Loading...
HomeMy WebLinkAboutBUSINESS PLAN ~L, .. ·,6' " NORTH '" SITE/FACILITY DIAGRAM FORM 5 SCALE: UNIT#: OF BUSINESS NAME:! \ f\ I DATE: l.; / ~/jßI\ FACILITY NAME: FLOOR:·· OF (CHECK ONE) SITE DIAGRAM v FACILITY DIAGRAM J t. ö J.<~ ~D- o -"'6 -..:r ~ ~~;5 ¿r-9J ~~ \ ~ ~ t¿ ct ~j.,.~ ~ () . - J ¿,t;.. ~ d- --9. Ç,..J) c:J; Q) J ~ ~ () I- e - A~ ~ -- J) .- J~ q,. ~ c£ .:.:- "J c¡) 7' Q ~ g. -5"'. ,~ ""'Ö ~ úL ..;,ß. c., ~ ¿ ~ -- .-l.~~. ~-;r'O.JJd , 0>\ \-?<a' -:.- (Inspector's Comments): -OFFICIAL USE ONLY- . < " , . ..". ~. ,,,) f~., _. ,.,. . þ e -- HMCU-13 · t -". SITE/FACILITY DIAGRAM FORM 5 NORTH SCALE: BUSINESS NAME:1ttd. FLOOR: OF f u...-m e ~ \ d. t~ G...ty\ e.- DATE: It. /~1?/2'l FACILITY NAME: UNIT #: OF (CHECK ONE) SITE DIAGRAM FACILITY DIAGRAM V J ~ I J \.- a .J :~ I- ~~ ' \ ~ 1. ~ ~ .~ J 0 - j ~ 0- c k <J\J ~\ 'í \ ~ Ii .~ <"ð' ( ( çJl di ~ I, (Inspector's,Comments): -OFFICIAL USE ONLY- It , - ./" ~ HMCU-13 - '1' :, :,~,./ :":.~. "':1:'2-S-;'(1):";';),1 ,\. ...- '-'~' ".' -..-.' ",. "". .. ".,¡;¡:\;.} ;. ',,:-"',; PLEASE 'MAKE' CHEÇKS P~ Y ABLE TO CITYdF BÀKERSFIELD RETURN THIS COpy WITH PAYMENT tfAlARDOUS "ATER¡'~lS(HV.lS:~ON RETURN PAYMENTS TO: CITY OF BAIŒRSFIELD ?-, <i,.,~ox 2057: .,.. . . . "KERSFIELD, CA 93303-2057 tfM699$Ol ,.."," .:', , 7~a5.0Ô ""'<,';!',:;', 1'," ,I' ·-'~~~;'t/~ l~\:1)\f'f;:~~ '::," ..ª~J~~.C,~'!"i . " .,.'.. e a:y,,~ r"~ . ., ,.-: , ,>;' " \:. " .... ", :~' .'. .. 67/16191 ¡¡J"'WIÙ:':""" Pf'«tviOI,f,! for·· 011-11111 . . ACCOUNT NO '''a. ;i~.r do'~ ~' "~le rta~ $ H íib "d l i "gFees \:..:.,:-<,'¡",.~,,\.,..,,~. j, .",::,':'" .',..·..vf.-'.-.'- ' ',: ," _.,;"..,." .',~"- ,'\ - . ),-~;;;:' ;,,S:t't'e·Juldr:·~600· fIH,.8,L~·,:,,··R·Ð, . .' "'".. ..,t' "'ÞJrYflEifr$~"~f'ÊR'i~l!'~i91' NOT :ØIlf~1; S:El'1V" ¡(.f F()~ 7/119l.";""6/3019Z:l2;;;~( . ;\~ '- '\, ., ' f~~!t~~,w"¡;~l:j~;~j~~~!~Þ DQE 1 ~:f\;iFi~\;¡i"wi~~i!;ß~'}~¡:1~~W¡z~(; IS lLll1N<3 fA,. tE01/0119t '..'.' " ·'.·.·.'1·.··'." ...' , ,""'." ..'J'.' ".............'... 'f" (!^ , "." ,,' . ',' ...' , '"",... ,,',' I '&/tJ/Jl~hL/}IL()'" f Ä'J:~,~'~t;'¡';:'~,:~~"L:;~;.iU};;,D,::\::,?t..F,,:/;;~:;:;,,:;):;;,,;,{,.;; , IS O~EU~º~ RECElPT .' ., , " , .~$e{LL Hflt6C)'è) 50,1 , ' - , . '" . ANlr'~'FRA"e:' :, I;." ,... I:. 9~~;O~: lNf)EPENDENT."'~EEl 6,00 WiBLE ,fU) . ",,, ¡ïh~"·tSASF IEl p;". 'c:A . , . , 12,6-39?9' MUST RETuRN THIS COpy WÎTH PAYMENT' PLEASE PHONE 'THIS Bill, NUMBER INQUIRIES COf':/CERNING' NVOICE -,-::: 4;-' ,:. ..;ç.>~~,)~~:,,-" ·,-1' ;'~. ï . :;.~;;~' .'- >::. ': ~:'~}, '~~'-~". " PLEASE MAKE'CHECKS PAYABLE/TO . <~'~ " ,.'" "~' '. .' ,1 CI~ÖE. ,BAK'E'RSFIElD ') :·.~";.;r:,4~~,,~~:·" "',' ,'" Pi' e~\iii 0 Ù '$""B'~ tH tll~ION,» ,~~ ~~,.-, ~.,l _....-~":"~I AtS 699501 ~Ar€R¡ OO~S ,.~.~ -'~ ACCOUNT NO [t HAl;Á RETURN PAYMENTS TO , CITYOF BAKERSFIELD , ',' '".. . " '~OX 2057 -~-'.._." . '. .,' KERSFIELD; CA 93303-2057 t--la 23 f' d {HJß ,-, , . , , ~ Cll"'2;11P' HH 1'2'5':;,,0 0 ""1,2,5 ~º.O J:~~:'::::,;:::!<:'~: :'''~,_' . ¡ '/ t {~'ì9 y,m ø tI t " iJ,111-5J'91 .' "¡,', , for 'Pees N jl Î'1C1tèq>l ~t'S Hand ;,,\, ;'.;.- ... '.' . ".' .. '. ,$'tt:e f'\ c!:.ì ri¡¡\¡~:; ~iI5l!E, ~UJ Þà Vi1t ~ð is "A'f'rtH' ;:,t;¿:¡:-;jl"j''fj 1 seaVlcE FO~ 111/91 - ~'3 .' 135",Ot) CIIIio"~__",,=,,,<CI 1.35..QQ ~$ OUf Ç,J B/H..ANCf;: Ch;¿¡¢ " ":~;,, ", t'~ rrs"1: ,¡ T,O T ¡.oI¡l Ii . ~þ" 'I " ,~w,'- " ~u.trl~, G' . t~~:lE "Ol~O~/ ~-?L 7¡¿j~;С/7UT ;ri ~ C;h;,. '.1 . > , , , RECEI'PT IS DUE U?C\IJ N1JAl ~HLL A .5 -- .:..:....: HÞ1ð99501 ;.,,,- fRAME ANO 9JJi,}ij¡ ^', ~lHf:·fl " .! C.A , , .