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Home My WebLink AboutBUSINESS PLAN Per l1~t:i".;:'i PERMIT ID # 015-021-002206 ,t' ' y~, ,() , CENTRAL CITY VOCAtI@~~t'sc )" ,l': *1;~::;;'~~~~/"'-' LOCATION 1900 frRðx:~fÌN t;,·O" "·1 If ..~.! L; f~" ~0.. .} ~~. ",.",\ -}. -.~ '~"."" ..... ·~~7,¡ii"· " , I Issued by: it Operil.te to Hazardous Materials/Hazardous Waste Unified Permit ...... CONDITIONS OF PERMIT ON REVERSE SIDE This oermit is issued for the followin.9: o Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 lAY 3 3aijl Approved by: Issue Date Expiration Date: June 30, 2003 '~\ \- c DCÃ';) (G-!ÿ\ \~ . 'SIT t: I 0 ::tI C")~SIor{:0?:> (\~f1U: Cvn~oJ) ~i \ft,Ca1-Jt)~<L0 S~hd0) C~\)S, ;,,)_1)'::) ûc.LA fc.SS " ) c,\ O~ \ ( J ~,>í) A \) ( I if' V -') f .... 'i.. ..... ~ V) - <" 1J' ~ ~ '- . " " ~ ~ "- ~ II Ii ~ \1 Ii t " ~ ~ ~ "- "- ~ -+- ~ .. ~~ - ~ '-.\ <r ~ c ,¿ít .~ " >-" ~ ~,D 8 ''v ~ ~ ~ u ~ \j is '" ~ """~ (; -, . ~ ¡ .:.., ~ '~ , ~, ...., i - ~~ ...,~ <t~ ~. \ ''''I ..... --J> a -, ....J I I Ii iL I~ì ,_ '\1 , ' (. <oJ <::J' 7.- ~ c È 2 ... ~ -L ~ ~þ, \~ .., ~ C) ::2 ~ '1- 0 .... 'J 6"" N' ... '" û ~~V\ + c <;) I..... i ~ ,~ /\ \ lC.:r: ~I \ I \ ___-c-~ , : /! \~,,-, ,) I I -, ",--". . 220 f.p // /~±'~", / ' \. ,/ >- \ , <.-£ ) \'" // " / \ // '''-......__..-/' /~ ./ /' CD /~ " " .---- ,,/' OJ ,/ I /-, ,/ ,/ /' L_,___._____,_ i I I /~ r-- / /" // /' / 'I....... CO ~...... ...... '- i ......,., I ........... \ "- II ............ '......... I ..,""".. /" CD // ,,/ // /- / r--- ú) ./ ,,/''''' / ./ /' -- , I "-.. : ........... ... '... " <.0 ~ /.- ~ / '; / ' /" ./ / " ..........., IJ") (") .... .......... ...., '... '.............. ,/"/; / /~ . ..- .----/ / /' / '<7' ....... .......... ............ '......... ....... 0'ì ..., ........., ........... ............. N // // // 0 " .... ''>-...... ',.. ,'" "'- "'--<' -:... '-.' .'....., ~. /: / ' /' /'~/ (j) ~ .... ; .... _u__~ ,- - ._-- ----- '-\- . C/) ~ '. .. -e e CITY OF BAKERSFIEl..D FIRE DEPARTMENT OFFICE OF ENVIRONMENT At SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3fd Hoor, Bakersfield, CA 93301 oc1 () 1.0ø1 FACILITY NAME Ceh~"'~ I C(~J V(JC~fl1l1Al INSPECTION DATE Oq /30 J oJ ADDRESS Ot) rCl V\ I PHONE NO. (;3 4 ....q.oj~ I FACILITY CONTACT ' ,"''''''0 BUSINESS IDNO. 15-210- DJiS'-()a/-OIJ~()~ INSPECTION TIME ; 10 NUMBER OF EMPLOYEES 4 Section I: Business Plan and Inventory Program ~utine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS ~ " Appropriate permit on hand V Business plan contact information accurate \/ , \/ ,/ Visible address Correct occupancy I..- ". Verification of inventory materials V - Verification of quantities \.... ,. Verification of location c..-I Proper segregation of material ""') Verification of MSDS availability iv Verification of Haz Mat training V Verification of abatement supplies and procedures v.... " Emergency procedures adequate :V Containers properly labeled :v" Housekeeping tv Fire Protection V .V .... Site Diagram Adequate & On Hand -~ 1,7" Aoy hazardous waste 00 site?: Explain: DYes JifNo \Å/)~ Séé(] V ~ CULZð cI~ /V x~A; , Bus' ess Site Responsible Party Inspecto~ ~ C=Compliance V=Violation Questions regarding this inspecûon? Please can us at (661) 326-3919 White· Env. Svcs. Yellow· Station Copy Pink - Business Copy 10 :¡ . ' ~r , ',;:1 ;"';';""'?;'"·'·"'';i''ji''tf~~¡q,~ 1 ! . . "'. ,It -- If --..-.....--., '_N~'_____'_'~__ -.---'---,---.------,--.,..' ......_..., \ --i.,'="".-:-~~.~. '·r".!'I"",;,·~ 1...-:,-'" :,.1 . .J'¡~ CORRECTION NOTICE "', (ì'" 9 31 ,J I i ( '.' CITY OF BAKERSFIELD BUILDING DEPARTMENT .715 CHESTER AVENUE (805) 326·3720 / Location: /?ðð 17íuxrtr,J You are hereby required to take the following action at the above location; o CORRECT & CAll FOR REINSPECTION 0 CORRECT & PROCEED Compressed gas or oxygen bottles are not allowed inside the buildinq or work area. Any system handling comoressed gas or oxygpn mllc;t he "ard- piped, enQineered sJstem. ;3. Any hoods used for exhau~ting g~~~~ or odors mus~ b@ of a ~ t commercial type and properly sizp.d. pxh.'lI')ted and terminated. ;4. Any open !lames not allowed around combustibles. ,. L r ;2. i5. Extension cords are not allowed to bp. I1c:Prl for- t'"o'1nection ~.' of equipment. f6. i,.. Submit the following to thp RIli1rlinlJ and Fire npp"rt"pnt') ... for revip-w, approval and pprmit~ A. Floor plan - show boœmding size. room sizes, bathrooms. ha 11 ways. B. Show electrical recepticles. C. Show work stations and type of work to be done. Compleûon Date for Corrections: _1_1_ :~. I'" Received by: \ \ ;' Inspector: Rus hns n Initial: Þ J - Date: _il./ ~/-12L Desk Phone: (80S} 326·3935 (from ~am or 12:30pm to 1:00pm) . -------~-----_._~-~-------------_._----_.__._~--~-----,-_._-_._._-_._.~-_. --~'...~-,,- .. ~/- i , . " "f' , ~', :..:: ,~,~,t , '::';;~ f ',: ':\" '.. p.' .-.-. ;' :~f0~~~i~~~~~;{ ..~:~i.~!~rf~;~:¡~1}:;\?¡y;~- :;;;f,~:,;!;¡r;:;;f ¡ ¡ ¡, I' e - ,----- ¡ ,--.......------- CORRECTION NOTICE:]iJ7932 - CITY OF BAKERSFIELD BUILDING DEPARTMENT 1715 CHESTER AVENUE (805) 326-3720 /9tJð ~)(.,-r/Ai Location: You are hereby required to take the following action at the above location; o CORRECT & CALL FOR REINSPECTION 0 CORRECT & PROCEED D. An engineered piping system for gas and oxygen. E. An engineered exhaust system for work areas using 'pen flame. ~ 7 . : Do not operate any equipment that uses any gas or oxygen, compressed or bottled, or do any work that uses any of the above or open flames until the above items have been done. Misdemeanor citations will be issued if jPWPlry hlsiness is not shut down immediately. f" 18. .. " ;. t f ï í r Completion Date .for Corrections: / / f ::::1;\ -~- , ,,\ "-./: \ Received by: \,--.), j - J- ./ - f t Inspector: Russ Johnson Initial: Date: / .2...., -.!L/ D¡' ¡ Desk Phone: f805} 326-3935 (from 8:0: m to 8:30am or 12:30pm to 1 :OOpm) t f - .. r1 -" .ORRECTION W>TICEO 0 7 9 3 1 Location: CITY OF BAKERSFIELD BUILDING DEPARTMENT 1715 CHESTER AVENUE (805) 326-3720 /?M ~rrt,j You '3fe hereby required to take the following action at the above location; o CORRECT & CAll FOR REINSPECTION 0 CORRECT & PROCEED 1. Compressed gas or oxygen bottles are not allowed inside the buildinq or work area. 2. Any system handling compressed gas or oxyg~n mlJ~t hp hrtrrl- piped~ engineered system. 