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HomeMy WebLinkAboutBUSINESS PLAN 11/7/2003 Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF ,PERMIT ON REVERSE SIDE Permit ID #:: 015-000-001472 RICKS RECYCLING' LOCATION: 2200 S UNION AVE This permit Is Issued for the following: Ii1 Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES' 1715 Chester Ave., 3rd Floor ,Approved by: D Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: Issue Dale 'June 3J), 2003 .. to Per... it Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: zardous Materials Plan round Storage of Hazardous Materials agement Program Waste 2200 S UNION PERMIT ID# 01S-Q21.o01472 RICKS RECYCLING LOCATION Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805)326-3979 FAX (80S) 326-0576 *~- ph Huey. ffice of ental Servi es June 30, 2000 Approved by: Expiration Date: .... ,,- ''''''':'' ~ ~--- ,,.,.-' iIM~P ~/ -- 1:> LAN. .1V.lA.P SITE DIAGRAM FACILiTY DIAGRAM '~'lc-J¿~ ~/c:..l.t^~ ,/ v"¡ Business Name: Business ACdress: ~oo ,"\. I)~~n....... For Office Use Only FirST In Stetion: ,I)' Area Meo # l 7 ¡:¡ of 19-4 Insoecrion Sterion: 5(' NORTH 0 /:' ?lA"'2. RJ.. ~Ið '6% 'DIE5EL-D é7~ ~ It t ~< ::J c57 o I'f :r- ~ / / - ._-----/ ~ .n, , '-/ / ," \..... -" , ~V\V"r- ~' ,.¡. '( RICKS . L /J SiteI~21-001472 RECYCLING ÎI}~odor~ ~OEDORE WIESEMAN 2200 S UNION AVE BAKERSFIELD Manager : Location: City t.\\)'J 1 & i&W BusPhone: ,.. Map : 124 Grid: 17A (661) 832-3248 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 05 EPA Numb: SIC Code:5093 DunnBrad: Emergency Contact / Title THEODORE WIESEMAN / MANAGER Business Phone: (661) 832-3248x 24-Hour Phone : (661) 588-0635x Pager Phone () x Hazmat Hazards: Contact : MailAddr: 2200 S UNION AVE City BAKERSFIELD Owner Address City Period Preparer: Certif'd: ParcelNo: RICK WHITLOCK 2200 S UNION AVE BAKERSFIELD to Emergency Directives: --I~ /1 rn (J (J v fiT£- 75(() Emergency Contact RICK WHITLOCK Business Phone: 24-Hour Phone Pager Phone / Title / OWNER (661) 633-5040x (661) 664-1202x () x Fire Press ImmHlth DelHlth Phone: (661) 832-3248x State: CA Zip 93307 Phone: (661) 832-3248x State: CA Zip 93307 TotalASTs: = Gal TotalUSTs: = Gal RSs: No I, £ltHA~Ì':> .f1, bJHrrUJd( Do hereby certify tnat ! have (Type or print narfI0) reviewed the atl~chsd haæ~roous materials manage- ment pian forR.ld] fŒ(!,Yc!L/~G and that it along with (N8Ime of I?IUß~) any OOIT@ctioli1S oonstituteJ a1 ~©m~!st~ ~nd OOi"f~d man- agem*nt p!~n for my facility. lJ~~aQ Jf-7~ð-::S Date -1- 10/17/2003 (i· ó,p°- F RICKS RECYCLING f= Inventory Item = COMMON NAME / PROPANE . ~ SiteID: 015-021-001472 9 Facility Unit: Fixed Containers at Site 9 0001 CHEMICAL NAME Days On Site 365 Location within this Facility Unit Map: Ñ t CbILµtfl. ¡6D GAhl ~J.If1lv}JftP-r i!tP'\ Grid: CAS# 74-98-6 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 828.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 828.00 FT3 Daily Average 828.00 FT3 %Wt I 100.åo Propane HAZARDOUS COMPONENTS ~ CAS# 749861 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS f= Inventory Item 0003 F== COMMON NAME / CHEMI CAL NAME OXYGEN Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit WHERE IS IT LOCATED??????????? Map: Grid: CAS# 7782-44-7 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 1000.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 1000.00 FT3 Daily Average 1000.00 FT3 %Wt. RS CAS# 100.00 Oxygen I Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -4- 10/17/2003 ,¡:; ~~ ~. F RICKS RECYCLING f= Inventory Item F= COMMON NAME / DIESEL #2 . ~ SiteID: 015-021-001472 ì Facility Unit: Fixed Containers at Site ì 0002 CHEMICAL NAME Days On Site 365 Location within this Facility Unit ADJACENT TO N ENTRANCE Map: Grid: CAS # 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container Só\J 6~GAL AMOUNTS AT THIS LOCATION Daily Maximum 5lJÖ b5--o.o GAL Daily Average ~~ ~ 00 GAL %Wt. RS CAS# 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS HAZAR TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low D ASSESSMENTS -5- 10/17/2003 ADDRESS 1-7-DO FACILlTYCONTAC,T J --e¿.l\ R.c¿C/ c , l.~_____ ~ - VI/) ;OÞ"1 ---"--,-----+-~-----~._--_._._-- Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INSPECTION DATE INSPECTION TIME ?-'Z.l-03 ----- UNIFIED PROGRA.SPECTION CHECKLIST. \" ' SECTION l' Business Plan and Inventory Program PHONE No, ~ /"II'/) No, of Employees "3> -~-_._--,-------- ---~--------_.