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CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM (CERS) <br />CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLAN <br />Prior to completing this Plan, please refer to the INSTRUCTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLAN <br />A. FACILITY IDENTIFICATION AND OPERATIONS OVERVIEW <br />FACILITY ID k 1j <br />1 F <br />I I i I I <br />l A I —101 O 1 �-1I2 917 9 I <br />Al.CERS IDDATE <br />OF PLAN PREPARATION/REVISION A2, <br />F j <br />10184349 <br />4/21/2013 <br />BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3. <br />Pilot Travel Centers, LLC <br />BUSINESS SITE ADDRESS Ina. <br />15100 Thornton Road <br />BUSINESS SITE CITY 104. <br />ZIP CODE 105 <br />Lodi <br />CA <br />95242 <br />TYPE OF BUSINESS (e.g., Painting Contractor) A3. <br />INCIDENTAL OPERATIONS (e.g., Fleet Maintenance) A4. <br />Motor Fueling Facility <br />THIS PLAN COVERS CHEMICAL SPILLS, FIRES, AND EARTHQUAKES INVOLVING: (Check all that apply) As. <br />® I. HAZARDOUS MATERIALS; N 2. HAZARDOUS WASTES <br />B. INTERNAL RESPONSE <br />INTERNAL FACILITY EMERGENCY RESPONSE WILL OCCUR VIA: (Check all that apply) BI. <br />® I. CALLING PUBLIC EMERGENCY RESPONDERS (i.e., 9-1-1) <br />® 2. CALLING HAZARDOUS WASTE CONTRACTOR <br />3, ACTIVATING IN-HOUSE EMERGENCY RESPONSE TEAM <br />C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONS <br />Whenever there is an imminent or actual emergency situation such as an explosion, fire, or release, the Emergency Coordinator (or his/her designee when the <br />Emergency Coordinator is on call) shall: <br />I. Activate internal facility alarms or communications systems, where applicable, to notify all facility personnel. <br />2. Notify appropriate local authorities (i.e., call 9-1-1). <br />3. Notify the California Emergency Management Agency at (800) 852-7550. <br />Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall notify the California Department of Toxic <br />Substances Control (DTSC), the local Unified Program Agency (UPA), and the local fire department's hazardous materials program that the facility is in compliance <br />with requirements to: <br />1. 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 facility affected by the incident until <br />cleanup procedures are completed. <br />INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR VIA: (Check all that apply) C1. <br />® 1. VERBAL WARNINGS; ❑ 2. PUBLIC ADDRESS OR INTERCOM SYSTEM; Z 3. TELEPHONE; <br />❑ 4. PAGERS; ❑ 5. ALARM SYSTEM; [16. PORTABLE RADIO <br />NOTIFICATIONS TO NEIGHBORING FACILITIES THAT MAY BE AFFECTED BY AN OFF-SITE RELEASE WILL OCCUR BY: (Check all that apply) C2. <br />® I. VERBAL WARNINGS; ❑ 2. PUBLIC ADDRESS OR INTERCOM SYSTEM; ❑ 3. TELEPHONE; <br />❑ 4. PAGERS; ❑ 5. ALARM SYSTEM; ❑ 6. PORTABLE RADIO <br />EMERGENCY RESPONSE AMBULANCE, FIRE, POLICE AND CHP .............................................. 9-1-1 <br />PHONE NUMBERS: CALIFORNIA EMERGENCY MANAGEMENT AGENCY (CAL/EMA) ...................... (800) 852-7550 <br />NATIONAL RESPONSE CENTER (NRC) ................................ ...... ..... (800) 424-8802 <br />POISON CONTROL CENTER .................... ... ................ .............. (800) 222-1222 <br />LOCAL UNIFIED PROGRAM AGENCY (UPA/CUPA)................................... (209) 468-3420 C3. <br />OTHER (Specify): Jimenez - Pilot General Manager` C' i (209) 499-6788 C5. <br />`Jose - _ _ <br />NEAREST MEDICAL FACILITY / HOSPITAL NAME: t L Memorial Hospital Ce. i (209) 339-7575 C' <br />AGENCY NOTIFICATION PHONE NUMBERS: CALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC) ..(916) 255-3545 <br />464-3291 ca <br />REGIONAL WATER QUALITY CONTROL BOARD . .. .... (. (916) <br />U.S. ENVIRONMENTAL PROTECTION AGENCY (US EPA) ........... (800) 300-2193 <br />CALIFORNIA DEPT OF FISH AND GAME (DFG) .................... (916) 358-2900 <br />U.S. COAST GUARD ............................................. (202) 267-2180 <br />CAUOSHA..................................................... (916) 263-2800 <br />STATE FIRE MARSHAL ......................................... (9 16) 445-8200 <br />C9, CIO. <br />OTHER (Specify): <br />Cn. C12. <br />OTHER(Specify): <br />Rev, 06/27/11 <br />