HomeMy WebLinkAbout4101 WIBLE ROAD (5)HAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION FORM
For Use by Unidocs Member Agencies or where approved by your Local Jurisdiction
Authority Cited: Health and Safety Code §25503.3(c); 19 CCR §2729.5(c)
To: Agency Name: Bakersfield City Fire Department
Agency Mailing Address: 201 H Street
Bakersfield. CA 93301
Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials
Business Plan (HMBP) certification described below is hereby submitted for the following facility:
Facility Name: PG &E - Bakersfield Service Center
Facility Street Address: 4101 Wible Road City: Bakersfield
Date of Current HMBP: March 2010
I certify that: (Check the appropriate box.)
I have personally reviewed the Hazardous Materials Business Plan currently on file with your agency and
certify that the HMBP is complete and accurate. (See bottom ofpage for details.) If this facility is subject
to Federal Emergency Planning and Community Right to Know Act (EPCRA) reporting requirements, I
have submitted the following documents with this Certification Form: Unified Program Consolidated Form
UPCF) Business Activities page; UPCF Business Owner /Operator Identification page with current
signature and date; Hazardous Materials Inventory Statement page(s) with an original signature, photocopy
of an original signature, or signature stamp on each page for all Extremely Hazardous Substances (EHS)
handled at or above their Federal Threshold Planning Quantity (TPQ) or 500 pounds, whichever is less.
or
Revisions to the Hazardous Materials Business Plan are necessary. The HMBP as revised is complete and
accurate and is being implemented. A copy of the revisions has been electronically submitted or is
enclosed with this Certification along with a signed UPCF Business Owner /Operator Identification page
and UPCF Business Activities page if the HMBP revision include changes to the Hazardous Materials
Inventory Statement.
OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my
inquiry of those individuals responsible for obtaining the information reported above, I believe that the
submitted information is true, accurate, and complete. I understand that a revised HMBP must be
submitted within 30 days of any change in this facility's storage or handling of hazardous materials that
would require updating of the HMBP.
Name of Owner /Operator (Print): Lori Luces- Nakagawa Title: Environmental Scientist
Phone: 209.932.2556 Signature: I-- Date: 02 -24 -2012
By checking the upper box on this form, you are certifying that:
The information contained in the HMBP most recently submitted is complete, accurate, and up -to -date; and
There has been no change in the quantity of any hazardous material as reported in the most recently submitted Hazardous Materials
Inventory forms; and
The facility has not begun handling any hazardous material in .a HMBP reportable quantity that is not currently listed in the
Hazardous Materials Inventory; and
The most recently submitted HMBP contains the information required by Section 11022 of Title 42 of the United States Code; and
There have been no substantial changes in the facility's operations that would require revision ofthe current HMBP.
11N -039 - 1/1 www.unidocs.org Rev. 10/09/07
15- 021 - 001071, PG &E BAKERSFIELD SERVICE CTR, 2/23/2010 2:19:23 PM
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION
One page per material per building or area)
ADD DELETE REVISE
200, Page 32 of 33
I. FACILITY INFORMATION
BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3.
PG &E BAKERSFIELD SERVICE CTR
CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Building: HWSA / Location: HAZ WASTE_STOR_AREA YES ® NO
FACILITY ID # 1 1 0 1 0 7 111 I. MAP # (Optional) 203• GRID # (Optional) 204.
Agency Use Only) Figure 2 -1 D6
II. CHEMICAL INFORMATION
CHEMICAL NAME 205. TRADE SECRET 206.
Yes NoWASTEWETCELLBATTERIESIfsubjecttoEPCRA, refer toinstructiom
COMMON NAME 207• EHS' 208.
WASTE WET CELL BATTERIES Yes No
If EHS is "Yes," all amounts below must be in lbs. CAS# 209.
FIRE CODE HAZARD CLASSES (Completeijrequired by CUPA) 210.
HAZARDOUS MATERIAL 211. RADIOACTIVE 212. CURIES 213.
TYPE (Check one item only) a• PURE b. MIXTURE ® c. WAST Yes No 1
PHYSICAL STATE 214. LARGEST CONTAINER 215.
