HomeMy WebLinkAboutSLOUNIFLOW_FS1 Admin iRC3926i Color_2543_001I Environmental Health Services
j(805) 781-5544
:P.o.Box 1489
;2156 Siena Wav Ste. B
lsan Luis Obispo. CA 93406
:
,-lr
crty o[ san Luls oBlspo
FIRE DEPARllIEil'
2160 Sdta BarbaE Av{us'Sn Lu15 Obl6po'CA 93401-5240'{005) 781-7380
"Ctturtesy & SerYice"
Dale'. 0810212024
GERTTFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
COUNTY.6 SAN LUIS
OBISPO
lnsoection Tvpe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment TestinlFacility lD: FA0005138 CERS lD: 1 0437427
Facility Name: CENTURYLINK - SLO - SNLOCAMO
Phone: (720)888-1000
Serial Number: DACC4RZBA
Aqencv
trEHS
trcrw FIRE
Site Address'.775 Capitolio WaY
San Luis Obispo, CA 93401
trCa|ARP DTPEtrAGTtrHW Generator trUSTBHazmatPROGRAMS INSPEGTED:
trTPEtrAGTilCalARPtrUSTtrHazmattrHW GeneratorREINSPECTION REQUIRED:
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes
YES
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n
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NO
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N/A VIOL. #
tr BP01
BPO2
BPO3
TROl
TRO2
EROl
ERO3
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tr
tr
tr
tr
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BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505'
25508(aX1); 19 CCR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(a)(1)' 25506,
25508(axl), 19 CCR 2652,26s41
Site tayouU facility maps are accurate and submitted electronically (HSC 25505(a)(2)' 25508(aX1)' 19 CCR
26s21
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 25508(aXl)' 19CCR
2659, 22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(a)(4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSC 25s05(aX3), 25508(aXl), 1gCCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270'4-5;40 CFR
112.8(cX2)I
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local OrdinanceltrtrtrFE01
GPS Coordinates: Latitude: 35.256761 0000 G PS Coord i n ates : Lo n gtitude : -1 20 .6452030000
INSPECTOR: MATHESON BLISS FACILITY REP: Mark Bucis
FACTLTTY NAME: CENTU Itrur - slo - sNLocAMo ADDI'- -)s:
ABOVEGROUND STORAGE TANK (AST)
775 Capitolio Way
San Luis Obispo, CA 93401
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YES NO N/A VIOL. #
trtrtrArol
trntrAT20
Ar21
ATO2
ATO3
Ar22
ATO6
ATOT
ATOS
ATO9
ATlO
AT11
AT12
AT13
AT'14
AT15
AT16
AT1 8
A Prevention control and countermeasure (spcc) plan has been prepared and implemented at
facility (Note: An SPCG Plan is required for single tanks t,320 gallons or greater or
tanks/containers with a cumulative capacity of greater than 1,320 gallons of oil products; for farms,
nurseries, construction sites: single tanks greater than 20,000 gallons or tanks with a cumulative
capacity of greater than 100,000 gallons. (HSC 25270.4.5/REF. 40 CFR '112.1,112.3(dl' 112'61
SPCC plan has been reviewed and/or evaluated within the last 5 years and completion of the
review has been documented (HSG 25270.4'5(allREF' 40 CFR 112.5(b))
SPCC plan has been amended for changes (HSC 25270'4'5(a)/REF. 40 CFR 112.5(a))
The Spill Prevention Control and Countermeasure Plan is maintained on site or at the nearest field
office. (HSC 25270.4.51REF. 40 CFR 112.3(e )(1))
Secondary containment for the entire contents of the largest single tank, plus sufficient freeboard
to allow for precipitation, has been installed and is sufficiently impervious to contain discharges.
(HSc 25270.4.5/REF. 40 CFR 112.7(c ), 112.8(c)(2))
Secondary containment drainage restrained by valves/positive means and normally kept closed
( HSc 25270.4.5/RE F. 40 c FR 112.8(bl(21, 1 1 2.8(cX3))
Drainage of any uncontaminated rainwater from secondary containment is documented and
recorded. (HSC 25270.4.5; 40 CFR 112.8(cX3Xiv))
Liquid level sensing device is present and tested regularly. (HSC 25270.4.5/REF.40 CFR 112.8(cX8Xv))
The master flow valve that will prevent direct outward flow of the tank's content to the
environment is securely locked in the closed position when in non-operating or non-standby
status. (HSC 25270.4.5/REF.40 CFR 112.7(g))
The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are
inspected and tested regularly, documented, and records are maintained for three years' (HSC
2527 0.4.'|REF.40 CFR 1 1 2.8(dX4))
Each aboveground tank is tested for integrity (if applicable) on a regular schedule and whenever
material repairs are made. (HSC 25270.4.5/REF.40 CFR 112.8(cX6))
Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to
prevent vehicular departure before complete disconnect of flexible or fixed transfer lines' (HSC
2527 0.4.5 |REF.40 C F R 1 1 2.7 (hl(21, 1 1 2. 8(d X5 ) )
Guard posts or other approved means are being provided to protect storage tanks and connected
piping, valves, fittings, and dispensers from vehicular damage.
(HSC 25270.4.5/REF.40 GFR 112.7(a)(11,'t12.7ttl; CA FIRE CODE 5704.2.9'7.4)
Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are
being conducted and documented regularly, and maintained for three years. (HSC 25270'4.51REF.40
cFR 112.7( e), 112.8(d)(4))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC
2527 0.4.iIREF.40 cFR 1 r 2.8(cXl 0))
Facility lighting is commensurate with the type and location of the facility, giving consideration to
the discovery of spills occurring during hours of darkness both by operating personnel and
non-operating personnel (i.e. general public, local police/fire)
(HSC 25270.4.5/REF.40 cFR 112.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 CFR 112.7(g))
Spill prevention briefings for operating personnel covering the SPCC Plan are conducted and
documented annually to assure adequate understanding of the SPCC Plan. (HSC 25270.4.5/REF.40
cFR 112.7(f))
Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 CFR 112.7(c))
tr
E
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AT17 Facility has documented spill history and corrective actions taken. (HSC 25270.4.51REF.40 CFR 112.7)
AT19
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\
SUMM,^,{Y OF OBSERVATIONSVIOL }IOITIS
No violations of underground storage tank, hazardous materials, or hazardous waste laws/regulations were discovered.
SLO CUpA greagy appreciates your efforts to comply with all the laws and regulations applicable to your facility'
Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please inform th
CUPA in writinct
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA MUSt bE iNfOTMEd iN WTitiNg With A
certification that compliance has been achieved. A false statement that compliance has been achieved is a violation of
the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be
reinspected any time during normal business hours.
you may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective
actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or
criminal action.
FACILITY NAME: CENTURYLINK - SLO - SNLOCAMO ADDRESS: 775 Capitolio WaY
San Luis ObisPo, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Facility in well-maintained condition. Thank you
INSPECTED BY: MATHESON BLISS
DATE: 08t]2t2024
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of perjury that this facility has compl ied with the corrective actions listed on
is inspection form.
