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HomeMy WebLinkAboutPERMIT TO OPERATE, HAZ WST Per it to Operftte Hazardous Materials/Hazardous Waste Unified Permit " ~ CONDITIONS OF PERMIT ON REVERSE SIDE :"-'- ' Permit ID #:: 015-000-001784 GENTRYSRVREPAIR . ,LOCATION: 110 UNION AVE Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor' Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 ¡ - or): ~ ..I. ..' - ."- ,.', ' . . . , This permit Is Issued for the following: ItI Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Approved by: Issue Date Expiration Date: . June 30, 2003 Or'; ,,' ~:..:,<. .:! :: PerDl.Ït to Operil.te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the fOllowing: ":~ª~ardous Materials Plan . round Storage of Hazardous Materials agement Program Waste 110 PERMIT ID# 015-021.001784 GENTRYS RV REPAIR LOCATION Issued by: UNION 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 .1.~ ..1.. T.J. ..L T..L .1. e . SITE DIAGRAM ~ Business Name: _G&-Jy12:.:Y'S Business ACdress: l (d ...L ~ "' ..I.. J ~ .a..¿. - FACIUTY DIAGRAM I I ,,?,}j~'/? CÐ,/t.",ßJ" '.'~ "'_~:- -.-;~~- t~~'\J K.G r~_. v~_ _-__:.... ~.~ -.. .,-. _.-_. -. () tJ (c),J ÄJ For Office Use Only FirST !n S tetion: Insoec~ion Sterion: Area Mea .:: of NORTH -0 wo. l'et. 1'1C?ï6'2.. © ~ ~ () ~ ':2 J V kIA_G.-'rJ <sP A: ~ SToJG ------ ~ ") " ~ <.L il4 UN tori A ' T. S. S H-OP c.J~~ 01'- e. ~y. AC£~ (~ f'íJ~T úJþ.S~ 01.... t j <4.. ¡: ~ o -- \fl ~ WATC~ ~J ~Tð{?....AG-e ~ ,(. .-:t'-- \!«(..(..A t'NN M"OTGL. PfZO/'~E ATF IlO Utv ,()J 6G.tJ-rQ. Y IS Rv RGC'A,f'.. c,)(<I 4 <:£'r. . .~ ~ 'i - // -, (J<:, GENTRYS RV REPAIR SiteID: 015-021-001784 'Manager Location: 110 UNION AVE City BAKERSFIELD BusPhone: Map : 103 Grid: 32C (805) 323-9456 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 EPA Numb: SIC Code:7538 DunnBrad: Emergency Contact / Title Emergency Contact / Title JACK GENTRY / OWNER VERN HAMM / CO-TENNANT Business Phone: (805) 323-9456x Business Phone: (805) 322-8060x 24-Hour Phone : (805) 832-1950x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: (805) 323-9456x MailAddr: 110 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 ,..- . -....,IvED Owner JACK GENTRY Phone: (805) 832-1920x Address : 4404 VERN SEP 2 5 2000 State: CA City. : BAKERSFIELD Zip : 93307 .... . Period : to I II 'nuN. SERVICES TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: , One Unified List l All Materials at Site l SpecHaz EPA Hazards DailyMax MCP F IH DH G 249.00 FT3 Low F DH L 55.00 GAL Low f= Hazmat Inventory f== As Designated Order Hazmat Common Name... OXYGEN WASTE OIL 1,:r~J! 12~~jAtI Do hersby certify that. I haN3 ~pe~nnl!!ri!-J reviewed the attached hazardous materials manage~ ment plan 10 (}PIJI rlJ~. fJ/I and that it along with (t\'aWf Business) . any corrections constitute a complete and correct man- agement plan for my facility. fJuP!~i- ;7- r:OI2 09/05/2000 , e e F GENTRYS RV REPAIR p= Inventory Item 0001 = COMMON NAME / CHEMI CAL NAME OXYGEN SiteID: 015-021-001784 ì Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit INSIDE SE CORNER OF SHOP Map: Grid: CAS # 7782-44-7 - TYPE Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER Largest Container 249.00 FT3 AMOUNTS AT THIS LOCATION Daily Maximum 249.00 FT3 Daily Average 249.00 FT3 %Wt. RS CAS # 100.00 Oxygen, Compressed No 7782447 HAZARDOUS COMPONENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low HAZARD ASSESSMENTS p= Inventory Item 0002 F== COMMON NAME / CHEMI CAL NAME WASTE OIL Facility Unit: Fixed Containers at Site ì Days On Site 365 Location within this Facility Unit OUTSIDE BEHIND E WALL OF BLDG 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 55.00 GAL Daily Average 30.00 