HomeMy WebLinkAboutBUSINESS PLAN 11/14/2003
"Per
<d!1'~t1"
,//1,1,'::),
tf.1:~·"\,.·";:, »/
PERMIT ID # 015-021-002198 l\-"o~~'~_
KNIGHTS PUMPING &iPÓ~1:~BLE;
tA:¡¡:o~ª~
::;-. þ';-
t:·-· ~:.,
:~-
\ -ì
LOCATION
Issued by:
it
Operftte
to
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
,I
This permit is issued for the following:
~ Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
5555
i~CES INE:;\" \\
- - -AKERSFIEÛID'~%tk.:-~
'; i! ;:"'~~'J"'" ~ i~~'$"fF' r-2t
¡:'..,'-<j
.iJ
/,' -', ,lt
, ',.,;!,
/, ,(:',:-"¡,::,;t
jo, ¡1
r>/-"'~'
,¡Iii' ' , !
93307
'-"1
\\\
"\:--,", ,,'\
't:-- -,,-
"Ii" .
~,< ~L,>",\- ,It
'",-",,,,,
::;ç.~~~~~ ,.~~ " ~y;'
~"~-,. ; <,,', ...', - ',.¡,..""""
~""'''>..:i.6.,i~
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Approved by:
Issue Date
Expiration Date:
June 30, 2003
,I
... ;-.~:: r:: > -: . ~7 _i;1
,- ~
/
//
('
/.
/
/' .
f
N
SITEDIAGRAM~ . -SITE ID 2¡<¡<¡ç
Bu'!'- Name: ~\f>~ ~ FACILITY DIAGRAM r K I .
Busmess Address: ~c;;¡:) ~ ~\~ ç.~~$~) :t~
. . \~"-' -A.~f:::-. ,"
4s
w
0·, ~LUÞrTll)fJ
. 'P0lÑT
y\l\f\(~
o FflLE-
. 01e.0;9
~n~bt
~IT'\
~.
~~"!f
E-leclctLtc.\ eJë
'5 "'-\À1-. ~05J' ,
6f\'S~~ ~ ~f
:¡:~ ~zR ~
'SuLfuf.l L-
ál'\<-l~
O\L...-
'ìJ
D
~&w/\bE-
þ
UNIFIED.PROGR.I\M INJECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Depil
Enironmental Services
1715 Chester Ave
Bakersfield. CA 93301
Tel: (661)326-3979
INSPECTION DATE INSPECTION TIME
l-C--J--lT.f fJlJb#lJ.M---i--f!a~¡.4ßL.L--_.r~----'¡-~~~fi- /nIJ!?~ 1// :!1L___
ADDRESS' H ~- No of Employees
r S- S- S- ßÚ11-i LL~}/)~____ ___ !l~1Ll 2:~~~~
FACILlTYCONTACT Business ID Number
V? 15-021-0ða./9'~
FACILITY NAME
S~ction1: Business PlanélndlnveritòryPr~rëmï
LI Joint Agency
LI Multi-Agency
LI Complaint
LI Re-inspection
C V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
LI ApPROPRIATE PERMIT ON HAND
.~---_._-----_._-_.--~._--
._._--------,--------~---_.+- ---+--. --_._---_._------~--_._------_._--~-- -.--..- ----
LI BUSINESS PLAN CONTACT INFORMATIO~_~~~~~~:_=_____________ ___ _______--H.O~_~_~____'l.\)~~__ ______________ _________________________ _________
VISIBLE ADDRESS
--.--------.----------.---------.....--.
- -..----.---------..-+---------.-----.--.-.---.--.--+-+ _.--.._-_._------~.,..._---_., ----
CORRECT OCCUPANCY
'-I--~~-~~{---1iL1}-ð.11-------
LI VERIFICATION OF INVENTORY MATERIALS
--------.---------....--.---- -.._----" .-.-----.-.---------.---...------------------.-----..--
_..--._-~._._,_._.-
LI VERIFICATION OF QUANTITIES
---.----------------..-.-+--.------.-........-- ----------..------..-------.---------.-..-.-.----..-.------.+..---...--..--....-.---.------
LI VERIFICATION OF LOCATION
-~-------_._- ---~--+-----_._.._------------_..__._--_._--------------.-
LI PROPER SEGREGATION OF MATERIAL
.--~+---_._--,------_._-_._---- -------------+.----------.--..-.-----------------..-----.---.---.-..-......-----
LI VERIFICATION OF MSDS AVAILABILlTYE
--~--------------_._--_.._---_..._----_._--- ~--_._--_._-----_._---_._--_._-----_.._-----------------.---.----
;;r" LI VERIFICATION OF HAT MAT TRAINING
--.-----.-----.....---- -------------..--------*.-----------.-------.-.---.----_.._----------*----~-_.
