The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN 6/6/2008i~ California Water Srv 043-02 - - - - - - _ _ _ ~ 1111 6th St ,; n _ ~_ Hazardous Materials/Hazardous Waste Unified Permit - CONDITIONS OF .PERMIT ON REVERSE SIDE .~7~5 C~c~r Ave., ~r8 ~]oor APP~v~bY: ' / F..H. , J / --" ~~ " /18TH Sir _~ 1.9' 8LDG ~ ~ ' _ ,'~°~',u~' ,~ , ~' I ~ §~ ~ - - -- ~ - ~/~ -- ~ --"- ~ I I~ ~ ~ ~ · '~ ST~ ~ -~. 8TH ST ~ ~TJOZ. J" ..~..,.I , ~ ~ ,~ I ;"~ :~ ~ 4TH I I '~ET '' ,. 3 CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 Manager TIM TRELOAR Location: 1111 6TH ST City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: (661) 837-7200 Map 103 CommHaz High Grid: 31A FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / DISTRICT MGR (661) 837-7200x (661) 837-7200x ( ) - x RSs Contact BILL ROSICA MailAddr: 3725 S H ST City BAKERSFIELD Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone / Title / ASST DIST MGR (661) 837-7271x (.661) 837-7271x ( ) - x Fire Press ImmHlth 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 - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK Based on my inquiry of thosx~ inciivie3uais responsible for obtaining the information, 1 certify under penalty of !aw that I have personally examined and am familiar with the ir~farmation submitted and believe the information is true, accurate, and complete. o~.~-c,o. ) 17 S' ature Dat ..~~~. ~ ® 200 Gal Gal TotalASTs: _ TotalUSTs: _ RSs: Yes -1- 07/10/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE F P IH L 200.00 GAL Hi -2- 07/10/2007 -3- 07/10/2007 z. ~ F CALIFORNIA WATER SRV 043-02 ~ Inventory Item 0001 ~ COMMON NAME / CHEMICAL NAME I SODIUM HYPOCHLORITE Location within this Facility Unit STATE TYPE PRESSURE Liquid TMixtur~ Ambient SiteID: 015-021-001939 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 7681-52-9 TEMPERATURE CONTAINER TYPE Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL - r~~r~tcuuua uurirulv~iv 15 %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7861529 riHGAKL A5~~J51~1~1v"1.~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Hi -4- 07/10/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/11/2006 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. Employee Notif./Evacuation 02/26/2007 L;fNMANNED SITE . Public Notif./Evacuation 05/11/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan MERCY HOSPITAL, TRUXTUN AVE. 08/03/2006 -5- 07/10/2007 r F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/11/2006 ~ SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment THE SODIUM HYPOCHLORITE TANK HAS SECONDARY CONTAINMENT. 04/06/1999 1..1 CCL11 V~J i 1. V 1..1161 itC7V UtVC !'11~1~1VQ1.1 V11 -6- 07/10/2007 F CALIFORNIA WATER SRV 043-02 SitelD: 015-021-001939 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~rct:iai nci~aiu~ Utility Shut-Offs 08/03/2006 A) ELECTRICAL - MAIN BREAKERS IN ELECT PANELS B) WATER - WATER WELL C) LOCK BOX - NO Fire Protec./Avail. Water 08/03/2006 FIRE HYDRANT - WELL DISCHARGE Building Occupancy Level 02/27/2006 UNMANNED SITE. -7- 07/10/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08/03/2006 ~ MSDS SHEETS ON FILE IN ELECTRICAL PANEL. BRIEF SUMMARY OF TRAINING PROGRAM: DAILY SITE VISITS ARE MADE BY PUMP OPERATORS TRAINED IN HAZMAT REPORTING PROCEDURES. MONTHLY COMPANY SAFETY PROGRAMS ADDRESS HAZMAT TRAINING. rayc c Held for Future Use Held for Future Use -8- o~/l0/200~ UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and-Inventory Program ~ ; ~~~ ~ ~m-~ Prevention Services B ~ F'R s >: , n 900 Truxtun Ave., Suite 210 Fief Bakersfield, GA 93301 aernlr Tel.: (661) 326-3979 Fax: ~ (661) 872-2171 FACILITY NA~' ~ ~~~~ !