HomeMy WebLinkAbout2700 M Street KCEH PERMIT2010ENVIRON
KERN COUNTY
GOLDEN EMPIRE
82-11 GOSFORD f,
BAKERSFIELD O
General Heal
BUS PLAN ME
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ed to the_owner(s)`and e\stabIi\shmerftshown above subject to
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er V�Iid uh re r suspended for violation of
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YED IN THE PLACE OF BUSINESS
Kern County Environmental 2700 "M" Street, Suite 300
Health Services Department UNIFIED HAZARDOUS Bakersfield, CA. 93301
Certified Unified Program Agency 11A A Phone: (661) 862 -8700
Facility blame:
Location:
Hazardous Materials
Business Plan
Site ID #
111••:
Piping
Issue Date: January 01, 2002 �- r~ Expiration Date: December 31, 2004
- POST ON PREMISES -
NONTRANSFERABLE
SUMMARY OF CONDITIONS
All Facilities: Hazardous Waste Generator Facilities:
1. The facility will be considered in violation and operating without a permit
if annual fees are not received within 30 days of the invoice date.
2. The facility owner must advise the Environmental Health Services
Department within 30 days of transfer of ownership.
3. The owner and operator must meet all applicable requirements of Chapter
6.5, 6.67, 6.7, 6.75, and 6.95 of the California Health and Safety Code,
California Code of Regulations, and Kern County Ordinance Code.
4. The Hazardous Material Inventory and Release Response Plan must be
prepared and kept current at the site by the owner or operator at all times.
5. All releases of hazardous materials must be reported to this Department
within 24 hours if contained within the facility boundaries or immediately
if outside the facility property or beyond your control.
Above Ground Storage Tank Facilities:
6. The facility must maintain a Spill Prevention Control and Countermeasure
(SPCC) plan on site for all aboveground storage tanks that are subject to
the Aboveground Petroleum Storage Act (California Health and Safety
Code, Division 20, Chapter 6.67).
7. The SPCC Plan must be certified by a Registered Professional Engineer
once every three years.
California Accidental Release Program Facilities:
8. The facility must notify this Department at least five calender days before
implementing any changes of any processes subject to the California
Accidental Release Prevention program. Completed documentation must
be submitted within 60 days.
9. Generators of hazardous waste are responsible for the safe management of
such, including generation, accumulation, recycling, storage, treatment,
transportation, and disposal in accordance with California Health and
Safety Code, Chapter 6.5 and California Code of Regulations, Title 22.
Underground Storage Tank Facilities:
10. All underground storage tanks must be monitored according to the
applicable requirements in the California Code of Regulations, Title 23,
Division 3, Chapter 16.
11. A copy of the facility's underground storage tank leak prevention
monitoring program (including monitoring plan, response plan, and plot
plan), as approved by this Department, must be maintained on site.
12. All equipment installed for leak detection shall be operated and maintained
in accordance with the manufacturer's instruction, including routine
maintenance and service checks (at least once per year) for operability or
running condition.
13. A report documenting the maintenance, monitoring, and any changes to the
underground storage tanks shall be submitted to this Department each year
on the form provided along with the permit or another approved by this
Department.
14. The facility owner and operator shall ensure that the facility has adequate
financial responsibility insurance coverage, as mandated for all
underground storage tanks containing petroleum, and supply proof of such
coverage to this Department.
15. The owner and/or operatormust report any significant unauthorized release
- from underground storage tanks within 24 hours of discovery.
This permit is the property of the Kern County Environmental Health Services Department and may be
suspended or revoked for due cause
BUSINES. JWNER/OPERATOR IDENT,, .CATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300 Unified Program Consolidated Form (UPCF)
Bakersfield, CA 93301 FACILITY INFORMATION
GS+ Q 2 Z 6 S,
(661) 862-8700 _Fax (661) 862 -8701
IIj�EN TIFICATION Page 1 of I
FACILITY ID9
BEGINNING DATE loo .
101
.
FA0003819
1
151
-
1 0
1
0-
1 0
0
1 0
1 6
6
8
02/25/2010
ENDING DATE 02/25/2011
BUSINESS NAME (Same as FAC Y NAME or DBA- Doing Business As) 3
BUSINESS PHONE
102
GOLDEN EMPIRE CO � .
(559) 225 -3667
BUSINESS SITE ADDRESS 103
BUSINESS FAX
102a
8211 GOSFORD RD
BUSINESS CITY 104
ZIP CODE 105
COUNTY
log
BAKERSFIELD
CA
93313
Kern County
DUN & BRADSTREET 106
PRIMARY SIC 107
PRIMARY NAICS
107a
3273
None specified
BUSINESS MAILING ADDRESS
108a
PO BOX 9129
BUSINESS MAILING CITY 1086
STATE loge
ZIP CODE
load
FRESNO
CA
93790
BUSINESS OPERATOR NAME 109
BUSINESS OPERATOR PHONE
110
DON PERCIVAL
II. BUSINESS OWNER
OWNER NAME 111
OWNER PHONE
112
GOLDEN EMPIRE CONCRETE CO
(559) 225 -3667
OWNER MAILING ADDRESS
113
PO BOX 9129
OWNER MAILING CITY 114
STATE 115
ZIP CODE
116
FRESNO
CA
93722
1
III. ENVIRONMENTAL CONTACT
CONTACT NAME 117
CONTACT PHONE
118
DON PERCIVAL
(559) 225 -3667
CONTACT MAILING ADDRESS 119
CONTACT EMAIL
119a
P O BOX 9.129
dpercival @natcem.com
CITY 120
STATE 1121
ZIP CODE
122
FRESNO
I CA
1 93790
- PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY -
NAME 123
NAME
128
RON FUSSY
ROBERT THOMPSON
TITLE 124
TITLE
129
MANAGER
OPER/MGR
BUSINESS PHONE 125
BUSINESS PHONE
130
(661) 325 -6990
(661) 325 -6990
24 -HOUR PHONE 126
24 -HOUR PHONE
131
(661) 342 -9680
(661) 342 -6978
PAGER # 127
O -
PAGER #
O _
132
ADDITIONAL LOCALLY COLLECTED INFORMATION
133
APN: 10573
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 and believe the information is true, accurate, and complete.
SIGNATURE OF•OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE
DATE 134
NAME OF DOCUMENT PREPARER
135
Electronic Signature
02/25/2010
NAME OF SIGNER (print) 136
TITLE OF SIGNER
137
DON PERCIVAL
BUSINES.
)WN ER/O PIERATO R I D1EN ATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300,
Unified Program Consolidated Form (UPCF)
Bakersfield, CA 93301
FACILITY INFORMATION
(661) 862 -8700 Fax (661) 862 -8701
Page I of I
1. IDENTIFICATION
FACILITY ID#
I
BEGINNING DATE loo
101
FA0003819
1
151
-
0
11,101
=.
0.
0
0
6
6
8
03/02/2009.
ENDING DATE 03/02/2010
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
BUSINESS PHONE
102
GOLDEN. EMPIRE CONCRETE CO.
