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HomeMy WebLinkAboutBUSINESS PLAN 7/9/2003\' 1i, r~ l ,, TmJ 3/9 -/1/S' . ' ~ ALpt-~. tzli.-- \ :J~D ': ~;,.:,' ..,.. I~fl)'}¡' ;,~~t' ';~ ,,' '. _ __ :f~,·.t:,;..,~~.\ ' ' 'I~',', Sm: DIAGRAM' 'V t FACILITY 'DIAGRAM I ' f . ,t' .--: AIIi_ I' t' .' .. , !,;;' Bulin.. Name: i A-IJ ffi);o t1) Ò+-I \Ae. , '~.l':~Q,y~~_Address~_,__~?":'~_. (tJìlolcL {2-D oHG" .'___._~ .___ ___".w.,.._,._w.__~__ .~ (J' a\ ~ \ .o;;.~~.;c:....'1 ¡ i ~ ~ -', ..:.:ø - '- ( -" - ~ o - .:r ~ -OJ ~ ~ -er- r;:[ \b I ¡ \£) Cì- I c. -- x OJ ~ &1 Q-. q.J - ~ ~,~ , ~- ~ I I : t I ' , . .> ' --~ ¡ ¡ I I ! -y~'- .~. :k- ~ ¡¡ I i I~,~~..-, -' ¡....l......., .....'-0;. - . ~-tJC'.....-·, .. 'ë>,PHf..:t .' . ';>:' , ' XJ< .7(-7<- - \< ')( -~'<C4 'f' \ -J'! ,~ r--;¡~ I emb ~ . ^. ~-_·;tß~~--1 , Grt.Ar:s G(açs ~ ~~ ~ l- , ~ tw¡;~-;:-çi.-'· ~)iá'\:~;;K~~'"~ -··i {J~ .oft 0« .. ,""" \1 ,- _ c · . ........, .~. .- '::i &. TAN A-Vl'O(t)C}},V(: i ; ~ li."" ! ~ ::z:: ¡ ~e ,ø ,~.. -- ..".- "'~'""'- ~ ~ h 6 ~ : V i ----0 :JI -t:~'~~ 1 ~ .~ ALL ßod~ ßM~ ~ i. ~ , r·t _Jj :#;:r:. ALL BodS 5~l(J..p t c ,- '- ,a... t q. (ß / ~ f¡' j _J "~3-=~~ -----._------~--".. .- )'d1lV , , ,¡:- 1 ¡;:..¡- ¡ V3ß_~ f.' ~~ ~ A.- I ~ \11> I.· .~~) ¡ .~ k-. i ' r r I It V ¡ Î j P ¡ ~ f ~~ .01- (I) 'f .c- !) 0,'" ~ t:.õ :'b ~ Ç.. tP : ~.;,- tJi ;;;¡".. " õ: ~i , ,f'" w o ~ j L ± -'- ::t:- '1)1 , ' , ~. ' '+ '~yy-~., . ¡{~ii ~ ... ~---_"""""""''-_~'''.t«.<.o_~'''"'-_'_____~_'___ , " Qï;¡;-l· ÎtPfJdsolt J j«l\/U ~~~lQt\ '~~~§'A-\1Ð . @,.., --~, .._---- '..... , '::, " (, 8m DIAGaJ. [ .. Business Name: L ......r/-;':d,û I - Business Ad~i _f') , '1\ I , ~ ¡ ¡ i , , : ï ! .... _. ~~:>~' .-----~~~~ :.;:;.t';d e - r. ¡ '\; ,: t , " " Í¡ ¡ ¡ \ j ¡ I I ~ , ~ ß i--:- .~ ¡ 6 ~ 6- ~ .t1 -q ..-\ ¡. I} <i~ 1 o U: ~ o ð ~ 1 Ii ~ t j f~. Qý :^l l;# '''' .¢ii,"%, Cf~ ' 1 .'"' ..4' ' ::t. \! if. ¡ :3 ,(,~ ¡ ~ \ ;! o ¡ -r' ".:) -<î \0 , II I' ~-f , ( { I) ¡ t I: ¡ i ( I I -==-=-----h-==-- ~ ., îj :¡ ~l ~l1 () t fc~t:t 4' \0 ~ ~.:i :; ~:î ~ ,;, l~'¡' t, ) ._"-"?:'-~~,~~=::<'_-:«:".~~-...,--"'.~~:-~;.:;::;/!'~~..-.:7,' 't .f--: ~ ~ "t> 1¡.) ~ ( rr -<¡i-f) " ; C!..:- I ~~a~ . 1r~.:.;: ~ ~ 1 ,~ . ~ :::> ì ( I . ¡ \ , ~. I': ~ ~ ~_~"=,,<-~==c)t~J . ~' ;1 I r :/ ¡ "" - @ ~ ,. -"~ ~ - ~ ~-- ~ JJ '-If'~' <:t ,S ¡ "- I Q... 8'-<fl ~ I, f" n , :)-.11 I"':J' IÀÕ ~., ~ r~ --~', ~~, '-~=x.._~'''-~~':'. .'~'--1 _,n.~~~__ -.~- -~'ó '~.-', drJ ( ·î'"J1~ I' " I "0: , ~I :, ,r I II , tZ1 ; ~, i !, t' ...-~.--.,."..,...~~--,...,.. '_~_.,..___..v..-~:'-.; -- À v:) ~ ~ ~ G ~ " ~ I . I.' ·r !' ~ I ,C1<:';"--='---;~ J ' ' tc"-" "-',.. "r .,' ' ~~~~~;:~:~ ~~,~ '-~--<~~¿" , } -, .. :J: t- .~ () ~ i \I ¡¡ !. FACILITY DIAG ~'t±ì ,£t'ti.tf7\ /"YJ)'~> j) .:"",." RAM ' f , ,Ii', V ~;¡' . i._.-1> ! t) .r"J "'" "j . ~u <,~(;,- - I Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE 'Î! This permit is issued for the following: ~@,!:8rdous Materials Plan round Storage of Hazardous Materials PERMIT ID# 015-021.Q01260 agement Program TAN AUTOMOTIVE Waste LOCATION 4300 WIBLE ~ ï .1 Approved by: JÙn~30. 2000 Expiration Date: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 Issued by: -- . Hwll\IP SITE C'rAGRAM Œ::r , ",,,,, ->f' PLAN' ÑI~~P '7 IdGO F:'ILITY DIAGfR).M Œr" RECF\vED 3,,",s:::~SS ~ame: ~(.: /\1 Aj J[OVVl Of :V' e., RiCiPÆD ' JUl 2 3 1990 fAr ee! _ -y..{.^L;,~Le-C2-o(ÃJ -____ ~_ HA_Z,_ ~~T:. ~I~._, / -- . L.l / / / ~/' ~(l9 ~+ --- . po-r L~\''0 0..( e~ We S+ Fro PI. .. Doa e.. J "'._...... . o.Çç,c fID¡~lY\Gi.kc. ty:Wfè '~ ~ Sf' r 1 ()"¡(~ ¡e. --- vt:rJR t ofC\tí ' ~lIof ~ííor eli!C~p.\·<. V~\~~t~çç. pG\n~1 QI ~ S~[O¥J /(p . ~U10MtdIL/ , ._~--.-- - --' 1_ k '\)JlÁ.( H:' --- ,,- '-, -- --- '.. ~Sprif\l(~ee " /\ <------. ~ arwöÐ{~ o w.çk Dt'/ 'I . ] , ~'-fJIIIIIIP. (?