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HomeMy WebLinkAboutBUSINESS PLAN 10/1/2003Hazardous Materials~'azardous WaSte Unified,.Permit CONDITIONS.-OF~ PER:MITONREVERSE SIDE Permit ID#:: 015-000-000293 CALIFORNIA WATER SERV IELD' LOCATION: 4400 PANORAMA DR Issued by: Bakersfield Fire Department .~ OFFICE OF ENVIRONMENTAL SERVICES' .Al~Pro~edby: . 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 ' Voice (661) 326-3979 FAX (661) 326-0576 · This rmrmit is issued for the followln_q; 'gq Hazardous Materials Plan . [] Underground Storage of HazardOus Materials El Risk Management Program · [] Hazardous Waste On-Site Treatment June 30. 2003 · ' OfficcofEvimnmenllffServices '"' .* Expiration Date: Issue I~te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ~ ..~,=,~,,,,.~,~.?~?:i~,~=~:,~,.:?:,~x~%~.~,~,,, ........ This permit is issued for the following: ~- "-'-.~ ~ ~ ~- ~?i~... --, '2'~ ~ ~ ~ / '%~ ~ ". '~ ~q . '~---- ~ '~_~, ~ '.._, ~ "~>-. ~ .."' .,-":~=~= -7' _ ~ ~'~-~;:~.,"L.,'"'/"./'/'/'/'/;: ./ Issued by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., ~rd Floor Bakersfield, CA Voice (805) 326-3979 FAX (805) 326-0576 Approved by: Expiration Date: June '30, 2000 SECT/OH '-. %~ / / -~,, . / / · ~- ...~.. / / ~;_ x,,~ ~,x~, / / -%,~.~,,~ / / '~'-.~ / / '%. %. / /..-_ . , / FLAM V'I Eh4 ,~g~: I'*= ,40' V~C~N~Ty MAP NO F~-A? 52- CALIFORNIA WATER SERVICE CO. DA J~ ~ J~ F I J~ L E~ DIgTRICT ~jTA I~ - ~A~O~A~~, PROPOS~P ~00 ~L. DIESEL F~EL TAHK ...... ,,_ ~*~o ~. ~¢~ . + CALIFORNIA WATER SERV "~ STA176 Manager : Location: 4400 PANORAMA DR City : BAKERSFIELD CommCode: BAKERSFIELD STATION 08 EPA Numb: SiteID: 015-021-000293 + BusPhone: (661) ~ Map : 103 CommHaz : Low Grid: 14A FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title IV3gYnV~N BYRD /-~o~ .... Business Phone: (661) 396-2400x 24-Hour Phone : (661) 396-2400x Pager Phone : ( ) - x Hazmat Hazards: Emergency Contact / Title TiM TRELOA4% / GEN-SUBF~R-- Business Phone: (661) 396-2400x 24-Hour Phone : (661) 396-2400x Pager Phone : ( ) - x Fire + ImmHlth DelHlth } Contact : /// Phone~- (~08) ~51-8~700x MailAddr: P~-BOX it~0 State:~CA City : S/~ Zip : 951-6~. Phone: (408) 451-8200x State: CA Zip : 95112 Owner CALIFORNIA WATER SERVICE COMPANY Address : 1720 N FIRST ST City : SAN JOSE Period : to Preparer: Certif'd: ParcelNo: Emergency Directives: TotalASTs: = TotalUSTs: = l~q_q~- I~TC~ District Manager-Tim Treloar Asst. District Manager-Bill Harper Contact Person-Tamara Johnson !/.~'me-Ph on~n~e Num bers I Maiting Address Change: ~3 ~ 725 Sour "II" Str I;-'7~m,~O~ ~fo/ear~o/o, Do hereby e®r~if~ Bakersfield, CA 93304 Gal Gal reviewed the ar{ached hazardous ment plan forO_g/j ,,~. g,4/-'7'~C_ and that it ~on{~ with any corrections constitute a comp]ets and'corr~-'t man~ agemem plan for my facility. 1 07~30/2003 ~CITY OF BAKERSFIELD FIRE DEPARTMENT ~{~~ ~,]~! OFFICE OF ENVIRONMENTAL SERVICES ~,k~ .. 241~_,,~ .. '~ UNIFIED PROG~M INSPECTION CHEC~IST 1715 Chester Ave., 3~ Floor, Bakersfield, CA 93301 FACILITY NAME ADDRESS ~-~",f.O O FACILITY CONTACT INSPECTION TIME INSPECTION DATE PHONE NO. 3Z3 BUSINESS IDNO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine [] Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit 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 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 C=Compliance V=Violation Any hazardous waste on site?: Explain: [] Yes <~o Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Busines/~/~ Responsible Party Inspecto '~/.~'~'~ CALIFORNIA WATER SERV CO STA176 Manager : Location: 4400 PANORAMA DR City : BAKERSFIELD CommCode: BAKERSFIELD STATION 08 EPA Numb: SiteID: 015-021-000293 BusPhone: (805) 323-5439 Map : 103 CommHaz : Low Grid: 14A FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578. Emergency Contact / Title MELVIN BYRD / DISTRICT MANAGE Business Phone: (805) 396-2400x 24-Hour Phone : (805) 396-2400x Pager Phone : ( ) - x Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone : Pager Phone : / Title / GEN SUPER (805) 396-2400x (805) 396-2400x ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : MailAddr: PO BOX 1150 City : SAN JOSE Phone: ( ) State: CA Zip : 95108 X Owner CALIFORNIA WATER SERVICE COMPANY Address : 1720 N FIRST ST City : SAN JOSE Phone: (408) 451-8200x State: CA Zip : 95112 Period : Preparer: Certif'd: to TotalASTs: = Gal TotalUSTs: = Gal RSs: No Emergency Directives: = Hazmat Inventory --As Designated Order Hazmat Common Name... DIESEL FUEL (-ry~ or.print name) One Unified List Ail :Materials at Site ISpooHazlEPA Hazards Frm I DailyMax IUnit MCP F IH DH L 500.00 GAL Low hereby certify that I have reviewed ~he a~ached hazardous rnatsrials manage- merit plan for c ~u ~ and ~ha~ i~ along with ' ' (Name of Bu~iness) any corrections consfi~u~s a complete and correct man- agemem plan formy facilib/. 