Sig nature of Owner/Operator:-Title:- Date
COUNTY.6SAN LUIS
OBISPO
(805) 781-5544
f,a
)
Environmental Health :,-. rices ctty o[ san Luls oBlspo
FIRE OEPARIMENT
2160 3aila garbaB Avsuo' gao Lub Oblspo, CA 9340t'5240 ' {S05} 781-7380
"Courtesy & Service"
GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:Date: 1113012022
Facility Name: CENTURYLINK - SLO - SNLOCAMO Agency
trEHS
trctw FIRE
lnsoection Type
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Testing
Site Address: 775 Capitolio Way
San Luis Obispo, CA 93401
Phone: (720)888-1000
Facility lD: FA0005138 CERS lD:10437427
Serial Number: DARSCVQXE
PROGRAMS INSPEGTED:trHazmat trHWGenerator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHWGenerator trUST trAGT trCa|ARP trTPE
pERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES NOtrtr
trtr
trtr
trtr
trtr
trtr
trtr
BUSINESS PLAN
Business plan complete, current, available during inspection and submifted electronically (HSC 25505, 25508(a)
(1); 19 CcR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506, 25508(aX1)'
19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2)' 25508(aXl), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4)' 25508(aXl), 19CCR 2659'
22CCR6626s.r6)
Training documentation is maintained on site for current personnel (HSC 25505(aX4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submifted electronically, maintained onsite (HSC
25505(aX3), 25508(aXl), 1gCCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4'5;40 CFR 112.8(c)
(2)l
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.256761 0000 GPS Goord inates : Longtitude i -1 20.6452030000
N/A V|OL. #
tr BP01
tr BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
trtrtrFE01
INSPECTOR: MATHESON BLISS FAGILITY REP: Mark Bucis
FACILITY NAME: CENTUF^(IINK - SLO - SNLOCAMO ADDEIqFS:
ABOVEGROUND STORAGE TANK (Au'r)
775 Capitolio Way
San Luis Obispo, CA 93401
YES NO N/A VIOL. #
trtrtr4T01
trtrtrAr2o
AT21
ATO2
ATO3
AT22
ATO6
ATOT
ATO8
tr
tr
tr
tr
tr
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EI
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E
E
tr
E
E
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tr
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A Prevention control and countermeasure (spcc) plan has been prepared and implemented at facility (Note:
An SPCC Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a cumulat
capacity of greater than 1,320 gallons of oil products; for farms, nurseries, construction sites: single
greater than 20,000 gallons or tanks with a cumulative capacity of greater than 100,000 gallons. (HSG
25270.4.51REF. 40 CFR 112.1,112.3(d), 112.6)
SPGC plan has been reviewed and/or evaluated within the last 5 years and completion of the review has
been documented (HSC 2527O.4.5[aYREF. 40 CFR rr2'5(b))
SPGC plan has been amended for changes (HSC 25270.4.5(a)/REF. 40 CFR 112-5(all
TheSpillPrevention Gontroland Gountermeasure Plan is maintained on site oratthe nearestfieldoffice.
(HSc 25270.4.5/REF. 40 cFR 112.3(e Xl))
Secondarycontainmentforthe entirecontents of the largestsingletank, plus sufficientfreeboardtoallow
for precipitation, has been installed and is sufficiently impervious to contain discharges. (HSG
25270.4.51REF. 40 CFR 112.7(c ), 112.8(cX2))
Secondary containment drainage restrained by valves/positive means and nomally kept closed (HSC
2527 0.4.5|REF. 40 C F R 11 2.8(bl(21, I r 2.8(c)(3) )
Drainage of any uncontaminated rainwater from secondary containment is documented and recorded'
(HSC 25270.4.5; 40 CFR 112.8(cX3Xiv))
Liquid level sensing device is present and tested regularly. (HSC 25270.4.5/REF.40 CFR 112.8(cX8Xv))
The master flow valve that will prevent direct outward flow of the tank's content to the environment is
securely locked in the closed position when in non€perating or non-standby status. (HSC
2527 0.4.5 |REF.40 c F R 112.7 (gll
The masterflowvalve (i.e. gate valve, solenoid valve, etc.)and EmergencyShut-off switch are inspected
andtested regularly,documented,and recordsaremaintainedforthreeyears.(HSC 25270.4.51REF.40CFR
1r2.8(dX4))
Each aboveground tank is tested forintegrity(if applicable) on a regularschedule and whenever material
repairs are made. (HSC 25270.4.5/REF.40 CFR r12'8(c)(6))
Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to prevent
vehiculardeparture before complete disconnectof flexible orfixed transferlines. (HSC 25270.4.5/REF'40
cFR 11 2.7(h)(2), {r2.8(dX5))
Guard posts orotherapproved means arebeing provided toprotectstoragetanksand connected piping'
valves, fittings, and dispensers from vehicular damage.
(HSC 25270.4.5/REF.40 GFR 112.7(a)(11,112.7(tl; CA FIRE CODE 5704'2'9.7.4)
Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are being
conductedanddocumentedregularly,andmaintainedforthreeyears.(HSC25270.4.5/REF.40CFR112.7(el,
112.8(dX4))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSG
2527 0.4.5|REF.40 CFR r 1 2.8(cXr 0))
Facility lighting is commensurate with the type and location of the facility, giving consideration to the
discovery of spills occurring during hours of darkness both by operating personnel and non-operating
personnel (i.e. general public, local police/fire)
(HSC 25270.4.5/REF.40 GFR rr 2.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 CFR 1f 2.7(g))
Facility has documented spill history and corrective actions taken. (HSC 25270.4.51REF.40 GFR {12.7)
Spillprevention briefingsforoperating personnelcoveringtheSPGC Planareconductedanddocumented
annually to assure adequate understanding of the SPCC Plan. (HSC 25270.4.5/REF.40 CFR 112.7(f))
Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 GFR 112.7(c))
tr
rl
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ATO9
ATIO
AT11
AT12
AT13
AT14
AT15
AT16
A 17
AT18
AT19
SUMM -RY OF OBSERVATIONSVIOI \TIONS
tr No violations of underground storage tank, hazardous materials, or hazardous t*aste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
please inform the CUPA in writing
ALL VTOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA must be informed in writing with
a certification that compliance has been achieved. A false statement that compliance has been achieved is a violation
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the GUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: CENTURYLINK - SLO - SNLOCAMO ADDRESS: 775 Capitolio Way
San Luis Obispo, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
INSPECTED BY: MATHESON BLISS
DATE: 1'113012022
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
n: I certify under penalty of periury that this facility has complied with the corrective actions listed on
is inspection form.
ignature of Owner/Operato Title Date:
, l')
.Environmental Healt .-rvices
l(805) 781-5544
jP.O.Box 1489
12156 Siena Way Ste. B
lSan Luis Obisoo. CA 93406
ctty o[ $an Lurs oBrspo
FIRE OEPARTMENT
2160 Santa Ba.ban Avilu6' San Luh Oblspo, CA 93401-5248 " {805) 741-?380
"Courtesy & Service"
Date: 1111612021
CERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
COUNTY
bSANLUIS
OBISPO
Facility Name: CENTURYLINK - SLO - SNLOCAMO Aoencv
trEHS
trCITY FIRE
lnsoection Tvoe
trRoutine
[JReinspection
uChargeable Reinspection
uchange of Ownership
uComplaint
[lSecondary Containment Testing
ElChargeable Secondary Containment Testinl
Site Address: 775 Capitolio Way
San Luis Obispo, CA 93401
Phone: (720)888-1000
Facility lD: FA0005138
Serial Number: DAAFOTTLO
PROGRAMS INSPECTED:ElHazmat trHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHWGenerator trUST trAGT trCa|ARP trTPE
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
u
N9
tr
tr
tr
tr
tr
tr
tr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505,
25508(aX1); 19 CCR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl ), 25506,
25508(axl), 19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aX1), 19 CCR
26521
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4), 25508(aXl), 19CCR
2659, 22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(aX4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSG 25505(a)(3), 25508(aX1), 19CCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR
112.8(cX2)l
GENERAL EH VIOLATIONS
tl tl FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.256761 0000 G PS Coord i n ates : Lonqtitude : -120.6452030000
N/A VIOL. #
tr BPO1
BPO2
BPO3
TROl
TRO2
EROl
ERO3
INSPECTOR: MATHESON BLISS FACILITY REP: Mark Bucis
FACILITY NAME: CEN TU-trXLINK -
)
A'rrOVEG
SLO. SNLOCAMO ADDFT€S:
ROUND STORAGE TANK (Au f)
775 Capitolio Way
San Luis Obispo, CA 93401
YES
tr
NO N/A VIOL. #
tr tr ATol
trtrtrAT20
AT21
ATO2
ATO3
AT22
ATO6
ATOT
ATOS
ATO9
ATlO
AT18
tr
tr
tr
tr
u
tr
B
tr
tr
u
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E
tr
tr
tr
tr
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B
tr
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tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
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A Prevention control and countermeasure (spcc) plan has been prepared and implemented at
facility (Note: An SPCC Plan is required for single tanks 1,320 gallons or greater or
tanks/containers with a cumulative capacity of greater than 1,320 gallons of oil products; for farms,
nurseries, construction sites: single tanks greater than 20,000 gallons or tanks with a cumulative
capacity of greater than 100,000 gallons. (HSC 25270.4.5/REF. 40 CFR 112.1,112.3(d), 112.6)
SPCC plan has been reviewed and/or evaluated within the last 5 years and completion of the
review has been documented (HSC 25270.4.5(a)/REF. 40 CFR 112.5(b))
SPCC plan has been amended for changes (HSC 25270.4.5(a)/REF. 40 CFR 112.5(all
The Spill Prevention Control and Gountermeasure Plan is maintained on site or at the nearest field
office. (HSC 25270.4.5|REF. 40 CFR 112.3(e Xl))
Secondary containment for the entire contents of the largest single tank, plus sufficient freeboard
to allow for precipitation, has been installed and is sufficiently impervious to contain discharges.
