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HomeMy WebLinkAbout621 MONTEREY STREET/~ ~ /~ • U ~ CAB-'-PN BAND BOX CLEANERS 621 MONTEREY ST BAKERSFIELD CA 93305 ~'~ ~lL1~n ~'~~G-~.~ ~ ~ -r.- ' ` `7 - /- ~ a~ h.~„ ~~.- ,~ ~ ~,.~;~.- ,~~-- ~~o t G;T-~. ~'~:-~ f~~ G~ ~~ :~`/T~.~ ~e~,c,~ ~ a:L I'~1 ~+~nr~ ~ ~:.i+~ ' ~ c.~ ~G~--~i~ 7~ /G l~ ~ nl/~ 1~.z,~ e~~ ~ . 7~ _.~L~ ~-~. ~~- ~it,~ ~ ~ ~r~~~r~-~. ~.~ Zi~ ~ ~~e1~c.~ ~ ~ ~ ~~~ ~ ~~~ ~ Cc : ~%~°,~ G~,~~ ~~ ~ ~~ ~~~ ~~~~ ~~~ /~..~2 3 -~3~ ~ ~~ ~ , t-1AZARDOUS MATERIAL MANAGEMENT PLAN ~R ;" ~. wn~~;a~s,~ ~~~';^~~ =4.,,. ~ ~~"P h ~~ ~ ~~G , ~?~a ~'r~, .;; ~r s ~ ~~,,. ,..~ ,_ ~ ~ ~- _~ ~ , .; ~ ._ ~ : ..rll. ~~ L,~ z-~. .~cF ~_ ~ .- ( c ~~ A~PLICATION ~' _' %' "._ a.R.-_s..r__?.. _D ~_~ j~~ ,~ -~-r~t z_ ti~I~:f ~t.~~ , F~R~ BUSINESS OWNER/OPERATOR IDENTIFICATION FORM ARfAI T (HAZARD,OUS MATERIAL FACILITY INFORMATION) ~ ,.~ '.~ C~,~~ ~t.., l~Jc`- =~ ~~`-~;'~ `~ ~I `-~~G~~ ~~'1 • BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 151 Floor Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 2 I. FACILITY IDENTIFICATION FACILiTY ID 7F + '~ 1 YEA0. BEGINNING 300 YEAR ENDING y +y i+:+A t ~ 101 ~ ' ~ wt. ~ y TvY ~ ~ ,~/~ "5~ ~ ,x .1 , , f BUS1NE55 NAME (Same as FACILITY NAME or DBA) 'y " ~ 3 BUSINESS PHONE '~ " ~ , ' 'r, ,an ,~ A 302 ~ ~'~~'• r,t r;~ °~, ,;~ "~~, s :..' ~ ~;:~ `~s' f'~ ~ ~~;.,.'~ f ~ ~ k ~+ u7 SITE ADDRESS ~ ~ ~ f ~.~. ~ ~ ,~ : ~7`(I'w ~ ~~ t~r' . 1 . 1 . ~AtiY ~ 103 y , ~~ cmr g~K.F.R5~1 EI.A 304 / C~"C 21P CODE ~ J ~ P, ~ CJ ios DUNN & BRADSTREEf Y ~ 106 S1C CODE j ~ ~~~ ~ 107 ~ 108 COUNTY 1' L. ~p K/ L,~v`... / ' OPERATOR NAME "S ~~,~..~ ~t_..P ~'!!~ k~ N E.Zl,.~ 109 OPERATOR PHONE ~'~3~ ?~~ 110 IL .. . . OWNER INfORMATION . . "~r ' 1,.~~ ~) F ;, ~ ~, OWNER NA~1 ~S~} ~-~ :~ ~1 ~~ §"•~ 57 ~'+ ~ 111 OWNE~R~ PM~E~ ~fi~ ~~ ~ ' ` 112 .» . fl`~ ~ a :~ rs OWNER MAILING ADDRESS Q y~', ~~ S~fe, ~.1 i~ 1/ J'"'. ~i-~~~ ' 1 i t p { y,r 113 CiTV `}~.^ ~,, ~ L ~ '~ ~ C ~C...S 114 STAyT~E +~~^ 115 t._ ~ I..- ~!' ~ ZIP CODE ~ '~~ ~; j A/ 116 III. ENVYRONMENTAL CONTACT . CONTACT NAME ' ' ~ 117 CONTACTPHONE ~' ~~ ~~'~~ "~~~ 118 •~.t ~' t.._ ~. 1., r R d N L t'J ~.5 ~ ~~,. CONTACT MAIIING ADDRE55 ~',, ~. ~ ;t1ff !~ P`',1 ~ '" I ':., ~:,:, ~~ 119 cirr 4 ,~ ~t Y ~. ~~, w S,i ~~ 120 STATE '"~ 121 .i.y` n a ~ ;'~ ~ ('ry ...~ (,y~. A " ZIP CODE r' P . '~? . d . lZZ ... f A ~ : f":. . , ,~ . , w2 r c~n, .r .~ ~ A 'IV. E MERGENCYCONTACTS PRIMARY ~~ . . . ~ SECONDARY: . p~ NAME ~, ~ ~ ~ r ~ 123 NAME ~I ~.t!~ q @ . ~ ~ d ~^~ f ~~ ~ ~ ~ ~ P~ " 128 ~ t i:. ~. ~.,. ~ ~ :~ ,~. , KJ J ` ~ R N ~~ A ~ ~ •~ ~ ::~ . .. .CA% ,y ,,,,, c h TITLE ,;;,~~~ r "~ i~-.