(~ÐEPENOENT 6QO'NI8LE ND 8AKeRSFIELD~ , 32~""39'r9 .'i-"'-'---- -----º-USTOMEfl COPY - INQuiRIES CONCERNING ~~IS BILL, ,PLEASE PHONE: : NUMBER ~,':,,' . INVÒ{CE ,.0~?~"',\ I - ~'--"'-'~ . -- -- ..- ----- ---- HM_6~250 1 , I Account Number ACCOUNTS RECEIVABLE ADJUSTMENT e :.: -. ;.~ -I! ,~,., ", January 9, 1992 . Date . Valerie Pender2rass From: Fire Department -' Hazardous Materials Division Departm~ntJDivision New Account I New Address Close Account Service ChanQe I Other Adj. I Independent Wheel & Frame BilliÌ1 gNamêè;:' 'c. 600.Wible Rd., Bakersfield, Ca. 93304 , Billing Address Same- Site Address " ..-~ - ,~- Parcel # (If Applicable) Landlord Name & Address if Applicable ADJUSTMENT Last IBilled . ¡ }...: }-92 ! Correct (Billing i - 0- \ I I I \ 1 I . I . I ' 4~ , IAdjustment iTa Billing f [$135.00] ¡Effective Date 10f Change .. I I }-2-92 I I I I refunding last years fep. This business was found to be 1n the county~ We will also be Remarks: , ¡';" r' ~ e e Page: 3 ================================================================================ SUTL10B Account Billing/Collection Activity Inquiry -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Acct SSN Name Svc Add: 699501 Cyc St: CL Bill St: FB Parcel: INDEPENDENT WHEEL AND FRAME 600 WIBLE RD Cyc: 5 Rt: 1 Svc CIs :e Seq: BUSIN -------------------------------------------------------------------------------- Readings Cons Prev Rdg Curr Rdg Cons ------------------------------------------------------------------------------- 01/01/92 Fwd: Water: Sewer: Misc: Cred: Total: Amount $125.00 $0.00 $0.00 $135.00 $-125.00 $135.00 Misc Type Desc 99 PAYMENT F09 HAZ MAT HANDLING FEE Transactions Date 07/16/91 01/01/92 Amount -125.00 135.00 Receipt =It 36213 ================================================================================ Enter 'I' For More Billing History, 'D' For Detail Postings, '/C' for Credit an ALT-F10 HELp· ADDS VP . FDX· 9600 E71 . LOG CLOSED . PRT OFF . CR · CR Farm and Agriculture r-., L_.J KERN COUNTY FIRE DEPARTMENT ~ OJ Ct HAZARDOUS MATERIALS INVENTO~ r.4 DUN AND BRADSTREET NUM8ER ' '(. - aq-_·Z:gl.R-:.fi~ ;,~ Standard Business rv., L _,. .J BUSINESS NAME:Jl1d(>-Il()¡1de.nfLiJ/1€e/4Ha.rn~ OWNER NAME: EJd/JP:L hJ6SfJI ________._. ~~~~~I~~~ -!:tkjßj,i':Î d R/J~~;¡04 ~~~~~S~ ~ ~~~-:lttl;¡---R$_ð~c¿-~-·_--~-=:~ ~~~~~A:~---IN~t(c~RoDE-~=~~.? ----, ~~~~E 0;: THISð'-:fc~~:=)Ï1dë~di/17--'fijj)e~TtI;:;-Ctm~qe REFER TO INSTRUCTIONS FOR PROPER CODES of I "---~'--_._----_.--._-_._--,---_.._--------_.__.,,-~..._~.----.'..-.-.--..-----,--..-.---.-----.--.-----.__._._.__.____.___..____..._._ .·_..______.___.~.._._..._"_...."M..."_...._._._..~__'"__~.__,__..........."...._..._...... 1 Trans Code 2 rype Code 3 Max Amt 4 Average Amt 5 Annudl Est 6 Measure Units 1 Cant Type 8 9 Cant Cant Press 1 emp 10 ì 1 Use . % by Code Wt 1 ( Names of Mixture/Components See instructions ~;¡¡;;:- '1- '-Y''ø1 e r ---, L - -' Immediate Hea 1 th ~ Fire , .. . .. ;e ··2~f''1 _ ___.ØX~1j- n. n __.____.u,.... _ ._.. _..___._, __,_ __ _ .,. _.._ ,.___. ____ r-" L_,J Delayed Health -----....---.-------..--------.-....---. .--------------.---.-----......-.---. r- .-- -- ., ~ -~--J------]----~-¿j-----[---~~---[---~~-----l-;;~J---t?