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HomeMy WebLinkAboutBUSINESS PLAN ~' ,",' . 'f··¡.~'Op,erate Materials/Hazardous Waste Unified Permit " Hazardous ~ CONDITIONS OF :PERMIT ON REVERSE SIDE It! Hazardous Materials Plan o Underground Storage of Hazardous MaterIals o Risk Management Program o Hazardous Waste On-Site Treatment , . Permit ID #:: 015-000-000184 N B REPAIR SERVICE LOCATION: 1610 S UNION AVE Approved by: Issue Date Expiration Date: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Issued by: Operate to ~..;<c~____"...__~,._~. Per... it Waste Unified Permit Materials/Hazardous Hazardous CONDITIONS OF PERMIT ON REVERSE SIDE This ermit is issued for the followin ::tIªµrdous Materials Plan '.'. ."", ¡round Storage of Hazardous Materials lagement Program Waste PERMIT ID# 01S-021.Q00184 N B REPAIR SERVICE UNION s 1610 lOCATION ...,-- ~^ ...--- Approved by: Exnir~¡tinn n"t..· Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Issued by: i)- ',' "'" J- .:J.(' '. ~ -, _..~'~"""",-,_ . \ !'- .. .......¡;.. . . .. IbID s:' UJVìð¡1 SITE/FACILITY D'AGRAM # /?¿¡ FORM 5 I !vS(/ 5 NORTH SCALE: BUSINESS NAME:N. ß. \<..E<\>A-IR <SêRV(éE' FLOOR: \ O~ r \ DATE: :~ ,I ~ ,I~~7 FACILITY NAi'ifE:O t- F \ (£ + S \-\ 0 'V UNIT :;: \ OF \ (CHECK ONE) SITE DIAGRA)I FACILITY DIAGR.~~ V I !o-~ S-~ . F\ - DAv Lv~ !OfA-O~J~tN~ c Ie. - ~ Cfu.M.V\ IG -)j~ I~(""!~~~ @® ~~ ID 001:r. --->, Jpn 'SQ~\Q.. ~S '00 (J '1 I, cJ)S? ~tJl{?' , " 0 t9 ~ct .'- ~. , I JII .J.-.o,;l.) e'µ /()-- A ÒíV (~IS. ,cpt.! S ~ ¡R: ~I{!~' ~IÑ sP €!Y ~ Uf.., I @)@) dØ' I I ~-4' V - I \ YARù ~ , ST ()C K ROO'1tv\ \ ~ ,_~D,W~OO f'.\ w~ t0chA ~ ~, OFFICE OFF I c..e (Inspector's Comments): l--..> -OFFICIAL USE ONLY- - 5A - SITE DIAGRAM~Ui~iteeS) 1. Address: Identit~e principle buildin¡s by the Street nuabers. e ( ke"ox 9, Lock 10. MSDS Stora2e Box 11, Railroad TracKs 12, Fence or Barrier II. Wire b. Masonry c. Wood d. Gates 13. PoWel'.1ine9 14~ Guard Station 15. Stors¡e Tanks: Identify the capaci ty in ¡al. a. Above ¡round b. Under¡round 16. Dikin¡ or Ber. 17, Evacuation Route 2. Street(a). Alleys. Driveways. and Parkin¡ Areas adjacent to the property, Include the street naaea. 3, Store Drains. Culverts. Yard Dnins 4, Draina¡e Canals. Ditches. Creeks. 5, Bulldings a. Frftme construction b. Masonry construction c. Metal construction d. Aceesa Door 6, Utility Controls a. Gas - b, Electricity c. Water 7. Fire Suppression Syste.s: s. Fire Hydrants 18. Evacuation Area: Identity the location where eaployees w111 ..et. b. FIre Sprinkler Connections 19. Outside Hazardous Waste Storare c. Pire Standpipe Conne,ction8 20. Outside Hazardous Øaterial Stors¡e d. Water Control Valves tor protection systea. 21, Outside Hazardous MaterIal Un/Handlin¡ e. Fire PUllP 22. Type ot Hazardous Material/Waste Stored or Used (See Below) 8. Fire Depart.ent Acces. TYPE OF HAZARDOUS MATERI~~ F - FllUlllable I - EJtplo81ve L - LIquId R - Radlolo¡lcal C - CoC'C'oa1ve 0 - Oxidizer G - Gall P - Poison If - Water Reacti ve T . ToxIc S - Solid H . Cryo¡enic 0 . Waste B - Et101o¡ical Exa.ple: Pla..able Liquid . PL FACILITY DIAGRAM (Required ite.s In additIon to tha above) 1- Rhers tor Sprinklers 8. F1re E.cepes 2. Partition. g, Air Condition!n, Unit. 3. Stairways: IndIcate tbe 10. Windo.. levels sea'ved tro. hi¡beat to lowe.t. U. In.lde Hazardou. Wute Storale 4. Escalator: [ndicato the levels served tro. la. In.lde Hazardous hIrhe.t to low.at. Material. Stora¡. S. &levator 13. InsIde Hazardous Materials Use/Handline 6. Att1c Acces. 14. Sewer Drain Inlets T, Sky 11 eMs "'~... ,-:.':"~, \..' ",r;" 1_..£7~/ ~. ;~ .. ; ',- -- e eH.:\L\IP 51 T E DIAGRAM ~ P L_\~ ~I-\P- .C~ITY OIAGMAM I ! C .] . !co.- -Hi .- ,,\I I" .., ... 3= :"~S3 :lame, b\ ,"ß, Qec<i~ SenJ\c.e 1(010 ~Qn''()h ~ ~ /50 A=~a ~a~ z "'- ... - RECEIVED AUS 0 6 1990 d~ ~~ '.- ~rame :: :: ';¡,,~a: H.~7. MAT. DIY. - i EN\P1i h;íky \\fo(h~ l01'-A~e6~ ~t.'¥\ì fìe.. S't\op i c..- O FQrlB( ~Y\ì I\e 2- ŒÇ¡c.e <? ~( LVe\ \ ~eo.c\ d,\ E,\I).\~~t W'r'a~e~::.e. ~e'ro~ I , -' - --- - -I -'"ßer-Äer -0; \-' - ' I ~'v\\re 5 r"':'~ · \\¡,-p, 111 ~~\( SenJ ì ce. 0\\ -- - - - - - - \=\ ~ S \--.0 ~ L'4.u\ "'" I ~o.sseq ~~u.so\\ .-..-- - - . - .. , ' ......... - - - > fêrœ -- , .., Or;ç\Lf:.. 13e(\d~r O~\ 'J- r:J '3 OÇ~k-e QJ :) / -- C- P .~or+ eJ .5 ~J-ç- . Hce, \\~fD.r<\ ~O- Un'\o(\ Ave. I ADDRESS Þf7A~ <; F æ ,vJ.-<Þ E -~------_._-_._-----_._---------_._- Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INSPECTION DATE INSPECTION TIME 'ð: 91' !J¿L, -0 q J?>_ PHONE No, No, of Employees "3 '2.:L q5Ö _____~___,___ Business ID Number 15-021- 0001 <6'i UNIFIED PROGRAM-·tNlECTION CHECKLIST SECTION 1 Business Plan and Inventory Program FACILITY NAME 1610 FACILlTYCONTACT . UN :r-o¡J /h;¡;,. __~,______,__,____. , " Section 1: Business Plan and Inventory Program " - , C] Combined C] Joint Agency C] Multi-Agency C] Complaint C] Re-inspection µt-Routine C V ( C=Compliance ) V=Violation OPERATION COMMENTS 9" C] ApPROPRIATE PERMIT ON HAND -~-~--~----_._-~--------------~--- ,+_.__._------~.-._._----------,--~-------..-._.__._-_.--_._-----------~-_._---,_.__._--- ~' C] BUSINESS PLAN CONTACT INFORMATION ACCURATE _______.______....___,______.______ ----.----------------__._0._.-...--.--------..-._0..---.----.-,--,--.--..--------....--.----- gI' C] VISIBLE ADDRESS g" C] CORRECT OCCUPANCY ---------- g/ C] VERIFICATION OF INVENTORY MATERIALS ¡g/C] . ---------------..,-------------. ..-- _..____.___________._._._.______.____.__.________.___._....__..___~.___ m.._._____ .___._ ___...______..._.______n_...__._.______..___.__~_.__~_______.______.__._.._ _....__~_____.. ----~~----_._--_.__. .----...----.. -..