HomeMy WebLinkAboutBUSINESS PLAN 11/21/2002
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Hazardous MaterialslHaz~rd~us Waste Voifi
CONDITI,ONS,OF,PERM,ITON R.EVERS
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European Auto Repair. Maintenaf1ce
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Paul SP.il'1k . Owner , ~-l:) ~
5333 White L,a(le - Bakersfield, CA 93309
(8'ô~h837 ·2632
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iii Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous WaSte On-$Ite Treatment
-
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NDEPENDENT
VOLVO
Permit ID #:: 015-000-000105
INDEPENDENT VOLVO
LOCATION: 5333 WHITE LN C
...
Approved by:
Issue Date
Expiration Date:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Issued by:
Per.uit to Operate
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This permit is issued for the following:
rdous Materials Plan
round Storage of Hazardous Materials
PERMIT ID# 01S-Q21.QOO10S l.Q,agement Program
INDEPENDENT VOLVO "', Waste
LOCATION 5333 WHITE
Issued by:
Bakersfield Fire Department Approved by: _
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (805) 326-3979 Expiration Date:
FAX (805) 326-0576
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CITY OF BAKERSFIEI_D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd (·'Ioor, Bakersfield, CA 93301
FACILITY NAME tV 'De~e,,¡JDel'-1í ÙD{ùð
ADDRESS 5~333 W {-f/~jcz.-ve-
FACILITY CONTACT 't' () ~
INSPECTION TIME M ~ ~
INSPECTION DATE (( - :;¿ I - 0 d......
PHONE NO.
BUSINESS ID NO. 15-210- 000 IDS
NUMBER OF EMPLOYEES
Section 1:
~outine
Business Plan and Inventory Program
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION
C V
COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Hand
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
QYes QNo
White· Env, Svcs.
Yellow· Station Copy
Pink· Business Copy
Business Site Responsible Party
Inspector: f?Q~ ~
Koz.f oS ~ /315
Questions regarding this inspection? Please call us at (661) 326-3979
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
~
INSPECTION DATE / () - '3{ -0 I
PHONE NO. 1{3 L - 2(p 3 2-
BUSINESS ID NO. 15-210- (901 O~
NUMBER OF EMPLOYEES "2-
Section 1:
Business Plan and Inventory Program
~ Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Appropriate pennit on hand t.. ./
a.. ./
Business plan contact infonnation accurate
Visible address L.- V
Correct occupancy t.- V
Verification of inventory materials J,. V
Verification of quantities L. V
Verification of location t.. V
Proper segregation of material .... ~
Verification of MSDS availability l:- V
Verification of Haz Mat training l L--
Verification of abatement supplies and procedures ¿ V
Emergency procedures adequate t- v
Containers properly labeled J,. L--
Housekeeping t.. V
Fire Protection ... /'
Site Diagram Adequate & On Hand J.. ,... V'
,
C=Compliance
V=Violation NOrÇ :rA N 2COZ-
rn aJ / 1J6 "'YtJ: (o<?o ( WHlíE LAJ
..,' - "
BLò6 H 5ul're; 1-
W'1'(..,L /3£3 /N S7)q f "
Any hazardous waste on site?: ~Yes 0 No
Explain: Lc ~ 0 I L A's B Uf'fïJES5 PCA/
White - Env, Svcs,
Yellow· Station Copy
Pink - Business Copy
Inspector:
Questions regarding this inspection? Please call us at (661) 326-3979
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INDEPENDENT VOLVO
SiteID: 215-000-000105
Manager :
Location: 5333 WHITE LN C //
City BAKERSFIELD \ BY:- -
CommCode: BAKERSFIELD STATION 05
EPA Numb:
BusPhone: (805) 837-2632
Map : 123 CommHaz: Low
Grid: 15D, FacUnits: 1 AOV:
SIC Code:
DunnBrad:77-026-3874
Emergency
PAUL SPINK
Business Phone:
24-Hour Phone :
Pager Phone
Contact / Title
/ OWNER
(~Æ) 837-2632x
(m) 589-4460x
(H:( )<?0Ci -~'Ôqx
Emergency Contact
ANTHONY REA
Business Phon
24-Hour Phone
Pager Phone
Fire \'-Jo
Hazmat Hazards:
Owner
Address
