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Home My WebLink About_196 Suburban Docs!gat&tAT&T Services, IncEnvironment, Health & Safety2600 Camino Ramon, Room 3E000San Ramon, CA 94583May 20,2013Original Via Certified US Mail# 7012 0470 0002 4376 5086Keny Boyle, InspectorCounty of San Luis ObispoEnvironmental Health Services2156 Siena WaySan Luis Obispo, CA93406RE: Completion of Required Follow-Up Action, Your Inspection on 4-16-2013at AT&T Facility 196 Suburban Rd, San Luis Obispo, CA 93401(s8164) ITS #138787Dear Mr. Boyle:We are pleased to report status of the corrective action that you required pursuant to yourinspection referenced above:Status: REQUESTING RETRACTION. The owner/operator pages wereupdated on2/28/13 on the CUPA's local portal.Please contact me at the number below if the retraction of violation mentioned above is notacceptable.SincerelyManagerTel: 916-977-8017Email: pv5698@att.comcc: Karen Marasigan, Area Manager, EH&S PROGRAM CONSOLIDATEDFq"--YIF'ACILITY INFORMATIONHAZARDOUS MATERIALS BUSINESS PLANCERTIFICATION FORM 201 1a;l: : jj.lReturn all forms to:City of San Luis ObisPo2160 Santa Barbara Ave.San Luis ObisPo CA 93401805-78 1-73800Steve SkandersonName of Owner/Operator (Print)January 4,2011DateAssociate-Agent for AT&TTitle:inquirychangeorstoragefacilitylnthishazardoushandlingofsuatrsthethbmittedtrue,informationaccurateaIandcomplete.thatunderstandrevisedHMBPmyrresponseothoseofindividualsfoiblethbtaininginformationreportedIbelieveabove,OWNER/OPERAoTRCERTIF'ICAoNTIIherebyuponundercertifythB,ttoflawpenaltybasedSignature of Owner/OPeratormust be submitted within 30 days of anymaterials which would require updatingpursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous MaterialsBusiness plan (HMBp) certification described below is hereby submitted for the following facility:Facility Name:Pacific Bell Telephonedba AT&T CaliforniaFacility StreetAddress 196 SUBURBAN RDCity:SAN LUIS OBISPOzip:93403I have personally reviewed theHazardous Materials Business Plan currently on file with the CUPA datedlllzBtZOOB and certifr that: (Check one')VThe Hazardous Materials Business Plan is complete and accurate and no revisions are necessary*(See below for details); orRevisions to the Hazardous Materials Business Plan are necessary. The following new or revisedform(s) and/or information are enclosed to reflect the necessary changes:Business Activities formBusiness Owner/Operator Identification form-,,/ Hazardous Materials Inventory form(s)-./,/ Site Map formEmployee Training Program*By checking the top box on this form, you are certifuing that:uy fn. information contained in the annual inventory forms most recently submitted to the administering agency iscomplete, accurate, and up-to-date; andb) Theri has been no change'in the quantity of any hazardous material as reported in the most recently submittedannual inventory forms; andc) No hazardous materials subject to the inventory requirements are being handled that are not listed on the mostrecently submitted annual inventory forms; andd) There have been no substantial changes in the facility's hazardous materials operations which would requirerevision of the current HMBP; ande) The most recently submitted annual inventory forms contain the information required by Section 11022 ofTitle 42 of the United States Code'Business Plan Certification 201I 'IED PROGRAM CONSOLIDATEDFACILITY INFORMATIONBUSINESS ACTIVITIESsl:1$4Page I of I(You may also be required to provide additional information by yourcuPA or local agency')F. LOCALREQUIREMENTSl5Treatment subject to financial assurance requirements (for Permit by Ruleand Conditional Authorizaton)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned on-site?Generate in any single calendar month 1,000 kilograms (kg) (2'200 pounds)or more of federal RCRA hazardous waste, or generate in any single calendarmonth, or accumulate at any time, I kg (2.2 lbs.) of RCRA acute hazardouswaste; or generate or accumulate at any time more than 100 kg (220 lbs') ofspill cleanup materials contaminated with RCRA acute hazardous waste.E, HAZARDOUS WASTEGenerate hazardous waste?Recycle more than 100 kg/month of excluded or exempted recyclablematerials (per HSC 25143.2)?Treat hazardous waste on site?Household Hazardous Waste (HHW) Collection Site?ffives [No nlves fiNo 'o[ves lTNo "lvrs ffiNo',lves f;No',! ves lTNo r+f]vrs fiNo 'au!vrsl4bEPA ID NUMBER -- provide at the top of thispageRECYCLABLE MATERIALS REPORT(one per recycler)ON-SITE HAZARDOUS WASTETREATMENT. FACILITYON-SITE HAZARDOUS WASTETREATMENT-LINIT (one page per unit)CERTIFICATION OF FINANCIALASSURANCEREMOTE WASTE / CONSOLIDATIONSITE ANNUAL NOTIFICATIONHAZARDOUS WASTE TANKCLOSURE CERTIFICATIONObtain federal EPA ID Number, fileBiennial Report (EPA Form 8700-l3A/B), and satisry requirements forRCRA Lagre Quantity Generator.See CUPA for required forms.f.l.,Own or operate ASTs above these thresholds:Store greater than 1,32Q gallons ofpetroleum products (new or used)in aboveground tanks and containersSTORAGED. ABOVE GROUND PETROLEUM[ves ffio 'NO FORM REQUIRED TO CUPASC. UNDERGROUND STORAGE TANKS (USTS)Own or operate underground storage tanks?flves ffo 'UST FACILITY (Formerly SWRCB Fom A)UST TANK (One page per tank) (Formerly Form B)B. REGULARED SUBSTANCESHave Regulared Substances stored onsite in quantities greater than thethreshold quantities established by the california Accidential Releaseprevention Program (CalARP)?lves lTNo +"Coordinate with your local agencYresponsible for CalARP.A. HAZARDOUSMATERIALSHave on site (for any purpose) at any one time, hazardous materials at or above55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressedgas-es (include liquids in ASTs and USTs); or the applicable Federal threshold{uantity for an extremely hazardous substance specified in 40 CFR Part 355,App.nAi* A or B; or handle radiological materials in quantities for which an.rn".g.n"y plan is required pursuant to I 0 CFR Parts 30, 40 or 70?fivEs lNo oHAZARDOUS MATERIALSINVENTORY. CHEMICALDESCRIPTIONDoes your facility...If Yes,lease complete theseofthe UPCF..NOTE: If you check YES to any part of this list'Identificationsubmit the BusinessII. ACTIYITIES DECLARATIOSAN LUIS OBISPOBUSINESS SITE CITYCA105coDE 93403BUSINESS SITE ADDRESS 196 SUBURBAN RD103(Same as FACILITY NAME of DBA-Doing Business AS)Pacific Bell TelephoneCompany dba AT&T CaliforniaBUSINESS NAME3FACILITY ID#UseFAO002817EPA ID# (Hazardous Waste OnlY)cAT0800242682I. FACILITY IDENTIFICATIONUPCF Rev. (1212007)Printed: l/9/201 I NAME OF SIGNER (Print)136Steve SkandersonAssociate - Agent for AT&TTITLE OF SIGNER137/SIGNATURE OFJan.4,20ll134)ATENAME OF DOCUMENT PREPARERStantec Consulting Services lnc.135ItY oflaw thatfamiliar with the information subritted and believe the information is true, accurato, and complete.I have personally examined and amADDITIONAL LOCALLY COLLECTED INFORMATION805-245-4197132#..AGER#127800-566-9347 (800-KNOW-EHS)800-566-9347 (800-KNOW-EHS)126131PHONEPHONE805-546-7416877-322-4722125130PHONEPHONEEnvironmental Site Manager24 HR EMERGENCY SERVICE124129Sharon RamirezAT&T EHS HOTLINE123128IV. EMERGENCY CONTACTSSECONDARYPRIMARYSONTACT MAILING CITYSan Luis ObisPo120STATE'121CA122ZIP CODE93401119Morro St. Room 104872]ONTACT MAILING ADDRESS119aCONTACT EMAILs16541@att.comSharon Ramirez117118114115116III.NAMEPHONE805-546-7416MAILING CITYSan RamonSTATECAZIP CODE94583f,WNERMAILING ADDRESSP.O. Box 5095, Room 3E000't 13Pacific BellTelephone Company dba AT&T California111112109110NAMEOPERATOR PHONE416PHONE925-823-0725OPERATORNAMESharon RamirezBUSINESS MAILING CITYSan RamonSTATE1 08cCA94583ZIP CODE1 08dMAILINC ADDRESSP.O. Box 5095, Room 3E000108107PRIMARY SIC4813't0-340-1618DLTN BRADSTREET't 06107aPRIMARYNAICS517110CASUSINESS SITE CITYSAN LUIS OBISPO104105ZIP CODE93403]OIJNTY 108SAN LUIS OBISPOSITE ADDRESS196 SUBURBAN RDFAX103'lO2aPHONE805-546-74163102dba AT&T Californiaone comPacific BellTDBA - Doing Business As)USINESS NAME (Same as FACILITY NAME orBUSINESS OWNER/OPERATOR IDENTIFICATIONFAo00281 7100101'7- ol|,1 1:'iID#,|DATE11't2t31t2011FACILITY INFORMATIONCONSOLIDATED FORMDATEUPCF (Rev. 12/2007)Printed: 11912011t \ t'r, 1;r:,,b4\ .T.,IED PROGRAM CONSOLIDATED FOIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246areatSreaterpresentcomponentsIf morehazardousorthmt%ifnon-carcinogenic,byweightpapercarcrnogenlc,weightif%by0.ofadditionalsheetsattachrequiredinfomation.capturingthe242243244!v" Elu"2454250239240f}r". Elu"2413234l3J236flr., Elu"2372230231232[r.' E]u"255zzo227ES228nu"229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!u. euoveAMBIENr [c. BELOWAMBIENT !o cnvoceNlcXSTORAGE TEMPERATUREA, AMBIENT225STORAGE PRESSUREA. AMBIENTABOVE AMBIENT!c. BELow AMBIENT224ABOVE GROUND TANKLTNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERH.I. CYLINDERRAIL CAROTHERFIBERDRUMBAGBOXfla. cALLoNSlTl t. cuerc FEEr n c. PouNDS fl a. roNsone item221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218WASTEAMOUNT219STATE WASTE CODE220XXXa. FIRE,b. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)l-l a. soLID ! u. r,rOuroXone item only)c. GASSTATE214LARGESTCONTAINER 222215a. PURE ! u. rralxrune I c. wASrEX(Check one itemMATERIAL211X212RADIOACTIVENoYes213CURIESFG/ UR IICODE HAZARD CLASSES(Complete ifrequired by CUPA)21074-86-2209If EHS is "Yes", all amounts below must be in lbs.ACETYLENENAME207I v.' E*oEHS208ACETYLENENAME205!XNoto206IfTRADE SECRETYesreferII. CHEMICAL INFORMATTONI,jID#1FA000281 7203MAP# (optional)I204GRID# (optional)F5STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRA202NOYEShone Company dba AT&T CaliforniaNAME3Pacific BellTelepF'ACILITY INFORMATIONLADDXDELETEREVISE200of\UPCF (Rev. 1212007)Printed: 119120114l\1/ 9|jd4L .FIED PROGRAM CONSOLIDATED FOHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page par material per building or trea)IIEPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246areatgreaterpresentcomPonentsIf morehazardousoft%bythan%0,non-carcrnogenlc,weightifweightifcarcinogenic,bysheetsofpaperatlachadditionalrequiredinfomation.capturingthe5242243244!v.' Ehl"2454238239240f]r.' Eht"2413234235236!v.' Elu"2372230231o232[r"' Eh,233226227f]v". Du"228229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!c. BELOWAMBIENT f]o' cnvoclNtcXSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTIu225STORAGE PRESSUREA. AMBIENTABOVEAMBIENT!c. BELow AMBIENT224ABOVE GROTIND TANKTINDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONPLASTIC,O{ONMETALLIC DRUM223AINERft,CANCARBOYsILoRAIL CAROTHERnI o. roNsone item221a.GALLONSCUBICFEETb.POLTNDS222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOLINT 218AL WASTE AMOUNT219220TE WASTE CODEI a. nrne ! u. nracrlveXXc.PRESSURE RELEASEd. ACUTE HEALTHn e.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)I a. soLID ! u.r-rqunXc. GAS214one item only)STATELARGESTCONTAINER 222215X(Check one itema. PUREc. WASTEb. MIXTUREMATERIAL211X212NoRADIOACTIVE! Yes213CURIESNON-HAZARDOUSCODE HAZARD CLASSES(Complete ifrequired bY CUPA)2107440-37-1209IfEHS is "Yes", all amounts below must be in lbs.ARGONNAME207I v" E*o208ARGONNAME205I v.'Xto instructionsto EPCRA,TRADE SECRETNo206II. CHEMICAL INFORMATIONID#1FA000281 7203MAP# (optional)IF5204GRID# (optional)STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAlvrs E*o202hone Company dba AT&T CaliforniaNAME?Pacific BellTelepLINFORMAADDDELETEREVISE200ta of\\\\UPCF (Rev. 1212007)Printed: 11912011 ^FIED PROGRAM CONSOLIDATED FO\HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)L:;1,1 ii4If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246componentslf moreatgreaterpresenthazardousorbyweightthant%byweight%0.if non-sarcinogenic,attachadditionalifcarcinogenic,capturinglhesheetsofpaperrequiredinfomation.5C242Amines243244!v.' Ehl"68439-80-5245410238Polyosobutenyl Succinimide239o240[r.' Eh,67762-77-0241310234PETROLEUM SOLVENT, REFINED235[r.' E]u" 23664741-97-5237240230BASE STOCK231232!v* Elu"64741-88-4ZJJl7ozzoSOLVENT REFINED PETROLEUM OILS227228flr.' Elu"64741-89-5229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#E u. otutu"r nr.fl.STORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENT[u. cnvocexrc225Eu'otutttutfl..STORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223i. FIBER DRUMPLASTICAIONMETALLIC DRUMI. CANBAGBOXCYLINDERRAIL CAROTHERCARBOYsIoa. GALLONS [u. cuelcrerr! a. roNsXone itemc. POUNDS221222DAYS ON SITE:365VERAGE DAILY AMOIJNT217DAILY AMOLTNT 218WASTEAMOUNT219TATE WASTE CODE220! u. nEacrIVE n c.pRESSURE RELEASE lTl o. acure HEALTH ! e.CHRoNIC HEALTHXa. FIRE216HAZARD CATEGOzuESall that apply)! a. soLID I u. r.rourn fl c. ces214one item only)STATELARGESTCONTAINER 55215I a.PUnEl_| c. wASrEX(Check one itemb. MIXTUREMATERIAL211XRADIOACTIVE212NoYes213CURIEScL ill-B/ IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209lfEHS is "Yes", all amounts below must be in lbs.AUTOMATIC TRANSMISSION FLUIDNAME207XI v.'NoEHS208NAME205Xrefer to instructions! v.'NoTRADE SECRETto206II. CHEMICAL INFORMATIONACILITY ID#1FA000281 7203MAP# (optional)1204GRID# (optional)F5STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESone Company dba AT&T CaliforniaINESS NAME5Pacific BellTelephI. FACILITYADDDELETEREVISE200Paee [O of IUPCF (Rev. 1212007)Printed: 11912011u(lv ,T.-IED PROGRAM CONSOLIDATEDFOIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)$1:164IIf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246componenlstreIf morepresenthazardousatorweightifo/obygreater thanpaperbyweight0.non-carclnogenlc,tvoadditionalsheetsifcarcinogenic,attachtherequiredcapturingofinfomation.s 0.5242Sulfur243244!v", E]l"7704-34-9245499238Distillates, Straight Run Mid)?,4o240fl".' Eh,6BB1 4-87-924131234ETHYL BENZENE235eso236100-41-423721230NAPHTHALENE231232[r.' E]u"91 -20-3233lloo226DIESEL FUEL#2227228[r"' EN"68476-34-6229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#Eu.oru,r*t [t.fl'STORAGE TEMPERATUREABOVE AMBIENTBELOWAMBIENTflo. cnvocaurc225Eu. ot"tu*t f]u. anovrAMBIENr flc. BELOWAMBIENTSTORAGE PRESSURE224ABOVE GROTIND TANKLTNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223E;.I. CYLINDERTORAGERAIL CAROTHERFIBERDRUMBAGBOX! u. cuarcFEEr flc. PouNDS! a. roNs 221Xone itema. GALLONS222DAYS ON SITE:365VERAGE DAILY AMOLINT217DAILy AMOLINT 218WASTE AMOLINT219220TE WASTE CODE! u. neecuvE fl c.PRESSURE RELEASEXXa. FIREd. ACUTE HEALTHI e.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)! a. soLID! c. GesXb. LIQUID214one item only)STATELARGESTCONTAINER 1OO215I a.runenXc. WASTEb. MIXTURE211(Check one itemMATERIALX212NoRADIOACTIVE! ves213CURIESCL IU IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)21068476-34-6209IfEHS is "Yes", all amounts below must be in lbs.DIESEL No.2 LS (DYed)NAME207X! v.'NoEHS208NAME205XTRADE SECRET206NoYesrefer to instructionsII. CHEMICAL INFORMATIONID#IFA000281 7203MAP# (optional)1F7204GRID# (optional)PARKING LOT - WESTLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOflvesPacific Bell Telephone Company dba AT&T CaliforniaNAMEaI. FACILITY INFORMATIONADDDELETEREVISE200oflPageUPCF (Rev. 1212007)Printed: 11912011(,V 't- .TFIED PROGRAM CONSOLIDATEDFOiHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)itir: 134Please SADDITIONAL LOCALLY COLLECTED INFORMATIONIfHere246componentslf moreatgreaterpresenthazardousorbythant%t%by0.ifnon-cucinogenic,weightcarcrnogenlc,attachweightifcapturingthesheetsofpaperadditionalrequiredinfomation.242243244!v.' Eh,"2454239240flr.' Elu"241J234zJc236[r., EN"2372230USED OIL231ffr.' Elu" 2328002,05-9233I toozzoUSED OIL FILTERS227[r.' E]u"2288002-05-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!u. anovaAMBIENT !c. BELOWAMBIENT [o' cnvocENtcXSTORAGE TEMPERATUREA. AMBIENT225!rXSTORAGE PRESSUREA, AMBIENTABOVEAMBIENTl.lc. BELowAMBIENT224ABOVE GROTIND TANKLTNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOCLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERE;.I. CYLINDERRAIL CAROTHERFIBER DRUMBAGBOXf] a. cALLoNS E b. cuBIC FEErfla. roNs 221Xone itemc. POIJNDS222DAYS ON SITE:365217DAILY AMOLTNTDAILY AMOLTNT 218WASTEAMOLTNT219220STATE WASTE CODE223a. FrRn ! u. nEecuvE fl o.PRESSURE RELEASE ! a. acuru HEALTHXXe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)a. SoLID ! u. r-rqulo ! c. cesXone item only)STATE214LARGESTCONTAINER 2OO215a. PURE ! u, ulxruna [l c. wASrE(Check one itemMATERIAL211XNo212RADIOACTIVEYes213CT]RIEScL ilr-Bi IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209If EHS is "Yes", all amounls below must be in lbs.DRAINED USED OIL FILTERSNAME207! v..XNoEHS208NAME205Yesrefer toEtolo206IfTRADE SECRETINFORMATIONILACILITY ID#1FA000281 7203MAP# (optional)I204GRID# (optional)F4EAST SIDE OF SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAXn202NOYESe Company dba AT&T CaliforniaNAME?Pacific BellTelephonFACILITY INFORMATIONADDDELETEREVISE2001 of IUPCF (Rev. t212007)Printed: 11912011rt[v FOiL .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)ADDITIONAL LOCALLY COLLECTED INFORMATIONHerePlease246mor€Ifarecomponenlsgrcaterpresentathaardousbyweighl%thanbyweight0.ti f non-carci nogenic,%additionalsheetscarcrnogenrc,ailachiftherequiredofpapercapluringinfomation,5242243244[v.' E]u"2454238239240flr.' Elu"2413234235230ffr" Ehl"237)230231232[v.' Ehl"233226227[r.' f]u"228229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!un..XSTORACE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT!0. cnvocrNrc225n..STORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOWAMBIENT224ABOVE GROLTND TANKUNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAIL CAROTHERn a. GALLoNSb. CUBIC FEEr n c. PoIINDS[0. roNsXone item221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218WASTE AMOUNT219ATE WASTE CODE220! a.Frne ! u.neecrrvE E o.pRESSURERELEASE ! a,acurrHEALrH ! e.cHRoNIcHEALTHall that apply)HAZARD CATEGORIES216trI c. cesone item only)a. SOLIDb, LIQUIDSTATE214LARGESTCONTAINER 225215a. PURE I u. rralxrunE f] c. wASrEX211(Check one itemMATERIALXYes212RADIOACTIVENo213CUzuESNON.HAZARDOUSCODE HAZARD CLASSES(Complete ifrequired by CUPA)2107440-59-7209IfEHS is "Yes", all amounts below must be in lbs.HELIUMNAME207XYesNoEHS208HELIUMNAME205E*on206IfTRADE SECRETYesrefer toCHEMICAL INFORMATIONACTLITY ID#IFA000281 7203MAP# (optional)1F3204GRID# (optional)STORED IN OFFICELOCATIONLOCATION CONFIDENTIAL EPCRAX202NO! vesPacific BellTelephone Company dba AT&T CaliforniaNAME3I.FINFORMATIONADDDELETEREVISE200\t of\UPCF (Rev. 1212007)Printed: 119120'11 ffIED PROGRAM CONSOLIDATEDFOiHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne psge per material per building or area)1:>t: ''t4PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246morearepresentathaardousIfcomponentsorgreaterthanbyweight%byweightvo0.if non-cacinogenic,additionalsheetsifcarcinogenic,attachofpaper capturingtherequiredinfomation.5242243244!v.' Eh,"2454238t?olY* Elu" 24o2413234235[r.' Eh," 23623722z3vADDITIVES231232flv., EN.PROPRIETARY233l99226LUBRICATING BASE OIL227228[r.' E]u"229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTflr, anovnAMBIENrBELOWAMBIENT[0. cnvocrNlc225[u. enoveAMBtENr n..XSTORAGE PRESSUREA. AMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAJONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERH.RAIL CAROTHERa. GALLONS ! u. cuntcreerI a. roNsXone itemc. POUNDS221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218WASTE AMOUNT219ATE WASTE CODE220! u.nnacIVE n c.PRESSURERELEASE ! O.eCUTEHEALTHXXa. FIREe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)! a. soLIDXc. GASb, LIQUID214one item only)STATELARGESTCONTAINER 75215f] a. runeX(Check one itemc. WASTEb. MIXTUREMATERIAL211XYes212RADIOACTIVENo213CURIEScL ilt-BCODE HAZARD CLASSES(Complete ifrequired by CUPA)21020sIfEHS is "Yes", all amounts below must be in lbs.HYDRAULIC FLUIDNAME207! v.'XNoEHS208NAME205nYesrefer toE*oto206lfTRADE SECRETII. CHEMICAL INFORMAACILITY ID#1FA000281 7203MAP# (optional)1F5204GRID# (optional)LOCATIONSTORED IN SHOPLOCATION CONFIDENTIAL EPCRAX202NOYEShone Company dba AT&T CaliforniaNAME3Pacific Bell TelepI. FACILITY INFORMATIONADDDELETEREVISE200ofUPCF (Rev. t212007)Printed: 11912011r\t" I TFIED PROGRAM CONSOLIDATEDFO;HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or aea)3l:1ii4If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246componentsareIf moreorgrealerpresenthaandousalweightiflo/obythanifcarclnogenlc,byweight0,non-carclnogenrc,1o/opaper capturingthesheetsofattachadditionalrequiredinfomation.5242243244!v.' Elu"2454234239o240$.' Eh'241320234ADDITIVES235o236flr.. B,Proprietary23721230ZINC COMPOUND231232flr.. Eh,"PROPRIETARY233lss226LUBRICATING BASE OIL227228f}'" Elu"229VoWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!u. noovrAMBIENr n',XSTORAGE TEMPERATUREA. AMBIENTBELOWAMBIENTno. cnvocsNtc225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTl-lc. BELowAMBIENT224ABOVE GROI.IND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223E;.i. FIBER DRUMPLASTICAIONMETALLIC DRLMRAIL CAROTHERBAGBOXCYLINDERCANCARBOYSILOlTla. cALLoNS!u. cunrcFEEr Ec. PouNDSI a. roNs 221one item222DAYS ON SITE:365VERAGE DAILY AMOUNT 217DAILY AMOUNT 218WASTE AMOUNT219220TE WASTE CODEI a.nrne I t,nracuvE n 0.PRESSURERELEASE ! O.eCUTeHEALTHXe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)! a. soLIDXc. GASb. LIQUID214one item only)STATELARGESTCONTAINER 55215! a. runeX(Check one itemc. WASTEb. MIXTUREMATERIAL211X212RADIOACTIVENoflves213CURIEScL ilt-B/ IRR210CODE HAZARD CLASSES (Complete if required bv CUPA)209If EHS is ''Yes", all amounts below must be in lbs.MOTOR OIL (AllGrades)NAME207X! v.'NoEHS208NAME205Xn v.'206IfNoTRADE SECRETrefer to instructionsII. CHEMICAL INFORMATIONACILITY ID#1FA000281 7203MAP# (optional)1204GRID# (optional)F3.G4STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESPacific Bell Telephone Company dba AT&T CaliforniaS NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page { ofUPCF (Rev. 1212007)Printed: 11912011\\n/ . ,FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSFOIHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)lil,164If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246moreIfarecomponentsatgreaterhazardouspresentorweightifto/obythanvoby0.non.carclnogenlc,ifcarcinogenic,attachweightcapluringthesheetsofpaperadditionalrequiredinfomation.5242243244!v.' Elu"2454238t20[r.' Ehl" 24o241J234235236[r.' Eh,"2372230231232fir.' Elu"ZJJ226227flr.. flu"228229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#flu. eeoveAMBrENr [c. BELOWAMBIENT [o' cnvocnNlcXSTORAGE TEMPERATUREA, AMBIENT225nu.aN,rsrpxt Eu ABovEAMBIENt n.'STORAGE PRESSUREBELOW AMBIENT224ABOVE GROI,JND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223fti. FIBER DRUMPLASTICA{ONMETALLIC DRUMTORAGEAINERRAIL CAROTHERCANCARBOYSILOBAGBOXCYLINDERn a. GALLONSb. CUBIC FEEr fl c. PoUNDS! o. roNs 221Xone item222DAYS ON SITE:365VERAGE DAILY AMOLTNT217DAILY AMOUNT 218WASTE AMOUNT219STATE WASTE CODE220I a. rrne I u. nnacrrvnl-l e.CHRONIC HEALTHXc.PRESSURE RELEASEd, ACUTE HEALTH216HAZARD CATEGOzuESall that apply)I a. soLID I u. r.rqumXc. GAS214one item only)STATELARGESTCONTAINER 222215I a.run-e I u.nlxrune n(Check one itemc. WASTEMATERIAL211XYesNo212RADIOACTIVE213CURIESCODE HAZARD CLASSES(Complete ifrequired by CUPA)210OX7782-44-7209IfEHS is "Yes", all amounts below must be in lbsOXYGENNAME207! v.' Et"EHS208OXYGENNAME205El*oto206IfTRADE SECRETYesrefer toINFORMATIONII. CHEMICALACILITY ID#FAo00281 71203MAP# (optional)I204GRID# (optional)F5LOCATIONSTORED IN SHOPLOCATION CONFIDENTIAL EPCRA202NOYESe Company dba AT&T CaliforniaINESS NAMEaPacific BellTelePhonI. FACILITY INFORMATIONXADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11912011 I ,IFIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSFO!HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)sLa ai4If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246moreIfarecomponentsalgreaterhaardouspresentorweightbythanl%by0.non-carcinogenic,ifpaperifcarcinogenic,ottachweightcaPturingofadditionalsheetstherequiredinfomation.s 0.1242Ethyle Mercaptan243244!v* Eh"75-08-124545238Total Butanes239o240flr'. Eh,24178-28-536234Ethane235ffr" Eh,"23674-84-0237235230231PROPYLENE[r.'232115-07-1233lgo226PROPANE227228[r" E]u"74-98-6229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#Iul-lc, BELow AMBIENT !u' cnvocENtcXSTORACE TEMPERATI.JREA. AMBIENTABOVE AMBIENT225nSTORACE PRESSUREA. AMBIENTABOVE AMBIENTnc. BELOWAMBIENT224ABOVE GROUND TANKUNDERGROI.JND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAIONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223RAIL CAROTHERf]4. roNs 221a,c.GALLONSCUBICFEETb,POUNDSITS*one item222DAYS ON SITE:36sVERAGE DAILY AMOUNT217DAILY AMOLTNT 218WASTE AMOLINT219STATE WASTE CODE220! u. neecuvE E o.PRESSURE RELEASE!XXall that apply)a. FIREe.CHRONIC HEALTHd. ACUTE HEALTHHAZARD CATEGORIES216I a. soLID I u. r.rquro ! c. ces214ICAL STATEone item only)LARGESTCONTAINER 368215a. PURE lTl u. r'lxrunn I c, wASrE211(Check one itemMATERIAL212YesRADIOACTIVENon213CURIESCODE HAZARD CLASSES(Complete ifr€quired by CUPA)210FG74-98-6209If EHS is "Yes", all amounts below must be in lbsPROPANENAME207XYesNoEHSn208NAME205EtoTRADE SECRETton206Yesrefer toINFORMATTONII.ID#IFA000281 7203MAP# (optional)1204GRID# (optional)D4STORED IN YARDLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESUSINESS NAME Pacific Bell Telephone company dba AT&T california3I. FACILITY INFORMATIONADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11912011Jttu \--,IFIED PROGRAM CONSOLIDATED FO^HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)st.i 6nIf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246morepresentathazardouslfarecomponentsorthangrealerweightifo/obyifcarcrnogenrc,byweighl0.non-carclnogenlcl%sheetsof paperattachaddilionalrequiredinfomation.capturingthe5242243244!v" Elu"2454238239ES240241340234WATER235236!v"' Elu"7732-18-523721230DIETHYLENE GLYCOL231232flr.' Elu"1 1 1 -46-6233lso220ETHYLENE GLYCOL227[r* E]u"228107-21-1229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#flc. BELOWAMBIENT !o' cnvocrNtcXSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENT225IuXSTORAGE PRESSUREA. AMBIENTABOVE AMBIENT[c. BELow AMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINCSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYsIoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223E;.RAIL CAROTHERa. GALLoNS fl u. cuuc neer!a. roxsXone itemc. POUNDS221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOLTNT 218WASTE AMOTINT219220343ATE WASTE CODEfl a. nrnr I u. neecrrvE E c.PRxsSURE RELEASEXXd. ACUTE HEALTHe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)[-l a. soLIDXone item only)c. GASb, LIQUIDSTATE214LARGESTCONTAINER 55215! a. runn I u, rrarxruneX(Check one itemc. WASTE211MATERIALX212NoRADIOACTIVEf]Yes213CURIEScL ilt-B/ tRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209IfEHS is "Yes", all amounis below must be in lbs'USED ANTIFREEZENAME207I v.' E]"oEHS208NAME205Xto instructionsto EPCRA,! v.,TRADE SECRETIfNo206II. CHEMICALINFORMATIONID#1FA000281 7203MAP# (optional)1204GRID# (optional)F4STORED EAST SIDE SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAXNOYES202one Company dba AT&T CaliforniaUSINESS NAME3Pacific BellTelephF'ACILITY INFORMATIONADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11912011t( \,. {IFIED PROGRAM CONSOLIDATEDFo^HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)s':1{tiIf EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246arepresentcomponentsIf morehazardousatOT%bygreater than1o/oby0.non-carclnogentc,weightifpaperifcarcinogenic,attachweightcapturingofadditionalsheglstherequiredinfomation.242243244f]v.' EN"2454238239240[r.' Eh,"2413234235236[r., Elu"2372230231[r.' E]u" 232233zzoI 1ooMOTOR OIL, USED227[r.' Elu"2288002-05-9229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!un..XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT[0. cnvocnNtc225f]r. anovn AMBIENT n..XSTORAGE PRESSUREA. AMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAIONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERE;.I, CYLINDERRAIL CAROTHERFIBERDRUMBAGBOXa. GALLONS nl. custcpeern c. POUNDSflo. roNs 221Xone item222DAYS ON SITE:365VERAGE DAILY AMOI.INT217DAILY AMOUNT 218AL WASTE AMOLTNT219220TE WASTE CODE221a.FrRE ! U.neecIVE ! 0.PRESSURTRELEASE I O.nCUTTHEALTHXXe.CHRONIC HEALTH216HAZARD CATEGOzuESall that apply)I c. casXone item only)a. SOLIDb. LIQUIDSTATE214LARGESTCONTAINER 240215[..runr !I c. wASrE(Check one itemb. MIXTURE211MATERIALYes212RADIOACTIVEEl*o213CURIEScL ilr-B/ IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209If EHS is "Yes", all amounts below must be in lbs.USED MOTOR OILNAME207X! v.,NoEHS208NAME205E*oto206IfTRADE SECRETYesrefer toII. CHEMICAL INFORMATIONlD#IFA000281 7203MAP# (optional)1204GRID# (optional)F4,F5WEST SIDE OF SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESPacific BellTelephone Company dba AT&T CaliforniaNAMEJI. FACILITY INFORMATIONADDDELETEREVISE200Pageof\UPCF (Rev. 1212007)Printed: 11912011/LLlu MAP# ISITE VIAPRsr-Bn2-o11DNE 1ffi%'T-BUSINESBUSINESS ADDRESSS NAME AT&T Colifornio SNLOCAAU SE164196 SUBURBAN RDSAN LUIS OBISPO-..r'.-..-.u--r-lrt-'tOFFI93403DRAWING SCALENOT TO SCALEZIP CODE2345b78tlacu,caIDz@{llmm-{@A@@@@@-lio_olCLARlFlaUJo&UzoIo-UJUFiltEl5-p3fLUUIPORTABLE100 Gots. GENERATORHTLIUMHYDRAULIC FLUIDARGONOXYGENWASTE ANTIFREEZEMKALPACIFIC BELL/AT&T1383 N. Mcoo{€i; Bl'd.Petolumo, CA U.S-A.SYMBOL LEGENDEMERGENCY SHUT DOWNtlso-st |$$1;$D MSDSL FIRE HYDRANIFCFENCEEMERGENCY RESPONSEEQUIPM EN T/ABSORBEN TSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(coMBUSTIBLE LIOUIDS)BATTERY ELECIROLYIE(CORROSIVE LIQUID) ^-\GASOLINE 1(FLAMMABLE LIQUIDS, )DIESEL FUEL(COMBUSTIBLE LIOUIDS)NITROGEN(coMPRESSED GAS)PROPANE(FLAMMABLE LIOUID)ACETYLENI(cOMPRESSED GAS)AN TIFREEZI/COOLAN TSWASTE OIL(FLAMMABLE LIOUID)FIRE PULL BOXFLAM|llABLES CABINET+ DRAINAGE FLOW DIRECIIONAUTO.TRANS. FLUIDF@@@e,@lv\e-JL']iA-A@@@oo@o@@@#@C(----tTANK MONITORINGALARMTELEPHONEFIRST AID KITFIRE EXTINGU1SHERSTORM DRAINSANITARY SEWERSTACING AREAEVACUATION/ELECTRICAL PANELSHUT_OFFNATURAL GASSIUT_OFFWATER SHUT-OFFo!aoFCFCSTORAGEooooSTORAWATERTANKADMINISTRATIONBUILDINGF@I9BcDEFGHJ4/r< IdFtL t c0PyPacific BellUnderground Storage Tank(s)Written Monitoring ProceduresandEmergency Response PlanL996Bell - SE164(Faciliry Name and ID)196 SUBURBAN RD.(Faciliry Address)SAN IIIIS OBISPO(Faciliry City)AN LI]IS OBISPO(Faciliry County)^tPnflffirtN[[g8ztI hereby certify that all monitoring and maintenance of the UST(s) and equipment willbe conducted as required by Article 5, Title 23, CCR. To the best of my knowledge,under penalty of perjury, that the information containeC in this Underground StorageTank Monitoring Plan is true and correct. I undersl'r hat I may be required to showproof of compliance during any facility inspection coi,u ,..:ted by local, County, State orFederal authorities.Fnvironmental Manasement#r/efrPrint NameNancv ClancvCertificationDateTirleAuthorizedpg.L2 t: t$ q h riffffAr0 ?1,$ tI { #{[ {; u$, UST Monitori& Resonse Plan{nFaciIiInformationDate2r996City: San Ramon Zip:9a583-0995City: Sacramento Zip: 95860-1883Shift 3 Employees:Shift 3 Start:Shift 3 End:SE164Facility ID:cAT080024268EPA ID#:P O Rnv 601RR?Billing AddressP O Rox 5O95 Room 1N200Mailing Address:81Uniform Building Code Class.g?40?City: SAN LUIS OBISP ZipBusiness Typ1S6 STIBITRRAN RI-)Street Address' Deeific Rell (SNLOCAIR'lFacility NameD & B#: 10-340-1618 SIC Code: 4811Shift 2 Employees:Shift 2 Start:Shift 2 End:Shift 1 Employees:Shift 1 Start:Shift 1 End:e' TelecommunicafionGeneral InformationBILL KEENANSite ManagerEmergency Control Center24 hours/dayNancv ClancvCorp6rate ErivironmentalManagementRobert H. Lee & Associates. IncMr. Steven A. SkandersonEnvironmental ManagerPacific BellP.OSanRoomBox1N200Property Owner:Mailing Address:HMMP Contact:Title:Phone Number:800-765-1025Executive Contact:Title:Phone Number:5t0-823-4401Phone Number:91,6-977-7777Phone Number:415-331.-0924Primary Contact:Title:Secondary ContactPhone Number:41.5-33r-0924: 94583-0995ContactsFacilityWater Table (ft):UNKNOWNEarthcuake Fhults:None within I mileFlood Zone:unknownSnecial Land Uses (within) 1 mile)Direction Business NameContactPhoneAdjacent PropertiesDirectionNorth:South:East:WestBusiness NameVACANT LOTINDUSTRIALINDUSTRIALContactPhoneps. 1 tlST Monito& Response PlanilAll PersonnelInternal Notification:Offsite Notification:ER Plan Location:Evac. Procedures:Spill Procedures:Chemical HandlersHand/Store Method:PPE:Spill/Fire Equip:Exposure Hazards:YesYesYesYesYesN/AYesYesYesEmersencv Rmnonse DocumentsVerify ftaining YesDesc. training: Yes3 year archived YesDrill documentation YesEmerpencv Resnonse TeamRescue: NoShutdown: YesER Equip. Maint: YesER Procedures: YesAnnual Retrain: YesEmergency Response TrainingEmergency Response PlanFacility Name: Pacific BellDate: ApAl2, L996Facility ID:SE164Evacuation NotificationShouting: YesHorns: YesAlarms: YesP A Systems: YesTelephones: YesEvacuation ProceduresAssembly Area: YesMaps: YesRe-entry: YesEmergency ContactsEmergency: 916-977-7777Fire/Police/Ambulance: 91,1State Agency: 800-852-7550Other Agency Name: San Luis Obispo Co.Environ. Health DeptOther Agency Phone: 805-781-5555Nearest Medical Facility: dial 911 for local assistanceName:Address:City:Phone:Other Evacuation Planning InformationEmergency Response:Pacific Bell Emergency Control Center: 916-977-7777 Q4 hrs. a day)Abnormal, hazardous ancl emergency conditions which may effect service, company building and/or adversepublicity should be reported to the Emergency Control Center. This organization maintains the names, homeaddresses and phone numbers (office and home) of contact persons who are qualified and authorized to assistfederal, state and local emergency response personnel in the event of an emergency. The center is manned on a24-hour per day, 7-day per week basis.Emergency Response Trainingpe.2 UST Monito& Response PlanPersonal Protection EquipmentCommunication DevicesSpill Control EquipmentVeeder Root TLS-350Equipment Location:Responsible Inspector: Sacramento Fuel UnitLocation: 2 of 2Inspection Frequency : DailYPersonal Protection EquipmentFirst-Aid KitsEye Wash stationsGlovesHard HatsSafety GlassesCommunication DevicesTelephonesVerbalPa SystemAlarmsPagersLocation: L of 2Inspection Frequency: MonthlYEquipment Location: Engine RoomResponsible Inspector: Power SupervisorSpill Control BquinmentBroomsFire ExtinguishersNeutralizersEmergency Response EquiPlnentEmergency Response PlanFacility Name: Pacific BellDate: April 2, 1996Facility ID:S8164pg. 3 Inventory control monitoring of thq fuel and long term.tank monitoring fo^r prqgygt !91t19e is accomplished within-tin[ c"ontinuous product fronitoring provided lhrough the installation of the TLS-350 Tank Level Sensormanufactured by Veeder-Root.The TLS-350 consists of a Computerized Inventory Monitor (CIM) and one Digital Sending Probe (DSP) for eachtinl U"i"g tnonitored. The highly accurate, all elictronic probe has no.mo-ving p_arts f9r gleater accuracy-andiesi mainienance than other elEctio-mechanical, float-type devices. A single CIM can handle multiple probes andcontinuously monitor each one, analyzing their signals for liquid, temperature, depth and water level.Based on this input, the CIM computes volumes and stores this information for remote polling. The.RE-232CSeiial tnterface bommunication p6rt permits access to TLS-350 information from remote locations via telephoneiines. This serial interface is cafrable of handling up to 16 polling stations_from centralized remote locations'The output of the serial port can be formatted for teletype or computer (IBM-PC) interface.the RS-232 Telecommunications Interface.The Tank Inventory Report presents the current status of each tank. It provides station location, date and time,volume and level of fuel, water level and temperature.Interstitial/Piping Sump Leak monitoring will .b9 plovlde{. us-ing two tiryi{annular spacd anl in tlie tank manhole space. The LED display on the TLScause and location.sensors placed in the double wall tankconsole will flash indicating the alarmThe Automatic Delivery Increase Report features are generated two minutes after fuel is delivered to the tank.The printout includes date, time, volirme and temperature before and after the increase and the net increase oflnvVeeder Root - TLS-350Tank Monitoring EquipmentFacility Name: Pacific BellDate: April 2, 1996Facitity ID: SE164pacific Bell's UST/IS database system automatically calls the TLS monitoring system and "reads" alarms and tankdita four times per day. The alirms are investigatild by olrr personnel in the centralized Fuel AdministrationCenter located in Sacramento, California.sSiteRealEstateFacilFuelAdministratorCentervlaanarmontoAIof"InCaseinstructedcontactdevicethethepanelfollowing:PowerRoomevlceoneventInanarmsitethetheafeTLSdPowerRoom/FleetconditionthealpersonnelAlarm ConditionsAll equipmentmaintained inTheRecertification of Monitoring Devicepg. 4 UST Monito& Response PlanEmergency Response PlanFacility Name: Pacific BellDate: April 2, L996Facility ID: SE164Separation of MaterialsThis facility does not store material by type of quantity which requires special separation consideration. The facility wasdesigned to prevent fire or explosion in accordance with applicable National Fire Prevention Association Guidelines andlocal fire codes. The material of construction is compatible with the product stored.The tank(s) is secured to prevent unauthorized inputs or withdrawals.Monitoring Program' Fuel Storage TanksThe monitoring program consists of an "initial" precision leak test using the Horner "Ezy-Chek" technique (or equivalent)followed by in-tank product monitoring.RecordkeepingRecordkeeping is accomplished by a mechanized database that automatically polls the in-tank monitor daily. Records willbe made available to any agency of jurisdiction within 24 hours via fax. Requests for data should be called to PacificBell's Sacramento Fuel Unit on 91,6-972-4377 .All recordable leaks and spills will be recorded on a Hazardous Material Incident Report, Form Number FR-0023Emergency EquipmentA number of fire extinguishers are kept on the premises at all times. They are placed at strategic locations throughoutthe facility in accordance with the protection requirements of NFPA 10. Additional emergency equipment will beobtained as needed form Pacific Bell contracted hazardous material and hazardous waste handling vendors.The flre extinguishers are maintained and serviced by a professional outside contractor on a yearly basis.A visual inspection is made by the facility wardens on a regular basis to ensure the adequacy of the emergency equipment.Contingency PlanUnauthorized releases (leaks and spills) of petroleum products will be recorded utilizing the Hazardous Materials IncidentReport Form Number FR-0023 and reported by the operator of the underground storage tank immediately to thefollowing:1) San Luis Obispo Co. Environ. Health Dept, 805-781-55552) Office of Emergency Services 800-852-75503) National Response Center 800-424-88024) Pacific Bell Emergency Control Center 916-977-77775) Environmental Management (415) 331-09246) Real Estate Department Reports Center 800-953-10067) Respective upper management within grouppg. 5 UST Monitorin& Response PlanEmergency Response Plan (cont.)Facility Name: Pacific BellDate: April 2, L996Facility ID: SE164In case of fires, the local Fire Department and Pacific Bell Emergency Control Center will be notified promptly by theoperator of the underground tank.In each step of notification, documentation will be prepared to include:1) Location2) Specific description and location of the area involved3) Time and date of occurrence4) Description of spill and type of material5) Approximate quantity of material that spilled/leakedAll recordable leak and spill records will be maintained on the site.The key personnel on the site (Building Warden and Site Manager) are trained for responding appropriately to any majorcatastrophe.A training program conducted by the training department of Pacific Bell provides the information to the key personnelregarding emergency telephone numbers, reporting requirements, location of emergency equipment and evacuationprocedures.This information is true and correct. If there is any change which would materially effect the Hazardous MaterialManagement Plan, we will amend the appropriate sections.pg. 6 "UST Monitor& Response PlanPiping Construction: Double WallPiping Material: EFPiping Type:Tank Number:OTank Capacity:I20Fuel:WASTE OILWall:Installation: 190Tank Manufacturer:Tank Material:Tank Number:OTank Capacity:0Fuel:Wall:Installation:19Tank Manufacturer:Tank Material:Tank Number:0Tank Capacity:0Fuel:Wall:Installation:0Tank Manufacturer:Tank Material:TANK #6TANK #5TANK #4Tank Number:Zo30Tank Capacity:6016Fuel:UNLEADEDWall:DWInstallation:1995Tank Manufacturer:MOD WELDTank Material:COMPTank Number203ITank Capacity:4011Fuel:DIESELWall:DWInstallation: 1995Tank Manufacturer:MOD WELDTank Material:COMPTank Number:OTank Capacity:130Fuel:OILWall:Installation:190Tank Manufacturer:Tank Material:TANK #3TANK #2TANK #1Tank ConstructionFacility Name: Pacific BellDate: April 2, 1996Facility ID: SE164pg.7 BCDate: Aoril 2. 1996 ,-WRITTEN MONITORING PROCEDURESUNDERGROUND STORAGE TANK MONITORING PROGRAMThis monitoring program must be kept at the UST location at all times. The information on this monitoring program areconditions of the operating permit. The permit holder must notify San Luis Obisoo Co. within 30days of any changes to the monitoring procedures, unless required to obtain approval before making the change.Required by Sections 2632(d) and 2641(h) CCR.Facility Name PACIFIC BELL (5E'164)Facilitv Address 196 SUBURBAN RD.. SAN LUIS OBISPA. Describe the frequency of performing the monitoring:Tank: DailyPiping: DailyWhat methods and equipment, identified by name and model, will be used forperforming the monitoring:Tank: Veeder Root TLS-350Piping: Veeder Root TLS-350Describe the location(s) where the monitoring will be performed (facility plot planshould be attached):The monitoring will be performed at the site - the TLS-350 alarm panel is located in theENGINE/POV/ER ROOM and also monitored remotely by the Sacramento Fuel Unit.List the name(s) and title(s) of the people responsible for performing the monitoringand/or maintaining the equipment.Sacramento Fuel Unit, Jeff Kunz \ 916-972-7377Reporting Forrnat for monitoring:Inventory control monitoring of the fuel and long term tank monitoring for productleakage is accomplished with in-tank continuous product monitoring provided through theinstallation of the TLS-350 Tank Level Sensor manufactured by Veeder-Root.The TLS-350 consists of a Computerized Inventory Monitor (CIM) and one DigitalSending Probe (DSP) for each tank being monitored. The highly accurate, all electronicprobe has no moving parts for greater accuracy and less maintenance than other electro-mechanical, float-type devices. A single CIM can handle multiple probes andcontinuously monitor each one, analyzing their signals for liquid, temperature, depth andwater level.Based on this input, the CIM computes volumes and stores this information for remotepolling. The RE-232C Serial Interface Communication port permits access to TLS-350information from remote locations via telephone lines. This serial interface is capableof handling up to 16 polling stations from centralized remote locations. The output ofthe serial port can be formatted for teletype or computer (IBM-PC) interface.D.E.ps. 8 E.G.FReporting ro"rnufor monitoring: (cont.) (-'Th; TLS- System has four modes of operation - Leak Detection, Tank Detection,Interstitial/Piping Sump Lead Detection and Automatic Delivery Reporting. When theleak monitor mode is activated, the TLS System continuously monitors fuel levels in eachtank and can detect losses of 0.2 gph. An hourly report on each tank shows temperature-compensated inventory changes to 0.1 gallon based on inventories when the tank leakmode is initiated. The Leak Monitor is activated through a push-button mounted on thefront panel, or remotely through the RS-232 Telecommunications Interface.The Tank Inventory Report presents the current status of each tank. It provides stationlocation, date and time, volume and level of fuel, water level and temperature.Interstitial/Piping Sump Leak monitoring will beprovided using two liquid sensors placedin the double wall tank annular space and in the tank manhole space. The LED displayon the TLS console will flash indicating the alarm cause and location.The Automatic Delivery Increase Report features are generated two minutes after fuelis delivered to the tank. The printout includes date, time, volume and temperature beforeand after the increase and the net increase of inventory.Describe the preventative maintenance schedule for the monitoring equipment.Note: Maintenance must be in accordance with the manufacturers' maintenanceschedule but not less than every 12 months.A11 equipment used in implementing the monitoring program shall be installed,calibrated, operated and maintained in accordance with the manufacturer's instructions,including routine maintenance and service checks. The system is inspected once percalendaiyear by a third party in accordance with Article 5, Title 23, CCR. Copies ofthe receriification report shall be sent to the administering agency and copies will bemaintained on site.Describe the training necessary for the operation of UST system, including piping'and the monitoring equipment:The key personnel on the site are trained for responding appropriately to any majorcatastrophe. A training program conducted by the training department of Pacific Bellprovides the information to the key personnel regarding emergency telephone numbers,reporting requirements, location of emergency equipment and evacuation procedures.Al personnel involved with maintaining the monitoring system have been trained andcertified by the manufacturer of the equipment in accordance with Article 5,TitIe23,CCR.ps. 9 1EMERGENCY RESPONSE PLANUNDERGROUND STORAGE TANK MONITORING PROGRAMThis monitoring program must be kept at the UST location at all times. The information on this monitoring program areconditions of t[e operating permit. The permit holder must notify San Luis Obispo Co. in 30days of any changes to the monitoring procedures, unless required to obtain approval before making the change.Required by Sections 2632(d) and 2641(h) CCR.Facility Name Pacific Bell (SE164)Facility Addresc 106 SIIRTTRRANPT) SAN T TTTS ORTSPIf an unauthorized release occurs, how will the hazardous substance be cleaned up?Note: If released hazardous substances reaches the environmentr increase the fire orexplosion hazard, are not cleaned up from the secondary containment within 8hours, or deteriorate the secondary containment, then San Luis Obispo Co.Environ. Health Dept must be notified within 24 hours. If an unauthorized releaseoccurs contact the authorized person(s) listed below in #5. They will make arrangementswith Pacific Bell approved contractor for clean-up.2.Describe the proposed methods and equipment to be used for removing and properlydisposing of any hazardous substances.Immediate Action:a. Notify a responsible manager. Determine nature, location, magnitude and severity ofincident.b. Move people away from the area as appropriate.c. Contain by arranging physical barriers (i.e. dikes, berms, etc.)Use of sorbents (i.e., neutralizers, oil absorbent material, rags, etc.)d. If there has been a release into the annular space of the tank, Paciflc Bell willimmediately order one of their contractors and an approved Hazardous Material/WasteDispositionvendor to the site where removal and cleaning of the annular space wouldbe completed. Testing and replacing of the alarm sensors will be performed asrequired.Describe the location and availability of the required cleanup equipment in item 2above.Spill Control Equipment is located in the ENGINE/POV/ER ROOMDescribe the maintenance schedule for the cleanup equipment.Cleanup equipment is inspected monthly by the Power Supervisor.List the name(s) and title(s) of the person(s) responsible for authorizing any worknecessary under the response plan:BrLL KEENAN I 510-823-4401 I 415-201-7412Emergency Control Center on 916-977-7777 (24 hours a day).Environmental Management Hotline on 510-823-9833 (8am - 5pm).345pg. 10 OvervievID: PSRBCAIAScale:NoneFobles28th StrcetBELL SIIEshopstollBgeolficesindusuialconrmercirlPconmercialHIVERSIDE AVENUE26IHped<28TH STBEETtl24.le,6D;. J*zmatAdministrator'"Chemical Inventory '{& Map Symbols LegendD{lllllard,CbsclBIST - Blasting AgcnrCL- ComhstibleLiquidCCIRR - ConosiveETI - Etiological AgentHfPA- Explosive AEXPB - E:rplosiveBHtPc - ExplosiveCFG-FlunmableGasFL- Flammable LiquidFS - Flammable SolidIRR -IniatingMaterialNFG - Nonflanmable GasORM A - Other Regulatcd Material AORM B - Other Regulated Mareriat BOiltvt C - Ohcr Regulated Mat€rlal CORM D - O0rcr Rcgulated Material DORME - Otlrer RegulatedMat€rial EOXY-OxydizerPEROX -OrguicPeroxideFOIS A-PoisonAPOIS B - PoisonBRAD -RadioactiveMao Synbols- Knox Box-MSDS Files- Storm Drain- Sewer Drain- Abovcgroud Sorage Tank- Undergrowd Storage Tank- Fire Extinguisher- FireHydrant- Dnrmmed Hazardous Waste- Flammable MaterialPhyslcalSl$rM-MixureP - PureW-WasteL -UquidS - SolidG-GasMaxasMaximum quantity on sitc atany time during the yearMcLlVesselMaximum quantity in any onevesselAI8aly,Average quantity on siteduring the yearEAI,Waste Annual ThmughputContalnerTyD.A- AboveGmundTankB- Below GroundTankC- Tank Inside BuildingD- StcclDrumE- Plastic orNon-metal DmmF- CanG- CarboyH- SiloI- Fib€rdrumJ- BagK- BoxL- CylinderM- Glass Bottle or JugN- Plastic Bottle or JugO-ToteBinP-Tank WagonQ- Rail CarR- Other [User Defined]@ -RadioacriveMarerialE/ -t"tuinslecuical PanelGA -c.rMainshut-offWA -wurrMAinShutoffhessure= - Equal to Ambient> - Greater0un Ambient< - Less than AmbientTemoerature=-EqualoAmbient> - Greater than Ambient< - Less than AmbientCRY- CryogenicHealth CodesF- FlammableP- Stored under high hessurcR- RcactiveA-AcuteC-Chonicr#tall)CI0trIBl@oe(f,til,m,i6:Ennffi- Emergency Reqponse Equipnent- Main Enrance- Emerge,ncy Exit- Hazmat Sorage Locations- Detail Mapd- hessurized Gas n AN ESoP cormrNv (-ROBERT I{. LEE & ASSOCIATES, INC.AncnrrncruRE Pr,,lNxrxc ExvTnoNMENTAL Snnvrcrcsll37 Nor.rn McDowrr,r, Br,vo., Prrer,uul, CA 94954-lll0 Meu,woPnoNs 707-765-1660 Fs 707-765-9908Aoonrss: P.O.JOHN W. JOHNSONArchitectCo-Pr$identBRIAN F. ZITAArchitectCo-Presid€ntJOHN B. HICXSArchit€ctvi@ PresidentCEICIL R. SPENCERArchitectvice PresidentCHRIS LAWTONAssociateJAMES E. PRESTENAssociateJAMtr.S H. RAYCivil EngincrRE: UNDERGROUND STORAGE TANK WRITTEN MOMTORING PLANSBRUCE J. GREENFIELDArchitectAssociateDear Spencer Meye.rHOWARD G. XIMURAAssociateApril 16, 1996Spencer MeyerSan Luis Obispo City Fire Depaftment748 Pismo StreetSan Luis Obispo, CA 93401Enclosed are the Underground Storage Tank Monitoring Plan(s) and related documents for thePacific Bell facility at 196 Suburban Road, San Luis Obispo.If there are any further correspondences related to these submissions, please direct them to:Pacific BellNancy Clancy2600 Camino Ramon, Room 1N201San Ramon, CA 94583Sincerely,ROBERT H. LEE & ASSOCTATES, rNC.Steven A. SkandersonProject ManagerEnclosureNancy Clancy - Pacific BellFilef : \hazmat\pacbell\forms\A GENCY. LTRGARY M. SEMLINGArchitectAssociateBLYTHE R. WILSONArchitedAssociatecc:fiffivriliJ$lPfl lsstf,'xx.?o4'Mlnrrrte, GA S.e,cur,mNro, CA Brr,r,nvw, WALil HABRA, CAScorrsoar,e, AZOL' *?GTCF-.irt5;"i-s.q a1998 UPGRADE CERI'IFICAI!; NUMBER (ror local use only)429STATE UST FACILITY NUMBER (For local use only)424Environmental AssociateTITLE OF APPLICANT-NAME oF AFPLICANT (print)Armi D. Strickland426(800) 7s7-657s425PHONE10109/2000424DATEDANTF*-Certification - I certiff that the information provided herein is tnre and accurate to the best oflny knowledge.VII. APPLICANT SIGNATT]RE-eheck one bbx to indicate which address should be used for legal notitications and mailing.Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 is checked.E l.FACILMY T]2. PROPERTYOWNER E3.TANKOWNER421VI. LEGAL NOTIFICATION AND MAILING ADDRESSINDICATE METHOD(s) EX 1. SELF-INSUREDE 2. GUARANTEEE 3.INSURANCEE4. SURETYBOND E 7.STATEFUNDE 5. LETTER OF CREDIT E 8. STATE FIJND & CFO LETTERE6.EXEMPTTON E9.STATEFUND&CDE 10. LocAL GOVT MECTTANISME 99.OTHER: _422V. PETROLETJM UST FINANCIAL RESPONSIBILITY3TY (TK) HQ 44-4I9ICall (916) 322-9669 ifquestions arise421IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOI]NT NTJMBEREx l. CORPORATION E 2. INDIVIDUALE 3. PARTNERSHIPlJ 4. LOCALA0bNCY /DrSlruUl'E 5. COUNTYAGENCYLl 6. STATEAGb,NUYE 7. FEDERALAGENCYTANKOWNERTYPE42094583-0995419ZIP CODE418S'IA1'BCACITYSan Ramon4l't_ilM-LINGORSTREETADDRESSPO Box 5095, Room 3E000416(800) 757-6s75415PHONETANROWNERNANiilPacific Bell (SEl64)4t4III. TANK OWNER INT'ORMATIONffi I l.coRPoRATrON E 2.INDIVIDUALE 3, PARTNERSHIPE 4. LOCAL AGENCY / DISTRICTE 5. COTJNTYAGENCYE 6. STATEAGENCYfl 7. FEDERALAGENCY41393401-7524ZIP CQDE4124ltS'IATBCASan Luis ObispoUII I410rvi-ILTNC OR S-TREET ADDRESS--\"'i96 Suburban Road \409(800\ 7s7-6s7s408PHONEPROPERTY OWNERNAMEPacific Bell (SEl64)II. PROPERTY OWNER INFOKTvTA*TION404'IO'IAL NUMIJER OI 'I'ANKSREMAININGAT SITE2'll owner of US l ls a publlc agency: name of sup€rvisor of divlsion, s€ction or ollice whrchoperates the UST (This is the contact person for the tank records.)406Is l'acility on Indian Reservation ortrustlands?IYes fiNo405E r.coRPoRATrONE 2.INDIVIDUALE 3. PARTNERSHIPE 4. LOCAL AGENCY/DISTRICT+E 5. COUNTYAGENCY*E 6. STATEAGENCY*E 7. FEDERAL AGENCY* 4ozf ACILI'I'Y OWNER'I'YPL,TYPE E 2.DISTRIBUTOR E 4.PROCESSORXI 6. OrHER403401NEAREST CROSS STREETStSIIACILTI'Y ID#BUSINESS NAME (sme s SACILITYNAME or DBA - DoingBusiness As) 3Pacific Bell (SEl64)I. FACILITY / SITE INT'ORMATIONE 1. NEW SITE PERMIT E 3. RENEWAL PERMTTE 4. AMENDEDPERMITE T.PERMANENTLY CLOSED SITEE S.TANKREMOVED(Check one item only)TYPE OF ACTION400E 6.IEMPORARY SITE CLOSUREE s.CHANGE OF INFORMATIONspecifu change local use only\i o\ n?.IIIIED PROGRAM CONSOLIDATED FO.TANKSTJNDERGROI]ND STORAGE TANKS - FACILITY(one page per site) Page f of8UPCF (1/99 revised)Formerly SWRCB Form A ESTIMATED DATE LAST USED (YRA4O/DAY)4JllYes I NoTANK FILLED WITH INERTMATERIAL? 457456ESTIMATED QUANTITY OF SUBSTANCE REMAININGgallonsIV. TANK CLOSURE INI.-ORMAI-ION / PI'RMANI'N.I.CLOSUR$ IN PLACIIF DOUBLE WALL I-ANK OR'IANK WITH BLADDER(Check one item only)E 1 VISUAL (SINGLE WALL IN VATJLT ONLY)I 2 CONTTNUOUS TNTERSTTTTAL MONTTORTNGE 3 MANUALMONITORING454IF SINGLE WALL TANK lctrect all that apply)N 1 VISUAL (E)(POSED PORTION ONL9E 2 AUTOMATIC TANK GAUGING (ATG)E 3 CONTINUOUS ATGE 4 STATTSTICAL INVENTORY RECONCILIATION(SIR) BIENNIALTANKTESTINGE 5 MANUAL TANK GAUGING (MTG)E 6 VADOSE ZONEE TGROTJNDWATERE sTANKTESTINGE 99 OTHER453-Itr-fANK LEAK DETECTION (A dscription of the monitoring program shall be submitted to the local agency.)UVI1KIILL PRUIEU IIUN EQUII,MIIN I:YbAR INS I'ALLEL,tr 1 ALARM 1995E2 BALLFLOAT8 3 FILL TUBE SHUTOFF VALVE 1995N 4 EXEMPT4>ZSPT'LANDOVERFILL YEARINSTALLED(Check all that apply) I I SPLL CONTAINMENTE 2 DROP TUBEEI 3 STRIKER PLATE19951995199545o I'YPE (local useonly) 451tr e5 UNKNOWNE e9 OTTmRoTI#R CORROSTON E I MANTACTIJRED CATHODIC E 3 FIBERGLASS REINFORCED PLASTICPROTECTION IF APPLICABLE PROTECTION E 4 IMPRESSED CURRENT(Check one item only) tr 2 SACRIFICIAL ANODE(For local use only)444444WBERLINEDORCOATING E 2ALKYDLINING(Check one item only)E 3.EPOXYLTNTNGE 4PIIENOLICLININGE 5. GLASS LININGE 6I.]NLINED(For local use only)447E 99 OTTTERE 95. UNKNOWN446 DATEINSTALLEDE.3. FIBERGLASS / PLASTICEl 4. STEEL CLAD WFTBERGLASSREINFORCED PLASTIC (FRP)E 5. CONCRETEE 8. FRP COMPTTBLE W100% METTTANOL E 99. OTT{ERE 10. coATED STEELSTEEL(Checkoneitemonly) tr 2. STAINLESS STEEL! 5. CONCRETEE 95. IJNKNOWN 445N 3. FIBERGLASS / PLASTICE 4. STEEL CLAD WFTBERGLASSREINFORCED PLASTIC (FRP)E5. CONCRETE E95. UNKNOWNE 8. FRP COMPTIBLE W/IOO% METHANOL E 99. OTT'IER@BARESTEEL(Checkoneitemonly) E 2. STAINLESS STEEL444E 3. SINGLE WALL WIrHEXTERIOR MEMBRANE LINERE 4. SIGNLEWALLTN VAIJLTlJ 5. SrNUL!; WALL Wl lH lN l ERNAL lrLArJu_BK S Y S l EMEl e5. UNKNOWNE 99. OTHER_TYPE OF TANK(Check one item only)E 2. DOTJBLEWALLE I. SINGLEWALL44JIII. TANKCONSTRUCTIONCAS# lerom Uardous Materials Inventory page )442COMMON NAME (from Huardous Materials ltrventory page)44tTANK USE 43eE 1. MOTORVEHTCLEFUEL(Ifmarked @mplete Petroleum Type)E 2. NON-FTJEL PETROLEUME 3. CTTEMICALPRODUCTE 4. IIAZARDOUS WASTE(Includo Used Oil)D 95. UNKNOWNPETROLEUMTYPEfi la. REGLJLARUNLEADEDE lb. PREMIIJMIINLEADEDI Ic. MIDGRADEUNLEADEDE 2. LEADEDE 3. DTESEL84. GASOHOLE 5. JETFUELE 6. AVTATTONFUELE 99. OTI{ER_440ll. 'IANK CON lr;N lS-D--ITIONAIDESCRIPTIONGoTlo€luseonly)4384J)DAI'E INST'ALLED (Y BA-IVMU)4l9sN UMBER UI UUMPAKT'MEN'I'S2431TANK CAPACTI'Y IN GALLONS60004JOTANKID#20304J2434COMPARTMENI'ALIZED'I-ANK X Yes E NoIf "Yes", @mplete one page for each ompartment.Modern WeldingTANK MANUFACTURER433I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.)LOCATION WITHIN SITE (optional)43tItl'lT.AUILTI'Y IL'3BUSINESS NAME (Same s FACILITYNAME orDBA - Doing Business As)Pacific Bell (SEl64)T\?EOFACTTON E I NEWSITEPERMIT(Check one item only)8 3 RENEWALPERMITD 6 TEMPORARYSITECLOSUREE 7 PERMANENTLYCLOSEDON SITEE 8 TANKREMOVEDvwe/ of 7430(Specify reuon - for local use only) (Specify reuon - for local use only)E 4 AMENDEDPERMIT E sCIIANGEOFINFORMATIONPROGRAM CONSOLIDATEDT]NDERGROT]ND STORAGE TANKS - TANK PAGE 1TAI\KS(two pages per tank)UPCF (l/99 revised)10Formerly SWRCB Form B ,tPermit Number (For local ue only)Pemit Expiration Date (For local use only)Pemit Approved (For locsl use only)475473Sr Environmental Mgr1ILLE OF OWNER./OPEKA IUR[AtvG OF/AMNER"/0PRATOR (print)Stan Blodeckit0/9/00I certify that theprovided herein is true and accurate to the bst ofmy knowledge.IX. OWNER/OPERATOR SIGNATUREE 1. FLOATMECHANISMTTIAT SHUTS OFF SIIEARVALVEE 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMSEl 3. CONTTNUOUS DTSPENSER PAN SENSOR WITH AUTO SHUT OFF FORDISPENSER + AUDIBLE AND VISUAL ALARMSE 4. DArLY VTSUAL CrmCKE 5. TRENCH LINER / MONITORTNGE 6. NONE469DISPENSER CONTAINMENTDATEINSTALLED 468VUI. DISPENSER CONTAINMENTSINGLE WALL PIPING 467PRESSIJRZED PIPING (Check all that apply):E l. ELECTRONTC LrNE LEAK DETECTOR 3.0 GPH TEST !4Tr1 AUTO PUMPSHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AIJDIBLE AND VISUAL ALARMS,E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (O.IGPIDE 4. DArLYVTSUALCHECKCONVENTIONAL SUCTION SYSTEMS (check all that apply)E 5. DAILY VISUAL MONITORING OF PIPING AND PI.JMPING SYSTEME 6. TRIENNIAL INIEGRITY TEST (O.I GPH)SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROI]ND PIPING):E 7. SELFMONITORINGGRAVITY FLOW (Chek all that apply):E 8. DAILY VISUAL MONITORINGE 9. BIENNIAL INTEGRITY IEST (O.I GPIOSECONDARILY CONTAINED PIPINGPRESSIJRZED PIPING (Check all that apply):10. CONTINUOUS TTJRBINE SIJMP SENSOR WITTI AUDIBLE AND VISUALALARMS AND (Checkone)[] a AUTO PIJMP SHUT OFF WHEN A LEAK OCCURSE b AUTO PI]MP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEMDISCONNECTION[c NOAUTOPUMPSHUTOFFfl 11. AUTOMATTC LEAKDETECTORE 12. ANNUAL INTEGRITY TEST (0.1 GPTDSUCTION/GRAVITY SYSTEME 13. CONTINUOUS SIJMP SENSOR + AIJDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (Check all that apply)E 14. CONTTNUOUS SUMP SENSOR WITHOUT AUTO PIJMP SHUT OFF *AUDIBLE AND VISUAL ALARMSf] 1 5. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)E 16. ANNUAL INTEGRITY TEST (O.I GPII)E 17. DAILY VISUAL CIIECKSINGLE WALL PIPING 466PRESSURZED PIPING (Check all that apply):E 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST EITIIAUTO PIJMP SHUTOFF FOR LEAK, SYSTEM FAILIJRE, AND SYSTEM DISCONMCTION +ATJDIBLE AND VISUAL ALARMS.E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (0. IGPIDCONVENTIONAL SUCTION SYSTEMSE 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPINGINTEGRITY TEST (0. 1 GPIDSAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROI'NDPIPING):n 7. SELFMOMTORTNGGRAVITYFLOWE 9. BIENNIAL INTEGRITY TEST (O.I GPH)SECONDARILY CONTAINED PIPINGPRESSURZED PIPING (check &ll that apply):10. CONTINUOUS TLJRBINE SIIMP SENSOR WmIAUDIBLE AND VISUALALARMS AND (Check one)! a. AUTO P{JMP SHUT OFF WHEN A LEAK OCCIJRSE b. AUTO PIJMP SHUT OFF FOR LEAKS, SYSTEM FAILIIRE AND SYSTEMDISCONNECTION!o. NO AUTO PLJMP SHUT OFFEl I 1. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) !4q!FLOW SHUTOFF ORRESTRICTIONE 12. ANNUAL INTEGRITY TEST (O.I GPH)SUCTION/GRAVITY SYSTEME 13. CONTINUOUS SUI\,IP SENSOR + AUDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (Check ail that apply)E 14. CONTINUOUS SIIMP SENSOR WITTIOUT AUTO PIIMP SHUT OFF +AI,]DIBLE AND VISUAL ALARMSE 1 5 . AUTOMATTC LINE LEAK DETECTOR (3 .0 GPH TEST) !4THOlIt FLOWSHUT OFF ORRESTRICTIONE 16. ANNUAL INTEGNTY TEST (0.1 GPH)E 17. DAILYVISUAL CTIECK(A dscription ofthe monitoring program shall be submitted to the local agency.)all thatE I.BARESTEELE 2, STAINLESS STEELE 3. PLASTTCCOMPATTBLE WCONTENTSE 4. FIBERGLASSE 5. STEELWCOATTNGE 6. FRP COMPATIBLE wl00% METr{ANoLE 7. GALVANIZED STEELE S.FLEXIBLE(HDPE) E99. OTTIERE 9. CATI{ODIC PROTECTIONE 95. IJNKNOWN 465E 1. BARE STEEL E 6. FRP COMPATIBLE Wl00% METHANoLD 2. STAINLESS STEEL E 7. GALVANZED STEEL ! UnknownE 3. PLASTIC COMPATIBLE WCONTENTS ! 99. OtherE4.FIBERGLASS Es,FLEXIBLE(IIDPE)E 5. STEELWCOATING E 9. CATHODICPROTECTION 464E 1. STNGLEWALLE 2. DOIJBLEWALLE 95. TJNKNOWNE 99. OTIIER462463MANT]FACTURERCONSTRUCTION E 1. SINGLEWALL E 3.LINEDTRENCH tr 99. OT}IERMANT'FACTURER 8 2. DOIJBLE WALL E 95. TJNKNOWNMANI,]FACTI,]RER ENViTOfl CX46t460D 3. GRAVITY459E I.PRESSIJRE E2. SUCTTONn 3. GRAVITY 458SYSTEM TYPE E I. PRESSI]RE E 2. SUCTIONABOVEGROI]ND PIPINGIJNDERGROUND PIPINGofall thatIFIED PROGRAM CONSOLDATEDTJNDERGROT]ND STORAGE TANKS _ TANK PAGE 2TANKSUPCF (l/99 revised)12Formerly SWRCB Form B lYes ! NoTANK FILLED WITH INERT MATERIAL' 45 /ESTIMATED QUANTITY OF SUBSTANCE REMAINING- gallons456ESTIMATED DATE LAST USED (YR/MO/DAY)455IV. TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACEIF DOUBLE WALL T'ANK OR'I'ANK WTI'H tsLADDER(Check one item only)E I VISUAL (SINGLE WALL IN VAI.JLT ONLY)E 2 CONTINUOUS INTERSTITIAL MONITORINGE 3 MANUALMONITORING4)4IF SINGLE WALL TANK lctrect all that apply)E 1 VISUAL (E)(POSED PORTION ONL9E 2 AUTOMATIC TANK GAUGING (ATG)E 3 CONTTNUOUSATGE 4 STATISTICAL INVENTORY RECONCILIATION(SIR) BIENNIALTANKTESTINGE 5 MANUAL TANK GAUGING (MTG)E 6 VADOSEZONEE 7 GRO{JNDWATERE 8 TANK TESTINGE 99 OrHER453IV, TANK LEAK DETECTION (A description of the monitoring progrm shall be submitted to the local agency.)El l SPLLCONTAINMENTE 2 DROP TUBEEx3 STNKERPLATE199519951995Y-bAI( INS I'ALLEL'4)u I YPE (local use only) 4J ISPILL ANI,' UVI,KI'ILL(Check all that apply)OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452E 1 ALARM E 3 FILL TI.]BE SHUT OFF VALVE 1995E2 BALLFLOAT E4E)GMPTOTIIER CORROSION E 1 MANUFACTI.JRED CATIIODIC EI 3 FIBERGLASS REINFORCED PLASTICPROTECTION IF APPLICABLE PROTECTION E 4 IMPRESSED CI]RRENT(Check one item only) tr 2 S ACP TFICIAT . ANODEE es I]NKNOWNE 99 OTTIER(For local use only)c46444E l.RUBBERLINEDE 2ALKYDLININGE 3. EPOXY LININGE 4PHENOLICLININGE 5. GLASS LININGE 6IJNLINED(For local use only)441446 DA'IE INSIALL!.L'TANK INTERIOR LININGE 95. UNKNOWNE 99 OTTTERORCOATING(Check one item only)TANKMATERIAL-se@ndarytank E l. BARES'f'LliL(Checkoneitemonly) tr 2. STAINLESS STEELE3. FTtsLnGLASS/PLASICE 4. STEEL CLAD WFTBERGLASSRETNFORCED PLASTTC (FRP)N 5. CONCRETEE 5. CONCRETE E 95. UNKNUWN 44)E 8. FRp COMPTTBLE Wn00% METr{ANOL E 99. Orr{ERE 10. coATED STEELTAIII(I\,IATERIAI -primarytank B l. BARESTEEL(Checkoneitemonly) E 2. STAINLESS STEELE 3. FIBERGLASS / PLASTICL: 4. STEEL CLAD WFIBERGLASSREINFORCED PLASTTC (FRP)E 5. CONCRETE E 95. UNKN0WN 444E 8. FRP COMPTIBLE Wn00% METHANOL E 99. OTtmRE 1. STNGLEWALL82. DOUBLEWALLTYPE OF TANK(Check one item only)E 3. SINGLEWALLWTTIEXTERIOR MEMBRANE LINERE 4. SIGNLEWALLIN VATJLTE 5. SINGLE WALL WITII INTERNALBLADDER SYSTEME 95. UNKNOWNE 99. OTr{ER_443III. TANKCONSTRUCTIONCAS# lfrom Huardous Materials lnventory page )442COMMON NAME (from Hurdous Materials Invenlory page)441PETROLEUM TYPEI la. REGULARUNLEADEDE Ib. PREMIUMIJNLEADED! lc. MIDGRADEUNLEADEDE 5. JETFI,]ELE 6. AVIATIONFUELE 99. OTr{ER_82. LEADEDE 3. DIESELE4. GASOHOL440TANK USE 439I 1. MOTOR VEI{rCLE Fr.lEL(If marked omplete Petroleum Type)E2. NON-FUELPETROLEUME 3. CIIEMICALPRODUCTE 4. IIAZARDOUS WASTE(Include Used Oil)E 95. UNKNOWNu. lANl(cONlttNtsADDI'I'IONAL DESCRIPIIION (For local use only)438NUMBER OF COMPARTMENTS437'I'ANK CAPACI'I'Y IN GALLONS4000436435DAI E INS'I'ALLED (YEAIVMO)4195COMPARTMENTALIZEDTANK !Yes ffi NoIf "Ye", mmplete one page for each mmpartment.434TANK MANUFACTURER4332031TANKID#432l. lANl( lr[Scl(lr IION (A scaled plot plan wlm tlre locatton ot the US I system including buildings and landmarks shall be submitted to the local agency.)431LOUAIION WllruN SIIB (optional)ilIFACILITYID:BUSINESS NAME (Same s FACILITYNAME orDBA - DoingBusiness As)Pacific Bell (SEl64)E INEWSNEPERMIT tr 4 AMENDEDPERMIT E sCHANGEOFINFORMATIONE 6 TEMPORARY SITECLOSIJREE 7 PERMANENTLYCLOSEDON SITEE 8 TANKREMOVEDE 3 RENEWALPERMIT (Specifyre6on-forlocaluseonly) (Specifyreroon-forlomluseonly)Paee3 or T430TYPE OF ACTION(Check one item only)PROGRAM CONSOLIDATEDTJNDERGROTJND STORAGE TANKS - TANK PAGE 1TANKSpagestank)IJPCF (l/99 revised)l0Formerly SWRCB Form B Pemit Expiration Date (For local use only)Permit Approved (For local use only)Pemit Numb€r (For local use only)41s4't3Sr Environmental MgrIIILE O} OWNEruOPERA'I'OR4'12NAN,ry/OF OWNER/OPRATOR (print)StarfBrodecki1019100DA'IE47t)I certify that the infomation provided herein is lrue and accurate to the best ofmy knowledge.IX. OWNER/OPERATOR SIGNATUREE 1. FLOATMECHANISMTI{AT SHUTS OFF SIIEARVALVEE 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMSE 3. CONTTNUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FORDISPENSER + AIJDIBLE AND VISUAL ALARMSE 4. DATLYVISUALCTmCKE 5. TRENCH LINER/MONTTORTNGrl 6. NONE469DISPENSER CONTAINMENTDATEINSTALLED 468VIII. DISPENSER CONTAINMENTSINGLE WALL PIPING 46'IPRESSURIZED PIPING (Check all that apply):E I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WTTH AUTO PUMPSHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYS'IE-M DISCONNECTION +AUDIBLE AND VISUAL ALARMS.E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (O.lGPH)E 4. DAILY VISUAL C}IECKCONVENTIONAL SUCTION SYSTEMS (check all that apply)E 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEME 6. TRTENNTAL TNTEGRTTY TEST (0.1 GPr0SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):n 7. SELFMONTTORINGGRAVITY FLOW (Check all that apply):E 8. DAILY VISUAL MONITORINGE 9. BIENNIAL INTEGRITY TEST (O.I GPI{)SECONDARILY CONTAINED PIPINGPRESSURZED PIPING (Check all that apply):10. CONTINUOUS TTJRBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (Check one)I a AUTO PUMP SHUT OFF WHEN A LEAK OCCURSE b AUTO PT]MP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEMDISCONNECTION[c NOAUTOPUMP SHUTOFFE 11. AUTOMATIC LEAK DETECTORN 12. ANNUAL INTEGRITY TEST (O.I GPH)SUCTION/GRAVITY SYSTEME 13. CONTTNUOUS SUMP SENSOR + AUDBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (check all that apply)E 14. CONTTNUOUS SUMP SENSOR WTHOUT AUTO PUMP SHUT OFF +AUDtsLE AND VISUAL ALARMSE 1 5. AUTOMATTC LrNE LEAK DETECTOR (3.0 GPH TEST)E 16. ANNUAL TNTEGRTTY TEST (0.1 GPI{)E 17. DATLYVTSUALCHECKSINGLE WALL PIPING 466PRESSURIZED PIPING (Check all that apply):El l. ELECTRONTC LrNE LEAK DETECTOR 3.0 GPH TEST WrlqlAUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILIJRE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS.E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITYTEST(O.lGPH)CONVENTIONAL SUCTION SYSTEMSE 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPINGINTEGRITY TEST (0. I GII{)SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROIJNDPIPING):E 7. SELFMONITORINGGRAVITYFLOWE 9. BIENNIAL INTEGRITY TEST (0.1 GPIDSECONDARILY CONTAINED PIPINGPRESSURffiD PIPING (Check all that apply):IO. CONTINUOUS TI]RBINE SIJMP SENSOR WITTI AIJDIBLE AND VISUAIALARMS AND (Checkone)I a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURSE b. AUTO PIIMP SHUT OFF FOR LEAKS, SYSTEM FAILIJRE AND SYSTEMDISCONNECTION[c. NO AUTO PIJMP SHUT OFFE l l. AUTOMATTC LrNE LEAK DETECTOR (3.0 GPH TESD Vm! FLOW SHUrOFF ORRESTRICTIONE 12. ANNUAL INTEGRITY IEST (0.1 GPII)SUCTION/GRAVITY SYSTEME 1 3 . CONTINUOUS SUMP SENSOR + ATJDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (Check all that apply)' 14. CONTINUOUS SUMP SENSOR WIfiIOUT AUTO PUMP SHUT OFF *AUDIBLE AND VISUAL ALARMSfl 15. AUTOMATTC LrNE LEAK DETECTOR (3.0 GPH TEST) !4THOgT FLOWSHUT OFF OR RESTRICTIONE 16. ANNUAL INTEGRITY TEST (0.1 GPH)E 17. DArLY VTSUAL CIIECK(Check all that apply) (A description ofthe monitoring prcgrm shall be submitted to the localE I.BARESTEELE 2. STAINLESS STEELE 3. PLASTTC COMPATTBLE W CONTENTSE 4. FIBERGLASSE 5. STEELWCOATTNGE 6. FRP COMPATIBLE wroo% METHANoLE 7. GALVANZED STEELE S.FLEXrBLE(r{DPE) E 99. OTTTERE 9. CATI{ODIC PROTECTIONE 95. UNKNOWN 46sE l.BARESTEEL E 6.FRPCOMPATIBLE wh\o% METHANOLE 2. STAINLESS STEEL E T.GALVANZEDSTEEL I UnknownE 3. PLASTIC COMPATIBLE WCONTENTS ! 99. OfierE 4.FIBERGLASS 8 8. FLEXIBLE(I{DPE)D 5. STEEL WCOATING E 9. CATHODIC PROTECTION 464E 1. SINGLEWALLE 2. DOUBLEWALLMANIJFACTURERE 9s. TJNKNOWNE 99. OTr-rER462463CONSTRUCTION E I . SINGLE WALL E 3. LINED TRENCHMANUFACTURER EI 2.DOIJBLEWALL E 95. TJNKNOWNMANTJFACTTJREN. ENViTOflCX46046tE 99. OTTIERE 3. GRAVITY459E I.PRESSTJRE E2. SUCTTONSYSTEMTYPE E 1. PRESST]RE E 2. SUCTION E 3. GRAVITY 458ABOVEGROT]ND PIPINGI.]NDERGROT]ND PIPINC(Check all that apply)ofPageLrnrfIED PROGRAM CONSOLIDATED FORtdT]NDERGROLTND STORAGE TANKS _ TANK PAGE 2TANKSUPCF (l/99 revised)12Formerly SWRCB Form B Environmental Health ServicesP.O. Box 14892156 Sierra WaySan Luis Obispo, CA 93406Department of Agriculture2156 Sierra Way, Suite ASan Luis Obispo, CA 93401(80s) 781-ss44(80s) 781-s910otyo[sanl.urs(80s) 78r-7380CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)1012112003HOPWOOD, MATTHEWENVIRONMENTAL CONTACTPACIFIC BELL (SE-164)PO BOX 5095SAN RAMON, CA 945830995SUBJECT: REQUEST FOR ANNUAL CHEMICAL II\TVENTORY T]PDATEFACILITY #: FA0002817 196 SUBURBAN RD' SAN LUIS OBISPOPlease review your curent Business Plan for any significant changes that may have taken place within your facilityandlor your chemical inventory. The number of hazardous materials you handle andlor the number of hazardous wastestreams you generate impact your fees. Your fees are based on the hazardous materials business plan we have on filefor your business. We bill annually in December. In order for your bill to accurately reflect your inventory, pleasecomplete and return this form and copies of the attached Form I (if necessary), not later than 12/5/03. Attached is ourlisting of your last reported chemical inventory'If you have made additions/deletions to the listed chemicals, an increase/decrease in quantity, or a change in storagelocation, please notiff us by completing the attached chemical inventory form, and include these changes. If the listedchemicals, quantities, locations, and units are correct, sign this letter and return it to City of San Luis Obispo FireDepartment. R"f"r to the enclosed Hazardous Materials Business Plan Reporting Requirements for reportingrequirements and exemptions.Your inventory will be verified during your next annual inspection. Failure to provide accurate chemical inventoryinformation is a violation of the California Health & Safety Code, sections 25501 through 25515, and may result incivil and/or criminal penalites.If you have questions, please call Kerry Boyle, Hazardous Materials Section, at (805) 781-7383Fire Denartment2160 Santa Barbara AvenueSan Luis Obispo, CA 93401-5240\t\ilL{rr*'ft'''D. Kerry Boyle, Hazardous Materials CoordinatorCity of San Luis Obispo Fire DepartmentThe listed chemicals, quantities, locations, containers, and physical state are correct as listed.The listed information is incorrect or has changed. I have attached a copy of Form I with the correct in-formation for each chemical in our inventory.ISignature- *o".TitleDateRpt. 9612 PACTFTC BELL (SE-164)REQUEST FORANNUAL CHEMICAL INVENTORY UPDATEOur records show you have the following inventory at your facility:NAMECommon: HYDRAULIC FLUIDScientiJic: HYDRAULIC FLUIDCONTAINERS T. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:NAMECorzrzoniP@PAIIBScientitic: PROPANECONTAINERS 1. AGT, CYLINDER,ATEACH 2,LOCATION: 3.DAILY AMOUNTS:LOCATTON(S):1. STORED IN SHOPa3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED IN YARD,3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED IN SHOPa3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1.)3.l0/21/2003PAGE 2Average:Maximum:NAMECommon: LUBE OIL/MOTOR OILScientitic: LUBE OIL/MOTOR OILCONTAINERS 1. AGT, STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:55 GALLONS55 GALLONS3OO GALLONS368 GALLONS90 GALLONSIIO GALLONS56 POUNDS56 POUNDSNAMECommon: WASTE LEAD ACID BATTERIESScientitic: WASTE LEAD ACID BATTERIESCONTAINERS 1. BOX,ATEACH 2.LOCATION: 3.Average:Maximam:DAILY AMOUNTS:PHYSICAL STATE CODE: SOLID f'\\PACTFTC BELL (SE-164)REQUEST FOR ANNUAL CHEMICAL INVENTORY UPDATENAMECommon: NITROGENScientijic: NITROGENCONTAINERS 1. BOX, CYLINDER,ATEACH 2.LOCATION: 3.LOCATTON(S):r. OUTSIDE, BEHIND SHOP YARD,,3.PHYSICALSTATECODE: GASLOCATION(S):I. STORED IN SHOP,,3.PHYSICALSTATECODE: GASLOCATTON(S):I. STORED IN YARD,3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED EAST SIDE OF SHOP)3.1012112003PAGE 3DAILY AMOUNTS:Average:Maximum:NAMECommon: ARGONScientific: ARGONCONTAINERS I. CYLINDER,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:NAMECommon: WASTE OILScientijic: WASTE OILCONTAINERS 1. AGT,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:NAMECommon: WASTE ANTIFREEZEScientiJic: ETHYLENE GLYCOL WASTECONTAINERS 1. NONMETAL DRUM,ATEACH 2.LOCATION: 3.Average:Maximum:2536 CUBIC FEET2536 CUBIC FEET222 CUBICFEET222 CUBICFEETIIO GALLONSIIO GALLONS55 GALLONS55 GALLONSDAILY AMOUNTS:PHYSICAL STATE CODE: LIQUID PACTFTC BELL (SE-164)REQUEST FORANNUAL CHEMICAL INVENTORY UPDATENAMECommon: SUMP (GAS & WATER) WASTEScientitic: SUMP (cAS & WATER) WASTECONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:LOCATTON(S):t.t3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1.2.3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED IN SHOPa3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1.a3.r0t2t/2003PAGE 4NAMECommon: AUTOMATIC TRANSMISSION FLUIDSeientific: AUTCMATIC TRANSMISSION FLUIDCONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:Average:Maximum:NAMECommon: ANTIFREEZEScientific: ANTIFREEZECONTAINERS 1. STEEL DRUM,ATEACH 2,LOCATION: 3.DAILY AMOUNTS:Average:Maximum:55 GALLONS55 GALLONS55 GALLONS55 GALLONS55 GALLONS75 GALLONS55 GALLONS55 GALLONSNAMECommon: WASTE PARTS WASHER SLUDGEScientiJic: WASTE DEGREASER, AQUEOUS PARTS WASHCONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.Average:Maximam:DAILY AMOUNTS:PHYSICAL STATE CODE: LIQUID (PACTFTC BELL (SE-164)REQUEST FOR ANNUAL CHEMICAL INVENTORY UPDATENAMECommon: WASTE OIL FILTERSScientiJic: WASTE OIL FILTERSCONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.LOCATTON(S):1.a3.PHYSICAL STATE CODE: LIQUIDLOCATION(S):1.a3.PHYSICAL STATE CODE: SOLIDLOCATTON(S):1. STORED IN SHOP2.3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. OUTSIDE, BEHIND SHOP YARD"|3.t0/2U2003PAGE 5NAMECommon: OIL & FLOOR SWEEP WASTEScieniijic: PET. HYDROCARBON SOLIIT .il/ASTECONTAINERS I. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Averuge:Maximum:Average:Maximum:55 GALLONS55 GALLONS55 POUNDS55 POUNDSDAILY AMOUNTS:NAMECommon: HYDRAULIC FLUIDScientific: HYDRAULIC FLUIDCONTAINERS 1. STEELATEACH 2.LOCATION: 3.\>r{aat,\DAILYAverage:Maximum:NAMECommon: NITROGENScientific: NITROGENCONTAINERS 1.CYLINDER,AT EACHLOCATION3.Average:Maximam:W6,,n{**ttl55 GALLONS55 GALLONS2536 CUBIC FEET2536 CUBIC FEETvoK ,RucdoAMOUNTS:PHYSICALSTATECODE: GAS PACTFTC BELL (SE-164)REQUEST FOR ANNUAL CHEMICAL INVENTORY UPDATENAMECommon: ARGONScientiJic: ARGONCONT1. CYLINDER,ATLOCATTON(S):1. STORED IN SHOPa3.PHYSICAL STATE CODE: GASLOCATTON(S):1. STORED IN YARD13.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED EAST SIDE OF SHOP,,3.l0/2t/2003PAGE 6DAILY AMOUNTS:NAMECommon: WASTEScientific: WASTEAverage:Maximum:222 CUBIC FEET222 CUBTCFEEToQjcD-,f\Lor/lrrkI3.c'g,{tAT EACH1. AGT,)3.ufltc$"v/AMOUNTSverage:Maximum:NAMECommon: WASTE ANTIFREEZEScientiJic: ETHYLENE GLYCOLCONTAINERS 1.ATEACH 2.LOCATION: 3.DRUM,DAILYAverage:Maximam:NAMECommon: SUMP (GAS & WATER) WASTEScientific: SUMP (cAS & WATER) WCONTAINERS I. STEELATEACH 2.LOCATION: 3.Average:Maximum:IIO GALLONSIIO GALLONSWco''l55 GALLONS55 GALLONSPHYSICAL STATE CODE: LIQUIDLOCATTON(S):1.13.vv"t)lI,^f\'*55 GALLONS55 GALLONSDAILYPHYSICAL STATE CODE: LIQUID DAILY AMOUNTS:NAMECommon: PROPANEScientlfic: PR.OPANECONTAINERS r. AGT, CYLINDER"ATEACH 2.LOCATION: 3.DAILY AMOUNTS:NAMECommon: ANTIFREEZEScientffic: ANTIFREEZECONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:NAMECommon: LUBE OIL/MOTOR OILScienffic: LUBE OILA4OTOR OILCONTAINERS 1. AGT, STEELATEACH 2,LOCATION: 3.DAILY AMOUNTS:PHYSICAL STATE CODE: LIQUID(\, PACI'FIC BELL (SE-164)REQUEST FORANNUAL CHEMICAL INVENTORY UPDATENAMECommon: AUTOMATIC TRANSMISSION FLUIDScientiJic: AUTOMATIC TRANSMISSION FLUIDCONTAINERS I. STEEL DRUM,ATEACH 2.LOCATION: 3.r0t2U2003PAGE 8Average:Maximum:Average:Maximam:Average:Maximum:55 GALLONS55 GALLONS3OO GALLONS368 GALLONS7GALLONS90 GALLONSIIO GALLONSLOCATTON(S):t.a3.SSTATE CODE: LIQUID(s):IN YARD1.aJ.55o([5PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED IN SHOPa3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):1. STORED IN SHOPa3. PACTFTC BELL (SE-164)REQUEST FOR ANNUAL CHEMICAL INVENTORY UPDATENAMECommon: OIL & FLOOR SWEEP WASTEScientiJic: PET, HYDROCARBON SOLID WASTECONTAINERS I. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:NAMECommon: WASTE LEAD ACID BATTERIESScientific: WASTE LEAD ACID BA'I"IERIESCONTAINERS 1. BOX,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:STATE CODE: SOLIDLOCATTON(S):1.,,3.PHYSICAL STATE CODE: SOLIDLOCATTON(S):1.2.3.PHYSICAL STATE CODE: LIQUIDLOCATTON(S):l.,|3.t0l2v20a3'PAGE 7LOCATTON(S):l.,3.55 POUNDS55 POUNDS5656NAMECommon: WASTE OIL FILTERSScientiJic: WASTE OIL FILTERSCONTAINERS 1. STEEL DRUM,ATEACH 2.LOCATION: 3.DAILY AMOUNTS:Average:Maximum:NAMECommon: WASTE PARTS WAScientific: WASTECONTAINERS I.ATEACH 2.LOCATION: 3.55 GALLONS55 GALLONSSLUDGEAQUEOUS PARTS WASH55 GALLONS55 GALLONSvSTEELDAILY AMOUNTSAverage:PHYSICAL STATE CODE: LIQUID Date Run '. 118/032:27:58PMFACILITY INFORFA0002817PACTFIC BELL (SE-164)196 SUBURBAN RDSAN LUIS OBISPO, CA 93401FACILITY PHONEEXT,cep#lf,A-RR"rt(831) 372-2142(877) 322-4722No Primary Emerg. Pager ListedPageEMERGENCY CONTROL CENTER(877) 322-4722(877) 322-4722No Secondary Emerg. Pager Listedf)itt of San Luis ObispoJlHazardous Materials Facility lnventory and Emergency Contact lnformationEMERGENCY CONTACT INFORMATIONPACIFICBELLPRIMARYSECONDARY,*81fi'22.#T=roiffiilILITY OWNER*** Last Hazardous Materials lnventory Release Response Plan Date: NONE ON FILERECORD ID COMMON NAMECHEMICAL NAMEMAXIMUM DAILY AMOUNTLARGEST CONTAINERON SITEHZOOOO563 LUBE OIUMOTOR OILLUBE OIUMOTOR OIL11055 GallonsHZOOOO567 HYDRAULIC FLUIDHYDRAULIC FLUID5555 GallonsH20000570 NITRCGENNITROGEN{r EeA228 Cubic feetHZOO00572 WASTE OILWASTE OIL240120 GallonsHzoooogo3 suMP (GAS & WATER) WASTEsuMP (GAS & WATER)WASTE5555 GallonsHZOOOO9O5 WASTE LEAD ACID BATTERIESWASTE LEAD ACIDBATTERIES567 PoundsH20000907WASTE PARTS WASHER SLUDGE WASTE DEGREASER,AQUEOUS PARTSWASHER5555 GallonsHz:0001743AUTOMATIC TRANSMISSION FLUID AUTOMATICTRA[!9MISSION FLUID55 Gallons./E^tr',({5 .-1fobl+Mlo{lel,iun qtxF4(nl+^u{b,lTtM os,.> J4 C,l55 (t&latloxSite Visit Packet5121t02ity InformationOperator:Facility Name:Address Number:Address:Suite:City:zip:CrossStreet:Parcel No:Phone No:Facility Type:LARRY CODAYPACIFIC BELL SE164196SUBURBAN RDSAN LUIS OBISPO93401 -(408) 554-3557CorporationPermit NoFacility Number:60-0265OwnerName:Address:City:State:zip:Phone:00000-(000) 000-0000Underground Storage TankProperty Owner Name: PACIFIC BELLPhone: 4085543557Mailing/Street Address 196 SUBURBAN RDCity: SAN LUIS OBISPOState CAZip: 93401Owner Type:Status:Permit Expiration Date:iscellaneousSIC CodeDun BradstreetBusiness LicenseGuarantor Number (frT800?Ya G tCurrent Balance: $0.00ailing AddressName:Address:Care Off Address:City:State:zip:Phone:PACIFIC BELL2600 CAMINO RAMON, ROOM 3EOOSTAN BRODECKISAN RAMONCA94583-0995(925) 823-6161Business OwnerName:Address:CitY:State:zip:Phone:00000-(000) 000-ooo0EnvironmentalName:Address:CitY:State:zip'.Phone:Contactmergency contoclsBusinessPhone24HtDoys losf NomeFirsl NqmeTilleM g coDAYLARRYPROPERry MANAGER322-4722 (000)000-0000g EMERGENCYCONTROLCENTER24HR EMERGENCYSERVICE(877)(877) 322-4722LOCAL FACTLTTTES MGR (805) 546-7375 (805) 441-4073nN WALTERSJOE?e #'4se-\otele.nE I.J&,2U.'6umi A i,peJ,ilrrreclJ;/}/ k ilvE@l'q?1'77q \WAddress:196 SUBURBAN RD, SAN LUIS OBISPO60-0265Permit NFacility:PACIFIC BELL SE164Hazardous Materials Business Plan - List of ChemicalsWASTE PARTS WASHERSLUDGEDEGREASER, KT AQUEOUS PARTSCLEANERLiquidGAL5555WASTE OIL FILTERSGAL55WASTE OIL FILTERS55LiquidWASTE OILWASTE OILLiquidGALw)+av120WASTE LEAD ACID BATTERIESLBS56WASTE LEAD ACID BATTERIES7SolidWASTE ANTIFREEZEWASTE ETHYLENE GLYCOLLiquidGAL5555PROPANEGAL368PROPANE250LiquidOXYGENOXYGENGasCU FT124124OIL AND FLOOR SWEEP WASTE55Per. nvonocARBoN sollD wASTE55SolidLBSNITROGENCU FT2536NITROGEN228GasMOTOR OILMOTOR OILLiquidGAL11055HYDRAULIC FLUID55HYDRAULIC FLUID55LiquidGALGASOLINE, UNLEADEDPETROLEUM HYDROCARBONLiquidGAL60006000GAS & WATER WASTEGAL55SUMP WATERWASTE55LiquidDIESELDIESELLiquidGAL40004000ATFGAL55NUTOURTIC TRANSMISSION FLUI D55LiquidARGONARGONGasCU FT222222ANTIFREEZE75ETHYLENE GLYCOL55LiquidGAL118GasCU FT118Common NameChemical NameGrid NoMaximumDaily AmtUnitsPhysicalStateLargestContainerWnW Tf.6bzf rt-'*^Tbel*e- !1,"4r twcTuesday, May 21,2002Page 1 ot 1 ({-'ISite Visit Packet2t12t02Facility InformationOperator:Facility Name:Address Number:Address:Suite:CitY:zip:CrossStreet:Parcel No:Phone No:Facility Type:LARRY CODAYPACIFIC BELL SE164196SUBURBAN RDSAN LUIS OBISPO93401 -(408) 554-3557CorporationPermit NoFacility Number:60-0265perty ownerName:Address:City:State:zip:Phone:00000-(000) 000-0000Underground Storage TankProperty Owner Name: PACIFIC BELLPhone: 4085543557Mailing/Street Address 196 SUBURBAN RDCity: SAN LUIS OBISPOState CAZip: 93401Owner Type:StatusPermit Expiration DateEnvironmental GontactName:Address:CitY:State:zip:Phone:MiscellaneousSIC CodeDun BradstreetBusiness LicenseGuarantor NumberCurrent Balance: $0.00TotfBusiness OwnerName:Address:City:State:zip:Phone:00000-(000) 000-0000PkvMn)qV -0&.Mailing AddressName:Address:Care Off Address:City:State:zip:Phone:n-J:l="@,94583-0995(925) 823-6161PACIFIC BELL2600 CAMINO RAMON, ROOM 3EOOrgency ContactsBusinessPhone24 HrPhonePrimary Days Last NameFirst NameTitlePagerM M coDAYLARRYpRopERTY MANAGER (408) 554-3557 1877l, 322-4722 (OOOI(8771 322-4722 (8771 322-4722EMERGENCYCONTROLCENTER24HR EMERGENCYSERVICEJOELOCAL FACTLTT|ES MGR (805) 546-7375 (805) 441-4073nT WALTERSft'rlUM,TA{lutw Hazardous Materials Business Plan - List of Ghemicals196 SUBURBAN RD, SAN LUIS OBISPOAddress:-0265Permit NoFacility:PACIFIC BELLMaximumDaily AmtGommon Nameical NameTuesday, February 1 2, 2002Page 1 ofGrid NoLargestContainerlPhysicalUnits r State55LiquidGAL55DEGREASER, KT AQUEOUS PARTSCLEANERWASTE PARTS WASHERSLUDGE55LiquidGAL55WASTE OIL FILTERSWASTE OIL FILTERS120LiquidGAL110WASTE OILWASTE OIL7SolidLBS56WASTE LEAD ACID BATTERIESWASTE LEAD ACID BATTERIES55LiquidGAL55WASTE ETHYLENE GLYCOLWASTE ANTIFREEZE250LiquidGAL368PROPANEPROPANE124GasCU FT124OXYGENOXYGEN55SolidLBS55PET. HYDROCARBON SOLID WASTEOIL AND FLOOR SWEEP WASTE228GasCU FT2536NITROGENNITROGEN55LiquidGAL110MOTOR OILMOTOR OIL55LiquidGAL55HYDRAULIC FLUIDHYDRAULIC FLUID6000LiquidGAL6000PETROLEUM HYDROCARBONGASOLINE, UNLEADED55LiquidGAL55SUMP WATERWASTEGAS & WATER WASTE4000LiquidGAL4000DIESELDIESEL55LiquidGAL55AUTOMATIC TRANSMISSION FLUIDATF222GasCU FT222ARGONARGON55LiquidGAL75ETHYLENE GLYCOLANTIFREEZE118GasCU FT118ACETYLENEACETYLENE ,ISite Visit Packet4t6t01Permit NoFacility Number:60-0265Facility lnformationFacility Name:Operator:Address Number:Address:Suite:City:zip:CrossStreet:Parcel No:Phone No:Facility Type:PACIFIC BELLLARRY CODAY196SUBURBAN RDSAN LUIS OBISPO93401 -(408) 554-3557Property OwnerName:Address:City:State:zip:Phone:00000-(000) 000-0000Underground Storage TankProperty Owner Name: PACIFIC BELLPhone: 4085543557Mailing/Street Address 196 SUBURBAN RDCity: SAN LUIS OBISPOState CAZip: 93401Owner Type:StatusPermit Expiration DateMailing AddressName:Address:Care Off Address:City:State:zip:Phone:SBC COMMUNICATIONS, INC.2600 CAMINO RAMON, ROOM 3EOOSAN RAMONCA94583-0995(877) 322-4722Business OwnerName:Address:City:State:zip:Phone:00000-(000) ooo-ooooEnvironmental GontactName:Address:CitY:State:zip:Phone:MiscellaneousSIC CodeDun BradstreetBusiness LicenseGuarantor NumberCurrent Balance: $0.00tr(000) 000-0000EMERGENCYCONTROLCENTER24HR EMERGENCYSERVICE(877) 322-47 22 (87 7) 322-4722CODAYLARRYFACILITIES CONTACT(408) 554-3557 (877)322-4722 (000) 000-0000Emergency ContactsBusinessPhone24 HtPhonePDays Last NameFirst NameTitlePager r\'lCITY OF SAIV LLilS OBISPOFIREDEPARTMENT2160 santa Barbara Avenue * san Luis obispo, cA9340l-5240 * 805-781-7380.r tbu(BUSINESS PLAN UPDATE FORM/F\I FACILITY NAME: Pacific BelI SE164FACILITY ADDRESS: 196RANRD. SANLUISORTSPO CA 93403CONTACT PERSON: DAN VELEZ PHONE NUMBER: 408-554-3557Annual Inventory Update (Due every year by January 1)bl No Significant changes in inventory have occuffed since the last Business Plan or inventory wassubmitted.t ] New inventory forms are attached[ ] Replace previous inventory with attached inventory.[ ] Replace only designated pages of inventory.Additional Comments:Yearly Review and RecertificationtlI certiff that the Business Plan has been reviewed and the information contained in the BusinessPlan is accurate and complete as of this date.Other Updatesl( Please incorporate theinformation into the Business Plan for thisW,T,2v:{facilityerI declare, under penalty of pe{ury, that the information provided herein is true andcorrect to the best of my knowledge.Signature:Printed Name: Steve Skanderson. IU{L Design Group. Agent for Pacific BelPlease Return to: Molly Brown, Hazardous Materials SectionCity Fire Department2 1 60 Santa Barbara AvenueSan Luis Obispo, CA9340l-5240H:/BUSINESS PLAN UPDATE FORM MOLLYThe C1y of San Luis Obispo is commifted to include the disabled in all of its services, programs and activities.Telecommunications Device for the Deaf (805) 781-7410.3i! A'o',tl (print)Steve Skanderson136NAMEOFProject ManagerIITLE OF SIGNER137OF134DATE7/- aaNAME OF DOCUMENT PREPARER 135RHL DESIGN GROUP, INC. - AGENT FOR PACIFIC BELLI certify under penalty of law that I have personally examined and amlamiliar with the information submitted and believe the information is true, accurate, and completeresponsible for obtaining the information,Certification: Based on my inquiry ofthose individualsLOCALLY COLLECTED INFORMATIONPAGER#127408-236-8773132PAGER#877-322-472224-HOURPHONE126877-322-4722z4-HOURPHONE131BUSINESS PHONE125408-554-3557877-322-4722BUSINESS PHONE130Facility Contact124IITLE24 HR EMERGENCY SERVICEIITLE129DAN VELEZ123NAMEEMERGENCY CONTROL CENTER128NAMEIV. EMERGENCY CONTACTSPRIMARYSECONDARYSAN RAMON120CITY121'122CATE94583-0995CODECONTACT MAILING ADDRESS2600 cAMlNo RAMORM 3EOOOT119CORPORATE ENVIRONMENTAL MANAGEMENTACTPHONE800-757-6575ACTNAME117118III. ENVIRONMENTAL CONTACTSAN RAMON114CITYSTATECA'11511694583-0995CODEOWNERMAILING ADDRESS2600 CAMINO RAMON, RM 3EOOOT113PHONE877-823-9833PACIFIC BELL't11112NAMEII. BUSINESS OWNEROPERATORNAMEDAN VELEZOPERATORPHONE406-554-35571'10109SAN LUIS OBISPOCOTINTY108coDE (4 digit #)48111 0-340-1 61 8106-BRADSTREET107SAN LUIS OBISPO104CITYlztP10593403CACODESITEADDRESS196 SUBURBAN RD103(Same as FACILITY NAME or DBA - Doing Business As)Pacific Bell SE164PHONE408-554-3557102NAME3ID#ru11011001t1t2000DATE12t3112000DATEI. IDENTIFICATIONPageof) PROGRAMCONSOLIDATED FORMBUSINESS OWNER/OPERATOR IDENTIFICATIONFACILITY INFORMATIONUPCF (l/99 revised)167oEs FORM 2730 (1/99) Site Visit Packet1t12t01acility lnformationFacility Name:Operator:Address Number:Address:Suite:City:zip:CrossStreet:Parcel No:Phone No:Facility Type:PACIFIC BELLDAN VELEZ196SUBURBAN RDSAN LUIS OBISPO93401 -(408) 554-3557Permit NoFacility Number:60-0265Property OwnerName:Address:City:State:zip:Phone:PACIFIC BELL196 SUBURBAN RDSAN LUIS OBISPOCA9340'1-(805) 564-7375Underground Storage TankProperty Owner Name: PACIFIC BELLPhone: 4085543557Mailing/Street Address '196 SUBURBAN RDCity: SAN LUIS OBISPOState CAZip: 93401Owner Type:Status:Permit Expiration Date:Business OwnerName:Address:City:State:Zip:Phone:Environmental GontactName:Address:CitY:State:zip:Phone:MiscellaneousSIC CodeDun BradstreetBusiness LicenseGuarantor NumberCurrent Balance: $0.00ailing AddressName:Address:Care Off Address:City:State:zip:Phone:SBC COMMUNICATIONS, INC.2600 CAMINO RAMON, ROOM 3EOOSAN RAMONCA94583-0995(877) 823-9833(000) 000-0000EMERGENCYCONTROLCENTER24HR EMERGENCYSERVICE(877) 322-4722 (87 7) 322-47 22VELEZDANFACTLITTES CONTACT (408) 554-3557 (877) 322-4722 (408) 236-8773GontactsBusinessPhone24 HrPhonePrimary Days Last NameFirst NameTitlePager Hazurdous Materiuls Business PIan - List of ChemicalsPermit No: 60-0265 Facility: PACIFIC BELLAddress: 196 SUBURBAN RD, SAN LUIS OBISPOMaximumCommon NameChemical NameAmt UnitsPhysicalStateLargestContainer Grid No55LiquidGAL55ETHYLENE GLYCOLWASTE ANTIFREEZEUSED MOTOR OIL120LiquidGAL110PETROLEUM HYDROCARBON250LiquidGAL250PROPANEPROPANENITROGEN228GasCU FT2536NITROGEN120LiquidGAL120PETROLEUM HYDROCARBONMOTOR OIL55PETROLEUM HYDROCARBONHYDRAULIC FLUIDLiquidGAL556000LiquidGAL6000PETROLEUM HYDROCARBONGASOLINE UNLEADED40004000PETROLEUM HYDROCARBONDIESELLiquidGAL55LiquidGAL55PETROLEUM HYDROCARBONAUTOMATIC TRANSMISSIONFLUID222222ARGONARGONGasCU FT55LiquidGAL55ETHYLENE GLYCOLANTIFREEZEFriday, January 12, 2001Page I ofl (Site Visit Packet1216t99FacilityFacility Name:Operator:Address Number:Address:Suite:CitY:Zip:CrossStreet:Parcel No:Phone No:Facility Type:PACIFIC BELL196SUBURBAN RDSAN LUIS OBISPO93401(805) 546-7375Permit NoFacilitv Number:60-0265MiscellaneousSIC CodeDun BradstreetBusiness LicenseGuarantor NumberStatusPermit Expiration Dateusiness OwnerName:Address:City:State:zip:Phone:Environmental ContactName:Address:CitY:State:zip:Phone:Gurrent Balance: $0.00Property OwnerName:Address:Care Off Address:City:State:zip:Phone:PACIFIC BELL ENVIRONMENTAL MBOX 5095 RM 3EOOOTNANCY CLANCYSAN RAMONCA94583(800) 757-6575OperatorName:Address:City:State:zip:Phone:PACIFIC BELL196 SUBURBAN RDSAN LUIS OBISPOCA93401(805) 564-7375MEMER.CONTROL CTR.(916) 977-7777KEENANBILLSITE MANAGER(51 0) 823-4401 (916) 977 -7777Emergency ContactsPrimary Days Last NameFirst NameTitleBusinessPhone24 HtPhonePager HMMP Range: Not ApplicableTiered Permit(s):CaIARP: NoGhemical Inventory ReportPermit No: 60-0265Chemical Name:CAS NO:Avg Daily Amt:Type:PETROLEUM8006619Grid No:Max Daily Amt:6016n EHSUnits:GA,LPhysical StateLiquidn EHSUnits:GALPhysical State:Liquidn EHSChemical Name:CAS NO:Avg Daily Amt:Type:Chemical Name:CAS No:Avg Daily Amt:TYPe:Chemical Name:CAS No:Avg Daily Amt:TYPe:Chemical Name:CAS No:Avg Daily Amt:Type:Chemical Name:CAS NO:Avg Daily Amt:Type:Max Daily Amt:Max Daily Amt:Max Daily Amt:2400250CU FTGALGas%WT5.00%5.00%21.00%15.00%15.00%050%99.50%100.00%100.00%PACIFIC BELL196 SUBURBAN RDSAN LUIS OBISPO, CA 9340112t6t99CAS#912036847634677824477727379106978748407498674862ComponentsHazardous ComponentACEWLENEEHSnntrnTnTtrunnnnnnnInnnnntrnntrnnnnPETROLEUM68476346Grid No:Max Daily Amt:4011MixtureOXYGEN7782447Grid No:PureNITROGEN7727379Grid No:Max Daily Amt:1 596Units:PurePhysical StateGasPROPANE74986Grid No:UnitsPhysical State:Gasf] EHSGU FTE EHSMixtureACETYLENE74862Grid No:Units:Physical State:Liquidn EHS222CU FTMixture1,2,4-TRIMETHYL BENZENEBENZENEXYLENETOLUENEMETHYL TERT BUTYL ETHER956367143213302071 088831634044PETROLEUM DISTILLATESNAPHTHALENEDIESEL FUELOXYGENNITROGENBUTANE, GASETHANE, LIQUIDPROPANEPure100.00%Physical State:UnitsPage 1 of 2 PureGas't 00.ARGONPermit No: 600265Chemical Name:CAS NO:Avg Daily Amt:Type:Chemical Name:CAS NO:Avg Daily Amt:Type:Chemical Name:CAS No:Avg Daily Amt:Type:Chemical Name:CAS No:Avg Daily Amt:Type:Chemical Name:CAS NO:Avg Daily Amt:TYPe:Max Daily Amt:Max Daily Amt:Max Daily Amt:13055N EHSUnits:GU FTn EHSGALn EHSGALN EHSUnitsGALn EHSGAL85.00%85.00%100.00%2.O0V.3.00%3.00%1.OOo/"94.00%%vlrComponentsHazardous ComponentSOLVENT DEWXD DISTIL HV PARAFFINSOLVENT DEWXD DISTILL LT PARAFFINEHSCAS#647425/.7647426506474265080020s977581147732185PROPRIETARY11146610721164742650647425697440371Grid No222Physical State:PETROLEUM64742650Grid No:trunnnnnnnnxnnnnnTntrUnits:MixturePhysical State:LiquidPETROLEUM HYDROCARBON8002059Grid No:Max Daily Amt:120Units:MixturePhysical State:ETHYLENE GLYCOL107211Grid No:MixturePhysical State:64742569Grid No:Max Daily Amt:55Units:Physical StateLiquidHYDROTREATED DIST HV PARAFFINSOLVENT DEWAXD DIST HV PARAFFINPETROLEUM HYDROCARBONLiquidPETROLEUM DISTILLATESLiquidDIPOTASSIUM PHOSPHATEWATERADDITIVESDIETHYLENE GLYCOLETHYLENE GLYCOLMixture30.00%59.00%Page2of 2 f''rPAGE NO. 1,Buslness ID...: 3320BUSiNESS NAMC,: PACIFIC BEI,L SE164Administrative ReporLDisclosure Packet For Business: [3320] PACIFIC BELL SEI-64BID Range: [3320] To [3320]L1./ L2 / e8Nundcer. .SEreet. .Suite...BuildingCity. . . .State...zip codeMailing NameAttenEion. . .Street......city/sEaEe/zip,:195: SUBURBAN:: SAN LUIS OBISPO:CAt 9340].Business AddressMail j-ng AddressPACIFTC BELI,NANCY CI,ANCYBOX 5095 RM rN200sAN RAMON CA 94s83-099sOmer.. : PACIFIC BELI,Business Phone: (805) 545-'7375Shift HoursBusinegs Hourg Conf actlibleSITE MANAGERAf ter Busi-ness Hours ContactsSITE MANAGERNameB]LL KEENANPhone(s1o) 823-440124 HOURSBILL KEENAN24 I{OURSDoing Business As: PACIFIC BELLEMERGENCY CONTROL CENTERHazardous MaEerlaI Emergency ContactsEMERGENCY CONTROI, CENTER(915)(e15)()977 -'7777977 -7777(9r6) 977-77"17()ceneral and Building Inf ormationBusiness LicenseDun & BradstreetEPA ID.Operation Desc..Shift Hoursl-....shift Hours2,...sh.ift Hours3....sic....uBcL. . .uBc2. . .Non-ProfiE......LoE Size.Number of FloorsReporting Stabus10-340- 16L8CATOS 00242 68TELECOMMUNI CATIONSNumber of EmPloyeegl: 80Number of EmPloyees2 | 0Numlcer of Employees3: 0I'NKNOWN/UNDEFINED1INKNOWN/I'NDEFINEDNO0cA\0fb^{d\6I0\\1 BUSINESS(ES) ],ISTED(t/bbb\$r$ ("chemical Inventories ReportA11 Chemi"cals(In Maxj"mum QuanElty Per Day order)BID Range: 133201 To [3320]Lr/ 12 / 98PAGE NO, 1Trade Namechemical Names/componentsHazCIass Tw DoT#cAs# Ec tMaxPerDay Un Haz Rate LocationMaxPerDayBusiness: [03320] PACIFIC BELL S8L64GASOLINE -UNLEADEDCOMP1: METHYI, TERT'BUTYL ETHERComp2: TOLUENEComp3: XYLENE, LIQUIDDIESET.ComplOXYGENCompl: oxYGEN, CoMPRESSED (DoT)NITROGENCoMPI: NITROGEN, COMPRESSED GAS9 31 3LL63404410888313302075016.0 GA 230501. 654L.4842.2WEST SIDE OF LOT]N SITOPOUTSIDE BEHIND SHOPIN SHOPIN SHOPIN SHOPIN SHOPIN YARDP IN SHOPIN SHOP19 93109I4PROPANECompl" iComP2:Comp3:PROPANEETTIANE, I,IQUIDBUTANE, GASACETYLENECompl: ACETYLENE, GASARGONCompl: ARGON, GASMOTOR OILCOMP1: SOLVENT DEWAXD DIST HV PARAFFINComp2: HYDRoTREATED DIST I{V PARAFFINUSED MOTOR OILCompl" : PETROLETIM DISTILLATEANTI FREEZE - COOLANTCompl: ETHYLENE GLYCOL, LIQUIDComp2 : DIETHYLENE GLYCOLAUTOMATIC TRANSMISSION FLUIDCOMP1: SOLVENT DEWAXED DISTL], IJT PARAFFINCOMP2: SOLVENT DEWAXED DISTLI, HV PARAFFIN268 47 63 461993994011.0 GA 2203970.92L 737 7 82447107202400.0 cF 100 00.0t-37727379L97701s96.0 CF 3000.0I7 49967 4840L0697 I250.0 GA 1400.00.00.0I 287 486210 010222.0 CF r430.0137 44037 L10060222.0 CF 3100.031647 42650647 42547199385B5130.0 GA 120t 10.5110. 529800205972680120.0 GA 3300.09],072LLILr466s5.0 GA Ll-00.619869419647 42569647 4265055.0 GA 11032 .516.5197800059301.1 CHEMICAL(S) ],ISTED1- BUSINESS(ES) LISTED /CITY UF SATT LUIS bBISPOtFIRE DEPARTMENT748 Pismo Street * San Luis Obispo, CA 93401 * 805-781-7380HAZARDOUS MATERIAI.S BUSINESS PLAN TJPDATE FORMFACILITY NAME: 196 SUBURBAN RDFACILITY ADDRESSCAN T TIIS r)RISPO CA q14N1 TANK FARM ROADCoNTACT PERSON: E I Lt KEE^IAA/ PHONE NUMBER: ;ID:6V5-SA5ANNUAL INMNTORY UPDATE @ue every year by June 1)t I No Significant changes in inventory have occurred since the last Business Plan or inventorysubmitted.D( New inventory forms are attached (contact this office for blank copias).Xt1BIENNIAL REVIEW AND RECERTIFICATION @ue June 1 of even numbered years)[;q I certify that the Business Plan has been reviewed and the information contained in the business planis accurate and complete as of the date below.OTIIER I.]PDATESt 1 Please incorporate the following information into the Business Plan for this facility:I declare, under penalty of perjury, that the information provided herein is true and correct to the best of myknowledge.Replace previous inventory with attached inventory.Replace only designated pages of inventory.\tu t1Printed Name:51w€ A. SaPlOev*J :DGtGJSan Luis Obispo Fire DepartmentHazardous Materials Division748 Pismo StreetSan Luis Obispo, CA 93401Return form to:)-lo/ :BlDi(Hazardous MaterialsDisclosure lnformation PacketPlease Use Typewriter or Print ClearlyPaclfic Eall SEl64Bueinecs Nama196 SUBIJRBAN RD SAN LUIS OBISPO CA 93403Bueineae Addreee (Not a PO BoxlBrLL KEENAN/a,t, "o*our"ts,Dlbvs - sb6During Bue Hre Contact Name/TitlePhoneI certify, under penalty of perjury, that the proceeding information is true and correctto the best of knowledge-U-?v-11Signaturet6&"/Date14.Name and Title (please type or print)Ploasc r6tum {orm to:SAN LUIS OBISPO FIRE DEP] .748 PISMO STREET SAN LUIS OBISPO, CA 93401 California Envi ron mental Reporti ng System (CERS)Submittal SummarytqbAT&T California - SE164 (CERSID: 10435963)Jan {3,Submitted on 1t1312017 5:28:43 AM by Steve Taylor of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (SanRamon, CA)Comments by Submitter: Updated the inventory and the site map.Submittal was Accepfed on 111312017 8:15:23 AM by Kerry Boyle. Hazardous Material lnventory (12). Site Map (Official Use Only). Annotated Site Map (Official Use Only) (Adobe PDF, 121K8)EmergencySubmitted on 111312017 5:28.43 AM by Steve Taylor of PACIFIC BELL TERamon, CA)Comments by Submitter: Updated contingency plan.Submittalwas Accepfed on 111312017 8:15:35 AM by Kerry Boyle. Emergency Response/Contingency Plan. Emergency Response/Contingency P/an (Adobe PDF, 1 1 15KB). Employee Training Plan" Provided ln Submital Element: Emergency Response and Training Plans7LEPHONE COMPANY dba AT&T CALIFORNIA (SanJanSubmitted on 111312017 5:28:43 AM by Steve Taylor of PACIFIC BELL TELEPHONE COMPANY dbaAT&T CALIFORNIA (SanRamon, CA)Submittalwas Accepfed on 111312017 8:15:46 AM by Kerry Boyle. Remote Waste Consolidation Site Annual NotificationSubmitted on 111312017 5:28:43 AM by Steve Taylor of PACIFIC BELL TELEPHONECOMPANY dba AT&T CALIFORNIA (SanRamon, CA)Comments by Submitter: Annual HMBP Submission, Updated the contact infoSubmittalwas Accepted on 111312017 8:15:09 AM by Kerry Boyle. Business Activities. Business Owner/Operator ldentificationPrinted on L/I3/20I7 8:15 AM Ca lifornia Environmenta I Reporting System (CERS)Business ActivitiesldentificationT California - SE154CERS IDSuburban RdLuis Obispo, CA 9340110435953EPA lD NumbercAT080024268Luis ObispoStatusmitted on t/13/20L7 by Steue Taylor of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNTA (San Ramon, CA)ments by submitter: Annual HMBP Submission, Updated the contact info.ubmittal was Accepted; Processed on I\3/2OU by Kerry Boyle for San Luis Obispo County Environmental HealthMaterialsyour facility have on site (for any purpose) at any one time, hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200feet for compressed gases (include liquids in ASTs and USTs); or is regulated under more restrictive inventory local reporting requirementsYesbelowifpresent);ortheapplicableFederalthresholdquantityforanextremelyhzardoussubstancespecifiedtn40CFRPart3s5,Appendixororhandlematerialstnntitiesforwhichantsto10CFRParts40or70?Storage Tank(s) (UST!your facility own or operate underground storage tanks?Nos your facility a Household Hazardous Waste (HHW) Collection site?NoDoes your facilitygenerate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or more of federal RCRA hazardous waste, or generate NOn any single calendar month, or accumulate at any time, Lkg(2.2 pounds) of RCRA acute hazardous waste;or generate or accumulate at any timenore than 100 kg (220 pounds) of spill cleanup materials contaminated with RCRA acute hazardous waste.your facility need to report the closure/removal of a tank that was classified as hazardous waste and cleaned on-site?Noyour facility consolidate hazardous waste generated at a remote site?Yesyour facility'streatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)?Noyour facility treat hazardous waste on-site?NoWasteyour facility a Hazardous Waste Generator?Yesloes your facility have Regulated Substancesstored onsite in quantities greater than the threshold quantities established by the California AccidentalNolelease prevention Prosram (CalARP)?)oes your facility own or operate ASTs above these thresholds?rboveground tanks or containers.Store greater than 1,320 gallons of petroleum products (new or used) inNouded and/or Exempted Materialsyour facility recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC ZSt43.2l?Nolnformationadditional commentsPrinted on I/I3/20L7 8:15 AM California Envi ronmenta I Reporti ng System (CERS)Business Owner Operator&T California - SE164CERS IDSuburban Rd10435953n LuiscA 93401Statusubmitted on I/L3/20L7 by Steve Taylor of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (San Ramon, CA)by submitter: Annual HMBP Submission, Updated the contact info.was Acceptedi Processed onI/t3/2Ot7 by Kerry Boyle forSan Luis Obispo County Environmental HealthT CaliforniaBeglnning Dateth3/2oL7Dun & Bradstreet103401618Ending DatetlL2/2078SIC Code4813PhoneBusiness PhoneEusiness Fax546-7416(8oo) 33s-6088(92s) 973-0s84Primary NAICS5t7LtOFacility/Site Mailing Address308 S. Akard St., 17th FloorDallas, TX 75202lmergency Contactn Mahoney)wner)acific Bell Telephone Company dba AT&T California2t4l 74r-0460]08 S. Akard St., 17th Floor)allas, TX 75202EH&SHour Emergency Service24-Hour PhonePager Number566-9347lilling Contact\T&T EH&S2I4l74t-O46O g43573@att.comi001 Executive Pkwy, RM 4W2001;an Ramon, CA 94583nmentalsite ManagerPhones46-741624-Hour PhonePager NumberEmergency ContactHotlinePhoneEnvironmental ContactSrennan Mahoney:80s) s46-7416ET2Mono Street, Rm 305ian Luis Obispo, CA 93401bm800e@att.comof SignerSigner TitleManager - National EPCRA ServicesDocument PreparerPeter Burnell, Sigma Consultants, Inc.JacksonI nform ationunder the direction of AT&T Services, lnc.Fieldsor all of the following fields may be required by your local regulator(s).Property OwnerthoneMailing AddressAssessor Parcel Number (APN)Number of Employees54Facility lDooo28t7Printed on 1/13/2017 8:15 AM Steel DrumDays on Site: 355750 - Chronic healthll-ei1r1.9 . ....... .... Iry-19-!9--c*cq9."Ambient 352I9n-89.R*r9_.Ambient750CAS NoFleet WasteAbsorbents/Automotive Flu idsPounds 750State StorageContainerSolidI-YP.-"--.WasteUsed Antifreeze-QAl-lt-o..LO7-2r-l3 - Flammable andDays on Site: 365State55Pressue3435555Gallons 55Waste Codele LiquidsLiquid, Class lll-BLiquidIYp-e--.Waste- Acute Health- Chronic healthlJgIe_C_e_99_t'l_a_it.9rPlastic/Non-metalic DrumAmbient-r-e.nP9r9!gl-_e-..AmbientLubricating Base OilZinc CompoundsAdditivesCAS NoWaste Motor OilGallonsStatePressue55s00bustible Liquid, Class lll-BDays on Site: 3658s%bustible Liquids3 - Flammable andLiquidI-YP-9.....Waste- Fire- Chronic healthProprietaryProprietary110 559*t9jg-q9--c*o_gei!1-e-L-Steel Drum, Plastic Bottle or JugAmbient lry_q:!9c_qg-9--r-9.r1P9.n!yl-e*' 22tAmbientI%20%110.?F-s-s-99.-...-...-....Ambientlq.nP.gt?Hr_9_AmbientLubricating Base OilZinc CompoundsAdditivesMotor OilWaste Code55CAS NoState StorageContainerGallons 1108s%3 - Flammable andLiquidIYP-9.....MixtureSteel Drum, Plastic Bottle or JugDays on Site: 365- Fire- Chronic healthProprietaryProprietaryLlo20%ble Liquidsble Liquid, Class lll-B,Aboveground Tank, Steel DrumDays on Site: 365t40Pressue225Waste Codestible Liquid, Class llFB3 - Flammable andustible LiquidsHydraulic FluidlAt.L-'-...-LiquidlYss..MixtureGallons 225State StorageContainerAmbientIg.np-glg!-|{.r9._Ambient- Fire- Chronic healthLubricating Base OilAdditives99%2%274 - FirePressue waste code - Pressure;;bi;;i-" -- Rerease- Acute Health-LgltpgI9!l$-AmbientCAS Noon Site: 36574-86-2State274mable Gas(Reactive), Class 2,GasI-vP-9....Pure2.1- Flammable Gases ACetyleneCu. Feet 274PJgJe*e9-99_!1t.1it-e-t....-...CylinderAnnualWasteAmountFederal HazardCategoriesre Haz. ClassCommon NameUnitMax.QuantitiesCont.Name%wt EHS CAS No.Hazardous Componentsr mixturePACIFIC BETLTELEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401Chemical LocationMotor vehicle shopcERsrD 10435963Facility rD OOO28L7status Submltted on Lh3/2Ot7 5:28 AMNameBusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportGREASE / GEAR LUBECAS NoGallonsStateLiquidIYP_e....Mixture56 55-s,!9J9-99--c.9-tRtll9t..Steel Drum, Plastic Bottle or Jugon Site: 36566 _ Firel.'s:s-t-9-....-....-.... 1ry-?9-t-9-.-q9q.9. - chronic healthAmbientle-.nPgI-q!.gteAmbientSolvent Dewaxed Residuel OilHydrotreated Dist Hvy ParaffinSol Dewaxed Dist Hvy ParrafinHydrotreated BottomsAdditivess2%50%50%4L%12%64742-62-764742-54-764742-65-064742-57-0PROPRIETAhLiquid, Class llFBPrinted on 7/!3/20L7 8:15 AMPage 1 of4 AnnualWasteAmountre Haz, ClassCommon NameMax, DailyCont.LJ nitName%Wt EHS CAS No.Hazardous ComponentsFor mixtureFederal HazardCategoriesPACIFIC BEttTEIEPHONE COMPANY dba AT&T CALIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility lD 0002817Status Submltted onNE slde of site (Near UWAA)Chemiel Location5:28 AMBusiness/Org.NameCAS NoLiquefied Petroleum Gas (lpg)on Site: 365- FirePureIYP.s....2502soReleaseGas Aboveground TankPressue waste Code - Pressureified Petroleum Gas2.1 - Flammable Gases74-94-6Map: 1 Grid: D4Gallons 250State StorageContainer> Ambient-r-9.$-P-9rgpIe...AmbientHazardous Materials And Wastes lnventory Matrix ReportPrinted on 7/L3/20t7 8:15 AMPage 2 of 4 Diesel FuelGallonsState540Pressue720CAS NoDays on Site: 3653 - Flammable andLiquidsLiquid.Ivrs..-Pure- Fire- Chronic healthble Liquid, Class tt 68334-30-5720!].gp_e*e-!91tqh-ej.-..._Aboveground TankAmbient lf-$j-e-.-qp-q.9...I-g-npglq!sr9-AmbientAnnualWasteAmountCode/Fire Haz. ClassCommon NameQuantitiesFederal HazardComponent NameHazardous ComponentsUnitMax.Cont.Dailymixture%Wt EHS CAS No.PACIFIC BEtt TELEPHONE COMPANY dba AT&T CALTFORNTAAT&T California - SE164Chemical LocationPortable Generator Storage Area7 5z28AMNameBusiness/Org.196 Suburban Rd,San Luis93401Submitted oncERstD 10435963FacilrtyrD OOO28L7Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 7/L3/2017 8:15 AMPage 3 of 4 1000 400_s-19J9-99__c9-LtgiILel..._..Plastic/Non-metalic Drum, ToteBinDays on Site: 365CAS NoPoundsStatePressue600I--e-l]lP-g.R!-9.t9-181Universl Waste - Consumerelectronic devicesSolidI-w-e*.Mixture1580 -Acute Healthwaste code - Chronic healthAnnualWasteAmountHaz, Classcommon NameunitFederal HazardMax.QuantitiesCont.NameHazardous Componentsmixture%wt EHs cAs No.PACIFIC BEIL TEIEPHONE COMPANY dbA AT&T CATIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility lD 0002817Chemical LocationUniversal Waste Accumulation Area5:28 AMEusiness/Org.NameSubmltted onHazardous Wastes - Liquid tabPacks9$l-lte-....Gallons_s.I9Le-*LiquidI-YP.-e-WasteSteel DrumDays on Site: 36555 110 _ FirePressue waste code - Acute Healthffibfif*- ^*;i;** -chronic healthI_9_mP_g.r.?!s$-.'Ambient5555)OT: 5.1 - Toxic Substancesioxic, CorrosiveHazardous Wastes - Solids tabPacks-c.A-s-.ltg-......PoundsIte*!e*.SolidI-rP:..-Waste2OO 25O - Firepressue W-*-1g--qp-q-g.' - Acute Healthffi#;i--" 223 - chronic healthI-g.nPgnli19-Ambient250Days on Site:3656.1 - Toxic SubstancesCorrosive250-s.!_oji_C_e__c_o-l.!.3in-9.1.......-Steel DrumHazardous Materials And Wastes lnventory Matrix ReportPrinted on I/I3/2Ot7 8:15 AMPage 4 of 4 IGMAMAP# 1BUSINESS NAME AT&T Colifornio SNLOCAAU SE164BUSINESS ADDRESS 196 SUBURBAN RDCOMMERCIALSITE MAPDATE 1/13/2017ZIp CgDE 9340JDRAtrING SCAI,ENOT TO SCALE1SAN LUIS OBISPOCOMMERCIALSN4BOL LEGEND@@@@Ao+l(-A@23actDcaIDzairTtm{FI FCTRICAL PANELSHUT-OFFNATURAL GASSHUT-OFFWATER SHUT-OFFEMERGENCY SHUT DOYYIITANK MONITORINGALARMTELEPHONERRST AID KITRRE EXTINGUISIIERSTORM DRAINSANITARY SEYIER45AJ-6STAGING AREAEVACUATtO.t,/lnsp-sl [8l81[hdIND MsDsf- nne HyDRANTI@I/-1 ACEntENE\Iy' lcouenessED GAs)O nHmnrezE/coot-ANTs6\ WASTE OIL\-V (FLAMMABLE ueutD)fl nne puLL BoxFCFLAMMABLES CABINETFENCEEMERGENCY RESPONSEEQUIPMENT/ABSoRBENTSABO\EGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(coMBusnBLE uoutDS)BAT]ERY ELECTROLYTE(coRRosr\E uoutD)GASOUNE(FLAMMABLE UAUIDS)DIESEL FI'EL(coMBUsnBLE UOUTDS)NIIROGEN(CoMPRESSED GAs)PROPANE(FL^MMABLE UQUID)@5o(LUJzoIC5UFlE 'lJ_rJoEuloo7IPortoble GenerotorStoroge AreoRESTAURANT9@xrznnoous msre @ ueuuv(D uNrwnsnl. msrr @ HYDRAULTc FLUID@ wesre msonaerurs@ encoN@ oxveen@ msre ANTFREEzE- DRAINAGE FLOW DIRECIIONruMTl UN|IERSAL WAS]E- ACCUMULAIION AREAAFCFCSTORAGEAWATERTANKADMINISTRA'I'IONBUILDING@BcDEF\rHJKLM CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM(cERS)CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLANPrior to completing lhis Plan, please referto the INSTRUCTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLANSin t-uis Obispo, CA/French Hospital Medical Centefuc4.c5E I. VERBAL WARNINGS:E +. pecsns;E 3. TELEPHONE;E 6. PORTABLE RADIOc2.5. ALARM SYSTEM;AN OFF-SITE RELEASE WILL OCCUR BY: (Check all that apply)MAY BE AFFECTED BYNOTIFICATIONS TO NEIGHBORING FACILITIES THATE 2. PUBLIC ADDRESS OR INTERCOM SYSTEM;El r. vEnsnl wARNINGSTE 4. PAGERS;c1.OR ALARM NOTIFICATION WILL OCCUR VIA: (Check all that applv)COMMUNICATIONSINTERNAL FACILITY EMERGENCYE o. ponraelE RADIoEl s. el-eRvr SYSTEM;8:. rElspHoNE;E 2. PUBLIC ADDRESS OR INTERCOM SYSTEM;Emergency Coordinator is on call) shall:t. ajivate internal facility alarmi or communications systems, where applicable, to notifl' all facility personnel.2. Noti! appropriate local authorities (i.e., call 9-l-l).3. Notifi the California Emergency Management Agency at (800) 852-7550Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall notif, the Califomia Department of ToxicSubstances Control (DTSC), the local Unified program Agency (UPA), and the local fire department's hazardous materials program that the facility is in compliancewith requirements to:L provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release atthe facility; and2. Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the facility affected by the incident untilthe Emergency Coordinator (or his/her designee when theexplosion, fire, or release,situation such as anactual emergencyWhenever there is an imminent orcleanup procedures are completed.C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONSE I. CALLING PUBLIC EMERGENCY RESPONDERS (i,E.,9-I-I)E 2. CALLING HAZARDOUS WASTE CONTRACTORall that apply)BIRESPONSE WILL OCCUR VIA:INTERNAL FACILITY EMERGENCYEMERGENCY RESPONSE TEAME r. RcrtvnrmcB. INTERNAL RESPONSEE I. HAZARDOUS MATEzuALS; 8 2. HAZARDOUS WASTESA5.INVOLVING: (Check all that aPPIY)AND EARTHQUAKESFIRES,THIS PLAN COVERS CHEMICAL SPILLS,TYPE OF BUSINESS (e.g., PaintingTelecommunicationsA3.Contractor)INCIDENTAL OPERATIONS (e.g., Fleet Maintenance)CABUSINESS SITE CITYSan Luis OBispoI04.93401ZlP CODEI 05.BUSINESS SITE ADDRESS196 Suburban Rd103.ne Company dba AT&T California - SE164Pacific BellTelephoDBA - Doing Business As)BUSINESS NAME /Saze as Facility Name orFACILITY ID #F1966Al.CERS ID1 0435963DATE OF PLAN PREPARATION/REVISIONJanuary 13,2017A2A.FACILITYIDENTIFICATIANDOPERATIOVERVIEWoNoNSEMERGENCY RESPONSEPHONE NUMBERS:NEAREST MEDICAL FACILITY / HOSPITAL NAME:AGENCY NOTIFICATION PHONE NUMBERS:AMBULANCE, FIRE, POLICE AND CHPCALIFORNIA EMERGENCY MANAGEMENT AGENCY (CALIEMA)NATIONAL RESPONSE CENTER (NRC) .POISON CONTROL CENTERLOCAL UNIFIED PROGRAMOTHER (Specifr):9-1-1(800) 852-7550(800) 424-e802(800)222-1222(805) 781-5544(805) 543-5353, (916) 255-3545i (805) 54e-3147(800) 300-2193(916) 358-2900(202) 267-2180(916) 263-2800(916) 445-8200(800) 566-e347c3c7c8.CALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC)REGIONAL WATER QUALITY CONTROL BOARDU,S. ENVIRONMENTAL PROTECTION AGENCY (US EPA) . . . . . .CALIFORNIA DEPT OF FISH AND GAME (DFG)U,S. COAST GUARDCAL/OSHASTATE FIRE MARSHALOTHER (Specifu):cl0.ct2.OTHERAT&T EH&S HotlineRev.06121/ll CERS consolidated Emergency Response / contingency pran - page2 of 4Rev.06127lllADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (Check one of the following)fi I. HavE BEEN DETERMINED NoT NECESSARY; oTE 2. THE FOLLOWTNG ARRANGEMENTS HAVE BEEN MADE (Specifi):F2.FInecessaryarenotarrangementsmaysuchouvourthatdetermineYfacilityforappropriateasmadebecontractorsemergencyservlcesldshoulceand/orhospitals,departments,andpolarrangementsremenlocalfirewitht:AdvanceRequiplanationExofF. ARRANGEMENTS FOR EMERGENCY SERVICESandvisitors.bevisibleitwillwherelocationsinthepostedmustareas,prominentlybeandaltematestagingandemergencyprimaryexits,androutes,evacuationalternatemustandshowprimarymap(s)NoteTheREQUIREDASMAP(S)POSTEDTIONROUTEEVACUAandlor site visitors afterCoordinator must account for all on siteNote: TheIo! specific street comer, etc.)THE FOLLOWINGLOCATTON(S) rS/ARE EVEMERGENCY ASSEMBLY AREA(S) (i.e., FrontACUEEParking Lot Next to Suburban St - See EMOp Binder/Bldg Warden(CHECK ALL THAT APPLY):THE FOLLOWTNG ALARM SIGNAL(S)E l. BELLS;BE USED TO BEGIN EVACUATION OF THE FWILLFire Alarm4. OTHER3. VERBAL (r.8., SHOUTTNG);trtr2. HORNS/SIRENSE. FACILITY EVACUATIONEl t. uoNrroR FoR LEAKS, RUpruREs, pRESSURE BUILD-Up, ETC.;! z. rnovtoe STRUCTURAL PHYSICAL BARzuERS (e.g., Portable spill containment wails);Etr :. pnovlnp ABSORBENT pHySIcAL BARRTERS (e.g., pads, pigs, pillows);E 4. covER oR BLocK FLooR AND/ oR sroRM DRATNS;E s. eutlr-N BERM IN woRK / sroRAGE AREA;E 6. AUTOMATIC FIRE SUPPRESSIoN SYSTEM;EN 7. ELIMINATE SOURCES OF IGNITION FOR FLAMMABLE HAZARDS (e.g. Flammable liquids, propane);E s. srop pRocEssES AND/OR opERATTONS;E 9. AUToMATIC / ELECTRoNIC EQUIPMENT SHUT.oFF SYSTEM;ElI 10. SHUT.oFF wATER, GAS, ELECTRICAL UTILITIES AS APPRoPRIATE;El l l. CALL 9-l-r FoR puBlrc EMERGENCv RESpoNDER AssrsrANCE / MEDTGAL ArD;E 12. NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AREAS;E I3. ACCoLJNT FoR EVACUATED PERSoNS IMMEDIATELY AFTER EVACUA I'ION CALL;E I4. PROVIDE PRoTECTIVE EQUIPMENT FoR oN-sITE RESPoNSE TEAM;EJ 15. REMovE oR rsoLATE coNTATNERS / AREA As AppRopRrATE;EI I6. HIRE LICENSED HAZARDoUS wASTE CoNTRACToR;E I7. USE ABSORBENT MATERIAL FOR SPILLS WITH SUBSEQUENT PRoPER LABELING, SToRAGE, AND HAZARDoUS wASTE DISP.SAL ASAPPROPRIATE;f] I8. SUCTION USING SHOP VACUUM WITH SUBSEQUENT PROPER LABELING, SToRAGE, AND HAZARDoUs wASTE DISPOSAL ASAPPROPRIATE;E 19' wAsH / DECONTAMINATE EQUIPMENT w CONTAINMENT and DISPoSAL oF EFFLUENT / RINSATE AS HAZARDOUS wASTF.E] 20. PRoVIDE SAFE TEMPORARY SToRAGE oF EMERGENCY.GENERATED WASTES;E 21. OTHER (Specifu):DID2.releases,andtheyourforcontainingprocedurestoindicateapplyall(CheckthatboxesAND CLEANUP PROCEDURESSPILL PREVENTION, CONTAINMENT,andassociated harmand.fires orD. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES CERS Consolidated Emergency Response / contingency Plan - Page 3 of 4Rev.06121lll35OTHERG70.OtherOTHER34AUTOMATIC ALARM CHEMICALJJ.PORTABLE RADIOS32.G64.G653lINTERCOM / PA SYSTEMmunt-Systemsand(lncludes cellular)JI,lonesTelephones & Cellular PhThroughout FacilitYOTHER29SPILL OVERPACK DRUMS28.G57GAS CYLINDER LEAK REPAIR KITG54.G55.CHEMICAL NEUTRALIZERSSoda AshBattery AreaGs2.EMERGENCY SUMP / HOLDING TANK25EXHAUST HOOD24G49.SHOP VAC23G46.G4722.SHOVELG44.BROOM1Fleet AreaAll-PurposeBERMING / DIKING EQUIPMENTG4lt9CONTAINER FOR USED ABSORBENTFleet AreaG38.Plastic BucketG39.ABSORBENT MATERIAL18Kitty Litter/Grease SweepFleet AreaG36.UpSpillALL.IN-ONE SPILL KITt75.16.OTHERG32.15.STATIONSFIRE ALARM BOXES ORAdmin. BuildingG30.Fire Alarm Pull StationsG3l14.SPRINKLERS /FIXED FIRE SYSTEMS /FightingPORTABLE FIRE EXTINGUISHERSl3Throughout FacilitYABC Fire ExtinguisherG2712OTHERG24.G25OTHERllG22.PORTABLE EYEWASH KITS10.Bottle TypeFleet AreaPLUMBED EYEWASH FOUNTAIN / SHOWER9.9.FIRST AID KITS / STATIONS8.6.Main Building/Fleetlndustrial First Aid KitGl7SELF-CONTAINED BREATHING APPARATUS7Gl4.Gl5.CARTzuDGE RESPIRATORS6HARD HATS5.Gl1SAFETY GLASSESGOGGLES / SHIELDS4.Fleet AreaSafety G lasses/Goggles/ShielfSCHEMICAL PROTECTIVE BOOTSJ.G6.CHEMICAL PROTECTIVE GLOVESRubber/Chemical Gloves GsFleet AreaFirst AidCHEMICAL PROTECTIVE SUITS, APRONSIG3.TYPEAVAILABLELOCATIONCAPABILITYe.9.,ifresponsePROTECTIVECHEMICAI-use,neSpillGI-OVESsolventresistantoittimeo&kitonly.lresponseemergencyeckallchlistapplytoboxesthatatequipmentanwfacilitytheavailableherethelocation(s)identifytheandthedkeptequipmentr3G. EMERGENCY EQUIPMENT cERS consolidated Emergency Response / contingency plan -page 4 of 4R'ev.06127/llent for AT&T ServiceslncTITLE OF SIGNERPeter BurnellNAME OF SIGNERJanuary 13,2017DATE SIGNEDOF OWNER/OPERATORSIGNATUREoncopysite.availablelsISthatcomplete,andaccurate,true,andtheinformationbelleveandamsubmittedtheinformationfamiliarwithandexaminedpersonallyhavethatoflawunderpenaltycertif,theinformation,tryforobtainingresponsiblemyonindividualsof thoseinquBasedCertificationK. SIGNATURE / CERTIFICATIONJl.!2.1. NO ATTACHMENTS ARE REeUIRED; or2. THE FOLLOWING DOCUMENTS ARE ATTACHEDtrone oftheJ. LIST OF ATTACHMENTSLnrgeQuantityGenerator(LQG)TrainingRecords: Large quantity hazardous waste generators (i.e., who generate more than 270 gallons/I,000 kilograms ofhazardous waste per month) must retain written documentation ofemployee hazardous waste management training-sessions which includes:o A written outline/agenda of the type and amount of both introductory and continuing training that will ie given to persons filling each job position havingresponsibility for the management of hazardous waste (e.g., labeling, manifesting, compliince witf, accumulation ime limits, etc.).o Thename,jobtitle,anddateoftrainingforeachhazardouswastemanagementtrainingsessiongiventoanemployeefillingsuchajobposition;ando A written job description for each of the above job positions that describes job duties and the skills, education, oi other qualifications required of personnel assignedto the position.ofatafterleastmustthreeretainedbeaFormerofthefacilityuntilclosuremustberetainedrecordsatrainingemployeeCunentINDICATE How EMPLOYEE TRAINING pRocRAM IS ADMINTSTERED (check all that apply)E 1. FoRMALCLASSRooM; [2. vnnos; f] l. sanerv)rarlcereMEETrNGS;E 4. STUDY GUTDES / MANUALS (Specif,):t2.13.ll.DrooramtohendFACILITY HAS NO EMPLOYEES6. NOT APPLICABLE BECAUSEthe AT&Tonsite emeroeneiacE| s. Ofuen (Speciff): All emotovees are trainado Communication and alarm systems;r Personal protective equipment;r Use of emergency response equipment (e.g. Fire extinguishers, respirators,etc.);o Decontamination procedures,. Evacuationprocedures;o Control and containment procedures;Explanntion of Requirement: Employee training is required for all employees handling hazardous materials and hazardous wastes in day+o-day or clean-up operationsincluding volunteers and/or contractors. Training must be:o Provided within 6 months for new hires;o Amended as necessary prior to change in process or work assignment;o Given upon modification to the Emergency Response / Contingency Plan, and updated,/refreshed annually for all employees.Required content includes all ofthe following:o Material Safety Data Sheets;o Hazard communication related to health and safety;o Methods for safe handling ofhazardous substances;o Fire hazards ofmaterials / processes;. Conditions likely to worsen emergencies;o Coordination ofemergency response;o Notificationprocedures;ando USTIaws andI. EMPLOYEE TRAININGMotor V€hicle Shop H7.Portabl€ Generators H8.Motorvehicte Shop H9.Electriel & Gas: Outside NW Side ofAdmin Btdg, Water SW Comer of Facility Next to Ss6qrbal g1H I 0.NE side of site (NearLOCATIONSHlLHtz.E 2. TANKS (EMERGENCY SHUTOFF)E] 3. PORTABLEGAs CYLINDERSE 4. EMERGENCY SHUTOFF AND/OR UTILITY VALVESE 5. SPRINKLER SYSTEMSE] 6. STATIoNARY PRESSURIZED CoNTAINERSANDRACKSVES,CABINETSSHET,thatapply)allSYSTEMSVULNERABLEisolation anddue toulremotion.TIONS (e.g., shop, outdoor shed, forensic lab)H2.H3,H4.H5.Motor Vehicle Shop, portable Generator Storage Area, UWAALOCAVULNERABLE AREAS: (Check ail rhat apply)EJ I. HMARDOUS MATERIALS / WASTEE 2. PRocEss LrNES / prprNc! :.lanoneronvE 4. WASTETREATMENTAREASTORAGE AREAIdentifi areas of the facility that are vulnerable to hazardous materialsreleases / spills due to earthquake-related motion. These areas require immediate isolation andH. EARTHQUAKE VULNERABILITY Ca I ifornia Envi ron menta I Reporting System (cERs)Remote Waste Consolidation Site Annual NotificationCaliforniasE164CERS ID10435953EPA lD NumbercAT080024268Suburban RdLuis Obispo, CA 93401Statusmittedtl73/20t7bySteveTaylorofPACIFICBELLTELEPHONEcoMPANYdbaAT&TCALIFORNIA(SanRamon,cA)onDepartmentwasAccepted;ProcessedontlL3/zot7byKerryBoyleforSanLuisObispoCityFireSite lnformationSuburban Rdn Luis Obispo, CA 93401of Remote Location(s)sitesption of Waste(s) Collectedniversal wasteHazardous Waste TreatmentEstimated Monthly Volume Consolidated2OO PoundsFor Not Needing a Federal PermitThe hazardous waste being consolidated is not hazardous waste under federal law although the waste is regulated as hazardous waste under california state law'hazardous waste is hazardous waste under federal law, but transportation to and accumulation of the consolidation site of the waste is not submited to permitting requirementsfederal law for the following other reason(s):Nameowner/Operator TitleDate CertifiedJackson- National EPCRA ServicesPrinted on r/73/20L7 8:15 AM nbAT&T California - SE164 (CERSID: 10435963)Submitted on 111612016 5:57:18 AM by Pefe Burnetlof PACIFIC BELL TELEPHONE COMPANY dbaAT&T CALIFORNIA (SanRamon, CA)Submittal was Accepfed on211212016 9:01:39 AM by Kerry Boyle. Remote Waste Consolidation Site Annual NotificationCalifornia Environmenta I Reporting System (CERS)Submittal Summary2016Submittedo18 AM by Pete Burnellof PACIFIC BELL TELEPHONECOMPANY dba AT&T CALIFORNIA (SanRamon,Submittal wason2l12l2Q16 9:00:5'1 AM bY Kerry BoYle. Business Activities. Business Owner/Operator ldentificationSubmittedonII6t20167"8AMbyPeteBurnelloflFlC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (SanRamon, CA)Submittalwas Accepfed on211212016 9:01:02 AM by Kerry Boyle. Hazardous Material lnventory (14). Site Map (Official Use OnlY)" Annotated Site Map (Official Use Only) (Adobe PDF, 90KB)EmergencyandSubmittedon1t16t20I65:57IAMbyPeteBurnellofPACFICBELLTELEPHONE COMPANY dba AT&T CALIFORNIA (SanRamon, CA)Submittal was Accepted on211212016 9:01:19 AM by Kerry Boyle. Emergency Response/Contingency Plan' Emergency Response/Contingency P/an (Adobe PDF' '1 108K8)" Propane Spi// Response (Adobe PDF, 174K8)" Dlese/ Sp// Response (Adobe PDF, 330K8). Employee Training Plan' . Provided ln submital Element: Emergency Response and Training PlansPrinted on 2lI2l2OL6 9:01 AM California Environmental Reporting System (CERS)Business ActivitiesldentificationT&T California - SE154CERS IDSuburban RdLuis Obispo, CA 9340110435963EPA lD NumbercATo80024268Luis ObispoStatusbmittedonth6/2016byPeteBurnellofPACIFtcBELLTELEPHONEcoMPANYdbaAT&TCALIFORNIA(SanRamon,cA)wasAccepted;Processedon2/L2/2o16byKerryBoyleforSanLuisobispoCountyEnvironmentaHealthMaterialsyourfacilityhaveonsite(foranypurpose)atanyonetime,haza rdousmaterialsatorabove55ga llonsforliquidl500poundsforsolids,or200Yesbicfeetforcompressedgases(includeliquidsnASTsandUSTs);regulatedundermorerestrictiveinventorylocalreportingrequirementsbelowpresent)ortheapplicableFederathresholdquantityforanextremelyhazardoussu bstancespecifiedtn40CFRPart355,Appendixorhandletnntitiesforwhichanntsredto10CFRParts4070?orStorage Tank(sf (UST)your facility own or operate underground storage tanks?Noyour facility a Household Hazardous Waste (HHW) Collection site?NoNordouswaste.acutephazawithRCRAcontaminatedmaterialsspillcleanuofpounds)220100kgthananytimeataccuorormulategeneratewaste;acutehazardousRCRApoanyofnds)12.2kgtime,atoraccumulatemonth,anyncalendarsingleorgeneratewaste,hazardousRCRAmoreorpoufederalofnds)(2,20oke)1,000kilogramsmonthanysinglecalendaingenerateyourfacilitywas classified as hazardous waste and cleaned on-site?your facility need to report theNoof a tank thatYeshazardous waste generated at a remote site?your facility consolidateyour facility's treatment subject to financialPermit by Rule and Conditional Authorization)?Noassurance requirements (foryour facility treat hazardous waste on-site?NoYesyour facility a Hazardous Waste Generator?WasteyourAccidental NOntionCatheestablishedbyquantitiesuaqthresholdthegreaterthantitiestnstoredonsiteSubstancesRegulatedhaveNoor used) inorconta i ners.tanksbovegroundproductspetroleumgallonsof7,3tngreaterthanStoreoroownthresholds?abovetheseperateASTsyourlityfaciyour facility recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSc 25143.2)?Noand/or Exempted Materialslnformationadditional commentsPrinted on 2/L2/2O76 9:0L AM California Environmental Reporting System (CERS)Business Owner OperatorT&T California - SE154CERS ID10435953Suburban RdLuiscA 93401Statusbmitted on \/16/2016bv pete Burneltof PACIFIC BELLTELEPHONE COMPANY dba AT&T CALIFORNIA (San Ramon, CA)bmittal was Accepted; processed on 2h2/ZOt6 bv Kerry Boyte f or Sa n Luis Obispo County Environmenta I HealthT CaliforniaBeginning Date7/76/2016Dun & Bradstreet103401618Ending Dateuts/2017SIC Code4813PhoneBusiness PhoneBusineSs FaxI s46-74r6(805) s46-7416(92s) 973-0s84Primary NAICS5r7r70Mailing AddressS. Akard Street, Room 1708rx75202Emergency ContactENNAN MAHONEYronmental site ManagerPager Number546-7476Emergency ContactBell Telephone Company dba AT&T California274\ 464-2626S. Akard Street, Room 1708s,fX752OZHour Emergency ServicePager NumberContact&T EH&S464-2626943573@att.comExecutive Parkway, Rm 4W2001n Ramon, CA 94583PhoneT EH&S HotlinePhone566-934724-Hour Phone24-Hour PhoneContactMahoney546-7416bm800e@att.comMorro Street, Rm 305Luis Obispo, CA 93401of SignerSigner TitleArea Manager - EH&S Environmental ServicesDocument PreparerPeter Burnell, Sigma Consultants, lnc.ael Perrylnformationpared under the direction of AT&T Services lnc.Fieldsor all of the following fields may be required by your local regulato(s)OwnerAddressAssessor Parcel Number (APN)Number of Employees80Facility lD0002817Printed on 2/t2/2016 9:01 AM Pounds$e!e-."Solid-TJge-.-Waste77555Pressue775223Waste CodeDays on Site: 365ustible Liquid, Class lll-8,3 - Flammable andLiquidsWASTE OIt FITTERS-ca9_.ry-e,-_.....NAAmbientre$-P9l_*9r9_Ambient- Fire- Chronic healtht75ll9-I-9-C9-S9"tagrq__'Steel DrumAnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardUnitMax.QuantitiesNameCont. Avg. DailyHazardous Componentsmixture%Wt EHS CAS No.PACIFIC BELI TETEPHONE COMPANY dba AT&T CALTFORNTAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401cERsrD 10435953Facirity rD OOO28L7Status Submitted onGarageChrmlcal Location5:57 AMNameBusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/!2/2016 9:01 AMPage 1 of 9 Pounds9l_al-e-..SolidType .Waste750 - Chronic health.l!-e-:.il9..-..............w9ste.-q9.lg-q..Ambient 352r--e...|llP-91-1!{IF-..AmbientCAS NoStorage Container750750FLEET WASTEABSORBENTS/AUTOMOTIVEFTUIDSSteel DrumDays on Site: 365AnnualWasteAmountHaz. ClassCommon NameMax. DailyEHS CAS No.UnitCont.quantitiesName%wHazardous ComponentsmixtureFederal HazardCategoriesPACIFIC BEttTEIEPHONE COMPANY dba AT&T CALIFORNIAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility lD 0002817status Submitted ontll6l20l65t97 AMChemlcal LocationNameBusiness/org.GARAGEHazardous Materials And Wastes lnventory Matrix Report.\Printed on 2/t2/20I6 9:01 AMPage 2 of 9 Gallonsl!ele_LiquidI-yP-e-....Pure3 - Flammable andDiesel Fuel180Pressue667uG!!g-qeg_e_.CAS NoDays on Site:365mbustible LiquidsLiquid, Class ll68334-30-5Map: 1 Grid: F7AmbientI-enP-gr4sl9_Ambient- Fire- Chronic health667:l-o-R-c9-.9grls!!g-Aboveground TankAnnualQuantities U1s51gMax. Daily Largest Cont. Avg- Daily AmountHaz. ClassCommon NameFederal HazardComponent NameEHS CAS No.Unit%wtHazardous ComponentsmixturePACIFIC BELT TETEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE164cERsrD 10435963Facirrty rD O0O28t7Parking lot - Portable GeneratorsChemical Location5:57 AMNameEusiness/Org.196 Suburban Rd, San Luis93401Submitted onHazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/t2/2016 9:01 AMPage 3 of 9 CAS No74-46-2on Site:355AcetylenePureI-YP-e-..-222Pressue120Gas Cylinder2.1 - Flammable GasesCu. Feet 222State StorageContainer> AmbientI-qnP-en!-qLe-...Ambient- FireWaste Code - PressureRelease- Acute Healthnstable (Reactive), class 2,lammable GasAnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardHazardous ComponentsUnitNamemixtureMax. Daily Largest Cont. Avg. Daily%Wt EHS CAS No.PACIFIC BEtt TETEPHONE COMPANY dbA AT&T CALIFORNIAAT&T California - SE154196 Suburban Rd, san Luis Obispo 93401cERsrD 10435953Facillty lD 0002817status Submitted on 1/16/2016 5:57 AMChemical LocationshopBusiness/Org.NameHazardous Materials And Wastes lnventory Matrix ReportGREASE / GEAR LUBELiquid, class lll-B f$l- N-o- 'Map: 1 Grid: F451 559l_onaC9!9.nHin-e-L......Steel Drum, Plastic Bottle or Jugon Site:35550 - Fire.ple-s:q9...................Ue$g..-q-o.i--q-.-ch'onichealthAmbient-rrn_p9g-t-q.t9-...AmbientSolvent Dewaxed Residuel OilHydrotreated Dist Hvy ParaffinSol Dewaxed Dist HW ParrafinHydrotreated BottomsAdditivesGallonsStateLiquid-T-YP.-e-....Mixture52%50%50%47%72o/o64742-62-764742-54-764742-65-064742-57-OPROPRIETARYPrinted on 2/t2/20t6 9:01 AMPage 4 of 9 Plastic/Non-metalic DrumDays on Site: 3653 - Flammable andCAS Nor07-2t-rUsed Antifreeze55Pressue55343y-?9!_e_!e199...Map: 1 Grid: F4State StorageContainerGallons 55bustible Liquid, Class lll-BLiquidsLiquidTypeWasteAmbient19-P.9r?!"ql.e._...Ambient- Acute Health- Chronic healthAnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardHazardous ComponentsUnitNameMax. Daily Largest Cont. Avg. Daily%Wt EHS CAS No.PACIFIC BEtt TELEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility lD 0002817status Submitted onChemical LocationSTORED EAST SIDE SHOP5:57 AMBusiness/Org.NameHazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/L2/2OI6 9:01 AMPage 5 of 9 Ann ua IWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardComponent NameUnitQuantitiesMax. Daily Largest Cont.Hazardous Componentsmixture%Wt EHS CAS No.PACIFIC BELLTELEPHONE COMPANY dbA AT&T CATIFORNIAAT&T California - SE164195 Suburban Rd, San Luis Obispo 93401cERsrD 10435953Facility tD 0002817status Submltted onChemical LocationSTORED IN SHOP5:57 AMBusinesvorg.NameGallons 225 140_sl9!e_ !!9l3C999l'_lqit-ej._*Liquid Aboveground Tank, Steel Drum-r-YP-e-.."Mixture Days on Site: 365225lr-9:-s-!lF-..-...............AmbientTem per?t-ur_e_...AmbientCAS NoHydraulic Fluidw-?-sls-!g"d.e,Map: 1 Grid: G5bustible Liquid, Class lll-B3 - Flammable andFireChronic healthLubricating Base OilAdditives99%2%LiquidsHazardous Materials And Wastes lnventory Matrix Report3 - Flammable andLiquidsLiquid, Class lll-8,Motor Oil-cAl-I-o-.....Map: 1 Grid: F3Gallons 110 55-sl?I-e-."-sl_o_f_?-c.r...cp-|1Rin-e-L.''Liquid Steel Drum, Plastic Bottle or JugTyfe .Mixture Days on Site: 365110 - Firepressue - Chronic health; r b'" ;f "-- -w-?:-!g-9-o.gg-I-er-P-gn!-qI..-...AmbientLubricating Base OilZinc CompoundsAdditives85%7%zo%ProprietaryProprietaryPrinted on 2/72120t6 9:01 AMPage 6 of 9 Gallons_sl?,!-e-Gas-TJ-P.-e--"Pure250 - FirePressue waste code - Pressure;;bili* --"- - ReteaseTe m pe rat_ure-...AmbientCAS NoLiquefied Petroleum Gas (lpg)Aboveground Tankon Site:3552502.1 - Flammable GasesPetroleum Gas74-98-6Map:1 Grid; D4250Storage ContainerAnnualWasteAmountHaz. ClassCommon NameHazardous ComponentsLJnitMax-OuantitiesCont.DailyName%Wt EHS CAS No-Federal HazardCategoriesPACIFIC BEtt TETEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility rD OOO28L7Status Submitted onChemical l-ocationStored in the Yard5:57 AMBusiness/Org.NameHazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/12/2016 9:01 AMPage 7 of 9 AnnualWasteAmountCode/Fire Haz. ClassCommon NameLargest Cont.Federal HazardComponent NameUnitMax.QuantitiesHazardous componentsmixture%Wt EHS CAS No.PACIFIC BELTTETEPHONE COMPANY dba AT&T CAIIFORNIAAT&T California - SE154196 Suburban Rd, San Luis Obispo 93401cERsrD 10435953Facirity rD OO028t7status Submitted onChemical locationWaste Storage Area5:57 AMNameBusiness/org.rritantwaste oily waterGallonsState55CAS NoMap:3 Grid: H8on Site:365Liq uidlvl!-.Wasterz30PressueAmbient-r--e.].l11p.S.f .e_t_gI-e_...Ambient1250Waste Code12509l-o-n-C_e-.99lle!!-e.I*_Steel DrumGallons9!e!e-LiquidI-YP.-e-...Waste55 110 - FirePressue waste code - Acute Healthffibl;.t zx - cnronic healthI-e![Frq!-q.r9-...AmbientT55CAS NoDays on Site: 3656.1 - Toxic SubstancesCorrosiveHazardous Wastes - tiquid tabPacks110!!o.r.eee*99.n$ilt-9l......Steel DrumHazardous Wastes - Solids LabPacks_c.L-s-lLo-._....ZOO 250 - FirePressue waste code - Acute HealthAtb6;l--- -- 22J - cnronic health-r_enP-9-t3I9!e*AmbientMA1statePounds250Days on Site: 3656.1 - Toxic SubstancescorrosiveSolidlvls*Waste2s09ls:-a-c9-.99 j!3i!9r -*Steel DrumHazardous Materials And Wastes lnventory Matrix ReportUniversl Waste - Consumerelectronic devicesCAS NoPounds 1000 400state !!g€e,g_o-l}iitr-9l..'.Solid Plastic/Non-metalicDrum,ToteI-YP.3-..- BinMixture Days on Site: 3656001580 - Acute HealthPressue waste code - Chronic health_r-9.lfp_-e-f -q_t_q.I-e-...181Printed on 2/12/2016 9:01 AMPage 8 of 9 waste Motor oil9$.