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HomeMy WebLinkAboutBUSINESS PLAN I ' Per it Operftte to Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF ,PERI\lI;~T"ON REVERSE SID.E , ; "~: " ,\~: ;' '" "<L~' .,-._.. " ~ i :. , . '" . . ~.' :'.' .... " Permit 10 #:: 015-000-001458 VALLEY CECALINC . LOCATION: 3000 N UNION AVE, Issued by: ..... :; I"~~,, -" . '(," ~ . "-, \" . 'i'i" , 1J:~<~~" ! i~ . '~!j:' .... .1 ~'~,,,'{ "~'1' ~""',.'~ .~ t¡ . ~"-::,"\"~' t\ \". \~. '.~~. . . '( .. H.% X,. ':~~\;. \\ j' , . Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave" 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: Issue Date r Expiration Date: . . .;. ·,~::·;'f~~):~.~.~.:~~f:~·,·~. .~). ::~f .. June 30, 2003 PerDlit to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE PERMIT ID# 015-G21.Q01458 VALLEY DECAL INC LOCATION 3000 N UNION Issued by: This permit is issued for the following: zardous Materials Plan round Storage of Hazardous Materials gement Program . Waste Approved by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfiel "- - -~_.~ - '-- ':~ -. ~ V\ ~ ~ .~ ~ .~ .~ ~ H Mil P . ... PLAN. :MAP -- SITE' DIAGRAM I FACILITY DIAGRAM Business Name: /Þ7 /)~/ /ß~ Business Address: --:::5ÐPð /V" /~;:/P/,/ For Office Use Only First In Station: Area Map # of NORTH 0 Inspection Station: 3ÐOC::> Cð/LJ/Y /9'/¿::- ~, /V \ I ¥-~ ~. ~ ÐFRCE ç;f/o~ /' '~ - ·,eoom 4r/ß:;ø/7' ofß pA- 110 _~Æ '7 .:s; WóE p¡}- TJD eu!tfi7J ß- ) '\ .5 eI"¿:¿1/ ~. ~ ~ /7LLE Y ~ ~ tf) - ---. ~ ~ ~ ~~ I , ~- ---- . . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd I~'loor, Bakersfield, CA 9330J FACILITY NAME if ALu.:-( I)!-LA L ADDRESS 3000 ¡J, UIUIO"; FACILITY CONT ACT£"C:)W fA..( d INSPECTION TIME If) M I () " INSPECTION DATE J [) - ð C;d- ô 3 I PHONE NO. 327-204 , GOV'(I~aroUSINESS ID NO. 15-21O-00/1íE- NUMBER OF EMPLOYEES b Section I: ~outine Business Plan and Inventory Program o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate pennit on hand 'v Business plan contact infonnation accurate V / Visible address V Correct occupancy '" " V erification of inventory materials '\,I Verification of quantities v ./ Verification of location V ... Proper segregation of material \..- "" Verification of MSDS availability 'v ./ Veri fication of Haz Mat training Y Verification of abatement supplies and procedures \. ... Emergency procedures adequate \. ", Containers properly labeled t ,/ Housekeeping \ ",... 134 J V / Fire Protection \...., kf ~ J1 ."j/ Site Diagram Adequate & On Hand t... ~ ~A,_,,[.:7 r~ - (j C=Compliance V=Violation /Q - I ~ CLd-cL<c:<.- Nino / 8 Any hazardous waste on site?: IBÝ es 0 No J ) Explain: Lq r~I/-Þ~J fW"nn(lr} ~r,-ç?ft.