~ 9 ~"+ si" ._ 124 TITLE ,+ ~ ~_i j~§..,, ~`~ )r"' ~~ '~ 129 a~„~ ,~ ,., ~ (~ BUSINESS PHONE„ I~~ .7 ~ ~h n. 125 BUSINESS PHONE ,~s~ r, .2.~ „~ xx ~+~ ,J.p ~g~ ~ tl. . .i.U r 130 ~ ~ ,a J , . . ~ 24-HOVR PHONE .,, ~ 5„~ ~ ,o.r~,~ ;~'k ~~ ~ 126 ~ ~j yi ~h~ , 24-HOUR PHONE ..~ ~ i' } ~ 131 :, 4kf`- `~ , ' v `. . CELL PHONE ~~~ ~~~~ 127 CELL PHONE . r ,~' a ~::~ „r :s ..;~~ 132 133 V. CERTIFICATION Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted i n this inventory and believe the information is true, accurate, and complete. SIGNATUi~E OFDOCUMENT PREPAREF~ ~ , , ~ ~ ~ " ' ° 6 136 DATE / 134 ~ -~.v~ NAME OF DOCUMENT PREPARER(PRINT) ~~ ~1 ~1~~~1 135 ~ ~f' ' `l :;~. -•,~ ;" ~ ? z ,....:V,,. •r::~ g , dM:~, ~ ,, . .. . . p NAME OF OWNER/OPERATO(t (S[GN & PRINT) 137 T1TLE OF DOCUMENT PREPARER } ~ 13B %~ ~ l'~ ~eti: ~...~ r,;) 1 ~..~. ~ ~zr N"'~„ _ S '°" 'we*J ~ ` ~ _ __ ~'~aYw~..6..,.~.,~ i°~.y~--Gy:y+~ ~i,,.~°,4~.(~''! ~[ ~Kev O1/08) p ~?A HAZARDOUS MATERIAL MANAGEMENT PLAN ~`> ? ~-`.:~r~ ~`.s~uc~.~,m,~A z~, .r .. ~~a.r';&'' o-ir~r,as'<:,~~:~a~~a,„~„~i .~'~;~ts~.,"'~.t~;yii~»n-~,r~ ~ t BUSINESS ACTIVITIES PAGE ~~ (HAZARDOUS MATERIAL FACILITY INFORMATION) ~;~;~ B R 9 A _,_,D f/R~ wI~TM l ~ BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue Bakersfield, CA 93301 Phone: 661-326-3979 Fax: 661-852-2171 ,;; ` I: "FACILITY. ID:ENTIF.ICATION '. ` FACILITY ID x(for office use only) 3 EPA ID # 1 5• Y~ D /i ~ ~W ~ ~ ~/ ~ I ~ i ) ~~'"f .r,~N: •'}lF••• ~ 4i~ :!~yp :'~ ;~ ~ v I , ~ ~i ~ ~ry BUSINESS NAME (FACILITY NAME or DBA) 103 T S t~,~ l/ ,I ~,; " ' ~'° ~ ~ t~ ~N ~°~ ti ' " ~ ~ ~ i, ~ .r. w~• ;, - ! b II..~ACTIVITIES DECLAF~ATION DOES Your Facility... If Yes, Please Complete... 129 A. MAZARDOUS MATERIAL O Yes No • C HEMICAL DESCRIPTION FORM i3a 1. Have on site (for any purpose) hazardous material • H A2ARDOUS MATERIA~ MANAGEMENT PLAN at or above 55 gallons for Ilquids, 500 pounds for Mfnimum required olanning elements: solids, or 200 cu. ft. for compressed gases (include • E mergency Response Plan Iiqulds in AST and UST)? • M aps ; • T ralning • P revention • C ertification B. REGULATED SUBSTANCES (RS) ^ Yes ~~ No • C HEMICAL DESCRIPTION FORM 131 1. Have on site RS at greater than the threshold • RISK MANAGEMENT PLAN (RMP Submit to USEPA) planning quantities established by the California • CONSOLIDATED COMPLIANCE PLAN Accidental Release Preventlon program (CaIARP)7 • Incorporeting CaIARP Program Elements C. UNDERGROUND STORAGE TANKS (UST) ^ Yes a • U ST FACILITY FORM i3z 1. Own or operate Underground Storage Tanks7 • U ST TANK FORM (one per tank) Yes ~No • U ST FACILITY FORM 1~3 2. Intend to upgrade existing or fnstall new UST? • U ST TANK FORM (one per tank) • U ST INSTALLATION FORM (ane per tank) D. TANK CLOSURE/REMOVAL o Yes o • U 5T TANK FORM (Closure section - one per tank) 1. Need to report closing an UST that held hazardous material or waste? 