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HomeMy WebLinkAboutBUSINESS PLAN 7/17/2007~ ~~. - ~ ~ ,CAL WATER SRVC CO. (185-01) 4820 EVE STREET \+ . "ry1. CALIFORNIA WATER SRV 185-01 Manager TIM TRELOAR Location: 4820 EVE ST City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: SiteID: 015-021-001671 BusPhone: (661) 396-2400 Map 124 CommHaz High Grid: 18D 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 (661) 837-7200x ( ) - X Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone Fire Press / Title / ASST DIST MGR (661) 837-7271x (661) 837-7271x ( ) - X ImmHlth DelHlth Contact BILL ROSICA Phone: (661) 837-7278x MailAddr: 3725 S H ST State: CA City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE 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 E~aGed on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of lavr that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. 7 »~ Si lure Da e TotalASTs: _ TotalUSTs: _ RSs: No /U~ '~ 02007 Gall Gal -1- 07/10/2007 2 ry F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-001671 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ -- Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE DIESEL FUEL F P IH L 200.00 GAL Hi F IH DH L 500.00 GAL Low -2- 07/10/2007 -3- 07j10/2007 F CALIFORNIA WATER SRV 185-01 SiteID: 015-021-001671 ~ ~ Inventory Item 0002 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~mbient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 200.00 GAL 200.00 GAL 200.00 GAL r1H~Hxl~vu~ ~V1~irVlvriv l owt. Rs cAS# 12.50 Sodium Hypochlorite No 7681529 riHGHKL H7a~aa1~1L'~tv1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME DIESEL FUEL Location within this Facility Unit AT PLANT Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 68476-34-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient .Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 500.00 GAL 500.00 GAL 500.00 GAL tiHGHtCLV U.7 1.V1~lYV1VL" 1V 15 %Wt. RS CAS# 100.00 Diesel Fuel No. 1 No 70892103 tiHGHKL H~~~551~1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 07/10/2007 F CALIFORNIA WATER SRV 185-01 SiteID: 015-021-001671 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification Prul~J1VyCC 1VV l.1l / ~VdC:tld l,l Ui1 rui.lll~: 1vvl.lt . / r,VdC:Udl.1CJ11 Emergency Medical Plan 10/18/2006 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 07/10/2007 F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-001671 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/18/2006 ~ DAILY SITE VISIT BY CWS PERSONNEL TRAINED IN HAZMAT REPORTING. Release Containment LIQUID CHLORINE - SECONDARY CONTAINMENT 10/06/2005 V 1CQ11 IJ~J V ~. i1Gt itCDVIAl VC 1°ll.. l.1VQl.1 Vll -6- 07/10/2007 F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-001671 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ AjJCC:1d1 Lad"GdLUS Utility Shut-Offs 10/18/2006 NATURAL GAS/PROPANE: ELECTRICAL: MAIN BREAKERS IN ELECT PANELS WATER: WATER WELL SPECIAL: N/A LOCK BOX: NO Fire Protec./Avail. Water WELL DISCHARGE 10/06/2005 Building Occupancy Level UNMANNED SITE 03/07/2006 -7- 07/10/2007 F CALIFORNIA WATER SRV 185-01 SiteID: 015-021-001671 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2006 ~ MSDS IN FIELD OFFICE AND INSIDE STATION BUILDING. 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 c nciu tvi ru~ul.c vac Held for Future Use -8- 07/10/2007 t. ~e CALIFORNIA WATER SRV 185-O1 Manager TIM TRELOAR Location: 4820 EVE ST City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: SiteID: 015-021-0016'71 BusPhone: (661) 396-2400 Map 124 CommHaz High Grid: 18D 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 (661) 837-7200x 24-Hour Phone (661) 837-7271x Pager Phone ( ) - x Pager Phone ( ) - x .............. Hazmat Hazards: Fire Press ImmHlth DelHlth ....._...... Contact BILL ROSICA Phone: (661) 837-7278x MailAddr: 3725 S H ST ~ State: CA City BAKERSFIELD Zip 93304 __............ Owner CALIFORNIA WATER SERVICE Phone: (661) 'rte-i~~x Address 3725 S H ST State: CA 837-72vo 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 ENT`D ~ ~ ~ 2; 3 2007 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. Si ature Dat -1- 01/29/2007 5 F CALIFORNIA WATER SRV 185-01 ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001671 ~ By Facility Unit ~ Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MAP SODIUM HYPOCHLORITE DIESEL FUEL F P F IH IH DH L L 200.00 500.00 GAL GAL how -2- Ol/29/~007 -3- O1/29/~007 F CALIFORNIA WATER SRV 185-01 SiteID: 015-021-001671 ~ ~ Inventory Item 0002 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 LiTAid Mixture AmbRentURE TEMPERATURE CONTAINER TYPE qu~ T ~- ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL IlEiGH[CLV U.7 1..U1~lYU1V L" 1V 15 %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 IlEiGEilCL 1~.7,'~~A,J1~1.C~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME DIESEL FUEL Days On Site 365 Location within this Facility Unit Map: Grid: AT PLANT CAS# 68476-34-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Co500100rGAL Daily 500100m GAL I Daily 500r00e GAL ruyc~rutLVVa l..Vl"1rV1VLilV1~ sWt. RS CAS# 100.00 Diesel Fuel No. 1 No 708921n3 ritiGL'i.RL L"~ J J L' r7 iJl•1L' 1V 1 w7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 01/29/2007 n. F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-0016'71 ~ Fast Format ~ ~ Notif.jEvacuation/Medical Overall.Sit~ ~ ~ Agency Notification Employee Notif./Evacuation Public Notif./Evacuation Emergency Medical Plan 10/18/2017 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 01/29/2007 F CALIFORNIA WATER SRV 185-01 SiteID: 015-021-001671 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 10/18/20136 ~ DAILY SITE VISIT BY CWS PERSONNEL TRAINED IN HAZMAT REPORTING. Release Containment 10/06/20t'35 LIQUID CHLORINE - SECONDARY CONTAINMENT 1..1Cdi1 U~J Other Resource Activation -6- O1/29/~007 F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-0016'1 ~ Fast Format ~ ~ Site Emergency Factors Overall Side ~ Special tiazaras Utility Shut-Offs 10f l8/200 NATURAL GAS/PROPANE: ELECTRICAL: MAIN BREAKERS IN ELECT PANELS WATER: WATER WELL SPECIAL: N/A LOCK BOX: NO Fire Protec./Avail. Water WELL DISCHARGE l0/o6/2oas Building Occupancy Level UNMANNED SITE 03/07/2006 -7- 01/29/2007 r, ~ F CALIFORNIA WATER SRV 185-O1 SiteID: 015-021-0016'71 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2005 ~ MSDS IN FIELD OFFICE AND INSIDE STATION BUILDING. 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. rays ~ nclu ivi ru~uie use nvlu ivi ruuui~ u~C -8- 01/29/2007 UNIFIED PROGRAM INSPECTION CHECKLIST ~' .~~. :<,~~. Y,~:~:, tip-, ... h, ~ :..; ~ , :..: < :.. . - < ... ..: .:_ . , . ,... ... .SECTION 1: Business Plan and Inventory Program • BAHERSFIELD FIRE DEPT t, Prevention Services ,wl~~ 900 TYuxtun Ave., Suite 210 ~~rN ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME - NSPECTION DATE INSPECTION TIME C~ of K .c. GJc..~c~ 5er e c ~ f3 S~"~p ? -'?~-d(o /D .,n,v/~" ADDRESS HONE NO. O OF EMPLOYEES y f3 zv ~' v ~ `~`- FACILITY CONTACT USINESS ID NUMBER 15-021-p0 ~(~'7 f Section 1: Business Plan and Inventory Program ____ ~~ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^^ COMPLAINT ^ R 1 SPECTION r: C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~^ BUSint3SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY ~ ~ / / ~f ^ VERIFICATION OF HAZ MAT TRAINING ~D~ ^ 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: - _ __ •OUESTIONS REGARDING THIS INSPECTION? PLEASE CALL U8 AT (881) 328-3979 t !~~^ '. Inspector (Please Print) Fi Prevention / t" In / Shift of SNe/Station k Business Site/School Site Res sible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rtw. 02105) n o CAL WATER SRVC CO sTa-_~ ~~~ c ~' 4820 EYE STREET F 1 + CALIFORNIA WATER SRV 185-01 _________________________ SiteID: 015-021-001671 + Manager TIM TRELOAR BusPhone: (661) 396-2400 Location: 4820 EVE ST Map 124 CommHaz Low City BAKERSFIELD Grid: 18D FacUnits: 1 AOV: CommCode: BFD STA 05 SIC Code:4941 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR ~.2rhu~y Vales / ASST DIST MGR Business Phone: (661) 396-2400x Business Phone: (661) 3-%-~@~@x' 2 4 -Hour Phone ( 6 61) 3 9 6- 2 4 0 0 x 2 4 -Hour Phone ( 6 61) 3-96-= 2~O~x Pager Phone ( ) - x Pager Phone ( . ) 037 -7271 x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact CST ~;II IZ~SicA Phone: (661) 3-95-°-2~t3~6x MailAddr: 3725 S H ST State: CA 83~-727$ City BAKERSFIELD Zip 93304 Owner CALIFORNIA WATER SERVICE 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: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK ~N~'~ ~~~ Z ~ 200 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. 3 ~ ture Date ----------------------------------------------------------------------- -1- 03/07/2006 UNIFIED PROGRAM INSPECTION CHECKLIST ~- .nom SECTION 1 Business .Plan and Inventory Program • FACILITY NAME C r~ i ~f'dr .._1 ADDRESS ~/E3 ~_v__~v FACILITVCONTACT • Bakersfield Fire Dept. Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 HONE No. No. of Employees $ 37- ~ 2uo -~- usiness ID Number 15-021- od>~ -~~ Section 1: Business Plan and Inventory Program utine O Combined O Joint Agency OMulti-Agency O Complaint O Re-inspection ANY HAZARDOUS WASTE ON SITE: OYES ^ NO EXPLAIN: • QUESTIONS REGARDING THIS INSPECTIONS PLEASE CALL US AT ~C)6'I~ 326-3979 Inspector (Please Print) ~ Fire Prevention 1st-IMShik of Site lNhite - Envirommental Services Yelk7w - Staten Copy Business Site Responsible Pa (Please Print) Pink -business Copy CALIFORNIA WATER SE (1991) Manager : 9~E~N==B~%~ Location: 4820 EVE ST City : BAKERSFIELD CommCode: BAKERSFIELD STATION 05 EPA Numb: Sit/~015-021-001671 BusPhone:/ (661) 396-2400 Map : 124 CommHaz : UnRated Grid: 18D FacUnits: 1 AOV: SIC Code:4941 DunnBrad: Emergency Contact / Title B-iLL-F~RF~R /--~TI©N SUPV Business Phone: (661) 832-2141x 24-Hour Phone : (661) 396-2400x Pager Phone : ( ) - x Emergency Contact / Title Business Phone: (661) 396-2400x 24-Hour Phone : (661) 396-2400x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : ~i-LL HARPER MailAddr: 3725 S H ST City : BAKERSFIELD Phone: (661) 832-2141x State: CA Zip : 93304 Owner CALIFORNIA WATER SERVICE Address : 3725 S "H" ST City : BAKERSFIELD Phone: (661) State: CA Zip : 93304 39-6 96x 2400 Period : to TotalASTs: = Preparer: TotalUSTs: = Certif'd: RSs: No ParcelNo: r Emergency Directives: CALL BILL HARPER FOR ANY OPERATION QUESTIONS. District Manager-Tim Treloar Asst. Dist Manager-Bill Harper Contact Person-Tamara Johnson Same Phone Numbers J,'~~ ~Jfl~/tr50~3 Do hereby certify that I have (Type or I~int name) reviewed the attacherJ haza~'oous materials manage- ment plan for~31~_l ~-. t l~]'i-~;~- and theft it along with (N~me of 8us~e~) any c0rre~i0ns c0nsti~u~e a complete and c0rrec~ man- agement plan for my facility. Gal Gal -1- 10/10/2003 ' 1715 Ch~ter ~ve. Bake~fiel~ CA (661~ 32~3979 3.' ~sw~ ~e qu~o~ below for ~e b~ ~ a ~hole~ .. 4. ' Be ~ b~ef ~d'conc~e ~ possible. .. szcr~oN r: ~usn, m, ss mm, rrmic^r~oN LOc_~T~ON: M_Arr.~G ADDKESS: PRIMARY M_iILI~G ADDP,.ES S: EI/I~KGENCY NOTIFICATION CONTACT TrrLE BUS. PHONE 24 I-IR. PHONE - IV/ C E~GENCY _MiED.[CAL PLAN:; · '. :l " HAZARDO US MATERIALS.~IA~AG~NT PLAN SECTION .[I. 2: RELEASE RESPONSE PLAN ASSESSMENT AND PREVENTION MEASURES:. : <.. Bo RELEASE CONTAINMENT AND/OR MITIGATION: Co AND RECOV a¥ PaOC Dr: S;. SPECIAL: '-. LOCK BOX:... YESES) IF YES, LOC,,A_TION: PRIVATE F ..ItLE PROTECTION/WATER AVAILABILITY..:? A. PRIVATE FItLE PROTECTION: B. WATER AVAILABILITY (FIRE HY'D~: SECTION' III: TRAINING HAg. MAT MNO~'I' PLAN ~ IN~t'~,IJC 4 CITY OF B.AKERSFLELD OFFICE'OF ENVIRO~NT~ SERVICES 1715 Chester Ave. CA 93301 (661) 326-3979'..' I. FACtLJTY IDENTIFICATION . ................ ~'>~ TE~ .¢~',,~ ///~ g ~o///'A/VY~ .cFA ~O/V' /z~E; . .. FACtLITY ~NFORMATION Business Activities Page ~ of ~ 2 II. ACTIVITIES DECLARATION Does. Your Faciiity,..~ If YeS, PleaSe Complete... (~ES ©NO A] HAZARDOUS MATERIALS 1.. Have'on Site (.forany purp~3se) hazardous materials at or above 55 gallons:r0j~.l!quids; 5(!Opounds for Solids, or 200 cuft for compressed'gases (inclUde liquids in ASTs and USTs)? 2. Have any amount 0f,..an explosive matedal (other than ammunition) On site? B. 'REGULATED SUBsTANcES (RS) Have onsite RS at:greaterthan the threshold planning quantities established by the California Accidental Release Prevention,program ~CaiARP)? C. UNDERGROUND STORAGE TANKS (USts) OYES ~NO "'~ OYEs ~r~o . (~YES (~O ~. 'OWn or operate. Undergr°und~Storage .Tanks? Intend to upgrade existing or instalt new. USTs? I OYES D. TANK CLOSURE / REMOVAL OYES 1. Need toYeport ct0sing, a UST that'held hazardous matedats'0r waste? .. .~, 2.' Need .to report the closure/removal of a tank that was OYES (~NO .. claSsifie~l.~ as hazardous waste and cleaned onsite? E. ABOVE'GROUND PE'T~OEELIM S~'ORAGE. TANKS (ASTs) OYES (~0 Own or operate ASTs above these thresholds: any tank i cal~aclty is graat~!':than 660 gallons or the total capacity ~ 'for the facility is g~eater than' 1,320*ga/Ions. . F. HAZARDOUS WASTE: OYES ~"~'~'O 1. Generate hazardous waste? : 2. Recycie more than"100 kg/mo o~ recyclable materials at ~)YES (~.NO ! the same location !t was generated? ' "C)YES 3. Recycle mom than i00 kg/mo ~f recyclable materials at (~O an offsite location different from the point of generation? · 4. Treat Hazardous Waste.on site? ' OYES · 1 5. Subject to Financial. Assurance requirements? OY~S i 6. Consolidate Hazardous Waste generated at a remote OYEs site?" ,--~', - ' G. PERMIT CONSOLIDATION ZONE: ' L..)