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Home My WebLink AboutBUSINESS PLAN 7/18/2007TRIPLE E TRUCKING 1215 E. WHITE LANE .~ 7 . <~ TRIPLE E TRUCKING SiteID: 015-021-002892 Manager MIKE EHOFF Location: 1215 E WHITE LN City BAKERSFIELD BusPhone: (661) 834-0071 Map 124 CommHaz High Grid: 17C FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code: DunnBrad: Emergency Contact / Title Emergency Contact / Title JIM EHOFF / OWNER / Business Phone: (661) 834-0071x Business Phone: ( ) - x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact MIKE EHOFF Phone: (661) 834-0071x MailAddr: 1215 E WHITE LN State: CA City BAKERSFIELD Zip 93307 Owner JIM EHOFF Phone: (661) 834-0071x Address 1215 E WHITE LN State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives : ~1~~4U J ~-~ ~ ~ ~~~ PROG A - HAZMAT PROG H - HAZ WASTE GEN C•~am~r on my ingsJir}! of those individuals ra:,ncnsi~ie for obtainiE ~g the information, I certify ur!cier penalt~+ of ia~~~ that ! ha1re personally examined a.fid am familiar ~nlsth the information s~>:rnitt.~d r,nd =;elieue the information is true, accurate, and complete. 7--/~ e ~ 8i[r ,~ture Date -1- 07/16/2007 P TRIPLE E TRUCKING SiteID: 015-021-002892 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETYLENE E F P IH G 220.00 FT3 Hi DIESEL L 24000.00 GAL Low OXYGEN F IH DH G 747.00 FT3 Low WASTE OIL F DH L 55.00 GAL Low -2- 07/16/2007 '3- 07/16/2007 •, . F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR OF SHOP CAS# 74-86-2 ~GaSATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE TPure Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 110.00 FT3 220.00 FT3 110.00 FT3 • nt~~xtcl~uu5 uvrirulv~lv.la °sWt. RS CAS# 100.00 Acetylene Yes 74862 ti[',GAtCL r~~ar~aal~ilJlvl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: BACK OF BLDG CAS# Liquid TMixtur~ AmbRent~E ~ AE~MPeRATURE ~OVEOGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 24000.00 GAL 24000.00 GAL t1HGKCCLV u.7 l.VP7YVIV 1•S1V 1.7 %Wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 rit-1GHtC1J 1~.7.7L" J.71~1L' 1V l A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -4- 07/16/2007 F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR OF SHOP CAS# 7782-44-7 ~GasATE T TYPE ~AboveSAmbEent TA~PeRnPt,TURE ~ CONTAINER TYPE I Pure I PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Co249100rFT3 Daily M47100m FT3 I Daily 249r00e FT3 tiAGAtCLVUJ 1:V1~lYV1Vl"~1V17 %Wt. RS CAS# 100.00 Oxygen, Compressed No 7782447 riHGAKL A~~tS771~1~1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME WASTE OIL Location within this Facility Unit Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~ Liquid I Waste ~ Ambient ~ Ambient DRUM/BARREL-METALLIC AMO S UNT AT THIS LOCATION Largest Container Daily Maximum Daily Average yoc, ,- 0 GAL ~ 5.0 0 GAL ~p ~ 5 5.0 0 GAL nt~c~tlRlJVUA 1.V1~lYV1VP~1V 1.7 %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 11t1GL•iLCL HJ .7~J.71"1P~1V1r7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~-~ ~v~ G~~ ~~ ~~ ~~.~ ~~~ ~, ~ ~~s a -5- 07/16/2007 }, F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 03/02/2007 ~ 911 Employee Notif./Evacuation 03/02/2007 WE HAVE A SPEAKER SYSTEM FROM OFFICE TO SHOP TO TELL THE SHOP PERSONNEL TO EVACUATE AND THE SHOP WOULD HAVE TO TELL THE OFFICE. Public Notif./Evacuation HOUSES ACROSS STREET WOULD BE NOTIFIED BY ONSITE PERSONNEL. 