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SAN JOAQUIN COUNTY HAZARDOUS MATERIALS PROGRAM This survey form is intended to Identify businesses,which need to and reporting requirements with the huzerdoua materials emergency planning ment of Chapter 6.95 of the California Health and Safety Code. This statute requires businesses,which handle hazardous materials to prepare emergency plans for their employees'use In an emergency. Businesses must submit a COPY of this plan, along with annual Inventory of their hazardous materials,to public agencies for use In protecting emergoncy responders and the public. In San Joaquin County,the Office of Emergency Services(OES) has been designated to administer this program. Should you have any questions on this program or this form, Please call that office at(209)468- 969. Pleaso consider the following guidelines when completing the questions on the front of this form. ueslion 1: The few defines'hazardous material,,for purposconcentration, ores of this program ars any malarial Leat,because of Its quantity, safety or to the environment If released Into the worsitrkk plop or the environment. This ncludes,but Is limited to,fuels, petroleum products, paints, propene,oxxyy Present or potential hazard to human health and material that meals that definitloo to e�monle,chlorine,pesticides,/ertlllzee,and hezairdoua wastes. Answer'Yes'If you use a haze for esalalance. If ycu answer`Na end altle atteer date yout once lr the or a tenant on your property,our office at(209)469- hazardous materials,you must Inform the Office o/Emergency Services within 30 days. begins handling Question 2: If you answer'Yes,.you must meet the requirements of Chapter 6.95 of the California Health and Safety Code. Our office will be contacting you to provide assistance. These requirements must be met prior to Issuance of a certificate of 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 Ino following condilions. Then mark the appropriate boxes on the front of this form. Our office will contact you to make a (Incl determination of Inose exemptions. A. 80 ail C—�xOmullW^; products packaged for direct distribution to the general public are exempt from the Program. This exemption may not apply If 1)the queni ty handled creates an unacceptable public hazard. 2) the material Is being used directly by the business as part of its Opera tions 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 Etiom Medical offices which usenl cubic feel are required to meet modified requirements gen and/or nitrous oxide in quantities less than 1,000 C. Farm Edon.Farms, as defined In the question,must meet modified program requirements. The definition Of farm In the law applicalion services,product pro irLaWng clservices,or packinngde businessesldinshed eery lal ceac orf arrmeors.IrFaservces. fertilizer rms qualifying or exemption are still required to submit an annual chemlcal Inventory and fee to the County Agricultural Commissioners Department along with other requirements. Please contact the County Agricultural Commissioners Department for further Information. Businesses operating a commercial business In addition to farm as defined must comply with the HMMP program for those materials associated with the commerclal busfross. The Question 3: deral most oommonnAHMae goad n governments eventy include chlorine,approximSIMMONS,ately chefuric S u'AduLdy Hazardous Materiahi self r dioxide,The formaldehyde, nitro acid,vinyl acetate monomer, hydrogen any of these specific chemicals In on ulNrte ayatl,methyl bromide,aarototn sulfur dbxldo, y quantity at any one Ilene of the year Call ouP officees Of pfor iassistancnewer-Yes-e If you are of you use Question 4: cides A Answer*Yes*if the boundary of your property or facility will be within 1,000 feat of the boundary of a school(K thru 12), 1)