HomeMy WebLinkAboutBUSINESS PLAN 9/26/2003
Per
Issued by:
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it
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Hazardous Materials/Hazardous Waste Unified Permit
~ CONDITIONS OF ,PERI\I.IJT.:ON R~VERSE SIDE
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This pennit Is Issued for the following:
It! Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Sate Treatment
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SERVICES'
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Approved by: .
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Issue Date
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,"June 30, 2003
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¿;"~,"_/. SITEDIAGRAMM FAJDIAGRAMI
.r Business Name: I j .lEL.i!l£{)
/ Business AddJ:ess: .55CX) wOOl) fVIt:E-@
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UNIFIED PRo~RAM I.ECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
FACiliTY NAME
\a.en (
L.ùüo&m ~~_,___,
-r t
---.---
INSPECTION DATE INSPECTION TIME
~~_ é2b ð1'~__
PHONE No, No, of Employees
28?r~_ _____JB.____
Business ID ïU5~Õ21_ Ie¡ ï ï
ADDRESS
~~ption 1: Business Planånd Inventory Program
C] Joint Agency
D Multi-Agency
D Complaint
D Re-inspection
C V ( c=comPliance)
V=Violation
,¿ 0 ApPROPRIATE PERMIT ON HAND
------,-----------------..------- -"-'-.---\f"1.~!d\,-----------------'--'---'---'---'-..,-------,--,---",,----
r;(/ D BUSINESS PLAN CONTACT_~~~~~~TI~_~_~C~~ATE_....___ __}\~~..~..________,___,___________.._..n__u____.__,..n___..__
~. V'S'BLE ADDRE-""--~_________ /if-~L~~ ~-lY:'L~-
CORRECT OCCUPANCY, ,_______, _____'_u_'_n_______..__~~?!:'8~--~--,--
D VERIFICATION OF INVENTORY MATERIALS 1-// E ; ~~ IJI
~ _~::::::::: : ::~~~S __=:=~=-~-j=~~/v~~~-Ë_::: ____
~- PROPER SEGREGATIO~-~ MATERI~~-----'---- -------,-----..-,---,----------..---..---..--..--,-----
~ D VE;IFICATION OF MSDS AV~;~ABIL;~-;-n------....-..-- ,..--------,------ -..-..---...------- --------,..----..--
--,---,..,----..,---,-...-- -----.....-'-'------',-----"-,-..-----..---...---,.,---..--,,,"---"'V
if D VERIFICATION OF HAT MAT TRAINING
OPERATION
COMMENTS
--~-
------.----.----
----..---.-----.----- --------_.-------_.._------------------.---- -_.~~._-----_._------
VERIFICATION OF ABATEMENT SUPPLIES AND PROCED\JRES
EMERGENCY PROCEDURES ADEQUATE
-~--------------_._- ----~~-------_.__._-_._-_._-,------- ------------~------_.__.._-~._.._-----------_._,._-----
CONTAINERS PROPERLY LABELED
~';'::S::::DN- --m':~=~-t"· -5~~~~~9Ã~f~~~~-o~~--~~r~~-~~
/ . -~-------~--_._-----_.- _._---~--_._-----_._-_.__._--~--~-----_.._---_._-- .__...._-----~_.-
0/ D SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
~
D No
EXPLAIN: t A..hè-1u- ð\\ 1- AnTI'---Ç:fQ.fI9:€---
White - Environmental Services
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QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-397
1?~iYYl~_ELðJ_ .
Inspector Badge No.
Pink· Business Copy
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FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAJ«661) 395-1349
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAJ< (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
,It
-,
July 25, 2003
Mr. Robert Muniozquren
Well Analysis Corp.
(-SSOO-=W oodII1~r~Dñvú
Bakersfield, CA 93313
Dear Mr. Muniozquren:
This is to confinn that the Fire Prevention Division of the Bakersfield Fire
Department has received and reviewed your revised hazardous materials
inventory and site diagrams for the storage of small quantities of nitrocellulose
and dinitrotoluene explosives on site. Your unified Pennit to Operate for
hazardous materials, sent previously, is your approval from this agency.
This Permit to Operate does not supersede any requirements from other federal,
state, or local agencies but simply addresses the issues regulated by this office.
Sincerely,
Ralph E. Huey
Director of Prevention Services
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, . CITY OF BAKEKStll£LD _
OFF~ OF ENVIRON~IENTAL SERWCES
171S Chester Ave., CA 93301 (661) 326..3979
HAZARDOUS MATERIALS INVENTORY ~
CHEMICAL oeSCRIPTION _ \'ta'- ~'\\'¡),.
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3è13WaOOM 0099
~~89689199 00:Þ1 £øø~ïäiiL0-----
POOR OR!GIt4AL
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HAZARDOUI ø&1!I'IVITY
INIU'ABIUTY: Ullltlbllli wiIh helL UnItøIIM d!1Ifdç c:t\ergII. lInItIIII8 .. np.çt. Not ha2arcbJB if pIOducI U88d profJIrIy.
INCOIIPA1RJ1'Y:, ~ wifhåfl. _11ea,~, ,
. : 1!IIibaI~ ~ ). ~1IIti:1. nIWIluDw VIA' !l1............1II1:WI..., .;""....-. 0'uw111pOllli8 WllfllmjRla, Øibt;cI!IIrgea.
POL YIIER~:nON: PoIyft""Wdion will not 0I,':QIr.
-.,
. FIlE AND EXPLOSION DATA: IpIon T~: 1f1C).1~ 01' 32O-3S80f.
FIIIE ~ EXPLOSION ~ Htu:ard0u8 gas produced In file Ia cørÞon monoIdde. lUna UI'ICI'JI'IIrOI Produces IIwpnøI if confinec .
EXJWGtIIttINQ MEDIA: Nonø.
HEALTH ~ ItB.RMATlON
PRItCIPM. tEALTH HAZARDS ,
These IIOducb have rà œ..18It8d for1DlåCity. They.. a.s c ExpIaIIwe. aod burning, œnfined or unconIinIad, I:8lI aauøe ptlytlcll 1nIu'Y. induding
dMIh. The toxicity e1tà ~ below for the hazardous ~nbI may ~ from IJIOIS cI1ronic or açaM ~nt to 1118 I/OCåIcII by inhIIIIIon., eve
01''' conIIt:t or Îf9IIIÏU"'
I. 4-DN'I'AOTCILUE
Inhalation lC5O: 2.87 ~1, 1 tJour in nda
SIœt ~ AI..D: >1,000 mg.\g in I1IbI:1b
QIII.D6O: 177 m Jkg In rats
This ~ i$lIIIic by inhlllfian and iIgøøCiOn. ilia a illldn and .. IrritMt.. T 0IIIc effec:ta de8cr1bed in 8nÌnIII1 from expoIUI'I by inhalation, Îf1geItiUI, or
JIlin oorUct Inc:ble nonapøci& IfhIcIs IUCh IUS IW.Iœd weight gIIln. ~ and ær.cts on the oentraJ nervouI sptBm, 1h81t1P1tIducIhI8 ~
IfId bone marrow. In animal tells. tedlr11c81 SJ8de 2,4-d1n11rdo1uenø hu ~ic acIIvIty. Tests for mubIgImíc acIíYity II baI:iIrIaI and nwn....... cell
~... been bath podhe and negdive.1t hu dIn10nstnRed no embt~ activity In IlÎmaIa. It producea 18IIIcuIIr deg8ntntion $Id decrÐII8Id
...n...."'- ÍI ilia, mice end dIIgI. ~.In mD f8I1iIity ~ in dorfinant ~.~ In 1'811. ',.
HumIn heIIItt IIrecfs from OYtRIICpOeUre by inhlllllon, IkIn a 8)'8 contact or If9I8IIon rœy _11y iJdude reduc:Iion of the bIood'. oxygen œrrying ~
with OJIIIIIII, -1a1e88, or' short... of tnatn by mllhemoglOÞln fonndon; IIOfIIp8CIIIc cIIcI) ,tft,/t 8UGh 81 ...... headIIàIe, 1';OIIfu$ion, incoonlnatlon,
IœI of COI1IcIoulINI8I; tempowy ~g inifalion effødø with cough, cñcornkJrt. dlftlculty bredllng, fir sharIn8s$ of bnNdh; or joinl pùI. The compound IIppIIIn
to be abM to I4¡JIbtIy permeate the &kin. IncIYIdùIIa wiItt ¡w.-øng .... of !he œntraI flelWUf"'. pedphør'lll nervaus .... Junge, or
........ 0I9IftI1IIIY hMi IncdÞød ~ 10 the kIcicIIy oI4II\ÐIIIM.......
