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HomeMy WebLinkAboutBUSINESS PLAN 7/17/2007~ r C „ CALIFORNIA WATER SERV CO 66 ______ ~ it 601 TERRACE WAY (~ i .,(~1 1 1 ~~ ~~~ ~~ ~J __ Per it to Operil.te I ' Hazardous Materials/Hazardous Waste Unified Permit , ,i:: ',"¡ . , ' , CONDITIONS OF ,PERMIT ON REVERSE SIDE Permit 10 #:: 015-000-001940 This oermlt Is Issued for the following: 6ZI Hazardous Materials Plan o Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment , ~ 'j Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES' 1715 Chester Ave., 3rd Floor' Bakersfield, CA 93301 Voice '(661) 326-3979 FAX (661) 326-0576 Approved by: i í Issue Date . ", ! t' ':'::':,'J:!' , ': Exp~tion Date: . . . . . . <~-. .~ I.·.. . " t' ~. .... ! June 30, 2003 1 ' ¡ !" ,4-2301 '}J ~ 2"CI. LMO-692 2"CI. L-905 , } ~ ....: ~ ~ ~ l) ~ ,\ .? !..... f, ~ r ./5; r ~ß )~ :~ :~ tU CQ~ ~ ~ ~ ~' " ~ . I ~ A-2.36l rJLMA.œ ,::.~~ 6- Ell. ðÄ'. £-2966 -02 STA.66__- WELL 6~1)f " £-426Z-(RF.TIRél1) (,(,-oz. ~J2.()'b:·6ÅIJL__~", \S(iOiPil·?IIPlrxllLø£l16 ~~. -~ - - ---._-~ 'o:t - N a, ~ ~ '~, .. 1 CALIFORNIA WATER SRV 066-02 Manager TIM TRELOAR Location: 601 TERRACE WY City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: SiteID: 015-021-001940 BusPhone: (661) 837-7200 Map 124 CommHaz High Grid: 06B FacUnits: 1 AOV: 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 Address 3725 S H ST City BAKERSFIELD Period to Preparers Certif ~ d: ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK F3ased on my inquiry of those individuals responsible for obtaining the informatioe~rson Ily under penalty of law that 1 have p examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ? /J~ S n ture Date Phone: (661) 837-7200x State: CA Zip 93304 TotalASTs: _ TotalUSTs: _ RSs: Yes ~~ ~ ~ ~ ~ ® 2007 Gall Gal -1- 07/10/2007 -~ F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at 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 1r 1 F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ ~ 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: FENCED ENCL NEXT TO PUMP CAS# 7681-52-9 Liquid TMixture ~ AmbRient~E ~ AmbientTURE CONTAINER TYPE ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 GAL 200.00 GAL 200.00 GAL HAZARDOUS COMPONENTS sWt• RS CAS# 12.50 Sodium Hypochlorite No 7681529 I1LiGEitCL 1iJ ~r,~~1~1~1V 1J 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 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/08/2006 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. t ~~ LiI Ll~J1VyGG 1VV 1.11. ~ PTV 0.1.U0.1~1 V11 Public Notif./Evacuation 08/08/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICE PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan 08/08/2006 MERCY HOSPITAL, TRUXTUN AVE. -5- 07/10/2007 F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 08/08/2006 ~ SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment 04/06/1999 THE SODIUM HYPOCHLORITE HAS SECONDARY CONTAINMENT. t.1CQ11 V~! V~.iiai tCC~TVUIGC ACl.1Vc1L1Ui1 -6- 07/10/2007 