¡<\.r~ POdRo. iI2 --'- U U v,,"cK ;;bot¿ rJUI I ..., '. ':'1\ HAZ. MAT. DIV. t'\ ¡ ..:- - , ! No:''':~ Name 0: Ar~a: - - - '._~~jJ~l-d¡~_,_____~. ..McMm I í - . pØ\(Kt'~ (Ä(eO\... 1 froNl U ALJe ( 00J0f R e~,^,,' ~ I 1 J/ ~ ,.. ~ I\., ... .()\ ---.0, =.-. - _--=--~~'~-._~~-=-,--.~.::.:____ __ _~___~_ ~ II) .. ci ( I i1 I r I 1 I '~ ReOt(Z. ~ " Mat' ~elìc+R\'C VJa.\-t~ <2>.\-10 t oçç A:~a ~ap # 0: A:(/Í!J ~epa~'R -,....+_---.:....--- ------ _.~- - Reae. eA S./- co; ~o.; . fi/J (JéJ ~ ;;. .. ' , ~ ,~ , .. "4 / /~ ',;' SITE/FACILITY FORM 5 DI~~M/~ 6'é) 7 NORTH sr;:\LE: BUSINESS :-':AME: -- ;:'LOOR: ()': ..............~. ,.....-. ¡,,\ l ~ =, £' (CHECK ONE) SITE DIAGRA~: V FACILITY JIAGR¿,\:vr .......... ..- ._,~,-~ ~ - - - ......- - - 'AJ" bJ~ RiD ad ~ I I , - .--- n" t \{ /~ I f I ~ .:.-- '-. ....,. <:>ÎC\~ We;. \ \( -¡ 7:~1"j~ ~ -_"~_~__'~___.,_o_.____~ We,>-tef 1ft \tV w i f\~\!)r).,/'I ( q-o 'Ã~ o~ç,t,~ /Ii) . 6~e "\ tv~ to,,~ - C-@ ~ (tift,. ~~t\~~~~ ft.~r i)~{!¡.g., Jl ~<ii>~ ,~ Hi! ~~ ,~~ __ T\)\~ ß~" (,'" ~¡N~~~~H -OFFICIAL USE ONLY- -. (Inspe~tor!s Comments): - .'3.4. - rJUI , ...,. \' r~ HAZ. MAr DIV'6 I , REC¡;::\J¡:O.~ ( Hl\I l\I P SITE DIAGRAM ~ PLAN ~I.\P /¿Go FÁ':ILITY DIAG/R~M Œ I Sl.:.s:.::.ess :-lame: ~Q AJ!1o¡;t~J;i~ð :s /T'E {. (j,:t:J=. t.;lb 0 A:!!a ~aç # -#£ 0: Nc:'':~ Name 0: Ar!!a.: A()1ð 12e~ ---- \J " "- :> 't ~ c:;) ~ g: 0 ~ ~ - ,...: .) IV") « ,z "t:~ <) :1 <="J ~ ~ ~~ -' N ~ ,; ¥ .~ ;::) -:> « 16 ~ .'~~ :r ~ ~ ~ ~ " ,.. ~~~ Q..(I) f¡JJ o ~ ~ ~ .~Q , , ~~ ~ ~~c ~ '=: VQ..... :.; <I)" ~ ~ ......., -r+ (:'11' ~ \L !';) ::1 :G 1 .~ ¿ QJ ... ~ .,n ¥ ... " a.. "i .... ~ ~ -::x:: ~ \i.. . .....-I' 2- It ': ... ~ Q \~l u ~v -....~ ~~c g.4f ""- O(;)~'- ::¡: (- ~ ~ r\ 1 . -- ~l G::Iv- o ~~ ðo--;~ ¡~ OJ -J- V\ 01. C" ~ Q) t) ~ oJ ,þ \:S V .. c:x:: &> ¡ (\... ~ <.J,. fI' 'u.. ,..) ./1O'7¡j _..2.~c: s:.,. $'..; ~ cs ~ il'.,:: V\ Q. -;)~ v '- <.J.. ~ u.. E~O Q) ~~ -~1i i .. ~ ~ 1L .J;¿ QJ --.I ~ 't ¡ \ t:d.. ..s Qj ~ ......... .... --"-þ ~ ~ l' --~ f 'd..l~ "rJ:'PWt;; . ...;-> -- - ~ FiRE CHIEF ReN FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326,3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661)399-5763 e e July 9,2003 Mr. Joe Johnson Johnson Industrial Center 4300 Wible Road, Suite B Bakersfield, CA 93313 NO FURTHER ACTION REQUIRED Re: Hoist Investigation at 4306-D and 4312 Wible Road Dear Mr. Johnson: This is to infonn you that this department has reviewed the results of the Phase II Environmental Site Assessment associated with the hydraulic hoist removals perfonned at the above-referenced locations. Based upon the infonnation submitted, this office is satisfied with the corrective action perfonned and requires no further action at this time in the above-referenced matter. If you have any questions regarding this matter, please contact me at 661-326-3649. Sincerely, ¿J~l <:tJ W.£_ ~ Howard H. Wines, III Hazardous Materials Specialist - Registered Geologist #7239 Office of Environmental Services HW:db cc: J, Garcia (Glenfos, Inc.) ""Y~~??~ ~.A0Pe.r~ A ~~'I'I e v JOE JOHNSON// DBA JOHNSON INDUSTRIAL CENTER 4300 WIBLE RD SUITE 'B' BAKERSFIELD CALIF. 93313 PH# 661-836-8293 FAX3 661 832-9277 'E' MAIL JJ2B50@ CS.COM JIM CREECH MANAGER CEL# 661-619-0290 TO WHOM IT MAY CONCERN; TAN AUTOMITIVE MOVED FROM MY LOCATION AT 4300 WIBLE RD. SUITE "E" IN JUNE OF 2001 AND THIS IS RENTED OUT TO OTHER TENNANT. AFTER JUNE TAN AUTOMOTIVE WAS NOT AT THIS LOCATION. ' I AM THE OWNER OF THE INDUSTRIAL PARK, JOHNSON INDUSTRIAL CENTER, AND HAVE OWNED SINCE LATE 70s. ( I RE¥AIN) Y DR JOE J0&S ' 4300 WIBLE S T BAKERSFI D AUF. 3 13 \ \ ~-:.-- ~. ~ --<..~"'- ~- ~ '- -....: ,~ ~----.---- - --- - ____ "0.... ____~ "'-- _.__ .