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... NONE OF THE COUPQNENT(8) OF THIS MATERIAL IS LISTED AS A CARCINOGEN BV NTP, IARC, fir OSHA. DuPont COI'ItJoIs the following
oompoMI1t(I) I8poœn1i111 ~8t. 2.~.
!XPOSURI! "'"'
TLV (ACGlH): None MtIbIIIIed. (TI.V ie a regI8IMId nd8o.M.)
AEL (OSHA): None esIIIJIiIhed.
2, 4-OInIftIoIeune: AEl (DuPont) O.Iirr9M3, II & 12 nr. 1WA, Skk'I
PEL (OSHA) 1.5mWM3, Skin
1lV (ACGIH) 1.5n9M3, Skin
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DD 1ICIIt.......... Do not_In... De _fill an IIdn. Do nat.. on clalhlng. Wash!horough/y. handling. WIsh c:IoUing after l1li. Do not
InIItMI bumIng pcMIder Una Keep out of rIII:h of chlkhn,
8BJI'AlD
INHALATION:
If inh8led, mcMI eo fr88h Ilr. If not ~ g¡..... I...,.;......~ prøførably moutMo-mouth. If breIdhi1g II dfticult, ¡pv.~. Cd
. phpieien.
In cae of COI'IIIM:t.IIIISh""1OIp and pIInIy of_.
In .... of cor8I. ~ tIuIItI.- .. plenty 01_ tor It .... 15 mINIf8&. Cd. phy8IeØ'I.
'f snllOMId. indllll wmiIIng immedlafely bJ ØVlng two {11111181 of 'MIIØr and sticking fìngIør Qn III"*- Nt_ g/Je."., lit IIIØIIIIt
flit.. ØIIGØIJ.llaœ....... Cd I DlrvlIllIIn.
Burning smokeIeu powder INIY C8U88 exllrlllwllIId .. bum&. Get mecbI d8nIion imlJMldlålly. ImmIf8e Þumed 8188 In cold wa1el'.
SKIN CONT~:
EYE CONTACr:
INGESTION:
fIlJI:
NØ1'E 10 PHYSICIANS: ~ of 2. 4-Dln1lnl1vMn Into !tie body møy IeId eo 1he b1œIIan of ~, thIt, In ØficIIQ a.JrIOII1Ia1Ion, CIMII
qranœiø. Since I'\MI8ÏO'1 of III8\hemogIGbin W hemoglobin OOCUI8 epoIIIanIOUIIy . tenmIaIIon of GIIpOIIIR, modDra18 degrœ8 of cya.noeï. rwød to be
...... tuCtI as bed ,.. end oxygen inhalation. 'ThoI'ouØI dlllnllng of the IIÜII conlami....+M ,- øUIIa.Ix:I~. inI!UtInQ,
_nI neila iI or uIrnoIt importance. If cyanol6s is ..., 1nInMnou81n ecllan of ~ blue, _ ml1lp per kÎIIV"" rl bodr weight. nay be of
VIMJe. ~ ~in 912). on. rniIIi¡p'am ~. "IIy..ad reœwery, Intmenoue a,1d8 and blood transfusions "*I be incIC8I8d on
wry --........
PROTECnON INFOIIIIAT1ON
GENERALLY APPLIOABlECONmOL M&A$URES ANDPlECAut10NS
K.p..., from lINt, ~.....1Iames. Keep çontajner in . coaIpIIee, Do not rrå with 1lCiœ, øJkúas. Do not CCIIIBUIYJI food. drink, or
1Dbøo In ..... Wheft 1hey !lIlY b8cotnI co_mill. led wIIh .........,.
PlRIONAL PROTECTIVE EGtlPMENT
SIf8ty...... Prol8c:tM hearing ald.
SPILL; I-UK OR RELEASE
f1MM" FIRE AND EXPLOSION HAZARDS 81d WETY PAECAVTIONS b8fm pruueer.ing" dRn up. u.lllf'lplÐprÎlde PeRSONAL PROTECTIVE
_.... :b~4\!golMn., ~. '~"""""''''''.'_~."." ..._
AiImove lOUD of hell, eparIca tI8me. ifr1Iact, frietion. or~. Pick up by hand lor *PoRI. Do not .... powør tcJIÎpIIIR. Do II:It use dam8gød or_
maœrïaL ConItuI--.Io.... and ,.movt atId'CM of hMI or~. U. ~ tool. for clelnup.
WASTE mBPOML
ConIuIt.. u¡JioIMIs mlnut.:bnr far recomnølded rnettøxk of dMIrI¥ng øp/o8Iv8 ~8. ~., applicable Fedend Rllgulallons underthe
IIIfIarity of.. ~ ~i and RIcoveIy AI1 (40 a=I\ ..111 280Ø'1.)
... ..~..
SHIPPING I!fQRMAIIPN AS Of JANUAøY 1, ..
PERFORATOR 6 POWER_
SAND LIE CUT1BI
1m
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CIaaIoItion
IdldblIon
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NIl'Mø. OWn.
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Cartridgrls. PcMar DevIce
1AS
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ExpIcIeW 1 A
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251cg.11001cg,
ex-eo12031
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US;
UND070
Eq¡IoeIve f.4
134
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EX-a812032
JfOR~ CONDI"I1ON8
SIore In coal pIIœ. Stcn ¡II IUIOORI8noe will NItionII Fn Pr*1iun Alan, RIIguIdona. Stote In ICCOI'dInce with FØaI Fleglblions. Do not sIIIre or
~ food, dmII, or d8cco In __.....,. may beœme cam.l'oInIded wIIh 1his nftri.l.
ADDITIONAL INFORMA11ON ~ REFERENCES
PERSONS HANDI.JN9 EXPLOSIVES MUST BE TRAINED IN THE COAÆCT PROCEDURES FOR TJÐR USE.
P0 3Ð'i;ld
3èl3WOOOM 0099
ll89689199
00:P1 £00l/81/L0
ACORD", EVIDëN,CE
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, 11/20/02
THIS 15 EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BE.EN ISSUED, IS IN FORCE, AND CONVEŸS' AU~ THË
RIGHTS AND PRIVilEGES AFFORDED UNDER THE POLICY,
ïöROOúëÏ!R·-··..-..--'_·-·-..·_'·'-p.i~~;---·èi61. 39ï":-4980--'-"éOuP~ ---------' ..-.-----, ,,---.,, "....----
r--......iver Alliant 'r5surance -.---..- Star Insurance Company .
51 Pegasus Drive c/o Meadowbrook Insurance
~uìte 121 2998 Douglas Blvd. Suit 320
Bakersfield, CA 93308 Roseville, CA 95661
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::~C~nai~~is Corp. I Inc. _~..~_~200~~_~.~~~POl086~9-...---. ..._
I . Ð'FEC11Vf¡ UA1"" I E~7i~ON DA~
~~k~~B~~~l~ 0 o~ 93390 1-_11/ 02/ ~_.~_.._..~l/ 0 2/ ~__1L-~l~~~~~~.~_,__
, THIS IlliPI..ACES PRIOR ¡¡YI ENç£ ~TI!D:
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PROPERiY INFöRMATION
LOCATIONIDISCRlPTION
Location #1 5500 Woodmere Dr.
Bakersfield, CA 93313
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REMARKS,(b1c1udlngSped8tetmCtltlOriiiJ :,. "
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CANQEC.L:ÅMN " .. ...:: ::'~:''':''',': . ..."
n-tE POLICY 1$ SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT rnR EACH POlICY PERIOD. SHOULD THE
POLICY BE TERMINATED, TME COMPANY WILL GIVEn-tE ADDITIONAl.. INTEREST IDENTIFIEO BELOW 10 DAYS
WRITTEN NOTICE. AND WIll. SEND NOTII!ICATION os: my CHANGES TO niE POLICY THAT WOULD AFFEõCT THAT
IN'ÆREST IN ACCORDANCE WITH THE POLICY PROVI I S OR AS REQUIRED BY LAW.
ADi:JmoNAL,IN1'ERËST ':..
HAMI! AND ADOREti8
~ANK OF SIERRA
BOX 1930
r~~~=l~'~ CA~m8ß"M~' .. ......,<',.
