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HomeMy WebLinkAboutBUSINESS PLAN Per it Operil.te to Hazardous Materials/Hazardous Waste Unified Permit , CONDITIONS OF ·PERM,ITON REVERSE SIDE .' . ..' , .' . . , ".,., " ',' .'?!.;;~0.ji':', ....... . " · ' , . ~ Permit ID #:: 015-000-001833 HUNTERS LAWNMOWERS '··LOCATION: 96 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 . - ., , . . '·1 "- '. : . . ,,~.- .' . Approved by: Issue Date " '."-·,1 . June 30, 2003 PerDl.it to Operftte Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ~'~@~ardous Materials Plan ''''':{ground Storage of Hazardous Materials ·m agement Program Waste 96 PERMIT ID# 015-021.001833 HUNTERS LAWNMOWERS 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 - - 9~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 I FACILITY NAME l/ftlJ'k ~WAJ'lðe/t!YS ADDRESS /1(/ t/h/lln ~ FACILITY CONTACT i';)ðv'Ù~ i-e-¡Ç' - INSPECTION TIME /:r A7/¿Y INSPECTION DATE /11-/5"'-(// PHONE NO. no PÁ~ Qr:/-. bv/~~S BUSINESS ID NO. 15-210- 0/r33 NUMBER OF EMPLOYEES :2-- Sec~ 1: if Routine Business Plan and Inventory Program o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate pennit on hand -IyI Business plan contact infonnation accurate V Visible address ./ Correct occupancy ~ Verification of inventory materials ./ /' \ Verification of quantities ..¡ 5> ::Jq/Ic-? ¡)rv_ ~s -h// (~~) Verification of location ..¡ "- Proper segregation of material V Verification of MSDS availability \I Verification ofHaz Mat training .¡ Verification of abatement supplies and procedures .¡ Emergency procedures adequate V Containers properly labeled -/ -70 /qtJe/ (»7 !UQ ..s:k.- ~ Housekeeping / Fire Protection v' Site Diagram Adequate & On Hand II C=Compliance V=Violation L ONo Any hazardous waste on site?: Explain: ø ds..,-tZ ø,Þ(~ White - Env. Svcs. Yellow - Station Copy Pink - Business Copy /~~ Business Site Responsible Party Inspecto~ ~ Questions regarding this inspection? Please call us at (661) 326-3979 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 °Ho 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 - e May 3,2001 Mr. James Hunter Hunter's Lawnmowers 96 Union Avenue Bakersfield, CA 93307 Dear Mr. Hunter: 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) name of your business; 2) business address; 3) indicate which direction is North; 4) the cross streets neighboring business addresses (within 300 feet) 5) entrances and exits 6) location of utility shut-off's; 7) location of the nearest fire hydrant; 8) portions of the building protected by automatic sprinkler system; and most importantly 9) the location of the hazardous material(s). If you have any questions, please feel ftee to call me at (661) 326-3658. Thank you for your assistance. Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENTAL SERVICES /U Esther Duran, Accounting Clerk II Office of Environmental Services ED\db Enclosures C/' ) (/.' - /~'l .~ /~ </J ~~ ~~ JePf.-IÚ1~ de 6~Wl//lN/U7~ ._0/0"« ../Í/e;(}"~e .:YÁun- .ÁJ (:Y~'/lb"/'r · ¡< tit - HUNTERS LAWNMOWERS SiteID: 015-021-001833 Manager ED AMHED Location: 96 UNION AVE t/tf ljY/IOY7 City BAKERSFIELD BusPhone: Map : 124 Grid: 06B (805) 336-0702 CommHaz : Minimal FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 EPA Numb: SIC Code: DunnBrad: / Title ¡ Emergency Contact Emergency Contact / Title JAMES HUNTER / OWNER g'lJ-~ ED AMHED / MANAGER Business Phone: (805) ~~, Q?Q:dx 10¡;¿ Business Phone: (805) :nr; 0"762Ji Y7t!) p~ ~ 24-Hour Phone : (805) ,2~§ lS67)[ 24-Hour Phone : (805) .-ð26 8 () 14xcrOD.0;30 I . Pager Phone : ( ) - x Pager Phone : ( ) - X I I Hazmat Hazards: Fire DelHlth I I Contact Phone: (805) 336-0702x I : i MailAddr: 96 UNION AVE State: CA , City : BAKERSFIELD Zip : 93307 Owner JAMES HUNTER Phone: (805) 835-1867x Address : 96 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ¡ p= Hazmat Inventory f== Alphabetical Order One Unified List ì All Materials at Site ì Hazmat Common Name... SpecHaz EPA Hazards DailyMax WASTE OIL F DH L 27.00 GAL Low &1 J\/O & I~~S. ~<Õl\-e.. CO (v'lJ- r\í)ùeesS lS l \4 Vff 10 v1 -1- 09/06/2001 (805) 336-0702 """ '" ~-'" ~ ',~ Hunter's Lawnmowers JAMES & DORA HUNTER Owners Sales · Service Sharpening u 96 Union Avenue Bakersfield, CA 93307 ., e - '" CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES: UNDERGROUND STORAGE TANK PROGRAM 1715 Chester Ave., Bakersfield, CA (805) 326-3979 ,- 1. 2. To avoid further action, return this fonn within 30 days of receipt. TYPEIPRINT ANSWERS IN ENGLISH. Answer the questions below for the business as a whole. Be as brief and concise as possible. 5~G-__l {~~~ J ldLf-Dbb 04-- INSTRUCTIONS: 3. 4. ,- ri-,G ~dJ 8l~~ tp SECTION 1: BUSINESS IDENTIFICATIO:'\ DATA BUSINESS NAL\1E: +4Ufl..lTC-r( ~ L.A...JAJMOWC--.czS LOCATION: Cfb UrJ IO,J ,AJ , i . MAILING ADDRESS: CITY: STATE: ZIP: 9)"?,ö7 PHONE: DUN & BRADSTREET NlJj\1BER: SIC CODE: PRIMARY ACTI\ lTY: OWNER: -.1 ANrC-s. 4'1d p~cxo ~ IL/ MAILI:.IG ADDRESS: -( SECTION 2: E\ŒRGENCY NOTIFICA ITO\" CONTACT TITLE BUS. PHONE 24 HR.. PHONE 1. .JÞ-I'-1E 5- LluIJ-'rE It. E:wI\Jé/L 336 -070'- <6sç - ¡~b"7 2. ED ÅMrf..r5:::6 "'^k . , ~'2.b ,.. <lO14 - e HAZARDOUS MATERIALS MANAGEMENT PLAN ",:: ~'....:~" ". ~ - ..... ,., ¡",:-. ...:,",-'~ ,":, _r~1c .".,;.:.,:.',.~,~./,-,~:;',~..~,'.-~; ',?~\.';...;."..'",. - Ii' ~.,... .~~.. . . T '. "_ __' " . ,:~" :?:.~!~].:;-¡;.,' . SECTION 3: TRAINING NUMBER OF EMPLOYEES: '. . 