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Home My WebLink AboutBUSINESS PLAN 7/9/2007~; es+ t~ a}.-T~,~y. .rr ~ li• _ 1 ~~~ ` ii KERN ANIMAL CLINIC i r ~ ' i 4300 EASTON DRIVE, SUITE #1 e i ft 1 ANIMAL EMERGENCY & URGENT CARE Manager CRAIG ROBERTS Location: 4300 EASTON DR 1 City BAKERSFIELD CommCode: BFD STA 03 EPA Numb: SiteID: 015-021-000949 BusPhone: (661) 322-6019 Map 102 CommHaz Low Grid: 35A FacUnits: 1 AOV: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title KATHERINE RATLIFF / OWNER CRAIG ROBERTS / OPERATIONS MGR Business Phone: (661) 322-6019x Business Phone: (661) 322-6019x 24-Hour Phone (661) -°_° ''==^~r-3~326Z 24-Hour Phone (661) 387-9278x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact KATHERINE RATLIFF Phone: (661) 322-6019x MailAddr: 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Owner KERN ANIMAL EMERGENCY CLINIC INC Phone: (661) 322-6019x Address 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT of those individuals i ry ~a,ed on my inqu responsible for obtaining the information, 1 certify w that I have personally f l ENT'D J U L 11 2007 a under penalty o mined and a^"~ familiar with the information exa submitted and oe ieve the information is true, acc te, and ;~ Mete. 7 ~ 0 t 'nature Oa -1- 06/29/2007 r F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ I Hazmat Common Name... ISpecHazIEPA Hazards) Frm I DailyMax IUnitIMCPI OXYGEN F P IH G 1786.00 FT3 Lowl -2- 06/29/2007 -3- 06/29/2007 ,, n F ANIMAL EMERGENCY & URGENT CARE ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit SW CRNR BLDG STATE TYPE PRESSURE _ Gas TPure ~-Above Ambient SiteID: 015-021-000949 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 281.00 FT3 1786.00 FT3 1174.00 FT3 tiHGA1CLVU~ I:VL~lYV1VL'1V15 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 rir~c~Htcl~ s~~ ~~a~l~i~ivla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -4- 06/29/2007 '~ F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/10/2000 ~ FIRE DEPT OR HAZARDOUS MATERIALS DIVISION. Employee Notif./Evacuation PHONES HAVE BUILT-IN INTERCOMS - WORD-OF-MOUTH. 09/21/2006 Public Notif./Evacuation PHONES HAVE BUILT-IN INTERCOMS - WORD-OF-MOUTH. 09/21/2006 Emergency Medical Plan 10/10/2000 CALL 911. -5- 06/29/2007 -~ .t F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/21/2006 ~ CHAINS, UPRIGHT, PERMANENT VALVES IN WALL. WE HAVE INSTALLED A BRASS MANIFOLD SYSTEM ATTACHED TO THE WALL WHEREBY THE DELIVERY VALVES DO NOT HAVE TO BE CHANGED FROM TANK TO TANK. AIR LIQUIDE HAS SUPPLIED A REPRESENTATIVE WHO TRAINED STAFF ON ITS USE. STANDING RACK WHICH HOUSES THE SMALL 25 FT3 TANKS (CYLINDERS) WHICH SITS NEXT TO THE BANK OF J (256 CF) CYLINDERS DESCRIBED ABOVE. Release Containment AIR-GAS: 391-0117 AFTER HOURS: 857-3685 03/16/2006 Clean Up N/A 02/22/2007 Other Resource Activation -6- 06/29/2007 ,.,. F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~CC:1d1 Ild'GdL U.S' Utility Shut-Offs A) GAS - BY SINGLE WOODEN DOOR E SIDE BLDG B) ELECTRICAL - UTIL RM SE BEH WINDOWED OFFICE C) WATER - UNDERNEATH MAILBOX BY GAS D) SPECIAL - NONE E) LOCK BOX - NO 12/20/2006 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - ACROSS ST BEH 9~(CALIFORNIA AVE). ~uQ~tN4TorJ CaA7" FA~TdRY 12/20/2006 Building Occupancy Level 30 EMPLOYEES 12/20/2006 -7- 06/29/2007 ,~ ~, ~ F ANIMAL EMERGENCY & URGENT CARE SitelD: 015-021-000949 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/21/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EACH EMPLOYEE IS SHOWN HOW TO SAFELY TRANSFER ADMINISTRATION VALVES FROM TANK TO TANK. EACH EMPLOYEE IS INFORMED THAT BUMPING, MOVING, OR TIPPING OVER A TANK CAN MEAN EXTREME DANGER. EACH EMPLOYEE KNOWS TO TELL CUSTOMERS ABOUT NO SMOKING BECAUSE OF OXYGEN BEING IN USE IN THE BLDG. ra~c