HomeMy WebLinkAboutAST REPORT 4/9/2007(ABOVEGROUND STORAGE TANKS) ~` .
- VERIZON WIRELESS
5508 YOUNG STREET
~~
UNIFIED PROGRAM CONSOLIDATED FORM
~
~
FACILITY INFORMATION
BUSINESS OWNER/OPERATOR IDENTIFICATION ,~ ~(~
Paor of
I:?:IDENTIFICATION
FACILITY ID # t. BEGINNING DATE 100. ENDING DATE 101
~ (Agency Use Only)
BUSINESS NAME (same as FACILITY NA[vfE or DBA -Irving Business As) 3. BUSINESS PHONE 102
Verizon Wireless- Bakersfield MTSO Unstaffed
BUSINESS SITE ADDRESS 103
5508 Young Street
CITY 104 ZIP CODE tos.
CA
Bakersfield 93311
DUN & BRADSTREET 106 SIC CODE (4 digit #) 107
88-463-8305 4812
COUNTY tos.
Kern
BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE t 10
Mark Iverson/Verizon Wireless 661.203.3205
,. :; IL :BUSINESS OWNER -
OWNER NAME 111 OWNER PHONE 11z.
Verizon Wireless 866-694-2415
OWNER MAILING ADDRESS t 13.
255 Parkshore Drive
CITY 1ta. STATE 115 ZIP CODE 1t6.
Folsom CA 95630
" III. ENVIItON1VIENTAL CONTACT '`
CONTACT NAME 117 CONTACT PHONE us.
Environmental Compliance (Billing and Correspondence) 866-694-2415
CONTACT MAILING ADDRESS t I9.
255 Parkshore Drive
CITY 120 STATE tzt ZIP CODE tzz.
Folsom CA 95630
-PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY-
NAME tz3. NAME 1zs.
Network Operations Control Center Mark Iverson (Site Inspections)
TITLE 124 TITLE tze.
Operations Manager
BUSINESS PHONE 125 BUSINESS PHONE
~ 130
682-831-3523 A PR 9
661.203.3205
24-HOUR PHONE* tz6. 24-HOUR PHONE* tat.
800-264-6630 661.664.5601
PAGER # tz7. PAGER # ~ 13z.
ADDITIONAL LOCALLY COLLECTED INFORMATION: t33.
Property Owner: Phone No.:
Billing Address:
Certification: Base on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and
am familiaz with the formation submitted believe the information is true, accurate, and complete.
SIGNATURE OF OP TED RE NTATIVE ;~ t3a.
ATfr
t
-/
- NAME OF DOCUMENT PREPARER t35.
' ~
J.' )
l Verizon Wireless
NAME OF SIGNER (print) 136. TITLE OF SIGNER 137.
Shawn Stacey Supervisor Environmental Compliance
* See Instructions on next page.
UPCF hwf2730 (1/99) -1/2 http://www.unidocs.org Rev. 04/17/00
UNIFIED PROGRAM CONSOLIDATED FORM
- _r
'~ HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIP ION
(one page per material per building or area)
® ADD ^ DELETE ^ gEyISE 200.
.... ..- _ -- - P ge _ of_
-.:.
I FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3:
Verizon Wireless- (Site Name: Bakersfield MTSO)
~.nntvut,fv, l,ut;a11UN 201• CHEMICAL LOCAT N CONFIDENTIAL EPCRA 202.
Inside Equipment Shelter /Room or Outdoor Cabinet YES ®No
FACILITY ID # 1• MAP # (optional) 03. GRID # (optional) zoo.
(Agency Use Only)
C ed
_..
;:. II CHEMICAL INFORMATIO
N ' ..
CHEMICAL NAb4E28 205. T SECRET ^ Yes ®No 206.
ELECTROLYTE /SULFURIC ACID
If Subject to EPCRA, refer to instmctions
COMMON NAME
7.
Non-spillable Valve Re>ulated Lead Acid Batteries (Batte 1
HS* ^ Yes ®No zos
CAS# y
7664-93-9 =If EHS is "Yes," all amounts below must be in lbs.
FIRE CODE HAZARD CLASSE (Co ete if re red by local agency) 210.
Corrosive Batteries: Co e RR • H:2 F:0 R:1
HAZARDOUS MATERIAL
TYPE (Check one item only) ^ a. PURE ®b. MIXTURE ^ c.
RADIOACTIVE ^ Yes ®No~ 212.
CURIES 213.
PHYSICAL STATE 215.
(Check one item only) ^ a. SOLID ®b. LIQUID .GAS 214' LARGEST CONTAINER (gals/lbs): 1 S.U6 gal Or 152.1 1bS
FED ATEGORIES
(Check all that apply) ^ a. FIRE ®b. REAC RESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH 216
AVERAGE DAILY AMOUNT (gal/lbs) 217. D Y 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
(g bs
2168.64 gals or 21902.40 lbs 2168. g s o 2 02.40 0
UNITS 2z1.
® a. GAL b UBIC FEET ®c. POUNDS ^ d. TONS DAYS ON SITE 222.
Check one item on] * b EHS, amount must be in ounds. 365
STORAGE
CONTAINER ^ a. ABOVEGROUND T ^ e. P TIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR
^ b. UNDERGROUND TANK £C ^ j. BAG ^ n. PLASTIC BOTTLE
^ c. TANK INSIDE BUILDING ARBOY ^ k. BOX ^ o. TOTE BIN -
^ d. STEEL DRUM ^ h. SILO ^ 1 YLINDER ^ p. TANK WAGON
` ®r
OTHER: BATTERIES
. 223
STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22q,
STORAGE TEMPERATURE ®a. IENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC z25.
WT HAZARDOUS OMPONENT (For mixture or waste only) EHS CAS #
I • I s - 23°i° 226. ELECT OLYTE /SULFURIC ACID 227.
^ Yes ®No 228.
7664-93-9
229
.
2, 230. 231.
^ Yes ^ NO 232.
233.
3• 234. 235. ^ YeS ^ NO 236. 237.
Q. 238. 239.
^ Yes ^ No zoo.
241.
5• 242. 243.
^ Yes ^ No z4a.
z4s.
If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if wrcinogenit, attach additional sheets of papv capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246.
Most Verizon Wireless battery installations are Non-spillable or Valve Regulated Lead Acid (VRLA) Batteries that exceed
1997 UBC and/or 2000/2003 IBC Seismic Zone 4 specifications. (Non-spillable: The electrolyte is immobilized in either a
gelled or in an absorbent separator; it is not free flow in the event of mechanical damage. Spill containment should not be
~equired.) For more information on the specs, MSDS battery sheets, or corrections please contact the Environmental Contact on
the Owner/Operator page. Battery 1 Electrolyte and Lead Compound pages are for the same battery product.
If EPCRA, Please Sign Here.
~ UNIFIED PROGRAM CONSOLIDATED FORM
' HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION
(one page per material per building or area) ~1
~ ®ADD ^ DELETE 200.
^ REVISE
ge _of_
;`
I. FACILITY INFORMATION _'
BUSINESSNAME (Same as FACILITY NAME or DBA-Doing Business As)
3
Verizon Wireless- (Site Name: Bakersfield MTSO)
CHEMICAL LOCATION 201. CHEMICAL LOC ON CONFIDENTIAL EPCRA zoz.
Inside Equipment Shelter /Room or Outdoor Cabinet YES ®No
FACILITY ID # 1~ MAP # zo3.
GRID # zoo.
(Agency Use Only)
,:. tta e tta
,.
`II. CHEMICAL INFORMATIO
N .
CHEMICAL NAME 2os. T E SECRET ^ Yes ®No 206.
LEAD LEAD COMPOUND If Subject to EPCItA, refer to instructions
COMMON NAME 20~. zos.
Non-spillable Valve Regulated Lead Acid Batteries (Battery 1) EHS* ^ Yes ®No
CAS# 09.
743 9-92-1 *If EHS is "Yes," all amounts below must be in lbs.
FIRE CODE HAZARD CLAS S omp to if equired by local agenty) 210.
Corrosive Batteries: o s' e CORR • H:2 F:0 R:1
HAZARDOUS MATERIAL
TYPE (Check one item only) ^ a. PURE ®b. MLYTURE ^ STE 11.
RADIOACTIVE ^ Yes ®No 21z. 213.
CURIES
PHYSICAL STATE 215.
(Check one item only) ®a. SOLID ^ b. LIQUID c. A 2ta. LARGEST CONTAINER (lbs): 481 IbS
F CATEGORIES 216.
(Check all that apply) ^ a. FIRE ®b. VE c. PRESSURE RELEASE
® d. ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAILY 217. MA} DAILY (Ibs) 218. ANNIJAL WASTE AMOUNT 219. STATE WASTE CODE 220.
AMOUNT (Ibs)
692641bs 69 6 bs 0
UNITS* 22t.
^ a. G ON b. CUBIC FEET ®c. POUNDS ^ d
TONS DAYS ON SITE zz2.
.
Check one item onl * h EHS, amount must be in ounds. 365
STORAGE
CONTAINER ^ a. ABOVEGROUND ANK ^ LASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAII. CAR
^ b. UNDERGROUND TANK ^ AN ^ j. BAG ^ n. PLASTIC BOTTLE
^ a TANK INSIDE BUILDING ^ CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ b. SII,O 1. CYLINDER ^ p. TANK WAGON
® r. OTHER: BATTERIES
223
STORAGE PRESSURE ^ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224.
STORAGE TEMPERATURE a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225.
WT HAZARDO S COMPONENT (For mixture or waste only) EHS CAS #
1. 62 - 65% 226. LAD, LEAD COMPOUND ~~.
^ Yes ®No 228.
7439-92-1 229.
2 230. 231.
^ Yes ^ No 232.
233
3. z3a. 23s.
^ Yes ^ No 236.
237
4, z3s. z3s. ^ Yes ^ No 2ao. zal.
5. 242. 243.
^ Yes ^ No zaa.
zos.
If more hazard s components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 •/. by weight if carcinogeniq attach additional sheets of paper capturing the required information.
246.
