HomeMy WebLinkAboutBUSINESS PLAN 10/2/2003
UNIFIED PROGRAM APECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
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Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
INSPECTION DATE INSPECTION TIME
(..,.í:V: A-í ~ 6£~eJ ~__,_____,___,_u_,________,_.____,_, f¿ - ¿:f>3 j Q~_,__
PHONE No, No. of Employees
6TDC.A(.O~1:hl0'1 _________'______.'__ 30 ~,..ZßlOO _t!/~,..__
FACILlTYCONTACT Business ID Number
~V' rJ "(lZ.f) 15-021- D:?(~lB
Secti9f11: Business Plan and Inventory Program
D Joint Agency
D Multi-Agency
D Complaint
o Re-inspectìon
C V ( c=,comPliance)
V='Violation
gI 0 ApPROPRIATE PERMIT ON HAND
-----------------_._~----_._--~--_._------_..------ -_._,~--_._--_.._-_._--._----~-_._----_._--~--_._--_.-------"---------.-----..-.--.-----
c;(' 0 BUSINESS PLAN CONTACT INFORMATION ACCURATE
rI 0 VISIBLE ADDRESS
tt' 0' CORRECT OCCUPANCY
,gI 0 VERIFICATION OF INVENTORY MATERIALS
cY" 0 VERIFICATION OF QUANTITIES
OPERATION
COMMENTS
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--_._----~----------~~--_.__.~---._---_.._-- -----------_._----,---~_._---._---------_._.._._--~..-._._----.._-----,._.._"_.~._.._---~
r;v' 0 VERIFICATION OF LOCATION
------------------------------ ----------~----_.--,--.-.__.__._--~~-----_.._----~-------.---.-
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PROPER SEGREGATION OF MATERIAL
---~,---------_.._-----~ -.---.----..------,------------...-.-----.--------------_.-._-----_._~_.'--~.-- ,.---
VERIFICATION OF MSDS AVAILABILlTYE
-~------_..~----_._---_.._-.'-~----- ---_._~.._---_._- ---_.._~---_._--_.-----~-_._-----~_.__._---_._-
VERIFICATION OF HAT MAT TRAINING
._---_._---~-.---_.- ._--~-_.__.__._-------_._--_._~------_._._--,-_._~-----.--.-- -.---.----.---
o VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
.~-_._.__._---~_..- .----- -_._-_._-"------_.._-~--_.---._-.._----_._-~----_._.------,_.---
œ/ LJ EMERGENCY PROCEDURES ADEQUATE
g' 0 CONTAINERS-;;OPERL Y LABELED ,,-------,,-.----,- -_n'__________________,___"___,___,__.,_____'__n_'_'______,,.._
'70H~USEKEEPING-~-----_n.--------'-.-~I' .____'___.___,_______._,______'_._"n_____..n._____n_.__'___.
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¡¡:y SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?:
DYES
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EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326~3979
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Inspector Badge No,
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Business Site Responsible Party
White· Environmental Services
Yellow ' Station Copy
Pink -- Business Copy
10
Per
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LOCATION
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Issued by:
Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This pennit is issued for the followin9:
ItJ Hazardous Materials Plan
o Underground Storage of Hazardous Materials
o Risk Management Program
o Hazardous Waste On-Site Treatment
93309
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES'
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576 Expiration Date:
NOV 1 200Ò
Issue Date
June 30, 2003
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Business Name:
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+ CALIFORNIA WATER
SiteID: 015-021-001618 +
Manager :
ocation: 3321 STOCKDALE HWY
City BAKERSFIELD
~"\ 1 t~
BusPhone:
Map : 123
Grid: 02B
(661) 396-2400
CommHaz : Minimal
FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 07 SIC Code:
EPA Numb: DunnBrad:
+==============================================================================+
+=======================================+======================================+
