HomeMy WebLinkAboutBUSINESS PLAN
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Bakersfield Fire Dept.
Hazardous Materials Division
2130 "G" Street
Bakersfield, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
1.
2.
3.
4.
To avoid further action, return this form within 30 days of receipt.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be brief and concise as possible.
RIECE-WED
AUG 0 6 1990
HAZ. MAT. DIV.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: ~~e(0~\e~d C~..\-Lt Fi ('~ De.~ Sto. \ \
LOCATION: 700f) 6toc.k~
MAILING ADDRESS: QlD \ -\-\ ~ree-\-
CITY: ~\:.en:,tie.\ 0\. STATE: ~ ZIP: ~CjPHONE: 31ß- 1'112
DUN & BRADSTREET NUMBER:
SIC CODE:
PRIMARY ACTIVITY:
H re S0f>'~~-S\()f\
ð..Q ~ te \'5"\\ e \á
~IO\ H S-\-ree.-+
OWNER:
C~-9
MAILING ADDRESS:
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE
BUS. PHONE
24 HR, PHONE
1.
2.
1.
FD1590
I) Bakersfield Fire Dept. .
, Hazardous Materials Division
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
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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 "CALlFORNIA 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.
, '
, ¡ t
OTHER (S~ECIFY REASON) .
SECTION 5: CERTIFICATION:
I, F~+~, {JOfar-.... CERTIFY THAT THE ABOVE INFOR-
MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM1S OBLIGATIONS UNDER THE "CALlFORNIA HEALTH AND SAFETY CODE"
ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATlON'CONSTITUTES PERJURY.
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DATE
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FD1590
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BAKERSFIELD CITY FIRE DEPAR~NT
2130 "G" STREET
BAKERSFIELD, CA 93301
(805) 326-3979
OFFICIAL USE ONLY
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HAZARDOUS MATERIALS
BUSINESS PLAN AS A WHOLE
FORM 2A
INSTRUCTIONS:
- --- .-.- . -.
---.----- .
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1. To avoid further action, return this fo~m by
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.
SECTION 1: BUSINESS IDENTIFICATION DATA
A. BUSINESS NAME:_~ ~d~ t ~ ~~. S~' C¿¡¿..o~N--...
B. LOCATION / STREET ADDRESS: 7ò öo S~ +\U~.I\t" '
CITY: f)~ ZIP: 'I330Q BUS.PHONE: (caò~) 32<'0 303 Î
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.
E~PLOYEES TO NOTIFY IN CASE OF E~ERGENCY:
NAME: AND TITLE
A. 'B~ ()~, Ph#
DURING BUS. HRS.
32.~ 3q L.\4
Ph#
AFTER BUS. HRS.
o "'^ ~
B.JA~ ~ ,L)~...e..J~
Ph # "3 L.(.:, 3PI \ \
PM .5 2to 30Q E\
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: ~ ~
B. ELECTRICAL: ~ ~
C. WA TER : '7~ W0...Q.S2..
D. SPECIAL: D~,kJ ð'FF - on ~ ~ ~~ ~.
E. LOCK BOX: YES / ~O IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO
FLOOR PLANS? YES / NO
MSDSS? YES.I NO
KEYS? YES / NO
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SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSINESS AS A WHOLE
'S~~ - \,{O ~,
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SECTION 5: LOCAL EMERGENCY ~EDICAL ASSISTAJ.'lCE FOR YDtJR BUSINESS AS A WHOLE
S~ ~- ~ l/€'ht\\ \-N~)
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~~~~~
C)~~A~.
r,
SECTION 6: EMPLOYEE TRAINING
,
E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E~PLOYEES WITH INITIAL AXD
REFRESHER TRAI~ING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO J~ITIAL
A. ~ETHODS FOR SAFE HANDLING OF HAZARDOUS
:'4ATERIALS: . . .. . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . .. @ ~O
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RE, SPON.SE AGENCIES:.... .,... : . . . . . . . , , , . . . , . . . .IES, NO
C. PROPER USE OF SAFETY EQUIPME~T................... E NO
D. E~ERGENCY EVACUATION PROCEDURES:.... .,. ,.......... 'NO
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:...,... E NO
REFRESHER
~ NO
NO
~ NO
YE. NO
E NO
SECTION 7: HAZARDOUS MATERIAL
CIRCLE @ -.. NO - NONE
DOES YOUR BUSINESS HANDLE HAZARDOUS ~~TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A
SOLID, 55 GALLONS OF A LIQUID. OR 200 CUBIC FEET OF A COMPRESSED GAS:...... ~ NO
If ~~ ~QAî~ , certify that the above information is accurate.
