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HomeMy WebLinkAboutBUSINESS PLAN ·~{-' ~, H¡IMP SITE DIAGRAM 0 P~ MAP ; \ '1~ f~ FACILITY DIAGRAM Business Name: VirAL AiRF'. Business Address: ;2.(001 ÙN O~ AvE ßA~E'(.Ç.fìe.'J CA 93~ For Office Use Only First In station: Inspection station: Area Map # of NORTH 0 G:J waTer 5HIJT off: If. O-F1flIYYIAI3Le... GAS Fire. E'It1:INC¡O ISIICl O~ E5PEI: ST. UlJ - t="'e. HtlDro.Or dC.rl1,s6 6r t I 'FroNT ÞOO f ... e-GÙIP smruqG Are(.} ~ \) ~ 6 Æ lJ/J 101\1 AvE. w yeS ~\J) ~~. ~ 5 How QPO t-{ t SHUT off- . GAS ~,Þe. . 'BcJc.l.DI"~ l' I' 'ŸJ~ ff~ BæAK..RoOM OFF'ICe f'1..~f C'fI..x;v.stl4"· l¡J CI1).~ 1'0 I\-tTle. OFFIc.t 5 -----. ,--- JND AUWHAT;C spnNkL.efS \ \ -- ,I, ,. '. . ~MMP PLj\N . MAP ;.~ ~ SITE DIAGRAM Business Name: V TALAlr'E FACILITY DIAGRAM 1->< Business Address: 2..~ 0 I Ù N to 1J A v e. '13>A ¥)Er-s -fÚd J '133/)$ For Office Use Only First In Slatlon: Inspec1l0n Station: Area Map f# of NORTH 0 55 Pt.£... 30 I E.s?~'-= Sî' .' VAfKltJj k.OÍ VITALA/({5 M 6Ð/Cc£J STOre..... OFFICES I FLA,!,mÞB .(bA.5 ,-f , . E:D <.Age: LOq¡)t c PA(KI~ lOT, èÙO~E~OV5E ~~ ---, .-. \ ----- ~ ( ,,-"-" ¡, ~, HMMP e SITE DIAGRAM Business Name: \/,-rALAlrE PLAN e MAP FACILITY DIAGRAM I '>< Business Address: 2/001 UtJfOlJ Ave -gA¥¡Eró·f¡e...lcP '?33t)$ For Office Use Only First In station: '" Inspection station: Area Map 1# of 30 I f..sPFP Sî' 4' OFFICE'S I FLA~m. PfJ (QA5 " . EO <A< E: WRREHOÙ$£ rI~ ---, -. NORTH {} 55 'Pt.E... () ( 'YA(K'~3 k.OÎ !.D ADI c. PAOI, I~ lOT- \ . VITALA/(é M ED/CoÝ 5 TO (' e... ( - ~' ;. HWMP SITE DIAGRAM ~ P~ MAP '"~ <; FACILITY DIAGRAM Business Name: VITAL Aìl2~ Business Address: ,2,lDO 1 ÙN;O ~ . A"é ßAt'1E'(.S~ CA (l6305 For Office Use Only First In station: Area Map # of Inspection Station: NORTH {r Œ1 water SHIJT o~ 't Q-F1ftY'1A(ke.. GAS Fire.. €ltTll-1I1U l$lf~ 01- E5PE~ ST. un - ç'lre, Hl.Icro.n r (\C.r¿/~6 6r , I"(oNT þOO" ... e-QÙI P SrvrcJq6 Are.(.! ~ \) ~ ~ ~ Æ tJiJ 101\1 A" E o Yð I!I ~\J) ª~ ~ 5 How eoo N t x .; SHc..rr off - GAS ~Iþe.. . 'BcJt.t..DI"~ l' .;. 1Jf(.-f,~1 vf~~ 8æAK.. RooM OFF'! c.e .. r ¿ t¡<1 l.x¡v oS ".Q'" cµ Cf't).~ 10 I\-tTlc.. OFFIC£: s 'j.ND AUTOHATic spntJkL.e(5. ----- ---- . "::':-~.,-~;.;,; .5~/ ' ,!. " Ii ~~ H M\1 p PLAN- MAP SITE DIAGRAM .~ I FACILITY DIAGRAM I Business Name: V ¡-Tit I AI {!J¡J Business Address: 4'ácO "s'hNLRd S+e- 1003 Bt1KØ1:;-{IÆ ~ For Office Use Only First In Station: Area Map # of NORTH 0- Inspection Station: A\lE'--{ .~ © .¡- n";^ ~ f~~OOe.- ~s . ,----,~ ¡,~ r I r.. r:INYII1I!t6<Jl. 'I' T1 ~( ~ ~ï (bAS. ~!: i::. r:.r- o~ i .. I~ - - - - /'----.....--.-.--. to""" T 1[.,..1 IJ- < l ,.-In,w . €-'tbtl\lg. . STOV'p£\6 f\æþ. tl ¡;. ¡¿ I' ;¿ :) ~ ~I ~ WOfeJ\DUS£ ~ ~ {ft. ~ f " ..