~]---~----[--~---]--~--- ----- ------------~~-----~-~----------~~----~-------------- -ìïä-I~:~~t~~--------[-- ;+,::;,;:;,; -::-ïeme~-- =------- ¡;--e ------- ------ L--&------lf-L---e.--L-/--------- Hea 1 th ·__·fJyL___iá_i2___,_________Lf:__..__..__7LL__j__~.__. __m__, -' -..- ~ Fi re C:= ~ Delayed Health C ,A ,S, Number ___~_~_~__~§._..~ .~___ ---- ___........_..mm___'..__..___,_____,_______,.._._.,.___.._ -. '..n"__.. ~ Reactivity [~ Sudden Release of Pressure 1 3) # Oa ys on Site ----- --....--.-----_________.._._._.___,__.___.__.___.__.__·-__.-0_"___.--.--..-..-.--..--." C~=J Reactivity ~ Sudden Release of Pressure r -- -,., 13) # Days j :J.I _.cl on Site ~-J ....--..- ----------------------..---.--------..---.-------..---...--.,.----....--.-... ---~--]--..----]--------------r--ï----¿)--r---~~~----]~--J---~šì-]--------------4i--J---~j--- ----- --------~-----;i-------------------------------------------- ,,- ]~~~i~¡~-"'-7,2-c-¡li~t2iJZi~~r¡-~v¡;J-~-s-~I~~-~~-~--~-~~--~ IØl ::::::::::~~:!k;;__'Þ;;Z;¡¿:::_::-:::-_:_: , 2-4 ~ :s <6 - <!if C_A,S, Number__________________________. r'----., 8IPA r -·--1 L - _1 Fire r-" L. _..1 Delayed Hea lth - fÆ ] ¡;; III D> o '" ~-~-~-Ðí~-~~-----~~--~---~--------~----------------------------------------------------,---- ----- -------------------------------------------------------------- ~ t E Y CON CTS II N~jd&j1---Eu~-iS-~l---.----------m-- l(¡¥éZ·I1£1!:..-,.----.,--..--,..----..---- ¿rH1-~!ñe-9Æ63 ~ ( . . ~ MAR 2 1989 "i~~U _t!!2{!.:¡UiLt(j!ltlJL__ !i,~(!JY; li:J.cLf---- ___ R~fi~-.zéí'L C7 ~ ~f)---~~-------------------------------------------------------------------------------------------------------------------------------------------------------- ~ Certification (Read and ..dgn atïer comp,leUng all sections) I certify under penalty of law that I have person?l)y exami~e~ and ?m familia~ with the informa~ion s~bmitted, in ~his and 81' ttached documents, and that based on my inquiry of those individuals l'esponsible for obtalnlng th.e 1ntormatlon, I belleve that the subm1t 1 rmaø.l . s true, a c rate, and complete, £Ld d-n &d~eL (}-7.l.JLl e...,r ------T-- ST- _ _ ______.. _____ ________nm_mnm_nm_.'__~-q(K-;g~. ~ämë ã~-otfíëiãT-fífTe of-'õwnër7õpërãtö~ð~~wnër7operätõrrš-äúthõrížëò-rëprësentatlve re uate Jlgneu r- .-..- '-1 L _.J React ivity ~ Sudden Release of Pressure 13) # Days on Site _____ _·_____________________·_____·.__·__.0__.__·_____.____._____..________.___ ; / '.o¡.\ .. ,.J. '.' Trans Code (Column 1) INVENTORY CODE SHEET "'Ii' . , A = Add This Item D = Delete This Item R = Revised Information Type Code (Column 2) P = Pure Material M = Mixture of Substances W - Waste (Must Also: Add Appropriate Waste Code from "Waste Code Sheet") Measure Units (Column 6) ·~---=~EÆS-=~Pounds ~~~~ TON Tons (2,000 lbs) GAL = Gallons BBL Barrels (42 gals) Ft3 = Cubic Feet CUR Curies Container Type (Column 7) 01. Underground Tank 02. Aboveground Tank 03. Fixed Pressurized Cylinders 04. Portable Pressured Cylinders 05. Insulated Tank (Includes Cryogenics) 06. Drums or Barrels - Metallic 07. Drums or Barrels - Non- Metallic 08. Carboy(s) 09. Glass Container(s) 10. Plastic Container(s) 11 . Box ( es ) 12. Bag(s) r3--:-'M'él:ãl~-ëontainers -(Not- D-rums) 14. In Machinery or Processing Equipment 15. Bin(s) 16. Unlined Sumps Container Pressure (Column 8) Ambient Pressure Greater Than Ambient Press 3 = Less than