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Home My WebLink AboutHAZMAT INSP I,V ---- t'\ l\J rtþ ,.-it - ~~AZARDOUS r-v1ATERIALS INSPECTION BOSINESS IWIE, ,Ûp ~6 qdb ./ LOCATION: /~IIJ Mh/-f ¡tIC ., -....' INSPECTION DATE: 3.-/.£- g r INSPECTOR: -¡;1J Ir'l-/ / VERIFICATION OF INVENTORY MATERIALS ID~ VERIFICATION OF QUANTITIES ~ VERIFICATION OF LOCATION ~ PROPER SEGREGATION OF MATERIAL IQßJ COMMENTS: VERIFICATION OF HAZ MAT TRAINING œJ ØK] VERIFICATION OF MSDS AVAILABLE COMMENTS : OlL VERIFICATION OF ABATEMENT SUPPLIES & PROCEDURES 00 COMMENTS: CO (é' EMERGENCY PROCEDURES POSTED wø lÆ CONTAINERS PROPERLY LAB~·1m COMMENTS : or::: VERIFICATION OF FACILITY DIAGRAM ~ SPECIAL HAZARDS ASSOCIATED WITH THIS FACILITY: r - Æ iJ r~~ S~.--t'" '\ ~i q/....r- d r......, r 5(,; VIOLATIONS: §d. 7(/ If.-rMr I ¿;~~ 32G >c;l:1C( BU~Hf-¡ESS NAME PEP BOYS M NNY MOE & JACK tÔCATIOÑ' 1210 WIBLE RD ID~MBER 215-000-000926 HIGH HAZARD RATING 3 1. OVERVIEW LAST CHANGE 02/18/88 BY EVAMC JURIS CODE 215-007 JURIS MAP PAGE 123 GRID 01C FACILITY UNITS 1 HAZARD RATING 3 RESPONSE SUMMARY 2A SEC 4) ALL PERSONNEL TRAINED ON LOCATION AND USE OF FIRE EXTINGUISHERS. ALL PERSONNEL TRAINED ON USE OF ABSORBANT TO CONTAIN OR PICK UP SMALL OIL OR OTHER SPILLS. EMERGENCY CONTACTS 2A SEC 2) OSCAR FUENTES 834-6858 834-8706 DAVID DONALDSON (213) 748-5571 (213) 745-5618 UTILITY SHUTOFFS 2A SEC 3) A) GAS - PLANTER BED WEST OF NW CORNER OF BLDG. B) ELECTRICAL - NE CORNER INTERIOR C) WATER -SE OF BLDG. IN OLD GEMCO NURSERY YARD D) SPECIAL - NONE E) LOCK BOX - NO 2. NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 02/18/88 14:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME PEP BOYS MANNY MOE & JACK LOCATION 1210 WIBLE RD ID NUMBER 215-000-000926 HIGH HAZARD RATING 3 I 4. LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 02/18/88 BY EVAMC 2A SEC 5) MERCY HOSPITAL 2215 TRUXTUN AV 327-3371 CALL 911 A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 02/18/88 BY EVAMC ID PAGE 2 c' TYPE NAME LOCATION MAX AMT UNIT HAZARD USE CONTAINMENT 1 PURE MOTOR OIL NE CORNER SALES FLOOR BOX[ES] ID PERCENT COMPONENTS 2808.00 100.0 MOTOR OIL 3750 GAL UNKNOWN LUBRICANT HAZARD GUIDE UNKNOWN NL 2 PURE ETHYLENE GLYCOL E WALL STOCKROOM PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 2802.00 100.0 ETHYLENE GLYCOL 720 GAL UNKNOWN COOLANT HAZARD GUIDE UNKNOWN 28 3 PURE SPRAY PAINT E WALL OF SALES AREA METAL CONTAINERS ID PERCENT COMPONENTS 1006.00 30.0 ACETONE 1118.00 25.0 XYLENE, MIXED 339 GAL EXTREME PAINTING HAZARD GUIDE HIGH 26 HIGH 27 02/18/88 14:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 " - ~- BUSINESS NAME LOCATION' FACILITY UNIT PEP BOYS.NY 1210 WIBLE RD 01 MOE & JACK ID aBER 215-000-000926 HIGH HAZARD RATING 3 A. OVERALL HAZARDOUS MATERIALS INVENTORY ( * CONT I NUED * ) LAST CHANGE 