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HomeMy WebLinkAboutHAZ-BUSINESS PLAN 2/25/2011YRC Worldwide Inc- 10990 Roe Avenue Overland Park, KS 66211 -1213 Phone 913 696 6100 yrcw.com February 25, 2011 Bakersfield Fire Department Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 RE: Hazardous Materials Management Plan Certification 2010 YRC, Inc. (822) 4901 Lisa Marie Court Bakersfield, CA 93313 ia. The completed Hazardous Materials Business Plan including the Business Activities, Business Own/Operator Identification, Consolidated Contingency Plan, Site and Facility Maps, Hazardous Materials Inventory, and USTFacility Forms are enclosed for the YRC, Inc. location referenced above. There have been no operational changes or chemical inventory changes at this facility in 2010. This facility stores and uses four hazardous substances: Diesel, Motor Oil, Antifreeze, and Propane. Through careful study and audit, YRC, Inc. has determined that there are no extremely hazardous substances (EHS) present and are not required to report for releases of toxic chemicals required by §313 of SARA, Title III. YRC North American Transportation, Inc., (YRCNAT) is reporting on behalf of YRC, Inc. Should you have questions or need further information please contact me at YRCNAT Environmental Services Department at (913)- 344 -3644 or via e-mail at Ruben.Byerley@yrcw.com. Thank you. Ruben D. Byerley- Environmental Services Supervisor Enclosures- cc: Antonio Mensurado, 822 Bakersfield Fire Department HAZARDOUS MATERIAL MANAGEMENT PLAN BUSINESS ACTIVITIES PAGE HAZARDOUS MATERIAL FACILITY INFORMATION) RR AMTN T BAKERSFIELD FIRE DEPARTMENT Prevention Services 1501 Truxtun Avenue Bakersfield, CA 93301 Phone: 661-326-3979 Fax: 661-852-2171 I. FACILITY IDENTIFICATION FACILITY ID # (for office use only) 3 EPA ID # BUSINESS NAME (FACILITY NAME or DBA) 103 YRC, INC. (822) II. ACTIVITIES DECLARATION DOES Your Facility... If Yes, Please Complete... 129 A. HAZARDOUS MATERIAL XYes No CHEMICAL DESCRIPTION FORM 130 1. Have on site (for any purpose) hazardous material HAZARDOUS MATERIAL MANAGEMENT PLAN at or above 55 gallons for liquids, 500 pounds for Minimum required planning elements: solids, or 200 cu. ft. for compressed gases (include Emergency Response Plan liquids in AST and UST)? Maps Training Prevention Certification B. REGULATED SUBSTANCES (RS) Yes KNo CHEMICAL DESCRIPTION FORM 131 1. Have on site RS at greater than the threshold RISK MANAGEMENT PLAN (RMP Submit to USEPA) planning quantities established by the California CONSOLIDATED COMPLIANCE PLAN Accidental Release Prevention program (CaIARP)? Incorporating CaIARP Program Elements C. UNDERGROUND STORAGE TANKS (UST) IRYes No UST FACILITY FORM 132 1. Own or operate Underground Storage Tanks? UST TANK FORM (one per tank) Yes XNo UST FACILITY FORM 1332. Intend to upgrade existing or Install new UST? pg 9 UST TANK FORM (one per tank) UST INSTALLATION FORM (one per tank) D. TANK CLOSURE /REMOVAL Yes D[No UST TANK FORM (Closure section - one per tank) 1. Need to report closing an UST that held hazardous material or waste? 2. Need to report the closure /removal of a tank that Yes DENo UST TANK CLOSURE FORM was classified as hazardous waste and cleaned onsite? E. ABOVEGROUND PETROLEUM STORAGE TANKS Yes §t No HAZARDOUS MATERIAL MANAGEMENT PLAN AST) Incorporating Federal Spill Prevention Control and Countermeasure 1. Own or operate AST above these thresholds; any SPCC) Elements pursuant to 40 CFR Part 112. tank capacity Is greater than 660 gallons or the total capacity for the facility Is greater than 1,320 gallons? F. HAZARDOUS WASTE EPA ID NUMBER - provide on this page 1. Generate hazardous waste? Yes XNo To obtain EPA ID Number, please phone (916) 324 -1781 2. Recycle more than 100 kg /mo of recyclable Yes XNo RECYCLING FORM material at the same location It was generated? 3. Recycle more than 100 kg /mo of recyclable Yes 2fl No RECYCLING FORM material at an off -site location different from the point of generation? 