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HomeMy WebLinkAboutBUSINESS PLAN 7/24/2006~~~ ~ -- ~,I~ MARKETPLACE 9000 MING AVE. r~ _ _. .. iy UNIFIED PROGRAM INSPECTION CHECKLIST tEd Rr =4 h... ~k,`..~..w ..~..i~ .. ,_~,. .-.- x,s;«., r,.. a~z .a. ...., ~ ,_. ..,u,. .. s ~,:.::k" SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services ~IRa 900 Truxtun Ave., Suite 210 ARTM f Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ /~~ / ^- /q~ 2s- NSPECTION DATE INSPECTION TIME ADDRESS 00 /~~uh /,due HONE NO. O OF EMPLOYEES FACILITY CONT CT ~B~7 ~©ocf USINESS ID NUMBER ^ ,s-o2~- ~~ i ~ Section 1: Business Plan and Inventory Program ~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION \. • C V ~ C=Compliance OPERATION V=Violation t OMMENT 200 ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSIfIt?SS PLAN CONTACT INFORMATION ACCURATE ~ ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES !/. V ^ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITY ~ ^ ^ VERIFICATION OF HAZ MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES V ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE ~ ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ^ NO •OUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 - Inspecto (Please Print) Fire Prevention / 18~ In /Shift of Site/Station # Business Site/School Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) y ~' + DONAHUE SCHRIBER-THE MARI~;ET PLACE ___________________ Manager ~^~~DT "^^'~ ~m.r,n¢, O~er~-a~ BusPhone: Location: 9000 MING AVE Map 123 City BAKERSFIELD Grid: 08 SiteID: 015-021-002290 L SSq~ 22b - 4O8y ~ 103 CommHaz High A FacUnits: 1 AOV: 1 CommCode: BFD STA 09 SIC Code: I EPA Numb: Dunn$rad: _Emergency Contact / _ "g"itle _ Emergency Contact / Title ~CX't11! Q+ ~ . t-OG~Q(1 / O~-arG'~'ionS N+~CinOtg¢~ ~ oan nm ~o¢r+¢/ / ~'o {'Y ~`~-naq¢/ Business Phone: (~g54.) 2~6,'iO~y x to3 Business Phone: (ss'~)2z~ -NoBy ~~05 24 -Hour Phone (sS~i) ZSO - fod34 24 -Hour Phone ( Spa) 904 -527 x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth Contact Phone: (661) 664-6546x MailAddr: PO BOX 19703 State: CA City IRVINE Zip 92623 Owner DONAHUE SCHRIBER Phone: (661) 664-6500x Address PO BOX 19703 State: CA City IRVINE Zip 92623 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: p~ PROG A - HAZMAT I ~'~ ~ ENT'D J U L ~ 4 2006 ~~ Iv~~ ~ ~~ ~~ used on my inquiry of those individuals respansible 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, ary~compiete. Date -1- 03/10/2006 UNIFIED PROGRAM INSPECTION CHECKLIST`: w .~.n . ..,_„n. 2~'h ~....>'~3^u~.svr~ :~+,ka ~r ,.~..J .:.~ .'.:'.,. 4,a', XFi'.. T.~. .. ',- :-,..~c£#. 'c:. x- ,..'w.: #'. .~ „i. _,,,.. -.~ zi... -r.. 4:. ,. F.. .. i, SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services >, p t D f~R~ 900 Truxtun Ave., Suite 210 ~erM ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ INSPECTION DATE INSPECTION TIME ,c ~~ a ~~ l ~n a~ a 3a~., ti ~ . ADDRESS HONE NO. NO OF EMPLOYEES avo /Yl.,~~ /-~~~,~ • 6 ~ y- ~ FACILITY CONTACT USINESS ID NUMBER p ~ ~ 15-021- ~~ ~o Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION r ~J C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND _ _ __ __ ~ l~ ~~ ~ ~ ^ Business PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS L~" ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL LEI ^ 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 R ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~'NO EXPLAIN: .QUESTIONS REG/A~RDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1°' In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05) ,. DEC 2 01005 MARKET PL~P,CE ~ SiteID: q~ 015-021-002290 a Manager ROBERT BOON BusPhone: (661) 664-6554 Location: 9000 MING AVE Map 123 CommHaz High City BAKERSFIELD Grid: 08A FacUnits: 1 AOV: CommCode: BFD STA 09 EPA Numb: SIC Code: DunnBrad: Emergency Contact KEVIN ACOSTA Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / MAINTENANCE (661) 664-5895x (661) 328-9971x ( ) - x Contact ROBERT BOON MailAddr: PO BOX 11165 City BAKERSFIELD Emergency Contact ROBERT BOON Business Phone: 24-Hour Phone Pager Phone / Title / PROPERTY MGR. (661) 664-6546x (661) 327-9607x (661) 398-6393x Fire Press ImmHlth Phone: (661) 664-6500x State: CA Zip 93389 Owner CASTLE & COOKE CALIFORNIA INC Phone: (661) 664-6500x Address 10000 STOCKDALE HWY State: CA City BAKERSFIELD Zip 93311 Period to Preparers Certif'd: ParcelNo: Emergency Directives: TotalASTs: _ TotalUSTs: _ RSs: No ~, ~ ,~ Do ~®~y ~~~ that. ~ h~bt. qp Ml~ame . ravviewed the attached hazardous materials ~~'~'` meat plan for. ~• G . o and that it ~kA-~~. anyoosrec~ionscorute.aoampletsendczi-m®ct mr epemetrt p1ee ~ ~l ~~' ~ is .s Gall Gal -1- 09/02/2005 F MARKET PLACE SiteID: 015-021-002290 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH G ,7'.00 GAL Hi /S~~v c~ ~J w ~ v~ ~~ ~~~ ..~..... CALIFORNIA, INC. Robert (Bob) $oon Manager -- Property Management MAILING ADDRESS: P.O. Box 11165 DELIVERY ADDRESS: Bakersfield, CA 93389-1165 10000 Stockdale Highway, Suite 300 ~(661)~ Bakersfield, CA 93311 ~ E-Mail: bboon@castlecooke.com Fax: (661)664-9827 -- -2- 09/02/2005 r~ r F MARKET PLACE SiteID: 015-021-002290 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE SPRINKLER ROOM/j/'/J/iS/TEivA.t/GE CAS# ~GasATE TPureE ~-AboveSAmbEent AmbientT~E PORTCOPRESSERCYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average /~'!d0~7'. 