HomeMy WebLinkAboutBUSINESS PLAN 10/15/2003
it to Operftte
Materials/Hazardous Waste Unified Permit
Hazardous
CONDITIONS OF PERMIT ON REVERSE SIDE
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Materials
Date
Issue
Approved by:
Expiration Date:
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Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SERVICES
1715, Chester Ave., 3rd Floor
,Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Permit ID #:: 015-000-001680
R & H TRANSMISSION
LOCATION: 1600 S UNION AVE
Issued by:
Per it to Operate
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
....,......... ,... ..,............... This permit is issued for the following:
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PERMIT ID# 015-021.001680 '¡'; ¡"", ,,~!I :::m"J'I¡'i'ijl\\::"";,;¡,i',;',:,g¡ir"'a, ~:~;:;:~~~~~;:~azardous Materials
R & H TRANSMISSION :¡"¡'Gl':,. ""', Waste
LOCATION 1600 S UNION
Issued by:
Bakersfield Fire Department Approved by: _
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (805) 326-3979 Expiration Date:
FAX (805)326-0576
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PLAN It lVlAP
SITE DIAGRAM 1 V ' FACILiTY DIAGRAM
Business Name: ~ ~ tL.:::r~V'\S1'- ~ss ~
Business ACdress: l(~ÐO S, t)\^ ~¿> r-- Ave.-
For Office Use Only
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UNIFIED PROGRAM aPECTION CHECKLIST.
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACILITY NAME R tlH INSPECTION DATE INSPECTION TIME
~~,^~/~_,___---------_.~---,- Ie> ..../~ -ô"j /01->
~NE No, ---'~ f7.------,~.
ADDRESS No, of Employees
IbÓO 5. t.1/Atð1Ll________.._________, ~"?(- 7/'?D _m__d,,_,..___.._
FACILlTYCONTACT Business ID Number
15-021- C>o/6&'0
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Section 1: Business Plan and Inventory Program
, c
o Routine
o Combined
C] Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
C V ( C=Compliance )
V=Violation
OPERATION
COMMENTS
~ 0 ApPROPRIATE PERMIT ON HAND
--'______~,___,_~___"'_____,_________'_m ..,._,______"_,___"___________m..'....__,..,_,..'_,_~,_.____,___...._'_,___
œl 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE
------------_._~._.._~-.._-----_.._- ---- --,--_.~-_.__. ._--------_.__.~.__._--------_._------ .-----..-.,--...-----.-----..-.-.--------
'62l 0 VISIBLE ADDRESS
----_._--_.~---_._.-.-. .-., _.._-------------_._._._--~---_._----_._._--_._._--,-,.-.-...----- .......-----.-
eI--, 0 CORRECT OCCUPANCY
------,--,
..., _,_ _,__'_,_.._,_......_,_.... ______,_u,_,.__,_u._..__,________,~_,..__...._.. ___u....,____,_
'5l 0
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VERIFICATION OF INVENTORY MATERIALS
,
.___~___ __._._ ____.____. _.,_.___._._.._______,_.___~.________.___'____________nn._ '._____._~__
VERIFICATION OF QUANTITIES
~__.._____~__________~______~__~.___.___.....a....___. ___________________~__..________._____._._.._.___~__.__.____.___..._ _.~~_..__._.__._____._
csrD
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VERIFICATION OF LOCATION
-------------.-- ---~_._----_._-_._._--
-~--_..~------_._---_.__._..-
PROPER SEGREGATION OF MATERIAL
----
----~~_._-_.-----~_.._._---- .._---_.-.._~-------- _..._------------~- -----_..~._-_..._-_..._---
~,D VERIFICATION OF MSDS AVAILABILlTYE
--------
---.-------..------- ----_.._._---~-- -_._.,--_._----------------~--,----~---
s.., 0 VERIFICATION OF HAT MAT TRAINING
__ ______,___'____m'___ _,__,_~,__..______"__,____..,_,__._._.._,_,__",.._,___,_.._,_.....__
ß!J..., 0 VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
'_______.._,_______...'.._____ ,_________,__,....___,__"_"mm'____"'__,_.._,____,______m,__'
_Ct _~ EMERGENCY..':~OCEDURES ADEQ~~~~_____________'í-..'--'--'---....-'-..,-'-..--..,..,____..__,___"..__...._,__.._..~_,_,___
~ 0 CONTAINERS PROPERLY LABELED
---~------_.~------_._-------- ,.----.-.-, .__._---_._--_.._-----_._-------_._.__._-------_...'~---.-------------
òl 0 HOUSEKEEPING ~
____,_________ ,__,_,_______ _______~__m__m_..'___,_____,__,_.___'__n'..m
[5{ 0 FIRE PROTECTION
---,~---_._---,-----~--~-~--"'- -._,--~-_..-----,-,-,--,-'._-,.._-~,-'---~---'-",..,"-,---,---
(.1., 0 SITE DIAGRAM ADEQUATE & ON HAND
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EXPLAIN:
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HCtZ- 1'14+ 1'\A~ecf/~
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ANY HAZARDOUS WASTE ON SITE?:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
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Inspector I Badge No,
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White· Environmental SelVices
Yellow - Station Copy
Pink - Business Copy
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
RECEIVED
OCT 1 [) 2000
ENVIROM ~ERV'CES
FACILITY NAME~t\ TrA JS ml SS~l:>¡V
ADDRESS HolúS_ l.Ls..IID~ ~v e..