Checkone item only) ® a. SOLID b. LIQUID e. GAS 458.15
FED HAZARD CATEGORIES 216.
Check all that apply) a. FIRE b. REACTIVE e. PRESSURE RELEASE x d. ACUTE HEALTH e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT 217. MAXIMUM DAILY AMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
150 600 1600 791
UNITS' a. GALLONS b. CUBIC FEET ® c. POUNDS d. TONS 221• DAYS ON SITE 222.
Checkone item only) * IfEHS, amount must be in pounds. 365
STORAGE a. ABOVEGROUND TANK f. CAN Elk. BOX p. TANK WAGON 223.
CONTAINER b. UNDERGROUND TANK g. CARBOY 1. CYLINDER q. RAILCAR
C. TANK INSIDE BUILDING b. SILO m. GLASS BOTTLE r. OTHER
x d. STEEL DRUM i. FIBER DRUM n. PLASTIC BOTTLE
e. PLASTIC/NONMETALLIC DRUM j. BAG o. TOTE BIN
STORAGE PRESSURE ® a• AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224.
STORAGE TEMPERATURE N a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225.
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
226.
l•UNK
227.
SULFURIC ACID 50 -91%
228.
Yes No
229.
7664 -93 -9
230.
2'UNK
231.
LEAD
232.
3 Yes ® No
233.
7439 -92 -1
234.
3.
235. 236.
Yes No
237.
238.
4.
239. 240.
Yes No
241.
242.
5.
243. 244.
Yes No
245.
If more haurdom components are present at greater than I% by weight Ifnon - carcinogenic, or0.1% byweight Ifcarcinogenic, attach additional sheetsof paper capturing the required Information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246,
DOT Hazard Class: $
If EPCRA, Please Sign Here.
UPCF Rev. (12/2007)-1/2 www.unidocs.org
15- 021 - 001071, PG &E BAKERSFIELD SERVICE CTR, 2/22/2010 2:47:47 PM
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION
One page per material per building or area)
ADD DELETE REVISE
2 -. Page 7 of 26
I. FACILITY INFORMATION
BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3.
PG &E BAKERSFIELD SERVICE CTR
CHEMICAL LOCATION 201, CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Building: FLEET SERVICE / Location: FUEL ISLAND, R YES ® NO
FACILITY ID # j 0 1 0 17 1 I 1. MAP # (Optional) 203. GRID # (Optional) 204.
Agency UseOnl3) 1 Figure 2 -1 C2,D4,C4
IL CHEMICAL INFORMATION'
CHEMICAL NAME 205. TRADE SECRET
Yes No
206.
DIESEL FUEL, HS, #2 Ifsubject to EPCRA, refer to instructions
COMMON NAME 207. EHS' 209.
DIESEL FUEL, HS, #2 Yes 29 No
If EHS is "Yes," all amounts below must be in lbs. CAS# 209.
FIRE CODE HAZARD CLASSES (Complete iifrequired by CUPA) 210.
COMBUSTIBLE LIQUID, CLASS III -A
HAZARDOUS MATERIAL 211. RADIOACTIVE 212. CURIES 213.
TYPE (Check one item only) a. PURE ® b. MIXTURE c. WASTE Yes No
PHYSICAL STATE 214. LARGEST CONTAINER 215.
Checkone item only) a. SOLID ® b. LIQUID' c. GAS 4000
FED HAZARD CATEGORIES 216.
Checkall that apply) a. FIRE b. REACTIVE c. PRESSURE RELEASE 0 d. ACUTE HEALTH e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT 217. MAXIMUM DAILY AMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
2683 4025
UNITS' ® a. GALLONS b. CUBIC FEET c. POUNDS d. TONS 221' ON SITE 222'
Checkone item only) ' IfEHS, amount must be in pounds.
gDAYS
365
STORAGE 21 a. ABOVEGROUND TANK f. CAN k. BOX p. TANK WAGON
223'
CONTAINER b. UNDERGROUND TANK g. CARBOY I. CYLINDER q. RAIL CAR
c. TANK INSIDE BUILDING h. SILO m. GLASS BOTTLE r. OTHER
d. STEEL DRUM i. FIBER DRUM n. PLASTIC BOTTLE
e. PLASTIC/NONMETALLIC DRUM j. BAG o. TOTE BIN
STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT 224'
STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225'
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
226.