0 0 GAL /5!~`'i7'. 0 0 GAL 7.0 0 GAL Maximum Stored Maximum Open Use Maximum Closed Use GAL GAL GAL tiE~GHKIJVU~ (.:V1~lYV1V~1V'1'S %Wt. RS CAS# 100.00 Propane Yes 74986 -3- 09/02/2005 F MARKET PLACE SiteID: 0,15-021-002290 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 09/02/2005 ~ ??????????? Employee Notif./Evacuation 09/02/2005 ????????????? Public Notif./Evacuation 09/02/2005 ?????????????????? Emergency Medical Plan 09/02/2005 ?????????????????? -4- 09/02/2005 F MARKET PLACE SilteID: 015-021-002290 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 09/02/2005 = Release Containment ???????????????? 09/02/2005 Clean Up 09/02/2005 ~~~~o~~~~~~~~~~~~~ vLner xesource t~czivazion -5- 09/02/2005 a, r ~ . F MARKET PLACE SiteID: 015-021-002290 ~ F F ~ Site Emergency Factors ~ Special Hazards Utility Shut-Offs /~V Fire Protec./Avail. Water ??????????????? ast ormat ~ Overall Site ~ 09/02/2005 ~ 09/02/2005 Building Occupancy Level -6- 09/02/2005 F MARKET PLACE SiteID: 015-021-002290 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 09/02/2005 = rage ~ riela =or ruLUre use riela =or ruLUre use z -7- 09/02/2005 ~. ~ . ~ - (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN i INSTRUCTIONS FOR HMMP SECTION DISCOVERY AND NOTIFICATION (FORMS) SECTION I. -BUSINESS IDENTIFICATION DATA: H H B 9 P D /-fR/ ~IRfM T Page 1 of 2 BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave. , Ste. 210 Bakersfield, CA 93301 .,,~ Tel.: (661) 326-3979 Fax: (661) 852-2171 The Business Owner /Operator Identification Form FD2089, Chemical Description Form(s) FD2086, and other forms (e.g.; underground storage tank information, hazardous waste treatment, etc., as needed) may be submitted as the first section of the Hazardous Materials Management Plan in order to avoid duplication of information for initial submissions. HAZAR MATERIALS MANAGEMENT PLAN ECTION II.1 - ISCOVERY AND NOTIFICATIONS L AK DETECTION AND MONITORING PROCEDURES: Describe the procedures and equipment used to detect any release or threatened release of a hazardous material from any storage container, tank, or vessel at your business. Please provide a written explanation that also includes the make and model number of any automated or electronic leak detection equipment in use at your facility. B. EMPLOYEE AND AGENCY NOTIFICATION: What agencies and or corporate officials are notified incase of a hazardous materials spill or emergency -What procedures are used to notify these parties? At a minimum, you must call 9-1-1 and the Office of Emergency Services at 1-800- 852-7550 to report any spills that are a threat to life, safety or the environment, or for other non-emergency spill reporting, please call our office at (661) 326-3979. C. ENVIRONMENTAL RESPONSE MANAGEMENT: Please describe who will be responsible for what activities (notifying authorities, clean-up companies, etc.), and what the chain-of-command is at your facility for making sure these activities are carried out. D. EMERGENCY MEDICAL PLAN: Summarize your plan for handling medical emergencies occurring at your business. List the local medical facility capable of handling an accident involving Hazardous Materials used at your business. ARD MATERIALS MANAGEMENT PLAN SECTION II. ELEASE RESPONSE PLAN HAZARD ASSESSMENT AND PREVENTION MEASURES: Explain the procedures that you have developed and implemented to help prevent an incident from occurring. These steps could include, but are not limited to, storage methods, container types, segregation, safety equipment, andlor procedures used. B. RELEASE CONTAINMENT AND/OR MITIGATION: Explain the procedures that you have developed and implemented to assist in keeping a hazardous materials incident at your business as small or confined as possible. C. CLEAN-UP AND RECOVERY PROCEDURES: Explain what clean up procedures will be implemented in case of a release atyour business. This should address small spills, as well as a major release of material once the material is contained. Hazardous Waste: Please provide the name of the hazardous waste company that regularly removes the wastes from your business, and how often that waste is removed. Please keep all disposal receipts for the last three years available on site for inspection. MATERIALS MANAGEMENT PLAN ECTION II. RELEASE RESPONSE PLAN (CONT.) UTILITY SHUT-OFFS ~ ~ ~ ~+ ,, _... List locations of shut offs using compass points and known or obvious landmarks. If you have a lock box containing keys and maps of the facility for the Fire Department to use, please list its location also. PRIVATE FIRE PROTECTIONlWATER AVAILABILITY A. Private Fire Protection: Describe on-site fire protection for your business or facility unit, including sprinklers, fire extinguishers, alarm systems and private response teams. . B. Water Availability (Fire Hydrant): Give the location of the closest water supply or~fire hydrant to be used by the Fire Department in case of an emergency. SECTION III -TRAINING List the number of employees that are working in the area of the hazardous materials, use or storage. Include all employees who have any occasion to be in those areas. Give the location_ where Material Safety Data Sheets (MSDS) are kept on filer•The MSDS must be readily available on sitE in a place where employees can access them. Give a brief summary of your Hazardous Materials Training Program. Employees are required by State law to have a program which provides employees with initial and refresher training in the following areas: 1. Methods for safe handling of the hazardous materials used by your business. 