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Home My WebLink AboutBUSINESS PLANW 5 ti x~ w~., ~:~ 3~ aN ~ a V ~I _- -- '~ I~ ti i, i y UNIFIED PROGRAM INSPECTION CHECKLIST any :.:. Fnw':o-.= :?F,b 4Wn3..q ti..RTV':•.• a - .. .:..~-., .. ...,;. ... e:~n .SECTION 1: Business Plan and In~ntory Program BAKERSFIELD FIRE DEPT Prevention Services vitas 900 Truxtun Ave., Suite 210 ~,R1rN Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME /~ GL}Lr re I~Nt ~ [,U ~4 -- G~ SL.R-V 1 Cc Q"! ~Q ~ NSPgE ION ATE l 2Z ~ INSPECTION TIME 1bt c^t - ADDRESS ~~ ~ l~.J y( ~ ` 1 HO ENO O OF EMPLOYEES FACILITY CONTACT ~ USINESS ID NUMBER 15-021-D~Z3 7 Section 1: Business Plan and Inventory Program ~3~~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ' ^ COMPLAINT ~^ RE-INSPECTION r ~ C V (c=complia"°e) OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ~v N ~ ~ ~' ~-rG ^ ^ BUSIt18SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ . VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ENT ~ ~ V 0 ~ X006 ^ ^ ^ ^ 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 ANY HAZARDOUS WASTE ON SITE? ^ YES ~NO EXPLAIN: ~UESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 926-3979 Inspector (Please Print) Fire Prevention / 1" In / Shift of Sile/Station if WMte - Prwention Sarvieas Yellow -Station Copy Pink - Buainesa Copy FD204e (Rw. ~f05) + CALIFORNIA WATER SRV 093-0~1 ________________________= SiteID: 015-021-002371 + Manager TIM TRELOAR Location: 428 20TH ST (S~c~ 93-ot) City BAKERSFIELD BusPhone: (661) 396-2400 Map 103 CommHaz High Grid: 30B FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:4941 DunnBrad:. Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR B~bB-H~i~PER IZuc1y V~lles / ASST DIST MGR Business Phone: (661) 39~6~-2400x Business Phone: (661) ___ ______ 24-Hour Phone ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth Contact ~tll `l~os~~cA Phone: (661) ~3~b---2.4-6~A~c MailAddr: 3725 H ST State: CA e37-72~g City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (661) 396-2400x Address 3725 H ST State: CA City BAKERSFIELD Zip 93304 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT Based on my inquiry of those individ~.z-: responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. EN~`® BAR 16 X006 -- 3 0 6 Si ~ ture Da e -1- 02/27/2006 ;,~ °e CALIFORNIA WATER SRV 093-01 Manager TIM TRELOAR Location: 428 20TH ST City BAKERSFIELD CommCode: BFD STA 04 EPA Numb:` SiteID: 415-021-002371 BusPhone: (661) 396-2400 Map 103 CommHaz High Grid: 30B FacUnits: 1 AOV: SIC Code:4941 DunnBrad: Emergency Contact TIM TRELOAR Business Phone: 24-Hour Phone Pager Phone Hazmat Hazards: / Title / DISTRICT MGR (661) 837-7200x ( ) - x ( ) - x / Title / ASST DIST MGR (661) 837-7271x ( ) - x ( ) - x React 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) ""'~~~ Address 3725 H ST State: CA ~3~-7200 City BAKERSFIELD Zip 93304 Period to Preparers Certif~d: 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 believe the information is true, accurate, and complete. S' tore ~`' p 2e ~N~ ~ €'~~ ~ ~ ~Q07 Gall Gal Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone TotalASTs: _ TotalUSTs: _ RSs: No -1- 01/26/2007 .- ~ >, . t. F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE R IH L 200.00 GAL Hi -2- 01/26/2007 -3- 01/26/2007 C~ F CALIFORNIA WATER SRV 093-01 ~ Inventor-y Item 0001 COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Location within this Facility Unit AT PLANT STATE TYPE PRESSURE Liquid Mixture Ambient SiteID: 015-021-002371 ~ 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 ru~~tattLUUS ~ul~irviv~iv 1'S %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 tiF~GE~CL H55~SS1~1~1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -4- 01/26/2007 F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Employee Notif./Evacuation Public Notif./Evacuation Emergency Medical Plan 10/17/2006 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 01/26/2007 +~ F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/17/2006 ~ LIQUID CHLORINE - SECONDARY CONTAINMENT ' Release Containment 06/10/2002 LIQUID CHLORINE - SECONDARY CONTAINMENT Clean Up 10/17/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. ~,_ v~.iici nc~vui~.c ra~.