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ELECTRICAL SHUTOFF
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RUSTOLEUM ~
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Bakersfield Fire Depte
HAZARDOUS MATERIALS DIVISION·'
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Business Name: k. \ QU' I.D A f e,
() ~ rc t-2J
Business Identification No. 215-000 -4 Co 2- (Top of Business Plan)
Station No. '4- Shift -.ß Inspector 0 CO'-r~
òF 6U5(1J~ '\
Verification of Inventory Materials
Date Completed
?5-Z -'~r~
HECE/VED
AUG 5 1993
HAZ. MAT. D¡V,
Location:
2-50 l
Verification of Quantities
Verification of Location
Adequate Inadequate
D D
D D
D D
D
Proper Segregation of Material
Comments:
/
Verification of MSDS Availablity
D
D
Verification of Haz Mat Training
D
Comments:
D D
Comments:
D D
D D
Comments:
D D
Special Hazards Associated ith this Facility:
Violations:
All Items O.K :
Correction Needed
~ Business Owner/Manager
FD 1652 (Rev. 1-90)
White-Haz Mat Div. Yellow-Station Copy
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INSTRUCTIONS:
131ßÚ\
HAZARDOUS MATERIALS MANAGEMENT PLAN
tOb~;2q 4--.
tf,-. t.f-6
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.
o~
Bakersfi~ld, Fire Dept.
Hazardous Materials Division
2130 "G" Street'
Bàkersfield, CA. 93301
RECEI\I~D
'.J.UN 0 If \9921
HAZ. MAT. DIV.
1.
2.
3.
4.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Liqùid Air-Central California Region
LOCATION: 2501 Union Avenue Bakersfield, California 93305
.
MAILING ADDRESS:
p,o, Box 3519
CITY: Bakersfield
STATE: CA:" ZIP: 93385 PHONE: (805) 861-7000
DUN & BRADSTREET NUMBER:
N/A
SIC CODE:
N/A'
PRIMARY ACTIVITY: Resa 1 e of compressed ga?es and we I ding supp lies
OWNER: Li qü i d Air Corporat i on an Air Li qu i deCGJ.:QI:!frIOñipa~V
MAILING ADDRESS: 2121 North California Blvd. Suite 350
Walnut Creek, CA, 94596
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE
BUS. PHONE
24 HR. PHONE
1: Dan Lonon
Branch Manager (805) 861-7160
(805) 861-7081
2. Lee Poh I emann
Supervisor;Branèh-Operations (805)861-7194 (805)861-7081
-'.
~ - -- ----"- -- -- --
1.
FD15';
tþBakersfield Fire Dept.
Hazardous Materials Division
e
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HAZARDOUS MATERIALS MANAGEMENT PLAN
··¡~ì ,: ~ ¿r ;) .:1 H
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SEcYíÕN~3: ¡,tR:AINING:
N UV~~~ ~~'ê)F ~thþ L 0 YE ES:
17
MATERIAL SAFETY DATA SHEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
1, On going Branch wide safety meetings held monthly
2, Sales and Safety meetings every Monday morning with outside sales staff
3, P~sit~e employee safety record is criteria for a positive employee evaluation
or a neg-ative'recõrd is èriteriã for a nëgative Jöb evaluat-ion-.
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, B.UT THE QUANTITIES AT NO
TIMEEXCEED,THE MINIMUM REPORTING QUANTITlES.. ,
OTHER (SPECIFY REASON)
SECTION 5:' CERTIFICATION:
Walter L, Pohlemann
TITLE
6/01/92
DATE
.
"- ~- ---- "--
2.
FD1590
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.
.
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Bakersfield Fire Dept. e·
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name:
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
1. 911
B. EMPLOYEE NOTIFICATION AND EVACUATION:
1, Word of mouth
2, I ntercom from store area
C. PUBLIC EVACUATION:
1 . 911
2, Word of mouth
3. Intercom in sfore directing customers to evacuate through East store
entrance
D. EMERGENCY MEDICAL PLAN:
L '911
2,First Aid kits through~out store and warehouse
3, Employees are taken by Supervisor to Mercy M~di-Center
R20 34th St, Bakersfield, CA, 325-6334
3.
R:>161O
e Bakersfield Fire Dept. _.