(HSC 25270.4.5/REF. 40 cFR 112.7(c ), 112.8(cX2))
Secondary containment drainage restrained by valves/positive means and normally kept closed
(HSc 25270.4.5/REF. 40 CFR {12.8(bX2), rr2.8(c)(3))
Drainage of any uncontaminated rainwater from secondary containment is documented and
recorded. (HSC 25270.4.5; 40 CFR r12.8(cX3Xiv))
Liquid level sensing device is present and tested regularly. (HSC 25270.4.5/REF.40 CFR 112.8(c)(8)(v))
The master flow valve that will prevent direct outward flow of the tank's content to the
environment is securely locked in the closed position when in non-operating or non-standby
status. (HSC 25270.4.5/REF.40 CFR 112.7(g))
The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are
inspected and tested regularly documented, and records are maintained for three years. (HSC
2527 0.4.5|REF.40 CFR I I 2.8(d X4))
Each aboveground tank is tested for integrity (if applicable) on a regular schedule and whenever
material repairs are made. (HSC 25270.4.5/REF.40 CFR f 12.8(c)(6))
Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to
prevent vehicular departure before complete disconnect of flexible or fixed transfer lines. (HSG
25270.4.5,IREF.40 CFR 112.7 (hl(21, I I 2.8(dX5))
Guard posts or other approved means are being provided to protect storage tanks and connected
piping, valves, fittings, and dispensers from vehicular damage.
( HSc 25270.4.5/REF.40 C FR 1 1 2.7(a) (11, 112.7 $l; CA FIRE C.ODE 57 04.2.9.7.41
Spill prevention briefings for operating personnel covering the SPCC Plan are conducted and
documented annually to assure adequate understanding of the SPGC Plan. (HSC 25270.4.5/REF.40
cFR 112.7(f))
Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 CFR 112.7(c))
tr
tr
tr
ATlI
AT12
AT13 Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are
being conducted and documented regularly, and maintained for three years. (HSG 25270.4.51R8F.40
cFR 112.7( e), 1r2.8(dX4))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSG
2527 0.4.51REF.40 cFR 1r 2.8(c)(1 0))
Facility lighting is commensurate with the type and location of the facility, giving consideration to
the discovery of spills occurring during hours of darkness both by operating personnel and
non-operating personnel (i.e. general public, local police/fire)
(HSc 25270.4.5/REF.40 CFR r I 2.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 CFR 112.7(g))
AT14
AT15
AT16
AT17 Facility has documented spill history and corrective actions taken. (HSG 25270.4.51REF.40 CFR 112.7)
tr
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tr AT19
tr
suMM-RY OF OBSERVAT|ONSVIOI,-T|ONS
No violations of underground &torage tank, hazardous materials, or hazardous r{aste laws/regulations were discovered.
SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please inform th
CUPA in writinc
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA must be informed in writing with a
certification that compliance has been achieved. A false statement that compliance has been achieved is a violation of
the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be
reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective
actions. The issuance of this Summary of Violations does not preclude the GUPA from taking administrative, civil, or
criminal action.
FACILITY NAME: CENTURYLINK - SLO - SNLOCAMO ADDRESS: 775 Capitolio Way
San Luis Obispo, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
INSPECTED BY: MATHESON BLISS
DATE: 1111612021
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of periury that this facility has complied with the corrective actions listed on
this inspection form.
Signature of Title:- Date
COUNTY
bSAN LUIS
OBISPO
^\
crty o[ san lurs onrspo
FIRE DEPARlIilE}IT
2160 Sill. Barban Avmuo'se Lub obbpo,CA 93t0t-5210'(805) 78t-738{,
"Courtesy & Service"
Date: 10/30/2019
CERTTFTED UNIFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: CENTURYLINK - SLO - SNLOCAMO Aoencv
trEHS
trCITY FIRE
lnsoection Tvoe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
[lSecondary Containment Testing
trChargeable Secondary Containment
Testing
Site Address:775 Capitolio Way
San Luis Obispo, CA 93401
Phone: (720)888-1000
Facility lD: FA0005138
Serial Number: DACWIG3NU
PROGRAMS INSPECTED:BHazmat EHW Generator trUST trAGT UCaIARP trTPE
REINSPECTION REQUIRED:trHazmat trHWGenerator trUST trAGT trCalARP trTPE
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Mark Bucis Title: Field Technician
YES NOEtr
trtr
Etr
trtr
trtr
trtr
trtr
BUSINESS PLAN
Business plan complete, current, available during inspection and submifted electronically (HSC 25505, 25508(a)
(1); 19 ccR 2651)
tnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506, 25508(a)(1),
19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aXl), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4), 25508(aX1), 19CCR 2659,
22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(aX4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite (HSC
25505(a)(3), 25508(aX1), l9CCR 2658, 2zCCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR 112.8(c)
(2)l
GENERAL EH VIOLATIONS
tr tr tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.256761 0000 GPS Coord i nates : Lon gtitude : -120.6452030000
N/A VIOL. #
tr BP01
tr BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
INSPECTOR: KERRY BOYLE FACILITY REP: Mark Bucis
FACILITY NAME:
YES NSI N/A V|OL. #
tr tr tr Ar0,l
trtrtrAr20
AT21
ATO2
ATO3
AT22
ATO6
ATOT
ATOS
ATO9
ATlO
AT11
AT12
AT13
AT14
AT15
AT16
CENTLTI*1L|NK - SLO - SNLOCAMO ADD,'P-\S:
A3OVEGROUND STORAGE TANK (AsT)
775 Capitolio Way
San Luis Obispo, 94 93401
tr
tr
tr
tr
E
tr
E
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
A Prevention control and countermeasure (spcc) plan has been prepared and implemented at facility (Note:
An SPCC Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a cumulat
capacity of greater than 1,320 gallons of oil products; for farms, nurseries, construction sites: single
greater than 20,000 gallons or tanks with a cumulative capacity of greater than 100,000 gallons. (HSC
2527 0.4.5IREF. 40 CFR 112.1, 112.3(d), 1 1 2.6)
SPCG plan has been reviewed and/or evaluated within the last 5 years and completion of the review has
been documented (HSC 25270.4.5(allREF. 40 CFR 112.5(b))
SPCC plan has been amended for changes (HSC 25270.4.5(a)/REF. 40 CFR 1f 2.5(a))
The SpillPrevention Controland Countermeasure Plan is maintained on site oratthe nearestfieldoffice.
(HSC 25270.4.5/REF. 40 CFR 112.3(e Xl))
Secondarycontainmentforthe entirecontents of the largestsingletank, plus sufficientfreeboardtoallow
for precipitation, has been installed and is sufficiently impervious to contain discharges. (HSG
25270.4.51REF.40 CFR 112.7(c ), r12.8(cX2))
Secondary containment drainage restrained by valves/positive means and normally kept closed (HSG
2527 0.4.5 IREF. 40 C FR'11 2.8lbl(21, I 1 2.8(c X3))
Drainage of any uncontaminated rainwater from secondary containment is documented and recorded.