F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ aNc~:lca.L nac~aiu5 Utility Shut-Offs A) ELECTRICAL - SERVICE BOX INSIDE FAC B) LOCK BOX - NO 08/08/2006 Fire Protec./Avail. Water 08/08/2006 FIRE HYDRANT - WELL DISCHARGE Building Occupancy Level 02/27/2006 UNMANNED SITE. -7- 07/10/2007 .: :. F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 02/26/2007 ~ MSDS SHEETS ON FILE. BRIEF SUNIlKARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE CO PROVIDES THE FOLLOWING TRAINING: SAFETY PROCEDURES IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR THREATENED RELEASE; HAZARD COMMUNICATION STANDARD; EVACUATION PROCEDURES; PROPER HANDLING OF HAZARDOUS MATERIALS; AND HMMP IMPLEMENTATION. rayc c nc.LU ivt r u~uic v5c nc.LU ivi rul.ulC use -8- 07/10/2007 -~- CALIFORNIA WATER SRV 066-02 Manager TIM TRELOAR Location: 601 TERRACE WY City BAKERSFIELD SiteID: 015-021-001940 BusPhone: (661) 837-7200 Map 124 CommHaz High Grid: 06B FacUnits: 1 AOV: CommCode: BFD STA 06 EPA Numb: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact j 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 TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: Yes ParcelNo: Emergency Directives: PROG A - HAZMAT PROG T - ABOVEGROUND STORAGE TANK Based an my inquiry of those individuals responsible far obtaining the information, I certify under penalty of law that 1 have personally examined and am familiar with the information submitted and believe the information is true, accuCrate, and complete. ~"'~ ~ Date g ature ~N~~~ ~'~ B 2 6 2007 -1- 01/26/2007 i F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SODIUM HYPOCHLORITE F P IH L 200.00 GAL Hi -2- O1f26f2007 -3- 01/26/2007 F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ ~ 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: FENCED ENCL NEXT TO PUMP CAS# 7681-52-9 Liquid TMixture~ AmbRent~E ~ AmbientT~E ~ OVE GROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 200.00 GAL 200.00 GAL 200.00 GAL ril-~GKKLVU~ ~Vi~irVivr;ivl"5 %Wt. RS CAS# 12.50 Sodium Hypochlorite No 7681529 riHGHKL A~S~Sa1~1L1V 1"~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Hi -~4- 01/26/2007 ~: F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 08/08/2006 ~ CALL 911 AND 800-852-7550 OR 916-427-4341. ,~ P~Lll~J1VyCC lVV l.11 / P,~V QI.: UGLV1V11 Public Notif./Evacuation 08/08/2006 WE WOULD PREFER TO RELY ON EMERGENCY SERVICE PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION, AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan MERCY HOSPITAL, TRUXTUN AVE. 08/08/2006 -5- 01/26/2007 F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 08/08/2006 ~ SODIUM HYPOCHLORITE IS STORED IN AN ABOVEGROUND SECURE AREA. Release Containment 04/06/1999 THE SODIUM HYPOCHLORITE HAS SECONDARY CONTAINMENT. ~.. ~LCQ11 V~J V Vl1G1 iCC.7VUtVC 1"Sl.L1vCLL1V11 -6- 01/26/2007 ~s *+ F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ _, ,_ .