3. Any hoods used for exhausting grt~e~ or odors must be of a commercial type and properly sized. exhrtl.~tE'd and terminated. 4. Any open flames not allowed around combustibles. 5. Extens i on cords are not allowed to be uspd for çormecti on of equipment. , 6. Submi t the foLl owi n9 to thp RBi 1 rli ng and Fi re Departmpnt~ for review, approval and pprmit~ A. Floor plan - show building size, room sizes. bathrooms. hallways. B. Show electrical recepticles. C. Show work stations and type of work to be done. Completion Date for Corrections: I I Received by: . - ,>,' : ,_ . ~~~~~3~~5 I~:~ 8:008« 8:;oa~~~:12:~!d:;:rotp~' · . .. - ~ ~ 4=0RRECTION MnTICE ...... 007932 CITY OF BAKERSFIELD BUILDING DEPARTMENT 1715 CHESTER AVENUE (805) 326-3720 location: 19~ð '7Jlü)(~~ You are hereby required to take the following action at the above location; o CORRECT & CALL FOR REINSPECTION 0 CORRECT & PROCEED D. An engineered piping system for gas and oxygen. E. An engineered exhaust system for work areas using åpen flame. 7. Do not operate any equipment that uses any gas or oxygen, compressed or bottled, or do any work that uses any of the above or open fJames untj1 the above items have been done. 8. Misdemeanor citations wtll he tS$,ued if jelA'elry ðusi''lé$~ is not shut down immerl; ate ly. ' Completion Date for Corrections: I I Received by: , Inspector:..Russ Johnson Initial: pate: 1:1-1 I if 1 D I Desk Phone: ~ (from 8:0 m to 8:3()~m or 12:30pm to 1 :OOpm) e e CITY OF BAKERSFIEIJD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES' UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd I<'loor, Bakersfield, CA 93301 FACILITY NAME ø:~ ~TY ADDRESS f} Q.) tyLú'I·..:~1J1\J FACILITY CONTACT INSPECTION TIME va::... <;GL~ INSPECTION DATE PHONE NO. BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES 1"'L /, 101 , 22.OG Section 1: Business Plan and Inventory Program ~utine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping 11/ PU.4<;E Cl.IA...I,...) - Vf' <SA<> c.\-'v..voC~S Fire Protection V pLC4.Se- «ÄVé &'n,,¡uIsl-tC-tt-s $<:: .-¿,VicP) Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~o Questions regarding this inspection? Please call us at (661) 326-3979 White· Env. Svcs. Yellow· Station Copy Pink - Business Copy Inspector: L-c) ) I\.f'l2:::) £' . '.' ",1' , Ii,' ; ~ .. ~W' CITY OF BAKERSFIEI.¡D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd .'Joor,Bakersfield, CA 93301 ~. Sc:-(~fNSPECTION DATE ('1-/' /()I PHONE NO. BUSINESS ID NO. 15-210- Z2..Q6 NUMBER Of EMPLOYEES FACILITY NAME Ct..~\.. CtT'Ý ADDRESS Rex..:> -p'W"i---\U1\J FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program ~ûutine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection J¡ ¡I' , OPERATION C V COMMENTS Appropriate peon it on hand Business plan contact infoonation accurate Visible address Correct occupancy Veri fication of inventory materials Verification of quantities Verification of location Proper segregation of.material Verification of MSDS availability Verification of Haz Mat training Verificatíon of abatement supplies and procedures Emergency procedures adequate Containers properly labeled , Housekeeping ~ PL~SE: CIJA.b"J - Ví' 6A<; CI-'i..'NI)C.-cS Fire Protection V f7LC^Se- ~At.lc=. EY:r'INVISI-tc:.~5 SC .-£.v;Uð Site Diagram Adequate & On Hand If C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~o ,.' Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow· Station Copy Pink - Business Copy Inspector: L.t) ) Afl2...) 135/21/213131 13:45 U5/14/01. 1::':4U 5349585 "g'Þbl .' U;){O " ; 1, ~,' ) CENTRAL CITY VOCATIONAL SCHOOL CCVTS .t)):' IJ n.'l.L ;U^! IJ 1 . J~.j/ + (;-S~. 'ih~ . PAGE 131 'lllllWV-~ CJ1fd- ðor SiteID: Ol5-D21-002206 Manager : Location: 1900 TRUXTUN AVE City BAKERSFIELD BuaPhonè: Map : 102 Grid: 25D (661) 634-~?8~ CommHa~ : ~lI1.al FacUnits: 1 AOV; CommCode: BAKERSFIELD STATION 01 EPA Numb: SIC Code: DunnBrad: Ha:zmat: Hazards: Fire Press I Tit le I DAUGHTER IN LAW (661} 634-9082x (661) 863 -0186x () x ImmHlth DelHlth Emergency contact MM.IA QUEVEPO Business Phone: 24-Hour Phone : Pager Phone I Title I DIRECTOR (80S) 349-0514x (B05) 322-5825x () x Emergency Contact JULIE ARROYO Business Phone.: 24-Hour phone Page~- Phone Phone: (661) 634-9082x State: CA Zip 93301 phone: ,(80S) 6S0-3541x Stat.e: ::A Zip 93454 Contact : MailAdd~: 1900 TRUXTUN AVE City BAKERSFIELD Owner Add~ess City JESUS QUEVEDO 625 E LEE DR SANTA MARIA Period PrepaZ:@:t": Cex't;:if'd: to TotalASTa: '" Tot:alUSTs: ;;. RSs: &0 Gal Gal --- , --..,,...---" - J Emergency Directives: ""- One Unified List 9 ~ All Materials at Site 1 Isp~cnazlEPA Hazard~~D~ilYMax luni~rMCP . F IH DH G 281.00 FT3 Low E F P IH G 1aO.00 FT3 Hi 00 ~!e~~;¡'!J'f r.~;t\';\t \r\~~ ~ h~~\::'¡~ \' ~.' ~. "... f= Hazmat Inventory ~ Alphabetical Order Hazmat CommoD Name... OXYGEN PROPANE 'l i, _.._......,·..·,~·';::<f·:~~'·;;~,~'~!;~·r~ t~\~~·.~·:·;,~~; ... ._-, '~, ". .,. \~'. ~ '10'''- .10(; .;.:.. " ····\·i.,··~ I~' \'f. ¡, ," ,.~"" . ~ ~ '. '. ... . t.~~. :t':.~r {~·';;I(..l \i.:·.~ '.t~.~ft~\·..;.f~:~z-".;t ~1~~.h(.Ua~)\U$ ~~·)·~7.\~:\\,~,.:;.r!~ .r'f\~.~ :t:'1í:,}.. rr¡.',:è!\;, t}ìa;¡ to,' ''''¡"'t.1 tÏ';"\' ¡i l'f'H~,i: \¡¡:.) f.., , "'..-""."70"....'.,""....-.....,'..,'..,.,",. ,.,'11 ",' .""1 t~t..., "'1i1 ",\!" ~,'..::;\,.'i'~ ~~ 1."!~.1d,t~'~I'.1~~ ~ 6\\1yt 'l~N..ø!~tiCllE el)ìd,~titutH ~ c,o:rlp!(~t:,- ~t~(~ Cir)rI'(1oct n'1~r" agernam plan ~\~!' r-wy 1FJC;lily. S.tQlløturQ--"·-"·~ .-... ····...,.·..·QåT;.·"~·..·,> ....". pl-H-n ~ Gte,f A~ ~n SLß" ~ é) II ~ -[¡:> +n~ -1- 05/14/2001 , SC{O IV ,10 ,~ d mODQ Scz YV\ tþ S\'L e. I 65 be+t-Jrr ""'a.