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HomeMy WebLinkAboutBUSINESS PLAN 7/25/2007~.. ~~ rF~,° r~ ,~ ~. ~i,~~ ~fD r i U, ,~i~~ y593o~ _ . ___ _ ~~. _ ~ 'i SUNDALE COUNTRY CLUB \ _. ~~i 119' F SUNDALE COUNTRY CLUB & TAVERN Manager YOUNG OHR Location: 6218 SUNDALE AVE City BAKERSFIELD CommCode: BFD STA 11 EPA Numb: SiteID: 015-021-001197 BusPhone: (661) 831-4200 Map 123 CommHaz Moderate Grid: 03C FacUnits: 1 AOV: SIC Code:7997 DunnBrad: Emergency Contact / Title Emergency Contact / Title YOUNG OHR ~ / OWNER SHARON OHR ~ / GOLF SUPR Business Phone: (661) 831-4200x Business Phone: (661) 831-4200x 24-Hour Phone (661} 663-0878x - 24-Hour Phone (661) 319-8619x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact YOUNG OHR Phone: (661) 831-4200x MailAddr: 6218 SUNDALE AVE State: CA City BAKERSFIELD Zip 93309 Owner SUNDALE COUNTRY CLUB Phone: (661) 831-4200x' Address 6218 SUNDALE AVE State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: ~~~/~ ~ ~ C 2 6 2007 PROG C- COMM HOOD PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TAN K {~~ ^ed on my inquiry of those individuals res,~en:.ll:~le fur ot-•Eaining tl,e irrformation, !certify under penalty ci laM~ that 1 have personally examined and am familiar with the ~ formation sut~mitted and believe the inf -..ration is true, accurate, and campiefe. ~© ~ y nature Date -1- 07/16/2007 ~ ,"s` c~ F SUNDALE COUNTRY CLUB & TAVERN ~ Hazmat Inventory ~ MCP+DailyMax Order = SiteID: 015-021-001197 ~ By Facility Unit ~ Fixed Containers on Site ~ r Hazmat Common Name... SpecHazIEPA Hazardsl Frm I DailyMax IUnitIMCPI GASOLINE F IH DH L 245.00 GAL Mod DIESEL F IH DH L 245.00 GAL Mod CARBON DIOXIDE F P IH G 344.00 FT3 Low WASTE OIL F DH L 110.00 GAL Low WASTE OIL FILTERS F DH S 110.00 GAL UnR WASTE BATTERIES IH S 55.00 GAL UnR -2- 07/16/2007 Y -3- 07/16/2007 •~ F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Below Ambient Below Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 245.00 GAL 245.00 GAL 35.00 GAL • t1F~GHKLVU~ wrlr~lv~lvl~ %Wt. RS CAS# 100.00 Gasoline No 8006619 t1L-~GE~tCL AJSL' S~1~1L" 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this .Facility Unit Map: Grid: E END R SIDE CAS# 68476302 Liquid TMixture BelowSAmbEent BeMowAmbient ABOVEOGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 245.00 GAL 245.00 GAL 20.00 GAL HAZARDOUS COMPONENTS ~Wt• RS CAS# 100.00 Diesel Oil No 68476302 L3HGL•iiCL Liw 7 ,7 r,.7 ~71"1P~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 07/16/2007 i F SUNDALE COUNTRY CLUB & TAVERN ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Location within this Facility Unit SE CRNR SNACK BAR STATE TYPE PRESSURE _ Gas TPure -Above Ambient SiteID: 015-021-001197 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 124389 TEMPERATURE CONTAINER TYPE Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 344.00 FT3 344.00 FT3 