~Nc~.a.ai riac~aiua Utility Shut-Offs 08/08/2006 A) ELECTRICAL - SERVICE BOX INSIDE FAC B) LOCK BOX - NO Fire Protec./Avail. Water 08/08/2006 FIRE HYDRANT - WELL DISCHARGE Building Occupancy Level 02/27/2006 UNMANNED SITE. -7- 01/26/2007 ~~ F CALIFORNIA WATER SRV 066-02 SiteID: 015-021-001940 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08/08/2006 ~ MSDS SHEETS ON FILE BRIEF SUNIMARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE CO PROVIDES THE FOLLOWING TRAINING: 1. SAFETY PROCEDURES IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR THREATENED RELEASE. 2. HAZARD COMMUNICATION STANDARD. 3. EVACUATION PROCEDURES. 4. PROPER HANDLING OF HAZARDOUS MATERIALS. 5. HMMP IMPLEMENTATION. rctyc G nciu ivi ru~.u.~c v5c nciu ivi ru~.uic vaC -8- 01/26/2007 UNIFIED PROGRAM {NSPECTION CIiECKUST :~.~.. .SECTION 1: Business Plan and Inventory Program • BASERSF][E]LD FIRE DEPT Prevention Services ~lt~ 900 Truxtun Ave., Suite 210 ~•rn t Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME r/~ ~~ ~ ^ ~ U ~ ~", NSPECTI~ DATE D~ INSPECTION TIM 3 ~ ~- Q ADDRESS ~ ~_ ~r'r Gc~ ~ HONE NO. ~ Z O OF E PLOYEES FACILITY CONTACT , I ~ C7 S' 1 L G USINESS ID NUMBER 15-021- ~©l c . + c.r l Section 1: Business Plan aftnd inventory Program f ~ Q ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION r 1 ~ I C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ENT"D ~.+ l~ _ ^ BUSIYiQSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION In'~?v} ~ ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~( ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES qQ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN ^ YES ©NO ~UESTIONS REGARDING TH~I,S~IN`SPECTION? PLEASE CALL US AT (861) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of SNe/Station p ss Sit ool Ske Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink - Business Copy ~_- ~ FD2049 (R~v. 02105) - - - / ~~' ~r_.; + CALIFORNIA WATER SRV 066-02 _________________________ SiteID: 015-021-001940 + v 37 ~ 7ZcSU Manager BusPhone : ( 661) 3~~~4 @~9 Location: 601 TERRACE WY Map 124 CommHaz High City BAKERSFIELD Grid: 06B 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 fiu~y Valles / ASST DIST MGR Bus ine s s Phone : ( 6 61) ~~ v37~ 7za Bus ine s s Phone : ( 6 61) 3-9fr~~-@-x~3~- 72 2 4 -Hour Phone ( 6 61) ~ %~•~ c~3 7~ 7zeX, 2 4 -Hour Phone ( 6 61) 3 9 0~z-"x~~r^v~c 537 ~'7~ ~ Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth Contact ~,` ~ ~ '~c~Str=1~ Phone : ( 661) """ ^ " ""=_ MailAddr: 3725 S H ST State: CA d~7~7L7 ~ 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: Yes 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 O examined and am familiar with the information ,~ submitted and believe the information is true, accurate, and complete. ;~ 5 ~ ~ 06 r ature Dat ~N~ A ~/~ n ~/ ~®®U -1- 05/11/2006 -' /' r-/e// " t· \. /' ,?"'" ~ -" ", . + CALIFORNIA WATER SERi~C§TAbb·~~~~~~~~~~~~~~===~~~~~ f'l1)~~: Manager: MELVIN BYRB t ~ BusPhone: ocation: 601 TERRACE WY ~~~ Map : 124 City BAKERSFIELD Grid: 06B SiteID: 015-021-001940 + (661) 396-2400 CommHaz : Moderate FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:4941 EPA Numb: DunnBrad:00-691-3578 +==============================================================================+ +=======================================+======================================+ Emergency Contact / Title Emergency Contact / Title M Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x 24-Hour Phone : ( x 24-Hour Phone : () x Pager Phone : ( x Pager Phone : () x +---------------------------------------+--------------------------------------+ I Hazmat Hazards: RSs Fire Press ImmHlth I +------------------------------------------------------------------------------+ Contact : Phone: (661) 396-2400x MailAddr: 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 +------------------------------------------------------------------------------+ Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x Address : 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 +------------------------------------------------------------------------------+ ~eriOd : to TotalASTs: Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: Yes arcelNo: +---------------------------------------------------------------------~--------+ Emergency Directives: ( ì . District Manager-Tim Treloar Asst. District Manager-Bill Harper Contact Person-Tamara Johnson , Same Phone Numbers '-- - ~~~ IY~3 =============================================================================+ -1- 07/30/2003 1\ .~-- v -=-e e CALIFORNIA WATER SERV CO STA66 Manager : MELVIN BYRD Location: 601 TERRACE WY City BAKERSFIELD CommCode: BAKERSFIELD STATION 06 EPA Numb: BusPhone: Map : 124 Grid: 06B SiteID: 015-021-001940 3 f7("D (661) 396-2400 CommHaz : Moderate FacUnits: 1 AOV: SIC Code:4941 DunnBrad:00-691-3578 Emergency Contact / Title Emergency Contact / Title MELVIN BYRD / DISTRICT MGR TIM TRELOAR / ASSIST DIST MGR Business Phone: (661) 396-2400x Business Phone: (661) 396-2400x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: RSs Fire Press ImmHlth . Contact : Phone: (661) 396-2400x MailAddr: 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 Owner CALIFORNIA WATER SERVICE COMPANY Phone: (661) 396-2400x Address : 3725 S H ST State: CA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Pre parer: TotalUSTs: = Gal Certif'd: RSs: Yes Emergency Directives: One Unified List 1 All Materials at Site ì f= Hazmat Inventory ~ As Designated Order Hazmat Common Name... SpecHaz EPA Hazards DailyMax MCP CHLORINE F P IH ~(Ty~J-o ~~ Do hereby,certifo, that i have .... rp"n name 'I reviewed the attached hazardous materials manage- ment plan for L 200.00 GAL Ext I, (~~ ~inÐßS) and that it along with any corrections constitute a complete and correct man- agement plan for my facility. ~·~~~t ß-I~OO -1- 07/19/2000 i' i e e F CALIFORNIA WATER SERV CO STA66 p= Inventory Item 0001 F= COMMON NAME / CHEMI CAL NAME CHLORINE SODIUM HYPOCHLORITE 12.5% Location within this Facility Unit FENCED ENCLOSURE NEXT TO PUMP SiteID: 015-021-001940 l Facility Unit: Fixed Containers at Site l Days On Site 365 Map: Grid: CAS # 7882-50-5 STATE - TYPE Liquid Pure PRESSURE ---- TEMPERATURE Above Ambient Ambient CONTAINER TYPE ABOVE GROUND TANK , Largest Container 200.