03/02/2007 Emergency Medical Plan 03/02/2007 FOR MINOR INJURIES WE GO TO INDUSTRIAL MEDICAL GROUP. FOR MAJOR INJURIES WE WOULD CALL 911 AND DIRECT THEM TO TAKE THE INJURED TO THE NEAREST EMERGENCY ROOM HOSPITAL. WE ALSO HAVE AN EMERGENCY EYEWASH AND FIRST AID AND BURN STATION KITS ONSITE. -6- 07/16/2007 .. :., F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 03/02/2007 ~ CYLINDERS CHAINED TO CARTS. HOSES AND REGULATOR ARE LOOKED AT REGULARLY TO CHECK FOR LEAKS. ALWAYS IN THE OFF POSITION UNLESS BEING USED. Release Containment 03/02/2007 FOR ANY LIQUID SPILLS OR LEAKS, WE HAVE A LOADER TO PUT A DIKE AROUND SPILL TO CONTAIN. CYLINDERS ARE CHAINED TO CARTS TO PREVENT TIPPING OVER. Clean Up 03/02/2007 IF IT IS A SPILL WE ARE ALLOWED TO HANDLE, WE WOULD TAKE CARE OF IT. IF IT IS TOO LARGE OR WE ARE NOT ALLOWED TO HANDLE THE CLEAN-UP, WE WOULD CONTACT A LOCAL HAZARDOUS CLEAN-UP COMPANY THAT IS LICENSED. Other Resource Activation -7- 07/16/2007 ., 4 ,. F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a~~c: ~a.i ncizctrus Utility Shut-Offs 03/02/2007 GAS - E SIDE OF OFFICE NEXT TO WALK-IN DOOR ELECTRICAL - E SIDE OF OFFICE NEXT TO WALK-IN DOOR WATER - OUTSIDE DRIVE-IN GATE NEAR ST LIGHT POLE Fire Protec./Avail. Water 03/02/2007 FIRE EXTINGUISHERS: 1 ABC DRY CHEMICAL 5LB E WALL WALK-IN DOOR; 1 ABC DRY CHEMICAL 5LB REAR CONFERENCE ROOM; 1 ABC DRY CHEMICAL 5LB AT KITCHEN ENTR; 1 ABC DRY CHEMICAL 5LB NE CRNR SHOP INSIDE; 1 ABC DRY CHEMICAL 5LB BY MENS BATHROOM INSIDE SHOP; 3 DRY CHEMICAL 20LB INSIDE SHOP; AND 1 DRY CHEMICAL 20LB OUTSIDE SHOP. FIRE HYDRANT - ALONG ST IN FRONT OF YARD Building Occupancy Level 03/02/2007 10 EMPLOYEES -8- 07/16/2007 d' ! ti; ~ i . ~• F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 03/02/2007 ~ BRIEF SUMMARY OF TRAINING PROGRAM: SAFETY MEETINGS. NO SPECIAL TRAINING. DO NOT BE A HERO, CALL FOR PROFESSIONAL HELP AT 911. ALSO, REPORT ANY UNSAFE CONDITIONS OR SPILLS TO OFFICE. rc~yc ~ nciu ivt ru~uic ~cc nciu ivi ru~uic vac -9- 07/16/2007 ,. i. F TRIPLE E TRUCKING Manager MIKE EHOFF Location: 1215 E WHITE LN City BAKERSFIELD CommCode: BFD STA OS EPA Numb: BusPhone: Map 124 Grid: 17C SIC Code: DunnBrad: SiteID: 015-021-002892 (661) 834-0071 CommHaz High FacUnits: 1 AOV: Emergency Contact / Title Emergency Contact / Title. ALLEN EHOFF ~~ p c e_~ -NER JIM EHOFF / OWNER •. Business Phone• 834-0071x Business Phone: (661) 834-0071x 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ALLEN EHOFF Phone: (661) 834-0071x MailAddr: 1215 E WHITE LN ~ .~C Q~-S-~~ State: CA City BAKERSFIELD Zip 93307 Owner JIM EHOFF Phone: (661) 834-0071x Address 1215 E WHITE LN State: CA City BAKERSFIELD Zip 93307 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN Based on my inquiry of those individuals sible for obt i a ning the information, I oertify u der penalty of IaNJ that i have personally examined and am familiar with the information submitted and beli eve the information is true, accurate, and comp ate ~~~'D MAR 2 ~~~~ Si ture r''L~+'~ D~ / ~ -1- 02/20/2007 F TRIPLE E TRUCKING = ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-002892 