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HomeMy WebLinkAboutBUSINESS PLAN Operil.te Waste:Unified Permit it to Materials/Hazardous Hazardous SE SIDE Permit ID #::015-000-000691 TEXACO EXPRESS LUBE " . LOCATION: 6501 WHITE LN,' ' } " í ~ ~ Issue Date Approved by: Expiration Date: \·.,_L~':l:,.~:i. ':':':'._4;~'~-· "; . . Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661)326-0576 Issued by: Per Ït to Operöte Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE the followin PERMIT ID# 01S-Q21.o00691 TEXACO EXPRESS LUBE .'L':¡' ,! :. '¡H; Ii /¡ 'f:, ii i. j'" ¡;;; ;' ""0 i¡,; I' LOCATION 6501 WHITE SRIE::LD CA 'I ¡,g¡¡mmlr¡¡¡¡L Þ ,!:" H""'_"" ~~;!¡:<flf ,> ;~:~ ,î Issued by: Bakersfield Fire Department Approved by: _ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 Expiration Date: FAX (805) 326-0576 I . I ,.;. <1" . ~ ~",!".;/Ií' \ .1-~~· / ·It .\ SITE/FACILITY DIAGRAM FORM 5 / ~ / NORTH SCALE: I 7 be. FLOOR: OF UNIT #: OF (CHECK ONE) SITE DIAGRAM FACIL ITY DIAGRA.\i ~( .~ v¿j ~ ~ ~ ..¡ ~OO ~ J ~ ~ .... ,!:¡- .~ ~ !l ~j 'Iv -+- ~ V <¡~ q... ~ ~\ \t)Q; <! ~ \:j .;ù 11\ ~ " S; r ,,0 "- .~ ~#j\( J5 ~~ ~ -:z ~ \1 0 000 ï ~ I I ~..¿¡y1 s TO 12..A-éi; I-,J~ I~~j ~ fl ,t.....-_ ~ . '-..., . ;)j ! if ' /1.f o '(0:;:. "'" . , 0 ~ ~Q. ..~ ' , D¢' /).¡..~ ?" "/ ~ Î-.-. . :5 H£7U... (Inspector's Comments): -OFFICIAL USE ONLY- - 5A - SITE DIAGRAM (~red items) 1, Address: Identify the principle buildings by the Street numbers. - , " i''';;'''. ^,~ ,~ . .:~~ 9, Lock (key) Box ¡- t· 10, MSDS Storage Box 2, Street(s), Alleys. Driveways, and Parking Areas adjacent to the property, Include the street names, 11, Railroad Tracks 12. Fence or Barrier a, Wire b. Masonry 3, Storm Drains, Culverts. Yard Drains c, Wood 4, Drainage Canals. Ditches. Creeks, d. Gates b, Masonry construction c, Metal construction d, Access Door 6, Utility Controls a, Gas b, Electricity c, Water 7, Fire Suppression Systems: a, Fire Hydrants 13. Power lines 14. Guard Station 15, Storage Tanks: Identify the capaci ty in gal, a. 'Above ground b. Underground 16, Diking or Berm 17, Evacuation Route 5, Bu i I dings a, Frame construction 18. Evacuation Area: I den ti fy the location where employees will meet, b, Fire Sprinkler Connections 19. Outside Hazardous Waste Storage c, Fire Standpipe Connections 20. Outside Hazardous Material Storage d. Water 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 Department Access TYPE OF HAZARDOUS MATERIAL F Flammable E " Explosive L Liquid R Radiological C .. Corrosive 0 " Oxidizer G .. Gas P Poison W .. Water React! ve T Toxic S " Solid H Cryogenic D Waste B c Etiological Exa.ple: Fla.mable Liquid.. FL FACILITY DIAGRAM (Required items in addition to the above) 1. Risers for Sprinklers 8, Fire Escapes 2, Parti tions 9, Air Conditioning Units 3. Stairways: Indicate the 10. Windows levels served fro. highest to lowest. 