Emergency Contact / Title Emergency Contact / Title
MELVIN BYRD I lJl::i'lJ:UCT MGR T~.l<.~LOAR I A::iSl'T DIST MGR
Business Phone: (661) 396-2400x Business Phone: (661) 832-2141x
24 -Hour Phone : () x 24 -Hour Phone : () x
Pager Phone : () x Pager Phone: () x
+---------------------------------------+--------------------------------------+
I Hazmat Hazards: React ImmHlth I
+------------------------------------------------------------------------------+
Contact : Phone: (661) 396-2400x
MailAddr: 3725 S H ST State: CA
City : BAKERSFIELD Zip : 93304
+------------------------------------------------------------------------------+
Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x
Address : 3725 S H ST State: CA
City : BAKERSFIELD Zip : 93304
+------------------------------------------------------------------------------+
~eriOd : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
ertif'd: RSs: No
arcelNo:
+------------------------------------------------------------------------------+
Emergency Directives:
\
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3 3 ¿¡, ~ J.j-
í
, District Manager-Tim Treloar
Asst. District Manager-Bill Harper
Contact Person-Tamara Johnson
: Same Phone Numbers
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-=============================================================================+
-1-
07/30/2003
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CALIFORNIA WATER SERVICE
SiteID: 015-021-001618
Manager :
Location: 3321 STOCKDALE HWY
City BAKERSFIELD
CommCode: BAKERSFIELD STATION 07
EPA Numb:
BusPhone:
Map : 123
Grid: 02B
(661) 396-2400
CommHaz : Minimal
FacUnits: 1 AOV:
SIC Code:
DunnBrad:
Emergency Contact / Title Emergency Contact / Title
MELVIN BYRD / DISTRICT MGR TIM TRELOAR / ASS IT DIST MGR
Business Phone: (661) 396-2400x Business Phone: (661) 832-2141x
24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x
Pager Phone : ( ) - x Pager Phone : ( ) - x
Hazmat Hazards: React ImmHlth
Contact : Phone: (661) 396-2400x
MailAddr: 3725 S H ST State: CA
City , BAKERSFIELD Zip : 93304
.
Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x
Address : 3725 S H ST State: CA
City : BAKERSFIELD Zip : 93304
.
Period : to TotalASTs: = Gal
Prep~rer: TotalUSTs: = Gal
Cert,if 'd: RSs: No
Emergency Directives:
One Unified List ì
All Materials at Site ì
F Hazma~' Inventory
f== Alpqabetical Order
...~Hazmat Common Name. . .
SpecHaz EPA Hazards
DailyMax
MCP
SODIUM HYPOCHLORITE
R IH
L
200.00 GAL Hi
-1-
07/12/2002
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F CALIFORNIA WATER SERVICE
f= Inventory Item 0001
=== COMMON NAME / CHEMICAL NAME
SODIUM HYPOCHLORITE
SiteID: 015-021-001618 9
Facility Unit: Fixed Containers at Site 9
Days On Site
365
Location within this Facility Unit
FENCED CONTAINMENT STRUCTURE
Map:
Grid:
CAS#
7681-52-9
STATE - TYPE
Liquid Pure
PRESSURE ---- TEMPERATURE
Ambient Ambient
CONTAINER TYPE
ABOVE GROUND TANK
Largest Container
200.00 GAL
AMOUNTS AT THIS LOCATION
Daily Maximum
200.00 GAL
Daily Average
200.00 GAL
%Wt. RS CAS #
12.50 Sodium Hypochlorite No 7681529
HAZARDOUS COMPONENTS
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R IH / / / Hi
HAZARD ASSESSMENTS
-2-
07/12/2002
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SiteID: 015-021-001618 ì
Fast Format 9
Overall Site ì
11/28/2000
F CALIFORNIA WATER SERVICE
I
f= Notif./Evacuation/Medical
Agency Notification
CALL 911 AND OFFICE OF EMERGENCY SERVICES 1-800-852-7550 OR (916) 262-1621
ASK FOR MEL BYRD OR TIM TRELOAR.
Employee Notif./Evacuation
11/28/2000
CALL MEL BYRD OR TIM TRELOAR, ALL FACILITIES ARE UNMANNED.
Public Notif./Evacuation
I
11/28/2000 ]
I
I MERCY HOSPITAL, TRUXTUN AVE, 328-5223.
