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HomeMy WebLinkAboutBUSINESS PLAN 8/16/2006 ?~~ ~~~ C {_ u t HII HUi'~iE i~ LEiSt1Kt CtiwTEi ^ ~;~ ~3Ui WHITE Lid ~, ~~ UNIFIED PROGRAM INSPECTION CHECKLIST` .SECT{ON 1: Business Plan anc{ Inventory Program BAKERSFIELD FIRE DEPT Prevention Services e ~~~~ t 900 Tn>.xtun Ave., Suite 210 ~wr~ ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACIL~ NOAME , t~ ~ NSPECi I~=D~A`T~ I ~ PEC~TI~ON TIME ADDRESS,`~1 ~ ~ j HONE NO. ~~~~ OO~MPLOYEES C NTACT FACILITY ~~f ~ S ~Q~,~S,~ USINESS ID NUMBER / 15-021- Qa O ~L -- ~ 1 Section 1: Business Plan and inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION • C V ~ C=Compliance OPERATION V=Violation COMMENTS _ _ __ _ ^ _ APPROPRIATE PERMIT ON HAND _ _ . O BUSIf1QSS PLAN CONTACT INFORMATION ACCURATE ~ ^ VISIBLE ADDRESS oos ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ~, ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ' ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~9 ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING L7 ~ FIRE PROTECTION ~X'~v~ ~~~S~.cs h~ ~~;c-e ^ SITE DIAGRAM ADEQUATE & ON HAND ` `~, ~ a i~e ~,~ ~,,,~ ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ~ NO ~ STI NS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 r Inspector (Please Print) Fire Prevention / ia' In / Shift of a/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy ~~ FD2049 (Rev.02lOS) `~. IPNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSP TIO DATE INSPECTION TIME ADDRESS PH E No. of Employees _ _ ~~0- ~ --- t.~~• ~~- --- t-i~--- ----------- -- ----------____ 3_q8 ~ 1 ~ - - -_- - -- --- _ __ __ FACILITYCONTACT Business ID Number ~~(` ~ 15-021- Section 1: Business Plan and Inventory Pn~gram ^ Routine L~Combined D Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C ~ nce~ OPERATION ti COMMENTS r ®~ on \V=Voa ~~ J LY ^ APPROPRIATE PERMIT ON HAND C~ ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE LUG ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY I ~/ LJ ^ VERIFICATION OF INVENTORY MATERIALS ~ ~ ~~ ~ 'f1 (~ ^ VERIFICATION OF QUANTITIES CT ^ VERIFICATION OF LOCATION Ld ^ PROPER SEGREGATION OF MATERIAL L~ ^ VERIFICATION OF MSDS AVAILABILITYE l~ ^ VERIFICATION OF FIAT MAT TRAINING L~l ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE I ---- -- ^ -------- ---- _ -- ---- --- - i --- - CONTAINERS PROPERLY LABELED - - - -. _..... -- - - _-. _ _ _ _ __... _ _. _. LJ ^ HOUSEKEEPING f U ^ -- -------------------- ------------ -- ------------ FIRE PROTECTION -------- ---------------------------------- - -------.-..--- --- -. lJ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: EXPLAIN: O YES D~No QUESTIO REGARDING THIS INSPECTION? PLEASE CALL US AT (66'I) 3Z6-3979 / ~ C ~~~~s~ Inspector Badge No., Business Site Responsible Party While -Environmental Services Yellow - Sletgn Copy Pink -Business Copy ~i w +'~~` '~~ ~ CITY OF BAKERSFIELU FIRE UEPAR'I'MENT 6 ~ ~ ro OFFICE OF ENVIRONMENTAL SERVICES ;° , y'~'~ UNIFIED PROGRAM INSPECTION CHF.CKI.IST ~ _r~ ~gti,p'~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME ~~'~C.itiO(~cs~I ~C4~`t~ INSPECTION DATE ~1 ~g d Section 2: Underground Storage Tanks