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HomeMy WebLinkAboutBUSINESS PLAN ·ru,~~. lufJ ~_ d~fb1 /&.;~ . rr" -?',-:' .-/ ^/- - ',.':, ,'~" , 1..' ~) .'~'-- I' --." i "'"VIi ". /'" .. ~ "':;"'_ ""f ' // , 'i-tw' < ItJ", ,'-, IV ~, I It:) L , Q 1.1- :!i , ~ I .:::> ¡~ ~ .- J ,$I -+- J) ;;). 'f , NORTH SCALE: DATE: - _ :l..tJ /~, Lv eS Tf.,J INti r- .TE/FACILITY DI~RAM tf 79ß' I FORM 5 1l1JSP I BUS INESS NAt'lE: FACILITY DIAGRA'I (CHECK ONE) SITE DIAGRA;\I _j~;;'4i~:- ;..... I{\) vJ Œ-5+ w ~ f\) í) Kwk\s ~ ~ -~ ~\ g¿ t eo) P ~~-<> \.. -r-, r. \[::t. ~ \¡ .- ,~ <f ® í ~r- --r VJ vJ ,3 ~ - , i=t-I ~<: ~,tj¡>< (Inspector's Comments): P\~ ~ (I 1\\ ,~ ~, ~oJl ~ * - 5A - SITE DIAGRAM (Required lte.s) 1, Address: Ident~he principle buildin~s by the Street nu.bers. 9. LOCk. Box 10. M505 Stora~e Box 2, 5treet(sl. Alleys. DriveMays, and Parkin~ Areas adjacent to the property. Include the street na.es. 11. Railroad Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood d. Gates 13. Powerllnes 14. Guard Station 3, Stor. Drains. Culverts. Yard Drains 4, Draina~e Canals, Ditches, Creeks, 5, Buildings a. Fraae construction b. Masonry construction 15. Storage Tanks: Identify the capacity in gnl. a. Above ¡round c. Metal construction d. Access Door b. Underground 6. Utility Controls a. Gas 16. Dikin¡ or Bera b. Electricity 17. Evacu~tion Route c. Water 18. Evacuation Area: Identity the location where uployees w111 ..et. 7. Fire Suppression Syste.s: a. Fire Hydrants b. FIre sprinkler COMections 19. Outside Hazardous Waste Storage c. Pire Standpipe Connections 20. Outside Hazardous Material storage d. Water Control Valves tor protection syste.s 21. Outside Hazardous Material Use/Handline e. Fire Pup 22. Type ot Hazardoua Material/Waste Stored or Used (See Below) 8. FIre Depart.ent Accesa TYPE OF HAZARDOUS MATERIAL F · FllUlJlable It · Explosive L · Liquid C · Corrosive 0 · Oxidizer G · Gas W · Water Reactive T · Todc S · Solid R . Radiological P . Pobon H . Cryo¡enic D . Waste B . Etiological Exa.ple: Fla..able Liquid· FL FACII,ITY DI~GRAN (Required ite.s in addition to the above) 1. Risers tor Sprinklers 8. Fire ¡¡scapes Z. ParU tlon. II. Air Condition in. Unit. 3. stairways: Indicate the 10. Windoml levels .e~v.d eroa hi~hest to low..t. 11. Inside Hazardous Waste Stouse ... Escalato!": Indicate the levels served tro. 13. Inlide Hazardous higheat to lowest. Material. Storace 5. Elevator 13. Inside Hazardous Materials U.e/HandJin~ 6. Attic Acceas 14. Se,,",1' Drain Inlet:! 7. Skyl1¡hts .,-. ,,' -,' ....:, ~\-...~-.-~...i' _.": ~,{,... . 1" ,1"-.. ., , \\ " \ ~ ~ðJ/l_ . Bakersfield Fire Det. Hazardous Materials Inspection R£CflV£D AUG 9 1989 6/62-/ ~'d......_. e._. /7 Date Completed Business Name: ~~ ~ br/C?,.r Location: Jp/J <#-f) cJ~.þ)~ .