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HomeMy WebLinkAboutBUSINESS PLAN 5/10/2007','; THE-~iiVIAGE SOURCE~r~ `` II ~ i; 111214TH STREET _ ~___ ~, ~°~ ~o~~, UNIFIED PROGRAM INSPECTf CHECKLIST SECTION 1: Business Plan and Inventory Program Prevention Services R T R s F , . „ 900 Truxtun Ave., Suite 210 F~Re Bakersfield, CA 93301 ARTM T Tel.: -(661) 326-3979 2171 F 661 872 - ax: ( ). - FACILITY NAME ~ - Q N a w 15 nJCS o s2 n,,. INSPECTION DATE S j~ 0/ 0 7 INSPECTION TIME - ADDRESS ~ PHONE N0. NO OF EMPLOYEES I 1 t 2- ~`a ~ 5 2s -5~)g >~ FACILITY CONTACT ~ BUSINESS ID NUMBER 15-021-O1s- !l2:1"c~C3 Section 1: Business Plan and Inventory Program ^ ROUTINECOMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING a~ ^~ FIRE PROTECTION ~r v. t~ 8~+ ~F-ri--~.~.~ r 1-,4 . ~ - ~.J a-.. ~~e ~ ~ -B' ^ SITE DIAGRAM ADEQUATE & ON HAND Cd 17"` 0~-~C "- tOa.~i G+ Se d~.. W e ~t dwir 1 ANY HAZARDO`U'S WASTE ON ITE? AYES ^ NO EXPLAIN: ~/~ Ql 5 '~L ~1 k e r ~ w01 ~ t Z ^~ 2es 1 QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # .Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy - FD 2155 (Rev. 09/05 1 LD F ' ~'o CITY ®F BAKEItSFIELD FIRE DEPARTMENT ro OFFICE OF ENVIRONMENTAL SERVICES •'~ UNIFIED PROGRAM INSPECTION CHECKLIST ~`~gti,~~`~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME /~G ~' ~, n~ ~''~- t S ~, E ss •-~'v ~, ~„ s INSPECTION DATE ~ ~/~ ~ ~_ -~ Section 4: Ilazardous Waste Generator Program EPA ID # ~~-- d~ `~'~© ~ S ~ Z-7 ^ Routine ~l Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number !~L ~ppp ~ ~ ~` 2 Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekty inspection of storage azea Ignitable/reactive waste located at least 50 feet from property line N~~ Secondary containment provided N,~ ~ cz 0 S LG~nd c, C'v...-~'~ ~,. Conducts daily inspection of tanks + ~°~ ~1~or ~ c~~c xN~ Used oil not contaminated with other hazardous waste /~ Proper management of lead acid batteries including labels ~ ,~ Proper management of used oil filters Transports hazazdous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years ~j~~} ~ .~,..,~ ~,~y „~,yQ ~ Retains hazazdous waste analysis for 3 years ~ 'Y ~y s e l ~`~ ~ w ~ i ~ Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal wL .k ~~ ~=~ompuance v=vtoianon Inspector: ~~~"' ~ ^'^ ~~ Office of Environmental Services (661) 326-3979 Business Site Res nsi e P y White -Env. Svcs. Pink -Business Copy Y ~. ,. ~ . , . ~. '.~ KERN BUSINESS FORMS MFG SiteID: 015-021-002051 Manager GARY FULTZ Location: 1112 14TH ST City BAKERSFIELD BusPhone: (661) 325-5818 Map 103 CommHaz Low Grid: 30C FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: CAL000065927 SIC Code:2759 DunnBrad:DO-850-6487 Emergency Contact / Title Emergency Contact / Title GARY FULTZ / PRESIDENT RON CHAPMAN / VICE PRESIDENT Business Phone: (661) 325-5818x Business Phone: (661) 325-5818x 24-Hour Phone (661) 832-7160x 24-Hour Phone (661) 664-1384x Pager Phone (661) 319-5595x Pager Phone (661) 319-5594x Hazmat Hazards: ImmHlth Contact RON CHAPMAN Phone: (661) 325-5818x MailAddr: 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 Owner KERN FORMS INC Phone: (661) 325-5818x Address 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ ~ `~~~ PROG H - HAZ WASTE GEN , ~~~ ~~ ;: ~~,,,{~ erg my ir~~uiry of those individuals ;~~,~c;;~~;~,fe Sor obtaining the information, I certify cncte+~ p'=r'~alty or la\~~ that I have personally +:,Yarninecl and am familiar with the information ;~~,~,~n~i?Fcd an.! t?2iIP.