_ ~1=:: ' ___t:J ADOrrM)~LINsuRED_._.._.,._____._....._,..__,,_.~,___,_
LCWU 0902006-001
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WEL A
::~R~;EN~~~~~~:N~E~~!!~~7o~~~ :~~'~~~~ORCE. AND CO~~EE
RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY.
PROD~ER . Iðtc NExt: 661.391.4980
~r~ver AII~ant -Insurance
51 Pegasus Drive
uite 121
Bakersfield, CA 93308
COMPANY
Star Insurance Company
c/o Meadowbrook Insurance
2998 Douglas Blvd. Suit 320
Roseville, CA 95661
CODE: SUB COOE:
AGENC
CUSTOMER 10 II:
INSURED
Well Analysis Corp., Inc.
WELACO, Inc.
P. O. Box 20008
Bakersfield, CA 93390
LOAN NUMBER
0902006-001
CONTINUED UNTIL
TERMINATED IF CHECKED
POUCY NUMBER
CP0108639
EFFECTIVE DATE
11/02/02
THIS REPLACES PRIOR EVIDENCE DATED:
f)RORI:Rc1'YI~FÓRrdTiON</ ',' ,
LOCATtONlDESCRlPTtON·
Location #L 5500 ,Woodmere Dr_~,_
Bakersfield, CA 93313
COVERAGElPERlLSIFORMS
BUILDING/RC/SPECIAL FORM
BUSINESS PERSONAL PROPERTY/RC/SPECIAL FORM
AMOUNT OF INSURANCE
325,000
25,000
DEoucnBLE
500
500
I
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THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE
POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 10 DAYS
WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT
INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW.
AÓÓÎ'riÓNÃtINTêREST> '
NAME AND ADDRESS
RANK OF SIERRA
BOX 1930
~rterville, CA 93258
AUTHORIZED REPRESENTATIVE
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CITY OF BAKERSFIEI.D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301
FACILITY NAME W'.e..\ C{ (!t'"J
ADDRESS 6000 l.ÙéX~,ete.. 'Dr:
FACILITY CONTACT~", í?>e~~lÃrr,
INSPECTION TIME ':)..0 i'Y\~N
INSPECTION DATE q .... --:;J-f..o -02-
PHONE NO. 681.... 07 <OD
BUSINESS fD NO. 15-21 0- ~
NUMBER OF EMPLOYEES ~'J-
Section 1:
av£utine
'Business Plan and Inventory Program '~,
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION C V COMMENTS
Appropriate pennit on hand J "-
Business plan contact infonnation accurate / \
Visible address J \
Correct occupancy \IV \
Veri fication of inventory materials V ItJ-j-ðZ
-
Verification of quantities , hJ -¥tJ,U ø;#- (Àeecd %
-
Verification of location Iv' L't1/11¡JMtý, ¡ðd/d F 't7
-
Proper segregation of material V IìAÆ ¡JLd k ~tZ
-
Verification of MSDS availability V ~cU ~/nit',
-
Verification of Haz Mat training V . ð:-.
V -
Verification of abatement supplies and procedures SøV- /I!~,6ÞIJ e -lMJ ~i!!.- I
Emergency procedures adequate V
Containers properly labeled V
Housekeeping .¡ ¡
Fire Protection V '" '{
Site Diagram Adequate & On Hand VI Doe,> -()~-r V\CtJe... êJ((~r
C=Compl iance V = Violation
Any hazardous waste on site?: ~es
Explain: u..l~ ~-\-E oì 1 " al\tt' - ·fì~ ~~ _
Questions regarding this inspection? Please call us at (661) 326-3979
DNo
\(J¡) ~ :-/\e.$.5 \ \'" ~-e..~,. C.;¡ rr ot/1 t-
\\..~~~ -e)tp. to -oz-.
Business Site Responsible Party
Inspector: .~.i~~ q~
/3C-
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
~ WELACO W.n An"";, c~
DAN BEBOUT
General Manager
(661) 589-0760 Office
(661) 589-6822 Fax
, C661) 809-0601 Mobile
Ü
t(\
5500 Woodmere Drive
P.O. Box 20008
Bakersfield. CA 93390-0008
!
I
-~
·
-
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME W(;'L/).CQ
ADDRESS s-n:>O W~-V: DrL
FACILITY CONTACT 1)eJU,-- ~t ""6~
INSPECTION TIME
INSPECTION DATE
PHONE NO.
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
~ (:6 /ü:Jù:?
,
/'JeW
'2..ò
Section 1:
Business Plan and Inventory Program
o Routine
(29..çombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION C V COMMENTS
Appropriate penn it on hand µc-r..J PC~fk .,... íV 'õé- f 'S ScJéO
Business plan contact infonnation accurate 1/ -1Z) ßE ~tC-'rC.o\
-- ~
Visible address v'
Correct occupancy IV'"
Verification of inventory materials V ðß. 'TIOr, "'C-l) o"f'..I c;úÇp
Verification of quantities ¿
Verification of location <)
Proper segregation of material V
Verification of MSDS availability Iv'
Verification of Haz Mat training i/
Verification of abatement supplies and procedures ",
V
Emergency procedures adequate ;/
/' J ..peõJl f)<:;o
Containers properly labeled ../ H6.-z... WAs re UJßé(..5
Housekeeping ¡,/ v<9Z-Y ~
Fire Protection V
Site Diagram Adequate & On Hand Wt(,£... çéNO ~! NPl...cA,,w f/Jd<i::.-r"
C=Compliance
V=Violation
Any hazardous waste on site?: )2ÍYes 0 No
Explain: l/JIIJcs'í"'G c)l(.. f ~~
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
Inspector:
LAJ,~·s
./
.
-
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME We-Lô.CO
ADDRESS S""'-D oW~..rz..é D rL
FACILITY CONTACT 'DcJu,- SLJC.AQ...I~~
INSPECTION TIME
INSPECTION DATE
PHONE NO.
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
C:, f¿ /7J:Jùc.)
I
tJf::r.N
1...<:>
Section 1:
Business Plan and Inventory Program
o Routine
~Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS,
Appropriate permit on hand f./C-r,J p C:/Z ^'" ,.., IV õé () SliEO
Business plan contact information accurate 1/4Z) ßt; Cc)M,fLET'"C-o '\
'-
Visible address v'
Correct occupancy ,/
Verification of inventory materials V ðß~,~{;) ON ,A./çP
Verification of quantities ¿
Verification of location <)
Proper segregation of material y
Verification ofMSDS availability , III
Verification of Haz Mat training 1/ ",.r> ,.',
' ,
", .' , ." . - .~. . .....
Verification of abatemerifsupplies and procedures V
Emergency procedures adequate v"
/ )
'. Containers properly labeled ./ .y£ò./'0&) HÞ- -Z , INAs, re (.4~5
Housekeeping r/ v(E:rLY (,-à::>ð
Fire Protection " if'
Site Diagram Adequate & On Hand k)'<"'L ~CN() &-oJ I AfP(lcAíw../ (/!eke;,.-
C=Compliance
V=Violation
Any hazardous waste on site?: ,ØYes 0 No
Explain: WAS ~ ðt'- '~ A-rJr-~t<...L.~
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow- Station Copy
Pink - Business Copy
Inspector:
W, -..Iì2 s
e
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE 6(<;¡!Zct.o
r1!A
FACILITY NAME i/J't;LACO
Section 4:
Hazardous Waste Generator Program
EPA 10 #
o Routine
~ombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made VV
EPA ID Numbcr (Phone: 916-324-1781 to obtain EP A ID #) ^ V~
Authorized for waste treatment andior storage ¡/'
Reporkd releasc. tirc. or explosion within IS days of occuranèe
Established or maintains a contingency plan and training
Hazardous wastc accumulation time frames /"~ EvC4l.. Ý l<'60 ÖA'(S (, 2.7 ~
Containers in good condition and not leaking V'
Containers are compatible with the hazardous waste V
Containers are kept closed when not in use V
Weekly inspection of storage area e/
Ignitable/reactive waste located at least 50 feet from property line ¡J fA-
Secondary containment provided V
Conducts daily inspection of tanks V'
Used oil not contaminated with other hazardous waste ~
Proper management of lead acid batteries including labels Ii I\-
Proper management of used oil filters V'"
Transports hazardous waste with completed manifest
Sends manifest copies to DTSC /" "-
Retains manifests for 3 years ( 1/\/ $~)
--- /
Retains hazardous waste analysis for 3 years
Retains copies of used oil receipts for 3 years "1
Determines if\\'aste is restricted fì'om land disposal n
C=Complianee V=Violation rI-J, ) j -'7 --------
Inspector: '¿;JINes
Oftice of Environmental Services (805) 326-3979 .....B siness~Responsib]e Party
\\ hlte - EI1\, Svcs,
PlI1k - Business Cory
o DELETE
. CITY OF BAKERSFIEL"
OFFTéE OF ENVIRONMENTAL SÈ1iVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
(one form per material per budding or al8<l)
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COMMON NAME
CAS #
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If Subject to EPCRA, ref81 to instn.oc:tions
I OOt~
207
EHS·
209
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chi
213
TYPE
PURE
PHYSICAL STATE
~ SOLID
FED HAZARD CATEGORIES
(Check aJllhat apply)
ANNUAL WASTE
AMOUNT
o 1 FIRE
210
o m MIXTURE
o w WASTE
Yes 0 No
CURIES
211
RADIOACTIVE
212
o I LIQUID
OgGAS
LARGEST CONTAINER
'7
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215
CU~I es
214
o 2 REACTIVE
03 PRESSURE RELEASE ~ACUTE HEALTH
218 AVERAGE
DAILY AMOUNT
219 STATE WASTE CODE 220¡
o 5 CHRONIC HEALTH
216
217 MAXIMUM
CAlLY AMOUNT
UNITS·
DgaGAL OdCUFT
. If EHS. amount must be In Ibs.
