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Home My WebLink AboutUNDERGROUND TANK ,. , - ',. Q ð ~ ~ U) H > ~ ::¡ c::Q UNDEVELOPED //Iv/ Wf/lr£. L/ì-ttié. BI1JOE~ ,:/£ t-o PACIFICCBELL. (SA-532) UNDEVELOPED ]liI~ I , PACIFIC BELL SITE " , ---1 UNDEVELOPED DATE12/ 02/88 lANE SINGLE FAMILY VICINI1Y MAP SCALE 1"=200' ._-_._- . . ,,", . ¡ '¡: . FIRE HYDRANT~'O ~~ I ~~ 8ß CJ) :z: ........ O...J~ ,..::¡c.;¡....... ...J~I ê3~~ I Q I §~e ...:::> .......0 ~ ~ffi ~ :::> WHITE LANE FlU.. BOX ~ ~ ~ :> ~ ê5 ,.- - - - - __0- _ _ _ _ _ _ _ _ r'?f I~: l...~ " o I BUIlDING I I ~ A.C. PAVING ~ I J :0 CONC. BLOCK WAll.. ~ PACIFICeBELL. (SA-532) UNDEVELOPED AREA t I u~ DATE12/03/88 FACILI1Y S1ORAG£ MAP SCALE 1"=30' . . ,,.,,. .,.;~<~' :IU.C:4J... .., ",z::r:'o :I:»»C ~ê5~~ Qò 8~ F c:~ ~ ~~ @ G~ (J) .. .. .. ~ r' ' t-1~() ~ \0 r-' t-1 \0 C:::W w - -, -2~"'L' ~~"---"--"--·"--·----·l- ~ U I ToOL I&J lit L.~ :L: .X"'~_~ACQ DtL P \Ie I!J!!F II e I.C» TT"cC IIIoC:JL LDIo.J.1I.. ~ . ~ 'c£un"...·~~~~ ~Ð.J~ILWUI.IJO ) _ - STORAGE TANK DIESEL ODD-GALLON UNDERGROUND (O-88-1K) 1 ~ n - "'II - n £3 . III ,.. ,.. . ;-0.. (J) » I VI W N '-" - ~ ., (T ~ ~ o w "- (X) 00 - c: z '=' ~ C) ::d ,.... 'oJ c: Z '=' (J) a ~ (T ~ ?': o ~ » I-i r-' ., I~L F R . ;,- - HAZARDOUS MATERIALS KERN COUNTY FIRE (805)861-2761 ;5:642 VI CTOR ST BAKERSFIELD, CA 93308 015-010-003715 10/27/92 DUE BY: 11/26/92 rl I I I I I THI.S ANNUAL FEE IS FOR THE REVIEW AND PROCESSING OF THE EMERGENCY PLAN _,AND IS BASED ON QUANTITY OF HAZARDOUS MATERIALS AT YOUR BUSINESS . INVOICE FOR BUSINESS AT 11101 WHITE LN ~ INVOICE NO. 301982A AMOU NT DUE.: $ 40,,00 BY: 11/26/92 K.C.FÞD. HAZARDOUS MATERIALS 5642 VICTOR ST BAKERSFIELD, CA Q3308 TO PACIFIC BELL PO BX 7631 30 BAKERSFIELD, CA 94120 F R . I ~ ~ I I I ie I ~ r I HAZARDOUS MATERIALS KERN COUNTY FIRE (805)861-2761 5642 VICTOR ST BAKERSFIELD, CA 93308 - ~- 015-010-003715 01/10/92 DUE BY: 02/09/92 -Þ THIS ANNUAL FEE IS FOR THE REVIEW AND PROCESSING OF tHE EMERGENCY PLAN AND IS BASED ON QUANTITY OF HAZARDOUS MATERIALS AT YOUR BUSINESS. INVOICE FOR BUSINESS AT 11101 WHITE LN INVOICE NO. 201953A AMOUNT DUE: $ 50.00 BY: 02/09/92 K.C.F.D. HAZARDOUS MATERIALS, 5642 VICTOR ST BAKERSFIELD, CA 93308 TO PACIFIC BELL POBX 7631 30 BAKERSFIELD, CA g4120 /' BUSINESS NAME PACIFIC BE" LOCATION 11101 Whit~n \.r i:"'..... "i ,¡ ,0\::11,. '... .,I!!!h" II:::::::: II:::::::: () n..J W"..I! "'11"'· 1I..,"II]i: :::::::!ì. ....¡r· 11:::::11 ¡F::~:: "'~,~_ r_,}'c DATE 12/28/89 04/16/90 DESCRIPTION 1989 ANNUAL FEE (GROUP A) PAYMENT - CHECK NO, 860805 10 .. ·BER 015-010-003715 GH HAZARD RATING 0 LAST CHANGE 04/16/90 BY ANNET DEBIT 50,00 CREDIT 50,00 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BALANCE 50,00 0,00 · + I. ~.Ha UJ ~ _ 8 ~. '1 !2 _! .'~ ...:..;,¡ ~ ' ð ~ " ~~ ~ ,;..L ~.' ...-,' iii -"" . ¡;.' ~ k l L ,. · ~ :> UJ a: :::J "' ()) :;; rfJ c5 Z :;; a: · ~ · . F R o M ---------,.--, I 015-010-003715 : 01/15/91 ,I I , I DUE'.BY:- 02/14/911 I 1 ,~ 0 .§, ",,' >-- ð'~ .~ ~ z 1;1'¡w .wLYui . a: .~ rfJ UJ ...J « rfJ .ð o ...J a: :::J o . >- .0 ¡:¡ z o () a: .g N ill J J J ß .~I - I UJ UJ a: LL .g ...J ...J « () UJ -, a: .8 :;; Hj.\,Z~\RD()US jVIATERIÞ.LS KERN COUNTY FIRE (805)861-2761 r: , 0, 8 OX 8 1 7 9 6 ' BAKERSFIELD, CA 93380-1796 THIS FEE IS ,FOR REVIEW AND PROCESSING OF THE EMERGENCY PLAN BASED ON QUA!\n ITY or HAZARDOUS MATERTALS AT YOUR BUSINESS. '" } 'OUPLICATE;:,,~. '~OR BUSINESS AT 11101 WHITE LN t" . ~ I BY,: ' 0'2/14/91 <.:; ; ~ 34A AMOUi\:T DU E: $ 50.00 '.' ~I TI u , R I NI T1 oL______________________________ PACI FIC BELL PO BX 763 1 30 SAN FRANCISCO. CA 94120 K.C.F.D. HAZARDOUS MATERIALS P,D, BOX 81796 BAKERSFIELD, ,CA. 93380-1796- TO . . rUG ~ I_III- ~~ 8 ~. ¡ t ,j ~ L L u -~. § , , i. !), . cr, · ~ > UJ a:: :J tt) cr, ¿ (f) -t=b g ¿ a:: · t2 · , " !'" ,,;¡ ,", '''. ¡; ..ç:, "";.,- :~, '\' F R o M '\ HAZARDOUS MATERIALS KER~ COUNTY FIRE (&05)861-2761 , P ,0 .' B OX8 1 79. 6 BAKERSFIELD~ Ck, 93380-1796' ------,-----ì , I 1 015-010-003715 : r I. I I 0'3,/13/90 DUE BY 0¢/13/90 FO:R BUSINESS AT: 11101 WHITE LN DATE DESCRIPTION DEBIT '¡2,/28/89 '1.989 ANNUAL FEE (GROUP A) 50.00 CREDIT . , ,j ~"í:: 1 ¡J,' 1'/ j¡ '" . 1 ,~ BALANCE 50.00 .g 0, ~ '" I- .....¡:Q.. , ".. , lu .~ "" z UJ (f) UJ .11 (f) UJ -' ê7i .Šl G H :1 .\'~ ,\ " 1 ' :J ',", 0 >- .~ z o ü a: .g N <D rh N OJ .~ UJ UJ a: LI. .::J i2 -' H ·hdð UJ .8 ::; CURREN-TOVER 30 ' OVER" 60 OVER 90 D.OO 0.00 50.DO 0,00 ACCOUNTS'THAT ARE 90' DAYS OVERDUE ARE SUBJECT COt LECTIONS. THANK YOU FOR YOUR PROMPT PAYMENT. ,OVER 120 '0.0'0 TO B:E; REFERRED, TO CHECKS ONLY PLEASE,! R 1;, TI ~I 1'11, T1 oL______________________________ PACI FIC BELL 633 FOLSOM RM 320 SAN FRANC r sca K. C, F. D. HAZARDOUS MATERI ALS, P , (), EW X 8 1 7 96 BAKERSFIELD, CA. 93380-1796 TO CA 94 1 01 . -' · · ì ~. ":i '. ~ ~ ~ I- !~.. I ! · 1- , . - ; L ~ , .....'--- · , t .~ § :> UJ II: :J "' '" ::;; (/) o z ::;: II: · ¡¡: · I!' """'k. R "'E " T , U ,R 'N T o -- F R o ~ - -,- - -:- - -- -:- - --\ ", I 015-010-003715 : I I I I ' HAZARDOUS MATERIALS KERN COUNTY FIRE ,{80S)861-2761 P.O. BOX 81796 BAKERSFIELD, CA, 93380-1796 12/28/89 DUE BY 01/'28-/90 FOR BUSINESS AT: 11101 WHITE LN DATE DESCRIPTIO~~~ - DEBIT 12/28/89 1989 ANNUAL FEE (GROUP A) 50.00 CREDIT ~ , CURRENT cOVER 30 OVER 60 OVER 90 OVER 120 5 0 ;,,0 0 0 . 0 0 0 . 0 0 0 . 0 0 0 . 