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RAISED:~OivCRETE PAD,' LOCATION OF DOORS, WINDOWS AND EQUIPMENT. THE
Is''xe'x3 5/0;- FOR; .;' FILTRATION ·BUILDING SHALL 8E A BUTLER, ''SOULE OR
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POOR ORIGINAL
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May 1, 1990
Dear Business Manager:
The following questionnaire is a supplement to the
Acutely Hazardous Materials Registration Form previously
submitted by your business as required under Section 25534
of the California Health & Safety Code. This registration
i Y"ld i cates that (E. _1'a~le§._=-Cclrllt:.tiÇ!ÿIì-=t:2=Set"vices-º"i3_i::l':Cc_t___h.1::\Y"td les
Cë~Ifr';:..!::!!)e g_ª~,J aY"t aC1.ltely hazardc'us r.l-atet~Tal ( AHM ), in ë\Y"t
amount greater than the planning quantity for this chemical.
Additional information is necessary in order to complete
the risk management planning functions of this agency.
This questionnaire should be completed by an officer of
the company or other person having substantial management
control over all operations at the facility. If there is
any doubt as to whether or not the answer to a question is
yes Qt~ Y"I':', the aY"lswet~ "yes" shall be giveY"l.
With in tWQ weeks of receipt, complete and return the
questionnaire tQ: The Bakersfield Fire Department
Hazardous Materials Division
2130 G Street
Bakersfield, CA 93301
If you need additional information, please call 326-3979.
S i Y"cet~e 1 y,
Bat"bat~a Bt~eY"lY"Iet..
Hazardous Materials Planning Technician
- , 5 t ,\\ú.\~.
1.,0 \\\\ .;;,~;~-:!!1lJ¡
CITY of BAKERSFIELD . 3 t \!!/:::\\D,i>~
., WE C-IRE" /1 \/lP :~; t? ::r;;;
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ff.~ " 4 ''169
HAZ. MAT. DIV.
RE.CE'VEO
JAM 1 :\ 1989
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R. W. Stephens
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namei
Doh ere b:;c
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that I
ho. -,-e
revieh-ed
the
attached Hazardous Materials business plan
for
East Niles Community Service District - Treatment pRESEIVED
(name of business)
fEB 1 4 \969
and that it along with the attached additionsHAZ.MAT.DtV.
or corrections constitute a complete and correct
facili t~-.
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1-12-89
date
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CIT}T of BAKERSFIELD
Far. and Aqriculture
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Standard Bus;n!!ss '---'
HAZARDOUS MATERXALS XNVENTORY
NON-TRADE SECRETS
1 1
Paq!! _____ of ____
BUSINESS NAME:
LOCATION:
CITY, ZIP:
PHONE #:
i4ï~ ~~l~~St(~()Bdx s60~~r~~~:=s:~ME:
BakersfieldÓ CA 93386 CITY, ZIP:
( ~ 0 ~ ) ~ / 1 ~ ¡ U. PHONE 11:
ImI'lfR 2'0 IIIS'rIlUcrIOIIS roll PIlOPIlIl CC!DIlS
¡fAME OF TfnS ~J~JL1.TY:Plant
STANDARD IND. CLASS CODE
DUN AND BRADSTREET NUMB~R
95 - (g Ç2Q h rf?(¡;'/ _
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Cod!! Cod!!
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See IMtructions
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CcIIIpanInt 13 .... U.S. ......
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Cc.ponent II .... C.A.S. ......
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(Check ,11 tllet ""I,)
C.A.S, ..... _____________________ CoIIpoMnt 11 11_' C.A.S. IIuIbtr
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~ _.J Fir!! HlZard L - j IIttc:tivity L - j Del.yed L - j Sudden R.ltIS. L - -' ¡-.cII.t.
