HomeMy WebLinkAboutSLOUNIFLOW_FS1 Admin iRC3926i Color_2542_001COUNTY
bSAN LUIS
OBISPO
i Environmental Health uervices
l(805) 781-5544
lP.o.Box 1489
12156 Sierra Wav Ste. B
lSan Luis Obisoo. CA 93406
I
ctty o[ san lurs oBrspo
FIRE DEPARTITEIIT
2160 seta 8arba6 Avfluo'sil lub obl6po, cA 9310!-5210' {805) 7Ol-7380
"Courtesy & Service"
Dale 1110812024
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: H5 DATA CENTERS Agency
trEHS
trCITY FIRE
Inspection Type
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinl
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (805)286-0831
Facility lD: FA0017599 CERS lD
Serial Number: DA3KUVLYK
PROGRAMS INSPEGTED:EIHazmat trHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHW Generator DUST trAGT trCalARP trTPE
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES NO N/Atrtrtr 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,
2ss08(aXl ), 19 ccR 2652, 26s41
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)(a), 25508(a)(1), 19CCR
2659, 22CCR6626s.1 6)
Training documentation is maintained on site for current personnel (HSG 25505(a)(4), 22CCR66265.16)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSC 25505(a)(3), 25508(aX1), 1gccR 2658, 22ccR 66265.s2-.54)
Secondary containment is installed and sufficiently impervious to discharges. ICHSC 25270.4.5;40 CFR
112.8(cX2)I
GENERAL EH VIOLATIONS
tr tr tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
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GPS Coordinates: Latitude GPS Coordinates de:
INSPEGTOR: MATHESON BLISS FACILITY REP: Keith Meyers
FACILITY NAME:
YES NO N/A VIOL. #
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H5 DATA CENTERS 4ppa.gss:\);.-OVEGROUND STORAGE TANK (rr$T)
3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
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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(allREF. 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 Countermeasure Plan is maintained on site or at the nearest field
office. (HSC 25270.4.5|REF. 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
( HSG 25270.4.5/REF. 40 cFR 11 2.8(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(c)(3)(iv))
Liquid level sensing device is present and tested regularly. (HSC 2527b.4.5/REF.4O 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.s/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.A.6IREF.40 CFR rl 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(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. (HSC
2527 0.4.5 t REF.40 C F R 11 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 CFR 112.7(a)(11,112.7Q1; 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)(a))
There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSG
2527 0.4.5|REF.40 cFR 11 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 112.7(g))
FFacility is fully fenced and locked when facility is unattended. (HSC 25270.4.5/REF.40 CFR 112.7(g))tr
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Af17 Facility has documented spill history and corrective actions taken. (HSC 25270.4.51REF.40 CFR 112.7)
AT18 Spill prevention briefings for operating personnel covering the SPCC Plan are conducted and
documented annually to assure adequate understanding of the SPCG Plan. (HSC 25270.4.5/REF.40
cFR 112.7(0)
Spill control equipment is maintained on site. (HSC 25270.4.5/REF.40 CFR 112.7(c))AT19
SUMM'^-RY OF OBSERVATIONSVIO' \,TIONS
No violations of underground s- -,Lge 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 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 writinq
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 CUPA from taking administrative, civil, or
criminal action.
FACILITY NAME: H5 DATA CENTERS ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
CORRECTIVE ACTION REOUIRED
IMMEDIATELY TAKE A/ECESSARY ACTION IO ENSURE THAT THE 8US/NESS PLAN /S COMPLETE,
jUBMTTTED ELECTRONTCALLy AND AVATLABLE (VIS|T CALTFORNIA ENVIRONMENTAL REPORTTNG
SySIEM - "CERS'i hftps//cers.calepa.ca.gov). TMPLEMENT A PROCEDURE TO ENSURE THAT THE PLAN /S
U7DATED AS REQU/RED BY HEALTH AND SAFEry CODE SECTIONS 25505,25508(aN1) AND CALTFORNIA
CODE OF REGULATIONS SECI/ON 2651. FAILURE TO CORRECT THIS VIOLATION BY THE DATE
SPECIFIED /N IHIS REPORT MAY RESULT IN CIWL AND/OR CRIMINAL PENALTIES OF UP TO $2,OOO PER
DAY PER VIOLATION, AND/OR THE PENALTIES DESCR/BED IN THE CA HEALTH & SAFEW CODE SECTION
2551 5.