Ambient Press 1 ,.., £. Container Temperature (Column 9) 4 Ambient Temperature 5 = Grea~er than Ambient 6 Less than Ambient Temp but not Cryogenic ] = Cryogenic Condit1lÞs '., ~; '. ~. Use Codes (Column 1Ö) ). ";1 01. Additive 02. Adhesive ,_ ' 03. Aerosol/Inflat±on~ 04. Anesthetic: ,- ~ 05. Bactericide' 06. Blasting 07. Catalyst 08. Cleaning 09. Coolant/Antifreeze 10. Cooling 11. Drilling 12. Drying 13. Emulsifier/Demulsifier 14. Etching 15. Experimental/Analytical 16, Fabrication J:-7---;-,,- - Fer1:"i<1-j'ze-r'~~ -"!- - ~~c~ 18. Formulation/Manufacturing 19. Fuel 20. Fungicide 21. Grinding 22. Heating 23. Herbicide 24. Insecticide 25. Instructional 26. Lubricant 27. Medical Aid or Process 28. Neutralizer 29. Painting 30. Pesticide 31. Plating 32. Preservation 33. Refining 34. Sealer 35. Spraying 36. Sterilizer 37. Storage/In Storage 38. Stripper 39. Washing 40. Waste c=~~~Wãt'er=-f-reatmên:t 42. Welding Soldering 43. Well Injection or Service 44. Oil Treatment 45. Resale 46. Aircraft Systems 47. Battery/Electrolyte 48. Breathing Air 49. Drafting Aid 50. Finished Product 51. Fire Protection 52. Hydraulic Equipment 53. Road/Hwy Maintenance 54. Testing 55. Wholesale Chemicals 99. OTHER-Specify on anoth:r page e '~---:'.-:)~ .,-" ~ e e mrn©mnwrn¡m FR~ME 10 NUMBER 015-010-000096 JUL 2 01989 HIGH HAZARD RATING 0 KCP:D HMCU T BUSINESS NAME INDEPENDENT WHEEL & LOCATION 600 WIBLE RD '''II"~ () '\,01" IE: ¡¡:::;¡:: '~,.l::l[ IE:: ~~, J LAST CHANGE 08/09/88 BY ANNET COMM. CODE 015-004 COMM. BAKERSFIELD - 4 MAP PAGE 123 GRID 01A FACILITY UNITS 1 HAZARD RATING 0 RESPONSE SUMMARY AUTOMOTIVE CHASSIS REPAIR SHOP. OFTEN CONGESTED WITH CARS DUE TO RELATIVELY SMALL PARKING LOT THAT FRONTS WIBLE RD. - -, -- .-----~-~-::.- EMERGENCY CONTACTS A) ELDON FUSSEL - (805) 832-3537 OR (805) 831-9253 B) JUDY OICALLAGHAN - (805) 832-3537 OR (805) 832-2910 UTILITY SHUTOFFS A) GAS - FRONT OF BLDG 30FT N OF S END B) ELECTRICAL - FRONT OF BLDG 30FT N OF S END C) WATER - CENTER OF FRONT FLOWER BED D) SPECIAL - NONE E) LOCK BOX - NONE '....) .tt:::... .... Ir-,JI C:\I "11'" 1: F"::I[ 1(::: ,loI~h" ....11....::11:: ,(), 11"-.11 .r ".... PUBL1:C EVACUAT::II::ON LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION> -. ~ - -~--. ~~ - - " . -- ----- . -- PAGE 1 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 06/26/89 15:28 f\ ~ r~.1 ')-+. , / e e ~ BUSINESS NAME INDEPENDENT WHEEL & FRAME LOCATION 600 WIBLE RD ID NUMBER 015-010-000096 HIGH HAZARD RATING 0 ...."" ..:::.. - ADDITIONAL INFORMATION LAST CHANGE c:u II::> T" ::[ ar::Þ II'" ,~f~b. !I....... / / BY < NO INFORMATION RECORDED FOR THIS SECTION > " ! 4_ LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 03/18/88 BY ANNET 2A-SEC 5) MERCY HOSPITAl. 2215 TRUXTUN AVE BAKERSFIELD, CA (805-) 327-3371 - - - ~ -- ----+- -~ (V\e\(¡rlf)v" 1 a-\ ~;iO 34 "j"'h ßv..~-e~s,r;,e \,d 1--:\ Ð~ f>; +i:A.. t s+, -c ..e-+ e-A 1/~J/f) zo£ .3;}.ji r-/e¡&- PAGE 2 06/26/89 15:28 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 I, . / /' ,> - e / , BUSINESS NAME INDEPENDENT WHEEL & FRAME LOCATION 600 WIBLE RD ID NUMBER 015-010-000096 HIGH HAZARD RATING 0 !E;i; ,'. T ""'" 11::::::]i:: 1[:11 IE:;: !r"." -'II"" ~::;~i, LAST CHANGE / / BY INCIDENT DATE SUMMARY 11:':ï; ,~ ]i:: "..,.11 ::::::::i, IF;:" IE IC:::: '"11"" ::11:: U::::::IIII""II :::;:;:i, LAST CHANGE 08/09/88 BY ANNET DATE SUMMARY 08/02/88 ANNUAL/OK ,,'- PAGE 