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Home My WebLink AboutBUSINESS PLAN /U. PØ'¡,1£e-- '\' I " ~ ~ Ci'- ~ ~ ~ ~ Fe"ï42- .: ~ j '"\ t..P. 'J i-I ..r._' . .' ~. -. " .', - '..- . .~-..,.~ \ I - . '1 " ,', ;. NORTH " Vr ( I \ ( \ ¡ I 1 \ It ~/~_~.(hlé ReI ~&O Inf:JD. 7 SITE/FACILITY DIAGRAM f FORM 5 SCAL~:/An~/ BUSI~ESS NAME: ¡.¡- r I rr'" f71r&rv.A1iJ:J.- d- '7Î'"U- J e~'L~ OAF; i FACILITY NA.:'IE: [{-6....1 j L;/~ FLOOR: OF UNIT :It: OF (CHECK ONE) SITE DIAGRAM )C FACILITY DIAGRÂ~ £, Q~~ , \J{ I ~ . -t . ~~ ~ ({~ ~ ~ ~ ~ ~ ~ ~ 'C<:S .~ ~ ~ .~ ?ff~' ~ !/ ~ ·~(7 ~ (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - ~ 5, Buildings a, Frame construction . 9, Lock (key) Box 10. MSDS Storage Box 11. Railroad Tràcks 12, Fence or Barrier a, Wire b. Masonry c, Wood d, Gates 13. Power lines 14, Guard Station 15, Storage Tanks: Ident lfy the capaci ty in gal, a, Above ground b. Underground 16, Diking or Berm 17, Evacuation Route 18, Evacuation Area: Identi fy the location where employees will meet, -~- L t SITE DIAGRAM (ReqU~ Items) 1, Address: Identify the principle buildings by the Street numbers. ~~~;-. 2, Street(s), Alleys, Driveways, and Parking Areas adjacent to the property, lnclude the street names, '" .1 3, Storm Drains. Culverts. Yard Drains 4, Drainage Canals, Ditches, Creeks, b, Masonry construction . c, Metal construction d, Access Door 6, Utility Controls a, Gas b, Electr icity c, Water 7, Fire Suppression Systems: a, Fire Hydrants b. Fire Sprinkler Connections 19, Outside Hazardous Waste Storage c, Fire Standpipe Connections 20, Outside Hazardous Material Storage d. Watèr Control Valves for protection systems 21. Outside Hazardous Material Use/Handling e, Fire Pump 22. Type of Hazardous Material/Waste Stored or Used (See Below) 8. Fire Departlllent Access TYPE OF HAZARDOUS MATERIAL F Flamllable E Explosive L = Liquid R = Radiological C = Corrosive 0 Oxidizer G Gas P Poison W = Water Reactive T = Toxic S Solid H Cryogenic D = Waste B = Etiological Example: Flammable Liquid = FL FACILITY DIAGRAM (Required items in addition to the above) 1. Risers for Sprinklers 8. Fire Escapes 2, Partitions 9, Air Conditioning Units 3, Stairways: Indicate the 10. Windows levels served from highest to lowest. 11. Inside Hazardous Waste Storage 4, Escalator: Indicate the levels served frolll 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets ""':..' ! ~'- .. - t r' ' ~ ,I .... 'r' I' ':~ ," . Bakersfield Fire De. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 "~r~f"r:O MAR 6 1990 A08'd............ HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1, To avoid further action. return this form within 30 days of receipt. 2, TYPE/PRINT ANSWERS IN ENGLISH. 3, Answer the questions below for the business as a whole. 4, Be brief and concise as pOSSible, SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: IJ II/Me f'/íß(,;V(h?