HomeMy WebLinkAboutBUSINESS PLAN
FIRE CHIEF
;;m: FRAZE
ADMINISTRATIVE SERVICES
2101 "W Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "W Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
~
PREVENTION SERVICES
FIRE SAFETY SERVICES. ENVIRONMENTAl SERVICES
1715 Che~r Av~,
Bakersfield,'{;A 93301
VOICE (66'),326-3979
FAX (661)'f326-0576
"
PUBLIC EDUCATION
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-0576
FIRE INVESTIGATION
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
TRAINING DIVISION
5642 VIctor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
-
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September 8, 2003
CERTIFIED MAIL
Harris Market
1701 Union Avenue
Bakersfield, CA 93305
REMINDER NOTICE
Re:
Deadline for Dispenser Pan Requirements December 31,2003
Dear Underground Storage Tank Owner/Oper~tor:
A review of our files indicate that you have been receiving quarterly reminders
from April of 2002 to December 2002. Our files further show that since January
of this year you have been receiving monthly reminders.
The purpose of this letter is to remind you of the necessary retrofit of your
fueling system. Current code requires that you install under dispenser
containment pans prior to December 31, 2003. You will not be allowed to pump
fuel after December 31, 2003 unless you have completed the upgrade
requirements.
Contractors are already scheduling 8-10 weeks in advance. I urge you to retrofit
your facility as soon as possible.
Should you have any questions, please feel free to contact me at 661-326-3190.
Si~cerel:,,; ours,{££/ ", '
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, ,
Steve Underwood
Fire InspectorlEnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/db
~~..%~ de Ý5£vn//Uuu{? ~/e .~ope .o/Æu/l- ,-Æ W~y""
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SENDER: COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted ,Delivery is desired.
· Print your na{l1e and address on the reverse..".
so that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the fr;,ont if space permits,
1. Article Addressed to:
o Agent
o Addressee
C. Date of Delivery
q- I 0" 6~
D. Is d Ivery address different from item 1? 0 Yes
If YES, enter delivery address below: 0 No
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HARRIS MARKET
1701 UNION A VB
BAKERSFIELD CA 93305
3.\. Service Type
M.certified Mail
o Registered
o Insured Mail
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4, Restricted Delivery? (Extra Fee)
2, Article Number
(Transfer from service label)
: PS Form 3811, August 2001
o Express Mail
o Return Receipt for Merchandise
DC,O.D.
DYes
Domestic Return Receipt
7002 3150 0004 9985 4353
102595-02·M·1540
-- ._---
USE
¡ '.
Postage $
',3"
~ 0 Certided Fee
10 '
: 0 Return Reciept Fee
, '(E!!ct0rsement Required)
¡ 0 Restricted Delivery Fee
,LIl (Endorsement Required)
'.-=I
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Postmark
Here
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'0
: I"- ~6r.4P£N¡
or PO Box No
ëñÿ,-Siãië;Z¡]
HARRIS MARKET
1701 UNION AVE
BAKERSFIELD CA 93305
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--
PS Form 3800, June 2002 See Reverse for Instructions
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FiRE CHIEF
~ON FR,è.ZC:
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield. CA 93301
VOICE (661P26-3941
FAX (661) 395-1349
~
PREVENTION SERVICES
1715 Ctister Ave.
Bakersfield. CA 93301
VOICE (66,1) 326-3951
FAX (661) 326-0576
,
ENVIRONMENTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326·3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave,
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
'-
-
July 8, 2003
CERTIFIED MAIL
Hams Market
1701 Union A venue
Bakersfield, CA 93305
REMINDER NOTICE
Re: Deadline for Dispenser Pan Requirements December 31, 2003
Dear Underground Storage Tank Owner/Operator:
A review of our files indicate that you have been receiving quarterly reminders
from April of 2002 to December 2002. Our files further show that since January
of this year you have been receiving monthly reminders.
The purpose of this letter is to remind you of the necessary retrofit of your fueling
system. Current code requires that you install under dispenser containment pans
prior to December 31. 2003. You will not be allowed to pump fuel after
December 31, 2003 unless you have completed the upgrade requirements.
Contractors are already scheduling 8-10 weeks in advance. I urge you to retrofit
your facility as soon as possible.
