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HomeMy WebLinkAboutBUSINESS PLAN 7/17/20071 a ~~ ~ ~ • ~~ (~~~fD~~`l~ J C113 ,\~ ,~.-,d c~ ,~-t~.~.l cry ~ ~~-~ ~4/ ~~ ~ _ ~~ w ~~ it ~~- ~z~~~ ~- -_~ / ~v c a ~~ ~ ~ ~ G7 0° , ' ,:<_::~ '¡",' 'I:' ':' ,,::~..~~tf;~;:i?::'~U'~'-·: '/'·<'q;:~~::,~>:;jL:'w' ;. ,:!;t:'\~~;~§::~:';'¿t'~:';' "~~;:~)fit" ":,; :.~' ~ ;":'D"":'-">=/'_:~~ : "\P""~ -:..IM~:a:· "..'. " -"" .:,' .:::;'~;;,:,;:....: . .::::: .. ". . , .' . . , I ;\ . . " P .....,." . , 'er I 'I . Issued by: Hazardous MaterialslHazardous Waste Unified Permit I " . -:. '.,:. .< CONDIT,IO,NS-OF,':PE'R·M.IT,ON REVERSE SID,E ." ';. :~ " : ," ,'-', ~" . -,. ,,-' .:' ' , . ~~ ~. '. 'v'J ,. .. "', '.' ,- ,~.' . .', .' .'- . '. " ~;- ", This Demit Is Iss~ for the following: ' It! Hazardous Materlals,Plan o Underground Storage of Hazardous MaterIals ',D. Risk Management Program : o Hazardous Waste On-SiteTreatment I : I .. , . .: ~.' " , ' .. ""', ", , , . . -::.\. . .. , - " .... "'''.' '. 'i,:,' '; T, .'-',. . . '.A.~· ~ ~'. Bakersfield Fire Department .' , OFFICE OF ENVIRONMENTAL SERVICES' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: ~ . .' 'U-l-.t-R. ' . RaIp -H"';: . OfficeofEv' Services June 30, 2003 Issue Date Expiration Date: __.___. _._ ____u_ ---------. -~. \ Per... it to Operil.te Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: ':'~~~ardous Materials Plan . ··"·~r,ground Storage of Hazardous Materials agement Program Waste 4400 PERMIT ID# 015-021.000526 CALIFORNIA WATER SERV C LOCATION Issued by: " UNIVERSIT Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 *~ ph Huey, ffice of ental Servi es Approved by: Expiration Date: June 30, 2000 e e I~,~ - -~- , j <~... it SITE DIAGRAM 0 FACILITY DIAGRAM 0 BulÍneq Name: c:Au~'¡'~,f1 f¿. âlMté - P/.h-IP sr<f1la../ 14-~ . Business Address:UN/~Ú1Y ølPF- c:lrNOfIN , ¡ ., .! _·_~_o ~ '-...-... . .. ..... ......:-. - - ,."._, - , --~'"__ ~ .¥ia>__ -~-'-~. . . "£ß'" ':rI;~ ----... 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'0 '" ~ '" 0:: '" f T CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 Manager TIM TRELOAR Location: 4400 UNIVERSITY AVE City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: BusPhone: (661) 396-2400 Map 103 CommHaz Moderate Grid: 14A FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / DIST MANAGER (661) 837-7200x (661) 837-7200x ( ) - x Contact BILL ROSICA MailAddr: 3725 S H ST City BAKERSFIELD Emergency Contact / Title RUDY VALLES / ASST DIST MGR Business Phone: (661) 837-7271x 24-Hour Phone (661) 837-7271x Pager Phone ( ) - x Phone: (661) 837-7278x State: CA Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (661) 837-7200x Address 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK G2sed on my irquiry of ti~ose indivi~;~~a"s responsii~'e for ob*.ini^g the information, t certify under pQnalty r~t i~.w ti,at ! ra~•c~ oerson~.lly examined and am Sarr~iliar +:+~itii the 'niormation submitted a.nd ~~e±iws the :, ~fcrmation is true, accurate, a:nG com~;letc. Si ature Da~~ TotalASTs: _ TotalUSTs: _ RSs: No E~~°p ,1i~~ 2 ®2007 Gal Gal -1- 07/10/2007 r i F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... ~SpecHaz~EPA Hazards) Frm ~ DailyMax ~Unit~MCP~ DIESEL FUEL L 550.00 GAL Lowl -2- 07/10/2007 -3- 07/10/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL Days On Site 365 Location within this Facility Unit Map: Grid: CLOSE TO WELL SHELTER CAS# 68476-34-6 Liquid Mixture PRESSURE TEMPERATURE ABOVEOGROUNDRTANKE T ~ Ambient ~ Ambient AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 550.00 GAL 550.00 GAL 550.00 GAL HAZARDO US COMPONENTS %Wt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 rll'~LJtiLCL tiJ JLiJ ~71.1Jj1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -4- 07/10/2007 ,. F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/30/2000 ~ CALL 911. _, ,~ LuiN.a.vycc ivv~.it . ~ r,va~:ua~.lt~11 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 08/30/2000 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. -5- 07/10/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ ~ Mitigation/Prevent/Abatemt OveralloSite ~ ~ Release Prevention 10/18/2006 ~ INVENTORY RECONCILIATION OF THE ABOVEGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. Release Containment 10/18/2006 IF WE SUSPECTED THE ABOVEGROUND TANK WAS LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK, AND THEN AS QUICKLY AS POSSIBLE, REMOVE THE TANK. Clean Up 10/18/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY AGENCY. Other Resource Activation -6- 07/10/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ Special riazaras UL111Ly ~IIUL-VIES Fire Protec./Avail. Water 10/18/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - WELL DISCHARGE. Building Occupancy Level 03/10/2006 UNMANNED SITE -7- 07/10/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rays ~ raciu ivt ru~utc vac RGll1 lvl r u~.,utc vw -8- 07/10/2007 r -+ CALIFORNIA WATER SRV 148-A SitelD: 015-021-000526 Manager TIM TRELOAR Location: 4400 UNIVERSITY AVE City BAKERSFIELD BusPhone: (661) 396-2400 Map 103 CommHaz Moderate Grid: 14A FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DIST MANAGER RUDY VALLES / ASST DIST MGR Business Phone: (661) 837-7200x Business Phone: (661) 837-7271x 24-Hour Phone (661) 837-7200x 24-Hour Phone (661) 837-7271x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Contact BILL ROSICA Phone: (661) 837-7278x MailAddr: 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (4-@~8) 4~'_ "''^^__- Address 375 Sou- ~ S~~f State: CA66~ ~~~~)Zdo City 9~Pd-dam ~a~C¢.S.s~ie~(.