4. Treat Hazardous Waste on site? Yes KNo TP FACILITY FORM TP UNIT FORM (one per unit) 5. Subject to Financial Assurance requirements? Yes X No CERTIFICATION OF FINANCIAL ASSURANCE 6. Consolidate Hazardous Waste generated at a Yes X No REMOTE WASTE /CONSOLIDATION SITE NOTIFICATION remote site? FORM NOTE: If you checked YES to any part of Sections IIA — IIF above, then in addition to the forms requested above, please submit BUSINESS OWNER /OPERATOR IDENTIFICATION FORM. FD2143(Rev 01 /08) HAZARDOUS MATERIAL MANAGEMENT PLAN APPLICATION BUSINESS OWNER/OPERATOR IDENTIFICATION FORM HAZARDOUS MATERIAL FACILITY INFORMATION) BAKERSFIELD FIRE DEPARTMENT 8 B R s F 1 R "L D Prevention Services 4r, FIRE 1501 Truxtun Avenue, 1' Floor ARrN T Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 Page 1 of 2 FD2142 (Rev 01/08) I. FACILITY IDENTIFICATION FACILITY ID N 1 YEAR BEGINNING 100 1/1 /2010 YEAR ENDING 12/31/2010 101 BUSINESS NAME (Same as FACILITY NAME or DBA) 3 BUSINESS PHONE 102 YRC, INC. (822) 661- 833 -1895 SITE ADDRESS 103 4901 LISA MARIE COURT CITY $AF'15R- SFI6l_D 104 ZIP CODE 93313 105 CA DUNN & BRADSTREET A 00- 699 -8397 106 SIC CODE 4213 107 COUNTY 108 KERN OPERATOR NAME 109 OPERATOR PHONE 110 YRC, INC. (822) 913 - 344 -3644 II. OWNER INFORMATION OWNER NAME YRC, INC. (822) 111 OWNER PHONE 913- 344 -3644 112 OWNER MAILING ADDRESS 113 10990 ROE AVENUE MS A605 ATTN: ENV SERVICES CITY OVERLAND PARK 114 STATE 115 KS ZIP CODE 666211 -121 III. ENVIRONMENTAL CONTACT CONTACT NAME RUBEN D. BYERLEY 117 CONTACT PHONE 913-344-3644 118 CONTACT MAILING ADDRESS 10990 ROE AVENUE MS A6 0 5 ATTN : ENV SERVICES 119 T1CITYOVERLANDPARK 120 STATE 121 KS 1 ZIP CODE 122 66211 -1213 IV. EMERGENCY CONTACTS PRIMARY SECONDARY NAMEANTONIO MENSURADO 123 NAME RYAN SUTTERFIELD 128 TITLE TERMINAL MANAGER 124 TITLE SUPERVISOR 129 BUSINESS PHONE 661- 833 -1895 X3 125 BUSINESS PHONE 661- 833 -1895 X5 130 24 -HOUR PHONE 661- 978 -0026 126 24 -HOUR PHONE 661 - 343 -0792 131 CELL PHONE 127 CELL PHONE 132 133 V. CERTIFICATION Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted in this inventory and believe the Information is true, accurate, and complete. SIGNATURE OF DOCUMENT PREPARER 136 DATE 134 NAME OF DOCUMENT PREPARER(PRINT) 135 mac u,`q 2/22/2 010 DIANA THUNEN NAME OF O OPERATOR IGN &PRINT) 137 TITLE OF DOCUMENT PREPARE0. 138 RUBEN D.BYERLEY ENV. SCIENTIST FD2142 (Rev 01/08) HAZARDOUS MATERIAL MANAGEMENT PLAN CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIAL INVENTORY NEW ADD DELETE X REVISE 200 B A HiRtSFIBLID FlRjr ) O ARTM T BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 2 One form per material, per building, or area.) I. FACILITY INFORMATION BUSINESS NAME (FACILITY NAME or DBA) 3 YRC, INC. (822) CHEMICAL LOCATION 201 CHEMICAL LOCATION 202 INSIDE SHOP CONFIDENTIAL (EPCRA) Yes ?S No FACILITY ID # 1 MAP # (optional) 203 GRID # (optional) 204 SITE MAP F2 II. CHEMICAL INFORMATION CHEMICAL NAME 205 206 ETHYLENE GLYCOL TRADE SECRET Yes X No If subject to EPCRA, refer to Instructions COMMON NAME 207 EHS• Yes 175. No ANTIFREEZE If EMS Is yes, all amounts below 208 must be inCAS # 209 107-21-1 pounds. FIRE CODE HAZARD CLASSES (complete If requested by local fire chief) 210 TYPE 211 RADIOACTIVE: Yes No 212 CURIES 213 PURE X MIXTURE WASTE LARGEST CONTAINER 215 PHYSICAL STATE SOLID X LIQUID GAS 214 55 216 FED HAZARD CATEGORIES X FIRE REACTIVE PRESSURE RELEASE X ACUTE HEALTH X CHRONIC HEALTH Check all that apply) ANNUAL WASTE 217 218 AVERAGE 219 STATE WASTE 220 AMOUNT DAILY1AMOUNT 110 DAILY AMOUNT 80 CODE 221 DAYS ON SITE 222 UNITS X GAL CU FT 11 LBS TONS 365IfEMS, amount must be In Its. STORAGE CONTAINER: 223 ABOVEGROUND TANK CAN BOX TANK WAGON UNDERGROUND TANK CARBOY CYLINDER RAILCAR TANK INSIDE BUILDING SILO GLASS BOTTLE OTHER X STEEL DRUM FIBER DRUM PLASTIC BOTTLE TOTE BIN PLASTIC /NONMETALLIC DRUM BAG STORAGE PRESSURE: AMBIENT ABOVE AMBIENT BELOW AMBIENT 224 225 STORAGE TEMPERATURE:X AMBIENT ABOVE AMBIENT BELOW AMBIENT CRYOGENIC WT HAZARDOUS COMPONENT EHS CAS # 1 95 226 ETHYLENE GLYCOL 227 Yes 70 No 228 107-21-1 229 2 5 230 DIETHYLENE GLYCOL 231 Yes XNO 232 111 -46 -6 233 3 234 235 Yes No 236 237 4 238 239 Yes No 240 241 5 242 243 Yes No 244 245 III. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 RUBEN BYERLEY, ENVIRONMENTAL SERVICES SUPERVISOR ZS— FD2144(Rev 08/07) HAZARDOUS MATERIAL MANAGEMENT PLAN CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIAL INVENTORY NEW ADD DELETE X REVISE 200 B B A P I D FIRE ARTM r BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661-326-3979 • Fax: 661-852-2171 Page 1 of 2 One form per material, per bulldlnq, or area.) I. FACILITY INFORMATION BUSINESS NAME (FACILITY NAME or DBA) 3 YRC, INC. (822) CHEMICAL LOCATION 201 CHEMICAL LOCATION 202 PROPANE TANK RACK CONFIDENTIAL (EPCRA) Yes X No FACILITY ID # 1 MAP # (optional) 203 GRID # (optional) 204 SITE MAP E3/4 II. CHEMICAL INFORMATION CHEMICAL NAME 205 206 LIQUIFIED PROPANE GAS TRADE SECRET Yes X No If subject to EPCRA, refer to Instructions COMMON NAME 202 EHS* Yes IX NoPROPANE If EHS Is yes, all amounts below zoe must be inCAS # 209 74-98-6 pounds. FIRE CODE HAZARD CLASSES (complete if requested by local fire chief) 210 TYPE 211 RADIOACTIVE: Yes X No 212 CURIES 213 PURE MIXTURE WASTE LARGEST CONTAINER 215 PHYSICAL STATE SOLID LIQUID X GAS 214 7.9 216 FED HAZARD CATEGORIES X FIRE REACTIVE X PRESSURE RELEASE X ACUTE HEALTH CHRONIC HEALTH Check all that apply) ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 220 AMOUNT DAILAMOUNT 189.61 DAILY AMOUNT 47.4 CODE 221 DAYS ON SITE 222 UNITS X GAL CU FT LES TONS 365IfEHS, amount must be in lbs. STORAGE CONTAINER: 223 ABOVEGROUND TANK CAN BOX TANK WAGON UNDERGROUND TANK CARBOY X CYLINDER RAIL CAR TANK INSIDE BUILDING SILO GLASS BOTTLE OTHER STEEL DRUM FIBER DRUM PLASTIC BOTTLE TOTE BIN PLASTIC /NONMETALLIC DRUM BAG STORAGE PRESSURE: X AMBIENT ABOVE AMBIENT BELOW AMBIENT 224 225 STORAGE TEMPERATURE: X AMBIENT ABOVE AMBIENT BELOW AMBIENT CRYOGENIC WT HAZARDOUS COMPONENT EHS CAS # 1 100 226 LIQUIFIED PETROLEUM GAS 227 Yes XI No 228 74 -98 -6 229 2 230 231 Yes NO 232 233 3 234 235 Yes No 236 237 4 238 239 Yes NO 240 241 5 242 243 Yes No 244 245 III. SIGNATURE PRINT NAME 8. TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIG TURE DATE 246 RUBEN BYERLEY, ENVIRONMENTAL SERVICES SUPERVISOR j 21 / jI V — O Q FD2144(Rev 08/07) HAZARDOUS MATERIAL MANAGEMENT PLAN CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIAL INVENTORY NEW ADD DELETE X REVISE 200 B B R S 'I R7 D P/Ri Aim r BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 Page 1 of 2 One form per material, per building, or area.) I. FACILITY INFORMATION BUSINESS NAME (FACILITY NAME or DBA) 3 YRC, INC. (822) CHEMICAL LOCATION 201 CHEMICAL LOCATION 202 UNDER FUEL ISLAND CONFIDENTIAL (EPCRA) Yes X No FACILITY ID # 1 MAP # (optional) 203 GRID # (optional) 204 SITE MAP F2 II. CHEMICAL. INFORMATION CHEMICAL NAME 205 206 2 DIESEL FUEL TRADE SECRET Yes X No If subject to EPCRA, refer to instructions COMMON NAME 207 EHS* Yes X. NoDIESELFUEL208 If EHS Is yes, all amounts below must be InCAS # 209 68476 -34 -6 pounds. FIRE CODE HAZARD CLASSES (complete if requested by local fire chief) 210 TYPE 211 RADIOACTIVE: Yesk 212 No CURIES 213 PURE G MIXTURE WASTE LARGEST CONTAINER 215 PHYSICAL STATE SOLID (X. LIQUID GAS 214 12,000 216 FED HAZARD CATEGORIES X FIRE REACTIVE PRESSURE RELEASE X ACUTE HEALTH X CHRONIC HEALTH Check all that apply) ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 220 AMOUNT DAILY AMOUNT 11,500 DAILY AMOUNT 500 CODE 221 DAYS ON SITE 222 UNITS X GAL CU FT LBS TONS 365IfEHS, amount must be In lbs. STORAGE CONTAINER: 223 ABOVEGROUND TANK CAN BOX TANK WAGON X UNDERGROUND TANK CARBOY CYLINDER RAILCAR TANK INSIDE BUILDING SILO GLASS BOTTLE OTHER STEEL DRUM FIBER DRUM PLASTIC BOTTLE TOTE BIN PLASTIC /NONMETALLIC DRUM BAG STORAGE PRESSURE: X AMBIENT ABOVE AMBIENT BELOW AMBIENT zza 225 STORAGE TEMPERATURE: X AMBIENT ABOVE AMBIENT BELOW AMBIENT CRYOGENIC WT HAZARDOUS COMPONENT EHS CAS # 1 0 -100 226 Full Range Straight Run Middle DistillatI22 Yes M No 228 68814 -87 -9 229 2 0 -40 230 Light Catalytic Cracked Distillate 231 Yes XNo 232 64741 -59 -9 233 3 0 -0.05 234 SULFUR 235 Yes XNo 236 7704 -34 -9 237 4 238 239 Yes No 240 241 5 242 243 Yes No 244 245 III. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 RUBEN BYERLEY, ENVIRONMENTAL SERVICES SUPERVISOR Zs— V / U FD2144(Rev 08/07) HAZARDOUS MATERIAL MANAGEMENT PLAN CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIAL INVENTORY NEW ADD DELETE X REVISE 200 H 8 R 8 F I B L D P/R< ARTS r BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661 - 852 -2171 Page 1 of 2 One form per material, per building, or area.) I. FACILITY INFORMATION BUSINESS NAME (FACILITY NAME or DBA) 3 YRC, INC. (822) CHEMICAL LOCATION 201 CHEMICAL LOCATION 202 INSIDE SHOP CONFIDENTIAL (EPCRA) Yes $S No FACILITY ID # 1 MAP # (optional) 203 GRID # (optional) 204 SITE MAP F2 II. CHEMICAL INFORMATION CHEMICAL NAME 205 206 SOLVENT REFINED PARAFFINIC PETROLEUM OIL TRADE SECRET Yes X No If subject to EPCRA, refer to instructions COMMON NAME 207 EHS' Yes X NoMOTOROIL If EHS is yes, all amounts below Zoe must be inCAS # 209 64742-54-7 pounds. FIRE CODE HAZARD CLASSES (complete If requested by local fire chief) 210 TYPE 211 RADIOACTIVE: Yes 4 No 212 CURIES 213 PURE X MIXTURE El WASTE LARGEST CONTAINER 215 PHYSICAL STATE SOLID X LIQUID GAS 214 55 216 FED HAZARD CATEGORIES X FIRE REACTIVE PRESSURE RELEASE X ACUTE HEALTH X CHRONIC HEALTH Check all that apply) ANNUAL WASTE 217 218 AVERAGE 219 STATE WASTE zzo AMOUNT DAILY AMOUNT 110 DAILY AMOUNT 80 CODE 221 DAYS ON SITE 222 UNITS X GAL CU FT . LBS TONS 365IfEHS, amount must be in lbs. STORAGE CONTAINER: 223 ABOVEGROUND TANK CAN BOX TANK WAGON UNDERGROUND TANK CARBOY CYLINDER RAILCAR TANK INSIDE BUILDING SILO GLASS BOTTLE OTHER X STEEL DRUM FIBER DRUM PLASTIC BOTTLE TOTE BIN PLASTIC /NONMETALLIC DRUM BAG STORAGE PRESSURE: K AMBIENT ABOVE AMBIENT BELOW AMBIENT zza 225 STORAGE TEMPERATURE:X AMBIENT ABOVE AMBIENT BELOW AMBIENT CRYOGENIC WT HAZARDOUS COMPONENT EHS CAS # 1 99 226 REFINED PETROLEUM DISTALLATE 227 Yes $1 No 228 64742 54 -7 229 2 1 230 ZINC COMPOUNDS 231 Yes XNO 232 68649 -42 -3 233 3 234 235 Yes No 236 237 4 238 1 239 Yes No 240 241 5 242 243 Yes No 244 245 III. SIGNATURE PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 RUBEN BYERLEY, ENVIRONMENTAL SERVICES SUPERVISOR - 2 5—// / IV' ( FD2144 (116 08/07) HAZARDOUS MATERIAL MANAGEMENT PLAN B AS S P APPLICATION SECTION DISCOVERY & NOTIFICATION A, Rrm r FORMS) INSTRUCTIONS 1. To avoid further action, return this form within 30 days of receipt. 2. Type /print answers in ENGLYSH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. BAKERSFIELD FIRE DEPARTMENT Prevention Services 1600 Truxtun Ave., Suite 401 Bakersfield, CA 93301 Phone: 661 - 326 -3979 • Fax: 661-852-2171 Page 1 of 2 SECTION I: FACILITY IDENTIFICATION BUSINESS NAME (FACILITY NAME or DBA) YRC, INC. (822) ADDRESS (for local use only) 4901 LISA MARIE COURT FACILITY ID # 1 SECTION IIA: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: THE MOTOR OIL AST IS VISUALLY EXAMINED FOR LEAKS. THE DIESEL FUEL UST IS EQUIPPED WITH AN AUTOMATIC MONITORING DEVICE. B. EMPLOYEE AND AGENCY NOTIFICATION: THE SUPERVISOR ON DUTY WILL NOTIFY THE EMERGENCY CONTACTS, THE FIRE DEPARTMENT, AND THE YRC NORTH AMERICAN TRANSPORTATION CHEMICAL HELP LINE (800- 395 - 5446). C. ENVIRONMENTAL RESPONSE MANAGEMENT: IN THE EVENT OF A LARGE RELEASE, THE FACILITY WILL BE EVACUATED AND THE NOTIFICATION PROCEDURE WILL BE FOLLOWED. IF NECESSARY A HAZARDOUS MATERIALS CONTRACTOR WILL BE COORDINATED THROUGH THE YRCNAT CHEMICAL HELP LINE TO CLEAN UP THE SPILL. SMALL SPILLS WILL BE CLEANED BY TRAINED PERSONNEL USING ABSORBANTS AND AN OVERPACK DRUM TO CONTAIN RECOVERED MATERIAL UNTIL PROPER DISPOSAL. D. EMERGENCY MEDICAL PLAN: IN THE EVENT A SERIOUS INJURY OCCURS AT THE TERMINAL,•911 WILL BE CALLED FOR EMERGENCY SERVICE RESPONSE. ALL OTHER PERSONNEL SUSTAINING INJURIES WILL BE TRANSPORTED TO MERCY SOUTHWEST HOSPITAL AT 300 OLD RIVER ROAD, STE 200, BAKERSFIELD, CA 93311. SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESMENT AND PREVENTION MEASURES: YRC INC SPILL PEVENTION PRACTICES INCLUDE MONTHLY PRESENTATIONS AT SAFETY MEETINGS AND ANNUAL FIRST RESPONDER TRAINING AND HAZARD COMMUNICATION TRAINING. THE UST HAS AN AUTOMATIC MONITORING DEVICE. B. RELEASE CONTAINMENT AND /OR MITIGATION: EMPLOYEES DO NOT RESPOND TO HAZARDOUS MATERIALS EMERGENCIES. EMPLOYEES ARE TRAINED TO EVACUATE DURI EMERGENCIES AND CONTACT CONTRACTORS TO PROVIDE EMERGENCY RESPONSE. CLEAN -UP SUPPLIES AND EQUIPMENT ARE USED ONLY FOR NON EMERGENCY RELEASES WHERE EMPLOYEE SAFETY CAN BE MAINTAINED. C. CLEAN -UP AND RECOVERY PROCEDURES: IN THE EVENT OF AN INCIDENTAL RELEASE, THE SOURCE IS IDENTIFIED AND CONTROLLED SO THAT THE SPIL IS STOPPED. SPILL CONTAINMENT