HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This ~ermit is issued for the following:
[] Hazardous Materials Plan
[] Underground Storage of Hazardous Materials
[] Risk Management Program
PERMIT ID # 015-021-002106 [] Hazardous Waste On-Site Treatment
CALIFORNIA WATER
LOCATION: 503 26v" STREET ~i'~- ~'~?
%~ "~ CA 93301
OFFICE OF ENVIRONMENTAL SER VICES' " ~'
1715 Chester Ave., 3rd Floor ^pprovedby: U~p~t.u~.h~! ~fi 1'5 ~
Issue Date
Bakersfield, CA 93301 OmceotEv~Services '~
Voice (661) 326-3979
FAX(661) 326-0576 Expiration Date: June 30. 2003
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This r~ermit is issued for the following:
[] Hazardous Materials Plan
[] Underground Storage of HazardOus Materials
[] Risk Management Program
[] Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002107 ,. ~,~ .- ~
CALIFORNIA WATER 140-0'
LOCATION
OFFICE OF ENVIRONMENTAL SER VICES' ·
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301. o~,~of~.~n~,~smi~
Voice (661) 326-3979 .
FAX (661) 326-0576 Expirati0nDate: 'JUl~
ITE DIAGRAM ~ FACILIT~GRAM ! ,~ !
I'~UXT
CALIFORNIA WATER STA14001 SiteID: 015-021-002107
Manager : ~ ~% BusPhone: (661)
Location: 503 26TH ST Map : 103 CommHaz : Minimal
City : BAKERSFIELD Grid: 30A FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 01 SIC Code:4941
EPA Numb: DunnBrad: 00 - 691 - 3578
Emergency Contact / Title Emergency Contact / Title
............................. / GEN SUP~
Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x
24-Hour Phone : (661) 396-2400x 24-Hour Phone : (661) 396-2400x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: RSs Fire ImmHlth DelHlth
MailAddr: ~O BOX 1~ State:
City : S~ Zip : .95108
Owner CALIFORNIA WATER SERVICE COMPANY Phone: (408) 451-8200x
Address : 1720 N FIRST ST State: CA
City : SAN JOSE Zip : 95112
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif 'd: F--RSs_: Y_e_s
ParcelNo: ' Dis~|ct Managed-Tim Treloar
Asst. D~r~ct Manag~-Bil! Ha~er
Emergency Direct ives: "Contact Person-Tampa 3ohnson
. Same Phone Numbers
CONTACT PERSON K-~M--~F~R-DG~ 832-2141. !;
Mailing Address Change:
d --~ t/~_..9~ 3725 South "H" Street
I, .~.~_mB~4 .... Do h~reby certif~ Bakersfield, CA 93304
(Type or print name)
reviewed t?)e attacheo h~ardous materials manage- -
ment plan for(',qi~F, tom-~_ and that it along
(Name of, 8uain~o)
any oorr~ions ~ns~ituto a ~mpl~ ~nd e~rr,~
~®rnent plan ~r my ~aci~ity.
-1- 07/30/2003
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979 ~.~.?¥ ..
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
1. To avoid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
5. You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: ~_.= ~, [,., ....,; ~. ~ ,,. [......- <~ ,_..-.q, ,._._ co.
LOCATION: ~z~. s4-~. ,.+o-o~ ,
MAILING ADDRESS: '5 n 'z '~ ~o. v~
CITY: r~ ~., .. s ~- ,',_, a STATE: c._,a, . ZlP:q~J'5o,4 PHONE:
PmMARYACTIVITY: .-., ,~.-{ .. ,- o~- 3o,~._~.~-,'~ ,..o~
OWNER: ~.~-, e_ PHONE:
MAILING ADDRESS:
EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 HR. PHONE
' ( 9
ItAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1' DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
B. EMPLOYEE AND AGENCY NOTIFICATION:
CO, c_e.~l qll ~,ntt o~-~,-e__ o(-
-.) /
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
D. EMERGENCY MEDICAL PLAN:
2
i~ARDOUS MATERIALS MANAC~ENT PLAN
SECTION II.2: RELEASE RESPONSE PLAN
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
B. RELEASE CONTAINMENT AND/OR MITIGATION:
C. CLEAN-UP AND 1LECOVERY PROCEDUILES:
.UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
WATER:.