(HSC 25270.4.5; 40 CFR 1r2.8(cX3Xiv))
Liquid level sensing device is present and tested regularly. (HSC 25270.4.5/REF.40 CFR f f 2.8(cX8Xv))
The master flow valve that will prevent direct outward flow of the tank's content to the environment is
securely locked in the closed position when in nonoperating or non€tandby status. (HSC
2527 0.4.5|REF.40 CFR 112.7 (gll
The masterflowvalve (i.e. gatevalve, solenoid valve, etc.)and Emergency Shut-off switch are inspected
andtested regularly,documented,and recordsaremaintainedforthreeyears. (HSG 2527O.4.5|REF.40CFR
112.8(dX4))
Eachaboveground tank is testedforintegrity(if applicablelon a regularscheduleandwhenevermaterial
repairs are made. (HSC 25270.4.5/REF.40 GFR 1r2.8(cXG))
Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to prevent
vehicutardeparture before complete disconnectof flexible orfixed transferlines. (HS,C25270.4.51REF.40
cFR 1r2.7(h)(2), 112.8(dX5))
Guard posts orotherapproved means are being provided toprotectstoragetanksand connected piping'
valves, fittings, and dispensers from vehicular damage.
(HSc 25270.4.5/REF.40 CFR 112.7(aX11,112.7$l; CA FIRE GODE 5704.2.9.7.4)
Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are being
conductedanddocumentedregularly,andmaintainedforthreeyears.(HSC25270.4.5/REF.40CFR112.7(el,
1r2.8(dX4))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC
2527 0.4.51REF.40 CFR 1 1 2.8(cXl 0))
Facility lighting is commensurate with the type and location of the facility, giving consideration to the
discovery of spills occurring during hours of darkness both by operating personnel and non-operating
personnel (i.e. general public, local police/fire)
(HSC 25270.4.5/REF.40 cFR I I 2.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 CFR 112.7(g))n
tr
tr
tr
tr
tr
tr
tr
AT17 Facility has documented spill history and corrective actions taken. (HSC 25270.4.51REF.40 CFR 112.7)
ATIS Spillprevention briefingsforoperating personnelcoveringtheSPCCPlanareconductedanddocumented
annually to assure adequate understanding of the SPCG Plan. (HSC 25270.4.5/REF.40 CFR f 12.7(0)
AT19 Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 GFR f 12.7(c))
suM[r*Ry oF oBSERVAT|ONSV|O'"- (rtONS
tr No violations of underground s -wrage tank, hazardous materials, or hazardous waste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your
facility.
tr Violations were obseryed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
please inform the CUPA in writing
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA must be informed in writing with
a certification that compliance has been achieved. A false statement that compliance has been achieved is a violation
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: CENTURYLINK - SLO - SNLOCAMO ADDRESS: 775 Capitolio Way
San Luis Obispo, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Facility is under permit for the AGT program and has completed/submitted an SPCC plan, all paperwork in
good order.
HMBP has been submitted electronically for CY 2019 via CERS database. No violations noted.
INSPECTED BY: KERRY BOYLE
DATE: 10t30t2019
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
this inspection form.
Signature of Owner/Operator:- Title:- Date:-
ru!I
t;
Datez /
Time:
*,dT
T
i, -1
6r
lrils ffiryoGounty of San Luis ObisPo
Environmental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406
,:
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401'5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:
o/w,'Xt/f
FACILITY NAME
Result Code:
-70 -80 -90Action Code: _32 -37 -33 -31
Reinspection
Other
Routine
Complaint
AGENCYE EHsn nc DEPT
, l-l- clty Flne
. \, v , J,/
PHONE:I
ffnor ncnlnnpI usr,Business Plan n xw GeneratorPROGRAMS INSPECTED:
n usr ffio"'ncnr-nnpn Hw GeneratorBusiness Planofi'*o I YESREINSPECTION REQUIRED:
and andlewtrevngcopyingphotographs,lngISSION TO INSPEGT:
withrmt codes. GRANTED BY
may involve
YE
,n_Evfl
La,F
La',
F,'
IE
IE,,
NiAnnn
!n
n
n
cosnnn
un
tr
T
NOnnn
nn
tr
ntr NTnn
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
A"I02
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)
Inventory of hazardous materials is complete (Hsc 25504, Title 19 ccR2729)
Site layout/facility maps are accurate (HSC 25504' Title 19 CCR2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
66265.16\
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (IISC 25504, Titte 19 CCR273I & 22
ccR s 6626s.s3ts4)
Facitifo is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment. Maintains all required or appropriate
equipmentincludinganalarmandcommunicationssystem(Title19CCR2731 &22CCR66265,31-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SpCC Plan is reviewed and certified try a registered engineer within last 5 yrs. (40 CFR 112.5(b))
SPCC Plan is maintained on site or nearest field office; (HSC 25270)
to http://www materials.htm, to obtain forms to with BPO1-8P03, TRO1 EROl
INSPECTOR:
decimal min
F'ACILITY REP:
decimal minGPS Coordinates: Latitudel deg
-min-
COUNTY
bSAN LUIS
OBISPO
'"1
Environmental H€:.,u r Services
r(805) 781-5544
lP.O.Box 1489
i2156 Sierra Wav Ste. B
l@
z-\,)
crty o[ san Lurs oBlspo
FIRE OEPAR'TMENT
2160 Sania Barbaa Avsuo' San Lub Obbpo, CA 93101-52{0 ' {81}5) 781-7380
"Cotvtesy & Servit:e"
Date:0212212019
GERTIF|ED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
trCITYFlRE trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Facility Name: LEVEL 3 COMMUNICATIONS - SLO -trEHS
Testi
Phone: (720)888-1000
Site Address:775 Capitolio Way
San Luis Obispo, CA 93401
lnsoection Tvoe
trRoutine
Facility lD: FA0005138
Serial Number: DAPCRCS2Q
AAGT trCalARP trTPEPROGRAMS INSPEGTED:trHazmat trHWGenerator trUST
UCaIARP trTPEREINSPECTION REQUIRED:trHazmat trHWGenerator trUST trAGT
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
Title: Field TechnicianGRANTED BY (NAME/TITLE): Name: Mark Bucis
YES NOtrtr
trtr
trtr
trtr
Etr
trtr
trtr
trtr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSG 25505, 25508(a)
(1); 19 GGR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506, 25508(axl),
19 CCR 2652,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(aX2), 25508(aX1), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(a)(4), 25508(a)(1), 19CCR 2659'
22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(aX4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite (HSG
25505(a)(3), 25508(aXl), 19CCR 2658, 22CCR 66265.52-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR 112.8(c)
(2)l
GENERAL EH VIOLATIONS
tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinancel
GPS Coordinates: Latitude: 35.256761 0000 G PS Coord inates : Lon gtitude : -120.6452030000
N/A VIOL. #
tr BP01
tr BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
tr
tr
tr
tr
INSPECTOR: KERRY BOYLE FACILITY REP: Mark Bucis
FACILITY NAME:
YES NO N/A VIOL. #
trtrtrAT01
trtrtrAr20
AT21
Am2
Am3
AT22
Am6
ATOT
ATOS
ATO9
ATlO
AT11
AT12
AT13
AT14
AT15
AT16
LEV-'..3 COMMUNICATIONS - SLO - AP'\FESS:
sNL''AbUqEGRouND sroRAGE rANK (ASr)
775 Capitolio Way
San Luis Obispo, CA93401
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
cl
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
A Prevention control and countermeasure (spcc) plan has been prepared and implemented at facility (Note;
An SPGG Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a cumulat
capacity of greater than {,320 gallons of oil products; for farms, nurseries, construction sites: single
greater than 20,000 gallons or tanks with a cumulative capacity of greater than 100,000 gallons. (HSC
25270.4.5|REF. 40 CFR 112.1, 112.3(dl, 112.61
SPCC plan has been reviewed and/or evaluated within the last 5 years and completion of the review has
been documented (HSG 25270.4.5(allREF. 40 CFR 112.5(b))
SPCG plan has been amended for changes (HSC 25270.4.5(a)/REF. 40 CFR 1f 2.5(a))
TheSpillPrevention Controland Gountermeasure Plan is maintained on site oratthe nearestfieldoffice.
