HomeMy WebLinkAboutBUSINESS PLAN 3/13/2006i
+ UNION CEMETERY ASSOCIATION __________________________ SiteID: 015-021-000610 +
Manager BusPhone: (661) 324-9648
Location: 730 POTOMAC AVE Map 103 CommHaz Moderate
City BAKERSFIELD Grid: 32A FacUnits: 1 AOV:
CommCode: BFD STA 02 SIC Code:6553
EPA Numb: DunnBrad:
~
~feY'genc
ntact / Title Emergency Contact / Title
/ SUPERVISOR RUTH WEST / SUPERINTENDENT
Business Phone: (661) 324-9648x Business Phone: (661) 324-9648x
24-Hour Phone (661) $li'~~~J 24-Hour Phone (661) 325-4194x
Pager Phone ( ) - x Pager Phone ( ) - x
"- ~ Hazmat Hazards :~ ~ y ~ ~ ~ ~-"`~ - "y''` Fire; ~ - - ~`-___,_._.,_ _ImmHlth '-"'~-1-
- - -
-- -- -
Contact Phone: (661) 324-9648x
MailAddr: PO BOX 3066 State: CA
City BAKERSFIELD Zip 93385
Owner UNION CEMETERY ASSOCIATION Phone: (661) 324-9648x
Address PO BOX 3066 State: CA
City BAKERSFIELD Zip 93385
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
- - - ENT BAR 0 ~~A6
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 fami-iar with the information
submitted and believe the information is true,
accurate, and c plete.
~/3C~(~
ignature D to
-1- 02/28/2006
\ `
UNION CEMETERY ASSOCIATION
Manager RUTH N WEST
Location: 730 POTOMAC AVE
City BAKERSFIELD
SiteID: 015-021-000610
BusPhone: (661) 324-9648
Map 103 CommHaz Moderate
Grid: 32A FacUnits: 1 AOV:
CommCode: BFD STA 02
EPA Numb:
SIC Code:6553
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
JOSE LEYVA / SUPERVISOR RUTH N WEST / SUPERINTENDENT
Business Phone: (661) 324-9648x Business Phone: (661) 324-9648x
24-Hour Phone (661) °'" "^'^" 2~~'~3 ~ 24-Hour Phone (661) 325-4194x
Pager Phone ((~(~~) ~~ 3 -7U(p~ x Pager Phone ( ~a5) 233 - y3Ly x
Hazmat Hazards: Fire ImmHlth
Contact JOSE LEYVA Phone: (661) 324-9648x
MailAddr: PO BOX 3066 State: CA
City BAKERSFIELD Zip 93385
Owner UNION CEMETERY ASSOCIATION Phone: (661) 324-9648x
Address PO BOX 3066 State: CA
City BAKERSFIELD Zip 93385
Period to TotalASTs: = Gal
Prepares: _ TotalUSTs: = Gal
Certif'd: ~ RSs: No
ParcelNo:
Emergency Directives:
PROG A- HAZMAT ENT'D A U G 0 8 2007
PROG T - ABOVEGROUND STORAGE TANK
used on my inquiry of those indivir,'uals
resp,^;?sib;e fcr obtainin
the i
f
g
n
ormation, Irertify
under penalty er iar; that I have personall
y
examined and am familiar with the information
submitted and I:elieve the information is true
,
a~,,,~rate, and complete.
- _ ~ 7~~~0 7
'
Fgnature
Otte
-1- 07/16/2007
~ `
F UNION CEMETERY ASSOCIATION
~ Hazmat Inventory
~ MCP+DailyMax Order
= SiteID: 015-021-000610 ~
By Facility Unit ~
Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
GASOLINE F IH L 500.00 GAL Mod
-2- 07/16/2007
,,_
-3-
07/16/2007
Y t
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
GASOLINE Days On Site
365
Location within this Facility Unit Map: Grid:
15-20 FT W OF OFFICE C'AS#
8006619
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid Mixture Ambient Ambient ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
500.00 GAL 500.00 GAL 300.00 GAL
riHGH~t1JUU~ (.:UM1'UN~N'1'S
%Wt. RS CAS#
100.00 Gasoline No 8006619
-- L1HL~KRL tiJ JP~JJI~IJ;1V 1 J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Mod
-4- 07/16/2007
1
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 12/11/2000 ~
PHONE 911, IF NECESSARY ADVISE PROPER AGENCY FOR SPILL OR CLEANUP.