11. Inside Hazardous Waste Storage 4. Escalator: Indicate the levels served fro. 12. Inside Hazardous highest to lowest. Materials Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling 6. Attic Access 14. Sewer Drain Inlets ...... _.., ! _t, .. ._ '" / FACILITY NAME I"cd\~ \~CC ADDRESS E~ft'5 S 'I" t>é ~_____~__________u____ 'å ~~~ .ß.L____u_______~------ -;- Bakersfield Fire Dept. :~ Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INSPECTION DATE INSPECTION TIME q I mQ.L. LG,~<L____ PHONE No, No_ of Employees <6 ~ 7 - Ó 4 S- ___3________ Business ID Number 15-021-000&9/ UNIFIED PROGRAM-'N'ECTION CHECKLIST SECTION 1 Business Plan and Inventory Program . Secti,on1: Business Plan and InveritoryPrograrT1 C] Combined C] Joint Agency C] Multi-Agency C] Complaint C] Re-inspection c V ( C=Compliance ) V=Violation OPERATION COMMENTS IJ C] ApPROPRIATE PERMIT ON HAND ---~---~---~-----~------_._------- _._---~------,-_.~_._-~---_._~-----+._----_._-_.__._---~-_.--_._--_.--_._.---- 11!1 C] BUSINESS PLAN CONTACT INFORMATION ACCURATE -----.-.--...------------- --". -_._-------"-- ---_._----~_._--_.---- ----------."----------.-..-.-....---------....-- .-------- (ÿJ C] VISIBLE ADDRESS __.~__________________.____.__.._ _ ·_~.__._______·_.m___.._____.~_____._.__.___.__.·___·______....._..._______._ 51 C] CORRECT OCCUPANCY -~--_.._-------_._._-_._...._-----_._._..--_._----._-----._---"---- -.---.-.--.. ~-~_.~--_..__. riiI C] VERIFICATION OF INVENTORY MATERIALS _.______.______.___~._. .___.______...._.._,___,___._________.___.________...___________·_____ø______·.._·_ .___._._.___ ISI C] VERIFICATION OF QUANTITIES -------_._-_._----------_._------_._---_._~. ----.-------.------..-.---------------.-.-.--..---------...-------.-....--.-..-..----.- . ~ C] VERIFICATION OF LOCATION ~ C] PROPER SEGREGATION OF MATERIAL -------_._-----~_.._._--,-- ti C] VERIFICATION OF MSDS AVAILABILlTYE -----_._-------_.,---~._._----_.__..__._._--._--------------- ._._---~-_._------------ .-.._-.""----_._----~------_.__.__._--"._~-_.------ ---~--- -------..-----.. --.--------. ----~-_..-._---~-._-- ----_._----------~--_._----~..~----_._._---- rg C] VERIFICATION OF HAT MAT TRAINING -------_..-----_...~----- --~~------_._--_._-_._--------_._-----.__.-._----~_.- ----_._--~---_. ÇI C] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ._--~-~.._._--- ----.--------.--.-------.------------.----------------------.-- øa C] ~ C] EMERGENCY PROCEDURES ADEQUATE -------------------- --.--.--.----..--.-.--------.-------------.--------.---_._._-----~~_.__._.._---- CONTAINERS PROPERLY LABELED ---------- -.--.----- -------------_.~----_._---_.._--+_._----_._-----_...._-----.---.----------. ŒI C] HOUSEKEEPING -.--..--.----------- ---------------_._._--~-------_._---_._----_. II C] FIRE PROTECTION -----~-----_._._----_._----------_._-------- .__...._---~---_. I!J C] SITE DIAGRAM ADEQUATE & ON HAND .