2. The Cal OSHA Hazard Communication Standard. 3. Correct use of emergency response equipment and supplies available at your business. 4. The prevention, minimizing and clean up procedures you have developed for your business. 5. The emergency evacuation plans you have developed, as well as, your notification procedure and medical plan. 6. Procedure to coordinate with and assist the local emergency personnel that may respond to your business. 7. Who and how to call for immediate assistance in the event of an accident involving hazardous materials. CERTIFICATION Please fill in your name, title, and sign and date on the signature line. IMPORTANT You must return this plan, inventory forms, and map within 30 days of receipt. If you have any questions please call us at (661) 326-3979 Thank you for helping to keep our All America City cleaner and safer. CITY OF BAKERSFIELD BAKERSFIELD FIRE DEPT., OFFICE OF PREVENTION SERVICES 900 Truxtun Avenue, Suite 210, Bakersfield, CA Page 2 of 2 FD2085a (Rev. o2ios) HAZARDOUS MATE~iIALS MANAGEMENT PLAN APPLICATION FOR SECTION DISCOVERY AND NOTIFICATION (FORMS) B B S P I D P/R/ Al~lM f INSTRUCTIONS 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: `(661) 326-3979 Fax: (661) 852-2171 Page 1 of 2 SECTION I: FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) ... ~ . : ,. , .. _ .. . a.. ~" ~ ®~ / ADDRESS (For local use only) fD BOO clc~v~~~' ~ y ~~/'~'~ ~~'~~ ~ /'/ FACILITY ID NO. 1 SECTION 11.1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORIN , ,y --- ~Oi1/~' ~-- f~/~//O/~ ~f~i~GG~ ~ f ~Os~/1i/G`~ /~`-~ e~G ~-oiG B. EMPLOYEE AND AGENCY NOTIFICATION: , /~O ~E"~T .~~ ~ O Oi/ C. ENVIRONMENTAL RESPONSE MANAGEMENT: ~,/~ D. EMERGENCY MEDICAL PLAN: / SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD ASSESMENT AND PREVE /c7jPQ~4i~7/VC G-~~ ~''~~~~~~ A~~ G ~U a,/Z B. RELEASE CONTAINMENT AND/OR MITIGATION: ~j~/L` C. CLEAN-UP AND RECOVERY PROCEDURES: '~, - ~ r ~~ FD2085 (Rev. 02/05) Page 2 of 2 :.i SECTION 11.2: ELEASE RESPONSE`PLAN-CON'T: UTILITY SHUT-OFFS (LOCATION OF SHUT-O CILITY) -~ NATURALGAS/PROPANE: /1 l~JJ/>~ ~~~~ A ELECTRICAL: LL EC~/PICi~~ ~~~~/~~d /7'IG GI ~ - Gt ~~6/v WATER: /1~i~L~ r ~ ~ ~~ r/ C~/1~~~/U SPECIAL: ~G s'E PRIVATE FIRE PROTECTIONNJATER AVAILABILITY: / ~/~// /,/~) A. PRIVATE FIRE PROTECTION: C~/7 ~ e. L ~i~~'LC/ZorF/ ~~•~ i~ ~' " r~`~ /`~ ~'~~ B. WATER AVAILABILITY (FIRE HYDRANT): `• SECTION III:ITRAINING NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: .. ~ ~ _ ~ ,, , , U~.~ BRIEFSU MARY OF TRAINING PROGRAM: ~-~ G ~ - ,,~e ,,,;.•.~ ' ~ •. --, i~~1 ~! "' /t/'i57/f~/L ra /Y ° ~/"~ `i2'~J/i~/iVG'~~'~'~~D ~~ > CERTIFICATION . ` Based on my inquiry of those individuals responsible for obtaining the information, /certify under penalty of law that /have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. IGNATURE OWN /OP RA O DESIGN TED REPRESENTATIVE DATE 477 / /~ ~,~ G~ NAM SI NER (print) 478 4.c4E/ll~- ~'~Qa~c/ TITLE OF SIG ER 479 /l~jlO,d~/1 r/ ~~ .vAGE~ FD2085 (Rev. 02105) (HMMP) HAZI4RDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS FOR CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIALS INVENTORY FORM 8 H R S F I D F/RB A~ T BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Make as many copies of the chemical description form as necessary to report your entire inventory of hazardous materials. Report every hazardous material handled in quantities equal to or exceeding 55 gallons of a liquid, 500 pounds of a solid or 200 cubic feet of a gas. Report any amount of any hazardous waste being generated or handled on site. I. FACILITY INFORMATION: Check the appropriate box for a new inventory or for additions, revisions or deletions to an existing inventory. Enter the business name at the top of the form. Enter the page number in the right hand comer. Describe the exact location of the hazardous waste or material being reported. NOTE: Chemical location information is considered confidential unless you check "no." If a site map is being submitted, you may refer to the map number and grid coordinates for the approximate locatiot of the material, as shown on the map. ILCHEMICAL INFORMATION: Each of the instructions below correspond to the entry field with the same number on the chemical description form. CHEMICAL NAME 205 Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the International Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture or a hazardous waste, do not complete this field; complete the "common name" field instead. TRADE SECRET 206 Check "Y" for yes if the information in this section is declared a trade secret, or "N" for no, if it is not. State requirement: If yes, and business is not subject to EPCRA, disclosure