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 200.00 GAL Daily Average 200.00 GAL HAZARD US COMPONENT %Wt. RS CAS # 12.50 Chlorine ( EPA) Yes 7782505 o S HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No Yes No No/ Curies F P IH / / / Ext -2- 07/19/2000 e e F CALIFORNIA WATER SERV CO STA66 I p= Notif./Evacuation/Medical Agency Notification SiteID: 015-021-001940 ì Fast Format ì Overall Site ì 04/06/1999 CALL 911 AND (800) 852-7550 OR (916) 427-4341. ¡=:; Employee Notif./Evacuation N/A - UNMANNED SITE. 04/06/19991 04/06/1999 Public Notif./Evacuation WE WOULD PREFER TO RELY ON EMERGENCY SERVICE PERSONNEL TO DETERMINE IF AN EVACUATION IS NECESSARY. HOWEVER, WE WILL EVACUATE THE AFFECTED LOCAL POPULATION AS NECESSARY, IF EMERGENCY SERVICES PERSONNEL ARE NOT AVAILABLE. Emergency Medical Plan 04/06/1999 MEDICAL ASSISTANCE WOULD BE PROVIDED BY MERCY HOSPITAL ON TRUXTUN AVE. -3- 07/19/2000 It It F CALIFORNIA WATER SERV CO STA66 I p= Mitigation/Prevent/Abatemt Release Prevention SiteID: 015-021-001940 ì Fast Format ì Overall Site ì 04/06/1999 SODIUM HYPOCHLORITE IS STORED IN AN ABOVE GROUND SECURE AREA. Release Containment 04/06/1999 THE SODIUM HYPOCHLORITE HAS SECONDARY CONTAINMENT. Clean Up Other Resource Activation -4- 07/19/2000 :'" "" e e F CALIFORNIA WATER SERV CO STA66 I f= Site Emergency Factors ~ Special Hazards Utility Shut-Offs SiteID: 015-021-001940 ì Fast Format ì Overall Site ì I 04/06/1999 A) GAS - N/A B) ELECTRICAL - SERVICE BOX LOCATED INSIDE FACILITY C) WATER - N/A D) SPECIAL - N/A E) LOCK BOX - NO Fire Protec./Avail. Water 04/06/1999 PRIVATE FIRE PROTECTION - NEAREST FIRE HYDRANT - ON SITE WELL DISCHARGE. Building Occupancy Level -5- 07/19/2000 0.' .,-, -. 'f:. e e F CALIFORNIA WATER SERV CO STAGG I F Training Employee Training SiteID: 015-021-001940 1 Fast Format 1 Overall Site 1 04/06/1999 WE HAVE NO EMPLOYEES AT THIS FACILITY - UNMANNED SITE. WE DO HAVE MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: CALIFORNIA WATER SERVICE COMPANY PROVIDES THE FOLLOWING TRAINING: 1. SAFETY PROCEDURES IN THE EVENT OF A HAZARDOUS MATERIALS RELEASE OR THREATENED RELEASE. 2. HAZARD COMMUNICATION STANDARD. 3. EVACUATION PROCEDURES. 4. PROPER HANDLING OF HAZARDOUS MATERIALS. 5. HMMP IMPLEMENTATION. Page 2 r I I Held for Future Use Held for Future Use -6- 07/19/2000 ~ -r,?Z ,¿' ¿;" A/"~ , ð~(!#.?7()/1/ --- ¡ - - .~ . \ ?,-\_Dél) CITY OF BAKERSFIELD bG OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 -- ~. -- ---. ;. INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPEIPRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: C ÅL I FOi?)"\(~ \AI þ..Tf;;.R ~ERV ICt 111\l"::>Å~'-(' .:$719 ¿,4- , LOCATION: .¿"';tÞ/ 7~Arl.k I....VAY ,. u MAILING ADDRESS: ""372.5 S"' <:) w"" W Ç'""'E-....r CITY: P.::>AI.