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Per
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Hazardous Materials/Hazardous Waste Unified Permit
'"
CONDITIONS OF PERMIT ON REVERSE SIQE
Permit I D #:: 015-000-001191
RELIABLE MOVING INC
LOCATION: 4350 WIBLE RD
Issued by:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date:
This permit Is Issued for the following:
ItJ Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
.
Issue Date
.June 30, 2003
Per... it
to
Operote
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This permit is issued for the following:
, "'ti@¡Eardous Materials Plan
, round Storage of Hazardous Materials
J~,agement Program
mm" Waste
4350
PERMIT ID# 015-021.001191
RELIABLE MOVING INC
LOCATION
Issued by:
WIBLE
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (805) 326-3979
FAX (805) 326-0576
*~
ph Huey,
ffice of ental Servi es
Approved by:
Expiration Date:
June 30, 2000
;> ,,~R~LIABLE MOVI.fNC.
" . ~OJ~-'BLE ROAD '
';,ð'AKERSF.lELD. CA 93313
j 805/397-4521
Wafs: 800/325-5896
CA Wafs: 800/648-9613
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DATE:\~l~~/~1.FACILITY ;iA,\fE; L0p\\i:"õ-c~a'-.)Sç:/ "-
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FACILITY DIAGR.~\f
(CHECK ONE)
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,~.I:. / F Þ..C I L I TY
FORM 5
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FLOOR: \ OF d....,
UNIT
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SITE DIAGRA.'f
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(Inspector's Comments):
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SITE DIAGRAM (~eq~tems)
1. Address: Ide~ifY the
principle buildings
by the Street numbers.
.,.
.'
r:-- "~
~;; .
- .
'"
¡'--,~ i:
9, Lock (key) Box
10. MSDS Storage Box
~_\
.
2. Street(s). Alleys.
Driveways. and Parking
Areas adjacent to the
property. Include the
street nalles.
11. Railroad Tracks
12. Fence or Barrier
a. WIre
b. :oIasonry
3. Storm Drains. Culverts.
Yard Drains
c. Wood
4. Drainage Canals. Ditches.
Creeks.
d. Gates
13. Power lines
5. Buildings
a. Fralle construction
14. Guard Station
b. Masonry construction
15. Storace Tanks:
Identify the
capacity in fal.
a. Ahove rround
c. Metal construction
d. Access Door
- b. t1nderzround
6. Utility Controls
a. Gas
18. Diking or Be~
b. Electricity
17. Evacuation Route
c. Ifater
18. Evacuation Area:
Identity the
location where
..ployee. will
_to
7. Plre Suppression Syste..:
a. Plre Bydrauts
b. Plre Sprinkler
Connection.
19. OUtside Hazardou.
Wa.te Storace
c. Plre Standpipe
Connections
20. OUtside Hazardous
Material Storage
d. Ifater Control Valves
for protection syste.s
21. OUtside Hazardoua
Material
Use/Handling
e. Fire Pultp
22. TYPe of Hazardous
Material/Waste
Stored
01" Uaed (See
Below)
8. Pire Depart.ent Access
TYPE OF HAZARDOUS 1o(ATERIAL
" - Flllllllable E · Explosive L · Liquid
C . Corrosive 0 · Oxidizer G · Gas
" - Water Reactive T · Toxic S · Solid
R - Radiololtical
p . Poison
II . Cryogenic
D . Waste B . Etiological
Exaaple: Flaa.able Liquid - FL
FACILITY DIAGRAM (Required items In addItion to the above)
1. Risers for Sprinklers 8. Fire Escapes
2. Partitions 9. Air Conditioning Units
3. Stairways: Indicate the 10. WIndows
levels served froll
highest to lowest. 11. Inside Hazardous Waste
Storage
4. Escalator: Indicate the
levels served (roil lZ. Inside Hazardous
highest to lowest. Materials Storace
5. Elevator 13. Inside Hazardous
Materials Use/Handling
6. At'ttc -'Access
14. Sewer Drain Inlets
1. Skyl1~hts
r-.
_R~LIABLE MOVI!.ø, INC.
4350 WIBLE ROAD ..
6'AKERSFIELD, CA 93313
805/397-4521
Wafs: 800/325-5896
CA Wafs: 800/648-9613
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11 RELIABLE MOVING .LNC :III
ct 5f1J ¡¿¡¡ (bf-
Manager :
Location: 4350 WIBLE RD
City BAKERSFIELD
.