c. nclu iv.L ruuui~ u5C nclu ivi r UI.ULC UDC -8- 06/29/2007 r ANIMAL EMERGENCY & URGENT CARE Manager CRAIG ROBERTS Location: 4300 EASTON DR 1 City BAKERSFIELD SitelD: 015-021-000949 BusPhone: (661) 322-6019 Map 102 CommHaz Low Grid: 35A FacUnits: 1 AOV: CommCode: BFD STA 03 EPA Numb: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title KATHERINE RATLIFF / OWNER CRAIG ROBERTS / OPERATIONS MGR Business Phone: (661) 322-6019x Business Phone: (661) 322-6019x 24-Hour Phone (661) 858-2550x 24-Hour Phone (661) 387-9278x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact KATHERINE RATLIFF Phone: (661) 322-6019x MailAddr: 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Owner KERN ANIMAL EMERGENCY CLINIC INC Phone: (661) 322-6019x Address 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ENT'D F E B 2 2 2007 Eiased 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 elieve the information is true, acc te and l t , p e e. ~ / 27 ~ natu e D to -1- 01/24/2007 ;a ; ~ ` F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F P IH G 1786.00 FT3 LOw -2- Olj24j2007 .4 ~f~ -3- O1/24/~007 f v F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR BLDG CAS# 7782-44-7 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient FIXED PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container ~ Daily Maximum Daily Average 281.00 FT3 1786.00 FT3 1174.00 FT3 HAZARDOUS COMPONENTS °sWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 ru3~titcL r-~5a~~~i~i~iv~1 a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low -4- 01/24/2007 a ~,, r~ F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/10/2000 ~ FIRE DEPT OR HAZARDOUS MATERIALS DIVISION. Employee Notif./Evacuation PHONES HAVE BUILT-IN INTERCOMS - WORD-OF-MOUTH. 09/21/200 Public Notif./Evacuation PHONES HAVE BUILT-IN INTERCOMS - WORD-OF-MOUTH. 09/21/2006 Emergency Medical Plan 10/10/2000 CALL 911. -5- 01/24/2007 rs `~ ~` . . F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/21/2006 ~ CHAINS, UPRIGHT, PERMANENT VALVES IN WALL. WE HAVE INSTALLED A BRASS MANIFOLD SYSTEM ATTACHED TO THE WALL WHEREBY THE DELIVERY VALVES DO NOT HAVE TO BE CHANGED FROM TANK TO TANK. AIR LIQUIDE HAS SUPPLIED A REPRESENTATIVE WHO TRAINED STAFF ON ITS USE. STANDING RACK WHICH HOUSES THE SMALL 25 FT3 TANKS (CYLINDERS) WHICH SITS NEXT TO THE BANK OF J (256 CF) CYLINDERS DESCRIBED ABOVE. Release Containment 03/16/2006 AIR-GAS: 391-0117 AFTER HOURS: 857-3685 t.1Cd11 U~J NIPS v 1.11CL iCC~V Ul.LC EiU l.lVdl.l Uil -6- 01/24/2007 :~ t* a- F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JYCC:ldl IldGdl lid Utility Shut-Offs _ 12/20/2006 A) GAS - BY SINGLE WOODEN DOOR E SIDE BLDG B) ELECTRICAL - UTIL RM SE BEH WINDOWED OFFICE C) WATER - UNDERNEATH MAILBOX BY GAS D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - ACROSS ST BEH VONS (CALIFORNIA AVE). 12/2.0/2006 Building Occupancy Level 30 EMPLOYEES 12/20/2006 -7- 01/24/2007 ,~ ~. ~-, F ANIMAL EMERGENCY & URGENT CARE SiteID: 015-021-000949 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 09/21/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EACH EMPLOYEE IS SHOWN HOW TO SAFELY TRANSFER ADMINISTRATION VALVES FROM TANK TO TANK. EACH EMPLOYEE IS INFORMED THAT BUMPING, MOVING, OR TIPPING OVER A TANK CAN MEAN EXTREME DANGER. EACH EMPLOYEE KNOWS TO TELL CUSTOMERS ABOUT NO SMOKING BECAUSE OF OXYGEN BEING IN USE IN THE BLDG. rctyC L aiciu ~.vi i~ u~.uic vac nciu ivi ru~uic ~5C -8- 01/24/2007 UNIFIED PROGRAM INSPECTION CHECKLISTr __..._ ______.._.- _ _ -__ .._~ _. - T -~_._. -...____ W.._. _.-~ r _! i SECTION 1: Business Plan and Inventory Program , • E E R S E I D F/RE D ARTM T Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ADDRESS ~-! 