EQUIPMENT IS USED TO CLEAN AND CONTAIN THE SPILL UNTIL PROPER DISPOSAL. IN AN EMERGENCY, A HAZARDOUS MATERIALS CONTRACTOR WILL BE USED TO CLEAN UP EMERGENCY SPILLS. FD2169 (Rev 08/07) Page 2 of 2 SECTION II.2: RELEASE RESPONSE PLAN (CONT) UTILITY SHUT -OFFS (LOCATION OF SHUT -OFFS AT YOUR FACILITY) NATURAL GAS PROPANE: ON THE NORTHERN PORTION OF THE WEST SIDE OF THE FACILITY ELECTRICAL: ON THE NORTHERN PORTION OF THE EAST SIDE OF THE FACILITY WATER: ON THE NORTHERN PORTION OF THE WEST SIDE OF THE FACILITY SPECIAL: THE PUMP SHUTOFF AND GAS SHUTOFF FOR THE DIESEL FUEL UST IS LOCATED ON THE EAST SIDE OF THE FUEL ISLAND. LOCK BOX: YES IXNO IF YES, LOCATION: PRIVATE FIRE PROTECTION /WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: NONE B. WATER AVAILABILITY (FIRE HYDRANT): LOCATED ON THE NORTH SIDE OF THE FACILITY. SECTION III: TRAINING NUMBER OF EMPLOYEES: 15 MATERIAL SAFETY DATA SHEETS ON FILE: X YES NO IF YES, LOCATION: IN MANAGER. S OFFICE BRIEF SUMMARY OF TRAINING PROGRAM: SEE ATTACHED TRAINING PLAN PAGE. CERTIFICATION Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE F OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 477 46 S// 1 NAME SIGNER RIN 478 RUBEN D. BYERLEY TITLE OF SIGNER 479 ENVIRONMENTAL SERVICES SUPERVISOR FD2169 (Rev 08/07) City of Downey Describe the equipment and its numbered aDwamlately. ifneet Business Application Package If applicable, specify any testinglmaintenance procedureslntervals. Aftach additional pages, City of Downey Fire Department — Participating Agency 11111 Brookshire Ave. Downey, CA 90241 Section IC: CONSOLIDATED CONTINGENCY PLAN FORM Part I: BUSINESS PLAN and CONTINGENCY PLAN FF 'WYEE'TVRA m . All facilities that handle hazardous materials.-.must have a written employee training plan. An outline of a typical plan is provided below for you to complete and submit. The items listed below are required per Health and Safety Code Section 25504 © and Title 19 Section 2732. Facility personnel are trained as follows: 10 1. Familiarity with all plans and procedures specified In the Contingency Plan. 0. 2. Methods for safe handling of hazardous materials. P 3. Safety procedures in the event of a release or threatened release of a hazardous material. 10. 4. Use of emergency response equipment and supplies under the control of the business. P 5. Procedures for coordination with local emergency response organizations. Training shall be provided: P Initially for all new employees. 10, Annually, including refresher courses, for all employees. Note: These training programs may take into consideration the position of each employee. Additional training should include: P 1. Internal alarm /notification procedures. 2. Evacuation /re -entry procedures and assembly point locations. b 3. Material Safety Data Sheet (MSDS) training including specific hazard(s) of each chemical to which employees may be exposed, including routes of exposure (i.e. inhalation, ingestion, absorption). V EdERAR RIIIVGF If your business Is a hazardous waste generator, you are required to provide training in hazardous waste management for all workers who handle hazardous waste at your site (22 CCR §66265.16). You are also required to document training. The items below are required. EMPLOYEE TRAINING 1. Facility personnel will successfully complete training within six months after the date of their employment or assignment to a facility or to a new position at a facility. 2. Employees will not handle hazardous wastes without supervision until trained. TRAINING DOCUMENTATION The owner or o erator must maintain the following documents and records at the facility: 1. Job title for each position at the facility that Is related to hazardous waste management, and the names of the employee(s) filling the osition s . 2. Description for each position listed above (must include required skill, education, or other qualifications, as well as duties of employees assigned to the position). 3. Description of type and amount of both introductory and continuing training given to each employee. 4_ Records that document that the requirements for training or job experience have been met, 5. Current employees' training records to be retained until closure of the facility). 