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Home My WebLink AboutBUSINESS PLAN 7/12/2007 CAL WATER SRVC (cBx-iNTExFac> T1000_BUENA-VISTA RDs- Hazardous Materials/Hazardous Waste Unified Permit .~ ~CONDITIONS' OF .PERMI~O~N.REVERSE SIDE · ' ~- - ~ ' ; , This _uermit is Issued for the followinq; : [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-001795 , r~ Risk Management Program CALIFORNIA WATER SERV ~n-S~t,,'rr,,,,t,~t LOCATION: 1000 BUENA VISTA RD " [P,~-.it, .'. OFFICE OF ENVIRONMENTAL SERVICES' ;^pprovedby: 1715 Chester Ave., 3rd Floor ': o ~. ~: ~.~z, attersnetu, CA 93301 - .',... Voice (661) 326-3979 .' FAX'(661).326-0576 :' -: i!!xpii~ation' Date: June 30. 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: CALIFO~IA wATER _ LOCATION 1000 BUENA..:~IST~:4' B~ersfield F~e Dcpa~ment Approv~ by: O~ICE OF E~R O~AL S~ ~CES 1715 Chewer Ave., Md Floor B~e~el~ CA Voic~ (805) }2&~7~ ;~ (S05),2,,5,6 Exp~tionDate: June 30, 2000 CBK OFFICE ./-, INTERFACE FACILITY · c~ ~ 24" pvc ~,y ~ LINE 49 60 50 40 J 2~ 27 ~ 22 32 * DR 2 LEVEE CANAL. I - s LIVE~'OOL ~Y /'CS u~o C~INO rJ.. OR T` CALIFORNIA WATER SRV CBK-INTERFAC Manager TIM TRELOAR Location: 1000 BUENA VISTA RD City BAKERSFIELD CommCode: BFD STA 11 EPA Numb:. SiteID: 015-021-001795 BusPhone: (661) 396-2400 Map 123 CommHaz High Grid: 06C FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / DISTRICT MGR (661) 837-7200x (661) 837-7200x ( ) - X RSs Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone Fire Press / Title / ASST DIST MGR (661) 837-7271x (661) 837-7271x ( ) - x ImmHlth DelHlth Contact BILL ROSICA Phone: (661) 837-7278x MailAddr: 3725 S H ST State: CA City BAKERSFIELD Zip 93307 Owner CALIFORNIA WATER SERVICE CO Address :3725 S H ST City BAKERSFIELD Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK Phone: (661) 837-7200x State: CA Zip 93307 TotalASTs: _ TotalUSTs: _ RSs: Yes ENT°D J U L 17 2007 based on my inquiry of those individuals responuible for obtaining the inforrr~tion, I certify under penalty of law that I have personaify examined and am familiar with the information submitted and believe the information is true, a~cc-u1rate, and complete. Sig t re Date Gall Gal -1- 07/10/2007 ~j, t; F CALIFORNIA WATER SRV CBK-INTERFAC ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001795 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE F P IH L 1600.00 GAL Hi DIESEL FUEL F IH DH L 500.00 GAL Low -2- 07/10/2007 -3- 07/1Oj2007 L. F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: NEXT TO BLDG CAS# 7681-52-9 Liquid TMixture I Ambient~E ~ A~PeRATURE ABOVEOGROUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1600.00 GAL 1600.00 GAL 1600.00 GAL t1E~G.HKLVUS 1~V1~lYV1VL'1V 15 %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 tit~~tilcl~ t~aa~~~ri~ivl a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL Facility Unit: Fixed Containers at Site ~ Days On Site 365 Location within this Facility Unit Map: Grid: NEXT TO BLDG CAS# 68476-34-6 Liquid TMixture =Ambient~E ~ A~PeRATURE ABOVEOGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 500.00 GAL 500.00 GAL 500.00 GAL - ruac~t~u~LV V a ~.vrirvtvaty ~. ~ %Wt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 11FiGtiRL H.7 .7P~JJP7L~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/10/2007 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/12/2006 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. Employee Notif./Evacuation Public Notif./Evacuation 04/12/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan 08/30/2000 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. -5- 07/10/2007 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/12/2006 ~ DIESEL IS STORED IN AN ABOVEGROUND FUEL CELL, SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment 10/18/2006 THE DIESEL FUEL CELL HAS A BUILT-IN SECONDARY CONTAINMENT USING DOUBLE-WALL CONSTRUCTION. THE SODIUM HYPOCHLORITE TANK IS SECONDARILY