-__ ______ _, - j II -- 4t- 0/)- O;¿l- ÓÓ /;2-G. 0 C;;;;;Y CITY OF BAKERSFIEI,D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd I<'loor, Bakersfield, CA 93301 ( FACILITY NAME let"'- t\~ ) /M.O ~ Jw ADDRESS 4~OD (,/Jl þ/~ ~ FACILITY CONTACT_ INSPECTION TIME INSPECTION DATE /0-/0-0 ( PHONE NO. ~,3 q - ~"~ BUSINESS ID NO. 15-21 0- ~ I U 0 NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~. DC b' d OJ . tA D M If A / DC 1 . DR . n outme om me om gency u l-~CY omp amt e-mspectlO OPERA TION ( Ý K COMMENTS Appropriate pennit on hand 11 (j / Business plan contact infonnation accura~ tf\( J 7 / Visible address \J\;\J / Correct occupancy \ // Verification of inventory materials f 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 DNo Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party White - Env, Svcs. Yellow - Station Copy Pink - Business Copy Inspector: ,-' "- - - ,¡ e RRrEIVE JAN 5 2000 BY:- /' ~ \ /'/ -' TAN AUTOMOTIVE SiteID: 215-000-001260 Manager : Location: 4300 WIBLE RD E City Bakersfield BusPhone: Map : 123 Grid: 13C (805) 834-6665 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 07 EPA Numb: SIC Code:7539 DunnBrad: Emergency Contact / Title Emergency Contact / Title TAN NGUYEN / / Business Phone: (805) 834-6665x Business Phone: ( ) - x 24-Hour Phone : (805) 834-9085x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: ( ) - x MailAddr: 4300 WIBLE RD E State: CA City : BAKERSFIELD Zip : 93313 Owner TAN NGUYEN Phone: (805) 834-9085x Address : 3800 WHITE LN A State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì f= Hazmat Inventory p== MCP+DailyMax Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP WASTE MOTOR OIL WASTE COOLANT F F DH DH L L 110.00 GAL Low 55.00 GAL Low I, -nAf NG-U yE !J Do hsU'~b11 C~iiö~ ~i1~~ ~ hraMB (Typo or print name) reviewed the attached hazardoos mSl~SffÛtæl$ mSln~g(à!- ment plan 101' íÃ-M~~= lI~~oo ~oo~ ß~ ~~©In~ ~öih sny coi'redioVls OOq'bs't¡~9J~~ Ia1 com¡o;s~® ~n(Q1 ooi"U'®d mali1- a~)ismsi"li plan ~oU' my ~©m(y. ~ 12/21/1999 e e F TAN AUTOMOTIVE f= Inventory Item 0001 = COMMON NAME /CHEMICAL NAME WASTE MOTOR OIL SiteID: 215-000-001260 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit NE CORNER INSIDE BLDG Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container, , 55 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average S ~ct,Q 35 . 0-0 GAL %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS HAZARD ASSESSMENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH ./ / / Low S f= Inventory Item 0002 F== COMMON NAME / CHEMICAL NAME WASTE ,COOLANT Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit IN SHOP Map: Grid: CAS # I' 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE PLASTIC CONTAINER 55 AMOUNTS AT THIS LOCATION Daily Maximum 55.00 GAL Largest Container GAL Daily Average 1.-2 g;.Q15. 00 GAL %Wt. RS CAS # 100.00 Ethylene Glycol No 107211 HAZARDOUS COMPONENTS ZARD ASSESSI.JIENT TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ ' Curies F DH / / / Low HA S -2- 12/21/1999 .' e e SiteID: 215-000-001260 ì Fast Format ì Overall Site ì 09/21/19921 09/21/1992 F TAN AUTOMOTIVE I , p= Notif./Evacuation/Medical ~ Agency Notification CALL 911 Employee Notif./Evacuation CALL 911 EVACUATION, FRONT DOOR OR REAR DOOR EXIT Public Notif./Evacuation 09/21/19921 09/21/1992 VERBAL Emergency Medical Plan NEAREST HOSPITAL, MERCY HOSPITAL -3- 12/21/1999 e e F TAN AUTOMOTIVE I f= Mitigation/Prevent/Abatemt r=: Release Prevention I USE CORROSION PROOF CONTAINERS r=:: Release Containment ~ILD DAM OF ABSORBANT RICE HULL I Clean Up . USE WET VAC TO CLEAN UP SPILLAGE I SiteID: 215-000-001260 ì Fast Format ì Overall Site ì 09/21/1992 ] ] 1 I 09/21/1992 09/21/1992 Other Resource Activation -4- 12/21/1999 e e SiteID: 215-000-001260 ì Fast Format ì Overall Site ì I F TAN AUTOMOTIVE I f= Site Emergency Factors r== Special Hazards Utility .Shut-Offs 09/21/1992 A) GAS - SOUTHEAST BUILDING INSIDE B) ELECTRICAL - SOUTHWEST