--- Plan 10 # 215-000 -:¡-75 (Top right comer Business Plan) Station No. I Shift Æ-" Inspector ~ ~ . . / Adequate Inadequate 9 cz( ~ ~ G1 Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: ®~ ~~ ~~ Verification ofMSDS Availability D NurnberofEmployees ?'-/l? Verification of Haz Mat Training o Comments: o o o o ~. ~ ca" Verification of Abatement Supplies & Procedures o Comments: ø o ~ Emergency Procedures Posted Containers Properly Labeled Comments: ø o Verification of Facility Diagram o Special Hazards Associated with this Facility: æ( Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office ...,-...~.-""- ~ , ' . . . ~ ' . v( . , ~.,~-_// o/-~ .//'" ~/// . __- c·- ..-- .' ~ - - -- --- _/-- ,. ,:£.--.-...,......-' . " - K ',7··:~ ~:¡¡;/ ",,- '\. .. 4IÞBAKERSFIELD CITY FIRE DEPAR~ 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 , /02-- 26 !3 s {II @ ~tU5P I fie! z / OFFICIAL USE ONLY ID# ~ ~s~D BUSINESS NAME HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A ~ .t-.. ~~ ~ 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: rY'\o",-\-e)s Fko00 C,OO erì ^j B. LOCATION / STREET ADDRESS: cJo LS UJ e..S+ ,.ù '6 A),D -4!= A CIT;ßS-Ç l<l ZIP: Q33ö '- BUS.PHONE: (~D5) ,7j;;J..?;-B5:C}t 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 NAME AND TITLE A..}'\ \ \(e. \.\t:\~\.t~~ B. PAv\.. \)~(.l\. IN CASE OF EMERGENCY: E~~L0'ftt f.Y\ ~l,o ~ -€ ( DURING BUS. HRS. Ph# . "jd-.,,-ft:{fJ1 . Ph#~-a~fl' Ph# AFTE~ BUS. HRS. 81 ~- Id. S 1 .3 b b - q.o'--\ '-\ Ph# SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE ~. NAT. GAS/PROPANE: No¡..se... . /ìELECTRICAL: ß c.\.( wC'\r¡,t\~~J~ t,. N Q..)(T C. WATER: <: IU. . D. SPECIAL: ~ E. LOCK BOX: YES'l~IF YES, LOCATION: IF YES. DOES IT CONTAIN SITE FLOOR PLANS? YES / NO MSDSS? YES / NO PLANS? YES / NO KEYS? YES / NO - 2A - "~ \ .:':\ ì.:':!", , .~,r-r ._'>,. ...' 0' . . . -~ . t "- 'I SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE r I j . bm~ \O~E.is o...r~~: kM uJ °c*,- e)( r t ~ VO~~rº- SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE c., \ OS.~ ~ +- H- 0 s f' ~ '1-õJ - (Y\Q.., Y'Cj 0 n trlA.)< +O"Y\ A v ~ . Se\J~'¿j S~~5 ~~s ;rù ~\~O SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES 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:..... , . I~ITIAL REFRESHER 0Y NO YES NO YES NO YES NO YES NO YES NO @ NO YES NO YES ~ YES NO SECTION 7: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MAT. ERIAL IN QUANTITIES~ THAN 500 POU~1d( SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:.... .. ~~ I ,JV\O ~\e. l, 14An.lt¥~ ~ " " certify that the abo~e 1nformat1on 18 accurate. I understand that this informat1on 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. SIGNA'L'URE ~ J, ~ TITLE OW µ t"- DATE Jv~..t1../-&'l - 2B - " //"" - ./' i '; ~ . . BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 ¡~ ~ OFFICIAL USE ONLY ID# ------ BUSINESS NAME: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS I, 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# <:1 FACILITY UNIT N.""",,,.YYJO¡/J Je..s} r/ /I dl~AJL (l. ~·IJ:. /...I...tl--L+. t r / OOJe- (/)(),¡:,J I" (J SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDtffiES IV ð h A- z.. IQ. RJ:\ CJlA-:=:' rr\Q k ì ~ \ 5 CL\- %ì.s \)j\)\t *8' f:-~~~+@:;9~\\o-t\ f:ð~e- t Mlá; 4- \-- \001( 0..6 h<2-S\\J~ w\\\clÁ IS (lJO í 0 0 PM" C o-f\ 1...