-.----.- -------.---.--.-----,----------.------.. -.....-.. .-----.-.---.- VERIFICATION OF QUANTITIES -~--------------'--'-------'--'-----'-'-""--- ¡:¡:y C] VERIFICATION OF LOCATION ___._________ _______nn____.______________._,.___._..___..__,_.____..__.._ ~,_n..__._ ._u____ ~---~--~-----~--~--------- -------~-------_.._-._---------_..--_._----_.__.__._--.-..- g/'C] PROPER SEGREGATION OF MATERIAL -----.--.-----------""-,----.- ..-------,-------.- -...----.--.------------- -------.----.---."'-......--- ¡g/ C] VERIFICATION OF MSDS AVAILABILlTYE ~~____~·___~_______.___·_____n._______ ____._.__.__.__._____..___._____________._____..______.______ r:;;v'" C] cg/' C] VERIFICATION OF HAT MAT TRAINING ----------.----..---.- --~._------,._------_._-------_._-_....__._._----_._----.-.---------- VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES -.---.-------.--..---- --------.--------,--.-..-..---.-------..-------..----.-.------.--. C] -~ EMERGENCY PROCEDURES ADEQUATE ._----------~.._------~_._----- __..._·_______~nm_'_____~_______·_____..._~·_·_____..____._,.______.__....___ CONTAINERS PROPERLY LABELED -~ C] H~US~~~EPING ______,____u_______ ,-,--- ,---,---.-----,----,--,------,,--,----------,-----------, ~--~~~' PROTECTION---'-------- ---,-------,-,----.-,-------, --,------ ~ SIT;oIA~AM ADEQU';"~-& ONH¡~-----'----·-- -'---------,...-..----,------,------------,------'-.--,-, ANY HAZARDOUS WASTE ON SITE?: C] YES ø-No ~v ~~ ~ Ulfo ¡"../ EXPLAIN: ~Æ:'S'NS~:TIO::::; US~661) 326-3979 X ~_ . ~ Ir¡sp tor Badge No, Business Site Responsibl White· nvironmental Services Yellow· Stalion Copy, Pink· Business Copy 5c ) :¡, "..~ - N B REPAIR SERVICE Manager: DAVID <ßf5W,/ Location: 1610 S UNION AVE City BAKERSFIELD ,/. - sPhone: 124 id: 08A -- SiteID: 215-000-000184 ~I ~) 397-1950 CommHaz : Moderate FacUnits: 1 AOV: .~ OCT 2 81999 ') BY:" , / CommCode: BAKERSFIELD STATION 05 EPA Numb: SIC Code: DunnBrad:11-273-7549 Emergency Contact NORMAN BERRY Business Phone: 24-Hour Phone : ~~ Phone : Hazmat Hazards: / Title / Ow ~ €(2.- (661) 397-1950x (661) 588-7732x (QIoI) Cf1Q -1fo(O~ Emergency Contact DAVID BERRY Business Phone: 24-Hour Phone : Pager Phone : / Title / VV'A.NPt~Q (661) 397-1950x (661) 392-1138x (~I) ~33 -~':n5'"x Fire Press ImmHlth DelHlth Contact : MailAddr: 1610 S UNION AVE City : BAKERSFIELD \ Phone! ( ) State: CA Zip : 93307 - x Owner Address City NORMAN BERRY : 333 W HARDING AVE : BAKERSFIELD Phone: (805) 397 -1950x State: CA Zip : 93308 Period : Preparer: Certif'd: to TotalASTs: = TotalUSTs: = RSs: No Gal Gal Emergency Directives: i, (01'1\' ~ -<Ba-1f\)(£tL Do hereby certify th~ I ~®''ìj'S (Type 0( ¡)fInt 11QMO) reviewed ~hs a~ch~:J1 hmaJrdous m~t~ri.mls Manage- ment plal1 ~©¡r~ -'8- SALE? and ~tðeìt i~ ~~@~ wò~h (~roo of B\JsInEISG) any ooij'i"ootà©~s oonsti~ut® ~ romplst(9 ~UI1(Q1 oom~ci ffitðJn- agement pl~n 1©ú' M)J m<cm~. lfI/ C(~1:..~ lO - 'd--(o-q-q DaIIII -1- 10/18/1999 ., e e SiteID: 215-000-000184 ì By Facility Unit ì Fixed Containers on Site ì '/ SpecHaz I EPA Hazardsì Frm I DailyMax Unit/MCP F L 110 GAL Mod F L 110 GAL Low F DH L 55 GAL Min F L 55 GAL Hi F L 110 GAL Low F IH DH L 15 GAL Mod F P IH G 244 FT3 Low F P IH G 200 FT3 Hi F DH L 110 GAL Low f N B REPAIR SERVICE p= Hazmat Inventory p== As Designated Order Hazmat Common Name... CLEANING SOLVENT HYDRAULIC OIL MOTOR OIL CARBURATOR CLEANER KEROSENE GASOLINE OXYGEN ACETYLENE WASTE OIL -2- 10/18/1999 '" e e SiteID: 215-000-000184 ì Facility Unit: Fixed Containers on Site ì F N B REPAIR SERVICE f= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME CLEANING SOLVENT Days On Site 365 Location within this Facility Unit Map: Grid: MIDDLE OF SOUTH WALL IN SHOP & NORTHEAST CORNER OF SHOP CAS # STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Naphtha Solvent No 8030306 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Mod HAZARD ASSESSMENTS f= Inventory Item 0002 F= COMMON NAME / CHEMI CAL NAME HYDRAULIC OIL Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit Map: Grid: MIDDLE OF NORTH^WALL IN SHOP & SOUTH WALL OF OFFICE BLDG + ~í14- Wt\U-- CAS # STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Hydraulic Brake Oil (Diethylene Glycol Monobuty... No 0 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Low HAZARD ASSESSMENTS -3- 10/18/1999 e e SiteID: 215-000-000184 ì Facility Unit: Fixed Containers on Site ì f N B REPAIR SERVICE p= Inventory Item 0003 = COMMON NAME / CHEMI CAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit SHOP Map: Grid: CAS # 8020835 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Motor Oil, Petroleum Based No 8020835 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESSMENTS p= Inventory Item 0004 F= COMMON NAME / CHEMI CAL NAME CARBURATOR CLEANER Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit MIDDLE OF NORTH WALL IN SHOP Map: Grid: CAS # STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER Largest Container GAL AMouNTS AT THIS LOCATION Daily Maximum 55.00 GAL Daily Average 15.00 GAL %Wt. RS CAS # 40.00 Dichloromethane No 75092 15.00 Cresylic Acid No 1319773 5.00 Potassium Hydroxide No 1310583 10.00 Methanol r' No 67561 10.00 1,3-Dichlorobenzene No 541731 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Hi HAZARD ASSESSMENTS -4- 10/18/1999 e e SiteID: 215-000-000184 ì Facility Unit: Fixed Containers on Site ì F N B REPAIR SERVICE f= Inventory Item 0005 F== COMMON NAME / CHEMI CAL NAME KEROSENE Days On Site 365 Location within this Facility Unit NORTHEAST CORNER OF SHOP Map: Grid: CAS # 68476-30-2 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Kerosene No 70892103 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Low