() W~ ~ Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs. Yellow - Station Copy Pink - Business Copy nsible Party Jf-ß "" '" - ~. It RRrETVED e VALLEY DECAL INC SiteID: 215-000-001458 Manager : / Location: 3000 N UNION AV Y: City BAKERSFIELD' ,/ BusPhone: Map : 103 Grid: 20C (805) 327-2041 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title ~.M. Emergency Contact / Title EDWARD J CORRIGAN / JiaM!~~¡PP RON WALLACE / PRODUCTION MGR Business Phone: (805) 327-2041x Business Phone: (805) 327-2041x 24-Hour Phone : (805) 588-3336x 24-Hour Phone : (805 ) 864-1333x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Owner Address : City . - 7' .-.'g ~~;.~~-:._~. c'- ,,~~~t.. .':: :~~r\ - Phone: ( ) State: CA Zip : 93305 Phone: (805) 327-2041x State: CA Zip : 93305 - x Contact : MailAddr: 3000 N UNION AVE City : BAKERSFIELD . 3000 N UNION AVE : BAKERSFIELD Period : Pre parer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: I, £dw~~ .f Co rvzA1,Á.D~ hsrs©~ C~iii~ ~h2ft ! haViS (Tv~ or lnm i'I!:lmo) reviewed ths ~tiBlChsd hsztalrdoos malft~ú'USlI$ managiSJ- ment plan ~orUIHb~p~Jr and ~hSl~ ift along wiîh . any corrsctioK'ls constitu~s a romplete BInd corr~ct man- agement plan 101" MY ~cmty, ~ .. ~ 0jt-- 1;2-/3- qq. ~ -., , -1- 11/12/1999 I e e F VALLEY DECAL INC p= Hazmat Inventory p== MCP+DailyMax Order SiteID: 215-000-001458 ì By Facility Unit ì Fixed Containers at Site ì specHaz EPA Hazards Frm DailyMax unitlMCP Hazmat Cornman Name,.. INDUSTRIAL LACQUER RETARD THINNER SOLVENT BLEND SCREEN WASH F F F L L L 60,00 GAL 55,00 GAL 55.00 GAL Mod Mod Mod -2- 11/12/1999 e e SiteID: 215-000-001458 ì Facility Unit: Fixed Containers at Site ì F VALLEY DECAL INC p= Inventory Item 0003 F== COMMON NAME / CHEMI CAL NAME INDUSTRIAL LACQUER Days On Site 365 Location within this Facility Unit Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container , GAL AMOUNTS AT THIS LOCATION Daily Maximum ...:. "'0 ~ GAL I ...-;.p , Da,ily Average I 'P¡rJ1" ~o GAL %Wt. RS CAS # 36.00 2-Butoxyethanol No 111762 11.00 Aromatic Hydrocarbon No 8030306 9,00 Isopropyl Alcohol No 67630 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME RETARD THINNER SOLVENT BLEND Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 78-59-1 STATE - TYPE Liquid Mixture PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container I GAL AMOUNTS AT THIS LOCATION Daily Maximum ,,- . 6rA-'.~ ~ GAL Daily Average <6'"ð~ ~ GAL %Wt, RS CAS # 50,00 Isophorone No 78591 50,00 Benzene No 71432 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Mod HAZARD ASSESSMENTS -3- 11/12/1999 --- ~-- - e e SiteID: 215-000-001458 ì Facility Unit: Fixed Containers at Site ì F VALLEY DECAL INC p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME SCREEN WASH SWC-37 Location within this Facility Unit Days On Site 365 Map: Grid: CAS # STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Con~~~ 59~1 ~ GAL AMOUNTS AT THIS LOCATION Daily Maximum l O..Jj;~¢r' ~OO GAL o 0 Daily Average '/z. qAL.