(559 ) 225 -3667
BUSINESS SITE ADDRESS .,
103
BUSINESS FAX
102a
8211 GOSFORD RD.
BUSINESS CITY
104
ZIP CODE 105
COUNTY
108
BAKERSFIELD
CA
93313
Kern County
DUN & BRADS•TREET
106
PRIMARY SIC 107
PRIMARY NAICS
107a
3273
None specified
BUSINESS- MAILING ADDRESS
loka
PO BOX 9129
BUSINESS MAILING CITY
108b
STATE 10kc
ZIP CODE
lokd
FRESNO
CA
93790
BUSINESS OPERATOR NAME
109
BUSINESS OPERATOR PHONE
110
ON PERCIVAL
.11. BUSINESS OWNER
OWNER NAME
111
OWNER PHONE
112
GOLDEN EMPIRE CONCRETE
CO
(559) 225 -3667
OWNER MAILING ADDRESS
113
PO BOX 9129
OWNER MAILING CITY
114
STATE 115
ZIP CODE
116
FRESNO
CA
93722
III. ENVIRONMENTAL CONTACT
CONTACT NAME
117
CONTACT PHONE
Ilk
DON PERCIVAL
(325) 699 -6990
CONTACT MAILING ADDRESS
119
CONTACT EMAIL
119a
P O BOX 9129
dpercival @natcem.com
CITY
120
STATE 121
ZIP CODE
122
FRESNO
CA
93790
- PRIMARY-
IV. EMERGENCY CONTACTS' -SECONDARY -
NAME
123
NAME
128
RON FUSSY
ROBERT THOMPSON
TI'T'LE
124
TITLE
129
MANAGER
OPER/MGR
BUSINESS PHONE
125
BUSINESS PHONE
130
(661) 325 -6990
(661) 325-6990-
24 -1 -TOUR PHONE
126
24 -FIOUR PHONE
131
(661) 342 -9680
(661) 342 -6978
PAGER #
127
PAGER #
132
ADDI'T'IONAL LOCALLY COLLECTED INFORMATION:
133
APN:
10573
Certification: Based on my inquiry of those individuals.
responsible for obtaining the information, I certify under penalty of law that 1 have personally
examined and am familiar with the information submitted and believe the information is true, accurate, and complete.
SIGNA'T'URE OF OWNER /OPERATOR OR DESIGNATED REPRESENTATIVE
DATE 134
NAME OF DOCUMENT PREPARER
135
03/02/2009
NAME OF SIGNER (print)
136
TITLE OF SIGNER
137
DON PERCIVAL
BUSINESS.
WNER/OPERATOR IDENTIOCATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300
Unified Program Consolidated Form (UPCF)
Bakersfield, CA 93301
FACILITY INFORMATION
(661) 862 -8700 Fax (661) 862 -8701
I. IDENTIFICATION Page I of I
FACILITY ID#
1
BEGINNING DATE loo
101
FA0003819
1
151
-
0
1
0-
0
0
0
161
6
8
03/10/2008
ENDING DATE 03110/2009
BUSINESS NAME (same as FACILITY NAME or DBA - Doing Business As) 3
BUSINESS PHONE
102
GOLDEN EMPIRE CONCRETE CO.
661 325 -6990
BUSINESS SITE ADDRESS
103
BUSINESS FAX
102a
8211 GOSFORD RD
BUSINESS CITY
104
ZIP CODE 105
COUNTY
108
BAKERSFIELD
CA
93313
Kern County
DUN & BRADSTREET
106
PRIMARY SIC 107
PRIMARY NAICS
107a
3273
None specified
BUSINESS MAILING ADDRESS
108a
P O BOX 9129
BUSINESS MAILING CITY
108b
108clZIP
CODE
I 08
FRESNO
!STATE
CA
93790
BUSINESS OPERATOR NAME
109
BUSINESS OPERATOR PHONE
110
CLINT BONE
II. BUSINESS OWNER
OWNER NAME
111
O
112
GOLDEN EMPIRE CONCRETE CO
(559) 225 -3667
OWNER MAILING ADDRESS
113
P0 BOX 9129
OWNER MAILING CITY
114
STATE 115
ZIP CODE
116
FRESNO
CA
93722
III. ENVIRONMENTAL CONTACT
CONTACT NAME
117
CONTACT PHONE
118
RONALD FUSSY
(325) 699 -6990
CONTACT MAILING ADDRESS
119
CONTACT EMAIL
119a
P O BOX 25000
rfussy @natcem.com
CITY
120
STATE 121
ZIP CODE
122
BAKERSFIELD
CA
93390 - -500
- PRIMARY-
IV. EMERGENCY CONTACTS -SECONDARY -
NAME
123
NAME
128
RON FUSSY
ROBERT THOMPSON
TITLE
124
TITLE
129
MANAGER
OPER/MGR
BUSINESS PHONE
125
BUSINESS PHONE
130
(661) 325 -6990
(661) 325 -6990
24 -HOUR PHONE
126
24 -HOUR PHONE
131
(661) 342 -9680
(661) 342 -6978
PAGER #
O -
127
PAGER #
O -
132
ADDITIONAL LOCALLY COLLECTED INFORMATION:
133
APN:
10573
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 and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE
DATE 134
NAME OF DOCUMENT PREPARER
135
melnomfo
03/11/2008
1
NAME OF SIGNER (print) .
136 TITLE
OF SIGNER
137
Don Percival
BUSINESIMWNER/OPERATOR IDENT_ .CATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300 Unified Program Consolidated Form (UPCF)
Bakersfield, CA 93301 FACILITY INFORMATION
(661) 862 -8700 Fax (661) 862 -8701
❑ NEW BUSINESS ❑ OUT OF BUSINESS ❑ REVISE/UPDATE (EFFECTIVE 03/13/2007) Page I of I
I. IDENTIFICATION
FACILITY ID# _M5
I
BEGINNING DATE 100
ENDING DATE
101
-
0
1
0=
0
0
0
6
6
8
FA0003819
05/25/2006
05/25/2007
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
BUSINESS PHONE
Io2
GOLDEN EMPIRE CONCRETE CO.
(661) 325 -6990
BUSINESS SITE ADDRESS
103
8211. GOSFORD RD
CITY
104
ZIP CODE
.10
BAKERSFIELD
CA
93313
DUN & BRADSTREET
106
SIC CODE (4 digit #)
10
COUNTY
log
Kern County
BUSINESS OPERATOR NAME
09
BUSINESS OPERATOR PHONE
110
CLINT BONE
II. BUSINESS OWNER
OWNER NAME
I I I
OWNER PHONE
112
GOLDEN EMPIRE CONCRETE CO
OWNER MAILING ADDRESS
113
P O BOX 9129
CITY
14
STATE
ZIP CODE
116
FRESNO
1 CA
93313
III. ENVIRONMENTAL CONTACT
CONTACT NAME
117
CONTACT PHONE
118
RONALD FUSSY
(325) 699 -6990
CONTACT MAILING ADDRESS
119
P O BOX 25000
CITY
120
STATE 21
ZIP CODE
122
BAKERSFIELD
CA
93390 - -500
- PRIMARY-
IV. EMERGENCY CONTACTS -SECONDARY -
NAME
123
NAME
128
ROBERT THOMPSON
MIKE BRADLEY
TITLE
124
TITLE
129
OPER/MGR
BATCHMAN
BUSINESS PHONE
125
BUSINESS PHONE
130
(661) 325 -6990
(661) 833 -4495
24 -HOUR PHONE
126
24 -HOUR PHONE
131
(661) 589 -9057
(661)663 -8058.
PAGER #
127
PAGER #
132
Q -
(332) 530 -5301
ADDITIONAL LOCALLY COLLECTED INFORMATION:
133
APN:
10573
Environmental Contact E -Mail Address:
rfussy @natcem.com
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 and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTAT
DATE 134
NAME OF DOCUMENT PREPARER
13
E&
03/13/2007
1
NAME OF SIGNER (print)
136
TITLE OF SIGNER
13
Ron Fussy
BUSINESMWNER/OPERATOR IDENZ. !CATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300
Bakersfield, CA 93301
(661) 862 -8700 Fax(661)862 -8701
Unified Program Consolidated Form (UPCF)
FACILITY INFORMATION
❑ NEW BUSINESS 0 OUT OF BUSINESS 1:1 REVISE/UPDATE (EFFECTIVE 05/25/2006 ) Page I of
I. IDENTIFICATION
FACILITY ID#
1
BEGINNING DATE 00
ENDING DATE
101
1 1151-101
1
101-101
0
0
6
6
8
FA0003819
05/25/2006
05/25/2007
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
BUSINESS PHONE
102
GOLDEN EMPIRE CONCRETE CO.