Prepare and submit a Hazardous Materials Business Plan through CERS (cers.calepa.ca.gov) by
1t2t25. lnclude Business Owner/operator information, chemical inventory, facility site map,
response and employee trainin olan.
VIOL. NO
BPOl
ATOl
Demonstrate SPGG Plan has been prepared and regular visual inspections of the tanks/piping are
being documented
INSPECTION COMMENTS:
Items marked N/a not reviewed during inspection. lnitial inspection after ownership change and addition of
two diesel generators.
INSPECTED BY: MATHESON BLISS
DATE: 11t08t2024
NAME OF FACILITY REP: Keith MeYers
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
Sig natu re of Owner/Operator:Title: Date:
COUNTY.bSAN LUIS
OBISPO
r-\
Environmental Health r,-,,lices
{d05\ 781-5544
P.O.Box 1489
2156 Sierra Way Ste. B
San Luis Obispo. CA 93406
crty o[ san luls oBlspo
)
FIRE DEPARTMETIT
2160 Santa Sarban Avsu6' Sd Luh ObkPo, CA 93401'5240 ' (805) 781'?380
"Courtesy & Servit:e"
Dale'. 1110812024
CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time.
lnspection Type
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinl
Facility Name: CENTURYLINK - SLO - SNLOCAOT
Phone: (720)888-1000
Aoencv
trEHS
trCITY FIRE
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Facility lD: FA0005342 CERS lD 10438174
Serial Number: DALLC44TL
trCalARP trTPEtrAGTtrHW Generator trUSTtrHazmatPROGRAMS INSPEGTED:
trTPEtrAGTtrCalARPtrHW Generator AUSTtrHazmatREINSPECTION REQUIRED:
pERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, a nd
determining compliance with adopted codes.
YES NO N/Autrtr vtoL. #
BPOl
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505,
25508(aXl); 19 CCR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axl), 25506'
2s508(ax1 ),'l I cCR 2652, 26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(a)(2), 25508(aX1), 19 CCR
26521
TRAINING PLAN
Facitity has appropriate training program, submifted electronically (HSG 25505(a)(4), 25508(aXl)' 1gCCR
2659, 22CCR6626s.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 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(cX2)l
GENERAL EH VIOLATIONS
Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Longtitude: -120.6408330000
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GPS Coordinates: Latitude: 35.2557730000
INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez
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suMMl sY oF oBSERVATIONSVIOL ^\TIONS
No violations of underground s. ige tank, hazardous materials, or hazardou. lrste laws/regulations were discovered'
SLO CUpA grealy 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 writinq
ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA MUSI bE iNfOTMCd 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 punishabie by a fine of not less than g2,000 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 - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION COMMENTS:
Observed hazardous waste manifest dated 10116124 for waste refrigerant and small quantity of corrosives.
The HMBP program will now be the responsibility of H5 Datacenters. Papenarork has been submitted to
remove this facility from the program.
INSPECTED BY: MATHESON BLISS
DATE: 11t08t2024
NAME OF FACILITY REP: Bob Fernandez
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:_
t!
COUNTY
bSAN LUIS
OBISPO
.\
EnvironmentalHeat. lrvices
t(805)?81-5544
'P.O.Box 1489
r2156 Sierra Way Ste. B
]San Luis Obisoo. CA 93406
j
/'\
)crty oF san Lurs oBtspo
FIRE OEPARTMENT
2160 Santa Barbaa Avsuo' San Luls 0bispo, CA 934015240 ' {805} 781-7300
"Cotvtesy & Service"
Date: 1012512023
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time.
