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;AN JOAQUIN COUNTY HAZARDOUS MATERIALS PROGRAM
<br /> Chis survey form is intended to identify businesses,which need to comply with the hazardous materials emergency Planning and
<br /> epong requirements of Chapter 6.95 of the California Health and Safety Code. This statute requires businesses,which handle
<br /> are emergency plans for their employees' use in an emergency. Businesses must submit a copy of this
<br /> iazardous materials to prep
<br /> ous materials,to public agencies for use in protecting emergency responders and
<br /> plant,along with atmua]inventory of their hazard Services(OES)has been designated to administer this program•
<br /> the public. In San Joaquin County'the Office of Emergency 468-3969.
<br /> Should you have any questions on this program or this form,please call that office at(209)
<br /> please consider the following guidelines when completing the questions on the front of this form
<br /> estion 1:
<br /> as any material that;because of its quantity,concentration,
<br /> to human health and safety or to the
<br /> The law defines"hazardous material"for purposes of this program limited roducts, ts,
<br /> or physical or chemical characteristics,poses a significant present or potential hazard
<br /> environment if released into the work place or the environment.�do�W teses t tAnswerYes,if you a material that meets
<br /> propane oxygen,ammonia,chlorine,pesticides,fertilizers, 468-3969 for assistance. If
<br /> quantity at least once in the Year. to You are unsure,cert,,begins
<br /> ei handling hazardous materials,you must
<br /> that definition in any
<br /> you answer"No" and at a later dateyou your im�es30O tenant on your property,
<br /> inform the Office of Emergency
<br /> Question 2: Code, Our office will
<br /> t be at prior to issuance of a certificate of occupancy.
<br /> If you answer"Yes,"You must meet the requirements of Chapter the California Health and Safety
<br /> be contacting you to provide assistance. These requirements must be me
<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
<br /> conditions. Then mark the
<br /> u to make a final determination of these exemptions.
<br /> answered"Yes"to questions 1 and 2,determine whether your business meets one of the following
<br /> appropriate boxes on the front of this form. Our office will contact you exempt from the pe exemptions
<br /> This
<br /> A. u railrail E_—tee "�ti�n' products packaged for direct distribution to the general public are hazard;
<br /> if 1 the quantity handled creates an unacceptable public hazard;2)the material is being used
<br /> exemption may not apply )
<br /> public;or 3)the general public does
<br /> directly by the business as part of its operations in addition to being sold to the general
<br /> not have ready access to the product as it is stored by the business,e.g.,in a warehouse.
<br /> B Medical tion:Medical offices which use onl oxygen and/or nitrous oxide in quantities less than 1,000 cubic feet are
<br /> required to meet modified requirements. requirements
<br /> The definition of farm in
<br /> Farm Exertion: Farms, as defined in the question,must meet modified program q product
<br /> C. , commercial pest control services,fertilizer application services,prod
<br /> the law does not include businesses providing for exemption are still required to subrmre
<br /> processing services,or
<br /> packing shed services for farmers, Farms qualifying Department along with other req
<br /> annual chemical inventory and fee to the County Agricultural Commissioner's
<br /> Please contact the County Agricultural Commissioner's Department for' information. foruthosesmaterial associated
<br /> commercial business in addition to a farm as defined must comply with the HMW program
<br /> with the commercial business.
<br /> Question 3:
<br /> acrolein,sulfur dioxide,
<br /> The Federal and State governments have defined approximately 366 chemicals as"Acutely Hazardous Materials" e
<br /> sulfuric acid,methyl bromide,aide,and many types of pesticides. Answer"Yes" if you use
<br /> formaldehyde,nitric acid,vinyl acetate monomer,hydrogen
<br /> most common"ARMs"used in the County include chlorine,ammonia,p�
<br /> any 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: of a school(K thru 12).
<br /> Answer"Yes"if the boundary of Your property or facility will be within 1,000 feet of the boundary
<br /> ,nEvsVCTianning Applicabon FOrmW"pe kt(RwAsed 02-03.10) Page 7 of 9
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