, "-
v
Site
015-021-001191
~~
fS1'\ 'l,a,
BusPhone:
Map : 123
Grid: 13C
(66l) 397-4521
ComrnHaz : High
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 07
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact
EILEBN BUCKLEY
Business Phone:
24-Hour Phone :
Pager Phone :
/ Tit~e ,I' Emergency Contac~ r / e~Title
/ OWNER Sfé-¡)~ bù<f1e.« e"51:ÞQ DUNEHEW Sc.ù€-h¡"t(1ev¡t'" OPS ~4ANAGEROu)¡Ù Eo('
(661) 397-452lx Business Phone: (661) 397-4521x
(66l) :3 98 04 Ð1x80~O"'ll7\:-; 24 -Hour Phone : (661) 3-27 8823x~o9..o~ iole
( ) - x Pager Phone : (661) 638 6"741x
Hazmat Hazards:
Fire
ImmHlth DelHlth
Contact :
MailAddr:
City :
5fe.-v e...- ~'h e.. \r v- e "'C-.---
4350 WIBLE RD
BAKERSFIELD
JOIIN & BILBEN BUCKhRY $-Ie,)€.- -t';I/lØrHA
: 7403 R.'\NCH HOUSE DR &-µ.·ne¿,2.f::.-z.-
: BAKERSFIELD /3/01 ,ðK'lrn. ItffLL 1<1.:)
Phone: (661) 397 -4521x II;;J.
State: CA
Zip : 93313
Phone: (661) 397 4S21x
State: CA !7'Y'1-Ú7 [??~
Zip : -9-~ 93:3/ L{
Owner
Address
City
Period :
Preparer:
Certif'd:
ParcelNo:
to
TotalASTs: =
TotalUSTs: =
RSs: No
Gal
Gal
Emergency Directives:
St!1:Îve Gutierrez
Sales Manager
.-rJ ,ðJEðõ hereby carti1y that , have
/IfIßJtfll ~tI¿(~ -
': '(fÿiië or print name) d us materials manage
attached hazar ~L:-hJ M6 f,
reviewed the , ,./ pv,t£.1P tV-r/11' . ·t -long with
f3;Æ~Þt..(.. D /,14 __and tha\ I è1.I
ment p\an tor_ (NameotBullineSS) dcorrect man-
nute a complete an
any corrections cons \
, n tor my facUity.
~ment p a
!J!!!!ŒQ
r. . ,.-
*'
, rQu~ i'îP.
~- ~ona~ ~
/~.-g.~~
- DaI8
RELIABLE MOVING & STORAGE
4350 Wible Road
Bakersfield, CA 93313
661/397-4521
661/397-0765 FAX
USA 800/325-5896
CA 800/648-9613
-1-
10/17/2003
-- --- ~-~--..~.- ----
~
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~
RELIABLE MOVING INC
SiteID: 215-000-001191
-.",.
BusPhone:
Map : 123
Grid: 13C
(805) 397-4521
CommHaz : High
FacUnits: 1 AOV:
'Manager :
Location: 4350 WIBLE RD
City BAKERSFIELD
BY: ,..'
CommCode: BAKERSFIELD STATION 07
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title
EILEEN BUCKLEY / OWNER
Business Phone: (805) 397-4521x
24-Hour Phon~: . ~ ~;M- 1'11ð.k
Pager Phone ~ (tAr I ) 2)'~g -U/o x
Emergency Contact, / ' TitleC¥6'~ðK
SOOIE 3CO'P'i':I\ m .Dll,f)'e~
Business Phone: (805) 397-4521x
24-Hour Phone : (~ &3-6~x
Pager, Phone : í~f ) ~,~~ - r;~r
Fire ImmHlth DelHlth
Hazmat Hazards:
Period :
Preparer:
Certif'd:
JOHN & EILEEN BUCKLEY , ,
: 3-6-'31: ~LCIA DR r¡ 105 R.'¡::¡-/16h :.J-/.c;j,{s€' D<
: BAKBRSFIELD ÓfJICfAs/i"CkA C¡:;- Q38cq
J
Phone: ( )
State: CA
Zip : 93313
Phone: (805) 397-4521x
State: CA
Zip : 93313
-
x
Contact :
MailAddr: 4350 WIBLE RD
City : BAKERSFIELD
Owner
Address
City
to
TotalASTs:
TotalUSTs:
RSs: No
=
Gal
Gal
=
Emergency Directives:
Hazmat Common Name...
