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HomeMy WebLinkAboutBUSINESS PLAN 8/22/2003 Per it to Operil.te Permit ID #:: 015-000-001470 JIMMYS BODY SHOP LOCATION: 2020 S UNION AVE Hazardous Materials/Hazardous Waste Unified Permit ~ CONDITIONS OF ,PERMIT ON REVERSE SIDE Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Approved by: Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: This oennlt Is Issued for the following: i1 Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Issue Date Issued by: June 30, 2003 Pernait to Operil.te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: , !:itlª~élrdous Materials Plan round Storage of Hazardous Materials agement Program Waste 2020 S UNION PERMIT ID# 015-021.Q01470 JIMMYS BODY SHOP LOCATION Issued by: 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 Servi es Approved by: Expiration Date: June 30, 2000 )0 "_"(" _... -I ~". ,.. HMi¡P _ n ..PLAN . lVlA.P ~~ Business ACcress: .~y"V1 ~;'.s 9-ó~ <i FACILITY DIAGRAM ß~ ßL6{" /'~ SITE DIAGRAM Business Name: L..f '^- .~ '" ,Ä (1 e-- For Office Use Onlv Insoec~jon Station: ~t\ ~ Area Meo it l 7. iii ot l~t.t NORTH 0 --- Firsr In Starion: 5 ~ 1· ""\; ~.1 <;, ;! . '" <., J ~ Q ~ ~ cf1 _ 1. - ~~:p ..y~ .,,' ( \ ðr:.t~C.e. 1'1- \ s ~ 78 :.1 \.'0 ~ ~ ~ S J] & ~ ' !!J \ 1. 1,. 1'2. -- ....""-:... 'UNIFIED PROGRArASPECTION CHECKLIST. SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 ", -¥-s.~~Q.J V' ~5-h-d-~-,--,--------------,---.. ADDRESS -,---- -l, o'Z 0 S - C/f /1. " 0 ~,____________, FAC\lITYCONTACT INSPECTION DAT~ Y--2?-Ö> PHONE No, -'-~' Business ID Number _'__m_'_'__,~, 15-021- 00 J'-I7D Section 1: Business Plan and Inventory Program JrRoutine o Combined D Joint Agency o Multi-Agency D Complaint ORe-inspection C V ( C=Compliance ) V=Violation OPERATION COMMENTS (}'C 0 ApPROPRIATE PERMIT ON HAND -~~---~-_.~--~._._----~-~------------ ._._._--_._-----~ ~----------------_.,------_.,-_.__._-_._---_._.,-------.--,--.--.--.---- "0 K'D 'l(D BUSINESS PLAN CONTACT INFORMATION ACCURATE ______~_____ ___..___. _.__._______.____.._.. ___._.________.___. __...____'.~__.__._,_" _______~__.___.____ n_..__.._._..m_____.*.._·.,.__._____.~_ VISIBLE ADDRESS ____.___...________._______.___..__... ...__. _ ..u_>_______ __~___._.. ___.______.____.__.______.__.___ __ __~,___.'_'__'.'_._...____~ CORRECT OCCUPANCY ._-----~-----~-_._-_.__.._._-_._- ---_..._.__.__._--_.._._._.._------_.._..._--_._,--~---.__.__.----------.....~._---_...- ~ D VERIFICATION OF INVENTORY MATERIALS ~._---------_._---_.__._,- .--- ~"~---_.. -.----.-.- ----------._-_._~._------~.._---_.__._--- --.-.'--- .-. -.., - --- ~ 0__ VERIFICATION OF QUANTITIES ~ D VERIFICATION OF LOCATION ""¥:. D PROPER SEGREGATION OF ~ATERI~~__,_______,______..__.__~_________,_,_ ..__~,__._______,__ _____,___,~__..'_~ Ii[ D VERIFICATION OF MSDS AVAILABILlTYE ----------------------.---..----.. .-.---...-- ---~-.--.- .-.----.----.~--....--.------------.----~~~.--------..- 1f., D VERIFICATION OF HAT MAT TRAINING ..-.--.--.------....-.-- -_._----------_._---.._,._-_._---+--------_._._.__._-~.--.----- .---.-- .....-. -.-------------.---.--- ----_.__._-_._-_._----_._--_._-----~--,--_._--_.._-_.- -----_._--_._-~~-,---- ._-~--_.._-----~._-----,_._._------_.__.~--- --.---.-----.--.-.