Should you have any questions, please feel free to call me at (661) 326-3190.
Sincerely,
Ralph Huey
Director of prãtio~ s~rvices
~d1uv
By: Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SU:db
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SENDER: COMPLETE THIS SECTION
r
· Complete items 1, 2, and 3, Also complete
item 4 if Restricted Delivery is desired,
· Print your name and address on the reverse
so that we can return the card to you.
· Attach this card. to the back of the mailpiece,
or on the front if'space permits;
1, Article Addressed to:
,I
,
'\
D, I delivery address different from item 1?
If YES, enter delivery address below:
HARRIS ,MARKET
1711 UNION AVENUE
BAKERSFIELD CA 93305
3. Service Type
J8. Certified Mail
o Registered
o Insured Mail
o Express Mail
o Return Receipt for Merchandise
o C,Q,O,
,
,'---~ -~-~~~~~~~,~~~~./
4. Restricted Delivery? (Extra Fee)
DYes
2, Article Number
(Transfer from service label
PS Form 3811, August 2001
7002 3150 0004 9985 3424
, .
Domestic Return Receipt
102595·02·M-1540
USE
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10
o
,0
P~ $
Certlr.@Fee
--
Return Recie¡Ít Fee
(Endorsement Requlred)- _
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Restricted Delivei!y Fee
(Endorsement Required)
Postmark
Here
:0
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ru
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Total Postage & Fees $
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.
!'iR2 CHIEF
"'O~¡ rRAZE
ADMINISTRATIVE SERVICES
2101 "W Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "W Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
FIRE SAFETY SERVICES· ENVIRONMENTAl SERVICES
1715 Chester Ave.
Bakersfield. CA 93301
VOICE (661) 326-3979
FAX (661) 326-<J576
PUBLIC EDUCATION
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-<J576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield. CA 93301
VOICE (661) 326-3951
FAX (661) 326-<J576
TRAINING DIVISION
5642 VIctor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
e
--
June 5, 2003
Harris Market
1701 Union A venue
Bakersfield CA 93305
REMINDER NOTICE
RE:
Deadline for Dispenser Pan Requirements December 31, 2003
Dear Underground Storage Tank Owner:
A review of our files indicate that you have been receiving quarterly
reminder notices since April of 2002. Effective January 2003, you can
expect them monthly.
The purpose of this letter is to remind you of the necessary retrofit of
your fueling system. Current code requires that you install dispenser
pans prior to December 31,2003. You will not be allowed to remain
open after December 31, 2003 unless you have completed the upgrade
requirement. Contractors are already scheduling work 6-8 weeks out.
I urge you to start planning to retrofit your facility as soon as possible.
Sin)
Steve Underwood
Fire InspectorÆnvironmental Services
Office of Environmental Services
SBUlrs
~~y~ &, ~/n.nu~ ~ '~OPe .9T~ t./-.Ø; W~?"
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HARRIS MARKET
SiteID: 015-021-000701
Manager :
Location: 1701 UNION AVE
City BAKERSFIELD
BusPhone:
Map : 103
Grid: 29C
(661) 636-0271
CommHaz : Low
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 02
EPA Numb:
SIC Code:5541
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
HYON & SOON KIM / OWNER JOHN KIRLEY / JACO OIL
Business Phone: (661) 636-0271x Business Phone: (661) 633-7544x
24-Hour Phone : ( 661) 665-2809x 24-Hour Phone . (661) 393-7000x
.
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact : JOHN KERLEY Phone: (661) 393-7000x
MailAddr: PO BOX 82515 State: CA
City : BAKERSFIELD Zip : 93380
Owner JACO HILL Phone: (661) 393-7000x
Address : PO BOX 82515 State: CA
City : BAKERSFIELD Zip : 93380
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
~ r u¥ Do hereby certify that I have
I ().\\\. t, IN- \
r (Type or print name) ,
. ed t'he attached hazardous materials manage-
review
~ t\ ~ ~ and that it along with
ment plan for, ~Name of uSlness)
any corrections constitute a complete and correct man-
agement plan for n;¡y facility.