¿e~F'_'-D ' STATE:CA ZIPÐ33D4 PHONE{S05}3%-14o~ DUN & BRADSTREET NUMBER: 0 <::) - <O~ t . 3Sï B SIC CODE: 4 '94 I PRIMARY ACTIVITY: RII:2.~e...'('öQ Of= D(.:)1'II~"'c \ Al.b.'T'¡¡;"R,. OWNER: S'A 'Jo-1tE. MAILING ADDRESS: 'SAM E. SECTION 2: EMERGENCY NOTIFICATION CONTACT 1. MEI-V'", BVRD TITLE BUS. PHONE 24 HR. PHONE ~"TUICï M~~6£Q (805)~b-2400 CSA"'~E: 2.1ïM T R-t:LoAR. Å95I"ST/1-......ï 'ùs.ï2/CT W"'~R II II 1 , . e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: IRAINING NUMBER OF EMPLOYEES: N o~æ - U~M~f0.4£:() S I'T1!: MATERIAL SAFETY DATA SHEETS ON FILE: ~S BRIEF SUMMARY OF TRAINING PROGRAM: CÅ~\~'A W A-~Q~i;2.Vlc.e OO'vlI='A....V PR.òJ, R6S "T1+E. Fou...Dw IN 6 TRAI N 'WGr : (!)~F~"1'1 ~O<::.e-Dv~1!!IIiå I,... ~~ ~"ENT "t:JF A ~A"Z,6.:~Ouu~ 1\"ATe 2.I~S R."E.uë¡'SE D ¡;:z TH-~~ïEN £1:) R:E "- 5iJ -ss!. <Ð ,W.,Þo'Z.b0J2i")CoN1 ~U""'IC:A"" ~'" ~"H)~I;> ~ EVÞ<:.ù/lao"T10N ~o<:,_ouQ.~~ @ ~~~ U. A..... þU IV<ir ç:::¡:: J-tA2ÂtZool..l~ 1'1I,,'"r'1!!AtÞ'-s ® H M IYI ,,:> I1Vt Puæ.N1 EN..,..... 1""1 0 N SECTION 4: EXEMPTION REOUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION I, ~t-,. t-te:D~'CK. CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT TmS INFORMATION WILL BE . USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET At.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. Ç?-Æ- U ~Q ~ SIGNATURE ~':)DUCT\O"" ~ peR ~ £:::er-." TITLE .d -'o-~8 DATE 2 ,. e e HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: CALL. Sf' ANt) (eoo) E3S2-iSSo Ol-Z ~(~) -427-434' B. EMPLOYEE NOTIFICATION AND EVACUATION: ~A . U"-J t-AÅ~I~D Ç\-re. C. PUBLIC EVACUATION: \(./£ \AIOU'-\) PC2.E'frR TO R¡;,¡,.... Y o..¡ EtvtE."Q(-rl::NCY SE~\./I CEc; PëRSO"NWb.L- TO Dt=- 1£R.~ ,..... ~ It:: A N .EY~ AT1 ON'S Ne.~A'R'-(. W(;)\;uE:::.'\.IE'R.t \NE WlLL E-VACUÁTE Tf+E. A1=FECT~ t..oCAL PC>'PULAI1~ AG NEc.E.~ARY, IF i='fo-"'EC6é:to...1c't'" ~12..\Jlce.S ' DE.1<So"'n'\~L A"RE NOT Ä"Ä \L.Þ5LE... , ,I D. El\1ERGENCY MEDICAL PLAN: 1'-A'E.DICA L. As:3'~TÄNCE. W OUI.-\""::> BE.. ~c>V IDE.O ð'( }..A.E.R.CY ~DSPITÞ.L, TRu'>Lï1...hJ A\' ~Lle..,EÄ~Ç'-U) ., , 3 i' e e HAZARDOUSMATEmALSMANAGEMENTPLAN SECTIÚN 7: MITIGATION. PREVENTION AND ABATEMENT PLAN A. RELEASE PREVENTION STEPS: SoDIUM ~'''''PDCH LQí?rrE \S ~J2¡;D I~I 06.1-1 A'ßo'le. G-f<OUND ~W~~, AR'Iii:~. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: T~ SOCtUl''' HYPDC~LD~ l"'œ \5 ~~CA 2I&-Y CONTÞINE.U. C. CLEAN-UP PROCEDURES: SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: N/ A. ELECT~CAL: ~V'oE e,(:N.. L-OC::.-re.'; IN'510E... 1=""ÁC' 1.-1 ïY WATER: NIp,. SPECIAL: f'...1 / ~ LOCK BOX: YEs@) IF YES, LOCATION: II SECTION 9: PRIV ATE FIRE PROTECTION/W A TER A V All.ABILITY A. PRIVATE FIRE PROTECTION: i' B. WATER AVAILABILITY (FIRE HYDRANT): Fa~WYD~Mï -ON Grt-¡ë \~L-&.. D\g::."p.~ 4 j' '. - e CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 HAZARDOUS MATERIALS INVENTORY F ACll..ITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ ] BUSINESS NAME CALI FOR'N I A W Aj'E.r.:;? ~c:z..VI.C£ Cbl'I1P,6..,....,Y FACILITY NAME .::sTt19 ¿.