----- D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES -.-.---------..-.---- ------.--.----.--.-----,---..----------. ----..--""-"'-.--.--.--.-- D EMERGENCY PROCEDURES ADEQUATE -----------------._-------~---~._----_._-------- ---,----_._--_...,_._----~----_..._-----_._._---_._- .---,-.-------.---.-- -..--- ______________.___.____._______.___ e··___·_._. .________._________~_____.__,_____._,___.___________.______.______.______ D HOUSEKEEPING ._-----,--~ - ------_..__._----_._--_._-----------_.~-----_._-_._-----. D FIRE PROTECTION ._-_._._-------~--_._---- -------------~._.._-_._-,------_._,--_.._-_._..- ._~_.---------- D SITE DIAGRAM ADEQUATE & ON HAND ~ ~~ / ~ d/VðfA-/ ANY HAZARDOUS WASTE ON SITE?: o YES o No 1.17 'r-:.~'u" c:: , .. ~ I 0-/ F7 f';';" {",---- 6_'5 ~ f (i ' EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 LÆ Business --L2/1~ --------,..-H -Z_~,__ l r ' Inspector Badge No, 01/- .---- . ' ite Responsible Party White· Environmental Services Yellow· Station Copy Pink - Business Copy 5G þ e e (}:) JIMMYS BODY SHOP SiteID: 015-021-001470 Manager : Location: 2020 S UNION AVE City BAKERSFIELD CommCode: BAKERSFIELD STATION 05 EPA Numb: CAL000162880 BusPhone: Map : 124 Grid: 08C (805) 398-3125 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:7532 DunnBrad: Emergency Contact / Title Emergency Contact / Title MICHELLE ERICKSON / RELATIVE JIMMIE ENRIQUEZ / OWNER Business Phone: ( ) - x Business Phone: (805) 398-3125x 24-Hour Phone : (805) 396-9689x 24-Hour Phone : (805) 397-1738x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: 2020 S UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Owner JIMMY ENRIQUEZ Phone: (805) 398-3125x Address : 2020 S UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: f= Hazmat Inventory f== Alphabetical Order One Unified List 9 All Materials at Site 9 SpecHaz EPA Hazards DailyMax MCP F P IH G 352.00 FT3 Hi F P IH G 2016.00 FT3 Min F IH DH G 440.00 FT3 Low Hazmat Common Name... ACETYLENE ARGON OXYGEN ~, ~'I':f- [/vtt-IõufL[))@ Û'U®m©v ©®rríti~ ~~~ ij Û'UIZM® (Yy~ @r¡Jfint MfIIQ) r®\fi®Wê©1 ~h® lSì~ch~©1 Û'U®:f:@lf©1@~@ [ijj1®~®rro®ij~ úVù@Uì®~®- ~--I5 &~ S'¿þ/ ITi<3Uì'i p!tãlfi ~©«' ®~©1 ~~®~ i~ @ij@~ _Û'U (~~~ lZflli!cbJeœ) ~ú1V ©@H'Y®d~@ú1~ OOú1$S~~~~~® @ OOm¡9J~®~® wru©1 OOIT®©l m@úl)9 @l~®[ijj1®~~ ~ij®~ ~@Ií rn1V ~~©iijij\t11o 10/31/2002 ¡, e e SiteID: 015-021-001470 ì Facility Unit: Mobile Containers at Site 9 F JIMMYS BODY SHOP f= Inventory Item 0002 == COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit PORTABLE Map: Grid: CAS# 74-86-2 - TYPE Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 352.00 FT3 Daily Average 352.00 FT3 HAZARDOUS COMPONENTS ~ Yes CAS# 748621 I l~~~öoIAcetYlene 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 == COMMON NAME / CHEMICAL NAME ARGON Facility Unit: Mobile Containers at Site ì Days On Site 365 Location within this Facility Unit PORTABLE Map: Grid: CAS# 7440-37-1 - TYPE Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 2016.00 FT3 Daily Average 2016.00 FT3 HAZARDOUS COMPONENTS ~ CAS # I 7440371 I l~~~öoIArgOn HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -2- 10/31/2002 e e SiteID: 015-021-001470 9 Facility Unit: Mobile Containers at Site 9 F JIMMYS BODY SHOP f= Inventory Item 0001 ¡::= COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit PORTABLE Map: 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 440.00 FT3 Daily Average 440.00 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- 10/31/2002 e e SiteID: 015-021-001470 ì Fast Format 9 Overall Site 9 05/01/1996 F JIMMYS BODY SHOP I f= Notif./Evacuation/Medical Agency Notification CALL 911 IN EMERGENCY. CALL BAKERSFIELD FIRE DEPT, OFFICE OF ENVIRONMENTAL SERVICES WITH HAZ WASTE INCIDENT. r=:: Employee Notif./Evacuation VERBAL NOTIFICATION. Public Notif./Evacuation 05/01/1996 1 05/01/1996 PUBLIC ONLY USES WAITING ROOM AREA, OR IS ESCORTED THROUGH WORK AREAS. Emergency Medical Plan 05/01/1996 ] MERCY HOSPITAL & KMC. -4- 10/31/2002 e e SiteID: 015-021-001470 ì Fast Format ì Overall Site ì 05/01/19961 05/01/1996 F JIMMYS BODY SHOP I f= Mitigation/Prevent/Abatemt ~ Release Prevention ~BSORBANT MATERIAL. Release Containment LIQUID SOLVENT IS STORED IN METAL CONTAINERS PROVIDED BY THE SUPPLIER, AND IS RECYCLED. Clean Up 05/01/19961 I ABSORBANT MATERIAL. Other Resource Activation -5- 10/31/2002 e e SiteID: 015-021-001470 9 Fast Format 9 Overall Site 9 I F JIMMYS BODY SHOP I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs A) GAS - NW CORNER OF BLDG B) ELECTRICAL - INSIDE W WALL TO RIGHT OF DOOR C) WATER - NW CORNER OF BLDG D) SPECIAL - SPENT SOLVENT OUTSIDE OF PAINT BOOTH E) LOCK BOX - NO 05/01/1996 Fire Protec./Avail. Water 05/01/1996 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS NEAREST FIRE HYDRANT - 200 YDS. ON THE SE CORNER OF WATTS AND S UNION. Building Occupancy Level -6- 10/31/2002 · . . ~ e e SiteID: 015-021-001470 ì Fast Format ì Overall Site ì 05/01/1996 F JIMMYS BODY SHOP I F Training Employee Training WE HAVE 3 EMPLOYEES AT THIS FACILITY. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY MEETINGS TWICE MONTHLY. Page 2 [ I I Held for Future Use Held for Future Use -7- 10/31/2002 e - CITY OF BAKERSFIEIJD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd F'loor, Bakersfield, CA 93301 s+ÞP FACILITY NAME .j l MM ~ 5 BoO ~ INSPECTION DATE b ......2.7·- O'L ADDRESS '2.ð2-0 ç! lÅ¡.J I üÑ- PHONE NO. 3<=Jg-3/1'Lb" FACILITY CONTACT .J ¡"~'\I\Mi ê}.l¡QlW'L'lBUSINESS ID NO. 15-210- öð ,t..to..m INSPECTION TIME 2..ð 1411'/. NUMBER OF EMPLOYEES ctSf Section I: ¿ROUtine Business Plan and Inventory Program o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C I/V COMMENTS Appropriate permit on hand 1/ Business plan contact information accurate 1/ Visible address .I Correct occupancy ,/ Veri fication of inventory materials ;' Verification of quantities I Verification of location / / Proper segregation of material /1 Verification of MSDS availability / ( tle& It-c1.rrV L£N£. fÚ.~J6 Verification of Haz Mat training I Verification of abatement supplies and procedures / Emergency procedures adequate I Containers properly labeled j Housekeeping / Fire Protection / Site Diagram Adequate & On Hand / C=Complíance V=Violation Any hazardous waste on site?: Explain: DYes ~o White - Env, Svcs, Yellow - Station Copy Pink· Business Copy Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 C&h {J¡J DEC-18-87 FRI 12:09 CITY OF BKFLD WW DIV e FAX NO. 805 835 0912 e P,OI CITY OF BAKERSFIELD CALIFORNIA PUBLIC WORKS DEPARTMENT W ASTEW A TER DIVISION FAX PHONE NO. (80S) 835-0912 TELECOPIER MESSAGE DATE DEL. /9 _ 19 ~ 7 PLEASE ROUTE AS SOON AS POSSmLE TO: NAME: --1::l11~ '0 ,~S COMPANY/ORGANIZATION: BJ ).tW,J~c;AJ~ Jëi!.N. GE-S FAX NO. SENDING MESSAGE TO: (80S) .