City
PAUL SPINK
5333 WHITE LN C
BAKERSFIELD
Phone: (
State: CA
Zip 93309
Phone: (805) 837 -2632x
State: CA
Zip 93309
x
Contact :
MailAddr: 5333 WHITE LN C
City BAKERSFIELD
Period
Preparer:
Certif'd:
to
TotalASTs: =
TotalUSTs: =
RSs: No
Gal
Gal
l+olV\£. AVDR~c;~
l~<Õ'D4 L-ÆS G-~4\bAS
"ðAt.{~<;~(~1:> LÆ C13~r2
Emergency Directives:
I, p~l- <3P/Nk...:.-_ Do hereby certify that I have
(Type or prin: name)
reviewed the attached hazardous materials manage-
ment plan for ~Ç)~p~ VOL\4ndìhat it along with
--¡¡fame 01 Business)
any corrections constitute a complete and con"sct man-
agement plan for my facility.
~
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Dale
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02/28/2000
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SiteID: 215-000-000105 ~
By Facility Unit ~
Fixed Containers on Site ~
specHaz EPA HazardS Frm I DailyMax Unit MCP
F INDEPENDENT VOLVO
f= Hazmat Inventory
f== Alphabetical Order
Hazmat Common Name...
KEROSENE
WASTE OIL
F
F
DH
DH
L
L
55.00 GAL Low
110.00 CAL Low
. "<Ç. OD ((At. .
-2-
02/28/2000
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F INDEPENDENT VOLVO
f= Inventory Item 0002
= COMMON NAME / CHEMI CAL NAME
KEROSENE
SiteID: 215-000-000105 ì
Facility Unit: Fixed Containers on Site ì
Days On Site
365
Location within this Facility Unit
Map:
Grid:
CAS #
8008-20-6
STATE - TYPE
Liquid Pure
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
DRUM/BARREL-METALLIC
Largest Container
55.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
55.00 GAL
Daily Average
55.00 GAL
HAZARDOUS COMPONENTS
%Wt. RS CAS #
100.00 Kerosene No 70892103
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
HAZARD ASSESSMENTS
f= Inventory Item 0001
F== COMMON NAME / CHEMI CAL NAME
WASTE OIL
Facility Unit: Fixed Containers on Site ì
Days On Site
365
Location within this Facility Unit
NE CORNER
Map:
Grid:
CAS #
221
STATE - TYPE
Liquid Waste
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
DRUM/BARREL-METALLIC
Largest Container
GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
tl.2-:~ GAL
Daily Average
50.00 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
-3-
02/28/2000
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í INDEPENDENT VOLVO ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000105 i
íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Fornnat i
íë Notif./Evacuation/Medical ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j
íëë Agency Notification ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 i
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o PERSON TO BE NOTIFIED IS OWNER
o
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o CALL 911 _
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëë Employee Notif./Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 j
o 0
o EMPLOYEE IS VERBALLY TOLD OF A SPILL OR EMERGENCY. EMPLOYEE IS V/IPE OF
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëëë Public Notif./Evacuation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 i
o 0
o NO PUBLIC IN AREA
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëëëë Emergency Medical Plan ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 j
o 0
o MEDICAL FACILITY AJACENT TO BUILDING
o
o
o
åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
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02/28/2000
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í INDEPENDENT VOLVO ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000105 ¡
íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast F onnat j
íë Mitigation/Prevent/ Abatemt ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j
íëë Release Prevention ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 i
o 0
o STORED IN STEEL DRUMS WHICH ARE SECURED DOWN.
