HomeMy WebLinkAboutBUSINESS PLAN- - I ..
_ ~ ~~ -- ~ ~ Jims Supply Co ~- _ __
', _ 3530 Buck Owens Blvd
JIMS SUPPLY CO SiteID: 015-021-001001
Manager TIMOTHY J MORENO
Location: 3530 BUCK OWENS BLVD
City _ BAKERSFIELD
BusPhone: (661) 324-6514
Map 102 CommHaz Extreme
Grid: 23B FacUnits: 1 AOV:
CommCode: KCFD STA 66
EPA Numb:
SIC Code:5051
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
TIMOTHY J MORENO / HR MANAGER GREG BOYLAN / VICE PRESIDENT
Business Phone: (661) 324-6514x Business Phone: (661) 324-6514x
24-Hour Phone (661) 331-9026x 24-Hour Phone (661) 322-4694x
Pager Phone (661) 331-9026x Pager Phone (661) 303-5950x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact TIMOTHY J MORENO Phone: (661) 324-6514x
MailAddr: 3530 BUCK OWENS BLVD State: CA
City BAKERSFIELD Zip 93308
Owner DOREEN M BOYLAN Phone: (661) 324-6139x
Address 260 EL CERRITO DR State: CA
City BAKERSFIELD Zip 93305
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif ' d: RSs : No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ~~
ABOVEGROUND STORAGE TANK ~
~~
~~
~
~~~
Lased on my ina,uiry of those individuals
responsible for obtaining the information, I certify
under penalty of lave that I have personally
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
~- ~~~~~
Si . ature Date
-1-
07/12/2007
~-r-
ti: ~
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Hazmat Inventory By Facility Unit ~
~ MCP+DailyMax Order Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
ACETYLENE E F P IH G 600.00 FT3 Hi
PROPANE E F P IH G 500.00 GAL Hi
MISC PAINTS AND WATERSEAL F IH L 110.00 GAL Mod
CLEANING SOLVENT F DH G 90.00 GAL Mod
SOLVENT F DH L 55.00 GAL Mod
OXYGEN F P IH G 1400.00 FT3 Low
DIESEL #2 F IH DH L 550.00 GAL Low
WASTE OIL F DH L 110.00 GAL Low
HYDRAULIC OIL L 55.00 GAL Low
GEAR OIL F DH L 5.00 GAL Low
OIL F DH L 300.00 GAL Min
RIGID THREAD CUTTING OIL F IH L 90.00 GAL Min
LUBRICANT F L 5.00 GAL Min
KUTWELL 82 DH L 110.00 GAL UnR
FEBIS K68 F IH L 5.00 GAL UnR
RUSTLIC F IH L~ 5.00 GAL UnR
-2- 07/12/2007
-3- 07/12/2007
F JIMS SUPPLY CO
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
ACETYLENE
Location within this Facility Unit
S SIDE LG SHED
STATE TYPE PRESSURE _
Gas TPure -Above Ambient
SiteID: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
74-86-2
TEMPERATURE CONTAINER TYPE
Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
300.00 FT3 600.00 FT3 500.00 FT3
tir~~r~xLw~ c.;~rirvlv~ly 1
aWt. RS CAS#
100.00 Acetylene Yes 74862
t1E~L,HK1J I~aJ~~J1~1~1V1~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
~ Inventory Item 0012
COMMON NAME / CHEMICAL NAME
PROPANE
PROPANE - COMPRESSED
Location within this Facility Unit
SW CRNR NEAR VINEYARD BLDG
STATE TYPE PRESSURE _
Gas TPure -Above Ambient
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
74-98-6
TEMPERATURE CONTAINER TYPE
Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
500.00 GAL 500.00 GAL 500.00 GAL
ruic~tucLV u ~ ~.vrlrvl.V 1~L~ t S
oWt. RS CAS#
100.00 Propane Yes 74986
LSHGL~iICL HJ JP~J aI"1P~1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
-4- 07/12/2007
F JIMS SUPPLY CO
~ Inventory Item 0007
COMMON NAME / CHEMICAL NAME
MISC PAINTS AND WATERSEAL
Location within this Facility Unit
SEATRAIN REAR YARD
STATE TYPE PRESSURE
Liquid TMixture~Ambient
SiteID: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
TEMPERATURE CONTAINER TYPE
Ambient METAL CONTAINR-NONDRUM
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
55.00 GAL 110.00 GAL 80.00 GAL
tit~GlitCL V U 5 1:u1~1ru1v L" 1v15
%Wt. RS CAS#
5.00 Naphtha No 8030306
10.00 Toluene No 108883
40.00 Xylene, Mixed No 1330207
5.00 n-Butyl Acetate No 123864
tiAGEittL A55~551~1L'~1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Mod
