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Home My WebLink AboutBUSINESS PLAN / ' _ CITY OF BAKERSFIELD _ &--0 OFF. OF ENVIRONMENTAL SE.ICES ~ J ' 1715 Chester Ave., CA 93301 (661) 326-3979 / ,/ BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMATION Page _ Of _ FACILITY ID # I I 1 Year Beginning i ¡ ! I BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) L t-tO.vDPr ( A~'~~ <:;(>t?'C.-\A'U,STS I SITE ADDRESS LJ I) (J'L ,/\ 'f]" ~ ., C LV -IJ WI fbLE N-J ~ I \ CITY ß~~~Srll:fUJ I DUN& I BRADSTREET ¡ COUNTY K~ï-4.f I OPERATOR NAME \2-..ðd£.-. I I , ' ';;1. FACllI'rv lo'ENTIFICÅ'Î'10N ~~" -- ' ." :-.>,;:' 100 : Year Ending I 3 ¡ BUSINESS PHONE ;(&£(/) <æ?J7- '01 102 '-I).. CJV 103 104 I CA ! ZIP Q3'311 \ "3 I 106 ¡ SIC CODE I (4 Digit #) 105 107 108 109 I OPERATOR PHONE <i53 4- - f..{ le {; l, 110 ^~"ì¿~2W~:~^~iNFOB~ÄT,¡~~ > ~'~':I:~~~~!'/~t:>'" >';~:'¡~ff.' !: ^,;,;i,:'f' '~S't;;, ,:(,/:1 i OWNER NAME I W H t 1""'\A1<. r;v1-- W t f3w ")2..(;), 111 ! OWNER PHONE I 112 113 ì i I ¡ CONTACT NAME I CONTACT MAILING i ADDRESS I CITY 114 STATE c.~~5'Ji¥::~~ ~~:;<0?jf/i;~::" ,-' . '.' . -:, J < . :: t~:il~\~1>fL~l'>~·~ }X;'~i\1~: ENVIRÓNMENtÁ(:C0N~AC];,,;~ '.i_I' ':.';..¿"/j;.f: 1+\:;"}/, :-t,~,,~,u<;,,;__·· - . ,_,:':"~~.{ ".:',.: ·_,;"{.,\,:,~AMt"*";"i.L};·*'-' '- ,,0A,,· -,. 117 i CONTACT PHONE ¡ 118 119 24-HOUR PHONE I PAGER # 123 NAME 125 TITLE 126 BUSINESS PHONE 127 24-HOUR PHONE 130 131 132 128 I PAGER # ::Jl#~~;ft~~~1'ì=,èÄT'Õ: . 133 l I Certification: Based on my inquiry of those individuals responsible for obtaining the information. I certify under penalty of law that I have personally examined and am familiar with the information submitted in ttíis inventory and believe the information is true. accurate. and complete. SIGNATUR~ O~ OWN~RIOPERATOR DAT" 1341 NAME OF DOCUMENT PREP~RER 711-4/ i#- ~ ~ 1/ D 3 i S¥\-ec-\'~ Lû\r\ \ NAM S Of OWNER/W"r0R (p'ol) ". TI LE OF OWNER/OPERATOR , Ð ^l' taL-1V\ A1U A-G1ZiL 135 137 UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd '\ 'i . . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS SECTION I. - BUSINESS IDENTIFICATION DATA: The Business Owner / Operator Form, Chemical Description Form(s) and other Forms (e.g.: underground storage tank information, hazardous waste treatment, etc., as needed) may be submitted as the first section of the Hazardous Materials Management Plan in order to avoid duplication of information for initial submissions. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. I - DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Describe the procedures and equipment used to detect any release or threatened release of a hazardous material from any storage container, tank, or vessel at your business. Please provide a written explanation that also includes the make and model number of any automated or electronic leak detection equipment in use at your facility. B. EMPLOYEE AND AGENCY NOTIFICATION: What agencies and or corporate officials are notified in case of a hazardous materials spill or emergency - What procedures are used to notify these parties? At a minimum, you must call 9-1-1 and the Office of Emergency Services at 1-800- 852-7550 to report any spills that are a threat to life, safety or the environment, or for other non-emergency spill reporting, please call our office at (661) 326-3979. C. ENVIRONMENTAL RESPONSE MANAGEMENT: Please describe who will be responsible for what activities (notifying authorities, clean-up companies, etc.), and what the chain-of-command is at your facility for making sure these activities are carned out. D. EMERGENCY MEDICAL PLAN: Summarize your plan for handling medical emergencies occurring at your business. List the local medical facility capable of handling an accident involving Hazardous Materials used at your business. HAZARDOUS MATERIALS