-r' . ! FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 21 01 "H" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395·1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAX (661) 326·0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326·0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399·5763 - - May 3, 200 I Central City Vocational School 1900 Truxtun Avenue Bakersfield, CA 93301 Dear Business Owner: Enclosed, please find your "Permit to Operate," which is a consolidated permit authorizing as many as four separate hazardous materials or hazardous waste programs. Thee programs have now been consolidated as part of the State's efforts to coordinate the regulated activities into one Unified Program at the local level. You mayor may not participate in all of these programs and your permit will indicate which programs or activities are authorized at your facility. These activities include: ~ Hazardous Materials Business Plan and Inventory (which also in~ludes hazardous waste generation and management requirements) ~ Underground Storage of Hazardous Materials ~ Risk Management Program ~ Hazardous Waste On-Site Treatment We value your feedback. If you have any questions or comments regarding either your permit or your responsibilities as a regulated facility, please call us at 661 326-3979 or visit our environmental Services web site at Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENTAL SERVICES ¡JJ Esther Duran, Accounting Clerk II Office of Environmental Services RH\ED\db C/) ) Cf:' ' ú'Z: .,z,/ ú7"J:l d CL7 " ~\~éP~ &. (:Y~Wl/nufiÆ{?, .3ÞOP JÞbope tJ"/tO/b ./"0 0éAb'/,r- Per it to Operate ~'r Hazardous Materials/Hazardous Waste Unified Permit LOCATION Issued by: CONDITIONS OF PERMIT ON REVERSE SIDE Bakersfield Fire Department C r:FICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 1900 This permit is issued for the following: It! Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment 4- .;1 ~... .'~ '.:~~~~. \\ t~f301 r ^':~;r Æ1 . ' ,J /',1 I' \,JF "" ;', t?' ""if, \ ¡^~' .~ I 't,', " Approved by: lAY 3 aaijl i;t ~~~1 PERMIT ID # 0 15-021-002206,,l," ";, ,'.' .~.:_, ' ,/. ',"'" CENTRAL CITY VOCAtlf:..~ .:E SC~ fIef '~ø 1. TR~T1JN "~,.::\ t{ v\"· \4\" ,,;:<ìl' '.' \;:',,~~,. ,,<~,.t LAi..¡n., ''\:::''', ,If '.;~ ' ". ":::'~<'I ~~~ Issue Date Expiration Date: June 30, 2003 # 7' ( ( .~ e - CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 \) .., l. 2. 3. 4. 5. HAZARDOUSMATEmALS~AGEMENTPLAN 1~()~~ /" r R 1:;' 01?' ~ 0 /"J ;20lD A· --,lVE;~ ~ ;.)?~':)S c7' PR 2 0 .LJ , -. 2001 1 L To avoid further actign,-Feturñffiis onn within ã1d.äys of receipt. rI. , \ TYPEIPRINT ANSWERS IN ENGLISH. ~ {!(J Answer the questions below for the business as a whole. Be as brief and concise as possible. You may also attach Business Owner I Operator Form and Chemical Description Fonn(s) to the ftont of this plan instead of completing SECTION I. below for initial submission. INSTRUCTIONS: SECTION I: BUSINESS IDENTIFICATION DATA ~ BUSINESS NAME: cPn1mJ O~t 'vtca:homl &.h<::¡;:)] LOCATION:jgQ') \ (\~~n A\Je. MAILING ADDRESS: \Clm 11uv-h~)Yì AVe. r"-~ \ , \eLo , CITY: ~bÁ_'n(L\c\ STATE0jl ZIP~fpHONE:~?I¿) PRIMARY AcrMTY;J$:u~ l'^1 {òr. .1..wJL\ ~ .\- ~1 ,) l '~ OWNER: \ )Q~SUS C~.J~v.edo PH8~q~-S~~S- '--' . MAILING ADDRESS: lJb)ç- ~. l e¿ Dr. EMERGENCY NOTIFICATION CONTACT 1. \\p "è.o ÙJed C!.. 4 ) 2Juh'9. ATr¡¿p TITLE BUS. PHONE 'IPS Jjf('cior 3-B--06~ 24 HR. PHONE ~ ~-S8':::)S 8~3- OJ g(p tb.0j hiP ctn-l () I . ) (~. ( _ e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION ILl: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: v , S\J~ B. EMPLOYEE AND AGENCY NOTIFICATION: \J -ZY\u~ C. ENVIRONNIENTAL RESPONSE MANAGEMENT: ~SD~\~l2.-ý . '. D. EMERGENCY MEDICAL PLAN: í\w-.ý~~ hospikj) 2 1-':- ... . \.:. ~. . ",. '" -". ~. ". . . HAIRDO US MATERIALS l"IANAGE!NT PLAN f ~ . ".. -~~ y ~ SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: ~~ Dp'~cam; p-~ V~S + -hfu~r B. RELEASE CONTAINMENT AND/OR MITIGATION: \\0 C@n+~l ~~-1 C. CLEAN-UP AND RECOVERY PROCEDURES: ( , no ~Y\ up C)Î íe COV-ßr(J" Wùu1d ~ S$W1l~Y UTILITY SHUT -OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY) NATURALGAS/PROPANE: n\-A _ ELECTRICAL: . ~ nn --t.t ß-." (; )l-c::;';)~oC. h IItdL~ WATER:' ~ SPECIAL: ~ LOCK BOX: YES~ IF YES, LOCATION: PRIV ATE FIRE PROTECTION/W A TER AVAILABILITY A. PRIVATE FIRE PROTECTION: t ('r:> () ~/"~ '-- ~n'jul~~ýS WATER AVAILABILITY (FIRE HYDRANT): ''/ Q ~ 0 n fu C!-Ò(tU.A- o\: J~+'ðî 1- S~~'St- + \, ~~1- ~ T M\u~ Av-c, ( B. e e HAZARDOUS MATERIALS MANAGEMENT PLAN ~.' '.~ "'... J ~ ''\.;;. . ii, '.. SECTION III: TRAINING NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: 'Y~S BRIEF SUMMARY OF TRAINING PROGRAM: ~tJ ~I' I \ ~ 3)\~Llr\ð,--, ~~ Y' ÇY\~~-Ts v ~ CJ (J \. CERTIFY THAT THE ABOVE INFORMATION CCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO LFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATIQN CONSTITUTES PERJURY. L<-"",· /i2 d~-dh OUl ~ ¡fGNATURE ,., ' TITLE Oq..,. /8-- Ô 1 DATE HAZ MAT MNOMNT P' '" &. INSTRUC 4 ~ '-""_/11- e CITY OF BAKERSFIELDe OFFICE OF ENVIRONNIENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 FACILITY INFORMATION Business Activities Page of I. FACILITY IDENTIFICATION , , - FACILITY 10 # (For office use only - please leave blank) EPA 10 # 2 DBA/FACILITY NAME .-----..--..-- 3 .. .-.-.- -.. ---.. -..-.-. ----. ----..- -.-- ~.._- ---.- - ---.- -.--.-.--. - .--.-.--.--- --.-..-- .------.-...------...------...--- .---.---. .. ---_..__.~-_.~. -.----.----.----.-.--..--.--.------- II. ACTIVITIES DECLARATION _ __.___ _____no -..- -.--------- -.-.- -....-. ....---.- '--- .----.----.----. .-.-....----.-.. ..---..----.- .--- --.--------..----.----...-..-....---.- -- -- -----.---- --------.-------.--+--. I mÃ~HAZARDOUS MATERIALS - U_ u___ ------- --- --------~~--OÑO -----~---;;_------ÖES- FORM 2731u(ëhemical oescri~;;';~Form)----- 1. Have on site (for any purpose) hazardous materials at Dr ' v' CONSOLIDATED COMPLIANCE PLAN above 55 gallons for liquids, 500 pounds for solids. or 200 Minimum required planninq elements: cu ft for compressed gases (include liquids in ASTs and . Emergency Response Plan USTs)? . Maps Have any amount of an explosive material (other than ~'ONO' 5 . Training ammunition) on site? ¡ . Prevention . Certifications -B~·-FÙ~GuLÄTED-šuBSTANC-ËS¡R-S) ___'n.