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HomeMy WebLinkAboutBUSINESS PLAN 9/1999 Per It to Operate Hazardous Materials/Hazardous Waste Unified Permit Issued by: , CONDITIONS OF,·p~:B,. 1 . ~.._; ~ . ~ ',. ......¡_~, ION REVERSE SIDE ....-.;.~_.-..~..~ ' ' '. .,'.:..... ".. "'.' S:"'~" . ,', .' ".-.; ', This pennlt Is Issued for the following: , iii Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment . ,- J 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: . , . ,I ; Issue Date ~¡ '1.: . ,,-. "" - ~; ,~ : ¡. -/ . . ..' .', 1,: ExpJration. Date: :.':~ :: ~~~~1·;,~í~~(~~f!~11i~;·f~ ~",' ~~ ~. ,:: 'June 3D, 2003 r j . . ~-' -I " -":r", FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 r. e May 3,2001 Ms. Maria Guerrero Maria's Tires & Auto Repair 124 Union Avenue Bakersfield, Ca 93307307 Dear Ms. Guerrero: Enclosed, please find the Site and Facility Diagram Instructions packet. When your Hazardous Materials Management Plan and Inventory were submitted it was lacking the diagram portion. Please draw and submit the diagram(s) of your facility by June 8, 2001. The diagram should include the following: 1) 2) 3) 4) 5) 6) 7) 8) name of your business; business address; indicate which direction is North; the cross streets neighbo~ing business addresses (within 300 feet) entrances and exits location of utility shut-offs; location of the nearest fire hydrant; portions of the building protected by automatic sprinkler system; and most importantly the location of the hazardous material(s). 9) If you have any questions, please feel fi-ee to call me at (661) 326-3658. Thank you for your assistance, Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENT AL SERVICES ?d Esther Duran, Accounting Clerk II Office of Environmental Services ED\db Enclosures ~\~~ ~ ?S~,/WU//U(~ '-~~ J/6oPe .%U'/b vT6 ~.nbl'~r"" 7 . i"'f -- ~ Manager : Location: City · I RECEIVED I MARIAS TIRES AND AUTO REPAIR. SE :J _ P 3 1999 124 UNION AVE < .i"¥? BAKERSFIELD 7'. - --- e SiteID: 215-000-001961 BusPhone: Map : 103 Grid: 32A (661) 861-9160 CommHaz : FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title MARIA GUERRERO / OWNER JORGE GUZMAN / HUSBAND Business Phone: (661) 324-0984x Business Phone: ( ) - x 24-Hour Phone : (bb l ) ß0X.- ,'Uf.,ex 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 861-9160x MailAddr: 124 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Owner MARIA GUERRERO Phone: (661) - 32x40984 Address : 904 PERSHING ST State: CA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: One Unified List ì All Materials at Site ì ~ Hazmat Inventory p== Alphabetical Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP ¡TyP8 or print name) F DH F DH Do hereby certify that ! havG L L 30 GAL Mod 110 GAL Low SOLVENT WASTE OIL I, re"iewed the attachoo hazardous materialls manage- ment plan 101' (Namsof Búsineoo) t&nroJ ihæ ift ~I@~ with any corredit::m® <oor¡¡~å~t!1~~ S\ complete ~1n©1 OOWœft mall'i° agemsü"Ot piQri ~©r my ~mtW. o ,,-l) / --0/1 -1- 08/02/1999 ~ .¡~ e e F MARIAS TIRES AND AUTO REPAIR p= Inventory Item 0002 = COMMON NAME / CHEMI CAL NAME SOLVENT SiteID: 215-000-001961 9 Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit \ N S \ DE T\4-6 ~+-\-O~, õ'E'W6J.J -rf\-E z. 