UNK
227.
GAS OIL, BLEND
229.
1:1 Yes N No 64741 -44 -2
229.
230.
2. 100
231.
DIESEL
231
Yes ® No 68476 -34 -6
233.
234.
3,
235. 236.
Yes No
237.
239.
4,
239. 240.
Yes No
241.
242.
5,
243. 244.
Yes No
245.
If more hvardous components are present at greater than 1 % by weight Ifnon - carcinogenic, or 0.1% byweight Ifcarcinogenic, attach additional sheetsof paper capturing the required Information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246.
DOT Hazard Class: 3
If EPCRA, Please Sign Here.
UPCF Rev. (12/2007)-1/2 www.unidocs.org
M
15 -'021- 001071, PG &E BAKERSFIELD SERVICE CTR, 2/22/2010 2:47:47 PM
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION
One page per material per building or area)
ADD DELETE REVISE
200. Page 7 of 26
I. FACILITYJNFORMATION _
BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3.
PG &E BAKERSFIELD SERVICE CTR
CHEMICAL LOCATION 201. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Building: FLEET SERVICE / Location: FUEL ISLAND, R YES ® NO
FACILITY ID # 1 S 1 O Z 7 1
1. MAP # (Optional) 203. GRID # (Optional) 204.
Agency Use Only) Figure 2 -1 C2,D4,C4
II.. CHEMICAL INFORMATION
CHEMICAL NAME 205. TRADE SECRET 206.
DIESEL FUEL, HS, #2 subjecoEPCRA ,refertoinstructiom
Yes NoIftt
COMMON NAME 207. EHS' 20e
DIESEL FUEL, HS, #2 yes ® No
If EHS is "Yes," all amounts below must be in lbs. CAS# 209.
FIRE CODE HAZARD CLASSES (Complete ttfrequired by CUPA) 2M
COMBUSTIBLE LIQUID, CLASS III -A
HAZARDOUS MATERIAL 211. RADIOACTIVE 212. CURIES 213.
TYPE (Check one item only) a. PURE ®b. MIXTURE c. WASTE Yes No
PHYSICAL STATE 214. LARGEST CONTAINER 215.
Check one item only) a. SOLID ® b. LIQUID c. GAS 4000
FED HAZARD CATEGORIES 216.
Checkall that apply) a. FIRE b. REACTIVE c. PRESSURE RELEASE Q d. ACUTE HEALTH e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT 217. MAXIMUM DAILY AMOUNT 218• ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
2683 14025 r
UNITS" ® a. GALLONS b. CUBIC FEET c. POUNDS d. TONS 221' DAYS ON SITE 222'
Check one item only) • IfEHS, amount must be in pounds. 365
STORAGE x a. ABOVEGROUND TANK f. CAN k. BOX p. TANK WAGON 223'
CONTAINER b. UNDERGROUND TANK g. CARBOY I. CYLINDER q. RAILCAR
c. TANK INSIDE BUILDING h. SILO m. GLASS BOTTLE r. OTHER
d. STEEL DRUM i. FIBER DRUM n. PLASTIC BOTTLE
e. PLASTIC/NONMETALLIC DRUM j. BAG 0. TOTE BIN
STORAGE PRESSURE ® a. AMBIENT b. ABOVE AMBIENT C. BELOW AMBIENT 224'
STORAGE TEMPERATURE ® a. AMBIENT b. ABOVE AMBIENT C. BELOW AMBIENT d. CRYOGENIC 225'
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
226.
UNK
227.
GAS OIL, BLEND
228.
Yes ® No
229.
64741 -44 -2
230
2.100 DIESEL
231.
Yes ® No
232. 233
68476 -34 -6
234.
3.