~ zip ~1~- 9.~3~i ._.._.__.. Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK 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 with the information submitted and helieve the information is true, accurate, and complete. oho. ? /6 ~ Si ture Da e ENT°® F E ~ 2 1 2007 -1- 01/29/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP DIESEL FUEL L 550.00 GAL Low -2- 01/29/2007 -3- 01/29/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL Days On Site 365 Location within this Facility Unit Map: Grid: CLOSE TO WELL SHELTER CAS# 68476-34-6 Liquid TMixtur~mbRent~E ~ AmbientT~E ABOVEOGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 550.00 GAL 550.00 GAL 550.00 GAL tiL-'~G.'itCLVUJ ~~1nr~iv~iVlb ~Wt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 ril-1G1-~tCL .'~~ JI;~J1~1~1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -4- 01/29/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/30/2000 ~ CALL 911. Employee Notlt./Evacuation 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 08/30/2000 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. -5- 01/29/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/18/2006 ~ INVENTORY RECONCILIATION OF THE ABOVEGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. Release Containment 10/18/2006 IF WE SUSPECTED THE ABOVEGROUND TANK WAS LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK, AND THEN AS QUICKLY AS POSSIBLE, REMOVE THE TANK. Clean Up 10/18/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND~TO THE SATISFACTION OF RESPONSIBLE REGULATORY AGENCY. Other Resource Activation -6- 01/29/2007 F CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~JC C.:ld1 lldGdlUS Utility Shut-Offs Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - WELL DISCHARGE. 10/18/2006 Building Occupancy Level UNMANNED SITE 03/10/2006 -7- 01/29/2007 p CALIFORNIA WATER SRV 148-A SiteID: 015-021-000526 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rayc ~ nciu ivi ru~uiC v5c RC1lA Zvi r u~uiC lJSC -8- 01/29/2007 ,..1 .,~ -P~~' T~ - CITY OF BAKERSFIELD FIRE DEPARTMENT arm ~ OFFICE OF ENVIRONMENTAL SERVICES ~~' y~ UNIFIED PROGRAM INSPECTION CHECKLIST ~. ~ ~ `w ~gti,~~ 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 ,~ ~ ~ (i~ `~. FACILITY NAME (~4t GvA~CE~ ~1`Fg INSPECTION DATE (o -IO -0 3 ADDRESS X00 UN r U t,~~ ~ PHONE NO. ~3 Z- Z I ~ I FACILITY CONTACT BUSINESS ID NO. 15-210- D~OSZlo INSPECTION TIME ~ ~ t~ NUMBER OF EMPLOYEES ~ Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Muiti-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Q Verification of inventory materials x 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?: ^ Yes ~ No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Whitt - Em. Svcs. Yellow -Station Copy Pink -Business Copy Business Site sponsible Party Inspector: UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plangand Inventory Program • Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 FACILITY NAME WSPECTION DATE INSPECTION TIME C~-1- ±~!%~1-~--/'- -- ~-ram- ---- -~ _7-~_-. --1-`j--~ _ -- ---- - - . _ ---- --- --- ~ l~ ~~6 _~ - rJ`~t - ADDRES LI `I 00 _ -_ - - -- _ -- ~ ~ PHONE No. No. o~mployees l _ .. . - ----------.I----.. -- ---- - FACILITYCONTACT Business ID Number rc.~ a ~ ~ s-o21- oil sz6 Section 1: Business Plan and Inventory Program ~outine O Combined O Joint Agency ~ Multi-Agency O Complaint O Re-inspection ANY HAZARDOUS WASTE ON SITE: ^ YES (~ NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~GG'I ~ 326-3979 Inspector (Please Print) ~~Fire Prevention 1st-INShift of Site White -Environmental Services Yelkriv -Station Copy Business Sit es ~ t>fe Party (Please Print) B Pink -Business Copy UNIFIED PROGRAM INSPECTION CHECKLIST: SECTION 1: Buseness Plan and Inventory-Program FACILITY NAME ' - / / /~ ADDRESS ~l~1ao ~~~'v~srt j FACILITY CONTACT .~ r / 17 l Prevention Services A _~ r a s F , a . „ FIRE ~ 900 Truxtun Ave., Suite 210 . Bakersfield, CA 93301 d~ aesM r Tel.: (661) 326-3979 Fax: (661) 872-2171 (INSPECTION DATE iINSPECTION TIME /D- -06 //30 'PHONE NO. NO OF EMPLOYEES 15-021- ~S~ ; __, --- _ Section 1: -Business Plan and Inventory Program _ ~I?6~ !i '~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( C=Compliance) OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND [~, ^ BUSIIIeSS PLAN CONTACT INFORMATION ACCURATE )-aCl ^ VISIBLE ADDRESS i I ^ I CORRECT OCCUPANCY - .