- ". '" .-. , . ." "... ..... 3Z/, - 0S7 ~ FROM: NAME: l-A14 ~NM OFFICE PHONE NO.: S2+P- 3UQ DEPT. CODE (3 DIGIT SUBPROGRAM#): NUMBER OF PAGES (INCLUDING COVER SHEET): SPECIAL INSTRUCTIONS: ~tHEfj ~: @ CD ,j 1M-MY 's S;ðy SIJDf l.d45n: /t44IJ / ~, ® L ~G, I AJC- (¡:~£ .rf~vQ, ') ~()~. /Œff1.{ £UELc'~ ,It Fe::, S'A-tO YoJ LNJ 1'2Et¡.Jrl'€q- AJJ'/ Tit¡ E 1 ~ E!ilfiL,r¡1).f I/ÚG · S iXJ¡J£ 1 ~ 8c ~ S LvD6i? i.£:.& tJ c:¡r - " S -HCcJLO fl£.t'Æ~ &.E AN 'In kr; . 8101 ASHE ROAD BAKERSFIELD, CA 93313 UI\Vo'W1'NtWP DEC-19-91 FRI 12:10 ;;10'0 ui (ol¡!o,n,o-En."onmon,al P'ol.CI'On Ago",1' e '7 ~<) 1 '5 - 4 1 ~..'m "ppl"..d OMð No, 20S0-o0J'i' (hpi,.. 9'~O'9~) P\ea~. ¡.';f\f\! Qt' type, 101m drfls.iql1ec/ fot 1.1.1. g" _Ii,. ( Z·pirchl rYJ1Cfw,iJ.r CITY OF BKFLD WW DIV FAX NO. ~Q?j.~5..jJm.2~~_____.i._O~__~_.__ See 'n~truc;tions on bo,k.?oge 6. 0 ""' ""' ... N ... ~ g ~ ~ -J ..; c{ v (¡ . r< ."¿ ~ ::< ....,v ''2: -= ~ G N E 0 N <:0 E co ""I' R N A 'ot 6 T 0 0 ~ R Q; w ... Z .... v w V'¡ Z 0 ... VI W /;:t; ... <! Z 0 ;::. < Z \I. x: .... .J c( ..) -' ... ;:: I) -.; ) ) 7 oJ , ( ~ DepClrtmont Qr 10.(..:: Suo\tC('~'d\ Ç~tllr,~~ Sa<:rClmcrt.!Q, (QI,'OUho. UNIFORM HAZARDOUS WASTE MANIFEST \, InfQrm.at¡oo in the ).nod"d OtOQ~ 1 ¡, "(II 'eql,, :j~, i)y f.c;t"(QI fc.... 1 G.n.roto( L NQm. and ""'0;1;"9 Add'reu ?020 S UNION 9AKERSr~E:L.D 4 Go,..o'o" P~Q". ( EO:l ")q~-,112~\ ~ T tQn 'pqtl.l 1 Compc:u~)' Name SArEr~~~Lf.EN COk? 7, T,Q,"PO"., 2 Ç_pon~ Nom. 9, C"'q::ot.d 'Q';¡:'1 Nom. and Sit. Add,... ' SAFETY-KLEEN CORP. 10625 H1C~$ON ST, UNIT A EL ~ONTE $ CA 917~1 , " uS DOT Þ..<riptìon (including P'op./ Shippin\! Nom.. HQ~C>'" CI"... 0"" ID N...mb.rI o. WASTE PAINT ~E~ATED HATERIAL ~ UN12~3 PG IICFOOS. F003.D001.000a.001S DO¿2.Dö28.01 35. 0039. D010) (ERGj121}!.:2¡IG b, , ~s..r£~~~~.P...:~Á:¡£fUAL~ :) 'tJNT~:r"""F1; 11 (. ,,«:!!. ~"!!.3:"'I.I;Qri+...Ð:~~Oða+ < O()"tS";"r:~~5îtJU3"t, {)O·U)~-£~C'" ?1-~ H~jL (, d. 15. Sp.cial Ho...dling In,'r,,(tion. ond ...dditionollnlornlOlic>n EMERGEN(.Y RESp-.aOO-46S-17bO 24HR I-A D039 A: 10077 8: 10078 C; D: ,.- ~. A!;; N~~ 16, GE~UATOR'S C~.TIJIC"'TlCN: 11.."\:'7 .,I.cI",. ~"'" ,h. conl,n', 01 p¡'i. c"n.ignmonl cia fully and oc<o,o'ol7 d.",¡bed obo~. b~ prop« shippln; nom. and or. c1a..ili.d, loch". ma,l..d, a"ð 10b.l.d, a"d Qr. in all ',.p.cr. :.n ¡¡<Op.' condition for t","lpo,t by höQhwoy occQ(ding '" op¡¡lkablo in'o/no'ional .....d na'ional go~.tnm,n! '''1Iulalion" 1/ , om 0 lorgo quonti", g_no'Q!ot, I c,rliFy Ihall 1.0.. a p""9,om in pia.. Po ,od.,. ,h. volume ond IQ~i'¡1T of "'Q$I. g.n.tQI.d 10 ,h, <;I'g'.. I hovo d.'.'III;no<l 10 b. ..'no...i,01l7 ptQ~t'cQbICl: Qr\d 1\'01 , hQv. ).1.,).0 the p'rocti(obt. m.)~ò<f oJ t,oc_"".tI), stOlQ¡.. or dhpo:aol ev(("nil, ovaitob , ro me ......hi,h min'mj,;.$ the pres8nJ ,Qnd iutvn threat to hutnan heQhh ""d the ðtlV 'Onmont; O~. if I QJT'I QI W'ftolf quon'ity ¡."eroror, hove mad. (J good fI'Jith .'fort 10 Mi"imizQ WIT -osfo g'8.l\uolion o.l'\d seJect the best ....qit. m'3na':)4tl'\"'" mc.thQ.d. .hot ;~ ovo;IQol. fo mo ond ,hal I COn offQ,d, Ptin~!T7P.d Na",o ...... ~ ( I A <: I L I T .,. \ 9, bi'ct.pon"" Ind;'otion Spo,. ",caticf'll 1:1' r..