300 ~.A~ia~l ~~-- ~ 1 PHONE NO. ~ z-~ r-o,~ NO OF EMPLOYEES ~ D FACILITY CONTACT K/-FTf~f~~f~-t t'~ ~ ~TC,I ~F BUSINESS ID NUMBER 15-021- DOZ~q ~1 Section 1. Business Plan. and Inventory Program (~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND LSY ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ~I, I o ~ ~ l1 ,~ ~ ~Q~6 I~ ^ VISIBLE ADDRESS C3~ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~ ^ VERIFICATION OF QUANTITIES ,.,. L4' ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~Y ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Lam' ^ EMERGENCY PROCEDURES ADEQUATE C~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING B' ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN ^ YES ~~O 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 '~ y ,. + KERN ANIMAL EMERGENCY CL]CNiIC INC ____________________ SiteID: 015-021-000949 + Manager BusPhone: (661) 322-6019 Location: 4300 EASTON DR 1 Map 102 CommHaz Low City BAKERSFIELD Grid: 35A FacUnits: 1 AOV: CommCode: BFD STA 03 EPA Numb: SIC Code:0742 DunnBrad: Emergency Contact / Title Emergency Contact / Title ~ KATHERINE RATLIFF / OWNER CRAIG ROBERTS '~~~T~~~~£E MANAGER ` Business Phone: (661) 32'2.-6019x Business Phone: (661) 322-6019x 24-Hour Phone (661) 858'-2550x 24-Hour Phone (661) 387-9278x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact Phone: (661) 322-6019x MailAddr: 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Owner KATHERINE RATLI:F'F DVM Phone: (661) 322-6019x Address 4300 EASTON DR 1 State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT 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, an plete. ignat D 6(a ~~a os -1- 03/02/2006 UNIFIED PROGRAM INSPECTION ChIECKLIST'. ..~, ,,. 1~.. i'€;R'h"; ~+3^..: -^d°R:A+-46..~,......+.:Vm,`?'.F'.. 4*R. ,[-,r ~Y'?:fi:, Kt'x rrt ~.:.:.. ..+.'_ a~...,.;S....: ~... :,:_:.+a..-_„~.. ., ._ <.. •: .-, ~.:- >,. SECTION 1: Business Plan and inventory Program • BAKERSFIELD FIRE DEPT 1 Prevention Services ~1R1 900 Truxtun Ave., Suite 210 ARTM t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME KE¢~~ A rJtirv~. ~nn~2G~tvc.`t Cu n1 ~~.. f tv ~. INSPECTION DATE INSPECTION TIME ADDRESS 300 ~k5i ati1 p~ ~- I HONE NO. 32~-~0~ O OF EMPLOYEES FACILITY CONTACT ~ ~ ~ - USINESS ID NUMBER ~s-o2~- ~qy9 n~ ~ ~, ~ ~-t~~ N~~ Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ,_,/ ICJ ^ BUSIrI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION E ~ ^ PROPER SEGREGATION OF MATERIAL - / l~ ^ VERIFICATION OF MSDS AVAILABILITY ~ ^ VERIFICATION OF HAZ MAT TRAINING , / t_I ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO CEDURES , / L7 ' ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES B'NO .QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 ~1 ~~~ ~cC.IfOv~ 3 ~~- Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station ff White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) c~o~~r ~F~ d .~, -o .l ~~ CITY OF BAKERSFIEI,D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAI~1 INSPECTION CHECKLIST 1715 Chester Ave., 3rd I' loor, Bakersfield, CA 93301 FACILITY NAME_/~'f ~~ /~h~•.~• n r C-I• •~ ~~~ ADDRESS "'7~~G ~' iC,aif~-~ ~ ~ FACILITY CONTACTx~~Lr eK~a~l• ~f INSPECTION TIME / ~ r- K s INSPECTION DATE 7 ' 21 ' U7 PHONE NO. 322 • LEI S BUSINESS ID NO. 15-21 U- ~`.s'- 62 / - GYSO ~yS NIJMBER OF EMPLOYEESI~ Section 1: Business Plan and Inventory Program outine ^ Combined ^ Joint Agency ^Mu1ti-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 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~io Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Whin • Env. Svcs. Yellow -Station Copy Pink - Hus~ness Copy ` LC~ Y~' KERN ANIMAL EMERGEN LINIC INC SiteID: 015-021-000949 Manager : BusPhone: (661) 322-6019 Location: 4300 EASTON DR 1 _ %%~ Map : 102 CommHaz : Low City~ : BAKERSFIELD ~%% Grid: 