I understand that this information will be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
Sec. 25500 Et AI.) and that inaccurate information constitutes perjury.
. SIGNATURE .~~
TITLE~" ¡J'G
DATE 2 . S . 8 'ò
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BAKERSFIELD CTTY FIR::: DF.P,\RTII::X7
2130 "G" STHEET
BAKERSFIELD, CA 93301
OFFICIAL CSE OXLY
ID#
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BUSINESS ~A;';!E:
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS
1. To avoid further action. this form must be returned by:
2. TYPE/PRINT YOGR ANSWERS IN ENGLISH.
3, Answer the questions below for THE FACr:r~Ft:y,_ UXIT_ LISTED BELOW'---------- '--'-
4. Be as BRIEF and CONCISE as possible. .- - "- ". ~
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FACILITY UNIT;':: FACILITY UNIT NA.'Œ: B F ð 51(;; fl@r) II
I.
SECTION 1: MITIGATION. PREVENTION, ABATEM~-r PROCEDL~ES
,ÔY7 focflh::J /J.f/A h"re Chle / ~ç~,!CO A'~6'c/q(~rv;~
~~-h U¿¿frÞ~ ~~~ .
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Þ '""'1 ~ µ,.,¡;? ~ ~ ~ Þ h..o~Zð~
SECTION 2: ~OTIF!CATION A~~ EVACGATICN PROCEDLKES AT THIS u~IT O\LY
Nt)lllfí(,..Q-}/O'1 ~ f,r~ (A;)~VJ1C/"/C¿;I/&4.J ce:~;1er
Vt'a phoelte-( ("aJio +r~ 1t1¿..
¡J()fl·t,~I,iM 1)1 Þ1Ç}/~1; pg;:rJØ)/)Ael '~
jI.I,;f¡/,'e,.((ìllø" -k ~$f~ nre CÁ¡~/ /G¡ÇÆI?Øp/~&/ep/
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SECTION 3: HAZARDOUS ~ATERIALS FOR THIS UNIT OXLY
A 0 th F 1 t "t t H \f" . 1 .., ~.·E ".' ·0
. oes is i1ci i y \.;ni con .::tin ,i1z'lràous . BI..Crli1_S. .. . , .. ~ "
If YES, see B,
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES ~
If No, complete a separate hazardous materials inventory
form marked: ~ON-TRADE SECRETS OXLY (white form :4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS OXLY (yellow form :4A-2) in addition to the non-trade
secret form. List only the trade secrets ori form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTIOX .
F,i-e e}(+íV\~v,sher:s. CtJrnèd} Or .fare qpparo¡'BJS,
SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E~RGENCY RESPONDERS
Sf) ~ I/J t?~ -I tJ f tJÞ 'h:rl n;",
SECTION 6: lOCATIOX OF UTILITY SHUT-OFFS AT THIS UXIT OXLY.
~ \""T I~'r.- ,'l)....OP"···-· . -- ~
...., ....., , v.....,)·C¡\ ·,"\r:.·C0..5T µc;/~ Ó¡//~;~
B. SLECTRICAL: 5VPPl0eoler ¡l"O()PV? /~$;~,
C, WATER :fa..sl cJa// -- ~¡/15/.~e.
0, SPECIAL: b~e.5el !ShtJf oIl' fleJ(1 ~ dJ~se) {Yve J pll~PJ
E. LOCK BOX: YES'&:> ~~ YES, LOC,HIOX:
IF YES, SITE PLA~S? YES / XO
FLOOR PLAXS? YES XO
~SDSs? YES XO
~EYS'" YES! XO
- 3B -
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. . , , , :. .