HHlth of Pressure H"lth
Co.ponent 12 .... C.A.S, "'**'
------------------------- ------
CœIIonInt 13 .... C.A,S, ....r
~fRGfNCYCI*TACTS 11 R. W. Stephens Mgr. ,--, 871-2011
lIi¡¡-~--- -- ------ -- - -- ------------------- TU'¡---·,------------------- 7.-R¡:-PI\iiii¡--------
n Vernon Lancaster Superintendent 871-2011
Iiii------------------------------- T1!1¡------------------- lI-WP-Pftðftl---------
(Read and sign after co_plP-ting all sections) ~______
, ---- '
I clrt-fy und.r "",lty of 1.. thet I hey. Pl!rson.lIy ....ined end .. fHiliar .Ith the Infor..tion ,tut.ftttel In t j 1 .tt.c
f~ obt~H\n9 the infor..tlon. I believ!! tllet tM subllitted infol'tlltion ;5 trut!. ,ccurat., .nd o-ø"l!!!...
:-General Manager ~-
A..~ ana::'õTHéì¡ 1-m1;}f-õWi!!r ToP¡¡:¡{õr-tIR-õWi@r7õÕ@r¡{õrTiü{liõ¡:ma-;:@õ¡:üiñ{im-
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cIóc:_ts, and tllet bastel on -v i~lry of those Ind1vlclut1s l'tSIDIIsib'.
1-12-89
Dit@-Sì¡ñïa----------------------------
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BdsINESS NAME EAST NILES COMMUNITY SERVICES DIS ID NUMBER 215-000-001356
LOCATION 1417 VALE ST HIGH HAZARD RATING 4
,.
OVERVIEW
LAST CHANGE 01/06/89 BY ESTER
JURIS CODE 215-042 JURIS COUNTY STATION 42
MAP PAGE 103 GRID 26A FACILITY UNITS 1 HAZARD RATING 4
RESPONSE SUMMARY
2A SEC 4) PERSONNEL TRAINED IN REPAIR OF MINOR LEAKS IN SYSTEM. EQUIPMENT
ON HAND TO REPAIR AND TO ALLOW PERSONNEL ACCESS TO AREA. OTHER
QUALIFIED PERSONNEL AVAILABLE WITHIN LOCAL AREA TO HANDLE MORE
SERIOUS PROBLEMS.
EMERGENCY CONTACTS 2A SEC 2)
R. W. STEPHENS - 871-2011 OR 871-5967
LARRY WHITE - 871-2011 OR 366-7122 VERNON LANCASTER - 871-2011 OR 366-7154
UTILITY SHUTOFFS 2A SEC 3)
A) GAS - BETWEEN CHLORINE BLDG & PLANT BLDG B) ELECTRICAL - AT FRONT OF PLANT
BLDG C) WATER - NONE D) SPECIAL - NONE E) LOCK BOX - NO
..
NOTIFICATION / PUBLIC EVACUATION
LAST CHANGE / / BY
< NO INFORMATION RECORDED FOR THIS SECTION >
~GE 1
01/06/89 14:35
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
BUSINESS NAME EAST NILES COMMUNITY SERVICES DIS ID NUMBER 215-000-001356
LOCATION 1417 VALE ST HIGH HAZARD RATING 4
.. HAZ MAT TRAINING SUMMARY
LAST CHANGE / / BY
v
3~~ 1~ :::-. \ L
1) ~
< NO INFORMATION RECORDED FOR THIS SECTION >
þtð1Jt Ms '00
e·
LOCAL EMERGENCY MEDICAL ASSISTANCE
LAST CHANGE 01/06/89 BY ESTER
2A SEC 5) ANY OF THE LOCAL HOSPITALS OR EMERGENCY FACILITIES ARE AVAILABLE
MOST PARTICULARLY KERN MEDICAL CENTER.
e
PAGE 2
01/06/89 14:35
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
e
-
BÚSINESS NAME
LOCATION
FACILITY UNIT
e e
EAST NILES COMMUNITY SERVICES DIS ID NUMBER 215-000-001356
1417 VALE ST HIGH HAZARD RATING 4
01
..