2. Need to repoK the closure/removal of a tank that ^ ves ~.tvo • U ST TANK CLOSURE FORM was classified as hazardous waste and cleaned onsite7 E. ABOVEGROUND PETROLEUM STORAGE TANKS ^ Yes ~I,No • H A2ARDOUS MATERIAL MANAGEMENT PLAN lAST1 • I ncorporating Federal Spill Prevention Control and Countermeasure 1. Own or operate AST above these thresholds; any (SPCC) Elements pursuant to 40 CFR Part 112. tank capacity Is greater than 660 gallons or the total capacity for the facllity Is greater than 1,320 gallons7 F. HAZARDOUS WASTE ~jve o ruo 9 N B d n 1. Generate hazardous waste7 s . , 916 324-1781 please pho e . T o obtaf E A D Number, ( ) 2. Recycle more than 100 kg/mo of recyclable ^ ves 1~No . R ECYCLING FORM material at the same Iocation it was generated? 3. Recycle more than 100 kg/mo of recyclable ^ ves ,~No . R ECYCLING FORM materlal at an off-site locatlon different from the point of generatlon7 4. Treat Hazardous Waste on site? F ^ ves I~ tvo . T P FACILITY FORM • T P UNIT FORM (one per unit) 5. SubJect to Financlal Assurance requirements7 ^ ves ,~~tvo • C ERTIFICATION OF FINANCIAL ASSURANCE 6. Consolidate Hazardous Waste generated at a ^ Yes,~NO • R EMOTE WASTE/CONSOLIDATION SITE NOTIFICATION remote site? FORM NOTE: If you checked YES to any part of Sections IIA - IIF above, then in addition to the forms requested above, please submit BUSINESS OWNER/OPERATOR IDENTIFICATION FORM. , ~ - - FD2143 (Rev 01/08) I.VD . 't / o/ a vvv .~ . tv ..~u rri rnva: a i vvc. a~ an va.a • a.a BAKERSFIELD FIRE DEPARTMENT Prevention Services HAZARDOUS MATERIAL MANAGEMENT PLAN B n s p n e n 1600 Truxtun Avenue, Suite 401 '~Re Bakersfield, CA 93301 CHEMICAL DESCRIPTION FORM o~w~ f Phone: 661-326-3979 • Fax: 661-852-2171 HAZARDOUS MATERIAL INVEM'ORY Page i of 2 0 NEW ~ ADO o DELETE ~ REVISE 200 . ' •^-- °-- -° __•--°-' --- ~..~~~.__ . ' ' ~ ~ ~ I: ~FI'kCILITY I~NFORNIATION ~ ~ . . .. . . , . . BUSINESS NAME (FACILITY NAME ar DBA) ~ 3 ` ~~ ~ ~3.if !z• d .~• i~: ~~i°~~~ =^~ ~ CMEMICALLOCATION " d ~ ,,.~„ f ti y ~..,,,., 201 , ~~:'~ t,; ~ f . `~ ~ ~.~ .~ ~t. a ~<r ~ :, rl ;~~=i~a.