---:-------~---~---~...--,. J 'F'\nz é.\G'rIIl.t¡, ,. BfQQ.,10 Roo If\ o Çf¡ C..6 1 l L.. 01~~ t e-OÞom o ~~~~~lÊ--1 - t-· f FVOJJT OooP- @ @ 'j HNfMP PLANt MAP FACILITY DIAGRAM ~ SITE DIAGRAM Business Name: Business Address: . le~-. ~~I . VITAl A/{UV 43.cO -ShNê.-Rd Sk taro . Bt1K~eJdG4i For Office Use Only First In Station: Area Map # of NORTH ^ ,. ", .. ~ ~ Inspection station: -,.. ..-..--.- -..-.. ,..-..- ~ __ ,h___'____________n____h::.=~~.-. _on ,___, ... .____ _.__ ....________ _______..__._____ ___,___ ~ ~ ~.._----_.. - .-.. -_. -- - .-- u=="< ~.. ~ (,10'. ?/>'X?/NYf'; u. ~ ~ .. ':) :r. VI '" ~\ ~,~ ,¡!6<>< c;J F'=f'T, ~ ~ ffnlMÞl<í ttlD/<- n;J,. fCf?; Ytfµ"AI~ 'v' 1/1<2 IIŒ~cç~a~~ .~ SEP 141993 M By ~ -..- It - .~ ~ .. . .Æ'\~V- lA- ;; Ita Ire® ': " .. '.::::::::::::::::::::::::::::.1 uu:::::;:::::;;; :::;;;;::;;: it!::!:::::::::::::::::::::::: 2601 UNION AVENUE BAKERSFIELD, CA 93305 PHONE (805) 861-7083 FAX (805) 323-4920 January 13, 1993 Valerie Pendergrass Hazardous Material Division City of Bakersfield 2130 G st. Bakersfield, CA 93301 ~...-'-w.. _"\ .";¡. .,- -.,""....- . _ ._...._. ~ ~". __ . '1 ',___ _~r----.. -....,... ~...~....).~.\.-. ';._.~ ...~~.......-. ~_ .....',..__....IH~~ ~_.-~ -.......:~~~~;..~~.......~_.... Dear Valerie, - -'--_:>'"----~~~ As we discussed today VitalAire will be moving to a new location in Bakersfield. Our tenative move date is February 15th. Our new address will be 4300 Stine #603. Please send me a new plan and change our address on your records. Thank you for yowrtime. ~~ l\'C\? V·.. \ Sincerely, (!Ad.4.. tt..J~ Carla Weiss General Manager '":1 '., ~ ~ . ',. . .'; \. . '. ~. .'"..:::,.!"'.,,,:,:....,. ..... e e 1I)1( 73770) :: VitalAi re® ........mlllulllllllnllllllllllm'.. ..1111111111111111111111111 mummmmmmmmm ¡¡ ¡ ¡¡ ¡ ¡¡ ¡¡ ¡ ¡ ¡ ¡ 2601 UNION AVENUE BAKERSFIELD, CA 93305 PHONE (805) 861-7083 FAX (805) 323-4920 January 13, 1993 Valerie Pendergrass Hazardous Material Division City of Bakersfield 2130 G St. -"'-, ...~~,--, ---'Bakers'f±e-l-d,=€A-~9-3 3'0-1~~---_-.....~~- ~.....,,--,~-- ~,~ -~~~~-,~ '- -- . '--~' ".-=-- Dear Valerie, As we discussed today VitalAire will be moving to a new location " in Bakersfield. Our tenative move date is February 15th, Our new address will be 4300 Stine #603, please send me a new plan and change our address on your records. -. Thank you for YOŒrtime. Sincerely, CAd.~ tU..L.i.4IJ Carla Weiss General Manager "_~c....,__~.:--:-=~,__-_~_;-,,<..>.-=.- _ __' _' _.::_ _'. . _, ~'_" ,~ ~ W~L~- TY~~~~-- ,.-;;;-~~~- - n~-rOCa.TLôn -=-,-~--- ;;:.'~-""" ~--.-- ~-- ~".... -- .- -- e " , , - - -- - - ---- - - ---- - - "- .- - -- --" . .~ ~~..' I( ~ \_.____ .u§~ ..... . ..~.....u '--- ~~', ----~ -'~..