CONTAINED ALSO. l.1 CGL11 IJ~J V 1.11CL rcC~vurcC HCL1VaL1Oi1 -6- 07/10/2007 .; F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ or~~:ial nc«.ciiu5 Utility Shut-Offs 12/27/2006 A) ELECTRICAL - SERVICE BOX INSIDE BLDG B) LOCK BOX - NO Fire Protec./Avail. Water 10/18/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER. FIRE HYDRANT - ON SITE. Building Occupancy Level 03/14/2006 UNMANNED SITE -7- 07/10/2007 ~. F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE CO PROVIDES THE FOLLOWING TRAINING: 1. SAFETY PROCEDURES IN THE EVENT OF A HAZMAT RELEASE OR THREATENED RELEASE. 2. HAZARD COMMUNICATION STANDARD. 3. EVACUATION PROCEDURES. 4. PROPER HANDLING OF HAZMAT. 5. HMMP IMPLEMENTATION. rayc ~ ~ Held for Future Use Held for Future Use -8- 07/10/2007 I. i CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 Manager TIM TRELOAR Location: 1000 BUENA VISTA RD City BAKERSFIELD CommCode:-BFD STA 11 EPA Numb: BusPhone: (661) 396-2400 Map 123 CommHaz High Grid: 06C FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / DISTRICT MGR (661) 837-72OOx (661) 837-7200x ( ) - x RSs Contact BILL ROSICA MailAddr: 3725 S H ST City BAKERSFIELD Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone / Title / ASST DIST MG~2 (661) 837-7271x (661) 837-7271x ( ) - x Fire Press ImmHlth DelHltli ............... Phone: (661) 837-7278x State: CA Zip 93307 Owner CALIFORNIA WATER SERVICE CO Phone: (4-6-~) ^ ~~ -~~nnY Address 1~/T~rSd TTT~`~T~S 3725 So~"~ ~ Sf~ State: CA ~6~ ~37.7zoo city SAES-a~6sE '~ a l: e~s~~ cl d z ip ~-5-1-1.2 9.330 9 Period to Preparers Certif ~ d: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK TotalASTs: _ TotalUSTs: _ RSs: Yes ENT'D F~Eg ~ ~ ZpO7 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. 5 lure ~~ Da e Coal Coal -1- Ol/29/~007 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-00175 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Sits ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit f'~+ICP SODIUM HYPOCHLORITE DIESEL FUEL F P F IH IH DH L L 1600.00 500.00 GAL GAL ~# ~t~w -2- Ol/29/~007 -3- O1/29/2n07 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-00175 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: NEXT TO BLDG CAS# 7681-52-9 Liquid TMixtur~Ambient~E ~ AmbientT~E ABOVEOGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1600.00 GAL 1600.00 GAL 1600.00 GAL ----- - - r1~~t~tcLVU~ ~vlnrvl.V~lvl~ %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 t1E~GE'~1tL E'~JJr,JJ1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No Yes No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME DIESEL FUEL Location within this Facility Unit NEXT TO BLDG STATE TYPE PRESSURE Liquid TMixture ~ Ambient Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 500.00 GAL 500.00 GAL 500.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892ib3 I1HGtitC.L HJ JJ;JJ1~1r,1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M~1a No No No No/ Curies F IH DH / / / Lew -4- O1/29/2n07 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001785 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04'/12/20016 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. Employee Notif./Evacuation Public Notif./Evacuation 04/12/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE: Emergency Medical Plan 08/30/20170 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. -5- 01/29/2007 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Sits ~ ~ Release Prevention 04/12/20()5 ~ DIESEL IS STORED IN AN ABOVEGROUND FUEL CELL, SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment 10/18/2005 THE DIESEL FUEL CELL HAS A BUILT-IN SECONDARY CONTAINMENT USING DOUBLE-WALL CONSTRUCTION. THE SODIUM HYPOCHLORITE TANK IS SECONDARILY CONTAINED ALSO. l~1CQ11 V~J V 1~11C1 .RC.7 VL.Li I..C Hl:L1VGLL1Vll -6- 01/29/2007 ~\ t P CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-00179 ~ Fast Format ~ ~ Site Emergency Factors Overall Sites ~ Special riazaras = Utility Shut-Offs A) ELECTRICAL - SERVICE BOX INSIDE BLDG B) LOCK BOX - NO 12/27/20015 Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE. EXTINGUISHER. FIRE HYDRANT - ON SITE. 10/18/20n5 Building Occupancy Level 03/14/20n5 UNMANNED SITE -7- O1/29/Z007 t1 F CALIFORNIA WATER SRV CBK-INTERFAC SiteID: 015-021-001795 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/20(75 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE CO PROVIDES THE FOLLOWING TRAINING: 1. SAFETY PROCEDURES IN THE EVENT OF A HAZMAT RELEASE OR THREATENED RELEASE: 2: HAZARD COMMUNICATION STANDARD. 3. EVACUATION PROCEDURES. 4. PROPER HANDLING OF HAZMAT. 5. HMMP IMPLEMENTATION. rage Held for Future Use Held for Future Use -8- 0l/29/~bo7 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST'' B e R s F , 0 90o Truxtun Ave., suite 210 _ ~_ __.__., _.~_._.~___~~ __._ _ __ _ _.__ FIRE _ Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ''"'"' ~ Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME /t/~ ~ 1 ~~~ ~~s ~ ~ ~~~~~~ INS CTIO~ -T~ / V INSPE~O ~ E ADDRESS /~ _ HONE NOi ~~/ ^ / S NO OF ~ OYEES (// FACILITY CONTACT BUSINESS S ID NUMBER 15-021- ~~~7~`3" v Section 1. Business Plan and Inventory Program '~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSItl2SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDI THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~~ r-.~ is-~~ Inspector (Plea Print) Fire Prevention / 1s' In /Shift of Site/Station # ^ YES ^ NO White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 l ~~ ~ Bakersfield Fire Dept. UIVI~IED PR®GRAIIA INSPECTIGN CHECKLIS~ Enironmental Services _ ~ ..-: - _ ~ ~ ~~ `' 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ~ INSPECTION DATE INSPEC ON TIME l ~ ~~ ADDRESS PHONE No. No. of Employees --- /dam - -~-~--=°~~~"-~~ ~'=---- ----- -------- - - - -- ------ ---- 3 '2~ Business 10 Number FACILITYCONTACT -~--- - _--- ~---- _ r~~,v 15-021- D7' jq T ~ i Section 1: Business Plan and Inventory Program Routine ^ Combined O Joint Agency ^Mnlti-Agency ^ Complaint ^ Re-inspection C V \V=Vioatoinncel OPERATION COMMENTS ^ APPROPRIATE PPERMIT ON HAND ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS ~ ^ CORRECT OCCUPANCY ^ ~ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ... ,- -... - ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ~ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE EXPLAIN~J ~ /~.~ ,/ mil/ ~ ~l,~d'iv/~' v i L ~% /~ ~° ^ No d' QUESTIONS R RDI IS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention tst-InlShik of Site White -Environmental Services Yellow -Station Copy YEs _ ~~~`~'-.''C)` GEC? -------- Business Site Responsible Party (Please Print) 8 N Pink • Business Copy °- i, I ' + CALIFORNIA WATER SRV CBK-INTERFAC ___________________ SiteID: 015-021-001795 + Manager Location: 1000 BUENA VISTA RD City BAKERSFIELD BusPhone: (661) 396-2400 Map 123 CommHaz Extreme Grid: 07A FacUnits: 1 AOV: CommCode: BFD STA 11 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT `MGR ~huel.~ Vd~~~r / ASST DIST MGR Business Phone: (661) 396-2400x Business Phone: (661) 3~fr-z^~6$~f 837-72 ~ 24-Hour Phone (661) 396-2400x 24-Hour Phone (661) 396-2400x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth DelHlth Contact ~.1I h. os ~'cn Phone : ( 6 61) 8~-=~T~ ' MailAddr: 3725 S H ST State: CA v37-727 City BAKERSFIELD Zip 93307 Owner CALIFORNIA WATER SERVICE CO Phone: (408) 451-8200x Address 1720 N FIRST ST State: CA City SAN JOSE Zip 95112 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK Based on my inquiry of those individuals responsible for obtaining the information, 1 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. 