170.00 FT3 nt~~titcL~u~ ~~i~ir~lv~lvl~ %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1E~GHKL A5~L' ~.71~1~,1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / /• Low ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TWaste ~ Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 20.00 GAL nr~ZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 - -- ruic,rircL ria aaaai~tr~ivia TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -5- 07/16/2007 F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL FILTERS Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 221 ~SolidE I Waste ~~ PRESSURE TEMPERATURE CONTAINER. TYPE I Ambient ~ Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 20.00 GAL cwt. RSI CAS# til-~GE~tCL L-1 ~J~JJ1~1~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL HAZARDOUS COMPONENTS , %Wt. RS CAS# HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR HAZARDOUS COMPONENTS -6- 07/16/2007 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid Waste ~ Ambient ~ Ambient DRUM/BARREL-METALLI~ F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/07/1999 ~ CALL 911. Employee Notif./Evacuation 01/02/1991 USE VERBAL AND PUBLIC ADDRESS SYSTEM AND CALL 911. Public Notif./Evacuation 12/07/1999 ALL CHEMICALS STORED IN A LOCKED AREA IN THE MAINT YARD AND PUBLIC IS NOT EXPOSED. Emergency Medical Plan LOCAL AND CLOSE HOSPITAL FACILITY OR CALL 911 FOR HELP. 12/07/1999 -7- 07/16/2007 F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/02/1991 ~ CO-2 IN PRESSURIZED CONTAINERS PROPERLY STORED. Release Containment 02/19/1999 ALL MATERIALS ARE STORED IN PROPERLY LABELED CONTAINERS LOCKED IN A SEPERATE STORAGE BLDG. Clean Up 01/02/1991 ALL CLEAN-UP PROCEDURES ARE IN ACCORDANCE WITH THE INSTRUCTIONS GIVEN BY CHEMICAL MANUFACTURERS AND IN ACCORDANCE WITH HAZARDOUS CHEMICALS LAWS OF THE STATE OF CALIFORNIA. Other Resource Activation -8- 07/16/2007 n F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~J~JCC:1d1 ridGd.LU.y' Utility Shut-Offs A) GAS - FRONT YARD FRONT OF SW CRNR OF MAIN BLDG B) ELECTRICAL - PG&E NW CRNR OF BLDG TWO PATIO DECK C) WATER -'S CTR OF BLDG ONE D) SPEACIAL - NONE E) LOCK BOX - NO 01/23/2007 Fire Protec./Avail. Water 01/23/2007 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM, KITCHEN HAS SYSTEM FOR GREASE AND COOKING FIRES PLUS HAND-HELD EQUIPMENT, CONCRETE STORAGE BARN HAS SPRINKLERS. FIRE HYDRANT - S CTR OF DOWNSTAIRS OUTSIDE OF BLDG FRONT OF BACK DOOR ENTR. Building Occupancy Level 68 EMPLOYEES 03/22/2006 -9- ~ 07/16/2007 e ~~-: ;Z F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/23./2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: A HEALTH AND SAFETY ORIENTATION MEETING IS HELD WITH EACH NEW EMPLOYEE AND AT REGULAR INTERVALS THROUGHOUT HIS/HER EMPLOYMENT AT SUNDALE COUNTY CLUB. THESE WILL PROVIDE INFORMATION ON THE FOLLOWING: AN OVERVIEW OF REQUIREMENTS