OVERALL HAZARDOUS MATERIALS INVENTORY
LAST CHANGE 01/06/89 BY ESTER
ID
TYPE NAME
LOCATION
CONTAINMENT
MAX AMT UNIT HAZARD
USE
1
PURE CHLORINE GAS
CONCRETE BLOCK BLDG PORTABLE PRESS. CYL.
ID PERCENT COMPONENTS
1028.00 100.0 CHLORINE (EPA)
13750 FT3 EXTREME
BACTERICIDE
HAZARD LISTS,
EXTREME EPA
.
B. FIRE PROTECTION / WATER SUPPLIES
LAST CHANGE 01/06/89 BY ESTER
3A SEC 4) ON SITE EXTINGUISHERS AND UNLIMITED SUPPLY OF WATER. PERSONNEL
READILY AVAILABLE IN THE EVENT OF ALARM.
3A SEC 5) LARGE STEAMER HYDRANT LOCATED LESS THAN TWENTY-FIVE FEET DIRECTLY
IN FRONT OF CHLORINE BLDG.
eGE 3
01/06/89 14:35
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
BUSINESS NAME EAST NILES COMMUNITY SERVICES DIS ID NUMBER 215-000-001356
LOCATION 1417 VALE ST HIGH HAZARD RATING 4
..
EMPLOYEE NOTIFICATION / EVACUATION
LAST CHANGE 01/06/89 BY ESTER
3A SEC 2) THIS UNIT IS NOT MANNED AND ALARMS ARE SET TO PROVIDE NOTICE
BEFORE ENTERING CHLORINE BLDG. ALARMS ALSO MONITOR AND REPORT
ANY LEAKS. PERSONNEL HAVE BEEN INSTRUCTED ON HOW AND WHAT TO
CALL (FIRE DEPT, ETC.) IN THE EVENT OF LEAK.
.
E. MITIGATION / PREVENTION / ABATEMENT
LAST CHANGE 01/06/89 BY ESTER
3A SEC 1) FACILITY IS LOCATED SEPARATE FROM OTHER OPERATIONS IN CONCRETE
BLOCK BLDG. IT IS EQUIPPED WITH CHLORINE GAS DETECTORS AND ALARM
SIGNALS. TRAINED PERSONNEL ARE AVAILABLE TO SHUT DOWN ANY LEAK.
.
PAGE 4
01/06/89 14:35
MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800
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2. NOTIFICATION I PUBLIC EVACUATION
All personnel have been instructed in
making immediate notification in the
threatened release of chlorine gas.
four listed below.
the requirements for
event of a release or
They are to call all of
1, Hazardous Materials Division of City Fire Department
2. Hazardous Materials Bureau of Kern County Fire Department
3. Kern County Health Department
4. Emergency Services, State of California
List and Numbers posted in Office and at Treatment Plant Site
3. HAZARDOUS MATERIAL TRAINING SUMMARY
All field employees and management personnel have been given
special training sessions by qualified instructors (William
Moran, McMor Chlorination) in safety for handling emergencies
that could arise with the chlorine gas containers or equip-
ment, These training classes are repeated and updated every
months. /'
CIT}T of BAKERSFIELD
farto and Aqr;cultur~
'--'
~
St.nd.rd BU5,n65 '---'
HAZARDOUS MATERXALS XNVENTORY
NON-TRADE SECRETS
1 1
P.C~ ___ _ of ___
8USINESS NAME: 'Prl~t- Niip~ C'nmm Spr1i reOWNER NAME: . NAME OF TrrtS FA_ÇJL1.TY:Plant #1
:'OCATION: 1417 Vale St. Box 60 8 ADDRESS: STANDARD IND. CLASS CODE
:ITY. ZIP: BakersfieldÓ CA 93386 CITY. ZIP: DUN AND BRADSTREET NUMBER
'HONE ,: PHONE ,: - -
(HO~) ~/1. ¿ 1.1. - - - -- - - --
RUB ro I1lSrRUC1'IOItS rDR PROPIUl CODIlS
2 3 & 5 , 1 1 , 11 11 12 13 .. U
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1rlM lyoe .... AvwrMe ""-I ...",... IOys tent tent tent !In location lINN ,by __ of .irt_/C-t.