3 z~ ~ ature Date ENT p p~ ~ ~ 2006 -1- 03/14/2006 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME I INSPECTION DATE INSPECTION TIME ADDRESS PHONE No. No. of Employees FACILITYCONTACT Business ID Number M,~L ~y RD I 15-021- ()Ip(7 ~~ Section 1: Business Plan and Inventory Pn~gram ^ Routine 'Combined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection C V ncel OPERATION t COMMENTS \V=Vioa on ^ APPROPRIATE PERMIT ON HAND 6 ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE QCT ^ VISIBLE ADDRESS (~ ^ CORRECT OCCUPANCY - ^ - VERIFICATION OF INVENTORY MATERIALS ----- ------ --- - -- ------ - ------ -...--- - ------------------- ------ - ^ - - -- VERIFICATION OF QUANTITIES - -- - - ,1 /7 /~ ~~ 7 7'~ t~ ^ VERIFICATION OF LOCATION - ~E~~ ~ ~~~ \ ^ - -- --- PROPER SEGREGATION OF MATERIAL - ------- C-vim --------------- //``~~~r// ^ VERIFICATION OF MSDS AVAILABILITYE Je[1 ` ^ VERIFICATION OF HAT MAT TRAINING ~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING f~ ^ FIRE PROTECTION -------- - ----- -------------~------- ------~-- ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES EXPLAIN: \~~ r ~"° ~ r/ V QUESTIONS REGARDING HIS INSP CTION~ PLEASE CALL US AT ~C)6'I ~ 326-3979 ---- ----- ----_..-----~3~ ----- Inspector Badge No While • Environmental Services Yellow - Slatbn Copy Busin esponsible Party Pink -Business Copy ~ I RICKS, TAYLOR & ASSOCIATES INC. CONSULTING CIVIL ENGINEERS BUS. (805) 323-3169 1326 H ST. SUITE 21 FAX. (805) 323-4331 BAKERSFIELD, CA 93301 RES. (805) 399-4860 _ (5) The following accessories shall be provided: (a) One complete set of replacement filters for oil, air, and fuel. (b) Battery rack, battery cables, battery(les) capable of delivering the minimum cold-cranking amps required at minus 25 degrees Fahrenheit per SAE Standard J-537. (c) Gasproof, seamless, stainless steel, flexible exhaust connector(s) ending in SAE flange, no screwed connections. Transition flanged exhaust piping to unit mounted exhaust silencer. (d) Flexible fuel line(s) rated 300 degrees F and 100 PSI ending in pipe thread, capable of connecting to fuel supply. (e) Engine exhaust silencer, critical sound reduction type, coating to be temperature and rust resistant, rated for critical applications. Exhaust noise shall be limited to 65 dba as measured at 10 feet in a free-field environment. The silencer will be mounted so as to prevent any condensation from damaging the engine and shall have a drain valve at the lowest end. Supply weighted exhaust pipe closure to close exhaust outlet when engine is off. Exhaust silencer and all exhaust piping inside building except flexible connection are to be lagged with insulation rated for maximum degree of exhaust plus 100 degrees. (f) Block heater of proper wattage and voltage, thermostatically controlled to maintain engine coolant at proper temperature to meet the start-up requirement of NFPA-99 or NFPA-110 Regulations at minus 25 degrees F. (g) 10-Ampere automatic float and equalize battery' charger with +- 1% constant voltage regulation from no load to full load over +- 10% AC input line variation, current limited during engine cranking and short circuit conditions, temperature compensated for ambients from -40 degrees C to +60 degrees C, 5% accurate voltmeter and ammeter, fused, reverse polarity and transient protected. Provide with indicating meter of charging voltage and amps. (h) Appropriate Metalbestos ventilated roof thimble for exhaust pipe type P-VT (i) Provide a Convault or equal 500 gallon concrete encased EPA approved above ground diesel fuel tank. Provide with vent and spill cap, 1 1/4" suction pipe with foot valve, fuel level indicator, and leak de%ector ( two ~lrCUlt) one for the space between tank walls and one to be placed in the dual walled underground fuel suction line piping. O3O + CALIFORNIA WATER COMPANY~-P~C~-=-=: Sit~eID: 015~021'-'001795 + l~Manager : ~ BusPhone: (661) ~ lLocation: 1000 BUENA VISTA RD 123 Com~az Moderate Map : : --City : BAKERSFIELD ~ ~ Grid: 07A FacUnits: 1 AOV: CommCode: BA~RSFIELD STATION 11 SIC Code:4941 EPA Nu~: DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title ~L BYRD ~ / ~T~~ ~ ~T~ ~*~ / ~*'~* SUPE~ Business Phone: (661) 396-2400x/~ Business Phone: (661) 396-2400x 24-Hour Phone : ( ) -/x 24-Hour Phone : ( ) - x Pa~er Phone : ( ) //x Pa~er Phone : ( ) - x I MailAddr: 3725~ H ST' State: CA I City : BA~SFIELD Zip : 93307 + .............. /4 ............................................................... + Owner CALIFO~IA WATER SERVICE COMPLY Phone: (408) - 45x18200 Address : 1720 N FIRST ST State: CA City : S~ JOSE Zip : 95112 + + Period to TotalASTs: = Gal : Preparer TotalUST~: = Gal ertif'd RSs: Yes arcelNo Emergency Directives: ; Contact Person-Tampa Jonson ~ S ePhoneS rs / ¢ -t- 07/30/2003 ~CTION CHECK IL ST I~_ Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave SECTION 1 Business Plan and Inventory Program Bakersfield, CA 9330l Tel: (661)326-3979 FACILITY NAME INSPECTION DATEINSPECTION TI,ME C--,¢L,~,~,~ ~v~-~'~-,~- ~_¢/z_~_~__ ...................... ADDRESS PHONE No. No, of Employees FACILITYCONTACT Business ID Number : .' -'; :,i: :: '::. ;. · :~ ,~ '~.~,' :secti°n ~l~BUsiness Plan.and Invento~Program FI Routine {~rCombined Fl Joint Agoncy Fl MUlti-^goncy Fl Complaint Fl Ro-inspoction C V (c=compliance'~ OPERATION COMMENTS x, v=Violation _~ Fl APPROPRIATE PERMIT ON HAND o c .................. .................................................... ~ Fl VISIBLE ADDRESS Fl CORRECT OCCUPANCY ,~ Fl VERIFICATION OF INVENTORY MATERIALS ~ Fl VERIFICATION OF QUANTITIES [~ Fl VERIFICATION OF LOCATION ............. -~i~'~7~ .................................... J~ Fl PROPER SEGREGATION OF MATERIAL [~ Fl VERIFICATION OF MSDS AVAILABILITYE J~ Fl VERIFICATION OF HAT MAT TRAINING ~ Fl VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES Fl EMERGENCY PROCEDURES ADEQUATE .J~ Fl CONTAINERS PROPERLY LABELED J~ Fl HOUSEKEEPING j~ Fl FIRE PROTECTION ,~ Fl SITE DIAGRAM ADEQUATE & ON HAND ' ANY HAZARDOUS WASTE ON SITE?: Fl YES ,~No QUESTIONS REGARDING HIS INSP CTION? PLEASE CALL US AT (661) 326-3979 -- Inspector Badge No. ponsible Party White - Environmental Services Yellow - Station Copy Pink - Business Copy ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~ Floor, Bakersfield, CA 93301 FACILITY ~AM~ ~m~ ~t~ca, ~SPECTION DATE FACILITY CONTACT "'~,,~ ~,~"~ - BUSINESS ID NO. 15-210- ~SPECTION TIME ~ ~;~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program dRoutine [~ Combined [~ Joint Agency [~} Multi-Agency ~.~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address b/ Correct occupancy v/ Verification of inventory materials Verification of quantities . ~. e/ Verification of location ~, Proper segregation of material / Verification of MSDS availability / Verification of Haz Mat training l/ (~,t.'fD~{ ~ {)~tq'~O~ Verification of abatement supplies and procedures I,,/' ~ I,~ /~,(~h~(4" ~t'l~, Emergency procedures adequate V/ -~ Containers properly labeled t./ ]J,,~.lJf ~c[ ~ (~]~c Housekeeping .. ~ Fire Protection / Site Diagram Adequate & On Hand / /'-- C=Compliance V=Violation Any hazardous waste on site?: [~ Yes ~'~o Explain: ..~_~_~.~,._~.~_~,_~ ~ Questions regarding this inspection? Please call us at (661) 326-3979 Business Site Responsible Party White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: ~ CALIFORNIA WATER SERVICE COMPANY SiteID: 015-021-001795 Manager : MEL BYRD BusPhone: (805) 832-2141 Location: 1000 BUENA VISTA RD Map : 123 CommHaz : Moderate City : BAKERSFIELD Grid: 07A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 11 SIC Code:4941 EPA Numb: DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact ~/ Title MEL BYRD / DISTRICT MGR TIM TRELOAR / GENERAL SUPER Business Phone: (805) 396-2400x Business Phone: (805) 396-2400x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) ~ x Pager Phone : ( ) - x Pager Phone : ( ') - x Hazmat Hazards: RSs Fire Press ImmHlth DelHlth Contact : Phone: (805) 832-2141x MailAddr: 3725 S H ST State: CA City : BAKERSFIELD Zip : 33307 Owner CALIFORNIA WATER SERVICE COMPANY Phone: (805) 832-2141x Address : 1720 N FIRST ST State: CA City : SAN JOSE Zip : 95112 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: Yes Emergency Directives: ---- Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site ISpecHazlEPA HazardsI Frm DailyMax Unit MCP Hazmat Common Name... DIESEL #2 F IH DH L 500.00 GAL Low CHLORINE I, ~L~/u%.