\r P, the information is true, aocurute, ar~d compiAte. ~f~ ~~ Sign tur Dat -1- 07/12/2007 F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... ISpecHazIEPA Hazards) Frm I DailyMax IUnitIMCPI WASTE INK IH L ~Cf' GAL UnR 2505 -a- 0~/12/200~ -3- 07/12/2007 F KERN BUSINESS FORMS MFG ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE INK Location within this Facility Unit SE CRNR IND AREA STATE Liquid TYPE PRESSURE Waste ~ Ambient SiteID: 015-021-002051 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Daily Average 5.00 GAL Largest Container Daily Maximum 5.00 GAL 5.00 GAL HAZARDOUS COMPONENTS cwt. RS CAS# t1HGEiKL L~J~L' .5.~1~11;1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -4- 07/12/2007 F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/18/2000 ~ VISUAL. Employee Notif./Evacuation 05/08/2006 OPERATIONS MANAGER, GARY FULTZ, OFFICE OF ENVIRONMENTAL SERVICES 326-3979, AND SAFETY KLEEN 559-486-1960. Public Notif./Evacuation 10/18/2000 OPERATIONS MANAGER OR PRODUCTION MANAGER TO NOTIFY AUTHORITIES. Emergency Medical Plan 10/18/2000 REMOVE PERSONNEL FROM AREA, TRANSPORT TO MERCY HOSPITAL EMERGENCY ROOM. -5- 07/12/2007 F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/05/2006 ~ CONTRACTED WITH SAFETY KLEEN FOR PROPER CONTAINMENT EQUIPMENT AND DISPOSAL. PERIODIC INSPECTION BY SAFETY KLEEN AND PLANT MANAGEMENT. Release Containment 05/08/2006 REDUCED CONTAINER SIZE TO LIMIT AMOUNT STORED AT ANY GIVEN TIME, 15-GAL CONTAINER, NEVER MORE THAN 50% FULL. Clean Up SAFETY KLEEN REMOVAL AVERAGES 12-15 WEEKS. 06/05/2006 V1.11G1 1ZC a7VU1 l.C til: 1.1 VGLL1V11 -6- 07/12/2007 F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JC 1:1Q1 ncL C,aiu~ Utility Shut-Offs 05/11/2007 GAS - OUTSIDE IND AREA BEH OFFICE W PARKING LOT ELECTRICAL - INSIDE IND AREA BEH OFFICE W WALL WATER - FRONT OF OFFICE NEAR ST Fire Protec./Avail. Water 02/02/2007 PRIVATE FIRE PROTECTION - 4 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - CRNR M & 14TH ST 200-300FT SW OF OFFICE. Building Occupancy Level 06/05/2006 EMPLOYEES -7- 07/12/2007 u_ F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/08/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE READ ALL OUR MSDS SHEETS WHICH PRETTY WELL SUMS UP THE PRODUCT AND ITS DANGERS. rays ~ ilclu LV1 rUI.UlC V5C nG 1l.L 1Vl r ul.UtC USC -8- 07/12/2007 a~:.. KERN BUSINESS FORMS MFG SiteID: 015-021-002051 Manager GARY FULTZ Location: 1112 14TH ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: BusPhone: (661) 325-5818 Map 103 CommHaz Low Grid: 30C FacUnits: 1 AOV: SIC Code:2759 DunnBrad:DO-850-6487 Emergency Contact / Title Emergency Contact / Title GARY FULTZ / PRESIDENT RON CHAPMAN / VICE PRESIDENT Business Phone: (661) 325-5818x Business Phone: (661) 325-5818x 24-Hour Phone (661) 832-7160x 24-Hour Phone (661) 664-1384x Pager Phone (661) 319-5595x Pager Phone (661) 319-5594x Hazmat Hazard ~__.