- Business ID Number ~ .s 15-021-00 I 7 ¿ , , 1l'Routine Section 1 : Business Plan and Inventory Program .' ' , , , , c:J Combined tJ Joint Agency c:J Multi-Agency c:J Complaint c:J Re-inspection C V ( c=comPliance) V=Violation 6; c:J ApPROPRIATE PERMIT ON HAND ~c:J -;USINE~~~-LAN C~~TACT INFOR~~~~;:~~~~~----- ------,--.-"--.--.-------------.--,------.,--.-.-----,-.,--.- ~ c:J VISIBLE ADDRESS OPERATION COMMENTS _________._.__.._.___.______._._ _____ ___"_______ .___.______.__._._,.__________._.__.______ _._.____._.m______+__·__ ...__._____.__ .-.------------.-..-----.---+..-.-. - ,-..----.-----------.-.---.-------.------,-----..-.-----..-----...--.....-.--.---. _.--- c:J CORRECT OCCUPANCY 5("c:J ~ c:J VERIFICATION OF QUANTITIES ~---~ERIF~CATION OF LOC~~I~-:----------'----~ -----------.----,------------------,--,------.--..,---..-,---- - -----------------.--- -------------.-..-..--. ----..---------,-.---------. VERIFICATION OF INVENTORY MATER-IAL;--------·--- S¡;¡:;-¡¿m'c:;¡gs-Z('--'6-';;Tj-.pf,'t- S--Ci;:.¡m 'S}=-I-e , _______.____,______'-£.01: ____~eç,~1-£'~.:-J~1.'ºT.-JL21-~Ø.--,--- R'" c:J PROPER SEGREGATION OF MATERIAL ------------.---.------ ..--------..--------.-- --..-.--.------------..------.--.---.----..--...-.-- ~ c:J VERIFICATION OF MSDS AVAILABILlTYE ----~--------_.._---_._----_._--_.._- ---------.-----------.--.-.+-------------.--------.-------- I!I c:J VERIFICATION OF HAT MAT TRAINING --------------,---_...._--- --------_.._-~----,-------_.__._--_._._,-_._-_.._.--._----...---------- ~ c:J VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~c:J EMERGENCY PROCEDURES ADEQUATE fJ( c:J CONTAINERS PROPERLY LABELED ~ D-H~us~~E~PING ---, Jf ,C:J FIRE PROTECTION .--..-------..-.----- -_._----,----,._-,-----_.._-_._-,-----_._----~-_._---_.--.---_._- .------------------.------..--.--.- -_._-----_....._,-----_.._-_.._----~---_._----_._..,--_.-------.-----.-+...,---- -------------_. ..---..-- -----._------_._._---------_._--_._---_._-~-_._.,..._---_._-----~----_.. _.__.~----_.~.__.- ------------_._-_._--~-----_._---_._-_.__._----- ----~-~-~~._--~. -------.- -.-----.---.-.----------.--------.-.---.,--..---.-- .--..-.------. ~ c:J SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: c:J YES 1!IJcNo \ ~ ~ v ~~ EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 __ /J ¿ #/ /~¿______. r-=-=-""---- L{Z___ Badge No, 7IJ6- :dJj ~us n Site Responsible Party ðC White· Environmental Services Yellow - Station Copy Pink - Business Copy CORRECTION N'-ICE 04886 BAKERSFIELD FIRE DEPARTMENT Location 2-200 S· U""¡/dN Name ~\a Is QGc..Y C.UNG- You are hereby required to make the following corrections at the above location: Cor. No. ú) ?¿,~S€ '2E(..oclJ..1'"€ (J~Eo OIL Dflull1$ 'To vJ f f'1.I.,,.J -n-t€ ?i2ðPC.t2 r'r' ~ 1fAV€ paoPGt2-LY ~éc..SJ~(C-o ~ :)(~Pð5G1.) of: ,;. 81( ,A llCfENcc:o vSø Ol'- ' . L.~. Completion Date for Corrections Date llG] IC3 I ItGl03 W INCS Inspector 326-3951 FD 1950 " ,-,; a - RICKS RECYCLING SiteID: 015-021-001472 Manager : THOEDORE WIESEMAN Location: 2200 S UNION AVE City BAKERSFIELD CommCode: BAKERSFIELD STATION 05 EPA Numb: BusPhone: Map : 124 Grid: 17A (661) 832-3248 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:5093 DunnBrad: Emergency Contact / Title Emergency Contact / Title THEODORE WIESEMAN / MANAGER RICK WHITLOCK / OWNER Business Phone: (661) 832-3248x Business Phone: (661) 633-5040x 24-Hour Phone : (661) '588-0635x 24-Hour Phone : (661) 664-1202x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: (661) 832-3248x MailAddr: 2200 S UNION AVE State: CA City : BAKERSFIELD ¡.:¡ E c ¡:: ¡¡..<- Zip : 93307 Owner RICK WHITLOCK tifOlJ ~u Phone: (661) 832-3248x Address : 2200 S UNION AVE 092000 State: CA City : BAKERSFIELD ENVIRON e.,....~ Zip : 93307 Period : to ' "''':.H1V¡CES TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì p= Hazmat Inventory f== As Designated Order Hazmat Common Name... SpecHaz EPA Hazards PROPANE DIESEL #2 OXYGEN .F P F F IH IH DH IH DH G L G DailyMax MCP 828.00 FT3 Hi 65.00 GAL Low FT3 Low I R /tH/ttlò A , Wit í ructDo hereby cermy ~ha~ , have , (Typs or print name) reviewed the attached hazardous materials manage~ Q., '¿~5 , ' " ' . . ent Plan ior ~l¡¿-c.}{tl.l ¡J (:, ,,%,¡J tand that I~ along with m ' (Name of BusIness) any corrections constitute a complete and correct manM agement plan ior my iacility. Ì'\ 10/12/2000 ,. e e 0001 CHEMICAL NAME SiteID: 015-021-001472 ì Facility Unit: Fixed Containers at Site ì F RICKS RECYCLING f= Inventory Item = COMMON NAME / PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 74-98-6 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 828.