HomeMy WebLinkAbout307 E BRUNDAGE LANEUNIFIED PROGRAN~ INSPECTION CHECKLIST
SECTION 1: Busine:~s Plan and inventory Program
Prevention Services
9 P R s e~ E. ~ 900'I~-uxtun Ave., Suite 210
FiRE Bakersfield, CA 93301
of AR~M ~ T Tel.: (661) 326-3979
~ - Fax: (661) 872-2171
FACILITY NAME ~~
~ , INSPECTION DATE
/ t~ (~. ~O ~"O INSPECTION TIME
~~~Gt.1 h.t ..
ADDRESS
07 ~:' ,~ ;- P ONE
~'6'~ 32S"6// O OFEMPLOYEES
/
FACILITY CONTACT BUSINESS ID NUMBER
)
~ 15-021-
~
~
~
t~
l/
~
~ ~ ~ ~ ~~ ~
3~~ .. $ectio;n 1 Business Plan and lnuen#ory Program, ~~
:~a~
e .~. n ~ ,. ~:<,. .e . . . e : „ ., . . ~ ,~~... ,~ a a e .
ROUTINE ^ COhIBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ( c=comP~iance~ OPERATION
V=Violation COMMENTS
~ ^ APPROPRIATE PERMIT ON HAND
~ ^ BUSIf12SS PLAN CONTACT INFORMATION ACCURATE
~ ^ VISIBLE ADDRESS
~I ^ CORRECT OCCUPANCY .
~ ^ VERIFICATION OF INVENTORY MATERIALS
~I ^ VERIFICATION OF QUANTITIES
~LI ^ VERIFICATION OF LO~:ATION
~ ^ PROPER SEGREGATI~JN OF MATERIAL -
~ ^ VERIFICATION OF MSDS AVAILABILITY
` I~I ^ VERIFICATION OF HA? MAT TRAINING
~Q ^ VERIFICATION OF AB.4TEMENT SUPPLIES AND PROCEDURES
l~ ^ EMERGENCY PROCEUURES ADEQUATE
~ , ^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
~ ^ FIRE PROTECTION ~~, 'f ~`~
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON :iITE?
EXPLAIN:
^ YES ~ NO
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
~ f • ~¢ur ~o~'~ ~~
Inspecto (Please Print) Fire Prevention / 1s' In / Shift of Site/Station #
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD ~155 (Rev. 09/OS
+ NEW CRETE INC =_______________________________________ SiteID: 015-021-001567 +
Manager : ROBERT ls HENRY
Location: 307 E B~tUNDAGE LN
City : BAKERSF7~=ELD
BusPhone: (661) 325-6115
Map : 124 CommHaz : High
Grid: 05A FacUnits: 1 AOV:
CommCode: BFD STA 06
EPA Numb:
SIC Code:2819
DunnBrad:00-8390-494
t_______________________________________________________________________________+
+___________________=____________________+ ______________________________________+
Emergency Contact / Title Emergency Contact / Title
ROBERT E HENRY / PRES/TRES/MGR JENNIFER HENRY / SECRETARY
Business Phone: ~;661) 325-6115x Business Phone: (661) 325-6115x
24-Hour Phone : ~;661) 871-0703x 24-Hour Phone :(661) 587-2440x
Pager Phone : ~;661) 809-0432x Pager Phone :(661) 301-1866x
+-------------------•--------------------+ --------------------------------------+
~ Hazmat Hazards: RSs Fire React ImmHlth DelHlth ~
+-------------------~--------------------- --------------------------------------+
Contact : ROBERT F~, HENRY Phone: (661) 325-6115x
MailAddr: PO BOX ''0305 State: CA
City : BAKERSF]:ELD Zip : 93387
+-------------------~--------------------- --------------------------------------+
Owner NEW CRE7'E INC Phone: (661) 325-6115x
Address : 307 E BF;UNDAGE LN State: CA
City : BAKERSF]:ELD Zip : 93307
+-------------------~--------------------- --------------------------------------+
Period . to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: Yes
ParcelNo:
+------------------------------------------------------------------------------+
~ Emergency Directives: ~
PROG A - HAZMAT
PROG T- ABOVEGROLIND STORAGE TANK
+______________________________________________________________________________+
-1- 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Hazmat Inventory __________ _______________ _________ ______ _ By Facil ity Unit +
+_= MCP+DailyMax Orcier _______ _______________ ________ Fixed Containers at Site +
+------------------------------ ---+-------+-----------+ -----+---------- +----+---+
~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~
+------------------------------ ---+-------+-----------+ -----+----------+----+---+
UCAR. LATEX 130 E L 550.00 GAL Hi
R-522 D L 550.00 GAL Hi
QUILON CHROMIUM CC)MPLEXES F R L 52.00 GAL Mod
PETRO BAF POWDER S 2000.00 LBS Min
METHOCEL F IH DH S 1500.00 LBS Min
METHOCEL F IH DH L 1500.00 GAL Min
ADIPIC S 200.00 LBS Min
MOTOR OIL F DH L 55.00 GAL Min
NEW CRETE H-500 L 2350.00 GAL UnR
AIR FLEX RP226 S 1750.00 LBS UnR
PETRO BAF LIQUID IH L 55.00 GAL UnR
+______________________________________________________________________________+
-2- 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Inventory Item OU06 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / C~iEMICAL NAME ______________________________+________________+