~ Inventory Item 0018 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
CLEANING SOLVENT Days On Site
MISC CLEANERS (BRAKE & ELECT) & PAINT 365
Location within this Facility Unit Map: Grid:
TOOL RM; WHSE; STEEL YARD CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Gas TMixture Above Ambient Ambient METAL CONTAINR-NONDRUM
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
11.25 GAL 90.00 GAL 90.00 GAL
ru~c~tucLVUa winrulv~ivl~
%Wt. RS CAS#
100.00 Naphtha Solvent No 8030306
tit,Gt~ttL .~,aa~a~i~i~ivl~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Mod
-5- 07/12/2007
F JIMS SUPPLY CO
~ Inventory Item 0013
COMMON NAME / CHEMICAL NAME
SOLVENT
SOLVENT - PETROLEUM BASED
Location within this Facility Unit
SE OF VINEYARD BLDG
STATE TYPE PRESSURE
Liquid ~Mixtur~ Ambient
SitelD: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
TEMPERATURE CONTAINER TYPE _
Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Con55~00rGAL Daily M55100m GAL Daily A55r00e GAL
tit~~r~tcLVUS w1nr~1vlJly l
oWt. RS CAS#
100.00 Naphtha No 8030306
titiGAttL x~a~~~l~l~ly l a
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Mod
~ Inventory Item 0001
COMMON NAME / CHEMICAL NAME
OXYGEN
Location within this Facility Unit
S SIDE LG SHED
STATE TYPE
Gas Pure
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
7782-44-7
= PRESSURE TEMPERATURE CONTAINER TYPE
Above Ambient Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Co300100rFT3 - Daily1400100m FT3 I Daily1300r00e FT3
rii-1G1-1tCLVU.7 L:vl~irvlVJ~,tV 1.7
owt. Rs cAS#
100.00 Oxygen, Compressed No 7782447
tiHGt1KU 1~ ~~~JJ1~1J;1V1~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Low
-6- 07/12/2007
r
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0010 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
DIESEL #2 Days On Site
RED DYED #2 DIESEL 365
Location within this Facility Unit Map: Grid:
OUTSIDE SHOP IN REAR OF YARD CAS#
68476-34-6
Liquid TMixture ~mbRent~E ~ AmbientT~E ABOVEOGROIUNDRTANKE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
550.00 GAL 550.00 GAL 550.00 GAL
- riHGHKLVUJ 1:V1~lYV1Vt;1Vlb
%Wt. RS CAS#
100.00 Diesel Fuel No. 2 No 68476302
riAGHKL H~Ji5J~1~1L~1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / j / Low
~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
WASTE OIL Days On Site
365
Location within this Facility Unit Map: Grid:
NEAR SHOP REAR YARD CAS#
221
STATE TYPE
Liquid Laste T PRESSURE
I Ambient TEMPERATURE
~ Ambient CONTAINER TYPE
DRUM/BARREL-METALLT~
AMOUNTS AT THIS LOCATION
Largest Con55100rGAL Daily MlOl00m GAL I Daily A55r00e GAL
nHC~Htu~vu~ ~V1~lrvivr,lV1~
~Wt. RS CAS#
100.00 Waste Oil, Petroleum Based No 0
tll-1GtitCL H.` ~.'7J:,~~1~1J;1V 1 ~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
-7- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
HYDRAULIC OIL Days On Site
365
Location within this Facility Unit Map: Grid:
SHOP REAR OF YARD CAS#
STATE T TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE _
Liquid I Mixture I Ambient ~ Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
55.00 GAL 55.00 GAL 1 55.00 GAL
-" tiHGHKLVUS 1;V1~lYV1VL' 1V 15
°sWt. RS CAS#
100.00 Hydraulic Brake Fluid (Diethylene Glycol Monobu... No 112345
t1AGE1KL E1.7.7L' .7~71"1L"i1V~15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
~ Inventory Item 0014
COMMON NAME / CHEMICAL NAME
GEAR OIL
Location within this Facility Unit
TOOL ROOM IN VINEYARD BLDG
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
STATE TYPE PRESSURE
Liquid TMixtur~mbient
CAS#
64742-57-0
TEMPERATURE CONTAINER TYPE
Ambient -~STIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
IlEiGEitCL V U .7 1. V1~lY V1V I;1V 15
aWt. RS CAS#
100.00 Light Machine Oil No 8020835
ruj~rjtcl~ r~aa~aal~i~ly 1
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
