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Home My WebLink AboutBUSINESS PLAN 10/8/2003 Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit ~ CONDITIONS OF "PEBMIT ON REVERSE SIDE ..:' :Y~:r,J'; ".- . ' ' " , This pennit is issued for the following: ItI Haz8Ìrdous Materials Plan , 0 Underground Storage of Hazardous Materials . 0 Risk Management Program , 0 Hazardous Waste On-Site Treatment Permit 10 #:: 015-000-001760 ,.~ /" ::..~: ;;;',...;, :>.,J''1~ :",' ',. LOCATION: 3118 UNION AVE '. "~'" ~ . . .. .. . Issued by: I 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 . ~.. . , ,~ ,"> '..,,> -l'~~-'" ;', ":. ,",. -.; ,.;.Expiration. Date: .. . ~~l'oh·~:~;~i~::;Y:~~/.~-;;>::~·;-: "..; :June 30, 2003 i " PerDl.it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ardous Materials Plan round Storage of Hazardous Materials agement Program Waste 3118 PERMIT ID# 015-021.001760 ~UTOMOTIVE TECHNICAL SE LOCATION Issued by: UNION Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 *~- ph Huey. ffice of ental SeIVi es June 30, 2000 Approved by: Expiration Date: . ..... .....,r ,....:¡ . J ./"", ~ J . I ( " SITE CIAGRA' c:z5 FACl~ DIAGRAM l Business Name: fJ.µ-ro(VfOTI v~ --rECflrVICA<- $E«Jic.c. 3usiness ACC:ress: :S, I <b UNION Av ~cr Ctfice Use Onlv ~¡rST !n S tencn: Area Meo ;; ~t !nsoec~cn SteTicn: NORïH 0- A'-'TA VISTA ()'E.i\.JT1s''Ï ~~~c.ES rn ~~ 00 Lu\~é 01(.. 0 .,.-",u"> s~ $l-\oP ~r^ R-12. .J ") Rï:.CJlI~;.JT'S <:1 I J.. ç: "0::( l0 ~ J 7 J C ~ - J :t:>AR.. I( .,vG- VJ ¿ r.. ~ /. ,< )'_. '?'- y. ..., '" . y , &. / .... / ') $.A¡L'DoA'TS or- <ßo.\4~S 1==. é LO , ~ < J.. t' '7 ~..... (í2é~E 51 ( ~~r ~ I. . CITY OF BAKERSFlEtD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd J·'loor, Bakersfield, CA 93301 <; till/fa.. FACILITY NAME A\JTÕ pi\O{lv£. ItLI/vll4\C INSPECTION DATE 10 -O<t ~03 ADDRESS :f" 11 g U~IO,v PHONE NO. :5 2..,7- 0 15<.0 FACILITY CONTACT Äf1d'''I--r<,I>Geívo. BUSINESS 10 NO. 15-210-0<'/760 INSPECTION TIME I ð f\I1l (\ J NUMBER OF EMPLOYEES 3 Section I: Business Plan and Inventory Program Œ(Routine o Combined O·Joint Agency o Multi-Agency o Complaint O· Re- inspection OPERA nON c v COMMENTS v .. Appropriate permit on hand Business plan contact information accurate V "" , V I' Visible address v '" Correct occupancy Verification of inventory materials \;" Verification of quantities \..../ Verification of location \.,.. ", Proper segregation of material /I ~ Verification of MSDS availability v "" Verification of Haz Mat training v Verification of abatement supplies and procedures ¡..... ~ ., Emergency procedures adequate \,,- ~ Containers properly labeled t.../ ,'i' Housekeeping \... " Fire Protection l,..... '"E LS-c, -+ " r f>... I COV~.Ý" Site Diagram Adequate & On Hand ,...... .... C=Compliance V=Violation Any hazardous waste on :Jle?: ~es 0 No Explain: v:.Ia!::>t'Ð OJ J ¡1 <lie) +VCH1<,rr? }SSt1Y'1 all Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Res onsible Party Whik . E,..g,,,. V.11ow . ...... C"'" PI'k . ".I,~ c.., Inspector: Ù ~ D r /Y}0/~Q . ~~ AUTOMOTIVE TECHNICAL SE~CE '0 . )\\\.. ~ ~~'A/ " SiteID: 015-021-001760 ... v -. Manager : Location: 3118 UNION AVE City BAKERSFIELD BusPhone: Map : 103 Grid: 32A (661) 327-0156 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 04 C '. EPA Numb: f SIC Code:7538 DunnBrad: (: Emergency Gbntact ~ ANDY TEIXEIRA Business Phone: 24-Hour Phone Pager Phone / Title ¿JfNJ1 ~ (' / tffil~L ~'I'þJ~R (661) 327-0156x (661) 327-7751x () x ency Contact DON HAME Business Phone: 24-Hour P P Tit L PARTNER 7-9900x 845- (661) ( ) Hazmat Hazards: Fire Press ImmHIth DelHlth Contact : MailAddr: 3118 UNION AVE City BAKERSFIELD Phone: (661) 327-0156x State: CA Zip 93305 Owner Address City ANDY TEIXEIRA/DON HAMES PARTNERS 730 HOLTBY RD BAKERSFIELD Phone: ( 6 61 ) State: CA Zip 93304 32x70156 3J.7 -7751 Period Preparer: Certif'd: ParcelNo: to TotalASTs: TotalUSTs: RSs: No Gal Gal Emergency Directives: " ÁH1r~vJ r;,)œl~d Do he"eb rt'l.