GAL %Wt. RS CAS # 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS N TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low HAZARD ASSESSME TS -2- 09/05/2000 e e F GENTRYS RV REPAIR I f= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-001784 1 Fast Format 1 Overall Site 1 04/28/1997 IN OFFICE TO CALL FOR HELP BY DIALING 911. Employee Notif./Evacuation 04/28/1997 VERBAL NOTIFICATION SUFFICIENT BETWEEN SHOP AND ADJACENT OFFICE. Public Notif./Evacuation 04/28/1997 NEIGHBORING BUSINESSES WOULD BE NOTIFIED TO EVACUATE THE COMMON YARD THROUGH THE SW GATE. Emergency Medical Plan 04/28/1997 ] FIRST AID KIT. CLOSEST HOSPITAL - MERCY. 1l07k' ~ '1lørco-~ J~~ J)~ I~ 30/-CD?/ #t?71if - ~3 5' -- 11~~ 7 -3- 09/05/2000 - e F GENTRYS RV REPAIR I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-001784 ì Fast Format ì Overall Site ì 04/28/1997 COMPRESSED GAS CYLINDER KEPT CHAINED TO CART. ~ Release Containment ~SORBANT USED TO SOAK 04/28/19971 04/28/1997 UP SPILLS. Clean Up WASTE OIL PICKED UP BY KERN OIL FILTER RECYCLING. Other Resource Activation -4- 09/05/2000 e" e F GENTRYS RV REPAIR I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 015-021-001784 ì Fast Format ì Overall Site ì I 04/28/1997 A) GAS- N/A B) ELECTRICAL - INSIDE PARTS RM, IN NE CORNER OF SHOP C) WATER - METER VALVE IN GROUND AT SW CORNER OF YARD D) SPECIAL - NONE E) LOCK BOX- NO Fire Protec./Avail. Water 04/28/1997 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS IN SHOP NEAREST FIRE HYDRANT - 8D ¿¿rÚul1!lf/É- J~~{)~¡tJ# Building Occupancy Level -5- 09/05/2000 "fJ .' ... ..... e e F GENTRYS RV REPAIR I F Training Employee Training SiteID: 015-021-001784 ì Fast Format ì Overall Site ì 04/28/1997 vA f}. - Or.: riD ~ HOW MANY EMPLOYEES AT THIS FACILITY??????????? DO YOU HAVE MSDS SHEETS ON FILE??????????? GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM: Page 2 [ I I Held for Future Use Held for Future Use -6- 09/05/2000 .. -. - - SiteID: 215-000-001784 GENTRYS RV REPAIR Manager Location: 110 UNION AVE City BAKERSFIELD BusPhone: Map : 103 Grid: 32C (805) 323-9456 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 EPA Numb: SIC Code:7538 DunnBrad: Emergency Contact / Title Emergency Contact / Title JACK GENTRY / OWNER VERN HAMM / CO-TENNANT Business Phone: (805) 323-9456x Business Phone: (805) 322-8060x 24-Hour Phone . (805) 832-1950x 24-Hour Phone : ( ) - x . Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire lnunHlth DelHlth Agency-Defined Topic Title F Hazmat Inventory f== MCP+DailyMax Order One Unified List ~ All Materials at Site ~ Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP OXYGEN WASTE OIL F F IH DH DH G L 249 FT3 Low 55 GAL Low -1- 04/28/1997 ¡. .. e e F GENTRYS RV REPAIR p= Inventory Item 0001 == COMMON NAME / CHEMICAL NAME OXYGEN SiteID: 215-000-001784 1 Facility Unit: Fixed Containers at Site 1 Days On Site 365 Location within this Facility Unit INSIDE SE CORNER OF SHOP CAS# 7782-44-7 STATE - TYPE Gas Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE PORT. PRESS. CYLINDER AMOUNTS STORED AND IN USE Lrgst Cont.this Lac FT3 DailyMax this Lac FT3 DailyAvg this Lac FT3 249.00 249.00 249.00 DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3 HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Oxygen, Compressed No 7782447 -2- 04/28/1997 " e e F GENTRYS RV REPAIR p= Inventory Item 0002 = COMMON NAME / CHEMICAL NAME WASTE OIL SiteID: 215-000-001784 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Location within this Facility Unit OUTSIDE BEHIND E WALL OF BLDG CAS# 221 STATE - TYPE Liquid Waste PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE DRUM/BARREL-METALLIC Lrgst Cant. this Lac GAL DailyMax this Lac GAL DailyAvg this Lac GAL 55.00 55.00 30.