o Ib LBS
o In TONS
DAYS ON SITE
222
221
STORAGE CONTAINER o a ABOVEGROUND TANK De PLASTlCINONMETALlIC DRUM o i FIBER DRUM o m GLASS BOTTLE o q RAIL CAR 223
(Check all that apply) o b UNDERGROUND TANK Of CAN OJ BAG o n PLASTIC BOTTLE o r OTHER
o ç TANK INSIDE BUILDING 0 Ok BOX 00 TOTE BIN
o d STEEL DRUM o I CYLINDER o P TANK WAGON
STORAGE PRESSURE o ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~IENT o aa ABOVE AMBIENT o ba BELOW AMBIENT o c CRYOGENIC 225¡
230 231 Dyes ONo 232 233
t: 234 235 OYesONo 236 m
238 239 o Yes 0 No 240 241
I
5 242 243 DYes 0 No 244 245
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S:\CUPAFORMS\OES2731.TV4,wpd
. CITY OF BAKERSFIELDa
OF~E OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
1.W?ls~~vitð~;~ilð~tit),i':\:··
BUSINESS NAME (Same as FACILITY NAME 0If DBA - Doing Business As)
µ-C~A;CC) .
(one fonn per material per building or area)
Page of
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3
CHEMICAL LOCATION
N GND o? YtV<.O
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CHEMICAL NAME
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o Ves 0 No 202
204
206
If Subject to EPCRA. refer to instructions
COMMON NAME
EHS·
oVes oNo 208
207
¡ CAS'
209
FIRE CODE HAZARD CLASSES (Complete if requested by local ftre chief)
210
TYPE ~PURE o m MIXTURE o w WASTE 211 RADIOACTIVE
PHVSICAl STATE ~ SOLID o I LIQUID ogGAS 214 lARGEST CONTAINER
FED HAZARD CATEGORIES o 1 FIRE 02 REACTIVE o 3 PRESSURE RELEASE 5lf.4 ACIJTE HEALTH
(Check all that apply)
ANNUAL WASTE 217 MAXIMJM 218 AVERAGE
AMOUNT DAILY AMOUNT DAILY-AMOUNT
UNITS· o ga GAl DdCUFT o Ib LBS o In TONS
. If EHS, amount must be In Ibs.
05 CHRONIC HEALTH
CURIES
213
7
215
"'-
216
21g
STATE WASTE CODE
220,
221
DA VS ON SITE
222 '
223
STORAGE CONTAINER o a ABOVEGROUND TANK De PLASTlCINONMETALlIC DRUM o i FIBER DRUM o m GLASS BOTTlE
(Check all thai apply) Db UNDERGROUND TANK Of CAN OJ BAG o n PLASTIC BOTTLE
DC TANK INSIDE BUILDING ~Y Ok BOX 00 TOTE BIN
o d STEEL DRUM SIL o I CYLINDER o P TANK WAGON
I
I STORAGE PRESSURE ~ a AAoeIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT
I ¡
STORAGE TEMPERATURE o aa ABOVE AAoeIENT o ba BELOW AMBIENT o c CRVOGENIC
224
225f
i , 230 231 233
I 2 i o Ves 0 No 232
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3 I 234 235 o Ves 0 No 236 237
4 238 239 OVes ONo 240 241
5 242 243 o Ves 0 No 244 246
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S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIELDA
OFF1f:E OF ENVIRONMENTAL SIMVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
~EW
200
D DELETE
DADO
".'".
~ ..:"
~1B~fIc)i":~;"J;>~~':~;'" " '
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
W'C-cAcð .
(one form per material per budding or area)
Page of
~
CHEMICAL LOCATION
ÓV<010C ¡J
C-vo
oç 2>~
201 CHEMICAL LOCATION
CONFIDENTIAL (EPCRA)
203 GRID # (optional)
CHEMICAL NAME
~~Tfé ANnR?tc-c...G
o Yes 0 No 202
204
o No 206
If Subject to EPCRA, ,efer to instructions
COMMON NAME
EHS·
DYes oNo 208
207
CAS #
209
FIRE CODE HAZARD ClASSES (Complete if requested by locaIlinI
210
TYPE opPURE o m MIXTURE
i PHYSICAL STATE o s SOLID -)Xl LIQUID
FED HAZARD CATEGORIES 01 FIRE o 2 REACTIVE
(Check all thaI appty)
ANNUAl WASTE 217 MAXIMUM
AMOUNT CAlLY AM:>UNT
DYes 0 No
21S
w WASTE
211
RADIOACTIVE
212
CURIES
213
lARGEST CONTAINER
tðO
ogGAS
214
o 3 PRESSURE RELEASE
04 ACUTE HEALTH
o S CHRONIC HEALTH
216
(ðO
218 AVERAGE
CAlLY AMOUNT
219 STATE WASTE CODE 220!
UNITS·
~GAL odcUFT
. If EHS. amount must be In Ibs.
o Ib LBS
o In TONS
221
DAYS ON SITE
222
STORAGE CONTAINER
(Check all that apply)
~VEGROUNDTANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
De PLASTlCINONMETALlIC DRUM
Of CAN
o g CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
00 TOTE BIN
o P TANK WAGON
STORAGE PRESSURE
R..a AMBIENT
o as ABOVE AMBIENT
o be BELOW AMBIENT
o q RAIL CAR
o , OTHER
223
224
STORAGE TEMPERATURE
o as ABOVE AMBIENT
o be BELOW AMBIENT
o C CRYOGENIC
225
230 231 o Yes 0 No 232 233
234 23S oYesoNo 236 237
236 239 DYes DNa 240 241
242 243 245
UPCF (7/99)
S:\CUPAFORMS\OES2731.1V4.wpd
. CITY OF BAKERSFIELÐA
OFF~E OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
D REVISE
200
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o Yes 0 No 202
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DYes 0 No 206
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209
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TYPE
o P PURE 0 m MIXTURE
210
w WASTE 211 RADIOACTIVE DYes oNo 212 CURIES 213
OgGAS 214 LARGEST CONTAINER ~ 215
PHYSiCAl STATE
o s SOLID ~lIQUID
o 1 FIRE 0 2 REACTIVE
o 3 PRESSURE RElEASE
o 4 ACUTE HEALTH
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217
218 AVERAGE
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o IÞ LBS
o In TONS
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. If EHS, amount must be In Ibs.
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(Check all tIIal apply)
~VEGROUNDTANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
De PLASTlCINONMETAllIC DRUM
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o g CARBOY
o h SilO
o i FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GlASS BOTTLE
o n PlASTIC BOTTLE
00 TOTE BIN
o P TANK WAGON
219 STATE WASTE CODE 220¡
221
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o q RAil CAR
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~ AMBIENT
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o ba BELOW AMBIENT
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o ba BELOW AMBIENT
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o c CRYOGENIC
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: 3 234
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4 238
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DYes DNo 228
,
231 DYes 0 No 232 2331
!