MANAGEMENT PLAN I e . SECTION 11.2 - RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: I Explain the procedures that you have developed and implemented to help prevent an incident from occurring. These steps could include, but are not limited to, storage methods, container types, segregation, safety equipment, and/or procedures used. B. RELEASE CONTAINMENT AND/OR MITIGATION: Explain the procedures that you have developed and implemented to assist in keeping a hazardous materials incident at your business as small or confined as possible. C. CLEAN-UP AND RECOVERY PROCEDURES: Explain what clean up procedures will be implemented in case of a release at your business. This should address small spills, as well as a major release of material once the material is contained. Hazardous Waste: Please provide the name of the hazardous waste company that regularly removes the wastes from your business, and how often that waste is removed. Please keep all disposal receipts for the last three years available on site for inspection. UTILITY SHUT -OFFS List locations of shut offs using compass points and known or obvious landmarks. If you have a lock box containing keys and maps of the facility for the Fire Department to use, please list its location also. PRIVATE FIRE PROTECTIONIW ATER A V AILABILITY A. Private Fire Protection: Describe on-site fire protection for your business or facility unit, including sprinklers, fire extinguishers, alann systems and private response teams. B. Water Availability (Fire Hydrant): Give the location of the closest water supply or fire hydrant to be used by the Fire Department in case of an emergency. 2 . . SECTION ill - TRAINING List the number of employees that are working in the area of the hazardous materials, use or storage. Include all employees who have any occasion to be in those areas. Give the location where Material Safety Data Sheets (MSDS) are kept on file. The MSDS must be readily available on site in a place where employees can access them. Give a brief summary of your Hazardous Materials Training Program. Employees are required by State law to have a program which provides employees with initial and refresher trainin~ in the followin~ areas: 1) Methods {or safe handling of the hazardous materials used by your business. 2) The Cal OSHA Hazard Communication Standard. 3) COlTeCt use of emergency response equipment and supplies available at your business. 4) The prevention, minimizing and clean up procedures you have developed for your business. 5) The emergency evacuation plans you have developed, as well as, your notification procedure and medical plan. 6) Procedure to coordinate with and assist the local emergency personnel that may respond to your business 7) Who and how to call for immediate assistance in the event of an accident involving hazardous materials. CERTIFICATION Please fill in your name, title, and sign and date on the signature line. IMPORTANT You must return this plan, inventory forms, and map within 30 days of receipt. If you have any questions please call us at (661) 326-3979 Thank you for helping to keep our All America City cleaner and safer. 3 CITY OF BAKERSFIELD OFFI.F ENVIRONMENTAL SE.CES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN Section 11.1 - DISCOVERY AND NOTIFICATIONS I. FACILITY IDENTIFICATION . , BUSI/IIESS NAME (Same as FACILITY NAME or DBA . Doing Business As) H-00P è U ~e'{,\~US\ S ADDRESS (For local use only) , Lf~ó(p- D It)(ß~~\2.Þ - ~~f\-- 3 476. FACIlITY ID. crr DISCOVERY /--::",. A. LEAK DETECTION AND MONITORING PROCEDURES: \-\. M11 W IA-S,~ [(90 \ t\\vT è UJ~'\"€' <,Iv 110 \}V.µ VV\ 'j Pit' í?1't<1L íZ.o L!-- uP bÐD ~, ~< IV >p~ ÎJA. ~ V , , I I '." ' " " " ,,",:Nó~hFICÅti~ff~'~¿'~,'<>.:?:; B. EMERGENCY AND AGENCY NOTIFICATION PROCEDURES: :tF u) M l't?"" L..GV\\.l..S \.P ~ U. sr;:-' I /~ 'tT Y ~(-ræt.. 1"0 A-1b So (.2...