· h C"" . I' Y ce .Ii\( t ,at 0 hav.o I ype or prInt name) . . 'Q reviewed the attached hazardous materials manage- Automotive Technfcal Service ment plan tor 3118~UnlonAve. that it alnng 'th Bak~aflilSf . .1... WI '. CQQ1) 327·0 58 any correctIons constitute a complate and correct man- ~@men~ ¡alan for my iaciliiy. .~l!?Mj f'~U¡.'S/OV! Si!JN!IU~ 7-1-0,) DÐtø -1- 07/02/2003 F AUTOMOTIVE TECHNICAL SEAlÞCE p= Hazmat Inventory f== MCP+DailyMax Order . SiteID: 015-021-001760 ì By Facility Unit ì Fixed Containers at Site ì Hazmat Common Name", SpecHaz EPA Hazards DailyMax MCP I ./ " .\ ~~ ~~;~ AUTOMATIC TRANSMISSION FLUID F DH L 300,00 GAL Low WASTE OIL _ A () ,. ,O~¡t.P F DH L 300,00 GAL Low REFRIGERANT 12 ty~~~- F P IH G 1587.00 FT3 Min MOTOR OIL. , J úf.. F 30 ~ L A "'~ö~oo GAL Min ¡ .1<-<Æ1 ..nm1 /34" 5"6 "ja.L.... ':7ryOÃ / (§ c¡zc-~, GO tJ Q V} . >-.¡.. 7111 -e.' _ . ./)1!¿; ~ ~q~~ 'I~ () . ~ > ~1 qaJ 01.1 r4 ~1rz1 ~~~ !'~~ '~-c, ~drot ~ /"\ -2- 07/02/2003 F AUTOMOTIVE TECHNICAL SE~CE f= Inventory Item 0002 F== COMMON NAME / CHEMICAL NAME AUTOMATIC TRANSMISSION FLUID . SiteID: 015-021-001760 ì Facility Unit: Fixed Containers at Site ~ Location within this Facility Unit INSIDE NW CORNER OF SHOP Days On Site 365 Map: Grid: CAS# 64742-56-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 60,00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 300,00 GAL, Daily Average 60,00 GAL HAZARDOUS COMPONENTS %Wt, RS CAS# 100,00 Transmission Fluid (Petroleum-Based) No 0 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low Ag,Defined1: MISC. LOCAL AGENCY DATA Ag,Defined2: Ag,Defined3: Ag,Defined4: Ag,Defined5: Ag,Defined6: Ag,Defined7: Ag,Defined8: Ag,Defined9: Ag,Define10: I- Ag, Define11 -3- 07/02/2003 · e F AUTOMOTIVE TECHNICAL SERVICE f= Inventory Item 0003 == COMMON NAME / CHEMICAL NAME WASTE OIL SiteID: 015-021-001760 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SHED AREA NE CORNER OF LOT , Map: Grid: CAS# 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55,00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 300,00 GAL Daily Average 55,00 GAL ZARDO MP N T %Wt, RS CAS # 100,00 Waste Oil, Petroleum Based No 0 HA US CO 0 EN S ARD A MEN TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZ SSESS TS Ag,Defined1: MISC, LOCAL AGENCY DATA Ag,Defined2: Ag,Defined3: Ag,Defined4: Ag,Defined5: Ag,Defined6: Ag,Defined7: Ag,Defined8: Ag,Defined9: Ag,Define10: ~ Ag,Define11 -4- 07/02/2003 F AUTOMOTIVE TECHNICAL SEIltCE f= Inventory Item 0003 e SiteID: 015-021-001760 9 Facility Unit: Fixed Containers at Site 9 WASTE DATA Treated On Site CA Code US Code GAL Generated/Mo, GAL Generated/Yr, No Treatment UnitID: I Unit Type: Agency-Defined Text Label -5- 07/02/2003 · e F AUTOMOTIVE TECHNICAL SERVICE p= Inventory Item 0004 ~ COMMON NAME / CHEMICAL NAME REFRIGERANT 12 SiteID: 015-021-001760 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Location within this Facility Unit INSIDE CABINET AT SW CORNER OF SHOP Map: Grid: CAS# STATE - TYPE Gas Pure Largest Container 3Ò /.b '~FT3 PRESSURE ---- TEMPERATURE ~ /Jj)tf(\c)} Ambient AMOUNTS AT THIS LOCATION Daily Maximum 1587,00 FT3 CONTAINER TYPE METAL CONTAINR-NONDRUM Daily Average 857,00 FT3 HAZARDOUS COMPONENTS %Wt, RS CAS# 100.00 Dichlorodifluoromethane No 75718 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min Ag,Defined1: MISC, LOCAL AGENCY DATA Ag,Defined2: Ag,Defined3: Ag,Defined4: Ag,Defined6: Ag,Defined7: Ag,Defined9: Ag,Define10: Ag,Defined5: Ag,Defined8: I- Ag ,Define11 -6- 07/02/2003 . . F AUTOMOTIVE TECHNICAL SERVICE p= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME MOTOR OIL SiteID: 015-021-001760 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit INSIDE NW CORNER OF SHOP Map: Grid: CAS# 8020835 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE' Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container 60,00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 300,00 GAL Daily Average 60,00 GAL HAZARDOUS COMPONENTS %Wt, RS CAS# 100,00 Motor Oil, Petroleum Based No 8020835 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min Ag,Defined1: MISC, LOCAL AGENCY DATA Ag,Defined2: Ag,Defined3: Ag,Defined4: Ag,Defined6: Ag,Defined7: Ag,Defined5: Ag,Defined8: Ag,Defined9: Ag,Define10: - Ag,Define11 -7- 07/02/2003 F AUTOMOTIVE TECHNICAL SE~CE J f= Notif,/Evacuation/Medical Agency Notification . SiteID: 015-021-001760 ì Fast Format ì Overall Site ì 01/18/2000 PHONES AVAILABLE IN OFFICE & SHOP TO DIAL 911, ~ Employee VERBAL, Notif,/Evacuation 01/18/2000 1 02/03/1997 Public Notif,/Evacuation THROUGH OFFICE DOOR TO SW CORNER OF LOT, Emergency Medical Plan 02/03/1997 FIRST AID KIT IN OFFICE RESTROOM CLOSEST HOSPITAL AND MEMORIAL, .- 8- 07/02/2003 " F AUTOMOTIVE TECHNICAL SE~CE I f= Mitigation/Prevent/Abatemt Release Prevention . SiteID: 015-021-001760 9 Fast Format =¡ Overall Site 9 02/03/1997 & DEGREASERS AVAILABLE, Release Containment 02/03/1997 WASTE MATERIALS STORED SEPARATELY IN SHED AREA NE OF LOT, Clean Up 02/03/1997 CRANES WASTE OIL SERVICE EPA # CAL 000178343, Other Resource Activation -9- 07/02/2003 ~ i\ ' F AUTOMOTIVE TECHNICAL SE~CE I f= Site Emergency Factors r== Special Hazards 4IÞ SiteID: 015-021-001760 9 Fast Format,=¡ Overall Site =¡ I Utility Shut-Offs A) GAS - NE CORNER OF SHOP BLDG B) ELECTRICAL - NE CORNER OF BLDG C) WATER - NE CORNER OF LOT FENCE D) SPECIAL - NONE E) LOCK BOX - NO 02/03/1997 Fire Protec,/Avail, Water 01/18/2000 PRIVATE FIRE PROTECTION - PORTABLE EXTINGUISHERS, FIRE HYDRANT - 75FT S OF ALLEY AT IRENE ST, Building Occupancy Level -10- 07/02/2003 :¡. <.) '.' F AUTOMOTIVE I F Training Employee TECHNICAL SE~CE' . SiteID: 015-021-001760 9 Fast Format 9 Overall Site 9 02/03/1997 Training WE HAVE~ EMPLOYEES AT THIS FACILITY, WE DO HAVE MSDS SHEETS ON FILE IN THE OFFICE, BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES INFORMED ON HAZARD COMMUNICATION AND MSDS USEAGE, Page 2 r= I I Held for Future Use Held for Future Use -11- 07/02/2003 ¡ ---- _....'.i' - RRc;EIVED e, AUTOMOTIVE TECHNICAL SERVICE SiteID: 215-000-001760 Manager : Location: 3118 UNION AVE City BAKERSFIELD CommCode: BAKERSFIELD STATION 02 EPA Numb: BY: B sPhone: p : 103 Grid:. 