑ ~.. Ac It) ~ I Otv.nlCS 1,e..tC. dve. tv be.. .s-\-õ~ \'V" ð.. WI e-14 \ cabi1it. ®CfiR(1)D Y.! 0 t ))e.\e.rîe¡/\t ØtV1~ 1>ì lve"1r q'{ e '" Dt- -to I¿)e- .3 ~~~&7 t> "<:::1\ 1.1 V e.:(" ~ C~~e.J .""~ \"\ CONíR\~M~tVT.' SL-,oJJ aV1~ c¿~:rko-yS rV~+Lwe-1 Sp;¡l¡ or l€.O\kav-.. Ot.J.fessrv-.t'l'/ 0* ~e.. aW\OI1V\\- oi J'f\I\AS~ WI\\ \o€. MMe... L€.£~ 4ch\ \ Cð..~\..;,()y ~r- 6' ~~lI~ \.U~\\'~ c\etH,e¿{) W\~ ~~~t>y~t1"vd MA1en~ ~-t- w.\\ ~~ pl~c~ ilf\ bio""~~r~ l.Dâ~p - Sp'll~j Dver c; ~JlCNII WIt( \:'>e. vacl.Jv\N\e! I.\)rt-~ G\ we.t - vac .... ~o.,W\ w~\\ \De v€V\+j'~~ t>V\t\l ca~ pet 1.ç(ol>rìV\~ t\V"j..t. . . SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THE UNIT ONLY ~~ eW\r'D--(€e. 011\ S ,t€- w\ll t>~ doorJ ~ veV1+; l,,-k rz;>ow\ ðt.~ C~\\ S~ Sl-,e,n{tl (Jr ßlì~ WG\~ -to "D+i~ -+\~~ ~()\t "'- ~r1'H ~a~ oc('v-r~J - T -Ç' ~~ <2lMployee f\D-\ìUð t\. ~l'1f\7 01- ð.\è~.i\I2SJ ~ ~W ')'0 DlA.tS\&e- ~r -Ç'reJ~ a\v- - P~la::::nvt 'Jeø..v- ì.t ~ 1- ~1-V\V-QÂ. ·' e e .. ,. " ' SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials?..... G~NO If Yes, see B. If NO, continue with SECTION 4 B. Are any of the hazardous materials a bona fide Trade Secret? YES ~ If NO, complete a separate Hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-1) If YES, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (Yellow form #4a-2) in addition to the non-trade- secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION f~R.e e)C-b""j\l\ihm q,V'( l()(þ.~~ ~."'" ~ -Pëtci \i\; a$ VV'la\o-~R DV\ ~~ PAtlL\T\{ p~. , " I SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS (Fire Hydrant) , flttE'" tt'(þlt~T \J LOCA-TCÞ f}-T \\D~' r11(€'Ef It~D 'THE' ·/H.L.iy "'BE~..~ --tk ',f"'f\-C'((;'1,"Y -.. \o'c)u S~€'ET \~ wesT f)ç: 2)\)(( .,:'RE'\qt1 r "DÒl>~. SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NATURAL GAS/PROPANE: ~ Me"~ /.J »\JT "'''~F \.t'" -w -nTe- L.~f--r '- wEtT} or¡ ð E" pF ¡fiE'"" ~t4:'~)ff" l>/:)~. B. ELECTRICAL: .s~\?T - r:JPF ( .J '1>~efcj(.' INS I )E" -F.e~ tÁ# r "þf)O~. C. WATER: SHu.- (:> r': \ ~ 1>1AE"1:Tt. Y Le t=r( WE"tr) .Ð,F F£f/&tJr 'l>OI~ D. SPECIAL: E. LOCK BOX: YES /@ IF YE;S, LOCATION: . f==\Lfr Cft(JIJJ~ IF Y~S, SITE PLANS? NO FLOOR PLANS? YES ~ NO MSDSs? ~ NO KEYS? ~ NO - 3B - CITY of BAKERSFIELD Far. and Agriculture '8 \ HA~ARDOUS MATERIALS INVENTORY NON-TRADE SECRETS ,. L-.I Standard Bus ¡nus BUSINESS NAME: mO~r~ \..~~D"'QtO"1 Se,f"'Ø ~ LOCATION: g~ \ClT ~-t I I CITY, ZIP:\l:er.s-At//tot, cA PHONE': "''1~ Ot{-\.\\.t OWNER NAME: ~. ~t> ADDRESS: '3bOO P1>~ LoN CITY, ZIP: ~A\(t.r.s-A~I& Gt33n 'PHONE ,,: G,¡"q - qS'f'- urø '1'0 INS'l'RUC'1'IONS rOR PROPIDl CODa I 2 Irans Type Code Code 12 location hI" Stored In F.cility ] IlaK Mt 7 I I Oys Cont on Sit. Type , 10 Cont Cont Pres, T..p 11 II.. Cod. 5 Annual Est , lleasul'e Units . Averag. AIIt Page ____ of ____ ' NAME OF Tft1S ~~JL~TY: STANDARD IND. CLASS CODE DUN AND BRADSTREET NUMBER l(7r '"11 - L)!?