__________--=: ~ ONO---6-~----6ES F6RM-Ú31(ëh~~i~ID~;;;;;;O;;-F~)----n- ----- Have onsite RS at greater than the threshold planning , v' RISK MANAGEMENT PLAN (RMP Submillo USEPA) quantities established by the California Accidental v' CONSOLIDATED COMPLIANCE PLAN Release Prevention program (CaIARP)? . Incorporating CalARP Program Elements uc.-LTN-DERGRÖUÑ(S-STÖRÄGË-TANKS-iDSTs¡--------·--~·ÖYES-~---~;;-----ÜST-í=ACiLITYFORM-- ------------- -.------ 1 Own or operate Underground Storage Tanks? v' UST TANK FORM (one per tank) Intend to upgrade existing or install new USTs? i OYES ~ 8 v' UST FACILITY FORM I I v' UST TANK FORM I v' UST INSTALLATION FORM (one per tank) -O.--rÄNK·ClOSURËIREMOVAL '--------------¡ðYES--~--g;~--USTTÃNKFOR-M(do~~-r-;;~ect;;';;-~e p;r~;~k_¡__--- 1. Need to report closing a UST that held hazardous materials or waste? Does Your Facility... If Yes, Please Complete... 2. 2. OYES~ 10 v' TANK CLOSURE FORM Need to report the closure/ removal of a tank that was classified as hazardous waste and cleaned onsite? u-E-:-ABOVE-GRoiJ~Jõ-pËTROCËUMsTöRÄGETANKSiÃSfS)--:'-ðYES~---'-':-'~------ëÖ~¡sö-¡jbÄTËDC6MPCíAÑCE PLAÑ-- ---- Own or operate ASTs above these thresholds: any tank i ,. Incorporating Federal Spill Prevention capacity is greater than 660 gallons or the total capacity i ¡ Control and Countermeasure (SPCC) for the facility is greater than 1,320 gallons. L : Elements pursuant to 40 CFR Part 112 ~: HAzÄ~~~~::~~~~~us wa~~~~-- -------.-------¡ 'Oy~-~·-~--~~---~:~~~i~ü;::~;:,r~~l~:-:-~~~~:(~~~) ~~:~-178-:- 2. Recycle more than 100 kg/mo of recyclable materials at , OYES GNd 13 v' RECYCLING FORM the same location it was generated? Recycle more than 100 kg/mo of recyclable materials at OYES Q.MO an offsite location different from the point of generation? Treat Hazardous Waste on site? 3. 14 v' RECYCLING FORM i OYES QM6 I I I OYES 910 Consolidate Hazardous Waste generated at a remote I OYES 9Mö" ~~ I G.-- PERMfTCÒNSOÜOATiöN ZONE-: ______u,__. __U_ - --- -----.--: -ÖYËS-<®~- Intend to consolidate other Cal/EPA agency permits? ¡ (If yes, please complete Section III and attach) i Subject to Financial Assurance requirements? 15 V v' 16 v' 17 v' -..... -.... 18 v' TP FACILITY FORM (DTSC Form 1772) TP UNIT FORM (one per unit) CERTIFICATION OF FINANCIAL ASSURANCE 4. 5, 6. REMOTE WASTE / CONSOLIDATION SITE NOTIFICATION FORM . .__ ._ + u_ ___m._' _ _._._ ".+_.__.._.. ..__ _.____._. _..______ CONSOLIDATED COMPLIANCE PLAN . Incorporating all other environmental permit requirements per 27 CCR 10410 JTE: , ./ If you checked YES to any part of Sections IIA-IIG above. then in addition to the forms requested above. please Submit OES Form 2730. UPCF (7/99) S:\CUPAFORMSIACTIVITY,wpd "ì::::,~ " , ~!k~~If~ . - ',- e CITY OF BAKERSFIEL~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 .. __._ no __. ____._..._ .. .._. _'"_"..__... I. FACILITY IDENTIFICATION ---~--.'.-.-.- . FACILITY ID # (For office use only· please leave blank) . - ____.___ ._" ""___"_ _._______.__ n·..._.._.._._._.._.n.'____________ .".."..---'''.- ---.---.-- ---." ... -~- .--. .._- DBNFACILlTY NAME FACILITY INFORMATION Business Activities Addendum Page of .---- 1 fÊPAïÖ¡¡--U 1_- -. - .. -- .. -. --. -..-.--- ..---..----- 2 3 ----..-------...--'----------------."."---------------------.--.-------..----------..-----.-------" --------- ---.---------.- --------_.. III. CONSOLIDATED PERMIT ACTIVITIES '------Is your Facility Compliance Plan subject to review by... - i for satisfying the ë;;ndiiiåns of these permits? l_~.______ _______.____,_._.___... ____.___~_____~_~.________.._________ _-----!.-______ _______ ._____.______ ...___.___.__ ___.._._ ._ __.____ i H. DEPARTMENT OF TOXIC SUBSTANCES CONTROL OYES 'ONO V STANDARDIZED PERMIT '--------- . . All Modifications OYES ONO OYES IQNO Iv v Non-RCRA HAZARDOUS WASTE FACILITY RCRA HAZARDOUS WASTE FACILITY "-I-,'SÃN':¡ÖÄÓUÏÑVALLE'iÜNïï=ïEDJxïRPë5LïIiTiON·--'---- OYESONO-¡-'¡--- ----AUTHORITYTO·CONSTRU-ër----- CONTROL DISTRICT I QYES ONO , V PERMIT TO OPERATE ¡ i V NATIONAL POLLUTION DISCHARGE ! ELIMINATION SYSTEM (NPDES) , I uK:-CACIFORÑ'IÄTÑTEGRATËDWÄSTEMANAGEMENTBÕ~ ÖVESQÑO-¡-'';¡---REGISTRATIOÑ PERMIT---- ! -......-.-------.------------------ OYES- ONO OYES ONO , J. STATE WATER RESOURCES CONTROL BOARD :NTRAL VALLEY REGIONAL WATER QUALITY CONTROL tSOARD !V ;V , , !V OYES ONO OYES ONO -------.-+---..-------.------ ---.-...------.--.-----.---.----.-------. j L. KERN COUNTY RESOURCE MANAGEMENT AGENCY j OYES ONO V i OYES ONO Iv I , OYES ONO I Iv OYES ONO Iv I OYES ONO Iv , -----------------. WASTE DISCHARGE REQUIREMENT (WDR) GENERAL PERMITS SPECIFIC PERMITS ENVIRONMENTAL HEALTH SERVICES PERMITS Domestic Water Well Permit Haz Mat Monitoring Well Permit Septic System Permit Public Swimming Pool Permit Food Facility Construction Permit OYES ONO Ii V Solid Waste Local Enforcement Agency (LEA) Related Permits OYES ONO I V Medical Waste Related Permits M~-CiT),.ÖFBÄKERSFIËL6WÄsTEwÃTERuDivlsiÖÑ' -------OYES- -ÖNÒ----"-j,--.;-'----'-~E~~~RiÄì.:WÄSfË-WAfËFfDïSCHÄFfGE- NOTE: V If you checked YES to any part of Sections III-H to III-M above. then please address all applicable permit requirements in the Facility Compliance Plan. S:\CUPAFORMS\Activdyodondum,wpd July 1, 1998 " ~>.'~ . ., , L. ERSFI .. CITY OF BAKERSFIELI}a OFPrtE OF ENVIRONlVlENT At S~VICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION Page Of . -..- -.-.. .... ..-..... .______.._..._.__._._. "U'.,_ .__ ___._.__.... .. -___._._._....._._ _h'__"u,,_" '_"__".__'" __ . ··_·______uo_ I. FACILITY IDENTIFICATION FACILITY ID # , 1 Year Beginning 100 Year Ending ~o, ~~Ect~ACv~t;~'~)U . .'LR~ïSIN~34°~qDY,;¿ . ", SITE ADDRESS l q ex) -r ru~ \-DnA v Q. , 103 CITY ____~k\~£l~ld ,,"-:-~.-,_~=~--~_-~--~__-~-~-:__ :~~_~.~_::-------__-:~~~~~~-_~~~:_ _ZI~_A~t~:~-~~_~-_: _=_,___-:__:~~_=-10~, ~~~~!~~~~____J_l_Q3J,:L~_~______._____. 1~6_~_~~i~~~)~ ____.._______' 107 COUNTY ~ '("\ 108 -,-,--,----- ----.-.- 'T-- -----..--------'---------------;---,.---------;----...---, .-- _?PERA_TOR NAM~ 12. SU5~ Quo 1) d.o 109 , OPERATOR PHONM"\. £13 L\ -Gta~~ 110 -' II. OWNER INFORMATION _ -?~~_~~_~~~~__=_~~s- -Q\'L~\l~c __.______.____._~~__~~NE~~_~O_NE _~~~~_c?~ ~ OWNER MAILING t ~ "\ r i _ r\_, ADDRESS UQ./5"' e;. ~ I-Jf 113 ---.