___ _ . _ _ -~, ImmHlth Contact : , ~~,©~ G~~~I/~p(u,~l~( Phone: (661) 325-5818x MailAddr: 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 Owner KERN FORMS INC Phone: (661) 325-5818x Address 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE .GEN of those individuals i ry Ba=ed on my inqu responsible for oofial wgthat 11 fhavetlpersona ly a. under penalty mined and am familiar with the information e t , exa ru submitted and believe the information is lete ~~ ~ ~ ® ~ ~ l7 ~~~~ . _ accurate, and comp ~" Q Signa ur Date i -1- 02/02/2007 ~~ ~ F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP WASTE INK IH L 30.00 GAL UnR -2- 02/02/2007 -3- 02/02/2007 F KERN BUSINESS FORMS MFG ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME WASTE INK ' Location within this Facility Unit SE CRNR IND AREA STATE TYPE PRESSURE Liquid TWaste ~ Ambient SiteID: 015-021-002051 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 15.00 GAL 30.00 GAL 30.00 GAL HAZARDOUS COMPONENTS gWt. RS CAS# riAGA1CL A~~i5~51~11";1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -4- 02/02/2007 ;. F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/18/2000 ~ VISUAL. Employee Notif./Evacuation 05/08/2006 OPERATIONS MANAGER, GARY FULTZ, OFFICE OF ENVIRONMENTAL SERVICES 326-3979, AND SAFETY KLEEN 559-486-1960. Public Notif./Evacuation OPERATIONS MANAGER OR PRODUCTION MANAGER TO NOTIFY AUTHORITIES. 10/18/2000 Emergency Medical Plan 10/18/2000 REMOVE PERSONNEL FROM AREA, TRANSPORT TO MERCY HOSPITAL EMERGENCY ROOM. -5- 02/02/2007 F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/05/2006 ~ CONTRACTED WITH SAFETY KLEEN FOR PROPER CONTAINMENT EQUIPMENT AND DISPOSAL. PERIODIC INSPECTION BY SAFETY KLEEN AND PLANT MANAGEMENT. Release Containment 05/08/2006 REDUCED CONTAINER SIZE TO LIMIT AMOUNT STORED AT ANY GIVEN TIME, 15-GAL CONTAINER, NEVER MORE THAN 50o FULL. Clean Up SAFETY KLEEN REMOVAL AVERAGES 12-15 WEEKS. 06/05/2006 ~,_ v~.tict ncavu~.~c 111..1.1V0.1.1V11 -6- 02/02/2007 ,. F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~~J~C:1ci1 rici'GdiU~ Utility Shut-Offs 12/13/2006 A) GAS - OUTSIDE IND AREA BEH OFFICE W PARKING LOT B) ELECTRICAL - INSIDE IND AREA BEH OFFICE W WALL C) WATER - FRONT OF OFFICE NEAR ST D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 4 FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - CRNR M & 14TH ST 200-300FT SW OF OFFICE. 02/02/2007 Building Occupancy Level 06/05/2006 8 EMPLOYEES -7- 02/02/2007 ~; F KERN BUSINESS FORMS MFG SiteID: 015-021-002051 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/08/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: WE READ ALL OUR MSDS SHEETS WHICH PRETTY WELL SUMS UP THE PRODUCT AND ITS DANGERS. ray e ~ Held for Future Use _,~ r-- aaciu ivi i'u~utc vac -8- 02/02/2007 + KERN BUSINESS FORMS MFG _____________________________ SiteID: 015-021-002051 + Manager ~~.v ~~~-- Location: 1112 14TH ST City BAKERSFIELD