Employee Notif./Evacuation
12/11/2000
OFFICE TO ADVISE WORKMEN ON GROUNDS BY FOREMEN AND ASSIST PUBLIC EVACUATION.
Public Notif./Evacuation
12/11/2000
FOREMEN WOULD ASSIGN MEN TO ESCORT VISITORS BEYOND GATE TO SAFE DISTANCE.
Emergency Medical Plan
TRANSPORT ANY CASUALTIES BY AMBUANCE TO KMC.
12/11/2000
-5- 07/16/2007
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 12/11/2000 ~
POSTED WARNINGS AND EMPLOYEE EDUCATION.
Release Containment 12/11/2000
RESPONSIBILITY FOR SHUT OFF ASSIGNED. NOTIFICATION OF AUTHORITIES 911.
Clean Up 12/11/2000
VERIFY METHOD OR AGENCY BEFORE APPLYING ANYTHING.
Other Resource Activation
-6- 07/16/2007
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
-~ -~-
.~j/c~.s.a.i aiac~aiua
Utility Shut-Offs 04/04/2007
GAS - BEH OFFICE
ELECTRICITY - OFFICE INSIDE PANEL - CLOSET BY MENS RM
WATER - PRIVATE SYSTEM - PUBLIC SYSTEM FIRE HYDRANT 100FT E
Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - CHEMICAL EXTINGUISHERS.
12/11/2006
FIRE HYDRANT - OUR OWN WELLS & PRESSURE TANKS AS WELL AS PUBLIC SYSTEM FIRE
HYDRANT 100FT E OF OFFICE.
Building Occupancy Level
20 EMPLOYEES
12/11/2006
-7- 07/16/2007
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 12/11/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE ALL MADE AWARE OF LOCATION
AND WHAT IS STORED, ALL MADE AWARE OF NONSMOKING AREA, ALL MADE AWARE OF
POWER BEING "OFF" AT ALL TIMES WHEN NOT IN USE, WHO TO NOTIFY IN EVENT OF
ACCIDENT OR EMMINENT DANGER OF EXPLOSION DUE TO FIRE.
rayc ~
Held for Future Use
Held for Future Use
-s- 0~/16/200~
Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST 900TruxtunAve:
Suite 210
. ,_ .~ . t ._ ~. ...~.d~ _ ,., ~ , _.. _ ,. ._ __,.._~._ . _ ......... A F R ~ f,
F-eE ,
Bakersfield, CA 93301
- SECTION 1: Business Pian and Inventory Program ARrM t
~ Tel.: (661) 326-3979
F
661
872
217
•
FACILITY NAME ax: (
)
1
-
INSPECTION DATE INSPECTION TIME
GlNloN c (~,rt~~~'l~/1- ~ X455 c~<4T~o,(J // - G -OG 1 / ,3
ADDRESS PHONE NO. E NO OF EMPLOYEES
~TO,~a-~ 3ay-9Gy~ Za _
' _
FA LLTY NTAC - BUSINESS ID NUMBER
' 15-021- QDOG/~
Z
- - -
~ '~
L'f ROUTINE -
Section 1: Business Plan and Inven
^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY
tory Program
^ COMPLAINT -
Ip
^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND
^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS ,~ 2006
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
i~ ^ PROPER SEGREGATION OF MATERIAL
~
^ VERIFICATION OF MSDS AVAILABILITY
,..
/
p ^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
i
^
EMERGENCY PROCEDURES ADEQUATE
~ i~ ^ CONTAINERS PROPERLY LABELED
i~ ^ HOUSEKEEPING
^ FIRE PROTECTION
I ~ ^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
`~ti'i ~foay G~4C~ ~ ~ Z l~-
Inspector (Please Print) Fire Prevention / 1°` In /Shift of Site/Station #
i
.White -Prevention Services Yellow -Station Copy Pink -Business Copy
^ YES ~ NO
FD 2155 (Rev. 09105
UNIFIED PROGRAM INSPECTION CHECKLIST
Bakersfield Fire Dept.