6. Former em to es' training records to be retained at least three years after termination of employment). City of Downey: Application Package 13 Last Updated: 612003 3cdtCUPAAppPack N REFERENCE TO NORTH INCLUDE ALL ADJACENT STREETS BY NAME DRIVEWAY /GATE ADDITIONAL SYMBOLS: Symbol Description. Date z1 \wj.u'ti MSDS MATERIAL SAFETY DATA SHEETS BEP & BUSINESS EMERGENCY PLAN RAILROAD TRACKS OS SEWER STORM DRAIN UTILITY CONNECTIONS /SHUTOFFS 0 ELECTRIC METER 0 ELECTRIC SHUTOFF GAS METER O GAS SHUTOFF PUMP'SHUTOFF OW WATER MAIN LINE GATE VALVE STORAGE TANKS O ABOVE GROUND TANK UNDERGROUND TANK Symbol Description FACILITY NAME: ADDRESS: DOORS ERE EMERGENCY RESPONSE EQUIPMENT EVACUATION ROUTE E1S EVACUATION /STAGING AREA EH:F& FENCE /BARRIERS FIRE ALARM FIRST AID QF FIRE HOSE QF FIRE EXTINGUISHER FIRE HYDRANT FLOOR DRAIN ADDITIONAL SYMBOLS: Symbol Description. Date z1 \wj.u'ti MSDS MATERIAL SAFETY DATA SHEETS BEP & BUSINESS EMERGENCY PLAN RAILROAD TRACKS OS SEWER STORM DRAIN UTILITY CONNECTIONS /SHUTOFFS 0 ELECTRIC METER 0 ELECTRIC SHUTOFF GAS METER O GAS SHUTOFF PUMP'SHUTOFF OW WATER MAIN LINE GATE VALVE STORAGE TANKS O ABOVE GROUND TANK UNDERGROUND TANK Symbol Description FACILITY NAME: ADDRESS: 014 SITE MAP 4Z5,4 Af44 --IF- e77: l p FacUTY NAME: *YO C -- r-AjC. . Date: d- 73 p V ADDRESS: 9 q0l Li s&f %%e ''r V,r 1 Q 1 2 3 I - 4 5 A S Fk c D I1 E i Nkoitf n,;1 946 Soo DIE8B FUELr G I I l p FacUTY NAME: *YO C -- r-AjC. . Date: d- 73 p V ADDRESS: 9 q0l Li s&f %%e ''r V,r 1 Q l FACILITY MAP A 1 3 l 4 8 PQ 1 1 I ne i 1 l I j 1 G j I Date: 02 (9/0 FACIL)TY NAME: ADDRESS:. 091 UNDERGROUND STORAGE TANKS UNIFIED PROGRAM CONSOLIDATED FORMS APPLICATION UST FACILITY - (STATE FORM A) TYPEOFACTION: (Check one Item only) er 1. NEW SITEPERMIT d 2. INTERIM PERMIT I. FACILITY /SITE BAKERSFIELD FIRE DEPT. Prevention Services I 'p i a JL n 900 Truxtun Ave., Ste. 210 4p, fIR/ } Bakersfield, CA 93301ARrmr Tel.: (661) 326 -3979 Fax: (661) 852 -2171 Page I of 2 X 3. RENEWALPERMIT . 5. CRAMEOF INFORMATION (Specifychange- .r 7. PERMANENTLY CLOSEDSITE r 4. AMENDED PERMIT Mceluseonly) e. TEMPORARY SITE r e. TAN( REMOVED 400 CLOSLOE I. FACILITY /SITE INFORMATION BUSINESS NAME (Sarre as FACILITY NAME or DBA - Doing Business As) 3 ACILITY ID No YRC, INC.(822) NEAREST CROSS STREET - 4o, ACI OWNER TYPEr. CORPORATION As 4. LOCAL AGENCY /DISTRICT' es 2. INDIVIDUAL K 5. COUNTY AGENCY* WOODMERE DRIVE As 3. PARTNERSHIP es 6. STATE AGENCY' es 7. FEDERAL AGENCY' 402 BUSINESS TYPE es 1. GAS STATION et 3. FARM 5. COMMERCIAL es 2. DISTRIBUTOR .s4. PROCESSOR .es 6. OTHER 40 TOTAL NUMBER OF TANKS Is facility on Indian Reservation or Ifownerof UST a public agency: Give the EMAINING AT SITE 404 Trustlands7 &Yes Ss No 405 11ame of supervisorof division, section oroffice STEPHEN GUTIERREZ 1 Nh1rh operates the UST. (This Is the contact rson forthe tank records.) (Please print Contact person's norm) 4 II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 407 4 YRC, INC C/O YRC NORTH AMERICAN TRANSPORTATION (661)833 -1895 AILING OR STREETADDRESS 409 10990 ROE AVENUE MS A605 TTY 410 41 OVERLAND PARK ISTATF KS 66211 PROPERTY OWNER TYPE ix1. CORPORATION .e 2• INDIVIDUAL .s 4. LOCAL AGENCY/ DISTRICT K 6. STATE AGENCY d 3 . PARTNERSHIP s 5. COUNTY AGENCY •s 7. FEDERAL AGENCY 4,3 III. TANK OWNER INFORMATION TANK OWNER NAME 414 PHONE 41 YRC, INC (822) 661)833 -1895 AILING OR STREET ADDRESS 416 10990 ROE AVENUE MS A605 TTY 417 STATE 418 ZIP CODE 41 OVERLAND PARK KS 66211 TANK OWNER TYPE . CORPORATION is 2. INDIVIDUAL .es 4. LOCAL AGENCY/ DISTRICT .es 6. STATE AGENCY et 3. PARTNERSHIP & 5. COUNTY AGENCY & 7. FEDERAL AGENCY 420 IV. BOARD OF EQUALIZATION UST STORAGE FEE rY (TK) HO 1 4 4 Call (916) 322 -9669 If questions arise 421 V. PETROLEUM UST FINANCIAL RESPONSIBILITY YCX. SELF - INSURED K 5. LETTER OF CREDIT 9. STATE FUND & CD INDICATE METHOD(S) .es 2. GUARANTEE .es 6. EXEMPTION 10. LOCAL GOVT MECHANISM es 3. INSURANCE .es 7. STATE FUND 99. OTHER: d 4. SURETY BOND .es 8. STATE FUND & CFO LETTER 42 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to Indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 Is checked. a 1. FACILITY ,i1: 2. PROPERTY OWNER a 3. TANK OWNER 42 VII. APPLICANT SIGNATURE