'f~ . MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REOUEST I CERTIFY UNDER PENALTY OF PERJL"RY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: \VE DO NOT HANDLE HAZARDOUS MATERIALS, \VE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTlllliS AT ~O TIME EXCEED THE ~fD.lMUJ\1 REPORTING QUANTITIES. OTHER (SPECIFY REASO:\,) SECTION 5: CERTIFICATION I, CERTIFY THAT THE ABOVE INFOR.\1ATION IS ACCURATE. I L;"'l)ERSTAND THAT THIS INFORMATION WILL BE USED TO Fu1.FILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOCS ~1ATERIALS (DIY. 20 CHAPTER 6.95 SEC. 25500 ET AI..) AND THAT INACCURATE ~rOR.\1ATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 i I ., ~ous MATERIALS MANAGEME'T PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: B, EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC E\'ACUATION: D, E:VŒRGE\'CY :\1EDICAL PL.-\.\; 3 - - HAZARDOUS MATERIALS MANAGEMENT PLAN 0" ~~1 ."~. ~- . ~-':'" .~-~-. '-:- ."'. J.':.,, 1 . ~'t:.;'t.~-~'~·t~~"'·~-· ~".;Ì\-'~"7\i¡~'''''·':r'_~ SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN·! .< ' . . .-t A. RELEASE PREVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATL"RAL GAS/PROPA.1\ffi: ELECTRICAL: WATER: SPECIAL: LOCK BOX: YES/NO IF YES. LOCATION: SECTION 9: PRIVATE FIRE PROTECTIO);¡W ATER AVAILABILITY A. PRIV ATE FIRE PROTECTION: B, WATER AVAILABILITY (FIRE HYDRANT): 4 ---- - - --- ~..- ..-- -- - - -- - ... --. .-. :¡ness Name .AJ~t> L.~ Address .qþ ra~ç_v _ utJ10e CHEMICAL DESCRIFTlON 'INVENTOAYSTA1US: New4f) AddiIianI J ANIion( J Detellanl·-J ChecIc if dIenticå....NON,i1RADlUECIEPF!?:..1RM&IECRET..r ) 3) COT II (opciaM ) 'CommonNMIe: ~<re Dl.I- Chema N.....: AHM r ) CAS II PHYSICAl & HEALTH 1'iAZAAD CATEGORIES Fire PHYSiCAl R.actMI () Sudden Releae of Prenure HEAlTH Immediå Health (Acute) r) CeIa¥ed HMIh (Chranic) r USE CODE 40 WASTE CLASSIFICATION (3-diglt code from DHS Form 802.21 PHYSICAL STATE Solid ( I LioUld ~ Gas ( J "ure [J Mixtunt (] West. ~ ~r') '">ofQf AU. ;-;... r APÞ.· ÄMOUNT AND TIME AT FACILITY MU.lmum Dali., Amount: Ayerage Oaliy Amount: Annual Amount: Largest Size Container: # Days On Site ~NliS OF MEASURE :05 ( J gal k::!] :':3 [ ] cunes ( ¡ 8) STORAGE CODES a) Contatner: b) PreuUnI: c) Temoeratunl: 27 15"" Ç-S- <" 3bS"' P(,ð..S-flL Deu^1 f 4- :;rcle Whlcn Momns: Ä Year. w, F, M, A, M, J. J. A, S. O. ~. D MIXTURE: wst :~e tnree most nazaroous ::"!emrcal comoon.nlS or J.I1y AHM comoonents COMPONENT CAS # %wr 1) ~\ -, 31 LocatIon ,J s+{op I AJS· ~e .$I~~ oÇ CHEMICAL DESCRIPTION 'NENTCRY STAT1...'S New i :'cc:t!on i ! =evlslon ( ) Celetlon' :heCK If cnemrca.i is a NON TRADE SECRET [ TRADE SECRET [ i :"mmon Name: 3) DOT # (oDtlONll) , :,',em'CaJ Name' AHM r ] CAS # I =~YS1CAL & HEAL~ i - .l..ZARD CA TEGCR!E5 Fire ¡ i I .