(HSC 25270.4.5/REF. 40 CFR 112.3(e Xi))
Secondary containmentforthe entirecontents of the largestsingle tank, plus sufficientfreeboard toallow
for precipitation, has been installed and is sufficiently impervious to contain discharges. (HSC
25270.4.5|REF.40 CFR 112.7(c ), 112.8(cX2))
Secondary containment drainage restrained by valves/positive means and normally kept closed (HS(,
2527 0.4.5 IREF. 40 c F R 11 2.8(bl(21, r 1 2.8(c X3))
Drainage of any uncontaminated rainwater from secondary containment is documented and recorded.
(HSC 25270.4.5; 40 CFR 112.8(cX3Xiv))
Liquid level sensing device is present and tested regularly. (HSC 25270.4.5/REF.40 CFR f 12.8(cX8Xv))
The master flow valve that will prevent direct outward flow of the tank's content to the environment is
securely locked in the closed position when in non-operating or non-standby status. (HSC
2527 0.4.5 t REF.40 C FR I 1 2.7 (gll
Themasterflowvalve (i.e. gate valve, solenoid valve, etc.)and Emergency Shut-offswitch are inspected
andtested regularly,documented,and recordsaremaintainedforthreeyears. (HSG 25270.4.51REF.40CFR
r{2.8(dx4))
Each aboveground tank is tested for integrity (if applicable) on a regularschedule and whenever material
repairs are made. (HSC 25270.4.5/REF.40 CFR 112.8(cXG))
Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to prevent
vehicular departure before complete disconnectof flexible orfixed transferlines. (H5C25270.4.5/REF.40
cFR 1 r2.7(h)(2), 1 r2.8(dX5))
Guard posts orotherapproved means are being provided to protectstoragetanks and connected piping,
valves, fittings, and dispensers from vehicular damage.
(HSc 25270.4.5/REF.40 GFR I I 2.7(a)( 11, 11 2.7 ltl; CA FIRE CODE 57 04.2.9.7 .41
Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are being
conductedanddocumentedregularly,andmaintainedforthreeyears.(HSC25270.4.5/REF.40CFR112.7(el,
112.8(dX4))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC
25270.4.'|REF.40 CFR I I 2.8(c)(r 0))
Facility tighting is commensurate with the type and location of the facility, giving consideration to the
discovery of spills occurring during hours of darkness both by operating personnel and non-operating
personnel (i.e. general public, local police/fire)
(HSC 25270.4.5/REF.40 CFR 1 1 2.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 GFR 112.7(g))
tr
tr
tr
AT17 Facility has documented spill history and corrective actions taken. (HSC 25270.4.51REF.40 GFR 112'7)
AT,I8 Spillprevention briefingsforoperating personnelcoveringtheSPCC Planareconductedand documented
annually to assure adequate understanding of the SPGC Plan. (HSC 25270.4.5/REF.40 CFR 1 12.7(f))
AT19 Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 CFR 112.7(c))
SUM-'-}ARY OF OBSERVATIONSVI. \.ATIONS
tr No violations of undergrourid storage tank, hazardous materials, or hazarclous waste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your
facility.
D Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
please inform the CUPA in writing
ALL VIOLATTONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA must be informed in writing with
a certification that compliance has been achieved. A false statement that compliance has been achieved is a violation
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: LEVEL 3 COMMUNICATIONS - SLO -
SNLOCAMO
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
ADDRESS: 775 Capitolio Way
San Luis Obispo, CA 93401
INSPECTION COMMENTS:
SPCC Plan is current and available on site.
All paperwork and permits are in good order. HMBP to be updated electronically and submitted via CERS
database for CY 2019.
INSPECTED BY: KERRY BOYLE
DATE:02222019
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Certification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
is inspection form
Sig natu re of Owner/Operator:- Title:- Date:-
County of San Luis Obispo
,--\
cffvo[
sari hils ortspoEnvironmental Health Services
(805) 781-5s44
P.O. Box'1489
2156 Sierra Way
San Luis Obispo, CA 93406
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:
FACILITY NAME
Complaint n Otner
Result Code: _70 _80 _90
Action Code: 32 37 33 31
Routine ReinspectionEHS
AG DEPT
TY FIRE
PHONE
n usr p/aer IcnnnegEf Business etan n |-lw GeneratorPROGRAMS INSPECTED:
n Hw Generator n usr daer Icru-nneREINSPECTION REQUIRED:l,s*o tr YES Plan4fru"in"""
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
letermining compliance with adopted codes. GRANTED BY (NAME/TITLE):
nx$aVlerr
YES
Ln.
ffi
H
ua
El/
,H
N/Antrn
ntr
n
n
cosnnu
nu
n
n
NOuntr
nn
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
ATO2
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)
Inventory,of hazardous materials is complete (HSC 25504, Title 19 CCR2729)
Site layout/facilif maps are accurate (HSC 25504' Title 19 CCR2729)
i
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504' Title 19 CCR273I & 22
ccR s 6626s.s3ts4)
Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment, Maintains all required or appropriate
equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR 112.5(b))
SPCC Plan is maintained on site or nearest field office. (HSC 25270)
trInnnn
COMMENTS Goto to obtain foms to with BP01 I andER0l
TNSPECTOR:
mrn
FACILITY REP:
GPS Coordinates: Latitude: deg min Longitude:_deg
-min-decimal
min
/)44fl ld ';;{tic: f
7fr.5"; ",1,3)'- I .:q t
COUNTY
b SAN LUIS
oEISPO
.-\
I
Environmental Health --rvices
(805) 781-5544
P.O.Box 1489
2156 Sierra Way Ste. B
San Luis Obispo. CA 93406
crty o[ -Jan tuls oBtspo
FIRE DEPARIilEI'T
2160 Sala Barbac Avsuo' Sa Lub Obbpo, CA 93101-52,10 ' (8{E} 78t"7380
"Colfftesy & Service"
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Date:0212212018 I 6'
BUSINESS PLAN
Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)
lnventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729)
Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR 2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22
ccR) 66265.16
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan is complete, updated, and maintained on site (HSC
25504, Title 19 CCR 2731 & 22 CCR S 66265.53/54)
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment. Maintains all required or
appropriate equipment including an alarm and communications system (Title 19 CCR2731&22
ccR 66265.31-.37, 40CFR I 265.31)
Secondary containment is installed and sufficiently impervious to discharges.