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 828.00 FT3 Daily Average 828.00 FT3 HAZARDOUS COMPONENTS. ~ CAS # 749861 ~Wt I l~O.ÓO Propane TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS f= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME DIESEL #2 Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit ADJACENT TO N ENTRANCE Map: Grid: CAS # 68476-34-6 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Ambient Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 65.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 65.00 GAL Daily Average 65.00 GAL 9¡)Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -2- 10/12/2000 e e SiteID: 015-021-001472 ì Facility Unit: Fixed Containers at Site ì F RICKS RECYCLING p= Inventory Item 0003 = COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility WHERE IS IT LOCATED??????????? D'J, Unit )£ Map: P~"ìI'Z 0 ""' .,,1, ,\ Days On Site 365 Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum Daily Average FT3 FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -3- 10/12/2000 e r=:: Employee Notif./Evacuation VERBAL NOTIFICATION. I Public Notif./Evacuation VERBAL NOTIFICATION. e SiteID: 015-021-001472 ì Fast Format ì Overall Site ì 05/01/1996 1 05/01/1996 ] 05/01/1996 ] 04/09/1998 F RICKS RECYCLING I f= Notif./Evacuation/Medical r=: Agency Notification ~ALL 911 IN EMERGENCY. Emergency Medical Plan DR CHRISTIANSEN ON 22ND ST AND/OR MERCY HOSPITAL. -4- 10/12/2000 e e SiteID: 015-021-001472 1 Fast Format ì Overall Site 1 05/01/1996 F RICKS RECYCLING I p= Mitigation/Prevent/Abatemt Release Prevention MATERIALS ARE STORED IN PROPER CONTAINERS. r=:: Release Containment KITTY LITTER. 05/01/19961 05/01/1996 Clean Up USED ABSORBANT MATERIAL IS KEPT IN METAL CONTAINER. Other Resource Activation -5- 10/12/2000 ~ ~ e e F RICKS RECYCLING I p= Site Emergency Factors r=: Special Hazards CUTTING TORCH. SiteID: 015-021-001472 ì Fast Format ì Overall Site ì 09/17 /1999 ] 09/06/1996 Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - N WALL WEND C) WATER - W WALL OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire protec./Avail. Water 09/06/1996 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - NW CORNER OF PROPERTY. Building Occupancy Level -6- 10/12/2000 i·.' 'i. ,it e e F RICKS RECYCLING I F Training Employee Training SiteID: 015-021-001472 9 Fast Format 9 Overall Site 9 05/01/1996 WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MONTHLY SAFETY MEETINGS. Page 2 r I I Held for Future Use Held for Future Use -7- 10/12/2000 e - CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 7 FACILITY NAMEj2,' c..ILs (2~<:..~ <:..-1: (\., ADDRESS ;J..:l. ðU s... J"''-(j n F ACILITY CONTACT -¡-~ d uJ .. 0 '$.Q tv\ a.. '" INSPECTION TIME I () .....,' "''' t.~ :s INSPECTION DATE I CJ - Ó V - 0 0 PHONE NO. ~ 1:;). - 3 ~ L/ X> BUSINESS ID NO. 15-210- 00 It.( ì .:l NUMBER OF EMPLOYEES .;t Section 1: Business Plan and Inventory Program Ii} Routine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate permit on hand Y... Business plan contact information accurate :x Visible address Ý.. Correct occupancy Ý.. Verification of inventory materials "- iLL! Ih v" .. 0 ___ C./'...Jev- , Verification of quantities " Verification of location 1"- Proper segregation of material X Verification of MSDS availability 'I. Verification of Haz Mat training X- Verification of abatement supplies and procedures [~ Emergency procedures adequate Iv Containers properly labeled 'I.. Housekeeping y. Fire Protection '/. Site Diagram Adequate & On Hand ;.¡. C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~No White - Env, Svcs, Yellow - Station Copy Pink - Business Copy ~' ','~ -' . . usin';'s Site Responsible Party Inspector: (2 ~ f· (C...e tJ, Questions regarding this inspection? Please call us at (661) 326- 3 9 7 9 ·' ,. e RICKS RECYCLING Manager : Location: 2200 S UNION AVE City BAKERSFIELD jV':',',':-) BusPhone: Map : 124 Grid: 17A ~/' /,I .. CommCode: BAKERSFIELD STATION 05 EPA Numb: -- SiteID: 215-000-001472 (805) 832-3248 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:5093 DunnBrad: Emergency Contact / Title Emergency Contact / Title THEODORE WIESEMAN / MANAGER RICK WHITLOCK / OWNER Business Phone: (805) 832-3248x Business Phone: (805) 633-5040x 24-Hour Phone : (805) 588-0635x 24-Hour Phone : (805) 664-1202x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth - , - . Contact : Phone: ( ) - x MailAddr: 2200 S UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Owner RICK WHITLOCK Phone: (805) 832-3248x Address : 2200 S UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì specHaz EPA Hazards Frm I DailyMax Unit MCP p= Hazmat Inventory p== Alphabetical Order Hazmat Common Name... DIESEL #2 F IH DH PROPANE i, £ ¡CM;? '9 ¡}. 