'PolES Map: Grid: CAS # STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE OTHER - SPECIFY Largest Container 30.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 30.00 GAL Daily Average 30.00 GAL ~Wt I l~o.åo Naphtha HAZARDOUS COMPONENTS CAS # I 8030306 I~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod HAZARD ASSESSMENTS p= Inventory Item 0001 F= COMMON NAME / CHEMI CAL NAME WASTE OIL Facility Unit: Fixed Containers at Site 9 Days On Site 365 Location within this Facility Unit OUTSIDE SW CORNER OF SHOP Map: Grid: CAS # 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 55.00 GAL %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSMENTS -2- 08/02/1999 F MARIAS TIRES AND AUTO REPAIR I F ¡oo .-;, e e SiteID: 215-000-001961 ì Fast Format ì Overall Site ì Notif./Evacuation/Medical Agency Notification '.~ M.J ~e9éM::...Y L"FI\2.-6) q I \ . ro£.. M.GD1~ ~€1JCA/ \r A 5?\ LL.. O<:'U (2..R..ES we: CI:::AJ ~~~{..E. u..~ ~\)I~C. [ I I Employee Notif./Evacuation .H-€ ?LÄcK IS 5MA-<Á-. wE- NaT\ r=Y BY \JOICE.. Public Notif./Evacuation -¡-+\-6 '?()"õUC- ~ ~oT ~~5 \'0 \T\-E .Q+\C>"(>, Emergency Medical Plan k€eJJ 1vŒL:> 1 ~ CE-1JTE-í2.- -3- 08/02/1999 ... '. e e F MARIAS TIRES AND AUTO REPAIR I p= Mitigation/Prevent/Abatemt Release Prevention '-UE-- ~E --n-\'G cl-\6t.AIC~ 10 Å.. ~~'?¿:"'~.6.TE b~t:> ~¡.J As ~~ C4S\1.J"\7.:0..1 ~G--Q::... SiteID: 215-000-001961 ì Fast Format ì Overall Site ì ~ A. '??~ ':?I þ... \t:; ?<-A DE. \ r Release Containment ~ ~.u c-~ %b..\J:b ~l~C "P<...bR..!ié:- Clean Up \' " We US€ AßSO<R.;B Ä<-I..- \"D ,"?\c..~ ù"t'" .5~\u....s f 01Z- M~~ ~LE-t::::St:;S WE: ¡)øK)', cr.:,.,12--\Z-\€ æ>\"? ..brMOù~1S o-::ç: ~. Other Resource Activation -4- 08/02/1999 ... 4, e e F MARIAS TIRES AND AUTO REPAIR I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs A) GAS - we- 1:x:)k)T- \Ÿ-56 B) ELECTRI CAL -.;.;:r ~T O'F ~ 6T'O"f' C) WATER - Ð~t0þ "ï'"'l4€- 'PÄ.~A../\ D) SPECIAL - E) LOCK BOX - SiteID: 215-000-001961 1 Fast Format 1 Overall Site 1 I 08/02/1999 Þo.=> 12- Fire Protec./Avail. Water 08/02/1999 PRIVATE FIRE PROTECTION - £~, \W6\U \ ~S ~ uJÀ~ ~s.e, NEAREST FIRE HYDRANT - t...HS':>L\ TO ~ r~x.J\ 'Doo~ Building Occupancy Level -5- 08/02/1999 i~ ; -: ~ e e F MARIAS TIRES AND AUTO REPAIR I ,F Training Employee Training SiteID: 215-000-001961 ì Fast Format ì Overall Site ì 08/02/1999 HOW MANY EMPLOYEES DO YOU HAVE AT THIS FACILITY????? 1-JOIJ.E; DO YOU HAVE MSDS SHEETS ON FILE?????? Ñ'O GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM: ").)~ ...IÅh.~ "-JOT --r1Zb "-.) i ~'1 'P'i2-.0q (U::::.~ Page 2 [ I I Held for Future Use Held for Future Use -6- 08/02/1999 ~ ~~ e e CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSTRUCTIONS: 1. To avoid further action, return this fonn within 30 days of receipt. 2. TYPEIPRINT 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 BUSINESS NAME: M..t:..:e' Þ-:.::) \ \ 1,2.-€ ~ .b.~\D ~ b \ R... LOCATION: \24 Ut-.)\010 ~\f&. MAILING ADDRESS: ~~ CITY: 13 b.~5 +- Ué:<-.J) STATE: Q.