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CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326
Manager TIM TRELOAR BusPhone: (661) 396-2400
Location: 10200 POLO SADDLE DR Map 102 CommHaz High
City BAKERSFIELD Grid: 18D FacUnits: 1 AOV:
CommCode: KCFD STA 65
EPA Numb:
SIC Code:
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 Reac t. ImmHlth DelHlth
Contact BILL ROSICA Phone: (661) 837-7278x
MailAddr: 3725 S H ST State: CA
City BAKERSFIELD Zip 93304
Owner 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
ENT'D MAR 8 2007
Based on my inquiry of those individuals
responsible for obtaining the information, I certify
under penalty of lavr that 1 have personally
examined and am familiar vvith the information
submitted and believe the information is true,
accurate, and complete.
ature ~~`' 3 2 U
Dat
~~~
h"`
-1- 01/29/2007
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
~ 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
DIESEL FUEL F R IH DH L 500.00 GAL Low
-2- 01/29/2007
-3- 01/29/2007
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~
/Y /~f eA JP\AT ITT ART ~ /TTTTART ITTT ATT ART _ --~--
AMOUNTS AT THIS LOCATION
Largest Container Daily Maximum Daily Average
200.00 GAL 200.00 GAL 200.00 GAL
til-~GE~KLVUJ 1:V1~lYV1VL'~1V1~
%Wt. RS CAS#
12.50 Sodium Hypochlorite No 7681529
t1AY,E~KL H~ 5J;571~1251V 1'a
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies R IH / / / Hi
~ Inventory Item 0002
COMMON NAME / CHEMICAL NAME
DIESEL FUEL
Location within this Facility Unit
STATE TYPE PRESSURE
Liquid TMixture~Ambient
Facility Unit: Fixed Containers at Site ~
Days On Site
365
Map: Grid:
CAS#
68476-34-6
TEMPERATURE CONTAINER TYPE
Ambient ABOVE GROUND TANK
AMOUNTS AT THIS LOCATION -
Largest Container Daily Maximum Daily Average
500.00 GAL 500.00 GAL 500.00 GAL
riL~iGHKLVUJ 1=V1~lYV1VJ;1V1J
oWt. RS CAS#
100.00 Diesel Fuel No. 1 No 70892103
t1AGF~iCL A~JJl"~JS1T11"~1V 1 7
TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F R IH DH / / / Low
-4- 01/29/2007
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid TMixture~ Ambient ~ Ambient ABOVE GROUND TANK
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
Fast Format ~
~ Notif./Evacuation/Medical Overall Site ~
tigency ivoLizicaLion
Employee Notif./Evacuation
Public Notif./Evacuation
Emergency Medical Plan 10/18/2006
MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL, TRUXTUN AVE.
-5- 01/29/2007
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
Fast Format ~
~ Mitigation/Prevent/Abatemt Overall Site ~
~ Release Prevention 03/23/2005 ~
DAILY SITE VISIT BY CWS PERSONNEL TRAINED IN HAZMAT REPORTING
Release Containment
03/23/2005
DIESEL - DOUBLE-WALL CONVAULT; LIQUID CHLORINE - SECONDARY CONTAINMENT
Clean Up
03/23/2006
RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION
CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY
AGENCY.
~Lner xesource ticLivaLion
-6- 01/29/2007
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
Fast Format ~
~ Site Emergency Factors Overall Site ~
_, ,_
.~~c~,iai rlac~aiu~
V1.1111.y iJ11Ul.-V11.7-
~.
i'11.c r1Vl.cV/t9V CL11. YY Cl l,C1
Building Occupancy Level 03/23/2006
UNMANNED SITE
-7- 01/29/2007
F CALIFORNIA WATER SRV CBK-L207 SiteID: 015-021-002326 ~
Fast Format ~
~ Training Overall Site ~
~ Employee Training 10/18/206 ~
MSDS IN FIELD OFFICE AND PUMP 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.