BusPhone: (661) 325-5818 Map 103 CommHaz Low Grid: 30C FacUnits: l AOV: CommCode: BFD STA O1 SIC Code:2759 EPA Numb: DunnBrad:DO-850-6487 Emergency Contact / Title Emergency Contact / Title . GARY FULTZ / PRESIDENT RON CHAPMAN / VICE PRESIDENT Business Phone: (661) 325-5818x Business Phone: (661) 325-5818x 24-Hour Phone (661) 83.2-7160x 24-Hour Phone (661) 664-1384x Pager Phone ((~6 i ) 3(~ -~~'~x Pager Phone ( j~, ~ ) 3 rq - ~~~ Hazmat Hazards: ImmHlth Contact Phone: (661) 325-5818x MailAddr: 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 Owner KERN FORMS INC Phone: (661) 325-5818x Address 1112 14TH ST State: CA City BAKERSFIELD Zip 93301 +---------------Y--------------------- -----------------------------------------+ Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG H - HAZ WASTE GEN ~N~ ~ ~~~Zp~~ f i=3ased on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally ?~amined and am familiar with the information s~:omitted and believe the information is true, accurate, and complete. ~ 6~0 Date -1- 05/08/2006 ' "'" ' -'~ ':',N" street Ink I.::i~i::.¥.:.l Plates Film Wash.UPTank -> ~ i!i:~::::::I~. '~: (Safety Kleen) ::'.;":~ :?' :~.i Flammables i:/::: Waste Ink 15 gaI.Cont. --> O }!!}}?'~:'::'] {Safety Kleen) ..:':.:Photographic:.:. ?)~ Chemicals ~:'~:'~ & Supplies ?'. Entrance Freight "--~ ~ Door ~s ~ O~ : 0~ Water Entrance "M" Street " ..~ NOTE CHANGE OF ADDRESS: tllJoNI Kern's Fitzgerald Graphics 1112 - 14th Street 324-3579 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This I;~rmit is Issued for the following: E] Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program [] Hazardous Waste On-Site Treatment PERMIT ID # 015_021-002051 KERN BUSINESS LOCATION 1112 ~ C t301 OFFICE OF ENV1R ONMENTAL SER VICES' c~ 1715 Chester Ave., 3rd Floor Approved by: /0 ~o'D~'~-~ Bakersfield, CA 93301 umceofEv~Services Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: -lun~_ -~fl~ ~flfl~ T~du~t:r±al area 60.3' 100.0 ~torag~ 100. O' 0.~'~ 95 0 ' 22&0'30 0_0_' :~_~e~n~ 30. D' Office ~-~0, 4 O' W 108.0' KERN BUSINESS FORMS MFG SitelD: 015-021-002051 Manager :_e9~%~'- BusPhone: (661) 325-5818 Location: 1112 14TH ST ~' Map : 102 CommHaz : Minimal City : BAKERSFIELD Grid: 34D FacUnits: 1 AOV: commCode: BAKERSFIELD STATION 03 SIC Code:2759 EPA Numb: DunnBrad:DO-850-6487 Emergency Contact / Title Emergency Contact / Title GARY FULTZ / PRESIDENT RON CHAPMAN / VICE PRESIDENT Business Phone: (661) 325-5818x Business Phone: (661) 325-5818x 24-Hour Phone : (661) 832-7160x 24-Hour Phone : (661) 664-1384x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: ImmHlth Contact : Phone: (661) 325-5818x MailAddr: 1112 14TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner KERN FORMS INC Phone: (661) 325-5818x Address : 1112 14TH ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: (TyM or print name) reviewed the attached hazardous materials mar~age- ment plan for ~;: .~~ ~7'~, an~ ~ha~ ~ a~¢n~ with any ~e~ions ~nstitute a ~;~t~ a~d ~rr~ man- a~ement plan for my facility. -i- 08/22/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., yd Floor, Bakersfield, CA 93301 FACILITY NAME ~r-v.