HomeMy WebLinkAboutBUSINESS PLAN
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SITE DIA(;RAM ¡'Ii ~ FA~GRAM I
Business Name:
Business Address: (Y;:;~ __ Cf£
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUSMATEIDALSMANAGEMENTPLAN/
INSTRUCTIONS:
To avoid further action, return this form 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.
You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for ir@b!~ion.
SECTION I: BUSINESS IDENTIFICATION DATA\_'1 DEC 1 2 2000
ENVIRO,." ~ERVICES
1.
2.
3.
4.
5.
BUSINESS NAME: j) ¡ ;JI-~ iI 5 't rl r II r .5
LOCATION: ~K S r / /)¡ Ca /
MAILING ADDRESS: ~/7 11/1710'//1 All£-
r[) 1./ r· ' (1J'1. 93JtJ7 ~(- -::9
CITY: rY-l'- 5r I~ STATE:u,:-ZIP: PHONE: J 9'Y/7"70
PRIMARY ACTIVITY: II S<-e dCaf'-5
OWNER:
MAILING ADDRESS:
EMERGENCY NOTIFICATION
CONTACT
1. KH'eh L iuY~T/
2. \)ÕrY f, W,/u7/
TITLE
24 HR. PHONE
BUS. PHONE
vav~ 41;1:-
/
Ow J17' t---
HOM 'e (oQ ~ 1- !ll/-I ¿ JfJ'
H~ (P(PI- 3 r;'~oCcP3
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HAZARDOUSMATEIDALSMANAGEMENTPLAN
SECTION 11.1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
!1J~.
B. EMPLOYEE AND AGENCY NOTIFICATION: NO £ M ~/o /' e e-
C.
ENVIRONMENTAL RESPONSE MANAGEMENT: )
oJ ",j ~ f ¡ç~", I" 0'( t11...f~Þ ':'./:$ ~"- j)ð/'i 0Y <{ 7T
D. . EMERGENCY MEDICAL PLAN:
c~ II f//
2
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 11.2: RELEASE RESPONSE PLAN
A.
HAZARD ASSESSMENT AND PREVENTION MEASURES:
1»011' K\4~/p ClVL,/ /{i;?af-d tUtf?t---e-- 4/1-V..fL ql/ () I'~/ ('4~~~
-c1C)~ "f' ",<"¡'" ¡/v 6-< :3 Z 0¡þ 5 w Å'-f'1-t tVY'.? "c!' -T- S Fn () J
B. RELEASE CONTAINMENT AND/OR MITIGATION: V-e c/o", '''/ /<\.O'-<'r:, 4'1-t;/
i(J4 5 r~ 4ft' pÞ/."A
C.
CLEAN-UP AND RECOVERY PROCEDURES: jVc~ ¡¡JO /H.v~/-/;~
ry(~ 1<---,,1' ( 7 e~~I^'1h (~ I(¡tv leJ 0 Jý- () f C !-"'-
UTILITY SHUT -OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
J'.!A TURAL GAS/PROP ANE: a t- tI~ . /VI. '¿~r 0 "L ~ rd. if
ELECTRICAL:54vf--o.s~ W~~t-- s¡J.O,f-"f}f[~ ~"c....Á- ~/cI~
WATER: Cðrl¡~&,.>-...ç 3J~ *- t.I.-'Yl<~ 111/-<..- ...,-:1- .self 5-.(>frVl<-"+> 3f.-tP~ C+cPfrd/::tfi
SPECIAL:
. LOCK BOX: YESINO IF YES, LOCATIQN: N ()Y'VL-
PRIVATE FIRE PROTECTION/W A TER AVAILABILITY
A.
PRIVATE FIRE PROTECTION: C~) 0fr~~ -e x1ï~ju..I·5 k-f';- S
B.
WATER AVAILABILITY (FIRE HYDRANT):
c .. -1.../ tVc. t-r- t-- 4 + '3.u. ~Uø /;J1
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3
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HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES:
1\J~"
MATERIAL SAFETY DATA SHEETS ON FILE:
!IJ~
BRIEF SUMMARY OF TRAINING PROGRAM: IJl~
CERTIFICATION
I~ DON tv,!" tI CERTIFY THAT TIlE ABOVE INFORMATION
IS ACCURATE." I ERSTAND THAT THIS 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
~
TITLE
! 2-/(-~
DATE
4
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--
e
DONS USED CARD
SiteID: 015-021-002078
Manager :
Location: 217 UN]ON AVE
City BAKERSRIELD
BusPhone:
Map : 103
Grid: 32A
(661)
CommHaz Low
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 06
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title f)WJ1~¡' Emergency Contact / Title
/ fc· / )5él?J_~
Business Phone: «(0'" ) 37>- J r x ð' Business Phone: ( x
24-Hour Phone : (~tPl ) J"" - "6 xc:?J 24-Hour Phone : ( ) - x
Pager Phone : <f:"n71.f7-3lo xl? Pager Phone : ( ) - x
Hazmat Hazards: Fire DelHlth
Contact : Phone: (661)37.J=. /7 xf'J?
MailAddr: 217 UNION AVE State: CA
City I Zip
: BAKERSE'IELD : 93307
Owner DONS USED CARD Phone: (661)3f'~ /7 x FrY
I
Address : 217 UN]fON AVE State: CA
City : BAKERSFIELD Zip : 93307
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
Emergency Directives:
AJ tJY'--L--
One Unified List ~
All Materials at Site ~
p= Hazmat Inventory
p== As Designated Grder
Hazmat Commo~ Name...