UCAR LATEX 130 Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
MIDDLE METAL BLDG ~ CAS# I
+______________________________________________________________+________________+
+= STATE _+= TYPE ____+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL I
+_________+_________=_+_______________+_______________+_________________________+
+___________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con55i()OrG~ I Daily 550100m G~ I Daily A~e~r~a~ge G~ I
+__________________=________+_________________________+_________________________+
+_______+__________==__= HAZARDOUS COMPONENTS ______________+___+_______________+
°sWt. RS CAS#
0.30 Vinyl Acet~~te Yes 108054
0.20 Formaldehyc~e (EPA) Yes 50000
+_______+___________=_______________________________________+___+_______________+
+_______+___+______~-__________= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes Yesl No No/ Curies I I/// I I Hi 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
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Inventory Item Oc)07 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / C~~EMICAL NAME ______________________________+________________+
R-522 D Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
MIDDLE METAL BLDG ~ CAS# I
+___________________=__________________________________________+________________+
+= STATE _+= TYPE __=_+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-NONMETAL ~
+_________+________=__+_______________+_______________+_________________________+
+___________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con55i('e~rG~ I Daily 550100m GAL I Daily A~OrOOe G~ I
+___________________________+_________________________+_________________________+
+_______+__________=___= HAZARDOUS COMPONENTS ______________+___+_______________+
°sWt. RS CAS#
IPolyvinyl ~~cetate INo I 9003207I
+_______+__________==_______________________________________+___+_______________+
+_______+___+_=====i-====______= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes IYesl No No/ Curies I I/// I I Hi 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 -----~-----------------------------------------------------------+
t_____________________________________________________________________---------+
-4- 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Inventory Item Ol)13 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~ION NAME / C1iEMICAL NAME ______________________________+________________+
QUILON CHROMIUM C()MPLEXES I Days On Site I
365
Location within this Facility Unit Map: Grid: +----------------+
MIDDLE METAL BLDG I CAS# I
67-63-0
+___________________=__________________________________________+________________+
+= STATE _+= TYPE ____+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
I Liquid ~ Mixture ~ Ambient ~ Ambient ~ DRUM/BARREL-METALLIC ~
+_________+________=__+_______________+_______________+_________________________+
+__________________=________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con52ine~rG~ Daily M52im~u~m G~ I Daily A14r00e GAL I
+___________________________+_________________________+_________________________+
+_______+__________==__= HAZARDOUS COMPONENTS ______________+___+_______________+
°sWt. RS CAS#
61.00 Isopropyl ~~lcohol No 67630
16.00 Acetone No 67641
0.30 Chloroacetone No 78955
+_______+__________=________________________________________+___+_______________+
+_______+___+______~-__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Haz RN~d~oactive/Cu~l'es I FPA Razards I%F~A/ I USDOT# I Mod I
+_______~'___+_=====1'____________________+_____________'~'____==-==t--------+------F
+___________________=______= 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 -----•-----------------------------------------------------------+
-*___________________~___________________________________________________________+
-5- 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Inventory Item 0001 _______________ Facility Unit: Fixed Containers at Site +
+_= CONIMON NAME / C1~EMICAL NAME ______________________________+________________+
PETRO BAF POWDER Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
S METAL BLDG ON DUCK I CAS# I
0
+______________________________________________________________+________________+
+= STATE _+= TYPE ____+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Solid ~ Mixture ~ Ambient ~ Ambient ~ BAG ~