02/18/88 BY ID PAGE 3 TYPE NAME LOCATION CONTAINMENT 3 PURE SPRAY PAINT ( * CONTINUED * ) ID PERCENT COMPONENTS 1155.02 16.0 PROPANE 1130.00 15.0 TOLUENE 4 PURE OIL ADDITIVE E WALL OF SALES AREA METAL CONTAINERS ID PERCENT COMPONENTS 2808.00 100.0 MOTOR OIL 5 PURE FREON R-12 E WALL OF SALES AREA PORTABLE PRESS. CYL. ID PERCENT COMPONENTS 1086.00 100.0 DICHLORODIFLUOROMETHANE 6 PURE ELECTROLYTE (SULFURIC ACID) N WALL E SIDE SALE AREA PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 1076.00 100.0 SULFURIC ACID 7 MIXTURE FUEL ADDITIVE E WALL OF SALES FLOOR PLASTIC CONTAINER[S] ID PERCENT COMPONENTS 1145.01 60.0 METHYL ALCOHOL 1140.00 20.0 METHYL ETHYL KETONE 2802.00 20.0 ETHYLENE GLYCOL 8 PURE CARBURATOR CLEANER E WALL OF SALES FLOOR PLASTIC CONTAINER[S] ID PERCENT COMPONENTS MAX AMT UNIT HAZARD USE 339 GAL EXTREME HAZARD GUIDE EXTREME 22 HIGH 27 89 GAL UNKNOWN ADDITIVE HAZARD GUIDE UNKNOWN NL 1857 FT3 LOW COOLING HAZARD GUIDE LOW 12 175 GAL HIGH OTHER HAZARD GUIDE HIGH 39 100 GAL HIGH ADDITIVE HAZARD GUIDE HIGH 28 HIGH 26 UNKNOWN 28 100 GAL UNKNOWN CLEANING HAZARD GUIDE MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 02/18/88 14:11 BUSINESS NAME PEP BOYS MANNY MOE & JACK LOCATION 1210 WIBLE RD FACILITY UNIT 01 ID NUMBER 215-000-000926 HIGH HAZARD RATING 3 B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > D. EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 02/18/88 BY EVAMC 3A SEC 2} STORE MANAGEMENT IS RESPONSIBLE FOR NOTIFICATION OF EMERGENCY SERVICES (FIRE DEPT., AMBULANCE, POLICE) THAT ARE DEEMED NECESSARY. ALSO NOTIFICATION OF CORPORATE OFFICE WHICH WILL IN TURN NOTIFY ANY OTHER AGENCIES INDICATED, I.E. LOCAL HEALTH DEPT., DOHS, ETC. MANAGEMENT HAS ALSO BEEN TRAINED AND IS RESPONSIBLE FOR EVACUATION OF THE BUILDING SHOULD THEY FEEL IT NECESSARY AND ARE DIRECTED TO DO SO BY AUTHORITIES. p w: ~ ~ PAGE 4 02/18/88 14:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ~ ~ - - . BUScIfmss NAME LÒCATION . FACILITY UNIT PEP BOYS .NY 1210 WIBLE RD 01 MOE & JACK ID ~BER 215-000-000926 HIGH HAZARD RATING 3 E. MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 02/18/88 BY EVAMC 3A SEC 1) ALL PERSONNEL TRAINED IN PROPER HANDLING OF HAZARDOUS MATERIALS STORED AT THIS SITE. INCLUDES USE OF EMERGENCY EQUIPMENT, ABSORBANTS TO CONTAIN SMALL SPILLS, LOCATION OF SHUTOFF VALVES AND SWITCHES. MSDS SHEETS AVAILABLE ON SITE TO ALL PERSONNEL. TRAINING COORDINATED BY SAFETY AND TRAINING DEPARTMENTS THROUGH USE OF WEEKLY SAFETY MEETINGS. PAGE 5 02/18/88 14:11 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 / / e . OFFICIAL USE ONLY I· I BAKERSFIELD CITY FIRE. DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 USINESS NAME ID# ---1 [~'b5· 000926 HAZARDOUS MATERIALS ¿efl··G/ ~ BUSINESS PLAN AS A WHOLE \10 FORM 2A 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Ans~er the questions below for the business as a whole. 