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL AMOUNTS STORED AND IN USE %Wt. EHS CAS# 100.00 Waste Oil, Petroleum Based No 0 HAZARDOUS COMPONENTS -3- 04/28/1997 ~ e e F GENTRYS RV REPAIR I f= Notif./Evacuation/Medical Agency Notification SiteID: 215-000-001784 ~ Fast Format ~ Overall Site ~ 04/28/1997 TELEPHONES IN OFFICE TO CALL FOR HELP BY DIALING 911. Employee Notif./Evacuation 04/28/1997 VERBAL NOTIFICATION SUFFICIENT BETWEEN SHOP AND ADJACENT OFFICE. Public Notif./Evacuation 04/28/1997 NEIGHBORING BUSINESSES WOULD BE NOTIFIED TO EVACUATE THE COMMON YARD THROUGH THE SW GATE. Emergency Medical Plan 04/28/1997 ] FIRST AID KIT. CLOSEST HOSPITAL - MERCY. -4- 04/28/1997 .. e e F GENTRYS RV REPAIR I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-001784 ~ Fast Format ~ Overall Site "I 04/28/1997 COMPRESSED GAS CYLINDER KEPT CHAINED TO CART. Release Containment 04/28/1997 ABSORBANT USED TO SOAK UP SPILLS. Clean Up 04/28/1997 WASTE OIL PICKED UP BY KERN OIL FILTER RECYCLING. Other Resource Activation -5- 04/28/1997 '. e e F GENTRYS RV REPAIR I p= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 215-000-001784 ì Fast Format ì Overall Site ì I 04/28/1997 A) GAS- N/A B) ELECTRICAL - INSIDE PARTS RM, IN NE CORNER OF SHOP C) WATER - METER VALVE IN GROUND AT SW CORNER OF YARD D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 04/28/1997 PRIVATE FIRE PROTECTION - PORTABLE FIRE EXTINGUISHERS IN SHOP NEAREST FIRE HYDRANT - Building Occupancy Level -6- 04/28/1997 - .,~. ....'Ç, e e F GENTRYS RV REPAIR I F Training Employee Training SiteID: 215-000-001784 ~ Fast Format ~ Overall Site ~ 04/28/1997 HOW MANY EMPLOYEES AT THIS FACILITY??????????? DO YOU HAVE MSDS SHEETS ON FILE??????????? GIVE A BRIEF SUMMARY OF YOUR TRAINING PROGRAM: Page 2 [ I I Held for Future Use Held for Future Use -7- 04/28/1997 . - . ~~ Q w:Zfb'7( v, . SiteID: 215-000-oe1)~~+ + GENTRYS RV REPAIR =================================== Manager Location: 110 UNION AVE City BAKERSFIELD BusPhone: Map : 103 Grid: 32C (805) 323-9456 17~· CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:7538 EPA Numb: DunnBrad: +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title JACK GENTRY / OWNER VERN HAMM / CO-TENNANT Business Phone: (805) 323-9456x Business Phone: (805) 322-8060x 24-Hour Phone : (805) 832-1920x 24-Hour Phone : () x Pager Phone : () x Pager Phone : () x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: Fire ImmHlth DelHlth I +------------------------------------------------------------------------------+ Ag.def2 : Phone: () x MailAddr: 110 UNION State: CA City : BAKERSFIELD Zip : 93307 +------------------------------------------------------------------------------+ BusOwner JACK GENTRY Phone: (805) 832-1920x Address : 4404 VERN State: CA City : BAKERSFIELD Zip : 93307 +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: EHSs: No +------------------------------------------------------------------------------+ Agency-Defined Topic Title +==============================================================================+ -1- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + += Hazmat Inventory ========================================= By Facility Unit + +== MCP+DailyMax Order ============================== Fixed Containers at Site + +--------------------------------+-------+-----------+-----+----------+----+---+ I Hazmat Common Name... ISpecHazlEPA Hazards Frm I DailyMax UnitIMCP , +--------------------------------+-------+-----------+-----+----------+----+---+ OXYGEN F IH DH G 249 FT3 Low WASTE OIL F DH L 55 GAL Low +==============================================================================+ -2- e - + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + += Inventory Item 0001 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+= Days On Site =+ OXYGEN I 365 I +----------------+ I CAS# I PORTABLE CART INSIDE SOUTHEAST CORNER OF SHOP. 7782-44-7 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Gas I Pure I Above Ambient I Ambient I PORT. PRESS. CYLINDER I +=========+==========+===============+===============+=========================+ +========================== AMOUNTS STORED AND IN USE =========================+ I Lrgst Cont.this Loc FT3 I DailyMax this Loc FT3 I DailyAvg this Loc FT3 I 249.00 249.00 +--------------------------+-------------------------+-------------------------+ I DailyMax Stored FT3 I DailyMax Open Use FT3 I DailyMax Closed Use FT3 I +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I IEHS CAS# I 100.00 Oxygen, Compressed No 7782447 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ I TSecretI EHSIBioHazI Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F IH DH / / / Low +-------+---+------+--------------------+-------------+---------+--------+-----+ UFC Article 80 Control Zone: USDOT Hazards Location within this Facility Unit In Cabinet? Sprinklered Area? +=======================================+======================================+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Defined1: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: +- Ag.Define11 ----------------------------------------------------------------+ +==============================================================================+ -3- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + += Inventory Item 0002 =============== Facility Unit: Fixed Containers at Site + +== COMMON NAME / CHEMICAL NAME ==============================+= Days On Site =+ WASTE OIL I 365 I +----------------+ I CAS# I OUTSIDE BEHIND EAST WALL OF BUILDING. 221 +=============================================================+================+ += STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+==== CONTAINER TYPE =====+ I Liquid I Waste I Ambient I Ambient I DRUM/BARREL-METALLIC I +=========+==========+===============+===============+=========================+ +========================== AMOUNTS STORED AND IN USE =========================+ I Lrgst Cont.this Loc GAL I DailyMax this Loc GAL I DailyAvg this Loc GAL I 55.00 30.00 +--------------------------+-------------------------+-------------------------+ I DailyMax Stored GAL I DailyMax Open Use GAL I DailyMax Closed Use GAL I +==========================+=========================+=========================+ +=======+============== HAZARDOUS COMPONENTS ==============+===+===============+ I %Wt. I IEHS CAS# I 100.00 Waste Oil, Petroleum Based No 0 +=======+==================================================+===+===============+ +=======+===+======+=========== HAZARD ASSESSMENTS ===+=========+========+=====+ Tsecret EHSIBioHaz Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F DH / / / Low +-------+---+------+--------------------+-------------+---------+--------+-----+ UFC Article 80 Control Zone: USDOT Hazards Location within this Facility Unit In Cabinet? Sprinklered Area? +=======================================+======================================+ +========================== MISC. LOCAL AGENCY DATA ===========================+ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.DefinelO: Ag.Defined8: Ag.Defined9: +- Ag.Define11 ----------------------------------------------------------------+ +==============================================================================+ -4- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + += Inventory Item 0002 =============== Facility Unit: Fixed Containers at