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Home My WebLink AboutBUSINESS PLAN (2) - ~~ 'II}/( ~ " , J ;1 ,) ,il I" " I'i :i I' 11 II II i :! )iIIfilf:.,~\ II 'W1 iI ii I. i, .,~o' _ ./ ~, SBC IISA532 E ' 11101 WHITE LAN ,~ '1;)"3S01 __ [ -, -,- ',', r '~l, ,- ,\ r~ " v ,v v V 01 01 . b C:;3 /' ,~ -~~,~:~ UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION HAZARDOUS MATERIALS BUSINESS PLAN CERTIFICATION FORM 2007 Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials Business Plan (HMBP) certification described below is hereby submitted for the following facility: Facility Name: Pacific Bell Facility Street Address 11101 WHITE LANE SA532 / BKFDCA 19 City: BAKERSFIELD Zip: 93301 I have personally reviewed the Hazardous Materials Business Plan currently on file with the CUP A dated 12/1/2006 and certify that: (Check one.) D ~ The Hazardous Materials Business Plan is complete and accurate and no revisions are necessary* (See below for details); or Revisions to the Hazardous Materials Business Plan are necessary, The following new or revised formes) and/or information are enclosed to reflect the necessary changes: Business Activities form ~ Business Owner/Operator Identification form Hazardous Materials Inventory formes) Site Map form Emergency Response Plans and Procedures Employee Training Program tNT7J J,q N 3 0 lOO? _x *By checking the top box on this form, you are certifYing that: a) The information contained in the annual inventory forms most recently submitted to the administering agency is complete, accurate, and up-to-date; and b) There has been no change in the quantity of any hazardous material as reported in the most recently submitted annual inventory forms; and c) No hazardous materials subject to the inventory requirements are being handled that are not listed on the most recently submitted annual inventory forms; and d) There have been no substantial changes in the facility's hazardous materials operations which would require revision of the current HMBP; and e) The most recently submitted annual inventory forms contain the information required by Section 11022 of Title 42 of the United States Code. OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my inquiry of those individuals responsible for obtaining the information reported above, I believe that the submitted information is true, accurate, and complete. I understand that a revised HMBP must be submitted within 30 days of any change in this facility's storage or handling of hazardous materials which would require updating o~he HM,>>P, Signature of Owner/Operator: _ ~/ __ Title: Project Manager-Agent for AT&T Name of Owner/Operator (print) Steve Skanderson Date: JAN () 5 2001 Return all forms to: Bakersfield Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield CA 93301 661-326-3979 Business Plan Certification 2007 SA532 ,., -:-v=:~ " UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I i---- __~_~_~_________ .I Page IFACILITY 10# I i [BUSINESS NAME i I. IDENTIFICATION ITIJl [IT'.' -n-J-L-JI' 1 JBEGINNING DATE-----WO-[ENDING DATE-~--101-'; ~__ 1/1/2007 ~ 12/31/2007_ .i (Same as FACILITY NAME or DBA - Doing Business As) 3 BUSINESS PHONE 102 i Pacific Bell SA532 BKFDCA19 661-664-0008__~___J 103 I I ! 11101 WHITE LANE L__ iBUSINESS SITE ADDRESS i__.__ _____________________ !CITY I i l____.