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HomeMy WebLinkAboutBUSINESS PLAN -j NORTH-;-- SCALE: " , BUS INES~ NAME:, .. ":¡::i -- FLOOR;- r OF ,- :..:--.,\.~"~~\ J ::./00 it C(~C (f:: K. STr//lt I)K(' ~ - '" DA.TE.: q h..-do.? F' ITY NAME: Ll I q 9' A- 'UNIT #: IOF ) .... I ..:v 0 î (j U NId'¡J I '¡I.::. ï(~F(t ' (CHECK ONE) SITE DIAGRAM ~ ßí..cl" \ .¡ I Eh¥>11 of!=lt!;. H-VMé,5 ~ ! " f ~ , $ ~ 4 . i ¡ i 1 . ? ~ UJ ~ <:I. 2 a 2 :s FACILITY DIAGRAM (' i' ~o(} \., ,,,-,',;4 .,/ t V 11 C'/'t N l l.\ tV 1:)E\) r:'- v f k Þ A (Z f:: f'f c: 'D 1- '-'-. tv'. ß v... S ArV r ~ o ø AO FL ~ F;..'- ( -.... -...:-~--_.__. '-. I I ! H-,o IV\ ¡ J, ~ ALL~ E S -OFFICIAL USE ONLY- YJ<f H- 0 (\/\ E::- 5" .. , , ¥r 'J «---- /'v\ ) f\J f: K s r- . :0;:,: -,~~~.. .~~ 1:- ~~~_~~~,......._..., H 0 I\¡\ £: 5 (Inspector's Comments): · Bakersfield Fire Apt. Hazardous Materials Inspection Date Co~pleted -.J2.~ z9'- 8-1 I·· I - ~I>'··'-----;- - Business Name: G,e.CL-E K OtV\O r0 Âut Lf- í 9 Location: 410) ß Plan ID # 215-000'19 Lp' (Top right comer Business Plan) S Inspectör&~ ,,',,' ~ cJ p ~OS J AJ E ~ ~ ... Ade uate Inadequate Verification of Inventory Materials 0 0 Verification of Quantities 0 0 Verification of Location 0 0 Proper Segregation of Material 0 0 Comments: Verification ofMSDS Availability o Number of Employees Verification of Haz Mat Training o Comments: o o Verification of Abatement Supplies & Procedures o Comments: o Emergency Procedures Posted o o Containers Properly Labeled Comments: o o Verification of Facility Diagram o Special Hazards Associated with this Facility: o Violations: FD 1652 (Rev,.3-89) White-Haz Mat Div, Yellow-Station Copy Pink-Business Office Farm and Agriculture r-., L_J KERN COUNTY FIRE DEPARTMENT HAZARDOUS' MATERIALS INVENTORY Standard Business n nUN ANi! [¡¡WhiRl:,: Nil''',;,!; 4 BUSINESS NAME:C.\~\..ê \(. S,...-Q..Iã \J!-\~~__ OWNER NAME:\>\.e Q,~...,,; \( C~~_'6'l.~"N___·__ LOCATION: +\<\~ Ú ...\O~ k. ADDRESS: \1"\ <l , G"..¡",-.> ~T' l' ~~6~É ;~p'~~~rn~t~ -: ~~;--<\~~- ~~6~É ;~~1~~~'~'~~---(~\i,i---=-~~~~~=-=-, STANDARD' -'IN~Cï.Ãsl·~CODE-;-,~~~_~Ii'i'~~--=-~=-= NAME OF Ti{-f}FACï:'i.-fiY';=~~~~_- \(_S~-~~~~¡-l,. REFER TO INSTRUCTIONS FOR PROPER CODES v j""_H f'aqp at ----..--- - -.----.-~ --.---.-.--.--.----.. .u_.____.___ ."_ ._.__,_ .. ..,___...__....__.__ _.".__'._. ..___ n_ __ _ _'__'_'.__."_ _.0__ _..__..__._.___.___...._...__ _ _,_~__,______,,__ _ ....___"_...._,. . _ ....._...__.....___,.__......_..__. .,. 1 2 3 4 5 6 1 R 9 10 11 It 1 rans Type Ma;< Aver'age AnnlJ.Jl Measure Cant Cant Cont Use % by Names of Mi xture/l;omponel1 t s Code Code Amt Amt Est Units lype Press lemp Code Wt See Instruct Ions 00__4, _______._ _.__."__... __ _ ___.__._. --.'-- ..-..-- e ._-,q..,~, ~ -~y~--- L.~~_,.. JL,~-r:, _~ ,i-:~\ qJr1t~ \" Q,,",~'I>u> Sf" _;)~:;~J~~~~~]~~~~[-~~[~~~~~[~~~~~~~~~~~]~~~~]~~~~~~~]~~~~~~~~~~[~~~~~~]~~~;~.;~~~ ~~~~ ~~~~~-~~~~~~~~~~~~~~~~-~~~-~~~~~~~-~-~~~~--~---~~-~---~-~~---- I _--I ImH:~li:~p ~--'.