HomeMy WebLinkAboutBUSINESS PLANHazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This ~ermit is issued for the following:
El Hazardous Materials Plan
[] Underground Storage of HazardOus Materials
[] Risk Management Program
[] Hazardous Waste On-Site Treatment
PERMIT ID # 015-021-002113
CALIFORNIA WATER
LOCATION
Issued by:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES'
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576
Approved by:
Expiration Date:
'June 30. 2003
issue Date
,N
'/
240I
SACO
KER/¥
3100
AV
COLOt4BO
SA~EV i EW
3308
MEADOWS
F~£LD
AIRMORT
-q
9100
8100
PETRIS
\
RO~F..RS ST
8100
Cl'
LUCILLE
AV
~¥
7400
ELOY-
?300
MAP 0 .25 .~S
, , miles 1 in. -1900 ft.
+ CALIFORNIA WATER
STAL203
Manager :
Location: SEWARD & OLIVE ST
City : BAKERSFIELD
CommCode: COUNTY STATION 61
EPA Numb:
SiteID: 015-021-002113 +
BusPhone: (661) ~
Map : 102 CommHaz : Minimal
Grid: 11 FacUnits: 1 AOV:
SIC Code:4941
DunnBrad:00-691-3578
Emergency Contact / Title I Emergency Contact / Title
MELVIN BYRD / DiST~CT-~2~A~E~TIM TRELOAR / GEN SUPER
Business Phone: (661) 396-2400x I Business Phone: (661) 396-2400x
24-Hour Phone : (661) 396-2400x I 24-Hour Phone : (661) 396-2400x
Pager Phone : ( ) - x I Page~_r Phone : ( ) - x
I MailAddr: P~ ~ St~--S~--
.... ........................... ...............
Owner CALIFOR~TA WATER SERVICE COMPANY Phone: (408) 451-8200x
Address : 1720 N~IRST ST State: CA
City : SAN JOSE Zip : 95112
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif ' d: RSs: Yes
ParcelNo: ~
.............................................. District Manager-Tim Treloar .......
Emergency Direct ives: Asst. District Manager-Bill Harper
Contact Person-Tamara Johnson
Same Phone Numbers
CONTACT PERSON K~ 832-2141.
· Mailing Address Change:
~ '~ ~,~ </~///LL~A/ 3725 South "H" Street
~ ~ ~ ~ ~ i, ~//~/'///~crv.~,,a.t..~,) - Do hereb:y Bakersfield, CA 93304
reviewed the attached hazardous, ................
merit Dian for:~/7~z-''/-c, ~4.~47-~,~ arid '~S! it along
(l~e of Bu~nem;;)
any corrections constitute a complete and correct man-
agement plan for my facility.
I 07/30/2003
CITY OF BAKERSFII~
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
3.
4.
5.
TYPE/PRINT ANSWERS IN ENGLISH.
Answer the questions below for the business as a whole.
Be as brief and concise as possible.
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: C__--_F.t..~-.,,:~ ,.-,~.t-~.,-<o~,-,,,,,-e co.
MAILING ADDRESS: :Z",'z.~ $o. 6
STATE: cz,,. ZIP:9~zo~ PHONE: (t,,t,,C} 3n~z~oo
PRIMARY ACTIVITY: 'Q,.,,--~e-/o¢ or- Ao,...,..,~-~c_ ~,~,--
OWNER:
PHONE:
MAILING ADDRESS:
EMERGENCY NOTIFICATION
CONTACT
1. /M*l-t,',a {2o,/,-el
2. "Ti'-,,,., 'W;-~ o_l ~,.-
TITLE BUS. PHONE 24 HR. PHONE
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION II. 1: DISCOVERY AND NOTIFICATIONS
LEAK DETECTION AND MONITORING PROCEDURES:
EMPLOYEE AND AGENCY NOTIFICATION:
Co
EMERGENCY MEDICAL PLAN:
r~-~'a~ ~'-~ '~-~-~
OAZARDOUS MATERIALS MANA~MENT PLAN
Ao
SECTION II.2: RELEASE RESPONSE PLAN
HAZARD ASSESSMENT AND PREVENTION MEASURES:
Bo
RELEASE CONTAINMENT AND/OR MITIGATION:
Ce
CLEAN-UP AND RECOVERY PROCEDURES:
UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)
NATURAL GAS/PROPANE:
ELECTRICAL:
WATER:
SPECIAL: ~/s,
LOCK BOX: YES/~
IF YES, LOCATION:
PRIVATE FIRE PROTECTION/WATER AVAILABILITY
Bo
PRIVATE FIRE PROTECTION: ~
WATER AVAILABILITY (FIRE HYDRANT):
HAZA~I~ous MATERIALS MANAGEMENT PLAN
SECTION III: TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE:
BRIEF SUMMARY OF TRAINING PROGRAM:
CD.
CERTIFICATION
l, --q'-~l.- {-- ,aa ~,.., ~.~,,, 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 IIAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND
THAT INACCURATE INFORMATION CONSTITUTES PEILTURY.
SIGNATURE TITLE DATE
4
i FFICE OF ENVIRONMENT~i~ SERVICES
715 Chester Ave., CA 93301 ~I~1) 326-3979
BUSINESS OWNER I OPERATOR IDENTIFICATION
FACILITY INFORMATION
Page Of
" ' . ir..'. !~:1. FACILITY IDENTIFICATION -
..... ................................. ~ BUSINESS PHONE
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As)
SITE ADDRESS
DUN &
BRADSTREET
COUNTY
106
SIC CODE
(4 Digit #)
103
OPERATOR NAME (..~t~.L~,-~o., ~.5~-~.~- %e,-.~.~ Co ·
'.? ..,:ibOWNER · ~'.