¿ LOCATION: ;2 j /2.. tv /J, It::- fie!., c;I- r r ~~ Sé!/'C--';1Ce LJ 'i~, CÆ )')Jocr MAILING ADDRESS: , CITY: STATE: _ ZIP: PHONE: ?J.2 -.;2.,P 7eJ I I _ I I DUN & BRADSTREET NUMBER: SIC CODE: PRIMARY ACTIVITY: ¡::Jre£V'l)~d d- Tre.e r/"')~n?/V¡~ OWNER: chf'/J ¿, m q re. 1-/ c£, . MAILING ADDRESS: ff'~e )ECTlON 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR, PHONE 1 . 2. '.. .- 1 . FOI S;>C ~ :~ ~.. Bakersfield FIre Dept. HAZA.~;z~~;~sR:~;r~~~~;~~. PLAN ..~~ ¡; 1, :,-,¡;. ''1 SECTION 3: TRAINING: NUMBER OF EMPLOYESS: MA TERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: -... ....... - " ,~" . \ ,'\ . . \ ,c ¡' SECTION 4: EXEMPTION REQUEST: , I é-ERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: r: ''''WE''G)ONOT HANDLE"HAZARDOUS MATERIALS. WE DO HAND.LE HAZARD.OUS·.MATERIALS,/ BUT THE,QUANTITIES AT NO TlMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, ChrJ'J L, fV),~fJcc.. CERTlFYTHATTHEABOVEINFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ~ ~-/'Z. ~ -ð2£.v0er :3-.{-7ø SIGNATURE TITLE DATE 2, FOI590 If~ ;y.:" //~AK£"', ./·O~ ..... ';0 ,. ~<S');, ./;è: -.,.~\ \ i:ù =-,-..I.~' ç,), ". ~--:-'I,_..,_' . '¡"'-"~~,¡:':';'i è , ..... -" . <\ç'p'~':~:,-,J' " ···:1l.t'-"·-i.1\'?o: , :-"!,t.o.~"/ -~ - e ~~\~\'~m~ CITY of BAKERSFIELD i?-'Y·'<l. ,/<~ Lao -,,,, \~. ,-)¡ :0.'- ? D='~"·~ .~= \ :1 =~:o,. ::,:::::::; fb -. , . ~"',:"':' ,g ~--:.,- ., .,'. ,,~ C£Y' åhÎííÍ~ "WE CARE" I Ch('/J /-, /Þ7 5' /,e ;1-;7 C0 (tYDe or print name) RECEIVED Doh ere by c e r t i f y t hat I h a "\" ere \- i e h" e d the J AN 1 0 1989 Ans'd............ . attached Hazardous Materials business plan for I:J /P/ne P; rc:- e-vcJ¿;d d- T /' ~e- -S é!/C/,:;é e (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. ~~&. ~ /-f-ð<J signat.ure date I ,p I. 'Jf~ CIT}T of BAKERSFIELD Far. and Aqricu !turl '~ ~ HA~ARDOUS MATERXALS X~VENTORY St.nd.rd BusinlSS - ~ NON-TRADE SECRETS I BUS INESS NAME: IfIPllle- j:7JøCU(?¿'J¿ d'/~ME: c.hr / J L, /'1'7 r:¡'/?!!t-jc..~ NAME OF TrttŠ ~J~JL.!TY: LOCATION: ~:.J~'2- ~1bfe.. /Zd. ADDRESS: Z/.:J- wfl.5/e /U¡ . STANDARD IND. CLASS CODE I CITY, ZIP: /). '('¿.r.J"i '1t:N- C-A: Cjj.:JC)Z¡ CITY, ZIP: ¡-If'/çe,..f/1"-/eld Cf9." 5'::!¿¡Of5/ DUN AND BRADSTREET NUMBER PHONE #: _"t¿-o- J.J- -;).¡J'7tJ . PHONE.: Y~?L. ~ ;¿'1!:..70 Rlll"IlR ro IlISrRUC1:IOllS roB PROPIlR CODIlS Plql _ ___ of ____ <01 I 2 Irlns Tyøe Codl Codl 3 'IlK AIIt . AverlCJt Aet 5 Annuli Est & .....u... Units 7 IOys II! Sit. 11 Un Code 12 locat ill! ...... StOl'ld ,in Feci Itty 13 ,by lit 1. "- of .lxture/CollDanlnt. S. InstructiCIII Get /'C?j' ? -------- -- ------- Ph~iClI end HH Ith lieui'd f Clwck .11 that '1IIIIy) ,.- ..-., L ~r. H.urd .. -... Røctiyity to.pønent 11 .... U.S. ...... 1?7 ø r/&/' Ø/ j) I ------------- ..,..., .. -., "\7" ..~... o.l.yed ..-... SudIMn llel.... ..