Facility Name: CENTURYLINK - SLO - SNLOCAOT Aoencv
trEHS
trCITY FIRE
Insoection Tvpe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Testing
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (720)888-1000
Facility lD: FA0005342 CERS lD:10438174
Serial Number: DAWQ9YBDS
PROGRAMS INSPECTED:EIHazmat trHWGenerator trUST trAGT trCa|ARP trTPE
REINSPECTION REQUIRED:trHazmat EHW Generator trUST trAGT trCa|ARP trTPE
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES
tr
tr
tr
u
tr
tr
tr
NO
tr
tr
tr
tr
tr
tr
tr
tr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505, 25508(a)
(1); 19 GCR 2651)
lnventory of hazardous materials is complete and submifted electronically (HSC 25505(axl), 25506, 25508(a)(1),
19 CCR 26s2,26541
Site layouU facility maps are accurate and submitted electronically (HSC 25505(a)(2), 25508(a)(1), 19 CCR 2652)
TRAINING PLAN
Facility has appropriate training program, submifted 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, submifted electronically, maintained onsite (HSC
25505(aX3), 25508(a)(1), 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)t
GENERAL EH VIOLATIONS
tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinancel
GPS Goordinates: Latitude: 35.2557730000 GPS Goordinates: Longtitude: -120.6408330000
N/A VIOL. #
tr BP01
BPO2
BPO3
TROl
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ERO3
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INSPECTOR: MATHESON BLISS FACILITY REP
suM |UARY oF oBSERVATTONSVTOLATTONS
-Ef tlo violations of underground' )rage tank, hazardous materials, or hazard<f ),vaste laws/regulations were
discovered. SLO CUPA greatly appreciates your efforts to comply with all the raws 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 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 - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE AGTION REQUIRED
INSPECTION COMMENTS:
Observed the nine compressed refrigerant gas cylinders and otherl-gallon to S-gallon containers of presumed
hazardous waste stored outside on pallet during inspection of new aboveground diesel generator tanks at the
back of the facility. lmmediately properly recover and dispose of/recycle wastes through a licensed hauler.
Failure to properly dispose of wastes under manifeslby 11126123 will result in a Notice of Violation Office
Hearing andor additional enforcement action including, but not limited to, Administrative Enforcement Order.
lmmediately activate a temporary EPA lD number to properly dispose of the wastes.
The following is currently in violation:
Health and Safety Code (HSC) section: 25189.5, 2520'l(a); California Code of Regulations (CCR) Title 22
66262.12: Hazardous wastes disposed of at an unauthorized location.
HSC 25123.3(bxly(dy(hx1); 22 CCR 66262.34(d): Hazardous waste are improperly accumulated on site,
greater than 180 days.
22CCR 66262J2: Generator does not have an active EPA lD number to store or dispose of hazardous waste.
HSC 25189: (e) A person who intentionally or negligently treats or stores, or causes the treatment or storage
of, a hazardous waste at a point that is not authorized according to this chapter shall be liable for a civil
penalty not to exceed seventy thousand dollars ($70,000) for each separate violation or, for continuing
violations, for each day that the violation continues.