~u~-~gJ~._~_..~l.G.u_~~_, ~,I- - .,- _O,".,J_~mq~'hq~_ ,-- --. --1 L -- -' Immediáte Heù 1 th ~ Fire ~ Delayed Health C. A. S. Number _u_ ___~_~~,~~_':\. __ _ _ ___ r-., L .__1 Reactivity r ,-- , L -- -I Sudden Release of Pressure 13) n Days on Site r- -- .-.- ì ¡3C.~1 L ___ _u ...J ~'Fire ~ Delayed Health C.A,S, Number_____~.~~~_'_~____.,m r" '- , L__-' Reactivity r --, L -- ,) Sudden Release of Pressure 13) n Days on Site r--- -.. , i3C.'51 t____ -1 _L,,~~.L,.._~ ___~~__, - ~~~~~~]~~f~~~]~~~õ~~~~~l~~r~~~~~r~~;;~~~~~l~;~~]~~~~~~-]-~-~)~~~~~r~~-~-~~J~~ÿ~~-~~. ~~~- ~~~~~~~~,:-:::::-:::::-:---:-------::-:-:---:-::-:-:--:------ [~:~ Irnæ:~i:~e ~~___,~Nu_\_:_~':I~_~~__!_J!_(".____~~m-~~,------ _r~_'y_~___U~,.. G_~q _~, ~ Fire ~ Delayed Health C.A,S, Number ,~.~-\~,~,~, _qm .L~.~----'-----..,b--Jt;:~-..," "u_,.,___,..__ 2 " ., r- , 11) n Days ~ "3. ~.;_~ -----Tu' UI L - _J Re,jct ivily L ... -' Sudden Rp lease of Prl'ssure on Site ~ ------·-------.,--~----------.-:-;~~~--;~--Ä--.-~:~-~-~~~---C5~~~-~-~------------------ . ----- ----------------------:=-~-~ï5~-~;-~~;;~;--------- - ~ o rn © t3 ~~rm' W Nãme --. --- .-- m, _._)_n - .. ,.. -- -'-----.----,--- Tìtle..··--'q·--' '-'--"C"'-- ----------- 2r H~"Pt\o~~ ,. .,e\.., ~ 00. A P R 1 41989 " o¡,f·-T w¥"<.,L.. '1..<,,, "'''''''n Y'-"'m}- m Hm _n m m ';;f;. ~;'à~) ';.; ~:, :; ~~ ~ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ~ Certít1t< iF (HHtÍ;AGMd ~;jf.1I at'Ler comµ}uUng all SE.'cUons) I . íy un er pen, lt.y of la", that I have person,llly eMmined and am fami 1 íar with the informat ior submi tted in inqui yo t se individuals responsible for obtaining the information. I believe that the submitted inform " ~ .l- '«~\{.1:-- '3ðt..·:~7:t.~!-!o:-v~-£Ii~-~-'!..oa .JJ-~~1?'fA!F-5' .~____ nuh_H_ , a I t ífTë-ôf'õwner7ôµerator R owner Ibperator s aut orlZe represerftatwe 19n ture . I NVE&ORY Trans Code (Column 1) A = Add This Item D = Delete This Item R = Revised Information Type Code (Column 2) P = Pure Material M ='Mixture of Substances W = Waste (Must Also: Add Appropriate Waste Coàe from "Waste Code Sheet") Measure Units (Column 6) LBS = Pounds TON = Tons (2,000 Ibs) GAJ:. - Gallons BBL = Barrels (42 gals) Ft3 = Cubic Feet CUR Curies Container Type (Column 7) 01. Underground Tank 02. Ahoveground rank 03. Fixed Pressurized Cylinders 04. Portable Pressured Cylinders 05. Insulated Tank (Includes Cryogenics) 06. Drums or Barrels - Metallic 07. Drums or Barrels - Non- Metallic 08. Carboy(s) 09. Glass Container(é) 10. Plastic Container(s) 11. Box(es) 12, Bag(s) 13. Metal Containers (Not Drums) 14. In Machinery or Processing Equipment 15. Bin(s} 16. Unlined Sumps Container Pressure (Column S) 1 Ambient Pressure 2 = Greater Than Ambient Press 3 = Less than Ambi~nt Press Container Temp&~ure (Co 1 umn 9) 4 = Ambient Te;rn'~~¡r'rture :, = Greater tb.:år-l<='.$A.mbient 6 Less than '<ÂmìŠ1 en t Tel1'p but not C l'Y'üge!: i c 7 Cryogenic Conditions CODE SHEA Use Codes (Column .10) 01. 