3 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 06/26/89 15:28 ~ e e .r / " ,/ / BUSINESS NAME INDEPENDENT WHEEL & FRAME LOCATION 600 WIBLE RD FACILITY UNIT 01 ID NUMBER 015-010-000096 HIGH HAZARD RATING 0 A_ OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 09/07/88 BY ANNET ID TYPE NAME LOCATION CONTAINMENT 1 PURE OXYGEN PORTABLE CARTS PORTABLE PRESSURIZED ID PERCENT COMPONENTS 2359.00 100.0 Oxygen, Compressed 2 PURE ACETYLENE PORTABLE CARTS PORTABLE PRESSURIZED 10 PERCENT COMPONENTS 1241.00 100.0 Acetylene 3 PURE C02 (CARBON DIOXIDE) PORTABLE CARTS PORTABLE PRESSURIZED 10 PERCENT COMPONENTS 1251.00 100.0 Carbon Dioxide MAX AMT UNIT HAZARD USE 300 FT3 HIGH WELDING SOLDERING HAZARD LISTS LOW 260 FT3 EXTREME WELDING SOLDERING HAZARD LISTS HIGH 275 FT3 LOW WELDING SOLDERING HAZARD LISTS NONE B_ FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 09/07/88 BY ANNET 3A-SEC 4,5) FIRE EXTINGUISHERS. WATER SUPPLY LOCATED AT CRNR OF BELLE TERRACE AND WIBLE RD. PAGE 4 06/26/89 15:28 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ./ 4' //"...,.." '" e e ".4" ~ BUSINESS NAME INDEPENDENT WHEEL « FRAME LOCATION 600 WIBLE RD 10 NUMBER 015-010-000096 HIGH HAZARD RATING 0 C_ SPECIAL HAZARDS LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > D_ EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 03/18/88 BY ANNET 3A-SEC 2) BY WORD OF MOUTH - LET EMPLOYEES KNOW TO LEAVE OUT OF THE NEAREST APPROPRIATE EXIT. PAGE 5 06/26/89 15:28 MATERIAL SAFETY DATA SYSTEMS, INC. (80~) 648-6800 -// :. Ii ,..,.?/ //" e e ~/-'"" 1 BUSINESS NAME INDEPENDENT WHEEL & FRAME LOCATION 600 WIBLE RD 1D NUMBER 015-010-000096 HIGH HAZARD RATING 0 E_ MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 03/18/88 BY ANNET 3A-SEC 1) ROUTINELY CHECK VALVES AND REGULATORS FOR PROPER FUNCTION. PAGE 6 06/26/89 15:28 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 ,'" /- /' ../-; HAZaRDOUS MATER:i:ALS~UREAU . . INSPECTION PO~ ID . q~ DATE ~ / L / ~~ ANNUAL INSPECTION ~EXEMPTION ___ RE-INSPECTION __ COMPLAINT__ ALL ITEMS OK:[~] VIOLATIONS NOTED: [ ] INSPECTION SUMMARY: o - Does not Apply 1 - In Compliance 2 - Correction Needed 3 - Verbally Warned 4 - N.O.V 5 - Citation 6 - R~ferred to (Specify) EMERGENCY PROCEDURES (CCR TITLE 19-2729 & 31) PREVENTION & CLEANUP PROCEDURES (CCR TITLE 19-2731 A. Agency Notification Plan (O.E.S., PD) + 8. Employee Notification & Evac. Plan C. Emergency Responder Notification -y- D. Medical Assistance ~ E. Private Response Team Procedures ~ TRAINING REQUIREMENTS (CCR TITLE 19-2732) P. Training Records G. MSDS Available to Employees H. Employees Familiar with MSDS I. Use of Personal Protective Equipment J. Waste Material Permits & License K. Employees familiar with evacuation plan. e? T " --L o ( Comments: -ALL A(<':G.A$ - 0 /<. L. Work Area Safety M. Clean-up Materials placement/availability N. Clean-up Equipment o. Pire Protection Systems P. Waste Handling & Storage Q. Availability of Protective Equipment I II ..L ...L ± -L INY. & DIAGRAM VERIPICATION (CCR TITLE 19-2729) R. Inventory Quantities S. Storage, Container Cond., & Labeling T. Location in Pacility Unit U. Emergency Water Supply V. Evacuation Plan & Area W. Surrounding Exposures X. Utility Shut-offs . Y. Other -L -+ ± + Clearance Granted [ ~ ] / / Re-inspection Required [ ¡;;, ~K co.p.leted~: 3~ , J4-'ÍhdAr ' I spector on_/ / D.E. Total Time_:-'.Q. Miles on Insp . p~ ~. 