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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 /> 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
<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).
<br /> FADevsystPlanning Application Forms Page 2 of 2
<br /> Hazardous Materials Disclosure Survey (Revised 03-09-09)
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