----------------.--~~ h:-iQ~~ 114 ~ STAili-~~~-·~;-~~Q~yS~ 116 III. ENVIRONMENTAL CONTACT ,C·~~!~~~_~;~~__~¿u~--G5-Q~~~==.-.-.-~===----------.-1_~7___C~~~;~~~~?~~~tQ3i4J----~-~- CONTACT MAILING 119 _~DD~_~:.~______B è:Q_U-l )x_~() _r:LÆ~L-__________________________. _,________________.. _________ __~'!__~_____J3Qk_~LSfkjd-----------.._----------_---_-----~~~2:.~~_t~__12~_ ___ ----.~~~-~J-- _~__ -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY· -·------~-)l ) u ~-.-..--.--------------- ----,--------------...--- ----,----.-..---------- ---------------------- '__ NA_~~_ __ ArrL~------~~-L~AME _'C"1:b.c.l.ß_a..vw.d0._.__.__________._______~ : T'~~______ckw&k.c-JÅ~~L~.----_-...----------~2~J.~~~~-~--._L:>,(.cL~~£_____n___.____ __ _________ _ ._.___..___._~~. , BUSINESS PHONE 126 BUSINESS PHONE ~s lo2{O -354 131 , 24~~O~~-~~;~~~_.§k3.~~51-C;----=~=-==-::-==-~~~--L~~~~~~~~~~_~~~~-~~_9~:¿;- $e4~_-' ._~_~ ,- '-_..__---1~~~ -PAom-DV SSq qDLD L¡ &"~.5 128 : P-ACER~ 133 V. CERTIFICATION __._ .__.....__...__,.._______.________._______.__w___·_____.___ ::::r €,Su,S,__, ---[£;2-\1. {>.V, :e..~~ , NAMES OF OWNER/OPERATOR (print) Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined : and am familiar with the information submitted in this inventory and believe the information is true, accurate, and complete. , SIGNÄTURE-Ö-F' OWNERiOPERATÔR ----- _ ---·------------r ÕATË-- ------ -----..;i;¡-~-NÄMEOI=DOCUMEN:fpRË·PARËR------ ---"-~;5- I. ; ,,--------- -;36-1 qíf{E~~F~~N~rtöPERATOR I iu - ____.._...._.u._. _._._.. __...__..._ :37 . . . -.....- ... ..--- .... UPCF (7/99) S:\CUPAFORMS\OES2730. TV4. wpd _¡ness Owner/Operator Identifice,n ~ " ." Please submit the Business Activities page, the Business Owner/Operator Identiflcation page (OES Fonn 2730). and Hazardous Materials· Chemical Description pages (OES Fonn 2731) for all hazardous materials inventory submissions. For the inventory to be considered complete this page must be signed by the appropriate individual. 'Jote: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used Jr electronic submission and are the same as the numbering used in 27 CCR, Appendix C. the Business Section of the Unified Program Data Dictionary,) Please number all pages of your submittal. This helps your CUPA or AA identify whether the submittal is complete and if any pages are separated. 1. FACILITY 10 NUMBER· This number is assigned by the CUPA or AA. This is the unique number which identifies your facility, 3, BUSINESS NAME· Enter the full legal name of the business. 100, BEGINNING DATE· Enter the beginning year and date of the report. (VYYYMMDD) 101, ENDING DATE· Enter the ending year and date of the report. (YVYYMMDD) 102, BUSINESS PHONE· Enter the phone number. area code first. and any extension. 103. BUSINESS SITE ADDRESS· Enter the street address where the facility is located. No post office box numbers are allowed. This infonnation must provide a means to geographically locate the facility. 104. CITY· Enter the city or unincorporated area in which business site is located. 105. ZIP CODE· Enter the zip code of business site. The extra 4 digit zip may also be added. 106. DUN & BRADSTREET· Enter the Dun & Bradstreet number for the facility. The Dun & Bradstreet number may be obtained by calling (610) 882-7748 or by Internet. 107. SIC CODE· Enter the primary Standard Industrial Classification Code number for primary business activity. NOTE: If code is more than 4 digits, report only the first four. 108. COUNTY - Enter the county in which the business site is located. 109. BUSINESS OPERATOR NAME - Enter the name of the business operator. 110. BUSINESS OPERATOR PHONE - Enter businåss operator phone number, if different from business phone. area code first, and any extension. 111. OWNER NAME - Enter name of business owner, if different from business operator. 112. OWNER PHONE - Enter the business owner's phone number if different from business phone, area code first, and any extension. 113. OWNER MAILING ADDRESS - Enter the owner's mailing address if different from business site address. 114. OWNER CITY - Enter the name of the city for the owner's mailing address. 115. OWNER STATE - Enter the 2 character state abbreviation for the owner's mailing address. 116. OWNER ZIP CODE - Enter the zip code for the owner=s address. The extra 4 digit zip may also be added. 117. ENVIRONMENTAL CONTACT NAME - Enter the name of the person, if different from the Business Owner or Operator. who receives all environmental correspondence and will respond to enforcement activity. 118. CONTACT PHONE - Enter the phone number. if different from Owner or Operator, at v.11ich the environmental contact can be contacted. area code first, and any extension. 119. CONTACT MAILING ADDRESS - Enter the mailing address where all environmental contact correspondence should be sent. if different from the site address. 120. CITY - Enter the name of the city for the environmental contact=S mailing address. 121. STATE - Enter the 2 character state abbreviation for the environmental contact=s mailing address. 122, ZIP CODE - Enter the zip code for the environmental contact=S mailing address, The extra 4 digit zip may also be added. 123. PRIMARY EMERGENCY CONTACT NAME . Enter the name of a representative that can be contacted in case of an emergency invoMng hazardous materials at the business site. The contact shall have FULL facility access, site familiarity, and authority to make decisions for the business regarding incident mitigation. 124. TITLE· Enter the title of the primary emergency contact. 125, BUSINESS PHONE - Enter the business number for the primary emergency contact, area code first, and any extensions. 126. 24·HOUR PHONE· Enter a 24-hour phone number for the primary emergency contact The 24-hour phone number must be one which is answered 24 hours a day. If it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the ìndMdual stated above. 127" PAGER NUMBER - Enter the pager number for the primary emergency contact, if available. 