Program ^ Routine ~ Combined ^ Joint Agency ^Mu1ti-Agency I ^ Complaint ^ Re-inspection Type of Tank pc1JFCS Number of Tanks Type of Monitoring ~~, Type of Piping _~~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data ou the Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations " Has there been an unauthorized release? Yes NO Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Z'anks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfilUoverspill protection'? C=Compliance V=Violation Y=Yes N=NO 1 t iq Inspector Office of Environmental Services (661) 326-3979 white - inv. Svcs. Pink -Business Copy r Business Site Responsible Party • • • UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME INSPEC7TI~ON DATE INSPECTION TIME AOORESS 3t? ~ ~ ~ ~ -~ --- - - -- PHONE No. 833 - 6 3 ~ No. of Employees ---/5 ---- FACILITYCONTACT Business ID Number 15-021- OOO~'fl( t=. ' _ Secfitm 1: Business Plan and InventotyProgram ~' Routine ^ Combined O Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection V C \V=Vioapolnncel OPERATION J COMMENTS ~ ~ ^ A CJ PERMIT ON HAND PPROPRIATE Ia ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE ----- --- --- ------- ---- /'~ ------ -1.. ±-a-~-'~' ---~ ~-C^^~-------- --- -- - ^ VISIBLE ADDRESS ---- --------------------------- ~~ W, a - ------- ~^ CORRECT OCCUPANCY ~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES LI L^ VERIFICATION OF LOCATION ---- --- ------ --------- y,,~, ~ ' - - --- - - ~- ^ PROPER SEGREGATION OF MATERIAL ' /_-- ~ l ^ VERIFICATION OF MSDS AVAILABILITYE - --------------- ------- -----20- `-~-~ ~ 6L~-------------- - --------- ~/ Ia ^ VERIFICATION OF FIAT MAT TRAINING ~^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ H OUSEKEEPING ,~,~ la ^ FIRE PROTECTION -------------- ---------------- ------- ------------ ^ SITE DIAGRAM ADEQUATE 8c ON HAND ------------ J ------------------- ----------- ANY HAZARDOUS WASTE ON SITE?: ^ YES L'7 IVO EXPLAIN: QUESTIONS EGARDING THIS INSPECTION? PLEASE CALL US AT (66~ ~ 326-3979 --- ~ ~p~----13-.C~ Inspector Badge No. Site Responsible Party White • Environmental Services Yellow -Station Copy Pink -Business Copy HOME & LEISURE CENTER SiteID: 015-021-000901 Manager QURESH CASSIM Location: 5301 WHITE LN City BAKERSFIELD BusPhone: (661) 833-6399 Map 123 CommHaz High Grid: 15C FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5251 DunnBrad:01-960-2432 Emergency Contact / Title Emergency Contact / Title QURESH CASSIM. / OWNER QURESH/CASH CASSIM / MANAGERS Business Phone: (661) 833-6399x Business Phone: (661) 833-6399x 24-Hour Phone (661) 397-0786x 24-Hour Phone (661) 397-7631x Pager Phone (661) 496-6778x Pager Phone (661) 703-1846x Hazmat Hazards: Press React ImmHlth DelHlth Contact QURESH CASSIM Phone: (661) 833-6399x MailAddr: 5301 WHITE LN State: CA City BAKERSFIELD Zip 93309 Owner QURESH CASSIM Phone: (661) 397-7631x Address 6201 GALANOS CT State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ENro a~ r 1 o ~o~~ hose in~l~ .