of the designated trade secret information is bound by Health and Safety Code, Section 25511. Federal Requirement: If yes, and business is subject to EPCRA, disclosure of the designated Trade Secret information is bound by Title 40 Code of Federal Regulations (CPR) and the business must submit a "Substantiation to Accompany Claims of Trade Secrecy" form (40 CFR 350.27) to USEPA. COMMON NAME 207 Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. EHS 208 Check "Y" for yes if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CPR, Part 355, Appendix A. If the material is a mixture containing an EHS, leave this section blank and complete the section on hazardous CAS 209 Enter the Chemical Abstract Service (CAS) number for the hazardous material. For mixtures, enter the CAS number of the mixture if it has been assigned a number distinct from its components. >f the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous components in the section below. FIRE CODE HAZARD CLASSES (Please leave blank) 210 HAZARDOUS MATERIAL TYPE 211 Check the one box that best describes the type of hazardous material: pure, mixture or waste. If waste material, check only that box. If mixture or waste, complete hazardous components section. RADIOACTIVE 212 Check "Y" for yes if the hazardous material is radioactive or "N" for no, if it is not. CURIES 213 If the hazardous material is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. PHYSICAL STATE 214 Check the one box that best describes the state in which the hazardous material is handled: solid, liquid or gaseous (gas). LARGEST CONTAINER 215 Enter the total capacity of the largest container in which the material is stored. FEDERAL HAZARD CATEGORIES 216 Check all the physical and health hazards associated with the hazardous material: PHYSICAL HAZARDS: Fire: Flammable Liquids and Solids, Combustible Liquids, Pyrophorics, Oxidizers Reactive: Unstable Reactive, Organic Peroxides, Water Reactive, Radioactive Pressure Release: Explosives, Compressed Gases, Blasting Agents Page 1 of 3 FD2086a Ewz~aeMa~.snvr~l-nm~ IN5tAl.1CT1~IS FOR HAZARDOUS MATERIALS INVENTORY C}~ALit~IFOAfiA Page2af3 ~ ~ ' HEALTH HAZARDS: Acute Health (Immediate): Highly Toxic, Toxic, Irritants, Sensitizers, Corrosives, other hazazdous chemicals with an adverse effect with short term exposure. Chronic Health (Delayed): Carcinogens, other hazardous chemicals with an adverse effect with long term exposure. ANNUAL WASTE AMOUNT 217 If the hazazdous material being inventoried is ~a~waste, provide an estimate of the annual amount handled. MAXIMUM DAILY AMOUNT 218 - .. ,:,• .~F; Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacent/outside area at any one time over the course of the year. This amount must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions, deletions, or revisions projected for the current yeaz. This amount should be consistent with the units reported in box 221. - - ' AVERAGE DAILY AMOUNT 219 Calculate the average daily amount of the hazardous material or mixture containing a hazardous material,•in each building or adjacenboutside azea. Calculations shall be"based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the,number of days the chemical will be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. STATE WASTE CODE 220 If the hazazdous material is a waste, enter the appropriate California 3-digit hazardous waste code as listed on the back of the Uniform Hazardous Waste Manifest. A list of common State Waste Codes are included on page 4 of these instructions. UNITS 221 ' Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that the material is stored in (gallons, pounds, cubic feet, or tons). DAYS ON SITE 222 List the total number of days during the year that the material is on site. STORAGE CONTAINER 223 Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one. STORAGE PRESSURE 224 Check the one box that best describes the pressure at which the hazardous material is stored. STORAGE TEMPERATURE 225 Check the one box that best describes the temperature at which the hazardous material is stored. HAZARDOUS COMPONENT 1 - 5 (% by weight) 226, 230, 234, 238, 242 If a range of percentages is available, report the highest percentage in that range. HAZARDOUS COMPONENT 1 - 5 Name 227,231,235,239,243 When reporting a hazardous material that is a mixture, list up to five chemical names of hazazdous components in that mixture by percent weight (refer to MSDS or, in the case of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater than 1% by weight if non-carcinogenic, or 0. 1% by weight if cazcinogenic, should be reported. If more than five hazardous components are present above these percentages, you may attach an additional sheet of paper to capture the required information. When reporting waste mixtures, mineral and chemical composition should be listed. ,~. , , HAZARDOUS COMPONENT 1 - 5 EHS 228,232,236,240,244 Check "Y" for yes if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "N" for no, if it is not. HAZARDOUS COMPONENT 1 - 5 CAS 229, 2.33, 237, 2415 245 List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. III. SIGNATURE: 246 Please print name, title, sign and date each chemical description form. If you have any questions please call us at (661) 326-3979 Page 2 of 3 FD2086a Code Description CALIFORNIA WASTE CODES Inorganics III Acid solution 2 < pH < 7 with metals (antimony, arsenic, barium, beryllium, cadmium, chromium, cobalt, copper, lead, mercury, molybdenum, nickel, selenium, silver, thallium, vanadium and zinc) 112 Acid solution without metals 113 Unspecified acid solution 121 Alkaline solution pH >12.5 with metals (see 111) 122 Alkaline solution without metals ,.,_ .. ._ „ - , ;......,, .. 