ICHSC 25270.4.5; 40 CFR 112.8(cX2)l
GENERAL EH VIOLATIONS
YES NO N/Atrtrtrtrtrtrtrtrtr
trtrtrtrtrtr
trtrtr
trtrtr
BPOl
BP02
BPO3
TROl
TRO2
EROl
ERO2
trEtrER03
tr tl tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.2567610000 GPS Coordinates: Lonqtitude. -120.6452030000
rl /V/T
lnsoection Tvoe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testint
Facitity Name: LEVEL e coulvrlrrrrcnrfirtri"- slo 1\
SNLOCAMO V
Phone: (720)888-1000
Aoencv
trEHS
trCITY FIRE
Site Address 775 Capitolio Way
San Luis Obispo, CA 93401
Facility lD: FA0005138
Serial Number: DAOGGSYSR
trCa|ARP trTPEEHW Generator DUST trAGTPROGRAMS INSPEGTED:EHazmat
trTPEtrHW Generator trUST trAGT trCalARPREINSPECTION REQUIRED:trHazmat
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
c RANrE D BY ( NAM E/rrrLE) : *"'"',ffiI/$rd),,.$Title: Field Technician
INSPECTOR: KERRY BOYLE FACILITY REP: Mike Seiler
FACILITY NAME:LEVEL'\OMMUNICATIONS-SLO- ADpr:=1SS
SNLoAEdqEGRouND sroRAcE TANK (Au i)
775 Capitolio Way
San Luis Obispo, CA 93401
YES
tr
tr
tr
tr
tr
tr
tr
tr
B
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
N9
a
tr
tr
tr
tr
tr
tr
u
tr
tr
tr
tr
tr
tr
tr
tr
u
tr
tr
N/A VIOL. #
tr ATOI A Spill Prevention Control and Countermeasure Plan (SPCC) has been prepared and certified
either by a registered engineer or self-certified (if a qualified facility) within last 5 yrc. (Note: An
SPCC Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a
cumulative capacity of greater than 1,320 gallons of oil products; for farms, nulseries, construction
sites: single tanks greater than 20,000 gallons or tanks with a cumulative capacity of greater than
lOo,ooo gallons. (HSC S25270.4.5)/(ref.40 CFR $112.1)/(ref.40 cFR $112.3(d)/(ref.40 CFR 5112.6)
tr AT02 The Spill Prevention Gontrol and Countermeasure Plan is maintained on site or at the nearest field
office. (HSG $25270.4.5)(ref.40 cFR S 1r2.3(e))
tr AT03 Secondary containment for the entire contents of the largest single tank, plus sufficient freeboard
to allow for precipitation, has been installed and is sufficiently impervious to contain discharges.
(HSc S25270.4.5)/(ref. 40 cFR Slr2.8(cX2))
tl AT04 Drainage from the secondary containment is restrained by valves or other positive means.
(HSc 525270.4.5)/(ref. 40 cFR $r r2.8(c)(3))
tr AT05 Drainage valves installed in the secondary containment are normally closed.
(Hsc S25270.4.5)/(ref. 40 cFR 5112.8(cX3Xi))
tl ATOG Drainage of any uncontaminated rainwater from secondary containment is documented and
recorded. (HSC S25270.4.5)/(ref. 40 CFR $112.8(cX3))
tr AT07 Liquid levelsensing device is presentand tested regularly. (HSC 525270.4.5)/(ref' 40 CFR $112.8(c)
(8Xv))
tr AT08 The master flow valve that will prevent direct outward flow of the tank's content to the
environment is securely locked in the closed position when in non-operating or non-standby
status. (HSC S25270.4.5)(ref. 40 cFR Srr2.7(gX2))
tr AT09 The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are
inspected and tested regularly, documented, and records are maintained for three years. (HSC
$25270.4.5)/(ref. 40 cFR 5112.8(dX4))
tr AT10 Each aboveground tank is tested for integrity (if applicable) on a regular schedule and whenever
material repairs are made. (HSC S25270.4.5/(ref. 40 CFR Sif 2.8(cXO))
tr AT11 Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to
prevent vehicular departure before complete disconnect of flexible or fixed transfer lines. (HSC
S25270.a.5)/(ref. 40 cFR 5112.7(h)(2y(ref. 40 CFR S r12'8(dX5))
tr AT12 Guard posts or other approved means are being provided to protect storage tanks and connected
piping, valves, fittings, and dispensers from vehicular damage.
(HSc 525270.4.5)/(ref. a0 CFR $112.7(c))/(GA Fire Gode $3404.2.9.6.5)/ ref.40 CFR 5112.70))/(ref.40 CFR
sr12.8(dx5))tr AT13 Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are
being conducted and documented regularly, and maintained for three years. (HSG $25270'4.5)/(ref'
40 cFR $r 1 2.6(c)(4))/(ref. 40 CFR $1 12.7(e))/(ref. 40 cFR 51 I 2.8(dX4))
tr AT14 There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC
$25270.4.5)/(ref. 40 cFR $112.8(c)(10))
tr ATlS Facility lighting is commensurate with the type and location of the facility, giving consideration to
the discovery of spills occurring during hours of darkness both by operating personnel and
non-operating personnel (i.e. general public, local police/fire)
(HSc S25270.4.5)/(ref. 40 cFR 51 17.2(gX5))
tr AT16 FFacility is fully fenced and locked when facility is unattended. (HSC S25270.4.5)/(ref. 40 CFR $f 12.7(g
(1 ))
tr AT17 Facility has documented spill history and corrective actions taken. (HSG S25270.a.5)/(ref' 40 CFR
sr12.7)
tr ATIS Spill prevention briefings for operating personnel covering the SPGG Plan are conducted and
documented annually to assure adequate understanding of the SPGG Plan. (HSC S25270.4.5)/(ref. 40
cFR S112.7(f))
tr AT19 Spill control equipment is maintained on site. (HSC S25270.4.5)/(ref. 40 CFR $112.7(c))
SUMM^RY OF OBSERVATIONSruIO'- \TIONS
tr No violations of underground storage tank, hazardous materials, or hazar[ious waste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to yot
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
olease inform the CUPA in writinq.
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing w
certification that compliance has been achieved. A false statement that compliance has been achieved is a violatior
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: LEVEL 3 COMMUNICATIONS - SLO -
SNLOCAMO
ADDRESS: 775 Capitolio Way
San Luis Obispo, CA 93401
VIOL. NO
ATOl
VIOLATIONS
CORRECTIVE ACTION REQUIRED
PREPARE AND PROVIDE A COPY OF A SPILL PREVENTIOA/ CONIROT AND COUNTERMEASURE PLAN TO
YOUR INSPECTOR WITHIN 60 DAYS OF THIS NOTICE. THE FINE FOR THIS VIOLATION /S 4N INITIAL
PENALW OF $5,OOO PER DAY, PER VIOLATION AND/OR $1O,OOO PER DAY PER VIOLATION FOR EACH
REPEAT OFFENSE.
INSPECTION COMMENTS:
Updated HMBP to be completed by 313112018 for CY 2018. Facility in good order and no violations noted
during facility inspection.
Need 5 year certification for SPCC Plan signed and stamped by a P. E. All else ok.
INSPECTED BY: KERRY BOYLE
DATE: 0?/222018
NAME OF FAGILITY REP: Mike Seiler
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
rtification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
is inspection form.
of Owner/O Title: Date:-
-)
County of San Luis Obispo
Environ mental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA 93406 "
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
'l''
cffypt-
san luls -l
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPEGTION FORM
EFW data
entry by:
o^r",71f;fr
Time:1'''
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nn
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n
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tru
tr
tr
YES
,n
ffi
d
,a
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,d.E
N/A
BUSINESS PLAN
Business plan is completeo current, & available during inspection (HSC 25503.5, Title 19 CCR2729)
Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)
Site layout/facility maps are accurate (HSC 25504, Title 19 CCR2729)
TRAININGPLAN
Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR
6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is completeo updated, and maintained on site (HSC 25504' Title 19 CCR273L & 22
ccR s 6626s.s3/s4)
Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of
hazardous materials/waste constituents to the environment. Maintains all required or appropiiate
equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-
.43)
ABOVEGROUND PETROLEUM STORAGE TANK ACT
SPCC Ptan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR 112.5(b)
SPCC Plan is maintained on site or nearest field office. (HSC 25270)
u!trtr
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
ATO2
FACILITY NAME:
ADDRESS:
AGENCYn eHsn no DEPTn crTY F|RE
Complaint n Otner
Result Code: _70 _80
Action Code: 32 37
9033 31
Routine Reinspection
J
P'aar !cnmnp,dgusiness PIan I xw Generator n usrPROGRAMS INSPECTED:
fl usr p"ear Icnmne,F'business Plan n lw GeneratorREINSPECTION REQUIRED:[g*o N YES
PERMISSION TO INSPEGT: tnspections may involve obtaining photographs, reviewing and copying records, and
determininq compliance with adopted codes. GRANTED BY (NAME/TITLE)r
Go to http://www materials.htm, to obtain forms to comply with BPO1 TR01 andER0l
INSPECTOR:
mrn
FACILITY REP
I
decimal minGPS Coordinates: Latitude: _deg
)
Environmental Health Services
(q05) 7815544
P.O.Box 1489
2156 Sierra Wav Ste. B
San Luis Obispo, CA 93406
,
t\
cltvOr
aili lrfts ontspo
Fire Department (80$ 7817380
2160 Santa Barbara Avenue
Date: 1110712016
San Luis Obispo CA 934015240
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: LEVEL 3 COMMUNICATIONS - SLO -
SNLOCAMO
Aoencv
I]EHS
trCITY FIRE
lnspection Tyoe
trRoutine
ElReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
uChargeable Secondary Containment Testinl
Site Address: 775 Capitolio Way
San Luis Obispo, CA 93401
Phone: (720)888-0676
Facility lD: FA0005138
Serial Number: DAC9LIUUM
PROGRAMS INSPECTED ElHazmat trHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED trHazmat trHW Generator trUST trAGT trCa|ARP trTPE
PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Mark Bucis Title: Field Technician
YES NO N/Atrtrtrtrtrtrtrtrtr
BUSINESS PLAN
Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)
lnventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729)
Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR 2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 56265.16)
Training documentation is maintained on site for current personnel (Title 19 CCR2732 &22
ccR) 66265.16
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan is complete, updated, and maintained on site (HSG
25504, Title 19 CCR 2731 & 22 CCR S 66265.53/54)
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materials/raraste constituents to the environment. Maintains all required or
appropriate equipment including an alarm and communications system (Title 19 CCR 2731& 22
ccR 66265.31 -.37, 66267.34 (dX2), 40CFR 1 265.31)
Secondary containment is installed and sufficiently impervious to discharges.