~ F!;] ^ VERIFICATION OF INVENTORY MATERIALS J ~ ~ ~ ~~0~+ (~ ^ VERIFICATION OF QUANTITIES I~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~ ^ VERIFICATION OF.MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING rbI ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES QL ^ EMERGENCY PROCEDURES ADEQUATE ~xI ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING fir] ^ FIRE PROTECTION ® ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES j~l NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 •~~~~ c ~ Inspector (Ple se Print) ire Prevention / 1" In /Shift of Site/Station # Bus Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09105 ;:.. + CALIFORNIA WATER SRV 148-A __________________________ SiteID: 015-021-000526 + Manager Location: 4400 UNIVERSITY AVE City BAKERSFIELD BusPhone: (661) 396-2400 Map 103 CommHaz Low Grid: 14A FacUnits: 1 AOV: CommCode: BFD STA 08 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR ?ud,( Valles / ASST DIST MGR Business Phone: (661) 396-2400x Business Phone: (661) '^` ^^^^~~ 63)•7 ~f 24-Hour Phone (661) 396-2400x 24-Hour Phone (661) 396-2400x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Contact L~~II 2osrcA Phone• (661) ~3-9$-~ MailAddr: 3725 S H ST State: CA X37-72~v City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (408) 451-8200x Address 1720 N FIRST ST State: CA City SAN JOSE Zip 95112 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK Based on my inquiry of those individuals ENT IvIQR y ~ ZnO~ responsible for obtaining the information, 1 certify t~ .1 U under penalty of law that I hav® personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. '~~~ Da e 'g ature -1- 03/10/2006 _r- + CALIFORNIA WATER SERV~ STA148 . ,/ Manager : Location: 4400 UNIVERSITY AVE City BAKERSFIELD BusPhone: OCT 11.00~ ~: 103 oct '1 trrid: 14A SiteID: 015-021-000526 + 34 to - 2<-1-00 (661) 832 2141- CommHaz : Low FacUnits: 1 AOV: --------------------- --------------------- CommCode: BAKERSFIELD STATION 08 SIC Code:4941 EPA Numb: DunnBrad:00-691-3578 +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x 24-Hour Phone : (661) 396-2400x 24-Hour Phone : (661) 396-2400x Pager Phone : () x Pager Phone : () x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: I +------------------------------------------------------------------------------+ Contact : V- Phone. (408) 4S1 O~Ox MailAddr: Pe BOX 11~0 State· CA City : SAN J03B Zip : 95100 +------------------------------------------------------------------------------+ Owner CALIFORNIA WATER SERVICE COMPANY Phone: (408) 451-8200x Address: 1720 N FIRST ST State: CA City : SAN JOSE Zip : 95112 +------------------------------------------------------------------------------+ Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ( + - - - - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _, District Manager-Tim Treloar Emergency Directives: . Asst. District Manager-Bill Harper Contact Person-Tamara Johnson Same Phone Numbers ( I \ ,+ \ r,IA 111 Ii (èA JDH~W~ Do hersray (C®~i~ (TyP3 or prim namø) rsviewed the a~ìachsd hæC!i'dous mat~fi~i$ mSUlag€i· Mailing Address Change: 3725 South "H" Street Bakersfield, CA 93304 ment plsln ~©ú"C.AL I ¡::'. {,JAT~dC sun©1 ~h~~ i~ &ill©fD@ wi~lfì¡- (Ncmo of ~Ø6) ®.i11;7 OOIT®di©lI'i!~ ©©IJ1I~~¡t~~ Bl oompi@~~ ~n(Q1 oorr®d m~ ~®m$ffiJÍ1 [OJioo t!©w my ~t§!cili~y. ~~ 104&1 , I!Jste +==============================================================================+ -1- 07/30/2003 .. .. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 / FACILITY NAME CA<- W~ i!.('fg ADDRESS ~oO LJ#JIV~§£1Ý FACILITY CONTACT INSPECTION TIME Z, 1\1'\ tJ INSPECTION DATE C, -to -0 > PHONE NO. 2' 3l- 2..1 '-f , BUSINESS ID NO. 15-210- OOOS'Uo NUMBER OF EMPLOYEES Jð"' / Section 1: Business Plan and Inventory Program ~ Routine D Combined D Joint Agency D Multi-Agency D Complaint D Re-inspection OPERATION C V COMMENTS Appropriate penn it on hand Business plan contact infonnation accurate Visible address Correct occupancy ~ Verification of inventory materials X Verification of quantities X- Verification of location t Proper segregation of material Verification of MSDS availability Verification ofHaz Mat training Verification of abatement supplies and procedures Emergency procedures adequate 'It Containers properly labeled ~ Housekeeping y Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~o Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs, Yellow - Station Copy Pink - Business Copy Inspector: " " -" , I - _. Manager : Location: 4400 UNIVERSITY AVE City BAKERSFIELD BusPhone: Map : 103 Grid: 14A SiteID: 015-021-000526 317 (ó I (805) 832-2141 CommHaz : Low FacUnits: .1 AOV: CALIFORNIA WATER SERV CO STA148 CommCode: BAKERSFIELD STATION 08 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title , Emergency Contact / Title MELVIN BYRD / DISTRICT MANAGE TIM TRELOAR / GEN SUPER Business Phone: (805) 396-2400x Business Phone: (805) 396-2400x 24-Hour Phone : (805) 396-2400x 24-Hour Phone : (805) 396-2400x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : Phone: ( ) - x MailAddr: PO BOX 1150 State: CA City : SAN JOSE Zip : 95108 _. Owner CALIFORNIA WATER SERVICE COMPANY' Phone: (408) 451-8200x Address : 1720 N FIRST ST Stat:e: CA City : SAN JOSE Zip : 95112 Period : to TotalASTs: = Gal Preparer: , TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: - One Unified List 9 All Materials at Site 9 p= Hazmat Inventory p== As Designated Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP DIESEL I, .:f. ~( M M.L."w\ . ype or print nama) Do hereby certify that I have L 550.00 GAL Low reviewed the attached hazardous materials manage- ment plan for Co u.J ~ and that it along with (Name of Business) any corrections constiiute a complete and corred man- agement plan for my facility. t~~l. '&- a+-ob QelQ -1- 07/19/2000 'i e e F CALIFORNIA WATER SERV CO STA148 F Inventory Item 0001 F== COMMON NAME / CHEMICAL NAME DIESEL SiteID: 015-021-000526 ì Facility Unit: Fixed Containers on Site ì Days On Site 365 Location within this Facility Unit CLOSE TO WELL SHELTER Map: Grid: CAS # [. ~TA~E I TYPE ~ P~ESSURE lTEM~ERATURE ~ =LlqUld __pure ~mblent Amblent ~ AMOUNTS AT THIS LOCATION Daily Maximum 550.00 GAL CONTAINER TYPE UNDER GROUND TANK Largest Container 550.00 GAL Daily Average 550.00 GAL %Wt. RS CAS # 100.00 Diesel Fuel No. 2 No 68476302 HAZARDOUS COMPONENTS HAZARD ASSESSMENTS : TSecret RS BioHaz Radioactive/Amount I EPA Hazards NFPA USDOT# MCP No No No No/ Curies I / / / Low -2- 07/19/2000 'i e - F CALIFORNIA WATER SERV CO STA148 I p= Notif./Evacuation/Medical r=:~~~ency Notification L::911 r:N/AEm_PTIHoYIeSe Notif . /Evacuation ~ IS AN UNMANNED SITE! Sit~ID: 015-021-000526 l Fast Format l Overall Site l 10/05/1992 1 10/05/19921 10/05/1992 Public Notif./Evacuation 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, BAKERSIELD -3- 07/19/200,0 · e e í CALIFORNIA WATER SERV CO STA148 ëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000526 i íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Forrnat i íë Mitigation/Prevent! Abatemt ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site j íëë Release Prevention ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10/05/1992 i o 0 o INVENTORY RECONCILIATION OF THE UNDERGROUND DIESEL TANK IS PERFORMED ON A o WEEKLY BASIS. 0 o o o PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Release Containment ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 10105/1992 j o 0 o o IF WE SUSPECTED THE UNDERGROUND TANK WAS LEAKING, ARRANGEMENTS WOULD BE MADE o TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. AND THEN AS QUICKLY AS 0 o POSSIBLE, REMOVE THE TANK. 0 o 0 åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Clean Up ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëèë 10105/1992 i o 0 o RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION o CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Other Resource Activation ëëëëëëëëëëëëëëëëëëëëëëèë:ëëëëëëëëëëi~ëëëëëëëëëëëi v o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë~ëëëëëëëëëëëëëëëf o o -4- e e 07/1912000 '1.' . e e í CALIFORNIA WATER SERV CO ST A148 ëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000526 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format j íë Site Emergency Factors ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site i íëë Special lIazards ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëj 0' 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Utility Shut-Offs ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 04/24/1990 j o 0 o A) GAS - ?????????? o B) ELgCTRICAL - ?????? o C) WATER - ???????? o D) SPECIAL - ?????????? o E) LOCK BOX - ?????????? o o o ;) o c o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Fire Protec.lAvail. Water ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 04/24/1990 j o 0 o PRIV A TE FIRE PROTECTION - FIRE EXTINGUISIIERS o o o 0 0 0 0 0 0 s o o o o FIRE IIYDRANT - ON-SITE WELL DISCIIARGE o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë~ëëëëëëëëëëëf íëëëëë Building Occupancy Level ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 (, o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf -5- 07/19/2000 -' '. .. e e í CALIFORNIA WATER SERV CO STA148 ëëëëëëëëëëëëëëëëëëëëë SiteID: 015-021-000526 j íëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Fast Format i íë Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë Overall Site i íëë Employee Training ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë 09/27/1994 i o 0 o WE HAVE NO EMPLOYEES AT THIS FACILITY. o o o o WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. o o o o BRIEF SUMMARY OF TRAINING: o o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëë Page 2 ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë¡ o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë j o 0 o o åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf íëëëëë Held for Future U se ëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëë i o ê o ~ åëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëëf I -6- 07/1912000 \.} __ ,..,ä:., ....Iï"~æ;;~ co k lB ~. s Iii! . -¡, MAY 21 1997 AV . .. ,//) ¡/g¿ STATION, e CALIFORNIA WATER SERV SiteID: 215-000-000526 Manager : Location: 4400 UNIVERSITY City BAKERSFIELD sPhone: p : 103 G id: 14A (805) 832-2141 CommHaz : Low FacUnits: 1 AOV: CommCode: BAKERSFIELD EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title MELVIN BYRD / DISTRICT MANAGE TIM TRELOAR / GEN SUPER Business Phone: (805) 396-2400x Business Phone: (805) 832-2141x 24-Hour Phone : (805) 2Ji J 1 ftx~"''\.E. 24-Hour Phone : (805) 30T 1.161xSAM-£ Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Agency-Defined Topic Title p= Hazmat Inventory I p== MCP+DailyMax Order One Unified List ~ All Materials at Site ~ Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP DIESEL FUEL F IH DH L 550 GAL Low I, .tt:M 12 let£. Do hereby carmy ~hSì~ ~ halV® Yþ3 or print flamG) reviewed the attached hazardcus materials manage- ment plan "101'_ C ~~r B£~::S; and that it alon@ with any correction.s constit!Jts a complete and com~©t man- agement plan ior my ~~CÒliiy. J~ \;l Slgru;¡1Ure Oy 0-10-5)1 ~ta -1- , . - , e e F CALIFORNIA WATER SERV CO 148-01 f= Inventory Item 0001 = COMMON NAME / CHEMICAL NAME DIESEL FUEL SiteID: 215-000-000526 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Location within this Facility Unit CLOSE TO WELL SHELTER CAS# 68476-34-6 STATE - TYPE Liquid Pure PRESSURE Ambient TEMPERATURE Ambient CONTAINER TYPE UNDER GROUND TANK Lrgst Cant. this Lac GAL DailyMax this Lac GAL DailyAvg this Lac GAL 550.00 550.