123 Unspecified alkaline solution 131 Aqueous solution (2 < pH < 12.5) contain- ing reactive anoins. (azide, bromate, nitrite, perchlorate and sulfide anions) 132 Aqueous solution with metals (see 111) 133 Aqueous solution with total organic residues 100% or more 134 Aqueous solution with total organic residues less than 10% 135 Unspecified aqueous solution 141 Off-spec, aged, or surplus inorganics 151 Asbestos containing waste 161 FCC Waste 162 Other spent catalyst 171 Metal sludge (see 111) 172 -Metal dust and machining waste (see 111) 181 Other inorganic solid waste Organics 211 Halogenated solvents (methylene chloride, chloroform, TCE, TCA) 212 Oxygenated solvents (acetone, butanol, M EK) 213 Hydrocarbon solvents (stoddard solvent, xylene) 214 Unspecified solvent mixture 221 Waste oil and mixed oil 222 Oil/water separation sludge 223 Unspecified oil -containing waste 231 Pesticide rinse water 232 Pesticide and other waste associated with 241 Tank bottom waste 251 Still bottoms with halogenated organics 252 Other still bottom waste 261 PCB's and material containing PCB's 271 Organic monomer waste (includes Code Description Organics (con't) 272 Polymeric resin waste 281 Adhesives 291 Latex waste . 311 Pharmaceutical waste 321 Sewage sludge ~~ 322 Biological waste other than sewage . sludge ~ ,. _ 331 Off-spec, aged or surplus organics 341 Organic liquids (non-solvents) with _ ;halogens ~ . _ 343 Unspecified organic liquid mixture 351 Organic solids with halogens - ~ ~~ Sludges 411 Alum and gypsum sludge 421 Lime sludge 431 Phosphate sludge 441 Sulfur sludge 451 Degreasing sludge 461 Paint sludge 471 Paper sludge/pulp 481 Tetraethyl lead sludge 491 Unspecified sludge waste Miscellaneous 511 Empty pesticide containers 30 gal or more 512 Other empty container 30 gal or more 513 Empty containers less than 30 qa1 521 Drilling mud 531 Chemical toilet waste 541 Photo chemical/photo processing waste 551 Laboratory waste chemicals 561 Detergent and soap 571 Fly ash, bottom ash, and retort ash 581 Gas scrubber waste . . 591 Bag house waste 611 Contaminated soil from site clean-ups 612 Household wastes Page 3 of 3 FD2086a (HMMP) ~~ HAZARDOUS MATERIALS MANAGEMENT PLAN UNIFIED PROGRAM CONSOLIDATED FORMS a B R s p i n FIRt CHEMICAL DESCRIPTION FORM "~ f HAZARDOUS MATERIALS INVENTORY ^ NEW ^ ADD ^ DELETE ^ REVISE 200 liAliLK~r'1L~'LL r'1K1: LL''Yl'. Prevention Services , 900 Truxtun Ave., Sty. 210 ~ ~~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 ;, (One form per material, per building, or area.) D.. ....i ..t n I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) CHEMICAL LOCATION 201 CHEMICAL LOCATION 20 /r/,ir~I//7~/t~iS~~t~G'G~~aB~ CONFIDENTIAL(EPCRA) ^ Yes ~N' FACILITY ID No. • 1 MAP No.-(aptionap - ~ 203 • GRID NO:'(optionel) 20 i s a ~ i o o ~ ~ 9 0~ . ._ia~~.. ....._..~. d,~~ .. R.- ~-- ... ,...,~ . II. CHEMICAL INFORMATION CHEMICAL NAME 205 20 Y~~G ••r-~ ~°~ ~ ~~~~~ ~20 v ~ / ~--~~~~y~F~rs „ „ ,TRADE SECRET ^ Yes ~''No ' , ~ / j ect to EPCRA refer to i structio If Sub ns COMMON NAME 207 ~~~/o~J~G~ EHS' ^ Yes ^ No 20 CAS No. 209 ~~ J ~ ~- / ( 'If EHS is "Yes," al{ amounts below must be in lbs p . FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 21 TYPE 211 RADIOACTIVE: ^ Yes C~ No 21 CURIES 21 ~ p PURE ^ m MIXTURE ^ w WASTE PHYSICAL STATE ^ s SOLID ^ I LIQUID ~g GAS 214 LARGEST CONTAINER / Q~~.+ ~( r~~ ~/ i-^ /~/~/~ 215 ~~, ~, V , ` 216 FED HAZARD CATEGORIES ~1 FIRE ^ 2 REACTIVE ~3 PRESSURE RELEASE ^ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH (Check all that apply) , ANNUAL WASTE 217 MAXIMUM 21g AVERAGE 219 STATE WASTE 22 AMOUNT ~ ~ DAILY AMOUNT DAILY AMOUNT CODE ' 221 222 ^_ UNITS ^ ga GAL ^ cf CU FT ^ Ib LBS ^ to TONS DAYS ON SITE If EHS, amount must be in lbs. G_~ 22 STORAGE CONTAINER ^ k BOX ^ p TANK WAGON (Check all that apply) ^ a ABOVEGROUND TANK ^ f CAN ^ b UNDERGROUND TANK ^ g CARBOY ~I CYLINDER ^ q RAI L CAR ^ c TANK INSIDE BUILDING ^ h SILO ^ m GLASS BOTTLE ^ r OTHER ^ d STEEL DRUM , ^ i FIBER DRUM ^ n PLASTIC BOTTLE ^ e PLASTICINONMETALLIC DRUM ^ j BAG ^ o TOTE BIN STORAGE PRESSURE ~ a AMBIENT ^ as ABOVE AMBIENT - ^ ba BELOW AMBIENT 22 STORAGE TEMPERATURE ~ a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS CAS # 1 /~D s/a 226 !