lcHsc 25270.4.5; 40 CFR't 1 2.8(cl(2ll
GENERAL EH VIOLATIONS
tr tr tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.2567610000 GPS Coordinates: Lonstitude: -120.6452030000
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ERO3
E
tr
u
u
tr
tr
tr
D
u
u
trtr
INSPECTOR: KERRY BOYLE FACILITY REP: Mark Bucis
FACILITY NAME: LEVEL 3 ,MMUNICATIONS - SLO - ADDR i
sNLof,i$UVEGRouND sroRAGE rANK (Asr)
YES
775 Capitolio Way
San Luis Obispo, CA 93401
N/A VIOL. #
tr ATOI A Spill Prevention Control and Gountermeasure Plan (SPCC) has been prepared and certified
either by a registered engineer or self-certified (if a qualified facility) within last 5 yrs. (Note: An
SPCC Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a
cumulative capacity of greater than 1,320 gallons of oil products; for farms, nulseries, construction
sites: single tanks greater than 20,000 gallons or tanks with a cumulative capacity of greater than
100,000 gallons. (HSC S25270.4.5)/(ref.40 CFR $112.{)/(ref. 40 CFR 5r12.3(d)/(ref.40 CFR Srr2'6)
tr AT02 The Spill Prevention Control and Countermeasure Plan is maintained on site or at the nearest field
office. (HSC $25270.4.5)(ref.40 CFR $ 112.3(e))
tr AT03 Secondary containment for the entire contents of the largest single tank, plus sufficient freeboard
to allow for precipitation, has been installed and is sufficiently impervious to contain discharges.
(HSc S25270.4.5)(ref. 40 cFR 5112.8(cX2))
tr ATO4 Drainage from the secondary containment is restrained by valves or other positive means.
(HSc S25270.4.5)/(ref. 40 cFR $1r2.8(c)(3))
tr ATO5 Drainage valves installed in the secondary containment are normally closed.
(HSc $25270.4.5)(ref. 40 cFR 51{2.8(cX3Xi})
tr AT06 Drainage of any uncontaminated rainwater from secondary containment is documented and
recorded. (HSC S25270.4.5)/(ref. 40 CFR $r12.8(c)(3))
tr AT0z Liquid level sensing device is present and tested regularly. (HSC S25270.4.5)(ref. 40 CFR $f 12.8(c)
(8Xv))
tr AT08 The master flow valve that will prevent direct outward flow of the tank's content to the
environment is securely locked in the closed position when in non-operating or non-standby
status. (HSc 525270.4.511(ref .40 CFR 5112.7(gX2))
tr ATO9 The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are
inspected and tested regularty, documented, and records are maintained for three years. (HSC
S25270.4.5)(ref- 40 cFR Sl 12.8(dX4))
tr AT1O Each aboveground tank is tested for integrity (if applicable) on a regular schedule and whenever
material repairs are made. (HSC S25270.4.5)(ref.40 CFR Sf 12.8(cX6))
tr ATil Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to
prevent vehicular departure before complete disconnect of flexible or fixed transfer lines. (HSG
$25270.4.5)/(ref. 40 cFR S{ 1 2.7(hx2y(ref. 40 GFR S 1 1 2'8(dX5))
tr AT12 Guard posts or other approved means are being provided to protect storage tanks and connected
piping, valves, fittings, and dispensers from vehicular damage.
(HSc 525270.4.5[(ref. 40 cFR Sl 12.7(c))/ (GA Fire Code $3404.2.9.6.5}/ ref. 40 CFR Sl 12.70])(ref. 40 CFR
s112.8(dX5))tr AT{3 Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are
being conducted and documented regularly, and maintained for three years. (HSC $25270.4.5)(ref.
40 cFR $r I 2.6(c)(4))/(ref. 40 cFR Sl 1 2.7(e))/(ref. 40 cFR Sl 1 2.8(dX4))
tr ATl4 There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSG
$25270.4.5)/(ref. 40 cFR $1 12.8(cX10))
tl ATIS Facility lighting is commensurate with the type and location of the facility, giving consideration to
the discovery of spills occurring during hours of darkness both by operating personnel and
non-operating personnel (i.e. general public, local police/fire)
(HSc 525270.4.51t(ref .40 cFR 5117.2(gX5))tr ATtO FFacility is fully fenced and locked when facility is unattended. (HSC $25270.a.5)/(ref. 40 CFR 5112.7(g
(r ))
tr AT17 Facility has documented spill history and corrective actions taken. (HSC S25270'4.5)/(ref. 40 CFR
sl12.7)
tr ATIB Spill prevention briefings for operating personnel covering the SPCC Plan are conducted and
documented annually to assure adequate understanding of the SPCG Plan. (HSC S25270.4.5[(ref, 40
cFR S{r2.7(0)
tr AT19 Spill control equipment is maintained on site. (HSC S25270.4.5)(ref.40 CFR $1{2'7(c)}
NO
utr
tr
EI
tr
tr
tr
tr
tr
tr
tr
EI
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
SUMMA I OF OBSERVATIONS/VIOL. -.IONS
tr No violations of underground storage tank, hazardous materials, or hazardous waste lawslregulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to yot
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the
corrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,
olease inform the GUPA in writinq.
ALL VTOLATTONS MUST BE CORRECTED W|THIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing w
certification that compliance has been achieved. A false statement that compliance has been achieved is a violatior
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the GUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: LEVEL 3 COMMUNICATIONS - SLO -
SNLOCAMO
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
ADDRESS: 775 CaPitolio WaY
San Luis Obispo, CA 93401
INSPECTION COMMENTS:
Spill Prevention Control and Countermeasure Plan reviewed. Received copies of PE stamp and signature
for 2009. No changes warranting an update. No violations noted.
Hazardous Materials Business Plan has been updated and submitted electronically via CERS database.
Facility in full compliance, no violations noted.