„ oht~ininc~ thF informatior::, a f- ~: '. ' . ,,. f ersonally , i .n„~•,r'r 'n~~lty of ia~ti' that t have p iliar with the information l' ~~ F"'" fam •~ ~:tanned and aml. the information is ru , d and be i ;.L,t,rr, tte Mete. / n~~ 7 accurate, and co np / / r /Q ~ Date i~narture -1- 10/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP MURATIC ACID E R DH L 80.00 GAL Hi SWIMMING POOL BLEACH P R IH L 55.00 GAL Hi TRICHLORO-S-TRIAZINETROINE R DH S 1000.00 LBS Mod -2- 10/01/2007 -3- 10/01/2007 r F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MURATIC ACID Days On Site 365 Location within this Facility Unit Map: Grid: E WALL WHSE CAS# STATE T TYPE ~~ PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Mixture I Ambient ~ Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 4.00 GAL 80.00 GAL 40.00 GAL t1AGKKIJVUJ I.VL~lYV1Vl;1V1J %Wt. RS CAS# 31.00 Muriatic Acid Yes 7647010 riL-'~GHK1J s-~JJ1,Jaln1~,1Vla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Hi ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME SWIMMING POOL BLEACH Location within this Facility Unit S WALL WHSE STATE TYPE PRESSURE Liquid TMixtur~Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7681-52-9 TEMPERATURE CONTAINER TYPE Ambient -~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 55.00 GAL 50.00 GAL !1L-~GtiKLJVUJ 1.V1~lYV1V1~,1V 1.7 oWt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 IIHGKKJJ H J.7L' iJw71"1L'1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P R IH / / / Hi -4- 10/01/2007 F HOME & LEISURE CENTER ~ Inventory Item 0008 COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINETROINE Location within this Facility Unit POOL SUPPLIES BY FRONT COUNTER SiteID: 015-021-000901 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# ~SolidE TMixture Tmbient~E ~ AmbientT~E -~STICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Con35100rLBS Dailyl000100m LBS I Daily 500r00e LBS t11~GKK11V U ~ l:vlYlrvlV L' 1V t oWt. RS CAS# 99.00 Trichloro-s-triazinetrione No 87901 ru~~r~tc~ r~aa~~art~lvt~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Mod -5- 10/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/08/1999 ~ CALL 911. Employee Notif./Evacuation 06/18/1990 VOICE COMMUNICATION AND CALL 911. Public Notif./Evacuation 12/08/1999 VOICE COMMUNICATIONS. Emergency Medical Plan 12/08/1999 NEAREST HOSPITAL. -6- 10/01/2007 1 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/28/2000 ~ STORED ON SHELVES ATTACHED TO THE WALL. CANNOT BE KNOCKED OFF ACCIDENTLY IN APPROVED CANS. Release Containment PRODUCT IS IN SMALL CONTAINER FOR RETAIL SALE. 12/08/1999 Clean Up 12/08/1999 SODA ASH. Other Resource Activation -7- 10/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~J~C:1ci1 riciGdiU~ Utility Shut-Offs 03/06/2007 GAS - E SIDE OF BLDG OUTSIDE NE CRNR ELECTRICAL - W SIDE OF BLDG OUTSIDE SW CRNR WATER - E SIDE OF BLDG OUTSIDE SE CRNR Fire Protec./Avail. Water 11/30/2006 PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM & FIRE EXTINGUISHERS: ONE S SIDE AND ONE N SIDE. FIRE HYDRANT - 2 E SIDE GRISSOM AND ONE S SIDE ALDRIN CT. Building Occupancy Level 12/08/2006 10 EMPLOYEES -8- 10/01/2007 w' ., V ;t F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/30/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE IN OFFICE 5. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE EXPLAINED MATERIAL SAFETY DATA SHEETS TO EMPLOYEES. THEY HAVE BEEN TOLD ABOUT HAZARDS OF MIXING ACID AND CHLORINE TOGETHER. THEY HAVE BEEN TOLD TO EVACUATE IN CASE OF SPILL OF ACID OR CHLORINE. ruyc ~ nciu Lvi L•u~.uic vac nclu tvi ruLUic v5C -9- 10/01/2007 s ,. HOME & LEISURE CENTER Manager QURESH CASSIM Location: 5301 WHITE LN City BAKERSFIELD SiteID: 015-021-000901 BusPhone: (661) 833-6399 Map 123 CommHaz High Grid: 15C FacUnits: 1 AOV: CommCode: BFD STA 13 EPA Numb: SIC Code:5251 DunnBrad:01-960-2432 Emergency Contact ,/ Title Emergency Contact / Title ~ul~'E3N C}1S$'~/jy~OWNER QURESH/CASH CASSI M / MANAGERS Business Phone: (661) 833-6399x Business Phone: (661) 833-6399x 24-Hour Phone (661) 397- 0'78,6 24-Hour Phone (661) 397-7631x Pager Phone (661) '~$~1X Pager Phone (661) 703-1846x Hazmat Hazards: Press React ImmHlth DelHlth Contact QURESH CASSIM Phone: (661) .833-6399x MailAddr: 5301 WHITE LN State: CA City BAKERSFIELD Zip 93309 Owner €-£~~R (~t.~,~ ~ ~ ~ ~ ~ Phone : ( 6 61) 3 9 7 - R ~ 763' Address ~E~T~D ~~~t 6 Zt9 ~ ~Y1AL.A N©SState : CA City BAKERSFIELD ~''q`~3/~ Zip 933~~ Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ~ q ~QQJ ®~ I~~` Based on my inquiry of those individuals respon~ibie for obtaining the information, !certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate nd complete. ` w -~~~~ Signature Date -1- 02/01/2007 F HOME & LEISURE CENTER ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-000901 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP MURATIC ACID E R DH L 80.00 GAL Hi SWIMMING POOL BLEACH P R IH L 55.00 GAL Hi TRICHLORO-S-TRIAZINETROINE R DH S 1000.00 LBS Mod -2- 02/01/2007 -3- 02/01/2007 s F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MURATIC ACID Days On Site 365 Location within this Facility Unit Map: Grid: E WALL WHSE CAS# Liquid TMixtur~ Ambient~E ~ AmbientT~E I PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 4.00 GAL 80.00 GAL 40.00 GAL riAGHt'CLVU.7 trV1~lYV1V1=,1V15 %Wt. RS CAS# 31.00 Muriatic Acid Yes 7647010 - ri!'~GEitCL 1-~.`~A1;.7w71~11;1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Hi ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME SWIMMING POOL BLEACH Location within this Facility Unit S WALL WHSE STATE TYPE PRESSURE Liquid TMixture ~mbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7681-52-9 TEMPERATURE CONTAINER TYPE Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 55.00 GAL I 50.00 GAL HAZARDOUS COMPONENTS $Wt. 12.50 Sodium Hvnochlorite RSI CAS# No 7681529 rLtiL~t~iVJ ti J JLiJ J1"1P~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P R IH / / / Hi -4- 02/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINETROINE Days On Site 365 Location within this Facility Unit Map: Grid: POOL SUPPLIES BY FRONT COUNTER CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixtur~mbient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 35.00 LBS 1000.00 LBS 500.00 LBS • ru~~.yxLVU~ ~ui~irulv~lv'1'S oWt. RS CAS# 99.00 Trichloro-s-triazinetrione No 87901 riHGHl{L AS~L"~551~11'~1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Mod -5- 02/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/08/1999 ~ CALL 911. Employee Notif./Evacuation 06/18/1990 VOICE COMMUNICATION AND CALL 911. Public Notif./Evacuation VOICE COMMUNICATIONS. 