{ V'L0Ý S- Ill/ ~ßU /HC/J~ ê5?'f7-c<:.- AÞVe ~øfr:, SpðVI['- k/~ SECTION 2: NOTIFICATION ~~ EVACUATION PROCEDURES AT THIS UNIT ONLY ()", ~ ~ Eo- ,Ú!'S - ~ r<rl\+ o-Ç(;ce áOö( r ,Uo..v-e hð1A.'S.e 01 ~ ì JV ~ i1 Se. ð ~ Q)I'IIQn~!!.M (~ m 0 So -\- \ r.>.R u ~ +hr- V -Kv e doocs ð~ ,0/'/1 c.// ;7// ~ æ--J~;;; ~ Þh//~~ /5, ¿V~~æ/~ ,- 3A - . . U ,j_ _ ~ -"\.....~, þ ",., .\ ';, ~. SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES~ YESt) A. Does this Facility Unit contain Hazardous Materials?...,. If No, complete a separate hazardous materials inventory form marked: NDN-TRADE SECRETS ONLY (white form #4A-l) 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, (e- t;", ~3Ù1~k.~ -- Sf"- ; I\. kl e.-v5 SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E}ŒRGENCY RESPONDERS SECTION 6: LOCATION A. NAT. GASíPROPANE: f\Jo 3A~ B. ELECTRICAL, ' + it ß NO ekck-;~oJ S~lÀ+ c:-Ç-.ç 'I~. ~~~,\'.w \)J~house o \torte¿ C '\ rC\J-\- '00 '/.... \ N I . . f L ! c. WAT&: \ " A '\J ~ ~\lLd .\-0, er : 1.N b~+ydt5)'t\ ~V\e.l St Nf-) ( I, ~ i S!?( \ 1\ ~ \ e$ ~ .(\) ð IJ--\- - ê)~, ce ~ \Úo1 Q. \J'ù{ s'C · OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. ìN+h\~ LJ lI\ \ +- tl: 6 D. SPECIAL: ¡¡)f+- E. LOCK BOX, YES B IF YES. LOCATION, IF YES, SITE PLANS? YES í NO FLOOR PLANS? YES í NO MSDSs? YES í NO KEYS? YES í XO - 3B - L 1\\(. of -.....------ .' Page LD CITY FIRE FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY DEPARTMENT BAKERSFIE # D I ·1 ~~~~:~L~i~t>,iè~-~ "J ÃÖÖRËSS-:-'-ß'\rb'-L~~;~(y~ a~.:FÃëI-LITY UÑÏT-ÑÃMË:W'e:~+"~~ I CITY, ZIP: "P,Ks-Ç\d. C'A-L¡,.ç. q ~~O ~ PHONE #: ~<D to - .;l3 79 IOFFICIAL USE CFIRS CODE ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT. UNIT CODE CODE FACILITY UNIT liJ: A CHEMICAL OR COMMON NAME CODE GUIDE P , IDG-A-I "606't\ ~A-\ 04- a Q.. (\ +s2- \' 1<. e.o... (' 0 T _ ~ ro DtU(\ e..,. . 1=L L~ w C\... ("' ~ ¥\.(') ú ç Q., ì)1f. 90 ¿5()() G-~\ % 0:;[ E AS-\-S~Ò.~ of- \)Jo..~ou<:,e__ J:le-:;.:>:,s F \E \ (..oÚQV'ì ~ .!~~~ìvQ. f:N'-CV . 1,8 ~ (" .. \ ¿, ,'I\J ð \ eu W\ e:'f.\ () , ' l;x)j.D 7 3ô~ ?Q 6e,o I eU.I1 Ì) f S + I /I C( L...e S- 0,1..· d7ift . ~C)· O'~ cY Q 5 boe s t-C)~.. /37 "3, , - NAME : -ÍÛ.oñ~ U.-Q,O\QSS TITLE:~..ßlÜ=~)2" SIGNATURE: '-Y'^ ~ -:"\ Il. Lt.. D_ l.'\ - DATE: (I')--d O-F'J7 mi\Ze \4.,.QraQ\~<.( .TITLE: --\".1\Jc.,~\le.