-- EXPLAIN: W4-\ T~ Ö/'- t¿J.c¡ ~/ddd- V· /'hO/7 / ---- ANY HAZARDOUS WASTE ON SITE?: ~YES C] No e QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~ ~Ú(~... to Inspector White - Environmental Services Yellow - Station Copy xç~_ r, Tsus,ness Site Responsible Party q L/ Pink - Business Copy -----------LQ5-~------ Badge No, ,_ .-0 ~~ì - - TEXACO EXPRESS LUBE RECEI SEP 1 1999 \ ./BY:' STATION Ó9 SiteID: 215-000-000691 Manager : Location: 6501 WHITE LN City BAKERSFIELD sPhone: p : 123 id: 16D (805) 397-1189 CommHaz : Low FacUnits: 1 AOV: = CommCode: BAKERSFIELD EPA Numb: SIC Code:7549 DunnBrad: Emergency Contact / Title Emergency Contact / Title BRIAN BRANSON / OWNER BILL BRANSON / OWNER Business Phone: (805) 397-1189x Business Phone: (805) 397-1189x 24-Hour Phone : (805) 589-3637x 24-Hour Phone : (805) 589-9649x Pager Phone : (805) ~ l~ !x 1~],'B" Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: ( )~1 - tt.Vî x MailAddr: 6501 WHITE LN State: CA City : BAKERSFIELD Zip : 93309 Owner BRIAN BRANSON Phone: (805) 589-3637x Address : 9500 SPOKANE AVE State: CA City : BAKERSFIELD Zip : 93312 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Çertif'd: RSs: No Emergency birectives: MOTOR OIL WASTE OIL F F DH DH One Unified List ì Materials at Site ì DailyMax IUnit MCP 1250 GAL Min 1200 GAL Low f= Hazmat Inventory ~ Alphabetical Order All specHaz EPA HazardS Frm I Hazmat Common Name... L L ~,~IAtJ~~tl (i'VP3 or print name) IDo hsrebl? œiii~ ~ha~ ~ havs rsviewsd ~he attachoo1 hm:~O~$ m~eria\ls manage- men~ plan 1oi"~"'» WB6 ~nd ~ha¡ it allordg with ~of Business} any corr~ciioH'il$ ronstitu~s Bl ~m~!~t® ta1nd OOIT~©'R mSll1Jo agem~V'I~ ~~lf'8 ~()U' M1f ~~©ð!i~ 0 /\:.T -1- 07/19/1999 e - SiteID: 215-000-000691 1 Facility Unit: Fixed Containers on Site ì F TEXACO EXPRESS LUBE p= Inventory Item 0001 COMMON NAME / CHEMICAL NAME = ~ MOTOR OIL Days On Site ) 365 Location within this Facility Unit Map: Grid: SOUTHWEST CORNER STORAGE ROOM CAS # STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 1250.00 GAL Daily Average 900.00 GAL %Wt. RS CAS # 100.00 Motor Oil, Petroleum Based No 8020835 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min HAZARD ASSESSMENTS p= Inventory Item 0002 = COMMON NAME / CHEMI CAL NAME WASTE OIL Facility Unit: Fixed Containers on Site 1 Days On Site 365 Location within this Facility Unit BASEMENT SE CORNER Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Largest Container GAL AMOUNTS AT THIS LOCATION Daily Maximum 1200.00 GAL Daily Average 600.00 GAL %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSMENTS ~J- '7 W~ ~. -º-ö-c:~J (, _ _ ~ w~cd- ~ cW-~ ~J- ~ ~ ': c\:-\~ ~~20 ~o~~&-ç 07/19/1999 ~ ~CX)I--\ '5$ ~ 'I:lfiJ.... MN)f:D W1't"Vr w~ FfDµ. ~q~ 1"1) AD D ill c:()~~ c..¡æ::;,. ~ I . ~ C {<£.<::. µ¡I\l ) &:v~ï 't ~ e e F TEXACO EXPRESS LUBE I p= Notif./Evacuation/Medical ~~:e::: Notification ~ Employee Notif./Evacuation CRBAL I Public Notif./Evacuation \JS?