FACILlTYCONTACT~A.AJnI JJ.¿(~
INSPECTION TIME ..20 '-,~
INSPECTION DATE 10 - b - óO
PHONE NO. ð3t/- ¡, 3D
BUSINESS ID NO. 15-210- O() illJðD
NUMBER OF EMPLOYEES 2-
Section 1:
J&1 Routine
Business Plan and Inventory Program
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Appropriate permit on hand V
Business plan contact information accurate / ? --- 4+JJ 2 tJrJ c&:nJ j~-!-
Visible address / DA--V I J ~rNA-rJ J-c. 7'
Correct occupancy ./ 2. e.I ,.f,- or,9 - :SS'J.3
Verification of inventory materials ,/'
Verification of quantities ./ t/ P -::....~ J Qþ('AHh+ø~
'" AL~ h.f \'U'\-<.
Verification of location ./ -
Proper segregation of material v - C> V 'f9-~
/ . ..
Verification of MSDS availability - Arçw,,J
, Verification of Haz Mat training ,¡ v
Verification of abatement supplies and procedures I
Emergency procedures adequate V
Containers properly labeled V
Housekeeping ,/
Fire Protection LI
Site Diagram Adequate & On Hand I
C=Compliance
V=Violation
Any hazardous waste on site?; ~ es 0 No
Explain: U/I't5~ 6, /
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White - Env. Svcs,
Yellow - Station Copy
Pink - Business Copy
Questions regarding this inspection? Please call us at (661) 326-3979
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MISCELLANEOUS RECEIVABLES ADJUSTMENT
DATE3-/~ -~
NEW ACCOUNT 1
ADDRESS CHANGE
CLOSE ACCT I
: FINANCE CHARGE I ~ I
' OTHER ADJ ! ,X
£¿cþ\
MAILING ADDRESS \ ~' S-
CITY M.-e£~ ~ì ..::.\01., STATE
CUSTOMER NAME
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SITE ADDRESS
PARCEL NUMBER
(IF APPUCA8I.E)
ADJUSTMENT
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R~Af;S: b~; ~ó ~~(ck~~ slojJ-'vp_
APPAOVEDBY 4~.-/
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~'. ' ð~ BAKERSFiELD CITY FIRE DEPARllViENT
OFF:E OF ENVIRONMENTAL S!VICES
1715 CHESTER AVENUE, 3RD FLOOR
BAKERSFIELD, CA 93301
(805) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHECK IF BUSINESS IS A FARM [
, 3US¡NESS NAME ~ ~~~\A""-,"Þ\A.-~~D^
FAc:un DESCRIPTION
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Differential- T/Cases - Drivelines
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R & H TRANSMISSION
1600 S. Union Ave, Bakersfield, CA 93307
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NICK ROSAN-Owner
(805) 834-7130
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EME~GENCY C8NT ~CTS
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<f?3<f - 7 t3Õ
24-HOUR PHONE ~73 - 8~
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BAKER56LELD CITY FIRE DEPAiTMENT~
HAZAWbous MATERIALS INVEN"feRY :
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~siness Name
Address
~ CHEMICAL DESCRIPTION -.......... '. '.,
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1) INVENTORY STATUS: N_I I Addition I ) Revision ( I Deletion I I Check if chermc.¡ is . NON TRADE SECRET' r -J ' TAACe SECRET [ J