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP ACETYLENE E F P IH G 220.00 FT3 Hi OXYGEN F IH DH G 747.00 FT3 Low WASTE OIL F DH L 55.00 GAL Low ~L~ yf~~ ~~t'~~'~°- ~~~~~~ -2- 02/20/2007 ~v~~l ~o~ ~~ ~•x~ ~~~~5 ~ ~~~~ ~~J~~~ -3- 02/20/2007 r .1 F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ACETYLENE Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR OF SHOP CAS# 74-86-2 STATE T TYPE T PRESSURE TEMPERATURE CONTAINER TYPE ~GaS I Pure I Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 110.00 FT3 220.00 FT3 110.00 FT3 riE~Gf~1CLVU~ 1:V1~lYV1VL'~1V17 %Wt. RS CAS# 100.00 Acetylene Yes 74862 t1HGF1ttL I~~ JL' J J1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME OXYGEN Location within this Facility Unit SE CRNR OF SHOP STATE TYPE PRESSURE _ Gas TPure -Above Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7782-44-7 TEMPERATURE CONTAINER TYPE Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 249.00 FT3 747.00 FT3 249.00 FT3 HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 riE~GL-1tCL 1~.7JJ;.7.71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 02/20/2007 ., F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TWaste -~mbient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL - riHGHKLVUS 1:V1~lYV1Vr;1V'1'S oWt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 riHGAtt1J A~~~SS1~1~1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -5- 02/20/200 F TRIPLE E TRUCKING SitelD: 015-021-002892 ~ Fast Format ~ ~'Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification ~~i = Employee Notif.jEvacuation,' ~~ %l% ;~~ v-~..~, ~ J ~~ ~~' s~~ ~~,,~~ ~~~ t_U1J111: lVV l.11 ~ ~VCL I: UCLL1Vll ~J ,( / ~ ~ ~~ /~~ /'~ j ~ ~ ~f~~fi~// LSO t0~~ ~~ ~0 ~~ ~~! ~ /V~ n'~ S~ ~~ ~.~f/r S J Nli-f/> Emergency Medical Plan ~,~ %ai~4i~ %~w ;fnJ': ~~o~ J 6b lnc:~us~ri ~~ /~^~/c•~ /G~~~~ -6- 02/20/2007 F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ jRelease Prevention,' _ _l _ -~ i y /" ~o Svs ~~ Y~1 ~~" ;,- ~' ~,, /~, ~~~ ~~ ,!~-i v l-~1 ;~~ Gig `wJ ~ ~~~ ~~~ G/~/L.~~ $ / a7 ~ ~-[~ 17~~ ~~ J i ~~JU~Li l1,!'l /~. 5 S ~~/ u~ !^/.~Z/ Release Containment. ~~ ~~T~ ,~~ i~ ~Dyn~ s,~,'ll ~~ G~~~~~~;a~ V1C0.11 VtJ - ll ~ ~ /~e~ ~ ~ ~ (~/~v! ~~~ V1.11C1 iCC.7-VULLC HL L1Vdl.1.UA -7- 02/20/2007 r . ~, , r F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~JCC:1d1 tld'GdlU.`~' - v~.Lllff~y allu~-vl.l.~ ss7'~~ ~G ~ ~-~-, `P~c, f~-c-~k~ ~t1 v~~~~ ~ /~ ~ve~-- Y~ ~ ~~I S s~ `' ~ `'~-~ vr~~~.~. /r) ~. inn o v~S".~ ,~1 ~~ %~.~, ~n ~,~~~ ~~~ S / /~~ ~i S h~ ~~ 1-v `Fire Protec.//rAvail. Water / J ,y' -~ ~~ p~ ~~~~ ~. ~ ~ns,' S~ l o v i s,; ,, y C~ , ~ ~ ~ J M cG ~ ; ~~M ~~~G,.~ Rte, d / 4.J~ /~~ ~n~~pfM~)/yJi~~~~/~CS/~ ~J~ Du111A 111y Vtr I. U~JQlll.y LCVC1 -8- 02/20/200 _ _ / _,~ _ _ ~'" i F TRIPLE E TRUCKING SiteID: 015-021-002892 ~ Fast Format ~ Training Overall Site ~ r~Ill~J1Vy CC 1tGL 1111110. '~ 1 ~/v ~~ ~~, ~~~ r ~ S C~~ ~a{ ~ra~~ ~,~ f ~~l ~ ~'`~~ W un S ~ ~ ~ ~ i7 U~~~ C'-e1 rayc c. . ~ t r L1G 1lA 1V1 1'Ul. lAtc l.l~C azciu ivi rut.uic Vic -9- 02/20/2007 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST l~ _ B A F R s F, , p 900 Truxtun Ave., Suite 210 ~~~~-_ _ ,_ ~~.- _~~ e~._a~~~ . ~ ~. _~m~-~ ~_~...