HomeMy WebLinkAboutBUSINESS PLAN
Operil.te
to
it
Per
Waste Unified Permit
Materials/Hazardous
Hazardous
CONDITIONS OF PERMIT ON REVERSE SIDE
, .
h rmi i
It) Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
Permit ID #:: 015-000-001261
QUALITY DOOR INC
LOCATION: 4250 WIBLE RD
-
\_~
Approved by:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Date
Issue
Expiration Date:
Issued by:
Per it to Operate
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
~ ",:;;;,;,:¡:~;:m:';"",,::;,,~::; F:,,,,,,,,,,, This permit is ~ssued for the fOllowing:
, , ",' "~,,uazardous Matenals Plan
~I ;,¡~~;;¡~~:;;;~~,¡;¡ ~::~::~:;;¡1!;;;;;' ;;;:~:::::::'9:::~:.;,,,,,;,..
PERMIT ID# 015-021 ~01261 ::::':::¡"::"::':;'.:;;:!¡"~;;;"¡,,~:ii!!,!~;!"~ ."'" ,r~~;::~~~~~:;:a~zardous Materials
QUALITY DOOR INC '''''''';:/·''GJ ',., Waste
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LOCATION 4250 WIBLE " 'h,';;'"
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Issued by:
:.----
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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SITE/FACILITY
FORM .5
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D I L~G RÞ..M #- ) 1 b I
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NORTH SCALE: BUS INESS NAME: FLOOR: ()f
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(CHECK ONE) SITE DIAGRAM FACILI7\" JIAGRAM Ý
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CITY OF BAKERSFIEI,D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301
FACILITY NAME Q,-",-\.<\-~ ~,
ADDRESS ~~c:;c:::. ~(.'-\~ ~
FACILITY CONTACT_
INSPECTION TIME
INSPECTION DATE \~ \.~\o~
PHONE NO. <iS~4- '--\ ~'-\~. "
BUSINESS ID NO. 15-210- 6òl..\ L. \
NUMBER OF EMPLOYEES '
Section 1:
Business Plan and Inventory Program
o Routine
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
" OPERA TION C V COMMENTS
AP~riate pennit on hand ~. ..C- 'u... -.:-......e-.. ,"'~ _r-
Busines~ contact infonnation accurate .-..L ~ \.... - e-.. \. -_.' J ':;.r--.
...
Visible address ~ -
Correct occupancy ~
Verification of inventory mat~
Verification of quantities ~
Verification 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 "
Site Diagram Adequate & On Hand '"
C=Compl iance V=Violation ~
. ?
Any hazardous waste on site. .
Explain:
DYes DNo
Questions regarding this inspection? Please call us at (661) 326-3979
Business Site Responsible Party
White - Enll, SIICS,
YeHow . Station Copy
Pink - Business Copy
Inspector:
1fl.
\
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~
Dear Business Owner:
This notice is meant to act as a reminder that the California Health and Safety
Code, Chapter 6.95, requires any handler of hazardous materials to revise their
materials business plan within 30 days of anyone of the following events:
1. A 10 per cent or more increase in the quantity of a previously-
disclosed material.
2. Any handling of a previously-undisclosed hazardous material,
subject to the inventory requirements of Chapter 6.95.
3. Change in business ownership.
4. Change in business address.
5. Change of business name.
I have enclosed a copy of your Business Plan. Please review and make any
changes. Whether there are changes or not I need you to sign in the designated
area and return. If you have any questions regarding these required revisions,
please call the Hazardous Materials Division
at (661) 326-3979.
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Sincerely yours,
4~~"
Ralph E. Huey
Director, Office of Environmental Services
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QUALITY DOOR INC
SiteID: 015-021-001261
Manager :
Location: 4250 WIBLE RD
City BAKERSFIELD
BusPhone:
Map : 123
Grid: 13C
(661) 834-4844
CommHaz : Moderate
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 07
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / ' Title Emergency Contact / Title
VIRGIL BEARD / PRESIDENT TIM BEARD / VICE PRESIDENT
Business Phone: (661) 834-4844x Business Phone: (661) 834-4844x
24-Hour Phone : (661) 832-0298x 24-Hour Phone : (66l) 397-7985x
Pager Phone : (661) 328-2823x Pager Phone : ( ) - x,
Hazmat Hazards:
Contact : Phone: (661) 834 -4844x
MailAddr: 4250 WIBLE RD State: CA
City : BAKERSFIELD Zip : 93313
Owner VIRGIL BEARD Phone: (661) 834-4844x
Address : 4000 HARRIS RD State: CA
City : BAKERSFIELD Zip : 93313
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
f= Hazmat Inventory
f== Alphabetical Order
One Unified List 9
All Materials at Site 9
Hazmat Common Name...
SpecHaz EPA Hazards
DailyMax
MCP
PROPANE FUEL
E
G
500.00 GAL Hi
I,
(Type or print name)
Do hereby certify that ¡ have
reviewed the attached hazardous materials manage-
ment plan for
(Nam~ of Busin3SS}
and that it along with
any corrections constitute a complete and correct man-
agement plan for my facility.
Signature
It
-1-
04/23/2002
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F QUALITY DOOR INC
f= Inventory Item 0001
F= COMMON NAME / CHEMICAL NAME
PROPANE FUEL
SiteID: 015-021-001261 ;
Facility Unit: Fixed Containers on Site;
Days On Site
365
Location within this Facility Unit
OUTSIDE BLDG
Map:
Grid:
CAS #
STATE - TYPE
Gas Pure
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
FIXED PRESS. CYLINDER
Largest Container
500.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
500.00 GAL
Daily Average
500.00 GAL
%Wt. ]
lOO.OO Propane
HAZARDOUS COMPONENTS
G;]
CAS#
749861
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Hi
HAZARD ASSESSMENTS
-2-
04/23/2002
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F QUALITY DOOR INC
I
f= Notif./Evacuation/Medical
~ Agency Notification
CALL 9l1.
SiteID: 015-021-001261 ì
Fast Format ì
Overall Site ì
10/20/2000 1
10/20/2000
Public Notif./Evacuation
10/20/2000
Employee Notif./Evacuation
NO EVACUATION PROCEDURES.
NONE LISTED.
Emergency Medical Plan
10/20/2000
WHITE LANE MEDICAL CENTER, 540l WHITE LANE, 832-2000.
-3-
04/23/2002
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F QUALITY DOOR INC
I
f= Mitigation/Prevent/Abatemt
Release Prevention
SiteID: 015-021-001261 9
Fast Format 9
Overall Site 9
lO/20/2000
THE LARGEST AMOUNT OF CONTACT CEMENT IN THE BLDG IS 1 QUART. WE DO NOT
BUILD CABINETS ANYMORE.
Release Containment
[
I
I
Clean Up
Other Resource Activation
-4-
04/23/2002
"
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F QUALITY DOOR INC
I
p= Site Emergency Factors
[ Special Hazards
Utility Shut-Offs
SiteID: 015-021-00l261 ì
Fast Format 9
Overall Site 9
I
10/20/2000
A) GAS - SW CORNER OF BLDG
B) ELECTRICAL - INSIDE BLDG W END NEXT
C) WATER - FRONT & CENTER OF BLDG
D) SPECIAL - NONE
E) LOCK BOX - NO
TO OFFICE
Fire Protec./Avail. Water
10/20/2000
PRIVTE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM, FIRE EXTINGUISHERS,
SONITOL SECURITY SYSTEM.
FIRE HYDRANT - S OF BLDG.
Building Occupancy Level
-5-
04/23/2002
·'
. .
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F QUALITY DOOR INC
I
F Training
Employee Training
SiteID: 015-021-001261 ï
Fast Format ï
Overall Site ï
10/20/2000
WE HAVE 2 EMPLOYEES AT THIS FACILITY.
DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE????????????
GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM?????????????????
Page 2
[
I
I
Held for Future Use
Held for Future Use
-6-
04/23/2002
-
STATEMENT OF ACCOUNT 4IÞ
PAGE
1
CITY OF BAKERSFIELD
POBOX 2057
BAKERSFIELD, CA 93303-2057
DATE
DATE: 6/01/02
TO: QUALITY DOOR
4250 WIBLE R
BAKERSFI
CUSTOl'iER NO:
E: ESi
3358
TOTAL AMOUNT
-..-..---- -.....------
------...---..-----
5/01/02
674. 50
c"' ,,~., _). ~__ ~ -, ,~. _ .n,' " .,P"_ _ __, :\()J ,1 ,'I
THIS IS ¡I;N ANNtJÄ'í.:;,,'B1t:.LING,cFÖ'RF/IsCAL VR 200i-'2002.