- -- _-C '__0' ,- "-~371' -- -- .. .~·~·2.=.lt .<0:.. .. -'- ,.- -~ - ,',- , - -- -- ~ , -- - -'=-,' v- . ~~~)~'-' :.. oj~~~)k. :pµ ~CciauJ2b;;¿Lu. ... .....;;;d-~~# ~.~ . . - - - - ,/ e - May 21, 1992 . Ms. Carla Weiss, General Manager VitalAire Medical Store 2601 Union Ave. Bakersfield, Ca. 93305 Dear Carla, Per our phone conversation of May 21, 1992, please complete the rest of the forms for the Hazardous Materials Management Plan. Please make a copy for your files and return to us as soon as you can. Your business is not a hospital or a doctors office, therefore the threshold of 10,000 cubic feet does not apply. If it did, you would be required to file a plan and keep us updated as to any changes anyway. Hospitals and doctors with quantities under 10,000 cubic feet, but over 200 cubic feet must also file a plan under Community Right to Know laws. Thank You, Valerie Pendergrass Hazardous Materials Division ~ It e Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 r ...eJ.l- cy ~ INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt, 2. lYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: \l1-rA,-A,~f!!..,J ') HgDI~' STOt'"E. v LOCATION: (2Dr",nef of UNtD'" Ave) 2lcOl ufoJlOtJ Ave . ~ £6pe~ MAILING ADDRESS: . 2lo01ÙnlOIJ Ave CITY: BAK£rsfìe.td STATE:~ZIP: '?3.3lDPHONE: g'fol-1\1 Ç'f!t)::tÞ .... DUN '& BRADSTREET NUMBER: qq ...2.,ì- "2..U5 SIC CODE: 511o q / PRIMARY ACTIVITY: -11EDI~(l \ & "pl~ OWNER: V'TAIA"re., COR-po MAILING ADDRESS:' ~121 kJo. CaJ,.é::òf"()to... a:~ uJalrHJí Cree t:. q~S0 '- SECTION 2: EMERGENCY NOTIFICATION: CONTACT ./ TITLE BUS. PHONE 24 HR, PHONE 0"- g ~ (- ì I H He me.. 2fDlo -Sl i9 ß''' , -1 \( , f-þt).e. 399 - ~9 8' 7 . CAdA uJ~\~ GQn~(a.1 n1a.na.~ 2. Rüth "~)lJSTarno..~Te. Re.~p· Jher-apLST 1. .J 1. ----. --- ---- ~ i. .j. \/ ..... - -- - ~ u-Bakersfield Fire- Dep( e · Hazardous Materials Divi~ HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: .5 . MATERIAL SAFETY DATA SHEETS ON FILE: c.¡c:.s- BRIEF SUMMARY OF TRAINING PROGRAM: HS'DS ~n o}(.q.~n.3'\Je.r\ 10' eGc+t e.tr\p'-Dy~e...0-(on3 ë:v'<2It rn6er'UIW 'tT"a.ln I n 5 ... 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 "CALIFORNIA 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. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, C Ql R t'l.... . LU/..l ~ ;) CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION Will BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC, 25500 ET Al.) AND THAT INAêcURATE INFORMATION CONSTITUTES PERJURY. . Ctu ~ð. _I.Á 1'1~ SIGNA TURE J/em.IAaJL m~ ( TITLE .' ~/<f Ic¡~ DÁTE 2. f01S, ---. --- .,',.,~~. --- '.: .. ~ N~.'--, ...., ..... _' /J:¡/.> \ïJ5iiP) '\!' ~ . Bakersfield Fire Dept. Hazardous Materials Division e ðJ>-_ ~ ,; j~ HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: VITALAIQ.~ SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: CAJ..I... PIllE 1:J&pT. - CoA.i'rlia-r VITIlt..//;¡¿iJ \SupJ--UI,S£ÁJ . /, JJonFY "AJï~ ..s~'1 c:ú..¡:rr, B. EMPLOYEE NOTIFICATION AND EVACUATION: V~rbllL. NOTlFœA-rloN TO ev/J(!.,U4T€ puurn/~$,..J IIV ~S:. OP ~ev~ -Sf1/~ C. PUBLIC EVACUATION: Verbai NOT'Fi~ArtuYt TD e.V/K..UA-T4 prern 1s.L~ IV C4~ OF ~ Lt..a..£ q ..sp/~ D. EMERGENCY MEDICAL PLAN: _ 6/'Y)pLDf..jEeS IAJSTrt.Jc..'Ted 7D C!OIVTl:'<.Cr- ~ptuVl.sci) - 90 TO H~Y(!'1 ~ (}eAJï<c.,L) - 'jD 7l> (! / ().SILS:T I-IOsp IT 19(" IF See Ve.t..L- ¡::uo1J..-úrn t. ~ ---- - --.- -. 3. . FD]fI;Q ~ ~ 7"!j ~ - /' . . e Bakersfield Fire Dept. ' Hazardous Materials Division ~.i~, HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: - Ct.¡UAJDEJ¿5 C/lI}¡N€..D o;¿ ;..ù HOt..l)~NC¡ ¡lAsE - c'1L./Nl:Jé€S pLaCE/j liv A¡¿E'19 OdT OF lOAt¡ OF M:J€maf2 FC.ðti) OP 712a.FFIG - .sTAFF /IIISe./"vlC£tJ tJ/\/ CÓl"v.e(!, HANDLINe¡ p'0c.edl.J~ B. RELEASE CONTAINMENT AND/OR MINIMIZATION: SHU"r OFÞ O~ VaL.Y'€$ IJR. pUT OAj CONTINUOUS FLOW 7tJ émp",/ (3t¡L/ucR..LL C. CLEAN-UP PROCEDURES: AIe..ML7E- p.u-mi.$£s '\ SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: OVT.:5I0t2- ¿V~rw/l'-'- 7OuJO-Ads 50c..JTH C~ ELECTRICAL: ntJ7SJt:J8.. LUes r u):vll 'TDu.)O--tdt¡ '.50UTf-! c~· WATER: DtJT:SJD O:J {¡Æ;ST I.J n 1/ AlDen..} ~LA. SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: ' SECTION 9: PRIV ATE FIRE PROTECTION/WATER A V AILABILlTY: A, PRIVATE FIRE PROTECTION@ Fj¡¿e. exrtN9t.1ISHtUS - ú..k.srOffJCJ2.. <:(; &LK fJ:q, RLArm ..sc¡$TQm T{!L -Te~ - no~ Qn-<R.C!.,/f/tLJ B. WATER AVAILABILITY (FIRE HYDRANT): Ac (0 S~ sr. .sOUTH ~0VYlt.A Un ¡lff) o..u.e... I EsfJ-fl-<-.. 4. FD1:'. '> '\ > \ '41 page-1of-\- . " OF BAKER.SFIELD MATERIALS ',i<. CITY HAZARDOUS INVENTORY and Agriculture ŒJ Standard Business ID 14 Names. of Mixture/Components ~ee Instructions TO 8 Cont .. REFER 5 Annua1 Amt 4 Average Amt ,;¿~O t{~:i~ No . t,' Farm jt~¡:h";:': ',' . !:{ SÙSlNESS NAME i.:'';'LOCATION: IX: CITY, ZIP' It ,PHONE t: ~~:ii 4S;~ j"è' ¡-~,.¡". ,:.t;¡. NAME OF THIS~FÂCILITY: \I STANDARD IND. CLASS CODE: - DUN AND BRADSTREET NUMBER/FEDERAL '!. 4_ - ~ ~ '1. - ~ ~ ~ ~ :,,;,:.' TRADE SECRET NON - OWNER NAME: ADDRESS: CITY,.' ZIP: PHONE ,.f: : Number NUmber Number .A,S C,A.S, C,A,S, & & Name Name Component It 2 Component,1t 3 ~ì .., g"'2 - '-t 4 - ,., Delayed Health o Number D D Reactivity C,A,S Sudden Release of Pressure o Number Number Number & C,A,S & C,A,S & C,A,S, Component It 1 Name Component It 2 Name Component It 3 Namé Delayed Health o Number o C,A.S. o Physical and Health Hazard . (Check all that apply) "0 Fire 0 ..