Emergency Medical Plan
-3-
07/12/2002
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F CALIFORNIA WATER SERVICE
f= Mitigation/Prevent/Abatemt
Release Prevention
SiteID: 015-021-001618 ì
Fast Format ì
Overall Site 9
11/28/2000
THE HAZARDOUS MATERIALS AT THIS SITE HAVE SECONDARY CONTAINMENT. EACH SITE
IS MONITORED DAILY BY COMPANY EMPLOYEES. HAZARDOUS MATERIAL IS STORED IN
ABOVE GROUND, SECURE AREA.
Release Containment
11/28/2000
HAZARDOUS MATERIAL IS SECONDARILY CONTAINED.
Clean Up
11/28/2000 1
I
AS DIRECTED BY EMERGENCY SERVICES.
Other Resource Activation
-4-
07/12/2002
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F CALIFORNIA WATER SERVICE
I
f= Site Emergency Factors
~ Special Hazards
Utility Shut-Offs
SiteID: 015-021-001618 9
Fast Format 9
Overall Site 9
I
11/28/2000
A} GAS - N/A
B} ELECTRICAL - MAIN PANEL
C) WATER - N/A
D} SPECIAL - N/A
E} LOCK BOX - NO
Fire Protec./Avail. Water
11/28/2000
PRIVATE FIRE PROTECTION - N/A.
NEAREST FIRE HYDRANT - ON SITE WELL DISCHARGE.
Building Occupancy Level
-5-
07/12/2002
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F CALIFORNIA WATER SERVICE
I
F Training
Employee Training
SiteID: 015-021-001618 9
Fast Format ì
Overall Site ì
11/28/2000
THIS IS AN UNMANNED SITE.
WE DO HAVE MSDS SHEETS ON FIL IN FIELD YARD OFFICE.
BRIEF SUMMARY OF TRAINING PROGRAM:
Page 2
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Held for Future Use
Held for Future Use
-6-
07/12/2002
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CITY OF BAKERSFIEIJD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
. UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301
FACILITY NAME(.A-( (JÆ'T¡ÇJ?.:)ç(?d.
ADDRESS ?;~71 5TD<: 1'" 041 £HI J"(
FACILITY CONTACT vy\&:l \JI1\.) G",<LO
INSPECTION TIME '
INSPECTION DATE I - q "" 0 '3
PHONENO.3~~~?400' .
BUSINESS 10 NO. 15-210- 00/ Ie 18
NUMBER OF EMPLOYEES '
Section 1:
e(Routine
Business Plan and Inventory Program
o Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
.
OPERA TION C V COMMENTS
Appropriate pennit on hand
Business plan contact infonnation 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:
,OYe~ ONo
Questions regarding this inspection? Please callus at (661) 326-3979
Business Site Responsible Party
White· Env, Svcs.
Yellow - Station Copy
Pink· Business Copy
Inspector:
,- ,
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KERN COUNTY ENVIRONMENTAL HEALTH SERVICE~ ErC / II
(805) 862-8700 1'-(~ ') 3 (¿::> ;L J
."....Business Name
10
101
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Forms Due By: .RItICES
HAZARDOUS MATERIALS
BUSINESS PLAN
FORM 2
SECTION 1: BUSINESS IDENTIFICATION DATA
,
A. FULL LEGAL BUSINESS NAME: ¿.....I " Lo.......... ; ~ w ~ \-c..- S Lr"", c...c.. <:"0.
B. PHYSICAL LOCATION/STREET ADDRESS: ~~4..."¡'~ - O"'l- ~~ L.' ~ t-o~¿.1 ~ k\.oV'L..
CITY: ßc.. Ie:... f!';"'~ c. , «..' d
ZIP: <:\ "?"? 0 4' BUSINESS PHONE: ( b to t ) '3 q b"Z. q 0 0
C. MAIUNG ADDRESS: ? . -z.. S ~ <::>. . ~. ~ 4-.
.
CITY: ßc:. (.. ct... ~ c. , ... , d ZIP: Oc ~ '"3 0 ~
D. HAVE YOU FILED A BUSINESS PLAN WITH THE DEPARTMENT UNDER A DIFFERENT NAME WITHIN THE
LAST 1WO YEARS? YES NO ~
-.'