ADDITIONAL LOCALLY COLLECTED INFORMATION
Most Verizon Wireless battery installations are Non-spillable or Valve Regulated Lead Acid (VRLA) Batteries that exceed
1997 UBC and/or 2000/2003 IBC Seismic Zone 4 specifications. (Non-spillable: The electrolyte is immobilized in either a
gelled or in an absorbent separator; it is not free flow in the event of mechanical damage. Spill containment should not be
required.) For more information on the specs, MSDS battery sheets, or corrections please contact the Environmental Contact on
the Owner/Operator page. Battery 1 Electrolyte and Lead Compound pages are for the same battery product.
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION
(one page per material per building or area)
ADD ^ DELETE ^ REVISE 200 Page _ of_
I'. FACILITY INFORMATION
BUSINESSNAME (Same as FACILITY NAME or DBA-Doing Business As) 3.
Verizon Wireless -Bakersfield MTSO
CHEMICAL LOCATION 201. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Sealed Batte Case ^ YES ®NO
FACILITY ID # 1 MAP # zo3. GRID # zoo.
(Agency Use Only)
II. CHEMICAL INFORMATIO N
CHEMICALNAME 205. TRADE SECRET ^ Yes ®No 206.
Valve-Regulated Lead/Acid Batte (VRLA) If Subject to EPC1tA, refer to instructions
COMMON NAME zm. zos.
EHS* ^ Yes ®No
Electric Stora a Batte
CAS# 209.
'If EHS is "Yes," all amounts below must be in ]bs.
See Below
FIRE CODE HAZARD CLASSES (Complete if required by local agency) 210.
Corrosive H=2, F=O, R=1
HAZARDOUS MATERIAL
^ a. PURE ®b. MIXTURE ^ c. WASTE 2t1.
RADIOACTIVE ^ Yes ®No zlz.
CURIES 213.
TYPE (Check one item only)
PHYSICAL STATE 21a.
(Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS
LARGEST CONTAINER 152.1 lbs or 15.06 gals 215.
FED HAZARD CATEGORIES 216.
(Check all that apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAII,Y AMOUNT 217. MAXIMUM DAILY AMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
25552.81bs/ 2530.08 als 25552.8 Ibs/2530.08 als 0 N/A
221• DAYS ON SITE 222.
UNITS' ^ a. GALLONS ^ b. CUBIC FEET ®c. POUNDS ^ d. TONS 365
Check one item onl • If EHS, amount must be in ounds.
STORAGE
CONTAINER ^ a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR
^ b. UNDERGROUND TANK ^ £ CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ h. SILO ^ L CYLINDER ^ p. TANK WAGON 223.
STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a.
STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225.
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1. 18-23 226. Electrolyte/ Sulfuric Acid zz7. ^ Yes ®No 22s. 7664-93-9 229.
2, 230. 231. ^YCS ^ NO 232. 233.
3• 234. 235. ^YCS ^ NO 236. 237.
4. z3s. 239. ^ Yes ^ No zoo. zal.
5• zaz. za3. ^ Yes ^ No zaa. 2a5.
If more hazardous components are present at greater than 1 % by weight if nao-carcinogenic or 0.1% by weight if carcinogeniq attach additional sheeb of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 2a6.
DOT Hazard Class:
168 Batteries C&D MCT-4000 Electrolyte and Lead Chemical sheets are for the sam Batte pr duct.
If EPCRA, Please Sign Here.
(~~~~C~~~, ~l
UPCF hwf2731(1/99) -1/2 http://www.unidocs.org Rev. 04/17/00
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION
(one page per material per building or area)
ADD ^ DELETE ^ REVISE 200 Page _ of
I' FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3.
Verizon Wireless -Bakersfield MTSO
CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Sealed Batte Case ^ YES ®NO
FACILITY ID # 1. MAP # 203 GRID # zoo.
(Agency Use Only)
IL CHEMICAL INFORMATIO N
CHEMICAL NAME 205 TRADE SECRET ^ Yes ®No zo6.
Valve-Regulated Lead/Acid Battery (VRLA) If Subject to EPCRA, refer to instructions
COMMON NAME 2°z
EHS* ^ Yes ®No 2os.
Electric Stores a Batte
CAS# 209
*If EHS is "Yes," all amounts below must be in lbs.
See Below
FIRE CODE HAZARD CLASSES (Complete if required by local agency) 210.
Corrosive (CORK) H=2, F=O, R=1
zt3.
HAZARDOUS MATERIAL ^ a. PURE ®b. MIXTURE ^ c. WASTE 2t t. RADIOACTIVE ^ Yes ®No 2t2. CURIES
TYPE (Check one item only)
215.
PHYSICAL STATE eta.
(Check one item only) ®a. SOLID ^ b. LIQUID ^ c. GAS LARGEST CONTAINER 481 Ibs
FED HAZARD CATEGORIES 216.
(Check all that apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAII,Y AMOUNT 217. MAXIMUM DAILY AMOUNT z1s. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 2zo.
808081bs 808081bs 0 N/A
221. DAYS ON SITE zzz.
UNITS* ^ a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365
Check one item onl ' If EHS, amount must be in ounds.
STORAGE
CONTAINER ^ a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR
^ b. UNDERGROUND TANK ^ £ CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223.
STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a.
STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225.
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1. 72 226. Lead/ Lead Compound zz7. ^ Yes ®No zzs. 7439-92-1 zz9.
2. 23°. 231. ^ YeS ^ NO 232. 233.
j 234. 235. ^ Yes ^ NO 236. 237.
4, z3a. z39. ^ Yes ^ No zoo. zest.
5, zaz. za3. ^ Yes ^ No zaa. zas.
If more hazardous components are present at greater than t % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION za6.
DOT Hazard Class:
168 Batteries C&D MCT-4000 Electrolyte and Lead Chemical sheets are for the same ry pro uct.
If EPCRA, Please Sign Here.
lJ~ ' -
UPCF hwf2731(1/99) -1/2 http://www.unidocs.org Rev. 04/17/00
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION
(one page per material per building or area)
ADD ^ DELETE REVISE 200. Page _ of_
' 'I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3.
Verizon Wireless -Bakersfield MTSO
CHEMICAL LOCATION zol. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Sealed Batte Case ^ YES ®NO
FACILITY ID # 1. MAP # 203. GRID # zoa.
(Agency Use Only)
_>:II.: CHEMICAL INFORMATIO N
CHEMICAL NAME zos. TRADE SECRET ^ Yes ®No zob.
Valve-Regulated Lead/Acid Battery (VRLA) If Subject [oEPCRA,refertoinswctions
COMMON NAME zoo. 2os.
EHS* ^ Yes ®No
Electric Stora a Batte
CAS# zo9.
*If EHS is "Yes," all amounts below must be in lbs.
See Below
FIRE CODE HAZARD CLASSES (Complete if required by local agency) 21 .
Acute/Chronic H=3, F=O, R=1
HAZARDOUS MATERIAL ^ a. PURE ®b. MIXTURE ^ c. WASTE 21 t.
RADIOACTIVE ^ Yes ®No 212.
CURIES 213.
TYPE (Check one item only)
PHYSICAL STATE 21a.
(Check one item only) ®a. SOLID ^ b. LIQUID ^ c. GAS
LARGEST CONTAINER 88.6 lbs 215.
FED HAZARD CATEGORIES 216.
(Check all that apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT 2l~ MAXIMUM DAILY AMOUNT 21g. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220.
354.401bs 354.401bs 0 N/A
zzt. DAYS ON SITE 222.
UNITS* ^ a. GALLONS ^ b. CUBIC FEET ®c. POUNDS ^ d. TONS 365
Check one item onl * If EHS, amount must be in ounds.
STORAGE
CONTAINER ^ a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAII. CAR
^ b. UNDERGROUND TANK ^ £ CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223.
STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224.
STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225.
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
I. 79 226. Lead/ Lead Compound zn. ^ Yes ®No ns. 7439-92-1 229.
Z. 230. 231. ^ Yes ^ NO 232. 233.
3. z3a. z3s. ^ Yes ^ No 236. 237.
q. z3a. z39. ^ Yes ^ No zao. zal.
g, zaz. za3. ^ Yes ^ No zaa. zas.
If more hazardous compoaenb are present at greater than 1 % by weight if om-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional aheeb of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION zab.
DOT Hazard Class:
Batteries NorthStar NSB 170FT Electrolyte and Lead Chemical sheets are for the same battery product.
If EPCRA, Please Sign Here.
UPCF hwf2731(1/99) -1/2 http://www.uuidocs.org Rev. 04/17/00
UNIFIED PROGRAM CONSOLIDATED FORM
HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION
(one page per material per building or area)
ADD ^ DELETE ~~tEVISE 200 Page _ of
._ ''I. FACILITY INFORMATION
_. - _.._. _...
3.
BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As)
Verizon Wireless-Bakersfield MTSO
CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202.
Sealed Batte Case ^ YES ®NO
FACILITY ID # 1. MAP # zo3. GRID # zoa.
(Agency Use Only)
IL CHEMICAIINFORMATIO N
CHEMICAL NAME 205 TRADE SECRET ^Yes ®No zoe.
Valve-Regulated Lead/Acid Battery (VRLA) If Subject toEPCItA,refertoinstmctions
COMMON NAME z°~ 2oa.
EHS* ^Yes ®No
Electric Stora a Batte
CAS# 209
*If EHS is "Yes," all amolmts below must be in Ibs.
See Below
FIRE CODE HAZARD CLASSES (Complete if required by Iocal agency) 21°.
Corrosive H=3, F=O, R=1
213.
HAZARDOUS MATERIAL ^ a. PURE ®b. MIXTURE ^ c. WASTE 211. RADIOACTIVE ^Yes ®No 212. CURIES
TYPE (Check one item only)
215.
PHYSICAL STATE z1a.
(Check one item only) ®a. SOLID ^ b. LIQUID ^ c. GAS LARGEST CONTAINER 2.08 gals or 23.20 lbs
FED HAZARD CATEGORIES z16.