1 07/19/2000 CALIFORNIA WATER SERV CO STA176 ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME DIESEL FUEL Location within this Facility Unit CLOSE TO SHELTER SiteID: 015-021-000293 Facility Unit: Fixed Cont,ainers on Site Map: Grid: Days On Site 365 CAS# 68476-34-6 rSTATE Liquid TYPE PRESSURE Pure Ambient TEMPERATURE Ambient CONTAINER TYPE'-- ABOVE GROUND TANK Largest ContainerGAL AMOUNTS AT.THIS LOCATION Daily Maximum 500.00 GAL Daily Average 500.00 GAL %Wt. Diesel 100.00 Fuel No. HAZARDOUS COMPONENTS 2 I ~S CAS# N 68476302 HAZARD ASSESSMENTS Radioactive/Amount EPA Hazards No/ Curies F IH DH NFPA /// USDOT# MCP Low 2 07/19/2000 CALIFORNIA WATER SERV CO STA176 SiteID: 015-021-000293 Fast Format = Notif./Evacuation/Medical --Agency Notification CALL 911 Overall Site 10/05/1992 Employee Notif./Evacuation N/A - THIS IS AN IINMANNED SITE! 10/05/1992 Public Notif./Evacuation 10/05/1992 EVACUATION OF THE LOCAL POPULATION TO BE DETERMINED BY EMERGENCY SERVICES PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL. Emergency Medical Plan .10/05/1992 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVENUE, BAKERSFIELD. 3 07/19/2000 CALIFORNIA WATER SERV CO STA176 SiteID: 015-021-000293 Fast Format ~ Mitigation/Prevent/Abatemt --Release Prevention DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK. Overall Site 09/27/1994 --Release Containment 09/27/1994 IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. THE CONVAULT TANK HAS A BUILT IN SECONDARY CONTAINER, & IS ENCASED IN --Clean Up ~ 09/27/1994 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY Other Resource Activation -4- 07/19/2000 CALIFORNIA WATER SERV CO STA176 SiteID: 015-021-000293 Fast Format Site Emergency Factors Special Hazards Overall Site --Utility Shut-Offs A) GAS - ???????? B) ELECTRICAL - ?????????? C) WATER - ???????? D) SPECIAL - ??????? E) LOCK BOX - ????????? 04'/25/1990 -- Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS 04/25/1990 FIRE HYDRANT - ON-SITE WELL DISCHARGE Building Occupancy Level -5- 07/19/2000 CALIFORNIA WATER SERV CO STA176 SiteID: 015-021-000293 Fast Format Training -- Employee Training WE HAVE NO EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: Overall Site 09/27/1994 Page 2 Held for Future Use -- Held for Future Use -6- 07/19/2000 CALIFORNIA WATER SER~I~CQ~-~A~Ui~_~~%#~_~i. - SiteID: 215-000-000293 Manager : 'I~)L~L~L~U ~/ L-~Bl~iPhone (805) 323-5437 Location: 4400 PANORAMA DR M , : 103 CommHaz : Low City : BAKERSFIELD .,~ : 14A FacUnits: 1AOV: CommCode: BAKERSFIELD STATION ~Y/~ SiCt Code:4941 EPA Numb: ~' DunnBrad:00-691-3578 Emergency Contact / Title MELVIN BYRD / DISTRICT MANAGE Business Phone: (805) ~z~lx 24-Hour Phone : (8051 ~rxX ~ Pager Phone : ( - Hazmat Hazards: Emergency Contact / Title TIM TRELOAR / GEN SUPER Business Phone: (805) ~lx~ 24-Hour Phone : (805) 3~x Pager Phone : ( ) - x Fire ImmHlth DelHlth Agency-Defined Topic Title ~ Hazmat Inventory ---- MCP+DailyMax Order Hazmat Common Name... DIESEL FUEL One Unified List Ail Materials at Site ISpooHazlEPA HazardsI Frm I DailyMax lUnitlMCP F IH DH L 500 GAL Low ~,---,~ r-~-.c>iz, tv- Do hereby certify th~ ~ have ~Y~ or pdnt ~) -- reviewed fl-~,:~ .~. ~, ~ched hazardous mmedals manage- ment plan far~~ ~o. and that it along with (NAme of BusLqe~) any corrections constitute a complete and corre~ man- agement plan for my faci~i~, CALIFORNIA WATER SERVICE COMPANY ~ Inventory Item 0001 -- COMMON NAME / CHEMICAL NAME DIESEL FUEL Location within this Facility Unit CLOSE TO SHELTER SiteID: 215-000-000293 Facility Unit: Fixed Containers on Site Days On Site 365 CAS# 68476-34-6  STATE -- TYPE PRESSURE Liquid Pure I Ambient TEMPERATURE Ambient CONTAINER TYPE ABOVE GROUND TANK Lrgst Cont.this Loc GAL DailyMax Stored GAL AMOUNTS STORED AND IN USE DailyMax this Loc GAL 500.00 DailyMax Open Use GAL DailyAvg this Loc GAL 500.00 DailyMax Closed Use GAL %Wt. 100.00 HAZARDOUS COMPONENTS Diesel Fuel No. 2 IEHSI CAS# No 68476302 -2- CALIFORNIA WATER SERVICE COMPANY SiteID: 215-000-000293 Notif./Evacuation/Medical Agency Notification CALL 911 Fast Format Overall Site 10/05/1992 ----- Employee Notif./Evacuation N/A - THIS IS AN UNMANNED SITE! 10/05/1992 ------ Public Notif./Evacuation 10/05/1992 EVACUATION OF THE LOCAL POPULATION TO BE DETERMINED BY EMERGENCY SERVICES PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL. Emergency Medical Plan 10/05/1992 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVENUE BAKERSFIELD. ' -3- CALIFORNIA WATER SERVICE COMPANY SiteID: 215-000-000293 Fast Format Mitigation/Prevent/Abatemt Release Prevention DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK. Overall Site 09/27/1994 -- Release Containment 09/27/1994 IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. THE CONVAULT TANK HAS A BUILT IN SECONDARY CONTAINER, & IS ENCASED IN -- Clean Up 09/27/1994 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY Other Resource Activation -4- CALIFORNIA WATER SERVICE COMPANY SiteID: 215-000-000293 Fast Format Site Emergency Factors Special Hazards Overall Site -- Utility Shut-Offs 04/25/1990 A) GAS - ???????? B) ELECTRICAL - ?????????? C) WATER - ???????? D) SPECIAL - ??????? E) LOCK BOX - ????????? -- Fire Protec./Avail. Water 04/25/1990 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SITE WELL DISCHARGE Building Occupancy Level 5 CALIFORNIA WATER SERVICE COMPANY SiteID: 215-000-000293 Fast Format Training -- Employee Training WE HAVE NO EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: Overall Site 09/27/1994 -- Page 2 -- Held for Future Use Held for Future Use -6- 08/04/94. CALIFORNIA WATER SERVICE COMPANY 215-000-000293 Overall Site with 1 Fac. Unit General Information Page Location: 4400 PANORAMA DR City : cOntact Nam.e Business Phone: (805) 24-Hour Phone : (805) I .Pager Phone : ( ) Map~103 Haz~2 Type: 3 [ Grid. 14A F/U.. 1 AOV: 0.0[ Contact Name ~ Title ~ Business Phone: (805) 832-2141x 24-Hour Phone : (805) 327-2161x Pager Phone : ( ) - x Title DISTRICT MANAGE 324-6011x 327-2161x - x Administrative Data Mai~ Addrs: P.O. BOX 1150 City: SAN JOSE Comm Code: 215-008 BAKERSFIELD STATION 08 D&B Number: 00-691-3578 State: CA Zip: 95108- SIC Code: 4941 Owner: CALIFORNIA WATER SERVICE COMPANY Phone: (408) 451-8200 Address: 1720 N FIRST ST State: CA City: SAN JOSE Zip: 95112- Summary I, ~¢v~J~ ~.~,,. Do hereby certify that I have reviewed_ the~ attached hazardous materials manage- ment plan for,. ~,,.'o,s.~.~) -_and that it along with any corrections constitute a complete and correct man- agement plan for my facility. 08/04/94 Pln-Ref CALIFORNIA WATER SERVICE COMPANY 215-000-000293 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Name/Hazards Form Max Qty Page MCP 2 02-001 DIESEL FUEL · Fire, Immed Hlth, Delay Hlth Liquid 500 GAL Low 08~04~94 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order Page 3 02-001 DIESEL FUEL · Fire, Immed Hlth, Delay Hlth Liquid 500 Low GAL CAS #: 68476-34-6 Form: Liquid Type: Pure. Daily Max GAL 500 I Storage ABOVE GROUND TANK Trade Secret: No Days: 365 Use: FUEL Daily Average GAL 500.00 Annual Amount GAL 500.00 Press T Temp Location IAmbient[AmbientlCLOSE TO SHELTER -- Conc~ Components 100.0% [Diesel Fuel No. 2 MCP --~Guide Moderate[ 27 08/04/94 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site <D> Notif./Evacuation/Medical Page 4 <1> Agency Notification CALL 911 <2> EmploYee Notif./Evacuation N/A - THIS IS AN UNMANNED SITE! <3> Public Notif./Evacuation EVACUATION OF THE LOCAL' POPULATION TO BE DETERMINED BY EMERGENCY SERVICES PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL. <4> Emergency Medical Plan MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVENUE, BAKERSFIELD. 08/04/94 CALIFORNIA WATER SERVICE COMPANY 00 - Overall Site <E> Mitigation/Prevent/Abatemt 215-000-000293 Page 5 <1> Release Prevention <2> Release Containment A HA2~RDOUS ~IQUIB~ SUCH Aj$ GASOL~/NE OR ~ESEL, ~BAND ST~RED AT ~I~E FIELD~/ ABSmB~T. /A~ C~I$~D S~WILL ~E~RO~E~7 DIgP~ED O~. ~ ~ ' IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, AR~NGEMENTS WOULD BE ~DE TO I~EDIATELY REMOVE ALL FUEL FROM THE TANK. <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation 08/04/94 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site <F> Site Emergency FactOrs Page 6 <1> Special Hazards <2> Utility Shut-Offs A) GAS - ???????? B) ELECTRICAL - ?????????? C) WATER - ???????? D) SPECIAL - ??????? E) LOCK BOX - ????????? <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SITE.WELL DISCHARGE <4> Building Occupancy Level 08~04/94 CALIFORNIA WATER SERVICE COMPANY 00 - Overall Site <G> Training 215-000-000293 