INSPECTED BY: MATHESON BLISS
DATE: 1o125t2023
NAME OF FAGILITY REP:
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
COUNTY.b SAN LUIS
OBISPO
l
crty o[ san lurs oBtspo
FIRE OEPARTMENT
2160 ganta BarbaE Avdu6'gan Lub 0blepo, CA 93401-5240'{805} 781-7380
"Cotrtesy & Service"
Date:0110612023
GERTTFTED UNTFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: CENTURYLINK - SLO - SNLOCAOT Aoency lnsoection TyoetrEHS trRoutine
trClTY FIRE trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Contai n ment Testinl
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (720)888-1000
Facility lD: FA0005342 CERS lD:10438174
Serial Number: DAROCNI9K
PROGRAMS INSPECTED:EHazmat trHWGenerator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat trHW Generator trUST trAGT trCa|ARP trTPE
PERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
N9
tr
tr
tr
tr
tr
tr
tr
tr
YES
tr
tr
tr
tr
tr
tr
tr
tr
BUSINESS PLAN
Business plan complete, current, available during inspection and submitted electronically (HSC 25505,
25508(aXi); 19 CcR 2651)
lnventory of hazardous materials is complete and submitted electronically (HSC 25505(axf ), 25506,
25508(aXl), 19 CCR 2652,26541
Site layouU facility maps are accurate and submifted electronically (HSC 25505(a)(2), 25508(aXl), 19 CCR
2652)
TRAINING PLAN
Facility has appropriate training program, submifted electronically (HSC 25505(a)(4), 25508(aX1), 19CCR
2659, 22CCR66265.16)
Training documentation is maintained on site for current personnel (HSC 25505(a)(4), 22GCR66265.15)
EMERGENCY RESPONSE PLAN
Emergency response/contingency plan complete, current, submitted electronically, maintained onsite
(HSC 25505(a)(3), 25508(a)(1), 19ccR 26s8, 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
tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Goordinates: Latitude: 35.2557730000 GPS Coordinates: Lonqtitude: -120.6408330000
N/A V|OL. #
E BP01
tr BPO2
tr BPO3
TROl
TRO2
EROl
ERO3
INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez
suMM \Y OF OBSERVATIONSVIOLATIONS
No violations of underground s Age tank, hazardous materials, or hazardour iste 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
GUPA in writina
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 houts.
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 - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION COMMENTS:
Observed nine cylinders of dichlorotrifluoroethane(R-123, refrigerant) gas stored under AC units with foot
rings of cylinders rusting through. Per facility representative, AC units have not been used in a long period
of time. Properly recover refrigerant and dispose of cylinders. Send a copy of the manifesUreceipt once
completed to mbliss@slocity.org.
INSPECTED BY: MATHESON BLISS
DATE: O1tOOl2O23
NAME OF FACILITY REP: Bob Fernandez
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.
Signature of Owner/O Title:- Date
COUNTY
bSANLUIS
OBISPO
crty o[ san luls ontspo1(805) 781-5544
lP.O.Box t489
.2156 Sierra Wav Ste. B
iSan Luis Obisoo. CA 93406
FIRE OEPARTMENT
2160 Santa 8arba6 Avfiu6'san Luis Obhpo, CA 93401-5240 " 1805) 781-7380
Date: 1111812021
"Courtesy & Service"
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: CENTURYLINK - SLO - SNLOCAOT Aoencv lnspection TvpetrEHS trRoutine
trClTY FIRE trReinspection
trChargeable ReinsPection
trChange of OwnershiP
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinl
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (720)888-1000
Facility lD: FA0005342
Serial Number: DAPWNS9KK
PROGRAMS INSPECTED:EIHazmat trHWGenerator trUST EAGT trCa|ARP trTPE
REINSPECTION REQUIRED:EHazmat trHWGenerator trUST trAGT trCalARP trTPE
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
YES NOtrtr
Etr
Etr
Etr
trtr
trtr
trtr
N/A VIOL. #
tr BPO1
E BP02
tr BPO3
TROI
TRO2
EROl
ERO3
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 submifted electronically (HSG 25505(axl), 25506,
25508(aXl), l9 CCR 2652,2654)
Site layouU facility maps are accurate and submitted electronically (HSC 25505(a)(2)' 25508(aXl), 19 CCR
26521
TRAINING PLAN
Facility has appropriate training program, submitted electronically (HSC 25505(aX4), 25508(aX1)' l9CCR
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(aX3), 25508(aXl), l9CCR 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]trtrtrFE01
GPS Goordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude: -120.6408330000
INSPECTOR: MATHESON BLISS FACILITY REP: Bob Fernandez
su M MARY OF OBSERVATI ONSVIO'- -q,TlONS
No violations of underground )age tank, hazardous materials, or hazardou- lraste 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 writinq
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 - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA93401
VIOLATIONS
VIOL. NO
BPOl
CORRECTIVE ACTION REOUIRED
IMMEDIATELY TAKE NECESSARY ACTION IO ENSURE THAT THE BUS/NESS PLAN /S COMPLETE,
SUBM\TTED ELECTRONTCALLY (EZSUBMTTSLOGOV.ORG OR CERS) AND AVAILABLE. IMPLEMENT A
PROCEDURE IO E'VSURE THAT THE PLAN /S UPDATED AS REQU'RED BY HEALTH AND SAFETY CODE
SECI/ONS 25505, 25505(aX1) AND CALIFORNIA CODE OF REGULAIIONS SECTTON 2651. FAILURE TO
CORRECT THIS VIOLATION BY THE DATE SPECIFIED IN THIS REPORT MAY RESULT IN CIVIL AND/OR
CRIMINAL PENALTIES OF UP TO $2,OOO PER DAY PER VIOLATION, AND/OR THE PENALTIES DESCR/BED /N
THE CAHEALTH & SAFETY CODE SECI/ON 25515.