'," ,0 /' .';' ,'/, , i ( 1', ".'j ,.'"
IF YOU HAVE ALREAriYP'fS.lDi/pLEASE CALL 326,-3642,
-------------- -~------------- -------------- --------------
CURRENT OVER 30 OVER 60 OVER 90
--------------- -~------------ --------------- --------------
674. 50
DUE DATE: 7/01/02
P A ,{I"IENT DUE:
TOT AL DUE:
674. 50
$674. 50
6/01/02
CUSTOMeR NO:
nUl; DATE: //01
:335e
GUA!... I ·rv DOOR
CUSTOMER TVP!:ESI
DETACH AND SEND THiS CCPYWITHR.EMITTANCE
33"e
R.E!'-1IT AND !'-1 A IKE CHEC~, PAYABLE TO:
CITY 8AKERSFIELD
PO ,BOX 2057
BAKERSFIELD CA 93803-2057
(661)326-3642
TOTAL DUE:
$674. 50
e
STATEMENT OF ACCOUNT ~
PAGE
1
CITY OF BAKERSFIELD
POBOX 2057
BAKERSFIELD, CA 93303-2057
TO: QUALITV DOOR A;
4250 WIBLE ROAD,,'"
-...------- -.~""',
HA~~K~~l~LD. C~;933i3
ì l'
,\ 1/
:-~'~-~-':_«'--- '~..,/ ~ ~~-/':-:'''.). -.,,...,-,-,;';';
(:6'61: )'/j2b:':'3642}
h ~-~' i -:' l- ~_'__ f /""i~ ,~,:;., '- ~,,:: '~"">«;~,:<-.4. x
DATE:
5/01/02
CU5TOi-U::R NO:
CUSTOMER''fYPE: ESi
3358
-----------------~..,;;..~---..;:;.-......~'--~~----~~~'~;.-~+-~:.....'-----------~,-,-...._--'-~~----------------
----~:~= :~~:~~ji~~~~~=;;h;~~~~ÆL!ii~q4~fl~!l~~ ~~:~~:~!
TOTA'LAMOom
. ~
. -....-..-
\.::tMt..'.::P:....
------
--------------
4/01/02
674. 50
FOR GUESTIONS,'OR"·.CHANGES,TO;¡YöUR,, ACCOUNT PLEASE
f ,{'./ ... _,/ _ ,_ _~- ,':' " _" " " > " ; ", ~
CALL THE NUMBER 'AT THE'/T.Oe..,þFc/-THIS STATEMENT.
-------------- -------------- -------------- --------------
CURRENT OVER 30 OVER 60 OVER 90
-------------- -------------- -------------- --------------
236. 00
438. 50
DUE DATE:
- ....,- ."'-
:.J/w.':'/t."=.:
PAYMENT DUE:
TOTAL DUE:
674. 50
$674. 50
;-
'7
-
-
Manager
Location: 4250 WIBLE RD
City BAKERSFIELD
(It> -S><!>q,~t< :
~I~Þ I / /~b
'v'Þ¡þ ~"(7?
( '!OJ¿ <"V'V'fl
\/ 'v. & "
~~t-J
CommCode: BAKERSFIELD STATION 07 7C~8
EPA Numb:
SiteID: 015-021-001261
QUALITY DOOR INC
BusPhone:
Map : 123
Grid: 13C
(805) 834-4844
CommHaz : Moderate
FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / Title
VIRGIL BEARD ",,'; PRESIDENT
Business Phone: (~) 834-4844x
24-Hour Phone ~) 832-0298x
Pager Phone ('foI ) 328 -2Rz.3 x
Emergency Contact
TIM BEARD
Business Phone:
24-Hour Phone
Pager Phone
/ Title
/ VICE PRESIDENT
(805) 834-4844x
(805) 397-7985x
() x
Hazmat Hazards:
Owner
Address
City
VIRGIL BEARD
4000 HARRIS RD
BAKERSFIELD
Phone: (
State: CA
Zip 93313
Phone: (t-ç.¡) 13'L- -(9.2.9-.px
State: CA
Zip 93313
x
Contact :
MailAddr: 4250 WIBLE RD
City BAKERSFIELD
Period
Preparer:
Certif'd:
to
TotalASTs: =
TotalUSTs: =
RSs: No
Gal
Gal
/lJo
C/J
(
Emergency
p= Hazmat Inventory
p== As Designated Order
One Unified List ì
All Materials at Site ì
Hazmat Common Name...
SpecHaz EPA Hazards
DailyMax
MCP
PROPANE FUEL
500.00 GAL Hi
I ..tAD ,/ f?t-=/J¡2;/J Do hereby certify that I have
, ~TYpe or print name)
reviewed the attached hazardous materials manage-
ment Plan for CJv/J~'7Y ð~O'...... .T",,<:and that it along with
.... (Name of Business)
any corrections constitute a complete a.nd correct man-
agement plan for rAY facility.
...;.,'
z}~<dt~
/~~oø
te
10/12/2000
,.
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F QUALITY DOOR INC
f= Inventory Item 0001
= COMMON NAME / CHEMICAL NAME
PROPANE FUEL
SiteID: 015-021-001261 l
Facility Unit: Fixed Containers on Site l
Days On Site
Location within this Facility Unit
OUTSIDE BLDG
Map:
Grid:
CAS #
r STATE T p~;~E I PRESSURE I TEMPERATURE -,
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum
GAL 500.00 GAL
CONTAINER TYPE
FIXED PRESS. CYLINDER
Daily Average
GAL
HAZARDOUS COMPONENTS
~
CAS #
749861
I l~~~òolpropane
HAZARD A ESSMENT
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Hi
SS S
-2- 10/12/2000
-;
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F QUALITY DOOR INC
I
p= Notif./Evacuation/Medical
r=: Agency Notification
LL 911
SiteID:
015-021-001261 ì
Fast Format ì
Overall Site ì
01/07/1990 1
1
01/07/1990
r=::NO Employee Notif./Evacuation
~ EVACUATION PROCEDURES
I Public Notif./Evacuation
· NONE LISTED
Emergency Medical Plan
01/07/1990 ]
01/07/1990
WHITE LANE MEDICAL CENTER, 5401 WHITE LANE, 832-2000
-3-
10/12/2000
e
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SiteID: 015-021-001261 ì
Fast Format ì
Overall Site =¡
01/07/1990
F QUALITY DOOR INC
I
f= Mitigation/Prevent/Abatemt
Release Prevention
THE LARGEST AMOUNT OF CONTACT CEMENT IN THE BUILDING IS 1 QUART. ·'I'II- ~
eALLôN DJttIM Tß LOŒ~TRn ()TJT~TnE 'T'J..:r:¡¡: ~YI1.J;)ING-. Wb~ ()c:J ¡(/0r L? ,// "'~
'õ)(.h'/oI C4~/~vt::-;r 4N'y~O~
Release Containment
r
I
I
Clean Up
Other Resource Activation
-4-
10/12/2000
..
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F QUALITY DOOR INC
I
p= Site Emergency Factors
r== Special Hazards
Utility Shut-Offs
SiteID: 015-021-001261 ì
Fast Format ì
Overall Site ì
I
01/07/1990
A) GAS - SOUTHWEST CORNER OF BUILDING
B) ELECTRICAL - INSIDE BUILDING WEST END
C) WATER - FRONT & CENTER OF BUILDING.
D) SPECIAL - NONE
E) LOCK BOX - NO
NEXT TO OFFICE.
Fire protec./Avail. Water
01/07/1990
PRIVTE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM, FIRE EXTINGUISHERS,
SONITOL SECURITY SYSTEM
FIRE HYDRANT - SOUTH OF BUILDING
Building Occupancy Level
-5-
10/12/2000
1- -. r."~
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F QUALITY DOOR INC
I
F Training
Employee Training
2.
WE HAVE ~ EMPLOYEES AT THIS FACILITY
SiteID: 015-021-001261 ì
Fast Format ì
Overall Site =¡
01/07/1990
DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE?
BRIEF SUMMARY OF TRAINING:
Page 2
[
I
I
Held for Future Use
Held for Future Use
-6-
10/12/2000
.,.
;.
(Ù
CITY OF BAKERSFIELD FIRE DEPARTMENT I¡~C~/t'.