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL AMOUNTS STORED AND IN USE DOU E %Wt. EHS CAS# 100.00 Diesel Fuel No. 2 No 68476302 HAZAR S COMPON NTS -2- e e F CALIFORNIA WATER SERV CO 148-01 I p= Notif./Evacuation/Medical r=: Agency Notification CALL 911 SiteID: 215-000-000526 ì Fast Format ì Overall Site ì 10/05/19921 10/05/1992 Employee Notif./Evacuation Public Notif./Evacuation 10/05/1992 N/A - THIS IS AN UNMANNED SITE! 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, BAKERSIELD -3- · e e F CALIFORNIA WATER SERV CO 148-01 I f= Mitigation/Prevent/Abatemt Release Prevention SiteID: 215-000-000526 , Fast Format , Overall Site, 10/05/1992 INVENTORY RECONCILIATION OF THE UNDERGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. Release Containment 10/05/1992 IF WE SUSPECTED THE UNDERGROUND TANK WAS LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK, AND THEN AS QUICKLY AS POSSIBLE, REMOVE THE TANK. Clean Up 10/05/1992 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY Other Resource Activation -4- o . < . e e F CALIFORNIA WATER SERV CO 148-01 I p= Site Emergency Factors r== Special Hazards Utility Shut-Offs SiteID: 215-000-000526 1 Fast Format 1 Overall Site 1 I 04/24/1990 A) GAS - ?????????? B) ELECTRICAL - ?????? C) WATER - ???????? D) SPECIAL - ?????????? E) LOCK BOX - ?????????? Fire Protec./Avail. Water 04/24/1990 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SITE WELL DISCHARGE Building Occupancy Level -5- .. .," ~ ,0:., e e F CALIFORNIA WATER SERV CO 148-01 I F Training Employee Training SiteID: 215-000-000526 ~ Fast Format ~ Overall Si te ~ 09/27/1994 WE HAVE NO EMPLOYEES AT THIS FACILITY. WE DO HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: Page 2 [ I I Held for Future Use Held for Future Use -6- tlÞBAKERSFIELD FIRE DEPARTME~ HAZARDOUS MATERIAL DIVISION 1715 CHESTER AVE., BAKERSFIELD, CA 93304 (805) 326-3979 APPLICATION TO PERFORM A TIGII'l'NES~ES~ 0 ~ 1 .'... FACILITY(}Uf' WAnZ5Ð2-Yla G,. ADDRESS (JMlJ€R.JY1Y A-1Æ' PERMIT TO OPERATE # OPERATORS NAMEi<J,t( If£DI!ICI<. NUMBER OF TANKS TO BE TESTED / OWNERS NAME&u F W"1-7'fX. S~C£ G '\ IS PIPING GOING TO BE TESTED )I~s . TANK # I VOLUME 550 G#L CONTENTS DI6'S({L 2 - I J .-'"' I~~ TANK TESTING COMFANYUAlD€.rzGIt..?VM/ /;1--A;K.., ADDRESS /587// M 2f'¿f, VIJ'';-V'!Ý/ ~ TEST METHODI.lST~Î / C/JMPO-µ/~ '1'3C¡ , NAME OF TESTER6'@. Y~G# CERTIFICATION;if loSO-32~ STATE REGISTRATION # 90-/237 DATE & TIME TEST IS TO BE CONDUCTED 7-/2 - ~ 7 -/0-95 DATE \JÜ¡J ~ V SIGNATURE OF APPLICANT $D BY: ;¡' ";.----/ e e ~ 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 Overall Site with 1 Fac. Unit Page 1 General Information Location: 4400 UNIVERSITY AV Map:103 Haz:2 Type: 3 City . BAKERSFIELD Grid: 14A FlU: 1 AOV: 0.0 . - Contact Name Title r--- Contact Name G--. ..5 u i~r'\~~I\ð.e.1'\ 1'"' T tIe ~ V\~'^~ by..^- / DISTRICT MANAGE MELVIN lU{¥9 "W\\rlt.\OQ.1/"" / ASSIST DHiiT MAN Business Phone: (805) 324-6011x Business Phone: (805) 832-2141x 24-Hour Phone · (805) 327-2161x 24-Hour Phone · (805) 327-2161x · · Pager Phone · ( ) - x Pager Phone · ( ) - x · · Administrative Data Mail Addrs: P.O. BOX 1150 D&B Number: 00-691-3578 City: SAN JOSE State: CA Zip: 95108- Comm Code: 215-008 BAKERSFIELD STATION 08 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 \4¡--ot (jVr I, ~(¿'t\ t- J\.àV\~t Do hereby certify that I have (fype or print !lam reviewed the attached hazardous materials ma:' age- e...\ it WQ,~r Sre~\~ Co. ment plan for and that it along with (Name of Business) any corrections constitute a complete and correct man- agem~nt plan for my facitity. L\~~/ 't /31J:1 .. ] e e 08/04/94 CALIFORNIA WATERSERV. CO. 148-01 215-000-000526 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 02-001 DIESEL FUEL Liquid 550 Low ~ Fire, Inooed Hlth, Delay Hlth GAL .' e e 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 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 550 --¡ Daily Average GAL 550.00 I Annual Amount GAL -- 550.00 Storage UNDER GROUND TANK r Press T Temp ~I . Location Ambient Ambient CLOSE TO WELL SHELTER - Cone l 100.0% Diesel Fuel No.2 Components r; MCP ----rGuide Moderate 27 \) ~ e e 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 4 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation N/A - THIS IS AN UNMANNED SITE! I <3> Public Notif./Evacuation EVACUATION OF THE LOCAL POPULATION ~O 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, BAKERSIELD ,õ ~, e e 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 5 <E> Mitigation/Prevent/Abatemt <1> Release Prevention INVENTORY RECONCILIATION OF THE UNDERGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. <2> Release Containment IF WE SUSPECTED THE UNDERGROUND TANK WAS LEAKING, ARRANGEMENTS WOULD BE MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK, AND THEN AS QUICKLY AS POSSIBLE, REMOVE THE TANK. <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation · , e e 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 6 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - 111??????? B) ELECTRICAL - ?????1 C) WATER - 111??111 D) SPECIAL - ?1???11111 E) LOCK BOX - ????1??1?? <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - ON-SIT]~ WELL DISCHARGE <4> Building Occupancy Level .