~ GAL HAZARD US COMP NENTS %Wt. RS CAS # Petroleum Distillate, Heavy Paraffinic, Dewaxed No 8030306 n-Propoxyethanol No 2807309 Diacetone Alcohol No 123422 HAZARD SSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Mod A -4- 11/12/1999 e e F VALLEY DECAL INC I p= Notif,/Evacuation/Medical r=: Agency Notification L:-1-1, r=::T~::Y:: :::i:~~vacuation I Public Notif,/Evacuation , N/A I Emergency Medical Plan MEMORIAL HOSPITAL SiteID: 215-000-001458 l Fast Format l Overall Site l 07/07/1994 1 1 1 07/07/1994 07/07/1994 07/07/1994 1 -5- 11/12/1999 e e SiteID: 215-000-001458 9 Fast Format 9 Overall Site 9 07/07/1994 1 07/07/1994 ] 07/07/1994 F VALLEY DECAL INC I p= Mitigation/Prevent/Abatemt r=: Release Prevention . I SOLVENT CONTAINERS IN 1 GALLON CANS. rARelease Clean Up Containment WIPE WITH PAPER TOWELS & DRY BEFORE DISPOSING, Other Resource Activation -6- 11/12/1999 / e e SiteID: 215-000-001458 ì Fast Format ì Overall Site ì I F VALLEY DECAL INC I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs 07/07/1994 A) GAS - NE CORNER OF ALLEY B) ELECTRICAL - NE CORNER OF ALLEY C) WATER - E APPROXIMATELY MIDDLE OF D) SPECIAL - NONE E) LOCK BOX - NO PROPERTY IN ALLEY Fire Protec,/Avail, Water 07/07/1994 PRIVATE FIRE PROTECTION - EXTINGUISHERS NEAREST FIRE HYDRANT - IN ALLEY ACROSS THE STREET Building Occupancy Level -7- 11/12/1999 · e e /. _' F VALLEY DECAL INC I F Training Employee Training /p WE HAVE -, EMPLOYEES AT THIS FACILITY, SiteID: 215-000-001458 1 Fast Format 1 Overall Site 1 07/07/1994 WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: POSTING OF CHARTS. Page 2 r I I Held for Future Use Held for Future Use -8- 11/12/1999 VALLEY DECAL INC e O)~ (CT~"~-w ~ SiteID: AUG 13 199J' BusPhone: -By ) Map : 103 - - Grid: 20C tit ;.. i:o- - _.. 215-000-001458 Manager : Location: 3000 N UNION AV City BAKERSFIELD (805) 327-2041 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title ~ß'I....I'> ~h8R ~.~ RON WALLACE / PRODUCTION MGR Business Phone: (805) 327-2041x Business Phone: (805) 327-2041x 24-Hour Phone : (805) ~~ ~äAx 24-Hour Phone : (805) ~.1 ^).,1 S.X Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Agency-Defined Topic Title p= Hazmat Inventory p==MCP+DailyMax Order One Unified List ~ All Materials at Site ~ Hazmat Common Name", SpecHaz EPA Hazards DailyMax MCP INDUSTRIAL LACQUER RETARD THINNER SOLVENT BLEND SCREEN WASH F F F L L L 60 GAL 55 GAL 55 GAL Mod Mod Mod I, Fdlút4-tr.cI :r ¿;'1f~9Å~ l!)@ &ìJ®f@~W ~~úl(8~ ~~~ ~ Ûì!®W) C'ì1'P3 or print ._~ ~ reviewe¡d th® attachsd If'ù~~~ 1fìfb@]\¡®IfÛ®~ m®¡n~PJ®- men~ pla~ ffo>rt/iJl ~~'1"t.: ®wtill ftM~ aR $1&Q)~ mí1Ûì! tal~~ oo8'li~i(grn~ ©@ú'U~~¡~~® ~ ©©1mf9J~$)~® t§lfiìJ©J OOIi'fi'®©K ffi~V'ù- ~@®m®U1)~ ~~úî) ~©Ii' mw b®©úijñ\iV, ~&j4 ) '~ 3-/ - 97. {IÌ!