-:.¡ , 01 J..cr,crrøOUI Mbl<lriO" (O't'.f.J b .his mQII'\;IIII5t CI.x<1It , QJ. fLored in t!em I~, S:gnallJ,. DO NOT WRITE BELOW THIS LINE. '$C eQn" "/97) ... aìoo-n '1',110...., GENE~... T(')Q g~t "IN" ~...... -~........,_..... ~-:::~ " ~ -~ FREE ESTIMATES rPICK-UP & DELIVERYl 398·3125 <'~~~~', . ,'·ft>,"'.:·,'" _ - ~ _ +;¡,: JŒf\!!MßIE: ~I\'JIPJß¡Q)ILU~¿: 2020 S. UNGiON AVE. · BAKERSFIELD ~.....~-~-.... ,~..,..,-, - 'C '-'¡¡" 'I BAKERI=IELC·CITY FIRE DEPtRTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN ~~;;..:J- ~~s.-- INSTRUCTIONS: 2. ~ ..;, , -, ~7~ ) ) ~o avoid fUrTher action. reTurn :his form within 30 days of receiot. iYPE/PRINi ANSWERS IN ~NGL:Sè-i, Answer ~he cuestions below fer ~he ousiness cs a whole. 3e bnef and concise as oossib!e. F(tq I L(7() r <'~, -(t-é- L-.. L V..\/ .; SECTION 1: 3USINESS IDENTIFICATION DATA 3USiNcSS NAME: "S~\M-"""'i~ ßl)J..) 5kD? ¡ ,~"... '-¡ON' '__'_1-\\\ . ~b".l..D $. u""'S-O....... p.u,e..._ I\';A;~:~JG ,;::: RESS: S A-Y'Y\..e, c:-;-'/: ßp.k~~~øJ. S~A,ï=: ~~ ZiP: q~:Y>7 PHONE: 39B-ßl~ =~!~< & :::(,~\=~;~==¡ :JU¡v16ë~: SiC C80::: 75 ~:l. ,=I~¡,'vî;:\~Y .':'\,::~;\/:T'(: A~\(h br-Àl, ~~ p¿. I :: \// N::;<: - ~.. "- \~,e '-., ~f'\.rz.\'1 ve '2- '. ,~:... ' '\J "::. :... ~ ~. ':; = :: -::: ' ;J. ():::;2..l) C'" .t., ,....... \.::: , ,~_ "__....... --....:;), (..) ""'-- ... t. ) '-"I S:::C-:-¡ON:?: ::MERGENCY NOTiFICATION: CC~ïAC~ 24 HR, PHONE ~:T¡_= 3US. ?~ONE 1, m~è.lel(a Fe,èk~Y\ ~~~ 83~8()91 ') )\. '-- F;'-- . . """ ""-,, .e --- '^- e.t t I )~ z.. 318 ~ l2\ <:'1 7 - 17 ""?B 6/Af /I\......~ baKersneJ.Cl l;lre DeDt. eazaràous Materials Di~sion e HAZARDOUS MATERIALS MANAGEMENT PLAN ,. ~.!... r SECTION 3: TRAINING: NUMBER OF EMPLOYEES: :3 MATERIAL SAFEìY DATA SHEETS ON FILE: yt::-S BRIEF SUMMARY OF TRAINING PROGRAM: S A{'~'t-7 .;IA ~.ei~~ +w "c€. ~o'^'~~ SECTrCN 4: :XEMPTION REQUEST: : C:::~T¡FY UNCE~ ?~NAL¡'( CF ?Ei<';CRY -:-::-i,4.ï\1Y 3USiNESS IS EXEMPT FROM THE ,~E~CRT[NG ~=;:U¡RE:víENTS CF C:~APE:< 6.95 OF ïHE'CALlFORNIA HEf~,lTH & SAi=:::Y C:::C::' =C~ ih:: :=CLLCWING K=.:',SCNS: :r¿ : j ~Cï :~,~NDL= ',~¡\L":,,RCC US MA ïë~!ALS. ,\í: :C :~,":',Ì'¡CL= :~A,Z.":',;\C:::LJS (¡1ATEKíA,lS, SUT ¡HE QUANTíTiES AT NO -'~¡\==:<C:::::c: :r:: ~¡\lÌ'l!MUÌ\\ ,~::~C>~ïiNG ;:UANTITIES. =7:~=~ (~;:=':::;:.'( ~~.~5C>~'J SEC-:-!ON 5: CE:<T1F¡CAT¡ON: !, :S:~JÑ\ ~o E^~~f"Je'"2-- C::KT1FY TH,AJ THE ,~BOVE INFOR- MATiON IS ,;C:::.JRAíE. ! JNOE~STÂNC ir.?J THIS INFORMAliON WIll BE USED TO ¡:;jl:=iLL MY ~:Kivi'S CBl:GATlCNS UNCE~ ~HE'C:.;UFCRN!A HEALTH AND SAF:::Y CeDE" CN "\'^Rr""'Ir"IIS M'A---¡ALS 'OIV ,~("1 ,......., \ri~-,- , 95 ~-~ 2&:;-"'0"'- AL) 'NO 'HA- l ,~,"".w-'\ L..'-/"'; i IC:'( \'. .::..'''; ""ì}-'\rlc:( a. ~c'--. ....,~u cl ....-'\l I I INACCURAiE ¡NFORMATíON CONSTiTUTES PERJURY. TITLE 3t DATE ;¡ BAKERSFiELD C.TY FiRE DEf-"Aif:-MEi.., f e e OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE, 3RD FLOOR BAKERSFIELD, CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY i FAC:UTY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] 3USiNESS ~AME ~~IA-.;S t30~ ~~1C:. =AC'L'-:-V ~'AME ¡ I.. 1 I i\l I ~, 1\ " ~ " '. SiTE ADDRESS ~D~O ~. C:~ ß~~~ ,a,lð \)"" ~I"II/\ 'PI r )e...,. --,-- C :;11"\1= 4- 'odx; !?