HomeMy WebLinkAboutBUSINESS PLAN 5/7/1997~~
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Materials/Hazardous
Hazardous
CONDITIONS OF PERMIT ON REVERSE SIDE
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Ii!) Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
Permit ID #:: 015-000-001260
TAN AUTOMOTIVE
LOCATION: 4300 WIBLE RD E
Date
Issue
Approved by:
Expiration Date:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Issued by:
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STATEMENT OF 'ACCOUNT
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CITY OF BAKERSFIELD
150l TRUXTUN AVE
BAKERSFIELD, CA 93301-0000
(805) 326-3979
TO: DISCOVERY SALES CO
4306 WIBLE ROAD
SUITE D
BAKERSFIELD, CA 93313
DATE: 9/01/95
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13ðD ¡;) ~ 11~8D
CUSTOMER NO:
3615
CUSTOMER TYPE: ES/
3615
--------------.----.----
...--,,;.-=--_.---..-..-..._~----~"""' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
CHARGE
DATE DESCRIPTION
REF-NUMBER DUE DATE
TOTAL AMOUNT
------ -------- ------------------------- ---------- -------- --------------
1/01/95 BEGINNING BALANCE
186.50
NEW STATEMENTS! Please call 326-3979 if you have
questions or changes regarding your account.
-------------- -------------- -------------- --------------
CURRENT OVER 30 OVER 60 OVER 90
-------------- -------------- -----~-------- --------------
. 'j;'
186.50
DUE DATE: 9/0l/95
PAYMENT DUE:
TOTAL DUE:
186.50
$186.50
PLEASE DETACH AND SEND THIS copy WITH REM I T'l'ANCE
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9/01/95
DUÉ D~TE:. 9/Ó1/95··
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REMIT AND MAKE CHECK PAYABLE TO:
CITY OF BAKERSFIELD
P.O. BOX 2057
BAKERSFIELD CA 93303-2057
CUSTOMER NO:
3615
CUSTOMER TYPE: ES/
TOTAL DUE:
3615
$186.50
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CUST rA & NO.~S ~ IS-
MISCELLANEOUS RECEIVABLES ADJUSTMENT
DATE 5-7-97
NEW ACCOUNT
ADDRESS CHANGE
CLOSE ACCT
FINANCE CHARGE!
OTHER ADJ)(' ¡
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CUSTOMER NAME [\~Cé)v'e.(y éxLles Cð.
MAILING ADDRESS 4 ~b WI hIe, eJ So>\e 0
CITY ßa\u~(7)0; f.' \J STATE ~* ZIP CODE q ~~ ( ~ I
SITE ADDRESS '-i-~ lO't b\ €- f2J,. '<)l)~ ~e=: 4-
PARCEL NUMBER
(IF APPLICABLE)
ADJUSTMENT
CHG DATE. CHARGE CODE
)-)-97 N-fl//0c:)
ADJUSTMENT AMOUNT
dt II()ED
REMARKS:
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APPROVED BY ~---
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STATEMENT OF ACCOUNT
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CITY OF BAKERSFIELD
1501 TRUXTUN AVE
BAKERSFIELD, CA 93301-0000
RECEIVED
DEC 0 5 1995
(805) 326-3979
CITY OF BAKERSFIELD
PLANNING DEPARTMENT
DATE: 10/06/95
TO: DISCOVERY SALES CO
430Q WIBLE ROAD
SUITE .
BAKERSFIELD, CA 93313
CUSTOMER NO:
3615
CUSTOMER TYPE: ES/
3615
I ---------------------------~----------------------------------------------------
·-~eHARGE B:ATE-DESeRI"PTTON REF=NUMBER-DUE "'DATE-TOTAL-AMOUNT-~
------ -------- ------------------------- ---------- -------- --------------
9/01/95 BEGINNING BALANCE
PB017 10/01/95 FINANCE CHARGE
FC011
PB017 10/01/95 FINANCE CHARGE
FC011
186.50
1. 86
1. 86
Please call 326-3979 if you have question or
changes regarding your account.
-------------- -------------- -------------- --------------
CURRENT OVER 30 OVER 60 OVER 90
.