(661) 325 -6990
BUSINESS SITE ADDRESS
103
8211 GOSFORD RD
CITY
104
ZIP CODE
to
BAKERSFIELD
CA
93313
DUN & BRADSTREET
106
SIC CODE (4 digit #)
10
COUNTY
log
Kern County
BUSINESS OPERATOR NAME
109
BUSINESS OPERATOR PHONE
110
CLINT BONE
II. BUSINESS OWNER
OWNER NAME
111
OWNER PHONE
112
GOLDEN EMPIRE CONCRETE CO
(661) 325 -6990
OWNER MAILING ADDRESS
113
P O BOX 25000
CITY
114
STATE
ZIP CODE
116
BAKERSFIELD
CA
93313
III. ENVIRONMENTAL CONTACT
CONTACT NAME
117
CONTACT PHONE
118
RONALD FUSSY
(325) 699 -6990
CONTACT MAILING ADDRESS
119
P O BOX 25000
CITY
120
STATE - 121
ZIP CODE
122
BAKERSFIELD
1 CA
93390 - -500
- PRIMARY-
IV. EMERGENCY CONTACTS -SECONDARY -
NAME
123
NAME
128
ROBERT. THOMPSON
MIKE BRADLEY
TITLE
124
TITLE
12
OPER/MGR
BATCHMAN
BUSINESS PHONE
125
BUSINESS PHONE
130
(661) 325 -6990
(661) 833 -4495
24 -HOUR PHONE
126
24 -HOUR PHONE
131
(661) 589 -9057
(661) 663 -8058
PAGER #
127
PAGER #
132
Q -
(332) 530 -5301
ADDITIONAL LOCALLY COLLECTED INFORMATION:
133
APN:
10573
Environmental Contact E -Mail Address:
rftissy@natcem.com
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 and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTAT
DATE 134
NAME OF DOCUMENT PREPARER
ad. $ G
05/25/2006
1
NAME OF SIGNER (print)
36
TITLE OF SIGNER
1
RONALD FUSSY
05/25/2008 12:05 IFAX EH @CO.KERN.CA.US
05/25/2006 12:07 661635 GO Dept Main 2 003 /004
GOLDEN EMPIRE C�E PAGE 03
Business–Owner—Operator—Print k'age 1; oz a.
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_._ GOLDEN EMPIRE C RE PAGE 04
Hazardous Materials List Page t or i
FA0003819
GOLDEN EMPIRE CONCRETE CO,
Chemical Name
Unit Name
ACCELGUARD HE (.EUCLID)
Fixed Containers at
Site
ACCELGUARD NCA (EUCLID)
Fixed Containers at
Site
ACETYLENE
Fixed Containers at
Site
DIESEL #2
Fixed Containers at
Site
DONAX T TR ANSMISSION OIL
Fixed Containers at
SitE
EUCON AIR 40 (EUCLID)
Fixed Containers at
Site
Fixed Containers at
EUCON D S DELVO (EUCLID)
Site
EUCON NW (EUCLID)
Fixed Containers at
Site
EUCON X15 (kUCLID)
Fixed Containers at
Site
GEAR OIL SPIRAX 85W/140
Fixed Containers at
Site
NITROGEN
Fixed Containers at
Site
OXYGEN
Fixed Containers at
Site
SHELL ROTEL LA XLA (MOTOR
Fixed Containers at
OIL )
Site
shell tellus. byd 46 oil
Fixed Containers at
Site
WASTE OIL
IFixed
Containers at
�.—
cation
CENTRAL OF
Ty
OF FUEL TANK
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GOLDEN EMPIRE CONCRETE
8211 GOSFORD RD.
BAKERSFIELD, CA 93313
FA0003819
ft
BUSINESS OWNER/OPERATOR IDENTIFICATION
Kern County Environmental Health Services Department
2700 M Street, Suite 300 Unified Program Consolidated Form (UPCF)
Bakersfield, CA 93301 FACILITY INFORMATION
(661) 862 -8700 Fax(661)862 -8701
LJ NEW BUSINESS 0 OUT OF BUSINES LJ REVISE/UPDATE EFFECTIVE 02/09/2005 Page I of I
I. IDENTIFICATION
FACILITY ID#
BEGINNING DATE
ENDING DATE
1
5-
0
1
0-
1010101616181'
01/01/1900
01/01/1900
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
BUSINESS PHONE
GOLDEN EMPIRE CONCRETE CO.
1 (661) 325 -6990
BUSINESS SITE ADDRESS
8211 GOSFORD RD
CITY I
ZIP CODE
BAKERSFIELD
CA
93313
DUN & BRADSTREET 106
SIC CODE (4 digit #)
COUNTY
Kern County
BUSINESS OPERATOR NAME
BUSINESS OPERATOR PHONE
CLINT BONE
II. BUSINESS OWNER
OWNER NAME
OWNER PHONE
GOLDEN EMPIRE CONCRETE CO
(661) 325 -6990
OWNER MAILING ADDRESS
P O BOX 9129
CITY
STATE 115
ZIP CODE
FRESNO
CA
1 93390 -5000
III. ENVIRONMENTAL CONTACT
CONTACT NAME 117
CONTACT PHONE
CONTACT MAILING ADDRESS
CITY 120
1 STATE 1271p
CODE
- PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY -
NAME
NAME
ROBERT THOMPSON
YOUNES HARRAK
TITLE
TITLE
OPER/MGR
BATCHMAN
BUSINESS PHONE
BUSINESS PHONE
661 325 -6990
661 833 -4495
24 -HOUR PHONE
24 -HOUR PHONE
(661) 589 -9057
(661) 765 -6072
PAGER #
PAGER #
ADDITIONAL LOCALLY COLLECTED INFORMATION:
APN:
Environmental Contact E -Mail Address: rfussy @natcem.com
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 and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTAT
DATE
NAME OF DOCUMENT PREPARER
ew $i
02/09/2005
NAME OF SIGNER (print)
TITLE OF SIGNER
Robert Thompson
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
HAZARDOUS MATERIALS, BUSINESS PLAN CERTIFICATION
FEBRUARY 2004
FACILITY INFORMATION: Site ID: 000668
Facility Name: GOLDEN EMPIRE CONCRETE CO., FA0003819
Physical Location: 8211 GOSFORD RD
City: BAKERSFIELD, CA
Facility Phone: (661) 325 -6990
OWNER INFORMATION FOR MAILINGCORRESPONDENCE ONLY:
Name:
GOLDEN EMPIRE CONCRETE CO
In Care of
RON. FUSSY
Address:
P O BOX 25000
City, State, Zip:
BAKERSFIELD, CA 93390 -5000
Contact's Phone:
(661) 325 -6990
Environmental Contact's
E Address:.
Fl l <�* /'1��!',�f/�. jam`
-Mail
BILLING INFORMATION ONLY:
Name:
GOLDEN EMPIRE CONCRETE CO
In Care of:
RON FUSSY
Address:
P O BOX 25000
City, State, Zip:
BAKERSFIELD, CA 93390 -5000
Contact's Phone:
(661) 325 -6990
EMERGENCY CONTACT INFORMATION:
NAME: TITLE:
ROBERT THOMPSON 6Pe✓2
Day Phone: (661) 325 -6990 Ext:
Night Phone: (661) 589 -9057 Ext:
REGULATED ACTIVITIES AT THIS FACILITY:
Hazardous Material Business Plan
NAME: TITLE:
YOUNES HARRAK, BATCHMAN
Day Phone: (661) 833 -4495 Ext:
Night Phone: (661) 765 -6072 Ext:
CERTIFICATION:
PLE SE CHECK ALL THAT APPLY:
The most recently submitted hazardous materials business plan and inventory are complete, accurate, and
current. There have been no changes in the quantity of any hazardous materials as previously reported. No
hazardous materials subject to the inventory requirements are being handled that are not currently listed.
0 I have enclosed a business plan and inventory for the facility described above.
Other:
I certify, under penalty of perjury, that the information provided above is correct.
r-" Am,
Tit e
Date Report # 7000
KERN COUNTY Z,..VIRONMENTAL HEALTH SERVICES DEPARTMENT
HAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION
FEBRUARY 2003
FACILITY INFORMATION: Site ID: 000668
Facility Name: GOLDEN EMPIRE CONCRETE CO., FA0003819
Physical Location: 8211 GOSFORD RD
City: BAKERSFIELD, CA
Facility Phone:. (661) 325 -6990
OWNER INFORMATION FOR MAILING CORRESPONDENCE ONLY:
Name: GOLDEN EMPIRE CONCRETE CO
In Care of. RON FUSSY
Address: P O BOX 25000.