02, 03, 04, 05. 06, 07, OS. 09. 10, 11. 12, 13, 14, 15. 16, 17. lS, 19. 20, 21. 22. 23. 24. 25. 26. 27. 2S, 29, 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40, 41. 42. 43, 44. 45~ 46. 47. 48. 49. 50, 51. 52. 53. 54. 55. 99. Additive Adhesive Aerosol/Inflation ,. Anesthetic Bactericide Blast,ing Catalyst Cleaning Coolant/Antifreeze Cooling Drilling Drying Emulsifier/Demulsifier Etching Experimental/Analytical Fabrication Fertilizer Formulation/Manufacturing Fuel Fungicide Grinding Heating Herbicide Insecticide Instructional Lubricant Medical Aid or Process Neutralizer Painting Pesticide Plating Preservation Refining Sealer Spraying Sterilizer Storage/In Storage Stripper Washing Waste Water Treatment Welding Soldering Well Injection or Service Oil Treatment Resale Aircraft Systems Battery/Electrolyte Breathing Air Drafting Aid Finished Product Fire Protection Hydraulic Equipment Road/Hwy Maintenance Testing Wholesale Chemicals OTHER-Specify on ano"Cner page Farm and Agriculture r -- "' L_.J KERN COUNTY FIRE DEPARTMENT HAZARDOUS MATERIALS INVENTORY ,~ [)lI~4fJ1~~~.n:Ji.R' L: "00'''' ''''eo" ~ _ n __- _ _ ~'" 1i' ,BUSINESS NAMEQ I.n..c.~ 'LS~~ tj':' \~<t~ OWNER NAME: ~tZ Q~<!-e-~§î~~'ß-f(j~1'-\'c.I~L. ,4Prf LOCATION: ._~ \~_OIo.. \.Q>J ~~.:..________ ADDRESS: __~1"\':6-L_~_~.~~.._~.!:.., ,_ _____n. __ ' 1M'! CITY, ZIP:~A\ù;""Il-Sf'E1-0 ,01\ ~'-')'?>à4 CITY, ZIP: '"T(Z.""¡,¡..,)j.Î I c..I\ <i:Ä.11'-\ HAZ M PHONE #: (~osTI1.1> -"S~"; PHONE #: ('1I'-t~U¡ -(.,\40 '-' ~'f~qr.DIV.ot STANOARO'-IN~ CLÃSS-CODE-~-~.~__~~1~_~'=--==-= NAME OF T'¡:iISFACILITŸ: _ç;;::c~~ ~ ~~__~_o \~'K~ REFER TO INSTRUCTIONS FOR PROPER CODES NIIM,;l.li I 4: I I !. 1 lr~ns Code ----'--_._-----------,------_..__.__._~,_.,_._----._-.~- ".-----. '-- _._- ----.--..-.- --. - _..__._---~,-_._----,_._--,_., -----------.-.------.---.--..--..-"' .". ....... 2 rype Code 3 MdX Amt 4 A ve"dge Amt 5 AnnlJ031 Est & Medsure Units 1 Cant lype R 9 Cant Cant Press 1 E'mp 10 Use Code 11 % by Wt 17 Names of Mixtur~/(omponei1ts See Instruct! Jns I __1>.______ .. _n____ uq___.___~~,.-- ,_~'='l!'!1=. 'i~~~__.:-: n\J)P-ç:r.Q_~~..~~.l f__ .~~ C.A.S. Number -----~~-43~-l.1;--n-.-. \., I '.Ii -'-"c(\ _ 11 r-, r-, . 13) tt Dðys i3G.SI H.U~.!..y_________" ..........,--- --.-. --'...,.._..,._ d. _::::::j:-::::j~~:::::::::-[s::[:::~:::~~:[-.~:~::~::::::::::]::::::]~:::::::]::::::::::î:::::::]::::::::: ::::: ~,t:~~:~~~::~::::"::::::::::::~:::::::::-:::::::::: ,e .... Î l. -- -I Immediate He" 1 th .. - -. . -- - ...·u -- -----.. --------.,- --- - -- _·h__._ --..- --..-- _'U -..- -, ---__,.._.. _. _on '" -."' L..:.-J , ~Oelayed Health l' 1\ ,. v !' '" ... , L _.J Fire r --., L_..J Oelayed Health . -~..._ ___·____.~_____n_.__..___.._______...._.__.. ._.._.. ".___.. _ _ _ ,. _ _ ",. ..... C.A,S. Number -------..--.. .._--- .--....- - - - -,--- r"-' , r - , L __.J Redct ivity L _.J Sudden Release of Pressure 13) tt Days on Site r- .-- -- , i I l___J .._- . -----....