HAZARD ASSESSMENTS f= Inventory Item 0006 F== COMMON NAME / CHEMI CAL NAME GASOLINE Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit SHOP Map: Grid: CAS # 8006-61-9 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 15.00 GAL Daily Average 15.00 GAL %Wt. RS CAS # 100.00 Gasoline No 8006619 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DR / / / Mod HAZARD ASSESSMENTS -5- 10/18/1999 e e SiteID: 215-000-000184 1 Facility Unit: Fixed Containers on Site 9 F N B REPAIR SERVICE f= Inventory Item 0007 F== COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit MIDDLE OF SOUTH WALL IN SHOP 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 244.00 FT3 Daily Average 122.00 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 P IH / / / Low HAZARD ASSESSMENTS f= Inventory Item 0008 F= COMMON NAME / CHEMICAL NAME ACETYLENE Facility Unit: Fixed Containers on Site 1 Days On Site 365 Location within this Facility Unit MIDDLE OF SOUTH WALL IN SHOP Map: Grid: CAS # 74-86-2 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container FT3 AMOUNTS AT THIS LOCATION Daily Maximum 200.00 FT3 Daily Average 100.00 FT3 I l~~~óoIAcetYlene HAZARDOUS COMPONENTS ~ CAS # 748621 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi HAZARD ASSESSMENTS -6- 10/18/1999 e e SiteID: 215-000-000184 1 Facility Unit: Fixed Containers on Site 1 F N B REPAIR SERVICE p= Inventory Item 0009 = COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit OUTSIDE NORTHEAST CORNER OF SHOP Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSMENTS -7- 10/18/1999 e e F N B REPAIR SERVICE I p= Notif./Evacuation/Medical ~ Agency Notification CALL 911 SiteID: 215-000-000184 1 Fast Format 1 Overall Site 1 07/21/19921 07/21/1992 ] 07/21/1992 ~ Employee Notif./Evacuation ~L FIRE DEPARTMENT AND EXIT Public Notif./Evacuation BLDG. INFORM ANY CUSTOMER IN BUILDING OF SPILL AND SHOW THEM TO NEAREST EXIT. CALL FIRE DEPT. Emergency Medical Plan 07/21/19921 MERCY HOSPITAL - 2215 TRUXTUN - 327-3371 -8- 10/18/1999 ~ ~ e e SiteID: 215-000-000184 ì Fast Format ì Overall Site ì 07/21/1992 f N B REPAIR SERVICE I p= Mitigation/Prevent/Abatemt Release Prevention STORAGE IN METAL CONTAINERS FLOOR ABSORBENT IS USED TO CONTAIN AND CLEAN SPILLS Release Containment 07/21/1992 FIND SOURCE OF LEAK TAKE PROPER STEPS TO STOP IT. Clean Up 07/21/1992 USE FLOOR ABSORBENT TO CLEAN SPILL. PUT ABSORBENT INTO METAL CONTAINER. Other Resource Activation -9- 10/18/1999 · f10 e e SiteID: 215-000-000184 ì Fast Format ì Overall Site ì I f N B REPAIR SERVICE I p= Site Emergency Factors [:: Special Hazards Utility Shut-Offs 01/07/1990 A) GAS - UNION AV AT MAIL BOXES ON STREET B) ELECTRICAL - IN STOCK ROOM 2 SOUTH SIDE; C) WATER - SOUTHWEST CORNER OF PROPERTY D) SPECIAL - NONE E) LOCK BOX - NO M If) DLé ~ öt.. "n,~, wa.u... I ~ SH-óf Fire Protec./Avail. Water 01/07/1990 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN SHOP AND SHOWROOM ^ 1\'\ lDO L-~ FIRE HYDRANT - SOUTHWEST CORNER OF PROPERTY Building Occupancy Level -10- 10/18/1999 - , : e e ~ í N B REPAIR SERVICE ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000184 íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 07/21/1992 ¡ o 0 o WE HAVE 7 EMPLOYEES AT THIS FACILITY o o o o WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE : BRIEF SUMMARY OF TRAINING: ~~~ihL MEETING ON WHAT STEPS TO TAKE IN o CASE OF ANY TYPE OF EMERGENCY. o o o o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ 0 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future Use ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf '}. ,. ~ -- e / ~ 06/12/92 N B REPAIR SERVICE 215-000-000184 Overall Site with 1 Fac. Únit Page 1 General Information Location: 1610 S UNION AV Map: 124 Hazard: Moderate Community: BAKERSFIELD STATION 05 Grid: 08A FlU: 1 AOV: 0.0 ..--- Contact Name Title Business Phone --:- 24-Hour Phone NORMAN BERRY (805) 397-1950 x (805) 399-0801 DAVID BERRY (805) 397-1950 x (805) ,~Q;j - II ~~ Administrative Data Mail Addrs: 1610 S UNION AV D&B Number: 11-273-7549 City: BAKERSFIELD State: CA Zip: 93307- Comm Code: 215-005 BAKERSFIELD STATION 05 SIC Code: Owner: NORMAN BERRY Phone: (80S' ) 3'ì'1 - '150 ,Address: 333 W HARDING AV State: CA City: BAKERSFIELD Zip: 93308- Summary ()\~ I, 1:S:,.u~;"~~ Do hereby certify that I have reviewed the attached hazardous materials manage- menaplan for ~~~\r ~ú' ~and that it along with ( of BUSIRMi) , anyGOn8Ctions COnstitute a complete and correct man- agement plan for my facility. G ~,¡, ~~~r g Ie 7 - \4 -'1.;). Date ~ e e 06/12/92 N B REPAIR SERVICE 215-000-000184 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 CLEANING SOLVENT , ~ Fire Liquid 110 Moderate GAL CAS 4t: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING ---- Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 110 I 55.00 I 220.00 Storage ~ Press ì Temp Location DRUM/BARREL-METALLIC Ambient Ambient MIDDLE OF SOUTH WALL IN SHOP & NORTHEAST CORNER OF SHOP - Conc l Components 1-; MCP ~List 100.0% Naphtha Solvent Moderate 02-002 HYDRAULIC OIL Liquid 110 Low ~ Fire GAL CAS 4t: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT ---- Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 110 I 55.00 I, 220.00 Storage ~ Press ì Temp Location PLASTIC CONTAINER Ambient Ambient MIDDLE OF NORTH WALL IN SHOP & SOUTH WALL OF OFFICE BLDG - Conc l 100.0% Hydraulic Brake Oil / 02-003 ~OTOR OIL ~ Components I~ MCP -,List Low I / L'?