128. SECONDARY EMERGENCY CONTACT NAME· Enter the name of a secondary representative that can be contacted in the event that the primary emergency contact is not available. The contact shall have FULL facility access, site familiarity, and authority to make decisions for the business regarding incident mitigation. 129. TITLE - Enter the title of the secondary emergency contact. , , 130. BUSINESS PHONE· Enter the business telephone number for the secondary emergency contact, area code first, and any extension. 131. 24-HOUR PHONE - Enter a 24-hour phone number for the secondary emergency contact. The 24 hour phone number must be one v.11ich is answered 24 hours a day. If it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the individual stated above. 132. PAGER NUMBER - Enter the pager number for the secondary emergency contact, if available. 133. ADDITIONAL LOCALLY COLLECTED INFORMATION· This space may be used for CUPAs or AAs to collect any additional information necessary to meet the requirements of their indMdual programs. Contact your local agency for guidance. 134. DATE - Enter the date that the document was signed. (YYVYMMDD) 135, NAME OF DOCUMENT PREPARER - Enter the full name of the person who prepared the inventory submittal information. 136. NAME OF SIGNER - En!?r the full printed name of the person signing the page. The signer certifies to a familiarity with the information submitted and that based on the signer=s inquiry of those individuals responsible for obtaining the information, all the infonnation submitted is true, accurate and complete, SIGNATURE OF OWNERI OPERATOR OR DESIGNATED REPRESENTATIVE - The Business Owner/Operator, or officially designated representative of the Owner/Operator. shall sign in the space provided. This signature certifies that the signer is familiar with the information submitted and that based on the signer=s inquiry of those individuals responsible for obtaining the information it is the signer=s belief that the submitted infonnation is true, accurate and complete. 137, TITLE OF SIGNER - Enter the tlUe of the person signing the page. e CITY OF BAKERSFIEL.e OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION o NEW ' 0 ACD 200 o DELETE o REVISE I. FACILITY INFORMATION BUSrfSS ÑAME~(Sáme ãS"FÁClLlTY ÑÃiÆ Öt ÖåA, DOing- ~ Às}f - .. '-' () ------.--.-'---.--.-. ljL(Xtc~ _, C¡~,\lDCo..tt[)()aJJ. ~\._. CHEMICAL LOCATION , C1 00 -T f"'\)x:tvYì- Av f?..... ._~~~í~~I~~¡ .'j ""J= ':'~-']J_: -L._· "--- , --1jMAPi(oPt~ñ~"'---"'-'''''' -- . .--.-.-----.--..- . 201, CHEMICAL LOCATION , CONFIDENTIAL (EPCRA) 2Ó3" GRiD"# (opÌiÖnaï)-" ",-' .--......-------. (one form per maleria' per budding or area) Page 0( '. - .---, -.. . "---3 -~ . ._,~_..._-_... ~es 0 No 202 - ........'...-----.2{¡.Ï II. CHEMICAL INFORMATION ,.:::t:.::_.~.~_~º_~/'g'~~~~~,~__==~~~~~~~~~~~~=_=~__~:~_:~~_-.~'-~~~;~~_~~~e~'~?s~::20; , ' E.~ ' ' 207 , COMMON NAME " "- ' : EHS' 0 0 ____.__._,__~y.fJ{L,1J ~__. Yes No 208 CAS II J 209 , 'If EHS is·Yes.· all amounts below must be In lbs. . ARE CODE HAžÃRÒCLASSESiCoïñsiìëiëìf requested by loCal fire chiéi) -- ._-,----- 210 - ------..,.--.-----.... ".._- _.__._-------~_._-----_. ·fYþC-----..------- -- Õ ;-~~Re--- 0-;;' MlxW~~ 0 :-;¡~;ë 211: ;;;'OACTlVE ---·O~--Õ;;---·-;;;_·· ëüRiËšWh'-- ·..-·~13- 215 ¿;)g ~ - ---------------'.~ -~-~---- -.--.---- PHYSICAL STATE LARGEST CONTAINER o s SOllO o I LIQUID o g GAS 214 "...---.---------. ----...----.----- FED HAZARD CATEGORIES Ir~.a. all thai apply) Al WASTE An.vUNT 01 FIRE o 2 REACTIVE o 4 ACUTE HEALTH o 5 CHRONIC HEALTH -----..----..-"------.--"--.-- 220 o 3 PRESSURE RELEASE ~ --_......,-.------~_._----- 217 ,MAXIMUM' 'lCl 218, ¡AVERAGE .____ ¡ DAILY AMOUNT <:::::..L -1l..L. ¡ CAlLY AMOUNT UNITS' 0 ga GAL ' 0 cf cli FT 0 Ib LBS 0 In TONS . If EHS. amount must be In Ib$, -"-,,,--.-..-.. .-'.-.. ---..-- ---. .._-~ 216 219 STATE WASTE CODE ----- - 221 DAYS ON SITE 222 --------...---.--------..--.-..----... .--------..-------.----------.-.-- STORAGE CONTAINER (Check an /hal epply) o a ABOVEGROUND TANK Db UNDERGROUND TANK o c TANK INSIDE BUILDING o d STEEL DRUM De PLASTIC/NONMETALLIC DRUM Of CAN 09 CARBOY o h SILO o i FIBER DRUM OJ BAG Ok BOX o I CYLINDER o m GlASS BOITLE o n PLASTIC BOme 00 TOTE BIN o p TANK WAGON -,.------..... ...........----.------..--.- o q RAIL CAR o r OTHER 223 ....--.--.-------------------- .--- -------------- .-.---------._-_._--.__._-_._----~--_.__._---,----- STORAGE TEMPERATURE 0 a AMBIENT 0 aa ABOVE AMBIENT 0 ba BELOW AMBIENT 0 c CRYOGENIC ¡..__ _..%~__._.¡_-,----.--_-. H~~~.~~~.??M~.O'~~!'I!__...._ __._..__.._.___~-_-.:~~_+-.,----. CAS # 1 , 226 ¡ 227 I 0 Yes 0 No 228 ! " . ¡. . ¡! .. -·0·-·---..--·-1-------------· -'.-'--------..--..----...--'......--'.---¡---------..,..-.--..----.--- 2 230 i 231 J oVes ONo 232 ' , I , .,.. -.- .1-..,.... -,"... ,_.. .. ---- --..--, . - -'" ----.- .....- ,-...-..- ,......--..-,-.....,..... __,_.._..L.___ .... ....-,,_..-'. 'T - . .- .., -..----.... ..... 234 ¡ 235 1 0 Yes 0 No 238 237 ... _,_".....1.._..,_._..,_.............,..._ ..., . ..... -...---...-.....---.........-...--. -.----.--.----..-..-..--- ·1..·.._ -.... ..-..,...-.....----..' .~-:-_~~ ~L~~-~_~~~_=~--~=~__:~~=__~~_;~r;~~~~~±.~==_=~=_ : - ,.;"''''''' .""'''''"'''''''Wiëõ"''AW....''''''A~~~.--.- - -_..._.-~\1..~(j )... ! STORAGE PRESSURE o a AMBIENT o 88 ABOVE AMBIENT o ba BELOW AMBIENT 3 224 22S 229 233 IIPr.¡: f7/QQ' S:\CUPAFORMS\OES2731.TV4.wpd ;,~; HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION . CITY OF BAKERSFIELt:a OFFT'CE OF ENVIRONMENTAL Srf{VICES 1715 Chester Ave., CA 93301 (661) 326-3979 'f. DNEW DADO 200 D DELETE D REVISE '-'P- __.' _...._~__.._. .... _...-- '- ..-. -. ~~_._- I. FACILITY INFORMATION BUS~SS' NAME-(Såmè-aš FÃCILiTY ·ÑÄM'Ë örDBA . Do,ng-ãüs,neSs Ãs)-; --.. ---7)---------. --.---- -.- . --- ._h -. ..-- l.;~..(xt"f~J G:.~_ v'ÒCQtt[)()aJ)-~-\.-- CHEMICAL LOCATION \qéX) )~NY'r Av,,<- __:~iL~~IÕ # j-T . . J=~~_~_- . -I_'-L..~~~.._~J-MÄ~~:opï~nah-n-----.-- , ____u._ .. --.- -- _..__...._._-----~_.__.--- .... 2011 CHEMICAL LOCATION , CONFIDENTIAL (EPCRA) 203-· GRiÔii ¡öpììöiiaï)-n- " - (one form per material per bUilding or area) Page of '..- -. ._..