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I, "'___'=,====~==,=,..~=',_=..__,,~,~~=",=_____" I "''.______, I .. . -...----,.. ,"~ .~===~~_.=~~...,..,_ - Pacific Gas and Electric Company -" Kern Division 1918 H Street Bakersíield, CA 93301 July 10, 1998 ~ mr:~ Ms. Lori Smith California State Office of Emergency Services 2800 Meadowview Road Sacramento, CA 95832 Dear Ms. Smith: This is the follow-up written report for the verbal spill notification discussed with you on Wednesday, June 17, 1998 at 12:20 p.m. At that time you assigned the following O,E.S, control number 98-2782 to this spill event. Notification was also made to the Bakersfield City Fire Department (C.u.P.A.) via phone call on June 17, 1998. Ms. Winters with the National Response Center in Washington D.C. was notified via a phone conversation on June 17, 1998 at 12:25 p.m. The N.R.C. assigned control number 442034 to the spill event. At approximately 10:00 p.m. on June 16, 1998 Pacific Gas and Electric Company investigated a reported oil leak in a vacant lot approximately 1/8 mile west of California Street on Stockdale Highway in the city of Bakersfield, Kern County, California. The field was the site of a burned down abortion clinic which was demolished, leaving a padmount transformer on the site. It was discovered that the contractor had damaged the transformer in the process of grading the site, causing approximately 45 gallons of oil to leak from the secondary bushings on the 500 KV A padmount transformer. Oil had leaked onto the freshly plowed ground and flowed to a block wall with a small amount leaking to the adjacent sidewalk. An oil sample was tested, and the oil was determined to be non-PCB. No waterways, crops or vehicles were involved in the spill. No oil came in contact with people. PG&E contracted with Allwaste Transportation and Remediation to excavate all contaminated soil and removed the oil contaminated cement pad and the contaminated portion (approximately 10 linear feet) of the block wall. All contaminated soil and debris were shipped to Chemical Waste Management at Kettleman Hills, California, for disposal as hazardous waste. If you have any questions or wish to discuss this matter in greater detail, please contact me at (805) 398-5842. smce:1)~~. Mike Westbrook Gas and Electric Supervisor cc: Mr. Howard Wines Environmental Services Department 'Ms. Winters National Response Center '.~ ~"'~ 4. '., ~ ~ .- !!-~ (. II R S F ( 8 L D - Haz Mat Emerg o Spill RepO_ \. [2] Complaint Environmental SOlVicos D Date Haz Mat Incident / Spill Report / Complaint Follow Up &((rolct<b (j)c.