OFFICE OF ENVIRONMENTAL SERVICES OD! 0 ~/)
UNIFIED PROGRAM INSPECTION CHECKLI~'v", 9 ¡Oa
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 ,'9n,,,, ~ , 'IJ
~.9~
V~S
INSPECTION DATE /0- L¡ -66
PHONE NO. ~ 3~ - Lf?i-IJ 4-
BUSINESS ID NO. 15-210- I?.. (Ç I
NUMBER OF EMPLOYEES
e,
Seer 1:
¡ri'Routine
Business Plan and Inventory Program
D Combined
D Joint Agency
D Multi-Agency
D Complaint
D Re-inspection
OPERA nON
C v
COMMENTS
Appropriate penn it on hand
Business plan contact infonnation accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification 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
Site Diagram Adequate & On Hand
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
DYes
~
White - Env, Svcs,
Yellow - Station Copy
Pink - Business Copy
~i~re~~
Inspector: ß. ~~
Questions regarding this inspection? Please call us at (661) 326-3979
-.
\~. ' I
CUST Me & NO. e:s - 3s<::8
, - I
,
MISCELLANEOUS RECEIVABLES ADJUSTMENT
DATE3 - I ~ -crt
NEW ACCOUNT !
ADDRESS CHANGS
CLOSE ACCT J
: FINANCE CHARGE
, OTHER ADJ I
CUSTOMER NAME GULLI: +--y 000 r
MAILING ADDRESS 4~q) t0~ h\e ~
CITY ßJ(~{~~·Î c-.(rt STATE r~,
ZIP CODE q~31~
I SITE ADDRESS
PARCEL NUMBER
(lFAPPUCA8LE)
ADJUSTMENT
\,
A~;S:b~ ~b ~l.Ìrc-ba~~ doJ\,^'v~
APPROVED BY ~
--
'.\
~'.
ì)
of
MATERIAL INVENTORY
NON-TRA SECRETS
BAKERSFIELD
S
CITY
HAZARDO
o
US
I
of
-1--
-----
Page
NAME OF THIS FACILITY'
STANDARD IND. CLASS CÒOF~
DUN AND BRADSTREET NUMBER
- -
- - - -
DE
OWNER NAME
ADDRESS'
~IT~Ë ~~P:
R'l''lER TO~N5TRUCTIONS rUt( ~ROPER
BUS! ness
Standard
o
ture
Agticu
BUSINESS NAME
~9f¢TlO~~
PHONË ~:
and
Farm
tl
~ixture/çc~conen~,
Instructlcns~
13
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eertif içatio~ (Reed and $ i gn a fjßr cÇ)mp 7 e t 7f1g (37 7 sect ions)
I certIfy under enall 0 la th t I have pe(sona 1~ exam]n Q 0 d III familIar it the informatIon
attaçhed dQCUllen~s, an~ t at ~ase~ on IIY InquIry Q lhose Inålvl~ua's responsib1e ~or obtaIning the
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EMERGENCY CONTACTS
f-;)-'ì I
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City of Bakersfiera
, . Fi.~e ~_ep~Dlent
2101 uHI street
Bakersfield, CA 93301
f.
Fax Phone No. (805) 395-1349
Officê (805) 326-3941
Date:~ ,19C}'
PLEASE ROUTE AS SOON AS POSSIBLE TO:
Name: m ( . T: CY\ ~CL('è
companY/Organization:~_uc&:~ door
Fax No. Sending Message to: £3 ~<-f -olllo
---------------------------------------
FROM:
Name: \SA~J\ ~ - bAú-rs/~e-\C ~re'
Contact Person: .~doo.sf(b..TUì~ ~v~:\'C9'ì
Numberof Pages (including cover sheet): 3
Description of Materials Sent: UFG bon cae· '3.0\ C~)~)()
, TX'\~~ ù~i:ë ~f(~
Special Instructions: fuo..b.t ,(t.-.\-J(N '-\t'\,~~----r(M- S~~.
~~ k~, \~.f\I\~ Nh~ ~(' ~K. ~ro-\:rl~l9A
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8AKERSFIELD CITY
FIRE DEPARTMENT
BARBARA BRENNER
HAZARDOUS
PLANNING MATERIAL
TECHNICIAN
1
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f
1
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326-3979
2130 "G" STREET
aAKERSFIELD. CA 93301
1
,
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--
UNIFORM FIRE CODE
80.301-80.302
that, will relieve excessive internal pressure. Such relief devices shall vent to an
approved location or to an exhaust scrubber or treatment system when specified in
Sections 80.302 through 80.315.
(u)Mànuai Aiarm. A local fire alarm manual pull~tatÏQ!1Q!...approved emer-
. ency si nal dev' c~LbëJñstaUedoÜtŠì(íe of eaCh interior exit door ofštorage
bUl mgs, rooms or areas. Activation of the manual alarm shall sound a local
alarm.
:~:::: (v) Supervision. When manual alarm. emergency signal. detection or auto-
matic fire-extinguishing systems are required in Sections 80.302 through 80,315.
. _ such systems shall be supervised bY an approved central. proprietary or remote
~ . +'!'> ,,"i?n "",i" 0' ,h.1I inili... on .ndihle.nd ,i,uoI ,i,..I.t. ,..,"ntly .ltonded
DC, ~~- Ite location.
~ ~ . (w rotection from Vehides. Guard posts or other means shall be provided to
ª pro ect exterior storage tanks from vehicular damage. When guard posts are
~ installed. the posts shall be:
~ 1. Constructed of steel not less than 4 inches in diameter and concrete filled.
~ 2. Spaced not more than 4 feet between posts on center.
ª 3. Set not less than 3 feet deep in a concrete footing of not less than IS-inch
~ diameter.
~ 4. Set with the top of the posts not less than 3 feet above ground: and
ª'-111 ~ocated not less than 5 fed from the tank.
i 'I" ~Iearance from Combustibles. The ~rea surrou~ding an exterio,r storage
ª area or tank shall be kept clear of combustible matenals and vegetation for a
~ minimum distance of 30 feet.
~ (y) Fire Access Roadways and Water Supply. Fire access roadways and
~ approved wàter supplies shall be provided for exterior storage areas in accordance
ª with the following:
:
~ 1. Fire access roadways. Fire apparatus access roadways shall be provided to
ª .' within 150 feet of all portions of an exterior storage area. Such access
~ roadways shall comply with t~e provisions of Section 10.107.
ª 2. Water supply. An approved water supply shall be provided. Fire hydrants or
~ other approved means capable of supplying the required fire flow shall be
ª provided to within 150 feet of all portions of an exterior storage area. The
~ water supply and fire hydrants shall comply with the provisions of Section
ª 10.301,
~ (z) Noncombustible Floor. Except for surfacing, floors of storage areas shall
~ _be of noncombustible construction.
V':'c-~ ~aa) Professional Engineer. The chief may require design submittals to bear
\. . :::,::::: ::::~:t:::n:::œ
Sec. 80.302. Storage of explosives and blasting agents shall be in accordance
330
'1:,
'~
e
e
CITY of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT
D, S, NEEDHAM
FIRE CHIEF
2101 H STREET
DECEi'lBERI, 1990 BAKERSFIELD,93301
, 326-3911
DEAR f"IR. BEARD,
NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE
-----------------------------------------------
-----------------------------------------------
IN THE INSPECTION OF YOUR BUSINESS QUALITY DOOR,
LOCATED AT 4250 WIBLE ROAD, BAKERSFIELD, CA 93313 ON
DECEMBER 7, 1990 THE FOLLOWING HAZARDOUS MATERIALS REGULATION
VIOLATIONS WERE IDENTIFIED:
1. Material safety data sheets must be obtained and made
available to all employees. Employees shall be informed of
their right to know about the properties and characteristics
of hazardous materials in their workplace. Written
documentation of hazardous materials training must be
maintained.
VIOLATION OF OSHA 1910.1200(G)
'-
....
(9) Material safety data sheets may be kept in
any form, including operating procedures, and may be
designed to cover groups of hazardous chemicals in a
work area where it may be more appropriate to address
the hazards of a process rather than individual
hazardous chemicals. However, the employer shall ensure
that in all cases the required information is provided
for each hazardous chemical, and is readily accessible
during each work shift to employees when they are in
their work area(s).
VIOLATION OF OSHA 1910.1200(H)
(2) Training. Employee training shall include at
least:
(i)Methods and observations that may be used
to detect the presence or release of a hazardous
chemical in the work area (such as monitoring
conducted by the employer, continuous monitoring
devices, visual appearance or odor of hazardous
chemicals when being released, etc.);
(ii)The physical and health hazards of the
chemicals in the work area;
~
~
e
e
(iii~The measures employees can take to
protect themselves from these hazards, including
specific procedures the employer has imp~emented to
protect employees from exposure to hazardous
chemicals, such as appropriate work practices.
emergency procedures, and personal protective
equipment to be used; and,
(iv)The details of the hazard communication
program developed by the employer, including an
explanation of the labeling system and the material
safety data sheet, and how employees can obtain and
use the appropriate hazard information.