(00. Cod. Mt Mt Est Units on Sit. tyoe Press t-. CocIt Stcnd In facility lit See IlISt 1'IICt1_
n~L_~J. --9-98~ T ~6Ù-OO L5òooõ -, Ip:iT'1 365 I 04 I ? r 4 1 00:*1 of Chlor. !100 ,Chlorine G -
Center . q's-.:Z:~ ~
phy5;c.1 and HN Ith "-zard 7782-50-5 - l:Hq~. ~recKenr~d( e F d.
C.A.S, IIumr eo..ø-t 1 ..... C.A.S. ......
tChlck all that ,"Iy) *Water Treatment - .
:e,,.. H.zard -'
,.-., ,.-., ,.-., ,.-., ea.c.-ntl2 ... .. u.s. ......
L - '" RNCt;vity L - '" De I..,.c L_'" SucIIMn hl_ JL", l-.dl.t. ;
Hølth of Pres..,.. ....Ith ----
eo..ø-t 13 ... .. C.A.S. ...... ,
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( hick .11 that 'DIIly)
,..-.., ,..-., ,.-., ,.-., ,.-., eo..ø-t 12 ... . C.A.S. ......
~ _.J Fi... "-l.rd L_'" RNetivtty L_'" Del~ L_'" SucIIMn hl_ L - '" l-.din.
Hølth of PreSUt'l ....Ith
eo..ø-t 13 ... . C.A.S. ......
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P~;C'I and llealttl IIItll'd U.S. ... CœIIaMnt II ... .. C.A.5. ......
( heck . II that 'DIIly)
..-.., ,.-., ,.-.., ,.-., ,.-., CœIIaMntl2 __ . C.A.S. ......
.. _.J Fi,.. H.urd L - '" Retet ;v; ty L - '" Dela,," L _.J Suclct.n R.IHSt L--' l-.dlat. - ~~
HNittl of Pressu,.. H..-. th
eo.øc-nt 13 ... . C.A.S. ......
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'~;c.1 and HNlth "-I.rd C.A.S. ..... to.poMnt 11 ... . C.A.S. ......
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Hetl th of Prnsurt H,,1 th - --- ----
j c-.nt 13 ... .. C.A.S. IIœIIer
IfRGfHCY COIIUCTS 11 R. W. Stephens Mgr. 871~2011 n Vernon Lancaster Superintendent 871-2011
J._-~------------------------------ Tin¡-------------- WR;:-Pfiiiii¡---- &ii ------ nnr- 7n!rJlMllf---
,rtil;cat,on (Rt!lJd IInd sil!Tl lifter co.pip-ting IIll st!ctJonsJ ,_----,-:-..-'--~?r;>...
Clrtllv und.,. DeMlty of 1.. that I hav. oer5on.l1y ....;ntd and .. IHI1;.r withtht info....t;on 5u_HiM! I" t / -ill .tttched'doc_ts. and that btstd on wy inqu;ry of thos. indlvidut\s responsib\.
3r"o~t~'n,"q-tht int_tiOll. 1 .Hlv. that the SUOIIitttd into....t;on is tNt. .ccur.te. MId c_l.t."'-"........-: ~. /'
.---Ci1.~!1eral Manarrer ~'-. ~ ?%~_---?~~ 1-12-89
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BAKËR;;IE~D.:;)~~~~~3301 ~NO" ¡;'ld/€fj
(305) 326-3979 V .¡¡ 11&
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OFFICIAL CSE ONLY
ID;:
001356
HAZ~,~CUS MA7E~IALS
BUSINESS PLAN AS A WHOLE
FORM 2A
:J'A.\fE
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.
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E'TSTIUCTIONS:
SECTION 1: BUSINESS IDENTIFICATION DATA
East Niles Community Services District
A. BUSINESS NAME:
8. LOCATION I STREET ADDRESS: 1417' Vale Street, P.O. Box 6038 .
CITY:
Bakersfield
ZIP:
93306
BUS.PHONE: ~05) 871-2011
I
I
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 äe~artment and the Stùte Office of Emergency Services as required by
law.