Environmental Services
900 Truxtun Ave., Suite 210
Bakersfield, CA 93301
Tel: (661)_326-3979 _
il
SECTION 1 Business .Plan and Inventory Program
FACILITY NAME WSPECTION DATE INSPECTION TIM
I.GV>b C~£ rh ~~ ~ r,.%LY - __~ ~Sooi.~o ~ ~ IDYo o ti
--- ---------~ -- - ----- -- - - _ . ~ - -----... - - - --- ~__...._ _.-._.. _........ _ --- --- - - ---- ------------ ~--- P y .._...._. _ .
ADDRESS PHONE Plo. No. of Em to ees
~ 3D---_- ~~ ~ ~ L 3LY- gG~ 2-O
FACILI T - Business ID Number
li rre.z I t s-021- OQ~~/O
Section 1: Business Plan and Inventory Pn~gram
A'E~utine ^ Combined O Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection
C V (C=Compliance
) OPERATION ~
COMMENTS
lV=~lrolation i
6~J ^ APPROPRIATE PERMIT ON HAND
'~1 ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
--
^
---- ------- ---------- -- - -- --------..__._ .._._-
VISIBLE ADDRESS
.I r
^ CORRECT OCCUPANCY
~^ _
VERIFICATION OF INVENTORY MATERIALS __-. _ _
CJ ^ - VERIFICATION OF QUANTITIES
-------..__ __. _.- ._._.._. _-...:_ _..___ -- JI
--
----._. ._ __..._-...
~ ^ .VERIFICATION OF LOCATION I
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSD$ AVAILABILITYE
l
I~ ^
VERIFICATION OF HAT MAT TRAINING ----.__.......-- - -.. _ _.._ _.. _ - .___... --- - ------- ---- ------ _
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I
---r----
1~ ^ -------- ------------ ------------...._ _.
EMERGENCY PROCEDURES ADEQUATE +- _ - -- .. __ ____ ._. __ _ _ -. __._ .. ._ ----..-------- --.._ - ._ ..
~
~^
CONTAINERS PROPERLY LABELED - .._..-
-J----
D ^ --- -------- ------------------------ -._---._..- ---- - -. _._-_
HOUSEKEEPING . '-_. _ ..__.. -- - - _.. _. _._ ... - ._...- - . . _ _ .._ _ .. ----- __ _----- -- -
~
f
CJ ^. ---- -- -----------~---- -.._ _..-...--- ----------
FIRE PROTECTION __i- ---- ... .. ...... . .. . .......- _- _. .. .
- ....- - ... - ----_ -- -- -_- --- --
~
D ^ SITE DIAGRAM ADEQUATE ~ ON HAND
ANY HAZARDOUS WASTE ON SITE?: ^ YES !~J IVO
EXPLAIN:
• QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT 661 326-3979
Inspector (Please Print) Fire Prevention 1st-In/ShiN of Site
White -Environmental Services Yelbw - Sletion Copy
usiness Site Res ible Pally (Please ri
o,
B
Pink -Business Copy
~;' ~~ ~~
UNION CEMETERY ASSOCIATION SiteID: 015-021-000610
Manager J~U-~~ ~_ ~~~~ ; BusPhone: (661) 324-9648
Location: 730 POTOMAC AVE Map 103 CommHaz Moderate
City BAKERSFIELD Grid: 32A FacUnits: 1 AOV:
CommCode: BFD STA 02
EPA Numb:
SIC Code:6553
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
JOSE LEYVA / SUPERVISOR RUTH WEST / SUPERINTENDENT
Business Phone: (661) 324-9648x Business Phone: (661) 324-9648x
24-Hour Phone (661) 871-9032x 24-Hour Phone (661) 325-4194x
Pager Phone ( ) - x Pager Phone- ( ) - x
Hazmat Hazards: Fire ImmHlth
Contact :~~ ~,~~V(%~ = - - - Phone: (661) 324-9648x
MailAddr: PO BOX 306 State: CA
City BAKERSFIELD Zip- 93385
Owner UNION CEMETERY ASSOCIATION Phone: (661) 324-9648x
Address PO BOX 3066 State: CA
City BAKERSFIELD Zip 93385
.Period to - TotalASTs: = Gal
Preparers TotalUSTs: = Gal
Certif'd: ~ ~- RSs: No
ParcelNo
Emergency Directives:
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK eNT~D A ~j~ ~ ~~A~
!~ H lj .