-------------- -------------- -------------- --------------
190.22
DUElJATE:-r07'O-67'9"5
PAYMENT-DUE :--- '--190.22
TOTAL DUE: $190.22
PLÈASE DETACH' A.ND SEND THIS}::qPY'WITH REMITTANCE
10/06/95
DUE DATE: 10/06/95
REMIT AND MAKE CHECK PAYABLE TO:
CITY OF BAKERSFIELD
P.O. BOX 2057
BAKERSFIELD CA 93303-2057
CUSTOMER NO:
3615
CUSTOMER TYPE: ES/
TOTAL DUE:
3615
$190.22
HAZARDOUS MA ..eIALS INSPECTION
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&akersfield Fire Dept.
Hazardous Materials Division
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Business Name: \)\ 5 Co verí
Location: t..¡ ~ cro tv \ b k
Date Completed
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Business Identification No. 215-000 ófJD bO 8'
Station No. ? Shift C-
(Top of Business Plan)
Inspector \þ L- /ð- l (L
Arrival Time:
Departure Time:
., Co'; 1'0 \
Verification of Inventory Materials
Verification of Quantities
Verification of Location
Proper Segregation of Material
Inspection Time:
Adequate Inadequate
o
o
o
o
Comments:
Verification of MSDS Availability 0
Number of Employees:
Verification of Haz Mat Training ,
o
Comments:
Verification of Abatement Supplies & Procedures
Comments:
o
Emergency Procedures Posted
Containers Properly Labeled
o
o
Comments:
Verification of Facility Diagram 0
Special Hazards Associated with this Facility:
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Violations:
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Business ONnerlManager PRINT NAME
SIGNATURE
All Items O.K r:J
Correction Needed r:J
White-Haz Mat Div
Yellow-Station Copy
Pink-Business Copy
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HAZARDOUS MATERIALS MANAGEMENT PLAN
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Bakersfield F'ire Dept.
Hazardous Materials Pivision
2130 "G" Street '
Bakersfield, CA 93301
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INSTRUCTIONS:
1. To avoid further action, return this form within 30 days of 'receipt.
2. 1YPE/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: j) /.5 e. c.:dl'é~¿,/ SA L £.5 CD
LOCATlòN: .)..300 w/B¿'¿: ¿d fr /)
MAILING ADDRESS: ß .§¿J ~ ~7~ ~ i ~/CW'.....sr~é Lei CJ _ 9.5&J>t¡'
CITy:Æ,c:.E¿::sP/8¿d STATE:<1LL ZIP:g~qL =? PHONE:J9.1'-,.5/.y/
DUN & BRADSTREET NUMBER: SIC CODE:
PRIMARY ACTIVITY: ~(Jé ,/ £-,ÿc-d A J.Jto é" - &¿Iü/ ¿ r .4Ú¡;; ¿.,¿J 6/ ¡;é~S
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OWNER: I!?C8ALC) R C; E /J~V ~' ¡f¿¡/)A C;e/}~V'
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MAILING ADDRESS:./? c&x -¥/ 7&./1 t'aAtcéÆ'.";Þ/Uc! {} A P--3~.r/
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SECTION 2: EMERGENCY NOTIFICATION:
CONTACT
TITLE
BUS. PHONE!'
1. ¡/UtlJA b8A-4=Y ðW~ J97-S/¥/
2.
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24 HR. PHONE
J!9-7/7'/
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Bakersfield Fire Dept. e
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS:· ,~.
MATERIAL SAFETY DATA SHEETS ON FILE: YES
BRIEF SUMMARY OF TRAINING P~OGRAM:. , fl \
E--I-I ¿,e i U #h,uc/ L / V (;, A.'tJd U,,£/J ¡J - ¥ ö H /J--ye::¿¡ A ¿ S
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SECTION 4: EXEMPTION REQUEST: - ,u D
I CERTIFY UNDER PENÄLTY 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.
~ WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO
TIMEEXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
I, #cH-4dE.G EÆJL&Y " CERTIFY THAT THE ABOVE INFOR-
, MATlON IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLlGA nONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET Al.) AND THAT
~C:ATE INFORMATION C, ONSTITUTES PERJURY.
.~~/~~... tfäbcL/ ;;/48&
SIGNATURE .., ' TITLE DATE
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2.
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e Bakersfield Fire Dept.