E~PLOYEES TO NOTIFY IN CASE OF E)1ERGENCY:
NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS.
A. R. w., Stephens Ph# 871-2011 Ph;;: 871-5967
Larry Whlte 8/1-2011 366-7122
B. Vernon Lancaster Ph;;: 871-2011 Ph# 366-7154
--
SECTION 3: LOCATION OF TITILITY SHUT-OFFS FOR BUST~ŒSS AS Å :iHOLE
A. ~AT. GAS/PROPANE:
B. ELECTRICAL:
C. WATER:
D. SPECIAL:
E. LOCK BOX: YES / ~O
Between Chlorine B]d~. & Plant B1dq.
At Front ot Plant BU11dlng
~\/A
IF YES. LOCATION:
IF YES, DOES IT CO~TAIX SITE PLANS?
FLOOR PLA~S?
YES / :-10
YES .I ::0
;.fSDSS? YES / 010
KEYS? YES / :10
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SECTTm¡ -!: PR [VATE ~ES?():¡SE TE;\~ f."OR aCSEESS .\S .\ ~'/'HOL::
Personnel trained in repair of minor leaks in system. Equip~ent
on hand to repair and to allow personnel access to area. Other
'. quali~ied personnel available within local area to handle ITDre
1 .,. ,,' ,. "" l~ '., 'í
~ «serious problems.
~SECTIO~ 5: LOCÀL EMERGE~CY ~EDICAL ASSISTANCE ~OR YOUR BUSI~ESS AS A WHOLE
X
^ "
Any of the local hospitals, emergency facilities, are available,
most particularly Kern Medical Center.
SECTION 6: EMPLOYEETRAINING
E:IP~CYE:ZS ARE REQUIRED TO HAVE A ?ROGRA~I \ŒICH PROVIDES E:'IPT.OYEES \'iITH I~HTI..\L A~D
REFRESHER TRAIXING IN THE FOLLOWIÑG AREAS.
CIRCLE YES OR XO
A. ~ETHODS FOR SAFE HANDLI~G OF HAZARDOUS
:-!.Ä.TERIALS:........"............................ .
8. PROCEDURES FOR COORDI~ATI~G ACTIVITIES
WITH RESPONSE AGENCIES:. .... ... .... ........... '"
C. PROPER USE OF SAFETY EQUIP~EXT:..................
0, C::'!E?GEXC'! EVACt:'ATION PROCE:J1.;RES:" , , , , , , . , , , " , . . '
E. DO YOU :'IAINT.-\IN E:IPLOYEE TRAI~mG RECORDS:,....,.
IXITIAL REFRESHER
YES :;0 YES ::0
YES :-;0 YES :-;0
YES NO YES ~O
v""~ XO ".-.... ~':o
- "- rr:..:--::
YES ;¡O YES :;'0
SECTION 7: HAZARDOUS ~TERIAL
CIRCLE YES -, NO - NONE
DOES YOUR 3USP;ESS HANDLE HAZARDOI¡S :·L<HERIAL I)j QUANTITES LESS 7:1.4:\..,'500 ?OC;DS OF A
SOLID. 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A CO~PRESSED GAS:,.. ... YES NO
I. R. VJ. Stephens certify that the· above infor:':1ation is accurate.
I understand that this information will be used to fulfill my t'ir:n's obligat:'ons unde!"
the new California Health and Safety code on Hazardous ~aterials (Div. 20 Chapter 6.95
Sec. 25500 Et AI.) and that inaccurate information constitutes perjury.
,....
"./.........
'S¡G¡¡ATL~
Secy-Treas.
