HomeMy WebLinkAboutBUSINESS PLAN 10/20/1987
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SITE/FACILITY DIAGRAM
FORM 5
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(CHECK ONE) SITE DIAGRA~
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FACILITY DIAGR.~~
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(Inspector's Comments):
-OFFICIAL USE ONLY-
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SITE DIAGRAM (ReqUi1llÞlteaS)
1. Address: Identity the
principle buildlnas
by the Street nu.bers.
.
9. Lock ¡key) Box
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la, MSDS Storae8 Box
Z. Street(s}. Alleys,
Drive_aya. and Parkin¡
Areas adjacent to the
property, Includa tha
street na.es.
II. Railroad Tracks
12. Fence or Barrier
a. WIre
b. Masonry
3. Star. Drains. Culverts,
Yard Drdna
c. Wood
4. Drainaee Canals, Ditches,
Creeks,
d. Gates
13. Powerl1nee
5. Butldinlts
a. Frft.e construction
14. Guard Station
b. Masonry conatructlon
15. Storaee Tanks:
Identify the
capaci ty In fill..
a. Above ¡round
c. Metal conatruction
d. Acceas DooC'
b. Underp'ouad
6. Utility Controls
a. Ga.
18. DikJnc or Ber..
b. Electricity
c. Water
1. Fire SuppC'esaion Syste.s:
a. rtr. lfyárlUlu
17. Bvacuation Route
la. Evacuation Area:
IdenUty the
location _ere
8IIploy... .Ul
_to
b. Fire Sprinkier
Conn.ctions
18. OUtaide Hazardous
hate Storap
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.____ _ ~ Plr~St.a~dplpe
. - . Conaectlona .
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ao~ Outside Hazardous
!later lal Storaae -
d. "ateC' Control Valves
tor protection syate..
al. Outside Hazardoua
!laterial
Uae/llandllnc
e. FiC'8 PuIIø
Z2. Type ot Hazardoll8
Material/Waate
StoMld
or Uaed (See
Below)
8. Pire Depart..nt Acceaa
TYPE OP HAZARDOUS MATERIAL
F · Fl_ble I . b:ploaive L .. Liquid
C · Corro.ive 0 · Oxidizer G . Gaa
W · WateC' Reactive T . Toxic S . SoUd
R . Radiolorical
P . Poison
II . Cryo¡enic
o . Wa.te 8 . !tiolorical
Exe.ple: Fla..able Liquid· FL
FACILITY DIAGRAM (Required Ite.. in addition to the above)
1- Rl.era toC' Sprinklers 8. lire Escape.
%. Putt tton. ø. AIr Condltioninl Unit.
3. Stairwaya: Indicate the 10. Window.
levels ae~ved (ro.
hiICheat to lo...t. 11. Inllde Hazardou. Wa.te
Storace
4. Escalator: IndIcate the
levela lerved (1'0. Ja. In.ide Hazardoua
hl¡he.t to lo...t. Materlal. Storsee
~. ElevatoC' 13. Inalde Hazardous
Materials U.e/Handline
6. At tic Access
14. Sewer Drain Inlets
7. Skyli¡hts
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RETURN PAYMENTS TO: ,
I CITY OF BAKERSFIELD
: ,:.,'P.O. BOX 2057
BAKERSFIELD, CA 93303-2057
PLEf'SE MAKE CHECKS PA ;~BLE TO:- 1:,
CITY OF BAKERSFIELD :
RETURN THIS COpy WITH PAYMEN;,
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ACCOUNT NO. ., f"H; ~~l(Hjl
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INi UIRIES CONCERNING THIS Bill, PLEASE PHONE:
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MUST RETURN. COf?Y WITHJ?AYMENL.._.
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RETURN PAYMENTS TO:
CITY OF BAKERSFIELD
P.O. BOX 2057
BAKERSFIELD, CA 93303-2057
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ACCOUNT NO.
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~aIÐraau~ lðt~ri3lG h~ndltnB Fees fer 011-11117
~AlARUOUS ~~T(~iA~S ~A~JlING
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INQUIRIES CONCERNING THIS Bill, PLEASE PHONE:
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CUSTOMER COpy
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L'<crrv elf IaAII<ERSlriUD
. I P:O. BOX 2057
,BAKER FIELD, CALIFORNIA 93303-2057
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RESS CORRECTION REQUESTED
DO NOT FORWARD
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City of Bakersfield ¡;"
TRA_NSMITT AL SLIP
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From....~.&.e:!:~L.::....=.!...,~.~?l:~.f.f.B/¿....................__._...._
For Your:-
o Signature ~ion ~ormation 0 File
Please :-
o Return 0 See Me 0 Follow Up 0 Prepare Answer
Copy to: ..................................................................................._........._.._...........
