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HomeMy WebLinkAboutBUSINESS PLAN 4/11/2005 ~I JOSCO CONSTRUCTION, INC. II ~ ~ 317 KENTUCKY STREET l ~ -- ---- UNIFIE® PROGR~-M INSPECTION CHECKLIST s ._.~.,.o...~.__.~.~.~.,._........__K.___ _.__.T..._.__ SECTI®N 1 SusinESS Plan and Inventory Program Bakersfield Fire I~9~pt~ ~ Environmental Services ?(j~~r 900 Truxtun Ave., Suite 210 ` Bakersfield, CA 93301 Tel: X661) 326-3979 _ _ _ FACILITY NAME WSPECT N O TE INSPECTION TIME ..wS Cd ~, ~S __--_---------- _._.._......_._ . ... ~ ~t _ ADDRESS ~ ~ PHONE No. No. of Employees 31 7 ~~~v~vcrcY ______ ___ FACILITYCONTACT Business ID Number 15-021- t'-Z~J Section 1: Business Plan and Inventory Program ^ Routine ^ Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-i C V (C=Compliance OPERATION G®MMENTS ////// `\ V=Violation '~ /~~~ ^ ^ APPROPRIATE PERMIT ON HAND ~) P~Z!'h. ~ ~' t ~ J ~f ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ ~ VERIFICATION OF INVENTORY MATERIALS (7,~rScT{-r n/C ~ I C-S~ P~~, f~ ~,P~,,,,~ CJ~Z OZ.~-~ ^ ^ VERIFICATION OF QUANTITIES ~~ ~UC.~ ST~ ~ / ti Z~ __._. _. __ . - -- , Z~ ^ ^ .VERIFICATION OF LOCATION ~~ ~- 5 t ti/~~ ~L9(9 ~ ~ Six Yom, ~ A ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ~ \ ^ ^ VERIFICATION OF HAT MAT TRAINING ! 1 ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEOUATE -- -. _ ._ ~ ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ FIRE PROTECTION ~ ~~~ sL.!'t,,~/'IGL ~ I~~NT ~-S,i~ ~„/~tst-C25 ^ ^ SITE DIAGRAM ADEQUATE ~ ON HANG ANY HAZARDOfU~S WASTE ON SITE?: L~'~ES ^ NO EXPLAIN: ""r ' ~~ ~! L QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ------_ ~ ~ N~.~__----.-------------------- --- ~~3- --- - ----- Inspector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Yellow -Station Copy Busi ss i e Responsible Party (Please Print) rn Pink -Business Copy -'!'~ CITY OF 13AKERSI'IELD - B E R s F ' °.~ OFFICE OF ENVIRONMENTAL SERV[CES € ,jR M t 1715 Chester Ave., CA 93301 (661) 326-3979 _' •~ HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one /orm per material per building or area) NEW ^ ADD ^ DELETE ^ REVISE 200 Page _ of I. FACILITY INFORMATION _ _ ____ ___ BUSINESSS NAME Same as FACILITY NAME or DBA - Ooin Business As - 3 ~O ~ GJ~S'~?,JG`R clY~J CHEMICAL LOCATION (~ ~,,n ^ 201 CHEMICAL LOCATION ('~T S (~~ (J,.) S r n ~ ~~ y' l`~ ~-+' CONFIDENTIAL (EPCRA) ^ Yes ^ No 202 --- FACILITY ID # ; '~, r~l~~_-"-I ~ -i~_-~ ` ~ 1I MAP-k (optionaQ 203 GRID # (optionaQ ~ ~ ~- - --- 204 I .r.lr ~ I . N. CHEMICAL INFORMATION i CHEMICAL NAME . 205 TRADE SECRET ^ Yes ^ No 206 . ~ I'~~t`~L - 1! Subject to EPCRA. refer to in5lructions ----- -------- -- .. - -. - 207 .. _ . ---------------------------.- --- ' COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 •If EHS is'Ya,' all amounts below must be in lbs. ' ( p equested by local fre chief) FIRE CODE HAZARD CLASSES Com lete if r ~ - ~ ~- ~ ~~~ 270 TYPE - ...._. _. _. -.....