~¢[~ D0 hereby ce~i~ ~aF~ ha~ G 1600.00 GAL Ext reviewsd the attached hazardous rna/,srials rnanage- ment plan for c,_u ~ and ~ha~ il alomg wi~h (Name of Business) any corrections constiiu~e a cornple~e and correc~ man- agemem plan for my facility. ~ i Signature - Date 1 07/19/2000 CALIFORNIA WATER SERVICE COMPANY SiteID: 015-021-001795 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site --~COMMON NAME / CHEMICAL NAME DIESEL #2 Days On Site 365 Location within this Facility Unit Map: Grid: NEXT TO FACILITY BLDG ~. CAS# 68476-34-6 Liquid Pure Ambient Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 500.00 GAL 500.00 GAL 500.00 GAL HAZARDOUS COMPONENTS %Wt.I ~S CAS# 100.00 Diesel Fuel No. 2 N 68476302 HAZARD ASSESSMENTS TSecretl RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP NoIN° No No/ Curies F IH DH / / / Low ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ -- COMMON NAME / CHEMICAL NAME CHLORINE Days On Site SODIUM HYPOCHLORTE 12.5% 365 Location within this Facility Unit Map: Grid: NEXT TO FACILITY BLDG CAS# 7882-50-5 F STATE ~ TYPE PRESSURE I TEMPERATURE CONTAINER TYPE / I I Ambient Pure Above Ambient . · Gas PORT PRESS CYLINDER AMOUNTS AT THIS LOCATION Largest COntainer Daily Maximum Daily Average 1600.00 GAL 1600.00 GAL 1600.00 GAL HAZARDOUS COMPONENTS %Wt. y~ CAS# 12.50 Chlorine (EPA) 7782505 HAZARD ASSESSMENTS TSecret Y~ Bi°Hazl Radi°active/Am°untNo No No/ Curies I EPA Hazards INFPAF P IH / / / USDOT# MCPExt 2 07/19/2000 i CALIFORNIA WATER SERVICE COMPANY ~~~E~E~ SitelD: 015-021-001795 i iE Notif./Evacuation/Medical EEEEEEEEEE~EEE~E~EEEEEEEE~EEEEEE~EE Overall Site i iE~ Agency Notification EEEE~E~EEE~E~EEEEE~~EEEEE~E 08/19/1997 i o o o CALL 911 AND 1-800-852-7550 OR 1-916-427-4341. o O o iEEE Employee Notif./Evacuation EEEEEEEEEEE~EEEEE~EEEEEEEEE~EEEEE 08/19/1997 i o O ° NOT APPLICABLE THIS IS AN UNMANNED SITE. ° o o iE~EE Public Notif./Evacuation ~EEEEE~EEE~E~E~E~EE~E~E~EEE~E~E 08/19/1997 i O o ° WE WOULD'PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IF AN o ° EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL ° ° POPULATION AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. o o O iEEEEE Emergency Medical Plan EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE~EEEEEE 08/19/1997 i o o ° MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL - TRUXTUN AVE. o o o -3- 07/19/2000 CALIFORNIA WATER SERVICE COMPANY i/~ Mitigation/Prevent/Abatemt ~~~~~ Overall Site i~ Release Prevention ~~~~~~~ 08/19/1997 o DIESEL IS STORED IN AN ABOVEGROUND FUEL CELL, SODIUM HYPOCHLO~TE IS STORED IN AN ABOVEGROUND SECURE AREA. O i~ Release Contaiment ~~~~~e~~ 08/19/1997 O THE DIESEL FUEL CELL HAS A BUILT IN SECONDARY CONTAINMENT USING DOUBLE WALL CONSTRUCTION. THE SODIUM HYPOCHLO~TE TANK IS SECONDA~LY CONTAINED ALSO. O O o i6~ Other Resource Activation o o -4- 07/19/2000 i CALIFORNIA WATER SERVICE COMPANY ~~¢~~ SitelD: 015-021-001795 i~ Site Emergency Factors ~~~~~~ Overall Site i i~fi Special Hazards O o o o i~ Utility Shut-Offs ~~~~~~~ 08/19/1997 o o ° A) GAS - N/A o B) ELECTRICAL - SERVICE BOX LOCATED INSIDE FACILITY BLDG o ° C) WATER - N/A o .o D) SPECIAL - NONE o ° E) LOCK BOX - NO o o o aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee ~f i~ Fire Protec./Avail. Water ~~~~~ 08/19/1997 o PRIVATE FIRE PROTECTION - ??????? o O o o O o NEAREST FIRE HYDRANT - FIRE HYDRANT ON SITE. o O O ~ Building Occupancy Level 0 0 -5- 07/19/2000 CALIFORNIA WATER SERVICE COMPANY i8~~8~~~~~8~8~8~ Fast Format i i8 Training ~8888~88~~~8~8~8~888888~88~~888 Overall Site i/~/~ Employee Training/~88/~8~5~88888/~8/~/~/~888~/~8/5/588~888~fi~888888~8~ 08/19/1997 o THIS IS AN UNMANNED SITE. o O WE DO HAVE MSDS SHEETS ON FILE. ° o BRIEF SUMMARY OF TRAINING PROGRAM: 'CALIFORNIA WATER SERVICE COMPANY o PROVIDES THE FOLLOWING TRAINING: o 1. SAFETY PROCEDURES IN THE EVENT OF A HAZARDOUS MATERIAL RELEASE OR ° THREATENED RELEASE. o 2. HAZARD COMMUNICATION STANDARD. ° 3. EVACUATION PROCEDURES. ° 4. PROPER HANDLING OF HAZARDOUS MATERIALS. , ° 5. HMMP IMPLEMENTATION. o o O o i~.Held for Fumre Use o o i~i~ Held for Fumre Use o o z6- 07/19/2000 ARTMENT BAK SFIELD CITY FIRE HAZARDOUS MATERIALS DIVISION I715 'CHESTER'.AVl; BAKERSFIELD, CA. 93301 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 brier and concise as po~ible. SECTION 1' BUSINESS IDENTIFICATION DATA LOCATION: I O O °':E)',-,,~'~ ,'*"k~.S'r"'". ~----b,. MAILING ADDRESS: ~.-~'-/2-~ ~,..~,..r'r~." ~¢..~" CITY:~z_~'~.~c:,~;,.-.e STATE:~-/'¢' ZIp?DS'~OZI, PHONE~D~~-~I DUN&BRADSTRE'ETNUMBER' 0~-~1-~5~ SIC CODE: ~1 PRIMARY ACTIVITY: ~ . MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE · .~ ~ t~zardoum ~ateria4s Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: T~AININO: NUMBER OF EMPLOYEES: ~o~-u~~~~, MATERIAL SAFETY DATA SHEETS ON FILE: '"d~% · BRIEF SUMMARY OF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT'MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TiMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, -~1 ~-,~ ~ ~ IZ)~,c~ CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION· CONSTITUTES PERJURY. Hazardous Niateri~ls Df~sioil~ HAZARDOLIS I~A?ERiAL$ MANA(~EMIENT PLAN Facility Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A, AGENCY NOTIFICATION PROCr. DURE.~. 8, EMPLOYEE NOTIFICATION AND EVACUATION: "1',,.Io~ ..... · :.~ .-~ : BskersSel&Fire Dept~ Haz~dous Materials Divisfl~ ...... HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITI(~ATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: B. RELEASE-CONYAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCAT[ON OF SHUT-OFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: ~'J/~' WATER: SPECIAL: ~ , LOCE BOX: YE~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECT[ON: B, WATER AVAILABILtTY (FIRE HYDRANT): ~,i~~-- ~-~R~,~'r' Ot,,.t ~','-t-'m-. . , :_,,.~ HAZARDOUS MATERIALS DIVISION .. ..,)~ 1715 CHESTER AVE. ,' .~ BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARBOUS MATERIALS INVENTORY FAC:LIT;Y DESCRIPTION =AC',~ NAME ~,~ CCDE ~4 I DUN & BPADSTRE~ NUMBER 4) PH~IC~ & H~ PH~I~ H~ H~O CA~ES Rte ~ Re~ ( I S~en Re~ et Pr~sure ~) WAS~ C~SSIRCA~ON {3~ig~ ~de ~m OHS Fo~ 8~) USE ') X~OUNT ~NO n~E ~ ~AC~U~ UN~TS 0~ )~SURE a) S~O~aE COO~ A~I 0aN A~um: ~ :unea ( ] b) Pre--e: Ann~ ~t: ~ 0 c) Ternary: M Oa~ On Site ~ C~rcte~ich Months: AllYe~. J. P. M. A. M. J. J. A. ~, O, N. O :nem~ cam~n= or ~y AHM com~ne~ 2t [ ] CHEMICAL DESC~I~ION :N~NTCRY STA~S: New~ z¢a~on f ) ~e~sion ( ] Deter,on ( ] Che~ ~ chem~ ~ a NON ~E S~' ~E SECR~ [ ] CommonN~e: ~ ~~ I~ '3) ~Te (o~) PHYSICA~~ '~RO CA~GORIES F~re ~ ~ qeamwe j J Suaaen He,e~eox ~'essure PHYSICAL STA~ Solid [ ' ~au~d ~ G~ { ] Pure ~ M~ure [ ] W~[e [ ] R~ [ ] ' -'MOUNT AND ~ME AT F~C;~( ;NITS CF M~SURE 8) STOOGE Ave~aqe 0~ Amount: ~ :unes Annum Amoun%: ~ ' c) Tem~: ~gest ~*zeCom~ner: t ~0 0 ~ ~a~ On Si~e ~ ~;rcle ~cn Mom,s: All Ye~. MITRE: ~st COMPON~ C~ · % ~ AHM :~e (brae most ~ous '~ [ ] c~em~ com~nen~ or ~y AHM com~nen~ =~ [ I I~ N~e & ~e or ~nz~ Como~ Re=res~e ~ign~ HAZARDOUS MATERIALS DIVISION .1715 CHESTER AVE. BAKERSFIELD, CA. 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION rAC,L,~ NAME C;~ ~t~ ~~ STAT=- ~. ZiP .EiC CODE 4~ 4 I DUN & BPAOSTREET NUMBER ~- ~ :.,iAIL;NG ,.-,,...,.CF, ESS ,%7'2,6' C;"F¢ .,~,~.l..4..~p_.,~..~,,-:_,.-~ -_., A, .z ~-"~,A-. ZiP BAKERSFIELD Cl'i FIRE DEPARTed/lENT HAZARD! JS MATERIALS INVENTOI r Page._of-- . ?:.: ..' . CHEMICAL DESCRIPTION ~:~:'?" ":'~. ~) ~NVF. NTORY STATUS: Ne,,,'j~.