0/1/11.1 ~ hereby certify ~a~ ~ rna:: (fvrn or prim mlII1O) rS~Dswsd a'll~ ®~~h®©1.hm~trdoos ma~siÌal$ manage- 12 /(!-K.s mei1~ ~lai1 ~©U' 12aŸ(~i I ~, ..7Pé~nd ~h~~ it along wiih (NM13 01 ~ucl7iesa) any cortr~~åons ©onsmute a complate ªnd cörrsc~ man- agsmen~ plan 1oú' my 1acili~. ~{¡B.t¡;W~ q,d-9J L G 65 GAL Low 828 FT3 Hi -1- 09/07/1999 e e SiteID: 215-000-001472 ì Facility Unit: Fixed Containers at Site ì F RICKS RECYCLING p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME DIESEL #2 Days On Site 365 Location within this Facility Unit ADJACENT TO N ENTRANCE Map: Grid: CAS # 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container 65.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 65.00 GAL Daily Average 65.00 GAL %Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME PROPANE Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 74-98-6 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 828.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 828.00 FT3 Daily Average 828.00 FT3 'Wt I l;o.åo Propane HAZARDOUS COMPONENTS ~I CAS # 749B61 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS -2- 09/07/1999 e e F RICKS RECYCLING I p= Notif./Evacuation/Medical ~ Agency Notification CALL 911 IN EMERGENCY. ~ Employee Notif./Evacuation VERBAL NOTIFICATION. I Public Notif./Evacuation VERBAL NOTIFICATION. SiteID: 215-000-001472 ì Fast Format "I Overall Site "I 05/01/19961 05/01/1996 05/01/1996 ] 1 Emergency Medical Plan 04/09/1998 DR CHRISTIANSEN ON 22ND ST AND/OR MERCY HOSPITAL. -3- 09/07/1999 e e SiteID: 215-000-001472 ì Fast Format ì Overall Site ì 05/01/1996 F RICKS RECYCLING I p= Mitigation/Prevent/Abatemt Release Prevention MATERIALS ARE STORED IN PROPER CONTAINERS. ~ Release Containment KITTY LITTER. 05/01/1996 ] 05/01/1996 Clean Up USED ABSORBANT MATERIAL IS KEPT IN METAL CONTAINER. Other Resource Activation -4- 09/07/1999 e e SiteID: 215-000-001472 ì Fast Format ì Overall Site ì 09/06/19961 09/06/1996 F RICKS RECYCLING I p= Site Emergency Factors r=: Special Hazards LUTTING TOURCH Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - N WALL WEND C) WATER - W WALL OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 09/06/1996 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - NW CORNER OF PROPERTY. Building Occupancy Level -5- 09/07/1999 J .', e e SiteID: 215-000-001472 ì Fast Format =¡ Overall Site =¡ 05/01/1996 F RICKS RECYCLING I F Training Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MONTHLY SAFETY MEETINGS. Page 2 r I I Held for Future Use Held for Future Use -6- 09/07/1999 ~, 'f: e RICKS RECYCLING Manager : APR & 1998 Location: 2200 S UNION AVE City BAKERSFIELD BY: CommCode: BAKERSFIELD STATION 05 EPA Numb: e SiteID: 215-000-001472 BusPhone: Map : 124 Grid: 17A (805) 832-3248 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:5093 DunnBrad: Emergency Contact / Title Emergency Contact / Title THEODORE WIESEMAN / MANAGER RICK WHITLOCK / OWNER Business Phone: (805) 832-3248x Business Phone: (805) 633-50~X 24-Hour Phone : (805) 588-0635x 24-Hour Phone : (805) 664-12 x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Emergency Directives: F Hazmat Inventory One Unified List l p== MCP+DailyMax Order All Materials at Site l Hazmat Common Name. . . SpecHaz EPA Hazards DailyMax MCP PROPANE F P IH G 828 FT3 Hi DIESEL #2 F IH DH L 65 GAL Low HYDRAULIC OIL IH DH L 55 GAL Low ~9 e ItiMf'ò úJ+!-lí/"'ðt( (Q)o hereby c~JÎi\y 1nai ij ha\!~ (V11~ @'l ~ ~i'iW) í'®Vb®W~rQ] ~!h® ~~61e~e~ ~~a(¡"doo$ mat~~~i~ ffi~fI~®~ \ M@ú1~ tQ)ßta!ú"õ ~@Ii' £ IlL', r¿~&I c,{..(þ~oo ~~®~ i~ ~I©~@ wiU, (~OI ~1iCZ3) ~~~ OOH'ß"®dñ©liî® ©@V'ùmô~I.