Memo : ......Y.:.~.f:.:-..g:!.!::.!..g:...::.......L......l:t:.'!?.~....&!..~~f:!...___...__
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I-/n 4741-0 I
,ACCCXJNT NUMBER
. ...-.. ". -
CASH MANAGEMENT
ADJUSTMENTS TO ACCCONTS ROCEIVABLE
DATE ~. 25-9/
PARCEL '~
( ) NEW ACCOONT
, ( ) DELETE
Þ() $ ADJUS'IMENT
( ) SERVICE CHANGE
( ) ADDRESS CHANGE
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SITE ADDRESS
30/9 /~z!: S"7"7
ProPERTY CMNER
AœaJNr NAME S 1'9 .v -l 0 n (¡) t.( IN fò Ou ~ E:'~ {/ / C!..-b-
'lJI.5T I CORR...~ I ADJ. TO NEXT
!Bïi.T.ING A..1'1CDì\'T'!' BILLING À"XXJ!\'YT BILLING + -
I I < 102.07
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MA.ILIN::;' ADDRESS
CITY, ~, ZIP
REMARKS ç, LoS-ù 'õ AN ~ -¡;¿U? 7"C.- f-' 9 - 2- /P - f'7' G H ,L)¡)rG"R / / - ~.If..) V h /LTG" ÌJ r-o
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. ?EC-O-;¿Î)'\ /.N7)/(:!A/c:;- f?/'}, ?V~, 04'/
ð F' '] u nO. Do /¡.)& ð S" 3-1- 90 " '
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March 15, 1990
TO: Nina Mayer, Accounts Receivable
FROM: R~lph E. Huey, Hazardous Materials Coordinator
SUBJECT: San Joaquin Food Service, Inc.
Nina, account # HM451201 moved its location, instead ox us
changing the address we gave them a number by mistake. The
previous balance ox $300.00 should be voided because they are
receiving an invoice under the other account.
Thanks
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BAKERSFIELD CITY FIRE DEPAR~NT
2130 "G" STREET
BAKERSFIELD. CA 93301
(805) 326-3979
RECEIVED
OCT 2 8 1987
AIl~·d.... ........ '
OFFICIAL USE
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ID#
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001099
US INESS ~AME
HAZARDOUS MATERIALS -~- ~~
BUSINESS PLAN AS A WHOLE\V(ì
FORM 2A ~.etL 6/ ~ ~
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INSTRUCTIONS:
¡jJu-
~ß
1. To avoid further action, return this form by
2. TYPE/PRINT ANSWERS IN ~~GLISH.
3. Answer the questions below for the business
4. Be as brief and concise as possible.
as a whole.
.
SECTION 1: BUSINESS IDENTIFICATION DATA
A. BUSINESS NAi'tE: $AIJ 5ÛAO¡J.~ ~f)D
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B. Ï.OCATION I STREET ADDRESS: '::Ù6" _ Q Ll.-ï.; J~"' ~'ï'
CITY: ~Krl«F 'Ð-n ZIP: 93305:
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BUS . PHO~"E : (805) 3;).7 -7fd)(".,
SECTION 2: EMERGENCY ~OTIFICATIONS
In case of an emergency involving the release or threatened release of a
hazardous material. call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify
your local fire department and the State Office of Emergency Services as required by
law.
E~PLOVEES TO NOTIFY IN CASE OF E~ERGENCY:
Nk~AND TITLE Dù1RING BUS. HRS.
A. ta<.$..y L. rrJOf{E;LAIJD Ph#3;;l.;;l-JOx-1
B. 1)(',[1(1 AlJbL~U
Ph# 3;)"ì -7(,.,~(,..,
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PR0tr~E: fló~~.
~: ;~~~~~ICAL; ¡/K~f ::c-c ~~ ~~~~;~: /~~~:~~:~
D. SPEC rAL; ¡J(JuV:
E. LOCK BOX: YES i ~O IF YES, LOCATION: Uo
AFTER Bes. HRS.
Ph# R7:J.-s').s<.f
Ph# xs4-411"J...
IF YES. DOES IT CONTAIN SITE PLANS? YES / ~O
FLOOR PLANS? YES / ~O
- 2/\ -
MSDSS? YES / NO
KEYS? YES / ~O
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SECTION 4: PRIvATE RESPONSE TEA." FOR BUSINESS AS A WHOLE
Þ//h,J'Af4ltYv\arT' .. ÐAJ 6 I T¿ 1f¡4t1~ Is -;),0 y~,c~ F;Jt..f't:.""t.,tZlJw W Ir f rill 5> FAc../l../r'r AAJO CKJ.J
lmmft-TE;I..'í ~~ILUí ""-...., A'I." <:.-o~,- r " A ,- - f'A<'
,;> T .J.X)""""",,, V'TlLI,r .."'....V,o...c;:s. . c;.)l..rCR/f::.I<.lc:Æ: r>l-õ>I-> <:.~ ".....ES TIh!: A-4}L.lí't'
/,0 OE:ra..r AµD .+vOl Q Po!>!./ðtL £yY)~Q€:¡JCI£.>. E ('~'E:}jc.e:o /)HhuA6~ mëÞ'r jJ61--1.e-JJY1::.-....