City, State, Zip: BAKERSFIELD, CA 93390 -5000
Contact's Phone: (661) 325 -6990
BILLING INFORMATION ONLY:
Name: GOLDEN EMPIRE CONCRETE CO
In Care of. RON FUSSY
Address: P O BOX 25000.
City, State, Zip:. BAKERSFIELD, CA 93390 -5000
Contact's Phone: (661) 325 -6990
EMERGENCY.CONTACT INFORMATION:
NAME: TITLE: NAME: TITLE:
,.- ROBERT THO_ MPSON YOUNES HARRAK, BATCHMAN
/ Day Phone: . (661) 325 76990 Ext: Day Phone: (661) 833 - 4495 Ext:
Night Phone: (661) 589 -9057 Ext: Night Phone: (661) 765 -6072 Ext:
REGULATED ACTIVITIES AT THIS FACILITY:
Hazardous Material Business Plan
CERTIFICATION:
PLEASE CHECK ALL THAT APPLY:
C2f The most recently submitted hazardous materials business plan and inventory are complete, accurate, and up
to date. There have been no changes in the quantity of any hazardous materials as previously reported. No
hazardous materials subject to the inventory requirements are being handled that are not currently listed.
I have enclosed a business plan and inventory for the facility described above.
0 Other:
I certify, under penalty of perjury, that the information provided above is correct.
Ronald Fussy
Pri ame
Signattrre
General. Manager
Title
February 12, 2003
Date Report # 7000
KERN COUNTY _.4VIRONMENTAL HEALTH SERVl..AS DEPARTMENT
HAZARDOUS MATERIALS BUSINESS PLAN UPDATE
FEBRUARY 2002
FACILITY INFORMATION:
Site ID: 000668
Facility Name:
GOLDEN EMPIRE CONCRETE CO., #003819
Physical Location:
8211 GOSFORD RD
City:
BAKERSFIELD, CA
Facility Phone:
(661) 325 -6990
OWNER INFORMATION FOR MAILING CORRESPONDENCE ONLY:
Name:
GOLDEN EMPIRE CONCRETE CO
In Care o£
RON FUSSY - --
_ h
Address:
P O BOX 25000
_-
City, State, Zip:
BAKERSFIELD, CA 93390 -5000
Contact's Phone:
(661) 325 -6990
If N
BILLING INFO
Name:
In Care o£
Address:
City, State, Zip:
Contact's Phone:
RMATION ONLY:
GOLDEN EMPIRE CONCRETE CO
RON FUSSY
P O BOX 25000
BAKERSFIELD, CA 93390 -5000
(661) 325 -6990
EMERGENCY CONTACT INFORMATION:
' 11
NAME: '' TITLE: - NAME: TITLE:
Robert Thompson
GLAW3EAi xA4A?*Ad@f& YOUNES HARRAK, BATCHMAN
Day Phone: (661) 325 -6990 Ext: Day. Phone: (661) 833 -4495 Ext:
58 9-9 0 5 7 Night Phone: (661)02-1-310D Ext: Night Phone: (661 �fz8 Ext:
:, 765 -607
REGULATED ACTIVITIES AT THIS FACILITY:
Hazardous Material Business Plan
If this facility generates hazardous waste and does not have an EPA ID number, Call 1- 800 -618 -6942 and obtain
one. Please provide this department with that number when it is available.
ADDITIONAL INFORMATION REQUESTED:
PLEASE CHECK ALL THAT APPLY:
C:1 There are no changes to my business plan and inventory.
0 I have enclosed a business plan and inventory for the facility described above.
Other: Chanae of contact and phone number
I certify, under penalty of perjury, "that the information provided above is correct.
Ronald Fussy
Print e
Signature
Manager
Title
Date
February 6, 2002
Report # 7000
KERN COUNTY E1..IRONMENTAL HEALTH SER4�CES DEPARTMENT
HAZARDOUS MATERIALS BUSINESS PLAN UPDATE
MARCH 2001
FACILITY INFORMATION:
Facility Name: GOLDEN EMPIRE CONCRETE CO., #003819
Physical Location: 8211 GOSFORD RD
City: BAKERSFIELD, CA
Facility Phone: (661) 325 -6990
Site ID: 000668
OWNER INFORMATION FOR MAILING CORRESPONDENCE ONLY:
Name:
GOLDEN EMPIRE. CONCRETE CO
In Care of:
RON FUSSY
Address:
P O BOX 25000
City, State, Zip:
BAKERSFIELD, CA 93390 -5000
Contact's Phone:
(661) 325 -6990
BILLING INFORMATION
ONLY:
Name:
GOLDEN EMPIRE CONCRETE CO
In Care of
RON FUSSY
Address:
P O BOX 25000
c.
City, State, Zip:
BAKERSFIELD, CA 93390 -5000
Contact's Phone:
(661) 325 -6990
EMERGENCY CONTACT INFORMATION:
NAME: TITLE: NAME: TITLE: r.- - —
CLINT BONE, MANAGER YOUNES HARRAK, BATCHMAN
Day Phone: (661) 325 -6990 Ext: Day Phone: (661) 833 -4495 Ext: _
Night Phone: (661) 323 =1090 Ext: Night Phone: (661) 763 -0058. Ext:
Cellular /Pager Number: Cellular/Pager Number:
EPA Hazardous Waste ID Number,(if applicable):
ADDITIONAL INFORMATION REQUESTED:
REQUIRED INFORMATION -TO BE SUBMITTED:
o Plot Plan Drawing (showing location of hazardous materials and utility shut offs).
o Site Map (if your facility is in a rural location, a map to the facility is required).
PLEASE CHECK ALL THAT APPLY:
There are no changes to my business plan and inventory.
O I am unable to find a copy of my current plan and inventory. Please send me a copy.
o I have enclosed a business plan and inventory for the facility described above.
o Other:
I certify, under penalty of perjury, that the information provided above is correct.
Printed N Title
Signature Date
Report # 7000
KERN COUNTY E"vIRONMENTAL HEALTH SER4i.CES DEPARTMENT
HAZARDOUS MATERIALS BUS.INESS.PLAN'UPDATE
MARCH 2000�-
FACILITY INFORMATION:.- Site ID: 000668
Facility Name:. GOLDEN EMPIRE CONCRETE CO., #003819
Physical Location: 8211 GOSFORD RD
City: BAKERSFIELD, CA
Facility Phone: (661) 325 -6990
OWNER INFORMATION FOR MAILING CORRESPONDENCE ONLY:.
Name: GOLDEN EMPIRE. CONCRETE CO
In Care of: RON-FUSSY
Address: P O BOX 25000.
City; State, Zip: BAKERSFIELD, CA 93390 -5000
Contact's Phone: (661) 325 =6990 ,
BILLING 'INFORMATION ONLY"
Name: GOLDEN EMPIRE CONCRETE CO
In Care of: RON FUSSY
Address: P O BOX 25000
City, State, Zip: BAKERSFIELD, CA 93390 -5000
Contact's Phone:
EMERGENCY 'CONTACT INFORMATION:
NAME:
TITLE:
CLINT BONE, MANAGER 3z S - 6 9 9 0
Day Phone: (66,1) 933-44915- Ext:
Night,Phone: (661) 323 -1090 Ext:
Cellular/Pager Number:
NAME: TITLE:
oavt e,9 14arra`4'
IL PI-4a �v�Ii i �, BATCHMAN
�17TS11T
Day Phone: (661) 833 -4495 Ext:
Night Phone: (661)x_ 4 Ext:
Cellular/Pager Number: 963 °�sg
EPA Hazardous Waste ID Number (if applicable):
ADDITIONAL' INFORMATION REQUESTED:
REQUIRED INFORMATION TO BE SUBMITTED
C-1 Plot Plan Drawing (showing, location of hazardous materials and utility shut offs).
o Site M-ap..(if your facility.;,-, -in a rural .location; a map to the facility is rec-+.i-e-d).
PLEASE CHECK ALL THAT APPLY:
o There are no changes to my business plan 'and inventory.
o I am unable to find a copy of my current plan and inventory. 'Please send me a copy.
o I have enclosed'a business plan and'inventory f, e facility described above.