Û@ 2 eompiete &lfõ@ OOIi'Ii'OO m&\ú"I~ ~@®m®~ft pil2!tro Q@1i' MY ~d~ôiy. 1~3 "c¡~ ~te -1- 03/24/1998 .. e e SiteID: 215-000-001472 ì Facility Unit: Fixed Containers at Site ì F RICKS RECYCLING p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 74-98-6 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 828.00 FT3 Daily Average 828.00 FT3 HAZARDOUS COMPONENTS ~I CAS # 749861 I l~~~òolpropane TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS p= Inventory Item 0002 F== COMMON NAME / CHEMI CAL NAME DIESEL #2 Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit ADJACENT TO N ENTRANCE Map: Grid: CAS # 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE METAL CONTAINR-NONDRUM Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 65.00 GAL Daily Average 65.00 GAL %Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS -2- 03/24/1998 e e SiteID: 215-000-001472 ì Facility Unit: Fixed Containers at Site ì F RICKS RECYCLING p= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME HYDRAULIC OIL Days On Site 365 Location within this Facility Unit Map: Grid: CAS # 112345 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Hydraulic Brake Fluid (Diethylene Glycol Monobu... No 112345 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low HAZARD ASSESSMENTS -3- 03/24/1998 e e F RICKS RECYCLING SiteID: 215-000-001472 =¡ I Fast Format '1 f= Notif./Evacuation/Medical Overall Site '1 r=: Agency Notification 05/01/1996 1 CALL 911 IN EMERGENCY. ~ Employee Notif./Evacuation 05/01/1996 ] VERBAL NOTIFICATION. I Public Notif./Evacuation 05/01/1996 ] VERBAL NOTIFICATION. Emergency Medical Plan 05/01/1996 DR. CHRISTIANSEN ON 22ND STREET AND/OR MERCY HOSPITAL. -4- 03/24/1998 e e SiteID: 215-000-001472 l Fast Format l Overall Site l 05/01/1996 F RICKS RECYCLING I f= Mitigation/Prevent/Abatemt Release Prevention MATERIALS ARE STORED IN PROPER CONTAINERS. ¡=:: Release Containment KITTY LITTER. 05/01/19961 05/01/1996 Clean Up USED ABSORBANT MATERIAL IS KEPT IN METAL CONTAINER. Other Resource Activation -5- 03/24/1998 é e e SiteID: 215-000-001472 ì Fast Format ì Overall Site ì 09/06/1996 1 09/06/1996 F RICKS RECYCLING I f= Site Emergency Factors r=: Special Hazards CUTTING TOURCH Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - N WALL WEND C) WATER - W WALL OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 09/06/1996 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - NW CORNER OF PROPERTY. Building Occupancy Level -6- 03/24/1998 .... (1 'ii ~. e e SiteID: 215-000-001472 l Fast Format l Overall Site l 05/01/1996 F RICKS RECYCLING I F Training Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MONTHLY SAFETY MEETINGS. Page 2 [ I I Held for Future Use Held for Future Use -7- 03/24/1998 ~i. . - ___.._ t;; t 09/12/96 - e , lfà ~ «; ~ II ~ (7 ~ ~ 215-000-001472 ~. - W ~aqe 1 RICKS RECYCLING Overall Site with 1 Fac. Unit l OCT 16 1996 General Information "~-~\ I ''1:_ -' '-, I '-"""-/ Location: 2200 S UNION AV Map:124 Haz:3 Type: 3 City : BAKERSFIELD Grid: 17A F/U: 1 AOV: 0.0 .----- Contact Name Title - Contact Name Title THEODORE WIESEMAN / MANAGER RICK WHITLOCK / OWNER Business Phone: (805) 832-3248x Business Phone: (805) 633-5040x 24-Hour Phone · (805) 588-0635x 24-Hour Phone · (805) 664-1212x · · Pager Phone · ( ) - x Pager Phone · ( ) - x · · Administrative Data Mail Addrs: 2200 S UNION AV D&B Number: City: BAKERSFIELD State: CA Zip: 93307- Comm Code: 215-005 BAKERSFIELD STATION 05 SIC Code: 5093 Owner: RICK WHITLOCK Phone: (805) 832-3248 Address: 2200 S UNION AV State: CA City: BAKERSFIELD Zip: 93307- Summary 't f11c¡.¡~ í?~ A. ÚJ# IíL() t ~ . YP8orprintnamo) 0 hereby Certify that , have rev,ewed the attached h " . f azarclous materials manage- ment plan for !UC,f5 ¡¿£é,~t tJC; (Name of S:JSil1J;{ and that it along with any corrections constitute a complete and correct man. agement plan for my facility. ~~ ¡ ~'I If) /1~9fí uere ' -; e e 09/12/96 RICKS RECYCLING 215-000-001472 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers at Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 PROPANE Gas 828 High ~ Fire, Pressure, Immed Hlth FT3 02-002 DIESEL #2 Liquid 65 Low ~ Fire, Immed Hlth, Delay Hlth GAL 02-003 HYDRAULIC OIL Liquid 55 Low ~ Immed Hlth, Delay Hlth GAL e e 09/12/96 RICKS RECYCLING 215-000-001472 02 - Fixed Containers at Site Page 3 Hazmat Inventory Detail in MCP Order 02-001 PROPANE ~ Fire, Pressure, Immed Hlth Gas 828 High FT3 CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: HEATING Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 828 I 828.00 I 36,000.00 Storage r Press T Temp ~ PORT. PRESS. CYLINDER Above Ambient I Location - Conc l 100.0% Propane Components I~ MCP ----r-Guide Extreme I 22 02-002 DIESEL #2 ~ Fire, Immed Hlth, Delay Hlth Liquid 65 Low GAL CAS #: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 