HomeMy WebLinkAboutBUSINESS PLAN
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CITY Of BAKERSFIELD
\ P.O. BOX 20~7
I BAKERSFIELD, CALIFORNIA 93303-2057
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I ADDRESS CORRECTION REQUESTED
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:RUIZ'S COMP TUNE
~?20 0 E CALTFDRNIA AVENUE
¡ E:A~Œ:¡:;:SF:Œ:LD CA ('13:;U) 7,
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RU.!l"S COMPTUNE
1217 WASHI NGTON
BAKERSFIELD, CA 93305
HH461601
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March 5, 1990
TO: Nina Mayer, Accounts Receivable
FROM: Ralph E. Huey, Hazardous Materials Coordinator
SUBJECT: Ruiz's Cdmp Tune
Nina, account #461601 has moved to the county. This business
should be rebilled with a prorated bill xor July and August and
then the account should be closed.
Thanks,
Valerie
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KERN COUNTY FIRE DEPARTMENT rQ) æ A re ø t'\n rÐ rm
5642 VICTOR STREET ~ æ ~ œ w æ ~
BAKERSFIELD. CA 9~308
(805) 861::-27()1 ß AUG 11187 R E CE I V ED
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OFFICIAL USE ONLY
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001224
INSTRUCTIONS:
HAZARDOUS MATERIALS
BUSINESS PLAN AS A WHOLE
FORM 2A
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1. To avoid further action, return this form byJ,Ul ß~ AUG 07 1987
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
B. LOCATION / STREET ADDRESS:
CITY: ßd/~últl
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/P? / 1¿JtlrÁ¡''Y~ Y
ZIP: tl3-3ð :r BUS. PHONE: (
) ¿Jd);;). - ..It; 7'7
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A. BUSINESS NAME: nj./ I z,j'"
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 INCASE OF
NAME ~D !ITL% K ~ ~
A . d ø .5 tf"Jð 1'<. . ¿,4. f Z-
M I ,¿ r
B. .' 0FÞle,- f( f./...tþ
EMERGENCY:
~G BUS. HRS.. ~TE~BUS. H~ _
PhL~ :?~:2It1 ?Jph ~r &"7/ ,,9 /
Ph{r?ob~7//1'f/Ph# <:?:?/ 7s~6
SECTION 3:
A. NAT. GAS/PROPANE:
B, ELECTRICAL: t7. I
C. WA TER: ¿1/~... /tfl
D. SPECIAL:
E. LOCK BOX: YES
IF YES, DO~S IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO
FLOOR PLANS? YES! NO KEYS? YES / NO
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SECTION 4: P,RI_ ~¡S~6~E TEAM FOR BUSINESS AS A WHOLE . _fA 11,' I
c/~nd' ~e5p~~~ .
: .' .owtíer Çí~fI-.. r"~".Æffvt1~ýe-e. ~ d2$:5 e,$ eHlev~ft~ /
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SEC..':-ION 5: LOCAL. EMERGENCY 'M~DH~A~ A~SISTANCE FOR _Y,..UR BUSINESS AS ~ A WHOL~...,£ €" v:/
:¡¿, 'jØe- c:?(¡~F¡ 1-',p /J6) ~ .,k-P(j 1,0;( reI' "£ 'lh>¿ sevef'/7 hr,? ~('q' Þ( t/
b ¿~ æ¿(7~/Jt(;fct"l'¡J ~ VPt::-. Kat;? t'r p %el" eCo¡~Þ('e~~ 1M hts d¡f.>enc~,
..IA~7::.e r ~V5}(~L 5~ X//! M ý/ 6 c. ./e.e ¡..¡- ¿'/ /7f( /M -~.Ædr·
~ fJ r~ V¿,í ,'f- /"i '- 4. /~ I ~ ø il?1fi cr' ~h pc -¡-; ~- - . .
...-r.. '-/. . C CpI ~ . ' r.> CJ' / /Pf/'/ # t;/ <S?- ¿lZ? &£ f:)¡;'; d?Ý5C- by
:Z'1 rite..., Cer f~ t7/ ¿:;c vC'"r~ / J a I /e /, . I'
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SECTION 6: EMPLOYEE TRAINING
EMPLOYÈRS ARÈ REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO INITIAL
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
MATERIALS.: . . . . . . . . . . . . . . . . , . . . . ó. . . . . ; . . . 0 . . . . . .. @ 'NO
B. PROCEDURES FOR COORDINATING ACTIVITIES . .
WITH RESPONSE AGENCIES:...........,..,........... IES NO
C. PROPER USE OF SAFETY EQUIPMENT: . . . . , , . . . . . . . . . . . ° NO
D. EMERGENCY EVACUATION PROCEDURES:.....".......... . 'NO
E..-DO-'r'OUMAIN'rAIN~-EMBLOYEE TRAINING_.RECORDS :_._._.._... '_'_ YES_@_
REFRESHER
@NO,
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,YES W~(L f k/fI/(/tI. .