BEHIND'BUILDING C) WATER - SOUTHWEST. BEHIND BUILDING D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 09/21/1992 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM ALARM, FIRE EXTINGUISHERS FIRE HYDRANT - END OF BUILDING. Building Occupancy Level -5- 12/21/1999 · "'; ~ '<II> e e F TAN AUTOMOTIVE I , F Training Employee Training SiteID: I 215-000-,1001260 ì Fast Format ì Overa~l Site ì 09/21/1992 I I I I MATERIALS. I 1 I I I I WE HAVE 1 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: EXPLAIN HANDLING AND CLEAN UP OF Page 2 r I I Held for Future Use Held for Future Use -6- I I I 12/21/1999 I I ........ .. ..,' ,i. i' e e ~ ." 09/03/92 '.' TAN AUTOMOTIVE 215-000-001260 Overall Site with 1 Fac. Unit Page 1 General Information Location: 4300 WIBLE RD E Map: 123 Hazard: Low Community: BAKERSFIELD STATION 07 Grid: 13C , FlU: 1 AOV: 0.0 - Contact Name Title Business Phone - 24-Hour Phone TAN NGUYEN ,-AfV' A-u'7õ M 0 11u:..- (805) 834-6665 x (805) 834-9085 ( ) - x ( ) - Administrative Data Mail Addrs: 4300 WIBLE RD E D&.B Number:, City: BAKERSFIELD State: CA Zip: 93313- Comm Code: 215-007 BAKERSFIELD STATION 07 SIC Code: 7539 Owner: TAN NGUYEN Phone: (805) 834-9085 Address ,: 3800 WHITE LN A State: CA City: BAKERSFIELD Zip: 93309- Summary ~ç ¡~,yJs €X:-P\6_·..~ , -1lu~'. .j ß7. j, 1~~ tJP RECEIVED SiP 1 7 19921 HAZ. M.AT. DIV. ,"- ()~ -1P ~. J ~,TA^tr NfrUyelV Do hereby certify ~hat i have \,pI'! or print MIne) reviewed ÜiB attô.crw{f ~,:;,;/:,:;,¡'(:[¡";US materials manage- ment plan fo~:::m-jLA,U_TQ.t1iìi&j that it along with (N:¡r;¡~ :;~ ;~'.r1i¡.øsg) any corrections constitute a cornpiete and corroc1 man- agemsni plan for mlf~aciiiW. --' ~- ~- qZ, I '; e e '. 09/03/92 TAN AUTOMOTIVE 215-000-001260 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 WASTE MOTOR OIL. ~ Fire, Delay Hlth Liquid 110 Low GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL 1101 35.00 I 220.00 storage DRUM/BARREL-METALLIC r Press T Temp ~ Location Ambient AmbientlNE CORNER INSIDE BLDG - Conc l Components 100.0% Waste Oil, Petroleum Based r:- MCP -¡-List Low I - Notes ..... ~ e e 09/03/92 t TAN AUTOMOTIVE 215-000-001260 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical , <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation CALL 911 EVACUATION, FRONT DOOR OR REAR DOOR EXIT <3> Public Notif./Evacuation VERBAL <4> Emergency Medical Plan NEAREST HOSPITAL ~erCy Ho"f,Î W · . e 09/03/92 ¡ e TAN AUTOMOTIVE 215-000-001260 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page 4 <1> Release Prevention USe Cor<f?OS,t1r} pro-of Con~"t} ~S l <2> Release Containment Bo\ld dwn cYt AßSo ~ e¡Ce. Jlul/ <3> Clean Up USe \JJe~ -VG\.C 'lO c\ean CI p S~t'lJ~ <4> Other Resource Activation vi 'J - e 4· '.... 09/03/92 ¡ TAN AUTOMOTIVE 215-000-001260 00 - Overall Site Page 5 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - SOUTHEAST BUILDING INSIDE B) ELECTRICAL - SOUTHWEST BEHIND BUILDING C) WATER - SOUTHWEST BEHIND BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM ALARM, FIRE EXTINGUISHERS FIRE HYDRANT - 111111111111 'S~( i t)~e~ys;Wm, f 6ftd 01 Be) f Ld \~ <4> Building Occupancy Level " , J e e ~ (. -:-. '.. ,; 09/03/92 TAN AUTOMOTIVE 215-000-001260 00 - Overall Site Page 6 <G> Training ., < 1> Page 1 WE HAVE 1 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: , ~ ~fX~n ~GNll\~o(~~~_ <1~~ Vt>, '?