12/08/1999 Emergency Medical Plan 12/08/1999 NEAREST HOSPITAL. -6- 02/0l/200~ F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/28/2000 ~ STORED ON SHELVES ATTACHED TO THE WALL. CANNOT BE KNOCKED OFF ACCIDENTLY IN APPROVED CANS. Release Containment 12/08/1999 PRODUCT IS IN SMALL CONTAINER FOR RETAIL SALE. Clean Up 12/08/1999 SODA ASH. v~.iac~.. ncavui~.c r~~.~.iva~.l.~il -7- 02/01/2007 F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~Pec:ial nazcircz~ Utility Shut-Offs 11/30/2006 A) GAS - E SIDE OF BLDG OUTSIDE NE CRNR B) ELECTRICAL - W SIDE OF BLDG OUTSIDE SW CRNR C) WATER - E SIDE OF BLDG OUTSIDE SE CRNR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/30/2006 PRIVATE FIRE PROTECTION - AUTOMATIC SPRINKLER SYSTEM & FIRE EXTINGUISHERS: ONE S SIDE AND ONE N SIDE. FIRE HYDRANT - 2 E SIDE GRISSOM AND ONE S SIDE ALDRIN CT. Building Occupancy Level 10 EMPLOYEES 12/08/2006 -8- 02/01/2007 -~, F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/30/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE IN OFFICE 5. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE EXPLAINED MATERIAL SAFETY DATA SHEETS TO EMPLOYEES. THEY HAVE BEEN TOLD ABOUT HAZARDS OF MIXING ACID AND CHLORINE TOGETHER. THEY HAVE BEEN TOLD TO EVACUATE IN CASE OF SPILL OF ACID OR CHLORINE. ruyc ~ Held for Future Use nciu ivi ru~uic ~5C -9- 02/01/2007 ~~ ~ -~ ~ 6'1 ~ HOME & LEISURE CENTER SiteID: 015-021-000901 Manager QURESH CASSIM Location: 5301 WHITE LN City BAKERSFIELD CommCode: BFD STA 13 EPA Numb: BusPhone: (661) 833-6399 Map 123 CommHaz High Grid: 15C FacUnits: 1 AOV: SIC Code:5251 DunnBrad:01-960-2432 Emergency Contact / Title Emergency Contact / Title ~~.~ ~.~~ $~~OWNER QURESH/CASH CASSIM / MANAGERS Business Phone: (661) 833-6399x Business Phone: (661} 833-6399x 24-Hour Phone (661) 397-& ,~ 24-Hour Phone (661) 397-7631x Pager Phone (661) Pager Phone (661) 703-1846x Hazmat Hazards: Press React ImmHlth DelHlth Contact QURESH CASSIM Phone: (661).833-6399x MailAddr: 5301 WHITE LN State: CA City BAKERSFIELD Zip 93309 Z7 ATTT TT TSI Owner ~ ~~~~ ~ ~ Phone : a-"L~- ( 6 61) 3 9 7 - 8'~- p~ ~/ / Address a~r~-~-r-~a~.~9D ~~ ~ ~ A~~~,State : ~f+ CA II ' City BAKERSFIELD ~~~~-.~ Zip 933 Period to TotalASTs: - Gal Preparers TotalUSTs: - Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT ©~ ~ ENT'D APR 0 2007 3 ~`~S~r; Q{' nl~J I!'.(~tsl Y~V r:i't ~{'If ~,i •~: li'i C.~i~li [i t,??1.9 x re v~~.:li~~.':I(~!IC' 11 ~i ~'. P •~~~i"$:eilf li.i f,~~:,: ~l i~~:~l~ili:~.,.; ~3-1~,.3 E f,-~('i~~•~i ~ ut'l.~c'.~r I')Er 7.}ii~r r ~ i~~,:~ s~ [§t E ??:_,n.; rr~r,;~7n[31iy E;X2.r?~IRr^r!:{ cii~!! ~f'n {;::;'"~,4i?%?.? ~PJ~ti1 Cli< i'1'iG"'f~i1~tlC~fi sf_Ibrnitiec' <,I-?E{ s,;.;iir;lt-i ?, I,; ~;;i~~Cli, <<fn,, is truF'+. BCCLIrBtG';,.