35A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code:0742 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title KATHERINE RATLIFF / OWNER CRAIG ROBERTS / OFFICE MANAGER Business Phone: (661) 322-6019x Business Phone: (661) 322-6019x 24-Hour Phone : (661) 858-2550x 24-Hour Phone : (661) 387-9278x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact : Phone: (661) 322-60i9x MailAddr: 4300 EASTON DR 1 State: CA City · : BAKERSFIELD Zip : 93309 Owner KATHERINE RATLIFF, DVM Phone: (661) 322-6019x Address : 4300 EASTON DR 1 State: CA City : BAKERSFIELD Zip : 93309 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, I~'P.~,~ J~i~Z,o.~-5 Do hereby certify that I have revie~ tbs ~chsd h~ardous mmeri~ls I~ ~L mere plan for ~~ ~nd ~t i~ along ~ith any ~s~ions consfi~u~s a ~mpis~s ~d ~rr~ man- ~emen~ Plan ~or my facili~. -1- 08/22/2003 :~ERNANIMAL E~ERGENCY CLIN SitelD: 015-021-000949 Manager : BusPhone: (~9) 322-6019 Location: 4300 EASTON DR 1 Map : 102 CommHaz : Low City : BAKERSFIELD Grid: 35A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 03 SIC Code:0742 EPA Numb: DunnBrad: ~ ~r~o~rr~ _ _ Emergency Contact / Title ~er~ency uonEac5 / Title KATHERINE RATLIFF &~l/ OWNER ~U~CES P~TLI~ ~//.OFFICE MANAGER Business Phone: (~.) 322-6019x Business Phone: (.~,) 322-6019x 24-Hour Phone : (~) 858-2550x 24-Hour Phone : (~) ZGG 779Gx- Pager Phone : ( ) - x Pager Phone : ( ) ~rq~TFx Hazmat Hazards: Fire Press Im~lth Contact : ~ Phone: ( ) - x City · B~ERSFIELD ~ ~ 'p : 9330 O~er ~THERINE ~TLIFF, D~D~ ~ ~3;~D- Phone: ~) 322-6019x t Tota = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: ~ Hazmat Inventory One Unified List -- As Designated Order Ail Materials at Site Hanmar Common Name... ISpeoHazlEPA Hazards Frm DailyMax UnitlMCP OXYGEN F P IH G 1786.00 FT3 Low ~, ~-;~. 'F,,~-H,'~' Do hereby certify that i have (Type or print name) reviewed the attached hazardous materials manage- ment plan for l<'enn ~r~'l,~d/:7~~ t~,~ it along with " (Name of Businass) any corrections constitute a complete and correct man- agement plan for my faciliiy. -1- 09/28/2000 ,KERN ANIMAL EMERGENCY CLINIC INC SiteID: 015-021-000949 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHWEST CORNER BLDG CAS# 7782-44 -7 STATE ~ TYPE PRESS~E i TEMPE~T~E CONTAINER TYPE Gas Pure ~ove A~ient Ambient FIXED PRESS. CYLINDER AMO~TS AT THIS LOCATION Largest Container I Daily Maximum Daily Average FT3I 1786.00 FT3 1174.00 FT3 ~Z~DOUS COMPONENTS __~0 .~0~00~ge~_~om~r~ss~d_ . ........... N. _ .7782447 ~Z~D ASSESSMENTS ITSecretl RSIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No No No No/ Curies F P IH / / / Low -2- 09/28/2000 F KERN ANIMAL EMERGENCY CLINIC INC SiteID: 015-021-000949 -- Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 01/07/1990 FIRE DEPARTMENT OR HAZARDOUS MATERIALS DIVISION -- Employee Notif./Evacuation 01/07/1990 PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH Public Notif./Evacuation 01/07/1990 PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH Eme~gency~Mediqa% pla~ .............. 01/07~19~? II CALL 911 3 09/28/2000 F KERN ANIMAL EMERGENCY CLINIC INC SiteID: 015-021-000949 -- Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 04/03/1995 CHAINS, UPRIGHT, PERMANENT VALVES IN WALL. WE HAVE INSTALLED A BRASS MANIFOLD SYSTEM ATTACHED TO THE WALL WHEREBY THE DELIVERY VALVES DO NOT HAVE TO BE CHANGED FROM TANK TO TANK. AIR LIQUIDE HAS SUPPLIED A REPRESENTATIVE WHO TRAINED STAFF ON ITS USE. STANDING RACK WHICH HOUSES THE SMALL 25 FT3 TANKS (CYLINDERS) WHICH SITS NEXT TO THE BANK OF ~ (256 FT3) CYLINDERS DESCRIBED ABOVE. "H" -- Release Containment 04/03/1995 NOTIFY JIIRE LIQUIDE. ~ Clean Up Other Resource Activation -4- 09/28/2000 I F KERN ANIMAL EMERGENCY CLINIC INC SitelD: 015-021-000949 f Fast Format F Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 04/03/1995 A) GAS - BY SINGLE WOODEN DOOR EAST SIDE BUILDING B) ELECTRICAL - UTILITY ROOM SOUTHEAST BEHIND WINDOWED OFFICE C) WATER - UNDERNEATH MAILBOX BY GAS D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/03/1995 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT- DIRECTLY ACROSS STREET BEHIND ~JILDERS ~.