Hazardous Materials Division
,; ~ '}-:.':"':~~
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HAZARDOUS MATERIALS MANAGEMENT PLAN
.
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS:
1, All cylinders have safety caps and chained to minimize chances
to fall over
2, Bulk Rustoleum is stored between tement walls
, B. RELEASE CONTAINMENT AND/OR MINIMIZATION: '
1, Fire walls on cylinder dock for flammable cylinder fulls and empties
C. CLEAN-UP PROCEDURES:
1. Iff I ammab Ie 'fýT:-d'(ve'-f'9:R"Lþ' L~f,<¿~7\l: ¡ s moved to a safe I ocat i on and
allowed to empty, '. -~. ,.
2, All other cylinder gases are non-flammable that can displace air .
in a confined area but not harmful others01se,
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE:
North side of whse - outside wall
ELECTRICAL: West side of whse. - outside wãll
VVATER: North side of whse, - outside wall
SPECIAL: N/A
LOCK BOX: YES/NO
IF YES, LOCATION:
N/A
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAilABILITY:
A. PRIVATE FIRE PROTECTION:
1; Fire extinguishers throughout store, whse and offices
.
B. VVATER AVAILABILITY (FIRE HYDRANT):
1, NW corner of Union Ave and Espee St,
4.
FD15'
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CITY OF' BA~RSFIELD
HAZARDOUS MATERIAð INVENTORY
:í.i
NON - TRADE SECRET
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and Agricultu~tandard Business
NAME OF THIS"FACILI
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL
-- ---
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OWNER NAME:
ADDRESS:
CITY, ZIP:
PHONE,':
lrm
lESS
nON:
, ZIP
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FOR PROPER CODES
REFER TO
C,A.S.
& C,A,S.
component , 2 Name
o
Number
o
Reactivity
C.A,S
o
Heðlth Hazárd
that apply)
r=J Budden Release
ot Pressure
~al and
)ck all
irre Hazard
&C,A.S.
'& C.A.B,
COlDpOnent , 1
Component , 2 Name
Component , 3 Name
Delayed
Health
o
Iuunedbte
Health
Number
o
Reactivity
C,A,S
o
Budden Release
ot Pressure
cal and Health Hazard
eC,,"all that apply) .
Fire
p
Hazard
Number
Number
Number
& C,A.S.
& C,A,S
& C.A,S
1 Name
2 Name
3 Name
.
ColDpOnent .
Component .
component
'.
Delayed
Health
o
Immediate
Heal th
Number
o
()
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C.A.S
D
Sudden Release
ot"· Pressure
~al and Health Hazard
)ck all that app~)
o
Fire Hazard
Number
Number
& C,A,S.
& C,A,S.
component , 1 Name
COlDpOnent , 2 Name
Number
C,A,S
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:al and Health Hazá~tç.:: "
Ick all that apply)ìJ'ii.
t·~ .
Fire 0 BU~'deJRèlÐase
ot Pre
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Hazard
~GENCY CONTACTS
those
inquiry ot
~-/-p~ -
DATE SIGNED
my
based on
and that
I attached documents
plete.
..
ation (READ AND SIGN AFTER COMPLETING ·ALL SECTIONS) ,
y under peanlty ot law that:I haver personaUY examined and am familiar with the information Bubmitted in this
ale reBpo~sibletor obtaining the intormation. I believe that the submitted information is true, accurate,
.
CITY OF BA~RSFIELD
HAZARDOUS MATERIÀ!I INVENTORY
:~.
NON - TRADE SECRET
~ndard Business
.
arm and Agriculture
NAME OF THIS"FACILITY:
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL
- -
- - - - - - -- - -
1
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OWNER NAME:
ADDRESS:
CITY, Z ffi
PHONE ,J:
NAME
NESS
TION:
, ZIP
E It
CODES
12
Location Where
stored in Facilit
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FOR PROPER
REFER TO
- -
7 8
, Days Cont
on Site Ty¡
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6
4
Number
NUmber
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& C,A.S.
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cal and Health Hazård
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ock all that app~)
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Number
component , 3 Name
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oek all that apPlY)' ("'I;:,
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#1
RGENCY CONTACTS
those
ot
24
inquiry
l-f'e,
DATE SIGNED
my
based on
Title
and that
'and all attached documents
and complete.
Name
o ..