~ I Emergency Medical Plan CLOSEST HOSPITAL AROUND SiteID: 215-000-000691 ì Fast Format ì Overall Site ì 01/07/1990 1 1 I 1 01/07/1990 01/07/1990 J.ita~l.\ ~'Mtu81 -3- 07/19/1999 '·'e ~ ,t¡ '~e .- SiteID: 215-000-000691 ì Fast Format l Overall Site ì 01/07/1990 ] 01/07/1990 F TEXACO EXPRESS LUBE I p= Mitigation/Prevent/Abatemt r=: Release Prevention ON WALL IN STORAGE ROOM Release Containment DRY CLEAN - KITTY LITTER Clean Up 01/07/1990 1 I OUTSIDE CONTRACT Other Resource Activation -4- 07/19/1999 e e SiteID: 215-000-000691 1 Fast Format =¡ Overall Site =¡ I F TEXACO EXPRESS LUBE I f= Site Emergency Factors r== Special Hazards Utility Shut-Offs 01/07/1990 A) GAS - EAST SIDE OF BUILDING B) ELECTRICAL - SOUTH SIDE OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/07/1990 PRIVATE FIRE PROTECTION - 4 FIRE EXTINGUISHERS FIRE HYDRANT - ? Building Occupancy Level -5- 07/19/1999 t· ..... ~ '. e e F TEXACO EXPRESS LUBE I F Training Employee Training SiteID: 215-000-000691 9 Fast Format 9 Overall Site 9 06/08/1995 WE HAVE 7 EMPLOYEES. WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY COURSE EVERY FRIDAY Page 2 r I I Held for Future Use Held for Future Use -6- 07/19/1999 t o 'i --- - -- / , '< - , 215-000-00069 ~ r¡;; (Ç;~~VJ~~.ge ~í.22/95 TEXACO EXPRESS LUBE Overall Site with 1 Fac. Unit rl JUN 6 1995 General Information L -- Location: 6501 WHITE LN Map: 123 Haz:2 Type: 3 City . Bakersfield Grid: 16D FlU: 1 AOV: 0.0 . - Contact Name Title ~ Contact Name Title BRIAN BRANSON I OWNER BILL BRANSON I OWNER Business Phone: (805) 397-1189x S~- Business Phone: (805) 397-l189x 24-Hour Phone · (805) ~~x Î 24-Hour Phone · (805) ~2J7JxS~~q · · Pager Phone · ( ~ ) ¿j3;2 "7355? x Ì)iÏ . Pager· Phone · ( ) - x · · Administrative Data Mail Addrs: 6501 WHITE LN D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-009 BAKERSFIELD STATION 09 SIC Code: 7549 Owner: BRIAN BRANSON Phone: ( ðö~)5'2;>~ -~~l Address: 4JOO ORRICK CT q~ 5Po ~A~E Á<..Jb State: CA City: BAKERSFIELD Zip: 9~-q3=3¡L Summary 1 l, ~~AJ fu}.\-st:J. --Do-hereby GertiflHha~ i have ITy~ or print name) rs;:>;:'l~·,?d the attached hazardous materials manage- ]r E L ment plan 1(»«" t;¡(Aco . . fP£l;JS \)bd.and that it along with (Name of Business) any correctié)ns cOi1sti~ute a complete and COiTSd man- agemen~ plan 10r my 1acility. '2~ W Signature ~t~q~ Date e - 051.22/95 TEXACO EXPRESS LUBE 215-000-000691 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site I PIn-Ref Name/Hazards Form Max Qty MCP 02-002 WASTE OIL Liquid 1200 Low ~ Fire, Delay Hlth GAL 02-001 MOTOR' OIL Liquid 1250 Minimal ~ Fire, Delay Hlth GAL e e 05j.