HomeMy WebLinkAboutHAZ-BUSINESS PLAN 5/7/1993
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Materials/Hazar4o,us·'WasteUnifiedPermit
CONDITIONSOFPERM1TÓNi=lÊÝÊRSESIDE
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Hazardous
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.1iI Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
Date
Issue
Approved by:
Expiration Date:
Permit ID #: 015-000-000406
WHITE LANE AUTOMOTIVE
LOCATION: 7001 WHITE LN 104
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:
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WHITE LANE
AUTOMOTIVE
* Auto * Truck * RV
G (805) 397-4406
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7001 White lane, #104 '
Bakersfield, CA 93309
STEVE HENQ
Owner
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Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
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PERMIT ID# 015-021.000406 ;';"ç'" ~,agement Program
WHITE LANE AUTOMOTIVE'£ iI~¡,Waste
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LOCATION 7001 WHITE ...
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Issued by:
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Bakersfield Fire Department Approved by: ~
OFFICE OF ENVIRONMENTAL SER VICES _
1715 Chester Ave., 3rd Floor Servi es
Bakersfield, CA 93301
Voice (805) 326-3979 . . .June 30 2000
FAX (805) 326-0576 ExpIratIon Date: _" _ _ _ _ "_ _ _
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PLANIJI~ MAP
SITE DIAGRAM IX~ FACILITY DIAGRAM
Business Name: White Lane Automot ive
7001 White Lane #104
Business Address: Bakersf ield. CA 93309
For Office Use Only
First In Station:
Area Map # of
NORTH V
Inspection Station:
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Bakersfield Fire Dept.
Hazardous Materials Division
2130 "G" Street
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RECEIVED
,#,fA Y ì J993
HAZ. MAT. OlV
Bakersfield, CA. 93301
HAZARDOUS MATERIALS MANAGEMENT PLAN
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INSTRUCTIONS:
l.
2.
3.
4.
To avoid further action. return this form within 30 days of receipt. q A
TYPE/PRINT ANSWERS IN ENGliSH. . D -- "-
Answer the questions below for the business as a whole. \
Be brief and concise as possible.
SECTION': BUSINESS IDENTIFICATION DATA
BUS I NESS N A ME: Wh i teL an e Au to ill 0 t i v e
LOCATION:
7001 White Lane #104
MAILING ADDRESS: 7001 White Lane fll04
CITY:
Bakersfield
STATE: ~ ZIP: 93309 PHONE: 805 397-4406
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DUN & BRADSTREET NUMBER:
PRIMARY ACTIVITY:
554 47 6231
SIC CODE: - 7538
Auto Repair
OWNER:
Steven R. Hendrix
MAILING ADDRESS:
7001 White Lane #104
Bakersfield, CA 93309
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR, PHONE
1. Steven R. Hendrix Owner 805 397-4406 805 398-8569
2, Roy Hendrix 805 831-3891 805 831-2862
1.
_Bakersfield Fire Dept. ,
. ~azardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
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SECTION 3: TRAINING:
NUMBER OF EMPLOYEES:
-0-
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
I have no employees. I have been
trained in the handling of ~hazardous and potentially ~hazardous
material by prior employers.
I am self trained through continuously reviewing mY2handling
procedures.
SECTION 4: 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 5: CERTIFICATION:
I, S-rz:.v-6 ~-/Þ?~ ;..x: 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 ·HAZAROOUS MATERIALS (01'1, 29 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY; J
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SIGNATURE
TITLE
s--7-93
DATE
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2.
FD1590
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.. Bnkerslleld Fire Dept. .
~azardous Materials Division .
HAZARDOUS MATERIALS MANAGEMENT PLAN
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Facility Unit Name:
White Lane Automotive'
SECTION 6: . NOTIFICATION AND EV AC,UATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
1. In ev~nt of emergency notify fire dept. by telephone.
2. If s~tuation effects adjacent bu~iness notify owner/manager
in person. Notify property manager df the c6mplèx is
2. 'effected.
,
ß, EMPLOYEE NOTIFICATION AND EVACUATION:
n/a no employees
C. PUBLIC EVACUATION:
Should a customer be on the premises and an emergency arose
I would announce it and request them to move out of the building .-
and move to the vacant field directly south of the shop.