LI LI VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
.---------..-.---- --------_._-_."_.--_._-_.__._-----------._--'-~---~_._~"-------
}if LI EMERGENCY PROCEDURES ADEQUATE
--~----~-~_._------_._-------_.
------------------------------------------------------------------~
LI CONTAINERS PROPERLY LABELED
--~--~--------------------_._---_._._.
--------------.-------.-------------.---...------....------------.-----
.E:'~~~~_SEKEEPING____________~--------_---------------_________________________
;;r' LI FIRE PROTECTION ~
~------_._--_._._----_._--_.__._---- -._---------_._-~_._.._-_._-----------~-----_._-_.__.-----.--..-.-------.
LI SITE DIAGRAM ADEQUATE & ON HAND
"
,
ANY HAZARDOUS WASTE ON SITE?:
LI YES
LI No
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 . ' /7
I! /! 11/ .J"!L X. Ltw'1 'V n ~~t/
~ vfqPec~--------------------Bãdge Nô~-----------Business -Site Responsible Party
~hite - Environmental Services Yellow - Station Copy Pink - Business Copy
6þ
_/
~ ~;.r"
~IGHTS PUMPING & POtllBLE SV INC
.v
.
~--,-,.-
- .....
/'
c,/'-
SiteID: 015-021-002198
Manager :
Location: 5555 S UNION AVE
City BAKERSFIELD
~~
~~~
<t,1)
BusPhone:
Map : 124
Grid: 02A
(661) 397-4116
CommHaz : Moderate
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 05
EPA Numb:
SIC Code:1623
DunnBrad:
Emergency Contact
MAUREEN NAPIER
Business Phone:
24-Hour Phone :
Pager Phone :
/ Title
/ PRESIDENT
(661) 397-4116x
(661) - x
( ) - x
Emergency Contact / Title
MARK NAPIER- / VICE PRES
Business Phone: (661) 397-4116x
24-Hour Phone : ( ) - x
Pager Phone : ( ) - x
Hazmat Hazards:
Fire Press
ImmHlth DelHlth
Period :
Preparer:
Certif'd:
ParcelNo:
to
Phone: (661) 397-4116x
State: CA
Zip : 93384
Phone: (661) 665-8877x
State: CA
Zip : 93311
TotalASTs: = Gal
TotalUSTs: = Gal
RSs: No
Contact :
MailAddr: PO BOX 41657
City : BAKERSFIELD
Owner
Address
City
MAUREEN NAPIER
: 1802 WEDGEMONT PL
: BAKERSFIELD
Emergency Directives:
-
.- '.-
I, lLvL{O KALfz..0 Do hereby certify that I have
(Ty~ or print lIÐITIe)
rs~iswed the a~ac~d hazardOfl~ mat~f'ials manag&- .
K~Iht"""? f"1MflMb r f~~t..e ~M(æ? t uu6
ment plan for - and that it aJong with
(Name of Bu&inÐ8ß)
oo)f corrections constitute a complete and oorred man-
agement plan ~or my facility.
Ji2~~
q {?-Io~
~
-1-
08/22/2003
II ~\ ,',\
'(
I
\
::.r-~ :'-
h, .
-
-
/,
// !"
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
, .-
INSTRUCTIONS: ( ;2A''t
1. To avoid further action, return this 'tor!])..Witlíiñ3Õ"'dåysbf receipt.
2. TYPE/PRINT ANSWERS IN Ewe;LíSH. -
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
5. You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
\ ':).,q-, ::::ìO ~
cs-
SECTION I: BUSINESS IDENTIFICATION DATA
A
"'-
BUSINESS NAME: ~\0M'TS \>\J.~~i (Ç) 4. \>b~LF ~~ \L\z?'S, --::t:tY ___,
,
LOCATION: SS-S-S: ~ÐLtt1-\ U.~\D~ -A~C::-,.
MAILING ADDRESS: \JD ~Di- L...' \ LD67
CITY: ~~~SR~~ STATE: LA.... ZIP:~PHONE: ßq}-4/1 h
PRIMARY ACTIVITY: çPr~"ft:.Tíf)i::J "f:)t:?-\J\ L-E5
OWNER: -M.~~ ~~\~. PHONE: lol£-eJbl7
MAILING ADDRESS: 'Ißö'Zr WG])&;"t\O).Jf fLAce;~r.,(ŒSFIEt]~) cA·C;ÆII
EMERGENCY NOTIFICATION
CONTACT
TITLE BUS. PHONE 24 HR. PHONE
(
-e~ . - '617-'-11 Lip - ' ~"I7-LfII tp
~t~. 317-Lflll.o 317-41!þ
-
1.W\fuJ...~~ ~\~
2. \M~ ~~\.~
'.
