Loading...
HomeMy WebLinkAbout9870 BRIMHALL ROAD #200 (2)~4AYARDOUS MATERIAL MANAGEMENT PLAN ~~ G.: 1'`` ~'~'*`~ "~ x"`~ ~7 `;~'~°° ~~~'~'''~"~~~°~~". ~~° ~°~ ~y ~' ~'"~~` ~ BAKERSFIELD FIRE DEPARTMENT APPLICATION B,,,_ _6.A....$_,.F_I. D Prevention Services p(R~r 1501 Truxtun Avenue, 15L Floor BUSINESS OWNER/OPERATOR IDENTIFICATION FORM AR1AI T Bakersfield, CA 93301 ~(HAZARDOUS MATERIAL FACILITY~ORM~~ Phone: 661-326-3979 • Fax: 661-852-2171 n_nn ' "~1 ~~Z ~ ~.~f~X • . fi ~ Page 1 of 2 #~1-TS ~ 5~~1_3~ / I. FACILITY IDENTIFICATION FACILIN ID 11 ~ 1 YEAR BEGINNING ~ 300 VEAR ENDING 101 / ~ ~ O ~ O ~~~~ \O ~~~ BUSINE55 NAME (Same as FACILITY NAME ar DBA) l-E U E2 3 ^EZ BUSINESS PHONE ((a (~ 1(o l~- 1q ~ ~ 102 SITE DDRE55 c(g~0~ /21M!-H~L(~ Tc . ZOD l03 CITV ~/'CIt..EfW~~ELY , 304 c~ ZIPCODE 9 331 Z 105 DUNN & BRADSTREET # (( li LDO ~~S Z'Z 2 ' ~ 306 ~\ SIC CODE E-~1~0~ CG P 307 COUNTV ~ ~ ' 108 OPERATOR NAME I~j1~NllA~V1~1 H2 R 1 109 ~ OPERATOR PFIONE f~(D I g`7 Z- c~ 1~O 110 II.` OWNER INFORMATION; OW ER NAME . ~~ /1~^~ ~~~~ \J 1 V ~ 111 ~~1P ONE~~~~O'~ Q . ~ 112 OWNER MAILING ADDRE55 ~o 0 2Z oo ~ ~~3 ~~TM /~KE 5 " 114 STATE 115 C~A ZIP CODE O - DO 116 III. ENVIRONMENTAL CONTACT CONTACT NAME D~KVn~-~ ~ 117 CONTACT PHONE C(~~ ~~ z- o ~so 118 CONTACT MAIIING ADDRESS ~D D 2 D~ ' 119 C1TY • 120 STATE 121 ~- ZIP CODE q 3 0 -~.5 oa 122 IV EMERGENCY.CONTACTS PRIMARY ... `SECONDARY NAME nr ~ ~ ~~r 123 NAME ~ R~Ec v M,~N ~ 128 TITLE 4 ~~ ~,. ^ ~L 124 , TITLE a'T~9U I I~ ISTlL19-7D12, 129 BUSINE55 P ONE (al~~ ~l~-1~1~1o lZS B()SINE~'H NE ~ r 5- ~ 9~-/o . C~Q 130 z4~~ c~ ~H~E ~ 5-- t~3 ~I ~zb z4C~ i~ i 322 - z~r a~f _ ~3~ C LL PHONE ' ~~ ~ ^ ~ S I ~ 127 ~ ~ ~ I CELL PHONE~ ~~ ~ I ` ~~ ~ ' ~ ~ ~ ~ l l 132 133 V. CERTIFICATION Certification: Based on my inquiry of th ose individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted in this inventory and believe the info~mation is true, accurate, and complete. S GNAT E DOCUM NT PREPARER p ' 136 ATE 134 ~J ~ZOIO`z~ NAME OF DOCUMENT PREPARER(PRINT) .~FNN7 ~OSRI.ES 135 NAME OF OWNER/OPERATOR (SIGN & PRIN 137 TITIE OF DOCUMENT PREPARER 13g /2EG i 02 DF NC7Q5 /rtl • V dT~~//~C\V~~'~l /\/T.~ ~~% ruti401/08) ~ ~~ ~- ~~- ~~ ~~ ~ 1~,~~ ~ ~ HAZARDOUS MATERIAL MANAGEMENT PLAN CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIAL INVENTORY C~I~EW ^ ADD ^ DELETE ^ REVISE zoo H x B R S A~ s n F/RB A~ T BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue, 1~` Floor Bakersfield, CA 93301 Phone:661-326-3979 • Fax:661-852-2171 Page 1 of 2 (One form oPr matnrial_ pp~puildino. or area_l ~ t7,,p,~'v~aro4 ~ N y ~ r+s~a~ °~tz r r~ '4"s'"W ~~ , ,x ~~ ~ of~ ~ ~ ~r t ~ a a.~ r ,~ ~~+ s ~ ~a~. rr~=; ~, c.„~'~ t ~-u. ; ~ ti~+ ,mt~, . ~,~d3, ,ry°+t ,+... ~t ,y~~~,~n,~,~!,p..,,~~.g,a S~ Y~/r_,G r,~, .~;ror.t G ...zr~~ Z*v_ ':~,~ 3r~SM..J.,<::..~ y.3'~?,.r.~u.~ ....§~..~..~~.. .e,. ,.c.,..~ „ct,,.xw~~~ P .e..~ ~ „ ~`~ fi ~u ,,:4;~. . U$i~~f'~ ~ ~' ~' ~~ft' ~J,~1~ r S ~q~f UIV~~, ;;4"~ 1i ~iS:igr'~ ~I' ~:Y ~ Yh~E~ E~;~: af. ' t`-~ P ,,:,„k 5 S ~~t,,~~, l~ ~d ' a y/~; ~ ~ `~i ,'* } ::i„`~~~a~l~ ~f,~.:u. }~ ,~? ~~y~ aS~;~i~'r~n:~i~ iG~.~..."lvfkhl'ik ~f ~,~.~.8 ~ .::g.f P ~5~~~ ,~,~t 4+. ..,,. " ;~ .. "`~r, ?"mY,~.