-8- 07/12/2007
F JIMS SUPPLY CO
~ Inventory Item 0004
COMMON NAME / CHEMICAL NAME
OIL
Location within this Facility Unit
NEAR SHOP IN REAR YARD
STATE TYPE PRESSURE
Liquid TMixture ~mbient
SitelD: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
8020835
TEMPERATURE CONTAINER TYPE
Ambient DRUM/BARREL-METALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum ~ Daily Average
55.00 GAL 300.00 GAL 250.00 GAL
tiL~GH1tLVU~ ~vl~trvlvl~,tv1~
%Wt. RS CAS#
100.00 Motor Oil, Petroleum Based No 8020835
I31-~GKtCL H.7.7L' .7.71~1L' 1V l a
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Min
~ Inventory Item 0008
COMMON NAME / CHEMICAL NAME
RIGID THREAD CUTTING OIL
Location within this Facility Unit
S SIDE LG WHSE
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
0
Liquid TMixture ~mbient~E ~ AmbientT~E DRUM/BARRELEMETALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
55.00 GAL 90.00 GAL 60.00 GAL
ruic~tucLV~a ~.vllrvivl;lvta
%Wt. RS CAS#
100.00 Cutting Oil No 0
L1t~LatiLCL tiw 7.71'.,.7 J1°11J1V 1iJ
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Min
-9- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0017 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
LUBRICANT Days On Site
LUBRICANT 191-5 365
Location within this Facility Unit Map: Grid:
TOOL RM IN VINEYARD BLDG CAS#
64741964
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid_TMixture ~ Ambient ~ Ambient DRUM/BARREL-METALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
ntiGtitcLVIJA ~.v1~1rv1V L~1V 1 J
~Wt. RS CAS#
100.00 Lubricating Oil (Petroleum-Based) No 8020835
iltiGriRL L-1. 7.7~J.71"1P~1V 1 ~7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F / / / Min
~ Inventory Item 0011 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
KUTWELL 82 Days On Site
365
Location within this Facility Unit Map: Grid:
NEAR SHOP AT REAR OF YARD CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid Mixture Ambient Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
110.00 GAL 110.00 GAL 110.00 GAL
HAZARDOUS COMPONENTS ~ ,
~Wt.
RSA CAS#
l lt][.iriLCL ti J a7 P~ ~7 ~71•1L' 1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies DH / / / UnR
-10- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0015 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
FEBIS K68 Days On Site
365
Location within this Facility Unit Map: Grid:
TOOL RM IN VINEYARD BLDG CAS#
Liquid TMixture ~mbRent~E ~ AmbientT~E ~PLASTICTCONTAINERE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
r HAZARDOUS COMPONENTS ,
oWt.
RSA CAS#
ruyc,t~utL rsa ~~aartaivt~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / UnR
~ Inventory Item 0016 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
RUSTLIC Days On Site
365
Location within this Facility Unit Map: Grid:
TOOL RM IN VINEYARD BLDG CAS#
Liquid TMixture ~mbient~E ~ AmbientT~E I PLASTOICTCONTAINERE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
HAZARDOUS COMPONENTS ,
~Wt.
RSA CAS#
HA
ZARD AS SESSMENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / UnR
-11- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001
Fast Format
~ Notif./Evacuation/Medical Overall Site
~ Agency Notification 04/06/2006
IF A RELEASE OF HAZARDOUS MATERIALS OCCURS AT THE SITE THE FOLLOWING
AGENCIES WOULD BE CONTACTED AND INFORMED:
STATE OF CALIFORNIA 800-852-7550
CALL 911
HAZARDOUS MATERIALS DIVISION 326-3979
Employee Notif./Evacuation 10/25/2000
IN CASE OF AN EMERGENCY NECESSITATING AN EVACUATION, ALL OFFICE PHONES ARE
CONNECTED TO AN INTERCOM LOUD SPEAKER MOUNTED ON THE NORTHEAST CORNER OF THE
WAREHOUSE. THIS LOUD SPEAKER WOULD ALLOW IMMEDIATE NOTIFICATION OF ALL
EMPLOYEES. ALL WAREHOUSES, SHEDS, ETC ARE VERY OPEN, ENABLING QUICK
EVACUATION IF NECESSARY.