C\4¿~
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Date
-1-
07/25/2002
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F HARRI S MARKET
SiteID: 015-021-000701 9
STORAGE CONTAINER DATA (UST FORM A)
Last Action Type:
FACILITY/SITE INFORMATION
Business Name: HARRIS MARKET
Cross Street :
Business Type: Org Type:
Total Tanks : 3 IndnRes/Trust: No PA Contact:
PROPERTY OWNER INFORMATION
Name : JOHN KIRLEY Phone: (661) 633-7544x
Address:
City : State: Zip:
Type : PARTNERSHIP
TANK OWNER INFORMATION
Name : JOHN KIRLEY Phone: (661) 633-7544x
Address:
City : State: Zip:
Type : PARTNERSHIP
BOE UST Fee# : 019753
Financ'l Resp: SELF INSURED
Legal Notif : Tank Owner Mailing Address
Date:06/07/2000 Phone: (661) 393-7000x
Name:ROBERT HALL Ttl:GAS OPERATIONS MGR.
State UST # : 1998 Upg Cert#: 00773
f= Hazmat Inventory One Unified List 9
f== Alphabetical Order All Materials at Site 9
Hazmat Common Name. . . SpecHaz EPA Hazards DailyMax MCP
CARBON DIOXIDE F P IH G 600.00 FT3 Min
REGULAR UNLEADED F IH DH L 12000.00 GAL Mod
SUPER UNLEADED F IH DH L 12000.00 GAL Mod
UNLEADED PLUS F IH DH L 12000.00 GAL Mod
-2-
07/25/2002
.
.
SiteID: 015-021-000701 9
Facility Unit: Fixed Containers on Site 9
F HARRI S MARKET
f= Inventory Item 0004
F== COMMON NAME / CHEMICAL NAME
CARBON DIOXIDE
Days On Site
365
Location within this Facility Unit
SODA FOUNTAIN
Map:
Grid:
CAS#
128-38-9
- TYPE
Pure
PRESSURE
Above Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
600.00 FT3
Daily Average
600.00 FT3
%Wt. RS CAS#
100.00 Carbon Dioxide No 124389
HAZARDOUS COMPONENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Min
HAZARD ASSESSMENTS
f= Inventory Item 0003
== COMMON NAME / CHEMICAL NAME
REGULAR UNLEADED
Facility Unit: Fixed Containers on Site 9
Days On Site
365
Location within this Facility Unit
UST
Map:
Grid:
CAS#
8006-61-9
STATE - TYPE
Liquid Pure
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
UNDER GROUND TANK
Largest Container
,12000.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
12000.00 GAL
Daily Average
7000.00 GAL
%Wt. I
100.00 Gasollne
HAZARDOUS COMPONENTS
~.
CAS # I
8006619
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
HAZARD ASSESSMENTS
-3-
07/25/2002
.
.
SiteID: 015-021-000701 9
Facility Unit: Fixed Containers on Site 9
F HARRI S MARKET
f= Inventory Item 0001
== COMMON NAME / CHEMICAL NAME
SUPER UNLEADED
Days On Site
365
Location within this Facility Unit
UNDERGROUND STORAGE TANK
Map:
Grid:
CAS#
8006-61-9
STATE - TYPE
Liquid Pure
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
UNDER GROUND TANK
Largest Container
12000.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
12000.00 GAL
Daily Average
7000.00 GAL
HAZARDOUS COMPONENTS
l;rl
CAS # I
8006619
%wt. I
100.00 Gasoline
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
HAZARD ASSESSMENTS
f= Inventory Item 0002
=== COMMON NAME / CHEMICAL NAME
UNLEADED PLUS
Facility Unit: Fixed Containers on Site 9
Days On Site
365
Location within this Facility Unit
UNDERGROUND
Map:
Grid:
CAS #
8006-61-9
STATE - TYPE
Liquid Pure
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
UNDER GROUND TANK
Largest Container
12000.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
12000.00 GAL
Daily Average
7000.00 GAL
%Wt.
I Gasoline
HAZARDOUS COMPONENTS
~
CAS # I
8006619
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Mod
HAZARD ASSESSMENTS
-4-
07/25/2002
.
.
Employee Notif./Evacuation
SiteID: 015-021-000701 ì
Fast Format ì
Overall Site ì
12/18/1998 1
01/30/1991
F HARRIS MARKET
I
f= Notif./Evacuation/Medical
~, Agency Notification
CALL 911.