0 0 THIS FEE IS :FOR THE, REVIEW ,AND PROCESSING OF YOUR <EMERGENCY THE INSPECTION OF YOUR BUSINESS PER STATE LAW. CHECKS ONLY I r I ·1.. I I L_____________________________ PACIFIC BELL 633 FOLSOMRM 320 SAN,FRANCISÇO, , K,C.F.D. HAZARDOUS MATERIALS P.O. BOX 81796 ' BAKERSFIELD, CA, 93380-1796 TO BALANCE 50.00 , . - . PLAN AND PLEASE, . CA 94107 4 " .J '" o CO) ~-> '" .~ il',), ~ I :1 ~I ~ I- .~ UJ II: "- UJ II: .-(/) ~ (/) ...J « ü .~ :J o >- I- Ü .~ o Ü II: o ,~O .~ : '" ! N CO) 6 o ro .~ II: ~ I{ ~, ~ " b .' I- j i « , ü UJ II: ,,0 .~ . ~~~ O;¡ \2/93 "', -- -.... ,,0ACIFIC BELL 015-010-003'411 .. Overall Site with 1 P a~g e , General Information 1==============================================================================1 I I 1----------------------------------------------------------------------------1 I II Location: 111011tJHITE LN Map: 123 H;:;Jzard: Unrated I! I ¡Community: "BFD" RESPONSE AREA" Grid: 18A. 1 AOV: 0.0 II II ===-;~~~:~~-ì~:~~-===ï======-~;;~~-======ï==-;~~;~~~~-~~~~~-==ï-i~=~~7~~~~~ i ,I I ¡.JIM ASBURY ISITE MANAGER 1(805) 393-001o/x 1('4/~%-) 8~777711 1 I I I (5¡ 0) <6l..~-"Yl-:n x I (57") J:rl!J -71711 I 1 1--------------------1-------------------(--------------------1--------------1 I ! 1---------------------------- Administrative Data ----------------------------1 I I Mai 1 Addrs: 2600 CAMINO RAMON 2N550C D&B Number: 1 C340 "~', ,. II City: SAN RAMON State: CA Zip: 945 J'!!:.' J,~, I I Comm Code: 015-909 "8 FD" RESPONSE AREA," SIC Code' "' : I í ---'---.-,---------------------------------------------------- -,é:f::! t,,· I I Owner: PACIFIC BELL/SUSAN JONES Phone: (510) 8 I I Address: 2600 CAMINO RAMON 2N550C State: CA II City: SAN RAMON Zip: 94583- I [ I 1----------------------------------------------------------------------------¡ I I I Summary -------------------------------------------------------------------1: II II I ¡TELEPHONE CENTRAL OFFICE FACILITY, DIESEL FOR GENERATOR IN THE AG TANK. I I I IBA'fTERIES STORED IN RACKS. I I II I : II II II II I 1----------------------------------------------------------------------------! I 1==============================================================================¡ JJht/ IW¡J YJ \' (f) [Ærn@rnuwrn[Q) JAN 2 'i 1993 '7 KCFD HMCU I, ~A-'J0 6, ,7btJð-s _ Do hereby certify that i have (TYP9 or print n¡>me) reviewed the attac:lsd h2z3ï,:aus materials manage- ment plan 'for _f~I1=/ C&LL and that it along with (Nar;,;) of Business) any corrections constitute a complete and correct man- age.. ;ent plan for my facility, ~~r (-/(.-93 Date ,&_ 0 1 / 1 2 / 9 3 .-. .¡;. Hazmat Pln-Ref Name/Hazards .DACIFIC BELL 015-010-003'. I , en tory List in Reference N ~ber Order 02 - Fixed Containers on Site Form Quantity Page 2 ------.-------------------------------------------------------------------------- MCP 02-001 DIESEL FUEL > Fire Liquid 1000 Low GAL ----------------------------------~--------------------------------------------- 02-002 BATTERY ELECTROLYTE > Immed Hlth Liquid 372 High GAL --.------------------------------------------------------------------------------ --------------------------------------------------------------------------------- ND C!-/A-tJ ~ ¡¿- 01/12/93 \;- ."r .... .'ACIFIC BELL 015-010-003_ 00 - Overall Site ..~. Page 3 I I 1 <H> SCHOOLS WITHIN 1/2 MILE -------------------------------------------------------------------------------- <1> High Schools ,---------------- STOCKDALE HIGH SCHOOL ACROSS THE STREET FROM 11101 WHITE LN. BAKERSFIELD. <2> Jr. High Schools -------------------- NO JR HIGHS IN VICINITY. <3> Elementary Schools ---------------------- NO ELEMENTARY'S IN VICINITY. <4> Private & Pre Schools .~------------------------ NO PRIVATE & PRE SCHOOL. ~o 8/0'7 /9 2 ~ ~ General Information 1==============================================================================1 i I 1----------------------------------------------------------------------------1 I I I Location: 11101 WHITE LN Map: 123 Hazard: Unrated I I ¡ICommunity: BAKERSFIELD - 4 Grid: 18A 1 AOV: O.O! I I 1--------------------------------------------------------------------------,--1 11--- Contact Name ---1------ Title ------1-- Business Phone --I 24-Hour Phonel I I ¡JIM ASBURY ISITE MANAGER 1(805) 393-0010 x 1(415) 823-77771 I II 1 I() x I() II I 1--------------------1-------------------1--------------------1--------------1 I ¥ -~~~~-~~~~~~,-~~-~~-~~;~-;;.- /dmi ni st rat i ve Data ----~~;-~:~~~~~-~~;~~~~~~---IIII II City: 8:'\KER5FIELD State: CA Zip: 94120- II ~I I -~~~~-~~~~~-~~~~~~~-~~~~~~~~~~~-~-~---------------~~~-~~~~~-~~~~------- I I 1 Owner: PAC I F I C BELL/NANCY CLMJCY, þ-U),ù :JõN&-J" Phone-;1{ 41 S) :::;42 :J 0 6-(7 A I II Address: ,PO ax 76:)1 30 / State: CA /j I ¡ 1_______:2~:~_~~~~~:~~~~~__~____________________________=2~~_:~2~~__~~____1 I I I Summary -------------------------------------------------------------------1 I II II I ¡TELEPHONE CENTRAL OFFICE FACILITY, DIESEL FOR GENERATOR IN THE AG TANK. I I IIBATTERIES STORED IN RACKS. II II II \I II II II \~:::::::::::::::::::::::::rf:::::::::::::::::::::~::::::::::::::::::::::::~\ )f' c2{,ù 0 CA-m I tV ù \.<::..AYYt <> tV d. N !5 ç 0 0 ð/AtJ (2Arnð rJ ( ~, qL/b-h // - . () !s'L3-- ~ 6'100 <S VL ~~-f4/"L / . ~J I V1,W" }¡-z,J -\.. AJ \'V ~PACIFIC BELL 015-010-003\~ Overall Site with 1 ~ 13""/0 I.~Ç~Ñ {S, JöI\lI5-J Do hereby certify that I have (Type or print name) reviewed the attached hazardous materials manage- ment plan for f'JAèA ¡:.(C && I...L and that it along with (Name of Business) any corrections constitute a complete and correct man- agerì1ent plan for my facility. ~~ !2----lð ,-fi- Date Page !ÆfË!