~ ~ 3r;v`~:.,~t fi~'ti ,,,: ~~ ;, ~,; F. f~ ~ ~t`i~~3~~l.hwti°~ ~ ~ `~ ~ r k ~, ~' " ~ s ~ x s ~ ~ ^ r € ° ~ ~ FACILITY "~ ~" I INFORMATION ~ ~ ~ ~ ~ ~ ~ ~ ~ , , * . , , ~ t ~ ., ., , ~ ; p ,5 * ~ ~. ~~ ,n , L ,, ,.~ r~ ..rn~p,~',, ~„ , ;fh ~ ~ A ~,w f.~~~fif ~, ~ s ~, ~~,~ ~ ~ ~!p;73 ~ ~y ~1 y.~ ~ # , ~i $~~ '~`aK s~a .~'c~ . ~+ ' ~7 i~ ' "t~. y`~i ~. ~ ~! ~, ~N ~'$ `~ '3~ +~'~''" ~ ` 1 } ~ ~ ~ 'yk~~"?~ ~ ~' ` ~~° : ~ ~' ~ ~~" ~ ~ " - i ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~, ~ „ . . ti ! . ~ r.. 9 , + .. ~ 1 r + ~ ~> n, r. Ps. ~ . -. ; f . k , ~1 . :A:'4I=4,~.~z .s.n :.,~. sn _,r,~ ' ~t s~, sHFA:r.fi.iL.,A ~ ~.,~. ~..,.~;,.g,....t'~;tl.~s?` v:3~rs..a.. i~R.a .h..~£ ~..'}".L,~. .,.:5-:. Y~. .fi. "fu.#t.t~r_&k4 '~ir T.~ z"-.,.~`, ,E°,...~.n.t~,.. a,.. F3, A, , BUSINE55 NAME (FACILIIY NAME or DBA) 3 ~ CHEMI L A ON 201 CHEMICALLOCATION 202 C~ , ,I ~ ~ . ~ T CONFIDENTIAL (EPCRA) ^ Yes ^ No FACILIiY ID # `^~';+< ~ 1 MAP #(ovtional) 203 ` ~~v ~ ~~ GRID #(optionaq 204 . k' ~~p! n,. yy.~t,~ ) v 4~?Yt}k{~• 4k Y ~q,[y:,~~:*G {y A!i ~R~` "~{yC',L. Y 'ts, ,;~~~~, ~ ~~g~ ~}~~"`tii.. ifl~~1~'R+eYr~~~~'~ ~~$~~~~sr, ~S ~'~i'~~ n ~z ~+~~ ['~fiC"s`i"~~ ,~Fn `~1'w } "~r~ 1•~~~'2j7~+Y `~~il`y2 u„~'C'~~~ `~~~"}m -~i.,. ~ K~~' ~ 3. ~~S~+x4x ~.~ }S~ ~~~~ x 5a .w ~ 'LC`+ ~ IU ri3~ ~ ~~ ~ -~ r ~-~~ '~'-- II~'~CHEMICALz~INFORMA~TION~ ~ ~'~~ ~-~ ~N . .~ ~ 'f~Y£~',~."' { C,,CU~.~ K~`i~~N., ~ 4;,-,. :~~ .N ~ ~..,4ya~~ ~~ ~ ~'~. ~~~~~ '~'~ `F ~ ~~ ~ ' ~ ~ , T, ,~, , , y . t - - ~ * ~~."jh~~~ '~~ ~~- '~ :~~~Y ~' ~~~ '"~~^'w~ ~' ~~~~ 'k~' ~ ;~~` ~ '~ ~- ~'~ ~ ~'+ '" ~` ~ n ~ ° ` ~ ; ~ ~~~ r, ~ ,~ y~ ' ~~~ ~ ~ " ~ ~ ~ ~ '~ ' ~ ~ ,c '~ , ~r. ,t ~ 1 ,~, r~. rr , F t . .~ i ~ ,s s~ -~, rz~v;~ra Gs #~„ ~~t;w r.. ~ ,-s <, ~ ~~~7.,;~: ?~. (.r7, ~F..,~°~r;#~.W~. i d'"x ~ ^; ..lx ;~ }.-a t, ` .~,~s,i" ~r.3 Yr~adw; 's,.-~z. <: , CNEMICALNAME 205 206 TRADE SECRET ^ Yes 0~ C ~ If su 'ect to EPCRA, refer to InsWCtlons COMMON NAME zp7 ~ t n EHS* ^ Yes ^ No 208 CAS # 209 'If EHS is yes, all amounts below must be in pounds. FIRE CODE HAZARD CLASSES (complete if requested by local Rre chie~ 2i0 TYPE 2i1 ^ PURE C~MIXTURE ^ WASTE RpDIOACTIVE: ^ Yes wrvo zlZ ~RIES 213 PHYSICAL STATE ^ SOIID ^ LI UID ~ 4 ~ ~RGEST CONTAINER 215 Q q{ 5 21a G. 4~ o ~.-~c~4- ~ o~ i` 0 ` ~ 216 FED HAZARD CATEGORIES t+/ FIRE ^ REACTIVE ~RESSURE RELEASE ^ ACUTE HEALTH ^ CHRONIC HEALTH (Check all tha[ apply) ANNUAL WASTE Z17 MAXIMUM 218- AVERAGE Z19 STATE WASTE 220 AMOUNT DAILY AMOUNT ~(,f Iz v DAILY AMOUNT ~~ L`~ ~ CODE zzl DAYS ON SITE 222 ^ UNITS~ ^ GAL C~CU FT ^ LBS ^ TONS If EHS, amount must be in Ibs. STORAGE CONTAINER: zZ3 ^ ABOVEGROUND TANK ^ CAN ^ BOX ^ TANK WAGON ^ UNDERGROUND TANK ^ CARBOY 1~YLINDER ^ RAIL CAR 0 TANKINSIDE BUILDING ^ SILO ^ GLA55 BOTTLE ^ OTHER 0 STEEL DRUM ^ FIBER DRUM ^ PLASTIC BOTTLE ^ TOTE BIN ^ PLASTIC/NONMEfALLIC DRUM ^ BAG 224 STORAGE PRESSURE: AMBIENT ^ ABOVE AMBIENT ^ BELOW AMBIENT ~~ ~ 225 STORAGETEMPERATURE ~7/ AMBIENT ^ ABOVE AMBIENT ^ : BELOW AMBIENT 0 CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 ~ v ,'~ 227 ^ YES ^ NO 226 229 2 230 231 ^ Yes ^ No 232 233 3 234 235 ^ YES ^ NO 236 237 4 238 , 239 ^ Y25. ^ NO 240 241 5 2a2 2a3 ~ Yes ^ No 244 2a5 v~7 ~ ,~ ~ ( t nvrm~a'~ ~~."'~ ~t.~'~'~.:.~f~y y~~ ,: ~ L~` ~, .r."' ''i^. , ~.~' a" tw -s,a '`~£~.~ a -0~.~~,.:~Kar '~ ~, ~,.M.. ~'."~~ -.v.°~`~'.ze"~~~4„ t'~a+s~~y., a ~.