2. All compressed gas cylinders must be securely chained to
the wall or otherwise protected from falling.
VIOLATION OF UFC 74.107
(a) General. All compressed gas cylinders in
service or in storage shall be adequately secured to
prevent falling or being knocked over.
3. The propane tank must be protected from vehicular
collision.
VIOLATION OF UFC 80.301
(e) Security. The storage of hazardous materials
shall be safeguarded with such protective facilities as
public safety requires.
The above violations must be corrected by January 7, 1990.
The department will schedule a re-inspection of your facility
to verify compliance. If you have any questions regarding
this notice, please contact Barbara Brenner at 326-3979.
Sincerely,
Barbara Brenner
Hazardous Materials Planning Technician
""
""" ..,. y
...... ~~~
'BakersfIeld FIre Dept.
Hazardous Materials Inspection
,;,/
Date Completed
!ô -- j /.:.. ? ò
~ Station No. 7 Shift L
L Verification of Inventory Materials
L Verification of Quantities
Verification of Location
,
Business Name: ð01fri 4 (JñO,.
Location: If ~ C;; Ô
Plan ID # 215-000 I ~ {¡; I (Top right comer Business Plan)
'.~'" ~ (, ¡ ,:''';
~\='\n'::,! '¡¡t \,."
or.T 1 ? 1990 .
.....- ".'\"f~, "i,~ ~,". L-'; ~~,,: .
t-t !:i / -.
Inspector
ß L-/~/ f2-
Adequate Inadequate
--- Proper Segregation of Material
ø 0
o ø
o ø
o 0
Comments: I {) ~¡W'\ ·~~,ehA.iÌi\¡~ / ~)(,dI\e ,h""b, ¡/le€(~') t~ki-t~~
Verification ofMSDS Availability 0 [Z]
Number of Employees 1 5'
Verification of Haz Mat Training
Comments: AJee-J e'" O~-e..r P^-pf'f(¡.lr")/"-'l.
Verification of Abatement Supplies & Procedures
o
~
¡a
o
Comments:
Emergency Procedures Posted
o
~
o
Containers Properly Labeled
[2J
Comments:
Verification of Facility Diagram
g
o
Special Hazards Associated with this Facility:
Violations: --I ~/'" ôle ~}r{;{",c.e, '6ß-L'("J Sf í ,'" b l-er'S
FD 1652 (Rev. 3-89)
White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
/
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Þ Lep ~ ffr11!7r5 {;¡)¡de -Iv /{c¡g Com"'- wi /'Y. 6tcvd.
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CITY of
OHAZARDOUS MATERIAL INVENTORY
NON-TRADE SECRETS
BAKERSFIELD
S
o
1___
Page
NAME OF THIS FACILITY'
STANDARD IND. CLASS CÒOF:-'-
DUN AND BRADSTREET NUHBER-
- -
OWNER NAME
ADDRES~'
~I6Y Íi1p:_--
R~F~~ tO~N5TRUCTIDNS~R-PROP£R
ness
Standard Bus
o
ture
cu
BUSINESS NAME
LOCA T ION,;'
CITY ZIt'
PHON~ It:_
and Agt
Farm
14
~ixture{çcroonents
Instruc Ions
Hailes of
See
3
, by
wt
CODES
12
on Where
n FaCility
10
Cant
Temp
9
Cant
Press
h~e
I
on
6
Hea$ure
Units
~
5
Annua
Est
~
Average
Allt
3
Max
Allt
2
TYQe
Code
I
Tr~ns
Code
y
d.
3~
SDD
C.A.S. Humber
NUllber
Nunber
NUllber
C.A.S
C.A.S
C.A.S
NUle I
NUle I
COllponent
IImediate(OIlPonent .2
Health
COllponent 13
o
rJîSudden Release
"fJ of Pressure
De layed
Health
o
Physical end Health Hatard
(Check all that apply)
o
Hazard
o
u
th..."t5!&
D
I
Reacti v i ty
re
NUllber
NUllber
NUllber
C.A.S
C,A.S
C.A.S
I
Nalle
Halle I
IlImediate COllponent .2
Health
Component 13
o
suddfn Release
o Pressure
o
C.A.S
Delayed
Health
o
ty
Physical eod Health Hafard
(Check all that apply
Reactiv
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Hazard
re
o
Number
NUllber
NUllber
C.A.S
C.A.S
C,A.S
Nalle
Halle
Nalle I
Component .
IlImediate COllponent .2
Health
COllponent 13
o
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o Pressure
Number
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C.A.S
o
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(Check all that apply
Reactivity
o
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o
NUllber
Hunber
NUllber
C.A.S
C.A.S
C.A.S
Nalle
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IImediate Component .2
Health
COllponent 13
o
Sudden Release
of Pressure
NUllber
o
Delayed
Health
C.A.S
o
vity
th Hafard
apply
React
o
Physical end Hea
I Check a II that
Hazard
re
o
nl{fTñ~
~~-:; r~eo-90-
TIt
end all ,
me that t~he
~ --
s-rgõa ure
this
I be
tl2
rm;
,ubllitte~ in
Inforllatlon
2T1Ir Phone
in9, i:1", ~ect ions)
famIliar WIt the inforllatlon
responsIble or obtaIning the
horlzed reDresen
v
Ttt
CertHiçatio~ fReed and $i9n afJfÚ' c9mp1~t
1 certIfy under enalt 0 la th t I have persona I~ exam!n Q 0 d I
attaçhed docUllen~sl an~ t at ~ase~ on IIY Inquiry 0 lhose InåIYI~ua's
submItted Inforllatlon IS true, accurate, and cOllplete
I1TIiefiiõofTCIT
R1
tI
EMERGENCY CONTACTS
,..:...:.-~-
"i' ,;,1:
~6 4-1-'11 .
fOv~ 63L - 0 I /(0
prD~, C4N J'J,(ç¡--ftC -f-{ o^-
Cod~ Ÿ.Cí.
e'
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~
(- 7~C¡ (
DECEMBER 7,
/. CrJ1Lt PIv ~ù i
?{1J~(€")s rt-po(.{ . . '
, ,I "J\£: œc-~ 11\ Lj.ú.£ (CJ
,.. w·(...v ')( .
WIC'7· 41> II-t{'fð
1l:; _____
1990 /
c¡f
flr¿{,',)¡(\. cll.o-(-ii3^-.,. -'1:1','t',,":~(,)¡èð
i';t'N
DEAR MR.tBEARD,
NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE
-----------------------------------------------
-----------------------------------------------
IN THE INSPECTION OF YOUR BUSINESS QUALITY DOOR,
LOCATED AT 4250 WIBLE ROAD, BAKERSFIELD, CA 93313 ON
DECEMBER 7, 1990 THE FOLLOWING HAZARDOUS MATERIALS REGULATION
VIOLATIONS WERE IDENTIFIED:
1. Material safety data sheets must be obtained and made
available to all employees. Employees shall be informed of
their right to know about the properties and characteristics
of hazardous materials in their workplace. Written
documentation of hazardous materials training must be
maintained.
VIOLATION OF OSHA 1910.1200(G)
(9) Material safety data sheets may be kept in
any form, including operating procedures, and may be
designed to cover groups of hazardous chemicals in a
work area where it may be more appropriate to address
the hazards of a process rather than individual
hazardous chemicals. However, the employer shall ensure
that in all cases the required information is provided
for each hazardous chemical, and is readily accessible
during ~ach work shift to employees when they are in
their work area(s).
VIOLATION OF OSHA 1910.1200(H)
(2) Training. Employee training shall include at
least:
(i)Methods and observations that may be used
to detect the presence or release of a hazardous
chemical in the work area (such as monitoring
conducted by the employer, continuous monitoring
devices, visual appearance or odor of hazardous
chemicals when being released, etc.);
(ii)The physical and health hazards of the
chemicals in the work area;
:1
I
¡ ~~ ~
e
e
(iii)The measures employees can take to
protect themselves from these hazards, including
specific procedures the employer has implemented to
protect employees from exposure to hazardous
chemicals, such as appropriate work practices,
emergency procedures, and personal protective
equipment to be used; and,
(iv)The details of the hazard communication
program developed by the employer, including an
explanation of the labeling system and the material
safety data sheet, and how employees can obtain and
use the appropriate hazard information.