@& IT ~J IE @ DEe 1 b lÇ~2 /} kCFD HMCU P8/07/92 ~PACIFIC BELL 015-Ó10-003~ 02 - Fixed Containers on Site Page 2 . , Hazmat Inventory Detail in Reference Number Order -------------------------------------------------------------------------------- 02-001 DIESEL FUEL > Fire Liquid 1000 Low GAL ----------------------------------------------------------------------- CAS #: 68476-34-6 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL ---- Daily Max GAL 1,000 ----!-- I Daily Average GAL 1,000,00 --I-- I Annual Amount GAL -- 1,000.00 ------ Storage -------1 Press I Temp -1------------ Location UNDER GROUND TANK IAmbientlAmbientlUNDERGROUND TANK ---------- - Conc -1---------------------- Components --------------1- MCP --List 100,0% ¡Diesel Fuel No,2 IModeratel -------------------------------------------------------------------------------- 02-002 BATTERY ELECTROLYTE > Immed Hlth Liquid 372 High GAL ----------------------------------------------------------------------- CAS #: 7664939 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: BATTERY/ELECTROLYTE ---- Daily Max GAL ----1-- Daily Average GAL --1-- 372 I 372,00 I ------ Storage -------1 Press 1 Temp -1------------ UNDER GROUND TANK IAmbientlAmbientlFIRST FLOOR Annual Amount GAL 372.00 Location ---------- - Conc -1---------------------- Components --------------1- MCP --¡List 100.0% ISulfuric Acid (EPA) ¡High EPA ....08/07/92 ~PACIFIC BELL 015-010-003~ 00 - Overall Site Page 3 t <H> SCHOOLS WITHIN 1/2 MILE ·-------------------------------------------------------------------------------- <1> High Schools ~--------------- -.s TOc-t£ b Itl-E HI C,H SC-f-ts~ .r-- ~s.& ~ ~ ~ 1"01 tJH'T¿ LN; . ß.A.. ''-6{Z..:!..¡= I €~ . <2> Jr, High Schools ~------------------- Alo J {2- (~, r, ( <3> Elementary Schools ~--------------------- ¡J ;J E L. [;; I?-{ <4> Private & Pre Schools I ~------------------------ ¡J () P (L/ UflTé q.... P{2.E )~ð '- I~- . . 08k31/9p, e PACI FIC BELL 015-01 0-00:e5 . Overall Site with 1 Page 1 General Information- 1==============================================================================1 I I----------------------------------------------~-----------------------------1 I II Location: 11101 WHITE LN Map: 123 Hazard: Unrated II II Community: "BFD" RESPONSE AREA" . Grid: l8A 1 AOV: 0,0 II it!-~~~;- ~:~~ - ~~~ï~~~~~~:~:~ ~~-~~~~~~ï~~:~~;~ ~ ~~~:~~~:~- ~~ï~~~~~~~;: ~~~~~ \ ¡ I ¡EMERGENCY CONTROL CTI 1(510) 823-7777 x 1(510) 823-77771 I I I--------------------I--~----------------¡---------------------1--------------1 I 11--------------------------- Administrative Datá ----------------------------1 I II Mail Addrs: 2600 CAMINO RAMON-2E450FF D&B Number: '10340'1618 II II City: SAN RAMON State: CA Zip: 94583- I! II Comm Code: 015-909 "BFD" RESPONSE AREA" SIC Code: ~1<~SL' II I I -------------------------------------------------------------------------- I I II Owner: PACIFIC BELL/SUSAN JONES _ . ¿p~,,- Yhone: (510) 823-3560 II I! Address: p.Q ex 76ð1 DEPT 3i3 ~oo (Y9/-!/Aj;¿¡6ð:r1¿J4ï St.ate: CA 1\ I' City: SAN fRANCI3CO S/j-N f?-ItHtJ/ý /- / Zip: --9-4120-- 7~n AI I 1----------------------------------------------------------------------------11 I I Summary -------------------------------------------------------------------1 I II II' I ITELEPHONE CENTRAL OFFICE FACILITY, DIESEL FOR GENERATOR IN THE AG TANK. I I IIBATTERI ES STORED IN RACKS, II II II \ I II /I II I 1----------------------------------------------------------------------------1 I 1==============================================================================1 Jl1[g©rnowrnib r.J ~~ ~ ¿rJ) ·7~ t7 SEP 1 7 1993 ~~. º \ c9ù" et-1 !f {J KCFD HMCU V -" 1, SUSAN E. JONES Do hereby certify that I have (Type or print name) , reviewed the attached hazardous materials manage- ment plan for PACIFIC BELL and th2.t it along with (Name of Business) any corrections constitute a complete and correct man- agE-ant plan for my facility. 5--1 ¥ - 0/} Dato 08[31j9<;;3 I PACIFIC BELL 015-010-00_5 Hazmat ventory List in Reference Number Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty Page 2 MCP 02-001 .-------------------------------------------------------------------------------- Low Liquid DIESEL FUEL > Fire 1000 GAL ------------------------.-------------------------------------------------------- 02-002 BATTERY ELECTROLYTE > Immed Hlth Liquid 372 High GAL ================================================================================ ~ · 08¿31/9.3 ___ -=4 :::.,. tit PACIFIC BELL 015-010-00ila5 00 - Overall Site Page 3 <0> Notif./Evacuation/Medical ~-------------------------------------------------~----------------------------- <1> Agency Notification ----------------------- CALL -- 911 and then (800) 852-7550 or (916) 262-1621 National Response Center - (800) 424-8802 / <2> Employee Notif./Evacuation ~----------------------------- EVACUATION ROUTE - N ON S EXIT - ONE (1) MAN MAXIMUM OFFICE - PART TIME SHOUTING, HORNS, ALARMS. ./ Vocal, whistle and fire alarms are used to notify employees to evacuate. The instructions for emergency exits and alternate routes to be used for evacuation are posted on each floor. <3> Public Notif,/Evacuation / ---------------------------- RESIDENCES TO S AND EMPLOYEES OF BLDG. The Pacific Bell Emergency Operating Procedures, (SL.131.5) Building Warden as the responsible contact to work with all emergency/rescue personnel to notify building neighbors, identifies the agency <4> Emergency Medical Plan -------------------------- MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFIELD, CA (805) 327,-3371 The immediate supervisor or for contacting an ambulance ./ available Building Warden is responsible or medical facility for an injured employee. o 8/3 ~/$.3 ; tt PACIFIC BELL 015-010-00~5 00 - Overall Site Page 4 <E> Prev./Minimization/Cleanup -------------------------------------------------------------------------------- <1> Release Prevention -----------~---------- MATERIALS: HAZARDOUS MATERIALS ARE UTILIZED AND STORED FOLLOWING MANUFACTURES RECOMMENDATIONS AS WE ARE A CONSUMER OF PRobuCTS AND NOT A MANUFACTURER OF HAZARDOUS MATERIALS. TRAINING: Employees are provided training annually through the Pacific Safety Plan Modules on how to handle hazardous materials and how to read an MSDS as required by the hazardous communication standard. Additionally annually they are trained on emergency operating procedures (81 131.5) and Pacific Safety Plan." <2> Release Containment .t ~---------------------- BATTERY ELECTROLYTE: Contained in batteries located in an Earthquake braced structure. Absorbtion material on site to handle leaks or spills. Contained in an underground, doubled wall steel tank, Monitored sensor between walls to detect leakage. Absorbtion material on site, .' '" DIESEL FUEL <3> Clean Up ..."----------- IN THE EVENT OF A SPILL OR RELEASE A HAZARDOUS MATERIALS CLEAN-UP CONTRACTOR WILL BE CONTACTED. <4> Other Resource Activation ----------------------------- As outlined in Pacific Bells Hazardous Materials Management Plan Item G "Unauthorized releases (leaks and spills) of petroleum product will be reported immediately by the operator of the underground tank to the foll, Pacific Bell Emergency Control Center (5]0) 823-7777 Paci#ic Bell Real Estate Staff (510) 823-1028 ~ Any unauthorized releases will be recorded using the HazardöusMaterial Incident Report Form Number FR-0023, as shown in Appendix III. For incidents involving spill, the operator of the underground tank will notify the Fire Department. . 08/3,!!~3 ,,~ tIÞ PACIFIC BELL 015-010-00tIÞI5 . 00 - Overall Site Page 5 <F> Site Emergency Factors ---------------------------------------------------------------------~---------- <1> Special Hazards ------------------- <2> Utility Shut-Offs --------------------- A) GAS/PROPANE - N/A B) ELECTRICAL - INSIDE N WALL 30 FT W OF N ENTRANCE TRANSFORMER, NE CRNR OF LOT INSIDE THE GATE. C) WATER - N SIDE OF BLDG - CEMENT CASE HOLDER D) SPECIAL - N/A E) LOCK BOX - NO <3> Fire Protec./Avail, Water .~---------------------------- PYRO TRONICS ALARM SYSTEM III ZONED ALARMS 'ARE REMOTED TO 24 HOUR SURVEILLANCE. FIRE HYDRANT IN FRONT OF 8LOG NW CRNR OF FRONT YARD, <4> Earthquake Vulnerability ---------------------------- · 08/31/93,.. II __... It PACIFIC BELL 015-010-00_15 00 - Overall Site Page 6 <G> Training ---------------~-----------------------------------------------.----------------- <1> T~aining Record Location ---------------------------- EMPLOYEES ARE PROVIDED TRAINING ANNUALLY THROUGH THE PACIFIC SAFETY PLAN MODULES ON HOW TO HANDLE HAZARDOUS MATERIALS AND HOW TO READ MSDS' AS REQUIRED BY CAL/FED OSHA HAZARD COMMUNICATION STANDARD, ADDITIONALLY ANNUALLY THEY ARE TRAINED ON EMERGENCY OPERATING PROCEDURES. (REF: PACIFIC SAFETY PLAN/SI 131/5) THE IMMEDIATE SUPERVISOR IS RESPONSIBLE FOR ENSURING THAT EMPLOYEES ARE TRAINED AND FOR MAINTAINING DOCUMENTATION AS APPROPRIATE. <2> Describe Training Program v "m_-ËrnpÏõÿëëš-ärë-piõ"Tdéd-fñftial Safety Plan training on the Hazard Recognition Communication module as well as the function specific modules before they begin their work operations. This also includes training on the Emegency Operati~g2Procedures, (Pacific Safety Plan SI 131.5). Specific new employees are sel~cted to be Building or Floor Wardens. Emergency Operating Instructions (SI 131,5) serve as a reference guide for the Building Warden. Additionally they receive on the job training from the previous warden and may attend the Interdepartmental Training Course #6127 Building and Floor Warden Training. First Aid Training and Training on Pacific Safety Plan are also required, Additionally the Pacific Safety Plan requires that employees receive annual Refresher training on the Hazard Recogniton/Communication module, <3> Emer. Agency Coordination ----------------------------- The PACIFIC Bell Emergency Operating Procedures (SI 131.5) identifies the Building Warden as the responsible employee to the Supervisors in the ./ building to ensure that all employees are accounted for. The Pacific Bell Emergency Operating Procedures,(SI 131.5) identifies the Building Warden as the responsible contact to work with all agency emergency/rescue personnel to notify building neighbors, The immediate supervisor or available Building Warden is responsible for contacting an ambulance or medical facility for an injured employee, <4> Emer. Response Equipment ---------------------------- A number of registered fire extinguishers are kept (Halon, Carbon Dioxide, Y Water) on the premises at all times. They are placed at strategic locations throughout the facility in accordance with the protection requirements of NEPA 10. Additional emergency equipment will be obtained as needed from Pacific Bell contracted Hazardous material and Hazardous waste Handling vendors. The fire extinguishers are maintained and serviced by a professional outside contractor on a yearly basis. A visual inspection is made by the facility Wardens on a regular basis to ensure the adequacyof the emergency equipment, , .. e eoorn©rnuwrnrm 2 ICUUf COOM'l'Y J'IRE DEP ARTMEHT (805) 861-2761 DEG 1 4 1989 ;;: "'~ ID# k.lìt'1J 371S HMCUj I I I DO ROT DID IIf 'l'BIS BOX HAZARDOUS MATER~ALS BUS~NESS PLAN FORM :2 J'orms Due By: r, ¡-" () '.