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E UNITED .RENT-:ALL - ,
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SITE/FACILITY DIAGRAM ~
FORM 5 .1=~ ~~
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NORTH SCALE: BUSINESS NAME:
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DATE:/17 /g7 FACILITY `'A:KE:
(CHECK ONE) SITE DIAGRAH .~f~
FLOOR: OF
1 1
UNIT =: OF
FACILITY DIAGR.4:~I
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(Inspector's Comments): -OFFICIAL L'•SE ONLY-
-SA-
SITE DIAGRAM (Requlred~we)
1. Address: Identify th_ 9. Lock (key) ox
principle buildln¢s
by the Street nusbera. 10. MSDS Storage Box
2. Street(s), Alleys, 11. Railroad Tracks
Drlveraya, and Perking
.Areas adJacent to the 12. Fence or Barrier
property. Include the a. Mire
street Hawes. ,
b. Masonry
3. Storw Drelna, Culverts,
Yard Drains c. Nood
d. Drainage Canals, Dltchea, d. Gates
Creeks,
13. Poaerlinea
5. Buildings
a. Frawe construction 14. Guard Station
b. Masonry construction 15. Storage Tanks:
Identify the
c. Metal construction _
capncity in gal.
a. Above ground
d. Access Door
b. Underground
e. Utility Controls
a. Gas 18. Diking or Sera
b. Electricity 17. Evacuation Route
c. Mater 18. Evacuation Area:
Identify the
7. -Fire Suppression Syatews: location where
a. Pire Hydrants ewployees sill
went.
b. Fire Sprinkler 19. Outside Hazardous
Connections Meets Storage
e. Fire Standpipe 20. Outside Elazardoua
Connections Material Storage
d. Mater Control Valves 21. Outside Hazardous
for protection syatews Material
Use/Handling
e. Fire Puwp 22. Type of Hazardous
Material/Neste
Stored
8. Pire Dapartaant Acceea or Uaed (See
BOlON~
TYPE OF HAZARDO US 11ATE RIA4
P Fleawabie B Bzplosive L Liqui d R Radiological
C Corrosive 0 Ozidizsr 0 Oas P Poison
N ~ Nater Reactive ? Toxic 9 Solid R Cryagenlc
D ~ Neste 8 Btlologica!
Fatawpls: Flaoable Llquld FL
PAC[LITY DI~IGRAM (Required !teas !a addition to the.sbo va)
2. Risur• for Sprlnklare d. Pire Bacapss
2. Partitions 9. Air Coaditioniag Units
3. Stairways: Indicate the 10. NSndow•
levels aecved [row
highest to lowaet. 11. Inside Haaardaua Mesta
Storage
4. Escalator: Indicate the
levels carved frog 12. Inside Hazardous
hlghaat to lowest. Material• Storage
S. Elevator 13. Inside Hazardous
Matarlala Uae/Handling
8. Attic Accosa
lt. Sewer Drain Inlets
~:~r-:r ~`~'
- rsct _'~ k.:.
.j.
7. Skylights
~~;
MEMORANDUM
'~
T0: RALPH HUEY, HAZARDOl1S MATERIALS COORDINATOR
~`
FROM: DREW SHARPLES, FINANCIAL INVESTIGATOR
SUBJECT: UNITED RENT-ALL HM 430301
DECEMBER 27, 1990
Jimmie R. and Barbara M. Fallin DBA United Rent-All filed Chapter 7 Bankruptcy
on November 19, 1990. Please close account as of that date.
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DS1227901
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BARERSFIELD CITY FIRE DEPARTMENT
2130 "G" STREET _~ Q R E C E I V E D
BARERSFIELD, CA 93301~~~ 3
( 805 ) 328-3979 i _ J U L 2 2 1987
Ans'd.---•----...
OFFICIAL USE ONLY
ID#
INESS NAME
HAZARDOUS MATERIAL S
B US I NE S S P LAN AS A WH O L E
FORM 2 A
~~~~9
INSTRUCTIONS:
1. To avoid further action, return this form by
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
SECTION 1: BUSINESS IDENTIFICATION DATA
A•. BUSINESS NAME:
_~//
B . LOCATION / STREET ADDRESS : o~~/~ .Cjji'~~iG~/~~~:~ ~it/•~
/' - / a
CITY: .~~/~~1~~/~c~ ZIP: ~~~,~7~C/ BUS.PHONE: (~js~) :~~_3-~i1~2~
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or threatened release of a
hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify
your local fire department and the State Office of Emergency Services as req~.~ired by
law.
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY:
NAME AND T TLE ~ DURING BUS. HRS. AFTER BUS. HRS.