&- ~~~I'~~~ <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use / / ¡Y~OF BAKERSFIELD , ZARDOUS MATERIALS I NON - \ OWNER NAME ~DRESS: 3 ÎCITY, Z : . PHONE ,# I. " page_o; ,~ CI - .... ,.' INVENTORY and Agriculture'O o ~ NAME OF THIS'FACILITY:-¡¡' STANDARD IND. CLASS coDË: DUN AND BRADSTREET NUMBER/ - - -- --- ---- TRADE SECRET Standard Business Farm BUSINESS LOCATION: CITY, ZIP: PHONE i , e~ 13 , by wt FOR PROPER CODES 12 Location Where Stored in Facilitx & C.A.S. & & Name Name Component # 3 Name # 1 # 2 N, # 3 Name Component # 1 Component # 2 Component component Component .. Delayed Health o I IDDDediite' \ Heal~ Number o 6 C.A.S. o 4 1 Physical and Health Hazard ",(Check all that apply) F~·:: . ':;'0 Fire 0 .,:, , Number Number Numb~~ I Numbef & C.A.S. & C.A.S. & C.A.S Component # 1 Name Component # 2 Name Delayed Health IDDDed~e 0 Hea~ Reactivity Number Reactivity o C.A.S Sudden Release of Pressure o o Hazard & C.A.S. Name Component it 3 Sudden Release of Pressure Fire Hazard Number Number Number If¡ & C.A.S & C.A.S Component # 1 Name Com~onent # 2 Name Number C.A.S physical and Health Hazard (Check all that apply) Cl & C.A.S Component # 3 Name Delayed Health o Reactivity Sudden Release of Pressure o Fire Hazard o of those inquiry my based on Title and that and all attached documents and complete. i1 Certification (READ AND SIGN AFTER COMPLETING AL, SECTIONS) I certify under peanlty of law that I haver personally examined and am f,-iliar with the information submitted in this 'individuals responsible for obtaining the information. I believe that ~ submitted inforlÌ1ation is true, accurate, '~'.' j amER/OPERATOR L ~R/OPBRATORjl""I OR EMERGENCY CONTACTS '" .., ¡r: i~·~ J,1 e Bakersfield Fire J!pt. Hazardous Materials Inspection / ./5' Ð c.;f 'j / Date Completed Business Name: ~ ft.J .4,< 10 n1 t:J /./ ~ ~ 1./3 .... (::) I I 0, 'I ¿ Ie _r:: Ir Location: L"'" t..Æ-' I::J RECEIVED OCT 1 7 1991 HA7 MAT.DIV. 00/;).(,0 Plan ID # 215-000 (Top right comer Business Plan) Station No. 7 Inspector ~. Lt<t'J'1s L Shift Adequate Inadequate Verification of Inventory Materials cxr 00 ~ ~ Verification of Quantities Verification of Location 11) 't--- Proper Segregation of Material V Comments: Verification ofMSDS Availability Number of Employees >- o o o o [SZ] Verification of Haz Mat Training [S( ~ Comments: D o Verification of Abatement Supplies & Procedures &J Comments: Emergency Procedures Posted o M Containers Properly Labeled Comments: Verification of Facility Diagram D Special Hazards Associated with this Facility: Violations: o o o o Md. .,. FD 1652 (Rev. 3-89) Yellow-Station Copy Pink-Business Office 'i e e \\ Ii \1l1TJ17h.. t ~ t! 0 ~ ;);:':~~~6;:~:!% CITY of BAKERSFIELD II (p(p(pì7~~~'~\ ø~'~~ .. ¡VE C-iRE" (] ~'1'- ~~; '~' :;i~ D ~\. ,~ ,/~ ;;t--.' - , w>' ~ åJ"ííÍ~ , ,/:::::~AK£-',. /o't ""'" ~<S');, ...,.)..',.,', ~\ 'f:_ .~" ("', : ,(..; - ,J. C), (., ::'=-':-.~c,-' ,.' t'~ -,~1,·"",1 " \ ~- ---" , ',\,("',.: ," .J "',:'ttrto'@);, .~ @ RECE'V~O JAN 1 2 19R9 Ans'd. ........ T iArv - N6UVEN (tYDe or print name) Do her e b ~- c e r t i f y t hat I h a -\ - ere vie h- e d the attached Hazardous Materials business plan for ~II/ AU '10/10 IJ/Je (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. "...-...--.- --- ¡;..Jf - ?q date ~ of BAKERSFIELD CIT}T ., INVENTORY SECRETS MATERIALS TRADE == HAZARDOUS NON- €. .~ I.-..J .' of Pa". NAME OF Tft1Š ~~JL~TY: -r7 STANDARD IND. CLASS CODE_ DUN AND BRADSTREET NUMBER - - 11 "- of lixtUN,c-tl See IlIItructi_ JJJ¿lP f.. -'ii1-. ---- 1] 'by 1ft Standard BU5,nl!55 F.r. .nd A9r1Culturl! BUSINESS NAME: LOCATION:_ CITY, ZIP: PHONE . ( 1Z lGCIt10n IIIwe Stortd in Faci I1ty 7 . I Oys Cont on Sit. Type ~~b~ (:) 6 C.I.S, 6 IløIU... Units . I_a~ Aat 3 ... Mt 2 Tvoe Cod. 1 ''In, Cod. ~~-- ... . C.I.S. ....... J ; ....... ....... · C.I.S. ... ...... ______ c:a...nnt II ,. - ., to.aønInt 12 ~._.J c:a...nnt 13 Sudden It 1_ of P.......... ,.-., I.._.J Del a,.cl Heilth ,.-., I.._.J and HH I th Hlzlrd all thlt IIIP Iy) ,.-., I.. _.J RlICtivity Fir. Hazlrd Physical fr.hKk r-, L_.J l-.dilt. ....Ith · C.I.S. ... -----.-.....---- ....... ....... · U.S. ....... · C.I.5. · U.S. ... ... ... c:a...nnt 11 c:a...nntl2 c:a.an.nt 13 ......--- ,.