~ "~os~.~ 'j~ INSPECTION DATE //- ADDRESS Il ~ & I q,.ra $,,; PHONE NO. FACILITY CONTACT "~o~,j C/~a?t~^o BUSINESS ID NO. 15-210- INSPECTION TIME ~.~ ~,~J NUMBER OF EMPLOYEES Zn 1: Business Plan and Inventory Program urine I~ Combined [~ Joint Agency [~ Multi-Agency [-~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training v/ Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~Yes I~] No Questions regarding this inspection? Please call us at (66 i ) 326-3979 any White- Env. Svcs. Yellow- Station Copy Pink- Business Copy lnspecto.r: . ~ ~_.,_.,.,~,~___ FITZGERALD GRAPHICS SiteID: 015-021-000909 Manager : ROOER &PAULINE POIRI~ BusPhone: (661) 324-3579 Location~ ~0~ l@~I ~T ~1~_/~~ Map : 103 CommHaz : Moderate City : BAKERSFIELD '- -'' Grid: 30D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:7336 EPA Numb: DunnBrad:22-65-9916 Emergency Contact / Title Emergency Contact / Title .~ULI~m J ~oinI~n / OWneR aO~n ~ ~OIRI~ / OWNER Business Phone: (661) 324-3579x Business Phone: (661) 324-3579x 24-Hour Phone : (661)589 10293c~.~b 24-Hour Phone : (661)509 1029x~-~ Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : ROCER & PAULINE POIRIER Phone: (661) 324-3579x MailAddr:,900 18TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner ROCER & PAULINE POIRIER ~~~. Phone: (661) 589-1029x Address :, 105 RITTER CT /1l~144~. State: CA City : BAKERSFIELD Zip Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: BUSINESS SOLD TO KERN BUSINESS FORMS 11/00 DELETED BILLING FOR FITZGERALD. WAITING FOR NEW OWNER TO SUBMIT BP. ~ Hazmat Inventory One Unified List ~--Alphabetical Order Ail Materials at Site Hazmat Common Name... IspecHazlEPA HazardsI Frm I DailyMax Iunit MCP ISOPROPYL ALCOHOL F L 70.00 GAL Mod MISC. PRINTING INKS F DH S 394.00 LBS Min PRINTING PRESS CLEANER E F DH L 350.00 GAL Ext ~y~ or p~nt name) reviewed ~he a~ached h~ardous materials manage- ment plan any corrections conmitu~o a comple~o and correc~ man- agement plan for my facili~. KERN o~.~z BUSINESS, (80~) ~2~8~8. [=ORMS ~AX (80,5) 325-0834. MFG. 1112 - t4th Street p.;,..,~' Bakersfield. CA 93301 CITY OF BAKERSFIELDO OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALs MANAGEMENT PLaN I. o o' further.~ion, return this ~orm within"30/d:ys of receipt. 2. TYPE/PRINT~ANSWERS IN ENGLISH. ,~r.......~ 3 Answer the questions below for the business as a whole · . 4. Be as brief and concise as possible. 5. 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 initial submission. SECTION I: BUSINESS IDENTIFICATION DATA MAILING ADDRESS: Ba.~- · CITY: ~O~,'~.~,. STATE: 0-~ ZIP: ?~ot PHONE: PRIMARY ACTIVITY: ?rt q- ~lS4w~-a~,,- gu~,t~,~e-s'x ~ OWNER: ~:~ e4rln ~r-u~<~ ~[~ucO-, PHONE: MAILING ADDRESS: Ill 9.- /L/fi` EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN. SECTION II. 1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: B. EM?LOYEE AND AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN - . .... ! ~-. '- A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: 0~,~. ~ ELEC~C~: ~ ~~ ~ , ~ WA~R: ~~ ~ V~ ~ ~--- SPEC~: LOCK BOX: ~S~ ~ ~S, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDe): 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 5 MATERIAL SAFETY DATA SHEETS ON FILE: ~,'{-e._ ~ ..