~=v~ TM ......... ~.-. Building Occupancy Level -5- 09~28/2000 / ~IKERN ANIMAL EMERGENCY CLINIC INC SiteID: 015-021-000949 Fast Format ~ Training Overall Site -- Employee Training 01/07/1990 WE HAVE~ EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE EACH EMPLOYEE IS SHOWN HOW TO SAFELY TRANSFER ADMINISTRATION VALVES FROM TANK TO TANK. EACH EMPLOYEE IS INFORMED THAT BUMPING, MOVING, OR TIPPING OVER A TANK CAN MEAN EXTREME DANGER. EACH EMPLOYEE KNOWS TO TELL CUSTOMERS ABOUT NO SMOKING BECAUSE OF OXYGEN BEING IN USE IN THE BUILDING. -- Page 2 -- Held for Future Use Held for Future Use 6 09/28/2000 IAGRAM __ ~-~. ,~ FACII2'I~ DIAGRAM au~m Nme: Dr. . 933~ ~ ~ ~. Bu~ae~ Name: I Businm Adc[ten: -~ Kern Animal Emergency C;iinic 4300 Easton Dr. Suite I ~ .5 Bakersfield, CA 93309 .[: ~ ~ /..3---~"-'-'- ~ EXIST1NG~ ~---?--..~~PARKING ~-' EXIST1NG. PARKING KENNETH GONDE [ rt , 4300 EAS~N DR.:' ¢-% ~%~% JUL 2 0 '1990' '-0 RGE~Y N~ ~-N.O. ~N~ ' ~ ~o ~.N.O. LIN~ ~ ~L ~,v w~ ~,/ ~ ~UNGE ~' ~ ~' EXaM i ~- c~.o. ) ~~.~.. ~.. ',N' I l u.~_ - ~,~ ~ ~ EXAM 2 WAITING w~ ~ . . REC~T.' .~.~ NOTE S ~ ~ ~/ . w/~ ~' STAFF ,~o" ~ ~ ~.~o. .' ~t~ ~~ ~. , ,. ~~ ~ ~~~' PA~TITIO~ PLAN !18" 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-00(~'~ Page Overall Site with 1 Fac. Unit jLA, PR 31995 ,~ General Information By Location: 4300 EASTON DR 1 Map:102 Haz:2 Type: 3 i City : Bakersfield Grid: 35A F/U: 1 AOV: 0.0 --Contact Name Title Contact Name Title 'KATHERINE RATLIFF / OWNER FRANCES RATLIFF / OFFICE MANAGER Business Phone: (805) 322-6019x Business Phone: (805) 322-6019x 24-Hour Phone : (805) 858-2550x 24-Hour Phone : (805) 366-7796x Pager Phone : ( ) - x 'Pager Phone : ( ) - x Administrative Data Mail Addrs: 4300 EASTON DR 1 D&B Number: City: BAKERSFIELD State: CA Zip: 93309- Comm Code: 215-003 BAKERSFIELD STATION 03 SIC Code: 0742 Owner: KATHERINE RATLIFF, DVM Phone: (805) 322-6019 Address: 4300 EASTON DR 1 State: CA City: BAKERSFIELD Zip: 93309- Summary I, ~Z_~..~,~ '~;~,.~,,~ Do hereby certify that I have " (Ty~ or print name) reviewed the attached hazardous materials manage- ment plan for~'~.,.~.,,.q ~~nd that it along with (Name of Business) ' any corrections constitute a complete and correct man- agement plan for my facility. SignatuFe j~'[ ' Date 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 2 Hazmat Inventory List in MCP Order 02~-'Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-001 OXYGEN Gas 842 Low · Fire, Pressure, Immed Hlth FT3 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 3 02 - Fixed Containers on Site · - Hazmat Inventory Detail in~MCP Order 02-001 OXYGEN Gas 842 Low · Fire, Pressure, Immed Hlth FT3:~~ CAS #: 7782-44-7 Trade.Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 ~ Daily Average FT3 I Annual'Amount FT3 ~ I ~ I .33,720.00 Storage Press T TempI Location FIXED PRESS. CYLINDER Above ]AmbientlSOUTHWEST CORNER BLDG -- Conc Components MCP Guide 100.0% Ioxygen, Compressed ILow I 14 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <l>.Agency Notification FIRE DEPARTMENT OR HAZARDOUS MATERIALS DIVISION <2> Employee Notif./Evacuation PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH <3> Public Notif./Evacuation PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH <4> Emergency Medical Plan CALL 911 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention CHAINS, UPRIGHT, PERMANENT VALVES IN WALL. ~WE