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Home My WebLink AboutBUSINESS PLAN 7/17/2007~ __ _ I~, ii Cam' WATER SRV (~~~-oi) ~, i~ 4613 SIAM COURT _,_ _ ~. j` ~-TE~3~s7 ~j~ ~~ UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: business Plan and Inventory Program ,~ ~~ i~~-_. nnr~~rRSrirl.n F/BE ,~~ D`~ ARTM~~T "~' '~ Prevention Seryices 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY N/~'A'~ME ~ / ~ `,!a lL i ~ ~;,' nJ / •~- W .'~'.~.~ P' ~ r?'~ I! ~1 .. a ~ INSJPECTION DATE / ~ ~ ~ I/ INSPECTION TIME f G Zd fyJ ADfDR'~ESS HO ENO. /~ /~ NO OF EMPLOYEES FACILITY - 1~ ~Dl j~ ~~ ~'~- ~O ~ a'1 BUSINESS ID NUMBER 15-021- ~~ Section 1: 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 ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~ ~ {'~ ~ _~ t k `~ ^ CORRECT OCCUPANCY L~ ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~' ^ VERIFICATION OF LOCATION ~l ^ PROPER SEGREGATION OF MATERIAL ~`t V ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~1 ^ EMERGENCY PROCEDURES ADEQUATE `~ ^ CONTAINERS PROPERLY LABELED (~ ` ' ^ HOUSEKEEPING ~ ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES I{~J NO / \ EXPLAIN: /-~"'~~~ .~7 . ~ ~ , ti, - (~l , 3 ~ ~ ~- ~ !~ ( ~~!>'~ ;a ~•~rq'~"+wyS ) QUESTIONS REGARDING/THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Pleas/e Print) Fire Prevention / 1°` In Shift of Site/Station # Busin s Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ~. CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002106 Manager TIM TRELOAR Location: 4613 SIAM CT City BAKERSFIELD BusPhone: (661) 837-7200 Map 124 CommHaz High Grid: 18C FacUnits: 1 AOV: CommCode: BFD STA 05 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: TotalASTs: = Gal TotalUSTs: = Gal RSs: Yes 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 !aw that I have personally examined and am familiar with the information submitted and believe the information is true~y~v accurate, and complete. ! ® /~ ~ ~~. 7 ~J~~~ ~ ~®Z ature p~-°r`~° ~Q' -1- 07/10/2007 r~ F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002106 ~ ~ 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- 07/10/2007 F CALIFORNIA WATER SRV 177-01 ~ Inventory Item 0002 COMMON NAME / CHEMICAL NAME SODIUM HYPOCHLORITE Location within this Facility Unit FENCED ENCLOSURE NEXT TO PUMP STATE TYPE PRESSURE Liquid TMixtur~ Ambient SitelD: 015-021-002106 ~ 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 I Daily Average 200.00 GAL 200.00 GAL 200.00 GAL - riAGLj.hCLVUS 1:V1~lYV1Vi;1V~1J $Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 tlE~GHttL F~551;J~1~1L'1V'15 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 177-O1 SiteID: 015-021-002106 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/30/2000 ~ CALL 911. Employee Notif./Evacuation 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 MERCY HOSPITAL, TRUXTUN AVE. 08/08/2006 -5- 07/10/2007 F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002106 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/27/1994 ~ DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK. Release Containment 10/18/2006 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 05/16/2006 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 F CALIFORNIA WATER SRV 177-01 SiteID: 015-021-002106 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards Utility Shut-Offs Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - WELL DISCHARGE. 08/08/2006 Building Occupancy Level 05/16/2006 UNMANNED SITE -7- 07/10/2007 F CALIFORNIA WATER SRV 177-01 SiteID: 015-021-002106 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/16/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rayc ~ nciu Lvi ru~.uic voc nciu ivi ru~uic vac -8- 07/10/2007 CALIFORNIA WATER SRV 177-01 Manager TIM TRELOAR Location: 4613 SIAM CT City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: SiteID: 015-021-0021016 BusPhone: (661) 837-7200 Map 124 CommHaz High Grid: 180 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 MGM (661) 837-7271x (661) 837-7271x ( ) - x Fire Press ImmHlth Phone: (661) 837-7278x State: CA Zip 93304 Owner CALIFORNIA WATER SERVICE CO Phone: (~-8-~ ^~'-Q~nna Address n3725 .