( IDDDediate Health Reactivity Sudden Release of Pressure Hazard Number & C,A.S Name Component It 1 Physical and Health Hazard (Check all that apply) o 0 i Number Number & C.A,S & C.A.S. Component It 2 Nàme Name Componsnt It 3 Delayed Health o IDDDediate Health Number o D Reactivity C,A,S Sudden Release of Pressure Hazard Fire Number Number & C,A.S. & C,A,S. Component It 1 Name Component It 2 Name Number Cl C.A,S o physical and Health Hazard :" (Check all that apply) L:. D Fire D Number & C,A,S Name Component It 3 #2 o Delayed Health IDDDediate Health Reactivity Sudden Release of Pressure EMERGENCY CONTACTS Hazard ~f Certification (READ AND SIGN AFTER COMPLETING ALL SECTIONS) I cèrtifY under peanlty of law that I haver personally examined and am familiar with the information submitted in this individuals responsible for obtaining the information. I believe that the submitted information is true, accurate, those of inquiry my based on and that and all attached documents and complete, 2.. SI GEtJER.AL- . I'1ItNItf:j<vt OWNER/OPERATOR · S AUTHORIZED REPRESENTATIVE CARLA WE/S.s NAME' AND OPFICIAL TITLE OF OWNER/OPERATOR OR e·. . Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 ô ~ (G ~-~'\#'~ ~ MAY 18 1992 ~ By:;; HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1 . To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: \IITAL..A,~f!..,Þ '> MEOlcA' STO..-e. LOCATION: l tlD("nef of c.JNID~ A'IIi!!.) 2IDOl LJtJIDtJ Ave. ~ E..!tpeQ. MAILING ADDRESS: . 2lðO i ùnlolJ Ave CITY: J3AK€rsfìe.ld STATE:~ ZIP: '73.3llSPHONE: 8'~1-1 \ II çep:tÞ .... DUN & BRADSTREET NUMBER: C\""''' 2."- '2.U5 SIC CODE: ~ PRIMARY ACTIVITY: -Ì1EDIQG\ &ppl~ OWNER:' \/'TAIA,Y-e.. COR-P. MAILING ADDRESS: ,,),12.1 Uo. CalfÞòroto... a:\I€' uJalt1ùí Cree to q\.fS"" SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS, PHONE 24 HR. PHONE D~ g'CðI-ì 1 II Herne.. ~fDlD-S1 f9 ß''' , -1 \I' tþr).e. 39ct -"398' 7 . ' CAt"'IA uJ~'&S (6(2r1Q('a,1 rY\a.t1a.~ 2. Rùth ~LJSTarno..nTe.. Re~p. 4het'"Q.p LST 1. 1. ----, -- ------ =~ ,.v' " '\ .,-----" - - -B-~kersfield Fi~e Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: ..5 MATERIAL SAFETY DATA SHEETS ON FILE: (. e-:s.- BRIEF SUMMARY OF TRAINING PROGRAM: HS 'DS ~n ox.q.an .ð,vQ..ra iO' OOCtf el11p~y~e.. 0...(0(\,3 ë: vQ./b rn6e.YLJIc..L> "trlltn n.5 ' 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 "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. 'X WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, C Ql R a.... U 11..1 ~ 1 J CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION Will BE USED TO FULFill MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. . C (U P.-'J .l.J. 1 ~ ~ SIGNATURE -AlØ1MaL m~ TITLE ...:sjlý /9 ~ DÁTE -------2 , FDI S'XI ----. ------- ,H-'.L>.- --