-s-'1,t-_o .Map: 1 Grid: F4Gallons3StatePressue55227ustible Liquid, Class lll-BDays on Site: 365Lubricating Base Oil8s%Liq uidsmable andLiquidI-YP-e--.WasteAmbient-r-P.nP.9-t1tLt-9...Ambient500Waste Code- Fire- Chronic healthProprietaryProprietary110 ss-sl-o-rl-C-e-.9_on!A'Lr_gf __."Steel Drum, Plastic Bottle orJugZinc CompoundsAdditives7%20%AnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardEHS CAS No.UnitMax.QuantitiesNameCont. Avg" Daily%wrHazardous ComponentsmixturePACIFIC BETTTELEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERstD 10435963Facillty tD 0002817status Submitted onWEST SIDE OF SHOPChemical Location5:57 AMNameEusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/72/20!6 9:01 AMPage 9 of 9 MAP# 1SITE MAPBUSINESS NAME AT&T Colifornio SNLOCAAU SE164BUSINESS ADDRESS 196 SUBURBAN RD4 coMMERcTALDATE 3/12/2014ZIP CODE93403DRAWING SCALENOT TO SCALE237ISAN LUIS OBISPOCOt\,,lMERClALio_ol CLARIFIER-5@ctrcf,IDza-lf,mm-llaUJoo-UzoI(IUJUFm)otUoOL6@@POLEPortoble GenerotorsRESTAURANT@ nrr-ruur@ rvonnuuc FLUID@ nncor'r@ oxvcrn@ wlsrr ANTTFREEZEASYMBOL LEGENDEMERGENCY SHUT DOWNTANK IVONITORINGALARMTELEPHONEFIRST AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEWERli/-sdsl 133[?rd\ND MSDSL FIRE HYDRANIFENCEEMERGENCY RESPONSEEQUIPMENT/ABSORBEN TSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(CoMBUSTIBLE LIOUIDS)BATTERY ELECIROLYTE(coRRosrvE LTQUID)GASOLINE(FLAMI\,lABLE LI0UIDS)DIESEL FUEL(coMEusrBLE LtQUIDS)NITROCEN(COMPRESSED GAS)PROPANE(FLAMI/ABLE LIOUID)ACETYLENE(CoMPRESSED GAS)ANTIFREEZE/COOLAN TSWASTE OIL(FLAMMABLE LIQUID)fl rrne PULL BoxFCFLAMMABLES CABINET+ DRAINAGE FLOW DIRECTIONllq /-Ffl UNIVERSAL WASTE- ACCUMULATION AREAERE@(a@@Jvle+A-A@@.He()STAGING AREAEVACUATION/ELECTRICAL PANELSHUT-OFFNATURAL GASSHUT_OFFWATER SHUT-OFF1383 N. McDowell Blvd.Petolumo, CA U.S.A.PACIFIC BELL/AT&@ADMINISTRATIONBUILDINGASTORAGEO6OoOoooAWATERTANK9BcDEFGHJKLM Hospital Medical CentetcSan Luis Obispo, CA/Frenchc5.c4.CALIFORNIA DEPT, OF TOXIC SUBSTANCES CONTROL (DTSC)REGIONAL WATER QUALITY CONTROL BOARDu.s. ENVTRONMENTAL PROTECTION AGENCY (US EpA). . . . . .CALIFORNIA DEPT OF FISH AND GAME (DFG)U.S. COAST GUARD . . .CAL/OSHA. - - .cl0.c8.c7c3.566-9347OTHER (Specifo):STATE FIRE MARSHALAGENCY NOTIFICATION PHONE NUMBERS :NEAREST MEDICAL FACILITY / HOSPITAL NAME:OTHER (Specify):PHONE NUMBERSEMERGENCY(805) 543-5353) 781-5544(800) 300-2193(916) 358-2900(202) 267-2180(916) 263-2800(916) 445-8200POISON CONTROL CENTERLOCAL UNIFIED PROGRAMAMBULANCE, FIRE, POLICE AND CHPCALIFORNIA EMERGENCY MANAGEMENT AGENCY (CAL/EMA)NATIONAL RESPONSE CENTER (NRC), (916) 255-3545i (805) 54e-31479-1-1(800) 852-7550(800) 424-8802(800) 222-1222E l. tgr-ppgoNs;E o. ponrRer-E RADIoTOthat apply) c2FFECTED BY AN OFF-SITEFACILITIES THAT MAY BF,WILL OCCUR BY:E s. ellnv sysE 2. PUBLIC ADDRESS oR INTERCoM SYSTEM;8 I. VERBAL WARNINGS;4 PAGERS1 Activate internal facility alarms or communications systems, where applicable, to notiry all facility personnel.2. Notift appropriate local authorities (i.e., call 9-l-l).3. Notiry the Calilornia Emergency Management Agency at (g00) g12-il550.Before facility operations are resumed in areas ofthe facility aflected by the incident, the emergency coordinator shall notify the Califomia Department ofToxicSubstances Control (DTSC), the local Unified Program Agency (UPA), and the local fiie departmint's hazardous materials prog.u. that the facility is in compliancewith requirements to:I Provide.for proper storage and disposal ofrecovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release atthe facility; andtransferred, stored, or disposed of in areas of the facility affected by the incident untilwhen theCoordinator (orSYSTEM;ORINTERCOMapplv)VIA:(CheckLLOCCTJRwtALARMNOTIFICAORare2. Ensure that no material that is incompatible with the released material isan imminent orWhenever thereEl4.PE I VERBAL WARNINGS;FACILITYEmergency Coordinator is on call) shallfire, or release, theemergency situation such as an3, TELEPHONE;6. PORTABLE RADIO2. PUBLIC ADDRESS5. ALARM SYSTEM;oNSoCATITIONSNOTIFICAANDNUMBERSPHONEMMUNIoCEMERGENCYc.TEAMatrtr3. ACTIVATING IN-HOUSE EMERGENCY RESPONSEWASTE CONTRACTOR2. CALLING HAZARDOTISRESPONDERS (i.e., 9- I - I )I, CALLING PUBLIC EMERGENCYVIA: (Check all thatRESPONSE WILLINTERNAL FACILITYB. INTERNAL RESPONSEFIRES, AND EARTHQUAKES INVOLVING: (Check all that8 I. HAZARDOUSMATERIALS; EI 2. HAZARDOUSWASTES45.THIS PLAN COVERS CHEMICALAL OPERATIONS (e g.,Maintenance)BUSINESS (e. g., Painting Contractor)TelecommunicationsA3.TYPE OF93401ZIP CODE105.CASan Luis OBispoBUSINESS SITE CITY104.BUSINESS SITE ADDRESS196 Suburban Rd103.l.BUSINESS NAME /Same as Facility Name or DBABusiness As)- Dotngpany dba AT&T CaliforniaPacific Bell Telephone ComDATE OF PLAN PREPARATION/REVISION A2.February 12,2015Al.CERS ID1 0435963F1 966l.FACILITY ID #cATIwOVERVIETIONSPERAANDoONACILITYIDENTIFIF'A.ENVIRONMENTAL REPORTING SYSTEM (CERS)CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLANthis PIAN, PICASC TCfET IO thc INSTRUCTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLANPnor toCALIFORNIAAT&T EH&S HotlineRev.06127lll /-'(CERS Consolidated Emergency Response / Contingency Plan -Page2 oI 4R.ev.06/27lllADVANCE ARRANGEMENTS FOR LOCAL EMERGENCY SERVICES (ChecK oNE Of thE fOIIOWiNg)El I. HAVE BEEN DETERMINED NOTNECESSARY; oTE 2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (SPECifu):F2.F1ExplanationofRequirement:Advance arrangements with local fire and police departments, hospitals, and/or emergencydetermine that such arrangements are not necessaryappropriate for your facility. You mayservices contractors should be made asF. ARRANGEMENTS FOR EMERGENCY SERVICEStothelnlocationsitwhereandvisitors.ote:emergencymap(s)mustTheNareas-routes,andaltemateshowprimaryexrts,andpilmaryevacuationmustprominentlypostedandstagingandaltematebeACUEVPOSTEDASMAP(S)for all on siteCoordinator mustand/or sitelot, specific street comer, etc.)ASSEMBLY AREA(S)Theevacuation.FrontParking Lot Next to Suburban St - See EMOP Binder/Bldg WardenTION(S) IS/ARE EVACUEETHEAL(S) WLL BE USED TOEVACUATION OF THE FACILITYALL THAT APPLY):THE FOLLOWINGEI 3. VERBAL (I.E., SHOUTING);Fire AlarmOTHER1. BELLS;2. HORNS/SIRENS;E. FACILITY EVACUATIONE I. MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP, ETC.;E 2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls);E 3. PRoVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, pigs, pillows);El 4. COVER OR BLOCK FLOOR AND/ OR STORM DRAINS;[f 5. BUILT-IN BERM IN WORK / STORAGE AREA;E 6. AUTOMATIC FIRE SUPPRESSION SYSTEMIE 7. ELIMINATE SOURCES oF IGNITION FoR FLAMMABLE HAZARDS (e.g. Flammable liquids, Propane);E 8. STOP PROCESSES AND/OR OPERATIONS;E 9, AUTOMATIC / ELECTRONIC EQUIPMENT SHUT.OFF SYSTEM;E IO. SHUT-OFF WATER, GAS, ELECTRICAL UTILITIES AS APPROPRIATE;E I I. CALL 9.1-1 FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE / MEDICAL AID;8 12. NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AREAS;EI 13- ACCOI.TNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION CALL;E I4. PROVIDE PROTECTIVE EQUIPMENT FOR ON.SITE RESPONSE TEAM;E 15. REMOVE OR ISOLATE CONTAINERS / AREA AS APPROPRIATE;E 16. HIRE LICENSED HAZARDOUS WASTE CONTRACTOR;EI I7. USE ABSORBENT MATERIAL FOR SPILLS WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOUS WASTE DISPOSAL ASAPPROPRIATE;E I8. SUCTION USING SHOP VACUUM WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOIJS WASTE DISPOSAL ASAPPROPRIATE;E I9. WASH / DECONTAMINATE EQUIPMENT w/ CONTAINMENT and DISPOSAL OF EFFLUENT / RINSATE AS HAZARDOUS WASTE;E] 20. PROVIDE SAFE TEMPORARY STORAGE OF EMERGENCY.GENERATED WASTES;E 21. orHER (specifo):D2.Dl.SPILL PREVENTION, CONTAINMENT, AND CLEANUPpROCEDURES: (Check all boxes that apply to indicate your procedures for containing spills, releases,orand.associated harm tothe environment.D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES CERS Consolidated Emergency Response / Contingency plan - page 3 of 4Rev.06127/llG70.OTHER35.G68.OTHER34.c,66.AUTOMATICCHEMICAL-ttG64.PORTABLE32c63.INTERCOM / PAITelephones & Cellular Phone$'Throughout FacilityTELEPHONES (IncludesSystemsCommuni-cationsandOTHEROVERPACK DRUMS8.LEAK REPAIR KITSoda AshBattery AreaG52.NEUTRALIZERSG50.HOLDING TANK25.G49.G48.EXHAUST HOOD24.G47.SHOP VAC23.G45.SHOVEt,All-PurposeFleet AreaBROOM2BERMING / DIKING20Plastic BucketFleet AreaCONTAINER FOR USED ABSORBENTt9Kitty Litter/Grease SweepFleet AreaMATERIAI,l8ALL-IN.ONE SPILL KITl1pdG32.16.Fire Alarm Pull StationsAdmin. BuildiG30.BOXES OR STATIONS15.FIREG28.TEMS / SPRINKLERS /FIXED FIRE14.ABC Fire ExtinguisherThroughout Facilityca6.PORTABLE13.EXTINGUISHERSFireFightingCr25.G24.t2.OTHERG23.OTHERltBottle TypeG2lFleet AreaPORTABLE EYEWl0Gl9.PLUMBED EYEWASHSHOWERlndustrial First Aid Kit't.reaMain Building/Fleet AFIRST AID KITS / STATIONS15.SELF-CONTAINED BREATHING APPARATUS7RESPIRATORS6.HARD HATS5.Safety Glasses/Goggles/ShiSFleet AreaG8.SAFETY4.GOGGLES / SHIELDSESG6.BOOTSCHEMICAL3.Rubber/Chemical Gloves G5'Fleet AreaG4.GLOVESCHEMICALG3CHEMICAL PROTECTIVE SUITS, APRONS,ISafetyandFirst AidCAPABILITYLOCATIONAVAILABLEGl.TYPEpt and theuse,solventresistantoittime&responseOnekitSpillCHEMICAI-PROTECTIVEGLOVESkeequipmenttsthewherethelocation(s)andidentifyrtresponsethebleequipmentrvailafacilityCheck all boxes that apply to listifG. EMERGENCY EQUIPMENT /' '\I\CERS Consolidated Emergency Response / Contingency Plan - Page 4 of 4Rev.06127lllK3.TITLE OF SIGNERAgent for AT&T Services, lncK2.NAME OF SIGNER (print)Sheila CaballeroKIDATE SIGNEDFebruary 12,2015SIGNATURE OF OWNEzuOPERATORCertification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined andam familiar with the information submitted and believe the information is true, accurate, and complete, and that a copy is available on site.K. SIGNATURE / CERTIFICATION(Check one ofthe following)E I. NOATTACHMENTSAREREQUIRED; oT8 2, THE FOLLOWING DOCUMENTS ARE ATTACHED' AT&T Description of Employee Training' AT&T Emergency Response ProceduresJl.12.J. LIST OF ATTACHMENTSLargeQuflntityGenerator(LQG)TrainingRecords: Large quantity hazardous waste generators (i.e., who generate more than 270 gallons/l,000 kilograms ofhazardous waste per month) must retain written documentation ofemployee hazardous waste management training sessions which includes:. A written outline/agenda of the type and amount of both introductory and continuing training that will be given to persons filling each job position havingresponsibility for the management of hazardous waste (e.g., labeling, manifesting, compliance with accumulation time limits, etc.).o The name, job title, and date of training for each hazardous waste management training session given to an employee filling such a job position; ando A written job description for each of the above job positions that describes job duties and.the skills, education, or other qualifications required of personnel assignedto the position.r Cunentemployeetrainingrecordsmustberetaineduntilclosureofthefacility.r Former emnlovee training records must be retained at least three years after termination of employment.INDICATE HOW EMPLOYEE TRAINING PROGRAM IS ADMINISTERED (Check all that apply)f] I. FORMALCLASSROOM; 82. VIDEOS; E 3. SAFETY/TAILGATEMEETINGS;E 4. STUDY GUIDES / MANUALS (SPCCifo):E S. OfUgn (Speci!): All employees are trained to handle onsite emerqencies throuqh the AT&T online program.E 6, NoT APPLICABLE BECAUSE FACILITY HAS NO EMPLOYEESt2.13.llr Communication and alarm systems;r Personal protective equipment;r Use ofemergency response equipment (e.g. Fire extinguishers. respirators,etc.);o Decontamination procedures;. Evacuation procedures;o Control and containment procedures;o UST monitoring systemandnrocedrrres /if annl icable)Explanation of Requirement: Employee training is required for all employees handling hazardous materials and hazardous wastes in day-to-day or clean-up operationsincluding volunteers and/or contractors. Training must be:r Provided within 6 months for new hires;o Amended as necessary prior to change in process or work assignment;o Given upon modification to the Emergency Response / Contingency Plan, and updated/refreshed annually for all employees.Required content includes all ofthe following:o Material Safety Data Sheets;. Hazard communication related to health and safety;r Methods for safe handling ofhazardous substances;o Fire hazards ofmaterials / processes;o Conditions likely to worsen emergencies;. Coordination of emergency response;r Notification procedures;r Aoolicable laws and reeulations:I. EMPLOYEE TRAININGLOCATIONSFleel Area H7 'Portable cenerators H8Fleet Area H9Eleclriql & Gas: Outside NW Side ofAdmin Bldg, Water: Sw corner of Fscilny Ne{ to Subul6sn 51Hl 0Hll.Fleet Yard NeXt To Recycle Hl2VULNERABLE SYSTEMS: (Check all that apply) H6E] I, SHELVES, CABINETS AND RACKSE 2. TANKS (EMERGENCY SHUTOFF)E 3. PORTABLE GAS CYLINDERSE 4. EMERGENCY SHUTOFF AND/OR UTILITY VALVESE 5. SPzuNKLER SYSTEMSE 6. STATIONARY PRESSURIZED CoNTAINERS (e.g., Propane dispensing tank)Identifu mechanical svstems vulnerable to releases / spills due to earthquake-relatedmotion. These svsl.ems require immediate isolation and inspection.LOCATIONS (e.g., shop, outdoor shed, forensic lab)Fleet Area & Store RoomH2.H3.H4,H5.H1.VULNERABLE AREAS: (Check all that apply)E I. HAZARDOUS MATEzuALS / WASTE STORAGE AREAEI 2, PRocEss LINES / PIPINGE 3.LABORATORYE 4. WASTE TREATMENT AREAIdentify areas of the facility that are vulnerable to hazardous materials releases / spills due to earthquake-related motion. These areas require immediate isolation andinsoection.H. EARTHQUAKE VULNERABILITY AT&T Environment Health & SafetyHazardous Materials and Waste HandlingTraining OutlineEmployees are provided initial Safety Plan training on the Hazard Communication Certification, as well as functionspecific before they begin their work operations. This also includes training on the Emergency Operating procedures.The training is taken as an online interactive course. Training is recorded electronically.The training includes the following:Lesson 1: lntroductionLesson 2: Roles and Responsibilities OverviewLesson 3: ldentiffing Hazardous Materials and Regulated WastesLesson 4: Handling, Management & Disposition of Waste StreamsLesson 5: Generator RequirementsLesson 6: Emergency PlanningLesson 7: Hazardous Materials lncidentsLesson B: SummaryAppendix A - FinalAssessment Questions and AnswersAdditionally, theAT&T Emergency Plan requires that employees receive annual refresher training on the HazardCommunication Certification, function specifics and the Emergency Operating lnstructions.The AT&T Emergency Plan Binder serves as a reference guide for the Emergency Site Coordinator/Building Warden.Rev.06127lll Emergency Response FLEET.docAT&T ETUENCCruCY RESPONSE PLANThe following describes what actions our business willtake to stoppotential hazards caused by the release of ahazardous material orwaste:The Emergency Site Coordinator/Building Warden is responsible for following these steps as outlined in the facilftyEmergency Plan Binder or the site Spill Prevention Control and Countermeasure (SPCC) Plan where one isrequired.1. Determining the nature, location, magnitude and severity of the incident.2. Move people away from the area as appropriate.3. Avoid inhalation of all gasses, fumes or smoke.4. Stop the release and/or contain materials if adequately equipped and it is safe to do so, by arranging physicalbarriers, use of absorbents (i.e., bulk absorbent materials or absorbent socks).5. Make appropriate notifications as outlined in the site Emergency Plan Binder and as described NotificationProcedures section of this document.AeRreMeNT (sroP THE HAZARD)The following describes the procedures that must befollowed to minimize any harm or damage to persons,property or the environment:Hazardous Materials Drums: DOT approved drums are inspected for leaks and/or deterioration. Absorbentsare stored at the garage for containment of any releases.1. Motor Oil: Stored in drums in a controlled area. Drums are visually inspected daily to ensure integrity.2. Antifreeze/Coolant (New & Used): Stored in drums in a controlled area. Drums are visually inspected daily toensure integrity.3. Waste Oil/Oil Filters: Stored in aboveground tanks or drums in a controlled area and visually inspected daily toensure integrity.4. N itroqen/Hel i u m/Acetvlen e/Oxvq en/Arqon :Compressed gasses are stored in a controlled and separate areaCvlinders have safetv caps, are stored upright instoraqe stands and secured.Mrnerrroru (neouce rHE HAZARD)The following describes what action our business will take to prevent ahazardous materials or hazardous wasterelease from occurring:1. TnruHrno: AT&T employees are required to complete a variety of training related to the management, use,storage and proper handling of hazardous materials and hazardous wastes. The type and frequency oftraining is dependent upon the employee's job responsibilities and is delivered in a classroom environment oron-line through one of AT&T's Learning Management Systems'2. MareRnus: Hazardous materials are utilized and stored following manufacturer's recommendations, as ourbusiness is a user of chemical products and not a manufacturer of hazardous materials.PnrverronAT&T's Operating Practice 130 (The Fire Safety Program and EmergencyPlan) is described in the AT&TEmergency Plan Binder. The Emergency Site Coordinator (ESC) for the facility is responsible for completing anemergency action plan (i.e. the AT&T Emergency Plan Binder) for the facility that is available for review by theoccupants of the building. Supervisors are responsible for advising their direct reports on how to reportemergencies, such as a hazardous materials incident and how to evacuate or shelter in place, as directed by thesite AuitOing Emergency Organization. Additionally, the Emergency Site Coordinator will immediately notiff AT&T'sinternal contacts as appropriate including the local Security Office and the AT&T Environment Health & SafetyOrganization. The ESC will also work with EH&S and Legal to determine if notification of the CA EmergencyManagement Agency (CAL E-M-A) and Local Administering Agencies is required. All spill/release notifications toreoulatorv aqencies will be done by an EH&S lncident ManagerNorncmoN PRocEDURESI \HAZMAT\PACBELL\2-FORMS\Emergency Response FLEET docLast Updated : 12120/20131 Emergency Response FLEET.docEarthquake resistant construction isemployed in the building construction of the sites. Electrical transmissionand telecommunication systems are designed and built to be earthquake resistant.Remedial Measures are standardized bracing systems using vibration resistant equipment.Following an earthquake, upon arrivalto the site, the technician will inspect the hazmat storage areas forleaks and/or spills. ln the event of a release, attempt to contain the release as described above. Evacuate thearea to the designated staging area located away from the equipment. lf necessary shut down the power tothe equipment using the main electrical panel.ldentify areas requiring immediateattention following an earthquake. lf power is to be shut off or someequipment needs to be shut down please describe procedure, who does it and where shut off is locatedEnRrnounKE RESPoNsEThis varies with each buildingstandard statement would be:and should be verified with the Emergency site coordinator of each facility. AMerxoo or ALARM To Eruproyees:Vocal, intercom and fire alarms are used to notifi7 our employees to evacuate.Roures or Ecness:This also varies with each building and should be verified with the Emergency Site Coordinator of each facility. Astandard statement would be:Evacuation Plan:AT&TPracticeEHS-1200-PRC.SmallSprResponseandClean-up"requtresallncidentaIandemergencyspillstobereportedtotheEH&SHotlne,emergencyprompt1Thisdocumentalsoinstructsfacilitiesonpre-planning,recognizngandreportingspllsspillclean-updecisionmakingrequiredtraining,spiIkitnformationndwastedsposition.EH&SemergncycallsaremanagedasdescribedinAT&TnternalOperatingProcedureEHS-116-loPEnvironment,Health&SafetyHotltneProceduresAnon-DutyEH&SncidentManageriscontactedtoassistwithreportedspills,includtngdispatchofaspillclean-upVEndorandcompletinganyspill/releasenotificationscontractors utilized to clean up spills and releases for our facilities include:1. Shaw EnvironmentalDiesel Fuel: The AT&T Hazardous Materials Management Plan ltem G (Contingency Plan): ouflines thenotifications required for incidents involving spills which include::1.2.3.4.5.LocalFire DepartmentDepartment of Public HealthAT&T Environment Health & SafetyAT&T Real Estate Client Service CenterAT&TSprllsnto Lelxs oF HAzARDous MATERTALSEmployeescompletefunction-specifictrainingthatISfortheirworkoperationsasoutlinedtntheapplicableAT&TEH&STrainingMatrices.Newemployeesoremployeeswhotransferintoanenvironmentallyimpactingjobmustcompletetheirtrainingwithin90daysandmaynotperformenvironmentalresponsibiitiesunlesstheyarervisednEmptoYee TRnrnneI IHAZMAT\PACBELL\2-FORMS\Emergency Response FLEET.docLast Updated: 12/20120132 FLEET.docAT&T has emergency response plans and procedures in place for all facilities. The following is a descriptionof theprograms and procedures in place:1. The AT&T EH&S Hotline is a 24-hour communications center established through which emergency conditioninformation flows from and within AT&T. ln the event of a major emergency the center also providescoordination, communications and is the established liaison with federal, state, local and military agencies.2. EueRcency PLAN Brxoen, The AT&T Operating Practice 130 provides fire, safety and emergency guidance,checklist, forms, and company contacts for emergency situations, interruptions of company services, and otherthreats to our operations, facilities, personnelor property.Outlined in the AT&T Operating Practice 130 is the Emergency Site Coordinator/Building Warden program.The Emergency Site Coordinator/Building Warden is involved in directing and coordinating the followingactivities with the occupants of the facility.o Establishing and training the building emergency organization.o lmplementing the Emergency Procedure Plan.o Occupant emergency preparedness.o Reviewing the Planning Engineering sketch.o Establishing and maintaining the Emergency Procedures Board.o Developing and maintaining the Emergency Methods and Procedures (EMOP) binder.r Scheduling and conducting semi-annual fire and take cover drills and recording drill results on theFire/Evacuation Drill Report.o Conducting fire safety surveys using form SBC3077o Daily administration of fire prevention practices.r Reporting all bomb threats to appropriate security office and the ECC.r Advising security of all emergencies.o Accompanying external or internal agencies on building inspections.o Arranging for selection of Emergency Site Coordinator/Building Warden successor (transfer ofresponsibilities).r Communicating to occupants via emergency communications systems (if applicable).r Contact the Environment Health and Safety Organization in the event of an OSHA visit.The AT&T Operating Practice 130 also requires that each facility have an Emergency Plan binder. The binder isa guide providing for personal protection and emergency procedures for company locations duringemergencies. The binder is developed and held by the Emergency Site Coordinator at each facility locationwhen the minimum legal required building headcount is reached.Emergency Response Plan"Employees exit through front, rear and side doors. Alternate routes include...."The instructions for emergency exists and alternate routes to be used for evacuation are posted on eachfloorMETHoD To AccouNT FoRALL Pensons:The AT&T Operating Practice 130 identifies the Emergency Site Coordinator/Building Warden as the individualresponsible for working with the location management to determine occupant accountability in the event of anevacuation or other emergency. This includes the establishment of assembly areas where accountability can bedetermined. Employees for this facility are instructed to meet..... (obtain this information from the Emergency SiteCoord i nator/B u ild in g Wa rde n).Alemnc NelcHsons:The AT&T Operating Practice 130 identifies the Emergency Site Coordinator/Building Warden as the responsiblecontact to work with all agency emergency/rescue personnel to notif,7 facility adjacent properties.I IHAZMAT\PACBELL\2-FORMS\Emergency Response FLEET.docLast Updated : 1212012013-t FLEET.docAdditionally, the AT&T Operating Practice 130 provides the following procedures for the Emergency SiteCoordinator and Site Managers in the event of a hazardous materials incident at the facility.1. ldentify and locate the problem.2. lsolate, relocate or evacuate employees as required.3. Notify emergency rescue personnel if needed.4. lnvestigate the problem.5. Avoid inhalation of all gasses, fumes or smoke.6. lf the release or threatened release has the potential to harm the population and environment contact:oAT&T Environment Health & Safety Hotline 800-KNOW EHS (800-s66-9347), prompt 1. Environmental Control Center for Fuel Storage Tanks 800-KNOW EHS (800-566-9347), prompt 1oAsset Protection (AT&T) 800-807-4205oLocal Hazardous Emergency ResponseAgency 911oCA Emergency ManagementAgency (CAL E-M-A) 800-852-75503. ln the event of a spill or release, onsite personnel call 1800 KNOW EHS to report the incident the HazardousAT&T's Environment Health &is to beMaterials lncidentI :VIAZMAT\PACBELL\2-FORMS\Emergency Response FLEET.docLast Updated: 12/20120134 IThe Propane used can be hazardous in the event of a spill or release, or if there is a fire atthe facility' Propane is flammable, in the event of a fire; the container could explodeviolently due to the high heat of the fire.Propane is an odorless, colorless, flammable gas. often an odorant is added for fuelpurposes' A release in a confined area may.cause rapid breathing, diminished mentalalertness, and impaired muscurar coordination, *Jiuurty.;uag*rrr"nt, depression of arlsensations, emotional insrab'ity and fatigue nr;*n;i;ri;; progresses, nausea'vomiting and loss of consciou.n"r, muy result.Spill or \elease:In the event of a rerease from the propane tanrr/cyrinder, do the foilowing:]. Evacuate all personnel from the affected area.?. Stay upwind of the release and out of low-lying areas.3. Avoid breathing gases.4' If the leak is in a coniainer or valve, contact the propane supplier for assistance.5. ventilate the area before attemptinj the re-enter th";;.6' Do not enter the building untit ime.igency personner have notified you that it is safe.7 ' contact management using the r**rlrory phone rist procedure.Fire:l. Follow the Fire and Explosion evacuation procedures.2. Notifu emergency personnel of the tank location.Prevention Procedures :1. store tank andlor cyrinders with varve protection caps instaled.2' ffi:n|ln:f,ders should be stored uprieht *J idiy r"our.a ro prevent falling or3' containers should be stored in a sool, dry, well ventilated area awayfrom sources of. heat or ignition and direct sun light. '4' If you suspect any problems wit[ the tank notifu the supplier immediately to have thesystem inspected,Spill/Release Response procedures for propaneI :\FIAZMAT\AT&T Mobi lify\Z_ Forms\Sp i I I plan - propane.doc Spill/Release Response Procedures for Diesel FuelThe Dieser Fuer used can be hazardous in the event of a spi* or rerease, or if there is a fire atthe facitity. Diesel r,iiit'""*uusiine. r"irt"L*ti of ' fi'"'.the container may be ignited byheat, sparks or ttamei. V"por. may travei'to " touttu of ignition and flash back' The vapors*11'"r5o ."use oizzlie"r bi *uroiation if within a confined space.proper response to a diesel fuel spill is necessary to protect employees' the public' and theenvironment. use il.e torro*ing procedures if a spill or release occurs:Minor spills'l:nttl?ilt"lJjtfil?;ttins up oranse cones and keep unnecessary people awav'Stay upwind and keep out of low areas'B. Try to eliminate att sources otignition. Do not start cars, light cigarettes, or u$eelectrical equiPment'c. ur"'oilirilniioi.orotnent pads in spill kit to absorb spill'D. Wear personal protectivJ-e,iip*"^t (safety vest' gloves and goggles) whencleaning uP the absorbent'E. lf the spill cannot be contJned and is flowing towards a sewer or storm drain' tryton6c[theflowandcalltheFireDepartment.F. lf in doubt, call the Fire Department'G. tmmediately notify tn. ir-gTi*"rg"n.v callcenter at 800-KNOw EHS' (800-566-9347) if the spill flows off-site,tntels a storm drain' or contacts bare soil'H. Sff::y1l"J!:::11ffi"Y?l;:*rrs in accordance with rocar, state and rederar,r*fii|oo,ffiie:;;iifie Ar&r Emersency call Genter to arranse for disposal'l.Besuretoorderadditionaloildryandaspillkitifneeded.Maior SPills - more than 5 gallons .Shut down opbrations immediately'B. Callthe Fire DePartment'c'lsolatetheareabysettinguporangeconesandkeepunnecessarypeopleawayStay upwind and keep out of low areas'D. lf you can safely oo ro,-ifp tn" tro* of tuel - use absorbent pads or oilabsorbents to prevent h"*hl" Oiains or the sewer and contain the spitl'E. Try to eliminate att sourJes oilg;iiion' Do not start cars light cigarettes' or useelectrical equiPment'F. rnio* tir plidont in the area about the spill'G. lf the product release causes adverse reactions to an employee or other on sitepersonnel, attention r;ihildiately be given to their safety and well being'H. tmmediately notify tn" niai'r*ig"n"y c"allcenter at 800-KNow EHS' (800-,. 1?t+t#,1).on,r.t the abatement contractor for creanup and.disposal'J, AT&T Environment 11j#i; il 5"i"ty *1t make allagency notifications'K.Besuretoorderacoitionatoildryindaspillkitifneeded.l:\HAZMA'I1AT&T Mobility\z- Fornrs\Spill Plan' Diesel'doc9/r9n0l I IPreventionffill;t visually inspected monthly during routine maintenance and testing ofthe emergencyDuring employee *{"iy meetings, emn!9yeeg are provided the information contained within theiifilX"rfiJVlaterials Business [t"n tno tire emeigln.v-ilrponse procedures contained withinMitigationBarrier tape will be placed around the released material. A qualified contractor will handlereleases exceeding the capabilities of the employees.The tank is double walled and will contain 11.0% of its original capacity. ln the event of anunauthorized release, which is not contained within in" Jiril" wall of the tank, spill kits areavailable on the Technician's truck to contain ; *il;iu;irpiil. lAbatementA gualified contractor will handle releases exceeding the capabilities of the emptoyees.site staff will contact. the AT&TEm*rgrr'.y cail clnter it aoo-xruow EHs, (Bb0-566-9 347) forany unauthorized releases' AT&T Environmeni H""rtn'a safety will contact the abatement;:|lffi,ilJ:r cleanup and disposal. rnvironmeni ii"Ju. a satetv *iii-ii"r" au asencyIlHMMAT\AT&T Mobilitye- F.ornrsL5pill plan - Dicscl.doc9tt9/2An California Environmental Reporting System (CERS)Remote Waste Consolidation Site Annual NotificationCaliforniasE154CERS ID10435953EPA lD NumbercAT080024268Suburban Rdn Luis Obispo, CA 93401StatusAT&TCALIFORNIA(SanRamon,cA)7/16/2016byPeteBurnellofPACIFtcBELLTELEPHONEcoMPANYdbaonBoyleforSanLuisObispoCityFireDepartmentwasAccepted;Processedon2lt2l2ot6byKerrySite lnformationSuburban RdLuis Obispo, CA 93401of Remote Location(slsitesof waste(s) collectedniversal wasteEstimated MonthlY Volume ConsolidatedHazardous Waste Treatment200 PoundsForNotNeedingaFederalPermitunderCaliforniastatelaw.underfederallawalthoughthewastetsregulatedhazardouswastelhehazardouswastebeingconsolidatedtsnothazardouswasteandaccumulationoftheconsolida6onsiteof thewastet5notsubmitedtopermittingrequirementshazardouswastelshazardouswasteunderfederallaw,buttransportationtofederal law for the following other reason(s):Owner/oPerator TitleDat€ Certified/Operator NameALTAMIRANOPrinted on 2/L2/2OLG 9:01 AM California Environmental Reporting System (CERS)Submittal SummaryAT&T Galifornia - SE164 (CERSID: 10435963)PM by Sfeve Skanderson of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (SanRamon, CA)Submittal was Accepted on 212612015 8:25Q7 AM by Kerry BoyleSubmitted on 21 121201 5 6:07:01. Business Activities. Business Owner/Operator ldentificationPM by Steve Skanderson of PACIFIC BELL TELEPHONE COMPANY dba AT. Hazardous Material lnventory (13). Site Map (OfficialUse Only)" Annotated Site Map (Official Use Only) (Adobe PDF, 90KB)IATSubmittal was Accepfed on 212612O15 8.27:41AM by Kerry Boyle5Submitted onRamon, CA)of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA. Emergency Response/Contingency Plan" Emergency Response/Contingency Plan (Adobe PDF, 1 108K8). Employee Training Plan" Provided ln Submital Element Emergency Response and Training PlansSubmittal was Accepfed on212612015 8:28:33 AM by Kerry BoyleSubmitted on211212015 6:07:01 PMRamon, CA)Ramon, CA)Submittalwas Accepfed on2126120158:29:26 AM by Kerry BoyleHONE COMPANY dba AT&T CALIFORNIA (IFL15 6:07:01 PM by Sfeve Skandersonon2l1. Remote Waste Consolidation Site Annual NotificationPrinted on 2/26/2015 8:29 AM California Environmental Reporting System (CERS)Business Activitiesiite ldentification\T&T California - SE164196 Suburban Rdian Luis Obispo, CA 93401:ounty;an Luis ObispoCERS ID10435963EPA lD NumbercATo80024268iubmittal Statuslubmittal wasAccepted; Processed on2/26/2075by KerryBoyle forSanLuisObispoCountyEnvironmental Health{azardous Materials)oes your facility have on site (for any purpose) at any one time, hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200:ubic feet for compressed gases (include liquids in ASTS and USTS); or is regulated under more restrictive inventory local reporting requirementsshown below if present); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix\ or B; or handle radiological materials in quantities for which an emergencv plan is required pursuant to 10 CFR Parts 30, 40 ot 70?Yes,nderground Storage Tank(s| (UST))oes your facility own or operate underground storage tanks?No)oes your facility have Regulated Substances stored onsite in quantities greater than the threshold quantities established by the California Accidentallelease prevention Program (CalARP)?No)oes your facility own or operate ASTS above these thresholds? Store greater than 1,320 gallons of petroleum products (new or used) inrboveground tanks or containers.NoExcluded and/or Exempted Materials)oes your facility recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC 25143.2\?Nos your facility a Household Hazardous Waste (HHW) Collection site?No)oes your facility generate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or more of federal RCRA hazardous waste, or generaten any single calendar month, or accumulate at any time, I kg Q.2 pounds) of RCRA acute hazardous waste; or generate or accumulate at any timeIore than 100 kg (220 pounds) of spill cleanup materials contaminated with RCRA acute hazardous waste.No)oes your facility need to report the closure/removal of a tank that was classified as hazardous waste and cleaned on-site?No)oes your facility consolidate hazardous waste generated at a remote site?Yess your facility's treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)?No)oes your facility treat hazardous waste on-site?Noflazardous Wastes your facility a Hazardous Waste Generator?YesAdditional lnformation\o additional comments providedPrinted on 2/26/2Ot5 8:29 AM California Environmental Reporting System (CERS)Business Owner OperatorCalifornlasEL64CERS IDSuburban Rd10435953LuiscA 93401Statusbmitted on 2/72/2015 by Steve Skandelso, of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (San Ramon, CA)bmittal was Accepted; Processed on 2/26/20t5 by Kerry Boyle for San Luis Obispo County Environmental Healthldentification3RENNAN MAHONEYf,perator Phonel80s) s46-7416Business PhoneBusiness FaxBeginning Dater/r/2o7sDun & Bradstreet103401618Ending Date72/37/2O7sSIC Code4873(80s) s46-7416(92s) 973-0s84Primary NAICs5r77r0Facility/Site Mailing Address308 S. Akard Street, Room 1708)allas, TX 75202Emergency ContactEmergency ContactBell Telephone Company dba AT&T California14) 464-2626S. Akard Street, Room 1708las,Tx75202EH&S HotlineHour Emergency ServicePhone24-Hour PhonePager Number566-93473illing Contact\T&T EH&S274]| 464-2626 mpO873@att.com1600 Camino Ramon, Room 4W2001;an Ramon, CA 94583MAHONEYntal site ManagerPhone24-Hour PhonePager Number546-7476Environmental Contact3RENNAN MAHONEYl80s) s46-7416372 Moffo Street, Rm 305;an Luis Obispo, CA 93401bm800e@att.comof SignerSkandersonSigner TitleAgent for AT&TDocument PreparerSteve SkandersonlnformationFieldsor all of the following fields may be required by your local regulator(s)Property Ownerthonevlailing AddressAssessor Parcel Number (APN)Number of Employees80Facility lD0002817Printed on 2126/2015 8:29 AM AnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardNameHazardous ComponentsUnitMax.QuantitiesCont.mirture%wt EHS CAS No.Gallons-sle-!_e-.Liq uidf-YP"PureCAS NoDiesel FuelWaste Code100Pressue727bustible Liquid, Class llDays on Site: 365bustible Liquids3 - Flammable and68334-30-5Map: 1 Grid: F7Ambient-r-9-.glP-9-.t-?!-s.t9-...Ambient- Fire- Chronic healthL27-s.!9_I_?_99_._c.p-t*glt-e-L..-..Aboveground TankPACIFIC BEtt TELEPHONE COMPANY dbA AT&T CAIIFORNIAAT&T California - SE164196 SUBURBAN RD, SAN LUIS OBISPO 93401cERsrD 10435953Facirity rD OOO28L7status Submitted onParking lot - Portable Generatorschemi€l Location6:07 PMNameBusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/26/20L5 8:29 AMPage 1 of 8 ll?lP-.-GasI-YP_e-..Puremmable GasCAS No74-46-2Acetylene222Pressue720on Site: 3552.1 - Flammable Gases(Reactive), Class 2,> Ambient-r-9.llP-9.t-?!-'1r-...Ambient-s.I-o-F-cg-p.9*r!9i1el-....CylinderCu. Feet 222- Firewaste code - PressureRelease- Acute HealthCode/Fire Haz. ClassCommon NameMax. DailyFederal HazardHazardous ComponentsUnitName%Wt EHS CAS No.l-argest Cont.AmountAnnualQuantities WastePACIFIC BELL TETEPHONE COMPANY dbA AT&T CALIFORNIAAT&T California - SE164196 SUEURBAN RD, SAN LUIS OBISPO 93401cERsrD 10435963Facility lD 0002817status Submitted on2h2l20l5 6:07 PMChemical LocationNameBusiness/Org.shopHazardous Materials And Wastes lnventory Matrix Reportustible Liquid, Class lll-BGREASE / GEAR IUBECAS NoMap: 1 Grid: F4Gallons-s.!?l-e-..Liq uidMixture55Steel Drum, Plastic Bottle or Jugon Site:365- FireWaste code - Chronic healthSolvent Dewaxed Residuel OilHydrotreated Dist Hvy ParaffinSol Dewaxed Dist Hvy ParrafinHydrotreated BottomsAdditives64742-62-764742-54-764742-65-064742-57-0PROPRIETARY5061s2%so%so%4r%72%PressueAmbient-r-9.nP-9.r-?!-rt.I9-...AmbientPrinted on 2/26/2015 8:29 AMPage 2 of 8 Plastic/Non-metalic Dru mDays on Site:36555lr-q:-s-gR.***Ambient_r_enp-FI_alC..l*AmbientUsed AntifreezeCAS No5555lombustible Liquid, Class lll-Bw?:!F-9-og9343707-zL-tMap: L Grid: F4Liq uid-T-yP-e-....WasteGallons 55State StorageContainer- Acute Health- Chronic health)OT:3-Flammableand3ombustible LiquidsAnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardNameUnitMax.QuantitiesCont.Hazardous Componentsmixture%Wt EHS CAS No.PACIFIC BELL TETEPHONE COMPANY dba AT&T CAIIFORNIAAT&T California - SE164196 SUBURBAN RD, SAN LUIS OBISPO 93401cERsrD 10435963Facility lD 0002817status Submitted on 2h2l2OI5 6:07 PMSTORED EAST SIDE SHOPChemi6l l-ocationNameBusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 2/26120L5 8:29 AMPage 3 of 8 AnnualWasteAmountCode/Fire Haz. classCommon NameFederal HazerdEHS CAS No.UnitMax.Namequantitieso/.wHazardous ComPonentsLargest cont. Avg. DailYCh€mlcal LocationSTORED IN SHOP6:07 PMNameEuslness/Org,196 SUBURBAN RD,sAN LUIS OBISPO 93401PACIFIC BETLTETEPHONE COMPANY dbA AT&T CALIFORNIAStatusSubmltted onAT&T California - SE154cERsrD 10435953Facirity rD OOO28L7Hydraulic FluidSA-s x-o_*.Map: 1 Grid: G5Gallons zLS 140st?l-e_- tl9-L?C-e-.-c.9..1!3!!9I-.-Liquid Aboveground Tank, Steel Drum_r,y-P_g-Mixture Days on Site: 365AmbientLubricating Base OilPressuer45Ambient-r_9tlP-gt-dgl-e--.ye9j.9 -qeg-eAdditivesLiquid, Class lll-B- Fire- chronic health99%3 - Flammable andbustible LiquidsHazardous Materials And Wastes lnventory Matrix Report3 - Flammable andbustible Liquidsmbustible Liquid, class lll-B,Motor Oil-949-.lt-o---..Map: 1 Grid: F3Gallons 165 55state . :!_o_ttag_e__q*ki[9l'.Liquid Steel Drum, Plastic Bottle or Jug-T-YP.-e-..-Mixture Days on Site: 365110lI_q9-slle-.....-............Ambient,r-9.nP-9.I9-1-Yr-e..-AmbientFireChronic healthLubricating Base oilZinc CompoundsAdditivesWaste Code8s%7%20%Proprieta ryProprietaryPrinted on 2/26/2015 8:29 AMPage 4 of 8 -s$_!9-..Gas-T-yP-e-....PureCAS NoOxygen222Pressue2s0Storagedizing, Class 22.2 - Nonflammable GasesCylinderon Site:3657782-44-7Map: 1 crid: F5> AmbientI9,!rp_el?!-y.I_e_-.Ambient- FireWaste Code - pressure''''''''' '''" ReleaseCu. Feet 444AnnualWasteAmountCode/Fire Haz. ClassCommon NameComponent NameEHS CAS No-UnitMax.Cont.Daily%wtHazardous ComponentsonFederal HazardCategoriesHazardous Materials And Wastes lnventory MatrixReportBusiness/ors. PACIFICBEtt TETEPHONE COMPANY dba AT&T CALTFORNTANameAT&T California - SE164196 SUBURBAN RD, SAN LUIS OBISPO 93401Chemi6l l-ocationStored in shopcERsrD 10435963Facirity rD OOO28L7status Submitted on6:07 PMPrinted on 2/26/201,5 8:29 AMPage 5 of 8 cERsrD 10435953Facility rD 0002817status submitted onChemical l-ocationStored in the Yard6:07 PMNameBusiness/org.PACIFlC BELLTETEPHONE COMPANY dbAAT&T CATIFORNIAAT&T California'SE164195 SUBURBAN RD, SAN LUIS OBISPO 93401GallonslleIl.GasI-v-q9--.PureCAS NoLiquefied Petroleum Cas (lPg)Site: 365250250tt-9_s_s_{-e-...................W?{e.g-o.i-euified Petroleum Gas2.1 - Flammable Gases74-98-6Map:1 Grid: D4250$_oje-c_-e--c.-ojleit'-9I.........Aboveground Tank- Fire- PressureRelease> AmbientIglp-glcl1l.t-9AmbientAnnualWasteAmountCode/Fire Haz. Classcommon NameMax. DailyFederal HazardunitQuantitiesNameCont. Avg. DailyHazardous ComPonentso/"Wt EHS CAS No.HazardousMaterialsAndWasteslnventoryMatrixReportPrinted on 2/26/20L5 8:29 AMPage 6 of 8 Gallons 110State StoraseContainerLiquid Steel DrumType .Waste Days on Site:365CAS No755Pressue556.1 - Toxic SubstancesCorrosiveHazardous Wastes - liquid LabPacksAmbientIgirPst_*t.rg*Ambient110 - FireWaste Code - Acute Health"*- tB - Chronic healthPounds 25OState StoraseContainerSolid Steel DrumTy-pe .Waste Days on Site:365ZOO 2S0 _ Firepressue waste code _ Acute HealthA.rbi""l** -2il - Chronic heatrh-r-9-.np.-ei4ge*AmbientCAS No12506.1 - Toxic SubstancesCorrosiveHazardous Wastes - Solids labPacksWaste Oily Water_cl9- ry-o__._Map:3 Grid: H8Gallons:!9!e-._LiquidI-v-PF_-Waste55on Site:3557250PressueAmbientIenP-e'I-?_qgle*Ambient1250Waste Codet2509!9te-g-_e19$ggt_-ej..-_Steel DrumAnnualWasteAmountCode/Fire Haz. CtassCommon NameFederal HazardUnitMax.QuantitiesNameCont. Avg.Hazardous ComponentsmixtureYowt EHS CAS No.6:07 PMPACIFIC BELI. TETEPHONE COMPANYAT&T California - SE164dba AT&T CATIFORNIAEusiness/Org.Name196 SUBURBAN RD, SAN LUIS OBISPO 93401Submltted onChemlel LocationWaste Storage AreacERsrD 10435963Facirity ID OOOZaITHazardous Materials And Wastes lnventory MatrixReportUniversl Waste - Consumerelectronic devicesCAS No1000 400:!9I3C9. _cjjtallgf_Plastic/Non-metalic Drum, ToteBinDays on Site: 365600 1580 - Acute Health.ll9:t8..__.._ _Uh:!e._qgg_e... - Chronic health181Temperal_u_r_€PoundsStateSolidI-v-P9*MixturePrinted on 2/2612075 8:29 AMPage 7 of 8 6:07 PMNameBusiness/Org.dbA AT&T CALIFORNIACOMPANY196 SUBURBAN RD,sAN LUls oBlsPo 93401StatusSubmittedon2llChemical LocationWEST SIDE OF SHOPPACIFIC BELL TELEPHONEAT&T California - SE154cERsrD 10435963Facility lD 0002817Code/Fire Haz' ClassCommon NameFederal HazardUnitMax.NameCont. Avg.Hazardous ComPonentsAnnualWasteAmount%Wt EHS CASNo.Waste Motor OilS8: l*o *Map: 1 Grid: F4775ll,e.:.s*q.e-..................Ambient-r-9.11P-9r-?tuLq....AmbientState240Gallons 2403 - FlammableandLubricating BaseoilLiquid, Class lll-B85%stible LiquidsLiquidI_YP._e-...WastestoraEe ContainerIdGilil;d i;nii, Plastlc eottleor JUBDays on Site: 365500w-?:19 !gq"e277- Fire- Chronic healthProprietarYProprietaryZinc ComPoundsAdditivest%z0%rdous Materials And Wastes lnventory Matrix ReportHazaPrinted on 2/26/2075 8:29 AMPage 8 of 8 MAP# ISITE MAPornio SNLOCAAUSE1 64BUSINESS NAME AT&T ColifBUSINESS ADDRESS196 SUBU4RBAN RD---:_SAN LUIS OBISPOCOI\4MERCIALDATE 3/12/201ZIp C6DE 93403DRAII]NG SCALENOT TO SCALE1234"-T ---- -5COI/IVERCIAL@cIDc],u,zaf,rnm-{tr\).uUoOqUjoLUzoI0-U)UFio-bl cLARPortoble GenerotorsRESTAURANT@@PULL7---J:8@ Heuul,r@ lvoneur:c FLUID@ ancolr@ oxvcrrv@ wnsrr ANTFREEzEELECTRICAL PANELSHUT_OFFNATURAL CASSHUT-OFFWATER SHUT-OFFEMERGENCY SHUT DOWNTANKMMONTTORTNGTELEPHONEFIRST AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEWERSTAGING AREAEVACUATION/mEbEl HtvtvP, AND MSDS- LOCATIONL FIRE HYDRANTFENCEEMERGENCY RESPONSEEQUIPMENI/ABSoRBEN TSABOVEGROUNDSTORAGE IANKUNDERCROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE LIQUiDS)BATTERY ELECTROLYTE(coRROStvE LIQU|D)GASOLINE(FLAIilMABLE LIQUIDS)DIESEL FUEL(coMBUSIIBLE LIOUIDS)FCNITROGEN(COMPRISSED GAS)PROPANE(FLAMN/ABLE LIOUID)ACETYLENE(COMPRESSED GAS)AN TIFREEZElCOOLAN TSWASTE OIL(FLAIilMABLE TIQUID)FIRE PULL BOXFLAMMABLES CABINET+ DRAINAGE FLoW DIRECTIoNl!frIEl UNIVERSAL WASTE- ACCUMULATION AREA@@@@Ao+K-AElJ@@o@oo@@@trlnc.138J N. McDowett Btvd.Petolumo. CA U-S.A.trw.stontec.comPACIFIC BELL/AT&TIFADMINISTRATIONBUILDINGFCSTORAGTO-oooooo-- -'iA(ll\lUw-EA-lWATERTANKqcDEFGHIJKLM (SanLuisospObispoHCAJFrenchitalMedicalCeCALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC)REG]ONAL WATER QUALITY CONTROL BOARDU.S, ENVIRONMENTAL PROTECTION AGENCY (US EPA) ' ' ' ' ' 'CALIFORNIA DEPT OF FISH AND GAME (DFG)U,S. COAST GUARD . . .CAL/OSHATE FIRE MARSSTAHOSPITALAGENCYNOTIFICATIONPHONENUMBERS:NEARESTMEDICALFACIL]TYNAME:PAGENCYPOLICE AND CHPRESPONSE AMBULANCE,FIRE,OTHEROTHER (SPecifo):PHONENUMBERS805) 781-5544LOCAL UNIFIEDOTHER (SPecifu):CALIFORNIA EMERGENCY MANAGEMENT AGENCY (CAL/EMA)NATIONAL RESPONSE CENTER (NRC)PO]SON CONTROL CENTER . . '(800) 300-2193(916) 358-2900(202)267-2180(916) 263-2800445,820-0 .566-9347(895) 91q:53539-1-1(800) 852-7550(800) 424-880222'?-r?22.NEIGHBORING FSMAY BETHA(Check all that apply)RELEASE WILL OCCUR BY:4 PAGERSEl t. vr,nsat-wARNINGS;5. ALARM SYSTEM;E 2. PUBLIC ADDRESS OR INTERCOM SYSTEM;AN OFF6. PORTABLE RADIO! 3. trleruoNe;5. ALARM SALFEI I. VERBALWARNINGS;E 4. PAGERS;6. PORTABLE RADIOEl t. tplspuoNe;VIAall that apply)E 2. PUBLIC ADDRESS OR INTERCOM SYSTEM;WILLTIONS OR ALARMBefore fac'ity operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall notif, the califomia Department of roxicsubstances contror (DTSC), rrr.l"""r u"in"a program o;:rifi;; ;d'il i";;ii* departmint's hazardous materiars program that the facilitv is i'compliancewith requirements to:l . provide fbr proper storage and disposar of recovered waste, contaminated soir or surface water, or any other material that results from an explosion' fire' or release at#n,,at..iut that is incompatible with the released material is transfened, stored, or disposed of in areas of the facility affected by the incident until15 anor actual emergencysuch as an exPlosion,the Emergency Coordinator (ordesignee whenorthe facility;2. Ensure that(i.e.,NJ.otifl,theCaliforniaEmergencYManagementAgencyat(800)852-7550.2Notifrappropriatelocalauthorities)call9-orItyActivatealarmsfacilinternalcommunicationssystems,whereapplicable,tonotif!facilitvallpersonnelEmergencYonCoordinator1Scall)shallcEMERGENCYCOMMUNITICAONS,PHONENUMBERSNOTIFICAANDTIONSBI(CheckthatAEMERGENCYCALL]NGHAZARDOUwSASTECONTRACTORCALLINGPUBLIC.e.,EMERGENCYRESPONDERS9-(iINTERNALFRESPONSEWILLOCCURB. INTERNAL RESPONSEall that apply)MATENALSI Ei Z, HNZENNOUSWASTES8 I.HAZARDOUSFIRES, AND EASPILLS,CHEMICALTHIS PLANTelecommunications(e.g., PaintingOF(e.g., FleetOPERASan Luis OBisPoSITE CITYCA93401ZIP196 Suburban RdSITE ADDRESSATneacificPmpanyBelCoTelephorndbaifoTCal&iao3(SameofFacilityDBABusinessAs)ID#FF1 966l.looassgogFeDATE OF12,2015PREPARAENTIFICATIFA.ACILITYIDONANDoPERAoVERVIETIONSwtoPriorcompletingtltistoPlan,pleasetherefer/NSZRUCTIONSFORCOMPLETINCATEDCONT]NGENCYCONSOLIDAPLANCONSOALIDTEDEMERGENRESPCYNSo/COEENCYNTINGPLANCALIFORNIAREPORTINGSYSTEM(cERS)AT&T EH&S HotlineRcv.06127lll rRS Consolidated Emergency Response / Contingency plan _ page 2 of 4SPILL PREVENTION,D. EMERGENCYCONTAINMENTAND CLEAIIUPPROCEDURESfires orAND CLEANUPall boxesthat apply toyour proceduresandtotheRev.06/27lllcontainingspills, releases,F2.Fl.one of the following)ADVANCE ARRANGEMENTS FoR LOCAL EMERGENCY SERVICES (CheckEI I. HAVE BEEN DETERMINED NoTNECESSARY; oTE 2 THE FOLLOWING ARRANGEMENTS HAVE SEEN NAAOE (SPECifo):arenotarrangementsassuchthatoumaydetermineyourmadeYshouldbecontractorsfacilityappropnateemergencyforservicesand/orhospitals,departments,policeandfirelocalarrangementswithAdvanceuirement:of ReqExplanationSERVICESCYENEMERGFORARRANGEMENTSF'facNote: The map(s)visitors.bevisiblewherepostedmustprominentlybeareas,andstagingaltemateandexlts,emergencyprimaryandroutes,evacuatlonalternatepnmaryandmustshowASROUTEall on siteNote: TheParking Lot Next to Suburban St _ See EMOP Binder/Bldg Wardenstreet comer, etc.)aftersiteE3.lot,EVLOCATHE.e.,FrontAREA(STHATFAC]LITYEVACUA,E2.trtrEY)OFTOBEFireAlarm4OTHERSHOUTTNG);E.,0VERBALJALARMI. BELLS;2. HORNS/SIRENSEVACUATIONE. FACILITYMONITORFORLEAKS,RUPTURES,PRESSUREBUILD-UP,ETC.DI2.PROVIDESTRUCTURALPHYSICALBARRIERS(e.g.,Portablespillcontainmenttr3.PROVIDEABSORBENTPHYSICALwalls);BARRIERS(e.g.,Pads,pigs,pillows),4COVERORBLOCKFLOORAND/ORSTORMDRAINS5BUILT-INBERMINWORKSTORAGEAREA;tr6.AUTOMATICFIRESUPPRESSIONSYSTEM;7ELIMINATESOURCESOFIGNITIONFORFLAMMABLEHAZARDS8.STOPPROCESSESAND/OR(egFlamrnableliquids,Propane);OPERATIONS;tr9.AUTOMATICELECTRONICEQUIPMENTSHUT.OFFSYSTEM;0SHUT.OFFwATER,GAS,ELECTRICALUTILITIESASAPPROPRIAtrCALL9-FORPUBLICTE;EMERGENCYRESPONDERASSISTANCEMEDICALAID;tr12.NOTIFYANI)EVACT]ATEPERSONSINALLTHREATENEDAREAS3.ACCOUNTFOREVACUATEDPERSONSIMMEDIATELYAFTEREVtr4.PROVIDEACTJATIONCALL;PROTECTIVEEQUIPMENTFORON-SITERESPONSETEAM;5.REMOVEORISOLATECONTAINERSAREAASAPPROPRIATE;6.HIRELICENSEDHAZARDOUSwASTECONTRACTOR;E7USEABSORBENTMATERIALFORSPILLSWITHSUBSEQUENTAPPROPRIATE;PROPERLABELING,STORAGE,ANDHAZARDOUSwASTEDISPOSALAStr '' 'YFX"?[T;il,G SHOP VACUUM WITH SUBSEQUENTPR.PER LABELING, ST.RAGE, AND HAZARD.US 'ASTE DISP.SAL ASE I9. WASH / DECONTAMINATE EQUIPMENT W CONTAINMENT and DISPOSAL OF EFFLUENT / RINSATE AS HAZARDoUS WASTE;EI 20. PROVIDE SAFE TEMPORARY STORAGE OF EMERGENCY-GENERATED WASTES;E 2l . OTHER (Specif,):D2. CERS Consolidated Emergency Response / Contingency Plan - Page 3 of 4Rev. 06/2?/l I35.OTHER34OTHERATJTOMATICJJ.32PORT31/PAand30TELEPHONESThroughout FacilitYTelephones & Cellular Ph29OTHERG58.SPILL2G56.LEAK REPAIR KIT27GASG54.Battery AreaG52.Soda AshTKG50.24.HOODEXHAUSTG48.SHOP VAC23.SHOVEL21Fleet AreaAll-PurposeDIKINGL19ABSORBENTFOR USEDCONTAINERFleet AreaPlastic Bucket18.MATERIALFleet AreaLitter/Grease SweePKittyandClean-UPSpill17KITALL.IN-ONE SPILL16.t5STAALARM BOXESFIREAdmin. BuildingFire Alarm Pull StationsI14.Sl3FIREout FacilitYThroughABC Fire Extinguisher12.OTHEROTHERl1l0EYEWKITSFleet AreaBottle TypeFOUNTAIN /PLUEYEWFIRSTKITS /ATIONS8.Main Building/Fleet Alndustrial First Aid Kit7APPARATUSBREATHINGSELF-CONTAINEDGl4.6.RESPIRACARTRIDGEGt2.HARD HATSGl0.I/ SHIELDS4.GLASSFleet AreaG8.SafetyGlasses/Goggles/ShielfSEG6.2.GLOVESPROTECTIVECHEMICALFleet AreaG4Rubber/Chemical G lovesandFirst AidSUITSG3.TYPEAVAILABLELOCATIONCAPABILITYifle.g.,ECHEMICALPROTECTIVECLOVESresponseSpillkituse,One&solventoittimeboxesCheckallonly.Iresistantemergencyapplytothatresponselistequipmenttheavailableatefacilityandidentifythwherethelocation(s)keptequipmenttstheandG. EMERGENCY EQUIPMENT ;RS Consolidated Emergency Response / Contingency plan _ page 4 of 4Rev.06/27lltH. EARTHQUAKE VULNERABILITYareasofthe facility that are vulnerable to hazardous materialsreleases / spills due to earthquake-rerated motion. These areas require immediate isoration andt for AT&T ServiceOFs, lnc.Sheila CaballeroNAME OFK2.February 12,2015TOROFonsite.copyaavailableisthatcomplete,andaccurate,lsandtrue,examtheinformationandbelleveandinedlysubrnittedhavepersonalinformationamthatoflawthewithunderpenaltyiarfamilcerti4/information,theobtainingforresponsibleindividualsmyofthoseinquiryBasedCertificationCATIONGNATURECERTIFIISIK.B2J2.JITTACHED:AAREDOCUMENTSFOLLOWINGTHEorREQUIRED;ARENOAoneAT&T Description of Employee TrainingAT&T Emergency Responsb procedurEsJ. LIST OF ATTACHMENTSofafteratthreemustaFormerofthefacilityuntilclosuremustberetainedrecordstrainingemployeeCurrentpersonnelassignedofrequiredortootherqualificationstheposition_education,skills,andthedutiesjobdescribesthatpositionsjobaboveof theforeachdescriptionandjobAwrittenposition;jobsuchfillingtoemployeesesslongivenmanagementtrainingwastehazardouseachfortrainingofanddatename,ajobtitle,Thetrmeetc.).limits,accumulationcompliancewithmanifesting,ing,(e.9.,labelwastemanagementhazardousofhavingpositioneachjobpersonsforthefiIIingtoresponsibilitygrvenbewilithattrainingcontinuingandamountintroductoryofbothandtypetheofoutline/agendaAwrittenincludes:sesslonswhichmanagementtrainingwastehazardousofemployeedocumentationogramswrittenmustretainperofmonth)wastekitons/l,000more270gallthangeneratehazardouswhogenerators(i.e.,wastequantttyhazardousLargeTrainingRecords:(LQG)GeneratorrgeLatityQuant2.I3.FtoHAS NOE6. NorE 5. OTHER (Specify)/ MANUALS (Specify):E]4. STUDYGUIDESADMINISTERED (Check all that apply)E 3. SAFETY/TAILGATE MEETINGS;E 2 VIDEOSCLASSROOM,D I FORMALEMPLOYEE TRAINING PROGRAM ISINDICATE HOWandaUSTaandlawscontalnmentprocedures;Controlandprocedures;aNotificationprocedures;aEvacuationresponse;emergencyofCoordinationprocedures;Decontaminationemergencles;worsentoikelyConditionsetc.);processes;arespirators,of materialsextinguishers,hazardsFire(e.9.FireresponseequipmentemergencySEofUsubstances,ofhazardoushandlingasafeforMethodsequlpment;protectivePersonalandsafety:tohealthcommunicationrelatedHazardsystems:alarmandaCommunicationDataSheets;MaterialSafetyofthefollowing:alcontentincludesRequiredallernployees.forlyannualupdated/refreshedPlan,andContingencyResponseEmergencytothemodificationup0naGivenorprocessassrgnment;workpnortonecessarychangeasAmendednewhires;lnformonths6withProvidedmustbe:orTrainingcontractors.lnoperationsand/orclean-upvolunteersday-to-daywastesincludingandhazardousmaterialshazardoushandlingallemployeesrequiredforlstrainingEmployeeRequirement:ofplanationExI. EMPLOYEE TRAININGElect.i@l & cas: Outside NW Side of Admin Bldg, Waler: SWComer of Facitily Next to Subu.ban StH 10.H7.H8.H9.RecycleFleet Yard Nelt ToHr t.Hl2.Portable GeneratorsFleet AreaLOCAT]ONFleet AreaEJ 2. rANKS (EMERGENCY SHUTOFF)EI 3. PORTABLEGASCYLINDERSEI 4 EMERGENCY SHUToFF AND/oR UTILITY VALVESE 5. SPRINKLERSYSTEMStank)H6.CONTAINERS(e.g.PRESSURIZEDATIONARY6.STANDRACKSCABINETSVES,SHELapply)(CheckSisolationtotot12.H3.H4.H5.lab)shed,Floet Area & Store RoomTIONS (e.g., shop,El T.HAZARDoUsMAE 2. PR0CESS LINES /E 3. LABOMTORYAREAE 4.WASTETREATMENTPIPINGAREASTORAGEASTEwTERIALSapplyallthatAREAS: AT&T Environment Health & SafetYHazardous Materials and Waste HandlingTraining OutlineEmployeesareprovidedinitialsafetyPlantrainingontheHazardCommunicationCertification,aswellasfunctionspecific before tn",, oJg]n'ir"ir *"fr. "n"r"tionr. ifiis also includes training on the Emergency operating procedures'The training is taken "t""n onfin" inteiactive course' Training is recorded electronically'The training includes the following:Lesson 1: lntroductionLesson 2: Roles and Responsibilities OverviewLessong:rdentifyingHazardousMaterialsandRegulatedWastesLesson a: Handling]Management & Disposition of waste streamsLesson 5: Generator RequirementsLesson 6: EmergencY PlanningLesson 7: Hazardous Materials lncidentsLesson 8: SummaryAppendix A - Finalhssessment Questions and AnswersAdditionaily, the AT&T Emergency pran requires that emproyees receive annuar refresher training on the HazardCommunication CertifiJaiionliunltion specifics and the Emergency operating lnstructions'The AT&T Emergency pran Binder serves as a reference guide for the Emergency site coordinator/Building warden'Rev.06127lll Emergency Response FLEET.docAT&T EuencerucY REsPoNsE PLANThe Emergency site coordinator/Building warden is responsible for following these steps as oulined in the facilityil;,l:::* Plan Binder or the site spiil Prevention controt and countermeasure (spcc) ptan where one isthisdocument.ofsectionNotificationasdescribedandlanBinderPEmergencysiteastheinoutlinednotificationsappropriateMake5.socks).orabsorbentmaterialskabsorbentbu(i.e.useabsorbentsofbarriers,arrangphysicaso,ingtsbytodosafeeqndituippeduatelyifadeqmaterialscontainand/ortherelease4.Stoporsmoke.gasses,fumestnallofhalationAvoid3.ASappropriateareatheawayfrompeopleMove2theincident.severityofndmagnitudelocationngnaturetheDeterminiorwaste:amaterialeofhazardousreleasebythcausedhazardspotentialstoptonesstakewillourbusiactionswhatdescribesfollowingTheAeRrenileNT (srop rHE HAZARD)Hazardous Materials Drqms: Dor approved drums are inspected for leaks and/or deterioration. Absorbentsare stored at the garage for containment of any releases.1' Motor oil: stored in drums in a controlled area. Drums are visually inspected daily to ensure integrity.,ffi:Storedindrumsinacontrolledarea.Drumsarevisuallyinspecteddailyto3 ffiH llters: stored in aboveground tanks or drums in a controiled area and visualty inspected daily toThe followingproperty or thedescribes theenvironment:procedures that mustbe followed tominimize any harmto persons,or damageare stored in a controlled and separate area.and secured.tnstandsarehtstoredrshavegassesCompressed4.Mmolnon (neouce rueHAZARD)2' Merenlels: Hazardous materials are utilized and stored following manufacturer,s recommendations, as ourbusiness is a user of chemical products and not a manufacturer oinazaroous materials.Systems.ngManagementoneT'SLearnAT&ofhthrougoroniinementronaenviclassroomindeliveredandisresponsibilitiesemjobuponployee'sthegisdependenttraininuencyofanfreqdThetypewastes.hazardousandmaterialshazardousofpropehandlinganduse,storagemanagement,thetorelatedtrainingofvarietycompletetoarerequiredTemployeesAT&Tnalnrrucoccurring:fromreleasewasteorhazardousmaterialshazardouspreventtowilltakeourbusinessactionwhatdescribesfollowingThePneverurtoruATATFireanncidentMaEH&Sdonebewilltonotificationsspill/releaserequired.AilisAgenciesisteringAdminLocalandE-M-A)(cALAgencyManagementCAEmergencyoftheifnotificationtodetermineLega&SandwithEHworkalsowillESCTheOrganization.Safety&nvronmentHealthTEAT&thendrityOfficelocalSecutheappropncludingriateAScontactsinternal&T'snotiffimmediatelywillCoordinatoriteStheEmergencyAdditionally,Organization.EmergencyuildingsitebytheaspdirectedlaceorshelterinevacuatehowtoncidentandmaterialsaashazardoussuchemergenciesreportontohowrectreportsditheirforadvisingresponaresibleSupervisorslding.buoftheoccupantsthebyrevtewforavailablethatisfacilitynthefonder)BiPlaEmergencyTAT&(i.e.theplanencyactionemergnngcompletitsforresponsiblethefacilityfor(ESc)SiteCoordinatorTheEmergencyBinder.PlantnEmergency&TthedescribedisPlan)EmergencyandProgramSafety(The130PracticeOperatingAT&T'sNotrrrcRtroN pRocEDUREsI IHAZMAT\PACBELLU-FORMS\Ernergency Response FLEET.docLast Updared : 12120/2013 Emergency Response FLEET.doceasuresareMiaRemedIstandardizedSngsystembracinequusintvibrationresistaipmentndaretelecommunugsystemsicationeadestobnedandqrthbeItresuakestant.quaconkeEarthemresistantISstructioncotntheployednstbuildingructioncathesites.ofElectritransmissionFollowing an earthquake, upon arrival to the site, the technician will inspect the hazmat storage areas forleaks and/or spills. ln the event of a release, attempt to contain the release as described above' Evacuate thearea to the designateO slaging area located away from the equipment' lf necessary shut down the power tothe equipment using the main electrical panel'ake. lf power is to be shut off or somedoes it and where shut off is located.equrpmentneedsbetopdownshutdpleasere,beescriroceduwhoareasrequrnngldentifyIMmediatenganattentionfollowiearthquEIRTXOUNKE RESPONSEstandard statement would be:Mersoo orAunnm ro EMPLoYEES:Vocal, intercom and fire alarms are used to notify our employees to evacuate'Roures or Eeness:This also varies with each building and should be verified with the Emergency site coordinator of each facility. ASite Coordinator of each facility. Averified with the EmergencYing and should beThis varies with each buildstatement would be:standardEvacuation Plan:completing any spill/release notifications'contractors utilized to clean up spills and releases for our facilities include:1. Shaw EnvironmentalDiesel Fuel: The AT&T Hazardous Materials Management Plan ltem G (Contingency Plan): outlines thenotifications required for incidents involving spills which include::&TAT&ManagerIStocontactedwithallassistreportedls,spiln-upasptngincludspatchdivendoriltcleaofandureronEProcedHEtoP16-S-1mentnvtu&HealthresHotlineSafetyProcedOn-DutyEHAnncident&Sn.oandemergedwastearencyEspositiASmanH&ScallsnageddescribedoperatingnternTApnnnganrecognlangSreping,spdtztporticlean-ullspidecrslonreqmakinspiiltng,uitrainredkitinformationsprepotobllstnetotherted&SHotlEHemergencyprompt1onpre-isdocuThfaciltnstructsmentalsoitiesPracticeTa.SmallEHS-1200-PRCResponseSprequndClean-up"encyemergandntaincidealtres5. AT&T1. Local Fire DePartment2. Department of Public Health3. AT&T Environment Health & Safety4. AT&T RealEstate Client Service CenterSpn-usAND LEAKs oF HAzARDous MATERIALSanTraining&TATntngcompletetraintheimay90withanddaysnotUNperformareenvironmentatheylessresponsibilitiesEH&SorMatrices.NewemployeesanenvtemployeeswhomntotransferustjobmpactingronmentallyEmployeescompletengtrainfunction-sPecificisforthatnasworktheiroperationstheoutlinedapplicableEruproYee TRnxlno:I \HAZMAT\PACBELL\2-FORMS\Ernergency Response FLEET docLast Updated : 12120120132 FLEETAT&Thasemergencyresponseplansandproceduresnplaceforfacilities.Thfollowingtsdescriptionpr0gramsandprocedtnaoftheuresplace1' The AT&T EH&S Hotline is a 24-hour communications center established through which emergency conditioninformation flows from and within AT&T. ln the event of a major emergency the center also providescoordination, communications and is the established liaison with federal, statel tocat and military agencies.2' EMeneeNcv Puru Btloen, The AT&T operating Practice 130 provides fire, safety and emergency guidance,checklist, forms, and company contacts for emergency situations, interruptions or company services, and otherthreats to our operations, facilities, personnel o, ploperty.outlined in the AT&T operating Practice 130 is the Emergency Site Coordinator/Building warden program.The Emergency site Coordinator/Building warden is inv6tved in directing and coorJinating the folowingactivities with the occupants of the facility.r Establishing and training the buirding emergency organization.o lmplementing the Emergency procedure plan.r Occupant emergency preparedness.r Reviewing the planning Engineering sketch.r Establishing and maintaining the Emergency procedures Board.r Developing and maintaining the Emergency Methods and procedures (EMOp) binder.r Scheduling and conducting semi-annual fire and take cover drills and recording drill results on theFire/Evacuation Drill Report.r Conducting fire safety surveys using form SBC3O77r Daily administration of fire prevention practices.r Reporting all bomb threats to appropriate security office and the ECC.r Advising security of all emergencies.r Accompanying externar or internaragencies on buirding inspections.o Arranging for selection of Emergency Site Co-ordinator/Building Warden successor (transfer ofresponsibilities).r Communicating to occupants via emergency communications systems (if applicable).r Contact the Environment Health ano S-fety organization in the Lvent of an OSHA visit.The AT&T Operating Practice 130 also requires that each facility have an Emergency plan binder. The binder isa guide providing for personal protection and emergency procedure. ior. iomp"ny locations duringemergencies' The binder is developed and held by the Emergency Site Coordinator at each facility locationwhen the minimum regar required buirding headcouni is reachedlResponse PlanEm'Employees exit through front, rear and side doors. Alternate routes include....,,The instructions for emergency exists and alternate routes to be used for evacuation are posted on eachfloorMtnroo roAccouNr FoRALL pensors:The AT&T operating Practice 130 identifies the Emergency Site Coordinator/Building Warden as the individualresponsible for working with the location management to determine occupant accountability in the event of anevacuation or other emergency. This includes the establishment of assembly areas where accountability can bedetermined' Employees for this facility are instructed to meet..... (obtain this information from the Emergency SiteCoordinator/B u ildin g Warden).AleRIttc NeteHgons:TheAT&T operating Practice 130 identifies the Emergency Site Coordinator/Building warden as the responsiblecontact to work with all agency emergency/rescue personnel to notify facility adjacent iroperties.3I :\HAZMAT\,PACBELL\2-FORMS\Emergency Response FLEET.docLast Updated : 12120/2013 I{.docAdditionally, the AT&T Operating Practice 130 provides the following procedures for the Emergency SiteCoordinator and Site ManagerJ in the event of a hazardous materials incident at the facility'1. ldentify and locate the problem'2. lsolate, relocate or evacuate employees as required'3. Notify emergency rescue personnel if needed'4. lnvestigate the Problem.5. Avoid inhalation of all gasses, fumes or smoke'6. lf the release or threaiened release has the potential to harm the population and environment contact:rAT&T Environment Health & safety Hotline 8OO-KNOW EHS (800-566-9347)' prompt 1oEnvironmental control centerfor Fuel storage Tanks 800-KNOW EHS (800-566-9347)' prompt 1.Asset Protection (AT&T) - 800-8074205.LocalHazardous'Emergency ResponseAgency 911oCA emergency tvtanagJmentAgency (CA' E-M-A) 800-852-7550&T',stobeisATEnvironmentHealth&orapersonofspillonsiterelease,nel800calltoKNOWEcidentthethetnreportHSHazardous3. ln the eventMaterials lncidentI\HAZMATWACBELL\2-FORMS\Ernergency Response FLEET docLast Updated: 12120120134 ia Environmental Reporting System (CERS)Remote Waste Consolidation Site Annual NotificationStatuson2/12/2o1sbySteyeSkondersonofPACIFIcBELLTELEPHONECOMPANYdbaAT&ittalwasAccepted;ProcessedTCALIFORNIA(SanRamon,cA)on2/26/2}tsbyKerryBoyleforSanLuisobispoCityFireDepartmentT&T California - SE164SUBURBAN RDLUIS 0BtsPo, cA 93401CERS ID1043s963EPA lD NumbercATo80024268/Operator NameOwner/Operator TitleDate CertifiedDETTE ALTAMIRANO4Site lnformationSuburban RdLuis Obispo, CA 93401of Remote Location(s)unication/uverse sitesof Waste(s) Collectedniversal wasteHazardous Waste TreatmentEstimated Monthly Volume Consolidated200 PoundsFor Not Needing a Federal permitThe hazardous waste being consolidated is not hazardous waste under federal law although the waste is regurated as hazardous waste under california state raw.hazardouswastetshazardouswasteunderfederallaw,buttransportationtoandaccumulationtheconsolidationfederallawforthefollowingotherreason(s):siteofthewastetsnotsubmitedpermittingrequirementsPrinted on 2/26/2015 8:29 AM ar-California Environmental Reporting System (CERS)Submittal SummaryAT&T California - SE164 (CERSID: 10435963)Ramon, CA)Submittal was ;Accepfed on 61812015 1.32.31 PM by Keny BoyleT&T CALIFORNIA (Sdbaof PACIFIC BELL TELEPHONEon 413012Q15 1:4316 PM by Steveu. Business Activities. Business Owner/Operator ldentificationComments by Submitter: Additional diesel fuel added. 100% increasesubmittal was Accepfed on61812015 1"32.01 PM by Kerry Boyle. Hazardous Material lnventory (13). Site Map (Official Use Only). Annotated Site Map (Official Use Only) (Adobe PDF, 90KB)dba AT&T CALIFORNIA (SanSkanderson of PACIFIC BELLSubmitted on 413012015 1 :43:16 PM byRamon, CA)Printed on 618/20L51:32 PM California Environmental Reporting System (CERS)Business ActivitiesldentificationT&T California - SE164CERS ID10435963EPA lD NumbercAT080024268Suburban Rdn Luis Obispo, CA 93401n Luis ObispoStatuson 4/3O/20I5 by Steve Skonderson of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (San Ramon, CA)I was Accepted; Processed on 6/8/2075 by Kerry Boyle for San Luis Obispo County Environmental HealthHazardous Materialsfoes your facility have on site (for any purpose) at any one time, hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200:ubic feet for compressed gases (include liquids in ASTs and USTs); or is regulated under more restrictive inventory local reporting requirementslshown below if present); or the applicable Federal threshold quantity for an extremely hazardous substance specified in 40 CFR Part 355, AppendixA or B; or handle rA{iological materials in quanfities for which an emergency plan is required pursuant to 10 CFR parts 30, 40 or 70?YesUnderground Storage Tank(s) (UST))oes your facility own or operate underground storage tanks?No)oes your facility have Regulated Substances stored onsite in quantities greater than the threshold quantities established by the California Accidentallelease prevention Program (CalARP)?No)oes your facility own or operate ASTs above these thresholds? Store greater than 1.,320 gallons of petroleum products (new or used) inrboveground tanks or containers.NoExcluded and/or Exempted Mat€rials)oes your facility recycle more than 100 kg/month of excluded or exempted recyclable materials (per HSC 25743.2)?Nos your facility a Household Hazardous Waste (HHW) Collection site?No)oes your facility generate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or more of federal RCRA hazardous waste, or generaten any single calendar month, or accumulate at any time, tkg(2.2 pounds) of RCRA acute hazardous waste; or generate or accumulate at any timenore than 100 kg (220 pounds) of spill cleanup materials contaminated with RCRA acute hazardous waste.No)oes your facility need to report the closure/removal of a tank that was classified as hazardous waste and cleaned on-site?No)oes your facility consolidate hazardous waste generated at a remote site?Yess your facility's treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)?No)oes your facility treat hazardous waste on-site?NoHazardous Wastes your facility a Hazardous Waste Generator?Yeslnforma6onadditional commentsed.Printed on 618/2015 1:32 PM California Environmental Reporting System (CERS)Business Owner OperatorT&T California - SE164CERS ID96 Suburban Rd10435963Luis ObicA 93401bmi$al Statusbmitted on 4/30/2015 by Steve Skonderson of PACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIA (San Ramon, CA)bmittal was Accepted; Processed on 6/8/2Of5 by Kerry Boyle for San Luis Obispo County Environmental HealthT&T CaliforniaBeginning Date3/27 /201sDun & Bradstreet103401618Ending Date3126/201.6SIC Code4813PhoneBusiness PhoneBusiness Fax546-7416(80s) s46-7416(92s) 973-0s84Primary NAICS5r71.70Mailing AddressS. Akard Street, Room 1708llas, TX 75202Emergency Contactmental Site ManagerPhone 24-Hour PhonePager Numberdary Emergency Contactific Bell Telephone Company dba AT&T California21.41 464-2626S. Akard Street, Room 1708as,IX75202Hour Emergency ServicePhonePager NumberSilling Contact\T&T EH&S21.4\ 464-2626 mpo873@att.com;001 Executive Parkway, Room 4W200Wian Ramon, CA 94583N MAHONEY546-7416EH&S Hotline566-934724-Hour PhoneEnvironmental Contactlrennan Mahoneyi80s) s46-7416372Mo.ro Street, Rm 305;an Luis Obispo, CA 93401bm800e@att.comme of signersigner TitleAgent for AT&TDocument PreparerSteve SkandersonSkandersonlnformationlly-collected Fieldsor all of the following fields may be required by your local regulator(s).,roperty Ownerthonevlailing AddressAssessor Parcel Number (APN)Number of Employees80Facility lDooo2877Printed on 6/8120L51:32 PM Aboveground TankDays on Site:36566j _ Firepressue - Chronic healthffi ;i ; il**" Y--?:!e-q"*q-e-Tempsat-ure-...AmbientCAS NoDiesel Fuel180State StorageContainerGallons 667lombustible Liquid, Class ll68334-30-5Map: 1 Grid: F7Liquid-r-yPJ-..-Pure)OT:3-Flammableand:ombustible LiquidsHazardous Componenti(For mixture only)AnnualWasteMax. Daily l-arBest Cont. Avg. Daily AmountFederal HazardCategories)OT Code/Fire Haz. ClassCommon NameComponent NameUnito/"Wt EHS CAS No.:ERS Euslness/Ort.iacility NamePACIFIC BEtt TETEPI{ONE COMPANY dbA AT&T CAI-IFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERs rD 10435963F cilitylD 0002817status Submlfted on 4/3Ol2oI51:43 PMchemlel l-ocefinParking lot - Portable GeneratorcHazardous Materials And Wastes lnventory Matrix ReportPrinted on 6/8/20151:32 PMPage 1 of 8 -sl9I_e_..GasIYP--e_Pure- Fire- PressureRelease- Acute HealthCAS NoWaste Code74-86-2222Pressue1202.1 - Flammable Gases Acetylenenstable (Reactive), class 2,lammable Gas> AmbientI-enP-9r-q!-qr9-.Ambientpl_o-n-c_e-.9_qIliit19l-.......CylinderCu. Feet 222AnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardHazardous ComponentsUnitMax.NameCont. Avg. Daily%Wt EHS CAS No.PACIFIC BELL TETEPHONE COMPANY dba AT&T CALIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963facirityrD 0OO28l7status Submitted on 4/30/2015 1:43 PMChemical LocationshopBusiness/OrB.NsmeAmbient-r-9l]1P-9r-e!-qr-...AmbientSolvent Dewaxed Residuel OilHydrotreated Dist Hvy ParaffinSol Dewaxed Dist Hvy ParrafinHydrotreated BottomsAdditivess2%s0%50%47%72%64742-62-7647 42-54-764742-65-064742-57-0PROPRIETARYLiquid, Class lll-BGREASE / GEAR LUBECAS NoSite: 365Mixture55Pressue50Map: 1 Grid: F4Liquid Steel Drum, Plastic Bottle orJugTy-pe .Gallons 61State StorageContainer- Firey--?:lg---cg{9 - chronic healthHazardous Materials And Wastes lnventory Matrix ReportPrinted on 6/8/2075 L:32 PMPage 2 of 8 Used Antifreezegl-s-..[-o-.-..-107-2I-1Map: 1 Grid: F4Gallons:!3!e_..LiquidI--v-P9-...Waste55ll-e!l]l,e.AmbientI-9nP__ei?!_u_I9_.Ambient55mbustible Liquid, Class lll-BDays on Site: 3653 - Flammable andLiquids]Y-?r*-q9ie-343- Acute Health- Chronic health5s 55:19_I9-C_e-.S-oi ta!rcr _..."Plastic/Non-metalic DrumAnnualWasteAmountFederal HazardCategoriesCode/Fire Haz. ClassCommon NameEHS CAS No.UnitMax.euantitiesNameCont. Avg. Daily%wtHazardous ComponentsmixturePACIFIC BEtL TEIEPHONE COMPANY dba AT&T CALIFORNIAAT&T Callfornia - SE164196 Suburban Rd, San Luis Obispo 93401cgnsrD 10435963Faclllty lD 0002817Chemical LocationSTORED EAST SIDE SHOPNameBusiness/Org.Submitted on 4130/2073 t'.43 PMHazardous Materials And Wastes lnventory Matrix ReportPrinted on 6/8/20151:32 PMPage 3 of 8 Hydraulic Fluid-q^-s".ry--o- ...Map: 1 Grid:G5Gallons,sl?-1-e-...Liquid-r-yP_9_...MixtureI45lr-g::re. ..............AmbientI-9.nP-9.r-eI-qLe-..AmbientWaste CodeLubricating Base Oilt40AdditivesLiquid, Class lll-B3 - Flammable andLiq uids2L5Storage ContainerAboveground Tank, Steel DrumDays on Site: 365- Fire- Chronic health99%2%AnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardComponent NameEHS CAS No.UnitQuantitiesMax. Daily Largest Cont.%wtHazardous ComponentsmixturePACIFIC BELL TETEPHONE COMPANY dbA AT&T CALIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401STORED IN SHOPChemlcal Location4/30/2015 1:43 PMNameBusiness/Org,cERsrD 10435963Facility lD 0002817status SubmittedHazardous Materials And Wastes lnventory Matrix Report3 - Flammable andustible Liquidsbustible Liquid, Class lll-8,Motor Oil941-.1-e_..Map: 1 Grid: F3110ll-g:-s-g-c.. .......AmbientI-e".nP.9l-?l-rl.t-9....Ambient- Fire- Chronic healthLubricating Base OilZinc CompoundsAdditivesGallons 16555State StorageContainerLiquidI-YPg-...MixtureSteel Drum, Plastic Bottle or JugDays on Site: 365w?:19 qgge.85%1.%Proprieta ryProprieta ryrritantPrinted on 6/8/20L51:32 PMPage 4 of 8 OxygenS*-s-..ry-e....7782-44-7Map: 1 Grid: F5-sJ-a!9_..I-YP-"-...Pureon Site: 365Pressue waste code - Pressure, A;il;;l- ' RereaseCylinder222250AmbientIs.nP-9.t-c!-,1$-...FireStorage Containerizing, Class 22.2 - Nonflammable GasesCu. Feet 444AnnualWasteAmountCode/Fire Haz. ClassCommon NameFederal HazardComponent NameHazardous ComponentsUnitMax.LaOuantitiesCont.o/ow EHS CASNo.PACIFIC BELL TETEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE164cERsrD 10435963Facirity rD OOO28L7status Submitted onStored in shopChemi6l Location1:43 PMNameBusiness/Org,196 Suburban Rd, San Luis93401Hazardous Materials And Wastes Inventory Matrix ReportPrinted on 6/8/20151:32 PMPage 5 of B ZSO _ FirePressue waste code - Pressure; ffibi;;l*" " Rerease"r-g-nP.-el?!-q.t-9....AmbientCAS NoLiquefied Petroleum Gas (lpg)Pureon Site: 365-T,yP.e-....250Gas Aboveground Tankuified Petroleum Gas2.1 - Flammable Gases74-98-6Map: 1 Grid: D4Gallons 25OState StorageContainerAnnualWasteAmountHaz. Classcommon NameFederal HazardEHS CAS No.UnitMax.LaComNameCont- Avg. Daily%wtHazardous ComponentsPACIFIC BETL TETEPHONE COMPANY dbA AT&T CALIFORNIAAT&T California - 5E164196 Suburban Rd, San Luis Obispo 93401cERsrD 10435953Facilrty rD 0O028L7Status Submitted onChemical LocationStored in the Yard1:43 PMNameBusinesVOrg.Hazardous Materials And Wastes Inventory Matrix ReportPrinted on 6/812015 L:32 PMPage 5 of 8 Gallons_sl-al-e_...Liquid-r_ypJ-....WasteSteel DrumDays on Site: 365Map: 1'Ple::se..................ye*g-qeg-e-1105555223CAS No)OT: 6.1 - Toxic Substancesloxic, CorrosiveHazardous Wastes - Liquid LabPacks110Storage ContainerAmbientI__eirP.-e-.Bgl.t9_...Ambient- Fire- Acute Health- Chronic healthHazardous Wastes - Solids LabPackss+.9_.1,r--o_ -Solid Steel DrumIvP-i.Waste Days on Site: 365200 2SO _ FirePressue waste code - Acute Healthffibl;;l-*- --)i;-*" - chronic health-r-9.nP-9l-q"*{9-..AmbientMap:1250)OT: 6.1 - Toxic Substancesloxic, CorrosivePounds 25OState StorageContainerLiquidWasteL2509l9F_g_e_-cJ..t!iit'_eI.........Steel DrumAmbientI-9-.nP,-e-P!-,1.t_9-...AmbientWaste Oily WaterCAS NorritantStateGallons557250y-?:!e.qedeMap: 3 Grid: H8on Site: 3657250PressueAnnualWasteMax. Daily Largest Cont. Avg. Daily AmountFederal HazardCategoriesCode/Fire Haz. ClassCommon NameHazardous ComponentsUnitNamemixture ono/oWI EHS CAS No.PACIFIC BEIL TETEPHONE COMPANY dba AT&T CATIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cFRsrD 10435963Facitrtyro OOO28L7status Submltted on4l3O/2O751:,43PMWaste Storage AreaChemical LocationNameBusiness/Org.Hazardous Materials And Wastes lnventory Matrix ReportUniversl Waste - Consumerelectronic devices-c4-lIp-Pounds 1000 400State StorageContainerSolid Plastic/Non-metalicDrum,Toter-YP-e-..- BinMixture Days on Site: 3651580 - Acute Healthwaste code - Chronic health181500Pressue19ttP9.li!_ql_e-..Printed on 6/8/20151:32 PMPage 7 of 8 Code/Fire Haz. ClassCommon NameComponent NameEHS CAS No.UnitAmountMax. Daily Largest Cont.%wtHazardous ComponentsmixtureAnnualQuantities WasteFederal HazardCategoriesPACIFIC BELT TELEPHONE COMPANY dbA AT&T CATIFORNIAAT&T California - SE164196 Suburban Rd, San Luis Obispo 93401cERsrD 10435963Facility lD 0002817status Submitted on2015 1:43 PMNameBusiness/org.Chemi€l l"ocationWEST SIDE OF SHOPr/>lL$:g-e-...................Ambient-r--e.aP-g.!-?!-qLe,AmbientWaste Motor Oil221240CAS NoLubricating Base Oil85%bustible Liquids3 - Flammable andLiquidI-YP-"-....WasteAboveground Tank, Plastic Bottleor JugDays on Site: 365Gallons 240State StorageContainer500Waste Code- Flre- Chronic healthProprietaryProprietarybustible.Liquid, Class lll-B Map:1 Grid: F4Zinc CompoundsAdditives20%Hazardous Materials And Wastes lnventory Matrix ReportPrinted on 6/8/2015 1:32 PMPage 8 of 8 PACIFIC BELL/AT&TMAP# 1SITE hiIAPBUSINESS NAME AT&T Californio SNLOCAAU SEl64BUSINESS ADDRESS 196 SUBURBAN RDDATE s/12/2O14SAN LUIS OBISPOZIp CSDE 93403COMMIRCIALio ol CLARDRAWING SCALENOT TO SCALI12345F78COMIVERCIALacIDcf,IDz/K!fnITaUJoIzILU)UF-I)-aUoO@+r#POLERPortoble GenerotorsRESTAURAN T@ nruurr,r@ nvonnurrc FLUID@ ancolr@ oxvcrrrr@ wnsrr ANTTFREEZEGFASYMBOL LEGENDELECTR]CAL PANTLSHU T_ OFFNATURAL CASSHUT-OFFWATER SHUT_OFTEMERCENCY SHUT DOWNTANK MONITORINGALARl,4TELEPHONEFIRST AID KITFIRE EXTINCU]SHERSTORM DRAINSANITARY SEWERSTAGING AREAEVACUAT]ON/H[IiVP, AND ]VSDSLOCAT ONFIRE HYDRANTFEN CEEMERCENCY RESPONSEEQUIPMENI/ABSORBEN TSABOVEGROUNDSTORAGE TANKUNDERCROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE L]QUIDS)BATTERY ELECTROLYTE(coRRosrvE LrourD)GASOL]NE(FLAMMABLE LIOU DS)DIESEL FUEL(COMBUSIIBLE LIQUIDS).NITROGEN(COMPRESSED GAS)PROPANE(FLAIvIMABLE LIQUID)ACETYLENE(coMPRESSED GAS)AN TIFRIEZI/COOLAN TSWASTE OIL(FLAMMABLE LIQUID)fl r,ne PULL BoxFCFLAMMABLIS CABINTIERE+ DRAINAGE FLOW DIRECT0NIiFAi] UNIVERSAL WASTE- ACCUMULATION AREA@@@@,rilo,o+K-AEL@)+eStantec ArchitectuE lnc.1383 N. McDo{ell 8lvd.Peiolumo, CA U-S.A.@ADMINISTRATIONBUILDINGFCFCSTORAGToooAWATIRTANK9BcDEHJKLM UNIF'IED PROGRAM CONSOLIDATED FORMF'ACILITY INF'ORMATIONBUSINESS ACTIVITIES(You rnay also be required to provide additional infomation byCUPA or local agency.)F. LOCALREQUIREMENTS15E YESnYES! vrsSvrsE vesS vesI vesI vnsE. HAZARDOUS WASTEGenerate hazardous waste?Recycle more than 100 kg/month of excluded or exetnpted recyclablematerials (per HSC 25143.2)?Treatment subject to financial assurance requirements (for Permit by Rule andConditional Authorization)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified EtShazardous waste and cleaned on-site?Generate in any single calendar month 1,000 kilograms (kg) (2,200 pounds) ormore of federal RCRA hazardous waste, or generate in any single calendarmonth, or accumulate at any time, I kg(2.2 pounds) of RCRA acute hazardouswaste; or generate or accumulate at any time more than 100 kg (220 pounds) ofspill cleanup materials contaminated with RCRA acute hazardous waste'Household Hazardous Waste (HHW) Collection site?Treat hazardous waste on-site?EPA ID NUMBER - provide at the top ofthis pageRECYCLABLE MATERIALS REPORT(one per recycler)ON-SITE HAZARDOUS WASTETREATMENT - FACILITYON.SITE HAZARDOUS WASTETREATMENT - UNIT (one page per wit)CERTIFICATION OF FINANCIALASSURANCEREMOTE WASTE / CONSOLIDATIONSITE ANNUAL NOTIFICATIONHMARDOUS WASTETANKCLOSURE CERTIFICATIONObtain federal EPA ID Number, fileBiennial Report (EPA Form 8700'l3A/B), and satisfy requirements forRCRA Large Quantity Generator.See CUPA for required forms.Own or operate ASTs above these thresholds:Store greater than I,320 gallons of petroleum products (new or used) inaboveground tanks or containers.D. ABOVE GROIJND PETROLEUMI vesNO FORM REQUIRED TO CUPASC. UNDERGROUND STORAGE TANKS (USTs)Own or operate underground storage tanks?EvrsUST FACILITY @omerly SWRCB Fom A)UST TANK (one page per tuk) (Fomerly Fom B)B. REGULATED SUBSTANCESHave Regulated Substances stored onsite in quantities greater than thethreshold quantities established by the California Accidental Releaseprevention Program (CalARP)?lvEsCoordinate with your local agencyresponsible for CalARP.A. HAZARDOUSMATERIALSHave on site (for any purpose) at any one time, hazardous materials at or above55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressedgasis (include liquids in ASTs and USTs); or the applicable Federal thresholdquantity for an extremely hazardous substance specified in 40 CFR Part 355,lsorto40CFRParts070?ororanradiologicalhandleB;AppendixAforwhichtnquantitiesmaterialsE] YESHAZARDOUS MATERIALSINVENTORY _ CHEMICALDESCRIPTIONDoesof the UPCFYtheseNOTE: If you check YES to any part of this listnIdentificatione submit the Business OwnII. ACTIVITIES DECLARATIONCABUSINESS SITECITY SAN LISPOSITE ADDR-ESSt03(Same as Facility Name of1B2000AF(Agency Use Only)768Waste Only)I. F'ACILITY IDENTIF'ICATIONlofUPCF Rev. (1212007) TITLE OF SIGNERAgent for AT&TNAME OF SIGNER (print)Steve SkandersonNAME OF DOCUMENT PREPARERStantec Architecture lncDATE04t2312013OF OWNER/OPERATORSubmitted via Public PortalREPRESENTATIVEBased on my inquiry ofthoseresponsible forI certify underI have personally examined andarn familiar with the information submitted and believe the information is true, accurate,and complete.ADDITIONAL LOCALLY COLLECTED INFORMATIONPAGER # / CELL PHONE #PAGER# / CELL PHONE #24-HOURPHONE24-HOUR PHONE8005669347BUSINESS PHONE8005669347BUSINESS PHONE9258230725TITLE24 HR EMERGENCY SERVICETITLEEH&S ManagerNAMEAT&T EHS HOTLINENAMECathy Castillo-PRIMARY-Iv. EMERGENCY CONTACTS -SECONDARY-ZIP CODE94583STATECACITYSan RamonMAILING2600 Camino Ramon - Room 3E000CONTACT PHONE9258230725CONTACTNAMECathy CastilloilI. ENVIRONMENTAL CONTACTZIP CODE945830995STATECACITYSAN RAMONOWNER MAILING ADDRESSPO BOX 5095OWNERPHONE9258230725OWNERNAMEPACIFIC BELL TELEPHONE COMPANY dba AT&T CALIFORNIAII. BUSINESS OWNERBUSINESS OPERATOR PHONE9258230725eHWS"SfifrSAroRNAMECOUNTYSan Luis ObisooZIP CODE93401CACITYSAN LUIS OBISPOBUSINESSc FACILITY NAME or DBA - Doing Business As)BUSINESS PHONE9258230725PACIFIC BELL dba AT&T (SE-164BUSINESS196 SUBURBAN RDI.IDENTIF'ICATIONF'ORM S _ SAN LUIS OBISPO COUNTY CERTIF'IED UNIF'IEDPROGRAM AGENCYBUSINESS OWNER/OPERATOR IDENTIFICATION IADDITIONAL LOCALLY COLLECTED INFORMATIONare present at greaterorattachthe5E Yes E tto4[Yes [Noflves [No2EYes Et'to1flves [NoYrWTEHSIIAZARDOUS COMPONENT (For mixture or waste only)CAS #STORAGETEMPERATURE EI A. AMBIENT E b' NSOVEAVEINNTI c. BELOWAMBIENTE d. CRYOGENICE A. AMBIENT E b. ABOVE AMBIENTSTORAGE PRESSUREE c. BELOW AMBIENTtrtrtrb. UNDERGROUND TANKc. TANK INSIDE BUILDINGd. STEEL DRUMtrtrtrf. CANg. CARBOYh. stl-oE] J, BAGE k. Box[E I. CYLINDERtrtrtrn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONTANKFIBER DRUMtrtra.m.DRUMq. RAIL CARr. OTHERSTORAGECONTAINERUNITS*(Check one items t. cunrc rerr E c. POUNDS*IfEHS, amount must be in Pounds.Ia. GALLONSE d. roNS365.0DAYS120.0AVERAGE DAILY222.0AMOUNTWASTESTATE WASTEE A. FIRE Et b. REACTIVE E C. PRESSURERELEASE EI d. ACUTEHEALTH(Check all that apply)E e. CHRONIC HEALTHFED HAZARD CATECORIESE a, SOLID E b. LIQUID 14 c. GAS(Check one item only)PHYSICAL STATELARGEsrcoNrAt*"" 222.0E A, PURE E b. MIXTURE E C. WASTE(Check one item only)HAZARDOUS MATERIAL TYPERADIOACTIVE EYes ENoCURIESFlammable Gas (3.2), Unstable (Reactive), Class 2 (6'1-2)CLASSES (complete if .equired by CUPA)FIREc^s# 74-86-2*If EHS is "Yes", all amounts below must be in lbs.NAME AcetyleneIYes ENoEHS*NAMEAceleneIfSubject to EPCRA, refer to instructionsTRADENoYesil. CHEMICAL INF'ORMATIONFACILITY ID #(Agency use only)FA000281 71F5CHEMICAL LocArIoN Stored in ShopLOCATION CONFIDENTIALEYES DNOBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) PAC I F lC BELL dba AT&T (SE-164)I. FACILITY INF'ORMATIONIeooEDELETEF'ORM I - SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYmaterial ADDITIONAL LOCALLY COLLECTED INFORMATIONlf moreare present at greaterpaDer.aPturing thec&rcinogenic, attachflves [No5.04TOTAL BUTANESEves DNo78-28-56.03ETHANEE Yes El tto74-84-035.02PROPYLENEfives !tto115-07-1t 9o.oPROPANEI ves f] No74-98-6o/"WTIIAZARDOUS COMPONENT (For mixture or waste only)EHSCAS #STORAGETEMPERATURE EIA,AMBIENT Eb.ABOVEAMBIENTE c. BELOW AMBIENTE d. CRYOGENICE A. AMBIENT E b. ABOVE AMBIENTSTORAGE PRESSUREE c. BELOW AMBIENTtrtrtrb, UNDERGROUND TANKc. TANK INSIDE BUILDINGd. STEEL DRUMEJ. BAGEl k. BoxEI I, CYLINDERp. TANK WAGONtrtrtrtro. TOTE BINGROUND TANKa.i. FIBERDRUMElcaNTICA.IONMETE n, PLASTIC BOTTLES BOTTLEm,q. RAIL CARr. OTHERSTORAGECONTAINERg. CARBOYh. SILOUNITS+(Check one itemIu. cuntc Foer E c. PoUNDSfia. GALLONSE d. roNS*If EHS, amount must be in365.0250.0AVERAGE DAILY250.0AMOTJNTWASTESTATEWE A. FIRE E b. REACTIVE E C, PRESSURERELEASE E d' ACUTEHEALTH(Check all that apply)E e. CHRONIC HEALTHFED HAZARD CATEGORIESE a. SOLID E b. LIQUID E c. GAS(Check one item only)PHYSICAL STATELARGESTcoNTA^* 250,0Ea.PURE EIb.MIXTURE Ec.WASTE(Check one item only)HAZARDOUS MATERIAL TYPERADIOACTIVE EYes EI.ToCURIESFlammable Liquefied Gas (3.21)CLASSES (complete if requiied by CUPA)FIRE CODECAS#*If EHS is "Yes", all amounts below must be in lbs.PropaneEHS*! Yes E tloLiquified Petroleum GasIfSubject to EPCRA, refer to instructionsTRADE SECRETesNoII. CHEMICAL INFORMATIONFACILITY ID #(Agency use only)FA0002817ID4CHEMTCAL LOCATIoN Stored in YardEPCRALOCATIONEYES ENOBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) PAC lF IC BELL dba AT&T (SE-164)I. F'ACILITY INFORMATIONLeooEDELETEF'ORM I _ SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORY iADDITIONAL LOCALLY COLLECTED INFORMATIONcomponents are present aaor o,lvothsn 17o bypapeflhe5fives [NoEves ENo3! ves fl tlo2.02ADDITIVESfives [Not 99.0LUBRICATING BASE OILflves [No%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS #STORAGETEMPERATURE E A. AMBIENT E b. ESOVPAVBICNTE c. BELOW AMBIENTE d. cRYocENIcSTORAGE PRESSUREfl c. BELoW AMBIENTS A, AMBIENT E b. ABOVEAMBIENTE b. UNDERGROTIND TANKE c. TANK INSIDEBUILDINGE d. STEEL DRUMJ. BAGK. BOXI, CYLINDERtrtrtrn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONI q. RAIL CARE r. OTHERCONTAINERm.DRUMEe.El h.EICANa. ABOVE GROUNDCARBOYSILOflu. cunlc reer E ". P0UNDS*If EHS, amount must be in Pounds.(Check one item only)[la. GALLoNSE d. roNSUNITS*365.0DAYS ON130.0Y AMOUNT130.0MAXIMUM DAILAMOUNTWASTEFED HAZARD CATEGORIES(Check all that apply)EI A. FIRE E b, REACTIVE ! C. PRESSURERELEASE E d. ACUTEHEALTHE e. CHRONIC HEALTHE a. soLID El u. lrquto E c. GAS(Check one itern only)PHYSICAL STATELARGESrcoNrot""* 75.0E a. PURE I8 b. MIXTURE E C. WASTE(Check one item only)HAZARDOUS MATERIAL TYPERADIOACTIVE EYes flNoCURIESCombustible Liquid, Class lll-BHAZARD CLASSES (Complete if required by CIJPA)FIRECAS#*If EHS is "Yes", all amounts below must be in lbs.NAME Hydraulic FluidEHS*!Yes ENo'o* MixtureIf Subject to EPCRA, refer to instructionsYesSECRETII. CHEMICAL INF'ORMATIONFACILITY ID #(Agency use only)FA00028171MAP#G5Stored in ShopCHEMICALEPCRACHEMICAL LOCAEYES NNOBUSINESS NAME (Same as FACILITY NAME or DBA - Doing BusinessAt PACIFIC BELL dba AT&T (SE-164)I. F'ACILITY INF'ORMATIONEennEDELETEFORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIF'IED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORY hnz{rdous aomponents are present at grealerl% by weight ifADDITIONAL LOCALLY COLLECTED INFORMATIONorAtt.chpaperthe requiredflves [No5El Yes D tlo4EYes E NoADDITIVESJ20.0E ves E i.toZINC COMPOUND21.0Eves ENoLUBRICATING BASE OILt 85.0CAS #EHSHAZARDOUS COMPONENT (For mixture or waste only)%wTSTORAGETEMPERATURE EI A, AMBIENT E U. AEOVE EVSIPNTE c. BELOW AMBIENTE d. CRYOGENICa.1.j.k.l.FIBER DRUMBAGBOXCYLINDERm.CONTAINERtrtrE]b. UNDERGROUND TANKc. TANK INSIDE BUILDINGd. STEEL DRUMErceNI g. CARBOYEh.SItOtrtrtrn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONtrtrq. RAIL CARr. OTHERSTORAGE PRESSUREs a. AMBTENT E U. aSOVS aVSIBNTE c. BELOW AMBIENTDAYSoNtttt'365.0UNITS*(Check one item only)fia, GALLONSflr, cuatc reer I c. PoUNDS*If EHS, amount must be in Pounds.E d. roNSSTATE WASTE CODEANNUAL WASTE AMOUNTMAXIMUM DAILY AMOUNT165.0AVERAGEDAILY AMOUNT150.0FED HAZARD CATEGORIES(Check all that apply)EI A. FIRE E b. REACTIVE E C. PRESSURE RELEASE E d, ACUTE HEALTH@ e. CHRONIC HEALTHLARGEsrcoNrot*t* 55.0PHYSICAL STATE(Check one itern only)E a. soLID EI l. uqulo El c. GASCURIESRADIOACTIVE EVes ENoHAZARDOUS MATERIAL TYPE(Check one item only)E A. PURE E b. MIXTURE E C. WASTEFIRE CODE HAZARD CLASSES (Complete if required by CUPA)Combustible Liquid, Class lll-B, lrritant (lrr)*If EHS is i'Yes", all rmounts below must be in lbs.CAS#EHS*!Yes ENocoMMoNNAME Motor Oil (All Grades)TRADESECRET IYes ENoIfSubject to EPCRA' refer to instructions.HEMI.ALNA* M ixtu reil. CHEMICAL INFORMATIONo*'on F3-G4MAP# 1FA0002817FACILITY ID #(Agency use only)CHEMICAL LOCATION CONFIDENTIAL EPCRAEYES ENOCHEMICALLocATIoN Stored ln ShopBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) PACI FIC BELLdba AT&T (SE-164)FORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIFIED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYmaterirl!eonEoglere,REVISEI. FACILITY INF'ORMATION {ADDITIONAL LOCALLY COLLECTED INFORMATIONor 0.17o by w€ightAre presenl at gr€ater than l7oofpaper capturing the5Eves ENo4I ves I tlo3Eves Eno1.02DIETHYLENE GLYCOLfives [No11 1-46-6t 5o.oETHYLENE GLYCOLfives [No107 -21-1%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS #STORAGETEMPERATURE EA.AMBIENT Eb.ABOVEAMBIENTE c. BELOW AMBIENTE d. CRYOGENICE A, AMBIENT E b. ABOVE AMBIENTE c. BELOW AMBIENTSTORAGE PRESSUREE b. UNDERGROTIND TANKE c. TANK INSIDE BUILDINGE d, STEEL DRUMEtcaNI g. CARBOYE tr. stlotrtrtrm. GLASS BOTTLEn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONCONTAINERtr j. BAce,DRUMa. ABOVE GROUND TANKK. BOXI. CYLINDERE q. RAILCARE r. OTHERIu. cuelcreer E c. POUNDS*If EHS, amount must be in pounds.Sa. GALLoNSE d. roNSUNITS*one item only)DAY'oNtttt'365.055.055.055.0ANNUALSTATEE A, FIRE E b. REACTIVE E C. PRESSURERELEASE E d, ACUTEHEALTH(Check all that apply)E e. CHRONIC HEALTHFED HAZARD CATEGORIESE A. SOLID E b, LIQUID E C. GAS(Check one item only)PHYSICAL STATELARGESrcoNrAtt"* 55.0RADIOACTIVE EYes ENoE a. PURE E b. MIXTURE E c. WASTE(Check one item only)HAZARDOUS MATERIAL TYPECURIESCombustible Liquid, Class lll-B, lrritant (lrr)CLASSES (Complete if required by CIJPA)FIRE*If EHS is "Yes", tll amounts below must be in lbs.NAME Used AntifreezeEHS*El Yes E No*o* MixtureIf Subject to EPCRA, refer to instructionsNoYesSECRETrr. CHEMICALINFORMATIONFACILITY ID #(Agency use only)FA0002817o*ton F41cHEMrcALLocArIoN East Side of ShopEPCRACHEMICAL LOCATIONEYES ENOBUSINESSNAME(sameasFACILIrYNAMEorDBA-DoingBusinessAs) PACIFIC BELL dba AT&T (SE-164)I. F'ACILITY INFORMATIONf]ADD!oElere'FORM I _ SAN LUIS OBISPO COUNTY CERTIF'IED UNIF'IED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORY ADDITIONAL LOCALLY COLLECTED INFORMATIONcomponents are present at greatefby weightmoreorweightof paperE Yes fl No99.04DISTILLATES, STRAIGHT RUN MIDEYes ENo6881 4-87 -90JETHYL BENZENEfl ves I No100-41-41.0NAPHTHALENEfives [No91-20-31 t oo.oDIESEL! ves I tto68476-34-6YoWTEHSFIAZARDOUS COMPONENT (For mixture or waste only)CAS #STORAGETEMPERATURE EA.AMBIENT EU.ASOVEAMNIPNTI c. BELOW AMBIENTE d. CRYOGENICSTORAGE PRESSUREE c. BELOW AMBIENTP A. AMBIENT E b. ABOVE AMBIENTtrtrtrb. UNDERGROLTND TANKc. TANK INSIDE BUILDINGd. STEEL DRUMtrtrtrf. CANg. CARBOYh, SILOJ. BAGK. BOXI. CYLINDERutrtrn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONCONTAINERDRUMe.m. GLASSI q. RAIL CARE r. OTHERa. ABOVETJNITS+(Check one item only)!u. cunrc neEr E c. POUNDSfia. GALLONSE a. roNsamount must be in pounds'*IfDAY' oN tttt, 365.0127.0Y AMOUNT127.0MAXIMUM DAILYANNUALSTAFED HAZARD CATEGORIES(Check all that apply)E A. FIRE E b. REACTIVE E C. PRESSURERELEASE E d. ACUTEHEALTHE e. CHRONIC HEALTHE a. SOLID E b. LIQUID E c, GAS(Check one item only)PHYSICAL STATELARGESTCoNTAINER 1 00.0Ea.PURE Eb.MIXTURE Ec.WASTE(Check one item only)HAZARDOUS MATERIAL TYPERADIOACTIVE E Yes ENoCURIESCombustible Liquid, Class ll (1.1 ll), lrritant (lrr)CODE HAZARD CLASSES (Compl€re if required by CUPA)cAS# 68476-34-6*If EHS is "Yes", all amounts below must be in lbs.coMMoNNAME Diesel #2 LS (Dyed)EHS*EYes ENo.HEMICAL NA* M ixtu reIfSubject to EPCRA, refer to instructionsNoYesSECRETII. CHEMICAL INFORMATIONFACILITY ID #(Agency use only)FA0002817o*ton F71LocArloN Parking Lot - westEPCRACHEMICAL LOCATIONEYES ENOBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) pACIFIC BELL dba AT&T (SE-164)I. FACILITY INFORMATION!ADDNDELETEFORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIFIED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYtrear morecomponGnls are present at greaterweight ifADDITIONAL LOCALLY COLLECTED INFORMATIONorcarcrnogenrc,paper caPturing theProprietaryI ves I t'toAdditives512.0647 42-57 -0flves [NoHydrotreated Bottoms441.064742-65-0Eves ENoSolvent Dewaxed Dist Hvy Paraffin350.064742-54-7I ves I l.toHydrotreated Dist Hvy Paraffin250.064742-62-7EYes ENoSolvent Dewaxed Residual Oilt s2.oCAS #EHSIIAZARDOUS COMPONENT (For mixture or waste only)%wTSTORAGETEMPERATURE E A, AMBIENT E b. ABOVEAMBIENTI c. BELOW AMBIENTE d. CRYOGENTC[la. GALLONS Iu. cuelc roor f] c, PoUNDSE a. ronsDA'"'365.0UNITS*(Check one item only)*Ifamount must be ina.e.DRUMFIBERm, GLASS BOTTLECONTAINERtrtrEb. UNDERGROUND TANKc. TANK INSIDE BUILDINGd. STEEL DRUMT CANg. CARBOYh. SILOtrtrtrJ. BAGK. BOXI. CYLINDERE n. PLASTIC BOTTLEE o. TOTE BINI p. TANK wAGoNtrtrq, RAIL CARr. OTHERSTORAGE PRESSURE$ A. AMBIENT If b. ABOVE AMBIENTE c. BELOW AMBIENTSTATE WASTE CODEANNUAL WASTE AMOUNTMAXIMUM DAILY AMOUNT61.0AVERAGE DAILY AMOUNT50.0FED HAZARD CATEGORIES(Check aU that apply)E A. FIRE E b. REACTIVE I C. PRESSURERELEASE E d, ACUTEHEALTH@ e. CHRONIC HEALTHLARGESrcoNrAt"u* 40.0PHYSICAL STATE(Check one item only)E a, SoLID El u. t-tQulP E c. GASCURIESRADIOACTIVE EVes ENoHAZARDOUS MATERIAL TYPb(Check one item only)E a. PURE E t. rr,trxrunr E c. wASTEFIRE CODE HAZARD CLASSES (complete if required by CUPA)Combustible Liquid, Class lll-B, lrritant (lrr)*If EHS is "Yes", all amounts below must be in lbs.CAS#EHS*IYes ENocoMMoNNAME Grease / Gear LubeTRADESECRET lYes ENoIf Subject to EPCRA, refer to instructionsCHEMICALNA* MixtureII. CHEMICAL INF'ORMATIONo*ton F4MAP#1FA0002817FACILITY ID #(Agency use only)CHEMICAL LOCATION CONFIDENTIAL EPCRAE YES fl NoCHEMICALLOCAION Stored in ShopBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business A0 PACI F I C B ELLdba AT&T (SE-164)FORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIF'IED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYmeterialI. FACILITY INF'ORMATION ADDITIONAL LOCALLY COLLECTED INFORMATIONcomponents are pfesent at gfealerattach sdditionalmoreinformation,5fives [No[Yes [No!ves Ilto5.02USED OIL8002-05-9flves I Not t oo.oUSED OIL FILTERSI ves I I.to8002-05-9%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS #STORAGETEMPERATURE @A,AMBIENT Eb.ABOVEAMBIENTfl c. BELOW AMBIENTE d, CRYOGENICE A. AMBIENT E b. ABOVE AMBIENT! c. BELOW AMBIENTSTORAGE PRESSUREE b, UNDERGROUND TANKE c. TANK INSIDE BUILDINGE d. STEEL DRUMErcarE e. CARBOYE n. stlotr j. BAcE k. BoxE I. CYLINDERtrtrtrn. PLASTIC BOTTLEo. TOTE BINp. TANK WAGONq.r,CONTAINERFIBER DRUMm.TIC/NONMETa. ABOVE GROUND TANKRAIL CAROTHERDAYS oN tttt' 365.0!u. cunrc reer E c. POUNDS! a. GALLoNSE d. roNSUNITS*one item only)*If EHS, amount must be in100.0200.0AMOT'NT200.0AMOUNTTE CODEFED HAZARD CATEGORIES(Check all that apply)E A. FIRE E b, REACTIVE EI C. PRESSURERELEASE E d. ACUTEHEALTHE e. CHRONIC HEALTHB a. SOLID E b. LIQUID E c. GAS(Check one item only)PHYSICAL STATELARGESTcoNTAt*t* 200.0HAZARDOUS MATERIAL TYPE(Check one item only)Ea.PURE Eb.MIXTURE Ec.WASTERADIOACTIVE EYes EttoCURIESCombustible Liquid, Class lll-B, lrritant (lrr)FIRE CODE HAZARD CLASSES (Complete if required by GIJPA)CAS#*If EHS is "Yes", all amounts below must be in lbs.coMMoNNAME Drained Used Oil FiltersEHS*Ives ENo.HEMICALNA* MixtureIfSubject to EPCRA, refer to instructionsTRADE SECRETNoII. CHEMICAL INFORMATIONFACILITY ID #(Agency use only)FA000281 7ooon F41cHEMlcALLocAnoN East Side of ShopCHEMICALLOCAEPCRAEYES ENOBUSINESSNAME(SameasFACILITYNAMEoTDBA-DoingBusinessAs) PACIFIC BELL dba AT&r (sE-164)I. F'ACILITY INF'ORMATION!ADDEDELETEF'ORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIF'IED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYormate riel ((ADDITIONAL LOCALLY COLLECTED INFORMATIONcomponents afe prsent al greateror 0.19lo byshe€ts ofpaper5fives [NoEYes ENo3lves [NoI ves I l.tot t oo.oMOTOR OIL, USEDEYes ENo8005-05-9%wrHAZARDOUS COMPONENT (For mixture or waste only)EHScAs #STORAGETEMPERATURE [I A. AMBIENT E b. ABOVEAMBIENTE c. BELOW AMBIENTE d. cRYoGENrcE a. AMBTENT E b. enovp atvtslpNrSTORAGE PRESSUREfl c. BELOW AMBIENTtrtrtrf. CANg. CARBOYh. srl-otrtrtrJ, BAGk. BoxI. CYLINDERE n. PLASTIC BOTTLEE o. TOTEBINI p. TANKWAGONALLIC DRUMtrtrm. GLASS BOTTLEE b. UNDERGROLIND TANKGROUND TANKa,E q. RAIL CARE r. OTHERSTORAGECONTAINERc. TANK INSIDE BUILDINGd- STEEL DRUM!u. cunrc rrer E c. POUNDS*IfEHS, amount must be in pounds.(Check one itemfla. GALLONSE d. TONSUNITS*oNSITE:365.0240.0240.0240.0ANNUALSTATE WEtr A. FIRE E b. REACTIVE E C. PRESSURE RELEASE E d. ACUTE HEALTH(Check all that apply)E e. CHRONIC HEALTHFED HAZARD CATEGORIESE a. SoLID E b. LIQUID E c. GAS(Check one item only)PHYSICAL STATELARGESTcoNTAt*"* 240. 0E A. PURE E U. VIXTUNS E C. WASTE(Check one item only)HAZARDOUS MATERIAL TYPECURIESRADIOACTIVE EYes El.loCombustible Liquid, Class lll-B, lrritant (lrr)HAZARD CLASSES (Complete if required by CUPA)CAS#*If EHS is "Yes", sll amounts below must be in lbs.Used Motor OilEHS*IYes EuoMixtureIfSubject to EPCRA, refer to instructionsNoYesECRETII. CHEMICAL INF'ORMATIONFACILITY ID #(Agency use only)1MAP#FA0002817F4, F5cHEMrcALLocArIoN West Side of ShopLOCATIONE]YES NNOBUSINESSNAME(SameasFACILITYNAMEoTDBA-DoingBusinessAs) PACIFIC BELL dba AT&T(sE-164)I. FACILITY INFORMATIONr]ADDEDELETEF'ORM I - SAN LUIS OBISPO COUNTY CERTIF'IED UNIFIED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYor (Ifmore hazardous comDonen(s f,re pr€sent at greaterif non-carcinogenic, or 0,19lo byADDITIONAL LOCALLY COLLECTED INFORMATIONofpaper capturing theE Yes E tlofives [No4Eves ENo3fives flwo2Eves ENoICAS #EHSHAZARDOUS COMPONENT (For mixture or waste only)VoWTSTORAGETEMPERATURE @ A. AMBIENT E b. ABOVEAMBIENTE c. BELOW AMBIENTE d. CRYOGENTCSTORAGE PRESSUREE a. AMBTENT E b, aSovp avstEl\lrE c. BELOW AMBIENTONMETALLICDRUM E i. FIBERDRUME m. GLASS BOTTLEE n. PLASTIC BOTTLEE o. TOTE BINI p. TANK wAGoNCONTAINERE b. UNDERGROUND TANKE c. TANK INSIDE BUILDINGE d. STEEL DRUMtrtrtrfl CANg. CARBOYh. srl-oJ. BAGK. BOXI. CYLINDERE q. RAIL cARE r. OTHERDAYS oN tttt' 365.0UNITS*(Check one item only)[a. GALLONSfiu. cuerc rerr I c. POUNDS*If EHS, tmount must be in pounds.E a. roNsSTATE WASTE CODEANNIJAL WASTE AMOUNTMAXIMUM DAILY AMOUNT444.0AVERAGE DAILY AMOUNT250.0FED HAZARD CATEGORIES(Check all that apply)EI A. FIRE E U. NEACTIVE E C. PRESSURERELEASE E d. ACUTEHEALTHE e. CHRONIC HEALTHLARGESTC0NTAt*"" 222.0PHYSICAL STATE(Check one item only)E a, SOLID EI b. LIQUID E c. GASCURIESRADIOACTIVE EYes EltoHAZARDOUS MATERIAL TYPE(Check one item only)EIA.PURE Eb.MIXTURE EC.WASTEFIRE CODE HAZARD CLASSES (complete if required by cuPA)Oxidizer, gas (4.4)*If EHS is "Yes", all amounts below must be in lbs'c^s# 7782_44_7EHS*! Yes D tlocoMMoNNAME oxygenTRADESECRET !Yes ENoIfSubject to EPCRA, refer to instructionsCHEMICALNAME ^uxygenil. CHEMICAL INF'ORMATIONoooo FsMAP# 1FA0002817FACILITY ID #(Agency use only)CHEMICAL LOCATION CONFIDENTIAL EPCRAEYES DNocHEMrcALLocArIoN Stored in ShopBUSINESSNAME(SameasFACILITYNAMEoTDBA-DoingBusinessAs) PACIFIC BELL dba AT&T (SE-164)I. F'ACILITY INF'ORMATIONF'ORM I - SAN LUIS OBISPO COUNTY CERTIFIED UNIF'IED PROGRAM AGENCY (CUPA)CHEMICAL INVENTORYmaterial!ADDlosr-erp PACIFIC BELLIAT&TlH tr kCM.' g'ud.F?tclNrc. * U-!f,g{jSINESS NAMEA,T&r Colrnio SNLOCABUSI}iESS!96 SU8SITE MAP\.qt-at f}-lr\\\^Ti l+ffiuAtL / 1LJ 'e -SAN L|JIS OBISPOZIP CODE934C3MAP# 1!criDRAI1TNG SCALErini Tf\ Cn r fl\ur r\/ JUnLLSYMBOL LEGENDii.CIRICAL PANELsHur-oaiNATURAL GAsSHUT.O'FwAf€R sHU]-oFFi|,!ERG€NCY Si4Ur D0'1i,"{TAN( [iIONiiORINGAIARMIELEPHONE.IRS-i AI' K1YgtRE :xilNcuts:lERSTORU DRAINSANITARY SEWERSTACINS AREAFyACIIATLCN,/HMUP. tN9 r,tsDgLOCATIONFIRI HYDRAXIEMERC[NCY RESPOiTS'EQUIPM€NT/ABSORgEN TSABOVEffiOUNCSTCRACE IANKi---.) ITNDERGRcLJNo--- S1CRAGE IANKMOIOS OILS & LU3RICANiSic0MgusTrs'-E LrculDS)SAiT€RY ELECTROLYTE(coRRostv-: LtQulD)6ASCLINE(FLAMMABLE LIQUIOS)9IESIL FUSL(coMBUsltBl-E U0u]'s)NITROCTN(CIMPRES5E0 6AS)PROPANE(FLAMMAgLE LIOUlD)ACEIYLEi'I€(Co|JPRESSE9 GAS)ANTIFREEZE/COQLAN iSA WASTE OIL\V (rreuv€LE Lrouro)fl r,ce ?uLL BoxFCFLAMMASLES CABII{!IDN---r--qrF---l-rllooo\y#^e+t!)-AtfrsTlL.#234567acwcTUTz6-lTmmJIIl@@@@@8I=ffi@oo@(9(l)@PCRTABLToCENiRAIORilll11l-r-T--Il||1tl0f Gqls.F/:-\\l,i1-l----g---- - - - r *Ht!.luMSYORAUI.IC FLUIOOXYCiNWASTE AI.]TliRiAZELKAFCoWATERTAI\(sTORACEADMINlSTRATI9NBUtL0tNCIBcDLGHJM+ DRatN,qC[ |"LCW DIP€CT|ON@ ruro.nnns. r,-u,o MAP# 1AT&T Colifornio SNLOCAAU Stl64196 SUBURBAN RDSITE h4AFDRAi{ING SCALENOT TO SCALEBUSINESS NAMEBUS]NESSc0[/t\tERclAL234567ISAN LUIS OBISPOCOMMERCIALio:d ctARlFlDATE 1 1412ZIP CODE9J403U)cwcll(Dz@-ltrrnrn-lK@@@@@U!oLUzoI&Jt)otUoO{zffi+fiPOLEPortoble GenerotorsRESTAURANTHELIUMHYDRAULIC FLUIDARGONOXYGENWASTE ANTIFREEZEKALPACIFIC BELL/AT&TPetolumo, CA U.S.A.1385 N. McDowell 8lvd.lnc.SYMBOL LEGENDELECTRICAL PANELSHUT_OFFNATURAL GASSHUT-OFFWATER SHUT_OFFEMERGENCY SHUT DOWNTANK MONITORINGALARMTELEPHONEFIRS1 AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEWERtffit l8sidjuD "sDs! r,nr HYDRANT# FENCEEMERGENCY RESPONSEEQUIPMEN T/ABSORBENTSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUERICANTS(COMBUSTIBLE LIOUIDS)BATTERY ELECTROLYTE(coRRosrvE LlourD)GASOLINE(FLAMMABTE LlOUlDS)DIESEL FUEL(COMBUSTIBLE LIQUIDS)NITROGEN(COMPRESSED GAS)PROPANE(FLAMMABLE LIOUID)ACETYLENE(COMPRESSED GAS)AN TIFREEZE/COOLANISWASTE OIL(FLAMMABLE LIQUID)f rrne PULL BoxFCFLAMMABLES CABINET+ DRAINAGE FLOW DIRECTIONllry\i-FA'l UNTVERSAL WASTE- ACCUMULATION AREA@@@@r0o.o+K-A@@{@@o@eo@@oSTAGING AREAEVACUATION/FCFCSIORAGEoooAWATERTANKADMINISTRATIONBUlLDING@9BcDEFGHJM FORM ESAN LUIS OBISPO COLINTY CERTIFIED UNIFIEDPROGRAM AGENCY (CI-JPA)EMERGENCY RESPONSE PLANOr Hazardous Waste Contingency Plan02t2012013Date:SECTION I-A: BUSINESS IDENTIFICATION DATABUSINESS NAMEPACIFIC BELL dba AT&T (SE-164)STTEADDRESS196 SUBURBAN RDCTTYztPCODE93401SAN LUIS OBISPOFACILITYL'NTTTELEPHONENlJMBERBUSINESS MAILING ADDRESSCITYztPCODE'l Hazrdous MaterialsUnderground Storage #2. Hazardous WasteGenerator #Ifyour business has a license or permitfrom any ofthefollotoing qencies, please indicate the docununt numlter,3. Air Pollution ControlDistrict #4. Responding Fire Dept& Permit #please provide the following information as it pertains to your business and its location. You are not required to notifu these companies in theevent of an em ergency. Thi s i nformation i s provi ded for y our reference and t o assi st em ergency response personnel i n respondi ng t o ahazardous materials emergency at your facility. List the name and phone number of the utility company.Electrical ServicePACIFIC GAS & ELECTRICTelePhone # gooz435oooGas ServicePACIFIC GAS & ELECTRICTelePhone # aooz43soooSanitationSAN LUIS OBISPO UTILITIESTelePhone # eosz g172rsWater DistrictSAN LUIS OBISPO UTILITIESTelePhone # aoslg1721sSECTION I-B: OWNER CERTIFICATION OF DATA (Certiff either I or2)l. This is a XNpW ftan IUPDATED Existing Plan. I have personally examined the information it contains and am familiar with theoperation of the plan. (If you check either of the above two options, continue to complete the remainder of the Emergency Response /Contingency Plan).Z. fl 1'nis plan requires no change and is on file with San Luis Obispo County Certified Unified Program Agency and does not needany change. (If you check this section, please proceed directly to Form T, the Training Program.)I certifr under penalty of law that the above information is true and accurate.PRINT NAME OF OWNER OR OPERATORSICNATUREDATESteve SkandersonSubmitted via Portal02t2012013DOCUMENTS PREPARED BYSIGNAT1JRESubmitted Via PortalDATEStantec Architecture I nc02120120131 SECTIONII: EMERGENCY RESPONSE PLANS AND PROCEDURESNote: Complete all sections of this Emergency Response Procedure below. Use of terms such as "N/A" (Not Applicable) will not be accepted.A. FIRE, SPILL, OR RELEASE: The fire code requires immediate notification through dialing 911, by whoever first sights theincident. ln the event of release or spill of hazardous materials, you must also notify:l. San Luis Obispo County Certified Unilied Program Agency during business hours @ 805-781-5544. After business hoursdial 911.2. The California Emergency Management Agency (CAL EMA) - (800) 852-7550.List the individuals responsible for verifying that these calls have been made and also indicate their position in yourcompany.F'OR VERIF'YING THE DIALING OF 911:NAMEPOSITIONCathy CastilloEnvironmental ManagerIndividual responsible for calling San Luis Obispo County Certified Unified Program Agency and CAL EMA: (Normally the EmergencyCoordinator of your business).NAME POSITIONCathy Castillo Environmental ManagerB. List the local emergency medical facilities that will be used by your business in the event of an accident or injurycaused by a releaseor threatened release of hazardous materialsNAMEADDRESSCITYFrench Hopital Medical Ctr 1911 Johnson AvePHONESan Luis Obispo805-542-6377NAMEADDRESSCITYPHONEC. List the Emergency Coordinator(s) at your facility:PRMARY COORDINATOR'S NAMECathy CastilloTITLEBTISINESS PHONEEnvironmental Manager 925-823-07 2524TIRPHONEPAGER#SECONDARY COORDINATOR'S NAMETITLEBUSINESS PHONE24 HRPHONEPAGER#AT&T EH&S Hotline24 hour Emergency Ser 8005669347D. Does your business have an on-site emergency response team? !V"t [Vo Describe procedures your business will follow inthe event ofa release or threatened release ofhazardous materials.2 (E. Ifyou have acutely hazardous materials above threshold planning quantities, list (by name and address) adjacentneighboringbusinesses and residences, schools, hospitals, etc. Include sensitive facilities (schools, hospitals and rest homes) within 1'000 feet(straightJine distance from your property line). List telephone numbers for all businesses; for apartment buildings, list manager'sphone. Do not list telephone numbers for private residences.F.Briefly describe your standard operating procedures in the event of a release or threatened release of hazardous materials.Emergency response procedures must comply with all federal, state and local regulations. Existing emergency response proceduresmay be referenced and attached to this document.1. Prevention -- Describe the accident potentials associated with the hazardous materials present at your facility. What actions wouldyour business take to reduce accident potentials? Include description ofsafety, storage, and containment procedures.The following describes what action our business will take to prevent a hazardous materials or hazardous waste release from occurring:I.TRAINlNG: AT&T employees are required to complete a variety of training related to the management, use, storage and proper handling ofhazardous materials and h'azardous wastes. The type and frequency of training is dependent upon the employees job responsibilities and isdelivered in a classroom environment or online through one of AT&Ts Learning Management Systems.2.MATERIALS: Hazardous materials are utilized and stored following manufacturer's recommendations, as our business is a user of chemicalproducts and not a manufacturer of hazardous materials.2. Equipment -- List the emergency response equipment at your facility (e.g. fire extinguishing systems, spill conhol equipment,decontamination equipment).ItemMaintenance ProcedureAbsorbentsMonthly lnspectionsFireExtinguishersAnnual lnspectionsFirst Aid KitMonthly lnspectionsPers. ProtectiveGearReplace As Neededvou will immediately evacuate yourFleet AreaPresonnelProtectionFirst AidFleet Area / MainBldgSee Site MapsFire SafetyFleet AreaFire SafetyLocationUse3. Evacuation -- Describe how3facilitv. Where are the designated meeting locations? What communications or alarmsused? How will you operate these during powera,-This €des wih each building and should b€ vsrifsd wih lhs €mergency Sit€ Coo.dinator ofsach facilily. Aslandard statsmont would bs:METHOD OF AURM TO EMPLOYEES:Vocal. inlsrcom and frrc alams ar6 used to nolify our employsos lo ovacualeROUTES OF EGRESS:This atso variBs with each building and should be verlfied wih tha Emee€ncy Sils Coordinalorofsach facilily. A slandard sbtemenl would bo:"Employe€s axit through frcnt, r€arand sids doors. Altemats routes includ8. ..The lnslruclions for omerg€ncy exists and all€mate routes lo bo used for svacualion are posted on 6ach floorMETHOD TO ACCOUNT FOR ALL PERSONS:inctud€s the astab[;hmsnt olass€mbly areas wh6re accountability cn be detemined. Employoes fo. this lacility ar€ Insructed to: SEE EMOP BINDER.ALERTING NEIGHBORS:4. Shutdown -- Describe the procedures to shutdown the facility in case of an emergencyDue to regulatory requirements, the emergency power system can not be shut down. lf necessary,alternate power supplies can be brought to the facility (i.e. portable generators), while the primarypower system is repaired.5a. Response -- Describe what is done to lessen or mitigate the harm or damage done to person(s), property, or the environment,and toprevent the event from getting worse or spreading, What is your immediate response to:Fire:Small - Use a fire extinguisher.Large - Call 911 if possible, evacuate & allow the fire department to respond.Explosion:Call 911 if possible, evacuate & allow the fire department to respondSpill:ln the event of a minor release (<10gals) from the batteries, employees will stop the leak, if possible withoutrisk, using bicarbonate of soda or soda ash and/or dike the material to confine it to a safe location.Earthquake:The batteries are securely braced to prevent leaks and are inspected regularly. Additionally, thebatteries, diesel tanl</fuel lines, and halon cylinders will be inspected following an earthquake.MajorpowerFailure: The facility utilizes industrial batteries and a generator as a backup power systemFlood:lne bauenes are tn racKs tnal areelevated on me Tloor. lt ls not llKelythat me area willbe subject to water levels thatwould impede the operation at the facility.b. Is this facility located on a 100-year flood plain? Syes f]Noc. Earthquake - Identi$ facility areas and list mechanical or other systems that require immediate inspection or isolation because oftheir vulnerability to earthquake related ground motion,All aboveground petroleum storage and overhead racks will be checked following an earthquake6. Clean-Up -- How do you handle the complete process of cleaning up and disposing of hazardous material releases at your facility?Note: Noti! the Certified Unified Program Agency when clean up is complete'Determining the nature, location, magnilude and severity of the incidentMove peopl6 away from lhe area as appropriate.Avoid inhalation of all gasses, fumes or smoke.G. Location -- Your business is required to keep a copy of the Business Plan and related Material Safety Data Sheets (MSDS) on-site.Describe where this information is located.4 A copy of the business plan, MSDS sheets are located at: FRONT ADMIN. LOBBY (also see site map)5 FORM TSAN LUIS OBISPO COUNTY CERTIFIED LINIFIEDPROGRAM AGENCY (CUPA)EMPLOYEE TRAINING PROGRAM02t2012013Date:A. Describe the safety training for all employees in the event of a release or threatened release of hazardous materials. Thistraining shall include, but not be limited to the following: new employee training, annual training, and safety meetings whichcover familiarization with the facility's hazard communication program and Emergency Response Plan/Contingency Plan.l. Summarize the training for all employees that work with or come in contact with hazardous materials/hazardous wastes. Describehow these employees are trained to avoid exposure.All employees who handle hazardous materials are trained to use appropriate methods and torecognize any potential hazards. Periodic refresher training is provided in bi-monthly safety meetingswhen required. Employees who work at thesite are familiarized with the location of the MSDS that areassociated with the materials at the facility.All batteries that have exceeded their usefulness will be removed and recycled.2. Summarize training specific to those employees that would respond to a release or threatened release of hazardous materials orhazardous waste.Employees are trained in the proper use of a fire extinguisher. All employees who handle hazardousmaterials are trained to use appropriate handling methods and to recognize any potential hazards.Periodic refresher training is provided in bi-monthly safety meetings when required.ln the event of a minor release from the batteries, employees will absorb the spilled material usingbicarbonate of soda and/or dike the material to confine it to a safe location. Barrier tape will be placedaround the released material. Spills exceeding the capabilities of the employees will be handled by aqualified contractor. AT&T Environmental Management will be notified to make all necessaryarrangements with an environmental firm for cleanup and disposal of any spills (AT&T EnvironmentalManagement: 800-566-9347 [800-KNOW-EHS] 3. Indicate frequency and duration of training for employees that work with or come into contact with hazardous materials/hazardouswaste.All employees who handle hazardous materials are trained to use appropriate handling methods and torecognize any potential hazards. Periodic refresher training is provided in ANNUAL safety meetingswhen required.4. Describe how your employees access training materials. (E.g., bulletin board, employee newsletter, staff meetings, etc.)Employees are provided lNlTlAL Safety Plan training on the Hazard Communication Certification, as well as function specificbefore they begin their work operations. This also includes training on the Emergency Operating procedures' There is alsohazardous mat,erials/waste management training for employees as appropriate. The training may either be leader-led or taken asan online interactive course. Training is recorded electronically. A series of Job Aides that briefly describe each of the topicsaccompanies the training. Additionaily, the AT&T Emergency Plan requires that employees receive ANNUAL REFRESHERtraining on the Hazard Cbmmunication Certification, function specifics and the Emergency Operating lnstructions'B. List person(s) in charge of training and indicate their qualifications to conduct the training.The training may either be leader-led or taken as an online interactive course. Training is recordedelectronically.C. Indicate where training records are kept. (Records must document the type of training, duration, completion dates, names andpositions of employees receiving training and the name of instructor/trainer')The AT&T Emergency Plan Binder serves as a reference guide for the Emergency SiteCoordinatoriBuilding Warden. Employee training records are maintained in the employee files FILETHIS DOCUMENTENVIRONMENT, HEALTH & SAFETYGREEN COMPLIANCE BINDERSECTION1Plan Revised:Plan Revised:Plan Revised:at&tHazardous Materials Business Planand Annual InventorY UPdateYEAR 2OI2ir.I fIEPacific BellComdbaAT&T California - SE164and ID)196 SUBURBAN RD(Facility Address)SAN LUIS OBISPO(FacilW CrA)SAN LUIS OBISPO(FaciliO County)MAINTAIN THIS DOCI.JMENT ON SITE SO ITWILL BE AVAILABLE IN THE EVENTOFA COVERNMENT AGENCY INSPECNON, STTE ASSESSMENT OR AUDIT'Printed: ll5l20l2 IUNIFIT,' PROGRAM CONSOLIDATEDFACILITY INFORMATIONHAZARDOUS MATERIALS BUSINESS PLANCERTIFICATION F'ORM 2012,T,Return all forms to:City of San Luis ObisPo2160 Santa Barbara Ave.San Luis ObisPo CA 93401805-78 1 -73 80OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based uponmy inquiry of those individuals responsible for obtaining the information reported above, I believethat the submitted inforrnation is true, accurate, and complete. I understand that a revised HMBPmust be submitted within 30 days of any change in this facility's storage or handling of hazardousSteve SkandersonName of Owner/Operator (Print)2-2012Date: JanuaryAssociate-Agent for AT&TTitle:theSignature of Owner/Operator:materials which would require uTVpursuant to Section 25503.3(c) of California Health and Safety Code (HSC), theHazardous MaterialsBusiness plan (HMBP) certification described below is hereby submitted for the following facility:Facility Name:Pacific Bell Telephone Company dba AT&T CaliforniaFacilityStreet Address 196 SUBURBAN RDCitySAN LUIS OBISPOzip93403I have personally reviewed theHazardous Materials Business Plan currently on file with the CUPA dated12l1SlZO11 and certiff that: (Check one.)The Hazardous Materials Business Plan is complete and accurate and no revisions are necessary*(See below for details); orRevisions to the Hazardous Materials Business Plan are necessary. The following new or revisedform(s) and/or information are enclosed to reflect the necessary changes:Business Activities formBusiness Owner/Operator Identifi cation formHazardous Materials Inventory form(s)Site Map formEmergency Response Plans and ProceduresEmployee Training Program*By checking the top box on this form, you are certifying that:u) fn. iniormation contained in the innual inventory forms most recently submitted to the administering agency iscomplete, accurate, and up-to-date; andb) There has been no change-in the quantity of any hazardous material as reported in the most recently submittedannual inventory forms; andc) No hazardous materials subject to the inventory requirements are being handled that are not listed on the mostrecently submitted annual inventory forms; andd) There have been no substantial changes in the facility's hazardous materials operations which would requirerevision of the current HMBP; ande) The most recently submitted annual inventory forms contain the information required by Section 11022 ofTitle 42 of the United States Code,/,r/,r/\/Business Plan Certifi cation 20 12 UNIFIED PROGRAM CONSOLIDATED FORFACILITY INFORMATIONBUSINESS ACTIVITIES..;r:Page I oflS(You may also be required to provide additional information by yourcUPA or local agency.)F, LOCALREQUIREMENTSl5E. HAZARDOUSWASTEGenerate hazardous waste?Recycle more than 100 kg/month of excluded or exempted recyclablematerials (per HSC 25143.2)?Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permit by Ruleand Conditional Authorizaton)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned on-site?Generate in any single calendar month 1,000 kilograms (kg) (2'200 pounds)or more offederal RCRA hazardous waste, or generate in any single calendarmonth, or accumulate at any time, 1 kg (2.2lbs') of RCRA acute hazardouswaste; or generate or accumulate at any time more than 100 kg (220 lbs') ofspill cleanup materials contaminated with RCRA acute hazardous waste'Household Hazardous Waste (HHW) Collection Site?ffivns f]No ,! vrs MNo 'o!ves lTNorr!vrs lTlNorz[]ves l-lNo',Ivns MNo'oflvrs fiNo'0"YESl4bEPA ID NUMBER - provide at the top ofthis pageRECYCLABLE MATERIALS REPORT(one per recycler)ON-SITE HAZARDOUS WASTETREATMENT - FACILITYON.SITE HAZARDOUS WASTETREATMENT-UNIT (one page per unit)CERTIFICATION OF FINANCIALASSURANCEREMOTE WASTE / CONSOLIDATIONSITE ANNUAL NOTIFICATIONHAZARDOUS WASTE TANKCLOSURE CERTIFICATIONObtain federal EPA ID Number, fileBiennial Report (EPA Form 8700-l3A/B), and satisry requirements forRCRA Lagre Quantity Generator.See CUPA for required forms,D. ABOVE GROI.IND PETROLEUM STORAGEOwn or operate ASTs above these thresholds:Store greater th an 1,320 gallons of petroleum products (new or used)in aboveground tanks and containersn*tpfNo 'NO FORM REQUIRED TO CUPASC. UNDERGROUND STORACE TANKS (USTs)Own or operate underground storage tanks?! ves [fr.ro sUST FACILITY (Fomerly SWRCB Fonn A)UST TANK (One page per tank) (Formerlv Form B)B. REGULARED SUBSTANCESHave Regulared Substances stored onsite in quantities greater than thethreshold quantities established by the California Accidential Releaseprevention Program (CalARP)?lves fJNo ouCoordinate with your local agencYresponsible for CalARP.A. HAZARDOUS MATERIALSHave on Site (for any purpose) at any one time, hazardous materials at or above55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressedgasis (include liquids in ASTs and USTs); or the applicable Federal threshold[uantity for an extremely hazardous substance specified in 40 CFR Part 355,App.nOi* A or B; or handle radiological materials in quantities for which anemergency plan is required pursuant to l0 CFR Parts 30, 40 or 70?E*tlNo IHAZARDOUS MATERIALSINVENTORY. CHEMICALDESCRIPTIONDoes your facility...If Yes, please completethese pages of the UPCF..NOTE: If you check YES to any part of this listoIdentificationsubmit the BusinessII. ACTIVITIES DECLARATIONSAN LUIS OBISPOBUSINESS SITE CITYCA105coDE 93403BUSINESS SITE ADDRESS 196 SUBURBAN RD103(Same as FACILITY NAME of DBA-Doing Business AS)Pacific BellTelephone Company dba AT&T CaliforniaBUSINESS NAMEFACILITY ID#Use00028 1 7EPA ID# (Hazardous Waste OnlY)cAT0800242682I. FACILITY IDENTIFICATIONUPCF Rev. 02n007)Printed'. l/5/2012 UNIFIED PROGRAM CONSOLIDATEDFACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATIONNAME OF SIGNER (Print)Steve Skanderson136Associate - Agent for AT&T137OF SIGNER135LOCALLY COLLECTED INFORMATIONOFNAME OF DOCUMENT PREPARER134theinformationlarwithfamiltrue,believethesubmittedandaccurate,informationlsandcomplete.myonBasedlngthoseindividualsoftheobtainresponsibleforexamcertiryunderamIhavelawthatpenaltyofandinedpersonally2,2012Stantec Architecture I nc.PAGER #:127132PAGER#800-566-9347 (800-KNOW-EHS)z4-HOUR PHONE126800-566-9347 (Boo-KNOW-EHS)Z4-HOUR PHONE131805-546-7416BUSINESS PHONE125800-566-9347 (800-KNOW-EHS)BUSINESS PHONE130Environmental Site Manager124TITLE24 HR EMERGENCY SERVICE129TITLESharon Ramirez123NAMEAT&T EHS HOTLINE128NAMEIV. EMERGENCY CONTACTSPRIMARYSECONDARYCONTACT MAILING CITYSan Luis Obispo120STATE121CA122ZIP CODE93401119orro Street. Room 305B72MCONTACT MAILING ADDRESS1 19aCONTACT EMAILsl6541@att.comSharon Ramirez117'118114115116NAME805-546-7416ACT PHONEMAILING CITYSan RamonSTATECAZIP CODE94583CWNER MAILING ADDRESSP.O. Box 5095, Room 3E000113111112109OPERATOR PHONE110NAMECompany dba AT&T CaliforniaPacific BellTelephonePHONE925-823-0725OPERATOR NAMESharon RamirezBUSINESS MAILING CITYSan RamonSTATE1 08cCA94583ZIP CODE1 08dS MAILING ADDRESSP.O. Box 5095, Room 3E0001081 0-340-1 61 8DUN BRADSTREET106107PRIMARY SIC4813107aPRIMARYNAICS517110SAN LUIS OBISPOBUSINESS SITE CITY104CA105ZIP CODE93403COUNTY 108SAN LUIS OBISPOSITE ADDRESS196 SUBURBAN RDFAX103102aPHONE805-546-74161023dba AT&T Californiane comPacific BellTeleDoing Business As)NAME (Same as FACILITY NAME or DBA -ID#000281 71DATE12DATE1011100oftUPCF (Rev. 1212007)Printed: 11512012 sii :'l.lUNIFIED PROGRAM CONSOLIDATED FOHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)If EPCRA, Please SADDITIONAL LOCALLY COLLECTED INFORMATIONHere246Ifmore huardous components are ptesent at greater than l% by weightif non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper capturing the requi red infomation5 0.5242Sulfur243244[v" EN"7704-34-9245499238Distillates, Straight Run Mid239240f1".. E]*"6881 4-87-924131234ETHYL BENZENE235236flv.' Elu"100-41-423721zJvNAPHTHALENE231232D.' EN"91-20-3233I 1oo226DIESEL FUEL#2227fl".' Elu"22868476-34-6229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#[r. anoveAMBIENr !c. BELOWAMBIENT !o' cnvocrutcXSTORAGE TEMPERATUREA. AMBIENT225!un'XSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224PLASTICAIONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223a. ABOVEGROUNDTANKp. OTHERRAIL CARTORAGEAINERTJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMa. GALLONS ! U. CUntcnrEr! c. PoLrNDS! a. roNs 221Xone item222DAYS ON SITE:365VERAGE DAILY AMOIjNT217MUM DAILY AMOUNT 218AL WASTEAMOI.JNT215ATE WASTE CODE220I a.rrRE ! U.nEncrrvr ! o.PRESSURERELEASEXXe.CHRONIC HEALTHd. ACUTE HEALTH216HAZARD CATEGORIESall that apply)n a, soLIDXone item only)c. GASb. LIQUIDSTATE214LARGEST CONTAINER 1OO215I a. PURE! c. wASrEX(Check one itemb. MIXTUREMATERIAL211212RADIOACTIVENoflves21sCURIEScL il/ IRRCODE HAZARD CLASSES(Complcte ifrequired by CUPA)21068476-34-6209If EHS is "Yes", all amounts below must be in lbsDIESEL NO. 2 LS (DYed)NAME207X! vesNoEHS208205NAMErefer toI v.'No206rTRADE SECRETINFORMATIONII.ACILITY ID#I0002817203MAP# (optional)I204GRID# (optional)F7PARKING LOT - WESTLOCATIONLOCATION CONFIDENTIAL EPCRAXNOYEStr202e Company dba AT&T CaliforniaNAMEPacific BellTelephonACILITY INFORMATIONI.FADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11512012 UNIFIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSFORHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)\lJ .jIf EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246morepresentatIfarecomponantsorgrcaterhzardous0.weightif1o/obythanf carcinogenic,byweightnon-carcrnogenlc,1o/ocaPluringlhesheetsofpaperattachadditionalrequiredinfomation.5242243244!v.' EN"2454238239240flv" EN"241320234ADDITIVES235236f|v., EN"Proprietary23721230ZINC COMPOUND231232[r" EN"PROPRIETARY233l8s226LUBRICATING BASE OIL227flv', El*"228229o/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#[u. enoveAMBIENT !c. BEI-OWAMBIENT !o cnvoceNtcXSTORACE TEMPERATUREA, AMBIENT225!un..XSTORAGE PRESSUREA. AMBIENTABOVE AMB]ENTBELOW AMBIENT224PLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONIT223AINERa. ABOVEGROUNDTANKp. OTHERRAIL CARLTNDERCROUND TANKTANK INSIDE BUILDINGSTEEL DRUMa. GALLONS ! U. CUetcrner! c PouNDSf] o. roxs 221Xone item222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOLINT 218WASTE AMOUNT219ATE WASTE CODE220a. FrRE f] U. neacrrvE n 0.PRESSURE RELEASE ! O. aCUrE HEALTHXXe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)! a. SOLIDXone item only)c. GASb. LIQUIDSTATE214LARGESTCONTAINER 55215f]a runr! c. wASrEX(Check one itemb, MIXTUREMATERIAL211Yes212RADIOACTIVEEl*o213CURIEScL ill-B/ IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209If EHS is "Yes", all amounts below must be in lbsMOTOR OIL (AllGrades)NAME207XNoYesEHS208NAME205X! v..TRADE SECRET206Norefer to instrurlionsII. CHEMICAL INFORMATIONACILITY ID#10002817203MAP# (optional)1F3-G4204GRID# (optional)STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYEShone Company dba AT&T CaliforniaNAME3Pacific BellTelepI. FACILITY INFORMATIONADDDELETEREVISE200oflUPCF (Rev. t212007)Printed: 11512012 UNIFIED PROGRAM CONSOLIDATED FORr'-HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)Please SADDITIONAL LOCALLY COLLECTED INFORMATIONIfHere246Ifmore hazardous components are present at grgater than l70 byweight i f non-carcinogeni c, or 0. I % by weight if carcinogenia, attach additional sheets of paper capturing the required infomation512242ADDITIVES243!v., Elu"244PROPRIETARY245441238HYDROTREATED BOTTOMS239fl".' Elu" 24064742-57-0241350234SOL, DEWMED DIST HVY PARAFFIN235236f]v" EN"64742-65-0237250230HYDROTREATED DIST HVY PARAFFIN231232]* Elu"64742-54-7233lsz226SOLVENT DEWMED RESIDUAL OIL227flv" EN"22864742-62-7229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#Eu.o*utr*, !u. eaovEAMBIENr !c. BELowAMBIENT flo cnvoceNtcSTORAGE TEMPERATURE225!u. enovrAMBIENT nc. BELOWAMBIENTSTORAGE PRESSUREA. AMBIENT224ABOVE GROUND TANKUNDERGROI.IND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDER223AINERE;.m.GLASS BOTTLERAIL CAROTHERPLASTIC BOTTLETOTE BINTANK WACONnone itemd. TONS 221a.GALLONSc.CUBICFEETb.POUNDS222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218AL WASTE AMOLINT219ATE WASTE CODE220! u. nEacrrve I o.pRESSURE RELEASE f] o. ecure HEALTH lTl e.CHRoNIc HEALTHXall that apply)a. FIREHAZARD CATEGORIES216! a. soLID I u. r-lQuro ! c. Gasone item only)STATE214LARGESTCONTAINER 30215! a. PUneXc. WASTEb. MIXTURE211AZARD MATERIAL(Check one itemXYesNo212RADIOACTIVE213CURIEScL ill-B/ rRR210CODE HAZARD CLASSES (Complete if required bv CUPA)209If EHS is "Yes", all amounts below must be in lbsGREASE/GEAR LUBENAME207EHS208! v.' El*oNAME205E"oto206IfTRADE SECRETYesrefer toII. CHEMICAL INFORMATIONID#1000281 7203MAP# (optional),|204GRID# (optional)F4STORED IN SHOPLOCATIONLOCATION COMIDENTIAI- EPCRAX202NOfl*,one Company dba AT&T CaliforniaNAME3Pacific BellTelephI. FACILITY INFORMATIONXADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11512012 UNIFIED PROGRAM CONSOLIDATEDFORtr.HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area):l-:4,';If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246If more huardous components are present at greater than | % by weightifnon-carcinogenic, or 0.1% by weight ifcarcinogenig, attach additional sheets ofpaper capturing the required infomalion5242243244!v.' EN"24545238Total Butanes239240[v.' E]*"78-28-524136234Ethane235236[r" E]*"74-84-0237235230PROPYLENE231232f}r., El*"I 1 5-07 -1233226l90PROPANE227D.' EN"22874-98-6229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!un'XA. AMBIENTSTORAGE TEMPERATUREABOVE AMBIENTBELOW AMBIENTno. cnvoceutc225[u. enoveAMBIENr l-lc. BELOWAMBIENTSTORAGE PRESSUREA. AMBIENT224ABOVE GROUND TANKLINDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAIONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONINERRAIL CAROTHER! u. cunrc rerr ! c. PoUNDS ! o. ror'rsXone itema. GALLONS221222DAYS ON SITE:365VEMGE DAILY AMOLTNT 217DAILY AMOLTNT 218ANNUAL WASTE AMOLTNI219ATE WASTE CODE220n u.nencrrve I 0.PRESSURERELEASEXXa. FIREe.CHRONIC HEALTHd, ACUTE HEALTH216HAZARD CATEGORIESall that apply)fl a. soLID I u. r-rOurn ! c. ce,sone item only)STATE214LARGESTCONTAINER 250215! a. PUnE I u. rr,rrxrunen c.wASrE(Cheok one itemMATERIAI211X212YesRADIOACTIVENo213CURIESCODE HAZARD CLASSES(Complete if required by CUPA)210FG74-98-6209lf EHS is "Yes", all amounts below must be in lbsPROPANENAME207XNo! v..EHS208NAME205Xto instructions! v.,TRADE SECRETtoIfNo206II. CHEMICAL INFORMATIONID#1000281 7203MAP# (optional)I204GRID# (optional)D4STORED IN YARDLOCATIONLOCATION CONFIDENTIAL EPCRAlvrs E*o202Pacific Bell Telephone CompanyNAMEedba AT&T CaliforniaI. FACILITY INFORMAADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11512012 /1CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANZIP CODECITY:SAN LUIS OBISPOADDRESS:2180 JOHNSON AVENUEPHONE NO:805-781 -4800HOSPITAL/CLINIC:SAN LUIS OBISPO GENERAL HOSPITALList the local emergency medical facility that will beused by your business in the event of an accident or injury caused by arelease or threatened release of hazardous materialEMERGENGY MEDICAL FACILITY**.|..:.**.f.Your Name and the Telephone Number from where you are calling'Exact address of the release or threatened release.Date, time, cause, and type of incident (e.g. fire, air release, spill etc.)Material and quantity of the release, to the extent known.Current condition of the facility.Extent of injuries, if any.Possible hazards to public health and/ or the environment outside of the facilityINFORMATION TO BE PROVIDED DURING NOTIFICATIONAFTER the local emergency response personnel arenotified, you shall then notifu this Unified Program Agency and the Office ofEmergency Services.Local Program Agency:State Office of Emergency Service:National Response Center:805-78 1 -7380(800) 852-7550 or (916) 845-891 1(800) 424-8802Your business is required by State Law to provide an immediateverbal report of any release or threatened release of a hazardousmaterial to local fire emergency response personnel, and the Office of Emergency Services.IF YOU HAVE A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS, IMMEDIATELY CALLFIRE/PARAM EDICS/POLICEPHONE:911*Notifications*EMERGENCY RESPONSE PLANS AND PROCEDURESPAGER #PAGER #805-245-419724-HOUR PHONE800-566-9347 (800 KNOW EHS)24-HOUR PHONE800-s66-9347OO KNOW EHSBUSINESS PHONE877-322-4722BUSINESS PHONE805-546-7416TITLE24 Emergency ServiceTITLESiteNAMEEmergency Control CenterNAMESharon RamirezSECONDARYPRIMARYEMERGENCY CONTACTSEPA ID NUMBERCATO80024268ZIP CODE93403CITYSAN LUIS OBISPOSITE ADDRESS196 SUBURBAN RDFACILITY ID #FA0002817BUSINESS NAMEPacific Bell Telephone Company dba AT&TCaliforniaSE164FACI LITY IDENTI FICATIONBUSINESS PLAN (01/2000 Version) ./tl,CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANF st Aid Kit: FLEET AREA/MAIN BLDGWater:OFFICEFLEETN/ATank Monitor Alarm:ElectricalMATNSpill kit / Absorbent:FLEETN/ANatural Gas/ProPane:Environmental Documents:REA/GASFLEET]II,DTNG-TELtr,PHONF, TERMINAT, ROOMLOCSTYsQUATtoNLFUTIo-oFFHUTsEMEANDNCYERGENTPMEwould require immediate inspection or isolation because of theCabinets n ShelvesGas Cylinders X TanksOther: Tank Monitor Alarm PaneltrtrXntrXldentify mechanical systems where releases could occur orvulnerability to earthquake related ground motionUtilitiesRacksProcess PipingSprinkler SystemsPressure VesselsShutoff ValvesXXtrvulnerability to earthquake related ground motion'X Hazardous Waste/ Hazardous Materials Storage Areas n Production Floor fl Process Linesn Bench/ Lab ! Waste Treatment tr Other:ld require immediate inspection or isolation because of theldentify areas of the facility where releases could occur or wouEARHQEERABIUAKTLNVULITYincluding spreading the alarm and confirming the business has been3. X Individual(s) responsible for coordinating evacuationevacuated:Sharon Ramirez, Site Manager2. X Evacuation map is prominently displayed throughoutthe facilityX Verbal ffi Telephon e (including cellular) X Alarm System n puUtic Address System ! IntercomI lagers I Portable Radio n Other (specifu):the facility (check all which apply)L The following alarm signal(s) will be used to begin evacuation ofEVACUATION PLAN2BUSINESS PLAN (01/2000 Version) {'\ l--CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANEMERGENCY PHONE NUMBERSOther-5EET537-Other I mportant NumbersAgencynotificationnumbersState Water Qualitv Control Board Reqional OfficesNorth Coast RegionSan Francisco BaY Region"'..'Central Coast Region....'.Los Angeles RegionCentralValleyRegion: SacramentoOfficeFresno OfficeRedding OfficeLahontan Region: Victorville OfficeLake Tahoe Office.......'...Colorado River Basin RegionSanta Ana Region...............San Diego Region......US Environmental Protection Agency (Region 9) ""916-324-1826800-852-7550National ResPonse Center800-424-8802415-744-1702707-576-2220510-622-2300805-549-314721 3-576-6600916-255-3000559-445-51 1 6530-224-4845760-241-6583530-542-5400760-346-7491909-782-4130619-467-2952State Department of Toxic SubstancesControlCalifornia Office of EmergencYServicesFire .........Police/Sheriff..........,........California HighwaY PatrolCity of San Luis ObisPo...Ambulance ServicePoison Control Center...... ............91 1...............91 1.. ............91 1805-781 -7380,...............91 1800-342-9293EmergencyresponsephonenumberName of medicat facility/nearest hospital (enter):SAN LUIS OBISPO GENERAL HOSPITALPhone number of medicat facility/hospital (enter):805-781-48003BUSINESS PLAN (01/2000 Version) UNIFIED PROGRAM CONSOLIDATED FOR,HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)51 1' I ir:1If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246than l% by weight if non-carcinogenic, or O. l% by weight if csrcinogenic, anach additional sheets of paper capturing the required infomationIfmore heardous compongnts are present at gr€ater242243244!v.' Elu"2454238239240f]v.' El*"2413234235236f}." El*"zct2230231o232F.' Eh,233100226MOTOR OIL, USED227[r.'Elu"2288002-05-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#Elu.oru,u,u, !t. eeovrAMBIENr !c. BELOWAMBIENT flo cnvoceNtcSTORAGE TEMPERATURE225!u. enoveAMBIENr !c. BELOWAMBIENTXSTORAGE PRESSUREA, AMBIENT224ABOVE GROUND TANKUNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUM223AINERm.GLASS BOTTLEi. FIBER DRUMPLASTICNONMETALLIC DRUMI. CYLINDERRAIL CAROTHERCANCARBOYSILOPLASTIC BOTTLETOTE BINTANK WACONBAGBOXUNITS*(Check one itemI a. GALLoNS! u. cuerc FEEr n c, PoLrNDSflo. roNs 221222DAYS ON SITE:365VERAGE DAILY AMOI.INT217DAILY AMOLINT 218AL WASTE AMOLINT219220221TATE WASTE CODEfl u. nEecIVE n c.PRESSURE RELEASE ! O. acure HEALTHXXall that apply)a. FIREHAZARD CATEGORIESe,CHRONIC HEALTH216f] c. cesXa. SOLIDb. LIQUID214one item only)STATELARGESTCONTAINER 2402'15! a. rune ! u. vrxrunrXc. WASTE211(Check one itemMATERIALXYesRADIOACTIVE212No213CURIEScL lil-B/ IRR210CODE HAZARD CLASSES (COMPIEIC if TEqUiTCd bY CIJPA)209IfEHS is "Yes", all amounts below must be in lbs.WASTE MOTOR OILNAME207Xn v',NoEHS208NAME205El"oto206IfTRADE SECRETYesrefgr toINFORMATIONII. CHEMICALACILITY ID#10002817203MAP# (optional)1204F4,F5GRID# (optional)WEST SIDE OF SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOn*'hone Company dba AT&T CaliforniaINESS NAME3Pacific BellTelepI. FACILITY INFORMATIONADDDELETEREVISE200ofPageUPCF (Rev. 12/2007)Printed: 11512012 UNTFIED PROGRAM CONSOLIDATEDFORr,^HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)!l'r'lIf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246Ifmore hzardous componenls are present at greater than l% by weightif non-carcinogenic, or 0.1% by weight ifcarcinogenic, attach additional sheets of paper capturing the required infomation5242243244!v* El*"2454238239240D" EN"2413234235236[v.' EN"23722s0USED OIL231232fl"" El*"8002-05-9233I too226USED OIL FILTERS227!v.' El*"2288002-05-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!rn..XSTOMGE TEMPEMTUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT[0. cnvoceNtc225!u. enove AMBIENT E..XSTORAGE PRESSUREA. AMBIENTBELOW AMBIENT224ABOVE GROUND TANKLINDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WACON223AINERi. FIBER DRUMPLASTICA{ONMETALLIC DRUMRAIL CAROTHERCANCARBOYSILOBAGBOXCYLINDERna. cALLoNS nI o. roNs 221Xone ltemc. POUNDSb, CUBICFEET222DAYS ON SITE:365VERAGE DAILY AMOTINT217DAILY AMOUNT 218WASTE AMOLINT219220223ATE WASTE CODE! u.neecrvE n 0.PRESSURERELEASE ! O,ACUTTHEALTHXXall that apply)a. FIREHAZARD CATEGORIESe.CHRONIC HEALTH216a. soLID I u. r-rquroXc. GAS214one item only)STATELARCESTCONTAINER 2OO215! a. ruru [ u. vrxrunrXc. WASTE211(Check one itemMATERIAL212RADIOACTIVEYesE*o213CURIEScL ilt-B/ rRR210CODE HAZARD CLASSES (Complete if required bv CUPA)209IfEHS is "Yes", all amounts below must be in lbs.DRAINED USED OIL FILTERSNAME207X! v.'NoEHS208NAME205XTRADE SECRET206NoYesrefer to instructionsMICAL INFORMATIONII. CHEACILITY ID#10002817203MAP# (optional)1204GRID# (optional)F4EAST SIDE OF SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYEShone Company dba AT&T CaliforniaNAMEJPacific BellTelepI. FACILITY INFORMATIONADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11512012 UI\IFIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CIIEN{ICAL DESCRIPTIONOne page per material per building or area)-aFOR:ii:'1l':If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED IT''FORMATIONHere246Ifmore hurdous components are present at greater than l% by weightif non-carcinogenic, or 0. l% by weight if carcinogenic, attach additional sheets of paper capturing lhe required infomation.242243244f]v.' EN.2454238239240fl".' EN"241340234WATER235236F* EN"7732-18-523721230DIETHYLENE GLYCOL231232[r.' Elu"1 1 1-46-6233lso226ETHYLENE GLYCOL227flv" EJ*"224107-21-1229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#nu. eeovsAMBIENT !c. BELOWAMBIENT !o' cnvocrNrcXSTORAGE TEMPERATUREA. AMBIENT225IuXSTORAGE PRESSUREA, AMBIENTABOVE AMBIENTnc. BELOWAMBIENT224ABOVE CROUND TANKLINDERGROUND TANKTANK INSIDE BUILDINCSTEEL DRUMPLASTICAIONMETALLIC DRUMCANCARBOYstLoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERE;'c.RAIL CAROTHERa. GALLONS ! u. cuercnEerflc. PouNosI o. roNsXone item onl221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOLTNT 218UAL WASTE AMOUNT219220343TATE WASTE CODEn! u. nrncIVE n 0.PRESSURE RELEASEXXa. FIREd. ACUTE HEALTHe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)f] a. sollnXone item only)c. GASb, LIQUIDPHYSICAL STATE214LARGESTCONTAINER 55215tra. PURE ! r. rtrrxruneI c. wAsrE(Check one itemMATERIAL211XYes212NonRADIOACTIVE213CURIEScL ilt-B/ IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209If EHS is "Yes", all amounts below must be in lbs.WASTE ANTIFREEZENAME207XYesNoEHSn208NAME205El"oTRADE SECRETtotr206Yesrefer toINFORMATIONII. CHEMICALACILITY ID#I000281 7203MAP# (optional)I204GRID# (optional)F4STORED EAST SIDE SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESone Company dba AT&T CaliforniaNAMEPacific BellTelephFACILITY INFORMATIONADDDELETEREVISE200Page ai of IUPCF (Rev. 12/2007)Printed: 11512012 Ui{IFIED PROGRAM CONSOLIDATEDFOR.HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area):] :,1lf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465242244!v" EN"2432454238240f!* EN"teo2413234235zJo]'. EN"23722230ADDITIVES231232ft.' Elu"PROPRIETARY233226lggLUBRICATING BASE OIL227flv" Elu"228229%wrEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#Elu. otu,t*t !u.n.!0. cnvoceNtcSTORAGE TEMPERATUREABOVE AMBIENTBELOW AMBIENT225n.XSTOMCE PRESSUREA, AMBIENTBELOW AMBIENTABOVE AMBIENT224FIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONTIPLASTICNONMETALLIC DRUM223CANCARBOYSILOSTORAGECONTAINERo. RAIL CARp. OTHERc, TANK INSIDE BUILDINGd. STEELDRUMABOVE GROUND TANKUNDERGROLTND TANKUNITS*iCheck one item only)I a GALLONS I u. cuerc FEEr E c. PouNDS f] o. roNsif EHS amounf must he in nounds221DAYS ON SITE:365VERAGE DAILY AMOUNT217TATE WASTE CODEWASTE AMOLTNT219220DAILY AMOUNT 218FED HAZARD CATEGORIES(Clreck all that apPly)! u. ruecrrvE n O.PRESSURE RELEASE I O. ACUre HEALTHXXa. FIREe.CHRONIC HEALTH216! a. sor-lD [] u.lrqun ! c. cas(Check one item only)PHYSICAL STATE214LARCESTCONTAINER 75215nnXIYPE (Check one itema. PUREc. WASTEb. MIXTUREHAZARD MATERIAL211RADIOACTIVE !ves E^o212213CTJRIEScL lll-B210CODE HAZARD CLASSES (Complete if required bv CUPA)CAS#209If EHS is "Yes"- all amounts below mtrst be in lbs.HYDRAULIC FLUIDCOMMON NAME207XNo! v.'EHS208Xto instruclionsect to! v.'ACILITY ID#NoNAME205206204IfMAP# (optional)1GRID# (optional)203TRADE SECRETCHEMICAL INFORMATION1G5oo02g17STORED IN SHOPCFIEMICAL LOCATIONCHEMCAL LOCATION CONFIDENTIAL EPCRA202NOYEShone Company dba AT&T CaliforniaBTJSINESS NAME3Pacific BellTelepI. FACILITY INFORMATIONADDDELETEREVISE200Page IO of 15UPCF (Rev. 1212007)Printed: 11512012 UNIFIEDPROGRAMCONSOLIDATED FORI,.HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246moretfarecomponentsoratgreaterhuardouspresentbyweightthanlVoweightifvoby0.ifnon-carcinogenic,additionalsheetscarclnogenlc,attachtherequiredofpaper capturinginfomation.55242Amines243244!v" EN"68439-80-5245410238Polyosobutenyl Succinimide239240fl".' EN"67762-77-O2413 10234PETROLEUM SOLVENT, REFINED235ozcoflv., Eh'64741-97-5237240230BASE STOCK231232ft" El*"64741-88-4233lzo226SOLVENT REFINED PETROLEUM OILS227228flv'. Elu"64741-89-5229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!u. eaovrAMBIENr !c. BELOWAMBIENT !o' cnvocaNrcXSTORAGE TEMPERATUREA. AMBIENT225IuXSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTnc. BELow AMBIENT224ABOVE GROUND TANKI.INDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223E;.g. CARBOYi, FIBER DRUMPLASTICN.IONMETALLIC DRUMSILOCANRAIL CAROTHERBAGBOXCYLINDERtrn! o. roNs 221Xone itema.GALLONSc.CUBICFEETb.POLTNDS222DAYS ON SITE:365VERAGE DAILY AMOL]NT217DAILY AMOUNT218WASTE AMOLINT219220WASTECODEI u.nrncrrvE n c.PRESSURERELEASEXXa. FIREd. ACUTE HEALTH! e.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)fl a. soLIDXone item only)c. GASb. LIQUIDYSICAL STATE214LARGESTCONTAINER 55215! a. ruREtrX(Check one itemc. WASTEb. MIXTUREMATERIAL211XYssRADIOACTIVE212No213CURIEScL ilt-B/ IRRCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209If EHS is "Yes", all amounts below must be in lbsAUTOMATIC TRANSMISSION FLUIDNAME207! v.' E*oEHS208NAME205E*olo206IfTRADE SECRETYesrefer toINFORMATIONII. CHEMICALACILITY ID#1000281 7203MAP# (optional)1204GRID# (optional)F5STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYEShone Company dba AT&T CaliforniaNAME3Pacific BellTelePI. FACILITY INFORMATIONADDDELETEREVISE200Page IofUPCF (Rev. rZl2007)Printed: 11512012 UPROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEI\iIICAL DESCRIPTIONOne pag€ per material per building or area)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246are present at greater than l% by weight ifnon-carcinogenic, or 0. l% by weight if carcinogenic, anach additional sheets of paper capturing the required infomationIf more heardous components5242243244!v., EN"2454238240[r" EN"239241-t234235236flr.' EN"2372230231ft" EN"233226227fl".' fl*"228229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#Eu. o*",r*, [u. enovnAMBIENr f]c. BELowAMBIENT f]o cnvoceNtcSTOMCE TEMPERATURE225n.STORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROLTND TANKTANK INSIDE BUILDINCSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223H'RAIL CAROTHERSTORACECONTAINERUNITS*(Check one item only)fla cALLoNS! a. roNsX221if FHS amorrnf mrrst he in noundsc. POUNDSb, CUBIC FEET222DAYS ON SITE:365AVERACE DAILY AMOLINTWASTE AMOLNTATE WASTE CODE219217220DAILY AMOLTNT 218FED HAZARD CATEGORIES(Check all that apply)n! u. nrncrveo.pRESSURERELEASE ! a.ecurEHEALTHXa. FIREe.CHRONIC HEALTH216PHYSICAI STATE(Check one item only)! a. sollo ! u.lrquroXc. GAS214LARGESTCONTAINER 225215HAZARD MATERIALTYPE (Check one itemI a. PURE f] u, vlxrunlc. WASTE211Yes212RADIOACTIVENo213CURIES210NON-HAZARDOUSCODE HAZARD CLASSES (Complete if required bv CUPA)7440-59-7]AS#209If EHS is "Yes", all amounts below must be in lbsHELIUMCOMMON NAME207XI v.'NoEHS208HELIUMCHEMICALNAME205X206Notf Subiect to EPCRA, reler lo instructionsrRADE sEcREr fl vesII. CHEMICALINFORMATIONFACILITY ID#10002817MAP# (optional)1203204GRID# (optional)F3STORED IN OFFICECHEMICAL LOCATION]HEMCAL LOCATION CONFIDENTIAL EPCRA202NOYESone Company dba AT&T CaliforniaBUSINESS NAMEPacific BellTelephI. FACILITY INFORMATIONADDDELETEREVISE200Page t?