EMPLOYEES, ONLY 1 OR 2 IN STORE, COULD BE CALLED BY VOICE AS STORE IS SMALL.
Public Notif./Evacuation
12/18/19981
03/10/1998
VERBAL.
Emergency Medical Plan
MEMORIAL HOSPITAL - 2215 TRUXTUN AVE - 327-3371.
-5-
07/25/2002
.
.
SiteID: 015-021-000701 9
Fast Format 1
Overall Site 9
01/30/1991
F HARRIS MARKET
I
f= Mitigation/Prevent/Abatemt
Release Prevention
SIGNS ON GAS PUMPS. AUTOMATIC SHUT-OFF FOR GAS PUMPS.
Release Containment 01/30/1991
CONTACT JACO OIL TO GET SHUT OFF PROCEDURES OR REPAIR.
Clean Up
01/30/1991
PUT KITTY LITTER OVER SPILL AND CLEAN UP IN APPROVED CONTAINER.
Other Resource Activation
-6-
07/25/2002
0- .
.
.
SiteID: 015-021-000701 9
Fast Format 9
Overall Site 9
I
F HARRIS MARKET
I
p= Site Emergency Factors
~ Special Hazards
Utility Shut-Offs
03/10/1998
A) GAS - NONE
B) ELECTRICAL - NE CORNER OF STORE
C) WATER - NW CORNER IN ALLEY WAY
D) SPECIAL - NONE
E) LOCK BOX - NO
Fire Protec./Avail. Water
12/18/1998
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER.
FIRE HYDRANT - CORNER OF 17TH AND UNION 50FT FROM GAS PUMPS.
Building Occupancy Level
-7-
07/25/2002
.
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SiteID: 015-021-000701 ì
Fast Format ì
Overall Site ì
03/10/1998
F HARRI S MARKET
I
F Training
Employee Training
WE HAVE 4 EMPLOYEES AT THIS FACILITY.
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TOLD WHAT TO DO IN CASE OF
POSSIBLE HAZARD AND INSTRUCTIONS ARE ON HAND.
Page 2
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I
I
Held for Future Use
Held for Future Use
-8-
07/25/2002
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 MH" Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661)395-1349
SUPPRESSION SERVICES
2101 MH" Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
1715 Chester Ave,
Bakersfield. CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
ENVIRONMENTAL SERVICES
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Viclor Ave,
Bakersfield. CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
--
-
July 1,2002
Harris Market
1701 Union Avenue
Bakersfield, CA, 93305
RE: Deadline for Dispenser Pan Requirement December 31, 2003 for Site
Location at 1701 Union Ave., Bakersfield.
REMINDER NOTICE
Dear Underground Storage Tank Owner,
You will be receiving updates from this office with regard to Senate Bill 989
which went into effect January 1,2000.
This bill requires dispenser pans under fuel pump dispensers. On December
31, 2003, which is the deadline for compliance, this office will be forced to
revoke your Pennit to Operate, for failure to comply with the regulations.
It is the hope of this office, that we do not have to pursue such action, which
is why this office plans to update you. I urge you to start planning to retro-fit
your facilities.
If your facility has been upgraded already, please disregard this notice.
Should you have any questions, please feel free to contact me at (661)326-
3190.
Si2rJ1,mo
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
"Y~ ûfe W~ .¥CP vØ60Pe .r~ .Æ W~"
'- CITY OF BAKERSFIEI£,
OthCE OF ENVIRONMENTAL.RVICES
1715 Chester Ave., CA 93301 (661) 326-3979
BUSINESS OWNER I OPERATOR IDENTIFICATION
FACILITY INFORMATION
;:r-/r't~;.\':' ¡'>', ';:~~;'~~':f~~ :.*,/~; ~':,~;: ti;t~"f\<¡~'·~~!i.~¡:," ':'~";':.~,,,,;; ,~. ..;,¡-) i;:\¡..\~ '. .; ,:;',:. ;;"":
::~~t:FACILITY;lDENTlFICA TlON\:;:'t;;::, ,;, ."