-~ .4{~ ZIP C(3:3£)7 , .\JA iL;;:;E CF ::USINESS t:}(A'i-Ò SiC CeDE 7S'3?-. '=UN & 8PADSïREET NUMBER , t'""IIVNE- 'C"""--' ....c,..... ..., , ':""-1 ¡- =:-,r\ I i1 UAIL'''IG \""',.....,.....-'""'..... ,'il H'1'" f"'\t.....w:'i=':::.::J C:ïY ~'-.d.ó-- -r, "-. ~_ LA-'\. "^"'- .-e.- t '- V\ ~l'î( ~;:2.. PHONE 3~-.5L~ 5e.e ~1Ie.- S7A~= (\q ZIP 'i33ð7 =::,'E::1GENCY CONTACTS : ....~AME -S-~"""'-~~ E"'~~tl ~e"2..- I :::UC:'NE~C: =~ONE I _.....1 _..... I , , ! , -;-¡iL:: hvv""'l/2..~ 3£:18 -31~Ç 24-HOUR PHONE 3t::¡'7 - 1:3 B , .AM E m ~~C"klL.e.... f:'-\:..~~ '^ ,I BUSINESS r:HONE s.c.- 31 1S18Z -¡....L- ¡ I = -G- 24-HOUR PHONE ~- ~'L AlGlClNV \.DC STNICAAO...' BAKERSFI£LD CITY FIRE DEPAQiMENT HAZAFlJOUS MATERIALS INVENT!J¡y ~ .~~ "~ ~ge_of_ , II : I, .~ ' ~siness Name Address ,,'. / CHEMICAL DESCRIPTION ~'¡F '...,~ , Check if chemical is . NON TRACE SECRET' ~~ ~ r J 1) INVENTORY STAruS: N_ (I,.( Addition ( I Revision ( I C.letion ( ] :) Common NII'M: 6)(. Y.!Y'JI'\ 3) COT # (oPlioMl) ChemICal Narne: AHM r ) CAS # I l) PHYSICAL. & HEAlTI-f PHYSICAl HEAlTH HAZARD CA TEGOAIES Fire [ I ReactIVe I J Sudden RelelSe of Pressure ( I Immediate Health (Acute) I ) 0e1ayM Health (Chronic) ( ] 1 ':) WASTE CLASSIFlCAT10N (Jo(jigit code from DHS Fonn 8022) use CODe I ! '3) PHYSICAL. STATE [ ] uQuld ( J Gas (~ Pure (~Mixture I I Weste I] i Solid RadIoIIdiw ( J I ;¡.¡ECK AU. -:1-IAT APPl' , , 7) AMOUNT AND T1ME AT FACIUìY UNITS OF MEASURE 8) STORAGe CODes \4lWmum Daily Amount: :S 4'-tO ~!Þ :bs [ ] ;¡aJ ( ] :'t3[~ a) Container: ,~ Average Daily Amount: 'i "\.0 .çr~ ;:.mes [ 1 b) Pressure: Annual Amount: ~4V.!t+" c) Temperature: Lf Largest SizeContamer: ",. .~~ 2:2.0~~ ~J.F, :;, Days On Site ~(9C;- Circle Which Months: M. A, M. J. J. A. S. O. N. D 3) MIXTURE: ust COMPONENT CAS # %wr AHM :ne three most hazardous 1) [ J C:1emlcal components or any AHM components 2) [ I 3) ( J . 0) LOca!lon P~R.'t L.o._ I / CHEMICAL DESCRIPTION ') INVENTORY STATUS: ~~ew ( ~ditiOn f 1 "eV1Sion ( ] Deletion r ] Check if chemical is a NON TRADE SECRET [~TRACE SECRET [ ] J :) Common Name: ~¥~~ ~!cRlA .p 3) COT # (optional) i , CnemlcaJ Name: AHM ( ] CAS # ~) PHYSICAL & HEALTIi / PHYSICAL HEAl TI-f , "'iAZ.ARD CATEGORIES F¡re [J "!eactlVe ( I Suoden Release ot P'!!ssure [ : Immediate Health (Acute) [ ] Delayed Health (Chronic) ( ] 5) WASTE CLASSIFICAT10N ,3-<1iglt cooe from DHS Form 80221 USE CODE '2.. 2- I 3) PHYSICAL STATE Solid ( ] 'jould ( ! Gas ¡W-- Pure [~lXture [ ] WlSte [ ] Radioactive [ ] : -..€'::t Au ,",'AT~. y :") AMOUNT AND TIME AT FACIUìY ,',1axlmum Daliy Amount: 3£:'d-. ~~ Average DaJly Amount: ~, AnnuIU Amount: ~ Largest Size ContaJner: 17(e. o..ff- " Davs an Site 3" S 3) MIXTURE: Ust the three most hazaraous C:1emlCaJ components or any AHM CXlmponents UNITS ~F MEASURE '00 ¡ ] ;aJ [I :'13 [k""" ;:.nes ( I 8) STORAGE CODES a) Container: b) Pressure: cj Temperature: öLt 2 '-¡ Circle Whicn Months: I Ye . J, F, 1.1, A, M. J. J. A. S. O. N. D COMPONENT CAS # '" WT . AHM [ I [ I [ J 1) 2) 31 i 0) Locaùon 'ff} unaer penlUty t law. U7at I nave psrsonaJly eumtnfJO ana am familial WIU7 U7e IntomlJDOn suomI ;mitted information is tTus, aCCUfIItIt, and compis". :..J ¡ /h--! /'; Z- , 1./1' L.