Other: tart la c GQ *s &_ s rto
I certify, under penalty of perjury, that the - information provided above is correct.
Printed Nam
Signature
CJtOerzJ e• 5 Nccoto.2er•
Title
Date
Report # 7000
KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
HAZARDOUS MATERIALS. BUSINESS PLAN UPDATE
February 1999
FACILITY INFORMATION: Site ID: 015- 010 - 000668
Facility Name: GOLDEN EMPIRE CONCRETE CO., #003819 a'
Physical Location: 8211 GOSFORD RD m
City: BAKERSFIELD, CA o
Facility Phone: 661- 325 -6990
E P A ID Number:
FACILITY CONTACT AND ADDRESS USED TO MAIL CORRESPONDENCE:
Name: itio�deH �rH� %rt �'p�creVt Co.
f11"f rLIT fl
In Care of :. _.._... ____._._r7r�Arfr _R- Aon Fuss
Address: P O BOX 12080
City, State Zip: BAKERSFIELD, CA 93389 -2080
Contact's Phone: -@85- 325 -6990
INFORMATION FOR BILLING ONLY: f j
Name: - -BRENT BEZEMBE{? �o�den �m�0;ra CAncre'!e, Cio.
In Care of: E?REPdT -BEP-_..__, . Qen Fuss
Address: P 0 BOX 12080
City, State Zip: BAKERSFIELD, CA 93389 =2080
Phone:
EMERGENCY CONTACT INFORMATION:
CLINT BONE
Business Phone:
24 -Hour Phone:
661- 833 -4495
661- 323- 1.919-
661- 33
7 /090
PLEASE CHECK ALL'THAT APPLY:
DANNY HIGHTOWER
Business' Phone: 661 - 833 -4495
24 -Hour Phone: 661 - 831 -7214
• There are no changes to my business plan and inventory.
• I am unable'to find a copy of my current plan and inventory. Please send me a copy.
• I have �enclo ed a businrjs,pl n a d T*/entory for jhe facil�il de cribed.-
Other .O rug� ��1` ._: �oa k� iI hohe IV14m �ers
I certify, under penalty of perjury, that the information provided above is correct.
C soy e—
Printed Nam Title
Signature Date
Please check if you are submitting a new plan, because you have either changed your
plan, or you were provided a business plan application by the Department.
hm129
HAZARDOUS MATERIALS
BUSINESS PLAN
i O FORM -2
S
Forms Due By:
SECTION 1: BUSINESS IDENTIFICATION DATA,
A. FULL LEGAL BUSINESS NAME: GOLDEN EMPIRE CONCRETE CO,
B. PHYSICAL LOCATION /STREET ADDRESS: 8 211 GOSFORD ROAD
CRY: BAKERSFIELD ZIP: 93313 BUSINESS PHONE: (805 325 -6990
C. MAILING ADDRESS: P-0- BOX 12080
CRY: BAKERSFIELD ZIP: 93389
D. a HAVE YOU FILED A BUSINESS PLAN WITH THE DEPARTMENT UNDER A DIFFERENT NAME WITHIN THE
LAST TWO YEARS? YES NO • X
IF YES, UNDER WHAT NAME DID YOU FILE?
E. THIS SUBMISSION IS A NEW • X OR REVISED BUSINESS PLAN
F. DOES YOUR BUSINESS HANDLE ANY "ACUTELY HAZARDOUS MATERIALS" LISTED ON THE ENCLOSED
HANDOUT, IN ADDITION TO OTHER TYPES OF MATERIALS? YES NO
SECTION 2: EMERGENCY NOTIFICATIONS
In the event of an emergency involving the release or threatened release of a hazardous material, telephone 9 -1 -1,
and then (800) 852 -7550 or (916) 262 -1621. This will notify your local fire department and the State Office of
Emergency Services, as required by state law. Additional federal reports may be required.
PERSONS WHO SHOULD BE NOTIFIED IN CASE OF EMERGENCY AT YOUR BUSINESS THAT HAVE FULL
ACCESS AND CAN PROVIDE TECHNICAL ASSISTANCE:
NAME AND TITLE DURING BUSINESS HOURS AFTER BUSINESS HOURS
A CLINT HONE__ MANAGER Ph# 805 -833 -4495 Ph #805 -323 -1019
B. DANNY HIGHTV�OER BATCHMAN Ph# 805- 833 -4495 Ph #805- 831 -7214
- CONTINUED ON REVERSE -
(1)
SECTION 3: LOCATION OF THE MAIN UTILITY SHUTOFFS FOR THE ENTIRE BUSINESS
A. NATURAL GAS/PROPANE: NONE 4.
B. ELECTRICAL: ELECTRICAL CONTROL BUILDING BESIDE TRANSFORMER EAST EDGE
OF PARCEL
C. WATER: VALVE UNDER PRESSURE.TANK'BESIDE WELL AND STORAGE TANK ON
NORTH EDGE OF PROPERTY BESIDE DRIVEWAY
D. SPECIAL/OTHER: NONE
E. LOCK BOX: YESINO IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDS? YES) NO
FLOOR PLANS? YES / NO KEYS? YES / NO,
SECTION 4: PRIVATE RESPONSE TEAM DESCRIPTION
Do you have a group of employees trained to handle minor accidents involving hazardous materials at-your
business?
Yes No X
If so, you must explain the level of training and equipment they possess and how they are notified to respond.
SECTION 5: IDENTIFICATION OF THE CLOSEST' APPROPRIATE EMERGENCY MEDICAL ASSISTANCE
AVAILABLE TO YOUR BUSINESS
#1 SAN JOAUIN HOSPITAL
ADDRESS: 2615 EYE STREET
CITY: BAKERSFIELD
PHONE: ( 805 ) 395 -3000
COMMENTS /ADDITIONAL INFO:
#2 MERCY HOSPITAL
.2215 TRUXTUN AVE.
BAKERSFIELD`
( 805, .) 632 -5000
- CONTINUED ON NEXT PAGE -
(2)
SECTION 6: EMPLOYEE TRAINING ('... "
EMPLOYERS ARE REQUIRED BY STATE LAW TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH
INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS:
1) Methods for safe handling of the hazardous. materials used by your business;
2) The CAL OSHA Hazard Communication Standard;
3) Correct use of emergency response equipment and supplies available at your business;
4) The prevention, minimization, and cleanup procedures,you have developed for your business and explained
on the business plan forms;
5) The emergency evacuation plans you have developed, the notification procedures used to alert people to
evacuate, and the closest location to obtain appropriate emergency medical care;
6) ' Procedures 'to coordinate with and assist the local emergency personnel that may respond to your business;
7) Who and how to call for immediate assistance in the event of an accident involving, hazardous materials.
Describe the location of the written plan and the training records which. are required to be developed and
maintained. State law requires your training records be inspected.
>ti
33 S. REAL ROAD
BAKERSFIELD, CA 93309
(805) 325 - -6990 ,
- CONTINUED ON REVERSE -
(3)
SECTION 7: EXPLAIN WHAT PREVENTION, MINIMIZATION, AND CLEANUP PROCEDURES YOUR EMERGENCY
PLAN INCLUDES.. INCLUDE A. DESCRIPTION OF MONITORING METHODS AND PROCEDURES.
A. RELEASE PREVENTION:
MONTHLY SAFETY MEETINGS
B. RELEASE CONTAINMENT:
REPORT TO CENTRAL DISPATCH OF ANY ACCIDENT
C. CLEANUP:
SMALL SPILL'ABOSRBED WITH KITTY,LITTER
LARGER AMOUNTS WILL BE HANDLED BY APPROPRIATE AGENCY
SECTION 8: EXPLAIN THE NOTIFICATION METHOD AND EVACUATION PROCEDURES YOU HAVE DEVELOPED .
FOR THE EMPLOYEES TO USE IN AN EMERGENCY. YOU MUST INCLUDE A MEETING POINT.