65 I 65.00 I 8,500.00 Storage r Press T Temp ~ Location METAL CONTAINR-NONDRUM Ambient AmbientlADJACENT TO N ENTRANCE - Conc _I 100.0% Diesel Fuel No.2 Components r; MCP ----r-Guide Moderate 27 02-003 HYDRAULIC OIL ~ Immed Hlth, Delay Hlth Liquid 55 Low GAL CAS #: 112345 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 55 I 55.00 I 500.00 Storage r Press T Temp ~ DRUM/BARREL-METALLIC Ambient Ambient Location - Conc - Components I~ MCP ----r-Guide 100.0% Hydraulic Brake Fluid (Diethylene Glycol MonobulLow I 27 e e 09/12/96 RICKS RECYCLING 215-000-001472 00 - Overall Site Page 4 <D> Notif./Evacuation/Medica1 <1> Agency Notification CALL 911 IN EMERGENCY. <2> Employee Notif./Evacuation VERBAL NOTIFICATION. <3> Public Notif./Evacuation VERBAL NOTIFICATION. <4> Emergency Medical Plan DR. CHRISTIANSEN ON 22ND STREET AND/OR MERCY HOSPITAL. ~ e e 09/12/96 RICKS RECYCLING 215-000-001472 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention MATERIALS ARE STORED IN PROPER CONTAINERS. <2> Release Containment KITTY LITTER. <3> Clean Up USED ABSORBANT MATERIAL IS KEPT IN METAL CONTAINER. <4> Other Resource Activation · e e 09/12/96 RICKS RECYCLING 215-000-001472 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards CUTTING TOURCH <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - N WALL WEND C) WATER - W WALL OF BLDG D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - NW CORNER OF PROPERTY. <4> Building Occupancy Level . . e e 09/12/96 RICKS RECYCLING 215-000-001472 00 - Overall Site Page 7 <G> Training <1> Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: MONTHLY SAFETY MEETINGS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use Rick's .' ~ Recyr;ling, In¿. TED WIESEMAN MANAGER I , 2200 So. Union Avenue (~05) 832-3248 Bakersfield, CA 93307 RC 5874 - ~ " / -1 -'" e e BAKERSFIELD CITY FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN ~\ ~Î -Ì.~Ç? INSTRUCTIONS: 16t\ " 70 avoid further action. reTurn This ferm within 30 days of receipt. IYPE/PRINT ANSWERS IN ENGUSH. Answer The questions below Tor the cusiness as a whole. 3e brief end conc:se as pos.sibie, ~, - SECTION 1: BUSINESS IDENTIFICATION DATA :;~S¡~~ESS NAME: ?~~ *eL(c'l~ :_= C,':',iiON: 2-?-öÐ 0" <JfA.-~cY'- 4uL- roC¡ I 4 '1 d--, ~)G' \~,~\;~~¡\jG ACCRESS: (ì- ~'-'I, ~~ ~- l ( _II:, p \,.I~ :::- ,\ _I =, r7. 710· -..,Ií"\ _.~L.¡I. PHONE: ='~:~ 2;. SRA2Sï~t=¡ NUMBE~: SiC COO::: c5'O<)3 == ','/ N ER: ~cL~ s;<~~, ~^ )~.\+I fK.J.¿ ,= ~ \ ~v\F\RY i; C~;'vf\T'(: , ''':' ' ,,\j ":: ::''-'', ,""' ')::::::' ~ ~QC) " \._.' ~ ¡ 1__1,_'"",-" S. ()V\ l~V\ H ve.... S::C-;-10N 2: ~MERGENCY NOTIFìCAT¡CN: CONTACT -.-, - , ¡ I L:: BUS. PHONE ,..... {¡V~e,.SQ)¡'V\ <4 Y\ ~.r:JQfR..D- (i jS: ¡¡ ,,~14 fI4~tp, , Rè~ u ~ -1-1 £7cfc ¡:a~ :3~J~ ~ -:::r? - S?:f41D 24 HR. PHONE $aS 0é3S'--- b¡;tf - I .2t' 2-. :oaKersrieid i:ïre DeDt. e=razardous Materials Di~sion e HAZARDO US MATERIALS MANAGEMENT PLAN é<Õ SECTtON 3: TRAINtNG: NUMBER OF EMPLOYEES: 3 MATERIAL SAFETY DATA SHEETS ON FILE: yeS BRIEF SUMMARY OF TRAINING PROGRAM: J 1J1()'~ 5~ #it]? SECTION 4: :XEMPTION REQUEST: I C::~TiFY UNCt~ ?E:--JALTY C=F ?=~JURY ~:-1A.ï \1Y 5US¡NESS is EXEMPT FROM THE i~E?ORïfNG~=;:U¡RE:'víENTS OF C:-1APi:::< 6.~5 OF THE "CALIFORNIA HE.ALTH & SA¡:=~Y CeCE' =CR i~= ~CLLCW\NG K::.':',SCNS: ,'/E :C ~~CT :-iANDlE :-i,-\L~,RCCUS MAïë~!AlS. ,1/: :C :~,~.Ì'JCL:: :-iA,ZA,RCCUS \1A TE~¡A,LS, SUT THE 'QUANTITIES AT NO -:,'vl==:<C=== ~~= .'v!lNIMU¡\1 ~=?':)RTìNG QUANTfTlES. =~~=~ ;:~;:=C:~·~ ~E.~SC>~'! SECTION 5: CE~TlF¡CÂT¡ON: !, if/EDOo¡:¿t Yv.)/~sEfV\,NY C~in1FY THP,T THE ,A.BOVE INFOR- MAnON IS ;',C:::.JRA iE. ! UNDERSTAND THi'.T THIS !NFORMATION WILL BE USED TO FULFILL MY ¡::RM'S OBliGATiONS UNCE~ THE'C.;UFCRNIA HEALTH ,A.ND SAFE:f CODE" ON :-LAZARCCUS ìv\AïE~¡ALS (O¡V, 20 C:-i.A.PTER Ó.95 SeC. 25500 ET Al.) AI\jD THAT INACCURATE ¡NFORMA T¡CN CONSTiiUTES PERJURY. QJÍlIlrrt .J) ÆiJ!k . SIGNA TURE ( __lAhJ~J?iL TITLE J- 'I / l6 DATE ..J ~', , , , '\ ... ~ t",j") ......~ .\ e BakersñeldFire Dept. e Hazaràous iYIaterials Division ."..... . HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION i: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELE.'~SE PREVENTION STEPS: (Y\~"A6 ~ 6~ ~ '^- fF<cpofl- c:..o-*A ~.e.cL~ 3. RELE.~SE C8NTAINMENT AND/OR MINIMIZ.~TiON: 'K~ l~~ _______________~ ~ '~, C:~=.~,N-UP ?~CCEc)URES: .~ ~fr\"v"t' ~Al 'r~ \¿'{.?* ~~ ~04\. co~.<:\~V\eR- SECTION S: UTILITY SHUT-OFFS (LCC.