Revise and resubmit Hazardous Materials Business Plan through CERS by 1211812021. Revise
primary emergency contact information (John Sharp no longer at facility), revise chemical
inventory and site mao for hvdroqen (no lonqer stored at facilitv).
INSPECTION COMMENTS:
Items marked N/A not reviewed during inspection.
INSPEGTED BY: MATHESON BLISS
DATE: 11fiU2021
NAME OF FACILITY REP: Bob Fernandez
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.
ignature of Owner/Operato Title:- Date
COUNTY
b SAN LUIS
OBISPO
Environmental Health {- ,Ces
(805) 781-5544
P.O.Box 1489
2156 Siena Way Ste. B
San Luis Obisoo. CA 93406
'^1
ctty o[ san Lurs oBtspo
FIRE DEPARTMEIIT
Date: 1012112019
2160 Santa Barbah Avmuo " San L!b Obkpo, CA 93401-5240 ' (805) 781-7380
"Courtesy & Service"
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: CENTURYLINK - SLO - SNLOCAOT Aoencv
trEHS
trCITY FIRE
lnsoection Tvoe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment
Testing
SiteAddress: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (720)888-1000
Facility lD: FA0005342
Serial Number: DAKV1MZ01
PROGRAMS INSPECTED:trHazmat trHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:trHazmat EHW Generator trUST trAGT trCalARP trTPE
PERMTSSION TO INSPEGT: Inspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: John Sharp Title: Lead Operations Technician
YES NOtrtr
trtr
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(a)(1),
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(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, submifted electronically, maintained onsite (HSC
25505(aX3), 25508(a)(1), 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
FE01 Environmental Health fees paid. [CBPC 17200, Local Ordinancel
GPS Goordinates: Latitude: 35.2557730000 GPS Coordinates: Longtitude: -120.6408330000
N/A VIOL. #
tr BP01
tr BPO2
tr BPO3
TROl
TRO2
EROI
ERO3
tr
tr
D
tr
tr
INSPECTOR: KERRY BOYLE FACILITY REP: John Sharp
^t
SU M MARY OF OBS ERVATIONSVIOLATIONS
tr No violations of underground s )ge tank, hazardous materials, or hazardou' )ste 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 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 - SNLOCAOT ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION COMMENTS:
HMBP is crrent and has been updated for CY 2019 via the CERS database. Good employee training program
in place.
INSPECTED BY: KERRY BOYLE
DATE: 10t21t2019
NAME OF FACILITY REP: John Sharp
SIGNATURE OF FACILITY REP:
&^'iLn
STATEMENT OF COMPLIANCE
rtification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
is inspection form.
