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104 CLYDE STREET
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CALIFORNIA WATER SRV 083-01 SiteID: 015-021-002097
Manager TIM TRELOAR
Location: 104 CLYDE ST
City BAKERSFIELD
BusPhone: (661) 837-7200
Map 103 CommHaz High
Grid: 32D FacUnits: 1 AOV:
CommCode: BFD STA 06
EPA Numb:
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
Preparers
Certif' d:
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
TotalASTs: _
TotalUSTs: _
RSs: Yes
Based on my inquiry of those individuals
responsib6e for ohta~ning the information, I certify
under penalty of law that f have personally
examined and am familiar with the information
submitted and iaelieve the information is true,
accurate, and complete.
~ /7 ~
' n ture Da e
~~
Gall
Gal
-1- 07/10/2007
r
F CALIFORNIA WATER SRV 083-01 SiteID: 015-021-002097 ~
~ Hazmat Inventory By Facility Unit ~
~ MCP+DailyMax Order Fixed Containers on 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- o~/io/aoo~
,-
F CALIFORNIA WATER SRV 083-O1 SiteID: 015-021-002097 ~
~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~
COMMON NAME / CHEMICAL NAME
SODIUM HYPOCHLORITE Days On Site
365
Location within this Facility Unit Map: Grid:
FENCED ENCL NEXT TO PUMP CAS#
7681-52-9
Liquid TMixtur~AmbRentURE ~ A~PeRATURE ABOVEOGROUNDRTANKE
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum I Daily Average
200.00 GAL 200.00 GAL 200.00 GAL
t11~GKKLV U 5 l.: V 1~1Y V1VL' 1V l A
%Wt. RS CAS#
12.50 Sodium Hypochlorite No 7681529
ru-i~~-sccl~ r~~ ~lJ~al~ir,ly l ~
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 083-01 SiteID: 015-021-002097 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 08/30/2000 ~
CALL 911.
~~
~uiNivyca ivv~li . ~ r,va~:ua~.ivii
Public Notif./Evacuation 10/05/1992
EVACUATION OF THE LOCAL POPULATION TO BE DETERMINED BY EMERGENCY SERVICES
PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL.
Emergency Medical Plan 08/04/2006
MERCY HOSPITAL, TRUXTUN AVE.
-5- 07/10/2007
F CALIFORNIA WATER SRV 083-01 SiteID: 015-021-002097 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 09/27/1994 ~
DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK.
Release Containment
10/17/2006
IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, ARRANGEMENTS WOULD BE
MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. THE CONVAULT TANK HAS A
BUILT-IN SECONDARY CONTAINER AND IS ENCASED IN CONCRETE.
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.
V1.11C 1_ 1CC .7'V UI. C:C liC: l.lVdl.l Vil
-6- 07/10/2007
F CALIFORNIA WATER SRV 083-01 SiteID: 015-021-002097 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
A~CC:1d1 11dGdl US
Utility Shut-Offs
Fire Protec./Avail. Water 08/04/2006
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS.
FIRE HYDRANT - WELL DISCHARGE.
Building Occupancy Level 02/27/2006
I:fNMANNED SITE .
-7- 07/10/2007
F CALIFORNIA WATER SRV 083-O1 SiteID: 015-021-002097 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 05/12/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE.
rcayC ~
Held for Future Use
aiciu ivi ru~.utc vac
-8- 07/10/2007
;~
CALIFORNIA WATER SRV 083-O1
Manager TIM TRELOAR
Location: 104 CLYDE ST
City BAKERSFIELD
CommCode: BFD STA 06
EPA Numb:
SiteID: 015-021-002097
BusPhone: (661) 837-7200
Map 103 CommHaz High
Grid: 32D 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: (4~8~1 4~~---~-~x
Address 372.5 Sou. N S~ State: CA`s f'37-?2ou
City 9~T-d~9,SE ~d1Ce~.r-~r.e,~d Zip °~~-- y~o4
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.
~. 2 6
ature D e
TotalASTs: _
TotalUSTs: _
RSs: Yes
ENt~ ~ E B ~ 6 2007
Gall
Gal
-1- 01/26/2007
s
F CALIFORNIA WATER SRV 083-O1
~ Hazmat Inventory
~ MCP+DailyMax Order
= SitelD: 015-021-002097 ~
By Facility Unit ~
Fixed Containers on 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 083-01
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
SODIUM HYPOCHLORITE
Location within this Facility Unit
FENCED ENCL NEXT TO PUMP
STATE TYPE PRESSURE
Liquid TMixtur~ Ambient
SiteID: 015-021-002097 ~
Facility Unit: Fixed Containers on 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
r1t~~t~tcLVU~ 1:V1~lYV1Vt51V1J
%Wt. RS CAS#
12.50 Sodium Hypochlorite No 7681529
tll-~GF~tC1J H~~r,~~71~1tS1V 15
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 083-O1 SiteID: 015-021-002097 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
~ Agency Notification 08/30/2000 ~
CALL 911.