CONTAINED IN THE HAZARD COMMUNICATION REGULATION, INCLUDING EMPLOYEE RIGHTS, SHOW WHERE HAZARDOUS CHEMICALS ARE STORED AND USED IF ANY. rctyC L Held for Future Use nciu ivi ru~uic v~C -10- 07/16/2007 ~~ ~~ ~. SUNDALE COUNTRY /CLUB & TRAVERN SiteID: 015-021-001197 Manager :. ~~~~~" ~ a~" 1 BusPhone: (661) 831-4200 Location: 6218 SUNDALE AVE- Map 123 CommHaz Moderate City BAKERSFIELD Grid: 03C FacUnits: 1 AOV: CommCode: BFD STA 11 EPA Numb: SIC Code:7997 DunnBrad: Emergency Contact / Title Emergency Contact / Title YOUNG OHR / OWNER SHARON OHR / GOLF SUPR Business Phone: (661) 831-4200x Business Phone: (661) 831-4200x 24-Hour Phone (661) 663-0878x 24-Ho ur Phone (661) 319-8619x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact ~~ Phone: (661) 831-4200x MailAddr: 6218 SUNDALE AVE State: CA City BAKERSFIELD Zip 93309 Owner SUNDALE COUNTRY CLUB Phone: (661) 831-4200x Address 6218 SUNDALE AVE State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG H - HAZ WASTE GEN PROD T - ABOVEGROUND STORAGE TANK ~NT'D F,~~ ~ ~ X00 Eased on my inquiry of those individuals responsible for obtaining the informati on, I certify under penalty of law that I have person exa ll i a y m ned and am familiar with the information submitted and belie ve the information is true, accurate, and complete. Z2Z~~ ~ Si " g. , u e Date -1- 02/16/2007 1 -:5' F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP GASOLINE F IH DH L 245.00 GAL Mod DIESEL F IH DH L 245.00 GAL Mod CARBON DIOXIDE F P IH G 344.00 FT3 Low WASTE OIL F DH L 110.00 GAL Low WASTE OIL FILTERS F DH S 110.00 GAL UnR WASTE BATTERIES IH S 55.00 GAL UnR -2- 02/16/2007 n. -3- 02/16/2007 5' F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Below Ambient Below Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 245.00 GAL 245.00 GAL 35.00 GAL I1HGEitCLVU~J I..VP7YV1V1;1V 1.7 sWt. RS CAS# 100.00 Gasoline No 8006619 IlEiGHl(L HJ ~JP~~7.71°1~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL .Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 68476302 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Below Ambient Below Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 245.00 GAL 245.00 GAL 20.00 GAL ruyc,rucLV~J ~.v1~lrvtvaly 1 S %Wt• RS CAS# 100.00 Diesel Oil No 68476302 iltiGriRL ti. 7JIJJ.7P7.C~1VliJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -4- 02/16/2007 F SUNDALE COUNTRY CLUB & TAVERN SitelD: 015-021-001197 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR SNACK BAR CAS# 124389 ~GasATE T TYPE PRESSURE ~~ TEMPERATURE CONTAINER TYPE I Pure Above Ambient I Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 344.00 FT3 344.00 FT3 170..00 FT3 ru~~tucl~vua ~~l~~r~lvli,lvl~ °sWt . RS CAS# 100.00 Carbon Dioxide No 124389 t1KGHt'C1J 1~~~7J;.7~71~1J;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Low ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: E END R SIDE CAS# 221 LiquidWaste ~ AmbRent~E ~ AmbientT~E DRUM/BARRELEMETALLI~ ' AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ( Daily Average 55.00 GAL 110.00 GAL L 20.00 GAL I1HGL-1[C.LVU~ l.Vl~lt'V1V~1V 1.7 owt. Rs cAS# 100.00 Waste Oil, Petroleum Based No 0 nrj~titcl~ r~a ~~~al~i~lvt5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -5- 02/16/2007 ,. ~. F SUNDALE COUNTRY CLUB & TAVERN ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME WASTE OIL FILTERS Location within this Facility Unit E END R SIDE STATE TYPE PRESSURE Solid ~aste -dent SiteID: 015-021-001197 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 221 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 20.00 GAL HAZARDOUS COMPONENTS , %Wt. RS CAS# ntj~.y.ttL t~,~a~~~ri~ivta TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME WASTE BATTERIES Location within this Facility Unit STATE TYPE PRESSURE Solid TWaste ~ Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL HAZARDOUS COMPONENTS , %Wt. RS CAS# nHZARD AS SESSMENTS TSecret RS BioHaz RadioactivejAmount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR -6- 02/16/2007 I F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 12/07/1999 ~ CALL 911. Employee Notif./Evacuation 01/02/1991 USE VERBAL AND PUBLIC ADDRESS SYSTEM AND CALL 911. Public Notif./Evacuation 12/07/1999 ALL CHEMICALS STORED IN A LOCKED AREA IN THE MAINT YARD AND PUBLIC IS NOT EXPOSED. Emergency Medical Plan 12/07/1999 LOCAL AND CLOSE HOSPITAL FACILITY OR CALL 911 FOR HELP. -7- 02/16/2007 F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 01/02/1991 ~ CO-2 IN PRESSURIZED CONTAINERS PROPERLY STORED. Release Containment 02/19/1999 ALL MATERIALS ARE STORED IN PROPERLY LABELED CONTAINERS LOCKED IN A SEPERATE STORAGE BLDG. Clean Up 01/02/1991 ALL CLEAN-UP PROCEDURES ARE IN ACCORDANCE WITH THE INSTRUCTIONS GIVEN BY CHEMICAL MANUFACTURERS AND IN ACCORDANCE WITH HAZARDOUS CHEMICALS LAWS OF THE STATE OF CALIFORNIA. V1~11CL 1CC.7~V ULl.:C L'iC: l.lVdl.1 V11 -$- 02/16/2007 ~, i~' r F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ .7iJCC:1dl 17d"G dl 1.1.5' Utility Shut-Offs 01/23/2007 A) GAS - FRONT YARD FRONT OF SW CRNR OF MAIN BLDG B} ELECTRICAL - PG&E NW CRNR OF BLDG TWO PATIO DECK C) WATER - S CTR OF'BLDG ONE D) SPEACTAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water 01/23/2007 PRIVATE FIRE PROTECTION - SPRINKLER SYSTEM, KITCHEN HAS SYSTEM FOR GREASE AND COOKING FIRES PLUS HAND-HELD EQUIPMENT, CONCRETE STORAGE BARN HAS SPRINKLERS. FIRE HYDRANT - S CTR OF DOWNSTAIRS OUTSIDE OF BLDG FRONT OF BACK DOOR ENTR. Building Occupancy Level 03/22/2006 68 EMPLOYEES -9- 02/16/2007 ~' .