¡-rdJ ~Jcq,c;'¡'¡ e:., Time 2- ~Q::') Reporting Party Address Telephone No. Environmental Services Contact .3'1'{) ... ~c,l uJf,Jß Location of the incident 5:~o 5-foe,kJ.~1e... (s ). t. of.t...r~ ð (f,Ce... ~f ~x - a. rSOA "5'~ J Description of the incident ( Chemical name and Quantity ) 4~ 5C.1lcM.5 ~;).tr""rv- 0'( ~f';(l~ ~ pc..J ~-kJ +rc."'5£r~eI- W~ d.eJ1--ð(,-hO'\. Co.--..(,-...c-6r <;"1'tC,SS"-J UII'J~ c.c.,~l~ t blbt.e.. C~~JO','c.. bus/'" ;"'3 Cc;"s'::;:j ð t (,b (~I:.. 40 4("O~J / pe.J.. I s~c.. tY' ~,eI<.We.J k.. Responding to Incident Y ~ Observations Special Conditions and I or health risks NO pcB r.s ,"",volvJ Haz Mat Team Dispatched v($) ~N Van Cellular No. 332-7865 OES Number Required Number Poss Exposure Victims N~ Medical Attention Required or Obtained ¿J (A Probable Hazardous Waste Clean Up Q N Cl<:c.,^ -up ~ld~.by r~'(E ~se C,~:¡ vJ~k. ~",-f qff.<r kcrc.ry Discussion and Disposition ..st.../lff~ <fo ~ 6.lvr~ a.+ ~l~ ~«"" Yo.../'J_ Referral ? ~ HM445701 Account Number -- ---... - ACCOUNTSRECENABLEADJUSTMENT April 4. 1994 Date Fire Department. Hazardous Materials Division Department/Division x Esther Duran From FAMILY PLANNING ASSOC MED GP Billing Name 5700 STOCKDALE HWY . STE 300 Billing Address Site Address Parcel # (If Applicable) Landlord Name & Address (If Applicable) ADJUSTMENT Last Billed Correct Billing Adjustment to Effective Date of Billing Change 19.22 <19.22> 03·01·94 ~- Remarks: BUSINESS NOW LOCATED AT 2500 H STREET. BILL WAS GOING TO THE WRONG ADDRESS (5700 STOCKDALE HWY . STE 300). WE AGREED TO WRITE OFF THE FINANCE CHARGES. ") ['..,-¡ ~'"ð14 ) e tit BAKERSFIELD CITY FIRE DEPARTMENT _IL rix:fk.. L-, 2130 "G" STREET "fJf{) BAKERSFIELD. CA 93301 ~ (805) 326-3979 :)3-03 6 ~ Or~ @ ~{ù \ \ OFFICIAL USE ONLY ID# 001036 HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. RECEIVED SEP S 0 1987 Ans·d........... . INSTRUCTIONS: SECTION 1: BUSINESS IDENTIFICATION DATA A. BUSINESS NAME: h/h/£Y' ~AIJ)/J)I/JJ(i ,))S~ð~ _M61J 0¡?- B. LOCATION / STREET ADDRESS: 57tf7J S70tß/)J]£é rÁ.lwy" ~ 3-rI-O CITY,¡f;;I!Ei!?ñQjP ZIP, 93i'tf I BUS. PHONE, ($n 3J3-~¡j;J3, SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material. call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE A. I?tI'f'l/ .& ¡!/ufs B. S1'ð¡Ø/I/JJ/IG lh£:.òSI/I/ll/r DURING BUS. HRS. Ph# .f ~-¡rJ :J.--3 AFTER BUS fHRS . Ph# $y%--/ /~ . , Ph# þ3-- b rJ;L3 Ph# SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: /1/65'7 5)!Jð (é~AI7ðd) Ilrme/l47Y ~: ~~;~~~ICAL: S:¡~~~~. 3:~ZR D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO FLOOR PLANS? YES / NO MSDSS? YES / NO KEYS? YES / NO - 2A - e e ~l ~~ . ","¡ ,," , , . Ii<.