Page 7 <1> Page 1 WE HAVE NO EMPLOYEES AT THIS FACILITY. DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF SUMMARY ~F TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 08/04/94 CALIFORNIA WATER SERVICE COMPANY 00 - Overall Site <H> RMPP DATA 215-000-000293 Page <1> Release Containment <2> Offsite Consequences '<3> In House Capabilities <4> Plant Shutdown Instruction 08/04/94 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site' <I> Underground Storage Tanks Page 9 <1> Leak Monitoring Methods <2> Leak/Spil.1 Response Plans <3> Financial Responsibility <4> Tank Test/Service Company F ADMN Multi-User Main Selections = Hazmat Handler Search (Add/Modify) --Matching Business Names Business Name ID I Location <1> cALIFORNIA WATER SERVICE COMPA <2> CALIFORNIA WATER SERVICE.COMPA <3> CALIFORNIA WATER SERVICE COMPA <4> CALIFORNIA WATER SERVICE COMPA <5> CALIFORNIA WATER SERVICE COMPA <6> CALIFORNIA WATER SERVICE COMPA <7> CALIFORNIA WATER SERVICE COMPA <8> CALIFORNIA WATER SERVICE COMPA <9> CALIFORNIA WATER SERVICE COMPA ~~ MILL OAK .RUN\PARK VIEW DR BURR ST\BRICYN LN WARRENTON AV\MARYLHURST S COLUMBUS ST\WENATCHEE AV E GOSFORD\N WESTWOLD STINE RD/N OF HARTFORD 2009 YARNELL CT 4400 PANORAMA DR llTH ST\EYE ST Select <Key>, <PgUp/PgDn> Scroll <Fi> Help <Esc> Exit F ADMN Multi-User Main Selections = Hazmat Handler Search (Add/Modify) --Matching Business Names Business Name <1> CALIFORNIA WATER SERVICE COMPA <2> CALIFORNIA WATER SERVICE COMPA <3> CALIFORNIA WATER SERVICE COMPA <4> CALIFORNIA WATER SERVICE COMPA <5> CALIFORNIA WATER SERVICE COMPA <6> CALIFORNIA WATER SERVICE COMPA <7> CALIFORNIA WATER SERVICE COMPA <8> CALIFORNIA WATER SERVICE COMPA <9> CALIFORNIA WATER SERVICE COMPA ID I Location ~00~D-~2100 cASTRO LN ~ SILLECT AV ~ UNIVERSITY AV\CAMDEN ST ~TRUXTUN AV\MOHAWK ST ~0~ 3401TRUXTUN AV ~OSFORD RD\PACHECO RD ~IU/7~ 2116 N ST ~ RANCHO LABORDE DR a --9725 s H ST Select <Key>, <PgUp/PgDn> Scroll <Fi> Help <Esc> Exit FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF Mr. B.D. Lewis: CITY of BAKE;2S , [£LD "~ CARE" November 17, 1992 2101H STREET BAKERSFIELD, 93301 326-3911 NOTICE OF VIOLATION AND -SCHEDULE FOR COMPLIANCE The following hazardous materials regulation violations have been identified regarding the California Water Service facility located at 4400 Panorama Drive in Bakersfield, CA : A hazardous materials site diagram has not been filed. VIOLATION OF CALIFORNIA HEALTH & SAFETY CODE CHAPTER 6.95, SECTION 25509 Inventory forms; contents; amount of hazardous material; federal requirements (a)(5) Sufficient information on how and where the hazardous materials disclosed in paragraphs (1),(2), and (3) are handled by the business to allow fire, safety, health, and other appropriate personnel to prepare adequate emergency responses to potential releases of the hazardous materials. The above violations must be corrected by December 17, 1992. A blank form and instructions to be used to complete the site diagram are enclosed. Failure to correct these violations will result in enforcement action. The department will schedule a re- inspection of your facility to verify compliance. If you have any .questibns regarding this notice, please contact me at 326-3979. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc:~ Ralph Huey, Hazardous Materials Coordinator Michael Allford, Deputy City Attorney 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 Page Overall Site with 1 Fac. Unit General Information Location: 4400 PANORAMA DR Map: 103 Hazard: Low Community: BAKERSFIELD STATION 08 Grid: 14A F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- B.D. LEWIS DISTRICT MANAGER (805) 324-6011 x (805) 327-2161 MELVIN BYRD ASSIST DIST MANAGER (805) 832-2141 x (805)' 327-2161 Administrative Data Mail Addrs: 3725 S H ST D&B Number: 00-691-3578 City: BAKERSFIELD State: CA Zip: 93304- Comm.Code: 215-008 BAKERSFIELD STATION 08 SIC Code: 4941 Owner: CALIFORNIA wATER SERVICE COMPANY Phone: (408) ~ Address: 1720 N FIRST ST State: CA City: SAN JOSE ' Zip: 95112- Summary RECEIVED $~P 2 4 1992 HAZ. MAT. DIV. I, ~/~v~v Do hereby c~r~ffy that ! have reviewed the aEached hazardous maZerials manage~ merit plan fO~and th~ i~ along wi~h any corrections constitute a complete and correct man- agement plan for my f~:ility. 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order Page 2 02-001 DIESEL FUEL ~'Fire, Immed Hlth, Delay Hlth Liquid 500 Low GAL CAS #: 68476-3426 Trade Secret: No Form: Liquid Type: Pure Days: 3'65 Use: FUEL Daily Max GAL 500 I Daily Average GAL 500.00 Annual Amount GAL 500.00 Storage ABOVE GROUND TANK Press T Temp Location Ambient|AmbientlCLOSE TO SHELTER - Conc ! 