235 o Yes 0 No 236 7311
I
239 Dyes oNo 240 241 I
i
!
243 DYes 0 No 244 246
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIELa
OFn"CE OF ENVIRONMENTAL SI"'RVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
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o Yes 0 No 208
207
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209
210
PURE o m MIXTURE o w WASTE 211 RADIOACTIVE DYes ONo 212 CURIES 213
o s SOLID o I LIQUID ~GAS 214 LARGEST CONTAINER 30~ 215
FIRE CODE HAZARD CLASSES (Complete if requested by local fire
iYPE
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(Ched< all that appty)
ANNUAL WASTE
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~ PRESSURE RElEASE
o 4 ACUTE HEALTH
o 5 CHRONIC HEALTH
216
01 FIRE
o 2 REACTIVE
217 " MAXIMUM
DAILY AMOUNT
3~
218 AVERAGE
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219 STATE WASTE CODE
220
UNITS·
OgaGAL OdCUFT
. If EHS, amount must be In Ibs,
o Ib LBS
o In TONS
221
DAYS ON SITE
222
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(Check aU tha/apply)
o a ABOVEGROUND TANK
o b UNDERGROUND TANK
DC TANK INSIDE BÙILDING
o d STEEL DRUM "
De PLASTlCJNONMETALLIC DRUM
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o g CARBOY
o h SILO
o I FIBER DRUM
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o q RAIL CAR
o r OTHER
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o be BELOW AMBIENT
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DYes 0 No 228
2 I 230 231 233
I o Yes 0 No 232
I
3 234 235 OYesONo 236 m
4 238 239 Dyes ONo 240 241
5 242 243 DYes 0 No 244 245
UPCF (7/99)
S:\CUPAFORMS\OES2731,TV4.wpd
. CITY OF BAKERSFIELIA
OFF'rCE OF ENVIRONMENTAL SnVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
W
DADO
D DELETE
200
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DYes 0 No 206
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207
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DYes DNa 208
CAS'
209
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TYPE ~RE D m MIXTURE
PHYSiCAl STATE D s saUD D I LIQUID
FED HAZARD CATEGORIES ¡ek...FIRE o 2 REACTIVE
(Check all thaI apply)
ANNUAl WASTE 217 MAXIMUM
AMOUNT CAlLY AMOUNT
210
D w WASTE 211 RADIOACTIVE Dyes DNo 212 CURIES 213
~,GAS 214 LARGEST CONTAINER ~c;ð 215
~ PRESSURE RElEASE
o 4 ACUTE HEALTH
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219 STATE WASTE CODE 220
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. If EHS. amount must be In Ibs.
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o In TONS
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I ! STORAGE CONTAINER D a ABOVEGROUND TANK De PLASTlCJNONMETAllIC DRUM o i FIBER DRUM o m GlASS BOTTLE o q RAIL CAR 223
! (Check all /JIat apply) Db UNDERGROUND TANK Of CAN DjBAG D n PLASTIC BOTTLE o r OTHER
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I D d STEel DRUM o h SILO ~CYLINDER D P TANK WAGON
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,
2 230 231 Dyes D No 232 233
t: 234 235 DYesDNo 236 237
238 239 Dyes D No 240 241
5 242 243 DYes D No 244 246
I 1
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
I CITY OF BAKERSFIELIA
OF CE OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
o DELETE
200
(one form per malenal per budding or area)
Page 01
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207
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CAS #
209
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210
~RE o m M1X1URE o w WASTE 211 RADIOACTIVE DYes ONo 212 CURIES 213
o s SCUD o I lIQUID ~GAS 214 lARGEST CONTAINER ZgJ 215
TYPE
PHYSICAL STATE
FED HAZARD CATEGORIES
(Check all thaI apply)
ANNUAL WASTE
I AMOUNT
217 MAXIMUM
DAilY AMOUNT
~ PRESSURE RELEASE 0 4 ACIJTE HEALTH
/ -"'-\ 218 AVERAGE
{.çL/l.../ DAilY AMOUNT
05 CHRONIC HEALTH 216
o 1 FIRE 0 2 REACTIVE
219 STATE WASTE CODE 220
UNITS'
o 98 GAL œ:.s:t cu FT
. It EHS, æIOUIIl must be In Ibs,
o IÞ L8S
o In TONS
221
DAYS ON SITE
222
STORAGE CONTAINER o a ABOVEGROUND TANK De PlASTlCINONMETALLIC DRUM o i FIBER DRUM o m GLASS BOTTLE o q RAIL CAR 223
(Check all that apply) Db UNDERGROUND TANK Of CAN OJ BAG o n PlASTIC BOTTLE o r OTHER
DC TANK INSIDE BUILDING o g CARBOY Ok BOX 00 TOTE BIN
o d STEEL DRUM o h SILO ~ CYLINDER o p TANK WAGON
STORAGE PRESSURE o a AMBIENT ¢...aa ABOVE AMBIENT o ba BELOW AMBIENT 224
STORAGE TEMPERATURE ~AMBIENT o aa ABOVE AMBIENT o be BELOW AMBIENT o c CRYOGENIC 225
DYes 0 No 228
2 ì 230 231 DYes 0 No 232 233
~
234 235 OYesoNo 236 zrT
238 239 DYes 0 No 240 241
5 242 243 DYes 0 No 244 246
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
~
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CHEMICAL NAME
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COMMON NAME
CAS #
e CITY OF BAKERSFIELIa
OFFICE OF ENVIRONMENTAL S~VICES
1715 Chester Avel, CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
200
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Page 01
3
o Yes 0 No 202
204
o Yes 0 No 206
If Subject to EPCRA. refer to instructions
o Yes 0 No 208
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief)
209
TYPE
o P PURE
PHYSICAL STATE
o s SOUD
FED HAZARD CATEGORIES
(Chedt all thai apply)
ANNUAL WASTE
AMOUNT
01 FIRE
STORAGE CONTAINER
(Check aI/thaI apply)
o a ABOVEGROUND TANK
o b UNDERGROUND TANK
o c TANK INSIDE BUILDING
o d STEEL DRUM
STORAGE PRESSURE
o 8 AMBIENT
STORAGE TEMPERATURE
)IZ(. AMBIENT
2
AA&ù~
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234
238
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o Yes 0 No
210
212
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211
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215
216
219 STATE WASTE CODE
220,
o I LIQUID
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LARGEST CONTAINER
~S-6
2. !
05 CHRONIC HEALTH
221
DAYS ON SITE
222
214
o 2 REACTIVE
~PRESSURE RELEASE
04 ACUTE HEALTH
o q RAIL CAR
o r OTHER
223
217
MAXIMUM
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218 AVERAGE
DAILY AMOUNT
,
224 ¡
I
o 88 ABOVE AMBIENT
o be BELOW AMBIENT
o C CRYOGENIC
225
OlOXI i)t:" 231 o Yes 0 No 232 233
235 o Yes 0 No 236 ZS1
239 o Yes 0 No 240 241
243 DYes 0 No 244 246
UNITS·
o ga GAL ~ CUFT
. If EHS. amounl must be In Ibs.
o Ib LaS
o In TONS
UPCF (7/99)
De PlASTICINONMETALLIC DRUM
Of CAN
o 9 CARBOY
o h SILO
o I FIBER DRUM
OJ BAG
o k BOX
.¡;([evUNDER
o m GLASS BOTTLE
o n PlASTIC BOTTLE
00 TOTE BIN
o P TANK WAGON
18188 ABOVE AMBIENT
o ba BELOW AMBIENT
S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIELDA
OFFi'éE OF ENVIRONMENTAL SÈftVICES
1715 Chester Avel, CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one fonn per material per budding or a"'8)
Page of
~:~~g~'¿:~i}~;·~;~;;lì"~~:--·r"':'T:.' ~~~ ~'
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203 I GRID # (optiona/)
oVes DNa 202
204
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o Ves 0 No 206
If Subjecl to EPCRA. refer to instructions
207
COMMON NAME
EHS·
o Ves 0 No 208
CAS #
209
FIRE CODE HAZARD ClASSES (Complete' requested by local fire chieI)
210
PURE o m MIXTURE o w WASTE 211 RADIOACTIVE oVes DNa 212 CURIES 213
o s SOLID ~IQUID ogGAS 214 lARGEST CONTAINER -::?ð'ð 215
TYPE
, PHYSICAL STATE
FED HAZARD CATEGORIES
(Check all that apply)
ANNUAL WASTE
I AMOUNT
}Ek¿IRE 02 REACTIVE
o 3 PRESSURE RElEASE
o 4 ACUTE HEALTH
05 CHRONIC HEALTH 216
217 MAXIMUM
DAilY AMOUNT
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218 AVERAGE
DAilY AMOUNT
219 STATE WASTE CODe 220
UNITS-
~GAL odCUFT
. If EHS, amount must be In Ibs.