Public Notif./Evacuation
10/25/2000
IN CASE OF AN EMERGENCY NECESSITATING AN EVACUATION, ALL OFFICE PHONES ARE
CONNECTED TO AN INTERCOM LOUD SPEAKER MOUNTED ON THE NE CORNER OF THE
WAREHOUSE. THIS LOUD SPEAKER WOULD ALLOW IMMEDIATE NOTIFICATION OF ALL
EMPLOYEES AND ANY PUBLIC WHO MAY BE IN THE FACILITY. ALL WAREHOUSES, SHEDS,
ETC ARE VERY OPEN, ENABLING QUICK EVACUATION IF NECESSARY.
Emergency Medical Plan 09/10/2003
ALL EMERGENCY MEDICAL PROBLEMS ARE REPORTED TO THE OFFICE WHICH AT THAT TIME
ARE REPORTED TO THE DOCTOR, HOSPITAL, EMERGENCY STATIONS, AND THE INSURANCE
CARRIER.
LARRY CHO MD, VALLEY INDUSTRIAL MEDICAL GROUP, 2501 G ST.
-12- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001
Fast Format
~ Mitigation/Prevent/Abatemt Overall Site
~ Release Prevention 10/25/2000
OXYGEN AND ACETYLENE ARE STORED IN A METAL ENCLOSED BIN AWAY FROM ANY HEAVY
TRAFFIC AREAS. ALL DIESEL FUEL IS CONSUMED THROUGH STANDARD ABOVE GROUND
FUEL PUMPS WHICH ARE PROTECTED BY STEEL PIPE BARRIERS. ANY 50 GAL OIL DRUMS
ARE TAPPED WITH MANUAL OPERATED SHUTOFF VALVES. ALL WASTE OIL IS KEPT IN
DRUMS AND THEN SOLD AS USED OIL TO A LOCAL REFINERY. FIRE EXTINGUISHERS ARE
LOCATED NEAR ALL OF THE ABOVE MENTIONED AREAS.
Release Containment
11/30/1990
SHOULD ANY RELEASE OF HAZARDOUS MATERIALS OCCUR AND NECESSITATE FURTHER
CONTAINMENT A COMPANY QUALIFIED AND LICENSED FOR THAT PARTICULAR MATERIAL
WOULD BE CONTACTED IMMEDIATELY TO PREVENT ANY FURTHER RELEASE.
Clean Up 04/06/2006
CLEAN-UP OF A HAZARDOUS MATERIALS RELEASE WOULD BE DONE BY A COMPANY
QUALIFIED AND LICENSED TO HANDLE AND DISPOSE OF THAT PARTICULAR MATERIAL.
v~uci ncavui~..c B1l.. 1~1V0.1.1 V11
-13- 07/12/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
.7iJCC:1d1 rid'GdLUS
Utility Shut-Offs
A) GAS - N END OF OFFICE BLDG
B) ELECTRICTAL - SW CRNR OF OFFICE
C) WATER - SW CRNR OF PARCEL AT ST CURB
D) SPECIAL - NONE
E) LOCK BOX - NO
12/13/2006
Fire Protec./Avail. Water
12/13/2006
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN OFFICE, WHSES, AND SHOP.
WATER VALVES WITH HOSES NEAR WHSES AND SHOP.
FIRE HYDRANT - NE CRNR BUCK OWENS BLVD & ORIN WY
Building Occupancy Level 02/27/2007
90-100 EMPLOYEES
-14- 07/12/2007
,,.
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 12/13/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE IN OFFICE AND WHSE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE PERIODICALLY BRIEFED AS TO
THE LOCATION AND GENERAL CONTENTS OF THE MATERIAL SAFETY DATA SHEETS ON
FILE.
rayc ~
Held for Future Use
_ ~ ~ r _
iiciu ivi ru~..uic vac
-15- 07/12/2007
JIMS SUPPLY CO SiteID: 015-021-001001
Manager ~ ~ ~np-Hnv~ .~. 1' ~d~~~1O
Location: 3530 BUCK OWENS BLVD
City BAKERSFIELD
BusPhone: (661) 324-6514
Map 102 CommHaz Extreme
Grid: 23B FacUnits: 1 AOV:
CommCode: KCFD STA 66
EPA Numb:
SIC Code:5051
DunnBrad:
Emergency Contact / Title Emergency Contact /,_ Title
TIMOTHY J
MORENO / : •~'R V!10~1/14g~ '
GREG BOYLAN aa
/, Y i rte. ~ccS ~ cN~v~`~
Business Phone: (661) 324-6514x Business Phone: (661) 324-6514x
24-Hour Phone (661)-~~-~~°-zx3'~~•gb~ 24-Hour Phone (661) 322-4694x
Pager Phone (661) 331-9026x Pager Phone (661) 303-5950x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact "~jr~~y J. Moc~~,~ _ Phone: (661) 324-6514x
MailAddr: 3530 BUCK OWENS BLVD State: CA
City BAKERSFIELD Zip 93308
Owner DOREEN M BOYLAN Phone: (661) 324-6139x
Address 260 EL CERRITO DR State: CA
City BAKERSFIELD Zip 93305
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
PROG H - HAZ WASTE GEN -
PROG T - ABOVEGROUND STORAGE TANK
based on my inquiry of those individuals
res
onsibl
f ~~~~ ~ '"
~
p
e
or obtaining the information, I certify
under penalty of law that I have
~
~ ~oo~
personally
examined and am familiar with the information
submitted and believe the information is true
,
accurate, and complete.