/UIJ.. ~ Minimal GAL CAS 4t: Trade Secret: No Form: Unknown Type: Pure Days: 3~- Use: LUBRICANT Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 50 I 0.00 I 250.00 Storage PLASTIC CONTAINER , r Press T Temp ::;¡ ~ ~ SHOP Location - Conc l Components 100.0% Motor Oil, Petroleum Based r; MCP :-rList Minimal I '. . e 06/12/92 N B REPAIR SERVICE 215-000-000184 02 - Fixed Containers on Site, Page 3 Hazmat Inventory Detail in Reference Number Order 02-004 CARBURATOR CLEANER .. Fire Liquid 55 High GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 55 I 15.00 I 100.00 Storage PLASTIC CONTAINER r Press T Temp ~ Location Ambient Ambient MIDDLE OF NORTH WALL IN SHOP Components MCP List High Moderate Moderate High Low Cone 40.0% 15.0% 5.0% 10.0% 10.0% Dichloromethane Cresylic Acid Potassium Hydroxide Methanol 1,3-Dichlorobenzene 02-005 KEROSENE .. Fire Liquid 110 Low GAL CAS #: 68476-30-2 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 110 I 55.00 I 330.00 Storage r Press T Temp ~ Location DRUM/BARREL-METALLIC Ambient AmbientlNORTHEAST CORNER OF SHOP - Conc -I 100.0% Kerosene Components ~o~CP ,List i' . e 06/12/92 N B REPAIR SERVICE 215-000-000184 02 - Fixed Containers on Site Page 4 / 02-006~SOLINE ~ Hazmat Inventory Detail in Reference Number Order ~ t...J 'ð /Jd d 15 GAL Moderate CAS #: Trade Secret: No Form: Unknown Type: Pure Days: Use: FUEL Daily Max GAL ----r-- Daily Average GAL ~ Annual Amount GAL -- 15 I 0.00 I 30.00 Storage DRUM/BARREL-METALLIC r Press T ~emt> l ~. ~_ SHOP Location - Conc -, 100.0% Gasoline Components r; MCP ~List Moderate 02-007 OXYGEN ~ Fire, Pressure, Immed Hlth Gas 244 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 -- 244 I 122.00 I 366.00 Storage r Press T Temp ~I Location PORT. PRESS. CYLINDER Above Ambient MIDDLE OF SOUTH WALL IN SHOP - Conc _I 100.0% Oxygen, Compressed Components ~ MCP -----rList Low I 02-008 ACETYLENE ~ Fire, Pressure, Immed Hlth Gas 200 High FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 ----r-- Daily Average FT3 ~ Annual Amount FT3 -- 200 I 100.00 I 300.00 Storage r Press T Temp -:r Location PORT. PRESS. CYLINDER Abov~ Ambient MIDDLE OF SOUTH WALL IN SHOP - Conc -, 100.0% Acetylene Components ~ MCP -----rList High , e e 06/12/92 N B REPAIR SERVICE 215-000-000184 02 - Fixed Containers on Site Page 5 Hazmat Inventory Detail in Reference Number Order 02-009 WASTE OIL ~ Fire, Delay Hlth Liquid 110 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL ~ 110 I, 55.00 I 250.00 Storage DRUM/BARREL-METALLIC r Press T Temp ~ Location Ambient AmbientlOUTSIDE NORTHEAST CORNER OF SHOP - Conc -I Components 100.0% Waste Oil, Petroleum Based r=- MCP -¡List I Low I · e e 06/12/92 N B REPAIR SERVICE 215-000-000184 00 - Overall Site Page 6 <D> Notif./Evacuation/Medical <1> Agency Notificatio~ CALL 911 <2> Employee Notif./Evacuation CALL FIRE DEPARTMENT AND EXIT BLDG. <3> Public Notif./Evacuation NONE LISTED Inform any customer in building of spill and show them to nearest exit. Call Fire Dept. <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN - 327-3371 J e e 06/12/92 N B REPAIR SERVICE 215-000-000184 00 - Overall Site <E> Mitigation/prevent/Abatemt Page 7 <1> Release Prevention STORAGE IN METAL CONTAINERS FLOOR ABSORBENT IS USED TO CONTAIN AND CLEAN SPILLS <2> Release Containment Find source of leak take proper steps to stop it. <3> Clean Up Use floor absorbent to clean spill. Put absorbent into metal - container. <4> Other Resource Activation ~ ~ e e 06/12/92 N B REPAIR SERVICE 215-000-000184 00 - Overall Site Page 8 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS ~ UNION AV AT MAIL BOXES ON STREET B) ELECTRICAL - IN STOCK ROOM 2 SOUTH SIDE C) WATER - SOUTHWEST CORNER OF PROPERTY D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN SHOP AND SHOWROOM FIRE HYDRANT - SOUTHWEST CORNER OF PROPERTY <4> Building Occupancy Level ~, :1. " .. e e 06/12/92 N B REPAIR SERVICE 215-000-000184 00 - Overall Site <G> Training Page 9 <1> Page 1 WE HAVE 7 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: Semi-annual meeting on what steps to take in case of any type of emergency. <2> Page 2 as needed <3> Held for Future Use .. ;.' 'tt '';' <4> Held for Future Use I q/e47- C~Ct "1j~. . I 'F:né~e/li L j Gn-fc, c.--f:s ' ~ *" ~O ø ;t/ or<. YI1 c, n ße.ler<. y 517-/950 3c¿Cj-ogo/ Da.víJ 8~ry 397-/'1s0 3;} 7- 9~t.¡5 -, CITY Of'J~:~~:,SFIELD 11,~ -0 ~q1-\q~ @ RECEIVED e L" /:-~ co " '-o'i-:,::;-R-s').j\ ::~,;"',," ~,\ ,~ ~ ~ C) i\~,c~,'/~'; ",:1(,I-"-'·"~ J "- '-~!.0J3.~"/ .~ I Do hereby e "~ Iii, I \\\\\\",,'---- ...." "\l) - '~ ~II.".. :.- ¿//~'~.. ~";.:-...-: .::::~.:: \ \. ~/- -:::~ ~ _ -.1 -,_.. =~;; -:_" ~\~;; ........ / I'~ ~...... ~,; '::::7 ~~--~t',~""7\\;.·:I J ~ "¡IIIÎÍÍñ~ _N\J~vnCtV1 Bef<. (-( \{ . " .. prlnt. name) (tYDe or r e'\- i eh-ed ffB 2 1 1989 HAZ. MAT. DIV. certify that I have thE= attached Hazardous Materials business plan 5ev(\J;ce for -1LB 1<F ~CA'\ ~ (name of business) and that, it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. 4:t~ I - -: 1-/1- CJc¡ date c z\OO e e -; BUSINESS NAME N B REPAIR SERVICE LOCATION 1610 S UNION AV ID NUMBER 215-000-000184 HIGH HAZARD RATING 3 1. OVERVIEW LAST CHANGE OS/24/88 BY ESTER JURIS CODE 215-005 JURIS BAKERSFIELD STATION 05 MAP PAGE 124 GRID 08A FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS 2A SEC 2) NORMAN BERRY - 397-1950 OR 399-0801 TIM BERRY - 397-1950 OR 322-0764 UTILITY SHUTOFFS 2A SEC 3) A) GAS - UNION AV AT MAIL BOXES ON STREET B) ELECTRICAL - IN STOCK RM 2 SOUTH SIDE C) WATER - SW CORNER OF PROPERTY D) SPECIAL - NONE E) LOCK BOX - NO 2. NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/13/88 15:35 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME N B REPAIR SERVICE LOCATION 1610 S UNION AV ID NUMBER 215-000-000184 HIGH HAZARD RATING 3 3. HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY }vt~DS; ~~ <l"ro DŒORM.'