-. t~0" Lh:.t, :, . JuJ SECTIOtf 1: BOSlBESS IDEtfTIJ'ICATIOR DATA A. FULL LEGAL BUSINESS NAME: ~A C( f=lC l\\Ol BE-LL ' W t-h .n; UJ B, PHYSICAL LOCATION/STREET ADDRESS: CITY: ßA-Ke<5FI e.W ZIP: BUS. PHONE: (_) MAILING ADDRESS: PO B6 'I- 7 Cost ÞEPT ~ CI'l'Y:~ FRANC.l:6.C.D ZIP: 9412..0 C. D. HAVE YOU FILED A BUSINESS PLAN WI~H THE DEPARTMENT UNDER A DIFFERENT NAME WITHIN THE LAST TWO YEARS? YES 'NO ~ IF YES, UNDER WHAT NAME DID YOU FILE? E. THIS SUBMISSION IS A NEW V OR REVISED BUSINESS PLAN SECTIOtf 2: EMERGElfCY ROTIJ'ICATIOtfS In the event of an emergency involving the release or threatened release of a hazardous material, telephone 9-1-1 and then (800) 852-7550 or (916) 427-4341, This will notify your local fire department and the State Office of Emergency Services as required by Stàte law, Additional Federal reports may be required. PERSONS WHO SHOULD BE NOTIFIED IN CASE OF EMERGENCY AT YOUR BUSINESS THAT HAVE FULL ACCESS AND CAN PROVIDE TECHNICAL ASSISTANCE: NAME AND TITLE ~(K) DURING BUS, HRS, AFTER A. 0 þVt /$bu tt¡ - :rb Ø1l.f'l' Ph#. (Íi") ;13'/Ø/~# bu-l'-J 5~pí!. Ph# (ý:J5") ~/ì# Ø6'~Ph# BUS, HRS, B, CONTINUED ON REVERSE - ( 1 ) e e I.: . SECTION 3: LOCATION 01' THE MAIN UTILITY SHUTOFFS FOR THE ENTIRE BUSINESS ~ A, NAT,GAS/PROPANE: iJj;} B, C. WATER: D. SPECIAL/OTHER: iJ~ E, LOCK BOX: YES~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS?" YES / NO MSDS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM DESCRIPTION Do you have a group of employees trained to handle minor accidents / involving hazardous materials at your business? Yes ____ No~ If so, you must explain the level of training and equipment they possess and how they are notified to respond, SECTION 5: IDENTIFICATION 01' THE CLOSEST APPROPRIATE EMERGENCY MEDICAL ASSIST CE AVAILABLE TO YOUR BUSINESS #1 ê)t.{! #2 ADDRESS'il ~¡/ ~kN þ. CITY: f;?-teÆsfie/~ , PHONE: (i1:f:;5 ,~21" =j 3 7/ PHONE: (____) COMMENTS/ADDITIONAL INFO: CONTINUED ON NEXT PAGE - ( 2 ,. ..' .;, e e SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED BY STATE LAW TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS: 1) Methods for safe handling of the hazardous materials used by your business, 2) The CAL OSHA Hazard Communication Standard, 3) Correct use of emergency response equipment and supplies available at your business, 4) The prevention, minimization, and cleanup procedures you have developed for your business and explained on the business plan forms, 5) The emergency evacuation plans you have developed, the notification procedures used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care, 6) Procedures to coordinate with and assist the local emergency personnel that may respond to your business, 7) Who and how to call for immediate assistance in the event of an accident involving hazardous materials, Describe the location of the· written plan and the training records which are required to be developed and maintained, State law requires your training records to be inspected. E£11.)ay¿~. /tt2.LE PlZòVlasD /721-tÆ/IAr'6 /9N11<¿1/K..-~c/AI Hòu'/ 7?/12-edt7/·~l T(iE" P/I-V;fc.. .9lÆ5(fj ?~ /Î/¿ja/¿£~ /2-£ÆD TO fþf-Na.¿ µÆzAaaW3 HA-?B2¥A-LS ~O .d/,f~~ /W£055 ~ 12£.~//2£-:P By _~~.c;> .. /fNNt//I-i--LL/ C!{)7tI & i/ A/rCYf-r7fJ,(j ~,T711Vß~ . Aû0r T7ðA./'A-LL ~'p~-=y /\1'4 -I' 71fGf: /P2Æ. T72A:rtVi50 ðÆ( EA/&26p~¿L/ - . P/t-ó{lhO///Z£S, (12.61=: PA-e/A? 5A7C-~,,~¿M/ /~I 13~5) T7-f5 //1t//~A7C" SVP'&.2$Y('S¿¡/2 _/.5. /2Þ-5PðV~%-M/O Q/,Ç¿I/Zr'/VCr /7~ "GA,I/~~~~%~ / ~.opo,P/2/~C. /0/2- H /¥A/17ft' Nt' A/6; ..A:)cU/ Â--/~ STOP! Is your business divided into smaller geographic areas or units? No Continue on with Sections 7 through 10 of this form, Yes Do not answer Sections 7 through 10 of this form, Sign your name at the bottom of Page 5, then fill out a Form 3 for every area your business was subdivided into, CONTINUED ON REVERSE - ( 3 ) <:; - .~ ... e e -: SECTION 7: EXPLAIN WHAT PREVENTION, MINIMIZATION, AND CLEANUP PROCEDURES YOUR EMERGENCY PLAN INCLUDES. INCLUDE A DESCRIPTION OF MONITORING METHODS AND PROCEDURES. Training: Employees are provided training as described in section 6. Materials: Hazardous materials are utilized and stored following manufacturers recommendations as we are a consumer of products and not a manufacturer of hazardous materials. Clean Up: In the event of a spill or release a hazardous materials clean up contractor will be contacted: Monitoring: Name ~, -r Tel b(~)'- 2&- Z_- /f¿1Ö b/lld IV~E¿&¡ . . .L4ck,¿,pµ 5/:~Sdd 'Þe-~EeÆJW~ 76 -kd !Î"~h'ltf~ SECTION 8: EXPLAIN THE NOTIFICATION METHOD AND EVACUATION PROCEDURES YOU HAVE DEVELOPED FOR THE EMPLOYEES TO USE IN AN EMERGENCY. YOU MUST INCLUDE A MEETING POINT. ~ _' I- e{/¡ku~t1 ¡føcl~- ~~;LLI)K~l~~ ¿l</ - / !#1.4,U ¡J1,4ý;ttI~/# ¿)tW!'~ - ¡LdW~A_e.- f - CONTINUED ON NEXT PAGE - (4) ~ e e SECTION 9: EXPLAIN WHAT PRIVATE PIRE PROTECTION SYSTEMS ARE IN PLACE THAT MAY ASSIST EMERGENCY RESPONDERS. ;~ f) -. / 'r ¿' jJ !AI¿lJl ¿ y.51F //1 7// fl! ~¿ /¡:c.;'¡(./ /r- :.J r! ,!c fr,/../C¿ /J/.4/¿/II<) Alfie J/lc/j/(:W ¿Jj /1/t', :)Uli ¿JFII(A~,eE SECTION 10: LIST THE LOCATION OP ANY WATER SUPPLIES THAT MAY BE USED BY EMERGElfCY RESPONDERS. frItZ J4ck.4H,L - /~14~-,L-(J.p Þ-u<d,<,'7 (J. _ ... j) /U(}~~~. þr{ur ~v¿)r~ I, /,(/A~.I/(/ /7/.LLI/~ . /~~L- ~w~, , certify that the information submitted on all the busi ess plan forms is accurate and complete, I understand that this information will be used to fulfill my obligations under California Health and Safety Code Division 20 Chapter 6,95 et seq, and Title 42 U,S,G.C, Section 1100 et seq, and false information may be punishable by fine, imprisonment, or both, c¿~ {¿{ø'?U£f1- Signatur ~ tl4NA&612- Title (q/ff8.9 Date ( 5 ) .