------..---...---...--..... ------ ---- .--.. -...-.. .-._. ...-.-... ~~~~~~J~~~~~,~J~~~~~~~~~~~-[~~r~~~~~~~~~~~r~~~~~~~~~~~~~~~~]~~~~~~J~~~~~~~~]~~~~~~~~~~r~~~~~~~J~~~~~~~~~ ~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~--~~~~~~~~~~~~~~~~~~~~~_.~~~~~~~-.-_.~~, r --., L _,.J Immediate Health ------------------------..------------------.-------------------..---.-..-----. r _. '1 e L _.J Fire C.A,S, Number --.._- ··--··--·-·r--=--·:':·;-_··--~··· ~ ~_=~_~~~~~::_i~~___~_~~~_~~~~~~_~~~~:~~_ ~ ~~~~~~"-i::-:::-!~~~-h-:-::rt~------------- .--- -~~-~ --~~~~~~~~~~~~~~~~~~:-~~~~-;~-.~~~-~~4~,:~~-~~---~~-~---___~ ~ 00 Œ: @,~"Ii"'Wr!'11\) "",]J;.-,J.~--m_. -- - - _<>I""R,_ ___""""'_. n~'¡~.._.u_n_.__. _m -- n _m mm"'-""n- '\'~1,,3;1' _ ,_"'" J ~ MAR 2 41989 u2~~-~~:-~.~~,+.E~~.~~N,~~.~-L~~t~·~..,--....--.......-..··,·u-'...._,- ~W·p~~~~~l\~:a+ ~ ~ '" r-, L -- I De 1 ayed Hea 1 t h - ....------------- --- -.. --.. _ .. ~ ~.- _ _.. _.... _~... _. .u.~.... .... u_"'_.. __. .~ _ _.._ _ _ .._. --- -------------------------------------------------------------------------------------------------------------------------------------- Certifici}~"CPi0('aÑiMOOsjp.J) after complutjng all Sl.'(:Uons) I ~-:::::::-::~:r-:::~;::-:;-::~-: Mt -; h". ,or,,", 11 Y ."" ,,,d ,,' " f,,' li" , i th t", '" for," i" "b,it t , '" th' '" ,\ 1 moth,d 'OC"""". ,,' th" b,,,' " 'I lnquiryof those individuals I'es.pons~e for obtaining ~ information, I believe that the submitted io is rue a, cura~e. and compìete. . ';~¡;i;Jr¡ö¡~ Mi~,.,~)';pi~M~7ji1"E__1_1..}l#diã'it~¡¡~¡i~"f¡Ìi&i-- mnun__ _n un mm -- u_ m un:? -õJi '5Jò~ - -- _ _ _ . Farm ( r -- , riculture L_J KERB COU FIRE DEPARTMENT , HAZARDOUS MATh~IALS INVENTORY Stðnd~rd Business ~ BUSINESS NAME :0. ,~\.,.~ \( s...~ \J!-\:?~__ LOCATION: ,_-.!~'1-__~ ""O~ A..ve.~__,____._. CITY, ZIP:,~~....\,ÐA'I u~~>'?:04 PHONE # :u,_=áó~ __~1..~__=_~-Ì.._,____ .._________ STANDARD IND. CLASS CODE :,___ ~t1~_________ REFER TO IIlIN h~11 ¡IRA(\:" ~I:: Nil"',,!;, ,4 OWNER NAME:\"oe Q.~~.;.~ C~Q._"Q.~)~~·· ~~~~~S~ ~ p:~~.~~,~~T~iiï4'--- .~~~~~_.~' , ~~~:E 0:: T.I}~\.~A¿-i~Ú~ÿ;~~~~':;_"i_5~~~~\_~~ l. INSTRUCTIONS FOR PROPER CODES tJ J,.., 1'.".It' 01 _________·___u___.. _.____.._..______. ..__._u._______ .._.__ --- --- -. --'-- --.--------..---.-----.- -.---.------- "'- .....---.-.------..,...---..- 1 Ir~ns Code 2 rype Code 3 MdA Amt 4 Allel'ðge Allt 5 AnnlIJ I Est b Me.,sure Units 1 Cant lype R 9 Cant Cont Press It!mp 10 Use Code \1 % by wt I;' Nðlles of Mi ~turt!/l:o}lnOOI1"l1h See Ill" t ruct 1(J/IS e -- - ..- .,... ,~, ~~ .~y.....~ ,. L.~""",. N ~9 '"'t: ,~~~ \ '"'~- \1.. Qú~e.u> Sr -~J~:~~J~~~~~]~~;~~[-::[:;;;;;;;;;::[::1;;;:Ç;~-:~:::]:;:~::][::;:;::]-::::;::::[::~:::]:::;-.;::: ::;;: --::--:::::::::::::::---::--::::------:----------------------- , '-'Immediate ~~_I.>.J.m\':-::J-º~._~_.~\,(..._.~~,__ ~\(_ _. ~~ . ~ ~ He~lth ,U.".,J,~..__.___.,,__,., '_'., ".....'10::, ~ Fire ~ Delayed Health C.A,S, Number_____~,~~~..'