-., I.._.J Sudden Rt 1.... of P...._ C.I.S ,.-., I.._.J OIl ayed Heilth PhysicII and Heilth Hlzlrd (ChKk 111 thlt IlIIIly) r-., ,.-, r--, '- _.J FI... Huard I.. _.J Ructivity I.. _.J l-.dilt. ....Ith eo..on.nt 11 c:a...nnt 12 c:a.an.nt 13 ____JL____L____________1--____________JL___________J______l______L_______J_~JL____---L--______ Physicll and HHlth ",Zlrd C.I.S. "'-bIr tc.Dontnt 11 (Chtck all thlt ..,1,) r - , ,. - , COII IOIIIIIt 12 '- _.J Flrl! Hazard I.._.J COII IOIIIIIt 13 ----- Physlcll and IfNlth Hlzlrd (Chtck 111 thlt IlIIIly) ,--., ,.-., '-_.J 1.._.JRllctivity ....... ....... ....... · C.I,S. · C.I.S ... 1- ...... - ,.-, I.._.J C.I.S ,.-, L._.J ,.-, L._.J - ....... Iüber ....,. · C.I.S · C.I.S · C.I.S ... ... ... l-.dilt. Heilth ,.-, I.._.J Sudden R.1N1. of Pressu... OIl a,.cl HHlth ,.-, L._.J ,.-, L._.J Firl! HIZlrd ----------------------___________________________________e______ · C,I.S ... 1~~%~16..L l-.diat. H.llth Suddl!ll RI! I NIl! of Prl!Ssurt __Ji.a_--:__THl~~_r{Ç1±I.¿______ Ri. Dt laytd H81th IIHct iviry n~:t.;fí:z.6..-?- T1m---D.wJ2~ß... -------- thol. of thlt basil! on wy inquiry 12 Q¡;rf±.rY-7....N..fi:JLY-~IJI..____ and In this Tifli------------- n________ Cer iution (Reed /md sign lifter co.plf'ting 1111 sections) I certl¡~ und.r IIMlty of la. thlt I hlvl! trsonally I!xI.intd and I. f..iliar .ith thl inforaation su.ittld for obt"(ininv thl inforaltlon. I btl1ev! thlt thl! su.1tttd inforaation is trut, lC:curlte, and cc.plet.. 1100 - n-·a~--,Xft,/JI.t,·::-,JL-6:.Tc(L'i-GD~L--7-----r--·----tr=---=,.---------t-t--- 4_ .nno 'C1. ,1 I! 0 OWIl!r oDl!rðtor ~l'õionl!r OOl!ra,or 5 au ""r1Z~ rl!pres." a 'VI! '\ Siqñitm--- 11 IIERGENCY CIllTACTS ...... " .I ~.: 'BUSINESS NAME TAN AU.OTIVE LOCATI ON 4300~ E WI BLE RO 10 NU~ 215-0ØØ-0Ø1ZS0 HIGH HAZARO RATING Z t. OVERVIEW LAST CHANGE 12/01/$8 BY VAL ,JURI S CODE 2 t 5-005 JURI S BAKERSFI ELO STAT! ON 05 MAP PAGE 123 GRID 13C FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) NO PRIVATE RESPONSE TEAM EMERGENCY CONTACTS ZA SEC Z) TAN NGUYEN - 834-6665 OR 834-9762. UTILITY SHUTOFFS ZA SEC 3) (1) GAS - SE BlDG INSIDE 8) ELECTRICAl. - SW BEHIND SLOG C) WATER - SW BEHIND BlOG Ç» SP~CIAl - NONE E) LOCI< BOX - NO Z. NOTIFICATION / PUBLIC EVACUATION l.AST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE J 1Z1ZZ/13B" rz:3'Z,' , MATER! AL SAFETY DATA SY5TEMS, I Nt. (805) 648,-6800 .. -----~;.... BUSINESS NAME TAN AUTOMOTIVE LOCATION 4300-E WIBLE RD 10 NUMBER 215-000-00J260 HIGH HAZARD RATING Z 3. HAZ MAT TRAINING SUMMARY N'å LAST CHANGE / I BY < NO INFORMATION RËCORoED FOR THIS SECTION> 4. L.OCAL EMERGENCY MEDICAL. ASSISTANCE LAST CHANGE J2/0J/88 BY VAL ZA SEC 5) NEAREST HOSPITAL PAGE Z .,.-. 12/2Z1B8 12:32 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 e . "BUSINESS NAME TAN AU~OTIVE l,OCATI ON 4300--E WIBLE RD FACILITY UNIT 01 10 NU& ZI5'-000-001260 HIGH HAZARD RATING Z A. OVERf~LL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 12/01/88 BY VAL 10 TYPE NAME !_OCATION CONTAINMENT MAX (~MT UNI T HfUAHD USE WASTE WASTE MOTOR OIL 110 GAL UNKNOWN NE CORNER INSIDE BLDG DRUMS OR BARRELS MET.. WASTE 10 PERCENT tOMPONENTS HAZARD LIST 159B.00 100.0 WASTE OIL UNKNOWN 'µ~ B. FIRE PROTECTION / WATER SUPPLIES LAST CHANGE lZ/01/88 BY VAL 3A SEe 4) NO PRIVATE FIRE PROTECTION 3A SEe 5> FIRE HYDRANT - ? PAGE 3 1 ZrZZff.fa fl: 3Z"~ MATERIAL SAFETY DATA SYSTEMS, INC. (80S) 648-S80Ø ?., ._',~A BUSINESS NAME TAN AUTOMOTIVE LOCATION 4300-( WIBl.E RD ID NUMBER ZI5-00Ø-001Z60 HIGH HAZARD RATING Z D. EMPLOYEE NOTIFICATION I EVACUATIQN LAST CHANGE 12/01/88 BY VAL 311 SEe 2) CALL 911 EVACUATION, FRONT DOOR OR REAR DOOR EXIT E. MITIGATION I PREVENTJON 1 ABATEMENT LAST CHANGE 12/01/88 BY VAL 3A SEC 1) SPRINI<LER SYSTEM ALARM, DIRE EXTINGUSIHERS PAGE 4 lZ/2Z/88 12:32 MATERl AL SAFETY DIHR SYSTEMS, I NC. (805) 648-6800 ~.. . ~- ('.. e - / / / e ~ BAKERSFIELD CIrl FIRE DEPART{E~T 2130 "G" STREET BAKERSFIELD. CA 93301 (805) 326-3979 v RECEIVED MAY 5 1988 Ans'd............ OFFICIAL CSE O~LY /~:3-/3V 5~. /0~D ID# US IXESS :;A.'1E HAZARDOUS MA7E~IALS BUSINESS PLAN AS A WHOLE FORM 2A -IJ~ c!c022¿ ~(;¡ e. INSTRUCTIONS: 1. To avoid further action, return this fQrm by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: -I ~AJ B. LOCATION / STREET ADDRESS: I~(Å kev~h'~ \¿ . I CITY: ..- ...... ., 1f(J 110 NO /J ð ~-e. 4300 (Ah'ble Î9..Ot;\d ZIP: 133/? ::ttg BUS.PHONE: (80s) Sf?'¥- -tp-66Ç SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. '- h E~PLOYEES TO NOTIFY IN CASE NAME AND TITLE A. -r~ tv AJ~~f' ~~ B. OF E~ERGENCY: DURING BUS. HRS. Ph;: ~3.4- q; !: (J;, S AFTER BUS. HRS. Ph;: <2'~ ~ . (,(7.6 7-. Ph: Ph# -, SECTION 3: LOCATION OF UTILITY SHùï-OFFS FOR BUSltŒSS AS A riHOLE ~: m~;~¿~~~~OPAN~ 'W~~tkÄ~!.~:;t¡lt~ ). D. SPECIAL: E. LOCK BOX: YES ,I NO IF YES, LOCATION: ¡VO IF YES. DOES IT cO~:Tli:: SITE PLANS? YES / ~;O FLOOR PLANS? YES / ~o !fSDSS? KEYS? ,-r:- c: L;,....-.I / ~O YES / :;'0 - 2.'\ - - e ,~ ,,' ~,;". ~ 'VO :1 t.. ' . "'-... , '1 SECTION 4-: PRIVATE RESPONSE TEA"f FOR BUSI~ESS AS A \VHOLE .1 I NoN'Q, SECTION 5: LOCAL EMERGENCY ~EDICAL ASSISTANCE FOR YO{;"R BUSINESS AS A IVHOLE N r¿aee s·i ilosfilAL , SECTION 6: EMPLOYEE TRAINING E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH ?ROVIDES E~PLOYEES ~I73 :XI7IAL A~D REFRESHER TRAIXING IN THE FOLLOWING AREAS. CIRCLE YES OR NO A. ~ETHODS FOR SAFE HANDLING OF HAZARDOUS yIATERIALS:.......,..................,........". . B, PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: ........ ... . .. .... .... . ... C. PROPER USE OF SAFETY EQUIP~EXT: . . . . , . ,.. . . .. . . . . . D. E)IERGENCY EVACUATION PROCEDURES:.....,....,.,..., ' E. DO YOU MAINTAIN DIPLOYEE TRAINING RECORDS:..,. . , . IXITIAL RE?~ESrìER YES NO YES ::0 YES NO YES XO YES NO YES NO YES XO YES XO YES NO YES NO SECTION 7: HAZARDOUS ~TERIAL CIRCLE YES - NO - NONE DOES YOUR 3USIXESS HANDLE HAZARDOUS :,1.'\TERIAL I:.I QtiAXTI'l'IES LESS TH.~X'5()n ?OC:DS OF A SOLID. 55 GALLONS OF A LIQUID. OR 200 CtiBIC FEET OF A COMPRESSED GAS:". ... YES NO I. , certify that the above information is accurate. I understand that this information :~ill be used to fulfill my :ïr~'s Dbligac'.ons under the new California Health and Safety code on Hazardous ~aterials (Div. 20 C~apter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury, 'Srm¡ATt'RE 7ífiv (I/~J~ TITLE OlAJN((~ DATE S- - ~- g-~ - :::3 - T-~ , .;;..-;- J/ ~~ ~ -i Þ " e e ,¡¡ J BAKERSFIELD (ITY FlRE OE?ART:'!EXT 2130 "G" STREET BAKERSFIELD, CA 93301 .. -' lJ~?:CT:\~ CSE ~x~~ ID~ ------ BUS IXESS >:.:\~,u:: BUSINESS PLAN SINGLE FACILITY UNIT FCRl'l! 3A nrSTRUCTT 0:;5 1. To avoid further action. this form must be returned hy: 2. TY?E:'PRgT VOCR AXS\ŒRS I~ E~;GLISH, 3, An~wer the questions b~lo~ for THE FACILITY ~XIT LISTED BELOW 4. Be as 8R¡~f and CJ~C:SE as possible.- FACILITY UXIT~ FACILITY UNIT ~A~: SECTION 1: ~ITIGATION, PRËVE~~IONo ABATE~E~ï PROCEDú~ES Sf(rnk1e"57~+'€-VV'- ~ r f'r/¿ d'si-{~uf>À.ec. SECTION 2: ~OTTFICATTûN A~D EVAC0ATIO~ PROCEDl~ES AT THIS l~TT OXLY calL 1// ~ ,º-ùo...cûC\.+;ovt ¡f('Ov-d "þðoe o(~ fZecd:~ ~olê eX (')1' .. - ,?A - e e SECTIO~ :): HAZARDOUS \fATER IAtS FOR THIS ¡~IT OXL Y A. Does chis Facility ':-;:S contain Ha:~rdous ~aterials?,." ' ~ ~ '.... wi11l If YES. see '3. If ~O, continue with SECTIOX ~. B, of the hazardous materials a bona fide Trade Secret YES XO If ~;o , c ;naIeri:::.ls inve!;.tcr:· form marke : XO~-TRADE SECRETS OXty (white form ~4A-l) If Yes. com.lete a hazardous matet'ials inventory for::! ma:-:<ed: , I OXLV (yellow for::! =4A-2) in addition co :he non-~-arle secret for~. ist o~ly the trade seèrets on form 4A-2. C. WATER: SECTION 5: LOCATIO~ OF WATER S~?PL SECTIO~ 6: LOGATTOX A. )~)\ T. GAS.. PRO?