~2/95 TEXACO EXPRESS LUBE 215-000-000691 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-002 WASTE OIL ~ Fire, Delay Hlth Liquid 1200 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 1,200 I 600.00 I 10,000.00 Storage ABOVE GROUND TANK r Press T Temp ~I Location Ambient AmbientlBASEMENT SE CORNER - Cone l Components 100.0% Waste Oil, Petroleum Based r=- MCP ----rGuide I Low I 27 02-001 MOTOR OIL ~ Fire, Delay Hlth Liquid 1250 Minimal GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 1,250 I 900.00 I 12,000.00 Storage ABOVE GROUND TANK r Press T Temp ~ Location Ambient AmbientlSOUTHWEST CORNER STORAGE ROOM - Cone l Components 100.0% Motor Oil, Petroleum Based r; MCP ----rGuide Minimal I 27 e e 0~~22/95 TEXACO EXPRESS LUBE 215-000-000691 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation VERBAL <3> Public Notif./Evacuation <4> Emergency Medical Plan CLOSEST HOSPITAL AROUND " I. I.' 05l22/95 TEXACO EXPRESS LUBE 215-000-000691 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention ON WALL IN STORAGE ROOM <2> Release Containment DRY CLEAN - KITTY LITTER I I <3> Clean Up OUTSIDE CONTRACT I I I <4> Other Resource Activation -~I ... e - 05"/2.2195 TEXACO EXPRESS LUBE 215-000-000691 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - EAST SIDE OF BUILDING B) ELECTRICAL - SOUTH SIDE OF BUILDING C) WATER - EAST SIDE OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 4 FIRE EXTINGUISHERS FIRE HYDRANT - ? <4> Building Occupancy Level .. .:., e e 05¿,22/.9'5 TEXACO EXPRESS LUBE 215-000-000691 00 - Overall Site Page 7 <G> Training <1> Employee Training WE HAVE f~EMPLOYEES WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE SAFETY COURSE EVERY FRIDAY. <2> Page 2 <3> Held for Future Use <4> Held for Future Use ,ì -. Business Name: Location: 650 , JUN 8 l~~j (fop of Business Plan) q ~HAZ.MAT.DIV. Inspector ' e ~¡¿e _ Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISIO~ f5"' xf t""~ ~ s \.AI'" J-c.- . L '" Date Completed Lv b-R- -r;'¡('"'otC' 0 Business Identification No. 215-000 () 0 06 ~ I Station No. o¡ c Shift I'~v~mments: S'<; V Number of Employees Comments: Adequate Verification of Inventory Materials D Verification of Quantfties m Verification of Location (9 Proper Segregation of Material G' ~Ià \. ; 1r u vo--. OI~ ~: ,- r V"{>-e 2. ~ Verification of MSDS Availablity {'ý/ 't Verification of Haz Mat Training G" / 6'- 4- - <= '} RECEdED Inadequate m- D o o q J20t ) D o o ~ Verification of Abatement Supplies & Procedures Comments: Comments: Emergency Procedures Posted Containers Properly Labeled Œr 8 o o D IJr Verification of Facility Diagram Special Hazards Associated with this Facility: Violations: .~;s~ BusIness Owner/Manager FD 1652 (Rev. 1-90) All Items O.K. D Correction Needed rn- White·Haz Mat Div. Yellow-Station Copy Pink-Business Copy e . Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 RECEIVED J U L 2 1 1989 Ans' d............ #rJ a&e ¿ ~œ &- t!- HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: OOObq ~ ® 1. 2. 3. 4. To avoid further action, return this form within 30 days of receipt. TYPE/PRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be brief and concise as possible. IdS - (Io D 6) ,.'ÞJf' q It- SECTION 1: BUSINESS IDENTIFICATION DATA. BUSINESS NAME: JE.