4. Be as brief and concise as possible. RECEIVED OCT 1 5 1987 Ans' d............ . INSTRUCTIONS: SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: ~,ç:¡J J.36'fS B, LOCATION / STREET ADDRESS: /~/¿) CITY; rßøç~ .{¡~/¡ - ZIP: (J1/l/l/,¡?V, /J1ð~ -v- ,¡;.,.. k ( / {¿)} b)£' J20A-d '1 \. 3: fLJ J./ BUS. PHONE: «(1C61..B3'1-~(?58 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 :~~~~~7t~ EMERGENCY: DURING BUS. HRS. AFTER BGS. HRS. PhI (?CJç.$f-&'~s-8 Ph# ~q3LJ-8?¿)6 Ph#flJd-/~~ -53~7/ PhI§¡ 1- 7?(Ý;56/!? SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE'~T~ Il~~,.k~ d.- AJ.IJ) :;;;;:.~&.ç ;;tJ:Vj î ;:ml~\~·'~!1tt:Jj f:jT~fi'Y¿ff~~: :,~:;;:~Æ .~ 'I 'Þiii- E. LOCK BOX: Y#S/~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES I NO MSDSS? YES / NO KEYS? YES / NO '¡', e . ...- ¡: ~ " -"' I , SECTION 4: PRIVATE RE~SE TEAM FOR BUSINESS AS~. WHOLE _ /' ~;-E ÞX//NXU;~' 1f!/¡JIf7l..So/ý/!/C! //l/hre/rJ) &~ /¿:>~~¿)/ÍJ V ,¡t/ði::- ~ '/ "" - (/ I Eí(!J" _/HI IrIl5e>n/n/e-1 //f..ø./;V¿r¿J ¿)/"P ,y~ ~ ~ ~,~T "$ /p~~"; e>t2¡ht.-k VI 6n--n¡r1/0>;/ 0/2 o~~tl- ~ß SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE t,q If '1/1 ~f)(L f/;mbvl7Jl1){~¿ , ' . fl/p7l1l.ébZ 'Çt111£1L'}t=/lle-y h~/}¡7i! ;;;.hmvclk ~/jc>k /¡1)Vb!VINJ ¡{>'t2i'JÍLdt'?J¥_rm~ EI2/~ ~ /S : 1 " jV¡fí'lLy ffC6/[)//IJ-/ tlf}..lS' 71ui<.PiJ Rv£" 811 Kél16f,él/! 3~ 7- 33 7 / 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 INITIAL A. ~;~~~~~L~~~.~~~~.~~~~~~~~.~~.~~~~~~~~~..".,..", ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: . . . . . . . . . . . , . . . .. , , . . . . . . .IES ~O C. PROPER USE OF SAFETY EQUIPMENT: . '" , :. , . . , ..... ., Y NO D. EMERGENCY EVACUATION PROCEDURES:... . " , , , , , , , ,... ~O E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:",.,., YES NO SECTION 7: HAZARDOUS MATERIAL REFRESHER ~ NO jNO NO Y NO ES NO HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF~ F A LIQUID OR 20J CUBIC FEET OF A COMPRESSED GAS:, . . '" YES ~ I, ¿?~, certify that the above information is accurate. I un erstanct 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. SIGNAmE ¡!111M TITLE Ç%/ )é-d 7M - 2B - DATE 7r- 3/-67 , " e - , , BAKERSFIELD CITY FIRE DEPARTY.E~T 2130 "G" STREET BAKERSFIELD, CA 93301 OF;;-TCT.AL [SF.: O:,'LY BUSINESS NA)IE: ID# ------ I I BUSINESS PLAN . SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS ·1. To avoid fl1rther action, this form must be r8turned 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# FACILITY ú~IT NA~E: SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES ( If/I ~£/{.5¿>¡I/¡PP/~ 1ï2IP,/~Fd I~ ¡>/lJ>,ð£A. h~¿;;~~ ~ l1#-Z~///~J ø~1"/~ .s1Þ1I.iÉ-~ d'T 7JJí.5 5/h;: JW¿/~.dt3 ¿I~¿-tØ5- £tbI&djflVðY T~I?J¿F'T (t!),pj/~ Frb~/)AJ,/hfIZ; íP t!P,v7#-¡dJ .5111;// 5/,1/6 I.p~¡t/---¡;;":¡,5' ihv/ pI! /..r!