One Unified List 9
All Materials at Site 9
F Hazmat Inventory
f== Alphabetical Order
EPA Hazards
DailyMax
MCP
PROPANE
, F IH DH L
I, ~u ì A- W~ 1/; t.t (tiS Do hereby certify that I have
(Type or print natne) i'
reviewed the attached hazardous materials manage-
ment plan ~or 'e.-i" c¿ b . , ()~i I~d that it along with
( ante of mess
any corrections oonsiitute a complete and correct man-
agement pltìn ferrAY facility.
/ t/utú1lvJ ¡Ö/bß5
gnature 'Dare
250 GAL Hi
-1-
08/24/1999
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SiteID: 215-000-001191 ì
Facility Unit: Fixed Containers on Site ì
F RELIABLE MOVING INC
p= Inventory Item 0001
= COMMON NAME / CHEMICAL NAME
PROPANE
Days On Site
365
Location within this Facility Unit
SW CORNER PARKING LOT
Map:
Grid:
CAS #
74-98-6
[ ~TA~E I TYPE ~, P~ESSURE ---¡ TEM~ERATURE I CONTAINER TYPE
=Llquld __~pure ~mblent ---1 Amblent ~ ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
GAL 250.00 GAL 250.00 GAL
HAZARDOUS COMPONENTS
~
CAS #
749861
I l~~~ôolpropane
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Hi
HAZARD ASSESSMENTS
-2-
08/24/1999
e
.
..
Employee Notif./Evacuation
SiteID: 215-000-001191 ì
Fast Format ì
Overall Site ì
01/31/1990 ]
01/31/1990
F RELIABLE MOVING INC
I
f= Notif./Evacuation/Medical
¡=: Agency Notification
CALL 911
:TO MAKE SURE OCCUPANTS ARE SAFELY ESCORTED TO THE NEAREST FIRE EXIT WHICH
ARE POSTED.
Public Notif./Evacuation
01/31/1990 1
01/31/1990 ]
NONE LISTED
Emergency Medical Plan
MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371
-3-
08/24/1999
e
.
SiteID: 215-000-001191 9
Fast Format ì
Overall Site ì
01/17/1990
F RELIABLE MOVING INC
I
p= Mitigation/Prevent/Abatemt
Release Prevention
TO MAKE SURE THE DISPENSER IS PROPERLY INSERTED INTO THE FORKLIFT TANK AND
TO MAKE SURE A LEAK IS NOT POSSIBLE, IF THIS SHOULD OCCUR EVACUATE SITE
IMMEDIATELY AND TRY TO SHUT OFF VALVE IF POSSIBLE, OTHERWISE, NOTIFY CAL
GAS, TO REPLACE. ALSO NOTIFY FIRE DEPARTMENT
Release Containment
L
I
I
Clean Up
Other Resource Activation
-4-
08/24/1999
e
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:>
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SiteID: 215-000-001191 ì
Fast Format ì
Overall Site ì
I
F RELIABLE MOVING INC
I
p= Site Emergency Factors
~ Special Hazards
Utility Shut-Offs
01/17/1990
A) GAS - SOUTHWEST CORNER OF PARKING LOT (PROPANE)
B) ELECTRICAL - NORTHEAST WALL INSIDE BUILDING C) WATER - NORTHWEST CORNER
OUTSIDE BUILDING
D) SPECIAL - NONE
iE) LOCK BOX - NO
Fire Protec./Avail. Water 01/17/1990
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER NEAR PROPANE TANK
FIRE HYDRANT - FRONT OF BUILDING
Building Occupancy Level
-5-
08/24/1999
e
Ie
" r '.
F RELIABLE MOVING INC
I
F Training
Employee Training
SiteID: 215-000-001191 ì
Fast Format ì
Overall Site ì
01/17/1990
WE HAVE 20 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: 5 EMPLOYEES WILL HANDLE PROPANE. GO OVER USE OF
FIRE EXTINGUISHER NEXT TO PUMP AND GO OVER 'SAFETY PROCEDURES. ALL EMPLOYEES
HAVE BEEN HERE OVER 3 YEARS.