, Hazard~us Materials Divisione
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name:
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCY NOTIFICATION PROCEDURES:
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B. EMPLOYEE NOTIFICATION AND EVACUATION:
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C. PUBLIC EVACUATION: '
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D. EMERGENCY MEDICAL PLAN:
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3 GoLde¡J0HP / æ-c:.. 4~ ß-L AlUé!é. ...;'';?7- 9ðt9ð
ft>lm
a Ba~ersfield 'Fire Dept.
, ~azardoUs Materials Division
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS: '
, ¿/S~ &~O.s/tJ¡J ¡J/UJOF {2c/UY;¡¡;'uEL~
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
ßtI/'ld d,.qµ or-/l¿$ð¿8/J1<J1 /d/C-é. HVLt..S
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C. CLEAN-UP PROCEDURES:
V S£, WE;t ~ ~(!.. 7Ci U"tplJ u¡:J S ¡ð l' / /A- b 6
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY):
~
ÑÃ;~;~L GAS PROPANE: p:Á)d ð¿ &1 ß. 1..0.£1(" .ß./ /4T~ /?ArÌ
ELECTRICAL:,/ß:~b· ør- "~ð-d úJ/BL8 U ' ,
'WATER: e/Ud 'CJ~ &c/g.
u
SPECIAL:
. LOCK BOX: YES/NO
IF YES, LOCATION:
c
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SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
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A;
PRIVATE FIRE PR, OTECTION,: , n---. '
:;;. ¡:J "f!/ ,Uk L V¿ r:S1 ,y-y êÃ#4
B. 'WATER AVAILABILITY (FIRE HYDRANT):
EttJ d ¿)r ßú;¿d /'ì.Jt:.
, 4.
FD159Ü
OF BA.KERSFIELD
MATERIALS
CITY
HAZARDOUS
page-L0fL
INVENTORY
Standard Business
and Agriculture ìlI
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ID~#
NAME OF THIS FACILITY:
STANDARD IND. CLASS CODE:
DUN AND BRADSTREET NUMBER/FEDERAL
-- ---
SECRET
£"A ¿¿,
TRADE
NON -
OWNER NAME
ADDRESS:
CITY, ZIP:
PHONE ,#: .
Farm
BUSINESS NAME:
LOCATION:...
CITY, ZIP:
PHONE #:
14
Mixture/Components
Instructions
Number
Number
Number
PROPER CODES
12
Location Where
Stored in Facility
& C.A.S
& C.A.S.
& C.A.S
Component # 1 Name
# 2 Name
Name
Component # 3
Component
FOR
INSTRUCTIONS
9 10 11
Cont Cont Use
P~ss Te~ Code
I
Delayed
Health
00.
Immediate
Health
#
6
Number
00 Reactivity
o
5
Annual
Amt
Gt.:1L
C.A.S
.300
Sudden Release
of Pressure
4
Average
Amt
L.2o
o
1
/
Db
..u~
GAL.
/SO
;?"s--
Number
Number
Number
& C.A.S
& C.A.S.
& C.A.S
Component # 1 Name
Component # 2 Name
Component # 3 Name
Delayed
Health
IDDDediate m
Health
Number
o
Reactivity
C.A.S
~
Sudden Release
of Pressure
Physical and Health Hazard
(Check all that apply)
D 0
Hazard
Fire
Number
Number
Number
& C.A.S
& C.A.S
& C.A.S
Component # 1 Name
Component # 2 Name
component # 3 Name
Delayed
Health
o
Immediate
Health
Number
o
o Reactivity
C.A.S.
,
Sudden Release
of Pressure
Physical and Health Hazard
(Check all that apply)
D 0
Hazard
Fire
.
Number
Number
& C.A.S.
& C.A.S
Component # 1 Name
Component H 2 Name
Number
C.A.S
Physical and Health Hazard
(Check all that apply)
Delayed
Health
o
IDDDediate
Health
o
o
o
o
Number
& C.A.S
Name
Component H 3
Reactivity
Sudden Release
of Pressure
Fire Hazard
#2
Phone
those
Hr
inquiry of
24
my
SIGNED
based on
DATE
Title
and that
Name
~ertHication (READ AND SIGN AFTER COMPLETING ALL SECTIONS)
"1, è-«tHy under peanlty of law that I haver personally examined and am familiar with the info:rmation submitted in this and all attached documents
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l,nd'1viduals responsible for obtaining the information. I believe that the submitted information is true, accurate, and complete.
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Phone
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24
Title
Name
#1
EMERGENCY CONTACTS
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