(Check all that apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH
AVERAGE DAILY AMOUNT zl~ MA}QMUM DAILY AMOUNT 21 a. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE z2o.
8.32 als or 92.80 lbs 8.32 als or 92.801bs 0 N/A
221. DAYS ON SITE 222.
UNITS• ^ a. GALLONS ^ b. CUBIC FEET ®c. POUNDS ^ d. TONS 365
Check one item onl • If EHS, amount must be in ounds.
STORAGE
CONTAINER ^ a. ABOVEGROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR
^ b. UNDERGROUND TANK ^ £ CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER
^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN
^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223.
STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a-
STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225.
WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
1. 14 zze. Electrolyte (Sulfuric Acid) 2n. ®Yes ^ No zza. 7664-93-9 229.
2. 230. 231. ^ Yes ^ NO 232. 233.
3, 234. 235. ^Yes ^ NO 236. 237.
4, z3s. z39. ^Yes ^ No 2ao. zal.
5. zaz. za3. ^Yes ^ No 244. zas.
If more hazardous components are present at greater than 1 % by weight if om-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 2a6. ~
DOT Hazard Class:
NorthStar NSB170FT Electrolyte and Lead Chemical sheets are for the same battery product.
If EPCRA, Please Sign Here.
UPCF hwf2731(1/99) -1/2 http://www.unidocs.org Rev. 04/17/00
~•
MATERIAL SAFETY DATA SHEET
LEAD ACID BATTERY
~~.__ __
DATTL*RY Cl'.`AM Y`ANY
Sprin~eld, Missouri
I. PRODUCT IDENTIFICATION:
A. Chemical/Trade Name (per on label):
B. Chemical Family/Classification:
C. Manufacturer's Name & Address:
D. Contact:
Lead Acid Battery
Electrical Storage Battery
NorthStar Battery Co. LLC
4000 Continental Way
Springfield, MO 65803
U.S. - NSB Safety and Health Department
Phone: (417) 575-8219
Fax: (417) 575-8250
Aust. Power-One Energy Solutions Pty Ltd.
Phone: +612 9889 3111
E. Emergency Information: Chemtrec (US, Canada & Mexico)
Phone: (800) 424-9300
Chemtrec (Outside US, Canada & Mexico)
Phone: +1 (703) 527-3887 (call collect)
F. Non-Hazardous Classification
Per US DOT, Northstar Battery Company products, submitted and tested by Wyle Labs,
have been deemed to meet all requirements as specified in 49CFR§ 173.159 (d) for
exception as hazardous material classification.
HAZARDOUS INGREDIENTS/IDENTITY INFORMATION:
NORTH AMERICAN INFORMATION
Air Ex osure Limits u /m
Materials % by Wt. CAS Number OSHA AGGIH (TLV) NIOSH
Lead 57 7439-92-1 50 150 100
Lead Oxide 22 1309-60-0 50 150 100
Electrolyte (Sulfuric Acid) 1.400 sg 14 7664-93-9 1 1 1
AUSTRALIAN INFO RMATION
Chemical or Material Australian Dangerous Goods Hazardous Substance Australian Poison Schedule
Classification Classification as per NOHSC Classification
Australia
Non-Spillable Exempt under A67 (NATA R341R41 Schedule 6
Lead Acid Battery Identification Guide) and Clause 238 Agricultural, Domestic and Industrial
of the Australian Dangerous Goods Substances
Code, A endix 3
Note: Product contains toxic chemicals that are subject to the reporting requirements of Section
302 and 313 of the Emergency Planning and Community Right-to-Know Act of 1986.
III. PHYSICAL DATA:
Material is solid at normal temperatures.
A. Electrolyte:
1. Specific Gravity: 1.250 -1.350 kg/dm3
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 1 of 6
MATERIAL SAFETY DATA SHEET
LEAD ACID BATTERY
r____._~....__.....~ _ ...__ . ..
IV~J~'T!-1',~T'AR
2lATTL'Il Y CCs ~./ PAN V
Sprin~eld, Missouri
2. Boiling Point: 110°C (230°F)
3. % Volatiles By Weight: Not Applicable
4. Solubility in Water: 100%
5. Melting Point Lead: 327°C (621 °F)
6. Vapor Density Not Determined
B. Appearance and Odor
1. Electrolyte is a clear liquid with an acidic odor.
IV.
HEALTH HAZARD INFORMATION:
Under normal operating conditions, because the battery is "non-spillable", the internal material will
not be hazardous to your health. Only internally exposed material during production or case
breakage or extreme heat (fire) may be hazardous to your health.
A. Routes of Entry:
1. Inhalation: Acid mist from formation process may cause respiratory irritation.
2. Skin Contact: Acid may cause irritation, burns and/or ulceration.
3. Skin Absorption Not a significant route of entry.
4. Eye Contact: Acid may cause sever irritation, burns, cornea damage and/or
blindness.
5. Ingestion: Acid may cause irritation of mouth, throat, esophagus and stomach.
B. Signs and Symptoms of Over Exposure:
1. Acute Effects: Over exposure to lead may lead to loss of appetite, constipation,
sleeplessness and fatigue. Over exposure to acid may lead to skin irritation,
corneal damage of the eyes and upper respiratory system.
2. Chronic Effects: Lead and its components may cause damage to kidneys and
nervous system. Acid and its components may cause lung damage and
pulmonary conditions.
3. Potential to Cause Cancer: The International Agency for Research on Cancer
has classified "strong inorganic acid mist containing sulfuric acid" as a Category
1 carcinogen, a substance that is carcinogenic to humans. This classification
does not apply to liquid forms of sulfuric acid or sulfuric acid solutions contained
within a battery. Inorganic acid mist is not generated under normal use of this
product. Misuse of the product, such as overcharging, may however result in the
generation of sulfuric acid mist.
C. Emergency and First Aid Procedures:
1. Inhalation: Remove from exposure, move to fresh air, and apply oxygen if
breathing is difficult. Consult physician immediately.
2. Skin: Wash with plenty of soap and water for at least 15 minutes. Remove any
contaminated clothing. Consult physician if skin irritation appears.
3. Eyes: Flush with plenty of water immediately for at least 15 minutes, lifting lower
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 2 of 6
MATERIAL SAFETY DATA SHEET ~'-~~
No~rHTa~
LEAD ACID BATTERY n"zT~nY °",~''"'"
Springfield, Missouri
and upper eyelids occasionally. Consult a physician immediately.
4. Ingestion: Do not induce vomiting. Give large quantities of water. Never give
anything by mouth to an unconscious person. Consult a physician immediately.
D. HANDLING AND STORAGE
1. Safe Storage: Store in a cool, dry place in closed containers. Keep away from
ignition sources and high temperatures.
1. Contact NorthStar Battery Company (417-575-8200) for shelf life information.
2. Handling: Avoid skin or eye contact. Avoid breathing vapors. Do not use near
sources of ignition
V. CARCINOGENICITY: See section IV, Part B "Signs and Symptoms of Over Exposure"
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: See section IV, Part B "Signs and
Symptoms of Over Exposure"
VI. FIRE AND EXPLOSION HAZARD DATA:
A. Flash Point: Hydrogen = 259°C
B. Auto ignition Temperature: Hydrogen = 580°C
C. Extinguishing Media: Dry chemical, foam, COZ
D. Unusual Fire and Explosion Hazards: Hydrogen and oxygen gases are produced in the
cells during normal battery operation (hydrogen is flammable and oxygen supports
combustion). These gases enter the air through the vent caps. To avoid the chance of a
fire or explosion, keep sparks and other sources of ignition away from the battery.
E. Firefighting PPE: Full protective clothing and
NIOSH-approved self-contained breathing apparatus
with full facepiece
VII. REACTIVITY DATA:
A. Stability: Stable
B. Conditions to Avoid: Sparks and other sources of ignition.
C. Incompatibility: (materials to avoid)
1. Lead/lead compounds: Potassium, carbides, sulfides, peroxides, phosphorus,
sulfur.
2. Battery electrolyte (acid): Combustible materials, strong reducing agents,
most metals, carbides, organic materials, chlorates, nitrates, picrates, and
fulminates.
D. Hazardous Decomposition Products:
1. Lead/lead compounds: Oxides of lead and sulfur.
Date: 04/06!2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 3 of 6
_.
MATERIAL SAFETY DATA SHEET ~ "~~~
IVC?RTf~>~T~1 ~`
LEAD ACID BATTERY nwrr~nr CC}MI`..Nl'
Sprin~eld, Missouri
2. Battery electrolyte (acid): Hydrogen, sulfur dioxide, and sulfur trioxide.
E. Conditions to Avoid:
High temperature. Battery electrolyte (acid) will react with water to produce heat. Can
react with oxidizing or reducing agents.
VIII. CONTROL MEASURES:
A. Engineering Controls:
Store lead/acid batteries with adequate ventilation. Room ventilation is required for
batteries utilized for standby power generation. Never recharge batteries in an
unventilated, enclosed space.
B. Work Practices:
Do not remove vent covers. Follow shipping and handling instructions which are
applicable to the battery type. To avoid damage to terminals and seals, do not double-
stack industrial batteries.
C. Personal Protective Equipment:
1. Respiratory Protection: None required under normal handling conditions. During
battery formation (high-rate charge condition), acid mist can be generated which
may cause respiratory irritation. Also, if acid spillage occurs in a confined space,
exposure may occur. If irritation occurs, wear a respirator suitable for protection
against acid mist.
2. Eyes and Face: Chemical splash goggles are preferred. Also acceptable are
"visor-gogs" or a chemical face shield worn over safety glasses.
3. Hands, Arms, Body: Vinyl coated, VC, gauntlet type gloves with rough finish are
preferred.
4. Other Special Clothing and Equipment: Safety shoes are recommended when
handling batteries. All footwear must meet requirements of ANSI 241.1 -Rev.
1972.
IX. ACCIDENTAL RELEASE MEASURES:
A. Not applicable under normal conditions.
B. In case of damage resulting in breakage of the battery container, see VIII, Sec. C
Personal Protective Equipment.