~. :c ~ M'k"JSð Q..;~L ð C.AÁRJ~.e'\) We¡ ()JðU V f) Gf\1.L . Tl+fÍ (::t it V bt;rP\ Þ Ý , " I I :.. ,"/ ,_ ~",-:¡1~·'-:,;,~~:·::.'·:},.~~~·~:.· ENViRONMENTAL MANÄGÈIlliÊNT, , '.'.' .' .~"~"7 ......... ";, ,"""i~ ' . . C. SPECIFIC RESPONSIBILITIES OF EMPLOYEE~: 'TO CJL.. (otv -rA-\ ~\)t¥1I?-S' ()Jw\~L..-'( f i ì/u. Fj).,l?)1f f\?J5v ~ì'$A-NT \.h)þ~ Ì':>~V I . . ,~'. '. .' , ' ~" , EMERGENCY MEDICA~'PLÂN , , D. CLOSEST LOCAL MEDICAL FACILITY: 'M~VV\,e)~\ ~ t*ÐS Pl i1A"G ð 'rtJ3l("tV\ Sr...· ~ UPCF (7199) S:\PROCEDURE MANUAL\New HMMP lorm.wpd HAZA~US MATERIALS MANAGEME.LAN 'ction 11.2 - RELEASE RESPONSE PLAN PRELI",INARY ASSÈSSMENT I i A. HAZARD ASSESSMENT AND PREVENTION MEASURES: I I I I iJR.ùV\ s LOCb;f~ OJ-r ~ ~ aI= ¡Q.4FF'c ~ . _ d:'" .:·t:{!:..~-"·"·." '.. , ... I...:',;.... :'. ~ ~: ,," 'RI;~PQ~SE;~:AçrIO"S B. RELEASE CONTAINMENT AND MITIGATION: . , ' .' ,.' , -,::~1?:~i:, ..... .' , , " Äß5a<2ßl.WT M'A.t...Aß¿E A/2cµ{Ú1) ï:¥lUI1.1S , : " ,,' FO,LLOW-UP ACTIONS C. CLEAN-UP AND RECOVERY PROCEDURES: ".0", ., .' , '.-..~ . tLS~ ~ frl?SD~~ -rD M_f\jð~ '" ~ C, l.~ \.À\) 'fr'N t{, ~<:p( LL- 'S ~\""- UPCF (7188) S:\PROCEDURE MANUAlINew HMMP form.wpd HAZAAus MATERIALS MANAGEMENftLAN Section 111.1 - FACILITY AND LOCALITY INFORMATION UTILITY SHUT -oFFS LOCATION OF SHUT-OFFS AT YOUR FACILITY: NATURAL GAS I PROPANE: ELECTRICAL: !J?EJ Ç¡Dç J'tT f,!l-CIL 0E 'SfI-{)Þ V/ WATER: SPECIAL: LOCK BOX: YES I NO IF YES, LOCATION: . .' :. .... . PRIVATE'FIRE,PROTECTION I-WATER AVÂILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): , TRAINING .' . ~ . A. NUMBER OF EMPLOYEES: B. MATERIALS DATA SHEETS ON FILE: Yøs C. BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION Based on my Inquiry of those individuals responSible for oblaining the informaUon, I certify under penalty of law that I have personnaly examined and am familiar with the InformaUon submitted and believe the InformaUon is true, accurate. and complete. SIGNATURE OF OWNER I OPERATOR OR DESIGNATED REPRESENTATIVE DATE 471'1 479, ð/J#/ó3 478, TITLE OF SIGNER ~¢6 UPCF (7199) S:IPROCEDURE MANUAl\New HUMP fonn.wpd · CITY OF BAKERSFIELD . OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS INVENTORY INSTRUCTIONS CHEMICAL DESCRIPTION FORM Make as many copies of the chemical description fonn as necessary to report your entire inventory of hazardous materials. Report every hazardous material handled in quantities equal to or exceeding 55 gallons of a liquid, 500 pounds of a solid or 200 cubic feet of a gas. Report any amount of any hazardous waste being generated or handled on site. I. FACILITY INFORMATION: Check the appropriate box for a new inventory or for additions, revisions or deletions to an existing inventory. Enter the business name at the top of the fonn. Enter the page number in the right hand comer. Describe the exact location of the hazardous waste or material being reported. NOTE: Chemical location infonnation is considered confidential unless you check "no." If a site map is being submitted, you may refer to the map number and grid coordinates for the approximate location of the material, as shown on the map. II. CHEMICAL INFORMA nON: Each of the instructions below correspond to the entry field with the same number on the chemical description fonn. CHEMICAL NAME 205 Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the International Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture or a hazardous waste, do not complete this field; complete the "common name" field instead. TRADE SECRET 206 Check "Y" for yes if the infonnation in this section is declared a trade secret, or "N" for no, if it is not. State requirement: If yes, and business is not subject to EPCRA, disclosure of the designated trade secret infonnation is bound by Health and Safety Code, Section 25511. Federal