~... 1-.cII.t. "" Ith of Pr.IU'" IIeIlth ta.aønlnt 12 .... U.S. ...... --- -- ~t IJ .... C.A.S. ...... v ----- -- Phys ic.1 end "" Ith H".1'd (ChKk .11 that 'Illy) ~A ..-., ..y.. ..-., ..~ L.,.... FI... HllIrd ..~... RHctlvlty ..p.... o.leyed ..-... SuddIn ;'1_ ..4:.... 1-.cIln. IIMlth of P....IVI'I IIeIlth ... . C.A.S. ...... 1/ Y"d /~ ij/~ c;. ð..J/ ta.ooMnt n .... U.S. ...... CoIIDanInt 13 .... C.A. S. ...... Phys Ic.1 end 11M Ith Hlz.1'd (Check .11 that 'Illy) ~ ~ Fire H"ard r = ~ RlICtivity r:;f o.l.yed r: ~ SuddølR.IHI. ~ l-.cIi.t. H..I th of P''IS'u", H..I th C.A.S. ....... e CoIIDanInt 11 .... C.A.S. ...... (/-.f'ed 0; / --- ----- CoIIDanInt 12 1_' C.A.S, ...... ~t 13 .... C.A.S. ...... II ~---l------------1-.---------___JL_____________J______l________l_______J_~JL____---L~_ Physic.1 end HHlth 1I1I.1'd C,A,S, ......_______________________ to.IIanInt II ..., C.A.S. ...... (ChKk .11 that ""Ir) r-, ,..-, r-, r--¡ ,..-., ~ -... Fi~I Hlzard 1..-... IIHc:tivity ..-... OII.yed ..-... Suddtn R.IHI. ..-... 1-.cII.t. Hfllth of Pres.ure HHlth Co.øønIIIt 12 ..., C.A.S, IMber -------------------------- ------ CoIIDanInt IJ .... t.A,S. "'r "f RGENCY COIITACTS II C'h/'J'J l"'"Jç~r)C; øÚ..."'.Æ2.-r cf7.:l;I-;L"'p?¿:J 12 ,~ ~ '\J'7l'Je- tß?7~/".ff4d'~ ¡;ø..c~~~ ðJ72~~ Ri¡¡-~----------------------------------- nt1i ---------------------- '.-R¡:-Pfiiiñï------ Q¡¡------------------.--------- nt1l------~--------------- "",'"1'I11III,------ ¡ : I, Cert If ic.till! (Read IInd sign lifter co.p1eting 1111 sections) . I ttrt1fy under """lty of 1.. that I hav. Plrson.lly I~..intd IIId .. fHiher .lth the Infor..till! su.ittld in this end.ll.ttec:hed cIoc_t., IIICI that based on .., inquiry of thol. individual. resICII.ible i lor~ßlbt~.,jn;n9 the infCM:M. tl~.l. lllli.YI that the su.ituld i"fore.till! is tMII. .ccuratl. .nd coilø1et.,_ ./ ~.. . i ·"r...~ C4/IJ' C, /2-f~/é:-#c.h tfJc-~r- ~~-. . /-/~/ß , Il';!ij; ¡ri~- õrHë i¡'l~f ifl¡-õr-ö;ñ¡;: Toõi;:¡¡õ;:-OJl-õWñ¡;:7õõë;:¡fõ;: 'š-¡üf ~;:ii¡n¡¡;;:išiñt ¡m¡ Siijñ¡türë---:----------------------------------------- --. . llifniijñiil---------------------------- ¡ ~/; ~ ;;:¡~~ t .,-/~: ... - e . BAKERSFIELD CITY FIRE DEPARTMENT ;, 2130 "G" STREET BAKERSFIELD. CA 93301 (805) 326-3979 ·L RF:~rr~'F.O O~ ;iCy OFFICIAL USE ONt Y . ;:t" NO V -': 9 1988 1X'- ~'; T";r~}'r.~,~ .. ,... Anc d ' .. ,; . ,,' ............ rb ~ #1-\,,/ - [ß ID# ' u013H30 ~{JS INESS NA.\1E HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A ~C'øðaÁ \f'œ &' . ~, ."~'" INSTRUCTIONS: 1, To avoid further action, return this form by ~,' 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: IJ-j fJ/ l7e PJI'ß lIA/)t.?ø o-I/'¿ß Jéd/V/èe. ;LJ /2- Ú/lh/e /<cJ" ZIP: C/:JJ¿) V BUS.PHONE: #J>: j?J'.?~)"''? 70 B. LOCATION / STREET ADDRESS: CITY: ðí/C.. 