1J'0 °ør/Manager ./ . ... e e -; KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD, CA 93308 ID#_ _Cf..k _ ~ ,NDEv&lDArJ'I W/-1éL- <t BUSINESS NAME ~-e INSPECTOR QUESTIONNAIRE BUSINESS PLAN AS A WHOLE FOR USE WITH THOSE BUSINESSES COMPLETING A BUSINESS PLAN (2A). INSTRUCTIONS: 1. Complete this form only once for each occupancy. 2. Attach this form to BUSINESS PLAN (2A) and forward to Data Entry. BUSINESS PLAN VERIFIED ON: Q' / "2- / <2í:( SECTION 1: RESPONSE SUMMARY (Limit to 4-5 lines) A.tJí0r-1()-r1 ¡)~ ~~Assl$ í2--ePA rÇ<.. s.-H:c>p. Of"«E;N CDN&Z=Çít:=D vJ ,1')-{ c.A«..$ DuE: ~ f2-e:'l..A 1"\ J é'- ~ ..... R..D - Y"rWrJT'S WIßL.l:' s{VIþ(...1-. ?ARt'N~ lßl lI~r ~ SECTION 2: NOTIFICATION / EVACUATION OF AFFECTED PUBLIC (Limit to 13 lines) " HMCU-:Q rr » e e t ç: KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD. CA 93308 NAME rD. _ _ ~~ ~_ INSPECTOR'S QUESTIONNAIRE SINGLE FACILITY UNIT FOR USE WITH THOSE BUSINESSES COMPLETING A BUSINESS PLAN FORM (2A) THAT REQUIRES A BREAKDOWN INTO FACILITY UNITS (FORM 3A). INSTRUCTIONS: 1. Complete this form for each FACILITY UNIT. 2. Attach this form to BUSINESS PLAN 3A and forward to Data Entry. BUSINESS PLAN VERIFIED ON:~/~ / ~~ FACILITY UNIT #: FACILITY UNIT NAME: SECTION 1: SPECIAL HAZARDS ASSOCIATED WITH THIS UNIT ONLY ____ rJ cn-Je HMCU-7 '; 8Y , , ~ KERN COUNTY FIRE DEPARTMENT .5642 VICTOR STREET BAKERSFIELD. CA 93308 (805) 861-2761 -~ 00 II C œ .0 w œ (ID . JUN 30W/ KCFD HMCU / Vi I OFFICIAL USE ONLY TNDF.PF.NnF.NT WHF.F.T ~ F.RAMF. BUSINESS ~AME ID# 000096 . HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A c)3-o\ ?r c·' \ . r!-- Q_? o 0 . n291987 RECEIVED MAR 5 fQqf Ans'd.. .""........ ._.---~-----'- ---..-. - INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3, Answer the questions below for the business 4, Be as brief and concise as possible. as a whole. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUS I NESS NAME: \ V\ à ~ E:...r'\ r\ f'_¥\ t Lù '(\ of e\ d. ç:.X"D-XY'a e- B. LOCATION / STREET ADDRESS: to on W \ D \e..... ~ 10M CITY: lS(\~-PÁt:J~\'f'1rl ZIP: 0¡330Q BUS.PHONE: (ßo..!5) ~3~- 3531 SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or ~hreatened 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 I~r CA5È OF EMERGENCY: ' - -- NAME AND TITLE 'r:--, _. - - .\ DURING BUS 0 HRs. A. f\Ó ((') (") - ~~S'é:..;_ Ph# ~ 6;). (~5~'lPh# B Lh~rh_\D' C--u \ (,\ r~h"-f\ ~h' R2d ,:3~ ~'L--Ph' AFTER _ BUS. HR.S. ~?)\.. Q~,~~. "6 ~ð - d-CìW) SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. .NATo GAS/PROPANE:~()\"\t, Ð-\2 \XÅ~l;hnr~'- 30 frob n.(")('-\h ~ 'ÔOut\ì..Qs\Ó B, ELECTRICAL: 5o...~ 'I" C. WATER: t.Æ' í\-\ P S 0 ~(' 0 ý\-\ .Ç? l 0 I weJf 'c e d Do SPECIAL: Y\-Û'f\~. .,. E. LOCK BOX: YES /~ IF YES, LOCATION: "- IF YES, DOSS IT CO~TAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO -Over- HMCU-4 ..----._~- . dj\~ W a'\J ::» mw .. --~-~,=~~-- - '(81 0 ~ ~Ht~' ' SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE U:ÞMHQli»$ " W [0\-£-(, / ~\Ç e.- ClÙ &A \ ó-b \ L Ú~òLt!JO \\Þ US, 0 e :sS ee ':-~:,l~, ' ~, , -~=---~~~,:"",,-.,..\;- ~o ~'. .... e-)(-\ t n~6h ff6 J .ç\(~\1 (lul k,1 ~~'\- €- SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE . '::T\1l\À'¥\¡~\7--¿ e-""".ij"~e-ý\~ m-ed"C~~_::'~--.-_ ~¿~~~W-b~~~~-:-r\Õis p:t-;:.r-'--~ :,; ¡( '~ - .,J :" , " ".""" , . ,¡/:~<{ ::;:' ~,\.:. .. SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . . . . . ; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ; .. ,.