rc~yC G
Held for Future Use
Held for Future Use
-8- 0l/29/ZOOS
+ CALIFORNIA WATER SRV CBK-L207 _______________________ SiteID: 015-021-002326 +
Manager
Location: 10200 POLO SADDLE DR
City BAKERSFIELD
BusPhone: (661) 396-2400
Map 102 CommHaz High
Grid: 18D FacUnits: 1 AOV:
CommCode: KCFD STA 65
EPA Numb:
SIC Code:
DunnBrad:
Emergency Contact / Title- Emergency Contact j Title
TIM TRELOAR / DISTRICT MGR ~-~.vc~y Vd IIeS / ASST DIST MGR
Business Phone: (661) 396-2400x Business Phone: (661) 3.96-~-44}A~ 6~~-7" .~l
24-Hour Phone (661) 396-2400x 24-Hour Phone (661) 396-2400x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire React ImmHlth DelHlth ,
Contact 3.~-d~AHN~@N ~~ 1~ O~o5i'cfr Phone: (661) 837-~-27-5-x
MailAddr: 3725 S H ST State: CA 727
City BAKERSFIELD Zip 93304
Owner 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
ENTD APR ®5 2006
Based on my inquiry of those indlvlduois
responsible for obtaining the informe4lon, I Certify
undQr penalty of law that. I have pars®nelly
examined and am familiar wlth 4h@ information
submitted and believe the Information Is true,
accurate, and complete.
atu re Date
-1- 03/23/2006
~ .may
~ BAKERSFIELD FIRE DEPT
Prevention Services
-~UN¢F~iED PROGRAM INSPECTION CHECKLIST:: ~~~i 900TruxtunAve.,Suite210
~~,:A.r~.~~:N~~;-~_~f ~ .:_ _ _..~.; ..-. ~_ . >:5 .;_.-. s: z=:_ - ~wsr Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program ~ ~ Tel.: (661) 326-3979
• Fax: (661) 872-2171
C ~
J
FACILITY NAME
l; a ~ ~ 4 ~ NSPECTION DATE
~z. ,~ NSPECTION TIME
~~ o
ADDRESS
O O ~ ~ S l HONE NO.
37 ~7~7.s O OF EMPLOYEES
DF
FACILITY CONTACT USINESS ID NUMBER
J' ti ~~
~s-oz~-
v
Section 1: Business Plan and Inventory Program ~~
OUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTIO
C V ~ C=Compliance OPERATION
V=Vblation COMMENTS
~^ APPROPRIATE PERMIT ON HAND
~0 BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
~^ CORRECT OCCUPANCY
VERIFICATION OF INVENTORY MATERIALS
7
fa'j^ VERIFICATION OF QUANTITIES
VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
~ VERIFICATION OF MSDS AVAILABILITY _
^ VERIFICATION OF HAZ MAT TRAINING
VERIFICATION OF ABATEMENT SUPPLIES AND
ROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
~^ HOUSEKEEPING
^ FIRE PROTECTION
SITE DIAGRAM ADEQUATE 8 ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
^ YES
?3~'
•OUESTIONS REGARDING THIS INSPECTION? PLEASE cALL us AT (egg) 326-3979
~. ~- z ~
Inspector (Please Print) Ire revention 1" In /Shift of Site/Station # Business Site/ hoo esponst a Party (Please Print)
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev. 02/05)
7
+
I ,~
~ CALIF WATER SERV CO CBKL-207 _________
_______________ SiteID: 015-021-002326 +
Manager BusPhone: (661) 396-2400
ocation: 10200 POLO SADDLE DR Map CommHaz
City BAKERSFIELD Grid: 18C FacUnits: 1 AOV:
CommCode: KCFD STA 65 SIC Code:
EPA Numb: DunnBrad:
Emergency Contact / Title Emergency Contact / Title
TIM TRELOAR / DISTRICT MANAGE BILL HARPER / ASST DIST MGR
Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x
24-Hour Phone (661) 396-2400x 24-Hour Phone (661) 396-2400x
Pager Phone ( ) - x Pager Phone ( ) - x
Hazmat Hazards: Fire React ImmHlth DelHlth
Contact TAMARA JOHNSON Phone: (661) 396-2400x
MailAddr: 3725 S H ST State: CA Ss'3~l- 7~7~
City BAKERSFIELD Zip 93304
~y~~®3Z~_
+----------------------------------------------------------------
--+
Owner
Address 3725 S H ST
City BAKERSFIELD
Phone: (661) 396-2400x
State: CA
Zip 93304
Period to TotalASTs: = Gal
Preparers TotalUSTs: = Gal
ertif' d: RSs : No
arcelNo:
Emergency Directives:
-1- 11/08/2005