Page 2
¡=
I
I
Held for Future Use
Held for Future Use
-6-
08/24/1999
"
õ'
..
~ BUSINESS NAME RELIA.MOVING INC
. LOCATION 4350 WIBLE RD
10 NI~R Zí5~ØØ0-Ø0tí9t
.. HAZARD RAT! N6 4
.,
1. OVERVIElJ
LAST CHANGEt i/lS/Sa BY VAL
JURIS CODE 715,-007 ,JURIS BAKERSFrn,U'STfHION 07
MAP PAGE 123 GRID 13f. Ft1CrUTYtiNTTS'THAZARORAlING4
RESPONSE SUMMARY 2A SEC 4>
NO PRIVATE RESPONSE TEAM
EMERGENCY CONTACTS ZA SEC Z) 33LI-q~~8
EILEEN BUCKLEY - 397-45Zt on 843 9J~
S(¡SIE SCOTT - 397-4521 OR 3Z2 '7£:EØ~'-,)8(P9--
uTILITY SHUTOFFS ZR SEC 3}
A) GAS - SW CORNER OF PARKINl:; LOT (PROPANE) B) ELECTRICAL - NEWALL us BLOG
() WATER - NW CORNER 0/5 8LOC'; 0) SPECIAL - NONE f) LOCI< BOX - NO
2. NOTIFICATION I PUBLIC EVACUATION
lAST CHANGE I / BY
U!~
< NO INFORMATION RECORDED FOR'THIS SECTION>
PAGE 1
lZfZ0/a8 1Z:33
MATERIAL SAFETY DfHASYSTEM5,lNL l'H05) 648-6800
.,.
~ BUSINESS NAME RELIA~MOVING INC
" LOCATION 4350 WIBLE RD
10 NI"'R 215-000-001191
~i HAZARD RATINt:; 4
~
3. HAZ MAT TRAINING SUMMARY
LAsr'q-ìANGE I I BV
Yv/71 };Efi.- ðF EmjJ)t:;/E¿ '.5
5" W:I! A~r(j Ie prof CIne .
/1/15 f}::::.. f)II' Dr de (ì
I f I VO:¿NO INFURrfATI9IN'f(£CURDEO'TORTHTS"'SEcnON > - '
{pc> ove./' vS~ err- '
f/re e.-t+I'!.5v;.J-,er- (led- -fv fðPfJ
! r 7)1er saIe+y frfK'~c/¡)res.
.4/1 etr1f(oi e= }¡o.'¡Q. be£r\ -tÅef¥L 'ð'€î.3 '1 rs .
5fdz. h1eel-ìf[J5> held if ~(' lI(ð
õ>n
~ .
4. LOCAL EMERGENCY MEDICAL ASSI5T~NCE' ~
LAST 'CHANGE 11/28/88 BY VAL
ZA SEC 5) MERCY HO~PITAL - ZZ 15 TRUXTUW AVE:.. -327,-3371
PAGE Z
12/ZIð18ß' l'n'3T '
MlnERI AL' 5AFETY'DflTf-\,"SY'STEM'S, 'TNC': 'C8Ø'F.ì'>' '61r8-'BtlØ0
;.¡:
.~. BUSINESS NAME RELIA. MOVING
" LOCATWN 4350 WIBLE RD
FACILITY UNIT 01
INC
10 NaR 215'-000-001191
HIGH HAZARD RATING 4
0,
fl. OVERALL HAZARDOUS MATERIALS IN\7ENTDR\'
LAST CHANGE' 1 ¡ 1Z8/88 BY VAL
10
TYPE NAME
LOCATI ON
CONTfUNMENT
MAX AMT UNIT HA¡ARO
USE
PURE PROPANE
SW CORNER PARKING LOT" ABDVF'GROUNU TANKS
10 PERCENT COMPONENTS
1155.02 100.0 PROPANE
ZS0 GAL EXTREME
FUEL
HAZARù LI ST
EXTREME
B. F1RE PROTECTION / WATER SUPPLIES
LflST CHANGE 1 /Z8/SS BY VAL
3A SEC 4) NO PRIVATE FIRE PROTECTION
Hrt:.. 'tfll"tJf;~r r1t>ar f~
3A SEe S> FIRE HYQRANT - 1 -f('ðtr/-rl-- h!)ð ;)f -''I.,!
