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HomeMy WebLinkAboutBUSINESS PLAN 1/16/2009tY ~ UNIFIED PROGRAM INSPECTION CHECKLIST'€ ~~---~-- _I~ pn resr•i .o _ _ - --- . . _ _..~ _.. _ __ _ ___ __ P/BE ~ - - - _ - --_ _._- --- _ _ .~ ---- .--_ ___.. _ ~. __.~. --. SECTION 1. Business Plan and Inventory Program ~~ ° aRrM ~ Prevention Services 900'IYuxtun Ave., Suite 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ INSPECTION DATE INSPECTION TIME Ve ~ 2~^ ~ ~~ ~33 ADDRESS ~ /~ /'~ ; t I ~ P~NE NO. "~°1 ~ O OF EMPLOYEES r~ ~ ; ~ 5 c~y FACILITY CONTACT ~ BUSINESS ID NUMBER 15-021- 633~(; Section 1: Business Plan and Inventory Program ^ ROUTINE ^ COMBINED ^ JOINTAGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( c=~omP~iance~ OPERATION V=Violation COMMENTS 6d ^ APPROPRIATE PERMIT ON HAND Is ^ BUSIII2SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS l~ ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~ ^ VERIFICATION OF MSDS AVAILABILITY L1 ^ 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? ^ YES L7 NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 r~ , xt- ~~~,~5~ -~ ~ ~C~ 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/OS + VERI~ZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + Manager : MARK IVERSON Location: 1516 RICHLAND ST City : BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: (661) 664-5601 Map : 124 CommHaz : High Grid: 06A FacUnits: 1 AOV: SIC Code:4812 DunnBrad:88-463-8305 +______________________________________________________________________________+ +_______________________________________+______________________________________+ Emergency Contact / Title Emergency Contact / Title MARK IVERSON / OPS MANAGER NETWORK OPERATIONS / CONTROL CENTER Business Phone: (661) 664-5601x Business Phone: (682) 831-3523x 24-Hour Phone :(661) 203-3205x 24-Hour Phone :(800) 264-6620x Pager Phone : ( ) - x Pager Phone : ( ) - x +---------------------------------------+--------------------------------------+ ~ Hazmat Hazards: Fire ImmHlth ~ +------------------------------------------------------------------------------+ Contact : SHAWN STACEY Phone: (866) 694-2415x MailAddr: 255 PARKSHORE DR BLDG B State: CA City : FOLSOM Zip : 95630 +------------------------------------------------------------------------------+ Owner VERIZON WIRELESS Phone: (866) 694-2415x Address : 255 PARKSHORE DR BLDG B State: CA City : FOLSOM Zip : 95630 +------------------------------------------------------------------------------+ Period . to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: +------------------------------------------------------------------------------+ ~ Emergency Directives: ~ PROG A - HAZMAT CALL MARK IVERSON, 203-3205, FOR INSPECTIONS. +______________________________________________________________________________+ -1- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + += Hazmat Inventory _________________________________________ By Facility Unit + +_= MCP+DailyMax Order ______________________________ Fixed Containers at Site + +--------------------------------+-------+-----------+-----+----------+----+---+ ~ Hazmat Common Name... ~SpecHaz~EPA Hazards~ Frm ~ DailyMax ~Unit~MCP~ +--------------------------------+-------+-----------+-----+----------+----+---+ I ELECTRIC STORAGE BATTERY F IH S 6153.84 LBS Hi I ELECTRIC STORAGE BATTERY F IH L 81.76 GAL Hi +______________________________________________________________________________+ -2- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + += Inventory Item 0002 _______________ Facility Unit: Fixed Containers at Site + +_= CONIMON NAME / CHEMICAL NAME ______________________________+________________+ ELECTRIC STORAGE BATTERY I Days On Site I 365 Location within this Facility Unit Map: Grid: +----------------+ SEALED BATTERY CASE ~ CAS# I +_____________________________________________________________+________________+ += STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ ~ Solid I Mixture ~ Ambient ~ Ambient ~ OTHER - SPECIFY ~ +_________+__________+_______________+_______________+_________________________+ +__________________________+ AMOUNTS AT THIS LOCATION =________________________+ I Largest Con93i~~rLBS I Daily6153184m LBS I Daily6153r84e LBS I +__________________________+_________________________+_________________________+ +_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+ I 72t00ILead INosl CAS#7439921I +---_--_+__________________________________________________+___+_______________+ +_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSNc~retlNoSIBNo~Hazl RN~d~oactive/Cur1'es I FPA HalHrds I jFjA/ USDOT# I HiP I +_______+___+______+____________________+_____________+_________+---_----+_____+ +__________________________ MISC. LOCAL AGENCY DATA =__________________________+ I Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: ( Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag . Def ined8 : Ag.Defined9: Ag.Definel0: +- Ag.Definell ----------------------------------------------------------------+ t______________________________________________________________________________+ -3- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + += Inventory Item 0001 _______________ Facility Unit: Fixed Containers at Site + +_= CODM~ION NAME / CHEMICAL NAME ______________________________+________________+ ELECTRIC STORAGE BATTERY Days On Site I 365 I Location within this Facility Unit Map: Grid: +----------------+ SEALED BATTERY CASE ~ CAS# I +_____________________________________________________________+________________+ += STATE _+= TYPE ___+_= PRESSURE ___+ TEMPERATURE __+___= CONTAINER TYPE _____+ ~ Liquid ~ Mixture I Ambient ~ Ambient ~ OTHER - SPECIFY I +_________+__________+_______________+_______________+_________________________+ +__________________________+ AMOUNTS AT THIS LOCATION =________________________+ I Largest Container I Daily Maximum I Daily Average I 2.92 GAL 81.76 GAL 81.76 GAL +__________________________+_________________________+_________________________+ +_______+______________ HAZARDOUS COMPONENTS =_____________+___+_______________+ I 1Ot00ISulfuric Acid (EPA) INosl CAS#7664939I +_______+__________________________________________________+___+_______________+ +_______+___+______+__________= HAZARD ASSESSMENTS =__+_________+________+_____+ ITSecretl RSIBioHazl Radioactive/Amount I EPA Hazards I NFPA I USDOT# I MCP I No No No No/ Curies F IH /// Hi +_______+___+______+____________________+_____________+_________+________+_____+ +__________________________ 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 ----------------------------------------------------------------+ *______________________________________________________________________________+ -4- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + +_________________________________________________________________ Fast Format + += Notif./Evacuation/Medical ___________________________________= Overall Site + +_= Agency Notification ___________________________________________ 03/12/2007 + PHONE 800-621-2622 AFTER NORMAL BUSINESS HOURS, LOCAL PERSON IN CHARGE WILL BE NOTIFIED AND WILL RESPOND. SITE SHOULD BE IDENTIFIED BY SITE NLTMBER. DUR.ING REGULAR HOURS, USE CONTACT NUMBERS PROVIDED IN SECTION 2: EMERGENCY NOTIFICATION. +______________________________________________________________________________+ +__= Employee Notif./Evacuation _______________________________________________+ +______________________________________________________________________________+ +___= Public Notif./Evacuation ________________________________________________+ +______________________________________________________________________________+ +____= Emergency Medical Plan _________________________________________________+ +______________________________________________________________________________+ -5- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + +_________________________________________________________________ Fast Format + += Mitigation/Prevent/Abatemt ___________________________________ Overall Site + +_= Release Prevention ____________________________________________ 03/12/2007 + BATTERIES ARE LOCATED INSIDE LOCKED COMMUNICATIONS SHELTER AND ARE MONITORED 24-HRS PER DAY BY THE LOCAL SWITCHING STATION. INSPECTED ONCE PER MONTH BY SITE TECH. +______________________________________________________________________________+ +__= Release Containment ______________________________________________________+ +______________________________________________________________________________+ ±___= Clean Up ____________________________________________________ 03/12/2007 + INTERNATIONAL TECHNOLOGY CO 800-262-1900 +______________________________________________________________________________+ +____= Other Resource Activation ______________________________________________+ +______________________________________________________________________________+ -6- 08/25/2008 + VERIZON WIRELESS - CHESTER _________________________= SiteID: 015-021-003366 + +_________________________________________________________________ Fast Format + += Site Emergency Factors _______________________________________ Overall Site + +_= Special Hazards ___________________________________________________________+ +______________________________________________________________________________+ +__= Utility Shut-Offs ___________________________________________= 03/12/2007 + ELECTRICAL - E SIDE OF BLDG +______________________________________________________________________________+ +___= Fire Protec./Avail. Water ___________________________________ 03/12/2007 + 1 HALON 1211 FIRE EXT (9 LBS) L SIDE OF ENTR DOORS. +______________________________________________________________________________+ +____= Building Occupancy Level ___________________________________ 03/08/2006 + UNMANNED SITE +______________________________________________________________________________+ -7- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + +_________________________________________________________________ Fast Format + += Training _____________________________________________________ Overall Site + +_= Employee Training _____________________________________________ 03/12/2007 + MSDS SHEETS ON FILE. +______________________________________________________________________________+ +__= Page 2 ___________________________________________________________________+ +______________________________________________________________________________+ +___= Held for Future Use _____________________________________________________+ +______________________________________________________________________________+ +____= Held for Future Use ____________________________________________________+ +______________________________________________________________________________+ -8- 08/25/2008 + VERIZON WIRELESS - CHESTER __________________________ SiteID: 015-021-003366 + +_________________________________________________________________ Fast Format + += Response/Risk Management _____________________________________ Overall Site + +_= Operations ____________________________________ + +______________________________________________________________________________+ +__= Planning _________________________________________________________________+ +______________________________________________________________________________+ +___= Logistics _______________________________________________________________+ +______________________________________________________________________________+ +____= Finance/Administration _________________________________________________+ +______________________________________________________________________________+ -9- 08/25/2008