-xAt:.D ß'if>Q,(:s5 Lu Bé- LOCATION: {oSO I lAI^;~ l.AJ MAILING ADDRESS: ~& CITY:.Þ ~~ STATE: ~ zIP~3.3ð4 PHONE: a~ì-t l ßC{ DUN & BRADSTREET NUMBER: PRIMARY ACTIVITY: f'j- ( clArt\l<i:t ~ OWNER: t)e~~ ~crJ MAILING ADDRESS: -..$DD D~QjCG CA- SIC CODE: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 1, ""'BRJ A:1J "ßKk~ öWNP'L (1'11"'! I&' tj 2, \6 j [I BeAU;;; ð0 ðW/l1éf- 24 HR, PHONE :59-3- ~<I'I 313- ~~l3 1 , FD1590 I -, I . Bakersfield Fire Dept. _ Hazardous Materials Division ~ -.. '.).' .' " , .. ' \; HAZARDOUS MATERIALS MANAGEMENT PLAN , I II SECTION 3: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: ./ qll B. EMPLOYEE NOTIFICATION AND EVACUATION: ./' '{te~ .1 C, PUBLIC EVACUATION: D, EMERGENCY MEDICAL PLAN: Ü-OSg:S ~~ ftØUL/;D x 2. fDl&;o ·' I.i' ) , '... e Bakersfield Fire Dept. e Hazardous Materials Division' i~1 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 4: MITIGATION, PREVENTION AND ABATEMENT PLAN: A, RELEASE PREVENTION STEPS: v 61J .. W~ lj 6ml2A6,& ~ B. RELEASE CONTAINMENT AND/OR MINIMIZATION: . . t)12-Y ~ "'- /é/ñY LIrre¿ C. CLEAN-UP PROCEDURES: ~¿fð~ ~+-~ SECTION 5: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: EPr7:5l 6) I}e O\: 9u ¡ ldJv~ ELECTR ICA L: ó::D 'fìk .5 Úð-Q Õ"'~ e-u--v k£/I~ ßksI ) I &/1 .11 WATER: SPECIAL: LOCK BOX; YE@ IF YES, LOCATION: \ \ , . 3, FD1590 ~" ,r- - --"I{ e Bakersfield ,Fire Dept. . Hazardous Materials Division . .' ''\' ~ {~f :. ~, HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 5: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY: A, PRIVATE FIRE PROTECTION: 4- -Fire B, WATER AVAILABILITY (FIRE HYDRANT): SECTION 6: TRAINING: NUMBER OF EMPLOYESS: 4 MATERIAL SAFETY DATA SHEETS ON FILE: LJt,S BRIEF SUMMARY OF TRAINING PROGRAM: c5~~ Coafè0e- e~ f:0¡!JiV¿ c SECTION 7: EXEMPTION REQUEST: I CERTIFY 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: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 8: CERTIFICATION: /, _tseLAU ~tt:Se»J CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE, I UNDERSTAND THAT THIS INFORMATION WilL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODP ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC, 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY, ~~ SIGNA TURE ðl01t ~ TITLE 1b'-/ I tr I 'DATE 4. FD1590 ' CIT}T of BAKERSFIELD ...'J..---' I~.- .~ ,~ ,.¡;:¡¡¡;¡- HAZARDOUS MATER::I:ALS ::I: NVENTORY F... and Aqr ;eu !turf L--J St.nd.rd Bus ,nns I..-.-: NON-TRADE SECRE'J'S , P"f of .-, b'tf)K..t:sS Lo OWNER NAME :]SRi ~ ~dÞJ BUSINESS NAME:~ E:1:. ¡¿, NAME OF TinS ~_CIL!.TY:_ - LOCATION:~ :tL ire LA.l. ADDRESS: ~ O~L~ c..+ STANDARD IND. CLASS CODE_ - - - CITY. ZIP j. . ~es D 1 CA.- q~3C DUN AND BRADSTREET NUMBER qì. - CITY, ZIP: oB PHONE II: ~o-s::-- 1- PHONE II: '3Gj ~-Sù<"¿'-f - - \. - - - - -- - - IrUIØl ro IlISf'IIUC'rIOItS roll PIlOPD CODD - - I 2 ] . 5 , 1 I II 11 n 1] " Iran, lyøe 11111 A_. Annuli ......,. I Dye CcIIt CcIIt u.. leat tan ...... 