32A (805) 327 - 0156 CommHaz : Low FacUnits: 1 AOV: SIC Code:7538 DunnBrad: Emergency Contact / Title Emergency Contact / Title ANDY TEIXEIRA / GENERAL PARTNER DON HAMES / GENERAL PARTNER Business Phone: (805) 327-0156x Business Phone: (805) 327-9900x 24-Hour Phone : (805) 327-7751x 24-Hour Phone : (805) 845-2426x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (805) 327-0156x MailAddr: 3118 UNION AVE State: CA City : BAKERSFIELD Zip : 93305 . Owner ANDY TEIXEIRA/DON HAMES PARTNERS Phone: (805) 327-0156x Address : 730 HOLTBY RD State: CA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: F Hazmat Inventory One Unified List 1 p== MCP+DailyMax Order All Materials,at Site 1 Hazmat Common Name,., EPA Hazards DailyMax MCP AUTOMATIC TRANSMISSION FLUID F DH L 300,00 GAL Low WASTE OIL F DH L 300.00 GAL Low REFRIGERANT 12- -' -- . F P IH G 1587,00 FT3 Min MOTOR OIL F DH L 300,00 GAL Min I, AYI~ Íð~el rei Do hSi"sby certify ~hat ~ have (Type or print name) reviewed the attached hazamous ma1terial~ manage- ment plan for A()&~of, v<=: kc.h)¡I':'ð'~~~along with (Name of Ðusinsss) any corrsdilOú1s constitu~s a complete and com~d man- agement plan for my facility, ~ 4.*,- ¡7 . s / - 5 -oð D1!1~ 12/20/1999 '. - e F AUTOMOTIVE TECHNICAL SERVICE p= Inventory Item 0002 F== COMMON NAME / CHEMI CAL NAME AUTOMATIC TRANSMISSION FLUID SiteID: 215-000-001760 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit INSIDE NW CORNER OF SHOP Map: Grid: CAS # 64742-56-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 60.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 300,00 GAL Daily Average 60.00 GAL %Wt, RS CAS # 100,00 Transmission Fluid (Petroleum-Based) No 0 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSMENTS p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME WASTE OIL Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit SHED AREA NE CORNER OF LOT Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest ,Container 55,00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 300,00 GAL Daily Average 55.00 GAL U %Wt, RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDO S COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / I / Low -2- 12/20/1999 ~ e e F AUTOMOTIVE TECHNICAL SERVICE p= Inventory Item 0004 = COMMON NAME / CHEMI CAL NAME REFRIGERANT 12 SiteID: 215-000-001760 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit INSIDE CABINET AT SW CORNER OF SHOP Map: Grid: CAS # - TYPE Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 285,00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1587,00 FT3 Daily Average 857.00 FT3 %Wt, RS CAS # 100,00 Dichlorodifluoromethane No 75718 HAZARDOUS COMPONENTS ZARD A SESSMENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min HA S S p= Inventory Item 0001 F= COMMON NAME / CHEMI CAL NAME MOTOR OIL Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit INSIDE NW CORNER OF SHOP Map: Grid: CAS # 8020835 [ ~TA~E I TYPE ~ P~ESSURE ---r TEM~ERATURE -, ==Llquld __pure , ~mblent ---1 Amblent ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 60,00 GAL 300,00 GAL CONTAINER TYPE ABOVE GROUND TANK Daily Average 60,00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS # 100,00 Motor Oil, Petroleum Based No 8020835 MENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESS S -3- 12/20/1999 e F AUTOMOTIVE TECHNICAL SERVICE I p= Notif,/Ev~cuation/Medical Agency Notification ., e SiteID: 215-000-001760 ì Fast Format ì Overall Site ì 02/03/1997 PHONES AVAILABLE. IN OFFICE & SHOP TO DIAL 9-1-1, r Employee VERBAL Notif,/Evacuation I' Public Notif./Evacuation . THROUGH OFFICE DOOR TO SW CORNER 02/03/1997 02/03/19971 ] OF LOT, Emergency Medical Plan 02/03/1997 FIRST AID KIT IN OFFICE RESTROOM CLOSEST HOSPITAL AND MEMORIAL. -4- 12/20/1999 ; e e F AUTOMOTIVE TECHNICAL SERVICE I p= Mitigation/Prevent/Abatemt r=: Release Prevention ~SORBANTS & DEGREASERS AVAILABLE, SiteID: 215-000-001760 ì Fast Format =¡ Overall Site ì 02/03/1997 ] 02/03/1997 Release Containment WASTE MATERIALS STORED SEPARATELY IN SHED AREA NE OF LOT, Clean Up CRANES WASTE OIL SERVICE EPA # CAL 000178343, 02/03/1997 ] I Other Resource Activation -5- 12/20/1999 .' ."