~.'t ?R~. '~;,?',,c }~ ~.ir.,: z }~ -~';r titG~'".~~-~^~'a~§'~ ^~~.'~`~ ~`'~ ~~+.}~' ~^,Y,~_ ~ Sl' i ~. ~Y 'V+~~'t"h.: ~ y~ .k{r ~ Y~,i~y ~ ~~ '~S~ ~ ~.r.uT~,rd ~~~ 7 @L..a ~- ~a "Sr,a r ~.. p z r?<~' 4'd 'S :~5.'',~ .1~~s~ ly~~1~~~., N'~n ~"fke FG~ e~' u F~:f"t 'Gf ~3. '-~a'S~4~;t ~'„ a~Y~~ ~ sa ~ T** v'~2F e ~Y: ~ ~~ ~ ~~, ~ ~ ~ ~~r ~ s ~ a~ ~ ~ G N ATU R E ~~~ '~'~ ~ ~ ~~ ~ w ~ ~ V ~ ~ ~ ~ ~ ~ , ~ ~ , - ,. .~~ ~~,~ ~~, ~ ~ ~ ~ , ~.'. ~- ., } e: +ii h t~y ,} .~k t'!' 'hf .:,.' lt'~ :~...e Yyk .t...~~ . ~ 1' ,rY. 3 s F a w ' '4~. ~~~~a ~~~ ~ ~ ~ ~~ ~ ~ %~r*'~: ~'~'~'~ ' ~ ` ~'~i'~ .~ ~ + ' ~~~ ~~ ~ ~ ~~ ~ ~'~' ~ ~ ' ~ ~ ~~ t~~Y ~~~~ ` ~ ' ~' " w w' ~7~ " , aVs~g';~ ~7~'.~,r "Rfk?.:~R . k. n.7$. f? ;?.,:: . [~, . ~, i?~:.,; : r~ 71 T., ? c , ~:,:. :, .~: ~' ;'+c~ -... ,^+ d . at~ .;:.. . . .u... . „a .. . ... ... ...~ .. , . . F .. .w .. w , ` '~`~ . ~,~ ."~~~'a PRINT NAME & T1TLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGN DATE 246 JEN~`'I~OSPI.~S ~~CL~L-~02 ~F ~~(LSiNU ~~OSc~ '~v ~~ l la ~ D~ ~ ,, ~c~ FD2144 (Rev 06/07) i;,~j HAZARDOUS MATERIAL MANAGEMENT PLAN ~~~;[ ~.wo.,..,.r...~.., k~.?d ~~1 CHEMICAL DESCRIPTION FORM ~~ ~~ HAZARDOUS MATERIAL INVENTORY =-, C~,/I~EW ^ ADD ^ DELETE ^ REVISE zoo BAKERSFIELD FIRE DEPARTMENT Prevention Services H 8 R 9 P I n 1501 Truxtun Avenue, 1~` Floor F/R@ Bakersfield, CA 93301 idRTM T Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 2 r~.:au;ALi ~°k~s t~'k~~:v~aih ,^r f ¢ 4'_ y ~- ; r ~~:asx~~ "~ a ~,~.a~df. W} ~~:;' < ,.i.~ "~ ,~~} ~ ~ ~..~ .rx'r~i~~t~ ~~~ e~'~ ~ ' ..~,~..z;~ •~i~ J 7 a~ ~iF:: „$7' ~ . a~, J ~4' Ft C ~ g"7w x .. ~sE' '' ~} 1 ~"!` a„t -~~} ( aw~`ci ~ ~ ~:'~ ~..~'l~,d ~~ .~iil~. ~ ~, 2 .F,'ST' ~ R 1 Y ~fi~,n) A a'T~' ~"~ ) .~.~5. $ ~ r F ~ ~?k 3 ~' '£-,. .~ uu~Fr ,i '~:.; SC 5 s~' `v ~fi.i'y'~~'~: ~~~ ~~ TTY INFORMATION~- ACIL ~ ~ ~~ ~ '~~~' ~ ~ ~ ~ :~4 x I . ~ ~. w ~~.~,~~y ~~. _ , , ?: ~~ ~s ~ ;,~ h,.; ~ ~- ~} ~?~ ~a :F '~~,~~',4 ~~ v~~IJ`.k;,7MMTy .,1„~Y~N':y~h*T7cvti.?u^F~SP* ~-:r~i:_~ a'! ~ ";~,v...'.~.v~:" ,...',k..: ?~ .j`,.X~.~._.~ F. ,..~i:~;.; ~ .. ~ .~i}.~~, r~'{ ifir.'~.`!~.,.~:,<:f4^:~.~ 'n'~`,~i~,~.Y `;~.i'i"i~.:5~~~7.. s3 v~f , ~z,,~ ~.~w~a. ~„ ~.rr, M ,r.. ~ ti ~~:~'~, ,s . . ~~ BUSINESS NAME (FACILITY NAME or DBA) 3 v~ ~ CHEMI L A ON 201 CHEMICALLOCATION 202 ~~ ,~ ~ j ~~ , 1 CONFIDENTIAL (EPCRA) 0 Yes ^ No ,.~ ~ 1 MAP # (optlonal) 203 GRID # (optlonal) 204 FACILITY IO # ~' ~~ ~ ~~z c ~+~ ~~ ~ `'~ p k 1+~ ^~ ae ~j 2.,m',~, ~~Y^ ,""~.;v'K' 1 "JEsi ;y~jW ~!, s~.~Y01 ~e'~ 1A3'C":~ i -~~.:.J 1 lYl ,~ SY.i.~S b a 4'r ~:. Ai y~ Y. :..:Y{~~.. ~1~..,!.'~`~ ~~E.'i~.:~^ ~i} ~ rf\1 :. hi, f ~~ .,r~.My g ~ .:}F 2~ {X r'~y k,"'•Mi 'F..,l ~~~: ~ ~I ~.5.1~+A `i q"~~a ~ YYIM1 ~ 7,~l,yy~~ i ~x++~. ~.s~'s+G ..~~ ~ ~ x -3~~~ T~~..~ ~i ~ : '~' 7' ~~x~ r ~ t Ta4 ~ ~i, r~ „~ ~~~I ,a ~~ iF"~„~ A ~ ~ ~M`~ . p T ~ ~s x~ x ~ F ~ ~~~~;. ~,s~ ~~.~ HEMICAL ~~d ~~ ~~ ~" ~~ ~ ~ <~ ` ^~~~L ; 4~INFORMATION ~ ~ ~ , ,~ ,~, , , . y+I ,~, ,~ x ~1 . ~ ~ ?: ~ ~s.."4 ~l.k • W- i~ T e.' YS J~ _ 1~ . ,}'Jd"OA~~~t ~ ~ i ~ I /~ti~ ~f~'ii''N:~.7~'~E ~ ~ ~ y,~p~ 7 L } ~ ~"~ .J'~~ ~^:w~ '~ A~ ~ '" ~ z '~ ~ ~ : ~ ~ ~~ ~ ~ ~ , ~ n W .~, ai .p:.;. ~.. _ 4~ 4 a J ._ _ . r.x. c - .a , n.'r s m~ : ~ra~,r,, ~'~;ds.s:,. ^~!~~?>.~;!~.ry. t~.r~~.M-s~~_a.. wt~rx.~, s2.~ S.-.x ,__,~ ~.':, . ~'~r~i,: & ,~».t.~,.:~r.