X. PRECAUTIONS FOR SAFE HANDLING AND USE:
A. Hygiene Practices: Following contact with internal battery components, wash hands
thoroughly before eating, drinking, or smoking.
B. Respiratory Protection: Wear safety glasses. Do not permit flames or sparks in the
vicinity of battery(s). If battery electrolyte (acid) comes in contact with clothing, discard
clothing.
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 4 of 6
MATERIAL SAFETY DATA SHEET "'~
MORTJ'~~STAR
LEAD ACID BATTERY n AzT ~ R Y c~, M''"'" Y
Springfield, Missouri
C. Protective Measures:
1. Remove combustible materials and all sources of ignition. Cover spills with soda
ash (sodium carbonate) or quicklime (calcium oxide). Mix well. Make certain
mixture is neutral, then collect residue and place in a drum or other suitable
container. Dispose of as hazardous waste.
2. Wear acid-resistant boots, chemical face shield, chemical splash goggles, and
acid-resistant gloves. Do not release unneutralized acid.
D. Waste Disposal Method (*):
Battery electrolyte (acid): Neutralize as above for a spill, collect residue, and
place in a drum or suitable container. Dispose of as hazardous waste.
2. Do not flush lead contaminated acid to sewer.
3. In case of accidental spill, utilize personal protective equipment, i.e., face shield,
rubber apron, rubber safety shoes.
4. Batteries: Send to lead smelter for reclamation following applicable Federal,
State and local regulations. Product can be recycled along with automotive (SLI)
lead acid batteries.
5. Battery may be returned, shipping pre-paid, to the manufacturer or any distributor
for recycling. See 1.C for manufacturer's address or visit our web site @
www. north starbattery. com.
*In accordance to Local, State and Federal regulations and laws.
E. Other Handling and Storage Precautions: None Required.
XI. ECOLOGICAL INFORMATION:
Lead and its compounds can pose a threat if released to the environment.
See Waste Disposal Method in Section X, Part D.
XII. NFPA HAZARD RATING: SULFURIC ACID:
Flammability (Red) = 0
Health (Blue) = 3
Reactivity (Yellow) = 1
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 5 of 6
MATERIAL SAFETY DATA SHEET
LEAD ACID BATTERY
nn-rznnv cca>.,.~r..Nv
Sprin~eld, Missouri
XIII. DEPARTMENT OF TRANSPORTATION AND INTERNATIONAL SHIPPING REGULATIONS:
Proper Shipping UN2800 -Battery, wet, non-spillable (electric storage)
Name
Batteries must be packed to protect against short circuits and firmly secured to skids or pallets.
IATA
Packaging instruction 806 Not restricted per special provision A67.
Northstar Battery Company products, submitted and tested by Wyle Labs, have been deemed to
US DOT meet all requirements as specified in 49CFR§ 173.159 (d) for exception as hazardous material
classification.
Northstar Battery Company products, submitted and tested by Wyle Labs, have been deemed to
IMDG meet all requirements as specified in special provision 238 for determination of "Non-Spillable" and
are not subject to the provision of this Code.
XIV. SPECIAL REQUIREMENTS:
TLV
^ Sulfuric Acid -Occupation Exposure Limit -AUSTRALIA TWA 1 mg/m3,JAN1993
^ Lead -Occupation Exposure Limit -AUSTRALIA TWA 0.15 mg/m3, 2002
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 6 of 6
To Whom It May Concern:
The Verizon Wireless Operations Managers make sure that their Field Operation
Staff, at the date of hire depending on their position, are trained in the applicable
topics located in the Environmental Health Safety Awareness Training Overview.
There is also annual online training with TargetSafety.com performed in
Hazardous Communications, Combustible & Flammable Liquids, Eye Safety, and
Personal Protective Equipment.
Attached are the following and are placed with the Hazardous Materials Business
Plan located at the site.
o VZW Environmental Health Safety Awareness Training Overview
o VZW Network Training Matrix that gives the training topic and frequency of
training.
o TargetSafety.com training objectives, table of contents, and a list of staff
that have completed the online annual training.
o California's Proposition 65 Letter
Individual test verification is available from the Operations Manager or Cell
Technician upon request. Contact information is located on the Business
Owner/Operator Identification page, and under the primary and secondary
emergency contacts.
Thank you,
VZW Environmental Compliance
•'
requency o
Training Topic Regulation Training Application
Hazard 29CFR1910.1200 Annual - Prior to working with or
Communication TargetSafety.com around hazardous
materials such as battery
acid or diesel fuel.
Emergency Action 29CFR1910.38 Annual Drills and All employees.
Orientation
Personal Protective 29CFR1910.132 to Annual - Prior to use, in job
Equipment 139 TargetSafety.com functions that require the
use of PPE such as,
gloves, safety glasses or
Lockout Tagout 29CFR1910.147 Initial w/ updates Prior to performing
maintenance on covered
equipment with the
potential to release
stored energy such as
generators, air handling
equipment or electrical
equipment greater than
Electrical Safety 29CFR1910.332 Initial w/ updates Prior to working on
Related Work electrical facilities or
Practices equipment were
Lockout/Tagout is not
Power Industrial 29CFR1910.178 every 3 years Prior to operating power
Trucks (Forklift & industrial truck and
Powered Pallet Jack) material handling
Ladder Safet 29CFR1910.25 to 27 initial w u dates Prior to use ladders.
Confined Space Entry 29CFR1910.146 initial w/ updates Prior to entry into
confined spaces such as
generator pits, under
equipment vaults or
Fall Protection 29CFR1910.21 to 30 initial w/ updates Prior to working in areas
which present fall
hazards such as rooftops,
scaffolding or ladders or
construction sites.
Asbestos Awareness 29CFR1910.1001 Every 2 years Prior to performing
maintenance, repair or
installation work in areas
with known or potentially
asbestos containing
materials(ACM) such as
but not limited to floor
tiles, roofing materials or
insulation.
Lead Awareness 29CFR1910.1025 initial w/ updates Prior to working in areas
with lead based paint
such as buildings, water
Respiratory Protection 29CFR1910.134 initial w/ updates Prior to working in area
which require the use of
respiratory protection
beyond a loose fitting
Hearing Conservation 29CFR1910.95 initial w/ updates Prior to working in area
were noise exposure is in
excess 85 d6 over an 8
hour period such as
generator or boiler
First Aid & CPR 29CFR1910.151 every 1-2 years HII IICIU U~.JCI dIIVII
employees.
Spill Response, First 29CFR1910.120 initial w/ annual Prior to working in
Responder Operational updates facilities which contain
Level hazardous materials
above threshold
quantities triggering
SPCC requirements, such
as MTSO, Hub and Data
RF Exposure 29CFR1910.97 initial w/ annual Prior to enter into area
updates that excess the FCC's
General
Population/Uncontrolled
Maximum Permissible
Bloodbourne 29CFR1910.1030 initial w/ updates All employees trained in
Patho ens First Aid.
Powered Hand Tools 29CFR1910.241 to initial w/ updates Prior to using powered
244 hand tools such as drills
. .,.....c... ,iar~..~ . :~'
•
Verizon Wireless Hazardous Communincation Training
Training Objectives 8 Table Of Contents Attached
Last Name
First Name
Title
Region Covered ue a e
Scheduled /
Completed
Allen Dar I O erations Northern CA/NV Februa -07
Alo Lehi K. O erations Northern CA/NV Februa -07
Anderson Mike O erations Northern CA/NV Februa -07
Arzate Dann O erations Northern CA/NV Februa -07
Ayala Tony O erations Northern CA/NV Februa -07
Barbano Larry Operations Northern CA/NV Februa -07
Bona Alfredo B O erations Northern CA/NV Februa -07
Carl E Bowling Jr O erations Northern CA/NV Februa -07
Bagaybagayan Catherine D O erations Northern CA/NV Februa -07
Baloto Glenda T O erations Northern CA/NV Februa -07
Bradley Wayne O erations Northern CA/NV Februa -07
Brown Bridgett O erations Northern CA/NV Februa -07
Bullock Craig A Operations Northern CA/NV Februa -07
Burkhart James O erations Northern CA/NV Februa -07
Castillo Jorge O erations Northern CA/NV Februa -07
Catoe Chuck O erations Northern CA/NV Februa -07
Chau Philip O erations Northern CA/NV Februa -07
Cinquini Jim O erations Northern CA/NV Februa -07
Cocanour Richard O erations Northern CA/NV Februa -07
Cross Co O erations Northern CA/NV Februa -07
Cruz Stella O erations Northern CA/NV Februa -07
Cunningham David O erations Northern CA/NV Februa -07
Danielsen Michael O erations Northern CA/NV Februa -07
Danville Rolf Operations Northem CA/NV Februa -07
David John Net-Ops Invento /Distrib Northern CA/NV Februa -07
Day Peter O erations Northern CA/NV Februa -07
Desmond Matthew O erations Northern CA/NV Februa -07
Dickeson Francine J. O erations Northern CA/NV Februa -07
Dietz John O erations Northern CA/NV Februa -07
Dobbs Larry Network Construction Northem CA/NV Februa -07
Faia Dean Operations Northern CA/NV Februa -07
Ferguson Jim Network Construction Northern CA/NV Februa -07
Francis Georgia O erations Northern CA/NV Februa -07
Fraties David W O erations Northern CA/NV Februa -07
Frederick Armando O erations Northern CA/NV Februa -07
Galicia Ed O erations Northem CA/NV Februa -07
Gamiao Gert O erations Northern CA/NV Februa -07
Garcia Eric O erations Northern CA/NV Februa -07
Gose Dennis Operations Northern CA/NV Februa -07
Graham James Network Construction Northern CA/NV Februa -07
Griffin Gene O erations Northern CA/NV Februa -07
Groves Walidah O erations Northern CA/NV Februa -07
~~" ,~~! ~~~ {~''f~s^ ~r~ ~ i ~ ~:~/ / 1,
.,
W.c~ ~.:.....~..
