SAN JOAQUIN COUNTY HAZARDOUS MATERIALS PROGRAM
<br />This survey form is intended to identify businesses, which need to comply with the hazardous materials emergency planning and
<br />reporting requirements of Chapter 6.95 of the California Health and Safety Code. This statute requires businesses, which handle
<br />hazardous materials to prepare emergency plans for their employees' use in an emergency. Businesses must submit a copy of this
<br />plan, along with annual inventory of their hazardous materials, to public agencies for use in protecting emergency responders and
<br />the public. In San Joaquin County, the Office of Emergency Services (OES) has been designated to administer this program.
<br />Should you have any questions on this program or this form, please call that office at (209) 468-3969.
<br />Please consider the following guidelines when completing the questions on the front of this form.
<br />Question 1
<br />The law defines "hazardous material" for purposes of this program as any material that, because of its quantity, concentration, or
<br />physical or chemical characteristics, poses a significant present or potential hazard to human health and safety or to the environment
<br />if released into the work place or the environment This includes, but is limited to, fuels, petroleum products, paints, propane,
<br />oxygen, ammonia, chlorine, pesticides, fertilizers, and hazardous wastes. Answer "Yes" if you use a material that meets that
<br />definition in any quantity at least once in the year. If you are unsure, contact our office at (209) 468-3969 for assistance. If you
<br />answer "No" and at a later date your business, or a tenant on your property, begins handling hazardous materials, you must inform
<br />the Office of Emergency Services within 30 days.
<br />Question 2:
<br />If you answer "Yes," you must meet the requirements of Chapter 6.95 of the California Health and Safety Code. Our office will be
<br />contacting you to provide assistance. These requirements must be met prior to issuance of a certificate of occupancy.
<br />U you answer "No," our office may conduct an inspection after you begin operations to verify your exemption.
<br />The statutes establish some modified requirements or program exemptions for certain uses of hazardous materials. If you answered
<br />"Yes" to questions 1 and 2, determine whether your business meets one of the following conditions. Then mark the appropriate
<br />boxes on the front of this form. Our office will contact you to make a final determination of these exemptions.
<br />A. Retail Exemption: Products packaged for direct distribution to the general public are exempt from the program. This
<br />exemption may not apply if 1) the quantity handled creates an unacceptable public hazard; 2) the material is being used
<br />directly by the business as part of its operations in addition to being sold to the general public; or 3) the general public does
<br />not have ready access to the product as it is stored by the business, e.g., in a warehouse.
<br />B. Medical Exemption: Medical offices which use only oxygen and/or nitrous oxide in quantities less than 1,000 cubic feet are
<br />required to meet modified requirements.
<br />C. Farm Exemption: Farms, as defined in the question, must meet modified program requirements. The definition of farm in
<br />the law does not include businesses providing commercial pest control services, fertilizer application services, product
<br />processing services, or packing shed services for farmers. Farms qualifying for exemption are still required to submit an
<br />annual chemical inventory and fee to the County Agricultural Commissioner's Department along with other requirements.
<br />Please contact the County Agricultural Commissioner's Department for further information. Businesses operating a
<br />commercial business in addition to a farm as defined must comply with the HMMP program for those materials associated
<br />with the commercial business.
<br />Question 3
<br />The Federal and State governments have defined approximately 366 chemicals as "Acutely Hazardous Materials" (AHM). The
<br />most common "AHMs" used in the County include chlorine, ammonia, sulfuric acid, methyl bromide, acrolein, sulfur dioxide,
<br />formaldehyde, nitric acid, vinyl acetate monomer, hydrogen peroxide, and many types of pesticides. Answer "Yes" if you use any
<br />of these specific chemicals in any quantity at any one time of the year. Call our office for assistance if you are unsure.
<br />Question 4:
<br />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).
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<br />Hazardous Materials Disclosure Survey (Revised 8-25-03)
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