100.0% IDiesel Fuel No.2 Components . MCP iList Moderate 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site <D> Notif./Evacuation/Medical Page 3 <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation Not Applicable - this is an unmanned site! <3> Public Notif./Evacuation :Evacuation of the l'ocal population to be determined by emergency services personnel, unless evacuation is necessary prior to their 'arrival. <4> Emergency Medical Plan MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVENUE, BAKERSFIELD. 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site <E> Mitigation/Prevent/Abatemt Page 4 <1> Release Prevention <2> Release Containment In the event of an emergency involving the release or threatened release of a hazardous liquid such as gasoline or diesel, sand stored at the Field Office would be used to dike the release, and would also be used as an absorbent. Any contaminated sand will be properly disposed of. If an aboveground convault tank were to start leaking, arrangements would be made to immediately remove all fuel from the tank. <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF THE.RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000293 00 - Overall Site <F> Site Emergency Factors Page 5 <1> Special' Hazards <2> Utility Shut-Offs A) GAS - ???????? B) ELECTRICAL - ?????????? C) WATER - ???????? D) SPECIAL - ??????? E) LOCK BOX - ????????? <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SITE WELL DISCHARGE <4> Building.Occupancy Level 08/18/92 CALIFORNIA WATER SERVICE COMPANY 00 - Overall Site <G> Training 215-000-000293 Page 6 <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use ~-12/271/91 ' CALIFORNI ATER SERVICE COMPANY 21 00-000293 Page 1 Overall Site with 1 Fac. Uni~ General Information L Location: 4400 PANORAMA DR Map: 103 Hazard: Low Community: BAKERSFIELD STATION 08 Grid: 14A F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- B.D. LEWIS DISTRICT MANAGER (805) 324-6011 x (805) 327-2161 MELVIN BYRD ASSIST DIST MANAGER (805) 832-2141 x (805) 327-2161 Administrative Data Mail Addrs: 3725 S H ST D&B Number: 00-691-3578 City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-008 BAKERSFIELD STATION 08 SIc Code: 4941 Owner: CALIFORNIA WATER SERVICE COMPANY Phone: (408) 453-8414 Address: 1720 N FIRST ST State: CA City: SAN JOSE Zip: 95112- Summary RECEIVED JAN 0 6 ~992~ HAZ M~T. DIV. l, ~-6'~ A~v~.v - Do hereby certify that ~ have ~vlewed the attached ~ .... ~'~'~ materials mana~o- CALIFORNIA WATE~ SERVICE CO, merit plan for ~r~d ~h~ it ~ong w~lh (N~me oJ Bu~ineo~) any ~rrections constitute a complete an~ corre~ man- agement plan for my facility. 12/27/91 CALIFORNI~ATER SERVICE COMPANY 21~00-000293 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 'Page 2 02-001 DIESEL FUEL Fire, Immed Hlth, Delay Hlth Liquid ~-550 Low GAL CAS #: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days:., 365 Use: FUEL Daily Max GAL Storage -~N~Sh~GROUND TANK -- Conc~ Components 100.0% IDiesel Fuel No.2 Daily Average GAL ] Annual Amount GAL ~ -5-5-0 ~ 00 Press T Temp Location IAmbientlAmbientlCLOSE TO SHELTER MCP --~List 12/27/91. CALIFORNIA~NATER SERVICE COMPANY 21 00 - Overall Site <D> Notif./Evacuation/Medical 0-000293 Page <1> Agency Notification CALL. 911 <2> Employee Notif./Evacuation <3> Public Notif./Evacuation <4> Emergency MediCal Plan MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVENUE, BAKERSFIELD. 12/27/91 CALIFORNI ATER SERVICE COMPANY 21 00-000293 Page 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention ~N~CONCILIATiON OF-THE ....... u.~.~.~..~~'"'~ DidSt.,, T~FO~.iED ON A <2> Release Containment <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation 12/27/91 CALIFORNI]{m'WATER SERVICE COMPANY 21 00 - Overall Site <F> Site Emergency Factors 0-000293 Page <1> Special Hazards <2> Utility Shut-Offs A) GAS - ???????? B) ELECTRICAL - ?????????? C) WATER - ???????? D) SPECIAL - ??????? E) LOCK BOX - ????????? <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SITE WELL DISCHARGE <4> Building Occupancy Level 12/27/91 CALIFORNI~wATER SERVICE COMPANY 00 - Overall Site <G> Training 215~-000 -000293 Page <1> Page 1 WE HAVE NO EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF CITY of BAKERSFIELD "WE CARE" November 17, 1992 21_01 H STREET