- INT Name'" Title of AutI70nzea Comoanv ReOl1ls8 tativ. · '.~o#- CAf\..:.n~rU::'LU \-'11' T r-U1t:. Ut::.~AH IIVwib.N I HAZAWOUS MATERIALS INVEN.V Page_of_ 3usìness Name Address / CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New I J Addition I J Revision I ) Deletion I J Check if chemical is a NON TRADE SECRET Iv( TRADE SECRET I ) Chemical Name: ,q ~ 3) DOT # (optional) AHM [ ] CAS # 2) Common Name: 4) PHYSICAL & HEALTH HAZARD CATEGORIES PHYSICAL Fire ~active [J Sudden Release of Pressure ~ HEALTH Immediate Health (Acute) I) Delayed Health (Chronic) I J 5) WASTE CLASSIFICAJI0~ ,..-' (3·digit code from DHS Form 8022) USE CODE Pure I ~re I) Waste I) Radioective ( J 6) PHYSICAL STATE Solid I J Uquid I) Gasl~ O1'ECKAU. THAT APPlY' 7) AMOUNT AND TIME AT FACIUTY Maximum D8Jly Amount: Average D8J1y Amount: Annual Amount: Largest Size Container: # Days On Site UNITS OF MEASURE 3::3'=>)( to ~d-O\~lbs [ ] gaJ [] 113 ~ curies [ I ~ ~ Ccc-#(oQs:. 8) STORAGE CODES a) Container: b) Pressure: c) Temperature: Circle Which Months: AU Year, J, F, M. A. M, J. J. A. S. O. N, D 9) MIXTURE: Ust the three most hazardous chemical components or aI1.y AHM components COMPONENT CAS # %WT AHM I I [ I [ I 1) 2) 31 ----- 1 Q) Location .------------- ----' CHEMIC-A1;-Ðf-SCRÎ PTION 1) ,NVENTORY STATUS: New [..(Âddition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET 1.(' TRADE SECRET [] I 2) Common Name: ,~~ S~'+ ~Ivevv+ 3) DOT # (optionaJ) ChemlcaJ Name: AHM [ ] CAS# ~) PHYSICAL & HEALTH "AZARD CATEGORIES PHYSICAL Fire [..(" Reactive (] Sudden Release of Pressure [ I HEALTH Immediate Hearth (Acute) [] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION ~ ~Lj (3-digit code from DHS Form 8022) USE CODE 08 5) PHYSICAL STATE Solid [] liquid [6!"" Gas [ ] Pure [toY''Mixture [ Waste [] Radioactive I ] ;¡,iCJ< ~ -;1.;,U A.PPl Y ì) AMOUNT AND TIME AT FAC/UTY ~-' - ,\ ~.1a:otlmum Dailv Amount: 1"\1 ! Average Dally Amount: - , ,/ A.nnual Amount: ~ Largest Size Container: :/ Days On S,te UNITS OF MEASURE bs [ ì gaJ [K 1t3 [ ] cunes [ ] 8) STORAGE CODeS a) Contaíner: b) Pressure: c) Temperature: l~ 4 '1 CirCle Which Months: Ie, J, F, M, A, M, J, J, A, S, 0, N, D 9) MIXTURE: Ust :he three most hazardous c:-:emlcaJ components or any AHM components COMPONENT CAS # %wr AHM [ J I] [ ] 1) 2) J) 10) Location N ~.....-3Q 1aiit2 ::...,..... ,.--'"'. BAKERS~LD CITY FIRE DEPAeTMENT HAZARDOUS MATERIALS INVENTORY Page_of_ 3usiness Name Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New ( ] Addition ( ] Revision ( ] Deletion ( ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) Chemica! Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ I Reactive ( ] Sudden Release 01 Pressure [ ] Immediate Health (Acute) ( ] Delayed Health (Chronic) ( ] : I 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid ( ] Liquid [ ] Gas ( ] Pure [ ] Mixture [ ] Waste [ ] Radioactive ( ] O1EO<AlL TUAT APR.' 