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COMPLIANCE INFO_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1900 - Hazardous Materials Program
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PR0544006
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COMPLIANCE INFO_2019
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Last modified
4/28/2020 8:54:05 AM
Creation date
1/9/2020 10:23:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0544006
PE
1919
FACILITY_ID
FA0007567
FACILITY_NAME
EL PATIO ORIGINAL
STREET_NUMBER
1005
STREET_NAME
PESCADERO
STREET_TYPE
AVE
City
TRACY
Zip
95376
APN
21306040
CURRENT_STATUS
01
SITE_LOCATION
1005 PESCADERO AVE STE 123
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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CERS Consolidated Emergency Response/Contingency Plan <br /> INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR BY(Check all that apply): C I L <br /> [11.VERBAL WARNINGS; [12.PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑3.TELEPHONE; <br /> ❑4.PAGERS; ❑5.ALARM SYSTEM; ❑6.PORTABLE RADIO <br /> NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY(Check all that apply): Ciz <br /> ❑ 1.VERBAL WARNINGS; ❑2.PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑3.TELEPHONE; <br /> ❑4.PAGERS; ❑5.ALARM SYSTEM; [16.PORTABLE RADIO <br /> EMERGENCY COORDINATOR CONTACT INFORMATION: c i <br /> PRIMARY EMERGENCY COORDINATOR NAME: PHONE NO.: PHONE NO.: <br /> ALTERNATE EMERGENCY COORDINATOR NAME: PHONE NO.: PHONE NO.: <br /> ❑Check if additional Emergency Coordinator contact and address information is available onsite or by calling PHONE NO.: <br /> Note:If more than one alternate emergency coordinator is designated,attach a list in order of responsibility. <br /> D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES <br /> Check the applicable boxes to indicate your facility's procedures for containing spills and preventing and mitigating releases,fires and/or explosions. <br /> Dl <br /> ❑ 1. MONITOR FOR LEAKS,RUPTURES,PRESSURE BUILD-UP,ETC.; <br /> ❑2. PROVIDE STRUCTURAL PHYSICAL BARRIERS(e.g.,Portable spill containment walls,built-in berms); <br /> ❑3. PROVIDE ABSORBENT PHYSICAL BARRIERS(e.g.,Pads,spill pigs,spill pillows); <br /> [__14. COVER OR BLOCK FLOOR AND/OR STORM DRAINS; <br /> ❑5. LINED TRENCH DRAINS AND/OR SUMPS; <br /> [16. AUTOMATIC FIRE SUPPRESSION SYSTEM; <br /> ❑7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS; <br /> ❑8. STOP PROCESSES AND/OR OPERATIONS; <br /> ❑9. AUTOMATIC/ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM; <br /> ❑ 10.SHUT OFF WATER,GAS,ELECTRICAL UTILITIES; <br /> ❑ 11.CALL 9-1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE AND/OR MEDICAL AID; <br /> ❑ 12.NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AND/OR INDACTED AREAS; <br /> ❑13.ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION; <br /> ❑ 14.PROVIDE PROTECTIVE EQUIPMENT FOR ON-SITE EMERGENCY RESPONSE TEAM; <br /> ❑ 15.REMOVE CONTAINERS AND/OR ISOLATE AREAS; <br /> ❑16.HIRE LICENSED HAZARDOUS WASTE CONTRACTOR; <br /> ❑17.USE ABSORBENT MATERIAL FOR SPILL CONTAINMENT; <br /> ❑18.VACUUM SUCTION USING APPROPRIATE VACUUM(e.g.,Intrinsically safe)FOR SPILL CONTROL AND/OR CLEANUP; <br /> ❑19.DECONTAMINATE PERSONNEL AND EQUIPMENT WITHIN DESIGNATED AREA AND DISPOSE OF WASTEWATER AS HAZARDOUS WASTE; <br /> ❑20.PROVIDE SAFE TEMPORARY STORAGE OF HAZARDOUS WASTE GENERATED DURING EMERGENCY ACTIONS; <br /> ❑21.OTHER(Specify): D2. <br /> E. FACILITY EVACUATION <br /> THE FOLLOWING ALARM SIGNALS)WILL BE USED TO BEGIN EVACUATION OF THE FACILITY(Check all that apply): El. <br /> ❑1. BELLS; E2. <br /> ❑2. HORNS/SIRENS; <br /> ❑3. VERBAL(i.e.,Shouting); <br /> [14. OTHER(Specify): <br /> THE FOLLOWING LOCATION(S)WILL BE USED FOR AN EMERGENCY ASSEMBLY AREA(S)(e.g.,Parking lot,street comer): E3. <br /> Note:The Emergency Coordinator must account for all onsite employees and visitors after evacuation. <br /> EVACUATION ROUTE S AND ALTERNATE EVACUATION ROUTES ARE DESCRIBED AS FOLLOWS: E4. <br /> ❑ 1.WRITTEN PROCEDURES DESCRIBING ROUTES,EXITS,AND ASSEMBLY AREAS; <br /> ❑2.EVACUATION MAP(S)DEPICTING ROUTES,EXITS,AND ASSEMBLY AREAS; <br /> ❑3. OTHER(Specify): E5. <br /> Note:Evacuation procedures and/or maps should be posted in visible facility locations and must be included in the Contingency Plan. <br /> F. ARRANGEMENTS FOR EMERGENCY SERVICES <br /> ADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES(Check one of the following): Fl. <br /> ❑ 1. HAVE BEEN DETERMINED NOT NECESSARY; <br /> ❑2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE(Specify): Fz. <br /> Note:Advance arrangements with local fire and police departments,hospitals,state and local emergency response teams,and/or emergency services <br /> contractors should be made for your facility,if necessary. Large Quantity Generators must describe arrangements in the Contingency Plan. <br /> Rev.03/07/17 Page 2 of 4 <br />
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