~~ ~ ~ FiR~ ~ . Bakersfield, CA 93301 SECTION 1: _ Business Plan and.lnvento . Pro ram ~ "R'M Tel.: (661) 326-3979 ry g ~ _"'~= ~ Fax: (661) 872-2171 .;,~ FACILITY NAME ~ ~ - INSPECTION DATE INSPECTION TIME ADDRESS />~ ~ ~' w ~ L.~ - PHONE NO. y ~~i O OFEMPLOYEES 60 FACILITY CONTACT = BUSINESS ID NUMBER ~s-o~~- a-gC~ ~.' e ~ rat - - - - - - - - Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTI i C V ~ C=Compliance OPERATION V=Violation COMMENTS ~ ^ APPROPRIATE PERMIT ON HAND 1 ICJ ^ BUSIf1eSS PLAN CONTACT INFORMATION ACCURATE I~ ^ VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY ,! IJ ^ VERIFICATION OF INVENTORY MATERIALS Office' (661) 834-0071 Mike Ehoff Fax: (661) 834-0072 All Eh ff Its ^ VERIFICATION OF QUANTITIES I en o ~ * n ~ ~+~"LE Jim Ehofl' Cl~ ^ VERIFICATION OF LOCATION I ^ PROPER SEGREGATION OF MATERIAL ?' ~s Cdr ^ VERIFICATION OF MSDS AVAILABILITY RUCKi~ 1215 E White Lane • Bakersfield CA 93307 ; ^ VERIFICATION OF HAZ MAT TRAINING . , "We haul dirt, rock, sand & asphalt" ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Double Bottoms • Transfers • End Dumps ____ _, _--~ _ _~_ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY-LABELED ^ HOUSEKEEPING \ [~ ^ FIRE PROTECTION ~ O ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? r,.~r~Sa-r~ D~ L EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 1= ~~,~ ~~ Inspector (Please Print) Fire Prevention / 1~~ In /Shift of Site/Station # ' [t~'~ES ^ NO White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 - ~~ a sfield Fire Dept. UNIFIE® PROGRAM INSPECTION CHECKLIST Enironmental services - _ ~ ~ 1715 Chester Ave SECTION 1 Business Plan and Invento Pro ram ~' rY 9 ~~ Bakersfield, CA 93301 . Tel: (661)326-3979 FACILITY NAME ~- ADDRESS 1' 2 i.S ~ l~~i`t rf c t,n/ INSPECTIO DATE z_t~ of ID Number 15-021- J~Ls..l Section 1: Business Plan and Inventory Program ^ Routine Combined ^ Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V C=Compliance OpEI2ATION V=Violation ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ^ ^ VISIBLE ADDRESS ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ f ROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITYE ^ ^ VERIFICATION OF HAT MAT TRAINING ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE 8c ON HAND ANY HAZARDOUS WASTE ON SITE: YES ^ NO EXPLAIN: ~n.J'Ay'r'C U+~ / ` COMMENTS ~-cJ ~G2....~,~ Sr7i _.._ --- -- - - Cy1 ~- ~-M~l7'GS ~~~ ~~•c,~, 1"' C~'Mr^~l'.9 can/ : wS(' Z4~ ,c3~_ l lu >r Z /nJJ;+7rv'; fir' e:_n12 cJ~ S(-Fv(° ----- - F~ C~ -- ~ C~ `/ --- l~ _ - ~~- -- - - ------ -- _ - _ ' ~ --- -- ..- __. -_ ~d -- -- _ ---- ~-- ---- _ - - - -- - -- --------- --E~ T'' ~ Oftice: (661) 834-0071 Mike Ehoff ---~ Fax: (661) 834-0072 Allen Ehoff ~iD! _. ~~PLFi Jim Ehoff __ (i { - - I - CK 1215 E. White Lane • Bakersfield, CA 93307 "We haul dirt, rock, sand & asphalt" ~ ~- - ~ Double Bottoms • Transfers • End Dumps - QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~66~~ 3Z6-3979 L~t~~ Inspector (Please Print) Fire Prevention 1st-InlShift of Site White -Environmental Services Yellow -Station Copy Business Site Responsible Party ( e se rint) g Pink -Bus+ness Copy wry V ~ A ~r.