A. AGENCY NOTIFICATION:
CALL 911-EMERGENCY
CALL CALIF STATE OFFICE OF EMERGENCY 800 - 852 -7550
CALL KERN COUNTY ENVIRONMENTAL SERVICE DEPT. 862 -8700
B. - EMPLOYEE NOTIFICATION /EVACUATION:
'CONTAINOUS BLAST ON AIR HORN
EVACUATE"TO NORTH EAST.CORNER OF PROPERTY
- CONTINUED ON NEXT PAGE -
(4)
SECTION 9: EXPLAIN WHAT PRIVATE FIRE PROTECTION SYSTEMS ARE IN PLACE THAT MAY ASSIST
EMERGENCY RESPONDERS.
4" FIRE HOSE CONNECTION ON 15,000 GAL WATER STORAGE TANK
PORTABLE FIR EXTINUUISHERS MOUNTED AT APPROPRIATE PLACES
ON STRUCTURES
SECTION 10: LIST THE LOCATION OF' ANY WATER SUPPLIES THAT MAY BE USED BY EMERGENCY
RESPONDERS.
15,000 GAL WATER "STORAGE TANK LOCATED ON NORTH EDGE OF
PROPERTY BESIDE DRIVEWAY
I, CLINT BONE , certify that the information submitted on all the
..business plan forms is accurate and complete. I understand that this information. will be used to fulfill my
obligations 'under,.California Health and Safety Code Division 20 Chapter 6.95 et seq. and Title 42 U.S.G.C.
Section 1100 seq nd false information maybe punishable byline, imprisonment, os both.
MANAGER
Z2 J/ `
Signature Title Date
(5)
Farm and Agriculture [ ] KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT
HAZARDOUS MATERIALS INVENTORY
Standard Business [Xj FORM 4
BUSINESS NAME: GOLDEN EMPIRE CONCRETE COGWNER NAME: BRENT M. DEZEMBER
LOCATION: 8 211 GO S FOR ROAD ADDRESS: P . 0 . ,BOX 12080
CITY, ZIP: BAKERSFIELD 93313 CITY, ZIP: BAKERSFIELD. 93389
PHONE#: 805 -833 -4495 PHONE#: 805- 325 =6990
STANDARD IND. CLASS CODE: 521128 NAME OF THIS FACILITY: WESTSIDE PLANT
REFER TO INSTRUCTIONS FOR PROPER CODES
DUN AND BRADSTREET NUMBER
Page 1 of
ID#
Map Grid
1
2
3
4
5
6
7
8
9
10 •
11
Trade
Trans
Code
'Type
Code
Largest
Container
Maximum
Amt
Average
Amt
Aeasure
Units
Cont
Type
Cont
Press
Cont
remp
% by
Wt
NAMES OF MIXTURE /COMPONENTS
SEE INSTRUCTIONS
Secret
Y/N
A
ri
10,000
9300
4500 =
GAL
00
1
4
PRODUCT NAME #2" DIESEL FUEL
Y
[ ] Immediate Health Location NORTH CENTRAL OF PROPERTY
Component & CAS
Component & CAS
] Fire [ ] Delayed Health CAS Number
Component & CAS
[ ] Reactivity [ ],Sudden Release of Pressure # Days on Site [ ]
r�
141
250
200
125
Gal
02
1
4
PRODUCTNAME MOBIL DELVAC 1230 MOTOR OIL
Y
[ ] Immediate Health Location EAST `OF "FUEL TANK
Component& CAS
Component & CAS
E J Fite ( ] Delayed Health CAS Number
Component &CAS
[ ] Reactivity [ ] Sudden Release of Pressure # Days on Site [ 3 6 5 J
PRODUCT NAME
[ ] Immediate Health Location
Component & CAS
Component & CAS
[ ] Fire [ J Delayed Health CAS Number
Component & CAS
[ ] Reactivity [ . ] Sudden Release of Pressure # Days on Site [ ]
EMERGENCY CONTACTS #1 CLINT BONE = MANAGER 805- 323 -1090
DANNY HIGHTOWER BATCHMAN Title 805 -8 2 p
ft'E lfl%
#2
Name Title 24 Hr Phone
Certification (Read and sign after completing all sectioni)
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all attached documents, and that based on my inquiry of
those individuals responsible for obtaining the information, I believe that the submitted information is true, accurate, and complete.
CLINT BONE, MANAGER
Name and official title of owner /operator or owner /operator's authorized representative Signature Date Signed
BUSINESS PLAN MAP
[ A SITE MAP - Form 5 [ ] AREA MAP - Form 5A
Business Name: - GOLDEN EMPIRE CONCRETE CO.
If Form 5A box is checked: Area Map # of
Name of Area:
SEE ATTACHED
N 00'42'10" E
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ENVIRONMENTAL HEALTH SER. .%ES DEPARTMENT RESOURCE MANAGEMENT AGENCY
STEVE McCALLEY, R.E.H.S., Director DAVID PRICE Ill, RMA DIRECTOR
2700 "M" STREET, SUITE 300 Community and Economic Development Department
BAKERSFIELD, CA 93301 -2370 Engineering & Survey Services Department
Voice: (661) 862 -8700 Environmental Health Services Department
Fax: (661) 862 -8701 Planning Department
TTY Relay: (800) 735 -2929 Roads Department
e -mail: eh @co.kern.ca.us
CERTIFIED UNIFIED PROGRAM AGENCY
INSPECTION REPORT
Date: 't-,41-
II Type of Inspection: EP Routine ❑ Re- inspection ❑ Complaint
Programs Inspected: Business Plan/UFC Article 80 ❑ AST
'k HW Generator ❑ UST ❑ Cal ARP
Envision Facility ID #:
Facility Name: _a
Facility Location: 4
C - Comnliant NA - Not Annlicable
Business Plan #: 0 00 L,(V?
City: Dcs', S i
I - Class I Violation II - Class 11 Violation M - Minor Violation
C
NA
Code
GENERAL REQUIREMENTS
I
II
M
COMMENTS
TRAINING
Facility has training program appropriate for size of busi-
TROI
ness and nature of hazardous materials handled (Title 19,
§2732). .
TR02
Training documentation is maintained for current personnel
(Title 19, §2732).
CONTINGENCY /EMERGENCY PLAN
Contingency plan is complete, updated and maintained on
ERO1
site (HSC 6.95, §25504, Title 19 CCR, §2731, Title 22
CCR, §66265.53 -54).
Maintains and operates facility to minimize a release of
ER02
hazardous waste to the environment which could threaten
human health (Title 22 CCR, §66265.31).
ER03
Maintains all required or appropriate equipment (Title 22
CCR, §66265.32 -.34).
BUSINESS PLAN
BPO1
Inventory of hazardous materials is complete (HSC 6.67,
t n- t
§25504, Title 19 CCR §2729).
C, L' D
BP02
Site layout/facility maps are accurate (HSC 6.67, §25504,
Title 19 CCR §2729).
ABOVE GROUND STORAGE TANKS
# of Tanks: Total Volume: bbls or gal
Product Stored: ❑ Diesel ❑ Gasoline ❑ Crude Oil ❑
ATOI I
SPCC Plan prepared as required (HSC 6.67, §25270)
Re- inspection Required: xNo ❑ Yes ❑ Business Plan/UFC ❑ HW Generator ❑ UST ❑ AST ❑ Cal ARP
CONSENT: Consent to conduct inspection, which may involve obtaining photographs, review and copying of records, and sampling
to de te compliance wit Certified Unified Program Agency requirements.