- of lfUPCF (Rev. 1212007)Printed: 11512012 ,FIED PROGRAM CONSOLIDATED FO|HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area),tf: r;..:If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246atemoreatgreaterpresentcomponentshuardoustfort%bylhan0.non-carcrnogenlc,weightift%carclnogenrc,attachweightifbycapturingthesheetsofpaperadditionalnfomation.raluired242243244!v.,2454238239240flt., Elu"2413234235o236$.' Eh,2372230231f]".' EN" 232233226227flv.' fF"228229o/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!r!'XSTORAGE TEMPERATUREA, AMBIENTABOVE AMBIENTBELOW AMBIENT[0. cnvoceNtc225nu'o*utu^tn,STORAGE PRESSUREABOVE AMBIENTBELOW AMBIENT224PLASTICAIONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223H'a. ABO\rE GROUND TANKTORAGEAINERRAIL CAROTHERI.JNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMnb. cuBrcFEEr n c. POUNDS I A. roNsXone itema. GALLONSzzt222DAYS OI". SITE:365VERAGE DAILY AMOTJNT217DAILY AMOTJNT 218AL WASTE AMOUNT219TATE WASTE CODE220I a. rrne ! t. neacrrvEl.l e.CHRONIC HEALTHXXc.PRESSURE RELEASEd. ACUTE HEALTH216HAZARD CATEGORIESall that apply)! a. soLID l-l t. r-rquroXone item only)c. GASSTATE214LARGESTCONTAINER 222215a. PURE I u. vlxrunr I c. WASTEX(Check one itemMATERIAL211212RADIOACTIVENo! Yes213CURIESFGi UR IICODE HAZARD CLASSES(Complete ifrequired by CUPA)21074-86-2209If EHS is "Yes", all amounts below must be in lbsACETYLENENAME207XYesNoEHS208ACEryLENENAME205X206IfNoYesTRADE SECRETrefer to instructionsII. CHEMICAL INFORMATIONID#10002817203MAP# (optional),|204GRID# (optional)F5STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRA202NOYESone Company dba AT&T CaliforniaNAME3Pacific BellTelephFACILITY INFORMATIONI.ADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 11512012 ,IFIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)If EPCRA, Please SADDITIONAL LOCALLY COLLECTED INFORMATIONHere246areatgreaterpresentcomponentslf morehzardousorI%thanpapert%by0.ifnon-carcinogenic,byweightadditionalsheetscarclnogenro,attachweightiftherequiredcapturingofinfomation.5242243244!v" EN"2454238239240f]v" EN"2413234235236[r.' EN"2372230231232flv'. EN"233226227[v.'|J.r.228229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#lTlu. ,cMBrpNr f]u. aeovEAMBIENr [c. BELOWAMBIENT [o' cnvocrNtcSTORAGE TEMPERATURE225STORAGE PRESSUREA. AMBIENTABOVE AMBIENTl-lc. BELowAMBIENT224ABOVE GROUND TANKUNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRLMPLASTICA.IONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223RAIL CAROTHERa. GALLONS I U. CUBTCFEET n c. POUNDStrone itemd. TONS 221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 215*ASTE AM9LINT219ATE WASTE CODE220! a. rrRE I u. nne,crrvE E o.pRESSURE RELEASE I o. ecuru HEALTH ! e.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)! a. soLID ! u. r-rquroXone item only)c, GASSTATE214LARGESTCONTAINER 222215a. PURE ! t. vlxrunE ! c. wASrEX(Check one itemMATERIAI211X212NoYesRADIOACTIVE213CURIESCODE HAZARD CLASSES(Complete ifrequired by CUPA)2't0NON-HAZARDOUS7440-37-1209If EHS is "Yes", all amounts below must be in lbsARGONNAME207Xn y.tNoEHS208ARGONNAME205X206IfNoTRADE SECRETrefer to instructionsYesII. CHEMICAL INFORMATIONID#000281 71203MAP# (optional)1204GRID# (optional)F5STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESPacific BellTelephone Company dba AT&T CaliforniaNAME3I. FACILITY INFORMATIONADDDELETEREVISE200ofPageIUPCF (Rev. 1212007)Printed: 11512012 u.,IFIED PROGRAM CONSOLIDATED FOt\,,1HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)5li i,:1lf EPCRA, Please Sign HereADDITIONAI LOCALLY COLLECTED INFORMATION246aremoreatgreaterprasenlcomponentshuardousrorthan100.ifnon-carcinogenic,byweightlo/opaparcarcrnogenlclanachweightifbycaPturingofadditionalsheetstherequireiinfomation.5242243244!v" El*"2454238239240[.' EN"2413234235236flr.' Elu"2371230231!v" EN"232233226fl"'. [l"228229o/oWTHAZARDOUS COh4PONENT (For mixture or waste only)EHSCAS#!u[c. BELOW AMBIENT !o' cnvocmrcXSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENT225nu' o*"tt*tn'STORAGE PRESSUREABOVE AMBIENTBELOW AMBIENT224ABOVEGROUNDTANKLTNDERCROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERH.I. CYLINDERRAIL CAROTHERFIBER DRUMBAGBOXnb. cuBrc FEEr fl c. POUNDS ! O. rowsXone itema. GALLONS221222DAYS ON SITE:365VERAGE DAILY AMOLINT217DAILY AMOUNT 218WASTE AMOLTNT219TATE WASTE CODE220o.pRESSURERELEASE I o. ecuraHEALTHnXa. FIREl-l u, npacrtvpe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)I a. sol-lD ! r. r-lquroXc. GAS214one item only)STATELARGESTCONTAINER 222215a. PURE I u. vrxrune I c. wASrEX(Check one itemMATERIAL211RADIOACTIVE212NoYes!213CURIESCODE HAZARD CLASSES(Complate ifrequited by CUPA)210OX7782-44-7209lfEHS is "Yes", all amounts below must be in lbs.OXYGENNAME207X! vesNoEHS208OXYGENNAME205X! v.'206IfNoTRADE SECRETrefer to instructionsII. CHEMICALINFORMATIONITY ID#1000281 7203MAP# (optional)1F5204GRID# (optional)STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRA202NOYESNAME3ny dba AT&T CaliforniaPacific Bell TelePhone CompaFACILITY INFORMATIONI.ADDDELETEREVISE200ofUPCF (Rev, 1212007)Printed: 11512012 BUSINESS NAMEBUSINESS ADDRESSMAP#AT&T Colifornic SNLOCAAU SE164196 SUBURBAN RDSITE MAFDRA1TING SCALENOT TO SCALE234567SAN LUIS OBISPO@!o:ol cLARlFrDATE 11112011ZIP CODE93403ac@cawza-lflmrnK@@@@@8nU)oLUzoIo-UJUF@ptfr:Portoble GenerotorsH ELIU [/HYDRAULIC FLUIDARGONOXYGENWASTE ANTIFREEZEKALPACIFIC BELL/AT&TlJ83 N. McDosell Blvd.Petolumo, CA U.S-A-SYMBOL LEGENDIMERGENCY SHUT DOWNNsD.n l8At'irdilD MSDSJ- rrnr HYDRANT-)<-.'e FENCEEREEMERGENCY RESPONSEEQUlPI\IEN T/ABSORBEN TSABOVEGROUNDSTORAGE IANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE LIQUIDS)BATTERY ELEClROLYIE(coRRosrvE Lr0urD)GASOLINE(FLAMMAELE LIOUIDS)DIESEL FUIL(coMBUSTTBLE Lr0UlDS)NI TROGEN(COTvIPRESSED GAS)PROPANE(FTAIVMABLE LIOUID)ACETYLENE(COMPRESSED CAS)AN Ii FREEZElCOOLAN ISWASTE OlL(FLAMMABLE LiQUID)FIRE PULL BOXFLAIVMABLES CABINET_* DRAINAGE FLOW DIRECTION@{)@@@@,tfr,o-JL-riK-Al-E7s'lo(.9,)eo@@@trAUTO.TRANS. FLUIDELECTRICAL PANELSHUT-OFFNATURAL GASSHUT_OFFWATER SHUT_OFFTANK MONITORINGALARMIELEPHONEFIRST AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEWERSTACINC AREAEVACUATION/oOFCFCSTORAGEooo/Y/f\WATERTANKADMlNISTRATLONBU LD]NG9BcDEF\,HJM 5 [ ro.1AT&T Site Managercl I805-245-4197c\2.AT&T EH&S Hotline(800) 566-9347cl0.549-3147HOSPITAL MEDICAL CENTERc6.805-542-6377c5805-781-7380c3.255-3545445-8200OTHEROTHER (Specify):NEAREST MEDICAL FACILITY / HOSPITAL NAME:OTHER (Specif):PHONE NUMBERS:'r)) _1)))AGENCY NOTIFICATION PHONE NUMBERS :U.S. COAST GUARD. . ,CAL/OSHASTATE FIRE MARSHALPOISON CONTROL CENTERLOCAL LINIFIED PROGRAMAMBULANCE, FIRE, POLICE AND CHPCALIFORNIA EMERGENCY MANAGEMENT AGENCY (CAL/EMA)NATIONAL RESPONSE CENTER (NRC) . .(800) 300-21e3(er6) 3s8-2e00(202)26',7-2t80(916)263-28009-l-l(800) 852-7ss0(800) 424-8802CALIFORNIA DEPT. OF TOXIC SUBSTANCES CONTROL (DTSC)REGIONAL WATER Q{JALITY CONTROL BOARDU,S, ENVIRONMENTAL PROTECTION AGENCY (US EPA) . , . . . .CALIFORNIA DEPT OF FISH AND GAME (DFG)all that apply)tr+.X I, VERBAL WARNINGS;TO5. ALARM SYSTEM;E 2, PUBLIC ADDRESS OR INTERCOM SYSTEM:THAT MAYBY AN6, PORTABLE RADIO! 3. TELEPHONE;WLL OCCURX 3. TELEPHONE;E 6, PORTABLE RADIOFX 1, VERBAL WARNINGS;4, PAGERS;XI 5. ALARM SYS'TEME 2. PUBLIC ADDRESS OR INTERCOM SYSTEM;OR ALARMWLL OCCUR VIA:all that apply)Emergency Coordinator is on call) shall:f . njivati intemal facility alarms or communications systems, where applicable, to notit/ all facility personnel2. Notifo appropriate local authorities (i.e., call 9-l-1)3. Notifu the Califomia Emergency Management Agency at (800) 852-7550.Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall notifi the Califomia D.epartment of ToxicSubstances control (DTSC), the local Unified program Agency (uPA), and the local fire department's hazardous materials program that the facility is in compliancewith requirements to:l. provide for proper storage and disposal ofrecovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release atthe facility; and2. Ensure that no material that is incompatible with the released material is transfened, stored, or disposed of in areas of the facility affected by the incident untildesignee whenareas an explosion, fire, oremergency situationan imminent orEmergencyWheneverc.EMERGCYENcoTIoNs,CAMMUNIPHONENUMBERSCATIANDNOTIFIONSBI3. ACTIVATING IN-HOUSERESPONSE TEAM2. CALLINC HAZARDOUS WASTE CONTRACTORXI I, CALLTNG PUBLIC EMERGENCY RESPONDERS (i.E.,9-I.I)AL FACILITYRESPONSE WILLVIA: (Check all thatB. INTERNAL RESPONSE8 I. HAZARDOUS MATERIALS; El 2. FIAZARDOUS WASTESINVOLVINGall that apply)FIRES, ANDCOVERS CHEMICALTelecommunicationsContractor)BUSINESS (e.g.,TYPEOPERATIONS (e.g.,INCIDENTFleet Maintenance104.SAN LUIS OBISPOSITE CITYCAI 05.ZIP CODE93403I 03.196 SUBURBAN RDBUSINESS SITE3.dba AT&T Californiane com- Doing Business As)as Facility Name orBUSINESS NAMEPacific BellTFACILITY ID0002817CERS IDl.2,2012JanuaDATE OF PLAN PREPF'ACILITYIDENTIFICATIVERVIEWA.ONANDNSoTIooPERACONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLANtO thc INSTRT]CTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLANPrior lo completing this Plan, please referTrNG SYSTEM (CERS)CALIFORNIA ENVIRONMENTAL REPORRev.06/21lll ADVANCE ARRANGEMENTS FOR LOCAL EMERCENCY SERVICES (ChCCK ONC Of thE fOIIOWiNg)El I, HAVE BEEN DETERMINED NOT NECESSARY; OTE 2. THE FOLLOWING ARRANGEMENTS HAVE BEEN MADE (SPECiff):F2.FIYoumayyourforarenotarTangementsthatsuchdeterminearrangementsofRequirement:ExplanationwithAdvanceemergencydepartments,andpolicelocalfireasand/orhospitals,contractorsservlcesmadeshouldbeF. ARRANGEMENTS F'OR EMERGENCY SERVICESNote: The map(s) must show primary and altemate evacuationroutes, emorgency exits, and primary and altemate staging areas, and must be prominently postedE4.lnthe facilwhere it will beand visitors.TION ROUTEAS REQUNote: Themust account for allafter evacuation.TION(S) IS/AREe., Frontlot, specific street comer, etc.)Y AREA(S)and/orsiteEMERGENCYSEE EMOP BINDERTHEtrtraWILL BE USEDEVACUATIONACILITY (CHECKT APPLY)El.THEALARMFIRE ALARM4. OTHERI. BELLS;2. HORNS/SIRENS;3. VERBAL (i.e., SHOUTING);E. FACILITY EVACUATIONatrtrtrDtrtrtrtrtrtrEXtrtraxI. MONITOR FOR LEAKS, RUPTURES, PRESSURE BUILD-UP' ETC';2. PROVIDE STRUCTURAL PHYSICAL BARRIERS (e.g., Portable spill containment walls);3. PROVIDE ABSORBENT PHYSICAL BARRIERS (e.g., Pads, pigs, pillows);4. COVER OR BLOCK FLOOR AND/ OR STORM DRAINS;5, BUILT.IN BERM IN WORK / STORAGE AREA;6. AUTOMATIC FIRE SUPPRESSION SYSTEM;7. ELIMINATE SOURCES OF ICNITION FOR FLAMMABLE HAZARDS (E,g. FIAMMAbIC IiqUidS, PTOPANE);8. STOP PROCESSES AND/OR OPERATIONS;9. AUTOMATIC / ELECTRONIC EQUIPMENT SHUT-OFF SYSTEM;10. SHUT.OFF WATER, GAS, ELECTRICAL UTILITIES AS APPROPRIATE;I I. CALL 9-I-I FOR PUBLIC EMERGENCY RESPONDER ASSISTANCE / MEDICAL AID;12.NOTIFY AND EVACUATE PERSONS IN ALL THREATENED AREAS;13. ACCOUNT FOR EVACUATED PERSONS IMMEDIATELY AFTER EVACUATION CALL;14. PROVIDE PROTECTIVE EQUIPMENT FOR ON.SITE RESPONSE TEAM;I5. REMOVE OR ISOLATE CONTAINERS / AREA AS APPROPRIATE;I6. HIRE LICENSED HAZARDOUS WASTE CONTRACTOR;I7. USE ABSORBENT MATERIAL FOR SPILLS WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOUS WASTE DISPOSAL ASAPPROPRIATE;E I8, SUCTI6N USIN6 SH6P VACUUM WITH SUBSEQUENT PROPER LABELING, STORAGE, AND HAZARDOUS WASTE DISPOSAL ASAPPROPRIATE;E I9. WASH / DE69NTAMINATE EQUIPMENT W CONTAINMENT and DISPOSAL OF EFFLUENT / RINSATE AS HAZARDOUS WASTE;X 20. PROVIDE SAFE TEMPORARY STORAGE OF EMERCENCY-GENERATED WASTES;E 2l,OTHER(Speci!):D2.harm tooontaining spills,to indicate your proceduresall boxes thatSPILL PREVENTION, CONTAINMENT, ANDandand.orand the environment.D. EMERGENCY CONTAINMENT AND CLEANUP PROCEDURES i:.1OTHER370.LerOTHER34.069.AUTOMATIC ALARM33.32.RADIOS3lINTERCOMG63.Communi-cationsandAlarmSystemsTELEPHONES (lncludesThroughout FacilityTelephones & Cellular phonesOTHER29SPLL OVERPACK DRcs7CYLINDER LEAK REPAIR26.NEUTRAI-IZERS/HOLDING TANKEMERGENCY25.c5lEXHAUST HOOD24.23SHOP346.SHOVELG45.2lJANITOR/FLEET AREAAll PurposeBERMING20EQUIPMENT340.CONTAINER FORIFLEET AREAPlastic BucketG39.18.MATERIALFLEET AREAKitty Litter / Grease SweeppillALL.IN-ONEt7KIT334.16.G33FIRE ALA15.OR STATIONSAdmin Bldg.Fire Alarm Pull StationsFIXED FIREIG29.FightingFire13TFIREThroughout FacilityABC Fire ExtinguisherG2't.12.OTHEROTHERIG23.10.TABLE EYEWASHFLEET AREABottle typeG2l.PL9.FOUNTAIN /FIRST AID KITSFLEET AREA / MAIN BLDGlndustrial First Aid KitGt7.AINED BREATHINGARATUSSELF7G r5.CARTRIDGE6.TORSHARD HATS510.GilGLASSES /4SHIELDSFLEET AREASPI.ASHG9.PROTECTIVE BOOTS3.CHEMICALGLOVESFLEET AREAG4.INSULATINGAidIPROTECTIVEc3TYPEAVAILABLEl.LOCATIONCAPABILITYequipment'sCHEMICALapplicable.le.e.'ifresponsePROTECTIVEGLOVESSpilluse,kitoiltimeOne&onlylsolventresistantemergencyresponseapplytoboxesthatCheckalllisttheavailableatequipmentpmentwherethelocation(s)andidentifyfacilitykeptandlsequithetheG. EMERGENCY EQUIPMENTRev,06127lll str 104K2.SIGNERNAMESteve SkandersonAssociate / Agent for AT&TTITLE OFTURE OFJanuary 2,2012SIGNEDDAfamiliarthewithtrue,andinformationsubmittedonacopyaccurate,lstheinformationbelieveandthatandcomplete,site,ablelsavailmyonBasedCertificationthoseindividualsinquiryofobtainingtheresponsibleforoflawunderpenaltycertifuinformation,personallyexaminedhavethatandK. SIGNATURE / CERTIFICATIONAT&T Description of Employee TrainingAT&T Emergency Response Procedures12.JIorACHMENTSAREREQUIRED;aaX 2, THE FOLLOWING DOCUMENTS ARE ATTACHED:J. LIST OF ATTACHMENTSwritten job descriPtionthe position,aFormermustatberecordsleastretainedthreeafterterminationofaemployeeCunentmustberecordstrainingoftheuntilclosureretainedfacilitytoAposjobtheaboveeachoffororobdutiesdescribesitionsthateducation,skills,andtherequiredofotherqualificationspersonnelassignedname,obtitle,Thewasteforeachoftraininganddateatoanmanagementhazardousemployeesesslonglventrainingjobsuchfillingposition;andmanthemanagementityforresponsibilwasteofhazardousaccumulabeling,(e.9.etc.withcompllanceifesting,).limits,lationtimeaAamountthetypeoutline/agendawrittenofofandbothpospersonstoandcontinuingintroductoryglvenwillbetrainingthatitionjobingeachfillhavingperwastemonth)hazardousmustretainwrittenwastemanagementemployeehazardousdocumentationoftrainingchincludes:sesslonswhiQuantityGeneratorLarge(LQG)TrainingRecords:wastegeneratorsquantityLargee.more(ihazardousgeneratethanwho270kilogramsofgallons/ 1,000INDICATE HOW EMPLOYEE TRAINING PROGRAM IS ADMINISTERED (ChCCK AII thAt APPIY)E I. FORMAL CLASSROOM; E 2, VIDEOS; E 3. SAFETY / TAILGATE MEETINGS;12.13.ram.onlinehthfl 6. Nor APPI.ICABLEUSE FACILITY HASareXl 5. OTHER (Specifr): Allto handle onsiteE 4. SrUDY GUIDES / MANUALS (Specif):Explanation ofRequirement:Employee training is required for all employees handling hazardous materials and hazardous wastes in day-to-day or clean-up operationsinciuding volunteers and/or contractors. Training must be:r Provided within 6 months for new hires;o Amended as ngcessary prior to change in process or work assignment;o Given upon modificaiion to the Emergency Response / Contingency Plan, and updated/refreshed annually for all employeesRequired content includes all ofthe following:o Material Safety Data Sheets;c Hazard communication related to health and safety;o Methods for safe handling ofhazardous substances;o Fire hazards ofmaterials / processes;o Conditions likely to worsen emergenciesir Coordination ofemergency response;o Notification procedures;r Communication and alarm systems;o Personal protective equipment;o Use ofemergency response equipment (e.g. Fire extinguishers, respirators,etc.);o Decontamination procedures;o Evacuation procedures;. Control and containment procedures;ando IJSTlicableI. EMPLOYEE TRAININGYARDITERMINAL ROOMWater: FRONT SWNERBIN BUILDING-TELEPHElectricalAREAH'lI. SHELVES, CABINETS AND RACKS2. TANKS (EMERGENCY SHUTOFF)3, PORTABLE GAS CYLINDERS4. EMERGENCY SHUTOFF AND/OR U'IILITY VALVESRIZED CONTAINERSSTATIONARY PRESSE 5. SPRINKLER SYSTEMSapplv)SYSTEMS:to releases /due tomotion. Theseimmediate isolation andmechanicalH5.TankFLEETD3 I. HAZARDOUS MATERIALS /WASTE STORAGE AREAE 2. PROCESS LINES / PIPINGE 3. LABORATORYHl.4. WASTE TREATMENT AREAall thatoutdoorIdentiff areas ofthe facility that are vulnerable to hazardous materials releases / spills due to earthquake-related motion' These areas require immediate isolation andH. EARTHQUAKE VULNERABILITY Additionally, theAT&T Emergency Plan requires that employees receive annual refresher training on the HazardCommuniiation Certification, function specifics and the Emergency Operating lnstructions'The AT&T Emergency plan Binder serves as a reference guide for the Emergency Site Coordinator/Building Warden'{^AT&T Environment Health & SafetYHazardous Materials and Waste HandlingTraining OutlineEmployees are provided initial Safety Plan training on the Hazard Communication Certification, as well as functionspe'cinl before they begin their work operations. This also includes training on the Emergency Operating proceduresThe training is taken as an online interactive course. Training is recorded electronically.The training includes the following:Lesson 1: lntroductionLesson 2; Roles and Responsibilities OverviewLesson 3: ldentifying Hazardous Materials and Regulated wastesLesson 4: Handling, Management & Disposition of Waste StreamsLesson 5: Generator RequirementsLesson 6: EmergencY PlanningLesson 7: Hazardous Materials lncidentsLesson 8: SummaryAppendix A - FinalAssessment Questions and AnswersRev.06/27lll Emergency Response FLEET.docAT&T EMCNCTNCY RESPONSE PLANhazardous material or waste:The Emergency Site Coordinator/Building Warden is responsible for following these steps as outlined in the facilityEmergenc-y plin Binder or the site Spill Prevention Control and Countermeasure (SPCC) Plan where one isrequired.1. Determining the nature, location, magnitude and severity of the incident'2. Move people away from the area as appropriate'3. Avoid inhalation of all gasses, fumes or smoke.4. Stop the release and/6r contain materials if adequately equipped and it is safe to do so, by arranging physicalbarriers, use of absorbents (i.e., bulk absorbent materials or absorbent socks)'S. Make appropriate notifications as outlined in the site Emergency Plan Binder and as described Notificationhazards caused by the release of awill take to stop potentialThe following describes what actions our businessres section of this document.ProceduAaRreMeNT (sroP rne xnzlno)st be followed to minimize any harm or damage to persons,propefi or the environment:ilazardous Materials Drums: DOT approved drums are inspected for leaks and/or deterioration. Absorbentsare stored at the garage for containment of any releases'1. Motor oil: Stored in drums in a controlled area. Drums are visually inspected daily to ensure integrity.2. Antifreeze/Coolant (New & Used): Stored in drums in a controlled area. Drums are visually inspected daily toensure integritY.3. Waste Oil/Oil Filters: Stored in aboveground tanks or drums in a controlled area and visually inspected daily toaredershaveSanstoredstandinhtdsecured4.gassesareaN itrogen/Heliu m/Acetylene/Oxyqen/Arqon :areaCompressedstoredcontrolledinandseparateenSUrerity.integThe following describes the procedures that muMrroenot (neouce rHE HAZARD)release from occurring:1. Tnrutrnc: AT&T employees are required to complete a variety of training related to the management, use,storage and propei hindling of hazardous materials and hazardous wastes. The type and frequency oftrainiig is dependent upon the employee's job responsibilities and is delivered in a classroom environment oron-line through one of AT&T's Learning Management Systems'2. Mlrennls: Hazardous materials are utilized and stored following manufacturer's recommendations, as ourbusiness is a user of chemical products and not a manufacturer of hazardous materials.hazardous materials or hazardous wasteke to prevent aThe following describes what action our business will taPneveNloru&TAT&T's&TAT&T'sanawillbeHEdoneMncident&ScyManagementAgenandCALE-M-A)AdministeringLocalisrequiredAgenciesspill/releaseAItonotificationsOrganization.aalsoESCwillThenrnermH&SwithEworkdetetondLegaofnotificatioiftheCAEmergencyasinternalcontactsthelocaincludingappropriateSecurityOfficeEnvironmenttheATand&SafetyHealthencyEmergBuildingsiteOrganizationtheEmergencyAdditionallynatorCoordSitelyimmediatewillnotifyaASsuemergencles,evacuardoushazachoralsincidentmateriASatehowtondplaceinsheltedbyrectedtheoccupantsaretheofbuildingSupervtsorsonresponsiblefordirectreportsadvisingtheirtoreporthowemergencye.action(iplantheATavaPlanEmergencyfacilitythatfortheBinder)forrevtewlableisbythencyergencyEmergeThelanBinderPeSiteEmnganthESC)forCoordinatorisresponsiblefacilityforcompletianPOperating(TheFire1ractice30dSafetyProgramISEmergencyPlanthdescribedinTAT&NorrncRnoN PRocEDURESI:\ILAZMAT\PACBELL9-FORMS\Emergency Response FLEET docLast Updated: ll13l20l2 Emergency Response FLEET.docpment.eqLJIresistantgmsvibrationustnngsystebracidardizedarestanMeasuresRemedialnt.resistauakebeearthqabuilttondrenedadesigsystemsmunicationtelecomandstransmissionElectricalites.thecoofctionngnstruenbuitdipemthnloyedconisstructiontresistauakeEarthqFollowing an earthquake, upon arrival to theteaKs and/or spills. ln the event of a releasearea to the designated staging area locatedequipment using the main eleitrical panel.site, the technician wiil inspect the hazmat storage areas forattempt to contain the rerease as described aboie. gvacuate tneaway from the equipment. tf necessary shut down the t;;;1; il"ereSislocatedanoffhutdwhitf€'whodoesprocedupdescribeleasedownhubeneedstoequorsomeipmentutoffshISbetopowerfanngearthquake.followiattentionngmmediaterequreastfladentifyEenrneunKE REspoNSEMeruoo orAunm to Enaployees:Vocal, intercom and fire ararms are used to notify our emproyees to evacuate.RourEs or Ecness:#;'ffrHlHJtlffiJtuildins and should be verified with the Emersency site coordinator of each facitity. Awouldbe:statementstandardAfacility.eachofCoordinatormergencySiteEwiththeverifiedbeandshoulditdingeachbuwithvariesThisEvacuation plan:contractors utirized to crean up spiils and rereases for our facirities incrude:1. Shaw EnvironmentalDiesel Fuel: The AT&T Hazardous Materials Management plan ltem G (contingency plan): ou.ines thenotifications required for incidents invorving spiils which iicruoe::1. Local Fire Department2. Department of public HealthATAT&s.cationnotifivspganill/releasepcomletinandn-upvendoraspillcleaofpatchngtsdincludils,pireportedaltwithassisttoISnagercontactedMlncident&SutyEHon-DuresAnrocedPineHotlSafety&rthnment,HeaEnviroOPure6-lHS-1ErocedngPOperatitnnternaT&asdescribedmanagedareemergencycalls&SEHapositiondiswastengSndnformationkitprrequtng,iredtraininupmaktodecisclean-spilrepollssplngartingrecogndInpre-nlztonESinplanfacilitistructsinmentalsoocudThtsncypromptrgeme1tnHotl&SHtheEtoreportedspcybetomergeneillsandncidentalprequalln-uiresSEcleaandaResponSpillilSmEHS-12OO.PRCPracticeTEnvironment Health & SafetyReal Estate Client Service ienter3. AT&T4. AT&T5. AT&TMRrenllt.sOFHRzenoousANDLLSLeexsSplreutheynlessitiesresponsibilmentaenvironperformmustjobimpactingmellyntaanenvironintotransferwhoAT&TbleapplicatntheasNSoutlinedoperatioworktheirEruployee Tnrururuc:I:\}IAZMA2Last Updated : 1 I l3l20t2Response FLEET,doc docAT&T has emergencyprograms and proceduresponse plans and procedres in place:ures in place for all facilities. The fottowing isa descriptionof theoutlined in the AT&T operating Practice 130.is the Emergency site coordinator/Building warden program.The Emergency site coordinator/Building warden is inv"ovei in directing "no ,ooioinating the followingactivities with the occupants of the facility.r Establishing and training the building emergency organization.o lmplementing the Emergency procedure plan.r Occupant emergency preparedness.r Reviewing the planning Engineering sketch.r Establishing and maintaining the Eriergency procedures Board.o Developing and maintaining the EmerglncyMethods ano pioceoures (EMop) binder.r scheduling and conducting semi-an-nual fire and tare covli drills and recording dril results on theFire/Evacuation Drill Report.r Conducting fire safety surveys using form SBC30Z7r Daily administration of fire pieventidn practices.r Reporting ail bomb threats to appropriate security office and the ECC.r Advising security of all emergencies.r Accompanying externar or internar agencies on buirding inspections.t ^i:ilnJl!,o,it,!:r)rt"'utt'on of eme-rgencv site co6rdin'atorlBuirding warden successor (transfer of'1' The AT&T EH&s Hotline is a 24-hour communications center estabrished through which emergency conditioninformation flows from and within AT&T. ln the uu"r,t ti i ryror.emergency the center also providescoordination' communications and is the established liaison wiin teoerat, rt"tdlo.ll ano military agencies.2' Eruencerucv Puru BINDER, TheAT&T operating Practice 130 provides.fire, safety and emergency guidance,checklist' forms, and company contacis tor e-mergencv ,iti,Jtionr, interruptions'J .o,,.,p"ny services, andother threats to our operations, facirities, personner or pr6pertv.r communicating to occupants.v.ia emergency^communications systems (if appricabre).r contact the Environment Health ano sirety-organization in tne Lvent of an osHA visit.The AT&T operating Practice 130 also requires that each facility have an Emergency plan binder. The binder isa guide providing for personal proteciion ?P g1epency nroc99rr1 roi dorprn1, tocations duringemergencies' The binder is developed and held o)l tne imeiLefcy site cooroinatoi 5i eacn facirity rocationwhen the minimum regarrequired buirding headcount is reachedlResponse PlanEmergencyand alternate routes to be used for evacuation are posted on eachMETHoD ro Accourur FoR ALL PERsoNs:The AT&T operating Practice 130 identifies the Emergency site coordinator/Building warden as the individuatresponsible for working with the location management to determin" o".rp"nr"".orint"oility in the event of anevacuation or other emergency. This includes the establishment of asr"r'ory "r"", *nuru accountability can be3?1;#l?l;5J]l5|||"fi,:l;:il1 raciritv are instructeo to meet - iootain tnis inrormaiion rrom th" E;;dr"v'b,,"AteRlruc Neroxeons:The AT&T operating Practice 130 identifies the Emergency site coordinator/Buitding warden as the responsiblecontact to work with all agency emergency/rescue personnel to notify facility adjacent properties."Employees exitThe instructionsfloorthrough front, rear andfor emergency existsside doors.routes include...."AlternateI:\[IAZMAT\PACBELL\2-FORMS\Ernergency Response FLEET, dooLast Updated : I / t3/2012 .docAdditionally, the AT&T Operating practice 130 provides the following procedures for the Emergency siteCoordinator and Site Manageri in the event of a hazardous materials incident at the facility'1. ldentify and locate the problem.2. lsolate, relocate or evacuate employees as required'3. Notify emergency rescue personnel if needed.4. lnvestigate the Problem.5. Avoid inhalation of all gasses, fumes or smoke'6. lf the release or threat6ned release has the potential to harm the population and environment contact:oAT&T Environment Health & Safety Hotline BOO-KNOW EHS (800-566-9347), prompt 1o Environmental Control Center for Fuel Storage Tanks 800-KNOW EHS (800-566-9347), prompt 1oAsset Protection (AT&T) 800-8074205eLocal Hazardous Emergency ResponseAgency 911oCA Emergency ManagementAgency (CAL E-M-A) 800-852-7550ATcombetstorou&EnviT'sronmentHealth&aorofrespillrelease,onsite1800personnelcallporttoHSKNOWEtheHazardoustheincident3. ln the eventMaterials lncidentI:\HAZMAT\PACBELLU-FORMS\Emergency Response FLEET.dooLast Updated: 1 ll3l20l24 (ii:l' i: l [r.i(732TITLE OF OWNER/OPERATORAssociate, Agent for AT&T731NAME OF OWNEW6PERATOR (Print)Steve Skanderson730DATEJanuary 21,2012SIGNATUREIV. CERTIFICATIONSI certify under penalty oflaw that the agtivities described in these documents meet the applicable eligibility and operating requirements ofstate.statutes and regulationsfor remote waste and consolidation sites. I further certif that this document and all attiihments were prepared under my direction or supervision in accordance with asystem designed to assure that qualified personnel ptop"tly gather and evaluale the information submitted. Based on my inquiry of the person or persons who managetie system, ir those directly r.tponriut. rot gathering ihe iniormation, the information is, to the best of my knowledge and beliel true, accurate, and complete. I amaware that there are substantiaLpenalties foriubmittiig false information, including the possibility of fines and imprisonment for knowing violations.729(Check all that apply)ffi a. The hazardous waste being consolidated is not hazardous waste under federal law although the waste is regulated as hazardous wasteunder Califomia state law.E b. The hazardous waste is hazardous waste under federal law, but transportation to and accumulation at the consolidation site of the wasteis not subject to permitting requirements under federal law for the following other reason(s):III. BASIS FOR NOT NEEDING A FEDERAL PERMITUNITS I a. Pounds E b. Gallons728ESTIMATED MONTHLYVOLT]ME CONSOLIDATED290727Do you treat your hazardous waste at this consolidation site?EYes XNoDESCRIPTION OF TTIE TYPE OF HAZARDOUS WASTE THAT MAY BE COLLECTEDUsed Motor Oil, Used Antifreeze, Drained Used Oil FiltersDESCRIPTION OF THE TYPE(S) OF REMOTE LOCATION(S) AND SOURCE(S) FROM WHICH THE NON-RCRA HAZARDOUS WASTE WILL BE COLLECTED 0.e.724power pole)Telecommunication sitesZIP CODE 93403723CA722CITYSAN LUIS OBISPO2FACILITY EPA ID# CATO8OO24268ADDRESS 196 SUBURBAN RDII. CONSOLIDATION SITE INFORMATIONIFA000281 7FACILITY ID#BUSINESS NAME (same as TACILITY NAME or DBA or- Doing Business As)Pacific BellTelephone Company dba AT&T California3UNIFIED PROGRAM CONSOLIDATED FORMHAZARDOUS WASTEREMOTE WASTE CONSOLIDATION SITE ANNUAL NOTIFICATIONa. Initialb. Revisedc. AnnualoflI. GENERAL INFORMATIONUPCF (12199 revised)Formerly DTSC 1196 {Stantec Architecture lnc.1383 North McDowell Blvd., Suite 250, Petaluma cA 94954 - 707,765.1660 - fax707.765.9908StantecJanuary 26,2012City of San Luis ObispoFire DepartmentKerry Boyle21 60 Santa Barbara Ave.San Luis Obispo, CA 93401RE: AT&T REMOTE WASTE CONSOLIDATIONDear Kerry Boyle:Enclosed is the annual Remote Waste Consolidation form for the AT&T facility:SE164 - 196 Suburban Road, San Luis Obispo, 93403If there are any further correspondences related to these submissions, please direct them to myself or:AT&T CorporationEnvironment Health & SafetY2600 Camino Ramon, Room 3E000San Ramon, CA 94583Sincerely,Stantecre Inc.EnclosureAT&TFile707.774.8331 FACILITY INFORT,TATIONBUSINESS ACTIVITIESPage I of t"l(You ma-v also be required to provide additional inlormation by yourCUPA or local agency )l5F. LOCAL REQUIREMENTSE. HAZARDOUS WASTEGenerate hazardous waste?Recycle more than 100 kg/month oflexcluded or exempted recyclablematerials (per HSC 25143.2)'!Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permit by Ruleand Conditional Authorizaton)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned on-site?Generate in any single calendar month 1,000 kilograms (kg) (2'200 pounds)or more of lederat RCRA hazardous waste, or generate in any single calendarmonth, or accumulate at any time, I kg (2.2lbs') of RCRA acute hazardouswaste; or generate or accumulate at any time more than 100 kg (220 lbs') ofspilt cleanup materials contaminated with RCRA acute hazardous waste.Household Hazardous Waste (HHW) Collection Site?f,lves fl uo ,f,ves MNo,oI t_--^ I /t,.^ !!Ll Y b5 lvllr\u I 'f ves Mruo'tffves f]No ',f] ves MNo 'oNO l4bI vesNO l4aYESUEPA lD NUMBER - provide at the top of thispageRECYCLABLE MATERIALS REPORT(one per recycler)ON-SITE HAZARDOUS WASTETREATtviEi{T - FACILITYON-SITE HAZARDOUS WASTETREATMENT-LNIT (one page per unit)CERTIFICATION OF FINANCIALASSURANCEREMOTE WASTE i CONSOLIDATIONSITE ANNUAL NOTIFICATIONHAZARDOUS WASTE TANKCLOSURE CERTIFICATIONObtain lederal EPA lD Number, fileBiennial Report (EPA Form 8700-l3A/B), and satisS requirements lorRCRA Lagre QuantitY Cenerator.See CUPA for required forms'Own or operate ASTs above these thresholds:Store greater than 1,320 gallons ofpetroleum products (new or used)in aboveground tanks and containersSTORACED. ABOVE GROL'ND PETROLEUMf,ves ff*o 'NO FORM REQUIRED TO CUPASC. UNDERGROLJND STORAGE TANKS (USTs)Own or operate underground storage tanks?[vesffo 'UST FACILITY (Fomerly SWRCB Form A)UST TANK (One page per tank) (Fomerly Fom B)B. REGULARED SUBSTANCESHave Regulared Substances s(ored onsite in quantities greater than thethreshold quantities established by the california Accidential Releaseprevention Program (CalARP)?f,ves MNo o"Coordinate lvith your local agencyresponsible lor CalARP,A. HAZARDOUS MATERIALSHave on site (for any purpose) at any one time, hazardous materials at or above55 gallons for liquids, 500 pounds for solids, or 200 cubic feet lor compressedgasls (include liquids in ASTs and USTs); or the applicable Federal threshold[uantiry for an extremely hazardous substance specified in 40 CFR Part 355,Appendix A or B; or handle radiological materials in quantities for which an.-Lrg"n.y plan is required pursuant to 10 CFR Parts 30, 40 or 70?plves f No oHAZARDOUS MATERIALSINVENTORY - CHEMICALDESCRIPTIONDoes your facility...pleaseUPCF.eS'comppageYfletethesetheofsubttheBusinessmlOrvner/OtordentificIationvoanypIfTENOtoeckYESchofthisartlist,SAN LUIS OBISPOBUSINESS SITE CITYCA105coDE 93403BUSINESS SITEADDRESS 196 SUBURBAN RD103phone Company dba AT&T CaliforniaBUSINESS NAMEiness AS) Pacific Bell Tele(Same as FACILITY NAlvlE of DBA-Doing BusFACILITY ID#UseFA00028 I 7EPA lD# (Hazardous Waste OnlY)cAT080024268I. FACILITY IDENTIFICATIONUPCF Rev. (lZ/2007)Printed: l/9/201 I s8154.,ROGRAM CONSOLIDATED FORMFACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATIONAssociate - Agent for AT&TOF SIGNER136137Steve SkandersonOF SIGNER134135and amLOCALLY COLLECTED INFORMATION:OFthewithsubmittedandinformationtrue,accurate,informationbelievetheandlscomplete.onmyBasedofthoseresponsibleforobtainingthecertiryunderinformation,IIhaveoflawthatpenaltypersonally3t1112011TENAME OF DOCUMENT PREPARERStantec Consulting Services lnc.127132#AGER#800-566-9347 (800-KNoW-EHS)800-566-9347 (800-KNOW-EHS)126131PHONEPHONE805-546-7416800-566-9347 (800-KNoW-EHS)130PHONE125PHONEEnvironmental Site Manager24HR EMERGENCY SERVICE't24129Sharon RamirezAT&T EHS HOTLINE123128AMEIV. EMERGENCY CONTACTSPRIMARYSECONDARYr3ONTACT MAILING CITYSan Luis ObisPo120STATECA121122Ztr CODE93401Room 104119]ONTACT MAILING ADDRESS872M1 19ams16541ACTEMAILSharon Ramirez1',17118114115116NAME805-546-7416ACT PHONEMAILING CITYSan RamonSTATECAZIP CODE94583)WNERMAILINC ADDRESSP.O. Box 5095, Room 3E000113111112110NAME't 09dba AT&T CaliforniaPacific Bell TelePhone ComPanYOPERATORPHONE7416PHONE925-823-0725OPERATORNAMESharon RamirezBUSINESS MAILING CITYSan RamonSTATE1 08cCAZIP CODE945831 08dMAILINGADDRESSP.O. Box 5095, Room 3E0001081 0-340-161 8DTIN BRADSTREET106107PRIMARY SIC4813107aPRIMARYNAICS517110CASAN LUIS OBISPOBUSINESS SITE CITY104105ZIP CODE93403COI.JNTY 108SAN LUIS OBISPOSITE ADDRESS196 SUBURBAN RD103FAX102aPHONE805-546-74161023&TnePacificelephoBellTrnComdbalifoCaTAtaorNAMEFACILITYNAME(SameDoingDBABusinessAs)FA0002817DATEDATE10011101LolID#UPCF (Rev. 1212007)Printed: 311112011 Jan 26 1108:14a Cranmer9704&5407I4p,2State of California - Calbmia Environrnenlal Protection AgencyIDepartmenl of Toxic Srbstances Conlrol(Ctsd( dl lhat apply)E a. TTp hrzardous wasto beirE consolidaled is not hazardous waste under federal law allhough lhe w?sle ts regulaled as hazardd$ wasteunder California state hw'El b. The hazardous wast€ is hazardous wasle under lederal law, but transporlation b and accumulation at lhe consolidation site of lhe wasleis not subjed to pamitling requirements under federal law for the follcwing olher reason(s):M. CERTIFICATIONSI cedrff under penalty of la,v that lhe activities desctibed in these documenls meet lh€ applicable eligibility and operating requirements of state stalulesand regulations for refiohe waste and consolidation siles. I furthet c€rtit lhat ftis document and all attachmenls rvere prepared under my ditection orsupervislon ln a@ordance with a system designed lo assure that quallfled personnel properly galhq and €valuate the informalion submitted. Based onmy hqulry of the person or p€rEons who manage the system, cn lhose directly responslble for gathering the informalion, lhe infonnauon is, lo lhe best ofmy knowledge and belief, lrue, accurate, and comfle[e. I am aurare thal there are substanlial penalli€s for submitting false intorrnalioo, including thepossibilily of fines and lmprisonrnent for lfiorrylng violaliors.DTSC 1404 (03/11/05)TITLE OF OINN ER/OPERATOREnvironmental ManagerT32^,Ard€OF OwivER OPERATOR (Prlnl)'t31James CranmerJanuary ?6,2011DATE/JUOWNER/OPERATOR'II. BASIS FOR NOT NEEDING A FEDERAL PERMITUNITS E a. Pourds f, U. C.altons7ZBrz7ESNU6TED MONTHLYVOLUME CONSOLIDATEO10Do you lreal your h&ardous wasE at lhfu mnsolidalion sib?{oprord) [ Yes Pl ttorz+tUsed oil, used antifreeze, fuel and oil fifters resulting from generator maintenanceDESCRIPTION OF THETYPE OF HAZARDOUS WASIE THAT MAY BE COLLE€TED725DESCRIPTION OF THE TY?E(S) OF RE]VIOTE LOCATIOI,{S) AND SOURCE(S) FROM \4/}|ICH THE NO}{.RCRA HAZARDoUS WASTE WLL BE CoLLECTED(i.e. po,ver pob)Remote unmanned telecomrnunications sites (radio tower and unmanned central oflice sites) with back up generators.IA7ECA zlP coDE 9340172clTY San Luis Obispo2FACTLTTY EPA tD# CAT080024268ADDRESS 196 Suburban Road721II. CONSOLIDATION SITE INFORMATION1FACILITY ID#BUSINESS NAME (Srm ac rACUW tlAt E or DBA - Dotng SuitrsA5)Pacific Bell Telephone Company d/b/a AT&T Ca3I. GENERALINFORMAT]ONE a. lnitialp"su-ll ot i721D c. Annualb. RevisedREMOTE WASTE CONSOLIDATION SITE ANNUAL NOTIFICATIONCERTIFIED UNIFIED PROGRAM AGENCYCUPA-Ipage 1 of 2 ;r_'lTFILE THISTHEENVIRONMENT, HEALTH & SAFETYGREEN COMPLIANCE BINDERSECTIONIat&tHazardous Materials Business Planand Annual InventorY UPd ateYEAR 2OO9Pacific Bell Telephone ComDanydba AT&T California - 58164(Facility Name und ID)196 SUBURBAN RD(Fscility Address)SAN LUIS OBISPO(Facility City)SAN LUIS OBISPO(Ftcility County)MAINTAINTHIS DOCUMENT ON SITE.SO ITWILL BEAVAILABLE INTHE EVENTOF A GOVERNMENT AGENCY INSPEC'IION, SlTE ASSESSMENT OR AUDIT'0qg(/Printed: 121812008Ctuil BUSINESS ACTIVITIESFACILITY INFORMATIONFO{^.IED PROGRAM CONSOLIDATEDPage I ol 12-(You may also be required to provide additional inlormation by yourCUPA or local agency.)t5F. LOCALREQUIREMENTSE. HAZARDOUS WASTEGenerate hazardous waste?Recycle more than I 00 kg/month of excluded or exetnpted recyclablematerials (per HSC 25143'2)?Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permit byRule and Conditional authorizaton)?Consolidate hazardous waste generated at a rernote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned onsite?Generate in any single calendar month l,000kilograms (kg) (2,200pounds) or more offederal RCRA hazardous waste, or generate in anyiingle calendar month, or accumulate at any tirne, I kg(2'2 pounds) orRCRA acute hazardous waste; or generate or accumulate at any timemore than 100 kg (220 pounds) of spill cleanup materials contaminatedwith RCRA acute hazardous waste.Household Hazardous Waste (HHW) Collection Site?f,lvas I No n! ves lTlNo 'o! vas lTlNo ' 'I vEs p]No ',vas lTlnor:vrs f;Nor+!ves f]No '0,NO l4bIvrsEPA ID NUMBER--provide at the top of this pageRECYCLABLE MATERIALS REPORT(one per recycler)ONSI'fE HAZARDOUS WASTETREATMENT - FACILITYONSITE HAZARDOUS WASTETREATMENT-UNITlone page per unit)CERTIFICATION OF FINANCIALASSURANCEREMOTE WASTE / CONSOLIDATIONSITE ANNUAL NOTIFICATIONHAZARDOUS WASTE TANKCLOSURE CERTIFICATIONObtain federal EPA ID Nunrber, file Biennial Repoft(EPA Form 8700-13A/B), and satis! requirements forRCRA Lagre Quantity Generator.See CUPA for required forms.D. ABOVE GROLIND PETROLEUM STORAGEOwn or operate ASTs above these thresholds:Store greater than 1 ,320 gallons of petroleum products (newor used) in aboveground stanks and containerslves ff^o 'NO FORM REQUIRED TO CUPASC. UNDERGROUND STORACE TANKS USTS)Own or operate underground storage tanks?f]ves fi*o 'UST FACILITY (Forrnerly SWRCB Form A)IIST TANK (One page per tank) (Formerly Forrn B)B. REGULARED SUBSTANCESHave Regulared Substances stored on site in quantitied greater than theThreshold quantities established by the california Accidential Releaseprevention Program (CalARP)?f vrs fJNo o"Coordinate with your agency responsiblefor CalARP.A. HAZARDOUS MATERIALSfru* on site (for any purpose) hazardous materials at or above 55gallons for liquids, 500 pounds for solids, or 200 cubic feet forcompressed gases (include liquids in ASTs and USTs); or theapplicable Federal threshold quantity for an extemely hazaldoussutstance specified in 40 CFR Part 355, Aappendix A or B; or handlein quantities for which an ernergency plan is0 CFR Parts 30,40 or 70?radiological materialsrequired pursuant to IfivEs ! No oHAZARDOUS MATERIALSINVENTORY - CHEMICALDESCRIPTIONIf Yes, pleasecomplete these pages of the UPCF'..Does your facilityNOTE: If you check YES to any part of this list'tor ldentificationsubmit the Business OwnI. ACTIVITIES DECLARATIONSAN LUIS OBISPOBUSINESS SITE CITYCA105coDE 93403BUSINESS SITEADDRESS 196 SUBURBAN RD103DBA-DoingBusinesAS) PagifiC Bell Telephone Company dba AT&T CaliforniaBUSINESS NAMESE164(Same as FACILITY NAME orFACILITY ID#Use Only)EPA ID# (Hazardous Waste OnlY)CATO80024268I. FACILITY IDENTIFICATIONUPCF Rev. (12/2007)Printed: l218/2008 136Steve SkandersonOF SIGNERSr. Project Manager, Agent for AT&TOF SIGNER137OF OWNER/OPERA12t8t2008134NAME OF DOCUMENT PREPARER135lncStantec ConsBased on rny inquiry ofthose individuals responsible lbr oI certily under penalty oflaw that I have personally examined and amiar with the information subrnitted and believe the information is true, accurate, and complete.btaining the information,AL LOCALLY COLLECTED NFORMATION:805-245-4197AGER#:127132AGER#B0o-566-9347 (800-KNOW-EHS)126PHONE800-566-9347 (Boo-KNOW-EHS)131PHONE805-546-7416S PHONE125877-322-4722tJuPHONESite Manager12424 HR EMERGENCY SERVICE129Sharon Ramirez123EMERGENCY CONTROL CENTER128AMEPRIMARYIV. EMERGENCY CONTACTSSECONDARYACT MAILING CITYSan Ramon120STATE121CAZIP CODE22P.O. Box 5095, Room 3E000119MAILING ADDRESS1 19aACT EMAILgchimienti@ATT.comEnvironment Health & Safety, attn: Gary Chimienti117NAMEACT PHONE118AMAILING CITYSan Ramon114S1'ATE115ZIP CODE116MAILING ADDRESSP.O. Box 5095, Room 3E000113Pacific BellTelephone Company dlbla AT&T CaliforniaNAME111(800) 566-9347112PHONEIOPERATORNAMESharon Ramirez1091 '101SS OPERATOR PHONESan RamonSS MAILING CITY1 08cCATE945831 08dCODEP.O. Box 5095, Room 3E000MAILINC ADDRESS10810-340-161 I106BRADSTREET4813Y SIC 107107aPRIMARY NAICS51CASAN LUIS OBISPOSITE CITY104105CODE93403SAN LUIS OBISPO108196 SUBURBAN RDUSINESS SITE103973-0584USINESS FAX102aSE164dba AT&T CaliforniaPacific BellTelenne ComDoing Business As)NAME (SameasFACILITYNAMEoTDBA-102USINESS PHONE831-372-2142ACILITY ID#1FA0002817100ECINNING DATEt2009101ENDING DA1E1213ITION2- olPROGRAM CONSOLIDATED FORMFACILITY INFORMATIONBUSINESS OWNETVOPERATOR IDENTIFICATIONUPCF (Rev. 1212007)Printed: 121812008Cdoluq -FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)vr'If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246If morc hazardous componenls5242244!v.. El*"24314J4238??o240flv.' Elu"241320234ADDITIVES235236flv" Ehl"Proprietary23721230ZINC COMPOUND231232[r.' E]u"PROPRIETARY233B5226LUBRICATING BASE OIL227es228M"229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!t'. anovEAMBIENr flc. BELOWAMBIENT l-lo cnvocBNtcXA. AMBIENTSTORAGE TEMPERATURE225f,u. anovaAMBIENT !c. BELOWAMBIENTXSTORAGE PRESSUREA. AMBIENT224ABOVE GROUNDTANKLINDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUM223PI-ASTICNONME'f ALLIC DRUMm. GLASS BOTTLEi. FIBER DRUMI. CYLINDERRAIL CAROTHERSTORAGECONTAINERCANCARBOYSILOPLASTIC BOTTLETOTE BINTANK WAGONBACBOXLTNITS*iCheck one item only)b. cuBrcrEEr Ic, PoUNDS !0. TONSif FHS cnrnrnt mrrsf he in nottndsXa24a. GALLONS222DAYS ON SITE:365VERACE DAILY AMOUNT217WASTE AMOUNT215220DAILY AMOUNT 218ASTEwCODEI u. neacrrvE f]X(Check all that apply)a. FIREd. ACUTE HEALTHc.PRESSURE RELEASEFED HAZARD CATEGORIESe.CIIRONIC HEALTH216PHYSICAL STATE(Check one item only)n a. soLID [] u. r.rOuro trc. GAS214LARGESTCONTAINER 55215nXIYPE (Check one itema. PUR-Ec. WASTEb. MIXTUREHAZARD MATERIAL211X212RADIOACTIVENofl Yes213CURIEScL ilt-B/ IRRCODE HAZARD CLASSES(CoNplcle ifrequired by CUPA)210]AS#209IfEHS is "Yes", all amounts below must be in lbs.MOTOR OIL (AllGrades)COMMONNAME207l v'. Et"EHS208CFIEMICAL NAME205TRADE SECRETIfSubject! v.'X206to EPCRA, refer to instructionsNoII. CHEMICAL INFORMATIONFACILITY ID#1203MAP# (optional)1204GRID# (optional)F4,G5STORED IN SHOPSHEMICAL LOCATIONCHEMICAL LOCATION CONFIDENT'IAL EPCRAX202NOI vesPacific Bell Telephone Company dba AT&T CaliforniaBUSINESS NAMESE164I. FACILITY INFORMATIONADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 121812008Ad?" TJ. ,FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per nlaterial per building or area)If EPCRA, Please4,r*\tpADDITIONAL LOCALLY COLLECTED INFORMATIONHere246Ifmore hazardous components are present al grealer lhan lyo byweight if non-carcinogenic, or 0. I % bl weight i f carcirrogenic, altach additional shects of paper capturing thc required inforrnalion5 0.1242Ethyle Mercaptan245244!v"' EN"75-08-124545238Total Butanes239240[r.' EF"24178-28-536234Ethane235236f1"., EN"74-84-0237235230PROPYLENE231ESEl*" 232115-07 -1ZJJlgo226PROPANE227o228ffr.'74-98-6229%wrHAZARDOUS COMPONENT (For mixture or rT'aste only)EHSCAS#!u,[".XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOWAMBIENT!0. cnvocaNtc225TE.STORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224ABOVE GROUND TANKLTNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA.IONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERI. CYLINDERRAIL CAROTHERFIBER DRUMBAGBOXa. GALLoNS I u. cunrc FEEr f]flo. roNsXone itemc. POUNDS221222DAYS ON SITE:365217DAILY AMOLTNTDA]LY AMOUNT 218UAL WASTE AMOLTNT219STATE WASTE CODE224fl u. neecrrvE E c.PRESSURE RELEASEXXall that apply)a. FIREd, ACUTE HEALTHHAZARD CATEGORIESe.CHRONIC HEALTH216n a. SOLIDI c. cnsXone item only)b, LIQUIDSTATE214I,ARGEST CONTAINER 368215! a. runr lTl u. utxrunPn c. wasrE(Check one itemMATERIAL211Yes212RADIOACTIVENoI213CURIESby CUPA)210FGCODECLASSES (Complele74-98-6209IfEHS is "Yes", all arnounts below must be in lbs.PROPANENAME207XNoYesEHS208NAME205E*o1o206IfTRADE SECR,ETYesrefer toII. CHEMICAL INFORMATIONACILITY ID#1203MAP# (optional)1204GRID# (optional)E3STORED IN YARDLOCATIONICAL LOCATION CONFIDENTIAL EPCRAXT202NOYESPacific Bell Telephone Company dba AT&T CaliforniaSE164NAMEJI. FACILITY INFORMATIONADDDELETEREVISE200zofUPCF (Rev. 1212007)Printed: 121812008 .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per malerial per building or area)If EPCRA,ADDITIONAL LOCALLY COLLECTED INFORMATIONHete2464su\a'tlf more hazatdous componenls5242o244[v.' Eh,2432454238o240flr'. EI,2413234235236!v",23722230ADDITIVES231232flv.. El'u"PROPRIETARY233199226LUBRICATING BASE OIL227fl',.6"228229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#[c. BELOWAMBIENT l_lo' cnvoceNtcXSTORAGE TEMPERATUREA, AMBIENTb- ABOVE AMBIENT225I-X-IU, AMSENT !U' AAOVEAMBIENT NC' BELOWAMBIENTSTORAGE PRESSURE224ABOVE GROUND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERI. CYLINDERi. FIBER DRUMRAIL CAROTHERBAGBOXcunrc nEer ! r.! o. roNs 221XbPOUNDSa. GALLONSTS*one item222DAYS ON SITE:365VERAGE DAILY AMOUNT217UM DAILY AMOUNT 218WASTE AMOLTNT219STATE WASTE CODE220l-l r. neacrrvE !Xa. FIREc.I,RESSURE RELEASEd. ACUTE HEALTFIe.CI'IRONIC HEALTH216HAZARD CATEGORIESall that apply)I a. soLID I u. r.lOulo ! c. cas214one item only)STATEI,ARGEST CONTAINER 55215I a. r,uRE lTl u. rutxrunE(Check one itemc. WASTEMATERIAL211XYesNo212RADIOACTIVE!213CIJRIEScL ilt-BCODE HAZARD CLASSES(Complete ifrequired by CUPA)210209IfEHS is "Yes", all amounts below must be in lbsHYDRAULIC FLUIDNAME207Xn v..NoEHS208NAME205Xrefer to inslructions! v.'TRADE SECRETtoNo206II. CHEMICAL INFORMATIONACILITY ID#1203MAP# (optional)1204GRID# (optional)F4.F3LOCATIONSTORED IN SHOPLOCATION CONFIDENTIAL EPCRAX202NOYESPacific Bell Telephone Company dba AT&T CaliforniaUSINESS NAMEsE164?I. FACILITY INFORMATIONADDDELETEREVISE200PageofUPCF (Rev. 1212007)Printed: 121812008 .f.IED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DBSCRIPTIONOne page pcr material per building or area)0qIf EPCRA, Please Sign l{ereADDITIONAL LOCALLY COLLECTED INFORMATION246afeatgrcaterpresentconrponentslf morehazardousorby%thanpaperby%0.ifnon-carcinogenic,weightadditionalifcarcinogenic,attachweighttherequircdcapturingofsheetsinforrnalion.5242243o244!v.' Eh,2454238239o240f}'.' Eh,2413234235o236flr.' EhzJt2230231232!v" El*"233zzo227f]"",228229%wTFIAZARDOUS COMPONENT (Fol mixture or waste only)EHSCAS#!u. eaovEAMBIENr n"XSTOMGE TEMPERATUREA. AMBIENTBELOW AMBIENTno. cnvoceNlc225XSTORAGE PRESSUREl-l u' aNae''Nrb, ABOVE AMBIENTl-lc. BELow AMBIENT224CLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WACONzzJH'i. FIBER DRUMPLASTICNONMETALLIC DRUMd. STEEL DRUMTORAGEAINERRAIL CAROTHERABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGCANCARBOYSILOBAGBOXCYLINDERb. CUBIC FEEr I c.! o, ror.rs 221Xone rtema, GALLONSPOUNDS222DAYS ON SITE:365VERAGE DAILY AMOTJNT217DAILY AMOUNT 218WASTE AMOUNT219220WASl'ECODEfl a. nrRE Xn e.CI'{RONIC HEALTHXXb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASE216HAZARD CATEGORIESall that apPly)! a. soLID fl u. rrqurnXc. GAS214one item only)STATELARGESTCONTAINER 222215I a.nunE n u.N,Irxrune(Check one iternc. WASTEMATERIAL211XRADIOACTIVE212NoYesnCURIES213NON-HAZARDOUSRE CODE HAZARD CLASSES(Complete ifrequired by CUPA)2107440-37-1tnoIf EHS is "Yes", all amounts below must be in lbs.ARGONNAME207I v.' E"oEHS208ARGONNAME205fl v',Xret:r to instructionsTRADE SECRETtoNo206II. CHEMICAL INFORMATIONrD#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAX202NOYESPacific Bell Telephone Company dba AT&T CaliforniaSE164NAMEFACILITY INFORMATIONI.ADDDELETEREVISE200ofUPCF (Rev. 12/2001)Printed: 121812008W,rat* . .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)u,.oogL.,,ADDI'|IONAL LOCALLY COLLECTED INFORMATIONIfHere246than l% by ueight ifnon-carcinogenic, or 0.1% by wcight ifcarcinogenic, atlach additional sheets olpaper capturing the r€quired infonnalion.lfmore hazardous cotrponents are present at grealcr5242243244!v"' EN"2454238239240f1".. Eh"241J234235flr.' Elu" 2362372230231232f,r'. Elu"233I toozzoMOTOR OIL, USED227flv"'2288002-05-9229%wrHAZARDOUS COMPONENT (For mixtule or waste only)EHSCAS#!"XA. AMBIENTSTORAGE TEMPEMTUREb. ABOVE AMBIENTBELOW AMBIENTflo. cnvocrNtc225!un"XSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMCLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINERi. FIBERDRUMPLASTICAIONMETALLIC DRUMCYLINDERK. BOXBAGRAIL CAROTHERCANCARBOYSILOlTl a. cALLoNs ! u. cuetc neErfl o. roNs 221one item onc. POUNDS222DAYS ON SITE:365VERAGE DAILY AMOUNT217gM DAILY AMOUN'| 218WASTE AMOUNT219220221ATE WASTE CODEa. FIRE I u. nEecrlvE n c.I'RESSURE RELEASE l_l o. acure HEALTHXXe,CHRONIC HEALTII216HAZARD CATEGORIESall that apply)f] a. soLIDf, c. cesXone item only)b, LIQUIDSTATE214LARGESTCONTAINER 2402't5J-l a. PURE ! u. vrxruneX(Check one itemc. WASTE211MATERIALXNo212YesRADIOACTIVE213CURIEScL ilt-B/ IRRCODE HAZARD CLASSES(Complele ifrequired by CUPA)210209IfEHS is "Yes", all amounts below must be in lbs.USED MOTOR OILNAME207XYesNoEHS208NAME205Xlo206IfNol-l v'.TRADE SECRETrefer to inslructionsINFORMATIONII. CHEMICALACILITY ID#1203MAP# (optional)1204GRID# (optional)F5WEST SIDE OF SHOPLOCATIONICAL LOCATION CONFIDENTIAL EPCRAXNOYESPacific Bell Telephone Company dba AT&T CaliforniasE164NAMEACILITY INFORMATIONI.FADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 121812008\cAg\olo* ,FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material pcr building or area);rtetIf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246noreIfconlponentsatgrealcthazardouspresentorweiglrtiflVobythanpaperweight%by0.non-carcrnogenlc,addilionalsheelscarcrnogenlc,altachifthcrequiredcapluringofinfonnalion.5242243o244!v.' E]-2454238,20240fl".' EN"241340231WATER235236ffr., El*"7732-18-5,1721230DIETHYLENE GLYCOL231232[r* Elu"111-46-623350226ETI-IYLENE GLYCOL227flv,. EF"228107-21-1229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#ful-lc. BELOWAMBIENT f]o' cnvoceNtcXSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENT225!uXSTORAGE PRESSUREA, AMBIENTABOVE AIVlBIENTl-lc. eElowAMBIENT224GLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223i. FIBER DRUMPLASTICA{ONMETALLIC DRUMa. ABOVEGROUNDTANKCYLINDERK. BOXBAGp. OTHERRAIL CARUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMCANCARBOYSILOnXone itema. GALLONSc. POUNDSb. CUBIC FEETd. TONS 221222DAYS ON SITE:365VERAGE DAILY AMOUNT217UM DAILY AMOUNT 218WASTE AMOUNT219220343.IATE WASTE CODE! u. neecIVE tr o.PRESSURE RELEASEXXall that apply)a. FIREd, ACUTE HEALTI-iHAZARD CATEGORIESe.CI-IRONIC HEALTH216! a. soLID I u.lrquro I c. casone item only)STATE214LARGESTCONTAINER 55215fl a. runr f] u. vrrxruneXc, WASTE211(Check one itemMATERIALRADIOACTIVE212YesNo213CURIEScL ilt-B/ IRRCODE FIAZARD CLASSES(Complete ifrequired bY CUPA)210209IfEHS is "Yes", all arnounts below must be in lbs.USED ANTIFREEZENAME207l-l v,, El*oEHS208NAME205l-l v.'XTRADE SECRET206Noto EPCRA, refer to instruclionsCHEMICAL INFORMATIONII.ID#1203MAP# (optional)1204GRID# (optional)F4STORED EAST SIDE SHOPLOCATIONI-OCATION CONFIDENTIAL EPCRAtr202EJ*oYESPacific Bell Telephone Company dba AT&T CaliforniaNAMESE1643INFORMATIONI. FACILITYADDDELETEREVISE200zofUPCF (Rev. 1212007)Printed: 121812008{fr<- .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONLIere240Ifmorc hazardous components arc prcsent at grealgr lhan l0lo byweight ifnon-carcinogenic, or 0.1% by wcight ifcarcinogenic, attach additional sheets olpaper capturing the rcquired informalion.55242Amines243!v" Elu" 24468439-80-5245410234Polyosobutenyl Succinimide239240!v"' EN"67762-77-02413 10234PETROLEUM SOLVENT, REFINED235230flr". EN"64741-97-5237240230BASE STOCK231232flr". EN"64741-88-4233lzo226SOLVENT REFINED PETROLEUM OILS227[r*6"22864741-89-5225o/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!un..XA. AMBIENTSTORAGE TEMPERATUREABOVE AMBIENTBELOWAMBIENT!0. cnvoceNtc225!..XSTORAGE PRESSUREA. AMBIENTb. ABOVE AMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUM223AINERm.GLASS BOTTLEi. FIBER DRUMPt-ASTICNONMETALLIC DRUMc.RAIL CAROTHERCANCARBOYSILOBACBOXCYLINDERPLASTIC BOTTLETOTE BINTANK WAGON[u. cunrcFEET trc. PoUNDSf] o. roNs 221Xa, GALLONSTS*one item222DAYS ON SITE:365VERAGE DAILY AMOIJNT217DAILY AMOUN'I 218WASTE AMOUNT219220TF, WASTE CODEa. FrRE ! U. nracIVE fl 0.PRESSURE RELEASEXXd. ACUTE HEALTHe.CI-IRONIC HEALTII216HAZARD CATEGORIESall that apply)l-l a. soLID I u. r-rquro ! c. cesone item only)214STATELARGESTCONTAINER 55215a. PURE I u. rvuxrune ! c. wASrE(Check one itemMATERIAL211XYes212RADIOACTIVENo!213CURIEScL lll-B/ rRRCODE HAZARD CLASSES(Complcte ifrequired by CUPA)210209IfEHS is "Yes", all amounts below tnust be in lbs.AUTOMATIC TRANSMISSION FLUIDNAME207XYesNoEHS208NAME205! v.'XTRADE SECRET206Noto EPCRA, refer to instructionsCHBMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONLOCATION CONFIDENTIAL EPCRAT202NOYESPacific Bell Telephone Company dba AT&T CaliforniaSE1 64NAMEINFORMATIONI. FACILITYADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 121812008t\M0qflu .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per malerial per building or area)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246atgreatcrpresentcomponentsIf morehazatdousotbyweighto/othan0.1%ifnon-carcinogcnic,byaltachadditionalitcarcrnogenlc,weighltherequiredofpapercapturingsheetsinfornration.5242243244!v.' Elu"2454238239240ffr" EN"2413234235esElu"250237X2230USED OIL231flv"2328002-05-9233226I tooUSED OIL FILTERS227[r.. E]u"2288002-05-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#!ul-lc. BELOWAMBIENT flo' cnvoceNtcXSTOMGE TEMPERATUREA. AMBIENTABOVE AMBIENT225!uXSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTl-lc. BELow AMBIENT224ABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMI.'IBER DRUMBACBOXCYLINDERCLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONPLASTIC/NONMETALLIC DRUMtl5TORAGEAINERCANCARBOYSILORAIL CAROTHERf] a. cALLoNS! u. cuarc FEEr El c. PoUNDS! a. roNsone item221222DAYS ON SITE:365VERAGE DAILY AMOUNT217MUM DAILY AMOUNT 218WASTE AMOUNT219220WASTECODE223a. FIRE ! u, neecrlvE f|XXall that apply)c.PRESSURE RELEASEd. ACUTE HEALTHHAZARD CATEGORIESe.CHRONIC I-IEALTH216one item only)STATEfl c. GasXb, LIQUID214SOLIDI,ARGEST CONTAINER 2OO215I u. rurrxrunaX(Check one itemc. WASTEMATERIAL211a. PUREXYes212RADIOACTIVENoCURIES213cL ilt-B/ IRRCODE HAZARD CLASSES(Complele ifrequired by CUPA)210209lf EHS is "Yes", all amounts below mtrst be in lbs.DRAINED USED OIL FILTERSNAME207! v.' E"oEHS208NAME205nto EPCRA,Xlo instructionsYesTRADE SECRETNo206II. CHEMICAL INFORMATIONrD#I203MAP# (optional)1204GRID# (optional)F4EAST SIDE OF SHOPLOCATIONICAL LOCATION CONFIDENTIAL EPCRANO2Q2I vasPacific Bell Telephone Company dba AT&T CaliforniaSE164NAMEJINFORMATIONI. FACILITYADDDELETEREVISE200ofUPCF (Rev. 1212007)Printed: 121812008{at lotsc- - .FIED PROGRAM CONSOLIDATED FOI'HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)5U'If EPCRA, Please Sign I-lereADD]TIONAL LOCALLY COLLECTED INFORMATION246are presqnt al grealcr lhan l% by wcight ifnon-carcinogenic, or 0,1% by rveight ifcarcinogenic, atloch addilional sheets ofpaper capturing lhe requircd inforrralionIf more hazardous components5242243244!v* Elu"2454238239240flv" El*"2413234235236[r* E]*"2372230231232[v.' E]t"233zzo227f},",6"228nao%wrHAZARDOUS COMPONENT (Fol mixture or waste only)EHSCAS#Eu. ot",r*, !u. aaoveAMBIENr nc, BELowAMBIENT f]o' cnvocaNlcSTORAGE TEMPERATURE225[u. euovnAMBIENT [c. BELOWAMBIENTSTORAGE PRESSUREA, AMBIENTABOVE GROUND TANKTINDERCROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/I.IONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223RAIL CAROTHERn a. GALLONSb. CUBIC FEEr n c. PoI-INDSflo. roNsXone item221222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218ANNUAL WASTE AMOUN]219STATE WASTE CODE220o.pRESSURE RELEASE ! O. ncure HEALTH l-l e.cllRoNIC HEALTHXa. FIREf] u. nracrrve16HAZARD CATEGORIESall that apply)n a. soLID n u.l-rQuroXc. GAS214one item only)STATEI-ARGEST CONTAINER 225215a. PURE f] u. vuxrunE I c. wASrEX(Check one itemMATERIAL211XYesRADIOACTIVENo212CURIES213NON.HAZARDOUSCODE HAZARD CLASSES(Conrplete ifrequired by CUPA)2107440-59-7209IfEHS is "Yes", all amounts below must be in lbs.HELIUMNAME207Xf, v.,NoEHS208HELIUMNAME205Xf]v"TRADE SECRETto206Norefer to instructionsINFORMATIONII. CHEMICALtD#1203MAP# (optional)1204CRID#F3STORED IN OFFICELOCATIONLOCATION CONFIDENTIAL EPCRAX202NOflvEsPacific Bell Telephone Company dba AT&T CaliforniaSE164NAMEII. FACILITY INFORMATIONADDDELETEREVISE200zPageofUPCF (Rev. 1212007)Printed: 121812008.5p\,t .FIED PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area){tu\%If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATIONHere246moreareotgreaterhazardousIfcomponentspresentort%bylhan0.non-carclnogelllc.weightifl%paperif carciilogcnic,afiachbyweightcapturingofadditionalsheetsrequiredinforrnation.thes 0.5242Sulfur243244!v"' Elu"7704-34-9245499238Distillates, Straight Run Mid239es2406881 4-87-924131aaAETHYL BENZENEIJJ236f}'.' EF"100-41-423721230NAPHTHALENE231o232f},". Eh,91 -20-3233226I tooDIESEL FUEL#2227[r.,6"22868476-34-6229OAWTHAZARDOUS COMPONENT (For mixtule or waste only)EHSCAS#fc. BELOWAMBIENT !o cnvocrNtcXSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTf,u.225XSTORAGE PRESSUREA. AMBIENTb. ABOVE AMBIENTl_lc. BELowAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONIVlETALLIC DRUMCANCARBOYSILOFIBER DRUMBACBOXCYLINDER223b.f.p. TANK WAGONRAIL CAROTHERCLASS BOTTLEPLASTIC BOTTLETOTE BINa. GALLoNS l-l u. cugtc PaerI o. roNsXone itemc. POUNDS221222DAYS ON SITE:365VERAGE DAILY AMOUNT217IMUM DAILY AMOUNT 218WASTE AMOUNT219220wASTECODEI a. nrne I u. nrAcrlvE I c.PRESSURE RELEASEXd. ACUTE HEALTHI e.CHRONIC HEALTI]216HAZARD CATEGORIESall that apply)! a. soLIDXone item only)c. GASb. LIQUIDSTATE214LARGESTCONTAINER 1OO215I a.I'UREX(Check one itemc. WASTEb. MIXTUREMATERIALzt IXRADIOACTIVE212YesNoCURIES213cL il/ IRRCODE HAZARD CLASSES(Complcte ifrequired bY CUPA)21068476-34-6209lfEHS is "Yes", all amounts below must be in lbs.DIESEL NO. 2 LS (DYed)NAME207Xl-l v.'NoEHS208NAME205Xto206IfNo! v.'TRADE SECRETrefer to instruclionsII. CHEMICALINFORMATIONtD#1203MAP# (optional)1F7204GRID# (optional)PARKING LOT - WESTLOCATIONCAL LOCATION CONFIDENTIAL EPCRAX202NOf vesSPacific Bell Telephone Company dba AT&T CaliforniasE1642I. FACILITYTION/lx^DD/DELETEREVISE200.z-Page 3 of tUPCF (Rev, 1212007)Printed: 121812008 /u,MAP# 1NAME AT&T CollforniSNLOCA1R SE1DATE s/2o/2ool fn WISITE MAPBUSINESSBUS]NESS4DRAW]NG SCALENOT TO SCALI196 SUBURBAN RDSAN LUIS OBISPO--rrr?-E!---rl--rt--Z]P CODE934032CIIi'tI345U)c(DcflIDza-lflmrn-lKHYD OIL60 GAL6UJo0-UzoIL!uF6io_ol cLARrFltR-PORTABLEGENERATORStuu (,ots.tr--78Gil nncoru@ oxvcrxn WASTTt9 nnlrrRrtztALoo0oIiFCSTORAGEB3o t.St oroooor(-lWATTRTANKEADMINISTRATIONBUILDINCF@PACIFIC BELL/AT&TllJT N. McDo,ell Blvd.Peiolumo, CA U.S.A,lMsDsl f88f;i#D N/SDSL FIRE HYDRANT-)+ FENCTFCEMERGENCY RESPONSEEQU] PMENT/ABSORBEN TSABOVTGROUNDSTORACE TANKUNDERGROUNDSTORACE TANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE LlQUIDS)BATTERY ELECTROLYTE_(coRRosLVE LrourD) :GASOLINE /,(FLAMMABLE LIQUIDS)DIESET FUEL(COMBUSTIBLE LIQUIDS)NITROGEN(COMPRESSED GAS)PROPANT(FLAI/MABLE LIQUID)ACETYLENE(coMPRESSED GAS)AN TI FREIZElCOOLANTSWASTE OIL(FLAMMABLE LIOUID)FIRE PULL BOXFLAMMABLES CABINET+ DRAINAGE FLOW DIRECTIONAUTOMATIC TRANSIVISSIONFLUIDo@@@;00.o'JL'riA-Am@@TANK MONITORINGALARMSYMND@@oo@o@@@trSTAGING AREAEVACUATION/TTLEPHONEFIRST AID KITFIRE EXTINGUISHERSTORI/ DRAINSANITARY SEWEREMERGENCY PUIIJPSHUT- OFFELECTR1CAL PANELSHUT_OFFNATURAL GASSHUT_OFFWATER SHUT_OFFIBcDEFGHJKM FORM ESAN LUIS OBISPO CITYFIRE DEPARTMENTEMERGENCY RESPONSE PLANOr Hazardous Waste Contingency Plan(see instruction Page vii)Date: 12108108SECTION I-A: BUSINESS IDENTIFICATION DATABUSINESS NAMEPacific Bell Telephone Company dba AT&T CaliforniaSE164/SNLOCAAUCITYZIP CODESITE ADDRESSSAN LUIS OBISPO93403196 SUBURBAN RDTELEPHONENUMBERFACILITY TJNIT831-372-2142BUSINESS MAILING ADDRESSCITYZIP CODESan Ramon945832600 Camino Ramon, Room 3E000Ilyour business htts o license or permilfrontany ofthelottotuing agencies, please indicate lhe document nuntbenl. Hazardous MaterialsUnderground Storage #2. Hazardous WasteGenerator #3. Air Pollution ControlDistrict #4. Responding Fire DePt& Permit #please provide the following information as it pertains to your business and its location. You are not required to notify these companies in theevent of an emergency. This infonnation is provided io, yout referenca and to assist emergcncy response personnel in responding to ahazardous materials emergency at youl' facility. List the name and phone number of the utility company.Electric ServicePacific Gasand F.lectricTelephone #800-743-5Gas ServicePacificand Electric# 800--s000SanitationSan Luisohisno Iltilities#805-78 1-l5Water DistrictSan I-uis Ohisno I ItilitiesTelephone #805-781-l5SECTION I-B: OWNER CERTIFICATION OF DATA (Certify either I or 2)1. This is a [NEw rlanUPDATED Existing Plan. I have personallyexamined the infonnation it contains and amfamiliar with theoperation ofthe plan. (Ifyou check either ofthe above two options, continue tocomplete the remained of the Emergency Response /Contingency Plan).j. n ini, plan requires no change and is on file with city of San Luis obispo Fire Department and does not need any change. (If youcheck this siction, please proceed directly to Form T, the Training Program')I certi! under penalty oflaw that the above information is true and accurate.t2108108AT&TPRINT NAME OF OWNER OR OPEMTORSteve SkandersonDOCUMENTS PREPARED BYDATEt2108108SIGNATUREDATEi:\HAIMAT\FACBELL'r?051\t:fis.g*nry Fr{espon*e Form M*rge $*C I ?/il$108Pase I of 3- SECTION II: EMERGENCY RESPONSE PLANS AND PITOCEDURESNote: Complete all sections of this Emergency Response Procedure below. Use of tenns such as "N/A" (Not Applicable) will not beaccepted.A. FIRE, spILL oR RELEASE: The fire code requires immediate notification through dialing 911, by whoever first sights theincident. In the event of release or spill of hazardous materials, you must also notify:l. City of San Luis Obispo Fire Department during business hours @ 805-781-7380. After business hours dial 911'2. The State Officc of Emergency Services - (800) 852-7550 or (916) 262'1621.List the individuals responsible for verifying that these calls have been made and also indicate their position in your company'FOR VERIFYING THE DIALING OF 9II:Sharon RamirezSite ManagerPOSITIONNAMEIndividual responsible for calling cify of san Luis obispo Fire Depanment and the state office of Emergency services: Q'{ormally theEmergency Coordinator of your business.)Sharon RamirezSite ManagerPOSITIONNAMEB.List the local emergency medical facilities that will be used by your business in the event of an accident or injury caused by areleaseor threatened release ofhazardous materials.SAN LUIS OBISPO GENERAL HOSPITAL'2I8O JOHNSON AVENUE, SAN LUIS OBISPO 805-78I-4800CITYPHONENAMEADDRESSCITYPHONENAMEADDRESSC. List the Emergency Coordinator(s) at your facilityPrimary: Sharon RamirezSite Manager 805-546-74161 805-245-4197(800) s66-9347 (800-KNOW-EHS)BUSINESS PHONE24 HR PTIONEPAGER #NAMETITLESecondary: AT&T Emergency Control Center(8oo) s66-e347 (800-KNOW-EHS)BUSINESS PHONE24 HR PHONEPAGDR I'NAMETITLED.Does your business have an on-site emergency response team? [ves XNo Describe procedures your business will follow inthe event ofa release or threatened release ofhazardous materials.The Emergrlncy SiteCoordinator/Building Wardenis responsible for following these steps asoutlined in the Hazard CommunicationManagement Handbook and theAT&T Operatins Practice 130.the HazardousMaterials/WasteL Determining2. Move peoplethe nature, location,away from the areamagnitude and severity of the incident.as appropriate.3. Avoid inhalation of all gasses, fumes or smoke'4. contain materials as ap"propriate by arranging physical bariers, use of absorbents (i,e., clirt, oil baking soda or other absorbent material)'5. Notifii appropriateemergency personnel.6l:\HA?MAT\rACBALL\2051\fnerser]cy Respcnse Fo.m Msr$e p*C l ?/$til08P^g. 3-qL 2 - E.If you have acutely hazardous materials above ttrresholtl planning quantities, list (by name and address) adjacent neighboringbusinesses and residences, schools, hospitals, etc. Include sensiiivc facilities (schools, hospitals and rest homes) within 1,000 fcct(straight-line distance from your property line). List telephone numbers for all businesses; for apartment buildings, list manager'sphone. Do not list telephone numbers for private residences'North: COMMERCIAL COMP. GAS STORAGESouth: INDUSTRIALEasr INDUSTRIALWest:The Spice Hunter, 184 Suburban Rd, SLO 93401 805-544-4466FBriefly describe your standard operating procedures in the event ofa release or threatcned release of hazardous materials'Emergency response procedures rrruit ,orply with all federal, state and local regulations. Existing emergency response proceduresmay be referenced and attached to this document.1. prevention - Describe the accident potentials associated with the hazardous materials present at your facility. what actionswould your business take to reduce accident potentials? Include description of safety, storage and containment procedures'The batteries are securely braced to prevent spills during an earthquake. Additionally, the hazardous materials are only handled byor contractors that have been properly trainedemployeesTRAINING: Appropriate employees aretrained on hazardousrnaterials/waste management. Ths training iseither leader-led or delivered inan online interactive fonnat through the A1'&T Leaming ManagementCenter. Employees are also provided tlaining annually on how toread an MSDS as required by the Hazard Cornmunication Standard; they are alsotrained on the AT&T Operating Practice 130.MATERIALS: Hazardous materials are utilized and stored following manufacturer's recommendations, as we are a consumer of products andnot a manufacfurer of hazardous materials.aEquipment * List the emergency response equipment at your facility (e.g. fue extinguishing systems, spill control equipment,decontamination equiPment).ItemMaintenance ProcedureAbsorbentsRoutine inspections and replenished as necessaryFire ExtinguisherAnnual inspection and recharged by a contractorFirst Aid KitMonthly inspection and replace items as necessaryPersonnel ProtectiveGearReplace as necessary3.Evacuation - Describe how you will immediately evacuate your facility, what communications or alarms are used? How wiyou operate these during power failure?ilPersonnelProtectionBattery AreaFirst AidFLEETAREAA4AIN BLDGFire SafetySEE SITE MAPSSpillsFLEET AREAUseLocationIn the event ofan emergency requiring evacuation while employees are present,notificationwill be given verbally and/orwith fire alarms. The evacuation routes are posted throughout the facility. Employees will exit through the nearest exit andproceed to the evacuation staging area located at: SEE EMOP BINDER7t t\HAZirjAT\PACBILL\?051 \Hff * rgensy flespons* F$rm Merg*. i)fJC 1 2/0s10t"]Page of--6- 4. Shutdown - Describe the shutdown for each site or facilityDue to regulatory requirements the emergency power system can not be shut down. If necessary, altemate power supplies can be brought tothe facility (i.e. portable generators) while the diesel tank/system is repaired.In the event of a release fiom a battery, the individual battery maybe taken out of service and replaced as necessary5a.Response - Describe what is doneprevent the event from getting worse orto lessen or mitigate the harm or damage to person(s), property' or the environment, andspreading. What is your immediate response to:Fire: Small- use a fire extinguisherLarge- call 911 if possible, evacuate and allow the fire department to respond.Explosion: Call 911 if Possible,evacuate and allow the fire department to respond'Spills: ln the event of a minor release (<10gals)from the batteries, emPloyeeswill stop the leak, if possible without risk, usingbicarbonateof soda or soda ash and/or dike the material to confine it to a safe locationFor larger spills (>1Ogals)contain the flow with absorbent and call 911 for the San Luis Obispo City Fire Department and callthe San Luis Obispo Co. Hazardous Materials Agencyisoatch operator: "you arereportinq a snill and to contact theCountv Hazardous Materials Specialist"Tellthe dSevere Ground Motion: The batteries are securelybraced to preventleaks and are inspected regularly. Additionally, thebatteries, dieseltank/fuel lines, and halon cylinders will be inspected following an earthquakeMajor Power Failure: The facilitYutilizes industrial batteries and a generator as a backup power systemFlood: The batteries are in racksthat are elevated off the floor. lt is not likely that the area will be subject to water levels thatwould impede the operation at the facilityb. Is this facility located on a 100-ycar flood plain? Xyes nNoc, Earthqualie - Identiff facility areas and list mechanical or other systems that require immediate inspection or isolation because oftheir vulnerability to earthquake related ground motion.The batteries,dieseltank, fuel lines, and halon cylinders will be inspected following an earlhquake.6, Clean-Up (Remove the Hazard)facility? Note: NotiS the HazardousMaterials Unified Program Agency when clean up is complete.-- FIow do you handle the complete process ofcleaning up, and disposing of related materials at yourThe EmergencySite CoordinatoriBuilding Warden is responsible forfollowing these steps as outlined in theHazald Communicationthe Hazardous l\'laterials/Waste MIlandbook and the AT&TPractice 130Program,Determining the nature, location, magnitudeand severify ofthe incident.Move people away from the area as appropriate.Avoid inhalation of all gasses, fumes or smoke.Contain materials as appropriate by ananging physical barriers, use of absorbents (i.e., dirt, oil baking soda or other absorbent material)Notify appropriate emergency personnel'G. Location -- your business is required to keep a copy of the Business Plan and related MSDS sheets on-site. Describewhere this infonnation is locatedA copy ofthe business plan,MSDS sheets are located at: FRONT ADMIN. LOBBY (also see site map)sl :\HAZI!141'TPACBr LL\?051 \f; n1e r'!]sncy R*sponse Form Merg+ DflC l ?lSS/08p^s"l-0r-6- FORM TSAN LUIS OBISPO CITYFIRE DEPARTMENTEMPLOYEE TRAINING PROGRAM Date:12108108A.Describe the safety training for all employees in the event of a release or threatened release of hazardous materials. Thistraining shall include, but not be limited to, the following: new employee training, annual training, periodic refreshcr courses'and famitiarization with Emergency Plans and Procedurcs of this Business Plan / Contingency Plan.Summarize the training for all employees that work with or come in contact with hazardous materials4tazardous waste. Describehow these employees are trained to avoid exposure.IAll employees whohandle hazardous materials are trained to use appropriate methods and to recognize any potentialhazards. Periodic refresher training is provided in bi-monthly safety meetingswhen required. Employees who work at thesite are familiarizedwith the location of the MSDS that are associated with the materials at the facility.All batteries that have exceeded their usefulness will be removed and recycled'2Summarize training specific to those employees that would respond to a release or threatened release of hazardous materials orhazardous wasteEmployees are trained in the properuse of a fire extinguisher. All employeeswho handle hazardous materials are trainedto use appropriate handling methods and to recognizeany potentialhazards. Periodic refresher training is provided in bi-monthly safety meetings when required.ln the event of a minor release from the batteries, employeeswill absorb the spilled material using bicarbonate of soda and/ordike the material to confine it to a safe location. Barrier tapewill be placed around the released material. Spills exceeding thecapabilities of the emploYeeswill be handled by a qualified contractorAT&T EnvironmentalManagement willbe notified to make all necessaryarrangements with an environmentalfirm forcleanup and disposal of any spills (AT&T Environmental Management: 800-566-9347) il-800-I-KNOW-EHSI7l:\HAIMAT\|*ACBEIL\?051\f meisency Response Form Merge $fiC 1 ?l0B/08pug"-g- of-Q- Jlndicate frequency and duration of training for employees that work with or come into contact with hazardous materials/hazardouswaste.All employees who handle hazardousmaterials are trained to use appropriate handling methods and to recognize anypotential hazards,Periodic refresher training is providedin ANNUAL safety meetings when required4.Describe how your employees access training materials. (E.g., bulletin board, employee newsletter, staff meetings, etc')Employees are provided rmrnl Safety plan training on the Hazard Communication Certification, as well as function,p."if,, before tirey begin their work operations. This also includes training on the Emergency operating procedures. 'rhereis also hazardous materials/waste management training for employees as appropriate. The training may either be leader-ledor taken as an online interactive course. Training is iecorded- electronically. A series of Job Aides that briefly desoribeeach of the topics accornpanies the training.Additionally, the AT&T Emergency Plan requires that employees receiveANNUAL REFRESHER training on the llazardCommunication Certiflrcatiou, function specifics and the Emergency OperatingInstructions.B.List person(s) in charge of training and indicate their qualifications to conduct the training.The training mayeither be leader-led or taken as an online interactive course. Training is recorded electronicallyC.Indicate where training records are kept. (Records must document the type of training, duration, completion dates, names andpositions of employees receiving training and the name(s) of instructors / trainer')TheAI&T EmergencYplan Binder serves as a reference guide for the Emergency Site Coordinator/Building WardenEmployeetraining records are maintained in the employee files.sI :\HAZMAT\FACBHLL\205 1 \f n*r:qcncy Response For m Merge D$C 1 2lti8/08ease 6 or-L- Emergency Response New FLEET 9-25-08.docAT&T EuERcerucY RESPoNSE PLANhazardous material or waste:The Emergency site coordinator/Building Warden is responsible for following these steps as outlined in the facilityEmergenc! plan Binder or the site spill prevention Conhol and Countermeasure (sPcc) Plan where one isrequired.1. Determining the nature, location, magnitude and severity of the incident.2. Move people away from the area as appropriate.3. Avoid inhalation of all gasses, fumes or smoke.4. Stop the retease and/6r contain materials if adequately equipped and it is safe to do so, by arranging physicalbarriers, use of absorbents (i.e., bulk absorbent materials or absorbent socks)'5. Make appropriate notifications as ouilined in the site Emergency Plan Binder and as described Notificationres section of this document.Procedustop potential hazards caused by the release of abusiness will take toThe following describes what actions ourAeltetuEl.tr (sroP THE HAZARD)be followed to minimize any harm or damage to persons'property or the environment:'Haza.rdbus vaterialg Drums: DoT approved drums are inspected for leaks and/or deterioration. Absorbentsire stored at the garage for containment of any releases'1. Motor Oil: Stored in drums in a controlled area. Drums are visually inspected daily to ensure integrity.2. Antifreeze/Coolant (New & Used): Stored in drums in a controlled area. Drums are visually inspected daily to3. Wqste oil/oil Filters: Stored in aboveground tanks or drums in a controlled area and visually inspected daily toensure integritythe procedures that mustfolThedescribeshttnsecuandstandsred4.gassesnaareCoSEmpressedstoredarea.parateandcontrollednsurentegrity.Mrrceloru (neouce rHE HAZARD)release from occurring:1. Tmrrurruc: AT&T employees are required to complete a variety of training related to the management, use,storage anO propei handling of hazardous materials and hazardous wastes' The type and frequency oftrainiig is dependent upon tfie employee's job responsibilities and is delivered in a classroom environment oron-linethrough one of AT&T's Learning Management Systems'2. Mnrennls: Hazardous materials are utilized and stored following manufacturer's recommendations, as ourbusiness is a user of chemical products and not a manufacturer of hazardous materials.hazardous materials or hazardous wastesiness will take to Prevent aThe following describes what action our bu&TATAT&T&T's&TreAiluiredVleasetonotificationsanbedonewill&SEHncidentManeifdetermicytheofnotificationCaliforniaEmergenOfficeofngLocarvicesandSenisteriAdmlAgencieststheandEnvironement&HealthOrganizationSafetyESCThwithalsoworkwillLegalEH&SandtoASenginternalcontactsappropriatethincludinformationOperationsnteControlCeS),loca(otccecurityOfficencysiteanuildingEmergorgizationmergencytheEAdditionallySitetmmedCoordinatorwl&T'SiatelynotifyASaemergencleshazardoussuchsocidentmaterialslnASlnphowtoandehelevacuateterdirectedlace,thbyoccupaupentsresponarebuildingtheofrvlsorsSonsibleOWtheirforadvisingreportsdirecttohreportncyemergeeplanactionthe(iATEmergencyPlanethe0forBindethatISfacilitybytheforavailablrevrewencyenPEmerglanTheBindEmergencySitecomponsres(ESCatoCoordinanrsthefacilityforforblepletingATPracticeOperatingramFire0(The13nProgSafetyandEmergencyisdPlatheATescribedtnI:\HAZMAT\PACBELLV-FORMS\Emergency Response New FLEET 9-25-08 docLast Updated: 1218120081 (IEmergency Response New FLEET 9-25-08'docMETHOD OFALARM TO EMPLOYEES:Vocal, intercom and fire alarms are used to notify our employees to evacuate'RourES OF EGRESS:This also varies with each building and should be verified with the Emergency Site Coordinator of eachfacility. A standard statement would be:"Employees exit through front, rear and side doors. Alternate routes include."'"The instructions for ei'terg"n.y exists and alternate routes to be used for evacuation are posted oneach floorMerHoo ro AccouNT FoR ALL Pensorus:The AT&T Operating practice 130 identifies the Emergency Site Coordinator/Building Warden as theindividual responsible for working with the location management to determine occupant accountability in theevent of an evacuation or othei emergency. This includes the establishment of assembly areas whereaccountability can be determined. Employeei for this facility are instructed to meet..... (obtain this informationfrom the Emergency Site Coordinator/Building Warden).ALERTING NEIGHBORS:The AT&T Operating practice 130 identifies the Emergency Site Coordinator/Building Warden as theresponsible contact to work with all agency emergency/rescue personnel to notify facility adjacent properties'Site Coordinator of each facility. Averified with the EmergencYThis varies with each building and should bestandard statement would be:Contractors utilized to clean up spills and releases for our facilities include1. Shaw EnvironmentalDiesel Fuel: The AT&T Hazardous Materials Management Plan ltem G (Contingency Plan): outlines thenotifications required for incidents involving spills which include::&Tpcomanyvendorclean-uonspletingandl/releasespilnotificatiancoenagutyDEHMcident&Ssrepotontactedisangwithalassistcludils,tnpilrtedspiloftspatchdngureronperatinternalo6-S-1EProcedHument,nvtEPloH&SafetyHealthrocedinePotlrgs"On-AnposkitspillncyrgeemeandwasteinformationASremanagaitiondiscalEH&SedTinAdescribednnpre-pesonnglngngrefacilitin-uprecognlzlgonls,spilportiandteqectsdcleaspilgnmakinulredtntraiemergencyrepostonertedbespiltoergencyemHotltheEH&SmocuSprompt1ntdThtnstructsalso&TATPracticeareqUSpilEH9-.1200-PRC"SmallrncClean-uResponseandrresp"nddenta6. AT&T1. Local Fire DePartment2. Department of Public Health3. AT&T Operations lnformation ControlCenter4. AT&T Environment Health & Safety5. AT&T Real Estate Client Service CenterSprlt-s AND LEAKs oF HAzARDous MATERIALS:areuannlessthemncedcoimpactingJonmpletebmustwithnrngtheirtramayponsresdays90ndnotperformbilitiesenvironmentalewngAT&oreTrainTHE&SempNMatrices.anmployeesenvtrontraloyeeswhomentatntonsferllycomEcmployeesWOetspletefuasthatnrngtranction-specifirkforthoutloperationstheapplicablenedlnEnnplovee Tnnrutruc:I:\HAZMAT\PACBELLV-FORMS\Emergency Response New FLEET 9-25-08 docLast Updated : 1218 120082 EFLEET 9-25-08.docAT&T has emergency responseplans and procedures inplace for all facilities. The following is a descriptionof the programs and procedures in place:1. The O-perations lnformation CorurRor CeHrcn (OICC) is a 24-hour communications center establishedthrough which emergency condition information flows from and within AT&T. ln the event of a majoremerlency the cent6r alio provides coordination, communications and is the established liaison withfederal, state, local and military agencies'2. EMeRceNcy PLAN BrruoeR, The AT&T Operating Practice 130 provides fire, safety and emergencyguidance, checklist, forms, and company contacts for emergency situations, interruptions of companyiervices, and other threats to our operations, facilities, personnel or property'Ouilined in the AT&T Operating practice 130 is the Emergency Site Coordinator/Building Wardenprogram. The Emergency Site Coordinator/Building Warden is involved in directing and coordinating thefollowing activities with the occupants of the facility.o Establishing and training the building emergency organization'r lmplementing the Emergency Procedure Plan.r Occupant emergency preparedness'r Reviewing the Planning Engineering sketch.r Establishing and maintaining the Emergency Procedures Board'r Developingiand maintaining tfre Emergency Methods and Procedures (EMOP) binder.r Scheduling ano conductin! semi-annual fire and take cover drills and recording drill results on theFire/Evacuation Drill RePort.o Conducting fire safety surveys using form SBC3077r Daily administration of fire prevention practices.o Reporting all bomb threats to appropriate security office and the ECC.r Advising security of all emergencies.I Accompanying external or internal agencies on building inspections.r Arranging for selection of Emergency Site Coordinator/Building warden successor (transfer ofresponsibilities).I Communicating to occupants via emergency communications systems (if applicable)'r Contact the Environment Health and Safety Organization in the event of an OSHA visit.The AT&T Operating Practice 130 also requires that each facility have an Emergency Plan binder' Thebinder is a guide pioviding for personal protection and emergency procedures for company locationsduring emerlencies. The b'inder is developed and held by the Emergency Site Coordinator at each facilitylocation wfren tfre minimum legal required building headcount is reached.Additionally, the AT&T Operating Practice 130 provides the following procedures for the Emergency SiteCoordinator and Site Managers in the event of a hazardous materials incident at the facility'1. ldentify and locate the problem.2. lsolate, relocate or evacuate employees as required'3. Notify emergency rescue personnel if needed.4. lnvestigate the Problem.5. Avoid inhalation of all gasses, fumes or smoke.6. lf the release or threatlned release has the potential to harm the population and environment contact:.Operations lnformation ControlCenter 877-3224722.AT&T Environment Health & Safety Hotline 800-KNOW EHS (800-566-9347)' prompt 1. Environmental Control Center for Fuel Storage Tanks 800-KNOW EHS (800-566-9347)' prompt 1.Asset Protection (AT&T) 800-8074205.Local Hazardous Emergency ResponseAgency 911r office of Emergency services (oES) 800-852-75503. ln the event of a sPillHazardous Materials lncidentor release, onsite personnel call 1800 KNOW EHS to report the incident theis to be comAT&T's Environment Health &Emergency Response PlanI:\HAZMAT\PACBELLV-FORMS\Emergency Response New FLEET 9-25-08 docLast Updated : 12/8/2008J PROGRAM CONSOLIDATED FORMBUSINESS ACTIVITIESFACILITY INFORMATIONPageE. LOCAL REQUIREMENTS(You may also be required to provide additional information by yourcUPA or local agency )1ENeed to report the closure/removal of a tank that was classified asD. HAZARDOUS WASTE1. Generate hazardous waste?2. Recycle more than 100 kg/month cf,excluded or exemptedrecyclable materials (per HSC ! zslqg'z\z3. Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permitby Rule and Conditional authorizaton)?Consolidate hazardous waste generated at a remote site?64.5.hazardous waste and cleaned onsite?flveslTlNo,oYESfJNol2YESlTlNol3fy'ves f]NO11YEs ElYES E]NOeNO10EPA lD NUMBER-provide at the top of this pageRECYCLABLE MATERIALS REPORT(one per recycler)ONSITE HAZARDOUS WASTETREATMENT - FACILITY(Formerly DTSC Form 1772)ONSITE HAZARDOUS WASTETREATMENT-UNlTlone page per unit)(Formerly DTSC Form 1772A,8,C,D' and L)CERTIFICATION OF FINANCIALASSURANCE (Formerty DTSC Form 1 232)REMOTE WASTE/CONSOLI DATION SITEANNUAL NOTI Fl CATION (FormerlYDTSC Form 1232)HAZARDOUS WASTE TANK CLOSURECERTIFICATION lFormerty DTSC Form 124e)3. Need to rePort closing a UST?C. ABOVE GRoUND PETROLEUM STORAGE -[ANKS (ASTs)- Own or operate ASTs above these thresholds:--any single tank capacity that is greater than 'l ,320 gallons' or--cumulaiive storage of 1,320 gallons stored in containers 55 gallons1. Own or operate underground storage tanks?2. lntend to upgrade existing or insiall new USTs?or greater?YES MNo 5YES lv/lNo 6[.]vrsp]lro z[ ]vesflruo uUST FACILITY (Formerly SWRCB Form A)UST TANK (One page per tank) (Formerly Form B)UST FACILITYUST TANK (One Per tankUST INSTALLATION . CERTIFICATE OFCOMPLIANCE(one page per tank)(Formerly Form C)J UST TANK (ctosure portron-one page per tank)J NO FORM REQUIRED TO CUPASHave on site (for any purpose) hazardous materials at or above 55gallons for tiquiOs, SbO pounds for solids, or 200 cubic feet for6ompressed gases (include liquids in ASTs and USTs); or theapplicable Feleral threshold quantity for an extremely hazardoussubstance specified in 40 CFR Part 355, Aappendix A or B; orhandle radiological materials in quantities for which an emergencyplan is required pursuant to 10 CFR Parts 30' 40 or70?pvesINO4HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION(oES 2731)lease complete these pages of the UPCF.Does your facilitY..lf Yes, pNOTE: lf you check YES to anY Partse submit the Business owner/operator ldentification page (oES Form 27301-pleaof this list,I. ACTIVITIES DECLARATIONSE164 '196 SUBURBAN RD SAN LUIS OBISPOCompany dba AT&T CaliforniaPacific BellTelePhoneFACILITY NAME or DBA-Doing Business AS)INESS NAME (Same asACILITY ID#EPA lD# (Hazardous WastecATo800242682Only)FACILITY IDENTIFICATION2uPcF (1/99) .,ROGRAM CONSOLIDATEDFORMFACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATION Crrr103USINESS SITE ADDRESS196 SUBURBAN RDPHONE831-372-2142BUSINESS NAME102FACILITYemneBelPacificTCoa&ATdbaiforniCaTSE641or(SameNAMEDBAAs)DoingBusiness1,,,"=ji:', 1t'il rr:':: Ii '::::::: 11BEGINNINGDATE0110112007roo lnNorNc pateI 'trrztrzoot101ACILITY ID#NPage 2- of117120TATECODE93403SIC CODE (4 disit #)4813121ACT PHONE925-823-8866CODE94583-0995CA105CITYSAN LUIS OBISPO106109CA107108DUN BRADSTREET1 0-340-1 61 8SAN LUIS OBISPOBUSINESS OPERATOR NAMESharon RamirezII.CITYiiSAN RAMONACTNAMEEnvironment Health & Safety, attn: James StehrACT MAILING ADDRESS2600 CAMINO RAMON, RM 3EOOOSAN RAMON114CONTlcoNr118119122104115ATECA11694583-0995CODEPacific Bell Telephone Company d/b/a AT&T California111NAME1 '13112MAILING ADDRESSP.O. Box 5095, Room 3E000PHONE800-566-9347110INESS OPERATOR PHONE805-546-741 6PRIMARYIV. EMERGENCY CONTACTSSECONDARYEMERGENCY CONTROL CENTER24 HR EMERGENCY SERVICESharon Ramirez124126127128129Site Manager125INESS PHONEPHONEAGER#805-546-741 6800-566-9347 (800-KNow-EHS)LOCALLY COLLECTED INFORMATION132800-566-9347 (800-KNOW EHS)PHONE131877-322-4722USINESS PHONE1309t1412007SIGNATURE OF OWNER/OPERA134TEiliarwiththeinformationtrue,thebellevesubmittedandaccurate,lsinformationandcomplete.nqulryonmyBlngasedindividualsofthosetheobtainresponsibleforgxamlcertifyinformation,IamIlawthatpenaltyofundernedpersonallyhaveandNAME OF DOCUMENT PREPARERRHL DESIGN GROUP, INC. - AGENT FOR AT&TProject Manager - Agent for AT&T135AME OF SIGNERSteve SkandersonUPCF (l/00 revised)136t67OF SIGNERoES FORM 2730 (1199) MAXIMUM DAILY AMOUNT218219WASTE AMOUNT120XXb. REACTIVEC.PRESSURE RELEASEd, ACUTE HEALTHE.CHRONIC HEALTH216VERAGE DAILY AMOUNTA. FIRE217FED HAZARD CATEGORIESall that apply)XA, SOLIDc. GASb, LIQUID214one itern only)STATELARGESTCONTAINER 55215X212YesRADIOACTIVENoIf EHS is "Yes", all amounts below must be in lbs.XYesNoEHS208lfsubject to EPCRA, refer to instructionsX206NoYesTRADE SECREThone Company dba AT&T CaliforniaSE1 64BUSINESS NAMEoPacific Bell TelePI. FACILITY INFORMATIONADDDELETEREVISE2AOPageofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)HAZARDOUS MATERIALSPROGRAM CONSOLIDATED FOII. CHEMICAL INFORMATIONLOCATION CONFIDENTIALYES,El*o203GRID# (optional)F4,G5CURIESWASTE CODE202I,OCATIONSTORED IN SHOPMAP# (optional)1204FAC|L|TY lD# |NAME205209207lcassNAMEMOTOR OIL (All Grades)FIRE CODE HAZARD CLASSES(Complete ifrequired by CUPA)MATERIALIII-B COMBUSTIBLEa. PUREb. MIXTUREc. WASTEa. GALLONSb. CUBIC FEET210213(Check one itetnifam^rrnf milcf211c. POLJNDShe in nounds.220222[] o. roNs 221DAYS ON SITE:365one item only)XXAINERABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMi, FIBER DRUMBAGBOXCYLINDERCANCARBOYSILOGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAIL CAROTHER0514iSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTCRYOGENIC%wr15-20234238IfmorehaardouscomponentsarepfsentatgfeaterthanITobyweightifnon-carcinogenic,or0.l%byweightifcarcinogenic, attach additional sheets ofpapet @pturing the required informationADDITIONAL LOCALLY COLLECTED INFORMATION223224225CAS#245242246lf EPCRA, Please Sign HereXX243es244239240[v".241Additives235esozJoProprietary23721230Zinc Compound2319S232Proprietary233I eo-ss226LUBRICATING BASE OIL227228Various229HAZARDOUS COMPONENT (For mixture or waste only)EHSIUPCF (1/e9)169OES Form 2731 ABOVE GROUND TANKLTNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAIONMETALLIC DRUMCANCARBOYsILoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON223AINER1201f.RAIL CAROTHER222DAYS ON SITE:365AXIMUM DAILY AMOUNT218219WASTE AMOL]NT1 000ATE WASTE CODE220XX214(Check one iternMATERIAL211c. WASTEone item only)STATEa. SOLIDA. PUREb. LIQUIDb. MIXTUREC. GASX212NoYesRADIOACTIVE213CURIES1203MAP# (optional)1STORED IN YARDCHEMICAL LOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell Telephone Company dba AT&T GaliforniaSE164USINESS NAME3I. FACILITY INFORMATIONADDDELETEREVISE200of)PageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)HAZARDOUS MATERIALS-,, PROGRAM CONSOLIDATEDGRID# (optional)E3204ACILITY ID#II. CHEMICALINFORMATION205TRADE SECRETYesNoIfsubiecl lo EPCRA, refer to inslructions206NAMELiquified Petroleum Gas2072091)nA1COMMON NAMEPROPANE74-98-6CODE HAZARD CLASSES (Complete if required bv CUPA)HAZARD CATEGORIESall that apply)VERACE DAILY AMOUNT217UNITS*one item onSTORAGE PRESSUREEHSYesNoLCAS#If EHS is "Yes", all amounts below must be in lbse.CHRONIC HEALTHFlammable GasLARGESTCONTAINER 250a. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTH210215216224Ala. GALLONSb. CUBIC FEETc. POUNDSA. AMBIENTABOVE AMBIENTI a. roNs 221BELOW AMBIENTXXXXXXSTORAGE TEMPERATUREEl u otutu*tABOVE AMBIENTBELow AMBIENT [ ]o cnvoceNrc225t-icIllo/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHS22622722874-98-6PROPANE231PropyleneIf more haardous components are pr6ent at gfeater than I % by weight if non-carcinogenic, or 0. lo4 by weighl ifcarcinogenic, attachADDITIONAL LOCALLY COLLECTED INFORMATIONCAS#aaoIf EPCRA, Please Sign HereIr123023465<35<6tF2465 <0.1242Ethyle Mercaptan243[v* EN" 24475-08-12454<5238Total Butanes23924078-28-5241Ethane236!v"' EN"74-84-02372321',t5-07-1233UPCF (l/99)169additional sheets ofpaper mpturing the required informationOES Form 2731 tl1XWEST SIDE OF SHOPLOCATION202NOLOCATION CONFIDENTIALYESPacific Bell Telephone Company dba AT&T CaliforniaSE164BUSINESS NAMEI. FACILITY INFORMATIONJADDDELETEREVISE200oflPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)HAZARDOUS MATERIALSPROGRAM CONSOLIDATED FOMAP# (optional)203GRID# (optional)F5204ID#II. CHEMICAL INFORMATIONUSED MOTOR OIL(Complete ifrequired by CUPA)COMBUSTIBLE LIQ.3Ba. PUREb. MIXTUREc. WASTEABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMzu5TRADE SECRETYesix1N"IfSubject to EPCRA, refer toinstructionsEHSYesXNoIf EHS is "Yes", all amounts below must be in lbs.206NAME207208210NAMEICAS#209FIRE CODE HAZARD CLASSES211MATERIAL(Check one iternFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAIL CAROTHERll"llpXX221VERAGE DAILY AMOTJNTDAILY AMOUNT217218222220a. GALLoNS f -l u. cunlc FEEr n c' PoUNDSTATE WASTE CODE219UNITS*Check one item365DAYS ON SITE221d. TONSWASTE AMOUNT240FED HAZARD CATEGORIES(Check all that apply)XXa. FIREc.PRESSURE RELEASEb. REACTIVEe,CHRONIC HEALTHd. ACUTE HEALTH216Xa. SOLIDc. GASb. LIQUID214one item only)STATELARGEST CONTAINER 240215XYes212RADIOACTIVENoCURIES21301STORAGE PRESSUREFl u o*"'uttCANCARBOYSILO223ABOVE AMBIENTBELOW AMBIENT224naFABOVE AMBIENTBELOW AMBIENTCRYOGENICSTORAGE TEMPERATUREA, AMBIENT%v'/TI 1oo%226230ADDITIONAL LOCALLY COLLECTED INFORMATION238246If EPCRA, Please Sign Hereat greater than I % by weight if non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper 6ptuting the required informalionIfmore hazardous components are prsent242243es244245239eso2402413234235es236237231ESlcJMOTOR OIL, USED227es2288002-05-9229HAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#UPCF (1/ee)169OES Form 2731 PROGRAM CONSOLIDATED FOHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)LOCATIONEAST SIDE OF SHOPII. CHEMICAL INFORMATIONTRADE SECRETYesNo206IfSubject to EPCRA, referto instructionsNAME207208DRAINED USED OIL FILTERSEHS209If EHS is "Yes"- all arnounts below rnust be in lbs.CODE HAZARD CLASSES(Complete ifrequired by CUPA)210COMBUSTIBLE LIQ. 38211HAZARD MATERIALa. PUREb, MIXTUREC, WASTE(Clreck one iternSTATEA. SOLIDb, LIQUIDC. GAS214one itern only)216a. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTHVERAGE DAILY AMOTINT217a. GALLONSb. CUBIC FEETC. POLTNDSI o roNs 221one itemi- I "* [4 *"05TORAGECONTAINERIi sronace PRESSUREABOVE GROUND TANKUNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMA. AMBIENTPLASTIC/NONMETALLIC DRUMCANCARBOYSLOABOVE AMBIENTi. FIBER DRUMBAGBOXI, CYLINDERBELOW AMBIENTGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAILCAROTHER223STORAGE TEMPERATUREA. AMBIENT[ ]u eeovrAMBrENr ilc. eeLowAMBrENr l- lc. cnvoceNlc225222DAYS ON SITE:365DATLY AMOLINT 218WASTE AMOTINT219220223TATE WASTE CODELARGESTCONTAINER 55215XYes212RADIOACTIVENo213CTJRIESNAME205ID#I203MAP# (optional)1204GRID# (optional)F4X202NOLOCATION CONFIDENTIALYEShone Company dba AT&T CaliforniaSE164BUSINESS NAMEI. FACILITY INFORMATIONPacific Bell TelepADDDELETEREVISE200of t{Page AXXXXXXXX%wrHAZARDOUS COMPONENT (For mixture or waste only)226USED OIL FILTERS230USED OILADDITIONAL LOCALLY COLLECTED INFORMATIONEHSCAS#229233If EPCRA, Please Sign HereL2312288002-05-98002-05-9i3234238242246at greare, than l% by weight if non-carcinogenic, or 0. l7o by weight ifcarcinogenic, attach additiolal sheets of paper mpturing the required informationlfmore haardous components are prsent243244245239240241aaE236237$"'232UPCF (l/99)169OES Form 2731 DIETHYLENE GLYCOL231l50226ETHYLENE GLYCOL227228$.' FJu"HAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#222DAYS ON SITE:365Xa. PUREc. WASTEb. MIXTURE211(Check one iternMATERIAL213CURIESCOMBUSTIBLE LIQ.38CODE HAZARD CLASSES(Complete ifrequired by CUPA)210107-21-'lCAS#209IfEHS is "Yes", all amounts below must be in lbsXNoYesEHS208X2061203204IfNoYesMAP# (optional)TRADE SECRETto EPCRA, refer to instructionsGRID# (optional)F41"",.lf,.,,1',1FACILITY ID#[,,]t:1l:':.,, ri;l i13HEMICAL LOCATION CONFIDENTIALXNOYESEPCRA202REVISE200ofPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)HAZARDOUS MATERIALSPROGRAM CONSOLIDATED FOADDINESS NAMEICAL LOCATIONCHEMICALNAMENAMEDELETEI. FACILITY INFORMATIONPacific Bell Telephone Gompany dba AT&T CaliforniaSTORED EAST SIDE SHOPII. CHEMICAL INFORMATION205GLYCOLSUSED ANTIFREEZERADIOACTIVEYesNoSTATE[] a. solrDb. LIQUIDc. GAS214LARGEST CONTAINER 55one itern only)aSE164207212215216FED HAZARD CATEGORIES(Check all that apply)AVI]RAGE DAILY AMOUNT55iUNII-S*jlCheck one item only)TORAGEABOVE GROUND TANKIJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMAINERSTORAGE PRESSUREA. AMBIENTSTORAGE TEMPERATUREA. AMBIENT%wT1%40WATERI u. neecIVE Jl c.PRESSURE RELEASE fl a. ecure HEALTH217XIMUM DAILY AMOUNT 218UAL WASTE AMOUNT55a. GALLONSb- CUBIC FEETf] c. PotrNDs I d, roNS 221TIa. FIREPLASTICAIONMETALLIC DRUMCANCARBOYSILOABOVE AMBIENTABOVE AMBIENTFIBER DRUMBAGBOXCYLINDERBELOW AMBIENTBELOW AMBIENTe.CHRONIC HEALTH219TATE WASTE CODE343GLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONCRYOGENIC107-21-1220RAIL CAROTHER06tta224225229lt.,232aeazJt230234235111-46-67732-18-5zJvES[^]r"236240241lq238242243esIfnore hazardous components are ptsentat greater than l% by weight ifnon-carcinogenic, or 0. l7o by weight ifcarcinogenic, attach additional sheets ofpaper opturing the required information|J"'245244246lf EPCRA, Please Sign HereXXXXXXUPCF (1/99)LOCALLY COLLECTED INFORMATION169OES Form 2731 PROGRAM CONSOLIDATED FOHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)Page ? ofI. FACILITY INFORMATIONJBUSINESS NAMEI,OCATIONPacific Bell Telephone Company dba AT&T GaliforniaSTORED IN SHOPII. CHEMICAL INFORMATION205HYDRAULIC FLUIDCODE HAZARD CLASSES(Complete ifrequired by CUPA)III-B COMBUSTIBLE211HAZARD MATERIALa. PUREb. MIXTUREc. WASTE(Check one iternVERAGE DAILY AMOUNT217AL WASTE AMOUNTTJNITS*sE't64IinacrLlrv torNAMENAMESTORACECONTAINER05207209210219STATE WASTE CODEDAYS ON SITE:365220222Check one itenr ortlY)f l a. cer-r-oNs !b. CUBIC FEETc. POUNDSI a. roNs 221ilEHS- amorurlnruslbe in Bounds,.a. ABOVE GROUND TANK ie.i iu uNnancRouND rANK i Itc. TANK INSIDE BUILDING iCi X 'a. Sreel OnUV ,hilPLASTIC/NONMETALLIC DRUMCANCARBOYSILOl.FIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WACONI o. RAIL CARiiI lP orHERDAILY AMOIJNT 218XXa. FIREc.PRESSURE RELEASEb, REACTIVEd. ACUTE HEALTHe,CHRONIC HEALTH216HAZARD CATEGORIESall that apply)Xone item only)a. SOLIDc. GASb. LIQUID214STATELARGESTCONTAINER 55215XYes212NoRADIOACTIVE213CURIESIfEHS is "Yes", all arnounts below rnust be in lbsXNoYesEHS208Xto EPCRA, refer to instructions206IfNoYesTRADE SECRET1XIlves204202NOGRID# (optional)203LOCATION CONFIDENTIALEPCRAF4,F3MAP# (optional)1ADDDELETEREVISE200XXSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTl= lc. BELow AMBIENTSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTCRYOGENIC2 1-2230234Ifmore hazardous components are present at greaterthan I % by weight if non-carcinogenic, or 0. l% by weight ifcarcinogenic, attach additional sheets of paper 6pturing the fequired inlormation.ADDITIONAL LOCALLY COLLECTED INFORMATION223224zJt241245If EPCRA, Please Sign Here225246X5242243eso24442382399S240es236231AdditivesES232ProprietaryzJcI ga-gg226Lubricating Base Oil227es228Various229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#UPCF (l/ee)169OES Form 2731 PROGRAM CONSOLIDATEDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)II. CHEMICAL INFORMATION205TRADE SECRETYesNoCHEMICALNAME]COMMON NAME206208207EHSYesNoAUTOMATIC TRANSMISSION FLUIDtnolfEHS is "Yes", all alnounts below lnust be in lbsHAZARD CLASSES (Complete if required bv CUPA)210213ztoMATERIAL(Check one itemSICAL STATEone itern only)IAVERAGE DAILY AMOLJNT217one item only)III-B COMBUSTIBLE211CURIESa. PUREb. M1XTUREc. WASTEA. SOLIDb. LIQUIDc. GAS214A. FIREb, REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHf ] e.cHRoNIC HEALTHa. CALLONSb, CUBIC FEETc. POTINDSPLASTIC/NONMETALLIC DRUMI a. roNs 221AINERABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAILCAROTHER05CANCARBOYh. SILOll223-224 :ABOVE AMBIENTc. BELOW AMBIENT222DAYS ON SITE:365DAILY AMOUNT 218WASTE AMOLJNT219220WASTECODELARGESTCONTAINER 55X212NoYesRADIOACTIVEACILITY ]D#1203MAP# (optional)1F4204GRID# (optional)X202NOLOCATION CONFIDENTIALYESPacific Bell Telephone Company dba AT&T CaliforniaSTORED IN SHOPSE164JUSINESS NAMEI,OCATIONI. FACILITY INFORMATIONADDDELETEREVISE200of ttPageXXXXXXSTORAGE PRESSUREl{u otutt*t [lot-lo225STORACE TEMPERATURElxlu nvamNt i 1uABOVE AMBIENTBELOW AMBIENTCRYOGENIClr%WTHAZARDOUS COMPONENT (For mixture or waste only)EHSlzoSolvent refined Petroleum Oils22750-7020-402300-10234Ifmore hazardous components are prsent at greater than I% by weight ifnon-carcinogenic, or 0 l% by weight ifcarcinogenic,ADDITIONAL LOCALLY COLLECTED INFORMATIONCAS#If EPCRA, Please Sign Here246243zJo2391-50-1 0AminesPolyosobutenyl Succinimideeso24468439-80-5245eso24067762-77-0241Petroleum solvent refined235ES23664741-97-5237Base Stock231es23264741-88-4233es22864741-89-5229UPCF (l/9e)169attach additional sheets ofpaper apturing the required information'OES Form 2731 PROGRAM CONSOLIDATED FOHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or area)I. FACILITY INFORMATIONcBUSINESS NAMELOCATIONNAMEiCOMMON NAMEI NITROGENCODE HAZARD CLASSES (Complete if required bv CUPA)INERT GASHAZARD MATERIALa. PUREb. MIXTUREc WASTE(Check one itemSICAL STATEone item only)[l a. sor-ro f 1u r-rOuroc. GASPacific Bell Telephone Gompany dba AT&T CaliforniaII. CHEMICAL INFORMATION205NITROGENSE164212RADIOACTIVEYesNoCURIESLARGEST CONTAINER OID#207210213211214215216HAZARD CATEGORIESall lhat apply)r-l a. Frne [l u nrecrtuE E I c.PRESSURE RELEASE l_ld. ACUTE HEALTHf :l e.cHRoNIC HEALTH7727-37-9209If EHS is "Yes", all amounts below mrtst be in lbs.XNoYesEHS208X206IfNoTRADE SECRETto EPCRA, refer to instructionsYesIMAP# (optional)203204GRID# (optional)X202NOLOCATION CONFIDENTIALYESADDDELETEREVISE200Page lO of tKXX217MAXIMUM DAILY AMOUNT218AL WASTE AMOUNTa. GALLONSb. CUBICFEET f ] c. PouNDSI o. roNs 221219STATE WASTE CODE]SIUNITS*ilcheck one item only)TORAGEAINERABOVE GROUND TANKUNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsLoFIBER DRUMBAGBOXGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAIL CAROTHERn.o.I, CYLINDER230231235zJo242Ifmore haardous components are prsent at greater than l% by weightif non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper @ptu.ing the required informationADDITIONAL LOCALLY COLLECTED INFORMATIONzzJl3'4241245239243246If EPCRA, Please Sign HereXes244es[]*o232240zJotzoI 1oo%NITROGENo[v.'2282377727-37-9233229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#X[u. eaovr AMBIENT ItSTORACE TEMPERATUREA. AMBIENTBELOW AMBIENTCRYOGENIC225STORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224222DAYS ON SITE:365UPCF (1/99)169OES Form 2731 DAILY AMOUNT 218WASTE AMOUNT219XA. FIREC.PRESSURE RELEASEb, REACTIVEC.CHRONIC HEALTHd. ACUTE HEALTH216HAZARD CATEGORIESall that apply)LARGESTCONTAINER 228215XXone item only)STATE214211A. SOLIDA. PUREb. LIQUIDb, MIXTUREC. GASC, WASTE(Check one itemMATERIALX212YesRADIOACTIVENo213CIJRIESINERT GASFIRE CODE HAZARD CLASSES(complete ifrequired by CUPA)210IfEHS is "Yes", all amounts below must be in lbs.XYesNoEHS208HELIUMCHEMICALNAME205Xto206IfNoTRADE SECRETrefer to instructionsYes1ADDDELETEREVISE200PageofHAZARDOUS MATBRIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)HAZARDOUS MATERIALS, PROGRAM CONSOLIDATED FORN'UNI. FACILITY INFORMATIONUSINESS NAMEPacific Bell TelePhone Company dba AT&T CaliforniaI-OCATIONSTORED IN OFFICESE164LOCATION CONFIDENTIALe202MAP# (optional)1207NO203GRID# (optional)F3TATE WASTE CODEi lvas204ACILITY ID#NAMEHELIUM7440-59-7VERAGE DAILY AMOLTNTII. CHEMICAL INFORMATION209217a. GALLONSb. cuBrc FEEr [l222q am^ilnl mrlsfc. POUNDShe in norrnds.[] o. roNs 221DAYS ON SITE:365ione item only)ifXXTORAGEAINERABOVE GROUND TANKUNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMi. FIBER DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINp. TANK WAGONRAIL CAROTHER2CANCARBOYSILOBAGBOXCYLINDERSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTCRYOGENlCI 1oo226Ifmore hazardous components are prsent at greaterthan l% by weight if non-carcinogenic, or 0. I % by weight ifcarcinogenic, attach additional sheets of paper 6pturing the required information224X5242243es244245256239ES240241235esEN" 236z230231232HELIUM2272287440-59-7tao%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#246ADDITIONAL LOCALLY COLLECTED INFORMATIONIf EPCRA, Please Sign HereUPCF (1/e9)169OES Form 2731 PROGRAM CONSOLIDATED FOIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or area)rI. CHEMICAL INFORMATION205TRADE SECRETzuof lv"' i4r"NAMEiCOMMON NAMEARGONIfSubjectto EPCRA, refer lo instructions2077440-37-1CODE HAZARD CLASSES(Complete ifrequired bY CUPA)IHAZARD MATERIALlrvpE(Check one iternSTATEone itern only)HAZARD CATEGORIESall that apply)VERAGE DAILY AMOUNT217TORAGEABOVE GROUNDTANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMAINER12PLASTIC/NONMETALLIC DRUMCANCARBOYSLOEHSll v'. LIjNoIfEHS is "Yes", all arnounts below rnust be in lbsGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONARGON209NON-FLAMMABLE GAS211a. PUREb, M1XTUREc. WASTEa. SOLIDb, LIQUIDc. GAS214a. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHf l e.cHRoNIC HEALTHTATE WASTE CODEDAYS ON SITE:365210216220222i. FIBERDRUMk.BAGBOXCYLINDERRAIL CARp. OTHER5242243244245238239!v.'240241235ES236231oes232233ARGON227es2287440-37-1229EHSone item onlya. GALLONSc. POTINDSb. CUBIC FEETI o. roxs 221DAtLy AMOLTNT218NNUAL WASTE AMOUNT219LARGEST CONTAINER 222215X212RADIOACTTVENoYes213CURIES1203MAP# (optional)1F4204GRID# (optional)FACILITY ID#LOCATIONSTORED IN SHOPX202NOLOCATION CONFIDENTIALYESPacific Bell Telephone company dba AT&T CaliforniaSE164USINESS NAMEJFACILITY INFORMATIONI.ADDDELETEREVISE200PageofXXXA. AMBIENTI lu. ,teove AMBIENTBELOW AMBIENT224225STORAGE PRESSURE[]c. ner-ow AMBTENT i ]oiItllIrsroRAGE TEMPERATURE ix lu otutu^tlloABOVE AMBIENTCRYOGENIC%v'tTHAZARDOUS COMPONENT (For mixture or waste only)100226230Ifmore hazardous components are prsent at greater than l7o by weight ifnon-carcinogenic, or 0 l% by weight ifcarcinogenic' attachADDITIONAL LOCALLY COLLECTED INFORMATIONCAS#If EPCRA, Please Sign Here1234246UPCF (l/e9)169additional sheets ofpaper 6pturing the required information'OES Form 2731 FORM ESAN LUIS OBISPO CITYFIRE DEPARTMENTEMERGENCY RESPONSE PLANOr Hazardous Waste Contingency Plan(see instruction Page vii)Date: 09114107SECTION I-A: BUSINESS IDENTIFICATION DATABUSINESS NAMEPacific Bell Telephone Company dba AT&T CaliforniaSEI64/SNLOCAAUCITYZIP CODESITE ADDRESS196 SUBURBAN RDSAN LUIS OBISPO93403TELEPHONE NUMBERFACILITY I.JNIT831-372-2142BUSINESS MAILING ADDRESSCITYZIP CODESan Ramon945832600 Camino Ramon, Room 3E000Ifyour business has a license or permitfrom anyofthefotlowing agencies, please indicste the document numher'l. Hazardous MaterialsUnderground Storage #2. Hazardous WasteGenerator #Electric ServicePacificand ElectricGas ServicePacificand F.lectricSanitationSan Lobisno UtilitiesWater DistrictSanObisoo3. Air Pollution ControlDistrict #4. Responding Fire DePt& Permit #please provide the following information as it pertains to your business and its location. You are not required to notifl these companies in theevent of an emergency. rlis information is provided io, yout reference and to assist emergency response personnel in responding to ahazardous materials emergency at your facility. List the name and phone number of the utility company.Telephone #800--5000Telephone #800-743# 805-71-7215Telephone #805-78 I -l5SECTION I-B: OWNER CERTIFICATION OF DATA (Certify either I ot 2)L This is a [NnW Plan ILJPDATED Existing PIan. Ihavepersonally examined the information it contains and amfamiliar with theoperation ofthe plan. (Ifyou check either ofthe above two options,continue to complete the remained of the EmergencyResponse /Contingency Plan).i. n Tr,i, pran requires no change and is on file with city of San Luis obispo Fire Department and does not need any change' (If youcheck this siction, please proceed directly to Form T, the Training Program.)I certify under penalty of law that the above information is true and accurate'AT&T-A09114107DATEPRINT NAME OF OWNER OR OPERATOR09114107Steve SkandersonDOCUMENTS PREPARED BYSICNATURE DATE5l:\l-tA3lr,4AT\FAC[,[LL\?05'1\ilneissxcy R**pon** Ftlrm M*rg*: |)c)C C$iI410'rPase l3of 6- SECTION II: EMERGENCY RESPONSE PLANS AND PROCEDURESNote: complete all sections of this Emergency Response procedure below. use of terms such as "N/A" (Not Applicable) will not be acceptedA. FIRE, SPILL oR RELEASE: The fire code requires immediate notification through dialing 911, by whoever first sights theincident. In the event of release or spill of hazardous materials, you must also notify:l. City of San Luis obispo Fire Department during business hours @ 805-781-7380. After business hours dial911.2. The State Office of Emergency services - (800) 852-7550 or (916) 262'1621.List the individuals responsible for verifying that these calls have been made and also indicate their position in your companyFOR VERIFYING THE DIALING OF 911:Sharon RamirezSite ManagerPOSITIONNAMEIndividual responsible for calling City of San Luis obispo Fire Department and the State office of Emergency Services: (Normally theEmergency Coordinator of your business.)Sharon RamirezSite ManagerPOSITIONNAMEB.List the local emergency medical facilities that will be used by your business in the event of an accident or injury caused by a releaseor threatened release of hazardous materialsSAN LUIS OBISPO GENERAL HOSPITAL21SO JOHNSON AVENUE, SAN LUIS OBISPO 805-78I-4800CITYPHONENAMEADDRESSCITYPHONENAMEADDRESSC. List the Emergency Coordinator(s) at your facilityPrimary: Sharon Ramirez Site Manager805 -5 46-7 41 6 I 805 -245 -4197(800) 566-9347 (800-KNOW-EHS)TITLEBUSINESS PHONE24 HR PHONEPAGER #NAMESecondary: AT&T Emergency Control Center(800) 566-9347 (80O-KNOW-EHS)TITLEBUSINESS PHONE24 HR PHONEPAGER #NAMED.Does your business have an on-site emergency response team? [ves ffiNo Describe procedures your business will follow inthe event ofa release or threatened release ofhazardous materials.TheEmergency Site Coordinator/BuildingWarden is responsible for followingthese steps as outlined in the Hazatd Communicationthe Hazardous Materials/WasteHandbook and theAT&TPractice 130l. Determining the nature, location,magnitude and severiry of the incident'2. Move people away from the area as appropriate'3. Avoid inhalation of all gasses, fumes or smoke,4. contain materials as aplropriate by ananging physical barriers, use of absorbents (i.e,, dirt, oil baking soda or other absorbent material)'personnel5Notifo appropriate$l :\HAf MAT\FACBr LL\:05 1 \f *l*r{]8'isy Re+ponse Fonr M*rgil D*S C$'r1 410':Pase Y of l(-- E. If you have acutely hazardous materials above threshold planning quantities, list (by name and address) adjacent neighboringbusinesses and residences, schools, hospitals, etc. Include sensitive facilities (schools, hospitals and rest homes) within 1,000 feet(straightJine distance from your property line). List telephone numbers for all businesses; for apartment buildings, list manager'sphone. Do not list telephone numbers for private residences.North: COMMERCIAL COMP. GAS STORAGESouth: INDUSTRIALEast:INDUSTRIALWest: The Spice Hunter 184 Suburban Rd, SLO 93401 805-544-4466FBriefly describe your standard operating procedures in the event of a release or threatened release of hazardous materials'Emergency response procedures -urt "o*pty with all federal, state and local regulations. Existing emergency response proceduresmay be referenced and attached to this document.1 prevention -- Describe the accident potentials associated with the hazardous materials present at your facility' What actionswould your business take to reduce accident potentials? Include description of safety, storage and containment procedures'The batteries are securely braced to prevent spills during an earthquake. Additionally, the hazardous materials are only handled byemployees or contractors that have been properly trained.Tnanmc: Appropriate emPloYees aretrained on hazardous materials/waste management.Thetraining is either leaderled or delivered inan online interactive format through the AT&T Leaming ManagementCenter. Employees are also provided training annually on how toread an MSDS as required by theHazard Communication Standard; they arealso trained on the AT&T Operating Practice 130MATERIALS: Hazardous materials are utilized and stored following manufacturer's recommendations, as we are a consumer of products andnot a manufacturer of hazardous materials.Z. Equipment - List the emergency response equipment at your facility (e.g. fire extinguishing systems, spill control equipment,decontamination equiPment).ItemAbsorbentsFire ExtinguisherFirst Aid KitPersonnel ProtectiveGearMaintenance ProcedureRoutine inspections and replenished as necessaryAnnual inspection and recharged by a contractorMonthly inspection and replace items as necessaryReplace as necessary3.Evacuation -- Describe how you will immediately evacuate your facility. What communications or alarms are used? How willyou operate these during power failure?PersonnelProtectionBattery AreaFirst AidFLEETAREAA4AINBLDGFire SafetySEE SITE MAPSSpillsFLEET AREA/GASISLANDUseLocationIn the event of an emergency requiring evacuationwhile employees are present, notification will be given verbally and/orwith fire alarms. The evacuation routes are posted throughout the facility. Employees will exit through the nearest exit andproceed to the evacuation staging area located at: SEE EMOP BINDER7l.\l4AtrldAT\FACliIL|-US51 \hnBrgency lte*pcnoe F*rrt M+rge D*S CSl1 "rl0'7Pase lS of1K- 4, Shutdown - Describe the shutdown for each site or facilityDue to regulatory requirements the emergency power system can not be shut down. If necessary, altemate power supplies can be brought tothe facility (i.e. portable generators) while the diesel tank/system is repaired.In the event of a release from a battery, the individual battery maybe taken out of service and replaced as necessary.5a. Response -- Describe what is done to lessen or mitigate the harm or damage to person(s), property, or the environment, andprevent the event from getting worse or spreading. What is your immediate response to:Fire: Small- use a fire extinguisherLarge - Call 911 if Possible, evacuate and allow the fire department to respondExplosion:call 911 if possible, evacuate and allow the fire department to respondSpills: ln the event of a minor release (<1Ogals)from the batteries, employees will stop the leak, if possible without risk, usingbicarbonate of soda or soda ash and/or dike the material to confine it to a safe locationFor larger spills (>10gals)contain the flow with absorbent and call 911 for the San Luis Obispo City Fire Department and callthe San Luis Obispo Co. Hazardous Materials AgencyTellthe dishrator:are reasll and to contact theHazardous Materialsalist"Severe Ground Motion: Thebatteries are securely braced to preventleaks and are inspected regularly. Additionally' thebatteries,diesel tank/fuel lines, and halon cylinders will be inspected following an earthquakeMaior Power Failure: Thefacilityutilizes industrial batteries and a generator as a backup power system.Flood: The batteries are in racks that areelevated off the floor. lt is not likelythat the area will be subject to water levels thatwould impede the operation at the facilityb. Is this facility located on a 100-year flood plain? Xyes nNoc. Earthquake - Identify facility areas and list mechanical or other systems that require immediate inspection or isolation because oftheir vulnerability to earthquake related ground motion.The batteries, diesel tank,fuel lines, and halon cylinders will be inspected following an earthquake6. Clean-Up (Remove the Hazard)facility? Note: Notifi the HazardousMaterials Unified Program Agency when clean up is complete'-- How do you handle the complete processof cleaning up,and disposing of related materials at yourThe Emergency Site Coordinator/BuildingWarden is responsible for following these steps asoutlined in the Hazard CommunicationProgram, theHazardous Materials/Waste ManagementHandbook and the AT&T Operating Practice 130.Determining the nature, location, magnitude and severityof the incident.Move people away ffom the area as appropriate.Avoid inhalation of all gasses, fumes or smoke'contain materials as appropriate by ananging physical barriers, use of absorbents (i.e., dirt, oil baking soda or other absorbent material).Notif, appropriate emergency personnel'G. Location -- your business is required to keep a copy of the Business Plan and related MSDS sheets on-site. Describewhere this information is located.A copy ofthebusiness plan,MSDS sheets are located at: FLEET AREA (also see site map)sl:\1"1AfF,riAliPAStlfLL\2051\ilfl]ei$*rl*y ltr**p*n** F*rrr: Merge il*C *t/14/t7Pase lb of JY- FORM TSAN LUIS OBISPO CITYFIRE DEPARTMENTEMPLOYEE TRAINING PROGRAMDate:09tr4107A.Describe the safety training for all employees in the event of a release or threatened release of hazardous materials. Thistraining shall include, but not be limited to, the following: new employee training, annual training, periodic refresher courses'and familiarization with Emergency Plans and Procedures of this Business Plan / Contingency Plan.Summarize the training for all employees that work with or come in contact with hazardous materials/hazardous waste. Describehow these employees are trained to avoid exposure.All employeeswho handle hazardous materials are trained to use appropriate methods and to recognize any potentialhazards. Periodic refresher training is provided in bi-monthlysafety meetings when required. Employees who work at thesite are familiarized with the location of the MSDS that are associated with the materials at the facilityAll batteries that have exceeded their usefulness will be removed and recycled'2summarize training specific to those employees that would respond to a release or threatened release of hazardous materials orhazardous waste.Employees are trained in the properuse of a fire extinguisher. All employees who handle hazardous materials are trainedto use appropriate handling methods and to recognize anypotentialhazards. Periodic refresher training is provided in bi-monthly safety meetings when requiredIn the event of a minor release from the batteries, employeeswill absorb the spilled material using bicarbonate of sod a andlordike thematerial to confine it to a safe location. Barrier tape will be placed around the released material. Spills exceeding thecapabilities of the employees will be handled by a qualified contractorAT&T Environmental Managementwillbe notified to make all necessary arrangements with an environmentalfirm forcleanup and disposal of any spills (AT&T Environmental Management: 800-566-9347) D-800-I-KNOW-EHSI7l :\HAXtulAl'rFAC#liLLU05 1 \*slsrgsncy lt**pon*e Sorm Merge D*C St/l'''10'7Page l''l Of-lf.- 3. Indicate frequency and duration of training for employees that work with or come into contact with hazardous materials/hazardouswaste.Allemployeeswho handle hazardous materials are trained to use appropriate handling methods and to recognize anypotentiaI hazards. Periodic refresher training is provided in ANNUAL safety meetings when required4.Describe how your employees access training materials. (E.g., bulletin board, employee newsletter, staff meetings, etc.)Employees are provided nrrur, Safety Plan training on the Hazard Communication Certification, as well as functionrp""int before they begin their work operations. This also includes training on the Emergency Operating procedures. Thereis also hazardous mateiials/waste management training for employees as appropriate. The training may either be leader-ledor taken as an online interactive course. Training is recorded electronically. A series of Job Aides that briefly describeeach of the topics accompanies the training.Additionally, the AT&T Emergency Plan requires that employees receive ANNUAL REFRESHER training on the HazardCommunication Certification, function specifics and the Emergency Operating InstructionsB. List person(s) in charge of training and indicate their qualifications to conduct the training.The training mayeither be leader-led or taken as an online interactive course. Training is recorded electronicallyC.Indicate where training records are kept. @ecords must document the type of training, duration, completion dates, names andpositions of employees receiving training and the name(s) of instructors / hainer.)The AT&T EmergencyPlan Binder serves as a reference guide for the Emergency Site Coordinator/Building WardenEmployee training records are maintained in the employee files.sl:\HA3I',{AIfFACSILL\2051\l{nr$r'S$ncy lt*sponss Form M+rge.]*C 0t/l 4107eage (( of-tg- MAP# 1SITE h{AFBUSINESS NAMEBUSiNESSAT&TSNLOCAl R SE1 64DATE 531oa7zrP CODE 93403DRAW]NG SCALENOT IO SCALT2196 SUBURBAN RDSAN tUIS OBISPOr-r-----lr-rt--III3456acwcflulza-tllrnm-tKHYD OIL TAN:60 GALio ol CLARIFIaUJoo-UzoTLUjUF78R@WASTIANTIFREEZIKAPACIFIC BELL/AT&TPREPARED BYGRoUP INcSYMBOL LEGENDELECTRICAL PANITSH U T- OFFNATURAT GASSH U T- OFFWATER SHUT-OFFEMERGENCY PUMPSHUT_ OFFTANK N/ONITORINGALARIVTELEPH ONEF RST AID KIIFIRE tXT NGUISHERSTORl\,4 DRAINSANITARY SEWERSTAGING ARIAEVACUAIT0N/Itsps-t l$S'irdilD MSDSL FIRE HYDRAN'EREFENCEEIVERGENCY RESPONSEEQUI PMEN T/AB SORBE N TSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGT TANKMOTOR O]LS & LUBRICANTS(COIVBUSTIBLE LIQU]DS)BATTERY TTECTROLYTE(coRRosrvE LrQurD)GASOLINE(FLAMN/ABLE LIQUIDS)D ESEL FUEL(COMBUSTLBLE LIOU DS)NITROGEN(c0r,/PRtsstD GAs)PROPANE(FLAMMABLE LIQUID)ACETYLEN E(COMPRESSED GAS)AN TIFREE ZE /COOtAN TSWASTI OIL(FLAMMABLE LIOUID)f rnr PULL BOXGil encoN@ oxvcrNSr) elrovnrrc -RANsMrssto\- FLUID@@@@lilo.o+lt\-ta:\m-)*l)ooo@@@HIVOTORICLEKSTORAGEUI I lLLKILAIVI/ ABLtSTOR AGWATERTANKATADl\/INISTRAT]ONBU LDING+K9BcDEFGHJLM Page(you may also be required to provide additional information by yourcUPA or local agency.)15E. LOCAL REQUIREMENTSf,ves []Iives f7ruorzf lvesfir.rorsI iveslTllror+NO11YESEvrs ffiNOeNO 10D. HMARDOUS WASTEL Generate hazardous waste?2. Recycle more than 100 kg/month ( excluded or exemptedrecyclable materials (per HSC ! 25143.2\?3. Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permitby Rule and Conditional authorizaton)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned onsite?6.4.6EPA lD NUMBER-provide at the top of this pageRECYCLABLE MATERIALS REPORT(one per recycler)ONSITE HMARDOUS WASTETREATMENT - FACILITY(Formerly DTSC Fo'm 1772)ONSITE HMARDOUS WASTETREATMENT-UNlTlone page per unit)(Formerly DTSC Form 1772A,8,C,D, and L)CERTIFICATION OF FINANCIALASSURANCE lFormerty DTSC Form 1232)REMOTE WASTE/CONSOLI DATION SITEANNUAL NOTI FICATION (FormerlyDTSC Form 1232)HMARDOUS WASTE TANK CLOSURECERTIFICATION lFormerty DTSC Form 1249)1. Own or operate underground storage tanks?2. lntend to upgrade existing or install new USTs?--any single tank capacity that is greater--cumulative storage ol 1,320 gallons stored in containersor greater?thresholds:55 gallonsthan 1,320 gallons, oror operate ASTs above these3. Need to report closing a UST?[']vesfir.ro zI lves fy' ruo eflves ffi ruo u[- lvesp]lro oJ UST TANK (closure portion-one page per tank)J No FoRM REQUIRED To CUPASUST FACILITY (Formerly SWRCB Form A)UST TANK (One page per tank) (Formerly Form B)UST FACILITYUST TANK (One per tankUST INSTALLATION - CERTIFICATE OFCOMPLIANCE(one page per tankXFormerly Form C)NO4fives i IA. HAZARDOUS MATERIALSHave on site (for any purpose) hazardous materials at or above 55gallons for liquids, 500 pounds for solids, or 200 cubic feet foriompressed gases (include liquids in ASTs and USTs); or theapplicable Federal threshold quantity for an extremely hazardoussubstance specified in 40 CFR Part 355' Aappendix A or B; orhandle radiological materials in quantities for which an emergencyplan is required pursuant to 10 CFR Parts 30' 40 or 70?HMARDOUS MATERIALS INVENTORY .CHEMICAL DESCRIPTION(oES 2731 )Does your facility...lf Yes, please complete these pages of the UPCFNOTE: lf you check YES to any part of this list,please submit the Business Owner/Operator ldentification page (OES Form 27301.I. ACTIVITIES DECLARATION196 SUBURBAN RD SAN LUIS OBISPOaFAClLlry NAME or DBA-Doing Business AS)BUSINESS NAME (Same asPacific Bell dba AT&T SE164tD#2EPA lD# (Hazardous Waste OnlY)cAT080024268I. FACILITY IDENTIFICATIONofBUSINESS ACTIVITIESFACILITY INFORMATIONUNIFORM)GRAM CONSOLIDATED2uPcF (1/e9) ID#I100BEGINNING DATE0110112006ofPageFACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATION OCT 2 2006CONSOLIDATED FORMI.INIFIEDI. IDNAME (Same as FACILIry NAME or DBA - Doing Business As)Pacific Bell dba AT&TBUSINESS PHONEDATE12t3112006831-372-2142101102103107110112113119122SE164ESS SITE ADDRESS196 SUBURBAN RDSAN LUIS OBISPODUN BRADSTREET1 0-340-1 61 8COUNTYSAN LUIS OBISPO104114STATE115CACONTACT117SIC CODE (4 disit #)4813805-546-741 6lowNgn PHoNE866-492-6836ZIP CODE94583-0995CONTACT PHONE925-823-8866lzp cone94583-099510608INESS OPERATOR NAME109BUSINESS OPERATOR PHONESharon RamirezIjrr. BUSINES,S OWTTER111NAMEAT&T Services, lnc.ICITYADDRESSP.O. Box 5095, Room 3E000SAN RAMONur.6oICONTACT NAMEi Environmental Management, attn: James StehriCONTACT MAILING ADDRESS2600 CAMINO RAMONRM 3EOOO120ATECActry. SAN RAMONIBUSINESS PHONEi 805-546-7416PRIMARYIV. EMERGENCY CONTACTSSECONDARY123AMEEMERGENCY CONTROL CENTERSharon Ramirez124129Site Manager24HR EMERGENCY SERVICE125PHONE877-322-4722124-HOUR PHONE126PHONE131866-492-6836 (866-l WANT EM)866-492-6836 (866-l Want EM)AGER#1t7AGER#132ADDITIONAL LOCALLY COLLECTED INFORMATIONBased on my inquiry ofthose individuals responsible forobtaining the information,I certi! under penalty of law that I have personally examined and am lamiliar :rwiththe information submitted and believe the information is true, accurate,and complete.SIGNATURE OFDATE10t1312006134NAME OF DOCUMENT PREPARERRHL DESIGN GROUP, INC. - AGENT FOR AT&TProject Manager - Agent for AT&Ti-135t3tINAME OF SIGNER (Print)Steve SkandersonCA10593403CODEl'"UPCF (l/00 revised)136t67OF SIGNERoES FORM 2730 (tteg) XPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per matqial per building or ilea)HAZARDOUS MATERIALS- JGRAM CONSOLIDATED FORMLIIIIFIEDREVISE200ofADDDELETEI. FACILITY INFORMATIONlCHEMICAL LOCATIONID#CHEMICAL NAMEON NAMESTORED IN SHOPSE164MAP# (optional)1LOCATION CONFIDENTIAL- ivpsilNO203GRID# (optional)NAME Pacific Bell dba AT&T202II. CHEMICAL INFORMATIONF4,G5205TRADE SECRET I I Y., ix i Nolf Subject lo EPCRA. refer to inslruqttons204206208MOTOR OIL (All Grades)FIRE CODE HAZARD CLASSES (Completc ifrequfed bv CUPA), lll-B COMBUSTIBLEEHS209If EHS is "Yes", all amounts below must be in lbs211212RADIOACTTVEYesNoCURIES214LARGESTCONTAINER 55WASTEAMOUNT120219STATE WASTE CODEc, POUNDSI I o. roNs221DAYS ON SITE:365rYes ,X Notil-.210II213iIlIII216HAZARD MATERIAL(Check one itemPHYSICAL STATE(Check one item only)HAZARD CATEGORIESall that apply)VERAGE DAILY AMOUNT217one itern only)f Ia.rune f xIu.r'axrunu i la. SOLIDb. LIQUIDa. FIREb, REACTTVEc. WASTEc. GAS215,f l c.pREssuRE RELEASE I a. ecure HEALTH iTl e.cHRONIc HEALTH220222ITI a. GALLONS N b, CUBICFEET [-]ilEHS. amount tnuslbein Pounds, .iSTORAGEicoNr,cn'tenI0514iI;a. ABOVEGROUNDTANK-lib, UNDERcRoLTNDTANK: c. TANK INSIDE BUILDINGix io. srenr- onr-naPLASTIC/I{ONM ETALLIC DRUMCANCARBOYSILOABOVE AMBIENTABOVE AMBIENT(For mixture or waste only)9.f.a,i, FIBER DRUMk,BAGBOXCYLINDERGLASS BOTTLE 'IPLASTIC BOTTLE iTOTE BINTANK WAGON'itn.'lr in.:li lo.t:liplo.Ilp.RAILCAROTHERSTORAGE PRESSUREl=x-]u o*utt*tSTORAGE TEMPERATUREA. AMBIENT%\tr/T,l ao-esBELOW AMBIENTBELOW AMBIENT[ ]0. cnvoceNrcEHS228VariouszzJ225ICAS#.l2292272311 .1"", [i'[rl"I }* ixbl" 232 Proprietaryf}". BlN" 236Proprietary239[}". lI]*" 240)'l3l-1415-20zinc uompouno234Additives238242243es244ADDITIONAL I-OCALLY COLLECTED INFORMATION245 ;lf EPCRA, Please Sign HereXDAILY AMOI.INT 218XXXXUPCF (l/ee)169OES Form 2731 ll.-i:ri:lii:': !:ii1CHEMICAL LOCATIONSTORED IN YARDADDDELETEHAZARDOUS MATBRIALS INVENTORY - CHEMICAL DESCRIPTIONOne page pe matoial po building or aea)HAZARDOUS MATERIALS- yGRAM CONSOLIDATED FORMI.]NIF'IEDINEss NAME Pacific Bell dba AT&TREVISEI. FACILITY INFORMATIONII. CHEMICAL INFORMATION211SE,164CHEM ICAL LOCATION CONFIDENTIALYESNO203GRID# (optional)200PageofL93206210216222MAP# (optional)1204III-lIlID#CHEMICAL NAMECOMMONIf - -.,..iCAS#AINER0112i STORAGE PRESSUREE3NAME74-98-6RE CODE HAZARD CLASSES (Complete if required bv CUPA)HAZARD MATERIAL(Check one itemPTrySICAL STATE(Check one item only)HAZARD CATEGORIESall that apply)VERAGE DAILY AMOUNT300one item only)STORAGEPROPANEABOVEGROUNDTANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRI'I\4Liquified Petroleum GasFlammable Gasa. PUREb. MXTUREc. WASTE205TRADE SECRETYesNoIf Subject to EPCRA, refer to irotructioroEHSYesl"l*"If EHS is "Yes", all amounts below must be in lbs.21RADIOACTIVE i I Yes208207209il *oCURIESa. SOLIDb. LIQUIDc. GAS214LARGESTCONTAINER 250a. FIRE["] t. nnacrwrc.PRESSURE RELEASEd. ACUTE HEALTH217WASTE AMOTJNT1 000f a. cALLoNS a-b. CUBIC FEETc. POUNDSI l o. roNs221DAYS ON SITE:365e.CHRONIC HEALTH219ATE WASTE CODE21220UM DAILY AMOUNT368PLASTIC/NONM ETALLIC DRUMCANCARBOYs[,oFIBER DRUMBAGBOXCYLINDERBELOW AMBIENTGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONf-i"floRAILCAROTHERA. AMBIENTfilu. nsovs AMBIENTliic223224225229233237STORAGE TEMPERATUREii,u. o*u,u*t i ]r ABovE AMBIENT l lc. eEl-ow AMBIENT i lo' cnvocnNtcHAZARDOUS COMPONENT (For mixture or waste only)PROPANEPropyleneEthane238Total ButanesII242 jt lv.. B lN" 244 "75-08-1EHScAs#%wrIhlrIt2ilrI- ir* iiN"l]v* i"]*o[]"'235239|J"'24374-98-6zJt115-O7-1zJo74-84-024078-28-5228>65<35<5zzo230234<6t4245l5 <0.1Ethyle Mercaptan.t-Ifmore huardous components de ptsentat grearer than lolo by weight ifnon-cucinogenic, or 0.lolo by weight ifcacinogenic, attach additional sheets ofpaper capturing the tequired infomationADDITIONAL LOCALLY COLLECTED INFORMATIONIf EPCRA, Please Sign HereXXXXXXXUPCF (l/ge)169OES Form 2731 XHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page pc material po building or aea)HAZARDOUS MATERIALS.OGRAM CONSOLIDATED FORMLIIIIFIEDDELETEREVISE200Page $ .! 7/tADDI. FACILITY INFORMATIONNAMEPacific Bell dba AT&TLOCATIONSTORED IN SHOPFACILIry ID#CHEMICAL NAMENAMEHYDRAULIC FLUIDCODE HAZARD CLASSES (Complete if required bv CUPA)MATERIALa. PUREb. MXTUREc. WASTE(Check one iternSTATEa. SOLIDb, LIQUIDc, GASone item only)FED HAZARD CATEGORIESa. FIREII. CHEMICAL INFORMATIONIII-B COMBUSTIBLE211205TRADE SECRETYesNolfEHS is "Yes", all amounts below must be in lbs.RADIOACTTVEYesi*r*"^r1I CURIESa202204206208216220222WASTE CODE22322405IIIiSE164LOCATION CONFIDENTIALYESNOGND# (optional)F4,F3l--l v" ll i""to EPCRA, refer to instrucliom20720922215214LARGESTCONTAINER 55[1 u. neecrwE 1 'l c.pREsSURE RELEASe l -1 o AcUrE HEALTH I X ] e.CHRoNIc HEALTHapplv)!DAILY AMOUNT217 IMAXTMUM DAILY AMOUNT60218ANNUAL WASTE AMOUNTILtI60ix;a. ce,lloNs Il b. cuBICFEET [l c. PoUNDS [ l a. roNs221DAYS ON SITE:365only)if FHS amorrnl mrrst he in noundsABOVE GROLTND TANKUNDERGROI.JND TANKTANK INSIDE BUILDINCSTEEL DRTA4e. PLASTICA{ONMETALLIC DRUMf. CANg. CARBOYh. SILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAIL CAROTHER! l*.illn.IIi lo.iloio,IlP'ISTORAGE PRESSUREiklu ot"tutt I ]u ABovEAMBIENT ...BELOW AMBIENTlIlII:STORAGE TEMPERATUREA. AMBIENTABOVE AMBIENT%wTHAZARDOUS COMPONENT (For mixture or waste only)I g8-ggzzbLubricating Base Oil1-22302344BEI,OW AMBIENTCRYOGENICCAS#225229233237241245t5!227231EHS[xlNo228Varioustt i*oj x n,ro,x lNoProprietarylzII,3i lv*.ll243 iIi l'* pf,n244o,ADDITIONAL TOCALLY COLLECTED INFORMATION246If EPCRA, Please Sign Hereil1203MAP# (optional)1XXXXXXUPCF (l/9e)169OES Form 2731 [[\tFIED-/GTTAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per bullding or aea)I. FACILITY INFORMATIONINESS NAME Pacific Bell dba AT&TSE164LOCATIONlcunn,t tcal locATIoN coNFIDENTIAL202OUTSIDE BEHIND SHOP YARDEPCRA203GRID# (optional)ives x NolLiIt.ID#NAMEMAP# (optional)1E3204206II. CHEMICAL INFORMATION205TRADE SECRETYes{ q"!199! 19 EIq\4,r:I:l tS-ryq!"tigry; :Yes .X lo:ile.CHRONIC HEALTHGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONll ""NITROGEN207208210]COMMON NAMEEHSNITROGEN209LCAS#7727-37-9FIRE CODE HAZARD CLASSES (Complete if required by CUPA)HAZARD MATERIAL(Check one itemSTATEone item only)HAZARD CATEGORIESall that apply)AVERACE DAILYLINITS*(Check oneIf EHS is "Yes", all amounts below must be in lbs.INERT GAS211RADIOACTTVEflYes ElNo_-212CURIESa. PURE [] t. ttaxtu*E [ lc. WASTEa. SOLIDb. LIQUIDc. GAS214LARGESTCONTAINER 228a. FIREb, REACTTVEc.PRESSURE RELEASEd. ACUTE HEALTHDAILY AMOLTNT 218WASTE AMOUNT2536219ATE WASTE CODE25?6GALLONSb. CUBIC FEETc. POUNDS[-1 o. roNs 221DAYS ON SITE:i8365if FLIS cmnunf mrrst he in nortnds3215'l216 Il220222STORAGECONTAINER12ABOVE GROIJND TANKUNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMe. PLASTICNONMETALLIC DRLMCANg. CARBOYh, SILOFIBER DRUMBAGBOXCYLINDERRAILCARp. OTHERlIll1STORAGE PRESSUREf 1u. err,rereNr [i]u ABovE AMBIENT f- lc. BELow AMBIENT223224225IILSTORAGE TEMPERATURE%wrI too%2fx iu. orutu"t l -it ABovE AMBIENT [ ]"HAZARDOUS COMPONENT (For mixture or waste only)BELOW AMBIENTd. CRYOGENICEHSCAS#zzoNITROGEN2272287727-37-9230231l-'F* EN"232234235230238239[-Jv"'240242243llv"244ADDITIONAL TOCALLY COLLECTED INFORMATIONI ir* El*"229ot4i5IIIi-If EPCRA, Please Sign Here| ,+uoDELETEREVISE200Page i0 or,i,,'.:I,,',,'1i .::.::, ii::: l| .a.... : .tiiXXXUPCF (l/99)r69OES Form 2731 ADDDELETEREVISE200ofPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page po material per building or rea)HAZARDOUS MATERIALS^"JGRAM CONSOLIDATED FORMTINIFIED!='lIIsNAME Pacific Bell dba AT&TLOCATIONSTORED IN SHOPICALNAMEARGONCOMMON NAMEARGON7440-37-1RE CODE HAZARD CLASSES (Complete if requfed bv CUPA)MATERIALa. PUREb. MXTUREc. WASTE(Check one itemSTATEa. SOLIDb. LIQUIDone item only)FED HAZARD CATEGORIESrRADE sECRET ye; i *o!_ r , .- lIf Subject ro EPC[(A. Jgf.er !9 llt!ructlgsl j"* [L*"I. FACILITY INFORMATIONII. CHEMICAL INFORMATIONEPCRA i- ltur B] "oICAL LOCATION CONFIDENTIALCRID# (optional)3SE164MAt# (optional)1207EHSzog III204202206208 lID#205209NON-FLAMMABLE GAS211e. PLASTICNONMETALLIC DRUMf. CANg. CARBOYsILoIf EHS is "Yes", all amounts below must be in lbs.212RADIOACTIVEYesEl^"CURIESWASTE AMOUNT2222c. GAS214LARGESTCoNTAINER 222c.PRESSURE RELEASEd. ACUTE HEALTHt-l e.CHRONIC HEALTHl2WASTE CODEJ215621220222lIIIa. FIREb. REACTTVEAMOUNT217MAXIMUM DAILY AMOUNT 218222a. GALLONSb. CUBIC FEETc. POUNDSIIUNITS*lsronncplcoutRnqgRd. TONSFIBER DRUMBAGBOXCYLINDER221DAYS ON SITE:GLASS BOTTLE iPLASTTC BOTTLE ITOTE BINp. TANK WAGONII365(Check one item onlv)[ -.:- --if EHS,-amolnJ-rnusttrein.pounds- ,- I10.Fii lb.rrI tntt'-1L"ldABOVE GROUNDTANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRLMtl,IIjo.loRAIL CAROTHER'12IIl223224225i sronace PREssUREi lu. otutu^r i!-u ABovE AMBIENTBELOW AMBIENTILloTEMPERATUREfx-]u. otutu*tABOVE AMBIENT%wTHAZARDOUS COMPONENT (For mixture or waste only)226ARGONBELOW AMBIENTEHSCRYOGENIC1-lt 100227CAS#241245If EPCRA, Please Sign Here229233237230231zJz235236238[jv* EN"240If more h@ddous componentsa.e prsent at greater thm I % by weight if non-cacinogenic, or 0. I %o by weight if cacinogenic, attach additional sheets of paper capturing the required infomation.ADDITIONAL TOCALLY COLLECTED INFORMATIONi v* LlN"')tes234XXXXX5242243o244239UPCF (l/9e)169OES Form 2731 I.INIT'IEDJGRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material per building or oea)DELETEREVISE200Page?f 3,2T. FACILITY INFORMATIONsNAME Pacific Bell dba AT&TSE164ICAL LOCATIONLOCATION CONFIDENTIAL3202NAMENAMECAS#-.IFIRE CODE HAZARD CLASSESlWEST SIDE OF SHOPUSED MOTOR OILII. CHEMICAL INFORMATIONCOMBUSTIBLE LIQ.38XNOGRID# (optional)F5205TRADE SECRETYestx]noto EPCRA, refer to instructioNEHSYesNoIfEHS is "Yes", all amounts below must be in lbs.[- I ves204lIllI,iID#207206208209(Complete ifrequired by CUPA)zi212 i!IlI52121MATERIALTYPE (Check one iternIPHYSICAL STATE(Check one item only)I i a. puRE i I t. rraxrunE itl c. wASrE:RADIOACTIVE i , Yes iX NoI CURIESb. LIQUID [ ] c. cas214a. SOLIDLARGESTCONTAINER 24OFED HAZARD CATEGORIES(Check all that apply)fxia.nnr nb. REACTTVEf-l c.rnrssuRE RELEASE f l o. ncurn HEALTH rfx I e.cnnoNrc HEALTHzrzlvrnxnruMIiDAILY AMOUNT2IOALWASTE AMOUNT240219ATE WASTE CODE221 ] DAYS ON SITE:i 365218220AVERAGE DAILY AMOUNT240UNITS*lF a. ceLLoNS i_l b. cuBICFEET l lc. PouNDSt ! a. roNsone itern only)if EHS, amount must be in pounds,iSTORAGECONTAINER01ABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONItl"IltPLASTIC/NONMETALLIC DRUMCANCARBOYSLOm.o.i io'ilpRAILCAROTHERc.id.2i3STORAGE PRESSUREE]u o*"t"*tSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTHAZARDOUS COMPONENT (For mixture or waste only)1 rco%226MOTOR OIL, USED230ABOVE AMBIENTjc. BELOW AMBIENTBEIOW AMBIENTes231t lY*tXI235 ii239I243II V* lln"223225CRYOGENICCAS#229233227t3zltJo234242zJo24024423724',\246If EPCRA, Please Sign HereL!*"ADDITIONAL TOCALLY COLLECTED INFORMATION2455ADDX203MAP# (optional)I1XX%wTEHSXUPCF (l/99)169OES Form 2731 ADDDELETEREVISE200LINIFIED.JGRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page pq material po building or rea)PageofI. FACILITY INFORMATIONBUSINESS NAME Pacific Bell dba AT&T3SE164CHEMICAL LOCATION CONFIDENTIALYESNO202GRID# (optional)F4204II. CHEMICAL INFORMATIONICALNAME205TRADE SECRET206208212121220222GLYCOLSRADIOACTIVE I YestlNoYesNoll!y!g.t t9 EP9!4, ."ft ' lolNjyl1i9l!EHSYesNoIfEHS is "Yes", all amounts below must be in lbs.212CURIESMON NAME207USED ANTIFREEZE107-21-1209RE CODE HAZARD CLASSES (Complete if required by CUPA)MATERIAL(Check one itemiI".eune llPHYSICAL STATE(Check one item only)FED HAZARD CATEGORIESall that apply)VERAGE DAILYone ltemAINERABOVEGROUNDTANKUNDERCROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMb, MXTUREc. WASTEa. SOLIDb. LIQUIDc. GAS214LARGESTCONTAINER 55a. FIREb, REACTTVEc.PRESSURE RELEASEd, ACUTE HEALTHCOMBUSTIBLE LIQ.382113216 1WASTE AMOI.INT55e.CHRONIC HEALTHSTATE WASTE CODE343DAYS ON SITE:365BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON21e IllilIa. GALLONSb. CUBIC FEETc. POUNDS[ I a. roNs 221PLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXI. CYLINDERRAILCAROTHER06PRESSUREA. AMBIENTl- lu. eeovnAMBIENr i-lc. BEI-oWAMBIENT223224255LtSTORAGE TEMPERATUREA. AMBIENTb. ABOVE AMBIENTo/nWTHAZARDOUS COMPONENT (For mixture or waste only)I g4%21%3 10%2o/ol-, 1c. BELOW AMBIENT I d. CRYoGENICEHS : CAS#226ETHYLENE GLYCOL228107-21-1230i DIETHYLENE GLYCOL2321 1 1-46-6234238242DIPOTASSIUM PHOSPHATE7732-18-57758-11-4ADDITIONAL TOCALLY COLLECTED INFORMATION227zJl244239243237241-l245'III246If EPCRA, Please Sign HereFACILIry ID#1203MAP# (optional)1STORED EAST SIDE SHOPLOCATIONXXXXXXXXXXXXes240236WATER235UPCF (1/99)qrt69OES Form 2731 T]NIFIEDJGRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page pq matqial po building or uea)I. FACILITY INFORMATIONBUSINESS NAMEPacific Bell dba AT&TsE164IIiCHEMICAL LOCATIONFACILIry ID#NAMENAMESTORED IN SHOP202204208lrMAP# (optional)205TRADE SECRET207203GRID# (optional)tF4i_II. CHEMICAL INFORMATION[-v"' ixiN"206AUTOMATIC TRANSM ISSION FLUI DCODEHAZARDCLASSES (CompleteifrequiledbvCUPA)III-B COMBUSTIBLEHAZARD MATERIALb. MXTURE i- l c. w.esrE(Check one itema. PURE217MAXMUM DAILY AMOUNT 218209If sqqig9! t9EPCM. refer to instructioNEHSi_l v". l" t^"lf EHS is "Yes", all amounts below must be in lbs.212210211221215II1IIllIRADIOACTTVENoCURIES;l YesSTATEa. SOLIDb. LTQUTDf l c. cAS214LARGESTCONTAINER 55one item only)HMARD CATEGORIESa. FIREb. REACTTVEc.PRESSURE RELEASEd. ACUTE HEALTHfl e.CHRoNIC HEALTHall that apply)zto220222VERAGE DAILY AMOUNT55WASTE AMOUNT110219ATE WASTE CODEIUNITS*i(ch99t 9n9119misroRRcnlcoxrerNen05only)fE a. GALLoNSABOVE GROUND TANKUNDERGROI.ND TANKTANK INSIDE BUILDING55b. CUBIC FEET i l c. POUNDSif EHS. amo-unt rnusLbe in4olnds.