"
. -
1
-
-
,,I. 'h
......-,~ . ~
~~ .
HAZARDOUS MATERIALS MANAGEMENT PLA~
~~).~ .
~
~\,
'\,~
SECTION 11.1: DISCOVERY AND NOTIFICATIONS
.-- '\
" !
" I
',:
A.
LEAK DETECTION AND MONITORING PROCEDURES:
N/A
'.
-, ~..,.
/.
B. EMPLOYEE AND AGENCY NOTIFICATION:
~~t 0--\\ e~\~\a:<;. oœ~;L \Á)tLtj" çolìo O\~.V\
j",- \I!{a, L4-t\ q,U ~V\tl LaU (alì4-0((I¡Ct&HlL~
~UJ' e-(I1A~~ef\.LLf ~~f\}\L6. ~ ~-7§D
C. ENVIRONMENTAL RESPONSE MANAGEMENT:'
\Ml\~ ú"'Wttf- u.)9().L~ bE- ~es.Çt;~\ßLE- D~L()t\õBO~
\.tÛø-S \e-8- ~ LMe6E \0 ~Oll FY AûfttDfJTl ES)
~~ L.LEf\:t0 ll\> LDM~\t:.S
-
. . " ~ ~ ~ ¡
"' I i
D. EMERGENCY MEDICAL PLAN:
"TttE, S~Ef..ó\;.~L>1" l,(JÜllkD Ç-t~S\ ßE '1f;-SfiSS~
,0 t\OlAJ SÞ€-lDLlS. \ \J~~~, VÙO~ WDt.LL-~ t()~
10 ~L flLL-E.-~ D Lr I r TIME-" ffL.Ll)I..{)~,
" .J
W\ bMÐ F-l frL- ~C6R rr~'L"" l<---~ 'W\.~tLItL Lf;N~)
o{L, <6 \is I ~ ~sSH-TÞA-uTt Ñ E;Tvll>R-L.. LV ft/)/'~ ': (}.j E-
Ll ~E, ffJ(L v00~ ~&LffI~' ~~lÅ~ltt:-S ~
2
i t:'
I j, "-
I
,~ .,
!
/'
, ,
/
/
I
I '
e
e
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 11.2: RELEASE RESPONSE PLAN
A.
HAZARD ASSESSMENT AND PREVENTION MEASURES:
(tll þ\JV\Ç)LD'1 eG--S ~ ~D l~O~ Itv -Y'\\-E:-- '{tî.£-~ Df?: F(~ ~E.
l ~t~D $.~Ff~;r-Y E&(,l[ P(\1 ~ (/ ~., \LI\)Du) W ttt=-~~ \ö F-~ ~ I
~'. T\-\~Y ft~E:.~FD~ßß Df-- TttE:- \ Mfl>~LE- DF' I
VJ~l).j6. Ttt~ ~r-¡i~r-¡ bEA€-- J:N ~Bf6~-A;Tf5.ð M-~.
I
B.
RELEASE CONTAINMENT AND/OR MITIGATION:
~~~L ~D~ ~~lbl\)f't'1~ Prræ~ ~Il~ R-i\J ~\Ã)N:-t::J.
SLùÆ- D~ A.- G~~ ~L~~ ItS (Á)E-~As. Æ ~)pV-'1
'"S tT~\- o¡;::-ç:. AN~ PN'CL-<.1Stt RB~ .
Oll-'fo~ , ~ t.\tl~ ~ D\1 Ei:-Pl.Aû ~ l Ñ TD Lf¥rL\:t-' $ ?lLlS ,
C.
~\
CLEAN-UP AND RECOVERY PROCEDURES:
-SlJL~~.\L ~: ~~W::\¿ V0\~ uJ~\-e.\, ð\J\& v'Sf..
~l~ S~ -fa fÎb.ltr-{J.L~ t/J-{{jI, .
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE: ~~,~D ~~:\~L-E;L ()j:) ~ìt.m1S1f'fZ..t>f pØ»?
ELECTRICAL: AT ~U\l_ ~O'f.. l)~ \Ðuìf.::.-X:\1:>LE ~. DF b'tA-/A\ p~~
WATER: l~~~ 'òF- g,~ ,eAatE? D~\ ~1)J..'11-P\~E-DF-'~P .
