HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This hermit is Issued for the followin~_:
[] Hazardous Materials Plan
[] Underground Storage of Hazardous Materials
[] Risk Management Program
PERMIT ID # 015-021-002100 [] Hazardous Waste On-Site Treatment
C ALIFO RNIA WATER .c?'~ vc~, ~,~.~ ~
LOCATION: CLAFIJN & 32"~ S;TREE~()V ~AKERSFIELD CA 93301
Issued by: Bakersfield Fire Department ./9 ,~ ~
OFFICE OF ENVIRONMENTAL SER VICES' ~~' d'
1715 Chester Ave., 3rd Floor Approved by: J~{J{~' 1 ~ ~_~1_~
Bakersfield, CA 93301 O~ceofE.~~ices...d Issue Date
Voice (661) 326-3979
FAX(661) 326-0576 Expiration Date: Jl, lNe 30.. 2003
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This _permit is issued for the followin_.:
[] Hazardous Materials Plan
[3 Underground Storage of Hazardous Materials
[3 Risk Management Program
[3 Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002100
CALIFORNIA WATER
LOCATION
1715 Chester Ave., 3rd Floor Approved by: (~Ralp~Huey. D~~5 Issue Date
Bakersfield, CA 93301 OfficeofEvimnmenl~Services '"
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date: 'June 30.. 2003
SITE DIAGRAM~____~ FAQL~DIAGRAM !
Business Name: ~..t',i.,,,.-,.,;~ ~.,--1-,-,-- s,,.~.,,;_~
Business Address: ~-. s4-.. ~a-o~ c_.~,,,~-ti~, ;. ~v._''j s4-.
OU
CALIFORNIA WATER SERV STAll801 SiteID: 015-021-002100
~ BusPhone 39 ~- ~O O
Manager : ~ _~ ~'i~ : (661) 325 7120
Location:
CLAFLIN & 32ND ST ~ Map : 103 CommHaz :
Minimal
City : BAKERSFIELD Grid: 19C FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 01 SIC Code:4941
EPA Numb: DunnBrad: 00-691-3578
~--~
Emergency Contact / Title Emergency Contact / Title
! ~x, SUPER
MELVIN BYRD / DISTRICT M33!AGE TIM TRELOAR ,
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 Press ImmHlth
Contact : Phone: (40~x
MailAddr
: ,/ State: -~A --
City : SAt~--~S4~ Zip :
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: RSs: Yes
ParcelNo:
.................................................... D|s~c~ Manager-Tim Treloar
Emergency Direct ives: Asst. Dis~ict Manage-Bill Ha~er
Contact Person-Tamara Johnson
CONTACT PERSON '~ii, i HEDKiCK 832-2141. Same Phone Numbers
Mailing Address Change:
~'~'~ ~ ~ ~ ~"7 ~tQ~_ 3725 South "H" Street
Do heroD? certify ~Insl Bakersfield, CA 93304
reviewed the attacl~eO hazardous m~'~erials manage-
~. ,6~. E.¢--., and %h~t i~ along wi~h
=xny o~e~ion~ oons[i~u~e a corn¢~e ~nd eorr~ man°
~®m®m gan ~r my ~acili~y.
+
1 07/30/2003
CITY OF BAKERSFIELD .......
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
1. To avoid further action, retum this form ~Siin 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
MAILING ADDRESS: ~.n 'z '5 ~o. ~ ~ +.
CITY: ~ e....- · f-,'~, ,:t. STATE: c_t, ZIP:q~'5o,4 PHONE:
PRIMARY ACTIVITY: ~-~,-.~a.~,o,- of- ~o,,,..~,~-,'~._
OWNER: ~,--.,~, e_ PHONE:
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 MONITOI~ING PROCEDURES:
B. EMPLOYEE AND AGENCY NOTIFICATION:
C. E~IRO~NT~ ~SPONSE ~AGE~NT:
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).
NATUILAL GAS/PROPANE: ..
ELECTKICAL: ..5~_.-,~,i..~. ~o, to~.~..t-`-~ o,~ .~.:~, e_.
WATER: ~/~.
SPECIAL: ~/~,
LOCK BOX: YES/~_.O IF YES, LOCATION: '--'--
PRIVATE FIRE PROTI?.CTION/WATER AVAILABILITY
A. PRIVATE FIRE PROTECTION: ------
B. WATER AVAILABILrFY (FIRE HYDRANT): ~,-~- -k~,[,-o..-,4 ,~g ,...,,_ti.
I~ZARDOUS MATERIALS MANAGEMENT PLAN
..SECTION III; TRAINING
NUMBER. OF EMPLOYEES: ~4o,,,.c. - ta ,,, ,,,., e..,,, ,,, .,.~ -,.,~-~.
