HomeMy WebLinkAboutBUSINESS PLANW
U
z ~'
F t,:,
s ~'
w o
~i U
;\~
r
(HMMP)
HAZARDOUS MATERIALS MANAGEMENT PLAN
(UNIFIED PROGRAM CONSOLIDATED FORM)
APPLICATION
BUSINESS OWNER/OPERATORIDENT~ICATION FORM
(HAZARDOUS MATERIALS FACILITY INFORMATION)
BAKERSFIELD FIRE DEPT. A ,
Prevention Services ~~
B B R S P I D 900 Trtzxtun Ave., Suite 210 /~.
F/RF Bakersfield, CA 93301 ~ ~ V
'u r Tel.: (661) 326-3979 ~4
Fax: (661)852-2171
Page 1 of 2 ~~~~~
L FACILITY IDENTIFICATION'`
~
FACILITY ID NO. ear eginning too Year Ending to
I R o 0 o i "- 5 0
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) ~ 3 BUSINESS PHONE to
~ U.S. Postal Service Bakersfield Vehicle Maintenance 661.392.6190
SITE ADDRESS to
"~3400-Pegasus- Dri`ve~ _- - _----.-.-_.- ----------- - - - - .- . -_~-- - -
CITY toa
cA IP to
Bakersfield 93380-70
DUNN 8 BRADSTREET tos IC CODE ~~
4Dig
~ t0
783601420 11
'i
COUNTY ~ t0
Kern
OPERATOR NAME toe OPERATOR PHONE tt
Vehicle Maintenance Facilit 661.392.6190
.
- IL. OWNER INFORMATION
OWNER NAME ttt OWNER PHONE ~
5190
392
661 tt
United States Postal Service .
.
OWNER MAILING ADDRESS tt
3400 Pegasus Drive
CITY tta STATE - tts IP ~- - - tt6'
Bakersfield CA 93380-7033
- II I. -ENVIRONMENTAL CONTACT:.
CONTACT NAME to CONTACT PHONE
6190
661.392 tt
Dave Brown .
CONTACT MAILING ADDRESS tt
CITY
720
STATE t21
ZIP
12
Bakersfield CA 93380-7033
`PRIMARY' `- _~ . _ = `IV: EMERvEN CY CONTACTS: -: :_:,-.. ~ ; ,' -__SECONDARY " _
NAME
Dave Brown 123 NAME -
Rob Cizek 12
TITLE -
Manager, VMF t2 I-LE
Lead Automotive Technician 12
BUSINESS PHONE ~ ~ 12 " BUSINESS PHONE 13
661.775.6741 661.392.6192
24-HOUR PHONE 12 4-HOUR PHONE 131
626.216.9149
PAGER No 12 PAGER No 13~
13
' ` : .. V. CERTIFICATION ~ _
Certification: 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 in this inventory and believe the information is true, accurate, and complete.
G AT O OWNER/OPE TOR (fu ted name)
~ 13
~~
~ DATE//. 13
~ NAME OF DOCUMENT PREPARER (full printed name) 13
~ ~ ~ //
2~
J~
~7~/' //~ ~ ~ ( `~ v rf'
SIGNATURE OF OWNER/OPERATOR/OR DESIGNATED 13 TITLE OFOWNER/OPERATOR/OR DESIGNATED 13
REPRESENTATIVE REPRESENTATIVE (SIGNER)
FD 2142 (Rev. 09/05)
6