SPECIAL:
LOCK BOX: YE@ IF YES, LOCATION:
PRIVATE FIRE PROTECTION/W A TER 'AVAILABILITY
A.
B.
PRIVATEFIREP~OTECTION: r:\.e-t:..- Þ'i--TI~61.1'~\-\-&~~ Ll)L~T{;.b :1;0
~ D'PPll..-t::- \e.A\.~~ ~ M~ \tŒ-6 tTD~ ~ f\S WE-LL
WATER A V AILABILITY (FIRE HYDRANT): to.....
bkJE- t\(J5~ ~\b ßj ~~ DFFiLE- Tf:A--L~, fcN~
O~é- ttb~\Z.- ß\ß. l-otA~ ~ .sttop ft:reA-.
3
-
-
.: ,1" _ "t
.; ~ ..'"
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES: t3
MATERIAL SAFETY DATA SHEETS ON fILE: 'I ev~
BRIEF SUMMARY OF TRAINING PROGRAM:
Ef"cp\Oi~e... i:t~~DDI¿) u)"';~ LCAt-~I"'-S,
tL~ ì~)&J.-(Y tlV\J ìlll\t <;. <;. pŒ\\ev'\.-D OK) ~l.'<f\ ~
~CL~ elM,~Dyee... IS, ìÇ.SLl~J V,^-e \ tL"lJ
D~€- '\S tt\SO "-~ l f\ DlJ-' V'A~l n DfR ~
+ (Ct\\e-r:-
':\
I, , L> CERTIFY THAT THE ABOVE INFORMATION
IS ACCURATE. l}NDERSTAND 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 INACC TE INFORMATION CONSTITUTES PERJURY.
~ ~ (¿S {&td:
TITLE
4
. CITY OF BAKERSFIELQa
OFF1r:E OF ENVIRONMENTAL SI!IfVICES
1715 Chester Ave., CÀ 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
(one (orm per male riel per building or areaj
. Page .-z- oi L
f:},:'.}~~ ": ;,~' ~~: :,~~ :~) :t;;;¡\:'i~i~'~;U'Ç-tj\?b/j'\:.i:'~ ,r:~hJ.~U. ::~j\i'
¡..".~ nf;~ACIL'T'(' l~fºRMAJ",ON
( ame as
\..
~\~~ Ç(~Q\~(? á.-~~lE- ~\.
B
~L
CHEMICAL LOCATION
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
203 GRID # (oplional)
OYes~o 202
204 -
',' ~\- ..;</r~~~·~i.\:· _' :-:'::_~:; :'(tFh:';·:'/.,,'- >:,.-. -':':<'-~/':;:':"'!,,~?/
ìì. CHEMiCÀLINi:ÖRMÀ tléi
~";~"';" ',~:',": 0;;' ~";'::;:'~'<""~/':1'.,;:_.,> ;-,,\"', " ,. ~Y.'L:¡;"~ ~
CHEMICAL NAME
vvtL
V-o-r
W\
G '60
COMMON NAME
CAS #
FIRE CODE HAZARD CLASS
TYPE
210
MIXTURE o w WASTE 211 RADIOACTIVE o Yes ~o CURIES 213
--
OgGAS 214 LARGEST CONTAINER 65 215
o P PURE
PHYSICAL STATE
o s SOLID
FED HAZARD CATEGORIES
(Check all that apply)
o 2 REACTIVE 0 3 PRESSURE RELEASE )(LACUTE HEALTH
MAXIMUM '1 c- 218 AVERAGE .,
DAILY AMOUNT 01-. - ~ DAILY AMOUNT - L-.-
~ CHRONIC HEALTH
219 STATE WASTE C DE
2..2-
221 DAYS ON SITE
3lP~
01 FIRE
ANNUAL WASTE
AMOUNT
217
~
UNITS·
~GAL OdCUFT
. II EHS. amount must be In Ibs,
o Ib LBS 0 in TONS
STORAGE CONTAINER
(Check alllhal apply)
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o p TANK WAGON
o a ABOVEGROUND TANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
~ STEEL DRUM
o e PLASTIC/NONMETALLIC DRUM
Or CAN
o 9 CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
o k BOX
~YlINDER
STORAGE PRESSURE
)CÍa AMBIENT
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
STORAGE TEMPERATURE
216
220
222
o q RAIL CAR
o r OTHER
223
224
225
~~~~~~., ~\.~~
----J ~l-u IDO
. {I
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4,wpd
