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CERS Consolidated Emergency Respoine/Contingency Plan
<br /> INTERNAL FACILITY EMBRGBNCY COMMUNICATIONS OR ALARM NOTFFICATION WILL OCCUR BY(Check all thin apply): ci r.
<br /> CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM(CEAs) ❑1.VERBAL WARNINGS; ❑2.PUBLIC ADDRESS OR INTERCOM SYSTEM;
<br /> CONSOLIDATED EMERGENCY RESPONSE/CONTINGENCY PLAN [14.PAGERS• [13.TELEPHONE;
<br /> ❑5.ALARM SYSTEM; [16.PORTABLE RADIO
<br /> Prior to completing this Pion.Please F li to the INSTRUCTIONS FOR COWLETINGA CGAWLIDATED CONTINGENCYPL1N NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY(Check all Wit apply): etr.
<br /> 111.VERBAL WARNINGS; [12.PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑3.TELEPHONE;
<br /> DP Y)
<br /> ❑4.PAGERS; ❑5.ALARM SYSTEM; ❑6.PORTABLE RADIO
<br /> FACILITY IDB t. DATE OF PLAN PREPARATION/REVISION Aa EMERGENCY COORDINATOR CONTACT INFORMATION:
<br /> 1 E lOB I � (MM/DD
<br /> YYYY) µ
<br /> BUSINESS NAME(+Same as Fueilily Nome orOBA-Doing BusinneuAs) PRIMARY EMERGENCY COORDINATOR NAME: PHONE NO.: PHONE NO.: cu.
<br /> 0 Y rr Lr ALTERNATE EMERGENCY COORDINATOR NAME: PHONE NO.:
<br /> USINESS SITE ADDRESS PHONE NO.:
<br /> n , NEl' Check ifaddilionel Emergency Coordinator cmtad and address information is awilable onsite or by easing PHONE NO.:
<br /> BUSINB3S SITB CITY Aa ZIP CODE Al Note:If more then re ugemy coordinator is ddignued,attach a list in order of--nsibiliry.
<br /> TYPE OF BU SS(a,g.,Painting Contractor) Aa INCIDENTAL opBRArIONsA 453 - D. E AGENCY CONTAINMENT AND CLEANUP PROCEDURES
<br /> / (ag.,Fleet Meintemme) nn.. CLeck the liable n ro indi ro our Tncili 's roeedurea for containin s ills and m and mitt do relevd,firs and/or ea livona.
<br /> Lf�! D�C (]l.MONTfOR FOR LHAKS,RUPTURES,PRESSURE BUILD-UP,ETC.; ol.
<br /> THIS PLAN COVERS CHEMICAL STILTS,FIRES,AND EARTHQUAKES INVOLVING(Check all that apply): ai ❑2.PROVmE STRUC(URAL PHYSICAL BARRIERS en
<br /> I.HAZARDOUS MATERIALS;❑2.HAZARDOUS WASTES (ag.,Poneble spill cinlaiiiment walla,bnilt•in berms
<br /> ❑3.PROVIDE ABSORBENT PHYSICAL BARRIERS e..,Pads,s JI )
<br /> ( B D Piga.spill pillows);
<br /> ❑4.COVflR OR BLOCK FLOOR AND/OR STORM DRAINS;
<br /> ERNAL FACILITY EMERGENCY RESPONSE WILL OCCUR BY(Check all that apply): at. ❑5.LINED TRENCH DRAINS AND/OR SUMPS;
<br /> I.CALLING PUBLIC EMERGENCY RESPONDERS(e.g.,9-1-1) ❑6.AUTOMA77C FIRE SUPPRESSION SYSTEM;
<br /> 2.CALLING HAZARDOUS WASTE CONTRACTOR 137-ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS;
<br /> 3.ACTIVATING IN-HOUSE EMERGENCY RESPONSE TEAM ❑8.STOP PROCESSES AND/OR OPERATIONS;
<br /> ❑9.AUTOMATIC/ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM;
<br /> In the event ofm cmc g ❑10.SHUT OFF WATER,OAS,ELECTRICAL UTILITIES;
<br /> rgenry involving heaardous materials and/or haeodoua waste,till facilities mustlMMED1ATElY: II.CALL9-I-I FORPUBLICEMERGENCY RESPONDERASSISTANCE AND/OR MEDICAL AID;
<br /> 1.Nati fy facility penom<I anJ evacuate if necessmy in ecenrdance witL We Emergency Asim Plan(Title 8 CaEfomia Code if Regulations§3220);
<br /> 2.Notify local emergency rdpondera by calling 9-1-1; 12.NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR IMPACTED AREAS;
<br /> 3.Notify the local Unified Program Agency(UPA)M We phone number below;and ❑13.ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION;
<br /> 4.Notify We State Wanting Center at(800)852-7550. ❑14.PROVIDE PROTECTIVE EQUIPMENT FOR ONSITE EMERGENCY RESPONSE TRAM;
<br /> ❑15.REMOVE CONTAINERS ANDlOR ISOLATE AREAS;
<br /> Facilities that Ramon:,meati stag car dispose of feta rdous waste have additional responsibilities to notify and coordinate with other resportse agencies.Whenever there ❑16.HIRE LICENSED HAZARDOUS WASTE CONTRACTOR;
<br /> ..an iiiht imn`r azlost emergentry.iteration such as an eaplirion,fire,or release,the Emergency Coordinator must follow We appropriate requimmene,for the category ❑17.USE ABSORBENT MATERIAL,FOR SPILL CONTAINMENT;
<br /> y m type is Code
<br /> involved: ❑I8.VACUUM SUCTION USING APPROPRIATE VACUUM
<br /> I.I'sle 22 Celifamia Code of Regulation.¢66265.56.Emergency o Look,or for generators of'-000 f kilograms or more o Unfit-for-Use