o Ib LBS
o In TONS
221
DAVS ON SITE
222
STORAGE CONTAINER ~ABOVEGROUND TANK De PlASTlCINONMETALlIC DRUM o i FIBER DRUM o m GLASS BOTTLE o q RAil CAR 2Z3
(Check aU that apply)
i , Db UNDERGROUND TANK Of CAN OJ BAG o n PlASTIC BOlTlE o r OTHER
DC TANK INSIDE BUILDING o g CARBOY Ok BOX 00 TOTE BIN
I o d STEel DRUM o h SILO o I CYLINDER o p TANK WAGON
I
I STORAGE PRESSURE .ø...a M'8IENT o aa ABOVE AMBIENT o ba BELOW AMBIENT 224
,
STORAGE TEMPERATURE ,
~IENT o aa ABOVE M'8IENT o ba BELOW AMBIENT o c CRYOGENIC 225;
;
DYes oNo 228
2 230 231 DYes 0 No 232 233
,
I 3 ¡ 234 235 o Yes 0 No 236 Zf1
I
~,4 238 239 DYes 0 No 240 241
242 243 o Yes 0 Na 244 246
[ 5
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIEL"
OFFTéE OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per material per budding or aru)
Page of
iij~~tió¡i:;~,;i~~~;'j
3
BUSINESS NAME (Same as FACILIlY NAME or DBA . Doing Business As)
~-LACù .
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CHEMICAL NAME
jGc.òs G-.fG
! I COMMON NAME
I
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DYes oNo 208
207
CAS #
209
FIRE CODE HAZARD CLASSES (Complete if requested by lOcal fire chief)
210
TYPE
o m MIXTURE
o w WASTE
DYes 0 No
212
CURIES
213
~RE
211
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PHYSICAL STATE
&.LIQUID
LARGEST CONTAINER
~s-
215
o 9 GAS
o s SOUD
214
FED HAZARD CATEGORIES
(Check aU that apply)
ANNUAl WASTE
AMOUNT
J8G-FIRE
o 2 REACTIVE
o 3 PRESSURE RELEASE
o 4 ACUTE HEAlTH
05 CHRONIC HEAlTH
216
217
MAXIt.tJM ~~
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~ oáCUFT
. If EHS. amount must be In Ibs.
218 AVERAGE
DAILY AACUNT
o IÞ L8S 0 In TONS
UNITS'
STORAGE CONTAINER
(Check aU that apply)
o I FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
Om GlASS BOTTLE
o n PlASTIC BOTTLE
00 TOTE BIN
o p TANK WAGON
o a ABOVEGROUND TANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
c:da. STEEL DRUM
De PlASTlCINONMETALlIC DRUM
Of CAN
09 CARBOY
o h SILO
STORAGE PRESSURE
o be BELOW AMBIENT
AMBIENT
o aa ABOVE AMBIENT
STORAGE TEMPERATURE
o be BELOW AMBIENT
o aa ABOVE AMBIENT
226
2 I 230
I
,
! 3 234
4 238
5 242
227 DYes DNo 228
231 DYes 0 No 232
235 oYesoNo 236
239 DYes 0 No 240
243 DYes 0 No 244
219
STATE WASTE CODE
2201
221
DAYS ON SITE
222
o q RAIL CAR
o r OTHER
223
224
o c CRYOGENIC
¡
225;
;
229
I
233 ¡
I
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241
246
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
. CITY OF BAKERSFIEL¡A
OFFréE OF ENVIRONMENTAL SÈ1iVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
~W
200
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Page ot
.'~.' .....
3
Dyes D No 202
204
Dyes D No 206
If Subject to EPCRA, refer to inslluclions
COMMON NAME
207
EHS'
D Yes D No 208
CAS"
209
FIRE CODE HAZARD ClASSES (Complete if requested by local fire c:h
210
D w WASTE 211 RADIOACTIVE Dyes DNo 212 CURIES 213
DgGAS 214 LARGEST CONTAINER S-s- 215
TYPE PURE D m MIXTURE
PHYSICAL STATE D s SOLID œ::G.IQUID
FED HAZARD CATEGORIES c8.t..FIRE D 2 REACTIVE
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM
AMOUNT DAILY AMOUNT
218 AVERAGE
DAILY AMOUNT
D 3 PRESSURE RELEASE
D 4 ACUTE HEALTH
D 5 CHRONIC HEALTH
222
( 10
ß'í.ø.a GAL ,D d CU FT
. If EHS, amount must be In Ibs.
o Ib LBS
D In TONS
223
UNITS·
STORAGE CONTAINER
(Check all Mat apply)
D a ABOVEGROUND TANK
o Þ UNDERGROUND TANK
o c TANK INSIDE BUILDING
.8CLSTEEL DRUM
011 PLASTICINONMETALLIC DRUM
01 CAN
o g CARBOY
o h SILO
o I FIBER DRUM
OJ BAG
Ok BOX
o I CYLINDER
o m GLASS BOTTLE
o n PlASTIC BOTTLE
Do TOTE BIN
o P TANK WAGON
STORAGE PRESSURE
o as ABOVE AMBIENT
o ba BELOW AMBIENT
STORAGE TEMPERATURE
216
219 STATE WASTE CODE 220¡
221
DAYS ON SITE
o Q RAIL CAR
o r OTHER
224
2 230 231 D Yes D No 232 233
3 234 235 o Yes 0 No 236 231
4 238 239 o Yes 0 No 240 241
5 242 243 o Yes 0 No 244 246
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
· CITY OF BAKERSFIEL"
OFFTéE OF ENVIRONMENTAL S~VICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
(one form per malerial per building or area)
Page of
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206
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COMMON NAME
~'
207
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DYes 0 No 208
CAS #
209
FIRE CODE HAZARD ClASSES (Complete if requested by local fire
TYPE PURE o m MIXTURE
PHYSICAL STATE o s SOLID :&l LIQUID
FED HAZARD CATEGORIES .a:J FIRE o 2 REACTIVE
(Check all that apply)
ANNUAl WASTE 217 MAXIMUM
AMOUNT CAlLY AMOUNT
210
o w WASTE 211 RADIOACTIVE DYes ONo 212 CURIES 213
OgGAS 214 LARGEST CONTAINER -S-~ 215
o 3 PRESSURE RELEASE
04 ACUTE HEALTH
o 5 CHRONIC HEAlTH
216 .
~
218 AVERAGE
CAlLY AMOUNT
219 STATE WASTE CODE 220
UNITS·
~GAl Or:fCUFT
·It EHS. amount must be In Ibs.
o Ib LBS
o In TONS
221
DAYS ON SITE
222 :
I STORAGE CONTAINER o a ABOVEGROUND TANK o e PLASTICINONMETAlLIC DRUM o i FIBER DRUM o m GlASS BOTTLE o q RAIL CAR 223
, (Check aU /hal apply)
II Db UNDERGROUND TANK Of CAN OJ BAG o n PLASTIC BOTTLE o r OTHER
DC TANK INSIDE BUILDING o g CARBOY Ok BOX 00 TOTE BIN
I ~STEEL DRUM o h SILO o I CYLINDER o p TANK WAGON
I I STORAGE PRESSURE ~ AfJIIIENT o as ABOVE AMBIENT o ba BELOW AMBIENT 224
I
STORAGE TEMPERATURE ~ AMBIENT o aa ABOVE AMBIENT o be BELOW AMBIENT o c CRYOGENIC
2 230 231 o Yes 0 No 232 233
I~
! ~: 234 235 OYesONo 238 ZST
238 239 DYes 0 No 240 241
242 243 245
I 5
I ,I
UPCF (7/99)
S:\CUPAFORMS\OES2731.TV4.wpd
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1 15 Chester Ave., Bakersfield, CA (805) 326-3979
BUSINESS NAME:
WEL1CANALYSIS CORP. âba: WELACO
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SECTION 1: BUSINESS IDENTIFICATION DATA
LOCATION:
5500 Woodmere Drive, Bakersfield, CA 93313
MAILING ADDRESS:
P.O. Box 20008, Bakersfield, CA 93390-0008
CITY:
Bakersfield
STATE: CA ZIP: 93390 PHONE: 661-283-9506
DUN & BRADSTREET NUMBER:
606689115
SIC CODE:
PRIMARY ACTMTY:
Oilfield Production Logging / Wireline Services
O~R: Judy Bebout, President
MAILING ADDRESS:
P.O. Box 20008~ Bakersfield, CA 93390-0008
SECTION 2: EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 HR.. PHONE
1. Dan Bebout Generãl Manager 661-283-9506 661-832-2649
2. Larry Wright Drafting Manager 661-283":'9506 661-827-9505
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HAZARDOUS MATERIALS MANAGEMENT PLAN
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SECTION 3: TRAINING
NUMBER OF EMPLOYEES: 25
MATERIAL SAFETY DATA SHEETS ON FILE: Jjn main office located at 5500 Woodmere Dr.