Z) Common N.",.: (.A fA ~'i.;: 0'; I 3) DOT # (optional)
Chermcal Name: AHM [ J CAS #
I
.1) PHYSICAL & HEALTH PHYSICAL HEALl1i
HAZARD CATEGORIES Fire I ¡ AeacÙYe I ] Sudden Release 01 Pressure ! ] Immediate Health (Acute) [ J Delayed Healttl (Chronic) I J
':) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE
-3) PHYSICAL STATE Solid I] l.jqulCi I ) Gas I J Pure I Mixture ( J Waste [ ] RaáIoactiw [ ] I
;¡;(OC AU. T'HJ.T API't,
ì) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES I
."""om 00" Am,,,",, ! :bs ( ] -;¡aJ (tV 1'13 [ J a) Container:
,l.verage Daily Amount: :unes I ] b) Pressure: I
,l.nnuai Amount: t l 0 c) Temperature: i
Largest SizeConlêlJner. I
:I Days On Site Circle iNhicn Months: All Year. J, F, M, A. M. J. J. A. S. O. N. D I
3) MIXTURE: Ust COMPONENT CAS # %wr AHM I
:,'1e three most hazaraous 1) I I I
:,~emICal comoonems or !
any AHM comoonents 21 [ ] I
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3) [ ] !
. 0) LOCallon ,
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/ CHEMICAL DESCRIPTION
, I INVENTORY STATUS: New ( ] ,.J.ddition r ] ReVISion ( ] CJeletion f ] Check if chemical is a NON TRADE SECRET [ ) TRADE SECRET [ ]
::) Common Name: SO\\J~'t- 3) DOT # (optional) i
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,
C~emlcal Name: AHM { ] CAS # i
;
~\ PHYSiCAL.3. HEALTl-i PHYSICAL HEALTH ,
!
"'AZARD CATEGORIES Fire [ ] ~eactlve ( ] Suaden Release of Pr!ssure ¡ ] Immedime Health (Acute) [ J Delayed Health (ChronIC) [ I ;
5) WASTE CLASSIFICATION ~3-diglt coae from OHS Form 80221 USE CODE !
,
3) PHYSICAL STATE Solid ( IJOUIO ( I Gas ( ¡ Pure [ ] ~.1ixture [ ] Waste [ ] Radioactive I ) i
! I
:·f~.I.L..L --Ar APPl~
;") AMOUNT AND TIME AT FAC:UTY
,',1axlmum Oaliy Amount:
'-verage Oally Amount:
Annual Amount:
L...1rgest Size Container.
. Da~ an Site
~01
~<~
~~ --~
~ .
~,~
8) STORAGE CODES
a) Container:
b) Pressure:
c) Tempel1lNre:
C;rc!e iNhic:h Months: ~J, F, 1.1, A. M. J. J. A. S, O. N. D
JNITS (;F ~EASURE
Os !;aJ [V~3 [ ]
:~nes [ ]
3) MIXTURE: Ust
:he three most hazaraous
C:1emlCal components or
any AHM ccmponents
COMPONENT
CAS #
%wr .
AliM
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[ )
[ 1
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1 0) l.oca1ion
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INT Nám. & Title of AuthonZfKJ Comøanv Reoresenmtive SigndJre '-
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BAKER'IELD CITY FIRE DEP'RTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 CHESTER AVENUE, 3RD FLOOR
BAKERSFIELD, CA 93301
(805) 326-3979
I ,
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
.
,.
70 avoid fUrTher action, íe¡Urn this form within 30 days of íeceipt.
iYPEJPRINT ANSWERS IN ENG~¡SH.
Answer ¡he cuestions below tor the Dusiness as a whole.
Se brief and conc:se as ¡:cs.sibie.