~. e e 08/04/94 CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 7 <G> Training <1> Page 1 WE HAVE NO EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? yes BRIEF SUMMARY OF TRAINING: <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 't' ;;. e 08/04/94 - CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 8 <1> Release Containment <H> RMPP DATA <2> Offsite Consequences <3> In House Capabilities <4> Plant Shutdown Instruction .;1, ,~.¡,.~ e 08/04/94 e CALIFORNIA WATER SERVo CO. 148-01 215-000-000526 00 - Overall Site Page 9 <I> Underground Storage Tanks <1> Leak Monitoring Methods <2> Leak/Spill Response Plans <3> Financial Responsibility <4> Tank Test/Service Company BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 1715 CHESTER AVE., BAKERSFIELD, CA 93304 (805) 326-3979 e APPLICATION TO PERFORM A TIGHTNESS TEST I FACILITY <!.AL/~ III )a:T£/f ~/JV C F' ~~DRESS PERMIT TO OPERATE #: t(.t.I/¡)£re~ Ifv¿-, -- OPERATORS NiE t"C.. M :::::R OF \ANKS TO BE / . l-k..,lß " CL~" - "OWNERS-NAME'(1f.L;r u!J~ue ~ Ù\' Ci), TESTED~ IS PIPING ~OING TO BE TESTED~S ) . VOLUME_ J(~ /) -1i1J...!-._ '.-, CONTENTS 'J.:) ì~s.¿:;/ ~. TANK TESTING COMPANY Úñ> ¡'~H'ÜJj vA,ok J;;T~DRESS /$ð'7¿J /-Î-UE".' r2Ji8 TEST METHOD-f(!¿::;¿/~<;//)~) J~ S'ps T NAME OF TESTER £~/)r7~ ~(fÞt.. rl)~1t. CERTIFICATION #: .:. _ .)tJ-;¡b,;"":':3.;;;.-I' STÀTE REGISTRATION #: (9t!'J -/~.37 . DATE & TIME TEST IS TO BE CONDUCTED 7 - ;¿ g- :?¿b ~~dd-9~ 'AP RO. DATE .. y/L£ 4::?15 SIGNATURE OF APPLICANT '~, T . ~ ........ ~ , if., if fi ' e e ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Utilities General Account Maintenance PUTLS801 ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Acct Nbr: 645601 Cyc Stat: CL Bill Stat: FB Acct Cyc Stat: CL Transfer-from: Transfer~to: Page 1 of 6 Due: 0.00 1. 2. 4. 5. 8. 9 . I 10. 11. 12. 13. 14. 15. 16. 17. Customer Name: CALIFORNIA WATER Social Sec Nbr: Service Address: UNIVERSITY AV E OF Service City: BAKERSFIELD Parcel ID: Bill Cycle: 5 Route Nbr: Comments : TRANS TO 680601 Prev Acct: HM00526 23. Service Date: Fund no: Bill-to Addressl: 3725 S H ST Bill-to Address2: Bill-to City: BAKERSFIELD SERVICE CO 3. Telephone: CAMDEN ST 6. State: CA 7. Zip: 20. Water Svc Class: Misc Services: 23.1 F99 NOT IN BUSINESS 23.2 24. Closing Date: 10/05/90 18. State: CA 19. Zip: 93304 1~=============================================================================== Enter Save(S), Cancel(XX), Nextpage(/), or Field # to Change ALT-FlO HELP I ADDS VP I FDX I 9600 E7l I LOG CLOSED I PRT OFF I CR I CR r 'y,\010 \ 't '4' 'i e e' . t 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000526 Overall Site with 1 Fac. Unit Page 1 General Information Location: UNIVERSITY AV\CAMDEN ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 08 Grid: 14A FlU: 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 BRYD 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 4S"1- 11'Z-oG> City: SAN JOSE Zip: 95112- Summary r RECEIVED . SfP 2 4 1992 HAl. MAT. DIV. ~ <=..t{Q(¡,+ A-àlt\~ IDa hereby ceó1~~ ~h81~ ~ hays \lpeorpM¡ . . V'®vi!&w@o] ~h~ ~W~©hed hazardous mSlft~U'i@'l¡® mªrüSl@~o ~jJf©.IÆW~A WATER S[IRW~~[E ~IaD . fOOU1I~ ¡øi~8"ù ~~U' and fthaft öft ~©8"ù1ñl wifth (Ns:me or I8tromoOO) eJ MY OOf({®dÖ©Ii'O~ ©©Ii'O@ßjftYR@ ~ oom~~~~ ~/I'b©1 ©@V'U'®d m~Ý10 ~Wù®liì!ft ¡g¡iáWìJ ~@U' mw ~OO~~.; ~!.zi.r~,' ' V~b ~Il!ro crILl ~Z- 54.. 14'11"-01 e e 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000526 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 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 ~ Daily Average GAL --r-- Annual Amount GAL -- 550 I 550.00 I 550.00 Storage UNDER GROUND TANK r Press T Temp -:ì Location Ambient Arnbient CLOSE TO WELL SHELTER - Conc l 100.0% Diesel Fuel No.2 Components MCP -:-rList I-;oderate I e e 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000526 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation Not Applicable - 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, BAKERSIELD Î- '. e e 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-QOO-000526 00 - Overall Site Page 4 <E> Mitigation/Prevent/Abatemt <1> Release Prevention INVENTORY RECONCILIATION OF THE UNDERGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. <2> Release Containment If we suspected the underground tank was leaking, arrangements would be made to immediately remove all fuel from the tank, and then as quickly as possible, remove the tank. <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation or ~ e e 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000526 00 - Overall Site Page 5 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - ?????????? B) ELECTRICAL - ?????? C) WATER - 1??????? 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 :; -. e e ". 08/18/92 CALIFORNIA WATER SERVICE COMPANY 215-000-000526 00 - Overall Site Page 6 <G> Training <1> Page 1 WE HAVE NO EMPLO.......EES AT THIS FACILITY .-DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? BRIEF S~~RY OF TPAINING: {\ Ö ~'^" ?loY<i:~.£ ø..