---- - - - - - - - ---. _..--------- CURIES -----2i3 -PURE ^ m MIXTURE ^ w WAS-: .. r,-,UIOAC71Vc ^ Yes ^ No 212 PHYSICAL STATE ^ s SOLID LIQUID ^ g GAS 274 LARGEST CONTAINER ~grn1 FEO HAZARD CATEGORIES \~7' FIRE ^ 2 REACTIVE ^ 3 PRESS ;RE f:ELE (Check all Ihat apply) I,SE I^ 4 .4 :U-'E HEALTH ^ S CHRONIC HEALTH _ ' ! ANNUAL WASTE ' 277 ;d4XIMUtwt ^/ 218 ~ AVERAGE 219 j STATE WASTE CODE ~ ~~ AMOUNT DAILY AMOUNT C 1 GAILY AMOUNT j UNITS' ~ GAL ^ d CU rT ^ Ib LBS ^ to TONS 221 i DAYS ON SITE ' If EHS, amount must be in lbs. j STORAGE CONTAINER ~ ABOVEGROUND TANK ^ e PLASTICINONMETALLIC DRUbt ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR (Check all that apply) I ^ b UNDERGROUND TANK ^ f CAN ~, j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN i ^ d STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON ~ ! STORAGE PRESSURE ~ ~ AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT STORAGE 7EMPERATURE ~a AMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC 215 276 220 222 223 224 225 '. ' CAS # 229 233 237 241 245 111. JIl71VF11 URC - ' _ _ _ ______ _____ _ ___ _ _ ~~ o +~ PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE - SIGNATURE DATE 246 I I__- -- -- --- __----- --- ---- __ ------ ----------- - UPCF (7/99) S;\CUPAFORMS10ES2731.TV4.wpd JCS,.CC Construction Inc. Specializing in Insurance Claims Lic. #B-1621822 Fire Damage P.O. Box 3250 Water Damage Bakersfield, CA 93385-3250 Lock-Out 7 Days a Week Complete Repairs _ (661)328-1242 J. R. Jones :~ Voice Pager 631-7822 -''~~ CITY 01~ 13AI~ERSFIELD . 8 E R S P D. OFFICE OF ENVIRONMENTAL SERVICES P/RQ A/PT~M T 1715 Chester Ave., CA 93301 (661) 326-3979 _ HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one /orm per material per building or area) NEW ^ ADD ^ OELETE ^ REVISE 200 Page _ of ' I. FACILITY INFORMATION I T YNA ME r DBA -Doing Business As) BUSINESS NAME (Same as FACI L o 3 / ~ 1~ - ~ , r- CHEMICAL LOCATION ~~~ t ~~ ~ 5 r ~L Q~ ! y~ v' 20t CONFIDENT AL (E CRA) ^ Yes ^ No 202 FACILITY ID # ~~I ~-~~' I ~; MAP ~k (oPtronaQ I r;~ I i 203 GRID # (optionaQ"" - " -- -~-------------- -- -"-- 204 II. CiiEMiCAL INFORMATION 205 TRADE SECRET ^ Yes ^ No 206 CHEMICAL NAME ~ ,( A ~ ~t ~ J~ 1! Subject to EPCRA, refer to instructions 207 COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 9f EHS is'Yu,' all amounts txlow must !x in lbs. ' i FIRE CODE HAZARD CLASSES (Complete if requested by local fie chief) 270 TYPE PURE ^ m MIXTURE ^ w WA~;"= .. r,-J_'IOACTIVc ---- ^ Yes ^ No 272 CURIES 213 PHYSICAL STATE ^ s SOLID ~ !<IOUIO ^ g GF,S 27q ~RGEST CONTAINER ~ ~i'1 I J 275 FED HAZARD CATEGORIES FIRE ^ 2 REACTIVE ^ 3 PRESS JRE kELE.:SE ~ i 4 A :U'-E H EALTH ^ CHRONIC HEALTH S 2i6 (Check all that apply) ANNUAL WASTE 277 ;d4XIMUM 218 ' AMOUNT DAILY AMOUNT ~ A.VL-RAGE DAILY AMOUNT 219 i STATE WASTE CODE (vV I 220 UNITS' ^ ga GAL ^ d CU FT ^ Ib LBS ^ to TONS 221 ~ DAYS ON SITE 222 { ' If EHS, amount must be in lbs. j i STORAGE CONTAINER ~ ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM (Check a!I that apply) . ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 ' ^ b UNDERGROUND TANK ^ f CAN u j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN I ^ d STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON I STORAGE PRESSURE i AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~ gMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %VVr HAZARDOUS COMPONENT EHS I CAS # '. i ' 7 ~ 226 i ~ 227 229 i I ^ Yes ^ No 228 i ' 2 230 237 ! ^ Yes ^ No 232 233 i i 3 234 235 ^ Yes 237 ^ No 236 4 I 238 239 ~ 241 ~ ^ Yes ^ No 240 ~----~----------- -----I---.._.. _ ... __.. .. .. i _ ... - ----...-------- --- - ------------ 5 i 242 273 ~ 2a5 .. _. _ .. ^ Yes ^ No 2a4 III. SIGNATURE ~~ PRINT NAME & TITLE OF AUTHORIZEd CO(v1PANY~REPRESENTATIVE - "~ ~ ~ ~ ~ SIGNATURE ~Q`~-~ ~~/(faS' ....... _ . _...- - - ~ -~---------------"- ------I DATE 246 UPCF,(7/99) S:ICUPAFORMS10ES2731.TV4.wpd B CI'T'Y OF I3AkERSFIELD . OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 ~ w~... HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION NEW ^ ADD ~ DELETE ^ REVISE 200 I. FACILITY It~IFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) CHEMICAL LOCATION r~rs t o c ~ i~c FACILITY ID # I I . ~ tl MAP # (optionaQ ~ ~ ~ ~ - ~ ~ 203 f' _~_ I_--~---:.__.... IL CHEMICAL LVFORMATION (one loan per material por building or area) Page _ of _..-----------------------3 201 CHEMICAL LOCATION ^ Yes ^ No 202 CONFIDENTIAL (EPCRA) GRID # (oplronan ~ ~ 20a 205 TRADE SECRET ^ Yes ^ No 206 CHEMICAL NAME ~~ ~~ 1! Subjed to EPCRA, refer to instructions _-- -----..-_...--.- -. _. 207 . ... ....----------------------- ----- ' COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 •If EHS is'Yes.' all amounts below must be in IDs. _ _ _ i - I FIRE CODE HAZARD CLASSES (Complete it requested by local fire chief) ~ ~ 270 - - - - - TYPE -- ^ p PURE -- - - - ^~m MIXTURE - - ^ w WAE':: :.' ; R-~QIOACTIVE ^ Yes ^ No CURIES 212 2i3 PHYSICAL STATE ^ ~ ^ LARGEST CONTAINER ~ 215 FED HAZARD CATEGORIES (Check all that apply) ANNUAL WASTE AMOUNT STORAGE CONTAINER (Check all that apply) I ! STORAGE PRESSURE STORAGE TEMPERATURE s SOLID IOUID g G.~S 274 .FIRE ^ 2 REACTIVE ^ 3 PR::SS JRE REL&;SE J 4 AJU-'E HEALTH ^ 5 CHRONIC HEALTH 276 -- --- - _ 217. _ . .... - - - - - - - - ----------- - -- d4XIMURI 218 AVERAGE ~J 219 i STATE WASTECODE 220 DAILY AMOUNT ~~ DAILY AMOUNT J ~ j UNITS' ~ga GAL ^ d CU FT ^ Ib LBS ^ to TONS 227 i DAYS ON SITE 222 If EHS, amount must be in lbs. ^ a ABOVEGROUND TANK PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 ^ b UNDERGROUND TANK ^ f CAN v j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO ^ I CYLINDER ^ o TANK WAGON ~-a AMBIENT ^ aa_ ABOVE AMBIENT ^ ba BELOW AMBIENT 224 AMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC 225 --- -I --. ------ __ - ---r. 4 j 238 ( 239 ~ ~ ~ 247 ^ Yes ^ No 240 i 5 i 242 2s3 ~ ^ Yes No 4a ~ 245 -- --1 Ili. SIGNATURE PRINT NAME 8 TITLE OF AUTHORIZE15 COMPANY REPRESENTATIVE ~ ~ ~~ ~ ~ ~~ SIGNATURE ~ ~ ~ ~ ~ ~ DATE 246 ___ __...