, ~ '/Ii ;feà r #i:t tI('é':;- u, -
I, ~~ , certify that the above information is accurate.
I unders nd that this information wiÏl be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
See. 25500 Et AI.) and that inaccurate information constitutes. p,er jury.
SJGNATU~#¿ ¿5. TITLE~~~r'
DATE /~/-8'7
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BAKERSFIELD CITY FIRE DEPARTIIE:\T
2130 "G" STREET
BAKERSFIELD. CA 93301
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OFFICIAL CSE O:\LY
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BUSINESS PLAN
SINGLE FACILITY UNIT
FORM SA
INSTRUCTIONS
1. To avoid further action. this form must be returned bY:/~-~/~í'.
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~ FACILITY UNIT NA.'Œ: . ¡:¿ ¡J (75 C~ ;1/1,/J -¡;;'l ~,
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SECTION 1: MITIGATION, P~EVENTION. ABATEME~-r PROCEDL~ES ß i' l' ~ r '
t9f/ 5J) d/ -:5 un// j, '" C/e-?"e./ b(" -?'"f!1 vJ"It""ff 1J",,,e..t:1f
0/ I' ft Vn¿?~ r :ç /A/ ec.(/J ¡- V-.5 LI. d !f17-¿;,f //A¿;>-:,e#ð/;¡ /ð /--15
¡.-!-æ N vi k / ÇJ r fftt 115lJ tP r:j:~ 4 or r 0' n 7' f? ,vi ¿ 'f;"YI ¡f! U:
(j) ¡ / ;5 kél;l- /H fg. r ,elf -Ý' A rf7&'f I;Y <-Mr''-> j0 f-k eft/ ð-h ¡-/1
{)f..f j t'1/' d ØrcE' 1¡/~>0e ci,,,,;, e/ PJt~ ¡;" (I
SECTION 2: NOTIFICATION A~~ EVACUATIQN PROCEDLKESAT THIS L~IT O\LY
£vC/c U ,,-fr~~~ ~~" l(be- &cP~<P! S:k1 a~ IC'!5:: '. /¡J
l/æ ¿>&ýA,t1Þ:è U f ¡;, f4/é5 +- Þ YI fV<inc<!:. ,;> f- .;o¡',"!)l7tt1
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SECTIO~ 3: HAZARDOGS ~ATERrALS FOR THIS æ~rT OXLY
A. Does this Facility Unit con~ain Haz~rdous ~ateriJ!s?",.,. VES XO
If YES, see B.
If NO, continu~ with SECTIOX 4.
B. Are any of the hazardous materials a bona fide Tr~de Secret YES XO
If No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS OXLY (white form =4A-l)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS O~LY (yellow for~ #4A-2) in addition to the non-trade
secr~t for~. List only the trade secrets on form 4A-2.
SECTIO:-r 4: PRIVATI: FIRE PROTECTTO~ / I . c . / /r, _ (}í'; e
~ r .J:::::' '7-' f ",' r_Á fi( _?, 7- e¢(::;I"I c-'(/c;lJ Ý' I F) C /qc;;{Ukj ¿;.(;ß-l
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SECTION 5: LOCATION OF WATER Su~~LY FO~ USE BY ~G£NCY RES!O~~S ~
~~~...¡ \ ú/ ¿ 5' -Ç-J7 Ii'" F1 e t/ #:.f/ I r- .P /"'.2 {/ 7" ¿? Q-l tA/ d.:? 1 ',~_1 /.9 PI.:5 '
¡--,r.¿ fýJYdV11-
SECTIO~ 6: LOCATIO~ OF ~~ILITY SHLi-OFFS AT THIS üXTT ONLY,
A. ;;; ~l (~s :;:~~:tf
B. ELECTRICAL: / /r
/I, J:¡ ¡'.Ii" J ¿: --I / C Ý u // d 1,7'/7¿;,'
V or""¡/! t/vc;:; /-LtPrnc.J/-"'" ð"'::J~
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C. ~'lATER: -(' __ . _~.