~ ,.--'''::-.....i. SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE /l/ ðjUf(' SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE ,,:5;AJ;JðIJ4{¡/ðJ IÞ~ SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. ~~¿MÞaUt!IJu~ .ltu.~ C/<JJ,/j). CIlcLE YES OR NO ¿1 -~ A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:...................... .... C. PROPER USE OF SAFETY EQUIPMENT:....,..........., . D.EMERGENCY EVACUATION PROCEDURES:................. E, DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: .... ... INITIAL REFRESHER YES NO YES NO YES NO YES NO YES NO YES NO YES NO ·YES NO YES NO SECTION 7: HAZARDOUS MATERIAL ___ ! CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: . . . . .. YES' NO I, ~~JI ~¿I;1~/~ 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 AI.) and that inaccurate information constitutes perjury. SIGNATURE ';¡¡ttir¿k~ TrTLE~"~ DATE tjdð~7 - 2B - , ~ ..... '~' / e e ,~ . "'~~.--;,~ BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY BUSINESS NAME :hhJ/Lr jJ¿IJI1IAJIAJ9 j/.C:;<t1ð,JYJ8D.~r-' ID# - - -' - - - BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action. this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH, 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as ~ossible. FACILITY UNIT# FACILITY ù~IT NAME: SECTION 1: MITIGATION, PREVENTION. ABATEMENT PROCEDURES {'ih~ ~deW ~. rrþr ehTau-'t'L ~ ~~~/I,d~ SECTION 2: NOTIFICATION AND EVACUATION PROCEDL~ES AT THIS LÑIT ONLY J;dDt~ jJ ff tfkJ ~. I ca2f2 C¡I ;, - 3A - e e , , .. - "';"..' ....\... ~ ;: SECTION 3: ~~ZARDOUS MATERIALS FOR THIS UNIT ONLY ,A. Does this Facility Unit contain Hazardous Materials?...., YES NO If YES, see B. If NO, continue with SECTION 4. B. e any of the hazardous materials a bona fide YES NO If ¡ 0, complete a separate hazardous materials inventory form arked: NON-TRADE SECRETS ONL~ (white form #4A-l) If Yes, complete a hazardous materials inventory form n rked: TRADE S RETS ONLY (yellow form #4A-2) in addition to he non-trade secret fa List only the trade secrets on form 4A SECTION 5: SECTION 6: LOCATION A, NAT. GAS/PROPANE: UNIT ONLY. B. ELECTRICAL: C. WATER: 0, SPECIAL: E. LOCK BOX: YES IF YES, LOCATION: IF YES, SITE PLANS? FLOOR PLAi\S? YES / NO YES / NO MSOSs? KEYS? YES / NO YES ! :\0 - 33 - BAKERSFIELD CITY FIRE DEPARTMENT 1.0. # FORM 4A-l NON-TRADE SECRETS HAZARDOUS MATERIALS INVENTORY BUS INE~S NAME: 1'l1ff1/¿Y' ¡?1J¡¡¡)j }JAJt; ;:},<;çæ A16íH{e OWNER NAME :1;/11/1./1' ¿AAÜJIJl)~ JI~,1(!/ ADDRESS:. r:;7{)0.577JCR.O~15 Jltvy-H$tN!J ADDRESS: 3tJ5Ó /f/~F()J!!"Í W/J'r' FACILITY CITY, ZIP:ß;9KG£SFI¡;i.