'
Z '/'1~
Sig ature
"-'~__
D to
-1- 02/01/2007
F JIMS SUPPLY CO
~ Hazmat Inventory =
~ MCP+DailyMax Order
= SiteID: 015-021-001001 ~
By Facility Unit ~
Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
ACETYLENE E F P IH G 600.00 FT3 Hi
PROPANE E F P IH G 500.00 GAL Hi
MISC PAINTS AND WATERSEAL F IH L 110.00 GAL Mod
CLEANING SOLVENT F DH G 90.00 GAL Mod
SOLVENT F DH L 55.00 GAL Mod
OXYGEN F P IH G 1400.00 FT3 Low
DIESEL #2 F IH DH L 550.00 GAL Low
WASTE OIL F DH L 110.00 GAL Low
HYDRAULIC OIL L 55.00 GAL Low
GEAR OIL F DH L 5.00 GAL Low
OIL F DH L 300.00 GAL Min
RIGID THREAD CUTTING OIL F IH L 90.00 GAL Min
LUBRICANT F L 5.00 GAL Min
KUTWELL 82 DH L 110.00 GAL UnR
FEBIS K68 F IH L 5.00 GAL UnR
RUSTLIC F IH L 5.00 GAL UnR
-2- 02/01/2007
-3- ~ oa/oi/aoo~
F JIMS SUPPLY CO
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
ACETYLENE
Location within this Facility Unit
S SIDE LG SHED
STATE TYPE
Gas Pure
= PRESSURE _
Above Ambient
Days On Site
365
Map: Grid:
CAS#
74-86-2
TEMPERATURE CONTAINER TYPE
Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
300.00 FT3 600.00 FT3 500.00 FT3
HAZARDOUS COMPONENTS
%Wt. RS CAS#
100.00 Acetylene Yes 74862
til'~G1itCL E'~.7JJ;JAI~1,C~1V 1 ~7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
~ Inventory Item 0012
COMMON NAME / CHEMICAL NAME
PROPANE
PROPANE - COMPRESSED
Location within this Facility Unit
SW CRNR NEAR VINEYARD BLDG
STATE TYPE PRESSURE _
Gas TPure ~-Above Ambient
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
74-98-6
TEMPERATURE CONTAINER TYPE
Ambient PORT. PRESS. CYLINDER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
500.00 GAL 500.00 GAL 500.00 GAL
ru-~~~Y,rcLV U a ~:viYirviv riv l a
~Wt. RS CAS#
100.00 Propane Yes 74986
riE'~GE~tCL 1~J~t',~JJ1~11~,1V1J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
SiteID: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
-4- 02/01/2007
F JIMS SUPPLY CO
~ Inventory Item 0007
COMMON NAME / CHEMICAL NAME
MISC PAINTS AND WATERSEAL
Location within this Facility Unit
SEATRAIN REAR YARD
SiteID: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
STATE TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixture I Ambient ~ Ambient METAL CONTAINR-NONDRUM
AMOUNTS AT THIS LOCATION -
Largest Container Daily Maximum ~ Daily Average
55.00 GAL 110.00 GAL 80.00 GAL
tlr~~tixt~~u5 ~Vlnr~lvrlvl~
%Wt. RS CAS#
5.00 Naphtha No 8030306
10.00 Toluene No 108883
40.00 Xylene, Mixed No 1330207
5.00 n-Butyl Acetate No 123864
riHGHttL L-~JaL":551~11"J1V 1 7
TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Mod
~ Inventory Item 0018 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
CLEANING SOLVENT Days On Site
MISC CLEANERS (BRAKE & ELECT) & PAINT 365
Location within this Facility Unit Map: Grid:
TOOL RM; WHSE; STEEL YARD CAS#
~GasATE ~Mixtur~AboveSAmbEent AmbientT~E METALOCONTAINRTNONDRUM
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
11.25 GAL 90.00 GAL 90.00 GAL
riliGK[CLV V.7 1.V1~lYV1V~1V 1.7
°sWt. RS CAS#
100.00 Naphtha Solvent No 8030306
t1HGEitCL Eia JJ;5J1~1JJ1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Mod
-5- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0013 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
SOLVENT Days On Site
SOLVENT - PETROLEUM BASED 365
Location within this Facility Unit Map: Grid:
SE OF VINEYARD BLDG CAS#
Liquid TMixture I Ambient~E ~ AmbientT~E DRUM/BARRELEMETALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I -Daily Average
55.00 GAL 55.00 GAL 55.00 GAL
t1AGHKLVUJ 1.:V1~lYV1V1;1V7J
cwt. Rs cAS#
100.00 Naphtha No 8030306
riAGHt~CL A,S,'L"~5~1~1t51V 15
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Mod
~ Inventory Item 0001
~ COMMON NAME / CHEMICAL NAME
I OXYGEN
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Location within this Facility Unit Map: Grid:
S SIDE LG SHED CAS#
7782-44-7
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Gas TPure ~-Above Ambient Ambient PORT. PRESS. CYLINDER..