DATE 10-28-88
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BAKERSFIELD CITY FIRE DEPART~!EXT
2130 "G" STREET
BAKERSFIELD. CA 93301
CF?:ClA~ CSE OXLY
East Niles Community
BUSIXESS X.-\~Œ: Services District
ID~
------
BUSINESS PLAN
SINGLE FACILITY UNIT
FORM 3A
INSTRUCTIONS
1.~To avoid further action. this form must be returned hy:
2. TYPE/PRIXT YOGR A~S\iERS IN ENGLISH.
3. Answer the questions below for THE FACILITY UXIT LISTED BELOW
4. Be as BRIEF and CONCISE as possible.-
\
FACILITY UNIT:!t
Plant #1' FACUITY UNIT NA.'fE: Water Treatment Plant
SECTION 1: ~IT!GATíON. PREVE~i!ON, ABATE~E~-r PROCEDú~ES
Facility is located 'separate from other operations in concrete block
building. It is equipped chlorine gas detectors and alarm signals.
Trained personnel is available to shut down any leak.
/
SECT!Ûl~ 2:
NOT!FICATION A~~ EVAC~ATION PROCEDl~ES AT
"'~TC
~ ~l..l. '-"
eXIT OXLY
This unit is not manned and alarms are set to provide notice before
enterin~ 'chlorine building. Alarms also monitor and report any leaks.
Personnel have been instructed on how and what to call, (fire department,
etc.) in the event of leak.
- 3A -
.
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SECTIO~ 3: HAZARDOTJS ~ATERIALS FOR THIS !0rIT O~LY
A. Does this Facility Unit cont<tin Haz:1.råol1s :>[aterials?".." @ ~o
If YES, see B.
If NO. continue with SECTIO~ 4.
B. Are any of the hazardous materials a bona fide Trade Secret YES ~
If No, complete a separate hazardous materials inventory
. : form marked: ~O~-TRADE SECRETS OXJ.Y (white form =4A-l)
If Yes. complete a hazardous materials inventory form marked:
TRADE SECRETS O~LY (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 ?RC~CTTO~
On site extengishers and unlimited supply of water. Personnel
readily available in the event of alarm.
SECTION 5: LOCATION OF WATER SL~PLY FOR USE BY ~RGENCY RESPONDERS
Large steamer hydrant located less than twenty-five feet directly
in front of chlorine building.
SECTION 6: ^ tOCATIO~' OF UTILITY SHLï-OFFS AT THIS L~IT O~~Y.
A. XAT. GASiPROP;\XE:
Gas & Electric shut offs are both within0fifteen feet of front door
to chlorine room.
B. !::LECTRICAL:
Same as above.
C. WATER:
N/A
- D. SPECIAL:
E. LOCK BOX: YES ,tf9> IF YES. LOCATIOX:
IF YES, Sri:: PLAXS? YES / XO ![SDSs? 'rlES XO
-. FLOOR Pf.AXS? YES , XO ;{EYS? YES / XO
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BAKERSFIELD CITY FIRE DEPARTMENT
FORM 4A-l
NON-TRADE SECRETS
HAZARDOUS MATERIALS INVENTORY
Page
B\ISINESS NAME: East Niles Corrm. Servo Dist.
ADDRESS: 1417 Vale St.
CITY I ZIP: Bakersfield. CA 93306
PI/ONE #: (805) 8ii-20ll
OWNER NAME:
ADDRESS:
CITY,ZIP:
PHONE #:
FACILITY UNIT
FACILITY UNIT NAME:
---
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1 2 3 4 5 6 7 8 9 10
TYPE ~tAX ANNUAL CONT USE LOCATION IN TillS % BY IIAZAH
CODE -A~OUNT AÞIOUNT UNIT CODE COQ~_ FACILITY UNIT WT, CHEMIGAL OR COMMON NAME CO !n._
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Concrete Block Bldg 1Od. i
P131 ' m. .r ~Ton 04 05 @ Treatment Plant 100 Chlorine Gas ORMA
..
31ÕO £& &'aJ J:þ Breckenridge Road
2000' E. of Hornina
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N AÞf E : R. W. Stephens TIT L E : Secy-Treas. SIGNATURE:
, E G C r: R. W. Stephens TITLE: Manager - P II ø-NE # BUS IIOURS: 871-2 O'Ir
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EM R ENY ONTA T.