PAGE :1
tz1Z0/88 1 Z: 33
MATERIAL SAFETY DATA SYSTEMS. INC. (805) 648~Eì8.ØØ
:;;-- ~.~ '. ~
... 'I '"
,,, "..,. j~
BUSINESS NAME RELIA. MO'JING INC
LOCATION 4350 WIBLE RQ
to !\I-R Z í 5-000-001 t 91
~ HAZARD RATING 4
D. EMPLOYEE NOTIFICATION I EVACUATION
LAST CHANGI: IilZB/aa BY VAL
3A SEC 2) TO MAKE SURE OCCUPANTS ARE SAFELY ESCORT~D TO THE NEAREST FIRE
Exn WHICH ARE rmnED.- '",,'
~
E. MITIGATION I PREVENTION I ABATEMENT'
LAST CHANGE 11/Z8/88 BY VAL
3ft SEe 1} TO MAKE SURE THE DISPENSER IS PROPE:RL Y INSERTED INTO THE FORKLIFT
TANI< AND TO MAKE SURE A" LEtlKIS NOT POS-SfBLE, IF l'HIS SHOULD
OCCUR EVACUATE 'SITE TMME'Ol'ATEtY'AND'TRY 'TOSHUI OFF VALVE IF
POSSIBLE, OTHERWI$E~ NOTIFY CRt 6AS~ TU"REPt:ACE. ALSO NOTIFY
FIRE DEPHRTMENT
PAGE 4 fZI'Z0raS''TZ:33
MATËRIAL 'SAFETY DATA 'SYSTEM'S.'INL '(805) '648-8800
CITY oj lJAK./;'RSflLLLJ
f .r. .nd AQr leu I turf L-J
St.ndlrd 8u.in.n t
HAZARDOUS MATERXALS XNVENTORY
NON-TRADE SECRETS 1 l
"''' _ _ of ____
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AUS r NESS . NAM~: ,) ,.:~.< \ ~,') ,b.\~ .', I~~y~ i (ìC,
LOCATION. '\, ,.1' t t: \ \ ~(- \1 :1 ,\
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PHONE ,: /,q7 -. ...V~-...;) \ '
l1)~ . OWNER NAME:
ADDRESS:
CITY, ZIP:
PHONE fI:
ItUIØf ro ZIISf7ff1CJ'ZOIlS roa ""OPD CODa
NAME OF TltŠ ~~~L!t!:
STANDARD IND. CLASS CODE
DUN AND BRADSTREET NUMBER
I 1
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l.rt\fiell;on (Rf!lJd lJnd siRn ,,(ft:'r co."lf'tlng lJll spctlonsl
I c.rtify und.r .,...lty 01 1.. that' hay. ørrson.lly ....;ntd IIId .. IMl1far wfth the f"lor_tlon ..itt" fn t:111 11 'Uee" doc_u, IIICI that ba"d on., IIIC//try of thol. tndfV~'" I ....ÌfJI'IltIt1.
for Obf81nlnq the I"'or_tlon. I wli... that tilt subIIltttd inlo....tion it tMlt. accurat., anti eu.o t.. 1/ J J
R:,.· ¡ña- õT T ,t ,; 1- f mnt - ö;ñ¡¡: 7õDii' m;: ·011- ö;ñ¡;: 7õ~;:¡fõ;: Tiüfr,¡¡¡:ma-;:¡¡¡:¡¡iñf ¡m¡ 9ñitü¡:¡------------- --~------------------------ Dm~l~L __i!.2_______________
01/17/90
RELI.E MOVING INC 215-000-00.1
Overall Site with 1 Fac. Units
Page
1
General Information
Location: 4350 WIBLE RD
Ident Number: 215-000-001191
Map: 123 High
Grid: 13C Area of Vul: 0.0
,.--- C':'Y'lt act Name
EILEEN BUCKLEY
SUSIE SCOTT
Title
Bus i Y'less Ph':'Y'le -
(805) 397-4521 x
(805) 397-4521 x
24 Ho:.I_lr Ph':'Y',el
(805) 834-9328
(805) 836-28521
Administrative Data
Mail Addrs: 4350 WIBLE RD
City: BAKERSFIELD
GeoSubDiv: 215-007 BAKERSFIELD STATION 07
D&B NI.lmber:
State: CA Zip: 93313-
SIC C,::ode: l.J;;<)~
Owner: JOHN & EILEEN BUCKLEY
Address: 3531 ELCIA DR
City: BAKERSFIELD
Phone: (805) 834-9328
State: CA
Zip: 93313-
Summary
01/17/90
RELIABLE MOVING INC 215-000-001191
Hazmat Inventory List in Reference Number Order
Page
2
02 - Fixed Containers on Site
02-001 PROPANE
?