CHEMICAL NAME
b~'\6~
COMMON NAME
CAS #
,l~2:--Y4--~
.. CITY OF BAìŒRSFÌELQa
OFF!f:E OF ENVIRONMENTAL SIftVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALs INVENTORY
CHEMICÀL DESCRIPTiON
200
>"m~~~~¡l¡~:'N~~~MÄtiõ~";}1:;',:;,',\{%:'W';;î
" ;::¡'.' E~~irMtÁL(Ñi=6kMÄf¡ö~',1~,t},',;".,",;;,'~,',;¡,l;,'.,:;,,',";
;.'__""-.' c, '_>' ., ': :;.,: ,,_',;.).' '~"C,;_ - t '. '_', ',"., - ",_ ~ t..;:, '_~'_ ,';._ 0" _, ~ .... "
o
207
EHS'
209
TYPE
,)L> PURE
FIRE CODE HAZARD CLASSES (Complete if requested by local nre chief)
(
o Yes ~o
PHYSICAL STATE
o s SOLID
FED HAZARD CATEGORIES
(Check all that apply)
ANNUAL WASTE
AMOUNT
01 FIRE
UNITS·
STORAGE CONTAINER
(Check all that apply)
~ ABOVEGROUND TANK
Db UNDERGROUND TANK
~ TANK INSIDE BUIL[)ING
o d STEEL DRUM
STORAGE PRESSURE
o a AMBIENT
STORAGE TEMPERATURE
o m MIXTURE
o w WASTE 211 RADIOACTIVE
(one ;orm p¡'r "J.iIjeriel per building or area)
Page ..2 of 3
o Yes ~o 202
204
it:1B1:i,i¡,,;P':';:}:( ",,;;; ,¡ , :,< I
OYes~ 206
If Subject to EPCRÁ, refer 10 instructions
o Yes ~o 208
210
212 I CURIES
),
213 '
o I LIQUID
~g GAS
214
215
216
219
STATE, WASTE CODE
220
LARGEST CONTAINER
~
221
DAYS ON SITE
wS-
222
o 2 REACTIVE
~ PRESSURE RELEÁSE
o 5 CHRONIC HEALTH
o q RAIL CAR
o r OTHER
223
o 4 ACUTE HEALTH
217
MAXIMUM
DAILY AMOUNT
-"
218
AVERAGE
DAILY AMOUNT ----
0
2 230 231 DYes 0 No 232 233
3 234 235 OYesONo 236 237
4 238 239 o Yes 0 No 240 241
5 242 243 o Yes 0 No 244 245
o ga GAL œ- cf CU FT
. If EHS, amount mu~ Ibs,
o Ib LBS
o In TONS
VV\fteL- ~\>\Ee-
UPCF (7/99)
De PLASTIc/NONMETALLIC DRUM
Of CAN
o 9 CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
o k BOX
~CYLlNDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
Op TANK WAGON
jiILaa ABOVE AMBIENT
o ba BELOW AMBIENT
{t-I"2-1 lco
I (
S:\CUPAFORMS\OES2731,TV4,wpd
CHEMICÀL NAME
.. CITY OF BAKERSFÌELDa
öli'~E OF ENVtRöNMENtAt SIMVìCES
1115 Chester A \reo; CA ~j301 (661) 326-j97~
HAzA~DoUs MAtERIAls INVeNtORY
CHEMICÄL DESCRIÞTloN
200
';:'rt ~A'ðlt1W'Îij~~~MÃfíÕÑE{
::~;:):~.~:',-;: ;,:':.'; \'·7 {~~ :~:.- ~:< :
'-C "-, '.-"";'-
::<.~~:~~~/j~{~/~....: .-
". .;. ~··,,·'~':-l~f.¡.>fdt~~·;::<; '.i': :,:'. ::'; .;',' .,.',.:: >:-.' ·,··);'">'\\~'V:i.;.'-:-:.i·; 1J~: ',;':, ~i {~,:~-,:¡, \;:~':>/
;\,Ii¡:¡ff¡f,\lt;'\,;, II. cJ:iËMlc¡)L INFORMATION l;' 5~', Ji
:f~ , "tt,v.·;> 't~!,;l ~:},':: .-", ;a::'n~·.r< ':;, .~";!, ,; 'J::. "tf··,. <'","4""'- :. :,.\ ~ ''\--.;, ,', .:>;:,¡~:','.':¡ ~ .,. ':"\~'.
(onii ;0,," per m~17'¡ÌJI pe~ buifd'ng,orprea)
Pågò -=1 rn ~
"
'...
---J
.-.- ~
"'-----t-
!,."
o Yes ~o 202
204
,1tj(f\~é'~J"F'J' "f'
, TRAOË SECRET ' 0 Yes ~o 206
If Subed 10 EPCRÁ, relèr 10 Ingtrud;on.