+_________+________=__+_______________+_______________+_________________________+
+__________________:________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contaiiier I Daily Maximum I Daily Average I
40.U0 LBS 2000.00 LBS 50.00 LBS
+___________________________+_________________________+_________________________+
+_______+___________=__= HAZARDOUS COMPONENTS ______________+___+_______________+
I 100t00ISodium LinE~ar Alkyl Naphthalene Sulfonates INosl CAS# OI
+_______+__________==_______________________________________+___+_______________+
+_______+___+__====-F=====_____= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes No I No No/ Curies I I/// I I Min I
+_______+___+__====-F=====---------------+__________-__+---------+--------+-----+
+__________________________= MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5:
Ag.Defined6:
Ag.Defined7:
Ag.Defined8:
Ag.Defined9:
Ag.Definel0:
+- Ag.Definell -----•-----------------------------------------------------------+
*___________________=___________________________________________________________+
-6- 08/25/2008
+ NEW CRETE INC =__~___________________________________= SiteID: 015-021-001567 +
+= Inventory Item 0~~05 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / C]~EMICAL NAME ______________________________+________________+
METHOCEL Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
SW CRNR. FRONT BLDc;/S METAL ON DOCK I CAS# I
9004-65-3
+__________________~___________________________________________+________________+
+= STATE _+= TYPE _~__+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Solid ~ Mixture ~ Ambient ~ Ambient ~ BAG ~
+_________+________~__+_______________+_______________+_________________________+
+__________________~________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con5~~)OrLBS I Daily1500100m LBS I Daily AlOr00e LBS I
+__________________~________+_________________________+_________________________+
+_______+__________:___= HAZARDOUS COMPONENTS ______________+___+_______________+
I g3t00lSodium Chlc~ride INosl CAS#7647145I
+_______+__________=________________________________________+___+_______________+
+_______+___+__====-F=====_____= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes No I No I No/ Curies I F IH DH I/// I 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 ----~------------------------------------------------------------+
+_______________________________________________________________________________+
-7- 08/25/2008
+ NEW CRETE INC =__•____________________________________ SiteID: 015-021-001567 +
+= Inventory Item 0010 _______________ Facility Unit: Fixed Containers at Site +
+_= COPM~ION NAME / C]3EMICAL NAME ______________________________+________________+
METHOCEL Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
NW CRNR FRONT BLDti/S WALL MIDDLE FRONT BLDG I CAS# I
9004-65-3
+__________________~=__________________________________________+________________+
+= STATE _+= TYPE _=__+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid I Mixture ~ Ambient I Ambient ~ ABOVE GROUND TANK ~
+_________+___________+_______________+_______________+_________________________+
+__________________:________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contai~ier I Daily Maximum I Daily Average I
1000.~)0 GAL 1500.00 GAL 55.00 GAL
+___________________________+_________________________+_________________________+
+_______+__________:___= HAZARDOUS COMPONENTS ______________+___+_______________+
%Wt. RS CAS#
0,50 Sodium Chloride No 7647145
99.00 Hydroxypro~~oxyl Methylcellulose No 9004653
+_______+___________=_______________________________________+___+_______________+
+_______+___+__====-F=====_____= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes No I No No/ Curies I F IH DH I/// I 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.Definell
Ag.Defined9:
Ag.Definel0:
-----------------------------------------------------------------+
t_______________________________________________________________________________+
-8- 08/25/2008
+ NEW CRETE INC =__:___________________________________= SiteID: 015-021-001567 +
+= Inventory Item Oi)03 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / C]3EMICAL NAME ______________________________+________________+
ADIPIC Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
SW CRNR FRONT BLD(3/CTR RM FRONT BLDG I CAS# I
124049