nature of Title:- Date;-
Gounty"of San Luis Obispo Or,
luls oBtspo
cty
8anEnvironmental Health Services
(805) 781-5544
P.O. Box 1489
2156 Sierra Way
San Luis Obispo; CA 93406
Fire Department (805) 781-7380
21 60 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED TINIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:.t/
""",tf lhll 11
I rme:
FACILITY NAME:
EHS
AG DEPT
CITY FIRE
N
ne Reinspection
OtherComplaint
Result Code:
Action Code:
70 B0 9032 37 33 31
ADDRESS
PHONE:
PROGRAMS INSPECTED:Plan n Hw Generator n usr fl ecr !cnmne
REINSPECTION REQUIRED:F'No N YES Business Plan n nw Generator ! usr n aor ncnnnp
J
YES
VN
ffi
N/Atrnn
nn
n
n
costrntr
NO
tr!n
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ATOl
ATO2
BUSINESS PLAN
Business plan is complete, current, & available during inspection (HSC 25503.50 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)
iTRAINING 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
6626s.16)
EMERGENCY RESPONSE PLAN
Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273[ & 22
ccR $ 6626s.s31s4)
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 engineerwithin last 5 yrs. (40 CFR 112.5(b)
SPCC Plan is maintained on site or nearest field office. (HSC 25270)
'ffi,E E
tn
F/
ln nnn n
COMMENTS http to to comply with -BP03,TR01 andEROl
GPS Coordinates: Latitude:
-deg -min-decimal
min
INSPECTOR:FACILITY
)
Environmental Heal{i, -rrvices
(805) 781-5544
P.O.Box 1489
2156 Sierra Wav Ste. B
San Luis Obisoo. CA 93406
ctty o[ san Luls oBtspo
FIR€ DEPARTME}IT
2160 Silla BarbaE Avsue' Sil Lub Oblspo, CA 93401-5240 '(805) 781-7380
"Courtesy & Service"
GERTTFTED UNTFTED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:Dale:0412712018
COUNTY
b SAN LUIS
OBISPO
Facility Name: QWEST COMMUNICATIONS CORP Aoencv
trEHS
trCITY FIRE
lnsoection Tvoe
BRoutine
trReinspection
trChargeable Reinspection
uChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinr
Site Address: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Phone: (720)578-2006
Facility lD: FA0005342
Serial Number: DAUBRYFOB
PROGRAMS INSPEGTED:EHazmat 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.
GRANTED BY (NAME/TITLE):Name: JohnrSharp
tuvillfu4kln
Title: Lead Operations Technician
tw
[*t.^ \
lr, ,n J u$$0
YES NO N/Atrtrtrtrtrtrtrtrtr
trutrEtrtr
trtrtr
trtrtr
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
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 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 1 265.31)
Secondary containment is installed and sufficiently impervious to discharges.
ICHSC 25270.4.5; 40 CFR 1 12.8(cX2)I
GENERAL EH VIOLATIONS
trtrtrER03
tr tr tr FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.2557730000 GPS Goordinates: Lonstitude: -120.6408330000
INSPECTOR: KERRY BOYLE FACILITY REP: John SharP
.l
SUM MARY OF OBSERVATIONSA/IO' -qTIONS
tr No violations of underg )d storage tank, hazardous materials, or ha, Jous 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,
please inform the GUPA 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: QWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION GOMMENTS:
HMBP will be updated for Calendar Year 2018. Facility in good order, no violations noted
INSPECTED BY: KERRY BOYLE
DATE: 04127t2018
NAME OF FACILITY REP: John SharP
SIGNATURE OF FACILITY REP:
STATEMENT OF COMPLIANCE
Gertification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
inspection form
Signature of Owner/Ope Title:- Date
.'
I
.\
Gounty of San Luis Obispo
Environmental Health Services
(805) 781-5544 I
P.O. Box 1489
2156 Sierra Way
San Luis Obispo, CA93406
cffvo[
san luls oBtspo d-
Fire Department (805) 781-7380
2160 Santa Barbara Avenue
San Luis Obispo CA 93401-5240
CERTIFIED T]NIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIALS INSPECTION FORM
EFW data
entry by:
Date: l''
Time:
It{/1
t'
lni
,',,1
_.i i;'
FACILITY NAME:AGENCY
T EHS
CITY FIRE
DEPT
Result Gode: _70 _80 _90
Action Code: _32 _37 _33 _31
n Complaint
Routine Reinspection
Other
ADDRESS:
PHONE:'
I HW Generator n usr n ner !cnmnn,El'Business PlanPROGRAMS INSPECTED:
n aer ncnmnpp'Business Plan n HW Generator E usrREINSPECTION REQUIRED [r'*o ! YES
PERMISSION TO INSPECT: tnspections may involve obtaining photographs, reviewing and copying records, and
determininq compliance with adopted codes. GRANTED BY (NAME/TITLE):
YES N/A
Dnn
COSn!u
ntr
n
n
NOnn!
