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f <br /> '= SAN JOAQUIN COUNTY HAZARDOUS M <br /> " ATERIALS PROGRAM <br /> This:survey form is intended to,identify businesses,which need to comply with the hazardous materials emergency planning <br /> and reporting.requiremenis of Chapter fi:95 of the Califorp1a Health and Safety Code: 'his statute requires businesses, <br /> which handle hazardous materials to prepare emergency plans for their;employees use rn an emei gency:- Busiriesses:must, <br /> submit a copy df this plan along with annual inventory of their hazarcio is materials,to publie agencies:.for;use ire prot6ding <br /> emergency responders and#tie public In--San Joaquin County :the{Office of Emergency Services:(OES).tias been <br /> designated to administer thprogram Should you have;any questions;on this program or this fiorm,please callthat office at <br /> (209)468-3969. <br /> P,iease:considef 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; <br /> concentration,or physical or rttemical ch1.aracten5tics, poses a=significant present or potential hazard to human ltiealtFr and <br /> safety or to the:'enviror rrierit.if released into;the work ptace or tete environment. This includes, but�is limited to; fuels. . <br /> petroleum products;:paints;'propanej'.oxygen ammonia,chlorine; pesticides,fertilizers,.and hazardous wastes, Answer <br /> "Yee <br /> .' _ <br /> Yes if you use:a material that meets that,definition in any.quantity of.least once in the year: If you are unsure, contacf.our <br /> office at(209)'46&3969 for assistance. _lf you.ansWer.�'N6 and ata later date you" business; <br /> ,or a tenant on your property, <br /> begins handling hazardous.materials; you must inform the Office of'Eme(gency Services within 30 days,- <br /> uestion 2: . . <br /> If.you answer"Yes," eq p <br /> Y , you must meet the requirements of Cha ter 6.95 of the California Health and Safe Code, Our office <br /> will be contacting you to provide assistance. These requirements must be met priorto 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 /> I The statutes establish some modified requirements or program exemptionsfor.certain uses of hazardous materials. If you <br /> answered"Yes"to questions i and 2,determine whether your business meets one of the following conditions_ Then mark <br /> the appropriate 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 <br /> used directly by the business as part of its operations in addition to being sold to the general public;or 3)the general <br /> public does 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 9MI oxygen and/or nitrous oxide in quantities less than 1,040 cubic <br /> feet are required to meet modified requirements. <br /> i <br /> C. Farm Exemption: Farms, as defined in the question, must meet modified-program requirements. The definition of <br /> farm in the law does not include businesses providing commercial pest control services,fertilizer application services, <br /> product processing services, or packing shed services for farmers. Farms qualifying for exemption are still required <br /> to submit an annual chemical inventory and fee to the County Agricultural Commissioner's Department along with <br /> other requirements. Please contact the County Agricultural Commissioner's Department for further information. <br /> Businesses operating a commercial business in addition to a farm as defined must'comply with the HMMP program <br /> for those materials associated with the commercial business. <br /> Question 3:: <br /> The Federal and State governments have defined approximately 366 chemicals as"Acutely Hazardous Materials"(AHM). <br /> The most common"AHMs"used in the County include chlorine, ammonia,sulfuric acid, methyl bromide, acrolein, sulfur <br /> dioxide, formaldehyde,nitric acid, vinyl acetate monomer, hydrogen peroxide,and many types of pesticides. Answer"Yes"if <br /> you use any of these specific chemicals in any quantity at any one time of the year. Call our office for assistance if you are <br /> unsure. <br /> Question 4: `' 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:0EVSVCWLanning Application Forms%Use Permit(Revised 1-2-03) Page 7 of 9 4 <br />