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11 't" ;/ 7 /0 .1:::- Pí' / r« In ¿ .
D, SPEC~AL:
E. LOCK B(1X: yr::-S 'e I~ YES, LOc.\TIO:~:
r r- YES SiTf: P ~..\\'S ') t,rr- \~()
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, NON-TRADE SECRETS .
HAZARDOUS MATERIALS INVE~TORV
BUSINESS NAME: 'fU(-z:.$'Cóvní!J-j;;ÎI'~·. O~NER 'NAME:' Js.:;¡ed ¿ -~/:~:, FACILITY UNIT #:
ADDRESS: /;; j7 ,U/d't:;:J,.,¡........ 7ÐTA / __-r,. ADDRESS: "9~ø ~ /..ß~:~cK~./ FAC I L ITY UN IT NAM,E:
CITY. ZIP: .J I> K,r<r-.ç,.él'#', /C.e /".-£ Q 3 ':š tflS- : CITY. ZIP: ." 2 --:i.s.f-,,'è/þ C;,,//;J.; 9';§~tJG -,
PHONE #: /~G,ç-) ,:"?':'1'".'//~77 -r :f.:Jb-/t!'J?S PHONE #: r96J~)P7/ /b?Y· .OFFICIAL -USE CFIRS
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TYPE MAX ANNUAL CONT US&
CODE AMOUNT AMOUNT UNIT CODE CODE
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KERN COUNTY FIRE DEPARTMENT
FORM 4A-l
page-L ofL
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CODE
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LOCATION IN ·THIS
FACILITY UNiT
S:o~o.M'J:øsf c"rnef..Bv.í fJl.~J1
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WT. CHEMICAL OR COMMON NAME
/cor ~q;~tfP 10/ /'591;
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HAZARD
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GUIDE
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NAME: r7¿,~~ cR, rK',Úz. TITLE: t)cP~€Y.//I4IU:tr,_ SIGNATURE: .A'<~.L/_ _r . D~E :~:LL-
EMERGENCY lONTACT: t/o.çA/!.£ R.. <Reitz:. Tr'TLE: hone,-h....,.,v; .J /', PHONE #..ffiJs HOURS:C~Ð.s.· .?~~/()77
,j "..r ,/' AFTER BUS HRS: ('S()(=-.... ~?/ /¿,?:?,
" EMERG~NCY CONTACT: #c¡ner/' ot/"/Z- TITLE: Orø6feýf Æi71ie,,- 'PHON'Eo # BUS HOURS :I''W!J~} 9'7) /fr~6 ,.'
PRINC1'PAL BUSINESS ACTIVITY: ,4: C:e,¡¡<>r~/· AFTER BU-S HRS: . c'ir?/ )£f/,£h
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CONTAINER CODES
·tÞ
. CODES·'
01. Underground Tank
02. Aboveground Tank
03. Fixed Pressurized Tank
04. Portable Pressurized Cylinders
05. Insulated Tank (Includes Cryogenics)
06. Drums ~r.~arrels - Metallic'
07. Drums or B~rrels~- Non-Metallic
08.' Carboy (s)