¿;) ý'33tJ'l CITY,ZIP: Ltfjl/I'é. 15dßcH. ci:? a1'J!f()~ ~ J ~ ~ ¡..,,;- J~ -----=---- .. -'~' Page of"'~_ FACILITY UNIT #: UNIT NAME.: PHONE #: $,d-fJ d;)....3 PHONE #: (;1.13) 4;;J..6~c¡~tl 10FF Ie t AL USE CFIRS CODE ONLY - 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS % BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT, WT. CHEMICAL OR COMMON NAME CODE GUIDE f j;(o 7, FC:> cYf 27 :J.- Re<;O"e~y I~' / O.xvqe;J :¿o '70 /- kxrLL Þx. ~. .MIIJ" 2-f . IOo~ '", ...._U_J j ~ ~ À )"1 P /6~' 1.6 gO· F"é3. a'i ';¿7 /- e.os¡..SUf-9,til.:./eM.Y [2.) j;o¿ ^LO~.. NIi-!-""M', c:8ÖS J / ... . ¿) _ '/,:, JS '1I1'tO ~ , , , v I'C/ , ( , , " A ~ /1 / NAME: 0. _I I :""¡/A~S TITLE: A1¿J/lIß~eP S lGNA TURE: 7~.I·¿ ('~'Á AtVL../ DA TE: 9-.3()~ '/ A IA1 ÞI ¿, EMERGENCY CONTACT :¡;¡~ Þt!I[ g./( rµ./ S7t5J'Hnf'/le' j:J I K(}5H1M PHONE # BUS HOURS: AFTER BUS HRS: PHONE # BUS HOURS: AFTER BUS HRS: ~~3 'btJ ff¡Ã 9"f-lf 5 TITLE: ASGJ' 1fJ6f<." EMERGENCY CONTACT: 'PRINCIPAL BUSINESS ACTIVITY: TITLE: - 4A-l - ~ 'w"'. .~ /--::::::a~A/{"""" , ."¿a D...l:. '. ,"OC ," ~~, i·".. , " ~'" \ :...... '...', <!,'. \ , ,--. ("' "(..;,":' :0 .i-A~ ",,) l,\' ~~¡,,)', ..:~,::~~/ e e I ..,~ III, I \\\\1\",,_____ . CITY 01 BAKERSFIELD };:l:::,lD.¡<~~ ~ _,~ \~/i X% ~ ='''' \, '·¡¡II :::..~_" O -'-c'" ,,- j -,' -=,- ==,~ - -'\ -' + "\ ~, I I -:::':\',:"': ',.. ff :) 'd. 3- ft,o d- 3¡z,;¡j¡'i¡~" @ "WE C-iRE" RECEIVED JAN 1 9 1989 Do hereb'y certify that I ha',-e reVieh"ed the A Rs'd........... . tLJ attached Hazardous Materials business plan for and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. ~ J!:iz"- ." l;¡J1a/1Al rØJtfrLÐ) slgnat.ure date , _ d S €) 9 ~ (jO a' . ¡t1 . CITY of BAKERSFIELD F,r. ,ndAqricu !tur, '---' Standard Bus iness ~ "---' HAZARDOUS MATERIALS INVENTORY NON-TRADE SECRETS BUSINESS N~~' ~~ OWNER NAME:~' LOCATION :ß.', . 'I ~'1'3lú ADDRESS: 30, '. ( CITY, ZIP:_ ____ _ CITY, ZIP:i__ PHONE II: (1, ,. , PHONE ,,: R8I'Il1l ro rllSf'ltucrrollS roB nopø CODa P'9' ____ of ____ NAME OF TitS ~~JLÅTY: STANDARD IND. CLASS CODE DUN AND BRt9STREET NUMBER 1\1-l\. - _ _ _ - _ .' PhysiC' I and HH Ith Haz.reI lr.hKk .11 tllet ' I Ily) ...A ,.-., L.ir. H.urd L_.J RHctf,ity 1 2 Irans Type Code Code J 11111 Mt . .ver. Mt 5 Annuli Est , lIH.ul't Units 1 IOys an Sit. " Un CodI n locet1an ..... Stored In flCl1tty 13 ,by lit I. ..... of .tlltUN/c:o..c.-t. See Instructians -'4-@!=rl--- ------------ " ,.-., L. _.J IMldi.t, IIet Ith eo.n.nt 82 .... U.S. ...... ec.,on.nt 13 .... C.&.S. ...... r-., ,.-., L _.J Ftl't Haz.rd L. _.J IIHct Ivtty ...- ---- ec.oan.nt II ,--, ,.-., ,.-, ,.-., ,.