HomeMy WebLinkAboutBUSINESS PLAN 10/1/2003 Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This oermit is issued for the following:
[] Hazardous Materials Plan
[3 Underground Storage of HazardOus Materials
[3 Risk Management Program :
[] Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002096
CALIFORNIA WATER
LOCATION 93304
OFFICE OF ENVIRONMENTAL SER VICES' · ,." NOV 1 2§§0
1715 Chester Ave., 3rd Floor Appr°vedby:
Issue Date
Bakersfield, CA 93301 OfficeofEvironmenl~Services ~
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: June 30:2003
ITE DIAGRAM ~ FACILY~Y~DIAGRAM ~[ ~ !
Business Address: ~-. ~+~. ,a~-C~,lV-- z3. q '^' .4--
JlELI)
ITE DIAGRAM FACILIT~DIAGRAM !
Business Address: r~ ¢._.
+ CALIFORNIA WATER STA81012 / SitelD: 015-021-002096 +
_
S~- z_q~o o
Manager : ~ ~ "~"-%J~.$5~ BusPhone: (661)
Location: 234 A ST /~ ~- Map : 102 Com~az : Minimal
City : BA~RSFIELD Grid: 36D FacUnits: 1 AOV:
CommCode: BA~RSFIELD STATION 01 SIC Code:4941
EPA Nu~: DunnBrad: 00-691-3578
+== =+
Emergency Contact / Title ~ Emergency Contact / Title
' .... ~ ~GTM ~IM ~OAR / GEN SUPER
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
+ ............................... = .......... +
+J Hazmat Hazards: RSs ~ Fire Press Im~lth
Contact : ~ Phone: (~, .~-~__ J
.................................................. % n ~ ~9~gX
MailAddr: ~ ~ State: .~ J
City : S~E ~ Zip : -95!08 J
Owner CALIFO~IA WATER SERVICE COMPLY Phone: (408) 451-8200x
Address : 1720 N FIRST ST State: CA
City : S~ JOSE Zip : 95112
+ +
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Cert i f ' d: ..RS~es
ParcelNo:
Dis~ic~ ~aE~-Tim Trelo=
+ .................................................. Assr DJ~Jc~ ~a~-BJJJ ~er - - +
Emergency Direct ives: Conmc~ Person-Tampa 3o~son
S~e Phon~ N~b~rs
CONTACT PERSON .~IM ~ 832-2141. ~
~silin~ Ad,ess Ch~e:
3725 Soum "H"
reviewed ~h~ a~acbed h~ardous mm~als
men~ p~n for_~ c(c. ~e ~ and that it along with
~y ~emions ~nstit~e a ~mplets and ~rr~ man-
~ement plan for my fadlRy.
-1- 07/30/2003
1715 Chester Ave., Bakersfield, CA (661) 326-3979
1. To avoid further action, return this form wi~ receipt, t ~'-"-~ ('~ '~
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:
LOCATION: f'~ r-...
MAILING ADDRESS:
CITY: ~.~-~-,'.-,~ STATE: e:.~, ZIP:q~'~o,4PHONE:¢t,,~O'~qr,,z'+oo
PRIMARY ACTIVITY: i")~,--~--/o,' of-. ~o,~--~-~/r,'e-
OWNER: ~-.-~- e_ PHONE: sa~"~-
MAILING ADDRESS:
EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 HR. PHONE
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
A. LEAK DETECTION AND MONITORING PROCEDURES:
g~_t.,, l:~.,_;t;4,t ,., ,~,o~,:l-o,..a ,1,,;I../ t,.
B. EMPLOYEE AND AGENCY NOTIFICATION:
C. ENVIRONMENTAL RESPONSE MANAGEMENT:
l-4
D. EMERGENCY MEDICAL PLAN:
2
SECTION II.2: RELEASE RESPONSE PLAN
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
B. RELEASE CONTAINMENT AND/OR MITIGATION:
C. CLEAN-UP AND RECOVERY PROCEDURES:
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATUIOkL GAS/PROPANE:.
ELECTRICAL: cot.-,~,L~_ ~oo, ~oce.~-~& o.q ~.,'~,~.
WATER: ..
SPECIAL: '~/~,
LOCK BOX: YES/~__Q) IF YES, LOCATION: "-"--
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION:
B. WATER AVAILABILITY (FIRE HYDRANT): C2..-e. -k.-t~-o.~4 ~g ,.,,,,-ti-
3
I ARDOUS MATERIALS MANAGEMENT PLAN
SECTION Ilk TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
CERTIFICATION
I, .. 25'-.,_ {.-1--- ~ o.,,, ?,,., .... CERTIFY THAT THE ABOVE INFORMATION
IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA IIEALTH AND SAFETY
CODE" ON I[AZARDOUS MATER. IALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND
THAT INACCUILATE INFORMATION CONSTITUTES PEILIURY.