/ ~0~~~~ 227 Yes ^ No 228 ~~/G~/ / 6 22 2 230 231 ^ Yes ^ No 232 23 4 238 239 ^ Yes ^ No 240 241 5 ~ 242 243 ^ Yes ^ No 244 24 III. SIGNATURE PR NAME & TI E OF AU ORl C ANY REPRESE TATIVE SIGNATURE DAT E 24 C j / ~~~+~ - - FD2086 '' Hazardous Materials Inventory -Chemical Description UNIFIED PROGRAM CONSOLIDATED FORMS You must complete a separate Hazardous Materials Inventory -Chemical Description page for each hazardous material (hazardous substances and hazardous waste) that you handle at your facility in aggregate quantities equal to or greater than 500 pounds, 55 gallons, 200 cubic feet of gas (calculated at standard temperature and pressure) or the federal threshold planning quantity for Extremely Hazardous Substances, whichever is less. Also complete a page for each radioactive material handled over quantities for which an emergency plan is required to be adopted pursuant to 10 CFR Parts 30, 40, or 70. The completed inventory should reflect all reportable quantities of hazardous materials at your facility, reported separately for each building or outside adjacent area, with separate pages for unique occurrences of physical state, storage temperature and storage pressure. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or AA identify whether the submittal is complete and if any pages are separated. 1. FACILITY ID NUMBER -This number is assigned by the CUPA or AA. This is the unique number which ident'rfies your facility. 3. BUSINESS NAME -Enter the full legal name of the business. 200. ADD/DELETE/ REVISE -Indicate if the material is being added to the inventory, deleted from the inventory, or if the information previously submitted is being revised. NOTE: You may choose to leave this blank if you resubmit your entire inventory annually. 201. CHEMICAL LOCATION -Enter the building or outside/ adjacent area where the hazardous material is handled. A chemical that is stored at the same pressure and temperature in multiple locations within a building, can be reported on a single page. NOTE: This information is not subject to public disclosure pursuant to HSC §25506. 202. CHEMICAL LOCATION CONFIDENTIAL -EPCRA -All businesses which are subject to the Emergency Planning and Community Right to Know Act (EPCRA) must check "Yes" to keep chemical location information confidential. If the business does not wish to keep chemical location information confidential check "No".- 203. MAP NUMBER - If a map is included, enter the number of the map on which the location of the hazardous material is shown. 204. GRID NUMBER - If grid coordinates are used, enter the grid coordinates of the map that correspond to the location of the hazardous material. If applicable, multiple grid coordinates can be listed. 205. CHEMICAL NAME -Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the International Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture, do not complete this field; complete the "COMMON NAME" field instead. 206. TRADE SECRET -Check "Yes" if the information in this section is declared a trade secret, or "No" if it is not. State requirement: If yes, and business is not subject to EPCRA, disclosure of the designated trade secret information is bound by HSC §25511. Federal requirement: If yes, and business is subject to EPCRA, disclosure of the designated Trade Secret information is bound by 40 CFR and the business must submit a "Substantiation to Accompany Claims of Trade Secrecy' form (40 CFR 350.27) to USEPA. 207. COMMON NAME -Enter the common name or trade name of the hazardous material or mixture containing a hazardous material. 208. EHS -Check "Yes" if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CFR, Part 355, Appendix A. If the material is a mixture containinc an EHS, leave this section blank and complete the section on hazardous components below. 209. CAS # -Enter the Chemical Abstract Service (CAS) number for the hazardous material. For mixtures, enter the CAS number of the mixture if it has been assigned a number distinct from its components. If the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous components in the appropriate section below. 210. FIRE CODE HAZARD CLASSES -Fire Code Hazard Classes describe to first responders the type and level of hazardous materials which a business handles. This information shall only be provided if the local fire chief deems it necessary and requests the CUPA or AA to collect it. A list of the hazard classes and instructions on how to determine which class a material falls under are included in the appendices of Article 80 of the Uniform Fire Code. If a material has more than one applicable hazard class, include all. Contact CUPA or AA for guidance. 211. HAZARDOUS MATERIAL TYPE - Check the one box that best describes the type of hazardous material: pure, mixture or waste. If waste material, check only that box. If mixture or waste, complete hazardous components section. 212. RADIOACTIVE -Check "Yes" if the hazardous material is radioactive or "No" if it is not. 213. CURIES - If the hazardous material is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report activity in curies. 214. PHYSICAL STATE -Check the one box that best describes the state in which the hazardous material is handfed: solid, liquid or gas. 215. LARGEST CONTAINER -Enter the total capacity of the largest container in which the material is stored. 