~.s.va~.iv11 -6- 01/26/2007 F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ JjJCl.:1d1 ndGdl.lAe7- V 1.1111.y J11UL-V11.7 r 11C L'1 Vl.C l:. /tiVd11 Wdl~C1 Building Occupancy Level -7- 01/26/2007 ~: F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/17/2006 ~ MSDS SHEETS IN FIELD OFFICE AND STATION ELECTRICAL PANEL. BRIEF SUNIIKARY OF TRAINING PROGRAM: SITE VISITS ARE MADE DAILY BY PUMP OPERATORS TRAINED IN HAZMAT REPORTING PROCEDURES. MONTHLY COMPANY SAFETY PROGRAM ALSO ADDRESSES HAZARDOUS MATERIAL TRAINING. rctyC G Held for Future Use _, t_ nciu i.vi ru~utc voc -a- 01/26/2007 '+-r .. CALIFORNIA WATER SRV 093-01 Manager TIM TRELOAR Location: 428 20TH ST City BAKERSFIELD CommCode: BFD STA 04 EPA Numb: SiteID: 015-021-002371 BusPhone: (661) 396-2400 Map 103 CommHaz High Grid: 30B FacUnits: 1 AOV: SIC Code:4941 DunnBrad: 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 ( ) - x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth Contact BILL ROSICA Phone: (66'1) 837-7278x MailAddr: 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (661) 837-7200x Address 3725 H ST State: CA City BAKERSFIELD Zip 93304 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 c~;rtify under penalty of law that ! have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. cr?-~c~ 7 ~7~ S' ature Da e -1- 07/10/2007 F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE R IH L 200.00 GAL Hi -2- 07/10/2007 -3- o~/io/aoo~ 5 F CALIFORNIA WATER SRV 093-O1 ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Location within this Facility Unit AT PLANT STATE TYPE PRESSURE Liquid TMixture ~ Ambient SiteID: 015-021-002371 ~ 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 I Daily Average 200.00 GAL 200.00 GAL 200.00 GAL nt~~.ytcL~u~ ~vinrviv~ivla oWt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 r~~xxL t~~5~a~inr;lyla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -4- 07/10/2007 r F CALIFORNIA WATER SRV 093-01 SiteID: 015-021-002371 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification _~ r /r l:~ui~lvycc 1VV1.11 . ~ 1SV0.l.UCil.1V11 Public Notif./Evacuation Emergency Medical Plan 10/17/2006 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 07/10/2007 e i F CALIFORNIA WATER SRV 093-01 SiteID: 015-021-002371 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/17/2006 ~ LIQUID CHLORINE - SECONDARY CONTAINMENT Release Containment 06/10/2002 LIQUID CHLORINE - SECONDARY CONTAINMENT Clean Up 10/17/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. Other Resource Activation -6- 07/10/2007 i. ~ i F CALIFORNIA WATER SRV 093-01 SiteID: 015-021-002371 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7jJ~C;1d1 riclGdLU~ U1..1111..y ~Jllul.-V11.'. Fire Protec./Avail. Water DlAl ll1111y VI. I. U~l Qlll. ~/ 1.IC VC1 -7- 07/10/2007 (; ^f F CALIFORNIA WATER SRV 093-O1 SiteID: 015-021-002371 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/17/2006 ~ MSDS SHEETS IN FIELD OFFICE AND STATION ELECTRICAL PANEL. BRIEF SUMMARY OF TRAINING PROGRAM: SITE VISITS ARE MADE DAILY BY PUMP OPERATORS TRAINED IN HAZMAT REPORTING PROCEDURES. MONTHLY COMPANY SAFETY PROGRAM ALSO ADDRESSES HAZARDOUS MATERIAL TRAINING. rayC ~ nviu tvi r u~.uiC ~~~ Held for Future Use -s- 07/10/2007 UNIFIED PROGRAM INSPECTION CHECKLIST;: SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services e ~~~, ' D 900 Truxtun Ave. , Suite 210 ~R>rM r Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME INSPECT ON TE INSPECTION TIME ~~ 1 ~OQ~P.4 ~d4 i L~ S Z(e~l/fC~ nl IS 6 "7 ~ ~-^ v/. ADDRESS -~ ~ HON NO. NO OF EMPLOYEES y 20 `~ FACILITY CONS TACK ~ r ~ ' /L,LLo ~ ~ USINESS ID NUMBER 15-021- ~OZ3-7 Section 1: Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS _____ __ __ __ ___ Jam' ^ APPROPRIATE PERMIT ON HAND ~^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE UN M ~~~~ p ~~-D ~~~ ~ J ^ VISIBLE ADDRESS ~-- ~ ^ CORRECT OCCUPANCY ~, dG ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES I~ ^ VERIFICATION OF LOCATION ,^ Ig ,r ^ PROPER SEGREGATION OF MATERIAL Y / YX ^ VERIFICATION OF MSDS AVAILABILITY [ ~ ^ VERIFICATION OF HAZ MAT TRAINING - / l!d' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED EN ~ t ^ HOUSEKEEPING -„r ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ~O EXPLAIN: - __ _. _._ / _ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 lZ~~ ~of ~A I t ~{ Inspector (Please Print) Fire Prevention / 1`~ In /Shift of Site/Station # Business Site/School Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05)