+~sx~'~~t~w;` ",~.<,§r, .0 ~ 3'~ , , Y- 205 CHEMICAL NAME 206 ' TRADE SECRET ^ Yes C~fOS~ ~ I ~ ~ ~ C C ~ • t. C~ N~ It sub ect W EPCRA, refer to ins[rucUons COMMON NAME . Z~~ EHS~ ^ Ye5 ^ NO ...___......._ _. _ __ ..___.--_. ._~_._. ___ __._ _____...... _.____ __ ___ ___.. .. ._----- _.___._...--__. -It'.~~i --._.._ . ..__._.-- . _ __. _.--208 CAS # 209 *If EHS is yes, all amounts below must De in pountls. FIRE CODE HAZARD CLASSES (complete If requested by local flre chie~ 210 1.1,PE ~ zll `~ 212 RADIOACTIVE: ^ Yes 6~rrvo Q1RIE5 213 ~ ^ PURE L-/ MIXTURE ^ WASTE LARGEST CONTAINER 215 PHYSICAL STATE ^ SOLID ~LIQUID ^ Gn5 21a ~ ( ~ ` ~ ~ ~ ~ 216 FED HA2ARD CATEGORIES CI/ FIRE ~EACTIVE 0 PRESSURE RELEASE ~ACUTE HEALTH C~/EFiRONIC HEALTH (Check all that aOP~Y) ANNUAL WASTE Z17 MAXIMUM ~ z18 !, DAILY AMOUNT ' AVERAGE 219 DAILY AMOUNT ~ STATE WASTE 220 CODE ,~ AMOUNT ~ o ~~ ~ 221 DAYS ON SIfE 222 _ / ^ UNIfS' tj/ GAL p CU FT ^ LBS ^ TONS 'If ENS, amount must be In Ibs. ~ STORAGE CONTAINER: Z~ / 6~ ABOVEGROUND TANK ^ CAN ^ BOX ^ TANK WAGON ^ UNDERGROUND TANK ^ CARBOY ^ CYLINDER ^ RAIL CAR ^ TANK INSIDE BUILDING ^ SILO ^ GLA55 BOTTLE ^ OTHER 0 STEEL DRUM ^ FIBER DRUM ^ PIASTIC BOTTLE ^ TOTE BIN ^ PLASTIGNONMETALLIC DRUM 0 BAG ~ 224 STORAGE PRESSURE: lY AMBIENT ^ ABOVE AMBIENT 0 BELOW AMBIENT ~ 225 STORAGE TEMPERATURE: Q/ AMBIENT ~ ABOVE AMBIENT 0 BELOW AMBIENT ^ CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 r e ~j(, 227 ^ Yes ^ No 228 . 229 2 230 Z31 ^ YES ~ NO 232 233 3 Z3q z35 ^ Yes ^ No 236 z3~ 4 Z;g 239 ^ YES ^ NO 240 241 5 zpZ 2a3 ^ Yes ^ No 2aa 2a5 7V~r.~. "~~.. ;(1 yk^~,4~Y:x ^1i1~O~~4{F e.:~h ~+5~'. ~rY 5l ~~ i ~~.~"L~` n.' ~.~` ~ 1 "~ ~ ~ ~ ~ ,8R'~~ 1 ~~ ~.~ ~f+F.7'H,~i,. Y~. 4 4 i w,~:h lA` ~s ..~~..`..S1:uj x~, . . .xPa,y;a`rt"'Z~'s~ ~,s, ~ ~` t ~ +~,,'~'~" .,.''.~.~L~' ._ , ~ T~ ~y~.~ ~N ~ f~~ a k' .,k,~'4: ." ~,X,,,~ _ 4 '~ $- . Ct~i~~r,~ "1 . '" ; ~n'~t~" ~"` 'S~Y 1 J '+~ y' 1 ~ E l ' 3 I X s Z - ` h ~ URE GNA ~' e~ n ... ~. ~~. 4'3' . "~~.. ~ ~ ~v ~,~,~' fi'+'~ k~''"r~' .~4~~ ~+4a"1' x C+,~'t l ~~flit S(' s d~ t i ~'~~~~ ~ ;~~ ~ ~7 'S` ~~ ~ ~1 i.y~ 1 ' ~t,' .'~a.~'~i ~rt~ r:~t~~;~ ,~ y~ ~?~Pb9~"%A+,~'~~'~3vr5.",irv~Na' ., , ~.w aa ~t~~ z~ T z u ~ `~' ~n ~r. ".r, ~ t ~ y ,ZIZ.,SI r ~,,,ti`~ < ~ ~; ~" ..,~.';_.,~ ~~".~.~k~~~°~u~'.~`,~;'Y~bE'~a~n.~n~~h~iyv~,,.s"a~h.._a~d ~~~~~ -v,kew.Ct.. ,~,.~6~nb?,. .Nl.~~~ m l; C, _i ~m x . . , ,~ ~ ~r,;,t t ~` 3a ~, ~A~ ~~f; ~ ~ ~~c. :'~~ -7~n,~ u...u,~~~. .~rL,. - .. %,,.,.i s .,..._„ c ..,:~ PRINT NAME 8~ TITLE OF AUTHORIZED COMPANY REPRESENTATIVE I ATURE DATE 246 Jr.-~1tJy ~USRI-ES /IR.EL-[O~ZDF N~7IZSIN61 ~(~~~`^~^~~~nl ?I~~U1~~ FD2144(Rev 06/07) ~~ HAZARDOUS MATERIAL MANAGEMENT PLAN ~~ ''e 3~ °+,",>,r~'.~n +." i. „ , ;.•'~.z"~ :~, `A.r' ..,.,i'~ ~.r~,F 3, b>~, ,. . ~, . ~~~ ~ ~a"~~~ .. ~ ~. ~ w~~~ ~.:" ~ ,,~,'h~ ~~ B R 9 A I D BUSINESS ACTIVITIES PAGE ; P~Re (HAZARDOUS MATERIAL FACILITY INFORMATION) ~~~ ~~ T BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue Bakersfield, CA 93301 Phone: 661-326-3979 Fax:661-852-2171 I: FAGILITY IDENT3FICATION FACILITY ID #(for office use only) 3 EPA ID # BUSINESS NAME (FACILITY NAME or DBA) 103 ~} L~ sv/2C Er2~' N7~c iZ II. ACTIVITIES DECLARATION DOES Your Facility... If Yes, Please Complete... iz9 A. HAZARDOUS MATERIAL 1. Have on Site (for any purpose) hazardous material Yes O No . C HEMICAL DESCRIPTION FORM i3o • H A2ARDOUS MATERiAL MANAGEMENT PLAN at or above 55 gallons for Iiqulds, 500 pounds for Minimum required olanning elements: solids, or 200 cu. ft. for compressed gases (Include • E mergency Response Plan Ilqulds in AST and UST)7 • M aps • T raining • P revention • C ert(fication 8. REGULATED SUBSTANCE (RSl 1. Have on site RS at greater than the threshold ^ Yes o . C HEMICAL DESCRIPTION FORM • RISK MANAGEMENT PLAN (RMP Submit to USEPA) 131 planning quantities established by the California • CONSOLIDATED COMPLIANCE PLAN Accidental Release Prevention progrem (CaIARP)? • Incorporatfng CaIARP Program Elements C. UNDERGROUND STORAGE TANKS fUST) 1. Own or operate Underground Storage Tanks? 0 Yes o . U ST FACILITY FORM i32 • U ST TANK FORM (one per tank) 2. Intend to upgrade exlsting or install new UST? ~ Yes m~No • U ST FACILITY FORM 133 • U ST TANK FORM (one per tank) • U ST INSTALLATION FORM (one per tank) D. TANK CLOSURE/REMOVAL 1. Need to report closing an UST that held hazardous ^ ves o • U ST TANK FORM (Closure section - one per tank) material or waste7 2. Need to report the closure/removal of a tank that ^ res io . U ST TANK CLOSURE FORM was classifled as hazardous waste and cleaned onsite? E. ABOVEGROUND PETROLEUM STORAGE TANKS ^ Yes o • H AZARDOUS MATERIAL M (AST) ANAGEMENT PLAN 1. Own or operate AST above these thresholds; any • I ncorporating Federal Spill Preventfon Control and Countermeasure (SPCC) Elements pursuant to 40 CFR Part 112 tank capacity is greater than 660 gallons or the . total capacity for the facility Is greater than 1,320 gallons? F. HAZARDOUS WASTE 1. Generate hazardous waste? ^ Yes ~iO EPA ID NUMBER - provide on this page . T o obtain EPA ID Number, please phone (916) 324-1781 2. Recycle more than 100 kg/mo of recyclable ^ ves ra-~ . R ECYCLING FORM materlal at the same location it was genereted? 3. Recycle more than S00 kg/mo of recyclable ^ ves b'~ . R ECYCLING FORM materlal at an off-site location different from the point of generetlon? 4. Treat Hazardous Waste on site? • ^ ves ~ . T P FACILITY FORM • T P UNIT FORM (one per unit) 5. SubJect to Flnancial Assurance requlrements? ^ ves D~o . C ERTIFICATION OF FINANCIAL ASSURANCE 6. Consolidate Hazardous Waste generated at a ^ Yes o • R EMOTE WASTE/CONSOLIDATION SITE NOTIFICATION remote site? FORM NOTE: If you checked YES to any part of Sectfons IIA - IIF above, then in addition to the forms requested above please submit , BUSINESS OWNER/OPERATOR IDENTIFICATION FORM. FD2143 (Rev 01/08) ~ ~~ .« ., . . . :.~k.~'«T wS«'2' ^~i:S.,2.' ~"" 'm'"9,.Sw:R.';=~'m::~~xp« i6~7iM'i~'.S'3'S HAZARDOUS MATERIAL MANAGEMENT PLA ~~ ~r., APPLICATION ~y4 ~ SECTION DISCOVERY & NOTIFICATION (FORM) ~~~_. ~u H B R 9 F I D P/R! ARTM f 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, 15C Floor Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 ~r.~ y>A~.rlx~i~`5r~4.,,~y~',z~~k'f4~y~yA~.~~ ~.~4p.j i'~ ~.~~~, 98~.:. ,~.,ea, ^E' - ,~, t ?. .' z Z`t `s~; ~ ; ~ _~ , ~ ~~SECTION ~I ~FACILITY~IBDENTIFICATION ~ .~~ ~ ; „ , ~,x,~,, Y ~~~,~ ,.,,w.~,,,~. t ,,; E . ~, M , . _ ri ..«._ .s . . ..~. ,.