~ REC~ I Vfi.~,' RECEIVED of BAKERSFIELD CIT}T 37\) \VI [g U1 1991 u JAN 1.5 u11LStblli " _~RYIl8í1......., ..j :J: .... ../_'" _ __ 1990 1 1 JAN :if MATERIALS HAZARDOUS ~- KCPD-HMCU arll and Agriculture L..-J Standard Business HAl MAT.01V.. NAME OF Tfi1S ~ÇJL~TY STANDARD IND. CLASS CODE DUN AND BRADSTREET NUMBER / I L t¿ - ¿ Y Jl- !.. ~ _ f 2-() OWNER NAME ADDRESS:_ CITY, ZIP PHONE " RDlUl ..¿- BUSINESS LOCATION: CITY, ZIP PHONE II: .. lIa_ of IIhture/COII~t. See Instruction. 13 , by lit 12 Loeat ion llhere Stored In Flci IttV II Us. Code 10 Cont 1,," , Cont Pres. . Cont lVIII 7 Oys Sit. , ""sur. Units 5 Annua Est 4 Average AMt 3 lIu AMt 2 TYDe Code ___~__&sl_ 1 on ~~2. C.A.S ~_cm___ --?-(!;Q--- Irans Code ZJ-t. Phys i ca 1 and ,r~k al1 II 'ì~_':._9..L_________________ ______Þ-____ ______ _______ ____ _ _________ lIu.ber lIu.ber · C.A.S II... n COIIAonent Cøponent r-., L._.I r-, ,.-., L_J Dellyed L_J Hea Ith Hea Ith Hazard that aDPly) r-, L _.J React r -1'-, ý-.J -- -~~~~~~,~~~~~---------------------- -------------~~ 00 lluabtr ~~~--~!:~~~---------------- 11 II.... C.A,S. lIu.ber .,.. ¡ C.A.S. IlUllber · C.A.S III" 13 Co.ponent COII\IOIItIIt rz lMedllt. H..lth __~_2_~________ª_Z~____.§~.._~_0:L!?LJ._!.._L If . C.A.S. ....,. _______ r-., L_J Reactivltv Sudden R.le... of Pres.ur. r-., Sudden R.I.... L. - .I of Pres.ur. r-., Del.y" L_"" Heelth r-, L_.J vHy re Hazard __t____/:_1-?:___ Phys iCII and Hfa Ith Hazard (Check all that apply) ,.-, L_J .u.btr · C.A,S .... u COII~t laødllt. H..lth Fir. Hazard --------------------- COIIpanent 11 ..... C.A.S. IIu.ber --------------------------------------------------------- .... . C.A.S. .uabtr Mu.ber · C.A.S 11- IZ I] COIIøønent COIIponent IMedilte HHltll ..--' C.A.S. .'**'_ r-" Sudden Rrlllll L._.I of P.....ur. r-., De 1 ayed L - "" Hea Ith r-, L_.J Physicll and Health Huard (Check .11 that app IV) r-' L _ J React Iv!tV ire Hazard r-., L_.J ___l______l____________l_____________l___________L__--'_____L__l-L-l___1____ Physical .nd Health Hlzard C.A.S. lluabtr______________ COII\IOIItIIt (Check all that IIIlIly) .uallel' lIù.ber · C.A.S · C.A,S 11- "- 11 12 COIIIOIItIIt COIIponent .--, ,..-., Delayed L_"" Sudden Release L_.I IMediate Health of P....sure HHltll r-, L_.J r--, L_.J React r-, L_.J -----+------------------------------- .------------- ______a. r2/t¡p1~~-~bL--C.~1Þt1!,._------------------------- ¥{.;¡-f~:ZZZ7 Mu.ber · C,A.S .... I] «tf,~l:Z2.77 S'1-e ,A/q" q 9_~___.___ nm--------·--..,¡' I~ .._____ --'--r--------- víty :LÆ--- a.. , ---. (Read and sign after re Hazard " CON TAC1S IIERGENCY Inquiry of thos. Indlviduð IS ~{¡)(¿1I~-~-------------.----- --- responsible onar Ind that blsld doeUMllts .Ute'*' .n In this Ind sections} I have oersona lIy e.alll;ned and la f.aIH.r .ith the Inforaation subeitttd i.v. that the subaitted intol'll.tlon i. true. ICcur't., and co.pl.t.. co.pleting all cert1fy under pena!tv of la. or obtaining the inforaat Ion , R~in!if- õ1T~~ãlq*1~õ1lo¡,ñr¡;iõõr¡;ãtõ¡;·OR- õ¡'¡¡rr7õp@¡:¡¡õ¡:T¡ütr,¡jriiinëõrmñtitiŸ¡ that lbe itat ion (ert ''¡¡ 0 3 /2 2/9 1 \ .-fACIFIC BELL 015-010-003~ ~ Overall Site with 1 ~ Page -, w General Information 1==============================================================================1 I 1----------------------------------------------------------------------------1 I I ¡Location: 11101 WHITE LN Map: Hazard: Unrated I I Ident Number: 015-010-003715 Grid: Area of Vul: 0.011 I 1----------------------------------------------------------------------------1 I 11--- Contact Name ---1------ Title ------1-- Business Phone --I 24 Hour Phone- IIJIM ASBURY ISITE MANAGER y(S05) 393-0010 x I (illS }<j:l3 -77171''(1 II J)I DtHY SUpERvISOR II (805) 398-0066 x /' I ( ) - II 1--------------------1-------------------1--------------------1--------------1 I 11--------------------------- Administrative Data ----------------------------1 I II Mail Addrs: PO BX 7631 30 D&B Number: 10.3,-/0 /(pl!/, II II City: SAN FRANCISCO State: CA Zip: 94120- II II Comm Code: 015-004 BAKERSFIELD - 4 SIC Code: 1/8/1/ II II -----~:~:~~-~~;~~~;-;;~~ï-ÑñÑ~--¿Z~Ñ~J------------;~:~:~-t~~5~-~~~~{~~~ 11 I Address: PO BX 7631 30 State: CA I I City: SAN FRANCISCO Zip: 94120- I I 1------------------------------------------------------------------~---------I I I Summary -------------------------------------------------------------------1 I I II I II 1 II I II I II I II 1----------------------------------------------------------------------------1 I ==============================================================================1 n @ ;~ (1 ¡WV<' .. Qìí . {\~~ v.