~,TiC[\J OF SHUT-OFFS AT YOUR FACiLITY): \'A-r:r\' ~'~'~'"'(''"'''''E' /7'. ~ ~ ,!" I Vi l '\ I~ _ ....::::,~ ~ l ;-"' ~ < ,-,,' í ,~, I \~. t.---b' =~=C~R!C,:",_: A)n~ lAJ\C\.ll lAJE".çr .e~ IV r-\i::~: I. P...c:;'t (,u-Al( b~ b~^~ S:::E<::AL: LOC:< 3CX: '/-~,,@ - .... I ~ I __..... j ,F Y,::S,_CC,\iiCN: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE F¡RE PROTECTION: ~~e- B,O~~¡Sk.e~ B. WATER AVAILABILITY (FIRE HYDRANT): 1'[\N' ~O'tZ.. fI>~ r%t' _ ,'ì , ,,--' , ~ç r , 'J' -. ."' Jja.KerSn~lO. .t1re L-=pt. e Hazardous Materials Division e .. HAZARDOUS. MATERIALS MANAGEMENT PLAN Facility Unit Name:~~ Þef(ct~ SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. .~GeNCY NOTIFICATION PROCeDURES: ~ f\\L '; 1.1. ~ \I\.- e..~~e-lAC..) " ::). =~¡1PLCYE= NOTIFiCAïíCi'J ;',0JO ='./,A,CUATION: \Je..~\ VI. ð'\.:.Qc....c. {~c'^ --- ',-, , ,::; U SlIC ::\/ A C:J A no ¡\J: \J~41 Mo-tmC......'tlÐ-.. -. =:''1E~Gc:\jC'( ,\¡1EJiCAL ,:~,'::"N: ~ è..\.~~ MV\..5.e v\ ?-7- ~ s.+- ft\~~. , ~ =""'U,' ., BAKERSFif:LD-CITY FIRE DE:.rJAR-=l ¥ti~t;NT . OFF~E OF ENVIRONMENTAL SIVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY ¡ I FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] . BUSINESS NAME 'K' or-R<¡ :ßp-<=-)^'\ \<'.:) , FAC:UJY ;\ AME , SiTE ADDRESS :l.Î-e/f) ~. tJ r^-.'--r<. fA C . -r"\/ I I , BA\l.(~~plcl S~ATE CA ZIP , C::'C ----"""'DE i ,--I ~0 I 5cPL3 Rec.¡ ~ ,~ ~ DUN & BRADSTREET NUMBER : ,\ A ïLJ;:::E CF ::USINESS i : CV·INE~¡CF=~A TC R R~d~ l...Jl<.+tcr 1< , I PHONE C, 3 ~ - S-öl{ð IV1AIU~G AC:SESS ~?-OD ~. 0v\.~V\ Au 2._ : r"""'-ý <:2 _\\ r:> I ( ; '-' I I ¡ " ~~L<" \--0Q.~ i ¡ S7,~ ~= CA. Z!P <t 5307 =:ME::1GENCY CONTACTS >JAME \e.b\D~~_c,e.VvvA-""-- ì 2US¡NESS :=~ONE 8~~ - 3$}..4.~ -'-r ~ " ! II ~= rnX\~~ 24-HOUR PHONE (o(ò~ - l2.0L. NAME '\2:'''C:-\.::.. \~ï:~~k ,ISUSINESS FHONE Co:,>?, -SÐ'to TITLE ð LV V'vOI/è.. 24-HOUR PHONE m(c,4 - t"LD 2..; s.cu.-; Q. 1181 AIGICN'I U!PC STAHCAAD F\ BAKERS FJELD CITY FIRE DEPAi.TMENT ,~ HAZAMJOUS MATERIALS INVEN1!eRY ~ ""-.., !;" ,.. ~~e_of_ ,1\\: ~ -,' ~siness Name Address -,'. / CHEMICAL DESCRIPTION '¿¡''::=- . ,~. ~. ~'r/: ". " q IN'ÆNTORY STATUS: N_ ( 1 Addition ( I Reowision ( 1 Deletion ( 1 Check if chemical is . NON TRACE SECRET' t-~ 'TMœ SECRET ( J :) Common NUM: FOFQt'\~ 3) COT iÞ (oPlioMl) Chermcal Nwne: AHM ( 1 CAS iÞ I ~) PHYSICAL & HEALiH PHYSICAL ~ HEAL11i ) HAZARD CATEGORIES Fire ¡..( Reactive I ] Sudden Release 01 Pressure Immediate Health (Acute) ( ) Delayed Health (Chronic) ( J I ! :) WASTE CLASSIFICATION (3-( igit code from DHS Form 8022) USE CODE 3) PHYSICAl STATE Solid [ ¡ uQuid [.-( Gas ( 1 Pure, [..(" Mixture ( ) Waste ( ) RadIo-=tM ( ) ¡ :HfCXJ.U. ¡"AT ÞPJ'!t.., , I ì) AMOUNT AND TIME AT FACIUlY UNITS OF MEASURE ~ 8) STORAGE CODES MUlmum Daily Amount: ~ fII ~~I,) :bs [ ] gaJ (~'!3 a) Container: ~ 9..L{ Average Dally Amount: m,ç't'3 ~unes ! J AnnueJ Amount: ~ 3CÞeoo.ç¡.) b) Pressure: c) Temperature: Largest SizeContamer: , ~;).a Qt~ ~, J, F. M. A. M. I :; Days On Site õ(~'-> Circle 'Nhicn Months: J. J. A. S. O. N.D 3) MIXTURE: ust COMPONENT CAS # %wr AHM I :he three most hazaraous 1) [ I ! C:1emlcaJ components or any AHM components 21 [ J 31 J [ ] '0) Loca%lon pøcd-4 [(L. i ¡' CHEMICAL DESCRIPTION I I . j INVENTORY STATUS: New( ! ,Ideition r 1 "e'Mion f J Deletion ( ! Checic i1 chemical is a NON TRADE SECRET [~ TRACE SECRET [ J ! 21 Common Name: S)~ø 3) DOT # (o )CioneJ) i :~emlcal Narne: AHM { J CAS# t ; I ~1 PHYSICAL & HEALTI1 / PHYSICAL HEAlTIi h~) I -~ , -iAZARD CATEGORIES Fire [, 'ieactlve!] Sueden Release of Pressure ( i Immediate Health (Acute I (J Delayed Health (Chro ' ) ['] , ! 51 WASTE CLASSIFICATION /3-<2iglt coee trom DHS Form 8022} USE CODe / I , :31 PHYSICAL STATE Solid ( 'Jauld [~Gas [ ] Pure [~\Aixture [ J Waste [ J Radioec:tive [ J I -;...,'EOC A.LL "'1..", -'PØf_" ; :-) AMOUNT AND TIME AT FAC:UTY ,'Aaxlmum Oaliy Amount: Average Dallv Amount: AnnueJ Amount: Latgest Size Container: " Davs On Site ,ç < c..~ =::> ~ (D,5' ~c:;S UNITS ::F I,1EASURE ~bs ¡ j ;aJ [Þ"(" ~3 [ :wnes [ ] 8) STORAGE CODES aj Container: b) Pressure: c) Temperature: 1:3 I If I Cirde 'Nhich Months: AU Year. J, F, M. A. M. J. J. A. S. O. N. 0 3) MIXTURE: Ust :he three most hszlllClous C:1emlCal components or any AHM components COMPONENT CAS # %WT' AHM [ J [ J ! 1 ~ } Z) \1:\ )ft una., penlJJty 01 law. enat I nave Qel$OfIlJJiy exam ;mitted informtltion is true, accunrre. and complete. 