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SECTION 1: BUSINESS 1DENT1F¡CATION DATA
3US¡~~E5S NAME:
'T(4'$ T ~ I1Å- ;S.s 1<' ~V1
~'= C ,":'.TIC N:
I hf.ù ,3. Ù IA-~ A )().--
\'\A;!_:NG AC DRESS: ~\
C:~'(: \3~~S;-~~ S¡ A ï=: ~ Z\P: <ß3D7PHONE: 8~lf--7 (3.0
=~~~ 2 S~ACS¡~E=: >~¡.JM8:~:
SiC ::::)0=:
=~¡~vlARY ,~C¡;\¡!r(: T~V\bVv\.~55:c'" ,S'^-öf
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SEC710N 2: ~MERGENCY NOT1FIC,;ïION:
CCNïAC¡
ïiïL:::
8US. ?HONE
24 HR. PHONE
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ba.K.ersñeld Fire DeDt.
.azardous Materials Di~sion e
HAZARDOUS MATERIALS MANAGEMENT PLAN
.. ---....
...--..
SECT10N 3: TRAIN1NG:
NUMBER OF EMPLOYEES:...g--
MATERIAL SAFEïY DATA SHEETS ON FiLE: y.¿.5
BRIEF SUMMARY OF TRAINING PROGRAM: 0
SEcnON 4: ~XEMPTION REQUEST:
i C::::~TIFY UNCE~ ?::NALTY OF ?:::<JURY -:-;P.,I MY 3USiNESS IS EXEMPT FROM THE
¡~E~GRT[NG 2E';:UlREVlENTS OF C:-{APE:< :J.Y5 OF THE "CALlFORNIA HEALT~ &
:3AF=~Y C::JCE' :CR THE ~ClLCW\NG ~E,':',SCi'jS:
:r¿ :0 NOT ',-{ANDLE :-:,Ä='~,~CCUS MAïE~!ALS.
,IfE :0 :~i~,Ì'jCl= ~A,Z.":',;~=C ~S ~¡1A E~iA,LS, 3UT THE QUANTITiES AT NO
-::vlEE:<C=E= T:-:E :v1INIMLI\'ì~E~CrHiNG QUANTrT!ES.
:= 7;-':, =~ (SP =,::::=.,( RE.~SC :-l',
SECTION 5: CE~TIF¡CÂTION:
!, Jlt--J,L ~~ C::::<TIFY THAT THE ,A.60VE INFOR-
MAïlON IS ACC:~RATE. ¡ UNOERSTAi\c; Ti-1P..i THIS INFORMATION WILL BE USED TO
FULFiLL MY F:Riv1'S CBliGA ¡¡ONS UNCE~ T:-:E'C.';UFORNIA HEALTH AND SAFE:Y CODE"
ON H.A.ZARCCUS MATEK[ALS (O(V. 20::-:.A.PTER 6.95 SEC. 25500 ET AL.) AND THÁT
INACCURATE iNFORMATION CONSTiTUTES PERJURY.
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SIGNATURE
Ow /11'-( /"-
TITLE
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DATE
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-~- Bak.ersfieldFire Dept. .
Hazardous Materials Division
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEi~SE PREVENTION STEPS:
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3.
RELE.w..SC:'C8NTAINMENT AND/OR MINIMIZATION:
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C:~=.~,N-UP ?~CCEJURES:
U$.el A-b~6 ¿~ ~ s+-I:>e..-ed-
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SECTION 3: UTILITY SHUT-OFFS ~LCC.~T¡O[\ C~ Si-1UT-OFFS AT YOUR FActLlTY):
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SEC710N 9: PRIVATE FIRE PRCTEC¡ICNfWATER AVAILABILITY:
A. PR!V A TE ¡:¡RE PROTECTtON: H-eQ.. <2-'P'i-~~\.A,~~~ ~ t.u~L{
B. WATER AVAILABILlTY (FiRE HYDRANT):
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.DG..:).ersn.~la. .tile lJept.
e Hazaràous Materials Division.
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HAZARDOUS. MATERIALS MANAGEMENT PLAN
Facility Unit Name: \:iß- ~~ tlv\.b-s /ð/)
SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES:
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AGeNCY NOTIFICATION PROCEQURES:
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¿;Q tu-A- ~'Ì-e- ß) 'c l .!51C:> '-:: V
3. ='~¡1pl_C'YE= NOT!F¡C.~ï¡CÌ'l ,.).,Ì'lO::"lACUAilON:
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