Requirement: If yes, and business is subject to EPCRA, disclosure of the designated Trade Secret infonnation is bound by Title 40 Code of Federal Regulations (CFR) and the business must submit a "Substantiation to Accompany Claims of Trade Secrecy" fonn (40 CFR 350.27) to USEPA. COMMON NAME 207 Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. EHS 208 Check "Y" for yes if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CFR, Part 355, Appendix A. If the material is a mixture containing an EHS, leave this section blank and complete the section on hazardous components below. 1 CAS # Enter the Chemical 'tract Service (CAS) number for the hazardou.erial. For mixtures, enter the 209 CAS number of the mixture if it has been assigned a number distinct from its components. If the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous components in the section below. FIRE CODE HAZARD CLASSES (Please leave blank) 210 HAZARDOUS MATERIAL TYPE 211 Check the one box that best describes the type of hazardous material: pure, mixture or waste. Ifwaste material, check only that box. If mixture or waste, complete hazardous components section. RADIOACTIVE 212 Check "Y" for yes if the hazardous material is radioactive or "N" for no, if it is not. CURIES 213 If the hazardous material is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. PHYSICAL STATE 214 Check the one box that best describes the state in which the hazardous material is handled: solid, liquid or gaseous (gas). LARGEST CONTAINER Enter the total capacity of the largest container in which the material is stored. 215 FEDERAL HAZARD CATEGORIES Check all the physical and health hazards associated with the hazardous material: 216 PHYSICAL HAZARDS: Fire: Flammable Liquids and Solids, Combustible Liquids, Pyrophorics, Oxidizers Reactive: Unstable Reactive, Organic Peroxides, Water Reactive, Radioactive Pressure Release: Explosives, Compressed Gases, Blasting Agents HEALTH HAZARDS: Acute Health (Immediate): Chronic Health (Delayed): Highly Toxic, Toxic, Irritants, Sensitizers, Corrosives, other hazardous chemicals with an adverse effect with short term exposure. Carcinogens, other hazardous chemicals with an adverse effect with long term exposure. ANNUAL WASTE AMOUNT 217 If the hazardous material being inventoried is a waste, provide an estimate of the annual amount handled. MAXIMUM DAILY AMOUNT 218 Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacent/outside area at anyone time over the course of the year. This amount must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions, deletions, or revisions projected for the current year. This amount should be consistent with the units reported in box 221. AVERAGE DAILY AMOUNT 219 Calculate the average daily amount of the hazardous material or mixture containing a hazardous material, in each building or adjacent/outside area. Calculations shall be based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the number of days the chemical will be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. 2 STATE WASTE CODE . . 220 If the hazardous material is a waste, enter the appropriate California 3-digit hazardous waste code as listed on the back of the Unifonn Hazardous Waste Manifest. A list of common State Waste Codes are included on page 4 of these instructions. UNITS 221 Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that the material is stored in (gallons, pounds, cubic feet, or tons). DAYS ON SITE 222 List the total number of days during the year that the material is on site. STORAGE CONTAINER 223 Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one. STORAGE PRESSURE 224 Check the one box that best describes the pressure at which the hazardous material is stored. STORAGE TEMPERATURE 225 Check the one box that best describes the temperature at which the