íJO -1- r 07/18/1997 e e F VALLEY DECAL INC p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME INDUSTRIAL LACQUER SiteID: 215-000-001458 1 Facility Unit: Fixed Containers at Site 1 Days On Site 365 Location within this Facility Unit CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container Daily Maximum Daily Average GAL 60.00 GAL 20,00 GAL Maximum Stored Maximum Open Use Maximum Closed Use GAL GAL GAL AMOUNTS AT THIS LOCATION %Wt, EHS CAS# 36,00 2-BUtoxyethanol No 111762 11. 00 Aromatic Hydrocarbon No 8030306 9.00 Isopropyl Alcohol No 67630 HAZARDOUS COMPONENTS . ,) ~ {!.ð ((.fC tJÄ- £dUA-rz.d " ¡( ?,E,:S\ d.e..tJ -S~<iš.....3:S'S(é. <B~'-l- 133> I \ \ 1 \ \ -2- 07/18/1997 e e F VALLEY DECAL INC p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME RETARD THINNER SOLVENT BLEND SiteID: 215-000-001458 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit CAS# 78-59-1 STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCA 0 Largest Container Daily Maximum Daily Average GAL 55,00 GAL 20.00 GAL -. Maximum Stored Maximum Open Use Maximum Closed Use GAL GAL GAL TI N HAZARDOUS COMPONENTS %Wt, EHS CAS# 50,00 Isophorone No 78591 50,00 Benzene No 71432 -3- 07/18/1997 ... e e F VALLEY DECAL INC f= Inventory Item 0002 F= COMMON NAME / CHEMICAL SCREEN WASH SWt:;37 NAME SiteID: 215-000-001458 1 Facility Unit: Fixed Containers at Site 1 Days On Site 365 Location within this Facility Unit CAS# STATE - TYPE Liquid Mixture PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCA ION Largest Container Daily Maximum Daily Average GAL 55,00 GAL 20,00 GAL Maximum Stored Maximum Open Use Maximum Closed Use GAL GAL GAL T HAZARDOUS COMPONENTS %Wt" EHS CAS# f.l ILL)' 1 r>......<::Æate No 123864 I~Q~Lv~yi7Alcohol No -t) ì b ..:H1 'Po k ,JTI e --:-" No 1 -,r:-crOOOJ S~1Z£ £...J ~ ~,s ~ ~uJ è,.... ?>7. ? e +-12 0 LiE... _ "D ('<s"¡" ; l.. L- A .Le. C.A S:tt (p '-17'1 ;).. - CI S" - ~ ;l - -p fl,ö po )( y e. -nJ A ..., 0 L , ~S~ 2'iÌ'o7- '0- c¡ L:> I A c; -e...+ø µ L A.L '-0 h 0 L.. \ c..A-S~ 1 "2.. :s -4 z. - Z- - --- -- -4- 07/18/1997 '. e e F VALLEY DECAL INC I p= Notif,/Evacuation/Medical ~ Agency Notification L:-1-1. ~LETEmp10yee Notif,/Evacuation L: KNOW TO GET OUT, ~A Public Notif./Evacuation SiteID: 215-000-001458 ~ Fast Format ~ Overall Si te ~ 07/07/1994 ] 1 1 ] 07/07/1994 07/07/1994 I Emergency Medical MEMORIAL HOSPITAL Plan 07/07/1994 -5- 07/18/1997 ... e e F VALLEY DECAL INC r-- p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-001458 ~ Fast Format ~ Overall Site ~ 07/07/1994 SOLVENT CONTAINERS IN 1 GALLON CANS, r:ARe1ease Clean Up Containment 07/07/1994 1 07/07/1994 WIPE WITH PAPER TOWELS & DRY BEFORE DISPOSING. Other Resource Activation -6- 07/18/1997 · e e F VALLEY DECAL INC I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 215-000-001458 ~ Fast Format ~ Overall Site ~ I 07/07/1994 A) GAS - NE CORNER OF ALLEY B) ELECTRICAL - NE CORNER OF ALLEY C) WATER - E APPROXIMATELY MIDDLE OF D) SPECIAL - NONE E) LOCK BOX - NO PROPERTY IN ALLEY Fire Protec,/Avail, Water 07/07/1994 PRIVATE FIRE PROTECTION - EXTINGUISHERS NEAREST FIRE HYDRANT - IN ALLEY ACROSS THE STREET Building Occupancy Level -7- 07/18/1997 '", ,¡. . . e e F VALLEY DECAL INC. I F Training Employee Training SiteID: 215-000-001458 ì Fast Format ì Overall Site ì 07/07/1994 / WE HAVE 7 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: POSTING OF CHARTS, r Page 2 ~~d for Future Use Held for Future Use -8- 07/18/1997 ~..". . ,~,:-~""",~.:-,;,,/P'. -, BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISIO 0 ~(Ç~D'~Mll 2130 "G" STREET ¡ BAKERSFIELD, CA. 93301 ; APR 11 1994 ! . , I By , HAZARDOUS MATERIALS MANAGEME~/ o INSTRUCTIONS: 8'3-déX) I /1-{sg To avoid furtheractión. return this form within 30 days of receipt., t" 1YPE/PRINT ANSWERS IN ENGLISH. ' !Ó3 - ;~.ov . Answer the questions below for the business as a whole, . Be brief and concise as possible. F-ee r;." . ~ cr l. 2. 3. 4. 18 SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME:' yfi'LL L?:Y' ·ß~C.Þ7£. .//ÝC: LOCATION: ~ ~¿?¿'/O #' Y¿V/O..¿1/ ~#y¿=- MAILING ADDRESS: 5~~¿=- , C¡TY:~EP~#/) STATE:44 Z!P/.3~ PHONE: 92;.7.,ZCJ1// . f DUN & BRADSTREET NUMBER: S¡C CODE: S~þ PRIMARY ACTIVITY: /-?"'.ç""4/~~P~.~ ~/ ß&c"pð-. . OWNER: ø;Ø~ E,~~r Fd7pr:es P /'l./A?~ MAILING ADDRESS: ,3pav # .1///.//1/;7 ,~/~ SECTION 2: EMERGENCY NOTIFICATION: . CONTACT TITLE BUS. PHONE 24 HR. PHONE ."LJ' .. ¿'?/"L, g/2~ ~. W 1. '///(Ø4~ E /7~ ., 2. ßt,¡J h/r¡¿¿1I<:£ '&z7--2Ø'j' , 8 7.7..- 6 ~$l5'" /h~ .1 . /' Bakersfield Fire Dept. _ardous Materials Division e HAZARDOUS MATERIALS MANAGEMENT PLAN -"'- '" " ", -:. ,,'" ----...:":;.. "I -; "~j SECTION 3: TRAINING: NUMBER OF EMPLOYEES: 7' MATERIAL 'SAFETY DATA SHEETS ON FILE,: yes BRIEF SUMMARY OF TRAINING PROGRAM: . /bSÞ/?5 C?/¿hiPr,Þ E/ê \ "..........' SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAI' MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE IICALlFORNIA HEALTH & SAFETY CODEII FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. ~ WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANHTIES AT NO t^\r TIMEEXCEED THE MINIMUM REPORTING ~UANTrnES. ~ OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: NfY I, CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. ! UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HA:zARDOUS MATERIALS (OIV. 20 CHAPTER 6,95 SEC, 25500 ET AL.) AND THÂT , INACCURATE INFORMAnON.CONSTlTUTES PERJURY, ~~~~~ SIGNA TURE TITLE 3h.?/YÞ/' . / . / DATE -~_. ."--;r~_ 2. ~__.:.~~,...:-". ~':.~-. ;.~.:'::':'.:';':': _. -w.:.ø . ",' .';. . F015qO . . ~~,:",:".-.--....