EHS·
COMMoN NÂME
CASØ
1
FIRE CODE HAZARD
TYPE
PHYSICAL STATE
o 9 SOLID
FED HAzARD CATEGORIES
(Check all 'hat apply)
ANNUAL WASTE
AMOUNT
~FIRE
-'
UNITS·
STORAGE CONTAINER
(Check all thaI apply)
~ ABOVEGROUND TANK
Db UNDERGROUND TANK
o c TANK INSIDE BUILDING
o d STEEL DRUM
STORAGE PRESSURE
o á AMBIENT
STORAGE TEMPERATURE
2
07
o Yès ~o 208
209,.'~,í~r~.li¡;:~J~~.~~~~,~~pr~,~,·,~,',' ,
o m MIXTURE
)r;
o w WASTE
211
RADIOACTIVE 0 Yes
o I LIQUID
J(.g GAS
LARGEST CONTAINER
F
214
o 2 REACTIVE
~ PRESSURE RELEASE )i!itLACUTE HEALTH
218 AVERAGE
DAILY AMOUNT
o 5 CHRONIC HEALTH
217
MAXIMUM
DAILY AMOUNT
...----.
--.
o ga GAL ~ cun
. If EHS. amount musÚe'j;; Ibg,
o Ib LBS
o 'n TONS
De PLASTIC/NONMETALLIC DRUM
Or CAN
o g CARBOY
o h SILO
0; FIBER DRUM
OJ BAG
o k BOX
~CYLlNDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
Op TANK WAGON
~a ABOVE AMBIENT
o ba BELOW AMBIENT
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
o c CRYOGENIC
225
230 231 o Yeg 0 No 232
234 235 OYesONo 236
238 239 DYes 0 No 240
242 243 o Yes 0 No 244
4
"'"',v"q:';'" "lJ'"
,~~~':j:-'i¡~tJ..¡r.¡;.:: ""1" ")I~'
;!t;:':;~:ij:'::~~)k';?:;14¡~'
-~-Þ4ti)
.':......
:-~tr.'i"·:, .:"
." ;',
. ':'..,
~ t..JAV\Et:- \)\{~ ~~S
) ,
UPCF (7/99)
210
212 ~S 2¡r
~-------
215
216
219
STATI;.WASTE CODE
-,
220
221
DAYS ON SITE
~ la..~'
222
o q RÁIL CAR
o r OTHER
223
224
229
233
237
241
245
S:\CUPAFORMS\OES2731 ,TV4 ,wpd
.. CITY OF BAKERSFIEL"
OF~E OF ENVIRONMEN1'AL S!ftVICES
i 715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
o NEW
,,:~,~:' ,,":,'~;, :,_:,~~}:i~·_·~·,'<:;·~ ;,:}.:;;~:;};{ '>.).": ;;';;¡;;~ -",¡.\;:;~;:, ~:,:,~,:,,:.:V>;>'~ ::--;""" ,
. X)jjï:cijÈMiëÀE;ìNFÖRMÀ tlöN~?f':
. ·~S-1,,':' V:r:;. ¡'.' "'''·'"V..'·,''-:~+'·,~·;V,' ",:-;". ',"''''-<:~;<\:~ -;.:,', ;:"'/-'__k,,~',; ~>;<.';\;':;.,':;;.¡;:
CHEMICAL NAME
~lt.LÆ1.-L~L
~C-{
207
COMMON NAME oS ~~ L-
CAS # -¡ lo~tf- q 3 --
EHS'
~
Ñ
214
209
FIRE CODE HAZARD CLASSES (Complete if requested by local nre chief)
TYPE
211 RADIOACTIVE
o Yes jZú¡0
o w WASTE
LARGEST CONTAINER
PHYSICAL STATE
o 9 GAS
IDro~
LIQUID
(one ;0,," per m,,?' per building 0'j!!P")
Page ~ 01 ~
DYes ~ 202
204
o 206
If Subject to EPCRÀ, refer to instrudions
210
212
213
215
FED HAZARD CATEGORIES
(Check all that apply)
ANNUAL WASTE
AMOUNT
o 3 PRESSURE RELEASE ~4 ACUTE HEALTH
218 AVERAGE d
DAILY AMOUNT ìD "fcl-< .
~ CHRONIC HEALTH
219 STATE WASTE CODE
220
01 FIRE
o 2 REACTIVE
217
MAXIMUM 0.......