09. Glass Container(s)
10. Plastic Container(s)
11. Box(es) .
12. Bag ( s ) .
13. Metal Containers (Not prums)
14. In Machinery or processing equipment
15. Bin(s)
99. OTHER - Specify on separate sheet
. . ~ - -. ---.--- -. -.--,---.--
USE CODES
01. Additive
02.. Adhesive
03: Aerosol
04. Anesthetic
05. Bactericide
06, Blasting
07. Catalyst
08. Cleaning
09. Coolant
10. Cooling
11. Drilling
12, Drying,
13. Emulsifier/Demulsifier
14. Etching -'
15. Experimental
16. Fabrication
17, FertH i zer
18. Formulation
19. Fuel
20.. Fungicide
-, ----2=1. 'Gri'n~ing--
22. Heaqng
HAZARD CODES
EXPL Explosive
CMLQ Combustible Liquid
CMSL - Combustible Solid
CRMT - Corrosive Material
FLGS - Flammable Gas
FLLQ - Flammable Liquid
. FLSI. -, Flammable So] id
NFLG - ~on-Flammable Gas
.OG~X - Organic Peroxide
OXD - Oxidizer
~CRYO - Cryogenics
23. Herbicide
24. Insecticide
25, Instructional
26. Lubricant
27. Medical Aid or Process
28. Neutralizer
29. Painting
30. Pesticide
31. Plating
32. Preservative
33. Refining
34. Sealer
35. Spraying
36. Sterilizer
37. Storage
38. Stripper
39. Washing
, 40. Waste·
41. Water Treatment
42. Welding Soldering
. ,43', ~Well-Injection'-
44. Oil Treatment
99. OTHER-Specify on
ORMA ~ Anesthetic, irritant
ORME Hazardous Waste
ORMS - Other regulated
Material B,C,and D
PSNA - Poison 'A (Gas)
PSNB - Poison B (Liquid or Solid)
RAQI - Radioactive
WATR - Water Reactive
ETIO - Etiological Agent
PYRO - Pyrophoric, Hypergolic or
spontaneously combustible
P
M
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Pure
Mixtures of pure
substances
W = Wastes (Also add
appropriate waste'
code)
UNIT CODES
- ---.. --,~ -
LBS
TON =
GAL =
BBL =
Ft3 =
CUR -=
Pounds
Tons (2,000 lbs)
. Gallons
Barrels (42 gals)
Cubic Feet
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FORM 5
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BUSINESS NAME:
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UNIT #: ¡ OF I
FACILITY NAME:
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DATE: / /
(CHECK ONE)
SITE DIAGRAM
FACILITY DIAGRAM
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(Inspector's Comments):
-OFFICIAL USE ONLY-
HMCU-13
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KERN COUNTY FI RE DEPARTMENT
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ALSO SERVING
THE- CITIeS OF
Arvin
, Maricopa
McFarland
RIdgecrm
1'ahacf1apl
Wasco
Thomas P. McCarthy
Chief
Hazardous Materials Control Unit
_ 5642 Victor Street
Bakersfield, California 93308
Telephone (805) 861-2761
Dear Business Owner:
The b~siness plan you filed with the Kern County Fire Department is
returned to you for ihe following reasons.
Box for Official Gse Only
written in on Form
Form 5:
being
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+ Form
/7 Form
No signature on Form
2A not returned
2A not complete ~tt. ~~
Facility Diagram
_ Missing
_ Incomplete
Site Diagram
A Missing
_ Incomplete
)( Form 3A - Small facility AtDs~VG
~ needs to fill out Sections 1-5
Form 3Ä - Large facility
needs to fill out Sections 1-6
Other
. :
--'
Inventory Sheet
(Form 4A-l,2,3) not returned
(Form 4A-l,2,3) not complete
Please retur~ this form with the corrected business plan and resubmit
within 30 days ( f-3D - ct 7 .
Very truly yours.
THOMAS p, McCARTHY. CHIEf
Georf h:ilford. Cäpti1,in
Hazal'dous :.fat(~t'ials Contl'ul :'-tlL:'
La,: j I)
Protecting The Golden Empire
State of Callfçrnla-Healt h and Welfare Agency
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e
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Department of Health Services
Toxic Substances Control Division
HAZARDOUS WASTE NOTIFICATION STATEMENT
, This form is not a substitute for the Federal notification required by U. S. Environmental Protection Agency pursuant
to subsection (a) of Section 6930 of Title 42 of the U. S. Code.
Any person generating hazardous waste, or owning or operating a facility for the treatment, storage, or disposal of
hazardous waste, shall file this notification. If you have an EPA identification number you are not required to submit
this notification.
A. Business Name:
~ ; ¡
0.17- ~
Bus I ness Address
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e ~/?1
E. Business ActIV'jY:
4- fA./ 70
,
~ . ~
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ZIP Code
'3>.JCJS-
Equalization Tax Account Number:
8.
.. -
o No. Complete Item J and return
Telephone Number: IIGlfle.- 87 b '77
( ffð Gî ¡}"û;;;I;i~-s s "., '" / 0 '-7
ZIP Code
:5 Y ð-b
I. Waste Being Handled: Using the list below indicate type and amount of waste handled for the period January-
December 1986. A conversion chart for figuring the amount of waste is on the reverse side. .
TYPE OF WASTE ANNUAL AMOUNT
ø Less than 1-10 More than
1 Ton Tons 10 Tons
Corrosive
Example: acid, sodium hydroxide
Reactive
Example: phosphorus, cyanide
..--: ( &/( V
Ignitable (flammable) Vn;T It/!
_Example.:-waste..sol.v.e.nts,..gasoline .. . .
Toxic
Example: pesticides, lead, zinc
Explosive 54 c,e/e 1ø1 ¿ ~.
.
J. I am aware that, if I knowingly submit false information to the Department, I am subject to a civil penalty of not
less than $2,000 and not more than $20,000 for ~ach day that the false information goes uncorrected.