~:E~ ntend to consolidate ot~e¢ Cai~EPA agency permits2 (If yes, p/ease complete Section/11 and attach) · 8 DES FORM 273l (Chemca Oesc~aon Forint ~ONS'OLIDATED COMPI~JANCE PLAN Minimum required' planninq elements:. ' Eme~enb~/Response Piton Maps · Training PreventiOn Cert~cafions DES FORM 2731 (Ch~ica n~sc~ao, F~rm) RISK MANAGEMENT PLAN. (RMP Submil ta USEPA) CONSOLIDATED COMPLIANCE PLAN · Incorporating CalARP program Elements UST. FACIUTY FORM' .US.T T.~dK FOEM'(.~e,~e~m~.)'. UST FACILITY FORM UST 'T~,NK FORM UST INSTALLaTiON FORM (one per tan,) · UST TANK'FORM (cdosum se~on-~ne per rank) TANK. CLOSURE FORM. CONSOLJDA~ED COMPLIANCE PLAN · Incorporating Federal Spill Prevention Control and Countermeasure (SPCC) Btements pursuant to 40 CFR Part 112 EPA ID number--provide on this page To obtain EPA t1~, please phone(916) 324-1781 RECYCLING FORM -~ RECYCIINGFORM TP FACIliTY FORM (DTSC Form 1772) TP' U NIT 'FORM (one per unit) CERTIFICATION OF FINANCIAL ASSURANCE REMI~TE WASTE/. CONSOLIDATION SITE NOTIFICATION FORM CONSOLIDATED COMPLIANCE PLAN' Incoq3orattng all other environme0tai permit requirements per 27' CCR 10410 3TE: / If you checked YES to any part of Sections IIA-IIG above, ther{ in addition to the forms requested .above, please Submit OES Form 2730. UPCF (7/99) SACU PAFO RMS~C'rIvITY'v4:Id OFFICE' OF ENXGRONMENT~ SERVI. CES 171.5 Cl~ester Ave., Bakersfield,' CA 93301 (~i61) 326-3979 FACILITY INFORMATION Busings Ac~vitles Addendum · FAC1LFI~ ld # (For oflt~ use amy - please leave Nan~O I. FACILITY' IDENTIFICATION EPA ID # DBA/FACILiTY NAME III. CONSOLIDATED PERMIT ACTIVITIES' - . Is yoUr Fa~cility COmpliance· Plan subject to review by'..:.. H. DEPARTMENT'QF'T(~iC. St;JBSTANCES'CONTROL' ' iDYES i 1.. SAN JOAQU.INVALLEY UNIFIED.AIR POLLUTION CONTROL DISTRICT ' ] J. ~TATE WATER RESOURCES' CONTROL BOARD -'NTPAL VALLEY REGIONAL WATER QUALITY CONTROL 'F-~OARD !OYES OYES ~Es OYES OYES OYES C)YES oYEs K. CALIFORNIA INTEGRA'lED WAS?rE MANAGEMENT BOARD I_ KERN COUNTY RESOURCE MANAGEMENT AGENCY OYES OYES OYES OYES OYEs O-YES OYES M. CITY OF BAKERS~ELD WASTE-WATER DIVISION forsatisfy ng the conditions of theSe permits? w' ' STAN OARDI~M I'.t,';.. ~:. O' ' "Ali!MPdifrcati0nS.'. O ~' Non-RCRA HAZARDOUSWAS~TE FACILJTY (~O ~, RCRA HAZARDOUS WASTE FACILITY ONO' ~' AUTHORITY TO. CON~:FAUC,T · ONO ~' PERMI'T.~i'O OpEP, ATE ' ' ~f['qO · W. WASTE DISCHARGE REQUIREMENT'(WDR) (~'NO ~ GENERAL PERMITS (~NO' · v' SPECIF!O PERMITS- (~'NO ~ ~' NATIONAL POI~.UTION DISCHARGE " .' E~JM~NATIOfi sySTEM (NPDES)" ~ ..' REGIS~P, ATIQN PERMIT - ENVIRONMENTAL HEALTH SERVICES PERMITS ON0 v' · 'Domestic'wat~ ~'eil Fermit (~0 V haz Ma~MonitOdng, Well Permit (~O v' Septic System Permit (~/NO ~' Public Swimming Pool Permit (~/NO v' Food Facill~ Construction Permit (~0 ~' ' Solid Waste Locel"Enf0rcement Agency ? (LEA) Related Pem~itS ~NO v' Medical Waste R~tated Permits O v' .~ NDUSTRIAL WAS ]'E WA ];~-A DISCHARGE PERMIT NOTE: ' ; ~ If you checked YES ~o' any part of Sections III-H'to I II-M above, then please address ail applicable permit requirementS in ~e:Facility Compliance Plan. CITY OF BAKERSFIELD OFFICE OF ENVIRONM~E~NTAL SERVICES 17t5 Chester Ave., CA 93301 (661) 326-3979 BUSINES~S OWNER / OPERATOR IDENTIFICATION FAi21LITY INFORMATION Page Of J . ~ ,;;~J ~ , i ~ Year Beginning BUSINESS I~AME (S~e ~ FACI~ N~E or DBA- Ooing 8min~ ~) I. FACILITY IDENTIFICATION lOO i Year Ending 101 102 103 DUN & lO6, i' SIC CODE lo7 COUN~ ~ 1Da -' ':' il. OWNER INFORMATION !11. ENVIRONMENTAL CONTACT 113' 116 CONTACT NAME d~,~Z: ~'~'Z~//,~/'. r~7 , CONTACT PHQNE '~ ~s CONTA~ ~ILING ' . ~9 , . ~RIMARY- N. EMERGENCY'CONTACTS . ~ECONDARY- TITLE BUSINE~Ss PHONE 24.-HOUR PHONE TITLE 130 l?..S I' SUSINESS PHONE i~? ~ 24-HOUR PHONE '131 132 PAGER V. CERTIFICATION 133 ;erttflcaMon: Based on my inquiry of those individuals, responsible for obtaining the information, I certify under, penalty of law that I have personally examined ~nd am familiar with the information submitted in this inventory and believe the information is true, accu~te, and;complete. : ,~M-~ OF~/V~EPJOP/RATOR (pdnt) DATE 134 NAME OF DOCUMENT PREPARER ~3~ I TITLE OF OWNEPJOPEP-,A:I'(~-I~ .... I_ .'%.. ................ ? 135 137 Business Owner/Operator Identification Please submil: the Business Activities page, the Business OwnerlOperamr Identffica~n page (DES 'Form Z730), and Hazardous Mate~iaia Description pages (CES Form 2731) for all hazardous materials inventory' submissions, For the inventory to be censiderad complete. this page must be signed by the appropriate inclividual ~fote: the numbering of the insfft~c~ons foJlows the data element numbers that are on?the. UPCF pages.. These data elefflent numbem am used~ ,~r electronic submission and are ~he same as the numbedngused in 27 CCR, Appendix C, the Business Sectii~ of the Unified Program Data-~ctf%ary.) Please' number all pages of your submittal, This helps your CUPA'(~r AA iden~y whether the submittal is complete and if any pages am separated, 1. FACILJTY ID NUMBER - This numl3er is assigned by the CUPA or AA. This is the unique number wi~ictt idenl~ffes your facility. 