\ .. e e F AUTOMOTIVE TECHNICAL SERVICE I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-001760 ì Fàst Format ì Overall Site ì I 02/03/1997 A) GAS - NE CORNER OF SHOP BLDG B) ELECTRICAL - NE CORNER OF BLDG C) WATER - NE CORNER OF LOT FENCE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec,/Avail, Water 02/03/1997 PRIVATE FIRE PROTECTION - PORTABLE EXTINGUISHERS FIRE HYDRANT - 75FT S OF ALLEY AT IRENE ST Building Occupancy Level -6- 12/20/1999 .. .', .-. e e F AUTOMOTIVE TECHNICAL SERVICE I F Training Employee Training SiteID: 215-000-001760 ì Fast Format ì Overall Site ì 02/03/1997 WE HAVE 2 EMPLOYEES AT THIS FACILITY, WE DO HAVE MSDS SHEETS ON FILE IN THE OFFICE, BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES INFORMED ON HAZARD COMMUNICATION AND MSDS USEAGE, Page 2 r I I Held for Future Use Held for Future Use -7- 12/20/1999 p'.~ . . CITY OF BAKERSFIELD CLAIM VOUCHER I Vendor No, I certify that this claim is correct and valid, and is a proper charge against the City Agency and account indicated, CLAIMANT'S NAME AND ADDRESS: Automotive Technical Service (AUTHORIZED SIGNATURE OF CITY AGENCY) 3118 Union Ave Bakersfield, CA 93305 Date: 04-01-99 Initials of Preparer: CITY DEPARTMENT: FINANCE PLEASE PROVIDE SHORT EXPLANATION OF PAYME (Including Contract Number if Applicable) This customer made a duplicate payment on this years Haz Mat bill in the amount of $178.50. We have since made an adjustment to the California State surcharge in the amount of $8.50 leaving them with a credit of $187.00. Fund Dept. Base Ell Objt Project # Invoice # Amount Date of Invoice 11 0000 123 7900 $187.00 VOUCHER TOTAL $187.00 SECTION 72, PENAL CODE FINANCE DEPT. USE ONLY Section 72, Presenting False Claims. Every person who with intent to defraud, presents for allowance or for payment to any state board or officer, or any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, Examined & Approved for Payment Amount or writing, is guilty of a felony. ;. - . ~;;. lit STATEMENT OF ACCOUNT 4IÞ CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD, CA 93301-5201 (805) 326-3979 DATE: 4/01/99 TO: AUTOMOTIVE TECHNICAL SERVICE 3118 UNION AVE BAKERSFIELD. CA 93305 CUSTOMER NO: 8005 CUSTOMER TYPE: ES/ 14604 -------------------~-------------------------------------------------------- CHARGE DATE DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT ------ -------- ------------------------- ---------- -------- -------------- 3/01/99 BEGINNING BALANCE .00 2/02/99 PAYMENT 178. 50-- SS001 3/31/99 Charg& adjustm&nt 4/30/99 8. 50-- CA STATE SURCHARGE FOR QUESTIONS OR CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT, -------------- -------------- -------------- -------------- CURRENT OVER 30 OVER 60 OVER 90 -------------- -------------- -------------- -------------- 8. 50- DUE DATE: 5/03/99 PAYMENT DUE: TOT AL DUE: 187. 00-- $187.00-- " '_.uu_n__.__nn ,. uo____, ._ u_no.d ... . __n. .. ,. _.. _. .. _ ... ..__ ~----'--~.-~.--~~.~~--~~~---~~--.---~--,--.- .---~____"_.__.____.