<br /> a n waste in my calendar month. (e.g.,Intrimicelly safe)FOR SPILL CONTROL AND/OR CLBANUP;
<br /> 2.Tide 22 Cali(omia Code oC Rcgulatione¢66265.196.Response to Leah or Spills And Disposition of Leaking or Unfit-for-Use Tenk Systems. ❑19.DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE;
<br /> 3.7111,40 Code oCFWenI Regulations§302.6.Notification requirements for a release of a haardow substance equal to or greater thin the reportable quantify. ❑20-PROVIDE SAPS TEMPORARY STORAGE OF I{AygRpOUS WASTE GENERATEp DURING EMERGENCY ACTIONS;
<br /> 4.Title 22 California Cade of Regulatioru¢66262.34(dH2)and Title 40 Cade of Federal Regulatione§262.34(d)(5)(i)for generators of was than 1000 kilograms of 21.OTHPa(Specify) FI"I elf'ai S k 110u)LNPS a Qt\ s4 t;✓{(( I i
<br /> liazardoaa waste in any calendar mantra. p ngl era ns,er C ut�LuirrAca:n/1W!!� ;u
<br /> (n etc OU f n re a{/aaS E. FA CILITYEVACUATIONorDIP
<br /> Following notification and before facility operetiom are resumed in areas of the Facility affected by the incident,the Emergenry Coordinator shall notify the local UPA
<br /> toes the loll fire depermtent's hemMom materiels program,if necessary,the'the feciliry it in compliance with requirements to: THE FOLLOWING ARM SIONAL(S)WILL BE USED TO BEGIN EVACUATION OF THE FACILITY(Chink ell that apply): s,.
<br /> I.Provide Fit proper storage and disposal of recovered waste,contaminated soil 4 surface water,or my other material that results from an explosion,fire,or release at ❑1.BELLS;
<br /> the facility;and ❑2.HORNS/SIRENS; az
<br /> 2.Ensure char no material that is incompatible with the relmsed mmerial is transferred,stared,or disposed of in areas of We facility atFsted by the incident until cleanup ❑3.VERBAL(I...,Shouting);procedures are completed.
<br /> 4.OTHER S
<br /> WILL BB USED FOR AN EMERGENCY ASSEMBLY ARHA(S)(e.g.,Parking lot,sbeet mnra): 53
<br /> EMERGENCY RESPONSE AMBULANCE,FIRE,POLICE AND CHP.............................................. 9-11 THE FOLLOWING LOCATIONS)
<br /> -
<br /> PHONE NUMBERS: CALIFORNIA STATE WARNING CENTER(CS WCYCAL OES............................ (800)852-7550
<br /> Note:The finer ane CooNlnetor must accomt fw all onsite b sod vuitora atter evecuetiin.
<br /> NATIONAL RESPONSE CENTER(NRC).............................................. (800)424-8802 EVACUATION ROUTE S AND ALTBRNATE EVACUA710N ROUTES ARB DESCRIBED AS FOLLOWS:
<br /> POISON CONTROL CENTER........................................................ 800 222-1222 ❑1.WRITTEN PROCEDURES DESCRIBING ROUTES,EXITS.AND ASSEMBLY AREAS; u.
<br /> LOCAL UNIFIED PROGRAM AGENCY . ,..., ct. ❑2.EVACUATION MAPS)DEPICTING ROUTES.EXITS,AND ASSEMBLY AREAS;
<br /> OTHERS q. [13.07HER(Specify):
<br /> NEAREST MEDICAL FACILITY/HOSPITAL NAM �- C4 6 Now:Ev uassom procedures md/or roe i aboWd be ty
<br /> P posted in visible fec0i locations and most be included in We Contingency plea
<br /> AGENCY NOTIFICATION PHONE NUMBERS: CALIFORNIA DEPT.OF TOXIC SUBSTANCES CONTROL(DISC).... (91 6)255-3545 F. ARRANGEMENTS FOR EMERGENCY SERVICES
<br /> REGIONAL WATER QUALITY CONTROL BOARD(RWQCB)........ ca ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES(Check one of the following):
<br /> U.S.ENVIRONMENTAL PROTECTION AGENCY(US EPA)........... (800)300-2193 FL
<br /> ❑1.HAVE BEEN DETERMINED NOT NECESSARY;
<br /> CALIFORNIA DEPT.OF FISH AND WILDLIFE(CDFW).............. (916)358-2900 ❑2.THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE(Specify):
<br /> U.S.COAST GUARD(USCG)..................................... (202)267-2180
<br /> 916 263-2800 Note:Advance arrangements with local foe and police dcjuro-ta,hospitals,stem and local emergency reponse tdnv,and/or ewer enc
<br /> CALOSHA..................................................... ( ) ondomora should be made for you facility,irnec g raerviees
<br /> CAL FIRE OFFICE OF THE STATE FIXE MARSHAL(GSFM)...,..... 916 323-7390 a-+sa7.Large Qumtiry Crenerntors must describe arrangements In We Contingency Plan.
<br /> OTHER(Specify): I.. -. _ ...- M. �
<br /> OTHER(Speciry): I - -1 ma f Rev.03/07/17 Page 2 of 4
<br /> Rev.03107/17 Page I ot4
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