-., L _.J Fir, Haz.rd L. _.J RHCti,jty L. _.J OtI.yØ L. _.J Sudftn ~I.... L. _.J I-.eli,t. HH Ith of P.....Ul't IIH Ith ec.oan.nt It .... C .&.S. ...... ec.,on.nt IJ .... C... s. ...... ----l--__________1-.____________JL___________J_____J_______L____---1_~JL Phy,ic,1 tnd HHlth Haflrel (Check .11 tllet .,,1,) U.s. .... ________________ ec.oan.nt II .... C...S. ...... .- ---- ,..-., ,.-., ,.-, r-., ,.-., L _.J Fir' Hazard L. '7"".J IIHc:tivlty L. _.J OtlayØ L. _.J Sudden ~1..., L. _.J I-.eliet. H..lth of PrlSsur. H..lth C....t 12 .... C...S. ..... ~----------------------------------- ------ ec.,on.nt 13 .... U. S. IMber liE RGENCY COIIUCTS T1A11yr------------~~Q?) ~~~;JþL-- 12 q¡¡-------------------------- T1t1J---------------- n,.,-1'IIIIII1------ Clr.t ff ¡c,t ion (Read and s j 1!11 II f t c r eo.p J e ti ng II J J see ti ons J I clrtify und.r "",1tv of 1", that I hav, Dfrsonally ....;ned end ,. f..III.r with the inforllll~i t.Hted in this tnd .11 'ttlC"" doc_u, tnd tllet based an Iff ;nqulry of thos. tndtvidul1. ....pon.ib1. !o~ obt'in~'n the ¡nf_tlan. I beHlve tllet the subalued ;nfol'llltion is true. accuratl, Ind p tl. 11' 1 f-.. II·?~-:T- -! f}ht' IJ.f7 iLl. ,fJ:1.._ ':h t.o.('J¿,U11 A !~t~~---~,...--------t-f--- . _ _ ~t1lJ_ _. _wo1Rmu_______________ ft~ 1 ::5 I~_l j¿q______________________ 4_ ,no 0 ,c,m1ti. õfr·OWIerToPi~;tto!-ò'fowntr'~õ~~tõ~"šiu norJl~ repro"en . IVI! I U e , !HIt. ~~ ~, -~ " .. ;- BUSINESS NAME FAMIL4IÞlANNIN~ ASSOt MED GP lOCATION 5700,,300 STOCKDALE HWY , 10 N'-'ER 215-000-001036 m'GH HAZARD RATING' Z 1. ()'.)ERVIEW lAST CHANGE 10/08/87 BY ESTER JURIS CODE 215-011 JURIS BAKERSFIELD STATION 11 t1AP PAGE ,123 GRID 03B FACILITY UNITS 1 ¡"¡fUA~D RATING 2 RESPONSE SUMMARY 2A SEC 4) PRIVATE RESPONSE - NONE EMERGENCY CONlACTS lA SEC Z> RtlTt! ¡;1·fIt~5 1.': 1 . ·.2;rJ~A 11:;4 I. STEPHANIE HIROSHIMA luJ-- 323-6023 tuP?ltJ -t¡lfí') I 1... &ClA-\C- t:xu-I1LS ~ -l415" UTILITY SHUTOFFS 2A SEe 3} f\> GAS - WESt SIDE <CENTER} OF FACIUTY Bì ELECTRICAL - SOUTHWEST CORN£R c} WATER - SOUTHEAST CORNER 0} SPECIAL - NONE E) l.OCI< BOX - NO 2. NOT!FICATION 1 PUBLIC EVACUATION lAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SEctION > j~ ~1'W wou.lÃk, oc €.NGL~~ Wr .3 ~l-tS G.M~' \~\UJh'V\L {?Ò~Vd 0iY feU'" !df- Cfj~vyc(' ~.. +hu 9.ClXW,UH,-,\ tor .~ 1'\1ù oHll-V <;ju.m)\M~J O{hCkS ÙJlV '~\O\î~-G \r.?v\. ÒJ-~l~Yl~ Mvt{Jw~ . . PAGE 1 1 V 16/BB 17~06 f-'1AT£RlflL SAFETY DATA qYSTEM5. INC. <ß0S) 648,-6800 BlJSINESS NAME: FAMILeLANNHJG ASSOC MED GP LOCATION 5700-300 STOCKDALE HWY' ID N4IÞER 215-000-001036 HIGH HAZARD RATING 2 3. HAZ MAT TRAINING SUMMARY lAST CHANGE / / BY < NO INFORMATION RECQRDËO FOR THI~ SECnON > (Y\¿'D'7 'S'V\LL-f.s QYI..