DAILY AMOUNT ULJ 6f\k
~ GAL 0 cf CUFT
. If EHS, amount must be In Ibs,
o Ib LBS
o tn TONS
UNITS'
STORAGE CONTAINER ~
(Check all lhat apply) ABOVEGROUND TANK
b UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
-tJ e PLASTIC/NONMETALLIC DRUM
Of CAN
o g CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
o k BOX
~ CYLINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o P TANK WAGON
STORAGE PRESSURE
~ AMBIENT
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
STORAGE TEMPERATURE
~AMBIENT
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
216
-.:-
221
DAYS ON SITE
3lPtj
222
o q RAIL CAR
o r OTHER
223
224
o c CRYOGENIC
225
2 230 231 DYes 0 No 232 233
3 234 235 o Yes 0 No 236 237
4 238 239 o Yes 0 No 240 241
5 242 243 DYes 0 No 244 245
JY1
co~.____~¡ I Dc)
UPCF (7199)
S:\CUPAFORMS\OES2731,TV4.wpd
. cttv OF BAkERSFÌÉt
OFtl:t OF ENVtttöNMENt At ~vtCÈŠ
1115 Chêster A h~.; CA 93301 (66t) 326-j91~
HAZARDOUS MAtERIAls INVENtORY
CHEMiCAL DESCRIPTION
VISE
200
(omi ;0,," per malerial per bundlng r¡r area)
Page J¿, or Y2
,,'{j; ~Â8i[¡fŸ':íNfð~MXt'ið~X\:i
·~;:)f~,')}~::~:!f~4'·.·.:._~·,· ,.~
'.: .~{: " .:(.- ',;~
.,-:,:,¡",,r ,
'"":';"¡',:'.f:;;",."
" J
3
203
o Yes ~o 202
204
"'(:.;~1(."}..>.'.1.·'\;". ii}i.'.':I·I' C,; n.· ·¡'.·U.'·I'C<··".'L>;'I'¡i¡'F:.:O":... "MdA;; T'. ¡O;:'N':'.':i!.'.;.·.~.':.ii.·:.", .
~.,.;,_~,I~~;'h~~:lj~ k;,,_\t,.-',_. . HeM -", - N n. I ,,-Ç,\ ;:.:.:.. '''~::
,;5: _ '~':.,:,~. ;<.1;".1,:. (;,-}," .;" . ¡,,';',.\', ~>I'> ,,,: ~_.:::, ; '¿ .,. Y:,~' -;. -:4;' " ,",.. ~;.~..;.. ,- '.';"~~~: .,..-'; :' ;.....~.
;¡W~!VÒEí,i, " ., ·~1
Þ;"~~'6~:~~¿~;d ~.~~.~
II Subject 10 ÈpcRÁ, rer.... 10 ¡nslructions
CHEMIcAL NAME
ft~\)~
Co .
L
207
ÈHS'
d Yes ;ðlNo 208
COMMON NAME
CAS #
209 .,i,r~rl}¡,¡::;~~:M¥~~~~~;~r~r~,.~..~,..,
'M,l)(..,Lte.E
FIRE CODE HAZARD CLASSES (Complete ir requesled by local lire c/1le/)
N0l\.\ f~nAô;,~
o p PURE X m MIXTURE
210
PHYSICAL STATE
o s SOLID
o I LIQUID
~.GAS
214
LARGEST CONTAINER
3LD ._P
212 ~Š-------::213
L~_____,
215
TYPE
o w WASTE
211
RADIOACTIVE
o Yes ~o
FED HAzARD CATEGORIES
(Check all that apply)
ANNUÁL WASTE
ÁMOUNT
)5ti. FIRE
217
o 2 REACTIVE
MAxiMuM
DAILY AMOUNT
o ga GAL ~CUFT
. II EHS, amount must be In Ibs,
~PRESSURE RELEÁSE
04 ACUTE HEALTH
o 5 CHRONIC HEALTH
216
-'
218 AVERAGE
DAILY AMOUNT
219 STATE,WASTE CODE
---
220
UNITS'
o Ib LBS
o In TONS
221
222
STORAGE CONTAINER
(Check a/l rhal apply)
~ ÀBOVEGROUND TANK
o b UNDERGROUND TANK
o c TANK INSIDE BUILDING
o d STEEL DRUM
o e PLASTIC/NONMETALLIC DRUM
Dr CAN
o g CARBOY
o h SILO
o I FIBER DRUM
OJ BAG
o k BOX
~YlINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o P TANK WAGON
o q /'tAIL CAR
o r OTHER
223
STORAGE PRESSURE
o a AMBIENT
~a ABOVE AMBIENT
o ba BELOW AMBIENT