Certification: I certify that the In4orrnatlon provvided herein is true and accurate to the best of m knowledge. SIGNATURE-Of APPLI 424 j l 42 42 913)344 -3644 NAME APPLICANT (print) 427 TITLE OF APPLICANT 42 RUBEN BYERLEY ENVIRONMENTAL SERVICES SUPERVISOR STATE USTFACILITY NUMBER (Forlocal use only) 429 1998 UPGRADE CERTIFICATE NUMBER (For local use only) 43 FD 2093 (Rev. 09105) UNDERGROUND STORAGE TANKS o. BAKERSFIELD FIRE DEPT. UNIFIED PROGRAM CONSOLIDATED FORMS Prevention Services YRC, INC. (822) 900 Truxtun Ave., Suite 210 APPLICATION AFIRE , j, Bakersfield, CA 93301 LOCATION NfrHLN SITE one NORTHWEST OF TERMINAL DOCK, UNDER FUEL ISLAND I. TANK DESCRIPTION Tel.: (661) 326 -3979 TANK - (STATE FORM B) 1 Fax: (661) 852 -2171 Page 1 of 4 TYPE OF ACTION (Checkone Nam only): d 1. NEW SITE PERMIT d 4. AMENDED PERMIT d 5. CHANGE OF INFORMATION d 2. INTERIM PERMIT (Specllyreason - forlocel use only) d 6. TEMPORARYSITE CLOSURE T& 3. RENEWALPERMIT d 7. PERMANENTLY CLOSED ON SITE d 8. TANK REMOVED 430 BUSINESS NAME (Stime r FACILITY NAMEor rg ua neee o. YRC, INC. (822) LOCATION NfrHLN SITE one NORTHWEST OF TERMINAL DOCK, UNDER FUEL ISLAND I. TANK DESCRIPTION TANK ID No TANKMANUFACTURER 433 COMPARTMENTALIZED TANK rYea YINo 1 TDUSCO If 'Y.", complete ana pagofor each compenmenl. DATE INSTALLED(YEAR(MO) 436 TANK 436 NUMBER 437 5/89 12,000 N/A ADDITIONAL DESCRIPTION (F-b -1 use arty) N/A 11. TANK CONTENTS TANKUSE 43S PETROLEUM TYPE d 2. LEADED AT 99. OTHER 44 XXMOTORVEHICLE FUEL XZ 3. DIESEL Nmerkod, compleb PeColeum Type) d 1e REGULAR UNLEADED d 4. GASOHOL440 d 2. NON -FUEL PETROLEUM d ih. PREMIUM UNLEADED d 6. JET FUEL d 3. CHEMICAL PRODUCE d tc. MIDGRADE UNLEADED d 6. AVIATION FUEL AT 4. HAZARDOUS WASTE (6rcludes UsedC/o A5 5. UNKNOWN COMMON NAME (hamHazardous Matadals 1-fory pego) q41 m ere s s van page DIESEL #2 68476 -34 -6 III. TANK CONSTRUCTION 44TYPEOFTANKd1. SINGLE WALL d 4. SINGLE WALL INA VAULT d 99. OTHER Check one Namorgy) YC I DOUBLE WALL d 5. SINGLEWALL WITH INTERNAL BLADDER SYSTEM d 3. SINGLEWALLWITHEXTERIOR MEMBRANELINER d 95. UNKNOWN TANKMATERIAL - Primarytank YZ1. BARE STEEL &4. STEELCLAD W/FlBERGLASS d W. OTHERaItemo*) d 2. STAINLESS STEEL pLAg7IC d 3. FIBERGLASS / PLASTIC 65 ' CONCRETE AK 6. FRPCOMPATIBLE W1100% METHANOL AK 95. UNKNOWN TANK MATERIAL- SoroMarytank d 1. BARE STEEL d 4. STEELCLADW/FlBERGIASS d 10. COATED STEEL 44 Clredr onelhurl aM') d 2. STAINLESS STEEL REINFORCEDPLASTIC (FRP) d 95. UNKNOWN XX3. FIBERGLASS / PLASTIC d 5. CONCRETE .s 99. OTHER AK S. FRP COMPATIBLE W/100% METHANOL AT 9. FRP NON - CORRODIBLE JACKET TANK INTERIOR LINING 44 d 1. RUBBER LINES d 4. PHENOLIC LINING d 99. OTHERORCOATINGdpALKYDLININGd5. GLASSLININGCheckoneIfemDoty) Yj EPDXY LINING d 6. UNLINED DATE INSTALLED d95 UNKNOWN (Forkrca/ use orgy) 446 44 OTHER CORROSION d t. MANUFACTURED CATHODIC PROTECTION d 4. PIMPRESSEDCURRENT PROTECTION IFAPPLICABLE d 2. SACRIFICIAL ANODE d 95. UNKNOWN INSTALLED Check onel rrl ) Yaij. FIBERGLASSREINFORCED PLASTIC d 99. OTHER localForlocal use o*) SPILLAND OVERFILL U. SPILLCONTAINMENT YEAR INSTALLED 450 TYPE (Ibrkrcelweonly) 451 PROTECTION EQUIPMENT INSTALLED 452 Check all thatapply) d 2. DROP TUBE 1989 M.RFILL LEAK ALERT 14 ALARM AT 3. STRIKER PLATE AT 2. FILL TUBE SHUT OFF VALVE d4. EVR UPGRADB 3. BXALLFLOATKr4. EEMPT IV. TANK LEAK DETECTION TANK (Check a tap 53 IFDOUBLE WALLTANKOR TANK WITH BLADDER (aackone mo y: 4 d 1. VISUAL (EXPOSED PORTION ONLY) d 5. MANUALTANK GAUGING (MTG) d 1. VISUAL (SINGLEWALL INVAULT ONLY) AK 2. AUTOMATICTAN( GAUGING (ATG) d 6. VADOSE ZONE K 2. CONTINUOUS INTERSTITIAL MONITORING AS 3. CONTINUOUS ATG d T. GROUNDWATER d 3. MANUAL MONITORING d 4. STATISTICAL INVENTORY RECONCILIATION (SIR) d 6. TANKTESTING BIENNIALTANK TESTING d 99. OTHER WTANK CLOSURE'. INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YRIMO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCEREMAINING TANK FILLED WITHINERT MATERIAL? 