216. FEDERAL HAZARD CATEGORIES - Check all categories that descrihe the ohvsiral and health hazards assrtt:iated with the hazardous material. PHYSICAL HAZARDS HEALTH HAZARDS Fire: Flammable Li uids and Solids Combustible Li uids, P ro horics, Oxidizers Acute HeaRh (Immediate): Highly Toxic, Toxic, Irritants, Sensitizers,, Corrosives, Reactive: Unstable Reactive, Or anic Peroxides, Water Reactive, Radioactive other hazardous chemicals with an adverse effect with short term ex osure Pressure Release: Explosives, Compressed Gases, Blasting Agents Chronic HeaRh (Delayed): Carcinogens, other hazardous chemicals with an adverse effect with Ion term ex osure 217. AVERAGE DAILY. AMOUNT -Calculate the average daily amount of the hazardous"material or mixture containing a hazardous material, in each building or adjacenU outside area. Calculations shall be based on the previous year's inventory of material reported on this page. Total all daily amounts and divide by the number of days the chemical wil be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you project to be on hand during the course o the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum daily amount. 218. MAXIMUM DAILY AMOUNT -Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or adjacenUoutside area at any one time over the course of the year. This amount must contain at a minimum last year's inventory of the material reported on this page, with the reflection of additions, deletions, or revisions projected for the current year. This amount should be consistent with the units reported in box 221. 219. ANNUAL WASTE AMOUNT - If the hazardous material being inventoried is a waste, provide an estimate of the annual amount handled. 220. STATE WASTE CODE - If the hazardous material is a waste, enter the appropriate California 3-digit hazardous waste code as listed on the back of the Uniform Hazardous Waste Man'rfest. 221. UNITS -Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that the material is stored in (gallons, pounds, cubic feet, or tons). ' 222. DAYS ON SITE -List the total number of days during the year that the material is on site. 223. STORAGE CONTAINER -Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may choose more than one. 224. STORAGE PRESSURE -Check the one box that best describes the pressure at which the hazardous material is stored. 225. STORAGE TEMPERATURE -Check the one box that best describes the temperature at which the hazardous material is stored. 226. HAZARDOUS COMPONENTS 1-5 (% BY WEIGHT) -Enter the percentage weight of the hazardous component in a mixture. Ifa range of percentages is available, report the highest percentage in that range. (Report for components 2 through 5 in 230, 234, 236, and 242.) 227. HAZARDOUS COMPONENTS 1-5 NAME -When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that mixture by percent weight (refer to MSDS or, in the case of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater than 1 % by weight if non- carcinogenic, or 0.1% by weight if carcinogenic, should be reported. If more than five hazardous components are present above these percentages, you may attach an additional sheet of paper to capture the required information. When reporting waste mixtures, mineral and chemical composition should be listed. (Report for components 2 through 5 in 231, 235, 239, and 243.) 228. HAZARDOUS COMPONENTS 1-5 EHS -Check "Yes" if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR, Part 355, or "No" if it is not. (Report for components 2 through 5 in 232, 236, 240, and 244.) 229. HAZARDOUS COMPONENTS 1-5 CAS -List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. (Repeat for 2-5.) 246. LOCALLY COLLECTED INFORMATION -This space may be used by the CUPA or AA to collect any additional information necessary to meet the requirements of their individual programs. Contact the CUPA or AA for guidance. FD2086 (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN (UNIFlED PROGRAM CONSOLJDATED FORM) BUSINESS ACTIVITIES PAGE (HAZARDOUS MATERIALS FACILITY INFORMATION) 8 H R 9 A I D FIRa A~ T BAKER$FIELD FIRE DEPT. Prevention: S.ervrsces ~ ~" 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 I: FACILITY IDENTIFICATION FACILITY ID # (For Office use only -please leave blank) 3 EPA ID # DBA /FACILITY NAME .... ...:~ . ,.,~.. ~ .... . ..... . .. . ~... ... . , . . .. ,... ~ ~ ' ~ IL'ACTIVITIES DECLARATION DOES Your Facility ... _ _ If Yes, Please Complete ... t2 A. HAZARDOUS MATERIALS • CHEMICAL DESCRIPTION FORM 13 1. Have on site (for any purpose) hazardous ^ Yes f$,No • HAZARDOUS MATERIALS MANAGEMENT PLAN - materials at or above 55 gallons for liquids, ~ Minimum required olannina elements: 500 pounds for solids, or 200 cu. ft. for ^ Yes ~No • • Emergency Response Plan Maps \ compressed gases (include liquids in ASTs and • Training USTs)? • Prevention B. REGULATED SUBSTANCES (RSl ~ 131 1. Have on site RS at greater than the threshold ^ Yes ~ No • CHEMICAL DESCRIPTION FORM planning quantities established by the California • RISK MANAGEMENT PLAN (RMP Submit to USEPA) Accidental Release Prevention program • • CONSOLIDATED COMPLIANCE PLAN Incorporating CaIARP Program Elements (CaIARP)? C. UNDERGROUND STORAGE TANKS (USTsI ^ Yes J~ No • UST FACILITY FORM 13 1. Own or operate Underground Storage Tanks? • UST TANK FORM (One Per Tank) 2. Intend to upgrade existing or install new USTs? ^ Yes ~ No • UST FACILITY FORM 13 • UST TANK FORM (One Per Tank) • UST INSTALLATION FORM One Per Tank D. TANK CLOSURE /REMOVAL 2. Need to report closing