+______________________________________________________________+________________+
+= STATE _+= TYPE ____+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Solid ~ Mixture ~ Ambient ~ Ambient ~ BAG ~
+_________+___________+_______________+_______________+_________________________+
+__________________==_______+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Con501~)OrLBS I Daily 200100m LBS I Daily A20r00e LBS I
+___________________________+_________________________+_________________________+
+_______+__________:___= HAZARDOUS COMPONENTS ______________+___+_______________+
I 100t00lAdipic Acici INoS CAS# 124049I
+_______+___________________________________________________+___+_______________+
+_______+___+__====-F=====_____= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
Yes No I No No/ Curies I I/// I 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 -----------------------------------------------------------------+
*_______________________________________________________________________________+
-9- 08/25/2008
+ NEW CRETE INC =__--___________________________________ SiteID: 015-021-001567 +
+= Inventory Item 0()09 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CFiEMICAL NAME ______________________________+________________+
MOTOR OIL Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
E FENCE I ~Sg0208351
+______________________________________________________________+________________+
+= STATE _+= TYPE __=_+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ( Ambient ~ Ambient ~ DRUM/BARREL-METALLIC ~
+_________+________==_+_______________+_______________+_________________________+
+___________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contaiiier I Daily Maximum I Daily Average I
55.Q0 GAL 55.00 GAL 2.00 GAL
+___________________=_______+_________________________+_________________________+
+_______+______________= HAZARDOUS COMPONENTS ______________+___+_______________+
I 100t00IMotor Oil, Petroleum Based (Nosl CAS#8020835I
+_______+___________=_______________________________________+___+_______________+
+_______+___+__====-F=====_____= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlNoSIBNo~Haz RN~d~oactive/Cu~les FPA HazarDH I%F~A/ I USDOT# I Min I
+_______+___+__====-F____________________+_____________+_________+________+_____+
+___________________=______= MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag . Def ined5 :
Ag.Defined6:
Ag.Defined7:
Ag.Defined8:
Ag.Definell
Ag.Defined9:
Ag.Definel0:
-----------------------------------------------------------------+
t__________________==___________________________________________________________+
-10- 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+= Inventory Item 0011 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / C]iEMICAL NAME ______________________________+________________+
NEW CRETE H-500 Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
CTR FRONT BLDG/AT'.CACHED BLDG ~ CAS# I
+__________________==__________________________________________+________________+
+= STATE _+= TYPE ____+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient ~ Ambient ~ ABOVE GROUND TANK ~
+_________+_________=_+_______________+_______________+_________________________+
+__________________-________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contaiiier I Daily Maximum I Daily Average I
5000.()0 GAL 2350.00 GAL 4.00 GAL
+__________________==_______+_________________________+_________________________+
+_______+__________=___= HAZARDOUS COMPONENTS ______________+___+_______________+
I~Wt. I I RS~ CAS# ~
+_______+___________=_______________________________________+___+_______________+
+_______+___+__====-F==-----___= HAZARD ASSESSMENTS =__+_________+________+_____+
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No INo I No I No/ Curies I I/// I I UnR I
+_______+---+-------F____________________
--- ------ - +_____________+_________+________+_____+
+___________________=______= MISC. LOCAL AGENCY DATA =__________________________+
Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4:
Ag.Defined5: Ag.Defined6: Ag.Defined7:
' Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----•------------------------------------------------------------+
t__________________==___________________________________________________________+
-11- 08/25/2008
+ NEW CRETE INC =__•=___________________________________ SiteID: 015-021-001567 +