--------___---------..-.- _._..-----..... C4~~t.-----~ - _ E R S F 1 D P/AB ~RrM r UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd J~~ B E R S F I Dc P/RB ARTM T CITY OF I~AkERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION EW ^ ADD ^ OELETE ^ REVISE ' I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Busyness As) ~SCO C~s~ CHEMICAL LOCATION j------ -`_- t~.1,..-~ --L.-_, ..._- it MAP#(optionalj- ..... _ 203 --- , , FACILITY ID # '' I I 5.7,E II. CNEMiCAL LVFORMATION CHEMICAL NAME ~~~ COMMON NAME 20t CHEMICAL LOCATION CONFIDENTIAL (EPCRA) GRID # (optional - ---'__-^ ^ Yes ^ No 202 205 TRADE SECRET ^ Yes ^ No 206 I! Subject to EPCRA, refer to instructions 207 ._.. °------------------- --- EHS' ^ Yes ^ No 208 CAS # 209 'If EHS is'Yes,' all amounts Ixlow.must be in lbs. ' I FIRE CODE HAZARD CLASSES (Complete it requested by local fire chief) 270 --- - - - ~ ~ ~ -~ - - - ' TYPE ~! °~-. PURE ^ m MIXTURE ^ w WAS-; °_ .. CURIES P.-,UIpACTIVc ^ Yes ^ No ~ 272 273 PHYSICAL STATE ^ s SOLID ^ I LIQUID GAS 274 LARGEST CONTAINER ~ ~ -.~ 275 FED HAZARD CATEGORIES (Check all that apply) ~ FIRE ^ 2 REACTIVE ~3~PR::SS iRE ~:ELE; 1- ,SE ~ r..a.;U"-E HEALTH ^ 5 CHRONIC HEALTH 276 ' ANNUAL WASTE ' 217 w74XIMUM 278 2S ~ A.VLRACE 219 ' STATE WASTE CODE Z~"' 220 AMOUNT DAILY AMOUNT DAILY AMOUNT Z I UNITS' ^ ga GAL ~ CU FT ^ Ib LBS L~ In TONS 227 i DAYS ON SITE 222 If EHS, amount must be in lbs. j STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) ^ b UNDERGROUND TANK ^ f CAN u j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ~ ^ d STEEL DRUM ^ h SILO ~I CYLINDER ^ p TANK WAGON STORAGE PRESSURE ^ a AMBIENT ~ ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE I. a[! a AMBtEN7 ^ as ABOVE AMBIENT !~~ ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 ' %WT. - . - HAi ARDOUS COMPONENT t EHS ! CAS # ' 7 226 i 227 ~ ^ Yes ^ No 226 _- 229 2 ! 230 ~ I-- ---'-----_ ----------~ --------... .- - - _.- - 237 i ^ Yes ^ No 232 ~ _ :..-. -- - -- -------- ----------- 233 --- 3 234 .I I ~ I . .. - -- - 235 ^ Yes ^ Na 236 -- 237 I ~ ~ 4 I 238 ~ 239 ^ Yes ^ No 240 241 i 3 242 233 j ^ Yes ^ No 244 ~ 245 Ill. SIGNATURE ' ~ PRINT NAME & TITLE OF AUTHORIZELS COMPANY REPRESENTATIVE SIGNATURE ~ j - ~ DAT ~ OS 6 s~ _ (one /orm per material per building or area) Page _ of - UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd ;~• CITY Ol~ 13AKERSI'IELD o B_ B R s F ` °-~ OFFICE OF ENVIRONMENTAL SERVICES _ ,~,~ AIirTM ! 1715 Chester Ave., CA 93301 (661) 326-3979 '.J,v.w/ Ai ~ .. A Kia'I~ ~ ~4M't . HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one loan per material per building or area) w ^ ADD ^ DELETE ^ REVISE 200 Page of _ _ I. FACILITY INFORMATION _. ...---.--__-_----_.