hazardous material is stored. HAZARDOUS COMPONENT 1 - 5 (% by weight) 226, 230, 234, 238, 242 If a range of percentages is available, report the highest percentage in that range. HAZARDOUS COMPONENT 1- 5 Name 227,231,235,239,243 When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that mixture by percent weight (refer to MSDS or, in the case of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater than 1 % by weight if non- carcinogenic, or 0.1 % by weight if carcinogenic, should be reported. If more than five hazardous components are present above these percentages, you may attach an additional sheet of paper to capture the required infonnation. When reporting waste mixtures, mineral and chemical composition should be listed. HAZARDOUS COMPONENT 1 - 5 EHS 228, 232, 236, 240, 244 Check "Y" for yes if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "N" for no, if it is not. HAZARDOUS COMPONENT 1 - 5 CAS 229,233,237,241,245 List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. III. SIGNATURE: Please print name, title, sign and date each chemical description fonn. 246 If you have any questions please call us at (661) 326-3979 3 . '¡ . CALIFORNIA WASTE CODES Code Descriotion Inorganics III Acid solution 2 < pH < 7 with metals (antimony, arsenic, barium, beryllium, cadmium, chromium, cobalt, copper, lead, mercury, molybdenum, nickel, selenium, silver, thallium, vanadium and zinc) 112 Acid solution without metals 113 Unspecified acid solution 121 Alkaline solution pH >12.5 with metals (see 111) 122 Alkaline solution without metals 123 Unspecified alkaline solution 131 Aqueous solution (2 < pH < 12.5) containing reactive anoins (azide, bromate, chlorate, cyanide, fluoride, hypochlorite, nitrite, perchlorate and sulfide anions) 132 Aqueous solution with metals (see 111) 133 Aqueous solution with total organic residues 10% or more 134 Aqueous solution with total organic residues less than 10% 135 Unspecified aqueous solution 141 Off-spec, aged, or surplus inorganics 151 Asbestos containing waste 161 FCC Waste 162 Other spent catalyst 171 Metal sludge (see Ill) 172 Metal dust and machining waste (see Ill) 181 Other inorganic solid waste Organics 211 Halogenated solvents (methylene chloride, chloroform, TCE, TCA) 212 Oxygenated solvents (acetone, butanol, MEK) 213 Hydrocarbon solvents (stoddard solvent, xylene) 214 Unspecified solvent mixture 221 Waste oil and mixed oil 222 OiVwater separation sludge 223 Unspecified oil - containing waste 231 Pesticide rinse water 232 Pesticide and other waste associated with pesticide production Code Descriotion 241 Tank bottom waste 251 Still bottoms with halogenated organics 252 Other still bottom waste 261 PCB's and material containing PCB's 271 Organic monomer waste (includes unreacted resins) 272 Polymeric resin waste 281 Adhesives 291 Latex waste 311 Pharmaceutical waste 321 Sewage sludge 322 Biological waste other than sewage sludge 331 Off-spec, aged or surplus organics 341 Organic liquids (nonsolvents) with halogens 343 Unspecified organic liquid mixture 351 Organic solids with halogens Sludges 411 Alum and gypsum sludge 421 Lime sludge 431 Phosphate sludge 441 Sulfur sludge 451 Degreasing sludge 461 Paint sludge 471 Paper sludge/pulp 481 Tetraethyllead sludge 491 Unspecified sludge waste Miscellaneous 511 Empty pesticide containers 30 gal or more 512 Other empty container 30 gal or more 513 Empty containers less than 30 gal 521 Drilling mud 531 Chemical toilet waste 541 Photo chemicaVphoto processing waste 551 Laboratory waste chemicals 561 Detergent and soap 571 Fly ash, bottom ash, and retort ash 581 Gas scrubber waste 591 Baghouse waste 611 Contaminated soil from site clean-ups 612 Household wastes 4 A CITY OF BAKERSFIELD_ OFIWE OF ENVIRONMENTAL S~ICES 1715 Chester Ave., CA 93301 (661) 326-3979 ~EW D DELETE 200 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION DADO (one form per material per buitding or area) Page of ."