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COMPLIANCE INFO_2020
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514476
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COMPLIANCE INFO_2020
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Last modified
12/6/2021 11:45:51 AM
Creation date
5/19/2020 1:14:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0514476
PE
2229
FACILITY_ID
FA0010973
FACILITY_NAME
JIFFY LUBE #2322
STREET_NUMBER
500
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06208002
CURRENT_STATUS
01
SITE_LOCATION
500 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
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EHD - Public
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Consolidated Contingency Plan <br /> Hazardous Materials Division for Hazardous Materials,Hazardous Waste&Underground Storage Tank; <br /> `ACILITY IDENTIFICATION/OPERATIONS OVERVIEW <br /> I BUSINESS NAME FACILITY ID# DATE <br /> Jiffy Lube Store #2322 10183993 2113/2020 <br /> 2 BUSINESS ADDRESS <br /> 500 E. Kettleman Ln. _ <br /> Check elements covered by this consolidnleJ <br /> plan: Hazardous Materials El Hazardous—Waste 0 Underground Storage Tanks E] <br /> Supplemental elements submitted: UST Written Monitoring Plan ❑ <br /> TYPE OF BUSINESS(e.g.painting contractor) INCIDENTAL OPERATIONS (e.g.fleet maintenance) <br /> Automotive Quick Lube Facility <br /> HAZARDS/EVENTS COVERED BY PLAN(e.g.chemical spills,fire,earthquake,etc) <br /> Chemical Spills, Fire, Flood, Earthquake <br /> EMERGENCY COORDINATOR &ON-SITE TECH ADVISORS/INTERNAL RESPONSE <br /> 7 Identify your Emergency Coordinator&On-site Technical Advisors: <br /> s <br /> Name/Position: Store Manager: Brandon Bitz (MIT) <br /> Emergency Coordinator: Address: 500 E. Kettleman Ln. <br /> Must have the authority to classify the <br /> Phone#s: € Day:209-339-0900 ' After hours: <br /> release,make management decisions, & i <br /> determine appropriate response i Responsible for: spill prevention ® p contacting facility responders <br /> emergency assessment/ s <br /> (check all thatapply) managE!ment ® authorizing spill response work ❑ <br /> Person is: ® on-site or ❑ on-call <br /> interfacing with public emergency <br /> initiating alarms ® i responders ❑ <br /> agency notification ❑ i other: ❑ <br /> Alternate#1 Alternate#2 <br /> Name/Position: Glen Ganotis Joe Kaspari <br /> Address: 14711 Shore St. 1471 Shore St. <br /> Alternate Emergency coordinators: city: West Sacramento West Sacramento <br /> List In order of responsibility. Zip: 95691 1 95691 <br /> Day Phone: 916-375-1155 i 916-375-1155 <br /> After hours phone: 209-298-5373 916-267-4022 Ic <br /> Person is: ❑on-site or ®on-call El on-site or [I on-call <br /> 10 Onsite Technical Advisors <br /> Owner: Supervisor. <br /> (Available to provide site-specific ! <br /> technical advice to off-site emergency <br /> responders) Manager: General Manager Other. <br /> 19 Identify type of internal response: <br /> 12 Team Members(name or position): Responsibilities: <br /> ❑ internal facility 1. General Manager ' Spill Prevention, Control &Cleanup <br /> response team <br /> Options I <br /> (attach additional pages if needed: <br /> 2 Regional Manager Emergency AssessmentlMgmt <br /> indicate an attachment by Assistant Manager Serve in place during GM absence <br /> checking this box 0) 3. HSSE Coordinator Guidance for spill response <br /> (check <br /> I3 one or i <br /> Name:Asbury Environmental Services Describe`ole/responsibilities <br /> Used Oil,Filters,Antifreeze,Transporter& <br /> more) address: 300 E.Oaks Street.Compton,CA.90221 <br /> Contractor 1 Recycler. <br /> I phone#:800'727"2879 Can Provide response for oil Spills. <br /> ® Call public emergency responders 1911 <br /> ....................... <br /> Page CP 1.•Facility Identification, Emergency coordinator&Tech Advisors, Internal response <br />
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