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES I Maximum Daily Amount: 100 [ ] gal [ ] ft3 [ ] a) Container. I Average Daily Amount: cunes [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size 'Container: # Days On Site Circle Which Months: All Year, J, F, M, A. M, J. J. A, S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) ( ] cnemlca! components or I any AHM components 2) ( ] 3) [ ] I I 10) Location . I , CHEMICAL DESCRIPTION I I ¡ j I i 1) INVENTORY STATUS: New [ ] Addition [ ] Revision { ] Deletion ( ) Check if chemica! is a NON TRADE SECRET [ ] TRADE SECRET [ ] I I , I ,I 2) Common Name: 3) DOT # (optional) I I I I ChemlcaJ Name: AHM [ ] CAS # I I 4) PHYSICAL & HEALTH PHYSICAL HEALTH I HAZARD CATEGORIES Fire [ ] Reactive ( 1 Sudden Release of Pressure [ ] Immediate Health (Acute) [ I Delayed Health (Chronic) [ ] ! I 5) WASTE CLASSIFICATION (3-diglt code from DHS Form 8022) USE CODE I I I I 6) PHYSICAL STATE Solid ( ì Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive ( ] I -.'-<E(,J( AU ;>.Af APPly , I i I 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES ,I Maximum Daily Amount: Ibs [ ] gal [ ] ft3 [ ] a) Container: Average Oally Amount: cunes ( ] b) Pressure: I Annual Amount: c) Temperature: ; Largest Size Container: # Days On Site Circle Which Months: All Year, J, F, M, A, M, J, J. A. S, 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) [ ] chemica! components or any AHM components 2) [ ] , 31 [ I I I 10) Location ! certJry under penalty or law. ttJat I nave personaily exammed and am ramlllar Wlrf me mromaDon submitted on mls ana all attacned aocuments. Joel/eve me submitted informatÍon is true, accurate, and complete. PRINT Name & Title c' Authorized Company Representative Signature Date .; .... . e Bakersñeld Fire Dept. tit Hazaràous Materials Division ~.. . -) --. "..... .. HAZARDOUS MATERIALS MANAGEMENT PLAN SECT10N ì: MIT1GATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STE?S: A~56e b -AlA.. i- ýV\*i-Q~.\.+' /~ :). :'<ELE,A.SE,CGNTAlNMENT AND/OR M!NIMIZATION: .g, líf.utb. ~"e",-+(k'VV'A6t~ ~5 :?fvl''''¿ }" ~ r'\A~l CÐ<-!f"'~""'f$ f~\L~ ~1 ~ S~ îl(e~~ ~0 ~5 ~eLYL.l~ ...-- -' , C:~::..).,N-UP °RCCECJUR::S: ~\,>6R.6 4"'"'- +- vlA.A-~(lj~\ Sé:CT¡CN 3: UTILITY SHUT-OFFS ~:_CC,':,TIOÎ\ OF SHUT-OFFS AT YOUR FACILITY): \V\TUR,~,l2AS¡?RCPÞ,I\JE: ~ Albtê-~ \t.Jes'+ Gte.. ;i1 ~~ =~=C~~!C¡:\~: ¡""-s"I~ f£ID We~'f Lu-A(( 'io r2-l,:::!/'\~i- ;P d~~ .'/,~,i=:::: N w c..o~ ð~ ~~ SrEC:,';L: ~ 5/~+ 8t:>\uevt..t- I)t,tis~ A~ f>'4lA.-'t ~~ "'--'C'/ :::...--V, 'I=::::~ffó) -'--'; I....... .....\.-/\. ¡ -"'-"C/ ¡:: 'j:: S, _ C C ,-:" ¡¡ 0 N : SEC-:-ION 9: PRIVATE FIRE PRCTEC-:-¡ON/WATER A V AILABILlTY: B. ?RIVATE FIRE PROTECTiON: ,boOJ.rq.~/ce. ~'€. ex:..i- "~ ~s ~~5 5&" ~ WATER AVA¡LAB[UTY (FiRE HYDRANT): J.O'D y~ N~fy / c.()~ b\' w.,c::r71-s'_ <S. ÙV\..-v"I:>VV ~ A. -. {. ~'-. .-' DaKerSne1.G. ..:'lre lJcot. . - e1-Iazardous Materials Division e __ ... I .._ HAZARDOUS. MATERIALS MANAGEMENT PLAN -t "..-;? ( /"1 . Facility Unit Name: ), Y1Av'Vi I't:~ PtJ~1 :::>"v')p SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES: A. AGeNCY NOTIFICATION PROCEDURES: c.. .pJ.l 9 l t ~V\. -'2. ~.¿ ~ e......c. y C-AL( &kQ~'-.e((l Ree. Deþi- I ~Le ¡:; ~\L~eoVl~.e~~,A ( Suc.,s l...t?:~ ~ ~ ~ Z. >4 '<' C lo k. S 14.) ¡q <:;+.e f'-1. C. ,'cS '4L ..........'1- ~ =~¡1P~SY== Ì'JOTIFiCAïICN AND :;"/þ,CUAïION: \i~6A\ V\..Ð--+-~.ç~L'¿¡ -{ ,lOV\. ~U3L:C ='/AC'JAïiCN: -Rve\c.U--e- øvvly ~~ \JJð......4-,I...^"S ~o vv.... A~-Q...c::¡ l D~ <....5 eSC.o~i--~ ~~~ ~elc- 14\t.<Q-AS -\ -.J . =:\¡i=~G=~jC'( :V1EJiCAI.. ?~.~N: (he'ky ~?pt+4l I -kmc... ~ :""\11:..-