D, EMERGENCY MEDICAL PLAN:
Most medical emergencies can be handled by the Medi-Center
at Ashe & Ming or the Medi-Center on White Lane. If the
need is more serious then ER at San Joaquin or Mercy Hospital
are the closest.
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Hazardous Materials Ulvision
HAZARDOUS MATERIALS MANAGEMENT PLAN
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SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
, ,
A,
RELEASE, PREVENTION STEPS:
. - 2 .
1. All materials (ie. motor oil, waste o~l, etc.) are stored
in approved containers.
Waste oil is picked up and removed from the premises
on a regular scnedule. :
3. Waste and trash are placed in metal containers with lids.
RELEASE CONTAINMENT AND/OR MINIMIZAT.ION:
1. Containers are in good condition & free of ruptures.
2. Containers are properly labeled and situated away from
traffíc areas.
3j Oversized funnels to prevent spills.
B.
..
C.
CLEAN-UP PROCEDURES:
1. Stop or reroute traffic away from spill.
2. Capture & contain spills with absorbing material &
transfer to waste barrel for disposal.
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE: n/ a
ELECTRICAL:
, , .
Northeast corner wall; npxr rn rpQtroom
WATER:
So. wall of bldg.; east of roll up door.
SPECIAL:
LOCK BOX: ¥~S/NO
IF YES, LOCATION:
n/a
SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABllITY:
,
A. PRIVATE FIRE PROTECTION:
Building is protected by an automatic sprinkler system.
Fire extinguisher is ~~mouñted on the shop wall.
S, WATER AVAILABILITY (FIRE HYDRANT):
Fire Hydrant is located approx. 200' north of shop.
4.
-
8AKER~ELD CI~ FIRE DEP~8TMENT
, HAZ~OUS MATERIALS INVE_RY
~age.:-of_
White Lane Automotive . Address
7001 White Lane
Bakersfield. C~09
8usiness Name
.
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New;h Addition [ ] Revision ( ] Deletior:J ] Check if chemical is a NON TRADE SECRET [14- TRADE SECRET [ 1
2) Common Name: ///ð~-e Ø//- V 3) DOT # (optional)
ChemicaJ Name: AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire ( ] Reactive J-r] Sudden Release of Pressure [ 1 Immediate Health (Acute) [ ] Delayed HeaJth (Chronic) [ 1
5) WASTE CLASSIFICAT10N r.Pø?/ (3-digit code from DHS Form 8022) USE CODE ~
5) PHYSICAL STATE Solid [ ] Liquid p(I Gas [ ] Pure [ ] Mixture ( J Waste ( ] Radioactive [ ]
alêC< AU. TUAT .A.M.Y
7) AMOUNT AND T1ME AT FACIUlY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~. 100 ( ] gat [ ] 1t3 [ J a) Container: ~h
Average Daily Amount: 41'~ curies ( 1 b) Pressure: I'
Annual Amount: c.2t::ð c) Temperature: f~
Largest Size Container: .:rs- Circle.'M1ich Months: ~J,
# Days On Site F. M, A. M. J, J, A, S. O. N, D
9) MIXTURE: List I COMPONENT CAS # %WT AHM
the three most hazardous 1) ( ]
chemicaJ components or
any AHM components 2) [ ]
3) ( ]
10) Location " ,-
_. , . , -. . /- CHEMICAL DESCRIPTION
.
1) INVENTORY STATUS: New IV]- Addition [ ] Revision ( ] Deletion ( ] Check if chemical is a NON TRADE SECRET ;>d~ TRADE SECRET ( ]
2) Common Name: 4Pd?b~ ~// dY~ 3) DOT # (optional)
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Chemical Name: ~ AHM (] CAS #
4) PHYSICAL & HEALTH _. PHYSICAL. -, HEALTH Ii
HAZARD CATEGORIES Fire ( ] Reactive ()t Sudden Release- of Pressure ( ] Immediate Health (Acute) ( ] Delayed Health (Chronic) ( ] ,!
,
5) WASTE CLASSIFICAT10N Je5l/ (3-digit code from DHS Form 8022) USE CODE
#
6) PHYSICAL STATE Solid ( ] Liquid (Þ'-t- Gas_ ( ] Pure ( ] Mixture [ J Waste M.... Radioactive [ ]
(;)4ECi<.AU. "",AT APPt.1
7) .AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES t:}¿'
Maximum Daily Amount: ..:r.:r Ibs ( ] gat;<! ft3 [ ] a) Container:
Average Daily Amount: ~ curies [ ] b) Pressure: I'
Annual Amount: ~IW) c) Temperature: ¢
.