~, ,. - 1 L _,..J Immediate HeJ I th ~Fire , O"å .------.. ..--. ~ Delayed .Health C .A.S. NUllber ___h'_~_~~~\u", ____ r- u '---1 r'- , L. J Re.1r.t ill i ty r '--."1 L '- ,I Sudden Re lease of Pressure 13) . O~y> on Site 3C.~1 L n__ _._ ..J ,.. --, L _. ..J Redel ivity r .-- , L ,- ,I Sudden Release of Pressure \3) . Oðys on Site 1'-- -, 1 i"3c.'S1 L _._.-.J _L~c::.,,,,,-\~,L,__~ --~~- ' e ---,-- --~--- -~---~-~~--r-~~--r--~-~---]~~-~-]---~~--l----~-----r---~---]--~-~~-- -~~ -------------------------------------------------------..----.- ~~:;~:::¡:~.--Q--.. nl~~_-:'N:_::_:;~~~~___~I~:--,~---~n- ... .. .. .. P~,~",::_0=", G~.~ -PO' ,L~.--.u--."h-- ~~t:7 r........ ......-.=" Fire ~ Delayed Heðlth C.A.S, NlImber c¡~~<..\'\ .. ... -- - . - . ..- -. -. - - - - r -- .... , r 'I ,. '1 1J) . OJYs I ~ ,-," I L _.1 ~I!.¡et ¡IIHy L, ..J Sudden R!' lease (If Pressure on Site ~,.. ,J -----..--------------------------------------~------------------------~--------------..--- ----- -----------------------~~-~-~ë;~-~-i~-:~-~1L-~---------- EMHMNCY CONI ACTS a 1 Nå~ : __\~':'4 ~_o~~. -)- ØF~\_C4; . ,__ __. .. n ... ,_ Title . __, _ _ '.m.. _, ,______ ___ ~~'Ptk~~)"'}"\ '1 _ 0 '2.'\ ., a:.._'R.'_1'·_'t!,t\4,~'t ,L-~\~>4....,~~--y·\'~T· l~"·'-- ;~r~ J~\~~)'¿~~ --':;~~ ndme ' Ti\le t. lr .'fhn~ ~ .. <II "" o '" .. ... J: i!: .. m ~, ---------------------------------------------------------------------------------------------------------------------------------------------------------~---------------~- ~ LPrtiflcdlio/ (Nt'ad ä/ld sign it/If' ' ('(lmp/t-ling i:liJ St.·('tíOI1S) . 1 Y unrer pen'.llty ot ldlol that I halle personally (>x.}mined and dm tamiliar wIth the inrl)rmðtior submitted in se IndIvidual, I'f'sponslt>lp for obtalnlng the 1ntormðtlOn, I bpl1eve thðt thp submltted Inform . a I l~T: 6~w~'Tõpera~o~·637t~F.m'~Š-~~1Ù'fr'~p~~f'2\m~rè--n---.. .-- Tier Two EMERGENCY AND HAZARDOUS CHEMICAL INVENTORY Sruilic . ¡"lo,malloll by Ch#mlcal ·c Facility Idontlllcøl/on " OwnorlQpcrotor Name " ?-'.:' if' t Peg. -1- 0' ~ "n9'" Fn,m """'0"0(1 O""D ,Jo "O~O,OC1Z # 1386 ')om" Mall Add'.... > ~ CIOCLE K CORPORAT3jCN P.O. BOX 52084, PHoENIX, Phon. ,602) 253-9600 AZ. 85006 'Jam. Sl'ee' Add'... Clly CIOCLE K, COOVENIEK:E SIORE 419B UNION AV~U~ BAIŒRSFI,ELD CA 5'al.- 9jjU5 ZII' .;¡,., ~ ~fî Emergency Contnct '!' STORE MANAGER 1 ,- ' . Name ;~ Till. SIDRE MANAŒR 805) 323-5895 , r'honn ( .. 24 Hr. Phon. ( ) SAME ¡; MIKE SPINUZZI " DISTRICT MANAGER Nøme - .~, Till. (805 833-8881 . " , ) Phone .\..;: 24 Hr. Phone i Dun & B,ad r-or61-~-~ N..,n,oo( lJ:L1..QJ ~ ~ T'ad"D See,.' [i] Liquid o Onl SIC Cod. ~ FOR I OFFICIAL 10' USE' I ONLY D.I. Rec"lved I FFFF , Reporting Period r,nm JnnuMY I 1,0 D..com~r 31. 10 Important: R~ad all instructions b~fore conr"letinl1 form Physical and Health Hazards e Chemical Description I I] CAS~ f.:6Ji] [2J Chern. Name C,A..c;or.TNE Chte#¡ all that apply: o IX] o Solid Pure MI. CASC::CCO=O CD 0 Chern, Name .