-PLASTICNONMETALLIC DRUMCANCARBOYSLOABOVE AMBIENTABOVE AMBIENTi d, TONSIi. FIBER DRUMk.BAGBOXCYLINDERBELOW AMBIENTBELOW AMBIENTEHS221 i DAYS ON SITE:365GLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONCRYOGENICi,:lrlila.b.li:' ro.;li lp'RAILCAROTHERSTEEL DRUMsroRAcE PRESSURE Flu. *utt^tSTORAGE TEMPERATUREA. AMBIENT%wr226Solvent refined Petroleum Oils223224227f v', LII),{"64741-89-5CAS#229'233237245lf EPCRA, Please Sign Here228III so-zo:2 2O-40230Base Stock231es232 I 64741-g8-4234Petroleum solvent refined23523664741-97-50-10es0-1023867762-77-068439-80-5ADDITIONAL TOCALLY COLLECTED INFORMATION241IIl.lIADDDELETEPage q oft,REVISE200XXXXXs 1-5242ES244Amines243es240Polyosobutenyl Succinimide239HAZARDOUS COMPONENT (For mixture or waste only)XUPCF (l/e9)t69OES Form 2731 LINIFIED,GRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per matoial po building or rea)ADDI. FACILITY INFORMATIONBUSTNESSNAME Pacific Bell dba AT&TsE164LOCATIONLOCATION CONFIDENTIALEAST SIDE OF SHOP[i vns Bl*o203GRID# (optional)FACILITY ID#II. CHEMICAL INFORMATION205 I rRADE sEcREr i r "* l" I *"If S! gcl lo EPCR4T refer to istructions; v* ,xiNoiCAS#209If EHS is "Yes", all amounts below must be in lbs.Jf''trIfEiir[ilcHevrcnt- nnvE202204206208MON NAME207EHSUSED OIL FILTERSII,llIlIFIRE CODE HAZARD CLASSES (complete if required bv CUPA)i CoMBUSTIBLE L|Q.3B211212213ztoHAZARD MATERIALTYPE (Check one item[-l a. pune f -l t. r'axrunu I I c. wASrERADIOACTTVErl YestiLARGESTCONTAINER 55NoCURIESPTrySICAL STATE(Check one item only)[l a. soLID f] u. rrqun I214c. GASFED HAZARD CATEGORIESa. FIREb, REACTIVE[ ] o.PRESSUnE nu-ense Id, ACUTE HEALTHe.CHRONIC HEALTHl(Check all that apPly)VERAGE DAILY AMOLINT217llCheck one itern only)DAILY AMOUNT218WASTE AMOLTNTPLASTICNONMETALLIC DRUMi. FIBER DRUMBAGBOXCYLINDER219STATE WASTE CODE223YS ON SITE:365220222[ l a. cALLoNS l-] b. cuBlc nenr l-x'l c. PouNDS [ ] o. roNs 221if EHS, arnounlmust be-ilpolnds.rlSTORAGElcoNrnneRIlosla.IloF]Li"'ixldABOVE GROUND TANKLJNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUM' i'n.i1",[]"fiiipGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONRAILCAROTHER,o.ipCANCARBOYSILO1kllSTORAGE PRESSUREA. AMBIENT|u. e.noveAMBIENTBELOW AMBIENT224zzoUSED OIL FILTERS230USED OILABOVE AMBIENT[- lc. eelow AMBIENTEHS227flv'.zJtesCRYOGENIC2288002-05-9lir"u" 2328002-05-9225STORAGE TEMPERATUREA. AMBIENTHAZARDOUS COMPONENT (For mixture or waste only)I; %wtCAS#l1I roo%229233zJt2412i234235238239IVotl242243l lv"'244ADDITIONAL TOCALLY COLLECTED INFORMATION236240l524s',246lf EPCRA, Please Sign HereDELETEREVISE200Page | 7 ofXXXXXUPCF (1/99)169OES Form 2731 TINIF'IED..OGRAMCONSOLIDATED F'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIoNADDDELETEOne page per material per building or oea)REVISE200PageItoltI. FACILITYINFORMATIONS NAMEPacific Bell dba AT&TLOCATIONSTORED IN OFFICEFACILITY ID#ICALNAMEHELIUMNAMEHELIUM7440-59-7RE CODE HAZARD CLASSES(Complete ifrcquired by CUPA)II. CHEMICALINFORMATIONSE1 64EPCRAMAP# (optional)1LOCATION CONFIDENTIAI-3zoi[] vrs [! *o203GRID# (optional)F3204207205TRADE SECRETi 1v".Nolf Subjtrtto EPCM, refer to iNtructio6EHSYesNo209If EHS is "Yes,', all amounts below must be in lbs.21INERT GAS208210215MATERIALjtYPE (Check one iternl->l' u. Punn [-jb, MXTUREc. WASTE211IlIIll(Check one item only)HAZARD CATEGORIES[I a, FIRE [1 n. nencrrvE I'-I o.PRESSURERELEASEall drat apply)VERAGE DAILY AMOUNT217RADIOACTTVEYesNo214c. GASLARGESTCoNTATNER 229STATEa. SOLIDb. LIQUID[-1 a. acure HEALTH ll e.cHRoNrc HEALTH 216DAILY AMOLTNT 218ANNUAL WASTE AMOUNT219228f a. GALLONSb. cuBrc FEET I I c. pouNDsf l o. roNs221ATE WASTE CODE220222luNITs"'i(c!"gk ole'teT9{yljsronaceiCONTAINER)12IABOVE GROLTND TANKUNDERGROLJND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBER DRUMBAGBOXCYLINDERDAYS ON SITE:365GLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGONo. RAILCARjp. oTHEREHSamout muslbf. in4ounds_PLASTICNONMETALLIC DRUMCANg. CARBOYSILOifk.STORAGE PRESSUREI iu avrnraNriilr. eaove AMBTENT i lc. BELoWAMBTENTSTORAGE TEMPERATUREA. AMBIENTf]u. aeovrAMBrENr I"BErow AMBTENT [lo. cnvocer.rrc%wTI too226HELIUM227223224CAS#225 |l-lI230I y* [t]N"7440-59-7228i v* fx1N"232i2292332g7i241 ,245i2231'3234 t235I k* itN"238ixl*"l243 "IleslX lNo244 1lfmore huadous components ue prsent at greater thill% by weight ifnon-cacinogenic, or 0. l% by weight ifcarcinogenic,attach addirional sheets ofpaper capturing lhe required infomation.ADDITIONAL I,OCALLY COLLECTED INFORMATIONLl"240If EPCRA, Please Sign Here1il-tiXXXXXEHSHAZARDOUS COMPONENT (For mixture or waste only)XUPCF (t/9e)169OES Form 2731 FORM ESAN LUIS OBISPO CITYFIRE DEPARTMENTEMERGENCY RESPONSE PLAI\Or Hazardous Waste Contingency Plan(see instruction page vii)Date: 10113106SECTION I-A: BUSINESS IDENTIFICATION DATABUSINESS NAMEPacific Bell dba AT&TSEl64/SNLOCAAUCIryZIP CODESITE ADDRESS196 SUBIIRBANRDSANLUIS OBISPO93403FACLIryUNITTELEPHONE NUMBER831-372-2r42CITYSan RamonZIP CODEBIJSINESS MAILING ADDRESS2600 Camino Ramon, Room 3E00094583l. Hazardous MaterialsUnderground Storage #2. Hazardous WasteGenerator #Ifyour business has a license or permitfromany ofthe fottowing agencies, please indicate the document number'3. Air Pollution ControlDistrict #4. Responding Fire Dept& Permit #please provide the following information as it pertains to your business and its location. You are not required to notify these companies in theevent of an emergency. rhis information is provided for your reference and to assist emergency response personnel in responding to ahazardous materials emergency at your facility. List the name and phone number of the utility company'Electric ServicePacific GasF.lectric#800-743-5000Gas ServicePacific GasF.lectricTelephone #800-SanitationSan T.uissno I IfilifiesTelephone #80s-781-7215Water DistrictSan Luissno I ItilitiesTelephone #805-78 1 -l5SECTION I-B: OWNER CERTIFICATION OF DATA (Certify either I or 2)l. This is aPhn XUPDATED Existing Plan. I havepersonally examined the information it contains and amfamiliar with theoperation of the plan. (If you check either of the above two options, continue to complete theremained of the Emergency Response /Contingency Plan).z, n int pfan requires no change and is on file with City of San Luis obispo Fire Department and does not need any change. (If youcheck this section, please proceed directly to Form T, the Training Program.)I certiff under penalty of law that the above information is true and accurate,AT&Tt0n3l06PRINT NAME OF OWNER OR OPERATORSteve SkandersonDOCUMENTS PREPARED BYDATEr0lt3l06SIGNATUREDATE5l.\1{AulJA"f\PAf;*f;|^L\:il51\fin]ergetlcy Relf:onre Forrvr Merije.DOC 1ilj1:]ll)tipug" 13 or-f'V- SECTIONII: EMERGENCY RESPONSE PLANS ANDPROCEDURESNote; Complete all sections ofthis Emergotcy Response procedurebelow. Use of terms such as 'N/A,, (Not Applicable) will not be accepted.A. FIRE, SPILL ORRELEASE: The fire coderequiresimmediate notification throughdialing 911, by whoever first sights theincident. In the eyent ofrelease or spill ofhazardousmaterials, you must also notify:1' city of San Luis obispo tr'ire Department during business hours @ g05-7g1-73g0. After business hours dial g1l.2' The state office of Emergency services - (800) 852-7550 or (916) 262-162r,List the individuals responsible for verifying that these calls have been made and also indicate their position in your comparyF'OR VERIFYING THE DIALING OF,911:Sharon RamirezSite ManagerNAMEPOSITIONHill$r':'ffffff"i;rr"#tf.ru1i"""* obispo Fire Department and the state orfice orEmersoncy services: (Normauy rheSharon RamirezNAMESAN LUIS OBISPO GENERAL HOSPITALNAMEADDRESSNAMEADDRESSused by your business in the event ofan accident or injury caused by a release2I8O JOHNSONAVENTIE, SAN LUISOBISPO 805_781_4800CITYPHONEPHONESite ManagerB. List the local emergency medical facilities that will beor threatened release ofhazardous materials.805-546-7416BUSINESS PHONE(866) 492-6836BUSINESS PHONEPOSITION800-456-934724 HR PHONE800-4s6-934724 HR PHONECITYC. List the Emergency Coordinator(s) at your facilityPrimary: Sharon RamirezSite ManagerNAMETITLESecondary: AT&T Emergency Control CenterNAMETITLEDPACER #PACER #4. Contain5. NotifyDoes your business have an on-site emergency response team? !Vthe event ofa release or threatened release oihazardous materials.es [lNo Describe procedures your business will follow inThe EmergencySite Coordinator/BuildingWarden is responsiblefor followingthese steps asoutlined in theProgram, theHazardousMaterialsAV'asteManagement Handbookand ttreAT&THazard CommunicationL Determining thenature, location, magnitudeand severity of the incident.Practice 130.2. Movepeople away from the area asappropriate.3. Avoid inhalationof all gasses, fumes or smoke.materials as appropriate by anangingpersonnel.physical barriers, use of absorbents (i.e., dirt, oil baking soda or other absorbent material)tip.gu-lL or-Zzi.\lrAJlilAT\PACBil-ti3iJ$1\U{rrerrJ*ncy Raspcnre F..:rr1 Merqe.}q;C t$i1:.jr,i3e; (E. Ifyou have acutely hazardous materials abovethreshold planningquantities, list (by nameand address) adjacent neighboringbusinesses and residences, schools,hospitals,etc. Include sensitivefacilities (schools, hospitalsand rest homes) within 1,000 feet(straight-line distance fromyour property line). List telephonenumbers for all businesses;for apartrnent buildings, list manager'sphone. Do not list telephonenumbers for private residences,North: COMMERCIALCOMP. GAS STORAGESouth: INDUSTRIALEast:INDUSTRIALwest: The Spice Hunter 184 Suburban Rd, sl-o 93401 g05-5 44-4466F. Brieflydescribe your standard operating procedures in the event ofa release or threatened release of hazardousmaterials.Emergencyresponse procedures mustcomply with all federal, state andlocal regulations. Existing emergency responseproceduresmay be referenced and attached to thisdocument.l. Prevention - Describe the accidentpotentials associated with the hazardous materialspresent at your facility. What actionswould your business take to reduceaccident potentials? Include description of safety,storage and coniainment procedures.The batteries are securelybraced to prevent spills duringan earthquake' Additionally, the hazardous materials are only handled byemployees or contractorsthat have been properly trained.TRATNTNG: Appropriateemployees are hained onhazardousmaterials/waste management.Thetrarning is either leader-led ordeliveredman online interactive format throughthe AT&T LearningManagement Center. Employees arealsoprovided training annually on how toread an MSDS as required bythe Hazard CommunicationStandard; they are also trained on the AI&T Operating Practice 130.MatnRtals: Hazardous materials are utilizedand stored following manufacturer's recommendations, as we are a consumer of products andnot a manufacturer of hazardous materials2. Equipment - List the emergencydecontamination equipment).response equipment at your facility (e.g. fire extinguishing systems, spill control equipment,ItemMaintenance ProcedureAbsorbentsRoutine inspections and replenished as necessaryFire ExtinguisherAnnual inspection and recharged by a contractorFirst Aid KitMonthly inspection and replace items as necessaryPersonnel ProtectiveGear3. Evacuation - Describe how you willyou operate these during power failure?In the event of an emergencywith fire alarms. The evacuationReplace as necessaryimmediately evacuate your facility. what communications or alarms are used? How willrequiring evacuation whileemployees are present,notificationwill be given verbally and/orroutes are posted throughout the facility. Employees will exit through the nearest exit andproceed to the evacuation staging area located at: sEE EMop BINDER7BatteryAreaPersonnelProtectionFLEETAREA/MAINBLDGFirst AidSEE SITEMAPSFire SafetyFLEET AREA/GASISLANDSpillsLocationUse_ ,r' 4.7Pase_l> o|L2l:\J"rAZlv'1AT\PAC$if;L.l:ii$r\f:nlerger(ry Respr:ns* F,;rm Merire.Dd)c ii),Jlir(iii Il.lliAJfvlA^f \FA*lglr:!..-i-il,l*:,tj\r.ri.rlrrJ.J'rr.;y lk-.lr;frrnle ii:rr: i!igl.i;q,l.i,r*.J jc,i1:lii;ilp^su--lv or_'74 (4.Shutdown -- Describe the shutdown for each site or facilityDue to regulatory requirements the emergencypower system can not bethefacility (i.e. portable generators) while the diesel tanVsystemis repaired.In the event of a release from a battery the individualshutdorm. If necessary, altemate power supplies can be brought tobattery maybe taken out ofservice and replaced as necessarythe harm or.damage to person(s), property, or the environment, andyour immediate response to:5a.FireSmall - use a fire extinguisherLarge - Call 911 if possiblebicarbonate of soda or soda ashFor larger spills (>1Ogals) contain thethe San Luis Obispo Co. HazardousTellthe disResponse - Describe what is done to lessen or mitigateprevent the event from getting worse or spreading. What isExplosion: Call g11 if possible, evacuate andSpills: ln the event of a minor release, evacuate and allowallow the(<1 Ogals) from the batteries,the fire department to respondfire department to respondemployees willstop the leak, if possible without risk, usingLuis Obispo City Fire Department and callandlor dike the material to confine it to asafe location.flow with absorbent and call 911 for the SanMaterials Agency"vouare reportinqa spill andto contact theCountvHazardousMaterials Specialist"Severe Ground Motion: The batteries aresecurely braced to prevent leaks andbatteries, dieseltanUfuel lines, and halonMaior Power Failure: Thefacility utilizes induFlood: The batteries are in racks that arewould impede the operation at the facilitycylinders will beinspected following anstrial batteries and a generatorelevated off the floorare inspected regularlyearthquakeAdditionally, theubject to water levels thatas a backup power systemIt is not likely that the area will be s!Nosystems that require immediate inspection or isolation because ofThe batteries, diesel tank, fuel lines, and haloncylinders will be inspectedfollowing an earthquake.6. Clean-Up(Remove the[azard) -How doyou handle thecompleteprocess ofcleaning up, anddisposing offacilify?Note: Notift the Hazardous MaterialsUnified Program Agencywhen clean up is complete,related materials at yourThe Emergency SiteCoordinator/BuildingWardenis responsible forfollowing thesesteps as outlined in theProgram, theHazardousMaterialsAVasteManagement HandbookHazardCommunicationDetermimng theand theAI&TPractice 130.nafure, location, magnitude andseverity of the incident.Movepeople away from the area as appropriate.Avoidinhalation of all gasses, fumes or smoke."ffffffi?*:H##i,:3lJffJ,:* phvsical barriers, use of absorbents (i.e., dirt, ol baking soda or other absorbent mareriar).Gb. Is this facility located on a 100_year flood plain? XVesc' Earthquake - Identift facility areas and list mechanical or othertheir vulnerability to earthquake related ground motion.Location -- Your business is required to keepwhere this information is located.a copy of the Business plan and related MSDS sheets on-site. DescribeA copy of the businesssheets are located at: FLEETAREA (also seesite map)Ie^s" i1 o_[tplan, MSDSl:ll"rA:fr'lA"f lpAcgnLL\:Cjjl\[rr]srr]er]ry Respcnre Forrri Merr:e.i]*C 1fi1l:l;i.tii FORM TSANLTIS OBISPO CMYFIRE DEPARTMENTEMPLOYEETRAINING PROGRAMDate: 10/lA.Describe the safety training for all employees in the event of a rerease or threatened rerease of hazardous materiars. Thistraining shall include' but not be limited to, ttre touowirrg, n"* ffioyee training, annuar training, periodic refresher courses,and familiarization with Emergency Plans ano procedurur "r flri, frriness pran / contingency plan.n"rtilHffi"T:"flffi:ffi1:ffi:iffi:j|l:.*-o with or come in contact with hazardous materials/hazardous wasre. DescribeAll employeeswho handle hazardous materials aretrained to use appropriate methodshaznds. Periodicand to recognize any potentialrefresher training is provided in bi-monthly safety meetingswhen required. Employees who work atthesite are familiarizedwith the location of the MSDS thatare associated with the materials at thefacilityAll batteries that have exceeded theirusefulnesswill be removed and recycled.2.summarize training specific to those employees that would respond to a release or threatened release of hazardous materials orhazardous waste.Employeesare trained in the proper use of a fireextinguisherAll employeeswho handle hazardous materials aretrainedto use appropriate handling methods and torecogmze any potential hazards. periodicrefresher training is provided in bi_monthly safety meetings whenrequiredIn the event of a minor releasefrom the batteries, employeeswill absorb the spilledmaterial using bicarbonate of sod a and/ordike the material to confine it toa safe location. Barrier tape willbe placed around the released material,capabilities of the employeesSpills exceeding thewill be handled by a qualified contractorAT&T Environmental Management will be notifiedcleanupto make all necessary arrangements with an environmental firm forand disposal of any spills (AT&TEnvironmental Management: I _g00_I_KNOW_EHS)7p"g"-/?of,a/2J :\'IAZMAT\PACBfi L Lil'$ 1 \trnr*r$e*oy Reapr;nre Forr, Merge. il*C l 0i 1 _?iC6 JIndicate frequency and duration of training for employees that work with or come into contagt with hazardous materials/hazardouswaste.All employees who handle hazardous materialsare trained touse appropriate handling methodsand to recognize anypotential hazards. periodic refreshertraining is provided in ANNUALsafety meetings when required4Describe how your employees access training materials. (E.g., bulletin board, employee newsletter, staff meetings, etc.)EmployeesareprovidedINITIAL Safety Plan training on the Hazard, CommunicationCertification, as well as functionspecific before they begintheir work operations.This also includes trainingon the Emergency Operating procedures. Thereis also hazardousmaterials/waste managementtraining for employeesas appropriate.The training may either be leader-ledor takenas an online interactive course.Trainingis recorded electronicallyA series of Job Aides that briefly describeeach of the topics accompanies thetraining.Additionally, the AI&T Emergency plan requiresCommunication Certifi cation, function specifics andthat employees receive ANNUAL REFREsHER training on the Hazardthe Emergency Operating Instructions.List person(s) in charge of training and indicate their qualifications to conduct the training.The training may either be leaderJed or taken as an online interactivecourse. TrainingB.C.is recorded electronicallyIndicate where training records are kept. @ecords must document the type of training, duration, completion dates, names andpositions of employees receiving training and the name(s) of instructors I traner.)The AI&T Emergency Plan Binder serves as a referenceguide for the EmergencySite Coordinator/Building Warden.Employee training records are maintained in theemployee filestJl :\}TAZMAT\PAC[3* tl\f S$ 1 \*'r $r!]en*y Resp+nr;e F o*:: Meri.re. l)ilC .1 ill t :Ji,J{rp'g"--Y7 q-h p,za/23PACIFIC BELL/AT&TMAP# 1SNLOCAl RS{TE }IAFstl 64BUS]NESS NAME AT&-BUSJNESS ADDRESS1 96 SUBURBAN RDSAN LUIS OBISPOHYD OIL T60 GALDATE 9 /ZI/2AA6ZIp CgDE 93403DRAWING SCALENOT TO SCATTSYMBOL LEGENDELECTRICAL PANELSHUT- OFFNATURAT GASSHUT-OFFWATER SI-1UT-OFF('S-D ETvERGENCy puMpff^. TANKMMONITORING@@@23r-r----r--r--ac@cl,IDza-Jf,rnmJ456aUJooUzoIo-U!FIt,i,lIIo-ol CLARtFtt-=-i---i---_t-i-----.r-------r"..I-oJL''u-A-AmlrspslLt+e@@(JTETEPHONEF]RST AID KITFIRE EXTINGUISHERSTORN/ DRAINSANITARY SEWERSTAGING AREAEVACUATION/H]\IMP, AND MSDSLOCATIONFIRE HYDRANTFENCEE]\,4ERGENCY RESPONSEEQUIPMENT/ABSORBtN TSABOVECROUNDSTORAGI TANKUNDERCROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(coMBUST|BLE tloulDS)BATTERy rrtcrRor"ri(cORRostvE UOUiD)POI I-GASOLINE(FLAMI!/ABLE LIQUIDS)DIESEL FUEL(coivBusTtBLt IQUtDSNI TROGEN(cOMPRESSED GAS)PROPANI(FLAIV]!1ABLE LIQUID)ACETYLENI(COMPRESSED GAS)AN TIFREEZE,/COOLAN TSWASTE OIL(FLAM]\IABLE LIQUID)f rrnr puLL BoxGn) rncorl@ oxvcrirrfi) arr6var'6 TRANSvrssoN- FLU]D789A@WASTTAN TIFRITZEKLPREPARED BY:GRoUF nNc,] CLEOP]VOTORASTORAGIOFF]SAFTAIV[/ABLESTORAWATERTANK+KADMINISTRATIONBUILDINGIIIIIItIBcDEFGHJM CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANCITY:SAN LUIS OBISPOZIP CODEADDRESS:2180 JOHNSON AVENUEHOSPITAL/CLINIC:SAN LUIS OBISPO GENERAL HOSPITALPHONE NO:805-781 -4800medical facility that will be used by your businessin the event of an accident or injury caused by arelease or threatened release of hazardous materialList the local emergencyEMERGENCY MEDICAL FACILITY****a**Your Name and the Telephone Number from where you are calling.Exact address of the release or threatened release.Date, time, cause, and type of incident (e.g. fire, air release, spill etc.)Material and quantity of the release, to the extent known.Current condition of the facility.Extent of injuries, if any.Possible hazards to public health and/ or the environment outside of the facility.NOTIFICATION:INF'ORMATION TO BE PROVIDED DURINGEmergency Services.Local Program Agency: 805-781-7380State Office of Emergency Service: (800) 852-7550 or (916) 845-891INational Response Center: (800) 424-8802Program Agency and the Office ofpersorurel are notified, you shall then notifu this UnifiedAFTER the local emergency responseED RELEASE OF HMARDOUSFI RE/PARAM EDICS/POLICEPHONE:911HAVEREATENMATL:IATYOUFTHERELEASAORECALLYEMEDMRIALS,emergencyresponsetolocalfirematerialofEmergencytheOfficepersonnel,andServicesour1SananytoYbusinessreportLawbyStaterequiredoraimmediateprovidereleaseofverbalhazardousofthreatenedreleaseNotifications **EMERGENCY RESPONSE PLANS AND PROCEDURESPAGER #PAGER #8OO I KNOW EHS800-4s6-934724.HOUR PHONEOO I KNOW24-HOLIRPHONE800-456-9347BUSINESS PHONE805-s46-741666 I WANT866-492-6836BUSINESS PHONETITLESiteTITLE24hourNAMESharon RamirezControl CenterNAMEPRIMARYSECONDARYEMERGENCY CONTACTSEPA ID NUMBERcAT080024268SITE ADDRESSI 96 SUBURBAN RDZIP CODE93403CITYSAN LUIS OBISPOBUSINESS NAMEPacific Bell dba AT&TSE164FACILITY ID #FA0002817ACILITY IDENTIFICATIONV,2 t/23BUSINESS PLAN (01/2000 Version) CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANFT,EET OFFICEWater:First Aid Kit:FI,FETElectricalROOMMATN RIIII,[)N/ATank Monitor AlarmN/ANatural Gas/propane:Spill kit / Absorbent:FLEETEnvironmental Documents:AREAFLEET/MAIN RT,DG/GAS ISI,AND,trPHONE TERMINFUTILITYSoCATIONLOEMEAND-oFFSUTSHENTEQUIPMNCYRGEldentify mechanical systems where releases could occur or would require immediate inspection or isolation becausevulnerability to earthquake related ground motion.X Utilities n Sprinkler SystemsX Racks n Pressure Vesselstr Process Piping X Shutoff ValvesCabinets ! ShelvesGas Cylinders X TanksOther: Tank Monitor Alarm Panelof theldentify areas of the facility where releases could occur or would require immediate inspection or isolation because of thevulnerability to earthquake related ground motion.X Hazardous Waste/ Hazardous Materials Storage Areas tr Production Floor fl Process Lines! Bench/ Lab n Waste Treatment n Other:EARTHQUAKE VULN ERABILITY:. X tnalvidual(s) responsible for coordinating evacuation including spreading the alarm and confirming the business has beenevacuated:Sharon Ramirez, Site Manager2. X Evacuation map is prominently displayed throughout the facilityI . The following alarm signal(s) will be used to begin evacuation of the facility (check all which apply):X Verbal X Telephone (includ.ing cellular) X e.larm System flpublic Address System I Intercomf] pagers I Portable Radio D Other (specify):EVACUATION PLANe,'2Lf2A2BUSINESS PLAN (01/2000 Version) CONSOLIDATED CONTINGENCY PLAN & BUSINESS PLANEMERGENCY PHONE NUMBERSOther lmportant NumbersAT&T EmeroencvntrolCenter877-322-4722Shaw Environmental800-537-9540AT&T CorooEnvironmental Manaoent866-IWANT EMOtherCalifornia Office of EmergencyServices800-852-7550State Department of Toxic SubstancesControl916-324-1826State Water Quality Control Board Reqional OfficesNorth Coast RegionSan Francisco Bay RegionCentral Coast RegionLos Angeles RegionCentral Valley Region: Sacramento Office...........Fresno Office........Redding Office........LahontanRegion: VictorvilleOffice...............Lake Tahoe OfficeColorado River Basin RegionSanta Ana Region ..............San Diego Region707-576-2220510-622-2300805-549-3147213-576-6600916-255-3000559-445-51 16530-224-4845760-241-6583530-542-5400760-346-74919Q9-782-4130619-467-2952US Environmental Protection Agency (Region 9)415-744-1702National Response Center800-424-8802AgencynotificationnumbersFire ..........Police/Sheriff .............California Highway Patrol .......City of San Luis ObispoAmbulance ServicePoison Control Center911911805-781 -7380800-342-9293EmergencyresponsephonenumberName of medical facility/nearest hospital (enter):caNt I iltc nRt_qPnGENtrpar HnqptTAtPhone number of medical facility/hospital (enter):805-781-4800?,'L3/z?3BUSINESS PLAN (01/2000 Version) \CITY OF SAN LUIS OBISPOFIREDEPARTMENT2160 santa Barbara Avenue * san Luis obispo, c{9340l-5240 * 805-781-7380HAZARDOUS MATERIALS BUSINESS PLAN UPDATE FORMYEAR 2OO5FACILITY NAME:SBC SEl64ADDRESS:196RD. SANOBISPO CACONTACT PERSON' T.arnrTELEPHONE i 83 I -37 2-21 42Annual Inventory Update (due each year)tlNo Significant changes in inventory have occured since the last Business Plan or inventory wassubmitted.New inventory forms are attachedffi Replace previous inventory with attached inventory.[ ] Replace only designated pages of inventory'XAdditional Comments:t)4Yearly Review and RecertificationI ] I certifu that the Business Plan has been reviewed and the information contained in the BusinessPlan is accurate and complete as of this date.Other Updatesfollowing information into the Business Plan for thisSle l^aPI declare, under penalty of perjury, that the information provided herein is true andcorrect to the best of my knowledge.Signature:Date: November 10.2005Printed Name:SteveRHLsn Grouo. AsentSBCPlease Return to: Molly Brown, Hazardous Materials sectionCity Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA93401-5240H:/BUSINESS PLAN UPDATE FORM MOLLYThe City of San Luis Obispo is committed to include the disabled in all of its services, programs and activitiesTelecommunications Device for the Deaf (805) 781-7410. TITLE OF SIGNER137Project Mahager - Agent for SBCNAMEOF SIGNERSteve Skanderson136NAME OF DOCUMENT PREPARERRHL DESIGN GROUP, INC. - AGENT FOR SBC135DATE1211512005134OFCertification: Based on my inquiry of those individualsresponsiblefor obtaining the information, I certiff under penalty oflaw that I have personally examined and am familiarwith the information submitted and believe the information is true, accurate, and complete.LOCALLY COLLECTED INFORMATION:PAGER#132PAGER#12724-HOUR PHONE131866-492-6836 (866-l Want EM)z4-HOUR PHONE126866-492-6836 (866-l WANT EM)BUSINESS PHONE130877-322-4722BUSINESS PHONE125831-372-2142TITLE12924 HR EMERGENCY SERVICETITLE124Property ManagerNAME EMERGENCYCONTROLCENTER128NAME123Larry CodayPRIMARYTV. EMERGENCY CONTACTSSECONDARYATE121CODE122CA94583-0995CITY120SAN RAMONCONTACT MAILING ADDRESS1192600 CAMINO RAMONRM 3EOOOCONTACT PHONE925-823-8866118CONTACTNAME117Environmental Management, attn: James StehrilI.AL CONTSTATECA115CODE'11694583-0995CITY114SAN RAMONOWNER MAILING ADDRESSP.O. Box 5095, Room 3E000113OWNERPHONE866-492-6836112OWNERNAME111SBCII. BUSINESSOWNERBUSINESS OPERATOR PHONE831-372-2142110BUSINESS OPERATORNAMELarry Coday109COUNTY108SAN LUIS OBISPOSIC coDE (4 digit #)481 3107DUN BRADSTREET1061 0-340-1 61 8ZIP CODE10593403CACITY104SAN LUIS OBISPOBUSINESS SITE ADDRESS196 SUBURBAN RD103BUSINESS PHONE831-372-2142102BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)SBCJSE164ENDING DATE12t3112006101BEGINNING DATE01t01120061001ID#UNIF'IED.AM CONSOLIDATED FORMFACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATION ,tAN 2 3 2006ofLUPCF (1/00 revised)t67oES FORM 2730 (t199) If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242243es24424542382392402413 15-20234Additives235236237Proprietary1230232Proprietary233I eo-8s226Zinc CompoundLUBRICATING BASE OIL231227esI^o 228Various229%wrEHSIIAZARDOUS COMPONENT (For mixture or waste only)cAs#XA. AMBIENTSTORAGE TEMPERATUREc. BELOW AMBIENTABOVE AMBIENTCRYOCENIC225XSTORAGE PRESSUREc. BELOW AMBIENTA, AMBIENTABOVEAMBIENT224ABOVEGROUNDTANKI.JNDERGROLTND TANKTANK INSIDE BUILDINGSTEELDRUMPT-ASTICNONMETALLIC DRUMCANCARBOYsII0FIBER DRLMBAGBOXCYLINDERGT"\SS BOTTLEPI.ASTIC BOTTLETOTE BINTANKWAGON22305o. RAILCAROTHERI o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET't222DAYS ON SITE:365VERAGEDAILY AMOUNT217DAILY AMOUNT 218219ANNUAL WASTE AMOUNT120STATE WASTE CODE220XXa. FIREb. REACTTVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTH216FED HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MXTURE211MATERIALX212NoYesRADIOACTTVE213CURIESIII-B COMBUSTIBLE210CODE HAZARD CLASSES (Complete if required by CUPA)64742-65-0209If EHS is "Yes", all amounts below must be in lbs.MOTOR OIL (All Grades)COMMON NAME207XYesNoEHS208PETROLEUM HYDROCARBONNAME205XTRADE SECRETto206Norefer to iNtructioNYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONXEPCRA202NOLOCATION CONFIDENTIALYESNAME SBCsE164JI. FACILITY INFORMATIONADDDELETEREVISE200Page ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOnc page ps mtqial po building or re)HAZARDOUS MATERIALS^ JGITAM CONSOLIDATED FORMTINIFIEDUPCF (l/ee)t69OES Form 2731 lf EPCRA, Please Sigr HereADDITIONAL L,OCALLY COLLECTED INFORMATION246<0.1242Ethyle Mercaptan24324475-08-1245<5238Total Butanes23924178-28-5es240<6234Ethane23574-84-0237es236<35230232Propylene231115-07-1233I 165226esNo228PROPANE22774-98-6229%wrEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#Xc. BETOW AMBIENTA. AMBIENTSTORACE TEMPERATUREABOVEAMBIENTCRYOGENIC225Xc. BELOW AMBIENTSTORAGE PRESSUREb. ABOVE AMBIENTA. AMBIENT224ABOVEGROUNDTANKUNDERGROI.JNDTANKTANK INSIDE BUILDINGSTEEL DRUMGI-ASS BOTTLEPI.A,STIC BOTTLETOTE BINTANKWAGON0112223AINERi. FIBER DRLMPI-A,STICAIONMETALLIC DRUMI. CYLINDERRAILCAROTHERCANCARBOYs[oBAGBOX[] o. roNs 221Xone itema. GALLONSc. POUNDSb, CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOLNT217DAILY AMOLTNT 218215AL WASTE AMOUNT1 000STATE WASTE CODE220XXXa. FIREc.PRESSURE RELEASEe,CHRONIC HEALTHd. ACUTE HEALTH216b. REACTTVEHAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214P}rySICAL STATE(Check one item only)215LARGESTCONTAINER 250Xa. PUREc. WASTEb. MXTURE211HAZARD MATERIAL(Check one item213CURIESXYes212NoRADIOACTTVEFlammable Gas210CODE HAZARD CLASSES (Complete if required by CUPA)74-98-6209IfEHS is "Yes", all amounts below must be in lbs.PROPANENAME207XYesNoEHS208Liquified Petroleum GasNAME205Xto206IfNoTRADE SECRETrefq to irotructioNYesII. CHEMICAL INFORMATIONID#203MAP# (optional)11204GRID# (optional)E3STORED IN YARDLOCATIONX202NOLOCATION CONFIDENTIALYESBUSTNESS NAME sBcSE1643I. FACILITY INFORMATIONADDDELETEREVISE200Page ofHAZARDOUS MATERIALS INVBNTORY . CHEMICAL DESCRIPTIONOne pago pq matqial per building or uea)HAZARDOUS MATERIALS^ -/GRAM CONSOLIDATED FORM[]NIFIED(l169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL TOCALLY COLLECTED NFORMATION246at gr@ter thm I % by weight ifnon-crcinogenic, or 0. I % by weight if cucinogmic, attach additional sh@ts ofpaps captudng the required infomationIf more huardous componots ile pr6mt2422442432452382392402412342352362371-2230231Additivesf}"'232Proprietary233I g8-9g226Lubricating Base Oil227!v* I *o 228Various229o/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOW AMBIENTd. CRYOGENIC225XA, AMBIENTSTORACE PRESSUREABOVE AMBIENTBELOW AMBIENT224ABOVE GROLTND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEELDRUMPI-ASTIC/NONMETALLIC DRUMCANCARBOYSII,OFIBER DRUMBAGBOXCYLINDERGT.ASS BOT'TLEPLASTIC BOTTLETOTE BINTANKWAGON22305o.RAILCAROTHERI o, roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOLTNT 217DAILY AMOLTNT 218WASTEAMOLTNT219ATE WASTE CODE220XXa. FIREb. REACTTVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTH216FED HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55Xa. PUREc. WASTEb. MIXTURE211(Check one itemMATERIALX212NoYesRADIOACTTVE213CURIESIII-B COMBUSTIBLE210CODE HAZARD CLASSES (Complete if rsquired bv CUPA)64742-54-7209IfEHS is "Yes", all amounts below must be in lbs.HYDRAULIC FLUIDMON NAME207XNoYes208PETROLEUM HYDROCARBONNAME205X206IfNoYesTRADE SECRETto EPCM, refer to hstructiotrII. CHEMICAL INFORMATIONID#I204GRID# (opfional)F4203MAP# (optional)1STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSE164SBCNAMEI. FACILITY INFORMATIONADDDELETEREVISE200ofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mtqial po building or ue)HAZARDOUS MATERIALS,.JGRAM CONSOLIDATED FORMLINIF'IEDUPCF (l/ee)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL T,OCALLY COLLECTED INFORMATION246componentsIfmorcatgreatqpr6enthu ardousorbythmt%o/oby0,ifnon-cucinogenic,weightif cacinogmic,attachweighttherequiredof papqcapturingadditionalsheetsinfomation.242243o0s244245238239es240241234235eslJo237230231es232233zzoI too%NITROGEN227esNo2287727-37-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTc. BELOW AMBIENTABOVE AMBIENTCRYOGENIC225XSTORAGE PRESSUREA. AMBIENTb, ABOVE AMBIENT224ilc. nercw AMBIENTABOVEGROUNDTANKUNDERGRO1JND TANKTANK INSIDE BUILDINGSTEELDRUMPI.A,STIC/NONMETALLIC DRUMCANCARBOYSLOFIBER DRUMBAGBOXCYLINDERGL.{SS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON22312c.STORAGERAILCAROTHERXone itema. GALLONSc. POUNDSb. CUBIC FEETd. TONS221222DAYS ON SITE:365VERAGE DAILY AMOIJNT217DAILY AMOLTNT 218219WASTE AMOLTNT2536ATE WASTE CODE220XA. FIREc.PRESSLIRE RELEASEb. REACTTVEd. ACUTE HEALTH216[l e.cHRoNIC HEALTHHAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LTQUID214one item only)STATE215LARGESTCONTAINER 228Xa. PUREc, WASTEb. MIXTURE211HAZARD MATERIAL(Check one itemX212NoYesRADIOACTTVECURIES213INERT GAS210CODE HAZARD CI-ASSES (Complete if requircd bv CUPA)7727-37-9209IfEHS is "Yes", all amounts below must be in lbs,NITROGENNAME207XNoYesEHS208CHEMICALNAMENITROGEN205X206lfNoYesTRADE SECRETto EPCRA, refq to i$tructioNII. CHEMICAL INFORMATIONID#203MAP# (optional)1E3204GRID# (optional)OUTSIDE BEHIND SHOP YARDLOCATIONXEPCRA202NOLOCATION CONFIDENTIALYESNAME SBCSE164aI. FACILITY INFORMATIONADDDELETEREVISE200ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOnc page pq etqial po building or ua)HAZARDOUS MATERIALST.JGRAM CONSOLIDATED FORMUNIF'IEDUPCF (l/ee)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242243es244245238239241es240234235237es236230232231233226I 1oo$"' f]*o 228ARGON2277440-37-1229o/oWTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA. AMBIENTSTORAGE TEMPERATUREABOVE AMBIENTBELOW AMBIENTSTORAGE PRESSUREA. AMBIENT[lc. nercwAMBIENTABOVE AMBIENTCRYOGENIC225224ABOVE GROI.IND TANKLTNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONM ETALLIC DRUMCANCARBOYs[-oFIBER DRLMBAGBOXCYLINDERGT.ASS BOTTLEPI-A.STIC BOTTLETOTE BINTANK WAGON12223AINERRAILCAROTHER222DAYS ON SITE:365I o, roNs 221Xone itema. GALLONSc. POUNDSb, CUBIC FEETVERAGE DAILY AMOTJNT217DAILY AMOLTNT 218220WASTECODE219ANNUAL WASTE AMOIJNT222XXc,PRESSURE RELEASEa. FIREb. REACTTVEo,CHRONIC HEALTHd. ACUTE HEALTH216HAZARD CATEGORIESall that apply)Xone item only)c. GASa. SOLIDb, LIQUIDSTATE214215LARGESTCONTAINER 222X(Check one itema. PUREc. WASTEb. MXTUREHAZARD MATERIAL211213CURIESXYes212NoRADIOACTTVENON-FLAMMABLE GAS210CODE HAZARD CLASSES (Complete if required by CUPA)7440-37-1209lf EHS is "Yes", all amounts below must be in lbs.ARGONNAME207XNoYesEHS208ARGONNAME205XTRADE SECRET206Norefer to istructioNYesII. CHEMICAL INFORMATIONID#203MAP# (optional)11F4204GRID# (optional)STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESNAME SBCSE1643I. FACILITY INFORMATIONADDDELETEREVISE200Page ofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne psge ps mtqial pu building or rea)HAZARDOUS MATERIALS^.JGRAM CONSOLDATED F'ORMTTNIF'IEDUPCF (r/ee) I(t69OES Form 2731 fII[IFIED. JGRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page po rotoial pc building or rea)If EPCRA, Please Sign HereADDITIONAL TOCALLY COLLECTED INFORMATION246ile prqflt at greater thm I % by weight ifnon-c6chogenic, or 0. l% by weight if cilcinogmic, attach additional sheets ofpaper capturing thc required infomation.If more heardous compooflts242243es244245238239ES240241J234236|J* EN"235237230231es232233I too%226MOTOR OIL, USED227[J.' []"" 2288002-05-9229o/oWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTd. CRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOW AMBIENT224FIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWACON01223STORAGEe. PI,ASTICNONMETALLIC DRUMRAILCAROTHERTANK INSIDE BUILDINGSTEEL DRUMCANCARBOYsIloa. ABOVEGROUNDTANKb. I.TNDERCROIJNDTANK! o, roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOIJNT 218219ANNUAL WASTE AMOI.INT240220221ATE WASTE CODEf] o.pRESSURERELEASE I O. nCUTeHEALTHXXa. FIREe.CHRONIC HEALTHb. REACTTVE216}IAZARD CATEGORIESall that apply)Xa. SOLIDc. CASb. LIQUID214PHYSICAL STATEone item only)215LARGESTCONTAINER 240X212YesRADIOACTIVENo213CURIESXa. PUREc. WASTEb. MIXTURE211COMBUSTIBLE LIQ.38210CODE HAZARD CLASSES (Complete if required bv CUPA)HAZARD MATERIAL(Check one item8002-05-9209IfEHS is "Yes", all amounts below must be in lbsUSED MOTOR OILNAME207XNoYesEHS208PETROLEUM HYDROCARBONNAME205Xto206lfNoYesTRADE SECRETrefq to istructioNII. CHEMICAL INFORMATIONFACILIry ID#'lF4204GRID# (optional)203MAP# (optional)1EAST SIDE OF SHOPLOCATIONX202NOCHEMICAL LOCATION CONFIDENTIALYESEPCRANAME SBCsE164I. FACILITY INFORMATIONADDXDELETEPage ofREVISE200LrPCF (lhlee)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246thu I % by weight ifnon-cacinogenic, or 0, I % by weight ifcdcitrogenic, attach additional sheets ofpapo capturing the requircd infomationIfmore huardous componflts ile pr6mt at greats242243244245238239240241J2342352362370-5230Diethylene Glycol231ft.. EN" 2321 1 1 -46-6233I go-gs226ETHYLENE GLYCOL227[v"' [*o 228107-21-1229%wrFIAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOCENIC225l]r. enoveAMBIENT [c. BEL0WAMBIENTXSTORAGE PRESSUREA, AMBIENT224e, PLASTICNONMETALLIC DRUMf. CANg. CARBOYFIBER DRLMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANK WAGON0514zzJAINERs[od, STEELDRUMRAILCAROTHERABOVE GROI-JND TANKUNDERGROLTND TANKTANK INSIDE BUILDINGI o. roNs 221Xone itema. GALLONSc. POUNDSb, CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOTJNT218219ANNUAL WASTE AMOLTNT55STATE WASTECODE22QXXXa. FIREb, REACTIVEc.PRESSURE RELEASEd, ACUTE HEALTHe.CHRONIC HEALTH216TIAZARD CATEGORIESall that apply)Xone item only)a. SOLIDc. GASb, LIQUID214STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MXTURE211MATERIALXYes212RADIOACTTVENo213CURIESCombustible 3B210CODE HAZARD CLASSES (Complete if required by CUPA)107-21-1209If EHS is "Yes", all amounts below must be in lbs.ANTIFREEZE/COOLANTCOMMON NAME207XNoYesEHS208GLYCOLSNAME205XTRADE SECRET206NoYesto EPCRA, refq to instructioNII. CHEMICAL INFORMATIONID#1204GRID# (optional)F4203MAP# (optional)1STORED IN SHOPLOCATIONX202NOCHEMICAL LOCATION CONFIDENTIALYESEPCRANAME sBcSE1643I. FACILITY INFORMATIONADDDELETEREVISE200ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page po rotoial per building or re)IIAZARDOUS MATERIALS, _ JGTTAM CONSOLIDATED FORMT]I\IFIEDUPCF (r/ee)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL TOCALLY COLLECTED INFORMATIONffeatgreatqp16fltcomponotsIfmorehzardousorbythmt%o/oby0.if non-cocinogmic,weightadditionalsheelsif cacinogenic,attachweighttherequiredofpapocapturinginfomation.s 1-5242Amines243es24468439-80-52450-10238Polyosobutenyl Succinimide239ES24067762-77-O2410-1 0234Petroleum solvent refined235es23664741-97-523720-40230Base Stock231[vr'232I so-zo226Solvent refined Petroleum Oils227[v"' I^o 22823322964741-88-464741-89-5%w'tHAZARDOUS COMPONENT (For mixture or waste only)EHScAs#XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOW AMBIENTd. CRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224ABOVEGROUNDTANKTJNDERCROUND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONM ETALLIC DRUMCANCARBOYs[oGT.ASS BOT'TLEPI.ASTIC BOTTLETOTE BINTANKWAGON22305I. CYLINDERSTORAGERAILCAROTHERFIBER DRLMBAGBOXI a. roNs 221Xone itema. GALLONSc. POUNDSb, CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOLJNT217MAXMUM DAILY AMOTJNT 218219WASTE AMOUNT110ATE WASTE CODE220d, AcUrE HEALTH [l e.CHRoNlc HEALTHXXa. FIREb. REACTTVEo.PRESSURE RELEASE216HAZARD CATECORIESall that aPPIY)Xone item only)a. SOLIDc, GASb. LIQUID214STATE215LARGESTCONTAINER 55X(Check one itema, PUREc. WASTEb. MXTUREHAZARD MATERIAL211X212RADIOACTIVENoYes213CURIESIII.B COMBUSTIBLE210CODE }IAZARD CLASSES (COMPIEIC if TEqUiTEd bY CUPA)64742-56-9209If EHS is "Yes", all amounts below must be in lbs.AUTOMATIC TRANSMISSION FLUIDNAME207XNoYesEHS208HydrocarbonNAME205X204IfNoYesTRADE SECRETto EPCRA, refq to iNtructioNII. CHEMICAL INFORMATIONID#1203MAP# (optional)1F4204GRID# (optional)STORED IN SHOPLOCATIONX202NOCHEMICAL LOCATION CONFIDENTIALYESNAME sBcSE164eI. FACILITY INFORMATIONADDDELETEREVISE200ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONone page pq mtqial pu building or re)HAZARDOUS MATERJALS-. JGRAM CONSOLIDATED FORMUNIFIEDUPCF (1/9e)r69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL TOCALLY COLLECTED INFORMATION24652422442432452%238DIPOTASSIUM PHOSPHATE239o2407758-11-42411Oo/o234WATER235o2367732-18-52371%230DIETHYLENE GLYCOL231111-46-6233$"'232I g4%226esI^o 228ETHYLENE GLYCOL227107-21-1229%wTEHSFIAZARDOUS COMPONENT (For mixture or waste only)cAs#XSTORAGE TEMPERATUREc. BELOW AMBIENTA. AMBIENTABOVE AMBIENTCRYOGENIC225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENT224[-lc. BELow AMBIENTABOVE GROT]ND TANKUNDERGROI,IND TANKTANK INSIDE BUILDINCSTEEL DRUMFIBER DRUMBAGBOXCYLINDERGI-ASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON22306CANe. PT ASTIC/NONMETALLIC DRUMg, CARBOYsILoRAILCAROTHERI o. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOUNT217DAILY AMOUNT 218219WASTE AMOUNT55220343ATEWASTECODEXXXa. FIREb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTH216l] o.PRESSURE RELEASEHAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214PTrySICAL STATE(Check one item only)215LARGESTCONTAINER 55Xa. PUREc. WASTEb. MIXTURE211FIAZARD MATERIAL(Check one item213CURIESXYes212NoRADIOACTIVECOMBUSTIBLE LIQ.38210CODE IIAZARD CLASSES (complete if requbed by CUPA)107-21-1209If EHS is "Yes", all amounts below must be in lbsUSED ANTIFREEZENAME207XNoYesEHS208GLYCOLSNAME205Xto206tfNoYesTRADE SECRETrefq to iNtructioroII. CHEMICAL INFORMATIONID#1204GRID# (optional)F4203MAP# (optional)1STORED EAST SIDE SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESBUSTNESS NAME sBcsE1643I. FACILITY INFORMATIONADDDELETEREVISE200Page ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per material pa building or oea)HAZARDOUS MATERIALS^.JGRAM CONSOLDATED FORMUI\IFIEDUPCF (l/ee)169OES Form 2731 IINIFIED-, JGRAM CONSOLDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page po mtoial po building or uea)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246tr9pr6entcomponfltsIfmorehzardousOI%thmgr@terpapq0.non-cucmogilc,weightifbyifcacinogenic,attachbyweight%therequiredcapturingofadditionalsheetsinfomation.5242243o244245238239240241234235236|J"' EN"237230USED OIL231nY*2328002-05-9ZJJ1 noo%226USED OIL FILTERS227No2288002-05-9229%WTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA, AMBIENTABOVEAMBIENTBELOW AMBIENTf-lo. cnvocnNtc225XSTORAGE PRESSUREA, AMBIENTABOVEAMBIENTBELOW AMBIENT224ABOVE GROUND TANKT]NDERCROUND TANKTANK INSIDE BUILDINGSTEELDRUM22305m,GLASS BOTTLEi. FIBER DRUMPIASTIC/NONMETALLIC DRUMSTORAGERAILCAROTHERCANCARBOYsl.oBAGBOXCYLINDERPLASTIC BOTTLETOTE BINTANKWAGONI o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365VERAGE DAILY AMOUNT 217DAILY AMOTINT 215WASTE AMOLINT2't9220STATE WASTE CODE223XXa. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC ffiALTH216TIAZARD CATEGORIESall that apply)Xone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MXTUREHAZARD MATERIAL211X212YesRADIOACTTVENo213CURIESCOMBUSTIBLE LIQ.38210CODE TIAZARD CI-ASSES (Complete if required bv CUPA)8002-05-9209If EHS is "Yes", all amounts below must be in lbs'USED OIL FILTERSNAME207XNoYesEHS208PETROLEUM HYDROCARBONCHEMICALNAME205XTRADE SECRET206NoYesto EPCRA, rcfer to instructioNII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4LOCATIONEAST SIDE OF SHOPXEPCRA202NOLOCATION CONFIDENTIALYESNAME SBCSE164JI. FACILITY INFORMATIONADDDELETEREVISE200ofuPcF (l/ee)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL T.OCALLY COLLECTED INFORMATION246greatq thm l% by weight ifnon-cacinogenic, or 0. l7o by weight if cucinogenic, attach additional sh@ts ofpapq capluring the required infomation.lfmore heardous components tre pr6ent at242243244245238239241es240234es236235237230es232231233226I tooesNo228HELIUM2277440-59-7229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREABOVE AMBIENTBELOW AMBIENTCRYOGENIC225A. AMBIENTSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOW AMBIENT224ABOVE GROTJND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEELDRUMGTASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERi. FIBER DRUMPLASTIC/NONMETALLIC DRUMCYLINDERK. BOXBAGo. RAILCAROTHERCANCARBOYsII.oI o. roNs 221Xa. GALLONSc. POUNDSb. CUBIC FEETUNITS*one item222DAYS ON SITE:365217DAILY AM9LTNTDArLy AMOLTNT 218219ANNUALWASTE AMOLTNT228STATE WASTE CODE220d, AcurE HEALTH fl e.cHRoNlc HEALTHXa. FIREb. REACTIVEc.PRESSURE RELEASE216TIAZARD CATEGORIESall that apply)Xone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARCESTCONTAINER 228X(Check one itema. PUREc. WASTEb, MXTURE211MATERIAL213CURIESXYes212RADIOACTIVENoINERT GAS210FIRE CODE HAZARD CLASSES (complete if requbed by CUPA)7440-59-7209If EHS is "Yes", all amounts below must be in lbs.HELIUMNAME207XYesNoEHS208HELIUMNAME205XTRADE SECRETto206Norefs to iNtructioNYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F3STORED IN OFFICELOCATIONX202NOLOCATION CONFIDENTIALYESNAME SBCSE1643I. FACILITY INFORMATIONXDELETEADDREVISE200Page ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page pq mtsial po building or ae)HAZARDOUS MATERIALS^.JGRAM CONSOLIDATED FORMUNIFIEDUPCF (1/ee)169OES Form 2731 UNIF'IED^.JGRAM CONSOLIDATED FORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIoNOne page pq mtqial pqbuilding or ue)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246requiredinfomation.capturinglheofpapesheetsattachadditionalcrucinogenic,orif%by weight0.non-cacinogmic,weightif%bythilalgreatqtrep16fllcomponentshuardousIfmore2452442435242241es240239238237es23823523423323223123074-86-2229f1", f l*o 22sACETYLENE227| rcoyoazoCAS#EHSHAZARDOUS COMPONENT (For mixture or waste only)%wT[c. BEr.owAMBrENr []0. cnvocrNrcXABOVE AMBIENTA, AMBIENTSTORAGE TEMPERATURE225BELOW AMBIENTABOVEAMBIENTA. AMBIENTSTORAGE PRESSUREzz4ABOVE GROLTND TANKLTNDERGROTIND TANKTANK INSIDE BUILDINGSTEEL DRUMGI,ASS BOTTLEPII,STIC BOTTLETOTE BINTANK WAGON12CONTAINER223i. 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GALLONS:1.I o. roNs 221ATE WASTE CODE220219WASTE AMOTINT124DAILY AMOUNT 218217VERAGE DAILY AMOUNTXe.CHRONIC HEALTHc.PRESSURE RELEASE216b. REACTryEa. FIREf] o. ecureHEALrH t]HAZARD CATEGORIESall that apply)Xc. GASone item only)a. SOLID214STATEI u. r.rquro213CURIESX215212NoYesRADIOACTIVELARGESTCONTATNER 124Xc, WASTEb. MXTUREa, PURE211TIAZARD MATERIAL(Check one item210OXIDIZER 3(Complete ifrequired by CUpA)CODE }IAZARD CLASSESIf EHS is "Yes,', all amounts below must be in lbs.7782-44-7209XYesNo208EHSOXYGEN207NAMEXTRADE SECRET206NoYesirotructiomto EPCM, refq toOXYGEN205NAMETIONINFORMAII.CHEMICAL204GRID# (optional)E3203MAP# (optional)11ID#XNOYES202LOCATION CONFIDENTIALCHEMICALSTORED IN SHOPLOCATIONsE164SBC3NAMEFACILITYTIONINFORMAI.200REVISEDELETEADDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DEScRIPTIoNbuilding or ae)Orre page po mtoial po^.JGRAM CONSOLIDATED T'ORMUNIFIEDUPCF (l/ee)169OES Form 2731 MAP# 1StrTE N4APBUSINESS NAME SBCBUSINESS ADDRESSSNLOCA1 R ST1 641 96 SUBURBAN RDSAN LUIS OBISPODATE 10/31 /2005ztP CODE 93403DRA'IfING SCALENOT TO SCALE@cIDctrIDza-ll,mrn-J452367IiiJi{olcLARl-- i---j-r --r J-----i--r-- - --- - - - r -@WASTEANTIFRTTZEKALPREPARED BY:GRorrP XNcSYMBOL LEGENDIMsd-s-l |}t$irdilND MSDSL FIRE HYDRANT.x-* FENCTEMERGENCY RESPONSEEQUIPMENT/ABSORBENTSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE LIQUIDS)BATTERY TLECTROLYTE(coRRosrvE LTQUTD)GASOLINE(FLAI/MABLE LIQUIDS)DIESEL FUEL(cOMBUSTrBLt Lr0UrDiNITROGEN(COMPRESSED GAS)PROPANE(FLAMMAELE LIOUID)ACETYLENE(COMPRESSED GAS)ANTI FREEZElCOOLANTSWASTE OIL(FLAMMABLE LIQUID)FIRE PULL BOXARGONOXYGENAUTOMATIC TRANSiVISSIONFLUIDF@@@@@@;00,o+tr\-Al-EZ']STAGING AREAEVACUAIION/@@@TELEPHONEFIRST AID KITFIRE EXTINGUISHERSTORfuI DRAINSANITARY SEWERILECTRICAL PANELSHUT-OFFNATURAL GASSHUT-OFFWATER SHUT_OFFEMERGENCY PUMPSHUT_OFFTANK MONITORINGALARMSTORAGEOFFI CFLAN/l\/ABLEKWATERTANK+ADN/INISTRATIONBUILDINGMOTORVEHICLESHOP9BcDEFGHJM a-AT&T Services, Inc. Environment, Health & SafetyP,O. Box 5095, Room 3E000San Ramon, CA 94583&atatVIA CERTIFIED MAIL7006 0100 0002 3005 9931October 31, 2006D. Kerry Boyle, Hazardous Materials CoordinatorCity of San Luis ObispoCity Fire Department2160 Santa Barbara Ave.San Luis Obispo, CA9340l-5240RE: Inspection onl0t4t06 at Pacific Belt dba AT&T - 196 Suburban Road, San Luis ObispoAT&T Insp. # 3133Dear Mr. Boyle,This is in follow-up to your verbal request from Sharon Ramirez, Site Manager for the following document:Hazardous Materials Annual Inventory - 2006.aPlease see attached document, as requested. RHL Design Group, on behalf of AT&T has confirmed thatthey send the City of San Luis Obispo, City Fire Department copies of the Hazardous Material BusinessPlans and Inventories on an annual basis or sooner, ifthey are updated.Ifyou have any questions or need additional information, please contact me at (9ZS) 824-5783Sincerely,Andy TayloriFileSharon RamirezSteve SkandersonAttachmentccKM:sb ICITY OF SANLUIS OBISPOD(xFIRE DEPARTMENT2160 Santa Barbara Avenue * San Luis Obispo, CA9340l-5240 * 805-781-7380HAZARDOUS MATERIALS BUSINESS PLAI\ UPDATE FORMYEAR 2OO5FACILITY NAMEcRr- sF164ADDRESS1q6 SIIRITRRAN RDSAN T IITS ORTSPO (-A S14OCONTACT PERSONT.erru CodevTELEPHONE | 83 1 -37 2-21 42Annual Inventory Update (due each year)tlNo Significant changes in inventory have occured since the last Business Plan or inventory wassubmitted.New inventory forms are attached[ ] Replace previous inventorywith attached inventory.[ ] Replace only designated pages of inventory.Additional CommentsYearly Review and RecertificationI certify that the Business Plan has been reviewed and the information contained in the BusinessPlan is accurate and complete as of this date.Other UpdatestlPlease incorporate the following information into the Business Plan for thisfacili1ry:I declare, under penalty of perjury, that the information provided herein is true andcorrect to the best of myknowledge.Date: November 15.2004Printed Name:SteveRHL |)esisnAsent for SRCPlease Return to: Molly Brown, Hazardous Materials SectionCity Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA9340l-5240H:/BUSINESS PLAN UPDATE FORM MOLLYThe C1y of San Luis Obispo is committed to include the disabled in all of its services, programs and activitiesTelecommunications Device for the Deaf (805) 781'7410' UNIFIEDRAM CONSOLIDATED FORMBUSINESS OWNER/OPERATOR IDENTIFICATIONFACILITY INFORMATION136OF(print)Steve SkandersonProject ManagerOF SIGNER137134DATE11t15t20044 AtNAME OF DOCUMENT PREPARERRHL DESIGN GROUP, INC. - AGENT FOR SBCBased on my inquiry of those individuals responsible for obtaining the information, I certifyunder penalty of law that I have personally examined and am familiarthe information submitted and believe the information is true, accurate, and complete.PAGER#127PAGER#132866-492-6836 (866-l WANT EM)z4-HOURPHONE126866-492-6836 (866-l Want EM)24-HOURPHONE131831-372-2142BUSINESS PHONE125877-322-4722BUSINESS PHONE130Property Manager124IITLE24 HR EMERGENCY SERVICEIITLE129Larry CodayNAME123128NAME EMERGENCYCONTROLCENTERPRIMARYIV. EMERGENCY CONTACTSSECONDARYSAN RAMON120CITY12112294583-0995CODEATECA119RM 3EOOO2600 CAMINO RAMONCONTACT MAILING ADDRESSEnvironmental Management, attn: James StehrACT PHONE925-823-8866117118NAMEALrII M,NVTRrINMF"NTCONTACTSAN RAMON114CITY115STATECAOWNER MAILING ADDRESSP.O. Box 5095, Room 3E000113SBC111112866-492-6836NAMEPHONEil.OWNEROPERATORPHONE831-372-2142OPERATORNAME110'109SAN LUIS OBISPO108COUNTYIC CODE (a digit #)48131 0-340-1 61 BBRADSTREET107106SAN LUIS OBISPO104CITY10593403CACODEl'"SITEADDRESS196 SUBURBAN RD103BIJSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)SBCPHONE831-372-2142sE1643102-'ACILITY ID#1f ,if.1f t'' I0110112005DATE10010112t3112005DATEI. IDENTIF'ICATIONPage ofZTP CODE94583-0995116LOCALLY COLLECTED INFORMATION:UPCF (1/00 revised)167oES FORM 2730 (r/99) UNIF'IED..OGRAM CONSOLIDATED T'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per roterial per building or aea)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION?462422432442452382392402413 15-20234Additives235236Proprietary237230Zinc Compound231es232Proprietary2331 Bo-as226esI*o 228LUBRICATING BASE OIL227Various229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTc. BELOWAMBIENTCRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVEGROUND TANKUNDERGROTIND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSLOFIBERDRTIMBAGBOXCYLINDERGIASS BOTTLEPIASTIC BOTTLETOTEBINTANKWAGON22305c.RAILCAROTHERI a. roNs 221Xone item only)a. GALLONSb. CUBICFEETc. 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FACILITY INFORMATIONADDDELETEREVISE200Page of1.i\UPCF (l/ee)r69OES Form 2731 242!v"'2442432452382402392412342362352372 0-5230Diethylene Glycol2312321 1 1-46-62331 go-gs226ETHYLENE GLYCOL227No228107-21-1229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTBELOW AMBIENTABOVEAMBIENTCRYOGENIC225XA, AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOW AMBIENT224PT}.STICNONMETALLIC DRUMCANCARBOYsILoFIBERDRUMBAGBOXCYLINDERGI/,SS BOTTLEPI.ASTIC BOTTLETOTEBINTANKWAGON223TORAGE0514RAILCAROTHERc. TANK INSIDE BUILDINGd. STEELDRUMABOVE GROUND TANKTINDERGROUND TANKI a. roNs 221Xone item only)a. GALLONSc. POLJNDSb. CUBIC FEET222DAYS ON SITE:365MAXIMUMDAILYAMOUNT 218AVERAGE DAILY AMOLTNT217219WASTEAMOUNT55220WASTECODEXXa. FIREb. REACTIVEd. ACUTE HEALTHo.PRESSURE RELEASEe.CHRONIC HEALTH216(Check all that apply)FIAZARD CATEGORIESXa. SOLIDc. GASb. LIQUID214one itemonly)STATE215LARGESTCONTAINER 55Xa. PUREc. WASTEb. 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CUBIC FEETIINITS*one item222DAYS ON SITE:365217DAILY AMOUNTMAXIMUM DAILY AMOTINT 218219WASTEAMOUNT1 000STATE WASTE CODE220XXXa. FIREc.PRESSURE RELEASEb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTH216I{AZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID2't4one item only)STATE215LARGESTCONTAINER 250XA. PUREc. WASTEb. MIXTURE211HAZARD MATERIALTYPE (Check one itemXNoYesRADIOACTIVE212213CURIESFlammable Gas210CODE IIAZARD CLASSES (Complete if rcquir€d bv CUPA)74-98-6209If EHS is "Yes", all annurts below must be iIt lbs.PROPANENAME207XNoYesEHS208Liquified Petroleum GasNAME205X206IfNoYesTRADE SECRETto EPCRA, rcfer to instructionsII. CHEMICAL INFORMATIONFACILITY ID#1204GRID# (optional)E3203MAP# (optional)1STORED IN YARDLOCATIONX202NOLOCATION CONFIDENTIALYESSE164SBCNAMEI. FACILITY INFORMATIONADDDELETEREVISE200Page of{UPCF (l/ee)t69OES Form 2731 If EPCRA, Please Sign Here246ADDITIONAL LOCALLY COLLECTED INFORMATION242243es244245238239[v.'2402413234235oft"236237230231[vr.232z5Jzzo1 roo%$" I*o228MOTOR OIL, USED2278002-05-9229%wrEHSIIAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOWAMBIENTd. CRYOGENIC225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROLIND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsLoFIBERDRUMBAGBOXCYLINDERGIASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON2230'lRAILCAROTHERSTORAGECONTAINERf'l o. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217DAILY AMOTINTDAILY AMOUNT 218219WASTEAMOUNT110220STATE WASTE CODE221XXa. FIREc.PRESSURE RELEASEb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTH216I{AZARD CATEGORIESall that apply)Xc. GASa. SOLIDb. LIQUID214one item only)STATE2',15LARGESTCONTAINER 120X(Check one itema. PUREc. WASTEb. 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CIIEMICAL DESCRIPTIONOne page per mterial per building or aea)246'\-If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION242es243245238239241234235236237230USED OIL2312328002-05-9233226I roo%USED OIL FILTERS227o2288002-05-9229%wTHAZARDOUS COMPONENTmixture or waste only)CAS#XA. AMBIENTSTORAGE TEMPERATUREABOVEAMBIENTBELOWCRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOW224ABOVE GROLTND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUM05TORAGESLOf. CANDRUMGIASS BOTTLEPIASTIC BOTTLETOTE BINTANKWAGON223FIBERDRUMBAGRAILCAROTHERXc.a. GALLONSb. CUBIC FEETTINITS*one ltemI a. roNs 221222DAYS ON SITE:365217DAILY AMOUNTUM DAILY AMOUNTWASTE AMOLINT219220223TATE WASTE CODEXa. FIRE,b. REACTTVEc.PRESSUREHAZARD CATEGORIESall tlrat apply)Xe.CHRONIC HEALTHd. ACUTE HEALTH21621Xone item only)a. SOLIDc. GASb. LIQUIDSTATE215LARGESTCONTAINER 55211X(Check one itema. PUREb. 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CHEMICAL INFORMATIONFACILITY ID#203MAP# (optional)11204GRID# (optional)F4STORED EAST SIDE SHOPCIIEMICAL LOCATIONX202NOCHEMICAL LOCATION CONFIDENTIAIYESEPCRANAME sBcsE164oI. FACILITY INFORMATIONADDDELETEREVISE200ofPageUPCF (l/ee)169OES Form 2731 fINIFIED-.OGRAM CONSOLIDATED F'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per rot€rial per building or area)LOCATIONSTORED IN SHOPXA. GALLONSb. CUBIC FEETC. POUNDSI a. roNs 221one itemo/oV'/TIfmore huardous components are prsentat grearer thil I % by weight if non-carcinogenic, or 0. 1 % by weight if carcinogenic, attach additional sheets ofpaper capturing the required infomationUNITS*169 vt)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMAT1ON24052422432442452382392402412342352362371-2230Additives231es232Proprietary2331 g8-gg226Lubricating Base Oil227esI"o 228Various229EHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA. AMBIENTSTORAGE TEMPERATURE[t. enoveAMBIENTBELOWAMBIENTd. CRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVEGROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEELDRUMGI/,SS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON22305i. FIBERDRUMPLASTIC/NONMETALLIC DRUMg. CARBOYo.sLoCANTORAGEAINERRAILCAROTHERBAGBOXCYLINDER222DAYS ON SITE:365217DAILY AMOUNTDAILY AMOI.INT 218WASTE AMOTINT219TATEWASTECODE220XXa. FIREb, REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTH216HAZARD CATEGORIESall that appl,Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MIXTUREMATERIAL211X212NoYesRADIOACTIVE213CURIESIII-B COMBUSTIBLE210CODE HAZARD CLASSES (Complete if required bv CUPA)64742-54-7CAS#209If EHS is "Yes", all anmmts below mmt be in lbs.HYDRAULIC FLUIDNAME207XYesNoEHS208PETROLEUM HYDROCARBONNAME205XTRADE SECRETto206Norefer to instructionsYesII. CHEMICALINFORMATIONID#203MAP# (optional)11204GRID# (optional)F4X202NOLOCATION CONFIDENTIALYESNAME sBcSE1643I. FACILITY INFORMATIONADDDELETEREVISE200Page ofUPCF (1/e9)OES Form 2731 T]NIF'IED^.OGRAM CONSOLIDATED F'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CIIEMICAL DESCRIPTIONOne page per mteilal per building or area)If EPCRA, PleaseADDITIONAL LOCALLY COLLECTED INFORMATION246apprsentcomponentslf morehzardousatorg€ater thmt%0.ifnon-cucinogenic,bywe ighttvoifcucinogenic,attachbyweightcapturingrhesheetsofpaperadditionalrequiredinfomtion.1-5242Amines24324468439-80-52450-1 0238Polyosobutenyl Succinimide239!v.'24067762-77-O2410-1 0234Petroleum solvent refined23523664741-97-523720-40230Base Stock23123264741-88-42331 so-zo226Solvent refined Petroleum Oils227!v.' I*o 22864741-89-5229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTd. CRYOGENIC225XA, AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROTIND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMFIBERDRUMBAGBOXCYLINDERGI,ASS BOTTLEPIASTIC BOTTLETOTE BINTANKWAGON223uco.TORAGEAINERRAIL CAROTHERg. CARBOYh. srloPTASTICA{ONMETALLIC DRUMCANI u. cueIcFEEr Ef] a. roNs 221Xone item only)a. GALLONSc. POUNDS222DAYS ON SITE:365217DAILYAMOUNTDAILYAMOUNT 218219WASTEAMOLTNT110220WASTECODEXXa. FIREb. REACTTVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LTQUID214one item only)STATE215LARGESTCONTAINER 55Xa. PUREc. WASTEb. MIXTURE211(Check one itemMATERIALX212NoYesRADIOACTTVE213CURIESIII-B COMBUSTIBLE210FIRE CODE IIAZARD CLASSES (Complete if re4uired bv CUPA)64742-56-9209If EHS is "Yes", all amunts below must be in lbsAUTOMATIC TRANSMISSION FLUIDNAME207XYesNoEHS208HydrocarbonNAME205XTRADE SECRET206Norefer to instructionsYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESNAME SBCSE1643I. FACILITY INFORMATIONADDDELETEREVISE200Page ofUPCF (1/ee)t69VoOES Form 2731 UNIFIED^.OGRAM CONSOLIDATED X'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CIIEMICAL DESCRIPTIONOne page per roterial per building or uea)DAILY AMOLJNT217il246!.'LIf EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION5242244243245238240239241234235236237231!v* EN" 232233226I roo%NITROGEN227No228lJ.' I7727-37-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOW AMBIENTCRYOGENIC225STORAGE PRESSUREc. BELOWAMBIENTA, AMBIENTABOVEAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBERDRUMBAGBOXCYLINDERGI-ASS BOTTLEPIASTIC BOTTLETOTE BINTANKWAGONPLASTIC/NONMETALLIC DRUM22312CANCARBOYSLORAILCAROTHERSTORAGECONTAINER! o. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365DAILY AMOUNT 218219WASTEAMOUNT2536STATE WASTE CODE220! a.ecurnHEALrH trXa. FIREc.PRESSURE RELEASEb. REACTIVEe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID2't4one item only)STATE215I-ARGESTCONTAINER 228X(Check one itema. PUREc. WASTEb. MIXTUREHAZARD MATERIAL211XYes212RADIOACTTVENoCURIES213INERT GAS210CODE HAZARD CLASSES (Completc if required by CUPA)7727-37-9209If EHS is "Yes", all annmts below must be in lbs.NITROGENNAME207XYesNoEHS208NITROGENNAME205X206IfNoYesTRADE SECRETto EPCRA, refer to instructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (opfional)E3OUTSIDE BEHIND SHOP YARDCHEMICAL LOCATIONX202NOLOCATION CONFIDENTIALYESNAME sBcsE164JI. FACILITY INFORMATIONDELETEADDofREVISE200UPCF (1/9e)t69OES Form 2731 UNIFIED^.OGRAM CONSOLIDATED F'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mterial per building or uea)210HE"If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246thm l% by weight ifnon-cucinogenic, or 0. l% by weight ifcdcinogenic, attach additional sheets ofpaper capturing the required infomtion.lfmore huardous components ae prsent at gr€ater5243244245238239240241234/l(ts\i2352362372305^2312322331 too%226NE227[v.r [ro 22874-86-2229%wTCOMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENTd. CRYOGENIC225STORAGE PRESSUREa.ABOVEAMBIENTBELOWAMBIENT224UNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUM12TORAGEa. ABOVEGROUNDTANKGI},SS BOTTLEPI-{STIC BOTTLETOTE BINTANKWAGON223i. FIBERDRUMDRUMCANCARBOYSILORAILCAROTHERBAGBOXCYLINDERXone item only)a. GALLONSb.c. POUNDSFEETI o. roNs 221222DAYS ON SITE:365217DAILY AMOUNT218DAILY219WASTEAMOUNT118TE WASTE CODE220XXa. FIREb. REACTTVEc.I{AZARD CATEGORIESall that apply)Xd. ACUTE HEALTH216RELEASEf l e.cHRoNIC HEALTH214Xa. SOLIDc. GASb. LIQUIDone item only)STATE215LARGESTCONTAINER 1 18Xa. PUREc. WASTEb. MIXTURE(Check one itemMATERIAL213CTJRIESXNo212YesRADIOACTTVEFLAMMABLE GASCODE I{AZARD CLASSES (Complet€ if required by CUPA)74-86-2209IfEHS is "Yes", all arnourts below must be in lbs.ACETYLENENAME207XYesNoEHS208ACETYLENENAME205X206IfNoYesSECRETto EPCRA, refer to instructionsII. CHEMICALINFORMATIONID#1203MAP# (optional)1204GRID# (optional)E3STORED IN SHOPLOCATIONXNOLOCATION202NAME SBCSE164JI. FACILITY INFORMATIONDELETEADDPage ofREVISE200UPCF (1/ee)t69OES Form2731 UNIF'IED^^OGRAM CONSOLIDATED F'ORMI1 tooHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)226(If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242243244!v.' EN"245423823S240241J234235236237230232231233ARGON227No2287440-37-1229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTBELOWAMBIENTABOVEAMBIENTCRYOGENIC225STORAGE PRESSUREc. BELOWAMBIENTA. AMBIENTABOVEAMBIENT224ABOVE GROLTND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMPIASTICAJONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPIASTIC BOTTLETOTE BINTANKWAGON't2223RAILCAROTHERI a. roNs 221Xone item only)a. GALLONSb. CUBIC FEETc. POUNDS222DAYS ON SITE:365VERAGE DAILY AMOIjNT217MAXIMUM DAILY AMOUNT 218219WASTEAMOI.INT222220WASTECODEXa. FIREb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEe,CHRONIC HEALTH216(Check all tltat apply)IIAZARD CATEGORIESXone item only)a. SOLIDc. GAS214STATEI t. nqun215LARGESTCONTAINER 222X(Check one itema. PUREc. WASTEb. MIXTURE211MATERIAL213CURIESXYes212RADIOACTIVENoNON-FLAMMABLE GAS210CODE HAZARD CLASSES (COMPICIC if TCqUiTCd bY CUPA)7440-37-1209If EHS is "Yes", all ammts below must be in lbs.ARGONCOMMONNAME207XNoYesEHS208ARGONCTIEMICAL NAME205XTRADE SECRETto206NoYesrefer to instructionsII. CHEMICAL INFORMATIONID#1F4204GRID# (optional)203MAP# (optional)1STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESNAME SBGsE1643I. FACILITY INFORMATIONADDDELETEofREVISE200UPCF (l/ee)t69OES Form 2731 't2UNIF'IED^.dGRAM CONSOLIDATED F'ORMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CIIEMICAL DESCRIPTIONOne page per mterial per building or area)216d. ACUTE HEALTHE.CHRONIC HEALTHA. ABOVEGROUNDTANKT]NDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMSTORAGE1 1oo226b'230If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246Ifmore heardous components tre prsent at geater thm 1% by weighiifnon-cucinogenic, or 0.1% by weight ifcucinog€nic, attach additional sheets ofpaper capturing the required infomtion243lv"'244245238239es2402413234es236z3t[vr'232aaaOXYGEN227No2287782-44-7229%wTHAZARDOUS(For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREa.ABOVEAMBIENTBELOWAMBIENTCRYOGENIC225STORAGE PRESSUREa.BELOW AMBIENTABOVEAMBIENT224FIBERDRUMBAGBOXCYLINDERALLIC DRUM223BOTTLERAIL CAROTHERPI-A,STIC BOTTLETOTE BINTANKWAGONXone item only)b. CUBICf la. GALLoNSc. POUNDSI o. roNs 221222DAYS ON SITE:365VERAGE DAILY AMOUNT217218DAILYAMOUNT219WASTEAMOTINT124STATE WASTE CODE220Xa. FIREb. REACTTVEHAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID21one item only)STATE215LARGESTCONTAINER 124Xa. PUREc. WASTEb, MIXTURE211TIAZARD MATERIALTYPE (Check one itemXYes212NoCURIES213OXIDIZER 3210CODE HAZARD CLASSES (Complete if required by CUPA)7782-44-7CAS#209IfEHS is "Yes", all anrounts below must be in lbs.OXYGENCOMMON NAME207XYesNo208OXYGENCT{EMICAINAME205X206NoYesto EPCRA, refer to instructioroII. CHEMICAL INFORMATIONFACILITY ID#i t,,i li'=1204.GRID# (optional)E3203MAP# (optional)1STORED IN SHOPCHEMICAL LOCATIONX202NOCMMiCAL LOCATION CONFIDENTIALYESEPCRABUSINESS NAME SBCSE164aI. FACILITY INFORMATIONDELETEADDREVISE200Page ofUPCF (1/99)ft; tunOES Form 2731 MAP# 1SNLOCA1 R SEl 64SITE X4APBUSINESS NAME SBCBUSINESS ADDRESS 196 SUBURBAN RDSAN LUIS OBISPODATE 1 O312AO4ZIP CODE93403DRA\{]NG SCALENOT TO SCALT2345b78..r--+-tr-rt-tIlIlio_ol CLARIFIE-=-i -5-j -r _l -r I ---i --=-- - -:acu,cf,IDza-ll,rnm-lALPREPARED BY:GROUF NNCSYMBOL LEGENDELECTRICAL PANELSHUT_OFFNATURAL GASSHUT_OFFWATER SHUT-OFFEMERGENCY PUMPSHUT_ OFFTANK MONITORINGALARMTELEPHONEFIRST AID KITFIRT EXTINGUISHERSTORM DRAINSANITARY SEWERSTAGING AREAEVACUATION/HMMP, AND MSDSLOCATIONEREFIRE HYDRANTFENCEEMERGENCY RESPONSEEQUIPMEN T/ABSORBENTSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE IANKMOTOR OILS & LUBRICANTS(COMBUSTIBLE LIOUIDS)BATTERY ELECTROLYTE(coRR0stvE LTQUTD)GASOLINE(FLAMMABLE LIQUIDS)DIESEL FUEL(COMBUSTIBLE LIOUNlTROGEN(COMPRESSED GAS)PROPANE(FLA[/MABLE LIOUID)ACETYLENE(COMPRESSED GAS)ANTI FREEZElCOOLAN TSWASTE OIL(FLAMMABLE LIQUID)FIRE PULL BOXGD nncon@ oxvcu'r[l\ rurovarrc rRANS[,4rssroN" rLUtDFo@oo@@@@@@@r#o,oJL'u-A-A@IIsps-lLMMOTORVEHICLEorrrcrfiKSTORAGIM,/f \FLAMMABLESTORAWATTRTANK+ADMINISTRATIONBUILDINGIIIITItI9B-cDEF\lHJKM (-' FoRME f-\SAN LUIS OBISPO COT]NTY CERTIFIED UNIFIEDPROGRAM AGENCY (CUPA)EMERGENCY RESPONSE PLANOr Hazardous Waste Contingency Plan(see instruction page vii)FEB 2 8 2005Date: 02124/05SECTION I-A: BUSINESS IDENTIFICATION DATABUSINESS NAMESBCSET64/SNLOCAAUSITEADDRESS196 SUBITRBANRDCITYZIP CODESANLUIS OBISPO93403FACILITY TINITTELEPHONENUMBER831-372-2r42CITYZIP CODEBUSINESS MAILING ADDRESS2600 Camino Ramon, Room 3E000San Ramon945831. Hazardous MaterialsUnderground Storage #2. Hazardous WasteGenerator #Ifyour business has a license or permitfrom any ofthefollowing agencies, please indicate the document numben3. Air Pollution ControlDistrict #4. Responding Fire Dept& Permit #please provide the following information as it pertains to your business and its location. You are not required to noti$' these companies in theevent of an emergency. This information is provided for your reference and to assist emergency response persorurel in responding to ahazardous materials emergency at your facility. List the name and phone number of the utility company.Electric ServicePacific GasElectricTelephone #800-743-5000Gas ServicePacific Gas and ElectricTelephone #800-743-5000SanitationSan LuisIltilitiesTelephone #RO5-781-7215Water District San LuisUtilitiesTelephone #805-78 1-15SECTION I-B: OWNER CERTIFICATION OF DATA (Certify either I or 2)1. This is aPlan XUPDATED ExistingPlan. I have personally examined the information it contains and am familiar with theoperation of the plan. (If you check either of the above two options, continue to complete the remained of the Emergency ResponseContingency Plan).Z. n ihis plan requires no change and is on file with San Luis Obispo County Hazardous Materials Unified Program Agency and doesnot need any change. (If you check this section, please proceed directly to Form T, the Training Program')I certifu under penalty oflaw that theabove information is true and accurate.SBC02124105PRINT NAME OF OWNER OR OPERATORDATESteve Skanderson02124105DOCUMENTS PREPARED BYSIGNATUREDATE5\r.rhl-iraz\haertrat\HA;MA.|\.PACt3['LL\305t\.H$]*t.q*ncy l{*spons* i'tlrrn.L}SC *il:41*5Page I of -L- SECTION IIRESPONSE PLANS AND PROCEDURESNote: Complete all sections of this Emergency Response Procedure below Use of terms such as "N/A" (lr{ot Applicable) will notbe accepted.A. FIRE, SPILL OR RELEASE: The fire code requires immediate notification through dialing 911' by whoever first sights theincident. In the event of release or spill of hazardous materials, you must also notify:1. San Luis Obispo County Hazardous Materials Unified Program Agency during business hours @ 805-781-5544. Afterbusiness hours dial 911.2. The State Office of Emergency Services - (800) 852-7550 or (916) 262-L621List the individuals responsible for verifying that these calls have been made and also indicate their position in your company.FOR VERIFYING THE DIALING OF 91I:Larry CodayPropedy ManagerNAMEIndividual responsible for calling San Luis Obispo County Hazardous Materials Unified ProgramAgency and the State Off,rce ofEmergency Services: (Normally the Emergency Coordinator of your business.)Larry CodayProperty ManagerNAMEPOSITIONB. List the local emergency medical facilities that will be used by yoru business in the event of an accident or injury caused by a releaseor threatened release ofhazardous materials.SAN LUIS OBISPO GENERAL HOSPITAL 2I8O JOHNSON AVENUE, SAN LUIS OBISPO 805-781-4800NAMEADDRESSCITYPHONENAMEADDRESSCITYPHONEC. List the Emergency Coordinator(s) at your facilityPrimary: Larry Coday Propety ManagerNAMETITLEBUSINESS PHONE24 HRPHONEPAGER#Secondary: SBC Emergency Control Center(877) 322-4722866-492-6836NAMETITLEBUSINESS PHONE24 HRPHONEPAGER#D.Does your business have an on-site emergency response team? lVes XNo Describe procedures your business will follow inthe event of a release or threatened release ofhazardous materials'The Emergency Site coordinator/Building warden is responsible for followingthese steps as outlined in the Hazard CommunicationPrograrn the Hazardous Materials/TVasteManagement Handbook and the SBCPractice 130l. Determining the nature, location, magnitude and severityof the incident.2. Move people away from the area as appropriate.3. Avoid inhalation of all gasses, fumes or smoke.4. Contain materials as appropriate by arranging physical baniers, use of absorbents (i.e., dirt, oil baking soda or other absorbent material).5. Notifyemergency personnel.83t-372-2t42866-492-6836{i\\rhl-haa\haznr;lt\HA#MA'l \FAC13ULLUltlSf\Hfil*f$sncy l'lesponse ltronvr.llso *2/24i{}*I^I pagg /-o# E.Ifyou have acutely hazardous materials aoove threshold planning quantities, list (by name and address) adjacentneighboringbusinesses andresidences, schools, hospitals, etc. Include sensitive facilities (schools, hospitals and rest homes) within 1,000 feet(straightJine distance from your property line). List telephone mrmbers for all businesses; for aparhnent buildings, list manager'sphone. Do not list telephone numbers for private residences.North: VACANT LOTSouth: INDUSTRIALEast:INDUSTRIALWesf The Spice Hunter 184 Suburban Rd, SLO 93401 805-544-4466Briefly describe your standard operating procedures in the event of a release or threatened release ofhazardous materials.Emergency response procedures must comply with all federal, state and local regulations. Existing emergency response proceduresmay be referenced and attached to this document.1. Prevention -- Describe the accident potentials associated with the hazardous materials present at your facility. What actionswould your business take to reduce accident potentials? Include description of safety, storage and containment procedures.The batteries are secwely braced to prevent spills during an earthquake. Additionally, thehazardous materials are only handled byemployees or contractors that have been properly hained.FTnlttqnc: Appropriate employees are trained on hazardous materials/waste management. Thean online interactive format through the SBC Learning Management Center. Employees are alsotraining is either leaderled or delivered inprovided training annually on how to readan MSDS as required by theHazard Communication Standard; they are also trained on the SBC Operating Practice 130.Marpnrnrs: Hazardous materials are utilized and stored following manufacturer's recommendations, as we are a consumer of products andnot a manufacturer ofhazardous materials.2. Equipment - List the emergency response equipment at your facility (e.g. fue extinguishing systerns, spill control equipment,decontamination equipment).ItemMaintenance ProcedureAbsorbentsRoutine inspections and replenished as necessaryFre ExtinguisherAnnual inspection and recharged by a contractorFirst Aid KitMonthly inspection and replace items as necessaryPersonnel ProtectiveReplace as necessaryGearEvacuation -- Describe how you will immediately evacuate your facility. What communications or alarms are used? How willyou operate these during power failure?In the event of an emergency requiring evacuation while employees are present,notification will be given verbally and/orwith hre alarms. The evacuation routes are posted throughout the facility. Employees will exit through the nearest exit andproceed to the evacuation staging area located at: SEE EMOP BINDER3.7\\rlrl-haalh*r*rai\l-'iAlMAl1.'rA0$ALL\3*5:\.Hm*rssncy It*spons* i'orm.*OC A"S|"J4i{}*PersonnelProtectionbaItery arcaFirst Aidfleet area/main bldgsee site mapsFire SafetySpillsfleet arealgas islandLocationUsePage3 orb 4. Shutdown -- Describe the shutdown for each site or facilityDue to regulatory requirements the emergency power system can not be shut down. If necessary, alternate power supplies can be brought tothe facility (i.e. portable generators) while the diesel tank/system is repaired.In the event of a release from a battery, the individual battery maybe taken out of service and replaced as necessary.5a. Response -- Describe what is done to lessen or mitigate the harm or damage to person(s), properfy, or the environment, andprevent the event from getting worse or spreading. What is your immediate response to:Fire: Small- use a fire extinguisherLarge - Call 911 if possible, evacuate and allow the fire department to respond.Explosion: Call 911 if possible, evacuate and allow the fire department to respondSoills: ln the event of a minor release (<10gals) from the batteries, employees will stop the leak, if possible without risk, usingbicarbonate of soda or soda ash and/or dike the material to confine it to a safe location.For larger spills (>l Ogals) contain the flow with absorbent and call 91 1 for the local Fire Department and call the SanLuis Obispo Co. Hazardous Materials AgencyTellthe dispatch"you are reporting a spilI and to contact the County Hazardous Materials Specialist"Severe Ground Motion: The batteries are securely braced to prevent leaks and are inspected regularly. Additionally, thebatteries, diesel tank/fuel lines, and halon cylinders will be inspected following an earthquake.Maior Power Failure: The facility utilizes industrial batteries and a generator as a backup power systemFlood:The batteries are in racks that are elevated off the floor. lt is not likely that the area will be subject to water levels thatwould impede the operation at the facilityb. Is this facility located on a 100-year flood plain? Xyes nNoc. Earthquake - Identify facility areas and list mechanical or other systems that require immediate inspection or isolation because oftheir vulnerability to earthquake related ground motion.The batteries, diesel tank, fuel lines, and halon cylinders will be inspected following an earthquake6. Ctean-Up (Remove the Hazard) -- How do you handle the complete process of cleaning up, and disposing of relatedmaterials at yourfacility? Note: Notify the Hazardous Materials Unified ProgramAgency when cleanup is complete.The Emergency Site Coordinator/Building Warden is responsible for followingthese steps as outlined in the Hazard CommunicationProsrarrl the Hazardous MaterialsAVasteManagementHandbook and the SBC Ooeratine Practice 130.Determining the nature, location, magnitude and severity of the incident.Move people away from the area as appropriate.Avoid inhalation of all gasses, fumes or smoke.Contain materials as appropriate by arranging physical barriers, use of absorbents (i.e., dirt, oil baking soda or other absorbent material)Notifi appropriate emergency personnel.G. Location -- your business is required to keep a copy of the Business Plan and related MSDS sheets on-site. Describe where thisinformation is located.A copy of the business plan, MSDS sheets are located at: FLEET AREA (also see site map)I\l'rfrl-lraz\h;lzrn;lt\l-'lAIMAl-\fAC$HLL\*05f\.[sIer(Jsncy l{*spgns* lii>un.L}*C *)124i*5ease { u-l- FORM TSAN LTNS OBISPO COI-INTY CERTIFIED LINIFIEDPROGRAM AGENCY (CUPA)EMPLOYEE TRAINING PROGRAMDate: 02/24/05A.Describe the safety training for all employees in the event of a release or threatened release of hazardous materials. Thistraining shall include, but not be limited to, the following: new employee training, annual training, periodic refresher courses'and familiarization with Emergency Plans and Procedures of this Business Plan / Contingency Plan.Summarize the training for all employees that work with or come in contact with hazardous materials/hazardous waste. Describehow these employees are trained to avoid exposure.All employees who handle hazardous materials are trained to use appropriate methods and to recognize any potentialhazards. Periodic refresher training is provided in bi-monthly safety meetings when required. Employees who work at thesite are famlliarizedwith the location of the MSDS that are associated with the materials at the facilityAll batteries that have exceeded their usefulness will be removed and recycled.2. Summarize training specific to those employees that would respond to a release or threatened release of hazardous materials orhazardous waste.Employeesare kained in the proper use of a fire extinguisher. A11 employees who handle hazardous materials are trainedto use appropdate handling methods and to recognize any potential hazards. Periodic refresher haining is provided in bi-monthly safety meetings when requiredIn the event of a minor release from the batteries, employees will absorb the spilled material using bicarbonate of soda and/ordike the material to confine it to a safe location. Barrier tape will be placed around the released material. Spills exceeding thecapabilities of the employees will be handled by a qualified contractorSBC Environmental Management will be notified to make all necessary arrangements with an environmental firm for cleanupand disposal of any spills (SBC Environmental Management: 1-866-I-WANT-EM)7\\rlri-hazlhg?nr*i\l"lAXMAI"\FAOtSHLL\*O$?\fifiorgsncy li*sponse F onn.l.XlC 0?il4l0*1nase i or-[- |\3. Indicate frequency and duration of haining for employees that work with or come into contact with hazardous materials/hazardouswaste.All employees who handle hazardous materials are trained to use appropriate handling methods and to recognize anypotentialhazards. Periodic refresher training is provided in ANNUAL safety meetings when required4. Describe how your employees access taining materials. (E.g., bulletin board, employee newsletter, staff meetings, etc.)Employees are provided nvrrrar, Safety Plan haining on the Hazard Communication Certification, as well as function.p"riftr before they begin their work operations. This also includes training on the Emergency Operating procedures. Thereii also hazardous materials/waste management training for employees as appropriate. The training may either be leaderJedor taken as an online interactive course. Training is recorded electronically. A series of Job Aides that briefly describeeach of the topics accompanies the trainingAdditionally, the SBC Emergency Plan requires that employees receive ANNUAL REFRESHER training on the HazatdCommunication Certification, function specifics and the Emergency Operating Instructions.B. List person(s) in charge of training and indicate their qualifications to conduct the training.The training mayeither be leader-|ed or taken as an online interactive course. Training is recorded electronically.C.Indicate where training records are kept. (Records must document the type of haining, duration, completion dates, names andpositions of employees receiving training and the name(s) of instructors / trainer')The SBC EmergencyPlan Binder serves as a reference guide for the Emergency Site Coordinator/Building Warden.Employee haining record are maintained in the employee files.o0\Irhl-lraz\hazrnnt\HAZMAII.FACfiHLL\305?\.[$]*rgency lt*sp*ns* *:r:nrr.*$C 0;i]41*5Pase 6 oLA- PROGRAM CONSOLIDATED FORMBUSINESS OWNER/OPERATOR IDENTIFICATIONFACILITY INFORMATIONDEC 20 ?:i)lil136NAME OF SIGNE'R (prin|Steve SkandersonProject ManagerTITLEOF SIGNER137SIGNATURE OF134DATE11t22t2002RHL DESIGN GROUP, INC. - AGENT FOR PACIFIC BELL135NAME OF DOCUMENT PREPARERthose individuals responsible for obtaining the information, Icertify under penalty oflaw that I have personally examined and amfamiliar with the information submitted and believe the information is true, accurate,and complete.Certification: Based on mY inquiry ofLOCALLY COLLECTED INFORMATION127PAGER#PAGER#132877-823-983324-HOURPHONE126877-823-983324-HOURPHONE131831-372-2142BUSINESS PHONE125877-322-4722BUSINESS PHONE130Property ManagerTITLE12424 HR EMERGENCY SERVICETITLE129Larry CodayNAME123EMERGENCY CONTROL CENTERNAME128IV. EMERGENCYCONTACTSPRIMARYSECOIIDARYSAN RAMON121122CA12094583-0995CODECONTACT MAILING ADDRESS2600 CAMINORM 3EOOO119MATTHEW HOPWOODACTNAME117118AL CONTACTSAN RAMON115't14116ilr.94583-0995CODEATECAPHONE925-824-5784OWNER MAILING ADDRESS2600 CAMINO RAMON, RM 3EOOO113877-823-9833SBO/Pacific Bell11112TJSINESS OPERATORNAME109110NAMEPHONEil.owt[EROPERATORPHONE831-372-2142SAN LUIS OBISPO108COUNTYCODE (a digit #)48111 0-340-1 61 8106107DIJN BRADSTREETSAN LUIS OBISPOCITY10410593403CODElztYCASITEADDRESS196 SUBURBAN RD103PHONE831-372-2142NAME3102Business As)(Same as FACILITY NAME orDBA - DoingE164[*.1FA zstVID#110010101t0112003DATE1213112003DATEPage I ofUPCF (1/00 revised)zorTl67Gs167oES FORM 2730 (1199) .ED PROGRAM CONSOLIDATED,,vIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or d€)242If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATIONIv"'244243245238239o!v"'240241234PETROLEUM DISTILLATES235zcoNONE2370.5o/"230NAPHTHALENE231232$.' EN"91-20-32331 gg.syo226es228DIESEL FUEL NO. 222768476-34-6229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#X[c. BELOWAMBIENT f-lo. cnvocnNlcSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENT225XSTORAGE PRESSUREA.AMBIENTABOVEAMBIENTBELOW AMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBERDRUMBAGBOXCYLINDER223AINERCARBOYPLASTIC/NONMETALLIC DRUMsILoCANBOTTLERAILCAROTHERPLASTIC BOTTLETOTE BINTANKWAGONXI a. roxs 221one item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217VERAGE DAILY AMOIjNT40002't8DAILYAMOUNT4000219WASTEAMOUNT4000ATEWASTECODE220XXXa. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTEHEALTHe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb, LIQUID214one item only)STATE215LARGESTCONTAINER 4OOOOX(Check one itemA. PUREc. WASTEb. MIXTUREMATERIAL211XYesNoRADIOACTIVE212213CURIESCOMBUSTIBLE LIQ,IICODEI{AZARD CLASSES(Complete if rcquired by CUPA)21068476-34-6209If EHS is "Yes", all amounts below must be in lbs.DIESEL FUEL#2NAME207XNoYesEHS208PETROLEUM HYDROCARBONNAME205XTRADE SECRET206Noto EPCRA, refer to insructions! v"'II. CHEMICAL INFORMATIONID#1203MAP# (optional)1F7204GRID# (optional)WEST SIDE OF LOTLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Paciflc Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200PageUPCF (l/ee)169OES Form 2731 ,ED PROGRAM CONSOLIDATED.{HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CIIEMICAL DESCRIPTIONOne page pq material per building or uea)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION5242243es2442454 15o/o238!v"240SOLV, DEWAX DIST. LT PARAFFIN23964742-56924',|325234!v"'236ADDITIVES2352372 1.5230ZINC ALKYL DITHIOPHOSPATE231$.'232686494232331ts226LUBRICATING BASE OIL227228!v"' EN"64742-65-0229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225X!u.!c. BELoWAMBIENTSTORAGE PRESSUREA. AMBIENTABOVEAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDER223BOTTLERAILCAROTHERSTORAGECONTAINERPLASTIC BOTTLETOTEBINTANKWAGONUNITS*(Check one item only)! o. roNs 221Xa. GALLONSif FI{R qmnrrnf mrct he in nortndsc. POUNDSb. CUBICFEET222DAYS ON SITE:365DAILYAMOUNT110WASTEAMOTINT120217218TEWASTECODE2't9220DAILYAMOTINT90XX(Check all that apply)a. FIREe.CHRONIC HEALTHb. REACTIVEd. ACUTEHEALTHc.PRESSURE RELEASEFED HAZARD CATEGORIES216X(Check one item only)a. SOLIDc. GASb. LTQUIDPHYSICAL STATE214215LARGESTCONTAINER 55XIYPE (Check one itema. PUREc. WASTEb. MIXTUREHAZARD MATERIAL211XYes212NoRADIOACTIVECURIES213COMBUSTIBLE LIQ.38210CODE HAZARD CLASSES (Complete if rcquired by CIJPA)64742-65-0CAS#209If EHS is "Yes", all amounts b€low must be in lbs.MOTOR OIL3OMMONNAME207XNoYesEHS208205CHEMICALNAMEPETROLEUM HYDROCARBONX206NoIf Subject to BPCRA, refer to instructionsTRADE SECRETYesII. CHEMICAL INFORMATIONfI.FACILITY ID#tl203MAP# (optional)11204GRID# (optional)F4STORED IN SHOPCHEMICAL LOCATIONX202NOCI{EMICAL LOCATION CONFIDENTIALYESEPCRASBC/Pacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page 3 of r?UPCF (1/ee)169OES Form 2731 ^ED PROGRAM CONSOLIDATED,vIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page pcr material per building or ra)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242[v" EN" 244243245't -3238DIPOTASSIUM PHOSPHATE239es2407758-11-4241>1234WATER235es2367732-18-52370-8230DIETHYLENE GLYCOL231232$.' EN"1 1 1-46-623380-96226228[v.' EN"ETHYLENE GLYCOL227107-21-1229%wrEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA. AMBIENTSTORAGE TEMPERATUREABOVEAMBIENTBELOW AMBIENTflo. cnvoceNrc225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROTIND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223i. FIBERDRUMPLASTIC/NONMETALLIC DRUMTORAGEAINERRAILCAROTHERCANCARBOYSILOBAGBOXCYLINDERXI a. ror.rs 221one item only)a. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217VERAGE DAILY AMOUNT55218DAILYAMOUNT75219WASTEAMOUNT55ATEWASTECODE220XXa. FIREc.PRESSURE RELEASEb. REACTIVEe.CHRONIC HEALTHd. ACUTE HEALTH216HAZAPD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MIXTURE211MATERIALXYes212RADIOACTIVENo213CURIESCOMBUSTIBLE LIQ.38CODE HAZARD CLASSES(Complete if required by CUPA)210107-21-1209If EHS is "Yes", all amounts below must be in lbs'ANTIFREEZE/COOLANTNAME207XNoYesEHS208ETHYLENE GLYCOLSNAME205XTRADE SECRET206NoYesto EPCRA, refer to instructionsII. CHEMICAL INFORMATIONACILITY ID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164S NAME3I. FACILITY INFORMATTONADDDELETEREVISE200of l9PageuPcF (1/e9)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242244243245238239!v.'240241234BUTANE235o$"236106-97-82s7230ETHANE23123274-84-0233226224!v'. EN"PROPANE22774-98-6229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#!u. eeovnAMBIENTXA.AMBIENTSTORAGE TEMPERATUREBELOWAMBIENT[0. cnvocer.nc225STORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKI.JNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223CARBOYPLASTICNONMETALLIC DRUMSILOCANRAILCAROTHERI a. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217DAILYAMOUNT300218DAILYAMOTINT368219WASTEAMOUNT1 000ATEWASTECODE220XXXall drat apply)a. FIREc.PRESSURE RELEASEd. ACUTEHEALTHe.CHRONIC HEALTHHAZARD CATEGORIES216b. REACTIVEXone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARGESTCONTAINER 250X(Check one itema. PUREc. WASTEb. MIXTUREMATERIAL211XNoYesRADIOACTIVE212213CURIESFLAMMABLE GASby CUPA)210CODE HAZARD CLASSES (ComPlete74-98-6209If EHS is "Yes", all amounts below must be in lbs.PROPANENAME207XNoYesEHS208PETROLEUM HYDROCARBONNAME205X206IfNoYesTRADE SECRETto EPCRA, refer to instructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)E3STORED IN YARDLOCATIONX202NOLOCATION CONFIDENTIALYESSBO/Pacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200ofPageHAZARDOUS MATERIALS INVENTORY . CIIEMICAL DESCRIPTIONOne page per maierial per building or ue)HAZARDOUS MATERIALSPROGRAM CONSOLIDATED-r{UPCF (1/e9)r69OES Form 2731 .ED PROGRAM CONSOLIDATEDMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CIIEMICAL DESCRIPTIONOne page pcr material per building or rc)If EPCRA, Please Sign Here._-.\/ADDITIONAL LOCALLY COLLECTED INFORMATION24652422432442454238$"2402392413234$..236235237.,230231232233| 'too%226MOTOR OIL, USED2278002-05-9229es228%wrIIAZARDOUS COMPONENT (For mixture or waste only)CAS#EHSflo. cnvocer.ucXSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROLIND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223RAILCAROTHERSTORAGECONTAINERLTNITS*(Check one item only)I o. roNs 221Xa. GALLONSif FLIS emnrrnf mnst he in norrndsc. POUNDSb. CUBICFEET222DAYS ON SITE:365VERAGE DAILY AMOUNT110DAILYAMOTINT110WASTEAMOUNT110218219217220STATEWASTECODE221XX(Check all that apply)a. FIREc.PRESSURE RELEASEb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTHFED TIAZARD CATEGORIES216X[Check one item only)a. SOLIDc. GASb. LIQUIDPHYSICAL STATE214215LARGESTCONTAINER 120XIYPE (Check one itema. PUREc. WASTEb. MIXTUREHAZARDMATERIAL211XNoYesTRADIOACTIVE212CURIES213COMBUSTIBLE LIQ. 38210FIRE CODE HAZARD CLASSES (Complcte if required by CUPA)]AS#8002-05-9209If EHS is "Yes", all amotmts below must be in lbs.USED MOTOR OILCOMMONNAME207XNoYesEHS208PETROLEUM HYDROCARBONCHEMICALNAME205X206NoIf Subject to BPCRA, rcfa to insbuctionsYesTRADE SECRETII. CIIEMICAL INFORMATIONFACILITY ID#203MAP# (optional)1101204GRID# (optional)F4STORED IN YARDCHEMICAL LOCATIONX202NOCI{EMICAL LOCATION CONFIDENTIALYESEPCRASBC/Pacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page L of tVuPcF (l/ee)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242!v"'2442432452%238DIPOTASSIUM PHOSPHATE239$".2407758-11-424110%234WATER2352367732-18-52371%230DIETHYLENE GLYCOL231D.'2321 1 1-46-62332261 g4o/o228!v.' EN"ETHYLENE GLYCOL227107-21-1225o/"WTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA.AMBIENTSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENTCRYOGENIC225XSTORAGE PRESSUREA.AMBIENTABOVEAMBIENTBELOW AMBIENT224ABOVE GROUND TANKIJNDERGROLTND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGONPLASTIC/NONMETALLIC DRUM223RAILCAROTHERCANCARBOYSILO! o. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ONSITE:365217VERAGE DAILY AMOUNT5521ADAILYAMOUNT552't9WASTEAMOLINT55220STATEWASTECODE343XXa. FIREc.PRESSURE RILEASEe,CHRONIC HEALTHd. ACUTE HEALTH216b. REACTIVEHAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55Xa. PUREc. WASTEb. MIXTURE211HAZARDMATERIAL(Check one itemX212NoYesRADIOACTIVE213CURIESCOMBUSTIBLE LIQ. 38CODE IIAZARD CLASSESby CUPA)210107-21-1209If EHS is "Yes", a1l amounts below must be in lbs.USED ANTIFREEZENAME207XYesNoEHS208GLYCOLSNAME205XTRADE SECRET206NoYesto EPCM, refer to instructionsII. CIIEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED EAST SIDE SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page '1HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per maierial per building ot u6)HAZARDOUS MATERIALS.ED PROGRAM CONSOLIDATED,t{UPCF (1/9e)t69OES Form 2731 ^ .ED PROGRAM CONSOLIDATED,vIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOnc page pcr marcrial per building or uea)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2469%242TRADE SECRET243es244PROPRIETARY24590o/o238OIL MIST, if generated239240!v"'801 2-95-12412234$"'236ZINC ALKYL DITHIOPHOSPHATE2356864-94-2323785230SOLVNT DEWXD DISTLL HV PAMFIN231232!v.' EN"64742-65-0233185226HYDROTREATED DIST, HVY PARA227228!v"s EN"64742-54-7229o/nWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225XSTORAGE PRESSUREA. AMBIENT!u. enoveAMBIENTBELOW AMBIENT224ABOVE GROLJND TANKUNDERGROT]ND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsILoFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223o.RAILCAROTHERI o. roNs 221X(Check one item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217DAILYAMOUNT55218DAILYAMOUNT55WASTEAMOUNT219TEWASTECODE220XXXall that apply)a. FIREe.CHRONIC HEALTHo.PRESSURE RELEASEb. REACTIVEd. ACUTEHEALTHHAZARD CATEGORIES216Xone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MIXTURE211MATERIAL213CURIESXYes212RADIOACTIVENoCOMBUSTIBLE LIQ,38210CODE HAZARD CLASSES (Complete if required by CUPA)64742-54-7209If EHS is "Yes", all amounts below must be in lbs'HYDRAULIC FLUIDNAME207XYesNoEHS208205NAMEPETROLEUM HYDROCARBONXTRADE SECRETtoIf206NoYesrefer to instructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164S NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page tr ofUPCF (1/99)r69OES Form 2731 ^ED PROGRAM CONSOLIDATED.{HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEN{ICAL DESCRIPTIONOne page per material pet building or d@)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242ZINC ALKYL DITHIOPHOSPHATE243!v.'2446864942324590238$",240SOLVENT DEWAXED DIST., HVY PAR2396474265024190234HYRDOTREATED DIST, HVY NAPHTH235$.'2366474252523790230HYDROTREATED DIST., LT NAPHTH23'lo$.'232647425362332261goHYDROTREATED DIST, HVY PARA227es22864742-54-7229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENTCRYOGENIC225A. AMBIENTXSTORAGE PRESSUREA.AMBIENTABOVEAMBIENTBELOW AMBIENT224ABOVE GROUND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTICNONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223RAILCAROTHERI o. roNs 22'lXone item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217VERAGE DAILY AMOUNT55218DAILYAMOLINT55219WASTEAMOUNT110220WASTECODEXXa. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTH216HAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MIXTUREMATERIAL211X212NoYesRADIOACTIVE213CURIESCOMBUSTIBLE LIQ.3Brequired by CUP.d)210CODE HAZARD CLASSES (complete64742-56-9209If EHS is "Yes", all amounts below must be in lbs.AUTOMATIC TRANSMISSION FLUIDNAME207XYesNo208PETROLEUM HYDROCARBONNAME205X206Norefer to instructionsYesTRADE SECRETIfSubj€ct toII. CIIEMICAL INFORMATIONID#1203MAP# (optional)'l204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESNAME sBC/Pacific Bell sE1643I. F'ACILITY INFORMATIONADDDELETEREVISE200ofPageuPcF (l/ee)169OES Form 2731 %wr. -ED PROGRAM CONSOLIDATED-vIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CIIEI\ICAL DESCRIPTIONOne page pq material per building or d€)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465 5o/o242es244BENZENE24371-43-22454 90%238GASOLINE239240!v.' EN"241NONE3 14o/o234XYLENES235236!v.' EN"1330-20-7237Z 9o/o230TOLUENE231232$" EN"108-88-3233tfi%226228$" EN"METHYL TERT BUTYL ETHER2271634-04-4229EHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA,AMBIENTSTORACE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsLoFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223RAILCAROTHERSTORAGECONTAINERUNITS*(Check one item only)! o. roNs 221Xa. GALLONSFII( qtrnrrnt mncf he in nnrndsifc. POUNDSb. CUBICFEET222DAYS ONSITE:365VERAGE DAILY AMOUNT6000DAILYAM9LINT6000WASTEAMOUNT6000217219218STATEWASTECODE220FED IIAZARD CATEGORIESiCheck all that apply)XXXa. FIREb. REACTIVEc.PRESSURE RELEASEe.CHRONIC HEALTHd. ACUTE HEALTH216Xa. SOLIDc. GASb. LIQUID214PHYSICAL STATEiCheck one item only)215LARGESTCONTAINER 6016Xa. PUREc. WASTEb. MIXTURE211HAZARDMATERIALTYPE (Check one itemXYes212RADIOACTTVENoCURIES213I-A FLAMMABLE LIQUID210CODEHAZARD CLASSES (CompleteifrequiredbvCUPA)8006-61-9CAS#209If EHS is "Yes", all amormts below must be in lbs.GASOLINE - UNLEADEDCOMMONNAME207XNoYesEHS208PETROLEUM HYDROCARBONCHEMICALNAME205X206NoYesIf Subject to EPCM, refer to instructionsTRADE SECRETII. CHEMICAL INFORMATIONFACILITY ID#[,', ']1203MAP# (optional)1204GRID# (optional)F7WEST SIDE OF LOTCHEMICAL LOCATIONX202NO]}IEMICAL LOCATION CONFIDENTIALYESEPCRASBC/Pacific Bell SE164BTJSINESS NAME3I. F'ACILITY INFORMATIONADDDELETEREVISE200Page ,0 of lYuPcF (l/9e)t69OES Form 2731 .ED PROGRAM CONSOLIDATEI)Fd. -vrIIAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per marcrial per building or ue)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465242243245244!v.. EN"I238240!v". EN"2392413234235es236237')2302312322331 looo/.226NITROGEN227!v"'228229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#[t. nnoveAMBIENrXSTORAGE TEMPERATUREA.AMBIENTBELOWAMBIENTCRYOGENIC225A. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223RAILCAROTHERSTORAGECONTAINERLINITS*iCheck one item only)I a. roNs 221Xa. GALLONSif FLI( qmnrrnf mrrcf he in nottndsc, POUNDSb. CUBICFEET222DAYS ON SITE:365DAILY AMOUNT2536WASTEAMOUNT253(F217218ATEWASTECODE219220DAILYAMOUNT2536X(Check all that apply)a. FIREc.PRESSURE RELEASEb. REACTIVEd. ACUTE HEALTHFED IIAZARD CATEGORIESe.CHRONIC HEALTH216X(Check one item only)a. SOLIDc. GASPHYSICAL STATE214! t. rrquro215LARGESTCONTAINER 228Xa. PUREc. WASTEb. MIXTURE211HAZARDMATERIALIYPE (Check one itemXNoYesRADIOACTIVE212213CURIESINERT GAS210CODE HAZARD CLASSES (COMPICtE if TEqUiTCd bY CTJPA)7727-37-9CAS#209If EHS is "Yes", all amounts below must be in lbs.NITROGENCOMMONNAME207XNoYesEHS204NITROGEN3HEMICALNAME205X206NoIf Subiect to EPCRA, refer to ins!ructionsrRADE SECRET ! V".II. CHEMICALINFORMATIONFACILITY ID#1i-l203MAP# (optional)1204GRID# (optional)E3OUTSIDE BEHIND SHOP YARD]MMICALLOCATIONX202NO]HEMICAL LOCATION CONFIDENTIALYESEPCRASBC/Pacific Bell SE164NAME3DELETEADD200Page I t ofI. FACILITY INFORMATIONREVISEUPCF (l/99)t69OES Form2731 .ED PROGRAM CONSOLIDATEDJVIHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per matoial per building or re)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246weight if non-cacinogcnic, or 0. I o/o by weight if cucinogenic, attach additional shcets of paper captwing the required infomation.If more h@dow components ue pr€s€nt at grcat€r thm lolo by242244243245238239!v"'240241234235!v"'236237230231232[v"'233I too%226!vr, EN" 228227ACETYLENE74-86-2229HAZARDOUS%wrEHS(For mixture or waste only)CAS#XA. AMBIENT.STORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENICIo225STORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKI]NDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMCANCARB-r)YsILO...'FIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223DRUMRAILCAROTHERf.c.Xone item only)a. GALLONSb. CUBICFEETc. POUNDS! a. roNs 221222DAYS ON SITE:365217VERAGE DAILY AMOUNT118218DAILY AMOUNT118219WASTEAMOUNT118220WASTECODEXXXall that apply)a. FIREb. REACTIVEe.CHRONIC HEALTHd. ACUTEHEALTHHAZARD CATEGORIES216c.PRESSUREXone item only)c. GASSTATE214I a. soLID I r. r-rquln215CONTAINER 118X(Check one itema. PUREc. WASTEb. MIXTUREMATERIAL211X212NoYes213CURIESFLAMMABLE GASCODE HAZARD CLASSES (Compl€te if rcquircd by CUPA)210If74-86-2209"Yes", all amounts below must be in lbs.EHSACETYLENENAME207XYesNo208ACETYLENENAME205XTRADE SECRET206refer to instructionsNoYesII. CHEMICAL INFORMATIONACILITY ID#1203MAP# (optional)1204GRID# (optional)E3STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164NAME3I. FACILITY INFORMATIONDELETEADDREVISE200Lof tPageuPcF (l/ee)r69OES Form 2731 .ED PROGRAM CONSOLIDATEDf,l{H.A,ZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mat€rial pq building or il€)If EPCRA, Please SignADDITIONAL LOCALLY COLLECTED INFORMATION246presentcompooentsIf moreatofthiltyohmdousgreatcr%0.if non-crcinogenic,byweightatlachaddilionalifcilclnogenlc,byweighttherequiredof papercapturingsheetsinfomation.242243244fv"' EN"2452382392402413234235$"'236237230$.'232231233I 1oo226ARGON227$"'2287440-37-1225%wTHAZARDOUS COMPONENT @or mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENT!t. e,aoveAMBIENrBELOW AMBIENTf-]o. cnvocnNtc225A.AMBIENTSTORAGE PRESSUREABOVEAMBIENT[c. BELoWAMBIENT224ABOVEGROUND TANKLINDERGROTIND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTICN{ONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223AINERRAILCAROTHER! o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217VERAGE DAILY AMOI.INT222218DAILYAMQLTNT222219WASTEAMOUNT222TEWASTECODE220Xall that apply)a. FIREb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTHTIAZARD CATEGORIES216Xone item only)a. SOLIDc. GASb. LIQUID214STATE215LARGESTCONTAINER 222X(Check one itema. PUREf-l c. wASrEb. MIXTURE211MATERIAL213CURIESXYes212RADIOACTIVENoNON-FLAMMABLE GAS210CODE HAZARD CLASSES (Complete if required by CUPA)7440-37-1209If EHS is "Yes", all amounts below must be in lbs'ARGONNAME207XYesNoEHS208ARGONNAME205XTRADE SECRETto206NoYesrefq to instructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200PageofuPcF (1/9e)r69OES Form 2731 .ED PROGRAM CONSOLIDATEDilHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEN{ICAL DESCRIPTIONOno page per mat€rial psr building or 6@)If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246If more h@dous components ile presentorbyweightat gleater thmto/oweightif%by0.ifnon-c{cinogenic,Isheetsofpaperattachaddirionalcdclnogenrc,requiredinfomation.capturingthe242243es244245238239240!v..2413234$"'236237230IY"232233I too226OXYGEN2287782-44-7229%wTHAZARDOUS COMPONENTmixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOW AMBIENTf]0. cnvoceNtc225STORAGE PRESSUREA. AMBIENTBELOW AMBIENTAMBIENT224ABOVE GROLTND TANKUNDERGROUND TANKTANK INSIDEBUILDINGAINERd. STEEL DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDER223DRUMBOTTLERAILCAROTHERPLASTIC BOTTLETOTEBINTANKWAGONXone item only)A. GALLONSb. CUBICFEET! a. roNs 221222DAYS ON SITE:365217VERAGE DAILY AMOUNT124218DAILYAMOUNT124219*ASTEAMQLINT124STATEWASTECODE220XA. FIREb. REACTIVEc.PRESSURE RELEASEHAZARD CATEGORIESall that apply)d. ACUTEHEALTHe.CHRONIC HEALTH216Xa. SOLIDC. GASb. LIQUID214one item only)STATE2'.t5AINER 124X(Check one itema. PUREC. WASTEb. MIXTURE211MATERIALXNoYes212CURIES213OXIDIZER 3CODE HAZARD CLASSES(Complete if required by CUPA)2107782-44-7209If EHS is "Yes", all amounts below must be in lbs.OXYGENNAME207XYesNo208OXYGENNAME205X206Norefer to instructionsYesTRADE SECRETIf Subject toII. CIIEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)E3STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESSBC/Pacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200ofPageuPcF (l/ee)r69OES Form 2731 MAP# 1SITE MAPBUSINESS NAME PACIFIC BELL SNLOCA1RSE1 64196 SUBURBAN RDSAN LUIS OBISPO-r--q-+.tr------rr r - r rl - -lDATE 1OZIP CODE93403DRAMNG SCATENOT TO SCALEBUSINESS ADDRESS1234567IIITTERIESacIDcftIDz(t){f,rnrfl-.1HlulIIJ_]AAGAL-l-Il_-_rl -........__--ri -r -f --l --t -r_ -fr -MOTOR(l)lrSTORAGEOFFICEB\IIPALLET OFIlelrlERtrs IFLAM@ooWAlERTANK+ADMINISTRAlIONBUILDINGIIPACTFTC ffi eeU-PREPIRED BY:GrcUT IXqrMsp'sl f88'{'ndl{D MSDSf- nne HYDRANT,<--9+ FENCEEREEMERGENCY RESPONSEEQUIPMENT/ABSORBENTSABOVEGROUNDSTORAGE TANKt---t UNDERGROUNDSTORAG€ TANKMOTOR OILS & LUBRICANTS(cot BusnB[E uourDs)BATIERY ETECTROLT-\(coRRosr\E LTQUTD)DIESEL N'EL(corBusTrBLE uaurDS)NIlROGEN(CoMPRESSED GAs)PROPANE(FLAMMABI..E UOUID)ACETYTENE(corilPREssED GAS)ANTIFREEZE/COOLANTSwAsrE olL(RAMMABT.T LTOUTD)FIRE PULL BOX(fr) ARGoN@ oxveeN6 nurouanc TRANSMrssroN" FLUTD@@@@Ao+l(-A@TANK MONITORINGALARM/;\ GASOUNE\v (FLAMMABT5STAGING AREAEVACUAION,/uourDs)@@oTELEPHONERRST AID KITRRE EXTINGUISHERSTORM DRAINSANITARY SEWEREMERGENCY PUMPSHUT-OFFELECIRICAL PANELSHUT-OFFNATURAL GASSHUT-OFFWATER SHUT-OFFBcDEFGHJKLM Hazurdous Materiuls Business Plan - List of ChemicalsPermit No: 60-0265 Facility: PACIFIC BELLAddress: 196 SUBURBANRD, SAN LUIS OBISPOMaximumCommon NameChemical NameAmt UnitsPhysicalStateLargestContainer Grid NoWASTE PARTS WASHERSLUDGEDEGREASER, KT AQUEOUS PARTSCLEANER55LiquidGAL55WASTE OIL FILTERSGAL55WASTE OIL FILTERS55LiquidWASTE LEAD ACID BATTERIES56WASTE LEAD ACID BATTERIES7SolidLBSWASTE ANTIFREEZEWASTE ETHYLENE GLYCOLLiquidGAL5555WASTE MOTOR OIL110PET. HYDROCARBON (WASTE OIL)55LiquidGALPROPANEPROPANELiquidGAL250250OIL AND FLOOR SWEEP WASTE55PET. HYDROCARBON SOLID WASTE55SolidLBSNITROGENNITROGENGasCU FT2280228IVOTOR OIL110PETROLEUM HYDROCARBON55LiquidGALHYDRAULIC FLUIDGAL55PETROLEUM HYDROCARBON55LiquidGASOLINE, UNLEADEDPETROLEUM HYDROCARBON6000LiquidGAL6000GAS & WATER WASTEGAL55SUMP WATERWASTE55LiquidDIESEL4000PETROLEUM HYDROCARBON4000LiquidGALARGON / CARBON DIOXIDEARGON i CARBON DIOXIDEGasCU FT222222V^uilt\z/ t /o thwl<-c.l- 3L',r.\ @*1+og 55 + z5s 1t*J La'"trocl',Joe- Q".l R'1>,; + b-1315 o{kcsr-t+ 4l ^ +o1t ce t(Monday, Mareh 12' 2001I of 1 -CITYOFSANLUIS OBISPO,[(FIREDEPARTMENT2160 Santa Barbara Avenue * San Luis Obispo, CA9340l-5240 * 805-781-7380BUSINESS PLAN UPDATE FORMFACILITY NAMEPacific Rell SE164FACILITY ADDRESSIq6 STTRTIRRAN RT)c a l\T T r TTs. nTlTSE)n f- A O?4n?CONTACT PERSONla'rrCol+NUMBER:408-554-3557Annual Inventory Update (Due every year by January 1)Cov,.e(.tPhs!1e-tlNo Significant changes in inventory have occurred since the last Business Plan or inventory wassubmitted.New inventory forms are attachedffi Replace previous inventory with attached inventory.[ ] Replace only designated pages of inventory.r(Additional CommentsYearly Review and RecertificationI certify that the Business Plan has been reviewed and the information contained in the BusinessPlan is accurate and complete as of this date.Other Updatest ] Please incorporate the following information into the Business Plan for thisI declare, under penalty of perjury that the information provided herein is true andcorrect to the best of my knowledge.SignatureDate: December 15.2000Printed Name. Sfewe SknndersonRHLT.)ecion Grnrrn Aoenf fnr PacificBelI/SRCPlease Return to: Molly Brown, Hazardous Materials SectionCity Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA9340l-5240H:/BUSINESS PLAN UPDATE FORM MOLLYThe City of San Luis Obispo is committed to include the disabled in all of its services, programs and activities.Telecommunications Device for the Deaf (805) 781-7410. 136NAME OF SIGNER (print). Steve SkandersonProject ManagerTITLE OF SIGNER137srcNAruREoro**r;ffi hhklz.(9ooDATE134NAMEOFDOCUMENTPREPARER 135RHL DESIGN GROUP, INC. - AGENT FOR PACIFIC BELLCertification: Based on my inquiry of those individuals responsible for obtaining the information, I certiff under penalty of law that I have personally examined and amlamiliar with the information submitted and believe the information is true, accurate, and complete.LOCALLY COLLECTED INFORMATION :PAGER#-#il3€R67+3+127132PAGER#12624-HOUR PHONEffirctua+* b11 7 LL'+1L'2'877-322-4722Z4-HOUR PHONE'131408-554-3557BUSINESS PHONE125877-322-4722BUSINESS PHONE130Facility Contact124TITLEv24 HR EMERGENCY SERVICE129IITLE123NAME - tsif,FroEEEF- La,r-r\ LAWL,EMERGENCY CONTROL CENTER128NAMEIV. EMERGENCY CONTACTSPRIMARYSECONDARYATECASAN RAMON12012212194583-0995CODECONTACT MAILING ADDRESS I '2600 CAMINO MMON, RM 3EOOO119925-823-6161STAN BRODECKIACTNAME117118PHONEilI.SAN RAMONATE114115116CA94583-0995CODECWNER MAILING ADDRESS2600 CAMINO RAMON, RM 3EOOO113PHONE877-823-9833SBC Communications, lnc.111112NAMEOWNEROPERATORNAME€ffflffitrcc,vrQ'c-f-110L109S OPERATOR PHONE408-554-3557107SIC CODE (a digit #)4811108SAN LUIS OBISPO104COUNTYBRADSTREET106CITY1 0-340-1 61 8,SAN LUIS OBISPO93403C.A.CODE105l'"BUSINESS SITE ADDRESS196 SUBURBAN RD103BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)Pacific Bell SE164PHONE408-554-355731021213112001100ID#DATE1101ofPage1t1t2001DATEBUSINESS OWNER/OPERATOR IDENTIFICATIONJAil 1 1 2lJa1FACILITY INFORMATIONtUN'CONSOLIDATED F'ORVf.-JD PROGRAM{-ou l-l-O\UPCF (1/99 revised)lbS'/bh?167oES FORM 2130 (t/99) ADDITIONAL LOCALLY COLLECTED INFORMATIONIf EPCRA, Please2452442432425241240es2392384NONE237236esPETROLEUM DISTILLATES235234391-20-3233232esNAPHTHALENE2312302 O.5o/o68476-34-6229228DIESEL FUEL NO.2227I gg.s%226CAS#EHSHAZARDOUS COMPONENT (For mixture or waste only)%wTBELOWAMBIENTCRYOGENIC225STORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTXSTORAGE PRESSUREA. AMBIENT[t. anovrAMBIENrBELOWAMBIENT224XSTORAGESONTAINERABOVE GROUND TANKIINDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICAIONMETALLIC DRUMi. FIBER DRUMGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONRAILCAROTHERCANCARBOYs[ok.BAGBOXCYLINDER223DAYS ON SITE:365222a. GALLONSb. CUBIC FEETc. POUNDS! o. roNs 221UNITS*(Check one item only)if EHS. amount must be in oounds.XDAILYAMOUNT217DAILYAMOUNT4000218WASTEAMOUNT4000219ATE WASTE CODE2204000216FED I{AZARD CATEGORIESa. FIREb. REACTIVEo.PRESSURE RELEASEd. ACUTE HEALTHe.CHRONIC HEALTH(Check all that apply)XXX215LARGESTCONTAINER 4OOOO214PHYSICAL STATEa. SOLIDb. LIQUIDc. GAS(Check one item only)X213CURIES212RADIOACTTVEYesXNo211TIAZARD MATERIALc. WASTETYPE (Check one itema. PUREb. MXTUREXFIRE CODE HAZARD CLASSES (Complete if required by CUPA)210COMBUSTIBLE LIO. IIIf EHS is "Yes", all amounts below must be in lbs.CAS#20968476-34-6208EHSYesNoXCOMMONNAME207DIESEL FUEL #2TRADE SECRETYesNo206IfSubiect to EPCRA, refs to instructioroXCHEMICALNAME205PETROLEUM HYDROCARBONII. CHEMICAL INFORMATIONGRID# (optional)F7204MAP# (optional)12031FACILIry ID#CI{EMICAL LOCATION CONFIDENTIAL202EPCRAYESXNOCTIEMICAL LOCATIONWEST SIDE OF LOTBUSINESS NAME3Pacific Bell SE164I. FACILITY INFORMATIONREVISE200PageofDELETEADDI..T.IED PROGRAM CONSOLIDATED f.lMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOnc page per mterial per building or uea)UPCF (l/ee)169OES Form2731 ) ?1/l for use on ellle *tt Form No.*BT'E'HTffi+ O SKSTffiuv{rrn'#''E2. Pala 1 of CATOS00x{}681. Gensrator l0 Number UNIFORT TIAZARDOUT WASTE TANIFEST "btfi/tlv i!-Elgh$'I nB$*B!^TrY H*Y,'fiu ruoo,B[Altt wt3300t0000 e00- I 39- 39{3 Numbeft 10. Containors 12. Unit VVt./Vol. 13. Wasto Codor Tvpo 1 1. Total QuantitYNo.9b. U.S. DOT o08{ripton (indudlng Propet Shipplng Name, Hazald Cla$, lD Numb€r' anrt Pac*hg GrcuP (il any)){91P Ji:: Dn It{AsT; tIouIDSNOH tA8 NCRA TIASARDOUS, sonnrur AND OrL) ats packaged,nam8,propetbyabovsactunatelyandate h6andam Prlmarytfshipm€ntexporlregulations.nationsl govemm€ntalintemationalandtoapplicable Consenl.olAcknowlodgmont trua.lsquanftysmall(b)goneratol) I AT er [H*S aox 509il nAilotl ( 3 3 f D, CA) 000 l. N'TTH RNC RECORD"- - Cr ?{5s3-0995 ,\T&T lSiltoAut,}6 SUBUBBAN NOAD SAN I"UIS OBISPO p 0 A i:S I3{OlitJ{6 7 3 0s055 ?xn0000509 30 sY3tf,t{s, I}lc 94. HM A CD ol,sl2ul(9 HIP t40*(}fiT54 ,, ?a4 \ttlUV,<t 3f3ll09 CSG r -)c,) ff?Dr bbIl*7 60 (ITY.KtI c 9/t t HR Y}5 Port ol enfy/oxit:Expoti lrom U.S. lmpo.t to U.S.u.s.:Dah MeMabRocslpt olotAcknowlsdSfltsnt )r /t 3ystonr)anddlsposal,waste lroetmonl,hazadouglorcodesCod€8MethodManagementWasteRepottHazardoug19.4, 2. ?0. Itemn 18andedatm6firt6stlhesxcaplcovsredmatorialto{hazerdougolC6ftthalionrocsipto{Owner Oporatofl ttuu*r1o*Ip.*n,R.j*,t* I F Jtr lr ]C to (ol Phono: I l*l neslduaflr,*I orrnw, &. oisctopancl lndicadon SPao Dlscrepancl +i) ar€ RF.CFIVEII llll 25 ?rlfl DESIGNATEO FACILITY rO T;€N€FATOF CERTIFICATE OF DISPOSAL I July 11,2011 AT&T fSNLOAU Ig gUBURBAN RAOD SAN LUIS OBISPO, CA 93401 :his facilitY. Reference Number: ,. rh. is to certfy that waste ar defined on waste Manifest number002844740sKst002844740s* was received )! w.S. Ecology, lnc., on oat22l2o11;,.The waste(s) were "i'"qu""tty tt"ated' rf required by 40 CFR Part 268 md U.s. Ecorogy,s permits and disposed of by a6n2J?ali in accordancc with permits and laws regulating 1 1 062 1 045 87 -OO2844740SKS'1 - 1 llllaterlal:1 5 GALLON DRUM ( BATCH WASTE Frocesg: - .dnagomsnt Gode: ' FacilltY: gurface imPound NEVADA, INC. ment that will be closed as landfill 95 11 MILES S. OF BEATTY BEATTY, NV 89003 EPA lD: NW330010000 Waste TVPo: NON'RCRAWASTE CUSTOMET: SAFEW-KLEEN SYSTEMS, INC ,' Printed Namel SCOi-f WISNIEWSKI :] -:tidJ*Jd "r-tr*-0Slgnature: Tltle:EN\{iHEALTH & SAFETY MANAGER t- r.l RECEIVED JUL T5 ?O1I If EPCRA, Please Sign Hery'ADDITIONAL LOCALLY COLLECTED INFORMATION2465242es2442432454 15o/o23864742-56-9241es240SOLV. DEWAX DIST. LT PARAFFIN2393 28o/o234PROPRIETARY237es236ADDITIVES2352 85o/o23064742-54-7233232HYDROTREATED DIST. HV PARAFFIN2311 Bso/o226SOLVENT DEWAXD DIST HV PARAFFN22764742-65-0229228%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENIC225 . AMBIENTXABOVEAMBIENTSTORAGE PRESSUREBELOWAMBIENT224A. AMBIENTABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAILCAROTHERSTORAGECONTAINER222DAYS ON SITE:365LINITS*iCheck one item only)X| ] o. roNs 221a. GALLONSif EHS. amount must be in oounds.c. POUNDSb. CUBIC FEETSTATE WASTE CODE220DAILYAMOUNT120WASTEAMOUNTlX-218217219DAILY AMOUNT120XXlCheck all that apply)a. FIREb. REACTIVEe.CHRONIC HEALTHd. ACUTE HEALTHo.PRESSURE RELEASEFED }L{ZARD CATEGORIES216X(Check one item only)a. SOLIDc. GASb. LIQUIDPHYSICAL STATE214215LARGESTCONTAINER 12OXYesNoRADIOACTIVE212XTYPE (Check one itema. PUREc. WASTEb. MIXTUREIIAZARD MATERIAL21121sCURIESCOMBUSTIBLE LIO,38210FIRE CODE HAZARD CLASSES (Complete if required by CUPA)64742-65-0CAS#209If EHS is "Yes", all amorurts below must be in lbs.MOTOR OILCOMMONNAME207XNoYesEHS208PETROLEUM HYDROCARBON]HEMICALNAME205X206NoYeslfSubject to EPCRA, refs to instructionsTRADE SECRETII. CHEMICAL INFORMATION1t1FACILITY ID#204GRID# (optional)F4203MAP# (optional),|X202SHEMICAL LOCATION CONFIDENTIALNOYESEPCRASTORED IN SHOPCTIEMICAL LOCATIONPacific Bell SE164BUSINESS NAME3I. F'ACILITY INFORMATIONADDDELETEofPageREVISE200HAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)HAZARDOUS MATERIALS.dIED PROGRAM CONSOLIDATED,{MUPCF (l/ee)r69OES Form2731 ADDITIONAL LOCALLY COLLECTED INFORMATION246If EPCRA, Please Sign Here7758-11-4245244oDIPOTASSIUM PHOSPHATE2435 2o/o2427732-18-5241$.'240WATER2394 3o/o238PROPRIETARY237236esADDITIVES2353 3o/o2341 1 1-46-6233es232DIETHYLENE GLYCOL2312 1o/o230107-21-1229es228ETHYLENE GLYCOL227I g4o/o226CAS#EHSHAZARDOUS COMPONENT (For mixture or waste only)%wrBELOWAMBIENTflo. cnvocBNrc225STORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224XSTORAGECONTAINERABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYsLoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGONRAILCAROTHER223DAYS ON SITE:365222UNITS*fCheck one item only)a. GALLONSb. CUBIC FEETc. POUNDSI a. roNs 221if F.HS- amorrnt mrrst he in nounds.XVERAGE DAILY AMOUNT55217DAILY AMOI]NT552't8WASTEAMOLTNT219WASTE CODE220FED HAZARD CATEGORIESicheck all that apply)216a. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHXe.CHRONIC HEALTHX215LARGESTCONTAINER 55PHYSICAL STATE214a. SOLIDb. LIQUIDc. GASiCheck one item only)X213CURIES212RADIOACTIVEYesNoXI.IAZARD MATERIAL211a. PUREb. MXTUREc. WASTEIYPE (Check one itemXFIRE CODE IIAZARD CLASSES (Complete if required by CIIPA)210COMBUSTIBLE LIQ.38If EHS is "Yes", all amounts below must be in lbs.]AS#209107-21-1208EHSYesNoX]OMMONNAME207ANTIFREEZE/COOLANTTRADE SECRETYesNo206IfSubi€ct to EPCRA. rcfer to instructionsX]HEMICALNAME205GLYCOLSII. CHEMICAL INFORMATIONGRID# (optional)F4204MAP# (optional)1203IIFACILITY ID#C}IEMICAL LOCATION CONFIDENTIAL202EPCRAYESNOX]MMICALLOCATIONSTORED IN SHOPBUSINESS NAME3Pacific Bell SE164I. FACILITY INFORMATIONPageofREVISE200DELETEADD^riIED PROGRAM CONSOLIDATED,{MHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mterial per building or uea)UPCF (l/ee)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246524224424324542382402392413234es236BUTANEzJc1 06-97-B2372230es232ETHANE23174-84-0233226PROPANE22774-98-6229oes228%wTHAZARDOUS COMPONENT (For mixture or waste only)CAS#EHSXA. AMBIENTSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENIC225STORAGE PRESSUREABOVEAMBIENTA. AMBIENTBELOWAMBIENT224ABOVE GROIJND TANKTJNDERGROTJND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYs[oFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAIL CAROTHERSTORAGECONTAINER222DAYS ON SITE:365UNITS*(Check one item only)c. POUNDShe in norrnds-! o. ror.rs 221Xa. GALLONSif EHS. amount mustb. CUBICFEETDAILY AMOUNT250WASTEAMOLTNT1 000218ATE WASTE CODE217219220DAILYAMOUNT250FED TIAZARD CATEGORIES(Check all that apply)XXXa. FIREb. REACTTVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTH216Xa. SOLIDc. GASb. LIQUID214PHYSICAL STATE(Check one item only)215LARGESTCONTAINER 250Xa. PUREc. WASTEb. MTXTURE211HAZARDMATERIALIYPE (Check one item213CURIESX212NoYesRADIOACTTVEFLAMMABLE GAS210FIRE CODE I{AZARD CLASSES (Complete if required by CUPA)74-98-6CAS#209If EHS is "Yes", all amomts below must be in lbs.PROPANECOMMONNAME207XNoYesEHS208PETROLEUM HYDROCARBONCHEMICALNAME205X206NoIfsubject to EPCRA, rcfq to instructionsYesTRADE SECRETII. CHEMICAL INFORMATIONFACILITY ID#204GRID# (optional)G4203MAP# (optional)11STORED IN YARD:T{EMICAL LOCATIONX202NOCMMICAL LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAME3I. F'ACILITY INFORMATIONADDDELETEofPageREVISE200HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mtedal per building or uea)IIAZARDOUS MATERIALS.-r{.IED PROGRAM CONSOLIDATED.tMUPCF (l/ee)169OES Form2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATIONv2465242es2442432454238es2402352413234236!v".235237z230231f]v"232233226I looo/oMOTOR OIL, USED2278002-05-9229$.'228%wTHAZARDOUS COMPONENT (For mixture or waste only)CAS#EHSXA. AMBIENTSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTf lo. cnvoceNtc22sX[u. enovnAMBIENrA. AMBIENTSTORAGE PRESSUREBELOWAMBIENT224ABOVE GROUND TANKUNDERGROUNDTANKTANKINSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsLoFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONzzoRAILCAROTHERSTORAGECONTAINERL'NITS*(Check one item only)! o. roNs 221Xa. GALLONSnorrndsif EHS. amount must be inc. POUNDSb. CUBIC FEET222DAYS ON SITE:365DAILYAMOUNT110WASTEAMOTINT110217218219220DAILY AMOUNTWASTE CODE110221FED HAZARD CATEGORIES(Check all that apply)f l c.PRESSURE RELEASE f-lXXa. FIREb. REACTIVEe.CHRONIC HEALTHd. ACUTE HEALTH216X(Check one item only)a. SOLIDc. GASb. LIQUIDPHYSICAL STATE214215LARGESTCONTAINER 120XIYPE (Check one itemc. WASTEa. PUREb. MDOURETIAZARD MATERIAL211CURIES213XYesNoRADIOACTTVE212COMBUSTIBLE LIQ.38210FIRE CODE HAZARD CLASSES (Complete if rcquired by CUPA)CAS#8002-05-9209If EHS is "Yes", all amounts below must be in lbs.USED MOTOR OILSOMMONNAME207XNoYesEHS208PETROLEUM HYDROCARBON]HEMICALNAME205X206NolfSubject to EPCRA, refq to instructionsTRADE SECRETYesII. CHEMICAL INFORMATIONFACILITY ID#f203MAP# (optional)1101204GRID# (optional)F4STORED IN YARDCIIEMICAL LOCATIONX202NOCHEMICAL LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADDREVISEofPage200DELETEHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mtorial per building or il€a)H.A.ZARDOUS MATERIALS.TIIED PROGRAM CONSOLIDATED il ,TTVTUPCF (1/99)169OES Form 2731 ADDITIONAL LOCALLY COLLECTED INFORMATION246If EPCRA, Please Sign Here245o24424324257758-11-4241$.'240oDIPOTASSIUM PHOSPHATE2392384 2o/o7732-18-5237236WATER2352343 10To111-46-6233232esDIETHYLENE GLYCOL2312302 1Yo107-21-1229228esETHYLENE GLYCOL2271 g+%226CAS#EHSHAZARDOUS COMPONENT (For mixture or waste only)%wTBELOWAMBIENTf-]0. cnvocnNlc225STORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224XSTORAGECONTAINERABOVE GROLTND TANKIJNDERGROTIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONRAILCAROTHER223DAYS ON SITE:365222a. GALLONSb. CUBICFEETc. POUNDShe in norrnds.I o. roNs 221UNITS*(Check one item only)if EHS. amount mustXVERAGE DAILY AMOUNT55217DAILYAMOUNT55218WASTEAMOI.JNT55219WASTE CODE220343216FED HAZARD CATEGORIESiCheck all that apply)a. FIREb. REACTTVEo.PRESSURE RELEASEXd. ACUTE HEALTHe.CHRONIC HEALTHX215LARGESTCONTAINER 55PHYSICAL STATElCheck one item only)214a. SOLIDXb. LIQUIDc. GAS213CURIES212RADIOACTIVEYesNoXIIAZARD MATERIAIIYPE (Check one item211a. PUREb. MIXTUREc. WASTEXFIRE CODE I{AZARD CLASSES (Cotrrplete if required by CUPA)210COMBUSTIBLE LIQ.3BIf EHS is "Yes", all amounts below nust be in lbs.]AS#209107-21-1208EHSYesNoXCOMMONNAME207USED ANTIFREEZETRADE SECRETYesNo206If Subiect to EPCRA, refq to irotructionsXCHEMICALNAME205GLYCOLSII. CHEMICAL INFORMATIONGRID# (optional)F4204MAP# (optional)12031i',,]FACILITY ID#CMMICAL LOCATION CONFIDENTIAL202EPCRAYESNOXCHEMICAL LOCATIONSTORED EAST SIDE SHOPBUSINESS NAMEaPacific Bell SE164I. FACILITY INFORMATIONPageofREVISE200DELETEADD.^IIIED PROGRAM CONSOLIDATED I *VTHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per roterial per building or rea)UPCF (r/ee)t69OES Form2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465 goh242PROPRIETARY245244TRADE SECRET2434 9Oo/o238OIL MIST, if generated2398012-95-1241es2403 90%234SOLVNT DEWXD DISTLL HV PARAFIN23564742-65-0237236ft"'22%230232!v"' EN"ZINC COMPOUND231PROPRIETARY2331 go%226228!v.' EN"HYDROTREATED DISTLL HV PARAFIN22764742-54-7229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XA. AMBIENTSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENIC225XSTORAGE PRESSUREABOVEAMBIENTA. AMBIENTBELOWAMBIENT224ABOVE GROTIND TANKI.JNDERGROIJND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYsILoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAILCAROTHERSTORAGECONTAINER222DAYS ON SITE:365TJNITS*(Check one item only)XI o. roNs 221a. GALLONSif RHS- amount must be in oounds.c. POUNDSb, CUBIC FEETVERAGE DAILY AMOIJNT55DAILYAMOIJNT55WASTEAMOTJNT219218217STATE WASTE CODE220FED HAZARD CATEGORIES(Check all that apply)XXXa. FIREc.PRESSURE RELEASEb. REACTIVEe.CHRONIC HEALTHd. ACUTE HEALTH216Xc. GASa. SOLIDb. LIQUID214PIrySICAL STATE(Check one item only)215LARGESTCONTAINER 55X212NoYesRADIOACTIVEXc. WASTEa. PUREb. MXTURE2't1HAZARD MATERIALIYPE (Check one item213CURIESCOMBUSTIBLE LIQ.38210FIRE CODE HAZARD CLASSES (Complete if required by CUPA)64742-54-7]AS#209If EHS is "Yes", all amounts below must be in lbs.HYDRAULIC FLUIDsOMMONNAME207XNoYesEHS208X206NoYesIfSubiect to EPCRA, refq to instructionsTRADE SECRETPETROLEUM HYDROCARBONSHEMICALNAME205II. CHEMICAL INFORMATIONFACILITY ID#,|204GRID# (optional)F4203MAP# (optional)1X202CHEMICAL LOCATION CONFIDENTIATNOYESEPCRASTORED IN SHOP]HEMICAI LOCATIONPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADDXREVISE200DELETEofPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mterial per building or oea)HAZARDOUS MATERIALS.{M.-rtIED PROGRAM CONSOLIDATED t'IUPCF (l/ee)169OES Form 2731 ADDITIONAL LOCALLY COLLECTED INFORMATION246If EPCRA, Please Sign Here245Iv.'2442435242801 2-95-1241nY"240OIL MIST, if generated2394238PROPRIETARY237236esTRADE SECRET2353 <12o/o23464742-65-0233232esSOLVNT DEWXD DISTLL HV PARAFIN2312 30o/o23064742-56-9229IY*228SOLVNT DEWXD DISTLL LT PARAFIN2271 sgo/o226CAS#EHSHAZARDOUS COMPONENT (For mixture or waste only)%wrCRYOGENIC225STORAGE TEMPERATUREA.AMBIENTABOVEAMBIENTBELOWAMBIENTXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224XSTORAGECONTAINERABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEELDRUMPLASTICA{ONMETALLIC DRUMCANCARBOYSLOFIBER DRUMBAGBOXCYLINDERBOTTLERAILCAROTHERPLASTIC BOTTLETOTE BINTANKWAGON223DAYS ON SITE:365222t.INITS*(Check one item only)a. GALLONSb. CUBICFEETc. POUNDS! a. roNs 221if EHS. amount must be in oounds.XVERAGE DAILY AMOTJNT55217DAILYAMOUNT55218WASTEAMOUNT110219WASTECODE220FED }IAZARD CATEGORIES(Check all that apply)216a. FIREb. REACTTVEc.PRESSURE RELEASEd. ACUTE HEALTHXe.CHRONIC HEALTHX215LARGESTCONTAINER 55PHYSICAL STATE214(Check one item only)a. SOLIDXb. LIQUIDc. GAS213CURIES212RADIOACTWEYesXNoI{AZARD MATERIALIYPE (Check one item211a. PUREb. MXTUREc. WASTEXFIRE CODE IIAZARD CLASSES (Complete if required by CUPA)210COMBUSTIBLE LIQ.38If EHS is "Yes", all amounts below mut be in lbs.CAS#20964742-56-9208EHSYesNoXCOMMONNAME207AUTOMATIC TRANSMISSION FLUIDTRADE SECRETYesNo206If Subject to EPCRA, refq to instructionsXCI{EMICAL NAME205PETROLEUM HYDROCARBONII. CHEMICAL INFORMATIONGRID# (optional)F4204MAP# (optional)I2031tiFACILITY ID#CIIEMICAL LOCATION CONFIDENTIAL202EPCRAYESXNOCHEMICAL LOCATIONSTORED IN SHOPBUSINESS NAMEJPacific Bell SE164T. FACILITY INFORMATIONPageofREVISE200DELETEADD-rrIED PROGRAM CONSOLIDATED.lMHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)UPCF (l/ee)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246Vs5%242244[v.'BENZENE24371-43-22454 90%238240!v"'GASOLINE239NONE2413 14o/o2341330-20-7236XYLENES23529%230TOLUENE2311 08-88-3233232rrcn226es228METHYL TERT BUTYL ETHER227't634-04-4225%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREBELOWAMBIENTABOVE AMBIENTCRYOGENIC225A. AMBIENTXSTORAGE PRESSUREABOVE AMBIENTA. AMBIENTBELOWAMBIENT224ABOVE GROI]ND TANKUNDERGROTJND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTICA{ONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAIL CAROTHERSTORAGECONTAINERUNITS*(Check one item only)l ] a. roNs 221Xa. GALLONSif EHS'. amount must be in oounds.c. POUNDSb. CUBICFEET222DAYS ON SITE:365VERAGE DAILY AMOIjNT6000DAILY AMOUNT6000WASTEAMOUNT6000217218220219WASTE CODEFED IIAZARD CATEGORIES(Check all that apply)XXXa. FIREc.PRESSURE RELEASEb. REACTTVEe.CHRONIC HEALTHd. ACUTE HEALTH216Xa. SOLIDc. GASb. LIQUID214PHYSICAL STATE[Check one item only)215LARGESTCONTAINER 60,16XYesNoRADIOACTTVE212Xc. WASTEa. PUREb. MTXTURE211HAZARDMATERIALIYPE (Check one item213CURIESI-A FLAMMABLE LIQUID210FIRE CODE HAZARD CLASSES (COMPICIC if TEqUiTCd bY CUPA)8006-61-93AS#209If EHS is "Yes", all amounts below mut be in lbs.GASOLINE - UNLEADED]OMMONNAME207XNoYesEHS208X206NoYesIf Subiect to EPCM, refq to instructionsTRADE SECRETPETROLEUM HYDROCARBONSMMICALNAME205II. CHEMICAL INFORMATIONFACILITY ID#1IGRID# (optional)F7204203MAP# (optional)1WEST SIDE OF LOT]MMICALLOCATIONX202NOCHEMICAL LOCATION CONFIDENTIAIYESEPCRAPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADf)REVISE200DELETEPageofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mtgial per building or aea)HAZARDOUS MATERIALS-,dIED PROGRAM CONSOLIDATED T1 .TVTUPCF (l/ee)169OES Form2731 ADDITIONAL LOCALLY COLLECTED INFORMATION246vIf EPCRA, Please Sign Here5242243245oIv"'2444238o!v.'2402392413234236235237)230232!v.. EN"231aaeI 1oo%226NITROGEN227228!v" EN"229%wTHAZARDOUS COMPONENT (For mixture or waste only)CAS#EHSlo. cnvoceNtcXA. AMBIENTSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENT225STORAGE PRESSUREABOVEAMBIENTA. AMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROTJND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTICAIONMETALLIC DRUMCANCARBOYSLOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONaacRAILCAROTHERSTORAGECONTAINERUNITS*(Check one item only)b. CUBIC FEETif EHS. amountI a. roNs 221Xa. GALLONSmrrst he in nmrnds-c. POUNDS222DAYS ON SITE:365DAILYAMOUNT2536WASTE AMOUNT2536ATE WASTE CODE217219218220DAILY AMOTINT2536FED IIAZARD CATEGORIES(Check all that apply)Xa. FIREb. REACTTVEd. ACUTE HEALTHo.PRESSURE RELEASEe.CHRONIC HEALTH216Xa. SOLIDc. GAS214I r,. r.rquroPHYSICAL STATE(Check one item only)215LARGESTCONTAINER 228Xa. PUREc. WASTEb. MIXTURE211HAZARDMATERIAIIYPE (Check one item213CURIESXYes212NoRADIOACTIVEINERT GAS210FIRE CODE I{AZARD CLASSES (Complete if required by CUPA)7727-37-9CAS#209If EHS is "Yes", all amowrts below must be in lbs.NITROGENCOMMONNAME207XYesNoEHS208NITROGENCMMICALNAME205X206NoYesIfsubject to EPCRA, refq to instructionsTRADE SECRETII. CHEMICAL INFORMATIONFACILITY ID#[,1203MAP# (optional)11204GRID# (optional)G4]I{EMICAL LOCATIONOUTSIDE BEHIND SHOP YARDX202NOCHEMICAL LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAMEJI. FACILITY INFORMATIONADDXDELETEPageofREVISE200HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mterial per building or eea)HAZARDOUS MATERIALS-dIED PROGRAM CONSOLIDATED f -TVTUPCF (1/99)169OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465242!v..2442432454238240239\:5',2413234236235237z230232f]v.'231Y\233I roo%226228$".ACETYLENE22774-86-2229%wrCAS#EHS(For mixture or waste only)HAZARDOUSXA. AMBIENTSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENTCRYOGENIC225A. AMBIENTSTORAGE PRESSUREBELOWAMBIENTAMBIENT224ABOVE GROUND TANKUNDERGROUNDTANKTANK INSIDE BUILDINGSTEELDRUMFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223DRUMPLASTIC/NONMETRAILCAROTHERCANCARBOYs[oXone itema. GALLONSb. CUBIC FEETd. ToNs222DAYS ON SITE:221365217218VERAGE DAILY AMOUNT118DAILYAMOI.INT118219220TE WASTE CODEWASTEAMOUNT118XXXall that apply)a. FIREd. ACUTE HEALTHb. REACTIVEe.CHRONIC HEALTHIIAZARD CATEGORIES216c.PRESSUREX(Check one item only)c. GASa. SOLIDPHYSICAL STATE214! t.lrqurn215CONTAINER 118XTYPE (Check one itema. PUREc. WASTEHAZARDMATERIAL211b. MIXTURE213CURIESX212NoYesFLAMMABLE GAS210CODE IIAZARD CLASSES (Complete if required by CUPA)all amomts below mut be in lbs.74-86-2CAS#209ACETYLENECOMMONNAME207XNoYes208ACETYLENECIIEMICALNAME205XTRADE SECRET206Norefq to irutructionsYesII. CHEMICAL INFORMATIONFAC]LITY ID#203MAP# (optional)11204GRID#' (optional)F4STORED IN SHOPCHEMICAL LOCATIONX202NOCHEMICAI- LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONDELETEADDofPageREVISE200HAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea),^dIED PROGRAM CONSOLIDATED-tMUPCF (l/9e)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465242244243245A238240[v.' EN"2392413234236$" EN"237z230233232!v.s EN"231I 1oo226ARGON2277440-37-1229!v.'o228%wrHAZARDOUS COMPONENT (For mixture or waste only)CAS#EHSf lo. cnvoceNrcXA. AMBIENTSTORAGE TEMPERATUREBELOWAMBIENTABOVE AMBIENT225ABOVE AMBIENTA. AMBIENTSTORAGE PRESSUREBELOWAMBIENT224ABOVE GROUND TANKIJNDERGROLIND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223RAILCAROTHERSTORAGECONTAINER222DAYS ON SITE:365['NITS*lCheck one item only)I a. roNs 221Xa. GALLONSif F.HS amorrnf mrrst he in norrnds-c. POUNDSb. CUBICFEETSTATE WASTE CODE220DAILYAMOLTNT222WASTEAMOUNT222218217219DAILYAMOUNT222XXiCheck all that apply)a. FIREb. REACTTVEe.CHRONIC HEALTHd. ACUTE HEALTHc.PRESSURE RELEASEFED I{AZARD CATEGORIES216XiCheck one item only)a. SOLIDc. GASPHYSICAL STATE214! u.lrquro215LARGESTCONTAINER 222XTYPE (Check one itema. PUREc. WASTEb. MXTURET{AZARD MATERIAL211213CURIESXYes212NoRADIOACTIVEINERT GAS210FIRE CODE HAZARD CLASSES (Complete if required by CUPA)7440-37-1CAS#209If EHS is "Yes", all amounts below mrst be in lbs.COMMONNAMEARGON207XYesNoEHS208CHEMICALNAMEARGON205X206NoYesIf Subject to EPCRA, refq to instructionsTRADE SECRETII. CHEMICAL INFORMATIONt1FACILITY ID#204GRID# (optional)F4203MAP# (optional)1STORED IN SHOPCIIEMICAL LOCATIONX202NOC}IEMICAL LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONDELETEADDofPageREVISE200HAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per material per building or rea)HAZARDOUS MATERIALS.{IED PROGRAM CONSOLIDATED'lMUPCF (l/ee)169OES Form2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2465242!v"'2442432454., 238240$".2392413,r{236ft".235\J237z230233232$es231I 1oo2267782-44-7229$".228EN227%wTor waste only)CAS#EHSABOVE AMBIENTBELOWAMBIENTc\CRYOGENIC225STORAGE PRESSUREBELOWAMBIENTABOVEAMBIENTa,224ABOVE GROUND TANKI.JNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONDRUM223sILoTORAGEAINERRAIL CAROTHERXa. GALLONSifb. CUBICUNITS*(Check one item only)VERAGE DAILY AMOUNT124DAILYAMOUNT124WASTEAMOTINT124217WASTE CODE218220219Xall that apply)a. FIREb. REACTIVEe.CHRONIC HEALTHd. ACUTE HEALTHHAZARD CATEGORIES216XiCheck one item only)214a. SOLIDc. GASPHYSICAI STATEI u.uquro124215, LARGEST CONTAINERXIYPE (Check one itema. PUREc. WASTEb. MXTUREI{AZARD MATERIAL211CURIES213XNoYes212\DIOACTTVEOXIDIZER 3FIRE CODE I{AZARD CLASSES (Complete if required by CUPA)]AS#7782-44-7209lfIfiS is "Yes", all amounts below must be in lbs./OXYGEN]OMMONNAME207XYesNoEHS208SHEMICALNAMEOXYGEN205XTRADE SECRETto206Norefq to instructionsYesII. CHEMICAL INFORMATIONIFACILITY ID#203MAP# (optional)I1GRID# Jbftional),9/204STORED IN SHOP3I{EMICAI LOCATIONX202NOCI{EMICAL LOCATION CONFIDENTIALYESEPCRAPacific Bell SE164BUSINESS NAME3I. FACILITY INFORMATIONADDDELETEofPageREVISE200HAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOnc page per mterial per building or aea)HAZARDOUS MATERIALS.IIED PROGRAM CONSOLDATED.rMUPCF (l/ee)169OES Form2731 MAP# 1SITE MAPBUSINESS NAIIEBUSINESS20, 1995 0&Scqlc 360Umom.:SASPACIFIC BELL SNLOCA1R SE164196 SUBURBAN RDSAN LUIS OBISPO--t----4-tt-r| -l- rl r !-l-L-t -F .lDATEZIP CODE10 /10 /oo93403DRAMNG SCAI,ENOT TO SCALE1234567IactDcfttDza+f,mm-{Allt+t-- -l-- -r-r -l-l-J--al-T--l-r-...- r - -DSTORAGEOFFICE@oADMINISTRANONBUILDINGPAcrFrc S eeu-PREPIRED BY:Grom -IncIELEPHONERRST AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEII/ERSTACNG AREAEVACUAION/HMMP, AND MSDSLOCATIONHRE HMRANTFENCEEITERGENCY RESPONSEEQUIPMENT/ABSORBENTSABO\EGROUNDSTORAGE TANKr--.-r UNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(coMBUSTlBrE uot'JBATTERY ELEcIRoL J(coRRosr\E UQUtD)GASOLINE(FLAMMABLE uourDs)DIESEL RJEL(coMBUSIBIE UOUTDS)NIIROGEN(COMPRESSED GAS)ACETYTE}.IE(COMPRESSED GAS)ANNFREFZE,/COOLANTSWASTE OIL(FLAMMABLE UQUID)FIRE PUI.T BOXARGONOXYGEN@@@@@@@@Ao+A-A/f,. PROPANE\L/ (nnuuffiLEuourD)ELEC]RICAL PANELSIIUT-OFFNAruRAL GASSHUT-OFFWATER SHUT-OFFEMERGENCY PUMPSHUT-OFFTANK MONITORINGALARM@lTs'sl.t@IABcEF\,HJKLM EMERGENCY RESPONSE P/4NS AN.. iNAME OF FACILITY PACIFIL dELLD PROCEDURESS"y L6 C.aSITE ADDRESS6 Se.-t+N ./.tctoe#CONTACT PERSON & PHONE#b-/6 -736REPORTING AND NOTIFICATIONThe Building Warden/Site Manager for the facility is responsiblefor notifying the occupants of the building and advising them onhow t respond in the event of a hazardous materials incident asrequired in Pacific Bell's Emergency Operating Instructions (SI l-31.5)Additionally the Building Warden/Site l4anager will contact theCalifornia OES, Local Administering Agency and Pacific Be1lrs Internalcontacts as appropriate, the Emergency Control Center, Loca1 SecurityOffice, Environmental lvianagement, Safety District and Hea1th Services.The first employee on the scene is responsible for calling 9LL in theevent of an emergency. Pacific Bell as a company does not have specificpersonnel to provide emergency services, w€ rely on the city or countyemergency response teams.II. MITIGATIONBattery Electrolyte: Electrolyte is contained in batteries and batteriesare secured, in specially designed battery racks which work in con-junction with earthquake bracing.Diesel/eas /Oil-/Antifreeze: Under/above ground tanks are tested frequentlyto maintain the integrity of tank contents.Nitrogen/Acetytene: Compressed gasses are stored in a controlled andseparate area. Nitrogen tanks have safety caps.Ir{aterial.s: Hazardous materials are utilized and stored followingmanufacturers recommendations as we are a consumer of productsand not a manufacturer of hazardous materials.III. EVACUATIONThe Building Warden/Site Ivlanager for the facility is responsible fornotifying the occupants of the building and advising them on howto respond in the event of a hazardous materials incident as requiredin pacific BelI's Emergency Operating Instructions (Sr 13i..5)Alarm Sounds Paging Announcement if applicableEvacuate Building Routes are posted for multiple floor buildingsIr{eet outside building - each site report to S.C.C. forinstructions.tvEMERGENCY RESPONSE ASSISTANCEPacific Bell Emergency Operating Procedures (Sf 131.5),that the following agencies be notified in the event ofmaterials incident:reguaresa hazardousPacific BeI11 Emergency control CenterPacific Bel1 Security OfficeLocal Hazardous Emergency ResponseState Office of Emergency' ServicesPolice DepartmentFire Departments10)4Ls9l_ 19L6911911-823-7777542-2464427 -434L 2tV. MEDIGAL ASSISTANCECaII 911Police DepartmentFire DepartmentAmbulance7Methods for safe handling n".rrdoEmployees are provided training through the pacific safety planmodules oh how to handle hazardous maieriers and how to readMsDs as required by the osHA Hazard communication standard.Training is provided_ to employee" u.i"i" their work operationsbegin and annually thereafler. Additionarly they dre trainedon the "emergency operating procedures,, (SI 131.5)Procedures for coordinating Activities with Response Agencies:Pacific 8e11, s -Emerggncy Operating Instructions (Sf 131. 5)requires interfac" tiitrt- tnl approlriate emergency agencies aswell as the following internai-grbrrp"r- The Emergency controlCenter, Security office, Enviroim.;i;i Management, satetyDistrict and Uelttfr Services.2.3.Proper use of on'site Emergency Response Equipment by Emproyees:Employees are provj-ded trai-ning annually through the pacific safetyPlan Modules on how to handle iazardous materials and how to readMsDs as requi'red by the Federal Hazard communication st.andardHazardous materials are utilized ;;;-Jtorea following manufacturerrecommendations as we are a consumer of produ;;;-;; not amanufacturer of hazardous materials. nme( mainte;;;;" as outlined in piciii;;;ii:3"il.::H5il:";,i::ilitilil{.,",tPl-an' rtem F - nArt ""*u.r- of regist"t.a fire extinguishers are kept(Halon'carbon oioxiael'-wlt"t).;;';h;-ii!*i""s at ali times..rh"y aia praceaat strategic location; lh;;"ghout the'iici:-itv-ir,*il"ordancb with the 4'tans and ,f .rr".:Employees are provided Initial Safety PIan training on the HazardRecognition/Communication module as well as the function specificmodules before they begin their work operations. This also includestraining on the Emerg,ency Operating procedures.5. Provisions for Ensuring lnitial and Relresher Training:Employees are provided initial Safety Plan training on the HazardousRecognition/Communication module as well as the function specific modulesbefore they begin their work operations. This also includes trainingon the Emergency operating procedures. Additionally the Pacific SafetyPlan requires that employees receive Annual Refresher training on theHazardous Recognit.ion/Communication module, function specific safetymodules and the Emergency Operating Instructions. Employees are providedtraining annually through the Pacific Safety Plan modules on how tohandle hazardous materials and how to read as MSDS as required by theHazardous Communicaion Standard. Specific employees are selected to beBuj-lding or Floor Warden. Emergency Operating Instructions SI 13L.5)serve asa reference guide for the Building Warden. Additionally theyreceive on the job training from the previous warden and attend theInterdepartmental Training Course +6127 "Building and Floor WardenTrainingn". First Aid Training and Training on the Pacific Safety Planare also requiredCERTIFICATIONSUSAN E. JONES, certify that the above information will be used to fulfill my busincss'sobligations under the laws and(/t'\-- vf"that inacc\^r--urate information constitutes perjury under the law.SAFETY MANAGER)-t7n7Signature)TitleDate BUSINESS ACTIVITIESFACTLITY INFORMATIONFIED PROGRAM CONSOLIDATEDPageoft(you may also be required to provide additional information by yourcUPA or local agency.)15E. LOCAL REQUIREMENTSD. HAZARDOUSWASTE1. Generate hazardous waste?2. Recycle more than '100 kg/month of excluded or exemptedrecyclable materials (per HSC $zsl+e.21't3. Treat hazardous waste on site?Treatment subject to financial assurance requirements (for Permitby Rule and Conditional authorizaton)?Consolidate hazardous waste generated at a remote site?Need to report the closure/removal of a tank that was classified ashazardous waste and cleaned onsite?64.5.fives [ ruo sYEslTlNoloYEslTlNollIvesfiruorzIvesfilrorsIves17r.ro,r+EPA lD NUMBER-provide at the top of this pageRECYCLABLE MATERIALS REPORT(one per recycler)ONSITE HAZARDOUS WASTETREATMENT - FACILITY(Formerly DTSC Fotm 1772)ONSITE HAZARDOUS WASTETREATMENT-UNlTlone page per unit)(Formerly DTSC Form 1772A,8,C,D, and L)CERTIFICATION OF FINANCIALASSURANCE lFormerty DTSC Form 1232)REMOTE WASTE/CONSOLI DATION SITEANNUAL NOTI FICATION (FormerlyDTSC Form 1232)HMARDOUS WASTE TANK CLOSURECERTIFICATION (Formerty DTSC Form 1249)ffivesI[vesf;ruo zNO8NO6NO5YESYESB, UNDERGROUND STORAGE TANKS (USTS)1. Own or operate underground storage tanks?2. lntend to upgrade existing or install new USTs?3. Need to report closing a UST?C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTS)Own or operate ASTs above these thresholds:--any tank capacity is greater than 660 gallons, or--the total capacity for the facility is greater than 1,320 gallons?UST FACILITY (Formerly SWRCB Form A)UST TANK (One page per tank) (Formerly Form B)UST FACILITYUST TANK (One pertankUST INSTALLATION - CERTIFICATE OFCOMPLIANCE(one page per tank)(Formerly Form C)J UST TANK (ctosure portion-one page per tank)J No FoRM REQUTRED To cuPAsA. HAZARDOUS MATERIALSHave on site (for any purpose) hazardous materials at or above 55gallons for liquids, 500 pounds for solids, or 200 cubic feet forcompressed gases (include liquids in ASTs and USTs); or theapplicable Federal threshold quantity for an extremely hazardoussubstance specified in 40 CFR Part 355, Aappendix A or B; orhandle radiological materials in quantities for which an emergencyplan is required pursuant to 10 CFR Parts 30, 40 or 70?NO4ffivesIHAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (oES 2731 )Does your facilitylf Yes, please complete these pages of the UPCFNOTE: lf you check YES to any part of this list,please submit the Business Owner/Operator ldentification page (OES Form 27301.I. AGTIVITIES DECLARATIONBUSINESS NAMEPacific Bell196 SUBURBAN RD SAN LUIS OBISPO3AS)(Same as FACILITY NAME or DBA-Doing BusinessSE164ACILITY ID#12EPA lD# (Hazardous Waste Only)cAT080024268I. FACILITY IDENTIFIGATION2uPcF (1/99) tTITLE OF SIGNER137Project ManagerNAME OFSteve Skanderson136NAMEOFDOCUMENTPREPARER 135RHL DESIGN GROUP, INC. . AGENT FOR PACIFIC BELLDATE12t1512001134SIGNATURE OFCertification: Based on my inquiry of those individuals responsible for obtaining the information, Ifamiliar with the information submitted and believe the information is true, accurate, and complete.certify under penalty of law that I have personally examined and amLOCALLY COLLECTED INFORMATION:PAGER#132PAGER#127Z4.HOUR PHONE't31877-322-472224-HOIJR PHONE126877-322-4722BUSINESS PHONE130877-322-4722BUSINESS PHONE125408-554-3557TITLE12924 HR EMERGENCY SERVICETITLE124Property ManagerNAME128EMERGENCY CONTROL CENTERNAME123Larry CodayPRIMARYIV. EMERGENCY CONTACTSSECONDARY121CODE122CA94583-0995120SAN RAMONCONTACT MAILING ADDRESS2600 CAMINO RAMON, RM 3EOOO119CONTACT PHONE925-823-61 61118CONTACTNAME117STAN BRODECKI114ATECA115CODE116SAN RAMON94583-0995OWNER MAILING ADDRESS2600 CAMINO RAMON, RM 3EOOO113CWNER PHONE877-823-9833112OWNERNAME111Pacific BellBI]SINESS OPERATOR PHONE408-554-3557110BUSINESS OPERATORNAMELarry Coday109108SAN LUIS OBISPOSIC CODE (4 digit #)4811107DLTN BRADSTREET1061 0-340-1 61 IZIP CODE'10593403CACITY104SAN LUIS OBISPOS SITE ADDRESS196 SUBURBAN RD103NAME (Same as FACILITY NAME or DBA - Doing Business As)Pacific Bell SE1645PHONE408-554-3557102DATE100DATE10112t11200112t1t20021[:']ID#D PROGRAM CONSOLIDATED F'ORMF'ACILITY INFORMATIONBUSINESS OWNER/OPERATOR IDENTIFICATIONPageoflUPCF (l/00 revised)t67oES FORM 2730 (r/99) ADDITIONAL LOCALLY COLLECTED INFORMATIONIf EPCRA, Please Sign Heretre prsent at greater thil l% by weight ifnon-cucinogmic, or 0.1% by weight ifcucinogenic, attrch additional $heets ofpaper capturing the required infomtion.If more heildou components5242243244245238239o!v".240241234236[v.sPETROLEUM DISTILLATES235NONE2370.5%230NAPHTHALENE23123291-20-323399.5%226DIESEL FUEL NO, 222722868476-34-6229%w'lHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225XSTORAGE PRESSUREA. AMBIENTABOVE AMBIENTBELOWAMBIENT224ABOVE GROUND TANKI.]NDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBER DRUMBAGBOXCYLINDERPLASTIC/NONMETALLIC DRUM223BOTTLECANCARBOYsILoRAILCAROTHERPLASTIC BOTTLETOTE BINTANKWAGONI o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217DAILYAMOTINT4000218DAILYAMOUNT4000219WASTEAMOUNT-40ffi220TE WASTE CODEXXXall that apply)a. FIREb. REACTIVEc.PRESSURE RELEASEd. ACUTE HEALTHHAZARD CATEGORIESe.CHRONIC HEALTH216Xone item only)a. SOLIDc. GASb. LTQUTDSTATE214215LARGESTCONTAINER 4OOOOX(Check one itema. PUREc. WASTEb. MXTURE211MATERIALX212NoYesRADIOACTIVE213CURIESCOMBUSTIBLE LIQ. II210CODE IIAZARD CLASSES (Conplcte if required bv CUPA)68476-34-6209If EHS is "Yes", all amounts below must be in lbs.DIESEL FUEL#2NAME207XYesNoEHS208PETROLEUM HYDROCARBONNAME205Xto206IfNoTRADE SECRETrefer to instructionsYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1F7204GRID# (optional)WEST SIDE OF LOTI-OCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200of t5PageHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or mea)HAZARDOUS MATERIALS1ED PROGRAM CONSOLIDATED^1VIuPcF (l/ee)r69OES Form 2731 ADDITIONAL LOCALLY COLLECTED INFORMATION246If EPCRA, Please Sign Here242243es244245't5Yo234SOLV, DEWAX DIST, LT PARAFFIN239[v"'24064742-56-9241325234ADDITIVES235$.s2362371.5230ZINC ALKYL DITHIOPHOSPATE231o23268649423233lls226$..228LUBRICATING BASE OIL22764742-65-0229o/nWTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREABOVEAMBIENTBELOWAMBIENTCRYOGENIC225A. AMBIENTXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROLTND TANKI.JNDERGROI.IND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERRAILCAROTHERI a. roNs 221Xone item only)a. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217VERAGE DAILY AMOUNT90218DAILY AMOT]NT110219WASTE AMOTINTffiTE WASTE CODE220XXa. FIREb. REACTIVEd. ACUTE HEALTHe.CHRONICHEALTH216fl c.PRESSURERELEASE f lI{AZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one iten only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREC. WASTEb. MXTUREMATERIAL211xYes212RADIOACTIVENo213CURIESCOMBUSTIBLE LIQ.38210CODE IIAZARD CLASSES (Complete if required by CUPA)64742-65-0209If EHS is "Yes", all amounts below mwt be in lbs.MOTOR OILNAME207XYesNoEHS20820sNAME- PETROLEUM HYDROCARBONXTRADE SECRETto206NoYesref6 to i6tructionsII. CHEMICAL INFORMATIONACILITY ID#1204GRID# (optional)F4203MAP# (optional)1STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page t\ ofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)HAZARDOUS MATERIALSlED PROGRAM CONSOLIDATED F-rVIUPCF (l/e9)r69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246ile pr€sent at greater thm l% by weight ifnon-cucinogoic, or 0. l% by weight ifctrcinogenic, attrch additional sheets ofpaper captuing the required infomtionIf mre huudous components5242243es2442451-3238DIPOTASSIUM PHOSPHATE239es2407758-11-4241>1234WATER235es2367732-18-52370-8230DIETHYLENE GLYCOL231es2321't1-46-623380-96226ETHYLENE GLYCOL227es228107-21-1229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKTINDERGROTIND TANKTANK INSIDE BUILDINGSTEEL DRUMFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGONPLASTIC/NONMETALLIC DRUM223CANCARBOYsILoRAILCAROTHERI o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217VERAGE DAILY AMOUNT55218DAILYAMOIJNT75219WASTEAMOUNT"{220WASTECODEXXall that apply)a. FIREc.PRESSURE RELEASEd. ACUTE HEALTHT{AZARD CATEGORIESe.CHRONIC HEALTH216I t.nrecrrve IXone itern only)a. SOLIDc. GASb. LTQUIDSTATE214215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MIXTURE211MATERIALXYes212RADIOACTTVENo213CURIESCOMBUSTIBLE LIQ.38210CODE I{AZARD CLASSES (Complete if required bv CUPA)107-21-',!209If EHS is "Yes", all amounts below must be in lbs.ANTIFREEZE/COOLANTNAME207XNoYesEHS208ETHYLENE GLYCOLSNAME205XTRADE SECRET206NoYesto EPCRA, refs to instructioNII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDXDELETEREVISE200PageofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne pago per rotedal per building or uea)HAZARDOUS MATERIALS- rED PROGRAM CONSOLIDATED,VIUPCF (l/ee)169OES Form2731 ADDITIONAL LOCALLY COLLECTED INFORMATION2461If EPCRA, Please Sign Here242243es244245238239flv"'240241234BUTANE235$"236106-97-8237230232ETHANE23174-84-0233226[v.s228PROPANE22774-98-6229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225STORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDER223BOTTLERAILCAROTHERPLASTIC BOTTLETOTE BINTANKWAGONI o. roxs 221Xone ltema. GALLONSc. POIINDSb. CUBIC FEET222DAYS ON SITE:365217DAILYAMOUNT300218DAILYAMOUNT368219WASTEAMOUNTffia'STATE WASTE CODE220XXXa. FIREc.PRESSURE RELEASEb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTH216TIAZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LIQUID214one item only)STATE215LARGESTCONTAINER 250X(Check one itema. PUREc. WASTEb. MXTURE211MATERIALX212NoYesRADIOACTIVECURIES213FLAMMABLE GAS210CODE HAZARD CLASSES (Complete if required by CUPA)74-98-6209If EHS is "Yes", all amounts below mut be in lbs.PROPANENAME207XYesNoEHS208PETROLEUM HYDROCARBONNAME205Xto206IfNoTRADE SECRETrefs to iostructiomYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1E3204GRID# (optional)STORED IN YARDLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200oflPageHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)HAZARDOUS MATERIALS,vl,ED PROGRAM CONSOLIDATEDUPCF (l/ee)169OES Form273l If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION246242es244243245238239240241234235236flv.' EN"237230231$.,2322331 1ooy"226MOTOR OIL, USED227!v.'2288002-05-9229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT225f lo. cnvoceNlcXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKUNDERGROT]ND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGON223STORAGEAINERRAILCAROTHERX! a. roNs 221one itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217DAILY AMOTINT110218DAILYAMOIJNT110219WASTEAMOUNT110220221ATEWASTECODEXXa. FIREb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTH216IIAZARD CATEGORIESall dnt apply)Xa. SOLIDc. GASb. LTQUID214one itemonly)STATE215LARGESTCONTAINER 120X(Check one itema. PUREc. WASTEb. MTXTURE211MATERIALX212RADIOACTIVENoYesCURIES213COMBUSTIBLE LIQ.38210CODE IIAZARD CI-A.SSES (Complete if rcquired bv CUPA)8002-05-9209If EHS is "Yes", all amormts below must be in lbs.USED MOTOR OILNAME207XNoYesEHS208205NAMEPETROLEUM HYDROCARBONX206NoYesTRADE SECRETto EPCRA, refq to instructionsII. CHEMICAL INFORMATIONID#1204GRID# (optional)F4203MAP# (optional)110STORED IN YARDLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE'164NAMEoI. FACILITY INFORMATIONADDDELETEREVISE200ofPageHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)IIAZARDOUS MATERIALS^-. lED PROGRAM CONSOLIDATED-rMUPCF (1/99)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION242es2442432452o/o238DIPOTASSIUM PHOSPHATE2392407758-11-424110%234WATER235!Y"2367732-18-52371o/o230232DIETHYLENE GLYCOL231111-46-6233I g4o/o226228$es EN"ETHYLENE GLYCOL227107-21-',!229%wTEHSHAZARDOUS COMPONENT (For mixture or waste only)CAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKI.JNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDER223AINERBOTTLERAILCAROTHERPLASTIC BOTTLETOTE BINTANKWAGONI a. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217DAILYAMOTJNT55218DAILYAMOTINT55219WASTE AMOUNT55220WASTE CODE343XXall that apply)a. FIREb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTHTIAZARD CATEGORIES216Xone iiem only)a. SOLIDc. GASb. LTQUIDSTATE214215LARGESTCONTAINER 55Xa. PUREc. WASTEb. MXTURE211(Check one itemMATERIALX212NoYesRADIOACTIVE213CURIESCOMBUSTIBLE LIQ.38210CODEI{AZARD CL{SSES (CompleteifrcquiredbyCUPA)107-21-1209If EHS is "Yes", all amounts below must be in lbs.USED ANTIFREEZENAME207XYesNoEHS204GLYCOLSNAME205XTRADE SECRETto206NoYesreftr to instructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)I204GRID# (optional)F4STORED EAST SIDE SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACTLITY INFORMATIONADDDELETEREVISE200PageofHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or uea)HAZARDOUS MATERIALS^ ,ED PROGRAM CONSOLIDATED-l'IUPCF (1/e9)r69OES Form2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATIONgo/242TRADE SECRET243es244PROPRIETARY24590%238OIL MIST, if generated235of]"'2408012-95-12412234ZINC ALKYL DITHIOPHOSPHATE235IY"2366864-94-2323785230SOLVNT DEWXD DISTLL HV PARAFIN231232!v". EN"64742-65'0233lgszzoHYDROTREATED DIST, HVY PARA22722864742-54-7229%w'lHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENIC225A. AMBIENTXSTORAGE PRESSUREA. AMBIENTABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKTINDERGROTJND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsILoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERRAILCAROTHERXI a. roNs 221one item only)a. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217DAILYAMOIJNT55218DAILYAMOIJNT55WASTEAMOI.TNT219ATE WASTE CODE220XXXa. FIREb. REACTIVEd, ACUTE HEALTHe.CHRONIC HEALTH216fl o.PRESSURE RELEASEI.I,AZARD CATEGORIESall that apply)Xa. SOLIDc. GASb. LTQUTD214one itern only)STATE215LARGESTCONTAINER 55X(Check one itema. PUREc. WASTEb. MDffURE211MATERIALX212YesRADIOACTIVENo213CURIESCOMBUSTIBLE LIQ.38210CODE H,{ZARD CLASSES (Complctc if required bv CUPA)64742-54-7209If EHS is "Yes", all amowtts below must be in lbs.HYDRAULIC FLUIDNAME207XYesNoEHS204PETROLEUM HYDROCARBONNAME205XTRADE SECRETto206NoYesrefq to instructionsII. CHEMICAL INFORMATIONID#203MAP# (optional)1F4204GRID# (optional)STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIAIYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page q ofHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mtedal per building or aea)HAZARDOUS MATERIALS^ED PROGRAM CONSOLIDATED F,vIIJPCF (1/9e)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION242ZINC ALKYL DITH IOPHOSPHATE243o2446864942324590238SOLVENT DEWAXED DIST., HVY PAR23964742650241o$.'24090234236HYRDOTREATED DIST. HVY NAPHTH2356474252523790230es232HYDROTREATED DIST., LT NAPHTH2316474253623390226HYDROTREATED DIST, HVY PARA227$.'22864742-54-7229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVE AMBIENTBELOWAMBIENTCRYOGENIC225XA, AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKI.JNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsILoFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERRAILCAROTHER! o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217DAILY AMOIJNT55218DAILYAMOUNT55219WASTEAMOUNT-++t--220WASTECODEX! c.PRESSURERELEASE f lXall that apply)a. FIREb. REACTIVEd. ACUTE HEALTHe.CHRONIC HEALTHT{AZARD CATEGORIES216Xone item only)c. GASa. SOLIDb. LIQUID214STATE215LARGESTCONTAINER 55X(Check one iiema. PUREc. WASTEb. MTXTURE21'lMATERIAL213CI]RIESX212NoYesRADIOACTIVECOMBUSTIBLE LIQ.3B210CODEHAZARDCLASSES (CompleteifrequiredbyCuPA)64742-56-9209If EHS is "Yes", all amormts below must be in lbs.AUTOMATIC TRANSMISSION FLUIDNAME207XNoYesEHS208PETROLEUM HYDROCARBONNAME205XTRADE SECRETto206Norefq to instructionsYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1F4204GRID# (optional)STORED IN SHOPLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. T'ACILITY INFORMATIONADDDELETEREVISE200oftPageHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per rotorial per building or aea)HAZARDOUS MATERIALS.ED PROGRAM CONSOLIDATED FMUPCF (l/ee)t69OES Form 2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION2485 50h242BENZENE243Iv.'24471-43-224590o/o238GASOLINE239es240NONE24114lo234XYLENES235es2361330-20-72379o/o230TOLUENE231es2321 08-88-32331 1oo/o226228METHYL TERT BUTYL ETHER227't634-04-4225%v{-lHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTBELOWAMBIENTABOVEAMBIENTflo. cnvocenrc225XA. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROTIND TANKTINDERGROI.JND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYsLoFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERRAILCAROTHERI o. roNs 221Xone itema, GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217VERAGE DAILY AMOUNT6000218DAILYAMOLINT6000219WASTE AMOTINT*€@-ATEWASTECODE220XXXall that apply)a. FIREb. REACTTVEd. ACUTE HEALTHc.PRESSURE RELEASEe.CHRONIC HEALTHHAZARD CATEGORIES216Xone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARGESTCONTAINER 6016X(Check one itemc. WASTEa. PUREb. MXTURE211MATEzuALXYes212RADIOACTIVENo213CURIESI-A FLAMMABLE LIQUID210CODE IIAZARD CLASSES (Complete if required by CUPA)8006-61-9209If EHS is "Yes", all amomts below must be in lbs.GASOLINE - UNLEADEDNAME207XYesNoEHS208PETROLEUM HYDROCARBONNAME205Xto206IfNoTRADE SECRETrefq to instructioroYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1F7204GRID# (optional)WEST SIDE OF LOTLOCATIONX202NOLOCATION CONFIDENTIAIYESPacific Bell SE'164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200Page tl of l$HAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page po roterial per building or rea)IIAZARDOUS MATERIALS.ED PROGRAM CONSOLIDATEDvlUPCF (1/e9)169OES Form 2731 If EPCRA, Please SignADDITIONAL LOCALLY COLLECTED INFORMATION246de pres€nt at greater thm l% by weight ifnon-cucinogmic, or 0.1% by weight ifcacinogenic, attrch additional sh€cts ofpaper capturing the requir€d infomtion.If more huudous compon€nts5242Ives24424324s2382392402412342352362372302312322332261 too%NITROGEN227o[v.'228229%WHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225A. AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROI.JND TANKI.INDERGROUND TANKTANK INSIDE BUILDINGSTEEL DRUMPLASTICA{ONMETALLIC DRUMCANCARBOYs[oGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223I. CYLINDERTORAGEAINERRAILCAROTHERFIBER DRUMBAGBOXI a. roNs 221Xone itema. GALLONSc. POUNDSb. CUBICFEET222DAYS ON SITE:365217DAILYAMOI.JNT25362't8DAILYAMOIJNT2536219WASTEAMOUNT-*3F220WASTE CODEXall that apply)I{AZARD CATEGORIESa. FIREb. REACTIVEc.PRESSLIRE RELEASEd. ACUTE HEALTH216fl e.CHRONIC HEALTHXone item only)a. SOLIDc. GASb. LIQUIDSTATE214215LARGESTCONTAINER 228X(Check one iiema. PUREc. WASTEb. MXTUREMATERIAL211X212RADIOACTIVENoYes213CURIESINERT GAS210CODE IIAZARD CI-ASSES (Complete if required bv CUPA)7727-37-920sIf EHS is "Yes", all amormts below must be in lbs.NITROGENNAME207XNoYesEHS208NITROGENNAME205X206IfNoTRADE SECRETto BPCRA, refq to instructionsYesII. CHEMICAL INFORMATIONID#1203MAP# (optional)1E3204GRID# (optional)OUTSIDE BEHIND SHOP YARDLOCATIONX202NOLOCATION CONFIDENTIALYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200oflPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per mterial per building or aea)HAZARDOUS MATERIALS.ED PROGRAM CONSOLIDATED-ilUPCF (l/ee)r69OES Form 2731 If EPCRA, Please Sign HereADDIt'IONAL LOCALLY COLLECTED INFORMATIONMcomponents de prsent at greater thm l% by weight if non-cucinogoic, or 0.lolo by weight if cucinogmic, attrch additioml shcets of paper capturing the required infomtion.If more242243es244245$.,240239r n'lv'\i241234236!v.. EN"235237)230232f}.' EN"231233| rco%226AC227es22874-86-2229%wTHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREBELOWAMBIENTABOVEAMBIENTCRYOGENICa.225STORAGE PRESSUREABOVEAMBIENTBELOWAMBIENTa.224ABOVE GROUND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMFIBERDRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTEBINTANKWAGONALLIC DRUM223sILoSTORAGERAILCAROTHERXone itema. GALLONSb. CUBICc. POIJNDSI a. rorvs 221222DAYS ON SITE:365217DAILYAMOUNT118218DAILY AMOUNT118215WASTE AMOTJNT-YrT220TE WASTE CODEXXall that apply)a. FIREb. REACTIVEI{AZARD CATEGORIESXd. ACUTE HEALTHe.CHRONIC HEALTHRELEASE216Xone item only)c. GASa. SOLIDSTATE! u. r.rqun215LARGESTCONTAINER 118X(Check one itema. PUREc. WASTEb. MDOURE211MATERIALCURIES2'13X212NoYesFLAMMABLE GASCODE I{AZARD CLASSES (Conplete if required by CUPA)21074-86-2If EHS is "Yes", all amounts below must be in lbs.ACETYLENENAME207XNoYes208ACETYLENENAME205X206NoYesto EPCRA, refsr to instructiomII. CHEMICAL INFORMATIONID#1203MAP# (opfional)I204GRID# (optional)E3STORED IN SHOPLOCATIONNO202LOCATIONYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200oflPageHAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTIONOne page per ruterial per building or uea)HAZARDOUS MATERIALS^ED PROGRAM CONSOLIDATED-$UPCF (l/ee)169OES Form2731 If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATION5242244Iv"'243245238239240241234235o236237230231232233100226ARGON2272287440-37-',!229%wrHAZARDOUS COMPONENT (For mixture or waste only)EHSCAS#XSTORAGE TEMPERATUREA. AMBIENTABOVEAMBIENTBELOWAMBIENTCRYOGENIC225A.AMBIENTSTORAGE PRESSUREABOVEAMBIENTBELOWAMBIENT224ABOVE GROUND TANKTJNDERGROUND TANKTANK INSIDE BUILDINGSTEELDRUMPLASTIC/NONMETALLIC DRUMCANCARBOYSILOFIBER DRUMBAGBOXCYLINDERGLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223AINERRAIL CAROTHERI o. roNs 221Xone itema. GALLONSc. POUNDSb. CUBIC FEET222DAYS ON SITE:365217DAILYAMOTJNT222218DAILYAMOUNT222219WASTEAMOUNT222STATE WASTE CODE220XXall ftat apply)a. FIREb. REACTIVEd. ACUTE HEALTHc.PRESSURE RELEASEo.CHRONIC HEALTHI{AZARD CATEGORIES216Xa. SOLIDc. GASb. LIQUID2't4one item only)STATE215LARGESTCONTAINER 222Xa. PUREc. WASTEb. MDNURE211(Check one itemMATERIALX212YesRADIOACTTVENoCURIES213INERT GAS210CODE IIAZARD CLASSES (Complete if required by CUPA)7440-37-1209If EHS is "Yes", all amounts below must be in lbs.ARGONNAME207XNoYesEHS208ARGONNAME205X206IfNoYesTRADE SECRETto EPCRA, refq to irotructionsII. CHEMICAL INFORMATIONID#1203MAP# (optional)1204GRID# (optional)F4STORED IN SHOPI,OCATIONX202NOLOCATION CONFIDENTIAIYESPacific Bell SE164NAME3I. FACILITY INFORMATIONADDDELETEREVISE200ofPage tHAZARDOUS MATERIALS INVENTORY . CHEMICAL DESCRIPTIONOne page per mterial per building or aea)HAZARDOUS MATERIALS-ED PROGRAM CONSOLIDATED-{IuPcF (l/ee)169OES Form273l If EPCRA, Please Sign HereADDITIONAL LOCALLY COLLECTED INFORMATIONinfomtionrcquircdtheofpaper capturingsheetsadditionalattrchifcucinogcnic,weightolby0.to/oweightif non-cucinogoic,%bytheatgreaterilcpres€ntcomponentshzadousIfmore245244243242241240ft"'239V2372362342332322302297782-44-7oes228227OXYGE2261 tooCAS#EHS(For mixture or waste only)%wrABOVEAMBTENT !c. BELOWAMBTENT [0.CRYOGENIC225XSTORAGE TEMPERATUREa,BELOWAMBIENTABOVEAMBIENT224STORAGE PRESSUREa.GLASS BOTTLEPLASTIC BOTTLETOTE BINTANKWAGON223s[oi. FIBER DRUMDRUMRAILCAROTHERBAGBOXCYLINDERABOVE GROUND TANKTJNDERGROT]ND TANKTANK INSIDE BUILDINGSTEELDRUM222DAYS ON SITE:365C. POUNDSI a. rorvs 221Xone itemb. CUBICa. GALLONS220WASTE CODE219WASTE AMOUNT-12+218DAILYAMOUNT124217VERAGE DAILY AMOL'NT'124e.CHRONIC HEALTHd. ACUTE HEALTH216Xa. FIREb. REACTIVEall that apply)CATEGORIES215LARGESTCONTAINER 124Xone item only)C. GASA. SOLIDSTATEI o. uquroCURIES213XNoYes2'12Xc. WASTEA. PURE211! r. rr,rxrunE J(Check one itemMATERIAL210OXIDIZER 3(Conplete ifrequir€d by CUPA)CODE IIAZARD CI-A.SSESis ',Yes", all amomts below must be in lbs_7782-44-7209XYesNo208EHSOXYGEN207NAMEXto206NoYesrefq to instructionsTRADE SECRET205OXYGENNAMEINFORMATIONII. CHEMICAL204(optional)GRID#203MAP# (optional)11ID#XLOCATION CONFIDENTIALNOYES202STORED IN SHOPLOCATIONPacific Bell SE164aNAMEINFORMATIONI. FACILITYofPage200REVISEDELETEADDHAZARDOUS MATERIALSHAZARDOUS MATERIALS INVENTORY - CHEMICAL DEsCRIPTIoN-ED PROGRAM CONSOLIDATEDlIaea)One page per mterial per building orUPCF (l/99)169OES Form 2731 MAP#BUSINESS NAME PACIFIC BILLBUSINESS ADDRESS 1 96 SUBURBSITE MAP1SNLOCAi RSEl 64AN RDSAN LUIS OBISPO-rrl---r-rr'-_'----=--t -+!r rlDATE 10/16/2001ztP c0DE 93403-f----.n-----DRAWING SCALENOT TO SCALTELECTRICAL PANELSHUT-OFFNAIURAL GASSHUT_OFFWAIER SHUT-OFFEMERGENCY PUMPSHUT-OFFTANKMM0NTTORTNGTELEPHONEFIRST AID KITFIRE EXTINGUISHERSTORM DRAINSANITARY SEWERSTAGING AREAEVACUATION/mbE:l HMrvlP, AND TVSDS- LOCATIONT} FIRE HYDRANT-x-x- FENCEGFE) EMERGENCY RESPONSEW EQUIPMENI/ABSORBENTSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKSYMBOL LEGEND234(E)(c)AU@TMA(r)JL.liA-A@567II@culcftIDz@{tmm{)aMf MoroR OILS & LUBR|CANV (COMBUSNBLE LIQUIDS)BATIERY ELECTROLYTE(CORROSIVE LIOUID)GASOLINE(FLAMMABLE LIQUIDS)DIESEL FUEL(COMBUSTIBLE LIOUIDS)NITROGEN(COMPRESSED GAS)PROPANE(FLATvIMABLE LteUtD)ACETYLENE(c0MPRESSED cAS)ANIIFREEZE/COOLANISWASTE OIL(FLAMMABLE LIOUID)FIRE PULL BOXARGONOXYGENTSAr- -l- .-r--r-i---rf----l---r=:._=-8@@@20,1996ScoleJ60Usernome SASDLPACtFtc ffi aru_PREPARED BY:GRoUP INcASTORAGEOFFICEFLAMIT/ABLEWATERTANKJLUADMINISTRATIONBUILDINGIIIIIIIIF9ABcEFGH--JKM(i) eurovnlc rRANSMtsstoN- FLUID APPENDIX A(-tific.tionCALENDAR YEAR BEGINNINGBUsrNEss NAME @)stTE ADDRESS (s)crrY (6)DUN&BRADSTREETOPERATORNAMEOWNER NAMEOWNER MAILING ADDRESScrTY (17)CoNTACT NAME (20)MAILING ADDRESScrTY (23)NAME: (26)TITLE: (27)BUSINESS PHONE24-HOUR PHONE:PAGER #: (30)On-Site RegulatedSubstance?Galifornia E usiness(1)(16)Owner/Operator ldenENDTNG (2)OWNER INFORMATIONENVIRONMENTAL CONTACTBUSINESS PHONE: (S)owNER PHONE (15)Page(3) PAGE 1 OFCoNTACT PHONE (21)(22)EMERGENCY CONTACTSCALIFORNIA ACCIDENTAL RELEASE PREVENTIONPROGAM (GatARp)(36)and(28)(2e)(37)ADDITIONAL LOCALLYCOLLECTED INFORMATIONGertification: I certify under penalty ofinformation submitted in this lnventorylaw that I have personaily examined and am familiar with theand believe the information is true, accurate,and complete.Print Name of Document preparer (3S)Signature of Owner/Operator (g9)OES Form 2730(1 1/94)12t31t9913CASTATE (8)408-554-3557408-554-3557934034811DAN VELEZ1 0-340-1 61 ISAN LUIS OBISPO196 SUBURBAN RDPACIFIC BELL SE1641/1t99oPEMTOR PHONE (13)src coDE (4 DtctT#) (11)ztP (9)94583-0995ztP (19)CASTATE (18)SAN MMON2600 CAMINO RAMON, RM 3EOOOT877-823-9833PACIFIC BELL408-275-7490916-977-7777916-977-7777916-977-7777408-554-355724 HR EMERGENCY SERVICESite/Facility ManagerEMERGENCY CONTROL CENTERNAME: (31)TITLE: (32)BUSINESS PHONE:24-HOUR PHONE:PAGER #: (35)(33)(34)DAN VELEZ94583-0995ztP (19)CASTATE (18)SAN MMON2600 CAMINO MMON, RM 3EOOOT925-823-6161NANCY CLANCYlves E*oEPA l.D. #: CAT080024268RHL OESIGN GROUP, INC. - AGENT FOR PACIFIC BELLDate (40) {'-vAPPEIIDIX CGalifornia Hazardous Materiat lnventory Form/Addendum-Ghemical Description Pagefrmo Eoer-ere finrvrse I*oCHANGEPAGE (2)2oF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMECAS#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE%WT(4)(5)(6)1F4PACIFIC BELL SE'I64(8)(e)(10)(1 3)(14)(171(18)(1s)(20)(21)(26)GR|D# (6)TRADESECRET (11)CaIARP Listed (12)lf "Y" for CaIARP Listingall amounts must be in "pounds""GOMPLETE BLOCK (13) IF REQUESTED BY THE LOCAL FIRE CHIEF . REFER TO INSTRUGTIONS.RADTOACTTVE (15)(16)Ev 8ttCURIES(30) HMARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONALLOGALLYCOLLECTEDINFORMATIONIII.B COMB. LIQUID107-21-1USED ANTIFREEZE!v EruGLYCOLSNY ENBIENTIaeoveAMBIENTIeelowAMBIENTIcnvocerutcSmrarerur lmove AMBTENT [eelow rMBlENrGROUND TANKGROUND TANKWAGONDERCARINSIDE DUILDINGBOTTLEDRUMFIBER DRUMBAGBOTTLE BATTERYCELLDRUMBIN55uNrrs (22)MAX DAILYAMT (23)AVG DAILYAMT (24)*lf EHS, amounts must be in lb.ANNUAL WASTE AMT (25)5r)r F36555343lnne [neacrrve IPRESSURE RELEASEHEALTHRONIG HEALTH[souo fuoutDfloas[eune [ruxrune5.4. 2o/o3. 10o/o2. 1%1.94o/oT[*7758-114!flttDIPOTASSIUM PHOSPHATE7732-1&5! v flruWATER1114&6f*DIETHYLENE GLYCOL107-21-1f r.tETHYLENE GLYCOLOES Form 2730(11194) (""' { - ENkAPPEIIDIX CGalifornia Hazardous Materiat lnventory Form/Addendum-Ghemical Description Paget--laoo l-loel.ere [l:_J L-.jREVISEXNO GHANGEPAGE (2)oF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHAZARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE(2e) %wT5.4.3. <12%2. 30%1.590/o(4)(5)1F4STORED IN SHOPPACIFIC BELL SE164(6)GR|D# (6)TRADE SECRET (11)CaIARP Listed (12)lf "Y" for CaIARP Listingall amounts must be in "pounds"*COMPLETE BLOCK (T3) lF REQUESTED BY THE LOCAL FIRE CHIEF . REFER TO INSTRUGTIONS.RADTOACTTVE (15)(16)Iv truCURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(8)(e)(10)(13)(14)(171(18)(1e)(20)(21)(26)(s3) ADDITIONALLOCALLYGOLLECTEDINFORMATION)III-B COMB. LIQUID64742-56€AUTOMATIC TMNSMISSION FLUID!v ffittPETROLEUM HYDROCARBONEY ENffnrvrerenr [move AMBIENT [eer-owaMBIENT nCRYOGENIC[move AMBIENT [eelow aMHENTGROUND TANKGROUND TANKBOXCYLINDER[lrnnxwaeonI IRAIL CARL_JI lottrer....t_JBATTERY CELLINSIDE DUILDINGLASS BOTTLEDRUMR DRUMBOTTLEDRUMBAGBINffiuNrTs (22)MAX DAILYAMT (23)AVG DAILYAMT (24)*lf EHS, amounts must be in lb.ANNUAL WASTE AMT (25)55-25- {ffi}36555frrne fineacnve [enessunE RELEAsE fircure HEALTH E.tRONIC HEALTHx[-lsolroi---iLIQUIDIcnsIeunexMtxruRE flwasre! v ['r8012-9SlYfruOIL MIST, if generatedPROPRIETARYTflruTRADE SECRET64742-6*0!vINSOLVNT DEWXD DISTLL HV PARAFIN64742-5d9! v [NSOLVNT DEWXD DISTLL LT PARAFINOES Form 2730(11194) ('Galifornia Hazardous Material I(4)(5)(6)APPENDIX C f-nventory Form/Addendum-Ghemical Descgwription Pagelnoo loer.ers fnevrsECHANGEBUSINESS NAMECHEMICAL LOCATIONMAP#PAGE (2)TRADE SECRET (11)CaIARP Listed (12)lf "y" for CatARpall amounts must be inoF (3)13GR|D# (6)CHEMICAL NAMECOMMON NAMECAS#FIRE CODEHAZARD CLASSESTYPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTOMGECONTAINERPRESSURESTORAGESTORAGETEMPEMTURE(2s) %wf5.4.3.2.1.100(8)(e)(10)(13)(14)(17)Listing"pounds"*GoMPLETE BLOGK (13) tF REQUESTEDBYTHE LOCALFIRE CHIEF. REFER TO INSTRUGTIONS.RADTOACTTVE (15)CURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONAL LOGALLY COLLECTED INFORMATION(18)(1e)(20)(21)(26)INERT GAS7440-37-1Iv EruARGON!v [NARGONF41STORED IN SHOPPACIFIC BELL SE164(16)Iv Xr.rAMBIENTAMBIENTIeer-owBIENTI JABOVE[aruarsrurAMBIENTAMBIENT f]eelowxETALLIC DRUMBATTERY CELLRK INSIDE DUILDINGBINtLoBOTTLEBOTTLER DRUMDRUMCARWAGONGROUND TANKGROUND TANK&222il/ *365222[]r-es f]rorusFTMAX DATLYAMT (23)AVG DATLYAMT (24)ANNUAL WASTE AMT (25).lf EHS, amounts must be in lb.UN|TS (22)HEALTHHEALTHURE RELEASEf]cxnouci-lneacrveIrrneIDIr-nuIsor-roREIwnsreIuxrune! v flr.r[rufru[*Y7440-37-1fruYARGONOES Form 2730(11t94) lnoo loelere ffnevlse[ruo cneruaeBUSINESS NAMECHEMICAL LOCATIONMAP#APPENDD( C {-lnventory Form/Addendum-Ghemical Description pPAGE (2)oF (3)cRtD# (6)Galifornia Hazardous(4)(5)(6)tMaterial4age13\-/'CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHMARD CLASSESryPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATUREo/oW(8)(e)(10)(13)TRADESECRET (11)CaIARP Listed (12)lf ,,y', for CalARpall amounts must be inListing"pounds"'COMPLETEBLOCK (13) tF REQUESTED BYCHIEF - REFER TO INSTRUCTIONS.(15)(30) HAZARDOUS COMPONENTS(31) GalARp Listed? (32) CAS#(33) ADDITIONAL LOCALLYCOLLECTED INFORMATION(14)(17)(18)CURIES(1 e)(20)(21)(26)F4j1STORED IN SHOPPACIFIC BELL SE164(16)fv 8r'rAMBIENTAMBIENTIeelow[aaovei :AMBIENTLOWAMBIENTAMBIENT rBExETALLIC DRUMBINDRUMK INSIDE DUILDINGBOTTLEDRUMR GROUND TANKGROUND TANKCARWAGONBOTTLE BATTERYCELLt!S.118bo t#365118FTflronsflLasMAX DATLYAMT (23)AVG DATLYAMT (24)*lf EHS, amounts must be in lb.ANNUAL WASTE AMT (2s)uNrTs (22)HEALTH [cnnorurcRELEASEi-lReecrveHEALTHfr-rouroIsouo[wasreIurxruneFLAMMABLE GAS74-86-2Iv EwACETYLENE! v ffirlACETYLENE5.4.3.21. 100%fltr!vflru! v f ruI r.r74-86-2IwACETYLENEOES Form 2730(11t54) gY-+'APPENDIX CGalifornia Hazardous Material lnventory Form/Addendum-Ghemical DescriptionPage[mo troerere [nevrse EroCHANGEBUSINESS NAMECHEMICAL LOCATIONMAP#PAGE (2)TRADESECRET (11)CaIARP Listed (12)lf "Y" for CdARpall amounts must be inoF (3)13(4)(5)(6)vGR|D# (6)CHEMICAL NAMECOMMON NAMECAS#FIRE CODEHAZARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPEMTURE(29) VoWT5.4.3.2.1. 100(8)(e)(10)(13)(14)(17)(18)Listing"pounds"*coMpLETE BLOCK (13) tF REQUESTED By THELOCAL FIRE CHIEF. REFER TO INSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HMARDOUS COMPONENTS(31) CaIARP Listed? (92) CAS#(33) ADDITIONALLOCALLY COLLECTED INFORMATION(1 e)(20)(21)(26)(-pOXIDIZERA778244-7rv EruOXYGEN!Y ENOXYGENF41STORED IN SHOPPACIFIC BELL SE164(16)rv mruBELOWAMBIENT[aeove AMBTENTIcnvoceucAMBTENT [aer-ow IMBIENT[arr,ralerurxETALLIG DRUMBATTERY CELLR DRUMINSIDE DUILDINGBINDERBOTTLEBOTTLEDRUMCARWAGONGROUND TANKGROUND TANK1#124t-> +a365124[.--ll.as [rorusFTMAX DATLYAMT (23)AVG DATLYAMT (24)ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.uNrTs (22')InneIneecrveHEALTH [crnoucRELEASEHEALTHi-luouroLJIsor-roflnxrune [wasre['[ruY! v ffiru[*778244-7! v f ruOXYGENOES Form 2730(11t94) Bk*APPEI\DD( CGalifornia Hazardous Material Inventory Form/Addendum-Ghemical Description Pagei-laoo loelere ffnevtse I*o cHANGEPAGE (2)oF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMECAS#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE(29) ToWT(4)(5)(6)1lF7WEST SIDE OF LOTPACIFIC BELL SE164GR|D# (6)V(8)(e)(10)(13)(14)(171(18)(1 e)(20)(21)(26)TRADESECRET (11)CaIARP Listed (12)lf "Y" for CaIARP Listingall amounts must be in "pounds"*COMPLETE BLOCK (13) IF REQUESTED BY THE LOCAL FIRE CHIEF . REFER TO INSTRUCTIONS.RADTOACTTVE (15)(16)Ev 8ruCURIES(30) HMARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#5. 5o/o4. 90o/o3. 14o/o2. go/o1. 1Oo/o(33) ADDITIONALLOCALLYCOLLEGTEDINFORMATIONrlI-A FLAMMABLE LIQUID8006-61-9GASOLINE - UNLEADED[v flttPETROLEUM HYDROCARBONEY ENfnrunrenr [moveAMBIENr nBELOWAMBIENTRYOGENICffimrterexr lmove AMBIENT [aelow aMBlENrGROUND TANKf-lrnruxwAGoNl-lnat cnn[otn"r....BATTERY CELLDER GROUND TANKINSIDE DUILDINGILOBOTTLEDRUMBER DRUMPLASTIC BOTTLEMETALLIC DRUMBIN6t{DuNlTs (22)MAX DAILYAMT (23)AVG DAILYAMT (24)*lf EHS, amounts must be in lb.ANNUAL WASTE AMT (25)60163oo o 6EA365loorU 6a(fffinne [nencrrve [enessunE RELEASE facure HEALTHHEALTHIsor-toIarcPUREIwasre71-43-2Tf'BENZENENONE!vINGASOLINE't330-20-7! v f ruXYLENES108-88-3I r.rTOLUENE1634-04-4Yfl*METHYL TERT BUTYL ETHEROES Form 2730(11194) APPENDIX CGalifornia HazardousMaterial lnventory Form/Addendum-Ghemical Descriptionlnoo foel-ere fnevlse firuocnmlaePAGE (2)oF (3)BUSINESS NAMECHEMICAL LOCATIONMAP#GR|D# (6)wPage13(4)(5)(6)CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTOMGESTORAGETEMPEMTURE%oW(8)(e)(10)(13)TRADESECRET (11)CaIARP Listed (12)lf "Y,,for CalARpall amounts must be inListing"pounds""coMpLETE BLOCK (13) tF REQUESTED By THELOCAL FIRE CHIEF. REFER TO INSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONALLOCALLY COLLECTED INFORMATION(14',)(17)(18)(1e)(20)(21)(26)FLAMMABLE GAS74-98-6rv EruPROPANEIY ENPETROLEUM HYDROCARBONVJSTORED IN SHOPPACIFIC BELL SE164(16)rv xruAMBIENTIcnvoceuc[naoveAMBIENT[maelenrAMBTENT i-laelow aMBIENT[nraetelr ffaeovexBINDRUMWAGONtLoBOTTLEFIBER DRUMDRUMINSIDE DUILDINGCARBOTTLE BATTERYCELLGROUND TANKGROUND TANKtn250t>S 8365250fr-es frorusUFTMAX DATLYAMT (23)AVc DATLYAMT (24)ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.UN|TS (22)HEALTH [cnnonrcRELEASEInencrvrHEALTHIcnsj--lsouo|""jxMrxruRE [wnsreIeune5.4.3.2.1[*YI r.t106-97-8['BUTANE74-U-0f'YETHANE74-98-6! v flruPROPANEOES Form 2730(11t94) a'tGalifornia Hazardous Material Ilaoo loeure [nevrse flto cxnruceBUSINESS NAMECHEMICAL LOCATIONMAP#APPENDIX C .nventory Form/Addendum-Ghemical Description paapwPAGE (2)TRADESECRET (11)CaIARP Listed (12)lf ,'Y,'for CalARpall amounts must be inge13(4)(5)(6)oF (3)Listing"pounds"GR|D# (6)CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE(29) VoWf5. 2o/o4. 3%3. 3%2. 1o/o1. 94o/o(8)(e)(10)(13)*coMpLETE BLOCK (13) tF REQUESTED By THELOCAL FIRE CHIEF. REFER TO TNSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HMARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONAL LOCALLY COLLEGTED INFORMATION(14)(17)(18)(1e)(20)(21)(26)III-B COMB. LIQUID107-21-1Iv ENANTIFREEZE/COOLANTTY ENGLYCOLSF4STORED IN SHOPPACIFIC BELL SE164(16)Iv XlrENICAMBIENTi-.-lcnvooBIENTAMlleeLowu[neoveAMBTENT jleelow aMBIENTBrENr IABOVEl--lrarux wAGoNI IRA|L CAR[]other....BATTERY CELLXETALLIC DRUMFIBER DRUMBINBOTTLEBOTTLEDRUMINSIDE DUILDINGGROUND TANKGROUND TANK€E552S- s*36555flas flrousFTMAX DATLYAMT (23)AVG DATLYAMT (24)ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.uNlTs (22)lnne [-lREACTTVE [nnessuneHEALTHHEALTHRELEASElsouo fr_louroIcesIwasreleune7758-1't4['YDIPOTASSIUM PHOSPHATE7732-1&5! v Sr.rWATERPROPRIETARYNADDITIVES111-4&6fruYDIETHYLENE GLYCOL107-21-1fl'ETHYLENE GLYCOLOES Form 2790(11t94') APPEIIDD( CGalifornia Hazardous Material Inventory Form/Addendum-Ghemical DescriptionPager-_-leoo foelere fnevrse [no crnruceawPAGE (2)TRADE SECRET (11)CaIARP Listed (12)lf "Y,,for CalARpall amounts must be inoF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHAZARD CLASSESTYPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTOMGESTORAGETEMPEMTUREo/oWT(4)(5)(6)GRID# (6)(8)(s)(10)(13)Listing"pounds"'GoMPLETE BLOCK (13) tF REQUESTEDBYTHE LOCALFIRE CHIEF. REFER TO INSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONAL LOCALLY GOLLECTED INFORMATION(14)(17)(18)(1 e)(20)(21')(26)t0III-B COMB. LIQUID64742-6U0Iv EtrMOTOR OILIY ENPETROLEUM HYDROCARBONF4STORED IN SHOPPACIFIC BELL SE164(16)fv B1rAMBIENTAMBIENTf]eer-ow[neove[moveAMBIENTAMBIENT [aelowxBATTERY CELLBOXDRUMBINPLASTIG BOTTLEBOTTLEBAGBER DRUMDRUMINSIDE DUILDINGCARWAGONGROUND TANKGROUND TANK1g''1206ct tG365120f]-ss flrorusFTMAX DATLYAMT (23)AVG DATLYAMT (24)ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.UN|TS (22)i-lneecrve[acurrRONIC HEALTHTHHEALRELEASEInnessune!casi-lsorlo fr-rouroRE!wesrefeune frurxru5.4.15%3. 2go/o2. 85%1.85%N6/742-569! v f ruSOLV. DEWAX DIST. LT PARAFFINPROPRIETARYfruADDITIVES6/.742-54-7I r.rYHYDROTREATED DIST. HV PAMFFIN64742-6$10fruYSOLVENT DEWMD DIST HV PARAFFNOES Form 2730(11t94) (' r-'APPENDIX CGalifornia Hazardous Material lnventory Form/Addendum-Ghemical Description Pagevlraoo lorlere f nevrse [-]Ho cxnrucePAGE (2)ItoF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE(29) %WT(4)(5)1F7WEST SIDE OF LOTPACIFIC BELL SE164(6)cRtD# (6)TRADESECRET (11)CaIARP Listed (121lf "Y" for CaIARP Listingall amounts must be in "Pounds"*coMpLETE BLOCK (13) tF REQUESTED BY THE LOCAL FIRE CHTEF - REFER TO INSTRUCTIONS.RADTOACTTVE (15)(16)Iv 8nCURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(8)(e)(10)(13)(14)('t7l(18)(1e)(20)(21)(26)5.4.32. 05%1. 99.5%(33) ADDITIONAL LOCALLYCOLLECTEDINFORMATIONIICOMB. LIQUID68476-34-6DIESEL FUELfl!v [uPETROLEUM HYDROCARBONTY ENenr [aeoveAMBTENT [eelowIMBIENT ]cnvocerutc[aeove AMBIENT [eeuow TMBIENTGROUND TANKGROUND TANKANKWAGONCARINSIDE DUILDINGtLoLASS BOTTLEDRUMDRUMBOTTLE BATTERYCELLMETALLIC DRUMBIN4GFuNrTs (22')MAX DAILYAMT (23)AVG DATLYAMT (24)*lf EHS, amounts must be in lb.ANNUAL WASTE AMT (25)t10000 {,ooo}so a A&A365#r*"Yfrrne lnencrve [enessunE RELEASEHEALTHHEALTHIsot-loIcnsIeune[wnsre[*['NONEYINPETROLEUM DISTILLATES91-20-3Y['NAPHTHALENE68476-34-6YIttDIESEL FUEL NO.2OES Form 2730(11194) wAPPENDIX CGalifornia Hazardous Material lnventory Form/Addendum-Ghem ical DescriptionPage[eoo [oelere ffnevrse lro cHANGEaoF (3)13BUSINESS NAMECHEMICAL LOCATIONMAP#CHEMICAL NAMECOMMON NAMEcAs#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HAZARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPEMTURE%Vtfl(4)(5)(6)PAGE (2)TRADESECRET (11)CaIARP Listed (12)lf "Y" for CatARpall amounts must be inGR|D# (6)(8)(e)(10)(13)Listing"pounds""coMpLETE BLOCK (13) tF REQUESTED ByTHE LOCAL FIRE CHIEF . REFER TO INSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HAZARDOUS COMPONENTS(31) CaIARP Listed? (32) CAS#(33) ADDITIONAL LOCALLY COLLECTED INFORMATION(14)(17)(18)(1e)(20')(2't)(26)III-B COMB. LIQUID8002-0s9trv EruUSED MOTOR OILtrY ENPETROLEUM HYDROCARBONF4110STORED IN YARDPACIFIC BELL SE164(16)Iv 8lrRYOGENICAMBIENTIcAMBIENTlaelow[neoveAMBTENT leelowIMBIENTrerur [aeovei-lrnrurwAGoNI IRAIL cAR[otner....BATTERY CELLDRUMILOBINDERBOTTLEBOTTLEFIBER DRUMDRUMINSIDE DUILDINGUNDER GROUND TANKGROUND TANK110120ss@365tx0[r-as f]ronsFTMAX DATLYAMT (23)AVG DAILYAMT (241ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.uNrTs (22)221InercrrveInnessuneRELEAsE [acure HEALTHHEALTHflenslsor-ro flllouroImxruneleuneE4.3.2.1. 100%flru[*Yf*! v ffiru8002-019Yf r.rMOTOR OIL, USEDOES Form 2730(11t94) I\BW[aoo foer.ere ffinevss [no +rmaeBUSINESS NAMECHEMICAL LOCATIONMAP#APPEIIDIX Cntory Form/Addendum-Chemicat Description paget9California Hazardous Material lnve(4)(s)(6)PAGE (2)TRADESECRET (11)CaIARP Listed (12)lf "Y" for CalARpall amounts must be inoF (3)Listing"pounds"13GR|D# (6)CHEMICAL NAMECOMMON NAMECAS#FIRE CODEHMARD CLASSESTYPEPHYSICAL STATEFED HMARDCATEGORIESSTATE WASTECODEDAYS ON SITELARGESTCONTAINERSTORAGECONTAINERPRESSURESTORAGESTORAGETEMPERATURE(29) YoVtrf5.4.3.21. 1000/o*coMpLETE BLOCK (13) tF REQUESTED ByTHE LOCAL FIRE CHIEF . REFER TO INSTRUCTIONS.RADTOACTTVE (15)CURIES(30) HMARDOUS COMPONENTS(31) CaIARP Listed? (92) CAS#(33) ADDITIONAL LOCALLYGOLLECTEDINFORMATION(8)(e)(1 0)(13)(14)(17)(18)(1e)(20)(21)(26)INERT GAS7727-37-9Tv EruNITROGENTY ENNITROGENG4OUTSIDE BEHIND SHOPPACIFIC BELL SE164(16)Iv Xr.rAMBIENTNTIcnvoceucAMBIENTBIE!aer-owImoveBELOWAMBIENTAMBIENTlaruereHrllrarxwecoruI IRAIL CARrtl__Jottrer....BATTERY CELLDRUMBAGDRUMINSIDE DUILDINGBINPLASTIC BOTTLEBOTTLENDERDRUMGROUND TANKGROUND TANKeerg228t-715- 3ffi3653648[]-as flrorusFTMAX DATLYAMT (23)AVG DATLYAMT (24)ANNUAL WASTE AMT (25)*lf EHS, amounts must be in lb.UN|TS (22)[rrne l-*lneacnveRELEAsE [ecure HEALTHflcxnouc HEALTH[sor-lo lr-loulolmxrune [wnsre! v firvI r.r! v flruflruYfruNITROGENOES Form 2730(11t94) MAP# 1SITE MAPBUSINESS NAME PACIFIC BELL SBUSINESSI196 SUBURBAN RD.SAN LUIS OBISPO--r--_-t--r--.t -l_ t - r-l r t -- rlftTF64DATE128zIP CODE 93403DRAIT]NG SCAI,ENOT TO SCALE12345678Iactrcf,u,za+1rnm-l+t+tEolll_-ro-r ri-ff-rl-r -l-r l---l-r--r-r--- r r20,1995Scole:350Usemome: SASDPAcrFrc ffi eeu-PREPARED BY:crofp'IxcSYMBOL LEGENDEREELEC]RICAL PANELSHUT_OFFNATURAL GASSHUT-OFFWATER SHUT_OFFEMERGENCY PUMPSHUT-OFFTANK MONITORING -'\ALARM II.TELEPHONEFIRST AID KITFIRE EXINGUISHERSTORM DRAINSANITARY SEWERSTAGING AREAEVACUANON/HMMP, AND MSDSLOCATIONFIRE HYDRANTFENCEEMERGENCY RESPONSEEQUIPMENT/ABSORBENTSABOVEGROUNDSTORAGE TANKUNDERGROUNDSTORAGE TANKMOTOR OILS & LUBRICANTS(CoMBUST|BLE LtOUrDs,\BATTERY ELECTRO: }(coRRoslvE LteulD,l /DIESEL FUEL(COMBUSTIBLE LIOUIDS)NI'IROGEN(COMPRESSED GAS)PROPANE(FLAMMABLE LIOUID)ACETYLENE(cOMPRESSED GAS)ANTIFREEZE/COOLANTSWAS'IE OIL(FLAMMABLE LIOUID),T;\ GASOLINE\:/ (FLAMMABLEooo@o@tr@@LrourDS)FIRE PULL BOXARGONOXYGEN@@@@IMA+A-A@tffistLSTORAGEOFFICE@oADMINISTRATIONBUILDING9ABcEFGHJKLM . EMERGENCY RESPONSE PLAS A, ,. (. NAi'E OF FACILITY PACIFIC dELLND PROCEDURES&<l LaSITE ADDRESS6(,t--*Nlet0CONTACT PERSON & PHONE#b-/6 -736I. REPORTING AND NOTIFICATIONThe Building Warden/Site lr{anager for the facility is responsiblefor notifying the occupants of the building and advising them onhow t respond in the event of a hazardous materials incident asrequired in Pacific Bel1rs Emergency Operating Instructions (Sf l-31.5)Additionally the Building Warden/Site Manager will contact theCalifornia OES, Local Administerj-ng Agency and Pacific Bell's Internalcontacts as appropriate, the Emergency Control Center, Local SecurityOffice, Environmental lr{anagement, Safety District and Health Servj-ces.The first employee on the scene is responsible for calling 9LL in theevent of an emergency. Pacj-fic BeIl as a company does not have specificpersonnel to provide emergency services, w€ rely on the city or countyemergency response teams.MITIGATIONBattery Electrolyte: Electrolyte j-s contained in batteries and batteriesare secured in specially designed battery racks which work in con-junction with earthquake bracing.Diesel/Gas/oi1/Antifreeze: Under/above ground tanks are tested frequentlyto maintain the integrity of tank contents.Nitrogen/Acetylene: Compressed gasses are stored in a controlled andseparate area. Nitrogen tanks.have safety caps.Material-.s: Hazardous materials are utilized. and stored followingmanufacturers recommendations as we are a consumer of productsand not a manufacturer of hazardous materials.III. EVACUATIONThe Building Warden/Site Manager for the facility is responsible fornotifying the occupants of the building and advising them on howto respond in the event of a hazardous materials incident as requiredin pacific Bell's Emergency Operating Instructions (Sf 131.5) -Alarm Sounds Paging Announcement if applicableEvacuate Building - Routes are posted for multiple floor buildingsMeet outside building each site report to S.C.C. forinstructions -tvEMERGENCY RESPONSE ASSISTANCEPacific Bell Emergency Operating Procedures (Sf 131.5),that the following agencies be notified in the event ofmaterials incident:a(ilrequiresa hazardousPacific 8e111 Emergency control CenterPacific BelI Security OfficeLocal Hazardous Emergency ResponseState Office of Emergency ServicesPoIice DepartmentFire Departmentst 0)41,59l_ t_9'J,69L1_911823-7 7 7 7542-2464427 -434L ti,MEDICAL ASSISTANCECaII 911vtPolice DepartmentFire DepartmentAmbulance1Methods for safe handling n.."rdoEmployees are provided training through the pacific safety planmodules oh how to handle hazardous maferiels and how to readMSDS as required by the osHA Hazard communication standard.Il:i:irg,i" provided. to "*frov""" t.i;;; rheir work operationsoegrn and annually thereafrer. Addition.riv-[r."y"ii""trainedon the "emergency operating procedures,, (Sf 13L.5)Procedures for Goordinating Activities w*h Response Agencies:Pacific Be11's -Emergrgn_cy operating rnstructions (sr 131.5)requires interfac. ritrt'tttl approfriate emergency agencies aswell as the following internai-grb,rp"i- The Emergency controlcenter, security office, Enviroim";i;i Management, sitetyDistrict and uelttfr services.2.3.Proper use of on'site Emergency Response Equipment by Emproyees:Employees are provided training annually througfr the pacific safetyPlan Modules on how to handle frazardorr" *at"riaIs and how to readMsDs as required by the Federal ltazard communication standardHazardous materials are utilized ;;A-Jtorea following manufacturerrecommendations as we are a consumer or proarr;;;-;;rnot amanufacturer of hazardous materials. nmergency Equipment availability( maintenance as outlj-ned in piciil.-ii"ri'"-ftur.=J;5;" Material ManagementPlan' rtem F - 'rArr ""*u"r- of regist"r"J_tire extinguishers are kept(Halon'carbon oioxiael---w.t.r).;;-$;-iiJ*i""s at ali times.They are praced;:" ; ::il:fl{"#i::*:ff =':;"sg#' -i'i"'i I" i i i tv -i,, *il. o' aanc b *i tr, - t r,. ,.^" Familiarization with the Brl rss Emergency Response prans "na prf .,)r"",Empl0yees are provided rnitial safety plan training on the HazardRecognition/communication-modure u" r"ii as the tuiction specificmodules before r!"v besin t:i;. y;ir."Jijr.rions. rhi; ar_so includestraj-ni-ng on the Em6rg";;t operating procedures.(Provisions for Ensuring lnitial and Refresher Training:-Ejmployees are provided initial- Safety plan training on the HazardousRecognition/communication modul-e "" i,.ii*"" "if,i'^iili.tio' specifi.c modulesbefore they begin their wort< op*tutiorr". This ui; includls trainingon the Emergency operating pro-edures. Addit_ior,"iii trr" pacific safetyPlan requir6s ttrlt.;;;i;;."s receive Annual nerresirer rraining on theHazardous RecognitionTcoirmunication-mtdute, f;;;ti;; lpecific safety -modules and the-Emergency operati;; instructions.-nmptoyees are providedtraining annually trriougt the paciiic safety pi;r, *Laor." on how. tohandle hazardou=-*at"tiiis and how to read !s usDS is required by theHazardous communicaion standard. sp".iri.-"*prtilf"-rr" selected to beBuildins or F loor warden ] :T:rg..";i -gi:ratini.-iirstluctions sr r.31 . s )serve asa reference guide for [rre iuiiaing w;ra;;]-aaaitionally theyreceive on the job tiaining^from ttrg-ntevious ;;;d.; and attend thernterdepartmentil Training-course #6j,i7 uBuilding and Floor wardenl::':i:3",;n[ii!;.otu tiainine-""a' i'ii"i'g o,,-[i. paciric sarety planCERTIFTCATIONSUSAN E.JONES, certify that theabove information will be usedto fulfill my business,i ,obligations under the laws andthat inaccurate informationconstitutes perjury under the law.[1..-^,SAFETY MANAGER)-*'t tn7SignatureTitleDate Hazurdous Materiuls Bashtess Plan - List of chemiculsPermit No: 60-026t #;l:::' lffff,ffi1- RD, sAN LUrs oBrspoMaximum PhYsical LargestChemicalUnitsGrid NoPROPANEffiLiquidGALHYDROCARBON6016LiquidGALETROLEUM HYDROCARBON&11LiquidGALHYDROCARBON130LiquidGALPETROLEUM HYDROCARBON1nLiquidGAL55PETROLEUM HYDROCARBONLiquidGAL2MCU FTGas1596CU FTGas55GLYCOLLiquidGAL77)NCU FTGasCU FT2.GasTuesday, September 28' 1999Page I of I -- BtD i__f-rlazardous MateriatsDisclosure lnformation packet ver 3.oPlease Use Typewriter or print ClearlyPacifi cBeI IsEl 6Bueineee Name]-96 SrrBSANLUTSBTSPOBusiness SiteAddrees (Not a pO BoxlSuite/Btds #CA93403City/ State I ZipP. O.509s.RM lN200 .sann. eA945n3 -O995MailingAddrees Buciness Name lif different trom abovelMail to tha Attontion of2600 Ca.l_no200SanCA4583 -o995Mailing Addresslif different from abovel/ State I ZipPacificBe11Owner'e NameBusiness PhoneA) supply the name' title. phone and available hours of the responsibre person to contact Du4gg-ryusiiness Hours;SH]FT HOURSNAME/TITLE5Lo-823-4401PHONENUMBER (exrensionl415 - 253-q 3?Y -ptre.B) supply the names' titles, phone numbers and available hours or at reast two people to contact en", grrn""" n"rr":SHIFT HOURSNAME/TITLE91,6-977 -777PHONElwith extensionl24 HoEmercrentrolCenterSH]FT HOURSNAME/TITLEPHONElwith extenaionfSHIFT HOURSNAME/TITLEPHONE lwith extensionlc) supply the names' titles. phone numhers and available hours of two people to contact in case of an Emerqencv Haz Mat lncident:SHIFT HOURSNAME/TITLE9L6-977 -7777PHONElwith extensionl24 HoursSHIFT HOURSCityNAME/TITLEPHONE(with extensionl ,S'ectiuni;:i::!iii[::i::$i:i:rG.efi"$raliiiiafifl::ii:iBUiilfflfi:ui:::::1fi{utffiffiiofi:Pacific Bel'l sE1 64Doing Business As (DBA) - lf Different than Business Name10-340-161-8City Businoss Licenso #Dun & Bradstreet (D & B) #CATO8002 4268EPA ID #TelecommunicatinsGive description of tho main operation of your businossEmployee lnfo - enter # of employees on site per shift hrsShift HoursShift HoursShift HoursAdditional Business lnformation:8bNumber of EmployeesNumber of EmployeesNumber of EmployeesBL /82Uniform Building/Occupancy Code (UBC)NOAre you a non-profit organization?Standard lndustrial Codo (SlC)cLot Size - ldentify in sq. ft. or acroageNumber of floorsRoporting Status (see Sec.lV)A No Chemicals are used in any way in our business operations.B Chemicals are used in our company, but we do NOT meet therequirements for disclosure. We have no chemicals requiringdisclosure in any amounts.C Chemicals are used in our business and we are reporting ourChemical lnventory. t.,F * * tI SPECIAL NOTICE FOR DISCLOSURE PACKET UPDATES * X * *lf any of the following occurs, you are required to notify our departmentwithin fifteen(15) days to complete an updated Disclosure Form!1. Change of Business Address2. Change of Busineee OwnershiP3. Change of Bueinese Name4. Ceesation ol Bueinese Operation(e!5. Change of Business Occupancy Claes (UBCI6. Reclsseification of TRADE SECRET INFORMAT]ON7. Change of handling or uee of previously undiscloeed hazardoue material, waat€, or combination thereof.L storage ol any new hazardous material that would require you to comply with the disclosure laws.g. A significant change in handling of inventory quantity (* 10%l of any hazardous material lor which Disclosurelnformation hae already been made.I certify, under the penalty of perjury, that the above information is true and correctto the best of mY knowledge.-.8*d9*3r za r2Z*(,SignatureDateSteve A. Skandeon: Proiect Manaqer, RHL Design Group, IDq,Aoent foPar':i f ic BellName and Title (please type or print)Please roturn form to:SAN LUIS OBISPO FIRE DEPI .748 PISMO STREET SAN LUIS OBISPO, CA 93401 *IG*IGX** FOR OFFICIAL ADMINISTERING AGENCY USE ONLY **13***'I_/_/-Date Pack€t Returned_/_/_Date Packet ReviewedReviewed / lnspected byTotal Hours Spontif business ia a target hazard, describe whyBoundary CodeNFIRS CodoDistrict Codelnspection #Fire Mgnt ZonoBilling CategoryNotes:RMPP Dato CodeRMMP Dato RequiredRMMP Date CompliedFiling StatusChemical RangoBusiness Plan Range BID :Hazardous MaterialsDisclosure lnformation PacketPlease Use Typewriter or Print ClearlyPacilic Bell SE164Business Name196 SUBURBAN RDBusinese Address (Not a PO BoxlBII I KEENAN. SITE MA,NAGERl_l510-A23-4il01During Bus Hrs Contact Name/TitlePhoneI certify, under penalty of perjury, that the proceeding information is true and correctto the best of knowledge-&"2/LvDate2SignatureSteve A. Skanderson: Prnieet lVlanacer- RHL Desion Grorrn. lnc.Aoent for Pacific BellName and Title (please type or print)Pleaso roturn form to:SAN LUIS OBISPO FIRE DEPT.748 PISMO STREET SAN LUIS OBISPO, CA 93401 Enter Lic #County Sanitation District: lndustrial Waste Water Discharge Permit:County Underground Div: Public Works HazMatiWaste Permit:County Health Dept: Hazardous Waste Control License:State Health Dept: Radioactive Material License:Carcinogen Registration Number:Air Quality Management District Permit:Other Government Agency Requiring Chemical License (Agency, Lic#,Type)HazMat Disposal Company:Namo:Addrese:Phono:lT Coroorationtaoot 262-lgooEmergency and Buslness Contacts of this Dleposal Company:Name / TitleBus. Hrs:Alter Hrs:Othsr Agencies Used for Emergency Cleanup besldes this Disposal Company:Phone(_)(_)Name, Lic# & Type:lT n^rn^riridn nOO-t62-1qOOName, Lic# & Type: t-HazMat-Sl Chemical lnventory Cover PageFORBusiness Name:Pacific Bell 5E164Business .Address: leB sttBt|RBAN RD SAN LUIS OBISPO CA 93403Total Number of Pages:bBIDTotal Number of Trade Secret Chemicals Reported:oTotal Number of Non-Trade Secret Chemicals Reported:ilTotal Number of Chemicals Reported,il sF164 HazM5s'"3X,:Y,:^1lJTy:THlJ"i"$fYer3'0Please read attached lnstruction carefullyDate: Mar 5. 1997 BID: Page J-ot -LTrade Name:DTESEL FUEL#)Mixtures {List the three most hazardous lngredients)CAS# Chemical Nameo/o99.5oloO.5o/oEPA3O2 CarcinogenFire26A476-34-fjDIFSFI FIIEL NO. 2NNNNNN91-20-3NAPI{T}IAI FNFNONEPETROLEUMTESMisc. lnfoForm*:_.1QfType*: MDOT#: 1993Hazard ClassGeneral*:09Physical*:__.lO 1Health*: 0L 02Waste lnfoEPA: N/AMinTo:N/AHealth1React0Class*:- Rad: N/A(Circle)ROWCPEUnit ofMeasure: GA Max/Y4r)1 1Max Day: 401-l- Avg/Day:40Ll_Dayson Site: 3 65Map lnfo Codes'Page: l- Container Storage*: B Temperature Storage*: 4Grid: F7 Pressure Storage*:-l Disposal Treatment*:-Largest Container:Location Stored: WEST SfDE OF LOTHow Used/MiscFTTE T.s8164Trade Name:MOTOR OTLState:- Max%: N/AMixtures (List the three most hazardous lngredients):CAS# Chemical Nameo/o85o/o N85o/o NADDITIVESEPA3O2 Carcinogen64742-65-0SOLVENT DEWAXD DIST HV PARAFFNNN64742-54-7HYDROTREATED DIST. HV PARAFFINPROPRIFTARY28o/oMisc. lnfoForm*:_ [Type*; MDOT#: L27ONNHazard ClassGeneral*: 09Physical*:__10 LHealth ": 02 _Waste lnfoEPA: N/A Min%: N/AFirel-State:_Maxo/o: N/AClass *:_Rad: N/AUnit ofMeasure: GA Maxl/r: 13OMax Day:1_3 0Avg/Day: l-3 0Days on Site:365Healtht-React0(Circle)ROWCPEMap lnfo CodesPage: 1 Container Storage*: A Temperature Storage*: 4Grid: F4 Pressure Storage*: l- Disposal Treatment*:-Largest Container:130Location StoredcrFc}pEn TN slropHow Used/MiscT.T]RPTrlANT SE1 64Date: Mar 5. 1997 BIDHazMASl CHEMICAL INVENTORY FORfA.ver3.0( .tt clearly with INK or use typewriter O[Please read attached lnstruction carefullyPagebofLSElB4Trade Name:ANTTFREEZEI COOMixtures (List the three most hazardous Ingredients):CAS# Ghemical Nameo/o94o/o NNADDITIVESEPA3O2 Carcinogen107-21-1ETHYLENE GNN111-46-6NIFTHYI FNF GI YCOLPROPRIFTARY3o/oMisc. lnfoForm*: 01Type*: MDOT#: LL42NNHazard ClassGeneral": O9Physical*: O1Health*: 01 02Waste lnfoEPA: N/AState:_ Max%oClass*:_FireMin%N/AN/ARad: N/AUnit ofMeasure: GA Max/Yr:55Max Day:55Avg/Day: 55Health1l-ReactDayson Site: 3 65Largest Container:550(Circle)ROWCPEMap lnfo Codes'Page: 1 Container Storage*: D Temperature Storage*:1!-Grid: F4 Pressure Storage*:-l Disposal Treatment*:-Location Stored. SiFr)PI]N TN ST{OPHow Used/Misc. r.nnT.aNrFs8164Trade Name:PROPANNMixtures (List the three most hazardous Ingredientsl:CAS# Chemical Nameo/oEPA3O2 CarcinogenFire474-94-6PROPANENNNNNN74-A4-OETHANE106-97-8RIITANFMisc. lnfoForm*: 0l-Type*: MDOT#: l-978Hazard ClassGeneral*:09Physical*:01 03 -Health*: 01- 02Waste lnfoEPA: N/AMin%: N/A: N/ARadHealthReactState:- Max%Class":_2o(Circle)ROWCPEUnit ofMeasure: GA MaxNrz-l?ZoMax Day: 250 Avg/Day: 250Days on Site:365Map lnfo Codes--pige'-- L ----tontainer Storage*: L Temperature Storage*: 6Grid: G4 Pressure Storage*: 2 Disposal Treatment*:-Largest Container: 25OLocation Stored: STORED IN SHOPHow Used/MiscE'TTF'T. SE1 64Date: Mar 5. 1997 BID:HazM2r-Sl CHEMICAL INVENTORY FORlAver3.OI ,rt clearly with INK or use typewriter OlPtease read attached lnstruction carefullyPage b ot bsEt64Trade NameUSED MOTOROILMixtures (List the three most hazardous Ingredients)CAS# Chemical Nameo/olOOo/oEPA3O2 CarcinogenFire1l_aoo2-os-9MOTOR OIL. USDNNNNNNMisc. lnfoForm *: 01Type*: BDOT#: 9189Hazard ClassGeneral*:09Physical*:JLHealth*: 02 -Waste lnfoEPA: N/AState: 2 21Min%: N/AMaxo/o: N/AHealthReact0Unit ofMeasure: GA Maxl/r: l2ODays on?65Largest Container: 1,2OClass*Rad: N/A(Circle)ROWCPEMax12r)Avg/Day: L2OMap lnfo Codes'Page:-1- ContainerStorage*:-.,f, TemperatureStorage*: 4Grid: F5 Pressure Storage": 1 Disposal Treatment*:!-Location Stored:STORED TN YARDHow Used/Misc:USED OTLsBl64Trade Name:AIITOMATTC TRANSM.SSTON F'T.IITI-)Mixtures (List the three most hazardous lngredients):CAS# Chemical NameEPAo/o 3O2 Carcinogen64742-56-9SOLVNT DEWXD DISTLL LT PARAFIN59o/o N3Oo/o NTRADE SECRETNN64742-65-0SOI VNT DEWXD DISTLL HV PARAFINPROPRIETARY112o/oMisc. lnfoForm*:1[Type*:__11_DOT#: N/ANNHazard ClassGeneral*:-..1[Physical": 0LHealth *: 02 -Waste lnfoEPA: N/AState:_ Max%Min%: N/A: N/AFireHealthLLReactoClass *:_ Rad: N/AUnit ofMeasure: GA Max/Yr:JO Max Day: 55 Avg/Day: 55(Circle)ROWCPEMap lnfo CodesPage: l- Container Storage*: D Temperature Storage*: 4Grid: F4 Pressure Storage*: 1 Disposal Treatment*:-Dayson Site: 3 65LargestContainer: 55Location StoredSTORED IN SHOPHow Used/MiscT.TTRRT(1ANT SE1 64Date: Mar 5. 1997 BID:sEl04HazMp+St CHEMICAL INVENTORY FORI!-'.ver3.OI ,rt clearly with INK or use typewriter OtPlease read attached lnstruction carefullyPage { of bTrade NameGASOLTNE- TINT,F:ADET)Mixtures {List the three most hazardous lngredientsl:CAS# Chemical Nameo/o1oo/o N9o/o N14o/o NHealth2EPA3O2 Carcinogen1634-0,4-4MFTHYL TERTITYI FTI.IFRNNN108-88-3TOLUENE1330-20-7XYLENESMisc. lnfoForm*:--.QlType*: MDOT#:1203Hazard ClassGeneral*:_-.1[lPhysical*: 0l-Health*: 01 02Waste lnfoEPA: N/A Min%FireN/A3ReactUnit ofMeasure: GA Max/Yr: 6016Days on Site: 365Largest Container:601_5State:- Maxo/o: N/A0Class*:- Rad: N/.A(Circle)ROWCPEMax Day: 6O16Avg/Day: 601-6Map lnfo Codes'Page: l- Container Storage": B Temperature Storage* : 4Grid: F7 Pressure Storage*:-l Disposal Treatment*:-Location StoredT^ltrST STDEET T,NTFHow Used/Mis8164Trade Name:NITROGENMixtures (List the three most hazardous Ingredients)CAS# Chemical Nameo/oEPA3O2 CarcinogenFireNITROGENNNNNNNMisc. lnfoForm*:]QlType": PDOT#: 1,O66Unit ofMeasure: CF MaxiYrDays on Site: i65Largest Container: 228Hazard Class Waste lnfoGeneral*: 13 EPA: N/A Min%Health ":HealthReactPhysical*: 03 State:-Max%: N/AClass *:_ Rad: N/.A.(Circle)ROWCPE51C"Max Day: l-596 Avg/Day:L596Map lnfo Codes-Page:-L Container Storage*: L Temperature Storage*: 4Grid: G5 Pressure Storage*: 2 Disposal Treatment*:-Location Stored' r.lTIrFqTNT] RIIHTNNHow Used/Misc:D SE1 64Date: Mar 5. 1997 BID:sEl64Hazll/ler*Sl CHEMICAL INVENTORY FORDAver3.O( .nt clearly with INK or use typewriter O[Please read attached lnstruction carefullyPage 6 ot bTrade Name:ACETYLENEMixtures (List the three most hazardous lngredientsl:CAS# Chemical Nameo/olOOo/oEPA3O2 CarcinogenFire374-86-2AEFTYLENENNNNNNMisc. lnfoForm*:-.1Q1Type*: PDOT#: 1OO1Hazard Class Waste lnfoGeneral*: l-3 EPA: N/AReactMin%: N/AHealth2Physical*: 03 State:- Max%: N/AHealth *0Class*:- Rad: N/A(Circle)ROWCPEMax Day: 222 AvglDay: 222Map lnfo Codes'Page: 1 Container Storage": L Temperature Storage*: 4Grid: F4 Pressure Storage*: 2 Disposal Treatment*:-Unit ofMeasure: CF MaxNr: 5ooDays on Site365Largest Contai2)2Location Stored:STORED TNOPHow Used/Misc: WELDINGsE'l64Trade Name:ARGONMixtures (List the three most hazardous lngredients)CAS# Chemical Nameo/oEPA3O2 GarcinogenARGONNNNNNNMisc. lnfoForm*: O2Type*: PDOT#: 1005Hazard Class Waste lnfoGeneral*:-ll EPA: N/APhysical*:_..10 3 State:- MaxYoHealth "FireMin%: N/A: N/AClass*:-Rad: N/A(Circle)ROWCPEMap lnfo CodesPage:-L Container Storage*: L Temperature Storage*: 4Grid: F4 Pressure Storage": 2 Disposal Treatment*:-HealthReactUnit ofMeasure: CF Max/Yr:- 5a Max Dav: 222 AvglDav: 222Days on Site: 365Largest Container:Location Stored: STORED IN SHOPHow Used/MiscWELDTNG sE1 64Date: Mar 5 1997BID:sEta4HazlVlpt-Sl CHEMICAL INVENTORY FORlLver3.O{ nt clearly with INK or use typewriter OlPlease read attached lnstruction carefullyPage 6 of bTrade Name:oxv(]li:NMixtures (List the three most hazardous Ingredients):CAS# Chemical NameOXYGENo/o100EPA3O2 CarcinogenNNNNNNMisc. lnfoForm+:--.QlType*: PDOT#: LO72Hazard Class Waste lnfoGeneral*:-ll EPA: N/APhysical":--.103 State:- Max%:FireHealth *:Class*:_Rad: N/AUnit ofMeasure: CF Maxl/r2-LlWMax Day: 24OOAvg/Day:2400Min%: N/AHealthReactN/A(Circle)ROWCPEMap lnfo CodesPage: l- Container Storage*: L Temperature Storage": 4Grid: G4 Pressure Storage*: 2 Disposal Treatment*:-Days on Site365Largest Container: 222Location Stored: STORED fN SHOPHow Used/Misc:WEt-prr.t6 PAoFrc S aeu-FFEFAED ETIROEfrTRLE &ASgOqA'IEqSITE MAPBUSIMSS NAMEFIC BELL SNLOCA1 R SE164DATE 3/21 /e7196 SUBURBAN RDSAN LUIS OBISPOZrp CgDE 93403-r--- -r---t ---Jt -r----l --r---t ---El-r J -- '--rl -r -l -T-t--Tl T - - ---t - - - - r IrDRAT{ING SCAI"ENOT TO SCALESYMBOL LEGEND2(ttt@@]MA(t+IE\A/e\m34BUSINESSrt20 1996Scdle 360U*momeSASELECTRICAL PANELSHUT_OFFNATURAL GASSHUT-OFFWATER SHUT-OFFEMERGENCY PUMPSHUT_OFFTANK MONITORINGALARM.TELEPHONEFIRST AID KITFIRE EXI]NGUISHERSTORM DRAINSANITARY SEWERacIDcfttrza-{Imm-{STAGINGEVACUAIIAREAoN/lrsp-t l88f'n#D MSDS! rrne HYDRANTJ+ FENCE: EMERGENCY RESPONSELlM reurpurNT/ABS9RBENTS5678ABOVEGROUNDSTORAGE TANK1---y UNDERGRoUNDSTORAGE TANK/;\ MOTOR OILS & LUBRICANTS\"/ (coMBUSIBLE uautDs)/:\ BATIERYELECTROLYTE\r-l lconnosrw uouro)GASOUNE(FLAMMABLE LIQUIOS)DIESEL FUEL(COMBUSNBLE LIQUIDS),T,-:\ NI]ROGENU (covpnesseoGAS)PROPANE@(FLAMMABLE UOU|D)ACETYLENE(COMPRESSED GAS)ANItFREEZE/COOLANTSWASTE OIL(FLAMMABLE LIOUID)fl nne PULL BoxARGONOXYGENMDLSTORAGEADMINIS]RATIONBUILDINGII9ABcEF\,HJK@@ i$"uirrti:on:i,i$r;iiixiiiHHlHBG:Hly;Ev+Fffi NjiE:EE:o,RD$Give the location and brief description of the following, if applicable:1 ) Emergency operation PlanFNTRANEF OF BI.JIf\tG2l ldentification of nearby hazardous facilities and hazmat transportation routosNOT APPLICABLE3) Methods used for determining the occurrence ot a retease: Visual lnsoections as well as remote monitorino of theUnderoroundoe Tank4lMethods/Procgduroswhenrespondingtoa,ul'u"".incident. 2)Move oeoole awav from the area as aoorooriate. 3)Avoid inhalation of all qasses. fumes orsmoke. 4)Contain materials as annronriate bv arranoino ohvsical barriers. use of absorbents, etc.5) Notifv anorooriate emenev ner-qonnel-5) Emergency Notification Procedures: VerballV, Alarms6) Designation of community and facility ooordinatorsAll Parcnnnol aro frainorl fn handle minor emcroeneies7l Evacuation PlanFrranr re+6 f ^ tha indinetad lnnafinn nn f ho affanhed cife nlan All amnlnvees erA nofified8) Methods and schedule for exercising the evacuation planf hore afte r, All Emolovees are trained at the time of hire and annuallv r$e;ctlUini::::llr$Gonfing,Uu:l;ir*EM:8fr $fffi 'vii:::euAl!I;tneGgnuS9) Training Records, including implementation: ENTRANCE OF BUILDING1 0) orlr RecordsFNTRANntr Rt ill DING1 1) p"r"onner necoras: ENTRANCE OF BUILDING12) rvrsos Record Locations: ENTRANCE OF BUILDING13) taontity your on-Site Fire ream: NOT APPLICABLE1 4) taentity your on-Site Clean-Up TeamAll narcnnnal ara,^i^^'.f +a hanrlla omall ralaacac Far larnat innidonfc rlnsite personnel shall contact the local emeroencv response personnel as well as the Pacific BellFmeroencv CI Ccnter15) taentity your Medical Station (staff, training) OR your Medical Services (agency name address and phone)1 6) tOentity the type of Alarm System and special instructio $.edtloi[.rr;Miifiiry,1.Bnii:H66,,,i1n$,$toituiii:fi iico:NtrHgiEilf your business has any of the following: 1) identify which site map page and matrix coordinates theitems are tocated;21in words describe where the items area locatedNOTE: ALL ITEMS ARE LOCATED ON SITE MAP PAGE #11)Absorbents: POWER/ENGINE AREAS2l Firo Hydrants: See Attached Site Plan3) Extinguishers:SEE SPS4tNoNE5)Storm Drains: NoNg6)8) Supply PipiNONE 9) stand Pipes: NOT APPLICABLE.1 0) sprinttors/FDc: NONE1 1) rno* aox: NONE1 2) rm"rg"ncy / Fire Exit:All doorsexterior1 3) Entran""s and exits to the Property and Building:All doorsexterior-14) Entrun""s and oxits to the Parking and Loading ureas: NOT APPLICABLEShut-off Points15) c16) w.te17) power1 8) Electrical Panel Date:1212812016\ .: ,."Environrnental H6blih Services f,|f,V OFffi sArilrilsontspo2156 Sierra Wav Ste. B Fire Department (80$ 78tr7380San Luis Obisoo. CA 93406 2160 Santa Barbara AvenueSan Luis Obisoo CA 934015240GERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIAL INSPECTION FORMTime:PERMISSION TO INSPEGT: lnspections may involve obtaining photographs' revdetermining compliance with adopted codes.GRANTED BY (NAME/TITLE): Name: Brennan Mahoney Title: EHS Manageriewing and copying records, andREINSPECTION REQUIRED:trHazmattrUSTEHW GeneratortrAGTtrCa|ARPtrTPEPROGRAMS INSPECTED:BHazmattrUSTEHWGeneratortrAGTtrCalARPNTPEAcencv lnsoection TyoetrEHS trRoutineEICITYFIRE trReinspectiontrChargeable ReinsPectiontrChange of OwnershiPtrComPlainttrSecondary Containment TestingtrChargeable Secondary Containment TestintFacility Name: AT&T California - SE164Phone: (805)546-7416Site Address: 196 Suburban RdSan Luis Obispo, CA 93401Facility lD: FA0002817Serial Number: DAV0YFIW|YES NO N'AEtrtrtrtrtrtrtrtrBUSINESS PLANBpOl Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)BP02 lnventory of hazardous materials is complete (Hsc 25504, Title 19 CCR 2729)BP03 Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR 2729)TRAINING PLANFacitity has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16)Training documentation is maintained on site for current personnel (Title 19 CGR 2732 &22ccR) 66265.{6EMERGENCY RESPONSE PLANEmergency responselcontingency plan is complete, updated, and maintained on site (HSC25504, Title 19 CCR 273'l & 22 CCR S 66265.53/54)Facitity is operated and maintained to prevenUminimize/mitigate fire, explosion, or release ofhazardous materials/waste constituents to the environment. Maintains all required orappropriate equipment including an alarm and communications system (Title l9 CCR2731&22ccR 66265.31-37, 66267.34 (dX2), 40cFR 1 265.31 )secondary containment is installed and sufficiently impervious to discharges.ICHSC 25270.4.5; 40 CFR 11 2.8(cX2)lGENERAL EH VIOLATIONSEnvironmental Health fees paid' [GBPC 17200' Local Ordinance]trtrtrtrBtrEltrtrtrtrtrTROlTRO2EROlERO2ERO3FEO{trtrtrtrtrtrGPS Goordinates: Latitude: 35.2449830000GPS Goordinates: Lo-120.6684170000INSPECTOR: KERRY BOYLEFACILITY REP: Brennan Mahoney FACILITY NAME: AT&T C{EPA lD CAT080024268NUMBER:.- 1:mi? - SE164 ADDFi 9:HAZARDOUS WASTE GENERATOR196 Suburban RdSan Luis ObisPo, CA 93401Total generated/month:Waste Oi[ -Lbs or gals (average)Solvents:Others:-YEStrtrtrtrtrNOtrtrtrtrtrN4A V|OL. # EPA lD NO/PERMITStr GT01 Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardouswaste (Title 22CCRS66262.12) lf not, Call (800) 618-6942 to obtain your CAL EPA lD numberHAZARDOUS WASTE DETERM INATIONtr GTO3 Hazardous waste determination conducted (Title 22 CCR 566262.11)Eown knowledge tranalYsis trothertr GTO4 Hazardous waste analysis/test records are kept for at least 3 years(Title 22 CGR $66262.40.(c))D ISPOSAUT RANS PO RTATIO Ntr GTOS Hazardous wastes disposed of at an authorized location (HSC 525189.5,Title 22 CCR $66262'12)tr GT06 Facility utilizes a registered hazardous waste transporter, and hazardous wastesfor 3 yearstrtrtrGT07trtrtrcT08(Title 22 CCR 566263.4A 66262.23,66262.40 (a))STORAGE AND TIIIANAGEMENT OF CONTAINERSffANKSHazardous wastes are accumulated on site as follows (Title 22 CGR 566262.34)tr90 days if waste generated per month is greater than or equal to 100 kg. (220 lbs.)tr180 days if waste generated per month is less than 100 kg (see note)tr220 days if waste generated per month as less than 100 kg and transported more than 200miles (see note)Hazardous waste "satellite" collection is managed properly (completelabelingraccumulation time/S5-gal or 1-qt limit) (fitle 22 CCR 566262.34(c))lgnitable or reactive wastes are located t5 m (50 feet) from facility's property line (Title22 CCR 566265.176)Containers of hazardous waste are properly labeled (includes appropriate daIe"'HAZARDOUSwAsTE,* waste composition/physical state, hazardous properties, name/address ofgenerator) (Title 22 CCR 566262.31, 66262.34)Containers/tanks containing hazardous wastes are in good conditiory'handled tominimize the release or reaction (Title 22 CCR 566262-34 (dX2)'Containers/tanks/linets are compatible with waste stored or transferred (Title 22 GGRSs66262.34 (dX2), 66265.1 72)iontainers stoiing hazardous wastes are closed/sealed (Title 22 CCR SS66262.34 (dX2)' 66265.1Weekly inspection of areas where hazardous waste containers are stored is conducted (Title22 CCRSS66262.34 (dl(21, 66265.1 74)Daily inspection of all tank systems is conducted and documented (Title 22 CCR 5566262.34 (dX2)'66265.195)Empty containers or inner liners greater than 5 gal has date when emptied and are managedproperly within one year of date emptied (Title 22 CCR 566261.7 (f))RECYCLABLE WASTEUsed oil is manaSed as hazardous waste until recycled (includes proper labeling, storage, etc)(Title 22 CCRS 66266.13, HSC 525250.4)Used oil filters for recycling are managed properly (drained of free flowing liquid, stored inclosed rainproof container, labeled "drained used oil filters," and transferred for metalreclamation) (Title 22 CCRS 66266.13)Spent lea&acid batteries are being properly stored and transferred offisite under manifest orbill of lading for recycling, reuse, or reclamation (Title 22 CCR 566266.81)Solvents/other recyclable materaals are managed as hazardous wastes until recycled (Title 22ccR s66266.3)SOUnbe REDUCTION:For facilities generating >12,000 kg./yr. of hazardous waste on site'Generator is subject to SB14 and has prepared and retained current source reductiondocuments or is able make them available to the inspector within (5) days. (67100.7' 67100.8' HSCSource Reduction Evaluation and Plan contains the following five elements:certification, amountsof wastes generated, process description, block diagrams, and implementationschedule ofselected source reduction measures. (67100.7. 67100.8. HSC S25244.19)Hazwaste Contingency Plan prepared, current, submitted to the CUPA, maintained onsite' (Title22 CCR 566265.51-.54)trtrDntrtrtrtrtrtrtrtrtrtrtrtrtrtrtrtrBtrtrtrtrtrtr GTO9E GTrotr GT11tr GT12tr GT13tr GTI4tr GT15tr GT16tr GT17tr GTtstr GT19tr GTzOtr cr21trtrtrcr22trtrtrGT23trntrGT24 ( .'.SUMMI"TTY OF OBSERVATIONSMO(,TIONStr No violations of underground storage tank, hazardous materials, or hazardous waste laws/regulations werediscovered. SLO GUpA grealy appreciates your efforts to comply with all the laws and regulations applicable to yotfacility.tr Violations were observed/discovered as listed below. All violations must be corrected by implementing thecorrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,olease inform the GUPA in writinq'ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. GUPA MUSI bE iNfOTMEd iN WTitiNg Wcertification that compliance has been achieved. A false statement that compliance has been achieved is a violatiorof the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation' Your facility maybe reinspected any time during normal business hours.you may request a meeting with the Program Manager to discuss the inspection findings and/or the proposedcorrective actions. The issuance of this Summary of Violations does not preclude the CUPA from takingadministrative, civil, or criminal action.FACILITY NAME: AT&T California - SE164ADDRESS: 196 Suburban RdSan Luis ObisPo, CA 93401VIOLATIONSVIOL. NO CORRECTIVE ACTION REOUIREDINSPECTION COMMENTS:Hazardous waste properly managed , drums labeled properly and securely closed. No violations notedduring facility inspecion.INSPECTED BY: KERRY BOYLEDATE: 12t28t2016NAME OF FACILITY REP: BTENNAN MAhONCYSIGNATURE OF FACILITY REP:STATEMENT OF COMPLIANCEcertification: I certify under penalty of perjury that this facility hascomplied with the corrective actions listed onis inspection form.Signature of ,1.t" 'LEnvironmental Health Services(805) 781-5544P.O.Box 14892156 Sierra WaySan Luis Obispo. CA 93406r'-\styol-slnlulssrsDoFire Depafiment (805) 781-73802160 Santa Barbara AvenueSan Luis Obispo CA 93401-5240Date: 03/03/2015GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIAL INSPECTION FORMTime:pERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing andcopying records, and determining compliance with adopted codes.GRANTED BY (NAME/TITLE): Name: Brennan Mahoney Title: Env. Site Mgr.trTPEtrCalARPDAGTtrUSTtrHW GeneratorREINSPECTION REQUIRED:trTPEtrCalARPtrAGTtrUSTtrHWGeneratorPROGRAMS INSPECTED:lmHazmatFacility Name: AT&T California - SE164Aqency lnspection TypetrEHS ElRoutinetrClTY FIRE trReinspectiontrChargeable ReinsPectiontrChange of OwnershiPtrComplainttrSecondary Containment TestingtrChargeable Secondary Containment TestinSSite Address: 196 SUBURBAN RDSAN LUIS OBISPO, CA 93401Phone: (80q54e7416Facility lD: F40002817Serial Number: DA2ZGMFAYYES NO N/AtrtrtrtrtrtrBtrtrBUSINESS PLANBpOl Business plan is complete, current, available during inspection (HSG 25503.5, Title 19 CCR 2729)BPO2 lnventory of hazardous materials is complete (HSC 25504' Title 19 CCR 2729)BP03 Site layouUfacility maps are accurate (HSC 25504' Title 19 CCR 2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR 2732&22CCR 66265.16)Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 CCR)66265.1 6EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 GCR 2731&22ccR s 66265.53/54)Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release ofhazardous materials/waste constituents to the environment. Maintains all required or appropriateequipment including an alarm and communications system (Title 19 CCR 2731& 22 CCR 66265.31.37,66267.34 (dX2),40CFR 1 265.31)trtrtrtrTROlTRO2trtrEROlERO2B tr tr ERO3 Secondary containment is installed and sufficiently impervious to discharges. ICHSC2527 0.4.5; 40 CFR 1 I 2.8(cX2)lGENERAL EH VIOLATIONStr tr tr FEO1 Environmental Health fees paid. ICBPC 17200, Local Ordinance]GPS Coordinates: Latitude: 35.2449830000 GPS Goordinates: Longtitude= -120.6684170000INSPECTOR: KERRY BOYLEFACILITY REP: Brennan Mahoney '(/SUMIh..RY OF OBSERVATIONSruI(Ou-rTlONStr No violations of underground storage tank, hazardous materials, or hazardous waste laws/regulations werediscovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable toyour facility.tr Violations were observed/discovered as listed below. All violations must be corrected by implementing thecorrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,please inform the CUPA in writing.ALL VTOLAT]ONS MUST BE CORRECTED WITH|N 30 DAYS OR AS SPECIFIED. CUPA must be informed in writingwith a certification that compliance has been achieved. A false statement that compliance has been achieved is aviolation of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Yourfacility may be reinspected any time during normal business hours.You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposedcorrective actions. The issuance of this Summary of Violations does not preclude the CUPA from takingadministrative, civil, or criminal action.FACILITY NAME: AT&T California - SE164ADDRESS: l96SUBURBAN RDSAN LUIS OBISPO, CA 93401VIOLATIONSVIOL. NO CORRECTIVE ACTION REQUIREDINSPECTION COMMENTS:Facility in good order, recently updated version of HMBP has been submitted. No violations notedAnnual facility inspection - program well managed.INSPECTED BY: KERRY BOYLEDATE: 03/03/2015NAME OF FACILITY REP: Brennan MahonevSIGNATURE OF FAGILITY REP:STATEMENT OF COMPLIANCECertification: I certify under penalty of periury that this facility has complied withthe corrective actions listed oninspection form.nature of Owner/Operator:-Date: Environn,-, rtal Health Services(80$ 7815544P.O.Box 14892156 Sierra WaySan Luis Obispo. CA 93406iclwusAri lrirs2160 Santa Barbara AvenueSan Luis Obisoo CA 9340tr5240Date: O211012014GERTTFTED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIAL INSPECTION FORMTime:REINSPECTION REQUIRED:lnHarmattrHW GeneratortrCa|ARPtrAGTI]USTPROGRAMS INSPECTEDEHWGeneratorUCaIARPtrAGTtrUSTFacility Name: PACIFIC BELL dba AT&T (SE-164)Site Address: 196 SUBURBAN RDSAN LUIS OBISPO, CA 93401lnsoection TvoetrRoutinetrReinspectiontrChargeable ReinspectiontrChange of OwnershiptrComplainttrSecondary Containment TestingtrChargeable Secondary Containment TestingtrTPEtrTPEAoencvtrEHStrCITY FIREPhone: (831)372-2142A0002817Serial Number: DA4BWSSEBPERMISSION TO INSPEGT: lnspections may involve obtaining photographs, reviewing andcopying records, and determining compliance with adopted codes.GRANTED BY (NAME/TITLE): Name: David Whitehead Title: Facility Managerl\a^l-{dh^ldlu"lYES NO N/AEtrtrtrtrtrtrtrtrBUSINESS PLANBp01 Business plan is complete, current, available during inspection (HSC 25503.5, Title 19 CCR 2729)BPO2 lnventory of hazardous materials is complete (Hsc 25504, Title 19 ccR 2729)BP03 Site layouUfacility maps are accurate (HSC 25504' Title 19 CCR 2729)TRAINING PLANtr tr tr TROI Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16)tr tr tr TRO2 Tralningdocumentationismaintainedonsiteforcurrentperconnel (Titlet9CCR2732&22CCRI66265.16EMERGENCY RESPONSE PLANtr tr tr ERgl Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22ccR s 66265.53154)tr tr tr ER02 Facility is operated and maintained to prevenuminimize/mitigate fire, explosion, or release ofhazardous materials/rraste constituents to the environment. Maintains all required or appropriateequipment including an alarm and communications system (Title 19 CCR 2731&22 CCR 66265.31'.37'66267.34 (dX2),40CFR t 265.31)tr tr tr ER03 Secondary containment is installed and sufficiently impervious to discharges. ICHSC2527 o.4.5; 40 CFR I 1 2.8(cX2)lGENERAL EH VIOLATIONStr tr tr FEoi Environmental Health fees paid. ICBPC 17200, Local OrdinancelGPS Goordinates: Latitude: 35.2449830000 GPS Coordinates: Longtitude: -120.6684170000INSPEGTOR: KERRY BOYLEFACILITY REP: David Whitehead IFACILITY NAME: PACIFIC( -L dba AT&T (SE-164) ADDR(HAZARDOUS WASTE GENERATOREPA lD CAT080024268 Total generatedlmonth:NUMBER:Waste Oi[ -Antifreeze:196 SUBURBAN RDSAN LUIS OBISPO, CA 93401Lbs or gals (average)Solvents:Others:-YEStrtrtrtrtrN/AtrNOtrVIOL. # EPA ID NO'PERMITSGTOI Generator has an EPA lD number to treat, store, dispose, transport or transfer hazardouswaste (Tifle 22CCRS66262.12) lf not, Call (800) 618-6942 to obtain your GAL EPA lD numbertrtrntrtr GT03E GT04EI GTOstr GT06HAZARDOUS WASTE DETERMINATIONHazardous waste determination conducted (Title 22 CCR $66262.11)trown knowledge tranalYsis trotherHazardous waste analysis/test records are kept for at least 3 years(Title 22 GCR $66262.40.(c))DISPOSAL/TRANSPORTATIONHazardous wastes disposed of at an authorized location (HSC $25189.5 , Title 22 CCR $66262'12)Facility utilizes a registered hazardous waste transporter, and hazardous wastes shipped witha manifest (Title 22 GCR 566262.20, HSC 525160/25163(a))trmilkrun trotherml jiiilJt"mretearretacCR S66263.4a 66262.23, 66262.40 (a))STORAGE AND TTIANAGEMENT OF CONTAINERS/TANKSHazardous wastes are accumulated on site as follows (Title 22 CCR 566262.34)tr90 days if waste generated per month is greater than or equal to 100 kg (220 lbs.)tr180 days if waste generated per month is less than 100 kg (see note)tr270 days if waste generated per month is less than 100 kg and transported more than 200 miles (seenote)Note: Applies only if hazardous waste accumulated on site never exceeds 6000k9(13'200 lbs) and noHazardous waste "satellite' collection is managed properly (complete labelinglaccumulationtime/S5-gal or {-qt limit) (Title 22 CCR $66262.34(c))lgnitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCRs66265.176)Containerc of hazardous waste are properly labeled (includes appropriate daIe;'HAZARDOUSWASTE,', waste compositiory'physical state, hazardous properties, name/address of generator) (Iitle22 CCR 566262.31, 66262.34)Containers/tanks containing hazardous wastes are in good conditionlhandled to minimize therelease or reaction (Title 22 CCR 566262.34 (dX2)' 66265.171-.191'66265'177(c))Gontainers/tanks/liners are compatible with waste stored or transferred (Title 22 CCRSs66262.34 (dX2), 66265.1 72)Containersstoring hazardous wastes are closed/sealed (Title 22 CCR 5566262.34 (dX2)' 66265.173)Weekly inspection of areas where hazardous waste containers are stored is conducted (Title 22 CCR$s66262.34 (dX2), 66265.r 74)Daity inspection of all tank systems is conducted and documented (Title 22 CCR S$66262.34 (dX2)'66265.195)Empty containe6 or inner liners greater than 5 gal has date when emptied and are managed properlywithin one year of date emptied (Title 22 CCR 566261.7 (0)RECYCLABLE WASTEUsed oil is rnanaged as hazardous waste until recycled (includes proper labeling, storage, etc) (Title22 CCRS 66266.13, HSC S25250.4)Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closedrainproof container, I;belea "drained used oil filtets," and transferred for metal reclamation) (fitle 22ccRs 66266.13)Spent leadacid bafteries are being properly stored and transferred offsite under manifest or bill oflading for recycling, reuse, or reclamation (Title 22 CCR 566266.81)Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCRs66266.3)SOURCE REDUCTION:For facilities generating >12,000 kg./yr. of hazardous waste onGenerator is subject to SB14 and has prepared and retained current source reduction documents or isabte make them ivailable to the inspector within (5) days. (67100.7, 67100'8, HSC 525244.19 , 25244'211Source Reduction Evaluation and Plan contains the following five elements:certification, amounts ofwastes generated, process description, block diagrams, and amplementationschedule of selected sourcereduction measures. (67100.7, 67100.8, HSC $25244'19)trtrtrGT07trtrtrcro8trtrtrtrtrtrtrtrtrtrtrtrtrtrtrtrEtrtrBtrtrtr GTOgtr GT10tr GTI1tr Gt12N GT13tr GT14tr GT{str GT16tr GT17tr GT18tr GTIgtrtrtrGT20trtrtrGT21trtrtrGT22trEtrGT23 SUMMJ Y OF OBSERVATIONSMOT I]ONSNo violations of underground storage tank, hazardous materials, or hazardous waste laws/regulations werediscovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable toyour facility.tr Violations were observed/discovered as listed below. All violations must be corrected by implementing thecorrective action listed by each violation. lf you disagree with any of the violations or corrective actions required,please inform the CUPA in writing.ALL VTOLATTONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writingwith a certification that compliance has been achieved. A false statement that compliance has been achieved is aviolation of the law and punishable by a fine of not less than $2,000 or morle than $25,000 for each violation. Yourfacility may be reinspected any time during normal business houns.you may request a meeting with the Program Manager to discuss the inspection findings andlor the proposedcorrective actions. The issuance of this Summary of Violations does not preclude the GUPA from takingadministrative, civil, or criminal action'FACILITY NAME: PACIFIC BELL dba AT&T (SE-164)ADDRESS: 196 SUBURBAN RDSAN LUIS OBISPO, CA 93401VIOLATIONSVIOL. NO CORRECTIVE ACTION REOUIREDINSPECTION COMMENTS:INSPECTED BY: KERRY BOYLEDATE: O2J'\U2O14NAME OF FACILITY REP: David WhiteheadSIGNATURE OF FACILITY REP:f\a^F{- L,Jl^^fttf,n"tSTATEMENT OF COMPLIANCEI certify under penalty of periury that this facility has complied with thecorrective actions listed onDate:is inspection form.of t\(-Gounty of San Luis ObisPoEnvironmental Health Services(805) 781-5544P.O. Box 14892156 Sierra WaySan Luis Obispo, CA 93406!$Hfr-"silryo!i!::,:i::\!l::l\r$ds,iFire Department (805) 781-738021 60 Santa Barbara AvenueSan Luis Obispo CA 93401-5240CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPEGTION FORMEFW dataentry by:tDate:Time:NO COS N/Annntr!nnlnYES/HtrIEtptp,Fntr!nnnBPOlBPO2BPO3TROlTRO2EROlERO2ATOlATO2BUSINESS PLAIIBusiness 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/facitity maps are accurate (HSC 25504, Title 19 CCR2729)TRAININGPLANFacility has appropriate training program (Title 19 ccR2732 & 22 CCR 66265.16)Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR6626s.16)EMERGENCY RESPONSE PLAIIContingency plan is complete, updated, and maintained on site (IISC 25504' Title 19 CCR273L & 22ccR $ 6626s.53/s4)Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release ofhazardous materialsiwaste constituents to the environment, Maintains all required or appropriateequipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43)ABOVEGROUND PETROLEUM STORAGE TANK ACTSpCC 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)nn ntrn nffipections may involve obtaining photographs, reviewingand copying records, andN TO INSPEGT: Iiance withcodes. GRANTED BYREINSPECTION REQUIREDn Business Planfno IYESn usr! Hw Generatorncnnnpn norPROGRAMS INSPECTEDGeneratorpCBusiness etan!cnmnen ecr! usrsADDJ/,- I t.r,* {,t*,FACILITYAGENCYfl EHSN AG DEPTTPCITY FIREFE?r::Ww,filResult Code: -70 -80 -90Action Code: 32 37 33 31NRoutineGomplaintGomaterials.htm,forms towithITRQI andCOMMENTSINSPECTOR:nunmtnFACILITY REP:{ft..r*-' " r,fl; 4i ltGPS Coordinates: Latitude: -degnun tlFACILITY NAMHAZARDOUS WASTE GENERATOREPA IDNI]MBER:Tiered Permit:Treatment Equipment:,frE't/F,-1L.'Lbs or gals(average)Total generated/month:Waste oil:Antifreeze:Solvents:Others:N/AE-trtrcosE-TnnNOEnnYES..F-@''nnvIoL. #GTOlGT03GTO4GTO5GTO6GTOTGTOSGTO9GTlOGTIIGTl2GTI3GTI4GTl5GTl6GTITGTTSGT19GT2OGT2IGT22GT23EPA ID NO/PERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous,waste(Title 22CCR 966262.12) If Not, Call (800) 61S-6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATION JIlazardous waste determination'conducted (Title 22 CCR S66262.11)Eown knowledge lanalysis EotherHazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR $66262.40.(cDDISPOSALITRANSPORTATIONnn rnn rHazardous wastes were transported and/or disposed, !":9:ili!-*itl T EP+ ID NO. and permitor alrthorization from DTSC (HSC 525189.5, Titl1,t2 CAB $66262f 2) . 4piirirr<run p6trrer ,I,ti{lJ1W/i".lltv'!Hazardous wastes are rrtfrf,uoiffi"oi6.f6itt. 22Manifests and/or receipts are properly completed/retained by genelator for 3 years (Title 22 CCRs66263.421 66262.231pnrE'""F'd"flffi-,F..ltQ::-dEl,E^,u; !tinnSTORAGE AND MANAGEMENT OF CONTAINERS/TATIKSIl?zardous wastes are accumulated on site as follows (Title22 CCR $66252.34)yrfi!0 days if waste generated per month is greater than or equal to 100 kg (220 lbs.)" fl ttO deys if waste generated per month is less than 100 kg (see note)DZIO days if waste generated per month is less than 100 kg and transported more than 200 miles(see note)Note: Applies only ifhazardous waste accumulated on site neverexceeds 6000 kg(13,200lbs.)and no acutely/extremely hazardous waste over I kg Q.2lbs.) is held on site for over 90days.Ilazardous waste "satellite" collection is managed properly (complete labeling/accumulationtime/S5-gal or l-qt limit) (Title 22 CCR $66262.34(c))Ignitable or reactive wastes are located l5 m (50 feet) from facility's property line (Title 22 CCR$6626s.176)Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUSWASTE,' waste composition/physical state, hazardous properties, name/address of generator)(Title 22 CCR $66262.31,66262.34)Containers/tanks containing hazardous wastes are in good condition/handled to minimize releaseor reaction (Title 22 CCR $66265.1711.191,66265.177(c)lContainers/tanksAiners are compatible wilh waste stored ortransferred (Iitle 22 CCR$66265.172)Containers storing hazardous wasles ere closed/sealed (Title 22 CCR 566265.173)Weekly inspection of areas where hazardous waste containers are stored is conducted(Title 22 CCR$66265.1 74)Daily inspection of all tank systems is conducted and documented (Title 22 CCR $66265.195)Empty containers or inner liners grealer lhan 5 gal hes date when emptied and are managedproperly within one year of date emptied (Title 22 CCR $66261.7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling, storagg etc) GISC$2s2s0.4)Used oil tilters for recycling are managed properly (drained offree flowing liquid, stored in closedrainproof container, labeled *drained used oil filters," and transferred for metal reclamation)(Title 22 CCR$ 66266.130)Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill oflading for recycling, reuse, or reelamation (Title 22 CCR S66266.81)Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCRs66266.3)SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of haz ardous waste on site.Generator is subject to SBl4 and has prepared and retained current source reduction documentsor is able make them available to the inspector within (5) days. (HSC $25244.19,25244.21)Source Reduction Evaluation and Plan contains the following live elements:certification, empunts of wastes generated, process description, block diagrams, andimplementation schedule of selected source reduction measures. (HSC $25244.f9)trnntroAV .,/F.ti "*,oitdTnnnInnnnnn.ItrnntrdtrE"n!un#'rIt. ',\l1l! lliiil lli'' iCounty of San Luis ObisPoEnvironmental F{ealth Services{805} 78f-5544P.O. Box 14892l$6 Sierr* lVaYSan Luis Obispo, CA 93406//'Clff-rrfsAt^llglsffipffiFire Department tS05) 781173802{60 Santa Barbara Avenue$an Luic Obispc CAS3401-5240CERTIFIEB UNTF'IEI} PR.OGRAM AGENCY (CUFA)HAZARDOUS MATER.IAI.S IN$PECTION FORMEFW dataentry by:Ilate:Tirne:YES NO cOs'fl f, f",n n n-p n nnnnnililTlnnfI-dpr"dWNIAunuBPOlBPS2BPO3BUSINESS FLANBusiness pl*n i* complcte, current, &-available during inspection fiISC 255$3.5, Title 19 C{&?1291Inventory of hazardous materials ir complete (HSC X5504, Title 19 CCX"2729)Site layoui/facility maps nrc sccurate {HSC ?5504' Title 19 CCR 3?29iTRAININGFLANFacility has appropriate training program {Title f 9 CCR ?732 & 22 CCR 66265.16}Training documentation is mnintained an site for current personnel {Title 19 CCR 273? & 22 CCR66265.16)EMERGENCY R.ESFONSE PI,ANContingency plan is *omplete, updatedo and maintained on site (IISC 25504' Tifle t9 CCR 2731 & 12ccR $ 6626s.531s4)Faciliiy is operated and maintained to preventlminimizelmitigate lire, explosion, or release ofhazardous rnaterials/waste con$tituents to the environment. Maintaine all required or approprinteequipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCII 662653f -.43'ABOtr'EGROUND PETROLEUM STORAGE TANK ACT$pCC Plan is redewed and certified by a registered engineer within last 5 yrs. {4ll CFR f f 2.5(b}}SPCC Ft*n is maintained on sifc or nearect lield oflice. GISC 25270)to obtain forms to**ith BPfll-8P03and EROIilfnnTROlTR02nROtERI}2ATOlATO2Go to http:,r/mvn': lnspections may involve obtaining phctographs'reviewing and eopying rgcords, andwithcodes.BYdfio nYEsREINSPECTION REQUIREDff Fusiness Planil usrwg.*M;rflceuqnpil *srPROGRAMS INSFECTED:ld Business Planfl neril usr4rGeneratorilcnunpITDDv rf \ ,tttc { thFACILITY NAME:Res$lt Code,: _70 _80Action CodF: *32 *37310ther33907CITY FIRERoutineComplaintEHSAG DEPTINSPECTORIrmnrlerimalmrnS'ACIIITY REP:llunGPS Coordinates: Lrtitude: deg !FACILITY NAMEEPA IDNT]MEER:Tiered Permlt:Treatment Equipment:HAZARDOUS WASTE GENERATORLbs or gels(average)Antifreeze: -"' Others:--T_costr'tr!nn.p., J ni,,l$', b##N/AETnuntrndnntrnnntrnnnntr,cntrnDtrnntr!ntr!nnnNOEinnntrntrntrnntrn!nutrnYESFfrlfr,fr-rtnF"trnfrwM,c"ffi.VF/,.fl,,,FIEF,ta"'F,trDvIoI,. #GTOlEPA ID NO/PERMITSGenerator hes rn EPA ID number to trerl rtore, dispose, mnsPort or transfer hazardous w$te(Ttrle 22CCT, 966,262,12) If Not Call (S00) 6r&6942 to obtain your cAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determinetion"'conducted (Title 22 CCR S66262.f 1)Elown knowledge flanetyris EotherIlazardous watte anolysls/test records are kept for at least 3 years (TlOe 22 CCR $66262.{0.(c))DISPOSAI,/TRANSPORTATIONHazordous waster were tnnsported rnd/or disposed to o facility with en EPA ID NO' rnd permitor suthorlzrtlon from DTSC (HSC 525189.5, Tltle 22 CCR $66262.12)E]mUcun EotherHezrrdous wrstes are shipped with manlfost (TlOe 22 CCR 96626220,Mrnlfests rnd/or receipts are properly completed/retalned by generetor for 3 yean (TiOe 22 CCR9ffi263,421 66262.231STORAGE AND MANAGEMENT OF CONTAINERS/TAI{KSIfrzordous wastes are accumulated on slte as follows (Tltle 22 CCR $6626234)E] m-Oeys tf waste generated per month is greeter than or equrl to t00 kg (220 lbs.))A{aindayr if waste generated per month lc lers thsr 100 kg (see note)E 220 doys lf waste generrtod per month ls lcrs then llXl kg end trensported more than 200 mllcs(see note)Note: Applies only if hazardous wrste accumulrted on slte never exceeds 6000 kg(13'200lbs.)and no acutely/extremely hazrrdous waste over I kg(@.2lbs.) ls held on slte for over 90HlrOou, wrste trsatellite' collection ls maneged propurty (complete labeling/accumulatlondme/S5-gal or lqt ltnrlt) (Tttle 22 CCR $66262.34(c))Ignltoble or reoctlve wastes rre tocated 15 m (50 feet) from facillty's property line (title 22 CCR$66265.r76)iontainerr of hezardous waste me properly labeled (includes rpproprirte datet *HAZARDOUSWASTET" waste comporition/physicnl state, hazardous propertles, name/oddresc of generator)(fitle 22 CCR $66262.31,66262341Containers/tanks contrlning hazsrdous wostes rre ln good condttion/handled to minimfue relcrseor rerction (Tltle 22 CCR S66265.17tl.191,66265.177(cDContalners/tankr/liners are compalible wilh wsste ctored or trensferred (Tltle 22 CCR$66265.172)contalnerr storing hrzardous lyrstes ore closed/sealed (Tltle 22 CCR S66255.173)Weekly lnspectlon of areas where hazardous waste conteinerc lre storcd is conducted(Tltle 22 CCRS66265.l74)Dotly inspection ofall tank syslems is conducted end documented (IiOe 22 CCR $66265.195)Empty contriners or inner liners grcaler lhan 5 gal hss date when emptled end are managedproperly withln one year of dale emplied (Tltte 22 CCR S6626t.7 (f))RECYCLABLEWASTEUsed oil ls managcd rs hazardous wasle unttl recycled (includet proper lebellng stOrage' etc) (HSC$2s250.4)Used oll tllters for recycling ere managed properly (dnined of free llowing liquiA stored tn clocedroinproofconteiner, lebeled'drdned used oll lllters,'rnd trangferred for metal reclamation)(Tltle 22 CcR$ 66266.80)Spent lerd-ectd betterios ere being properly stored and trsnsferred ofrslte under manifmt or bill ofleding for recycling reuse, or reclamrtlon (Tltle 22 CCR $66266.81)Solventc/other recyclable materials rre managed as hazrrdous wesles undl recycled (IiOe 22 CCR$66266.3)SOURCE REDUCTION: For feclllties generatlng >12,1X)0 tg./yn of hezerdous wrsto on slte.Gcnerator fu rubJcct to SBt4 rnd has prepered and retdned current gource reductlou documentsor is rble mrke them rvdlable to the lnspcctor wlthin (5) dayc. (HSC $25244.19,25244.211Source Beductlon Evrluctlon and Plsn contains the followlng five elementc:cerdficrdon, rmpun$ of wrct6 generated, Procelss dercrtPtlon' block diagrarnc' rndlmphmentadon cchedulc of cetected source reducdon melsuret' filSC $252'H.f9)GTO3GTO4GTO5GTO6GTOTGTOEGTO9GTTOcTllGT12GTl3GT14GTl5GT16GTTTGTISGTT9GT2OGT2IGT22GT23 ,{-'\Gty-o[san tusEnvironmental lle.alth Services(EOs) 781-s544P,O. Box ItO92156 Sicrrr WeySen Luis Otispo' CA 9:14116ffiispoFIll Dcprttmcnt (805) 781'73802160 Santa Berbera AvrnucSen Luls Oblrpo CA 93.O162t10CERTIFIED T]NIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATEBIALS INSPECTION FORMt';Time:YESenIflIEM{'fi'F'NO N/AunnnnnuDtrnBmlBPllzBFO3TROIITO2EROIERO2A?01A1tr2BUSINF,SSPII\NBnsiness plen ls conplcte, current, & avellable during tnseccllon (HSC 2551t35' fitle 19 CCR2729,Inventory of hazardous metcrlals is cnmphtc (ESC 255M) Title f9 CCR 2729)Slte layout/fecillty maps rrc rccurete (HSC 25504, Titlc 19 CC:R 2729)TRAINING PLANFedlty has spproprlate trehlng prograrn (fiOp 19 CCR Zt32 & 22 CCR 66265.f6)Tnining documentrdon is meintrlned on rite for crureni personncl (fiile f9 CCR 2732 & 22rCCRffi255.t51EMERGEITCY RESFONSE PLANCorrdngcncy plm ls cornplcte, updeted, eld mdntalncd on sltc (HSC 2550f' Tltle 19 CCRnSl & X2ccR ! 662555:t/54)Frdlity isopcreted rnd nrhtrincd to prevulrhrinimiahnldgrte firqcxptodon, orrcleese ofhrrdrdorc mrterirls/wastc onsltfrrcnts to the cnvlronment Melntelnr dl requlrcd or apprupriatccquipment including an rtrrm 1d com:numcrttons rys3em (Tltte 19 CCR ZBf & t2 CCn' ffi26531- .41)ABOVEGROI'ND PETROLET'M STORAGE TANK ACTSPCC Phn ig reviewed rnd certified by a r€gist€r€d c'rgineer within last 5 yrs (4lt CFR f f2'5{b))SFCC Plrn ir mslntdncd on dte or neanect fieH otEcc. (IISC 252?0)ntrtrntr n.rDt]D'REINSPECTION REOUIRED:,F"NO trYESEf, ecrE usrE xwccrpretorE Eurlnrar PlanElcrr-enpPhnGcngnlorPROGRAMS INSPEGTED:EmlanpEllcrE usrPHONE:tt\)'"r"riFACTUTY NAME:p'crrv nneAT)ITK"/lACENCYEI exsNSPECNON TYPEffi""trtrtrOtherRelnspectlonEFW dataentry by:Gotom obrain forms to comply with BP0I-8P03, TROI and ER0lIINSPECIIOR:1 \Temp\c. lotus.notes.data\1 -lnspeclion Form Page 1 .doc 2/t-.Jan'O6nutGPti Cmrdlnrlcs: Latltudp: degminT'ACILITYREP: FACILITY NAMEEPA IDNT]MBER:Tiered Permit:Treatment Equipment:ADDRESSWASTE GENERATORLbs or gals(average)N/A[--nnntrNOEinnnnnYESF'\FlEl,tr{fl ";f,lr'p'8,ntrntrnnnntrnntrp'nTnntrtrtrnutrnnnnnntrIInnntrntrItrtrrFn\./Ettr.E'..Ell ./,n'E'vED1"vF'FcosE-nutrvIoL. #GTOlGTO3GTO4GTO5GT06GTOTGTOsGTO9GTIOGTIIGTI2GTI3GTT4GTl5GTT6GTl7GTTSGT19GT2OGT2IGT22GT23EPAIDNOIPERMITSGenerator has an EPA ID number to trett, store, disposen transport or transfer hazardous waste(Title 22CCR 866262.12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determinationconducted (Title 22 CCR $66262.11)Eown knowledge flanalysis EotherHazardous waste analysis/test records ere kept for at least 3 years (Title 22 CCR $66262.a0.(c)DISPOSAI,/TRANSPORTATIONHazerdous wastes were transported and/or disposed to a facility with an EPA ID NO. and permitor authorization from DTSC (HSC $25189.5, Title22 CCR $66262.f2)Ernin "un flotherHazardous wastes are shipped with manifest (Title22 CCR $66252.20)Manifests end/or receipts are properly completed/retained by generator for 3 years (fitle 22 CCR966263.42t 66262.23)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSIle?ardous wrstes are accumuleted on site as follows (Tttle 22 CCR S6626234)adrldays if waste generated per month is greater than or equel to 100 kg (220 lbs.)E ffO days ifwaste generated per month is less than 100 kg (see note)E 220 days if waste genented per month is less than 100 kg end transported more than 200 miles(see note)Note: Applies only if hazardous wrste accumulated on site never exceeds 6000 kg(13,200lbs.)and no acutely/extremely hazardous waste over I ltgQ.2lbs.) is held on site for over 90Ht"rdou, wrste *satellite" collection is managed prop..ly (complete labeting/accumulationtime/55-gal or l-qt limit) (Title 22 CCR $662623a(c)Ignitable or reactive wastes are located l5 m (50 feet) from facility's property line (Tifle 22 CCR$6626s.r76)Containers of hazardous waste are properly labeled (includes appropriete date,'IIAZARDOUSWASTET' waste composition/physical state, hazerdous properties, nome/address of generetor)(Title 22 CCR $66262.31,66262.341Contriners/tanks containing hazardous wastes are in good condltion/handled to minimize releaseor reaction (Title 22 CCR $66265.1711.191,66265.177(cl\Containers/tanks/liners are compatible with waste stored or transfered (Tifle 22 CCR$66265.f 72)Conteiners storlng hazardous wasles are closed/sealed (Iitle 22 CCR $66265.173)\ileekly inspection of areas where hazardous wcste containers are stored is conducted(Title 22 CCR$66265.174)Daily inspection of all tank syslems is conducted and documented (Title 22 CCR $66265.f 95)Empty containers or inner liners grealer than 5 gal has date when emptied and are managedproperly within one year of date emplicd (Title 22 CCR $56261.7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes properlabeling, storagg etc) (HSC$2s2s0.4)Used oil lilters for recycling are managed properly (drained offree flowing liquid stored in closedrainproof container, labeled *drained used oil filters," and transferred for metal reclamation)(Title 22 CCRS 66266.130)Spent leed-acid batteries are being properly stored and transferred offsite under manifest or bill ofleding for recycling, reuse, or reclamation (Title 22 CCR $66266.81)Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR$66266.3)SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of hazardous waste on site.Generaton is subject to SBl4 and has prepared and retained current source reduction documentsor is able make them available to the inspector within (5) days. (HSC $25244.19, 25244.211Source Reduction Evaluation and Plan contains the following five elements:certificetion, ampunts of wastes generated, process description, block diagrams, andimpbmentation schedule of selected source reduction measures. (HSC $25244.19)tr County of San Luis ObisPostysanoIlurs oBtspoW,,:#th'-,ffiEnvironmental Health Services(805) 781-5544P.O. Box 14892156 Sierra WaySan Luis Obispo, CA 93406Fire Department (805) 78'l-73802160 Santa Barbara AvenueSan Luis Obispo CA 93401-5240CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMEFW dataentry by:Date:Time:RMISSION TO INSPECT: lnspections may involve obtaining photographs, reviewing and copying records, andiance withcomrntnNAME/TITLEcodes. GRANTED BYREINSPECTION REQUIRED:tr NO IYES! Business Plann ncrI usrI HW GeneratorncnmnpPROGRAMS INSPECTEDI Business Plann ncrn usr! HW GeneratorncnrnnpPHONE:AGENCYtr ensn ac DEPTI ctrv nneN TYPE_33 _31_90fl GomplaintRoutineResult Code:Action Code:_70328037ReinspectionOtherYESnTnnTNO COS N/AnrnxrntrtrnBPOlBPO2BPO3BUSINESS PLANBusiness plan is complete, current, & availatrle during inspection (HSC 25503.5' Title 19 CCIR2729)Inventory of hazardous materials is complete (HSC 25504' Title I9 CCIi 2729)Site fayout/facilitS' maps are accurate (HSC 25504' Title 19 CCIR2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)Training documentation is maintained on site for current personnel (Title l9 CCR 2732 & 22 CCR6626s.16)EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC 25504' Title l9 CCIR273l & 22ccR $ 6626s.s3/s4)Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release ofhazardogs materials/waste constituents to the environment, Maintains all required or appropriateequipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31'.43)ABOVEGROUND PETROLEUM STORAGE TANK ACTSPCC 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)f,trnf,nnTROlTRO2nIBR()IERO2ATOlATO2nnnIGPSates: Latitude: -deg-deg--min-decimal minINSPECTOR:nilndecimal minFACILITY REP: l.FACILITY NAMEEPA IDNT]MBER:ADDRESSHAZARDOUS WASTE GENERATORAntifreeze:,iLbs or gals(average)Tiered Permit: LJcnsw LJcrsQrLlca LlpnnTotal generated/m.onth :Waste oil: t/Solvents:Others:Treatment Equipment:N/AE-TTTTGTOScosE'TxTNOE'nnnlYESFr/4f,WffiF/'w'nTTITtrITTTlITtrtr!TTnTtrn!nntrDtrtrn!TvIoL. #GTOTGTO3GTO4GTO5GTO6GTOTGTO9GTTOGTl1GTl2GT13GTT4GTI5GT16GTl7GTl8GTT9GT2OGT2IGT22GT23or autfiorizationffmilkrunEPA ID NO/PERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste(Title 22CCR 566262.12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determination conducted (Title22 CCR 566262.1f)nown knowledge [analysis lotherHazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR $66262.40.(c))DISPOSAL/TRANSPORTATIONHazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permitnEE',aoC""E"-.E,'4p"F,F'F'F"nTTnF'wfrom DTSC (HSC $25189.5, Title 22 CCIRS66262.12)!otherHazardous wastes are shipped with manif'est (Title22 CCR $66262.20)Manifests and/or receipts are properly completed/retained by generator for 3 years (Title 22 CCRs66263.42t 66262.23',)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHgdrdous wasles are accumulated on site as follows (Title 22 CCR $66262.34)F nO days if waste generated per month is greater than or equal to 100 kg (220 lbs')fl tfO days if waste generated per month is less than 100 kg (see note)flZIO days if waste generated per month is less than 100 kg and transported more than 200 miles(see note)Note: Applies only ifhazardous waste accumulated on site never exceeds 6000 kg(13,200lbs.)and no acutely/extremely hazardous waste over 1 kg (2.2 lbs.) is held on site for over 90days.Ilazardous waste "satellite'o collection is managed properly (complete labeling/accumulationtime/55-gal or l-qt limit) (Title 22 CCR $6626234(c))Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR$6626s.176)Containers of hazardous waste are properly labeled (includes appropriate date,''HAZARDOUSWASTE,' waste composition/physical state, hazardous properties, name/address of generator)(Title 22 CCR $66262.31, 66262.34)Containers/tanks containing hazardous wastes are in good condition/handled to minimize releaseor reaction (T itle 22 CCR $66265. I 7 I I .l I l, 66265.17 7 (c))Containers/tanks/liners are compatible with waste stored or transferred (Title 22 CCR$66265.f 72)Containers storing hazardous wastes are closed/sealed (Title22 CCR $66265.173)Weekly inspection ofareas where hazardous waste containers are stored is conducted(T itle 22 CCR$662 65. I 74)Daify inspection of all tank systems is conducted and documented (Title 22 CCR 566265.195)Empty containers or inner liners greater than 5 gal has date when emptied and are managedproperly within one year of date enrpticd (Title22 CCR $6626f .7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSCs2s2s0.4)Used oil filters for recycling are managed properly (drained offree flowing liquid, stored in closedrainproof containero labeled "drained used oil filters,t' and transferred for metal reclamation)(Titre 22 CCR$ 66266.130)Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill oflading for recycling, reuse, or reclamation (Title 22 CCR $66266.81)Solventsiother recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR$66266.3)SOURCE REDUCTION: For facilities generating >12,000 kg.iyr. of hazardous waste on site.Generator is subject to SBl4 and has prepdred and retained current source reduction documentsor is able make them available to the inspector within (5) days. (HSC 525244.19,25244.21)Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes generated, process description' block diagrams, andimplementation schedule ofselected source reduction measures. (HSC $25244.f9),'fi$ {j#-- Environmental Health Services(805) 781-s544P.O. Box 14892156 Sierrr l{aySan Luis 0bispo, CA 93{116Gwo[safi trils-lFlre Department (805) 781-73802160 Santa Barbara AvenueSan Lule Obltpo CA 93't{11-524OCERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMDate:EFW dataentry by:Time:NOYEfr/,WN/AnnnDntrtrtrud.6BPOIBm2BPO3TROITRO2EROIERO2ATOlATO2BUSINESS PLANBusiness plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)Inventorry of hazardous materials is completr (IISC 25504, Title 19 CCR2729)Sitc layouUfacility maps arc accurete (HSC 25504, Title 19 CCP. n2glTRAINING PLANFacility has appropriote tralning program (Title 19 CCR2732 & 22 CCR 66265.16)Training documentation is mointained on site for current perconnel (fitle 19 CCR 2732 & 22 CCR66255.t6)EMERGENCY RESFONSE PLANContingency plan is complete, updated, and maintained on slte (HSC 21i504, Title 19 CCR 2731 & 22ccR $ ffi26ss3ts4tFacility is operated and maintained to prevenUminimlze/mitigate firy exploeion, or release ofhazrirdous materialVwaste constlhrents to the environmenl Malntains all required or appropriateequipment including an alarm end communications system (Title 19 CCR 273f & 22 CCR 5626531..431ABOVEGROT'ND PETROLEUM STORAGE TANK ACTSPTCC PIan is reviewed end certified by a regisbered engineer within last 5 yrs ('10 CFR f f2"5(b))SPCC Plan is maintained on site or nearest field office. (IISC 25270){own!unnElcat-nnpE lcrflusrEl nW GcnsrrtorIE Buslness Pland"o nYEsREINSPECTION FEQUIRED:IcnuaneEl rcrE usr,Hr* GeneratorI Eueiness Ptan,}!PROGRAMS INSPECTED:PHONE:RoutlneReinspectionTYPEI ottrerntr\h&bl1- ,4,5 rrAGiEtVCYEHSCITY FIREFACILITY NAME:COMMENTS cototo obtain fonns to comply wift BP0l-BP03, TROl andINSPECTOR:C:\DOCPage 1mrnGPS Coordinatcs: Latitude: degmtnFACILITY\Temp\c. lotus.notes.data\1 _l nspection Form\ 'f i:a. -"': rJFACILITYI{AZARDOUS WASTE GEI\ERATORLbe or qels(average)EPAIDNT]MBER:fiercdPemit:TreatmentEquipment;LJcnswflcnser LJcrAndfreeze:Others:EPAIDNO/PERMITSC"r"*t".n-*""nin bnumbertotreat,storc,dispose,fansportortransferhazardouswastc(Tilie2:2CCRg66,1f,2.l2) If Not, Call (El[) 61&6942 to obtain your CAL EPA lD number.HAZARDOUS WASTE DETERMINATIONIlazardous waste detcrmination conducted (fitle 22 CCR S66252.11)Elotm howledge Eanalysis t]othernazarOoru wsste analysidtest records are kept for at least 3 years (Tille22 CCR $66262.40.(c))DISPOSAUTRANSPORTAIIONwithEPANO. andpermitorManifcsts and/or receipts are properly completed/retained by generator for 3 yeam Clttle 22 CCR$ffirn3.alffiK2.23)STORAGE AND MANAGEMENT OF CONTAII\TERS/TANKSHagrldous wastes are accumulated on site as follows (Tltle2? CCR $6626234)Ef90 days trwastc generated per nonth is gr.gater than or equal to 100 kg (220 lbs.)E fSO days ifwaste generated per month is less than 100 kg (see note)I ZZO aays itwaste generated per nonth is less than 1(X) kg and transported more than 2dX) miles (seenote)Note Applies only if hazardous waste accumulatcd on site never exceeds 60(X) kg(13"21[ lbs.)and noacutely/extrrmely hazardous waste over I kg (2.2 lbs.) is held on site for over 90 days.Hazardous wasje .tatellitd' ssll€cfiqn is mannged properly (complete labeling/accrunulation time/S5-galor l-qt timiO (fitle 22 CCR S6626234(cDIgnitable or reactive wastes are located 15 m (50 feet) from facility's Property line (Title 2:2 CCRs66t26s.t76)Containers of hazardous waste are properly labeled (includes appropriate drt€' 'IIIAZARDOUSWASTT," waste comlrceidon/physicat state, hazardous properdes, name/address of generator) (Iide 22ccR s662623\mXZ.v)Containers/tanks containing hazardous wastes are in good condition/handted to minlrirlzc release orl:eaction (Iitle Zi2 CCR $66255.17 U.lgl, 66,Xi5.177 (c))ContainerdtankMiners are compatible wtth waste stoltd or transferrcd (fitle 22 CCR$66265.|72)Containers storing hszandous wastcs are closed/sealed (Title 22 CCR $66265.173)\ileekly inspecdon ofareas where hazardous waste containers are stored is conducted(fitle 22 CCR$66265.174)Daily inspection of atl tank systems is conducted and documented (Title 22 CCR $66265.195) ,Empty containers or lnner llners gruter than 5 gal has date when emptied and are managed properlywithin one year of ilate enrptied (Title 2 CCR $66261.7 (0)RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling' storage' etc) (r{SCs2tr2s0.4)Used oil filters for recycling art managed properly (drained of free flowing liqui4 stored in closedrainproof containerr labeled'sdrained uscd oil ftltersrtt and transfered for metal reclamation) (Tltle/2ccR$ 66266.130)Spent lead,acid batteries are being properly storcd and iransferred ofrsite under manifest or bill oflading for necycllng reuse' or rcclamation (Title ZZ CCR $66256.81)Solvents/otner recyclable materials are menaged as hazardous wastes until recycled (Title 22 CCRgffi266slSOURCE REDUCTION: For facllities generating >12,0fl) kgJyr. of hazardous waste on site.Gcnerator is subject to SB14 and hrs prepared and retained curent source rcduction documents or isable make them available to the inspector within (5) days. (HSC $252C4.19,2524.21)Source Reducfion Evaluation and Plan contains the following five elemenb:certificadon, amounts of wastes generated, process description, block diagrams, and implementationschedule of selected source reduction mealures. (HSC $25244.19)WtvIoL.#GTOlGTO3GTO4GTOSGTIbGTlnGTOEGI1I9GTlOGT11GT12cT13GT14GT15GT16GT17GT18GT19GTzOGT21GTz:2GTzi}YES-. NOwEi{n{zfn{roVtrn./t,{{ad/nd-Jwndnwn{o{trN/Annnnntrnnnntrnutrtrutrnnnntrh,,/AC:\DOCUME-1\Repro\LOCALS-1\Temp\c.lotus.notes.data\2-Hazardous Waste Generalsr.doc 20-Jul-04 20-Jul-04 Environmental Health Serviges(805) 781-s544P.O. Box 1t1892156 Sierrr WaySan Luis Obispo, CA 93406cltyo[san lulsrL,0qFlre Department (805) 781-73802160 Santa Barbara AvenueSan Luis Oblspo CA 93'101-5240CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORM,t lv -tvDate: /o(i () r.{+entry by:EFW daYES NO N/AW r na' tr nD/ n trwGt'wVTime:BmlBPO2BPO3TROlTR02EROlERO2n W" AToltr a/ Ar02BUSINESS PLANBusiness 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 layouUfacility maps are accurate (HSC 25504' Title 19 CCR2729')TRAINING PLANFacility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR6626s.t6)EMERGENCY RESPONSE PLANContingency ptan is complete, updated, and maintained on site (HSC 255(X' Title 19 CCR 2731 & 22ccR $ 66265.s3/s4)Facility is operated and maintsined to prevent/minimize/mitigate fire, explosion, or releasc ofhazardous materialVwaste constituents to the environment. Maintains all required or appropriateequipment including an alarm and communications system (Titte 19 CCR 273f & 22 CCR 66265.31-.431ABOVEGROUND PETROLEUM STORAGE TANK ACTSPCC 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 nearesJ field oflice. (HSC 25270)E Busineee Plan#*o n YESREINSPECTION REOUIRED:Icx-nneI rcrflusrfl xw coneratorE usrfi,xw%.n"r"rotPlanPROGRAMS INSPEGTED:IcruneE aarPHONEADDRESS:ILITY NAME:nd'/i^r$ ^d{AGENCYEHSCITY FIRERoutineReinspectionComolaint . Ioth; $Mfit+4,"lTYPEtrntoGo/14to obtain forms to comply with BP0|-BP03, TROI and\i\GPS Coordinates: Latitude: degmin Longitude: deg min-decimal minFACILITY REP:INSPECTOR:C:\DOCU1\Re1 \Temp\c. lotus.notes.data\1 -lnspection Form.doc 24-Jan-06 HAZARDOUS WASTE GENERATOR, . FACILITYEPA ID IT[T,]MBER:Tiered Permit:TreatmentEquipment:Lbs or gals(average)Total generated/mgnth:Waste oil: i"r'Antifreeze: t,Solvents:Others:IL;YES NOE:"EN/AE-nnnnVIOL.#GTOlGT03GTO4GT05GT116GTOTGTOSGTO9GTlOGT11GT12GT13GTI4GT15GT16GT17GTlEGT19GT2OGT2IGT22GT23EPA ID NO/PERMITSGenerator has an EPA ID nurnber to treat, store, dispose, transport or transfer hazardous waste (Title22CCRE66?rt2J2) If Not, Call (800) 618'6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determination conducted (Title22 CCR S66262.11)Elown knowledge [anatysis lotherF-azardous waste analysiVtest records are kept for at least 3 years (Title 22 CCR $66262.40.(c))DISPOSAL/TRANSPORTATIONHazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit orManifests and/or receipts are properly completed/retained by generator for 3 years (Titte 22 CCRs66263.421 66262.n)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHazardous wastes are accumulated on site as follows (Title 22 CCR $66262.34)lTl m aays if waste generated per month is greater than or equal to lfit kg (220 tbs.)E fSO days if waste generated per month is less than 100 kg (see note)EZlOdays if waste generated per month is less than lfi) kg and transported more than 2ffi miles (seenote)Note: Applies only if hazardous waste accumulated on site never exceeds 6fiX) kg(13'2fi] lbs.)and noacutely/extremely hazardous waste over lkg(2,21bs.) is held on site for over X) days.Hazardow waste ..satetlite" collection is managed properly (complete labeling/accumulation time/S5-galor l-qt limit) (fitle 22 CCR 566262.34(c))Ignitabte or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CC.Rs6626s.176)Containers of hazardous waste are properly labeled (includes appropriate date, (HAZARDOUSWASIE,t'waste composition/physical state, hazardous properties, name/address of generator) (fitle 22ccR s66262.31,6262.y)ContainerVtanks containing hazardous wastes are in good condition/handled to minimize release or 'reaction(Title22CCR$66265.1711.191,66265-177(c)\Containersy'tankMiners are compatible with waste stored or transferred (Title22 CCRS66265.172)containers storing hazardous wastes are closed/sesled (fitle 22 CCR $66265.173)\ileekly inspection ofareas where hazardous waste containers are stored is conducted(Title ?12 CCR$66265. 174)Daily inspection of all tank systems is conducted and documented (TiUe22 CCR $66265.195),Empty containers or inner liners greater than 5 gal has date when emptied and are managed properlywithin one year of date emptied (Title ?12 CCR $66261.7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC$2s2s0.4)Used oil tilters for recycling are managed properly (drained of free flowing liquid, stored in closedrainproof container, labeled "drained used oil filters,tt and transferred for metal reclamation) (Title 22ccR$ 66266.130)Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill ofhting for recycling, reuse' or rectamation (Title22 CCR $66266.81)Solventr/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR$66266.3)SOURCE REDUCTION: For facilities generating >12,000 kgJyr. of hazardous waste on site.Generator is subject to SB14 and has prepared and retained current source reduction documents or isable make them available to the inspector within (5) days. (HSc 5252,14.19,25U4.21)source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes generated, process description, block diagrams, and implementationschedule of selected source reducfion measures. (HSC $2524.19)nnntr^El'dtr'trflnEtrtrtr'trtrE'ntrtrft':trE"trtrnnnnntrnntrnntrntrnnnnnnunutrC:\DOCUME-1\Repro\LOCALS-1\Temp\c.lotus.notes.data\2-Hazardous Waste Generator.doc 20-Jul-04 20-Jul-04 ,tIr!{',lcffyol-san lursEnvironmental Health Services(805) 781-5544P.O. Box 14892156 Sierra WaySan Luis Obispo, CA 93406oBtspoFlre Department (805) 781-73802160 Santa Barbara AvenueSan Luis Obispo CA 93401-5240CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)DOUS MATERIALS INSPECTION FORMDate:EFW dataentry ov, [,14TimeN/AnntrNOtrnnntrYESVn/:iltBPOlBPO2BPO3TROlTR02EROIERO2ATOlATO2BUSINESS PLANBusiness plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2729)Inventory of hazardous materials is complete (HSC 255M, Title 19 CCR2729)Site layouUfacility maps are accurate (HSC 25504, Title 19 CCF. 2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.161Training docurnentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR66265.16)EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273[ & 22ccR s 6626s.s31s4\Facility is operated and mainta'tned to prevenUminimize/mitigate fire, explosion, or release ofhazardous materials/waste constituents to the environment. Maintains all required or appropriateequipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43\ABOVEGROUND PETROLEUM STORAGE TANK ACTSPCC Plan is reviewed and certified by a registered engineer within last 5 yrs. (40 CFR f f2.5(b))SPCC Plan is maintained on site or nearest field office. (HSC 25270)trnWCOMMENTSGo to hup://www.slopublichealth.org/environmentalhealth/hazardous_materials.htm, to obtain forms to comply with BP01-BP03, TRO1 and ER0lfBusiness PlanD YES{ruoREINSPECTION REQUIRED:Ecamnpn rorE usrdr*Generatorfl rcrE usrfr^* ceneratorflBusiness Plan,PROGRAMS INSPECTED:EcnmnpPHOADDRESS:IAGENCYn EHSfl crv nne/lNAME:RoutineReinspectionTYPEI ComplaI ottrerGPS Coordinates: Latitude: - degmlnFACILITYINSPECTOR:C:\DOCE-11 \Temp\c.lotu$.notes.data\1 -lnspection Form Page 1 .doc 24-Jan-06mrn 1!rr r !.fi:'\'1ry$iiia;itrar.r J 7rliJ rti " ,.r.,".i )- J-. i, r- i"',ADDRESS_ t ;.,,,..:\..*,..:..i!,:11;liltFACILITYEPAIDNUMBER:Tiered Permit:TreatmentEquipment:7iHAZARDOUS WASTE GENERATORLbs or gals(average)ncnsw Llcrserflcr npnnTotal generated/month:Waste oit: tr'/ Sof""rrt*-l ' ,1Antifreeze: :./ Others: i.' .'. i,'jYES NO N/Atr]' tr E.wnnEnxnnntrwB'nnwunwntra'nnw n na/ n nFl'Ttrw' n trvroL.#GTOlGT03GTO4GTOSGTO6GTOTGTOSGTOgGTlOGTlIGT12GT13GT14GT15GT16GT17GT18GT19GT20GT2IGT22GT23EPA ID NO/PERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous22CCR 566262.12\ If Not, Call (El[) 618-6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determination conducted (Title 22 CCR 566262.11)ffo*tt knowledge flanalysis EotherSazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR $66262,40.(c))DISPOSAL/TRANSPORTATIONHazardorrs wastes were transported and/or disposed to a facility withEPA ID NO. and permit or22Manifests and/or receipts are properly completed/retained by generator for 3 years (Titte 22 CCR966?.63.4U 66262.23)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHazardous wasies are accumulated on sitc as follows (Title 22 CCR $66262.34)!fl'm a"yr if waste generated per month is greater than or equal to lfi) kg (220 lbs.)E fSO days if waste generatcd per month is less than lfi) kg (see note)E ZZO aays lf waste generated per month is less than lfi) kg and transported more than 200 miles (seenotc)Note: Applies only lf hazardous waste accurnulated on site never exceeds 6fi)0 kg(13,20 lbs.)and noacutely/extremely hazardous waste over lkg(2.21bs.) is held on site for over 9() days.Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/S5-galor l-qt limit) (fitle 22 CCR $66262.34(c))Igrritable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR$6626s.176)Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUSWASTE,'' waste composition/physical state, hazardous properties, narne/address of generator) (Title 22ccR $66262. 3t, 66?62.34)ContainerVtanks containing hazardous wastes are in good condition/handled to minimize release or ,reaction(Title22CCRS66265.l7ll.l9l,66fti5J77(c))Containers/tankMineni are compatible with waste stored or transferred (Title 22 CCR966265.172)Containers storing hazardous wastes are closed/sealed (TiOe 22 CCR 966265.173)\ileekly inspection of areas where hazardous waste containers are stored is conducted(Title 22 C CR$66265. 174)Daily inspection of all tank systems is conducted and documented (Tltle22 CCR $66265.195),Empty containers or inner liners greater than 5 gal has date when emptied and are managed properlywithin one year of date emptied (fitle2? CCR $6626f.7 (f))RECYCLABLE WASTEUscd oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC$2s2s0.4)Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closedrainproof container, labeled "drained used oil filters," and transferred for metal reclamation) (Title22ccRs 66266.130)Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill oflading for recycling reuse, or reclamation (Tltletl CCR $66266.81)Solventdother recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR$66266.3)SOURCE REDUCTION: For facilities generating >12,fi)0 kg./yr. of hazardous waste on site.Generator is subject to SB14 and has prepared and retained current source reduction documents or isable make them available to the inspector withtn (5) days. (HSC 92524.19,2524.21)Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes generated, process description, block diagrams, and implementationschedule ofselected source reduction measur€s. (HSC $25244.19)*,fin#-CI,*a';J nw n n{a ntrntr'@'trna'ntrtrQ' tlEI,' trnnnnC:\DOCUME-1\Repro\LOCALS-1\Temp\c.lotus.notes.data\2*Hazardous Waste Generator.doc 2Q-Jul-04 2O-Jul04 EnvironmentalHealf ervices(80s) ?sr-ss44 iP.O. Box 14892156 Sierra Way .San Luis Obispo, CA 93406Department of Aericulture/MeasurementStandardg (8os) ?81-se1o2156 Sierra Way Suite A oSan Luis Obispo, CA 93401iitof San LuisqFire Department (805) 781-73802160 Santa Barbara AvenueSan f,nis Ohisnn CA 93401-5240Utilities Departrnent e (805) 781-7215879 Morro Street o San Luis Obispo, CA 93401ICERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMPERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determiningcompliance with adopted codes. GRANTED BY (NAME/TITLE):! Business PlanREINSPEC'r'ION R"BIQ U rR-UD :ffiolYEsE Tiered PermittingIlcrn usr! c"tanpn uw GeneratorPROGRAMS INSPECTED:! Tiered Permitting[] acr! usrfl calnpffi* GeneratorPlanffio"i,*"PHONE:ADDRESS:FACILITYNAME:ReinspectionComplaint! ottr""AGENCYfl npnn ,q.c DEPTl-l crrv-MtrvFIREUTILITIESFACILITY ID NO:Date: tto">rime: 107AnCOMMENTS:EFW dataentry by:NO- N/AW!TIYESwWdWdtBPOlBPO2BPO3TROlTRO2EROlERO2BUSINESS PLANBusiness plan is complete, cunent, & available during inspection (HSC $25503.5, Title 19 CCR $n29)Inventory of hazardous materials is complete (HSC 525504' Title 19 CCR $2729)Site layout/facility maps are accurate (HSC $25504, Title 19 CCR$ 2729)TRAININGPLANFacility has appropriate training program (Title 19 CCR $2732 & 22 CCR $66265.16)Training documentation is maintained on site for current personnel (Titte 19 CCR $2732 &22 CCR S6626s.16)EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC 525504' Title 19 CCR$2731 & 22 CCR $6626s.s3/s4)Facitity is operated and maintained to prevenUminimize/mitigate fire, explosion, or releaseof hazardous waste to the environment. Maintains all required or appropriate equipmentincluding an alarm and communications system (Title 19 CCR $2731 & 22 CCR $66265.31-.43)GPS Coordinates: Latitude: _degmin decimalmin Longitude: deg min-decimal minmeo,,isrywJV,blalsi;,-InspectorFacility Representative:A:\CUPA inspection forms 2.doc 20-Mar-03 FACILITY NAME:EPAIDNUMBER:Tiered Permit:TreatmentEquipment:DATE:HAZARDOUS WASTE GENERATORoaNSPECTOR:Antifreeze: (9 Others:Lbs or(fu(average)CNYES.,ztwtwil-td/WNO N/ANTvroL.#GTOlEPA ID NO/PERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title22CCR566262,12) If Not, Call (800) 618-6942 to obtain your CAL EPA ID number.HAZARDOUS WASTE DETERMINATIONHazardous waste determination conducted (Title22 CCR $66262.11)Wd*lnknowledge lanalysis notherffazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR $66262.40.(c))DISPOSAL/TRANSPORTATIONHazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit orfrom DTSC (HSC $25189.5, Title 22 CCR *66262.12)notherHazardous wastes are shipped with manifest (Title 22 CCR $66262.20)Minifests and/or receipts are properly completed/retained by generator for 3 years (Titte 22 CCR966263.421 66262.23)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHazafdous wastes are accumulated on site as follows (Title22 CCR $66262.34)drO Uur"if waste generated per month is greater than or equal to 100 kg (220 lbs.)n fSO days ifwaste generated per month is less than 100 kg (see note)flZIO days if waste generated per month is less than 100 kg and transported more than 200 miles (seenote)Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg(13'200 lbs.)and noacutely/extremely hazardous waste over I kg (2.2lbs.) is held on site for over 90 days.Hazardous waste "satelliteo'collection is managed properly (complete labeling/accumulation time/55'galor l-qt limit) (Title 22 CCRS662623a@\)Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR$6626s.176)Containers of hazardous waste are properly labeled (includes appropriate date, "HAZATRDOUSWASTE," waste composition/physical state, hazardous properties, name/address of generator) (Title22ccR s66262.3 l, 66262.34)Containers/tanks containing hazardous wastes are in good condition/handled to minimize release orreaction (T itle 22 C CR $ 66265. 1 7 I l.l9 l, 66265.17 7 (c))Containers/tanks/liners are compatible with waste stored or transferred (Title 22 CCR$66265.172)Containers storing hazardous wastes are closed/sealed (Title22 CCR S66265.173)Weekly inspection of areas where hazardous waste containers are stored is conducted(Titte 22 CCR$66265. 174)Daily inspection of all tank systems is conducted and documented (Title 22 CCR $66265.195)Empty containers or inner liners greater than 5 gal has date when emptied and are managed properlywithin one year of date emptied (Title 22 CCR 566261.7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling, storage' etc) (HSCs2s2s0.4)Used oil filters for recycling are managed properly (drained of free flowing liquid' stored in closedrainproof container, labeled "drained used oil fittersr" and transferred for metal reclamation) (Title 22ccR$ 66266.130)Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill oflading for recycling, reuse, or reclamation (Title 22 CCR $66266.81)Solvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCRs66266.3)SOURCE REDUCTION: For facilities generating >L2,000 kg./yr. of hazardous waste on site.Generator is subject to SB14 and has prepared and retained current source reduction documents or isable make them available to the inspector within (Sidays. (HSC 525244.19,25244.21)Source Reduction Evaluation and Plan contains the following five elements:certification, amounts of wastes generated, process description, block diagrams, and implementationschedule ofselected source reduction measures. (HSC $25244.19)A:\CUPA inspection forms.doc 1 9-Sep-02nTfue NdfGT03GTO4GTO5GTO6GTOTGTOSGTO9GTlOGTl1G"t12GT13GT14GT15GT16GT17I cr18I crleGT2OGT21GT22GT23autborizationllfmilkrunTunTnTTdil6ITtt{ FACILITY NAVADDRESSSUMMARY OF OBSERVATIONS/VIOLATIONSNo violations ofunderground storage 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.Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective action listed byeach violation. If 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 SPECIFED. CUPA must be informed in writing with acertification that compliance has been achieved. A false statement that compliance has been achieved is a violation of the law andpunishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be reinspected any time duringnormal business hours.You may request a meeting with the Program Manager to discuss the inspection findings and/or the proposed corrective actions.The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action.CORRECTIVE ACTION REQUIREDe-arsVIOLATIONSNUMBER MINO} MAJOR1Pot ,,/ _6rw --II/l4-T ll43rre9re- nzp'T"II Ba- hr:COMMENTS:Inspected By:Date:Facility Rep Name:Signature:\I7Sign the certification below and mail this form to the CUPA inspector after all corrective actions have been completed. Retain a copy for your records.{ICertification: I certify under penalty of perjury that this facility has complied with the corrective actions listed on thisinspection form.Signature of Owner/Operator_ Title:Date:A;\CUPA inspection forms.doc 1 9-Sep-02 Division of Environmenta' rlealth(80s) 78r-ss44P.O. Box 14892156 Sierra Way r$nn Luis Obispo, CA 93406Department of A griculture/NleasurementStandards (8os) 7sr-s9ro2156 Sierra Way Suite A oSan Luis Obispo, CA 93401Crcof San Luis ObisoFire Department (805) 78f-73802160 Santa Barbara AvenueSarr I-uis Obispo CA 93401-5240Utilities Department r (805) 781-7215879 Morro Street r San Luis Obispo, CA 93401CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HMARDOUS MATERIALS INSPECTION FORMEFW dataentry by:(t, [n /0:]Date:Time:'15'5'PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliancewith adopted codes. GRANTED BY (NAME/TITLE):I Tiered Permittingn acrI usrn rrw Generatorn Business PlanEftor YESREINSPECTION REQUIRED:I Tiered Permittingn acrI usrffiw GeneratorPlanEd,rir"r.PROGRAMS INSPECTED:PHONEADDRESS:/q'NFACILITY NAME: F*i, Fi T fie I IRoutineReinspectionComplaintOthertrL]AGENCY-L] DEHf IcDEPTn prrv rrnnWctrv UTILITIESFACILITY ID NO:YESuurT9tvt"d4N/AnBPOlBPO2BPO3TROlTRO2EROlERO2BUSINESS PLANBusiness plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCF.2729)Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)Site layouUfacility maps are accurate (HSC 25504, Title 19 CCR2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16)Trainirrg documentation is maintained on site lbr current personnel (Title 19 CCR2732 & 22ccR 6626s.16)EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR273t & 22 CCIR S 6626s.s3/54)Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release ofhazardous waste to the environment. Maintains all rcquired or appropriate equipmentincluding an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43)WCOMMENTS:INSI'ECTOR: FACtrLITY REP:l'e''J;4lbzls lo Lj:r".. .ria) 1{)i.i I i.:i!, -' FAGILITY NAMEDATE:HAZARDOUS WASTE GENERATORINSPECTOR:EPA IDNUMBER:Tiered Permit:Treatment Equipment:cATlgrlc) a q'}\"nTotal generated/monthWasteoil: \I 6*(lntit ""r",@rns or@(average)CESWCESQTSolvents:Others:YES -"' NOWEN/AnnTDT{dTnTTTGTI2TuTTTnnfnTvrol. #GTOIGTO3GTO4GTO5GTO6GTOTGTOSGTO9GTIOGTIIGTI3GTI4GTI5GTI6GTITGTI8GTI9GT2OGT2IEPA ID NO/PERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title22CCR 66262.12) If Not, Call (800) 618-6942HAZARDOUS WASTE DETERMINATIONHa{rdous waste determination conducted (Title 22 CCR66262.ll)6onn knowledge f]analysis notherHazardous waste analysis/test records are kept for at least 3 years (Title 22 CCR 66262.40.(c))DISPOSAL/TRANSPORTATIONwere transported and/or disposed to a facility with an EPA ID NO. and permit orDTSC (HSC 25189.5, Title22 CCR'66262.12)IotherHazardous wastes are shipped with manifest (Title 22 CCR 66262.20)Manifests andior receipts are properly completed/retained by generator for 3 years (Title 22 CCR66263.42t 66262.23)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHa4drdous wastes are accumulated on site as follows (Title 22 CCn' 66262.34)'i/SO a^y, if waste generated per month is greater than or equal to 100 kg (220 lbs.)fJ ltO days if waste generated per month is less than 100 kg (see note)flZ'lO days if waste generated per month is less than 100 kg and transported more than 200 miles (seenote)Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg(f3200 lbs.)and noacutely/extremely hazardous waste over I kg (2.2lbs') is held on site for over 90 days.Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/55-galor l-qt limit) (Title 22 CCR 66262.34(c))Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR66265.176',)Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUSWASTE,'waste compositioniphysical state, hazardous properties, name/address of generator) (Title22ccR66262.34\Containersitanks containing hazardous wastes are in good condition/handled to minimize release orreacti o n (T itle 22 CCR 66265. I 7 I l.l9 l, 66265.17 7 (c))Containers/tanks/liners are compatible with waste stored or transferred (Title22 CCR66265.172)Containers storing hazardous wastes are closed/sealed (Title 22 CCR 66265.173)Weekly inspection of areas where hazardous waste containers are stored is conducted(Title 22 CCR 66265.174)Daily inspection of all tank systems is conducted and documented (Title 22 CCR 66265.195)Empty containers or inner liners greaten than 5 gal has date when emptied and are managed properlywithin one year of date emptied (Title22 CCR 66261'7 (f))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling' storage, etc) (HSC2s2s0.4)Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closedrainproof container, latreled "drained used oil filters," and transferred for metal reclamation) (Title22ccR 66266.130)Spent lead-acid batteries are transferred olfsite under ntanifest or bill of lading for recycling, reuse, orreclamation (Title 22 CCR 66266.81 )Solvents/other recyclable materials ane managed as hazandous wastes until recycled (Title 22 CCR66266.3')Hazardous wastesaulhBdzation fromTffmilkrun serviceTd{reproI I83 tSUMMARY OR OBSERVATIONS/VIOLATIONSNo violations of underground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requirements werediscovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.Viotations were observed/discovered as listed below. All violations must be corrected by implementing the corrective action listed by eachviolation. If you disagree with any of the violations or proposed action, please inform us in writing.ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing certifyingthat compliance has been achieved. A false statement that compliance has been achieved is a violation ofthe law and punishable by a lineof 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 proposed corrective actions. Theissuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as s result of theviolations noted or that have not been corrected within the time specilied.NTJMBERVIOLATIONSMINOR MAJORCORRECTIVE ACTION REQUIREDlct'dY)P'4-8WEAL_4trP+rriat5.\;0]-Ne>P.COMMENTS:InspectedDate:Facility Rep Name:Signature:L4rN 5repro ll27rev 1O:\DOCUMENT\Jeffp\FORMS\lnspection forrns\CUPA irrspectiotr fortns.doc i0-Sep-01 Mr. Andy Taylor March 24,2004 the WQO is imminent through natural biological processes. The maximum concentration of MTBE detected in groundwater at the site was l.l 1tglL. Please complete and sign the enclosed Case Closure Summary form and supplement e.g. document list, for the site and return it to this office. An electronic version of the Closure Summary can be provided upon request. If you have any questions, please contact corev walsh at (80il 542-4781. Sincerely @u,W. Briggs Executive Officer Enclosure: Case Closure Summary S:\UST\Regulated sites\San Luis obispo co\San Luis obispo\196 Suburban\closure Review.doc cc: Mr. Rob Delnagro Shaw Environmental, Inc. 4005 Port Chicago Hwy Concord, CA94520 Without Enclosure: 2 Mr. Kerry Boyle City of San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CA 9340I-5240 Mr. Mark Matranga State Water Resources Control Board Division of Clean Water Underground Storage Tank Cleanup Fund P.O. Box 944212 Sacramento, C A 94244-2120 Mr. Garry Holdgrafer Holdgrafer & Associates 3592 Broad Street San Luis Obispo, CA 93401 Mr. & Mrs. John & Linda Whitson 1216 Oceanaire Drive San Luis Obispo, CA 934054918 California Environmental Protection Agenqt €Reqcled Paper SAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF ENVIRONMENTAL HEALTH2156 Sierza Way o P.O. Box 1489 o San Luis Obispo, California 93400TETEPHONE (805) 78r-s54.J o FAX (805) 781-4211SAN LIJIS OBISPO COTINTY DEPARTMENT-DWISION OF EIWIRONMENTAL HEALTHiqu 5u rha4lerABAI{DONMENT PERNIITpERMrr #4163-4 FEE $180.00 cK#11168APPROVED BY JOHN SCHOLTES O,Et/CONTRACTOR NAME AND ADDRESS FACILITY NAME AND ADDRESSA.E. Schmidt Environmental10701 Riverside DriveNorth Hollywood, CA 91602OWNER NAME AND ADDRESSPacific Bell1420 Tuolumne, Room 300Fresno, CA 93732CONDITIONS AS FOLLOWS:1. This is not a Permit to oPerate.2. permit shall be shown upon request to this Department, County Air Pollution ControlDistrict, State Regional Water Board or any representative of local Fire, Building,Planning or Police jurisdiction.3. Owner, contractor, employees and agents shall comply with all Federal, State andlocal laws, ordinances, regulations and enactments.4. This permit may be suspended or revoked by this Department for sufficient cause.5. A 48-hour notice shall be given before inspection, and a fee may be assessed if a24-hour notice is not received to cancel inspection.6. Tank must be cleaned and rendered inert or rendered inert and hauied hazardous.7. Al1 samples taken must be taken by a Certified Technician under guidance of thisDepartment.8. All rinsate must be hauled by ahazardous waste hauler.%.cPERMIT EXPIRES 2I2II95APPROVAL DATE I2I2II94forms\ust\abanpmt. blkkt t2194Pacific Bell196 Suburban RoadSan Luis Obispo, CA 93401A DEPARTMENT OF THE SAN LUIS OBISPO COUNTY HEALTH AGENCY SAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF ENVIRONMENTAL HEALTH2156 Siena Way o P.O. Box 1489 o San Luis Obispo, California 93406TELEPHONE (805) 781-55M O FAX (805) 781-42TTSAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF EhIVIRONMENTAL HEALTHNEW INSTALLATION/REPAIR PERMITPERMIT E)(PIRES 2I2II95PERMIT # 417-T-I$112.00 St SrFEE $ 675.00APPROVAL DATE I2I2II94 CK# 15168 APPROVED BY JOHN SCHOLTESCONTRACTOR NAME AND ADDRESS FACILITY NAME AND ADDRESSflrA.E. Schmidt Environmental10701 Riverside Ave.North I{ollywood, CA 91602Pacific Bell196 Suburban RoadSan Luis Obispo, CA 93401OWNER NAME AND ADDRESSPacific Bell1420 Tuolumne, Room 300Fresno, CA.93732CONDITIONS AS FOLLOWS:1. This is not a permit to operate.2. Permits shall be shown upon request to this Department, County Air Pollution ControlDistrict, State Regional Water Quality Control Board or any representative of local Fire,Building, Planning or Police jurisdiction.3. Owner, contractor, employees and agents shall comply with all Federal, State and locallaws, ordinances, regulations and enactments.4. This permit may be suspended or revoked by this Department for sufficient cause.5. A 48-hour notice shall be given before inspection, and a fee may be assessed if a24-hournotice is not received to cancel an inspection.6. Al1 tests must be witnessed by this Department.7. Holiday tests or soap tests must be performed at the time of installation in excavation.8. A11 monitoring devices must be tested.9. All primary and secondary containment on tanks and product lines shall be tested.10. All tanks must have overspill protection.11. This Department must witness tanks being placed in the excavation.FORMS\USTUNSTLALT. PMTr2t94A DEPARTMENT OF THE SAN LUIS OBISPO COUNTY HEALTH AGENCY IA d IUIUIl-acility Name and Location:( {'^liSAN LUlS OBISPO COUNTYAppfrcatlon for Pernit f,o ConstructLJndergiound liazardous l'laterials Storage Tank(/ 9uTIV- t-Z tz4^h,!t9 ci0t970)rr€,bAGa-ct</lRecelpt /lPerrnicJl(ot& qol.,actJOWNER: Name !7tcl4ail ing Address :consEr \rc t:r on(plry.sical ) Addrcss:4OPEMTOR: Name:T'el ePhone:CONTRACTOR: Name:License: Class:TYPE OF CONSTRUCTION:Construccion New Tank\^JN6Repair Existtng Tankconract &.oK"X lnftZNo4ephone:Concact:1ot4 C:HltM(€?-Hai-ling Address:Uf 6+'11$0 &hr"!bt.t | &t4 V'eznJJ , *xKpl/r,n qM83o4ol-44\Fou6$TA.{-ContaCt:Le\JwfMailing Address, [o?ot Rrv_EKerpa pF.' rrlogrtl ri'ot-t-Ywop , cl-4lbtcz-lielephone:1bz'ct7cblNumber:LAqztoDescribe cank(s) Co be consErucEed, include secondary conEainmenr; Ieak detector systeEioverfill protectlon; and materials to be stored:cr,o4CtAl)'boJff,ILr"1 t6N000N-7VATTACH PLOT PI,AN SIiOWING:Tarrk(s) Double-Contained PipingScaI.eProperty l.inesSlgnacure, Tit1e of Applicant:t(QoJeafCHnn,,l Date:a?*4 w.U,Mt.l.wI lOoatme+t INcLeak Detection SystemOverfilI Protection SYstemExisting EquipuenE/t/ta'dHIIU3H 'dINN3 O] OlSBZ:TT v66l-ZB-)Zg 805-78 1 -5544Facility NFacility AddCOUNTY OF SAN LUIS OBISPO HEALTH DEPARTMENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406Routine lnspectionReinspection No.Complaint I nvestigationHAZARDOUS MATERIAL/UNDERGROUND STORAGE TANK/WASTE GENERATORINSPECTION REPORT/NOTICE OF VIOLATIONi\:; i' ') :,/l,l,r 1l'Contact PeTitle/Position,l)2HAZARDOUS MATERIALSP#UNDERGROUND STORAGE TANKS (COMP #H&S Code, Div. 20,H&S Code, Div. 20, Chap. 6.7)BUSINESS I.D. FORMATt.GENERAL3. Location of4. Hazardous material & amounts ITANK CLOSUREMaterial stored in proper containers& labelednot storedcontainmentPLOT PLAN8. Plotsubmitted9.streets &10. Location of hmaterials11. Fire extisource12. Emshut-off13. Location & verification of MSDS14.and/or storm drains15.areaifications inEMERGENCY RESPONSE PLAN17uate18.uate evacuationures't9.TBAININPROCEDURESThe above marked items represent violations of the California Health & Safety Code and the California Code ofRegulations and must be corrected.COMM5.6.7.bll containment37ishers36. Fire90d35.not stored34. lncomMaterial stored in proper containers& labeled32.3130. Waste oil recei29. Manifestsnsand/or28. Varia27. EPA identification numberGENtakenSoil samrinsedTanksabandonment26. Removal/inclosure25.24.23. Leak detectorsl.'' *22. Precision tank testreconciliation21. Inumber20. Permit tobtT// ',t1I-i 'r"i 5P,",'4'tLl .AIt)lj'.,'i rllnspector's SigOwner/Operator Signatu[,; i.l C i..'NOTE: Signature indicates receipt of this document onlyIan admission of the facts.Page- of- irAssociotes. lnc.?t5t Alctaandro Drna. Suite 2fit 'Will'da, Califomra 9S0t(809t e4l-0555 FAX {405} 64r$580F'ACSIMILE MESSAGEDate:3--qsnl{l$6r sf Fr0ar [dsdrE c6t[f drritArre?o:n{TFlnnlln D.p*lsohnl S ho lte zFax Numben(a5 lgl qail-lhu L.,Sr*n Luis0bl:lortlls oSAtin.:From:Reference: Project NamcProJedComrnents:IC tt Pt s N e!-isor.l - "o" (pq as€{1IF YOU OO NOT RECEIVE THE CORRECT OUANTITY OF PAGES OR THETRAHSMISSION AUALIfY IS NOTACCEPTABLE, PLEiSE NOTIFV US Al 80 .6$41n6555, OR 8Y F$( AT 805€41{560. THANK YOU,?L 1.r to\ ?tz G* rYr llb 87t$22>A Su0sidis4, ol Anet|r;an Tesling and Eagineering CorpordlionOl{ices n Meiot U.S. Ctlir.s/Sincd 1958ConsuttlnE E nvircnmtnlal. Geatechnicat andMeteiltls Eaotnce'leI0 'd0gqsltgg08 '0N xHcHUNJNTA CTJV BZ:ZI IUI E6-FZ-UUII I{AR-24-95 FRI 12129 ATEC VENTURA r lli 'i r 'i !! 