3..' BUSINESS NAME - Enter the full [egat name of. the business. , 100; BEGINNING DATE - Enter the beginning'year and date of the report, (YYYYMMDD) ~ .. 101; ENDING _[;:!ATE - Enter the ending year and date of the reporC (YYYYMMDD~ 102.- BUSINESS PHONE - Enter the phone number, area code flint, and any extension. 103. BUSINESS SiTE'ADDRESS - Enter the street address where the facility is located; No post office box numbers are atlowed. This information must provide a means to ge~graphically locate the facility. 10.4. CITY - Enter the city or unincorporated area in which business site is located. 105. 23P CODE - Enter the zip code of business site. The extra 4 digit zip may also be added. 106. DUN'& BRADSTREET - Enter the Dun & 8radsireat number for the facility. The Dun & Bradstrset number may be obtained by calling (6i0) 882.-7748 or by Intemet. · SICCODE - Enter the pdmary Standard [ndust~al Classification Code number for'prfmary business aca~ty. NOTE: If code is more than .4 digits, report onJy the first four. COUNTY ~ Enter the county in whic~ the bdSineas site is located. BUSINESS OPERATOR NAME - Enter the name of the business operator. . BUSINESS OPERATOR PHONE - Enter business operatq? phone number, if different ~3m business phone, area code first, and. any extension. OWNER NAME'- Enter name of business owner, if different fi'om business operator. OWNER PHONE - Enter the business owner's phone number if different from business phone, area code first, and any extension. OWNER MAILiNG ADDRESS - Enter the owner's mailing address if different from business site address. OWNER CITY - Enter the. name of the dry for the owner's mailing address. O.WNER STATE - Enter the 2 c~arac~er state abbreviation f~r the Owner's maiting~addross. OWNER 7_JP. CODE - Enter the zip code for the owner-~ address. The extra 4 digit zip may also be added. ENVIRONMENTAL CONTACt. NAME - Enter.the name of the person, if different from.the Business Owner or Operator, who receives'all' 107. 108. 109. 110. '111. 112. 113. 114. 115. 116. 117. environmental ,correspondence and will r~pond to enforcement activity. 118.. CONTACT PHONE * Enter the. phone number, if different from Owner or Operator, at which the environmental contact can be contacted~ c~de first, and any extension. 119. CONTACT MAILING ADDRESS - Enter the mailing adclress where all environmental contact cormspondenc~ should be sent,'if different site address. [20. CITY -'Enter the name of the city for the environmental contact=s mailing address. 121. STATE. Enter the 2 character state abbreviation for the environmental C°ntact=s mailing address. · 122. 7_JP'CODE - Enter the zip code for the environmental contec~'~ mailing addr~s; The extra 4 digit zip may also be added. 123. pRIMARY EMERGENCY CONTACT NAME - Enter the name of a representative that can be contacted in case o.f an emergency involving h~-~,=rdous materials at the business site. The contact shall.have FULL facility acce~__-~ site familiarity, and authority ta make decisions for the business regarding incident miUgation. 124. TI'TLE - Enter the title of the pdmery emergency contact. 125. BUSINESS PHONE - Enter the business number for.the pdmary emergency contact, ama code tirst, and any exten~ns. · 126. 24-HOUR' PHONE - EDter a 24-hour phone number for the primary emergency contact. The 24"hour anSWered 24 hours a day. If it is not the contact's home phone nU~tber, then the service answering ,the phone must be able to immediately contact the individual stated above. 127. PAGER NUMBER - Enter the pager number for the pdmary emergency contact, if available. 128. SECONDARY EMERGENCY CONTACT NAME - Enter the name of a secondaiy representative that can be contacted in the event that the pdmary emergency contact is not available. The contact shall have FULL fiacility a _cctv___. site familiarity, and authority to make decisions for the business regarding incident mitigation. , 129. TITLE- Enter the title of=the secondary emergency contac[, 130. BUSINESS PHONE - Enter the business telephone number for the secondary emergency contact, area code fimt, and any extension: 131. 