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HAZARDOUS WASTE CONTINGENCY PLAN <br />For use by Unidocs Member Agencies or where approved by your Local Jurisdiction <br />Aurhord y Cited: Tide 21, California Cade of Regulariom (CCR) §66165.51 w referenced by §66161.34(a)(4) m 67450.3(c)(9)(C) <br />Facilities that generate 1,000 kilograms or more of hazardous waste per month, or accumulate more than 6,000 <br />kilograms of hazardous waste on-site at any one time, must prepare a Contingency Plan. Facilities that generate <br />in any month more than 1 kilogram of acutely hazardous waste (AHW), or more than 100 kilograms of debris <br />resulting from the spill of an AHW, or which treat hazardous waste onsite under the Permit by Rule (PBR) <br />onsite treatment tier must also prepare a Contingency Plan. Many facilities that are required to prepare a <br />Contingency Plan are already subject to Hazardous Materials Business Plan (HMBP) reporting requirements <br />due to the quantities of hazardous materials/wastes they have onsite. If you have already DreDared a Unidocs <br />This site-specific Contingency Plan is the facility's plan for dealing with emergencies and shall be implemented <br />immediately whenever there is an imminent or actual fire, explosion, or release of hazardous waste or a <br />hazardous waste constituent which could threaten human health and/or the environment. At least one copy of <br />the plau shall be maintained at the facility for use in the event of an emergency and for inspection by the <br />local agency. A copy of the plan and any revisions must be provided to any contractor, hospital, or agency <br />with whom special (i.e. contractual) emergency services arrangements have been made (see Section E, below). <br />A. Facility Information: <br />BUSINESS NAME —� BUSINESS PHONE <br />/ Q <br />SITE ADDRESS r CII# ZIPCODE <br />. • oar 5-36.5 <br />If. Emergency Coordinators: <br />All personnel qualified to act as the facility's Emergency Coordinator must be listed in this plan. (Note: <br />Enter Coordinator responsibilities are described in Section F, below.) If more than two people are <br />qualified, list the names, titles, business and 24-hour telephone numbers, and pager numbers of the additional <br />qualified individuals on an attached page in the order in which they will assume responsibility as alternates, <br />then check the box beneath the Emergency Coordinator information table, below, and indicate the list's page <br />number in the space provided. <br />Primary Emergency Coordinator Secondary Emergency Coordinator <br />NAME NAME <br />TIME irILE <br />rw - r <br />BUSINESS PHONG BUSINESS PHONE <br />C <br />24-HOUR PHONE 24-HOUR PHONE <br />PAGER# PAGER# <br />(Check box only of applicable) Additional Emergency Coordinators are listed on page I I3 _ of this plan. <br />C. Evacuation Plan: <br />1. The following alarm signal(s) will be used to begin evacuation of the facility (check all that apply): <br />❑ Bells; ❑ Horns/Sirens; DgVerbal (i.a. shouting); ❑ Other (spec <br />UN -017-1/6 --idxs.419 Rev. COMM <br />Rt�� A <br />