\TIOH RECORDED FOR TIUq ~RCTION > ~---~ ,~ - -.,..... - --- -, - 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE OS/24/88 BY ESTER 2A SEC 5) MERCY HOSPITAL - 2215 TRUXTUN - 327-3371 PAGE 2 12/13/88 15:35 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 " e e , e e BUSINESS NAME N B REPAIR SERVICE LOCATION 1610 S UNION AV FACILITY UNIT 01 ID NUMBER 215-000-000184 HIGH HAZARD RATING 3 A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE OS/24/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE 1 PURE CLEANING SOLVENT 200 GAL EXTREME SHOP DRUMS OR BARRELS MET.. CLEANING ID PERCENT COMPONENTS HAZARD LISTS 1203.02 100.0 NAPHTHA SOLVENT EXTREME 2 PURE HYDRAULIC OIL SHOP & SHOWROOM PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 1224.00 100.0 BRAKE FLUID, HYDRAULIC 200 GAL UNKNOWN LUBRICANT HAZARD LISTS UNKNOWN 50 GAL UNKNOWN LUBRICANT HAZARD LISTS UNKNOWN 4 CARBURATOR CLEANER 50 GAL DRUMS OR BARRELS MET.. CLEANING EXTREME 7 PURE OXYGEN SHOP PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 2359.00 100.0 OXYGEN, COMPRESSED 3 PURE MOTOR OIL SHOP PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 2808.00 100.0 MOTOR OIL HAZARD LISTS MODERATE HIGH HIGH EXTREME HIGH 5 PURE KEROSENE 100 GAL MODERATE SHOP DRUMS OR BARRELS MET.. FUEL ID PERCENT COMPONENTS HAZARD LISTS 1178.01 100.0 KEROSENE MODERATE PURE SHOP ID PERCENT 2234.00 25.0 2580.01 20.0 1061.01 12.0 1203.00 12.0 1759.00 10.0 COMPONENTS METHYLENE CHLORIDE TETRACHLOROETHYLENE CRESYLIC ACID NAPHTHA 1,3-DICHLOROBENZENE 6 PURE GASOLINE 15 GAL HIGH SHOP DRUMS OR BARRELS MET.. FUEL ID PERCENT COMPONENTS HAZARD LISTS 1182.00 100.0 GASOLINE HIGH PAGE 3 8 PURE ACETYLENE SHOP PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 141 FT3 HIGH WELDING/SOLDERING HAZARD LISTS HIGH 140 FT3 EXTREME WELDING/SOLDERING HAZARD LISTS MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 12/13/88 15:35 BUSINESS NAME N B REPAIR SERVICE LOCATION 1610 S UNION AV FACILITY UNIT 01 ID NUMBER 215-000-000184 HIGH HAZARD RATING 3 A. OVERALL HAZARDOUS MATERIALS INVENTORY ( * CONT I NUED * ) LAST CHANGE OS/24/88 BY ESTER ID TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE 8 PURE ACETYLENE ( * CONTINUED * ) 140 FT3 EXTREME ID PERCENT COMPONENTS 1241.00 100.0 ACETYLENE HAZARD LISTS EXTREME I '- B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE OS/24/88 BY ESTER 3A SEC 4) FIRE EXTINGUISHERS IN SHOP AND SHOWROOM 3A SEC 5) FIRE HYDRANT SOUTHWEST CORNER OF PROPERTY PAGE 4 12/13/88 15:35 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 e e e e BUSINESS NAME N B REPAIR SERVICE LOCATION 1610 S UNION AV ID NUMBER 215-000-000184 HIGH HAZARD RATING 3 D. EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE OS/24/88 BY ESTER 3A SEC 2) CALL FIRE DEPARTMENT AND EXIT BLDG. - - - -- --~- .-. "-_. -- - - - - - E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE OS/24/88 BY ESTER 3A SEC 1) STORAGE IN METAL CONTAINERS FLOOR ABSORBENT IS USED TO CONTAIN AND CLEAN SPILLS PAGE 5 12/13/88 15:35 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 /,. ~, .,;' '--', ~ r ;J';.r"r J'" ( . \.1l.vI. ¡. L :~. , ') , L 1,,-;.... /~ ,r-- / \.J.' 2.//£1 ,u. 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I ,':'7ì ¡j/"W ~ e \NHOlESALf F¡LJElS MA TEIi.IAL SAFETY DATA SHEET ; ;, ...., I ************************************************************************************** , 'J PRODUCT/MA TERIAL: JPC 140 SAFETY SOLVENT MANUF ACIURER: WHOLESALE FUELS EMERGENCY PHONE 1\'050 MEDICAL: 213/664-2121 (LAo POXSO¡\j CE¡\~T£n. í:!~ HR f\!Ool CHEMTRECg BOO/ ~2~~9300 8USINESS8 805/327~~900' ADDRESS: 2200 Eo Brundage Lane Bakersfield California 93307-2806 QòaQøOQ~øØOQg~~Q___OØ_Ø~~~Ø_Ø~___~_ØO__o____Ø_____Ø______O____~_-Ø____cO________QOØQQ_-__~d__~_OQ__~_~q~~_c~ SECTION X - MATERIAL IDENTlFICA TION _Q______a_Q_______O___________________~______________O_oø___________________d____~_________~__o_·a~____o___~~ TRADE NAME: JPC 140 SAFETY SOL VENT PRODUCT CODE NOo: GENERIC NAME: Organic solvent MSD5 CODE NOoz MMDQOOJ030AC CAS REGISTRY NOo: Not registeredo CHEMICAL NAMEg Mixture of Petroleum hydrocarbons SVNONYMSz Mid~di9tiHatt:: mixtureo NIOSH REGXSTR Y NOoz' Not r'egieteredo CHEMICAL 'f AMIL Yz Aliphatic, aromatic hydrocarbons CHEMICAL fOR.MULAz Mi}{tl!re of petroleum hydrocarbonso ~âOQQ~__~OQ_~Q_~_Q____~_Ø~__ØQ_______OQ_~____________________~________Q______"_~___________~___~__~~_~_~QO__ ,SECTION XX ~ HAZARD IDENTIFICA nON 000____0___0_0___________________________________________ø____o________~______o_________________~__p=ø__o~~~ ' HEAL TH HAZARDS PHYSICAL HAZARDS ASPIRA nON HAZARD SKIN DEF A TTlNG AGENT COMBUSTIBLE LIQUID 0, MiSUSE OF EMPTY COI\IT AINERS CAN BE HAZJ.\RDOUS J31i\~D LEAD, TO SERIOUS INJUR V 0 RE?\D , SECTIONS v, VIII, X, & XL . _o_______oø______oo__________o_______ø_____________________________________________Ø__~~Q_~_o__ri__~~~o_~o___ 0000 T 0 HAZARD CLASSz Combustible Liquid UN HAZARD CLASS NOg None NFPA RArING: HEAL TH 2 FLAMMABILITY 2 REACrlvXTY ü OTH£R.: Corlsumer Product Safety Comm¡~sionrequires a label warning fo: QQPetro!eum distillateslQo ' ~COQQOO______øaøQ_GQQØ_~~-----O---"-Ø_-----------~o---____________o____o___oO_______________Ø____OØQ__ØØ~__~ SECTXON UK c> HAZARDOUS INGREmENTS AND RECOMMENDED EXPOSURE UMXT5 OQOQa_~O~c~_OQQ~O__~___~__________Q___Q_O~d~_Q__Q~_Ø___OØ~____QOO________~____~_ø_~_~__ø.ø___O~'Q__Qao__"~=on . NAZ/\RDOUS INGREDIENTS RECOMMENDED EXPOSURE UMKTS " UMIT TVPE AMOUNT AGENC\! 1) Petroleum distillates None establishedo ~OQ__4___0_______________________________________ft__________________~_Ø__~Q~~~__ØØ_~_Q_____ØØ___~_Ø__~___a_a 'I - -. .. . ~ - - _..... .,-.; - n '. __,. _.