Facility kep Signature Title Inspector Signature
POST INSPECTION INSTRUCTIONS:
C Within five days of correcting all violations, sign and return
to the above Agency address, Attention: L_r�lA d'r_ i
ENVIRONMENTAL HEALTH 580 4113 2097 (8/03)
Signature (Violations have been corrected as noted) Date
HAZARDOUS WASTE GENERATOR I
�► BP #: 000 6(��
EPA ID #: _/v L-- 6M 2`Q 0 2 0
Tiered Permit: ❑ CESW ❑ CESQT ❑ CA ❑ PBR
Waste Type
Amount
Lbs /Gal
Month/Year
Oil
O'O
COMMENTS
Antifreeze
Filters
Generator has an EPA ID.number
Solvent
Slud e
Hazardous waste determination made for all wastes
❑ Analysis Or-Generator knowledge ❑ Other
r _ r—Ii —t NIA - Mm Annlir hlr
I - Clncc i Vinlntinn If - t lace If Vinlntinn M - Minnr Vinlntinn
C
NA
Code
HAZARDOUS WASTE REQUIREMENTS
I
[ELM
COMMENTS
Recordkeeping/Docu mentation
GRO1
Generator has an EPA ID.number
GR02
Hazardous waste determination made for all wastes
❑ Analysis Or-Generator knowledge ❑ Other
GR03
Facility personnel demonstrates training/awareness
GR04
Manifests/LDR complete /retained for three years
GR05
TSDF signed copy of manifest available within 35 days of
waste shipment
GR06
Bills of lading/receipts available
GR07
On -site recycling reported using Recyclable Materials Report
Container/Tank Management
GC01
Containers are in good condition
GCO2
Containers are closed except when adding/removing
GC03
Containers inspected and documented weekly
j r�
GC04
Tanks inspected'and documented daily
aki
GC05
Tanks have appropriate secondary containment
GC06
Satellite containers at or near point of generation
GC07
Satellite wastes managed as required
Accumulation Time Limits
GA01
Waste is accumulated less than 90/180/270 days
GA02
Empty containers managed within one year
GA03
Universal waste accumulated less than one year.
GA04
Used oil filters off site within 180 days (1 year if <1 ton)
GA05
Lead -acid batteries off site within 180 days (I year if <1 ton)
Labeling/Marking
GLO1
Containers are properly labeled
GL02
Excluded recyclable materials marked properly
GL03
Universal waste container properly labeled
GL04
Used oil filters marked "drained used oil filters"
G1,05
Date written on spent lead -acid batteries
GL06
"Used oil" marked on all used oil tanks /containers
GL07
Empty containers are marked properly
Treatment, Transport and Disposal
GTO1
Treatment conducted with authorization/permit
GT02
Waste sent with authorized transport (gen. eligible)
GT03
Waste disposed of to authorized point/party
POST INSPECTION INSTRUCTIONS:
C Refer to the back of this inspection report for regulatory
citations and corrective actions
o Within five days of correcting all violations, sign and return
to the Agency at: Kern Co. Environmental Health Services
Dept., 2700 "M" Street, Suite 300, Bakersfield, CA 93301,
Attention:— Fu-,LL
ENVIRONMENTAL HEALTH 580 4113 2081 (8103) PAGE 1
Signature (Violations have been corrected as noted)
Date
4a , r 1.
CODE
Description of violation [Regulatory /statutory citation) Corrective actions to be taken for minor violations (marked in the "M'column on front)
GRO1
The facility failed to obtain an EPA, ID 'number [Title 22, CCR, 66262.12].' For a'California'EPA ID #, contact the Department of Toxic Substances
Control at 1- 800 -618 -6942 or download the application form at x, ww. dtsc .ca.gov /PublicationsForms /GISS FORM 1358.ndf. For an EPA ID #, call
415- 495 -8895.
GR02
The facility failed to make a waste determination for the waste noted on the front of this form [Title 22, CCR, 66262.11]. Make a determination of the
waste based on your knowledge (you can use MSDS or other documents for help) or have the waste sampled and sent to a state - certified laboratory for
analysis.
GR03
Facility p ersonnel d id n of d emonstrate that t hey w ere f amiliar w ith p roper w aste h indling"-p rocedures. [Title 2 2, C CR, 66262.34(d)(2)]. Provide
appropriate training to personnel.
GR04
The facility failed to complete or maintain hazardous waste manifests and/or Land Disposal Restriction notifications as required [ Title 2 2, CCR,
66262.23(a)(1), 66262.34(a)(4)]. The facility shall complete and maintain manifests as required by law. The facility shall determine if its waste is
subject to LDR requirements and, ifso, ensure that a LDR is prepared and submitted with each shipment of waste.
GR05
The facility failed to file an exception report to DTSC after not receiving.the signed TSDF copy of a manifest within 35 days [Title 22, CCR,
66262.42]. Make a copy of the manifest and send it with a letter to DTSC, PO Box 400, Sacramento, CA 95812 -0400 stating what you are doing' to
find out why you have not received the fnal, signed copy of the manifest. Include a signature and your findings in the cover letter.
GR06
The facility failed to have copies of receipts for the removal of hazardous wastes [HSC 25160.2- Consolidated manifests/ 66266.8 1 (a)(6)(B)-lead acid
batteries /66266.130- oil filters]. The facility shall maintain copies of receipts for at least three years.
GR07
The facility did not submit a recycling report [HSC 25143.10] The facility shall complete and submit the form 'Recyclable Materials Report. " The form
can be found at: www.co. kern. ca. us/ eh/ pdis/ GeneratorForms /KCForm2732RecyclableMater-zls. d
GCO1
The facility failed to maintain containers holding hazardous waste in good condition [Jtle 22, CCR, 66262.34(a)(1)(A)]. The contents of the
containers noted shall immediately be transferred to a container in good condition. -`
GCO2
The facility failed to keep containers closed except when adding/removing waste [Title 22, CCR, 66262.34(a)(1)(A)]. The facility shall immediately
close all containers and ensure that containers remain closed except when adding or removing waste.
GC03
The facility could not demonstrate that containers were being inspected weekly [Title 22, CCR, 66265.15(d) and 66262.34(a)(1)(A)]. The facility shall
develop and implementla plan that ensures that.all containers holding waste are inspected weekly and the inspections are documented.
GC04
The facility could not demonstrate that Yanks were being inspected daily [Title 22, CCR, 66262.34(a)(1)(A)]. The facility shall keep a log showing that
tanks holding ivaste ar`e inspected daily.
GC05
The facility failed to provide adequate secondary containment for waste tank systems [Title 22, CCR, 66262.34((a)(1)(A). Submit 'a schedule for the
construction of or engineering assessment of a secondary containment system that meets the requirements of Section 66265.193(b jg.
GC06
Containers utilizing satellite accumulation rules were not at or near the point of generation [Title 22, CCR, 66262.34(e)(1)(A)]. The facility shall move
the satellite container to a location that is at or near the point ofgeneration.
GC07
Satellite wastes were not managed according to the regulations [Title 22, CCR, 66262.34(e)]. The facility shall ensure that the waste is handled;
labeled and /or removed as required in the regulations .The waste shall be removed within one year or within 9011801270 days of waste being added.`
GA01
The facility accumulated waste for greater than allowed time limits (Storage without a permit) [Title 22, CCR, 66262.34(a)]. The facility shall
immediately arrange for the removal of the waste, and shall submit a copy of the manifest or bill of lading to KCEHSD, demonstrating removal within
the stated time frame.
GA02
The facility failed to properly handle contaminated containers within 1 year [Title 22, CCR, 66261.7(f)]. See GA01 above for corrections.
GA03
The facility held universal wastes for greater than one year [Title 22, CCR, 66273.15(a) or 66271 35(a)]. See GA01 above for corrections.
GA04
The facility held drained used oil filters for greater than 180 days /one year [Title 22, CCR, 66.: A.130(c)(4)]. See GA01 above for corrections.
GA05
The facility held lead acid batteries for greater than 180 days /one year [Title 22, CCR, 6626 81(a)(6)]. See GA01 above for corrections.
GL01
The facility failed to properly label all containers. Containers, contents and missing information are noted on the front of this page [Title 22, CCR,
66262.34(1)]. The facility shall clearly mark all containers with the following: 1) the words 'Hazardous waste, "2) composition and physical state, 3)
hazard property, 4) name and address of the generator, and 5) accumulation start date.
GL02
The facility failed to mark tanks /container(s) of excluded recyclable materials properly [HSC 25143.9(a)]. The tanks /containers of materials `shall be
clearly marked with the words 'Excluded recyclable material "instead of 'hazardous waste. "
GL03
The facility failed to mark a container of universal waste properly [Title 22, CCR, 66273.14 for SQH or 66273.34 for LQH]. The facility shall
immediately mark all containers holding universal waste with the words 'Universal Waste - "and the appropriate contents.