~ ZIP:q~lPHONE:{GÇ,I) 8bl q \ 60 DUN & BRADSTREET NUMBER: SIC CODE; - PRIMARY ACTMTY: ~VTO 12E?A'\ (2... OWNER: Iv{ A e I þ.., t-t£ ¡..,J ¡:.... '1 ù tS e.e.:eeo MAILING ADDRESS: \2-4 ùtJ \OJj ~\tE., ~'?€S~F\6L\) CÞ-. Q3307 SECTION 2: EMERGENCY NOTIFICATION CONTACT ' TITLE BUS. PHONE 24 HR. PHONE 1. ..J£>~€ bìÙZLAI::::.>0 Co ~ow0e12-- ~61 't\ bO 2. T2~'G-L ~Sb.-(ES :r \2.-\,€1-.) þ ( b0\) ~34 ~::? 82 1 ,~. r~ - e HAZARDOUSMATE~SMANAGEMŒNTPLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: ÒD0G MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REOUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. )<. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TInS INFORMATION Wll.L 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 TITLE DATE 2 e r:-;-... -;' .~, e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: i.JJE ~ve ~6c.u~ co~..n"'~\ I"YE;-12-S ~:b ~ ~~uC7\S ~e€ I to p..µ ~~~~R.\ Þ>\"'€ 9~C-E... B. RELEASE CONTAINMENT AND/OR MINIMIZATION: ~ C.lc\€M1.~ ~.VE ~\t==-\C... ~lA~~ 6 w~ ~- , ??oDÙe.\S IV ~ IV'r o~ ~L..£. .:5?\LLS, 0 \c==- ~b~.oi2- ~LEt:». S~ . C. CLEAN-UP PROCEDURES: w€- use \!Ä'S~e;ß ~þ,.s~. I' Þ-U- 'TO ?1.e~ U ~ ~~ ..:M;::.~~ SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: .¡...::sO ~e ELECTRICAL: ~ ~\ D~ -:Tt\-€ MDI~ ~~ oÇ-- '"l1-\-£ s-004=> WATER: 3E-f\tt0ß ---me 'B~-n-\'?Do 1J\.. . SPECIAL: LOCK BOX: YES/NO IF YES, LOCATION: 't-..b SECTION 9: PRIVATE FIRE PROTECTION/W ATER AVAILABILITY A. PRIVATE FIRE PROTECTION: ~::)'--T\ ~ {tU\ s~ B. WATER AVAILABILITY (FIRE HYDRANT): ~\ \Û ~ ~.0T ~O12- 0J.t- l\-þ\j1; ~ .:FI (2..G ~ '( \) {2...~ òT. 4 ',~. '<-~è. e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: I () Â tJ ~C(B~C '{ ( =ñ ~:) oJ €- cI:::J....L q \ \ B. El\.fPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: T+\e 'Po be l c... l-\;b.s ~ ~e3 \0 ~ st\ðçp ßùT I ~ W &1..£EQ...lqEP-.JCY WE UJ \LL ~o\ tr'f ßY VOlC-£- D. EMERGENCY MEDICAL PLAN: ( t..J ~ elvt&e..G(BA.jc. V ~ \RJ Å \\ D AJ wE: C.ê.LL c::r \. \ o ~ WE- v..h LL fl 0 \'0 ll--\-e" \L82.t...) u.E'DI~ C'Ë ~T€Q.. , 3 " . CITY OF BAKERSFI~ \q Þ \ TMENT OFFICE OF ENVI MENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 . , FACILITY NAME fll).fY:<'IA 5 ,ÅLKO ADDRESS J"L4 f.)A.i11lN FACILITY CONTACT -Jo<2f::rE. 6u"Zi'V1~ INSPECTION TIME INSPECTION DATE 2- !. PHONE NO. ~b ( - Cf t"o BUSINESS ID Nt). 15-210- NUMBER OF EMPLOYEES ð Section 1: Business Plan and Inventory Program o Routine ~ombined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate permit on hand ¡J'C-z,J 'jš L.>ç I";oJ C '5$ Business plan contact information accurate Visible address Correct occupancy ~ Veri fication of inventory materials - I I Veritication of quantities I . VoR Veritication of location I G£ t) I~ I I Proper segregation of material I ¡- Maria's I ¡ ¡- Verification ofMSDS availability ~ Tires and Auto Repair Verification ofHaz Mat training I I I >-- Verification of abatement supplies and procedures 124 Union Ave. Telephone I I Bakersfield, CA 93307 (805) ~ Emergency procedures adequat~ '~/-'/t'é) , Containers properly laheled Housekeeping Fire Protection v ' 7~se ~(R fúStß.L€ UN/<. oN TAN Site Diagram Adequate & On Hand .,- Ie.. C=Compliance V=Violation Any hazardous waste on site?: ~es 0 No Explain: 2... V/2.uMS ¿....J4~~ <:971- r Questions regarding this inspection? Please call us at (805) 326-3979 White - [n\'. S\'èS. Yellow - Station Copy Pink - Business Copy Ite Responsible Party Inspector: WII'VE'S ~ -- . e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROqRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME /Vl..