IF YES, UNDER WHAT NAME DID YOU FILE?
E. THIS SUBMISSION IS A NEW ,c
, BUSINESS PLAN'
OR REVISED
F.DOES YOUR BUSINESS HANDLE ANY "ACUTELY HAZARDOUS MATERIALS" LISTED ON THE ENCLOSED
HANDOUT, IN ADDITION TO OTHER TYPES OF MATERIALS? YES -L- NO
SECTION 2: EMERGENCY NOTIFICATIONS
In the event of an emergency Involving the release or threatened release of a hazardous material, telephone 9-1-1,
and then (800) 852-7550 or (916) 262-1621. this will notify your local fire department and the State Office of
Emergency Services, as required by state law. Additional federal reports may be required.
PERSONS WHO SHOULD BE NOTIFIED IN CASE OF EMERGENCY AT YOUR BUSINESS THAT HAVE FULL
ACCESS AND CAN PROVIDE TECHNICAL ASSISTANCE:
NAME AND TITLE
DURING BUSINESS HOURS AFTER BUSINESS HOURS
A. .1\'\(..\...,;", ß1..-d Q't>\-..·\c.A- Mj""". Ph. (101.0') ~c,to7.o.t-oo
B. fVV\ (;.«..100..--- A~~'h b~,::>·h·~c..t M~.r: Ph. (~<o1) 8'31..'2.14-\
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SECTION 3: LOCATION OF THE MAIN UTILITY SHUTOFFS FOR THE ENTIRE BUSINESS
A. NATURAL GAS/PROPANE: N/A
\
B. ELECTRICAL: ^"" a. ,\.A f' ~ "" c. t \ 0 Lo c.. ,,-, J. 0..... c... ,~+ L ,
C. WATER:, Nf",
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D. SPEtIAUOTHI?~: ",i:4.Ä-
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E. LOCK BOX: YES@IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS?
FLOOR PLANS?
-
YES I NO
YES / NO
MSDS?
KEYS?
YES/NO
YES / NO
SECTION 4: PRIVATE RESPONSE TEAM DESCRIPTION
Do you have a group of employees trained to handle minor accidents Involving hazardous materials at your
business?
Yes)( No
If 80, you must explain the level of training and equipment they possess and how they are notified to respond.
E.....plo,.c.¿:. c."'c... ..1-"'o:",cd.-:"" r"'o~c...... kO,^4:U:",,'5 of.. ~c.1-t;.rt;1.ou~ "",,c.1--,"':ø.l~ I
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SECTION 5: IDENTIFICATION OF THE CLOSEST APPROPRIATE EMERGENCY MEDICAL ASSISTANCE
AVAILABLE TO YOUR BUSINESS
#1 M~r<:-, I-\o~r; ~e. \ #2
ADDRESS:
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CITY:
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PHONE:
(~...\ ) '3-z..8S'Z.."2.:'
COMMENTS/ADDITIONAL INFO:
- CONTINUED ON NEXT PAGE -
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SECTION 6: EMPLOYEE TRAINING
EMPLOYERS ARE REQUIRED BY STATE LAW TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH
INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS:
1) Methods for safe handling of the hazardous materials used by your business;
2) The CAL OSHA Hazard Communication Standard;
3) Correct use of emergency response equipment and supplies available at your business;
4) The prevention, minimization, and cleanup procedures you have developed for your business and explained
on the business plan fonns;
5) The emergency evacuation plans you have developed, the notification procedures used to alert people to
evacuate, and the closest location to obtain appropriate emergency medical care;
6) Procedures to coordinate with and assist the local emergency personnel that may respond to your business;
7) Who and how to call for immediate assistance in the event of an accident Involving hazardous materials,
Describe the location of the written plan and the training records which are required to be developed and
maintained. State I.aw requires your training records be inspected.