AMOUNTS AT THIS LOCATION
Largest Co300100rFT3 Daily1400100m FT3 I Daily1300r00e FT3
tiHGKtCL V U J wlnrvlV 1J1V 1 ~
°sWt. RS CAS#
100.00 Oxygen, Compressed No 7782447
riHGKKL 1~~51;~51~1tS1V 1.`~
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Low
-6- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0010 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
DIESEL #2 Days On Site
RED DYED #2 DIESEL 365
Location within this Facility Unit Map: Grid:
OUTSIDE SHOP IN REAR OF YARD CAS#
68476-34-6
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixture~Ambient ~ Ambient ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
550.00 GAL 550.00 GAL 550.00 GAL
HAZARDOUS COMPONENTS
%Wt• RS CAS#
100.00 Diesel Fuel No. 2 No .. 68476302
ilti[~tiRL ti~ 7 JP..+J.71.1P~1V 1 ~J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH DH / / / Low
~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
WASTE OIL Days On Site
365
Location within this Facility Unit Map: Grid:
NEAR SHOP REAR YARD CAS#
221
Liquid TWaste ~Ambient~E ~ AmbientT~E DRUM/BARRELEMETALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
55.00 GAL 110.00 GAL 55.00 GAL
- rariuru~LVVa l.Vl•lrV1VL~1V1J
%Wt. RS CAS#
100.00 Waste Oil, Petroleum Based No 0
ritiL~tiLCL HJ JL' iJ .71.1P~1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
-7- 02/01/2007
F DIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
HYDRAULIC OIL Days On Site
365
Location within this Facility Unit Map: Grid:
SHOP REAR OF YARD CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _
Liquid TMixture ~mbient ~ Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
55.00 GAL 55.00 GAL 55.00 GAL
ti[-~G1-lKlJ V U 5 lr V1~lY V1V 1~,1V 1 J
oWt. RS CAS#
100.00 Hydraulic Brake Fluid (Diethylene Glycol Monobu... No 112345
tYHGHKJJ H.5~i5.7.71~1L'1V1w7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies / / / Low
~ Inventory Item 0014 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
GEAR OIL Days On Site
365
Location within this Facility Unit Map: Grid:
TOOL ROOM IN VINEYARD BLDG CAS#
64742-57-0
Liquid Mixture AmbRentURE TEMPERATURE CONTAINER TYPE
T ~- ~ Ambient -~LASTIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
rls-~c~s-uc1~VU~ ~VrirVlVnlyla
%Wt. RS CAS#
100.00 Light Machine Oil No 8020835
t11~GL•itCJJ 1-~. 7.7L" .7.71~1L' 1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Low
-8- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
OIL Days On Site
365
Location within this Facility Unit Map: Grid:
NEAR SHOP IN REAR YARD CAS#
8020835
LiTAid Mixture PRESSURE TEMPERATURE CONTAINER TYPE
qu~ T ~ Ambient ~ Ambient DRUM/BARREL-METALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
55.00 GAL 300.00 GAL 250.00 GAL
- nt~,~titcLVUa ~vi~trulv~ly l
oWt. RS CAS#
100.00 Motor Oil, Petroleum Based No 8020835
t1HGEilCL L-~JJtS~J1~1~1V 1.7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F DH / / / Min
~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
RIGID THREAD CUTTING OIL Days On Site
365
Location within this Facility Unit Map: Grid:
S SIDE LG WHSE CAS#
0
Liquid TMixture ~ Ambient~E ~ AmbientT~E DRUM/BNARRELEMETALLI~
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
55.00 GAL 90.00 GAL I 60.00 GAL
- ~~~~L~~a COMPONENTS
°sWt. RS CAS#
100.00 Cutting Oil No 0
ruyc~rucL r» a~Jai•lr~1v 1 a