~ . _ ~ ,. .. _ ,. , .., _ . _ . ,. . ~.. _,~ _. BUSINESS NAME (FACILITY NAME or OBA) 1-~- P c2 T c~ ADDRESS (for local use only) qg7o ~~u~~,+~-u~ ~. S ~ ~ zon FACILITY ID # ~`~;""+' Y f~y~: 1 .. ~ . c., ~rn. a' nu~e r~~c I,~ ;"k' yt "7FF' `„; ~ ; ~ ` -,~, k ~ ' ` ¢` ~~~~ ` ~"~° °~$ ~ ~~ ~ECTIO ~' '' ~ ~ ~ . a ~ ~4 ~ ~ ~ a~ rz ~ ~' N II' 1~ ~ DISCONER ~ ~ ~k ' ~ ~ ... ~~ : s . .~ Y~AND~NOT ~ IPICATIONS \ . ~ti~ ,~. ~ .~ n_,~~~~~r~r~~~: ~., .~f~.,~ce~, ..~, ..~ ~ , ~ ~,.~. '~ z.. ,~~ ~~x<. , ~ ~ . .. .n ~. ~ ~ ,~~ ,3~, ,,.> , ,_.r ~~ a y a._ ~... , .,. . ~ u ._, . .x . a , ._ . ,,.. ~,_ .. _ ~, . _, . A. LEAK DETECTION AND MONITORING PROCEDURES: ~ I S/~JS~-~~G~ ~`1 fh ~2C~-~5 - A-~~S B. EMP~OYEE AND AGENCY NOTIFICATION: ~~~~7Z ~i~L~ ~Jr c~3 ~~oD~ ~s"~ ~~ SS(~ a l ~ ~ r -i-~ G~ l d/ (ro2 ,vo,~- E~~~..~ ~-~~~ ~~<< <s ~ ~~~~3z~-3~~~ C. ENVIRONMENTAL RESPONSE MANAGEMENT: ~l~?ST ~~LD`1 ~~ 7'0 ~E`TCG~ ~I"T~~7ic~ wc.L~ /IUl?Ir`}7c °Ill ~~ ~~7r~L.CC~ ~n.- pF Nvr~Si~~, To C~7~c7- ou~~~2 , Gc~f~-i rv o~ Corvi wt~o I s ~ts S~~~n ~6 ve~ D. EMERGENCY MEDICAL PLAN: ~V'RLV ~~ ~ t~ ~ ff^1() 'T2~ j°o27 OF A-r=~EL7~D ~~ rJ l V ~~ ~7 e9-L S To ~-~A-2T l-~5Pr7~-~ T~"k)(~G f'~y.•~ +i>jr. ty~'S ~ ti .~r's 'i.~ ~ ~~.' V £ ..?,!5~,.:i 1 t"~R~~ ,•.a~' $~r.., s: .r~.~+P).>.a ,> ~ f3'`"^~_~}y ~~~: '~ ~~}' ~ ~~ ~ 1 y <f+~~5 T:S w $.~, ;~ ~ t 2 °~ LE ~ ~ ~ ~ S N RE ASE RESPONSE PLAN ~ °~~ ECTIO ~I~I ~ ~'~ ~ ~ ° ~ :~~~~ ~ :~ . , ~ , ~ ~ ;~ ~ ~;~4 z ~w :;~ ~ , 4 ~ '~,~~ ~ ~,~.. ,~~,~,, ,~k~. ~_~~. ,~.,_~~ ~~, ,~ _~~~~~ ..~_ .~~ _~_:~m.~~~~~ A. HAZARD ASSESMENT AND PREVENTION MEASURES: ~~C Ci`~J C7/Z-12E~ ~~ 1 S O/~J f~ Gl 2GV ( I I't/V ~ I s T~S 7C~ ~C lJ~'4 LL> 14~ ~ Q ~~ p~ IZ~'F~ C L- STl`}F~ O~~TG~ TJ Stlv~7-OFF /~C-V~5 •~~~~i~~J i.e c.- v~t. Nzc~ec~ on~ ~+~- cLbSco ~"~ 7e~L1-I~iN A P, B. RELEASE CONTAINMENT AND/OR MITIGATION: IZ~P~~ ~~S~DNbc '' ~,A-v ~ ~ ~ rv ~~- F--~ i o~ ~~n~-n,~,~-r-ac~j p Q-o c~ ~ 2-~5 C. CLEAN-UP ANO RECOVERY PROCEDURES: 5 Pc GG I~C~ ~s" vsCa r o2 ~~ p-~c ~n~ ~s -~~~ c-y c_L~ co~ ~rrz~~, c~ l MON7 ~ y~ ~0 2 +..J -9-ST~ g131~i25 1~ ~ G I 'I - 0 CY~H- o L 1 S ~ L~ " / V FD2169 (Rev O1/08) Page 2 of 2 ~ ` ~'' }~ ~~~'~~ °~~°~j~~~~SE C~TION`II.2•~~~RE~EA~SE~RESP'ONSE~P.L~AIV~ CON ).~1'~i~' ~.";~;~,_~~~: ~ ,~~~:~ °5t ~R'~~~~~a~~~ ~y~ ; " ~ ~ ~ ~ ` '~ ~~ ~ ~~~ ~~ ~ ~ ~ ~ ~ ~ y~ . ~~_ II .,:1. ;,~5', ~ }a 5 '+~'R.~T.4yn~K- -~Sn ?~:~ro %v~`.:ibihh"~saLL°'~~a~~J..~~"~;~..sS».a~`~.~.`~.~..iv-~.Yr~"°:EY.~~g,s~'x~'!vf ~Sa~'i7 ~~~h'r.'L ~,T~..`,~^`~. ~>SSt~Yi2~`MCS4;~S~iW.pKA{ - ~1^Y:~~ ,.i~s_R'~ :?In .:~ID~ , UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS PROPANE: C'7'IS i~OG~I 7~ ~ GUCS 1~=h~ Ll NG-~ w{~}"L~ C~LOS (_ ( O ~-'~~'-{ti~~"~7Zyq7OlL Q~j(N( l J /~ ~7 ,,1~n~,~, ELECTRICAL: ~Ol°~~~~~II;S' CL..v2~-~~/c.._ ~~V vl~l~'~-~2Qrc_-- 1G~CJ~LL WATER: ~~ ~ 11~~ ~~ ~~' Li~ 1 N~f SPECIAL: CJl` GI~'v ."/1~I1`~ Sl~"~ (-D~ IN ~5~~ ~r'1/`~17U I J~Dri /~ivl.7T FY'YGl/V~ ~I~'LL, ~ N f V V P1 -D AA t D T E LE U I Z~ IZ.~ p~ 2 Qp LOCK BOX: ^ YES ^ NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: CW'R.~ f~'I/ZC SP~Nl~.c.~~- StijSTCrv~~ F~2~ ~4 ~ ~ i ~ N~, ~~Si+e~S B. WATER AVAILABILITY (fIRE HYDRANT): il-~l%~SI ~~2r~~lz c~ I ~JI'~-~-~ ~~c~~~' ~~~ ~ 5~i2 - - ~"~ ~~E ~~~~~Z~N ~ ~ ~3v~ (.~tu~. ~~ e. ~~ ~~ ~ ~ ~ ~~ ~~ ~-~ ~ ~ ~ ~.: - ~ .~- ~ ~ ~ ~ ~.~, ., _;~~ ~ ~~ ~ ~ ; ~- ~ ~~~~`r ~,~ ~- ~-~~~~~. ~ ~ ~~ ~ SECTION~II~I,.~TRAINI3N:G~ ~ ~ ~#~ ~~~~A '~~~ ~j ~ ~ } E ,.