- j:VW -to)ß.£h.(.¡%¡~ a.rvL '(5 [JY\L. ovur liJl vYl3rvcl. - ~VÎ0D0 ~ (µ1(~ 01<;1> ~ át> 02- W IJ,G hriekK ~ÇYtJYJ. \5 ~~ . -- - ~ - -- 4.. LOCAL EMERGENCY MF.:DICAL ASSISTANCE l.AST ÇHANGE 10/03/87 BY ESTER 2A SEe 5) SAN JOAQUIN COMMUNITY HOSPITAL 2615 EYf. 5T (805) 3Z7~'l7t t PAG:=' Z 12/16/S8 17:06 MATERIAL SAFETY DATA SYSTEMS. INC. (805) 648-6800 " .. i BUSINESS NAME FAMIl4lÞLANNING ABSOC MED GP LOCATION 5700-300 STOCKDALE HWY FACILITY UNIT 01 10 N~R 215-000-001036 ~ HAZARD RATING Z A. OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 10/08/87 BY ESTER 10 TYPE NAME LOCATION CONTAINMENT MAX AMT UNIT HAZARD USE PURE OXYGEN RECOVERY RM/SURGERY RM PORTABLE PRESS. CYL. 10 PERCENT COMPONENTS 2359.00 100.0 OXYGEN. COMPRESSED 1.07 FT3 HIGH MEDICAL AID OR PROCESS HAZARD LIST HIGH z PURE NITROUS OXIDE SURGERY RM/STORAGE RM PORTABLE PRESS.. CYl. Ib PERCENT COMPONENTS 2345.00 100.0 NITROUS OXIDE ISB FT3 MODERATE MEOtCAL AID OR PROCESS HAZARD LIST MODERATE 8. FIRE PROTECTION I WATER SUPPLIES LAST CHANGE / J ßV < NO INFORMATION RECORDED FÒR THIS SECTION> 3 f1i'VjjC+í~\A1~5 PAGE :3 17./18/88 17:06 MATERIAL SAFETY DATA SY5T£~1S. INC. (B0S> 64B-6800 BUSINESS NAME FAMILeU",NNING ASSOC MËD GP LOCAiION S70Ø-30Ø STOCKDALE HWY O. EMPLOYEE: NOTIFICATION / t:VACUATION 3A SEt Z) INTERCOM PA OR VER8AL 3, CALL 911 E. MITIGATION I PREVENTION I ABATEMENT 10 N4IÞER 215-000-001036 HIGH HAZARD RAT! NG Z LAST CHANGE 10/08/87 8Y ESTER lAST CHANGE 10/08/97 BY ESTER 3A SEC t) COMPRESSED CYLINDERS ARE PROPERLY CONTAINED AND USE PROPER VALVES AND FITTINGS PAGE 4 MATERIAL SAFETY DATA SYSTEMS. INC. (805) 648-6800 lZ1\6/Ba \7:06 ii} ~ ~ '!-\ -~ e e o ~CG~aw~ . ~EP 4 1QQ? P By 1 ~ '''-'-i; 07/29/92 . FAMILY PLANNING ASSOC MED GP 215-000-00 Overall Site with 1 Fac. Unit ~ General Information Location: 5700 STOCKDALE HWY 300 Community: BAKERSFIELD STATION 11 Map: 123 Hazard: Low Grid: 03B, Flu: 1 AOV: 0.0 Contact Name GAYE BARNES STEPHANIE HIROSHIMA Title Business Phone (805) 323-6023 x (805) 323-6023 x 24 - Hour Phone . (805) 322-1415 (805) --398-94.11 Mail Addrs: City: Comm Code: Administrative Data 5700 STOCKDALE HWY #300 BAKERSFIELD 215-011 BAKERSFIELD STATION 11 D&B Number: State: CA Zip: 93309- SIC Code: Owner: FAMILY PLANNING ASSOC Address: 3050 AIRPORT WY City: LONG BEACH Phone: <3l0) L/ ~Co - if (PiP I State: CA Zip: 90806- Summary ~, (O~ D© ~@mby ceií1[Yw ~~ a G'B~@ )3) ó1 ~11'I1 name) , " r®vi®wooi R~iS att3ch~d tl';;:.;~., ,..,' ;\1aterial$ m~~@@J~o m\?m~ ~~n ~~r1:...lLÅ ~--!..LâiH:¡ that iR &If©U'itfIJ w¡~~ (N~'I1G or BU8I11E>S.'I) , W (ill~l? OOIiìi®©(ìå©ú'D$ OOi'H5ßÒftU~® al com¡<}!