----- ----I _ _____ _ , BUSINESS NAME (Same as FACILITY NAME or DBA - Dang Business As) '- 3 ~vScv ~ r CHEMICAL LOCATION 20 t CHEtAICAL LOCATION (/fS[/}` ~(.,QG.. ~ S~~ CONFIDENTIAL(EPCRA) ^ Yes ^ No 202 .FACILITY ID # i c-' ~ - ~- ~ -~-~ ` ' ~ . ~ _.- ti MAP # (oplionaQ 203 GRID # (optionaQ- - _ --- 20a I N. Ci1EMiCAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 ~~~~~ I! Subject to EPCRA, refer to instructions 207 COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 'If EHS is'Yes,' all amounts below must be in ibs. ' I FIRE CODE HAZARD CLASSES (Complete if requested by local fire chieF) 210 TYPE _.... - .. .... . - - _ ..-. .._. _ _. _...... - -----'--' CURIES 213 PURE ^ m MIXTURE ^ w WAS`= .. r',~,!~IOACTIVE ^ Yes ^ No 212 PHYSICAL STATE ^ s SOLIO ^ I LIQUtO l:~,g GAS 214 LARGEST CONTAINER ^~ ~~ 215 FED HAZARD CATEGORIES ^ 1 FIRE ~4-REACTIVE ~C3 PRESS JRE F:ELEF.SE I_ 4 .a :U-~E HEALTH C- ^ 5 CHRONIC HEALTH 216 (Check all that apply) ANNUAL WASTE 217 ;d4XIML'M 218 A.VLRA~,E 219 ! STATE WASTE CODE 220 ' AMOUNT DAILY AMOUNT DAILY AMOUNT I -- - - ---- UNITS' ^ ga GAL ~ CU FT ^ Ib LBS L7 to TONS 221 ~ DAYS ON S17E 222 If EHS, amount must be in lbs. j STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIGNONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) ' ^ b UNDERGROUND TANK ^ f CAN v j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO ~1.CYLINDER ^ p TANK WAGON STORAGE PRESSURE ^ a AMBIENT ~a ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~MBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 .. .... .. %WT HAZARDOUS COMPONENT EHS '•' CAS # ..: ... i 1 226 i 227 ~ ^ Yes ^ No 228 229 I 2 ~ 230 231 ! ^ Yes ^ No 232 233 I i 3 234 ~ 235 ^ Yes 237 ^ No 236 ~ - - I-- - --- ---° ---°--~ --... _.. . i 4 I 238 I 239 ^ Yes 241 Il ^ No 240 .., 5- ------------ - ---- ----- _.. - - _. .. .... . ------------------ -----------~_.-. i ^ No 244 `--- 242 243 I ^ Yes _._....._.._.....I 2a6 _~__--_.-__ --- I III. SIGNATURE i i i _ _ __ _ PRINT NAME & TITLE OF AUTHORIZES COMPANY REPRESEN"fATIVE ~ ~ SIGNATURE DATE 2a6 UPCF (7/99) S:ICUPAFORMS\OES2731.TV4.wpd ,~ CITY O1~ 13AKERSFIELD a E E R S P D: OFFICE OF ENVIRONMENTAL SERVICES ~R M t 1715 Chester Ave., CA 93301 (661) 326-3979 =' ~ _ ,.~ ~~~~~~' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ,~/' (one /orm per material per building or area) I ~+IEW ^ ADD ^ DELETE ^ REVISE ~0 Page _ of Y_-_ ___..--~----------------..._-.. _. ._ ... - - -_.... .. ...__--.._..------------------------- I. FACILITY I~IFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 --~Sca Cc~~~- CHEMICAL LOCATION 201 CHEtdICAI LOCATION ^ Yes ^ No 202 ~~ S r ~ (~ ~~~~ ~ S'~~ CONFIDENTIAL (EPCRA) ~ FACILITY ID # u ( - I ---I I , u - - --- i! -MAP # (optional] - - 203 GRID # (optionaQ- - - --- _--- 204 ,:, ,.,, 1 ... I I l._ ..---~---. _ ..---- Ii. CiiEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^ Yes ^ No 206 ~t-~`-t~~~l~--- I! Subject to EPCRA, refer to instructions 207 COMMON NAME EHS' ^ Yes ^ No 208 '; CAS # 209 •If EHS is"Yes,' all an7ouots below must tx in lbs. ' I FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 270 TYPE-- ----... _.. - ---- --- -- --- ......