~ d)~S ~ BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION I, C~ ~"-tz-t(,'~z-~ ' CERTIFY THAT THE ABOVE 12qFORMATION IS ACCLrRA~E. I UNDERSTAND 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. SIGNA TITLE DATE 4  CITY OF BAKERSFIE~ i~CE OF ENVIRONMENTAL~ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 "'*~'"'~~'"*'" ~*"'" BUSINESS OWNER / OPERATOR IDENTIFICATION FACILITY INFORMATION Page __ Of __ *." ' ~%C¢~.~:~%;~i~5~:*~`~;~`?+~<~G~:~:;~?~E;~!~7~d~`:~:; '! ~ ' '~ '~ · . '~F~',~.';'~:~./'.¥"~.' 4' . ,:'*..;*. ~, ' ' ''' '")' ' BUSINESS ~ME ('Same as FACILI~ N~E ~ DBA- Ooi~ Busin~ ~) 3 BUSINESS PHONE SITE ADDRESS I / l~' /~ ~ DUN& ~0 -- 8~ g g~ '~ SIC CODE ~a ,o7 B~DSTREET ~ (4 Digit g) ~ ~ ~ ! cou.w OPE~TOR NAME , ~ ~ '~. OPE~TOR PHONE ~[- ' ';"'~" G':['>' -'-',-~ &'-", ]'. '~-~ Lk"*'"';~' · ;-],-iV ~-:" · '~2~.~' ~Y--" q ;~'¢'""~ 'k'[' '.- ~- ~ ,~. ;'"'.",-'~~;:'. .C ' "'y~;~ ']?;'~.. ;".,'" ,~L' ;~--. ~.'.'. -. ~ ' . O~ER ~ME ~ ~S ~_ '" O~ER PHONE g; O~ER ~ILING CONTACT NAME ~ ~ ~ ~7 t CONTACT PHONE 118 CONTACT ~ILING ADDRESS CI~ 1~ ~ STATE 121 ~ ZIP ~. ~.'~-~ ~?'~< ,~L:;?".:',~~::~;. ':'~/:.'.-~ ~:77 :~.~L;?'~:~ EMERGENG~:.~ONT~GTS. y~:~:?.':-';~.~: '::~2,.,~:)~,~EGONDARY,~ ~:..' ;:~..:...: BUSINESS PHONE ~ 1~ 72¢~ ,~6 BUSINESS PHONE ¢~ f - 3~-~[¢g 24-HOURPHONE ¢~/- 3l~- 5~ 127 24-HOURPHONE ¢~t-- 3l?~¢ 132 PAGER g ~ ~ PAGER ~ ~' 133 ~aia~aon: Ba~d on my inqul~ of ~ose IndMduals responsible for ob~ining ~e Info~aaon, I ~ under penal~ of law ~at I have pe~nally examined and am ~miliar wl~ ~e in~aaon submi~d in ~is ~ventow and ~lieve ~e info~aaon Is ~e, a~m~, and ~mplete. SIG~~ DATE 1~ NAME OF D~UMENT PREPARER 135 ~MES OF O~E~O~TOR~dnt) ~ ~ae TITLE OF O~E~OPE~TOR ~CE OF ENVIRONMENTALn~IERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 '~""~~~'""~'"' HAZARDOUS MATERIALS INVENTORY CHEMICAL. DESCRIPTION (one form per material per building ~r ama) ri NEW [] ADD [] DELETE J~ISE 200 -. Page ~ of __ BUSINESS ~ (~e ~ FACIL~ ~ME ~ D~ - ~ng Bu~n~ ~) * 3 -CHEMI~LLO~TION ill~ tR~ ~-~~¢~ ~ _Jp' ' 201 CHEMI~LLO~TION FAC[I~ ID ~ ~ ~ ~ t ~ I ~P e (~naO / ' ~3 [ GRID ~ (op~naO ~5 ] ~DESECR~ ~Y~ ~ ~6 CHEMI~L ~E 207 ~M~N~ ~ ~ EHS' ~Y~ ~O 2~ [~:~.. '~,.- -~:/~ ,::':. ::.,_..' ." :.*-..: :.-.' r,: FIRE ~DE H~ ~S8ES (~pl~e if ~u~t~ ~ I~ tim 210 ~PE ~ p PURE ~ m ~RE ~WASTE 211 ~DIOA¢~ DY~ ~ 212 ~ CURIES 213 ~SOLID ~LIQUID ~ g ~S 214 ~RGEST~NER 215 P~SI~ STA~ FED~~RIES ~1 FI~ ~2 R~ ~3 PRESSURE~L~E ~4 AC~H~L~ ~5 CHRONICH~TH 216 DAYS ON SffE UNffS* ~ ~ ~L ~ d CU~ ~. lb LBS ~ ~ TONS STOOGE ~NER ~ a A~VEGROUND T~K ~ e P~STI~NM~A~IC DRUM ~ i FIBER DRUM ~ m G~S BO~ ~ a ~IL (Check all ~at ap~y) ~ b UNDERGROUND TANK ~ f ~N ~ j ~G ~ n P~STIC BO~LE ~ r OTHER ~ c T~K I~IDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE BIN ~S~EL DRUM. ~ h SILO ~ I ~UNDER ~ p TANK WA~N STO~GEPRESSURE ~A~IE~ ~ ~ A~VEA~I~ Dba BELOWA~IE~ STOOGE ~M~ ~A~IE~ ~ ~ ~ ~IE~ ~ ba BELOW A~I~ ~ c CRYOGENIC ?.',-,,'~,-'.'