250
High
GAL
e
-
01/17/'30
REL.E MOVING INC 215-000-00_1
00 - Overall Site
Page
3
(D) Notif./Evacuation/Medical
(1) Agency Notification
(2) Employee Notif./Evacuation
TO MAKE SURE OCCUPANTS ARE SAFELY ESCORTED TO THE NEAREST FIRE EXIT WHICH
ARE POSTED.
(3) Public Notif./Evacuation
(4) Emergency Medical Plan
MERCY HOSPITAL - 2215 TRUXTUN AVE - 327-3371
01/17/90
RELIABLE MOVING INC 215-000-001191
00 - Overall Site
Page
4
(E) Mitigation/Prevent/Abatemt
(1) Release Prevention
TO MAKE SURE THE DISPENSER IS PROPERLY INSERTED INTO THE FORKLIFT TANK AND
TO MAKE SURE A LEAK IS NOT POSSIBLE, IF THIS SHOULD OCCUR EVACUATE SITE
IMMEDIATELY AND TRY TO SHUT OFF VALVE IF POSSIBLE, OTHERWISE, NOTIFY CAL
GAS, TO REPLACE. ALSO NOTIFY FIRE DEPARTMENT
(2) Release Containment
(3) Clean Up
(4) Other Resource Activation
-
-
01/17/90
REL~E MOVING INC 215-000-00~1
00 - Overall Site
Page
5
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - SOUTHWEST CORNER OF PARKING LOT (PROPANE)
B) ELECTRICAL - NORTHEAST WALL INSIDE BUILDING C) WATER - NORTHWEST CORNER
OUTSIDE BUILDING
D) SPECIAL - NONE
E) LOCK BOX - NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER NEAR PROPANE TANK
FIRE HYDRANT - FRONT OF BUILDING
<4> Held for Future use
'01 / 1 7 / 90
RELIABLE MOVING INC 215-000-001191
00 - Overall Site
Page
G
<G} Tt~a i rli ng
<1> Page 1
WE HAVE 20 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF SUMMARY OF TRAINING: 5 EMPLOYEES WILL HANDLE PROPANE. GO OVER USE OF
FIRE EXTINGUISHER NEXT TO PUMP AND GO OVER SAFETY PROCEDURES. ALL EMPLOYEES
HAVE BEEN HERE OVER 3 YEARS.
<2> Page 2 as needed
<3> Held for Future Use
<4} Held for Future Use
-
-
ee
Bakersfield Fn!&pt.
Hazardous Materials Inspection
.//
IO-//-7D
Business Name:
Date Completed
æ-e/IA-h/¿ )7ÎOu/,uG¡ ..ENe:.
Location:
.Lj 3 fJ-() LJ " i,/ ~ /2 cJ
q~.~~C::~¿~';~f ~~
íJ~T '1 ? 1990
Plan 10 # 215-000·001/"'7 J (Top right comer Business Plan)
Station No. 7
c.
Inspector
W, LL-((!4S
Shift
i-' .", --:-:. ;'.;~ £:,\1". ~,:'...t.