FORM 4A-t Page ~o( -t--
NON-TRADE SECRETS
IIAZARDOUS MATERJ: ALS' I N'VENTORY
~ S N MI F.: "'ßA-tak\~FltL.b h ~t. P!Pf ~~n OWNER N ^ HE: ß~~K.Æ.f ft!.LÞ ñru ])£.-þ¡ FACII,ITY UNIT , :b~1J
: i~~ \.~u. H4J~ AUURE88 I tIt)' '» '';)f' F ^ C II, I TV UNIT NMIE: - ---"-
Z I I' : t<t. 4Æ.o.~ '13 ~o ~ C I TV. ZIP I . A-ttjtQs¡::"aJ» ~ ~ ~ø I
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:1 rIJ~LL -!1R!!!!l!L -YN I T, eUIJE_ CUU~ FACILITV UNIT tiT. CIlt:MHìAL OR CUMMON NAME -0!UL ~!!!J!I r
a.Al A R£At of' S'iAi J ) Ñ D \.t~L p!4,£ b cl b 'ì7Q,DI ftb~
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PIIONE . nus IIOURS: '3 2b~3C,--n-
AFTER nus IIRS:
PIIONE , nus IIOURS: 5 '1.~ -3C,1I
AFTER BUS. IIRS:
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10. ~SDS Stoe Sox
11. Railroad 7r~cks
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C~1v@wftYs. dnd ?ark1n~
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screec :1a.es.
1:. ~ence or 9arrler
a. Wlre
b. :iasonry
3. Sto~ C~ains. Culverts.
YarTi Crains
c. WCloci
4. C~aina~e Canals. C1tcbes.
Creeks. '
d. Gates
5. BuUd1n~
a. rra.e constrUction
13. Power 11nes
14. Guarci Stuion
15. Storace raaks:
IdsncHy the
ca~c1tT 111 ~1.
a. Above ~aad
b. aDderu'Ounå
lS. Dlk1Dc or Se~
IT. !Y1Iaac1oa Rouee
18. Ehcad.oa .veaz
Idne1l7 the
locad.oa .e.r.
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b. ~asonry conseruction
c. !fetal. c=nstrucUoa
ct. ~a Doo...
6. atl1ltV Co"e~ls
a. Gaa
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a. "c_
T. lIre SUppresaIoa Sywc...:
a. lire !l7QnIIU
It. FIre Sp...1Dicler
CøaD8C1:10_
a. OIIaide ~
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c. ,ire StaDdolow
CoDaecc1o_
:D. OIIaIde BazaraOUll
llaceria! Storaø
eI. ..c.... COncrol 'tuns
Co... ~ceec1oa systeee
:1. OIIa1de RazarUaua
:fatIll'1&!
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2:2. T7Pe at !lazard0Ull
IIIIcIII'11Ù/W..C.
Stonà
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s. lire O-.,ara.ac Accesa
T"r!'! ", 't4I.\RDOUS 'Q~t.U.
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C · C4rnaivw a · OJ:icU.:.... G ,. Gaa
. · ...c.... Resen:1 "Ie r · ,oxic S . SaUd
I . Radioloc1c:aJ.
p . Po'¡.;¡¡
II . Crracenic
D . 10Iasce II . Et1010C1c:d
1xaaoi.: 11aaaaa.1e ~lqu1d· 1L
YAC!tI1T ~TAGRAH (Required lteas La ~ddltioft to the above'
1. Risen !o... Spr1nX.1en a. 11" Escapes
%. Parci t10ns g. Air Condit1oniac Un1ts
3. Stairways: Inci1eaca the 10. Windows
l.",a13 sarveci ~r17.
b1eÞesc to la.esc. U. Inside iluaraoua Wastlt
Storaclt
4. Escalato~~ [naLcaes ~nlt
l~v..ls served (1"0. 12. IlIside !fazardous
!¡i~nesc to la_st. Maceriaia Stora~
,. Elevacol" 1:J. IlIside !fezsroous
~scer13¡s Use'nanQl~n~
s. ~Ct.ic ~c:cess
14- S~r :Jr:l1n [niet~
7, Sky I tenes
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BAKERSFIELD FIRE DEPART£'
BUREAU OF FIRE PREVENTION
ÂPPLlCÂ TION
fi- 3 -11
~ /4/-/90
Dote
Application No.