/Þ'"3 #ø'¢ 6k/IU-h63, frl5þ~ Sh~ JI}-¡//}-/Ú£- ¿>~ ø/./¿- ;;;; #///F71~""h~ J7l1f,rv;Þf t!~tJd¡;,¡¡;;{) 6y I 6111;::77 _1 ï/l,p-I'Idj: ¿F/.M~F,.;E "$~p~/ j/~¡ç pÇ ¿,µ¿:-çi:/j -6rl/:-7j /J11¡:::.-Z-Z/~..5 . SECTION 2: NOTIFICATION k~D EVACCATION PROCED0RES AT THIS L~IT ONLY Srt!>/U /J1~"'t¡;:/?J1F"~/ J6 /lF3¡JIÞR,s;/;k ø/l- ¡p1?¡;-f~~ ~ .E/h1r/b¡F#¿ "jEIl.¡/IÛ0 (~"~þ J)6}1T /I-ØlJvt¥~ ,PÞJà-) 'l'}¡/T ~~ j¡;rÞbcf) ¡¿)è:~S#7l ')... #h.ð> - rY¿p¿-?;'(!..¡j7,~ P:5 ~~P/lA1-7;?- ~d /¿//;;th k/;/! ;4 "'Iv¡l~ NÞT:t-'j /I#Jp71JØ?Z /l-f~I'P~/ß /~~¿~LJ ¡;, t.Þ¿""J ;/FtI/Ttt. b~r .l) £) H- S ~ , I / ~ ø1h'''fr''''t.vJ /¡~ ~þ J~ M..,.;/iip!J ~"/;6 /1f3?-,S'/<¡~ ~Il _fl/#CVJf-7:ðj 4- 'J1,~ JI?I(/~ ~dPvl/ ~ry /0-1 ,-C- ¡ÝJiZLÞ5S/My _d' ÞÆÆ-tb d,/lÞ2..?~=-,¡J ~ ,¡,., 6e> by t'Þ-;tM/~æ, -- 3.'\ - -- ,," e - ." ~. SECTION 3: HAZARDOUS MATERIALS FOR THIS ú~IT ONLY A. Does this Facility Unit contain Hazardous Materials?"..,' YES NO If YES. see B. If NO. continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES NO If No. complete a separate hazardous materials inventory form marked: NON-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 SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY, A, NAY, GAS!PROPAN~~ 8, ELECTRICAL: C. WATER: 0, SPECIAL: E, LOCK BOX: YES I NO IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO YES ! NO :-.1S0Ss? KEYS'" ,,-... I t.,~ NO NO YES - 38 - ¿ /' ,. J BAKERSFIELD CITY FIRE DEPARTMENT FORM 4A-1 NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY 1 TYPE CODE BUSINESS ADDRESS: CITY, ZIP: PHONE #: t) _ OWNER NAME: ·ADDRESS: CITY,ZIP: PHONE #: 9.13- 7#,Ç- C:;--'¿'¿)D Page -L of ~ I I . D'. # ACILITY UNIT #: FACILITY UNIT NAME: 2 MAX AMOUNT 3 ANNUAL AMOUNT 6 USE CODE 7 LOCATION IN THIS FACILITY UNIT OFFICIAL USE CFIRS CODE ONLY 1M -z" ;3 :; f tY1 S (p 8 % BY WT. 9 CHEMI AL OR NAME 2.Yð;f ~ 10 HAZARD D.O.T CODE GUIDE tt I 1 'ØJ!L I ; EMERG E'NCY P'R I N C I PAL / / DATE: CONTACT: T I n.E: PHONE # BUS HOURS: B:J5:~3¿¡- €l'7'.£- - / / . - AFTER BUS HRS: ~~- -;?7¿;"C:. CONTACT: 4. 4AJ/dÆ~<;r::r-TITLE' r.P.ø¿- ~~CØFL PHONE t BUS HOURS: r¡¡ð5~tfì>?4-bg$"'"R BUSINESS ACTIVITY:~ /;JIJ'-.d?;;: ~~~A:-~fCn-(~ þ,c.r-~~7~_ AFTER BUS. HRS: ~ff3Co 3Uo .~ ......... A. . .' 'e - SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: BUSINESS NA;\[E : FLOOR: OF DATE: I / FACILITY ~Ai\fE: UNIT #: OF (CHECK ONE) SITE DIAGRA.\f FACILITY DIAGR.~\f (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - · a Bakersfield Fire Dept. ACUTELY HAZARDOUS MATERIAI.S REGISTRATION AND RISK MANAGEMENT AND PREVENTION PROGRAM CHECK LIST 1. A.H.M. REQUESTED 5 -3 - 9 0 2. A.H.M. RECEIVED 3. R.M.P.P.REQUESTED 4. R.M.P.P.REVIEWED 5. R.M.P.P.APPROVED 6. R.M.P.P.INSPECTION COMMENTS: fi~~ =# qr0h I. DblUMBER