__ e e ;. / ~- PRODUCT IMA TERXAU JPC l~O SAFETY SOL VENT MSDS CODJË NO.g MMD0003Q30Þ.C 0"'"'0010 4OC>~OOQ ""c=-QOC3"""CIIOc:>OCO"""OC>____________"""__ _____.... ,..._ ___ __ ____ _ ________0___ ___... ___...__.....__c:> <::> ØO__40 a_oo_ro·....~q"""ct'.,,~_"'1'9'"""OO'I..,.c::'IP SECTION XV 0 HEAL TH HAZARD XNFORMA 1XOi\3 _""""____QC>oo"'__""____Q___O_____O_OC>__________________""_______""___C>__________CII_OO__Q""C>____CII____ö_~~~qQQ_OO~~<>~~ GENERALg This material is an aspiration hazard. OCULAR!EYEg This material may cause eye irritation. Contact with the liquid mey Cr't'Sf; burning? tearing? and redness. DERMAL/SKXNg This material may cause skin irritation. Prolonged or repeated contect me,;1 , cause burning, redness? drying and cracking 01 the skin? and dermatitis. XNHALA ¡XON/BREA THXNGg Exposure to mists or to excessive vapor ccncentraticr!s ~ey c('l's.s irritation of the nose? throat and respiratory tract; signs of c0ntra! r.ø::'J~!Js~ys\;zrr depression; i.e., headache? nl2lusea, drowsiness ~nd dizziness. XNGESTXON!5WALLOWXNGg Accidentally swallowing this materÃ8Il CSlf\ cause irr¡te~¡on 0'( tr.s stomach and digestive tract; Larger ingestions may cause signs or ce¡ntra! n~rVCl~S ~~/~;:3r.~ depressioni i.e., headache, nausea? drowsiness and dizziness. This mal:erialit; (W~ 28Ç1kr.r.I:Îoi: h87-ard and may enter the lungs when swallowing or vomiting and C8use ssr~ol!s ll'~g damB2'3. CHRONKC/OTHERg No known additional effects. ,', , ~ØO~O~OOQQOØOQO~QO_~ØQ~_____o____ø_oo______.o_o__ø_~____________o______ò________m__øo_o__O_~~~_~~_OQb~O_~_Q~ SECTION V 0 SPECIAL HAZARDS AND PRECAU1RONS ~_~O_Ø___Q____Oo__o_øa___o___O______Q______________~_______________=_øo_____a_d~_~-o_-_--_--h~-~-~ø-o-~~n~~~ HAZARDS, DURXNG NON~ROUTXNE OPERA TXONSg, Heating may generate irritE1t£r:9 2nd \:o;-:íc vapor~. SPECKAL PRECAUTXONS AND COMMENTSg Empty containers retain material residt·~ \."!hich ~P,y gener~~e hazardous vaporso Do not pressurize? cut? weld or expose empty ~n~0,~~~,:~ to !?:11}" source of heat or flames. MlEOXCAL CONOXTXON AGGRAVATED BY EXPOSUR.Eg Preoexåsting sldn disease. Chrcnic pulmon8ry disease. OQ~OÖQOOOOO=COQ~QQOO_QQ~_Q~_Q¢Q__ø_øgC_QOQ___O__~__O_O~_M__Ø_____~~ØØ~~_OQ___Q_O_~~_~_Qþ__ø~~Ø_~~~Q~~O_QUOO" SECTION VI 0 EMERGENCV AND FIRST AID PROCEDUR.ES _Ø~_QØ_Q_OdQQ_QOØ_O~O~_Q_þ_____O_O___OQQ_OØO~__O__~_~O__q__QOO~Q_QQQ~QQoo_~aQ_QO~~QO~Q_~_Ø_QOQØ~~~O~OQ~O~~u~ "A TTENTION~ IF VICTIM IS NOT BREATHING OR IF BREATHING D!FFICUL TlI::S DEVELOP ARTIFIC!AL RESPIRA nON OR OXYGEN SHOULD BE ADMINISTERED BY QUÞ,UFIEP PERSONNEL. ' OCULAR/EVE CONT ACüg Flush the affected eye(s) with water. U irri;:atioi1 c:C:'!I:';,ìO~8, see!,,: medical assistance. DERMAL/SKIN CONTACTg R~move contaminated clothing and flush contz:ct ar:;¡ss with "Ú,I\:e::- end then thoroughly cleanse contact by washing with soap and water. K1 årrital:¡cn OJ:' rednsss develop end persist? seek medical assistance. XNHALA 1XOi\!/SREA THXNGg If symptoms of exposure develoP? move én!'Jay from r-ource of,' cxp08ure to vapors or mists. If symptoms persist? seek medical, assÃste.:1Cø. INGESnON!SW ALLOWINGg DO NOT INDUCE VOMITING! ASPXRA TIOf\! HAZARD. Kf, victiæ i~ conscÄous and alert9 give milk or water to drink. Seek immediate medicol é\s$is~,!:'ncû. COMMENT5/PHYS!CKAN XNFQRMAüKONg This material is e modersteRy vO!6\tìA~? ',m";!visccs¡,t:~1 , . mi¡{ture of petroleum hydrocarbons with 8 low order of acute ~o)tñd~y., It i~ <:"n e.sp\rr::icn hazardo __~~~~ø~~gO~_~ø~______~__QQ~__________~___G______________________~--Ø___Q--Q--_Q_~-~_-_--_Q-_-~-~------O-Q-~ 'I .. _ _. _ ~~u'_·. _ _. _ ,__ - _.-----, .-- ~.~_.- .'- .~....:..I "---....L"..;¡~ e . " ;¡, 1', _'" 'JRODUCT/MATER!ALg JPC 140 SAFETY SOLVENT MSOS CODE NOo MMD000303Gt\C _~a_øa~~~oao~_~~_~_____________________~______________--------------------O-O__~~_~~____ø_aø~~~~~~~-~~onnaö~ SECTION VXX ~ CHEMICAL REACTIVKYV INFORMA nÒN _oaa~_oø_c__QO~_ØØQ_Q_~~_~_____ØQ_QØ~Ø_OO~___o__~a__ø___øOØ______Ø___QØ_~__QQOOØ_____~Ø_ØØ_Ø__øQQØ_~_O~OQQOO 5T ABXUTYg Stable under normal conditions of storage and handHng. REACrxVXTVg Reacts vigorously with strong mddizing agents. lNCOMPA r ABKLlTYg Incompatible with strong o~idizing agents. HAZARDOUS REACnON/OECOMPOSlTION PR.ODUCTSg Thermal decomposition yie!dscarbon dio~ide and carbon mono~ide. CONOKTXONS CONTRIBUTING TO HAZARDOUS POL VMERXZA TXONg This ma.terËó1! does r::Jt, polymerize. QØQØ_~Ø___o_o_oØØ__Ø_Ø__ØØ______e_______Ø_Q__~__~~._____Q________.__~____Ø_~_____Qa_______~__Ø_~QQ_Q__Ø~~~~ð SECTION VIII ~ FIRE AND EXPLOSION HAZARD INFORMA nON ~_~_o~o________________~~_____~___~_ø________~__________c____Ø_Q___________QØ~_____________~~_~~~b____~_~_~~ NFP A RA TXNGg HEAL fH 2 FlAMMAB!UTY 2 REACnVKYY -º-, FLASH POINT (METHOO)g 630C/TCC¡690C/TOC FIRE POINT/AUTOXGNXnON T£I\~Pg ~900F FLAMMABLE LIMITS (% BY VOLUME/AIR)g LOWERg 0.9% 'UPPERg l~.9% FIRE/EXPLOSIOfl.J HAZARDS: This material is a moderate fire and expiosion hazard and may b~ ignited by eny ignition source above its flash point. Vapors may travel to ignitio~sol!rce end flash back. Containers may e~plode in fire? Vapor explosion hazard indoors, outdoors or in sewers. Empty Contaìners retain material residue and may generate vapors which may ignit~ and e~plode. COMBUSTION PRODUCTSg Carbon dioxide9 carbon monoxide and water vapor. EXTINGUXSHING MEDXAg Carbon dioxide, dry chemical9 foam, and water spray. FIRE FIGHTING PROCEDURESg Wear protective equipment and clothing when fighting fìres~ includìng a seiføcontained breathing apparatus for fires in enclosed spaces. Use water spray . to coo! fire~e}(posed containers9 to dilute and disperse vapors9 protect personnelp end to, flush . unignited spills from fire