,.... .
g ~ -
Verizon Wireless Hazardous Communincation Training
Training Objectives 8~ Table Of Contents Attached
Last_Name
First_Name
Title
Region Covered ue a e
Scheduled /
Completed
Harry Matt O erations Northern CA/NV Februa -07
Hatchett Larry Operations Northern CA/NV Februa -07
Hefner Robyn G. Operations Northern CA/NV Februa -07
Heimer Dave O erations M r Northern CA/NV Februa -07
Herrera Steve M O erations Northern CA/NV Februa -07
Hockman Kirk O erations Northern CA/NV Februa -07
Iversen Mark O erations M r Northern CA/NV Februa -07
Jerucha Shawn O erations Northern CA/NV Februa -07
Johnson Don Operations Northern CA/NV Februa -07
Johnson Jim O erations Northern CA/NV Februa -07
Johnson Scott O erations M r Northern CA/NV Februa -07
Jones Claude O erations Northern CA/NV Februa -07
Kneisley Robert O erations Northern CA/NV Februa -07
Kohls Walt O erations Northern CA/NV Februa -07
Krohn Tom O erations Northern CA/NV Februa -07
Kuka Tim O erations M r Northern CA/NV Februa -07
LaFon Alan O erations Northern CA/NV Februa -07
Lawrence Dale O erations Northern CA/NV Februa -07
Lee Kwan O erations Northern CA/NV Februa -07
Lee Steve Network Construction Northern CA/NV Februa -07
Lorenzo Joseph O erations Northern CA/NV Februa -07
Lusch Tim O erations Northern CA/NV Februa -07
Lusch Timothy O erations Northern CA/NV Februa -07
Marks Pamela O erations Northern CA/NV Februa -07
Marks Gene O erations Northern CA/NV Februa -07
Maurer Rich O erations Northern CA/NV Februa -07
McGrath Phillip O erations Northern CA/NV Februa -07
Means Trent A O erations Northern CA/NV Februa -07
Merino Fernando O erations Northern CA/NV Februa -07
Metcalf Mike O erations Northern CA/NV Februa -07
Miller Bret O erations Northern CA/NV Februa -07
Miller Crai O erations M r Northern CA/NV Februa -07
Montes Adrian M O erations Northern CA/NV Februa -07
Morgan Harold D O erations Northern CA/NV Februa -07
Nasers Charles O erations Northern CA/NV Februa -07
Nasers Chuck O erations Northern CA/NV Februa -07
Nguyen John Operations Northern CA/NV Februa -07
O'Bannon Vincent C O erations Northern CA/NV Februa -07
Olsen Scott O erations Northern CA/NV Februa -07
Ormsbee Todd G O erations Northern CA/NV Februa -07
Reilly Shawn O erations Northern CA/NV Februa -07
Reneau Loni O erations Northern CA/NV Februa -07
~_'
~ -g- __ ~~ -- ,
~:~~ a
• - 7
Verizon Wireless Hazardous Communincation Training
Training Objectives 8~ Table Of Contents Attached
Last Name
First Name
Title
Region Covered ue a e
Scheduled /
Completed
Richardson Charles O erations Northern CA/NV Februa -07
Richter David Operations Northern CA/NV Februa -07
Robertson Dave O erations M r Northern CA/NV Februa -07
Rodrigues Carlos O erations Northern CA/NV Februa -07
Sager Ron O erations Northern CA/NV Februa -07
Schneider Russ O erations Northern CA/NV Februa -07
Schoneman Eric O erations Northern CA/NV Februa -07
Severance Skip O erations M r Northern CA/NV Februa -07
Severns Mike Operations Northern CA/NV Februa -07
Sewell Ernest O erations Northern CA/NV Februa -07
Sharp Ron Network Con. M r Northern CA/NV Februa -07
Shields James A O erations Northern CA/NV Februa -07
Shoopman Betsy O erations Northern CA/NV Februa -07
Simpson Keith A. O erations Northern CA/NV Februa -07
Small Dan O erations Northern CA/NV Februa -07
Smith Richard Operations Northern CA/NV Februa -07
Solga John O erations Northern CA/NV Februa -07
Stace Shawn Environmental Com liance Northern CA/NV Februa -07
Strand Robert M. O erations Northern CA/NV Februa -07
Sua Peter O erations Northern CA/NV Februa -07
Sullivan Elena O erations Northern CA/NV Februa -07
Swearingen David A O erations Northern CA/NV Februa -07
Temme Steve Operations Northern CA/NV Februa -07
Thiffault Paul Operations Northern CA/NV Februa -07
Thomson Tom O erations Northern CA/NV Februa -07
Thornburg Allen O erations Northern CA/NV Februa -07
Torres Oscar O erations M r Northern CA/NV Februa -07
Vasgaard Dennis O erations Northern CA/NV Februa -07
Velasquez Mark O erations Northern CA/NV Februa -07
Walker Brent Operations Northern CA/NV Februa -07
Walker Russ O erations Northern CA/NV Februa -07
Welty Rick O erations Northern CA/NV Februa -07
White Kevin O erations Northern CA/NV Februa -07
Ick Bernar Operations Northern CA/NV February-07
Indvidual Test Verification Is Available From Operations Managers Upon Request
irs'wt3(4z ~G3~ 337 ;' 9~,r.~r7 ~..ff 31 7.if; Li ;~h.GtdL°i .":
~'3bjeC#iV@S.
At the end of this course Yoh wlii be abl+a to;
. Explain the-need for haza~zt cornr~;c~ntCtitfAn'iii khe d~iarkptaa.~e;
. Underrtantis respnn~ibilkies under ih4 hazard communication 5ta~c3~rid
. Iciantdry tf~a fundarrre~nlal elements of a hazard comrnunicetion pr~r~m._.
. C7escrihc3 #t7e Criteria for determining whether=a substance 3sa hazacci=
. C3escrmbe the us4 Caf an MSDS andlor lat>~rt to t~btain taaxard information fvr e
particular che37~icst.
Table a# ~c~n#ents
t~~~sc~rx -1 The OSt~=Hazard Corrttrtunicstior7_Stethdard
Less~stt 2 Assessing the Hazards
t.esson 3 Mateti3l Safety Data Sheets (MSt35}
L+~s~on ~ W2filirif~ Labels
Casson 5 Written Plan
Lesson t'> Vithat ata Nazard~us Chemicals?
Lesson- 7. Raut~s_ af_ Entry.
Lesso» 8 Container t:atielii~g
Lesson.4 Inf4rmatiori and Trairiin~
Lesson 10 7axicalo~ical and Ecobgicat Hazards
Lesson i 3; rt3~gu~t33ry infarrr7atic~n
Lesson 32 Chemical Label Hazard lnfarrnatiiin
Summary. Summary
A
'~1t~.~~N~,~r
C'zi~ifesrt~ia's i'rc~~siti~~n fi5, the S~i'~ t.~rinl;in~; 'i~'c3tcriujc! "i`axic rtiforrezrat Act, :.
rerluires that'pcopte bo rued bt:foire-:they : cxptrscc3 to any chcTiiical'listect by:the St~tC of
Galit'arnia as a czrt:itc>~,zn or t~prtxlu~titisc tts~in. ~'erixc~n Wireicss relics than tlic cnc~piiics
that supply prexltucts to it to pravide tnatcrial sai"ety dicta sht?ets {";v1~llSs"~ c3s~criiaing tlic
characi~iistics of ilzos~: proctu~;ts, incltxlin~, it;s:ir health effects. Information conctrnin~ the
carc~inu~eni~ity anti rcpz<xluctive tavicity~f chenticals cwt ~;cn4rally he fr~unJ ii; the MSDSs.;ri:
°.Lhe scetian:; 4~ititic~t Hcalt}t Na~~rd Infonnatiota c+c Ht;alth Iffects.:Some of ttt~: prcxlueis ~nseci iii,:
`Vezizon ~'~iretc;;.~: t~lxr~~tionz that ~.GUSe ex~~:urc to cortirto~t:ns anNor rctacoctuctivc tuxins
inclt~ttc: u:+lvetts tt ;~ect in cle:-nin~, disinfc~ct~rtts, clr:uisrrs, paints, ~u~cr batt~rric.s ana dit:scl fuel.
(~xh7t~st enii<,siotts) ttscci in emcr8cncy t;cni:t~ators. Plca:~; revic~v the 1vISI~Ss ft~r the s~cific
Isrc~xiucis t~.~ed in yotarivoxkase:t forfitrth~erinTozrnation atxyut tla~ir hrilth cffects. Tttstnyccictns:
,. "~fc~r snf~. h:utdlingof tic products ~~=cusp: art sct fiortEt i~~ thc~i4t~TiSs. Always re:~ad artd~folltativ_
5:lfi: tl::C in:~trt#Ctli~~l$„-
-.
l~z>r a~tditional infnrritaticzn alwut Trap 65, pots may ~v:utt to ~o io
~att~~l;t~~v~v,r~-l~ts.~o~. l~~r mars irYfezrrtation about the pra~eiucta drscribc:~i in the 2~i~7~~s, ar
"Slbti~i~n t'~llr~lcs:,'s safciy pra};rztria, ct~ttta~:t }t~Y-488-7~~.
!~°'~i #
• •
UNIFIED PROGRAM CONSOLIDATED FORM
FACILITY INFORMATION
BUSINESS OWNER/OPERATOR IDENTIFICATION ~~''''''``
~,~C~~
Pacer of
I. IDENTIFICATION
FACILITY ID # 1- BEGINNING DATE loo. ENDING D lol-
(Agency Use Only)
BUSINESS NAME (Same as FACILITY NAA9E or DBA -Doing Business As) 3- BUSINESS PHONE 102.
Verizon Wireless -Bakersfield MTSO Unstaffed
BUSINESS SITE ADDRESS 103.
5508 Young Street
CITY 104. ZIP CODE ws
Bakersfield CA 93311
DUN & BRADSTREET 106. SIC CODE (4 digit #) toz
88-463-8305 4812
COiINTY T t~ los.
'
Kern ~~ j
`'~
BUSINESS OPERATOR NAME 109- BUSINESS OPERATOR PHONE 110.
Mark Iversen /Verizon Wireless 661-664-5601
II. BUSINESS OWNER
OWNER NAME 111 OWNER PHONE 11z.