EMERGENCY CONTACT: Vernon Lancaster TITLE: Superintendent
PRINCIPAL IHJSINESS ACTIVITY: Domestic Water System
AFTER BUS IIHS:
PHONE # BIIS HOURS:
AFTER.BUS IIRS:
871-596 7....m ____
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East Niles Cornmunit
Services District
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SEE ATTACHED
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CITY of BAKERSFIELD
-;:.- -
"WE CARE"
FIRE DEPARTMENT
D. S. NEEDHAM
FIRE CHIEF
2101 H STREET
BAKERSFIELD, 93301
326-3911
:WVE~!BER ~ 1. 19}3 8
EAST NILES COMMUNITY SERVICES DISTRICT
1417 VALE STREET
BAKERSFIELD, CA 93306
DEAR MR. R. W. STEPHENS:
THE ENCLOSED "ACUTELY HAZARDOUS NATERIALS REGISTRATIm,r FORM"
MUST BE COMPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUM
REPORTING QUANTITY OF ANY MATERIAL ON THE EPA LIST OF
EXTREMELY HAZARDOUS SUBSTANCES. (FED. REGISTER VOL. 52, NO.
77, P. 13397). YOUR COMPANY HAS REPORTED HANDLING THE
FOLLOWING ACUTELY HAZARDOUS MATERIALS:
CHLORINE GAS
PLEASE RETURN THE COMPLETED ACUTELY HAZARDOUS MATERIALS
REGISTRATION FORM TO:
HAZARDOUS MATERIALS DIVISION
2130 G STREET
BAKERSFIELD, CA 93301
IF YOU HAVE ANY QUESTIONS REGARDING THIS FORM PLEASE CALL
RALPH HUEY AT 326-3979.
SINCERELY YOURS,
â¡ll' ~~jJ
RALPH E. HUEY
HAZARDOUS MATERIALS COORDINATOR
REH/ed
ENCLOSURE
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ACUTELY H.ARDOUS MATERIALS RE.TRATION FORM
TIllS FORM MUST BE COMPLETED BY TIlE OWNER OR OPERA TOR OF EACH BUSINESS IN
CALIFORNIA WHICH AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL IN
QUANTITIES GREATER 1HAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT
STP.l TIllS FORM SHALL BE COMPLETED AND SUBMITfED TO YOUR LOCAL
ADMINISTERING AGENCY. (§25533 & 25536 Health & Safety Code)
Note Instructions on reverse
Business Name East Niles Community Services District
Business Site Address 1417 Vale Street, Bakersfield, California
Business Mailing Address (If different) P. O. Box 6038, Bakersfield, CA 93386-·6038
Business Phone ( 8 0 5 ) 8 71- 2011
Business Plan Submission Date2 10/28/88
P!~! ~1~natl0!1~_Et-~_~D__ ~r_eat~ent _~l~~_t --=_B!_eck~ri?~e_!,o~~
ACUTELY HAZARDOUS MATERIALS HANDLED4
-USE ADDITIONAL PAGES IF NECESSARY-
CHEMICAL NAME
QUANTITY
1 ~ 150 lb. Cylinder
lOne Ton Cylinder
Chlorine Gas p13l
GENERAL DESCRIPTION OF PROCESSES AND PRINCIPAL EQUIPMENrS:
Chlorine Gas is used as disinfection additive to Domestic (Potable)
Water Supply. Gas is educted from cylinder to water supply with
pressure water. Most critical points are in connections between the
chlorine cylinder and the chlorinator.
'7
mLE Secyc-Treas.
PRINTED NAME
R. ~.J. Stephens
DATE 11-30,",,88
California Office of Emergency Services FORM HM 3m (1-15-88)
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Superscripts:
1. Quantities for RMPP compliance are "equal to or greater than" the minimum criteria and apply to chemicals handled
"at anyone time".
2. Businesses handling reportable quantities of Acutely Hazardous Materials that have not submitted a business plan
MUST contact local Administering Agencies. The business plan submission date will assure the Administering
Agency that a business plan has been submitted and is on ftle. This will also immediately identify businesses that
have not submitted business plans.