24-HOUR PHONE - Enter a 24..hour phone number for the secondary emergency contecL ,The. 24 hour phone number must boone which is answered 24 hours a day. if it is riot the contac~:'s home phcne number, the,~/'~ the service answering the phone must be able to immedlatsiy contact the individual stated'above. 132. PAGER NUMBER - Enter the pager number for the secondary emergency contact, if available, 133. ADDITIONAL LOCALLY COLLECTED INFORMATION - This space may be used for CUPAs or AAs to collect any addiUonal information nec_e~_~ary to meet the requirements of their individual programs. C~3niact y~ur Itzcat ager~cy, for:guidanca. 134. DATE - Enter. the dam that the document was signed. (YYYYMMDD) 135. NAME OF OOCUMENT PREPARER - Enter the futl name of the person who prepared the inventory subrnittel information. 136. NAME OF SIGNER - En~.. r the full printed name of the person signing the page. The signer cerlJfles to a-familiarity with the information submitted and that based on the signer~ inquiry of those individuals responsible for obtaining the information, all the information submitted is true, accurate and complete. SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE - The Business Owner/Operator, or officially designated representative of the Owner/Operator, shall sign in the space provided. This signature cerlffles that the signer is familiar with the information submitted and that based on, the signer~ inquiry of those individuals responsible for obtaining the information it ie the sign~ belief tha~ the submitted information is true, accurate and complete. 137. T]_TLE OF SIGNER - Enter the title of the pemon signing the page. CITY OF BAKERSFIELD OFFICE OF ENYIRONM. ENT~ SERVICES 1715' Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION REVISE I. FACILITY INFORMATION (one form per matefi~l aer Ouilcling or a/~a~ Page of · SUSINESS NAME (Same as FAClLITY NAME of' DBA -~ r~o~ng I~d~ness As) II. CHEMICAL INFORMA~ON 2o5 i rRAOE SECRET [] Yes [~No 2~S CHEMICAL NAME If Subject to EPCRA. reJer to inslmc~iona J EH~" [] Yes ~o ,338 FiRE CODE HAZARD CL.~,SSES (Complete if requested by local fire c~iet). 209 i 210 TYPE m'-] p PURE D~nl MIXTURE PHYSICAL STATE [] $ SOliD ~1 lIQUID r'~ g GAS · : LARGEST CONTAINER CURIES 213 212 FED HA~RO CATEGoRIEs [] 1 FIRE u-'- :.~c~ a, Nat apply) 215 REACTIVE ~ 3 PRESSURE RELEASE · []'4 ACUTE HEALTH ] [] S CH.~ONIC HEALTH 216' f t AL WASTE 'N/~ 2171 MAX]MUM ,~.,.,.JUNT I DAlLy AMOUNT 218 i AVERAGE I' DAILY AIUOUNT 219 -. STATE WASTE CODE ~ ~ ' · DAYS ON SITE ~. · uNrrs- [] ga GAL F1 cf CU ~ ' [] ]b ~ [] tn TONS Z2~ · )f EHS,.amoun! mus~ be in lbs. ~ STORAGE CONTAINER (Cl]ec~ all ~at aopiy) ~ ,M~OVEGROUND TANK [] 13 UNDER(";ROUND TANK [] = TAN~ ~NS~DE ~UJU~NG [] d ST~ELDRUM [] · PLA,5'TIC/NONMETALUC DRUM [] i FIBIS~ DRUM '[:~ m GLA~S 8~ ~g ~OY ~k ~X ~o TO~a~ ~" SI~ ~ I ~N0~ ~ . TANK WAGON STORAGE PRESSURE AMBIENT [] as ASOVEAMBIEjqT [] ba BELOW AMBIENT 2.24 STORAGETEMPERATURE ~aAMBIE]qT [] aa ASOVEAMBIENT [] ba 8ELOWAMRIENT [] ¢ CRYOGENIC 225 %WT HAZARDOUS coMpoNENT EHS CAS ~ 3 23O 238 242 NAME & Ti'rt.~ OF AUTHORIZED COMPANY REPRESENTATIVE lie SIGNATURE DA'~ Hazardous' Materials Inventory - Chemical Description you must complete a separats Hazardous Motorists Invento~ - Chemical Description page t'or eaCJl I'laZardous matsrial (hazardo,,~ sUtistance~ and hazanfous waste) ~t you handle ~at youc facJlity in'aggregate quantifies ecluai o or greater iaan 500 ~oungs, $5 gatidn=. 200 cubic feet of gas (calculated at dtandard tsmpera~re on, pressure) or the t'e~lerai threshold plonking quantity t'or Ext~"emeiy Hazardous Substances, wi'tioJlever is Jess. Also correlate a page for asc~ cadioactJve marshal t~anOtsd over quantities for wttict~ an emergency plan ia requireg to be adoptecl pumuant to 10 CPR Parts 30, 40. ar 70. The com0idtaO invan~ sttould ceilec~ all reportabid quantifies of hazardous materials at your facility, ra0ortsd separately for each building or outside adjacent ama, wis sepa~te pages for unique occurrences of physical ststa, storage' temperature and storege pressure. (Note: the numbering of the instructions follows Se data element numbem that are on the UPCP pages. These data element numbem are usecl for electronic submiSSion and are [he same as the numbering used in 27 CCR, Appendix C, ~'/e 8usioese Section of the Unified Program Oats Dictionary.) Please number all pages of your sut~mRtal. This. hel0s your CUPA or AA identify whether the submiEal is complete and if any pages am 1. FACJlJTY lO NUMBER - This number is assigned by the Ct?PA or AA. Thisis~euniquenumtierwttichidentifissyourfacflity. ~ 3. BUSINESS NAME - Enter the ~tl legal name of the I~usines~. 