Verizon Wireless 866-694-2415
OVl'NER MAILING ADDRESS 113.
255 Parkshore Drive
CITY 114. STATE 115. ZIP CODE u6-
Folsom CA 95630
III. ENVIRONMENTAL CONTACT
CONTACT NAME 117- CONTACT PHONE na.
Shawn Stacey (Billing and Correspondence) 866-694-2415
CONTACT MAILING ADDRESS 119.
255 Parkshore Drive
CITY 1zo- STATE 1'-1- ZIP CODE tzz.
Folsom CA 95630
-PRIMARY- IV. EMERGENCY CONTACTS -SEGO -
NAME 123- lza.
NAME
Network Operations Control Center ~
Mark Iversen (Site Inspections)
TITLE 124. TITLE 1z9.
Network Operations Manager
BUSINESS PHONE 125. BUSINESS PHONE ~ 130
682 831 323 661 664-5601
24-HOUR PHONE* 126 24-HOUR PHONE* /L / 131.
800 264 6630 661-203-3205 ,J
PAGER # 127. PAGER # t32.
none
ADDITIONAL LOCALLY COLLECTED INFORMATION: 133-
Property Owner: See Contact Phone No.:
Billing Address:
Certification: Based on my inquiry oft se individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and
am familiarwith the information submitt d and believe the info Lion is true, accurate, and c plete.
SIGNATURE OF OWNER/OPERATO G ' TB [VE 134.
D NAME OF DOCUMENT PREPARER 135.
' ~~ ~ Q
~
O Debra Voth
NAME OF SIGNER (print) 136. ' TITLE F SI NE 137.
Shawn Stacey Spvsr Environmental Compliance
- gee Instrucnons on next page.
liPCF hwf2730 (1/99) - 1/2 http://www.unidocs.org Rev. 04/17/00
• •
{
MATERIAL SAFETY DATA SHEET ~--
NORTHSTAR
LEAD ACID BATTERY WATT = n Y ~ ~ ., ~. ,, _~ Y
Sprin~eld, Missouri
I. PRODUCT IDENTIFICATION:
A. ChemicallTrade Name (per on label): Lead Acid Battery
B. Chemical Family/Classification: Electrical Storage Battery
-~-- -L.: ---~rwuntFiaGrurc~ s-rvaine a r-CiureSS~ rvGrtn~rfir~tsattcry-C:G-~L-t;.-- -- - -
4000 Continental Way
Springfield, MO 65803
D. Contact: U.S. - NSB Safety and Health Department
Phone: (417) 575-8219
Fax: (417) 575-8250
Aust. Power-One Energy Solutions Pty Ltd.
Phone: +612 9889 3111
E. Emergency Information:
Chemtrec (US, Canada & Mexico)
Phone: (800) 424-9300
Chemtrec (Outside US, Canada & Mexico)
Phone: +1 (703) 527-3887 (call collect)
F. Non-Hazardous Classification
Per US DOT, Northstar Battery Company products, submitted and tested by Wyle Labs,
have been deemed to meet all requirements as specified in 49CFR§ 173.159 (d) for
exception as hazardous material classification.
HAZARDOUS INGREDIENTS/IDENTITY INFORMATION:
NORTH AMERICAN INFORMATION
Air Ex osure Limits u /m
Materials % by VYL CAS Number OSHA AGGIH (TLV) NIOSH
Lead 57 7439-92-1 50 150 100
Lead Oxide 22 1309-60-0 50 150 100
Electrolyte (Sulfuric Acid) 1.400 sg 14 7664-93-9 1 1 1
AUSTRALIAN INFORMATION
Chemical or Material Australian Dangerous Goods Hazardous Substance Australian Poison Schedule
Classification Classification as per NOHSC Classification
Australia
Non-Spillable 6cempt under A67 (NATA R34/R41 Schedule 6
Lead Acid Battery Identification Guide) and Clause 238 Agricultural, Domestic and Industrial
of the Australian Dangerous Goods Substances
Code, A endix 3
Note: Product contains toxic chemicals that are subject to the reporting requirements of Section
302 and 313 of the Emergency Planning and Community Right-to-Know Act of 1986.
PHYSICAL DATA:
Material is solid at normal temperatures.
A. Electrolyte:
1. Specific Gravity: 1.250 - 1.350 kg/dm3
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 1 of 6
•
•
MATERIAL SAFETY DATA SHEET ~~-
NORTHSTAR
LEAD ACID BATTERY nATT~nV ~`~.,,......,Y
Sprin~eld, Missouri
2. Boiling Point: 110°C (230°F)
3. % Volatiles By Weight: Not Applicable
4. Solubility in Water: 100%
5. Melting Point Lead: 327°C (621 °F)
--- ------------_--F - __- - --- \/annr f)cncifii _ _- __ _ __nlnf_rlatcrmincrl-- --
B. Appearance and Odor
Electrolyte is a clear liquid with an acidic odor.
IV. HEALTH HAZARD INFORMATION:
Under normal operating conditions, because the battery is "non-spillable", the internal material will
not be hazardous to your health. Only internally exposed material during production or case
breakage or extreme heat (fire) may be hazardous to your health.
A. Routes of Entry:
1. Inhalation: Acid mist from formation process may cause respiratory irritation.
2. Skin Contact: Acid may cause irritation, burns and/or ulceration.
3. Skin Absorption Not a significant route of entry.
4. Eye Contact: Acid may cause sever irritation, bums, cornea damage and/or
blindness.
5. Ingestion: Acid may cause irritation of mouth, throat, esophagus and stomach.
B. -Signs and Symptoms of Over Exposure:
1. Acute Effects: Over exposure to lead may lead to loss of appetite, constipation,
sleeplessness and fatigue. Over exposure to acid may lead to skin irritation,
corneal damage of the eyes and upper respiratory system.
2. Chronic Effects: Lead and its components may cause damage to kidneys and
nervous system. Acid and its components may cause lung damage and
pulmonary conditions.
3. Potential to Cause Cancer: The International Agency for Research on Cancer
has classified "strong inorganic acid mist containing sulfuric acid" as a Category
1 carcinogen, a substance that is carcinogenic to humans. This classification
does not apply to liquid forms of sulfuric acid or sulfuric acid solutions contained
within a battery. Inorganic acid mist is not generated under normal use of this
product. Misuse of the product, such as overcharging, may however result in the
generation of sulfuric acid mist.
C. Emergency and First Aid Procedures:
1. Inhalation: Remove from exposure, move to fresh air, and apply oxygen if
breathing is difficult. Consult physician immediately.
2. Skin: Wash with plenty of soap and water for at least 15 minutes. Remove any
contaminated clothing. Consult physician if skin irritation appears.
3. Eyes: Flush with plenty of water immediately for at least 15 minutes, lifting lower
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 2 of 6
• •
MATERIAL SAFETY DATA SHEET - =-~~:
IVDRTHSTAR
LEAD ACID BATTERY DATTCTY CO\,PA.JY
Sprin~eld, hfissorrri
and upper eyelids occasionally. Consult a physician immediately.
4. Ingestion: Do not induce vomiting. Give large quantities of water. Never give
anything by mouth to an unconscious person. Consult a physician immediately.
D. HANDLING AND STORAGE
1. Safe Storage: Store in a cool, dry place in closed containers. Keep away from
ignition sources and high temperatures.
1. Contact NorthStar Battery Company (417-575-8200) for shelf life information.
2. Handling: Avoid skin or eye contact. Avoid breathing vapors. Do not use near
sources of ignition
V. CARCINOGENICITY: See section IV, Part B "Signs and Symptoms of Over Exposure"
MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: See section IV, Part B "Signs and
Symptoms of Over Exposure"
VI. FIRE AND EXPLOSION HAZARD DATA:
A. Flash Point: Hydrogen = 259°C
B. Auto ignition Temperature: Hydrogen = 580°C
C. Extinguishing Media: Dry chemical, foam, COZ
D. Unusual Fire and Explosion Hazards: Hydrogen and oxygen gases are produced in the
cells during normal battery operation (hydrogen is flammable and oxygen supports
combustion). These gases enter the air through the vent caps. To avoid the chance of a
fire or explosion, keep sparks and other sources of ignition away from the battery.
E. Firefighting PPE: Full protective clothing and
NIOSH-approved self-contained breathing apparatus
with full facepiece
VII. REACTIVITY DATA:
A. Stability: Stable
B. Conditions to Avoid: Sparks and other sources of ignition.
C. Incompatibility: (materials to avoid)
1. Lead/lead compounds: Potassium, carbides, sulfides, peroxides, phosphorus,
sulfur.
2. Battery electrolyte (acid): Combustible materials, strong reducing agents,
most metals, carbides, organic materials, chlorates, nitrates, picrates, and
fulminates.
D. Hazardous Decomposition Products:
1. Lead/lead compounds: Oxides of lead and sulfur.
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 3 of 6
•
•
MATERIAL SAFETY DATA SHEET ~~" ~~.,~4
NORTHSTAR
LEAD A CID BATTERY D A T T L IL Y C ~~ ., P .'~ N ,-
Sprin~eld, fLlissouri
2. Battery electrolyte (acid): Hydrogen, sulfur dioxide, and sulfur trioxide.
E. Conditions to Avoid:
High temperature. Battery electrolyte (acid) will react with water to produce heat. Can
react with oxidizing or reducing agents.
VIII. CONTROL MEASURES:
A. Engineering Controls:
Store lead/acid batteries with adequate ventilation. Room ventilation is required for
batteries utilized for standby power generation. Never recharge batteries in an
unventilated, enclosed space.
B. Work Practices:
Do not remove vent covers. Follow shipping and handling instructions which are
applicable to the battery type. To avoid damage to terminals and seals, do not double-
stack industrial batteries.
C. Personal Protective Equipment:
Respiratory Protection: None required under normal handling conditions. During
battery formation (high-rate charge condition), acid mist can be generated which
may cause respiratory irritation. Also, if acid spillage occurs in a confined space,
exposure may occur. If irritation occurs, wear a respirator suitable for protection
against acid mist.