Bakersfielg, CA 93313
BRIEF SUMMARY OF TRAINING PROGRAM:
See RIA Manual (enclosed)
SECTION 4: EXEMPTION REOUEST
I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXE:MPT 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 TIME EXCEED THE MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION
I, Dan Bebout CERTIFY THAT THE ABOVE
INFORMATION IS ACCURATE. I UNDERSTAND THAT TIllS INFORMATION WILL BE
USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH
AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500
ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY.
~.~~~
SIGNATURE
General Manager
3-23-99
TITLE
DATE
2
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES
A. AGENCY NOTIFICATION PROCEDURES:
See RIA Manual (enclosed)
B. EMPLOYEE NOTIFICATION AND EVACUATION:
PLEASE SEE SECTION IV OF WELACO" S R1 A SAFETY MANUAL FOR ALL DETAILED
EMERGENCY PROCEDURES~
C. PUBLIC EVACUATION:
See RIA Manual (enclosèd)
D. EMERGENCY MEDICAL PLAN:
BAKERSFIELD OCCUPATIONAL HEALTH
4580 CALIFORNIA AVENUE
BAKERSFIELD, CA 93309
(661) 327-4527
SAN JOAQUIN HOSPITAL
2615 EYE STREET
BAKERSFIELD, CA 93301
(661) 395-3000
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN
A. RELEASE PREVENTION STEPS:
See RIA ManuaL- (enclosed)
B. RELEASE CONTAINMENT ANDIOR MINIMIZATION:
SEE SECTION IV OF WELACO'S RIA SAFETY MANUAL FOR DETAILED PROCEDURES
AND METHODS.
OUR RIA MATERIAL CONTAINS ALL PROPER PROCEDURES ON ALL ASPECTS OF EMERGENCY.
C. CLEAN-UP PROCEDURES:
See RIA Manual: (enclosed)
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
See plot mRp pn~loQP~
ELECTRICAL: See plot map enclosed
WATER: See plot map enclosed
SPECIAL:
LOCK BOX: YESINO IF YES, LOCATION: No
SECTION 9: PRIVATE FIRE PROTECTION/W ATER AVAILABILITY
A. PRIVATE FIRE PROTECTION:
See plot map enclosed,~
B. WATER AVAILABILITY (FIRE HYDRANT):
See plot map enclosed
4
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~OUS MATERIALS INVENT04
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Business Name Well Analysis Corp. WELACO
Page_of_
A~ 5500 Woodm~r~ nriv~. RakerRfield. r.A 91313
~
CBEN.UCALDESCRDnnON
2) Common Name:
I) INVENTORY STAruS: New [ ] Addition PC] Revision ( ] Deletion [ ] Check if chemical is a NON Trade Secret ( ] Trade Secret [ ]
3) OOT # (optional)
Chemical Name:
4) Physical & Health
Hazard Categories
AHM [ ] CAS #
PHYSICAL HEAL1H
Fire [ ] Reactive [ ] Sudden Release of Pressure ( ] Immediate Health (Acute) [ ] Delayed Health (Chronic) (
5) WASTE CLASSIFICATION
(3-digit code from DHS Fonn 8022)
6) PHYSICAL STATE
Solid [XX] Liquid kx] Gas lex]
Pure [
7) AMOUNf AND TIME AT FACILITY
UNITS OF MEASURE
Lbs [ ] Gal [ ] ft3 [
Curies ~O]
Maximum Daily Amount
Average Daily Amount
Annual Amount
Largest Size Container
# Days on Site
40
l..()
(¡O
l' x l'
365
Circle Which Months:
9)~: Li~
the three mo~ hazardous
chemical components or
any AHM components
COMPONENT
I) Cesium 137
2) AMBE 241
3) 1131 - Krypton HI)
10)LOCATION
5500 Woodmere Drive, Bakersfield, CA 93313
1) INVENTORY STAruS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ifchemical is a NON Trade Secret [ ] Trade Secret [ ]
3) OOT # (optional)
Radioactive 1131 Ambe 241 Cesium Krypton AHM [ ] CAS #
85
PHYSICAL HEAL1H
Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute)[ ] Delayed Health (Chronic)[x ]
2) Common Name:
Chemical Name:
4) Physical & Health
Hazard Categories
5) WASTE CLASSIFICATION
(3-digit code tÌOm DHS Form 8022)
6) PHYSICAL STATE
Solid [XX] Liquid roc] Gas kx]
Pure [
7) AMOUNf AND TIME AT FACILITY
Maximum Daily Amount 40
Average Daily Amount 40
Annual Amount 40
Large~ Size Container 3' x 3 "
# Days on Site 365
UNITS OF MEASURE
Lbs [ ] Gal [ ] ft3 [
Curies [40]
Circle Which Months:
9) MIXTI1RE: Li~
the three mo~ hazardous
chemical components or
any AHM components
COMPONENT
1) ('''''i~11m 137
2) 4.MU: 2/,1
3) 1131 KY)þËôft 85
USE CODE
Mixture [ ] Waste [ ] Radioactive rxx ]
8) STORAGE CODES
a) Container:
b) Pressure:
c) T emperatw'e
All Year. J, F, M, A. M, J, J, A. s, 0, N, D
CAS#
%Wf
AHM
[ ]
[ ]
[ ]
USE CODE
Mixture [ ] Waste [ ] Radioactive [x ]
8) STORAGE CODES
a) Container: 04 & 03
b) Pressure: 2
c) T emperatw'e 4
All Year, J, F, M. A. M. J, J, A. S, 0, N, D
CAS#
%Wf
AHM
[ ]
[ ]
[ ]
IO)LOCATION 5500 Woodmere Drive, Bakersfield, CA 93313
I certify under penalty of law, that I have personally examined and am familiar with the intòrmation on this and all attached documents. I
believe the submitted infonnation is true, accurate and complete.
Dan Bebout, General Manager
PRINT Name & Title of Authorized Company Representative
Signature
Date
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-3979
HAZARDOUS MATERIALS INVENTORY
FACILITY DESCRIPTION
CHECK IF BUSINESS IS A FARM [ ]
BUSINESS NAME WELL ANALYSIS CORP. dbà: WEM.GO
FACILITY NAME
SITE ADDRESS
WELACO
5500 WOODMERE DRIVE
CITY BAKERSFIELD
STATE CA
ZIP 93313
NATURE OF BUSINESS OILFIELD PRODUCTION LOGGING / WIRELINE SERVICES
SIC CODE DUN & BRADSTREET NUMBER 606689115
OWNER/OPERATOR JUDY BEBOUT
MAILING ADDRESS
CITY BAKERSFIELD
NAME DAN BEBOUT
PF£O~ 661-283&9506
P.O. BOX::20008
STATE
ZIP
CA
93390-0008
EMERGENCY CONTACTS
TITLE GENERAL MANAGER
BUSINESS PF£ONE (661) 283-9506
NAME
LARRY WRIGHT
24F£OURPF£O~ (661) 832-2649
TITLE DRAFTING MANAGER
BUSINESS PF£ONE (661) 283-9506
24 F£OURPF£O~ (661)827-9505
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State of California-Health and Welfare Agency e
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Department of Health Services
RADIOACTIVE MATERIAL LICENSE
Page 1 of 4 pages
Pursuant to the California Code of Regulations, Division 1, Title 17, Chapter 5, Subchapter 4, Group 2, Ucensing of Radioactive Material, and
in reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive,
use, possess, transfer, or dispose of radioactive material listed below; and to use such radioactive material for the purpose(s) and at the
places(s) designated below. This license is subject to all applicable rules, regulations, and orders of the Department of Health SefV;ces now
or hereafter in effect and to any standard or specific condition specified in this license.