3) OCumenD. elleve en. -¡ f.l.Ef)J..Y;fT; 'yj /ESE/nAIV INT Name &. Title of Aurhonzea Comøany R.,Qfflsentative <1f:,'~ 0 j) ~-~ ¿~ !'-lG gnature -,' Dat8 ~, ".~ '4, ¡;;'I"\n.~nvru;;....u "'II,' <I! If' rlnl:. ~_;6"I""''''n I rVIL._,,; W . HAZARifUS MATERIALS INVENT~Y Page_of_ :usiness Name Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ I Addition [ ) Revision [ Deletion [ ] 2) Common Name:~pA(,., (.'L:, ð ~ ( Chemical Name: Check if chemical is a NON TRADe SECRET ( TRADE SECRET ( I 3) DOT # (optional) 4) PHYSICAL & HEALTH HAZARD CATEGORIES AHM [ ] CAS # PHYSICAL eactive [) 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 [ ] Pure ~ixture [] Weste [] Radioctive ( ] CHECX ALL THAT APPLY 7) AMOUNT AND TIME AT FACIUTY Maximum Daily Amount: Average Dally Amount: AnnuaJ Amount: Largest Size Container: # Days On Site ~ .z::DI"/ .55" UNITS OF MEASURE Ibs [] gal [~ft3 [ ] curies [ ) 8) STORAGE CODeS a) Container: b) Pressure: c) Temperature: n~ 4 Circle Which Months: All Year. J, F, M, A. M, J, J, A, S, 0, N, 0 9) MIXTURE: Ust the three most hazardous chemical components or any AHM components COMPONENT CAS # %WT AHM [ ] [ ] [ ] 1) 2) 3\ ) 10) location S: New [ Alaition [ ] Revision [ 1 Deletion ( ] Check if chemical is a NON TRADE SECRET [J TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) ChemlcaJ Name: AHM [ ] CAS # ~) PHYSICAL & HEALTH :-iAZARD CATEGORIES Fire [ ] [ I HEALTH Immediate Health (Acute) [] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION USE CODE 5) PHYSICAL STATE Solid r] Liquid [] Gas [ ] Pure [J Mixture [ Waste [ ] Radioactive [ ] ì) AMOUNT AND TIME AT FACIUTY Maximum Oa¡jy Amount: Average Dally Amount: Annual Amount: Largest Size Container: # Days On S,te :ts [ 8) STORAGE CODES a) Container: b) Pressure: C) Temperature: Circle Which Months: S, 0, N. D 9) MIXTURE: Ust :he three most hazardous çnemicaJ components or any AHM components COMPONENT %WT AHM [ ] [ ] ( ] 1) Z) 3\ 10) Location -;erory under pemJJty or law, mar nave personal yexamm ~omltted information is crue, accurate. and complete, i I I el/eve me T {~f f} fìDfLE W ([,/S~ fV\~1J ~~ 'R/NT Name & Title of Authorized Company Representative (~- fìr-'i' Date oa~ 1sga REGIOt v LDC"-NOW) RJW BAKER.IELD CITY FIRE DEP~TMENT" HAZARDOUS MATERIALS INVENTORY ~_< ~ I Page_of_ 3usiness Name Address CHEMICAL DESCRIPTION , 1) INVENTORY STATUS: New [ ) Addition [ ) Revision [ ) Deletion [ ) Check if chemical is a NON TRADE SECRET r J TRACE SECRET r ) ! 2) Common Name: 3) DOT # (optional) , , Chemical Name: AHM r ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ) Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ) Delayed Health (Chronic) r] , 5) WASTE CLASSIFICATION (3·digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ J Uquid [ ) Gas [ ] Pure [ ] Mixture [ ) Waste [ ] Radioactive [ ] , CHECXAti 1H'AT APPU' 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES ¡ Maximum Daily Amount: !bs [ ] gal [ ] f!3 [ ] a) Container. Average Daily Amount: cunes [ ] b) Pressure: AnnuaJ 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 # %wr AHM the three most hazardous 1) [ ] , chemical components or I any AHM components 2\ [ ] ,I I ¡ 3\ [ ] :1 10) Location I CHEMICAL DESCRIPTION I I I I 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ 1 Deletion [ ] Check if chemical is a NON TRADE SECRET [ J TRADE SECRET [ ] I ,I 2) Common Name: 3) DOT # (optionaJ) :i Chemical Name: AHM [,] CAS # :1 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES "ire i ] Reactive [ 1 Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] I 5) WASTE CLASSIFICATION (3-digìt code from DHS Form 8022) USE CODE I I I 6) PHYSICAL STATE Solid [ j Liquid [ I Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] I ~J-.ECX AU ;¡"'A-T A.PPl" I 7) A,MOUNT AND TIME AT FACIUTf UNITS OF MEASURE 8) STORAGE CODES Maximum Dallv Amount: Ibs [ 1 gaJ [ ] 113 [ ] a) Container: , Average Dally Amount: cunes [ ] b) Pressure: ¡ Annual Amount: c) Temperature: ¡ Largest Size Container: I # Days On Site Circle Which Months: All Year, J. F, M, A, M, J, J, A, S, 0, N, 0 9) MIXTURE: Ust COMPONENT CAS # %wr AHM the three most hazardous 1) [ ] chemicaJ components or any AHM components 2\ [ ] , ! [ ] ¡ 31 I 10) Location certIfy under penalty of law, that I nave personally examined and am fam/llar w/t11 t11e mfomaDon submitted on thIS and all attached documents. I believe the 3ubmitted information is true, accurate, and complete. PRINT Name & Titfe ä Authorized Comoany Representative Signature Dale