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II IN 7 1 91ifi <br />CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM (CERS) <br />916 255-3545 <br />CONSOLIDATED EMERGENCY RESPONSE / CONTINGEl` M AL HEALTH <br />Prior to complelftfirle Plan, please refer to the INSTRUCTIONS FOR CONIPLEYMG A CONSOMDATEDCONTTNG T EfttACES <br />U.S. ENviRoNMINfAL PROTECTION AGENCY (us EPA)........... <br />A. FACILITY IDENTIFICATION AND OPERATIONS OVERVIEW <br />CALIFORNIA DEPT. OF FISH AND WILDLIFE(CDFW).............. <br />FACILITY IDH <br />IOA`' <br />— O <br />ll'1� <br />— <br />r'' <br />(916)323-7390 <br />a.I <br />OTHER (Specly$ . ..._...._..___.__...-_ . <br />ca <br />OTHER (Speridy)t I Cs. <br />I CIO. <br />t• <br />CERS 1D H A>, <br />DATE OF PLAN PRHP ONlREVISION <br />�[ <br />N. <br />U O <br />ISr <br />d put <br />(MMIDDIYYYY) - D / <br />BUSINESS NAME (Sarre as Fae7hry Name or DBA-DoArgBrvlaess Ael <br />M. <br />AL <br />BUSINESS SITE ADDR17SS <br />Aa: <br />Z35 <br />BUSINESS SITE CITY At, <br />ZIP CODE <br />A7. <br />t o CA <br />S2o� <br />TYPE OF BUSINESS (e.g., Painting Contractor) Aa. <br />INCII3ENTAL OPERATIONS (ag, Fleet Meintenenee) <br />As. <br />GA <br />THIS PLAN COVERS CHEMI AL SP ,FIRES, AND EAR QUAKES INVOLVING (Check all that apply): <br />AM <br />1. HAZARDOUS MATERIALS; 2. HAZARDOUS WASTES <br />B. INTERNAL RESPONSE <br />AL FACILITY EMERGENCY RESPONSE WILL OCCUR BY (Check all that apply): <br />ai. <br />. CALLING PUBLIC EMERGENCY RESPONDERS (e.g., 94-1) <br />2. CALLING HAZARDOUS WASTE CONTRACTOR <br />❑ 3. ACTIVATMG IN-HOUSE EMERGENCY RESPONSE TEAM <br />C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONS I <br />In the event of an emergency Involving hazardous materials and/or hazardous waste, all facilities must IMMEDIATELY: <br />I. Notify facility personnel and evacuate if necessary in accordance with the Emergency Action Plan (Tide 8 California Code of Regulations §3220); <br />2. Notify local emergency responders by calling 9-1.1; <br />3. Notify the local Unified Program Agency (UPA) at the phone number below, and <br />4. Notify the State Warning Center at (800) 852-7550. <br />Facilities that gencrak, treat, store or dispose of hazardous wage hava additional responsibilities to notify, and coordinate with other response agencies. Whenever there <br />is an inuninent or actual emergency situation such as an explosion, fire, or release, the Emergency Coordinator must fallow the appropriate requirements for the category <br />of facility and type of release involved: <br />1. Title 22 California Code of Regulations §6626556. Emergency Procedures for generators of 1,000 kilograms or mora of hazardous waste in any calendar mondr. <br />2. Title 22 California Cade ofRegulations §66265.196. Response to Leaks or Spills and Disposition of Leaking or Unfit -for -Use Tank Systems. <br />3. Title 40 Code of Federal Regulations §302.6. Notification requirements for a release of a hazardous substance equal to or greater than the reportable quantity. <br />4. Tile 22 California Code of Regulations §66262.34(d)(2) and Title 40 Code of Federal Regulations §262.34(dX5xu) for generators of less than 1000 kilograms of <br />hazardous waste in any calendar month. <br />Following notification and before facility operations are resumed to areas of the facility affected by de incident, the Emergency Coordinator shall notify the local UPA <br />and the local fire department's hazardous materials program, if necessary, that the facility is in compliance with requirements to: <br />I. Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release at <br />the facility; and <br />2. Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the foeility affected by the incident until cleanup <br />procedures are completed. <br />EMERGENCY RESPONSE AMBULANCE, FIRE POLICE AND CHP .............................................. 9-1-1 <br />PHONE NUMBERS: CALIFORNIA STATE WARNING CENTER (CSWC)ICAL GES ............................ (800) 852-7550 <br />NATIONAL RESPONSE CENTER (NRC) .............................................. (800) 424-8802 <br />POISON CONTROL CENTER........................................................ (800)222-1222 <br />LOCAL UNIFIED PROGRAM AGENCY A .................................. ...... 14t7h 126 -.5 i1 9 <br />OTHER (Specify): <br />ct <br />NEAREST MEDICAL FACILITY I HOSPITAL NAMEd`i CI' 3 2Uoa <br />AGENCY NOTIFICATION PHONE NUMBERS: CALIFORNIA DEPT, OF TOXIC SUBSTANCES CONTROL (DTSC) .... <br />916 255-3545 <br />REGIONAL WATER QUALITY CONTROL BOARD (RWQCB)........)r <br />ca. <br />U.S. ENviRoNMINfAL PROTECTION AGENCY (us EPA)........... <br />(800) 300-2193 <br />CALIFORNIA DEPT. OF FISH AND WILDLIFE(CDFW).............. <br />(916)358-2900 <br />U.S. COAST GUARD (USCG) ..................................... <br />(202) 267-2180 <br />CALOSHA..................................................... <br />(916)263-2800 <br />CAL FIRE OFFICE OF THE .STATE .FIRE ,DWt$IiAI. {osFt�,....... .. <br />.... <br />(916)323-7390 <br />a.I <br />OTHER (Specly$ . ..._...._..___.__...-_ . <br />ca <br />OTHER (Speridy)t I Cs. <br />I CIO. <br />Rev. 03107/17 Page Lof 4 <br />