Laserfiche WebLink
Nov 10 10 11:27a p.7 <br /> Butte County Consolidated Contingency Plan <br /> Environmental Health Division(COPA) For Hazardous h1aterials,llazanlous Waste&Underground Storage Tanks <br /> ' Submit completed document to aefle Counbj En,ironmental � <br /> FACILITY IDENTIFICATION I OPERATIONS OVERVIEW <br /> au SSNA E FAC ITV ID d DATE <br /> Ci c' 3� 1� i o <br /> 2 BUSINESS DDR S 9 1 V ( S3 76 <br /> 3 Chockoomonts cmersd by thiseonsosdA.c!plan: <br /> Hazardous Materials❑ Hazardous Wastexi Underground Storage Tanks ❑ <br /> S Supplementalelemenlssubmitted: <br /> UST Written Monitoring Plan ❑ <br /> s TYPE OF INESS(e.g.pe Ing cont ctor) �� INCIDENTAL ERATION (e.g.fleet malntenatloe) <br /> 6 HAZARDS EVENTS COVERED BY PLAN(e.g.chemical spills,fire,earthquake,etc) <br /> EMERGENCY COORDINATOR &ON-SITE TECH ADVISORS 1 INTERNAL RESPONSE <br /> y Idently your Emergency.CoordinatorB OIaslte Technical - ._ rs: <br /> a !,�NamelPoaWon: Ys _ <br /> 'mss nfi I <br /> Emergency Coordinator: dress' i <br /> Must have the authority to classify the I Phone#s0 Day: Aflarhours: <br /> - - 9. 8.5 ------- 5 <br /> release,make management decisions, S, I Responsible for: spill prevention contacting facility responders _ — <br /> determineappropriateresponse I emergency assessment! authorizing spill response work <br /> I <br /> (checkalllhalapply) management I <br /> Person is: n-ails or ❑oncall <br /> j ❑ interlacing with public emergency <br /> ❑initiating alarms responders <br /> agency r»lgteation I ❑other. <br /> I Altema #1 ,------- Alte. .te�f2 <br /> -- -- -- M — <br /> Name!Position: � _ <br /> Andress: _ .._S.e. .._ ._...._._..._ .._ •Y_-V_ r ..r-= _ <br /> ff <br /> Alternate Emergency Coordinators: D'H' <br /> Li s t l n o rder of responsibility. Zip: �/ /J,-y - •�/y _ <br /> Day phone: V'/ �JC>/—I✓ - `�- -�O�_.... -_ <br /> Anerhoursphone• T <br /> moo/ <br /> Pers is: ', �on site or ❑o Is �onsi[e or ❑on-call — <br /> On-Site Technical Advisors <br /> (Availabin to provide alta-wmcif lechnlpal Owner {�/ i $apeRri80G l/✓.may/,'./p/�t/ <br /> —.—.—._ —._ - _-_ _-._.....___1_r._--_ ,_-_ <br /> adviceteolb:itee.merge.ncyrespondemI, i Manager: Dow: V <br /> Identify type of Internal response: <br /> Team Members(name.,position): Raeponsibililras: <br /> ❑ Internal facility <br /> response team <br /> Option (at <br /> tach adc!Wmol pages if Headed: 2 <br /> ' Indbsle cn adachment by cMckin9 a. <br /> tMs box❑I _ _______ ._._.____ —__—__._ --___ ._........._..._- <br /> (check 4. <br /> is olxnbr i Name: I Describe role l responsibilities: <br /> more] .. ._.—.--------_._.'--------f <br /> ❑ Contractor <br /> pFtone#: ! <br /> .............................................................................................................................. <br /> Pano: BP-1 <br />