~< ~~' ~:- 3*,~ ~ , ,~ , y~., ~ ~ f f %~"L 3 -~' CHEMICALIOCATiON 201 ~ .. _ „~. g 4~~ a = , CONF[DENTInL (EPCRAj 0 Yes F~No T?' n. a~5 ~a . FACILITY iD A i MAP ~(optlonal~ ]0] GR[D 9(optlonal) 20e ~ / ~ ~ ~ ~ ° ~ ~ ~ ~ j ~ . . ~ II. CHEMICAL 3NFORMATI ~ N ~ .. . ~ .• - ~ ~ . . : . CMEMICAL NAME ~ 205 206 ~~~ ~~^ r F°" TRADE SECItET 0 Yes R° No ~ Tf ~u ect to EPCM, refer to t~rotnrctlom COMMON NAME i ~ 2a7 ~j GL C~~-- s EHS O Yes ~' No ` 208 CAS $ 209 •If B15 k yes, atl amounts 6alow rtwst be In ~ ~ , ~ .. / ~~ .~ ~ pat~s. . FIRE OODE MAZARD CLASSES (complete if requested by Ixal flre ehie~ iio rrve n pURE 0 M]XTURE ;(~ WASTE 211 Zi2 RADIOACTIVE: ^ Yes+6' No ~~ NRIES 213 LARGEST CONTAINER 215 PHYSiCAL StATE 0 SOLID ,E~ L[QUID 0 Ga5 21a ~ ~ ~ G,~ ~. 216 FED HAZARD CATEGOR3E5 O FIRE ~ REACTIVE O PRESSURE RELEASE 0 ACUTE HEAL7H 0 CMRONIC HEA~TH (cncck an tnat apply) ~. ~ G,~ APINUAL WAS7E 21~ MAXIMUM 216 A~ERAGE ~ 219 STATE WASTE 2I0 AMOUNT 3 ~ ~ t',~ ; DAIIY ~ I'IT OAILY AMOUNT CODE ~ i~`~ , ~ ?Z1 DAYSONSITE 222 0 UN1TS~ ~ GAl p~~ 0 LBS O TONS ' `~ if EMS, amount muot be In IEs. ~~ f STORAGE CONTAIfVER: 2A Q ABOVEGiiOUIYD TANK 0 CAN ^~OX 0 TANK WAGON 0 UNDEftGROUND TANK 0 CAll80Y ^ CrLIpDER 0 RAIL CAR 0 TANK INSIDE BUILDING 0 S[LO O GLA55 BOTfLE 0 OTHER 0 STEEL DItUM `~ FIBER DRUM ^ PLASTIC BOTTLE 0 TOTE BIN u~' PLpSTICJNONMETALLIC DRUM ~ BAG ~ u+ S70RAGE PRESSURE: ~ AMBIENT 0 ABOVE AMBIEPIT 0 BELOW AMBIENT -- 225 STORAGE TEMDERATURE: ~. AMBIENT O ABOVE AMBIEM O BEIOW AMBIENT 0 CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 ~ ~zs '~ [ i`' r`4 r; ~ ~ ~ i K?=7`~ t,r::_. ~ N F!. 22~ ~ o Ves ~ No zie - V ~ ~ a~s 2 230 ~ '231 0 Yes D No 232 237 ; 23< 275 0 Y85 O NO 236 I77 4 278 239 O~CS 0 NO 240 241 5 2C2 203 ~ Xe5 0 NO 244 245 III. SIGNATURE PRINT NAME d TIII.E OF AUTHORI2ED COMVANY REPRESENTATIVE 51GftlATURE ~ DATE i16 t ' +V ~' ~ ~ ~' ~ ~ ~~-.r~ ~ ~!°~~ `~ -- ~,. ,C= :. ~ ° . . .- ,:,~. r ; ; ~ , ~ p N A~ ~../~ FD2144 (Rev 06/07) ~.~-~~~,;~~~~° _ . ~,~-~,~,~~;~~-:~~.~. ~ ~; e HAZARDOUS MATERIAL MANAGEMENT PLA ~~ ~~~;. APPLICATION <; H $~,Rl ~ D SECTION DISCOVERY & NOTIFICATION (FORM) ~~ w`RTM ~ ~ ~ INSTRUCTIONS 1. To avoid further action, return this form within 30 days of receipt. 2. Type/print answers in ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 15` Floor Bakersfield, CA 93301 Phone:661-326-3979 • Fax:661-852-2171 .._. ....._....:1 .............. . ,. .-,....., . <...:: r:,...-; ~ : a~ nx~ ; .... a .~... ._ :~.L:. ~ .r~.~~ta:r . ~1~:; ../• : ~.:_{.f. 1 _. ..~.,.-. i- . 'C a~ '~ n.. k x~ ~y~.{~ it'"~r ,hl'tt~ L1Y' v~"Y"rok Et,'{'F ~ Y e' + y~Cri ~"" ~ r~~`~ t' ~ r~-~::~~ ~ I~~:DENTIFICATIO.N ~+~~ ~ '' `~ x=~ ~I• ~`FACILITY SECTIO~N ` y ~ i , . g ` y ~ .t. 3. -. `F ` ~ . i.,'.