Äfl-(,4'') .&V<f() Section 4: o Routine INSPECTION DATE 2/2-3/77 Hazardous Waste Generator Program Ai/A- EP A ID # ~ Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Hazardous waste determination has been made EPA ID Number (Phone: 916-324-17R I to obtain EP A ID #) ALL.- Authorized for waste treatment and/or storage rft~7IV1 S Reported release, tire, or explosion within 15 days of oecurance ð(L- Established or maintains a contingency plan and training Hazardous waste accumulation time tì'ames Û /l..J.J~ ~ LAßéC£:D ß'c; Containers in good condition and not leaking I N5 Péc- <.e>fL. 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 fïlters 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 fì'om land disposal - C=Complianee V=Violation Inspector: ~//\Je. 5 Office of Environmental Services (805) 326-3979 \\'hite - En\'. S\'cs. Pink - Business Cory · CITY OF BAKERSF'LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 -- FACILITY INFORMATION Page Of FACILITY ID # I. FACILITY IDENTIFICATION 1 Year Beginning 100 Year Ending 101 BUSINESS NA 3 BUSINESS PHONE ?5b - '9/60 102 SITE ADDRESS l2.-4 UN(ð~ 103 CITY 104 CA ZIP 105 DUN& BRADSTREET i COUNTY I 106 SIC CODE (4 Oigit #) 107 108 . ·······lì.:'(O'WNER 'INFORMÄTION') .. 'v':'~' I 110 I ¡ OPERATOR NAME 109 OPERATOR PHONE .. .. . -""'.: : . ^,;", .:. :>~. . .., :':: ' .'::.:i>:~: OWNER NAME 111 OWNER PHONE 112 ¡ I OWNER MAILING ¡ ADDRESS 904 $f>&2-S4,,.JG 5'1 114 STATE 115 ZIP y,·~·tÎ,'i~~~~1!8;g~,M~~I~ìl]~~Ñ~~~~f€·:.if~'(~j~0J;::¿¿:~;'j.f~~~f.~·.(:<~ 117 CONTACT PHONE 1$')04- 113 i i I 116 ! CITY ':'<':::S:~_.> /,. i 118 : i :"'é .; ~,_,' x-' .:'.:~,<<:::::;8:'.:':';': .;:-" ,":~::.;.:'t_'-:-:"':'. CONTACT NAME CONTACT MAILING ADDRESS 11g NAME . ,,-.....,.. ...... ....... . .. .;,. ;'PRíM~RY --~ '" ,,··...···,~i:~{:~~;f; ¡VIM.,4- (;, \).2- ,- ~~ OWAJ~4- (;.vt:;R..R.ew 120 STATE 121 ZIP :..;.....lyJ(~~~~.~q~~Ç~.F9~Î'ÅÇ!~1~:[~;:;2¡'.;~;·;f[W~;.i'/.)~i(.~EC()NDARY- 123 NAME ~DQ..G..é bU"'2..^""M 122 ; CITY 129 \ 3C,L¡ - ðq 84 125 TITLE '?,. J';AIW) 126 BUSINESS PHONE 127 24-HOUR PHONE 128 PAGER # 130 . TITLE BUSINESS PHONE 24-HOUR PHONE 131 132 I I 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 I and am familiar with the information submitted in this inventory and believe the information is true. accurate. and complete. r SIGNATURE OF OWNER/OPERATOR DATE 134 NAME OF DOCUMENT PREPARER I 1-..---- I NAMES OF OWNER/OPERATOR (print) ! . . ,. ,. , -.... .. .. ", .. .., :?;;Y.CERTIFICATI(jN ,.", .. ",. . ;" ., ,,'..-.." 133 : j PAGER # 135 : I ! 136 TITLE OF OWNER/OPERATOR 137 i _____ ,)E'j frJKM 27'Æ) (71'Jð) \ P:\OES2730. TV4.wpd . CITY OF BAKERS FIE. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 200 ;j;';'\'P'~~i~~Ãê~il\~:j~W8~MX. HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per material per building or area) Page of CHEMICAL LOCATION ð.