2. All compressed gas cylinders must be securely chained to
the wall or otherwise protected from falling.
VIOLATION OF UFC 74.107
(a) General. All compressed gas cylinders in
service or in storage shall be adequately secured to
prevent falling or being knocked over.
3. The propane tank must be protected from vehicular
collision.
VIOLATION OF UFC 80.301
(e) Security. The storage of hazardous materials
shall be safeguarded with such protective facilities as
public safety requires.
The above violations must be corrected by January 7, 1990.
The department will schedule a re-inspection of your facility
to verify compliance. If you have any questions regarding
this notice, please contact Barbara Brenner at 326-3979.
Sincerely,
Barbara Brenner
Hazardous Materials Planning Technician
e
e
04/08/91
QUALITY DOOR INC 215-000-001261
Overall Site with 1 Fac. Unlt
;:""'ge
General Information
t/-&'-~I
I
I
I ,
I ¡Location: 4250 WIBLE RD
I I Ident Number: 215-000-001261
I Contact Name Title
I VIRGIL BEARD PRESIDENT
TIM BEARD VICE PRESIDENT
I
i~lap :
l3r~ i d :
123
13C
Hazar~d :
Ar~ea of
'I
ìYocer~at e I
'Iul: Ci. () ¡
- - j
I
I Bus i Í"less PhoY',e _1' 24 HCIUr~ PhctJ",eì
I (805) 8~_'4-4844 x (805) 832-0298!
(805) 834-4844 x (805) 397-79851
Administrative Data
Mail A~drs: 4250 WIBLE RD
City: BAKERSFIELD
Comm Code: 215-007 BAKERSFIELD STATION 07
D&B Numbet~:
State: CA Zip: 93313-
SIC CClde:
Owner: VIRGIL BEARD
Addre~s: 4000 HARRIS RD
City: BAKERSFIELD
Phc'Y'le: (
State: CA
Zip: 93313-
r Summat~y
, ,
I I
I
I'
¡ I
1
0'" 1~..."..t:1¡"'Y cert¡f\l that I have
\.J 1 =r..,i >".....
\, IT·i~~. or print name) , ..... ge.
. .' I . '. -,_.-,,.";'''01 ,~~ matenalS m~na
d ,... iT'-- """0 i-" ", .-'\.,I.....o..J ..... .
reviews \.18 al..:;¡\.,II-r:: .---.
';;-,d that it alcng with
,f .~I,
m"''''t ""¡':In ,or ---",..,--
.v.' r........... . --~J' ,._~,,¡:.:;.,~!,,:,.~$)
, r' v ---,,,-
'.' .,., ,¡....ÿe a'x! correçt man·
+', nsc''''n'C',;ilutØ aCQlnp,c" ,
any ccrrecdO >J_1
agement plan for my facility.
Date
Signature
ì1\1t. ~CV\.Ol-. . " ~ o.ß2. . _Oll~_ I^ 0 I ~,,¡'¡ol ()JtQCLA.- ~ d-~
~~ ~ ()l, ~ _ -.,v.v(J~ " 3 ¡ctq I
~'~CL~t,~LÞ~~ ~,~ 0)
~h.a.,~J .
LJ áJ,.c..JV-"""
.co-r¿JL 3J-G- 3C,7 ~
-
c..bv<e. Q..,¥\Å.,ð 9ftL~ð"YW cpù Gl-J.L
(.S· ~ ljL~
-'1""'7 .
..'
e
. akersfield Fire Dept.
azardous Materials Division
2130 "G" Street
Bakersfield, CA. 93301 R EC E , V EO
DEG 2 1 1989
Aos'd'h
·....0....
AZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
1. To avoid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be brief and concise as possible.
~ SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: çJ UALrr-ý .D(u')R /A/('"
LOCATION: 4 d J,7J Lv I j/~ /<.1:)
A'A'K6/ZfF/éLO
933/'}7
MAILING ADDRESS: 0/771:r
CITY: 64I<t&z.JJ).../J STATE: L:rL ZIP: 9.f:S/.3 PHONE: (Þo.r-) P3~:"'Y/'9ý
DUN & BRADSTREET NUMBER:
PRIMARY ACTIVITY: 8A L E
SIC CODE:
od J)ðOÆ.. 'T/2-/--;??, I/~A....OW,?-~ -+ C4ð/'I/~
" ,
OWNER: ..1 )//~ ¡ / ,(J b/5l~
MAILING ADDRESS: ~ {lOa //Ar<A./..Í ,<,,~
t1..,¿- A:"S-"l,f ~-,,~¿;£? c<? 93 3 ~
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE
1. -0 ,Q~¡ 1 ßL~/2J:) fJlZ-ê/.
2. 77 f'h' ßL5Af.lI:J Vr ¡:)!<.t:.-r.
BUS. PHONE 24 HR. PHONE
R 31/-t//¥'t/ J? 3;l-{)2-9/
tf3l/~ Vt/~9" 3 97-79/J-
1 .
FDI5')'
N~ ~-; Bakersfield Fire Dept. e
~ ' . Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
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,
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SECTION 3: TRAINING:
/,NUMBER OF EMPLOYESS: / ð
V MATERIAL SAFETY DATA SHEETS ON FILE:
~ \ BRIEF SUMMARY OF TRAINING PROGRAM:
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.
L./
WE DO HANDLE HAZARDOUS MATERIALS. BUT THE QUANTITIES AT NO
TlMEEXCEED THE MINIMUM REPORTING QUANTITIES.
pt:JA) ¡t7 .P-rtð.. ,
OTHER (SPECIFY REASON) Lue. h"ue. OIUe. .JS7J 9·I'L T4;iV~':'- 9/6lJ 1itliF,
o 2. t l;T:s.
SECTION 5: CERTIFICATION:
I, V ~"I 8õAÆ.O CERTIFY THAT THE ABOVE INFOR-
MATION I 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 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
1.0~1 &adA/
IGNATURE
~
.
TITLE
/;¿-2/--r¡
DATE
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2.
FD1590
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Bakersfield Fire Dept.e
Hazardous Materials Division
y' - "'-"'~'
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility U nit Name:
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
B. EMPLOYEE NOTIFICATION AND EVACUATION:
I
C. PUBLIC¡; EVACUATION:
':,
D. EMERGENCY MEDICAL PLAN:
3.
FÐl &;D
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e Bakersfield Fire Dept. e
Hazardous Materials Division
~::-... '" ''J;.
~
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS:
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
C. CLEAN-UP PROCEDURES:
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE: mA17vu#i- <;h-ul-ð U aA3 7/?-/Vk:.
ELECTRICAL:
WATER:
SPECIAL:
LOCK BOX: YES/NO
IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY:
A. PRIVATE FIRE PROTECTION: FI/J.¡;;- S fl¡¿'Þ.Jtc/~ s-';YJ?l!!'H
B. WATER AVAILABILITY (FIRE HYDRANT): ¡Jbi!(;;í~{:"(, .§~¡ .:' :C'oMe-/L. cr/.
11£+//1 I'?VJ
4.
FD15'
CITY of I3AKEH~FIELU RECEIVED
'\
F d I t 0 r.JHAZARDOUS MATERIALS INVENTORY DEC 2 " 1989 ',-:::
arm'an ~g ICulture Standard BusIness ~
NON~TRADE SECRETS A'd Page _ of')-.t,.!