~..,+~'S;iA&aiw~1?h~f..~fv,-.. . . , v.. .t~^.[' ..%: ~.'..~e~ ». .d.w, s a,,..-..t . .....'~-~. ~ a.... , ..:. , . BUSINESS NAME (FACILITY NAME or DBA) ~ S"'t ~ ';4.. ~Y: ~.•- ~ f ' ~~ ~ 1"+".. ~ ADDRESS (for local use only) ~N$ ~a' .S~ ~^ ~~~ S i ~ ~~n S~i~,..~ tl Ms~:.~' R ~ FACILITY ID ~ ~~ ~ ~ B ~L~ °_ ~ 1, rJ °~ ~' CT ~' ~'~~" ~~u ~.~y ~'rd .~!'"`'h.. ~ '~ : t;z'~,g ~i'9;FSiu` °' ~"I'Lt~YF W T• L~ ~~ .. *c8• 1•~ ~ SECT~ION~II~ ~ ~ ' { ` ~ .s%'Az'i~.~ i'"r „#':~r.a n7S~~35~rS:nz~? ?'E 3fihTt3;,'S3:Ta~v~~t '~`ilc `{'-%^" 4"s~2 !. ~ l~k.,n . 'i d . i NOTIFICAThIONS ~.° ~,~ '~< fi ~ ~a f ax~,-~ , ti ~: '~ ' AND ~ .~ DISCOVERY : ~~ y~ ~!~~~ ~h~~~GS~°i~~3:.4. ~sL?.`x'i~Kd~~ ,;~ z'a. ,. .,.Y .~ lt~ 1. ~ S..av S .. wi. ~ t , x a 5«~ .x _ .c.wq.r. „~e~':'-... S_>cswmk,s~'. , A. LEAK DETECTION AND MONITORING PROCEDURES: L~• s ,+- . . .v.. J~ ~.r .•.: 4.,, ~ .~•' fy,y~. .~`"'~ Y'"~ •fa'~c.•~f:~T...~.r•.I~ 0~"' ~yi~a"~'y,.~ ~,.s1.n ~.~~e.'. f~;-' I~~~r!.a... ~ .~t~a ~ /~~ ~~~.~~i~~~ C~' ~r+! ~,;~:5 ; ~~ f r r + . , n~ p,., r .,~~t ~,.};,' y.o;'", ~. ~ - y+ ~ ~ f~ ,a=} ~ : . .. f~. .i . .,.. /~ S ~• ::[ : r" i ~ M . ~ ( t~! + . . . ? ..~/ . ..~ h~ / ,_ , } t, ,: B. EMPLOYEE AND AGENCY NOTIFICATION: l a ~ ,,. , t~ r 4.'i, { ,,• r r;° ` ~3 ~i ":" y~ a~', i '~ i.- tr~ {: ~,, < , ; y , c e ~ N o7" ~ Y t ~ r~'~'a n1 ~z~ ;~'s p,,'(a ~ "': ~ ' ,~,~ ..;; ~,' ~"~~ t' s ~ ~ P~l~ F,;. ~s ° ~:~ ~ ;;~ .: f' ~ ~ a - . ~ . , .M1 ~ . . ;~~,.:. i . ~ A~ ~~ si'~ d i f ~~ )y^^`' ! ~) p ~~ f " ~ ~~' ~ y ' S.r j ~ A `Fw; ;f~y.. , . i 'I•: r'i~ .. r^ .. 7 ~~ ~~ } ~ fi ] Y ~ 6' ~ ~ ^ '+.` .} } ~' A ~~ S t e T~ V y\ .f 1~ th'~ j ~4 5kp y.. ~~ ~ x b§, `~'h E ,' ' ~ d ; C.. :}. . . .. f r T/^~ i 4 < ~:. ~~ ~ ~ e d~/'?v'}y. F ~.. {~: f . s. ,. ,'.~ t;^y.;t` ,•..~ fs'd.~ ,r`~~y ~t ~~ .:::-1~~~~12~, 'L/fJ~ ~ ~~ . r o:'S ENViRONMENTAL RESPONSE MANAGEMENT ~' t c+ < <~' ~ ` 1~~ ," C . w ~ _ e _. . . , . " ' /~ ~ .k j p } ~~.~'~~'">. * o- ~~~~ S `i~: v.~.,- _ ~.] r°: ~~:.. y...._ . . , . ,j ~~ . pYJ~ ;0'•/5 i '.. r4a r5 d -^~ ~}t_. ~.1'~y~ '~ y" ~ ~ " ~~ ~ ^ ¢ „ . _ . ,.,. ( , , , , 9 ; ~~. t Q , y : ~ r / F+ ^ t F. ~ r" ,i , ~ 3 . ~i+~ ~ ~ ...T ~... rv ... .. , u . .. ,y . ~ {A ~. EMERGENCY MEDICAL PLAN: : ~ ;~ ~,~ €~.~ ~ ~~ ~ ~ ~.c,.~^~ ~ ~;C ` ;. • r:~ ~~ <•:'~ .. F i% a ~' i ' ~ ~ , y ~ .. . : . . 1 '"=1 ~ ~Fl.f ~ ~~ 't ~~~3' i ) N c, R S'~. fa F ~~ ,1~ `3 ~ ~~ ...: y : . ~, ~. • ~ .. ~~r r j ~ ~~, r} .~ Ati. ~'/ t` ,d I ~ .~..,.~tr !S,_~, r ~:`Eu,a.~,~.5 .1 .~ t. ~~:v ir^ ~y ~. '~ t` .rl~.. rr,;.~ ' '~ ,. s,,~, . -.