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Home My WebLink AboutBUSINESS PLAN~ n - .` - ~, g ~ ~~~3 COLLINS WAY ,~ l -- -- - ~ `* H6~:cA'-"~'i"tDOUS MATERIALS MANAGEMENT PLAN (UNIFIED PROGRAM CONSOLIDATED FORM) APPLICATION ~IVESS ONVNER/OPERATOR DET(iFICAl10N FORM (HAZARDOUS MATERIALS FACILITY INFORMATION) r s e_RSr_i .n f/R8 ~Rrr r BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 ~~~ ~~ Page 1 of 2 ~ `~ f ~~~ I. FACILITY IDENTIFICATION 1 FACILITY ID NO. , Year Beginning ,do Year Ending 107 BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 BUSINESS PHONE 102 ` ' i R W 2 Chi 3~ •- Z~ ! SITE ADDRESS toa LL ~ is CITY ,oa K Ft L cA Ip ~ ~ ~ O `~ ,05 DUNN 8 BRADSTREET ~~ ~ ~ ~ ~ .~~ ~ y t~ o ~. `IC CODE ~Z C ,07 4 Digit #) couNTY ~ ~ ~ ~ ,os OPERATOR NAME ,09 ~ ~~-~ a~$~~ OPERATOR PHONE 1 U ~~ 60~ 3~ 11: OWNER INFORMATION OWNER NAME ~~~ OWNER PHONE 112 ~-~''tlQ f-~S1Z~ ~~ OL - 2~7 OWNER MAILING ADDRESS t,3 o C ~' h ST CITY t,a STATE „5 IP tte ~~~ ~~ c~ q~~oi Ill. ENVIRONMENTAL CONTACT „7 CONTACT NAME CONTACT PHONE „s A n / ~ Q , r~~ ~-'CJ CONTACT MAILING ADDRESS ~~~ ,t9 CITY ,2o STATE 122 '= PRIMARY . IV. EMERGENCY CONTACTS -$ECUNDARY- NAME 123 ~~€~n/~iv 1f~Z NAME 128 ~ ~ I~l~ ~ IM~~>rZ TITLE 124 TITLE - 129 BUSINESS P NE C`' ~ / ~ ~ ~ ~ L/~~ 125 BUSINESS PHON /~~ ~ / 1 ~ ~~ ~ ~~ ' ~ 130 l/ J 24-HOUR PHONE 126 C"3 23~ 2 ~ 2 - 35 6 ~ 24-HOUR PHONE 131 PAGER N0. 127 PAGER N0. 132 133 V. CERTIFICATION Certification: Based on my inquiry of those individuals responsible for obtaining the information, t certify under penalty of taw that I have personally examined and am familiar with the information submitted in this inventory and believe the information is true, accurate, and complete. SIGNATURE OF SIGNER 136 DATE 134 NAME OF DOCUMENT RREPARFR 135 NAME OF OW ER/OPERATOR!SDIGNA111RE 3 PRIM`) 137 TITLE OF OWNER/OPERATOR 138 5 ~~~~~ FD 2142 ~~~) ~~3~ ~5~ (Rev. 09/05) ~~ ~, t 3 HAZARDOUS MATERIALS MANAGEMENT PLAN UNIFIED PROGRAM CONSOLIDATED FORMS CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIALS INVENTORY ~~ NEW ^ ADD ^ DELETE ^ REVISE 200 » n x..s_p_.,r n F/Bi ABTAI T BAKERSFIELD FIRE DEPT. Prevention' Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 (Ore form per material, per bnltding or ar'ea.? I. FACILITY NFORMATION BUSINES NAME Y me as FA ILITY NAME or D A - Do g Business As) D 6Y' CHEM AL LOCA ON 201 CHEMICAL LOCATION 202 CONFIDENTIAL (EPCRA) ^ Yes ^ N FACT ID No. 1 MAP No. (optional) 203 GRID N0. (optional) 2 Ii. CHEMICAL INFORMATION CHEM AL NAME ^ 205 2 ~, J ' ~ TRADE SECRET ^ Yes ^ No am ( J f ti COMMON N E 207 EHS' ^ Yes ^ No 20 CAS No. 209 'If EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 21 TYPE 211 212 CURIES 21 ^ p PURE m MIXTURE ^ w WASTE RADIOACTIVE: ^ Yes ^ No 1 / RGEST CONTAINE 21 PHYSICAL STATE ^ s SOLID ^ I LIQUID Jig GAS 214 " J ~/~_ iVl 21 FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTIVE ^ 3 PRESSURE RELEASE ^ 4 ACUTE H EALTH ^ 5 CHRONIC HEALTH (Check all that apply) ANNUAL WASTE AMOUNT 217 MAXIMUM 218 DAILY AMOUNT AVERAGE DAILY AMOUNT ~ 219 STATE WASTE CODE 22 ~ ~ ~ 221 222 ^ UNITS ^ ga GAL ~ cf CU FT ^ Ib LBS ^ to TONS DAYS ON SITE If EHS, amount must be in lbs. 22 STORAGE CONTAINER ^ k BOX ^ p TANK WAGON (Check all that apply) ^ a ABOVEGROUND TANK ^ f CAN ^ b UNDERGROUND TANK ^ g CARBOY ~ CYLINDER ^ q RAI L CAR ^ c TANK INSIDE BUILDING ^ h SILO h ' 1 ^ d STEEL DRUM ^ i FIBER DRUM ^ n PLASTIC BOTTLE ^ e PLASTIC/NONMETALLIC DRUM ^ j BAG ^ o TOTE BIN 22 STORAGE PRESSURE ^ a AMBIENT as ABOVE AMBIENT ^ ba BELOW AMBIENT 22 STORAGE TEMPERATURE a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 227 ^ Yes ^ No 228 22 2 230 231 ^ Yes ^ No 232 23 3 234 235 ^ Yes ^ No 236 237 4 238 239 ^ Yes !~ No 240 241 5 242 243 ^ Yes ^ No 244 24 111. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 24~ hIJ 2144 (Ftt3V. UylU5) ' `2 e~ 2 BASILIO IRON WORKS SiteID: 015-021-00341:b Manager ARTEMIO BASILIO Location: 1023 COLLINS WY City BAKERSFIELD BusPhone: (661) 378-4279 Map 103 CommHaz Low Grid: 33A FacUnits: 1 AOV: CommCode: KCFD STA 41 EPA Numb: SIC Code:3441 DunnBrad:100-736014 Emergency Contact / Title Emergency Contact / Title FERNANDO DIAZ / OWNERS FRIEND J IME JIMENEZ / OWNERS FRIEND Business Phone: (661) 3-~8-^^-s.?~~ ~CtsK~ usiness Phone: (661) 633-1712x 24-Hour Phone (323) 252-3565x 24-Hour Phone ( ) - x ~ Pager Phone ( ) ~~~-_ `8~ (tag Pager Phone ( ) - x _..... Hazmat Hazards: Fire Press ImmHlth _...... Contact ARTEMIO BASILIO ~ Phone: (714) 604-3203x MailAddr: 706 32ND ST State: CA City BAKERSFIELD Zip 93301 Owner ARTEMIO BASILIO Phone: (714) 604-3203x Address 706 32ND ST State: CA City :.BAKERSFIELD Zip 93301 .............. Period to TotalASTs: _ (dal 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, !certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, d complete. Signature Date ~Q QT _ -1- O1/26/2~07 F BASILIO IRON WORKS SiteID: 015-021-00341b ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ARGON/CARBON DIOXIDE F P IH G 252.00 FT3 din -2- Ol/26/2b07 -3- Ol/26/~b07 F BASILIO IRON WORKS SiteID: 015-021-003410 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ARGON/CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: FRONT OF PROP CAS# 7440-37-1 STATE T TYPE ~f~ PRESSURE ~~ TEMPERATURE ~ CONTAINER TYPE "........ ~GdS I MiXture I AbOVe Ambient i Ambient I PnRT _ PRF~~ _ ~!YT,TT~TT~F.R I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 252.00 FT3 252.00 FT3 252.00 FT3 HAZARD OUS COMPONENTS °sWt• RS CAS# 25.00 Argon No 7440371 75.00 Carbon Dioxide No 124339 ilti[~tiRL HA w7.G.7 w71"11'.~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -4- 01/26/2007 9 F BASILIO IRON WORKS SiteID: 015-021-003410 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ agency Notiricat~on C~,c, ~ ~ ~ Employee Notif./Evacuation c~ ~~~ ~~ ru.niic i~ozi=./~vacuazion Emergency Medical Plan Q,w,P (off -ems. I,li UU CY~"~ '~-m ~G~ !