HomeMy WebLinkAboutBUSINESS PLAN 3/20/2001
Per it to Operate
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This oermit is issued for the following:
", . ,<"!",,,,:r'i'1~ 1!:1 Hazardous Materials Plan
_",.;d'Y"} , : !{,? 0 Underground Storage of Hazardous Materials
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4f\ ",;,>/;:' - " 0 Risk Management Program
.Ftf " - ; :;<,(;~'" 0 Hazardous Waste On-Site Treatment
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PERMIT 10 # 015-021-002175 -l'~.l;;~ '.'>
WHITE OAKS FLORIS1l--.!)'~~-~t\,~, l;:"
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LOCATION 7850 ;~WHrFÉ 93309
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Issued by: Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SERVICES MAR 202001
1715 Chester Ave. 3rd Floor Approvedby: -
, Issue Date
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date:
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SITE DIAGRAM
Business Name: '
Business Address:
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CITY OF BAKERSFlEtD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd I;'loor, Bakersfield, CA 93301
i:<o$-dole f{~,
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INSPECTION DATE '""-
PHONE NO. "B?'Cø- 0 go ,
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
9 /?O 1.1J¡.Jt~ #~
~ 000
FACILITY NAME lù~~+e C\-AtS '\ \0("\ s +
ADDRESS 1"8'50 lA),,", .'te LN ..:#;: C
FACILITY CONTACT S,,",o<,óÑ (\).. \S()Ñ
INSPECTION TIME
Section I:
Business Plan and Inventory Program
o Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
.
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
I
Visible address
Correct occupancy
Verification of inveritory materials
Verification of quantities
Verification oflocation
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?: 0 Yes 0 No
e Explain:
Questions regarding this inspection~ Please caU us at (661) 326-3979
Business Site Responsible Party
White - Env, Svcs.
Yellow· Station Copy
Pink - Business Copy
Inspector:
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- CITY OF BAKERSFIELD-
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUSMATEIDALS~AGEMENTPLAN
INSTRUCTIONS:
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To avoid further action, return this fonn within 30 days ofr~ipt. R.2 0 Za,lJ.5D
TYPE/PRlNT ANSWERS IN ENGLISH. 1-:. '()I
Answer the questions below for the business as a whole. . . ~
Be as brief and concise as possible. .~
You may also attach BusinessÜwner I Operator Fonn and Chemical Description onn(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
1.
2.
3.
4.
5.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: /1Jh,' J.e. {JCLks. F )8 (1 '(~
LOCATION: '7 <g 5 0 lAJ It : k L YI i1:C
MAILING ADDRESS: S~
CITY:f;cekL-r-<3.f¡ ~I.d STATE:~ZIP9~HONE:b6!~~-Og'ðf
PRIMARY ACTIVITY: Flo t ì 9t
OWNER: Sha./r-ðY\ L, tJ eJSðr\
.
MAILING ADDRESS: 5~
PHONEb6! ¿ 2~J{) f(
EMERGENCY NOTIFICATION
CONTACT
I.S h.Q./f"é)11 AI.eJ SO /1
TITLE BUS. PHONE 24 HR. PHONE
15/-1) JLVr fp/¡;/-g:Jt-OFoj 393-/tJ g(
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 11.1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND M. ONr~O~G PR9CEDURE.~,A/J. S' ÁH:.I 1/.,1.' ~
þCÞÅ ~ Á4 (J,/~ ;n~tdJr - - rf H~vt Lfð
. ". ~ -. ~-. -'~B~~' EMï>LÕYEE AND AGEÑCY NOTIFÌCÃTION:-~--
I
-.-- - -----¡ --- -- -
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
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D.
EMERGENCY MEDICAL PLAN: . ' /-:h.-._ / /
?f Té ~5 W. &T/,JtJ# ~ 4 ~.~
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HA~RDOUSMATEmALSMANAGEMttTPLAN
SECTION II.2: RELEASE RESPONSE PLAN
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
ile.Jì tc m +a·rtk ,ì s ð--kCl;ned fD ~ tJ.)Cl-!( a+a I( r íll~
B. RELEASE CONTAINMENT AND/OR MITIGATION:
C. CLEAN-UP AND RECOVERY PROCEDURES: é: VC<..Cl.ttt~
eel. II ~ì te..b.epf-
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UTILITY SHUT -OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRICAL: ' ræ. e-
WATER:
SPECIAL:
LOCK BOX: YE~ IF YES, LOCATION:
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PRIVATE FIRE PROTECTION/W A TER AVAILABILITY
A.
PRIVATE FIRE PROTECTION: F¡- ð e e't-l-~/lc¡tl ìSÅ.þf
WATER AVAILABILITY (FIRE HYDRAN1): ì 11 (/Jcu--kì1'1 jo 1-",b.eÁ : /td
ß u-~JJ~ alof17 :s;de F~J\ced (]al1fl.J
B.
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAININGI?~OGRAM:~~ ~ ~~
.~ ~ A-M,~~ Dltt'~ ~ ku/l ~71 ¿oa4, '¥
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CERTIFICATION
I, &.JUi J' cJ-¡-\ lie) SØ71 CERTIFY THAT THE ABOVE INFORMATION
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 SEe. 25500 ET AL.) AND
THAT INACCURATE INFORMATION CONSTITUTES PERJURY.
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SIGNATURE .. TITLE
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DATE
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CITY OF BAKERSFIEI,D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd¡"loor, Bakersfield, CA 93301
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FACILITY NAME &Je.(..l"JtE dAKS ~ s-r
ADDRESS 7~Sð VJH-,fGúJ q;:t:'e-
FACILITY CONTACT SAt:\a.ø,J N'é:t.Sð,J
INSPECTION TIME
INSPECTION DATE 12./*7... 7/~
PHONE NO. ~cgðl
BUSINESS ID NO. 15-21 0- ~
NUMBER OF EMPLOYEES
Section 1:
Busin~ss Plan and Inventory Program
. 0 Routine
o Combined
o Joint Agency
O'Multi-Agency
o Complaint
D Re-inspection
OPERA TION
C V COMMENTS
Appropriate permit on hand
Wr £.L ($scJe
Business plan contact information accurate
Visible address'
Correct occupancy
Verification of inventory materials
<:..~(::
IN~ ...Oé W WAu... oF '?,GNLSHoI?
Verification of quantities
V erification 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
[>L ~S€ $t;<v'<:.é 8' ~é- ~
Site Diagram Adequate & On Hand
C=Compliance
V=Violation
~~ ybu
Any hazardous waste on site?:
Explain:
DYes ~o
White - Env, Svcs,
Yellow - Station Copy
Pink - Business Copy
y::/f¿U1l-?f ~I/~A
Business Site Responsible PartY'
Inspector: W~
Questions regarding this inspection? Please call us at (661) 326-3979
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