;..m.\=n"';""~-:.¡:..t~.tJ'':;'t'''.'':''''.};J:'''( '~"" "{;..,:, ~f....':t\-.."~;·'..,~~.;",\·-"~··..·,.',,,,'¡;,,, ,,:,:,.~ "".. ,:, ,.';:-:-.
1 Year Beginning 100 Year Ending
Page _ Of
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101
3
102
¡ SITEADDRESSð, Uµ/~ ME:.....
-CITY '/~Pf£Uþ
103
104 I CA
ZIP
105
!
~ DUN &
i BRADSTREET
106 SIC CODE
(4 Digit #)
107
I
I COUNTY
! OPERATOR NAME
106
I 24-HOUR PHONE
1-,
J PAGER #
127 24-HOUR PHONE
132
128 PAGER #
133
Certification: on my Inquiry of those Indlvfduals responsible for obtaining the Information, I certify under penalty of law that I have personally examined
and am fam a with Information subm tted In thl Inventory and believe the Information Is true, accurate. and complete.
ERlO RAt DAT ¡; 134 NA OF DOCUMENT P~e¡~~E~ /
9/:JflëJ 'w-~.
138 T'Tþo;r/~77frL ¿ ¡J~ð7Js )(~7
135
UPCF (7/99)
S:\CUPAFORMS\OES2730.TV4.wpd
- CITY OF BAKERSFIE.
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
DNEW
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200
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(one form oe, male"'" "", building 0' /lfN)
Page at
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3
1 MAP /I (oplionBl)
2011 CHEMICAL LOCATION
¡ CONFIDENTIAl (EPCRA)
203 i GRID /I (optional)
o Yes 0 No 202
204
FACILITY ID /I ,
!
i
·~~,~~~¥~'~~~~~,:1;~~~i~.Ç~~~~Iif9~rf~."~1¡F~"0Ú~:: ~";!~~'
o Yes No 206
If Subject to EPCRA. rtlf!If 10 inšll\ldions
CHEMICAL NAME 6-A-sð L ( Ale!:
COM~NNAt.E U 1\J L~b ~ ~ ¿G-úL14-!2-.
CASII ss-'-f I
207
EHS·
oVes oNo 208
209
FIRE CODE HAZARD ClASSES (Ccmplele if reques1ed by lOCal fire cheI)
TYPE
'720 67fU> 219
opPURE
o w WASTE 211 RADIOACTIVE
PHYSiCAl STATE
214
lARGEST CONTAJNER
ogGAS
FED HAZARD CATEGORIES
(Ched< ~ !hat apply)
ANNUAl WASTE
A~UNT
o 4 ACUTE HEAlTH
o 3 PRESSURE RELEASE
05 CHRONIC HEAlTH
218 AVERAGE
DAilY AM)UNT
UNITS"
II GAl 0 d CUFT 0 Ib L8S 0 In TONS
If EHS. amount must be In Ibs.
223
STORAGE CONTAINER
(Check all t/Jat apply)
o a ABOVEGROUND TANK
.l)i& UNDERGROUND TANK
o c TANK INSIDE BUILDING
o d STEEL DRUM
De PlASTICINONMETALlIC DRUM
Of CAN
o 9 CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GlASS BOTTLE
o n PlASTIC BOTTLE
o 0 TOTE BIN
o p TANK WAGON
210
212 ¡ CURIES
213
~L
215
216
221
222
220
o q RAIL CAR
o r OTHER
STORAGE PRESSURE
i1 a AMBIENT
o aa ABOVE AMBIENT
o ba BelOW AMBIENT
224
STORAGE TEMPERATURE
o . AMBIENT
o .. ABOVE AMBIENT
fiiS Þa BElOW AMBIENT
225
5
231 o Yes 0 No 232
235 o Yes 0 No 238
239 DYes 0 No 240
243
UPCF (7/99)
o c CRYOGEN,IC
233
237
241
245
:~ \:<1: ~'~~~~ ~~~~.