235. 236.
Yes No
237.
238.
4.
239. 240.
Yes No
241.
242.
5.
243. 244.
Yes No
245.
If more hazardous components arcpresent at greeter than 1% by weight Ifnon - carcinogenic, or0.1% by weight If carclnogenic, attach additional sheets of paper capturing the required Information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246'
DOT Hazard Class: 3
If EPCRA, Please Sign Here.
UPCF Rev. (12/2007)-1/2 www.unidocs.org
15- 021 - 001071, PG &E BAKERSFIELD SERVICE CTR, 2/22/2010 2:47:47 PM
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION
One page per material per building or area)
ADD DELETE REVISE
200. Page 6 of 26
I. FACILITY INFORMATION
BUSINESS NAME (Same as Facility Name orDBA - Doing Business As) 3.
PG &E BAKERSFIELD SERVICE CTR
CHEMICAL LOCATION 201. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Building: FLEET SERVICE / Location: FLEET C -VAN, O 1 YES ® NO
FACILITY ID # 1 5 1 0 10 1 0 7 1 1 MAP # (Optianal) 203. GRID # (Optional) 204.
Agency Use Only) a Figure 2 -1 C1,E7,C6,E8
IL . CHEMICAL INFORMATION
CHEMICAL NAME 205. TRADE SECRET
Yes ®No
206.
NATURAL GAS Irsubjeci to EPCRA, referto instructions
COMMON NAME 207• EHS'
Yes ® No
208
NATURAL GAS
If EHS is "Yes," all amounts below must be in lbs. CAS# 209.
FIRE CODE HAZARD CLASSES (Complete iifrequired by CUPA) 210.
FLAMMABLE GAS
HAZARDOUS MATERIAL 211. RADIOACTIVE 212. CURIES 213.
TYPE (Check one item only) a. PURE ® b. MIXTURE c. WASTE Yes No 1
PHYSICAL STATE 214. LARGEST CONTAINER 215.
Check one item only) a. SOLID b. LIQUID N c. GAS 10000
FED HAZARD CATEGORIES 216.
Check all that apply) x a. FIRE b. REACTIVE x c. PRESSURE RELEASE d. ACUTE HEALTH e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT 217. MAXIMUM DAILY AMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
31950 39425 1
UNITS' a. GALLONS ® b. CUBIC FEET c. POUNDS d. TONS 221' DAYS ON SITE 222'
Check one item only) + IfEHS, amount must be in pounds. 365
STORAGE Ix a. ABOVEGROUND TANK f. CAN k. BOX p. TANK WAGON 223'
CONTAINER b. UNDERGROUND TANK g. CARBOY I. CYLINDER q. RAILCAR
c. TANK INSIDE BUILDING h. SILO m. GLASS BOTTLE r. OTHER
d. STEEL DRUM i. FIBER DRUM n. PLASTIC BOTTLE
Q e. PLASTIC/NONMETALLIC DRUM j. BAG o. TOTE BIN
STORAGE PRESSURE [:]a. AMBIENT ® b. ABOVE AMBIENT c. BELOW AMBIENT 224.
STORAGE TEMPERATURE ®a. AMBIENT b. ABOVE AMBIENT c. BELOW AMBIENT d. CRYOGENIC 225'
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
226,
1.3
227.
PROPANE
228.
Yes ® No 74 -98 -6
229.
230,
2.2
231.
BUTANE
232.
El Yes ® No 106 -97 -8
233.
234,
3. 15
235.
NITROGEN N2
236.
Yes ® No 7727 -37 -9
237.
238,
4.75
239.
METHANE
240.
Yes ® No 74 -82 -8
241.
242.
5. 5
243.
ETHANE
244.
Yes ® No 74 -84 -0
245.
If more hazardous components are present at greaterthan 1% by weightif non - carcinogenic, or 0.1% by weight Ifcarcinogenic, attach additional sheets of paper capturing the required Information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246.
DOT Hazard Class: 2.1
If EPCRA, Please Sign
UPCF Rev. (12/2007)-1/2 www.unidocs.org