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, E~PLOYEES TO NOTIFY IN CASE OF EMERGENCY: ~AME AND TITLE J' /'1 DUHING BUS. HRS. A, C h Î' / .s f'VJ (;) í ¿..¡-, c t., (/ c..v ¿,a.r Ph# ðJ:2 - ;l-..J?7t:J , I F éìre"",;; "1 %..: 8, utlle (Í{CJGÎJsc4ez.. Ph# '~2~70 - AFTER Brs, HRS, ..19 ~ e Ph# Ph# .Jf~ e SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: * D. SPECIAL: E. LOCK BOX: YES /~ IF YES. LOCATION: IF YES. DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSS? YES NO KEYS? YES NO tit - L' \~ '>:'--':;:::"¡ 1 ~ SECTION 4: PRIVATE, RESPONSE TEAM FOR BUSINESS AS A WHOLE we c ~ rr..y J11 q t--¡d/7z?/'þ" P /'e 13 ><.¡-) h.J ~ ,I./'4 eLT L? L, /? / J U e- ?, 1 C, Ie J, ·we /J-, B:- #; c".,e- £ 0 ¿) '45' 4 /JIð C<./<; ~r Ifr ./e ~ '7-/ /? Gu,;;//C,z&'s"(? 7lJ ,:~fqcc., ~ / ~ ~ I0 c',Je ('/~ Ii'mBr$'&~":Y we. c¿,.Øcr/d pi.. / <7/1 /Ør j;6/,C? I SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE I c> II ¡q-IC~J we" þve é)&, Iy ~1J)c; ~/ðr ./5ZJc/ F9C.J/:J:fY/F SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROdRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAI~ING IN THE FOLLOWING AREAS. CIRCLE YES OR NO ,A. METHODS FOR SAFE HANDL ING OF HAZARDOUS ~TERIALS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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:....... INITIAL REFRESHER §J NO YES NO I NO YES NO NO YES NO E NO YES NO YES ŒW YES NO SECTION 7: HAZARDOUS MATERIAL C TRCLE YES OR NO QR NONE DOES YOUR BUSINESS HANDLE HAZARDOUS ~~TERIAL IN QUANTITIES LESS THAN 500 Por~DS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:.., . " ~ NO 1,- -61, rl.:J t., r"V1 rre f-/et., ,certify that the above information is accurate. I understand 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. SIGNATURE¿ø:' ~TITLE ¿}c.u~¡r- DATE / /- Y'-:.:?? - 2B - ~, ....,...- r ",.-/ j ~, - e e --BA*ERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD. CA 93301 OFFICIAL GSE ONLY/ ID# ------ BUSINESS NAME: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A . I NSTRUCT IONS 1. To avoid further action. this form must be returned by: 2, TYPE/PRIXT 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# I FACILITY UNIT NAME: ff /1:7) ~ ¡Ø) r~~¿J¿Jd SECTION 1: MITIGATION. PREVENTION, ABATEMENT PROCEDURES Pit It,¿ O!J / . h~rtz;IJ ~æ Ke/?d- :t: ~ /~ Gß'5e- 1/1 :t~- ~ JpJ II Jho'r /d f)CC0f ::t',f- CPtl'-1!d- ..6'~ tJ t.--¡ j/æ:- ~v.....8'~<f- J!'i & IL/o r ~ '-"1 ?"~ dÞ-/; "Í ~ ~ c?-, t/~ # C/'~4 /!<J C( ,p O:J I ~ C~ '-7 .",,!,,", LA ~ Ji--k/ du1cf- Or Pov'der- cJ- I<æp 2/- 1Z ~l at' J~/ed C7'~ I SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY J'1 C~~e o~ Ø'M~Í7~t1cy 0&- ~/J 0/<;/ Or ! I' qYld fHk-(jr Ife / ~ - 3A - e e -------- ~ - '----. """-1 SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY /\, Does this Facility Unit contain Haz;:u'dous :-Iaterials?""" éji) NO' If YES. see B. If ~O. continue with SECTION 4, B, Are any of the hazardous materials a bona fide Trade Secret YES @ If No, complete a separate hazardous materials inventory furm marked: ~ON-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 we hø.A/ tv., Ie"'/' /þJed d- FJ,,-e, ¿;çÆ-'¡:"/~,Sc/,;Jf(cY::J"' SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS W'i'!e/' fltJJe ~t../&...té/-- J}lde tt?..