HAVE INSTALLED A BRASS MANIFOLD SYSTEM ATTACHED TO THE WALL WHEREBY THE DELIVERY VALVES DO NOT HAVE TO BE CHANGED FROM TANK TO TANK. +K~Pt~LhR HAS SUPPLIED A REPRESENTATIVE WHO TRAINED STAFF ON ITS USE. <2> Release Containment <3> Clean Up <4> Other Resource Activation 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - BY SINGLE WOODEN DOOR EAST SIDE BUILDING B) ELECTRICAL - UTILITY ROOM SOUTHEAST BEHIND WINDOWED OFFICE C) WATER - UNDERNEATH MAILBOX BY GAS D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - DIRECTLY ACROSS STREET BEHIND BUILDERS EMPORIUM <4> Building Occupancy Level 02/21/95 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 7 00 - Overall Site <G> Training '<1> Employee Training WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE EACH EMPLOYEE IS SHOWN HOW TO SAFELY TRANSFER ADMINISTRATION VALVES FROM TANK TO TANK. EACH EMPLOYEE IS INFORMED THAT BUMPING, MOVING, OR TIPPING OVER A TANK CAN MEAN EXTREME DANGER. EACH EMPLOYEE KNOWS TO TELL CUSTOMERS ABOUT NO SMOKING BECAUSE OF OXYGEN BEING IN USE IN THE BUILDING. <2> Page 2 <3> Held for Future Use <4> Held for Future Use ~m~N ANIMAL EMERGENCY CLINIC INC 215-000- J~949 Pa~, 1 Overall Site with 1 Fac. Unit By, i 'General Information Location: 4300 EASTON DR 1 Map: 102 Hazard: Low. Community: BAKERSFIELD STATION 03 Grid: 35A F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- KATHERINE RATLIFF OWNER (805) 322-6019'x (805)' 858-2550 FRANCES RATLIFF OFFICE MANAGER (805) 322-6019 x (805) 366-7796 Administrative Data Mail Addrs: 4300-1 EASTON DR D&B Number: City:. BAKERSFIELD State: CA Zip: 93309- · Comm Code: 215-003 BAKERSFIELD STATION 03 SIC Code: 0742 Owner: KATHERINE RATLIFF, DVM " phone:` (~_~-),~-~°lfl Address': 4300-1 EASTON DR. State: CA City: BAKERSFIELD Zip: 93309- Summary 32 KERN. ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 OXYGEN Gas 842 Low · Fire, Pressure, Immed Hlth FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS -- Daily Max FT3 Daily Average FT3 I Annual Amount FT3 842 I 562.00 " 33,720.00 Storage PreSs T Temp Location FIXED PRESS.-CYLINDER IAbove ~AmbientlSOUTHWEST CORNER BLDG ~; -'~ -- C6~c Components '-'1 MCP ~List 100.0% IOxygen, Compressed Low 29/.92 KERN ANIMAL EMERGENCy CLINIC INC '215-000-000949 'Page 3 00 - Overall Site -<D> Notif./Evacuation/Medical <1> Agency Notification FIRE DEPARTMENT OR HAZARDOUS MATERIALS DIVISION <2> Employee Notif./Evacuation PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH <3~ Public Notif./Evacuation PHONES HAVE BUILT IN INTERCOMS - WORD OF MOUTH <4> Emergency Medical Plan CALL 911 07/29/92 KERN ANIMAL' EMERGENCY CLINIC INC 215-000-000949 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention CHAINS, UPRIGHT, PERMANENT VALVES IN WALL- <2> Release Containment NOTIFY HOPPER MEDICAL <3> Clean Up <4>~Other Resource Activation 07/29/92 KERN ANIMAL EMERGENCY CLINIC INC 215-000-000949 Page 5 00 - Overall Site <F> Site Emergency Factors . <1> Special Hazards <2> Utility Shut-Offs A) GAS - BY SINGLE wooDEN DOOR EAST SIDE BUILDING B) ELECTRICAL - UTILITY ROOM SOUTHEAST BEHIND WINDOWED OFFICE C) WATER - UNDERNEATH MAILBOX BY GAS D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS ~IRE ~HYDRANT - DIRECTLY ACROSS STREET BEHIND BUILDERS EMPORIUM <4>~Building Occupancy Level 07/29/92 KERN ANIMAL EMERGENCY CLINIC'INC 215~000'000949 Page 6 00 - Overall Site . <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIALSAFETY DATA SHEETS ON FILE EACH EMPLOYEE IS SHOWN HOW TO SAFELY TRANSFER ADMINISTRATION VALVES FROM TANK TO TANK. EACH EMPLOYEE IS INFORMED THAT BUMPING, MOVING, OR TIPPING .OVER A TANK CAN MEAN EXTREME DANGER. EACH EMPLOYEE KNOWS TOTELL CUSTOMERS ABOUT NO SMOKING' BECAUSE OF OXYGEN BEING IN USE IN THE BUILDING. <2> Page 2' as needed <3> Held for FutUre Use <4>~Held for Future Use TO: BUILDING DEPT. BUSINESS NAME ~r~ ,~;r~o,.,,O Er'~6~_r-O~_ O,:NfO ~ sTATUs CF HAZ MA/~E~ULATICN$ I. [-~ Required to complete ~ HczcrCcus Mctericls Business Ptcn :'-:" · r-] Hczcrdous Mctericis Business P!cn Complete .