SCAINTEIOSSN NAME: é)o..l -=- .òoo", J:AJ"- OWNER NAM~~ ì'}AAIJ NAME OF THIS FACIl~~Ÿ:"''''''·· , ,;"
:_ '-I'2.~ w ~ p.JJ ADDRESS' ()() Y4R~j /l.{) STANDARD IND. CLASS COOF:--- --
TOYNÈ Z!P: 13hl<.LSI'l..f 5:-tJ _,233''3 CITY 1- zìp: . A-K/SIU"P¿~4P 9~;¡L; DUN AND BRADSTREET NUMBER---,m_- -----
II. 8:D~ ,. -~ PHONt: II: _1t2..£__Æ2L2...- 02.~ --
REFER TO---rNSmUCTIDNS It ROPER CODES - - - - - - -
- -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
ans Tyae Max Average Annua1 Meawe I Dys Cont Cont Cont Use location Where 'by t¡alles of "i~ture{Co\Ponents
Ide Code A lilt Amt Est UnIts on SIte Type Press Temp Code Stored In FacIlIty Wt See Instruc Ions
ZIEJ9IóJFqS{»o~/f0061=.,t£Œ13".r I ~ 12 I ~ 1/9 IEI?~r <:AJ~ () p, G.ú_ =
Ph(YSical snld Health Ha~ard C.A.S. Number Component 11 Name & C.A.S. Number
Check al that apply/ _ __
, , Component 12 Name & C.A.S. Number
g Fire Hazard 0 Reactivity 0 Delayed (3' Sudd~n Release 0 Immediate
Hea I th of Pressure Heal th - -
Component 13 Name & C.A.S. Number
=0 I I D I I I I I ==
Physical snd Health Ha~ard C.A.S. Number Component 11 Name & C.A.S. Number
(Check all that apply) _ _ __
Component.2 Name & C.A.S. Number
o Fire Hazard 0 Reactivity 0 De1syed 0 Sudden Release 0 Immediate
Health of Pressure Health - --
Component 13 Name & C.A.S. Number
=r=1 I I D I I l I I ==
Physical snd Health Ha~ard C.A.S. Number Component 11 Name & C.A.S. Number
(Check all that apply/ _ _
Component 12 Name & C.A.S. Number
o Fire Hazard 0 Reactivity 0 De1syed 0 Sudden Release 0 Immediate
Health of Pressure Health --- --
Component 13 Name & C.A.S. Number
=0 I I 'I~ I I I I I _ ==
Physical snd Health Ha~ard C.A.S. Number Component.1 Name & C.A.S. Number
(Check all that apply,
- --
Component 12 Name & C.A.S. Number
o Fire Hazard 0 Reactivity 0 Delayed 0 Sudd~n Release 0 Immediate
Hearth of Pressure Health --- --
Component 13 Name & C.A.S. Number
EMERGENCY CONTACTS #1 Rf1.1:=..5 1/2--0291 #2 T/rl-. 1~ p, -397-7:9d"iJ'
n e Hr phone 1fã1íë' (fir - ZTlIr Phone
Certifiçatio~ (Reed and $ign af1er c9mp7eting, (177. sections) . .
1 certlf under enall 0 la th t I have persona 1 exam]n Q S d m famIlIar It the informatIon $U mltteð In his
attaçhedYdQcumen~sl an~ t at ~ase~ on my Inquiry 0 those Inålvl~ua's responsib1e ~or obtaIning the In~ormatlon. ¡ be
submItted lnfor;t4, tlO IS true. accurate, a]d complete.
/ II ~1æJJ 12--Z/??5
fITjïë-rrnfTfIT m owner operator ve Unnfqr.ed
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Bakersfield Fire lept.
Hazardous Materials Inspection
NO
I
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Date Completed
/1-t97-F f
Location:
C!?t/I4~T7 VOéJ.e -z;;;f>_.
4I.;ì'SV ith(~~ d
RECEIVED
NOV 2 IJ f989
HAl.. MAT. OlV.
Business Name:
Plan ID # 215-000a?/24;Ý (Top right comer Business Plan)
Station No.
7
Shift
L
Inspector
'--- -/ ~ á.4--S
Adequate Inadequate
Verification of Quantities
~ D
if D
~. D
~/ D
verification of Inventory Materials
Verification of Location
Proper Segregation of Material
Comments:
Verification ofMSDS Availability
D
w
Number of Ernployees
/S'
Verification of Haz Mat Training
D
w
Comments:
Verification of Abatement Supplies & Procedures
~D
Comments:
Emergency Procedures Posted
~D
D ~
Containers Properly Labeled
Comments:
Verification of Facility Diagram
D
D
Special Hazards Associated with this Facility:
Violations:
FD 1652 (Rev. 3-89)
White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
,'''~'~ ~¡1~'I.I-,'-;.,.U"'''-~'''''f'''' ....~"...., ,_., ' .
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::::0 '.C;" STREE7
3AKE~Së!:LJ. CA ~3~Ol
(80S) 326-39ï9
OFF!CIAL USE O~LY
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ID:::
CS C:ESS ::Ä,!E
HAZARDOUS MATERIALS
BUSINESS PL~~ AS A WHOLE
FORM 2.A.
INS7'RUC":"I mlS ;
1. To avoid further action. return this fo~~ by
2. TYPE/PRr:-;T A~SWE~S r:-; ~rGr.ISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
I' '
';
SEC7!O~ 1: BUSr~ŒSS TD~rrr:ICAT:O~ JATA
A. Bt;SI~IESS :-1Ai·!E: r¡JUALI /,Ý
D rJ CJ R. .z: A.) c...
3. L8C;;:-::1:: / 57:::::::- ADIJR::SS; ¿j ~ 50 WI 1, ~ .l2..D
C:7!: J3A/¿E)2fFIFLJ:) Z:?: 9.33/3 3CS.?~œ:E: (305"') J13t./-ÝJl~V
SEC7ION 2: ~RG~T~l ~OTIFICATIO~S
In case of an emerg~ncy involving the ~elease or threatened ~elease or a
hazardous ~aterial. call 911 and :-800-852-7350 or 1-916-4Zï-43~1. This ~ill notify
yct:.:' lcc:Ü fire department and th..=: 5t¡¡te Gf:':'ce of E:net"~~ncY' Se!:"'ic~s as !:,p.qllired by
la.w.
E~PLOYEES TO ~OT!FY I~ CASE OF
~AXE AND TITLE
A. III R. j ," / B S' A (¿IJ
B. '//M ßcAR-Ô
.
E:·!E~G2:·7~l :
DURI:'TG BUS. HRS.
Ph;: ð'3t/- ~¡;-~t/
Ph;; ?3é/-~t!¥y
A£1'E? 3t;S. as.
?h;: P3:-¿- 02.. 9R
?h:; 397- 793~
SEC7ION 3: LOCÂTION OF TITILIT! ShlIT-DF?S ~OR 3UST~ŒSS AS A WHOLE
I ~,
A. ~AT. GAS/PROPANE: SOI.tTJ-I WJ::$7' C.OI"JJJr;:I?-
B. ELEC7RICAL: )/JSIDL<' (-3uiJ)IA.U:, w/::-s'{ e-,u/)
C. íiATZR: FR()ðd.L -.J.. r.ëtyrEß 0'1- .ßu'/'¡~f
D. S?EC:::AL:
E. LOC:\ 30:\: YES /ŒV IF ·rES. Lcc:;r:o:,;:
01 '¿:¡ù-//cI~Nf
,A.) t! X1 h> ð PF / C In'
I '
rF YES. DOES IT em;'!'.;r:: sr:z PLANS?
ëLOOR ?LA:-¡S?
YES / ~ro
YES / :i0
:1SûSS?
:<E"!S?
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SECTION 4: ?R:rVAT'E' RESPO~SE TEA.~ FOR Bt:JSTXESS AS A ¡iHOLE
NONe
SECTIO~ 5: LOCAL E~ERGEXCY ~EDICAL ASSISTAXCE FOR VOt~ Bt:JSI~~SS AS A WHOLE
Wh, k ¿tJ HGO/CÆL.. ceJt:A-
SECTION 6: ~LOYEE TRAINING
E:-!?!.OYE~S ,.:..RE ?.EÇ:';:::~ED 70
~.,"::""':"
...n ~ .-
A ?RCGRA:! ~iEI ::~
??.OV:::::,ES
:::·!?!..8~:·=::::S
Wi_.::
::.:::-: ..~:
~ '.........
.-1...."iJ
REF~E:SF'=:2 7?~I:\::':G I:\ 7:::: ?OI.:cn';::~G ...\R:::..~S.
C:RC~E YES OR XO
A. ~ETHODS FOR SAFE HAXDLr~G OF HAZARDO~S
~1AT::R IALS : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. PROCEDGRES FOR COORDINATTNG ACTIVITTES
WITH RESPOXSE AGE~CIES:...... ..... ........ .......
C. PROPER USE OF SAFETY EQUTP~E~ï:... ...............
D. E:ŒRGEXCY EVAC:';A7IO~ PROCED~RES: ,... .......... ...
:. DO yot; ~·rAHrrAIN E?·fPLOYEE TRAIXING RECORDS:.......
I:·;~:-I.~L
~=-=~=!::-:..-:'::)
....-- .......- ..-.....
