HomeMy WebLinkAboutBUSINESS PLAN 1/16/2009UNIFIED PROGRAM INSPECTION CHECKLIST ;
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SECTION 1: Business Plan and Inventory Program ~
.
B A IC E R S F I E. D
F/RE
DE~ARTM ~Nf
Prevention Services
900 `IYuxtun Ave., Suite 210
Bakersfield, CA 93301 .
Tel.: (661) 326-3979
Fa~c: (661) 872-2171
FACILITY NAME / -
~
'
' INSPECTION DATE
9 INSPECTION TIME
-
~~--
c, C.
i ) - /C ~- ~ ~~,g
ADDRESS / r- PHONE N0.
v
` NO OF EMPL YEES
~ C~ ~ ~r ,~ c ~ ~--~-. ) - ~ Z V
Qi 3
FACILITY CONTACT BUSINESS ID NUMBER
15-021- ~ O 2a ~
Section 1: Busine5s Plan and Inventory Program
^ ROUTINE ^ COMBINED ^ JOINT AGFNCY ^ MULTI-AGENCY ^ COMPIAINT ^ RE-INSPECTION
C V ~ C=Compliance~ OPERATION
V=Violation COMMENTS
~ ^ APPROPRIATE PERMIT ON HAND
^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE
^ VISIBLE ADDRESS
~ ^ CORRECT OCCUPANCY
~J ^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ PROPER SEGREGATION OF MATERIAL
^ VERIFICATION OF MSDS AVAILABILITY •
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION ,
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
^ YES L'1'NO
/.
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
~ ', J~.` ,~ ~. ~ S 4 '^ ~ /~
Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station # Business Site / Responsible Party (Please Print)
White - Prevention Services Yellow - Station Copy Pink - Business Copy FD 2155 (Rev. 09/05
+ CA~IFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
Manager : TIM TRELOAR
Location.: 1606 LA FR.ANCE ST
City : BAKERSFIELD
BusPhone: (661) 837-7200
Map : 124 CommHaz : High
Grid: 06C FacUnits: 1 AOV:
CommCode: BFD STA 06 SIC Code:4941
I
EPA Numb: I
DunnBrad:00-691-3578
+------------------------------------------------------------------------------+
------------------------- ------------------- ---------
+_______________________________________+______________________________________+
Emergency Contact / Title Emergency Contact / Title
TIM TRELOAR / DISTRICT MGR RUDY VALLES / ASST DIST MGR
Business Phone: (661) 837-7200x Business Phone: (661) 837-7271x
24-Hour Phone :(661) 837-7200x 24-Hour Phone :(661) 837-7271x
Pager Phone : ( ) - x Pager Phone : ( ) - x
+---------------------------------------+--------------------------------------+
~ Hazmat Hazards: RSs Fire Press ImmHlth ~
+---------=--------------------------------------------------------------------+
Contact : BILL ROSICA Phone: (661) 837-7278x
MailAddr: 3725 S H ST State: CA
City : BAKERSFIELD Zip : 93304
+------------------------------------------------------------------------------+
Owner CALIFORNIA WATER SERVICE CO Phone: (661) 837-7200x
Address : 3725 S H ST State: CA
City : BAKERSFIELD Zip : 93304
+------------------------------------------------------------------------------+
Period . to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: Yes
ParcelNo:
+------------------------------------------------------------------------------+
~ Emergency Directives: ~
PROG A - HAZMAT
PROG T- ABOVEGROUND STORAGE TANK
+______________________________________________________________________________+
--------------
-1- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+= Hazmat Inventory _________________________________________ By Facility Unit +
+_= MCP+DailyMax Order ______________________________ Fixed Containers on Site +
+--------------------------------+-------+-----------+-----+----------+----+---+
~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~
+--------------------------------+-------+-----------+-----+----------+----+---+
~ SODIUM HYPOCHLORITE F P IH L 200.00 GAL Hi I
*______________________________________________________________________________+
-2- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+= Inventory Item 0002 _______________ Facility Unit: Fixed Containers on Site +
+_= COMMON NAME / CHEMICAL NAME ______________________________+________________+
SODIUM HYPOCHLORITE I Days On Site I
365
Location within this Facility Unit Map: Grid: +----------------+
FENCED ENCL NEXT TO PUMP I CAS# I
7681-52-9
+_____________________________________________________________+________________+
+= STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+
~ Liquid ~ Mixture ~ Ambient I Ambient ~ ABOVE GROUND TANK ~
+_________+__________+_______________+_______________+_________________________+
+__________________________+ AMOUNTS AT THIS LOCATION =________________________+
I Largest Co200100rGAL I Daily 200100m GAL I Daily 200r00e GAL I
+__________________________+_________________________+_________________________+
+_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+
I 12t50ISodium Hypochlorite INosl CAS#7681529I
+_______+__________________________________________________+___+_______________+
+_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+
ITSNc~retlYeslBNoHazl RN~d~oactive/Cur1'es I FPP HalHrds I%F~A/ I USDOT# I HiP I
+_______+___+______+____________________+_____________+_________+________+_____+
+__________________________ MISC. LOCAL AGENCY DATA =__________________________+
I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ~
Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag.Defined8: Ag.Defined9: Ag.Definel0:
+- Ag.Definell ----------------------------------------------------------------+
+______________________________________________________________________________+
-3- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+_________________________________________________________________ Fast Format +
+= Notif./Evacuation/Medical ____________________________________ Overall Site +
+_= Agency Notification ___________________________________________ 08/30/2000 +
CALL 911.