___._~____.____ IDUN _BRADSTREET 104 CA -----ENflJJ7rn 3 0 Z007 106 ZIP CODE 105 i ! 93301 I SIC CODE (4 digit #) 107 I 1 4813 i ; ----~. "i 108 BAKERSFIELD 10-340-1618 I ICOUNTY 1_____ IBUSINESS OPERATOR NAME 1 Grant Armstrong l_____._____________._______~ KERN r;:;-;;;:;;---.------------- 109 iBUSINESS OPERATOR PHONE 110 _____L_ 661-327-6903_________._ -I I IoWNERNAME ---- i Pacific Bell Telephone Company d/b/a AT&T California I [OWNER MAILING ADDRESS I , i ~ITY , i l__________.. I I rCON'rAcl:-NAME-------- 1____ Environment Health & Safety. attn: James Stehr fCONTACT MAILING ADDRESS i P.O. Box 5095, Room 3EOOO II. BUSINESS OWNER '" ]'WNE~ (~OO~~;~"'J 113 , I i ~]ZIP CODE-~4583 ---'-11-6-.1 ~-------- -. --- -: I ------118'-. i P,O. Box 5095, Room 3EOOO San Ramon 114 _ISTATE CA 115 III. ENVIRONMENTAL CONTACT 11i---lCONTACT PHONE (925) 823-8866 i ! ui 119 I i ___________~___~:J~TA~ CA ~:_~---IZIP CODE__~_~;~~__-------122 IV. EMERGENCY CO NT ACTS SECONDARY iCITY San Ramon ,-----------~--- i PRIMARY !NAME -~- 123 NAME 128 Grant Armstrong EMERGENCY CONTROL CENTER I rTITLE---~---- i EM Site Manager 124 TITLE 129 24 HR EMERGENCY SERVICE L____._____ iBUSINESS PHONE I 661-327-6903 i----.----~--------------- '24-HOUR PHONE I 800-566-9347 (800 KNOW EHS) ~------------ IPAGER# , 125 BUSINESS PHONE I , --130---! I 877-322-4722 !ADDlTIONAL-COCALL Y COLLECTED INFORMATION: ~PAGER# -----.-------------- --I 131 i 800-566-9347 (800 KNOW EHS) I I 132 --I I i 126 24-HOUR PHONE 661-721-4747 Property Owner: Pacific Bell Telephone Company d/b/a AT&T California Billing Address:_ P.o..BOX 509~, Room 3EOOO, San Ramon, CA 94583 Phone No.: 800-566-9347 ~---------~--~ - rcertifi~ation:-B;~~d on my-inquiry of those individuals responsible for obtaining the information, I certifY under pen;i\y oflaw ih;;'ITh;~~-pers~~~liy~~mined-;;;-d a~--- ----, Ifamiliar with the information submitted and believe the information is true, accurate, and complete. I~SIG-NATURE OF OWNER/OPERATOR . TED REPRESENTATIVE JiRNEo 5 200't 1-------------- _1.__________ INAME OF SIGNER (print) . 136 ITITLE OF SIGNER l_n_~_ Steve Skanderson I NAME OF DOCUMENT PREPARER 135 RHL DESIGN GROUP, INC. - ENVIRONMENTAL DEPT. ~~~----~~---,_..-_..~- . 137 Project Manager, Agent for AT&T UN-020UPCF - 5/15 www.unidocs.Of!! Rev. 01/16/02 Prevention Services 900 Truxtun Ave" Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program ( c=comPlianCe) V=Violation OPERATION NT'D DEe 27 20Q51MMENTS FACILITY NAME ADDRESS FACILITY CONTACT "",,~<~ o~p _- . ~;::.:,~a~ln~~~{p'~'~'(iiri~..ih~~lit()rYjsl~~'::{ D JOINT AGENCY D MULTI-AGENCY D COMPLAINT ApPROPRIATE PERMIT ON HAND Business PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY VERIFICATION OF QUANTITIES -5"lk/~ :t'- VERIFICATION OF INVENTORY MATERIALS PROPER SEGREGATION OF MATERIAL VERIFICATION OF LOCATION VERIFICATION OF MSDS AVAILABILITY VERIFICATION OF HAZ MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES EMERGENCY PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED FIRE PROTECTION ~!) -- /fft.p, , HOUSEKEEPING SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? DYES EXPLAIN: I? sJio~ ~ usiness Site / Respon ' e Party (Please Print) Prevention /1" In / Shift of Site/Station # White - Prevention Services. Yellow - Station Copy Pink - Business Copy FD 2155 (Rev, 09/05