HomeMy WebLinkAboutBUSINESS PLAN 1/23/2009Pa~evention Services
UNIFIED PROGRAM INSPECTION CHECKLIST~ B A F R S ~, e o 9oon-uxtunt~ve., suite 210
_.___
_.- -_ _ - _ _ _ _-- - _ -_ _ ___ _ -' ~ F/RE Bakersfield, CA 93301
~- -.-.. _ . _._ ___ __-- --- - -- ---- -- ~---
SECTION 1: Business Plan and Inventory Program 3! D ARTM T Tel.: (661) 326-3979
i~ Fax: (661) 872-2171
FACILIy~'pl ;ME -
I"I/ClI ~qc~-,%rc INSPE ION DA E
/ Z3 0 INSPECT19N TIME
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ADDRESS
~32'• l3~ /~e ~i'~fc.P Z PHONE NO.
~'3(~-2 ~2t~ O OF E PLOYEES
FACILITY CONTACT
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l0~
/"/ BUSINESS ID NUMBER
15-021-Ob~7D~~
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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
IG ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE
M~" O VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
~ ^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
r'J ^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES ANO PROCEDURES
•~ ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE 8 ON HAND
ANY HAZARDOUS WASTE ON SITE? ^ YES Ild NO
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661 ~ 326-3979
J~~^ Q~ ,~,~~- .
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # Business Site / Responsible Party (PI se Print).,
Wnite - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09lOS
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
Manager : MARION VAN MIDDENDORP
Location: 532 BELLE TERR 2
City : BAKERSFIELD
BusPhone: (661) 836-2520
Map : 124 CommHaz : Minimal
Grid: 06D FacUnits: 1 AOV:
CommCode: BFD STA 06
EPA Numb:
SIC Code:
DunnBrad:
*______________________________________________________________________________+
+_______________________________________+______________________________________+
Emergency Contact / Title Emergency Contact / Title
M VAN MIDDENDORP / OWNER /
Business Phone: (661) 836-2520x Business Phone: ( ) - x
24-Hour Phone :(661) 664-4787x 24-Hour Phone :( ) - x
Pager Phone : ( ) - x Pager Phone : ( ) - x
+------------------------------------- --+--------------------------------------+
~ Hazmat Hazards: Fire DelHlth I
+------------------------------------- -----------------------------------------+
Contact : MARION VAN MIDDENDORP Phone: (661) 836-2520x
MailAddr: 532 BELLE TERR 2 State: CA
City : BAKERSFIELD Zip : 93307
+------------------------------------- -----------------------------------------+
Owner MARION VAN MIDDENDORP Phone: (661) 664-4787x
Address : PO BOX 9576 State: CA
City : BAKERSFIELD Zip : 93389
+------------------------------------- -----------------------------------------+
Period . to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
+------------------------------------------------------------------------------+
~ Emergency Directives: ~
PROG A - HAZMAT
+______________________________________________________________________________+
-1- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+= Hazmat Inventory _________________________________________ By Facility Unit +
+_= MCP+DailyMax Order ______________________________ Fixed Containers at Site +
+--------------------------------+-------+-----------+-----+----------+----+---+
~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~
+--------------------------------+-------+-----------+-----+----------+----+---+
I LUBE OIL F DH L 100.00 GAL Min)
+______________________________________________________________________________+
-2- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+= Inventory Item 0001 _______________ Facility Unit: Fixed Containers at Site +
+_= CONII~ION NAME / CHEMICAL NAME ______________________________+________________+
LUBE OIL Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
OUTSIDE NE CRNR SHOP I 8020835 I
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture I Ambient ~ Ambient ~ DRUM/BARREL-METALLIC ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con55100rGAL I Daily 100100m GAL I Daily 100r00e GAL I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I 100t00ILubricating Oil (Petroleum-Based) INosl CAS#8020835I
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+_______-+_____+
ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cu~l'es I FPA HazarDH I jF~A/ I USDOT# I Min I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5:
Ag.Defined6:
Ag.Defined7:
Ag.Defined8:
Ag.Defined9:
Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-3- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+_________________________________________________________________ Fast Format +
+= Notif./Evacuation/Medical ____________________________________ Overall Site +
+_= Agency Notification ___________________________________________ 10/17/1995 +
TELEPHONES IN FRONT OFFICE AND ONE IN BACK OF SHOP.