Largest Size Container: ...:T6" Circle 'M1ich Months:'~'
1/ Days On Site 9v J. F, M. A. M, J. J. A. S. O. N, D
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9) MIXTURE: Ust COMPONENT. . - CAS 1/ %WT AHM
I the three most hazardous 1) [ ]
i chemical components or
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I any AHM components 2) n
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, I ceroty Under peneJry or law, tJ'1at I have personaJly exarmnfld and am famll/ar WItt! ene /nfomanon suomlCted on chiS and aJI atlacnfld documents. I Del/eve l
submitted information is true, accurate, and complete¡'
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Signature '
S-7.ðJ I
Date I
.At:QIOI'f/ I.IPCST~
Steven R. Hendrix
Owner
PRINT Name & Title of Authorized Company Representative
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8AK_SFIELO-CITY FIR'E
ARTMENT.
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HAZARDOUS MATERIALS DIVISION
2130 "GII STREET
BAKERSFIELD, CA. 93301
(805) 326-3979
HAZARDOUS MATERIALS INVENTORY
FACILITY DESCRIPTION_
CHECK IF BUSINESS IS A FARM ( ]
, ' '
BUSINESS NAME White Lane Automotive
FACILITY NAME .., . .~- =-':: ~ .... .- ,
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SITE.ADDRESS 7001 White Lane 111 04
CITY Bakersfield STATE 'CA ZIP 93309
NATURE OF BUSINESS Auto Repair
SIC ÇODE 7538 DUN & BRADSTREET NUMBER' S S II 554 47 6231
-
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OWNER/OPERATOR Steven R. Hendrix PHONE 805, 397.:,.4406
,,-
, MAILING ADDRESS 7001 White Lane 11104
CITY Bakersfield STATE CA ZIP 93309
K
EMERGENCY CONTACTS
NAME Steven R. Hendrix TITLE Owner
BUSINESS PHONE 805 397-4406 24-HOUR PHONE 805 398-8569
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NAME Roy Hendrix TITlE- n/a
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BUSINESS PHONE. 805 831-3891 24-HOUR PHONE 805 831-2862
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$eøemÞet :!Q, 15192 REGION V I.E?C ST.-NOAAC F-
BAKER.ELD CIl)' FIRE DEPARTMENT
. . HAZ.OUS MATERIALS INVE.RY
Page~of_
9usiness Name '
Address
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CHEMICAL DESCRIPTION
! 1) INVENTORY STAT\JS: New ( I Addition I ] Revision I ] Deletion I 1 Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ I
I 2) Common Name: 3) DOT ;I (optionaJ)
\
Chemical Name: AHM I] CAS #
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\ 4) PHYSICAL &. HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire ( ] Reactive ( ] Sudden Release of Pressure [ I Immediate HeaJth (Acute) [ ] ~Iayed Health (Chronic) [ I
I 5) WASTE CLASSIFICA1l0N (3-digit code from DHS Forni 8022)
USE CODE
6) PHYSICAL STATE Solid I] Uquid I ] Gas I ] Pure I] Mixture I ] Waste [ ] Radioactive [ ]
OIECX..l.l1. THAT APPI.'f
7) AMOUNT AND TlME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 100 I ] gaJ I ] 1t3 I ] a) Container.
Average Daily Amount: curies [ I b) Pressure:
Annual Amount:· c) Temperature:
Largest Size Container:
iF Days On Site Circle Which Months: AU Year. J. F, M. A, M. J. J. A. S. 0, N. D
9) MIXTURE: Ust COMPONENT CAS# %Wf AHM
the three most hazardous 1 ) I]
chemical components or
ar.y AHM components 2) I]
3) [ ]
10) Location
CHEMICAL DESCRIPTION
1) INVENTORY STAT\JS: New I ] Addition I ] Revision ( ], Deletion ( ] Check if chemical is a NON TRADE SECRET ( ] TRADE SECRET ( ]
..