- II. ri_ Risk Mcncgement & Prevention Progrcm Required ':" ,' [--] Risk Mcncgement & Prevention Progrcm Requirements ore I~ejng me? - CK to issue permit [--~ Risk Mcncgement end Prevention Progrcm I~cs b, een cpproved. 0~: to issue C_=,d'ificcte of 111. ~ No HazcrCcus Mcterict Requirements. IV. ~ All Hazcrdcus Mctericts Reporting Requirements Complete. Comments: HczcrCous Mctericls Division Date ~,~-, ~ ~55 rev ~ TO: BUILDING DEPT, STATUS CF HAZ MAT REGULATIONS I. ~ Required to complete a Hazardous Materials Business Plan ,,;,,.;, Hazardous Materials Business Plan Complete II. [] Risk Management & Prevention Program Required [--1Risk Management & Prevention Program Requirements are being met - OK to issue permit EZ] Risk Management and Prevention Program has been approved. OK to issue Certificate of Occupancy, III, I--1 No Hazardous Material Requirements. IV. [-'1 All Hazardous Materials Reporting Requirements Complete, Comments: H-azardous Material~ Division, Date FO 16,55 ,er 1/9o Bakersfield Fire Dept. Hazardous Materials DivisionNOV 1 3 1989 2130 "G" Street · i~~" Bakersfield, CA. 93301 ~,s'~ ............ HAZARDOUS MATERIALS MANAGEMENT PLAN ~ INSTRUCTIONS: 1.' To ovoid, further action,-return this form within 30'doys~ of'receipt. / (.~C~- :~'~ fJ~--' 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Ans~ver the questions below for the business as a whole. · '4. 'Be 6fief and concise as possible. SECTION 1:, BusINESS IDENTIFICATION DATA BUSINESS NAME: "" KERN ANIMAL EMERGENCY CUNICo INc. LOCATION: 4~oo EASTON BAKERSFIELD, CA 9330~ - (805) 322-601 MAILING ADDRESS: CITY: STATE:_ ZIP' -PHONE: DUN & BRADSTREET NUMBER: SIC CODE: MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION: - · CONTACT TITLE BUSi PHONE' 24'HR, PHONE .. · FDI5o, Bakersfield Fire Dept. ~ ~'%~W .' ; ~, ' Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING:. · NUMBER OF EMPLOYEss: -~. MATERIAL. SAFETY DATA SHEETS ON FILE:.~ ]fl~-..m BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6,95 OF THE "CALIFORNIA HEALTH & SAFETY CODE'~FOR THE FOLLOWING REASONS: WE. DO NOT .HANDLE. HAZARDOUS MATERIALS, WEDOHANDLE HAZARDOUS MATERIALS., BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES, OTHER (SPECIFY REASON) ~'~ SECTION 5: CERTIFICATION: I, K~¢',e T~/~ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. IUNDERSTAND THAT THIS INFORMATION WILL BE USEDTO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20' CHAPTER 6.95 sec. 25500 ET AL.) ANO THAT INACCURATE INFORMATION CONSTITUTES PERJURY. , - . ., .., ' . ~D1590 / ,~ . ' Bakersfield Fire Dept.~ ;' Hazardous Materials Divisio~l~ / -. ' HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATIO N'pR~oC EDURES: '~ ' B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: D, EMERGENCY MEDICAL PLAN' , Bakersfield Fire Dept. Hazardous Materials Division - HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION'7~:' MITIG,~'iON PREVENTION'AND ABATEMENT PLAN: A, RELEASE PREVENTION STEPS: B. RELEASE'CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): SPECIAL: LOCK BOX: YESN~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: B, WATER AVAILABILITY (FIRE HYDRANT): ~ ~ ~ ~ 4, FDI~ CITY of BAKERSFIELD ZARDOUS MATERIALS INVENTORY Farm and Agriculture D Standard Business NON--TRADE SECRETS Page _ df H (605)~-~i~ REFER ~O~NSTRUCTIDND~~ROPER CODES - - , 2 , 4 5 6 , 8 9 10 11 12 Trams ]y~e ~ax Xv?rage Annual ~easure I ~y~ Cont ConL ConL Us Loc~tjon.Xhe[e. tla~es of ~ixture/Co~oonents Code coae Amt Am[ EsL Units