~
STORAGE TEMPERATURE
)§..s AMBIENT
o aa ABOVE AMBIENT
. .;~'¡~~~~M~'M'
~r'::;'¡''' ;i"!):·i-)~~._ .~ p,·:·,:·,t,~)'.,!·)<:¡,~:~~¡'1
7 () -37 -
230 231 o Yes ~o 232 f;)Lj-öß--9 233
3 234 235 o Yes 0 No 236 237
4 238 239 DYes 0 No 240 241
242 243 o Yes 0 No 244 245
M~ ~M\~
~ \ l.E-f't~S
\
·"'"1····"'···,..,:'"..,·'" .:i' '..". . , ì' ';1'''' .,. "I
ŠìG.:NÄfÜR'Ê '~.";' ;·1'.'." 0'.".(,:, r: :'7' '0 '. ", ~"';-' ¥Jv",,;, i¿, 'I"
;t;iè':;iJii;it¡tt>:<EY'J? "J::~,. ~\\;¡:' ::, ':1" , . ,,'Ie;;, k::ff~f.j: '~~f:',~'
SIGNATURE [U DATE 246
A 'I ~ J?j/{)<ñ
~ ~----~~r-1ðlL--
UPCF (7199)
S:\CUPAFORMS\OES2731,TV-i,wpd
... CITY OF BAKERSFIELIa
OFF'lt:È OF ENViRONMENTAL Sim.VICES
1715 Chester Ave., CÀ 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
o NEW . 0 ADD 0 DELETE ~VISE
k~'~:~~::' N~~E;~~:~'~(l;~ltrt~'~~~~'i;~{~;~'í!ti~~~~Jl~:!:~~:lr:' ·~..i.· fACiGfflNFORMÂTlclN .:;';
1_ ~~\G:>\t\S. \>~~'.J'~,~b 8./ ~()H,A:ß~ S~
I CHEMICAL LOCATION
: ~ oS C\E._,
200
".
...
'",",
203
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
GRID # (optional)
FACILITY ID #
(ona (onn per material per building or area)
Page ..L ot L
!
j
o Yes ~o 202
204
~ ,'-::' ,:,'<"; ,.,.:',:':; ';',:¡ ::<1:;::'..··"..<.¡ ~_>.::': < :.::">;,-:?/ :(!"),....;.';~-: ,'-
CHEMicAL INFORMATioN :¡~\t;·.;/
"/,f,~^"" ,"; ,- - 'd_'i.,:;~..,;.,'-:<>X "... .""'(.;"'-'';-:',);-'' ..~.>.-.-,...", y"
COMMON NAME
~ Þ-wP<5~ ~~\,~~"
'~~é-
EHS·
'.-£_:.:-
, "
~ .
- -
207
206
1/ Subject 10 EPCRA, refer 10 instrudions
., DYes ~ 208
CAS #
209 .:ll;¡~~~!¡::F:;.·~·~:fr~;'~~fr~' ~'lli.:;;;.
W\ ~ ~lÂ-~_
FIRE CODE HAZARD CLASSES (Complele if requested by local fire chief)
TYPE
,,:;-
o w WASTE
211
RADIOACTIVE
DYes ONo
MIXTURE
PHYSICAL STATE
214
LARGEST CONTAINER
09GAS
FED HAZARD CATEGORIES
(Check alllhat apply)
ANNUAL WASTE
AMOUNT
o 4 ACUTE HEALTH
>
'¢
~ CHRONIC HEALTH
o 3 PRESSURE RELEASE
o 2 REACTIVE
01 FIRE
ISèga GAL 0 cf CU FT
/ """1 EHS, amount must be in Ibs,
AVERAGE
DAILY AMOUNT :2t/.:::C) 6
o Ib LBS 0 In TONS
MAXtMUM ? r---._
DAILY AMOUNT ~
L
STORAGE CONTAINER
(Check all thaf apply)
~BOVEGROUNDTANK
o b UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
Áe PLASTIClNONMETALLlC DRUM
Of CAN
o g CARBOY
o h SILO
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o 0 TOTE BIN
o P TANK WAGON
o i FIBER DRUM
OJ BAG
o k BOX
o I CYLINDER
STORAGE PRESSURE
~ AMBIENT
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
STORAGE TEMPERATURE
210
212
CURIES
213
"
215
216
219
STATE WASTE ¡DE
'3.2-
DAYS ON SITE
222
220
221
o q RAIL CAR
o r OTHER
223
226 227 o Yes 0 No 228 229
--
2 230 231 o Yes 0 No 232 233
3 234 235 OYesO No 236 237
4 238 239 DYes 0 No 240 241
5 242 243 DYes 0 No 244 245
-.----~/œ
UPCF (7/99)
S:\CUPAFORMS\OES2731,TV4,wpd