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HomeMy WebLinkAboutBUSINESS PLAN 12/21/2005a ~ 0 __ U ~t_1 ~ V/~\ /// \ / V UNIFIED PROGRAM INSPECTION CHECKLIST<` SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT e >, p t D Prevention Services ~,IR~ 900 Truxtun Ave., Suite 210 ~RrN r Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 F A CI LIT Y ME INSPECTION DATE INSPECTION TIME / ' ~ ( N ~r~ ~ ¢~~ ~ ~ ? ~~ tel.\~ - W ~ L -o -d s ADDRESS HONE NO. O OFEMPLOYEES ~ ~ ~ ~~Z FACILITY CONTACT USINESS ID NUMBER 15-021- pp 23 7G~ I i vv~ ~ - Section t : Business Plan and Inventory Program ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance OPERATION ~ V-Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE I t / 5 Qt. LC P Q7 Pv- ^ ^ VISIBLE ADDRESS I !! K e ~~ P-'' / vNOT ^ ^ CORRECT OCCUPANCY ~ ~ If ~O ~i1 ^ ^ 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 f ^ ^ HOUSEKEEPING I ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ^ NO QUESTIONS REGARDING THIS INSPECTION PL SE CALL US AT (661) 326-3979 _~ i . ~ ~~~ ~ Inspector Please Print) Fire Prevention / 1" I /Shift of ite/Station # Business Site/School Site Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02105) T, + CALIFORNIA WATER SRV 184-01 _________________________ SiteID: 015-021-002374 + Manager TIM TRELOAR BusPhone: (661) 396-2400 Location: 4507 PLANZ RD Map 123 CommHaz High City BAKERSFIELD Grid: 14A FacUnits: 1 AOV: CommCode: BFD STA 07 SIC Code:4941 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR 12vc~y Ualles / ASST DIST MGR Business Phone: (661) 396-2400x Business Phone: (661) z8a7-72 ~ 24-Hour Phone (661) 396-2400x 24-Hour Phone (661) 396-2400x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth Contact '~AMP~d8I~S9N-',3: I 1 12 os; cA Phone : ( 6 61) S~ -~~- MailAddr: 3725 S H ST State: CA X337-7278 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 : No ParcelNo: ~ Emergency Directives: ~ PROG A - HAZMAT Based on my Inquiry of those individuals responslbie for obtaining the information, I certify under penalty of !aw that 1 have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ature Da ~~~~ n~~ iR 1 s Zoos -1- 03/09/2006 ~. :; CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 Manager TIM TRELOAR Location: 4507 PLANZ RD City BAKERSFIELD CommCode: BFD STA 07 EPA Numb: 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 / Title / ASST DIST MGF2 (661) 837-7271x (661) 837-7271x ( ) - 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 Address 3725 S H ST City BAKERSFIELD Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK Phone: (661) State: CA Zip 93304 TotalASTs: _ TotalUSTs: _ RSs: No ~NT'6 ~ ~ ~ ~ 3 2007 Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of la~v that I have personally examined and am familiar with the information submitted and beli{ete the information is true, accurate, and comp -----~ Dat g' ature Gall Gal BusPhone: (661) 396-2400 Map 123 CommHaz High Grid: 14A FacUnits: 1 AOV: ~~-,~-~e.@x X37. 7200 -1- 01/29/2007 39 ,. F CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 ~ ~ 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- 01/29/2007 -3- 01/29/2007 .J j F CALIFORNIA WATER SRV 184-01 ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Location within this Facility Unit AT PLANT STATE TYPE PRESSURE Liquid TMixture ~ Ambient SiteID: 015-021-002374 ~ 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 rlcj~.ylcl.~uua ~vlnrvlvl;lvl~ oWt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 t11-~GHKL L-~5~7~5~71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -4- 01/29/2007 F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification P~lll~J1U~/CC 1VU1.11. / P~VdGUdl.lUil Public Notif./Evacuation Emergency Medical Plan 10/18/20© MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 01/29/2007 F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/10/2002 ~ DAILY SITE VISIT BY CWS PERSONNEL TRAINED IN HAZMAT REPORTING. Release Containment 10/18/2006 LIQUID CHLORINE - SECONDARY CONTAINMENT Clean Up 10/18/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. ~zner xesource r-~cLivaLion -6- 01/29/2007 F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7~J~C:1d1 ridGdLUS Utility Shut-Offs Fire Protec./Avail. Water Building Occupancy Level 03/09/2005 UNMANNED SITE -7- 01/29/2007 r F CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/200 ~ MSDS 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. rage Held for~Future Use Held for Future Use -8- 0l/29/~00~ _ - r• - •t CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 Manager TIM TRELOAR Location: 4507 PLANZ RD City BAKERSFIELD CommCode: BFD STA 07 EPA Numb: BusPhone: (661) 396-2400 Map 123 CommHaz High Grid: 14A 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 Contact BILL ROSICA MailAddr: 3725 S H ST City BAKERSFIELD / Title / ASST DIST MGR (661) 837-7271x (661) 837-7271x ( ) - x React 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 - HAZMAT PROG T - ABOVEGROUND STORAGE TANK B.a~eC! on my ir,q~;iry of th-cse individua;; resp~n:,ip12 f,r c:~tainin~ the information, !certify under pe:^,alty of is°~ that 1 have persona!Iy examined and am familiar vrith the informatics submitted and belie„e the information is true, ac;,urate, and ccmplpte. S~ ature ~ ~YJ ~ Dat TotalASTs: _ TotalUSTs: _ RSs: No N~~ Ju C 2 ®~~~, Gall Gal Emergency Contact RUDY VALLES Business Phone: 24-Hour Phone Pager Phone -1- 07/10/2007 F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ ~ 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- 07/10/2007 ~. 1 F CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 ~ ~ 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: '! AT PLANT CAS# 7681-52-9 LiTAid Mixture Ambient~E AmbientTURE CONTAINER TYPE qu' T ~- ~ ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL HAZARDOUS COMPONENTS oWt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 I1HGLitCL Li. 7.71;.7.7P7~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -4- 07/10/2007 ~ f F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ rayciil.Y iVV1.1111:Q1.1V11 Employee Notif./Evacuation ri.wii~ iVV 1.11. / L' VdC:Udl,1V11 Emergency Medical Plan 10/18/2006 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE. -5- 07/10/2007 F CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/10/2002 ~ DAILY SITE VISIT BY CWS PERSONNEL TRAINED IN HAZMAT REPORTING. Release Containment 10/18/2006 LIQUID CHLORINE - SECONDARY CONTAINMENT Clean Up 10/18/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. v~,tici iccaVUit.;c t~l.:l.1VQl.1V11 -6- 07/10/2007 r - F CALIFORNIA WATER SRV 184-01 SiteID: 015-021-002374 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~lC 1.:1d1 IldGdl. US U 1.1111. ~/ .711U 1.-V11.7' Fire Protec./Avail. Water Building Occupancy Level 03/09/2006 UNMANNED SITE -7- 07/10/2007 -. F CALIFORNIA WATER SRV 184-O1 SiteID: 015-021-002374 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 10/18/2006 ~ MSDS 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 c. nciu ivi ru~.uic vac nClu 1VL rlAl~uLC UDC -8- 07/10/2007