+= Inventory Item 01)04 _______________ Facility Unit: Fixed Containers at Site +
+_= CODM~ION NAME / CI3EMICAL NAME ______________________________+________________+
AIR FLEX RP226 Days On Site
365 I
Location within this Facility Unit Map: Grid: +----------------+
S METAL BLDG ON DUCK ~ CAS# I
+__________________==__________________________________________+________________+
+= STATE _+= TYPE _=__+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Solid ~ Mixture ~ Ambient ~ Ambient ~ BAG ~
+_________+_________=_+_______________+_______________+_________________________+
+___________________=_______+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contaiiier I Daily Maximum I Daily Average I
55.U0 LBS 1750.00 LBS 10.00 LBS
+___________________________+_________________________+_________________________+
+_______+______________= HAZARDOUS COMPONENTS ______________+___+_______________+
I°sWt• IVinyl Acet~ite Copolymer INosl CAS#9003207I
+_______+___________________________________________________+___+_______________+
+_______+___+______-=__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSYesetlNoSIBNo~Haz9 RN~d~oactive/Cu~l'es I EPA Hazards I%F~A/ I USDOT# I UC~P I
I
+_______+___+______:-____________________+_____________+_________+________+_____+
+__________________________= MISC. LOCAL AGENCY DATA =__________________________+
~ Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell -----~-----------------------------------------------------------+
+__________________==___________________________________________________________+
-12- 08/25/2008
+ NEW CRETE INC =__•=___________________________________ SiteID: 015-021-001567 +
+= Inventory Item Ol)08 _______________ Facility Unit: Fixed Containers at Site +
+_= COMMON NAME / CIiEMICAL NAME ______________________________+________________+
PETRO BAF LIQUID ( Days On Site I
365
Location within this Facility Unit Map: Grid: +----------------+
S SIDE MIDDLE MET~~I, BLDG I CAS# I
+______________________________________________________________+________________+
+= STATE _+= TYPE __=_+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid I Mixture I Ambient I Ambient ~ PLASTIC CONTAINER ~
+_________+___________+_______________+_______________+_________________________+
+___________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Contaiiier I Daily Maximum I Daily Average I
55.U0 GAL 55.00 GAL 1.00 GAL
+__________________==_______+_________________________+_________________________+
+_______+__________==__= HAZARDOUS COMPONENTS ______________+___+_______________+
~$Wt. ~ I RS~ CAS# ~
+_______+__________==_______________________________________+___+_______________+
+_______+___+__====-F=====__-_-- HAZARD ASSESSMENTS =__+_________+________+_____+
ITSecretl RSIBioHaz Radioactive/Amount I EPA Hazards I%F~A/ I USDOT# I UC~P I
Yes No No No/ Curies IH
+_______+___+______-~____________________+_____________+_________+________+_____+
+___________________=______= MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5:
Ag.Defined6:
Ag.Defined7:
Ag.Defined8:
Ag.Defineil
Ag.Defined9:
Ag.Definel0:
----~------------------------------------------------------------~
+_______________________________________________________________________________+
-13- , 08/25/2008
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+_________________________________________________________________= Fast Format +
+= Notif./Evacuatio~i/Medical ____________________________________ Overall Site +
+_= Agency Notificai~ion ___________________________________________ 03/16/2006 +
N/A WE CLEAN UP AI~TY SPILLS .
+__________________=____________________________________________________________+
+__= Employee Notif./Evacuation ___________________________________,07/27/1995 +
BY PERSONNEL CONT~~CT OR INTERCOM SYSTEM. EVERYONE HAS BEEN INSTRUCTED TO
MEET AT THE CORNEIt OF E BRUNDAGE AND BLISS.
+__________________-------______--------------------________________---------___+
------------ -------------------- ---------
+___= Public Notif.,~Evacuation ____________________________________ 07/18/2007 +
N/A
+__________________==___________________________________________________________+
+____= Emergency Meciical Plan _____________________________________ 10/05/2000 +
MERCY HOSPITAL, 2:>.15 TRUXTUN AVE, 327-1792 OR
KERN MEDICAL CENT~3R, 1830 FLOWER ST, 326-2000.