SpecHaz EPA Hazards
DailyMax
WASTE OIL
F
DH
L
110.00 GAL Low
~, :PòtV(T 4/~~ 77 Do hereby cei1if\l ìhaì ¡ have
ype orÞrrnt name) "
reViiewed the attached hazardous materials manage-
me:nt plan 1or/Jð4!..{)S't'rI~r5 and ìhaì jft aionfi with
(Name of BusIness) ~
;any corrections consìiìuie a compleie and correct man-
;ag~meni plan for my iacility.
-1-
11/09/2000
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0001
GHEMICAL NAME
SiteID: 015-021-002078 ì
Facility Unit: Fixed Containers at Site ì
F DONS USED CARD
f= Inventory Item
= COMMON NAME /
WASTE OIL
Days On Site
365
Location withi~ this Facility Unit
NE CORNER OF YD
Map:
Grid:
CAS #
221
STATE - TYPE
Liquid Waste
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
DRUM/BARREL-METALLIC
Largest Container
55.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
110.00 GAL
Daily Average
110.00 GAL
HAZ U EN
%Wt. RS CAS #
100.00 Waste Oil, Petroleum Based No 0
ARDO S COMPON TS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NfPA USDOT# MCP
No No No No/ Curies F DH / / / Low
HAZARD ASSESSMENTS
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11/09/2000
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- CITY OF BAKERSFIELD_~
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
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Of
101
102
103
105
107
108
F^ClLI'TY ID #
! SITE ADDRESS
2(1
CITY
DUN &
BRADSTREET
COUNTY
1 Year Beginning
100 Year Ending
3 BUSINESS PHONE
U!\f/OìJ
104 ~ ZIP
106 SIC CÇlDE
(4 Digit #)
,
i OWNER NAME
I
¡ OWNER MAILING
ADDRESS
113
CONTACT MAILING
ADDRESS
119
128 PAGER #
':'~~~~l~¡:'·f;;~~~~f;:,~;·:Y~fB~ílT!:I~;:'
Certification: Based on my Inquiry oNhose Individuals responsible for obtaining the Infonnation, I certify under penalty of law that I have personally examined
and am familiar with the infonnation $ubm/tted in this inventory and believe the infonnation is true, accurate. and complete,
SIGNATURE OF OWNER/OPERATOR DATE 134 NAME OF DOCUMENT PREPARER 135
NAME
TITLE
BUSINESS PHONE
24-HOUR PHONE
PAGER #
122
123 NAME
125 TITLE
126 BUSINESS PHONE
127 24-HOUR PHONE
129
130
131
132
133
NAMES OF OWNER/OPERATOR (print)
136 TITLE OF OWNER/OPERATOR
137
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UPCF (7/99)
S:\CUPAFORMS\OES2730.TV4.wpc
e CITY OF BAKERSFIELDe
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
a ~ DADD
200
D DELETE
D REVISE
,',". ~
(one form per mateli8/ per ÞuHaing or area)
Page of
~~. ." . . ,'.' ..':}t;::~'-¡I:f0?J::· C:;:;::,,;t:(+";'~~~~::,·:íS~Åê~ii~~~~~~:~?:',;;;,\·
BUSINESS NAME (Same as FACILITY NAME or DBA· Doing Business As)
DON (') vS &)
rJ E c.ot<rJC -12- c>F
".",
," '",.':
CHEMICAL LDCATION
fVL<)
y lY2.0
3 I
!
1 MAP # (optionlll)
203
..,. ·····.;:h:~:~~~~;;)t~:~i:(j~.Ç~~.~~~~t~~~;(;~;;):~i.~:.>'
:~.;::.:.~'
...:;...::';.;>.:....>
205
o Yes 0 No 206
If Subject to EPCRA. reff ( to instructions
CHEMICAL NAME
W'Ä') 'fE
CJ ( L
207
COMMON NAME
EHS'
o Yes 0 No 202
204
o Yes 0 No 208
CAS #
209
FIRE CODE HAZARD CLASSES (Complete requ\lSled by local fire chief)
210
TYPE
DpPURE
211
RADIOACTIVE
Dyes 0 No
215
o m MIXTURE
£F w WASTE
212
CURIES
213
PHYSICAL STATE
LARGEST CONTAINER
s-s-
Jã I UQUID
o 2 REACTIVE
OgGAS
o s SOUD
214
FED HAZARD CATEGORIES
(Check atl that apply)
ANNUAL WASTE
AMOUNT
Jf1 FI~
04 ACUTE HEALTH
o 3 PRESSURE RELEASE
o 5 CHRONIC HEALTH
218 AVERAGE
DAILY AMOUNT
217 MAXIMUM
DAILY AMOUNT
(()
110
10
221
DAYS ON SITE
222
UNITS'
~gaGAl OdCUFT
. If EHS. amount must be In Ibs,
o In TONS
223
o Ib LBS
STORAGE CONTAINER
(Check aD that apply)
o a ABOVEGROUJ':!D TANK
o b UNDERGROUf:lD TANK
Dc TANK INSIDE BUILDING
BiJ'd STEEL DRUM
De PLASTICINONMETALUC DRUM
Of CAN
o 9 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
216
219 STATE WASTE CODE 220
o q RAIL CAR
o r OTHER
STORAGE PRESSURE
o aa ABOVE AMBIENT
o ba BELOW AMBIENT
224
¡a . ~IENT
~.~IENT
STORAGE TEMPERATURE
o aa t'BOVE AMBIENT
o ba BELOW AMBIENT
o c CRYOGENIC
225
226
ZZ7 o Yes 0 No 228
231 o Yes 0 No 232
235 o Yes 0 No 236
239 o Yes 0 No 240
243 o Yes 0 No 244
2
230
3
234
4
238
5
242
,,' .... .
....., <~., .
/:~~~~:;x;;::r -,
DATE 246
.;~~ .
";,,".
229
233
237
241
245
JPCF (7/99)
S:\CUPAFORMS\OES2731,TV4,wpd