- -
:ation (READ AND SIGN AFTER COMPLETING ·ALL SECTIONS)
'y under peanlty of law that:I haver personally examined and am tamiliar with the information submitted in th
lals reaponaiblo,tor obtaining the intormation, I believe that the Bubmitted intormation is true, accurattf"
. .
OF
TITLE
OFFICIAL
.
J3A~SFIELD
MATERIALS INVENTORY
:~;
NON - TRADE SECRET
CITY OF
HAZARDOUS
,
.:
~gricultu~~standard Busines'
~ I'
.
lrm and
ì NAME OF THIS<FACILI~~
- STANDARD IND. CLASS CODE:
)
I DUN AND BRADSTREET NUMBER/FEDERAL
-
- -
- - - - -- - - --
S
OWNER NAME·
ADDRESS:
CITY, ZIP:
PHONE ,I:
NAME
ŒSS
rrON:
r ZIP:
~ #
..£.
7S
f _ -&)- I
)
~ ifá/- Ä
~~ 24 HI
and that based on my. inquiry of those
¿-/-92-
DATE SIGNED
,
.
Compqpen~ , 1 Nama & C.A.S. Number
Component , 2 Name " C,A.S. NUmber
t Component , 3 Name & C,A,S. Number
~oI 'ZJ/ (/;ýN-ci~"/bÏ' ~
::-
Component' 1 Name', C.A,S. Number
;.component , 2 Name 'C,A,S. Number
: . . I ~. .'
Component' 3 Namà " C.A.B. Number
~':>!ð/ ""¡d1" ~~~ ~
Component' 1 Name '·C,A.S. Number
" :
Component I 2 Name , C.A,B. Number
Component' 3 Name' C,A.B. Number
~/ µC~
Component I 1 Name , C.A,B,
Component I 2 Name , C,A,S
Component
6
s ,
i ~
] .i
-
C,A,S, Number
o Reactivity D :
.ðt(;j ~. D
C.A.S. Number
-
0 Reactivity o Immediate 0 Deiayed
Health Health
~ rdJ. rc;¡
C,A,g
FOR PROPER
!¡
Health Hazárd
that apply) . .
Fire Hazard Xsu~de~~ ReÌfl~se
. 'of Pr$iJu're
, ' .:~, .", ( :
b ~ ÇO~ 13~~j~)L
'. :,'~\~¡:;
aal and Health Hazard'." i'
Bck all that apply):,' '., .:;
Fire Haz~d ~~dden 'Rel~ase
',of Pressure
~al and
)ck all
o
o
o
''Budden Release
ot'. Pressure
:al and Health Hazard
¡ck all that app~)
o
Delayed
Health
Immediate
Health
Reactivity
Fire Hazard
C,A.S, Number
o Reactivity 0 Immediate 0 Delayed
Health Health
..
~: .... "-.
Health~Hazari.·¡"(' '.
that apply) f ,?,
~ '
Pire Hazard sU;deiR¡31ease
of Pressure
:al and
Ick all
.'
RGENCY CONTACTS
:ation (READ AND SIGN AFTER COMPLETING ,ALL SECTIONS) ,
~y under peanlty of law that:I have¡;- personally examined and am familiar with the 1ntormation submitted
~ls resporsible ~ obtaining,the information. I believe that the submitted information is true, a
.
CITY OF'" BA.~R.SFIELD
HAZARDOUS MATERI~ INVENTORY
:~j
NON - TRADE SECRET
.
Agricultur~tandard Business
'arm and
NAME OF THIS"'FACILIT$d-~
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL
- -
-- --- ----
5l'!"vtC
OWNER NAME:
ADDRESS:
CITY, ZIP:
PHONE ,,: .
NESS NAME
TION':
, ZIP:
E it
FOR PROPER CODES
,
6
5
Annual
4
" C,A.8.
, C.A.8.
" C.A.8.
I 1 Name
, 2 Name
I 3 Name
-
Component
Component
o
Nwnber
o
C.A,8
~cal and Health Hazard
leck all that apply):
Fira Hazard ~ sjdden Release
. ot Pressure
component
Delayed
Health
IJlDllooiate
Health
o ~ctivity
¿..~s
..,
Nwnber
Number
Number
C,A.S.