+___________________=___________________________________________________________+
-14- 08/25/2008
+ NEW CRETE INC =__•____________________________________ SiteID: 015-021-001567 +
+_________________________________________________________________= Fast Format +
+= Mitigation/Preve~lt/Abatemt ___________________________________ Overall Site +
+_= Release Prevent:~on ____________________________________________ 03/16/2006 +
JOB FOCUS.
+__________________==___________________________________________________________+
+__= Release Contaiiiment __________________________________________ 10/05/2000 +
WE KEEP ABSORBS OIJ HAND. WE HAVE WET/DRY VAC AND SQUEEGES FOR PICKING UP
SPILL.
+__________________=____________________________________________________________+
+___= Clean Up =___-________________________________________________ 07/27/1995 +
WE SCREEN AND REU:iE ANY SPILLS THAT MIGHT HAPPEN.
+_______________________________________________________________________________+
+____= Other Resour<:e Activation ______________________________________________+
+_______________________________________________________________________________+
-15- 08/25/2008
~
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+__________________==_____________________________________________= Fast Format +
+= Site Emergency F~~ctors ______________________________________= Overall Site +
+_= Special Hazards ___________________________________________________________+
+_______________________________________________________________________________+
+__= Utility Shut-Oi=fs ____________________________________________ 07/18/2007 +
GAS - FRONT OF BLI)G METER INSIDE PG&E DOOR
ELECTRICAL - BACK YARD ON WALL (W 1/3 BLDG) ~
WATER - FRONT OF ~3LDG (W OF THE 307 DOOR)
+___________________=___________________________________________________________+
+___= Fire Protec./~~vail. Water __________________________________= 02/05/2007 +
PRIVATE FIRE PROTI;CTION - 4 FIRE EXTINGUISHERS: ONE IN FRONT OFFICE, ONE
BEH FRONT OFFICE :CN LIQUID PROCESSING ROOM, ONE IN ROOM E OF LIQUID ROOM,
AND ONE IN WHSE.
NEAREST FIRE HYDR~~NT - SW CRNR E BRUNDAGE & BLISS.
+_______________________________________________________________________________+
+____= Building Occiipancy Level ___________________________________ 03/08/2006 +
2 EMPLOYEES
+__________________==___________________________________________________________+
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+ NEW CRETE INC =__-=___________________________________ SiteID: 015-021-001567 +
+___________________=_____________________________________________= Fast Format +
+= Training =______-_____________________________________________= Overall Site +
+_= Employee Trainiiig _____________________________________________ 12/28/2006 +
MSDS SHEETS ON FII~E .
BRIEF SUNIl~IARY OF '.CRAINING PROGRAM: EXPLAIN OPERATION OF ALL EQUIPMENT AND
PACKAGING OPERATIUNS. CONIMUNICATION BETWEEN US.
+___________________=___________________________________________________________+
+__= Page 2 =_______=___________________________________________________________+
+___________________=___________________________________________________________+
+___= Held for Futu~_e Use _____________________________________________________+
+___________________=___________________________________________________________+
+____= Held for Futlire Use ____________________________________________________+
+_______________________________________________________________________________+
-1~- os/25/2oos
+ NEW CRETE INC =__-____________________________________ SiteID: 015-021-001567 +
+__________________==_____________________________________________= Fast Format +
+= Response/Risk Maiiagement _____________________________________ Overall Site +
+_= Operations =___-____________________________________________________________+
+__________________=____________________________________________________________+
+__= Planning =____=____________________________________________________________+
+--------------------____________________----------___---------------------_____+
------------ ---------- ---------------------
+___= Logistics =____-----------------------------------------------------------+
---------------------------------------------------------
+_______________________________________________________________________________+
+____= Finance/Admiiiistration _________________________________________________+
+__________________==___________________________________________________________+
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