YES Çffi)
YES :.;0
\::5 i:o
YES NO
~::S :0
YES 10
Y::S :.;0
YES NO
YES XO
Ÿ.:;S NO
SEC'!'TON 7: HAZARDOUS ~'l'ERIAL
CIRCL~ NO - NONE ,/h e DIU/; týJ I/-rÉ'/'Z.¡I!~ vv~ )..ðN()!e IS CdN fl9-c-T Ct:Afù""'-
DOES YOLK öt:SIXESS HA~~LE HAZARDOUS ~~TERIAL IX Qt;~~ITIES LESS 7HAX 500 ?ot~;DS OF A
SOLID. 55 GALLONS OF ..~ LIQt;'ID. OR 200 C¡;BIC ?EET OF A CO~!?R::SSED GAS:...... ':~S :\0
T. /IÍ~// ßEAl2b , certify that the above information is ac::urate.
I under and that this inÌormation will be used to fulfill my ::rm's obli~ations under
the new Califor~ia Health and Safety code on Hazardous ~aterials (Div. 20 Chapter 6.95
Sec. 25500 Et AI.) and that inaccurate information constitutes perjury,
. SIG:;ATI:RE z(;;,j &4!d
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.
DATE ~6//t
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BAKERSFIELD CITY FLRE DEPART:"1EXT
2130 "G" STREET
BAKERSFIELD. CA 93301
OFF:CTA~ CSE ONLY
ID~
------
BUS EESS :';.-\;'!E:
I
I
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIO:IS
1. To avoid further action. this form must be returned hy:
2. TYPE/PRIXT YOUR AXSWERS I~ ENGLISH.
3. An~wcr the ~uestions b~lo~ fer THE FACII.ITY ~XIT LISTED BELOW
q. Be as BRIEf and C8NCrS2 as possible.-
FACILITY UNIT~
FACILITY UNIT ~A~:
SECTION 1: ~ITIGATION, PREVE~iION, ABATE~E~l PROCEDL~ES
í4€. 1-/flZ.JlY~r ffn->uwvr 0-1 cð/vf4C-1 C¡:,.,..swt'- //V Tie.. .6u//.iN5'
J $' F c/tÅrl~-~" - , 'Ti e s-r 94"-' f)'/<!-Un-> 'S L-vCA-7"ðj). .ðúI?'TP/.)¢...
¡he bUR) j¡r-T7 .
SECTION 2: ~OTTFTCATTûN A~~ EVAC0ATIO~ PROCEDlKES AT THIS l~IT O~LY
)J0¡J6-
-.
- 8A -
·-
-
-
~~ . ~ -,~
SECTIO:¡ 3: HAZARDOUS :1ATERIALS FOR THIS r;:¡TT O;':LY
A. Does ~his Facility Unit cont~in Hazardous ~ate~ials?, ,
v¡:'~~o
._;)~
If YES, see B.
If ~O. continue with SECTIOX 4,
B. Are any of the hazardous materials a bona fide Trade Secret YES ~
:~ ~;o, complete a separ~t2 ~~3zardous ma~2r:nlS inverrtJr~
form marked: XO~-TRADE SECRETS OXtY (white form ~4A-l)
If Yes, complete a hazaràous materials inventory form ma~ked:
TRADE SECRETS OXLY (yellow for~ =4A-2) in addition to ~he ~on-trarle
secret form. List o~ly the trade secrets on form 4A-2.
~~C~TO~ ~: PRIVATE FIRE PROTEC7TO~
,4~ /h4-itc. S jJt2-/",,/¿!to/l- ~Y.Té;nJ.
rt/2-G S'x TeJVtp~...j,<A.-
S (j~1 TJ'2.<J/ ,S'ecu/lZ417 çyi'Tð""'1'
FII2.E:
fh¡ ,¡ .
SECTIO~ 5: LOCATIO~ OF WATER S~PPLY FOR USE BY ~RGENCY RESPONDERS
2 f./ 0 I :10.# 0 ¡. )gUt ///NJ
C OJJNtrG--n OA.JfJ- PI R.6 . 5:¡'JI'U,v# t;,.. e A)tJq-/# vlTsr C O"'¿S'/Z- (?/,Il Jt!?tp//'¿?
SECTIO~ 6: LOrATIO~ OF GïTLITY Shül-OFFS AT THIS G~IT O~LY,
A. Y:~ T. (3..1.:).. PRO?iXE":
J,/ / A /.' / /" a- ;{J4-Tt-/~#-~ G4-J
Soú-rl1 Wb~;r CfM....,t<Js_ Or ~(þ' ,¿',...¿ (f"ð "
pp..,¡ I'4'AJb @ r/f/llK
B. SLECTRICAL:
:riel ~//JG'
I3LV,/j¡A/f
W/:;;-~/ eM/) -'7 0 FPIC,tr',f
C. í'iATER:
-
¡V/Lo/V r
D I- 13 !.VII ~¿ N7
/~
c e-A/re",
O. SPF.:C:::AL:
--
_, LOCK BO~; \':'::S '(~ ~ YES, LOC.UIO~~;
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k _oJ
::0
! :':0
~Irs 0 S s ?
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fLOOR ?!'.AXS?
'lES
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- 38 -
ßAK~RSFIELD CITY FIRE DEPARTMENT ' .
'""
FORM 4A-1 Page -L< 0 f L_
NON-TRADE SECRETS -,
HAZARDOUS MATERIALS INVENTORY "
OWNER NAME:J -
FACILITY UNIT #:
ADDRESS sl'ó FACILITY UNIT NAME
P: AA¡¿eR-S r{pL.D 9:3 31!1 CITY, ZIP: ßAkG'RSF/C¿LJ 9.33/3
/ RDS') %3:'/';' f./lt/ý PHONE #: ??o -::; - J732-- 02. 5' tf IOFFICIAL USE CFIRS CODE
" ONLY
1 2 3 :' 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIDE
\) ~ - 13" ¡:: /:AJ '-15" ,?:71 (¿,
P 55 /.10 I C;/l-I... ;¿ f'J1..J '/ $1 DS A¿¡¡/j'Mð. r nAJ-r',<u...-r C S' k~~;.v "F' F( ¿. 6)
p?) ../ e
i' 3 /.3 u'-/ '¿AJ~ IlSS,òr rLGS
Soo 5"00 !, GAL /9 ourS~De- PRo PI9Nê' ,¡::-~ 13/
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NAME: III R-¿/-/ 8E~ TITLE: Ðf<.E (' SIGNATURE: ?/;Â~'#~ß~~ DATE: .s-h /,ýf
ß ê:AfJ-D . , R3'1'- ¥~VV
u - IRCj~'1 TITLE: DA6t:' PHONE # BUS HOURS:
,
932..-02...9P
I . D #
BUSINESS NAME:
ADDRESS: ¿j <. ~72
AFTER BUS HRS.
PHONE # BUS HOURS
AFTER BUS HRS:
'AJeb
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1M
ACTIVI
EMERGENCY CONTACT:
PRINCIPAL 8USINESS
M-SDS4Þ' /~~
LD U/T¿'l T Ý J)OdfQ..
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03/11./88 .
BALLSUN COMPANY
4201 CHARTER STREET
VERNON, CA 90058
-.-:-.---------.------~..------...---:------:--;':---~.'""=--,,-------.;'""=---- ----.::-~.-:- ----. _.- --.---- --- - -- 1
SLJB.JECT: M.3ts¡-iat Safety Data StH~~et
PRODUCT F<EFERENCE: WB-23:59 '770
../"
D(,~.3¡- Custome¡-:
~ Enclosed are Material Safety Data Sheets (MSDS) for H. B. FuLLer
Comp.:} ny pn)d uc ts. We have r·f.~V i ew(-?d 0 u)- P)- od uc ts, co nd uc ted a ha za',-d
determination, and prepared an MSDS for each product, which to the
Jbest of our knowledge, is in compliance with the requirements of the
OccupationaL Safety and HeaLth Administration Hazard Communication
Standard 29 CFR 1910.1200. In some areas we may have provided more
information than the Standard requires.
If this product, or any component of it, is considered to be hazardous
or carcinogenic under the O~~A Hazard Communication Standard, .
information is indicated in the 'HAZARDOUS INGREDIENTS' section or in
the 'EFFECTS OF OVEREXPOSURE' sect Jon.
Fuller warrants that each of its products wi LL meet the specifications
published-in the FulLer product data sheet, for the sheLf life period
s tat f?d i nth at d at é1 sh ef? t. FULI...EF< MAKES NO OTHEF< WARRANT I ES . I f a
product fai ts to meet this warranty, FuLLer wi LL at its option replace
o¡- )"(~~pa i 1" the pr-'vcluc:t,_OI:-_ n~~'ft!nd, thr,,> ::p-m-(~~}i:},!;;0! PT LCf?.. NO -OTI,·IEI:;: F:Et1FDIEB
- (:r. NCUJD I NG CLA I MS FfJ:;~ I ND I F:ECT O¡:;~ -OTHE¡:~ DAMAGES) r-II:~E - (:W(.fr L.AB!..:!::. FDJ=i: -- - - -
COMPLETE INFORMATION ON FlLLER WARRANTIES AND REMEDIES, CONSULT THE
PJ~ODUCT DATA SHEET em PFWDUCT LABEL.