~"þ_ - 1] 'by lit If NaMS of IIIlxtul't/eo.oon.nt. Set fnstrvct lon, 11 _5WJ~n--.ß.f?9-ffi_____ ____ ~1Eß.J~..~~.'t__t._~~ß ~EÇE(¿~C~1JPUt> ____ Ph~lcalandH..lthHllard CAS NUIIber C 11 N 'CAS IIuIiber 1-~'(I>~nYP'1(HOINE'..l.-nhOfJ(·~~ - IO«k all that apply) . . . --------..,-- OII OntIIt - ... _:~1. ________~__1.t.\l:_21-~__n_______ _~_ ..-., ,..~ ,..-., ,..-., ,..-., to.Qonent 12 ....., C.A.S. ~ 1.0 "'O"''(\..P~i'''o')cY ?ÞLye"ttt~o?L. L_-' Fire Hazard I..~ R.activity 1.._-' o.l.~ I.._J Sudd... R.l..st I.._J IMediat. _:~_ ~___~O((P -",S-,_L- He.lth of Pres sur. Health sÞ~ ~st ~'!l___ __ _~~t- ( ~~ t2E~~~L ____ eo.pan.nt 1\ N_' C.A.S. ~ 2.- PI\EI-'Þ)\Ye:nt.')-MPL. _ .'P __=!__ I'-L-1"t.[, $601"-. Ç'L.,vÞA\OE' ... Î~it -'fq-'f- ... "'O~'1'" ø*"~^,, 11'1<)" Pl>t.'( ST'it ~~L.. .2.,) _ ~ I - -IE> t ~ - b\ l. '" e- ~ IløÞò -- -¡:-t4ÿ D ~Ø)Y PY~IOI ~ Tffiõ"'t :¡j~--- ----- .Ill.. t Wf -ì;¡-1- Cø.ponent n ....., U.S. ...,. -~- Physical .nd H..lth Huard (Check all that app Iy) C.A.S. ~_______ ~:] Fir. Hazard [~Reactivity r:J Delayed r:J Sudd.. R.l..1t r:J l-.dim H..I th of PI'tSIUI't H..I th to.ponent 12 ._. C.A.5. IIuMIr Cø.ponent I] ....., C. A. 5. ...,. ~- Phvsic.l and H",lth Hnard (Check .11 that app Iy) C. A. S. IIuIIbtr to.øonent 11 1IøI' C.A. 5. "'*'" ~-., ~~ ,..-, ,..-, r,-" L --' Fire Hazard 1.._ Reactivity 1.._-' Delayed I.._J Sudden RelNse I.._.J IMediate Health of Pressure Htllth to.ponent 12 ...., C.A.S. 1Iu.btr C~t I] N_' C.A.S. bbel' _~1~_L_':L~~___L_?:~~______L_..lÞ~~__14.~g2(Pf) l..J..l?._l.J-L~_L1:.LL__ Physical and H",1th HU'I'd (Check .11 that apply) C.A.S. Nu.btr ___________..__________ C08pon...t It N_' C.A.S. IIIIIIbtr r -., "-'?"1 ,.. -., ,. -., ... -., L --' Fire H.zard l..ðowJ Reactivity 1.._-' Delayed I.._J Sudden Rele.se 1.._-' IMedlate Hea 1 th ot Pressure Hea 1 th CQIIPOIItIIt 12 11_' C.A.S. lIù.btl' COIIponent I] N_' C.A.S. HUllbtl' ----- - ...- ----- ----------------- - '\)\\"t)t"t.JT Gt 00 ---- - 2. - P~"-)ty: e.~ J( _____.n__) - ~.'3Þ ~ \U.~~~-" _________________ c.f JO~IVM ¡C''''''1:Jih''~ _..__ ________~_2~_i..l:__'1!1..:...'i.---------..------- ------- I I I "ERGEHCY CONTACTS 11 ,&,JA/lI:P...L_______________________ T1r,~L--__-----~~ ~.-- . ""õoL.LI±~~~---= ,,,V...l~-:----1t1~-:~"~----· C~rtjf;cation (Read and sign after co.p1eting all sections) I certify under penalty of law that I hav~ oerson.lly eUlllined end.. f,.ili.r with the in for O~inin the ínfol'eatlon, f b4!¡;.... that the ZUblo' ted inforNtlon Is true, .ccurate, .----.. --TT - l--·'l--~T--~---~~O.--!£: ____!!~.f)£-:¿-.-~~----. -----£-,.-- "..~ dn 0 1C1a t1\ e 0 o""~r/operdtor "o",,~r o~erator s au nor1Zro reoresen dl1ve "y inquiry of 'J:I! individu.l. I'l!SpoIIsibl. II-<--S~~-~!