>r5¡fYE S"w Cj2¡J fè é)./:;- Sl-fðP 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 203 GRID # (optional) DYes 0 No 202 204 CHEMICAL NAME W1\<S1C: ðlL If Subject to EPCRA. refer to iinstructions 207 COMMON NAME EHS· o Yes 0 No 208 CAS # 209 FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210 o P PURE o m MIXTURE 21'" w WASTE 211 RADIOACTIVE DYes oNo 212 CURIES 213 o s SOLID Q I LIQUID ogGAS 214 LARGEST CONTAINER .ç~ 215 TYPE PHYSICAL STATE FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE AMOUNT P1 FIRE o 2 REACTIVE o 3 PRESSURE RELEASE o 4 ACUTE HEALTH o 5 CHRONIC HEALTH 216 217 MAXIMUM DAILY AMOUNT I (D 218 AVERAGE DAILY AMOUNT 219 STATE WASTE CODE 220 UNITS· (j¡t ga GAL 0 c:i CU FT . If EHS. amount must be in Ibs. o Ib LBS o In TONS 221 DAYS ON SITE 222 ! STORAGE CONTAINER (Check all that apply) o a ABOVEGROUND TANK Db UNDERGROUND TANK o c TANK INSIDE BUILDING Jõiit d STEEL DRUM De PLASTIC/NONMETALLIC DRUM Of CAN o 9 CARBOY o h SILO o i FIBER DRUM OJ BAG o k BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON o q RAIL CAR o r OTHER 223 STORAGE PRESSURE ~ a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~ a AMBIENT o aa ABOVE AMBIENT .:~1rt~~RRQ~&;~!~~;~N o ba BELOW AMBIENT o c CRYOGENIC 225 226 2 230 3 234 4 238 5 242 227 o Yes 0 No 228 231 DYes 0 No 232 235 o Yes 0 No 236 239 o Yes 0 No 240 243 DYes oNo 244 229 233 237 241 245 OES FORM 2731 (7/98) P:\OES2731.TV4.wpd . CITY OF BAKERS FIE. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 200 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per material per building or area) Page of 3 1 MAP # (optional) 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 203 GRID # (optional) D Yes D No 202 CHEMICAL LOCATION FACILITY 10 # 204 205 D Yes D No 206 If Subject to EPCRA, refer 10 iinstructions CHEMICAL NAME <Çh c./'C.. v-.-( 207 COMMON NAME CAS # 209 FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210 D s SOLID {6 m MIXTURE D w WASTE 211 RADIOACTIVE Dyes DNo 212 CURIES ~ LIQUID DgGAS 214 LARGEST CONTAINER 36 D 2 REACTIVE D 3 PRESSURE RELEASE D 4 ACUTE HEALTH D 5 CHRONIC HEALTH 213 TYPE D p PURE PHYSICAL STATE 215 FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE AMOUNT ~ FIRE 216 217 MAXIMUM DAILY AMOUNT 218 AVERAGE DAILY AMOUNT 3Ò 219 STATE WASTE CODE 220 UNITS' o ga GAL 0 cf CUFT . If EHS. amount must be in Ibs. o Ib LBS o In TONS 221 DAYS ON SITE 222 STORAGE CONTAINER (Check all that apply) D a ABOVEGROUND TANK Db UNDERGROUND TANK o c TANK INSIDE BUILDING ~d STEEL DRUM o e PLASTIClNONMETALLlC DRUM Of CAN o 9 CARBOY o h SILO o i FIBER DRUM OJ BAG D k BOX o I CYLINDER o m GLASS BOTTLE o n PLASTIC BOTTLE o 0 TOTE BIN o P TANK WAGON o Q RAIL CAR o r OTHER 223 STORAGE PRESSURE ~ a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT 224 STORAGE TEMPERATURE I!r"a AMBIENT o aa ABOVE AMBIENT o ba BELOW AMBIENT o c CRYOGENIC 225 226 227 D Yes 0 No 228 229 2 230 231 Dyes 0 No 232 233 3 234 235 DYes 0 No 236 237 4 238 239 o Yes 0 No 240 241 5 242 243 o Yes 0 No 244 245 OES FORM 2731 (7/98) P:\OES2731,TV4.wpd