~' ~ ~ F SUNDALE COUNTRY CLUB & TAVERN SiteID: 015-021-001197 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 01/23/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: A HEALTH AND SAFETY ORIENTATION MEETING IS HELD WITH EACH NEW EMPLOYEE AND AT REGULAR INTERVALS THROUGHOUT HIS/HER EMPLOYMENT AT SUNDALE COUNTY CLUB. THESE WILL PROVIDE INFORMATION ON THE FOLLOWING: AN OVERVIEW OF REQUIREMENTS CONTAINED IN THE HAZARD COMMUNICATION REGULATION, INCLUDING EMPLOYEE RIGHTS, SHOW WHERE HAZARDOUS CHEMICALS ARE STORED AND USED IF ANY. rayc ~ Held for Future Use _, t_ +aciu yvi rui.u.~c. vac -10- 02/16/2007 / f , + CINGULAR WIRELESS 14218 NEW ____________ _____________ SiteID: 015-021-001868 + - 2S, 5iro~ X902 (S','ah Manager ~,~~~Lt,~~1 I(V~/-~1hd.~, BusPhone: ( W~ ~~~~ Location: 2600 SUNNY LN Map 103 CommHaz High City BAKERSFIELD Grid: 21B FacUnits: 1 AOV: CommCode: BFD STA 08 SIC Code:4813 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title / ~(j~L,~.. rr1.~~~~ WIRELESS NETWORK / CONTROL CENTER Business Phone: (Q~6-`,-5.51-4123x 562 Business Phone: ( ) - x 24-Hour Phone (800) 832-6662x 4b~' ~~~ 24-Hour Phone (800) 832-6662x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth ~5 W ~k ~ ' + I S ttrc., ~~ Contact SIGWi ~rrr5-R Phone: (425) 580- MailAddr: PO BOX 97061 ~ State: WA y-~02 City REDMOND Zip 98073 Owner NEW CINGULAR WIRELESS PCS LLC Phone: (425) 580-7.5-1-~- Address PO BOX 97061 State : WA y-~j Q Z City REDMOND Zip 98073 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK ~~ Date ~~~\~~ ENT'D ~ U G 10 2006 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, -1- 05/31/2006 !, _ "" M 14218 / BKCL19 BUSINESS OWNER/OPERATOR IDENTIFICATION ~ /~j Q` KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT l KJ o 2700 M STREET, SUITE 300 Unified Program Consolidated Form (UPCF) BAKERSFIELD, CA 93301 FACILITY INFORMATION 661 862-8700 Fax 661 862-8701 Pa e 2 of 9 I. IDENTIFICATION FACSLITY SD # 0 0 0 0 0 0 0 0 0 0 0 t. BEGINNING DATE to°. ENDING DATE tot. (Agency Use Only) 09/01/05 09/01/06 BUSINESS NAME (Same as FACIL['CY NAME or DBA-thing easiness As) 3. BUSINESS PHONE 102. New Cingular Wireless PCS, LLC - Mt Vernon (14218) 425-580-4902 BUSINESS SITE ADDRESS to3. 2600 Sunny Ln CITY 1oa. ZIP CODE 1os. CA Bakersfield 93308 DUN & BRADSTREET 106 SIC CODE (4 digit #) to7. 10-202-6754 4812 COUNTY 1os. Kern BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 11°. New Cingular Wireless PCS, LLC 425-580-4902 II. BUSINESS OWNER OWNER NAME t n. OWNER PHONE 1 u. New Cingular Wireless PCS, LLC 425-580-4902 OWNER MAILING ADDRESS 113. PO Box 97061 CITY 114- STATE 115. ZIP CODE u6. Redmond WA 98073-9761 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 11s. Laurie Schmidt 916-561-4123 CONTACT MAILING ADDRESS 119. 3851 N Freeway Blvd CITY 120 STATE 121. ZIP CODE Izz. Sacramento CA 95834 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 1zs. Laurie Schmidt Wireless Network Control Center TITLE 124. TITLE 129. Network Engineer BUSINESS PHONE tzs. BUSINESS PHONE t3o. 916-561-4123 800-832-6662 24-HOUR PHONE* 126. 