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JAN-02-2002 1322 801 334 4774 P.06/OG RECEIVED JAN 0 2 2002 J�SEyIGEg cAN dOAgUfN COUNTY HAZARDOUS MATERIALS PROGRAMCEOF This surrey form is intended to identify businesses which nccd to comply with the hazardous materials eaxrCency olanrYax and rcpvrtiag requirements of C2rapter 6.96 of tic Califon uit Ifealth and Safety Cods_ This slatuta rcaurRs businesses which handle t hazardous materials to prepare cmttgency plans rot their etnpioyres'use in an emergency. Businesses must subunit a copy of this pian,along with an annual irventory of their hrlip"ous materials,to public safety agencies for use in protecting emergency responders and the public.In San Joaquin County.the Office of Emergency Services(OES)has been designated to administer .Usprogram. Should you have any questions on ibis program or this forth,please call that office at(209)469.3769. Please consider the following guidelines when completing the questions on the front of this form. QLGSIml; The law defines naaardous Matmal"for purposes of this program as any material that,because of its quantity, concentration,or physical or chemical characteristics,pasei a significant present or potential hazard to human health And safety or to the cnvirowncnt if rdtas^_d into the work place or the environment. This includes,but is not limited to fuels,petroleum products,pits,propane,oxygen,ammormia,chlorine,pesticides.frrtilizers,and hazardous wastes. Answer"Yes`if you use a material that meets that definition in any quantity at least once in the year. If you arc unsure,contact our office at(2U9)alio- 3969 fur assistance. if you answer"No"and at a later date your business.or a tenant on your property,begins handling hazardous meteria6,you must inform the Office of Emcigcncy Services within 30 days. If you answer"Yes",you must meet the mquircmcros of Chapter 6.95 of the California Health and Safety Code. Our office will be contacting you to provide assistance_ Thseerequirements must be met prior m issuance of a certificate of occupancy. If you answer"No",our office may conduct an inspection after you begin operations to verify your ezcmption. The suamms establish some modified requirements or program exemptions for certain uses of hazardous materialsif you answered"Yes"to questions l and 2,determine whether your business meets One of die following conditions. Illicit mark the appropriate boxes on the front Of this form. Our office will tvuta,:r you to make a final determination of There exemptions. A, ej�u-products packaged for direct distribution to the Central public we exempt from the zedProgram- handled handled creates an unacceptable public ha ,2)the material is This exemption may not apply if 1)the being used directly by the Nosiness as pari of its operations in addition to being sold to the general public,or 3)the general public does not lave ready access to the product as it is stored by the business,t.c..in a wambouse. D. anal:,- LgMWotion-Medical offices which use 2&oxygen andlor nitrous oxide in quantities less than 1,000 cubic fat are required m tracer modified requarciltents. _ C. _FNMLh&V2pLQp-Ferns,as defined in the question,must meet modified prupam requirements. The definition of farm in the taw AggLitol'vclade 6 si es s p priding commercial pest control services,fertilizer application services,protiva ptxessing services,w packing shed services for famrers. Farms qualifying for fie exemption aro still required in submit an annual chemical inventory and fee to the County Agricultural Cormhissioncr s Depinumm along with other requirements. please contact the County Agricultural Commissioner's Department for(other infaraation.Businneei operatinga commercial business in addition to a farm as def fined must comply with the HMMP program for those materials associated with the commercial business. tion : Rte Federal and Stafc governments have defined approximately 3566 chemicals as"Acutely Hazardous Materials"(AMM). The most common"AHMs-used in the County include chlorine,ammonia.sulfuric mid,methyl bromide,acrolein.adlttu dioxide, Formaldehyde,nitric acid,vinyl acetate moaner,hydrogen peroxide,and many types of pesticides. Answer"Yea"if you use any of these specific chemicals in any quantity at any one time of the Year. Call our Office if YOU are unsure for uldstaoce- Qtt651104¢: Answer"Yes'if the boundary of your property or facllity,will be within 1,000 feet of the boundary of a school(K tfuu 12). TOTAL P.06