!tr
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 CCR66265.I6)
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 $ 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 appropriate
equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265,31-
.43)
BPOl
BPO2
BPO3
"tr
tr'n
TROl
TRO2
EROl
ERO2
A
A
ABOVEGROUND PETROLEUM STORAGE TANK ACT
T01 SPCC Plan is reviewed and certi{ied by a registered engineer within last 5 yrs. (40 CFR 112.5(b)
T02 SPCC Plan is maintained on site or nearest field office. (HSC 25270)
materials.htm,to obtain forms to comply with BPO1 TROl EROlGoCOMMENTS
;i
GPS Coordinates: Latitude: _deg decimal min Longitude
INSPECTOR:FACILITY
Environmental Heal.,,.gC&CS
(80$ 7815544
P.O.Box 1489
2156 Sierra Way Ste. B
San Luis Obisoo. CA 93406
Clt!-t ,'sffrlursoBrspo
Fire Deoartment (80$ 7817380
2160 Santa Barbara Avenue
Date: 1010712016
San Luis Obisoo CA 934015240
GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)
HAZARDOUS MATERIAL INSPECTION FORM
Time:
Facility Name: QWEST COMMUNICATIONS CORP
Site Address: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
Agency
trEHS
trCITY FIRE
lnsoection Tvoe
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment Testinr
Phone: (720)578-2006
Facility lD: FA0005342
Serial Number: DAJX60Z4P
PROGRAMS INSPECTED:trHazmat flHW Generator trUST trAGT trCalARP trTPE
REINSPECTION REQUIRED:EHazmat DHW Generator trUST trAGT trCalARP trTPE
PERMISSION TO INSPEGT: Inspections may involve obtaining photographs, reviewing and copying records, and
determining compliance with adopted codes.
GRANTED BY (NAME/TITLE): Name: John Sharp Title: Lead Operation Tech
-frf
YES NO N/A BUSINESS PLAN
tr tr tr BP01 Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)
tr tl tr BP02 lnventory of hazardous materials is complete (HSC 25504, Title 19 CCR 2729)
tr tr tr BP03 Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR 2729)
TRAINING PLAN
tr tr tr TROI Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)
tr tr tr TR02 Training documentation is maintained on site for current personnel (Title 19 CCR2732 &22
ccR) 66265.16
EMERGENCY RESPONSE PLAN
tr tr tr ER01 Emergency response/contingency plan is complete, updated, and maintained on site (HSG
25504, Title 19 CCR 2731 & 22 CCR S 66265.53/54)
tr tr tr ERO2 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 -.37,66267.34 (dX2), 40CFR 1 265.31)
tr tr tr ER03 Secondary containment is installed and sufficiently impervious to discharges.
[cHSc 25270.4.5; 40 CFR 112.8(cl(2ll
G E N ERAL EHIIIOLAI.IQNS
tr tr tr FE01 Environmental Health fees paid. ICBPC {7200, Local Ordinance]
GPS Goordinates: Latitude: 35.2557730000 GPS Coordinates: Lonqtitude: -120.6408330000
INSPECTOR: KERRY BOYLE FACILITY REP: John SharP
SUMMARY OF OBSERVATIONSMOhATIONS
tr No violations of undergt )d storage tank, hazardous materials, or ha ilous waste laws/regulations were
discovered. SLO GUPA greatly appreciates your efforts to comply with a,,rtne 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,
Dlease inform the CUPA in writinq.
ALL VTOLATIONS 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: QWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REQUIRED
INSPECTION COMMENTS:
Hazardous Materials Business Plan will be updated and submitted electronically via "E Z Submit Portaf'
Facility well managed, and good employee training program.
One diesel generator on site with less than 1,320 gallon capacity so no need to submit Spill Prevention
Control and Countermeasure.