on s~ce Type Press iemo Co~eStored ~n Faci/l[y~ S~e instructions Physical and Health ~azard C.A,S. Number ~- 9~-] Co~pon~n[ II Na~e I C,~,S. Number (Check all thai ap~l~) ' Componen[ Nu~ber Health of Pressure...,.,, -- Component 13 Name ~ C.A.S, Number Physical tod Health Hazard C,A,S. Number Component I1 Name S C,A.S. Number {Check al1 that applyJ Component 12 Name & C.A.S. Number ~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Health of Pressure Component 13 Name S C.A,S. Number Physical and Health Hazard C.A,S. Number Component Il Name I C,A,S, Number (Check a11 that apply) Componen[ 12 Hame & C.A.S, Number ~ ~ireHazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Health of Pressure Componen[13 Name &C,A,S. Number Physical 8nd Health Hazard C,A.S, Number Component II Hame I C.A,S. Humber (Check a11 that apply) Component 12 Hame i C.A.S. Number ~ Fire Hazard ~ Reactivity ~ Delayed' ~ Sudden Release ~ Im~i~ Health of PressuFe Component 13 Hame & C,A.S. Humber ~me ~e Title j 2T~/ Fhone erti[igatioq ,(Re~d An~.?ign af~pr compl¢ti(~g,all..~cCipn~) cer~tCy~un~erpen~m~x9~nq~J~avepers~naH~ex~m~nq~q~Qm~amim~L~1~ne)n~rmaC)pn~u~mittfdin thisQndall t~acneo,oOcvmenc), milo thc emseo on.my i.nqulry F. cnose lnOlVlOUm/S responsIDme Tot obtaining cna lnrormacIon, 1 believe that the uemlttee lntor~8clO~ I~ true, mccurmce, 8no compmece. ~ ie 0t owner/ooera,or uH own~dpetatorTM authorized r~resentative ~JJ- ~ ,~. · RECEIVED ~,z< c~ ~.,~,~' HAZARDOUS MATERIALS COMPLIANCE STATEMENT ' (To be completed by Building Permit Applicant and/or Site Plan Review Applicant) J~N 2 9 1990 KERN ANIMAl. ~MERGENCY CMN/C, ,"NC. BUSINESS NAME 4~b-'~ EASTCN STF_. I H.~. BAKERSFIELD, CA 93305 LOCATION {fl,qE} 293-~.01.°.- PLEASE READ ALL OF THE INFORMATON CAREFULLY, FAILURE TO COMPLY WITH THE HAZARDOUS MATERIALS REGULATIONS MAY RESULT IN CIVIL LIABILITIES OF UP TO $2000.00 FOR EACH DAY IN WHICH THE VIOLATION OCCURS.' Will the Applicant or future building occupant be required to complete a Hazardous NO Materials Business Plan? (NOTE) If you handle, store, use or dispose of, reportable quantities of any hazardous substance, you are required by California Law to complete a Hazardous Materials Business Plan. Forms can be obtained from the Bakersfield Fire Department, Hazardous Materials Division, 2130 G Street. Typical every day hazardous materials you may find in your facilities may include, but not limited to: compressed gases; fuels - all types; solvents; oils (new and waste); thinners; caustic or corrosive materials; poisonous or toxic materials; and radioactive materials. ,,.. Will the applicant or future building occupant be required to complete a Risk Manage- ment and Prevention Program? (NOTE) If you handle, store, use or dispose of reportable quantities of any extremely hazardous substance you must develop a Risk Management and Prevention Program. THIS PLAN MUST BE APPROVED BY THE LOCAL ADMINISTERING AGENCY BEFORE YOU COMMENCE OPERATIONS AT THIS FACILITY. The list ofregulated chemicals is contained in Appendix A of part 355 of Subchapter J of Chapter I of Title 40 of the Code of Federal Regulations. This list of chemicals isavailable Qt the Bakersfield Fire Department, Hazardous Materials Division, 2130 G Street. Will the applicant or furture building occupant be required to obtain a permit from the YES NO Kern County Air Polution Control District? E] E~ Location within 1,000 feet of outer boundry of the tallowing: YES NO School -(any school, public or private used tar the purposes of education of ~'~ ~ children Kindergarten or any of grade 1 to 12, inclusive) Hospital- F-~ ~ Long Term Care Facility- r-'l ~ Check here if none *of the above apply to this project. F-1 [] Signed: (Owner, Priniple or Offic/~/of'Bus' e s) I