200. AC)D/DELETE/REVISE - indicate if the matedai is being added to ~e inventscy, deisted from the inventor, or if the infotmstton previously submilted is being revise~ 'NOTre. You may ct~oese to leave this bisnl~ if you resubmit your entire inventory annually. 20i. C~EMICAL LOCATION - Entel' the building or outside/adjacent ama where ~le hazardous material is handled. A chemical that is stored at the sams pressure and ternperature, in multiple ldcotipns within a building, can be reported on a singis page. NOTE; This information is not sul:)jec{ to public disc~[osure pu~uant to HSC §25506,. 202. CHEMICAL [.0OATION CONFIDENTIAL - EPCRA - ~11 businesses whit. J1 are subjec~ to the Emen:jency PPanping and Community Rtgt'lt to Know Act (EPCRA) must check "Yes' ~ keel= chemical location informatidn conflpential. If ~e business does not wish te kesg chemical location (nfon'na~ion con~dantisl ctteck. 203~ MAP NUMBER - If a mob ia included, enter the number of Se map on whioh the idcatk~n Of the hazardous matedai is shown. 204. GRID NUMBER - If grid coordinates are used. enter the gdd coordinates of the map that correspond to ~e location of the hazardous material, if appiin~l~le, muitigis grid coordinates can be listed. 205. CHEMICAL NAME - Ents= the pr"o'~er ci~emicat name ~..~socJsted with the Chemical Abstract Sea,'ina (CAS) number ~f the hazardous material.. This shouid be the Mtematienal Union of Rum and A~plied Chemism/ (IUPAC) name found on the Matsrisl Safety Oats Sheet (MSC)S). NOTE; If the chemical is a mixture, do ncr compiste this field; complete the ~COMMON NAME' field iastoad. 206. TRADE SECRET - Chec~ "Yes" if the information in Sis section is doctsred a trade.secret, or ~No' if it is not.' State. requiramenl: if yes, and business is not su~iect to ~CRA, dis=esum of ~e designated ~-ade secret information is bound by HsC ~..5511. · Federal requirement: If yes, and business is Subiec~ ts E~CRA, dlscldsura bf the designated Trads Secret information is bound by 40 CFR and the business must sul3mit a "Substantiation to Acc~ml~y C~es of Trade Senmcy' fon~ (~40" CFR 350.27) ~ USEPA.. . .. 207. COMMON NAME - Enter the cornmdn name or trade name of the hazardous marshal or mixture contsining a hazard¢~ua material 208. Et-IS - C~eck "Yes" if ~e hazardous matedai is an Exlmmely Hazardous Substance (EHS), as deIMed in 40 C~R, Part 35~, Appendix .~. If the msterisi is a rnixtum containing an EHS, Jeave this section bisnR and complete the sechon on hazardous components below. 209. CAS # - Enter the Chemical Abstract Service (CAS) numtier for the hazardous marshal For mixtures, snmr the CA~ number of the mixture if it has'been assigned a number distinct from its components. If the'mixt~.u'e has no C..,A~ number, leave this column blank arid report the CAS numbe~ of the individual hazardous components in ~e ap~roprfate section bstow. . . 210. FIRE CODE HAZARD CLASSES - F~ra C,~le Hazard Cia_ss_ es describe to first respondere the type and level of hazardous materfais wbictl a business handles. This information shall only be provided if the local fire chisf deems it neCes~;and requests the CUPA ar AA to collect iL A iisi: of the hazard classes and iesm. Jctions on how to de,ermine whic~ ctsas a material fails under are inctuped in the appendices of AriSe 80 of the Uniform Ere Code. If a material has mom than one applicable' hazard class, include all. Contact CUPA or AA for guidance, 2.11.' HAZARDOUS MATERIAL TYPE - C~ec~ the One bo~that ~est d~c_.ribes the b~e of hazardous matshal:' pure, mixture or waste. If waste mated'at, ~ec~ on'ty that box. if mixture or waste, comp!eta hazardous componen~ section. ~12. RADIOACTIVE - Chec,~ "Yes' if the hazardous rnatedat..is radlesstive or 'No' il'ir'is hal ~13. CURIES - tf the hazardous matodal is radtcec~ive, 'use this area to .r.~rt the activity in curies. You may use up to nine ~ with a.tioating dec,hal point to repOrt . activity in cude~ . 214. PHYSICAL. STATE - Check the one box that heat describes the ststa in whic~ the hazardous material is handled: solid, Jlquid or gas. 215. LARGEST.CONTAINER ~-' Ente~' the totsl capacity of the is~jest canteieer in which the matehai is stored. 