~,
In conformity with provisions of pertinent ordinances, codes and/or regulations, application is made
by:
{}WUA ~ ~ ili. 17D ot~, 9i1
Name oi Company / / Address
to display, store, install, use, operate, sell or handle materials or processes involving or creating con-
ditions deemed hazardous to life or properj'V as follows:
,,1ß.->->~ fr) 55 D -~';tr¿ ,£, L:)...j¿ -*~ i Jt ùW0
~. ..1~ ,k. II) 7ð"Uö /f,tÞ-.liv ~.
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Authorized Representative
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perm~~.......~.!C2.' Z~J.Q...................
tte
By. ...................4K........ ........ ........................' '" ....
(I!..i) Fire Morshal
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JUN 04 '9Ø 10:05
P. 02 ~L.- 3~'f
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...- GARY J. WICKS
...."C'( Olrtc;tor
(IOSI 881·3502
STEVE McCAUoEY
D'~tOf
~700 M Street. Sullo 300
eake"lIelcJ. CA 93301
Tel,phone (80S) 86'·3636
Tel,cople' (805) 88'-3~2¡
RESOURCE
PERMIT FOR PERMANENT CLOSURE
OF UNDERGROUND HAZARDOUS
SUBSTANCES STORAGE FACILITY
PERMIT NUMBER A 1219-18
FACILITY NAME I ADDRESS:
OWNER(S) NAMEI ADDRESS:
CONTRACTOR:
Bakersfield Fire Station #11
7000 Stockdale Hwy.
Bakersfield, CA
City of Bakersfield
1501 Trux.tuD. Avenue
Bakersfield, CA 93301
Placer Tractor Service
P. O. Box 170
Loomis, CA 95650
Phone: (805) 326-3724
License #440591
Phone: (916) 652-5535
PERMIT FOR CLOSURE OF
PERMIT EXPIRES August 31, 1990
APPROVAL DATE
J. TANK(S) AT ABOVE
LOCATION 550 ::c;-!!-
~~JL.,
APPROVED BY
Michael Driggs
Hazarc10us Materials 5p èlalist
. ......... ......... ............ ...... ......... ................ ........... ...... ...... POST 0 N P REMIS ES...... ......... .... ....... ....... .............. ... ............ ........
1.
CONDITIONS AS FOLLOWS:
It is the responsibility of the Permittee to obtain permits which may b-: required by other regulatory agencies prior to beginnin~ work. (i.e.. i::
Fire and Building Department!.)
PerlUittee must notify the Hazardous Materials Managctllent Prog.am at (80S) 861-3636 two worklag days ~rior to tank removal or abandocr:-,
in place 10 arrange: for required inspections(s).
TapJc closure activities mUSI be per Kern CounlY Envirol1menlal Health and Fire Department approved methods u descrjbed in Handbook'
~ '
It is the contraclor's rc:sponAibUity to know and adbere to all applicable !aws regarding the hancUil1g, transportal1on or trealtnc:nt of ha¡ar,
materials,
The tank remo"al contnclor mUllt Þ.ave a qlJ:;¡liiied camp an)' employee onsite supervising the: ta.nk removaL The employee mUllt have tank~:::
experience prior 10 working unsupervised.
U any contractors o/ber tban IhOJe listed on permit allo permit applicalion arc to be utilizecl. prior approval must oe granted oy rite ~
listed on the pcnuil. Deviation (rom thc submitted application is ItOt allow~d.
Soil Sampling:
a. Tank si%.C IC$$ than or equal to 1,000 gal1oD.& - a minimum of two sample$ must be retrieved from beneath the center of the tank at de
of approximately two teet and six !eet.
b. Tank size greater thu 1,000 to 10,000 gaiJo¡)$ . a minimum of four samples must be retrieved one-third of the way in from tbe e::
each tank at depths at approximately two feet and ~ix (ee!.
c. Taü size greater thall 10,000 ¡allou - a minilnum ot six uCllples must be retrievec;l on-fourtb or tbe way in from the enÔs oí eae::
and beneath the cetuer of each tank at ~cptlu 0{ approximately two Ceet and six 'eel.
Son Sampling (pipinc area):
A minimum of two samples must be retricved at depths of approximately two teet and six re~t tor every 15 jD"f fcct of pipe run and und
dispenser area.
2.
3.
4.
s.
6.
7.
s.