~-
LdLl~J1UyCC 1VV 111 ~ ~Vdl.:LLdl.t V11
Public Notif./Evacuation
10/05/1992
EVACUATION OF THE LOCAL POPULATION TO BE DETERMINED BY EMERGENCY SERVICES
PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL.
Emergency Medical Plan 08/04/2006
MERCY HOSPITAL, TRUXTUN AVE.
-5- 01/26/2007
F CALIFORNIA WATER SRV 083-O1 SitelD: 015-021-002097 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 09/27/1994 ~
DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK.
Release Containment 10/17/2006
IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, ARRANGEMENTS WOULD BE
MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. THE CONVAULT TANK HAS A
BUILT-IN SECONDARY CONTAINER AND IS ENCASED IN CONCRETE.
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.
V1.11CI 1SCaVULLC 1~t_:1..1Vd1.1V11
-6- 01/26/2007
r_
F CALIFORNIA WATER SRV 083-O1 SiteID: 015-021-002097 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
~7~JCC:1d1 LldGdL(A~
U1.1111.y .7ilUl.-VLL.S'
Fire Protec./Avail. Water 08/04/2006
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS.
FIRE HYDRANT - WELL DISCHARGE.
Building Occupancy Level 02/27/2006
UNMANNED SITE.
-7- 01/26/2007
F CALIFORNIA WATER SRV 083-01 SiteID: 015-021-002097 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 05/12/2006 ~
MATERIAL SAFETY DATA SHEETS ON FILE.
rcxyC ~
raciu r_vi r-u~uic ~~c
Held for Future Use
-8- 01/26/2007
e,' ~' Prevention Services
UNIFIED PROGRAM INSPECTION CHECKLIST' a , ~ F R S r , 9oo'IYuxtun Ave., Suite 210
FIRE - - Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program "RrM Tei.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME ~ ~~ . ~ ~~ L D~ ~ ~~ ~ IN~PECTI N DAT ~~ INSP~ION y~
ADDRESS
O /~ l /~
V C~ ~ ~ G/ y
~ / ~ PHON NO. NO OF EMPLOYEES
FACILITY CONTACT
'~(l'''1 '" ,~
LDWrI'` ~
LL ~lR"/~-~ ~ BUSINESS ID
~ NUMBER
15-021-06 2O`~ 7
_ ~ _ ~ t'-- _ __ _ _ _ -
I --
_
Sec
tion 1: Business Plan and Inventory Program
~
~
cJd ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-
TIO
_
11
C V ~ C=Compliance OPERATION ~
V=Violation COMMENTS
^ APPROPRIATE PERMIT ON HAND
^ BUSIneSS 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
^ 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 I~IVCJ
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
GGo~~,~r ~ z~ ~
Inspector (Please Print) Fire Prevention / 1s~ In / Shift o Site/Station # Business Site /Responsible Party (Please Print)
White -Prevention Services Yellow.- Station Copy - Pink -Business Copy - FD 2155 (Rev. 09/05
L:{ ()
+ CALIFORNIA WATER SRV 083-01 _________________________ SiteID: 015-021-002097 +
f~37~ 7z~®
Manager BusPhone : ( 661) 3-~~'8-
Location: 104 CLYDE ST Map 103 CommHaz High
City BAKERSFIELD Grid: 32D FacUnits: 1 AOV:
CommCode: BFD STA 06 SIC Code:4941
EPA Numb: DunnBrad:00-691-3578
Emergency Contact / Title / Title
Emergency Contact
TIM TRELOAR / DISTRICT MGR j
~vc~~ vc1 ~4~5 / ASST DIST MGR
Business Phone: (661) "" ^" ^^_=b~7~7zo~ Business Phone: (661) ~°~--z~-8~,~~.3~~72 1
24-Hour Phone (661) °'"' ""^^`_g3~7~7za(, 24-Hour Phone (661) „'~""^^__":37.7'z.. r
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: RSs Fire Press ImmHlth
Contact ~; ~ f ~ps'I~/~ Phone : ( 661) 3-9~~-0~x
MailAddr: 3725 S H ST State: CA ~37~~Z7~j
City BAKERSFIELD Zip 9330.4
Owner CALIFORNIA WATER SERVICE CO Phone: (408) 451-8200x
Address : 1720 N FIRST ST State: CA
City SAN JOSE Zip 95112
Period to TotalASTs: = Gal
Preparers TotalUSTs: _ ~ Gal
Certif ' d: RSs : Yes
ParcelNo:
~ Emergency Directives: ~
PROG A - HAZMAT
PROG T - ABOVEGROUND STORAGE TANK
CONTACT PERSON : 8 3 2 - 2141 ~~~~ ~ t t~
R£tcn~ On
resuonsible for ob akin n y of those individuals
un: ier penalt 9 the information, I certify
exa Wined and of law that I have
~abmi?tad am familiar with the ipformnally \X~ \ -
and believe the information is t uen ~ \
accurate, and complete.
Si ture Z~
Date
• i
-1- 05/12/2006