~7if?CI Cpp1lF>>iCff'. r J ~ _ ~ r Signature mate -1- 02/01/2007 t~ ~ ~ , F~HOME & LEISURE CENTER SiteID: 015-021-000901 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax fUnitlMCPI MURATIC ACID E R DH L SWIMMING POOL BLEACH P R IH L TRICHLORO-S-TRIAZINETROINE R DH S 80.00 GAL Hi 55.00 GAL Hi 1000.00 LBS Mod -2- 02/01/2007 -3- 02/01/2007 fj F~HOME & LEISURE CENTER ~ Inventory Item 0002 ~ COMMON NAME / CHEMICAL NAME I MURATIC ACID Location within this Facility Unit E WALL WHSE STATE TYPE PRESSURE Liquid TMixtur~Ambient SiteID: 015-021-000901 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE ~~ CONTAINER TYPE Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 4.00 GAL 80.00 GAL 40.00 GAL tiHG1~KLUU~ ~v1~1ru1vL'1v15 ~Wt. RS CAS# 31.00 Muriatic Acid Yes 7647010 t1AGHKL A~ ~~~~1~1L'1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Hi ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME SWIMMING POOL BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: S WALL WHSE CAS# 7681-52-9 Liquid TMixtur~mbRent~E ~ AmbientT~E PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 55.00 GAL 50.00 GAL nt~~titc.l~wa ~vi~irvlv~ly 1 $Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 t1AGKttL 1-~S JL' JJ1~1L';1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P R IH / / / Hi -4- 02/01/2007 F'HOME & LEISURE CENTER ~ Inventory Item 0008 COMMON NAME / CHEMICAL NAME TRICHLORO-S-TRIAZINETROINE Location within this Facility Unit POOL SUPPLIES BY FRONT COUNTER Days On Site 3b5 Map: Grid: CAS# ~olidE TMixture ~ AmbientURE ~ AmbientT~E ~ PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 35.00 LBS 1000.00 LBS 500.00 LBS tiLiG.'u<LUU~ l.:UlylYUlVL';1V'1'S aWt. RS CAS# 99.00 Trichloro-s-triazinetrione No 87901 ti1~GAJ.CL HJ 7L' a~71Y1.C~1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R DH / / / Mod SiteID: 015-021-000901 ~ Facility Unit: Fixed Containers on Site ~ -5- 02/01/2007 F1 HOME & LEISURE CENTER SiteID; 015-021-000901 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/08/1999 ~ CALL 911. Employee Notif./Evacuation 06/18/1990 VOICE COMMUNICATION AND CALL 911. Public Notif./Evacuation 12/08/1999 VOICE COMMUNICATIONS. Emergency Medical Plan 12/08/1999 NEAREST HOSPITAL. -6- 02/01/2007 F~HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/28/2000 ~ STORED ON SHELVES ATTACHED TO THE WALL. CANNOT BE KNOCKED OFF ACCIDENTLY IN APPROVED CANS. Release Containment 12/08/1999 PRODUCT IS IN SMALL CONTAINER FOR RETAIL SALE. Clean Up 12/08/1999 SODA ASH. Other Resource Activation -7- 02/01/2007 _, F~HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~rc~,ia.i. naaaiua Utility Shut-Offs 11/30/2006 A) GAS - E SIDE OF BLDG OUTSIDE NE CRNR B) ELECTRICAL - W SIDE OF BLDG OUTSIDE SW CRNR C) WATER - E SIDE OF BLDG OUTSIDE SE CRNR D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 11/30/2006 PRIVATE FIRE .PROTECTION - AUTOMATIC SPRINKLER SYSTEM & FIRE EXTINGUISHERS: ONE S SIDE AND ONE N SIDE. FIRE HYDRANT - 2 E SIDE GRISSOM AND ONE S SIDE ALDRIN CT. Building Occupancy Level 12/08/2006 10 EMPLOYEES -8- 02/01/2007 . ,~. F HOME & LEISURE CENTER SiteID: 015-021-000901 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 11/30/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE IN OFFICE 5. BRIEF SUMMARY OF TRAINING PROGRAM: WE HAVE EXPLAINED MATERIAL SAFETY DATA SHEETS TO EMPLOYEES. THEY HAVE BEEN TOLD ABOUT HAZARDS OF MIXING ACID AND CHLORINE TOGETHER. THEY HAVE BEEN TOLD TO EVACUATE IN CASE OF SPILL OF ACID OR CHLORINE. rage Held for Future Use nciu ivi r u~.uLC v~C -9- 02/01/2007