2. Eyes and Face: Chemical splash goggles are preferred. Also acceptable are
"visor-gogs" or a chemical face shield worn over safety glasses.
3. Hands, Arms, Body: Vinyl coated, VC, gauntlet type gloves with rough finish are
preferred.
4. Other Special Clothing and Equipment: Safety shoes are recommended when
handling batteries. All footwear must meet requirements of ANSI 241.1 -Rev.
1972.
IX. ACCIDENTAL RELEASE MEASURES:
A. Not applicable under normal conditions.
B. Incase of damage resulting in breakage of the battery container, see VIII, Sec. C
Personal Protective Equipment.
X. PRECAUTIONS FOR SAFE HANDLING AND USE:
A. Hygiene Practices: Following contact with internal battery components, wash hands
thoroughly before eating, drinking, or smoking.
B. Respiratory Protection: Wear safety glasses. Do not permit flames or sparks in the
vicinity of battery(s). If battery electrolyte (acid) comes in contact with clothing, discard
clothing.
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD-430-01-05 Page: 4 of 6
r - '
MATERIAL SAFETY DATA SHEET ~ ~-~,~
NDRTHSTAR
LEAD ACID BATTERY DATTCIiV CO`,D/~NY
Sprin~eld, .Missouri
C. Protective Measures:
XI. ECOLOGICAL INFORMATION:
D. Waste Disposal Method (*):
Remove combustible materials and all sources of ignition. Cover spills with soda
ash (sodium carbonate) or quicklime (calcium oxide). Mix well. Make certain
mixture is neutral, then collect residue and place in a drum or other suitable
_~_container._Disgose of as_haza[dous_waste._ .__ __ __ --.._- _______=T_~_______.__:
2. Wear acid-resistant boots, chemical face shield, chemical splash goggles, and
acid-resistant gloves. Do not release unneutralized acid.
1. Battery electrolyte (acid): Neutralize as above for a spill, collect residue, and
place in a drum or suitable container. Dispose of as hazardous waste.
2. Do not flush lead contaminated acid to sewer.
3. Incase of accidental spill, utilize personal protective equipment, i.e., face shield,
rubber apron, rubber safety shoes.
4. Batteries: Send to lead smelter for reclamation following applicable Federal,
State and local regulations. Product can be recycled along with automotive (SLI)
lead acid batteries.
5. Battery may be returned, shipping pre-paid, to the manufacturer or any distributor
for recycling. See 1.C for manufacturer's address or visit our web site
www. northstarbattery.com.
*In accordance to Local, State and Federal regulations and laws.
E. Other Handling and Storage Precautions: None Required.
Lead and its compounds can pose a threat if released to the environment.
See Waste Disposal Method in Section X, Part D.
XII. NFPA HAZARD RATING: SULFURIC ACID:
Flammability (Red) = 0
Health (Blue) = 3
Reactivity (Yellow) = 1
Date: 04/06/2005 DCR: 621-S05 ISO Clause: 4.3.1 DOC Code: MSD~30-01-05 Page: 5 of 6
--
•
MATERIAL SAFETY DATA SHEET ~ -
No~rHSraR
LEAD ACID BATTERY nATTrnV °""'_""r
Sprin~eld, Missouri
XIII. DEPARTMENT OF TRANSPORTATION AND INTERNATIONAL SHIPPING REGULATIONS:
Proper Shipping UN2800 -Battery, wet, non-spillable (electric storage)
Name
- -•~-~ -
`Batteries~must-de pa~cked-to protect against shori circuits and nrrniy s~cu~ed to skids or pauets-~
IATA
Packaging instruction 806 Not restricted per special provision A67.
Northstar Battery Company products, submitted and tested by Wyle Labs, have been deemed to
US DOT meet all requirements as specified in 49CFR§ 173.159 (d) for exception as hazardous material
classification.
Northstar Battery Company products, submitted and tested by Wyle Labs, have been deemed to
IMDG meet all requirements as specified in special provision 238 for determination of "Non-Spillable" and
are not subject to the provision of this Code.
XIV. SPECIAL REQUIREMENTS:
TLV
^ Sulfuric Acid -Occupation Exposure Limit -AUSTRALIA TWA 1 mg/m3,JAN1993
^ Lead -Occupation Exposure Limit -AUSTRALIA TWA 0.15 mg/m3, 2002
Date: 04/06/2005 DCR: 621-SOS ISO Clause: 4.3.1 DOC Code: MSD-430-01-OS Page: 6 of 6
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations
This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared
for each monitorine system control Hanel by the technician who performs the work. A copy of this form must be provided to the tank
system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30
days of test date.
A. General Information
Facility Name: VERIZON WIRELESS
Site Address: 5508 YOUNG ST
Facility Contact Person: JOHN
BIdg. No.:
City: BAKERSFIELD Zip; 93312
Make/Model of Monitoring System: VEEDER ROOT TLS-350
B. Inventory of Equipment Tested/Certified
CheC~C t11e annrnnriaM hnzac M in.l:rotn c..on:fin ......e,.a ;..~...,..s..a i -.~....a.
Date of TestinglServicing: ~ 19 / 06
Tank ID: T-1 DIESEL ABOVE GROUND ~ ._._ Tank ID:
® In-Tank Gauging Probe. _ Model: ^ In-Tank Crauging Probe. Model:
® Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model:
® Piping Sump /Trench Sensor(s). Model: ^ Piping Sump /Trench Sensor(s). .Model:
^ Fill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Modet:
^ Mechanical Line leak Detector. Model: ^ Mechanical Line Leak Detector. Model:
^ Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model:
^ Tank Overfill 1 High-Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model:
^ Other ui ment and model in Section E on P e 2). ^ Other (s ui ment a and model in Section E on P e 2).
Tank ID• Tank ID:
^ In-Tank Gauging Probe. Model: ^ In-Tank Gauging Probe. Model:
^ Annular Space or Vault Sensor. Model: ^ .Annular Space or Vault Sensor. Model:
^ Piping Sump J Trench Sensor(s). Model: ^ Piping Sump /Trench Sensor(s). Model:
^ Fillll Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model:
^ Mechanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model:
^ Electronic Line Leak Detector. Model: ^ Electronic i.ine Leak Detector. Model:
^ Tank Overfill /High-Level Sensor. Model: ^ Taok Overfill 1 High-Level Sensor. Model:
^ Other (s ui ant and model in Section E on P e 2). ^ Other (s ui ment and model in Section E on P e 2).
Dispenser ID: Dispenser ID:
^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model:
^ Shear Valve(s). ^ Shear Valve(s).
^ Di nser Containment Floats and Chains . ^ Dis user Containment Ftoat(s and Chain(s).
Dispenser ID: ~p~. ID:
^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model:
^ Shear Valve(s). ^ Shear Valve(s).
^ Di nser Containment Floats and Chains . ^ Dis nser Containment Floats and Chains .
ID: Dispenser ID:
^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model:
^ Shear Valve(s). ^ Shear Valve(s).
^Dis ser Containment Floats and Chains . ^ Dis nser Containment Floats and Chains
.
.....•...~ wu......u uaviG aaa16J Vi ll1ApG11JGi,, wpy fins roan. mcmae mrormauon for every IanK and dispenser at the facility.
C. CertificatiOri - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'
guidelines. Attached to this Certification is information (e.g. manufacturers' ch necessary to verify that this infomration is
correct and a Plot Plan showing the layout of monitoring equipment. For any p cape a of generating such reports, I have also
attached a rnpy of the report; (check all that apply): ®System set-up arm ry report
Technician Name (print}: RON ROGERS Signature:
Certification No.: 006-05-2040 License. No.: 813 A HAZ
Testing Company Name: ACE PETROLEUM SERVICES, INC. Phone No.:~ 661 } 387-6522
Site Address: 15540 STREBOR DR /BAKERSFIELD / CA Date of TestinglServicing: ~ 17 06
Contact Phone No.: ( 661 } 721-1358
Page 1 of 3 03/01
Monitoring System Certification
D. Results of Testing/Servicing
Software Version Installed: 119
COmnlete the fnlinwinu rl~vrtrlicf•
® Yes ^ No* Is the audible alarm o rational?
® Yes ^ No* Is the visual alarm operational?
® Yes ^ No* Were all sensors visuall in ted, functionall tested, and confirmed o erational?
® Yes ^ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will
not interfere with their ro er o eration?
^ Yes ^ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem)
® N!A operational?
^ Yes ^ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment
® N!A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate
positive shut-down? (Check all that apply) ^ Sump/Trench Sensors; ^ Dispenser Containment Sensors.
Did ou confirm sitive shutdown due to leaks and sensor failureldisconnection? ^ Yes; ®No
® Yes
^ No* .
For tank systems that utilize the monitoring system as the primary tank overfill warning device (i
e: no
^ N/A .
mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill rot(s)-and rating ro rly? If so, at what t of tank ce aci does the alarm tri er? 90 %
O Yes* ®No Was any monritoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced
and list the manufacturer name and model for all re lacement arts in Secfion E, below.
^ Yes* ®No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ^
Product; ^ Water. If es, describe causes in Section E, below.
® Yes ^ No* Was monitoring s tem set reviewed to ensure ro settings? Attach set u , if a livable
®Yes ^ No* Is aIl monitorin ui ment o tional er manufacturer's s 'fications?
..- -.......... ~ ...~......w u.s~ ouu nuca~ u1W~ uCUCJCLI:IeS were OT Wlll nQ COPTCCte(t.
E. Comments•
Page 2 of 3 03/01
w~, .
..4~,.
~~."
F. In-Tank Gauging /SIR Equipment:
® Check this box if tank gauging is used only for inventory control.
^ Check this box if no tank gauging or SIR equipment is installed.
This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring.
Cmm~le~ the fnllnmino rha.•l:licf.
® Yes ^ No* Has all input wiring been inspected for groper entry and termination, including testing for ground faults?
® Yes ^ No* Were all tank gauging probes visually inspected for damage and residue buildup?
® Yes ^ No* Was accuracy of system product level readings tested?
® Yes ^ No* -Was accuracy of system water level readings tested?