________.._ _~_,___·___·__'h_______._~__~. ._~__~___~_.,~__ s t-:O?V ".. ^ ft "r;or A,~~it t: 4F')~ DU~ DAT1'E: 5/z\}3P19 ~rËt;nT AN~ ~<·~¡tI,~\E CHEC~r.. PAVP-t3LJE TO: c:rrv OF ~£;\¡.UERSFIELtþ PO 190)( 2057 aAt4.E.RS~ lr ELD CA 93308-2057 (805) 326-3979 CUSTOMER NO: 8005 CUSTOMER TYPE: ES/ TOTAL DUE: 14604 $187.00- '. \ GUST ~ NO. ES '300S- I I I MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE 3" II -:tt NEW ACCOUNT 1 ADDRESS CHANGE CLOSE ACCT i . FINANCE CHARGE . OTHER ADJ CUSTOMER NAME ~l)+O(Y\O+¡ v't' teChnirn I MAILING ADDRESS 3'1 \ ~ L~ ~ 0 n A ú {) . -. CITY &l~\c:::,~íe\cA STATE 0* Se r {í C€ ZIP CODEq3~S SITE ADDRESS PARCEL NUMBER (1FAPPUCABLE) ADJUSTMENT R~\;S:b~: :tit ~ùrck~~ stoJ\ck'vp_ APPROVED BY ~ ¿ - - =:; ':: , I BAKERSFa.D· CITY FIRE DEPA.MENT HAZARDOUS MATERIALS DIVISION 1715 'CHESTERAV£~ BAKERSFIELD. CA. 93301 INSTRUCTIONS: HAZARDOUS MATERIALS MANAGEMENT PLAN f.F/ gOt)' / D3-3;24- ¿;2¡¡-~ r!J«µJ ~ V-.øl{;-¡ 70 avoid furTher action. reTurn ;nis ferm within 30 days of receipt. TYPE/PRINT ANSWERS IN tNG~¡SH. ,:"nswer rne QuesTions below ter the ::uslness as a whole. 3e onet cna c::Jnc:se as oesslbie, - 'Ó ¡ . 2. ~ I 7 roD 3. SECTION 1: 3USINESS IDENTIFIC;"TION DATA 3US¡N=SS NAME: -Å..UTOMvT'VE. (C::GLINIC.AL 5.6f2ViCG' : ,~.~ , -./"' N·)J ~ l 1 'g - ~ '-- ,-,llv I , . - UN/C),...) A.J~ ,\~';A ;L:;'~G ;:\:::--: =53: 5A"M E --1-.,/. _II . S-:-A~=. _ ::P: 9330,)' ?~ONE: )'z-7 - C>I~G = ~~.'~ .3.: : ¡~/':':: :~~ =::; >~ l.] tv16 =~: ~'C ........,.................- ~¡ ''-........ L... =: ,= '~:;\'Í,.:.!~'( .~, ,~~:'-y:.~'(: ÅJ'\O æ:c"'¡;>A ¡(L ='.\'N:~: A;tV i)<,J '-rEI X E IRA d ì)ON /-(A 1'V1é:5:. GAR rJC..e.$f-/-! ;;Y - . ,- .:. - - - - -- 7 3() +(0'-'7 is « Vè~ 04 '~"'-'~- --'--_. 2='=7iCN:: =~f~t~G=NC'( ~CTI~~C~7~2·N: ':.: NT,~,C~ ,) :..= : us, ,= ~ C N'E: :4 r-:~, ~~ONE ANì~'rJ -rei)(E¡(2A GC-N, PTJ~ ~'L Î,-015"6 :r 2- 7 -77<>1 Do,0 tJA /\It E;;' /1- I,J'C;..J, f'1'Nfè.... '1 '2.. 7 - '79a::> ~4Ç-24z.6 ,.., / .oé:I.Äël"Snel.a ..c U"e .uept. . . Hazaråous Materials Divisione HAZARD-OUS MATERIALS MANAGEMENT PLAN " , . . . SECTION 3: TRAINING: NUMBER OF EMPLOYEES: 'Z- MATERIAL SAFETY DATA SHEETS ON FILE: I ...J aF0c~ BRIEF SUMMARY OF TRAINING PROGRAM: ~Pl..OYEí35 I^'Ço.¡¿rvr~ ðN ~~ OY"7(V1U>'llIC/..\D~ ~ M 50 S (JS~. Foreign Domestic 7 ,,' Antiques Er- "^.s U . }. ... r' / I . 'AUTOMOTIVE TECHNICAL SERVICE 3118 Union Ave, Bakersfield, CA 93305 - (805) 327-0156 ANDY TEIXEIRA SECTTON 4: ::XEMPTfON REQUEST: . C:::~Tir:'( UNC=~ ~=~JALTY OF P:~":UR'( ~~,A,I:v1Y 5USiNESS IS EXEMPT FROM THE ~=?CRi¡NG ~::;::.J!RE:vIENiS OF C:~Ar:7=~ 6.Y5 OF THE "':ALlFORNIA HE.';',LT~ & SAFE:"! C::C::':=CR THE ~CLLCWING ~=.~,SCI\JS: ·,'I=' : c· I~C ~ :~A!\JC·L= :~.~,:'~,:~DC us ¡\1A ï~~:~A,LS. ','/: :::: :"';.~I\JCL= :~).z...:.,~=C ~...!S ,\1 A ïC~¡A,LS. 3UT THE QUANïiTi::S AT NO -:,\¡íë::>~C==J THE :\¡IINlivIL\,1~::;:CRTiNG ;:UANTiTfES. .='~:~=~ ;:S?~;:::=·,( ~=.~,5':>~', SEc-:-rON 5: C::~TrF!C~ TIC N: ANDY IE.1 XE· ¡A C~~ïi¡:Y THAT TH~ ABCI/E INFCR- .'v1ATiCN is AC:::';RATé, ! UNDE~SiAI\JC ~;-iP.,i THIS INFCRMAnON WILL:: USED TO ,=JL¡:¡LL :'v1Y F:~1'v1rs C3UGA nONS L.'NCE~ ~:-i= "C.~,LtFCRNIA ~EA.LTH AND SA.F:::{ ceDE" r'N ""-\~OC'I, \'1'A--~!ALS (C'V -,.., ,......'p--... ,....- --..... '-'--"'0 --'L' 'NO -HA- ......., l ;¡~"""L~i-< u...... ¡V I ~:"( \¡ . :-....; '-',~,'"'\' ~ =l~ 0.'7':: ~ ::'__. .::.==u ~ t r\ "/ .-.t I I i iNACCURATE iNFCRMAiíCN C~0JSTiTUTES P=~JURY. # ¿S{--- ." SIGNA TUR &.8ue-l'à/ ~,.f.rrr' nTlE /-/O~qb DATE. :t !J tr¡aràOUs Materials Division fÎ HAZARDOUS. MATERIALS MANAGEMENT PLAN Facility Unit Name: ,ÀJ-rDfVlD-r,vE (~NrCÔL' SL:.