BAKERSFIELD, 93301 326-3911 Mr. B.D. Lewis: NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE The following hazardous materials regulation violations - have been identified regarding the California Water Service facility located at 4400 Panorama Drive in Bakersfield, CA : A hazardous materials site diagram has not been filed. VIOLATION OF CALIFORNIA HEALTH & SAFETY CODE CHAPTER 6.95, SECTION 25509 Inventory forms; contents; amount of hazardous material; federal requirements (a)(5) Sufficient information on how and where the hazardous materials disclosed in paragraphs (1),(2), and (3) are handled by the business to allow fire, safety, health, and other appropriate personnel to prepare adequate emergency responses to potential releases of the hazardous materials. The above violations must be corrected by December 17, 1992. A blank form and instructions to be used to complete the site diagram are enclosed. Failure to correct these violations will result in enforcement action. The department will schedule a re- inspection of your facility to verify compliance. If you have any questions regarding this notice, please contact me at 326-3979. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc:~ Ralph Huey, Hazardous Materials Coordinator Michael Allford, Deputy City Attorney CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S.D. JOHNSON FIRE CHIEF August 30, 1991' 2101H STREET BAKERSFIELD, 93301 326-3911 B.D..Lewis California Water Service Co. 3725 South H St. Bakersfield, CA 93304 Mr. Lewis: The hazardous materials management plan which we ha~e on file for the California Water facility.located at 4400 Panorama Drive does not include an acceptable site diagram. I have attached a copy of the site diagram so that you understand why we find it illegible.. Please use the enclosed forms and instructions to complete an updated site diagram for this facility. The diagram should be submitted at 2130 G Street, Bakersfield, 93301 on or before September 30, 1991. Please call me at 326-3979 if I can be of any assistance. Sincerely, Barbara Brenner Hazardous Materials Planning Technician cc: Ralph'Huey BAKERSFIELD. FIRE DEPARTMENT ~te APPLICATION Application No. In conformity with provisions of perti_n~eot ordinance.s, codes and/or regulations, application ;is made Name of Company' / Address to display, store~ install, use, operate, sell or handle materials or processes involving or creating con- ditions deeme~l hazardous to life or property as follows: /~..~.~-~/c / .) .'?~ o -- :,..? .~.,.,~...,.~,,~e. ~.,~..~ ~.b ~.~ .~,~ ,~ ~ .~.~ . . .~~ ~1 ~--~.,~ ~ ..~.~.~ " ~ ~/ Authorized Repre~ntative Perm~ ..... ~;~}..:..~.: ..................... 8v ......L ~ ' ' ........................ ~;;"~X~i ................................ , . · REsoURCE MANAGEMENT AGENCY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT PERMIT FOR PERMANENT CLOSURE -" OF UNDERGROUND ~DOU$ :'-SUBSTANCES STORAGE FACILITY STEVE McCALLEY, REHS, DIRECTOR 1Aq[LLIAM ,L RODD¥. APCO PERMIT NUMBER A 1415-09 FACILITY NAME/ADDRESS: · ., ~., ;' ::", · : : ,':'.:'- ..... ;: :.'. :.-: . ... Californi:, Walcr Service, Stalion 17(; No. of Panorama Dr., hctwccn Columbus St. and Wildfire Dr. Bakcr~ficld, CA PERMIT' FOR CLOSURE OF ' OWNER(S) N,~k:tAODRES$. ."'CONT?,ACTOR: .... Kern EnvironmcnuiI ..qcrviccs 1LO. Box 5337 B:~kcrsficld. CA )3388 License #432372 Phone: 805.$89.5220 ~pr=jL[5,._!991 TANK(S) AT ABOVE LOCATION AIq"ROVAL DATE January. IS, 1991 Laur~l-'~hnk ,' Hazardous Materials Specialist ............................................................................................... ?_©_S.T_O.¥'_PZ .~ M~ ,, E ,.S.. ................................................................................................ CONDITIONS AS FOLLOWS: : ,: .' h i,~ tim rcslw, nsibility o{' th~: I!rrmittee to ohtain pmnits wI~ic'h :nay N: ,vqmrv,.I hy nther a'ltuI'.d~D, agcncirx prior to tx'gl:thing work (i.e,, (thy Fire nnd llaildlng D~jxlnnIents), ammgc for r~ttirctl hL~pccliom(s). ' 3, Tan~ ckxqu~c netivltle~ must bc I~'r ~ml Count~ ]'{nvir(mmenml I icl,lib :md l'"irr D<'p;.tment approvtxJ Rlethods a~ dcscril<d hi II:mdbonk UT.30,' :' prior to ~r~ing tmsu~is~t.. . at depfl~s of approximately Iwo Ibc[ ;mit six {'ecl. ' ' the center Of ¢llch l:lnk :it duplhs or' approxim;dcly Iv,'~ reel :md ~;ix feel, .. 