&. nl/ D ~PPIY: Pure o o Solid MI. Chern. Name CASC::CCO=O CO 0 Chu#¡ 01/ 111(1/ apply: o PIP" MI.. Solid LI'I\J'rl On' (/(tOd ond JI~" 0/1" ((/,"p"""~ nit JlC//trnJ) Celllllctlllon o o Trade 0 Secre' o LIquid o 0,,'5 Inventory Avg. No. 01 Dally DllYs Amounl On- 511 0 (code) (dn)'5) stor:age! C()~es, andLoca.t~p.~~':P::: (Non ,::~onnd~r1t al) ,.': ':.':. ,'. ',: Storage Code Stora8~Locatio;¡s .::..' . ':. .:P:< (chl>Ck all Ihal apply) M,,)(. D"lIy ^mounl (code) , Jh. UNDERGRCX.JND TANKS .' " T,adeO Sec,et o o ~FI'. Sudden ne'eftSe 01 P,,,"U'. R"actlvlty Immedlal" (.cule) D.lay"d (ch'onlc) B 1 4 [Q]J] [QW UI6:EJ .,' ;'- :~ ~Flr. SlIdden Releue of Pre,'Surø r-TI ITI Roacllvlly L-J.-1 l...-.l-J Immedla'" (acute) Oelay"d (ch,onlc) ~.,-\. :~~ ~~\'- CEO -. "1' ~,., , ; <t¡ y '," ;.jlt;.~ . .¡;, .t it, tij ·if, '~' ,!) ,;'i,i,? j.:;' ~~l ~FI,e Sudden Release 01 P'''Hure nenctlvlly CD CD Immodlal" (acu',,' Delayed (chronic) CEO --- 1'''j;'' , .'~' ~ ~:;:1·. ,,"- '¡:,¡J- i.. ~ (: , . .'.... .. ;~ ;'i ~ ;s .\;'';'' ,,~, ;j-' f"' t~~· " " i.-, :~~i . '1'.c .J__" ~}.~ ,~ "'1 J .J~ aþ ] .~, Opllonal Atlachmontl ,(Checll one) . . 'c..,IIIy under penally ollaw Ihtll have ".rlonally ".amlned and am lamlllar wllh Ih" Inlorn'allo" ,,,h'nltlf'd In Ihl' nnd ,"" a"n"IIM docum"nll, IInd Ihat't>a.ed on' my Inqul,y ollhOU IndiVidual., rølponslblo lor ob'Alnlng Iho Inlormatlon, I believe Ihal tlll1~Uh' d 'nlo,mllt/on )~" I'"". .:;¿;ccu,a . II d complo''', ' .' . ¿ .. , , PAT WRIGHT, ENVI~AL DIRECTOR Þ'"'. -/~ 'A ~ cx:::'roBER, r J.,llIr It"'" nfl·clftl tlllp ,,;,t owner/operalor on ownér/vµOlalor's aulhodled renre't"!nlallve SIO"Alulø / Date slgnç.d ;:. B I "ave ."ached a sll. plan . I t1av" a".ched a "sl 0' "". coo,dln.,. tbbfevlallont lQ89 :\i' , ~. -,:to vb ~ fcÝ-' _ f~ ,v4;JJ t:;r ' S1-o ~ tI: /3?G BAKERSFIELD CITY FIRE D.EPAR~ 'R E r. ~ , V E D 2130 "G" STREET .,. ,,16.11' 1:. . . BAKERSFIELD. CA 93301 ¡ð3~Ji" 'SEP 1 1987 (805) 326~3979 . Ans'd, ........... ® ID# r?O 1~0 OFFICIAL USE ONLY USINESS NAME HAZARDOUS MATERIALS .BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: .1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole, 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: . e./ ¡E!LJ./..-E k ao~t'J~"' J # ISg~ B. LOCATION / STREET ADDRESS: ~/9/5 'áAJ/¿)/c» */£AJ/L,Æ, CITY: L1/9£ÆR8~F~ zIP:9óao~ BUS.PHONE: t30SJ(~.:?-589.5 I I I SECTION 2: EMERGENCY NOTIFICATIONS 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. EMPLOYEES TO NOTIFY IN CASE OF NAME AND TITLE "// A. P ,E¡tÇ¡Ç-f/ ~AJL).5:bF B. /JAJAJ .£hfl /lJŒLJ EMERGENCY: DURING BUS. HRS. ~TER B~. HRS. Ph~)ß.6#-ß~~Ph# ~~) ~-Ó3~&' Ph#&~»89 -¡j'lð1ék>h#~ 2£<9 - ðt.:?.:?/ SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. B. C, D. E. IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO, MSDSS? YES I NO KEYS? YES / NO 2A ,'. JliJ ~:I"~":þ. ~' ~ ~ (Ç) 'Ø-.. ___ \.- .~ ~\ ' ...;.:~:. ,~c' '6" ~ BAKERSFIELD CITY FIRE DEPARTMENT A 2130 "G" STREET _ - BAKERSF I ELD, CA 93301- 5 h y€.. t::t /386 (805) 326-3979 OFFICIAL USE O~LY BUS INESS NAI.