o
o
o
åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëë Release Containment ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë i
o 0
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëëë Clean Up ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 i
o 0
o CLEANED UP WITH FLOOR SWEEP THEN WASHED DOWN WITH DEGREASER & SOAKED UP WITH 0
o FLOOR SWEEP. 0
o
o
åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëëëë Other Resource Activation ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡
o 0
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
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02/28/2000
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í INDEPENDENT VOLVO ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000105 i
íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j
íë Site Emergency Factors ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j
íëë Special Hazards ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j
o 0
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëë Utility Shut-Offs ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 j
o 0
o A) GAS - NONE 0
o B) ELECTRICAL - BEHIND OFFICE OF C & R AUTOMOTIVE
o C) WATER - IN FRONT OF BUILDING AT NORTHWEST CORNER
o D) SPECIAL _ NONE 0
o E) LOCK BOX - NO 0
o 0
o
o
åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëëë Fire Protec./Avail. ·Water-ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 j
o 0
o PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLERS AND 3 FIRE EXTINGUISHERS
o
o
o
o
o
o
o
o
o
o FIRE HYDRANT - NORTHWEST CORNER OF PROPERTY
o
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íëëëëë Building Occupancy Level ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj
o 0
o
o
åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
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02/28/2000
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í INDEPENDENT VOLVO ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë SiteID: 215-000-000105 i
íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast F onnat ¡
íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j
íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 02/21/1991 j
o 0
o WE HAVE ONE EMPLOYEE AT THIS FACILITY
o
o
o
o DO YOU HAVE MATERIAL SAFETY SHEETS ON FILE
'-IE'?
o
o
o
o BRIEF SUMMARY OF TRAINING: WENT OVER EVACUATION PROCEDURE WITH EMPLOYEE
o
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åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf
íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡
o 0
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íëëëë Held for Future U se-ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j
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~ -- "'- ---
-7-
02/28/2000
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. .
Bakersfield FIre Dept.
Hazardous Materials Division
2130 "G" Street
J . Bakersfield, CA 93301
ß?~ 5~6B
. HAZARDOUS MATERIALS MANAGEMENT PLAN Cøth 2.
!;)3-ISl) ~
INSTRUCTIONS: 0
\fCea (;r ~
e
RECEIVED
FE B 5 1991
ARs'd.
...........
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.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: T tJl()£'p£t.-,)b~ \it) t.-VO
LOCATION: S-~~"?:>,' l0~(--re- LA:-µE-.
MAILING ADDRESS: ç'3~ ~ f W l4 1TE- LI'HJ~ ~ fo
ClTy:1SIA-fLf.ß~,t:CD STATE: êJ4- ZIP: 0~d1 PHONE: ru,.?1o ~-z..
DuJ~BJ~b~R~E~ NUMBER: 7, -()t1o~<r,l y.- SIC CODE:
PRIMARY ACTIVITY: Á Uïo ºt.P~í2- .
OWNER: P Av'- SPt~~
MAILING ADDRESS: S~£-,4$) A~ðV~.
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
1. PAvL- gPclÙ1L
TITLE
() w /Ùfd--
BUS. PHONE
24 HR. PHONE
<t1> ( -l.-h ~ ¿..
-PO,-,-?,O,S-1 .
2.
1.
FD1S'"
_ Bakersfield Fire Dept. e
Hazardous Material~ Division
/:
HAZARDOUS MATERIALS MANAGEMENT PLAN
"
~"
-. ~
,. . t .
.. ".'
'. SECTION 3: TRAINING:
NUMBER OF EMPLOYESS:
0-..,6-..
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
"LùJ OO~ ~~Jl~ fLÎÙl.~~ w~
\Q.W\.{Áo-v¡~ ~
~ l
SECTION 4: EXEMPTION REQUEST: ,\ .
I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE
REPORTING REQUIREMENTS bF 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 QUANTITJES AT NO
TlMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
I, _f4tlL- SPUJK-· . 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 CODE"
ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET Al.) AND THAT
INACCURAT INF RMATlON CONSTITUTES PERJURY.