~..., . - ~ . . ~ . --.:;' . e 'Bakersfi~ld Fire Dept. - : Hazardous Materials Division e HAZARDOUS. MATERIALS MANAGEMENT PLAN Facility Unit Name: ¿/"~ ..0-/"-<9/ k~ ~ SECTION 6: NOTIFICATION AND EV ACUATlON PROCEDURES: ~A. AGENCY NOTIFICATION PROCEDURES: fll B. EMPLOYEE NOTIFICAilON AND EVACUATION: ¿~ ÞocJ / /ør ~d/ C. . PUBLIC EVACUATION: /P4-- D, EMERGENCY MEDICAL PLAN: . / /' ~h7¡P"/o/ ß~/78/~· ( . _. 3~ ¡tH~ ,", .~. . . .. BakersfieldFire Dept. e Hazardous Materials Division . '" ..~...->-;-r ............ - HAZARDO'US MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: . ,,1-- / ¿ ~t!f2Þ~/ . U/?~///~ 6'èi:W..s //1 //,ß/A// . B. RELEASE'CONTAINMENT AND/OR MINIMIZATiON: /2//'9- C. ClEAN-U;' PROCEDURES:_ _ _ ~d.s;:-· øp-e ?l//M /~t::'/" 7~ I OJ! Þeftre '/eYC.97- SECTION 8: UTILITY S!1UT-OFFS (lOCATI()N OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: /l!E Cðrð~ 0/7 #/~-/. ELECTRICAL: . -5d~G ' , é: ~,p?J/, /Z.LX~ £lð?/Qh Øþl ., . /' / ' ~/~ ~ WATER: SPECIAL: , LOCK BOX: YES~ .IF YES. LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY: 8, ... PRIVATEFIREPROTECTION:-:"k . .' r~f/C. . C;Y/ß/£-'A$~ð--= WATER A V AILABILlTY (fIRE HYDRANT): . r.£~ ..jJ 0,1'/ #~ a::.s.>ße 5yr'Ct! ' A, . . ~-.-:...,,-~-~...~..... - ~. . . ~ . .-.~' . e Bakersfi~ld Fire Dept. : Hazardous Materials Division e HAZARDOUS. MATERIALS MANAGEMENT PLAN Facility Unit Name: ,¿/~. "L7-~~:.&:. ~ SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES: ~A, AGENCY NOTlFfCATION PROCEDURES: fl/ B. EMPLOYEE NOTIFICATION AND EVACUATION: ¿~ ~ðc-J / /~ dd7- C. . PUBLIC EVACUATION: ¡tJ#- D. EMERGENCY MEDICAL PLAN: . /" /' ~h7iO?/E-/ ß>þf?/ /8¿1'~ . r .... 3. ?:)I~ .. " - "" ..f, '- ~< BAKER~IELD CITY FIRE DEPARTMENT \ HAiWRoous MATERIALS INVEeORY Page~of_ ! Business Name Address CHEMICAL DESCRIPTION V 1) INVENTORY STATUS: Chemical Name: Addition ( Check if chemical is a NON TRADE SECRET ( TRADE SECRET [ .~ 3) DOT '# (optional) AHM ( ] CAS # HEALTH Immediate Health (Acute) [I Delayed Health (Chronic) [ 4) PHYSICAL &. HEALTH HAZARD CATEGORIES PHYSICAL Fire ra Reactive ¡ 1 Sudden Release of Pressure ( I o~' 5) WASTE CLÁSStFICATlON (3-digit code from DHS Form 8022) USE CODE Pure [] Mixture [ Waste [] Radioactive ( I ô) PHYSICAL STATE Solid [] Liquid .r:::.r---Gas ( ] CHECXALl. rHAT APPlY 7) AMOUNT AND TlME AT FACIUTY Maximum Da,jly Amount: Average Da,jly Amount: Annual Amount: Largest Size Container: # Days On Site 9) MIXTURE: . List the three most hazardous 1 ) chemical components or ar.y AHM components 2) 10) Location .3 OOC::::> \5'l7 ,;2..0 /}#/ UNITS OF MEASURE Ibs [ ] gal XL tt3 [ ] curiés [ ] 8) STORAGE CODES a) Conta,jner: b) Pressure: c) Tem'perature: ¿---I 3 I ~ 3) I, \ I I . \ I . r .\ I Ii I Ii I ! Circle Which Months: A. M. J, J. A, S. O. N. D CAS # %wr AHM Q 7fS-.,5Q-¡ , "-Or- [] 6 ¿¡'1 7.2..