..; ;-~' < - - <- ',\',.. 3 ~ . '~.' . -~; ~\,~}",; ,;,-'~:~ ~ ,,< - I',"<'~ '-:,-, .,,', ",?-.<',,^\-., . 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 203 GRID # (optional) '^ o Yes !!i No 202 204 ><:.:~¡t·èHEMlcAì.'IN'FORMÁTIÔN'l:;, ,', , ,,' <-:'" ',:: ',: ..,>..,--~~",,,- . '. ,'<\~/',,^~',: ,\ ,'.., _t,,,-,x - _ ., - ,';,_ ", ',..', . ',-,'.:\' ~~,~.~., ' CHEMICAL NAME OIL I¿ EHS' 207 COMMON NAME DYes o Yes ~o 208 CAS # 209 FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) TYPE o P PURE 210 I5iJ w WASTE 211 RADIOACTIVE DYes ~ 212 I CURIES -ð- 213 o 9 GAS 214 LARGEST CONTAINER l'Ç)"(ø~ PP-V..~ 215 o m MIXTURE PHYSICAL STATE LÍI LIQUID o s SOLID FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE L AMOUNT )§o1 FIRE o 2 REACTIVE o 3 PRESSURE RELEASE o 4 ACUTE HEALTH o 5 CHRONIC HEALTH 216 217 MAXIMUM DAILY AMOUNT UNITS' 0 ga GAL 0 á CU FT . If EHS. amount must be in Ibs, 218 AVERAGE DAILY AMOUNT o Ib LBS 0 tn TONS STORAGE CONTAINER (Check a/I that apply) ~e PLASTIC/NONMETALLIC DRUM Of CAN ' o 9 CARBOY o h SILO o i FIBER DRUM OJ BAG Ok BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON o a ABOVEGROUND TANK o b UNDERGROUND TANK DC TANK INSIDE BUILDING o d STEEL DRUM STORAGE PRESSURE bg' a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT STORAGE TEMPERATURE ~a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT o c CRYOGENIC 225 219 STATE WASTE CODE 9...., DAYS ON SITE ~lo5 220 221 222 o q RAIL CAR o r OTHER 223 224 1-' I 230 231 o Yes 0 No 232 233 .~ 234 235 OYesONo 236 237 238 239 o Yes 0 No 240 241 242 243 DYes ONo 244 245 íI~'(¡J~~ '7-{0 ? UPCF (7/99) S:\CUPAFORMS\OES2731.TV4,wpd ~ \, .. '" ~t· '~n~~-1 ,_D ."......."'~ ~..........- . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE., BAKERSFIELD, CA (661) 326-3979 SITE AND FACILITY DIAGRAM INSTRUCTIONS FOR HAZARDOUSMATERMLSMANAGEMENTPLANS These instructions explain the use of the site diagram and the facility diagram. NonnalJv. srnall and medium size businesses will only have to submit a site diagram. If you have subdi\, .;d yc' , business into smaller areas because of the complexity or size, then you will be completirg and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business if it is in a remote location. All diagrams must be on 8 !t2 x 11 paper and drawn using a straight edge tool. SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following infonnation: 1. Check the box on the top left comer of the fonn provided that indicated "Site Diagram" . 2. Print the name of your business, as shown in your HMMP, on the top of the diagram. 3. Label the location of the hazardous materials and identify them by name and type of hazard (ie. Flammable liquid, corrosive solid). 4. Label the location of utility shutoff points for gas, electric and water 'services. 5. Label the location of fire hydrants. 6. Label portions of the building protected by automatic sprinkler systems. 7. Label the direction representing north on the diagram. (The diagram fonn provided includes a north arrow). Map labelina must be leA and cuily understandable. Try to _d the use of abbreviations or symbols. If you must uillrern. provide a lesend explaininS yo~stem. . '" '~ .,"." ... .i:: Maps may be returned ror correction if you fail to follow these instruction. FACILI1Y DIAGRAM INSTRUcnONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. 1. Check the box in the upper risht hand comer of the fonn provided that indicated uFacility Diagram". 2, Print the name of your business as shown on your HMMP. Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. 3. Indicate which area the cfiasram represents and the total number of&cility diagrams that you are including. If a map represented the first of four areas, it would be labeled Nl of 4. 