1, Ucensee \yell Analysis Corporation, Inc.
3. Ucense Number
4210-15
Amendment Number: 18
4. Expiration date
August 16, 2000
(3)
2. Address 6804 Fishback Road
Bakersfield, CA 93308
Attention: Danny E. Bebout
Radiation Safety Officer
5. Inspection agency
Radiologic Health Branch
Los Angeles
License Number 4210-15 is hereby amended as follows:
6. Nuclide 7. Form 8. Possession Limit
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A, Iodine-Bl A. Any A. Not to exceed 300 millicuries.
B. Scandium-46 B. Baked on sand or gravel B. Not to exceed 30 millicuries.
C. Cesium-13? C, Sealed sources C. 3 sources not to exceed
(Gulf Nuclear Model CSV or 125 millicuries each.
Model VL-l)
D. Cobalt-60 D. Wire D. Not to exceed 15 millicuries.
E. Krypton-85 E. Gas E. Not to exceed 30 curies.
F. Xenon-B3 F. Gas F. Not to exceed 9 curies,
G, Americium-241 :Be G. Sealed source G. I source not to exceed 3 curies.
(Gulf Nuclear Model 71-1)
H. Americium-24I :Be H, Sealed source H. I source not to exceed 20 curies.
(Amersham Model AMN.CYN
series)
I. Americium-241 :Be I. Sealed source I. 1 source not to exceed
(Gammatron Model AN-HP) 350 millicuries.
9. Authorized Use
A., E. & F, To be used as tracers in oil and gas wells.
B. To be used to determine steam injection profile in steam injection wells.
C., G. & H, To be used as components oftools for well-logging of oil and gas welIs.
D,
To be used for marking collars and/or gravel in gravel packed liner to determine settling at gravel pack.
I.
To be used for calibration of well logging tools.
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State of California-Health and Welfare Agency
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Department of Health Services
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RADIOACTIVE MATERIAL LICENSE
Page 2 of 4 pages
License Number. 4210-15
Amendment Number. 1!
LICENSE CONDITIONS
10. Radioactive material shall be used only at the following locations:
(a) 6804 Fishback Road, Bakersfield, CA
(b) 5500 Woodmere Drive, Bakersfield, CA
(c) Temporary job sites of the licensee in areas not under exclusive federal jurisdiction throughout the State of
California (see Condition 24).
11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at anyone time
as specified in Items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in
accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual
cost-of-living adjustment pursuant to Section 100425 of the California Health and Safety Code.
12, Radioactive material shall be used by, or under the supervision and in the physical presence of, the following
individuals:
(a) Danny E. Bebout
(b) Martin G. Feldt
(c) Robert Muniozquren
(d) Larry Wright
(e) Mike Brown
(t) Martin F. Chapman
13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material
described in Items 6, 7, 8 and 9 of this license in accordance with the statements, representations, and procedures
contained in the documents listed below. The Department's regulations shall govern unless the statements,
representations, and procedures in the licensee's application and correspondence are more restrictive than the
regulations.
(a) The application with attachments dated July 16, 1990, signed by Dan Bebout as modified by letters with
attachments dated June 1, 1993 and August 10, 1993, both signed by Dan Bebout.
(b) The letters with attachments dated September 14, 1998 and September 18, 1998 both signed by
Dan Bebout, relative to addition of new use and storage location.
14. (a) The Radiation Safety Officer in this program shall be Danny E. Bebout.
(b) The Alternate Radiation Safety Officer in this program shall be Larry Wright.
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State of California-Health and Welfare Agency
e
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Deparbnent of Health Services
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Page 3 of 4 pages
RADIOACTIVE MATERIAL LICENSE
License Number: 4210-15
Amendment Number: il
15. Sealed sources possessed under this license shall be tested for leakage and/or contamination as required by Title 17,
Califorq,ia Code of Regulations, Section 30275 (c),
.
16. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be
performed only by persons specifically authorized to perform that service.
17, The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license
using leak test kits acceptable to the California Department of Health Services:
(a) The Radiation Safety Officer
(b) Qualified individuals designated in writing by the Radiation Safety Officer
-
18. Records of leak test results shall be kept in units of microcuries and maintained for inspection. Records may be
disposed of following Department inspection, Any leak test revealing the presence of 0.005 microcuries or more of
removable radioactive material shall be reported to the Department of Health Services, Radiologic Health Branch,
601 N. 7th Street, P,O, Box 942732 - MS 178, Sacramento, CA 94234-7320, within five days of the test. This
report shall include a description of the defective source or device, the results of the test, and the corrective action
taken.
19, Radioactive materials shall be used by occupational workers in such a manner that the dose limits specified in
Title 10, Code of Federal Regulations, Part 20, Subpart C, Sections 20.1201 through 20.1208 are not exceeded.
20, The licensee shall monitor occupational exposures to radiation and shall supply and require the use of individual
monitoring devices by personnel as required by Title 10, Code of Federal Regulations, Part 20, Section 20.1502 (a),
21. The licensee shall monitor occupational intakes of radioactive material by, and assess the committed effective dose
equivalent to, individuals who may have exceeded or are likely to exceed, the limits specified in Title 10, Code of
Federal Regulations, Part 20, Section 20.1502 (b). Suitable and timely measurements used for determination of such
internal exposures shall be performed as specified by Section 20.1204.
22, The licensee is authorized to hold radioactive materials with a physical half-life of less than 65 days for decay in
storage before disposal in ordinary trash provided:
(a) Radioactive waste to be disposed of in this manner shall be held for decay in storage for at least 7 half-lives.
(b) Before disposal as normal waste, radioactive waste shall be surveyed to determine that its radioactivity cannot
be distinguished from background, All radiation labels shall be removed or obliterated.
23. The licensee is authorized to conduct tracer and well logging studies only in well bores drilled for production of oil
and gas. Such studies shall be conducted subject to the provisions of Title 17, California Code of Regulations and
the following requirements:
(a) The wells shall be cased and cemented from the surface to levels below all potable water zones, Before
introduction of radioactive material into the bore holes, the casing shall be proven intact by procedures
acceptable to the California Division of Oil and Gas in order to preclude introduction of any radioactive material
into surface or underground water sources with a mineral concentration of 3,000 milligrams per liter or less of
total dissolved solids,
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State of California-Health and Welfare Agency
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Department of Health Services
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RADIOACTIVE MATERIAL LICENSE
Page 4 of 4 pages
License Number: 4210-15
Amendment Number: II
(b) Tracer studies shall not result in emission from well bores of gas or oil containing radioactive material in
c09centrations greater than those specified in Title 17, California Code of Regulations, Section 30237,
Schedule C.
(c) Tracer studies shall not result in emISSIon from well bores of brine containing radioactive material in
concentrations exceeding those specified in Title 10, Code of Federal Regulations, Part 20, Appendix B, Table
2, Column 2.
(d) The licensee shall maintain available for inspection such records as are necessary to establish compliance with
requirements of this condition for all radioactive material introduced into well bores_ These records shall
include the kinds and amounts òf radioactive materials, dates introduced into well bores, and locations and
identification of the well bores. These records shall be maintained subject to inspection at the well site for the
duration òf work at the site and at the address specified in Condition 10 following completion of such work.
24. Before radioactive materials may be used at a temporary job site at any federal facility, the jurisdictional status of the
job site must be detennined, If the jurisdictional status is unknown, the federal agency should be contacted to
detennine if the job site is under exclusive federal jurisdiction. A response shall be obtained in writing or a record
made of the name and title of the person at the federal agency who provided the detennination and the date that it
was provided. Authorization for use of radioactive materials at the job sites under exclusive federal jurisdiction shall
be obtained either by:
(a) Filing an NRC Fonn-241 in accordance with the Code of Federal Regulations, Title 10, Part 150,20 (b),
"Recognition of Agreement State Licenses", or
(b) By applying for a specific NRC license.
Before radioactive material can be used at a temporary job site in another State, authorization shall be obtained from
the State if it is an Agreement State, or from the NRC for any non-Agreement State, either by filing for reciprocity or
applying for a specific license.
Date: September 18, 1998
By:
Radiologic Hea h Branch
{,
P.O. Box 942732-MS178. Sacramento, CA 94234-7320