-."V,' (t t! fJ8 fè @ & 0 'irJ UIIN lè @ (j~ N Do hereby certify that' have 7 1991 I. Nty~e~intnam~~ dous materia\s managJ!CP"D HM , d the attached hazar Cu revlewe r?t.. Pì tLL- and that it along with ment plan tor a(~ate(.,o' Business) d orreet man- . t a complete an c any corrections constltu e . nt Plan tor my facility, age"ìe ~~ ~q7~ - Signature " 03/22/91 ~ACIFIC BELL 015-010-003~ Page 2 Hazmat _ entory List in Reference ber Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Quantity MCP -------------------------------------------------------------------------------- 02-001 DIESEL FUEL > Fire Liquid 1,000 v' GAL Low -------------------------------------------------------------------------------- 02-002 BATTERY ELECTROLYTE > Immed Hl th Liquid 372 v GAL High -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- 03/22/91 '-¡ACIFIC BELL 015-010-003. .., 00 - Overall Site Page 3 I . <0> Notif./Evacuation/Medical -------------------------------------------------------------------------------- <1> Agency Notification ----------------------- <2> Employee Notif./Evacuation ------------------------------ EVACUATION ROUTE - N ON S EXIT - ONE (1) MAN MAXIMUM OFFICE - PART TIME <3> Public Notif./Evacuation ---------------------------- <4> Emergecny Medical Plan -------------------------- MERCY HOSPITAL 2215 TRUXTUN AV BAKERSFIELD, CA (805) 327-3371 03/22/91 ~ACIFIC BELL 015-010-003i1i ~ 00 - Overall Site .., Page 4 I ,. <E> Prev./Minimization/Cleanup ------------------------_.~------------------------------------------------------ <1> Release Prevention ---------------------- HAZARDOUS MATERIALS ARE UTILIZED AND STORED FOLLOWING MANUFACTURES RECOMMENDATIONS AS WE ARE A CONSUMER OF PRODUCTS AND NOT A MANUFACTURER OF HAZARDOUS MATERIALS, <2> Release Containment ----------------------- <Z> Clean Up ------------ IN THE EVENT OF A SPILL OR RELEASE A HAZARDOUS MATERIALS CLEAN-UP CONTRACTOR WILL BE CONTACTED, <4> Other Resource Activation ----------------------------- · 03/22/91 ~ACIFICBELL 015-010-003}1i ... 00 - Overall Site ~ Page 5 " <F> Site Emergency Factors -------------------------------------------------------------------------------- <1> Special Hazards ------------------- <2> Utility Shut-Offs --------------------- A) GAS/PROPANE - N/A B) ELECTRICAL - INSIDE N WALL 30 FT W OF N ENTRANCE TRANSFORMER, NE CRNR OF LOT INSIDE THE GATE, C) WA T E R - N SIDE OF BLDG - CEMENT CASE HOLDER D) SPECIAL - N/A E) LOCK BOX - NO <3> Fire Protec,/Avail. Water ----------------------------- PYRO TRONICS ALARM SYSTEM III ZONED ALARMS ARE REMOTED TO 24 HOUR SURVEILLANCE. FIRE HYDRANT IN FRONT OF BLDG NW CRNR OF FRONT YARD. <4> Held for Future use ----------------------- · 03/22/91 ~OACIFIC BELL 015-010-003}1i ~ 00 - Overall Site ,., Page 6 7 <G> Training -------------------------------------------------------------------------------- <1> Page 1 ---------- EMPLOYEES ARE PROVIDED TRAINING ANNUALLY THROUGH THE PACIFIC SAFETY PLAN MODULES ON HOW TO HANDLE HAZARDOUS MATERIALS AND HOW TO READ MSDS' AS REQUIRED BY CAL/FED OSHA HAZARD COMMUNICATION STANDARD. ADDITIONALLY ANNUALLY THEY ARE TRAINED ON EMERGENCY OPERATING PROCEDURES, (REF: PACIFIC SAFETY PLAN/SI 131/5) THE IMMEDIATE SUPERVISOR IS RESPONSIBLE FOR ENSURING THAT EMPLOYEES ARE TRAINED AND FOR MAINTAINING DOCUMENTATION AS APPROPRIATE, <2> Page 2 as needed -------------------- <3> Held for Future Use ----------------------- <4> Held for Future Use ----------------------- ~r 'I KER~OUNTY FIRE dlPARTMENT HAZA'DOUS MATERIALS BUREAU INSPECTION REPORT 5&¡2 Victor Street, Bakersfield, CA 93308 (805) 861-2761 Business Name: ?~~¿l>d l Location: ¿¡;I a- I (~-f.-e._ I-...~ , BusJness Phone: 3 ~3/óõrJ II> # 3 f 1'5 DATEi/ J..'3 /.5...l- Key Map j~3 Sec, I~-A: / '\ INSPECTION SUMMA",RY ¡, ANNUAL Jc- EXEMPTION _ RE- INSPECTION COMPLAINT ~ /' ALL ITEMS OK: [)oJ VIOLATIONS NOTED: [ o - Does Not Apply 1 - In Compliance 2 - Co~~ection Needed 3 - Ve~bally Warned 4 - N,O.V. 5 - Citation 6 - Referred To (Specify) EMERGENCY RESPONSE PROCEDURES PREVENTION & CLEANUP PROCEDURES A. Local Agency Notification Plan ( B. Employee Notification & Evacuation ± c, Release Mitigation P~ocedu~es D. Emergency Medical Assistance E, Housekeeping & Work A~ea Safety F. Fire Extinguishers & Fixed Systp.ms G. Minimization & Cleanup Equipment H. Emergency Fire Water Supplies I f HAZARDOUS MATERIALS TRAINING INVENTORY & DIAGRAM VERIFICATION I, Employee Training Records 1 J, MSDS Availability & Familiarity ± K, Personal Protective Equipment L. Hazardous Material Permits M. Utility Connections & Shutoffs N. Aboveground Tank & Containe~ Labeling O. Quantities, Locations, & Separations p, Othe~ J =t~ f Comments: \ .4// ~~r ~ --------.... O'r~¡r- ¡;; co '" o ... .------.--.- --.-.--- --,---------- > ., a: ; C] earance Granted ~l or C ~ Started~:OO II) ... .. N o co II) Re-Inspection Required r On / / D,E,_..._ 7:¿?GJ Total Time_:~ No, of racilities_____ [S ] cO~R~f~~~L .--.---. no ~ Ü::Milf's on Inspection Printed Name ------ ~-- \'-:\) />~ KER~OUNTY~IRE JlPARTMENT HAZ~DOUS MATERIALS BUREAU INSPECTION REPORT 5512 Victor Street, Bakersfield, CA 93308 (805) 861-2761 ;~_'1-., '.- Bus i nes s Name: ?Ac:., 0 c.. 1>-d I Business Phone: 3 ~3-()O I d II> # 31-1'5 Location: 1!.-¡alt.Jltfe f.-...IA DATE----Ï-/ J..1 /.5..1- Key Map /ól-3 Sec. I%-A INSPECTION SUMMARY: ANNUAL;k:- EXEMPTION RE-INSPECTION COMPLA£NT ALL ITEMS OK: [)c] VIOLATIONS NOTED: [ o - Does Not Apply 1 - In Compliance 2 - Correction Needed 3 - Verbally Warned 4 - N,O.V. 5 - Citation 6 - Referred To (Specify) EMERGENCY RESPONSE PROCEDURES PREVENTION & CLEANUP PROCEDURES A, Local Agency Notification Plan , 8. Employee Notification & Evacuation ± c, Release Mitigation Procedures D, Emergency Medical Assistance E, Housekeeping & Work Area Safety F. Fire Extinguishers & Fixed SYHtems G. Minimization & Cleanup Equipment H. Emergency Fire Water Supplies 1 U T 1 - ~ HAZARDOUS MATERIALS TRAINING INVENTORY & DIAGRAM VERIFICATION 1. Employee Training Records i J. MSDS Availability & Familiarity ± K, Personal Protective Equipment L. Hazardous Material Permits M. Utility Connections & Shutoffs N. Aboveground Tank & Container Labeling O. Quantities, Locations, & Separations P. Other ! Comments: \ .