-a...\Jt c..e- SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES: A. AGeNCY NOTIFICATION PRCC~~URES: ?~k)tJéS AVAiLß.(1;<'¿ ,-J ð.f¡;:;c-¿ t ~p "TU OIAL q_),_1 ~ 3. =:'I1PLCY== NorlFiCAìICN AI\JC ="':ACUAïlON: UC~ßAL .= :J 3 L: C = "'/ A C :...; A if eN: m..1l2.c:v&ti ifFiC'C woe... -ro $~ c¡q.;{L oç:- <..a¡-- =:'/i E~ ': =>¡ C'( ~v1 E:; ¡C~;L ~ ~.:.!\~: ~¡z.s« 11, Þ, .t< If 1.0 QFÇcc..E rv=s., ~ ¿4.ß>SC->7 þ.ø$Pr7A(,. :: J\..1<::"'1'1òtE';AC · BakersñeldFire Deu~ Hazaràous Materials Di~~ ""_... .. 1. . " HAZARDOUS MATERIALS MANAGEMENT PLAN I I SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASe: PREVENTION STEPS: J\~-:þ<2flAJ(..5 à:: <v£Ga:.~...e..5 Aï..lAit...AßLe :. REL=.;SE·CONTAINMENT ANC/OR MINIMIZATION: UJ(l-s.1'£ 1V1A,C~jAL~ s.-rotC.E.') SC.P!JtzJXiEL ~ I,..,) SHé/) Þ£8:J. N E C>~ LD .., ·=~=.'::'.\J-UP ?~CC=JUR=5: c ~,J¿ '~ G-P A :ë:! ~ (... ~ 01/ ...",/>. I ,...- ¡ <:::. ~ ;:><.;:.<..;.v Ie,=- é2AL C;OD 1'7g~43 SéC-r¡CN 3: UTILITY SHUT-CFF=S n_= =,':',~¡CN CF S:-iUT-OFFS AT YOUR FACiLITY): >j A 7l.; ~ I~.l :;. ,~, ~ ;' ? R C' := ¡~\ N E : rJ E CJl1J(2. ðF ç+Je> P ß'-1X::r :: :,~-~:r-:.., ~é c..~¡JR.. ~ ßt.D& --- ~,,',\...-, '-' :!).¡=~: pJE Cß.AJ~ Dr (.Þ<: FGvCE: ~:: = I: :/:, L: ". . ,"-" ,...-,1' :''- '.(. ----'-'......... ....."-.,. ",...~ "IC ~ =:,' 1 '-1 ~ ',/=:, _=:.:.,~;GN: , SéC7ICN C: PRIVATE F=iRE ?RCT=C71CN/WATER AVAlLABlllTY: .~. ?R¡VAïE FiRE PROTEC7:CN: ?~.¡a,~c<t' C:5c.(i~6u'$I-fGe.S a, WATER AVAILABIUTY (FiRE HYDRANT): ~ I A} 7 ~ ' $ oF ,ALlt.=.T í1.'T I (è:c-NE ST BAKERSFIELD CITY FIRE DEPARtMENT HAZARdlJS MATERIALS INVENTORt Page_of_ ï 5 '- ~/VI(:Yf(Jt '""ï"cC.(..\- SJ::.4:.J Address '3..1 ( <6 UNIU"J 3usiness Name CHEMICAL DESCRIPTION 1) INVENTORY STA11JS: New ( J Addition ( J RlMsion ( J Deletion ( J Check if chemical is . NON TRADE SECRET r J TRADE SECRET r J 2) Common N.......: f\/l¿!J::' oIL ð'IL 3) DOT II (optione) Chemical Name: AHM ( 1 CAS II 4) PHYSICAl & HEAlTH PHYSICAl HEAlTH HAZARD CATEGORIES FireA"J Re8Ctive( J Sucklen Releue of Pressure ( ] Irnmedillte Health (Acute) ( J Delayed HøIIh (Chronic) ( J 5) WASTE CLASSIFlCAi10N (3-digit code from DHS Fo"" 8022) USECOOE U 6) PHYSICAl STATE Solid ( J Uquid{l'] Gas ( ] Pure (4) Mixture [ 1 Watt! [ 1 R8cIioer:ävw ( ] O<EC/(ALL IllATAPI'lr 7) AMOUNT AND i1ME AT FACIUTY ~O UNITS OF MEASURE 8) STORAGE CODES '2- Muimum Daily Amount: Ibs ( 1 gal ""I ft3 ( ] a) Container: Average Daily Amount: 40 curies ( 1 b) Pressure: 1 Annual Amount: 300 c) Temperature: á- Largest Size 'Container: 1f"'0 " # Days On Site 'S<ò cç- Circle Which Months: All Year. J. F, M. A, M. J. J. A. S. 0, N. D 9) MIXTURE: Ust COMPONENT CAS # %WT , AHM the three most hazardous 1) ( ] chemical components or any AHM components 2) ( ] 31 [ 1 1 0) Location 7NSI f/ç; pJW CR.cJiL oÇ s"'=bç:> I CHEMICAL DESCRIPTION I I I 1) INVENTORY STATUS: New [ ] Addition { ] Revision { ] Deletion { J CheCl< if chemical is a NON TRADE SECRET ( ] TRADE SECRET [ ] ! Au-roIlAA", (.,.. .--,-RA,J >/l;t I S S T=-- YLu I t') ! 2) Common Name: 3) DOT # (opàonai) I I Chemical Name: AHM ( ] CAS# ì , I 4) PHYSICAL & HEALTH PHYSICAL HEALTH I I HAZARD CATEGORIES Fire 1"'] Reactive ( ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ J I I 'Zb I 5) WASTE CLASSIFICATION (3·digit code from DHS Form 80221 USE CODE , 6) PHYSICAL STATE Solid [ ! :":cUld ~] Gas [ I ?ure -i='r '.\ixture [ ] Waste [ ] Madioactive [ 1 I -.