@$ NO B. PROCEDURES FOR COORDINATING ACTIVITIES I WITH RESPONSE AGENCIES:...... . . . . . . . . . . . . . . . . . . . .1 C. PROPER USE OF SAFETY EQUIPMENT:. ................. '~D-;--·E-ME-RGENGY~EVAeUAT1"ON=PROCEDURES: . . . .:. ;-: .~. ;~-:--..:- . ,,-..,;= -, E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:....... ES INITIAL REFRESHER t9 NO NO NO NO ð19 ~ :g ~~O--' YE'S <rl@) -&1_';>'_ --~-=..,....:...:.:::.;~-- I; ¡¿\ ò..f\ '\\ Y-v.. 'S <st..-\ cerÚfy that the above information is accurate. I understand that this information will be used to fulfill my firm's 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. SJGNA;UR~ 4 TITLE O{i J '(\é')( DATE \n - d. {n ~~~ HMCU-4 ., .¡t(~ '''',;,;.,. . ~ ',,", -"h ./' '>:¡ . '" - ...... j' "'jlf" e e KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD, CA 93308 , , OFFICIAL USE ONLY ID# ------- BUSINESS NAME: BUSINESS PLAN SINGLE FACIL~TY UNIT FORM 3A INSTRUCTIONS ~ 1, To avoid further action. 'this forni must be returned by: :JlJl 29 1987 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Ans~er the question~ below for THE FACILITY UNIT LISTED BELOW 4. ~e as BRIEF and CONCISE ~s possibl~. FACILITY UNIT# ' \ FACILITY UNIT NAME':J\'\r\~P.y\d.p/V\~ UJ--b£.£J A Ç"('(}.W) L SECTION 1: MITIGATION. PREVENTION. ABATEMENT PROCEDURES AJi--G. !/ ,KOU vu\ \ 1\ ~\ i-j. ,'VD'(" . Q f ð~iO U Œ-h e-~k ' Ù (L\ ù e..s ~ (\ Qj: ( 10(1 0-%\ d r t:~U \ oJ- 0 f6 SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY 'l\ ~J\ ~L í\ ~.[U <lS 'T- tXY~~\D~~~S (L~p r Op ,'[Ltb 1ü\e.(tv L eJl,J' i Ovt rhL . e HMCU-6 e . /~f ",-- -,,;' ~.., \; ,," SECTION 3: HAZARDOUS MATERIALS FOR TRISONIT ONLY A. Does this Facility Unit contain Hazardous Materials'?. . . .:@ NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the h'azardous materials a bona fide Trade Secret defined by Section 6254.7 of the Government Code?........ as L) YES c!y If No, complete a separate hazardous materialsinv~ntory form marked: NON-TRADE SECRETS ONLY (white form #4A-l) If Yes, complete a hazardous materials inventory form marked: fRADE;SËCRETS ONLY (yellow form #4A-2) in addition to the,non-trade 'sècrét fb~~. List only the trade secrets on form 4A-2. ~í('t ~,¡Jì(\qu~s'hQJ.5 IWlL1lf - 'n - -:--"'-Fl. _;L~~ -:r:..~~~ y/ . SECTION 4 :,PRIVATEFIRE ~PROTECTION - SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS _ t,LAI.ß1. ~ t r ~ \-uAc\ r (lJfLl Q.O r" if t~ b-eJ\~1cr(ac£.. ~ LðlDre.- 'QCJ~ SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT TRIS UNIT ONLY. A. NAT. GAS/PROPANE: Sr\fj,~-\. 0\ bu.,\d;\,,~ - - ~O' ~ee.-t r'U!)f fu- fI.!t-- D~SDLL~ -end B. ELECTRICAL: \ / ,I ~ _,_d__~,--WAIgR~__~,-=-,~ ~-,.-_,,_~__.,--,..,. __ _ _ __-~-,-- ~ _____ - ....-. .--~ ------,.~ t~\ ei Ðt tr~ ~\b~ ex but D. SPECIAL: \1\0 h~ E. LOCK BOX: YES / ~ 'IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs'? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO HMCU-6 e e, - 4__ I. D. , ' KERN COUNTY FIRE D,EPARTMENT" FÖRK~A-l _ NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY page_ of~ - i BUSINESS NAME :\ V\ð..f';ÇV<'\t1Pf"'\ wt\,f;e...,\ à YrCUYlf_OWNER NAME :E \ ~ 0(\ \LJ.~~ ADDRESS: \0 ~ ~ W \ \0* R D 6.n. . ADDRESS: ~l.\ ;l....\ 0Ðcd \.... FACILITY UNIT #: FACILITY UNIT NAME: 5c...~f" . Ii' ,¡ r CITY, ZIP: ~(}. ¥.