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Min
-9- 02/01/2007
F JIMS SUPPLY CO
~ Inventory Item 0017
COMMON NAME / CHEMICAL NAME
LUBRICANT
LUBRICANT 191-5
Location within this Facility Unit
TOOL RM IN VINEYARD BLDG
STATE TYPE PRESSURE
Liquid TMixture~ Ambient
SiteID: 015-021-001001 ~
Facility Unit: Fixed Containers on Site ~
Days On Site
365
Map: Grid:
CAS#
64741964
TEMPERATURE CONTAINER TYPE -
Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum ( Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
tit~c,xres~uua ~ui~irviv~iv 15
%Wt. RS CAS#
100.00 Lubricating Oil (Petroleum-Based) No 8020835
nta~tircL ti~~~~~i~i~iv~l~a
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F / / / Min
~ Inventory Item 0011 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
KUTWELL 82 Days On Site
365
Location within this Facility Unit Map: Grid:
NEAR SHOP AT REAR OF YARD CAS#
STATE - TYPE PRESSURE TEMPERATURE CONTAINER TYPE _
Liquid .Mixture ~ Ambient ~ Ambient DRUM/BARREL-METALLIC
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
110.00 GAL 110.00 GAL 110.00 GAL
HAZARDOUS COMPONENTS
%Wt.
RSA CAS#
ns,ZARD A SSESSMENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies DH / / / UnR
-10- 02/01/2007
P DIMS SUPPLY CO SiteID: 015-021-001001 ~
~ Inventory Item 0015 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
FEBIS K68 Days On Site
365
Location within this Facility Unit Map: Grid:
TOOL RM IN VINEYARD BLDG CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixture~Ambient ~ Ambient _~ PLASTIC. CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
HAZARDOUS COMPONENTS ,
%Wt.
RSI CAS#
t1AL,HKL AS~J;SS1~1J;1V'1'S
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / UnR
~ Inventory Item 0016 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
RUSTLIC Days On Site
365
Location within this Facility Unit Map: Grid:
TOOL RM IN VINEYARD BLDG CAS#
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixture ~mbient ~ Ambient -~STIC CONTAINER
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
5.00 GAL 5.00 GAL 5.00 GAL
HAZARDOUS COMPONENTS ,
%Wt.
RSI CAS#
-- - riHGHKL Ei77t',~~1~11"~1V 1,5
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / UnR
-11- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001
Fast Format
~ Notif./Evacuation/Medical Overall Site
~ Agency Notification 04/06/2006
IF A RELEASE OF HAZARDOUS MATERIALS OCCURS AT THE SITE THE FOLLOWING
AGENCIES WOULD BE CONTACTED AND INFORMED:
STATE OF CALIFORNIA 800-852-7550
CALL 911
HAZARDOUS MATERIALS DIVISION 326-3979
= Employee Notif./Evacuation 10/25/2000
IN CASE OF AN EMERGENCY NECESSITATING AN EVACUATION, ALL OFFICE PHONES ARE
CONNECTED TO AN INTERCOM LOUD SPEAKER MOUNTED ON THE NORTHEAST CORNER OF THE
WAREHOUSE. THIS LOUD SPEAKER WOULD ALLOW IMMEDIATE NOTIFICATION OF ALL
EMPLOYEES. ALL WAREHOUSES, SHEDS, ETC ARE VERY OPEN, ENABLING QUICK
EVACUATION IF NECESSARY.
Public Notif./Evacuation
10/25/2000
IN CASE OF AN EMERGENCY NECESSITATING AN EVACUATION, ALL OFFICE PHONES ARE
CONNECTED TO AN INTERCOM LOUD SPEAKER MOUNTED ON THE NE CORNER OF THE
WAREHOUSE. THIS LOUD SPEAKER WOULD ALLOW IMMEDIATE NOTIFICATION OF ALL
EMPLOYEES AND ANY PUBLIC WHO MAY BE IN THE FACILITY. ALL WAREHOUSES, SHEDS,
ETC ARE VERY OPEN, ENABLING QUICK EVACUATION IF NECESSARY.