~ ..--.- ...,------y ... n_' _. _._. .__ .,,----.------_.. .øÇes 0 No 202 , ·'-'-'------204 II. CHEMICAL INFORMATION ...----...--.---------------- __h__._._ -.---.--., .,. U ._h -- .____h. -.- . ". .n__. ---.- u. ------.---.--- --------.-- -- - .n__. 2ÒS·--i'RÄÕËSÈ-CREr 0 _ ¡s---- _~~:~_~ ~~~_~__. ftOÇQJLR________ _ ____ _________________.__________.. __ .____ -.2õ7-If- SUbJ~_t~ ~C_~~~ef~r ~~~slrucl~o:S _:~. ~_O~::=:~__._~Ç2m-ÇXln 0 CAS # EHS' 209 o Yes 0 No 208 ----------- . 'FlRE CODËHAZARÒ-CLASSES(Cor,îpiete if requested by loCal fire èh;ef) ·.f EHS is' Yes, . all amounts below muSI be in Ibs. 210 ---. .__._-_.~----- TŸPE---·- .-.,.------.-.-- --0 ~-~~~~--. [] m MI~~~;--- 0 -:-;~Š~ ---- . --~----_.._------------_. .-..- -~-_.._-----------_._--------- ·-o~~--[f~---·-·-;;;-· C¡¡RÎeS ____ __u________·_·___ _~._.__ _ ._..._._._~__.__ LARGESTC~AINER ;L~O Cù b)C ff-. 215 --------- --------------------- _.._-~~--- -.--..------ 211 : RADIOACTIVE PHYSICAL STATE o I LIQUID o s SOLID OgGAS 214 -..-.------.--- ----- .....----.-----.-------- FED HAZARD CATEGORIES (f"'''Ck all that apply) AL WASTE A..,,-,UNT o 4 ACUTE HEALTH 01 FIRE o 2 REACTIVE o 3 PRESSURE RELEASE o 5 CHRONIC HEALTH ___________.____________. __·___.n_________ 217 ¡ MAXIMUMnrTit\-,·-:-~;ï;i-AVERAGE ___ _______-1 DAILY AMOUNT U c.vC) c... . i DAILY AMOUNT UNITS' 0 ga GAL 0 d CU FT 0 Ib LBS 0 In TONS . If EHS. amount must be in Ibs. --------- ----------- 221 DAYS ON SITE 222 ---_._--------_._---_.._-~.__.__._.---_._------ -..-------- -.--------.------ .-------.---.-.-- 223 STORAGE CONTAINER (Check all that apply) o a ABOVEGROUND TANK o b UNDERGROUND TANK Dc TANK INSIDE BUILDING o d STEEL DRUM o e PLASTIC/NONMETALLIC DRUM Of CAN o 9 CARBOY o h SILO o i FIBER DRUM OJ BAG o k BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON ....--- ..,--.------. 213 216 219 STATE WASTE CODE 220 o q RAIL CAR o r OTHER STORAGE PRESSURE o aa ABOVE AMBIENT o ba BELOW AMBIENT .-..----.----. --- .------------------.---- -------------------_._--~------------. ------ ----_._--_._--~---_.._------_..._-_._----~ STORAGE TEMPERATURE 0 a AMBIENT 0 aa ABOVE AMBIENT 0 ba BELOW AMBIENT 0 c CRYOGENIC ".-'- _._%w:r:__._._r-_._.___._____~~~~O_~~_~?~~.()~~~!_____ __. ______.___l____~_~~____L_.u______u. CAS # 1 226 ¡ 227 I 0 Yes 0 No 228 I ,--,.---,.--..,-.---+------..--,-----,-,.----.---..---.-----..---..' ._-,-------~---------_.,~+_..,-_._-- --------.--. 2 230 I 231 ! 0 Yes 0 No 232 ¡ ,. _...,.L __ u, ...._ ,.,_.,._.,__,...._ . ." _.... .__._._ .___._... ___._ ' ,.,.u..______'...... m.._..___,.1._._ _._ '..._" ,_...,..'. ..t. . , I 234 ¡ 235 I 0 Yes 0 No 236 I _ _...,_.. _..! __"._. ___., h.......__,_ ....., _.~.__,...,. ,__.., ,_. ,. _____u..,_...,._._..... .,.". ._ _,_.__u,__... ,,__, _. " ..__. ---.·--..f·--..... '_.m_._h _,_ _., ,_.., _,.. 'u_ . 4 , 238 I 239 I 0 Yes 0 No 240 ! _,=:_= -;.;t-_~~__-~=_=~===--_==-=__~=__: __=__'~1;;~~~~~L_ __-:=~== '" .. '0'''"'"', ,",,0, AfifHõ.¡;"ÕCði.,-Ã"'-..""S,"'''~·-:~----- - ----- -- - . o a AMBIENT ....~-----_._--_.__.- -------.-----------.----.---- ---------.------.--- I 1 3 . .___._ __.__~. .. ... h . 224 225 229 233 ... -...-------........ 237 . -...--..--.-------... 241 " .---- ---oÄrË- 246-- _ __. ..u__ __. UPCF (7/99) S:\CUPAFORMS\OES2731,TV4.wpd J e e ,.0- Hazardous Materials Inventory - Chemical Description You must complete -I <eparate Hazardous Matenals Inventory· Chemical Descnplion page for each hazardous matenal (hazardous substances and hazardous waste) that you handle at your facility In ,]ggregate quantities equal 10 or ']reater than 500 pounds. 55 gallons, 200 cubic feet of gas (calculated at standard temperature and pressure) or lhe federal threshold plannmg quanhty for Extremely HazardOus Substances, whichever is less, Also complete a page for each radioactive material handled over quanhtles for which an emer<)ency plan 's reqUired 10 be adopled pursuant to 10 CFR Parts 30, 40. or 70, The completed Inventory should reflect all reportable quantities 0' hazardous matenals at your facility, reported separately for each building or outside adjacent area, with separate pages for unique occurrences of physical state, storage lemperature and storage prflssure, (Note: the numbenng of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronrc submission and are the same as the numbering used ,n 27 CCR. Appendix C, the Business Section of the Unified Program Data Dictionary,) Please number all pages of your submittal. This helps your CUPA or AA identify whether the submittal is complete and ,f any pages are separated, 1. FACILITY 10 NUMBER· This number is assigned by the CUPA or AA. This is the unique number which identifies your facility, 3, BUSINESS NAME· Enter the full legal name of the business. 200, ADO/DELETE/ REVISE· Indicate if the material is being added to the inventory, deleted from the inventory, or if the information previously submitted is being revised, NOTE: You may choose to leave this blank if you resubmit your entire inventory annually, 201, CHEMICAL LOCATION· Enter the building or outsidel adjacent area where the hazardous material is handled. A chemical that is stored at the same pressure and temperature, in mulliple locations within a building, can be reported on a single page, NOTE: This information is not subject to public disclosure pursuant to HSC §25506. 202, CHEMICAL LOCATION CONFIDENTIAL - EPCRA . All businesses which are subject to the Emergency Planning and Community Right to Know Act (EPCRA) must check "Yes' to keep chemical location information confidential. If the business does not wish to keep chemical location information confidential check 'No'. 203, MAP NUMBER· If a map is included, enter the number of the map on which the location of the hazardous material is shown, 204, GRID NUMBER· If grid coordinates are used, enter the grid coordinates of the map that correspond to the location of the hazardous material. If applicable, multiple grid coordinates can be listed, 205, CHEMICAL NAME· Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the Intemational Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture, do not complete this field; complete the 'COMMON NAME· field instead. 