24-HOUR PHONE* 13t. 800-832-6662 PAGER # 127 PAGER # t32. ADDITIONAL LOCALLY COLLECTED INFORMATION: 1 ~ /I U ^ O ~ ]33. - ~oo~ Environmental Contact E-Mail Address: ehs.compliance(c~cingular.com ~~ Certification: 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 GN A T E OF OWNER/OPER ATOR OR DESIGNATED REPRESENTATIVE DATE 13a. NAME OF DOCUMENT PREPARER t35. , , g ~ / W~I~l1/ ~'~/ aJ Mitch McGowan NAME OF SIGNER (print) 136. TITLE OF SIGNER 137. William McMahan Field Operations Manager * See instructions on next page. (7/02 revised) KC Form 2729 GENERAL NOTES ~~~ t FDR TTE PukPOSE of Fa+sTkurnoN OkaraNC. TTE FoILOWTNC DEFlwnp15 $HN1 APPLY: CONTRACTOR _ BECHTFl --~~~. --__ Red Li - n SUBCONTRAC1lM - (.T3IFILK CONTRACTOR (CONSTRl1CnON) @S ~/V ONNER - ATQT 1YRElE35 SERVICES 2 PNgi ro THE SUNI11590N Q BIDS, THE BIOgNG SUBCONTRACTOR SHNL VI51T 1HE' CE71 SITE ro ~ FAYIJM~ Wlnl THE ET95nN0 CONg7NM/5 ANO TO CONF9A/ THAT n1E l4DRiC CAN BE ALCWPl1S1Ep AS SHOWN ON THE CONSTPUCTION DRANINGS ANY dSCREPANCY Fg1NO SHALL I ~G'/.~• W'-!'•`<. C.~/ BE BRaeLarT m liE ArnNnaN a WNTRACTOR _-_ ~/R .~ ~ y'~/3~;- 3 ALL YAlQBAIS FURNLgIEO AND 95TA11ID SHALL BE M STRICT ACCORDANCE W1H ALL APPROPfdATE NOnffS µp CONPL ANO ORDIN uWS, aRpNANCES,CkUIF~ CIAAnONS. AND ~ 7 L1 ~`> Jj ~ 5' ., I J ~ / ` UWFUL ORDERS OF ANY PUNK AUTILRLITY REGARONG iNE PERFORMANCE ai THE WORI(. ,~ YW]RK CARTUm ~R ~ Ep1PLY Y~,N GAUFORIpA BULDWG Wes. IATESf EAfTION. gqEECiRICK 1TORN SHALL ~ W ACCORDANCE N1TN All APPLICABLE MUNICRK YECHANICK ATO ~ ' -2 ~ J AT & T WIRELESS SERVICES INC. ,, A!8) U7111TY CONPMR' S°ECEICAIWNS'AND LOCAL AATISLICTNMIK COOLS OfmMANCFS AND . 1 {, / -.~ ~~ J y.,7Cy ~, (~ APPLICABLE RECIAAnO15. ALL Y/DRI( SLAL1 BE M ACCOROMLCE WITH NFPA-7q 1998 NAnONA1 °~"'~" `°~ "~ `""°~" °E"~` "~ SITE NUMBER: C L19 !. ORAWWOS'PRONOEa MDE ARE NOT m BE SCAlID AIO ARE INTENDED m SNOW OUTLINE OILY. • X A I111LE5S N01ED OnERYSE, TIE WORIL SHALL NCLUOE FURNISMRIG YATWNS EWPMF7IT. APPURTENANCES. AND LABgt NECESSNIY ro CpIPLEIE All 815TALLAnRLS AS MgCA1Ep ON AS-BUILT ~ T ,SITE NAME: MT. ~ V E R N O N " 1IE aRAWwcs' 6. YAIERIAL SPEC8IED IN 1NE TABLE 'RF BAl 6 YAIpBNS' WILL BE SUPPLIED BY 7!ff ~ l - D Cg1TRACTgI TO ME SiJBCgIIRACIOft ALL OTHER YATEIBAIS SHNL BE 9JPPllFD 8Y ~ ~ PROJECT INFORMATION ~11 DRAWING INDE)U. REV / R 9LALL bLSTNl AIL EOLRPYENT AND YAlER1ALS M A4Y:ORDANCE WITH 7. 1HE SUBCCILIRA CfO ~ MANUFACiURL7YS RECD•IMEEmAnWS IRIlF55 SPEQEiCALLY 5TA7m ODERgSE . SCOPE a NdtK: lMYM1NED nlECCNL9NACA710N5 fACEITY YWW1CAl101b / ~ 8. IF 1HE SPEOflEO EgAPYENT CANNOT BE a/9TAllID AS SMOYN ON THESE UTAWINGS, 7HE 8AK-CL19-O1 TRLE SHEET AND GETIERAL NOTES 0 SITE ADDRESS 2900 STJNNY LAZE SUBGY1//1RACTOR 9IAtl. PROPOSE AN KTERNARVE OVSTAIURW SPACE FOR APPRWK BY 7NE ~~~ ~ ~ P ~ BANERSFk1D, CA O LAN U! BAK-CL19-02 EQUIPMENT U1i ' 9. SLACONRLAC70R 91N1 pETE1TY91E ACNK RW11NG aF coNOUIT. PoWER ANO n CABLES GRg1NgNC GIBIES AS SHOWN ON 7NE POWER, GRDUND8IG AND TFLW PCAN DMWOIG . BAK-CL19-03 0~ ~ lAn1U0E• 35.3895 ' ~aR 91~NL a~NFwY~Oi ~AC1u~K RouµDTw~wTM ~CDNT~RA~ oa As NEassvtY. - (BBU A 24VDC RF CA61NEn IDNGITIAE' -118.97A0 t0. 