8, Soil S:unplin~ (piping area): A ~inimum of two s.amplu.q must Im elric~cd at dcpll~ (~1' :,plm~xim:m:ly Iwo k'c: :u)d sk k'vt B.' ~cl7 15 linear foci of Pipe run a.d u,der thc disinter area. C.A:.!,-O~,N,,A 93301 (805) 861-3636 2700 "M" STREET, SUITE 300 BAKEHSF]ELD. ' .... "*' FAX: (805) g61-3d29 PERMIT FOR PERMANENT CLOSURE ' · OF UNDEROROUND HAZARDOUS ' '? < ..... f' ": :~' (?'' ' :' 9, SoiISnmplca~:dysj~: '. ~"~'"" ' ' ''~''''~:'':' c ' ' -..~. ,~'- : - '. . ~: .... : :: ......-~ ' ' ~troIc~ hy~r~ar~ll~ flor ~n~)l~nO. d, All soil ~nmpl~.~ ~lrk~ed from twill:fib c,~l~ltt oil cpok.~ :tn(I '.~slttu'lctl;,h~ Ii1u;;t I~ ;tl~:d}~.ed l~r oil :md Ih;il lll;i~ h:lve [~'ml stt~ed will,iff Ih~' Im~k. ..... . . :._ :..~:,.~ ...... ~.,..:;- ..... PERMIT NUMBER A 1415.09 · ADDENDUM .: -'..y=~.;.~. ;..;.1,.-;-: 3-:-:-~.?..:..=,.. ...... Al 1¢~:1,~! Itvo ',vC'¢'t:>, prior il) closun: nnfl tim( o~ ck~m'c unfl ~il s, mplin~ Materials M:.mngmll~nt I'ro~r;~m. All Iln~.~txtous nmnife.~a ~L/~I ~ signed by [l~c ~ecc. iver o[' thc Sanlplu :re;ii,sis to l'la?~irdous Materi:tls M:magenwnt : ..-- . _ -~ .-.. N- l:,t%'l' l'.::m fl wcsrkh]g d,'tys :liter ccmlpll:t[Oll ol':ulalyt~i~i ' L~.L -" l.iquid slmll t~ pumped fmlll i:lllk prior 1o pur':in; ~,wh ih;it less dm, ~4 g:flh,,; of fiquJd rem,in in re,k. (Cfil I&~C 4 lT0O) RECOMMENDATIONS/GUII)ELINi~ FOP, REMOVAL OF' This dep:~mnenI is rl..'spcmsibl¢ for cnfur¢ing Ih( ICcrn Co.my Ontin:mec C(.lc, I)ivi:,i(m ~; ;ITId si;lie regulations pen:fining lo {]ndergmund slot:Igc taflks. dcpartmetzt. 1, Job sit~ ,~tfcty i,'~ on( ¢)r our l~rimary c(mccr,,s, Fac:sv:,t/(,.s am? izfl.-rcnrly d;mllrm,a, h k ,.' comr:~clnr'x ~'Mmnsibi[ily 1o know nnd nbide I~ CAL.OSI IA .,it j.,,. zLs n gcncnd mi(, work~ itcc nm pc~itl~ in impml~rly slot~d cxcsvnfion~ or whcll un~t~ c~mdilk)ns exist in Ih~ hole, 'l'tsob: :md -qtfi{m.'nt :ur {o t,c u,:cd only :bt their dcsi~ncd f, ncfion, For ~[mpk', nrc Ii~cr substituted ~or laddct~. ' ' 2. l'ml~rly licellst, d c'nn~tcto~ arc assumed it) tmdc,~l:md the :'-(i,h','m,~!': nr Ih(.- p,,:'mh ]~;.~,t,d. 'H~c jr~h :bn'm~n i~ m~pon~iblc Iht knowing and abiding by tho LxtndiIiORS Of Iht' pt'mill, l)~i:llion II, lift thc pi'rlltil (x)t,lhi()l,~: ,):sy a-sull hi ;i ~::op-w,,rk (~r(icr. ' .Z - - ' · · LF~ch [u~k\1415-09,pta BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 I[;SINESS NAME OFFICIAL USE ONLY ID~ · HAZARDOUS' MATERIALS BUSINESS PLAN AS A WHOLE F'ORM 2 A INSTRUCTIONS: i. To avoid further action, return this form by 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. SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NA~E: California Water Service Comuany /¢ B. ~/ STREET ADDRESS: 3725 South "H:' Street - Field Yard CITY: Bakersfield ZIP: 93304 BUS.PHONE: (805)832-214l SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involvin~ the release or threatened release of a hazardous material, call 911 and 1-800-8S2-7~0 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by EMP~0YEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER Bt~S. HRS. A.B.D. Lewis, District Manager Ph~ 324-6011 Ph~ 327-2161 B.'Melvin Bryd, Assistant District. Manager Ph.~' 832-214l Ph# 327-2161 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: North of last parking stall near office building. B. ELECTRICAL: South-east corner of office building. C. WATER: lO' west of gas meterl D. SPECIAL: None E. LOCK BOX: YES /(N~ IF YES, LOCATION: No IF YES, DOES IT CONTAIN'SITE PLANS? FLOOR PLANS? YES / NO MSDSS? YES / NO YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE Company personnel would deal with any~emergency in concer~ with local emergency service agencies. Any and all removal of a hazardous material would be conducted by a private company specializing in removal of the particular substance. SECTION $: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE Medical assistance would be provided by Mercy Hospital, Truxtun Avenue, Bakersfield SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL ~D REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS: ........................................ ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES .................. D EMERGENCY EVACUATION PROCEDURES: ................. E DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... SECTION ?: HAZARDOUS MATERIAL REFRESHER No ~0 ~0 CrRCLE YES OR NO OR NONE ,DOES YOUR BUSINESS HANDLE HAZARDOUS ,MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, $§ GALLONS, OF A LIQUID. OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES ~ I, Raymond H. Taylor , certify that the above information is accurate. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. SIG LEDirector of Water Quality DATE - 2B - CALIFORNIA WATER SERVICE CO. pdt? BIJILDIN L~ BAKERSFIELD CITY FiRE DEPART)IEXT 2130 "G" STREET BAKERSFIELD, CA 93301 USE ONLY BUSINESS XAME: ID# BUSINESS PLAN NGLE FACILITY UNIT FORM SA INSTRUCTIONS l...To avoid further action, this form must be re'~urned by: . 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. .~ Answer the questions below fo:' THE FACILITY UXiT LISTED BELOW '.4. Be as BRIEF and CONCISE as possible.' California Water Service COmpany FACILITY UNIT-~ FACILITY UNIT N~uME: Station 176 SECTION 1: MITIOATION~ PREVEN'~ION~ ABATE.%IE)Fr PROCEDbqRES Inventory reconciliation of the underground diesel tank'is performed on ' a weekly basis. · i.'P'reci'sion testing of the tank i's performed annuallM. Release abatement would be performed by an independent remediation '.consultant as needed, and to the satisfaction o'f the responsible regulatory agency. SECTION q: NOTIFICATION AND MVACUATION PROCEDL-RES AT THIS L~iT 0NSY N/A - 3,4 - SECTION 3: HAZARDOUS'-MATERIALS FOR THIS b.~IT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~~0 If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade. Secret YES If No, complete'a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form ~4A-1) If Yes, complete a hazardous materials inventory.form marked: TRADE SECRETS ONLY (yellow form =4A-2) in addition to the non-trade ~ecret form. List only the trade secrets.on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION Fire Extinguisher SECTION 3: LOCATION OF' WATER SL~PLY FOR USE BY EMERGENCY RESPONDERS On-site well discharge. ,S, EcTIoN 6: LOCATION OF 5~FILITY Sh'b~r-OFFS 'AT THIS b~.'IT 05q%Y. A. XAT. GAS/PROP.%~YE} N/A, B. ELECTRICAL: Service"b~x is' located inside well pump enclosure. WATER: N/A D. SPECIAL: N/A LOCK BOX: YES. .'"'~ ..'F. YES, LOCATION: IF YES, SITE PLA~S? FLOOR PLANS? YES / XO YES ../ NO - 3B - MSOSs? KEYS? YES ."' NO · YES ../ NO / I I I I ;>. 40' ..~ T, lt T/ON_. / 7' d~ Z3 K -"~ .-~.. . .'-/ / ,'"-'. -':',2, /," / · 1"/ (~ I I ~ ' / . _ F:- /4 j " . .:,:---. _ j / ,? . t,- ~ '., t CII'Y of BAKERSFiELU HAZARDOUS MATERIALS INVENTORY Farm and Agriculture [] Standard Business ~ NON--TRADE SECRETS PaDe ~_ of. BUSINESS NAME: California Water Service Company OWNER NAME: California water Service Ge~panYNAME OF THIS FACILITY: Station 176 LOCATION: ~ Panorama urlve , ADDRESS: 1720 North Firsg ~t. STANDARD IND. CLASS CODE[ '4941 CITY. ZIP;' Bakersfield, CA -,: Y CITY. ZIP:" 5afl Jose, CA ~31Z DUN AND BRAaS~REE~ NDUH~BER~ PHONE #: :-- 8o~-8'~2-z14] PHONE ¢: ' 4o~-~5:~-8414 5 7 8 --.REFER TO'-ZNSTRffC7-fONS I-OlY ·PROPER CODES -- I 2 3 '4 5 6 7 8 Trans !y~e Hax Average Annual 'Neasure ! gy~ Cont Cont Cont Us locatjon,~heTe, Code come_ AeC ^mt Est Units, on ~lce Type, Press lemp Co~e Stored In eaclllcy See [nstru~?ons / PhysicalandHealthHazard C.A.S. Humber 068-476-346 Co~Ponentll NamelC,A.S. Numher (Check all. that apply) I ~Fire Hazard ~ Reactivity [] Delayed ~ Sudden Release ~ Immediate Component Name C.A,S, Health of Pressure Health Component 13 Name & C.A.S. Humber Physical and Health Hazard C.A.S. Humber Componen[ II Name t C,A.S. Number (Check ali that app)y~ Component I~ Name.t C.X.S. Number ~ Fire Nazard ~ Reactivity ~ Delayed D Sudden Release Health of Pressure ....Health Component 13 Na~e & C,A.S. Humber Fhysical and Health Hazard C.A.S. Number Component II Name I C.A.S. Number (Che:k ali that app]y) Component I~ Name & C.A.S. Number Fire Hazard [] Reactivity [] Oelayed ~ Sudden Release [] Immediate ,, Health of Pressure Health Componentl3 Hame & C.A.S. Number Physical and Health ~aTard C.A.S. Number Component II Name I C,A,S. Humber (Check all. that applH. [] Fire Hazard [] Reactivity [] Delayed [] Sudan Release [] ]mq~di,a~eC°mp°nent Name C.A.S. Number Health of Pressure Health .. Component 13 Name & C.A.S. Number ~.D. LOuis '- Dtstr~t. M a~a~ 327-216! fl2Hel.vin Byrd _ 327-2~6t' EMERGENCY COHTACTS #l~me ;' ~Cie ~dHrPhone NT'~e' ff[[~ Dt$~rictl~L-u'~er 2T'11r~one fertifil;atioq .(Re~l a..n.d.~fgn .aft;f~r comple~tfpg.~11 sections.) '. cerHLy,unoer penalc~ 9I)aF tnqc i nave. pecsonHff, examlnq~qo Q, tamJllac, yit~ the, ~ncoceaHpfl ~u~mittf~ in this lad at~acneo,oOc~enc~, 8flQ tpac based on,my lflqulry 9Lcnose lflOlVlO~a/s responsible ~or DOOm]fling one lflrormaclOn. J believe ti · · 'Z'Raymond H. Taylor, Director of 'Water Quality . ~a~e '~'O~i~i~i-titie of o~nertooer~tor uR o~ner/~peratbr's authorized representative