C,A,S
,
,
, 1 Name
, 2 Name
Component
Component
"
o
o
C.A.S
o
cal and Health Hazard
eck all that app¡Y)
Fire Hazard ~":8Udd~n Ralease
(. . ~t',Pre88ure
Numbar
, C.A,S.
3 Name
.
Component
Delayed
Heal th
IJlDllediate
HØAlth
Reactivity
, C,A,8.
, C,A,S.
Name
Component . 2 Name
Component . 1
Nwnber
C,A.S
o
~ ", ,;- :'-.;
cal and Health Hazál:d: ':.
Dck 8:1 that apPly)tr~;:;
Fire !IaZard~Udde; R.åleasa
ot Pre
, C.A~S.
. 3 Name
Component
Dslayed
Health
o
ImødiAte
Health
o
'Reactivity
RGEÑCY CONTACTS
"
:ation (READ AND SIGN AFTER COMPLETING ,ALL SECTIONS) .
'y under peanlty ot law that',I haver personally examined and am tamil1ar with the information submittød in this
~ls raspopsible tor. obtaining the· information. I baliava that the submitted information is true, accurate,
thoBe
of
inquiry
~/-fJ'L-
DATE SIGNED
my
basad on
and that
"
all attached documents
d/camplete,
. CITY OF BA..RSFIELD .
arm and Agricultur~ Standard Business HAZARDOUS MATERIALS INVENTORY
:~. ~
NON - TRADE SECRET
~~~~:AME'ts~~¿~ ¿~ . OWNER NAME: ,-S~ i NAME OF THIS"FACILITY:>~
ADDRESS: I STANDARD IND. CLASS CODE:
_ CITY, ZIP: %/. ?/~ý ! DUN AND BRADSTREET NUMBER/FEDERAL
- -
PHONE ,f: - - - -- - - --
6 14
Names of Mixture/CamponentJ
/ se~ Instru~s \,
II~ SlY/ð'J!;d
I t. '~Isð ~. I
eal and Health Hazård C,A.S, Number CoIllpQl1ent;. , 1 Name & C,A,Sò Number
eck all that apply) :
Fire Hazard ~~den Release o Reactivity 0 Immediate 0 Delayed COlllponent , 2 Name " C,A,S. NUmber 1# 7t1fb, J ,. I
" . ot Pressure Health Health t COlllponent , 3 Name , C,A,S. Number 3.-
L1!J~ 17,,~~5 I~~ ~1I ~~I V~<7/' ¿}CA::.. I /~+,-rjJ>'r
Vp~t'J~,v .
772 ")..!Þ ")-9 ~ -
eal and Health Hazard C.A,S. Number Component f 1 Name', C,A,S. Number
eck all thatapply)~
Fire Hazard P "'Moo ·Rel.'~R,"OUVHY o Immediate 0 Deiayed I ;.colllponent , 2 Name & C,A.S. Number
. :."., :'
:. ',of Pres sur . Health Heal th Component' 3 Namè" C.A,S. Number
C=I - I I I I c=r=J CJ
=al and Health Hazard C.A.S, Nwnber Component' 1 Name·'·C.A,S. Number
ack all that appl~) '. :
D':'sud~~~ ReleaBe 0 Reactivity 0 Immediate 0 Delayed .'~' Component' 2 Name , C.A,S. Number
Fire Hazard
ot', Pressure Health Health Component f 3 Name' C.A,S. Number
=:JI~:'" I I I c=r=J CJ
~ ",' ....
~al and Health Hazá~>::" C.A.S. Number Component' 1 Name , C,A.8, Number
~ck a1>1 that apPlY)lf'\~" ,
}j :',' Component I 2 Name & C,A.S. Number
Fire Hazard D 8udde) R.åleas() 0 Reactivity C1 Immediate 0 Delayed
of Pressure Health Health Component I 3 Nama & C,A~S. Number
Co
RGENCY CONTACTS # ~t~ ¿¿. ø~
ame Title ~~ 24 Hr
0 .. "
:a.tion (READ AND SIGN AFTER COMPLETING ,ALL SECTIONS)
:y un?er peanlty of law that:I, hav'er personally examined and am tamiliar with the information submitted and that based on my inquiry of those
lals respopsible tor obtaininQ the information. I believe that the submitted intormation is true,
, ~ 11~£ G-/-9¿
OFFICIAL TITLE AUTHORIZED REPRESENTATIVE DATE SIGNED