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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514476
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COMPLIANCE INFO_PRE 2019
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Last modified
9/30/2020 1:16:49 PM
Creation date
9/29/2020 3:59:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
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
KBlackwell
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EHD - Public
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Consolidated Conti jency Plan <br /> Hazardous Materials Division for Hazardous Materials.Hazardous Waste:> und,,iT� <br /> FACILITY IDENTIFICATION /OPERATIONS OVERVIEW <br /> BUSINESS NAME FACILITY ID# DATE <br /> Jiffy Lube Store #2322 3/23/09 <br /> BUSINESS ADDRESS <br /> 500 E. Kettleman Ln. <br /> Check elements covered by this consolidated <br /> plan. Hazardous Materials ET Hazardous Waste ® Underground Storage Tanks ❑ <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 8r. ON-SITE TECH ADVISORS / INTERNAL RESPONSE <br /> Identify your Emergency Coordinator&On-site Technical <br /> Advisors: <br /> i <br /> Name Position: David Curran <br /> ......................................................................._........— — --._._......—_._..........-......------—--...--- - <br /> Emergency Coordinator: Address: 500 E. Kettleman Ln. <br /> I <br /> Must have the authority to classify the phone#s: Day:209-339-0900 ; After hours: 209-712-9618 <br /> release,make management decisions. & :—.--.......................-............................._........................ — --....................--._.............._.....__.._.._..-- -_.-.....-.......--._..._ <br /> determine appropriate response <br /> i Responsible for. spill prevention Z contacting facility responders <br /> emergency assessment I <br /> authorizing spill response work <br /> a <br /> (check all that apply) I <br /> mnagement.._. ® ❑._ <br /> Person is: ®on-site or Elon-calli <br /> interfacing with public emergency <br /> t initiating alarms ® i responders ❑ <br /> agency notification ❑ other: ❑ <br /> Alternate#1 Alternate#2 <br /> ...... ..... .... .....................-_............ <br /> Name Position: Doug Brown Glen GanOtIS <br /> .... ....... ..... ......._._.--.__ 4.._- ......... .. ...... ___._.___..._-__.___...._._._....- <br /> Address: 1471 Shore St. 1471 Shore St. <br /> ... ..... ...... ..............................---- <br /> AlternateEmergencyCoordinators: city: West Sacramento West Sacramento <br /> ...... ___ .................. <br /> List In order of responsibility zip: 9569195691 <br /> .............. .. ..............................................._....---............ ._.-.__.-.-. ....... <br /> Day phone: 916-375-1155 916-375-1155 <br /> ..... ...... ...... .......—_......._..- __.............- <br /> j After hors phone: 209-298-4827 209-298-5373 <br /> .........................._...................................................... .....................................- _ _ ...._.._........._.............._.........._. <br /> ...._. <br /> Person is: Elon-siteor ®on-call Elon-site or ®on-call <br /> On-Site Technical Advisors <br /> available to provide site-specific technical Owner Supervisor: <br /> ...... --- <br /> v respa ders) Manager: General Manager Other: <br /> Identify type of internal response: <br /> Team Members(name or position): Responsibilities: <br /> ❑ Internal facility <br /> response team 1 General Manager Spill Prevention, Control &Cleanup <br /> ..._...._. .......... _......_............. ------- -.... ...... .... ............................. ......... .......................... <br /> 2 Regional Manager <br /> (attach additionai pages�f needec __._. Emergency Assessment/Mg mt <br /> Options: _ __-----.. <br /> Assistant Manager <br /> indicate an attachment by ; Serve In place during GM absence <br /> ........ <br /> ....................... _.... ----._..._ .» .. ..... ........ <br /> checking this box�) _ <br /> 13. IissEcoordinator Guidance for spill response <br /> Name:Asbury Environmental Services Describe role/responsibilities <br /> i............._..._. . _..._._.._.....----— - <br /> & <br /> i address: 300 E.Oaks Street.Compton,CA.90221 <br /> Used Oil,Filters,s,Antlfreez e,Transporter <br /> ® Contractor <br /> __...... —- <br /> - <br /> . <br /> _. <br /> phone#:800-727-2879 <br /> Can Provide response for oil Spills. <br /> ® Call public emergency responders/911 <br /> .............................................................................................................................. <br /> Page CP 1: Facility Identification, Emergency coordinator & Tech Advisors, Internal response <br />
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