~~,3~ P"''~"~ ~ ° N , _ n. 1 ~:v> S .. ~C. ~ 'w /~ ~~y n~. ~~jN ~/~ ~~ @t{ ~,, ~~~I ~ ~CN j ,V~ {J ~ 1 ' i..~~ "~f~s$r , -, ,~ ~ i';~u ~ T3~ib.~. '~4t °23s$~l~ Zy '~y:-^" Y,y~;~5"K;~.., :!,~~-°H-~~+~Yk~"efa"5~~.~.p_t~$C~~e' ~~v'4.vy,~`~ki~T+:!,i7~~#. a~'{~',~k~~~Zl2~g-.~~^2~`Y ~'t~k3?~''~w+wR'3F .YVh1Y '~. f Et,~,~:,y~` "``$K.c~ A ?Y LAN~~; P~ ,ONSE~ . ~ ~ ~ r ~' ~ '~ ~ ~ ~SECT~ION~II 2 ~~RELEASE~RESP ~ ~"~ ~ ~~ ~ ~~ _ 4 , ~ H ~. , :, ~, ~~~.~ w.~.~ .~. ~., ;. ,~.~._ ~ ,-w ..~ ~ , .~.s ~. .~ ' H , ~a~ ~ ~ , . . m y 1~~ ~ . r d f~ , HAZARD ASSESMENT AND PREVENTION MEASURES: ~'f r L- G~ P ~ ~ ~~~ D'~^'~ ~ E~`~1 r3 ~~~%`-` ~ 'p~~~`~ ~t 1 ~C ~ ~ ~"'~'"~ ~'.~ ° } ~„ ~~ A . ~ / , ~e k , ) ,;~~i ~ ('~ ~ ) r::. I "f t ~"~f.i./,~ n .~;Kl+ vJ•- ,.~','i -'~ :.f+..1: / ° r ~S.y.f ~ . i.~~~i:-_. A, J ' w ~~~n~a °'"~ .. ~'f~:r~.!.'+'! lw~.. ~. ~i. ~ ~ " ' 14 K * ~~ / /~ j w.. ;;• ~ . . J:~. ~ Y~ ~~r ., t ~'•1 h~~! j ~~.'r~ ~, f- ~ rvl r~ . Il~ ~r -" ..~.. /i/~i ~^l~~j /• ~/„"SU 1 v r. ~ 8. RELEASE CONTAINMENT AND/OR_MITIGATION. ~ i°'a ~, ~ ~,r v r~, t~r~~ y{t ~~.~= a"' ~( `~p'j, x{ y: "!S ~~ e° r{i ~ r P~°; A~ `~ '~' ' ~ ~~ ~ ' . ` , r,:w Ii Y3 YS :~ . . .. { :4 .,. , t : l ~ 1 ~ ~ : ~ i d . .. ~ .: ,,, .~. ~ ~sf~..~ ~ " , 1~'~ ~ ~~ ' ~~ My.~ ~~.~ ~ f kj i f.,~. ~ e j,~ ~ ~ I4. ~/v ~ f ~ ; ~ ,.., ,~, r ~ ~ , Y c.~ ~ ~ ~ : ~ r~ r~ r~, Ar r ` ~ ~ , ~ . , P ,, e ~ _„ l ~ .,~ d u G~ }~~ ~ ' r ~ ~ , ~ ;: r / ~ ~a ~~~ ~ ~ , ~ ~ ~ b ~ , ~ ~ ~ ~i ~. ¢, ~>: ~ ~. ~~° ~ ~ , , t ~ ~ .., : k ,. ., s : s ,; o- F;a~ -: , ~;s~~~ :~- n, ~~ * ~'"!•c ~d ~~f Ir ~.r.. ; ..- . °' '~ ~ " 4 ~ '~ ~ ` ~ ' J ~ q 9`k~ r . t. P i i. rJ r / , x, .: f - .s x ,. ~~'c ~ ~. ~ N ~ 1 ~ e .a fl~ ~ o ~ ~ ~ { ~ ~'3 -,'ve i i e ~,: F 4. . ~,~ . . ~ li .~Lt`.~'.°,r . .~L ~.~ ~^ ~'a • f .. .~d' ,_ t . .,. ~ #•~~~ r,~... ~~< 's'~ y ° .f 4 ' ' . .r ,,,. ii.f :3 J y~ jF d'~ EDURES C~`,-~/~ L~~ tJ°' .'A' ~~~~~ ~•~'T'~.-- ~L~~''~'r ~ `^'''~r ~"~`~ ~¢~"' i + ,+"~'~~~ ~ f `~-.y a2 RYPR O C C CLEAN-UPANDRECOVE ~ ~ , ~^ p ~ ~ ~ ~~ ~ t F~ .~ ~ .,r . 5~.;; '~. ~`~ s~ ; ~' ,. ~ . ~:: a ~'^ ., ~ i::" , .. ~P^- ~h . -y'?~ M . ~ ~ t , ~ ii'Y'1 ~~ 1 •~ 1~... ,:n'y ~l Y~ : f..~~ ~ ) ; ~ isj7~u,`r ~ !'H, ~'~f 'i.'i/ fri 'A ~.i'~ it ~ ~ ~i - e ~5 ~y.s.4: .t f .v. ~t -t' v'. i ~ ^'~ r " r ' f e ' /L~ . ~ .w ~sl ~.~ i y ~,.. i ~ , , , ., . .J>.' ;`3 ~ 'C' n'" ~ ~ ~ e'-.~ ~ ~ ~ ~ . , . ?,.a , ,. . : , r ,. t /' 1 1°r ~4{qj. i~.~ ~. ~,.~ `..yr-' "1 r ry ' .~~.~' . i7=. ~ . r +P" _ ...,E _s . _ S : 15 . _- +_.. ~ . ~ . - . . , , --,.__.,, t~ . , ; F ..ti~ FD2169 (Rev O1/08) ^ ' '~.: ~ ~ ~~. ~"k`: ~/ 'y~ t ~ r'I ~A ~ ~ ..'