\f PHONE # BUS -HOURS: 3á~ -g~()q ~~L ~~r.'tíL- TITLE, -:t-~~~K AFTER BUS HRS: ~7/- ¡á.S7 PHONE # BUS HOURS: ~~~ - 5I5D9 AFTER BUS HRS: ;; In fn - C¡o f-.f c fI~P6T L ifiJò leu e. I 4A-l - ~ k ,ï,~ . . Ii " #: 232 MATERIAL SAFETY DATA SHEET HMIS NFPA 704 MANUFACTURER'S NAME: THE W.W. HENRY COMPANY 5608 SOTO STREET HUNTINGTON PARK, CA 90255 EMERGENCY TELEPHONE: 213/583-4961 DATE OF PREPARATION: 85/10/28 HEALTH: 1 FLAMMABILITY: 3 REACTIVITY: 0 PERS.PROT.EQUIP: A --------------------------------------------------------------------------.----_. SECTION I - PRODUCT IDENTIFICATION -------------------------------------------------------------------------------- PRODUCT NUMBER: J232 PRODUCT NAME: ASPHALT CUTBACK ADHESIVE PRODUCT CLASS: ASPHALT CUTBACK -------------------------------------------------------------------------------- SECTION II - HAZARDOUS INGREDIENTS --------------------------------------------------------------------------------- INGREDIENT: PERCENT: OCCUPATIONAL VAPOR EXPOSURE LIMITS PRESSURE: TLV: PEL:': -------------------------------------------------------------------------------. PETROLEUM DISTILLATE 30 - 35% 500 PPM 500 PPM 10 MN @ 60 DEG.] CAS"# 64742898 PETROLEUM OIL 2 - 5% 5MG/CU M 5MG/CU M NIL CAS # 8012951 ASBESTOS 2 - 5% . NOT APPLICABLE* CAS # 1332214 * ASBESTOS FIBERS ARE COMPLETELY ENCAPSULATED BY ASPHALT SO NO DUSTING OCCURS. -------------------------------------------------------------------------------. SECTION III - PHYSICAL DATA -------------------------------------------------------------------------------. BOILING RANGE: 257-310 DEG.F VAPOR DENSITY: HEAVIER THAN AIR EVAPORATION RATE: SLOWER THAN ETHER % VOLATILE VOLUME: 40% WT/GAL: 7.9 LBS. % WATER VOLUME: 0% . . " ~ , ----------------------------------------------------------------------------- SECTION IV - FIRE AND EXPLOSION HAZARD DATA -------------------------------------------------------------------------------- FLAMMABILITY CLASSIFICATION: OSHA: II· FLASH POINT: 56 DEG.F DOT: FLAMM. LEL: 1% EXTINGUISHING MEDIA: FOAM: X "ALCOHOL" FOAM: ::::::: ::::F:::T:::L:::::D:::::D::K::J:OWN C02: X DRY CHEMICAL: X WATER FOG: OTHER: ---------------------------------------1----------------------------------------- SECTION V - HEALTH HAZARD DATA ___ I EFF::~:-::-:~::::::::::~-::::::~:::-::l::::::~::~::-~:::::-::~-::::~:::~:~--::-- LONG TERM LABORATORY TESTS TO DETERMINE CHRONIC EFFECTS. CONTAINS AN INGREDIENT SIMILAR TO MINERAL OILS REPORTED TO INduCE CANCER IN LABORATOR~ ANIMALS. THERE IS NO EVIDENCE OF ANY ADVERSE EFFECTS dN HUMANS IF SIMPLE PRECAUTIONS ARE TAKEN USING PROTECTIVE EQUIPMENT AND GOOD PE~SONAL HYGIENE. I MEDICAL CONDITIONS PRONE TO AGGRAVATIONI BY EXPOSURE: UNKNOWN PRIMARY ROUTE(S) OF ENTRY: DERM~L: INHALATION: X INGESTION: EMERGENCY AND FIRST AID PROCEDURES: MOV¡E PERSON TO FRESH AIR. APPLY ARTIFICIAL RESPIRATION IF NEEDED. WASH SKIN WIH SOAP AND WATER. WASH EYES WITH WATER 15 MINUTES. I ---------------------------------------¡----------------------------------------- SECTION VI - REACTIVITY DATA ______________________________________J_______________-------------------------- STABILITY: STABLE HAZARDOUS POJYMERIZATION: WILL NOT OCCUR HAZARDOUS DECOMPOSITION PRODUCTS: BLAC~ SMOKE, OXIDES OF CARBON I CONDITIONS TO AVOID: SOURCES OF IGNITION AND HEAT I INCOMPATABILITY (MATERIALS TO AVOID): MAY REACT WITH STRONG OXIDIZING MATERIALS 1'0 . . ,s,1 r -------------------------------------------------------------------------------- SECTION VII - SPILL OR LEAK PROCEDURES .------------------------------------------------------------------------------- ;TEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED: EXTINGUISH ALL ;OURCES OF COMBUSTION IN THE AREA. CLEAN UP SPILLS AS SOON AS POSSIBLE. lASTE DISPOSAL METHOD: SCOOP MATERIAL INTO METAL CONTAINERS AND REMOVE TO SAFE 'LACE. ALLOW TO DRY BY EVAPORATION OR DISPOSE OF BY BURNING IF PERMITTED. -------------------------------------------------------------------------------- SECTION VIII - SAFE HANDLING AND USE INFORMATION -------------------------------------------------------------------------------- :ESPIRATORY PROTECTION: PROPER VENTILATION SUFFICIENT 'ENTILATION: TO KEEP VAPOR CONCENTRATION BELOW 350 PPM 'ROTECTIVE GLOVES: NONE EXCEPT TO KEEP HANDS FROM BECOMING BLACK AND STICKY. ~YE PROTECTION: GLASSES TO AVOID SPLASHES ITHER PROTECTIVE EQUIPMENT: NONE ¡YGIENIC PRACTICES: WASH SKIN WITH SOAP AND WATER OR WATERLESS CLEANER EYES: FLUSH WITH WATER FOR 15 MINUTES .------------------------------------------------------------------------------- SECTION IX - SPECIAL PRECAUTIONS .------------------------------------------------------------------------------- 'RECAUTIONS TO BE TAKEN IN HANDLING AND STORING: KEEP AWAY FROM HEAT AND FLAME )R OTHER SOURCES OF IGNITION ITHER PRECAUTIONS! NONE --------.------------------------------------------------------------------------ SECTION X - TRANSPORTATION DATA .------------------------------------------------------------------------------- J.O.T. - UNREGULATED: REGULATED: X SHIPPING NAME: ADHESIVE, FLAMMABLE LIQUID HAZARD CLASS: FLAMMABLE LIQUID LABEL REQUIRED: RED ..M.C.O. - UN(NA) NO: 1999 CLASS: 3.2 PAGE: 3068 (j~ HAZARD~US MATERIALS Ir!PECTION BUSINESS NAME: jty\ o'V\;~E..S floC) \" ~-v e-r·'....--3 LOCATION: dJ)/5 ¿:, I X' W e-5.!w'\~d INSPECTION DATE: q - IS..... 8' õ' INSPECTOR: ßL ~ If:. VERIFICATION OF INVEN'l'ORY MATERIALS ~ [iL] 02J ø VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL COMMENTS : jJ~ lIIILð f e. ~5b.e5hs W~",1e VERIFICATION OF BAZ MAT TRADlDfG I~I Gd VERIFICATION OF MSDS AVAILABLE COMMENTS : VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES 1____1 COMMENTS : EMERGENCY PROCEDURES POSTED 1--1 o CONTAINERS PROPERLY ~Rt:T.1m COMMENTS : VElUFICATIOR OF FAaLITY DIAGRAM []2} SPECIAL IlAZARDS ASSOCIATED WITH THIS FACILITY: VIOLATIONS: RF:rJ:'!VFO SEP 1/t 1988 Ans'd. ...........