Adequate Inadequate
Verification of Inventory Materials
~
[8'
~
5d'
Verification of Quantities
Verification of Location
Proper Segregation of Material
Comments:
D
D
D
D
Verification ofMSDS Availability ~ D
.c::"\ L Number of Employees
U V:rification of Haz Mat Training ~ D
Comments: Ä¡V4 -J,'H-e. EI'H¡O/t>~ ~£.s j'rtJ>I'-e_/j Tr-"i-¡µe4
Verification of Abatement Supplies & Procedures 0 0
Comments:
Emergency Procedures Posted
[)5t
~
Containers Properly Labeled
Comments:
Verification of Facility Diagram
~
cial Hazards Associated with this Facility:
D
D
D
C¡'tl9·¡U~tž.. f//zo ¡P ¡5,leeÞ-J iSuf,k./e'r" ~~~/ J7/ð-
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White-Haz Mat Div. Yellow-Station Copy Pink-Business Office
FD 1652 (Rev, 3-89)
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Do hereby certify that I ha\'e re\-ie¡,'ed
at~ached Hazardous Materials business plan
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for
&\¡~b\e, Ü'rNìfì~\~_'
(name of business)
and that it along with the attached additions
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or corrections constitute a complete and correct
Business Plan for my facility.
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BAKERSFIELD CITY FIRE DEPAR~NT
2130 "G" STREET
BAKERSFIELD, CA 93301
(805) 326-3979
RECEIVED
DEC 2 8 1987
Ans' d............
OFFICIAL CSê O~LY
HAZARDOUS MATERIALS
BUSINESS PLAN AS A WHOLE
FORM 2A
,~
INSTRUCTIONS:
1. To avoid further action, return this form by /2 ~ 3/-161
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:
Reliable Moving, Inc.
B. LOCATION / STREET ADDRESS:
4350 Wible Road
CITY:
Bakersfield
ZIP: 93313
BUS. PHONE: (805) 397 4 'i? 1
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 DURING BUS. HRS. AFTER BUS. HRS.
A. Eileen Buckley /PARTNER Ph# 805 397 4521 Ph# 805 834 9328
B.
Susie Scott/OFFICE MANAGER
Ph# 805 397 4521
Ph#:
805 322 7660
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: SOUTH-WEST CORNER OF PARKING LOT (Propane) APPROV l~n' Frnm Rldg.
B. ELECTRICAL: NORTH-EAST WALL INSIDE BUILDING
C. WATER: NORTH-WEST C.ORNER OUTSIDE BUILDING
D. SPECIAL:
E. LOCK BOX: YES ,I ~O IF YES, LOCATION:?????do not know what thi¡;; i¡;;????????
IF YES, DOES IT CONTAI~ SITE PLANS? YES / NO
FLOOR PLANS? YES / NO
MSDSS? YES I NO
KEYS? YES / NO
- 2A -
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SECTION 4: PRIVATE RESPONSE TEA~ FOR BUSIXESS AS A WHOLE
None
, t: ~ ~1' I' .
,r'. ¡¡ ~ P Î i
-- - t,.;. .....' "->'
1 SECTION 5:
LOCAL EMERGE~CY ~EDICAL ASSISTANCE FOR YOt~ BUSINESS AS A WHOLE
mu~j ~~L
----' =rr:U'it-lAn -tlo er
6tlher6+ieLd CA.
)
----".--,0"-
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SECTION 6:
EMPLOYEE TRAINING
E~PLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH I~ITIAL A~D
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR ~O INITIAL REFRESHER
A. ~ETHODS FOR SAFE HANDLING OF HAZARDOUS
Y1ATERIALS:. .................... ..................~:;-O ~O
8. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES:.......................... ~~~âi'~~
C. PROPER USE OF SAFETY EQUIPME~T: ...... .......... . . NO S NO
D. DIERGENCY EVACUATION PROCEDURES: . . . . . . . . . . . . . . . . . NO YES ~
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:.... . .. YES (ŒQ) YES (~
--' : SECTTON-7-:-- HAZARDOUS--MATERI-AL--
CIRCLE YES - NO - NONE
DOES YO' . T SS HANDLE HAZARDOUS ~4TERIAL I~ QUANTITIES LESS THAN 300 POUNDS OF A
SOLID, 35 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:,.,.., ~NO
I, Eileen Buckley , certify that the above information is accurate.
I understand that this information will be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
Sec. 25500 Et AI.) and that inaccurate information constitutes perjury.
TT~,~
DATE~l r
- 23 -
i'
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.