4. Follow instruction (3 -7) for site diagrams regarding the specific details to be included on each tàcility diagram. 2 <Ii' " ( < '$ ''::J> ~~ , - '" ~';~<\'" .~. "-e-' í~ ¡ ~\"\ . ("\ . ~ ~ . ,........ " - <..r- "'.. ,_ _ \\. \'CI L- ("'. 'b' ~, t-'~ \l\ o . ":1> 01'). -ç¡ ~.'::'J ~ ~ - -\- -, ~ 'l ~~~5¡ " t <: V"\ t .r--. _ . v ~ ~ ~~ (¡J<- '1::, ~ , , ~' '/:Lt:-' .))' /' , (', /"« c ~~, / Á/\.) ~~ ~ ' . 94--- 8 -, ~ <~y t ~ ... -" -<.,. -\'" ~ ~ --. ~ \... \ - -'1 '\1 ("\, " ':.,1 . .( -v <:::) 0. '~ '. . (), --',J ~ <::> a 'f' \ .. ~ I ," l /; ~f"/' " 0"- ~ sm DIAGRAM t f BUIIaeU Name: _ Business Addreu: IPACILlTY DIAGRAM f"l J " --, ~-: 0, , ~ - , - ---- ;'" .. - \--~." ::; _7.4. .... . . ~ sm: DJA.GRAM~ < FAcn.r&JA.GRAM ~ BulineasName: ~~ ~ ~I}£ S{JRJ~ ~ Business Address: tf:>,n! ~ - ---= ----p il> '-iT__ I 13 ---;¿ F-/ - r I ± N tJ/5- ð~l- ótJd)-f/£3. /~3-)t/LJ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~A- rl ÄffuAA- ~8:.IA-LI~1""S 4)D~ - ~ (.,J¡ßC<S IW Hazardous Waste Generator Program INSPECTION DATE ?é t>\"\ . \xt b\ :\ \,\1. \¡\J' ()Ù \'" faLJ .~ !tz../ð S Section 4: EP A ID # C'ÆL evcJ 2.06"> 2.6 o Routine J2l Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Hazardous waste determination has been made ALL t <'ft:~ CJ t<. EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation 44 Ú/~~d.; --' Inspector: WI fV13-s Office of Environmental Services (661) 326-3979 Busin~ Site Responsible Party White - Env, Svcs, Pmk - Busmess Copy cHEMlCALLOCAT1OH . In .-.I'!:- 201 QiEMlCALLOCATION.. D D 'N~ r()cf- tJfAJ C.R.Nf.... t:J.F S~ . CONFJDENTIAl{EPCRA) - Yes No 202 FACllI'TY ID. ~-rr, ~_. ~-~ '--:---¡-1MPiCCIp/lollal) --.,. .n_". -2õ3"TãRiö"CopÌionaÏ--'" 204 ~ LL._ , IL CHEMICAC~;ORM~TlON --..-----.- ~ :~~.<::~,' '~'~',~! ":,-''-~~:'';:}'':(::~ '_____' . "," -.,. ,.,<..-,. . "..",.,¡ ì 205 : TRADE SECRET D Yes D No 206 If SuIIjed to EPCRA. reler to InstrucIIons CITY OF BAKERSFIEL.Il .ICE OF ENVIRONMENTAL_RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ¥-NEW DADO a DELETE D REVISE 200 _._.. ,..._____. .__.__.__ w.. . .._. ._... . ___ n__ _. .__.. ._ _._~_____.___ .. .. . II ..:.\. ~"-'-".,, ,: <'" ',:;:.;;~.:.:: ': I. FACILITY INFORMATION BUSINESS NAAE (s.m.. FACIlITY ÑÃMËÕr-óãA--:ï)öiñg'BUsiniïšÃsï-'" '00.' .--.. -, ~A tt k...("t,J~_~pø:..'A·""'''-rs. 'On""''', .~ 0-'___--'--- CHEMICAL NAAE WÄ-$l€ o u... ~-_.. ----------. ..- .... .... -. .. .. ----- -'-""2öf'~-- COMMON NAAE ! EHS· (one to"" per m.te//M per bIMIing O¥ area) Page d '. . ..... . . A : .:.~·~~.:.<····:i~ti~~~·(· 3 Dyes D No 208 ' CAS' - "'------------.- . _.... -_..__. . -._- . FIRE CODE HAlAAD aASSES (ComIIeIejfrequested~IocII..CHélf~-------- - ----. ---..-.--.----.-. 210 it.w WAS.!: . .. ... ft..otOACTIVE Dyes DNo 213 ..--.-.-.-- .--- ..-----.-. TYPE DpPURE D m MlXT\JRE 212 ! CURIES 214 ; LARGEST CONTAINER ~r -- _.~ -.---..---...---- PHYSICAL STATE QJ LIQUID D . saUD .D g GAS .--.-.-- --.---.----.-- - .--..--.-- FED HAZARD CATEGORIES (Check all thai apply) ¡ ANNUAl WASTE : AMOUNT g.. A.:uTE HEALTH ~FlRE D2REACTIVE D 3 PRESSURE RELEASE D 5 QiRONIC HEALTH 220 : ---, --...-- - .......-.-...-----.--.-.-----. 217 ' MAXIMUM ! DAIlY AMOUNT I 218 i AVERAGE : CAlLY AMOUNT Jb~ ( f, e;- 110 --.--.-..-......-. ---....----.--.-- ---_.-.. UNITS" ;!he GAL D d CU FT . r EHS. III1CUtII must be in Ibs. D Ib LaS o 111 TONS STORAGE CONTAINER (Check aU thaI apply) o i FIBER DRUM OJ BAG D k sox D I CYlINDER o a ABOVEGROUND TANK Db UNDERGROUND TANK Dc TANK INSlœ BUILDING ~CRUM 0., PlASTICINONMETAlUC DRUM 01 CAN o g CARBOY o h SILO D m GlASS BOTTlE o n PlASTIC SOTTlE Do TOTE BIN D p TANK WAGON ...-..-. .-. ._...... - ....-.--.-..---- STORAGE PRESSURE ~. AMBIENT D .. ABOVE AMBIENT o be BELOW AMBIENT ----_._-_._-_.._-_.._.-._...~_.- . .-..- .... ..-.-. 