AI4: Au...>A-YS f)¡J ':;'IT":: ÐURIOq ÐP~T/4J6-¡ #<Jv¡¿,!., FíR~T AI(,:) KIT' I~ Jr}¡t:¡I JrA'I<.I~-O &-.(.1 oS.lns
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SECTION 5: LOCAL EMERGENCY ~EDICAL ASSISTk~CE FOR YOUR BUSINESS AS A WHOLE
Au... ~ L.oC-A-L- ~~tW;1,.c."i' ~Vl~ CA-AJ HANOO~ AI..! 19'YUf:R.e:.e:w,.y 4'í "THIS F¡tfG/L,'r'f;.
í~ AR.(!;" No VNU5uA-L. f\'")·A~IAt.-$ I<.€f'r Ð~ n),4J1.JntlAJ5T;) OAJ ~H75,
If CfJLL.- 7'D q'l Avo loR.,. Lo~ PfM I fr/Y}ß>I.II.-It/Jw ~ PDLU.~ W8v'-D' W /n'MJð
I tv í~ E:Vé/-IT ÐF /'t¡..) (;Y>1~6l1c'r.
1 ~ s:-tlA-WA r~c>,-, '8P 'Tffb
'1 Hey .~ Itl{~ "'0 PAC¡ u Íl~
KNÐu) wliO Tff¡:;y A#-6 IIJ TIfG E:Van-
p~JL¡1"'( COUU;:' aC IiCt.ðrY\fL.If:>Jf6D UJITItIIU ýY)Jµ~
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SECTION 6: EMPLOYEE TRAINING
:.
ÐtPLOYERS ARE REQUIRED TO HAVE A PROGRA.'! WHICH PROVIDES Ð1PLOvn:S WITH I3ITIAL A..'¡"]) '.
REFRESHER TRAINING IN THE FOLLOWING AREAS. - ,'-',
CIRCLE YES OR NO I~!TIAL REFRESHER
A. ~ETHODS FOR SAFE HANDLING OF HAZARDOUS
~TERIALS: ........ ............................... ~~O ~~O
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES:.. .......... .......... ....fJ.~0 ~~O
C. PROPER USE OF SAFETY EQU!PME~L:.................. NO ~NO
D. EMERGENCY EVACUATION PROCEDURES: .... ......... .... ~O ~NO ~
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: , . . . . . . S @:> YES ~
SECTION 7:· HAZARDOUS MATERIAL
CIRCLE YES OR~
DOES YOUR BUSINESS HANDLE HAZARDOUS ~~TERIAL I~ QUANTITIES LESS THAX 500 POL~DS O~
SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...... YES ~
I. LAP-RoY ~, ßwf.>6L, , certify that the above information is accurate.'
r 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.
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BAKERSFIELD CITY FIRE DEPART)¡E~T
2130 "G" STREET
BAKERSFIELD. CA 93301
OFFICIAL CSE O~LY
ID#
- - -' - - -
BUSINESS NAME:
BUSINESS PLAN
SINGLE FACILITY UNIT
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 »ossible.
FACILITY UNIT#
FACILITY UNIT NA.'fE:
SECTION 1: MITIGATION. PREVENTION. ABATEME~! PROCEDURES
~ l~fI~ÞCJ> fl\Å1'E'Ct.IA..... AA~ H-A-rvoc.G-O I!J"" /4Jl>è:Pe-AJQ&IVï PIlðF6s.5N>tJ,f~.
¡::v.a...s ~u<.--tf A!. DiG'!.GL l Ul..£V'ICc:O' 4.u P';ILc..lfYh,,"¿Q· pllOrY\ l.¿H'-<.IÐÔEL- !b,(liJL€Ui1'\
.vUo HU.l. (Ci/r;;v:.~ Ttf6" T/hIJ,"-S. (Á)tI'¢¡J' FVrEl- I' 4Jüí l!>eJJ.:t, D/JfJ€il.J';"c-D THr£ jJUI"Y}.p~ ,1-/Z.£
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I;y PWeb6tOAJAC, ~ ÐvT.s.IIJ~íllC cO¡';-fB.O/v Or ~>'hV .;JOAQ¡,.J"0 fuD/J SE:eU~ t BIHJA'/ult
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SECTION 2: NOTIFICATION Ai'.1) EVACUATION PROCEDL1ŒS AT, THIS {JNIT ONLY
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SECTIO~ 3: HAZ1\RDOl;S ~rATERrALS FOR THIS U~HT ONLY
A. Does this Facility Unit contain Hazardous Materials?..... YES ~O
If YES, see B.
If NO, continup- with SECTIO~ 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES XO
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS OXLY (white form #4A-l)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS O~LY (yellow for~ #4A-2) in addition tò the non-trade
secr~t form. List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION
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SECTION 5: LOCATION OF WATER Su~PLY FOR USE BY E~RGENCY RESPONDERS
SECTIO~ 6: LOCATION OF UTILITY SHU~-OFFS AT THIS ú~IT ONLY.
A. XAT. GAS/PROPA~~1
B. ELECTRICAL:
C. WATER:
D. SPEC:AL:
E. LOCK BOX : y~S / ~O If YES. LOC.\TIOX:
IF YES, SITE PLA~S?
FLOOR PLA~S')
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FORM 4A-l
NON-TRADE SECRETS
HAZARDOUS MATERIALS' INVENTORY
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