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BAKERSFIELD CITY FIRE DEPART)IEXT
2130 "G" STREET
BAKERSFIELD, CA 93301
OFFTCTAL CSE OXLY
BUSINESS i\AME:
ID#
------
I
I
¡
c_,
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS
1. To avoid further action. this form must be returned by:
2. TYPE/PRINT YOUR ANSWERS IN ENGLISH.
3. Answer the questions,below for THE FACILITY UXIT LIS1'Ep BELOW
4. Be as BRIEF and CONCISE as possible.
FACILITY UNIT;;
FACILITY UNIT NA~:
SECTION 1: MITIGATION, PREVENTION. ABATEME~jL PROCEDURES
\ 13 m-Ahe 5uJe'-{-ne dEÌpÐYö~I~ prOÇ)er[~, ìn:ser+"é"cf
I (\+0 +h e- ..ç 0 r h 1,'..Ç> t- +-A n h CU1 d +-D m A-I.¡ e ~ur e Q
l eCLh '-5 no t- p 055 ' b Ie.. '\..r +h "6 6hou ld Oe..w%
e VQwo..:u, :6; -I-e.. ( m vY\e~~ D.Y)d +I"~ fo &11+
ð f-Ç. V cUv ¿ {1, passr b Ie ì_ _ ~ +h en.D~-s- €-J r'út-I' t-\J ~aL G-aS
'+0 (e.pla('£.. .D 160 rot-ì.f''j (.'1"0 de.pt. 1 J
SECTION 2: NOTIFICATION A~~ EVACUATION PROCEDt~ES AT THIS t~IT O~LY
T()m 4~e 5u.re.-
--t G +he.
o c-uLpló Ci.x e.. -..5::;L-t" + IJ es c.ø I" + e4
Vîe.eure.6+ ,t2I'í~ e,X,,'+ WV\I'ch QJe Ç>OQted..
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S:::CTIO~ 3: HAZ1\RDOGS :-,.rATERIALS FOR THIS Ti~~IT O~LY
A. Does this Facility Unit ~ontain Haz~rdous ~ate~¡~ls?"". VES ~o
If YES I see B.
If NO, continue with SECTiOX 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES XO
If No, complete a separate hazardous materials inventory
form marked: ~OX-TRADE SECRETS OXLY (Nhite form #4A-l)
If Yes, complete a hazardous materials inventory form mark~d:
TRADE SECRETS O~LY (yellow for~ #4A-2) in addition to the non-trade
secr~t for~. List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTIOX
. _.. __. . ._~.... 4 _.
SECTION 5: LOCATION OF WATER Su~PLY FOR USE BY ~RGENCY RESPO~ERS
SECTION 6: LOCATION OF UTILITY SHU1-OFFS AT THIS UXIT ONLY.
A. XAT. GAS¡PROPA8E~
8. ELECTRICAL:
C. WATER:
0, SPECAI..;
E, LOCK soX y~S ! XO IF YES, LOC\TIOX:
iF YES, srrr: P~AXS~
?~,OOR PT..\Xc.:~'
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III\I<.LHS I' J ;,I.IJ l. t i HL In I II/( IILti j
FORM 4A-I
NON-TRADE SECRETS
IIAZARDOUS MATERI ALS' I NVENTOHY
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1111111' I:
Reliable Moving, Inc.
.4350 Wible Road
Bakersfield
93313
OWtHW NAME:
^UUnESS:
CITY ZIP:
John & E:ilppn RI1l"'kll'>Y
3631 Rlcia Drive
Rake f' ~Q 93313
'.
F^CII.ITY UNIT ':Main,
FACII,ITV UNIT NAME: HHG Wh~p:_!
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PIIONE , : I£) F Fie I ^ I, lISE CFIHS !:{}tJF
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1i -1 !i 0 7 0 9 I (
^NN"^'. CliNT IISr. f. (J(: ^ r ION IN TillS ~ nv "^7,^11I1 II 11 I
^HOONI -º!!!l C; U!!!i, CUU~ FACILITY UNIT HT. CIIEMIÇI\L OR C U mID N NMIE CODE {; II I II E
----.---.-. So./West ----
9p.l. \ '\. corner of ~ ilSS. ~ <d-'
c:>.;j... ~~~ E IJ<L. LG-.
Parking Lot -- -- -----
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--- -- -- - -'-
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TITLE: SIONATURE: DATE: ---- - ..-- -
---
TM:T: TITf.E: PIIONE , nus fOURS:
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AFTER nus IIRS:
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TM:T: TITLE: PIIONE , BIJS IIOIJRS:
I tiE S S ACTIVITY: AFTER BUS, IIRS:
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