Site + +==================+=========+====== WASTE DATA ===========+===================+ I Processed On Site CA Code I US Code I GAL Generated/Mo. I GAL Generated/yr. No 200.00 +------------------+---------+---------+-------------------+-------------------+ Agency-Defined Text Label +==============================================================================+ -5- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Notif./Evacuation/Medical ==================================== Overall Site + +== Agency Notification =========================================== 02/22/1996 + TELEPHONES IN OFFICE TO CALL FOR HELP BY DIALING 9-1-1. +==============================================================================+ -6- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Notif./Evacuation/Medical ==================================== Overall Site + +=== Employee Notif./Evacuation =================================== 02/22/1996 + VERBAL NOTIFICATION SUFFICIENT BETWEEN SHOP AND ADJACIENT OFFICE. +==============================================================================+ -7- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Notif./Evacuation/Medical ==================================== Overall Site + +==== Public Notif./Evacuation ==================================== 02/22/1996 + NEIGHBORING BUSINESSES WOULD BE NOTIFIED TO EVACUATE THE COMMON YARD THROUGH THE SOUTHWEST GATE. I +==============================================================================+ -8- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Notif./Evacuation/Medical ==================================== Overall Site + +===== Emergency Medical Plan ===================================== 02/22/1996 + FIRST AID KIT. CLOSEST HOSPITAL: MERCY +==============================================================================+ -9- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +== Release Prevention ============================================ 02/22/1996 + COMPRESSED GAS CYLINDERS KEPT CHAINED TO CART. +==============================================================================+ -10- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Mitigation/Þrevent/Abatemt =================================== Overall Site + +=== Release Containment ========================================== 02/22/1996 + ABSORBANT USED TO SOAK UP SPILLS. +==============================================================================+ -11- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +==== Clean Up ==================================================== 02/22/1996 + WASTE OIL PICKED UP BY KERN OIL FILTER RECYCLING. +==============================================================================+ -12- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Mitigation/Prevent/Abatemt =================================== Overall Site + +===== Other Resource Activation ==============================================+ +==============================================================================+ -13- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Site Emergency Factors ======================================= Overall Site + +== Special Hazards ===========================================================+ +==============================================================================+ -14- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Site Emergency Factors ======================================= Overall Site + +=== Utility Shut-Offs ============================================ 02/22/1996 + NATURAL GAS/PROPANE: N/A ELECTRICAL: INSIDE PARTS ROOM, IN NORTHEAST CORNER OF SHOP. WATER: METER VALVE IN GROUND AT SW-CORNER OF YARD. +==============================================================================+ -15- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Site Emergency Factors ======================================= Overall Site + +==== Fire Protec./Avail. Water =================================== 02/22/1996 + PRIVATE FIRE PROTECTION: PORTABLE FIRE EXTINGUISHERS IN SHOP. +==============================================================================+ -16- - e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Site Emergency Factors ======================================= Overall Site + +===== Building Occupancy Level ===============================================+ +==============================================================================+ -17- - e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Training ===================================================== Overall Site + +== Employee Training ============================================= 02/22/1996 + NUMBER OF EMPLOYEES: 0 MATERIAL SAFETY DATA SHEETS ON FILE: ????????? +==============================================================================+ -18- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Training ===================================================== Overall Site + +=== Page 2 ===================================================================+ +==============================================================================+ -19- e e + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Training ===================================================== Overall Site + +==== Held for Future Use =====================================================+ +==============================================================================+ -20- e e + "GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + +================================================================= Full Format + += Training ===================================================== Overall Site + +===== Held for Future Use ====================================================+ +==============================================================================+ -21- ·' e . 'i + GENTRYS RV REPAIR =================================== SiteID: 215-000-004375 + += Fast Format =================== Type+Category+Sub-Category+Date1(ASC) Order + += INSPECTIONS ================================================== Overall Site + I +----------------+------------+------------------------------------------------+ i I Categorization I Dates I Summary Description I I +----------------+------------+------------------------------------------------+ I 10/09/1996 OK I +------------------------------------------------------------------------------+ -22- ~ u /' GENTRY'S RV REPAIR JACK GENTRY Owner . 110 Union Ave. Bakersfield, CA 93307 (805) 323-9456 ~- ....-....-... -- ""'- -,.~-......._- ~, ,. y. BAKE~FIELD·CITY FIRE DE'ARTMENT .. ..a HAZARDOUS MATERIALS DIVISION ,.., ~ ~ro1'1 1715 -CHEST£RA.v£.~ ~ BAKERSFIELD, CA. 93301 ~ I ~ Y ~ HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: ~ ¿e "2- r-02-~6--- 1. 2. io avoid further action. return this form within 30 days of receipt. -x TYPE/PRINT ANSWERS IN ENGLISH. ,_ ' ~ , lJ 'õ 1 v Answer the questions below for the DUSlness as a whole. '-I \/ ~ - Be brief and concise as possible. 3. 4. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: 6-ErJT(2..Y IS f2.v óZ..6P4 I R. LOCATION: I {O UNIoN .Au l'v1AllING ADDRESS: ~Â-f'1.G DUN & BRADSTRE::T NUMBE~: STAT::: _ Z!P: c:¡ ~307 PHONE: 32.3 - ~4S-G SIC CODE: 7_C;::S ~ CiTY: ?RIMARY,A,CTIV1TY: OWNER: .JA"c.K 6é<I\J TYl Y Îv1P\lLJNG ,~DDRESS: 4404 U~IÙ s.' "'75>07 SECTION 2: ~MERGENCY NOTIFICATION: CONTACT TITL:: BUS. PHONE l. Jðc..K. G<;;AlT/è. Y ð~~ 3'L3-44Çb 2. L/r=fl,V fl..