SIGNATUP, E TITLE DATE
4
'-'~,'--F}-R~--.-- 1715 Chester Ave., CA 93301 (661)-326-3979
""''~"'~' BUSINESS OWNER / OPE~TOR IDENTIFICATION
FACILI~ INFORMATION
Page
. ~' I. FACILITY IDENTIFICATION
~,~ ' ~ Year Beginning
! Year Ending ,,
I. UotNESS NAME (Same as
FACILITY NAME or DBA- Doing Business As}
SI'rE ADDRESS
ZIP
bUN & ~o~ SiC CODE
COUNTY I~ ~. ~' v~
·
OWNER MAILING
C()NTACT
NAME
L
~? / CONTACT PHONE
..........L
CONTACT MAILING
ADDRESS
CITY ~ ~2o
..... ' :': ?' :'::IV. qEMERGENCY: COTS
.. -PRIMARY.' -, , ,,'
-SECONDARY-
PAGER # ~ ~28 PAGER # ~ . ~:~
Cmlilicalion: Based on my Inqul~/of lhoso Individuals responsible for oblatning lbo information. I codt~/under penally of law Ihat I have personally oxami.r:d
;mrl mn familiar wilh tho informallon submillod In Ibis Invonto~ and believe lhe Information is true. accurate, and ~mplole.
NAMES OF OWNE~OPE~TOR (prinl) ~3~ TITLE OF O~E~OPE~TOR ~:~/
UPCF (7~99) S:\CUPAFORMS[OES2730.TV4.wpd
"-"'""'"~"'"""~" HAZARDOUS MATERIALS INVENTORY
., CHEMICAL DESCRIPTION
(one form per malapai per bugding or
~1~ NEW ~] ADD [] OELETE [] REVISE 200 Page ~ of
; ~:;,'¥~',~i~,~,,~:,:.,i~,*;'~.';,, .~f~,: ..'~ :*., :,, :~i'.::~'~",~:~'.;~,,~'~.'~..~.~,,~,~:~.,¥;~:';'~!;;~;;~'~,'~; h~:., '~,..:,~ ' ?!i/%.~.~ ~. :~.*,.'.. ~..,, · .., .,.~,: ~ ' ..........
BUSINESS NAME (Same as FACILITY NAME ~' DBA. O~ng Buslnass As) §-
EIIEMICAL LOCATION · , 2011 CHEMICAL LOCATION [] Yes I~J~No
0 ~ ~, t '¥ "" ! CONFIDENTIAL (EPCRA)
1 "1 i'l''' .............................
205 T~DE SECRET ~ Y~ ~ No 206
C}IEMI~L
If Subj~ tO EPC~ ref~ lo ins~cli~s
COM~N~ ' ~ EHS' ~Y~ ~No 20~
210
~ ~ p PURE ~ m ~RE ~ w WASTE 21t ~D~ACT~ ~ Y~ ~ No 212 ] CURIES~ .... 2~3-
PIIYSI~L STATE ~ s SOLID ~1 LIQUID ~ g ~S 214 ~R~STCO~AINER
~=~ ~ t ...........................
FED H~RD ~TE~RIES ~ 1 FIRE ~ 2 REA~ ~ 3 PRESSURE REL~E ~4 ACU~ H~L~ ~ 5 CHRONIC H~LTH
(Ch~ ~11hat
,.~u,z .........../~ I OA,LYA~Um ~oO 3at ~ .. O~LY~U~ ~oo 3 ~t .
UNffS* ~ ga ~L ~ d CU ~ ~ lb LBS ~ ~ TONS 221 ~ DAYS ON SITE ' ' ~ EHS, am~nt must ~ In ~.
g 10~GE CO~AINER ~ a A~VEGROUND T~K ~ · P~STI~NM~ALLIC DRUM D I FIBER DRUM ~ m G~SS BO~LE ~ q ~IL ~ 223
(Check ag that a~) .
Db UNDERGROUND TANK ~f ~N ~j BAG ~n P~TICBO~LE ~r OTHER
~ C T~K INSIDE BUILDING ~ g ~RBOY ' ~ k BOX ~ 0 TOTE BIN
~ d S~EL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WA~N
STOOGE PRESSURE ~ a A~IE~ ~ aa A~VE A~IE~ ~ ba BELOW A~IENT 224
STOOGE TEM~TURE ~ · A~IE~ D ~ A~VE A~IE~ ~ ~ BELOW A~IE~ ~ c CRYOGENIC 225
~, ,, ~ ...... ,~ ~ .:.;:.~ ?~ '.~.:.~,..... ~. .:,. ~ .
I ~ 226 227 229
I D Y. ~ "o 228
2 i 230 231 ~Ya ~232 233
3 234 . 235 ~ Y~ ~ ~ 236
~ I 238 239 ~Y~ ~ No 240 24
5 / 242 243 ~Y~ ~ No 244 245
.{~..,,.+,~, ~.,..i, ~. ~ ~.~,~..,~. ],.k ~ ~.~.~. · .~ . ~=~.~.~... ,: ....., ,
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-¢'J~lh~'~E & TITLE OF AU~OR~ED/. COMPAq, REPRESE~AT~E. ~ 81G~TuRE ~ .... ~
DA
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