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9 V <br /> FROM FAX NO. Feb. 05 2009 10:40AM P1 <br /> 0 4F <br /> EMERGENCY RESPONSE PLAN/CONTINGENCY PLAN <br /> L Facility Information: <br /> Facility Name: V 5 rcu V& Phone.2a q_8 2 4-dtL8 L <br /> Address: ®`t e 3Uytt t j L <br /> City: s Zip: °� 5 3 3 G <br /> II.Emergency Coordinators: <br /> Prim uz Coordinator mond Coordinator <br /> Name: �- j Apt,` Name: \CAZF-f1 Y--Ro j,* <br /> Title: Q z ,4 Title: <br /> Work Ph: 2.0� - Qiz-4- °l 2.a Work Ph:(f..o 9 ) <br /> After hours Ph: 9?.5 7 o S- 5 S 3 After hours Mat t5- 7 3 6- 8 4 a <br /> Pager: Pager: <br /> III.Emergency Telephone Numbers and Arrangements: <br /> The emergency coordinator shaft immediately notify the following whenever a release,fire,or <br /> explosion threatens human health or the environment, <br /> Agency Phone <br /> Fire Department 911 <br /> State Office of Emergency Services(UES) 1-800-852-7550 <br /> HospitaMedical.Center(if W uric) <br /> Waste Water Treatment Facility(if to sewer) <br /> Hazardous Waste Contractor(if clean up needed) <br /> Other agencies: <br /> IV. Arrangements: (Please check one box.) <br /> ! We have no formalized written agreements with any emergency respoon agency or contractor_ <br /> D We have formalized written agreements with <br /> Telephone: for emergency response. <br /> Page 1 of 3 CM-2-2.6 R BP ERP <br /> Rev.Date: 1 IW007 <br />