~ís BJn©1 oorO'OOfi m~61- ~®m®Iñrt(tºJ~[fi) b©f MV ~®©å~òftl?o '----' ~ . 2-(.q l-- ~ ~i:i j.,¡:: , .. ~Ü:j!~~· e e 07/29/92 " FAMILY PLANNING ASSOC MED GP 215-000-001036 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 OXYGEN ~ Fire, Pressure, Immed Hlth Gas ' 253 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: MEDICAL AID OR PROCESS Daily Max FT3 ~ Daily Average FT3 ~ Annual Amount FT3 253 I 207.00 I " 1,104.00 Storage r Press T Temp ~ Location PORT. PRESS. CYLINDER Above Afubient RECOVERY RM/SURGERY RM - Conc l 100.0% Oxygen, Compressed Components C MCP ---rList Low I 02-002 NITROUS OXIDE ~ Fire, Pressure, Immed Hlth Gas 336 High FT3 CAS #: 10024-97-2 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: 'MEDICAL AID OR PROCESS Daily Max FT3 ~ Daily Average FT3 ~ Annual Amount FT3 -- 336 I 224.00 728.00 Storage r Press T Temp ~ Location PORT. PRESS. CYLINDER Above AmbientlSURGERY RM/STORAGE RM - Conc l 100.0% Nitrous Oxide Components 1-= MCP ---rList High I e e 07/29/92· FAMILY PLANNING ASSOC MED GP 215-000-001036 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation INTERCOM PA OR VERBAL & CALL 911 <3> Public Notif./Evacuation THE OFFICE WOULD BE EVACUATED AT 3 EXITS AND A MEETING POINT AT FAR LEFT CORNER OF THE PARKING LOT. THE OTHER SURROUNDING OFFICES ARE NOTIFIED BY DESIGNATED EMPLOYEES <4> Emergency Medical Plan SAN JOAQUIN COMMUNITY HOSPITAL 2615 EYE ST BAKERSFIELD, CA. (805) 327-1711 e e .. 07/29/92 FAMILY PLANNING ASSOC MED GP 215-000-001036 00 - Overall Site ·Page 4 <E> Mitigation/Prevent/Abatemt <1> Release. Prevention COMPRESSED CYLINDERS ARE PROPERLY CONTAINED AND USE PROPER VALVES AND FITTINGS <2> Release Containment ~L,,- - "11 ~ l:uJ. ~ G6W- O¡JLv <3> Clean Up N () ~ - ~ f t~~ (b c~ (} tJ ~ý. <4> Other Resource Activation e e ~ .. 07/29/92 FAMILY PLANNING ASSOC MED GP 215-000-001036 00 - Overall Site <F> Site Emergency Factors \ Page 5 <1> Special Hazards <2> Utility Shut-Offs A) GAS - WEST SIDE (CENTER) OF FACILITY B) ELECTRICAL - SOUTHWEST CORNER C) WATER - SOUTHEAST CORNER D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - 3 FIRE EXTINGUISHERS FIRE HYDRANT - ? Iv.- ~cLVl"l":"~ Lot ~ f=-O-S~ ~:ck o~ <4> Building Occupancy Level ì e e 07/i9i92~ FAMILY PLANNING ASSOC MED GP 215-000-001036 00 - Overall Site Page 6 <G> Training <1> Page 1 WE HAVE 15 EMPLOYEES AT THIS FACILITY WE HAVE MATERIALS SAFETY DATA SHEETS ON FILE. MSDS SHEETS ARE GIVEN TO EACH EMPLOYEE AND IS GONE OVER WITH MANAGEMENT MSDS SHEETS ARE ALSO ATTACHED TO OXYGEN AND NITRUS OXIDE HOLDER. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use