SPECIAL:
LOCK BOX: YES/~Q) IF YES, LOCATION:
PRIVATE FIRE PROTF. CTION/WATER AVAILABILITY
A. PRIVATE FIRE I~ROTECTION:
B. WATER AVAILABILITY (FIRE HYDRANT): ~.-~ -~'~-o.-~4 -.~- ,,.,~ti-
~SECTION III; TRAINING
MATERIAL SAFETY DATA SItEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROG~M:
gERTIFICATION
I,.. ~ t.- f.- d~a ( ~ ~,., CERTIFY THAT THE ABOVE INFORMATION
IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL'BE USED TO
FUI.FILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA I'IEALTH AND SAFI?/I'Y
CODI?' ON l lAZARI)OUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND
THAT INACCURATE~NFOKMATiON CONSTITUTES PEILFURY,
SIGNATURE TITLE ~ s o ,,-
DATE
4
' ~l'-"rt~ ':.-- ~I15 Chester Ave., CA 93301 (61~l~J 326-3979
FACILI~ INFORMATION
·. Page ()~
· . "I, FACILITY IDENTIFICATION
I{IJSINESS NAME (Same as FACILI~ NAME or DBA- Ool~ Business ~) 3 BUSINESS PHONE '
51TE ADDRESS
CI [Y .... _~_ ~..~.~_~ ~..~. ~._~ ...... : ..................................................
I)(.iN & , . 1o6 m SIC CODE
UI{ADSTREET .... ~0- ~ I - ~Sq ~ . J (4Digit~) ~ ~
COUNTY I~ ~ ¢ ~
()WNER MAILING
Al)DE{ESS ~1~5 ~ o. ~ ~ ~
(;t)NTACTNAME %~ ~t~ 'z t CONTACT PHONE
CONTACT ~ILING , l loi
Al)DRESS
~4-HOUR PHONE ~ ~ ~ ~ ~; 24-HOUR PHONE ~ ~_ ......................................
I'AGER # ~ 128 PAGER ~ ~,~:~
<'edificalion: Basod on my inqul~ of Ihoso Individuals responsiblo for oblalning Ihe Information, I ~dl~ under ponally of law lhal I havo porsonall
;md am h millar wllh Iho info i~l;lllon submillod In Ibis Invonlo~ and believ4
~ ............................ :: ...... lhe information is true, accuralo, and ~mplole.
I..~. OF OWNE~OPE~TOR (prlnl) ............. ~3~'" TITLE OF OWNE~OPE~TOR- ......................................................
IU'CF (7/g9) S:tCUPAFORMS~OES2730.TV4.wpd
?r 1715 Chester Ave., CA 93301 (661) 326-3979
H~RDOUS MATERIALS INVENTORY '
· CHEMICAL DESCRIPTION
(One ~ per m~e~al
CI IEMI~L ~ME · 205 T~E SECRET
.dn ......
COM~N ~ ' ' 20~
['ItYSI~L STATE ~ s SOLID ~1 L~UID ~ O ~S 214 ~R~ST~NER
FFI) HA~RD ~TE~RIEG
(C~1h01s~) ~ I FIRE ~2 REA~ ~3 PRESSURE~L~E ~4 AC~H~L~ ~5 CHRONICH~LTH
UN~S' ~ ga ~L ~ d CU ~ ~ · ~S - ~ ~ TO~ ~1 DAYS ON SITE 222
g ;O[~AGE CO~AI~R ~ ~ A~VEGROUND T~K ~ · P~STI~ALUC DRUM ' ~ I FIBER DRUM ~ m G~S BO~LE ~ q ~IL ~ 223
(Check ag that a~) ~b U~ERGROUNDTA~ ~f ~N ~J ~G ~n P~STICBO~LE ~r O~ER
{~ ~ c T~K INSIDE BUILOI~ ~ g ~R~Y ~ k BOX ~ o T~TE BIN
~ d S~EL DRUM ~ h SILO ~ I C~NDER ~ p T~K WA~N
~IO~OE PRESSURE ~ a A~IE~ ~ aa .~VE~IE~ ~ ba BELOWA~IENT
STOOGE TEMPE~TU~ ~ a A~IE~ ~ ~ ~ A~IE~ ~ ~ BELOW A~IE~ ~ ~ CRYOGENIC ?;'.C~
] 22~ 227 ~ Y~ ~ No 22~
'Il 230 2a~ ~Y~ ~o2a2
~ 234 : 235 ~ Y~ ~ ~ 236
2~ 239 ~ Y~ ~ No 240
. 242 243 ~ Y~ ~ ~ 244
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