~ ~ ~~~ ~ F/ /L ~O~ _t,/) IN ~ CT~~~~ INSPECTION!/TyIME Jr ^ ADDRESS ~ l l ~- ~ ~ PHONE NO: '~ ~~ ~ ~~e' NO OF E M PLOYEES .~-.. FACILITY CONTACTS ~ BUSINESS ID NUMBER 15-021-t'jG(.~~~ 7 Il>~ ~ /~ ~ Section 1: Business Plan and Inventory Program - I C11//f~OUTINE l ^ .COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INS CTION n 1' 1 I C V (c=compliance OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ Q~ BUSIrIeSS PLAN CONTACT INFORMATION ACCURATE /~~,•~e ~N~d ~il~s u ~.~T~ G CCU'" ^ VISIBLE ADDRESS 0'' ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS E ~ ^ VERIFICATION OF QUANTITIES , ~ / Cf ^ VERIFICATION OF LOCATION ~^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITY ..~ ^ ^ VERIFICATION OF HAZ MAT TRAINING ~ ~ ~ 9Q~ L i~ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~ ^ CONTAINERS PROPERLY LABELED 0~ ^ HOUSEKEEPING 1~^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ Y,,EyyS C~IVO EXPLAIN:~'5~~~~`~~~~! QUESTIONS REGARDI TH INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1~` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~f. ;: CALIFORNIA WATER SRV 043-02 Manager TIM TRELOAR Location: 1111 6TH ST City BAKERSFIELD CommCode: BFD STA 06 EPA Numb :~, SiteID: 015-021-001939 BusPhone: (661) 837-7200 Map 103 CommHaz High Grid: 31A FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR 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: RSs Fire Press ImmHlth Contact BILL ROSICA Phone: (661) 837-7278x MailAddr: 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (661) 837-7200x Address 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: PROG A - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK ®h~o~l on my inquiry of those individuals respori~lble for obtaining the information, I certify under penalty of law 4hat I have personally examined and am familiar with the information submitted and bell@ve the information is true, accurate, and complete. . ~~ _ , .~ i nature Dat EN~~ ~~~ 2 6 ~nn uO7 -1- 01/26/2007 ~~ ~ F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE F P IH L 200.00 GAL Hi -2- 01/26/2007 -3- 01/26/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers~at Site ~ COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# _7681-52-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7861529 L1tiL~tiRL H J.7 P~J J1"1L,1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Hi -4- 01/26/2007 r. F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 05/11/2006 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. _ , ~ ,., r~u~N.i.vycc-1c ivv~.ii . ~ .r~va~ua~.ivt1 U -~I NL t~NNQt~ J J'd.~fON Public Notif./Evacuation 05/11/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan 08/03/2006 MERCY HOSPITAL, TRUXTUN AVE. -5- 01/26/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 05/11/2006 ~ SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment THE SODIUM HYPOCHLORITE TANK HAS SECONDARY CONTAINMENT. 