~XE: 8. SLECTRICAL: D. SPE:CI.-\L: -. _. LOCi-( 80:\: v;:"e;: ,':':0 "Y£S, LCG\TIC~~; i ~ ~·ES Sî:: ?LA~S? >i5ûSs? \'C :':0 .. _J . .-' ~ ~.._,-. :c....) ':0 FLOOR ?T..~2':S ') YES '._He;:') =,-r.:~. - 3B - ."-";;"':'" --- ,~, ¡. \-.., '" .0 .¡., I') .., ,-,.., .".I.J I.C'- ~ \ o\f , Page v' FIRE 4A-1 SECRETS DEPARTMENT IEI.D CITY FORM NON-TRADE BAKER SF # D I ~, ..' BUSINERS NAME: -rAAI- I(rI,-lflf/UJ Ig Ve OWNER NAME: -, r::: r:/¡;¡Vllk/iiO nw....u &. ~..~ & ... ADDRESS: 4-?JQt'J 1..u,·'Øe 111) ~e ADDRESS: 71.7f)1J.g. H ~ . v "till FACILITY UNIT NAME: \ CITY, ZIP: 13fi\s(elf~~~\ð elþ. Q~"3>~~ CITY,ZIP: AIf11ter¡\ro~K¿ º~ ' PHONE #: (<10$) C(.3"lf _ 66'S PHONE #: (<;(ð'-\" (YZlf -'~7--6L 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 P n() #4D RaL 06". 1êJ, h·~ rOifn~íl tÎfþrçD¡J~ /()O'?o l1Jn4. ::1nn~l'. nil lSq<ö -- ß~l: J i , I i i i ¡ ! , ;1 :¡ I I 1 I , ........ -- ,7 NAME :--rÞ§VJ Ill(rl) ......AID TITLE: ïp.AV Auf()f1@7ìile.ø SIGNATURE :A\l:'IIu~~~ -:;::..--- -- DATE: :;~4- ~il EM È R G E N C Y CON T ACT: i ' TIT J. E : ßH~ E # Tu S H 0 U R S : <; ~ \{ - 66'5 . l/ LiFTER BUS HRS: 2'!1v... 97b~ EMERGENCY CONTACT: , TITLE: PHONE # BUS HOURS: Q~ S P~INÇIPAL BUSINESS ACTIVITY: AFTER BUS HRS: 11' ~ ,h 4IÞBAKERSFIELD CITY FIRE DEPAR~ ' 2130 "G" STREET Jci-:> - /4 ~ BAKERSFIELD, CA 93301 ~7 (805) 326-3979 ~~ w'¡j/RECEIVED lil/tI OCT 2 " Ans'd. ........... ¡I ~( .' ,.~ OFFICIAL US ID# USINESS NAME HAZARDOUS MATERIALS BUSINESS PLAN. AS A WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by ____~~-~. D"PE/?_RJ~T A~~WE8~LJJL ,ENY~L_I.SR._, ,-~- 3, Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. ""' - ------- --., ':" SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: TAb! -AUTOMotiVE CITY:~t\~"~F'.E' t> a 4300 WI ßLE ~'D ZIP: q?/3 \ ~ BUS, PHONE: " " s.u i T£E' (S06) R7,L¡ -h'bbJ5 B. LOCATION / STREET ADDRESS: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material. call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. E~PLOYEES TO NOTIFY IN CASE OF E~ERGENCY: NAME AND TITLE A. --=r A ~ -\:UJ.!LN lH,AVE ~ Ph# DURING BUS. HRS. ~~\t b~b5 Ph# AFTER BGS. HRS. ~~;t '5'~3 B. Ph#' Ph#-- , SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: B. ELECTRICAL: C. WATER: D. SPECIAL: E. LOCK BOX: YES ! ~O IF YES, LOCATION: '\., "\. '~ IF YES. DOES IT CONTAIN SITE PLANS? YES / ~O FLOOR PLANS? YES / XO MSDSS? YES / NO KEYS? YES / ~O - 2.'\ - · e SECTION 4: ·.·PRIVATE RESPONSE TEA.\f FOR BUSINESS AS A WHOLE -, , '. ~:., .... ,. .! .' " SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTk~CE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING E~PLOYERS ARE REQUIRED TO HAVE A PROGRk~ WHICH PROVIDES ~~PLOYEES WITH INITIAL A~D REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR ~O I~ITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS !1ATERIALS: . , ,. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. YES SO YES SO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:.......................... YES ~O YES ~O C. PROPER USE OF SAFETY EQUIPMENT:. . . . . . . . . . . . . . . . .. YES NO YES NO D. EMERGENCY EVACUATION PROCEDGRES:..., .......... .,. YES ~OYES NO E. DO YOG MAINTAIN EMPLOYEE TRAINING RECORDS:.,..... YES NO YES Nq l.. e.s.S ~ S-Õ-ëafl ~ a.t-.12 SECTION 7: HAZARDOUS MATERIAL "y-:r ð~ _ N~ <" ð, L. CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~4TERIAL IS QGANTITIES LESS THAX 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID. OR 200 CUBIC FEET OF A COM~RESSED GAS:...... ~ NO I ! ~ -I, =(A-I\J-fJ-&UVEA!--- -- - ---,,-ce~tíLy tha:t_ !:hJ~_above_inf()rmati~:m 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 EtAl.) and that inaccurate information constitutes perjury, SIGNATURE ~--- TITLE ()Wflr! DATE IO-¡S - <;17 ' - 28 -