, )
I ' '),q - q f
TITLE
[)uJ 1Jefi- .
DATE
2.
FDI59'- I
~' ¡;
e
Bakersfield Fire Dept.-
Hazardous Materials Divisl
'"
~~f :."....."1~
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION 'AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS:
St-ur.uÁ, ~ ~~.u-\ ~~l] . wL~L ~~ ÅJ~od Jo-wV'- ·
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
C. CLEAN-UP PROCEDURES:
Cl-e.~.¿ul 4"w~fL ~ ÁW~ ~
~Wb ~cÅ C{~"'- fA.) :t~ ~-e.-'~c;..A.rv-í c+- .c\ Dl7I..IL.w{ tf
w~ ~ .h-W~ .
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE: 'Po"">£:
ELECTRICAL: ~~ o~ 4- c.. t- f- AJ"""o\.W..-. ..
WATER: 1",-µ ,,~ lc::JJ~ J:: ~CHK l.ùe¿,~ ~ .
SPECIAL:
LOCK BOX: YES/NO
IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A.
PRIV ATE FIRE PROTECTION: 3 I '- I ' {
A't~rMCt.k,-: Åf~~~~ +- ¡.ftM dL)c""tl.Þ\..{w-~~~.
WATER AVAILABILITY (FIRE HYDRANT):
r~ M<1~c.J--)o~~ oJ ~ Lùe.tl- ~
&i-. p~~ ' ' .
FD I 59\.'
B.
~- :.!.: ~~.
~
'"
. Bakersfield Fire Dept. e
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name: 1~~~ +- \JO\\JO
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
p~ h k tADkµ Þ eWv~, .
B. EMPLOYEE NOTIFICATION AND EVACUATION:
:"^ r<"-' =- . ~ . \JeA);,~ 10 (J + "'- Å\, 'vU Ih" 4«-<-......) "'^-"4 .
t~p{~~ .AÂ wct-e- :1- ~~ f .
C. PUBLIC EVACUATION:
,yJéJlV£. (100 ¡ulrk. ~
C1.4' ~ .
D. EMERGENCY MEDICAL PLAN:
.\.,":. ~
M....· ~~ ¡ ~~~p \ 1- Ú I (
. ~lu~ OLJ~r.k1) Io~ J~ '
.<1>
3.
F{)1~
'.\
CITY of BAKERSFIELD ~:
/"
HAZARDOUS MATERIALS INVENTORY n~
farm and AgtlCulture [] Standard BusIness []
NON-TRADE SECRETS Page of___
BUSINESS N. A~ J '-'01 ",,&->( . 'b ...Va OWNER NA~~ ~I¡'>f./. . ~~ NAME OF THIS FACILITY,
lOCATION' c¡)~ IW~ E: £.. ADDRES~' STANDARD IND. CLASS CÒDE:--- ---- ---=-
~M~~ W:- ~ ,~ - ~l6Y~ ~!P: 'm'Z!', o~ OUN ANO BRA~STR~ET NUHB~,\- " ... --
- <6~1 '2... RÊF~R TO-¡~ U 0 S ¡;'Uff PROPER CODES - 7. Q '1 Q "i î.. ":f-
1 5 6 7 8 9 10 11 12 13 U
Tr~ns 1ge Annual Hea$ure I Dys Cont Cont Cont Use loc~tion Vhere 'by Nalles of Mixture{çclIPonents
Coóe Est UnIts on SIte Type Press Temp COde Stored In facility Wt See Instruc Ions /
t-J lÇIr;r "'0 ~IE :3bS- 1 ofp I I I 't 121:- 401 ÞJ. E. f..efLuCUZ-. w~k. r:J' j;:._
C,A,S. Number Component'l Name I C,A.S. Number
., . Component'2 Name I C.A,S. Number
[] fire Hazard [] Reactivity [] Delayed 0 Sudden Release 0 Immedute
Health of Pressure Health ---
Component.3 Name I C,A.S. Number
I
Phy~ical 'od Health Hafard C.A,S. Number Component.1 Name I C.A.S. Number
ICheck a I that apply , ___