04/06/1999 t.1C0.11 V~J V 1.11CL lCC wS"V ULLC LiC:L1VCL l.1 Vll ' -6- 01/26/2007 F CALIFORNIA WATER SRV 0~3-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ a~CC:ia.L na~ctiu~ Utility Shut-Offs A) ELECTRICAL - MAIN BREAKERS IN ELECT PANELS B) WATER - WATER WELL C) LOCK BOX - NO 08/03/2006 Fire Protec./Avail. Water FIRE HYDRANT - WELL DISCHARGE 08/03/2006 Building Occupancy Level i:fNMANNED SITE . 02/27/2006 -7- 01/26/2007 F CALIFORNIA WATER SRV 043-02 SiteID: 015-021-001939 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08/03/2006 ~ MSDS SHEETS ON FILE IN ELECTRICAL PANEL. BRIEF SUMMARY OF TRAINING PROGRAM: DAILY SITE VISITS ARE MADE BY PUMP OPERATORS TRAINED IN HAZMAT REPORTING PROCEDURES. MONTHLY COMPANY SAFETY PROGRAMS ADDRESS HAZMAT TRAINING. rayC ~ Held for Future Use nciu ivi ru~uic ~~c -8- 01/26/2007 (HMMP) HAZ-~DO~~S MATERIALS MANAGEMENT PLAN APPLICATION FORM FOR BUSINESSOWNER/OPERATOR IDENVTIFICATION FORM (HAZARDOUS MATERIALS FACILITY INFORMATION H fl R S P 7 D FJIPB A~ T Page 1 of 2 Bakersfield Fire Dept. FIRE PREVENTION 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 Fax: (661) 852-2171 n~~ I. FACILITY IDENTIFICATION FACILITY ID NO. 1 5 X 2 1 0 0 1 9 3 9 ' ear eginning ,o0 2006 2006 ,o, Year Ending USINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 California Water Service Co. (Station 43-02) USINESS PHONE (661) 8.37-7200 ~~ ITE ADDRESS ,IX3 1111 6th Street ITY Bakersfield 1oa cA IP 93304 '~ UN 8 BRADSTREET ,os IC CODE ,o~ ouNTV Kern 108 PERATOR NAME California Water Service Company '~ OPERATOR PHONE (661) 837-7200 „o II. OWNER INFORMATION WNER NAME California Water Service Company,,, OWNER PHONE (661) 837-7200 12 WNER MAILING ADDRESS 3725 South H Street 13 ITY Bakersfield „4 STATE California „5 ,P 93304 1e III. ENVIRONMENTAL CONTACT ONTACT NAME Bill Rosica ~~~ CONTACT PHONE (661) 8.37'7278 178 ONTACT MAILING ADDRESS 3725 South H Street „8 ITY Bakersfield ~ ,~ STATE California ,2, zIP 93304 '~ -PRIMARY IV. EMERGENCY CON TACTS -SECONDARY- AME Tim Treloar 123 AME Rudy Valles '28 ITLE District Manager 124 ITLE Assistant District Manager '2g USINESS PHONE (661) 837-7200 125 USINESS PHONE (661) 837-7271 130 4-HOUR PHONE (661 ~ 837-7200 126 4-HOUR PHONE (661) 837-7271 ~j ~ ~~ 131 "" o PAGER No N/A 127 AGER No N/A 132 V. CERTIFICATION ertification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally xamined and am familiar with the information submitted in this inventory and believe the information is true, accurate, and complete. IGNATURE OF OWNER/OPERATOR 133 ATE 134 /2/06 NAME OF DOCUMENT PREPARER Bilt Rosica 135 AMES OF OWNER/OPERATOR (print) 136 Bill Rosica ITLE OF OWNER/OPERATOR 137 Environmental Affairs Project Manager FD2089 ,~ HMMP) HAZ/#~DOU~~ MATERIALS MANAGEMENT PLAN t- SITE A FACILITY DIAGRAM Page l of l Station BK-43-02 Business Name: Business Address 6~' Street r________________________________________I 1 1 I I 1 I I I I I I I ------------------ ------1 I ~ I 1 I I I 1 1 I 1 1 I 1 I 1 I cal 1 ~ 1 1 1 Well Chlorine ; I I ; 43-~2 ; I I 1 1 I 1 1 1 I 1 I I 1 1 1 1 1 I I 1 1 1 1 I I 1 1 I 1 I 1 1 Eleotrical I , 1 , I 1 1 I I I I I I 1 I I 1 I 1 I 1 •--------------J I 1 ~ I 1 1 1 1 I ________________________________________' L-------------------------------------- ------_ I Chain Link 4 NORTH B B R S A I D F/R6 ARTM T Bakersfield Fire Dept. FIRE PREVENTION 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 Fax: (661) 852-2171 SITE DIAGRAM FACILITY DIAGRAM California Water Service Company _ ___ _ _ 11116th Street Please indicate direction of North -a, ~. + CALIFORNIA WATER SRV 043-02 _________________________ SiteID: 015-021-001939 + Manager Location: 1111 6TH ST City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: E~37-72~U Bus Phone : ( 6 61) '' ^~-'~n Map 103 CommHaz High Grid: 31A FacUnits: 1-AOV: SIC Code:4941 DunnBrad:00-691-3578 +______________________________________________________________________________t Emergency Contact / Title Emergency Con act, / Title TIM TRELOAR / DISTRICT MGR 9Zu~.( ~CbII~S / ASST DIST MGR Bus ine s s Phone : ( 6 61) ' ^ ~ `' ^ ° ^-v t~'37Jza Bus ine s s Phone : ( 6 61) 3-96 =A~ ~3~ ~7 Z 2 4 -Hour Phone ( 6 61) "" `~ " "-°-^s=fa37, 7u~G 2 4 -Hour Phone ( 6 61) 3~-6 `~ro~E/,37 ~7 ~ ~ ~z~~ Pager Phone (, ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth Contact N ~= I ~ ~ SiCla Phone : ( 661) 3-9~-~8~63c MailAddr: 3725 S H ST State: CA X37-7L7~j City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (661) 396-2400x Address 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: _ Gal Preparers TotalUSTs: = Gal Certif~d: RSs: Yes ParcelNo: Emergency Directives: ~/ PROG A - HAZ WASTE GEN ~~ PROG T - ABOVEGROUND STORP~GE TANK based on my inquiry of those individuals responsible for obtaining the informatioe~rsonally under penalty of law that I have p examined and am familiar with the information submitted and believe the information is true, accurate, and complete. Date Si ture 6Yj~q~G o4?0 O6 ~~~~ 5~° -1- 05/11/2006 CkLIFORNIA WATER ~$~A4~--02 == SiteID: 015-021-001939 anager : MELVIN BYRD BusPhone: (661) 396-2400 ocation: 1111 6TH ST City : BAKERSFIELD ~ ~ Map : 103 CommHaz : Moderate Grid: 3lA FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:4941 EPA Numb: DunnBrad:00-691-3578 += ~ Emergency Contact / Title Emergency Contact / Title MELVIN BYRD / DISTRIC'I' MGR TIM TRELOAR / GEN SUPER Business Phone: (661) 396-2400x Business Phone: ·(661) 396-2400x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x ....................................... + ...................................... Hazmat Hazards: RSs ~ ·' ,Fire Press ImmHlth ................................ , .............................................. Contact : Phone: (661) 396-2400x MailAddr: 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 +- -+ Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x Address : 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 · Period to TotalASTs: Gal : reparer TotalUSTs: = Gal ertif'd RSs: Yes arcelNo Emergency Directives: District Manager-Tim Treloar Asst. District Manager-Bill Harper Contact Person-Tamara Johnson Same Phone Numbers 4- -1- 07/30/2003 Location: 1111 6TH ST Map : 103 CommHaz : Moderate City : BAKERSFIELD Grid: 3lA FacUnits: 1 AOV: CommCode~ BAKERSFIELD STATION 06 SIC Code:4941 EPA Numb: DunnBrad:00-691-3578 ' Emergency Contact ~/ Title Emergency Contact / Title MELVIN BYRD / DISTRICT MGR TIM TRELOAR / GEN SUPER Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth Contact-: Phone: (661) 396-2400x MailAddr: 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x Address : 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: Yes Emergency Directives: ~ Hazmat Inventory One Unified List [--- As Designated Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax IUnitlMCP CHLORINE F P IH L 200.00 GAL Ext reviewed ~he attached hazardous rnmerials manage- rnen~ plan for c_,.,.~--~ and tha~ i~ along with (Name of Business) any corrections constitute a complete and cormc~ man- agement plan for m~, facili~,. "~Si' ~gnatur~t''' " '~' Iq -o ,3 Date -1- 07/19/2000 CALIFORNIA WATER SERV CO STA43-02 SiteID: 015-021-001939 F Inventory Item 0001 Facility Unit: Fixed Containers at Site COMMON NAME / CHEMICAL NAME CHLORINE Days On Site SODIUM HYPOCHLORITE 12.5% 365 Location within this Facility Unit Map: Grid: FENCED ENCLOSURE NEXT TO PUMP CAS# 7882-50-5 F STATE [ TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Above Ambient Ambient ABOVE GROUND TANK ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 12.50 Chlorine (EPA) Yes 7782505 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Ext 2 07/19/2000 CALIFORNIA WATER SERV CO STA43-02 SiteID: 015-021-001939 Fast Format ~ Notif./Evacuation/Medical Overall Site Agency Notification 04/06/1999 CAL 911 AND (800) 852-7550 OR (916) 427-4341. Employee Notif./Evacuation 04/06/1999 N/A - UNMANNED SITE. Public Notif./Evacuation 04/06/1999 WE WOULD PREFER TO RELY ON EMERGENCY SERVICES PERSONNEL TO DETERMINE IT AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan 04/06/1999 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. 3 07/19/2000 CALIFORNIA WATER SERV CO STA43-02 SiteID: 015-021-001939 Fast Format ~Mitigation/Prevent/Abatemt Overall Site Release Prevention 04/06/1999 SODIUM HYPOCHLORITE IS STORED IN AN ABOVE GROUND SECURE AREA. Release Containment 04/06/1999 THE SODIUM HYPOCHLORITE TANK HAS SECONDARY CONTAINMENT. Clean~Up Other Resource Activation -4- 07/19/2000 CALIFORNIA WATER SERV CO STA43-02 SiteID: 015-021-001939 Fast Format F Site Emergency Factors Overall Site Special Hazards Utility Shut-Offs 04/06/1999 A) GAS - N/A B) ELECTRICAL - SERVICE BOX LOCATED INSIDE FACILITY C) WATER - N/A D) SPECIAL - N/A E) LOCK BOX - NO Fire Protec./Avail. Water 04/06/1999 PRIVATE FIRE PROTECTION - NEAREST FIRE HYDRANT - ON SITE WELL DISCHARGE. Building Occupancy Level 5 07/19/2000 CALIFORNIA WATER SERV CO STA43-02 SiteID: 015-021-001939 Fast Format F Training Overall Site Employee Training 04/06/1999 WE HAVE NO EMPLOYEES AT THIS FACILITY - UNMANNED SITE. WE HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE COMPANY PROVIDES THE FOLLOWING TRAINING: 1. SAFETY PROCEDURES IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR THREATENED RELEASE. 2. HAZARD COMMUNICATION STANDARD. 3. EVACUATION PROCEDURES. 4. PROPER HANDLING OR HAZARDOUS MATERIALS. 5. HMMP IMPLEMENTATION. Page 2 Held for Future Use Held for Future Use 6 07/19/2000 ! 1'7 o. OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 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 LOCATION: ~ 4%-02 CITY: ~,x~s~ e~D STAT~ . Z~~ D~ & B~ST~ET ~ER:OO- P~Y ACTIVITY: ~o~kr OWNER: ~-'.