+______________________________________________________________________________+
+__= Employee Notif./Evacuation ___________________________________ 10/17/1995 +
SHOP IS SMALL ENOUGH FOR VERBAL CONIMUNICATION.
+______________________________________________________________________________+
+___= Public Notif./Evacuation ________________________________________________+
+------------------------------------------------------------------------------+
--------------------------------------------------- -------------
+____= Emergency Medical Plan ____________________________________= O1/24/2001 +
CONTACT PRIVATE DOCTOR OR USE FIRST AID EQUIPMENT ON HAND.
+______________________________________________________________________________+
-4- 08/25/2008
+ MID MACHINE ________________________________________= SiteID: 015-021-001704 +
+_________________________________________________________________ Fast Format +
+= Mitigation/Prevent/Abatemt ___________________________________ Overall Site +
+_= Release Prevention ____________________________________________ O1/24/2001 +
ALL MACHINES HAVE CUTTING OIL COLLECTION PANS.
+______________________________________________________________________________+
+__= Release Containment __________________________________________ 04/17/2006 +
CUTTING OIL IS RECYCLED THROUGH CENTRIFUGE OUTSIDE NE CORNER IN BACK OF
BLDG. ABSORBENT READILY AVAILABLE.
+______________________________________________________________________________+
+___= Clean Up ____________________________________________________ 04/17/2006 +
ABSORBENT IS SPREAD ON SPILLED OIL.
+______________________________________________________________________________+
+____= Other Resource Activation ______________________________________________+
+______________________________________________________________________________+
-5- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+_________________________________________________________________ Fast Format +
+= Site Emergency Factors _______________________________________ Overall Site +
+_= Special Hazards ___________________________________________________________+
+______________________________________________________________________________+
+__= Utility Shut-Offs ____________________________________________ 12/11/2006 +
A) NATUR.AL GAS/PROPANE - E END MAIN BLDG
B) ELECTRICAL - ELECT MAIN E END OF SITE PANEL FOR SHOP IN STORAGE ROOM E
SIDE OF HALLWAY
C) WATER - OUTSIDE S DOOR (SHOP ONLY) MAIN ON W SIDE OF SITE
D) SPECIAL - NONE
E) LOCK BOX - NO
t______________________________________________________________________________+
+___= Fire Protec./Avail. Water ___________________________________ 02/05/2007 +
PRIVATE FIRE PROTECTION - ONE FIRE EXTINGUISHER BY FRONT DOOR AND ONE BY
BACK DOOR.
FIRE HYDR.ANT - SW CRNR OF PROP AND SE CRNR OF PROP.
+______________________________________________________________________________+
+____= Building Occupancy Level ___________________________________ 03/09/2006 +
1 EMPLOYEE
+______________________________________________________________________________+
-6- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+_________________________________________________________________ Fast Format +
+= Training _____________________________________________________ Overall Site +
+_= Employee Training _____________________________________________ 02/27/2007 +
MATERIAL SAFETY DATA SHEETS ON FILE.
+______________________________________________________________________________+
+--_ Page 2 ___________________________________________________ +
+______________________________________________________________________________+
+___= Held for Future Use _____________________________________________________+
+______________________________________________________________________________+
+____= Held for Future Use ____________________________________________________+
+------------------------------------------------------------------------------+
----------------------------------------------------------
-7- 08/25/2008
+ MID MACHINE _________________________________________ SiteID: 015-021-001704 +
+_________________________________________________________________ Fast Format +
+= Response/Risk Management _____________________________________ Overall Site +
+_= Operations ________________________________________________________________+
+------------------------------------------------------------------------------+
------------------------------- ---------------------------------------
+__= Planning =----------------------------------------------------------------+
-------------- ---------------------------
+______________________________________________________________________________+
+___= Logistics _______________________________________________________________+
+______________________________________________________________________________+
+____= Finance/Administration _________________________________________________+
+______________________________________________________________________________+
-8- 08/25/2008