INSPECTED BY: KERRY BOYLE
DATE: 1ot0712016
NAME OF FACILITY REP: John SharP
SIGNATURE OF FACILITY REP:
&
STATEMENT OF COMPLIANCE
: I certify under penalty of perjury that this facility has complied with the corrective actions listed on
inspection form.
nature of Owner/Ope Title: Date
SUMMARY OF OBSERVATIONSA/IOI ATIONS
tr No violations of underg ' ;nd storage tank, hazardous materials, or h tdous waste laws/regulations were
discovered. SLO CUP/ -.batly appreciates your efforts to comply with ail the laws and regulations applicable to you
facility.
tr Violations were observed/discovered as listed below. All violations must be corrected by implementing the correctil
action listed by each violation. lf you disagree with any of the violations or corrective actions required, please infort
the CUPA in writinq.
ALL VTOLATIONS MUST BE CORRECTED WITHIN 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 $25,000 for each violation. Your facility may
be reinspected any time during normal business hours.
You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed
corrective actions. The issuance of this Summary of Violations does not preclude the GUPA from taking
administrative, civil, or criminal action.
FACILITY NAME: QWEST COMMUNICATIONS CORP ADDRESS: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
VIOLATIONS
VIOL. NO CORRECTIVE ACTION REOUIRED
INSPECTION COMMENTS:
Annual inspection, good employee training program and record keeping. No changes to chemical
inventory. Hazardous Materials Business Plan has been updated and submitted electronicallyviaEZ
Submit Portal. No violations noted during facility inspection.
INSPECTED BY: KERRY BOYLE
DATE: O7t2Ol2O15
NAME OF FACILITY REP: Patrick Tavlor
SIGNATURE OF FACILITY REP:
I?,-At"l €P-2
STATEMENT OF COMPLIANCE
Certification: lcertify under penalty of periury that this facility has complied with the corrective actions listed on
this inspection form.
Signature of Title: Date
*L\.\
Environrr"er rt!l Health Services
(80$ 7815544
P.O.Box 1489
2156 Sierra Way
San Luis Obisoo. CA 93406
$ts'fii"o**rc
Fire Department (805) 7817380
2160 Santa Barbara Avenue
Date: 0712012015
San Luis Obisoo CA 934015240
GERTTFIED UNTFIED PROGRAM AGENCY (CUPA)
HMARDOUS MATERIAL INSPECTION FORM
Time:
trAGT trCa|ARPDHW Generator trUSTPROGRAMS INSPECTED: ltrnazmat
trAGT trCalARPtrHW Generator trUSTREINSPECTION REQUIRED: lnHazmat
Facility Name: QWEST COMMUNICATIONS CORP
Site Address: 3610 SACRAMENTO DR
SAN LUIS OBISPO, CA 93401
GRANTED BY (NAME/TITLE): Name: Patrick Taylor
BPOl
BPO2
BPO3
TROl
TRO2
EROl
ERO2
ERO3
lnsoection Type
trRoutine
trReinspection
trChargeable Reinspection
trChange of Ownership
trComplaint
trSecondary Containment Testing
trChargeable Secondary Containment TestinE
trTPE
trTPE
Title: Lead Operations Technician
Aoencv
trEHS
trCITY FIRE
Phone: (720)578-2006
Facility lD: FA0005342
Serial Number: DAPOHTPY2
PERMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and
copying records, and determining compliance with adopted codes.
\Pt---'
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 GCR 2732 & 22 CCR 66265.16)
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 (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 , 66267 .34 (dX2), 40CFR 1 265.31)
Secondary containment is installed and sufficiently impervious to discharges'
ICHSC 25270.4.5; 40 GFR 1 12.8(cX2)l
GENERAL EH VIOLATIONS
tr tr tl FE01 Environmental Health fees paid. ICBPC 17200, Local Ordinance]
GPS Coordinates: Latitude: 35.2557730000 GPS Goordinates: Longtitude: -120.6408330000
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YES NO N/Atrtrtrtrtrtrtrtrtr
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INSPECTOR: KERRY BOYLE FACILITY REP: Patrick TaYlor