216. FEDERAL HAZARD CATEGORIES - Check all cetecjories that describe the physical and health hazards aasocisted w~ the haza.,!:ious material: .' PHYSICAL- HAZARDS I ' HEALTH HAZARDS Rre: Flammable IJquids and Solids. Combustible l. Jquids. ,°ymphorics, OxidizersI Acute Heattlt (Immedtste}: Highly Toxic, ToxiC. In'bents, Sensitizem, C~maive~ Reactive: Unstable Reactive, On:Janio Peroxides. Water Resc~ve, Radioactive other hazardous chemicals with ab adverse effect with short term expoeura adveme eifect with long term ex~posura Pressure Retsase: ExplOSWes,. Compressed Gases. Blasting Agents Chronto Hesith (Delayed): Cam~eegenS. other hazardous ch~mii:ais with an 217~ AVERAGE DAILY AMOUNT - Calcuinte the average daily amount of the hazardous matadal or mixture contsining a hazardous mstehal, in each building or adlacantJ outside area. Caicuistions shall he based on the previous yeses inventor, of materisi reported on this page. Total ail daily amounts and divide by the number of days the chemical wilJ be on ~ite-. if this is a material that has not previousty been present at this location, the amount shall be the average daily amount you project, to be on hand dUring the course of the year. This amount sllouid he consistent with the units reporte~, in box 221 and should not exceed that of maximum ' daily amount-, ~- .... 218. MAXIMUM DAILY AMOUNT * Enter the maximum amount of each hazardous'material or mixture contsining a hazardous material, which is handled in a building or adjacent/outside area at any one time over the coume of the year. This amount must contain at a minimum last year's inventory of the material reported on this ' page, with the reflection of additions, dotstions, or revisions projected for the current year. This amount shsuld be consistent with the units reported in bo~ 221. 219. ANNUAl. WA~-"TE AMOUNT - If the hazardous matsrisl being inventoried is a waste, i:~ovlde an estJmats of the annual amount handled. 220. STATE WASTE CODE - If the hazardous material is a waste, enter the a!0propriate Caiifomis 3-digit hazardous waste code as' listed on the bac~ of the Uniform Hazardous Waste Manifest. 221. UNITS - Chec~ the unit of measure that is must apprephats for the mate~ai being repo~ted on thi~ page: gallons, pounds, cut,lc feet or t~ne, NOTE: if the matsrisi is a federally defined Extremely Hazardous Substance (EHS), ail amounts must be ~eported in pounds, if material is a mixture containing an EH,S, report tbs units that the material is stored in (gallons, pounds, cu~io feet.-or tons). 222. DAYS oN SITE - List the total number of days during the year that the material ia on site. 223. STORAGE CONTAINER - Check ail boxes that describe the type of storage containem in which the hazardous matsriai is stored. NOTE: If appropriats, YOu may choose more than one. . 22,4. STORAGE PRESSURE - Chec~ the one box that best describes the pressure at which the hazardous rr~tedai is stored... ?.25. STORAGE TEMPERATURE - Check the one box that hast describes the'temperature at which the hazardous material is stored. 226. HAZARDOUS COMPONENTS 1-5 (% I~ WEIGHT) - Enter the percentage weight of the hazardous component in a mixture, if a range of percentages is avaiisble, redort the I~ighest percentage in thai range. (Redort for combonents 2. through 5 in 230, 234, 2,38, and 242.) 227. HAZARDOUS COMPONEHT$1-5 NAME - When reporting a hazardous matsrial that is a mixtt.we, ilst ul~ to five chemical names of hazardous components in that mixture by percent weight (refer'to MSDS or, Jn the case of trade ascots, re,er to manufacturer). All hazardous components in the mixture present at greater than 1% by weight Jf non-carc~nogenic, or 0.1% by weight if carcinogenic,, should be reported, if more than ~we'ha~ardous components are pmesnt abnve these percentages, you may attach an additional sheet of paper to na0ture the required information. When reporting wast~ mixtures, nlineral and chemica compo~ition should De listed. (Report for components 2 through 5 in 2~31,235, 23g, and 243.) 228. HAZARDOUS COMPONENTS 1-5 EHS - Chd~,k "Yes" if the component of the mixture is considered an E~,~mely Hazardous Suhstanca as defined in 40 CFR, Part $5~, or "No' i'l, Jt ia not. (Report for components 2. through 5 in 232, 236. 240, and 244.) 229. HAZARDOUS COMPONENTS 1-5 CAS - IJst the Chemical Abstract Service (CAS) numbers as rotated to the Ilazardoua components in the mixture. {Repeat for 2.-5.) 246. LOCALLY COLLECTED iNFORMATiON - This space'may be used by the CUPA or AA to collect any additional information necessary to meet. the requiremen~ of their individual programs. Contact the CUPA or AA for guidance. UPCF (1/99) 7 OES Form 2731 TA. '1.8'5 .tO r~ SITE DIAGRAM Business Name: Business Address: FACILITY DIAGRAm[ ~ N S:\PKOCEDURE MANUAL'~.w~