2) Common Name: 3) DOT # (optional)
ChemicaJ Name: / AHM [ ] CAS #
4) PHYSICAL &. HEALTH PHYSICAL .. HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure ( ] Immediate Health (Acute) I ] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION (3.digit code from DHS Form 80221 USE CODE ]1
I'
6) PHYSICAL STATE Solid Uquid [ ] Gas I ] ( ] Mixture ( # Waste [ ] Radioactive I ] II
[ ] Pure ]
C}f£0<AL.L T?-fAr.APf1t'f
7) AMOUNT AND TlME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
: Maximum Daily Amount: Ibs [ ] gal ( ] it3 ( ] a) Container:
ì Average Daily Amount: curies [ ] b) Pressure:
Aonual Amount: c) Temperature:
, Largest Size Container.
i
# Days On Site Circle Which Months: All Year. J. F. M. A. M. J. J. A, S. O. N. D
, 9) MIXTURE: Ust COMPONENT CAS # %Wf AHM
i the three most hazardous 1) ( ]
:
I chemical components or
any AHM compOnentS' , 2) [ ]
:
: 3) 1\
;
j 10) Location ,-
,
I
1 cerùty Under penaJty of law, that I have personally exammed. and am familiar: wlm me mtomabon submitted on mls and all attached documents. I believe u
submitted information is l7tJe, accurate, and complete. 'I
PRINT Name & TitJe.JJf Authorized Company Representative
Signature
Date I
I'llQiOI'I \.ØCS'T»IQIfIIIIO'"
---
8AKE_R~ELD CtTY FIR,E DEP"TMENT
H~DOUS MATERIALS INVE_:ÒRY
Page_of_
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:Justness Name
Address
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ 1 Addition { I Revision [ ] Deletion ( 1 Check if chemical is a NON TRADE SECRET I] TRADE SECRET [ ]
2) Common Name: 3) DOT 1/ (optional)
Chemical Name: AHM! I CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ 11 Reactive ( ] Sudden Release of Pressure [ 1 Immediate Health (Acute) [ 1 Delayed Health (Chronic) [ J
5) WASTE CLASSIFICAT10N (:I-digit code from DHS Form 6022) USE CODE
6) PHYSICAL STATE Solid [ ] Uquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ]
04EO<~ THAT APPtY
7) AMOUNT AND T1ME AT FACIUTf , ' UNITS OF MEASURE 8) STORAGE CODES
I Maximum Daily Amount: 100 ( ] gal [ ¡ tt3 [ ] a) Container.
Average Daily Amount: curies [ ] b) Pressure:
Annual Amount: c) Temperature:
Largest Size Container:
# Days On Site Circle Which Months: All Year. J. p, M, A, M. J. J, A, S, O. N. D
9) MIXTURE: Ust COMPONENT CAS # %WT AHM
the three most hazardous 1) [ ],
chemical components or .
any AHM components 2) [ ]
. 3) [ ]
10) LoC<!.tion
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ -] Addition [ ] Revision [ ] Deletion [ ] . . Check if chemical is a NON TRADE ,SECRET [ ] TRAOE SECRET [ ]
2) Common Name: 3) OOT # (optional)
,/
Chemical Name: AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ 1 Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ J
i
5) WASTE CLASSIFICAT10N (3-digit code from DHS Form 6022) USE CODE
"
6) PHYSICAL STATE Solid [ I Uquid [ ] Gas [ ] Pure [ I Mixture [ ] Waste [ ] Radioactive [ ¡
c:H£CX.Al..L THAT.APf'ty
7) AMOUNT AND TIME AT FAC\UTf UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 100 [ ] gal [ ¡ 1t3 [ J a) Container.
Average Daily Amount: curies [ ] b) Pressure:
Annual Amount: c) Temperature:
Largest Size Container:
# Days On Site Circle Which Months: All Year. J. F. M, A. M. J. J. A. S. O. N. D
9) MIXTURE: Ust COMPONENT CAS # %WT AHM
the th~e most hazardous 1) [ 1
··r· chemi<:aJ components or
MY AHM components 2) [ I
3) (
10) LOCS1ion
cef11ty Under penalty ot law, that I nave personally examined and am tarn/liar WIth the '"tomatlOn sucm/rted on thIS ana aJI attacnea aocuments. I believe [
submitted informaâon is tTtJe, accurate, and complete.
-......
r
PRINT Name & Title of Authorized Company Representative Signature- Date
~~I- IICQIOtV \,ÆPI:"'~'