I declare under penalty of perjury that t~e above information is true and correct. /1
Dated this //1-. day of ¿7¿c ¿,¿f-vt.j pi"" 19.ß:Z, at t9 q ke /':..("}-Î; J.ß
h¡¡¿~
Signature
{) CUl) C r ~flllq r:
T!t1e /.../
, California.
,.
I 2..0
I Temp. 1091 (6/87)
I
., un . _ _
HAZARStWASTE NOTIFICATION STATEMENT IN.CTIONS
Use these instructions to complete the statement. Ensure al/ information is complete and accurate. If you have more than one facility, a
form must be completed for each facility.
Item A: List your t?usiness namè and address.
Item B: Enter the county wheì;e.business is located.
Item C:, Using the list below, indicate the Standard Industrial Classification (SIC) Code that best explains the process used to generate
waste. (Example: type of business could be SIC 24, waste oil could be generated from vehicle maintenance, and the process
would thenbe SIC 3710.)
Item D: Indicate your Board of Equalization Tax Account Number.
Item F: Indicate whether y()ur business generates a hazardous waste.
Item E: Indicate the type of business and primary function .O.e., Metal Plating, Automotive Service Station).
Item G.: List a person knowledgeable and available to respond in emergencies and give a 24-hour telephone number.
Item H: Enter owner or operator of business and address.
Item I: Indicate the type of waste handled and amount using the conversion chart below.
Item J: Owner or operator should print their name and title, and sign and date the form.
KEEP A COpy OF THE COMPLETED STA TEMENT FOR YOUR RECORDS.
Sign and return this statement by January 1,1988 to
Depa'rtment of Health Services
Toxic Substances Control Division
Program Monitoring and Personnel Section
. P.O. Box 942732 .
Sacramento, CA 94234-7320
Unit Conversion to Ton(s)
G
K
Gallon
Kilogram
0.004170 ton
0.001102 ton
L
M
Liter 0.001102 ton
Cubic Meter = 1.102000 tons
Formula:
Example:
Amount of Waste x
27 G x
1,000 K x
. Unit Conversion
0.004170
0.001102
Tonnage
,11 (less than 1 ton)
1.10 (1-10 tons)
Standard Industrial Classification (SIC) Codes
N
P
Y
Metric Ton
Pound
Cubic Yard
1. 102000 tons
0.000500 ton
0.842800 tons
Standard Industrial Classification is a nationally standard system for coding establishments by their industrial activity.
AGRICUL TURE
07 Agricultural Services
MINING
10 Metal Mining
13 Oil and Gas Exploration
CONSTRUCTION
16 Construction
MANUFACTURING
20 Food and Kindred Products
24 Lumber and Wood Products
25 Furniture and Fixtures
26 Paper and Allied Products
27 Printing and Publishing
2711 Newspapers
28 Chemicals and Allied Products
2810 Chemicals, industrial inorganic
2820 Plastic materials and synthetics
2830 Drugs
2840 Soaps, cleaners, and toile.t goods
2851 PaiiÙ and allied products
2860 Chemicals, industrial inorganic
2870 Chemicals, agricultural
2890 Chemical produc:m, miscellaneous
29 Petroleum Refining and Related Industries
2911 Petroleum refining
2950 Paving and roofing
30 Rubber and Miscellaneous Plastic Products
31 . Leather Tanning ànd Finishing
32 Stone, Clay, and Glass Products
3210 Glass and glassware
3270 Concrete, gypsum, and plaster
products
33 Primary, Metal Industries
3320 Foundries, iron and steel
3330 Nonferrous metals
34 Fabricated Metal Products
3410 Cans and shipping containers
3430 Plumbing and heating
3460 Forging and stamping
3470 Metal services
35 Machinery,except electrical
36 Electrical and Electronic Machinery
3674 Semiconductor and related devices
37 Transportation
3710 Motor vehicle
3720 Aircraft and parts
3730 Ships and boats
3760 Guided missiles and space vehicles
38 Instrumentes and Related Measuring Devices
39 Miscellaneous Manufacturing Industries
TRANSPORTATION
40 Rail Transportation
42 Trucking
49 Electric, Gas, and Sanitary Services
WHOLESALE/RETAIL SALES
51 Wholesale Trade
59 Retail Trade
MISCELLANEOUS
73 Business Services
75 Automotive'Repairs
95 Governmental Agency Except Military
97 Governmental Agency, Military
99 Not Otherwise Specified