{E ID# HAZARDOUS MATERIALS BUSINESS PLAN AS .A WHOLE FORM 2A ib&Þ:L : rJ"i22Gr~E.. INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4, Be as brief and concise as possible. I I SECTION 1: BUSINESS IDENTIFICATION DATA A, BUSINESS NAME: . e/"P~~ k ~~ßO~t")ÁJ # /380 B. LOCATION / STREET ADDRESS:. ~/9¿) áA-J/ ¿;/U ~./~,I( J/./Æ CITY: L1/9R;¥;R8~~L/) ZIP: 92aO¥ BUS.PHONE: ~(::£:?r:::j7-589.5 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened releas~ 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. EMPLOYEES TO NOTIFY IN CASE OF NA~E AND TITLE jY A, .,¡CJEÆ¡Ç-f/ ~~ B, /JA.JfJ .£hf/ /fJŒL; EMERGENCY: ~NG BUS.. HRS. åTER B~. HRS. Ph )8A'¢-ß~..;t;;LPh# ~~) W-Ó3W p~:&~~g¥ 7J1/¿;2~h#~ 2£<9 -ð¿)~ SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A, NAT, GAS/PROPANE: B, ELECTRICAL: C. WATER: No D, SPECIAL: E, LOCK BOX: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLkVS?YES / NO. MSDSS? YES· '/ NO KEYS?'fES / NO .. - 2A - ---.- .~' <) ~ '~ .. . e e ~. .j SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSINESS AS A WHOLE Y;5 SECTION 5: LOCAL EMERGE~CY MEDICAL ASSIST~VCE FOR YOUR BUSINESS AS A WHOLE ;./oS¡it /-¿( - fyvdvJ1 fl-(/~ ¿a-ke:r-rflé(d M e,yt!.-7 SECTION 6: EMPLOYEE TRAINING E~PLOYERSARE,REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E~PLOYEES WITH I~ITIAL A~D REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NQ I~ITIAL REFRESHER A. ~~~~~¡L~~~,~~~~.~~~~~~~,~:.~~~~~~~~~,., .,',.~ NO ~ ~O B. PROCEDURES FOR COORDINATING ACTIVITIES ~ii WITH RESPONSE AGENCIES:."......., .,...., ..,.... ES ~O ES XO C. PROPER USE OF SAFETY EQUIP~EXT:..... .,.. """.. E NO NO D. E~ERGENCY EVACUATION PROCEDGRES:... ..". ",.. '" ~O E, ~O E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:."..., NO E NO SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS O~ SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ".." YES~ I, M I k p . 5"(' ~ v I+t. a I" hp yo , certifÿ that the above information is accurate, I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Dlv, 20 Chapter 6,95 .Sec, 25500 Et AI,) and that inaccurate information constitutes perjury, 'SI~~Ã/1- TITLE ~ ~. ~ATE 9J1Ktg1 '.. - 2B - ... ~ ~~. KERN COUNTY FIRE DEPARTMENT,' ~642 VICTOR STREET 1!KERSFIELD, CA 93308 e r-- OFFICIAL USE ONLY ID# ------ BCSINESS NAHE: 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 possible. FACILITY UNIT# J 3 &>b FACILITY UNIT NAME: SECTION 1: MITIGATION. PREVENTION; ABATEMENT PROCEDURES Our training program includes the following: 1. How to handle reporting and clean-up of unauthorized s~face spills of motor fuels. 2. How to check the motor fuels equipment and insure its . correct use to'prevent unauthorized spills of motor fuels. .' 3. Unauthorized release of product due to leaking tanks and product lines is handled by the Environmental Geology Departrœnt. SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY Our training program includes the following: 1. How to turn off all power to pumps. 