~ ~-,~ ~= MAILING ADDRESS: SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES' t'.- { o ,,-t~.. - Ct ~,-, t~n ~l ~--:o ~--r~_. MATERIAL SAFETY DATA SHEETS ON FILE: SECTION 4: E~TION ~O~ST I CERT~Y ~ER PEN~TY OF PE~Y T~T ~ BUS,SS IS E~T ~OM T~ ~PORT~G ~Q~~S OF C~TER 6.95 OF & S~ETY CODE" FOR T~ FOLLO~G ~ASONS: ~ DO NOT ~LE ~~OUS ~~S. ~ DO ~LE ~~OUS ~TE~S, BUT T~ QU~IT~S AT NO T~ EXCEED T~ ~ ~PORT~G QU~TIT~S. OT~R (SPECWY ~ASON) SECTION 5: CERTIFICATION I, l~t-,~ ~--~__-C'~=~: ~'~_ CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TH/S INFORMATION WILL BE USED TO FULFILL MY FIRM' S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. SIGNATURE TITLE DATE 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: C'~A t_ ~ ~ ( I A.~! D B. EMPLOYEE NOTIFICATION AND EVACUATION: C. PUBLIC EVACUATION: HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: ~'o~a~l~l bl'-rC~Oc~t-,..%~ B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: b-4 /Ilk ELECTRICAL: ~~,~r..~. ~-~: L.~--r~!~ ~,.l~ ~c:,~ ~'~<:: ~ 'r'~ WATER: 'INI /jN SPECIM_,: NI/,a, . LOCK BOX: YE~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): 4 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERIALS INVENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] FACILITY NAME ~-r-~. A'~ SITE ADDRESS [ {{I $'~--" ~W-. ~ ['X,r[ CITY i::~. ~=.o_~r'~--t~t._O STATE NAT~ OF BUS.SS ~~~ ~ ~ SIC CODE ~ ~ ~ I D~ & B~ST~ET ~ER MAILING ADDRESS ~-t ~Z~ ~---'~om-~ M ~'r-. CITY ~~,~'~'t ~=,--o STATE ~ · ZIP .cz'0~E, o ZI EMERGENCY CONTACTS BUS--SS PHO~~~S ~' ~ OO 24 HO~ PHO~~ ~~ ~ N~ ~l ~ T~ ~~ TITLE ~~~m~~a t~~~ 1 l) ~OKY ~TA~S: N~w ~ AddiSon [ ] K~sion [ ] ~l~on [ ] C~ if~ is ~ NON T~d~ 8~ ~] ~ ~t [ ] 2) Co~on N~e:~ ~ ~ ~ 3) ~T ~ (op~o~) ] 4) Physi~ & He~ P~SIC~~{~ ~a~ard Catego~es Fife [ ] R~cfive [ ] Sudd~ Rel~ ofPres~e [ ] ~e~ate H~ (Acute) [ ] ~lay~ 5) WAS~ CLASSWICA~ON (3~igit c~ from DHS Fo~ 8022) USE CODE 6) P~SIC~STA~ Solid [ ] Liquid ~ G~ [ ] 7) ~O~ ~ ~ AT FAC~Y ~S OF ~S~ 8) STOOGE CODES M~Daily~o~t ~ Lbs[ ]G~[~3[ ] a)Coa~: Av~age Daily ~o~t ~ C~es [ ] b) ~es~e: ~ ~o~t ~ ~ c) T~a~e L~gest S~e Container ~ ~ g Days on Site ~ Cffcle ~ch Mon~: ~1 Y~, J, F, M, ~ ~ J, J, ~ S, O, N, D 9) ~~: List CO~O~ CASg · e ~ee most h~dous 1 ) [ ] ch~l com~n~ts or 2) [ ] ~y ~ componems 3) [ ] 10)LOCA~ON ~ 1) ~ORY STA~S: New [ ] Addition [ ] Revision [ ] Deletion [ ] Che~k if~he~al is a ~ON Trade ~et [ ] T~ ~et [ ] 2) Co--on N~e: 3) DOT ~ (optio~l) Chef,al N~e: 4) Physical ~ Heal~ P~SIC~ H~aCate~ones E~e[ ]Reaotive[ ]SuddenRel~ofPress~e[ '] 0[ ]~l~y~K~(C~o~)[ ] 5) WAS~ CLASS~ICA~ON (3-digit code from DHS ~o~ US~ CODE 6) P~SIC~STA~ Solid[ ] Liquid[ ] Gas[ ] ~e[ ] ~e[ ] Waste[ ] ~,e[ ] 7) ~O~ ~ ~ AT ~AC~Y O~ ~AS~ 8) STO~G~ COD~S Ma~ Daily ~o~t ] Gal [ ] ~3 [ ] a) Con~er: Average Daily ~o~t C~s [ ] b) Press~e: ~1 ~o~t c) Tem~m~e L~est Size Con~iner ~ Days on Site Circle ~h Monks: ~1 Ye~ ~, E, M, A, M, ~, ~, ~ ~, O, ~, D 9) ~~: List CO~O~ CASg % · e ~ee 1 ) [ ] che~cal or 2) [ ] 3) [ ] lC I ceni~ ~der pen~w of law, ~at I have personally exmed ~d m f~li~ m~ ~e ~fion on ~s ~d ~I a~h~ d~mm. I believ~ ~e sub~ue~ ~b~ation is ~e, acc~ate ~d complete. P~ Nme & Iifle of Auto.ed Comply Repres~mhve Si~e Da~