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PROM �^'� €FRI 3NOV 6 2009 0/--V;/3T_ P 7
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<br /> SAN JOAQUIN COUNTY HAZARDOUS MATERIALS PICOGRAM
<br /> This survey form is intended to identify businesses,which need to comply with the hazardous materials a ergency planning and
<br /> reporting requirements of Chapter 6.95 of the Califotziia 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 w1ast submit a copy of this
<br /> plan,along with annual inventory of their hazardous materials,to public agencies for use in protecting em rgency responders and
<br /> the public:. In San Joaquin County,the Office of Emergency Services(OES)has been designated to admiiister this program.
<br /> Should you have any questions on this program or this fort,please call that office at(249)468-3969.
<br /> Please consider the following guidelines when completing the questions on the front of this form.
<br /> o 'o 1:
<br /> The law c efines"hazardous material""for purposes of this program as any material that, because of its q antity,concentration,
<br /> or physiad or chemical characteristics,poses a significant present or potential hazard to human health and safety or to the
<br /> environni nt if released into the work place or the environment. This includes,but is limited to,fuels,petroleum products,paints,
<br /> propane,oxygen,ammonia,chlorine,pesticides,fertilizers,and hazardous wastes. Answer"Yes"if you u e a material that meets
<br /> that definition in any quantity at least once in the year. If you are unsure,contact our office at(209)468-3 969 for assistance. If
<br /> you answer"No"and at a later date your business,or a tenant on your property,begins handling hazardou materials,you must
<br /> inform thv Office of Emergency Services within 30 days.
<br /> ues 2:
<br /> If you answer"Yes,"you must meet the requirements of Chapter 6,95 of the California Health and Safety ode. Our office will
<br /> be contacting you to provide assistance. These requirements mast be met prior to issuance of•a certificate f occupancy.
<br /> If you answer"No,"our office may conduct"an inspection after you begin operations to verify your exemp ion.
<br /> The statues establish some modified requirements or program exemptions for certain uses of hazardous rn itcrials. If you
<br /> answered"Yes"to questions 1 and 2,determine whether your business meets one of the following conditions. Then mark the
<br /> appropriate boxes on the front of this form. Our office will contact you to snake a final determination of these exemption's.
<br /> A. ReAi 1 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 ExMption:Medical offices which use ogly oxygen and/or nitrous oxide in quantities less than 1,000 cubic fit 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 its i
<br /> the law does no 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 farrn as defined must comply'with the HMMP program for those materials associated
<br /> with the commercial business.
<br /> Que4ko-ii 3:
<br /> The Feden l and State governments have defined approximately 366 chemicals as"Acutely Hazardous Materials"(AIM). The �
<br /> most common"AHMs"used in the County include.chlorine,ammonia,sulfiiric acid,methyl bromide, acrolein,suifw dioxide,
<br /> formaldehyde,nitric acid,vinyl acetate monomer,hydrogen peroxide,and many types of pesticides, Answer"Yes"if you use
<br /> any of then.specific chemicals in any quantity at any one time of the year. Cafl our office for assistance if you are unsure.
<br /> Question
<br /> Answer"Yes"if the boundary of your property or facility will be within 1,000 feet of the boundary of a school(K tbm 12).
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<br /> F11oEMC Plenning Appllcalbn Fmm"Ne Approval.(Revised 05.11-09) Page 7 of 9
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