2. Proper instruction to evacuate all people fran the site. 3.. Make sure that all five extinguishers have proper service and maintenance. 4. Emergency list of telephone numbers for Fire Departrœnt, Hospital and Regulatory Agency for timely notification. ~_:.~...-t ..¡:~. .....,t " HMCU-6 -. -' B^~ERSFrELD CITY FIRE DEr^R~MENT . FORM 4A-l , & ! Page....l òt{1 o " .. ,'<r" NON-TRADE , , SECRETS I .. , . : 'H·AZARD.O·US MATERI AL,S INVENTORY .-. ,~. I i' " .' .- '-7 I bus ¡NESS - NAME: C!-/rè.le.', K f!..o-yø, OWNER NAME : (2ly~f~ I~ C!.-o ~ ð: '. FACILITY UNIT-':l.fR~ ~DORESS: ~7¡t ~. ~. , ADDR ESS: J ¿, ð I A/.ðY" fj., 7:l5£ -.;: + FACILITY UNIT NAME: :It=. I'? 9/,., CITY,ZIP:..1Z -'~,;y A z. ~'J')O ~ I ~:'~~É.:~ d:~ - ~i', . (If ' , . PHONE ,: ((;; ð 2) .:1 2 q 51/. Q I 10FFICIAL USE CFIRS' CODE I ONLY , . 2 3 4_ r.. 6 7 --- 8 9 10 " I MAX ANNUAl. CONT USE LOCATION ' IN 'THIS % BY HAZARD 0,0,1 PE, I'DE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT_ WT, CHEMICAL OR COMMON NAME CODE GUIDE ,/)-- -~---'-_. --~- -,---- 9_ ëi7.) V H.deYfY'O VKCI +:"iLtL-'" ~ f? C ú irL't- //~J-- (!MLCPL P ,/10 .ðAn Lo f')ð,.._, øl /9 41 t¡ tõ t/n foV( . 14-(/~- - 100 ' (Ç;J. c'i 0 Ie ~ e.- fþJ- Vkde.V"fyovk-d -r-¿~K , r::; /1 f ¡;¿ , - - . -------~- -- - 7' l/Yt t..P~ k d <!...ML {þ I ð-~ð~-- J, (.,.-:1') ,000 ?~- ,} " I /9 ' J..{ I 9 g LhH·ðVl A- (/ of. 1 (J 0 . .,...' ...) _ (" /J it H 42.. . r~ _....---~----:.---._----: ----.- --- --- --~~(~-' 1 r¡ l~h~e~TYov~ .~k~ '&>11 J {/ k-1 rÇ~ /'(l~ CM L(jJ ç:o' , lò ðnn , <'-0 ' (')t'H''L 01 J4 (9 g V"YZlcrn A-C/~ lð 0 II~ f.eð..¿cI sò f,,",,, i ,-, I I I I: - I' , ,; I . , .---~ I ¡r- --- I,' 1:- I . It' Ii! f: , A A ¡ME: ,J ~ --/-: ' l~.J 'r^ I " J ~+ ~.TLE: SvðeY-//(. r {} yo SIGNATURE: ~/'J \P"-/, J.A /4C /ýL DATE :X-:1 (,,-9 7 ~RGÐNCYCONTACT: r ./1. - - /.J L.I 'vi 'ç p c." . PHONE , BUS HOURS :1'i", ~)- Vl L;.-¡ L¡.2- :L TITI.E: LOYloe IVld~ d f p~ Ilf , 7(j' cr , AFTER BUS HRS:(~o5)~49ð .fiR I ,4-WYl ~/' . F,RGENCY CONTACT: 'Y1 t!i.s /') tITLE: ðffrC!.e M dYfd.. ç e r-. PHONE' BUS HOURS;ú?oS)~3~~ 1~'¿2., I I, , , r ~ ~ :(~","2\ 7 ? () ~ ¡II) :J I I ~NCIPAL RUSINESS ACTIVITY. '-tf~)1 VP.H. I t!.Yf t!'.{? s.¡..;.,~ AFTER R1J IIR NORTH , ": y J~,~J\t-/. " ,J W ~ , I , SCALE: j'J::: 2ß BUSINESS NAME-; CIRClL 1< d FLOUK: I OF ,I ! I 1;0(, DATE:c¡13dg < UNIT #: , OF UN!lJN ~ I I (CHECK ONE) SITE DIAGRAM '-ÍJ -:> <t ¿ \J 2 :S FACILITY DIAGRAM ~ 0¡9t.t;; - II) ~~ 4- C.oL~ M ßLlt.:'" ".. ?~,..,~~~. - H- 0 ¡V') Æ=- bAL , . , jIIN(bRA~í Ì''6PS 0 I_~_ , . I ~ I \ o¡ oov T - - - -, . I ~ I \O,O(X) tV' f ... .... - - -I ; à ( I" 'CXJo _3.1 _ ..J , sl.c ">4'')of(~'' 'It L f),:,~t__'L ~. G¡&\'- s'c GAl,... ~PlS 'h P'-'I'f'¡r 1\ 5th-IT.O ff ~. I" I ble, 1 j t >(' ~Jc. " ¡ )( f ~ ~' ¡ ~ t 1<- ~ 1 ~ . 1c k ! ~ ,k ¡ 6' 0- .,'~ ':f r Y 1< r )( ft, X )t Y)t' Y f:":! y \ 9 r¿ (Inspector's Comments): -OFFICIAL USE ONLY- ,--:-,'