ß // ~p'<.r ~ -n-- =1= 1- Or c.Le/ '" CIO "- o ... ,; Q) a: ; CJ earance Granted f/QI ., ~ Started~:OO ______..__·_·4 -- .-.-- -. -- - --.. ---.- .------.--- Re-Inspection Required r \ e,~/7 <:;;-h, /3 ~ '" / On / / D,E, --.-- In ... <f N ~ Inspt~ctor In ~ ii:Milf'S on Tnspection ..-' Total Time_____: :5c; No, of Facilities -- ----.-----.- --. Printed Name ------ r-t'- " e e KERN COUNTY FIRE DEPARTMENT 5642 VICTOR STREET BAKERSFIELD. CA 93308 I "'Pt!C'..; Ç( <'. 6<" J.l BUSINESS NAME ID#_ ~J..I ~ _ _ INSPECTOR QUESTIONNAIRE BUSINESS PLAN AS A WHOLE FOR USE WITH THOSE BUSINESSES COMPLETING A BUSINESS PLAN (2A), INSTRUCTIONS: 1. Complete this form only once for each occupancy. 2. Attach this form to BUSINESS PLAN (2A) and forward to Data Entry. BUSINESS PLAN VERIFIED ON: 1 / ~3 / í I SECTION 1: RESPONSE SUMMARY (Limit to 4-5 lines) ~/<=-t'4./tL t!e."LJr.a I '" rPc. e ¡;; C, /J¡/ I S J;""'" LA f} , 1ß-y¡ Ie 75..o//:rt ~ 5 'b -t, r C e-I ~ 12 A C/ I:. s -=z;¿ es~1 r / re: r 6 e//le.,r/J-1ö r SECTION 2: NOTIFICATION / EVACUATION OF AFFECTED PUBLIC (Limit to 13 lines) Pe'5:/ c::Ief/l ~ eJ 4 (/; £~¡a~'7-¿ £ J ~ v---I~ 0-- f 73'01_ j ./ (c// v~ HMCU-:Q e e ..xD# 3'1:f ACUTELY HAZARDOUS MATERIALS REGISTRATION FORM THIS FORM MUST BE COMPLETED BY THE OWNER OR OPERA TOR OF EACH BUSINESS IN CALIFORNIA wmæ AT ANY TIME HANDLES ANY ACUTELY HAZARDOUS MATERIAL IN QUANTI I1ES GREATER TIlAN 500 POUNDS, 55 GALLONS OR 200 CUBIC FEET OF GAS AT STP.l THIS FORM SHALL BE COMPLETED AND SUBMlTfED TO YOUR LOCAL ADMINISTERING AGENCY, (§25533 & 25536 Health & Safety Code) Note Instructions on reverse Business Name PA&R6 ŒLL Business Site Address ( II 0 ( W HI íC' LA AlE; ~.£Ll) . PM-lRC BBLL ~ . Business Mailing Address (If different) fb l3f'¥ 7(L;3f,.IEf?í 5tJ.:Ç;1'fJ RzIttJ(' ..l.£Cl5 J . . Business Phone fb;" - 393 - DO I ð . Business Plan Sub_slon Date2 I 'J-- I L/- v 89 Process Deslgnåtlon3 STOf2A.&£ E!It:r1E:/U~-~DBy Po~ ACUTELY HAZARDOUS MATERIALS HANDLED4 -USE ADDITIONAL PAGES IF NECESSARY· CHEMICAL NAME QUANTITY f3Æ=[T8e Y E1-£c::[72è¿VT£.. (4-7% ~ &FUI2Ic.. N!..tr» 3 7 Z Go A:L.LlJA.¡Ç _ (2}Ç:; '78 t?ò2A.JlOS) ~~~w,@ rõl~~ \N " ,q9\ ()C,t ~ . \oACÛ '" ~c'O GENERAL DESCRIPTION OF PROCESSES AND PRINCIPAL EQUIPMEN-rS: ~LyrEr' I~~IV~ IA.{ ~TG2Aé£ ~I'E~ IN}) U%Ð /Y2-;;;~ f::JtZ{)ER- II E-AT(&2I:£-s' -1-~ ç;Ee.Uea:; /AL' :=;:;¡?ECYlrtLy JE;;:{GAIE-D Bf'rllBU¡ ;27fCt:ç WkccH uJðf<K.. /AC ~¿If./'.::JlI#'c--TZðV Wtn+ ~QJtlÆ:t~ Be/t(YlJqw SIGNATURE ~-/~ PRINTED NAME ~o/ ~ MLE ~ LlM#t-~ DATE 912171.!)f California Office of Emergency Services FORM HM 3m {1-15-88) e e ~ Superscripts: " 1. Quantities for RMPP compliance are "equal to or greater than" the minimwn criteria and apply to chemicals handled "at anyone time", 2, Busiuesses 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 file. 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 fadlities that can most easily report by process, Thus, facility RMPP registration data could be submitted in a similar fannat to 8 business plan that is divided by process, "By process" data can initiate an emergency respo~ to 8 process incident rather than 8 general emecgency response to a major facility, Process desi¡maùon can simplify inspections for major facilities and improve future emergency response. 4. Refer to the EPA list of Exttemely Hazardous Substances from the Fedenl Register (Volwne 52, No. 77, p. 13397 ~, April 22, 1987), Each chemical has 8 threshold planning quantity, This list may be changed by EP A on an annual basis, Updates of this list may be available early in 1988, To comply with this element, you may attach 8 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 quanùties equal to or in excess of 1) SOO pounds, and 2) any EPA threshold planning quantity less than 500 pounds. 5. Do not include Trade Secret information in these descriptions, General: For emecgency response purposes, it would be desirable to describe the following to the Administering Agency: 1. Batch Process: 8, What raw materials? b, What operating pessure range? c, What operabng ttmpera&ure range? d. Batch capacity I'8ÔJ1g? e, Product cbaracttristìcs (e,g" chemical state, flammability, toxicity, etc.) f, Critical pocess poinIs and characteristics? 2, Continuœs pt-~~ {~,,:,,:1, - =~tion as abõT-ic,} NQIE: "Pursuant to 125534, die Adminisfaing Agerv;y may require the submission of 8 Risk Management Prevention Program (RMPP), if the ,4dmini~ AgeøJ:y defamiDes that 1hc bandJer's operation may preacnt an acutely hazardous materials accident risk. The bandler sba1l pIeIWe the RMPP in ICCCrdance wUb subdivisiœ (c) [of 125534], The RMPP shall be prepared within 12 mœths foUowiøg 1hc request made by d1e Administering Agertl:.y pursuant to this section. " (I 25534 (8) Hea1Ib and Safety Code) An amendment to the RMPP must be submitted to the Administering Ageœy within 30 days of: 1, Any Iddilional bIndling of ecute1y bazaRbJs maœria1s. 2, Any marerial 01' subsaanûal alteraâons 10 business activities, 3, Changc eX address, hnmness owocrsbip, or "lm~ name, (125533 (c) Health & Safety Code) · EVERY BUSINESS REQUIRED TO SUBMIT AN RMPP SHALL IMPLEMENT THE APPROVED RMPP · California Office of Emergency Services FORM HM 3m (1-15-88)