~~ CITI~' Ot~ l3:~tiERSI~ tELD OFFICE OF EN~'IROY~[E;~T.aL SER~'tCES 1713 Chester Ave., CA 93301 (66 t) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION NEW ~ AOD G1 DELETE ^ REVISE 20U I. FACILITY INFORMATION ""~'~ ~ ~ (one loan per matenal per Durlding Jr area: Page _ OI _ 9USINESS NAME (Same as FACILITY NAME or DBA - Doing Business As1 CHEMICAL LOCATION ` / ~ 201 CHEtA1CAl LOCATION wS r7~ S L.~ ~ Cn~2 ~ SE-( CONFIDENTIAL (EPCRA) -- FACILITY 10 k . ~ - _ - - ' - " -~~~- - ~ ~ ~- T MAP ft (oPfgnaQ 203 GRID C (optional) -- -~ ~ ~- .., . I II. CiiEMlCAL INFORMATION CHEMICAL NAME ~~~~~^ I COMMON NAME CAS # FIRE CODE HAZARD CLASSES (Complete it requesteC by local fire chief) ^ Yes ^ No 202 -- ------- ~y-- 205 TRADE SECRET ^ y~ ^ No 2C6 If Subject to EPCRA, reler to mstfUQionS 207 ~ ~ - EHS' ^ Yes ^ No 208 209 •If EHS is'Ya,' >U amounts bcbw muu be m Ibs. 2t0 TYPE 1~6L.p-PURE ^ m MIXTURE ^ w W.~S-O_ _ R•.C'IOACT:v'c ^ Yes ^ No 212 CURIES 2t3 PHYSICAL STATE ^ s SOLID ^ I LIOUID ~.y_GAS 214 LARGEST CONTAINER , ~O 2' S FED HAZARD CATEGORIES ~'' FIREREACTIVE ~3.PRESS iRE F.ELEr. SE ~ 4 A :U-E HEALTH ^ 5 CHRONIC HEALTH 216 (Checfc all that apply) ANNUAL WASTE 217 ;dAXIMUM ~ ~.~ 218 T ~ AVERAGE 219 STATE WASTE CODE T ~ ZU 220 AMOUNT OAIIY AMOUN DAILY AMOUN UNITS' ~! ga GAL ~_CU FT ^ Ib LBS iJ to TONS 221 ~ DAYS ON SITE 222 ' If EHS, amount must be in lbs. STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PLASTIGNONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAILCAR 223 (Check all that apply) ^ b UNDERGROUND TANK ^ (CAN V I BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO 1SILCYLINDER ^ p TANK'NAGON STORAGE PRESSURE ^ a AMBIENT ~ea ABOVE AMBIENT ^ ba dEIOW AMBIENT 224 STORAGE TEMPERATURE ,AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS CAS # 1 226 i 227 ~ ^ Yes ^ No 228 229 2 230 231 ^ Yes ^ No 232 233 7 234 235 ^ Yes ^ No 236 237 ~ a ,. 238 L_ i ~._ .- . _ ....._....._..._. .. .. __... - -- __ - --. ..... 239 ~ ^ Yes ^ No 240..._ 241 _ . .. . 5' 242 243 ~ ^ Yes ^ No 244 245 _ _ III. SIGNATURE - _ ~-.~ iz~~ ~a y ______ _ ________ __ ~ _ PRINT Ni1ME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 . ~_ 8 E R S F I 0 r/Rt AIPTM T 1PCF (7/99) S:ICUPAFORMS\OES2731.TV4.wpd ~~ B E R S F I b l~/R~ AIPTM T CITE' Of l3:~I~ERS1~lELD OFFICE OF EN~'IROV~IE~T.aL SERVICES 171 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION W ^ A00 ^ DELETE ^ REVISE 200 _ I. FACILITY INFORMATION 9USINESS NAME (Same ass fACILITV NAME or OBA - Dang eus~ness As1 CHEMICAL LOCATION ~ 9~.jS r'~ ~ ~ . . ~~ FACILITY ~ID # ;.:,+,, ' -- --- :... ~ --_ ~ ~ .. .T MAP # (optana0 - . _ is-1;. I 1_ ._. -_ _..... .- I CHEMICAL NAME COMMON NAME CAS # II. CiiEMiCAL INFORMATION .~ .~ (one /orm per matenal per bwlding or area: Page _ of 2J ~ CHEIAICAL LOCATION ^ Yes ^ No 202 CONFIDENTIAL (EPCRA) 200 GRID # (optionaQ ~ ---~~-- ------ ~--- ------ 2(}T-- 205 TRADE SECRET ~ yes ^ No 2C6 If Subjed to EPCRA. reler to inswttions 207... - --------------- -- ------° -- EHS' ^ Yes ^ No 208 209 •If EHS is'Yes,' all amounts below must be is ms. FIRE CODE HAZARD CLASSES (Complete if reijiiestea by local fire chief) 2t0 TYPE ~-PURE ^ m MIXTURE ^ w WAS-: _ R•,tJ10ACTlvc ^ Ves ^ No 2t2 CURIES 213 PHYSICAL STATE ^ s SOLID ^ I LIQUID C~GAS 214 LARGEST CONTAINER ZLI~' 2'.5 .FED HAZARD CATEGORIES , ^ 1 FIRE ~ REACTIVE ~ PRESS IRE c:ELEi.SE ~ 4 A :U-E HEALTH - ^ 5 CHRONIC HEALTH 216 (Check all that apply) NU~WASTE AN 277 ~ ~ ct6 ILY A ~ ~ 219 STATE WASTE CODE ~ 220 A '~ DA MOUNT DAILY AMOUNT UNITS' ~J ga GAL 1,~d CU FT ^ Ib LBS ^ to TONS 227 DAYS ON SITE 222 ' If EHS, amount must be in Ibs. STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PIASTIC/NONMETALLIC DRUM ^ i FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR 223 (Check all that apply) ^ b UNDERGROUND TANK ^ f CAN ~, I BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO ~YLINOER ^ p TANK'NAGON STORAGE PRESSURE ~t ^ a AMBIENT ~a ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE `AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %Wi' _ _- - HA7ARDOUS COMPONENT EHS CAS # t 226 227 ^ Yes ^ No 228 229 2 230 231 ^ Yes ^ No 232 233 3 234 235 ^ Yes ^ NO 236 237 4 ~.. ......238 ~ ... - -- - -..-.- _. _. _. _. .. _ 241 r- ~ ^ Yes ^ No 240..._ 5 -i 242 213 ! Yes No 244 245 ~^ ^ III. SIGNATURE __ _ __ _ ~ ~Zl (~~ _ _______ _ ________ __ PF21NT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 1PCF (7/99) S:\CUPAFORMSi0ES2731.TV4.wpd ' ~_ B E R S F I d r~~~ ARTM 1 --ti V ~ . A ~wy- CITI~- O1~ t3:~1~ERSl~ IELD OFFICE OF EN~'iRO~f ~IENT.-~L SER~'iCES 171 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION NEW ~ A00 Q DELETE C+ REVISE 200 I. FACILITY INFORMATION C' .~ / (one /omr per matenaf per bwlding dr area ~ '~ ---Page _ of _. 9USINESS NAME (Same as FACILITY NAME or DBA -Going Business Asl ~ -- - j (ZI (~~~. C, - --------------------- ' CHEMICAL LOCATION ~ ~S I~~ ~ ~~` C~ SE-I:~ COI CONF DENTI~L (EPOCRA) ^ Yes ^ No 202 -- - - FACIGTY 10 # ;;, k- - ----- ".-.. i - t: MAP # (optionaQ 203 GRID # (optionaQ --- - -- ---- -- ----- ZO.i -- ~:::. I 0. CHEMICAL INFORMATION CHEMICAL NAME ~,,~ ('`~' 7_ ~ COMMON NAME CAS # FIRE CODE HAZARD CLASSES (Complete i! requested by local fire chief 205 TRADE SECRET ^ yes ^ No 2C6 I! Subjed to EPCRA. reler to instructions 207~~ - --•---------------- --------- EHS' ^ y~ ^ No 208 209 •Il EHS is'Ya,' >V amounts below muu be is lbs. z,o TYPE ^ p PURE ~ra MIXTURE ^ w WAS-= ~' . R-,!`IOACTIV.= ^ Yes ^ No 272 -CURIES 273 PHYSICAL STATE ^ S SOLID LIQUID ^ g GAS 214 LARGEST CONTAINER J , 2t5 FED HAZARD CATEGORIE S ^ t FIRE ^ 2 REACTIVE ^ 3 PRESS IRE F'.ELEr.SE ~4 A ;U-E HEALTH ^ 5 CHRONIC HEALTH 2t 6 . (Check all tnat appy) ANNUAL WASTE AMOUNT 217 ;•14XIMU61 X78 DAILY AMOUNT ~~ AVERAGE 219 STATE WASTE CODE GAILY AMOUNT -~.S 220 UNITS' ,~-ga GAL ^ d CU FT ^ Ib LBS ^ to TONS 227 DAYS ON SITE 222 ' I7 EHS, amount must be in Ibs. 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 ^ / BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN (,STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK `NAGON STORAGE PRESSURE a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 22a STORAGE TEMPERATURE ~-a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS ~ CAS # 7 226 227 ^ Yes ^ No 228 229 2 230 237 ^ Yes ^ No 232 233 3 23a 235 ^ Yes ^ No 236 237 4 ;_ 238 i.. i I - .._-..._ ._ ......._ . _....._ ..... _ .... ._..- _. _ _. .. _ .. i ^ ~ 20.. _ 239. Yes No 4 - .247 I 5 ~ 242 2a3 Y N 44 ^ es ^ 0 2 245 III. SIGNATURE ~J /2 _ _ Pj21NT NAME~~& TITLE OF AUTFIORIZEO COINPANY ftEFRESENTAiIVE ~-~ ~~ ~~ ~~ - ~ SIGNATURE c /r/~4 - - -~---._ .._.