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- CONTINUED ON REVERSE -
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SECTION 7: EXPLAIN WHAT PREVENTION, MINIMIZATION, AND CLEANUP PROCEDURES YOUR EMERGENCY
PLAN INCLUDES. INCLUDE A DESCRIPTION OF MONITORING METHODS AND PROCEDURES.
A. RELEASE PREVENTION: ~..... "'A"LGoor-.lC".A.~ ~A ~,.., 'a..'::. 4 r .(..,-"S
~:.$-L. lA.....c... ~L.(..O"'JQ....l C.O",",",C.~VI"""~""+-.. Eø..<-'-'. ~,(..¿. ;4;> """O":'\.-Ct'"«..d.
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B. RELEASE CONTAINMENT: ~e..'2..e.....lou,~ a^A D- L..-.....;.. Æ- ( '":7 ~Ø-(.o.....d_...: l,
c..o "'" ......:....... c...J. .
j.,......
C. CLEANUP: I~ J.~"'L_l--!... b, E..~.....,...~.c.........c..., ~&.",~,'("'4-~.
SECTION 8: EXPLAIN THE NOTIFICATION METHOD AND EVACUATION PROCEDURES YOU HAVE DEVELOPED
FOR THE EMPLOYEES TO USE IN AN EMERGENCY. YOU MUST INCLUDE A MEETING POINT.
A. AGENCY NOTIFICATION: L,.".,,' ~" c: ",.,i 0 C--hc..&. oL
E.......c......s.c...'-U'ì ~c..;.."c.....~ ;. '''boo· B5"Z.."15So
"2..-1 k... : (cor, ~) 7.. (" '2.. , .. '2. ,
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B. EMPLOYEE NOTlFICA TlON/EVACUA TlON:
C-e.' t .1\1\-' ß.,,,.J or ~ -¡::::: \0"'_'
A 'l ~~ (.... 1 ; 1-: -4...... c."..- t... t.I '^ ....... .«. ~ '"'" .&. J.
- CONTINUED ON NEXT PAGE -
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SECTION 9: EXPLAIN WHAT PRIVATE FIRE PROTECTION SYSTEMS ARE IN PLACE THAT MAY ASSIST
EMERGENCY RESPONDERS. "'A
SECTION 10: LIST THE LOCATION OF ANY WATER SUPPLIES THAT MAY BE USED BY EMERGENCY
RESPONDERS. . I ,.
. 0'" ~..t"L .......c-ll d'~C-\""'c....~.L.
I, J' «- '- ~ J\..'\ LIo. " .\. : "" . certify that the information submitted on all the
business plan fonns is accurate and complete. I understand that this information will be used to fulfill my
obligations under California Health and Safety Code Division 20 Chapter 6.95 et seq. and Title 42 U.S.G.C.
Section 1100 et seq. an false information may be punishable by fine, Imprisonment, Q! both.
~
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TItle
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Date
Signature
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Farm and Agriculture
URN COUH"n' PIU DBPA.R~
HAZARDOUS IlADAIALS IHVIII'rORY
FORK t
Standard Business ("fo )
Page
of
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CALIFORNIA WA" SERVICE COMPANY
3725 SOUTH H STREET· BAKERSFIELD, CA 93304,653B . (661)396,2400
e
BAKERSFIELD DISTRICT
08/14/00
Bakersfield Fire Department
Office Of Environmental Services
1715 Chester Ave. Suite 300
Bakersfield, California 93301
Re: Hazardous Materials Management Plan
Esther Duran, I hope you will find these new business plans for our new California Water
Service sites satisfactory. If you have any questions regarding these, please contact me. I
suppose fees, etc., will be pending.
SinCerelY~
~ .
~ 0
Jeff Martin
Maintenance Supervisor
Enclosures
DlsrRlCT OfFICIS: BAKERSFIELD . BEAt GULCH . CHICO . DIXON . EAST LOS ANGELES . HERMOSA-REDONDO . KING CITY. LIVERMORE . LOS AlTOS SUBURBAN .
MARYSVlllE . OROVlllE . PALOS VERDES. SALINAS' MID·PENINSULA . SelMA' SOUTH SAN FRANCISCO. STOCKTON' VISAlIA . WESTLAKE. WILLOWS