area. Q_~O_~o~ø_=ø___~~o_____ØQ_~__~Ø_~_o_____a_a____________________~_~__~_oO______ø____Ø___c_c~O__~__~Q~__~_O~_c SECTXON 1)( ~ PERSONAL PROTECnON AND ENGXNEERING CONTROLS ~_øo_e_a__ø____ø__Qø~O_Q______Ø__o____________________~_______~__________~_____________o_oo__ø_~~6~~o___ø___ EVE AND FACIAL PROTECTIO~g Chemical goggles are recommended to prevent 'eye contact. SKIN PROTECTIONg' Protective gloves and clothing are recommended when prolonged contact with the concentrated material may occur. ';, RESPXRA TORY PROTECTIONg Respiratory protection may be required to minimize e¡tposura to vapors. Wear an approved organic vapor cartridge or supplied air respirator as"ne,ceSStu'Yo VENTXLA 1XON8 General mechanical ventilation or explosion-pro01' local e~haust 'Bre recommended to minimize exposure to vapors. - OTHERg An eye wash and a source of running water should be available to flush or wash, ths eyes rand skin. , "-I __~_O_~~_QOØ_OOOØ___o__~~__ooØ__O__Q____Q________.___________________~_Q_Ø_øQ_Ø____~-~-----ø-----.-~~---Qøø-q .....---- ---.-------------.------------------,.--..-- .--- --- --------_. - -~----~--------...---_.._-_._------- ---+ -,-- _.¿ _. .-- ---"'~,=_~""O~"'___..<='.:__'--- .-,"'___ .__...____ ~.::_.;:.. ~n__ --'_t<"...,;··---:-~~=~:_=-·-- -_..._~ e e . / :ð ._ ßÎRODUCr 1M A T-ERXAU JPC 140 $AFETY SOL VENT MSDS CODE NO.~ MMDOOC30;Of\r: eðC?ÞOC;)~C;>C>ÖCl~Q_C:OOC)OOCløO _""'__""0_""'0_00<:::>__0_""'__ __Cl___ ___......CI..,.__ _.,.._...._ ________010___00__<>_ _ _CI<U"""C::>C>O___oO__""'c'tClq"'~=<'=><:;IQ~""'<;3C>C:>c)""> ..) SECTION X ~ SHXPPXNG9 STORAGE AND HANDLING PROCEDURES ~Clao_~CI~__OC:Oc:loQClClClOO_.,_ø________o___o___o______________________C:O__Cl___Cl_____O_...____Q_~_~___...._ClCI~_Q~~P-_O~-~~~ SHIPPING XNFORMA nON: 0000 To SHXPPING i\~AMEg Pet.roleum distillate 0000 T 0 XI) NUM8ERg UN 1268 D.Oo T 0 HAZARD CLASSIFICA T!ON~ Combustible liquid. SiHXPPXNG REGULA nONSg No label required. See DOT regulations l~9CFR 173U.10a fer packaging requirements. 5ïORAGEg Store in closed containers in a cool well-venWated areß away' from aU, heat ,nÔ ignition and strong o){idizing agents. Containers should be electrics!!y bonded and gJ"Ctl!r.d3C: when transferring materials. HANDUNGg Use in a well~ventilated area and \!'Jear recommended protective ef.;11if.lmer.t 2nc' clothing. Use explosion~proof tools and equipment. Avoid breathing vapors, or r;¡iats ê.f'!d prolonged at repeated skin contact. MISUSE OF EMPTY CONTAINERS CAN BE HAZARDOUS. COMPLETEL V DRAIN AND Ht\VE COMMERC!ALL Y CLEANED BËFORE ANY REUSE. KEEP CONTAINERS CLOSED I\ND DO NCF USE TO STORE ANY OTHER MATÈRIALS BEFORE THEY HAVE BEEN COMMERCIÄlcV' CLEANED. 00 NOT CUT 9 WELD? DRILL OR SUBJECT CONTAINERS TO Ht;A T OR FLAMESn VAPORS MA V IGNl IE AND EXPLODE. . Ø~~~O~QØØOOO~O~Q~~OO_____~__~O~___~~OQCØ_OO__~~________________________Q_~~Q____~__~o~_____o6Q~~~~-~ö~O~O~O~ SECTION XI ~' SP!LLv LEAK AND DXSPOSAL PROCEDURES cnOQO__QQO~O_=_~QO__Ø__~_o__a~___o___a__o_______o_o___Ø_o_~_~a_oo____~~_O~Q_QOO~~QO~~ÓØoø___~eda~~o~~eO~Qøq- SPILL OR LEAK PROCEDURESg Evacuate area for large spills. Remove aU ignition ec~~tceD ~r.Œ provido e){plogion~proof ventilation. Wear recommended protective clothing and é(!u¡pmer.t. D':) not allow spills to enter sewers, streams or surface waters. Dike and contain spms. Use inori: absorben~ to reduce fumes and to pick up opill. Collect for later disposelo DISPOSAL PR.OCEDURESg DISPOSE OF IN ACCORDANCE WR1H FED£A.AL~ 57A TE AND 'LOC!\Î, REGULþ\ 7ION50 Empty containers should be commercially cleaned and reconditioned fo: r~)!Jse:o Ø~Q=OO_dQ~O~QO~~_QO~Ø~~_~~___Ø__~_~C_CQ_~________Ø_C_____~~______~__c_~~_~~Q____Ø_Ø____~__~cØ_~~Qøq~Q~~èøø~~ SECTION XU ~ PHYSICAL DESCRIPTION AND PR.OPER1I'::S ,-. , ^ QØQØOO____O_Ð~CØ__Ø______oØØ____~__~__________~__ob_____c___________O_~_O_Ø_ð_Q_C_~___~-___QØ~Q~__~___~~_O~O DESCRXPTXONg A clear water~white liquid with a characteristic petroleum hydrocarbon odor. MEL TING POINTg NA BOILING POINT /RANGEg 184-2100F OVERPOKNTg NA VAPOR PRESSURE: Imm 01 Hg ® 77°F % VOLA ïKLE BY VOLUMEg 100% VAPOR D:ENSXTYg (Air:::1) 504 EV ARORA iKON RA rEg (BuAc=1) 0.06 SOLUBILITY (W A TER)g Negligible pHg NA SPECIFIC GRA VIPfg 0080 API GRAVnVg No datao VXSCOSITVg 1.33 cSt ® 370SoC POUR POXNTg NA OTHERg None _~Ø_~øQQQ~øaoø~Q~oaø____~_~__~_O__~~q__~~__ø__~~____a__Q_________~____O___O_Q_Ø___O___O___~____~~_Q~___OØ~~_ MSDS CODE NOg MMD0003030AC REPLACES MSDA CODE' NOg New NEW ¡REVISION DA TEg ~~27 ~86 ORIGINAL DA rEg New . PREPAR.ED BVg David C. Markie APP~OVED BYg =-/!)fAM.12f1 ß~'1rUi~ DA TEg 5-10:..86 DA -rEg .-£f; ð' I c;t; " 0****************************************************************************a**~Þ**** @ CûPYrÅght~ 1986. Health & Hazard Systems? ~15 W. Foothillp Claremont? CA 91711, ' THIS MATERIAL SAFETY DATA SHEET WAS PREPARED UNDER CONTRACT TO HEALTH & HAZARD SYSTEMS WHO ASSUMES LIABILITY FOR THE INFORMATION CONTAINED HEREIN. ANY QUESTIONS OR COMMENTS RF.GARomr, THlS JNFORMATION SHOIJLO BF. DIRECTED TO: - -" .--~ .~. ----- -- ---.'~ ._---..---~-_._,--~---~- ._--- ~---,-~..--~-~., H~ HEALTH,& HAZARD SYSTEMS 415 W. FOOTHILL BLVDo' CLAREMONT. CA 91711 PHONE,NOg 714/621-9985 --- --- -- --. -...- - .- ---~---- e Bakersfield Fire IIpt. Hazardous Materials Inspection Date Completed ~ - Á '3- ~ 1- Business Name: N ß ~O \~ Location:_\ b to So U~I~V\ Plan ID # 215-000-ooc>l~lf- (Top right comer Business Plan) Station No. 5 Shift C- Inspector ~ e~JL-;~ ks 0 h Adequate Inadequate Verification of Inventory Materials æf 0 RECEIVED ~ 0 MIG 2 91989 ø 0 HA~_ MAT. DIV. ß D Verification of Quantities Verification of Location () ~ Proper Segregation of Material . . \ 11/ Comments: . 