MATERIAL SAFETY DATA SHEETS ON FILE: ~
BRIEF SUMMARY OF TRAINING PROGRAM:
c._O. $",~'--!"q ?,-o,_~d,.,,-.c~ ,,,, l-t.,_ ._.,...,+
CERTIFICATION
I, , , ~,,. g- I- "~.,- ~- ~,,, CERTIFY THAT THE ABOVE INFORMATION
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 INACCUILATE INFORMATION CONSTITUTES PEILYLIRY.
SIGNATURE TITLE DATE
4
,, ~_',~... s. ~ OI~CE OF ENVIRONMENTAL ~Ii~RVICES /eux~": ..... ;::::,;...
~-'~"~' BUSINESS OWNER I OPE~TOR IDENTIFICATION
FACILI~ INFORMATION
.. ~.' I. FACILITY IDENTIFICATION
LIUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 BUSINESS PHONE
~:,I'TE ADDRESS . ~ ~ ~
D~JN & 106 SIC CODE
BRADSTREET ~O- ~ I - ~ ~ (4Digit~) ~
COUNTY I~ ~ ~ ~
OPERATOR NAME ~t~L~t~ ~~ ~t~ ~o · lo9 OPE~TORPHONE
OWNER MAILING
ADDRESS ~1~ ~ ~. ~ ~ ~.
f:7 [ CONTACT PHONE ~ 118
CONTACT NAME ~ ~~
CONTACT MAILING
ADDRESS
CITY ~ ~ STATE ~ , ~21 Z P
: -PRIMARY-' '. E ERGEN ON
'
24-HOUR PHONE ~ ~ ~ ~2F 24-HOUR PHONE _~ ~
PAGER tt ~ ~28 PAGER ~ ~. ~:s
C,~rlificnlion: B~sod on my Inqu}~ of Ihoso Indivldu~ls responsible for obtaining the information. I ~dt~ under penalty of law thai I have p~rsonall7 oxarni~
;..I mn [nmilt~r wllh the informmllon submilled In Ibis Inwnlo~ and believe the Information is Irue. accurale, and ~mplele.
NAMES OF OWNE~OPE~TOR (prinl) ~36 TITLE OF OWNE~OPE~TOR
DF'CF (7/99) S:/CUPAFORMS/OES2730.TV4.wpd
/' ~ CITY OF BAKERSFIEL~ .~ o ~
, ~, ~ ~ ~ ,~ o OIN~CE OF ENVIRONMENTAI ~RVICES
~ ~1~ ~ ....
~A~.~ ~:'r 1715 Chester Ave., CA 93301 (661) 326-3979
~. CHEMICAL DESCRIPTION
(one ~ per material per Ouddm9 or
~NEW ~ADD ~ OELETE ~REVISE ~ Page ~ ol ·
CHEMI~L LO~TION · ' 201{ CHEMI~L LO~TION
O~ bi ~ '] ~NFIOENTIAL(EPC~) ~Yes ~No ~0Z ,
II Ill.,l, I ' . 1,
CHEMI~L ~ME
2O7
COM~N~ ' ~ EHS' ~Y~ ~No 208
210
TYPE ~ p PURE ~ m ~RE ~ w WASTE 211 [ ~DIOACT~ ~Y~ ~ 212[ CURIES~ 2~3TM,
~'HYS,~L STATE ~ s SOUU ~ UOU~U ~ g ~S 2{4 ~ROEST CO~NN[~ ~t.
FEDH~RD~TE~RIE9 ~ I FIRE ~2 REA~ ~3 PRESSURE REL~E ~4 AC~ H~LTH ~5 CHRONICH~LTH
(Ch~ e, that ap~)
DAYS ON SITE '
UNffS* ~ ga ~L ~ d CU ~ ~ lb LBS · ~ ~ TONS 221
* ~ E~. am~nt must ~ In I~.
g TO.GE CO~AINER ~ a A~VEOROUND T~K ~ · P~STI~N~ALLIC DRUM ' ~ I FIBER DRUM ~ m G~S BO~LE ~ q ~{L ~ 223
(Check afl that a~) ·
~b UNDERGROUND TANK ~f ~N ~j BAG ~n P~STICBO~LE ~r OTHER
~ C T~K INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE B~N
~ d S~EL D~M ~ h SILO ~ ) CYLINDER ~ p TANK WA~N
STOOGE PRESSURE ~ a A~IE~ ~ ~ A~VE A~IE~ ~ ba BELOW A~IENT 224
STOOGE TE~E~TURE ~ eA~IE~ ~ ~ A~VEA~IE~ ~ ba BELOW A~IE~ ~ c CRYOGENIC 225
[ 226 227 ~ Y~ ~ No 228
2 t 230 23~ ~Y~ ~ 232 233
242 243 ~ Y~ ~ No 244 245
' ~"RINT NA~E & TIT~E'oF ~U~O~E~ ~O~NY REP~ESE~AY~E ....... sI~T~E' ' ~ ~' ' DATE
/
UPCF (7199) S:\CUPAFORMS\OES2731.TV4,wpd