~~----------- , 'le 19nro :...':.::::f- '" CIT}T of BAKERSFIELD ~ ~, , t FarM and Agricultur! L-.J Standard Busin!ss ~ I HA~ARDOUS MATERIALS INVENTORY NON-TRADE SECRETS " Page ____ of ____ " " BUSINESS NAME:fi\~Jl,(~ ~~ra"'aPvw Ç~t'vìlJð lllK.. LOCATION: -þ:":' \~ ...10, ST T ~~~~É ;~p:æ~~~~4'~d . rA OWNER NAME: R· W*", (j) ADDRESS: :H,op pÞé LN. CITY, ZIP: 'PHONE ,,: RIIn!R 'l'O INS'rRUCrIONS 'OR PROPIlR CODðS NAME OF Tft1S ~~JLlTY: STANDARD IND. CLASS CODE DUN AND BRADSTREET ~UMBER or~ 11_ - º!f' '1'1 P9. Q.. _ I 2 Irans TYII! Code Code 3 1Ia~ A8t & Average AIIt 5 Annual Est 6 lIe sure Units t , , Oys Cont on Site Type , \0 Cant Cont Pres 1 T.-p 1\ III. Coel, n location lIhtre Stored In fec II I ty 13 'by lit It NalltS of IIhture¡eo.oon.ntl Stt Instruct lonl ,- - ., ~ ~ ~ r - ., r - ., '"V" L_-' fire Haurd LL'5i.Rlðctivity L_-' Delayed L_-' Suddlln RelHse ~ IMedlate Hlta Ith 01 Pressure H..lth CœQonent '2 Na.., C.A.S. bbet- ~~£__~{t~§):rJ L.1SE ~3~ 10 __~_~:~_:~_;~rl1~;~~~~_~Ã~~__ _4t 'þI>TA,S11 VM C'{ ft IÛl6 E' .... IS'I-:$O - r __ Physica I and Health Haurd tctl!Ck all that apply) C.A.S. NU8bIfr _________ Co.ponlllt 1\ N_' C. A. S. IIuIIber eo.pon.nt n ....., C .A.S. bbet- Physical and H.alth Haurd (Check a 11 that app Iy) C.A.S. Nu.btr _______ Cø.IIontnt 1\ ______ __ ___ RA-PU>_--=YlÉ ___ ____ N_ , C.A.S. ...... ~A't£a""'''lt.y AMMþto)htNt SAc.:r ~ 2.~ ___ il \\\ '\ - q ì ::L_________ I 9PT1UJL........ ~'(A"'I )I! <. ~ \ ';'1, SD ~ 2 PÞT1'\S.tll1;\o\ R;~Il\t'{~"'I6~ "" \~l (,-l.:.b~ -- --- ,...-, ~ r-., ,.-., r'~ L _.J fire Huard L þ.J Rlfactivlty L _.J Delayed L _.J Sudden RtINst L poi IMedllt. 'HNlth 01 Pressure H..lth to.ponent 12 M_' C.A.5. IIuMer eo.oon.nt 13 ...... C. A. 5. IMber < i)., --------- ..-.--- Phys ical and HN I th Huard (Check III that apply) C.A.S. IIuMItr Cø.IIontnt" 1IHt' C .A.S. ....,. -- ----- ,..-, ,..-, ,.-, ,.-., ,.-., L _.J fir! Hazard L - -' Reactivity L - -' De1aylfd L - -' Sudden Rel..n L _.J l-.diate Hea Ith 01 Pressurlt Hlta Ith to.ponent 12 N_' C.A.S. Nu.btr --------------------- .. ~t'3 "_, C.A.S. IMber --_l___L__________l_____________l__________J_____.l__l__1__-L__1____--1___ --- ---- - Physical and HNlth Haurd (Check all that apply) C.A.S. Nuabtr __________________ Co.ponent" N_' C.A.S. NUIIber --------------- ----- ,...-, r-' ,.-., ,.-., r--' L _.J Fir!! Hazard L - -' Reactivity L - -' Delayed L - -' Sudden Rel..n L _.J l-.diete Hea 1 th 01 Pressure Hlta 1 th COIIØOI'ItIIt 12 N_' C.A.S. Nùabtr ------------..--------------...------------------ ------- to.POI'IIIIt 13 N_' C.A.S. NUllbtr -E RGENCY CONT ACTS · I R¡JtJl~8'-liþ-- --____________________ ~~i-$..:--------------Bt~ ~I~~~~~------ '2 i¡¡---~~~ßJ-I:..I:-------------- mVë~-e.~---------------~ ~ ~t~-~I-------- Certification (RelJd and sign after co.pleting all sections) I c!!rt1fy under peIIaJty of law that I have Plfrsonally exallinl!d and aa faailiar with the i f~he~..,~¡;7r~sitt!d inloraation ;s true, accurate, R ~.@ - ¡¡;¡r õ 1 në iå' - tit, ë-õ1- õ;Öë¡: Toøë¡: ¡ t õ¡: -OnWñë¡:7õõë;: å tõ¡: 'š-åú t F\Õ¡:ma-rëõ;:mñt åHŸë ---- ... -------------....------------ sed on II'f inquiry of tho.. individuals responsible IIJ~s._-=~---{~iCjl2_--------- a,e 19nn>