| 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 /> 			repotting  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   L
<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
<br />       		environment  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  use  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)  468-3969  for  assistance.     If
<br />      		you  answer  "No"  and  at  a  later  date  your  business,  or  a  tenant  on  your  property,  begins  handling  hazardous  materials,  you  must
<br />      		inform  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 />    		C.  	Farm  Exemption:   Farms,  as  defined  in  the  question,  must  meet  modified  program  requirements,     The  definition  of farm  in  the
<br />     				law  does  not  include  businesses  providing  commercial  pest  control  services,  fertilizer  application  services,  product  processing
<br />     				services,  or  packing  shed  services  for  farmers.    Farms  qualifying  for  exemption  are  still  required  to  submit  an  annual  chemical
<br />     				inventory  and  fee  to  the  County  Agricultural  Commissioner' s  Department  along  with  other  requirements.     Please  contact  the
<br />     				County  Agricultural  Commissioner's  Department  for  further  information .       Businesses  operating  a  commercial  business  in
<br />    				addition  to  a  farm  as  defined  must  comply  with  the  HMMP  program  for  those  materials  associated  with  the  commercial
<br />    				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  03-09-09)
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