+ ~; So. Sit~ <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use i' 12/27/91 ~ CALIFORNIÞ WATER SERVICE COMPANY 2AtOOO-000526 Overall Site with 1 Fac. Unit Page 1 General Information 1 © Location: UNIVERSITY AV\CAMDEN ST Community: BAKERSFIELD STATION 08 Map: 103 Hazard: Low Grid: 14A F/U: 1 AOV: 0.0 Contact Name B.D. LEWIS MELVIN BRYD Title Business Phone DISTRICT MANAGER (805) 324-6011 x ASSIST DIST MANAGER (805) 832-2141 x 24-Hour Phone (805) 327-2161 (805) 327-2161 Administrative Data Mail Addrs: 3725 S H ST City: BAKERSFIELD Comm Code: 215-008 BAKERSFIELD STATION 08 D&B Number: 00-691-3578 State: CA Zip: 93304- SIC Code: 4941 Owner: CALIFORNIA WATER SERVICE COMPANY Address: 1720 N FIRST ST City: SAN JOSE Phone: (408) 453-8414 State: CA Zip: 95112- Summary JAN 0 6 )992- HA7 MAT, nW. E ¥ o~· ~. \\Q.vd:: AJ..~4t,.,.Y__ ~:'f(: ~':.rc:by certify that I haveì (T,·;....) ,." rv!nt rrfJiT!~ t re",¡¡;;:,'/.'¿:'; ",~.,/":":' ,,':)UG materials manage- CALlfORNI~ WATER SERVICE CO. 0, . ment pL.n fC::,__.....,... .____... ,....:;¡,-¡eJ that It along with . - '. {. ~",; ~ :.j ..!'.',,~- ¿ :.. ~.; an. v corrueJons conEli..i.J[r;J a cornc.lele and COiT8ct manu " , agement plan for my facility. -~~/ Signatur ~. _ JL ~Lc¡ ~~"' Date s~. \c..¡~-ðl ~ 12/27/91 -. CALIFORJltWATER SERVICE COMPANY 241Þ000-000526 02 - Fixed Containers on Site Page 2 Hazmat Inventory Detail in Reference Number Order 02-001 DIESEL FUEL Liquid 550 Low Fire, Immed Hlth, Delay Hlth GAL CAS =It: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL ~ Daily Average GAL ~ Annual Amount GAL -- 550 550.00 I 550.00 Storage UNDER GROUND TANK r Press T Temp ~ Location Ambient Ambient CLOSE TO WELL SHELTER - Conc l 100.0% Diesel Fuel No.2 I~ MCP -¡List Low I Components · 12/27/91 CALI FORJIþ WATER SERVICE COMPANY 2~000-000526 00 - Overall Site Page 3 <D> Notif./Evacuation/Medical <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, BAKERSIELD ~. t 12/27/91 CALI FORNtIÞ WATER SERVICE COMPANY 2~OOO-000526 00 - Overall Site Page 4 <E> Mitigation/Prevent/Abatemt <1> Release Prevention INVENTORY RECONCILIATION OF THE UNDERGROUND DIESEL TANK IS PERFORMED ON A WEEKLY BASIS. PRECISION TESTING OF THE TANK IS PERFORMED ANNUALLY. <2> Release Containment <3> Clean Up RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT AS NEEDED, AND TO THE SATISFACTION OF RESPONSIBLE REGULATORY AGENCY. <4> Other Resource Activation 12/27/91 CALIFORJIt WATER SERVICE COMPANY 2~000-000526 00 - Overall Site Page 5 <F> Site Emergency Factors <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 CALIFORJIt WATER SERVICE COMPANY 2t1l000-000526 00 - Overall Site Page 6 <G> Training <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 ~ 4IÞ BAKERSFIELD CITY FIRE DEPAR~ 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 £' J03-JttA '2,.. <f:~ OFFICIAL USE ONLY - ID# B!JSIXESS XA~E HAZARDOUS MATERIALS BUSINESS PLAN AS A WHOLE FORM 2A 5d0 ~ G.eQ, ¿ v"ºº ~ ¿ INSTRUCTIONS: 1. To avoid further action, return this fQrm 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 NAME: Cali fornia Water Service Comoany LOC4t: (oN ~ ozr B. 1 I [If / STREET ADDRESS: 1725 South "H" Street - Field Yard f5 -6) CITY: Bakersfield ZIP: 91104 BUS. PHONE: (805 ) 312-2141 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. E~PtOYEES TO ~OTIFY I~ CASE OF E~ERGEXCY: NA~E AND TITLE DURI~G BUS. HRS. A.B.D. Lewis. District Manager Ph# 324-6011 AFTER Bes. HRS. Ph# 327-2161 Ph# 327-2161 B.Melvin Bryd. Assistant District Manager Ph# 832-2141 SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. ~AT. GAS/PROPANE: North of last parking stall near office building. B. ELECTRICAL: South-east corner of office building. C. WATER: to' west of gas meter. D. SPECIAL: None E. LOCK BOX: YES /@ IF YES, LOCATION: No IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES , NO I FLOOR PLANS? YES / NO KEYS? YES / :-.10 ¡ e SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE e Company personnel would deal with any emergency in concert 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 5: 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 TRAIXING IN THE FOLLOWING AREAS. CIRCLE YES OR ~o I~ITIAL A. METHODS FOR SAFE HANDLING OF HAZARDOUS :-IATERIALS: . . . . . . . . ." . . . . . . . . . . . . . . . . . . . . . . , . . . . .. ~ NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES:... .................... ... ~ NO C. PROPER USE OF SAFETY EQUIPMENT:..,... ........ .... ~ NO D. EMERGENCY EVACUATION PROCEDURES:.... ......... .... ~~NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS:....... ~ NO SECTION 7: HAZARDOUS MATERIAL REFRESHER @ NO c:!Jj'S) NO :15 NO _ NO ES,) NO CIRCLE YES OR NO OR NONE .DOES YOGR BGSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POrXDS OF A SOLID, 55 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 Saféty code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et AI.) and that inaccurate information constitutes perjury. LEDicectoc of Water Quality DATE '3ko/~o , / - 2B - ".E~.lJ" ~tI'6 I .u"4L "'_'if - 'J"'n6 e - FRo..,r, ELEV,4TfOAJ ~ ELEVATfOAJ ~ "'--"'#''''- ..~ ~ = ~ ~ ---~ ~ = i I = ~ ... .L«'" _t.(JI ~f ,. ~,.f~~~ - ~ ~I(".~ =:2: ::L:.- RE.... ELfVATIOI{. ~'ÞE:. ELEVATION e -IyPl c..~ '- ?....mp BUIL-b IAJ C- ., ... -.....,1 uc.""-' ~ .·..,~·_i.;..6W· '''i~. N."U FOl/IJOATfOAJ 'FLOOI2 PUN CALIFORNIA WATER SERVICE CO. ÐfGINEERINCJ DEPARTMENT DISTIaCT - PU M P ßUILDIN& OAAWN .y DAn --- .,. ~ 11.