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S:\CUPAFORMS\OES2731.TV4.wpd
e CITY OF BAKERS FlEa
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
DNEW
DADO
200
o DELETE
,',
:~.~. "
(one form ;Je' matensl ~r bulding or area)
Page 01
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3
~
,
2011 CHEMICAL LOCATION
I CONFIDENTIAL (EPCRA)
203 GRID' (opâonal)
DYes 0 No 202
204
.... :
CHEMICAL NAME 6> fI 5ð Lj ¡V ~
COMMJNNA~ WL~j) PLUS
CAS' ss-c.¡ /
205
TRADE SECRET 0 Yes No 206
If Subject to EPCRA, refer to instllJdions
,.:, , -;.,.--. :
207
EHS·
DYes 0 No 20B
209
FIRE CODE HAZARD CLASSES (Complete if requested by local tire c:nieI)
TYPE
00 GA--t-S
oøPURE
o w WASTE 211 RADIOACTIVE
PHYSICAL STATE
214
lARGEST CONTAINER
ogGAS
FED HAZARD CATEGORIES
(Check ~ that apply)
ANNUAl WASTE
AMJUNT
o 3 PRESSURE RELEASE
o 4 ACUTE HEAlTH
o 5 CHRONIC HEAL lli
UNITS-
geGAL OdCUFT
If EHS. amount must be In Ibs.
218 AVERAGE
CAlLY AMOUNT
o Ib L8S 0 In TONS
210
212
213
~L
215
216
219
222
220
221
STORAGE CONTAINER
(Check all that apply)
o a ABOVEGROUND TANK
J)ì'& UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
o e PlAST1C1NONMETAlLIC DRUM
O/CAN
o 9 CARBOY
o h SILO
o i FIBER DRUM
DjBAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PLAST1C BOTTLE
o 0 TOTE BIN
o ø TANK WAGON
o q RAIL CAR
o r OlliER
223
STORAGE PRESSURE
ill AAeIEHT
o sa ABOVE AMBIENT
o be BELOW AMBIENT
224
STORAGE TEMPERATURE
D .. ABOVE AAeIEHT
W be BELOW AMfIEHT
225
o e AMfIEHT
o C CRYOGENIC
4
238
231 Dyes oNo 232
235 DYesDNo 238
239 o Yea 0 No 240
243 DYes 0 No 244
242
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/33()-M-7 237
233
241
245
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o as ABOVE AMBIENT o be BelOW AMBIENT 224
o as ABOVE AMBIENT W ba BELOW AMBIENT o ç CRYOGENIC 225
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231 DYes 0 No 232 (Ò f' -ff-3 233
235 OYesONo 238 330-~-7 237
239 DYes 0 No 240 241
243 245
. CITY OF BAKERS FIE.
OJ'hCE OF ENVIRONMENTAL ~RVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
L.
I CHEMICAL LOCATION
()L/NL
COMMON NAME Û ¡J LZA-V ~ $V f¡2.<é.hL ~ ðLI tV ~
CAS' ss-'-f (
FIRE CODe HAZARD CLASSES (Comp/ele if requested by local fire d1ieI)
TYPE
o Ib LBS
o In TONS
OpPURE
o w WASTE 211 RADIOACTIVE
PHYSICAL STATE
214
LARGEST CONTAINER
DgGAS
¡ FED HAZARD CATEGORIES
¡(Check aJ1lhat apply)
I ANNUAL WASTE ^ \ A-. I ~
I AMOUNT I V CT7\.) c::"--
UNITS·
o 3 PRESSURE RELEASE
o 4 ACUTE HEALTH
05 CHRONIC HEALTH
218 AVERAGE
DAILY AMOUNT
98 GAL 0 d CUFT
If EHS. amount must be In Ibs.
STORAGE CONTAINER
(Check all that apply)
I
I
I STORAGE PRESSURE
08 ABOVEGROUND TANK
~ UNDERGROUND TANK
o ç TANK INSIDE BUILDING
D d STEEL DRUM
,De PlAST1C1NONMETALLIC DRUM
Of CAN
09 CARBOY
o h SILO
o I FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PlASTIC BOTTLE
00 TOTE BIN
o P TANK WAGON
~ a AMBIENT
STORAGE TEMPERATURE
o a AMBIENT
238
242
(one form per material per bulding or area)
Page of
DYes 0 No 202
204
210
CURIES
213
215
216
219 STATE
~
220
221
DAYS ON SITE
222
o q RAIL CAR
Dr OTl-iER
223
UPCF (7/99)
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