GL04
The facility failed to mark a container of drained used oil filters with the words "drained used oil filters" [Title 22, CCR, 66266.130(c)(3)]. The facility
shall mark all filter containers with the words 'drained used oil filters. "
GL05
The facility failed to mark the date on which the battery was received [Title 22, CCR, 66266.81(a)(6)(r )]. The facility shall immediately mark the date
on each battery.
GL06
The facility failed to mark a tank/container of used oil destined for recycling with the words "used oil" [HSC 25143.9(a)]. Clearly mark all tanks and
containers with the words Ised oil. "
GL07
The facility failed to mark contaminated containers with the date emptied [Title 22, CCR, 66261.7(x]. Clearly mark all containers with the date
emptied.
GTO1
The facility failed to obtain a permit or other authorization for treatment of hazardous waste [HSC 25189.5(d)].
GT02
The facility failed to use a registered transporter /used a transporter or consolidated waste when they were not eligible [HSC 25165(a)/25160].
GT03
The facility disposed of hazardous waste at an unauthorized point [HSC 25189.5(a)].
ENVIRONMENTAL HEALTH 580 4113 2081 (8/03) PAGE 2
ENVIRONMENTAL HEALTH SEf :ES DEPARTMENT
STEVE McCALLEY, R.E.H.S., Director
2700 "M" STREET, SUITE 300
BAKERSFIELD, CA 93301 -2370
!Voice: (661) 862 -8700
Fax: (661) 862 -8701
TTY Relay: (800) 735 -2929
e-mail: eh®c& ern.ca.us
=SOURCE MANAGEMENT AGENCY
DAVID PRICE 111, RMA DIRECTOR
Community Development Program Department
Engineering & Survey Services Department
Environmental Health Services Department
Planning Department
Roads Department
Date: z 3 0 CERTIFIED UNIFIED PROGRAM AGENCY
Time In: INSPECTION EC'I ION IFORM IEu nlovee ID: 9Sl,
Record ID
,bona / .2 78'
Pro le
_
Svc
to
Result
_
Action
Insp Min.
Facility Violation
TRAINING
ET
❑
❑
TRO1 Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16)
❑
❑
PROGRAM/ELEMENT SERVICE CODES RESULT CODES ACTION CODES
CA00 AST CSOO UST 110 Routine Inspection 51 Inspection Refused 01 No Action/In Compliance
CB00 Business Plan 108 Follow -up Inspection 52 No Viol /Compl Achieved 03 Refer to Env Health
CG00 Generator/Tiered 53 Minor Viol. Observed 15 No Reinspection Required
CP00 C.U.P.A. 54 Major Viol. Observed
ENVISION FACILITY ID O.: jq,0003d1 1904.-.0-
FACILITY NAME: G e
FACILITY LOCATION: //
FACILITY CITY: L5Akvo
TEL. NO. (DAY): (24 HR):
TYPE OF INSP.: gRoutinc ❑ Re -insp. ❑ Complaint
INSPECTING AGENCY:
BEHSD ❑ KCFD ❑ AG ❑ WAM
PROGRAMS INSPECTED:
REINSPECTION REQUIRED: ONO ❑ YES
Business Plan E1 HW Generator ❑UST ❑AGT
❑ Business Plan ❑ HW Generator ❑ UST ❑ AGT
CONSENT: Consent to conduct inspection which may involve obtaining photographs, review and copying of records, and
ppdeet�termination of compliance with UST, AGT, ing hazardous materials /waste handling requirements.
C_TGranted ❑ Refused By (Name /Title): O S Reason (if refused):
GENERAL REQUIREMENTS
YES
NO
N/A
VIOL. #
TRAINING
ET
❑
❑
TRO1 Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16)
❑
❑
TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR 66265.16)
CONTINGENCY/EMERGENCY PLAN
A
❑
❑
ER01 Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR &
66265.53/54)
❑
❑
ER02 Facility is operated and maintained to prevent/minimize /mitigate fire, explosion, or release of hazardous
materials/waste constituents to the environment. Maintains all required or appropriate equipment including an
alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31 -.34)
BUSINESS PILAF
YES
NO
N/A
VIOL. #
❑
❑
BPOI Business plan is current & available during inspection (HSC 25503.5, Title 19 CCR 2729)
❑
❑
BP02 Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729)
❑
❑
BP03 Site layout/facility maps are accurate (HSC 25504, Title 19 CCR 2729)
ENVIRONMENTAL HEALTH 580 4113 2097 (12100)
SUMP " ` RY OF OBSERVATIONS/VIOLAT'7NS
'6y ,0661
No violations of underground tank, hazardous materials inventory, and hazardous waste laws, regulations, and requirements were
discovered. KCEHSD greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
Violations were observed /discovered as listed below. All violations must be corrected by implementing the corrective action listed
by each violation. If you disagree with any of the violations or proposed action, please inform KCEHSD in writing.
All minor violations must be corrected within 30 days or as specified. KCEHSD must be informed in writing certifying that
compliance has been achieved. A false statement that compliance has been achieved is a violation of the law and punishable by a
fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be reinspected at any time.
You may request a meeting with KCEHSD Program Manager to discuss the inspection findings and /or proposed corrective actions.
The issuance of this Summary of Violations does not preclude KCEHSD from taking administrative, civil, or criminal action as a
result of the violations noted or that have not been corrected within the time specified.
VIOLATIONS.
NO. .MINOR MAJOR CORRECTIVE ACTION REQUIRED
TRO
ERO
BPO
:GTO
•WDO
UTO
ATO
COMMENTS:
Insp. Agency
Date:
g:%azmat%cupainsp1
Rep.:
580 4113 2081 (5 -97)
i
�I
+ GOLDEN EMPIRE CONCRETE CO. __________________________ SiteID: 015 - 010 - 000668 +
Manager : RON FUSSY
Location: 8211 GOSFORD RD
City : BAKERSFIELD
BusPhone: (661) 325 -6990
Map : 123 CommHaz : UnRated
Grid: FacUnits: 1 AOV:
CommCode:
OLD RIVER AREA -STA 53
SIC Code:
EPA Numb:
DunnBrad:
+_ = = = = -y = - --
- - - - - ----------------------------------------------------
- - - - -+
Emergency
ConM�t / Title
Emergency Contact
/ Title
^GEINTo r "G
/ MANAGER
YOUNES HARRAXK
/ BATCHMAN
Business
Phone: (661) 325 -6990x
Business Phone:
(661) 833 -4495x
24 -Hour
Phone (661) 323 -1090x
24 -Hour Phone
(661) 763 -0058x
Pager Phone ( ) - x
Pager Phone
+---------------------------------------+-----------=-------------------=-
- - - - -+
Hazmat Hazards:
Fire
ImmHlth
+-------------------------------------------------------------------------
- - - - -+
Contact:
RON FUSSY
Phone:
(661) 325 -6990x
MailAddr:
P 0 BOX 12080
State:
CA
City
BAKERSFIELD
Zip :.93389
+----------------------------------=--------------------------------------
- - - - -+
BusOwner
GOLDEN EMPIRE CONCRETE CO.
Phone:
(661) 325 -6990x
Address
P O•BOX 12080
State:
CA
City
BAKERSFIELD
Zip :
93389
+-----------------------------------.-------------------------------------- - - - - -+
Period : 03/24/1998 to 03/24/1999 TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
+------------------------------------------------------------------------- - - - - -+
Agency- Defined Topic Title
-.1- 12/13/2001
i
i
+ GOLDEN EMPIRE CONCRETE CO. __________________________ SiteID: 015- 010 - 000668 +
+= Hazmat Inventory __________ _______________________________ By Facility Unit +
+_= DailyMax Order ___ _______________________________ Fixed Containers at Site +
+--------------------------------+-------+----------- +----- +---------- +--- - + - - -+
Hazmat Common Name... ISpecHazIEPA Hazards Frm I Dai-lyMax jUnitIMCPI
+--------------------------------+-------+----------- +----- +---------- +--- - + - - -+
DIESEL #2
MOBIL DELVAC 1230
F IH L .10000.00 GAL Low
L 250.00 GAL Min
/fo T,v S
-2- 12/13/2001