__-._------- DATE --- 246 F (7/99) S:ICUPAFORMS\OES2731.TV4.wpd ;.~ ~,'?-~ .~ CITY OIL I3AI~ERSFIELD ~~-•~.o PE' ° OFFICE OF ENVIRONI~'IENTAL SERVICES ~~~ B EP ~I Ali<TM T 1715 Chester Ave., CA 93301 (661) 326-3979 • ~,~~, Rtl -~ a ~~~~ ~~' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION ~ (one form per material per building or area) r NEW ^ ADD ^ DELETE ^ REVISE 200 Page _ of - I. FACILITY INFORMATION - . BUSINESS NAME (Same as FACILITY NAME or DBA - Ooing Business As) 3 '~-~ n~% G - - ------- ------ CHEMICAL LOCATION ~ ~,. ~ t~ 20t CHEMICAL LOCATION ^ Yes ^ No Ff ENTI ~~1 ~1~~: S L. (_+c.lV~`~ v~ ~(7„(, CON AL (EP RA) 202 - ----- ---~ j , T----r- c.,..-~ - -- -:- - -. - - tt MAP # (optionaQ _ _ - 203 GRID # (optionan .... 2~ - 11. CiiENIICAL INFORMATION ~ ___ __. .. -.._.. ___.. ___... _-`._. __. .. ._ ___.... _ _... .....__ . _ . . . ......... ..._..... __. 205 TRADE SECRET -- - =- ^ YeS ^ NO 206 CHEMICAL NAME i'~ w S ~~` ~ .l ~ 1' Subject to EPCRA, refer to instructions ' ~ " ---~ - ---- --- - - .. ~ ------ - - -- -- - - ... .. --- - --- - - --- 207 COMMON NAME EHS' ^ Ves ^ No 208 CAS # 209 •If EHS is'Yes,' aU amounts below most lx in lbs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) - 210 ' TYPE ~ PURE ^ m MIXTURE ^ w WASTE ~ ~ R~,OIOACTIVc ^ Yes ^ No 212 CURIES 213 PHYSICAL STATE ^ S SOLID ~LIpUID ^ g GAS 214 LARGEST CONTAINER ~~ J 215 :' FED HAZARD CATEGORIES ,J~j FIRE ^ 2 REACTIVE ^ 3 PRESS~JRE FiELEJ,SE I_; 4 A::U`: E HEALTH ^ 5 CHRONIC HEALTH 216 (Check all that apply) --t i ANNUAL WASTE 217 w14XIMUb1 218 P.VERAGE `7 ^y a 219 STATE WASTE CODE ' 7V ~ 3 ~ 220 ' DAILY AMOUNT , AMOUNT DAILY AMOUNT UNITS' (~'l.ya. GAL ^ d CU FT ^ Ib LBS t] to TONS 221 '; DAYS ON SITE 222 If EHS, amount must be in lbs. I STORAGE CONTAINER ^ a ABOVEGROUND TANK ^ e PIP,STIGNONMETALLIC 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 80X ^ o TOTE BIN I ~~STEEL DRUM ^ h SILO ^ I CYLINDER ^ p TANK WAGON I ---~-- ----- -------- --- - - -----~ I STORAGE PRESSURE AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 24 ~ STORAGE TEMPERATURE ~ gMBIENT ^ as ABOVE AMBIENT ^ be BELOW AMBIENT ^ c CRYOGENIC i 225 . °foWT I 1 ~ 226 j -.._ ~---~- I --~ ---'--- 2 ~ 230 -- - i ~ 3 ~ 234 I i { -4--~-----238-- ----------- i_ I 5 ~ 242 -- - - ---- - - ..,..III SIGNATURE , >,. , _. `i UPCF (7/99) 'i __..--- ------__ .__.-..._._. __._...._...:_ - - _ i EN7ATIVE ., SIGNATURE _ - - -~ - ~- --------- DATE 2a6 .. S:\CUPAFORMS10ES2731.TV4.wpd ..y .4 ~ A .w.~ CITE" O1~ ~3:~tiERSf~fELD OFFICE OF EN~'IROY~IENTAL SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION J~ NEW ^ ADD / ~ ^ DELETE ^ REVISE :00 , I. FACILITY INFORMATION - ---------~ -- ---- - 9 N A M Same as FACILITY NAME or OBA • Doin eus~ness As) BUSINES S E / ( ' 1~ ~~ ~ ' CHEMICAL LOCATION _ t (~V7~17C. ~~~ FACILITY ID # , j !~ . r-:_~~ -' ~ - - ~ t• MAP # (oPtiona~ , ~'ra. ,,, I _~.~ _. il. CNEMiCAL INFORMATION CHEMICAL NAME y~ COMMON NAME ~..w~pn E' • ,~~.• (one Porrn per material per building or area 1 ' Page _ of 201 CHEtdICAI LOCATION ^ Yes ^ No 202 CONFIDENTIAL (EPCRA) 203 ~ GRID # (oPtiona0 - - ~-------_---------~-_--- 20a - 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 below must be in Ibs. FIRE CODE HAZARD CLASSES (Complete-it requested by local fre chief) 2t0 . _ __.. __ - _.. TYPE ^ p PURE----. .