INSPECTED BY: KERRY BOYLE
DATE: 1110712016
NAME OF FACILITY REP: Mark Bucis
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
: I certify under penatty of perjury that this facility has complied with the corrective actions listed on
is inspection form
ignature of Owner/O Title:- Date
)
Environmental Health Services
(80$ 7815544
P.O.Box 1489
2156 Sierra Way
San Luis Obispo. CA 93406
,\
ctt;/1,a
smlrrlsoBtspo
Fire Deoartment (80$ 7817380
2160 Santa Barbara Avenue
Date: 1211512015
San Luis Obisoo CA 9340tr5240
CERTTFTED UNTFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
trUST BAGT trCa|ARPtrHWGeneratorPROGRAMS INSPECTED: lExazmat
trUST trAGT trCalARPtrHW GeneratorREINSPEGTION REQUIRED: lnHazmat
Facili$ Name: LEVEL 3 COMMUNICATIONS
Site Address: 77 5 CAPITOLIO
SAN LUIS OBISPO, CA 93401
BPOl
BPOz
BPO3
TROl
TRO2
EROl
ERO2
trtrtrER03
Agency lnspection TyoetrEHS ERoutine
trClry FIRE trReinspection
trChargeable ReinsPection
tlChange of Ownership
trComplaint
trSecondary Containment Testing
tlChargeable Secondary Containment Testing
Phone: (720)888-0676
Facility lD: FA0005138
Serial Number: DAlUHTCXB
trTPE
trTPE
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and
copying records, and determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: Michael Seiler Title: Technician
BUSINESS PLAN
Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)
lnventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729)
Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR 2729)
TRAINING PLAN
Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16)
Training documentation is maintained on site for current perconnel (Title 19 CCR2732 & 22
ccR) 66265.16
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan is complete, updated, and maintained on site (HSC
25504, Title 19 CCR 2731 &22CCR$ 66265.53/54)
Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of
hazardous materials/rraste constituents to the environment. Maintains all required or
appropriate equipment including an alarm and communications system (Title 19 CCR 2731&22
ccR 66265.31 -.37,66267.34 (dX2), 40CFR I 265.31)
Secondary containment is installed and sufficiently impervious to discharges.
IGHSC 25270.4.5; 40 GFR I 12.8(cX2)l
GENERAL EH VIOLATIONS
tr tr tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinancel
GPS Coordinates: Latitude: 35.2567610000 GPS Goordinates: Longtitude= -120.6452030000
YES NO N/Atrtrtrtrtrtrtrtrtr
tr
tr
tr
tr
tr
tr
tr
tr
INSPECTOR: KERRY BOYLE FACILITY REP: Michael Seiler
FActLtTy NAME: LEVEL I'-T)MMUNICATIONS ADDTIS:
ABOVEGROUND STORAGE TANK (AST)
775 CAPITOLIO
SAN LUIS OBISPO, CA 93401
N/A V|OL. #
tr ATot A Spill Prevention Control and Countermeasure Plan (SPGG) has been prepared and certified
either by a registered engineer or self+ertified (if a qualified facility) within last 5 yrs. (Note:
An SPCG Plan is required for single tanks 1,320 gallons or greater or tanks/containers with a
cumulative capacity of greater than 1,320 gallons of oil produc6; for farms, nurceries,
construction sites: single tanks greater than 20,000 gallons or tanks with a cumulative capacity
of greater than 100,000 gallons. (HSC S25270.4.5)(ref. 40 CFR Sl 12.1)/(ref. 40 CFR Sr r 2.3(d)(ref. 40
tr ATO2 The Spill Prevention Control and Gountermeasure Plan is maintained on site or at the nearest
field office. (HSC S25270.4.5)(ref. 40 CFR S 112.3(e))
tr ATO3 Secondary containment for the entire contents of the largest single tank, plus sufficient
freeboard to allow for precipitation, has been installed and is sufficiently impervious to contain
discharges. (HSC S25270.4.5/(ref. 40 CFR 5112.8(cX2))
E ATO4 Drainage from the secondary containment is restrained by valves or other positive means.
(Hsc S25270.4.5)/(ref. 40 cFR 51 12.8(cX3))
tr ATO5 Drainage valves installed in the secondary containment are normally closed.
(Hsc S25270.4.5)(ref. 40 cFR 5112.8(cX3Xi))
tr AT06 Drainage of any uncontaminated rainwater from secondary containment is documented and
recorded. (HSC S25270.4.5)(ref. 40 CFR 5112.8(cX3))
tr ATOT Liquid level sensing device is present and tested regularly. (HSC S25270.4.5)(ref. 40 CFR
$r r 2.8(c)(8)(v))
tr ATOS The master flow valve that will prevent direct outward flow of the tank's content to the
environment is securely locked in the closed position when in non-operating or non-standby
status. (HSC S25270.4.5)/(ref. 40 CFR Sr r 2.7(gX2))
tr ATO9 The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shut-off switch are
inspected and tested regularly, documented, and records are maintained for three yearc. (HSC
$25270.4.5)(ref. 40 cFR Sr 12.8(dX4))
tr AT1O Each aboveground tank is tested for integrity (if applicable) on a regular schedule and
whenever material repairs are made. (HSC S25270.4.5)/(ref. 40 CFR $1f 2.8(c)(6))
tr AT11 Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to
prevent vehicular departure before complete disconnect of flexible or fixed transfer lines.
(Hsc S25270.4.5)(ref. 40 cFR Sr r2.7(hx2y(ref. 40 GFR S 112.8(dX5))
tl AT12 Guard posts or other approved means are being provided to protect storage tanks and
connected piping, valves, fittings, and dispensers from vehicular damage'
(HSC S25270.4.5[(ref.40 cFR Sl l2.7(c)[ (GA Fire Code $3404.2.9.6.5)/ ref.40 cFR 5112.7fi])/(ref. a0
cFR 5112.8(dX5))tr AT13 Visual inspections of tanks, valves, piping, and appurtenances storing petroleum products are
being conducted and documented regularly, and maintained for three years. (HSG S25270.4.5y
(ref. 40 cFR Sll2.6(cX4)/(ref.40 cFR $112.7(e)/(ref. 40 cFR Sr12.8(dX4))
tr ATi4 There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC
S25270.4.5)/(ref. 40 cFR $1 12.8(c)(r0))
tr AT15 Facility lighting is commensurate with the type and location of the facility, giving consideration
to the discovery of spills occurring during hours of darkness both by operating personnel and
non-operating personnel (i.e. general public, local police/fire)
(HSc S25270.4.5)(ref. 40 cFR 5117.2(gX5))tr ATt6 FFacility is fully fenced and locked when facility is unattended. (HSC S25270.4.5)(ref. 40 CFR
Sr 12.7(gXr ))
tr AT17 Facility has documented spill history and corrective actions taken. (HSG S25270.4.5y(ref.40 CFR
sr r2.7)
tr ATlS Spill prevention briefings for operating personnel covering the SPGC Plan are conducted and
documented annually to assure adequate understanding of the SPGC Plan. (HSC S25270.4,5y
(ref.40 cFR 5112.7(f))
tr ATtg Spill controlequipment is maintained on site. (HSC S25270.4.5)(ref.40 CFR $1{2.7(c))
YES
E
tr
tr
tr
EI
E
tr
tr
tr
tr
B
tr
tr
tr
tr
B
EI
tr
tr
NA
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
tr
u
tr
tr
tr
tr
tr
tr
tr
SUMM RY OF OBSERVATIONS/VIO. ITIONS
tr No violations of underground storage tank, hazardous materials, or hazbrbous waste lawslregulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to you
facility.
tr Violations urere observed/discovered as listed below. All violations must be corrected by implementing the correctit,
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please infort
the CUPA in writinq.
ALL VTOLATTONS MUST BE CORRECTED WtTHtN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing wi
certification that compliance has been achieved. A false statement that compliance has been achieved is a violation
of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may
be reinspected any time during normal business hours'
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the GUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: LEVEL 3 COMMUNICATIONS ADDRESS: 775 CAPITOLIO
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Hazardous Materials Business Plan needs to be updated and submitted on line before the end of the
calendar year. All else ok, no violations noted.
Facility in full compliance with SPCC requirements, spill kit staged adjacent to AGT. No violations noted
during facility inspection.
INSPECTED BY: KERRY BOYLE
DATE: 1?/1512015
NAME OF FACILITY REP: Michael Seiler
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
I certify under penalty of perjury that this facility has complied with the corrective actions listed on
is inspection form.
ignature of Title:- Date:-