If YOU have any questions, please contact your SaLes Representative.
S i n<:(~H-e J. y yo U)~s,
H . !f + FULLER COMPANY
John R. Dotmar~~CIH
Manager, IndustriaL Hygiene
ro" .~ ::_.
..
~ ,_.~.~"".~:""'-;~_'''',1..;..,;.L_.~......_..,...J"~~~......._..-'........... _.0...--.,._ .._~... '_"~.._.,"'"
. ~." ..... ..._.:..__.__.;u_.5~~._ a:,
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F'a~~(-? 1
WB'-2359 770
06/2,,8~fJ7
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MATERIAL SAFETY DATA SHEET
0'.'
H. B. Fuller Company
1200 Wolters Boulevard
Vadnais Heights, Minnesota 55110
Date: 28 June 1987
Prepared by: John R. Dolmar
Telephone Number: 612/481-3300
PRODUCT IDENTIFICATION
P1-oduct Class:
SYNTHETIC RESIN based product
H. B. FulLer Company Name: WB-2359770
DOT Proper Shipping Name: Not a regulated material
WARNING STATEMENTS
No specific warnings for normal use conditions
PRECAUTIONARY MEASURES
.'~ - -- -- - - -~. - ~ _ ,A v·o-i~d--1~(f~ m P,(fH-,a.:t~ur:(-?~(f~xA~i'· (.:! fiHf! ~¡;-i~n--~;-'!~Oi""<:i,g'€h --: --,_-
EMERGENCY AND FIRST AID PROCEDURES
FIF~ST AID:
If in eye:
If on sk i n:
Flush immediately with water for 15 minutes.
Consul't a physicic':1n if Ï1Titation p(-?n¡;ists.
Wash affected area with soap and w~ter. Launder
contaminated cLothing before reuse.
If vapors inhaLed: Remove subject to fresh air.
In case of fire: This product is non-fLammable in the Li~uid state.
Use water spray, foam, dry chemicaL or carbon
dioxide ~n dried product. .
Sp ¡I. l 01- Leak:
Contain and remove with inert absorbent. Keep'spi lL
out of sewe1-S.
HAZARDOUS INGREDIENTS
MateriaL Name/CAS 0
LeveL
In Product
OSHA PEL
ACGIH TLV
(1986,1987)
This li~uid product contains materiaL identified by the ACGIH as a nuisance
par'n c u I.a te. In u!:,?f't ,j'-")f:~ _ maj'eJ~j,<)U ,'& U L- .no-t - pn~'s0~tlt_ èJ}1 0~XP osuTeLi5~ç . O]\çf:? _ _
the product has drIed and is abraded or disturbed, dusting may occur.
OCCUPATIONAL CONTROL PROCEDURES
Eye p\-ot(-?ction:
Wear safety glasses to reduce the potential for
eye contact; chemical safety ~og(l;leS are
appropriate if splashing is Llke.y. Have eye
washes avai table where eye contact can occur.
Prevent prolonged or repeated contact by using
rubber gloves and appropriate protective
cLothing. Launder contaminated clothi~g before
r'-(~H1!¡;(-? .
Sk i n P1- 0 t ec t i () n :
Respiratory Protection: Not normalLy required.
V(·:mt i I.at ion:
Standard industrial venti lation.
..
NA - not applicable
NE~- not established
..
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.- .,- Þ.~~t~ 2
Wn-2:'5~'59 770
06/28/07
FIRE PROTECTION
yen:; ion 1.001
Flash Point/Method:
ApP1- OPI- i ate
E x 'I' i n9 u i sh en:; :
Non-flammabl.e
Non-fLammable in I.iquid state; use water spr~y,
fo~m, dry chemical or carbon dioxide on dried
product.
Persons exposed to products of combustion
shoul.d wear seLf-contained breathing apparatus
and full. protective equipment.
There is the possibi lity of pressure bui Ldup in
cLosed containers when heated. Water spray may
be used to cooL the containers.
, -
SpeciaL Fire Fighting
PI" oc(·?d ul-es:
Unusua L F i n·1 "I nd
Expl.osion Hazards:
REACTIVITY DATA
St¡'lbi Lity:
I nc 0 mp at i b i lit y :
St,31:) I.e
Not ~1stab I. ished
1..1 a :r.J~ r~ d Ol,!!~ fl (~) c: ~) 1n J~9 J1L LtJ J1T.L..Ex.:Jtd uc:~tJ5..:_Ln<::.(!ml:L/.(~ :h·)---(;:-oml;)us-t-oi-o-n~-(:; "ì'n- -yi-€~- h:l- -l O~J -
~-~- --'-- -- - . (/}O I.(,~cul.ar· l-\1(~I(.;1t 1·lydl-oc':H·bon~:;, (:al-bon monoxld(~
Hazardous Polymerization:
Wi L I. not OCCU1-
EFFECTS OF OVEREXPOSURE
Eyes:
Direct eye contact with the product may cause
--i r-r- ita t ion +
Sk i n:
Prolonged or repeated contact with Liquid
product may cause irritation.
Exposure to vapors in poorly venti lated areas
may cause irritation of the nose, throat and
respiratory tract.
No anticipated chronic effects.
This product does not contain reguLated levels
of NTP, IARC, or OSHA Listed carcinogens.
Existing HeaLth Conditions Affected by Exposure: '
No known effects on other i I.lnesses.
I nh ,,1 La t ion:
Ch 1- 0 n i c :
PHYSICAL DATA
PhysicaL State: Liquid
,~- I.,'+!;¡.c O':i>+'tyt' ----~- ~~ ---- ~-~-(roO-"'C:i:>~fr--- ~---
~- ~ ~--:-:::. ~'- - ="
---
. .-..---- - -- --
% So I. i d':5 by W(~ i 911t: 4()
pI-I: 4. ~)
I:~o I I. I ng R.'iI nge: Gr'eate1- th,3n 200 F
So L ub I.f.~ in Wa te1" : Mls(:iblE..'
SPILL, LEAK & DISPOSAL INFORMATION
Spi LL or Leak Procedures:
~
Dike if necessary, contain spi LL with inert
absorbent and transfer to containers for .
disposal. Keep out of sewers, watersheds or
Wi:' t('~I" sy!:. t(·:~(/}s.
NA - not appLicabLe
NE-'--' not (,~!:.t,:11:) I. i !¡>h,,·~d
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'; y,.c,.f .....'* ~
.., F'a~f.~ 3
WB-2359 770
06/28/87
Waste Disposa L:
ve1- s ion 1. 001
This product does not meet the definition of
hazardous waste under the U.S. EPA Hazardous Waste
Regulations 40 CFR 261. Solidify and dispose of in
an approved industrial landfi ll; consuLt your state
or local authorities for proper disPosal in the
event more restrictive requirements apply.
STORAGE
Protect from freezing - product stabi lity may be affected.
ADDITIONAL INFORMATION
I This product contains Limited amounts of residuaL monomer. Under conditions
of normal handling and use the residual monomer does not present a hazard.
Monomer vapors released into the workpLace atmosphere when emulsions are
heat-cured or dried may present a heaLth probLem if góod venti Lation is not
us(~d .
In storage the monomer wilL migrate from the emulsion and estabLish an'-
etui librium between the headspace in the storage container and the liquid
emulsion. Levels in excess of acceptabLe exposures can accumuLate in
non-vented headspaces above the emuLsion. BuLk storage tanks shouLd be
v(~ n t c:~d .~i.:U:J~J2umJ_{:/J:LLe.d~ajx...___A-Ll.-p-1:..(),(;;.e-çj-U-1~ f.~~:>-"~PP1"--op'r--i-.c~h?- f-()r-~i:t -cÎnìf-¡-Tíecl-~:;p<:1-C'(~-- --
'~~i'1;;--yshouLd bE~ compLeted pr'io¡- to pe1-fonning any W01-" in a buU, st01-age
'l" .:1 nk . '
I
I
!
- -------
- -- ----------;:::- --------=--=
~=--=<---~~------~~--_.
----
~
NA - not appLicabLe
NE-- not estabLished
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