HomeMy WebLinkAboutHAZMAT INVENTORY 5/31/2005~' ~ _T,~z_ CIT'Y OF BAKERSFIELD FIRE DEPARTMENT
~ OFFICE OF ENVIRONMENTAL SERVICES
b
y UNIFIED PROGRAM INSPECTION CHECKLIST
;k~'~gti r~ 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ~ /~y 5 INSPECTION DATE S 31 ~;~
Section 4: Haaardous Waste Generator Program EPA ID # LAL O~ 291 -76~
Routine ^ Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection
OPERATION C V COMMENTS
Hazardous waste determination has been made
EPA ID Number (-•cwt~ JP
Authorized for waste treatment and/or storage c~s~~
~'~~~L= p+(„ ~ 7z ~ ~,.~ s. of
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
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 filters ~~~~ : L ~/~~ 7kEy
Transports hazardous waste with completed manifest J JsT
^T+u.~ a~ c. ~,
JA~~S ~~ s~3 13de~rr
Sends manifest copies to DTSC I Auto Repair
Retains manifests for 3 years I Starters and Alternators
Auto Electric
Retains hazardous waste analysis for 3 years 1
Retains copies of used oil receipts for 3 years I 790 East Brundage Lane
Bakersfield, CA 83307
Determines if waste is restricted from land disposal Tel.: (681)
~,-wwpuancc V = V lOlailOfl
Inspector ~ lh~~
Office of Environmental Services (661) 326-3979
White -Env. Svcs.
Pink - Businoss Copy
~~
324-1438' - _ _ --- y
' , - -
YC1~i
Bus ess Site Responsible Party
(HMMP) ,~;
HAZARDOUS MATERIALS MANAGEMENT
UNIFIED PROGRAM CONSOLIDATED FORMS
H A D
HAZARDOUS MATERIALS INVENTORY ,~ ~~ r ~
CHEMICAL DESCRIPTION FORM
NEW
^ ADD ^ DELETE ^ REVISE 200
t3AKL'K~1~'11+iLL 1~'1K1; LL'~Yl-.
Prevention Services
900 Truxtun Ave., Ste. 210
Bakersfield, CA 93301
Tel.: (661) 326-3979
(One form per material, per building, or area.)
Paoe1 of 2
. `I. FACILITY INFORMATION :;. ':. - ~ ~ .
BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3
CHEMICAL LOCATION 201 CHEMICAL LOCATION 20
~v,t,5 (~ ~ ~ 5 t D ~ ~ ~~ l..Jx`r CONFIDENTIAL (EPCRA) ^ Yes ^ N
FACILITY ID No. 2 MAP No. (optional) 203 GRID NO. (optional) 20
11. CHEMICAL INFORMATION
CHEMICAL NAME 205 20
~~~~ ~l ~ TRADE SECRET ^ Yes
' ^ No
ect to EPCRA refer to instructions
If Sub
COMMON NAME 207
EHS' G Yes ^ No
20
CAS No. 209
'If EHS is "Yes,' all amounts b elow must be
in lbs.
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 21
TYPE 221 212 CURIES 21
^ p PURE ^ m MIXTURE ~1t1(ASTE RADIOACTIVE: ^ Yes ^ No
LARGEST CONTAINER 215
PHYSICAL STATE ^ s SOLIDLIQUID ^ g GAS 214 5..~
J
FED HAZARD CATEGORIES G~9-FIRE ^ 2 REACTIVE ^ 3 PRESSURE RELEASE ^ 4 ACUTE HEALTH ~5 CHRONIC HEALTH - 21.
(Check all that apply)
ANNUAL WASTE 227 2t8
MAXIMUM AVERAGE 219 STATE WASTE 22
AMOUNT /
DAILY AMOUNT (r O
f DAILY AMOUNT ; l0 CODE
^ UNITS ~ GAL
^ cf CU FT ^ Ib LBS ^ to TONS 221222
DAYS ON SITE
~If EHS, amount must be in lbs.
22
STORAGE CONTAINER
(Check all tAet apply) ^ a ABOVEGROUND TANK ^ (CAN ^ k BOX ^ p TANK WAGON
^ b UNDERGROUND TANK ^ g CARBOY ^ I CYLINDER ^ q RAIL CAR
^ c TANK INSIDE BUILDING ^ h SILO ^ m GLASS BOTTLE ^ r OTHER
~d STEEL DRUM ^ i FIBER DRUM ^ n PLASTIC BOTTLE
^ e PLASTIC/NONMETALLIC DRUM ^ j BAG ^ o TOTE BIN
STORAGE PRESSURE p~a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 22
STORAGE TEMPERATURE ~ AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT
^ c CRYOGENIC 225
%WT HAZARDOUS COMPONENT EHS CAS #
1 226 227 ^ Yes ^ No 228 22
2 230 231 ^ Yes ^ No 232 23
3 234 235 ^ Yes ^ No 236 23
4 238 239 ^ Yes ^ No 240 241
5 242 ~ 243 ^ Yes ^ No 244 24
III. SIGNATURE
PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246
l
FD2086 (Rev. 02f05)