ó.. M. Nt Cd - T ENtJ.AtvT '32 Z-8'DbO 24 HR. PHONE ~3?.. - ''îZd 1 . lj akersfield Fire De'Dt. r&rdous Materials Di~sion HAZARDOUS MATERIALS MANAGEMENT PLAN e SECTION 3: TRAINING: NUMBER OF EMPLOYEES: [) MATERIAL SAFETY DATA SHEETS ON FIL~: BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST: ! CERTIFY UNDER PENALTY OF PERJURY ïHAf MY BUSINESS IS EXEMPT FROM THE i~EPORïlNG f<EQUIREMENTS OF CHAPTER ó.95 OF THE IICALlFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MA TtRIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANT!TiES AT NO TiME=XCE=J THE MINIMUM REPORTING QUANTITIES. '''-IWC:R (S:::C:C!¡:v RC:'\SON) ---.) ¡ .\-. I i.- ~'I I \-."'"'\ SECTION 5: CERTIFICATION: o:.~ .. '-" . I, .JAc..J<. GEtVTfL T' CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WIll BE USED TO FULFILL MY F!RM'S OBLIGATIONS UNDER THE IIC.ð..UFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER ó.95 SEC. 25500 ET AL.) AND THAi INACCURATE INF RMATlON CONSTITUTES PERJURY. ~ ~/L TITLE 2/ ~ !C;6 DATE J' ". .0 C:US..~r-:::il:l. e1<.l .r li" e .u e p G. e Hazaràous Materials Divisione HAZARDOUS. MATERIALS MANAGEMENT PLAN - Facility Unit Name: GEAJTa..Y I~ av fZ73PA I R... SECTION 6: NOTIFICATION AND EV ACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: --rE-U-:-PW:>NGs ,....J o-r=ÇtC.6 '0 CAc.....(... Ç'ðl2..... HE(P ~ ..J ptA-LtN& <:)-1-1 B. EMPLOYE= NOTIFICATION AND EVACUAilON: V <dLßk /'-lo <; ,¡:-tCÞ-1ioAl $0 ç.ç, Cft:N\" 'j3. E-n"'>EEN S /-IðP <tt Å~ ~ A<. t£S.J"¡ o<-r= \ c.. ë: C. PUBliC EVACUATION: ï6 N(S((;¡,{0:Þf2u..J& ßiJ~tNê?c;.S<S~ t...AJotJl-l) f3E NCJTd:,co SuJ G-Aï£ C\lÂ<...u.d,'E rn-¡; Cc)ŸL1~oN YA.a.O ~ T4E D. ë:v1ERGENCY MEDICAL PLA,N: çl.. Q...·S:T 4/ ö ,¿ /'1 ¿u> S ¿::"""'5 '1 ~ -; P t T "~L - }t....q::;f2.C y 1" ;v15' e Bakersfield Fire Dept. e Hazardous Materials Division "J,~ -ç - . ..,..... o. -, HAZARDO'US MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: C()W'lfl?-c~S~D G-.as. c.Yu/\J/)"E:RS KC<?T Ct-iAINED ~ c..AJ<.'t 3. RELEASE· CONTAINMENT AND/OR MINIMIZATION: ð ß $oQ... ßAJ-J -r- 0<; G-D <Tõ ~K. U P ~ P, <....l., S . r- ',-, . CLE.';N-UP PROCEDURES: WAÇ. 'Œ 0 ( (.... fi<...t<-eo vf) ß'y K~ ð (<- ç:¡ '- TE--'L ~c. <f-'c...t..t...J(:,.. SECTIO N 8: UTILITY SHUT-OFFS (LOCATION OF SHUT -OFFS AT YOUR FAC!lITY): NATURAL GAS/PROPANE: 0(1L ~LECTR!C.';L: ,A.JS,DE PAl<TS ~~. II..J ¡J 1;- C-æAJR... oC SfuP 'IV A ïE~: fVlerc-fl- VALuE- ,tJ ~f) ÁT SW -Coil/veil- oF Ç-IM..Ö SP~C¡AL: LOC:< BOX: YES/NO iF YES. LOC.~,.ï¡ON: SECTION 9: PRIVATE FIRE PROTECTION/WATER A V AILABILlTY: A. PRIVATE FIRE PROTECTION: ?O'l.Ta.~<..~ Ç'lèe= ~'í,,.JG-\J/$~-e..s ,,..,¡ $"~oP B. WATER A V AILABIUTY (FIRE HYDRANT): ::-. ~..' '" BAKERSfiELD CITY FIRE DEP~RTMENT HA!lRDOUS MATERIALS INVERltORY . Page_of_ 8~siness Name aEI\J¡-QY'!. (2\/ REPAIR.. Address I ( D f:.)~ (oN .Au CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New ~ Addition [ ) Revision [ ) Deletion [ ) Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: e >'- Y'~AJ 3) DOT # (optional) Chemical Name: AHM [ ) CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire I ) Reactive ~ Sudden Release of Pressure (CJ Immediate Health (Acute) [ ) Delayed Health (Chronic) [ ] . 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 42- 6) PHYSICAL STATE Solid [ ) Liquid [ ) Gas 1M Pure [ ) Mixture [ ) Waste [ ) Radioactive [ ] æECI<AU. THAT APPlY 7) AMOUNT AND TIME AT FACIUTY <L4q UNITS OF MEASURE 8) STORAGE CODES 4- Maximum Daily Amount: Ibsl)gal[] 1t3 ~ a) Container: Average Daily Amount: "ZA-"1 curies [ ) b) Pressure: Z. Annual Amount: 2.4"1 c) Temperature: 4 Largest Size 'Container: zA.."f # Days On Site "36.