¡L: !r¿JC/ Je d- ;? t.z 'T ~0- t? r¡' C Ie. V"f'/' d) /'; /e fI Y d /Ç' "-r- ¿J '? , ç¡J /' t.,j;-r Or w/~Ie- d- Ct-YIJð(,., SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. ' A. XAT. GAS/PROPANE: /L- IIJ ' I Q Î ,- /7L ,.Þ/ " /7é/ Ú-.J~ ' / (..V', C &' ?-t(!/¡T' (/ r- /..:.v.. B. ELECTRICAL: Á/,.lU, {t'/'ner t1r r~ jØvJe if rc/f.e. () t )G' 1.; ~ 'rt...e- ¿&; Cf r'«7 ye- r C, WATER: , SI ti ctJ/""Or ~'-f2 ¡1?c.-r /YJp /J/Jr/- ~ ~ .~ ¿)"Ct'è... Y~rc( 0, SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSs? YES / NO KEYS? YES / NO l - 38 - \ \.' BAKERSFIELD CITY FIRE DEPARnlENT <.,¥- -,~. ,- ,D. :t 'Ie.. . ~ FOR~j 4A-3 page_ of. , NON ... , - -FARM & AORICULTTTRR - \. " HAZARDOUS MATERIALS I N'TvENTORY . , , N A ~tE: III f,tJ Áe/ P. )fUi./Ptt:f-c;l--~J~~WN E R NA~IE: chrPJ j/"1"~ 1ïf:;t.¡ - ~J' I I BUSINESS FACILITY UNIT #: , ADDRESS: . ij /1- c;.., J .b t¿/ /Z.¿I, ADDRESS: ..Í i t1..r..e. FACILITY UNIT NAHE: ~~ CITY, ZIP: íl1/':':04:J ri& ~./.. er.1 S.& c¡ CITY,ZIP: J'1 k.. e PHONE ::: ROt,) I %,] Z. - ,)",:17(/ J PHONE #: ,J4~(2... 10FFICIAL USE CFIRS CODE ONLY , 1 2 3 4 5 6 7 8 9 10 ':YPE HAX ANNUAL CONT USE LOCATION IN TillS D_ BY HAZARD D.O.T '" ::ODE Mt 0 U N T MID U N T UNIT CODE CODE FACILITY UNIT \n. CHE~tI CAL OR COMMON NAME CODE GUIDE P\) .JQ 611 6ò/rJ71J ''il Db J-6 Gt 0.$ e.. /00 /'VJ&Hr e?;J1 ~~Ò~ C>RfI1g Iv -,/0 \ ~t( 1'1*' ,x/ (J r;)) .J~ /00 fr; l.sv b4! b' '")-, '¡J l' ¡'-t f e- 100 ffy d Fe; VI /;7C 0;;/ 1;).d-~ .Óc ðIV-" e ~ '"" 'J rW? ..5- J./ Sðfz¡/~ , ~.,. ( Ob :J& a f rr .f e...- U J9-d þV1D~r- o¡) I tSq<ö f.) ,ýe.J. too Ol?m e {f~/' I, .' , .' , i . I I' , , ' " e , , ..' . " , ./ ,::;\~!E: C{;,f',?J m '1 ¡-e'fj ~-4. TITLE: O~~/- SIGNATURE: ~'P -, ./7 DATE: /1-(, -??' .. '! :~IERGENCY CONTACT: fYJ'1I''f (1"14 re.. f )C/ t.., TITLE: f11 tJ./-t..ør PHONE :: BUS HOURS: rJ 1--:).2..6 if"' Ñ d-r;f '--t e"Z--TrTLE: AFTER BUS HRS: \J"7<o.L.- - , :c ~. r. F' r, r.... r Y corn ACT: a-vJe/ ¡'?; n:::- ~,. ¿., PHONE :: BUS HOURS: 1''3 2- --.Þ~7V II_..I~ '. J"-',\_ '!~: ~ \.~: I P,\I.. BUSINESS ACTIVITY: ·AFTER nus HRS: Jf. .......tZ/ - 4A-3 - J - DØ · ~-iJ~&~ BAKERSFIELD CITY FIRE DEP.AR~~ . . 2130 "G" STREET '. ~~BAKERSFIELD' CA 93301 o (805) 326-3979 Qøf: " - - . r \. .' \_~./ f? :<~, -l / RECEIVED DEC 0 7 1987 OFFICIAL CSE ONLY -.......... ID# CS IXESS ~A.'v{E HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A 7"'>~ - - - -. - ----:::-.~~ --~---= ----....