+______________________________________________________________________________+
+__= Employee Notif./Evacuation ___________________________________ 02/26/2007 +
UNMANNED SITE.
+______________________________________________________________________________+
+___= Public Notif./Evacuation ____________________________________ 10/05/1992 +
EVACUATION OF THE LOCAL POPULATION TO BE DETERMINED BY EMERGENCY SERVICES
PERSONNEL, UNLESS EVACUATION IS NECESSARY PRIOR TO THEIR ARRIVAL.
+______________________________________________________________________________+
+____= Emergency Medical Plan _____________________________________ 08/07/2006 +
MERCY HOSPITAL, TRUXTUN AVE.
+______________________________________________________________________________+
-4- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+_________________________________________________________________ Fast Format +
+= Mitigation/Prevent/Abatemt ___________________________________ Overall Site +
+_= Release Prevention ____________________________________________ 09/27/1994 +
DIESEL IS STORED IN AN ABOVEGROUND CONVAULT TANK.
+______________________________________________________________________________+
+__= Release Containment __________________________________________ 05/11/2006 +
IF AN ABOVEGROUND CONVAULT TANK WERE TO START LEAKING, ARRANGEMENTS WOULD BE
MADE TO IMMEDIATELY REMOVE ALL FUEL FROM THE TANK. THE CONVAULT TANK HAS A
BUILT-IN SECONDARY CONTAINER AND IS ENCASED IN CONCRETE.
+______________________________________________________________________________+
+___= Clean Up ____________________________________________________ 05/11/2006 +
RELEASE ABATEMENT WOULD BE PERFORMED BY AN INDEPENDENT REMEDIATION
CONSULTANT, AS NEEDED, AND TO THE SATISFACTION OF THE RESPONSIBLE REGULATORY
+______________________________________________________________________________+
+____= Other Resource Activation ______________________________________________+
+______________________________________________________________________________+
-5- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+_________________________________________________________________ Fast Format +
+= Site Emergency Factors _______________________________________ Overall Site +
+_= Special Hazards ___________________________________________________________+
+______________________________________________________________________________+
+__= Utility Shut-Offs ________________________________________________________+
+______________________________________________________________________________+
+___= Fire Protec./Avail. Water ___________________________________ 08/07/2006 +
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS.
FIRE HYDRANT - WELL DISCHARGE.
+______________________________________________________________________________+
+____= Building Occupancy Level ___________________________________ 02/27/2006 +
UNMANNED SITE.
+______________________________________________________________________________+
-6- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+_________________________________________________________________ Fast Format +
+= Training _____________________________________________________ Overall Site +
+_= Employee Training _____________________________________________ 05/11/2006 +
MATERIAL SAFETY DATA SHEETS ON FILE.
+______________________________________________________________________________+
+__= Page 2 ___________________________________________________________________+
+______________________________________________________________________________+
+___= Held for Future Use _____________________________________________________+
+______________________________________________________________________________+
+____= Held for Future Use _________________ +
+______________________________________________________________________________+
-7- 08/25/2008
+ CALIFORNIA WATER SRV 054-02 _________________________ SiteID: 015-021-002095 +
+_________________________________________________________________ Fast Format +
+= Response/Risk Management _____________________________________ Overall Site +
+_= Operations ________________________________________________________________+
+______________________________________________________________________________+
+__= Planning _________________________________________________________________+
+______________________________________________________________________________+
+___= Logistics _______________________________________________________________+
+______________________________________________________________________________+
+____= Finance/Administration _________________________________________________+
+______________________________________________________________________________+
-8- 08/25/2008