O~
based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of lav/ that i have personally
examined and am familiar with the information
submitted and believe the information is true,
accurate, and com lete.
_ 3 3v a
~~ nd~ure D .e
-1- 02/20/2007
l j
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
~ Hazmat Inventory By Facility Unit ~
~ MCP+DailyMax Order Fixed Containers on Site ~
Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP
GASOLINE F IH L 500.00 GAL Mod
-2- 02/20/2007
-3- 02/20/2007
~- 1
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
GASOLINE Days On Site
365
Location within this Facility Unit Map: Grid:
15-20 FT W OF OFFICE CAS#
8006619
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixtur~ Ambient ~ Ambient ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
500.00 GAL 500.00 GAL 300.00 GAL
HAZ
ARDOUS COMPONENTS
~Wt. RS CAS#
100.00 Gasoline No 8006619
IlEiGtiRL HJ JP~JJ1"1P~1V1J
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F IH / / / Mod
-4- 02/20/2007
P UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 12/11/2000 ~
PHONE 911, IF NECESSARY ADVISE PROPER AGENCY FOR SPILL OR CLEANUP.
Employee Notif./Evacuation 12/11/2000
OFFICE TO ADVISE WORKMEN ON GROUNDS BY FOREMEN AND ASSIST PUBLIC EVACUATION.
Public Notif./Evacuation 12/11/2000.
FOREMEN WOULD ASSIGN MEN TO ESCORT VISITORS BEYOND GATE TO SAFE DISTANCE.
Emergency Medical Plan 12/11/2000
TRANSPORT ANY CASUALTIES BY AMBUANCE TO KMC.
-5- 02/20/2007
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 12/11/2000 ~
POSTED WARNINGS AND EMPLOYEE EDUCATION.
Release Containment 12/11/2000
RESPONSIBILITY FOR SHUT OFF ASSIGNED. NOTIFICATION OF AUTHORITIES 911.
Clean Up 12/11/2000
VERIFY METHOD OR AGENCY BEFORE APPLYING ANYTHING.
~,_ _
v~.iici ncavui~.c ri~~iva~ivii
-6- 02/20/2007
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
J~JG l:1 ct1 ncLG Cil u7
Utility Shut-Offs 12/11/2.006
A) GAS - BEH OFFICE
B) ELECTRICITY - OFFICE INSIDE PANEL - CLOSET BY MENS RM
C) WATER - PRIVATE SYSTEM - PUBLIC SYSTEM FIRE HYDRANT 100FT E
D) SPECIAL - NONE
E) LOCK BOX - NO '
Fire Protec./Avail. Water 12/11/2006
PRIVATE FIRE PROTECTION - CHEMICAL EXTINGUISHERS.
FIRE HYDRANT - OUR OWN WELLS & PRESSURE TANKS AS WELL AS PUBLIC SYSTEM FIRE
HYDRANT 100FT E OF OFFICE.
Building Occupancy Level 12/11/2006
20 EMPLOYEES
-7- 02/20/2007
.:
F UNION CEMETERY ASSOCIATION SiteID: 015-021-000610 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 12/11/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE.
BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE ALL MADE AWARE OF LOCATION
AND WHAT IS STORED, ALL MADE AWARE OF NONSMOKING AREA, ALL MADE AWARE OF
POWER_BEING "OFF" AT ALL TIMES WHEN NOT IN USE, WHO TO NOTIFY IN EVENT OF
ACCIDENT OR EMMINENT DANGER OF EXPLOSION DUE TO FIRE.
rayc c.
Held for Future Use
Held for Future Use
-s- 02/20/200