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SAN JOAQUIN COUNTY RAZAR]DOUS 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 /> If 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 /> co 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 /> uestion 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) . <br /> F:\Devsys\Planning Application Forms Page 2 of 2 <br /> Hazardous Materials Disclosure Survey ( Revised 8-25-03) <br />