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(-' L:] rgf larrl;,1 !rrrrr.r,lqpl lrrll0fOO trrrqil13 auortraqfl,qg rrll'qol urrlttt0E par,ttRrnt olpo Dsduie$ epq $t luq;x I 'Jl rrtute : oonqrrarf ele{l : oorcp rorfol4 I eitlofi1 Ursllg : ./t lc$lild iC o4t E rlln 0?ogrgtog : $lun ; Fcqleg[ : qrl9u[ 9l 1flsr U tx rraf pf,gg4rupru on;rs r 0e HAR-Z4-gb FRI 12131 ATEC VENTURA )0 FA}( N0, 8056416560 P, 06 t o0rd ri ("'f$, . s6/g7/g ,, ealeire nel : *cqnir srst/t *+T,flrrrpf rye ilrl'ra 0*tv r-to'rrc s.rTlSlH {Jrsr!91....1$ r 0e rl+rr;lo1 6or,1 fvtw €I ''r IOI!3rrtr I ( role-rorlU l 'ttg:ufl lretA|ltrru ele$ gayhrmg e1p,.1 Of lile'13 # (fl egurEg : Darslr?r 4l*il : flrrafil l$ofor4 : rrtrrlil luela.J 'f rlilor{ tiJ Ot'|.. llrw U!0t l:ra;r.'t W.ll0l, : tl$n ! iloisffi : rt$311f 56fl{560P, 04v,FIt{se9."b$eItrgeee3st;j#!i ,fiF;;$.;i:rt(ft*H{R-24-95 FRI 12:30 ATEr{TENTURAIFAX NO, 8O*arr}s9*$FDeegEgct..ts2.8egroj$ n $ $$ n $ $$r$$$ s $ fi$s$$$'$$I$ir$$r$lIfi$$$o2artRff.::Fg,h;BEthl-cpRu,LbctEgEIT('ts$$i ilgH[iti;S 8O1 Sll{Gasoerel/SAZOFTEXi RESULTSDfrI'r\)*sI(o(tl'Tlfrt9OJD-{rrlc)b-;1-lfrDco-(=(tl-\oJLst-1(li)(.'1G)O:1r(=(.'14F eqilri 4 ;Clieflt ltitil!'E 'ffilIaru;Dac Recisrsd:$rnDh D fCfiart EDme SarpldDgbAMSrmmcTokgtegthtftsnsrcXt'bncCrsdhe;.i1'sl -a-r.r.i I t-i9-CTt02-i'.TEChclficBef Sm his0bisG3"215!ilm822{sP-tgtz:Ltw3'?*1e533eruz€se.z3lzat,s-'3ft2rg5ltgGIZe-?gF€3n2l953na€$+?a'i:,r'.t :14sthoCilrits :sGl2240sF43/22lgn?tAilt#SeiISTocKptLE$c.15i902twjt(gllgBzl€sPs3I2ZIW3r22S-S5I323Io3249}3920121S0&n4t ?1r{Dr0 10t{o96NDzoc 6524?7T ND4Wb{.-rntrc'TlD><P?00*-ff-' r'. . -acrtt ^Frye1 HAR-24-95 FRI 14:39ATEI iTENTURAGE Frojrcr rt :Cllsnt llrns :Prqhs-t'.1|rmc :Ootc iisiGvcd :8o2OM rgi.g:ftrr Rsur..rE.GfrO.e'felic'Profaa hil Srrtrlrrgo;,po.ylt/g[FA}( N0, 8056416560. /'-iP, 0trlrrth :tlbdroif :Unlb:$oil9Olef,! pi66.,gm0rXeOquple lGr fClierrr tD:D.tr CfrnpodDtte AltdyredDITSEILlborgtory Dircrr:lor,h,TU:u*r4)Greg'l{irianllD .,NDOKPogt'it'Fex Note 7671Mrttlri\L{Q(p'it:ButlADirpzrq''l{ .gt33/96gtnp,st&fb'sf-t3EgrgriseeigoAccotnpnruyirr3 rh A r>15 eor (.rt.{-e.\ .D is r eclo.rdnrt A P s+,r1{-"Fi rs*].\\Phone fiPhonoCo.ffi5 Nkri r'.trnl>2Fegr I iJIIIxIxIxIxIxIxIxIxIxIxIxIxII{AR-'lIIII24-95 FRI 14r40 ATEQ^u61'llUgPsotirtr,ls otrFtarrl*i an3- ? 3.qf,ellrqboLflt irFA}{ N0, 8056416560/--\(LP. 02tNxIxIXIxIsPtlaxt,UJc(Jzo{JatdSPftx-x-xStocKpile.szxssqjIfrxIxlsrzl9x,tIsFlIHL,IatrtIooDIIoC\(hi'goo\s- -o\\otoKGFSIII,OKGas+ec..t\o,1x,,lo.{Totroo{nDjeselS I = san;.tca ^rumb{.r tLocali6n-|la-cHlF+gu.e. l_sr*e PtnJ d/San Plc /ocaliorre;sCrri BRIAN F. ZITAAnch itectJOHN W. JOHNSONAnchit6ctJOHN B. HICKSAnchitectCECIL N. SPENCERA.chitectJAMES H, FIAYCivil EngineenAN ESSP COMPANYFIOBEFIT H. LEE A AsiSOGTATEsi, TI\IG.ANGHITECTURE ENGINEEBING ' ENVIRONMENTAL SERVICES1137 NoFITH McDOWELL BOULEVARD . PETALUMA, CALIFOFINIA 94954-1 11O (7O7J 765-1660Mailing Addness: P.O. Box 75O9OA, Petaluma, CA 94S75-O9OA Fax (7O7) 765-9904December 19, 1994Mr. John ScholtesSAN LI]IS OBISPO COUNTYDEPARTMENT OF ENVIRONMBNTAL HEALTH2156 Sierra WaySan Luis Obispo, California 93401UNDERGROUND STORAGB TANK REPLACEMBNTPACIFIC BELL196 SUBURBAN STRBBTSAN LUIS OBISPORHL JOB #9022.20Dear Mr. Scholtes,On behalf of PACIFIC BELL, we are submitting applications for UST Removal and USTInstallation Permits for the above subject site.The application for Permit to Abandon is for the removal of (1) 4,000 gallon Diesel Fueland (2) 10,000 gallon Gasoline underground storage tanks, (2) dispensers and associatedpiping and equipment.The application for Permit to Construct is for (l) new 6,000 (Gasoline)/4,000 (Diesel)gallon Dual Compartment underground storage tank, (l) dispenser all associated pipingand equipment.The Contractor for this project is A.E. Schmidt Environmental, Mr. Jerry Levitt(818) 762-2797, 1,0701 Riverside Drive, North Hollywood, CA 91602. (see attachedLicense and certificates)They will be picking up the approved permits, at that time they will present all otherappropriate licenses and certifications.The Environmental Consultant will be Ninyo & Moore, Mr. David Shaler,(7I4) 472-5444,9272 Jeronimo Road, Suite 1234, Irvine, CA92718, they will obtainthe soil samples and will have a on site Mobil Lab provided by GeoTest, Mr. MargaretMooradian, 1-800-332-5376,P.O. Box 90911, Long Beach, CA 90809.Enclosed are (4) sets of Plans (2) for the UST Removal Permit and (2) for the USTInstallation Permit, Removal and Installation Permit applications with State A & B formsand a check for $967.00 (nine hundred sixty seven clollars and 00/100 cents), which is$180.00 for the Removal and $787.00 for the Installation Permit fees.aTJMANIETTA, GASACFIAMENTO, CALA HABRA, CA , t.,page2 ofzMr. John ScholtesDecember 19, 1994Per our previous conversation you stated that this site was in the jurisdiction of the Cityof San Luis Obispo Fire Department, after contacting Mr. Spencer Meyer of the FireDepartment he stated that area of the city is in the County jurisdiction.I have already submitted to San Luis Obispo County A.P.C.D. and contacted the Cityof San Luis Obispo Building Department for information and permit requirements.Please contact me if any additional information and/or fees are required at this time.Very truly yours,ROBERT H. LEE & ASSOCIATES, INCTracy W. LumProject Job CaptainenclosuresTIC'BEFT H. LEE E ASSC'CIATEE' !NG.-!, 805-78 1 -5544/-r{COUNTY OF SAN LUIS OBISPO HEALTH DEPARTMENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406Routine lnspectionheinspection No.Complaint lnvestigationHAZARDOUS MATERIAL/UNDERGROUND STORAGE TANK/WASTE GENERATORINSPECTION REPORT/NOTICE OF VIOLATIONcontainment37.36. Fire-9035. Stobles not stored34.& labeled33. Material stored in proper containers32.ram/records3130. Waste oil29. Manifests28. Variances and/or27. EPA identification numberWASTE GENERATORStakenSoilTanks rinsedabandonmentclosure25.24.23. Leak detectors22. Precision tank testreconciliation21. I20. Permit toViol2Facility NameDate7z-Facility AddressContactTitle/Position#UNDERGROUND STORAGE TANKS (COMP #(CA H&S Code, Div. 20, Chap. 6.7)BUSINESS I.D. FORMATLGENERALnumber3. LocationutilitiesINVENTORY4. Hazardous material & amounts listedTANK CLOSURE5. Material stored in proper containers& labeled6. lncomnot storedcontainment11L7.PlotsubmittedPLANbuildi10. Location of hazardous materialsFisourceshut-off switches13. Location & verification of MSDS'14. Sewerand/orareatons tnEMERGENCY RESPONSE PLAN17.ate emeures18.evacuation'19.TRAINING PROCEDURESThe above marked items represent violations of the California Health & Safety Code and the California Code ofL12.15.Regulations and must beCOMMEa0(i.l._A-r-\c4^lnspector's SignatOwner/Operator SignNOTE: Signature indicatespt of this document only and not an admission of the facts.e^s" I ot)- DEC-22-1994 Z9:47r'.o co ENUIR. HEALTH\ Application for Permit to Abandon f-'Undsrground Hazardous Materials Storage Tanks-. :r*.LICLweg@re.*itr@4FACILITY: Name and Locatio " ?.&aeV ' 6gU -.t4OWNER: Name:el r,)-Contact:Mailing Addressturercpnone:L?,rA)44-'4b,OPERATOR: Name:?lcContact:{ov1Itffieq2'{tA2 OAvloNI?tqJJ. *Al-lilMailing Address:Telephone:(eo) 4ot-44c1bVI6FrtA4-'CONTRACTOR:Name: A'e'%rtM IDT ExrvlFoNTelephone:lut2r11bz-TIq7Mailing Address:License: Class:ArOg-' C%lNumber lq2.lDTYPE OF ABANDOMENT: Removal y' Abandon in ptace .- . TDescribe unk(s) involved, include what tank is made of, size, etc.Previous or existing contents: tIgQ to,mo &uNet) 4,N&who will be doing required sampling? , N rlYO * Maofe -' ' "' ' - 'Find disposition of rank(s)gxru€V l. Hauled off site not cleanedTo State Permined FacilitY%w.sna-DgpffieeHazardous Waste2. Cleaned and hauled off sire to metal salvager'Tank Cleaning Co-:Metd SalvageCo.:3. Cleaned and used aboveground' Tank Cleaning C'o': -Hazardous Waste Hauler: . 'NumberAddress where tank(s) will be reused and intented use of:-appabandTOTAL P.A1 o**Hc4lfACHIEVEMENTTHIS CERTIFIES THATMARLON GRHRING of A TS|HMIDT ENVIRCNMINTAiIS AWARDED THIS CERTIFICATE FOR SUCCESSFUTLY COIUPTETIilG THEMODEFN WETDITTIG TANK INSTATTERS INSTRUCTIOI{ TESTAWARDED THIS ,,68h OAy OF, 4,D., 19 tt -LT PRE/PT-nAtrt3:'m:(<<D72cF;af':\o-ulAc..-a<|JrInE-T;TI-{DTc3D1lOzmLzaPVFoiP. 1lTD {T(,rl(DOa_gv'',8,.iij.Iu ))"t*HG4r"ACHIEVEMENTTHIS CERTIFIES THATERAD B0l'lEN of AE SCHMIIIENVI RONUENTALIS AUI'ARDED TIIIS CERTIFICATE FOR SUCCESSFULTY COMPIENilG THEIUIODERN WELDING TAIUK INSTALLERS IIUSTRUCTIOTU TESTAfinRDED THIS _-ttu__ DAy OF, A'D." tg 95. ..,.,VICE PRESIDENT/PLANT I,IRNAGERT1Act3;Zt-cTio-$sil.ZraF:-a=rrDp2-:-T]ril--JDT.C3f)TI(fzLrF?"tr(DtsFlI)@s{oor.ul :_a vtladi=llm "**1Tc4 rrACHIEVEMENTTHIS CERTIFIES THATCLENN SVIRONMENTAIIS AUUARDED THIS CERTIFICATE FOR SUCCESSFULLY CONfrPLETI'UG THEI'IODERN WELDING TANK TNSTALLERS INSTRUCTION TESTAWABDED THISrthDAV OF, A,D., tg g5modeVICT PRESIDENT/PLANT MANAGERTlno3;z!r+72tsF,=s3rPAtr:'CB6nOItr-;rrl{DTc3D.Itfritt(<ZDoz.;"trG)ts}JU!(D|o(t{o(l\aSr,8q31) JRN 18 '95 14:44 R.H.FRTI'I : EN\IIROhICNTH. DIUISIO{LZt2Ellgg{ t6:54 o6s_('atrlllil.r'$il {;l.I't:.rl.{r!s{rtdlll lrlatrratl. r lI il[ .ri0(rARll.lr.1 lrl+$'Ilr./ll0tfi{;t:tl{tl;-ls rrtn Gar. Sr?lf)rr:crrtbrrr 2R. tg*lL. PETSLUI'1Agf=;ossr*JAr'r,16.1995 fr:i?En ? 2Fa. : 818 "5 5aa6PACE Orlulitoltru,q+|(t;t6ltt Ar$llf,tlRr'r;t8.lKlnq.il!.1r. I: rtlrorfi.J'lfllS3?'7l,ilt'ANsr$.ttuitsIX:n |rStrllfr'Tr',|'AiIES LWHELI'ENOISTRICT MANAGERiirAriw.t Cldtlc*airltlfrlllrryr.DcrrJcny.Thir laner ir to confirm Unr thr bdow liRcd cmploycog of A. E. Schmidt Envirsnmcntal hrvcnccivcd on U;iob train'rng igrha prolrr in.tr[dlioh of Envirollcx rluuble wall pping arrd hrvenrruiyrnl r;crtifir'.rlcr to thaactfect fiowt Total Coilainrncrrt. luurlxuttrctlMarlon Grhrin6,AntcnioCrrrir.Vm Rcgli,Bnd Pswcr.mdGlen SmithJrtry lgvittrt.6. Schmid Erwironmcnbl1639 Serkoy $rcsrVsn nuyt,CdifomiaRE Blvimflar miniogSirnrl:ly,Whcld:ntvlrnngar,TCl IcesHc4}6.ACHIEVEfUIEITITTHIS CERTIFIES THATANTONIO GARCIA of AE5CHMI DT ENVIR0tIMEt'iTALls ATUARDED THIS CEBTIFICATE FOR SUCCESSFULLY COIUPTENilG THEN'IODERN WELDING TANK INSTALLERS INSTRUCTION TESTAWABDED THIS6thDAY OFJanuaryD', 1995-aaVIPRESIDINT/PLANT I.I$iIAGERnnc]3;ib.2!af':s)?PA]o<m0rCI2r;rtl{]Drcn'uAaLFFF"F(DFFU:tlluUA.mi3TAH..(,AAF o*s$c4 l€ACHIEVEMENTTHIS CERTIFIES THATROBJE E RATLiFT of A T SCHMIDT ENVIRONMENTALIS AWAFDED THIS CERTTFICATE FOR SUCCESSFULLY COMPLENn|G T}IEII'IODERN WETDING TANK INSTATLERS INSTRUCTION TESTAWARDED THIS6thDAY OF, 4.D., 1395VICE PRESIDENTT I'IANAGER1]xlo3m€tn1El**sfit3,ixjuet:rn9nEit--un--tnt-cDToftC{ZDoz't': 6l(Dets| tllts$(I](nr0r('l ..A bJJ5\Js) 0)3'1'i^l A Cafifornia nLsional Water Quality C;ntrol BoardCentral Coast RegionArnold SchwarzeneggerTerry TamminenSecretary forEnvironmentalProtectionGovernorInternet Address: http://www.swrcb.ca.gov/rwqcb3895 Aerovista Place, Suite l0l, San Luis Obispo, Califomia 93401Phone (805) s49-3147 . FAX (805) 543-0397April29,2004Mr. Garry HoldgraferHoldgrafer & Associates245 TankFarm Road, Unit ASan Luis Obispo, CA 93401Dear Mr. Holdgrafer:UST: RESPONSE TO CASE CLOSURE REVIEW OF 196 SUBURBAN ROAD, SANLUIS OBISPO COUNTY; SBC / PACIFIC BELL FACILITY (RWQCB CASE NO. 3s18)Thank you for commenting on the proposed case closure of the above referenced undergroundstorage tank site. Regional Board staff has reviewed your cornments and concluded that the caseis appropriate for closure. The Regional Board will review staffs recommendation for siteclosure and provide direction at the Board's May 14,2004 meeting in San Luis Obispo. unlesssignificant objections are raised the case will be closed and a "no further action" letter will beissued for the site.As you know the area-wide methyl tertiary-butyl ether (MTBE) source investigation began inSeptember 2002, at the direction of Regional Board staff after notification by the County HealthDepartment of three small public water system wells where low levels of MTBE had beendetected. These wells are identified as Holdgrafer Well No. 1, located approximately 800 feeteast/southeast; Whitson Well No. 1, located approximately 1,,200 feet northeast and CopelandDistribution Center Well No. I located approximately 800 feet south of the site. The most recentMTBE sample results for the three water wells identified above are 8.8 trtglL,2.3 pglL, and 0.66pgll-, respectively. The Holdgrafer and Whitson wells continue to be sampled quarterly forMTBE. In addition, the nearest active water well is located on the site and is approximately 300feet northeast of the former UST location. This well is currently used for irrigation and firesuppression, and was sampled for MTBE in October 2002, as part of an area-wide MTBEinvestigation. Results of that sample event found MTBE to be non-detect (< 0.5 pdl,). Regionalgroundwater flow direction is generally west / southwest. The maximum contaminant level(MCL) or primary drinking water standard for MTBE is 13 pgll.The Pacific Bell leaking UST case was opened in June 2003 following the removal of a 10,000-gallon dual-compartment (gasoline and diesel) UST and associated product dispenser islands,piping and approximately 160 cubic yards of contaminated soil. Initial soil samples detected upto 6.6 milligrams per kilogram (mglkg) TPH-d, and 0.0067 mg/kg MTBE, and subsequentinvestigation in January 2004, required installation of fifteen temporary groundwater monitoringwells. Depth to groundwater was observed from 13 to 15 feet below ground surface (bgs).Groundwater sample analysis detected total petroleum hydrocarbons reported as diesel (TPH-d)at a maximum of 2,600 pgL. In addition, MTBE was detected at one location at 1.1 pgll.. NoC alifo r n ia E nv iro nm e ntal Protectio n Ag en cy€3Recycled Paper Mr. Garry HoldgraferLpril29,2004detectable levels of TPH reported as gasoline, benzene, toluene, ethylbenzene, or xylenes(BTEX) were observed, except at two locations with xylenes at 1 .9 ttdL and 2.8 VgL. Atotal ofthirty (30) soil samples were also analyzed for TPH-d, TPH-g, BTEX and fuel oxygenates, and allsoil results were below action limits.The recommendation for closure is based on the following: (1) contaminant mass has beenremoved, (2) remaining groundwater concentration above WQOs is localized in extent, (3) eventhough the concentration of TPH-d is above the WQO, it is only slightly above, and attainmentof the WQO is imminent through natural biological processes, (4) and the site assessment datadoes not support that the Pacific Bell site is a significant MTBE source or that the site hasimpacted adjacent small water well systems. Closure is also consistent with Section III.G. ofState Board Resolution No. 92-49, allowing the consideration of cost effective abatementmeasures for a site where attainment of reasonable objectives less stringent than backgroundwater quality does not unreasonably affect present or anticipated beneficial uses of groundwater,and will not result in water quality less than that prescribed by the Basin Plan.The Pacific Bell site does not appear to be a source of the MTBE detected during the area-wideinvestigation, which has impacted the three wells of concern. The cause of the MTBE detectionsin these wells has not been determined; however, staff will continue to investigate other possiblesources for the release to groundwater in this area.If you have any questions, please contact Corev Walsh at (80$ 542-4781.Sincerely,ftpW. BriggsExecutive OflicerS:\UST\Regulated Sites\San Luis Obispo Co\San Luis Obispo\l96 Suburban\Response.doccc:2Mr. Rob DelnagroShaw Environmental, Inc4005 Port Chicago IIwyConcord, CA94520Mr. Kerry BoyleCity of San Luis ObispoCity Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA 93401-5240Mr. & Mrs. John & Linda Whitson1216 Oceanaire DriveSan Luis Obispo, CA 934054918Mr. James StehrSBC / Pacific BellP.O. Box 5095, Room 3E000PSan Ramon, CA 94583-0995C alifo rnia E nviro n mental Prot ectio n Agen cy€Recycled Paper g Cafifornia nfiiorral Water Quality Control BoardCentral Coast RegionTerry TamminenSecrelaryforEnvironmentalProtectionArnold SchwarzeneggerGovernorIntemet Address: http://wwrv.swrcb.ca.gov/rwqcb3895 Aerovista Place, Suite l0l, San Luis Obispo, Califomia 93401Phone (805) s49-3147 . FAX (805) 5434397March 24,2004SBC / Pacific BellMr. Andy TaylorP.O. Box 5095, Room 3E000PSan Ramon, CA 94583-0995Dear Mr. Taylor:UGT: 196 SUBURBA|I ROAD, SAI\ LUIS OBISPO COUNTY; SBC / PACIFIC BELLFACTLTTY - CASE CLOSURE REVIEW (RWQCB CASE NO. 3s18)Regional Board staff has reviewed Shaw Environmental, Inc. (Shaw) February 2004, SensitiveReceptor Survey, and February 2004, Site Characterization Report for the undergtound storagetank (UST) site referenced above. Thank you for submitting the requested reports; Temporarygroundwater monitoring well sample results indicate total petroleum hydrocaibons reported asdiesel (TPH-d) at a maximum of 2,600 micrograms per liter (Wdl-) and methyl tertiary-butylether (MTBE) at 1.1 pgL. Initial soil samples collected under City of San Luis Obispo FireDepartment direction detected up to 6.6 milligrams per kilogram (mg/kg) TPH-d, and 0.0067mg/kg MTBE. The site is an inactive Pacific Bell fleet fueling facility, where one 8,000-ga11onsplit-wall gasoline/diesel UST and associated piping and fuel dispensing equipment wererecently removed. During the UST system removal, approximately 160 cubic yards ofcontaminated soil were excavated and disposed off-site.Regional Board staff has reviewed your cirse file and will recommend the site for closure at theRegional Board's May 14, 2004 meeting in San Luis Obispo. Unless significant objections areraised the case will be closed and a "no further action" letter will be issued for the site pursuantto section 272L(e) of Title 23 of the Califomia Underground Storage Tank Regulations andsubdivision (g) of section25296.l0 of the Health and Safety Code.The subject site lies within the San Luis Obispo Creek Hydrologic Subarea of the Estero BayHydrologic Unit (310.24). The "Water Quality Control Plan, Central Coast Region" (BasinPlan) designates this groundwater as having beneficial uses for domestic and municipal supply,agricultural supply, and industrial supply. Therefore, the pertinent water quality objectives(WQOs) for this site are as follows: 1,000 pglL, - TPH, I pglL -beruene,150 pgll- - toluene,300 pgll, - ethylbenzene, 1,750 $elL - xylenes, and 5 VglL - MTBE. The WQOs for MTBEand TPH have been established based on taste and odor thresholds.Staff recommends closure for this site based on the following: (1) the contaminant mass has beenremoved, (2) the remaining groundwater concentration above WQOs is localized, (3) and eventhough the concentration of TPH-d is above the WQO it is only slightly above, and attainment ofCalifornia Environm ental P rotection Agen cy€Recycled Pawr t,\,ii, i ; 11!,1 t'1, rt: i,i .';'',,t:, ;, :'| :I,,l1'f I :tri:r.r.i:,'ri September 20,2004 Kerry Boyle Hazardous Materials Coordinator San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CA 93401 Dear Mr. Boyle: Pacific Bell recently completed an internal audit of underground storage tank compliance in your jurisdiction. According to our records, all of the company's USTs in your jurisdiction are in full compliance with the UST laws. For your information, I've enclosed a spreadsheet showing the results of our internal audit. Please feel free to give me a call at 925-823-6161 if you have any questions about this letter or the enclosure. Sincerely, rcL Andrew M. Taylor Senior Environmental Manager SBC Environmental Management l1b h'il'4,ti^^ lJd . CD z Status, UST present on Ll2OO2 Address : E (! a!: I g. t 0 t> IAlolf h.lo lil'(b t<loEI CUPA 6 Nao z z Date of Most Recent UST permlt Fee Remittance of Current UST permit Receipt by EM im @ @ o Dispenser Containment requlred only for fuel pply Plping Secondary rn Plping Secondary of Test(s) Contractor Space Sump SumF facillties lnstallation Date Inoculation Date !iot s D. ob D.Eo aq I! o oo!!r: JoI zo oI n<o> n o {<m I a/-1oo o !9.mx6:ra ^<p - H-ggq J6 NOb2N6'B.E OoIO 6a 95o*o6Ei+o @@o@@ -.1co n+doi-zl-<F ca@ do .o 5' a-coo f,o{ c 3E!,p. 5'I D a d- td l,fo o fo o oa =6o a @ @@@ o J@ :. of,o =o =oE9 Oofo -qgo- co 6d o 3o t o o e go ot o E6l oIo o' po =. ='o 6'o oo366zo U, @cn @ zvI (t z-c6o @6T Repair Performed Permit Requlred for Repairs lu IDEE Repalr Contractor ELD Installatlon Date ELD Inoculatlon Date ELD Sampling Date ELD Analysis Date ELD Report,Dit6 (Tracer - Month tf Report) lLD Report Transmittal Date by fracer Research fracer Tank ID No, & Result +o 3ooo oo N olioo o 3-a q. oa d oo IL lE F.l6lololo l3E lol5lolololo t6la ls t6 P uioI s.gt- ou 6'!o a\\t Ut!t 0l TIoI Shaw Environmental & lnfrastructure, lnc 4005 Port Chicago Highway Concord, CA 94520-1 120 925,288.9898 Fax 925.288.0888 The Shaw Group lnc.* November 25,2002 Mr. Kerry Boyle City of San Luis Obispo Fire Department 2160 Santa Barbaru Avenue San Luis Obispo, California 93401 Subject:Scope of Work for Proposed Temporary UST Closu.re Activities, Pacific Bell Facility, 196 Suburban Road, San Luis Obispo, California Dear Mr. Boyle: On behalf of Pacific Bell, Shaw Environmental lnc. (Shaw) is pleased to present this scope of work pertaining to proposed temporary underground storage tank (UST) closure activities at the above-mentioned Pacific Bell facility. There is a split-wall UST containing gasoline and diesel at the site that Pacific Bell would like to take out of service pending future retnoval (F'igure 1). The following scope of work details anticipated closure activities to be performed in order to meet the State of California Code of Regulations Title 23, Division 3, Chapter 16, Section 267 [ UST temporary closure regulations and the City of San Luis Obispo Fire Department closure requirements. Copies of the State of California lorms are included in Attachment 1. Scope of Work Prior to temporary closure actir.ities, Pacific Bell will arrange for the removal of any fuels within the UST system. Prior to performing any work, Shaw personnel and their subcontractors will review the health and safety plan (Attachment 2). The UST and associated piping will then be triple-rinsed by a hazardous-certified subcontractor using a hot-pressure washer and detergent in order to remove any residual liquids, solids, or sludge. Following rinsing, the tank will be visually inspected to ensure all liquids, solids, or sludge have been removed. The rinsate will then be transported off-site under ahazardous waste manifest to Romic Environmental Technologies Corporation in East Palo Alto, California for recycling. A copy of the rinsate manifest will be forwarded to the City of San Luis Obispo Fire Department upon receipt. Following rinsing activities, the atmosphere of the tank will be inerted using dry ice at arate of approximately 20 pounds per 1,00O-gallons capacity. After approximately 15 minutes, the lower explosive limits (LEL) and oxygen concentrations will be measured. Once the LEL and oxygen concentrations are below L\o/o, the tank access ports will be sealed using locking caps. The vent pipe will not be sealed per UST temporary closure requirements. The power will then be disconnected from the fuel dispensers and locked out. The existing tank monitoring system will remain operational. Mr. Kerry Boyle November 25,2002 Page2 Prior to performing field activities, the City of San Luis Obispo Fire Department will be notified at least 48 hours in advance to witness temporary closure activities. Every three months, a visual inspection will be performed in order to document the tank is still out of operation, locks are still in place, and no fuels have been added. Atmospheric readings will then be measured inside the UST to ensure the LEL and oxygen concentrations remain below l0%. A copy of the monitoring form is included in Attachment 3. If you have any questions or comments, please do not hesitate to contact me at (925) 288-2103. Sincerely, Shaw Environmental, Inc. Rob Technical Task cc; Mr. Andrew Taylor, SBC Pacific Bell Attachments: Figure 1 - Site Plan with UST Location Attachment I - State of Califomia Forms Attachment 2 -Health and Safety Plan Attachment 3 - Quarterly Monitoring Form 905-9'91 FIGURE ATTAGHMENT 1 STATE OF CALIFORNIA FORMS UNDERGROUND STORAGE TANKS . TNCU,TTY (one page per site) Page I]NIF'IED PROGRAM CONSOI,IDATED FORM TANKS \"[_ TYPEOFACTION D I.NEWSITEPERMIT (Check one item only) E 3. REI.{EWAL PERMIT N 4, AMENDED PERMIT U T,PERMANENTLY CLOSED SITE ! S,TANKREMOVED 400F&TEMPORARY SITE CLOSURE E 5.CHANGE OF INFORMATION speciS change local use only I. FACILITY / SITE INFORMA'TION FACILITY ID#BUSINESS NAME (same 6 FACILITY NAME or DBA - Doins Business As) 3 Qqr,.Gr>{2,,[\ (tarnV STREET *rauc'Ce.. *'LtfNEAREST CROSS 401 FACILITY OWNER TYPE S.r. conrone,rtoN E z. ntorvrouel E r.pRRrNensHIp IJ 4. LOCAL AGENCY/DISTRICT* E s. couNrv AGENCY* E o. srnrp AGENcY* I z. relpnRl- AGENCY+ 402 BUSTNESS 'E I, GAS SIATION E:. TNNTU I-I 5. COMMERCIAL E z. orsrRrsuroR E 4. PRocEssoRftt.OTHER 403TYPE *lfowner ofUST is a public agency: name ofsuperuisor ofdivision, section or office which operates the UST (This is the contact person for the tank records.) 406 Is facility on Indian Reservation or trustlands? ! v... S.yo 405 TOTALNUMBER OF TANKS REMAINING AT SITE I 404 II. PROPERTY OWNER INFORMATION azq Qol lqo\PHONE 408PROPERTY OWNER NAME QaerRr- g.-l\4Ut ?ofux- WS', Lrn39rc,a MAILING OR STREET ADDRESS 409 STATE ZIP CODEqq 6. STATE AGENCY2. INDIVIDUALOWNER TYPE E z. peosnel AGENCYfl l. penrNensHlp 410 412CITY3 CORPORATION 4135. COUNTY AGENCY 4. LOCAL / DISTRICT III. TANK OWNER INFORMATION OWNERNAME PHONE4t4 415 r;> aMAILING OR STREET ADDRESS c L STATE6 418 ZIP CODEQqs*b 419tttt 9o.., fda rnorn 4r7 rer.tr-owNEnrvpe Slt.coRPoRATIoN E 2. INDIVIDUAL E:. pnnrNgnsutp t] 4. LOCAL AGENCY / DISTRICT U 6. STATE AGENCY 420 trs.7. FEDERAL AGENCYAGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER \a I 322-9669 if 42tCallIaflseTY ffK) HO 44-Dt7 V. PETROLEUM UST FINANCIAL RESPONSIBILITY fl ro. r-ocel covr MECHANTSM EI ss.orHBR: 422 fr. srlr-rusunno LI 2-. GUARANTEE E:. rNsuRelice E +. suRervsoNo E z. srereru{o E s. lprren oF cREDIT E a. srRrs FUND & cFo LETTER E o. exnuprton E s. srA.re ruND & cD INDICATE METHOD(s) VI. LEGAL NOTIFICATION AND MAILING ADDRESS E t.re.c[trv Ee t*otu*t"otolu* E:.reNrow]rEnCheck one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank omer unless box I or 2 is checked.423 VII. APPLICANT SIGNATURE Certification - I certiS/ that the infomation provided herein is true and accumte to the best ofmy knowledge. Qz€ ZRk ztoS 425PHONE424DATE \\'Zto'02 TITLE OF APPLICANT Prt"z tn 6P- P ilcr hc Br.(L 427NAME-OF APPLICAff (print) R"( (f), \'-s,an^D 1998 UPGRADE CERTIFICATE NUMBER (For local use onlv)429NUVbfn (For local use only)428STATE UST FACILITY 8UPCF (l/99 revised)Formerly SWRCB Fonn A UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANKS _ TANT PAGE 1 TANKS n l NEw srrE PERMIT El : nrNrwaL prnvlt E + lvrupBo prnrralr E 5 CHANGE oF INFORMATION fl e rrrrArOnARY SITE CLOSURE E z prnuaNeNTLYCLosEDoN strE fl 8 TANKREMovED Page:Lol 5 430(Specify reason - forlocal use only) (Specify reasotr - for local us€ only) TYPE OF ACTION (Check one item only) 3 FACILITY ID:IBUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ?ee$t L (4t-tu LOCATION WITHIN SITE (optional)431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) 434COMPARTMENTALTZED rANK E(es E No If'Yes", complete one page for each compadmenl. TANK ID #432 TANK MANUFACTURER f(la")ura h)e,\Arae-, 433 TANK CAPACITY IN GALLONS 4J6 lo. al) (h.v-qaslil4.x^s NUMBER OF COMPARTMENTS 437zDATE INSTALLED (YEAR/MO) 43s \la1 aDDiTiilNer. DESCRIPTION (For rocar use only)438 II. TANK CONTENTS E s. rpr nuer- E 6. AvrATroN FUEL E gg. orHen PETROLEUM TYPE $qt. nrcur.e,nuNLEADED E Ib. PREMIUM 1JNLEADED E Ic. MIDGRADEUNLEADED E z. leeoBo E r. upsrr E +. casosor- 440 CAS# (from Hazardous Materials Inventory page )442 TANK USE MOTOR VEHICLE FUEL (lf marked complete Pelroleum Type) E z. toN-ruBr- PETROLEUM n 3. CHEMTCALPRODUCT [4, HAZARDoUSWASTE (lncludes Used Oil) E ss. rNrNowN 439 ry\ COMMON NAME llrom Hazardous Materials Inventory page)441 III. TANK CONSTRUCTION U3. SINCLEWALLWITH EXTERIOR MEMBRANE LINER E +. srcNrE wa.LL rN VAULT Ess. uNrNowN E ss. orHsn TYPE OF TANK (Check one item only) LI 5. SINGLE WALL WITH INTERNAL tsLADDER SYS'|EM d.a oou""P watt 443E I. SINGLE WALL U 3. FIBERGLASS/ PLASTIC E 4. STEEL CLAD WFIBERGLASS REINFORCED PLASTIC (FRP) IJ 5. CONCRETE [J 95. UNKNOWN E 8. FRpcoMprrBLE wl00% METHANoL ! ss. orHtn TANKMATERIAL primarytank F.L SenESfppf (checkoneitemonly) E z. sterNr-ess srnnt 444 TANK MATERIAL _ SCCONdAT IANK E I. BARE STEEL E 3. FIBERGLASS / PLASTIC (checkoneiiemonly) 82. STAINLESSSTenT p.qSTEELCLADWFIBERGLASS REINFORCED PLASTIC (FRP) E s. coucnrrr, u 5. coNcRETE lJ 9s. UNKNOWN D 8. FRpcoMpflBLEwl00%METHANOL E gq. orupn E 10. coATED srEEL 445 LI 95, LTNKNOWN E gg ornnn E I.RUBBERLINED E z,qxvo lmnqc ! 3. EPOXY LINING E 4 PHENOLIC LINTNG LI 5. GLASS LINING ffiuNrt*to (For local use only) 446 DATEINSTALLED 447TANK INTERIOR LINING OR COATING (Check one item only) OTHERCORROSION EIMANUFACTUREDCATHODIC PROTECTIONIFAPPLICABLE PROTECTION (check one item only) I z secnrnctel ANoDE tsLr, rr*cless REINFoRcED PLASTIc E + rurpnesseo cURRENT D 95 UNKNOWN ! gg orHpn (For local use only) 448 DATE INSTAI-I,ED 449 OVERFILL PROTECTION EQUIPMENT:YEAR INSTAtto Q I 6i.nto*r E 3 FILL TUBE sHUT oFF vALVE Ez nellrloer tr4EXEMPr 452YEARINSTALLED A1 4so CONTAINMENT I 'J F? Wj Slsrnr TYPE (local use only) 451SPILL AND OVERIILL (Check all that apply) DROP TUBE STRIKER PLATE IV, TANK LEAK DETECTION (A description of the monitoring program shall be submifted 1o the local agency.) IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) E t vrsual lslNGLE WALL rN VAULT oNLy) E coNrrNuous INTERSTTTTAL MONIToRINC Pt!."o*ot toNlroRlNG 454IF SINGLE WALL TANK (check all that apply) E I vrsuAl (EXPOSED PoRTroN ONLY) D z aurovarrc rANK GAUGING (Arc) E: coNrtxuous nrc D + srertsrtcal INVENToRy RECoNCILIATIoN (SIR) BIENNIAL TANK TESTING E 5 MANUAL TANK GAUGING (MTG) E o v,qposp zowe E 7 cRoUNDwATER E s raNrrrsrtNc E ss orunR 453 IV, TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE .Av"r E No TANK FILLED WITH INERT MATERIAL? 457ESTIMATED DATE LAST USED (YPJMO/DAY) l'L-o2- 455 ESTIMATED gallons OF SUBSTANCE REMAININC 456 UPCF (12199 revised)l0 Formerly SWRCB Form B UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANKS - TIN]< PAGE 1 TANKS E t New stts pEnvrr E + avrNoBo ppnrralr E 5 CHANGE oF INFORMATIoN E 3 REUEWaLpBnVn (Specifyreason-forlocaluseonly) (Specifyreason forlocaluseonly) PageZoft} 6.6 revronenY srrE cLosuRE E z pBnveNpNTLYcLosEDoN srrE D 8 TANKREMOVED 430 TYPE OF ACTION (Check one item only) BUSINESS NAME lsame m TACILITY NAME or DBA - Doing Business As) Qaot?rc RqLL 3 FACILITY ID: LOCATION WITHIN SITE loptional;431 L TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) COMPARTMEN'|ALIZED TANK lliYes lJ No If"Yes", complete one page for each compadment. 434TANK ID #432 TANK MANUFACTURER fl)operntJelDrna 433 NUMBER OF COMPARTMENTS 437 2^ DATE INSTALLED (YEAPJMO) 4]5 ztq<I qOOO (6. lc- aan l rl -V- d.s"fr 436TANK CAPACITY IN GALLONS , 438ADDITIONAL DESCRIPTION (For local use oniyl' II. TANK CONTENTS PETROLEUM TYPE E la. REGULART.JNLEADED D Ib. PREMIUM LINLEADED fl rc. vlocnaoEUNLEADED E z. lpeprp 6p1 orasrr, 84. cASoHoL E s. lsr runr E 6. AVTATTONFUEL E gg. orHnn 440 CAS# llrom ttazardous Materials Inventory page )442 TANK USE 43e p.qloron vEHICLE FUEL (lf marked complele Pelroleum Type) B z. NoN-TUBLPETROLEUM 83. CHEMICALPRoDUCT D+. HazannousWASTE (lncludes Used Oil) E ss. uNKNowN COMMON NAME (from Hazardous Materials Inventory page)441 III. TANK CONSTRUCTION TYPE OF TANK (Check one item only) LI 3. SINGLE WALL WITH EXTERIOR MEMBRANE LINER E +. srcur-p w.qLL rN vAULT E ss. uNrNowN E ss. orFIBn LI 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM RDOUBLEWALL 443EI I. SINGLE WALL TANK MATERIAL - primary tank (Check one item only) FL BARE STEEL [ 2. STAINLESS STEEL U 3. FIBERGLASS/PLASTIC II 5. CONCRETE U 95. IJNKNOWN E+. srpBLct-IDWFTBERGLASS Es. FRpcoMprIBLEwt00%METHAN0L !99.orHER REINFORCED PLASTIC (FRP) 4M LJ 5. CONCRETE LJ 95. LINKNOWN E 8. FRpcoMpflBLEwl00%METHANOL D ss.orHrt E to.coareosrsel TAUTMATBP.TNL secondarytanK EI. BARESTEET E3. FIBERGLASS/PLASTIC (check one ilem onry) E z. stetNI-gss sreer- fr STEEL CLAD WFIBERGLASS REINFORCED PLASTIC (FRP) E s. coNcnrre 445 L] 5. GLASS LINING trfu^tt*"o IJ 95. UNKNOWN E gs orHrn E I.RUBBERLINED E 2 ALKYD LINTNG E 3. EPOXY LINING ! 4 PHENoLIC LINING (For local use only) 446 DATEINSTALLED 447TANKINTERIOR LINING OR COATINC (Check one item only) )fu .t"t*otoss REINFoRcED PLASrtc E 4 IMPRESSED CURRENT D 95 UNKNOWN n gg orHpn OTHERCORROSION EIMANUFACTUREDCATHODIC PROTECTIONIFAPPLICABLE PROTECTION (check one item only) E z sacp.rrrclel ANODE (For local use only) 448 DATEINSTALLED 449 qS *, TYPE (localuseonly) 451 SPILL CONTAINMENT DROP TUBE STRIKER PLATE SPILL AND OVERFILL .I YEAR INSTALLED d. E2 W3 (Check all that apply)pr-*ranv E z snrLnLoer OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED E : rnr rusg sHUT oFF vALVE E + rxEtrapr 452q5 IV. TANK LEAK DETECTION (A description of the moniloring program shall be submifted lo the local agency.) IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) E r vrsuel lstNGLE WALL rN VAULT oNLy) @, ao*t,tuous INTERSuTTAL MoNIToRING zIS.NIENJAL I'AONITORINC 454IF SINGLE WALL TANK (check all that apply) E t vrsual lexrosED PoRTION oNLY) E z ,qurouertc rANK GAUGTNG (ATG) E : coxrnruous erc E + sreflsrtcal TNVENTORY REcoNctLIATIoN (SIR) BIENNIAL TANK TESTING D s uaNuru- reNK GAUGING (MTG) E 6 vADoSEZONE E z cnotxowerBn E 8 TANK TESTTNG D ss orHpn 453 IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE Rv". E t',to TANK FILLED WITH INERT MATERIAL? 457ESTIMATED DATE LAST USED (YR/MO/DAY) 11,.0) 455 gallons OF SUBSTANCE REMAINING 456ESTIMATEAQUANTITY UPCF (12199 revised)l0 Formerly SWRCB Form B UNIFIED PROGRAM CONSOLIDATED FORM UNDERGROUND STORAGE TANKS _ T,q.NT PAGE 2 ABOVEGROUND PIPING TANKS UNDERGROUND PIPING sysrEM TypE E t. pRtssunr S.2. sucrtoN E 3. GRAVITY 458 E :. cnavrrv! I.PRESSURE D z. sucrtoN 459 coNsrRucrroN E t. srNclewnll MANUFACTuRER ftu. oounrr w.a,ll MANUFACTURER D :. LrNno rnE}.tcH ! gq. ornnn E ss.uNKNowN 460 461 ! t. stNcrewar,l E 2. DOUBLEWALL MANUFACTURER E ss.uNKNowN E ss. orHpn 462 463 D t. seRE srBBr tr 6. FRP C0MPATIBLE wl00% METIIANoL ! z. sterNLess srrrl E z. calvnrqlzED srEEL E unknom E r. pr,esuc coMpATIBLE w CONTENTS [ 99. other E +. nrssncr-A.ss @.r. TLEXIBLE (HDPE) E 5. srEEL wcoATINc E s. carnoolc PRorEcrIoN 464 VII.all that E t. eaRr srsEl- E z. srett.rt,ess srpel ! r. plesrtc coMPATIBLE w CoNTENTS C 4. FIBERGLASS E s. srBpI" wlcoATING E e . rnp covparlBlE wloo% METHANoL E z. car-veNIzBD srEEL E s. FLEXTBLE (HDPE) E ss. orHpn E s. cerHoolc pRoTECTIoN E 95. uNKNowN 465 shall be submitted to lhe local SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all rhat apply): E t. pr-BcrnoNlc LINE LEAK DETECTOR 3.0 cPH TEST wITH AUTo PUMP sHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. fl 2. MoNTHLY 0.2 cPH TEST E :. auNuel TNTEGRITY TEsr (o.lcPH) CONVENTIONAL SUCTION SYSTEMS E 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (O.I GPH) SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): i z. splr voNltonrNc GRAVITY FLOW E 9. BTENNTAL INTEGRITY TEST (0.1 cPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (check all that apply): IO. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check one) E a. AUTO PUMP SHUT oFFWHEN ALEAKOCCURS ! u. euro putrrp sHUT oFF FoR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION !c. NO AUTo PUMP SHUT OFF E r r. eurovarrc LINE LEAK DETECTOR (3.0 cPH TEST) wlrH FLow SHUT OFF ORRESTRICTION E r z. er.ryuar TNTEGRITY rEST (0.1 cPH) SUCTION/GRAVITY SYSTEM $gl. coNrnruous suMp sENSoR + AUDIBLE AND vISUAL ALARMS EMERGENCY GENERATORS ONLY (check allthat applv) E t+. coNrrNuous suMP SENSOR wITHour AUTO PUMP SHUT oFF * AUDIBLE AND VISUAL ALARMS E ls. AUT0MATIC LINE LEAK DETECTOR (3.0 GPH TEST) wlrHour FLow SHUT OFF OR RESTRICTION E to. aum;al nITEGRITY TEST (0.1 cPH) E n. tetLvvISUALCHEcK 467SINGLE WALL PIPING PRESSURIZED PIPING (check all rhat apply): E l. ELEcrRoNrc LINE LEAK DETECTOR 3.0 cPH TEST wlrH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. E 2. MONTHLY 0.2 cPH TEST E :. auuual ntrEcRITY TEST (o.lcPH) n4. DArLYvtsuAl-cHEcK CONVENTIONAL SUCTION SYSTEMS (check all that apply) E 5. DAILY USUAL MONITORING OF PIPING AND PUMPING SYSTEM E o. rruemvlar INTEGRITY TEST (0.1 cPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROIJND PIPING): E 7. SELFMoNrropJNc GRAVITY FLOW (Check all that apply): E 8. DAILY VISUAL MONITORING E 9. BrEr.{NrAL INTEcRrry rEST (0.1 cPH) SECONDARILY CONTAINED PIPING PR-ESSURIZED PIPING (check all that apply): IO. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) E a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS E b auro puup SHUT oFF FoR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION Ec NoAUTOPUMPSHUTOFF ! 1 I. AUTOMATIC LEAK DETECTOR E tz. awuuel INTEGRITY TEST (0.1 cPH) SUCTION/GRAVITY SYSTEM E tr. coNrrNuous suMp SENS0R + AUDIBLE AND vlsuAL ALARMS EMERGENCY GENERATORS ONLY (check allthat apply) N 14. coNTINUoUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS E ts. aurouenc LINE LEAKDETECToR(3.0 cPH TEST) ! 16. ANNUAL TNTEGRITY TEST (0.1 cPH) ! tz. ontlvvtsuAlCHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT DATEINSTALLED 468slqf fl r. rroer I{BcHANISM THAT SHUTS oFF SHEAR vALvE ! z. coNrrNuous DISPENSER PAN SENSoR + AUDIBLE AND vlsuAl ALARMS E :. coNrlxuous DISPENSER PAN SENSoR wITH AUTo sHUT oFF FoR DISPENSER + AUDIBLE AND VISUAL ALARMS EIr. orulv vlsuAl cHEcK E s. tRrucn r-rNER / M0NITORING E o. Nonr 469 IX, OWNER/OPERATOR SIGNATURE I certify that the infomation provided herein is true and accurate to the best ofmy knowledge. OF Pemit Approved (For local use only)474 Pemit Expiration Date (For local usc only)4'15Pffiit Number (For local use only) I 413 UPCF (12/99 revised)t2 Formerly SWRCB Form B ATTACHMENT 2 HEALTH AND SAFETY PLAN HEALTH AND SAFETY PLAN TEMPORARY UNDERGROUND STORAGE TANK CLOSURE VARIOUS PACIFIC BELL FACILITIES THROUGHOUT CALIFORNIA November 26,2002 Prepared for: SBC Pacific Bell 2600 Camino Ramon, Rm.3E000 San Ramon, California 94583 Prepared by Shaw Environmental & lnfrastructure, lnc 4005 Port Chicago Highway Concord, California 94520 Shaw Project No.: 838819.36 C NC D : tS H A R EIU STIO 2 - 0 0 68..1o c Table of Contents List of Appendices Disclaimer 1,0 Generallnformation. 1.1 Project Manager 1.2 Site Safety Officer,.,....,.,..,., 1.3 Work Objectives/Sc0pe.,.,.., 2.0 Site Health and Safety lnformation 2.1 Site Descripti0n......,,.,..,...... 2.2 Site Background/History,,.,. 3.0 Hazards 3.1 Known/SuspectedChemicalHazards 3.2 Monitoring for Chemical Hazards,... 3.3 First Aid 3.4 Physical Hazards and Biological Hazards,. 3.4.1 Fire/Explosion Hazards. 3.4.2 Pressure Washing Hazards 1-2 2-1 2-1 2-1 3-1 3-1 3-1 3-2 3-2 3.4.3 Weather Hazards (Heat, Cold, Rain, Fog, Lighting, Sparks) Slip, Trip, and Fall Hazards..... Noise .,.,.,.., Overhead Hazards...... Asphyxiation/Confined Space, Moving Equipment.. 3.4.9 Dry lce 3.4.10 Electrical Hazards..,.,.. 3,5 Site Control Measures 3,6 Personal Protective Equipment 3.7 Training....,. 3.8 Emergency Response Plan ..,., 4.0 Emergency lnformation 4.1 Nearby Hospital/Clinic - Note this is Applicable Only to the San Luis Obispo Site 4.2 EmergencyRoute,.,.,.,.. 4.3 Fire Department: Phone: 911 ,.,.. 4.4 Police Department: Phone: 911 5"0 Health and Safety Plan Approvals and Acknowledgement, 5.1 Approvals 5.2 Acknowledgments......,,.6.0 Health and Safety Plan Acknowledgement 3.4.4 3.4.5 3.4.6 3.4.7 3.4.8 .,3-5 3-55 3-55 3-55 3-6 3-6 3-6 3-7 3-77 3-77 .4-1 .4-1 .4-1 .4-2 .4-2 .5-1 .5-1 .5-1 .6-1 1 C NC D :\SH A REIU 5T\02-006 8.tloc List of Appendices Appendix A Proposition 65 Warning and Notification C NC D ^S IIA RE\U Sl.0 2 - 00 68. lo c Disclaimer The enclosed site Health and Safety Plan (HSP) has been designed for the conditions that Shaw Environmental & Infrastructure, Inc. (Shaw) presently believes may be encountered during temporary underground storage tank (UST) closure activities at various Pacific Bell facilities throughout California. These activities will be rinsing of the tanks, inerting the atmosphere using dry ice, and disconnection of the electrical power to the associated fuel dispensers. As the work is performed, conditions different from those anticipated might be encountered and the HSP may have to be modified. Therefore, Shaw makes no representations or waranties as to the adequacy of the HSP, except for warranties specifically stated in the HSP itself. This HSP is addresses the site at196 Suburban Road in San Luis Obispo, California. The same activities will be performed at over 20locations in California. This plan is intended to cover all of these sites, however the site emergency response plan for each is an addendum to this plan. C NC D : \S H A R E\U ST\0 2 - 0 0 6 L tl o c rl1 1.0 Generallnformation As described in Section2.0, the health and safety plan has been developed for work to be done for SBC Pacific Bell along at their facility at 196 Suburban Road in San Luis Obispo, Califomia and other comparable temporary closure sites throughout California. This is the base plan and has been prepared for the site in Bakersfield. The site activities, hazards, and control measures at all of the sites are anticipated to be identical except for the emergency response plan. Shaw Project No.:838819.36 Date: November 26,2002 Project Site Location: 196 Suburban Road, San Luis Obispo, Califomia 1.1 Project Manager: Sydney Geels for Shaw The Project Manager is responsible for all on-site activities, including having all appropriate plans prepared and distributing the plans to Shaw field personnel and to authorized representatives of each contractor employed to perform work on-site. The Shaw Project Manager is also responsible for ensuring that the provisions of this Health and Safety Plan (HSP) are carried out. This includes ensuring that all Shaw field personnel have received adequate training, that an adequate supply of safety and emergency equipment is available, and that the required safety reports are submitted to the area Health and Safety Manager/Project Certified Industrial Hygienist (CH). 1.2 Site Safefy Officer: Sfeven Aiosa or Rob Delnagro for Shaw The Shaw Site Safety Officer (SSO) is responsible for implementing this site-specific HSP. Irish Construction may also have a SSO or foreman that will be responsible for health and safety aspects of the work not covered by this plan. The SSO shall be knowledgeable in various state and federal regulations. This includes ensuring that field personnel have read and signed the HSP, that a Tailgate Safety Meeting is conducted on-site prior to initiating field activities, and that appropriate monitoring is conducted. In addition, the Shaw Site Safety Officer will be responsible for monitoring the site operations for compliance with the HSP provisions and any applicable federal, state or local requirements. The Site Safety Officer shall stop work due to violations and unsafe conditions until appropriate action is taken to correct these deficiencies. The HSP may be amended by the Site Safety Officer to include necessary changes. The Shaw Site Safety Officer is required to be on-site at all times during tank closure activities to ensure C NC D :\SH A RE\UST\02- 00 68. doc 1-1 compliance with the health and safety plan. If the designated Shaw Site Safety Officer must be absence, a qualified alternate will assume the SSO duties and responsibilities. 1.3 Work Objectives/Scope The scope of work for this project covered by this HSP is limited to temporary UST closure activities at the previously mentioned Pacific Bell facility. Activities Planned (Check those that are applicable): underground tank removal oversight of soil excavation with backhoe or other equipment confirmation soil during soil excavation and removal geophysical survey soil boring and soil sampling with HSA or air rotary drilling groundwater grab sampling from monitoring wells groundwater sampling of on-site wells X other: temporary closure of USTs - hot pressure washing of tank interiors, pumping of residuals from tanks, visual inspection of the interiors of the tanks, transporting of collected residuals, inerting of tank interiors, sealing tank pipes, and de-energizing the tanks C NC D :\SH A RE\U 3T\02-006 8 loc t-2 2.0 Stfe Hea lth and Safety Information 2.1 Sife Description SBC Pacific Bell plans to temporarily close the USTs located at various facilities pending planned future removal sometime next year. At San Luis Obispo, there is a 10,000-ga11on UST containing diesel and gasoline for the fueling of Pacific Bell fleet vehicles that will be closed. At the other sites, simil ar size tanks used to store fuels also are being closed Prior to closure activities, Pacific Bell will afiange to have fuels within the tanks to be removed. Shaw will then anange for the USTs and associated piping to be triple-rinsed by a certified hazardous waste subcontractor using a hot-pressure washer and detergent in order to remove any residual liquids, solids, or sludge. Following rinsing, the tanks will be visually inspected to ensure all liquids, solids, or sludge have been removed. The rinsate will then be transported off- site under ahazardots waste manifest. Following rinsing activities, the atmosphere of the tanks will be inerted using dry ice at a rate of approximately 20 pounds per 1,O00-gallons capacity. After approximately 15 minutes, the lower explosive limits (LEL) and oxygen concentrations will be measured. Additional dry ice or water will be added to the tanks if the LEL is above l0%o and oxygen level is gteater than 10olo. Once the LEL and oxygen concentrations are below target levels the tanks access ports will be sealed using locking caps, The power will then be disconnected from the fuel dispensers and locked out. The existing tank monitoring system will remain operational. Unusual Features: none 2.2 Site BackgroundlHistory Waste Type(s)(Mark those that are applicable): Other (please specify): municipal hash may be encountered X petroleum liquids groundwater soil CNCD)SHARE\US 02-0068.doc 2-l Waste Characteristics: (Mark those that are applicable): X X Volatile : fuel residuals - benzene, toluene, ethylbenzene, and xylenes radioactive Corrosive Other (please specify): see box above Xlgnitable (gasoline fumes) Combustible (diesel fumes) Toxic reactive CNC D : \S HA RE\U STIO2 -0068. doc 2-2 3.0 Hazards 3.1 KnownlSuspecfedChemicalHazards The primary suspected chemical hazards are fuel fumes and carbon dioxide. Fuel fumes from gasoline tanks can be explosive. Diesel fumes are less volatile, however they may pose an aspiration hazardif they are aerosolized. The evaporation of dry ice (carbon dioxide) displaces oxygen and may pose an asphyxiationhazard. In addition to these chemicals, the workers may be exposed to petroleum fuel exhausts, and volatile organic compounds (VOCs) including benzene, from the traffic. Over exposure to these compounds can cause headache, dizziness, nausea, and eye, nose and throat irritation. Some of the chemicals of concem have been determined to cause cancer and reproductive harm. Table 1 consists of a list of representative chemicals of concern and their occupational hazard characteristics (PELs, IDLHs, etc.). Appendix A lists the Proposition 65 chemicals of concem which is required by the State of California. Overall Hazard Level:n Unknown Onsite Monitoring Required ? [ Yes nNo 3.2 Monitoring for Chemical Hazards Combustible Gas Indicator (CGIy4-Gas Meter: During tank closure activities both the air in the breathing space of the workers and at the active face of the tank will be monitored continuously using a combustible gas indicator (CGD to determine the concentrations of explosive gases relative to the Lower Explosive Level (LEL). After the introduction of dry ice into the tanks, the bottom, middle, and top of the tank should be monitored for LEL and oxygen levels. Photoionization Detector (PID): During closure activities, the breathingzone will be monitored with a PID for non-methane organic vapors concurrently with CGV4-Gas Meter monitoring to determine if any gases detected are likely to be toxic. A PID is not sensitive to organic carbon levels at lower concentrations than the CGI, thus it should be used to monitored the breathingzone.. n Lown Serious X Moderate C NC D :\SHA RE\UST\o2- 00 68.tl oc 3-1 Results of all monitoring will be recorded on Field Activity Daily Logs. Background concentrations in air will be established upwind and downwind of the work area before work begins. Calibration and maintenance procedures for field sampling and monitoring equipment is provided in Table 2. Action levels are provided in Table 3. 3.3 First Aid Inhalation: At first signs of headache or dizziness, remove victim from work area and give fresh air. If breathing has stopped, administer artificial respiration. Get medical attention immediately. Skin and Eye Contact: Flush eyes immediately with water for at least 15 minutes, occasionally lifting the eyelids. Remove contaminated clothing. Wash affected body areas with large amounts of soap and water. Get medical attention if irritation persists after washing. Ingestion: Do not induce vomiting. Keep victim warrn and at rest. Get medical attention. 3.4 Physical Hazards and Biological Hazards These hazards are primarily associated with on-site equipment and the general nature of construction work. The majority of these hazards (e.g., construction machinery safety and electrical safety) are managed under the Irish Construction plans and procedures. For this HSP, the physical and biologi calhazard identification has been limited to issues associated with trenching and landfill conditions, that is, the issues for which Shaw is responsible. Asphyxiation Moving Equipment Other: Dry lce 3.4.1 Fire/Explosion Hazards The closing of the tanks, particularly those that contained gasoline, may create a fire/explosion hazard. Prior to the work being started, all ignition hazards within 25 feet of the tanks should be eliminated. This area should be barricaded and only workers involved in the temporary closure activities should be allowed in this exclusion zone. No vehicles should be allowed in the exclusion zone. All electrical equipment should be grounded prior to starting cleaning operations. Sparkless tools should be used. X X X Electrical Slip, Trip, Fall Noise Overhead Hazards X X X Fire/Explosion Weather Hazards (Heat, Cold, Rain, Fog) Pressure Washing X X X X CNC D :\SH A R E\UST\O2 -00 68. doc 3-2 3.4.2 PressureWashingHazards Only trained workers will be allowed to operate the pressure washing equipment. The equipment must be inspected prior to use to ensure it is operating conditions, in particular a spring-released trigger should be present and working and the hoses should be in good condition. The lowest pressure that is effective to do the job should be used. Workers operating the equipment and those within the exclusion zone must be aware of the potential for splash from the heated water and flying objects from the washed area. Workers must use a face shield with side protection and water-proof coveralls (polycoated tyvek or rain gear that can be decontaminated). The pressure wand should never be pointed at another person. Loose or frayed clothing, rins, chains, or other dangling clothing should not be worn. If there is a sudden or slowing stopping of the water flowing through the wand, the machine should be shut off immediatelybefore other damagemay occur. All workers should have non-slip footwear that is in good condition that will also solid footing on slippy surfaces that may be created during the pressure washing. 3.4.3 Weather Hazards (Heat, Cold, Rain, Fog, Lighting, Sparks) It is anticipated that this work will be done during the fall and winter months. Work may continue in light rains and wind, but must be suspended when be suspended if the rains are heavy or wind speeds are above 20 mph. Work shall not be done if there is any potential for an electrical storm to occur. Additional, if fog interferes with workers ability to remain in visual contact, work must be suspended. In addition, workers should be aware that when humidities are very low (e.g., <20o/o) there is an increase chance of having sparks caused by friction. During the fall and winter, workers must be prepared for working in cold temperatures. Workers should take steps to prevent cold stress and be aware of the symptoms of cold stress. Preventative steps include: a Dressing warmly: - dress, in layers with materials that insulate but also allow sweat to evaporate (e.g., cotton and wool), clothing should include items which protect the feet, hands, head, and face. However, hoods, loose fitting clothing, dangling belts and jewlery should not be worn due to the other threat of catching in moving machine parts. a Keep dry: wetness greatly increases the chance of cold stress, have extra clothing available if there's a chance you could get wet. a Take a break: become fatigued during physical activity reduces the body's ability to properly retain heat. CNC D : \S H A RE\UST\O2 - 00681oc J-J a Replace fluids: replace lost fluids and calories by drinking warrn, sweet, caffeine-free nonalcoholic drinks and soup. The effects of cold stress may not be apparent to its victim. The first symptoms of hypothermia are uncontrollable shivering and the sensation of cold. The heartbeat slows and may become irregular, and the pulse weakens. As the condition worsens, severe shaking or rigid muscles may be evident. The victim may also have slurred speech, memory lapses, and drowsiness. Cool skin, slow, irregular breathing, and exhaustion occur as the body temperature drops even lower. This is a serious condition requiring immediate medical attention. Frostbite can occur without accompanying hypothermia. Frostbite occurs when the fluids around the body's tissues freeze. The most vulnerable parts of the body are the nose, cheeks, ears, fingers, and toes. Symptoms of frostbite include coldness and tingling in the affected part, followed by numbness; changes in skin color to white or grayish-yellow, initial pain which subsides as the condition worsens, and possibly blisters. Frostbite can cause irreversible tissue damage and requires immediate medical attention. Workers should protect their skin using sun block or clothing. Workers should also be familiar with the signs and symptoms of heat stress. Workers should use the buddy system to watch for signs of heat exhaustion - cramps, pale cool moist skin; excessive sweating; dizziness, nausea - and more advanced cases of heat stress. Workers should also drink plenty of water, an electrolyte drink (e.g., Gatorade) or other fluid on a regular basis. Also, a cool location for breaks should be identified. If necessary, the safety officer should adjust work/rest cycles to account for worker heat acclimatization, PPE, and whether conditions. For this site permeable personal protective equipment (PPE) is required. Assuming temperature acclimated workers are on the site, the guidelines for the work-rest cycle are as follows: . For temperatures at or below 78oF, an individual can work 60 minutes per hour . For temperatures between 78oF and 82oF, an individual canwork 45 minutes per hour . For temperatures between 82oF and 86oF, an individual can work 30 minutes per hour . For temperatures above 86oF, an individual can work 15 minutes per hour For temperatures above 98oF, an individual should be provided with body cooling equipment CNC D :\S H A RE\U ST\0 2-00 68. doc 3-4 3.4.4 Slip, Trip, and Fall Hazards All work areas should be cleared of unneeded equipment and debris to minimize slip, trip, and fallhazards. Materials being excavated from the landfill need to be managed so not to create a hazard. In addition to creating atiphazard, the waste may create cut hazards. The work should be done in a manner that avoids or minimizes worker direct contact with the waste. If handling is required, workers should wear gloves with good puncture resistance, coveralls, and boot covers. During the pressure washing of the tanks - the hoses shall not be laid over ladders, steps, walkways or in other fashions that creates atiphazard. 3.4.5 lVoise The general environment and the use of heavy construction equipment may cause ambient noise levels to be 85 dBA or more. It is anticipated that the worker using the pressure washing equipment will be exposed to high noise levels and should begin work using hearing protection. A rule of thumb will be used as an indicator of potentially dangerous noise levels: if workers need to raise their voices to be heard while in close proximity (e.9., I to 4 feet away) the noise level is likely to be 85 dBA or more. At this point the SSO may initiate noise monitoring or take corrective actions, such as using hearing protection and reducing the source(s) of the noise, if feasible. 3.4.6 Overhead Hazards There may be underground and aboveground utility lines. Prior to initiating work, the site will be surveyed for overhead lines and obstructions that may interfere with operations. If an overhead line is found, the electrical company or other wire owner should be contact to determine the appropriate height separation for the power of the line. 3.4.7 Asphyxiation/Confined Space The inerting of the tanks using dry ice will create an oxygen-poor environment. Workers conducting the visual inspection will not lower their heads into the tank where the oxygen level is less thanl9.5o/o oxygen. No entry into the tanks will be allowed since this is a permit-required confined space. 3.4.8 Moving Equipment The work must be arranged to minimize the potential for workers to be run-over or hit by moving equipment. Workers will wear hard hats and high visibility traffic vests. Hand signs, C NC D : \SH A R EIUST\02-0068..|oc 3-5 backup alarms and other means of communication must be used when the heavy equipment is being moved. Workers should not be within the area traversed by the backhoe boom and bucket. 3.4.9 Dry lce Workers will be using dry ice for inerting the tanks. Skin contact with dry ice will burn the skin. Workers should use heavy, cloth gloves when handling this material. 3.4.10 Electrical Hazards The work involves working with tanks that have electrical power. Prior to initiating all work, the power source for the tanks and pumps must be identified and tanks de-energized under a lock out/tag out procedure. Only a qualified electrician shall disconnect the tanks from the inerted, cleaned tank. 3.5 Site Control Measures Work areas (to be a minimumof 25 feet in all direction from the tank) willbe secured from the public by orange traffic cones or other appropriate barrier. Drinking or smoking is not permitted in the work area. At a minimum at 20N20BC fire extinguisher will be present at the site. The Site Safety Officer shall enforce these measures and the buddy system, PPE and training requirements for all on site personnel. Spills are not expected to be a concern on the project. However, if a spill is to occur, adsorbent materials are available. A Tailgate Safety Meeting will be held by the Site Safety Officer for all site personnel. The safety discussion will include, in addition to other items in this HSP, the following issues: Site Entry Procedures: The Contractor shall provide the Contract Manager or the Contract Manager's designee with safe access to the work site during the investigation. Personal Decontamination Procedures: Eating, drinking, chewing gum or tobacco, smoking, or any practice that increases the probability of ingestion of material is prohibited in the work site. Wash hands and face prior to eating, drinking or smoking and before leaving the site. Kneeling, sitting, leaning, or general contact with potentially impacted surfaces, or with surfaces suspected of being potentially impacted by petroleum products should be avoided. Medicine and alcohol can alter the potency of toxic chemicals. Prescribed drugs should not be taken by personnel if the likelihood of such potentiation effects exists. Ingestion of alcohol is prohibited. Flammable Gas Hazards: . Worker safety precautions include: no smoking on the site . Workers should use non-sparking and/or explosion-proof tools CNC D : \SH A RE\UST\0 2 -00 68. d oc 3-6 . No vehicles will be allowed within the exclusion zone 3.6 Personal Protective Equipment Safety Eyewear Respirator (Type): Standby fu ll-face air-purifyin g respirator (APR) Filter Type: Organic Vapor and high-efficiency particulate air (HEPA) Gloves (Type): Latex or nitrile duing sampling; heavy leather work gloves for managing dry ice Other: Face shields when power washing Other Emergency/Safety Equ ipment: Barricades Traffic Cones Additional emergency/safety equipment includes pagers and cellular phones. Workers are encouraged to avoid use of hand-held cellular telephones while operating motor vehicles. Handheld tools should be constructed of non-sparking materials. 3.7 Training All personnel on site will be provided with on-site training that provides an awareness of the hazards of fuel vapors and power washing hazards that may be encountered. At least one person at the site will have first aidlCPR training. All workers designated for fire suppression in the work zone shall be provided with training in the operation of the fire extinguishers that will be supplied at the site. 3.8 Emergency Response Plan The Emergency Response/Contingency Plan (ER/CP) is designed to define and communicate procedures to be followed in case of an emergency. Due to the nature of this work, there is a potential for an explosion or fire to will occur if landfill gases are encountered. In case of an emergency, the Site Safety Officer shall ensure that all personnel working at the site shall know at a minimum the following evacuation procedures: X X X X X X High visibility, brightly colored Vest Hearing Protection (as needed) Tyvek Coveralls (if needed) Hard Hat Safety Toed Boots X X X 15 Minute Eyewash First Aid Kit X X l/B/C Fire Extinguisher - minimum of 20N20BC Potable Water X X CNC D : \S HA REt UST\o 2- 0068. doc 3-7 1. If evacuation is necessary, all personnel will proceed to a predetermined location in the support zone, upwind and upslope (as necessary) of the work zone. THE SIGNAL FOR WILL BE THREE SHORT BLASTS IN SUCCESSION AN AIR OR CAR HORN. 2. Site-specific evacuation incident procedures will be discussed and documented by the Site Safety Officer. 3. Workers should tum off all engines and other equipment prior to evacuation 4. Any person requiring medical attention shall be evacuated promptly from any contaminated area. For personnel requiring medical attention, the emergency information guidelines in Section 4.0 shall be followed. CNCD:\SHA RE\US 02-0068-.loc 3-8 4.0 Emergencylnformation If injuries occur on siteo take the following action: 1. Stop work, evacuate any injured personnel, initiate first aid, implement procedures to limit the extent of the emergency event (ensure response actions do not endanger site personnel). 2. Get medical attention for the injured person immediately, if necessary from the emergency medical facility. 4.1 Nearby Hospital/Clinic - lVofe this is Applicable Only to the San Luis Obispo Sife. The nearest hospital is the San Luis Obispo General Hospital in San Luis Obispo, California. Phone: Address 4.2 Emergency Route Figure la - Hospital Route Overview (805) 781-4800 2180 Johnson Avenue, San Luis Obispo, CA 93401 lmiis Obispo o ft+d Frrfr+rlc, .-aT_ t,r- ftdTt' - 88002 ltiapfl uest.com, lnc.; G8002 GDT, Tank Farm c NC D )S H A RE\U Sr.0 2 - 00 68. d oc nc. 4-1 a. E # Figure 18 - Destination Map for Hospital hinF*us {F EflflE hflE Fq uEEt.En m, ln*.; $ EflflE I'lauhath n Tech no hq ies From Site 1: Start out going West on SUBURBAN RD towards SHORT ST by turning right. 2: Turn LEFT onto S HIGUERA ST. 3: Turn RIGHT onto LOS OSOS VALLEY RD. 4: Turn LEFT to take the US-101 N ramp. 5: Merge onto US-101 N. 6: Take the CA-1 N exit towards MORRO BAY/HEARST CASTLE. 7: Merge onto OSOS ST. 8: Turn LEFT onto WALNUT ST. 9: Turn RIGHT onto SANTA ROSA ST. 10: Turn LEFT onto MONTEREY ST. 11: Turn RIGHT onto JOHNSON AVE. -t ilufr trurr Phone: 911 Phone: 911 tr r$ r$ r$ r$ r$ 's r$ ,s r$ r$ 4.3 4.4 Fire Department: Police Department: CNC D :\SHA R E\ U ST\02- 0 068. do c 4-2 5.0 Health and Safety PIan Approvals and Acknowledgement 5.1 Approvals I have read and approved this HSP with respect to project hazards,regulatory requirements, and Shaw procedures. Project Name: SBC Pacific Bell 6 z__ Date Project Manager z Marks, Cnl,#5776 Project Certified Industrial Hygienist 5,2 Acknowledgments I acknowledge receipt of this HSP from the Project Manager, and that it is my responsibility to explain its contents to all site persopnel and cause these requirements to be fully implemented. Any change in conditions, scope of work, or other change that may affect worker safety requires me to notify the Project Manager and/or the Site Supervisor/Foreman. Site Safety officer: Qzfi..l Date: 'lt,%'o?-- t( a CNCD :\S HA RE\UST\0 2 -006 8.do c 5-1 6.0 Health and Safety PIan Acknowledgement I have read this site-specific health and safety plan, or its contents have been presented to me, and I understand the contents, and I agree to abide by its requirements. Name (Print) Signature Representing Date C NC D : \S HA RE\ UST\O 2 - 00 68. doc 6-1 CaIOSHA PEL B- hour TWA(2) sTEL(3) 5000 ppm; 30,000 ppm 5 mg/me respirable; 10 mg/mr total 300 ppm ISTEL = 500 ppml Not Established 1 ppm [STEL = 5 ppml 50 ppm [STEL = 1 50 ppml ACGIH TLV 8-hourTWA(4) 3 mg/m: respirable; 10 mg/m3 total 300 ppm 5000 ppm 0.05 ng/m3 0.5 ppm 50 ppm |DLH (5) 40,000 ppm Not Established N/A (6) 500 ppm 500 ppm N TABLE 1 Chemicals of Concern and Occupational Characteristics (1) Chemical Carbon Dioxide Dust (Particulate Not Otherwise Regulated) Gasoline Diesel Engine Exhaust Benzene Toluene Nofes; Comments Major Constituent of dry ice, simple asphyxiate lnitation Carcinogen; fl ammable liquid; kidney toxin; headaches; dizziness; eye, nose, and lhroat initant (May be present due to proximity to highway traffic) Carcinogen, initant, odor and color vary by source (May be present due to proximity to highway trafiic) Carcinogen; fl ammable liquid with aromatic odor (may be a trace gas in landfill gases) Flammable liquid with benzene odor; liver and kidney toxin; skin iritant; dermatitis; dermal absorption; skin (6) 2. J. 4. 5. 0. 7. Source: National Institute for Occupational Safety and Health (NIOSH), Guide to Chemical Hazards, 1990. Ppm = pais per million. mg/m3 = milligrams per cubic meter. CaIOSHA PEL = 8 CCR 51 55 General lndustry Sfandards for Toxic and Hazardous Subsfances, Permissible Exposure Limit, i-hourtime weighted average (TWA) SIEL = Short-ferm Exposure Limit. ACGIH TLV = American Conference of Governmental lndustrial Hygienlsfs, Ihresho/d Limit Value. IDLH = lmmediately dangerous to life and health. N/A = not applicable Skin = The designation "skin" refers to potential significant contribution to the overall exposure by skin contact with vapors or with the substance. C NC D :\SH A RE\U ST\02 -0068. doc l of 1 Calibration Frequency CGI span calibrated once per month. CGI zero checked daily. Oxygen sensor calibrated daily. PID zeroed and span checked daily at start of work day. Check daily prior to start of workday. Verify airflow prior to and after use with sampling head in place. Spot check flow rate throughout sampling period. CGI sensor calibrated against known concentration of hexane (demonstration bottle). Zero setting checked in non-contaminated air. Oxygen sensor calibrated daily to 20.9 percent fresh, non-contaminated air. PID zeroed in clean air. Span calibrated using known concentration of isobutylene (demonstration bottle). Check air tightness of pump, time for one minute, chain should remain slack, lf chain taut, then maintenance required. Verify airflow using primary standard (bubble meter) or precalibrated rotameter. Calibration Method TABLE 2 Calibration and Maintenance of Field Sampling Equipment Monitor Type Combustible gas indicator (CGl)/oxygen meter/4 gas meter (02, LEL, hydrogen sulfide, and carbon monoxide) Photoionization detector (PrD) Draeger tube sampling system Air sampling pump Maintenance Schedule lnstrument cleaned as needed and no less than annually. Oxygen sensor changed annually and changes if necessary. Annual cleaning by qualified technician. Annual calibration of electronics by qualified technician. Clean lamp if sensitivity drops or if used in very dusty environment. Maintenance required whenever pump fails to pass leak test. Replace seals and/or lubricate per instruction manual. Minimum of annual cleaning. Clean whenever pump unable to hold flow rate. Maintenance required if pump will not hold charge or flow rate is erratic. CNC D :\SHA M\U ST\0 2-0066.doc l of I Action Levell > 0.5 mg/m3 above background > 5 ppm above background < 50 ppm > 0.5 ppm >23.5Y0 or < 19.5% > 10% of LEL TABLE 3 Airborne ChemicalAction Levels In Breathing Zone Parameter Dust Unknown VOCs Benzene Oz LEL Airborne ChemicalAction Levels in UST During Inerting Oz LEL Required Action2 Use Dust Suppression (watering or equivalent) Detector tube for benzene, continue to work if no benzene detected Stop work; contact ClH3 Stop work; determine cause3 Stop work; determine cause3 Required Action2 Continue inerting tank - trying distributing dry ice using water or adding additional dry ice, do not proceed with deconnecting electrical wiring until action levels have been met Continue inerting tank - trying dishibuting dry ice using water or adding additional dry ice, do not proceed with deconnecting electrical wiring until action levels have been met Parameter Notes; ppm= parts per million, LEL= Iower explosive limit. 1 , Five excursions above the action level in any 1 5 minute period or a sustained reading tn excess of the action levels for 5 minutes willtrigger a response. 2. Frequency of air monitoring may be adjusted by the CIH after sufficient characterization of site contaminanfs has been completed, tasks are modified or site controls have proven effective. 3. Contact with the Project CIH must be made prior to continuance of work. The Project CIH may then initiate integrated air sampling along with additional engineering controls. No one is permitted to downgrade levels of PPE without authorization from the Praject CIH. >10 % of LEL Action Levelr > 8o/o CNCD:\SHARE\US 02-0068..1oc l of I Appendix A Proposition 65 Warning and Notification As required under the Safe Drinking Water and Toxic Enforcement Act of 1986 (also known as Proposition 65), on February 27, 1987, the Governor published a listing of those chemicals determined by the State of California to cause cancer, birth defects, or other reproductive harm. Proposition 65 requires that businesses that handle any of the listed chemicals notify people in the affected area of that fact. Shaw anticipates handling some of the listed chemicals at the project sites. The chemicals present on site that have been determined to cause cancer include: . Diesel Engine Exhaust . Gasoline (whole vaporized) . Benzene The following contaminants on site have been determined by the State to cause reproductive harm: . Benzene . Toluene . Lead C N C D : lS I1 A R E\ U ST\0 2 - 0 0 6 fu I o c B-1 APPENDIX A PROPOSITION 65 WARNING AND NOTIFICATION C NC D : \ SHA RE\ UST\0 2 - 0 06 8..loc B-2 Equipment Decontamination Activity Pressure washing Equipment Pressure washer Control Measures Proper PPE will be utilized as described in this HSP Pressure washing activities will be in accordance with Shaw Policy HS 303. Only trained personnel shall operate pressure washi equipment. Ensure proper footing in wet areas. Training Pressure washer training 40 hour / 8 hour HMWOPER Site-specific training Hazards Contact with product Cutting hazards lnexperienced operator Slips, trips, falls lnspection Prior to use CNCD : \SHA RE\U ST\02 -006 8.doc B-3 ATTACHMENT 3 QUARTERLY MONITORING FORM Quarterly Monitoring Form Pacific Bell Facility 196 Suburban Road San Luis Obis California Date: Locks Secured: Tags in Place: No Power to Dispensers: LEL (in Percentage) Upper: Middle: Lower: Oxygen (in Percentage) Upper: Lower: Middle: Notes: Date: Locks Secured: Tags in Place: No Power to Dispensers: LEL (in Percentage) Upper: Middle: Lower Oxygen (in Percentage) Upper: Lower: Middle Notes: Quarterly Monitoring Form Pacific Bell Facility 196 Suburban Road San Luis Obi Galifornia Date: Locks Secured: Tags in Place: No Power to Dispensers: LEL (in Percentage) Upper Middle: Lower: Oxygen (in Percentage) Upper: Lower: Middle: Notes: Date: Locks Secured: Tags in Place: No Power to Dispensers: LEL (in Percentage) Upper: Middle: Lower: Oxygen (in Percentage) Upper: Lower: Middle: Notes: _ ,.ri I Gtyo[san luls oBtspo FIRE DEPARTMENT 2160 Santa Barbara Avenue ' San Luis Obispo, CA 93401-5240 ' 805/781-7380 "Courtesy E Seruice" August 12,2003 SBC Attn: Andy Taylor P. O. Box 5095, Room 3E000P San Ramon, CA. 94583-0995 196 Suburban Road, San Luis Obispo, CA. 93401. Closure of Soil Remediation Project Associated With Removal of Underground Storage Tanks. Dear Mr. Taylor: In cooperation with our local Regional Water Quality Control Board (RWQCB) we are advising you that we have no further requirements for the soils investigation related to the unauthorized release discovered during the course ofthe underground storage tank removal at the facility mentioned above. MTBE was detected at 6 parts per million which is well above the regulatory threshold of 5 parts per billion in groundwater. Provided all of the information submitted to us is complete and accurate, we have no further requirements and are closing the soil investigation. Please be advised that if additional contamination is discovered in the future, further characteization and remediation will be required. Mr. Corey Walsh of the Regional Water Quality Control Board in San Luis Obispo will be contacting you in regards to groundwater monitoring at the site. He will be working with you to maintain G water quality objectives of the basin and characteizingknown contamination at the site. The RWQCB will advise you of the constituents to be analyzed and other pertinent details. The existing monitoring well near the old tank pit will most likely be destroyed and be replaced by new groundwater monitoring wells. Please work directly with him on that project, and if you have any questions or concerns regarding the soils investigation contact me at (805) 781-7383. Sincerely, D. Kerry B Hazardous Materials Coordinator cc Mr. Corey Walsh, RWQCB RE N [rEl ,n" Citv ol San Luis Obispo is committed to include the disabled in all of its services, programs and activities. N-rLl fetecommunications Device for the Deaf (805) 781-7410.@ Mr. Andy Taylor 3 August 13,2003 This letter does not relieve you of other agency's requirements, which may continue to have jurisdiction and require further work. Generally, the San Luis Obispo City Fire Department is the lead oversight agency for tank permitting, inspection, removal, and soil contamination issues within the City, and the Regional Board is the lead agency for groundwater quality oversight. Please incorporate future City Fire Department and Regional Board requirements into a combined response, and provide both agencies with copies of all work products. Based on the above groundwater results, please submit a work plan for additional site investigation work to delineate the vertical and horizontal extent of soil and groundwater contamination at the subject site by October 31, 2003. Authority for this request is made pursuant to the provisions of Section 13267 of the California Water Code. Pursuant to Section 13268 of the Water Code, a violation of a request made p';rsuant to Water Code Section 13267 may subject you to civil liability of up to $1,000 per day. The Regional Board needs the required information in order to evaluate water quality at the site and to provide technical and regulatory oversight for the investigation and cleanup of impacted groundwater. You are being required to submit this information as the responsible party for the unauthorized release discovered beneath the subject facility. More detailed information is available in the Regional Board's public file on this matter. Any person affected by this action of the Regional Board may petition the State Water Resources Control Board (State Board) to review the action in accordance with Section 13320 of the California Water Code and Title 23, Califomia Code of Regulations, Section 2050. The State Board must receive the petition within 30 days of the date of this order. Copies of the law and regulations applicable to filing petitions will be provided upon request. If you have any questions, please contact Corev Walsh at (80$ 542-4781. Sincerely, lt{nt L*1*8u** I Roger W. Briggs Executive Officer Enclosures: 1) Site Investigation Report Checklist S:UCB\USA\Corey\San l-uis Obispo\l 96 SuburbanNOR.doc cc: cc: Without Attachment Mr. KerryBoyle City of San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CL 9340I-5240 Califurnia Environmental Protection Agency Mr. MarkMatranga State Water Resources Control Board Division of Clean Water Underground Storage Tank Cleanup Fund P.O. Box 944212 Sacramento, CA 94244-2120 s Recltcled PaPer f nvironrnenfol Moncgerent ?500 Comiru Ranron, Room 38000 SonQarron,CA 94583 925-867-Az4Itfax)e-fa RE VIA CERTIFMD MAIL August 31,2004 Keny Boyle Inspector City of San Luis Obispo Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CA9340t-5240 Inspection on 11/8/2001 at SBC Pacific Bell - 196 Suburban Rd., San Luis Obispo SBCID606 Dear Mr. Boyle: Pursuant to the Inspection, the status of corrective action for the violation found is noted below: Secondary containment for product pipingfailed test -- possibly due to penetration boots. Both diesel & unleaded failed. Dispenser pan also needs to be water tested after repair to product lines. Note: complete repairs & re-schedule inspection by I2/8/01. Tank was temporary closed on02/06/03 and permanently removed from service on 06/01/03. If you have questions or need additional information, please call me on925-824-5783 Environmental Manager "", l.Sp{o frWooten Division of Environm il Health (80s) 781-ss44 P.O. Box 1489 2156 Sierra Way rSan Luis Obispo, CA 93406 Department of Agriculture/Measurement Standards (sos) 781-s910 2156 Sierra Way Suite A rSan Luis Obispo, CA 93401 f t of San Luis Obis Fire Department (805) 781-7380 2160 Santa Barbara Avenue San Luis Obispo CA 93401-5240 Utilities Department r (805) 781-72I5 879 Morro Street r San Luis Obispo, CA 93401 I CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW data entry by:N(ADate: Time: t &J ,o/ l'' FACILITY ID NO: A FACILITY NAME: Ai\ADDRESS: AGDEPT CITY FIRE CITY UTILITIES AGENCYE nnn PHONE: Routine Reinspection Complaint Other --lJ ,l,U Business Plan EHw G"n"r^to,PROGRAMS INSPECTED:E usr !lcr n Tiered Permitting W*o l YES n BusinessPlan ! Hw Generator E ustREINSPECTION REQUIRED:! lcr n Tiered Permitting PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance ivith adopted codes. GRANTED BY (NAMEITITLE): 6 NOntrn I YES d,#,a w w N/A BUSINESS PLAN Business plan is complete, current, & available during inspection (HSC 25503.5, Title t9 CCR2729) Inventory of hazardous materials is complete (HSC 25504, Title 19 CCF.2729) Site layout/facility maps are accurate (HSC 25504, Title 19 CCR2729) TRAINING PLAN Facility has appropriate training program (Title 19 CCR2732 & 22 CCR66265.16) Training documentation is maintained on site for current personnel (Title 19 CCR 2732 & 22 ccR 6626s.16) EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR S 66265.53/s4) Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of hazardous waste to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43) FACILITY REP: # p BPOl BPO2 BPO3 TROl TR02 EROI ERO2 COMMENTS: INSPECTOR: Reprr: 1001 rev 1 r 0:\DfJCUMENI\,jeffp\F0RM$\lnspeetion fonns\CUPA insp*r:tion forms.doc 10-Sep-0'i . faa-Nttl tlbsrrurMm ,Q/. rlasl ny HAZARDOUS WASTE GENERATOR EPAID *o, CKI_,d,Ll&b8 Tiered Permit:- CESW - CESQT - CA - PBR Treatment Equipment: Total generated/mo:-lbs or gals Waste Oil:- Solvents:- Anti-freeze:_ Others:- NO T T tr ! !tr YES-E N/A!6 vIoL. # GTOl GTO2 GTO3 GTO4 GTO5 GTO6 GTOT GTOS GTO9 GTlO GTII GTL2 GT13 GT14 GTl5 GTl6 GT17 GTl8 GT19 GT2O GT2I EPA ID NOIPERMITS Generator has an EPA ID number to treat, store, dispose, trrnsport or transfer hazardous waste (fitle 22CCR 66262.12) Generator has a permit or authorization to conduct on-site waste treatment (litle 22 CCR 66270.1) HAZARDOUS WASTE DETERMINATION Hazardous waste determinatior conducted (fitle 22 CCR 66262'1 l) fflornn knowledge ffinatysis [otn", ffizardous waste analysis/felt records are kept for at least 3 years (fitle 22 CCR 66262.40.(c)) DISPOSAL/TRANPORTATION Hazardous wastes were offered to transporter and/or disposed to a facility with an EPA ID No. and permit Manifests are properly completed/retained by generator for 3 years (Iitle 22 CCR66263.421 66262.23) STORAGE AND MANAGEMENT OF CONTAINERS/TANKS Hazardous wastes are accumulated on site as follows (Iitle 22 CCR 66262'34) )J M).SO days if waste generated per month is > 100 kg (220 tbs.) ll. tnO days if waste generator per month is - less than 1000 kg (See Note) l= ZIO days if waste generator per month is - less than 1000 kg and transported more than 200 miles (See Note) Note: Applies only ifhazardous waste accumulated on site never exceeds 6000 kg and no acutely/extremely hazardous waste over I kg is held on site for over 90 days. Hazardous waste,,satellite" cotlection is managed properly (complete labeling/accumulation time/55-gal or 1-qt limit) (t itte 22 CCR 66262.34(c)) Ignitable or reactive wastes are located 15 m (50') from facility's property line (Iitle 22 CCR 66265.176) Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARI)OUS WASTE"' waste composition/physical state, hazardous properties, name/address of generator) (fitle 22 CCR 66262.34) Containers/tanks containing hazardous wastes are in good condition/handled to minimize release or reaction (fitlc 22 CCR 66265.17 ll,l9l, 6626s.177 (c)) Containers/tanks/liners are compatible with waste stored or transferred (Iitle 22 CCR66265.172) Containers storing hazardous wastes are closed/scaled (fitle 22 CCR 66265.f73) Weekly inspection of areas where haz, waste containers are stored is conducted/documented (title 22 CCR 6626s.174) Daily inspection of all tank systems is conducted and documented (title 22 CCR 66265.195) Empty containers or inner liners > 5 gal has date when emptied and managed properly within one year of date emptied (Title 2 CCR 66261.7 (f)) RECYCLABLE WASTE Used oil is managed as hazardous waste until recycled (includes proper labeling' storage, etc) (HSC 25250.4) Used oil filters for recycling are managed properly (drained of free flowing liquid' stored in closed rainproof container, labeled "drained used oil filters," and transferred for metal reclamation) (fitle 22 CCR 66266.f30) Spent lead-acid brtteries are transferred offsite under manifestation for recycling ' reuse, or reclamation (fitle 22CCR66266.81\ Solvents/other recyclable materials are managed as hazardous wastes until recycled (litle22 CCR 66266.3) nn tr d nn n nnn !n n! tr n ! nn n !n! n! tr T d W VtW { TwWil wwz d^V Catifornia Regional Water Quality Control Board Central Coast RegionTerry Tamminen Secretaryfor Environmental Protection Arnold Schwerzenegger Governor tnternet Address: hth:i/w$v.swrcb.ca.gov/rwqcb3 895 Aerovista Place, Suite I 01, San Luis Obispo, California 93401 Phone (805) 549-3147' FAX (805) 5434397 November 19,2003 SBC Mr. Andy Taylor P.O. Box 5095, Room 3E000P San Ramon, CA 94583-0995 Dear Mr. Taylor: UGT: 196 SUBURBAN ROAD, SAN LUIS OBISPO COUNTY; PACIFIC BELL FACTLTTY - WORK PLAN CONCURRENCE (RWQCB CASE NO. 3s18) Regional Board has reviewed Shaw Environmental and Infastructure's, (Shaw) October 2003, Wirk Plan for Sensitive Receptor Survey and Site Characterization Activities for the underground storage tank (UST) site referenced above, and discussed the proposed scope of work with your consultant, Mr. Rob Delnagro. The work plan proposes the following: conduct a sensitive receptor survey to identify water wells and off-site petroleum sources; drill and sample approximately fifteen soil borings to an estimated depth of 16 feet below ground surface Ogs); cbitect and analyze soil samples at five and ten foot bgs; convert borings to temporary groundwater monitoring wells, sample groundwater, and analyze samples; analyze soil and groundwater samples for total petroleum hydrocarbons reported as gasoline (TPH-g), benzene, toluene, ethylbenzene, and xylenes (BTEX), and methyl tertiary-butyl ether (MTBE). In addition, the location of proposed soil borings/temporary monitoring wells has been revised as discussed with Mr. Delnagro to incorporate former UST (removed March 1995) excavation, dispenser islands and down gradient area. Please provide revised Boring Location Figure and include the March 1995 UST excavation, dispenser islands and piping locations. please provide a complete soil and groundwater investigation report to this office and San Luis Obispo City Fire Department by Februarv 16. 2004. Authority for this request is made pursuant to the provisions of section 13267 of the California Water Code (CWC). Pursuant to iection 13268 of the CWC, a violation of a request made pursuant to CWC section 13267 may subject you to civil liability of up to $1,000 per day. The Regional Board needs the required informaiion in order to evaluate water quality at the site and to provide technical and regulatory oversight for the investigation and cleanup of impacted groundwater. You are being required to submii this information as the responsible party for the unauthorized release discovered beneath the subject facility. More detailed information is available in the Regional Board's public file on this matter. Any person affected by this action of the Regional Board may petition the State Water Resources Control Board (State Board) to revietv the action in accordance with section 13320 of the CWC and Title 23, California Code of Regulations, section 2050. The State Board must receive the petition within 30 days of the date of this order. Copies of the law and regulations applicable to filing petitions will be provided upon request. Enviro nm e ntal P r ot e ctlo n Ag en qtCalifornta $ Reqcled Paper ) Mr. Andy Taylor 196 Suburban Rd. November 19,2003 In addition, pursuant to section 25296.20 of the Califomia Health and Safety Code (CH&SC) the Regional Board is required to notify all current fee title holders of the subject site prior to considering corrective action or case closure. Since you are identified as the current primary or active responsible party for corrective action and cleanup at the subject site, we are requesting that you provide us with a complete mailing list of all record fee title holders for the subject site. If you have any questions, please contact Corev Walsh at (80$ 542-4781. Please provide this office with 48 hours notice prior to the start of any fieldwork activities. Sincerely, 2 w'Briggs Offrcerve cc: S:\ICB\USA\Corey\San Luis Obispo\l 96 Suburban\WorkPlanApp.doc Mr. Rob Delnagro Shaw Environmental, Inc. 4005 Port Chicago Hwy Concord, CA 94583 Mr. Kerry Boyle City of San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CA 93401-5240 Mr. Mark Matranga State. Water Resources Control Board Division of Clean Water Underground Storage Tank Cleanup Fund P.O. Box 944212 Sacramento, CA 9 4244-2120 Environm ental Protectio n Agen qt 4 California s Recycled Paper J California Regional Water Quality Lontrol Board Central Coast Region Winston H. Hickox Secretary for Environmental Protection Gray Davis GovernorInternet Address : http://www.swrcb. ca. gov/rwqcb3 895 Aerovista Place, Suite 101, San Luis Obispo, California 93401-7906 Phone (805) s49-3147'FAX (805) s43-0397 August 13,2003 Pacific Bell Mr. Andy Taylor P.O. Box 5095, Room 3E000P San Ramon, CA 94583-0995 Dear Mr. Taylor: UGT: 196 SUBURBAN ROAD, SAN LUIS OBISPO COUNTY; PACIFIC BELL FACTLTTY - NOTTCE OF RESPONSIBTLITY (RWQCB CASE NO. 3518) The Regional Board has reviewed Shaw Environmental and Infastructure's, (Shaw) June 13, 2003, (Jnderground Storage Tank Removal results, and has received the unauthorized release report (URR) of hazard,ous substances from the underground storage tank (UST) system at the loiation referenced above. Results of soil sampling indicate soil at this site is impacted with petroleum hydrocarbons. Soil samples collected under City of San Luis Obispo Fire Department direction detected up to 6.7 micrograms per kilogram (pglkg) methyl tertiary-butyl ether (MTBE), and 6.6 milligrams per kilogram (mg/kg) total petroleum hydrocarbons repofied as diesel (TPH-d). The site is an inactive Pacific Bell fleet fueling facility, where recently one 8,000-gallon split-wall gasoline/diesel UST, and associated piping and fuel dispensing equipment was removed. The subject site lies within the San Luis Obispo Creek Hydrologic Subarea of the Estero Bay Hydrologic Unit (310.24). The "Water Quality Control Plan, Central Coast Region" (Basin Plan) designates this groundwater as having beneficial uses for domestic and municipal supply, agricultural supply, and industrial supply. Therefore, the pertinent water quality objectives for this site are as follows: 1,000 micrograms per liter (VglL),- TPH, I pglL - benzene, 150 ug/L - toiuene, 300 pglL- ethylbenzene,l,T5A p"glL -- xylenes, and 5 pg/L - MTBE' The detection of the gasoline additive MTBE is of great concern. MTBE has been added to gasoline sold in Califoinia since 1979 as an octane booster, and since the late 1980's, MTBE has been added as an oxygenate to California's reformulated gasoline. Relative to other fuel hydrocarbons, MTBE his a high solubility in water. The compound has low retardation in gioundwater aquifers, and is slow to biodegrade. MTBE has taste and odor characteristics that ian impair *ui". supplies at very low concentrations. Combined, these characteristics make MTBE one of the most menacing petroleum related constituents. Not surprising, MTBE has been detected in a variety of petroleum investigation cases and in municipal water supply wells' Three small public water systems in your area have detected MTBE in their wells during periodic sampling. These water supply wells are located at 225 Tank Farm Road (Holdgrafer Well), 281 T;nk Farm Road (Whitson Well) and 181 Suburban Road (Copeland Well). California Environmentul Protection Agency *1)q.rf Recycled Paper Mr. Andy Taylor August 13,2003 Please be advised that Section25299.37 of Article 4, Chapter 6.75, of the California Health and Safety Code (CH&SC) requirerlthe tank owner, tank operator, and other responsible parties to take corrective action in response to an unauthorized release. Regional Board staff has identified Pacific Bell as being responsible for the implementation of the investigation and mitigation of this unauthorized release. California law also states contamination resulting from an unauthorized release (leak) of a petroleum product may pose a threat to public health and the environment. Title 23, Article 5 of the California Code of Regulations requires responsible parties (persons responsible) to conduct initial abatement measures upon the discovery of an unauthorized release from a UST system. In order for us to provide the best possible oversight of your investigation and cleanup, we need to be sure we have all relevant site information. In accordance with Water Code Section 13267, please provide all docurnents pertaining to waste discharge, hydrogeology, md other information directly relevant to the characteization and cleanup of waste discharged at the subject site. This includes, but is not limited to, reports on chemical usage and estimated volumes released, well logs, lab sheets, corrective action alternative analysis, other consultant reports, and reports prepared for financial institutions (e.g. Phase I Environmental Site Assessments). Until your case is closed, all such documents must be submitted promptly after they are written or received. If a document that is covered by this request is believed to be exempt from disclosure or is confidential, please submit a description of the document and an explanation of the legal basis upon which it is exempt from disclosure or is confidential. If there is any dispute regarding such a document, Regional Board staff will attempt to resolve it informally. Prior to the Regional Board closing this case, the responsible party or appointed agent will be required to attest under penalty of perjury that all documents and descriptions of documents required in this paragraph have been submitted. Al1 work and reports requiring engineering or geologic evaluations/judgments must be performed under the direction of and be signed and stamped by a registered professional engineer or geologist. In addition, the soil and groundwater investigation must be performed under the direction of a registered professional civil engineer or geologist, and address all items on the enclosed Regional Board Site Investigation Report Check List. Monitoring well construction must meet or exceed the standards contained in the Department of Water Resources Bulletin No.s 74-81 and.74-90, and comply with the reporting provisions of Sections 13750 and 13755 of the California Water Code, and applicable local agency permitting requirements. A California Department of Health Services certified laboratory must perform analysis of soil and water samples. In addition, documentation must be provided showing all sampling and analytical procedures were conducted based on a reasonable quality assurance/quality control program. Money spent on the investigation and cleanup of this unauthorized petroleum release may be reimbursable through the State Leaking Underground Storage Tank Cleanup Fund (Fund). The responsible party or appointed agent should request pre-approval of investigation and corrective action costs from the fund. The fund administrators can be reached directly at (800) 813-3863 for additional information about this program. Prompt compliance with this Regional Board's requests will protect eligibility for funding of this investigation and cleanup project by the Fund. California Environmental Protection Agenqt 2 I Recycld Paper UNDERGROUND STORAGE TANK UNAUTHORTZED RELEASE (LEAK)/ CoNTAMINATIoN slTE REPoRT HAS STATE OFFICE OF EMERGENCY SERVICES REPORT BEEN FILED ? -[_l vEs [TJt noffiHo EMERGENCY YES CASE 'REPORT DATE SIGNAPHONE $os )zer-z:a: NAME OF INDIVIDUAL FILING REPORT 1eD. Ke San Luis ObisPo CitY Fire COMPANY OR AGENCY NAME Dept.f-l owrueruopenrron l-l REGIoNAL BoARD FX-l locrr-reErucv [--l REPRESENTING OTHER san Luis Obispo2160 Sanfa Barbata Street ADDRESS STAYE CA 9340L doUFcro4Ucc -8866(gz PHONE ANDY TAYLOR PERSON xxfiEyxxxyx6x sBC NAME UNKNOWN 2500 Carnino Ramon, Roorn 3E000 94583-0995San Ramon AODRESS CA CITYSTREET U)o6> R3a*Uc 1B3I 137 3-2142 PHONEOPERATOR SBC FACILITY NAME (IF APPLICABLE) SBC PacBell) San Luisan Luis Obi ADDRESS 9 1 SYREET z tr ooJ Uto CROSS STREET South Iliguera Street PHONE ( PERSONAGENCY NAMELOCAL PHONE 81Corealsh o4atrsilo =U:ioL< REGIONAL BOARD Central t Methyl Tert NAME(1) Butyl Ether (MTBE) OUANTITY LOST (GALLONS) Fel uNxxowtr aU(}z Fo6lo Jo z [-_l uxrruowru (2t HOW DIS@VERED l--l rerur resr l--l tr{veNronv coNTRoL I l-ffi mNrneuoval D SUBSURFACE MONITORING OTHER NUISANCE CONDITIONSDATE DISCOV€RED #I 16 E DATE DISCHARGE BEGAN lE[ uruxruowru METHOD USED TO STOP DISCHARGE (CHECK ALL THAT APPLY} l-l REuovE coNrerurs fX4 closE rANK & REMovE REeATR TANK l--l ct-ose rnrux & FILL tN Pl-AcE l--l csaruoe pnocEDURE REPLAcETANK l--l orgen l-l neparR prprr.ro FzU UF 6 crU ooao lx* ves E *o 6 1 I 0 3 HAS DISCHARGE BEEN STOPPED ? IF YES, DATE cAUSE(S) f-l ovEnrru l--l coRnostot't F SPILL OTHER RUPTURE/FAILURE UNKNOWN l-X[ utlrnown [--l prprr'rc uEar OTHER SOURCE OF DISCHARGE TANK LEAKBu =a-f) UuOt OF [1-* uruoErenurruEo l-l sotlotllv l-l oRouttowrreR E DRINKING WATER . (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) CHECK ONE ONLY FzUGtlo NO ACTION TAKEN LEAK BEING CONFIRMED REMEDIATION PLAN DEn PRELIM INARY SITE ASSESSMENT WORKPLAN SUBMITTED PRELIMINARY SITE ASSESSMENT UNDERWAY CASE CLOSED (CLEANUP COMPLETED OR UNNECESSARY) g En POLLUTION CHARACTERIZATION POST CLEANUP MONITORING IN PROGBESS CLEANUP UNDERWAYT CHECK ONE ONLY CHECK APPROPRIATE ACTION(S)tsmxffir^s' {-l cnp srE (co} l-l corurltruueNr BARRTER (cB) l-l vncuuu ExrRAcr(vE) lffi excrvnrE& DtsPosE (Eo] [-l excnvnre&rREAr(Er] f] ruo lcroru REoUTRED (NA) REMOVE FREE PRODUCT (FP) PUMP & TREAT GROUNDWATER (GT) TREAruENT AT HOOKUP (HU} ENHANCED BIO DEGRADATION (IT) REPLACE SUPPLY (RS} VENT SO|L (Vs) l-l orxEn (ol J<zooU=>bui<E otszU oO Two groundwater monitoring we1ls proposed - one for the current tank excavation, and one for the former tank location which was closed in 1999 HSC 05 (8/90) Environmental Management 2600 Camino Ramon - Room 3E000 San Ramon, California 94538 January 31, 2003 KERRY BOYLE, Haz Mat Coordinator San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, CA 93401-5240 Dear KERRY BOYLE: RE: SBG-Emergency Generator UST Enhanced Leak Detection Scheduling Status ln October 2002,Tracer Research (on behalf of SBC) mailed to your agency a work plan and list of SBC Emergency Generator UST's to perform Enhanced Leak Detection testing in lieu of secondary containment testing. This submittal was made after Assembly Bil2481 (A82481) was approved and signed by Governor Davis on September 27,2002. One of the changes that AB2481 allowed was ELD testing for emergency generator USTs in lieu of secondary containment testing. The amended California Health and Safety Code (H&SC) section reads: H&SC Secfion 25284.1 (d!)@)(iil - Secondary containment components that are part of an emergency generator tank system may be fesfed using enhanced leak detection, fffhe fesf r.s performed at the frequency specified by the board for testing of secondary containment pursuant to Section 2644.1 of Title 23 of the CCR'S. lf the results of the enhanced leak detection test indicate that any component of the emergency generator tank sysfern is leaking liquid or vapor, the owner or operator shall take appropriate actions to correct the leakage, and the owner or operator shall retest the system using enhanced leak detection until the sysfem is no longer leaking liquid or vapor. On the State Water Resources Control Board's (SWRCB) UST web page there is a link to a Summary table that describes these changes. Page 3 of the summary concerns emergency generator UST's. Contract negotiations between Tracer Research and SBC have completed and an executed contract is expected during the first week of February. During this process SBC has been working with Tracer Research to develop a schedule to perform ELD testing at over 200 SBC facilities throughout California, and Tracer has been perfecting the ELD testing procedure for emergency generator USTs. Because of the size and scope of this testing program, it will be impossible to complete these tests in a short period of time. Currently Tracer only has one employee with a valid California tank tester's license. One testing crew has been established and Tracer hopes to be able to add a second and/or third crew to perform ELD testing. When this happens, our testing frequency will increase dramatically with testing being performed in several areas of the state simultaneously. Be assured that SBC and Tracer Research will do everything possible to expedite testing across the state lf you have any questions or need additional information, please do not hesitate to call me on 925-823- 6161. Sincerely, #bwtt, Stan Brodecki SBC Environmental Management - West Region cc: lrene Soto zR)Tait& Associates, Inc,November 22e,AWPringi ' Architecture ' EnvironmentalRouted from Building Dept.Cary BoyleCity of San Luis Obispo Fire DepartmentHazardous Materials Division2160 Santa Barbara AvenueSan Luis Obispo, CA 93401(805) 781-7380RE:Tank RemovalPacific Bell Fleet Fueling Facility196 Suburban Rd, San Luis ObisPoTAIT JOB # SWlO2ODear Cary:Per our conversations regarding the tank and piping removal at the above site, enclosedis the permit application and $612 permit fee. IT Corporation will be the designatedEnvironmental Consultant in charge of the soils testing, removal and hauling of the tankand piping components.Sydney Geels, IT CorPoration4005 Port chicao HwYConcord, CA94520(925) 288-2rt9Upon your review, if you have any questions or require additional information, pleasedo not hesitate to call me at (9t6) 669-1817 or by e-mail at bweaver@sac.tail-Q9!0.Your assistance on the matter is appreciated.BeckyeaverProject CoordinatorEnc.'Engineering Solutions to Enhance Ptoject Value'2880 Sunrise Blvd., #206 . Rancho Cordova, California 95742. 916.635.2444 .91-6.635.2606 FaxOrange County . San Diego . Sacramento . Phoenix . Reno . Las Vegas . Denver . Boisewww.tait,com l{ov 18 02 O3: 18pSpLn Luis Obispo CitY Fire t8951 543-8019l.ti(p. rSan Luis Obispo City Fire Department2160 Santa Barbara Avenue, San Luis805/78r-7380Permit No.Obispo CA 93401 ApplicationNo. of Tanks to beL,APPLICATION FOR PERMIT FOR TEMPORARY ORPERMANENTType.qf-Application (Fill Outt1A. FacilityCTOSURE/REMOVAL OF IJNDERGROI]NDHAZARDOUS SUBSTANCES STORAGE FACILITYOne Application Per Facility)Closure tl PermanentClosure}(nemouatContact PersonTelephone (days): (nights)Owner:s?c Qno irre- [3*.Address:Operator:YeA*.Telephone:(nc:l z,rz-asz,rAddress?/573Date Tankrnera'arr. lQfnVolume in Gallons:B. Water to Facility Provided by: - -Depth toC. Tank Removal Contractor:Address:Proposed Starting DateD. Chemicalof Materials StoredE. Final Destinadon of&-AddresssofCal. License NoCornpletion,4afuiwInsurer: .. -. -ztt{ilsyh'rThNKTelephoneF. Previousof tank(s) if Applicable:Date: . .NoV ,18 OA O3: 18p S,;': Lu i s ?bi =pP C i tv F i ne( 8PFj(543 -80 1 IAttach Plot Plan Showing:Locationofalltank(s)andpipingandtheirsecondarycontainmentI c^kdetection systemp.2GH-. Overfill Protection system-. Scale, North arrow. Property line-Nearest intersection or road. Equipment summary, giisiing equipment and equipment to be removedType of PrimarY Containment:[ ] Concrete ffFiberglassPiping/Materials oJ Construction:[ | Steel f[FiberglassType of Secondary Containment:[ ] Concrete ffiFiberglass[]Steel []FiberglassCoatedSteel [] Other[ ] Other[] Steel IlFiberglassCoatedSteet [] OtherLI.Was any part of thesystem cathodicallY Protected?If yes, whichpart(s)?Describe leak{etectionsysteur used, ifK. Describe overfill protection systemusedTHIS FORM TIASBEEN COMPLETED UNDERMYrS TRUE AND CORRECT.FIRE DEPARTMENT USEDescribe Method for Retrieving Samples:Samples Will be AnalYzedLaboratory That Will Perform AnalysisAddressPENALTY OF PERJURYAND TO THE BEST OFDateameONLY/(qNnWod \'o'I0{00t. City of San Luis ObispoFire DepartmentWolf Knabe, F'ire Chief2160 Santa Barbara Ave.San Luis Obispo, CA 93401Phone: (805) 781-7380FAX: (805) 543-801eFAX COVER SHEETTo:(Sender's Name)FAX:,-0From: San Luis Obispo City Fire DepartmentIDate:COMMENTS:tlb SU,t",,,ly,^.You should have recei*a | 0.- pages (including this cover sheet).If you do not receive all of the pages, or any of the pages are illegible, then please contact thesender at (805) 781-7380, or FAX (505) 543-8019.D,MnV\AL^,\q/\-f NWNIIfal_lrtfuA,r/l/r^ obwufq,riltd^x'% (SlHtff" oBrspoPERMITFIRE DEPARTMENT - 2160 Santa Barbara Avenue, San Luis Obispo, CA 93401-SZ4O,8OS/781-7g80"Courtesy & Service"ADDRESS1.96 Suburban Rd - paclfic BeltDATE:I)ecember 5, 2002Taic & AssociatesHas permission to maintain, store, use orhandle materials, or to conduct processes, or to install equipment as described below:Remorze 1-6000 ga1lon gasolire and I-4000 gr,.J-J,on c:'-esel tairk ancltheir pipiirg per cal.irornla Fire cocie. Tanks io be removed fr:omCity ;rf ter exc.avation.All requirements shall be per the Uniform Fire code and its standard.Date of Event and/or expiration:l.D. Number:J9, 2003Permit Fee:g 61 2- .00eWhltefipllow - FI]€ O€partmontPlnk - Formlttoo' , Goldenrcd - Flnanc€ DopartmontuTh. P4dt n. 91619. fl . Cfty.hmlt TaiTTait & Associates, Inc.December 9, Q@Pering' Architecture' EnvironmentalVia U.S. MailKerry BoyleCity of San Luis Obispo Fire DepartmentHazardous Materials Division2160 Santa Barbara AvenueSan Luis Obispo, CA 9340I(80s) 781-7380RE:Tank RemovalPacific Bell Fleet Fueling Facility196 Suburban Rd, San Luis ObisPoTAIT JOB # SWlO2ODear Kerry:Enclosed are thc State Tank fornis showiirg the closing of the above listed site. I havcreceived your approval to remove the tank, dated 1215102. I will forward to thecontractor, Balch Petroleum.If you have any questions please do not hesitate to call me at (91'6) 669-1817 or by e-mail at bweaver@sac.tait.com.BeckyverProject CoordinatorEnc.'Engineering Solutions to Enhance Project Value'2880 Sunrise Blvd., #206. Rancho Cordova, California 95742.916.635.2444.91.6.635'2606 FaxOrange County . San Diego . Sacramento . Phoenix . Reno . Las Vegas . Denver . Boisewww.tait.com (For local use only)ACILITY(For local use only)TEBecky WeaverAgent for Owner916-635-2444hereinand accurate to the best of rny knowledge.that the inforrnationCettification - I cerlifYVII. APPLICANT SIGNATTJRELegal notifications and tnailings will be sent to the talk owner urless box I or 2 is checked.I I.FACILITY E2, PROPERTYOWNER E3.TANKOWNER423oneVI. LEGAL NOTIFICATION AND MAILING ADDRESSINDICATE METHOD(s) [l 1. SELF-INSUREDE 2. GUARANTEEn 3. TNSURANCEE 4. SURETYBOND I 7. STATEFUNDE 5. LETTER OF CREDIT E 8. STATE FUND & CFO LETTER! 6. EXEMPTION n 9. STATEFUND&CDE 10. LOCAL GOVTMECHANISM! 99.OTHER: ____-422V. PETROLEUM UST FINANCIAL RESPONSIBILITYTYI91322-9669421IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOI.INT NUMBER3. PARTNERSHIP5. COLTNTY AGENCY7. FEDERALAGENCY420San Ramon411418CA4t9945832600 Camino Ramon, Room 3E000KSBC / Pacific Bell414(800) 7 s7 -6s7s415III. TANK OWNER INT'ORMATIONfl 3. PARTNERSHIP5. COUNTY AGENCYE 7. FEDERALAGENCY413TIONSan Luis ObispoCA93401412196 Suburban RdOR409SBC / Pacific Bell(800) 757-6s75408II. PROPERTY OWNER INFORMATION404REMAININGAT SITE0405orol'ltrustlands?!Yes fiNooperates the UST (This is the contact person for the tank records.)agency: name406ownerorTYPE E 2. DISTRIBUTOR E 4. PROCESSOR E 6. OTHER403NEAREST CROSS STREET401Stx I.CORPORATIONE 2. INDIVIDUAL! 3. PARTNERSHIPE 5. COUNTY AGENCY*E 6. STATEAGENCY*E 7. FEDERAL AGENCY*402(Same as FACILITY NAME or DBA - Doing Business As)Pacific Bell CLLC# SNLOCAAUI. FACILITY / SITE INT'ORMATION(Check one item only)E S.TANKREMOVEDSITE PERMIT400TYPEINFORMATIONPERMITCLOSEDE 6.TEMPORARY SITE CLOSUREE 4. AMENDED PERMIT specify change local use oulyI.INDERGROTJND STORAGE TANKS - FACILITYTANKSof(one page per site) PageCONSOLDATEDFIED PROGRAMUPCF (1/99 revised)171Formerly SWRCB Form A ESTIMATED DATE LAST USED (YPJMO/DAY)(local use only)RE(A dscription ofthe monitoring program shall be submilted to the local agency.)(Check all that apply)TANK FILLED WITH INERT MATERIAL?lYes I NoE 5 MANUAL TANK GAUGING (MTG)E 6 VADOSE ZONEE 7 GROUNDWATERE 8 TANK TESTINGE 99orHER _____UNKUNK(Checkallthatapply) E I SPILLCONTAINMENTEl 2 DROPTUBE8 3 STRIKERPLATE(Check one item only)I I VISUAL (SINGLE WALL IN VAULT ONLY)8 2 CONTINUOUS INTERSTITIAL MONITORINGE 3 MANUALMONITORING8 3 FILL TUBE SHUT OFF VALVEE 4 EXEMPTD I VISUAL (EXPOSED PORTION ONLY)D 2 AUTOMATIC TANK GAUGING (ATG)E 3 CONTINUOUS ATGN 4 STATISTICAL INVENTORY RECONCILIATION(SIR) BIENNIAL TANK TESTING8I ALARM UNKl2 BALLFLOAT _____ESTIMATED QUANTITY OF SUBSTANCE REMAININGOTHER CORROSION N I MANUFACTURED CATHODIC E 3 FIBERGLASS REINFORCED PLASTICPROTECTION IF APPLICABLE PROTECTION ! 4 IMPRESSED CURRENT(check one item only) tr 2 SACRIFICIAL ANODED e5 UNKNOWNE 99 OTHER(For local use only)446444E I.RUBBERLINL,DE 2 ALKYD LINING(For local use only)5. GLASS LININUI]NKNOWNLJ Y)LI J. EPTJXY LININLi U446 DATEINSTALLED 441TANK INlERIOR LININLiD 99 OTHEROR COATING(Check one item only)! 4 PHENOLICLINING O 6UNLINED! 2. STAINLESS STEEL ! 4. STEELCLADWFIBERGLASSREINFORCED PLASTIC (FRP)E 5, CONCRETEI 5. CONCRETE E 95. UNKNOWN 44)! 8. FRP COMPTIBLE Wl00% METHANOL ! 99. OTHER - - - - -E 10. coATED STEEL[Jrx J. IIStrKULADJ / |-LAD rrVsecondary tank5 t l1l1lI ANK MA I bT(rAL -(Check one item only)444/ PLAS'IIC'IANK MA IEKIAL - primaryCONCRETEDsJ. ILJ ).(Check one item only)E 8. FRP COMPTIBLE w/l00% METHANOLtank ! l. BARbSIEELE 2. STAINLESS STEELE 95. UNKNOWNE99.OTI{ER_____E 4. STEEL CLAD WFIBERGLASSREINFORCED PLASTIC (FRP)82. DOUBLEWALL(Check one itern only)(For local use only)440438COMMON NAME (from Hazardous Materials Inventory page)(from Hazardous Materials Inventory page )EXTERIORMEMBRANELINER E 95. UNKNOWNE 4. SIGNLEWALLIN VAULT ! 99. OTHER.-.--I l. MOTORVEHICLEFUEL(lfmarked mmplete Petroleum Type)D2. NON-FUELPETROLEUMn3. CHEMICALPRODUCTn 4. HAZARDOUS WASTE(lncludes Used Oil)[ 95. UNKNOWN! 5. JETFUELE 6. AVIATION FUELE 99. OTHER____-E 2. LEADEDE 3. DTESELn4. GASOHOLI la. REGULARUNLEADEDn lb. PREMIUMUNLEADEDI Ic. MIDGRADEUNLEADED4t)DATE INSTALLED (YEAR/MO)UNK436TANK CAPACITY IN GALLONS6,000NUMBER OF COMPARTMENTS437432TANK ID #1A433JA_N-MANUFACTURERUNKCOMPARTMENTALIZEDTANK IYes ! NoIf"Yes", complet€ one page for each compartment.434USTsystemincludingbuildingsandlandmarksslrallbesubmittedtothelocalagency.)LOCATION WITHIN SITE (optional)4313BUSINESS NAME lsame as rAclLlTY NAME or DBA - Doing Business As)Pacific Bell CLLC# SNLOCAAUFACILI'I'Y IL':E I NEW SITE PERMIT I 4 AMENDED PERMIT E 5 CHANGE OF INFORMATIONPage _ of _E 6 TEMPORARYSITECLOSTJREE 7 PERMANENTLYCLOSEDON SITE8 8 TANKREMOVED 430! 3 RENEWAL PERMIT (Specify reason - for local use only) (Specify reason - for local use only)TYPE OF ACTION(Check one item only)PROGRAM CONSOLIDATEDTJNDERGROT]ND STORAGE TANKS - T^q.NT PAGE I.TANKS(two pages per tank)UPCF (1/99 revised)173Formerly SWRCB Form B -Punrit Nmber lFor local use only)Pe.ilrit Approved (For local use only)Permit Expiralion Date (For local use only)473ffi(printf-- /Becky Weaver@Agent for Owner472I certify that the informatio[ provided herein i5 truetobestIX. OWNEWOPERATOR SIGNATUREknowledge.8 I. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE! 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMSil 4. DAILY VISUAL CHECKn 5. TRENCH LINER / MONITORINGn 6. NONEE 3. CONTINUOUS DISPENSER PAN SENSOR WITHDISPENSER + AUDIBLE AND VISUAL ALARMS469AUTO SHUT OFF FORDISPENSER CONTAINMENTDATEINSTALLED 468VIII. DISPENSER CONTAINMENTSINGLE WALL PIPING 466PRESSURIZED PIPING (Check all that apply):! I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS.E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (O,IGPH)CONVENTIONAL SUCTION SYSTEMSE 5. DAILY VISUAL MONITORING OF PUMPINC SYSTEM + TRIENNIAL PIPINGINTEGRITY TEST (0.I GPH)SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING):D 7. SELF MONTTORINGGRAVITY FLOWE 9. BIENNIAL INTEGRITY TEST (O.I GPH)SECONDARILY CONTAINED PIPINGPRESSURIZED PIPING (Check all that apply)l10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (Check one)I a. AUTO PUMP SHUTOFF WHEN A LEAK OCCURSD b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEMDISCONNECTION!c. NOAUTOPUMPSHUTOFFD I I. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUTOFF OR RESTRICTIONN I2, ANNUAL INTEGRITY TEST (O.I GPII)SUCTION/GRAVITY SYSTEM8 I3. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAI, ALARMSEIVIERGENCY GENERATORS ONLY (check all that applv)D 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *AUDIBLE AND VISUALALARMSD 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOWSHUT OFF OR RESTRICTIONN 16. ANNUAL INTEGRITY TEST (O,I GPH)E I7. DAILY VISUALCHECKSINGLE WALL PIPING 467PRESSURIZED PIPING (Check all that apply):c L ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP -SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS.E 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (0. I GPH)D4. DAILYVISUALCHECKCONVENTIONAL SUCTION SYSTEMS (check all that applv)E 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEME 6. TRIENNIAL INTEGRITY TEST (O.I GPH)SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):E 7. SELF MONITORINGGRAVITY FLOW (Check all that apply);D 8. DAII-Y VISUAL MONITORINGI 9. BIENNIAL INTEGRITY TEST (O.I GPH)SECONDARILY CONTAINED PIPINGPRESSURIZED PIPING (Check all that apply):IO. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (Check one)I a AUTO PUMP SHUT OFF WHEN A LEAK OCCURSE b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEMDISCONNECTION!c NoAUTOPUMPSHUTOFFI I L AUTOMATIC LEAKDETECTORE I2. ANNUAL INTEGRITY TEST (O.I GPH)SUCTION/GRAVITY SYSTEME 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (check all that applv)E 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *AUDIBLE AND VISUALALARMSE I 5. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)D 16. ANNUAL INTEGRIry TEST (O.I GPH)n r7. DAILY VISUALCHECKE I, BARE STEEL N 6. FRP COMPATIBLE W/IOO% METHANOL[ 2. STAINLESS STEEL n 7. GALVANIZED STEEL | ! uut no*nE 3. PLASTICCOMPATIBLE WCONTENTS ! 99 Other8 4. FIBERGLASS 8 8, FLEXIBLE(TIDPE)E 5. STEEL WCOATING N 9. CATHODIC PROTECTION 464I I.BARESTEELE 2. STAINLESS STEELE 3. PLASTTCCOMPATIBLE w/CONTENTSD 4, FIBERGLASSE 5. STEEL WCOATINGD 6. FRP COMPATIBLE w/loo% METHANOLE 7. GALVANIZED STEELI 8.FLEXIBLE(HDPE) D99- OTHER! 9. CATHODIC PROTECTIONE 95.IINKNOWN 465shall be submitted to the localall that apply) (A description ofthecoNsrRUCrroN f| l. SINGLE WALLMANUFACTURER I 2. DOUBLEWALLMANUFACTURER UNKE 3. LINED TRENCH E 99. OTHERn 95. UNKNOWN460461E l. STNGLE WALLD 2. DOUBLE WALLE 95. UNKNOWNE 99. OTTIER462463MANUFACTURER- -. - -SYSTEMTYPE ! I. PRESSURE 8 2. SUCTIONn 3. GRAVITY 458! 3. GRAVTTY459D I,PRESSURE E 2. SUCTIONI]NDERGROUND PIPINGABOVEGROUND PIPING(Check all thatPage _ of _UNIFIED PROGRAM CONSOLIDATED FORMTINDERGROT]ND STORAGE TANKS _ T.INT PAGE 2TANKUPCF (l/99 revised)17sFormerly SWRCB Form B ESTIMATED DATE LAST USED (YR/MO/DAY)(Check all that apply)(local use only)the local agency.)(A description ofthe monitoring program shall be submitted toTANK FILLED WITH INERT MATERIAL?[Yes I NoN I VISUAL (EXPOSED PORTION ONLY)D 2 AUTOMATIC TANK GAUGING (ATG)D 3 CONTINUOUS ATGn 4 STATISTICAL INVENTORY RECONCILIATION(SIR) BIENNIAL TANK TESTINGD 5 MANUAL TANK GAUGING (MTG)E 6 VADOSE ZONEn 7 GROUNDWATERI 8 TANK TESTINGE 99orHER _--__(Check all that apply) X I SPIL CONTAINMENTE 2 DROP TUBEX 3 STRIKERPLATEUNKUNKUNK(Check one item only)! I VISUAL (SINGLE WALL IN VAULT ONLY)I 2 CONTTNUOUS INTERSTITIAL MONITORINGE 3 MANUAL MONITORING8 3 FILL TLIBE SHUT OFF VALVEn 4 EXEMPT8 r ALARM UNKE2 BALLFLOAT ___-_ESTIMATED QUANTITY OF SUBSTANCE REMAINING_ gallonsOTHERCORROSION E IMANUFACTUREDCATHODIC E3FIBERGLASSREINFORCEDPLASTICPROTECTION IF APPLICABLE PROTECTION D 4 IMPRESSED CTJRRENT(Check one item only) ! 2 SACRIFICIAL ANODE(For local use only)(For local use only)E 99 OTHERn e5 UNKNOWNE 99 OTHERE 2ALKYDL]NING D 4PHENOLICLINING E 6UNLINEDORCOATING(Check one item only)! 4, STEEL CLAD WFIBERGLASSREINFORCED PLASTIC (FRP)E 5. CONCRETED 8. FRP COMPTIBLE Wl00% METT{ANOL E 99. OTHER - - - - -D 10. coATED STEEL445c()Ncl{,blBLJ ].1ANK MAI'bKIAL'3. T.ItsERGLASS / PLASTTUE 95. UNKNOWN(Check one item only)secondarytank E l. tsAl{I1SlEfjl-E 2. STAINLESS STEELE 2. STAINLESS STEEL N 4. STEEL CLAD WFIBERGLASS tr 8REINFORCED PLASTIC (FRP)CONCRETE E 95. UNKNOWNFRp COMPTTBLE w/l00% METHANOL D 99. OTHER - - - - _tLl r444/ TLAJ I ILI ANI( MA I EIUAL _IJ J.primarytank lJ l. tJAKb,bllltsL(Check one item only)El2. DOUBLEWALL(Check one item only)(For local use only)438440II.COMMON NAME 1r.ot Hazardous Materials lnventory page)(from Hazardous Materials Inventory page )n95. UNKNOWNE 99. OTmR_--__EXTERIOR MEMRRANE LINERE 4, SIGNLE WALL IN VAIJLT81. MOTORVEHICLEFUEL(lf marked complete Petroleum Type)82. NON-FUELPETROLEUM[ 3. CITEMICALPRODUCTD 4. HAZARDOUS WASTE(lncludes Used Oil)n 95. UNKNOWNa 5. JETFUELE 6, AVIATION FUELn 99. OTIIER_____E 2. LEADEDI3. DTESELE4. GASOHOLI la. REGULARUNLEADEDE Ib. PREMruMUNLEADEDE Ic. MIDGRADEUNLEADED415DATE INSTALLED (YEARA4O)UNK436_ffi[6 g4p46ITY IN GALLONS4,000TUMBEROFCOMPARTMENTS43'7IBIf "Yes", @mplete one page for each @mpartment.431LINKID434esagencyto(Optional)lBUSINESS NAME (same as fACILITY NAME or DBA - Doing Business As)Pacific Bell CLLC# SNLOCAAUFACILI'I'Y ID:E I NEW SITE PERMITE 3 RENEWALPERMITE 6 TEMPORARYSITECLOSURE! 7 PERMANENTLYCLOSEDON SITEI 8 TANKREMOVED470(Specify reason - for local use only) (Specify reason - for local use only)D 4 AMENDED PERMIT E 5 CHANGE OF INFORMATIONPage _ of _ryPE OF ACTION(Check one item only)FIED PROGRAM CONSOLIDATEDTINDERGROTJND STORAGE TANKS - TANK PAGE 1TANKS(two pages per tank)UPCF (1/99 revised)173Formerly SWRCB Form B .f ^'.T]NIFIED PROGRAM CONSOLIDATED FORMTJNDBRGROI.IND STORAGE TANKS _ TANK PAGE 2TANKuseuseffiBecky WeaverAgent for Owner472'l0RIIILE UI.UWNI cenify that the information ptovided herein is true andto the bestIX. OWNER/OPERATOR SIGNATUREEl I. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVEE 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMSE 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHI]T OFF FORD 4, DAILY VISUAL CHECKE 5. TRENCH LINER / MONITORINGn 6. NONE469DISPENSER + AUDIBLE AND VISUAL ALARMSDISPENSER CONTAINMENTDATE INSTALLED 468VIII. DISPENSER CONTAINMENTSINGLE WALL PIPING 466PRESSURIZED PIPING (Check all thatapply):D l. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WI.TJJAUTO_PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS.! 2. MONTHLY 0.2 GPH TESTE 3. ANNUAL INTEGRITY TEST (O,IGPH)CONVENTIONAL SUCTION SYSTEMSD 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPINGINTEGRITY TEST (O.I GPH)SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING):E 7. SELF MONITORINGGRAVITY FLOWu 9. BTENNIAL INTEGRITY TEST (0.1 GPH)SECONDARILY CONTAINED PIPINGPRESSURIZED PIPING (Check all that apply):IO, CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (check one)! a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURSD b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAII,IIRE AND SYSTEMDISCONNECTION!c. NO AUTO PUMP SHUT OFFN I I. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) Y]TH FLOW SHUTOFF ORRESTRICTIOND 12. ANNUAL INTEGRITY TEST (O.I GPH)SUCTION/GRAVITY SYSTEMI 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (Check all that applv)E 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *AUDIBLE AND VISUAL ALARMSD I5, AUTOMATIC LINE LEAK DETECTOR (3,0 GPI'I TEST) WITHOUT FLOWSHUT OFF OR RESTRICTIONE 16. ANNUAL INTEGRITY TEST (O.I GPH)E I7, DAILY VISUALCHECKSINGLE WALL PIPING 461PRESSURIZED PIPING (Check all that apply):D L ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PI]MP _SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS,N2. MONTHLYO.2GPHTESTE 3. ANNUAL INTEGRITY TEST (0.lGPH)84. DAILYVISUALCHECKCONVENTIONAL SUCTION SYSTEMS (check allrhat applv)[ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEMN 6. TRIENNIAL INTEGRITY TEST (O,I GPH)SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):E 7. SELF MONITORINGGRAVITY FLOW (Check all that apply):n 8. DA|LY VISUAI, MONITORINGE 9. BIENNIAL INTEGRITY TEST (O.I GPH)SICONDARILY CONTAINED PIPINGPRESSURIZED PIPING (Check all that applv):IO. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (Check one)I a AUTO PUMP SHUT OFF WHEN A LEAK OCCURSE b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILIJRE AND SYSTEMDISCONNECTION[c NOAUTOPUMPSHUTOFFI I l. AUTOMATIC LEAK DETECTORD I2. ANNUALINTEGRIryTEST(O.I GPH)SUCTION/GRAVITY SYSTEMCONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMSEMERGENCY GENERATORS ONLY (check all that applv)CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *AUDIBLE AND VISUAL ALARMSE 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)E I6. ANNUAL INTEGRITY TEST (0,I GPH)E 17. DAILYVISUALCHECK!13tr14E I, BARE STEEL E 6. FRP COMPATIBLE ilIOO% METHANOLD 2. STAINLESS STEEL E 7. GALVANIZED STEEL I E unkno*nI 3. PLASTIC COMPATIBLE W/ CONTENTS ! 99 Otlter8 4. FIBERGLASS 8 8. FLEXIBLE (HDPE)E I. BARE STEELE 2. STAINLESS STEELE 3. PLASTICCOMPATELE wCONTENTSE 4. FIBERGLASSE 5. STEELWCOATINGf] 6, FRP COMPATIBLE WIOO% METHANOLD 7, GALVANIZED STEELE 8. FLEXTBLE (HDPE) E 99. OTITERD 9. CATHODIC PROTECTIONE 95.I]NKNOWN 465all thatshall be subrritted to the local(A description ofthe464E 5. STEEL WCOATING E 9. CATHODIC PROTECTIONCONSTRUCTION E I. SINGLE WALLMANLITACTURER 8 2. DOUBLE WALLMANUFACTURER UNKfl 3. LINED TRENCH E 99. OTHERE 95. UNKNOWN460461E I. SINGLE WALLE 2. DOUBLEWALLE 95, UNKNOWNE 99. OTHER462463MANUFACTURER_----SYSTEMTYPE D I. PRESSURE 8 2. SUCTIONn 3. GRAVITY 458E 3. GRAVITY459E I.PRESSURE 82. SUCTIONUNDERGROUND PIPINGABOVEGROUND PIPING(Check all thatPage _ of -UPCF (l/99 revised)t75Formerly SWRCB Form B 0B/19/03 TEU 12:22 FAX 1S258272029SHAWE&I@ oo1#TFesharrGrouplncJ"Shirw Envlronffits.rrdl &lnfragtructute" lnc.4o:15 Port Chicago HighwayCoircord. Gallfomia 94520\H€,in(925) 288-9898Etir:ct(925) 288-2103Fa;c (925) 827'2025FaxTo:Vr,,From: Rol)Fax:tof i4i-Sant3Phone:Date:6.t-oI Urgent DFor Review [please Comment l,]ptease Reply EPlease RecyeleceRE:5LODoz'l>- t{ShnvafuylsolT >Cnulorfdrr;sr), t'''tl1\ne wercr-YLeoV> t\{Lea tQoVContidentiality NotieoThis infomra$on eontained in this fax is intended for lhe we of the iodividuirl cf entity fiamed and may c0ntain inlormaliontii"f f" .i"fiO""t at, priviteeed-;"'ol- .tt"n*lJ. exempt from disclosure un(l€r applicable law. lf you a-re not the lntended*"iiri-""t, '"-i iiri"*in.tiin, Oirt,iU"r,i"" oic"pying' ot tti" communlcatiu is strictly prohibited' 1f .you -received thiscommunication i1 enot, pl""r" r*ijry ,i immea;iielioy ielephgne and relurrr the original fax to us at the address shown'Thank ysllRevised 05/020 !I 4 007E&IOA/15/03 I]lU 12: 24 FA.X 1S258272029t:li 4ltI .t oo 6otso ,EE G ototg ilE a c .eu o !o Et E ol!I': ooE Ec s clil!a{}g EI d d€l?, !iltsut! Aa,Lt{ fr! 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I7Alos%ssDFl: I nlq,MrlrixDate Aralyzd: 06i lB/03LUeDI r,(r.:Date Extracied: (i6l i B/03Client Coneet Rob DeLnagrEDate Rcceived: 0E/16/A3Date Sampied: $6r'iTJO3Client Pro.iect ID: #B3BBl9; FB-SLSTrkPh@e ; gl5-79e- i62ti F-r, 9zt-798-l 622CAlli2nilAvaw 06/19/03 TIIU 12Jun 19 ao03 I:22 FAX 19258272029 SI]AW E & I:O"lPl't F!cCFl'!PBELL RNHLYTICRLI -925-?98- 16eO@ oozp.3I A MeCunpbcll Analytical Inc.Shcw EnviroaJn€nnl4005 Porr Chicago HvyCoucord, CA 94520IXerel Relge (Cf 0-C23) Ertrsctrble Hydro,;:rrbonr as Diercl*nthod: 5WJ'50CArutldcrj efiods; BVtSOt5':Wott hF 0306J57cTP.( E-or{13)Reporting Limit for. )F -l;ND e3ff rDr dateE d ,t olabove thc reps+Jn; limit' v.tsr md vtForan; mporicd inrenrp. s inllnon'equeous iiquidand all TCLP,'STLC I SPLP exlrecrrFAacluricred rhremalosrrm rErdiluti6n of origina ! ekt!actlltint ijn coch,acd lurtogstc and sempls pcaks. o'l surogate peak is m elcvatad bae€linB, ori EurmEFte htr bcen diminishedrbllorvingdcrcr.iptionrfths TPH ahromoto8rtrld discl ic sigrlificsnt; b)eignificant; o) unlnownre curoty in ng!ffi a.DdMcca$rpb€ll .A,lalytical is not rosponriblefor their ;nter?retrtion:or sealll/ rnodr$lttiesci ranS€ sompou[dguc significant; r,o rEeognigOble pitlcm;c) lgcrl diesel?is siBni{icasl}: d}tanEe eomp.rundB aftpcaks presenti g) oi, trmdium boillng pointpettcm thrl doo6 1(!t apFar to bc derjvrdfiom dlceal: f) onc !o 6 fEwIngccornpoundr arc significent; h) lighter thanwarer imrniscible f .rccn/Fuducl irprescnt; i) li$rj4 cdlple t\et eoniainiDIIS Certifrcadou No. 1544Rydctirr:, Lab Manager030616?{02A0306367-0U I ALab IDs\MnrC/KgNA,.UI,IArp'I 94.?G98. I?-/.,ss/o J!rirH(d)MatrixDatc Anlyzed: 06/18103Clieat P.O.:Drte Extacled: 05/f E/03Cljeor Conrscr: Ro,b DclnagroDatc Rcceivcd: 06/18/03Datc Sampled: A6/L7|O3Client Project IDr #838819; PB-SLC'Tclcprm iYTt-79t-LOm Fu i 9tt?9f;.!622CAl:006/1rr..03 THU 12: ll ITX/BL NO 51281 ftOOs 06/19/03 THU 12:22 FA-X 15258272025Jun 1s eoo3 I : o.'Pl'l FIccFIMPEELLSHAIY B & IRNFILYT I CRL1-9e5-?99-16eO@ oorP.2 _-_McCampbe ll Analytical Inc.Shaw Environrneuul4OO5 Pofl Chicago H'vyC,oncord, CA94520Grso.ioc Rangc (c6-ct2) Yoletile Hydrocnrbonl ll Gru oline wlth BTEX ud MTBE.Exhnlion rrhir(b $WJO]0EAMlyriEa) Eth.t: 5WB0Ai8/80t ilcmWorhonlt|: O3{t6167Cliail lDTP4E.03(l l)T?-OE.01ir3')Rrparrilrg Limit for DF -t.,ND BE atr nol dstscbd rr Grfoc {rc n:9ortil6; Hmitand Yaporarr reported in pg/l millamplcr inwipc sempk* rn€xttEtsttlLc luttlfcd chfonNroElun: 'ii npt" Fsk corluiss u,ith s$r,ogate peal<.follnwin3descripticnr r rf tht T,bH chnroaiognmat: cuno4y in nature etxlMceangbcll d ralytjorl ir no{respooaible forthtit intert'rgtttior); a)ar wc*ly modi8:d gt3olin i! rignittqrDrib) hcaviar garolinc rangecsopound;BrE crgnificaneiaged gteotinCQt eiiighBr gasoline wrgc(thc moit rnobih frection) are si1nitlcentd) lsotinc E lge cornpounds havingbrulrl cbrornatogrrphic pcakr rr_erigDi ficrnt ; b ic!ogi*!!;,Eaisline?; ci TPH pat Em ihai dotr oot 4pcaraobe dcrired &orr gaeoline(rtodderd solvr:ot / minarrl rpirit?);O on. lo r fcw isol.t?d norr-tarEctPrsseatlg) slnrn$y.agr d gablinc or diis.! ?a!gecompounda rrc sigtrificant; h) liXhrcr rirert rvatcr irnmieciblcrbBnlfoduct ir prtrnr; i) liquidllstconta[ns g'Eater t rgn -2 vol. 96 s.dimmtl j)r€poning limit raised due ro high MTITI: cont€aliTPlt Fas6rn thal rloca not aFpear- io bGvcd ftom guoline {ryistir rtmJ no reoognizebleDHS Cerrifiegtion Nc. I 644Rydelius, [:b MenagertIrlA00rALeb IDznilKgIU.UOJ0.005(.005IIo.0050,05t.0s!En-INAI{A'llANANANAwI88.9INDNDNDNDNDs79.2NDNTINDNDNDs%ssDtrXlrncrElhylbenzeneI OlU$rCECDZACMTBETbU/-\M8trixDate Analfz€d: CIfllE/O3Client P.O,Dotc Ertractod: 06/lE/03CUent Contact Rob DelnagroDaic Rcceivc& 06/lE/03Date Sampled: 06117103Client hoject tDr #83E819i PB-SLOTt&pnc I Y2t-798-162D Frr : 9li-79t-1622, Pu}Ecr, CA0S/il).;03 THU 12: ii ITX/RX No 5i2si G002 06119./03 TEU 1Z:23 FAX 192582?2029Jun 1g 2OO3 I : O4 Pl't Fle CHIIPBEILcuaw tr' g TBNNLYT ICHLIVt nnnp.4McCarnpbe 11 Analytical IncOrygcnated volgtlle Orgenicr by P&'!l :rnd G{CJIV!StM.lho&SWN2diBoan61E?-ont ASurrogeie Recoverirr ( ?ir)a rd all& SPLP BxEBclc src rlportcd!unplet1 -Szs-?9S- 16eOs4rnplcs-2 vol. 116 eedimcnt: j) srnple d jlurcd duc ro highShaw Bnvironrrrnral4O05 Pon Caiegp llrvyCorcord, CA94520Ermcdon Mtthod: gWS0tu IComponnrlDiirpmpyi stha (DIPE!Ethyl lcrt-bDtyl cthsr {ETB. i)Msthyl.t-bu.yl sthpr (MTB. i)t€n-Amyt nerhyl etbq (TA vtE]t-Bsttl alsohoi (TBA)%ss:Com*:illtJYEETvaForLab IDClient IDMatrixDFliqr id sarnplan in mgll.D means not drtlctcd rbo\: thc rBporting limig N/A mc.ri rllalge aot apliabic io drir anr.l'sig.lighrer lhrtt rv:lsr imn:isc ble phen?tmduct is prcEeot; ii iiquid rample thar coniain; Eleil.r :hen6nt6l,Ry'delius. Lab ManagerIrIrtT'x/Rx N0 srzsl &oo4INA2597.1ND99.?NDNAt.0NDNDNA5.ONDNDNDNA5.fiNDNDNDugLvgKcConcentrrt;i, jrawssTP-0E-0l(13)T?-oE-ol(13')DF ='lRcpc'.ting Limir for0306367-00r4Datc Anzlyt*d: fi61 1 8iD3Date Extracted: 06/t 6/OlClienr Contnct: Rfi DelnagroLuert r.tr.Date Received: O6llE/O3Datc Sampled: 06117103ClientProject ID: #838819; PB-SLOTrlr'lo* :915-?9&l6a0 Fu r 9tt-?t8.rotlfDehs,beo, eADHS Certification No. lti4406llg.'o3 TEU 12:11 ' 06/19103 Tllll 12:23 FAXr - ^, f MJUn l:J CUUJ l ' srr925827 2025M^CcrMElPFI ISHAWE&INNHLYT I CFL1-9a5-?:lB-15eo@ oos.p-5 _McCarnpbe .I Analyticat l:ue.Shaw Envirormrntal4005 Port Chicago HuyConcord, CA 94520sUFd: $lv:o504TP-o:$3(t3')TP-o 1-01(t 3,)Rcporring Limit fo r' )F - L:ND tiem nsl dEiEei :d at 6rrbove th; .algortint limitsanplls e rspctrtecin rCI-.SuroEatc cclvgty o, rlsidE of occeFianeeLead by iCP'.tulytfr;rlrdiBt; 6rlrrcWuLorrla: o305l5?samplamt,K&Fglv/ipe and rll Tc[.P /' SPLPruge due io marrix intcrferurca; ND t?leof,r nrra detcctsd abow the reponing limit; N/A melni nollo this smrple or ir stummt,itlqhodr: EFA 691D(i?iXl.7 lor aii elcrlnts cxccpr ZOIU I (wai€,r/liguid- Sb, As. pb, ,iie, Tl); 245.1 (Hg);70l0vipes - Ae. sa, T!)i ?a.?lB (Hg).liquid rampic that cootsino grsat€.lhsn -2 rrol. o/o rcdimcnt; this sedirnent is cxtrrctcd withtr:,lhuid, in accsrdlmc with EPA mcthodologiet anrt erRlff€st cport€d r! eld ior.c+ntrstionElj) :tponing linrir rairod due -ro ingu fficimi5a!r oie amounu yi cstirnBted yalurs duc to toy_rumgslcz) rcpcrting limir ra lad dua io mrtrixirterfrcns€,DIIS C.erriticatien No. 1544la Rydclius, Lab Manage,t0Jo6367-OD2Ao30636?-00 ) Al3bIDiIt041ITTLCs4.f,I5.6TTLEsv. ssDFIcadE .trect ioftD8ltc Anilyz*d:. O6/ I 8/93Clicnt P,O,Dste ExtEsted: [ldl8/o3Clicrrt Contact: Reb DelnagrcDatc Recsived: 06/18/03Date Sarnpled: lt6llJl03Client Pmjeci ID: #Ett8l9; PB-SLO'ttlc?horc r 925-79Lr62O Fa)t : 9e5-?98,!5?!94553-5160s3.ONAmgll<gTTIJCTTLCw06/19./03 THU 12:11 l-lx/Rx No 51281 BOOS 06/19/03 TltU 12:24 FAX t5258272029-Jrrn l9 2OO3 t 2: *E gPtl I1eCFIIIPEELLSIIAW B & IRNRLYT I CHLr -s25-?sa- 1 Gea@ ooso4l--'aMcCampbel I Analytical Inc.t !o jld Avftt.k sol,tb, tg?, ?!siacj. cA 9455f-5560' e}lDtotrd :915'79E-l620 Fu: 915-198-162?llp:ih, w.werqritll.corn $rnrrll mil4Qnrcolpixii.cm0306368-0018Llb lDSbaw Euvironmental4005 Por{ Chicago HuryConcord, CA 94520rethod! sWlSloCClient Project lD: #83881 9; PB-SLOClicut Contact Rob DelngcroClient P.O.;Diercl Rroge (e10-C23) ErFrcteble Hydro,ur,rbout ar DiereFAralytlccl mdrodn SWXOIsCWql Ondsn D3O6:6{Cli:ntW-ltl3l/2r)Rrporting Li.flit for l)F -l iliD mcenr nol dctet :d at sabovr lhe Epollint lisllt' rr'atsr lnc vap('J samFiEE aai: rEpoitcd in py'l rviprtaDr! gtmE/kg, producl/oiVnon+quoussamplesrad all TCLP.' STI,C I SPLP sttnctr ir ;rg/Lciuhcred chromarogram n5 llring in cululod surostte srrd ermple peaks. ot; tBtrogrta praL ir on clcvalsd buulina, or; rDrtog&te hrs bcan diminirlreddilurion of ongrnE! sy.r-Bctfollowing descriptiqN I f ths TPH chromatogrtm ar3 cuBory in naturc r'rdMccampbell ArrslFical is not respmsibls lbrtheir interprctetion: a)ar weaily modifi :d dieret ig signiiimt; b) dierci rlnge r:ompoundssc sigrtiffcilt; ilo 'Ecoglizblc prnm; c) rgcd dietel? i5 rigniticsnr): d)ranne comprrunds anr rignifisgrt; e) unknonm mediu- rn hcilingpoan! Fettera lhEl dec,e nr, t aFpe3r to b9 alenvd fmm diesei: l) or-re io a l-e*p?akE PaErE tt; g) oii t tngg ssmJtoundg arc significut;h) light€r thsr wrlcr immisciblr l.rocnlproduct ie prcrcnt; i) l iquid sunplc thar conrains-2 voi.DHS Cenification No. I644Rydcliue, Lab ManagerNAspc/Ll,fA:l:0w93.0It,Dw%ssDTMalrixDate Aozlyzed: 061 I ElUJDate Extocted: O,6118/03Date Received: O6i tBi03Date Sampled: O6/1?/0306/19/13 THU 12:06 {TX/RX NO 51271 @OOr 06/Is/03 TIIU 12:25 FAX 192582?202SSIIAW E & INNRLYT I CRLJun fS 2OO312: 5 lPl'! l'IccRIPBELLI1 -925-794- 16eoPMcCampbeil AnalYtical IncS ira w Errviiooias.nta I40OS Porl Cbicago Hu1Ccnccrd, CA 94520reR.nnge(ccclz}YolatilellydrocrrbonsrrGosolincrr'iihBTEXerdrtlIDD"Arslltirl mtirodt: slY8uziRSOllCltClienr lI)tttW-rlrt lra ) dRctr)f,bg Lidt tbr DF -1iNI] fi6Dr ml dttlclal lt 6abow ilt tlPodit€iibiiand Yatorr e regortel inpy'L, soit rnd sludgcsampicr in PglwiPe, ndextracis rn pglL.slullerEd ehronarogram; r ilnplc pc6k eo€lutcs with su[ogstE P!Ek'The foilowing dercraption! of thB TPHchrEnDlo8retn fi clr3ot'y ill naluG andMaCmrpba i ,\aalyticai is rot rc*ponribicfor thcir iFierPrelatir)n: a)unmodiiied ar weakly modi iied gasoli;tcEcslrtl t)) heavist grsclinc ra;rg=compounds n l signi5cant(oger! gasotina?):c) lighter gasolinn rr.nge{t}re il(rst mobi. : fraction) msignificant; d) gasolinc rangcconrpounds hsYiogbr(,rd chrsmslogtaPhic tprks llesiBnificrnti biologicellygaxrlincl;ei TPH pram tb&l doe not opPettto br daivcd fiom gasoline(:toddard :o .vcnt / mingral rpirit?)l f) one ro a fcw isolaerl noo'til8e!prc$cnt; g)elrongly a ;ed gasoline or dirsel rangccompounds arc si8niiicanl:!\ t:-L.--.t.--rrl rgrrrLr s 'arsatcr immisciblc sheen/pruCuct il presetti i) liquidlhat conteinr greals lhril -2voi, r, sedirnat; -i)repoding limit rri*d duc tohis,h M'lllE contcnti k) TPH Pattom tbat does nol lpplrt lobcfromnc (avia ioarn) nopallEm.DHS CertifrcationNo. 1644Rydelius, Lab Maoager@ oog3Gesolitgairctito Gtbod: SWSotoBo0lALab IDF\TANANAINANA5Dw0.55.O0.5NA.0.5ItEl'-I0.5IIiND't{ttND99.2INDT?H(s)MTgEBgnzrne1'oiugneXylencsEthylbazcleClientP.0,:Dste Ansllzed: o(til8103at:^-, ---.--., D-L ft-l-aah\/ll5lll gulllagl, rwv vErss6'vDgteExtraeted: 0$/18/03Dare Receiveri: 0tiil 8/03Client Pmiect ID: #E1BBl9; PB-SLODare Sasrplcd: D6/17/81Fu i 915-'?98-1522{ntr r-.,.r ^.,-^-- G-rtTillsPbor : 9?5-798-162U06/ t g /03 THU i: ; 08 i:fX.'RX NO 5I2? ] B 004 06/19/03 TBU 12:25 FAI 15258272025SI{AW E & IJLIN I J2OO3 i 2: 59Pl'! |"!cCRFIPBELL RNFLYT ICFLr-1 -925 -?SA - 1 620@ otop.sAverEMcCampbel AnalYtical Inc.l:lellffiB; !,25-79{-tfzt 8l4i s1t?98-1622Shaw Environmerttal40O5 Port Ctucago Hw IConcord, CA 94520Orygenatcd YolEdle Organlca by P&T a rd GCIRIS*Aaleclis MotlEd: !W5o3oBAldydcd Mrthod: SWE26OBWrkffor 0305169r -L lntCligttlDItaiiaDFr--ornpoundDiistprEpr*l elh€r ())lPE)Elhyt !en-but-Y! dhsr [ETB[ ]Mcthyt-t-trutyl ethtr (MTBI )ren-Arnyl mcthYl t"htr (TAi,itE)t-Aulvl alcohol (TBA]Surrogrte Reeoverier {Yo}t/o5SCorDmanltw{tttvlgor samples r& SPLP extrscls ore reporttd in pg/L,sampler in Ftlkg, wiPcIgwipc,liqr.id amplee in rngll.Deans nol deteured abor c tlc r€poning limitl NIA meonr rn&Iytc nol aF-Dlicrblc o this rnr. ysie'lightc, ths y.rsr immisc tbic shccniproducr as prescnri ti iiquid iamplc lhri qontrin! grearr:r 'han -2 vol. '/o rcditncnt: j) trmPlc diiur.d du to highganic contmt.Rydcliue, Lab Managcr5.0NA9l.tNDNDNAND0.J0.5NAND0.5NAND0.sNl,ILdLugksConcentrstr,. IswwiII:Iw-l(r3 1i2')II0306368-001cRqottids LimitforDF-lClientP.O.Datc Anallzed: OS/t8/0]Client Contact: Rob DelnagroDatc Exkacted: 06/18/03Date Received: O61lE/03Client Projcct lD: #83tEl9; PB-SLODatc Sanpted: 06/l?103DHS Certifical.ion Nc, I 64406/19,'03 THU i2:06 ttX/RX N0 512?; &OCA 08/15/03 TllU 12:26 FAI 19268272025Jr.rn 1S 20Og 12: E 9Pl1 Hce HF PBELTsltAw E & IRNRLYT I CHL1-925-79e-1EZS@ orrp.6McCampbel Analytical Inc.Shaw Environncntal4UUJ Pon UnrCagO rlw IConcord, CA 94520o.$o{t: P;100.9l- R+r"nB al"'rt*orI ND rnan6 nol dBtcclI rbove tbe reponirl#{i mtcr/liquid/oil rarnpler anIrf,trrcts in mE/L.lo *rr, ,ur.or"* recovory olowlisrblc to this sarnplc or irlrr"tyti.ot Mctbods; EFA 60l(rludt"ft oil/rolid/oil/produrtIit tiqria semplc th3t conulnslsignificanrlycficct rupon d rjrcco"ery; z) r?ortint limit nnr lDw-1(r3l/2):d rt or:lirairmC,t,lnaad/.gPLflaBade of scceptueo nnge duc lc nrittix intct&rcnce; ND rrur r:{ &fccled above thc rcponiog limil; N/A rnBqns rolrgltur|l€flt,OC/100.7 for ajl sbffidts sxDBpc 2uo.9 (aitcrlliquid- Sb. Ar, Pb. le, Tl); 2{5.1 (Hg}: ?Ol0rviFs - Ar, Sc, Tl); 74?tE (Hr).gredcr drrn -1 vol. 9" gedisrea!: tbi6 !.dirlent is rxlrecled wlll: t!:lr liquid, i;: gccesdgncg r+i:h El,A m€llddo3ics oird csatctd conocntatim; j) c.portltrg limit rliscd due to inu{ficicnt srrplc rmount: y} c8timalsd veluer dus to los rsrrog&tei$cd due f} rrrtrix iFlBr&rEno€.X-ydelius, Lab ManagerLead by Grlphile Furngse Aloroic il.ltsorptionrA3elyriul rrHlodr: El0O.9wqko.dH, 0306358DHS Cenification No. 644I :lcghw: 925.798.1620 F* ;925.79b1672915J].t560#D?,0l0616i-001 DhblDNrt1.10.020TTLCw9issDFI$dExtractiollv{rhixClientP-O.:Due Anatyzed: Ctill8i03Date Ex8actcd:, A&l 8lg3Date Rec€ived: 06/1E/01Date Sampled: O6117lO3Client Project ID: f838819; PB-$LOCliont Contact: Rob DelnagrotttE/kETTLCSNAme/L0,005TILCwa6/L9/,t3 THU l2;06 ITX/RX N0 512?l Booz llcCamphelt ArrallYllical Inrc.Gilfi til-xllF-Gu$rlL ltv ll m0 n[Page lof ILrCi cJro0lrnJ 11$c)0r l4rlJ lYC4 ror0#JTX:i3$ ctrniI:D ,j:IN-FOciHrnr-rilt I ll Sccond A'r,e nuc Soutlr, #tl7Pachc.o, cA 94553.5550(e35) ?9t.rd20Work0rder: {t30636tShew Environmental4W5 PortOhicago HnryvullllrtlJt vA ?tdsvirnl:nmple lDTEL:FAJ(PO:s2F20&21m{9251 027-202s$aaooah. Do ct nDdpcR'd't€d:Dan.Prlll,ted'6/tu036/lEo3GllattSarngDlfatrlrGolccrbn Drla FloldT.slscABDn6117103 12;$0:00 PMWatsrw.llr3 r/2')z.:Dr--< 12-rFrrdr)E:D "'rrFl*IaN(nI..J(o(!Imt\,(focDaf,(tc.,FidtsT0gli06It6S001Fl;{nxzcnOtllrl€trtr: fu"Prepr:'ed by: ltferle VenegerN{6(tF;1lN6 ju F *ali rat OA/19/O3 T1]r-l 12:26 FAI 1S258272029 SHAW E & I Jun 19 2OO3 12: 5 lPl'1 I'lcCFlt'tFBELL FNRLYT I CHL Ifu r ot 09/z'6tul zrjJ0bzd cs?-l r!E.wMnl tlErtt ll-yvY3 0t68 rQrUg . fg9 !.&t /ig s,vNd l r,t{vd otEg I gZ9 !-d3 0928 J 0tr28 / r?9 vd3 r aun s H'tr ngrl , eno \,Ja 0808 / 809 YlGi $iai t 299 vfjal A'lNo x3r8 otot / r09 v{3 (l.g lt] s Eqruo+I11rlnelua4 prol (J'TC,J?: 0?SS) r rlsrD T Il.} rlrmrs!.d lttot G;OSI:i=K n Hd.l istoE - Goscsei Fs*H4r T x3IB tl-) 1 -q2q-?ctgl- 14.2n P 06/19./l:'3 TIIU l2: 06 tTX/Rx NO sl271 @ 013 I il3 tt l t-;- z z - L-]';\ rf v) U z U e: 6rat q; sra \ -\J (_v)\s \ts (n (- ,\,f \ Tc{ Df\J f) a\ ie ea =B=<Zv3'j <! 9- z J rJ = z >' (.) IJ E t| az 9 I&o\F t v .1, oN dg\ It ntitJ E v)o I ._)-J I | .., uvzt( ltltttrlt *t, ,t:-;..)r il !ltt li!!ttitl,ti tii I i":' i illiltlt\l,itililxiit' t?lri ; i l\') iilt\ l Rrarl liix.i I I:l X iili i ; 1''"i r.glo I I totGt tf,H r(. lrI aB]t :tl {rttll JsBO' a5pn1g 'J,IV llos x - E r'te x II sreureruo3 a&\1 lil $sIIrElEDS #s I I g\ ! Eru-tfI [t I v E-tJ alc tfrf ! I I I I I I ! = ir(F it:tI:, J E U'\ tl bllFl I-il I q u n d e4 = I I c F L/ 009 Nr -i) t A-l-)/ fl ( tl ) lul ItIq)l It e V Division of Environi rtat Health(80s) 781-ss44P.O. Box 14892156 Sierra Way oSan Luis Obispo, CA 93406Department of A griculture/MeasurementStandards (8os) 781-s9102156 Sierra Way Suite A .San Luis Obispo, CA 93401Fire Deparj rt (805) 781-73802160 Santd --rbara AvenueSan Lrris Ohisno CA 93401-5240t lll:Utilities Department r (805) 781-7215879 Morro Street r San Luis Obispo, CA 934016 ,// ,ojCERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMEFW dataentry by:MADate:Time:TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determiningwith adopted codes. GRANTED BY (NAME/TITLE):nNotrYEsREINSPECTION REQUIRED:! Business Plannacrn usrn nw Generator! tiered PermittingPROGRAMS! Business Planfla.crI]STD Hw Generatorn TiereO PermittingPHONE:FACILITY NAME:F'ACILITY ID NO:AGDEPTCITY FIRECITY UTILITIESEAGENCY[] nrnNOtrTTBPOlBPO2BPO3TROlTRO2EROlER02BI]SINESS PLANBusiless plan is complete, current, & available during inspection (HSC $25503.5, Title 19 CCR $2729)Inventory of hazardous materiats is complete (HSC 525504, Title 19 CCR $2729)Site layout/facility maps are accurate (HSC S25504, Title L9 CCR$ 2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR S2732 & 22 CCR $66265.16)Training documentation is maintained on site for current personnel (Title 19 CCR $2732 &22 CCR $6626s.16)EMERGENCY RESPONSE PLANContingency plan is complete, updated, and maintained on site (HSC $25504, Title 19 CCR$2731 & 22 CCI.J.-g66265.s3ls4',)Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or releaseof hazardous waste to the environment. Maintains all required or appropriate equipmentincluding an alarm and communications system (Title 19 CCR $2731 & 22 CCR 566265.31-.43)trCOMMENTS:l,rilA,1t4'/,1414 il"i//r/h"'atd\,ffiAnf Pzt tilae"4,n'hb4aWb444.//44nffiy','M'hfuA:\CUPA inspection forms"doc 1 9-Sep-02 E T/N A.l\To:Urgent - Immetiiate ac1i91a-id/or response requrreoPAGE T UTPer your regu(styour infornraiion.es-&.*7wGe-r)t2'f44-- &/<eoneord, CA 94520a,ii/?Phone:Daie:Fax:Time:cc--rtG nlz-SllNI DT;t +:' i rr P;f:fi oti*,,aot 1'IA,il: (y4J' o&,-bv"roo FlI?6e0ezz8se6T xvJ l0:rr Iu.{ 00ltI/90 06/13/03 FRI 11: 38 FAX 1925827202S SI1AW B & I @ ool f 1I '1 -ru3I rA']Ul.lH l-l3gdt"luJcl'l hldzs : t Eooz z7 uiir rl kqFd* (hl R L_]6\ l^/1 ot9!-BE4-Sz6-T ).) nlgt 9l -i3t 4t€ FIgt !l =tutnt4tLi I I I ga tt',F JJe =E. .\- <-\fl ,Q5" f, t & E rcl;9 I otrri I III I ( o vt z i =c) t: Li (1 a a+e *, + It &t3E:i 9!d5r. - l.!z.- tc # Contairters Typc Colt:aincrs lrlater Snil 3 -tF >< nir Ice g 2a \6 f.j{Jr\,\o6I hJt. z iJ. f' l' to 6 vt-t)lh iacrt €\ta€ -_a (.!F =!-Rr.c lrt !j F. 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ANT DECISIONSIMPORTANT TELEPiiOi.IE CALLSDATE:oJ'I4obllo3r^rE A'rlJEE r^f\NnITIONS:lYLnl I lLr \VICIT'IQQ rlN qITFvlurrvrrvE (6r6t$qstsAg4Ut,| t/tSIGNATURE:r8Jtmvtt56e0eietge6T X-d"ri tS:IT iiiri ttlti/$fi12-98 f-Jun 12 aOOs 4: SZFi'i iicCRIiPBELL RNRLYT I CFL1-SeS-?98-16;lOAlglltMcCamPbell AnalYtioal Inc''r-sicpbas I9lJ-rtFioru rq 'Datc SamPled: 06/: l/O3Dale Received: 06/' 1/03Dats Entracred: 06i . iE3Data Aaallzed: 061 17|03GrsolineReage (CFCIQ v' o!s{l!EEydrocrrboncas Gasollre*lth DTEX end 1VITp.+Exinsicrmairorir SW5S3OBvaF0rsample artre,pctad in FglL'c!utt:-,ttd ckgma!,ogra:n; sanrplc pcdt ooclulcr with surrolptc peak'DHS Csrtificatioa No, I 644AslythltrElhoib:SWEfitIE/80r5Cnin mp[tg.-^-*t-wrrPrENDI{DNTIBE*vto*Odfi 0tO6Z5tFID0.005NAarlBd :' their in:erprerrlion: a)t lighq:r Srsolinc rangEiisniitlrni,; biologiesiiY. e fe.w irot€icd non-trgctJuet h Ftceart; i) liqoiddoc! ftol &ppc*f t4 bcItrdclius, Lab Managcr!.00.050.005-o.005o.005Ew8[?ctiry riuir lbr DF "i;ND nE1rurEt&EcLd rI or,,r--t-i!odlM wcForr5 Eru'NANANANANAo04Assw-o?-9NDiiDl!us,nf -I<sNDNDNDND0024$w-0t.6sNDim:.1.Dc01ATP.,0l-15END}IDNDI\DAIlNDNDNDl-gbFulltnl uTWt+\N'fIBEBcnzpucTolucncEfrtylfuo.aPUlont r,u.:Client Conll(:[ Rnb DelnrgroShaw BsYire@otal4005 Fofi CbicsgsHsYConcord, C,A945ZOClie*Project tD: FE38819;FB-SanLuisObispomgnqIugltI:lrte<(87.OI39.O1ItulDF14 SSe00 mI T t ,iiVHS6Z0ere8se6r xvJ 68:TT IUd gS,',STl90 06/13/03 FRI 11:40 FA]( 1S2582?2029 SHA\Y E & I rfl 006 rllr J3tFrBr{ qsT'firltP/i1 ou!!tuo! luql q(tutss Pln ,tral a €;'*o (F :ieet (o :(rrnrgnfF 11 l,trselP Pi (E :uollatildr.