~ SITE ADDRESS ~Ol rê~&= .u...:;AY CITY ~1Ef2'SF 11:-&....1":> STATE C~. ZIP 9360 , NATURE OF BUSINESS R.R.V&Voi< cF, t::o"-1fë:~""'c. \/...../ A.."rSt<. SIC CODE A c.:> L1 \ DUN & BRADSTREET NUMBER 00 - GS> ( - 3S ï8 OWNER/OPERATOR C-~FoFp.J,...\J~~~lc¿Co~ PHONE(eo5) 3~b-24oo MAILING ADDRESS :3 -¡ 2. '5 SCUTH ,. \--1 " ~'-(2E-E"" STATE CA. CITY e:,þ.....,Et:2-~F'~L-O ZIP ~b50A " EMERGENCY CONTACTS NAME M.¡;;L.~ ". BYIGD TITLE Dl~, Q'c..Tt'lt.....~-¡II.-~R BUSINESS PHONE (605) "3~G:,-<24 cO 24 HOUR PHONE S~ ~ NAME . T n·...1t TR.s-L.O A."C< TITLE ,t:1.<95'S,....~ï ~~,cr M..tJ,t.GBQ BUSINESS PHONE ('805 ) :59Cop 2.4 00 24 HOUR PHONE ~"'IIe. 1 " ~OUS MATERIALS INVENT. BúsinessÑam4.L...IFoR....'~J~~~tCE:a. Ad~ ..::srI'? ~~ Page l of..L - ¿'&JI /p¿1)E9C?Æ- ~;9Y .. CHEMICAL DESCRIPTION I) INVENTORY ST A rus: New [)( Addition [ ] Revision [ ] Deletion [ ] Chœk if chemical is a NON Trade Secn:t (X] Trade Secret [ 2) Common Name: O-!-ILOk"I....'5 3) DOT # (optional) Chemical Name: S 0 DIU,..." \-1'Y\:>oct-\ LORlTE;. 12.S¡..AHM[ ] CAS# ~7~1-529 4) Physical &.Hca1th PHYSIC~Co~:s,ve.J HEALTII - Car.goncs Fu. [ ] Reacti.. [ ] Sudden Release ofP;;;""" ( ] Immediate Health (~)[ 5) WASTE CLASSIFICATION (3-digit code from DHS Fonn 8022) USE CODE ] Delayœ Health (Chronic) W At 6) PHYSICAL STAlE Solid [ Liquid f)(] Gas [ ] Pure [)<.] Mixture ( ] Waste ( ] Radioactive ( 7) AMOUNT AND TIME AT FACILITY Maximum Dailv Amount 2. 0 0 Average Dailv Åmount 200 Annual AmOWtt '200 Largest Size Container 20 0 # Days on ~ite '3Cõ5 UNITS OF MEASURE Lbs ( ] Gal(')(] ft3 [ Curies [ ] 8) STORAGE CODES a) Container: 02 - R,Ao.~ c... b) Pressure: c) Temperature Circle 'W1úch Months: All Year, I, F, M, A. M, I, I, A. s, 0, N, D 9) MIXIURE: List the three most haZardous I ) chemical components or 2) any AHM components 3) COMPONENT CAS# %WT AHM .( ] [ ] [ ] IO)LOCATION 1_ r-e: ~ICe:...:) £~ICI-D~ù~e. NE:.,>£T T'\::) PÜ""",,I:> Chemical Name: 3) DOT 1# (optional) AHM[ ] CAS# I) INVENTORY ST A ruS: \"ew [ ) Addition [ ] Revision [ ] ~Ietion [ ] Check if chemical is a NON Trade Secret [ ~) Conunon Name: 4) Physical & Hc:alth PHYSICAL Hazard Categories F ire I I Reactive I ] Sudden Release oi Pressure [ ] Delayed Health (Chronic) [ 5 ) WASTE CL\SSIFICA TION 6) PHYSICAL STAlE Solid [ Liquid [ Gas [ J USE CODE Mixture [ ] Waste [ ] Radioactive [ 8) STORAGE CODES a) Container: b) Pressure: c) Temperanu-e i) AMOUNT :\,\1) TIME Ai FACll.ITY Ma.xunum bail~' Amount A verage Daily Amount Annual Amount Largest Size Cont.1lner tI Days on Site II' Circle Which Months: All Year, J, F, M, A, M, I, I, A. S, 0, N, D ." " COMPONENT CAS# %Wf AHM [ ] [ ] [ ] I certifÿ under penalty of law. that I have personally examined an~ am làmiliar with the information on this and aU aUachecl documents. I belie..1he submilled infonnation is true, accurate and eompIe... :==: k'1"'~ WE-DR.' CK. - ~OÞuCTto'''Ç''l)~¡z.I~t:QNt ~~--.r::: -.Q~ .4""0.95 PRINT Name & Title of Authorized Company Representative Signature Date