-- ~S~o. I ] Re~"=n [ ] ~,atmn I 1 Ch.ek ~ c,em~..~ ~= a NON T~gE sc-c~-r'~' ] PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire ~ ReeCtwe ( ] Sudden Release of Pressure [ ] lmmecliate HeaJ~ (Acute) { ] Delayed HeaJUl {Chrome) WASTE CLASSIFICATION (3~igit code from OHS Fon'n 8022} USE CODE ~ ~ PHYSICAL STATE Solid [ ] Liquid ~ Gas [ ] Pure ~)~ Mixture [ ] Waste { ] nadk~eclive ( ] ') AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Max~mumOa~NAmount: ._.~OO ;bs [] gaJ~ ~3 [] a) Contamer. Avera~Je ~alV Amount: ~ tunes { ] b) Pressure: AnnueJ Amount: b'~C~O c) Teml:)eratum: L.a, rcjest Size Contaner: ~C) O ~ Oars Qn Site ~ Circle W~ich Months: All Ye~. J, F, M, A, M, J, J, A, 8, O, N, D MIXTURE: List COMPONENT CAS ~ % WT AHM ~nem,ca~ comoonems or my AHM comf3onents 21 [ ] [] CHEMICAL DESCRIPTION · ) !NVENTCRY STATUS: New'~ .-'c~ition ~: I Revision { ] Cetetion { ] Chect( if chemicaJ is ,* NON TRADE SECRET~ 'TRADE SECRET '~) Common Name: ~ _{--t- '.~ ~ I ~ I=:::: 3) DOT # ~AZARD CATEGORIES F~re { ! =~eac~lve { I Suaaen Reieaseo~ vressure-T ] Irnmeaia~e HeaJth (Acute) ( ] Delm/ea HeeJth (Chmn~Cl ~ - 5} PHYSICAL STATE Solid [ ! Uau=d '1~ G~ [ ] Pure ~ Mixture [ ] Waste [ ] ,:') AMOUNT AND TIME AT F,;C;LJT'F UNITS CF' MEASURE 8) STORAGE CCDES Averaqe O~iy Amount: ~ curies [ ; b) Pressure: Annu~ Amount: [~O c) Temprite: ~qest S~ze Contmner: [ ~00 ~ O=vs On Site ~ C;rc~e W~cn Months: A~I Ye=. J. F, M, A, M, J, J, A. S, O, N, O MIXTURE: [Jst COMPONENT CAS # % w'r ' AHM :~e three most tlaza,,c3ous ~! [ ] C.-.emlcaJ coml)<3nen~ or any AHM comt:)onents 2.~ [ ] ~rary unaer ~ene~y or/aw, ~a~ ~ nave ~ersoneuly examined ann am ~aml.a~ w~[n me )nrornauon suornl~teo on ml~ eno all =mirted information is Due, a¢cura,~.~anO como~ete. INT Name & TTtle of Au~onzeo CornDany Re~resenlaove Signature BAKERSFIELD CITY FIRE DEPARTMENT H/~.ARDOUS MATERIALS DIVISION I715 'CHESTER':,A]VE~ BAKERSFIELD, CA. 93301 .,- 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 brief and concise os possible. SECTION l' BUSINESS IDENTIFICATION DATA LOCATION: I 0 0 °?~ O'-~w'~X'/~ s'r'~ MAILING ADDRESS: CITY: ~~ ¢,~0 STATE: DUN & BRADSTREET NUMBER: O~- ~1-~~ S~C CODE: PRIMARY ACTIVITY: ~~/~r~ MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION' CONTACT TITLE BUS. PHONE 24 HR. PHONE .: .. .. Bakersfield Fire Dept. .~--,-~ -~ ardous aterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN ' SECTION 3: TRAINING: MATERIAL SAFETY DATA SHEETS ON FILE: ""'r'~'~, BRIEF SUMMARY oF TRAINING PROGRAM: SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT'MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS' WE DO NOT HANDLE HA. ,~RDOUS MATERIALS. WE D°' HANDLE HAZARDOUS MATERIALS, BUT THE QUANTIT]E$ AT NO TIMEEXCEED 'THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, "~ ~ ~ E I~R,C~- CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSTANDTHATTHISINFORMATIONWILL'BEUSEDTO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZAROOUS MATERIALS (OtV.. 20 CHAPTER 6,95 SEC, 25500 ET AL.) AND THAT INACCURATE INFORMATION.CONSTEUTES PERJURY. SIGNATURE TITLE DATE. · .... · ~/,~.<., Bakersf!etcl Fire Dept. ~..~ ~,i ~-' PIazardous Materials Divisid HAZARDOUS MATERIALS MANAGI~MENT' PLAN Facili17 Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: B. EMPLOYEE NOTIFICATION AND EVAC. UATION: '1',,,)o~ C. PUBLIC EVACUATION' lX..[~__ kdCX.)~.D .D~_.~.~=~~ ~ ,~,.-"r. O~ · Bak~ sEeld. Fire Dept Hazardous 1V[aterials Division HAZARDOUS MATERIALS MANAGEMENT SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: B. RELEASE'CONTAINMENT ANO/QR MINIMIZATION: C. CLEAN-UP PROCEDURES' SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): ELFCTRICAL:~V tcce_~ ,~X~kOc-~-r~o IN6~DE ~lu~ P~O,~IN~ WATER' ~/~ " SPECIAL: ~ LOCEBOX: YE~ IFYES, LOCATION' SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:. A. PRIVATE FIRE PROTECTION' B. WATER AVAILABILITY (FIRE HYDRANT): ~,~-- ~-~'Di~/~'r C)k~ ~,-t~--.