·..ASTE CLASSIFICAT10N ""1YSICAL F'=eactlve i! Succen Release CT ?'~ssure HEAt TIi ,mmeaia1e HealU1 (AcUle~ [} :Je1aVed Health (ChroniC) r : 3-0lglt cooe trom OHS Fcrm 8cn' l,;SE CCCE " =~YS!CAL SiAiE Solid () ~CUIO [J Gas [ ] :'.Jre ] Mixture I Wate [ AIGIOaCtMI ( I -..-.:.)1;: ".. -_I r ./.0. ~MOUNT AND T;ME :'i F:'C:UTY Maximum Callv Amount: Average OallV Amount: Annual Amount: L.örgest Size Container: ., Days On Site _~;ITS ::F'.1EASUiìE 8) STORAGE CODE5 al C,.;¡ntalner: t:) Pressure: C) Temoerature: :S .;3..J.. ~3 ;:..;nes [ ; :,r~:e Wnlcn ,'.lontns: :'11 Yeai'. w, , , M, A. M, J, J, A, S, 0, ~. D ¡ ¡."'(TURE: C:JMPON::Ni ust CAS # %wr ~e (nree most nazaroous 1 . nemrcaJ comoon.ncs or ny AHM comoonenlS ;:: J\ location y unoe, peAflRy Qr law, UTat / nllVe oersomJl¡Y eJClJtnmso ana am familiar WIUT tne mromat/on $ t8d information rs aue, accunttlt. ana como/ere. I Nllme & Title of Au:~C:'lZeQ Comoany Represenrabve ¡ ØflUe¥e 1718 II :¡ :i ~ I :, Ii I' ,/ " i AHM II [ J [ ] [ I . :i :¡ AHM [ I [ J [ J Ii I, i! 11 1/ ¡ I I~nw,-,,,",,,", "I"'" I ~11I""'~~ II~ .I,,;,I~ . '-'" . t"age_oT_ ilness Name - ,~ Address e r~- CHEMICAL DESCRIPTION ¡ CommonJUme: , 'Checlcih:I..*_,.A'NOtfI,1RAœSECRet~·;t"Jt":nw:1e:~(' J . -, -f1' . ,J-...... _ ~ .;...~ '~ 3) DOT tI (......"'_ I INVEN'f'ORYrSTA11JI:'......",.J AdIIIan't'J .........~J~ DeiIIIoItt, J :,;' Chemicat tAme: AHM,( ) CAS tI. I WASTE ClASSlF1CAT10N (3-diglt code from DHS Form 80221 HEAlTH Imrnediar8 Health (Acure) () ~ He"" (Chronic) ( USE CODE ! II 'I :. I PHYSICAl & HEAlTH :-1AZARO CATEGORIES PHYSICAL Fire I J ReactMt I) Sudden Releae of Pressure MIXTURE: Ust :~e tnree most nazataOus :~emlcal comoonems or any AHM comoonents COMPONENT CAS ! %wr :i 1! ., ¡ " ,j :1 I ! AHM ;1 r 1 ! r J r I , PHYSICAl STATE Solid [] uauid r) Gas I ] Pure r] MixIIn [] W.... I] ~f'J '>oEOfAU. ;;'AT~" AMOUNT AND T1ME AT FACIUTY Muønum Cally Amount: Average Q~ Amount: Annual Amount: Latgest Size Container: # Days On Site ;';NITS OF MEASURE :bs ( J gal (] ~3 ( ] cunes [ ] 8) STORAGE COOES a) COntainer. b) Pressure: c) TemoetlllUnt: ::rc:le Whlcn Montns: All Year. ..;. F, 1.1, A, 1.1, J. J, A. S, O. N. 0 1) :) 31 I :) Locahon CHEMICAL DESCRIPTION ,'JVENTCAY STAi1..!S: New ( I Adortlon r I ~evlslon { ] Deletion; : CheCK if chemical is a NON TRADE SECRET ( -mACE SECRET r Common Narne: 3) COT ! (oooonal) .1 , :,',emICaI Name: AHM! CAS # =HYSICAL & HEAL'T:-: -Þ,ZARD CATEGCR!E5 Fire "HYSICAL iieactlve i I Sudden Release ci P'essure HEALTH Immediate Heaitn (Acute. r I DelaYed Health (Chronic) NASTE CLASSIFIC~T10N i:}-dlglt cooe trom DHS Fc:~ 8022' USE CeDE " =~YSICAL STATE Solid (I ~ould [I Gas ( J ='-Ire [] Mixture (] Wate ( ] RadicHllctiVe ( ] --~.cr. "-. -_<It..co.. ':'MOUNT AND TJME .:,j FACIUTY MSJumum CallV Amount: Average OallV Amount: Annual Amount: Largest S,ze Container: ,; Davs On Srte _:-,ms ;:;r= MEASURE :s i : çaJ l : ~3 [ =:ones [ : 8) STORAGE COOE5 a) Container: b) Pressure: c) Tempenuure: :¡rc:e ""'rucn Montns AJI Year, J, " 1.1, A, 1.1, J, J, A, S, O. N. 0 I MIXTURE; Ust 1 '"e tnree most nazaroous ;~emlcal comoonems or \I1Y AHM components COMPONENT CAS ! %wr AHM r] [ ] ( J i :! ;1 ¡¡ :1 ! . 1) 2) 31 , LocatIOn ry unae, pefllllry 01 IØII. url!t nave oerson/llly eJUJmm80 ana am familiar wlm me InrOlTll!l1on $1IDI1IIØfkJ on ttIIa enø IIIJ ~ tted information IS au.. l!ccunrtrt. and comø/ete. ÞeItetIe",. Signatl.n 0..' r Name & Title of Au:,-C:'TZed Comøany RepreaentIJtìVe nas Name Address CHEMICAL DESCRIPTION ? INWNTORY STAtUS: New-f J MIiIiDIt ( J ........ ( J DeteDoItH C,**jf~.~..NON1RADlUe:. -rl~J.,1'RM8~I· ( J 3) DOT ( (..... Common N..: :henIic:* Nwne: AHM' ) CAS¡ t WASTE CLASSIFICATION (3-diglC coøe from OHS Form 8022! HEAL'TH Immedi8raH.... (AcI.U) r ) CeIIIIøM.......(C1uanic) , USE CODE Ii PHYSICAL & HEALTH ~~D CATEGORIES PHYSICAL Fire 'I RelCÞW I I SudcI.n Rele.. of Pressure 'I " 2foiYSICAL STATE Solid ( ) UaUld () Gas ( ) Pure (J MixUn I ) Waste I ) p-·lIc...·fJ 'I II : :i ~fCXAU. .-.....r .;1Ø." ~MOUNT AND TIME AT FACIU'TY Maxønum Dilly Amount: Average aallY Amount: Annual Amount: L..vgesl Size Contllner: .- Cays On Site ~~ITS CF MEASURE :0$ { J ~a.I r J ~3 [ c:.:nes ( ] 8) STORAGE CODES a) COnt.llner: b) Preuura: c) TemDenllUt8: :i ,¡ .1 ,I :::ole Whlcn Montns: ':'11 Year. .;. , , M, ~ M, J, ~ A S, O. N. D .1IXTURE: Lst -e tnree most nazaraous .~em'C&I comconentS or w AI'tM comconents COMPONENT CAS.. %WT AHM :1 [ 1 :! ¡ 1 r ) , ; ,I " : 1) -. ~t ~1 Locanon CHEMIC:'L DESCRIPTION ,'ÆNTCRY Sï;'n.;S. ,'.Jew i ':'cc:t:on i ¡ ::¡eV1Slon ( I Celetlon' I ;mmon Name' :~ecK It enemlca¡ is a NON TRADE SECRET r TRACE SECRET [ : 3) DOT # (OctlOnll) emlCal Name: ':'HM r J CAS# ·"'SICAL & HEAL7':~ ·¡,ARC C":' TEGCFì!ES =,'e ""YSICAL '::eact.ve! : Suaaen Release~· '::"~sswre HEAL. TH ,rTlmeOlale HeaM (Acute) [: :.e1Øeá He8lltl (ChronIC) [ : ':'SiE CU.SSIFIC':'T1CN 3-Clglt coee !rom OHS Fc~ 8CZ:1 L.;SE CC::::E 'YS!CAL STATE Solid [: _:UIQ!: Gas [ ] "'~re j ) Mixture ( Waste [ I RIGIOeCÞVe ¡ ) - .-." --," '.1axlmum Callv Amount· Average Ùall\I Amount: Annual Amount: L..argest Size Container: 1# Oavs On Site :5 .., 8\ STORAGE COOE3 al Container: 0) Pressure: cj TemDercure: :CUNT ANC 7':,','= ~ ";'" ¡: ':'C;LJ~ _,',¡is :,= 1. .=.AsuF.= .:~;:es : ':.:.::e 'r~,M:C~ ...