... ._. ~21~~~ Page 2 of 2 /'~ ,- ,,. ,.,. . ~~ .. , m ~' ~* s~~ ~S ~ ~`~ ~ ~`° ~ ~ ` ~~ ~~ ~~~~~~~~ tt~~~``~f~~~x ~~~`~ ~~Q ~ ~IONrII:2:~:fiRELEASE,RESPONSE~iPLAN~.(`CONT)~~~~~~~~ ~~~:~~~~~~~~,~~~~ .-i~2p f39~ ~ V~~~I~ a W~ . a fi ,.~ r+~''...-v~mo`.?„~... ,r~"~lttti...~~ t~r~,r;c~'~:~1.r.,~r~~~~~~..~c""'~~;~~.f~.`<w~~~..'4°iG`~x..:t`..~°i'4~r.c~~,i.~.,F~",,:~ :~~i?t~, .~..~~.:.~"a,'3, a''r,~asw .-.`#'.~ff~,'4~..t .;°~:~~'z^.'~~?;?'Srr,~+.'~Li?1r~,2K~'°S'~~^`.4~,:.a~rYtk,...:=~..:,?u.<ve~.u.".u;..~ ..r UTIIITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILIIY) ~ .. .~%' S l ~ e -4~ r.~ - ~' ~ ~" 5 ~ :.~,~t~'.~S l.~.'o~,~ 0: a * ~;s ~-.,~~~~a~'~ ~ ~ ~;~~- ~ s~~~ ,~,~~; ~;~:, ~ NAT RAL GAS PROPANE: ELECTRICAI: « 1 _.-.. y n r, .a.zt- at ~1K p ~ ~ a~41~.""'s. ! e e ~ ~~. a ~r a: h4~ ~ax~?i ~:'~~ ~Ri 1ct ~.~~Y`F .$ ~3w•~4 P -~ v~. ~eP~^~ ;,! d".~".: ''~r,v2fc1 .i;~ ~rcd.` ~ ~,..e.~iE ~v~?~,xa WATER: ~' ~ 0 ~d~'~ 1~'-~ T~ i.'-~ ~°" ~.~~ ~~~ ~ ~' ~ ~ ~ ~ SPECIAL: ~pN~ LOCK BOX: ^ YES ~QlNO IF YES, LOCATION: o~ PRIVATE F[RE PROTECTION/WATER AVAILABILITY: ~ \ A, PRIVATE FIRE PROTECTION: ` ~ r .~' /`. s -Tw':.. ~•. ~ ~.'tNy, y"` a`:., .,i J ~ ,w,~. ~ ~d+ • ~R~ ~"'" r~ ;cr.~r w' ~•,. ;ro~' : , ~'' , ~' ~,~t't P !~~ 'a ~ ;,~ ~ ~. ~J °'~' ~tA;, ~ ~' iy~ a tiw.,, 7 a .,,.» w .e s ,~,..,~. ti . ~~i } .~ f ~ . a ' ~i ~ ",,,,, ~.~,° rzy 6 " ~ a ~,~k G.:U B. WATER AVAILABILITY (FIRE HYDRANT): + d' ~r,y «f , ~n ~~ ~r ' ! i ' Aw~-•'. •~ e~ . i~~ ~~ ~ Sr~t~~~: ~~ ~ en'1 ~~~~ f~ . C ~ A ~ ~+~'i ,~' jd ~ M4~i;` C~~~4s..~.,~!', 9 4=M+,~ C.:,? ~M~ ,~.§~},.,t u~. , k, ~?... ~% ~b..~ - l~ f._:-r~Y n~A ~ • ., ~~ f~ ~`:'-a ;f ~ P f A: ~~ ~~ ,~.~w'Y._' ~~ N~~-.,.:'...- y ~ . .a i ~'~ §,~ ~~- ~~L .: ~~~ ~ ~r. `~ ~~ b-~;~~~'~js ~:*~ ~, x~ ~~~~~ ~ ~~~ ~ ,~:~ e~~"SECT~ION~III:~T~RAI'NINXG~~'~ ` ~~~~~~~~~~°~~~~~~ x ~~. -~,~~,~~' ,~ -As• o-rv~.~.._.-,a_ ~"~;?~€t~'....~~.t. ~i~>~ ~ ~G~~~t~ ~~ t-.. `"- ~~`~ a~'~,"~~~~";~ ~ r < a:~- e~ ~ r ~.~. a~ ~, ~+J~ .~°s~i~'+?,~.~'`~7~".o-~'.fr`J.~~is. 9~` ~.;.~.~ .1'~~~,~K. ~.a~~i,~: ., ~.~~x~. b._. ..~~ ~t-'".~,__ ~-.. ~,e~,;.~'mw._ ~b,.,.»-c~7~,.,..~.._.~',~ ,~ '~~~e:. NUMBER OF EMPLOYEES: ~ MATERIALSAFEIY D97ASMtt~S Vrv ruc: y~rw u ivv ~~~, ~...-..~•..~~, I a F :- p• r - ~~. ~ ,a~-~ ~~,~ ~ ~~~ ;~ ~ ~, ~., ::~ ~ ,~„ ~;. ~ <. _ EF SUMMARY OF TRA1rv1rvCa rKUbecAr~ y.~, r ~~+ p {Q~ L~,°~,,.. ~ e? w~ ' t.~e ~F',r~ fwi }~:. ~ i ~ ~9 ~~:z~ ~ ~A _i~ i..-~, / y.':~.~t.~ ~,,,:` .. f~' I'~ ~ ~/:~;~ .. .,^~~..~~~ . ...... ~w~"~ ~ p .f~" ~1 ° ' : r~ . a . ~.~.. i'~Jµa.pv. ~~ ~FrF # A . ~ !L.,... r "'; k n .,.