7NE Sl18CgT1RACTgT SHALL Pf107ECf pO5TN6 NIPROVFAENiS PAVEMENTS C1WBS. LANDSCAPOIO I ~ BAK-CLt9-04 ANTENNA CONFIGURAfiON D FLEYATIOIt . AxD slmKTURES ANr DAMACTn PART S1ALL eE REPNREO AT ~BCaNnTACmRS E)PENSE ro ~ ~ CTION QTY aF BANFASTEID AM?R THE SA76FACMNI Di OVBER. BAK~L19-O5 ~ 81LL OF~MATERIAL3~A}ID CONSTRUCTION NOTES 0 , OI T ~ Te>ECawnaacAnaNS FACnm 11. SUBWNiRACTgI SHALL LEGALLY !PROPERLY olsPOSE ai ALL SCAM YAIFTBALS S11O1 AS COA)OK'CA8LE5 NO DRIER ITEMS REMOVED TROY 111E E705TMG iACLITY. ANIEIMAS REYDVID BULL BE IENRNED m OW11ER'S MSIQJATE21 IOCARON. , ' BAK-CL19-08 CONSTRUCTION DETAILS AND NOTES 0 ' ~0P°g° ~ TMuW"""I"~A~ FA°uTr 72 sTSWNTRACIDx sNAU Ir.TVEPaENSts a o.EAn WNaTroR. STRUCTURAL REVIEW 13. Au CONCRETC REPAn WOfe( sNALL BE GONE a AWl7mAd1~ T9TH ANERIGN CQIgETE A Tr q VlCINIIY MAP . ,, INSnn e ( a) 3 u. ANY NEW CONCRETE N®m FOR 1NE CONSTRUC710N SHALL NAPE IOW i'9 SRENGM AT 16 DRNING DIRECTIONS SRBICIURK ANALYSIS 6 NOf REWNID Fqi THIS 47E OAK. ALL CONCRLIWG WORN SHALL ~ DONE W ACCOROANIZ YA1H Aq 3T6 CODE W HEST ON PARK ST. ro BE,UTAFm AVE. TURN LEFT. TtR61 RNA1T aN LOCUS ST, (PALM - REL%IIIte1FNTS. STJ ro CA-9t N ro 1-905 N ro 1-5 N ro OA-99 N TO CAIFORNM AVE E70T. RIGHT 13. NL 57RI1CNRK STEEL. IlDl9c SHALL [IE LH7NE N ACWMANlS TW1H Nx SPEOFTCAl10N. qI CAl1FORt11A AV£ tErl DN uESTER AVE RIGT ON 23RD AT/CA-176 E m NAIEY ~ ST RAMP. STAY IOCNi, SUCFIT RIGHT ON HAIET' SL RIGHT 011 NE]GHT ST. lE}'T ON APpLtCABLE CODES AND STANDARDS 19. WI/S'IRLICIIOH SHALL GOLELY Wlnl ~ECFICA7NIN 2162J-033-3P9-AWZ-00002 'CENFNAL SINNT' LANE z CONSIRUCIIOH SAVN.ES FOR CONSifd1CI1R1 OF AWS JC 9nS' Y~9NEiT - ( ~ 1', - 300E f ; NT$ [AaIDMC CODE: l9aFOR11 BLMD8IG CODE ta97 17. SUBWNTRACTOR .41HL VEIRY All ET0511NG OWO19g15 AND Og6AnONS PRIOR m WL9.ENQIG ANY 11ORIC ALL OABDlSIONS aF ETaSTaLG WNSRIUCnW SHOIWI ON TFE ORAWMGS MUST BE I }TY~~ (4 + ciu wv~o I ~ ~~I ~ I ~ T NL woRN IS To COMPLY WaTN nE Ta99 CAl1FORt0A EnAIDNG OOOE(wC) ANEXOLIFRTS AND sTAfUM05. yERIF®_ gBCOI11kACfOR 91NL NO1aY THE WNRIACiOR 6 AM' g5C(tEtEPAMCES W60R TO y NcAb'AW ~ j I 1, ~ NClLD9lG TIE i0LL01WNO CWES M ORDER OF PIECIDENC£: OWETBNIC YATQBK OR PROCE}DWG YAill OONS7RUC7KWL 97E LS N FTRL CCARERCIK OPERAIlON. ANY CANSTRIICIIW YA76( BY iQ THE f7115T8LG EEU ~ ~ ;n 13 f10Db Aw p -~ ,q ~. J 1 i1 T ~ C e I '' ~ ~ TIE 1987: IRLffORY BLDG. CODE STANOAFB)S NTD AYENMSNTS IRIFORY ME'C11AlOCAL CODE STANDARDS AND AYENDYE7Ti5; UMfORII FIRE CODE STANDARDS AND AIETIOYQITS: UNIFORM Pl1LLI81NO CODE STANDARDS AIO . S6WNiRACTDR 9ULL NOT 0143UPT nE ETOSTNG NORYK WERATNIN, ANY WDTK ON OOSIING ~ g r bi CiSt ~--~ 1 b, IWi p'. { ' i 3 NiEND1ENT$ LOCAL UTAIDIMG QOOE: QTYJCd.'