A.fe c . ~/~-///~ Ph# 3 ~'3 •- _'~/4L L--Ph# r~~ ~ ' .7~~1a
B . ~/ . ~J - S~ ~ s~lz Ph# c~~ 3 '_ ~/y~ ~.._ Ph# ~.3~ '. 5'~S~t/
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE:
B. ELECTRICAL:
C. WATER:
D. SPECIAL:~
E. LOCK BOX: YES /, 0 IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO
FLOOR-PLANS? YES / NO KEYS? YES / NO
- 2A -
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SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE
~~~
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE
.,
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/////a`t1` [
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SECTION 6: EMPLOYEE TRAINING
~~~-
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YES OR NO
A. METHODS FOR SAFE HANDLING OF HAZARDOUS
MATERIALS :.......................................
B. PROCEDURES FOR COORDINATING ACTIVITIES
WITH RESPONSE AGENCIES :..........................
C. PROPER USE OF SAFETY EQUIPMENT :..................
D. EMERGENCY EVACUATION PROCEDURES :.................
E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:.....,.
SECTION 7: HAZARDOUS 1rWTERIAL
INITIAL REFRESHER
YES ~ YES NO
YES YES NO
YES YES NO
YES YES NO
YES YES NO
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 PO' F A
I, ~NI ~/~/ 14/ certify that the above information is accurate.
I understand that this information will be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95
Sec. 25500 Et Al.) and that inaccurate information constitutes perjury.
SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS:...:.. YES NO
f ~ .~
SIGNATURE TITLE DATE ~
4
-2B-
J~ - `
BAKERSFiELD CITY FIRE DEPARTME\TT
-2.130 "G" STREET
BAKERSFIELD, CA 93301
Orr :CI.+~I, USE OILY
I.D# ____
BUSI:dESS NAME:
BUS.I NESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTROC.TIDNS
1. To avoid further ~ZCtion, this form must be returned by:
2. TYPE/PRINT YOUR ANS4~ERS IN ENrLISH.
3. Answer t'ne questions i-~e7.ow fog TH.I: FACIIITY UNIT LISTED BEL06~
4. Be as BRIEF and CONCISE as possible. //
FACILITY L'1TITr FACILITY L'NIT NAME: ~ ~`J
SECTION 1: MITIGATION, PREVENTION ABATEMENT PROCEDURES
SECTION 2: NOTIFICATION A`'D EVACUATION PROCEDURES AT THIS U_vIT ONTLY
~Qda/ - ~~/ 9i/
- .;A -
SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY
A. Does this Facility Unit contain Hazardous Materials?...... YES NO
If YES, see B.
If N0, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES ~0
If. No, complete a separate hazardous materials inventory
form marked: NON-TRADE SECRETS ONLY (white form #4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY (yellow -form #4A-2) in addition to the non-trade
secret form. List only the trade secrets on form 4A-2.
SECTION 4: PRIVATE FIRE PROTECTION
SECTION 5: LOCATIO\~ OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS
SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY
A. NAT. GASiPROPANI:
B. ELECTRICAL:
C. WATER;
D. SPECIAL:
E. LOCK BOY: YES i NO IF YES, LOCATION:
IF YES, SITE PLANTS? YES / NO
FLOOR PLATS? YES ,/ NO
- 3B -
MSDSs? YES / NO
KEYS? YES i NO
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BAKERSFIEI.D CITY FIRE DEPARTMENT j
I.D. # FORM 4A-1 Page ~ of`~
N O N- T R A D E S E C R E T S
HAZARDOUS MATERIALS I NVENTORY
r7
BUSINESS NAME: ~ ~ OWNER NAME:~~°7 .!"'/, r~r~-~~~~~~J FACILITY UNIT #:
ADDRESS: ,~ ADDRESS: FACILITY UNIT NAME:
CITY, ZIP:; ~ .~ - CITY,ZIP:
PHONE #: ~ ;j ~ a,- 3/cL~ PHONE #: OFFONLYL USE CFIRS CODE
1 2 3 4 5 6 7 8 9. 10
TYPE MAX ANNUAL CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT. WT. CHEMICAL OR COMMON__NAME CODE GUIDE
3 ~®
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NAME:
EMERG NCY 0
TITLE:
EMER~E[~CY CONTACT
PRINCIPAL BUSINESS. ACTIVITY:
Yli SIGNATURE: `///7/`Z/~,.~ ~~~6/~' 'DATE:
TITLE: PHONE # BUS HOURS:
AFTER BUS HRS:
TITLE: PHONE # BUS HOURS:
AFTER BUS. HRS:
- 4A-1 -