-. ...-- - - --... - ---------' CURIES 273 ~URE ^ m MIXTURE ^ w WAS-_ .. P,-,OIOACTIVc ^ Yes ^ No ~ 212 PHYSICAL STATE ^ s SOLID ^ 1 LIQUID LARGEST CONTAINER J2- ~ 215 GAS 274 FED HAZARD CATEGORIESFIRE ^ 2 REACTIVE (~ PRESS iRE f:EL&;SE ~ 4 A ;U-'E HEALTH ^ 5 CHRONIC HEALTH 216 (Check all that apply) ANNUAL WASTE ~ ~ 217 ~d4XIMUM ~ ` ~ ~ 218' - AVERAGE ~ ~ ~ `~ ~ ~ 219 ~. STATE WASTE CODE 220 ~ AMOUNT DAILY AMOUNT / Z ( DAILY AMOUNT ( i I UNITS' ^ ga GAL ~ CU FT ^ Ib LBS ^ to TONS 227 ' DAYS ON SITE 222 i ~ ' If EHS, amount must be in lbs. i STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) ^ b UNDERGROUND TANK ^ f CAN v j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN i ^ d STEEL DRUM ^ h SILO ~I CYLINDER ^ p TANK WAGON ~ '------ ----..__ ...... .. ... ... ._.. -. -. .._ .--.. _ .rx... -. _...__ .-_-.. __. -..-_-.----- - _. STORAGE PRESSURE ^ a AMBIENT ~ as ABOVE AMBIENT ~ ^ ba BELOW AMBIENT ~ 224 t ---------.. - ...-- - -- -. - ._.. .. - - _. -. -..-.... _ -._ _ _ ---- -- i STORAGE TEMPERATURE ~pABIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %1NT HAZARDOUS COMPONENT EHS I CAS # I 7 I 226 ~ ~ 227 ^ Yes ^ No 228 229 ~__._:.----------------- -__.-.. _. i I - - --___. .. ._.. 2 230 231 i ^ Yes 233 ~ ^ No 232 I-- ---1- - --...-- ------ ---------... .... - - - - . . _ - _ _ - -... .. - - -- ---------..-----.---- ----- --- i 3 ~ 234 235 ^ Yes ^ No 236 237 4 I 238 239 ~ ^ Yes ^ No 240 247 I ~ i 5 242 ~ 273 Yes Na 244 245 III. SIGNATURE -PRINT NAME 8 TITLE OF AUTHORIZEd COMPANY-REPRESENTATIVE - SIGNATURE - DATE 246 UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd -'~ CITY OIL I3AKERSFIELD B ERs P ` ~ °y OFFICE OF ENVIRONMENTAL SERVICES ~R> M t 1715 Chester Ave., CA 93301 (661) 326-3979 ~~~~~~' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ~W ^ ADO ^ OELETE ^ REVISE 200 ' I. FACILITY ir`IFORMATION BUSINESS NAME (Same as FACILITY NAME or OBA -Doing Business As) ~OSCO Cr~y.1~T.. i CHEMICAL LOCATION /q ~q..,~ 201 CHEMICAL LOCATION wf a I~~ 3L`-+~^/D ~(/~,~ -y1~'`~~~`!~(~L CONFIDENTIAL (EPCRA) _. - - --- ~~------- --- i r ~ I . _L.._ , .. - ---- ii MAP p (optional _S _ _. .. .203 GRID # (opfionaQ-- _ ----- ~ FACILITY 10 ~.. ., ~- I ~ ~ IL CiiEMICAL INFORMATION s SOLID (OUID g Gr~S 2?4 S FIRE ^ 2 REACTIVE ^ 3 PR_SS JRE kELEF.SE ^ 4 A:~U`E HEALTH ^ 5 CHRONIC HEALTH 205 TRADE SECRET ^ Yes ^ No 206 CHEMICAL NAME ~rj `''~ ~ (~ I! Subject to EPCRA, refer to instructions 207 ' COMMON NAME EHS' ^ Yes ^ No 208 CAS # 209 •If EHS is'Yes,' aU amounts lxlow mutt lz in Ibs. ' FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief 270 i -------- - ................---- - -.._.. - .. - -. _. _ TYPE ^ p PURE ^ m MIXTURE - w WAS': °_ .. r.