4L[1;J Verification of MSDS Availability Number of Employees If [j}- D Verification of Haz Mat Training o o Comments: Verification of Abatement Supplies & Procedures eM- o Comments: Emergency Procedures Posted o g [i1 o Containers Properly Labeled Comments: f roc e1.v.-~ 5 ~o ,\-, t>os~J - Ql \\ s~~,Ay o~\\~~ c s....<\1! 0""..('.... .......IA s-h...r) Verification of Facility Diagram /. No J''''Vr"\'"'\ \NJ~ r\'-''''~C1.J~ Special Hazards Associated witli this Facility: I '" ~ct<r ...... '" ~,( '"", I", o o .JIíelatiöns. O~ l~\.Þ \\-~ d-.~ hr. #- FD 1652 (Rev, 3-89) ~P"''''Y .... r'"tr\C\~L l.7 -O¡<6tt-7 w~~ P",v-iJ. ßl>"; White-Haz Mat Div, Yellow-Station Copy Pink-Business Office .. ,v' ",·v·" e e BAKERSFIELD CITY FIRE DEPARTMENT 2130 "6" STREET BAKERSFIELD. CA 93301 (805) 326-3979 l RECEIVED JUN 8 1987 Ans'd.........@ S- \ ð-L\ -o~A ::JV5P \;;113 '15-35&'-/25 OFFICIAL USE ONLY ID# 000184 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: ~L~. R ~ ?A- \ R 5ER \) C E B. LOCATION / STREET ADDRESS: \& \ 0 S, UN'DN AilE, CITY: ßA\(E;RS F/el_O ZIP: q 3 3D 7 BUS.PHONE: (~D5) 397 -19~o 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 EMERGENCY: NAME AND TITLE A. NðR MAN ßER ~ '( DURING BUS. HRS. Ph# ~ '1 ï - \ '1 5 D B.JIM' BERRY Ph# .3 9l- I 'ì 5 0 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: UN 'ON ftVE B. ELECTRICAL: \ N ~ TOCk \<.00 M '2 C. WATER: <\(")UTHwES'T CORNe-I? D. SPECIAL: E. LOCK BOX: YES /~ IF YES. LOCATION: AFTER BUS. HRS. Ph# 3 '19 - 0 'i?O I Ph# '3 2 2--.0. 1 b 'i --;- I r AT, !VIAlL ~ OXES ON STREET AT SOUT\-\ 5\0£ /,,)F PROPfft'? r Y IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO - 2A - MSDSS? YES / NO KEYS? YES / NO fit e -_.~. .. ',',' :..\ \...1 SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE }l//q. " ¿ ~ ,,'. 8~ ' ,~;.:~ . \õ.', 'i":J. h ~ . ~ ,,: ,.j "~I' SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE \\l\e:~c y HOSPITA-L SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED JQ"HAVE A PROGRAM WHICH PROVIDES EMPLOYEE~ WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS, CIRCLE YES OR NO A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:.......................... C. PROPER USE OF SAFETY EQUIPMENT: . . . . . . . . , . . . . . . . . , D. EMERGENCY EVACUATION PROCEDURES: . . . . . . . . . . . . . . . . . E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:.,.. ,., INITIAL @) NO YES @ ~ NO ~~O YES ~ REFRESHER ~ NO YES @g) '&Ê) NO ~ NO YES @) SECTION 7: HAZARDOUS MATERIAL CIRCLE, YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID. 55 GALLONS OF A LIQUID. OR 200 CUBIC FEET OF A COMPRESSED GAS: , . , . ., YES ~ I. T\ M R e-R \t Y , certify 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 (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. SIGNATURE ~ f~ TITLE ~~ r DATE 6-1-¥'Î - 2B - '\ .,' ,. " ~ e e I '.' BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY BUSINESS NAME: N. IS.. Re--Pt-11R. Se-RVI¿c ID# fJ. 'i.- ~ 'f..8"~ J ~ >' ~ 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# , OF \ FACILITY UNIT NA."Œ: Or-FILe /J-t.J1J 5Hóf SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES S T DR ft.G-g- IN fV1 cr IJ-~ CON rll-lNI!fì( S. FL DO R A ß 5PR. e>¿7V7 1<; f/c;'¿; 0 7D CON rIJIN ÆN Ð CLEIlN' -SPILLS. . SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS ù~IT ONLY c.. It L l.. PI r< t: 0 e PA R ; »1Ctlr AN 0 8' XI r ßO/L Dvvr; - 3A - e e ¡.~ ;¡¡: ., ~ ''" ~ " 'i~ ",,- "-:" .. [1.. .(' .J- SECTION 3: HAZARDOUS MATERIALS FOR THIS L~IT ONLY A. Does this Facility Unit contain Hazardous Materials? . . , ., ® NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2, SECTION 4: PRIVATE FIRE PROTECTION f ll\e- eXT/fJßVISHi:RS IN "5HCJf' A-NO SHowRoOM SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS '50(./ rHlJe:>7 CoRNéf"'/!. c>P PR.oPc-R ry SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS u~IT ONLY, A. NAT. GAS/PROPANE: UNioN A-V€. A'" IN! ¡fIt. IJÞXe-S ON ST¡;¿If"'E r B. ELECTRICAL: IN "S-r()ct'r /) , ... /'-DO"'" z. ,47 SovT¡-I ~/Oc C. WATER: 50(1 fH wtt>'Í CoRNel< Df fRo'pCI2T r D, SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / :;0 - 3B - "1 o'~ ',- _ AI. ," ." . .. ,..f. i Page BAKERSFIELD CITY FIRE FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY DEPARTMENT >(fRV1C~ vir I. D # 'is-- ~S¥-I2.~~ BUSINESS NA ADDRESS: # p:gKS /Z-L I:? '13JD7 CITY,ZIP:lŠtc:5'fZL n '7330?' (~OS) "3"17-1'7>0 PHONE #: (f'OS) ]Íf)9-0f-ðl IOFFICIAL USE CFIRS CODE ......---/ I ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CON~ USE LOCATION IN THIS % BY HAZARD D.O.T ,CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE \") P ;.2..00qal I ()O~(\I ~ Ot, rJ1 S H O~ CLéAtJ¡tJr¡- Sot Vtnl/r- J¡)()3.0J. PlLQ 3-P_ ;1.009"\ \OOO~IP<rJJ') rr J~ Sµof? A~DSl-iow\?ooN \-\Y~~AuL C OiL (;)--;It{ flLG )' f 5DC¡Q.1 2~OqOt I ~ '} / :J, ~ SHOP 'MoTO R Of¿ ;;L~O <i Pt.Uj ~ P 5D<jC\1. '50~"ql ~ 00 09 S+{O~ c A~~()'RATOR CLEItN-E"R E'/fL S)p \ 00 <;jC\L 50D <jcd Gì4L Ó ; 19 S \-\0 f' ~ fi"RD'SIN e" /17 g .òr P! I hJ DP t S" ~ ~ I, 30 q (:\ \ Ie' ìJ¥- (j 6 /9 -;; H 0 ? G- A SOL j Nell ¥ :L If-LLG J ~f \4'ft3 '30D+p fT3 04 y~ SHoP OXYG-E,N J8~i I&Jr¿ 1;)(1 \LiO£fJ; 300ç-+3 pf' ny t..f7-'5Ho P ACEfYLl37Vé [á.<..{ I EXfL- J ,n· r""'" 1_ - : ./, 2..: " , . ~,;) L, J I..J.... {t-::;;.-; v ~ W i;: LJlh4~ f(D 0 e .. --- í 1M ß,t::Il/ê'r' TITLE: 6WA--µ 4(~ãR SIGNATURE: ~~ ~ ' DATE: &~ 1- ?7 . -------- NL/Æn1.4.A/ l?LrRRY _ TITLE:L)wJV'~ _, PHONE # ~S HOURS: 5'77-/'7SC> UNIT FACILITY FACILITY UNIT NAME: OWNER NAME :jVOR nt ADDRESS: JJ t...}. AFTER BUS HRS: PHONE , BUS HOURS AFTER BUS HRS: 4A-l E'MER EMERGENCY CONTACT: TIm ae-e~ PRINCIPAL BUSINESS ACTIVITY:~