® Yes ^ No* Were all probes reinstalled properly?
® Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed?
* Ill the Section H. below. de~rihe hnw 9nd Whe~1 thP_Ce rlelirienriac mars nr min h.. nnr.•n..toer
G. Line Leak Detectors (LLD): ®Check this box if LLDs are not installed.
Cumulate the fnllnwino rherlrlict•
^ Yes ^ No* For equipment start up or annual equipment certification, was a leak simulated to verify LLD performance?
^ N!A (Check all that apply) Simulated leak rate: ^ 3 g.p.h.; ^ 0.1 g.p.h ; ^ 0.2 g.p.h.
^ Yes ^ No* Were all LLDs confirmed operational and accurate within regulatory requirements?
^ Yes ^ No* Was the testing apparatus properly calibrated?
^ Yes ^ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
^ N/A
^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
^ NIA
^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled
^ N/A or disconnected?
^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions
^ N/A or fails atest? -
^ Yes ^ No* For electronic LLDs, have all accessible wiring connections been visually inspected?
^ N/A
^ Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed?
~„ ...~ ~ax:uu„ n, ueww, aescriue now ana when these de~iciencies were or will be corrected.
H. Comments:
Page 3 of 3 o3roi
onitoring System Certification
UST Monitoring Site Plan
Site Address: Verizon Wireless / 5508 Young St / Bakersfield, CA
..
........................................
........................................
........................................
..
........................................
........................................
........................................
..•..
..............
..............
..............
..............
. .~-l.
. .MONITOR . .
..............
..............
..............
S. S . .S
. .GENERATOR .
. _ 3
. .TANK .
,.
~.
Date map was drawn: 04 / 17 / 06 ,
Instructions
If you already have a diagram that shows all required information, you may include it, rather than this page, with your
Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify
locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular
spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak
detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan
was prepared.
Page of o5~00
IN-TANK-SETUP
SYSTEM SETUP
APR 17. 2000 2:40 PM
SYSTEM UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATF/TIME FORMAT
MON DD YYYY HH:MM:SS xM
VERIZON WIRELESS
GOSFORD PARK
BAKERSFIELD GA
COMMUNICATIONS SETUP - -
FORT SETTINGS:
COMM BOARD 1 (RS-232}
BAUD RATE aDDO
PARITY 1 STOP
STOP BIT
DATA LENGTH: 7 DATA
CODE ? DISABLED
AUTO TRANSMIT SETTINGS:
T L:DIESEL 1
PRODUCT CODE ;
T f{ERMAL COEFF :000450
TANK DIAMETER 86.00
LINEAR
TANK FRFULL VOL ~ 8060
FLOAT SIZE: 4.0 IN.
WATER WARNING : 2.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL: 8060
OVERFILL LIMIT 90~
7254
5f
SHIFT TIME I DISABLED
AUTO LEAK ALARM LIMIT HIGH PRODUCT 9 °
_ 7657
SHIFT TIME 2 DISABLED
$HIFT:TIME 3:_: DISABLED
- DISABLED
AUTO HIGH WATER LIMIT DELIVERY LIMIT - 15%
1209
DISABLED
SHIFT TIME 4 --=
DLSABLEI? _ ~.
ERF I LI- 'L i f'lI"F~
"
500
-
TANK PER TST NEEDED WRN
SABLED OV
AUTO--
DISABI-ED
LOW PRODUCT ~ LOW PRODUCT
LEAK ALARM LIMIT: 9g
DI
~.
TANK ANN TST NEEDED WRN
BLED
DIS AUTO
DISABLED
O THEFT LIMIT SUDDEN LOSS LINIIT: 0.~0
TANK TILT 0
00
.
A AUT
DISABLED .
PROBE OFFSET
I.I`NE RE-ENABLE METHOD gUTO,DELI.VER~.START
PASS LINE TEST DISABLED
DO DELIVERY END
SIPHON MANIFOLDED TANKS
LINE PER TST NEEDED WRN
SABLED A
DISABLED
O EXTERNAL I~UT ON T#: NONE
LINE MANIFOLDED TANKS
DI
LINE ANN TST NEEDED WRN AUT
DISABLED
INPUT OFF Tip: NONE
DISABLED {aUTO.EXTERNAL
PRINT TG VOLUMES DISABLED
--AUTO SENSOR FUEL ALARM
LEAK MIP1;'PERIOD3C: 806
ENABLED D I SA$L:ED WATER= ALARM
NSOk
'
`
-
~Mp COMPENSATION
G F }: 60.0 .
SE
T4
AU
DISABLED
TO SENSOR OUT FARM
LEAK MIN ANtdUAL : Sn6
VALUE tDE
STICK HEIGHT OFFSET AU
DISABLED
DISABI-ED PERIODIC TEST TYPE
TA FORMAT STANDARD
H-PROTOCOL DA
HEIGHT
DAYLIGHT SAVING .TIME
ENABLED
START ~~ i SUN
APR
START TIME
ANNUAL'TEST FAIL
ALARM DISABLED
SAGE PERIODIC TEST FAIL
32 END OF MES-' ALARM DISABLED
2:00 AM
END DA~~ 6 SUN
OCT
END TIME
2:00 AM
RE-DIRECT LOCAL PRINTOUT
DISABLED
EURO PROTOCOL FP,EFIX
S
S~fSTEM ,;$EGUR3 TY
CODE : 000000
CUSTOM ALARM LABELS
DISABLED
RS-2
DISABLED GROSS TEST FAIL
ALARM DISABLED
~NN'TEST AVERAGING: OFF
FER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY 15 MIN
PUMP THRESHOLD 10.001
I~ "~ ~ `
~ * ~ ~ ~ END ~ x ~ ~
LEAK TEST METHOD
TEST ANNUALLY: ALL TANK_
MAR ' -WEFT{ 1 SUN
START TIME 2:00 AM
TEST RATE :0.20 GALiHR
DURATION 2 }{O~
TST EARLY STOP:DISABLED
LEAK TEST REPORT FORMAT
NdRMAL
LIQUID SENSOR SETUP
OUTPUT RELAY SETUP
- R 1:REMOTE ALARM
. _ TYPE
STANDARD
NORMALLY CLOSED
LIQUID SENSOR ALMS
ALL:FUEL ALARM
3 WIRE CL ALARMS
ALL:FUEL ALARM
ALL:WATER ALARM
ALL:HIGH LIQUID ALARM
ALL:LQW LIQUID ALARM
ALL:LIQUID WARNING
R 4:OVERFILL ALARM
- TYPE:
STANDARD
NORMALLY dPEN
L i:DIESEL ANNULAR
TRI-STATE tSINGLE FLOAT}
CATEGORY ANNULAR SPRGE IN-TANK AI~RMS
ALL:OVERFILL ALARM
ALL:HIGH PRODUCT ALARM
~ ~ ~ ~ ~ END ~ ~ ~ ~
3 WIRE CL SENSOR SETUP
H 1:GENERATOR CENTER
-4SITE PANVSUMP:STANDARD
CATEGORY OTHER SENSORS
H 2:GENERATOR NORTH
-4SITE PANiSUMP:STANDARD
CATEGORY OTHER SENSORS
ALARM HISTORY REPORT
__ -- SENSOR ALARM -----
- H 1:GENERATOR CENTER
QTHER SENSORS
- LIQUID WARNING
APR 17, 2000 1:47 PM
H 3:GENERATOR SQUTH
-4SITE FANiSUfdIP:STANDARD
CATEGORY OTHER SENSORS
ALARM HISTORY REPORT
----- SENSOR ALARM ---__
L 1:DIESEL ANNULAR
ANNULAR SPACE
SENSOR QUT ALARM
APR 11. 2000 11:03 AM
FUEL AL~}RM
MAR 30, 2000 1:15 pM
ALARM HISTORY REPORT
----- SENSOR ALARM -----
H 2:GENERATOR NORTH
OTHER SENSORS
LIQUID WARNING
" APR 17. 2000 2:34 PM
LIQUID WARNING
APR 17: 2000- 1:50 PM
- FUEL ALARM
APR 17. 2000 1:48 PM
~~~~~END~3~ ~~~
ALARM HISTORY REPORT
----- SENSOR ALARM -----
H 3:GENERATOR SOUTH
OTHER SENSORS
LIQUID WARh1I NG
APR 17. 2000 1:50 PM
FUEL ALARM
APR 17. 2000 1:20 FM
+-VERIZON WIRELESS - YOUNG ____________________________ SiteID: 015-021-003445 +
Manager BusPhone: ( ) -
Location: 5508 YOUNG ST Map 123 CommHaz High
City BAKERSFIELD ~ Grid: 20B FacUnits: 1 AOV:
CommCode: BFD STA 09 0 ~ SIC Code:
EPA Numb: DunnBrad:
i ~___
s-
Emergency Contact-~~ / Title Emergency Contact ,./~-~"~~ Title
Bus ine s s Phone : ( ) - x~ Bus i ne s s Phone `~ ~ ~,
24 -Hour.;~Phone ( ) - O~~ 24 -Hour __PYione ~
Pagerh~Phone ( ) x Paged jPfione ) - x
+----~~//~--------------------------------+--~r!~------------------------------+
Ha~that Hazards: React ImmHlth DelHlth
Contact SHAWN STACEY Phone: (916) 357-2520x
MailAddr: 255 PARKSHORE DR BLDG B State: CA
City FOLSOM Zip 95630
Owner VERIZON WIRELESS
Address 2785 MITCHELL DR
City WALNUT CREEK
Phone: (925) 279-6455x
State: CA
Zip 94598
Gal
Gal
Period to
Preparers
Certif'd:
ParcelNo:
Emergency Directives:
PROG A - HAZMAT
Based on my inquiry of those individuals
the information, I certify
responsible for obtaining
under penalty of law 4hat I have personally
examined a d am familiar with the information
submitted d believe the information is true,
accurate, a d complete.
~3 btu
Signature
TotalASTs: _
TotalUSTs: _
RSs: No
ENT'D A U G 2 8 2006
~5~1\
~5~'~
-1- 07/10/2006