'by __ of lI"t_~t. (oeM Codf AIIt AM Est Uft1t1 an 5HI "... ,- Code 5tcncl In Feelllty 1ft See IMtruct1C11'11 - --- .____ 12Þ-P &9~_~ 1:..""1.- - OLL'__ - - ~... ...", ...... ....S._ -- tc.ponent II .... C. A .5. ..... k .~ tllet ' Ily) - --- ------------------------- - .- , r--, ,.- ,.-, ,.-, c:a..-.t 12 .... U.S. ...... L ..J Fir. H.urd L_..J AHctlv1ty ~I'yed L_..J Sudden ..1_ L_..I ."1Itl ; ....Ith of PreI... ....Ith ---- - - __e· tc.ponent IJ .... U.S. ....... - -So e· go I!gf. - -- p~ie.1 IIId ....lth HIllrd C.A.5. ...,. - tc.ponent II .... U.S. ..... ( heck .11 tllet ' Ily) - - .-. r~ ,.-, ,.~ ,.-, ,.-, ec..c.-t n .... U.S, ...... L ..J fire HIIl.rd "_..J IIwct1V1ty" IIIleyed "-.I Sudden "1_ "-..I l"llt. -- -- ....1 t h of p,..._ ....1 th c-t I] .... U.S. ...... - ---- -- . ----- P~le.1 IIId ....lth HIlerd C.A.5. ..... tc.ponent II .... C.A.S. ....... ( ,*k .11 tllet 1 Ily) . - --- ,--, ,.-, ,.-, ,.-, ,.-, tc.ponent n .... U.S. ...... L _J fire HIIl.rd L_.I RHct;vhy "-..I IIII.yed L_.I Sudden "I_I L_..I ."1.tl - - ---. ....Ith of P....sure ....Ith c-t I] .... U.S. ...... - ____JL______L________~-1-.------------JL----------J------l--------L-------J- I JL__--1__ -- p~ ;eal IIId ....lth 1111,", C.A,5, ...... ------------------- eo.on.nt II .... C.A.S. .... ( ,*k .11 tllet ""I,) - -- ---- ,--, ,.-, ,.-, ,.-, ,.-, C........t 12 .... C. A. 5, ........ L _ J fl~. HIl.rd L _.I IIHc:t;vity L. - J Del.yed L - J SudcIen "1_. L _.I I..t.t. --- - IIN Ith of Prlllurl IINlth ----------------------------- -, ----.. c-t I] .... C.A,5. ...... - IIfRGENCY COIITACT5 II 12 lip. ~- -- - - ------ -- ---------------------- T1£1¡---------- --- ---------- 7I"Anr.¡¡¡¡¡------- Iiii--------------------------------- T1!"--------------------------- 7tiNP-Pftðftf--------- - C.rttlication (Read IInd sign lifter co.pJpUng all sections} ~ I ,.c.rtHv und.r IIIIlty of 1.. tllet I llev. "rsan.I1t.,....;nlll end .. f..ili". .lth tM Infor..t;an su";tt. 1ft this IIId .n luee'" doc_u, IIId tllet bas. on ., ;nqulry of thot. 1nc1tvtdulls .... IIIII.ibl. _f,or~obtl;n;"q tM ;nf.....tlan. I balt.v. tllet the ,u utili ,nfo....t,an 1S tMII. lCeurat.. end eœpl.t., ~4.¡~¡;,a-òmëi¡1-tit1nT-õWii;: 7õPi;:ãm-OR-õWii;:]ò5i;:ãtõ;: Tãütliõm;a,:iørišiñtitm Siijñitürë DitïSiijñ¡a----- ,. \ mI 4J 7Jj_O I__ Account Number . --' -- -----.. (e ACCOUNTS RECEIVABLE ADJUSTMENT Valprip ppnrlPTgT~~~ From: Fire Department ~ Haz Mat Division, Departm~ntJDivision New Account ' I New Address Close Account I Service Change . I Other Adj. ! I 'March 24. 1992 Date Express Lube Tpx;:u'o Billin g Name 6501 White Lane, Bakersfield, Ca. Billing Address Site Address Parcel # (If Applicable) Landlord Name & Address if Applicable ADJUSTMENT I Last ! Billed· . $'294.00 I I I ,. I i I ! Correct IBilling i $94.00 I I I i i ¡Adjustment iTo Billing , I' i Effective Date !Of Change ' I ! 1-?-q? ! Approved By: Remarks: This account was billed for 4 underground st-orage tanks they do not have.