ç- Circle Which Months: All Year. J. F. M. A. M. J. J. A. S. O. N. D 9) MIXTURE: List ðXY~N COMPONENT CAS # %WT AHM the three most hazardous 1 ) lÐê::J I] chemical components or any AHM components 2) I] 3) I) 10) Location ?c>ll-T (j. ß<..E C/:!;a..T'" IN ç I J)l; s:G CRN R- c>-C -; tk) P CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New 14" Addition [ ] Revision I ] Deletion I ) Check if chemical is a NON TRADE SECRET I ] TRADE SECRET I ] 2) Common Name: iN ,ð.:'5 T (Ç;. 01<- 3) DOT # (optional) Chemical Name: AHM I] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ Reactive I ] Sudden Release of Pressure [ ) Immediate Health (Acute) I ] Delayed Health (Chronic) liJ 5) WASTE CLASSIFICATION 2'2..( (3-digit code from DHS Form 8022) USE CODE 4ö 6) PHYSICAL STATE Solid I ] Liquid rø Gas I ] Pure [ ] Mixture I ) Waste 'ftil Radioactive I ] CHECKAl...l.. THAT APPlY 7) AMOUNT AND TIME AT FACIUTY s;r UNITS OF MEASURE B) STORAGE CODES 6 Maximum Daily Amount: Ibs I ] gal flr¡1. ft3 I ] a) Container: Average Daily Amount: 3ò curies [ ] b) Pressure: ( Annual Amount: '2..Ci:'::> c) Temperature: 4- Largest Size Container: .s-rs- # Days On Site >c.~ Circle Which Months: All Year. J. F. M. A. M. J. J. A. S. 0, N, D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1 ) W'~TE O'L. I] chemical components or any AHM components 2) I] 3) I] 10) Location ðvÎS/r::>~ g~t.QND ~ úJALC o-Ç ßLO <P <artily und", penoJly of law, that I ha~ pe=""''Y ","""n.. and am familiar with tho '~:;i en thIS a '7d all attacneacrocuments. I believe-me submitted information is true, accurate, and complete, ~ ~ .JÂC-J< GE'N"'~ V ,. 0 £..U N 6R- . ~ PRINT Name & Title of Authorized Company Representative ~nafu,\ "-- J Date RECIOII L£PC8TNCWIDFCIW '9oeø~3Q 1i82 BAKERSFIIãl..D CITY FIRE DEPARiI/IENT HAZARðeUS MATERIALS INVENTO~ ..:''''" ç Page_of_ 3usiness Name Address " . CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition ( ] Revision [ ] Deletion ( ] Check if chemical is a NON TRADE SECRET ( ] TRADE SECRET ( ] i 2) Common Name: 3) DOT # (optional) . ! i Chemical Name: AHM ( ] CAS # ! i i 4) PHYSICAL & HEALTH PHYSICAL HEALTH , HAZARD CATEGORIES Fire [ ] Reactive ( ] Sudden Release of Pressure ( ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] i ! 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE I 6) PHYSICAL STATE . Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture ( ] Waste ( ] Radioactive [ ] I OIEQ(AU. mAT APPlY 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 100 [ ] gal [ ] ft3 [ ] a) Container: Average Daily Amount: curies [ ) b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year. J. F. M. A. M. J. J. A. S. O. N. D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1 ) [ ] chemical components or any AHM components 2) [ ] 3) [ ] 10) Location CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ) Addition [ ) Revision [ ] Deletion [ ) Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ] 2) Common Name: 3) DOT # (optional) ! Chemical Name: AHM [ ] CAS # 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ) Radioactive [ ] CliECI<ALL THAT..-Y 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: Ibs [ ] gal [ J ft3 [ ] a) Container: Average Daily Amount: curies [ ] b) Pressure: Annual Amount: c) Temperature: Largest Size Container: # Days On Site Circle Which Months: All Year. J. F. M. A. M. J. J. A. S. O. N. D 9) MIXTURE: List COMPONENT CAS # %WT AHM the three most hazardous 1) [ ] i chemical components or any AHM components 2) [ ) , 3) [ ] 10) Location certify under penalty OT law, mat I have personallyexammea and am familiar Wlt1'I t1'Ie mfOmation sulJmlttea on UlIS ana aJl attacnea aocuments. J lJelleve Ule submitted information is true, accunrte, and complete. PRINT Name & Title of Authorized Company Representative Signature Date 'Ò.ø.nÞw3Q 1i82 RECIOI¥ L£PCSTANOMOFafU