21.5 , 216 219 ¡ STATE WASTE CODE I "L.'"t..f 221 i CAYSON SITE I '2~r 222 ' D q RAIL CAR Dr OTHER 223¡ 224 ! 'I~~~~~V,irf~' 22e 1):tF¡\f~1~:~;':~~}~¥Ù~~~~~ij~:?<+: ' --....-----..---..,---. ---,---.--:.. ~-~~-9-~~.L 231 I Dyes 0 No 232 ¡ ----..-.---.--------.-.-... ..---....-.. -..-.... -. ---.-¡---..-.-.-----..-. -;- 235 ; D Yes D No 236 I --00'- _.'_ .____ .._____._. ,------1---- I ....__.=-------~~~~:.~: : I '<t~:::.~~;'~~.~;;,~~~!µ~~ :.:,~~O" r ,~~: ~'~<: , S~TURE·_..-·--- STORAGE TEMPEAATURE ~AaeIENT o ba BelOW AMBIENT o as ABOVE AMBIENT '.,...... 2 230 I I I 3 ! 234 ¡ , i 4 238 I I 5 242 ---_._.-...__. --.------ -..--..-. - ------- _._.__. - .. .--.. ..... -". --..-.-..-....--..---..., .... D c CRYOGENIC 229 ' 233 237 ì I i I 241 I i I 245 ! UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd ',: :.~i:',~~~.1~;:~ I. FACILITY INFORMATION BUSINESS NAME (Seme a FACILITY liiÃMê «DBA -DöiñgŠÚSin¡¡¡-Ãsï-oo, ",. - "'. -, , ~A €{ A-~,_. $P<r.V~US,~.,._.., CHEMICAL LOCATION .- I". hI!::... A' ,.. .ð _ po" A 201 CHEMICAL LOCATION - 0 0 ' (TV;:.'" YCS;, ,vW ......./êI\J..... CJ.r .s~r= . CONFIDENTIAL(EPCRA) _ Yes No 202 FACILITY '~. fTJJ±IlITLI~~.'-7-·~MÃPii~~~=, ~=·,,~~..~~"·~~iÖ.~iÕP~ai)--- 204 . . ,,~,~~:,;,:!,-.(,:" II. CHEMICAL INFORMATION, ,. :::~~:'::i~~~.:·:'::~~ln 205 : TRADe SECRET 0 Y_ 0 No ...... CHEMICAL NAME _ .."" W A~ ~ ~'f') ~~~'ì~ If SuÞjeclIO EPCRA. reter to InsInIcIions -------.. ---------_.. ..._ 0".- CITY OF BAKERSFIEI...Iil. <4tICE OF ENVIRONMENTAL.RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION t4w DADO a DELETE a REVISE 200 -,' ....----. ---.--.-- -,. ..... "4'_'40 ". '0_. _..... __ ..___. _.._ ,_ _.__.___.___ . ....---.--- .---- -'-~r-- (one (0"" ~, m.terial ~ buM:ling or aff/a) Page 01 . . :.0. ." '"'' :;.': :);l~,~', ';i1;)~<.1 3 COMMON NAME I EHS" 0 Yes 0 No 208 ' CAS' - ._-. ----- ----.. _.u_ - - --- __-;;;;_! .,,~~.,~~.'~~I . ':~~~.=.ç~~.:.~.:::~~~;! FIR£COoeHAZARDa.A8SES(CompIeIeifl'lllU8Stedltylocllh~-------____·_'_'_'__'_____'__ -, . J 210 TYPE ----.-.-.----.-. .------.- Ol/PURE o m uxnJRE ~ WAS';'!: ft..OIOACTIVë DYes 0 No -.. ..,. ---.t--------.-__...___ ___ PHYSICAL STATE ~UIO o I SOUD ,0 9 GAS 214 : LARGEST CONTAINER rs- --.-.-- ¡ FED HAZARD CATEGORIES : (Check all thai apply) i ANNUAl WASTE ¡ AMOUNT --...----------". ._-_._~_._- o 1 FIRE 02 REACTIVE 03 PRESSURE RELEASE ~ ACUTE HEALTH o 5 CHRONIC HEAL TIi ,~~ "--.. ._-..-._-.._--_._._-._-~---_.- 217 ,: MAXlKlt.I " i'!"" 218 i AVERAGE t I ;:"\ . DAILY AMOUNT ''0 ,;) : DAILY AMOUNT ,t..I UNITS" LJii:v. GAL 0 d CU-;;'---- -O-;;:;S-- 0111";;';--'-' -- -----.. " If EHS. ncunt mIlS! be in l1li. STORAGE CONTAINER (Check aI/that apply) o a ABOVEGROUND TANK Db UNDERGROuNDTANK o ç TANK INSIDe BUILDING .!1iG. STEEL DRUM o e PlASTICINONMETALUC DRUM Of CAN o 9 CARBOY o h SILO o i FIBER DRUM Cj BAG Ok BOX o I CYlINDER Om GlASS BOme o n PlASTIC BOTTLE o 0 TOTE BIN o p TANK WAGON -..-.......-. ..-......- ....-.--.-..----- i STORAGE PRESSURE , , øt. AMBIENT o .. ABOve AMBIENT o ba BELOW AMBIENT -----.---..--------...-.-....-.- . '._-- ..... .-------- STORAGE TEMPERATURE ~AaeIENT 212 ¡ CURIES 213 215 ' 216 ; 219 ¡ STATE WASTE CODE I 221 i DAYS ON SITE I 3ój- 220 : 222: o q RAIL CAR Or OTHER I 223i 224! ..:....(.~~.;;.:. . . .~.' '. o 118 ABOVE AMBIENT o ba BELOW AMBIENT ,~ ~:~:t~%g)4i~·!:~~::~~~~ç§~~~~,:y;:~):;L)~~,: ': ',-' 2 230, I 3 i 234 I I 4 238 242 ---..'.-'----..-----.,-... __.n_.___~.. ~~~-9-~~.L 231 I DYes oNo 2321 --....----.---------.--.. ...----~.-.. ........~. ---'-,-----.'..'.___.0_' _;_ 235 : 0 Yes 0 No 238 I _m_~ -=~_=-- --=~:.._~:~~: ;: : I /;~rh'~ ,,-.. ;ti:~~f'ê.:!t'~ ..::.__ ,," t. .---.--- -..-..- - ------ -..-.--. '- . ....-... '-." -.... -_... --..-.-....-......--..---. - ... UPCF (7/99) , 229! 233 237 ¡ I i I 241 I , I 245 ! I I ':~t;~~;,yi;;;, OA ~/r~~/ð1 S:\CUPAFORMS\OES2731.TV4.wpd