\ ·If r ~..ç ,'e.., '\ r\ q ~3 0 4 CITY, ZIP': O""f'1.~.p.Â.~~Îr\rÅ ~ ,,~~ct '6~~.... ~ 62> '1 " ~~\ .q ~5 ~ ." IOFF ~~i~L CÒDE PHONE #: PH 0 N-E #: USE CFIRS '. . 1 2 3 4 5 6 7 8 9 10 TYPE MAX, ANNUAL CO~T USE LOCATION IN ·THIS %- :~Y HAZ'ARD D.O.T_ CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE (J 3ü() !PDO -B~ DL\ k\;:l (\' (") rt- é'. .Y'\ l é.. (In í\t~ ì DO - f) "'/. í 1/1 pn 2354 V If5 'I.. I (\ -Çt~ I r J J Ar;.£; p ~ loO lonn n4 J4J ~ùr1'(lh\p- ßAIf'1:"" . ' nL t....."'t ( ~ \ .p If'\ è.". I ~Y-l \.. IDO J , r .,n A. - \ CD..r~ j)ìo><\~ '-.. 17 .. '4)' ~'le; ;). 'l~h, ~" ð'd h\d . O{$): (\~(J, hi ~ M Me; IDD N Fi...lc¡. I I 2...-::» . -, -. -. -' _. '- -. - - - . '- .. : .' ,.-- ',' .. -' .,' . .. - - . . - , ..---- .. .. . , ~ '. ~ , >-.111 ~ !J NAME: f\A or-- . Fi Á~ ). TITLE: O( t ) ~ f"j>(' SIGNATURE: j7~ri; A.Å ðV D ATE : -k.:- dJ,.. - <61 .. ' .. -77 MIONE E G NCY C NTACT: - TITLE:._ # BUS HOURS: EM R E --",.".-:, o ~~DÎ\ Çu6Se..\ n\~)I:ì-f'j\ . c'ONTA C T. "~I I í rI ~ 0 'C)K)i~t~ .TH.L. .E' -~;'X'''X ~ð BUS I NE.~ SAÇ T I TY: ~ _~o .'_ : ~ \) r /" c..,~c. s_~ -' . r è~--:--__ ~ - - - - . - ,- - 4 - . . _ -. - _ - - .' - ""_._ -. ,EMERGENCY .fpR;,lNC I pAL AFTER BUS HRS: PHONE # BU,S HOURS: AFTER BUS HRS:· '3 '3 rl. ,3~?' '\ ~ _~ \-L1 d F;3 ""'8 3.;t ~ 2>.5.=3 1 .?:>a~- ~~ \0 o' _:... _" , .. . - . .. .. .. .. .' o -, "~~"" HMCU-9 .::... "," 01. Underground Tank 02. Aboveground Tank 03. Fixed Pressurized Tank 04. .Portable Pressurized Cylind~rs Oa. Insulated Tank (Includes Cryo~enics) 06. Drums 'or Barrels - Metallic 07. Drums or Barrels - Non-Metallic 08. Carboy(s) 09. Glass Container(s) 10. Plastic Container(s) 11. Box(es) 12. Bag(s) 13. Metal Containers (Not Drums) 14. In Machinery or processing equipment 15. Bin(s) 99, OTHER - Specify on separate sheet CONTAINER CODES fill' ~ CODES ,·:l >-.~ " .p Pure . M Mixtu~~s of pur~ substances W Wastes (AI~o add appropriate waste code) 'fF UNIT CODES LBS TON = GAL BBL Ft3 = CUR Pounds Tons (2.000 Gallons Barrels (42 Cubic Feet Curies lbs) galS ) - ~ -~.--. . USE-'CCODES~'--'=------ '=-~-,~,~,. '. '·'0 ~ ~-..,.,--~ -........,.. -~-:---- ----_..--'~,:: 01. Addi ti ve 02. Adhesive 03. Aerosol 04, Anesthetic 05. . Bactericide 06, Blasting 07. Catalyst 08. Cleaning 09. Coolant 10. Cooling 11. Drilling 12. Drying 13.' Emulsifier/Demulsifier 14. Etching 15. Experimental 16. Fabrication 17. Ferti lizer 18. Formulation 19. Fuel 20. Fungicide 21. Grinding 22. Heating HAZARD CODES EXPL - Explosive CMLQ - Combustible Liquid CMSL - Combustible Solid , ~'-' CRMT - Corrosive Material FLGS - Flammable Gas FLLQ - Flammable Liquid FLSI. - Fl ammab"le So lid NFLG Non-Flammable Gas OGFX - Organic Peroxide !p O~rJ - Oxidizer " cín'07~ . Cryogenics 23. Herbicide 24. Insecticide 25. Instructional 26. Lubricant 27. Medical Aid or Process ~8. Neutralizer, 29. Painting 30. Pesticide 31. Plating 32. Preservative 33. Refining 34. Sealer 35. .Spraying 36. Sterilizer 37. Storage 38. Stripper 39. Washing 40. Waste 41. Water Treatment 42. Welding Soldering . 43. .Well Injection 44; Oil Treatmeñt ' 99. OTHER-Specify on ORMA - Anesthetic, Irritant ORME - Hazardous Waste ORMS - Other regulated Material B.C,and D PSNA - Poison A.(Gas) PSNB - Poison B (Liquid or Solid) RADI - Radioactive WATR - Water Reactive ETIO Etiological Agent PYRO - Pyrophoric, Hypergolic or spontaneously combustible