--~--'j'~ :.: .~..~-.,.'./t.?~ ~,,~? :'., .,,'~. ; ~,~ .%1- ...... ~' .~-% .......... : ~ -'~,t~., -,.~ .'-~,.~ .,,.~..--, .>'~. ~ , ~ ,.,~:~ . . · ,~':;'~:,~ ... :..:.';~ ..... - ,; -.- %~'., - .~ ....... ;:,~; :,?~.. ;~.~.~?.., ? ~:~ .-~?-~ .... ~.-;~,: ,, ~~s~e~.E~-~ v- .,,.;~-~ ~ v -=..: .-..~ ~-=.--.,r~.-,., :.,'.:E~S... :~.: ~.~' I,,: ~' : -. ',: ;. CAS 4 ~B ~9 ~ Y~ ~ ~ 240 241 5 242 243 ~ Y~ ~ No 244 245 ' '-'~'".'-,*;"'.*z:~,?:;~Z'~-~;';~*~'>~ *:,%Y?~ '-t.-.~';¥".;~."~-~ · ' ""~'~:~;~"*L~,~'~i"s'!": ''~;'q"7~ ~-,'~7'~":*:..''.':r.?;~'*'~"'c= /,W :~"',':'~'¥'2 .* ,'~ '-~:', PRI~ ~ & T~E OF A~OR~D ~MPA~ REPRESE~A~VE SIGNORE DA~ 246  ~ CITY OF BAKERSFIF~ s · O~rFICE OF ENVIRONMENTAL~ERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form Der matet~al Der building or a~) [] NEW [] ADO [] DELETE [] REVISE 200 Page BUSINESS ~E (~e ~ FACIL~ ~ ~ O~ - ~ng ~ ~) 3 ~ T~E SE~ ~N ~ EHS' FIRE ~DE ~ ~ES (~ E ~ W ~ tim ~ ~0 ~PE ~3 FED ~ ~ES ~1~ · ~ 2 ~ ~ 3 ~S~ ~E ~ 4 A~ H~L~ ~ 5 ~RONIC H~ ~6 ~U~ ~ILY ~ ~ILY ~ UNffS' ~ ~d~ ~ ~=TO~ ~ ~ STO~GE ~AINER ~ a ~G~UND T~K ~ · ~N~IC ~UM ~ i FIBER DRUM ~ m G~S ~ ~ q ~IL (~eck a8 ~at ap~) ~ ~ UN~UND T~K ~ f ~ ~ j ~G ~ n ~C ~ D r O~ER ~ c T~ I~1~ ~1~1~ ~ g ~Y ~ k ~X ~ o TO~ BIN  ~M ~ h SILO ~ I CYLINDER ~ 9 T~K WA~N STO~ P~SSU~ ~ ~IE~ D ~ ~VE ~IE~ ~ ~ BELOW ~1~ ~4 .4 ~ ~ ~ Y~ ~ ~ 2~ ~ 242 243 ~ Y~ ~ ~ 2~ 2~ UPCF (7199) S:\CUPAFORMS\OES2731 .'1'V4.wpd CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME .~"Z/4 gO..5. ~q-,~ INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # ~----~ c:x9oo 27 ,~ Routine [~] Co~nbined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA IDNumbcr (Phone:916-.~.4-1781 to obtain EPA ID Authorized for waste treatment and'or storage Reported release, fire. or explosion within 15 days ofoccurance Established or maintains a contingency plan and training Hazardous waste accumulation time fi'ames Containers in good condition and not leaking Containers are compatible with the hazardous waste are kept closed when not in use Containers Weekly inspection of storage area Ignitable/reactive waste located at least 50 ~et fi'om prope~y line Seconda~ containment provided Conducts daily inspection of tanks Used oil nm contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transpo~s hazardous waste w/th completed manifest Sends manil~st copies to DTSC Retains manil~sts tbr 3 years / Retains hazardous waste analysis tbr 3 years Retains copies of used oil receipts fi)r 3 years Determines if waste is restricted fi'om land disposal C=C°mpliance V=Vi°lati°n ~~ Office of Environmental Services (805) 326-3979 ..... KERN'BU.SINESS:.FORMS ~Print~ng and Manufa.ctu, : ' FAM{LY. OWNED AND OPERATED SINC~I'~9'~ *'" ' -' '" · - ..L'' "".-,, ' Stationery Comouter Ghec~ · -.~ Continuous Letterhead.. · ~ ~1~ ~1 1 [ Snap-A-Part Sets patHc'ia ~ng . · 1112-14th Street " (805) 325-5818 Bakersfield, CA 93301 : · FAX (805) 325-0834 ~. _ .*' [' ~ ~ ~ ............... . ..... ':: ..... BUSINESS FORMS · (8o5) 325-5818 FAX (805) 325-0834 MFG. · 1112- 14th Street · ~ PRINII-'.RS F Bakersfield, CA 93301 SINCE