206. TRADE SECRET. Check 'Yes' if the information in this section is decJared a trade secret, or "No' if it is nol. State requirement: If yes, and business is not subject to EPCRA. disclosure of the designated trade secret information is bound by HSC §25511. ,Federal requirement: If yes, and business is ~ubject to EPCRA, disclosure of the designated Trade Secret information is bound by 40 CFR and the business must submit a "Substantiation to Accompany Claims of Trade Secrecy' form (40 CFR 350.27) to USEPA. 207. COMMON NAME· Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. 208. EHS . Check "Yes" if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CFR, Part 355, Appendix A. If the material is a mixture containing an EHS, leave this section blank and complete the section on hazardous components below. 209, CAS # . Enter the Chemical Abstract Service (CAS) number for the hazardous material. For mixtures, enter the CAS number of the mixture if it has been assigned a number distinct from its components. If the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous components in the appropriate section below. 210, FIRE CODE HAZARD CLASSES - Fire Code Hazard Classes describe to first responders the type and level of hazardous materials which a business handles. This information shall only be provided if the local fire chief deems it necessary and requests the CUPA or AA to collect it. A list of the hazard classes and instructions on how to determine which class a material falls under are included in the appendices of Article 80 of the Uniform Fire Code, If a material has more than one , applicable hazard class, include all. Contact CUPA or AA for guidance. 211. HAZARDOUS MATERIAL TYPE· Check the one box that best describ6s the type of hazardous material: pure, mixture or waste. If waste material, check only that box. If mixture or waste, complete hazardous components section. 212. RADIOACTIVE· Check "Yes" if the hazardous material is radioactive or "No' if it is not. 213. CURIES· If the hazardous material is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. 214. PHYSICAL STATE - Check the one box that best describes the state in which the hazardous material is handled: solid, liquid or gas. 215. LARGEST CONTAINER - Enter the total capacity of the largest container in which the material is stored. 216. FEDERAL HAZARD CATEGORIES· Check all cat8Qories that describe the phvsical and health hazards associated with the hazardous material. PHYSICAL HAZARDS HEALTH HAZARDS Fire: Flammable liquids and Solids, Combustible liquids, Pvrophorics, Oxidizers Acute Health (Immediate): Highly Toxic, Toxic, lnitants, Sensitizers, Corrosives, Reactive: Unstable Reactive, Oroanic Peroxides, Water Reactive, Radioactive other hazardous chemicals with an adverse effect with short term eXPosure Pressure Release: Explosives, Compressed Gases, Blasting Agents Chronic Health (Delayed): Carcinogens, other hazardous chemicals with an adverse effect with lono term exposure 217. AVERAGE DAILY AMOUNT - Calculate the average dally amount of the hazardous matenal or mIXture containing a hazardous matenal, In each budding or adacenU outside area. Calculations shall be based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the number of days the chemical will be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. 218. MAXIMUM DAILY AMOUNT - Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacenUoutside area at anyone time over the course of the year, This amount must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions, deletions, or revisions projected for the current year. This amount should be consistent with the units reported in box 221. 219. ANNUAL WASTE AMOUNT· If the hazardous material being inventoried is a waste, provide an estimate of the annual amount handled. 220. STATE WASTE CODE· If the hazardous material is a waste, enter the appropriate Califomia 3-digit hazardous waste code as listed on the back of the Uniform Hazardous Waste Manifest. 221. UNITS· Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons, NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that the material is stored in (gallons, pounds, cubic feet. or tons), 222, DAYS ON SITE - List the total number of days during the year that the material is on site. 223. STORAGE CONTAINER· Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one, 224, STORAGE PRESSURE· Check the one box that best describes the pressure at which the hazardous material is stored. 225. STORAGE TEMPERATURE· Check the one box that best describes the temperature at which the hazardous material is stored. 226. HAZARDOUS COMPONENTS 1-5 (% BY WEIGHT) - Enter the percentage weight of the hazardous component in a mixture. If a range of percentages is available, report the highest percentage in Ihat range. (Report for components 2 through 5 in 230, 234, 238, and 242.) 227. HAZARDOUS COMPONENTS 1·5 NAME - When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that mixture by percent weight (refer to MSDS or, in the case of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater than 1 % by weight if non-carcinogenic, or 0,1% by weight if carcinogenic, should be reported. If more than five hazardous components are present above these percentages, you may attach an additional sheet of paper to capture the required information. When reporting waste mixtures, mineral and chemical composition should be listed. (Report for components 2 through 5 in 231, 235, 239, and 243.) 228, HAZARDOUS COMPONENTS 1·5 EHS . Check 'Yes" if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "No' i'it is not. (Report for components 2 through 5 in 232, 236, 240, and 244.) 229. HAZARDOUS COMPONENTS 1-5 CAS· List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture, (Repeat for 2.5.) 246, LOCALLY COLLECTED INFORMATION· This space may be used by the CUPA or AA to collect any additional information necessary to meet the requirements of their individual programs. Contact the CUPA or AA for guidance. UPCF (1/99) 7 OES Form 2731 ~, f z ::; -