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MATERIAL PROGRAM OUS emergency planning SAN dOAQW4 COUNT`f HAZARD vires businesses, which need to comply with tCoae? This h s statutetrequires Businesses must businesses, to ees' use in an emergency rotecting to public agencies for use in P This survey form is intended f identify lans for their amp Y OEs)has been re uirements of Chapter 6.95 of the California Health and safety and reporting q re are emergency p Emergency Services ( lease call that office Ian, along with annual inventory of their hazer Office of Ermerg which handle hazardous materials top p an vin County, ro ram or this form,p submit a copy onders and the public. tShould you have any questions on this p 9 emergency resp ram. designated to administer this pro9 at(209)468-3969. completing the questions on the front of this form• Please consider the following guidelines when comp Queue as any material that, because of its quantity, oses a significant present or potential hazard to human health and The law defines"hazardous material" for purposes of this program sbut is limited to,fuels, concentration, or physical or chemical characteristics, p lace or the environment. This includes, oxygen, ammonia, chlorine, pesticides,fertilizers, and he wastes. Answer safety or to the environment if released into the work p petroleum products, paints, propane, uanti at least once iWthe year. If you are unsure,contact our "Yes" if you use a material that meets that definition in any quat a later date antity office at(209 468-3969 hazardous as materials,you mousy inform he Office of Emergency Services within r30tdayst on your proper y, begins handling Question 2: the rnia Health and if I u answer"Yes," yu must meet contacting you oo provide assthe regUirements These of Chapter 6.95 must bof e met prior to issuance o Sa certificate Of afety Code. Our office occupancy. If you answer"No," our office may conduct an inspection after you begin operations to verify your exemption. The statutes establish some modified requirements or program exemptions for certain uses of hazardous materials. If YOU answered "Yes"to questions 1 and 2, determine whether your business meets one of the following conditions. Then mark the appropriate boxes on the front of this form. Our office will contact you to make a final determination of these exemptions. A. Retail Exemption: Products packaged for direct distribution to the general public are exempt from the program. This exemption may not apply if 1)the quantity handled creates an unacceptable public hazard; 2)the material is being used directly by the business as part of its operations in addition to being sold to the general public; or 3) the general public does not have ready access to the product as it is stored by the business, e.g.,in a warehouse. B. Medical Exemption: Medical offices which use only oxygen and/or nitrous oxide in quantities less than 1,000 cubic feet are required to meet modified requirements. C. Farm Exemption: Farms, as defined in the question, must meet modified program requirements. The definition of farm in the law does not include businesses providing commercial pest control services, fertilizer application services, product processing services, or packing shed services for farmers. Farms qualifying for exemption are still required to submit an annual chemical inventory and fee to the County Agricultural Commissioner's Department along with other requirements. Please contact the County Agricultural Commissioner's Department for further information. Businesses operating a commercial business in addition to a farm as defined must comply with the HMMP program for those materials associated with the commercial business. Question 3: The Federal and State governments have defined approximately 366 chemicals as "Acutely Hazardous Materials"(AHM). The most common "AHMs"used in the County include chlorine, ammonia, sulfuric acid, methyl bromide,acrolein, sulfur dioxide, formaldehyde, nitric acid, vinyl acetate monomer, hydrogen peroxide, and many types of pesticides. Answer"Yes" if you use any of these specific chemicals in any quantity at any one time of the year. Call our office for assistance if you are unsure. Question 4: Answer"Yes"if the boundary of your property or facility will be within 1,000 feet of the boundary of a school (K thru 12). F:\DevSvOPlanning Application Foms\Business License(Revised 12-31-02) Page 6 of B