3. "Process Designation" is provided as a reporting option (with the approval of the Administering Agency) for
facilities that can most easily report by process. Thus, facility RMPP registration data could be submitted in a
similar format to a business plan that is divided by process. "By process" dàta can'initiate an emergency
response to a process incident rather than a general emergency response to a major facility. Process designation
can simplify inspections for major facilities and improve future emergency response.
4. Refer to the EPA list of Extremely Hazardous Substances from the Federal Register (Volume 52, No. 77, p. 13397
~,April22, 1987). Each chemical has a threshold planning quantity. This list may be changed by EPA on
an annual basis. Updates of this list may be available early in 1988. To comply with this element, you may attach
a copy of the inventory submitted to your Administering Agency from your business plan and highlight all Acutely
Hazardous Materials. It is recommended that facilities list all extremely hazardous chemicals handled in quantities
equal to or in excess of 1) 500 pounds, and 2) any EPA threshold planning quantity less than 500 pounds.
5. Do not include Trade Secret infonnation in these descriptions.
General:
For emergency response purposes, it would be desirable to describe the following to the Administering Agency:
1. Batch Process:
a. What raw materials?
b. What operating pressure range?
c. What openu.ing temperature range?
d. Batch capacity rating?
e. Product characteristics? (e.g., chemical state, flammability, toxicity, etc.)
f. Critical process points and characteristics?
2. 'Continuous process: (similar information as above.)
- - t:!QIE:- -
-__ - - .____r_ _ __-,
-- -"' - - - - - "-;.--
"Pursuant to §25534, the Administering Agency may require the submission of a Risk Management Prevention Program
(RMPP), if the .4.dminillP.ring Agency detennines that the handler's operation may present an acutely hazardous materials
accident risk. The baDdler sbal1 prepare the RMPP in accordance with subdivision (c) [of §25534]. The RMPP shall be
prepared within 12 months following the request made by the Administering Agency pursuant to this section."
(§ 25534 (a) Health and Safety Code)
An amendment to the RMPP must be submitted to the Administering Agency within 30 days of:
1. Any additional handling of acutely bazardous materials.
2. Any material or substantial alterations to business activities.
3. Change of address, business ownership, or business name. (§ 25533 (c) Health & Safety Code)
I '
· EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP .
California Office of Emergency Services FORM HM 3777 (1-15-88)
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CITY of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT
D. S. NEEDHAM
FIRE CHIEF
2101 H STREET
BAKERSFIELD, 93301
326-3911
NOVENBER ¿I, 1988
EAST NILES COH~IUNITY SERVICES DISTRICT
1117 VALE STREET
BAKERSFIELD, CA 93306
DEAR MR. R. W. STEPHENS:
THE ENCLOSED "ACUTELY HAZAIWOUS rlATElHALS REGISTRATION FORN"
MUST BE COrlPLETED BY ANY BUSINESS, HANDLING ABOVE THE MINIMUN
REPORTING QUANTITY OF ANY NATERIAL ON THE EPA LIST OF
EVrI?Er1ELY lJAZ/UWOUS SUBSTANCES. (FED. REGISTER VOL. 52, NO.
77, P. 13397). YOUR COMPANY HAS REPORTED HANDLING THE
FOLLOWING ACUTELY HAZARDOUS MATERIALS:
CHLORIl'.JE GAS
PLEASE RETURN TIlE COMPLETED ACUTELY HAZARDOUS MATERIALS
REGISTRATION FORM TO:
HAZARDOUS MATERIALS DIVISION
2130 G STHEET
BAKERSFIELD, CA 93301
I F YOU HAVE !\NY QUESTIONS REGARDING THIS FORM PLEASE CALL
EALPII HUE'{ AT :326-3979.
SINCERELY YOURS.
tfl¡l (6' d1Jj/
RALPH E. EUEY
HAZARDOUS 1'IATERIALS COORDINATOR
REI-I I ed
ENCLOSURE