~~ z ~ ~~ ~ ~ ~~~ ~ ~ ;~ ~~ ~ ~ }~° ~~ ~ ~ ~ ~ ~~' ~ ~ ~ r ~ . , .<..: .,,~~~.~, ~ ~.. : .. ~ x~ ., ~ .~~~ ,.~~~~ ~~_,~~~:~ 3.r, .,.,~ _ ~~~~.. ~~~~ ~~ .~_, ti ~~," ~~~.~° ~F~ ~; ~.~ .~ ~ _~ .~ NUMBER OF EMPLOYEES: % _ t!/ MATERIAL SAFETY DATA SHEETS ON FILE: YES ^ NO IF YES, LOCATION: 2E~~v~n-ti (~oonn C~+-6~ov~ i f--3ovE S~n~k BRIEF SUMMARY OF TRAINING PROGRAM: / NS ~V r c~5 ; F~o -ti, C-~crv ~-n.-w~ 7 a2 ~ n~ S 7~3-c L~ ~o~ ~~p D+~-~ t ~.s ~- m n ~~ c'~v ~~vw~ ~ o-v 5.-r~t ~j C~f~ -rp )N5~-uICE R,~ ~ OSJ~-A 5~-~--n-~oA2p5, S~-~c ~-l~+nla L~rv~ Prz-~~~ ~ c.~, p q k 5 . ~i'{~'~~. ° _li' ~5 ~ ~~g*~,.^~y ti'~,yv:'~.:~ 2(u 79g:~: '~tS ~ `~ v'~' ~ ni'~h~- 'Fy. 'sz:'=i d YF ~`~, e p;~ b P ~~i~ } ~^t ~ 4 ~} a} F ~ ~ ~~ '~~.~~r q~ > 1 1 ~,* C ~ . 9 f ,~„' 1 ~~¢3 ~:~~ ~s ~' .l "Y ~ ~~ w~ ;'~p .~. <~' ( ~ ~. , R ~ ~~ ~~ ~ ~ 3 CERTIFICATION ~~ ~ ~ ~ ~ ~ ~ ~ ~., ~ , ~„~s~ ~ ~:, ~ ~~~ - ; ~~ ~ ~ ~~~~~:~~ ~ ~' ~~ ~~~ ~ ~ _ ~ ~ ` ` ~ '~~ ~` ~ '~ ~ ~~ ~~ , ~. . , „~ ~ ~. E , , ;~ ~ ~ ,.. ~~ ~~ ,~~: . _ ~ :~~ ~ ~ . ~e ~~~ .,. ~ .. _ ,~ ~ §~~ ~~ ~ ~ U~ ; ~, .~`,.~~ ~ 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 and believe the information is true, accurate, and complete. SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESEN VE DATE a77 ~ ! ~ ~ ~ NAME OF 5[GNER (PRINT) 4~8 TITLE OF SIGNER . a79 ~ V / / / V ~ , / ~ ~ ~ ~ ~ ~ V ~ ` T / ~ • ~/1 r W C^ S T ' l ~ ( ~ FD2169 (Rev O1/08) CITY OF BAK~RSFI~LD 17~5 CHESTER AVE HAKERSFIELD CA 93301 ~~~u O{ ~Q~~ZS.T I,ECGL J I 1~~ a~m~lz~ o f .~~.ci,~c~itz~ ~i2s~zE~ion C E R~ T F I C A T E O P O C C U P A N C Y P E R M A N E N T ,.:., Issue Date . . . . . :'5./.46/~08` .4i,~:~ ,,~, `, ' :~.~r,~..,. .._ ._...-,,,:..~;~~w ~~. _:''';;.;.~ .:~~ ~ ' . ; :y,}i~ '.,`r: l ~k~ ~~:: .. . ,,.: ~: ;,. Farc~l Numb~r . ' ~ : : u-~:,-.:,~ ~ , .,,:_A. ~ ; ' ;, ~~;~;, . 1 ~''~~,-;: '~ ~'~' ~::".'~~~,, y : ..?~~:.. Proper~.y Addres,~s~~ ~~ 98r'?T~...~R~~r~. ,,.~~~~ .::~-;, ,,, .' ,.;~: ~ ~~..~*. ...,~,~:.; _,~. ~• A ;;r~,, . „• ,.~`.~' -t' ~~; ':c, i:'~ t'r K~. .. : ~^ ^ .,~,,,. ~,:;, ' . , m. ,'i . .~Y ~ ~ ... Subdiva~sion N.a ~ `' .~`'' ;+~ _. • ' ; ,`... ;;,:.....,.~, ..; .::.: `,..,:::,,~.- . `;;. L~gal D~script.~o~ .,:;' _ PARCEL MAP 114'76 `~~;`~~?CFL ,~LOT . Property zon~~rigr.':.~„ ., •,. - S~~`~,; ';: ,..`,. - ~;~' :%'~,~ J,. s .. . . .~:~{kR., 1,'h..~.~,.: ,'. . .. .. , .. Qw11QY _ . .. , ". 'k~TCN'~.Y1I~T. . ,. , Contractor . ~ : . WAT;~~E .~& SM~~'I3,., CONTS ~,. , " : . , :`: ." ` - .>•.:•3;;1.7 r 1~~3~6 , ' • ~ :.:~r , '~ ' .. ` Applicatiion numbe~r . :.0,~~~O:DQ~O~~:'~$-.~"O~OO~ .:Q~O. : Description, ot Work . . ~~~``;~CQM..;ADD~ALT . . ~ . Construction ~Cype .. . `~'~`X~~?.~.5~~NON~-RATED occupancy type . . . ,B' ~; ~-oFFICEs F~ood Zone '~~ . . . . .. . , ~ ~ . -a., . Approved . . :~~. , ~~` , .. : . . . . . ..,. .. •. -....,..~ ~. ......;. ..,. • ... • , VOYT~ tiTNI~~S'~a ~;:'.~S~G~T~1?",• BY.' BUZ~,T?TNG,~. •OFFICYAL a ~ ::a.,; ~: ~:.. ,;:~~- ~ ~ ... .. . . . . . . ..~r:: ' • . Approved .................................. . f.~'~ ~ ,,~_ Inspeetor Dare This Cenificare issued pursuantto the requirements ofSectiorc 308 ofrhe Uniform I~uilclin~ Code certifying thut,at the trme af issuance rhis structr~re was in compliar~ce wit~t tlze variot.c,s ordinances of the City of ~3al~ersfiedd reguXating bu%ldin~ enrastructivn nr c~se. Z0/Z0 39t1d 2131N3~ A~139~If1S 3~ddG bb6T9T9Z99 BE~ZZ 800Z/EZ/L0 Permit to Operate To Be Posted Hazardous Materials/Hazardous Waste Unifiec0 Permit ,~~~.