~=r.t:¡s ':"JI Year. .... ,'A. A. M. J, J, A. S. 0, ~. û ~AE: l..;st I :nree most nazaraous I mIca¡ cò'mconenrs or AHM comconents CCMPC~::~í CAS.. %WT AHM [ J Ii I, 11 :1 1/ i¡ I~rn. ¡ J .' ~, 31 r I JcatJOn Jf)oe, pøntIItY 01 /11.l1li. tnat I nave øørsønllJJy eJUUnIn8Ø ana IJI7 familiar "",m me mromaøon suomrrrea on t1Us IIfJQ IIJ ~ ~ m--. ( inionnlltlOn 1$ trUe, IJccunrte. ana coma/ete. 5igfIIItUN Data I sm~ & Title of Au:~c:'lreø Comoany ReDfNenøJtJVe · -- - -- -- - - - - -- - - I "'::1""_--- :ness Name e Address e ctff...U--AL. DESCRIPTION IN'ÆNIOIW<8TA1US:iN_++ ?'- --- tI Aa 'f! n- cnn 1:-1- eomn..~: 'QlealcifdJl ulI..NONmWa~I··l~~""""""'.r J 3) DOT _ faJ l" ~ :hernicå .....: AHM.( ) CAS. !I ~ ?HVSICAL & HEALTH -ØRO CATEGORIES PHYSICAL Fire () Re8CÞW () Sudden ReIe.. of Pressure WASTE CLASSlFlCA110N (3-digtt COde from OHS Fo"" 10221 HEAL11f - ImIMdiCaH......CAcur.. r) ~"""l'Cf¡¡alic) r 1 USE COOE PHYSICAL STATE Solid ( ) WoUld I) Gal] Pure {] MixIIn I ] w_ [] f' Tine.. t: J ;/ II :i ?EŒ AU. ïJ.," AJD. .. ,I :¡ ~NliS OF MEASURE :05 { ] g41 {] ~3 [ ] cunes ( J 8) STORAGE COCES a Conra.r. Þ) Prnaure: c) T errtDer8lUnl: ..MOUNT AND TIME AT FACIUTY Muamum 0_ Amount: A~c.w Amount: Annual Amount: Latgesl Size Contllner: # Davs On Site :i 'I ::rcle Whicn Momns: All YeeJ. .;, '. M. A, M, J. J, A. S. O. N. C '~I,XTURE: Ust ~e tnree mosl nazaraous ::'!emlClll comoonents or ~" AHM comoonents COMPONENT CAS. %oWT AHM ;/ [ J .! [ ] rJ 1) ::) :31 Loc:anon CHEMICAL DESCRIPTION 'NENTCRY STAn.:S: 'ew i Aaortlon I ::¡eV1slon ( I Celetlon' . CheCK r1 cnemlC8l is a NON TRACE SECRET r TRACE SECRET [ :.;¡mmon Name: 3) COT # 10aaonal) ,~em'c:aI Name: AHM' CAS # I "'YSICAL.3. HEAL7:~ I .12ARD CA TEGOR!ES ,=ire "~YSICAL :;eact,ve i ì Suaoen Relesse Cf "'~5sure HEALiH ,mmeallllel1eann (Acute) (1 :Je1a¥8d He"" (ChronIC) :ASTE CLASSIFICATION 3-algrt coae lI'om DHS Fcr'"' eez:' USE CeDE I.fYSrCAL STATE Solid () ...;:UJO [J Gas ( ] ='.:re ] Mixture ( Wasle ( J Raøo.cava I ) -..-.:,.:.... -_4'.a..:»" MOUNT AND T1ME .:.¡ ~"C:UTY MUlmum Cauv Amount: Average i:)êUrv Amount: Annual Amount: Largest Size ContAIner: # Oavs On S.1e _,'<ITS ;:F '.\EASWñE :5 .;aJ i ~3 ;:.;nes [ : 8) STORAGE COOES al Contllner: b) Pressure: C) Temcercure: ':,r::e ~"'n'cn Montns: All Yeer, .;, , . M. A, M, J, J, A. S. O. N, 0 I IXTtJRE; Ust I e tnree most nazaraous ,'emlCal comoonentS or :'1 AHM comøonencs C:JMPCNENT CAS ;It %WT AHM [ J [ ] [ 1 I " ,I ,I I ;j :1 ! I 11 ::1 :31 ~oc:anon , una., pelVllty or 1lIW. mill nllV. O.1$OfJ1JJ1 f .1UIITItn8Ø ano sm rsm/llM w,rn 177. InTOmIIlIon suonuøeø on tIJIS lUIØ all .øacneø '8d intormation IS au.. accunltlt.lUIØ comø/.,.. ø.....,. me ~.",. & Title 0/ ~c~ Comoany fiepreøntlllllle Signan ~ Î ' e SITE DIAGRAM r 1 Business Name: Business-Address: ' e FAClLl'lYDIAGRAM r 1 . -.....r --- "-/:"' ...",)t.·.~,.... N<if