4 km d Yee d NoI FD 2094 (Rw.09/o5) UNDERGROUND STORAGE TANKS TANK — APPLICATION (CONT.D) (STATE FORM B) Page 3 of 4 Permit Number (Fa local uae only) 474 1 Perrnll Apptoed 475 Permit Expirellon Date 478 FD 2094 (Rev. 09/05) VI. PIPING CONSTRUCTION Check all that apply) ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SYSTEM c 1 SUCTION c 2 PRESSURE c 3 GRAVITY 469 G 1 SUCTION 2LA2 PRESSURE c 3 GRAVITY 458 G 1 SINGLEWALL c BSUNKNOWN SINGLEWALL G 3LINED TRENCH c89 OTHER CONSTRUCTION G 2DOUBLE WALL G 99OTHER 462 11! BDOUBLE WALL c 96 UNKNOWN 460 MANUFACTURER 463 MANUFACTURER 461 MATERIALS c 1 BARESTEEL c 6 FRPCOMPATIBLEWI 100% METHANOL c 1 BARE STEEL c BFRP COMPATIBLE W/ 100% METHANOL AND G 2STAINLESS STEEL G 7 GALVANIZED STEEL G 2 STAINLESS STEEL G 7GALVANIZED STEEL CORROSION c 3PVC COMPATIBLE WITH CONTENTS c 8FLEXIBLE G 3 PVC COMPATIBLE WITH CONTENTS G8FLEXIBLEPROTECTIONc4FIBERGLASSc9CATHODICPROTECTIONMFIBERGLASSG9CATHODIC G 5STEEL W/ COATING G 95 UNKNOWN G 5 STEEL W/ COATING o 95UNKNOWN PROTECTION G99 OTHER 485 c 99 OTHER 464 VII. PIPING LEAK DETECTION Check all that apply) ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SINGLE I IN SINGLE PIPING 467 466 PRESSURIZED PIPING (Check all thatapply): PRESSURIZED PIPING (Check M thatapply): G 1 ELECTRONIC LINELEN( DETECTOR 3.0 GPH TEST b(Bj;{ AUTO PUMP SHUT OFF FORLEAK, GI ELECTRONICLINE LEAK DETECTOR 3.0 GPH TESTAMAUTO PUMP SHUT OFF FORLEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS SYSTEM FAILURE, AND SYSTEMDISCONNECTION +AUDIBLE AND VISUAL ALARMS G 2 G 2 MONTHLY02 GPHTEST MONTHLY 0.2 GPHTEST G 3 ANNUALINTEGRITY TEST (0.1 GPH) G3 ANNUAL INTEGRITY TEST (0.1 GPH) G 4 DAILYVISUAL CHECK CONVENTIONALSUCTION SYSTEMS: (Checkall thatapply): CONVENTIONAL SUCTION SYSTEMS: (Check all thatapply): G4 DAILYVISUAL MONITORING OFPUMPING SYSTEM +TRIENNIA. PIPING INTEGRITY TEST (0.1 GPH) G 5 DAILYVISUAL MONITORING OF PUMPING SYSTEM TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE3lX:TKJN SYSTEMS: (Checkallthat apply) c 6 G5 SELF MONITORING SAFESUCTION SYSTEMS: (Check all thatapply) SELF MONITORING GRAVITY FLOW: (Checkallthat apply): G 7 G 6 BIENNIA. INTEGRITY TEST (0.1 GPH) GRAVITY FLOW : (Check all thatapply): G8 DAILYVISUAL MONITORING SECONDARILY CONTAINEDPIPING G9 BIENNIALINTEGRITY TEST (0.1 GPH) PRESSURZED PIPING ; (CheckaA that apply) SECONDARILY CONTAINEDPIPING G7 CONTINUOUS TURBINESUMP SENSOR )(MAUDIBLE AND VISUAL ALARMSAND G e AUTO PUMP SHUT OFFWHENA LEAKOCCURS XX AUTOPUMP SHUT OFF FOR LEAKS, SYSTEM FAILUREAND SYSTEM DISCONNECTIONPRESSURIZEDPIPING: (Check all thel apply) G c NO AUTOPUMP SHUT OFF CONTINUOUSTURBINE SUMP SENSORAn AUDIBLE ANDVISUALALARMS AND (checkane) G10 G a AUTO PUMP SHUT OFF WHENA LEAK OCCURS c 8 OMATIC LINELEAK DETECTOR (3.0 GPHTEST) yl([gjFLOW SHUTOFF ORRESTRICTION G b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEMFAILURE ANDSYSTEM DISCONNECTION XNNUAL INTEGRITY TEST (0.1 GPH) G11 c9ccNOAUTOPUMPSHUTOFF G12 AUTOMATIC LEAK DETECTOR SUCTIOWGRAVITY SYSTEM: (Check all that apply) ANNUAL INTEGRITYTEST (0.1 GPH) CONTINUOUS SUMP SENSOR + AUDIBLE ANDVISUAL ALARMSc10 G13 SUCTION/GRAVITY SYSTEM: (Checkallthat apply) DISCONNECTION: (Check all Dud apply) CONTINUOUS SUMP SENSOR + AUDIBLEAND VISUALALARMS Gil NO AUTO PUMP SHUTOFF EMERGENCY GENERATORS ONLY (Checkall tW apply) G12 AUTOMATIC LINE LEAK DETECTOR (3.0GPHTEST) G14 ANNUALINTEGRITY TEST (0.1 GPH) CONTINUOUS SUMPSENSOR WITHOUT AUTO PUMP SHUT OFF +AUDIBLEAND G13 VISUALALARMS EMERGENCY GENERATORS ONLY (Check all that apply) G15 AUTOMATIC LINELEAK DETECTOR (3.0 GPH TEST) G16 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMPSHUT OFF +AUDIBLE AND VISUAL ANNUAL INTEGRITYTEST (0.1 GPH) G14 ALARMS G17 DAILY VISUAL CHECK AUTOMATIC LINE LEAK DETECTOR (3.0GPHTEST) G16 ANNUALINTEGRITY TEST (0.1 GPH) GIB DAILY VISUAL CHECK G17 VIII. DISPENSER CONTAINMENT DISPENSER 468 GI FLOAT MECHANISM THAT SHUTSOFF SHEAR VALVE G4 DAILY VISUALCHECK CONTAINMENT c 2 CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE ANDVISUALHARMS G5 TRENCH LINER/ MONITORING Yee c No XX3 CONTINUOUS DISPENSER PAN SENSOR2M AUTOSHUT OFF FOR G6 NONE 469 DATE INSTALLED: DISPENSER+ AUDIBLE AND VISUALALARMS IX. OWNERIOPERATOR SIGNATURE I certifythat theintamatien pmNded herein to Uw & accurateto the heeld mykrwWedga. SIGNA OF OWN OPERATO 470 DATE 471 sZ /2 S/< NAME OFOWNER/OPERATOR (prkr 472 TITLE OFOWNER/OPERATOR 473 RUBEN BYERLEY ENVIRONMENTAL SUPERVISOR Permit Number (Fa local uae only) 474 1 Perrnll Apptoed 475 Permit Expirellon Date 478 FD 2094 (Rev. 09/05)