~~~'~~~ ~~'~~ ~~',~.~{~ :: ~ ~ N REVERSE SIDE PERMIT O CONDITIONS' OFF ~ , ~~ ~ "~~ ~.~~~ ~;;~ , ~ 3 ~ ~;~ ~ ~ ~ $;, p ~ ~ ~~~ ~' f . ; _~ ~~~ .~ ~~~~~; ~ ~ ~ y~~ S , s ~ S s .~'~ ~ ~ ~'` u*~~N{` -: , ~y ~ ~ x ~ ; ~iar.? ~ ~~ ~ k '` `£ ~` f ?' '~` w::_. . mit is issued for the following: This pe ~~ ~' ~~ RMIT ID#015-021-004 r ~~,.~. ;; , 000 #~~ i~ ~~~5~ 4 . * -~: 'SG`Y " k a,~4 +t° ~ ay~ . ~` `NM S r a':+a Y Hazardous Materials Plan ~ ~ m ~~t ~` ~PLE SURGERY CENTER ; ~ , ~ ~,. ". / ' . . r`~ .- pR +a ~ . ~ N:.,: ,~, y . C : +.r,~ - 4 ,; m'- + r 3 X .,-,.. , :' .§+ ' ~ ~ . ~- ^k~ . ~ ;.t yii I~: ; ` • .: e.. 70 BRIMHALL ROAD SU ; ~ ITE 200,~ ;'` ~ ` ~ " : ~ ~ ` ~ ,~.~= , . ,~ ~:~ ~ ~ , ~r..~,~ ,. . ~~~ ks ~ ~ ~ CA 93312 KERSFIELD . . E ~ ~ - ~ ~ `-~ ~~~~ ~;. -'~~ ~ ~ < ~~ ' ~ ~' : F~-~ r~~ , ~ ,~ k ; ~ , ~~ ~°*'~ ~~°•~~ ~ ~> ~~~~ `' ~ ~ ' ~ ,. . ~, ~ ~. :,~ ~ ~ ~,,~ ~ ~~~.~ ~ ; ` " ~ ~~ ~ ~ ~~ ~Rr ^ _ 5 4 -~' ~ ~ . '~i~~'f ~~~ 'LL k ~ ~~~Y~~„~~~~ ~ ~ .; .: ~''+~`~`~" . ' - ~ ~ a p y ~t=;. ~ - ~:~.F3' . '.~ -' > v f~ ; ., ~~~i ~.~ g f "s .~ s ~' f ~ ~~e.`~'~,. ~ . i ~ n. - 5~ ~ , ^ 4 '•7 ~ ~ 3 . } S ~ ~ ".: { ~i ~~~j` z ~ °~ ~". Y ., s r ~"- . t "" ai~ ~,y' a ~ ~ ~~~ ~:;~..y : : ,: ~ a~" ~ ~p~ ~ - . ~ ' . e 3 Z .. s ~ y ~ ~ ~~ ~~ I ~ ;~ 4 fA y # ~~~~# - ~' ~:~ ~ ~" ~' ~ ~ . K,~;, ., $ # ~ * , ~ q ~~.~, L ~y, ~, .. s r > ,? ,A ~~ ~ . _ *YF ~~~+.y; . ,y~ '~•{ e.rsv y+ y~~.~y ~ ~~gi'~~K,~y~ ~~~~L;.'°"' 'L~rS Bakersfield Fire Department Approved by: ued by: _~.-_ OFFICE OF PREVENTION SERVICES j~ <% ; f; ; j ; `'{'`"`~``~~. 1501 Truxtun Ave ~"~~~'`'"~`~~ s B R s F I n Bakersfield, CA 93301 Issue Date: July 1, 2006 F/I~B Voice 661-326-3979 AIPTIY T Expiration Date: ]une 30, 2009 FAX 661-852-2171 ~ ': ~ I Z~1 108 ~ 4W1 4~ ~ ~ ~~ ~;~ft a'_ ~ L' ~ O ~ K E Y N O T E 5 , o.<o+...~,e.~....~.m .a..... ~t.... s x> m....~ro.~a.....>.... muRUe~+u ~p:Mm~ r..o.o~.e wa..e..Ua enorM N v~nwuuseuw~wW~y~~ 11 ae~waen~ • ~uKn)_t M r~iort~ ~ m~ewixW ~~ w ~~~R Mw> n wu~Pq ~ M ~m.t~~ « p ~' • ~ ~ ~~ ~ rron~ M w[u M niw • M ~ ~~~'~~•~ twuwn _ o~,,, ~ ~ u.~~~.,...,~.,..~.w4. v~m~Mi • ,w„ ir.crwmer~[te~ `~,.~, M°~..~ M~ eoO~r u~e~ap~ ~ix~eminNMi ~~ ~~i w tnoRa. eiemenirrte~c~~ roel I ~ ~ ~~~oumu~m~ uri ~iw~ic.vm~~~`~~w~ n eriraomw~two[~~ ri0o~ ~ ` w, ' ,[FY ~ n~wrw~wwwa. P4iw. ~~~~A~r~rortauWiuvnrraau ~~ ~~ ~ 3_ ~: ~ o ¢ _ u, ~: o w ~ i- ~ " ~- ~ ~ ~ a ~_ (/~ ~ N C• ~~I ~, U. I ~~ Z Z ~y ~ RAYMOND FOX & ASSOCIATES Meoiui uicNrreciune s <oHwinnc Z F ,,,,.,.. .,,,~_. ~.~..a... r ~ . Q ~ . d j X, ~ 3 ~, r,a ~ O ~ ~~ ~ G<ENERAL 7LAN N*OTES oo~~~,~~eRwu. WALL LEGEND ~ .~.,.~.....a..~~~.,,~.~...~ ° wti.,o.~,.~. ..q. ~ am~.«.~,..~~„~....~<m ~ ,A.. ,..~.. ., o.. .~~~.~;, o.....,d..~, ..~o.. .o ~ .~, o ..~ ;ae ~..,~ ~ o ~ m~~L nvcm SYMBOLS e Mr~;m~ re~ ~ o[rutoaw.*Vw tee~eeert D0.01ERNAME THE ENDOSCOPY CENTER ~}100 BRIMHALL ROAD BUILDING bOo BAKE0.5FIELD, U q33t1 ~70 ~1M-~4q,LL Q~ Sr ~ 2.a0 ~~a.~. S,erw.t Qc~,~~ sHeErnne: 11 Z31~ FLOOR ~~ ' PLAN PEVILONS: Q o ~ ~ DMWNBY: CMKItEDBY: GPOIER i : OhTF ~SSUED.: ).~03 hYYa.ioo) YF'V/J1: SMEETNUMBE0. FLOOR PLAN =~ ~ Az.o