- crs- -(; ðO¿' [ ] [ ] CHEMICAL DESCRIPTION V 1) INVENTORY STATUS: New [ 1 Addition [ 1 Revision [ ] Deletion [ 2) Common Name: Chemical Name: 4) PHYSICAL &. HEALTH HAZARD CATEGORIES I 5) WASTE ClASSIFICATlON \ Check rt chemical is a NON TRADE SECRET,,>4- TRAOE SECRET [ 3) DOT # (optional) AHM [ ] CAS# t'P PHYSICAL Fire [I Reactive ¡ 1 Sudden Release of Pressure [ ] HEALTH Immediate Health (Acute) [] Delayed Health (Chronic) [ 1 (3-digit code from DHS Form 8022) USE CODE Pure [] Mixture [ Waste [ ] Radioactive [ ] 6) PHYSICAL STATE Solid [] Liquid)4. Gas [ ] OlEO< AU.. r¡.(AT-'PPtY 7) AMOUNT AND, TIME AT FACIUTY Maximum Daily Amount: Average Daily Amount: Annual Amount: Largest Size Container: # Da'r-l On Site i 9) MIXTURE: List the three most hazardous chemical components or any AHM components cS "2D ,S"O ~ ~ ;C>~ '&:;>¿J>;?9" 8) STORAGE CODES a) Container. b) Pressure: c) Temperature: Circle Which Months: ~ J. F, M. A. M, J. J. A. S. O. N. D UNITS OF MEA~ Ibs $ gal K ft:3 [ curies [ ] X' I -=3 I 4f COMPON~ /. 1) g".r:.1/.// .46"~~ 2) /~~PÞ~~y/ /~/¿~~/ 3) T~.///'A~·.e- CAS # 'Yowr AHM [ I n [ 1 10) Location actacneo aocumenl'S. Del/eVe ë æ,?/¿¿/77 E h~ PRINT Name & Title of Authorized Company Representadve !iIIIø_31,aar:I l::':.. a/~.:.-C:.~ f#ß7" ". Data "iClOt., t..EPC Sf IHOÞI'fO . \¿~ BAKE~FIELD'C'TY FIRE DE.RTMENT - HAZARDOUS MATERIALS DIVISION 2130 "G" STREET , BAKERSFIELD, CA. 93301 ' (805) 326-3979 HAZARDOUS MATERIALS INVENTORY \ FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME d¥7P~ ~ FACILITY NAME I SITE ADDRESS -==?Ob'O // ¿/ Þ:/þ.-'1 ~<~ CITY Lð¿;7þAV:::,Þ/¡/ STATE Cz. Z!P ~3 30 'Ç" , NA TURE OF BUSINESS /Ø'~~~y~ ß~J:s- SIC CODE DUN & BRADSTREET NUMBER i ? . i i ~~ I OWNER/OPERATOR ~~ i PHONE 32 /' '-:"';Z..CJj'/ , MAILING ADDRESS 3c?oo/Ý ¿/þ /LP~ ø-<-- CITY ß~~ß;r5;"~ 4/"'-/ STATE Ú--' ZIP ~-33oS- / I , EMERGENCY CONTACTS NAME #~~Þ- ~h~~ TITLE ~?Þ-.lQf , BUSINESS PHONE 32-7 -::?- o,>:/' 24-HOUR PHONE ··r· TITL~ ~~oi~ - 4/-'- NAME ~~ ø~Þ--?~ I' ' BUSINESS PHONE Þ 2- 7 - 2ß:'f/ 24-HOUR PHONE ~72. -~.y;/'S- \ 5eøemcet :xJ. 1 g¡¡:,z REGION V LE?C STANOAf'C F i ~ ;-. -"-~-'i-" /~ ~/ BAKERiilELD CITY FIRE DEP£RTMENT H~RDOUS MATERIALS INVE~ORY ~..:.'..;../..~ Page_of_ I I Business Name Address v CHEMICAL DESCRIPTION Chemical Name: Revision [ Deletion [ Check if chemical is a NON TRADE SECRET 'I>« TRADE SECRET [ 3) DOT # (optional) 1) INVENTORY STATUS: 2) Common Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH HAZARD CATEGORIES Fire...t9 PHYSICAL Reactive [ ] Sudden Release of Pressure [ ] HEALTH Immediate Health (Acute) [] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3·digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [] UqUid»{ Gas [ ] 7) AMOUNT AND TIME AT FACIUTY Maximum Daily Amount: 6 D Average Daily Amount: }1 0 Annual Amount: Ii 0 Large~t Size Container: ~ "') ~ ! # Days On Site $/e..?