-J-`IOACTIVc ^ Yes ^ No 2t2 CURIES 2t3 PHYSICAL STATE ^ ~ ^ LARGEST CONTAINER ('~f~ 215 L FED HAZARD CATEGORIE (Check all that apply) ANNUAL WASTE AMOUNT I STORAGE CONTAINER ` (Check all that apply) i i i ~i STORAGE PRES\RE 1- --~ - I STORAGE TEMPERATURE 217 ;~aXIMUM 218 ~ ~ AVERAGE - j ~O DAILY AMOUNT , DAILY AMOUNT ~ UNITS' ~ga GAL ^ d CU FT ^ Ib LBS ^ to TONS ' If EHS, amount must be in Ibs. ^ a A80VEGROUND TANK ^ e PLASTIGNONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS 80TTLE ^ b UNDERGROUND TANK ^ f CAN v j BAG ^ n PLASTIC BOTTLE ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON ~~ AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT s _ / (one loan per malenal per building or area) Page _ of --- ------°---- 3 ^ Yes ^ No 202 --- -- 204 - 2t6 219 i STATE WASTE CODE 220 I 221 ~ DAYS ON SITE 222 ^ q RAIL CAR 223 ^ r OTHER 224 AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 , ~ %VVT ~. HAZARDOUS COMPONENT EHS ~ ~' CAS # t I 226 ~ \ I I 227 ~ ~ ~ ^ Yes ^ No 228 i 229 .. - --..1.---------- 2 ~ - _ --_.._.. _ .. _ .-. .. . - - ---. .... . _... .. _--230 ~ ~ _ . - _ .. - - _- --- - - - --- 231 j ^ Yes ^ No 232 -------------- 233 _ -- 3 -- -- 234 • , 235 237 i \ ^ Yes ^ No 236. i 4 I 238 \\ 239 ^ Yes ^ No 240 24t I ----- ----- ------ -- -- ---- ----...- - - - -- i i 5 ~ 242 ~ ~ 293 ~i ^ ^ 244 ~ Yes No 245 _---__-__......_. ..._...~............_.. __. ........._ .. ..... ......_.._........ ._...._ ... ._- - ..._... -' _.....__ - ..--- ______ ---------------- ~. III. SIGNATURE ' \ PRINT NAME & TITLE OF AUTHORIZEb COMPANY REPRESENTATIVE ~\ - SIGNATURE [,~~ ~ - DATE 246 l C:~! ~~ UPCF (7/99) S:ICUPAFORMS\OES2731.TV4.wpd UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Programr Prevention Services B A F R s r, D 900 Truxtun Ave., Suite 210 Fie,F Bakersfield, CA 93301 ARTM Tel.: (661) 326-3979 Fax:. (661) 872-2171 FACILITY NAME T SG Co STritrUG r6~ INSPECTION DATE I - /~ - ~ INSPECTION TIME /1~.3 p ADDRESS 3 l? K ~LiV7uG~C y ~ HONE NO. 3 2 ~ l 2yz O OF EMPLO EES FACILITY CONTACT N I~~'-P t,.i-~ M ~ 1.,1 E_ ~ S BUSINESS ID NUMBER 15-021- (~/ 3C/ 3 Section 1: Business Plan and Inventory Program ~~~~ I~d ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (C=Compliance OPERATION V=Violation COMMENTS ,,__,,// Id ^ APPROPRIATE PERMIT ON HAND L7 ^ BUSIrt@SS PLAN CONTACT INFORMATION ACCURATE ^ ~/ISIBLE ADDRESS ~ / ~ " ^ CORRECT OCCUPANCY ~, // i+G ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES L ' f _ , / LJ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~r -/ L ~ ^ VERIFICATION OF MSDS AVAILABILITY ' ENT - ~# , _ ,/ L~l ^ VERIFICATION OF HAZ MAT TRAINING ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~ / LJ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ I"IOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WA,,,,~STE ON SITE? L~YtS ^ NO EXPLAIN: ~~S~~L ©~L- QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~Ttfo~~ ~.4L/t G~9~9' Z ~ig- Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White--prevention Services - Yellow -Station Copy -Pink -Business Copy - - FD 2155 (Rev. 09/05