-IIÞ-g1 ... NO. c~ ec:.u.a =:a. C.W7Qo NO ""Þ.1..E:. ¡ , f, "/ e e ~~ BAKERSFIELD CITY FIRE DEPART:'IEXT 2130 "G" STREET BAKERSFIELD. CA 93301 Gi:?:CTA~ CSE O~t~ ID;.: ------ BUS DiESS ~,-\~Œ: BUSINESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1~ To avoid further action. this form must be returned hy: 2. TYPE/PRIXT yor;R AXSWF.:RS r;.¡ ENGLISH. 3. Am:wcr the 'luest ions Of! lOt,' for THE FACILIïY ¡;SIT LISTED aE8~v 4. Be as 6RIEf and CONCISE as possible,- 1'\ " California Water Service Company Station 148-01 FACILITY UNIT N~~: FACILITY UNIT:: SECTION 1: ~I'!'TGATION. PREVE~ION. ABATE~IEX1' P~OCEDURES 0 , ,. " o· 0 Inventory reconciliation of the underground diesel tank is performed on a weekly basis. Precision testing of the tank is performed annually. Release abatement would be performed by an independent remediation consultant as needed, and to the satisfaction of the responsible regulatory agency, " . SECTiON ~: ;'¡OTIFTCATION ,. "."" ,,,,\~~U ZVACUATIO;'¡ P~OCEDl~ES AT THIS l~T~ O~LY N/A - 3A - - e " SECTIO~ ~: HAZARDOUS ~ATERIALS FOR THIS TDIT O~LY A 0 thO F 1 . t ". t t' U \f t ..' 1·') ~s "0 '. oes 1S aci 1 y \Jnl con .;Jln ..i1z:1råous . a e_liLs....... c:.y ;, 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 OXLY (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 sec~et form. List only the trade sec~ets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTTOX Fire Extinguisher SECTION 5: LOCATTO~ OF WATER SL7PLY FOR USE BY E~RGENCY RESPONDERS On-site well discharge. I I I·· . SECTIO~ 6: LOCATIO~ OF L~ILITY Shü~-OFFS AT THIS L~ITO~LY. A. X'AT. GAS/PRO?\XE: N/A B. ~r.ECTRICAL: Service box located inside well pump shelter. C. WATER: N/A D. SPECIAL: N/A " E. LOCK BOX: YES ,.@ I?" YES, LOC.UIOX: IF YES, SITE PLA~S? FLOOR PLAXS? YES / XO YES I XO !(SDSs? :-i:EYS? ..,.~"... . -,) ,¡c: s XO XO , - 38 '.,1 f:Í.~. ~ -1\ j "'¡¡, 'We.., Mo..~ .. 'i ~ ~Ú í'" I) RE~'SEO 8-8-7f'/?ll' Z)-""ew.s£o 7-30-70 ;Y.ð.~ ~)Æ'~""'Sé'O 5-3-73 (74N(-Al<>.<?) k.ð.T. 4) 1>~t>Eb I:oE». (FUn rAil 1(, f.f( ,,·/.4·00 v:~~-::;-y TRACED BY CHECKED BY ?/ ~/~c " f: eCALE /": 2°· EaT. HO, OWG. HO, e,t:; 4';SO '(4- (Ft/ Tt/R.e i -¡-_. ¿lA/ I ¡J. AYE) .s TA. 14Ó--ðl PIPING SCHEMATIC CALlFORNJA WATER SERVICE CO. ENGINEERING DEPARTMENT ./.3AKi:-æs r/e LO DISTRICT £)( TENDED i OF GIN/V. AI/€'. . 7"0 -.I"- ",4HðEA/ 8'W.e. Ii. .: tl~ ~ ~ , ~ I{\I,J " :, 'I- ~ ~~ ~ to ~ ~ /0 "Sr¿, IN~E:f ";JOh/A"", ~U...~ NOT'::=; : @ 6" COfV'l,=",'N¿;D A¿TI7UC->,'·c, ....'?OL.£/VOID Y~¿Þ""¿r (,/"I."'~t..Oc.~Teo s- ::.73) ¡ , rOltrAe.~~ e.oo~rf.1< ~....~t...O"''' AUX. t!..E~þ.rOt. '''IH YUMI' fu~~ J'I,IMI' '). - "',.." ~OP'P'£JI: ~IN~" . I" ," i7V~ ~ONt>Ulr, _ _I'h V£'1' wHÞor 1-' (, \- c,U~fIO" "uPP~'f) 7':5 þ,P>0ve. WI~bINt. , - Vþ.P01l: "E.f\.lR N !too <, t C¡';D t."'~. DOU~LE WA~~ UI.. "'"ROV!:.!> .,fE'\. fAN)(" fll'>£R- I toL....... t.oMEÞ. \)f'\J......~-ro.......).) o:~...1 e ~ 7:2?/VK {'/a_ e. 500,000 G";'¿,. STd~<: TANK L//I9. . <:;;'/' . s-¥<!,,,t: /7N;;H7" 23 , 1. reAAl$' 1'Þ.e..n:.e g CITY of BAKERSFIELU Farm and Agtlculture [] HAZARDOUS MATERIALS INVENTORY Standard Business ~ . Page of NON-TRADE SECRETS BUSINESS NAME: California Water Service Ccopany OWNER NAME: California Water Service CœpanyNAME OF THIS FACILITY: Station 148-01 - 19CATION: Universitv Ave. East ot Camden Street ADDRESS: 1720 NorthJir95 ~2' ST ANDARD IND. CLASS CODE: __!±941___.._____ - C TV Ë ZIP: BaKerStleLdj CA CITY Ë ZIPr-sañ JOs:¿ 1 DUN AND BRABSÒREE~ ~UHBER3 5 7 8 PHON If: OO'J~jL-Ll4 . PHON If: 4œ-4'J j 414 _ _ - _ _ .1 - _ _ _ _ REFER TO-rNSTRUCTTONS-p¡o~ROPER CODES - 1 2 4 7 8 9 10 11 .12 h 13 ( Tr~ns Type Average I Dys Cont Cont Cont uSå loc~tlon V e~e , by na~es of ~ixture{CC~Donents Co e Code Alllt on SIte Type Press Temp Co e Store In FacI Ity Wt See ¡nstruc Ions - N M N/A 365 1 1 4 19 Close to well shelter Diesel Fuel - Ph~fiicfl ind ~e8lth H8i8rd C.A,S. Number 068-476-346 Component 11 Name & C,A.S. Number ( ec a I tat a pp I y - Fire Hazard [] Reactivity o oelared [] suddf" Re I ease Component 12 Name & C.A.S. Number [] Immediate Hea th o Pressure Health - Component 13 Name & C,A.S. Number - - Ph~~ic~1 fnd ~e81th Haf8rd C.A.S. Number Component II Name & C,A.S. Number ( ec a I t at apply - [] Fire Hazard [] Reactivity [] Del8red [] suddf" Re I ease Component'2 Nallle & C.A.S. Number [] Immediate - Hea th o Pressure Health Component'3 Name & C.A.S. Number CD I I D I I l I I - - Ph~sical fnd ~e8lth Hajard C.A.S. Number Component' 1 Name & C.A.S. Number ( heck a I t at 8pply - o Fire Hazard [] Reactivity [] De Jared [] SUddf" Re J ease Component'2 Hame & C.A.S. Humber [] Immediate - Hea th o Pressure Hea Ith Component'3 Hame & C.A.S. Number ~ I I D I I I I I - , - Ph~sjcfl fnd Health "Biard C.A,S. NUllber Component' 1 Hame & C.A.S. Number ( hec a 1. that apply - [] Fire Hazard [] Reactivity [] De Jared [] suddf" Release Component'2 Hame & C.A.S. Number [] Immediate Hea th o Pressure Health - Component'3 Hame & C.A.S. Number - EMERGENCY CONTACTS #1 B.D. Lewis District Manager 327-2161 #2 Me 1 vin Bvrd r F7-2161 RIme Tftle 24lJr phone Rãiië -- Tllr !'hOne iertifi~!tio~ çReCfl and ~ifn 'afj~r cçmf7fting. Çt71. sec~ions) . . certl y un er enal 0 a th t I av persona examln 0 ft familiar It the InformatIon $U Iltted In attaçhed dQC~men~s, 8n~ t at ~ase~ on my In~uiry 1 lhose InålYI~uafs responslbfe ~or obtaining the In~orlBtlon D~i~ ~ubmltted In ormation IS true. accurate, an comp ete. > Raymond H Director of Water rUne {rð om ve