[u! {sql; xrrntt IsqS!$ Jo uoSnllp pcrlslulurlF uarq seq aEEa JrRr :rg 'anlF6sil P4"'r3F uo 11:ped arCouts :lo'q?od lt{iulrt piro atuiorrns g;Fl&l- -ri'! 3fililnsar urE€cle:::a'lq: parolrnle ld'nr lp Frr rnlduns art jffi PsE -f tFr a r!glnb$-gnrnbu €rldtn ul VN ON t-y'9 ON q'9'I (9'HdI etIoaif,8 ----- -Fa'.r.iqrrulg lirlq-v aiqEiciliEE €Sg'olc) rEu4g psa-tq fogg€,l\s 59g99{g :r'Flo tirdl|t _ -.-_ -- a- *IABoIC t r SIIOqrEsoi-Faii r^ Et h^--Atlzv, b L ltu .,ut .. r6n 1D5r/trlxltt llEdt>w .r----.- -. €0/I -./90 :P.rtaqxfl eteg it il'.tgo :Pcr'ir*tE 4sc €0/I t/gg ;peldureg ePg zz9Ya6J JZ6;xrt OEqt-861-!U6: Dqal,|tl VJ -lu3r-LA-lul+g 'l'1lEdl{u3.'t'l l"ldz9:t eooe zl unc '--,) f,;t8o VN b't A t f0t L I I6'96 .duss% s rr*,. !,llilld'- _,.:T'3.Tf .,ro la pill{taey rvs o$Fs ua : r- trC! 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O6rll/03Clisnt Contar:t: Rob DclragroDete Exirsttp& 06, 11i03'Lllg[l r.r.r. iDEt€ Anrllaed: M.'1210.3Orygenetcd l'oletlle Orgrntcs by P&T andGCI$ts*WoiIOrdaor06265Ertsastior i'i€tbt& S903CE,unMicrt Mctllod: SWt26{lBnrn4t4{-nn ! aSW-UlFtsI€orrcenirrtion.(i urtogde Recovericc (9o)do&irft|rt/t-s{riYsludgeJcolirittlrl rgtlrB' wrP!'vesorsampl€siiquiri rrmpioc inme/LrniBnBnor&Gctedabov'thercpo.linglimit;lsAmel.n$3'lalyt.notgpgllcsbtcrorhieanrlysir''trev*,,/@acl la plceng i.! liquid smPle t!81 sonteins Erralot dran -2 vot' % sedimedt; D er tplc dilutcd dus lo highhght€l lrun woEr lmmEcrerc rr€onte'}t,lydelius, Lab Manager-cl\IDNDNDNDuo|llmGnE%SS;99.397.9,o.t. 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'tBE*ti/ilkorihtl 9306266NDo.0{t5e{!EEr ln Pg[-r lhsir ittterPr€tstion: a),) liihtef grsolin€ renS!risnifi ceni;'rtiotolicrltiir a fcrv i'olat3d nol-3rgctdustir pr€srau; i) liquidrlocs trot appeer b beAogela Fydeliue, I-ab ManagcrTdctirrc:--- $- . -r^ o-* , dtaylf-rt&rerv 15 '-'*Lt4tDaieSrrmP,led: 06/11/03Datc Received: 06/lt/03Date Exiracieii: Oft i1/03Datc Analyzed: 0&12103Ga-'cllso P.gngc {c5-C 12 I Vote' d leHydrocerboal 48 Grsollns wlth BTDX snil MIlu$icrtErlhodst swloltEtt0lScmExiBed.n ffi$FA 3\Y5O.!0BNDNDNA1iuglLIe9.894.3tIv{,fDF%s$nrn EhnoT T .q ,{|VHS6Z0ZLZB976r XVJ rD:Tr rud e0/sr./90 tJun 12 zgog 5: O i PH l'tcCsl''lPBELL f'INHLYT I CRL1 -SZ5 -?*la - I t:z icA ;4ss3-5tn0tckFho,E:92t.?9&l{8o Puns:,t8-1611DgtG SanlPled: 06/11/03Dato Received: 0Q'! ll03Datc Extradted: 06ll t/03Dsie,Fiiialltz€d: o5i,tna,swriS0c!*ttat gldalgand all TCLFI STITC ISFI.F cttt8rts ltrclui€f€d ehrffisl.eggar* rerr:ltir:g in eo€tuls'l Eutro8sto uii satnplc p'ats' oriditrnon of origlnal axa*l't'ollorrdngdcrcripiiot-sirf lhe TPH 3t'.:smat o g!3!!r.' walclvmodifieddiccc! ir sfuniflcant; b)firnBcE stE 3ignificint; c)unktawnpcaLioilDHS Cgrtifrcation No' i 644Iltuiei Rrtge (Cl S-l)'13) ErtrsctableEydroeerbons ar Dietel*.aef!'lierlrlltboda;gstt0r5c14,t1.6'c2.7.btnda$plesNAt.0WlrtOrdc 0:06266rqseoD€cornpoundpreacot; t)sunogetc peat is on rlcvlicd bas€linet or; Jutrr Sete hgc boen dimirrishcdtbelrintcrgreudon: a)l^ }- -:_'E-.-D\' ^tcl ols€ll 13 ilBlrlrlvor.vr efiesal; l) onc tro a feryrid Barnplc that contsinrlyrtetiur, Lab Managcrtl IsrogIKgRoporting ijoii for iiF -1;rrh m6n! n6t detdltd lt Ofrsdve ths t€Poning littitNAo306?66403Aes (9"i2)DI1070306266-0024.cs (5-E)sIro?0306266.00iA\,D tr -,cInlLab ID-il,lYlaEl^VtDPClicnt P.O,:Clieai Ccntggl: F-eb DeloagroShaw Environirrmal4$0S Port Chjctgo !-lwyConccr4 CA94-I2OClieot?roiect tD: #838E19; PB'SutLuisObiepoMcCamPbell A:ralYt-ieal Inc'T To -'tl416TnflA{VHS6Z0ele89z6T XVd et:rr Iud 80./8Tls0 I -S25 -"98 - 1 62OP. EJun 12 eOO3 5:01Fi{ }1cCfll{PBELL I1HRLYTICflLCAz9?l-?9?.l99 4*:c?5-s8.16l7Deie Sanrplcd: OU. tlASDate Receivcdl 06l ll$3Drte Brfiact€d: 06/ .11+3Date AnalYzcd: 06/t2t03OxSryenaied V r rlnfllc Orgrnlcr bYP&T snd GC/MS"w'rrkor&tl 0306266Ertrrct'riii'le.bod:aw6adrrccu$kdMo{Ed:swsr6qBRcporting Limitfor0F-iConeenirrfionNDNDSrurogate Rccoverler (7o)dlcxtragb a:er€?ott€dln FgfL,wnprEt lll".;-r.-'in'x iEwrPetHrts Yq -'waler and wporsr,rnpies ln mgt-.m.at|s lot deloctcd sboTc the t€Podiog limit; NIA mea's anrtltc not rppliceblo lo &is rnrlyril''lisfur.r thrtr wBicr inmiagiiile ;hF6n./Frcd.uct ie pr*err€ i.i lla;:id rarnple thrt eq|tatns grcatef lb.r -2 vol. % sedlmcnt: j) sarrple diiutad due io higltI:ydeliru, LabMamgerNDNDrrlComBailllI9t.2vt.oND95.9ND2sHAt.Biliyl itegttcl {feA}7oS9:.n^r.!)tcri.Atnyt mglnyr EsFr' \ r A.rDNDHD5^0NAMc&yr-tjilryl ethcr (MTB E)NDND:;.oNAEthyt reft-butYt Gthet TETBE)NDND5.0NADiisgptoPYl E*tct (DIPE)NN5.ONACompormilrdKeudLDF5wMatriitsIsSClicntcs (I-4)cs (5-E)I tjs (9-tz,r-Ltnntn,it66-f}0l.lrlrsez?e-oozr0306266-003AShaw Environmcatal4005 Port Clric*go HwYConpord CA9452o^fin "L;llenE r.\r.;Client Conlac l; Rcb DetoagroLUIECliont hojeot nD: #83EEi9: PE-SqnObispoMcCaurPbell AnalYtical Inc'ZTO FIDHS Certification No' 1 644I T S ,ttVHS6Z0ZLZ89Z6T XVJ eF:Tr IUd S0./8r./S0 a/-sBC Services. Inc.( .6. Box 5095,A:lvironmentalManagement West RegionRoom 5E000San Ramon, California 94585Phone 925-825-9853Fax 925-975-0584Fax 925-867-0241e6May 1,2003City of San Luis ObispoParticipating Agency (PA) to San Luis Obispo County Certified Unified Program Agency(cuPA)Spencer Meyer - Hazardous Materials CoordinatorCity Fire Department2 | 6 0 S anta B arb ar a AvenueSan Luis Obispo, CA9340I-5240RE: Certification of Financial Responsibility - Underglound Storage TanksPlease find the enclosed copy of the annual State of California Water Resources Control Board'sCertification of Financial Responsibility form to demonstrate financial responsibility forSBC/Pacific Bell and its affiliate's underground storage tanks'Also enclosed is a list, Exhibit A, of SBC/Pacific Bell sites that have underground storage tankson the premises in your area ofjurisdiction.I can be reached at (925) 823-6161if you have questions regarding this correspondence.Stan BrodeckiS enior Environmental ManagerSB C Environmental ManagementAttachment: Certification ofFinancial ResponsibilityExhibit "A"2003 Financial Test of Self Insurance (CFO Letter) EXHIBIT A2OO3 UST FINANCTAL RESPONSIBILITYSAN LUIS OBISPO COUNTYLinda PorterSan Luis Obispo196 Suburban RoadCity of San Luis ObispoLinda PorterPaso Robles908 28th StreetSan Luis Obio Environmental HealthLinda PorterPaso Robles730 15th StSan Luis Obispo Environmental HealthLinda PorterMorro Bay788 Main StreetSan Luis Obispo Environmental Health DeptLinda PorterLos Osos2053 1Oth StreetSan Luis ObisEnvironmental HealthLinda PorterCayucos65 13th StreetSan Luis Obispo Environmental HealthLinda PorterBradleyLynch Canyon RdSan Luis Obispo Environmental Health DeptLinda PorterAvila Beach133 San Rafael StSan Luis ObisEnvironmental HealthLinda PorterAtascadero6220 Atascadero AveSan LuisEnvironmental HealthSite GontactLinda PorterArroyo GrandeLocation225 N Halcyon RoadSan Luis Obispo Environmental Health Dept A\ 3C,:xro3of lvittrGs orOatcJoSe-p\ F. Pqn:*r..qNr@ of wih6s o. Notrry'/ 3o, zeb3DarsSusan Johnson, Vice President-Finance (PBnlB)Nrnt rnd Titlc olTunk Owncr or OpcralorFucility Nrm/)FNiliry Addr6sFacility NrnEFacility AddrcasFaciliiy NrGFrciliry AddrdrFaciliry NamFacilicy AddrcsFrcility NumF4cility Ad&ssFrcility NrmFncility Addr6sD. Filcilily NrmSBC/Pacific BellSee Exhibit "A"Frcility Addr6sNote: Ifyou are using the Statb Fund as any part of your demonstration of financialresponsibility, your execution and submission olcertifies lhat you are in compliance with all conditions for participation in the Fund.this certification alsoFinancial Test ofSelf Insurance$ r,000,000 PerOccunence &$2,000,000AnnualAggregateNotApplicablefor StateAltemativelvlechanismPacific BellFinance2600 Camino RamonRm 4CN100San Ramon, CA 94583YesAnnual Nzlay l,2003 - April30, 2004YesC. IvlechanismMbchanismNumberName and Address of IssuerCoveragePeriodCoverageAmor.rntThird PartyCompensationCorrectiveActionherebycertities that it is in complianc6 with the requirements of Section 2807,Article 3, Chapter 18, Division 3, Title 23, California Code of Regulations.ASbThe mechanisnrs used to demonsh'ate financial respoSection 2807 are as follorvs:B. SBC/Pacific Bell(Nam oftunli Orncr or Opcrutor)A. IamrequiredtodemoustrateFinancial ResponsibilityintherequiredanomtsasspecifiedinSectiou2S0T,ChapterlS,Div.3,Tille2l,CCR:I soo,ooo dollars pel occrrrrence f, t million dollars annual aggregateor AND orX 1 miilion dollars per occurrence X Z mittion doliars arinual aggregateCERTIFICATION OF FII\AI\CIAL RESPONSIBILITYFOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEU]VIState of CaliforniaState lVater Resources Conrrol BoardDivision of Clean Water ProgramsP.O. Box 944212cA. 94244-2t2QSubmit original to local UST regulatory agency. Keep a copy at eac(I nst r u ct io ns o n Rev ers e)uN-049 - l/2rvwrv.u n idocs.o rgh UST facility.01t?'9t02 IhBLETTER FROIU CHIEF FINANCIAL OFFICERI am the chief financial officer of Pacific Bell, 2600 Camino Road, Foom 4CN100, San Ramon,Califomia. This letter is in support of the use of "the financial test of self-insuranca," to demonstratefinancial responsibility for taking corrective action and./or compensating third parties for bodily injuryand property damage caused by sudden'accidentai releases and/or nonsudden accidental releases in theamount of at least One Million Dollars ($1,000,000) per occurrence and Two Million Dollars($2,000,000) annual aggregate arising from operating certain underground storage tank(s).Undergrorind storage tanks at the following facilities are assured by this financial test or a financial testunder an authorized State program by this "owner or operator": Exhibit A contains the name andaddresses of each such facilities. All Underground Storage Tanks are assured by this financial test and afinancial test under a State program approved under 40 CFR Part 281.A "financial test," is also usedbythis "o',vneroroperator," to demonstrate evidence of financialresponsibility in the follorving amounts under other EPA regulations or state programs authorized byEPA under 40 CFR Parts 277 and 145:EPA RegttlationsAmountClosure ($$ 264.143 an{ 265.143)...Post-Closure Care ($$ 264.145 and 265.145).......Liability Coverage ($$ 264.147 and 265.147)......Corec'tive Action ($$ 264.101(b) ....Plugging and Abandonment ($ 144.63).Closure.....Post-Closure Care......Liability Coverage.......Corrective Action......Piugging and Abandonment......TotaI...........$ NiA..s N/A..$ N/A.$ N/A..s N/A..$ N/A..$ N/A.$ N/A.$ N/A.$ N/A..$ N/AThis "owner or operator," has not received an adverse opinion, a disclaimer of opinion, or a "goingconcern" qualification from an independent auditor on his financial statements lor the latest completedfiscal year. -Letter from Chief Financial OfficerPage 2Alternative I1. Anrount ofannual UST aggregate coverage being assured by a financial test, and/or guarantee$lM2. Amount of corrective action, closure and post-closllre care costs, liability coverage, and pluggingand abandonment costs' covered by a financial test, and/or guarantee $ 1M.3. Sum of Lines I and 2 S 2M$ i7.341 billion4. Total tangible assets5. Total liabilities $ 13.574 biilion6. Tangible net worth S 3.767 billionYes NoX7 . Is line 6 at least $ 10 rnillion8. Is line 6 at least i0 times line 3? X9. Have financial statements for the latestfiscal year been filed with the Securitiesand Exchange Commission?10. Have financial statements for the latestfiscai year been filed with the EnergyInformation Administration?N/AX1 1. Have financial statements for the latestfiscal year been filed with the RrualElectrifi cation Administration?N/A12. Has financial information been provided toDun and Bradstreet, and has Dun and BradStreet' provided a financial strength rating of 44' or 5.A.? XI hereby certify that the wording of this letter is identical to the wording specifrred in 40 CFR Part280.95(d) as such regulations were constituted on the date shown imrnediateiy below.on April?O. 200;ignature)Ms. SusonVice President-FinancePacific Bell/Nevada BeIl LETTER FROM CHIEF FINANCIAL OFFICERI am the Chief Financial Officer for Pacilic Bell, 2600 Camino Ramon, Room 4CNl00, SanRamon, Califomia.This letter is in support of the use of the Underground Storage Tank Cleanup Fund todemonstrate hnancial responsibilify for takrng corrective action and/or compensating third partiesfor bodily injury and property damage caused by an unauthorized release of peholeum in theamount of at least $ 1,000.000 per occurrence and $ 2.000.000 annual aggregate coverage.Underground storage tanks at the following faciiities are assured by this lefter:A list of SBC facilities , name , address, number of tanks and size are listed in Exhibit "Al'l. Amount ofannual aggregate coyerage being assuredby this 1etter............Total tangible assetsTotal liabilities.........S 2.000.000 million.S 17.341 billionTangible net worth (subtracl line 3 from line 2.Line 4 must be at least 10 times line 1).................$ 3.767 billionI hereby certiff that the wording of this letter is identical to the wording specified in subsection2808.1(dX1), Chapter 18, Division 3, Title 23 of the Califomia Code of Regulations,I declare under penalfy of perjury that the foregoing is true and correct to the best of myknowledge and belief.Executed at 175 E. Houston, Room 1307. San Antonio. Texas 78205On April.lo. 2003Susan JVice234.S 13.574 billionPacifi c BeilAtrevada Bell IlnvironmentalHealf ervices(s0s) ?s1{s44P.O. Box 14892156 Sierra Way oSan Luis Obispo' CA 93406Denartment of Asriculture/MeasurementStandards (805) 781-s9102156 Sierra Way Suite A oSan Luis Obispo, CA 93401of San Luis ObrsoFire Department (805) 781-73802160 Santa Barbara AvenueSnn f ,rris Ohisno CA 93401-5240Utilities Department o (805) 781-7215879 Morro Street o San Luis Obispo, CA 93401CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMblft /03EFW dataentry by:Date:Time:YESIITItrBPOlBPO2BPO3TROlTRO2EROlERO2BUSINESS PLANBusiness plan is complete, current, & available during inspection (HSC $25503.5' Title 19 CCR 52729)Inventory of hazardous materials is complete (HSC $25504, Title L9 CCR $2729)Site layout/facility maps are accurate (HSC 5255040 Title 19 CCR$ 2729)TRAINING PLANFacility has appropriate training program (Title 19 CCR $2732 &22 CCR 566265.16)Training documentation is maintained on site for current personnel (Title 19 CCR $2732 &22 CCR $6626s.16)EMERGENCY RESPONSE PLANcontingency plan is complete, updated, and maintained on site (HSC S25504, Title 19 CCRs2731 & 22 CCR S66265.s3/s4)Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or releaseof hazardous waste to the enyironment. Maintains all required or appropriate equipmentincluding an alarm and communications system (Title 19 CCR $2731 & 22 CCR $66265.31-.43)NOTO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determiningwith adopted codes. GRANTED BY (NAME/TITLE)! Business PlanYESNO! Tiered PermittingnncrUSTNn cranpn rrw Generatorl-l Business PlanPROGRAMS INSPECTED:! {ierert Permittingn.lcrfios,E calnpn IIw GeneratorPHONE:ADDRESS: f// -fut7itlln'/ 4FACILITY NAME: SiID NO:FINSPECTION TYPEn RoutinenuW3ff"i'"'fu,{tptzhtReinspectionDEHAGDEPTCITY FIRECITY UTILITIESCOMMENTS:mlnN, (,*uW\Inspector-4 'Q-Facility Representative:A:\CUPA inspection forms 2.doc 20-Mar-03 IIShaw Environmental, lnc.4005 Port Chicago HighwayConcord, CA 94521Phone: 925.288.9898Fax: 925.288.0888." Shaw Environmental, lnc.June 11,2003Shaw Project No. 838819.48Mr. Andrew TaylorSBC Services, Inc.2600 Camino Ramon; Room#3E000San Ramon, California 94583Subject: Letter Report for Quarterly UST Monitoring, SBC Facilities, L96 SuburbanRoad, San Luis Obispo, and LL89 58th Avenue, Oakland CaliforniaDear Mr. Taylor:Shaw Environmental Inc. (Shaw) is pleased to present this letter report outlining temporaryunderground storage tank (UST) quarterly monitoring activities completed at two SBC facilitieslocated at the above-mentioned addresses. The monitoring events are to ensure that the USTs remainin compliance with permits issued for the temporary closure activities which took place in the firstquarter of 2003.Field ActivitiesOr Ap.tt 9, ,003 and April 14,2003, Shaw visited the subject sites located in San Luis Obispo andOakland, California, respectively, to perform monitoring of the USTs. The lower explosive limit(LEL) and percent oxygen were measured using a field-calibrated photoionization detector (PID) toobserve that the levels remain below I07o, as required by the temporary closure permits and Shawprotocol. If initial LEL and percent oxygen readings were in excess of 107o, Shaw personneliowered them by adding dry ice at arate of 20 pounds per 1,000 gallons of tank capacity, withadditional dry ice added as needed. Time was then allowed for the dry ice to displace residual vaporsand oxygen from the tank before measuring the final LEL and percent oxygen. The amount of dryice used and the LEL and oxygen readings are summarized in Table 1.Shaw appreciates the opportunity to be of continued service to SBC. If you have any questions orcomments, please do nothesitate to contactme at (925)288-2L19-Sincerely,Shaw<-rProgram Managercc: Mr. Kerry Boyle, CSLOFDMr. Hernan Gomez, COFDAttachments:Table 1 - Quarterly UST MonitoringICNCD:\SHARAU5T\03-0048.docA ShawGroup Compaty TABLECNCD:\SHARRUST\03-0048.doc Table 1Quarterly UST MonitoringSBC Facilitiest t89 58* AvenueOakland, CA196 Suburban RoadSan Luis Obispo, CAAddresso4t14/0304t09103QuarterlyMonitoringDate4,000 gal6,000 gal.5,000 gal.5,000 gal.UST SizedieselgasolinedieselgasolineUST Contents0lbs.200lbs.50lbs.100 lbs.Amount of DryIce Added5.4Vo7.1Vo4.7Vo5.SVoInitialOxygen Percentage5.4Vo5.27o0.SVo7.6VoFinal8Vo7j%aLITo7j%oInitialLEL Percentage8VolVo5VoIVoFinalNotes:LEL - Iower explosive limitUST - underground storage tank-.^\CNCD:\SHARE\UST\03-OO48,dOC Stqte oI Colifornio-Environmenlql Protection AgencyForm Aooreved OMB No. 2050-0039 lExpires 9'30-991Pleose iiint o( lype. Fotm designed for use on elile (12-pitch)See lnstructions on bqck ofYr"$.Monifesl Documenl No.oDeportmenl of Toxic Substoncer ControlSocromenlo, Coli[ornioolor's US EPA lD No.DO NOT WRITE BETOW THIS IINEorsqsis not required by Federol lowtnA. Stote MqDocumeni2249 0 4 31Gando(JzUJod.ur2UIqoTIJtJ7UzB. Slole Generotor's lDISDF ..ai'l)-s :-: --aY ..i t;;C WITHIN 30 D,AYSI O ;:^ jJ.. --:c rnr:n'o ; .: 95812DTSC 80224 (r/9e)EPA 8700-22iVhtieYeorDoyMonthSignolurePrinted/Typed Nomein ltem I 9this monifestdsor1 ?. Discreponcy lndicotion SpoceFAcILITYYeorMonthDoyISignot\r--Printed/Typed Nomdy'18SignoturePrinted/Tv6elNom el f1KtlSfh (ovpotrMonth Dov YeorAr lol t i ll nt317na63YeorDoyMonlhlltPrir4{/Typed Nomg,.I\Air r N ( bLi-rAl5WEAR PROPER PROTECTIVE EQUIPMENT WHILE HANDLING. WEIGHTS OR VOLUMES ARE APPROXIMATE.24 HOUR EN4EP.GE!.ICY CONTACT: PACIFIC BE!.I. DISPATCH F.ES. cTR ECIJoB #the deoree I hove determined to be economicollvizes the-presenl ond luture threqt lo humon heoltfrselect the best wosle monogem€nl method thqt isrotely described obove by proper shipping nome ond ore clossified, pocked,opplicoble inlernqlionol ond nolionol governmenl regulolions.this consignment ore fully ond occutronsporl by highwoy occording toGENERATOR'S CERIITICATION:morked, ond lobeled, ond ore inI6ItA'l5lnstruclions ond Additionql lnformolionK. Hondling Codes for Wqsles listed Abovec.o.b.wrrH 15 LBs DRy rcE pER it*^rr*ttffi"'K"E BEEN INERTEDQTYJK # ?hDq\EPA/OtherStolertlld.EPA/OtherStot6EPAlOtherStotettb.l\ll.rl,ltrEPAlOtherotn il61,StoteP/tfiotototrNCfr\ RCRA HAZARDOUS WA$TE SOLIDITJASTE ET,/IPTY STCRAGE TANKTypeNo.14. unitI 3. TotolQuqntityI 2. ConloinersI l. US DOT Description (including Proper Shipping Nome, Hozord Closs, ond lD Numberfl. Woste Number9. Designoted Fqcility Nome ond Site AddressECOLOGY CONTROL INDUSTRIES255 PARE BLVDE,lt-lJtlatllt.l n ^ ar{on.rrrer..trvIrg vA J.tC)v Ic lAl n 0 0l llt 4r sr6r3rf! r?10. US EPA lD NumberslDG. StoteH.F. Tronsporter's Phone5E. Stote Tronsporler's lDD. Tronsporter's Phone5. Tronsporler I Compony NomeECOLOGY CONTROL INDUSTRIES8. US EPA ID6. US EPA ID4.)IaI2,aI0tlUaa)Z. Tronsporler 2 Compony NomeC. Stote Tronsporter's lD [@gyed.l3. Generolor's Nome ond Moiling AddresscElr^P.O, EOX 5095; ROOM 3E0004. Generotor's Phone { 916-977-7777SAN RAMONc494583GENERAToR2. Poge Ioi1UNIFORM HAZARDOUSWASTE MANIFESTItAfTlatStCG...,. Ii;fiti$',tlcr. rr,rq9r4a6",to nerFnlr GovenDNrr: 06106/2003 3:46 FMToNnur:CoMPANY.Flr'PACFS.Fsols!COMP.ANY:NAME:PHONC:FAX:lnepectorBoyleSan LuigObispo543-80192includinEcover pageBalchAutumnBleklev942-8686942131ReennolPc N01 0lHAz |'State of CaliforniaState Water Resoutces Conkol BoardDivision of Clean Water ProgramsP.O. Box 944212SacramentocA, 94244-2t20Submit original to local UST regulatory agency. Keep a copy at each(Instructions on Reverse)For State Use Only\vof Witnss otDrtc)rfo3Josup\ F. Qc\r.J*r.rS,/ sct, Zeb3OrcSusan Johnson, Vice President-Finance (PBn{B)Nanr rnd Titlc ofTrnk Owncr or OpcrltorFrcility Nrft/)Fucility Ad&6sFrciliry NarftFacility AddrdsFrciliry NrwFrcility AddrqsFrciliry NacFlciliry Addr6sFacility NrmF[cility AddrssFacility NrmFrcility AddrdsD, Faciliry NtrmSBC/Pacific BellSee Exhibit "A"Focility AddrgsNote: Ifyou ale using the State Fund as any part ofyour demonstration of, your execution and submission olthis certification alsocertifies that you are in compliance with all conditions for participationin the Fundfi nancial responsibilityFinancial Test olSelf InsuranceNotApplicablefor StateAlternativelvlechanismPacific BellFinance2600 Camino Ramon 'Rm 4CN100San Ramon, CA 94583$ r,000,000 PerOccurrence &$2,000,000AnnualAggregateYesAnnual lvlay 1,2003 - April30, 2004YesTvpeC. MechanismName and Address of IssuerCoverageAmountIvlechanismNumberCorrectiveActionCoveragePeriodThird PartyCompensationB' l"?ill :: [::":.'11,,^^ 11 b s'.t'a'^( b'"^ P4L tst-o(NrG ot tru u$cr or uPcrutor)hereby certities that it is in compliance with the requirements ofSection 2807'A.rticle 3, Chapter 18, Division 3, Tirle 23, Califomia Code of Regulations.fi.nancialresoonsibiiiw asThe mechanisms used to demonsh'ated bv Section 2807 are as follorvsA. I anr required lo demoostrate Finaucial Responsibility in the required amounts as specilied in Sectiou 2807, ChaPler 18, Div 3, Title 2], CCR:I Soo,ooo dollars per occurrence f t mittion dollars annual aggregateor AND orX 1 miilion dollars par occurrence ffi Z mittion dollars annual aggregateCERTIFICATION OF FIi\ANCIAL RESPOI\SIBILITYFOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUIVIut\-049 - 1/2rvwrv.u n idocs.o rgUST facility.07t29t02 fLETTER FROM CHIEF F'INAI\CIAL OFFICERI am the chief financial officer of Pacific Bell, 2600 Camino Road, Foom 4CN100, San Ramon,California. This letter is in sr.rpport of the use of "the financial test of qelf-insurance," to demonstratefinancial responsibility for taking corrective action and./or compensating third parties for bodily injuryand property damage caused by sudden accidental releases and/or nonsr-rdden accidental releases in theamount of at least One Million Dollars (Si,000,000) per occlrrrence and Two Million.Dollars(S2,000,000) annual aggregate arising ftom operating certain underground storage tank(s).Underground storage tanks at the following facilities are assured by this financial test or a financial testunder an authorized State program by this "owner or operator": Exhibit A contains the name andaddresses of each sr-rch facilities. A11 Undergrorind Storage Tanks are assured by this financial test and afinancial test und.er a State program approved under 40 CFR Part 281.A "finangial test," is also used by this "owner or operator," to demonstrate evidence of financialresponsibility in the following amounts under other EPA regulations or state programs authorized byEPA under 40 CFR Parts 271 and 145:EPA Reg.tationsAmountClosure ($$ 264.143 and 265.143)Post-Closure Care ($$ 264.145 and 265.145).......Liability Coverage ($$ 264.147 and 265.147)......Corrective Action ($$ 264.101(b) .......Plugging and Abandonment ($ 144.63),Closure........Post-Closure Care.........Liabiiity CoverageCorrective Action.......Plugging and Abandonment.....TotaI...........$..$..$.$..$..$,.$.$.$N/AN/AN/AN/AN/AN/AN/AN/AN/AN/AN/A$.$This "owner or operator," has not received an adverse opinion, a disclaimer of opinion, or a "goingconcern" qualification from an independent auditor on his financial statements for the latest completedfiscal year. (-'Letter from Chief Financial OfficerPage2Alternative I1. Amount of annual UST aggregate coverage being assured by a financial test, and/or guarantee$ livl2. Amount of corrective action, closure andpost-closllre care costs,liability coverage, andpluggingand abandonment costs'covered by a financial test, and/or guarantee $ I M.3. Sr-rm of Lines 1 and 2 $ 2N/t$ 17.341 biliion4. Total tangible assets5. Total liabilities $ 13.574 billion6. Tangible net worthS 3.767 billionYes No7 . Is line 6 at least $ 10 million? X8. Is line 6 at least 10 times line 3? X9. Have financial statements for the latestfiscal year been filed with the Securitiesand Exchange Commission?10. Have financial statements for the latestfiscal year been filed with the EnergyInform ati on Administration?N/A1 1. Have financial statements for the latestfiscal year been filed with the RuralElectrifi cation Administration?N/A12. Has tinancial information been provided toDrm and Bradstreet, and has Dun and Bradstreetprovided a financial strength rating of 44. or 5A? XI hereby certily that the wording of this letter is identical to the wording specified in 40 CFR Part280.95(d) as such regulations were constituted on the date shown immediately below..On epril?0. z0o:Ms. Sus.fohnsonVice President-FinancePacific Belt/Nevada Bel1X LETTER FROM CHIEF FINANCIAL OFFICERI am the Chief Financial Officer for Pacific Bell, 2600 Camino Ramon, Room 4CN100, SanRamon, Califomia.This ietter is in support of the use of the Underground Storage Tank Cleanup Fund todemonstrate financial responsibility for takrng corrective action and/or compensating third partiesfor bodily injury and property damage caused by an unauthorized telease of pekoleum in theamount of at least $ 1,000.000 per occurrence and $ 2,000.000 annuai aggregate coverage.Underground storage tanks at the following facilities are assured by this letter:A list of SBC facilities , name , address, number of tanks and size are listed in Exhibit "Al'Amount of annual aggregate coverage being assuredby this 1etter............$ 2,000,000 millionTotal tangible assets........$ 17.341 billionTotal liabilities..S 13.574billion12J4Tangible net worth (subtraq! iine 3 from line 2.Line 4 must be at least l0 times line 1).................$3 767 billionI hereby certify that the wording of this letter is identical to the wording specified in subsection2808.1(dX1), Chapter 18, Division 3, Title 23 of the California Code of Regulations.I declare under penalty of perjury that the foregoing is true and correct to the best of myknowledge and belief.Executed at 175 E. Houston. Room 1307, San Antonio. Texas 78205On Aprii lo. 2003Susan JVicelnancePacifi c BellA{evada Bell f-=Gtyo[sanluls oBlspoFIRE DEPARTMENT2160 Santa Barbara Avenue . san Luis obispo, cA 93401-5240 . 805/781-7380"Courtesy E Serr,tice"January 31,2003Mr. Leonard Mason, Staff GeologistThe Shaw Group,Inc.4005 Port Chicago HighwaYConcord, CA94520Re: 196 Suburban Road, San Luis obispo, cA. Temporary closure of TwoUnderground Storage TanksDear Mr. Mason:Thank you for the recent submittal of the Temporary Closure Permit for the tanksmentioned above. The Scope of Work and the permit application were thorough andacceptable to San Luis obispo city Fire. I have enclosed a copy of the approved permitapplication.please notify me in advance of closure activities so that I or another member of staff canmonitor the process. Should I not be available please contact Molly Brown at (805) 781-7560. I would also like to be advised in advance of each quarterly inspection so that Imay monitor the facility along with your field staff. The tank monitoring system shouldbe on line and continue to function during the temporary closure period. As agreed, thetanks will be removed, under permit, no later than July, 2003. Thank you for yourassistance in this phase of the project. Should you have any questions or commentsregarding our requirements please contact me at (805) 781-7383.Sincerely,N,{q^%,Md,D. Kerry soNHazardous Materials CoordinatorEnclosureThe citv of san Luis obispo is committed to include the disabled in all of its services, programs and activities.Teleconimunications Devic'e tor the Deaf (805) 781-7410.@ II(Shavi - .'vironmental & lnfrastructure, lnc.4005 Port Chicago HighwayConcord, CA94520925-288-2216FAX 925-288-0888AShEWrne snaw Group nc.January 28,2OO3Kerry BoyleCity of San Luis Obispo Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA 93401Dear Mr. Kerry Boyle:I am sending to you an Application for Permit for Temporary Closure of Underground HazardousSubstances Storage Facility and a Scope of Work for Proposed Temporary UST Closure Activities,pacific Bell Facility, 196 Suburban Road, San Luis Obispo, California (SOW). Unified ProgramConsolidation Forms for Underground Storage Tanks (USTs) are included with the SOW as Attachment1.We are tentatively scheduled to temporarily close the USTs as described in the SOW toward the middleor latter part of the week of February 3, 2003. Upon confirmation with our subcontractor, I will provideyou with the exact date.lf you have any questions, please feel free to contact me at (925) 288-2216.Sincerely,Leonard J. MasonStaff GeologistEnclosed1. Application for Permit for Temporary or Permanent Closure/Removal of UndergroundHazardous Substances Storage FacilityZ. Scope of Work for Proposed Temporary UST Closure Activities, Pacific Bell Facility, 196Suburban Road, San Luis Obispo, California Jan 2A 03 1O:SBaSan-..Luis Obispo City FireSan Luis Obispo City Fire Departmenr2160 Santa Barbara Avenue, San Luis Obispo CA 9340180s/78r-7380t ao5| 543-8019p.2Permit No.ApplicationateNo. of Tanks to bePlrcA'oil"l"#ffi l5ftr;f Yfi SiltEXoo##*NEI\rrHAZARDOUS SUBSTANCES STORAGE FACILITYType of Applicgtion (F'ill out one application per facility)fl Ternporary Closure I J Permanent Closure t ] RemovalA. Facility Name: 9Z C ( f.p*,a u;/ ftcft*)Address: /?6 Suaroa'J E"aoContact Person:Telephone (days)owner: flBLAddress: 7. O, 8o, 9o7 f ,, E-n Tf oo(nights):relephone: I Zf- fu t - ? ?o Ifa", Eaic4LtOttZip: 1t/;83Operator:<ts4lzS?ot- 7?olAddress:/ o. B^, So7f.ftrt36ooofet[en"l ( AziplvtajDate Tank Installed: OVolume in Gallons:oeoB. Water to Facility Provided byt C,r/ oF fi"l lury O^$PoDepth to Groundwater: - t / f/ 6G Basis of Determina tion: oN -strr S|ctftn '{ttuCTank Removal Contracto.,.$n*, f*u'o*m?4oL Cal. License No- 8lt6 A oAddress: 221d fbrt oe 6lJ. rtln"ao6n'"t, /ATeleplrone: YtA'360+pzProposed starting out,.,tff i',2*3osed Completion Date:Je* dny o5doAJJInsurerCr6€oD t/,t"et /rurrnen"FGDChemical Composition of Materials Stored:Tank # Chemical (common name) Dates Storedto74-tt&s" l;a.t2t/t czo3/ef l" t2/o2afif *.!_!lszSize Previous ChemicaloooE. Final Destination of Tank:c fatvtlo!*\€PIALf5<42,ut-oklt!,(Att /A'o A"o ,(AooofrrtAfefu^,sloi Jan 2A 03 1O:58aSa4-!uis Obispo Citv Fine(t"f-.=I 543-801SDatep.3,F.G.HPrevious .Oryners/Operators of tank(s) if Applicable:/v*3Attach Plot Plan Showing:_Loration of all fank(s) and piping and their secondary containment_L"uk detection system_Ouerfill protection systemScale- tlorth arrowProperfy line_-N.urest intersection or road. Equipment surnmary_E*isting equipment and equipment to be removedType of Primary Containment:I J concrete t J Fibergtass Xsteet [ ] Fiberglass coared steelPiping/Materials of Construcrion:[ ] Steel [ ] Fiberglass *4 Otner/Fc€*t3'-F t DPc )Type of Secondary Containment:I i-concrete [ ] "Fiberglass [ ] Steer ! niu-rgtass coared steelWas any part of the system cathodically protected? psIf yes, which part(s)?J. Describe leak-detectionsystem used, ifar/fr,r.t o- 7*-uayr*TottfoOtutK. Describe overfill protection system usG-74'tutil DtefcPlet.Apk\THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERIURY AND TO THE BESTOF MY KNOWLEDGE IS TRUE AND CORRECT.[ ] Other[ ] OtherIt/4otqr Lflcot- 28/03DateFIRE DEPARTMENT USE ONLYDescribe Method for Retrieving SamplesSarnples Will be Analyzed ForLaboratory That Will Perform Analysis:Address:H:FDP2694195G,WNI 4ITelephone:03 Environmental Management2600 Camino Ramon - Room 3E000San Ramon, California 94538January 27,2003KERRY BOYLEHaz Mat CoordinatorSan Luis Obispo City Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA 93401-5240Dear KERRY BoYLE, g(! S,rh/,hn,,t MM I s,L.il ,RE: SBC's Petroleum Storage Tank (PST) Major Repair and Upgrdde RecordsSBC's PST repair and upgrade records are maintained in a centralized filing location inSan Ramon, California, along with other historical environmental records for SBCfacilities in the West Region.Requests from state or local agencies for copies of these records should be made toSBC Environmental Management on 1-800-757-6575. Records will be faxed or mailedto the person making the request within 36 hours.Other tank related documents, such as UST Monitoring System Certifications, variousUST Tests, UST Monitoring and Response Plans, UST Certification of FinancialResponsibility, Permits, etc. are maintained on site and filed in Section 3 of theHazardous Materials, Plans, Programs, Permits Binder located on the white plasticboard that is typically located near the facility entrance.lf you have any questions or need any additional information, please do not hesitate tocall me on 925-823-61 61.ly,BrodeckiSr. Environmental ManagerSBC Environmental Management - West Regioncc: lrene Soto Shaw cnvironmental & lnfrastructure, lnc.4005 Port Chicago HighwayConcord, CA 94520-1 120925.288.9898Fax 925.288.0888The Shaw Group lnc.*November 25,2002Mr. Kerry BoyleCity of San Luis Obispo Fire Department2160 Santa Barbara AvenueSan Luis Obispo, California 93401Subject:Scope of Work for Proposed Temporary UST Closure Activities, Pacific BellFacility, 196 Suburban Road, San Luis Obispo, CaliforniaDear Mr. Boyle:On behalf of Pacific Bell, Shaw Environmental Inc. (Shaw) is pleased to present this scope ofwork pertaining to proposed temporary underground storage tank (UST) closure activities at theabove-mentioned Pacific Bell facility. There is a split-wall UST containing gasoline and dieselat the site that Pacific Bell would like to take out of service pending future removal (F'igure 1).The following scope of work details anticipated closure activities to be performed in order tomeet the State of California Code of Regulations Title 23, Division 3, Chapter 16, Section 2671UST temporary closure regulations and the City of San Luis Obispo Fire Department closurerequirements. Copies of the State of California forms are included in Attachment 1.Scope of WorkPrior to temporary closure activities, Pacific Bell will arrange for the removal of any fuels withinthe UST system. Prior to performing any work, Shaw personnel and their subcontractors willreview the health and safety plan (Attachment 2). The UST and associated piping will then betriple-rinsed by a hazardous-certified subcontractor using a hot-pressure washer and detergent inorder to remove any residual liquids, solids, or sludge. Following rinsing, the tank will bevisually inspected to ensure all liquids, solids, or sludge have been removed. The rinsate willthen be transported off-site under a hazardous waste manifest to Romic EnvironmentalTechnologies Corporation in East Palo Alto, California for recycling. A copy of the rinsatemanifest will be forwarded to the City of San Luis Obispo Fire Department upon receipt-Following rinsing activities, the atmosphere of the tank will be inerted using dry ice at a rate ofapproximate$ 2A pounds per 1,00O-gallons capacity. After approximately 15 minutes, the lowerexplosive limits (LEL) and oxygen concentrations will be measured. Once the LEL and oxygenconcenhations are below l0o/o, the tank access ports will be sealed using locking caps. The ventpipe will not be sealed per UST temporary closure requirements. The power will then bedisconnected from the fuel dispensers and locked out. The existing tank monitoring system willremain operational. Mr. Kerry BoyleNovember 25,2002Page2Prior to performing field activities, the City of San Luis Obispo Fire Department will be notifiedat least 48 hours in advance to witness temporary closure activities.Every three months, a visual inspection will be performed in order to document the tank is stillout of operation, locks are still in place, and no fuels have been added. Atmospheric readingswill then be measured inside the UST to ensure the LEL and oxygen concentrations remainbelow l0%. A copy of the monitoring form is included in Attachment 3.If you have any questions or comments, please do not hesitate to contact me at (925) 288-2103.Sincerely,Shaw Environmental, Inc.RobTechnical Taskcc; Mr. Andrew Taylor, SBC Pacific BellAttachments:Figure 1 - Site Plan with UST LocationAttachment I - State of California FormsAttachment 2 - Health and Safety PlanAttachment 3 - Quarterly Monitoring Form 3Un0tJ FIGURE 1SITE PI.AN WITHUST LOCAT]ONPACIFIC BELL FACIUTY196 SUBURBAN ROAD160 FEETSCALEo80PAC]RC BELLSAN RAMON. CALIFORNIAAsrffi$uE&[hxxxxxCABLE STORAGEJr AREAXx-xWATERVEHICLE MAINTENANCEASPHALT_PAVEDJPARKING LOT-l GATE F-x-xSUBURMN ROADrGATEF- xGARAGExxD(STING lO,OOO_GALLONANDGASoL|NE/DTESEL USrDISPENSER ISLANDcHArN-LrNK FENCE/PROPERTY LINEt{STORAGEBUILDINGPACIRC BELL BUILDINGIIItdoIIIt!UJtIx'oLo(,Co()lr.lOtrlroeEoS:\!0d)oblYoul-()ouoo-.I)otd(Dg.4. bJ=3oz..+{-IO)oo|o@ ATTACHMENT 1STATE OF CALIFORNIA FORMS I'NIFIED PROGRAM CONSOI,IDATED FORMUNDERGROUND STORAGE TANKS - FACILITY(one page per site)TANKSPage81998 UPGRADE CERTIFICATE NUMBER (For lear w only)(F6 l@l us only)STATE UST FACILITYQOFL(p(print)425 28t\ 2t03425PHONEl\'?,b'QZDATE42,4"ry\ry'T' LQ, ?. o-,R - 6rr r)Certification - I certiry that the infomation provided herein is true ud accmte to the bes of my knowledge.VII. APPLICA}IT SIGNATUREfl t.recrurv Xq. r*ott*t"owNER [3.rANKowNERCheck one box to indicate which address should be used for legal notifications and nailing.Legal notifications md mailings will be sent lo the tank omer unless box I or 2 is checked.423VI. LEGAL NOTIFICATION AI\D MAILING ADDRESSI to. local covr MEcHANtsMD 99.ornrR'422[]a.sunnrvnoNo D z.srernrtrNoE s. rnrrnR oF cREDIT E g. sreru FtiND & cFo LETTERD e. rxnuprroN D p. srarn ruqD & cDINDICATE METHOD(S)IIO I. SELF-INSURED,E>. GUARANTEEOa. wsunaNcn,V. PETROLEUM UST FINA}ICIAL RESPONSIBILITYCall (916) 322-9669 if questions arise421LIa\7oTY (TK) HQ 4+IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER[f 6. STATE AGENCYD z. nrornal AGENcYXCORPORATION LI 2. INDIVIDUAL LJ 4. LOCAL AGENCY / DISTRICTDr. peRrneRsHrp Ds.couNrvecENcYTANK OWNER TYPE420QqsebZIP CODE419418STATE6CITY)o^ (larnctn417Qo ba,9qq',odln VL(h>MAILING OR STREET ADDRESS4t6026 Qol -74'cl415PHONETANKOWNERNAME?ftu€rc Bq,cu414III. TANK OWNER INFORMATIONCORPORATION LJ 2. INDIVIDUALD s. peRntnRsulpLJ 4. LOCAL AGENCY / DISTRICT0 s. couxrv AGENCYLJ 6. STATE AGENCY[] z. rsonRer- AGENcyrr(1,PROPERTY OWNER TYPE4ttq,lsE3ZIP CODE412STATEC{+4lttttt5o^ Qt-or",n4t0?ob-w5-, Rn%tnoMAILING OR STREET ADDRESSMQ25 Qot 'tLlo\408PHONEPROPERTY OWNERQae&r-{\t l\q7NAMEII. PROPERTY OWNER INFORMATION+lf omq of UST is a public agency: nme of superuisr of division, section or office whichoperates the UST (This is the contact person for the tank remrds-)&6I v"r. $.yoIs facility on Indian Reservation or405trustlands?,t04ITOTAL NUMBER OF TANKSREMAININGAT SITEBUSTNESS -D I. GAS sfATIoN [ 3. FARM U 5. CoMMERCIALTypE O z. orsrnrsuron B c. rnocessonfll6, orHER 403FACILITY OWNER TYPE$rr.coRronerroND z. nrotvnualD:.panrNrnsHrpT] 4, LOCAL AGENCY/DISTRICT*0 s. conrry AGENCY'O o. sterE acnltcy*E z. retunal AGENcyr 4aSTREET*tato?e-srf,zt{f,nrrrhNEAREST CROSS,lOlFACILITY ID#BUSINESS NAME (Sme 6 FACILITY NAME or DBA - Doing Buincs As) 3Qqr','',G,c9r,nI. FACILITY / SITE INFORMATIONTYPE OF ACTION(Chck one item only)D I.NEWSITEPERMIT f]3.RENEWALPERMITD 4. AMENDED PERMITtf s,CHANGE OF INFORMATION U T.PERMANENTLY CLOSED SITEspecif change localueonly_ [ g.fANf REvOvep$(.reueonenv srrE cLosuRE400UPCF (l/99 revised)Formerly SWRCB Form A Sv"t [ 1oTANK FTLLED WITH INERT MATERTAL? 457gallonsOF STJBSTANCE REMAINING 456ESTIMATEDQUDNTY455ESTIMATED DATE LAST USED CYR/MO/DAY)lL-ozIV. TANK CLOSURE INFOR}{ATION / PERMANENT CLOSURE IN PLACEIF DOUBLE WALL TANK OR TANK WITH BLADDER(Chcck onc item only)O r usuAl (SINGLE WALL rN vArrLT oNLy)Elrz comnn-lous INTERsrrrrAL MoNIToRINGPA"o**"oMroRrNG454IF SINGLE WALL TANK (check all rhat apply)0 t vlsuer, lexrosED PoRTroN ONLY)D z eurouartc TANKGAUGING(ATG)D r cor'rrn*uous nrc0 c sralsrrcar rNvENToRy REcoNctLIATIoN(SIR) BIENNIALTANKTESTINGO 5 MANUAL TANK GAUGING (MTG)E ovaoosrzor.IEE z crouNpwernnD araNrrBsrrxcI sgorHrn453IV. TANK LEAK DETECTION te description of themoaitoringpogm shallbe submitt€d to the l@l agency.)OVERRLL PROTECTION EQUIPMENT:YEAR INSTALLED q 9CIfi"arenv E : nru rrmn sHUr oFF vALvEE z naLL noar fl a exrupr452YEAR INSTALLED r\ y' 450coNrArNMENr 1"F.,W1SqsrnrTYPE (loel ue onty; 45tSPILL AND OVERFILL(Check all that.pply)DROP TUBESTRIKER PLATEOTHER CORROSION D T IUru.N,TACTURED CATHODICPROTECTION IF APPLICABLE PROTECTION(chck one im only) o z sacrunlcnl ANoDEtsrrrsBncless REINFoRcED PLASucn 4 TMPRESSED CTiRRENTfI95 UNKNOWNIss orHnn(Forlcal w only).148 DATE INSTALLED 449E I.RUBBERLI.IEDD 2 ALKYD LININCf] 3, EPOXY LINING[ + ftreuorrclwrNcu 95. |.INKNOWNO sg orHen(For lml 6e only)0&uurNeoLI 5, GLASS LINING446 DATE INSTALLED 447TANK INTERIOR LININGORCOATING(Check onc item only)LJ5. CONCRETE U95. UNKNOWNO 8. FRp coMprrBLE w/r00% METHANOL ! ss. orHnRD lo. coATED srEELE z. srenu,Bss srrel pq srEEL cLAD wFIBERGLASs445(Check one ibm only)U 3. FIBERGLASS/ PLASTICTANKMATERIAL-seandaryrank E l BARESTEELREINFORCED PLASTIC (FRP)O s. coxcnr,rsTANK MATERIAL -primrytank p.{ BARESTEEL(checkoneitemoaly) o2. STAINLESSSTEELU3. FIBERGLASS/PLASTIC U5. CONCRETE LI95. TINKNOWN 44404. STEELCLADWRBERGLASS Ds. rRpcoNaprrBlEwloo%METH,ANOL Ess.orHEnREINFORCED PLASTIC {FRP)TYPE OF TANK(Check one ibm only)LI 3. SINGLEWALLWITHEXTERIOR MEMBRANE LINERO l. slcNLe waLL rN VAULTD ss. r.tNKNowN0 se. orHpndq oousrewA'-l-[J 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEMf] I. SINGLE WALL443III. TANK CONSTRUCTIONCAS# (fron Haardow Materials lnventory page )442COMMON NAME (rrcm Hardou Mabrials Inventory page)44tTANK USE$f\tuoron wHtcLE FLJEL(lfma*ed compleE Peholm Type)D z. r.ror-ruer PETRoLEUMO:. cHeutcArPRoDucrD4. HAZARDoUSWASTE(lncluds Used Oil)O ss. uNKNowN439PETROLEUM TYPE$g' nrcurenuNLEADEDD ru. pR-eutrna LiNLEADEDO r". ulpcnaoEuNLEADEDDz- teADBoEr. olesrlD +. ca.sonolDs. rsrFuEt-Eo. lvlartoNruelO sq. orHrn440II.TANKCONTENTSADDiTIbNAL DESCRIPTION (For I@aI w only)418TANK CAPACITY IN GALLONS436lo.arJ bv-qaslil4.tu JDATE INST\IAA2ED (YEAR/MO) 4r55NUMBEROF COMPARTMENTS2437(Yly!,,'.rt.' lt)t)A'na,TANK MANUFACTURER4lfTANK ID #432434COMPARTMENTALIZEDTANK Q(es I NoIf "Y6", somplel,e onc page for each @mparbnenlI. TANK DESCRIPTION (A scaled ptot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency-)LOCATION WITHIN SITE (optionaD43tlFACILITY ID:3BUSINESS NAME (sue o FeClLIfi NAME or DBA - Doidg Buines As)?eer$o (42Lt-B I lrEwstrE PERMITB 3 nsNpwaLprnunE + erasNDnupERMrr D 5cHANGEoFINFoRMATIoN ( o revnonanystrEclosuREf] z pBnvaNrNTLYcLosEDoN srrED t rersxnruowo(Spoiry re6on - for l@al wc only) (Sp@iry remn - for l@al se orly)Page I of 3430TYPE OFACTION(Check one il,em only)UNIFIED PROGRAM CONSOLIDATED FORMUNDERGROUND STORAGE TANKS _ T,q.NT PAGE 1TANKSUPCF (12/99 revised)l0Formerly SWRCB Form B ESTIMATED DATE LAST USED (YR/MO/DAY)1L,0')455RYes E NoTANKFILLEDwITHINERTMATERIAL? 457gallonsESTIMATETLQUANTITYoF st.tBsrANcE REMAINING 4s6IV. TAI\K CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACEtF SINGLE WALL TANK (chck all that apply)B r vrsual pxrosED PORTIoN ONLY)fl z Arrouertc rANK 6AUGING (ATc)D r coNrrNluous lrcI I srnrtsrlcer TNVENToRY REC0NCILIATIoN(SIR) BIENNIAL TANK TESTINGE s l,teNuer r^cNK GAUctNc (MTc)[] overosnzoNrI z ctouxnwerpnD s rANKTEsrrNcI ssoruEn45fIF DOUBLE WALL TANK OR TANK WITH BLADDER(Chet one item only)[1 r vrsual lsruclE wALL IN vAL]LT oNLY)@, co*t*ous rNTERsrrrrAL MoMToRINGZFrvar.ruAt- Naol.IrroRINc454IV. TANK LEAK DETECTION (A descripion of the monitoring progm shall be subnincd b lhe l@al agency.)OVEMILL PROTECTION EQUIPMENT:YEAR INSTALLEDtsF *"ARMD2 BALLFLOATO 3 FILL TUBE SHUT oFF vALvEO q exEN.rpr452q5spni e.No owRI.ILL TI YEAR INSTALLED A < 450(checkallrharapply) d.l SatatCOVfaINMENT lJRl onoerune'4, tt*t** *totuTYPE (lul ue only) 45torHERcoRRostoN DIMANUFASTUREDcATHoDIcPROTECTION IFAPPLICABLE PROTECTION(check one ir€m only) E z slcnrnlcral- AN0DE(For local u* only)O + ttupnrssno CURRENTFIBERGLASS REINFORCED PLASTIC(For lmal ue only)D ssornEn3, EPOXYI- RUBBER LINED5.g5.UNKNOWN 446 DATEINSTATLEDTANKD95 UNKNOWNE gs orHnn0 z alrcyp r,rNrwc D 4 IHENoLIC LnuNc !fu uNr-rNeoORCOATINC(Check one ibm oDly)t] 5. CONCRETE LJ 95. UNXNOWNE s. rRp cotr4pflBlE wl00% METHaNoL D sg. otuenD ro. coerno stupL445TANK MATERIAL - se@ndary tankE s. coNcnnrBE 3. FIBERGLASS / PLASTICE r. seREstpel-(Check one ibm only)STEEL CLAD WFIBERGLASSREINT'ORCED PLASTIC (FRP)D2. srArNLEsssraEr- frTANK MATERIAtirrmary ranr F.L BARE STEEI- D 3. FIBERCLASS i PLASTIC(checkoneitemonly) D2. STAINLESSSTEBI on. STEELCLADWRBERGLASSREINFORCED PLASTIC (FRP)tI5. CONCRETE [J95. UNKNOWND t. nrucorrlprrBlE wl00% METHANOL O qg. orHen444EXTERTORMEMBRANELINER DSS. UNKNOWN0+. stcNLswallrN vAULT Ds9. orHBnDOUBLE WALL(check one item only)ALL wlTH INTERNAL BLADDER SYSTEMIII- TANK CONSTRUCTIONI. SINGLEWALLCOMMON NAME (frcm Haardou Materials Invenlory page)44tCAS# 1ftom Haandou Maleials Inventory page )442TANK USE 43epq,loron vEHlcLEFuEL(If mark€d @mplete Pctrolem Tne)O z. NoH-nuBr- PETROLEUMOr. cusvrcalPRoDUcrD 4. HAzAR-Dous wAsrE(lnclud6 Used Oil)E ss- uNKNowNPETROLEUM TYPED ra. nrcwmuNLEADEDE ru- pneuruvUNLEADEDD tc. utocnq,oEUNLEADEDDz. rnnoen6p1 orrsrr0l- cesoHor-0 s. rpr mrnlBo. avtertoNFunlD gs. orgen44,)II. TANK CONTENTSTANKCAPACITYDATENUMBER OF COMPARTMENTS438437GALLONSADDITIONAL DESCRIPTION (For l@l w only)(YEAR/MO)TANK ID #432COMPARTMENTALIZED TANK llljes Ll Nolf 'Y6", complelc one page for @h compaffienl.43443tTANK MANTIFACTURER(bsuntJe,lDrnaI. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.)431LOCATION WITHIN SITE (optionat)3BUSTNESS NAME (sme a TACILITY NAME or DBA - Doing Buircs As)9auFrc BqttFACILITY ID:O r lrew srrs rnnvn O I avsxpBp pERMrr n 5 cHANGE oF TNFoRMATToN lX6 rrunounv strE cLosuREO f n-EVEWel pBRVff (speify l6on - for l@al ue odly) (Spmify recon - for lmal ue only)D z ppnMnNel{TLYcLosEDoN strEB 8 TANKREMoVEDPage 2 of.1430TYPE OF ACTION(Ch@k one irem only)T'NIFIED PROGRAM CONSOLIDATED FORMUNDERGROUND STORAGE TANKS - TANK PAGE TTANKSUPCF (12199 revised)l0Formerly SWRCB Form B 475Pemit Nmbs (For l@l ue only) I4't3Pemit Apprcved (For l@al se only)474Pmit Expi.ati@ Dare (For l@al w oDly)472TITLE OF471DA7bTE1rloz470I certiS rhat the infomtioD provided hercitr is me ild @wte to drc bst of my knowledge-IX. OWNER/OPERATOR SIGNATURE![M. oerly vrsuAt- cHECKD s. rnnrcu LnrER/MONITORINGD o.NoNeDISPENSER CONTAINMENTDATE INSTALLED .168slqfB I. FLoAT MECHANISM THAT SHUTS OFF SHEAR VALVEO z. cowrwuous DISPENSER pAN SENS0R+ ALIDIBLE AND vtsuAl- ALARMSB :. comrwous DtspENsER pAN sENsoR WITH Auro SHUT oFF FoRDISPENSER + AIJDIBLE AND VISUALALARMS469VIII. DISPENSER CONTAINMENTSINGLE WALL PIPING 67PRESSURIZED PIPING (ch€ck all rhar apply):B t. rlecrnoutc LINE LEAK DETECToR 3.0 cpH TEST wrrH AUTo puMpSHUT OFF FOR LEAK SYSTEM FA]LURE, AND SYSTEM DISCONNECTION +ATJDIBLE AND VISUAL ALARMS.D z. uoNrur-yo.2 cPH TESTO 3. ANNUAL TNTEGRTTY TEST(o.lcPrtBc- oarlyvrsuAl-cHEcKCOIWENTIONAL SUCTION SYSTEMS (Check all that apply)O s. oarlv vrsuAl. MoNtroRINc oF ptpING AND puMprNc sysrEMO o- rRrcwNral TNTEGRITYTEST(0.1 cpH)SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):D z. srlr UoUIToRINGGRAVITY FLOW (checkall ihat apply):O g, uArr.v vlsuAl MoMToRING0 s- srBlrNlAL rNTEcRrry IEST (0.1 cpH)SECONDARILY CONTAINED PIPINGPRESSURIZED PIPING (check alllhat apply):IO- CONTINUOUS TURBINE S{'MP SENSOR WITH AUDIBLE AND \TISUALALARMS AND (ch6k one)D a AUTO PUMP SHUT OFF WHEN A LEAK OCCURSO u errro put"tp SHUT oFF FoR LEAKS, sysrEM FAILURE AND sysrEMDISCONNECTIONflc NOAUTOPUMPSHUToFFI l l. ALTToMATIC LEAK DETECTORE rz. aMwAL r.ffEcRlry rEST (0.r cpH)SUCTION/GRAVITY SYSTEMD rr. corvrrxuous srjMp SENSOR + ATJDIBLE AND vtsuAl ALARMSEMERGENCY GENERATORS ONLY (check all rhat apply)I ta- coNrrNuous suMp SENSOR wITHour Auro puMp SHUT oFF *AIJDIBLE AND VISUAL ALARMSI r s. euroverrc LINE LEAK DETECT0R (3.0 cpH TEsr)O ro. arvm.ru rNTEGRrry rEST (0. r cpltD tz- oellvvtsuALcHEcKSINGLE WALL PIPING 46PRESSLINZED PIPING (Check all that apply):D t. rlrcrnouc LINE LEAK DETECToR 3.0 cPH TEST WITH AUT0 PUMP SHUTOFF FOR LEAK, SYSTEM FAILTJRE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS.f] z. t"tourulv 0.2 cPH TESTD r. mru.rel nqrEGRITy rEsr (o.lcpH)CONVENTIONAL SUCTION SYSTEMSO s. oetLy vtsuAl MoMToRINc oF puMptNG SYSTEM + TRTENNIAL PIPINGINTEGRITY TEST (O.I GP}I)SAFE SUCTTON SYSTEMS {NO VALIJES IN BELOW GROUNDPIPING):D l. selr prolutonrNcGRAVITY FLOWD 9. BrE).IMAL tl.i-rEcRrry rEST (0.1 cpH)SECONDARILY CONTAINED PIPINGPRESSIJRIZED PIPING (check all that apply):IO. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUALALARMS AND (ch€ck one)D a. AUTO PUMP SHUTOFF WHEN A LEAKOCCURSI u. auro purr,rp SHUT oFF FoR LEAKS, SYSTEM FA]LURE AND sYsrEMDISCONNECTIONOc- NO AUTO PUMP SHUT OFFD I I. ewoueTlc LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUTOFF ORRESTRICTIONE 12. ANNUAL Il.J-tEcRITy rEsr (0.1 cPH)SUCTION/GRAVITY SYSTEM$.g1. coNrnvuous suMp sENSoR + AUDIBLE AND vtsuAl ALARMSEMERGENCY GENERATORS ONLY (check all thatapply)E ra. coNrnruous suMp SENSOR wITHour AUTO PUMP SHUT oFF *ATJDIBLE AND WSUAL ALARMSD ts- arrrouerlc LINE LEAK DETECToR (3,0 cPH TEsr) wITHour FLowSHUT OFF OR RESTRICTIONO ro. nxuuel wrEcRlryrEST (0.1 cpH)0 tz. oerr-vvlsuAl cHEcKABOVECROTJND PIPINGVII. PIPING LEAK DETECTION (chek all thar applv) (A dcqiprion of the monitorinq Droram shall be submitted to the lcal asacy.)[] r. nnnr srneLO2. STAINLESSSTEEL0 r. prlsnc cOMPATTBLE wcoNTENTSn l. RspncrnssD:. srpelwcoATlNcO o. rnr coupnnBlE wloo% METHANoLB r. carveNzEDsrEEL0 t. ruxnrE IHDPE) O gg. orHERO s- cerHootc PRorEcrtoNOs:.uNKNowN MsD t. seRE srsEL 0 6- rRP CoMPATIBLE */loo% N{ETHANoLDz. stenrLess sreer- E z. carv.uuzrDsrEEL fl unknomflr.puesnccoMpATrBl-E wcoNTENTS Dgg. orhs[ 4. FTBERGLASS (FS. FLD0BLE(HDPE)n 5. srEEL wcoATrNG D g. carHoplc pRorEcrloN 464B r.srNcLewarlD z- pousln wALr-MANUFACTT]RER0 ss. uNKNowNE ss. orHrR462463coNsrRucrroN D t.snclpwal-l Or.Lnrpornr,ncu Dss.orHrn 4&MAlnJFAcruRER ftt.nounuwerl Bss-uNKNowNMANTJFACTIJRER 46IO r.pnrssunn Dz. suqrroNE r. cnaurv459sysrEMTypE D t. pnrssunr Sq. sucuoN I r. cnavtrv 458ABOVEGROI.JND PIPINGUNDERGROUND PIPINGofTJNIFIED PROGRAM CONSOLIDATED FORMUNDERGROUND STORAGE TANKS - T.INT PAGE 2TAI{KSUPCF (12199 revised)t2Formerly SWRCB Form B ATTACHMENT 2HEALTH AND SAFETY PLAN HEALTH AND SAFETY PLANTEMPORARY UNDERGROUND STORAGE TANK CLOSUREVARIOUS PACIFIC BELL FACILITIESTHROUGHOUT CALIFORNIANovember 26,20A2Prepared for:SBC Pacific Bell2600 Camino Ramon, Rm. 3E000San Ramon, California 94583Prepared by:Shaw Environmental & lnfrastructure, lnc4005 Port Chicago HighwayConcord, California 94520Shaw Project No.: 838819.36C NC D :EHA PdIUST\O 2 -00 68. do c Table of ContentsList of AppendicesDisclaimerilt1.0 Generallnformation............,..1-1..... .... ..... 1 - 1............,.1-1'..''''..,.,,.1.2,.,,2-1..............2-11.1 Project Manager1.2 Site Safety Officer..............,.1.3 Work Objectives/Scope........2.0 Site Health and Safety lnformation.2.1 Site Descripti0n....................3.03.33.43.4.23.4.33.4.43.4.53.4.63.4.74.32.2 SiteBackground/HistoryHazards......3.1 Known/Suspected Chemical Hazards.......3.2 Monitoring for Chemical Hazards..........2-1......3-1.3-1.'....'.3.1...,....3-2........3-2......3-22First Aid......Physical Hazards and Biological Hazards..3.4,1 Fire/Explosion Hazards.Pressure Washing HazardsWeather Hazards (Heat, Cold, Rain, Fog, Lighting, Sparks)..Slip, Trip, and FallHazards......Noise.........Overhead Hazards......Asphyxiation/Confi ned Space3.4.8 MovingEquipment..3.4.9 Dry lce3.4.10 Electrical Hazards.......................,3-3................3-3....,...........3-5................3-5..............3-55........,.....3-55.3-553.5 Site ControlMeasures ...........3-6.......,.3-6.........3-6..........3-73.6 PersonalProtectiveEquipment..3.7 Training,...................3-773.8 Emergency Response Plan........... .........3-774.0 Emergency lnformation ...................4-14.1 Nearby Hospital/Clinic - Note this is Applicable Only to the San Luis Obispo Site...............4-14.2 Emergency RouteFireDepartment Phone: 911.............4.4 Police Department: Phone: 9115.0 Health and Safety Plan Approvals and Acknowledgement.5.1 Approvals5.2 Acknowledgments.........6.0 Health and Safety Plan Acknowledgement..................4-2.4-1.4-2.$1.6-1CNC D : S IIA REI.U ST\O 2 - 0068 - do c List of AppendicesAppendix A Proposition 65 Warning and NotificationC N C D : lS M MIUST\02 - 0 0 6 E - de DisclaimerThe enclosed site Health and Safety Plan (IISP) has been designed for the conditions that ShawEnvironmental & Infrastructure, Inc. (Shaw) presently believes may be encountered duringtemporary underground storage tank (UST) closure activities at various Pacific Bell facilitiesthroughout California. These activities will be rinsing of the tanks, inerting the atmosphere usingdry ice, and disconnection of the electrical power to the associated fuel dispensers. As the workis performed, conditions different from those anticipated might be encountered and the HSP mayhave to be modified. Therefore, Shaw makes no representations or warranties as to the adequacyof the HSP, except for warranties specifically stated in the HSP itself,This HSP is addresses the site at 196 Suburban Road in San Luis Obispo, Califomia. The sameactivities will be performed at over 20 locations in California. This plan is intended to cover allof these sites, however the site emergency response plan for each is an addendum to this plan.C N C D : lS HA REI U ST\O 2 - 0O 68 - d rclll \1.0 General lnformationAs described in SectionZ.O, the health and safety plan has been developed for work to be donefor SBC Pacific Bell along at their facility at 196 Suburban Road in San Luis Obispo, Califomiaand other comparable temporary closure sites throughout California. This is the base plan andhas been prepared for the site in Bakersfield. The site activities, hazards, and control measures atall of the sites are anticipated to be identical except for the emergency response plan.Shaw Project No.:838819.36Date: November 26,2002Project Site Location: 196 Suburban Road, San Luis Obispo, Califomia1.1 Project Manager: Sydney Geels for ShawThe Project Manager is responsible for all on-site activities, including having all appropriateplans prepared and distributing the plans to Shaw field personnel and to authorizedrepresentatives of each contractor employed to perform work on-site. The Shaw ProjectManager is also responsible for ensuring that the provisions of this Health and Safety Plan (HSP)are carried out. This includes ensuring that all Shaw field personnel have received adequatetraining, that an adequate supply of safety and emergency equipment is available, and that therequired safety reports are submitted to the area Health and Safety ManagerlProject CertifiedIndustrial Hygienist (Ctr{).1.2 Site Safefy Officer: Steyen Aiosa or Rob Delnagro for ShawThe Shaw Site Safety Officer (SSO) is responsible for implementing this site-specific HSP.Irish Construction may also have a SSO or foreman that will be responsible for health and safetyaspects ofthe work not covered by this plan. The SSO shall be knowledgeable in various stateand federal regulations. This includes ensuring that field persorurel have read and signed theHSP, that a Tailgate Safety Meeting is conducted on-site prior to initiating field activities, andthat appropriate monitoring is conducted. In addition, the Shaw Site Safety Officer will beresponsible for monitoring the site operations for compliance with the HSP provisions and anyapplicable federal, state or local requirements. The Site Safety Officer shall stop work due toviolations and unsafe conditions until appropriate action is taken to correct these deficiencies.The HSP may be amended by the Site Safety Officer to include necessary changes. The ShawSite Safety Officer is required to be on-site at all times during tank closure activities to ensureCNCD :ISHA M\UST|0 2 - 0 068. d@.1-l compliance with the health and safety plan. If the designated Shaw Site Safety Officer must beabsence, a qualified alternate will assume the SSO duties and responsibilities.1.3 WorkObjectives/ScopeThe scope of work for this project covered by this HSP is limited to temporary UST closureactivities at the previously mentioned Pacific Bell facility.Activities Planned (Check those that are applicable):underground storage tank removaloversight of soil excavation with backhoe or other equipmentconfirmation soilsampling dudng soil excavation and removalgeophysical surveysoil boring and soilsampling with HSA or air rotary drillinggroundwater grab sampling from monitoring wellssampling of on-site wellsXother: lemporary closure of USTs - hot pressure washing of tank interiors, pumping of residuals ftomtanks, visual inspection of the interiors of the tanks, transporting of collected residuals, inerting of tankinteriors, sealing tank pipes, and de-energizing the tanksC N C D : lS HA RAU STt0 2- 0o 6 & d et-2 2.0 Stfe Hea lth and Safety lnformation2.1 Sife DescriptionSBC Pacific Bell plans to temporarily close the USTs located at various facilities pendingplanned future removal sometime next year. At San Luis Obispo, there is a 10,000-gallon USTcontaining diesel and gasoline for the fueling of Pacific Bell fleet vehicles that will be closed. Atthe other sites, similar sizetanks used to store fuels also are being closedPrior to closure activities, Pacific Bell will affange to have fuels within the tanks to be removed.Shaw will then affange for the USTs and associated piping to be triple-rinsed by a certifiedhazardous waste subcontractor using a hot-pressure washer and detergent in order to remove anyresidual liquids, solids, or sludge. Following rinsing, the tanks will be visually inspected toensure all liquids, solids, or sludge have been removed. The rinsate will then be transported off-site under a hazardous waste manifest.Following rinsing activities, the atmosphere of the tanks will be inerted using dry ice at a rate ofapproximat ely 20 pounds per 1,OO0-gallons capacity. After approximately 15 minutes, the lowerexplosive limits (LEL) and oxygen concentrations will be measured. Additional dry ice or waterwill be added to the tanks if the LEL is above l0% and oxygen level is greater than l0To. Oncethe LEL and oxygen concentrations are below target levels the tanks access ports will be sealedusing locking caps, The power will then be disconnected from the fuel dispensers and lockedout. The existing tank monitoring system will remain operational-Unusual Features: none2.2 SifeBackgroundlHistoryWaste Type(s) (Mark those that are applicable):Other (please specify): municipal trash may beencounteredXpetroleum liquidsgroundwatersoilC NC D : I SILA M\U STIO 2. OO 6 8. dOC2-l Xlgnitable (gasoline tumes)Combustible (dieseltumes)Toxicreactiver-,Waste Characteristics: (Mark those that are applicable):r-XXVolatile : fuel residuals - benzene, toluene, ethylbenzene,and rylenesradioactiveCorosiveOther {please specifi}: see box aboveC NCD : \S IIA RE!.U STt0 24068. de2-2 3.0 Hazards3.1 KnownlSuspecfedChemicalHazardsThe primary suspected chemical hazards are fuel fumes and carbon dioxide. Fuel fumes fromgasoline tanks can be explosive. Diesel fumes are less volatile, however they may pose anaspiration hazardif they are aerosolized. The evaporation of dry ice (carbon dioxide) displacesoxygen and may pose an asphyxiationhazard-In addition to these chemicals, the workers may be exposed to petroleum fuel exhausts, andvolatile organic compounds (VOCs) including benzene, from the traffic. Over exposure to thesecompounds cill cause headache, dizziness, nausea, and eye, nose and throat irritation. Some ofthe chemicals of concern have been determined to cause cancer and reproductive harm. Table 1consists of a list of representative chemicals of concem and their occupationalhazardcharacteristics @ELs, IDLHs, etc.). Appendix A lists the Proposition 65 chemicals of concernwhich is required by the State of California.OverallHazard Level:trUnknownOnsite Monitoring Required ? [l Yes[]No3.2 Monitoring for Chemical HazardsCombustible Gas Indicator (CGIy4-Gas Meter: During tank closure activities both the air inthe breathing space of the workers and at the active face of the tank will be monitoredcontinuously using a combustible gas indicator (CGD to determine the concentrations ofexplosive gases relative to the Lower Explosive Level (LEL). After the introduction of dry iceinto the tanks, the bottom, middle, and top of the tank should be monitored for LEL and oxygenlevels.Photoionization Detector (PID): During closure activities, the breathing zone will bemonitored with a PID for non-methane organic vapors concurrently with CGV4-Gas Metermonitoring to determine if any gases detected are likely to be toxic. A PID is not sensitive toorganic carbon levels at lower concentrations than the CGI, thus it should be used to monitoredthe breathingzone..n LowX Moderatetr SeriousCN C D :E M REIU ST\0 2 - 0 0 6 8. d @3-1 Results of all monitoring will be recorded on Field Activity Daily Logs. Backgroundconcentrations in air will be established upwind and downwind of the work area before workbegins.Calibration and maintenance procedures for field sampling and monitoring equipment isprovided in Table 2. Action levels are provided in Table 3.3.3 First AidInhalation: At first signs of headache or dizziness, remove victim from work area and givefresh air. If breathing has stopped, administer artificial respiration. Get medical attentionimmediately.Skin and Eye Contact: Flush eyes immediately with water for at least 15 minutes, occasionallylifting the eyelids. Remove contaminated clothing. Wash affected body areas with largeamounts of soap and water. Get medical attention if irritation persists after washing.Ingestion: Do not induce vomiting. Keep victim wann and at rest. Get medical attention.3.4 Physical Hazards and Biological HazardsThese hazards are primarily associated with on-site equipment and the general nature ofconstruction work. The majority of these hazards (e.g., construction machinery safety andelectrical safety) are managed under the Irish Construction plans and procedures. For this HSP,the physical and biologicalhazard identification has been limited to issues associated withtrenching and landfill conditions, that is, the issues for which Shaw is responsible.AsphyxiationMoving EquipmentOther: Dry lce3.4.1 FirelExplosion HazardsThe closing of the tanks, particularly those that contained gasoline , frly create a fire/explosionhazard. Prior to the work being started, all ignition hazards within 25 feet of the tanks should beeliminated. This area should be barricaded and only workers involved in the temporary closureactivities should be allowed in this exclusion zone. No vehicles should be allowed in theexclusion zone. All electrical equipment should be grounded prior to starting cleaningoperations. Sparkless tools should be used.XXXXXXElectricalSlip, Trip, FallNoiseOverhead HazardsXXXXFire/ExplosionWeather Hazards(Heat, Cold, Rain,Fog)Pressure WashingCTVCD: lSlt4.qEl USI1 o 2 - 00 6 8. d @3-2 3.4.2 Pressure Washing HazardsOnly hained workers will be allowed to operate the pressure washing equipment. Theequipment must be inspected prior to use to ensure it is operating conditions, in particular aspring-released trigger should be present and working and the hoses should be in good condition.The lowest pressure that is effective to do the job should be used. Workers operating theequipment and those within the exclusion zone must be aware of the potential for splash from theheated water and flying objects from the washed area. Workers must use a face shield with sideprotection and water-proof coveralls fuolycoated tyvek or rain gear that can be decontaminated).The pressure wand should never be pointed at another person. Loose or frayed clothing, rins,chains, or other dangling clothing should not be worn. If there is a sudden or slowing stoppingof the water flowing through the wand, the machine should be shut off immediatelybefore otherdamage may occur. All workers should have non-slip footwear that is in good condition that willalso solid footing on slippy surfaces that may be created during the pressure washing.3.4.3 Weather Hazards (Heat, Cold, Rain, Fog, Lighting, Sparks)It is anticipated that this work will be done during the fall and winter months. Work maycontinue in light rains and wind, but must be suspended when be suspended if the rains are heavyor wind speeds are above 20 mph. Work shall not be done if there is any potential for anelectrical storm to occur. Additional, if fog interferes with workers ability to remain in visualcontact, work must be suspended. ln addition, workers should be aware that when humidities arevery low (e.g., <20o/o) there is an increase chance of having sparks caused by friction.During the fall and winter, workers must be prepared for working in cold temperatures.Workers should take steps to prevent cold stress and be aware of the symptoms of cold stressPreventative steps include:t Dressing warmly: - dress, in layers with materials that insulate but also allow sweat toevaporate (e.g., cotton and wool), clothing should include items which protect the feet,hands, head, and face. However, hoods, loose fitting clothing, dangling belts and jewleryshould not be worn due to the other threat of catching in moving machine parts.a Keep dry: wetness greatly increases the chance of cold stress, have extra clothing available ifthere's a chance you could get wet.o Take a break: become fatigued during physical activity reduces the body's ability to properlyretain heat.C N C D : I SH A RR U STta 2- O0 68. d @3-3 t Replace fluids: replace lost fluids and calories by drinking warn, sweet, caffeine-freenonalcoholic drinks and soup.The effects of cold stress maynot be apparent to its victim. The first symptoms of hypothermiaare uncontrollable shivering and the sensation of cold. The heartbeat slows and maybecomeirregular, and the pulse weakens. As the condition worsens, severe shaking or rigid muscles maybe evident. The victim may also have slurred speech, memory lapses, and drowsiness. Cool skin,slow, irregular breathing, and exhaustion occur as the body temperature drops even lower. Thisis a serious condition requiring immediate medical attention.Frostbite can occur without accompanying hypothermia. Frostbite occurs when the fluids aroundthe body's tissues freeze. The most vulnerable parts of the body are the nose, cheeks, ears,fingers, and toes. Symptoms of frostbite include coldness and tingling in the affected part,followed by numbness; changes in skin color to white or grayish-yellow, initial pain whichsubsides as the condition worsens, and possibly blisters. Frostbite can cause irreversible tissuedamage and requires immediate medical attention.Workers should protect their skin using sun block or clothing. Workers should also be familiarwith the signs and symptoms of heat stress. Workers should use the buddy system to watch forsigns of heat exhaustion - cramps, pale cool moist skin; excessive sweating; dizziness, nausea -and more advanced cases of heat stress. Workers should also drink plenty of water, anelectrolyte drink (e.g., Gatorade) or other fluid on a regular basis. Also, a cool location forbreaks should be identified.If necessary, the safety officer should adjust work/rest cycles to account for worker heatacclimatization, PPE, and whether conditions. For this site permeable personal protectiveequipment (PPE) is required. Assuming temperature acclimated workers are on the site, theguidelines for the work-rest cycle are as follows:. For temperatures at or below 78oF, an individual can work 60 minutes per hour. For temperatures between 78oF and 82"F, an individual can work 45 minutes perhour. For temperatures between 82"F and 86"F, an individual can work 30 minutes perhour. For temperatures above 86"F, an individual can work 15 minutes per hourFor temperatures above 98oF, an individual should be provided with body cooling equipmentC NCD : \S H A RE\ UST\ 0 2 - 0O 6 8. do c34 i3.4.4 SIip, Trip, and Fall HazardsAll work areas should be cleared ofunneeded equipment and debris to minimize slip, trip, andfall hazards. Materials being excavated from the landfill need to be managed so not to create ahazard. Irn addition to creating atnphazard, the waste may create cut hazards. The work shouldbe done in a manner that avoids or minimizes worker direct contact with the waste. If handlingis required, workers should wear gloves with good puncture resistance, coveralls, and bootcovers.During the pressure washing of the tanks - the hoses shall not be laid over ladders, steps,walkways or in other fashions that creates a trip hazard.3.4.5 lVoiseThe general environment and the use of heavy construction equipment may cause ambient noiselevels to be 85 dBA or more. It is anticipated that the worker using the pressure washingequipment will be exposed to high noise levels and should begin work using hearing protection.A rule of thumb will be used as an indicator of potentially dangerous noise levels: if workersneed to raise their voices to be heard while in close proximity (e.9., I to 4 feet away) the noiselevel is likely to be 85 dBA or more. At this point the SSO may initiate noise monitoring or takecorrective actions, such as using hearing protection and reducing the source(s) ofthe noise, iffeasible.3.4.6 Overhead HazardsThere may be underground and aboveground utility lines. Prior to initiating work, the site willbe surveyed for overhead lines and obstructions that may interfere with operations. If anoverhead line is found, the electrical company or other wire owner should be contact todetermine the appropriate height separation for the power of the line.3.4.7 Asphyxiation/Confined SpaceThe inerting of the tanks using dry ice will create an oxygen-poor environment. Workersconducting the visual inspection will not lower theirheads into the tank where the oxygen levelis less thanlg.5Yo oxygen. No entry into the tanks will be allowed since this is a permit-requiredconfined space.3.4.8 Moving EquipmentThe work must be arranged to minimize the potential for workers to be run-over or hitbymoving equipment. Workers will wear hard hats and high visibility traffic vests. Hand signs,CNCD,|SHARE\US 02-G068.de3-5 backup alarms and other means of communication must be used when the heavy equipment isbeing moved. Workers should not be within the area traversed by the backhoe boom and bucket.3.4.9 Dry lceWorkers will be using dry ice for inerting the tanks. Skin contact with dry ice will burn the skin.Workers should use heavy, cloth gloves when handling this material.3.4.10 ElectricalHazardsThe work involves working with tanks that have electrical power. Prior to initiating all work, thepower source for the tanks and pumps must be identified and tanks de-energized under a lockouUtag out procedure. Only a qualified electrician shall disconnect the tanks from the inerted,cleaned tank.3.5 Sife Confrol MeasuresWork areas (to be a minimum of 25 feet in all direction from the tank) will be secured from thepublic by orange traffic cones or other appropriate barrier. Drinking or smoking is not permittedin the work area. At a minimum at 20N20BC fire extinguisher will be present at the site. TheSite Safety Oflicer shall enforce these measures and the buddy system, PPE and trainingrequirements for all on site personnel. Spills are not expected to be a concern on the project.However, if a spill is to occur, adsorbent materials are available.A Tailgate Safety Meeting will be held by the Site Safety Officer for all site personnel. Thesafety discussion will include, in addition to other items in this HSP, the following issues:Site Entry Procedures: The Contractor shall provide the Contract Manager or the ContractManager's designee with safe access to the work site during the investigation.Personal l)econtamination Procedures: Eating, drinking, chewing gum or tobacco, smoking,or any practice that increases the probability of ingestion of material is prohibited in the worksite. Wash hands and face prior to eating, drinking or smoking and before leaving the site.Kneeling, sitting, leaning, or general contact with potentially impacted surfaces, or with surfacessuspected of being potentially impacted by petroleum products should be avoided. Medicine andalcohol can alter the potency of toxic chemicals. Prescribed drugs should not be taken bypersonnel if the likelihood of such potentiation effects exists. Ingestion of alcohol is prohibited.Flammable Gas Hazards:. Worker safety precautions include: no smoking on the site. Workers should use non-sparking and/or explosion-proof toolsC N C D :lSIl A RE\U ST\0 2 - 00 68. i|@3-6 . No vehicles will be allowed within the exclusion zone3.6 Personal Protective EquipmentSafety EyewearRespirator (Type): Standby fu ll-face air-purifying respiratortAPR)Filter Type: Organic Vapor and high+fficiency particulateair (HEPA)Gloves (Type): Latex or nitrile duing sampling; heavyleather work gloves for managing dry iceOther: Face shields when power washingOther Emergency/Safety Equ i pment:BarricadesTrafiic ConesAdditional emergency/safety equipment includes pagers and cellular phones. Workers areencouraged to avoid use of hand-held cellular telephones while operating motor vehicles.Handheld tools should be constructed of non-sparking materials.3.7 TrainingAll personnel on site will be provided with on-site training that provides an awareness of thehazards of fuel vapors and power washing hazards that may be encountered. At least one personat the site will have first aid/CPR training. All workers designated for fire suppression in thework zone shall be provided with training in the operation of the fire extinguishers that will besupplied at the site.3.8 Emergency Response PlanThe Emergency Response/Contingency Plan (ER/CP) is designed to define and communicateprocedures to be followed in case of an emergency. Due to the nature of this work, there is apotential for an explosion or fire to will occur if landfill gases are encountered. In case of anemergency, the Site Safety Officer shall ensure that all personnel working at the site shall knowat a minimum the following evacuation procedures:XXXXXXHigh visibility, brightly colored VestHearing Protection (as needed)Tyvek Coveralls (if needed)Hard HatSafety Toed BootsXXX15 Minute EyewashFhst Aid KitXX/i/B/C Fire Extinguisher -minimum of 20F/208CPotable WaterXXCN C D :\S H A REIU ST\0 2 - 006 8. d @3-7 I1. If evacuation is necessary, all personnel will proceed to a predeterminedlocation in the support zone, upwind and upslope (as necessary) of the workzone.THE SIGNAL FOR EVACUATION WILL BE TIIREE SIIORTBLASTS IN SUCCESSION ON AIY AIR OR CAR HORN.2. Site-specific evacuation incident procedures will be discussed and documentedby the Site Safety Officer.3. Workers should turn off all engines and other equipment prior to evacuation4. Any person requiring medical attention shall be evacuated promptly from anycontaminated area. For personnel requiring medical attention, the emergencyinformation guidelines in Section 4.0 shall be followed.CiVCD.'lstl,{RElUSn O2-0M8. de3-8 4.0 EmergencylnformationIf injuries occur on site, take the following action:l. Stop work, evacuate any injured personnel, initiate first aid, implement procedures to limitthe extent of the emergency event (ensure response actions do not endanger site personnel).2. Get medical attention for the injured person immediately, if necessary, from the emergencymedical facility.4.1 Nearby Hospital/Clinic - IVofe this is Applicable Only to the San Luis ObtspoSfte.The nearest hospital is the San Luis Obispo General Hospital in San Luis Obispo, California.Phone:Address:4.2 Emergency RouteFigure la - Hospital Route Overview$2OOP ltrbpQuest.com. lnc.; O(805) 781-48002180 Johnson Avenue, San Luis Obispo, CA 93401lmiObispomitl',l'lIFJCIVCD: ISI{,{REIUSI1 02 - 0068. d &G:DT4-l -r\Figure lB - Destination Map for Hospital,Flery,,iq#i$'RFrom Site1: Start out going West on SUBURBAN RD towards SHORT STby turning right.2: Turn LEFT onto S HIGUERA ST.3: Turn RIGHT onto LOS OSOS VALLEY RD.4: Turn LEFT to take the US-101 N ramp.5: Merge onto US-101 N-6: Take the CA-1 N exit towards MORRO BAY/HEARST CASTLE.7: Merge onto OSOS ST.8: Turn LEFT onto WALNUT ST.9: Turn RIGHT onto SANTA ROSA ST.10: Turn LEFT onto MONTEREY ST.11: Turn RIGHT onto JOHNSON AVE-4.3 Fire Department:4.4 Police Department:r$r$:$:$,sr$r$:$r$r$Phone: 911Phone: 911C NC D :lSIt A RI1'USTIO2- 0O 68. do c4-2 5.0 Health and Safety PIan Approvals and Acknowledgement5.1 ApprovalsI have read and approved this HSP with respect to project hazards, regulatory requirements, andShaw procedures.Project Name: SBC Pacific Belltr /2-6/o -t-_-1), .//Sydne{freels_TDateProject Manager6p*-Srx"*S nlzulozBarbiraMarks, Cftl#5776 i 6ateProject Certified Industrial Hygienist5.2 AcknowledgmentsI acknowledge receipt of this HSP from the Project Manager, and that it is my responsibility toexplain its contents to all site personnel and cause these requirements to be fully implemented.Any change in conditions, scope of work, or other change that may affect worker safety requiresme to notify the Project Manager and/or the Site Supervisor/Foreman.Site Safefy Officer:Q,'{9,r1Date: lt'%'oz-'l''.tClfC.D'lSI/,{RElUSn0 2 4068.doc5-1 (-'6.0 Health and Safety PIan AcknowledgementI have read this site-specific health and safety plan, or its contents have been presented to me,and I understand the contents, and I agree to abide by its requirements.Name (Print) SignatureRepresentingDater-C NC D : lS H A RE\ U ST\O 2 406 8 - d oc6-l f"TABLE 1Chemicals of Goncern and Occupational Characteristics (1)ChemicalCarbon DioxideDust (Particulate NotOtheruise Regulated)GasolineDieselEngine ExhaustBenzeneTolueneNoles;CommentsMalrr Constituent of dry ice,simple asphyxiatelnitationCarcinogen; fl ammable liquid;kidney toxin; headadres;dizziness; eye, nose, and hmatinitant (lilay be present due loproximity to highnay baffic)Carcinogen, initant, odor andcolor vary by source (May bepresent due to proximity tohighway taflic)Carcinogen; fl ammable liquidwith aromatic odor (may be atrace gas in landfill gas€s)Flammable liquid wih benzeneodo[ liver and kidney toxin; skininitant dermatitis; demalabsorption; skin (6)1.z3.4.5.6.7.Source:NationallnstituteforOccupational SafetyandHealth (N/OSH), GuidetoChemical Hazards, 1990. Ppm=partspermillbn. mg/nf = milligrams percubic meter.CaIOSHA PEL = 8 CCR 51 55 General lndustry Standards for Toxic and Hazardous Subsfances, Permissible ExposureUmit. 84our time weighted avaage (IWA)SIEL = Short-term Exposure Limit.ACGIH TLV = Ameican hnference of Govemmental lndustrial Hygienists, Threshold Limit Value.IDLH = lnmediately dangerous to life and health.N/A = not applicableSkin = The designation 'skin' refers to potential significant contribution to the overall exposure by skin contact with vaporsor with the substance.rDLH (5)40,000 ppmNotEstablishedN/A (6)500 ppm500 ppmNACGIH TLV B-hourTWA(4)3 mgimr respirable; 10mg/ms total300 ppm50 ppm0.5 ppm0.05 ng/m35000 ppmCaIOSHA PEL B-hour TWA(2)srEL{3)5000 ppm;30,000 ppm5 mg/mr respirable;10 mg/mr total300ppm ISTEL=500 ppmlNot Established1 ppm [STEL = 5ppml50 ppm [STEL =150 ppmlC NC D : \SH A REI U STta 2 - 0O 68. d @I of I CGI sensor calibrated againstknown concenhation of hexane(demonstration botlle). Zero settingchecked in non-contaminated air.Oxygen sensor calibrated daily to20.9 percent fresh,non-contaminated air.PID zeroed in clean air. Spancalibrated using knownconcentration of isobutylene(demonstration bottle).Check air tightness of pumP, timefor one minute, chain should remainslack. lf chain taut, thenmaintenance required.Verify airflow using primary standard(bubble meter) or precalibratedrotameter.Calibration MethodCalibration FrequencyCGI span calibrated once permonth. CGI zero checkeddaily.Orygen sensor calibrateddaily.PID zeroed and span checkeddaily at start of work day.Check daily prior to start ofworkday.Verify airflow prior to and afieruse with sampling head inplace. Spot check flow ratethroughout sampling period.TABLE 2Calibration and Maintenance of Field Sampling EquipmentMonitor TypeCombustible gasindicator {CGl)/oxygenmeter/4 gas meter (O2,LEL, hydrogen sulfide,and carbon monoxide)Photoionization detector(PrD)Draeger tube samplingsystemAh sampling pumpMaintenance Schedulelnstrument cleaned as neededand no less than annually.Orygen sensor changedannually and changes ifnecessary.Annual cleaning by qualifiedtechnician. Annual calibrationof electronics by qualifiedtechnician. Clean lamp ifsensitivity drops or if used invery dusty environment.Maintenance requiredwhenever pump fails to passleak test. Replace sealsand/or lubricate per instructionmanual.Minimum of annual cleaning.Clean whenever pump unableto hold flow rate.Maintenance required if pumpwill not hold charge or flowrate is erratic.CNCD:\SEARE\US o2-0068.d@l of I TABLE 3Airborne ChemicalAction Levels ln Breathing ZoneParameterDustUnknown VOCsBenzeneOzLELAirborne ChemicalAction Levels in UST During lnertingRequired Action2Use Dust Suppression (watering or equivalent)Detector tube for benzene, continue to work if no benzenedetectedStop work; contact ClH3Stop work; determine cause3Stop work; determine cause3Required ActionzContinue inerting tank - trying distributing dry ice using wateror adding additionaldry ice, do not proceed withdeconnecting electrical widng until action levels have beenmetContinue inerting tank - trying distributing dry ice using wateror adding additionaldry ice, do not proceed withdeconnecting electrical whing until action levels have beenmetOzLELParameterNoles;ppm-- pafts per million.LEL= Iower explosive limit.1 . Five excursions above the action level in any 15 minute peiod or a sustained reading in excess of lhe action levels for5 minles will tigger a response.2. Frequency of ah monitoing may be adjusted by the CIH after sufficient characteization ofstfe contaminants has beencompleted, tasks are modified or sile controls h ave proven effective.3. hntact with the Praiect CtH musi be made pior to continuance of work. The Pro,ject CIH may then initiate integrated airsanpling along with additional engineeing controls. No one is permifted to downgrade levels of PPE without atfthoizationfromthe Prctject ClH.Action Levell> 0.5 mg/m3 above backgroundt 5 ppm above background< 50 ppm> 0.5 ppm223.5o/oor < 19.5%> 10% of LEL>10 % of LELAction Leveli> 8o/oC NC D : \S HA REt USAO 2 - 00 6 E. d @I of I Appendix AProposition 65 Warning and NotificationAs required under the Safe Drinking Water and Toxic Enforcement Act of 1986 (also known asProposition 65), on February 27,1987, the Governor published a listing of those chemicalsdetermined by the State of California to cause canser, birth defects, or other reproductive harm.Proposition 65 requires that businesses that handle any of the listed chemicals notiff people inthe affected area of that fact. Shaw anticipates handling some of the listed chemicals at theproject sites.The chemicals present on site that have been determined to cause cancer include:. Diesel Engine Exhaust. Gasoline (whole vaporized). BenzeneThe following contaminants on site have been determined by the State to causereproductiveharm:aBenzene. TolueneLeadaC N C D :EH A REI U $10 2 -0068. il ocB-1 APPENDIX APROPOSITION 65 WARNING AND NOTIFICATIONC NC D :\SHA M\US1\0 2- 00 6 8. d ocB-2 Equipment DecontaminationActivPressure washingEquipmentPressure washerControlMeasuresProper PPE will be utilized as described in this HSPPressure washing activities willbe in accordancewith Shaw Policy HS 303.Only trained personnel shall operate pressurewashing equipment.Ensure proper footing in wet areas.TrainingPressure washer training40 hour/ 8 hour HMWOPERSite-specific trainingPrior to uselnspectionSlips, lrips, fallslnexperienced operatorCutting hazardsContact with productHazardscNcD tslr,{RA usn 0 2 -0068 - d eB-3 ATTACHMENT 3QUARTERLY MONITORING FORM Quarterly Monitoring FormPacific Bell Facility196 Suburban RoadSan Luis ObisGaliforniaNotes:Middle:Lower:Upper:Oxygen (in Percentage)Lower:Middle:Upper:LEL (in Percentage)No Power to Dispensers:Tags in Place:Locks Secured:Date:Notes:Middle:Lower:Upper:Orygen (in Percentage)Lower:Middle:Upper:LEL (in Percentage)No Power to I)ispensers:Tags in Place:Locks Secured:Date: Quarterly Monitoring FormPacific Bell Facility196 Suburban RoadSan Luis ObiGaliforniaNotes:Middle:Lower:Upper:Orygen (in Percentage)Lower:Middle:Upper:LEL (in Percentage)No Power to Dispensers:Tags in Place:Locks Secured:Date:Notes:Middle:Lower:Upper:Oxygen (in Percentage)Lower:MiddleUpper:LEL (in Percentage)No Power to Dispensers:Tags in Place:Locks Secured:Date: Division of Envirog tr!-Eeelih(80s) 781-ss44P.O. Box L4892156 Sierra Way r$np Luis Obispo' CA 93406Denartmenl of Asricultut'e/NleasuretnentStandards (8os) 781-s9102156 Sierra Way Suite A oSan Luis Obispo' CA 93401Irire Deparl I (805) 781-73802160 Santa L,,- oara AvenueSan Lrris Ohisno CA 934O1-5240,|;,l";4Utilities l)epartment r (805) 781-7215879 Molro Street r San Luis Obispo' CA 93401CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALS INSPECTION FORMEFW dataentfy by:Date: V 1,r,, li;',Time: trlUYESgVEgEtrVNO N/AnTCOMMENTS 6\uo ').43)i; t l"i'.,V*- vt fRPOIBPO2BPO3TROlTRO2EROIERO2BUSINESS PLANBusiness plan is complete, current, & available during inspection (HSC S25503.5' Title 19 CCR fi2729)Inventor.y of hazardous materials is complete (HSC $25504, Title 19 CCR $2729)Site layout/facility maps are accurate (HSC $25504' Title 19 CCR$ 2729)TRAINING PLANFacitity has appropriate training program (Title 19 CCR 52732 & 22 CCR $66265.16)Trailing documentation is maintained on site for current personnel (Title 19 CCR $2732 &22 CCR S6626s.16)EMERGENCY RESPONSE PLANContilgency plan is complete, updated, aud maintained on site (HSC 1i25504' Title 19 CCR$2731 & 22 CCR S6626s.53/s4)Facility is operated and maintained to prevent/minirnize/rnitigate fire, explosion, or releaseof hazardous waste to the environment. Maintains all required or appropriate equipmentincluding an alarm and communications system (Title 19 CCI{ $2731 & 22 CCR 566265.31-la;;ls',rrt "',:'[' /Li<;':c';r-r , til'$'.> (1:"v, l''lU {t'l 1- \.,-t X":-1 !s:9 t.1.,.s- .',ktt'lt r'(/,.-i"(L1 ( 1 t',,'lr; l,:lii,zrL l/'y lo-.1;t,' r2t.Q. { f(.,) 1..1c)tL- :.O"Lrrr.,-r-r.{Jt"t(! /(:yt1r'u! , y.11i),;,, ,.."", { i:, ii.y({li.vr.k. , (i',trqjLL.i c i,", ,)c;i!\[ ,.,,i'u'ti ; I l'vl:l'*- I..i t ,--. - 'l r..r ,i.r i.-.1 1 t )'-.TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and deterlniningwith adopted codes. GRANTED BY (NAME/TITLE):REINSPECTION REQUIRED:fNoIYESI usrn gw Gcneratorl-l Business Plarrf] Tiered Permittingtrlcr! Business PlanPROGR,A.MS INSPECTEDE usrI rrw Generator! Tierett Permittingn lcrPHONE) 1.1ADDRESS:F'ACILITY ID NO:AGENCYn nnHn .tc DEPT"El. crrv rrnpI crrv UTILITIESRoutineReinspectionComplaintL lrr',lFl otherl-L.(-jTi:l-l.l(trtit,r,..;...ir',i,'.( !Lu..t li'-'-,-;'1,.i,,.\ it;1,,'1.1,:t.. rr{i' L',iL'; l;,q' Z/(o/b i l/ ll-''\'l:\:\,{.1 !, J I L;\ }t ;r,;1rlr;iit:r r lt:tttt$.t.lli-: } 1}-iir.,"1: i}l From:To:Date:Subject:Closurelts oemClosure"Mason, Leonard J" <Leonard.Mason@shawgrp.com>'Molly Brown' <Mbrown@slocity.org>211010310:00AMRE: 196 Suburban Rd., San Luis obispo, CA, Underground Storage Tank, TemporaryMolly,At 1BO5 hours, we recorded an LEL of 9% and an Oxygen of 7o/o. lf you haveany other concerns please feel free to contact me at (925) 288-2216.ThanksLen Mason---Original Message---From: Molly Brown [mailto:Mbrown@slocity'org]Sent: Friday, February 07, 2003 5:00 PMTo: leonard. mason@shawgrP.comSubject: 196 Suburban Rd., San Luis obispo, CA, Underground StorageTank, Temporary ClosureDear Mr. Mason,since your tank closure project was not complete by the time I left thesite yesterday at 5:30 pm, I will need documentation from you regardingthe final LEL and oxygen levels in the unleaded gasoline tank. Pleasesubmit this information to me by Wednesday, February 12th, 2003. Ane-mail response would be adequate.I was not able to hear your last phone message to me (Thursday night)as the message cut off right when you started speaking.Thank you.Molly BrownHazardous Materials lnsPectorCity Fire Department2160 Santa Barbara AvenueSan Luis Obispo, CA 93401-5240Phone: 805-781-7560 or 805-781 -7380Fax: 805-543-801 IE-mail: mbrown@slocitY.org96 Suburbanrounde1 )Asa fk4-ts b,a-V(tUNDERGROUND STORAGE TANK (UST)MONITORING CODESl. No monitoring2. Standard Inventory Control3. Modi{ied Inventory Control4. Statistical Inventory Rec. ' , t'5. Automatic tank gauge (list type)6. Continuous monitoring in tank annularspace/secondary containment7. Visual monitoring8. Manual monitoring annular space ,i9. Temporarily abandoned under permit10. Another methodPermit No.# PERMITTED TAIIKS# IJNPERMITTED TANKSOwner & operator as indicated on permit: n VgS nNOIf no, new owner name & addressnew owner name & addressN/A!nnIn!n!nInNOtrnntr!!trn!n!YESww,wWwg.gwWtMNo. ofTanks:Total Volume:vIoL. #UTOOlUTOO2UTO03UTOO4UTOO5UTOO6UTOOTUTOOSUTOO9UTOl()UTO1I- galsATOOIATOO2PERMITTINGSite has a permit to operate (HSC 25284)Permit is kept on the premisesChange of ownership is reported to the permitting agency within 30 days (HSC 25284(c))All UST(s) are properly permitted to operate or properly closed (HSC 25298)MONITORINGUST(s) monitored using method specified on the permit or approved by the permittirg agency (HSC 25293) (Writemonitoring code(s) observed -, - )Monitoring records are provided to regulatory agency upon requestAutomatic line leak detection system is installed & kept operational for all pressurized piping (HSC 25292)An annual report is submitted to regulatory agencyTank tightness test and./or piping test is being performed as required (fitle 23 CCR)Written Monitoring Plan submitted for electronically monitored tank system (fitle 23 CCR2632134)Facility maintains evidence of Financial Responsibility for corrective action and for compensating thirdparties for bodily injury/property damage caused by a release from the tank system (HSC 25292)ABOVEGROUND PETROLEUM STORAGE TAI\K ACTProducts Stored: n Oieset lGasoline [Crude oilI ottr"r.n*'' :t;otd?;Tt"1T'i:il':il::il':1'if;r:;ffi:l1,:k 10'000 ga'ons; ror rarms' nurseries' *"*""";i:l;""ffi-"t glT-i , tiltYES NO N/A VIOL.# UV'rnnn!!SPCC Plan is prepared and certified by a registered engineer within last 3 yrs.SPCC Plan is maintained on site or nearest field oflice.elqln) 6fury k,fl,wr M+n(L;ax';n(\T,* U\TLuwh/tM,tnl, t"lk /")a//,7Wkt tdl4 1r,w,/a'1,1't */ryw,ltltv "Fa4/ WwfY)-r/,u/hwh44Iut*4CA,ITfrfr,ifr( /,kh/AW A24'@4(,d- qm,N.ko^/t))) tiJFACILITY NAME:r4Jn t,.fl,SUMMARY ORTIONS/vIOLATIONStrNo violations ofunderground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requirements werediscovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility.-tViolations were observed/discovered as listed below. All violations must be corrected by implementing the corrective action listed byeach violation. If you disagree with any of the violations or proposed action, please inform us in writing.ALL MINOR VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED' CUPA MUSt bC iNfOTMCd iN WTitiNgcertifying that compliance has been achieved. A false statement that compliance has been achieved is a violation of the law andpunis'hable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be reinspected any time duringnormal business hours.you may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. Theissuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as a result of theviolations noted or that have not been corrected within the time specified.VIOLATIONSMINOR MAJORCORRECTIVE ACTION REQUIREDNUMBERBPTRERGTTUTATCOMMENTS:Inspected)Facility Rep Name:Signature:I zlu/Date:01nOCUMf; NT\Jeftp\F0ft ltl$\l nupection forrns\CUPA inspeciiernforrns.dcc 2-Jan-01 -aEnvironmentalPacific RegionManasemef\ f\f,3;J?1333' MAySan Ramon, CaliforniaPhone 925-825-9855Fax 925-867-O2471594585?{l01e6)14b 5"bv,/btu'^?r,rC\hg W)lApril20, 2001City of San Luis ObispoParticipating Agency to San Luis Obispo County Certified Unified Program AgencySpencer MyerHazardous Materials CoordinatorCity Fire Department2160 SantaBarabara AveSan Luis Obispo, CA 93401RE: Certification of Financial ResponsibilityThe attached is a copy of our Certification of Financial Responsibility for Pacific Bell and SBCAffiliates. Also enclosed is the list of our facilities with underground storage tanks in your areaofjurisdiction.Please call me on (925) 823-6161if you have questions regarding this correspondence.Stan BrodeckiSenior Environmental ManagerSBC Environmental ManagementAttachment: Certification ofFinancial ResponsibilityList of SiteE Name of Witness or NotaryArmiD. StricklandSignture of Witness or NotaryDate4,,r*.,//fu/- s/8/01Name and Title of Tank Owner or OperatorStan Brodecki, Senior Environmental ManagerEature of Tank Owner or OperatorDate5t8t011Facility AddressFacility NameFacility AddressFacility NameFacility AddressSee Attached ListD. Facility NamePacific BellNote: lf you are using the State Fund as any paft of your demonstration of financial responsibility, your execution and submission ofthis certification also certifies that you are in compliance with all conditions for pafticipation in the Fund.YesYesRenewedAnnually$2,000,000Per Occurrence &$2,000,000Annual AggregateNot ApplicableFor StateAlternativeMechanismSBCEnvironmental ManagementPacific RegionPO Box 5095, Rm 3E000San Ramon, CA 94583-0995Financial Test ofSelf lnsuranceThird PartyComoCorrectiveActionCoveragePeriodCoverageAmountMechanismNumberName and Address of lssuerC. MechanismTvpeB. Pacific Bell hereby ceftifies that it is in compliance with the requirements of Section 2807,(Name of Tank Owner or Opentor)Article 3, Chapter 18, Division 3, Title 23, Califomia Code of Regulations.The mechanisrns used to demonstrate financial responsibility as required by Section 2807 are as follows;A. I am required to demonstrate Financial Responsibility in the Required arnounts as specified in Section 2807, Chapter 18, Div. 3. Title 23, CCR:500,000 dollars per occurrenceorI miltion dollars per occurrenceANDI million dollars annual aggregateor2 million dollars annual aggregateXXCERTIFICATION OF FINANCIAL RESPONSIBILITYFOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUMState of Califomia fIi'aFor State Use Onlylt]lAY 1 5 ?001State of Water Resources Control BoardDivision of Clean Water ProgramsP.O. Box 944212Sacramento, CA 94244-2120(lnstructions on reverse side)CFR (Revised 04/95)FILE: Original - Local AgencyCopies - FacilityiSite(s) From:To:Date:Subject:Kerri RosenblumFD_All; PD_ALL1111010010:36AMAnnexationsFYI - The following annexations have been approved.204fank Farm RD where the new Farm Supply isare now in theCity. Alice is workis located anding onGG:sending the correct X Y coordinates over so that the Spillman system willverify correctly. A & R weldingis also on the annex list.Carter, AliceC-pL+lp,^, t^ Cr'ttf h ?ru14 hr>^tn t2 / oo\v'cvx Fo^ot San Luis Obispo Fire Dep"4mentI nspection I nformationld_numberAddressAssignmentBusinessBusiness phoneBusiness typeTime spent1966196 SUBURBANKB KERRYBOYLEPACIFIC BELL-SERVICE YARD811-31000.0 # of inspections in a 3 year periodSelf-inspection cycleEmployeet ltQ-{ {*ttt'tA)'u"jlnspectorNFIRS CodeResponsibleparty LARRYPhone I -Emergency phone I -Property owner PACIFAddress UNKCity, State, Zip UNKNOWNNo Lock Box LocationLast clear date I IHood test I ISprinklers I INo AlarmNo Clean AgentNo Basement PipesNo VentNo Stand pipesNo RemoteFire flow 2250Construction type V-lHStories 1Building Area 13000Occupancy area 0Occupancy load 49Occupancy B408.554,17-T^37V 4'12,L 4-TELEPHONE &HcA 99999-LocationLocationLocationLocationUFC YearOffice, professional, or service. Restaurants < 50LrL"lConut-k(,6."-\ . .{6p, ^,^AF+'-q4G 1315-4 Ltl +o13ooYrAgr-{.h)c{d.t\!(! rr',,'lPermitsViolationsPrevious violations 10122192Previous violations 04121 189Critical locations GAS S-A CURB. ELEC S-A. GALL FOR P.G.&EPreplan hazardNotesHAZMAT PERMITPermit monthPermit expires2o2l01lo1STORE/HANDLE/USE HAZARDOUS MATERIALS79.0079.0004117101Page@,^ {NCity of San Luis ObispoFire DepartmentRobert F. Neumann, Fire Chief2160 Santa Barbara Ave.San Luis Obispo, CA 934OIPhone: (805)781-7380FAX (80s)s43-8019FAX COVER SHEETTo:FAX:t,From:San Luis Obispo City Fire Department(Sender's Nanc)0//r- O IDate:You slnuld have recei(including this cover sheet).If you do not receive alt of thc pages, or any of the pages are illegible, then please contact thesender at 805-781-7380, or FA)( 805-543-8019-1&SObv\(k1COMMENTS:=Xr^,cN,)ct\qbqL^ -f'Hydrant information for H-20-42Hydrant #H-20-42Main12fiL,ocationSUBURBAN RDTeeL2"X6,S.E. HYDRANT @ SPICE HUNTERWater MainSUBURBAN L2Nt-WeE/Dry(w/D)WMake & Modelci,ow #206sMFG L996Outlets3 4r/2" 4r/2't 2L/2"Barrel Sj.ze New HYdrant8 " J-r'7 -01Yeart-998ilBranch6,MarkerOKSt. Valve Dist.L2t - 6nZoneDate01,/06/eePRESSURESTime Stat. Resid.1_040 92B7Pitot/outlet84 @ 2 l/2"GPM FLOWSObserv. @20#1s38 6493ByLM/JCII,AII{I:TENAI{CE RECORDDateRedCurbBy Painted ByColorThread ByLubeWeedEarthBy Flush By Marker By01,/06/ee oKLM YELLOWYES IJM OK JC YES LM OK JC/LMSpecial NotesSTAT/RESID TAKEN @ H-20-42. Ron Hanson - Re: 196 Suburban - Public Iment plans1From:To:Date:SubjectMike BertacciniHanson, Ron2l1l01B:274MRe: 196 Suburban - Public lmprovement plansThanks Ron. Regarding the public improvement plans in the building plan set...My comments to thearchitect were to remove them. lmprovement plans do not belong in a building plan set unless the plansare signed and approved and are there for reference only. We do not want the Building Dept to be placingan approved stamp on public improvement plans'>>> Ron Hanson Wednesday, January 31,2001 >>>Mike and Howard,lfound the Public lmprovement plans for 196 Suburbanlll The plans had been routed to Darren bymistake. I have already reviewed the Building plans previously. The Public lmprovement plans were alsopart of that review. I hive already routed comments to the Building Division and sent Howard an e-mailattachment. These comments are the same comments minus the on-site stuff'I'll route you the hard copy when Darren returns from vacation. Sorry for the delay.ccBirlew, Howard ...-__...8t_..l.Llir..l,r1fl+ MARPLoT1t,"TuoYrl "t1" 'b*"'?"@lnd. Parkwatersupply{@141 Subuftant6"'tt:\iilJ,.o"R*,.,00,,LosBuslnessJr water, z wettsFt.0."nhry 0.200.30 mi0.250.50 km@@W€ll: HorizonWater Co. water supplyWell: J.M. SimsWatWell: Trusco Ta FRBI'1 : .FULTON FIRE ENGINEERING?FAX N0. i AB5-489-t4?4fla4 ?aat 11:114N P1l1b S,.bt*ni* p.rci fi L (>€tLLTO,enCOI{PANY NA}IEILELOCATIONRE:Fnr€AIG'A]EEBII\J6, II\JC.2880 NARTHVBN AVE,, AHROYA GRANDECA 9342GFAX TRANSMISSION I\P*^//*TN.LUDTNG cov.R "ntt, .# I /FRO}I:TOTAL NU!{BER OF PAGESFIRE ENGINEERING, INC.COMPLE1E FBE PROTECTTON ENGTNEEBTNG ffRvtCES - FRON : f,ULTON FIRE ENGINEERINGFAX N0. 1 8,?'5-489-1424Prepxed forJanuary 4, 2001g4 z@gt 11:114M P?,trFIRE PROTECTION ANALYSISPACIFIC.BELL 58164196 SUBURBA]'{ ROADSNW I-UIS OBISPO, CALIFORNIARR}V[ DESIGN GROI'JP37OI SOUTH HICUERA STREETSEN IUS OBISPO, C ALIFORNIAByJohn C' Fulton' PEFTILTON FIRE ENGINEERING' INC'2880 NORTTryIEW AVENI'JE ^.ARROYO CMNOE, CALIFORI'IIA 93420-5560(805) 489-8400FULTONFIRNPAGL IOF 15 FRON : fULTDN FIRE ENGINEERINGFAX NO. i 8@5-4e9-1424rgl3t.(@4 20AL 11:12R14 P3FIRE PROTECTION ANALYSISPACIFIC-BELL SE164196 SUBURBAN ROAI}sAN iitis oB$Po, cALIFoRNIATABLE OT CONTENTSINTRODUCTION.OBJECTIl/EGENERALPLA].IT DESCRIPTION'''AREA/OCCUPA]'ICY SEPARATION WALLS'FIRE WALLS, FIRE DOORS A}ID E)flTS ' ' "PRINCIPLE OCCUPANCY, ..'IIAZARDOUS MATERIALS. ..SPECIAL HAZARDS.WATER SUPPLY.REQUIRED FIRE FLOWSPRINKLER SYSTEMHIGFI PILED STORAGE.FIRE ALARM SYSTEMS.FIRE CODE ANALYSIS. .. 'CONCLUSIONSRECOT\4MENDATIONS33J.J.4.,4...4,.4).5..6,... 6.... 6,...66T4.14FULTON I.,IREINGPAGE 2oF Is FROI'I : FULTON FIRE ENGINEERINGBuilding ABuilding BBuilding CBuilding DTrash ShedFRX NO. : AA5-4A9-1424Jan.g4 26A1 11:124N P4FIRE PROTECTTON ANALYSIS- -- rlcn'Ic-BELL sE164ise sunuRBAN RoADsAN iilis ontsPo, cALIFoRNIAThisreportwillpresenttheresultsofafireandlifesafetyfirecodeanalysisforthisproPerty.OBJECTN/EThe obiective of this Fire protection_Analy-sis is to fulfiltthe requirements of the city ofSan Luis Obispo ,nAiir."i."i"i, OUi-p" Eite Depanment to perform a third partvreview of thc fire "-di,f";;oy e."r11irrtti, prop"ny pursuant to an application for;;;;;ilty the citY of SanLuis obisPo'INTRODUCTIONGENERALPLANT DESCRIPTIONThephysicalplantconsistsofthefiollowingbuildings(sizesareapproximate).BUILDTNG OCCUPANCY UBC TYPE SQ FT CONSTRUCTIONWd Fr, Stucco WallsCor Ir St FrCor Ir St Frv-N 2ooCor Ir St FrYard Storage consists of the following:TrucksAutosCable reels, mostlY metalPoles, mostly woodConduitGas cvlindersilairift"."ts (manholes, standards'-etc)' .A 250 gallon o,op-t1'':tik' *"J fot nffing industrial trucksThis property is occupied by the Paoific Bell company as a field'maintenance center'operations include u.i;;"?i*";;;ilJ'[ne of if'site telephone equipment' slorageof parts antt equrpme* ffi';;;r"g"; rJ;;inr. ortrt* truck and vehicle fleet'AdministrationMaterials StorageVehicle RePairNo longer existsTrash Storagev-NV.NV-N900040001000FULTQNFIRENGPAGE3OF 15 FRDM : 'FULTDN FIRE ENGINEERINGFRX NO. I 8@5-489-1424JPotIe4 ?E6t 11 : 13Bl'1 P5AREA/OCCUPA NCY SEPARATION WALLSTherearenooccupancyseparationwallsinanyofthebuildings.BuildingAhasnumerou$ internal ottitit"# *;"t* dtffbrent oflfices and labs'rIR]C WALLS, FTRE DOORS AND EXITSTherearenofirewallsorfiredoors.Exitingfromallbuildingareasisadequate,properlysigned and marked'PRINCIPLE OCCUPAI{CYThe principal occupancy is support for.field telephone P3tlt:noT:' Offices aremaintained in Buirding i ror rourine "ominirtia-t'ion and fierd maintenance scheduling.-UgC O.""pancy classification is B'BuildingBisusedforsmallPuns,lorJgjandsomeactualmaintenancesuchascablesplicing, sompressor ,;#: il. 'IJBC "or"upn*y classification is F-l and S- l 'Building C is used for automobile and truck maintenance' UBC-OccuP'urcy classificationis H-4 (vehicle repair garage with occasioJ*"rJrgt- Most of the hazardous materialsused on-tite are uied in this building'HAZARDOUS MATTRHLSThe 1997 Hazardous Materials Inventory on file with the county Health Department liststhe following *o,"'iot' -d quantities ofhazardous materials:l.6000gallonsgasolineinburied'partitionedFRPtank'Thisisanewtankinstallcd i" tf'l ptti teveral y""'' Ct^tt IA or IB flammable liquid'2. 4000 gallons No' 2 diesel, in the same tank as ltem No' 1'Class II combustible liquid'3. 130 gallons motor oil in an approved container in Building C'ClasJ llIB combustibte liquid'Ethvlene glycol in 55-gallon drum in Building CClass IIni' combustible liquid'250 sallons propane in an approved tank in the yard area'ClasitA flarnmable liquid or gas'Used motor oil in a l20-gallon tank stored in yardClass IIIB combustible liquid'456FIII'.TON FIKEPAGE 4 OI'' I5 FRON : FULTON FIRE ENGINEERING /\FCX NO. | Pl8]5-4A9-1424J?*-, g4 2841 11:134N P6(7Automatic transmission fluid in 55-gallon drum in Building CClass IIIB combustible liquid'Nitrogerr. Stored in gas cylinders (max 1596 cubic feet) in yard'Non-flammable gas'8.g.Acetylene,storedingasrylinders(max222cubicfeet)inBuildingC'Flammable g*,' U;ifbr welding Stored on approved cart'I0. Oxygen. Stored in gas cylindo-{tt:2400 cubic feet) in Building C'Non-flammableoxidizinggas'Usedforwelding.storedonapprovedcart.Items noted during inspection whioh are not on hazardous materials list are the following:l.one55.gallondrumofhydraulicoil,ClasslllBcombustiblcliquid,usedforthehydraulii lift in Building C'2. Approximately S-gallon'9{Sl:d-d::d solvent in a cleaning tank in Building C(Class n "on,turtiili riqriJ, Fp los;:;;;. r''t i""ri"over is equipped withThe10'000buriedcombinationgasolineanddieseltankismonitoredbyaVeedor-Rootpanel located in Building c An emergencry *iut--ont*itcl-r fo1 the purnps is located at'the back door of Buit;i""; Ti#i"t"*.ri, u'" pio'ia:d f:: detection of undergrouncleaks. rhis rank was r'Ji"i.u ""i;;;; Fi; aoj* t" administered bv the californiaDivision of Forestry "J'il";-t"i, ouirpn c""itv rii" DEpartment, and is assumed to"r-pfv *rft Artid; 52 of the Uniform Fire Code'a fusible linkSPECIAL HAZARDSWATER SUPPLYrequired)Thereispresentlynopublicwatelsupplyavaitabletothispropgry'Theprivatewatertsfrom a small well or"ro.*rm;"a ""p"Jiry H;;;,;6;pLo ttot the well is storedin a 60,000 gallon uuoffiund tank. rhis taJ-suppliei an on-site private hydrarrt (6 byqbv 2.5by 2.5) bv s'"'"ii;;"; '?"i'"t zr';;t;;'#;;*' rn" hvdrant is supplied bv"*i,riot6'r*iitrt,;ltJpipe believed to be 6'inch steel'Astrongpublicwatersupplyexists.insuburbanRoad,Thisisa.I2-inchgravity.suppliedpipe whi<;h cunentlv d;;il;d; "t tr'tptunt pllp"iv' tr'" irl':'t:' o*td bv the citv of-san Luis obispo water Departmelt. Ir islilery thar this supply will furnish future fireprotection water to *,e p-lalisite ror on-siti;: ffiilt;i 6re spnnkler systems (ifF(ILTONFIREPAGI,:50F ls FRON : FULTON FIRE ENGINEERING /IFAX NO. i gA5-499-1424D4 2AAr 11:144N P7REQUTRED FIRE FLOWRequired water flow under the curent Fire Code would be based on Appendix III-A ofthe IggTlgg Uniform Fire Code. The required flow for the largest on-site building, o9000 square foot, non-sprinklered Type V-N building, is 2,500 gpm' The available flowfrom thl existing private systern, based on 4?0 feet of 6-inch steel main and the lank half-full would be about 500 gpm. This is considered to be deficient'SPRINKLER SYSTEMNone of the buildings are spnnklered'HIGE PILED STORAGEThere is no storage of ordinary combustiblcs in excess of 12 feeq or high hazadmaterials (plastics, etc) higher than 6 fcct.FIRE ALARM SYSTEMSBuilding A is equipped with a Pyrorronics System 3 Fire Alarm Control panel whichmonitors two zones of sntoke arid tta"t detectors and manual pull stations' The manualfuil station are located at exits. Indicating devices include one Klaxon horn Theinstaller, Central Coast Systems of Salinai, indicates the system is monitored (but notsupervised) by tlre Pacific Bell filed office in Sacramento' This is not a quali$ing alarrnsystem, otherthan for local alarm and occupant notification.Other buildings arc not equipped with fire alarm systems'FIRE CODE ANALYSISThe following witl consider sections of pertinent 1998 California Uniform Fire CodeCalifornia Code of netrlations Title z+i Articles that might be applicable to this facilitySECTION 102 . RETROACTIVE APPLICATION TO EXISTING CONDITIONSlO2.l Eristirrg Conditions. The provisions ofthis code shall apply t9 conditiors arisingafter the adoption tfrereofi, conditions not legally in-existence at the adoption of this.code'and ro conditious *h;, in the opinion of th-c c6ef;, constihrte a distinct hazald to life orproperry. crtmmeril: The localfire authority musl delermilte that non-complyingLoriaifion, nru a "di.rlincl" hazird. ttt $e or propefly in order l0 enfttrce lhis-provisirn'The term ',dislitrcr" is usrally lakn to ,"ori "uiorieptable", "ttrgenl", atrd beyond themec,fts of rhe fre departmeit to coge. In the opinittrt of Fu.!!gn f.'ire Engineering. lhereare ilo cottditions at'presenr fime int con$irute a "dislinct" hazard requiring miligation,excePt as identilied under "recommendations"'FTJLTON FIREENGINEENNGPAGE 615 FRON : FULTON FIRE ENGINEERINGFAX NO. i AO5-4A9-14?484 zgAL 11 : 14Rt4 PB105.3 Application for Pcrmit. Applications for permhs.shall be made to the bureau offire prevenrion in such for* una dliail as prescribed by the burg-au' Applications forpermits shall be "ororiuni.J Uy slct plans as required by the (fire prevention) bureau'comment: permrrswill probably he requ-irecl iitnu cialor such irens as compre'tsedgases, flammable antt cimbusri|le tiquids notirAout iiterials, hot work (welding)'liry,efied petroleum goiui {p*lane-\, mgtor vehicle lueling stauons, and vehicle repairgarage. These are the eonrlitions i;sted fn thi f ire Code as requiring permitting' Some'tf,quoiu,ity limitatiois, under which no perwil is required901.4.1 General- Marking of fire apPalatus, access roads' addresses and fire-protcctioneouiDment shall be in uu.o"tJ.*" *itt, S."tion 901'4 and the Fire Department'7i,i^.i',"";;;,;iil;i;;;;i;d;;*irt,ii,'i,"Firet-anemarkingatthistocatiot,901.4.2 Fire apparatus access roads, when required by-the-chief' approved signs orother appro""a notices sialt be provideO "J tJin"in'i fot fire apparatus access roadsto identiff such roads and prohibit tt* oUrt*.iio" ther"of or both C'omment: TheSLOFD inspectorswill reviau this item'g0l.4.3Fireprotcctionequipm:lt.","dfirebydrants'Fire-protectionequipmentandfire hydrants snail ucciffil.rlntigea in un oppiou:d Tag.] to nrevent ob'struction byparking and orher obstructlons. when ,uqui.Jiuy the chief, hydrant tocations sholl beidentilied by rhe installation of reflective markers' c'omment: sLoFD will rcquire.designated. "nct pa*ing" areas ryar fire nya*nt'' Aonufiedly a red berm or stripe' 6'incheswitte by l5-feeiin each direetir"i;;;;;'niiit- rnry *'ight also rerytire a hhteroadrefiector-g01.4.4 premises idcrrtification. Approved numbers or addresses shall be provided forall new and existing buitdings in such u poritioi as to be plainly visible and legiblc fromthe streEt or road fronting the property .. co.i"nt flris is required bv sLoF-D'Characrers slwll be o'tf,o" Slin"hes highwith a %-inch sttoke'g[z.z.lRequired access. Fire apparatus access roads shall be provided in accordancewith sections sor ani!;;'t f;':;"tY f't9iilv,;'li|*q or portion of a buildins hereafterconstructed o, *ou"i r"t" "i*r,rt it.3u.i*di"tion when any poftion of the faciliry orenv oortion of an exteri'or wall of the ntit tto-ty oithe buildingls located more t'han I50feit'G5720 mm) from fue apparatus u"ttt' u" measured by an approved route aroundffi#;"itri. f"iiarig oi facitity see also Secion 902 3 for personnel access tobuirdings co*^rn i'\ii, irTi:"i"'pi^iiitii*"un( lt luildnss' rhe puvins wasobviously designed to i"i*: ,:y itniry,Iru,"ti ot used hv Pacific Eell' and they could"i;;;ir; rrciablv xppoit 60'0o0 poundfire apparutus'902,2.2.|Dimensions.Fireapparatusaccessroadsshallhaveanunobstructedwidthofnor less rhan 20 feer (6096 mrn) and -.t;;;;.a u"tti.tt clearance of not less than 13feet6inches(4115 i^7. Co^irent: All"iiirrroads appeartobeatledst20leetin;;;i. No ve)ti,at obstnrctionswere notedFULTONPAGE 7oF 1s FROM : FULTDN FIRE ENGINEERINGadequate-hydrant.FAX NO. i AA5-459-14?4a4 28AL 11:154M P9g02.2,2.Tsurface.FireapparatusaccessroadsshallbedesiS,nedandmaintainedtosupport the imposed load.s of fire appararus u"J rrruu be providea with a surface so as toprovide a1-weather dfi;;ro.otliril-a'r;;; r To ie reviewe4firther by architect'g0z.z.z.tTurning radius. The turning radius of a fire apparllus access road shall be asapproved, co^ unt,"ili i;"iis riaii "iiit iiitt or:o*a buitdings appear n beg02.2.2.4Derdends.Dead.endfireapparatussccessroad-sin.excessofl50feet(45,120mm) in length shall be provided *tt, .pprorrJJ pro**io"* for the turning around of fire;;;t. "Co^.nnt' There areno dead'ends'goz.z.4,rGenerrl. The requirerl width of a fire apparatus-ac€ess road shall not beobstructed in any ***"', i't"ltJins n"1g1q;f "4"J";' M*TuT required widths andolearances estaUtisneJunder Sectio]n'902'2'2'l shall be maintained at all times'Entrances to roads, trails or other access*"yt *ii"tt fttyc been olosed with gates andbarriers in accordanc. *iri.'sr",i on go2.2.45shail not be obstructed by parked vehiclascomment: This troes not appedr to he apribiii ot p*t ing spaces are tlesignled'902'4KeyBores.Whcnaccesstoorwirhinastructureorsnafeaisundulydifficultbecause of secured ";;;;;;;;;where immeaiate eccess is necessary for life-saving orfirefighting purposes,'th. Jhi"ti, uungr*.9io ."quite a key box.to be installed in anaccessibte location il; k;;;"; shall be of"i rppro".d tvp: and shall contain kevs togain necessary u""urrTrllil;;T;il." Jn"t.-clo^^enti 'Th;s ttem will be reviawed bvthe SLOF'D.g03.2RequiredWaterSupplxforFireProtection.Anapprovedwatersupplycapableof supplying ,t " ,"q"i'"4"i['n'o* fo' fir" n*rc"1i9.n srtan bi provided to all premisesuoon which facilities, buildings or portronJoiUu'aingt are- heieafter constructed ormoved into or within the jurisdiction' Wft*n "ny portion of the facility or buildingprotected i, in "*".s* oiiio r." $5 1?9mm)-from a wate-r suPolv on a public strect' asmeasured uy "n ,ppro;;i;il;una tr"-u*itti"''ortrtu facilry or building' on-site firehvdrants and mains capable of supplying tit '"quitta 9t.l:* shall be provided whenriquired by rhe .ni"i. 3.. Seaion qm 4 ''iiiii""" Buildings are more than 150 feetfrom awater s,upply in a pubtic streel, *ln'*n*n the publicTuter mains are exteruled bythis site. The existtttg Privare n*9' o'.7yiy ana fire t11!r71: catt not provide the AppendixI I I _A fire itour ol t hte'iire code. It i s titniiyTi"'i;p lr Yitt .:::.ro t nw' ttn-sirc fireI,drants n nu pro.ieal iriiittit "^ the ext"ndedvarcr main' of the citv of san Ltri'sObisPo Water DeParhnent'g03.4.l.2Testingandmaintenance-Firehydrantsystemsshallbesubjecttosuchoeriodic tests as required by the .q-{. Tij itvit"", ,yrt.** shall be maintained in anoperative ,onaitio,ilt ,1 ,r'-r.t r"a ,r,"u #;.ffi',*ttt'" defective' Additions' repairs'alterations and senicing shall b" in ""co'l-""t|*ltft approvcd standards' Comment: Itcoukl not immediulely he dercrmined if there is a tesling program in elfectfor the exislirtgT,IILTONFIREPAGE 8Of rs FRON : TULTON FIRE ENGINEERINGFAX NO. i BA5-4A9-14?4Jan,g4 zgar 11:164N P1E100r.3 Plans. complete plans and sPecifications for fire alarm systems: fire'extinguishing systems, inctuding automatic.sprinklers .q y.*t and dry standpipes; halonsysteits andlfrer specialtype;f automatic fire-extinguishing systems; basement pipeintets; ,na other fire-prot".tion sysiems and appurtenances thereto shall be submitted to,ft. ni" department for review and approual prior to systet-n installation Plans andspecifications for fire alarm systems s-hall inciude, but not be limited to, a floor plan;location of all alarm-initiatin! and alarm-signaling devices; alarm control- and trouble-signaling equipment; .*unoi-"tion; power connection; batrery calculations; conductor,y!" ur,i sires; voltagc drop calc,riations; and manufacturer, model numbers and lislinginformation for all equipment, devices and materials, and_11e fire marshal listingnu-be, of all eguipm.nt, 4""i"". and materials requiring lisr:rng comment: This is anadvisory reqttireme.nf that all plansfor fite prolrifion ielarcd nems be sftmitlud to theSLOFDfoT revins and aPProvul-1001.5.1.1 A fire alarm system and its devices shalt be under the supervision of aquatified person as defined in NFPA ?2, Section 7'1,2.2, who shall cause proper tests tobc made and shall have general charye of the system, Fire alarm sysrem controlequipment and the derriis "o**.t.d to the control equipment shall be tested inaccordance with the appropriate standards in chapter 35 of the Building code and themanufacturers instruaio ni. Co^r"nt: The existingfire altm system in Ruilding A ist"*"a leriodicatly by the instoller. The frequenq, of testing could not be delermined'This ii a non-rod" qualtfyingfre dldrm systcmwhich i.; not Properly monitored orsapervised.f 001.5.I.2 A satisfactory egreement for periodic testing and. maintenanoe of fire alarm,yst"r. and extinguishing Jystems shall be.provided by qualified.persons. Llommenl:This item needs to be clari/iedwith o, urAtrritondf,g bit*een rie local plunl aild theFire Department.l1lL1-.lGeneral. Means of egress conforming to the rcquirements of the Building Cod,eunder which they were constiroted may be clnsidered as complying means.of egress if,in the opinion of thc chie{, they do not constitute a distinct hazard to life' The requiredfire-resistive rating of walls, ceilings and openings that are part of a means of egress shallbe maintained. Buildings ;;;,*.;t"s thai were not constructed under the requirementsof a building code shalimeet the minimum requirements of Article 12' Commenl: Theexistittg exiling appears to be adequate' There are atnv areaswhere sig4s are notilluminated.sEcTloN1203.MEANSoFEGREssoBSTRUcTloNsobstructions,includingstorage, shall rrot Ur pl".uOi" the required width of a means of egress, except projectionsas altowed by the Building code Means of egess shall not be obstructed in any mannerand shall remain rru" of "iV material or matte-r where its presence would obstnrct orrentler the means of "gr"rJf,."ardous. Commenf : Ihere were no condiilons noled whareegress obstructions exist- Thi'e is an advisorJ) cade section'F(II.TON FIREPACE 9 OF ]5 FRON :. FULTDN FIRE ENGINEERINGFAX NO. i AA5-4A9-1424!. 84 2881 11 : 15Al',l P11l204.lGeneral.Aislesshallbeprovided..fromaltoccupiedportionsoftheexita.ccesswhich contain su"ts, ta]Ufeslt rni"t'ing*, Oi*Pioys and *itnitur fixtures or equipment'Aisles located within;';;;ilb to"ur" of tJu*l strall utso complv with the Buildingcode requirements f;;;;;;;ib it ry. co^*uit, Thrru were no cuditions notecl whcreiiti "iriorions exist' 'fhis is an advisory code section'1207.1 Gencral. Exit doors shall be maintained in accordance with section 1207 ' Exitdoors shall b" muintai,i.-Jin ,n operrbb *ilil;'-n""* ittttrled as part of required fireassemblies shall be ,.1"i*"a in'u"cordan""-*iirr s..tion rrrr. comment: 'fhere wereno conditionr rr,rd;ir;;;'iii)"ri rtiit,otts exist. This is an adstisorv code sedion'l2ol.zswingandopeningForce.WhenrequircdbytheBuitdingCode,exitdoorsshallbe of the pivoted * ;ii;;"g;dswinging t;il;; ooott tt'or *ng in the direction ofthe path of exit *""ui'*i.i J"-ing ony [.i."aous er€a or when the area served has an'occupant loatl of 50;;;;"*il"?ooi"rtar swing to full-open position when an openrngforce not to exceed ";il;t ii13;5 n) is appl[d to the latch side' Commenr:Existing door-s uPPear to comPIY'rza7|t-ockingDevices.Exitdoorsshallbeopenablefi.:*l|.insidewithouttheuseofa key or any speciat il;l;dg" or efforr. g*it;;tr slrall not be locked. chained, bolted'barred,latched o, o't"t*i" iendered'nu*Ut"' Alllocking devices shall be of an;;;;;,yp "' coi"nr: Existing doors appear to comply'EXCEPTI.NS: I ln crrOups B; F; Mand S occupancies' key-locking hardware may beused on the main i'*hrn,i" m"in oit tonrirt, oi^ {nere -019r or pair of doors ifthereis a readily visible, ii,j;;d,r, gl adjacent to, the door.stating THIS DOOR MU5TREMAIN IINLoCKE;;UfrD'{CtBUSiNESS ttOunS This sien shall be in letters nottess than I inch (25,4 mm) high on a conrr;;t;;"kg'""nd d'e" unlocked' the singledoor or both leaves of a pair of doors *u.l U" [e* toi*ing without operation of anylatching device . '1f,"irrl'.f ;il i*..p,ion tuy be revoked by the chief or buildingoffrcial for due cause'lzlz,lGenerat.ForthepurposesoftheBuildingCode,.thg]:'',''exitsign',shallmeanthose required signs *iri"ill"ii"ute the path oi "it travel within the means of cgress,y*r.t. 'C<tmmeit: Advisory codc section'|zlzJ-WhercRequired.Thepathof.exittraveltoandwithinexitsinabuildingshallbeidentified by exit ,iS", .oJo#ng to the '"qui'"ments of the Building Code' Extt stgnsshaltbe readity "i*iblr;;;; u,falr..tio' oifrpto".h Exit signs.shall be located asneccssary to clearty il1;i;;"'""r'ri."#'."Jil;f6;;;ir1"el. No point shalt be more thanI00 feet (30 480 n*fi;;" n.or"u.ri*iui"ign. commeni: Advisory code wction'EXCEPTIONs: 1. Main exterior exit doors which obviously and clearly are identifiableas exit doors need ""iilu"" ",,ir signs *fr"n oppioved by lhe building oflicial'2. Rooms or areas *ttiti require ottly ont exit or exit accessF'IIL1'ONPAGE ]OoF t5 FRON :.FULTON FIRE ENGINEERINGFAX NO. i BA5-4A9-1424J.an,g4 2@Al 11 : 17R1.1 Ptzlzl2.|Grapliics. The color and designof lettering' ry9*: and other symbols on exitsigns shall be in high.*r"r, *i rt tn.lr u"oxgroun? g*i, signs shall have the worduExITu on the $gn rn block capital letters t"i f.tt irt* ui{!t: (I52 rnm) in height witha stroke of nol r"r, trr.ln'i7q infi tiq "-) il;;;'J 'ir'Xlr shall have letters having awidth of not less thanli*f,.t tSi *tl except for the letter "1" and a minimum spacmgberween letters otnotL.rlir*'3/8 incir (9 ilo,j' Signs with lettering larger than the 'minimum dimensions .t*Uiitit"J n"rein strait have the-letter width' stroke and spacing rnilffi;;;ii"ir l''ight' Comment: Advisory code sectiort'llL!.4llluminntiorr. Exit signs shall be internally or externally -illuminated when theface of an e*it sign is illuminited fiom "n *ti **t, it str*thave an intensity of notless than 5 footcandles (54 k) from either ;;;; "ilric'lamps' Internally illuminatedsigns shall providc "quiua.n, ruminance unJ br listed for the purpose. Cammenl:AdvisorY code section'ExcEPTroNlApprovedselflumirrarussignsthatprovidelY'ntvilluminatedlettersthathJ;minimum luminrnce of 0,06 foot lambert (0.21 cd/m2).lzl:,.SPowerSource.AllexitsignsshallbeilluminatedatalltimesToensureconrinued ilt,rmination-fioi-la,rrattn of not less than I l/2 hours in case of primary Powerloss, rhe exit signs shall additionally be connected ,o u1_"T,::g:::y electrical systemprovided tom storage Uuire1;ur, unit eguip*ent or an on-site generator set and the systemshau be instaled i" fiil;;;;*iti trtJ Eiectrical code. comment: Advisory codeseclion.EXCEPTION: Approved selfJuminous signs that provide continuous illuminationindcpendent ofan external power gource'2gol.lscope.Repairgaragesusedforseryiceorrepairofmotorvehiclesshallbeinaccordance with Article 29. Repair g*ug.t fo,- ulftiJftt which use more than one type offuel shall comply with the applicable sections ormicle 29 for each type of fuel used'Comment : .A Permil is reEtired'5g[LzPermits. For permits to use a structure * 1gT"-of-!l:iness for the purpose ofservicing or repairing'motor.\oehi"les, see Section t05.8, Permit r'3' The permit shallli."il,ittt ti q'pJt "rvehicles allowed to be repaired'2901.3 Flemmable and Combustible Liquids'2901.3.1 Genernl. storage, use arld.handling of flammable or combustible liquids shallbe in accordunr. *iir,-.liitcleTgand section"s 2901.3 and2902'2-ggll,,.zTankspillcontrol.SpillcontrolfortanksshallbeprovidedinaccordancewithSeotion 7901.8FLII.l,ON I;IREP,/IGE I loF 15 FROM :.FULTON FIRE ENGINEERINGIocalion.FRX NO. 1 g,A5-4A9-I424fn.84 zAgL 11:174M P13290|.4DispensingtnsideofBrrildings.Dispensingofmotol-vehiclefuelsshallbeinaccordancc *itn n ti"rc;,'C;^;rri, No"i"i'ii'ktp'nt'dinside of huildvtgs at this2901.s Ventitation. ventilation shall compry with rhe Building code, Mechanical code'and Arlicle 29. Conniitt: Buitding +fy1l'i'ir rii'it"ud7ia normal openings' Anymechan i cal venttlat i oi ia s not r ev-iu' e d dur i ng t h i s i n spe c t ion'Zgfil.il,iquids Drained from Vehicles'2gol.6.|Motor-vehiclefuel.Motor-vehiclefuelshatlnotbedrainedinGroupS,Division 3 occupancii, 'iiiii,, a"itai"gz;;;;;! q!ow,o' an s'3 hecruse alnolentiul welding operations' The occupan[y rc Ya: fiil can be drained tf proper;;;r*r';;;""ir",if"" per Articte 7e of the h'ire Code'zg0;,6.2Lubricatirrgoil.Lubric"iing.o.'lwhichhasbeendrainedfror-nmotorvehiclesshall be stored anA r,"?Jf"a as requirel f* &; Ul-n tiquids in accordance with Article7g. comment: oraineilaiii*i;ng oit, on ira in an outside a2\-gallon tank'2901.6.3 Tank-drrinage lines. Tank-drainage lines.terminating inside a building shall becouipped with a nonfemoveabte-rype "rp, ,u}, as a hinged oap. comment: No snchiuirr"g, lines are believed to exist'2901.7 Sources of lgnition'2g0l.l,lsmoking.smokingandopenflamesshallbeprohibitedinareasusedforservicing motor ".hi.i;;.- c;;tmeni: This needs to be enJorced'2gaL1.2Wclding. welding operations shall be conducted only in crroup H' Division 46;;;"t;ianJ"tnarr be ii sccordance with Article 4e'2go|.T,Soilywestemrterials.oilyragsandsimilarwastematerialsshallbestorcdinmetal, metal-lined ";;;; rpf*".0 coitainers equipped with tight fitting covsrs'Comment:. I'his is enforced'5201.1 Automotive, madne and aircraft motor vehicle frrel-dispensing stations shall be inaccordance witfr niicle 52 and UFC Standata SZ-f ' Suoh opeiations shall include bothpubtic accessibte #;l;;;;p"ot:*, ri^*.rur" and combustible liquids and LP-gasshall also Ue in accoiian"" *irir Artioles 79 and 82. Comnent: Adttisary stalemen,The fuet dispensing system aPpears .t.' '"'ii*t7l' ilti"t" 52' with respect to hoses' sltut-olf switches, tir"iii'p'n'"'i location of dispeyserc' *':::':island' sigrrs'extinguishers, ,o'i'{ "i Th' u'du'g.'ouni plons were not reviswed during thisinspeclion.FIREPAGE T2OF 15I FRON T.FULTON FIRE ENGINEERINGFAX N0. I AZ5-489-I424ran,@4 Zget 11 : lBAt"t PI47401.1 scope. storage, use and handlingof compressed gases in.cornpressed gas .conrainers, cylinders, ;;;#tt-t-*"shall be in accotJ*ce with Article 74' includingthose gases regulated Jsewhere in this code. Partially full compressed gas containers'cylinders or taflks .onirininJ rusiduat gases shait Ue considered as full for the purposes ofthe controls required. Com"rnent: Cylinders not in use are stored in designated yard areasand are ohained. All storage and usage appears to comply with Article 74'7901.|.lGenera|'storage,use,dispensing,mixingandhandlingofflammablcandcombustible liquids shail [ein accordanee with futlcle 79. Comment: No violations ofArticle 79 were"o,"il**pi ihara contaittment system is needed for the 13g-gallonlube oil storage vessel in Building c. Except for gssolinein vehicle tanks' all of theliquids in use in Buildinl - .t",'iith or,. excupti"f, Ctass IIIB combustible liquids TheFire Code permits up io"ri,ioo gallons of Class ttls to be stored in one "Controt Area"'The quantiti"s of Ctass lruiliqui'a here are less than 1000 gallons' There is one washtank which contains up,o fiu.'g"llons of a class II liquid (stoddard Solvent)'8001.1.1 Gcneral. Preventiott, control urd mitigation of dangerous conditions related to$orage, dispensing, ,r." una handling of hatardJus materials and inforrnation needed byemergency response p"r**"irrrdl-be-in accordancc wth-Alicl: 80. comment: Thereis a hazardous *rrcioi h"rrdlr"g ,"tl spill response plogram in effect, which includB"speriodic training. 'Ihi plant wili-need a *po::n*:i!?":ylerials inventorv and'submit a Hazarious Materials Matngemenl Plan lo lhe SI'QI'D'sEcTloN 8201 -scoPE storage, handling and transpott-"11?l of LP-gas and the. -instaltation of equipment pertinent io ,yrtr-. for zuch uses shall be in accordance withArticle 82. For d"t";;il; prop"niestf LP-geses, see UFC Standard 82-l' Appendix B'Commenr: Lp-gas;t *gZtrnitittt of 250 g;ln"i of propane in a single tank. Thisproduct is used tofuel fidustrfal tucks to iuoaU yiia sbrage. 7'he tank location and'dispensing operations complywith Article 82APPENDIX TT.EFire hydrants shall be provided in accordance with Appendix III'B for the protection ofbuildings, o, po*ionrf--f Uuildingr, hereafter constructed. Comnent: SeeRecommeruIaliotts.Fire hydrants shall be provided along required fire apparatus access roads and adjacentpublic street s. Commettt: See Recommendations'The minimum number of fue hydrants available to a building shall not be less than thatlisted irr Table A-III--B-IJtrr i"ruer of tire hydrants available to a complex orsubdivision shall not be less than that determiilC Uv spacing requirements listed in TableA-III-B-l when applied to fire apparatus o*uss roaas anO f,erimetet public streets fromwhich fire operations "oura be cond,rcte d. comment: see Recommendatiatts'h-ULTONPIREPAGE 13oF 15 FRDN : -FULTON FIRE ENGINEERINGFRX NO. I AA5-489-r424a4 ZgaI 11 : 1941,'l P15J,a..r.Existing fire hydrants on public streets are altowed to be considered as available Existingfire hydrants on oala""lni 'pr"p"ni-, shall not be considercd available unless {'ire apparatusaccess loads extend Uu't*l"n ptoperties -and casements are established to preventil;;,i"" of such roads Cimment: See Recommendqtions'TheaveragespacingbetweenfirehydrantsshallnotexceedthatlistedinTableA.tll-B-lComment: See Recommendalions'Exc'prroN: The chief may accept_adeficienoy of up.to.l0 Percent where existingfire hydrants provide ;f;; ft*ionofthe requirid fire hydrant service'Regardless of the r""*Jrpiting, fire tr1lrants shall be located such that all points onstreets and acsess ."ffi0i'""."r-* r uuhaing are within the distances listed in Table A-Hazardous materials inventory statements gnnsl and hazardous materials managementprans ftrMMp) *t i"h ;;;fiil; ut th::'t\i;f #suant !o Article 80 shall be providedfor hazardous mutenals in accordance with Appendix-Il-E' Comment: I)ue lo timecoilstraints this inspeition clicl rwt inchtde o fioiougt'haza'rdo.us,materials analysis' Theexisting inventory ,*tiioot is not complete, amt dieyyot include certain malerials' Aio* U'uts ana infu{P sfuiulcl submiltedto the SLOI'D'tI-B-IAPPENDIX II-ECONCLUSIONSI2This telephone maintenance facility shows evidence of strong management interest in fireloss prevention and nr" ,rr*tv. Most of the plant is not in compliance with current dayfire cod"t with respect to sprinklers and fire alarm systems'RECOMMENI'ATIONSAnewfireprotectionwatersupplyshouldbeprovided'ltstr9r1!besuppliedfrom the city of san --"i, ouir'pl w?r1 Department. Lt should include Bt leasttwo on-site fire hydranis *ith on* 4-inch and two 2'5-inch outlets lt should ber"ppft"Uby un "ifnt-inctl "o-e"tion, with 8-inch water mains to the two new;;il;;; tr," .isti"g-Jrv-banel hvdrant should be discarded'Fire sprinkler systems are required ro be re-trofitted in sxisting buildings when"iii* "i,rl- t*o fouowing conditions are found'^.Wheneveraherationsoradditionsresultinanincreaseinfloorareaof1000 square;;;;;;-e.a;, inctuding mezzanines and additional storiesb.WheneverthecostofalterationsoradditionStoanexistingbuildingofmore than ld;;;;;'it" *"*a- so.p"tlTt of the replacement cost ofthe building as detlrmined by the Building Offcial'FILLTONFIREINGPAGE ]4ob t5 FROM :,FULTON FIRE ENGINEERING.a3not clear.4.FAX NO. i P,B/5-4BE-7424oooOOOoooa4 28,@7 11:194M P16-nH Occupancies (Building C) are t:qY""d-lo be equipped with a fire alarm systemoer Section rooT -z-6ii?rt"'ni" Code' The id;d; of the San Luis obispo Firebepartment Regulation Guide as to retroactittJopfr'titution of this requirement isA double wall containment vsssel should be provided for the 120 and 130 gallonsof motor oil stored it "o*6"ti" in the yard and in Building C'FULTONFINEPAGE ]5ol; ts 'ffi SlIy",, gf . :*lJ""lYf:, gp,!,'.s,,n . ?, 781 718.Staff CommentsFireFireDate Routed 12120100Application Number 01223Application Date 12120100Project Address 196 SUBURBANAssessor'sParcelNumber0T6-352-033 ZoningProject Description CITY UTILITY CONNECTIONS & ALTERPARKINGPrinVType NameVLI,(rnDepartment Phone NumberProperty Owner PACIFIC TELEPHONE&TELEGRAPHMailing Address UNKCity/State/Zip UNKNOWN CA,99999-Contractor's NamePhone NumberFax NumberProject Manager RON MURPHY OR KARENPhoneNumber 543-1794x262ROUTED TO PLANNING, SITE, FIRE, PUBLIC WORKS'& WATER. ROUTED CONCURRENT WITHSUBMITTAL TO PUBLIC WORKS FOR REVIEW OFIMPROVEMENT PLANS. OFFSITE AND ONSITEIMPROVEMENTS INCLUDED IN ON PLAN SETSUBMTTAL. REC'D 3 SETS OF PLANS. APPLICANTNOTIFIED TO SUBMIT TWO ADDITIONAL PLAN SETS.HH)ur department will conduct a final inspection on this project YesDateNoStatus FIRF DEPAFNT PI AN EHEEKSUBJECT:OWNER:ADDRESS:JOB NUMBER:DATE:PLAN CHECKER:City Utility Connections & Alter Parking LotPacific Telephone and Telegraph196 SuburbanOO-1 17 PLAN CHECK #112t26tOORonald G. Hanson, Fire lnspector/Plan Checker (805) 781-7379To expedite the re-check process, note on this list (or a copy) where each correction itemhas been addressed, (i.e. ; indicate the sheet number, note number, or copy of page inspecifications that is referenced). Be sure to enclose the marked-up list when you submitthe revised plans.3) Emergency Access -a. Please submit an 8-1 12" x 1 1 " reduced copy of the site plan for updating our firedepartment response books,b. Mount a Knox-box at 6' height at the primary Administration Building entrance.Lockable exterior and interior doors shall be grandmaster keyed for emergencyaccess. Provide keys for placement in the Knox box.2) Existing Fire Alarm System -a. Provide conduit for valve tampers at the double check assembly per City Standard#6420 for monitoring by the existing fire alarm control panel.3)trira Flnrar -a. Recommend installation of an 8" x 8" x 6 or 4" Tee for future use at the end of thefire main.b. The on-site fire hydrant will require a minimum of an 8" underground fire main perCity Standard # 6310. A separate shut off valve is required adjacent to the firehydrant per City Standards.c. Omit private fire hydrant proposed for front parking lot.d. lnstall a new public fire hydrant at the southeasterly property corner per CFC,Appendix lll-A & B.e. A minimum of 3OOO gpm is required for the proposed size of the AdministrationBuilding. Only 2500 gpm is currently required. Two hydrants are required to beinstalled with this permit. An additional fire hydrant is located approximately 50'from the southwesterly parking lot entrance in front of Spice Hunter and may be usedto meet the required three hydrants per CFC, Appendix lll-8.f , Provide hydraulic calculations showing that 2500 & 3000 gpm can be obtained fromexisting and proposed on-site/public hydrants.s. The existing water tank shall be abandoned for fire protection use. cttyofsan lurs oBtspoDent of CommuniDevelomentPlanning DivisionNovember 3,2000TO:GTS (Dave Wilcox)FinonceUtilitiesPubl ic Works (Eng ineering)Public Works (Streets)Police Dispotch SupervisorPolice ChiefFire (Carrie)FROM: Dione StuortSUBJECT: Annexotion (196 Suburbon Rood)This proonnexedObispo.aJbeenty ofect hosgfficiollyProject Plonner:Prolect File No:Project Title:Annexotion No:to the CiSon LuisWhitney McllvoineAnnx. 213-99Pocific Bell#6r Fire Prevention BureauMemorandumFI[-HTo: Whitney MclvaineFrom: Darren Drake, Fire MarshalDate: AprilT,2000Re: 196 Suburban Road - Pacific BellI have completed the review of the fire protection analysis prepared by RRM Design Group for theabove facility. Overall it appears that they have a well-run facility and is reasonable fire safe. Pleaseincorporate the following language into the annexation agreement.Within 180 days of annexation the applicant shall extend connect to the City Water System and installfire hydrants for the purpose of providing the required fire flow.Within 180 days the existing fire alarm system in Building A shall be supervised by a UL listed CentralStation Service.Within 30 days of annexation the applicant shall obtain all required Fire Code permits and submit acurrent Hazardous Materials Business Plan.1 0S-05-00 09:59am From-TAIT EliVlR0tilENTAL7r 45808237T-563 P 0r/01 F-985TAIT Environmental SYstems(;enerelContriiclols' CA Llc *56d090September 5, 2000Mr. Aaron LaBarreCity of San Luis ObispoDivision of Environmental Health2156 Sierra WaySan Luis Obispo, CA 93401Re: Paciflc Bell196 Suburbsn$an Luis ObitPo, GADear Mr. LaBarre:On August 2E, 2000, Tait Environmental Systems repaired the visual leak at thediesel pump union and tested the product line afrer repairs wsre performed. Novisible-leaks were found after repairs. The dispenser pan wae cleaned out.Feelfree to callif you have any questions-Very Truly Yours,TAIT ENVIRONMENTAL SYSTEMSTeirAZaeMALAN THROCKMORTONCompliance ManagerAT:clb:\tes\pacbellUetters\san luis obispo,al701 NorthParkcenterDriue' SantaAna,Calitotnia92TOS ' Q't4',560-8222'(714)5tt0-9237 laxRegional Olfices. San Drcgo ' Concord ' Sacramento ' Phoenir ' Tucsonurww.TAlT.com @Envlronmental Hanagement P.O. Bor 5@liPaclficRegior Room3E000San Ramoq CA 04583UST & AST TONITOR GERTTFIGATION FORTTestingDate: 0&1S00Next Due Date: 0&1541Site Location:PACIFIC BELL196 SUBURBAN ROADSAN LUIS OBISPOCounty:SAN LUIS OBISPOMake & Model of Monitor System(s):Serial# of Monitor System(s):Tank lD #Type of Tank: (Single Wall or Double Wall) UST or ASTTank Material (Composite, Fiberglass, etc.)Contents of Tank:Capacity of Tank:Type of Product Line: (Gravity, Suction, Pressure)Type of Piping: (Single Wall or Double Wall)ALLSYSTEMSAnnular Space Sensor:Fillsump Senmr:Piping Sump Sensor:Piping Trench Sensor:Dispenser Containment Sensor:OherTypes (Sensors):Type of Overfill Protection (mechanical, elecfonic, bail noat)Type of Spill Containment (Make & Model)FOR PRESSURE TYPE SYSTEMS ONLYDate:0&1$mls Mechanical Line Leak Detector Present & Tested?:Does the Turbine Shut-Down if System Detects a Leak?:Does Positive Shut Down Occur if Monitor System is tumed oflr:ALL SYSTEMSln-Tank Gauge Present. Probe Type and Type of Leak Detection (Ex. .2 gph).Does the Monitoring System have Audible & Visual Alarms?ls fre Monitoring System installed to prevent unauhorized tampering?:ls the Monitoring Devices operable as per manufacture's specifications?Tank lD(s): 2030,2031CLLCCode: SNLOCA1RGeo Parcel:sE-164Site Contact i, BILL KEENAN!Site Contact Phone #:510-6455605VEEDER ROOTTLS.3SO41232526905001Compartmented Tank(s)MECHAIIIICALPHILTITE 5& 15 GALLONYES MAG .2YESYESYESTesling Company:Technician:TAIT ENVIRONMENTAL SYSTEMSBMNDON HAMDMD'WSUCTIONSUCTION40116016DSLUNLCOMPCOMPDW-USTDW-UST20312030Tank 4Tank 3Tank 2Tank 1FLOATYES PASSYES PASSYES PASSFLOATYES PASSFLOATTank 2Tank 1Sensor Type(Float, Discrim, etc.Tank 4Tank 3-TII-IIITank 4Tank 3Tank 2Tank 1IIIIIIIIIIICertified Testefs lD #: 39-3435Prht Name)'llardm (Division of Environmental HealthP.O. Box 14892156 Sierra Way.San Luis Obispo' CA 93406Denartment of Asriculture/MeasurementStandards (8os) 78r-s9lo2156 Sierra Way Suite A.San Luis Obispo' CA 93401M',ilrucitv of San Luis obispo ffiUtilities Departmento (805) 781-7215955 Morro Streeto San Luis Obispo, CA 93401oatez #t l-tt tOOCERTIX'IED UNIFIED PROGRAM AGENCY (CUPA)HAZARDOUS MATERIALSINSPECTION FORMTime In:CONSENTI Consent to conduct inspection which may involve obtaining photographs, review and copying of records, andwith USTdetermination of compliancet,ffi, Granted Bys materials/waste handling requirements., andPROGRAMS INSPECTED:REINSPECTION REQUIRED: N NO RYES! ttw Generatorfr$w Generatorf] Business Planfifl Business Plan! lcr!.tcrftusrflusrtt,IDTEL. NO.(Site):FACILITY LOCATION:F'ACILITY NAME:ENVISION FTYPE OF INSP: ffi noutine l-l n.-in.p. flComplaint!nnn fsloclrv [acnnnrINSPECTING AGENCY:CODES: (insert codes for above box using new Envision codes)Proey'EleaKa/- Record IDTLCIraplzActiono'7J1---Resqlto/Svcoe/Facilitv Violationt tYO"qInsp MintzaYES NO N/AVIOL. #TROlGENERAL REQUIREMENTSTRAININGFacility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.f6)Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR 66265.16)CONTINGENCY/EMERGENCY PLANContingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR $66265.53154\Facility is operated and maintained to prevenVminimize/mitigate fire, explosion, or release ofhazardousmaterials/waste constituents to the environment. Maintains all required or appropriate equipment including analarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43)BUSINESS PLANBusiness plan is current & available during inspection (HSC 25503.5, Title 19 ccR2729)Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729)Site layouUfacility maps are accurate (HSC 25504' Title 19 CCR2729}MVEROlTERO2NO N/A VIOL. #(^/ilU'Y (nSo ?ken{u.()W{w &*'a+,( ly/t'dnnr lM,c, har!(:\CUPAIN$P.D0C 1UsT itts€c-fd r\ onaofr:th1>@4wnst ./-r\e Pffsy't Ae o?h(r Tra / lr4 UNDERGROUND STORAGE TAIIK (UST)MONITORING CODES1. No monitoring2. Standard Inventory Control3. Modified Inventory Control4. Statistical Inventory Rec.5. Automatic tank gauge (tist type)6. Continuous monitoring in tank annularspace/secondary containment7. Visual monitoring8. Manual monitoring annular space9. Temporarily abandoned under permit10. Another methodPermit No.