~ -5- Ol/26/~d07 F BASILIO IRON WORKS SiteID: 015-021-003410 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ icc.a.ca~c rs_cvcll~.ivii Release Containment ~.icaia v~ V1.11C 1_ tCC5V U1_LC 1•iC.:L1Vdl.l Vll -6- O1/26/~007 F BASILIO IRON WORKS SiteID: 015-021-003410 ~ Fast Format ~ ~ Site Emergency Factors Overall Sits ~ JNc~.lal nac~as.u~ V l.llll.Y J11U 1.-VllS - .L 11c r1V,..C I: ~tiV 0111. I/V CL I,Ct Building Occupancy Level 01/26/2007 OWNER/OPERATOR -7- Ol/26/~007 F F BASILIO IRON WORKS SiteID: 015-021-003410 ~ Fast Format ~ ~ Training Overall Site ~ 1JllLtJ1VYGG 110.111111y O~S ~~ v ~ t'dyC G 17C 111 tVt 1'UI. u.LC VAC 17C1u 1VL t ULULC UDC -8- Ol/26/2~07 T '1 {~ + BASILIO IRON WORKS __________________________________ SitelD: 015-021-003410 + Manager ARTEMIO BASILIO Location: 1023 COLLINS WY City BAKERSFIELD BusPhone: (661) 378-4279 Map 103 CommHaz Low Grid: 33A FacUnits: 1 AOV: CommCode: KCFD STA 41 EPA Numb: SIC Code:3441 DunnBrad:100-736014 Emergency Contact / Title Emergency Contact / Title FERNANDO DIAZ / OWNERS FRIEND JAIME JIMENEZ / OWNERS FRIEND Business Phone: (661) 378-4279x Business Phone: (661) 633-1712x 24-Hour Phone (323) 252-3565x 24-Hour Phone.: ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact ARTEMIO BASILIO Phone: (714) 604-3203x MailAddr: 706 32ND ST State: CA City BAKERSFIELD Zip 93301 Owner ARTEMIO BASILIO Phone: (714) 604-3203x Address 706 32ND ST State: CA City BAKERSFIELD Zip 93301 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT k~1 ~ 5~ 6aaed 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 campiete. f r > Cccq ~,~ -22- d6 Signa ure Date gyro ~'AY ~ 3 2006 ------------------------------ ----------- -1- 05/10/2006 lac~5 UNIFIED PROGRAM INSPECTION CHECKLIST ,;._~ .rg~~..__ __~~. _. _.. SECTION 1: Business Plan and Inventory Program . Prevention Services A p R s e, , n 900 Truxtun Ave., Suite 210 F~~E ~ ' Bakersfield, CA 93301 v a e rM Tel.: (66.1) 326-3979 Fax: (661) 872=2171 FACILITY NAME a.S~ L~ o ~2.vA, ~a~~S INSPE TION9^ TE ~ t2(~~ INSPECTION TIME . ADDR~SS ~~ ~' 1 o Z3 PHONE NO. _ ~ ~~ 3~$ `~ NO OF EMPLOYEES ~ ~ ~ , s _ FACILITY~CONTACT _- BUSINESS ID NUMBER 15-021- l D .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 ^Q,,, ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES i N r~ ^ ^ 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 a'~ ^ I-IOUSEKEEPlNG FIRE PROTECTION ~ L e~ ~~ (~ ~~..~-.r y~,~ ~~a.-r ^ SITE DIAGRAM ADEQUATE & ON HAND ~a ANY HAZARDOUS WASTE ON SITE? ^YES ^~WD ,,..}}~~ `~~ g ~^ EXPLAIN: ~~~. `!'lti.. ~ ~ jT TSL)d'~`` ! ~ ~ G~~ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661j 326-3979 C-~ ~ ~~ Inspector (Please Print) Fire Prevention / 1°` In /Shift of Site/Station # ~~r ~' ~.~ri,~`~~ f~~~~i ~ t~~ Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05