-Y ~Þ'øð' Pur?t1 Mixture [] Waste [] CHECJ<ALl. 1}iAr APPtY Radioactive [ ] UNITS OF 'i~~ Ibs [ ] gal.3tP' ft3 [ ] curies [ ] 8) STORAGE CODES :--./' a) Container: ~ b) Pressure: c) Temperature: 13 I (' 1) Circle Which Months: M, A, M. J. J. A, S, 0, N. 0 9) MIXTURE: Ust the three most hazardous chemical components or any AHM components CAS # AHM ~ [ ] 2) %wr ð c."3-6' ::c /1 % q~ [ ] [ ] 3) 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ r Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH . HAZARD CATEGORIES PHYSICAL Fire [] Reactive [] Sudden Release of Pressure [ ] HEALTH Immediate Health (Acute) [] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [J Liquid [] Gas [ ] Pure [] Mixture [] Waste [ ] Radioactive [ ] CNECJ<ALl. TI-IAT APPt.Y 7) AMOUNT AND TIME AT FACIUTY Maximum Daily Amount: Average Daily Amount: Annual Amount: Largest Size Container: # Days On Site UNITS OF MEASURE Ibs [ ] gal [] ft3 [ ] curies [ ] 8) STORAGE CODES a) Container: b) Pressure: c) Temperature: Circle Which Months: All Year. J, F, M, A, M. J. J. A. S, O. N. 0 9) MIXTURE: Ust the three most hazardous chemical components or any AHM components COMPONENT CAS # %wr AHM [ ] [ ] [ ] 1 ) 2) 3) 1 0) Location PRINT Name & Title of Authorized Company RepresentatÍve Signature / Date 5cIr_ÞW3I:l1S!Q2 REGIOt" lÐC STNIONIIO FtJ'M BAKERSiL.ELD CITY FIRE DEPAjiTMENT HAZ!IfDOUS MATERIALS INVEN-mRY ~- . ~Y" .. ., ~'~:~~., Page_ot_ Business Name Address 1 I I CHEMICAL DESCRIPTION , I I 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ .] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] I I \ 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH . HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] CHfCJC. ALL THAT N'Pt. Y 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 100 [ ], gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size'Container: # Days On Site Circle Which Months: All Year, J, F. M, A, M. J, J. A, S. 0, N. D 9) MIXTURE: Ust COMPONENT CAS # %Wf AHM the three most hazardous 1) [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] CHEa< ALl. THAT /IPPlY 7) AMOUNT AND TlMEAT FACIUTY UNITS OF MEASURE 8) STORAGE CODeS Maximum Daily Amount: 100 [ ] gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year, J, F. M, A, M, J, J. A, S, 0, N, D 9) MIXTURE: Ust COMPONENT CAS.# %Wf AHM the three most hazardous 1) [ ] _,chemical components or .,. r] any AHM components 2) 3) [ ] 10) Location . certify under penalty of law, that {7Jave personally exammed and am familiar with the mfomation submitted on thiS ana 8.iT attached documents. I believe the submitted information is true, accurate, and complete. PRINT Name &. Title of Authorized Company Representative Signature Date .' s.ìat_r.30. 1ma AEGOtV l£PCST~~'" I