~nu~ N s}~ State: CA 6~ X37-~Zoc~ City AS•E C~AJ~e~-S~r~Ld Zip ~'~- g33o4 Period to Preparers Certif'd: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK TotalASTs: _ TotalUSTs: _ RSs: Yes ~N~~ ~ ~~~ ~p~9 Based on my inquiry of those indi'IdeuafY responsible for obtairnng the information, under penalty of law that i have personally examined and am familiar with the information submitted and k~el~1eie the information is true, accurate, and comp Z ~ G - - ~,-°°°_°`o~~ Dat Si tore Gall Gal -1- Ol/29/~007 t~. i F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002105 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit Nr~P SODIUM HYPOCHLORITE F P IH L 200.00 GAL F# -2- Ol/29/~007 -3- O1/29/Z007 S F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-0021015 ~ ~ 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 ENCLOSURE NEXT TO PUMP CAS# 7681-52-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~ Ambient ~ Ambient ABOVE GROUND TANK Largest Container 200.00 GAL • riAGAiCLVUJ 1.:V1~lYV1VL'1V1~ %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 HHL,HKL L~5 ~1;551~1L'1V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MSC No Yes No No/ Curies F P IH / / j Hi AMOUNTS AT THIS LOCATION Daily Maximum 200.00 GAL Daily Average 200.00 GAL -4- 01/29/2007 4 F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002106 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/30/200 ~ CALL 911. ~lllNlVyCC 1VV1.11 /.GVdC:UdL1V11 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 08/08/2006 MERCY HOSPITAL, TRUXTUN AVE. -5- 01/29/21707 +~ F CALIFORNIA WATER SRV 177-01 SiteID: 015-021-002106 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 09/27/1994 ~ DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK. Release Containment 10/18/2005 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 BUILT-IN SECONDARY CONTAINER AND IS ENCASED IN CONCRETE. Clean Up 05/16/2006 RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY AGENCY. v~.uci i~covui~.c tf.l.l~1V0.1.1V11 -6- O1/29/~007 F CALIFORNIA WATER SRV 177-O1 SiteID: 015-021-002106 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~1C 1:1d1 IldGdl U.S.' Utility Shut-Offs Fire Protec./Avail. Water 08/08/2005 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. FIRE HYDRANT - WELL DISCHARGE. Building Occupancy Level 05/16/2006 UNMANNED SITE -7- 01/29/2007 yam' 'Q F CALIFORNIA WATER SRV 177-01 SiteID: 015-021-002176 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 05/16/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE. rage ~ i1C1(.1 LVL .CUI.ULC UDC 11C1U LVI t ULULC UDC -8- Ol/29/~007 Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST - e A =, f R 5 r , „ 900 Truxtun Ave., Suite 210 ,,~=_ Fine ~" Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program ° aerM Tel.: (661) 326-3979 FACT}~TY NAME - INSPECTION DATE INSPECTION TIME ADDRESS .. ~ PHONE NO. 39~ ayaQ NO OF EMPLOYEES ~a FACILITY CONTACT ~~ (~ 1 C - BUSINESS ID NUMBER / 15-021- ~,,~~/O Section 1: Business Plan and Inventory Program jp~ (ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance) OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE )~ ^ VISIBLE ADDRESS ^ .CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION C~t7 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~I ^ CONTAINERS PROPERLY LABELED ,$`1 ^ HOUSEKEEPING ~I ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND. ANY HAZARDOUS WASTE ON SITE? ^ YES Ij~O EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (667) 326-3979 ~~ ~~ LcA~ ~/~ ~~c. Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Busin s ite /Responsible Party (Please Print) " White -Prevention Services Yellow- Station Copy Pink- Business Copy. FD 2155 (Rev. 09/05 ;`~ ~ ~ - + CALIFORNIA WATER SRV 177-01 _________________________ SiteID: 015-021-002106 + G3')-~7'Ltti~ Manager BusPhone : ( 661) ~~~ 2~v Location: 4613 SIAM CT Map 124 CommHaz High City BAKERSFIELD Grid: 18C FacUnits: 1 AOV: CommCode: BFD STA 05 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title TIM TRELOAR / DISTRICT MGR ~~d~ Ud Ii~s / ASST DIST MGR Business Phone : ( 6 61) ~ --+~37•-7zcv Business Phone : ( 6 61) ~.9~ `--~-~~c~37-) •L 1 f 2 4 -Hour Phone ( 6 61) '-" `"- ^ ^ ^ ^ --c~37-~z o6 2 4 -Hour Phone ( 6 61) ~==~~ -~ 4~~ E33~ - 7 z Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth Contact 3i ~I ~~s;z:A Phone : ( 6 61) 3Q~ ~^_-~- MailAddr: 3725 S H ST State: CA c~37~'7Z"7~ City. BAKERSFIELD Zip 93304 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: 832-2141 ~~TQ ~ ~4/~' ~~Q~ 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 Cortlplet®. . ~~ Z2 ~, 5i ature Da e ia~~~ h -1- 05/16/2006