~m MIXTURE ^ w WAS'°_ ' • . .. - CURIES R~,CIOACTIVc ^ Yes ^ No 212 213 PHYSICAL STATE ^ s SOLID ^ I LIOUID ~ g GAS 2t a LARGEST CONTAINER ~ ~ 1 215 FED HAZARD CATEGORIES (Check all that apply) - 0 1 FIRE ^ 2 REACTIVE ~ PRESS iRE RELEr,SE ~ 4 A.:U-E HEALTH ^ S CHRONIC HEALTH -- - --- - - - .. ... -. _. _ -...---- - -- - - _.. --- ----- 216 AN NU~WASTE 1 217 3~~ c18 4ILYA 219 STATE WASTE CODE ~ ~ 220 y~ MOUNT DA DALY AMOUNT j~+/ UNITS' ^ 9a GAL d CU FT ^ Ib LBS ^ to TONS 22t DAYS ON SITE 222 ' If EHS, amount mu t be in Ibs. 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 ^ d STEEL DRUM ^ h SILO ~I CYLINDER ^ p TANK WAGON STORAGE PRESSURE ^ a AMBIENT ~aa ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~e.AMBIENT ^ as ABOVE AMBIENT ^ b3 BELOW AMBIENT ^ c CRYOGENIC 225 %WT HAZARDOUS COMPONENT EHS ~ CAS # 1 ,~~ 226 ; ~ / ., 1 ~-ITVrV 227 ~ ^ Yes ^ No 228 229 2 n ~30 Gi ~~~7~ ~ r ~ ~ I 4,~ 231 ^ Yes ^ No 232 233 i - _ 234 l 3 i 235 ^ Yes ^ No 236 .237 i a ~ 238 - ---- - - ---- --- - -°-- ----- _ _ . _ . -.-... __ _ _- - -..- .. - 239. ; . -. _.. _ . -- -- - . _ ^ Ye's ^ Nd '240- - - - __241 .. I 5 i 242 243 I ^ Yes ^ No 244 245 - .. III. SIGNATURE ~ ~~~ -~ ---......._ f PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 _~"' B E R S F I D PIRA ~ R r~r r ~ UPCF (7/99) S:ICUPAFORMS\OES2731.TV4.wpd CITI~' OF l3:~tiERS1~ IELD OFFICE OF EN~'IROV~~[ENT.~L SERVICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION NEW ^ A00 ^ DELETE ^ REVISE 200 I. FACILITY INFORMATION ~BUSINE§S NAME (Same as FACILITY NAME or OBA -Doing eus~ness As) ~' .~ .~ (one /orm per material per Dwltling or areal Page _ of _ CHEMICAL LOCATION 201 CHEt+11CAL LOCATION ^ Yes ^ No 202 CONFIDENTIAL (EPCRA) FACILITY ID # i ; !~ ., ~ - Y MAP # (optiona0 203 GRID # (optional] --- -- - ----~ 2(}4 -- 11. C~IEMiCAL INFORMATION 205 TRADE SECRET ^ Yes ^ No 206 CHEMICAL NAME A J.~(1 ~~ ~ I! Subject to EPCRA. refer to ~nslructions --- --. .- .. -. ---- 207...-- ------------------- -..__.. COMMON NAME I EHS' ^ Yes ^ No 208 CAS # 209 •If EHSu'Yes,' all amounts below must be in ms. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) I, 270 ~ TYPE p PURE ^ m MIXTURE ^ w WAS'. L' . R~,OIOACTIVE Yes ^ No 272 CURIES ^ 273 PHYSICAL STATE '~ ^ s SOLID ^ I LIOUID 'fig GAS 2t4 LARGEST CONTAINER '~ ,' r 275 FED HAZARD CATEGORIES ^ t FIRE ^ 2 REACTIVE ~_ PRESS JRE F:ELE,' SE ~ a .4 :U-E H EALTH ^ 5 CHRONIC HEALTH 216 (Check all Utat aPPIY) ANNUAL WASTE 217 ;~14XIMUAf 278 ~ 1 AVERAGE 219 STATE WASTE CODE r 220 AMOUNT DAILY AMOUNT ~ DAILY AMOUNT UNITS' ^ ga GAL ~ d CU FT ^ Ib LBS L7 to TONS 227 DAYS ON SITE 222 ' If EHS, amount must be in Ibs. 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 u j BAG ^ n PLASTIC BOTTLE ^ r OTHER ^ c TANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o TOTE BIN ^ d STEEL DRUM ^ h SILO 'CYLINDER ^ p TANK WAGON STORAGE PRESSURE ^ a AMBIENT (pea ABOVE AMBIENT ^ ba BELOW AMBIENT 224 STORAGE TEMPERATURE ~ AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT ^ c CRYOGENIC 225 i `~%WT ' ' HA7ARDOUS COMPONENT EHS CAS # 7 226 i 227 ^ Yes ^ No 228 229 i i UPCF (7/99) '~~ 8 E R S F I D P/IPQ ARTM T S:ICUPAFORMS10ES2731.N4.wpd