Laserfiche WebLink
HAZARDOUS WASTE CONTINGENCY PLA 1 2oo8 <br />For use by Unidocs Member Agencies or where approved by your Local JurisdictioSA <br />Authority Cited: Title 22, California Code of Regulations (CCR) ¢66265.52 as referenced by §66262.34(a)(4) or <br />y D p ENTAL <br />11E4Lr <br />RRTAlE� <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 prepared 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 plan 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 I BUSINESS PHONE. <br />SITE ADDRESS `-1 CITY ZIP CODE <br />M <br />B. Emergency Coordinators: <br />All personnel qualified to act as the facility's Emergency Coordinator must be listed in this plan. (Note: <br />Emergency 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 />Prima!.1Emergency <br />Coordinator <br />Secondary Ernergenel Coordinator <br />NAME <br />�eWA <br />NAME <br />TITLE L <br />TITLE <br />% i C T + 0 <br />BUSINESS PHONE <br />6 6n <br />J <br />BUSINESS PHONE <br />2 y6 -o°2./ <br />24-HOUR PHONE <br />24-HOUR PHONE <br />a <br />Y) <br />c_ <br />®� <br />> �j <br />lt3_ /S�/ <br />PAGER # <br />PAGER # <br />❑ (Check box only if applicable) Additional Emergency Coordinators are listed on page 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; gVerbal (i.e., shouting); ❑Other (sped Aa- <br />Akl ph(" S <br />UN -017 -1/6 www.unidocs.org Rev. 03/27/08 <br />