Loading...
HomeMy WebLinkAboutBUSINESS PLAN7/20/1987 ~---- ~ ~t·, ~:~"".~:.;.~ "' " ~~ ::N,*-T~ .~·~r Û D á \)l \)j -z ~ e 5CN...f:.: e,Ù~I~ ;<7? Þ>JN--1t..: . F~: I ðF í D!f£;~ ~'-£=~-F~~H;1~-1:==1l4v~Mai=r~I~'=-o~ ÞI~ I ?J' ~I$ D'þ..~~"M V F~ILITY ()1,Þ>.6t~M '. .'............. ,.t.~ .-...---....--...-...... ,..... ..........--.......-.-.-....-.. .......... .._......_._._._~--_....... ..~....._....~~----_. A.Ff'Þ-.RTt-'lu,lí . ..~ ¿.t.:>t,,", f'L ex . , , , . . . . ,-'---'-'-,........._'-' ' , , , , , '-L-LJ.L-Je..L.L=-'_'-'-.J . , , , , , , , , , , , , , ., , , , . , , , ! t ( ~ I I If * I ,. i :f I -1 + ..( ,l '2 i ~ j f l- t ~ ¡ ~ 'f ~ lÏ'::xEC.t":' .~ I ~'~~:T j( , t t' I ) < . ,.. "J -sou nl WE'.<-7f T I fZ.a::. CE:t~TE;f<... M'5C.. f?-E;Tþ.JL -;, ~kr?o c.AR.L·~ J~, ~HlíE: LAt--tE:. - Off ¿"IN- LJ.;,¡:; ð..tL"ý - . ( . Sf'E;¿"í~ '<? C.o"""'1~"'T'; ~ ";.;.,- /..., ">-, ~'-..',,........,- , . ¡ - ii· /j -..Ji¡J ¿;. -~ ;75".1:'-' 'ii,' ' (".Ii-.;; ~. '/ ~~t1itT~ "'C.,. '·~Û'~ i'tJ 7ltr~ .:. - / / ! / I <;;L-ÄlÆ: __V4-"::. ~-O ' DÞ-íf;.: DI-:"'fLp.. -{ :..~ - -~- of I OF v ©~~ ^-~ ~) ....... < CD/,<.. @ . f/ ~ £ý ~t~H~~ N~~: sOlIn\ WEb -r 11~ ~..J í£'~ . f~ILlT1' ~,..t-\fo~ !If}:¿) 1JJd $IT¡; V1~~ F,A(..IL.IT'( DIÞ-éJRAM fLoOJ? : I .----.----..--. ~HIT.: r-~- -I L_ i?_ ~ P"-Iv'E WÞ-."( <7 fl:~~é ~HOf' CU"3-r(.w'€~ ~t:: ¡;:'ýfL.f: °ffl¿t ~ ......,¡ DÞU VE;Y"¡ þ... Y (1~<;fE;~TO~~ ~MME.tJT:S ): - OfFlc::..IÁL U$e;. O~L-(- I I ,",'1{-:. ~ _ '~'.. ì '_.'::;~'> 1"'_-~ _.;.&..;::,.:..-;;4",0 .,;,,;;::::::.:;;3.:':;:,-. ._,_ v · IMP~TANT MESSAGE FOR V ttY.-_ .... .'" CÞ,. LED TO SEE YOU / ,r WANTS TO SEE YOU PLEASE CALL WI LL CALL AGAIN RUSH RETURNED YOUR CALL SIGNED L D»-SI. - \SJ Q..t..... ~ . ASSOCIATED LJ,A2334 ~ Bakersfield Fire ~t. v Hazardous Materials Inspection ?qõ-()¿~l.\ Date Completed f? ?, C>Q 0-'-(,.·-0, Business Name: s (:)~, '^ \...).....)Q....':>') ~~ ~<'.. ~...J"'\ ò µ..,c'~ ,,~ Location: Ä. 'ð D 0 ~ '^ ~ "\ ~ LV'\._ Plan ID # 215-000"\ ~ õ (Top right comer Business Plan) Station No. l \3 ~\,) ~" :' '--- Shift Inspector Adequate Inadequate Verification of Inventory Materials @" B" G1" ~ Verification of Quantities RECEIVED AUG 2 4 \989 HAZ. MAT. OW. Verification of Location Comments: oK- , r'\q~' erification ofMSDS Availability Number of Employees ~' verification of Haz Mat Training Comments: o o o o 7 o Verification of Abatement Supplies & Procedures ff" Comments: o Emergency Procedures Posted .... ~ Containers Properly Labeled [3/ Comments: D o Verification of Facility Diagram ~ Special Hazards Associated with this Facility: o Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office " ~. ,~: ,¡, ,0-- .~, ,.. ~ - .. . "4 ¡.¡ oOJf" ~ e e BAKERSFIELD CITY FIRE DEPARTMENT R E C E' V E 0 2130 "G" STREET BAKERSFIELD J CA 93301 J tJ l 2 0 1987 (805) 326-3979 ,~-\ ~t- ' Ans d............ "3 :ItVSP 1 OFFICIAL USE ONLY USINESS NAME ID# --.J J :s ~·l HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A ~(JxW . ~ rJh- ~ £ O¡()0158 INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA , A. BUSINESS NAME: ~UTHwe~r '77;'<:.; ~I 14ulõ/hÐ'TlvO ~ B. LOCATION / STREET ADDRESS: La-OO ¿uk tr-e ¿,¡J , CITY: &ft:.:.eæç)Zrt;Lo cA- ZIP: Q3309 BUS. PHONE: (8'OS') 3<:¡Ý" Oà-~ SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE A. c::: I-k,,:/c (!A-¡¿vt'T7ð B. DttJA.I ¡11C,ûe,. ¿ DURING BUS. HRS. I!SST· fI/J~h# "3C}rt;;. Od--'d--I 5-e.etJ. ß-75/l.- Ph# ":]t7 f - 0 d- ).-/ AFTER BUS. HRS. Ph# '63/-1 '-119 Ph# <¡'3J-06c.;. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL:' C. WATER: M D. SPECIAL: E. LOCK BOX: YES PLANS? YES / NO PLANS? YES / NO MSDSS? YES / NO KEYS? YES / NO - 2A - e e SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE k> C.4 l ç ( /l..c.