--¿CJ( AU ~Ar.4.PPl" , 7) AMOUNT AND TIME AT FACIUTY L:NITS OF MEASURE 8) STORAGE CODES i ~e. Z I Maximum DaJlv Amount: ::,s ( ];aJ c!:.] ft3 [ ] . a) Container: 1 \ Average DaJI\/ Amount: 4C) ~unes i ] b) Pressure: 4 I Annual Amount: ~ c) Temperature: i Largest Size Container: I # Davs On Site 36~ Circle Wñicn Months: All Year, J. F, M. A. M. J, J. A. S. O. N. D 9) MIXTURE: Ust COMPONENT CAS# %WT AHM the three most hazarcous ~ ) [ ] cnemlcaJ components or any AHM components ..I [ ] I I J} [ ] ! 10) Location , ,0 S I f)é ,JW C(Z.4\,jæ ()Ç s;+0 r I ;erufy unaer penB./ty of law, mat I nave personally exammea ana am familiar Wlrt! the mfomaoon SUDmlttea on this ana ail attacned documents. I believe me Jbmitted information is true. accurare. and complete, #¿q~ Signature Dat& RINT Name & Title 0/ Authorizea ComD8f1Y Representative BAKER_IELD CITY FIRE DERIIRTMENT HAZARDOUS MATERIALS INVEATORY ~ Page_otLf , Jsiness Name Address CHEMICAL DESCRIPTION 1) INVENTORY STA11JS: N_ ( I Addition ( I Revision ( I Deletion ( I ChecK if c:hernic* is . NON TRADE SECRET ( ] TRADE SECRET ( ] 2) Common Name: (JÄ.,)T~ DIe.-> 3) DOT # (optIoN) Chemical Name: AHM( I CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire f'1 ReICtive ( ) Sudden Release of Pressure ( ] Immediate Health (Acute) ( ) DeI&yIId HøIIh (CIuanic) ýJ 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 40 S) PHYSICAL STATE Solid [ ] Uquid ~ Gas [ ] Pure ( I Mixture [ ] Ware IIIIIt Radio.œv. [I. "'EO< AU. Il<AT AIOU 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES G Maximum Daily Amount: 55'"' Ibs [ J gai .(Ø'] 113 [ I a) Container: Average Daily Amount: 40 curie. [ ] b) Pres.ure: , Annual Amount: ~ç-- c) Temperature: 4- " Largest Size Container: # Days On Site 36S- Circle 'M1ich Months: All Year. J, F, M. A. M, J. J. A. S. O. N. D 9) MIXTURE: Ust COMPONENT CAS # %WT AHM the three most hazardous 1) [ I chemICal components or aJ1Y AHM components 2) ¡ ] 3) [ I t I 1 0) Location S'µc=f) #C~ AlE Cr<AJ R. of=- Ló-r I CHEMICAL DESCRIPTION I I 1) INVENTORY STATUS: New [ J Addition [ ] Revision [ ] Deletion ( ] Check if chemical is a NON TRADE SECRET [ I TRADE SECRET [ ] I I ';2.:C.,-Ç'Q , C:, tQ.At-Jï" (;.AÇ~5 I 2) Common Name: 3) DOT # (opCional) ¡ I ! ChemicaJ Name: AHM [ ] CAS # ¡ i I 4) PHYSICAL & HEALTH PHYSICAL HEALTH I i . HAZARD CATEGORIES Fire [ ) Reactive [ J Sudden Release of Pressure ~ Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] I I 5) WASTE CLASSIFICATlON (3·digit code from DHS Form 80221 USE CODE i I I 3) PHYSICAL STATE Solid [ ) :"ould [ I Gas ~ Pure ~ Mixture [ 1 Waste [ ] Radioactive [ ] I "':-¿'CJ{AU.. THAT APPlY ì) AMOUNT AND TlME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES 4 Maximum Dallv Amount: '"2. 76 !bs i ] gaJ [ ] ft3 I'l"1' a) Container: Average Dally Amount: 2.c)Ù cunes [ ] b) Pressure: ;L Annual Amount: ~v c Temperature: 4- Largest Size Container: 0 # Days On Site 3b') Circle lM1ich Months: All Year. J. F, M. A. M. J. J, A. S. 0, N. D 9) MIXTURE: Ust Q.. -,.2- COMPONENT CAS # %WT AHM / the three most hazardous 1) 'D 1 C +twfZDD' ~t{)1<Ø/Y1 ETJ-{AiJE /àØ [ ] cnemlcaJ components or~ n4A [ ] ! aJ1V AHM components 2) i (YI~313) I I J \ 10) Location INS d)E Cj1B~T þ.~ .sW cQ.tJr¿ oF S~ I afT1ty unaer penalty or law. tI7at I nave personally exammea ana am famlllat With the mfomaaon suomlttec:l on thiS ana IIJI attacnea documents. 71,elleve the ~mitted information is true. accurare. and complete. "-...