~~ ,. , . ' . . /. . ~, : .,. ~ ~ , "` d'''s':~<. ~ ~? ^ ~~ ~~~"~ ~~ ~' I 8,....~ *~ '~ { 4 ,P , „ `~ + ,,-i. a, .C+^~ ~ ~ .}~~~ ~t r .r<<`. ' '~~:.~ .~ ax pl °~o"'+ y.'~ r`~, 6 ~~ iD ......... ...... .__ Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personaliy examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OWNER/OPEIiATOR OR DESIGNATED REPRESENTATIVE DATE 477 ~~ ~ ~;.:.~;~y. A ~ ,`k..;D ~ L !.x 1~y:1; ,,, r,~ << ,_ ; s : :,r, a~< ~r ~, NAME OF 5[GNER (PftINT)" '~' ° a78 TITLE OF SiGNER j \ 'k'~ " !_.*~. ~~ °:l ~~ k f'S"~ : I /~ 1 •T'J:T~`~"IfY~~`"vr,. fim 4~.: i , .a,6,.,~ FD2169 (Rev OS/08) I-9AZARDOUS MATERIAL MANAGEMENT PLAN ~ ~''M~'. 4~4R~~~Zir"~,~~,'~~.«...i~~„ ~~.,ai~~i~'~'~ ~';?'r~,~~.~m.tty+,~~~;~`..::a;~„~.,d„cs}.~ 43~., ~s'~ a :. ~~# SITE & FACILITY DIAGRAM ~~~ BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 15L Floor ~,... ,~R__~-n ~. <...-D gakersfieid, CA 93301 F/R~ Phone: 661-326-3979 • Fax:661-852-217] AR1AI T ~ Page 2 of 2 - - --- I SITE DIAGRAM ~ FACILITY DIAGRAM I ~ ~'S~ ~ ~ U;~, ~ ~ ~~r ~ ~'~'•,.~. Business Name: ---~-------_---- -.~T__.~,__----------...----~---------~-----.~........._._._.~._ ~ ~r^b~'~ ;+,;T~.~ "+_ ,;. ,y~a p-M, ~.._.... Business Address: .._.,._....----:~~.,..---.--..__...._..___.._.._...____.~.._~~,~_~ __.__.__.__._.___..._._._.._.._..._....._._.._----..._........._..__...._.._.__._.___._.__.__--.-.--..______:_..._~...__...._. ~ ~ ~o ^~ ~'v ~ ~`N~~ i r^-...~.. _.____. _.~________r__~______....._.._._.__...._ - ~ ; , - ~/rt k) /~,i , 1` t'.'-I=_ rj' `',. . . v~ . ~_ ,_,,,.__.......--._ _..-... ~ ~ -___"__-_._...~._.~._~..____._..__.__._"_'_......_._"..~__..._.^---____'__._._...._........~...._., ,~ d 4ra ~ ~ I I - r- .-- --- .._.-.., ~._.a,,...,-~+f-~------!'^~""~-"' ~.' ~~L.l ~ "u ~ ~( .r°~ '~.~~,'~- ~~ - I ry~t~ j~~~'t~` ~~ . i I:~,~..r~ ~ i I~j ;I ;.::~ ~ I ICLi~JkN/~6 ~ ~ ,'[ L__t' Y4~ ~~ct !rl ~~. ' '~ ^~~ ~ ~ i ~ p-~~'~f~~J2)I'.., i~ ~ti" f I IG~I ~LkC ~ r+;14:. ~ p `i~'`; ~ F ~ ?: 3 "~', ~ ~ .. 41 ~ ~(~d!'.1 i ~% i ' ~ ~ /~~a+~R~ ~''~ ~ ; ~ ( %j,~~.c ~ r~ \ `; .~ c_;;V~.tG 1~,J flc5.~-~. ~-- il : F~ ~" O ~ , ~ ~' ~ K" ~'~ :' ~t ~n ~ h~-}~--~- eb~---'-'-_ R*' -^'~ T- -:- ~ i. ~ ~ ~g~~':._ ~ iJ "J' p"J~ ~ n R ~ , ~F~j r --.. ..___-_ i; i ~ ~ ~z ~'T~~" ;I . ~yi $,~ ~ :~ ~°~ ~ ~ ~ ~'±~' }}~ ~ ~ j, Z ~ ti ~ ! ~ • ?` ~" t ~ ~ ~ ~ ~~ , ~ l~ ' I ` ~, i ~ 1 r ~ Y ~ -_ ,_..~....._... ( ~ ~ ~~ ~ _ _---. _~.. _ _ _ _._ . __ ~ _., - ~ r ~ ~ '~'°` ~ , . ._~_ _......... _......_ ---_ _.---- _ _ _ _-~- "~ ~~ ~ot-=`~t °`~~'~ ~ ' fl'~ ~ f I NORTH~ Please indicate direction of North, FD2170 (Rev O1/08)