- d)'""--fh. \\ ~r ,~t-')o '. . ""'- , wh~" LN' (\t\e cP~c.11- L e e N'I~ SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ~: ~ ;.,- " ',', > . .. , :. .~ l.¡., ,.. i ( .. ,,' SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGR~~ WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS B. ~~~~~~~~~'FÒR'ëòÒRÓÍÑÅTÍÑG'ÅëTÍVÎTÍË~""""'" ~ NO WITH RESPONSE AGENCIES:.....~.................... ~s NO C. PROPER USE OF SAFETY EqUIPMENT:...........:...... E NO D. EMERGENCY EVACUATION PROCEDURES: . . . . . . . . . . . . . . . . . E NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:.... . ,. ~ NO SECTION 7: HAZARDOUS MATERIAL REFRESHER YES NO YES NO YES NO YES NO YES NO CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...... YES NO I, -::Jl>h¡J -.;,ç~-h rI4VDÞ'€ , certify that the above information is accurate. I understand that this information will be used to fulfill my firmts obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. SIGNATURE ~ d- / ';'u TITLE p~ DATE /ð -7~ f/7 , - 2B - . -"~' / / . \ ' , -.;..-/' ...-..... i e e BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# ------ BUSINESS NMIE: / BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3, Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY'UNIT# FACILITY UNIT NA~E: SECTION 1: MITIGATION, PREVENTION, tv ac1e. 0 zj( VVl ð~ NdW--J ~ al!w ~ ¿4 U~~··~ " ~ ~ SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS C~JIT ONLY v ~ I' {J$ 9/( , 'n 3A - e e l ¡ .., ~ . If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES~ If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form #4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2, SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? , . . , , SECTION 4: PRIVATE FIRE PROTECTION _ 3 - l'iP.¿"6 ·/OÚ~ ¡::/~ @rg[) ~T(tú'fCrlS/fe,,¿ SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY, A. ~AT. GAS/PROPANÊ: B. ELECTRICAL: C. WATER: D, SPECIAL: E, LOCK BOX: YES ~IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLANS? YES / NO YES / ~O MSDSs? KEYS? YES / NO YES / :':0 - 38 - BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-1 NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY BUS I NESS NAME: ~<;'Oú'HW eS'7' 774..<" OWNER NAME: -;¡¡, tAl SJ,hVbNØ ~¡ , . Page of j¡ ADDRESS: ~ g OD (.1.) h ;n:: t.-~. ADDRESS: ¿¡Joe¡ ::M.r .P~~ FACILITY UNIT NAME: CITY, ZIP: 'i;A- ~.(;/l. S ¡:: I' e'O q3~ CITY,ZIP: ~)¡.K..G!..ilr ¡:;-" ¿u" q33/7 PHONE #: ~q{?~ O;;ëJ-J PHONE # : n3ð969 IOFFICIAL USE CFIRS CODE c- ONLY 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T C,ODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT. WT. CHEMICAL OR COMMON NAME CODE GUIDE 0v 3a>q/1L '000 Cþ.l qaL 01 "dole N. Df.{T~iÓe (!..{?r.s1'eA. 'DF :J./OD ~ OLO (f')/¿ ¡5q~ o~rnl; . ~l.t t ¿. I? I ivcï O/L. ~~rriifQ Luo II NI.( ') ~ 1) I to'"'-;d.. /t>ð,,~ ~,rll"" ~ h € /A/J/pe ß'~ ð¡:&iù. 11->5" UJr 1\Ie.4.) v v .-.. c;{ \ 't.... J) 110 ~r1~ Ë I "j So/A oÇJ .r ...r~()'1"" --rf?Q Nc::. . t::?i'...) \ (!Ji /.Jì / .00Òo,,), C!f) ;¡" r¡::-f4Jd-' Ibll/rJllIll'¡) / . , u U -, - J :SL ,AIda ~) '7ð 360· cr.; 10 09. N· fn ~~. ..±;-~ PàÅ If NI-:¡ (f><De~c.p . ~O·~ ORI1/J / le.r - J r A A "- NAME: -:j2) ~ AJ St-h , A ~...v~ TITLE: .yf~5 SIGNA TURE: ( jn ß.~ .,¿;, ~ ~ DATE: "?-7-1'"7 EME~GENCY CONTACT: .Tð hµ &-1, ( ¡q-v ¿).V ê TITLE: j)12~S ¡; PHONE # BUS HOURS: ~]>! ¡ .37[fl>:.1-<t FACILITY UNIT #: 0::- I .. EMERG',ENCY 'CONTACT: C!~K c"..A!.lÄ'Trc> -1 P R~ N C I PAL BUS I NE S SAC T I V I T Y : t'"77.a. e,j AFTER BUS HRS: ~"5"3 OF,. PHONE # BUS HOURS: 3$8 -o;;.(}.-/ AFTER BUS HRS: ! s/·/~/t:¡ TIT L E: ,i-p'7. /Þ2 &-/e- - 4A-l -