!'171' OIO)NAVCES EOUIPMETTi NUSf BE COORDINATED YAlll CONTRACTOR. AT CONTRACTOR'S OP7gN, WORK YAY BE SOEDlRE11 FOR AN APPRTPMATE NNNIENIWLI WINDOW IISTIALLY 8/ lDW iRAFi1C PERKJOS . ~ - .... P OJECT SRE - 11A/F1A-712-1998 F. 807 CQIYfltgAL BLA.DRIG GRWNOING .VA BONDING REQIEETEEN75 FOR AFTER YIDNNBIT. TELECg1YUNICARONs 1B. SMCE TIE LIIl aTE l5 ACnVE, All SAFETY PAECAl17N7N5 NUST EE TAKEN WiEN WO160N0 Wafts 5t .. ~ A6G WNSiRUC110N MANUAL. 9lN EdM1N OR LITER AROUND HX7H lFflS OF ELLCBIOIIAGNE7IC RAdAn0I1. UPON CON1RACfdCS P1761690N, EWNLENT SNgRD BE SHUIDOYM PRIOR ro PERFORIRIO ANY WORIL THAT CgRD EI~OSE iNE _ I S Y+~ "~ T ' - i - i NEC (NATIONAL ELECTRIC WOE) /999 (tiPA 70) YNRIORS TO DANCER PERSdIK RF EILPOSURE YOMTORS 6 ADVISED ro ~ 9aRN ro ALERT OF ANY DANGEROUS El0'OSURE IL,ELi ~ -- _p ____ _ D Li 2 I~-~ „ l ~ .: ; 5 NOIVA VLTRA9IE DRAYNN; B9U36500002CS721 OR IAIER REVI9pE : a c R ° ~'~ ~ E ~ ~ ~' 1CT DETYEFFI CODES AN ENLER NAI&D COOS TNES PRECEDENCE OVEA A U1FR IS A CONEl a i ~ ~ 8--~+ m. ~~ ~ !; P '(L _ ~: ~ 97 - ~ ~ ! 'f +~n ' i . WIEfF 1HEfE N/JIED CODE . . ~ ~ y- . y t a ` B ma^S ~ n n ~ IN ANY SPEC8IC CASE 011 CONFUCIS BETNEE/l SECTIONS OF ANY CODE REGMOWC YAIFRIKS MLT/1005 Di OR OIiLR REGINRE//DITS THE YOSi RESnBCTM1E SHALL GOVERN. YIFIERE REFE IS CONFUCf nMU 9 BGf 9R1 9 m ~ -` ~ CONSTRIIC110N, BETVEIII A g71ERAL REOIRREIAFNT AND A SPELSIC REQ11RElENL iME SPECff1O REOUIRELEtLT 51YLL _ - AY1S COMPLEX GR01NfH a~rre! relecortrExx~ca6one ~~ + ~ AT&7 TTTIE SHEEi AND ~lax GYowlh Project F - C CL19 8(IE NO GENERAL NG(ES a y AWS . 2800 SUNNY LANE ATiT YARElf53 SEIRVICE$ LNG 9 ,o ®30 ~• ~~na ra m¢ s 9w 12900 PARK PLAZA DRIVE ~~~ G WNw PAru NATA OIW( aaC AWm010 er °w ~Y °~ wW6n CERRR05. CA 90703 ' USID: 9531 G ,GL A; RWWN oESn,EC Nc On.a 6c 2Ae97 EWL-CLT9-0T 0 1 T fi . . C. Il- ~ _ ~~ - ~ o~- I 6 i T ~J~~ d~ ~ g ~~ ~ a { ~ W . ~ o g ~ '~ '~ v ~ ~ \ ~ O ~ O tl G ' - .S-.S 0 i 8 ~ Z ~ a ~ v Q -~ 0 S ~ .; •, a ~ ~ ~ a S -~~ • t ~ ~ ~ ~~ ~ --' J i .J LL c { ' ~.. -_ v - v4 ~`` z o ~ ~ 3 { 3 ~ `'..J ~ ~ ~.J N 1 - m ~ ~ .Z~~L ~ ~ C ~ ~ y ... 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Correct occupancy 2 Verification of inventory materials ~ ` 7 H~ ~?~1"F~ItiS Verification of quantities Verification of location Proper segregation of material jam- ~'J-1 L` ~.,. ~~ w~ Verification of MSDS availability Verification of Haz Mat training ~/ t:..~.~". ~T~4~~~.~tr ~ ~W Verification of abatement supplies and procedures Emergency procedures adequate \/ Containers properly labeled V~~4'J-i- ~ Housekeeping Fire Protection y ~~~t S ~ ~.~ ty~~ Site Diagram Adequate & On Hand ~/ C=Compliance V=Violation Any hazardous waste on site?: I~Yes ^ No Explain: ~'"~~i ~t~ Questions regarding this inspection'' Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy y G_. a~~ Business Site Responsible Party Inspector:~~~~~.,