Component'2 Name I C,A.S. Number
[] fire Hazard [] Reactivity [] Delayed 0 Sudden Release [] ImMediate
Health of Pressure Health --- --
Component.3 Name I C.A.S. Number
Physical end Health Ha~ard C.A,S, Number Component'l Name I C.A.S, Number
ICheck all that apply! ___
Component.2 Name I C.A.S. Number
[] Fire Hazard [] Reactiyity [] Delayed 0 Sudden Release 0 ImMediate
Health of Pressure Health ---
Component.3 Name I C.A.S. Number
Physical end Health Hafard C.A,S. Number Component 'I Name I C.A.S, Number
(Check all that apply ___
. . . Component 12 Nue I C,A.S. Number
[] Fire Hazard 0 ReactlYlty 0 Delayed 0 Sudden Release 0 Immediate
Health of Pressure Health --- --
Component.3 Name I C.A.S. Number
EMERGENCY CONTACTS 111 O~?P,-¡ '~'$~ 112~~ So..)Þ~ WtFt, ---)O¡ê'"?'~s-i
Ilã Tftî -rHfr ne ml TIt - HlIf-rTiõne--
Certification fReed and $jgn afjßr c9mp7~tjf1g. Çt", sect;jons) . . .
I certlf under enall 0 la th t I have pe(sona I~ examln Q 0 d m familiae It the Inroematl n ~u mltte~ In his ond al\
altaçheâYdQcu~en~sl an~ t at ~ase~ on my Inquiry 0 lhose InålYI~Ua'S responslb'e ~or obtaining t~e In~ormatlon, i believe that the (
submItted Infor~atlon IS ~e, atturat~anð to~plete. .
V;9.-v Ò~lIUiL. . _ ~ l- I 0' q ,
~~e ~rifofîfnTTl \tner rator ollner/opera STgnãture UHe-SiqF.e-a---
· Bakersfield Fire Dept. e
HAZARDOUS MATERIALS DIVISION
Date Completed /;¿ - / / - <=to
VoLVO
Business Name:
} i'-JuLYr~u\C.N--¡-
_I:) ~ ~ ~ W \\ \\L
Location:
L i'J -==ì=j:=:- C.
(Top of Business Plan)
InspectorS":? 1::7-~ '( / Rl?? )
I /
Adequate . Inadequate
~
Business Identification No. 215-000
Station No.
)-3
Shift
ß
Verification of Inventory Materials
Verification of Quantities
Verification of Location
Proper Segregation of Material
Comments:
~.
~
~
L , ~ c;-r£ ¡ ,\.1
o
o
o
o
o
Verification of MSDS Availablity
Number of Employees I
Verification of Haz Mat Training
J E-MvLò'\£V
Comments:
Verification of Abatement Supplies & Procedures
Comments:
o
~
o
o
o
Emergency Procedures Posted
Containers Properly Labeled
Comments:
Q/
{2('
o
o
Verification of Facility Diagram
Special Hazards Associated with this Facility:
o
o ~6 ? )..,,Þ..N
f:::\ L, þ:, 'D
0\'1- 2AeJ~
C 0 t<.--l ,P Ai\.] 1
(' Violations: fI À. ~ r:J _ 5....S C ~À LL ("J ~ S ~þ..~'\r
I ~~T?L.eA..\€ S8\)D ?>U6IrJE:SS Pt4Nfbr2.M.S' W 7ìhç
C O·r2... P l6m6 CoAJ/Y'k.., n-fÐv\. f?
All Items O.K. 0
Correction Needed 0
FD 1652 (Rev. 1-90)
White·Haz Mat Div. Yellow·Station Copy Pink· Business Copy