an UST that held hazardous ^ Yes ~~No • UST TANK FORM (Closure section -one per tank) materials or 3. Need to report the closure /removal of a tank that ^ Yes No • UST TANK CLOSURE FORM was classified as hazardous waste and cleaned on- site? E. ABOVEGROUND PETROLEUM STORAGE TANKS (ASTs) ^ Yes ~No • HAZARDOUS MATERIALS MANAGEMENT PLAN 1. Own or operate ASTs above these thresholds; • Incorporating Federal Spill Prevention Control and any tank capacity is greater than 660 gallons or the Countermeasure (SPCC) Elements pursuant to ao CFR Part 112. total capacity for the facility is greater than 1,320 F. HAZARDOUS WASTE ^ Yes ~No • EPA ID NUMBER -Provide on this page To obtain EPA ID Number lease hone (916) 324-1781 1. Generate hazardous Waste? , p p 2. Recycle more than 100 kg/mo of recyclable ^ Yes No • RECYCLING FORM materials at the same location it was generated? 3. Recycle more than 100 kg/mo of recyclable ^ Yes No • RECYCLING FORM materials at an off-site location different from the point of generation? 4. Treat Hazardous Waste on site? ^ Yes No • TP FACILITY FORM • TP UNIT FORM (One per unit) 5. Subject to Financial Assurance requirements? ^ Yes No • CERTIFICATION OF FINANCIAL ASSURANCE 6. Consolidate Hazardous Waste generated at a ^ Yes No • REMOTE WASTE /CONSOLIDATION SITE NOTIFICATION FORM remote site? NOTE: If you checked YES to any part of Sections IIA - IIF above, then in addition to the forms requested above, please Submit BUSINESS OWNER/OPERATOR IDENTIFICATION FORM (FD2089) FD2088 (Rev. 02105) BAKERSFIELD FIRE DEPT. '~~ ~ ~ ~ ' y ~ ~ (HMMP) Prevention Services HAZARDOUS _M4A'i'ERIAI:S MANAGEMENT PLAN a H R S A I n g00 Truxtun Ave., Ste. 210 INSTRUCTIONS _ parr r Bakersfield, CA 93301 SITE & FACILITY DIAGRAM'S ~ Tel.: (661) 326-3979 Fax: (661) 852-2171 Page lof 2 These instructions explain the use of the site diagram and the facility diagram.- Normally, small and medium size businesses will only have to submit a site diagram. If you have subdivided your business into smaller areas because of the complexity or size, then you will~be completing and additional detail map, facility diagram, for each of these areas. Include instructions that show the route to your business if it is_in a remote location. All diagrams must be 'on ~8 ~'/z x 11 paper and drawn using a straight edge tool. SITE DIAGRAM INSTRUCTIONS The site diagram is used to show your business and to indicate the businesses that immediately surround your property, usually within 300 feet. If you will be showing specific area detail on facility diagrams, use the site diagram to show an overall layout of the plant. If you will not be submitting facility diagrams, the site map must include all of the following information: 1. Check the box on the top left corner of the form provided that indicated "Site Diagram". 2. Print the name of your business, as shown in your HMMP, on the top of the diagram. 3. Label the location of the hazardous materials and identify them by name and type of hazard (i.e., flammable liquid, corrosive solid). 4. Label the location of utility shutoff points for gas, electric and water services. 5. Label the location of fire hydrants. . 6. Label portions of the building protected by automatic sprinkler systems. 7. Label the direction representing north on the diagram. (The diagram form provided includes a north arrow). 8. All labeling and identification on the diagram must be legible and easily understandable at the scale submitted. Diagrams must be sufficiently legible to produce a legible copy. Try to avoid the use of abbreviations or symbols. If you must use them, provide a legend explaining your system. Maps may be returned for correction if you fail to follow these instructions. FACILITY DIAGRAM INSTRUCTIONS Facility diagrams are supplements to the site diagram. Use them to show the subdivision details of a large business. 1. Check the box in the upper right hand corner of the form provided that indicated "Facility Diagram". 2. Print the name of your business as shown on your HMMP. Print the name of the area that this map represents. This name should be the same name that you used on this area's inventory report. 3. Indicate which area the diagram represents and the total number of facility diagrams that you are including. If a map represented the first of four areas, it would be labeled #1 of 4. 4. Follow instructions (3 -8)* for site diagrams regarding the specific details to be included on each facility diagram. UNDERGROUND STORAGE TANK FACILITIES PLEASE NOTE: * If you operate an Underground Storage Tank (UST) facility, the facility diagram shall also specify the location(s) of the UST continuous leak monitoring system and/or the location(s) where the UST monitoring will be performed. (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN SITE & FACILITY DIAGRAM Page 1 of 1 BAKERSFIELD FIRE DEPT,. ~. Prevention:Servtces ~ ' a a x s p r n g00 Truxtun Ave., Suite 210 FIRa Bakersfield, CA 93301 A`,,,Tr r Tel.: (661) 326-3979 T' Fax: (661) 852-2171 - _ -- SITE DIAGRAM ~ FACILITY DIAGRAM Business Name: ~ C~~rG~" ~~~-~..x~lc~' ~Gl~a~,i~~i~ Business Address: y4~ ~i~~ ~ ~v~ iiv~ !/~ NORTH. 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