Emergency Medical Plan
09/10/2003
ALL EMERGENCY MEDICAL PROBLEMS ARE REPORTED TO THE OFFICE WHICH AT THAT TIME
ARE REPORTED TO THE DOCTOR, HOSPITAL, EMERGENCY STATIONS, AND THE INSURANCE
CARRIER.
LARRY CHO MD, VALLEY INDUSTRIAL MEDICAL GROUP, 2501 G ST.
-12- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 10/25/2000 ~
OXYGEN AND ACETYLENE ARE STORED IN A METAL ENCLOSED BIN AWAY FROM ANY HEAVY
TRAFFIC AREAS. ALL DIESEL FUEL IS CONSUMED THROUGH STANDARD ABOVE GROUND
FUEL PUMPS WHICH ARE PROTECTED BY STEEL PIPE BARRIERS. ANY 50 GAL OIL DRUMS
ARE TAPPED WITH MANUAL OPERATED SHUTOFF VALVES. ALL WASTE OIL IS KEPT IN
DRUMS AND THEN SOLD AS USED OIL TO A LOCAL REFINERY. FIRE EXTINGUISHERS ARE
LOCATED NEAR ALL OF THE ABOVE MENTIONED AREAS.
Release Containment 11/30/1990
SHOULD ANY RELEASE OF HAZARDOUS MATERIALS OCCUR AND NECESSITATE FURTHER
CONTAINMENT A COMPANY QUALIFIED AND LICENSED FOR THAT PARTICULAR MATERIAL
WOULD BE CONTACTED IMMEDIATELY TO PREVENT ANY FURTHER RELEASE.
Clean Up 04/06/2006
CLEAN-UP OF A HAZARDOUS MATERIALS RELEASE WOULD BE DONE BY A COMPANY
QUALIFIED AND LICENSED TO HANDLE AND DISPOSE OF THAT PARTICULAR MATERIAL.
Other Resource Activation
-13- 02/01/2007
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
o~c~ia.i na~caiu5
Utility Shut-Offs 12/13/2006
A) GAS - N END OF OFFICE BLDG
B) ELECTRICTAL - SW CRNR OF OFFICE
C) WATER - SW CRNR OF PARCEL AT ST CURB
D) SPECIAL - NONE
E) LOCK BOX - NO
Fire Protec./Avail. Water 12/13/2006
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS IN OFFICE, WHSES, AND SHOP.
WATER VALVES WITH HOSES NEAR WHSES AND SHOP.
FIRE HYDRANT - NE CRNR BUCK OWENS BLVD & GRIN WY
Building Occupancy Level 04/06/2006
-8~ EMPLOYEES
Rd-!oo
-14- 02/01/2007
i
F JIMS SUPPLY CO SiteID: 015-021-001001 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 12/13/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE IN OFFICE AND WHSE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE PERIODICALLY BRIEFED AS TO
THE LOCATION AND GENERAL CONTENTS OF THE MATERIAL SAFETY DATA SHEETS ON
FILE.
rcayc a
Held for Future Use
nC.LU iii r u~uiC v5c
-15- 02/01/2007
+ JIMS SUPPLY CO ______________________________________ SiteID: 015-021-001001 +
Manager
Location: 3530 BUCK OWENS BLVD
City BAKERSFIELD
BusPhone: (661) 324-6514
Map 102 CommHaz High
Grid: 23B FacUnits: 1 AOV:
CommCode: KCFD STA 66
EPA Numb:
SIC Code:5051
DunnBrad:
--- - --
-_____+
.Emergency Contact / Title Emergency Contact / Title
BRYAN BOYLAN Ce.I~ ~ 1 / '3 j `Z - $' ~ `~ GREG BOYLANC4) ( ~, ~ / `'A3 -rj~ 5U
Business Phone: (661) 324-6514x Business Phone: (661) 324-6514x
24-Hour Phone (661) 325-8182x 24-Hour Phone (661) 322-4694x
Pager Phone ( ) - x Pager Phone (~ ) - x
Hazmat Hazards: Fire Press ImmHlth DelHlth
Contact Phone: (661) 324-6514x
MailAddr: 3530 BUCK OWENS BLVD State: CA
City BAKERSFIELD Zip 93308
Owner DOREEN M BOYLAN Phone: (661) 324-6139x
Address 260 EL CERRITO DR State: CA
City BAKERSFIELD Zip 93305
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives: ~
PROG A - HAZMAT
PROG H - HAZ WASTE GEN
PROG T - ABOVEGROUND STORAGE TANK
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of law that I have personally
examined and am familiar with the information
submitted and believe the information is true,
accurate, and complete.
i _._. ~~
Si ature Date
E~ A P ~ o s zoos
-1- 03/22/2006