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Nov 10 10 11:46a p.12 <br /> c cQN Consolidated Contingency Plan <br /> Environmental Health Division CUPA For Hazardous Fla:erinls,Hazardous'Waste&Urdergr..nd Stolaq.Tanks <br /> FACILITY IDENTIFICATION BUSINESS NAME FACILITYNUMBER <br /> EMERGENCY COMMUNICATIONS/PHONE NUMBERS f NOTIFICATIONS <br /> 14 Internal&External Emergency Communications <br /> 15 Individual responsible for on-site and ottalle emergency <br /> alarm notifications f communications: Name!Pasitlon: <br /> rs check all that <br /> Y <br /> Int verbal warnings public addressorintercomsystem <br /> INTERNAmalarm Jur <br /> _- <br /> L facility emergency communications or alar ___.__._____.— <br /> notification will Occur via: Iqq telephone ❑ pagers <br /> Q dam system portable radkf <br /> 17 check all at apply: <br /> EXTERNAL notifications l Communications to neighboring verbal warnings public address or intercom system <br /> facilities that may be affected by an off-site release will - ------ ------------------- <br /> occur by. <br /> telephone -papers <br /> alarm system portable radle <br /> 's Emergency Phone Numbers/Notification Lists <br /> n Ambulance,Fire,Sheriff&CHP-use for all <br /> emergencies Z 911 <br /> Emergency response phone <br /> numbers ✓/1 �it "Ii �5�-/p ji99"09B'7'!91(8 am-Spm) <br /> Eb _ <br /> �rtleCoonly rimnmental Healm --.---ncynum..__- <br /> i 911(24 houremerga+cy number) <br /> Poison Contrd Center t-B00-342A293 <br /> 2a <br /> 0.earnst medical lar;ilitylifospiial Nam.: Phone Y: <br /> 2, <br /> Your medical facility i hos glial Name: Phone e: <br /> 22 1 CA Dept of Tcrdc Subatanoes Corbel 913324-1324 - <br /> CAOfficeofEmergeneySerwces t-800852.7550 <br /> CA Water Quality Cordrel Seard,Central Valley Region 918255-3000 <br /> OS Emkonmented Protection Agency(US EPA) --- 1415.744-1500 _---- _ <br /> Agency Notification Phone List National Response Center _�----._--_------.-_ 1-8004244802 _------ <br /> .CADeplo/Fish&Gane------------- - 9184450045 -_----- <br /> USCoastGuard(sPiIIresponse)---_----.--- 1-510437-3073 ------_— <br /> CaIOSNA 918203-2800 <br /> State Fire Marshall 918445-3200 <br /> sa Omer Important Numbers l <br /> 2; <br /> Neighbor Notification List <br /> 27 List all businesses/structures bordering&!or adjacent to your facil <br /> 28 atraclli4's at_t5cilit - <br /> 1 i Business name: yr' Boniness name: .- -_-- _�- <br /> northern ----- -- -' -`i southem I <br /> border: 1 A V4 <br /> address. 1 border: address: <br /> ,.-Phone#:a� -_ —_.----•---_� phone# - <br /> O <br /> contact name,!position__-- contact name I position: <br /> 29 atfacdt sBusiness name. 1 O atfacilil s <br /> /t.v f✓ Boniness name <br /> eastern ---- V - p western <br /> border. ' addr858; l 51 -- L1Y/ i `�/'border: address: �{q�(ij <br /> plxxre0.- <br /> phonerk. �l-IIIJJ- )wn: <br /> aocontact name I poaitlon: contact nameI p. <br /> .............................................................................................................................. <br /> Page: BP-2 <br />