,. . INFORMATIoN
OWNER NAME C..,;g I', ~__o_~_~3~,__~_ ~-~J__~__~- <~ ~ ~ c ~. ~_o .
OWNER ~ILING
ADDRESS ~5 ~ o. ~ ~ ~.
105
107
108
110
113
CITY
CONTACT MAILING ~ ~9
ADDRESS
I
CITY _ ~20 . STATE
122
EMERGENCY CONTACTS ' r ' '4 ' ~ . ;:~ ' ' ' -SECONDARY-
NAME
BUSINESS PHONE
:~ 24-HOUR PHONE
PAGER #
NAME *"T'~,,,.,~ ""T~ ~..~<~e~v-
TITLE j~..,~'~.~,.~.~__0~.$_~'~,--
BUSINESS PHONE
24-HOUR PHONE
~~_
PAGER ~
Certification: 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 ,~_ith the information submitted in this inventory and believe the information is true, accurate, and complete.
S I G N ~,'T'i.J ~ ~*' ~) ~- ~,I-E-~,~i~I~-I~A~'~) I~--- *~-~:1'-~ ...... 134 I~1-.~, ~ E-(~I~-I~ ~'cO'r~ E N--T-15 R'I~ P~ ~ I~ ~
NAMES OF OVVIqER/OPERATOR (print) 136 TITLE OF OWNER/OPERATOR
UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd
/'"' ~ CITY OF BAKERSF~iLD
' "~FFICE OF ENVIRONMENTAL SERVICES·
l?lS Chester'Ave., CA 93301 (661) $Z6-3979
"~*'*'""~--""'~" HAZARDOUS MATERIALS INVENTORY
~. CHEMICAL DESCRIPTION
]~NEW [] ADD ' [] DELETE n REVISE 200 .. ' Page __ of
· '~!7:'' '"'; '"~' 'L? "- q~'~";';'' ' '"" 'T~, ,'.' ,', ~ -~', '.' ' '. ~ ~ .~ .... '.
BUSINESS ~ME (~e ~ FAClLI~ ~ ~ O~ * ~ng Bu~n~ ~)
C.E~,~L LO~T~N 2mi CHEMI~L LaoTIaN
~NFIDENTI~ (EPC~)
-~$ ...... ~ 1 ~P ~ (op~naO · ~3 GRID ~
.~ ;}[.~':;,~¢'~ .'~ ~.~L:c~:i~-~,*'. L..,?~:'~.r:~';:~*~,=~;~:~7~.~'.=%*'a'~".T'~:~?[i¢*~iT.~CF{:'-' ':"~,:,~71;~;' 'G.: ":?::~?'~'~.:~:~.~:~'~,.. ::: : '
!one form per material pet' buBding or area)
Yes ~.o ~o:
2O4
I CHEMICAL NAME
i
COMMON NAME
CAS #
o <.t.,lo.-, t- t
207
[]Yes ~No 206
If Subject to EPCRA, refer to instructions
2O9
EHS' '., I-lyes. ,.[~No
I'~ ~'IfEHS ;e y~, dl ._.M.n, bek)w must be m lbs.
FIRE CODE H~D C~SSES (~H~e If ~t~ by I~ fire
210
~PE
p PURE ~ m ~RE D w WASTE 2tl ~DIOACTI~ ~ Y~ ~ No 212 J
CURIES
PHYSI~LSTA~ ~ g ~S 214 ~RGESTCO~AINER 215
3 P~SSURE ~L~E ~4 ACU~ H~L~ ~ 5 CHRONIC H~LTH 216
[] s SOLID ~1 LIQUID
FED HAZARD CATEGORIES ~] 1 FIRE [] 2 REACTIVE
(Cnec~ all that apply)
AMOUNT ' OAILYAMOUNT '2, OO 3at, - OAILYAMOUNT 'Z. OO ~ ~[ . [
UNITS' ~ ga GAL [] d CU FI' r-I lb LBS ~ E] tn TONS 221 I DAYS ON SITE '222
' ff EHS, amount must be In lbs. ' i
STORAGE CONTAINER [~ a ABOVEGROUND TANK I~ · PLASTIC/NONMETALLIC DRUM ' [] I FIBER DRUM [] m GLASS 8OTI'LE [] q RAIL CAR 223
(Check all that apply)
[] b UNDERGROUND TANK [] f C. AN [] j BAG [] n PLASTIC BO'FrLE [] r OTHER
I~ c TANK INSIDE BUILDING [] g CARBOY ' [] k BOX [] 0 TOTE BIN
[] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON
STORAGE PRESSURE I~ ~, AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224
STORAGE TEMPERATURE 225
2 I 230
~] aAMBIENT [] aa ABOVE AMBIENT [] bo BELOWAMBIENT [] c CRYOGENIC
~ ~. ~ 'A~RDOUS' ' PONE
=7 ~Y~ 22e
231 QY~ Q~232
229
233
231
238 239 [] Yes [] No 240
242 243 [] Ye~ [] No 244
DATE
vI
UPCF (7/99) S:~CUPAFORMS\OES2731.TV4.wpd
ITE DIAGRAM~~~
Business Name:
Business Address:
FAC~ DIAGRAM
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