---._~ INSTRUCTIONS: 1. To avoid further action, return this form by I~ - 3/-t1 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. BUS,INESS NAME: ALPINE FIREWOOD AND ·tREE SERVICE '" CITY: 'B:ikersfield, C::Ilif.- 2312 Wible Road ZIP: 93304 BUS.PHONE: (80S) 832-2670 B. LOCATION / STREET ADDRESS: 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 ~____.~-:;,.. --l::awc.,:". __~~~~-::s.,.~.$-_~,.::-.._-. ~-:-~~- .~~ -.¿.~¿-~.:~~-'~ E~PLOYEES TO NOTIFY IN CASE OF E~ERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Ph# Ph# B. Ph# Ph:/: SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES! NO IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? FLOOR PLANS? YES / ~¡O YES / NO MSDSS? YES ¡NO KEYS? YES I NO - 2A - '- . \ :~<_~- _-,t ,~.~ ~,. ", I . ~4~ :~~: ~. , " ... . ~ --",", \~ t,; ',..1 ::~ ~-..: SECTION 4: PRIVATE RESPONSE TEA.". FOR BUSIXESS AS A WHOLE .~: .~ SECTION 5: , LOCAL EMERGE~CY ~EDICAL ASSISTfu~CE FOR YOÚ~ BUSINESS AS A WHOLE - .-~~,,". -~,~-~-- ~ . .-- -- '-..,.-~ -'-. ........~..- --....- .:.. -, ._.~" ~ -. SECTION 6: EMPLOYEE TRAINING E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES E~PLOYEES WITH I~ITIAL A~D REFRESHER JRAI~ING I~ THE FOLLOWING AREAS. CIRCLE YES OR NO A. ~ETHODS FOR SAFE HANDLING OF HAZARDOUS Y1ATERIALS: . . '.' . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:.......................... C. PROPER USE OF SAFETY EQUIPMEXT: . .... .. ......... .. D. E~ERGENCY EVACUATION PROCEDURES: .. ............ ... ' 1---- ,..E-.- 00- YOU_MAINTAIN..EMELQYEE TRAINING RECO.RDS:,...... INITIAL REFRESHER YES NO YES NO YES XO YES NO YES NO YES NO YES NO YES NO YES NO YES NO -- .- - - -- .. ~ -~- - . - SECTION 7: HAZARDOUS MATERIAL CIRCLE YES -(ii)- NONE DOES YOUR BUSINESS HANDLE HAZARDOUS ~~TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:,."" YES NO I, C&¡rìJ L,MS'/'erjV'-, ,certify that the above information is accurate. I understand that this information will be used to fulfill my firm's õbligations 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. SIGNATURE cIlr~TlE &w~r' DATE /7--3~t?7 .. - 23 - , /~ · ~ B~~JeldFire &pt. c] Hazardous Materials Inspection Date Completed /Î I¡> I"" j)~ CA->G>G>cJ ';;)... "3 , l fA..) I. k ( ¿, I Plan ID # 215-0013 (PO (Top right comer Business Plan) / / - d-7- ¡¡--r; . . RECEIVED NOV 2 9 1989 HÄ~, MAT. DIV. Station No. I c -g L l.lt!+'5 Shift Inspector Adequate Inadequate Verification of Inventory Materials D D Verification of Quantities Verification of Location 4// e.t~'/.,,_4.û/ Y- ;;9, '/ Ø/ov-eJ Verification of SDS Availability Verification of Haz Mat Training D D Comments: Verification of Abatement Supplies & Procedures D D . Comments: Emergency Procedures Posted 0 0 Containers Properly Labeled D D Comments: Verification of Facility Diagram D D Special Hazards Associated with this Facility: "/ , Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow·Station Copy Pink-Business Office