# PERMITTED TAIIKS# UNPERMITTED TANKSOwner & operator as indicated on permit: ffinS nNOIf no, new owner name & addressnew owner name & addressM/d\VwntrNOnntrnntr!nn!nYES -.vwZ,Wdwnw'Tw-wvrol. #UTOOlUTOO2UTOO3UTOO4UTOO5UTOO6UTOOTUTOO8UTOO9UTO1OUTOllPERMITTINGSite has a permit to operate (HSC 25284)Permit is kept on the premisesChange ofownership is reported to the permitting agency within 30 days (HSC 25284(c))All UST(s) are properly permitted to operate or properly closed (HSC 25298)MONITORINGUST(s) monitored using method ppecified on the permit or approved by the permitting agency (HSC 25293) (Writemonitoring code(s) observed --fuMonitoring records are provided to regulatory agency upon requestAutomatic line leak detection system is installed & kept operational for all pressurized piping (HSC 25292)An annual report is submitted to regulatory agencyTank tightness test and./or piping test is being performed as required (fitle 23 CCR)Written Monitoring Plan submitted for electronically monitored tank system (fitle 23 CCR2632134)Facility maintains evidence ofFinancial Responsibility for corrective action and for compensating thirdparties for bodily injury/property damage caused by a release from the tank system (HSC 25292),{BOVEGROUND PETROLEUM STORAGE TAIIK ACTgalsProducts Stored:ntrlGasoline lCrude oilNo. ofTanks:Total Volume:DieselOthersSPCC Plan is prepared and certified by a registered engineer within last 3 yrs.SPCC Plan is maintained on site or nearest field office.Note: SpCC required for tanks with total storage capacity of > 10,000 gallons; for farms, nurseries, construction sites individual storage capacity of>20,000 gal or total storage capacity of>100,000 gallons.YES NO N/AnnnTtrtrvIoL. #ATOOIAT()O2 --'SUMMARY OR OBSERVATIONSNIOLATIONSNoviolations ofunderground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requirements werediscovered. SLO CUPA greatly 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 byeach violation. Ifyou disagree with any ofthe violations or proposed action, please inform us in writing.All minor violations must be corrected within 30 days or as specified. CUPA must be informed in writing certifying that compliancehas been achieved. A false statement that compliance has been achieved is a violation of the law and punishable by a fine of not lessthan $2,000 or more than $25,000 for each violation. Your facility may be reinspected any time during normal business hours.you may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. Theissuance of this Summary of Violations does not prectude CUPA from taking administrative, civil, or criminal action as a result of theviolations noted or that have not been corrected within the time specified.VIOLATIONSNOMINOR MAJOR CORRECIVE ACTION REQUIREDTRERBPGTUTATCOMMENT:Inspected ByDate:n('€4neyn"(FacilityTitle:drre 7Tl-55q5M:\COMMON\W':\DOCUMTNT\JPOIL\FORMS\OFFICU97\TORMS\CUPAINSP.ilCC ?$-MAI.OO4aran Lu I 5t1512000lssue DatePACIFIC BELLSAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF ENVIRONMENTAL HEALTH2L56 Sierra Way O P.O. Box 1489 O San Luis Obispo, California 93406IELEPHONE (8Os) 78l-ss44 o FAX (80s) 78r-4211UNDERGROUND STORAGE TANK (UST) OPERATING PERMITTHIS PERMIT IS ISSUED TO THE UST OWNER OR OPERATOR.THIS PERMIT MUST BE KEPT AT THE UST LOCATION AT ALL TIMES.THIS PERMIT MUST BE RENEWED PRIOR TO EXPIRATION.5t15t2005Expiration DateAddressAddressAddress196 SUBURBAN ROADSAN LUIS OBISPO2600 CAMINO RAMONRM 3EOOOSAN RAMONcA 94583-099c2600 CAMINO RAMONRM 3EOOOSAN RAMONcA 94583-0912ONE TANK _ DOUBLE CHAMBETANK#1TANK#25/955/9540-000-17407-00440-000-1 7407-00564000GASOLINEDIESELDOUBLE WALL FRP COATED STEELDOUBLE WALL FRP COATED STEELDOUBLE WALL FLEX PLASTIC (SUCTION)DOUBLE WALL FLEX PLASTIC (SUCTION)cA 93401UST FACILITY NAMETANK OWNER'S NAMETANK OPERATOR'S NAMETOTAL NUMBER OF USTSDATE INSTALLEDSTATE UST ID NUMBERGAPACTTY (GALLONS)HAZARDOUS SUBSTANCETANK TYPEPIPING TYPETANK MONITORINGMETHOD-CCR Title 23PIPING MONITORINGMETHOD-CCR Title 23PACIFIC BELLPACIFIC BELL2634(dX1XA) -VR/TLS 350 ANNUAL MONTIORSYSTEM CERTIFICATION26AUDIBLEA/ISUAL ALARM2634(dX1XA) -VR/TLS 350 ANNUAL MONTIORSYSTEM CERTIFICATIONAUDIBLEruISUAL ALARMTHIS OPERATING PERMIT IS GRANTED SUBJECTTO THE FOLLOWING CONDITIONS:1. The owner or operator agrees that the above agency, or their duly authorized representatives, have the right to inspection at any reasonable time.2. The owner or operator shlll comply with all applicable State UST requirements contained in the California Code of Regulations, Title 23, Division 3, Chapters 16 and 1 B,the California Health & Safety Code, Division 20, Chapters 6.7 and 6.75, and allapplicable local requirements.3. The owner or operator must report any unauthorized releases to the environment to the above agency within 24 hours after the release has been detected or should havebeen detected.4. Monitoring and maintenance records must be maintained on-site for 3 years.S. The ownel or operator shall notify the above agency within 30 days of any changes to the permit or UST systems, unless required to obtain approval before making suchchanges.ISSUED BYO:\DOCtJiVENT\JOI-lN\PacificBel12 DOC 30-Oct-00 ctty san FIRE DEPARTMENT - 2160 Santa Barbara Avenue, San Luis Obispo, CA 93401-5240,805/781-7380 "Courtesy & Seruice" oI Lurs oBtspo PERMIT ,i,., '11...:ir r':/:, l;,,'l l'.,i' 1., i .. t', ".,DATE:. -' .,:: l;, r, ,., 'i t, i IADDRESS: Has permission to maintain, store, use or handle materials, or to conduct processes, or to install equipment as described below: , .i i l : :i'\.)). ;t i,r i"l'i iit i-r-l' i: r;i r : irl r. J ;: (i lr: .i i { l . . 'lr .,r'{i r.. il i'1/i:rl i : r,:: All req uirements shall be per the Uniform Fire Code and its standard Date of Event and/or expiration l.D. Number: 'a t.l ,t. l;tl.j Permit Fee:!tl" "l6 By: The Pryntors - 9/99 - 7l - City-PermitWhite/yollo,v - Fir€ Dopartm€nt Pink - Psrmittee Goldenrod - Finance Departmsnt ctty san FIRE DEPARTMENT - 2160 Santa Barbara Avenue, San Luis Obispo, CA 93401-5240,805/781-7380 "Courtesy & Service" i oI Lurs oBtspo PERMIT DATE .!l.l iilj.{ ADDRESS: Has permission to maintain, store, use or handle materials, or to conduct processes, or to install equipment as described below: ,:.,:-r,.I'f {.)r:r. r. r.l ,11|, ,..'tr.i. figr.-i I 1i,,1;,,1. ., ,';.; " rv , i Li .;- ,.i:i, .l:i,,,.-..r, : ., it, l- , ri' ii' ". : ,.:.."1 '"li11" l-' ''' All requirements shall be per the Uniform Fire Code and its standard. Date of Event and/or expiration l.D. Number: ll -'.tri.r- ,.,., b, r-r::ii!1)ti , r\ fi/! i ltj ji., 'i:";, il . .. ,;;,...-,, ";t; , r.r r. llIl..i. r'- i., ir i;-;.] y' i:. j:. i.)ii ; ,,ii ,r Permit Fee i. {iii 1.. By: i,' ' '.. I white/yellow - Fire Department Pink - Permittee Goldenrod - Finance Department The Prynlers - 9/99 - 71 - City-Permil DAlr t-urlr-, v;r-i -DIVISION OF ENVIRONMENTAL HEALTH2156 Sierra Way o P.O. Box I4B9 o San Luis Obispo, California 93406TET.TPHONE (BOs) 7BI-5s44 o FAX (8O5) 78r42rtUNDERGROUND STORAGE TANK (UST) OPERATING PERMITTHIS PERMIT IS ISSUED TO THE UST OWNER.THIS PERMIT MUST BE KEPT AT THE UST LOCATION AT ALL TIMES'THISPERMITMUSTBERENEWEDPRIORToEXPIRATION.52Expiration DateIssue DateUST FACILITY NAMETANK OWNER'S NAMETANK OPERATOR'S NAMETOTAL NUMBER OF USTSDATE INSTALLEDSTATE UST ID NUMBERCAPACTTY (GALLONS)HAZARDOUS SUBSTANCETANK TYPEPIPING TYPETANK MONITORINGMETHOD-CCR Title 23cPACIFICELLIC BELL2LETANK #1-5195406. OO0D.W. FIBERGLASS COATED STEELDOUBLE WALL FLEX PLASTICdo2SUINGAddressAddressAddressONoTANK #25195oDIED.W. FIBERGLASS COATED STEELWALL FLEXPLASTIC2634 (d1-) (A)VRoTFP993. -.\have the right to insPectionCalifornia Code of20, Chapters 6.7 andithin 24 hours afterUST systems, unlessCPIPING MONITORINGMETHOD-CCR Titlc 23a6THISANNULAR & PIPING SUMP PROBESANNULAR & PIPING SUMP PROBESopERATINc pERITIIT IS GRANTED SUBJECT To THE FOI,LOWING CONDITIONS:The owner or operator agrees that the above agency, or their duly authorized representatives,at any reasonable time-The owner or operator shall comply with12aII applicable State UST requirements contained in theRegulations, Title 23, Division 3, ChaPtersl-6 and 18, the California HeaIth & Safety Code, Division6.75, and al-I aPPlicablelocal requirements.The owner or oPerator must reportany unauthorized releases to the environment to the above agency wthe release has been detected or should have been detected.Monitoring and maintenance recordsmust be maintained on-site fot 3 years.The owner or operator shall notifYthe above agency within 3O days of anyrequired to obtain approval before making345John\(.lS l- Pcmitsuch changes.ISSUED BYs to the permit or Corporate Real Estate2600 Camino RamonSan Bamon, California 94583PAcrFrcil!BELr "A Pacific Telesis CompanySan Ramon, December I0,1999Mr. Darren DrakeFire MarshalCity of San Luis Obispo2160 Santa Barbara AvenueSan Luis Obispo, CA 93401Re: 196 Suburban, San Luis Obispo annexationDear Mr. Drake:As you requested, enclosed is a copy of the site plan for the above named location.Please let me know if additional information is required. If necessary, you can reachme at (925) 901-9066.Sincerely,PACIFIC BELLK.Real Property ManagerEnclosurecc:Ms. Whitney McllvaineDepartment of Community DevelopmentCity of San Luis Obispo990 Palm StreetSan Luis Obispo, CA 93401-3249 r''t''\\trILffiMemorandumTo: Whitney MclivainFrom: Darren Drake, Fire MarshalDater December 2,1999Re: 196 Suburban - PacificTelephone and TelegraphFire hydrants shall be installed in accordance with Section 903.4 of the California Fire Code.The location, number and type of hydrants connected to the City system shall be determinedusing Appendix lll-B of ine California Fire Code and the approved City EngineeringStandards.Miscellaneous:prior to annexation a facility fire and life-safety inspection shall be conducted and a technicalreport provided to the City Fire Department. The report shall be prepared by a qualifiedengineer, specialist or other person acceptable to the Chief and the owner and shall analyzethe fire and life- safety properties of the facilities and operations.Water Supplies:Water supplies shall be in accordance with Sections 901 and 903 of the California Fire Code.An approved water supply connected to the City distribution system and capable of providingthe required fire flow for flre protection is required. The fire flow shall be determining usingAppendix lll-A of the California Fire Code.Fire Hvdrants:Fire Prevention Bureau /rDate:tFq-? 7Division of Environmental HealthP.O. Box 14892156 Sierra Way .5sn Luis Obispo' CA 93406Department of Asriculture/MeasurementStandards (80s) 781-s9102156 Sierra Way Suite A.San Luis Obispo, CA 9340fru|]Jllflrucitv of san Luis obispo ffiUtilities Department o (805) 781-7215955 Morro Street o San Luis Obispo, CA 93401CERTIFIED UNIFIED PROGRAM AGENCYHAZARDOUS MATERIALSINSPECTION FORMTimea:zCONSENT: Consent to conduct inspection which may involve obtaining photographs, review and copying of records, andGrantedReasondetermination/if rpfrrsedl. and hazardous'/.lt*rru Att.-'materials/waste handlin g requirements.PROGRAMS INSPECTED:REINSPECTION REQUIRED:n vnsNOusr f] .rcrusr fl .tctIfW GeneratorIfW GeneratorBusiness PlanBusiness Plan12114v*lTEL. NO.(DAY):FACILITYNHUTST;\,ENVISIONFACILITYoF/?b(24 HR)FACILITY LOCATION:<'r e.LIDNTt?E OF INSP.: pffiutin" fl n"-in.p. ncomplaintI crrvurrl.lTrEs n o.AGENCY:INSPEC-'DINGWomRecord IDSvc=ActionResultInsp Min.Facility Violationl;'lYESwwddYES- NO N/Aff--z nflrZ nfltr!N/A!trnnNOnntrn\r.@'frTROlTRO2EROlERO2vIoI.. #BPOlBP02BPO3GENERAL REQUIREMENTSTRAININGFaculty has appropriate training program (title 19 CCR2732 & 22 CCR 66265'16)Training documentation is maintained on site for current personnel (Iitle 19 CCR2732 &22 CCR66265'16)CONTINGENCY/EMERGENCY PLANContingency plan is complete, updated, and maintained on site (HSC 25504' Title f 9 CCR 2731 & 22 CCR &66265.53ts4)Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of hazardousmaterials/waste constituents to the environment, Maintains all required or appropriate equipment including analarm and communications system (Iitle 19 CCR 2731 & 22 CCR 66265.31-.43)BUSINESS PLANBusiness plan is current & available during inspection (HSC 25503.5, Title 19 CCR2129)Inventory of hazardous materials is complete (HSC 25504' Title 19 CCR2729)Site layout/facility laps are accurate (HSC 25504' Title 19 CCR2729) r,UNDERGROUND STORAGE TANK (UST)MONITORING CODES1. No monitoring2. Standard Inventory Control3. Modified Inventory Control4. Statistical Inventory Rec.5. Automatic tank gauge (list type)6. Continuous monitoring in tank annularspace/secondary containment7. Visual monitoring8. Manual monitoring annular space9. Temporarily abandoned under permit10. Another methodPermit No.lo?# PERMITTED TANKS#UNPERMITTED TANKSOwner & operator as indicated on permit: ffit nNOIf no, new owner name & addressnew owner name & address(NO N/AINtr n_!trntrtrnVIOL. #UTOOlUTOO2UTOO3UTOO4UTOO5UTOO6UTOOTUTOO8UTOO9UTOIOUTOllPERMITTINGSite has a permit to operate (HSC 25284)Permit is kept on the premisesChange ofownership is reported to the permitting agency within 30 days (HSC 25284(c))All UST(s) are properly permitted to operate or properly closed (HSC 25298)MONITORINGUST(s) monitored using method specifiedpn the permit or approved by the permitting agency (IISC 25293) (Writemoniioringcode(s)obs-rved 5 (a . )Monitoring records are provided to regulatory agency upon requestAutomatic line leak detection system is installed & kept operational for all pressurized piping (HSC 25292)An qqel report is submitted to regulatory agencyTank tightness test and/or piping test is being performed as required (Iitle 23 CCR)Written Monitoring Plan submiffed for electronically monitored tank system (fitle 23 CCR2632/34)Facility maintains evidence ofFinancial Responsibility for corrective action and for compensating thirdparties for bodily injury/property damage caused by a release from the tank system (HSC 25292)ABOYEGROUND PETROLEUM STORAGE TANK ACTProducts Stored: I nieset lGasoline [Crude oilOthersItrnnnnYES NO N/AnntrnnnNote: SPCC required for tanks with total storage capacity of> 10,000 gallons; for farms, nurseries, construction sites individual storage capacity of>20,000 gal or total storage capacity of>100'000 gallons.No.ofTanks: _Total Volume:_ galsvIoL. #ATOOlATOO2SPCC Ptan is prepared and certified by a registered engineer within last 3 yrs.SPCC Plan is maintained on site or nearest field office. \HAZARDOUS WASTE GENERATOREPAIDC Af o8oo 2 Lll1- ?>Totalgenerat"ol-o, /y' tu,o'@Tiered Permit:- CESW - CESQT - CA - PBRTreatment Equipment:Waste Oilz-j]..Anti-freeze: /Solvents:Others:NOnTnnYES-wn(N/A!{vrol. #GTOlGTO2GTO3GTO4GTO5GTO6GTOTEPAID NOIPERMITSGenerator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (fitle 22CCR66262,12)Generator has a permit or authorization to conduct on-site waste treatment (litle 22 CCR 66270.1)HAZARDOUS WASTE DETERMINATIONHazardous waste determination condu cted (fitle 22 CCR 66262.11)[owo knowledge nanalysis [otherHazardous waste analysis/test records are kept for at least 3 years (Iitle 22 CCR66262.40'(c))DISPOSAL/TRANPORTATIONHazardous wastes were offered to transporter and/or disposed to a facility with an EPA ID No. and permitor authorization from DTSC (HSC 25189'5, Title 22 CCR 66262-12)lmilkrun service -- floth.. -Hazardous wastes are shipped with manifest (title 22 CCR 66262.20)Manifests are properly completed/retained by generator for 3 years (fitle 22 CCR66263.421 66262.23)STORAGE AND MANAGEMENT OF CONTAINERS/TANKSHazardous wastes are accumulated on site as follows (Title 22 CCR66262.34)!.m aryr if waste generated per month is > 100 kg (220 lbs.)Vt fiO days if waste generator per month is - less than 1000 kg (See Note)l, ZIO days if waste generator per month is - less than 1000 kg and transported more than200 miles (See Note)Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg and no acutely/extremelyhazardous waste over I kg is held on site for over 90 days.Hazardous waste..satellite" collection is managed properly (complete labeling/accumulation time/55'gal or 1-qt limit)(Iitle 22 CCR 66262.34(c)Ignitable or reactive wastes are located 15 m (50') from facility's property line (Iitle 22 CCR66265.176)Containers of hazardous waste are properly labeled (includes appropriate date, "HAZARDOUS WASTE," wastecomposition/physical state, hazardous properties, name/address of generator) (litle 22 CCR 66262.34)Containers/tanks containing hazardous wastes are in good condition/handled to minimize release or reaction (fitle22 CCR 66265,17 ll.l9l, 66265.177 (c))Containers/tanks/liners are compatible with waste stored or transferred (fitle 22 CCR 66265.172)Containers storing hazardous wastes are closed/scaled (Iitle 22 CCR66265.173)Weekly inspection of areas where haz. waste containers are stored is conducted/documented (Title 22 CCR66265.174)Daily inspection ofall tank systems is conducted and documented (Iitle 22 CCR 66265.f95)Empty containers or inner liners > 5 gal has date when emptied and managed properly within one year of dateemptied (Iitle 2 CCR 66261.7 (I))RECYCLABLE WASTEUsed oil is managed as hazardous waste until recycled (includes proper labeling' storage' etc) (HSC 25250.4)Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closed rainproofcontainer, labeled *drained used oil filters," and transferred for metal reclamation) (litle22 CCR 66266.130)Spent lead-acid bstteries are transferred offsite under manifestation for recycling, reuse' or reclamation (Iitle22 CCR 66266.81)Solvents/other recyclable materials are managed as hazardous wastes until recycled (litle22 CCR 66266.3)w,a nw n nT{trTGTOSwn{w{#v{t{{trnnx!!n!!Itrnnnn!!nnntr!nnnnGTO9GTIOGTIlGT12GT13GT14GTl5GTl6GT17GT18GT19GT2OGT21 (- r^SUMMAI( Y OR OBERVATIONS/VIOLAi rONSNo violations of underground tank, hazardous materials, inventory, and hazardous waste laws, regulations, and requirements werediscovered. SLO CUPA greatly 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 eachviolation. Ifyou disagree with any ofthe violations or proposed action, please inform us in writing.All minor violations must be corrected within 30 days or as specified. CUPA must be informed in writing certifying that compliance hasbeen 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 at any time.You may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. Theissuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as a result of theviolations noted or that have not been corrected within the time specified.VIOLATIONS.NO.CORRECIVE ACTION REQUIREDTROEROBPOGTOMINOR MAJORwDoUTOATOcoMMENr: -lJ,l,= :L/ TL 3rf41l1LS /-lAZrtfrX>s H{ruClA,CB fi"r i;x-ru-'LJ(€*(.ror-r-J:OOFLI :> I N €-1qlJ I r- / cA^/ rfrf ;, LI A}./(-QDate: llca4 M(It-ttlA"{Insp.ReplluFacility Rep:Title:i)ct1 r'TAIT Environmental SystemsGeneral Contractors CA Lrc. #588098.I96 SUBURBAN ROADsAN Luls oBlsPosAN tuls oBlsPo(u.s.T. & A.S.T. tYroN[oR GERTIFICATION FORIiTcrting Dolc:8117legPACIFIC BETLTonk lD(rl:CLLC Codc:Gco Porccl:Sitc Conlocl:County:Mokc & Modcl of Monitor SYrtcm(rl:2030 & 2031sNtocAlRsE-l 6/R,OBERT IEWSSitc Contocl Phonc #:VEEDER-ROOTTt9350l8o5l 5/6738rTonk ITank 2Tqnk 3TonklTqnk lD f 2030Typc of Tonk (singlc Wollor Doublc Wolll UST orASlConlcnlr of TonkCopocity of TonkTypc of Producl Linc: (Grovily, Suclion, PrcrurcfTypc of Piping: (singlc Woll or Doublc WollfUN|ND|CAIE THE SENSORS TESTED BY PIACING A YIS, NO, OR N/A & PASS OR FAIL lNCORRESPONDING BOX:Annulor Spocc ScnronFill Sump ScnronPiping Sump ScnronPiping Trcnch ScnronDirpcnrcr Conloinmcnl SsnronProblcmr Syrbm(sfFOR. PR,ESSUR,E TYPE SYSTEMS ONLYSTonk I Tonk2Tonk 3 Tonk4lr Mcchonicol Linc Lcok Dctcctor Prcrcnl & Tcrlcd?:Doc: fic Turbinc ShuFDown if Syrtcm Dclcct: c Lcok?:Docr Poritivc Shut Down Occur if Monitor Syrtcm ir turncd offil:SUCTIONDWTonk I Tonk2Tonk 3 Tonk,d ScnsorYES PASSYES PASSYES PASSlr Tonk Lcvcl Gouging Syrtcm Prcrcnl. Probc Typc ilApplicqblc'Typc of lrrTonk lcok Dclsclion Tcrt Pcrformcd by MonitonDocr thc Monitoring Syrtcm hqvc Audiblc &ViruolAlarmr?Elcctronic Ovcfill/Lcvcl:lr ths Moniloring Syrlcm inrlollcd lo prcvcnl unouthorizcd tcmpcring?:lr thc Monitoring Dcviccr opcroblc ot Pcr monufoclurc'r rpccificotionr?MAG.2 GPH DAITYYES90%YESYESDolc:8lt7l99Tochniciqn: BRANDON HAMCcrlificd Tcrlcr'r lD #:569€9€/35(Pri$t$wtlm hh-lsignoturcf701 North Parkcenter Drive . Santa Ana, california 92705 ' (714) 560-8222 ' (714) 560-8237 faxRegional offices: san Diego . concord . sacramento . Phoenix ' Tucsonwww.TAlT.comDWsuciloN/,000DIESETDwusT2031IIIYES PASSIII-IIIIIIIIII {t-//ie rg L-/aQr<)-'a,4'-/r-( f"t\JYt''Nancy Clancy / Environmental Advisortbfl-hroprl|rtrffr&OrrrqagLit dz.cZiSee Attached ListPacific BellmNole:JdarDrierinwt,,(lcldbttgaffindMt;lrrtrctotrullct lton,oty'',tttsdF,n dtp.,8ywSlrlousing,fYesYcsRcnqladAnnuallyNot Appliceblc ForStrte Altlm.tiwil'cchenirmFecffic BcllEnvironmcntel MrnegrmcntPO Bor 5095 RM,3Em0TSrn Rlmon, CA 94583{t995Ghief FinancielOfficer Lcttcr(attached)rsfrfrrr.'N7bf'nb-F)h a|Ilrp rfi Ar ,rgtj]rrllr d gt,lfn 2Nl,a,,,tbAlgildr/burld,rrdtrdrmttlpderfi.*rtwtra.t,DtvfutWr'8,ArhfrgDrErF-flrTlr.ttabrsdlnoe".--l-h*-t-r3.FcrYtl&&rrrE=-ffir.ratrF-rrEAIDJt.Trbzl,oc&11fly.ETtddllrq-tCERTIFICATION OF FINANCIAL RESPONSIBILITYcotTtmrEtEltolEnFmuEBorourDanmrcFfrresirdcthtastb rtt' Rr.rrlr cotrl Sa|tllrlbdCIr$:rFluFrPO.3qOaatl2cA .laflalzoiiICt(rid State Water Resources Control BoardApril 13, 1999Page TwoAlternative I (Source: Form lOK,December3l, 1998)L Amount of annual UST aggregate coverage being assured by a fnancial test, and/ or guarantee.........2. Amount of corrective action, closure and post-closure care costs, liability coverage, plugging andabandonment costs covered by a financial test, and/or guarantee.....3. Sum of lines I and2.........4. Total tangible assets5. Total liabilities (if any of the amount reported on line 3 is included in total liabilities, you may need toDeduct that amount from this line and add that amount to line 6).................6. Tangible net worth (line 4 minus line 5)7, Is line 6 at least $10 million?. .....................8. Is line 6 at least l0 times line 3?..........9. Have financial statements for the latest fiscal year been filed with the Securities and ExchangeCommission? ...................10. Have furancial statements for the latest fiscal year been filed with the Energy Information Admin. ....I l. Have financial statements for the latest fiscal year been filed with the Rural Elecrician Admin..........12. Has financial information been provided to Dun and Bradstreet and has Dun and Bradstreet providedA financial strength rating of a 4A or 5A?(answer "yes" only if both criteria have been met)$2.000.000$ 16,850,000.$ 18,850,000.$15,093,000,000$ l 1 ,833,000,000.s 3,260,000,000.YesYesYesN/AN/ANIA**For SBC Communications Inc. (holding company). YesI hereby certi8/ that the wording of this letter is identical to the wording specified in 40 CRF part 280.95(d) as such regulations were constituted on the date shown immediately below.4MtryRobert B. PickeringDated: q-t3 11 III805-78 1 -5544OF SAN LUIS OBISPO HEALTH DEDivision of Environmental Health,'/ENTP.O. Box 1489, San Luis Obispo, CA 93406HAZARDOUS MATERIAL/UN DERGROUN D STORAGE TANK/WASTE GENERATORINSPECTION REPORT/NOTICE OF VIOLATIONut{coRoutine lnspection "/Reinspection No.Complainl lnvestigation _Facility NameFacilily AddHAZARDOUS MATERIALS (2185) (COMP #(CA H&S Code, Div. 20, Chap. 6.95)BUSINESS I.D, FORM19.aContact PersonTitle/PositioUNDERGROUND STORAGE TANKS(coMP #t7+o'7(CA H&S Code, Div. 20, Chap. 6.ATL. #-- GENERALViol2.1. Comemenumber3. Location of utilitiesINVENTORY4. Hazardous material & amounts listedTANK CLOSURE5. Material stored in proper containers& labelednot storedher6.7.ll containmentrovidedPLOT PLAN8. Plot9. Veristreets &bWASTE GENERATORS COMP #10.of hazardous materials11. Firesourceshut-off swilches13. Location & verification ot MSDS14. Sewerand/or storm d15.16.EMERGENCY RESPONSE PLAN17. Adserocedures18. AdevacuationresTRAINING PROCEDURESThe aboveRegulationmarked items represent violations of the California Health & Safety Code and the California Code ofs and must be corrected.ll containment37.uishers36. Fire exti-9035.not stored34. I33. Material stored in proper containers& labeledlan32. Conti3130. Waste oil recei29. Manifests28. Variances and/or27. EPA identification numbertakenSoilTanks rinsedTanksabandonment26. Removal/inclosure25.24. Permit23. Leak detectors22. Precision tank testreconciliation2120. Permit loViolCOMMElnspector's SignOwner/Operator SignatNOTE: Signature indicates receipt ofment only and not an admission of the facts.e^,s" I otl- (7Fi\TAIT ENVIRONI/ENTAL SYSTEMSCA Lic. #588098 . AZ Lic. #095984Septembe( 28, 1998RETURN RECEIPT REOUESTEDMr. John ScholtesSan Luis Obispo Environmental HealthP.O. Box 1489San Luis Obispo, CA 93400RE: Pacific Bell Sites & CLLC Code:196 Suburban Road, San Luis Obispo CLLC Code: SNLOCA|RDear Mr. Scholtes:Enclosed are the following forms for the above-referenced facilities:U.S.T & A.S.T Monitor Certification Documents*Feel free to call if you have any questionsVery Truly Yours,TAIT ENVIRONMENTAL SYSTEMStru)'t'IJ b+uw't*CHERI L. BREWERProject CoordinatorCLBEnclosure:\jds\pb 1 998\letters\agoncy\sanlu isob\scholtes.j 1CC: Nancy ClancyDan Velez (Post At Site)Bob Lewis1 100 Town & Country Road . Suite 1200 . Orange, CA 92868 ' (714) 560-8222 ' (714) 560-821 1 FAXother Locations: san Diego, cA . concord, cA . sacramento, cA . Phoenix, AZ ' Tucson, AZEstablished 1964 TAITTAIT ENVIRONMENTAL SYSTEMSu.s.T. & A.s.T. MoillroR cERTlFlcATt0N FoRM cA Lic' #5880e8' AZ Lic' #0e5e84Testing Date:9tr 7t98Site Location:PATIFIC BELTTank lDlsl:CLIC Code:Geo Parcel:Site Contact:Site Contact Phone #2030, 2031SNLOCAI RsE.t64B0B tEWISt209t 485-7638196 SUBURBAN R()AOSAN [UIS ()BISPOSAN LUIS OBISPOCounty:Make & Model of Monitor System(sl:Tank l0 #Type of Tank: lSingle Wall or Oouble Walll UST or ASTContents of Tank:Capacity of Tank:Type of Product [ine: lGravity, Suction, PresswelType of Piping: (Single Wall or 0ouble WalllTank 1Tank 2Tank 3Tank 42030DWIUSTUNTEADED6,016SUCTI()NDWVEEDER.ROOT T[S.350IITIDICATE THE SENS(IRS TESTED BY PIACING A YES, NO, (lB III'A & PASS OB TAII IiI COBRESPOITIDIITIG BOX:Tank 1 Tank 2Tank 3Tank 4 SensorAnnulat Space Sensor:Fill Sump Sensor:Piping Sump Sensor:Piping Trench Sensor:Dispenser Containment Sensor:Problems System(slYES PASSYES PASSYES PASSNIAN'Als Mechanical Line leak Detector Present & Tested?:Does the Turbine Shut-Down if System Delects a Leak?:Does Positive Shut Down 0ccur if Monitor System is turned off?:ls Tank Level Gauging System Present. Probe Type if Applicable.Type of ln-Tank Leak Detection Test Performed hy Monitot:0oes the Monitoring System have Audible & Visual Alarms?Electronic 0verfilllLevel:ls the Monitoring System installed to prevent unauthorized tampering?:ls the Monitoring Devices operable as per manufacture's specifications?F()R PBESSURE TYPE SYSTEMS OITILY:Tank ITank 2 Tank 3 Tank 4MAG.2YESYES 95%YESYESDate:91r 7,98Technician:PAT BANBURYCertified Tester's lD #: 564'37'0364lSignaturel1100Town&CountryRoad.Suite1200'Orarye,CA92868 '(714)560-8222'(714) 560-8211FAXOther Locations: San Diego, CA . Concord, CA . Sacramento, CA ' Phoenix, AZ ' Tucson, AZEstablished 1964DWSUCTION4,011DIESETDWIUST2031NIANIANIAYES PASSNIAII CA Cert. No. 10068couNTY oF sAN LU|S OBISPOHEALTH AGENCYPUBLIC HEALTH DEPARTMENTDivision of Environmental Healthlssued by:6, ,o,DateAn upgrade compliance certificatehas been issued in connection withthe operating permit for thefacility indicated below. Thecertificate number on this facsimilematches the number on thecertificate displayed at the facility.Instructions to the issuing agency: Use the space below to enter the following information in the format ofyour choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility;facility identification number (from Form A); name of issuing agency; and date of issue. Other identifuinginformation may be added as deemed necessary by the local agency.40-oo0-017407PACIFIC BELLPACIFIC BELL1 96 SUBURBANSAN LUIS OBISPO CA 93401Underground Storage Tank FacilityUPGFADE COMPLIANCE CERTIFICATEThis upgrade complianca cartilicate is issuedpursuant to Chapter 6.f Section 25284(e),Califomia l{eallh and Salety Gode. Environmental ManagementP.0. Box 5095, Room 1 N200San Ramon, California 94583-0995April 15, 1998Nancy ClcyattachmentsPActFlcil!BELL.A Pacific Telesis Companyd\ffifrtgtertl f.1,City Of San Luis ObispoSpencer MeyerFire Protection Spec lHazCoord City Fire Dept.2160 Santa Barbara Ave.San Luis Obispo Ca93401-5240RE: Financial Test of Self lnsurance (Underground Tanks)The attached is a copy of our Chief Financial Officer Letter to demonstratefinancial responsibility for Pacific Bell's underground storage tanks.Also attached is the annual State of California Water Resources ControlBoard's Certification of Financial Responsibility form and a list of Pacific Bellsites that have underground tanks on the premises in your area ofjurisdiction.Please call me on 415-331-0924 if you have questions regarding thiscorrespondence.p_ lU"- 5r*br,,r\c,nho^",S ftv*- t"a.\ "( o Cr,t ,h1 "",>\o,rrg I Robert B. PickeringVice President andCh i eftinb'nci a I llf iice r2600 Camino Bamon, 4CS100San Bamon, California 9458{.r' -'{51 0) 867-2800tax {510) 867'9831E-mail: rp7271 @msg.Pacbell comEPA RegulationsClosure ($$ 264.143 and265.143)l4s)..............r47)............PAC|FtclrBErloA Pacif ic Telesis ComPanYAmount$400,000.$100,000.$2,000,000.$100,000.$N/A$7,400,000.$1,000,000.$2,ooo,ooo.$3,700,000.$150,000.$16,850,000April 15, 1998State Water Resources Control BoardDivision of Clean Water ProgramsUnderground Storage Tank Cleanup Fund2014T Street, Suite 130Sacramento, CA 95814Re: Financial Test of Self-Insurance (underground Tanks)I am Vice president, Finance & Chief Financial Offrcer of Pacific Bell,2600 CaminoRamon, Room +-Cj-tOO, San Ramon, California. This letter is in support of the use ofthe financial test of self-insurance to demonstrate financial responsibility for takingcorrective action and/or compensating third parties for bodily injury and propertydamage caused by sudden accidental releases and/or non-sudden accidental releases inthe amount of at least two million dollars annual aggregate arising from undergroundstorage tanks.Underground storage tanks at pacific Bell facilities are assured by this financial test or afinancLl test under an authorized State Program by this owner or operator'A financial test is also used by this owner or operator to demonstrate evidence offinancial responsibility in the following amounts under other EPA regulations or Stateprograms authorized by EPA under 40 cFR Pxts2Tt and 145.Post-Closure Care ($$ 264.145 and265'Liability Coverage ($$ 264.147 and265Corrective Action ($$ 264.101 (b))'......,Plugging and Abandonment ($$ 144.63)....'..Closure....Post-Closure Care........Liability CoverageCorrective Action.Plugging and Abandonment....Total..........This owner or operator has not received an adverse opinion, disclaimer of opinion, or a..going concern'; qualification from an independent auditor on his financial statementsfor the latest completed fiscal year.Alternative 1 (Source: Form 10K, December 31, 1gg7) Bo \-11hb6Nmc md Titlq ofTut OmaOp€ratorAdor Nohryof Tuk O*lcr/-5?vDakf.olityAddr6Faciliry NucFaciiiryAddrgFacilityNueFacili ry Addr 6sFaciliry NmcFaciliry Add16FadliryNucSee Attached Listresponsibility,theFundtnforconditionsallwitharetncertifiesthatalsocert'ficationofthisyourandsubmissionexecutionfinancialyourofasanydemonstntionFrtofFundareyou.9fateustngthetfNote:FacilityNmcAddr<PACIFIC BELLr6,850.m0.are as follovys:(NMc o f Tu k O*t q 6 Oyvztu )YESYES*ctionB.asfirnrrcialtodemonstateusedmechanismsTheofRegulationsCode23,CaliforniaTttte3,DivisionI8,3,ChapterArticlecertifies that it is in comptiarce with the requiremenE of *ction aao7,Pacific BetlEnvironmental Mgmt2600 Camino RamonRoom 1N200San Ramon, CA 945g3Chief FinancialOfficcr Lerter(auached)RenewedAnnuallyNot applicable for StateAlternadve MechanismANDffi , ttu,oo aotlt . "oou"t .gtrctarcl--l t .ilioo dollars annual lttrctstcCERTIFICITYLBNSPoESLRIANcANFIoFoNTAia ttc rcquircd emouots28{17. Cheptcr t8. Div. 3. Titlc 23. CCR:as spccificd in Scctionto dc6oostrat. Fiaancial RcsponsibilityA. I ru requircdl--l soo,mo dollars pcr occurrcnccorllXl r .iuioo dollars pcr occurrcaccC. "rolBoardState of CaliforniaState Water ResourcesF'It F' Ori&inal - Ioal AgncyCopics - Facitiry/Sitc{s) 1.1-59 225 N. HALCYON ROADARROYO GRANDE, CA]-1-09 6220 ATASCADERO AVEATASCADERO, CA1-1.50 1.33 SAN RAFAEI, STAVILA BEACH, CA1]-55 LYNCH CANYON ROADBRADLEY, CABzL 65 1.3TH STREETCAYUCOS, CALL1-0 2053 10TH STREETLOS OSOS, CATTOT 788 MAIN STMORRO BAY, CALO32 730 15TH STREETPASO ROBLES, CA2020908 2BTH STREETPASO ROBLES, CA2O2L 9OB 28TH STREETPASO ROBLES, CA2O3O ].96 SUBURBA\I ROADSAII LUIS OBISPO, CA2O3L ]-95 SUBI]RBAII ROADSAIV LUIS OBISPO, CAARGRCA]-2 SE253 SAI{ LUIS OBISPOATSCCA]-]- SEOO6 SAI{ LUIS OBISPOAVBHCA].]- SEl-62 SAN LUIS OBISPOBRDLCA]-2 SE1.6O SAN LUIS OBISPOCYCSCA1]- SEO26 SA}T LUIS OBISPOBYPKCAI-]- SEl-6]- SAN LUIS OBISPOI4RBACA]-]. SEOsO SAIT LUIS OBISPOPSRBCAO]- SEO67 SAI] LUIS OBISPOPSRBCAs]. SE625 SA}T LUIS OBISPOPSRBCAs]- 58625 SAN LUIS OBISPOSNLOCAAU SEl-54 SAI{ LUIS OBISPOSNLOCAAU SE]-64 SA}il LUIS OBISPO2OO5 DIESEL]-2OO5 DIESELI-520 DIESELI.1OO3 DIESEL15OO DIESELI-1_005 DTESELI_1-003 DTESEL12OOO DIESELI-5O].5 TJNLEADED4O].1 UNLEADED6015 UNLEADED40L1- DTESEL2 TAIT ENVIRONMENTAL SYSTEMSCALic. #588098 . AZ Lic. #095984MONITOR CERTIFICATION & SITE SURVEY FORMTesting Date:9t10t97Testing Time:Site Location: PACIFIC BELLTank lD #: 2030 & 2031196 SUBURBANCLLC Code: SNLOCAAUSAN LUIS OBISPOGeo Parcel: SE-164County:SAN LUIS OBISPOSite Contact: RON STANLEYAgency Required To Be On-Site? Yes INoXAgency Requiring Certification:SAN LUIS OBISPO ENVI RONMENTAL HEALTHAgency Contact:JOHN SCHOLTESAgency Phone No:(805) 78',1-5544Agency lnspector: N/ASignature: N/ASpecial Forms Required:Testing Permit Required:Permit Or lnspection Fee:Tank Testing Needed:Line Testing Needed:Leak Detector Test NeededYesYesYes IYesYesYesNoXNoNoXXNoNoNoX1100Town&CountryRoad .Suite1200.Orange,CA92868 '(714)560-8222'(714) 560-8211 FAXOther Locations: San Diego, CA ' Concord, CA ' Sacramento, CA ' Phoenix, Az ' Tucson, AzEstabliEhed 1964 TANK AND LINE INFORMATIONTank 1Tank 2CLCC Code: SNLOCAAUTank 3Tank lD #:20302031Product:UNLEADEDDIESELTank Material: STEELSTEELCapacity:60164,O11Diameter:96.0096.00Tank Type:Above GroundTank: YesProduct LineType:Single WallDouble Walltrto X YesTNoXSingle WallDouble WallXSingle Wall IDouble Wall ilSingle WallDouble WallSingle WallDouble WallTXTXYestto trSingle WallDouble WallLine Material:FIBERGLASSFIBERGLASSPump Type:Line LeakDetector:Leak DetectorType:PressureSuctionPressureSuctionTXTXPressureSuctionnYes INoX YesI NoXYes INoI2 CLCC Code: SNLOCAAUMONITOR SYSTEM INFORMATIONSystem # 1: Manufacturer:VEEDER-ROOTSerial Number:41232526905001System # 2: Manufacturer:Model:Serial Number:Tank 1Tank 2Tank 3Model: TLS-350Automatic TankGauge: YesType: CAPFuel Level: 3761AnnularSensor:ruoIMAG XGallonsYes X ruoIYesCAPNoIMAGXGallonsNotrMAG !GallonsYesCAP291757.50 lnches (mon)65.54lnches (mon)lnches (mon)58.70 lnches (stick) 65.00 lnches (stick) lnches (stick)Water in Tank: Yes I No X Yes I No X Yes E No f0 lnches (mon)0 lnches (mon)O lnches (stick) 0 lnches (stick)ATG Test: Pass X Fail trPass X Fail IPass I Fail f]lnches (mon)lnches (stick)Annular SensorTesting: Pass X faitYesXNoE YesI NoIPass X rail I3Pass I rait f AnnularSpace:Piping SumpSensor:CLCC Code: SNLOCAAUDry X Wet trDry X Wet fDry f Wet nYesNo X YesNoIYes f NonPiping Sump SensorTesting: PassFill SumpSensor:I Fait IPass X rail IPass n rail nYes XNotrYesNoXYes I ruonFill Sump SensorTesting: Pass X faitOther Sensors: NONEPass E rait EPass I rait DNONEWater Present(ln Sumps): YesWhere Present:TNoX Yes ENoIYesINoISump Pump-out:Waste Water Left on Site:YesYesNoXNoXSump Conditions:DRY4 TAIT ENVIRONMENTAL SYSTEMSCALic. #588098 . AZ Lic. #095984OVERALL MONITOR SYSTEM PERFORMANCECLCC Code: SNLOCAAURemote Electronic Overfill Alarm Present?YesXNotrDo all Alarms include both Audible and Visual Alarms? YesThe Monitor System is Certified Per the ManufacturersPerformance Standards?Audible and Visual Alarms Function for the RemoteOverfill Alarm?Certified By:DON S. THOMPSONPrintYesX NoIX nolYes X NoIDate: 9,,l0l97L_!.License Number: 545-92-3354Signature* This is a dual comPartment tank.:\jds\pacbell\pbl 997\monitorcert\SNLOCAAU. mc1100Town&CountryRoad . Suite 1200 . Orange,CA92868 ' {714)560-8222'(714) 560-8211 FAXOther Locations: San Diego, CA . Concord, CA ' Sacramenio, CA ' Phoenix, AZ ' Tucson, AZEstablished 19645 oEnvironmental ManagementP.0. Box 5095, Room 1 N200San Ramon, California 94583-0995PAC|Frcil!BELL.A Pacific Telesis CompanyAprilZl, I9VICity of San Luis ObispoCity Fire Dept2160 Santa Barbara AveSan Luis Obispo, CA9340l-5240RE: Financial Test of Self Insurance (Underground Tanks)The attached is a copy of our Chief Financial Officer Letter to demonstratefinancial responsibilrty for Pacific Bell's underground storage tanks.Also attached is the annual State of California Water Resources ControlBoard's Certification of Financial Responsibility form and a list of Pacific Bellsites that have underground storage tanks on the premises in your atea ofjurisdiction.Please call me on (415) 331-0924 if you have questions regarding thiscorrespondence.NancyEnvironmental ManagementattachmentFILE COPY P. A. DarbeeVice PresidentChief Financial Officerand Controller2600 Camino Bamon, Room 45(San Bamon, California 94583(51 0) 823-8520EPA RegulationsClosure ($$ 264.143 afi265.143)Post-Closure Care ($$ 264.145 and265.145).Liability Coverage ($$ 264.147 and265.147)Conective Action ($ $ 264. I 0 I (b))...............Plugging and Abandonment ($$ 144.63)Closure.........Post-Closure care..............Liability Coverage.....Corrective Action..........Plugging and Abandonment................Total.f' PAcrFrcillBELL,A Pacific Telesis CompanyApril3, 1997State Water Resources Control BoardDivision of Clean Water ProgramsUnderground Storage Tank Cleanup Fund2014T Street, Suite 130Sacramento, CA 95814Re: Financial Test of Self-Insurance (Underground Tanks)I am the Chief Financial Officer of Pacific Bell, 2600 Camino Ramon, Room 45001, San Ramon, California, 94583.This letter is in support of the use of the financial test of self-insurance to demonstrate financial responsibility fortaking conective action and/or compensating third parties for bodily injury and properfy damage caused by suddenaccidental releases and/or non-sudden accidental releases in the amount of at least two million dollars annualaggregate arising from underground storage tanks.Underground storage tanks at Pacific Bell facilities are assured by this financial test or a financial test under anauthorized State Program by this owner or operator.A financial test is also used by this owner or operator to demonstrate evidence of financial responsibility in thefollowing amounts under other EPA regulations or State programs authorized by EPA under 40 CFR Parts 271 and145.Amount$400,000.$ 100,000.$2,000,000.$ 100,000.N/A$7,400,000.$1,000,000.$2,000,000.$3,700,000.$ 150,000.$ 16,850,000This owner or operator has not received an adverse opinion, disclaimer of opinion, or a "going concern"qualification from an independent auditor on his financial statements for the latest completed fiscal year.Alternative I (Source: Form l0K, December3l, 1996) I . Amount of annual UST aggregate coverage being assured by a financial test; and/or guarantee....2. Amount of corrective action, closure and post-closure care costs, liability coverage, and pluggingand abandonment costs covered by a financial test, and./or guarantee.....3. Sum of lines I and 2.........4. Total tangible assets............5. Total liabilities (if any of the amount reported on line 3 is included in total liabilities, you mayneed to deduct that amount from this line and add that amount to line 6)......$2,000,000$ 16,850,000.$ 18,850,000.$ 14,649,000,000.$ 10,722,000,000.$3,927,000,000.YesYesYes6. Tangible net worth (line 4 minus line 5)...........7. Is line 6 at least $10 million?8. Is line 6 at least 10 times line 3?9. Have financial statements for the latest fiscal year been filed with the Securities and ExchangeCommission?Yes10. Have financial statements for the latest fiscal year been filed with the Energy InformationAdministration?.................N/AI 1. Have financial statements for the latest fiscal year been filed with the Rural ElectricianAdministration?.................N/A12. Has financial information been provided to Dun and Bradstreet and has Dun and Bradstreetprovided a financial strength rating of a 4,{ or 5A?(answer "yes" only if both criteria have been met)...I hereby certify that the wording of this letter is identical to the wording specified in 40 CRF part 280.95 (d) as suchregulations were constituted on the date shown immediately below.Sincerely,Peter A. DarbeeVice President, Chief Financial Officer, and ControllerPacific Bell// s /rrDater4J /*"tazrr%n/tbaulzz f/ DaE4l>Yl q ]Sigpirure of Wiq/s or Notary-2fu4Nme of flios or Notary(14/i2s rt nt Ke.C Z^"fu79=OrrucrNue ud Titlc of TmL Oqtrer or OpcrabrNancy Clancy ./Environmental AdvisorFaciliryNmeFacili ry AddrsFacilityNm€FacilityAddresFaciliryNueFaciliryAddressFaciliryNmeFacility AddrsPacific BellSee Attached ListFacilityAddrNFacilityNmeNote: lf you are using the State Fund as anypart of your demonstntion of financial responsibility, your executionare inof this certification also ceftifies thatwith all conditions forin the Fundand submissionChief FinancialOfficer Letter(Attached)Not Applicable ForState AlternativeMechanismPacific BcllEnvironmental MgmtPO Box 5095, RM 1N200San Ramon, CA 949583-0995YcsYesRenewedAnnuallYs16, 850,000,, ,,,, Mechanism ,' ,,,:',,,, ,,',' ,,, ,:,,' Numb€r ' , ,Third Party:' Comp.'Correctrve,',Actbn;: ',Covenge :,,. :,Amount',',,'B herebyceftifies that it is in compliance with the requirements of *ction 2807,( NM c of Tnk O*, t or OFsa tor)Articte 3, Chapter 18, Division 3, Title 23, California Code of Hegulations.*ction 2807 are as follows:asThe mechanisms used to demonstnte financialA. I ". t"quit"d ro demonstrate Financial Responsibility in the required amounts as specified in Se ction 2802 Chapter 18' Div. 3' Title 23' CCR:I million dollars annual aggregateor2 million dollars annual aggregateXI X ] r .iltioo dollars pe r occurrenceAND500,000 dollars per occurrenc€orCERTIFICATION OF FINANGIAL RESPONSIBILITYUNDERGROUNDMFciiRq/ - Sa6ecyU*OalyState Wat€r Resources Control BoardState of CalifomiaFILE: Original -Copies - FacilityiSia(s) Har 9? 16:02 199? tank-addr-cllc'geoPar-county-9al-product-device Page 31rt23 011 F0LS0|1 sTsgN FRnNCISC0, CnIt24 611 F0Ls0l1 sTsnN FRRNCISCo, CAsNFccR2l -tSNFCCR2l Rl024SNN FRNNCISCOSNN FRRNCISCOSNN JONOUINSNN LUIS OBISPOSNN LUIS OBISPO17s83 0IESELlt?583 0IESELI,rro,{ o( 350 ' RPLCCLt3220537948077958058061052rt0220292048204911038111 1093333 25TH STREETsFN FRnNCISCo, CR1330 16TH STREETsAN FRnNCISC0, Cn1812 CoLEY nVEESCRL0N, CA77 77 S . IICK INLEYFRENCH CR|1P, Ce124 l,J. ELll STLoDI, Cn907 LINCOLN RONOsToCKToN, cn7644 N. ASHLEY RONDsToCKToN, cn345 N. SAN JORQUIN STSTOCKTON, CF1413 BOURBON STSTOCKTON, CN4O5t NEUJTON ROFDSTOCKTON, CN23OO E. EIGHT I1ILE ROf,OSTOCKTON, CN23OO E. EIGHT NILE RONDSTOCKTON, CAsNFCCn05sNFCC879ESCLCR 1 ISKTNCE 14L00I ce0 1SKTNCE 1 1SKTNCn I 2SKTNCRO 1sKTNCnT3SKTNCN 1 6SKTNCNS3SKTNCRS3R4004R3034UGOlOUE 148uE020UE046UE123UE 149uE094UER4?UE?08UE?08SRNSANSRNSRNSRNSRNSANSRNSNNSRNSRNSANFRRNCISCOFRNNCISCOJONQUINJONQUINJORQUINJONQUINJONQUINJORQUINJORSUINJONQUINJONqUINJONOUINDIESELlUNLEADEDD IESELlD IESE L1DIESE L1OIESE L1DIESELlDIESE L1D IESEL IUNLEEDEDUNLEADEODIESELl(3s0) REPL(350 ) RPLC0(250r ) cnT(2s0) J00R(250I) r10D(2s01 )(250I ) Joo(250I+) RE(3s0 ) RPLCD(3s0) REPL(350 ) R PLCG(350)RPLCD601610 152500200040003500I 50025000300810152100?4503?10 E. 12TH STREETTRnCY, Cn225 N. HALCYON RORDRRROYO GRNNOE, CR6220 nrnscnDERo RvERTnSCnDER0, CnTRRCCRl 1 UEO58NRGRCRl2 SE253nTSCCRIt SE00,62OO5 DIESELl2OOO DIESELI2OO5 DIESELlRE PLR PLC(2s0 ){2s0 ){250} 0iJEN(3s0)REPLe( 3s0 ) RE PLC(3s0) REPL(3s0) REPL(350) REPL(3s0) REPL(3s0 ) REPL(250 & tER(3s0)RPLCG(2s0)(2s0)(3s0) RPLC(2s0r ) TRU(250 & LEA(2s0 & LER(3so)(2so)(3so )flar 2? 16:02 199? tank-addr-cllc-geopar-county-9al-product-device Page 3282381082L1110110710322020202L203 0203L92133 SAN RAFREL STRV I LN BERCH , CNLYNCH CRNYON ROFDBRBDLEY, CR65 13TH STREETCRYUCoS, CR2053 lOTH STREETLos 0s0s, cn?88 NAIN STr1oRR0 BAY, CA?30 1sTH STREETPASO ROBLES, CA908 28TH STREETPFSO ROBLES, CA908 28TH STREETPNSO ROBLES, CR196 SUBURBRN RONDSAN LUIS OBISPO, CA196 SUBURBFN ROADsRN LUIS 0BISPo, Ce1480 BURLINGNME AVEBURLINGRI1E, CNSANSANSRNSANSANsnNSRNSRNsnNSNNSAN5001 0005001 0051 0032 000DUIO40116 016401 14 000nvBHCP 1 1BRDLCR 1 2cYcscA 1 1BVPKCAllIlRBf,CR 1 IPSRBCNOlPSRBCRS 1PSRBCRS 1SNLOCRNUSNLOCNAUBR LNCEO 1LUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOLUIS OBISPOIlRTEODIESELlOIESELlDIESELlOIESELlDIESELlDIESELlUNLEADEOUNLERDEOUNLEAOEDD IESE L2D IESELlD IESE L1OIESELlDIESELlOIESE L1OIESELlO IESELlDIESE t1sE 162SE 160sE 026SE161SE O5OSEO67sE625sE62ssE164SE 104P3 006525 KELLY RVEHALF IIOON BAY! CA2950 SANOHILL ROAOIlENLO PARK, CA1O IICGNOLIA NVEt1I LLBRRE, Cn325 REINR DEL MNRPACIF]CA, CE1121 JEFFERSON FVEREDI,JOOD CITY, CA1101 SAN fiNTEO NVESRN BRUNO, CF840 I,J. SBN BRUNO RVEHhBncA I 2I1NPKCF 11HL ERCn 1 1PCFCCA 1 1RDCYCA O ISNBUCAO2SNBUCA5OPC083P30? 1P2003P2019P3 056P201 1R4059I1 1351009310839194702SANSANSANSRNsnNSRNSANI1R TEOI1F TEOIlRTEOTlATEOIlATEOMNTEONNTEO1 0031 0001 000I 00240001 00001 000 J',).4.,lj-])IAIJTTSISCERTIFIEDTANK TESTINCTANK CLEANINCMONITOR CERTIFICATIONp.o. Box 3178 * glxr vALL,Ey, cA 93093u.s.T MONITORING EQUTPMENTINSPECTION REPORTrkrk* ;MpSRTANT DOCUMEIqI *dcttYOUR r-OCAL REGLILATORY AGENCY W1LL REQUEST llo VIEW THISC--ER IFICA'|E, PLEASE KEEP A C]OPY AT'f}{E F'ACI].iTY.COMPANY NAME: Pacific BellLOCATION : SNLOC.{AUsE-164 \ #2030, #2031196 SuburbanSan Luis Obispo, CAOn Wednesclay, September I l, 1996, Dialysis Company, an authorized servise rcrpresentative ofVeeder-Roc'rt llnviroumenial Ploducts, certified one TI-S350 console, on an Llndergrotrnd StorageTank Syslem. Serial Number # 41232526905001.T'he following items were tested individually and ftrund to be in working order:Annular Space Sensor(s): I FloatLiquid Sump Sensor(s): 3 FloatTLM Probe(s):2 MagAlarnr Sinrulation: Iligh / Lrrw, Pass'fank'fype(s): ll4,0ll Diesel, Double Wall Undergt'ound Tank & Line. Suctionli6,0l6 LTnl", Double Wall underground Tank & [,ine. SuctionComments: Panel, probe and sensors were fbund to be functioning as per manufacturesspecifications. Double wall Tanks and lines. No testing required at this timc, Manifolded tanks.No exterior alarm present. Suction system.'fhe alarm panel was tagged witlr a Dialysis Company Seal.800-227"7879805-5204858FAX 805-527-38544ltt/'lt,SIGNED BY:'I'amara Zimmerman, Owner ITenk rnd Monitor SumuerYLocationAddressPacific BeII1 qA Sul'rrr rba nSanLrt^-iGeo/Parcel SE--164 ,--q\IT.NNA ATTTsnk #?n?n /2n'"'lTaDkPcrnit#-not nof-cd hy. taoh6,000 unleaded 2L52 37 .17 37 '6rank size:-,iifOUproau.Ljjir-u.rrpel lcvet @,tttjili-sa. 6g - ia-Iaonitor 70 ' 0 stickExpirationInrpoctlon RccordUudcrSround Stonge TenkAgencyrequiring Certifi cation ;San T.orr i s Olri sno Hea 1 thAgencysignsturc: .,N/A required to bc onf'\ORequiredTesting: Tenk no AnDual .Annrully Liner: no Annual Annua[yTcsting Permit Rcquired-Yes x NoTest Type: N/ATestTest Performed By:Soa l'rclTest Results:PhoncTestedPass/ Failarecru i redaf. th'i s t-ime. ---ifa1,{a,jl t-=nlrMonitorirySyrtemVocdcr RootAgency RequiringAgencyRequired Testing: xx Annual S€Dd'AnnttalTesting Pernit Requircd: Ycs x - NoTestTy!e: AnnUa1 moni tor cerf.i fi oat.i.on-.Test Date:o-1 1 -qTest Performd By; ComPanYDiaIsis ComnyContact:James or TrammermanPbone:TestedPass / Fail800 227-7879Test Rcsuls:passModel: TLS-350 ,, _ ..to be on site?_slJD-Annually.T:ma7{ nnarnrnserial No,: 4t232526905001Date of next test t 9-97 805-78 1 -5544Facility NFacility Addt^ (''ICOUf\I Y OF SAN LUIS OBISPO HEALTH DEPARIMENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406Routine lnspectionReinspection No.Complaint lnvestigationHAZARDOUS MATERIAL/U N DERG RO U N D STORAGE TAN K/WASTE GEN E RATORINSPE TION REPORT/NOTICE OF VIOLATION5E-\Flato'< -Ll - 4i aContact1\^DTitle/PositionqHAZARDOUS MATERIALS#H&S Code, Div. 20,BUSINESS I.D. FORM3. Location of utilitiesINVENTORY4. Hazardous material &amounts listedMaterial stored in proper containers& labeled6. lncombles not storedhercontainmentPLAN8. Plotitted9.streets &10. Location of hazardousmaterials11. Firesource12shut-off switches13. Location & verilication of MDS14.storm drains15.chns rnEMRESPONSE PLAN1718.uate evacuationemTRAINING PROCEDURESThe above marked itemsUNDERGROUND STORAGE TANKS(coMP # )(CA H&S Code, Div. 20,ATL. # GENERALTANKUREWASTE GENRS COMPViol2.5.719.resviolations of the California Health & Safety Code and the California Code of37.containment36. Fire extinquishers35. Storaqe - 90 days34. lncompatibles not stored together33.Material stored in proper containers& labeled32. Continqencv plan31. Traininq program/reco30. Waste oil receipt29. Manifestsr/AVariances and/or exemPtions28.27. EPA identification numberc) Soil samples takenb) Tanks rinsedTankslr26. Removal/in Place abandonment25. Temporary closureL./24. Permit23. Leak detectors22. Precision tank testAIAne numberemr,A21. lnventory reconciliationComplViol20. Permit to operateComplRegulations and must be coCOMMElnspector's SignOwner/Operator SignatNOTE: Signature indicatesof this document only and not anof the facts.Page- of- ((SAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF ENVIRONMENTAL HEALTH2156 Sierra Way o P.O. Box 1489 o San Luis Obispo, California 93406TELEPHONE (805) 78i-5544 o FAX (805) 781-42rrMay 2, 1996Mr. Bill KennanFacility Engineer2600 Camino Ramon, Ste.San Ramon, CaliforniaRE: Groundwater Samp1e Results Associated with Underground StoragreTank Removal, iacific BeIl, L95 Suburban street, san Luisobispo, CaliforniaUpon review of the analytical results of a ground-water samplecbllectea from the above-mentioned property, this office hasdetermined that no further action is required and that themonitoring well maY be abandoned.please be advised that this letter does not relieve you of aly;;;;;;"ibilities mandated by the California Heal-th & Safetv code ifadd.itional or previously uniaentified contamination is discoveredat the subject site.Should you have any questions regarding this matter, please contactthe nazbrdous Materials Division at (805)781--5555.LN20094583CHARLES K. TENBORG M,S.,.E.H.S, R.E.A.Senior Environmental Health SpecialistKA DEPARTMENT OF THE SAN LUIS OBISPO COUNTY HEALTH AGENCY SAN LUIS OBISPO COUNTY HEALTH DEPARTMENTDIVISION OF ENVIRONMENTAL HEALTH2156 Sierra Way o P.O. Box 1489 O San Luis Obispo, California 934OoTEIEPHONE (805) 78T-55M O FAX (805) 781-42TTMarch 29, L996Mr. Torn ChilcoteFacility Engineer2600 Camino Ramon, RttlSan Ranon, California3E2OOJJ94583RE: Groundwater Sample Resul-ts Associated with Underground StoragreTank Rernoval, Pacific BeII, !95 Suburban Street, San Luisobispo, CaI j-f orniaUpon review of the analytical results of a ground-water samplecollected from the above-mentioned property, this office hasdetermined that no further action is required and that themonitoring well maY be abandoned.Please be advised that this letter does not relieve you of anyresponsibilities mandated by the California Health & Safety Code ifadditional or previously unidentified contamination is discoveredat the subject site.Should you have any questions regarding this matter, please contactthe Hazardous Materials Division at (805)781-5555.o/,eCHARLES K.Senior EnvH.S, R.E.ASpecialistA DEPARTMENT OF THE SAN LUIS OBISPO COUNTY HEALTH AGENCY t-AifE@ Associoles, lnc.2151 Alessandro Drive, Suite 200Ventura, California 93001(805) 641-6555, FAX (805) 641-6560February 15,1996Mr. Charles TenborgSan Luis Obispo County Health AgencyDivision of Environmental HealthP.O. Box 14892156 Sierra WaySan Luis Obispo, California 93406RE: GROI]NDWATER MONITORING REPORTSEPTEMBER 1995PACIFIC BELL, 196 SUBURBAN STREETSAN LUIS OBISPO' CaliforniaATEC Project No. 45-07-95-00073Dear Mr. TenborgATEC Environmental Consultants (ATEC) works under contract with Pacific Bell to perfonnenvironmental services associated with the Pacific Bell facility located at 196 Suburban Street,San Luis Obispo, California. Enclosed is a report of findings for groundwater monitoringperformed by ATEC in September of 1995.On March 23,1995 one 10,000-ga11on gasoline UST was excavated and removed from the site.During this procedure a small arnount of gasoline was released into tlie groundwater within theexcavation. The release of gasoline was mitigated at that time by using vacuum trucks toremove water and product frorn the excavation. In compliance with San Luis Obispo CountyHealth Department (SLOCHD) recommendations, one groundwater well was installed in thegasoline UST excavation during backfill procedures. The SLOCHD stipulated that this well besampled six months following removal of the UST in order to determine if detectableconcentrations were still present in the groundwater.One groundwater well on site was rnonitored, sampled, and tested for total petroleumhydrocarbons - gasoline (TPH-G) and it volatile constituents. TPH-G was found in thegroundwater sample at a concentratiorts of 600 parts per billion by gas chromatograph analysis.Interpretation of the chrornatograph peaks observed by the laboratory indicated that they do notAmerican Testing and Engineering CorporationOffices in Maior U.S. Cities/Since 1958Consulting Environmental, Geotechnical andMaterials Engineers tMr. Torn ChilcotePacific Bell - San Luis ObisPoATEC Project No. 45-07-95-00073Page2, February 15' 1995fall within a range associated with a standard gasoline profile. This result suggests thatinterference from petroleum hydrocarbon compounds other than gasoline is responsible for thechromatograph Peaks.The SLOCHD indicated that the site, which is situated between Suburban Street and Tank FarmRoad, has a regional groundwater problem associated with off site leaking tanks. Thiscontamination from off site sources appears to be responsible for the peaks observed in theanalysis of the groundwater sample. Based on this, ATEC is recommending that the USTremoval site receive regulatory closure and that the rnonitoring well be abandoned.If you have any questions regarding this project, please contact Mr. David Oliver at (916) 878-6001.SincerelyATEC ENVIRONMENTAL CONSULTANTS*il,uefhafi.,qDavid W. OliverProject GeologistNorthern California RegionEnclosureC. Orlando,RDistrict ManagerIrene Soto, Pacific BellTorn Chilcote, Pacific Bell95073-02.rpt(do-1 8)ATE@\r*nA., C.P.G.iir.45i5 ?IEnvironmental Managf lnt2600 Camino RamonRoom 2E150San Ramon, CA 94583f"' PAcrFrclXlBELL "A Pacific Telesis Companytgr-i', IFebruary 24, 1995i,:. ii? s-r'1r,i lpyngntal FieatlCounty of San Luis ObispoJerry Le MoineHazardous Materials Coo rdi natorEnvironmental HealthP. O. Box 1489San Luis Obispo, CA 93406Jerry Le Moine:Attached is the annual State of California Water Resources Control BoardCertification of Financial Responsibility form which I have completed alongwith a copy of the Chief Financial Officer Letter. Also included is a list ofPacific Beit sites that have underground storage tanks on the premises withinyour county.lf you have any questions please give call me on 916-972-4229.qih /Y?il;u^Kim MelvilleEnvironmental Management Statc of CalificrniaStatc Water Rcsources Control BoardCERTIFIGATION OFFINANQ-|AL RESPONSIBILITYA. tr-rcquircdao d€6oostnt€ FiaeacirlRcspoosibility io rtcrcquircd ruouatr rtrpccificd io&aioo 2E{17. Cteptcr18. Div. 3. Tirlc 23. CClt:500.000 dollars pcr occurrcaocI oillion dollerseoouet rtt.ctttcffil t -iuioo oli"., *, *,,"o*ANDB.olXVl z -iuioo aotl'., .oou.r .rtrcrrrclnrebycertiliesAfi ft b in comptiarce withtle requkemen9of Wion2AOZArticle 3, Chapter18, Division g. Tiile 23,Calilornh @de of Regulatiors.The mechanisnstis,ed todemonstEtefrtptpialasfution 2SOTate asfollor*s:rcsca,a(htud Tirlc of Tut Ocd6 aOpqndO*[qaOpqrtd6f,hr.SignerunNmcPACIFIC BEI,LFdtitl&EGlnalltnalsoandsubmissbnyourexeattlonresprcibiliry,ftmrchlofyourdenotts/rratbnanyofpartasFuttdtl7FSlalearetsingt'oulfNote:YESRenewedAnnuallyt6,950,000.Not applicable for StateAlternadve Mectranism'Facific BellEnvironmenhl l\{anagernent2600 Camino Rarnon-Room 28t50San Ramon, CA 94Sg3Chief FinancialOffrccr t,eaer(auached)cFR(0.{/e2)Ffr F Oriioet - tel AtacyCopi6 - Friliryrsiiqr) riitPORT DATE: 02l 23/95LUST/ISTA}.IK TISTING REPORTPAGE: 3TTANK ADDRESSCLLCGEOPAR COUNIYPRODUCT225 \O5r NSTTITOI{ ROADsTocKToN, cA805 907 LTNCOLIT RD.sToclfroN, cA805 r5\b n. ASHLEY RoADsTocKToN, cA80? REDwooD & 5trr stREETssTocKToN, cA8oB tllr3 BouRBoN STREETsTocItToN, cAto52 g\5 N. SAN JOAQUTNsTocIlEON, CA1102 1I+13 BOI.IRBON SIREETsTocKToN, cA809 10 E. 12rH STREETTRACY, CA11_03 10 E. 12TH SIA"EETTRACY, CA811 225 N. HArcvoN RoADARRoYo GRA}IDE, CA82\ 5zzo erescaDgRo AVENUEATA^SCADERO, CA823 133 SA}I MFAEL STREETAVILA BEACE, CA810 tYNcH CAIIYON RoADBRADIEY, CA82t 55 13srr ssnEHrcAwcos, ca8zz 2053 lorrl STREETLOS OSOS, CA820 788 MArN SIREETMORRoI{ BAY, CASKTNCA16 I]ER\? SAI{ JOAQUINUNLEADEDsKTNCAr.l UE-0\5 SAl{ JoAQUTNDIESELlSKTNCA12 UE123 SAN JOAQUINDIESELlSKTNCAI\ lJE-1\8 SAN JOAQUINDIESELlsKTlrcA?3 rJE-59h SAN JoAQUINDIESEtlSKTNCAO1 rJE-0\2 SAI{ JoAQUTNDIESELlSKTNCAT3 UE59\ SA![ JoAQUTNDIESELlTRACCA11 UE-058 SAI'I JoAQUINDIESELlIRACCA11 U8058 SAI,I JoAQUTNDIESEtlaRGRCAL2 SE-253 SAII tuIS oBrSPoDIESELlATSCCAI]. SE-OO5 SA}I IUIS OBISPODIESELlAVBHCA1]. SE-162 SAI{ tuIS OBISPODIESELlBRDLCA12 SE-150 SAN tuIS OBISPODIESELlCYCSCA11 SE-025 SAI.I LUIS OBISPODIESEtlBYPKCA11 SE-161 SAII tWS OBISPODIESEtlI'IRBACA11 SE-050 SAt{ tUrS oBrSPoDIESELlPSRBCA51 SE525 SAI{ LuIS oBISPo58 908 28sH STREETPASo ROBIES, CAPROPRIETARY INFORMATION : Not for use or disclosureoutside Pacific BelI except under written agreementDIESEL2 REPoRT DATE: 02/23/95LUST/ISrANK LISTING REPORTPAGE: 38TA].IK ADDRESScLtcCEOPAR COTNIIYPRODUCT59 908 281H SI]REETPASO ROBLES, CAto32 730 15ffi STREETPASO ROBLES, CA55 195 suBrrRBANsAlI tuIS oBISPO, CA61 195 SUBIJRBAI,IsAlI LUrS OBTSPO, CA68 195 suBrrRBAl{sAN tuIS OBTSPO, CA81.7 872 MoRRoI{ STREETsAlI LUrS OBISPO, CA818 872 MoRRow STREETsAl{ Lurs oBrsPo, cA92 1l+80 BURLTNGAI,IE AVEBT,RLINGAIiIE, CAro\ 525 rGLrY AvE.IIAIF MOON BAY, CA100 2950 SAI{DHILL ROADIIIENIO PARK, CA93 10 MAGNOTIA AVEMILLBRAE, CA1083 325 RErNA DEr MARPACTFTCA, CA9L 112L JEFFERSON AttEREDWoOD CITY, CA9\ 1101 SA}I MATEO A\TEsal{ BRIINO, CA102 8l{0 I{.SA}I BRUNO AVE.sAlI BRI'NO, CAPSRBCA51 SE525sAl{ tus oBIsPoUNTEADEDPSRBCAO]. SE-067 SAI{ LUIS OBISPODIESELl-SNLOCMU STT5\ SAl{ LMS OBISPOT]NtEADEDSNLOCAAU STT5\ SAI{ LUIS OBISPOUNTEADEDSNTOCAAU SE15\ SAN LUIS OBISPODIESEL2sNtocAol sE-09\ SAI.I IUIS OBTSPOsN[ocAo1 su-09\ sAl'I turs oBrsPoBRINCA01 pSOO5 SAI'I l,tAlEODIESEL]-HMBACA12 PCO83 SAN MATEODIESEL1MNPKCA11 P3071 SAI{ l,tAI5ODIESEL1MLBRCA1]. P2OO3 SAI{ MATEODIESEL1PCFCCA11 P2-019 SAI{ I{ATEoDIESEtlRDcYcAol P3055 sAl{ MATEoDIESEL1SNBUCA02 P2011 SAN I'{ATEODIESEL1SNBUCA5o n\059 SAII MATEODIESEtlDIESEL1101 537 LAT'REI STREETsAlI caRtos, cAsNcRcAll P3057 SAI{ MATEo25 e5Z UeSr 19rrr A\rEsAl{ MAISO, CAsNMrcA5o P355\ sAl{ MArEoPROPRIETARY IIIFORMATION : Not for use or diselosureoutside Pacifie BeII except under written agreementITNTEIDED PAcrFrcl]lBELL.A Pacific Telesis CompanyJanuary 24, 1995State Water Resources Control BoardDivision of Clean Water ProgramsUnderground Storage Tank Cleanup Fund2014T Street, Suite 130Sacramento, CA 95814Re: Financial Test of Self-Insurance (Underground Tanks)I am the Chief Financial Officer of Pacific Bell,2600 Camino Ramon, Room 4CN100,San Ramon, California,94583. This letter is in support of the use of the financial test ofself-insurance to demonstrate financial responsibility for taking corrective action and/orcompensating third parties for bodily injury and property damage caused by sudden accidentalreleases and/or non-sudden accidental releases in the amount of at least trvo million dollarsannual aggregate arising from operating underground storage tanks.Underground storage tanls at Pacific Bell facilities are assured by this financial test or afinancial test under an authorized State program by this owner or operator.A financial test is also used by this owner or operator to demonstrate evidence of financialrbsponsibility in the following amounts under other EPA regulations or State programsauthorized by EPA under 40 CFR Parts 271 and 145:Corrective Action.$3,700,000...-.$150,000.Plugging and AbandonmentTotalThis owner or operator has not received an adverse opinion, a disclaimer of opinion, or a"going concern" qualification from an independent auditor on his financial statements for thelatest completed tiscal year-Alternative I (Source: Form 10K, December 31, 1992)1- Amount of annual UST aggregate coverage being assured by atinancial test, and/or guarantee.$2,000,000. .-2. Amount of corrL-"rve action, closure and post-closure care costs,liability coverage, and plugging and abandonment costs coveredby a financial test, and/or guarantee....................$16,950,000.3. Sum of lines I and 2 ............$ 19,g50,0004. Total tangible assets$19,379,000,000.5. Total liabilities (if any of rhe amount reported on rine 3 is includedin total liabilities, you may deduct that amount from this line andadd that amounr to line 6).............. .$13,224,000,000.6. Tangible net worth (line 4 minus line 5)....... ....$6,154,000,000.7. Is line 6 at least $10 million?................ ..............yes8. Is line 6 at least 10 times line 3?....... ..yes9. Have financial statements for the latest fiscal year been filed with theSecurities and Exchange Commission? .............yes10. Have financial statements for the latest fiscal year been filed with theEnergy Information Administration?....-.N/A11. Have financial statements for the latest fiscal year been filed with theRural Electrification Adininistration?........,......:....... ............N/AL2. Has financial information been provided to Dun and Bradstreet and hasDun and Bradstreet provided a financial strength rating of a 4A or 5A?(answer "Yes" only if both criteria have been met) ...........yeslh"*Uy gertify that the wording of this letter is identical to the wording specified in 40 CFRPart 280.95 (d) as such regulations were constituted on the date showi ihmediately below.4Peter A. DarbeeChief Financial OfficerPacitic BellDate Januarv 24- 19952 Joh n l"lc5.? o.rrdr eo,5 I s37S94s2P-61A!IPROTANK. INC.35+5 Lomlta Boulevard' Suite GTorrance, CA 90805Sender's Telephone:t31Ol 891-0470 Faesimlle:FAq$Ml[E CO\tEn SffEEr{3ito[ 891-0474DATE: O5/O5/95TO:FROMJohn tvtaetandreaPROTANK, INC.3545 Lornita Blvd, Suite GTorrancei cA 90505FAX #: 805-781-421:lTotal number o{ pages including cover sheet: 7This messsge is intended only lor the use ol the individual or entily ta which it ic addressed, a1d rnaT cootaininformation that is privileoed, conf idential and ex€rnpt from diselosure under applicable lew' lt !h! reader of tltis messGgeis not th€ inter}ded recipiim. or the omployee or agi€nt responsible lbr delivering ttte messagqfg the intended 1e6ipiem,you are hereby notiti€d that any dissomination, dinribution or cogying of this cornmunkatlon fs $trlctly prohibited" llyou have recsived this communication in €rygr. pleaso notify us immediately by telephone, lond return the originalmessa0e to us at the above address via lhe U.S. Postal ssrvice. Thank'you' lIt you do not receave the corrcct number of pages or there is sorne other ptoblem ln theDaisy Mosby, at (8OOl 438-111 1 or {31O} 891-O47O.please call me,COMMEfIITS:ENCLOSED PLEASE FIND THE TEST REPORT FOR THE PAqIFIC BEtLSUBURBAN STREET, SAN LUIS OBISPO .'Mr. Charles TenbergEnvironmsntal Division Joh n l"lqse ondr eo'E 1 E3?S9482P-A2ffucThe& !-ineTesting €o.April 25, 1995tvlr. JerrY LeavittA. €. Schmldt Envlronmentalt6509 Saticoy St-Van Nuys, CA 91406Dear Mr. Leavitt:Enclosed you wilt find two copies of the tank test report for the Pacific,Bell Facility locatedat 1196 Suburban Straet, San Luis Obispo, CA'I have snclosed two copies of the foliowing:1l2l3)4tA summary test certilicate'Tank te$t $ummary'Line test summarylnvoice.nn*{3vPlease contact me if you need addnional information or have any guestions'Sincerely.(',t 6'2Daisy E. MosbyVice Prosident of OPerationsEnclosures (As StatedlP13;ifrinlS* 3S4gromita Bdrttsard.!ui(eG.TortatKe.CAg0tOS'tll0l89l{{t0'18001 43S'llll ' FarlSl0l 8?l{l7rt Joh n l{ost crndr eo. 3145?e94e2CGf,TIFICATE/'--: TESTI]I6 UfTDEFGFOUITD ETOFAGgIATTF'SYSTETH-----t (ksTanlr, lnc.gS45 Lomita Elvd", Strite GTonanca, Gollfornh 0O5Ost3r0l891-O4?OP- 63CfieM:$te:Pac Seti Facilltyrt!t6 Sr*iiOan StrsetSan Lrir Olfspo, CAthc tollowlng tnslr woto co$ducted .t thc slt6 do*cribsd abovo in .ccord.nc. wirh all fpprloablo ponlone of Fa{ot6:.lr stett, and Loc.l lcCVlarlons'ProTurk; krc. apprcclatcr $r oppofiunlty to 3s.ve you, and ws look lorward to wg.klng wm you fr ftfafututq. Plqa*e crll any tim!. dayor tsgftt, wfrcn'you n€od ur. :RnTrnft, lm. Curftpmcr llervrke fisprcucnHiYe:Odry E.to$yTerring Gonfircud.by:A. E- Sch[nfdt EnvironmcntdlG509$aticoy $t.Van lhryr, CA 9f406a1*7A2.a797*ALY: DtrSc98073"69CUrln.EADEo0rGrDtrG23Ei?6t90DEISEI..{tr r2Tvpr$il!,[v+trnreoYtyStrea IY_ilq'FGorryh*dedltrygd!t?Td, IG*.rtf,..|PrutucfLrrdItlf,dr*rdOimrtrhhcbcfi!6rcrTrl3C?lritlhG{m.rdlkdrTAltrsrsrEil nFoilATlo{lrlrAflot*issPASSPASSPASS4.o1024zGgEil,Ail{tfns$FAS,$PngSPAS$+.0i2;II0+e$o5RedJ.tlrrl.o*DG.ai93ndtl.PanlfflMJeffilrltDstlciorfirrrefY-JbY]lr tln sgrd/av*q lircrhtrrffrrlltTItnat/F-W.llldfurdoad Tsr,brlFilYPITl...*Rrlr{FhtTr*ftlr5rTEthrTCSTfiE BE$'LTSF|oT-rlL ho. - 3E15 lnilhr ntd.. $ft (l - Torrno. Cjtuntr 3O!lt)S -(3rol{9r{ruo'I Joh n lnt{rsi qndr eq5 1 S3?9944?P. B4Tesr $ite; PAG BELI. 11!16 q'nrnnnn $TREE;, sAtl LUls ogsPrto4-!6'95tPO# Vsrbil fmarlontFASSPA€SPrelrdl+,010+.Q22Lqol lctc l8?lll:Tret dsratioil llv:mnl:2:512:tGMOilffOF WEttMONITOR WEL!|lgrr detennlned:DepJh ot gramdwetcr lhchcr bdow tenkl:'t2725llufbsr thermirtorr:u{DERFn"t, T€SIIJ'{DERFILL TEST0uorl![ or Undedill Tart:-.o4-.08f,atr ol ttrtBtrdurs efrangt loF/Hourl:.000638Thormal ctafiicient of upanrion loFl:Spedtic Gravlry:73Waror in tonk Fndrsl:00F€rcsrtrgo of copGcitr lilled (961:..:i..7576fb&l Vdumr lsddrl:49802952fhH leycl (indterl:73.566Fill pipe diamstor {ineherl:4flll PlFo ls1gth llnche$l:3333128.5{ineilrorl;Tglh Fpttorn ro lill top120.5Tark aofiorr ro grde {inctorl::t3?137Turk Disrroter lindrorf:969680rnot6 Flll3ltrtof{oMmilddod Piplng:doiloTrnkr:roiloTruc Capacity lgtorsr:6015401 1Proftrsl:UtILfADEDDIESELI{wnbr:'lTcl Ho:o{#r8'9Eo+f20,!t$TGtdrd llrd: IIDEYPLTADATATAilTPioTr*" frc. - t5a5 lomlt Ahrd., adr. G - Torrrrc. Cdtorrdr 9OltOE,- tSIOt gpl-O47o PAS$'ASShrrFt.o43.o19volumr. chrngo lGPttl:40t8Vdumo chrngs (ndl:354AFniqh kcrurc (prlf:t5l5Tart Timr hlnl:50Trrt Prrrrurr {9rll:2Lfr,rg Dlamotc? 0nl:DW FIEXDW FLEXLino llaterid:iloilolrolator:TOKEIMTOKEIMPpmp lllthe:SUCTIONsucT.oNPurF tfpo:DIESELUIILEADE9Product:ITant l{umbrr:off2Gr96o.rfit6E5Tcr Dfc:ljrr.TglldtodllrcG Foln Tttt3.rta [l, Vc$an l.OtNE T€STOATAJeh n l"l(rst clndr e*r5 1 &57S9462P. 85-rTest Site: pAG AELL. 1196 SUbJRBAN STRE€T, $Alrl LUIS O8lSPd ,O4t25/951 1lO# Verbal lMarlonlTutlFd,zSrdd llumbsr:lirh Octoctor Model:.ltiafirfrcturcr:P.odlct:Tsrk 9rg:Tat* tlumbry:Trrtflfd,ud ued: Ecd &d.tAltoFoTsrl. hc, - 35tr5 Lonirr thrd., suitr G - Tonmcc, Giltonde tx!5o5 - t3to, ggtJ+zo Je.h n !'tctst o,ndr ecr5 1 957494€2P. E6Test tiilte: pAc BELr, 1195 ${"arnBAII STREET, SAt{ IUIS OBSPr=O{-es9s' PO# Vertel (ilarlonlnASSPASSf,rccrFdFinal llitrogen tlow lcf,tl:Firdrh timc - t*t 3:Ullagn Trmparaturc l-Fl:Mtr,ogon llow lcfrrl:Starttlms-ffi3:oFtild f{itrogfir flotlu [cfltt:1,4461425Fhsh ilms - te't2:e8.309.5Ullagr Tonpordurs l'Fl:-2llltrogen llow lcfltl:r4t5t4058tel,$nro - tafi 2:.zflod.slltrogcn flow {cftl:r855'r355Flill& ihe - to*t l:68.369.5Unrgrc Tomporaturc ('Fl;.2Itlitrogelt llorr (cllrlr1355r345Et''t tlmr - lGl l:ra40l3zeTirne to trrt proarrtrolr335t320Tkne to I pS:13301316Flli rrat firnc:ro10Sttltlirttloa tlms lr*rFrt;2.02.1Ullagc teet peorrura [ptl:2.O21.92Fluld prurcuro on tcRL Donom bdl:r0501056U$agn vdtme lgldtt:ilot I60r0TrcCeprcity lgJmll:Dt€sEtUTILEADEPItrs4rct:2tI-* krnbrr:UI,.LIGETESTf,G DATAT6f Hdm.f Urcd: UT94TProTrnk. lnc. - 3546 Lomha Dlvd., guito G - Tofenco, Galifornia 9O5OS . {3101,89!.0470 Jc'h n I'logt o.ndr eo5 1 S3?S94S2P-A7Test $re: PAC BELL, 1196 Str-' nBAt STREET, SAI| LU|S OBtSPgr- 94-25-95t FO# Vofbal {Martonl6rrprirentmmrgfiYflnaltfurlngrttondmtrtfillnpilnpr. l'!d( dstsstsr. dirpenrar, rtc. conduct€dYnwhllctrubmrdblcolctvllrldWrrfully oprratlooJ ryon laeving rhr?: YulYal l@rtionWt' lock'out/tagoutprocoduro usod?: rdr 805-78 1 -5544FacilityFacilityr'"\ ( t'COUN1 Y OF SAN LUIS OBISPO HEALTH DEPAkTMENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406r.- (ContactRoutine lnspectionReinspection No.Complaint lnvestigationHAZARDOUS MATERIAL/U N DERG ROU N D STO RAGE TAN K/WASTE GEN ERATORINSPECTION REPORT/NOTICE OF VIOLATIONf; ",a'[ -'i"1,2:)Title/Position:-2.4.5.6.7.8.L1215.16.HAZARDOUS MATERIALS (21(CA H&S Code, Div. 20, ChaP.P # ptltrUNDERGROUND STORAGE TANKS (COMP # )H&S Code, Div. 20, Ch6.BUSINESS I.D. FORMATLl-1 (l QGENERALnumber3. LocationutilitiesNTORYus material & amounts listedCLOSUREMaterial stored in proper containers& labelednot storedll containmentPLOT PLANPlotansstreets &WASTERATORS COMP10. Location of hazardous materials11Fireishesourceshut-off switches13. Location & veritication of MSDS14. Sewerand/ordrainstnEMERGENCY R't7.uateresuate evacuationures19.TRAININGThe above marked items represent violations of the California Health & Safety Code and the California Code ofRegulations and must be corrected.37. Spill containmentul36. Fire extinquishers35. Storaqe - 90 days34. lncompatibles not stored togetherPONSE PLANll33. Material stored in proper containers& labeled32. Continoencv olana--31. Traininq proqram/records&-/30. Waste oil receipt29. Manifests,r./A28. Variances and/or exemptionsl*j27. EPA identitication numberL-'c) Soil samples takenb) Tanks rinseda) Tanks purqed26. Removal/in place abandohrnent--25. Temporarl*ulosur€.--.-Z. \Ferrd! approvedt-('23. Leak detectors.1.----.22. Precision tank test21. lnventory reconciliationttAu,tComplViolCompl20. Permit to operateCOMMEt..\lnspector's SignatuOwner/Operator SignatuNOTE: Signature indicatesof this document only and not an admission of the facts.Page- of- nEnvironmentalManaqement I2600 Camino Ramon. Room 2E050San Ramon. California 94583PAcrFrclX!BELL.A Pacific Telesis Companyr-NECEIVEDAUo 051904€nvironmentdlHealthIfly 28,1994County of San Luis ObispoJerryIr MoineHazardous Materials CoordinatorEnvironmentalHealthP. O. Box 1489San Luis Obispo, CA 93406Jerry Ir Moine:Attached is the annual tank test for the three tanks at 196 Suburban Road,San Luis Obispo. Pacific Bell also has a copy of the test results at the site for review.If you have any questions, please contact me on 510-867-5025.Sincerely,MelvilleEnvironmental Management CERTIFICATE OF UNDERGROUND STORAGE TANK DYSTEM TESTINGNDE ENVI RONMENTAL CORPORATION8906 WALL STREET, SUITE 306AUSTIN, TEXAS 78754(512') 719-4633FAX (512) 719-4986TEST RESULT SITE SUMMARY REPORTTEST TYPE: 'TIPIITTESTDATE: ilune 15, 1994WORK ORDER NUMBER: 913503-a-NDECLIENTATTN:PACIFIC BELIJATTNT LYIIE STUCK' BASEMEIf,II6801 AI.MADEN RDsAlI JOSE, CA 95120IrYLE STUCKSITE: PACIFIC BEI.I,195 SUBURBA}I RDSAII I.UIS OBISPO' CA 93401The following tests were conducted at the site above in accordance with all applicable portions of Federal, NFP A and local regulations.Tank TestsLine and Leak Detector TestsNDE appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us.NDE Customer Service Representative: Test conducted by:FRATIK MII,IJER DRAGON PESIC#58#55#57 S.DIESEIJI'NIJEADEDT'NI.E.ADED92.0092.0092.004, 00010,00010, 00 00.019-0.010-0.012PASSPASSPASSPASSPASSPASSDXESEITUNI.EADEDUNLEADED#58#55#57 S.NONONOReviewed:Technician Certification Number: tsst INDIVIDUAL .NK/LINLEAK DETECTOR TESi.]EPORT--NDET'N DE ENVIRONMENTAL CORPORATIONTEST DATE: ,fune 16' 1994CLIENT: PACIF'IC BEI.I.WORKORDERNUMBER: 913503SITE: PACIFIC BEI,IJ7NONEcoA:(Tank NoVent NoV/R: NoBottbm to toP f ill in inches:Bottom to grade f ill in inches:Fill pipe length in inches:Fill pipe diameter in inches:Stage I vaPor recoverY:Stage ll vapor recoverY:#58DIESEIJ{,00092.00141STEEIJTank lD:Product:Capacity in gallons:Diameter in inches:Length in inches:Material:Manifolded122.0132.030.0rt.0Test method: urs-4T sysEemTest time: 1{: oo-1rl r 3oUllage volume: 596Ullage pressure: 1.80RESULT PASSDATA FOR UTS.4T ONLY:Time ol test 1: 14:00-1{:10Temperature: 73.90Flow rate (cfh): o. zoo-Time of test 2: 14:10-14:20TemPerature; 73.80Flow rate (cfh): o-zoo-Time o{ test 3: 1t!:20-1tt:30TemPerature; 73 ' 80Flow rate (cfh): o.2oo-Test method:Psi at tank bottom:Fluid levelin inches:UFT/OFTFluid volume in gallons:Water level in inches:Test time:Number of thermisters:SPecific gravitY:Water table depth in inches:Determined by (method):Leak rate in gPh:RESULT:VPIJT2.2073.00UFT3,4040.7510:58-13:0950.84514C. CCPOINT VIEI,IJ0.019PASgNew/PasseddetectorTest method: rrnMake:Model:S/N:Open time in sec:Holding psi:ResiliencY cc:Test leak rate ml/min:Metering Psi:Calib. leak in gph:RESULTSUCTION IJINE.Failed/replaceddetectorMaterial: grEEr,Diameter (in): 1. sLength (lt): 10. oTest psi:Bleedback cc:Test time (min):Test 1: start timo:linlsh psi:vol change cc:Tesl 2: start llme:linish Psi:vol change cc:Tesl 3: start time:llnish Psi:vol chang€ cc:Finalgph:RESULTTest tyPe:Pump type: sucrroNU!{ABIJE TO TEST I,INE' TEST PORT IIiIACCESSIBI'E.Pump make: ToKEETM8906 /INDIVIDUALiLEAK DETESEPORTNDETIN DE ENVIRONMENTAL CORPORATIONTESTDATE: ihrne 15, 1994CLIENI PACITIC BEI,IJWORK ORDER NUMBER: 9 13 5 O 3SITE: PACIFIC BEIILNONONO#56STEEIJUNI,EJADEDManifoldedTank:Vent:L22.5L32.030.5{.0coA)(NONEBottom to top f ill in inches:Bottom to grade f ill in inches:Fill pipe length in inches:Fill pipe diameter in inches:Stage I vapor recoverY:Stage ll vapor recoverY:10,00092.00352Tank lD:Product:Capacity in gallons:Diameter in inches:Length in inches:Material:Test method:Psi at tank bottom:Fluid level in inches:UFT/OFTFluid volume in gallons:Water level in inches:Test time:Number ol thermisters:Specific gravitY:\{ater teble Cepth in inches:Determined by (method):Leak rate in gPh:RESULT:vPLT2.1,077.25UFIT8,9540.5010: {4-15:5950 .745140.00POINI !{EI,IJ-0.010PASgNew/PasseddetectorTest method: E'reMake:Model:S/N:Open time in sec:Holding psi:Resiliency cc:Test leak rate ml/min:Metering psi:Calib. leak in gph:RESULTSUCTION IJINE.Failed/replaceddetectorTest method: uTs-{T syssamTest time: ld:30'17:00Ullage volume: 1, 036Ullage pressure: 1.90RESULT PASSDATA FOR UTS-4T ONLY:Time of test 1: 15:30-16: {0Temperature: 73.20Flow rate (cfh): o. zoo-Time of test 2: 15:40-16:50TemPerature: 73 -20Flow rate (clh): 0.200-Time of test 3: 16:50-17:00TemPerature: 73 ' 10Flow rate (clh): o.20o-Material: srEgrrDiameter (in): 1. 5Length (ft): 10. oTest psi:Bleedback cc:Test time (min):Test 1: start time:linish psi:vol change cc:Test 2: slart time:llnish Psl:vol change cc:Test 3: start lime:linish psi:vol change cc:Final gph:RESULTTest tYPe:Pump type: sucrroNITNABLE TO TEST LINE, TEST PORr IIdACCESSIBLE'Pump make: ToKaErMWALLTEXAS INDIVIDUALEAK DETECTOTlEPoRr NDENDE ENVIRONMENTAL CORPORATIONttTEST DATE: ,fune 15, 1994CLIENT: PACIFIC BELIJWORKORDERNUMBER: 913603SITE: PACII.XC BEIJL1Tank lD:Product:Capacity in gallons:Diameter in inches:Length in inches:Material:Tank:Manifolded Vent:V/R:120. 5130.028.54.0coA)tNO![EBottom to top f ill in inches:Bottom to grade f ill in inches:Fill pipe length in inches:Fill pipe diameter in inches:Stage I vapor recovery:Stage ll vapor recovery:#57 S.I'NLEADED10,00092.00352STEELNONOTest method:Psi at tank bottom:Fluid level in inches:UFT/OFTFluid volume in gallons:Water level in inches:Test time:Number of thermisters:Specilic gravitY:Water table depth in inches;Determined by (method):Leak rate in gph:RESULTVPIJT2.2080.00UFlT9,2321. 0010:55-15:1550.745140.00POINT $IEI,IJ-0.012PtssNew/PasseddetectorTest method: rreMake:Model:S/N:Open time in sec:Holding psi:Resiliency cc:Test leak raie ml/min:Metering psi:Calib. leak in gph:RESULT:SUCTION IJINE.Failed/replaceddetectorTest method: urs-{T sysr€mTest time: 15:30-17: 0oUllage volume: 768Ullage pressure: 1. 80RESULT PASSDATA FOR UTS.4T ONLY:Time ol test 1: 15:30-16:40Temperaturei 7 4.7 0Flow rate (cfh): o.2oo-Time of test 2: 15:40-15:50Temperature: 74-70Flow rate (cfh): 0.200-Time of test 3: 15:50-17: 00TemPerature'. 74.50Flow rate (cfh): o.2oo-Material:Diameter (in):Length (ft):Test psi:Bleedback cc:Test time (min):Tost 1: start timo:linlsh psl:vol change cc:Test 2: starl time:linlsh psi:vol change cc:Test 3: start time:I'NABIJE TO TEST IJINE, TEST PORT IIiIACCESSIBI,E'Pump make: ToKtsErMgTEEIJ1.510.0linlsh psl:vol change cc:Final gph:RESULTTest type:Pumptype: sucrroN8906 WALL71 NDE ENVIRON MENTAL CORPORATION8906 WALL STREE, SUITE 306AUSTIN, TEXAS 78754(512]' 7 1 9-4633FAX (512) 719-4986NDE,tTESTDATE: ihrne 15, 1994CLIENT: PACIFIC BELLWORK ORDER NUMBER: 913603SITE: PACIFIC BEI,I,COMMENTSPARTS REPLACEDHELTUM PINPOINT TEST RESULTS (lF APPLICABLE)1ADAPTOR-AIi'M. CON(. OPW 4X SITE DIAGRAMN DE ENVIRONMENTAL CORPORATION8906 WALL STREET, SUITE 306AUSTIN, TEXAS 78754(512) 719-4633FAX (512) 719-4986-NDEttTESTDATE: .Iune l-6, L994cLIENT: PACIFIC BELLWORK ORDER NUMBER: 913603SITE: PACIFIC BELLSUBURBAN RD.# 68 DSL,NT (TYP.@e66 UNL.# 67 UNL. S.PACIFIC BELL196 SUBURBAN RD.SAN LUIS OBISPO CA. 93401w.o, # 9136036-16-94 @cND z'23-(3'CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTINGTestDats 16 ilul 1993NDE ENVIRONMENTAL CORPORATION2fiXX) Mariner Avenue, Suite 5lX)Torrance, California 90503Qfi) sa-4v2Work Order# z 96t267Site,.)qrbCIi-ent:Attn:PACIFIC BEI,I,6801 ALMADEN RD.sAlil irosELYI,E STUCKPACIFIC BEI,I,196 SUBURBAI{SAM,UIS OBISCACA95120The following tcsts were conducted at the site described above in accordance with all applicable portions of Federal, NFPA, and Local regulations.TANK SYSTEM INFORMATIONNONOSTEEL7 4.O0DIESEL924, 0003YEScoAxSTEEL65 .00ttNLEADED9210, 0002YEScoAxSTEEL74 .00I.'NLEADED9210, 0001Stagre IIStage fTankMaterialProductLevelInchesProductTankDlamet,erInchesTankCapacityGallonsTankNo.Vapor RecoveryTESTING RESULTSNOPASSPASSPASSPASS-0.0033NOPASSPASSPASSPASSU. UJ!T2NOPASSPASSPASSPASS-0.0101LeakDetectorResultsPass/Fai1LeakDetectorPresent?Yes,/noProductLinesPass/FailVent &VaporLinesPass/Fai1UllageTestPass/Fai1Wett.edPorti-onof TankPass/failVPLTVolumeChange(sph)TankNo.NDE appreciatcs the opporurnity to serve you, and lmks forward to working with you in the futrre. Please call any time, day or night, when you need us.NDE Customer Service Representative Testing conducted byF. MII,I,ERM. SHAWTechnician eertification no. :3 010Reviewed by:Alicea Test Date: 15 ilul 1993TANK TESTING DATANDE Volumetric Tank Tcs Method : YPLT-A SystemNDE Environmental Corporation - 20000 Mariner Avenue Stc 500 - Torran@, CA. 90503 - Ql0) 542-4342Work Order#: 96L267PASSPASSPASSPass/FaiI:-0.0030.034-0.010Leak Rate (GPH) :-0.002-0,0040.002Total fluid levelchange (inches):-0.0280.0620.039Total temperaturechange (degrees F):C9;05ttz42'lO.rO],2r29nn.?EtLz52Test, start time:Test f inish ti-me:WELLWELLWELLHow determined:13 0+13 0+13 0+Ground Water level-in555No. thermistor:UFTUFTUFTOFT/UFT:STEEI,STEEI,STEEI,Tank Construct,ion:0.850o.7200.720Specific Gravity:000wat,er in tank-in:3 ,4487 ,5529,620Fl-uid Volume-gaI:7 4.OO55.0074.00Fluid Level-in:444FlII pipe diameter-in92!42140140Tank di-ameter-in:Tank Bottomto top of grade-in:9292323030FilI pipe length-in1341-32L32Tank Bottomto t,op of fill-in:NONONOMani-folded VentsNONONOManifolded tanks:4,00010, 00010, 000True CapacitY-gal:DIESEIJIINIJEADEDTTNI,EADEDProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1Page I PASSPASSPASSPass/rai1:0.000.100.00Nitrogen Flow (cfh):13:05L3 r27L2245Fini-sh time - t,est 3:75.075.375.8Ul1age temperature-F:o.200.200.20Nitrogen flow (cfh):L2:55I.':I/L2:35Start, limetest ?z0.000.100.10Nitrogen flow (cfh):12:5513 :1712t35Finish time - test, 2z7 4.975.275.7U11age t,emperature:o.20o.20o.20Nitrogen flow (cfh):12:4513 :0712 r,25Start t.imetest 2t0.100.150.10Nitrogen flow (cfh):t2t4513 :0712t25Finish time - test, 1:7 4.875.175.6Ul1age temperature-Fo.200.200.20Ni-trogen flow (cfh) :!2235t2:57t2tL5Start, timetest, 1:132Time to test, pressure:142Time to 1 PSI:L2220L2z4012:00Fi1I start time:101010Stabilization time:2.802.402.20Ullage test pressure:2.2t1.59L.92Fluid pressureon tank bottom(Psi) :5522,4481,380U1lage volume-gal:4, ooo10, 00010, 000True Capacity-gal:DIESEI,TJNI,EADEDI'NI,EADEDProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1Test Date: 15 ilul 1993ULLAGE TEST COMMENTS:Work Order#: 96t267ULLAGE TESTING DATAlUllage test method: UTS - 4T Non-VolumetricNOTE: [2consecltivetest @ < 0.2T5constiurteaPASS ] [3 consecutivetest @ > 0.275 constiileaFAIL]NDE Environmental Corporation - 20000 Mariner Avenue Ste 500 - Torrance, CA. 90503 'Ql0) 5424342Ptge 2 TcstDate: 15 iIuI 1993Work Order#: 96t267LINE TEST DATAPASSPASSPASSpass,/Faj-1:0.0000.0050.003Volume change-GPH:000Vol Change (cc):151515Finish PSI:13 :4513 :10t2230Time (3 ) :040Vol Change (cc):15T415Finish PSI:13:3513 :00t2t20Time (21 z055VoI Change (cc):15t4I4Finish PSI:L3 22512:50L2ztOTime (1) :13 :15t224012:00Test start time:203020Bleed Back (cc):15I515Test pressurelPsi)151.51.5Line Diameter (in) :323030Line Length (ft):STEEI,STEETSTEELLine Material:AIR EI,MAIR EI,MAIR ELMIsolator:TOKHEIMTOKHEIMTOKIIEIMPump Make:SUCTIONSUCTIONSUCTIONPump type:DIESEI,ttNLEADEDITNI,EADEDProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1LINE TEST COMMENTS:Lire Test Method: PTK-EE VolumetricNDE Environmcntal Corporation - 20000 Marher Avcnue Ste 500 - Torrance, CA. 90503 - QIO) 5424342Pagc 3 TcstDate: 15 ilul 1993Work Order#: 96]-267LEAK DETECTOR DATAPass/Fai1:Detected Leak (Y/N):Metering PSI:Leak Rate - GPH:Leak calibration-cc:Resiliencycc:Element holding-Psi:Open timesec:Leak detectorserial number:Leak detector model:Leak Detectorrnanuf acturer:DIESEL,T'NLEADEDT'NLEADEDProduct,:321Serial number:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1TAILED LEAK DETECTORSpass,/Fai1:Leak Rate - GPH:Leak detectorserial number:Leak detector model:Leak Detectormanufacturer:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1LEAK DETECTOR TEST COMMENTS:Lcak Detcaor tcst method: Field Tc.* Appam[tsNDE Environmental Corporation - 20000 Mariner Avenue Stc 500 - Torrancc, CA. 90503 ' QIO) 542-4342Page 4 \\TestDate: 15 dlul 1993Work Order#: 96t267COMMENTSSITE CONDITIONS, NECESSARY REPATRS:ADDITIONAL WORK PERFORMED: INSTALLED WELL POINI.PARTS /EOUIPMENT PROVIDEDWas station manager or attendant present during final inspection?: YESWas a visual inspection of alletc. conducted while on-site?:submersible pumps, leak detectors, dispensers,YESwas locatj-on fu]1y operational upon leaving site?: YESWas lock-out/tag-out procedure used?: YESNDE Ervironmental Corporation - 20000 Mariner Avcnuc Ste 500 - Torrancc, CA. 90503 - GIO) 542'$4Page 5 LEGEND@GsooFILLPACIFIC BELL196 SUBURBAN RD.SAN LUIS OBISPOvv.o. # 961 267@TLS-250FT.VALVEVENTWELLooSHOPoo@€@@G@@€@SUBURBAN RD.ItlIItElDForC{tHProro(,oEEtoF?r-zUtdtdEoE'EoEIE.oo{EoEINEtstt.EooEEoU'ol^I-toIBI;F\oot,ot,do$N55N){oFtFoFlcr.(DF*toortsNor{ttDGIoo\ f(!(PACtFtcl:{ BELLA Fai,r c Ieres,s ComI,n,,February 12,1993State Water Resources Control BoardDivision of Clean Water ProgramsUnderground Storage Tank Cleanup Fund2014T Street, Suite 130Sacramento, CA 95814Re: Financial test of self-insurance (Underground Storage Tanks)i am the Chief Financial Officer of Pacific Bell, 2600 Camino Ramon, Room 4CN100,San Ramon, California, 94583. This letter is in support of the use of the financial test ofself-insurance to demonstrate financial responsibility for taking corrective action anilorcompensating third parties for bodily injury and property damage caused by suddenaccidental releases and/or non-sudden accidental releases in the iunounr of at least twomillion dollars annual aggregate arising from opcrating underground storage tanks.Underground storage tanks at Pacific Bell facilities are assured by this financial test or afinancial test under an authorized State program by this owner or operaror.A financial test is also used by this owner or operator to demonstrate evidence offinancial responsibility in the following amounts under other EPA regulations or srateprogams authorized by EPA under 40 CFR Parts 271 and 145:EPA RegularionsClosure ($$ 264.143 and 265.143).........Post-Closure Care ($$ 264.145 and 265.Liability Coverage ($$ 264. 147 and 265Corrective Action ($$ 264.101 (b) ).......Amount....$400,000......$100,000...$2,000,000......$100,000........N/A...$7,400,000.,..$1,000,000...$2,000,000....$3,700,000......$150,000..$16,850,000.Plugging and Abandonmenr ($$ 144.63)Closure......Post-Closure Care.....Liability Coverage..Corrective Action.......Plugging andTotaI.............Abandonment.This owner or operator has not received an adverse opinion, a disclaimer of opinion, or a"going concern" qualification from an independent auditor on his financial statements forthe latest completed fiscal year.Alternative I (Source: Form l0K, December 31, l99l)Amount of annual UST aggregare coverage be ing assured by afi nancial test, and,/or guarantee...$2,(X)0,0002. Amount of corrective action, closure and post-closure carecosts, liabilitycosts coveredcoverage, and plugging and abandonmentby a financial test, antVor guarantee1$ 16,850,Cn(:) 3. Sum of lines I and 2" " 4: Total ungible assets.Total liabilities (if any of the amount reported on line 3 isincluded in total liabilities, you may deduct that amountfiom this line and add that amount to line 6)Tangible net worth (line 4 minus line 5)..Is line 6 at least $10 million?.....Is line 6 at least 10 times line 3?.......Havc financial statements for the latest fiscal year been filedwith the Securities and Exchange Commission?.........5............$ I 8,850,000$19,036,000,000,.$7293,m0,000.$11;743,000,000,Yes No,........x.........x..x6.7.8.9.10.11.72.Havc financial statements for the latest fiscal year been filedwith the Energy Information Administration............ .........N/AHave financial statements for the latest fiscal year been filedwith the Rural Electrifi c ation Administration............N/AHas financial information been provided to Dun and Bradstreetand has Dun and Bradstreet provided a financial strengthrating of a 4A or 5A? (Answer "Yes" only if both criteria havebeen met)...XI hereby certify that the wording of this letter is identical to the wording specified in 40CFR Part 280.95 (d) as such regulations were consriruted on the date shown immediatelybelow.Urtt; f.William E. DowningChicf Financial OfficerPacific BellDa-tz-q2 PAC!FTCxBELL,A Pacif ic Telesis CompanyCompany Safety \2600 Camino Ramon, Room 2N650'ASan Bamon, California 94583December 15, 1992County of San Luis ObisPoDept. of Public Heal-th2L91, Johnson Ave . , P . O. Box 1,489San Luis Obispo, Cd. 93406To Whom It May Concern:The enclosed are Hazardous Material-s fnventory documents andAcutely Hazardous Material-s Registration forms for PacificBel-1 facilities.A l-ist of all- f acil-ities in your jurisdiction is on attachment 1.These documents have been prepared to satisfy California's"Community Right to Know", regulations as our 1-993 discfosure.Please note the mailing address for these facil-ities.Pacific Bel-] - ATTN: Susan E. Jones26ao camino Ramon - 2N5s0c 7E Ito FFSan Ramon, Ca. 94583P}ease ca.l-f me if you have any questionsr oD 510-823-3560 or510-823-8912.Thank you,n^jt)Susan E. JonesSafety Managerenclosures County of San Luis ObisPo \872 Morrow Street, San Luis Obispo - fn'/AAttachment 1t z,/ ,l3/ (''(r I2L"({s793L5 Encina Ave., Santa Margarit.a ,--t71/o.,1"33 San Rafael st., Avil-a Beach L-1'7 4 o tlzZS N . Halcyon Rd. ; Arroyo Grande z.-.-.-/zq'or 6220 Atascadero Ave., Atascaderott t/a 6 f Otfr Street, Baywood Park,^^s" W/S Bridge St., Cambria ,)< SEc33 T30s Rl-8E MDB&, cairisa Prain !11{ 0e65 13th Street, Cayucos L""'t z /ad 7 88 Main Street, Morro Bay . 2-sr4 N/S Dana St W/O Maf,l, NipomO/t/03 730 15th Street, Paso nobles?ee\"ays Nacimiento Dr., Paso Robles t-"-'{/{ 960 Dolliver St, , Pismo Beach p'-lTqoTnA Suburban Rd., San Luis obispo 1/G d{513 Main, Templeton ,/-908 28th St., Paso Robles Tl7'/o {'t 7L/O c( 6"-qJr. * RetaiPLEASE REMIT TO:n top portion for your records3oDA DEPARTT\,ENT OF THE SAN LU,S OBtSpO COUNT' HEALTH AGENC'TL7 07 bC-S 7{'daz 'l,dqzReturn bottom portion with paymentPACrFrc BELL (SE-006)6220 ATASCADERO AVEATASCADERO, CA 93422{ha.01-01-93 THRU 12-31-93 23_ :-740L23301DUE DATE: 0I-Og-92SLO COUNTY DEPARTMENT OFENVIRONMENTAL HEALTHP.O. BOX 14892L56 SIERRA WAYsAN LUIS OBISPO, CA 93406TOTAL DUE $ _€_e037(/ b3l. zf35b/6,o.'o3vt z<{to tr>3 Ifr/^- ('-*r:Pl^'-Irrxfr,. t^ nIA \ './\'J.r{':lQ:t;'r.10015 ((SUIIITTIAI?Y OF' UNDERGROUND STORAGE TAITK SYSTEIII TESTINGNDE ENVIRONI{ENTAL CORPORATION2OOOO I'Iariner Avenue, Suite 500Torrance, California 90503(310) s42-4342Work Order#z 960482Test Date: 14 Oct L992PACIFIC BEI,I,485 80UTH I,IONROE ST.SAII JOSE , CAAttn: LYLE STUCKPACIFIC BEI,I,196 SUBURBAI{ RD.SAN LUIS OBIS95128,CA93{01The following tests rA/ere conducted at the site described above in accordance*iin-arr uppii"i[i" p"iiio"= of federa], NFPA, and ]ocar regulations.TANK SYSTEM INFORMATIONNONEF. G.77.OODIESEIJ914rO004K DSIrNONEF. G.78. O0GAS9110, 0001OKR/UL'IIONEF. G.77.OOGAS9110r 0OOlOKUNI,VaporRecoveryTypeTankMaterialProductLeveIProductTankDiameterTankCapacityTankNo.TESTING RESULTSN/AltoPASSPASSPASSPASS-0.0064K DSIJN/ANOPASSPASSPASgPASS-o. 0131oKR/Ur,N/ANOPASSPASgPASSPASS-0. 002l.OKUNI,LeakDetectorResultsPass/FaiILeakDetectorPresent?Yes/noProductLinesPass/FailVent &VaporLinesPass/FailUllagePortionof TankPass/FaiIWettedPortionof TankPass/faiIVPLTVolumeChange(gph)TankNoNDE appreciates the opportunity to serve lou,you iir'the future. Plbase call any time, dayNDE Customer Service Representativeand looks forward to working withor night, when you need us.Testing conducted bYF. UILL,ERt{. LEVESQUE (^("TESTING SUMMARY92-14 05TECHNICIANCERTIFICATION NIJMBER :SITE TD #IOTHER NDE PERSONNEL:(80s r s46-7375SITE PHONE:TECHNICIAN SIGNATI'RE :CA934018A!I I,UIS OBISOKOIL CHECK!196 SUBURBAN RD.SITE ADDRESS:7OrS77VAN MILBAGE:PACIFIC BEIJIJSITE NAME:L7VAN NI'MBER:tll. LEVESQUErEcH(s):13: OOTEST START TIME:14 Oct ,.992TEST DATE:F. !'IILITERSALES REPRESENTATIVE:WORK ORDER #:9604A2page I (TANK TESTING DATAPessPASSPASSPass/FaiI:-0.006-0.013-0.002Leak Rate (GPH):-0.000-0.0000.001Total fluid levelchange (inches):-0.008-0.0280.010Total temPeraturechange (degrees F):aIaaaaaaa13s3015s3013s38LSz 4213!3615!39Test start tine:Test finish time:UFT50NOIwUFT50NOlnUFT50NOlvOFT/UFT:No. thermistor:Ground Water level:How determined:F. G.F. G.F. G.Tank Construction:0.8510. 7tl3o.7 43Specific GravitY:0ooWater in tank:3, 6109,L249,O24Fluid Volume:77.OO78.00?7.OOFluid Level:444F.ill pipe diameter:118118118Tank Bottomto top of grade:919191Tank diameter:313229FiII pipe length:,,22L23L20Tank Bottomto'top of fill:NONOlloManifolded Vents:NONONOSiphoned tanks:lIoNONOManifolded tanks:{, ooo10, 00010r 000True CaPacitY:DIESEI,GASGASProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1page 2 ULLAGE TESTTNG DATAPASgPASSPASSPass/FaiI:Nitrogen Flow (cF'H):aaaaaaaaFinish tine - test 3:aaaaaaStart time - test 3:0.200.200.20Nitrogen flow (CFH):aaa16:1516:1516s15Finish tirne - test 2:77 .4?7.278.3UIIage temPerature:0.200.200.20Nitrogen flow (CFH):aaaa16r0515:0516:05stirt tirne - test 2:0.2 00.200.20Nitrogen flow (CFH):aa16:0516!0516:05finish time - test 1:77.4?7.178.2Ul1age temPerature:0.200.2 00.20Nitrogen flow (cubicfeet per hour/CFH):aaaa15: 5515:5515:55Start tirne - test 1333Time to testpressure:111Time to 1 PSI:a15:4015s4015s40F'ill start time:101010Stabilization tirne(rninutes) :1.631.911. 93Test UIIagepressure (PSI):2.372.092.O7Fluid pressureon tank bottom(PSI):390a76976Ullage volurne:{, 00010r 00010,000True CaPacitY:DIESEIJGASGASProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1page 3 r-r-'LINE TEST DATAPASSPASSPASgPass/Fail:0.0000.0000.000GPH IOSS:000Volume loss:40tl040Finish pressure:101010Total test time:40{040Starting Pressure:aaaaa13!151330013!00Test start time:4040{0Test Pressure:ArR/Er,uArR/Er,!,tAIR/Er,UIsolator:TOrEruTOKEIUTOKEII,TPump tYPe:DIESEITGA8GASProduct:Tank 6Tank 5Tank 4Tank 3Tank 2Tank Ipage 4 LEAK DETECTOR DATAN/AN/AN/APass/Fail:Is seal/Pressurerelief tight (PLDonly) ?:Does leak detectorreset from GPHorifice?:Confirm sensing ofcalibrate leakafter keying nozzlezMetering PsI:Element holding:Open time:Leak calibration:Resiliency:Leak detectorserial nurnber:Leak detector model:Leak Detectormanufacturer:DTESEIJGAgGAgProduct:4K DSI,10KR/UrrlOKUNIJSerial number:Tank 6Tank 5Tank 4Tank 3Tank 2Tank 1page 5 805-549-5544FacilityFacility,/COUN ' r OF SAN LUIS OBISPO HEALTH DEPAh,./ENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406P:oRoutine lnspectionReinspection No.Complaint lnvestigation -HAZARDOUS MATERIAL/U N DERG ROU N D STORAG E TAN K/WAST E GEN ERATORINSPE TION REPORT/NOTICE OF VIOLATION,'', /, ,, i 'i.,<',t c>Contact Person:-Title/Position:-HAZARDOUS MATERIALS (21MP#H&S Code, Div. 20,BUSINESS I.D. FORMnumber3. Location of utilitiesINVENTORY4. Hazardous material & amounts listed5. Material stored in proper containers& labeledbles not storedUNDERGROUND STORAGE TANKS (COMP #(CA H&S Code, Div. 20, C6.ATL.#TANK CLOSUREGENERALViol2.6.7,PLOT PLANPlotsubmitted9.&ntbWASTE GENERATORS COMP #-10. Location of hazardous materials11uishers/water source12. Emshut-off switches13. Location & verification of MSDS14.and/or storm drains15.areaons rnEMERGENCY RESPONSE PLAN17.18.evacuationres19.TRAINING PROCEDURESThe above marked items represent violations of the California Health & Safety Code and the California Code ofRegulations and must be corrected.COMMll/futst:pJt*Zt/1fl;7o4at1aar--s'37. Spill containment36. Fire extinquishers35. Storaqe - 90 davs34. lncomoalibles not stored toqether33. Material stored in proper conlainers& labeled32. Continqencv plan31. Traininq proqram/records30. Waste oil receiot29. ManifestsNln28. Variances and/or exemptions27. EPA identification numberc) Soil samples takenb) Tanks rinsedpill containment provided,d'a) Tanks purqed26. Removal/in place abandonment25. Temporarv closure24. Permit aooroved^t-*--'/.".n.;:jl23. Leak detectors22. Precision tank testL'i/121. lnventory reconciliationViolComplComol20. Permit to oDerate'j )2,^ 77;r.,.,;,,.,,.-'. .ttt-,7/l";rr+-l Flnspector's SignOwner/OperatorSignatuNOTE: Signature indicates receipt of thismentand not an admission of the facts.Page- of- IENVI RONI{HNTALc0RP0RAr (^\UNDERGROUND ST0RAFE TANr,INTECRITY****hi^ FTr, nF(****cERTIFICAEBEGT$-[_ON !lU!"Ul1HIfi-L0 H.UANII-IIVn LHA.U r#Sr$NAVEI-Y IiNTERPRI$HS, INnnRpOF{ATEn }ras te*tmd the faL L*w.i.ngrlndereFrrrr-tfld s'b':'raile tank t;yntem*, anrJ certi'fie$ them TI6HTat tha: prndr-tc{: l'r*ri-gl'r1f gre'l*er than, ':'r erir-tfr1 tr, 6tratJei lsrvel,t-ist mf Tank Systems TestmrllraNu. c.0Nlhtils TsN.ti. aar"as,tlY raN]i uux3EnstaLJ.gbl NullBEB$AN I-LIIS NHISPNREffLII-AR FLJELi.JNI".HADEN FUHI-DIESET FUELGAL LNNSGAL LNN$;tiAr.-LnNsL tJ, {JtJil1.0 ! (:ttJtJ4,(]00#fiF,+t67+!68sE' .41.-? o+ETANh: LIICATI{lN; PAIIFIC FHl.-LJ.B6 SLIBI*IREIAN$AN l.-IJIS nFISPCI, CA gS,+(:tlE}NAVHLY HNTERPRISHS, IN{:CIRPllRATHn is auth';,ri.recl tc' test andcertify {:hi.rs$ t,}.n}::{ii by Tl'rei $tatr* bJatmr lteE,:rr-trcF$ C'3ntr,:'lEtnard in the finunty crf fiAN LIJIS UBI5P0NnH HNVIRINHHNI'AI.. fiCIRPfiRATInN!:i CHRTIFICATInN mearts ttrtrrmquirementtl ,rf 'hhn state resr"rLati,:n* and Ht"ticlel ineE hasedNati,:'nal Firr'.r Pr'::tr*cti'rn As$,:ciati,:n Tit lel 3':'3, Thi*;certificatir,n meq:ts r:rr t*v;reerjs certificnti,rn *-,tandards $etthsr FederaI, Statp, anrJ lr3cf,l j'.,tisd j-cti'3rl'?l agencies'13nhyCertificatir'n DatqlUertif i cati,rn Nr-rmber$tate l-icensed'lesterRec,rmmencled Recertif i cati':'n Test DatmCmrtif i catinn $ignaturerr (:)B/{:}3,/ 1?'31I NDI: -n'r *()fi 1';t:lu; BRYAN $}NAVEl-Y: AUGU$'I 1g9fV, P. 'TF.{:HNINALtltitle)Si. HHNDHR$C]N-P.0. BfrX 5S{tCt-345-16Sp(n)$NAVELY ENTERPRI$H$,cARUTHERS,I NCORPT]RA'THD * I3S81CAL IFT]RNIA ?36{IE !NDE VPLT COMPUTERIZED PRECIEION TEST REPORTr GENERAL REPORT FORI"I - CCOPYRIGHTPA6E 1PATENT PENDING119851.0wner ':rf $'Lrtrr<RFG? tanllsCnmpany representative?.Maiti.ng addresg ,:f 'rwner3. flwner ph':'ne nufnbFr4.5tati':n nr-rrnher5.1-,:-,cati'rn t-linm(" f 13l. tan[lgLc'catinn address friF tanh: sl.-r:r CrX b irSt-t pl-rrilrr1fi? nUlnb(3r'!l'lanaqef C,f ,:::,pefatnfti. Regr-1 latt'ry .rqency7, J'anlt rJesignati*n ':'r ID*E.Datrp tan!,: wa{s tested'3. T'ext i ng crsmFartyMailing addrrPi*ETel;t i ng c':"npany fJh':'nf3Ltl.l'echnician certifyinq tanh:$tatm Certi'f i catirrn Nr"rrntrer11, Capacity ritrf tanl';1I. Tanh: c':ngtrr-tc'bi':rn mateirinl13. T'esiting l. i.qt"rid14. I..INDERGROUNN STORAGEPRODI".ITT HHIGH-I' ECIUALPACIFIC EIELI,"RENATCI MARZAN3 N. SHCrJND ST, Rn0H 675sAN J0SF, frA, 951 13(:4(18) 'l'31-4335*66PACIFIC ETELL *ts{3186 SUHURFANsAN LUIS OEtISPCI, CA" 1?34I]1T,1R. PANI{RATZSAN LI.JIS OBISPC)REGULARctB/t-t3/19,31SNAVELY ENTERPRISH,$ INC.13381 S. HENDERSONCARUTHERS, CA, 93609gc,o-345-1633q*.^,Measr-rred Numerical l-eakage Rate i.s:+,C103Lnss (+) f,r Gain (:-).ThiE rneasnrement is within the al Iowableln NFPA 329 fnr e ttght tank system.SNAVELY ENTERPRISEg, INCORPORATED -13381p.o. Box 5 - CARUTHERS, CALIFORNIA 98609#90-1 I I4l.0, 00()STEELREGULAR.TANI.i $YSTEI4 IS CER'TIFIEDTN C]R HIGHER THAN 6RADEYf.g.gta I I c'nxT I {3HT ATI..EVELGal lans Per Hc'urlimits eetablishedSOUTH HENDERSON- EOO-345-1633 ; ;..NDE vPt.T C0I"IPUTERIZED llECIsIoNr..vE '' "', "-ortr'neL REP'RT Fo*llPA6ETEST REPORT. GCOPYRIBHTt-PATENT PENDIN6r985t.54.5,CapacitY ':f tl're tanl':Pas; h ct,nt;elnt sTest i. ng 1 i qr'r icJTanl,: constrr-tctic'n material1 O, 000RE6ULARREGTJLARSTEEL'12.1. ':r ^r:.4it;r13F71r;ta I 1':n!;inchet;i. n chesin c hesinctregi n c l-resin c hesnr-rrnbera.b"Tank inc l inatic'n (.e'legree* ., -ii;;i ptp" incL inatinn tldegrees') r:67a.b.I nter na I tl iameter 'a'fi'ann L!.:,tt,:m t'r gradetanhleveld iameter,;r tanh b*ttnm':' grade level8. Air vents-). 'I'ype ,:f f il1 pipe cap1(:). TyFt? nf Frr-lrnPi ng sYstem1 1 , {:,:,e'f f i c i.errt; rrrf t]rerrna l etvl 5:ansic'n1?..$Pecific tiravitY13, frr-r 1 k mc'd r-t I rrsi14. VaPc'r rt*c':'verY sYstern15. Deptlr r'f nrcrr'indwater bel':w qlrade16. Datt* tan[': h'a'!5 tapped f ':r tr*st i ng117. Tims tant'; lras tc'pped f r;r te*tingl18. Tc,tal pr':'rJr'tct level f r*m tan[': h'rttrmSNAVELYP.O. BOXa,bt'(:,d.Fi11 PiPe intern'rIFi t 1 Fi fre 1'engthTc,u nlf f ill PiFe tlnp nf fi1.1 pipe tCAFILCICI'';SUCT ICIN.Ocx)F,5f;fl.743lgB(:xl{:)PHASE IUNI.INOWNslg/ {lil/ 19? tI 7: (:l(:)13Finchesi n c l-re'[3ENTERPRXSES' TNtroRPORATE!E " --Cenurrmirs' cALIFoRNIA- 13381 S. HENDERSONggAOe - BfJO-3'+5-1633 NDE VPLT, COF{PLITERIZED PRECISION TEST REPORTGENERAL REPORT FORI'I - CCOPYRIFHTPACE 3-PATENT PENDING19851. General n':'terls anrJ Ing srntries:ARRIVED A1' ()7;3C). TOfiF; FIEASURHI'4ENTS AND BRCIUEHT FLUIDLEVEL AFCIVE 6RADE. I ETLED SYSTEf'1 AND ETEGAN SETTING-IJP FUI.LSYSTEM TEST. NEXT, r CALIE{RATED AND STARTED 'I'EST.Any mpeci.al l:lr':,cecJr-lrr;?lii '':'bl"rer than the NDE Cnmpr.rterleeclVPLT Tank TeetlnE Prncndurer.NCI:l3, Descripti,:,npf it:'r trlr rlrl'NONE{'f anyd r_rr i nglrepairE made tc, st':rage tank system'bl're terEt.4f)EtscribprN$NI;*\ny recr..,mmended repairs.any signi f icant deLay* nc't car"rsed by te$ter thatin delays in c'rrnplerting the testS, DetscriherFEr.r I tedNCINE6. Describe quantity af liqr"1isls rem':ved fr,:m tanl'; ,rr liqr"1j.slsaclded tr: tank by tegter f r'rm tester st':,rage tanl:s.30 GALLONS ADDED TO BLHED AND RAISE ABOVE GRADE.i.J(] GAI.-LONS REMOVEN AT HND NF TEST,Dnere;NNtanl: Sih'3r, eVidenCF rtrf vAprlrl" pACketS?SNAVELY ENTERPRXSEE, TNCORPORATED -l33Bt Si, HENDERSONp.o. Box 5 - CARUTHERB, CALIFORNIA 9B609 -BOO-345-163i37 '.INDE VPLT COMPUTERIZED PREEIBIT]N TEST REPORTI GENERAL REPT]RT FORI"I . GCOPYRI6HTPAGE 1. PATENT PENDINB1sB51.0wnef ':'f 5t':rrf,8f;1, tanl':lsC,:mpany representat ive3.|'lai I ing address ':f ':'wner3. 0wner pl'rr:rnF nr-trnber4, Stat i':rn nr-tmher5. Lc,cati'rn narnt* f rrrF tanllg1.,::r (::':1t i.'3n ;.rdd re*Eig f r,r tanlr:gLc'catirrn ph':'nH nrlmber ''!Manager ,:r ':'peratc'r6, Reqr-t I atrrry agency7. Tanl: desi gnat i':n c'r ID*B. Date tank wa.s tested9. Testing c*mpanyMailing addrFt;sTers'b i ng cnrnFfiny ph'rneLC). Techni cian certif ying tanllState Eertificatinn Nr-trnberll.Capacity c,f tanl,:1t. Tanll cnnstructi':,n materialPACIFIC FIELLRENATO MARZANl N. SECCIND S'r. RCI0t{ 67'sAN JoSE, CA. 951 13(408) .191 -4335*67PACIFIC EELL #671S6, STJEIURRANSAN l...t.JIS nBISPn, CA.'lSrlt)lT,IR. PANF;RATZSAN LUIS OBISPOUNLEADEDctg/t3/ lgslSNAVELY ENTERPRISES INC.1338T 5. HENDERSONCARUTHERB, CA. 93609BOO-345-1633#.3c'-1 1 141O, {rO0STEELgaI lnnsT I CHT ALEVEI.-13, T'estinq I iclt-rirJUNI..HADED1*I.LINDHRGROUND $TORAGE TAN].1 $Y$TEM IS CERTIFIEDPRODUCT HEIGHT EQLIAL T.N NR HIFHER THAN GRADEYEfr.I'lea*.r-rred Numer i cal Leal::age Rate is: +. O l CtL,:ss (:+) tr,r {3ain (] -),This meagr"trement is within the al lowablein NFPA 328 fnr a tight tank system.GaL lons Per H':urllmite establishedSNAVELY ENTERPRISEEI, IP.O.BOX$.CARUTHERBSOUTH HENDERStrN- EOO-349-1633-r338139608NCORPORATED, cALtF6hrure NDE VPLT COMPUTERIZED PRECISION, GENERAL REPORT FORlv4PA6ECapacity ':'f the tan[lPagt c':'ntent$Testing liqr-ridTanl,: cnnstrr"rctinn material'Ianlr inc 1inatinn (ideqreeslrFi11 pipr* incLinatic'n (idegtreeg)I nternal diametera'f tanlrTank b,:tt;c,m t,r grade levelFitl piFe internal diameterFiLl pi.Fe LengthTr:,lJ r:'f 'f i I I pi pe t': tank bnt tc,mT'':rFt nf f i I I pi pe t';, grade I eve I.i:. 'TEBT REPORT -PATENT PENDING. GCOPYRIBHT 19852lI f.r, {)00UNL.EADFDUNLEADEDSTEELga I I r:rns1.:,3.4,5.{lrb.drb"7, a.br.c,d.II6'3313I4391:111IcAML0CliSUCT ION,0cr06F30.74318BClOCIPHASE IUNhINOWN(ta / 1:t?./ I'3'3 1.17: (tf-tr3sinchesincheginchesinchesirrchesinrhegB, Air ventsg. Type nf filf pipe cap1rl. Type ,r'f pr-rrnpi nGt systemI I . [],:'ef f i cient nf thermal ey;pansinnlt.Specific qlravity13. Br-r I tl m':d t-r I ug14. Vap,:r rec':'vfPry g3ysterm15. D*pth c'f qr{'r..rndh,ater helr.,w grade16. Date tank Ha,$ f,c,pped f ,:,r testing17. Tiin€i tanl,: wasi tnpped f I'r teeting18. T':rtal pr':rduct ltevel f r,rrn tnnh b':ttnmnr-rmberinchesinches13381 S. HENDERSON93609 - 8f.rr1-34S-1633SNAVELYP.O. BOXENTERFRISEB, TNCORPORATED5 - CARUTHERS, CALIFORNIA NDE VPLT'COMPUTERIZED PRECISION TEST REPORTGHNERAL REPORT FORM - GCOPYRIBHTPAGE 3-PATENT PENDIN61985l. Gg?neral n,.--,.bes ancl 1r:'g entries;ARRIVED AT I)7:3t), TOOII T{EASUREMENTSLEVHI.- AETNVF GRADE. I FLEN 'SYSTHH, SET-UPBEBAN FULL SYSTEM T'EST.AND BROUGHT FLUIDTEST, CALIII.8ATED AND:6IJ4FJAny special pr':cedr-lr€l* nther than the NDE Cnmpr.rterlzedVPLT Tank Teeting Precedures.NNf)esrriptic'npr i':'r t,3 ,:'rNNNEnf anycl r-tv 1nnrep;rire; marje tc, xt'rraEte tanl:: systemt l're te*;t.Describe any recnmmended repairs,NONEhy tester that6, nescribe qr-rantity c,f I iqt-1 i6s rern,:ved f rnm tanl': 13r I.iclt..riclcacJder{ t,r, tanh by terterr f r,lm tester st,rrage tanhs.B GALI..CINS ADDED 'IO BLEED AND RAISE ABOVE CRADE.8 GALLNNS REMOVED AT END CIF TEsT.Daes tank sih,:'ul evidencE r:fNCIvapnr pockets?DescriberFsr.r I tedNONEany significant deLays nat causedin dnlaye in c':'m[:leting the test.7SNAVELY ENTERPRIBEB- TNCORPORAT,ED -!3iIB.1 SI, HENDERSONp.0. Box 5 - CARUTHLnS, eAltFdh-Nln efFoB -Boo-345-163s NDE VPLT COI{PUTERIZED PRECISION TEBT REPORT{ GENERAL REFORT FORM - GCOPYRIBHTPA6E T- PATENT PENDING19851 .0wner rlf 5tr:r1';1qp tAnl::!5Cc'mFany repres*ntat i vet. Ma i I i ng *rdd ress ,:f ':wner3,0wner pl-rrrne nr-rmber4. Stat i,:n nr.rmber5. L,:,cati'3n na,nt: f nr tanllELncatic'n acjcl regs fc,r tanl::El-rrcatirrn ph':ne nr-trnberPlanager'3r':'perator6. Regr-rI atr:'rY agency7, Tanl': tJesi grrat i':,n frr I n+t8. Date tank was tested9. Testing c{'rilpanyl"4ai I ing addressTel;ting cr:',nFany phrtrn€1(r, Techni cian certif ying tan[';Stattg Eerti ficati'rn Nr.rrnberll,Capacity ,;,1 tanl*l?. T,rnl* cr:'nEtrr-tctic'n rnaterial13.Testi.ng Lirir"rid14. I.JNDERGRNIJND STCIRAGEPRNDUtrT HF.IMHT EAUALPACIFIC BELLRHNATN F4ARZANI N. SECCIND ST. R00t{ 675sAN JOSE, CA. 951 13c4f_)Btr "t,31-4335#68PACIFIC BELL #6F19F, SUBUREIANsAN LUIS nFISPCI, CA, ,334011'IR. PANHRATZSAN LUI$ CIEtISPNNI ESEL.cta/Q3/1,391SNAVELY ENTERPRISES INE.T3381 S. HENDERSOHCARUTHERS, CA. 93609gOO-3.+S-1633{+90-111'14,00()STEELDI HSEt.TANI.; SYSI"EM IS CERTIFIED TIGH.T ATTO NR HIGHER THAN 6RADH L.HVHLYEggal LnnsGa11'rns Per H'rurIimits eEtablishedSOUTH HENDERSON- BO0-3.+5-1633Pleasr-rrecl Nr-rmeri cal l..eal:: agH Rate is: -.007Lnss (+) ,rr Gain { -),This measr.rrement is within the al lowablein NFPA 3?9 fnr a tight tank system.SNAVELY ENTERPRTSES, INCCIRpCIRATED -19381P.O. BOX 5 - CARUTHERS, CALIFORNIA 93609 :NDE VPLTMOMPUTERIZED PRECI$TONGENERAL REPORT FORMPA6ETE6T REPORT. CCOPYRIGIHT?-PATENT PENDINB198S561. f,apacity ,:,f the tanl,:t. Past c{,ntents3. Testing l iqr-rid4. Tanl': ccrfiEtrr-tcti,rn mate+rialTank inclinati,:n (degrees)Fill pipe inclinat.inn (.deErrees)I nter na I d iameterr''f tankTanl".: hrrrttrirft tc' glrad* lmvr*17.n. Fi l1 pipe internal cliameterb. FiII pipe lengthc. T':p ,if f i11 pipe t'r tank h*ttnnfJ. J'r;rp r:rf fil. I pipe trt' grade level.8. Air vents9. 1'ype nf fj.11 pipe capltl). Type nf Fr-rmFing g3ystFfnI l.Cnefficient,:rf therrnal eyrpansic,nlS.Specific qravityI3.Etr-rLk mrrduIr-rs14, Vap,:'y rec':'very system15. Depth c'f er,:'r"tnrJwater trel,:w grade16. Date tank \ras t,:pped f .:,r teating17,'t'i.me tanh: was f,qrpped f nr testing1€l .Tc'taL pr,:,clr-tct leveI fr,rm tank hrrttr:rnr{., tJ{J {)D I ESELDIESELSTHELga I l crns9?13';:inchesi.nchesrfrfJ1'I57inchesincheginchesinchesiICAMLCICI.::SUCT I ON.0004465. F53i:16crc)tlPHASE ItJNl;NOWN{:,€,/(l:/ I 9911 7 I tlttl135nr-rrnberi n c l'resinches- 1338I EI. HENDERSON33609 - 80q-34S-1633<:l rtj.r::l rh.I1SNAVELYP,O. BOXENTERPRISES, TNCORPORATEDg - CARUTHERS, CALIFORNIA ': :rINDE VPLTTCOMPUTERIZED PRECISION TEST REPORTGENERAL REPOR FORI"4 - GOOPYRIGHTPABE 3.PATENT PENDINBr 9951. General n':'tsrs and l*g entrims:ARRIVED AT t]I7I3t]). TOOI':: I{EASUREMENTS AND SET-UP THSTBLED SYSTEI"I AND FEGAN TO CALIBRATE. AFI'ER THAT I STARTEDGOOD TF:sT.A:AnyVPLTt\.10xpe*ci.al pr,:cedures ather thanTank Testing Pracedr.rres.the NDE Comprrteriaed3. De*scriptionpr i':rr tr3 AFNNNE'rf anycJ r-tr i n6lrepairs made t'r st,rrage tanh systemthe test,45Derscribe any rec':mmended repairs.NONEf)es;criberersu I teclNCINEany significant clelays rtrirt car-rsed hy teeter thatin delays in c,lmFleting thsr test,6. Describe qr"tantity ,rf I iquids rem,rved f rom tanh r:r l iquidsadded trl tank by tester f r'rrn tester stc,rage tanlle.IT GALLNNS ADDED TCI BLEED AND RAISE ABOVH 6RADE.Tf CATLONS REHOVED AT END OF TEST.7, Dnes tanl* shnw evidence f,'fNOVAp':'r pC, CketS?BNAVELY ENTERPRIBEB, XNFORPORATED -1B3Bt 6. HENDERSONP.O. BOX $ - CARUTHERS, CALIFORNIA Bg6Og -800-345-1633 IIar"\AitG'if]{}tr-" -,_,i* (L. !:: : -: !in';1. bC-lSAN LUIS OBISPO COUNTY HEALTH DEPT.Environmental Hea1th Divisi-onP.O. Box 1489San Luis Obispo, CA. 93406TO PERFORI{ PRECISION TEST ON UNDERGROUND STORAGE TANKSAUGUST 3, 1991Y 25, 1991APPLICATION DATETEST DATECTAPNFACILITY ADDRESS PACIFIC BELLJOB ADDRESS/LOCATTONCROSS STREETOWNER,S NAME PACIFIC BELLPHONEADDRESS196 SUBURBANCITySAN LUIS OBISPOTESTER ST\IAVET,Y ET{TIERPRISES. INCPHONE 1-800-345-1633TYPE OF TEST: DIDE VPLT Oottputerized*************'*******************************************************.*****SI ZE10,000 qal.,PRODUCT#66 REGULARAGE OF TANKCOMMENTSTANK #1110,000 gal. #67 UNLEADED4,000 qal. #68 DIESELCONDTTIONS OF TESTING:1FaiIedwithintes,ts shall be24 Hours2The PlotfndicatePlanadd!ereported to the local inforcement agencybel'ow shall be used to show location of tank ( s ) .ss and nearest cross street****'tk**************:t**********'******************************************* NDE VPIT1.0wner cr'f s'brirrrt0G! tankmCc'rnpany rFpresentat ive3.]"lai l inq address nf '3\rner3.0wner pl-r':'n(3 nr-tmber4, Stati,rn nurnber5. L,:,cati'311 name f 'rr tankgLncatinn address f,rr tanl:sLc,cati,rn ph':'nc? number ''!Manager ar ':'Feratc'r6. Regr-r l,:tc'ry aqency7. Tank desiqtnati,:n 'rr ID#B.Dat* tanlr wat; tested9. Testing carnFanyl,lai.l ing adrlre1;|3Test i nq1 c,trtnl:)<tt"ly ph';'ntlLt:). Tecl-rnician certifying tankState Cert i f i cat i':,n Nt-rmherll.Capacity crf tan[,:1t. Tanl,: c,:ngtrr-tcti':'n matfi?rial6OI",IPUTERIZED PRECISION TEST REPORTBENERAL REPORT FORN . GCOPYRIBHTPABE 1. PATENT PENDINB1885PACIFIfi BFLt.RENATO I.IARZANsAN JoSE, trA. ?5113(:4081) .191 -.*335*67PACIFIC BELI. #67T96 SUBURBANSAN |.UIS OBISP0, CA.'334{rlI"IR. PANI{RATZSAN LUIS OBISPNUNLEADEDttB/ {t3/ r.391SNAVELY ENTERPRISES INC.13381 S. HENDER$ONCARUTHERE, CA, 93609BOO-345- I 633#'Ir0-1t1,+1(:,, 000STEELqa I I c'nsT I ffiH'T At-EVFr..13, T'esting I iqt"tidUNI"FADED1.{. I.INDERGROI.JNN STNRAGE TANI.I SY$TEH IS CERT]FIEDPRODI"JCT HEIGHT EAUAL T'O NR HIGHFR THAN GRADEvEgMeasr.rred Nr-uneri. cal Leakage Rate i.sr +. O10Lc,gs (: +) ':'r Gain (. -).This measnrernent ls wlthin the al lowablein NFPA 3?€ for a tight tank syetem.SNAVELY ENTERPRISEE, INCORPORATEDP.O, BOX 5 - CARUTHERB, CALXFORNIAGaI lc,ns Per Hnr-rrllmits establighed-T3BB1 SOUTH HENDERSON93609 - 800-349-1639 NDH VPLT COMPI,JTERIZED PRECISION TEST REPORT, GENERAL REPORT FCIRM . GCOPYRIGHTPA6E ?-PATENT PENDIN619851I34Jf,apacity't''f the'hanltPast c':ntentslTest i nq l. i qr-riclTanll cr,nstructi*n materialrJiametertanll bcrt tr:rrngrade level1 O, t)t)t)UNL.EADEDUNLEANENSTET"L'33133cfT.,?1:111ICAl'lLOCl::sucT InN, {t0{)6550.743188*Cr0PHASE IUNI::N0WNQA / C,'L/ t 9t t17: {ttl135ga I 1':rnsi n c l-resincheginche:;inctresinchesi.nches1ta.b.'fanl: inc I inati*,n tideGtreesltFiIl pi.pre inclinati*n (.degreeg)6, a. Internal rJiameter.'n'f tantlb. Tank b,:,tt':'m ta grade leveL7, a. Fi11 pip*: internalb. Fi 1. I pi.pe l engt hc, Tr;rp mf 'fitI piFe tncl. T'':p nf fiLl pipe tc,€L Ai r vent,sL Type nf fitl pripe cap1t).'Type n'f Fr-rmpinGl systernll.Cnefficient c,f thermal ey:pansinn1t. Specifi c gravity13, Bt-t I l': mt d r-r 1 r..rs14, Vap,:r recrtvFry system15, Depth c'f or':'r..rndwater herlc'w grade16. Date tan[ wf,ls f,r;,pped f ,:,r testing :17. Time tanl': was, tnpped f c,r testing18. T,:'tal pr':tJr-rct level f r,rm tanl: br:'ttnrnnr-rmberinchesinches- 13381 S. HENDERSON93609 - FCIO-345-1633SNAVELYP.O. BOXENTERPRISES, TNCORPORATED5 - CARUTHERS, CALIFORNIA NDE VPLTt. Fl r-rid3, Hei.ghtCOIiPUTERI ZED PRECISIONEENERAL REPORT FORMPAGETEST REPORT. CCOPYRIGHT4.PATENT PENDIN6t9g51, TOTAL TEST CONDUCTION TII.IELeak rate cal cr-rlatic,nstart:enrj :I(lt3l(ttJI4rltime !l1:(t:!3313:tl3r 17fiNON/AN/AN/AN/AN/Ahr:tUr!;hrlr t-tFShnurEinchesi.nchesp5iFEiminr.tte*;a.bI evm l. ahr've grade,lr:rf water present in tank3PIPING PRESSURE TESTHYDROBTATIC PRESSURE DATA4. Piping prFJssr-tre test ctr,ficJr.tcted5. Am,:,r-rnt ,:rf prelssr-rre appl ied to system6. Am,:,r-tnt crf Fretsigr-trF drnp7. Elapsed tirnm dr-tring testB. System paes rirr fail2. Was, tr"rrbins: pump activatc*clll,Flave these1t. Was he I i r-rrnpi. np'3i nt i ngNO10. I f f r.rl L sy*;tern leakage ratesi are in ex cesg *f al I'rwahlelimits, were the 'rwners n':tifierJ 'r'f any aclditinnal testingpr,:,cFJdilreF necessary to..,,,igc,1ate leal';age. ta t.he .J.anh:..f1r' ta.nh:piping. N/AadcJitic'naL testing prncedr-rres been ccr.nFleted?N/ALealr FinF'rin'bingt servi ces retcc,mmended inL n cat ir-'n 'rf L eak .6NAVILYP.O, BOXSNTHnFRtAES, !NeFRFORATED5 - CARUTHERS, eATIFORNIA- lSSgtr 8. HHNpgnSoN93608 - 800-345-1633 NDE VPLT COMPUTERIZED PRECISION TEST REPORT. GENERAL REPORT FORM - GCOPYRIBHTPABE 1- PATENT PENDING!985I .nwner nf str:ra€e tanksiC':'mpany refJresentativel.l"lai I i.ng address ,:f rswner3. CJwner ph*r"re nr-rmher4, Stat ic'n nr..rmher5. [-':,rati'rn nafne f ':r tan[lsLncaticrn address f'rr tanl,:sl.-':rcAti':n plr'::ne nUmber,!Planager r:rr,:rperat':.'r6. Regr-tI cltr:rry aqen cy7. Tank rJesigtnatinn r:'r ID#8. Dattp tanl,: wag tested'3. Test i ng cnmFranyMailing adrlrr?ssTe*t i ng crtmFany f:fr'.--'nfi?1t:t. 1'*chnician certifying tankState Cer t i'f i cat irrn Number11, Capacity ':rf tank1'I.'Tanll cf,rflEtrr-rctinn m*terialPACIFIC BELLRENATN HARZAN3 N. SECNND ST. RCIOM 675sAN JOSE, flA. 951 13(4118) .trg1-4335*66PAf,IFIC BELL #6F,196 SUHURFANsAN LUrS CIFISPO, CA, ,33401r'IR. PANl.IRATZSAN LUIS CIEISPORE6ULAR0El/t)3/ 1'391BNAVELY ENTERPRI6ES INC.T3381 gI. HENDERSONtrARUTHERS, CA. 93609BC'O-34S-1633qr-^#9(t-11141(:), ()00STEEL13, Te*ting li.qr-ridREGULARl4.I.JNDER{FROUNN $TORAGE'TANI.I SYSTET',I IS CERTIFIEDPRCIDLICT HEIGHT EAUAL T'O CIR HIGHER THAN GRADEga 1, I nns.T I MHT ATL.EVELGal I'rns Per Hnurt lmttc nstnbl lshedYESl'leasr..rrsrd Nr"rmelri. cal l.eahage Rate is; +,0(:t!Lnss t: +) ':'r 6ain (: -)'.Thls moaaurement i.o wIthIn tho nl lowablatn NFPA 329 fnr 6 tlght tank nyutem,SNAVELY ENTERPRISES' INCORPORATED -l33Bt SOUTH HENDERSONP.O. BOX 5 - EARUTHERS, CALIFORNIA 93609 - 800-345-1633 NDE VPtT CCIMPUTERIZED PRECISIONGENERAL REPORT FORM, pAciETEST REPORT -PATENT PENDINB. GCOPYRIFHT 1985I1r) I OcttlRE6ULARREGTJLARSTEELgf, I I '3nsitt . Capa c i ty ';''f t l'rer tan[':'l-i . Past c,:'ntents3. Test i ng 1 i qr-r icl4. Tanh constrr-rctic,n materi.al5. a, 'fank inclinatinn (.de$rr*es)b. Fi11 pipe inclination t.deqrees)6, a. Internal diammterh'f tanhb. T'anl': L!':,tt':,m t,:, grade leVel7, a. Fif l pipe internal tJiameterh,, l-itl piFe Len6thc. Tf'p ,:''f f i I t pipe t,l tanh b':ttnmrJ. Tnp *f J'iL l pipe tc' grade levelg. Air vents'l T'ype nf f ill. pipe cap1(l). Typr," ,:f p'-rrnpi ng systern1 1 . f,';ref f i cient ':,f therfnal expansi':n1l?.Specific grravity13, Fr-r I k m,rd r,.t I r..rs;14' VaF':rr rect:,'vHry system15. Dnprth nf {:.lr':'r.rndw.atFr helnw grade16. Da tr.n tanl: wfrtB f 6,ppard f rtrl" tr*rit i. nqt17. Time tanl': was f ri'pped f or testinglB, T,:tal pr':rJr-rct level f r':'m tank bc,tt,:'mSNAVELYp.o. BoxENTERPRIEiE$, INCORPORATED5 - EARUTHERS, CALIFORNIA'3?13:linchet;i.nches4r:rl:r1r57inches3incheEiin c hesinchesICAI'lL0CllSUCTION.00r)F-,5:i0.743l BB()C,()PHASE IUNIIN0WN0B/0'J/ r'39 r.17 ! Cltl135numberinchesi n c l'rer5- 18381 Ei. HENDERSON93609 - BOO-345-16333!l ,: .,,NDE VPLT COMPUTERIZED PREEISION TEST REPORT -PATENT PENDINBr GENERAL REpoRr r3l[r-4ecopvRr6Hr r,ess1TOTAL TEST CONDUCTION TII'IE - I"IT:(JO:4I?Leal.; rate ral culatinn time !n. s{:art : d)8r;:(:)t*+'3t!, end : l(r; 11: BBht,t.trsh '::] t.t rshnurEinchesinchesp5ap5im i nr-r tet;';, Fl r-ridS, Heightlevnl abave grade.,1crf water present in tanl';3PIPIN6 PRESSURE TESTHYDROSTATIC PRESSURE DATA(tNCIN/AN/AN/AN/A4F67gPiping pressrre test c,:nductedAm*unt ':f pret;sr.tre appLied t,: systemAm,:t.rnt nf Flr6199,r-rre rJrr:,pEInp*ed tirne dr-rring test"$ystem fla$rsi ':'r f ai 19. Was turhine pt-t,np activatedN/A1C). If f ul I siystem lera|,:age rnteg ar$ in eyicess rrf al l':wablel. i,rni.'hm, werm thtn ';'wnrf,r$ nr:r{ii'f ietJ 'r'f 6ny arJrJi,ti':"'n{rl tr*stin51pr';rcHCJr"trFls nHcesfiary tc, is,:llate leral*: agr* tn the tarrl,l ,:rr tanh:piping, N/All.Haver thes,p..radditic,nal. te*tingt prncedureg been c'rrnpleted?N/Alenl:: pinp,:intingl*ervice$ rec':'mrnenrjed inL c, cat inn ,:rf L eal,: .11. Was he I i r-rmpi npni nt i. rrgtNCISNAVELYP.O. BOXENTERPRISES, INtrORPORATEDs - CARUTHERS, CALIFORNIA13381 S, HENDERSON93609 - Br.,O-345-1633 NDE VPLTCOMPUTERIZED PRECI$ION TEST REPORTGENERAL REPORT FORI',I . SCOPYRIEI{TPABE 1PATENT PENDINB19851.owner nf Et':'raqe tan|,:sCc,mFany reFrFsr?ntat i. ve!J. Mai I ing adrJress ,:f {'wner3. or-lner pl'r'3ne number4. Stat i,:n number5. Lr:catinn n&rnr? f nr tanh,sLacatic'n acjdress f':r tanl.': sl-C,catirrn pl'rrrrn€ nr.tmber''!l"lanaqer or':'peratr_'r6, Regt-11at,rry agency7. Tank degi qnat inn ':rr In#8. Date 'hanlt wfi$ testerJ9. Test i ng crtr{nt}€rfiyMai l ing acldrt:sgTest ing f,rlrilll)rrt"1t phrlrfl€1Ct, Techniclan certifyingl tanl,:Statr* Certi'f i cati'rn Nr.rmberll.Capacity r'f tanll1I. Tnnl,: crrrfi€tructirsn mat{iarial13. Test i. ng 1 i qr-ri.dT 4. I.JNNERGROI.JND STORAGEFRCIDL'CT HF,IMHT EAUALPACIFIC FELLRENATN HARZANt N. sEcCIND ST. R00l'{ F,75sAN JCI58, CA. 951 13( 4CtB ) "*91 -4335#68PACIFIC BELL *68196 SUFURBAN$AN l-UIS nFISPO, CA. '33*frlrlMR. PANI{RATZSAN LUIS OETISPODIHSELcta/ct3/ t.tgtSNAVELY ENTERPRISES INC.T3381 g. HENDERSOHCARUTHER6, CA. 93609800-345-1633{+'3Ct-111'{4, 00c)STEELDIHSEL.TANI.I SYSTEM I5 CERTIFIEDTB CIR HIGHER THAN GRADFYESgaL LnnsT I GH]" ATL.HVf:.L6a1lc,ns Per Hnurl imi.te establ ishedHeasr-rred Nr-tmeri. caI l-eeh:aqe Rate ie: -, CrCrTLnss ti+) r'r Gain { -).This measr.rrement is within the at Iawablein NFPA 329 fnr a tiEht tank system.SNAVELY ENTERPRISES, INCORPBRATED -13381 SOUTH HENDERSONP.O, BOX 5 - CARUTHERS, CALIFoRNIA 93609 - 800-345-1633 NDE VPLTCapacity ':,f 'l;hei tanllPast cf,'ntentsTest i ng I i- qr.ridTanl: cc'nstrr-tctimn materiaINOMPUTERIZED PRECI6ION TEST REPORTGENERAL REPORT FORM . GCOPYRIBHTPABE A-PATENT PENDINBt98SItJ45r+, Ct(:)flDIESELDI ESELSTHEL.9t13':rfd;t1t571CAML0CIIsucT I 0N. tx-rr14455.853t 16cxl(]PHASE IUNI{NCIWNcra/Q?./ l'391I 7 r tlttl135qa I 1r:rnsin c hesincheginchesinchesincl'resinctresiTank inc I inatinn tldeEtrees)Fitl pipe inclination (lclegreeslI nter na I d iametert,f tankTank h':t t':'m to qrnder I eve IFi I I pipe internnl cliameterFi11 FiFe lengtl'rT':p,3f 'filt pipe tn tanll b,:'ttc,mI'r;rp crf fi.l.t pipf, t,r qrade level8, Air vents9. T'ype nf f i. 1 I pi pe capl.{lt.fyps r3f pr.rmpinq syg;temll.f,nefficient nf thermal eupansionlS.Specific qravityI 3, Etr-r I t{ mnd r"t I us14. Vap,rY rec':'Very system15. Depth crf qrr:,ilndwater belc,w grade16. Date tanlt wels t*pped f ':'r testingt17, Tirne tank was tc,pped f nr testing18, Tntal pr'rdr-rct Ievel f r,rrn tanh h,:tt,:mSNAVELY ENTERPRIBEE, INCORPORATEDP.O. BOX S - CARUTHERS, CALIFORNIAnr-rrnberinchesincheeT33BI 8. HENDERSON93609 - sOO-345-16331Id.b.iR.h.67fr,b.cl" NDE VPLT COI'4PUTERIZED PRECISION TEST REPORT .PATENTGENERAL REPORT FORI'4 - €NOPYRIBHT 1985I PAGE4 I1. TOTAL TEST CONDUCTION TIME - 0!:(-)?:3tlrL.eak ratl? ca I c u I at inn t ime :a. start : CrSl 13: l,,lh. e+nd ; 1{r I 3l: 44PENDIN6l-r tf LtFlShr:rl-lf Sl'rc'r-trEinches;inchesp6ipsi.mi nr"rtes3. F I r-rid3. HeightleveL ab':ve Srcldr*'r,f water present in tanl,:Piping prsi$$r..rre te:;t c{rfidr..rf,i;eiclAtttr;;'r..1 |.lf '3'f prffi$,|;r,.tre appl iecJ 'bri' syStemAmr:'r..U"lt rt:j{r pl"*}ggr-tf e df ,:,t}Elapsecl ti.me rJr-rrinq testSystem pdlis, rrrF f aiI'3. Nal; tr-trbine ptirnp activatHd1Ct. If f rrl I syxte*m leakage ratesI imi'bt;, wert* t he nwners n,:t i f iedprncedl..tr€lsi necFsg3ary tc, isnlatepiping,.f,PIPING PRESSURE TEST . HYDROBTATIC PRESSURE DATA0NON/AN/AN/AN/A4s67BN/Aare in Ex crgs c,f al L r:wable':,'f any additinnal testingLeakage t,: the tanlr: r'r tanl.;N/All.Haver theser1:ii. War;i holl i.r.rrnp i. n;:,:' i n t i. rr r.tNOadditic,naL testinq prc,cedr..rreF been cc'mpLetecl?N/Al,+ir,nh: pi.np,::li ntl nq; $(i$rvl, cms rr?rr:',nrnrilncjGld Lrr.l.rlrcatir:rn rtlf IeAl': .SNAVELY ENTERpRTSEg, INEORPORATEDP,O. FOX 5 - CARUTHERS, CALXFORNIA18381 EI. HENDERSON?3609 - FOC|-345-1633 f,'-.#ln\.-..",*YT'ua..f ttlJLiL'n-'**'" *'* -JU\i 2 4 1sql$\i$t*rflr\LAMEFlICANENVIFI(]NM€NTAL MANAGEMENT Cc'FlrJ.Please Refer To:AEMC Job No. 8303020June 199LSan Luis Obispo County Health DepartmentDivision of Environmental HealthP.O. Box 1489San Luis Obispo, California 93406Attn: Mr. Lyle IrmenRE: RESULTS OF A SOIL IIWESTIGATION AT PACIFIC BELL FACILITT196 SUBIJRBAN ROAD, SAN LUIS OBISPO, CALIFORNIADear Mr. Lemen:American Environmental Management Corporation (AEMC) has been contrlcted by..Pacific Bell to oerform a limited-environmeirtal site aisessment at the Pacific Bell facilitylocated at the dbove-referenced site. This entailed constructing one soil boring that wasangled beneath a concrete containment sump, and the sampling and analysis of selectedsoil samples.Results of this studv indicate that there are no detectable concentrations of oil or grease atu A"ottt of 7.5 feet 6elow sround surface (bes) at a location 1".5 feet beneath the center ofitr. 6ur" of the concrete cbntainment sunipl One surface sample of oily material collectedadiacent to the outer sump wall was found to have an oil and grease concentration of+.t{OO Darts oer million. No detected concentrations of Benzene, Toluene, Xylene, andEthyllienzene (BTXE) and no hazardous concentrations of CAM metals were found ineith'er sample.'Detaili:d laboratory analytical results and chain-of-custody form areattached.This letter has been sent to you to confirm our telephone conversation of L8 June 1991regarding this elevated oil ahd grease concentratioi. To_recount, you stated that since theioILiu-Fle collected from direEtly beneath the sump had no deteited concentrations of oilittA gi"dr" or BTXE and since gr'ound water was odserved at 18, feet bgs, you did not feelthatThis presented a threat to tf,e ground water. Additionally, thg apparently small.andlocalized volume of affected mateiial onsite constituted a very minor environmentalproblem that required no regulatory intervention by your department.Based on this information, Pacific Bell has opted to leave the sump and the affected soil inthJground at this time. If the sump is removed in the future, the affected soil will berembdiated at that time.97'19 Lincoln Villoge Drive. Suite 501. Socromenlo. CA 95827 / (916)364-8872 -Mr. Lvle kmenSan Liris Obispo County Health Department20 June 1.99LPage 2Should youany furtherSincerely,David W. OliverProject GeologistEngineering DivisionDWO/scgl5pbe-06(do-6)Enclosurescc: Mr. Renato Marzan, Pacific Bellhave any questions regarding the above-referenced material or if we may be ofse*ice, pliase feel frie to glve me a call at (916) 364-8872.,l,l/ fufir,,*r- rv. pt I v J-V I ri1;18 ;Ai; Labcraicries Ccrg_36,30115;i 2/ tI{cA DOE$ EL{! AocrrC!Err!oall,.81:r=r-rl,06 N,:s5rr 1233A^|{ALYS]S REPORT: tocal 011 & Greasa, EpA yachoC 9O7iSnakar, DOHS Luf r t(och;d--CLIENT;ft-hc-?:oCcnect NoJProJDacaDateDeceDaceDar cExcAnaRePl.accedvz ad:'rred:ec!:2* k"t s&rSamoLed:Rec b ived:?honaALI{C Coniac::Job No.Lv'v LOgALYCBa ccBJotoN..l,E.j*4 -17- ft*/^ -/A -1to. I.-D. : /l&c,* .n No. : aqg/lx: ffiSanple i. DTocal Oii & GreaseCl1encA iVa/2- aI (/-64 ^ Ltuhs-/-5lgaoReportlng Lirair** UnIess ::rdicated wiri:i.n Darencheses3eND - Noc Decacced a: o): above lndlcaied .i.apo:::ag iirni: Y:A L LaDcra!cries u0rp, ; 6-i ?-91i 11:1.2.,.. jifi -.-a.bolt!gries Corp-._ .36.10155;i 2/ 2i{A^\AIYSIS RE?CRTgl goE:f i!J! Aac!.6lcrglonrletlrerrclon ilsbrr 1233Tocal !,ecroiau::r Hvdroca:ilo:rslEIt3, a3L {ececd 80i5/SC2'liil;; -"na-irip, !?-r' $ec'1'rc 5c3o?rcJ ec: r-o . :a.-* ' . ^. 'uWtlbCvL I?hono:.{A!C Coniac::;-i- $^ ,bfubLSEi;i@*AlYc 1 ,c,: l*C$* ,:. la^c^ I 't trllrfP:cJ ccc:Da ceDa:eDaceDaceSanp 1 e d:Reeb lveC:ixi:acsedAnaIYz cd :3.epor:ed:Sanpla I ' )bhl +ublaAEMClrLCoHe::ix:3o,t-a Su=:cqa:e R,ec ove rJ*) r i'eccve::"Cl:en:b-tULbl-l-"t4-7rzlh--A1,6lo1 rH-*fr-"tr;-W-tlo9 t-_*Joo-t_tI-T-.b.=-T-3-t'WffiyF-tIxqaebc-Dr,: . c/r--^i.'-EItdlv*_t'_l't\,.Sa-noie i . D.^1 r--- ' AfMaie:'.i enereb,Bacch +b-ltO,l-'tbt%+-+*rklJDi.DIJ_.I=fpI-1-J+--'hDi--r-v=l_I-T-:r-v=.L.Lz6-t+-ry--rte74-6.0 4.o 9'a5 -q^^--\i^!li.5vX- -r\u r-..- ^*Uniess ocnerr"'ise i':rdicaiEC in paren;:'lesesND - Soc lececcei a: cr a'cove iLclc3:eC R'elor::Le Linl: '1o S,ENT BY:A E Laboraiories Corp, ; 6-t g-9114;49 ;AE: LaDora;ori0rE?A 11€ cnoci 60iQl70C0P:cj oc: No ' :Ccrrae l:Yr\.nqo'; "r"9 ',ti.Y.C Corrcac::hq###,( A/L30.i0155 ;s 3/ 1ANALYS I S t'.5?ORi : CAI{ fle cals ' TT:'C 'cLIEr\T i A € m c L'nr'^/ n l/t //a4 ep//s loI(DaTd:P;cJ ecE tlc6S anp ied :.RacelveoEx::ac:eRnaIYze<iReportecr SampIE1, //>/gJob )lo. :aan I ^r \!n5 -'-',*YC !. D. :3a:clt )io. :R::. L1al:'(ns/kg)1n0,50cilc. icDa:)acDac6/ /E',s/s-/ilD,d. (7/q-NDNp/Jq^JDilD^)D^)DNDIJDilDAJPA)DtD\ ;1inc.cs5.0(n1^.'1 (11JV:,v.A60iclvcv5 01iCUlua'J -'JC\J.:.r'5010tnl d6 01.06 0:-06C::0esu:'csez/'Ag)(E,lellenc.{g ( S iiver)Ai (.{:senlc)3a (Ba;i-';:r)3e (Ee:Yiii'.l:)Cg (Cacni":::)Cr (f,n:cnluls - :ccai)Cc (Cob.elc)Cu (CoP?er)iig (Ke:curY)Yo (HoiY'ocienru)Ni (NlckaL)?b (Laac)Sb (-{rrcLn'onY)Se ( Seienl'.::r)ti ( rhall:ua)V (Vanadi"sr')Zn (Z:nc)CL,-r/(D?.a:. Ll:'l : - Rero::ing Lbl:-1 - ,- . t j''{ iND-NocDe:eccai-it'3=abc';e1:cic:':a::'''ic:::r'5r+:*-v i , $FN.T BY:A E Laboraiories Ccrp,i 6-i6-91 ;.:..-11:49 ;Ai. Lal:raioriCorP-E?.L Ya:iod 50iC//70C0?rcj ec: No . :a.^Fa!-r'?hone:i!,10j 5,!j.i .4i 1IINALYS iS R.EIOR.T : CA$ Xgcais ' i:LC 'CilEliT : AE fl I L !'tco / " y't//Y "\\\?roJ cc: :Po,9e // 9LOS arnp 1ed:R.ecb!.red:i:tt=aqced.{rraivz ed:R.epot:eC:nr Ss-aPicL/rz/4/1- //8'/ g /f..n8 -zAiYC Concaci:.'ob No. :CCC Lo5 No.:-Lb68v-zTffiEr,DeceDacaDacsDacaDaraCLiarFVa T 11 ,3ac:h No. :ltac::x:5at l-!ianen;AE (Sllver)As (Arsbnic)3a (Sariun)5a (3cryJ.1ir:a)Cl, (CEsl'::a)Cr (f,;:rcnius ' cccai)Cc (Cobai:)Cu (Ccppe:)Hg (Xa:cury)Xs (I{olYbdenu:a)Nl (Nlckel)?b (laaa)Sb (enc:-uonY)Se (Salcniur)TI (Th,aiii.'ra)!r (Vanadl';:l),t^ /?raa\{-J \ &r^rv /NDNOIJ^tLeQ--/.--J-^t7NDilD/€oIJPilDttDilD- /8333.esul;s(tg/ke)5^F T .l -.! r'(ueAg)1ac.500.505.05.C0. c5(^5.C300.50305.0;t.0.Ye:hoc50r.c7C6(r-^".,.)Ui.v,'t 47 CCU.i.u60:i0cv -vcLi:v60 tc6C 10in601.0F.:c. i.j:nic - ?-eror:1:6 llni:ND - I'ioc )e cas:ad. ar 5r :bove l:ilca:sc iepc;:l::g i'5:: AMEFlICANCHAIN OF CUSTODYTNVIFIG'NMENTAL LABGIFIATOFIIEg CclFIF.Loc No.23313t<,PPa.-\tl4 l/-frr,- y'-rrr.fia?.t/J/U'Yo llltll=a,(r@-q6IatrsEI\ZUJ3FIELO CONDITIONS:COMPOSITE:pRESERVATTVES: (i) HCL(2) HNo31ilv tLl,vl./1a-C(4)t1coNotTloNs/.t/7lI7rz\\\\$iNIrnsIN\t-74l/tl/-]I\$\Blvetzl/'l--742/IN\\\t7l77)'t{DllEtr|luE(/,f ." "s6r<9r/r"tt7!7t.r 5tl rts SCONTAINERNO.5oi/D-Sa'/sit7/>{)'3249 FITZGERALD RD.RANCHO CORDOVA, CA.95742OTHER@netcTYPE5ai76/.,"r'.a./t' , u <,/t'i.oMETHOOg/z't'u <r/.-' v'DEPTH(:'(-fl uesAIRBILL fFED XERB-tB-z8-3g-/-s -/ilEC'D AT LABl) n ---1,ISAMPLE,/7SUSPECTEOcLrENrN^MEy' +rB.-./ t. / O5-u /euu'sNAMEPROJECTc7pa/t' -S/ AoD,St/r/,<,2{ z?ea" a/)0"^ .,/ PHONE t.r. (t/'L..-%s/ottls/*ty's/at%t/c/71s/e7ANALYSIS REOUESTEDfloNDATEPFINT NAME'COMPANYSHIPPED VIAREC'O B\'(SIGN)PNINT NAME'COMPANY 805-549-5544Facility N/ilCOU|\ . t OF SAN LUIS OBISPO HEALTH DEPA' " IMENTDivision of Environmental HealthP.O. Box 1489, San Luis Obispo, CA 93406Rdutine lnspectionReinspection No.Complaint lnvestigationt.,AI t!rHAZARDOUS MATERIAL/U N DERGROU N D STORAGE TAN K/WASTE G EN ERATORINSPEC{ION REPORT/NOTICE OF VIOLATIONDatel=Facility Addl,'::it,1)-.1i1.-,, ;' 1" , . *-5'"i"='i-'Contact-.)l.L).Title/Position:-HAZARDOUS MATERIALS#UNDERGROUND STORAGE TANKS (COMP #(cAH&S Code, Div. 20,(cAH&S Code, Div. 20, ChaP.6.BUSINESS I.D. FORMATL. #--- GENERALnumber2.4.Hazardous material & amounts listedTANK CLOSURE3. Location of utilities5. Material stored in ProPercontainers& labelednotnmentPLOT PLAN8. Plotsubmitted&buildi't0.ofmaterials11. Fireuishers/water12. Emeswitches13.on & verilication of MSDS'14. Sewerand/or stormns15.alea16. ChanionsEMERGENCY RESE PLAN17. Adroced18. Adevacuationres19.TBAINING PROCEDURESThe above marked items represent violations of the California Health & Safety Code and the California Code ofRegulations and must be corrected.Viol6.il37. Soill containment36. Fire extinquishers35. Storaqe - 90 days34. lncompatibles not stored together33. Material stored in proper containers& labeled32. Continqency plan31. Traininq program/records30. Waste oil receipt29. Manifests28. Variances and/or exemPtionsu-."27. EPA identification numberWASTE GENERATORS C(c) Soil samples takenb) Tanrinsed/tlTanks26. Removal/in place abandonment25. Temporary closure24. Permit approved23. Leak detectorsL/"1r'"22. Precision tank test21. lnventory reconciliationComplViolCompl20. Permit to oPerateCOMM(:-l l tt)(=, lj: i:=€ir'1r'ti{;lnspector's SignatuOwner/Operator SignatNOTE: Signature indicates receipt ol thisonly and not an admission of the facts.Page- of- I\SaletyDepartment 30Post 0ffice Box 7631San Francisco, California 94120PACIFIClvlfrlBELL'A Pacific Telesis CompanyMarch 26, l-991COUNTY OF SAN LUTS OBISPODEPT. OF PUBLIC HEALTH2r9r JOHNSON AVE., P.O. BOX 93406sAN LUrS OBTSPO, CA. 93406RE: Annual Hazardous Materials Disclosure Permit FeesEnclosed is a draft for $ZZS.oo for Permit Fees for Disclosure ofHazardous Materials for the foltowing Pacific BeIl facilitieslocated in the COUNTY OF SAN LUIS OBISPO:Pacific BeII SiteAmount of Fee1 BRIDGE ST., CAMBRIA931-5 ENCTNA AVE., SANTA MARGARTTA$75. oo$zssoDA LAKE RD., CALTF. VALLEY226 W. DANA ST., NTPOMO.ooPlease contact me on (41-5) 542-3060 with any questions.NancyancySafety ManagerEnclosure - Draft # 4L7-Lo2 ($225.00)cc: Fresno Fuel Unit-/\y (r ( i'l sAN LUrs oBrsPo couNTY 1DEPARTMENT OF ENVIRONMENTAL HEALTHHAZARDOUS MATERIALS SECTION -- UNDERGROUND TANK PROGRAMINVENTORY RECONCILIATION REPORTLo/oL/Leeo ro L2/3L/L99O,trANK 58AGENEY TANK ID: CATO8OO243OOADDRESSE 908 28TH STREETPASO ROBT,ES, CATANK 59AGENCY TATiIK ID: CATO8OO243OOADDRESSS 908 28TH STREETPASO ROBLES, CATANK 66AGENCY TAI{K ID: CATO8OO24268ADDRESST L96 SUBURBANsAN LUrS OBTSPO, CATANK 67AGENCY TANK ID: CATO8OO24268ADDRESS: 196 SUBURBANsAN LUrS OBTSPO, CATANK 68AGENCY TANK ID: CATO8OO24268ADDRESS: 1,96 SUBURBANsAN LUIS OBISPO, CAPROPRIETARY INFORMATION : NOt fOT USE OT d'iSCIOSUTEoutside Pacific Bell except under written agreementFOR THE REPORTTNG PERIOD OF LO/OL/L990 TO T2/3L/L99O,I HEREBY CERTIFY THAT DAILY INVENTORY RECONCILIATION RECORDSHAVE SHOWN VALUES WITHIN ALI,OWABLE ERROR LIUITS SET BY THEWATER RESOURCES CONTROI, BOARD FOR THE ABOVE TANKS. FUEL LOGGINGHAZARDOUS-MATERTALS SECTION - UNDERGROUND TANK PROGRAMTNVENTORY REPORTLo/oL/Leeo ro tzlii/lsso^-r]_ r'REPvRT -- NONMETERED TANKSSAN LUrS OBISPO COUNTYDEPARTMENT OF ENViRONMiiTAT, HEALTHpage l_PROPRIETARY INFORMATION : NOt fOr USE Or diSCIOSUTEoutside pacific bEii-elicipt ""a"i o,iltiln asreement FUEL IOGGING RENT-- NONMETERED TANKSpage L8r REALTZE THAT MISREPRESENTATIONS OF DATA ON THIS FORM MAYRESULT IN cIvIL PENALTIES OF UP TO $25,OOO PER DAY PER VIOI,ATIONPERSUANT TO SECTION 25819 OF THE CALIFORNIA HEALTH AND SAFETY CODE.NAME:C. S. WALTERSSIGNATURE:e ,1 *)av-dTITLE3 FUEL SUPERVISORPacific Bell Fuel UnitL445 Van Ness Ave, Room 235Fresno, California 93762PROPRIETARY INFORMATION : Not for use or disclosureoutside Pacific BelI except under written agreementDATE:r/14/eL r-RECEIVED,JlH e2 tsetHnvlrcnrnental HealthnncracffiBEL[oA Pacitic Telesis CompanyC. S. $traltersFueI SupervisorL445 Van NessRoom 236Fresno, CA 93762January 14, 1991San Luis obispo CountyDivision of Environmental HealthP.O. Box 1489San Luis obispo, CA 93406Attention: Mike McceeAttached is Pacific Be1lrs Underground Tanks Reconciliation Disclosurefor the period from October l, 1990 through Decenber 31, 1990.If you have any questions, please call Sandy Pyle on (209) 442-2375.Thank you.O J ) rL(fr,4-C. S. WaltersFuel SupervisorJRC: SPAt,tachnents Data Char{'-}or Talk System Tightnef,* Testq,tEcElvEDFEB 4 tggtEelvironmental Ff ealth,LIAslxt<l, Ir-..rclNilPI(lIIS SRDCISTCN TTIG lIESUNGEACIFTC BELL 2 North 2nd St., Room # 579t San'JoseCa.95113?!g9at!7lantDtrlrto0aro!lE6,LadllralSTJBC}IAPTER16 OF C}IAPTER3 OF TITLE 23 OF T}IE CALIFOR}TIA ADtrNISTRATIVE CODEqftl.fERladat Ai,[$OiCIrlNERastio{ritadaurCrrv n.n6'roAotor Ag.VratrSrDhoml?umgr<oi{P /F/94.;-3da. M.tldd.aD.pth lo tha Walt lrbl.l.nts lo b. l,lLd - ht'Drtc Ant^god byf.rr?t p.odusr to top otf' ai(t ru6 TSIT Ho- .nd who to g.ovdc ) conr,der No LGldWhrci lantt tSeclan. a.6ola:Lla d lm6It rha ltrat ov, rl! laht ICt.n Etoldaghoaorrmrnrrororh..Gonr.ct NOT APPLICABLE.,f / F /t ocalonllodi ..rta. 6.rFtt.llsr ot tlls. llclillru3[a. t.talil dlr. O,o,aeDal i@r trlltC:r/-;ConrCccd. al.cl lot.lani dc{. r?cc27,/.re +aZc.5 jld.^rttv br Ditcl,ofr?iCrprcrtyBr.idlSuDCnGodrI, WHO RTOUEST€OITST ANO IYHENfOR THIS TEST?6. TAt'lK(S) lilV0LVE07. tilSTALLAT|0l{E. UNOTRGROUNOWATER9. FILL.UPARRAN6EMENTSIO. CONTRACTOR,"c,cHANtcS../ g1p, g.gnrrrcluh6lvt6II. OTHERINFORMATI()NOR REMARKS12. 5T RISULTSt3. ctRTltlcATl0Na-f --7-alaIA)?5.IS PAYINGt.3. ReASoil roRrtsTllrPllrn f ulhlz(lRCohoanrAddrlro^al rnlo,malron o^ ,hY ll?nlaDovtlrcrtl3 or olnarr to barhtn lGSlr^9 't r^ 0.ogtrtl o{ Gohttlalcddlu,,ng ttrl allItraDnoifObttrtt?lTatlr rrra rntda on tt{ abova trnl ryalam! !n rccotdanca wrlh iatl Procadu?at PtaaatrDd lolar atalrrLd on anachad lall chafll trth rctunl lt lollott.lrnt ldtnt,l'cal'o^lrLaatrgc lnd'C.lrdL€Pdts&Ortr fertrdu- r-a:jThra lr lo Ga.lrt} lhal tliaxItnl at3l.6r :o.a laalad oar lha at.laarlAaocratro^ P.mchltl l?9CHAMPION'Satlodn Thora {rdrcalad ll "Tighl" m"l llta cal-la arl'ur'hd bYPRECISION TNK TESTI}.IGX.l|o6.l Flta P?olactpau/-<- - -*,.7 u'/ /t,4tlr.l.rlr^o L(r^lr.(1451 oAlfiLJRSl' llAY,6 9t822 l,'4ooo/! rs. /tlnpratura h Tr*AlL?grqlhbr..",taitg.?rua ol Editla ,..t{ombd Cl9.ciyt4nf,t'--,J1-bNrmr ol S!- ':.r. O*nrf ot Oalllt15. TANK TO TESTTtrISa. BRIEF DIAGRAM OF TANK FTTLO16. CAPACITYi.l.o-.o.ti a-f*?DfrqrE o.* c..nf] tr,, Mmulrctrr..t ot..t[-l co.plnr tneu...t e o.t.I *r,. .upptl.d rlrhOdbdlorf Oafo.t4.. tbadha4Do-?g4aa Yl.rldr loLl blh. '!!r21. VAP0R REC0VERY SYSTEM flt.r.t Et-n2{b. COEFFICIETIT OF EXPANSIONRECIPROCAL METHOOttr.ol 'odrdT' Ed,6a,--'tsIv4 .,9! .,lrt.l!illrE.ntlo't(l .....qfl..toca l./-l+loOb..'rild AP.l. Otnlt ,,34;3eacbrccal2t8fz(|qn. -4-4,-t(doQCllytl,,; (.p-t.a\(j/,'tlrJ/-l-l *.,., rn rmr D Ltnth, b.lne t.rt.d rlth Lvllrf] *,0, r.,"r,.t. ln lJll lrcr|lbn(a)T{b}toLTrnl Ohmlarlolll qumllly htull l.nl ltl ot !t,ot /, f3/ t69I 72azOrlbmlrw.ltloayCo.tnchrl ol apa'llon lotlnvolvad prodscl4a'17. FIIL.UP FOR TESTsttd v{drr Borm3. Pr[3ura rt bottom ot llnla Falrurr .l loP ot ltnlldFlily bt8r.nd r^d OrtdaDrDlh ot bu.illlrnt dlr.oa -?.-l-'5I 's'--.-f- "r,!r mfr Tq,jd. .. .. 4 O O fScrprcllr chrl dril.O" - 6; il;flot-balda Flltupl6Orllont18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANKSar nrnu.l Gllont .ppllctbla. Chct balw and .co.d p,ocrduta ln log l27ltJla nulnum lllowaua Lrl prlrtu,l tot all ldll.fw. pound rula dst not tpply lo d@blartll.d rntr.Cmplrl! t?cllon brlw:l. b ldr Pound .ull taqul.ad?,-Eni5tffiln.2 ll.bhl to t2" nlA Irom bollm ol ttnl.l?Inl0LtablaNOTES:ln.4.t 8rold eu'rriy hluil lml llt o? ttlRaclprocll24c. FOR TESTING WITH WATER ... rrof. c t olvrl,r TiiD.rrf,t rt Chcrrldbr!rb|G...r.,,...Lfr4/ Inf'wwurla clrrrtrfrlltlf,rtt."?r.n tr F tfr t3.-.tlhr rbovc c.lcullllont lr. lo ba ur.d to. d?y toll condhlonl lo.'lablhh r potlllvtptrttura advanlrgc, oawhan utlng thclourpotmdrulc lo compcnlrla lol lhc prtarnct of lublurlacc wllti In thr l'nkIrcl.R.t.r lo N.F.P.A, 30. Sacllonl 2'3.2.1 md *7.2 lnd lh. lrnlmrnuhclurat rcaatdlng allorrbla tyllam llal prataurct25.coillcLilolfrt tll'l. D .................Ad(Sirt rln f]t O* tll,r.ircocrouretlr(c)gdatvdrtdlrliahlhbl.*'.t'|rht bLaI19. TANK MEASUREMENTS FORTSTT ASSEMBLYEollom ol lmi lo Irrit',,.",...............Tol.l lublng lo .|rrtrbb - aP9forhda . ... ..tfLkt30ItAdd s- lof 'r Prob. ary.......... tzL' b.C0EFFICIENT 0F EXPANSI0N (Complete aller circulatlon)24a, cour"rro A.P,t. o..vttyOblrmdAPl.OrtltvOb$fr.d Srnpl. TamP.tdu[ ...ltd.omtlrt rmployadTr.nrtrr COE lo Llfta rl'b'crr.ct.d A.P l. oravlly@ 6dF, from Tlblc A ... .Cdlllctml ol Erpmtlonlor lnwtvad Pto{rrrclF on lrua g ...,.,....22, mcrnrt-Scnro. tatdlno rllf cltculrllotr23. Orgn. p"t 'F ln nnia ol .tpactld Gh$e.6t-6? .tlalwn3L!dlgllt20. EXTENSION HOSE SETTINGTml lop lo gnda'Erland hora dr tucllon tuba C" s notobclow lrnt lop'll Fltl 9lp. .xlandt lbora enda. ula lot ol ftfl.Lc>hr7Qln.26.vokrm. chrt!tr pt 't llt o. 2tbltDtelllt.'f hl..lt,dad7 ,rli{,. l,I)\J/v,il.i!;\'l_(;vltUt5tat-Llt*'(;tt('(0r tl)r)dhQ4t)'r7tb-5'Pilv0'82lr{}alt!$lstat0t0Ic!!*2/"7'P"fW'/t.{ o/ i,?l fp-a {-*( (1 -r-,dJ ;9"ji ' '7'/ ' u t/ /S1li7;.t rtog ,r, 2'rr !-t,t'1./. :zti.r' 7 ,72/l/,tryi foJ- i; t / tlI peparu ll eult lo qt0u.lilnl ernl lmt Oupunr pusdn 0urll.i lo sllelap pror.uv!tilr-.',L.LI0I0ulprrg'6217,/ - uoltlrqltgc lolursslunotcoud r{ 901/.1it6?/?t"-t t]IIIti' i !I/,f,'t: ttAIb',tll't t,t"cl8'/" tt tto'hlh5l"t'E ka'Llto'Lh0 tl,o'ihG',tho'Br',C'tll'/0utpraUlo0uluuPrgltI2lIrz/II)0el0ullroJlunSsludlilYls0U0Ar{/IIo'dt,Dalo|lruq1{r0l la^a'lla{tul ultr^rl rqdCu.rS.,, r, l.'(tf,/,'tt-4 i. 'o ',{:eqtt2dwtio7,l 'Qh?'oh7'CI ?nc'a&h'oo h'cta'Qg?,o6L'QZ?'oLJ'(rtb0(t'Q2'L ,QZI'Q,Q 'out9uUarola8Qbo'oQS'.(ihh't;PC'QTE0?'( 'IQOTa1,lIo7L',Gi?,o?-t'rl th'qh'otT'oh&'o 6L'QZ?,at9 'oZ,rtdt€'az"t 'otl'0uprlUJlllfzt,rlmp.oq lileo{fagot1t1(l' fs t0't{"t itet It,'"(,''' It"!Q 'lrltO'lC',Q'+s 8e'*Q\Q,'fo8o'7o8o'lazl'+@/'+Qtl'l@l 'rttQl '+oa l'+a0l '"1vV t'ioQt'*aol'fl.l P.rl^ol!|rtPotal-, 9.rq0.u;rngora'[['ilc ro 0r 0u00lrlil Sil$riln$il ilnm.tle'tt ttt8Qt&809h0tlo.gIL4aut6lt,/EL281tbLbLLht, t)?Lf,u8sLo)L5hL6€t€ftL-r/zLL Lt'90tutprrU,0lrr€lilrr.ul+E+L-th'rf'+t+.-i4*+Trft+1,+€+-t'l7+Jtjr+!+-5+'l+?"t?+h+FI- ,trol. rr{|0Hr1ry9'90t 70'lt?o'+07tA'7t gs '"it?0 rll a'f?.0t'+Ito+Iol '+Q h0'+1,80'+t80 '+tE0't2 z l'-+2Ql'f20 l'+llo'+201'fzz l'l77t , t271 'rI a2'+- 0ql'3,]rr0t.uqildrtr(tlrpluoltay{rr€'/tt Qe'*100'-a t.o'tI 'Lo',--tao1t;t)--ZZe '-/ OA'-oho' +lCOn -tOQ'*b to'+I te'+5/otr8t Q't\aebfQ'1zoo'-2 2Ot-zzo'-?za'?hlo'+lttrtr - lAhUl-l uqprttuoc,o l.l l'otllrartlr4trr4ol- rumFffi-tlrttnaual0u0llu l{t\0xr9rYll3rmxn rtx'880l uoltvJ $nllulvsrldllo anlwiln3l'tebzo'+oto'+It o 'fI t ct'1*7, 0 "+L/o'ttto't"48o'4?-9 e'!tlQ'18lo'tbto'+E/ 0',+gla',+8la',+zQQ,*b to'1-2 ee'-zeo'*/107Q',t/I'lITl' Y'JI'r||rarfnOt*-r patl .al tylil|lHt0ilntuurl:l!,'682U'.-2?Q'al,lO't ,/:,)r'4<)nlqn)lJtt ..),( .,4 . ar s r |'.")rt,rt>,tIt1/IaIl'tt-/llr7.r'2.',/-?al21t2"o,t 3''/11. '/i'r' ..J/ i.,1t. Ii :i .'iI ":l,tt/?,./l2 Lrt3uLlti/ 3'4ILd(?q)t17-IIl!tlSll/IIt!,t1llt,L/rs,slo,/45"'t), 3?,:,5:, (),2]',O, /0(s, a40, L70,6 30, {to7i /,'),1, J, d'7#, t t(),4{o3?a<..',"). L7tt, /(tt/oat, 7s^t), [€,2,tr3t:*. Cti,:'! ,D3''t1 , (,,i ,.:{ O,'r,'1.:J.(.),,n:-)"f . r ''')'f (Vtttf,0&at . o/rt:*, a6n1,p{,.:s4 , Ct(',)*.11,!.,tttf'it?K7t+tgcf{1+zFtft l,lfst82f:?#rs-t+3!-t- Llrl't-t3+3+3t-3+3t4^f- 4f?t3+,oFl-l .a?l1.o6 |1.oi ILo4/*. dr/.,:)l rn{*,a bl+.oh I* abrf .at',t-1. ot'l+".a?o* <tZ/-' aal-,601*. aTl-1 0 7-l-,&/-.da I'-' d<7/+{2ool- aol- gtal* ot7+, aa+-f .ozrt,a z{-1, azd*. o 2-z+ c'tfl 7*, ozo". o/?'. ol?-, ot/-, oz2*, d2li/-'', 4r1 /+. 02q423rJ i ,.-P-T Tank Test Dala CharlAddlllonal lnlo,i"i,.r_../4, .t.2.,Slrlomtnl:X fanf rnd Foducl hmdllng tyrlom hll b..tr l.ttod lighl' 'rccordlng lo lh. Ploclllon Tcll Ctnatla rt trl.bli.hcd byN.F.P.A. publlctllon 320. Thl! ll nol lnltndcd lo lndlcllcpermlstlon of r lcrl.ORf] Trnt rnd producl h.ndllog rytt.m hs lall.d lh. llnl llghln.trlorl .ccordlng lo lhr Prcclllon Tell C.llorl. 13 orl.bllthcd byN.F.P.A. publlc.llon 329.ll h lh. r''ponrlblllly ot lh. o*n.l andbr oe.tdor ol lhitrytl.llr to kilmrdl.ldt .dyba tltlr l td bcd rdho.[lfr ol .rt'lrp[td hltl'd md lh. godbllty of rty '.podlblrpolbtln tolhl arffiimail l. r rl.un ol fi. lfillctl.d ldurr ol lt{r4.rlilt, Haalh conaunrnlq lmorporal ddoarnol l|t|l|rl fit.r.poillullly ot [.bllity lor rny b.l ol Foducl lo lhotnvlronmenl,-l .o/.1l. Nel volumochangotlSignaluro ol losler*.o//ol Procilion To.l -gphDalc:?:T.,-?/,Tant Ornllopardor '-1-t4.t-/.Nrnt ol Suppliar, Orntr ot Daalaf15.'TANK TO TEST-15a. BFIEF DIAGRAM 0F TANK Flu-r,16. CAPACITY.[-':.:,:. ],4 !rM,cJx-T)3 tNoihd C.t.ciyI 12,OA)/ OdbnalnffiloryOd. ot lar!ilnbn Chstt&l tlf,|uhdw.fi Cnl.lCon9ant tnghaarlng Oalt(hrlr tJrtlll(t rlllrq-?-qatord Oalo.r-.Fdln,/6a60/o/ dczl ochvgtl.EItrtrun,,l\l'. (t (^_Btrnd md Grld.17. FILL.UP FOR TEST$lct Yfur Bottmob.lda fln-upln.to tt":IffiffiJl'..,* lD/[mOttatOallonaTrrdrlo lln ltltaoillrl'lglot d,..t i?irtr.h?r*AnrCkarhlbotaiparaftr.a ol !ai$aOtltr.cqr l.r-1.,......,,., ;,Ot traa AP.l- Orarlit r..,.,,............ ... .. ...w* /{34 a,, s6'ldrnlily by potilonl. l! tout pdnd rula taquhad?e Habhl lo t?" mttl Iton Dotlm ol llnkl. Rarlut d boilm ol llntOttlh ol bu.idTrnt dlr,-d ,," D/ {"Lt ,^j,|r.l ,",.q6ln.Tanl Olamalx(a)foldqlr.adtthMt rmr lttor ltllal |n, {2ftr?. g7.(.t t tl-n(lrllonalg. spEclAL c0NDlTl0Ns AND pR0cEDUREs T0 TEST THls TANK flwerrnrmr E .n'nro.,no,nr.drrrhLvLLr3a. tnrnurl rcllon! rppllc.bl.. Chacl b.lil and tmtd ptoc.dt. ln ttC l2?1,ntL mrlnlm rllorlbll ittl ttalrut. ld all tdlt.Foi Dound rulr doat nol a9ply lo ddbldallad hnlt.Cornplala tccllon brld'2t. VAP0R RECOVERY SYSTEM El"-' D".rl ,,21b. COEFFICIEiIT OF EXPAilSIONRECIPSOCAL METHODlyt .l 'ro.fuct'', !'Q64sc*aQ/J .t74 .,+3tq./Z. ,l--:l-J-rn./2/I l? noroa , 63/ .0,{/s4gq"'<t,lillqu3{rth tl.d'?ocd hir| rirlFhtu{ trai tlt ot lA 0ib 11* F tttrblcNOTES:ln.21c. FOB TESTING WITH WATER.i fl.l.o I Dftl.r lmgarlhrlt .nar ClrcuElbnIrar.arr b tha tll-.fSaoltaftbttaI.bbc..,........Codtlcl,'rl ollvlltTha abov. crkul.tlonr ata lo ba Ul.d lot dty loll condltlont tocalablhh a po.hlvr pr.tlu?aldYlnllga, o?th.n lJ.lnglhr lour goundruL lo comprnrlta tot lha pr6cnca ol lubaurtlca slltt ln lha l|nka?aa.Bcl.r to N.F.P.A. 30. S.cllont 2-3.2.4 .nd 1?.2 md lh. lrntmrnuhclu.r? rcgt?dlng lllorrbb aytlam lcl Patlutct.r (!l-,rCo.tichrr ol.Iprrlon hhFhrn prldu.l2/ 4t.D|D.......,.,rantrrrrmr [Jv.. 0* vrri.rooclclvolun cr.t|rhltlL.*F"t 63Acf25.19. TANK MEASUREMENTS FORTSTT ASSEMBLYSonon o, lant lo graOa' .,..,.........,....ldd S' lor'T" pfob. rry....,.,...........lold lublng lo |tlribla - aot?orhaL ...,l3o30-76-brhh,C0EFFICIENT 0F EXPANSION (Complete aller circulatlon)243. cortaoa tP.l. OdllyObImd A P.l. O'DIV ...... ''...ltdromclff amp|oyd,....,..,,.,Ott$flld Samplr la0prtrluta . . ,aaColllclait ol CrFmtlonFron l.Ur I .,.,.,..,,...fr.nrLr COG lo Lldl ?l'b.Corcclrd A Pl. OtnltY@ 60ff, From Tabh A .,22. ttaort-scnror raadln! rllrr cltculltloa23, o9l. p.r .F ln rrnlll ol ap.cl.d chnea7d-7'7B.lim3rqdgntdlenr.F/77 /'!,,lanl top lo errd.'Erland holl on irctblt luba a- a fio?o'lt Flll DIpl .rlandr rboya Cra&. uta loo o, I['20. EXTENSION HOSE SETTING34ln./.1Ch.bdil lml lop26Vdum chsgo 9.t 'F ni o. 2ablolotlr gr 'F ln LalaVdrrl.cirr.o-dfil Iit1l ,+',t"5{",ri;4.t'):-}17)3f3*/,{l? a,q-(?;.I (;-l/ or,q<36la(t0dDDq.Iv)ffim?-Q-almEl?a lv.l28.0Alf)n---^/ ,4;J P,^:;/)t: '"L TF.-..-Tr..*a- /)rr{r o*.J'//,-. ^/ - .1- '-../ '72-)'pl/P t tl T'F .f .-- 5,16 ,Rrcord d!lrllr ol trlllng u9lnd running lrsl. (U!r lulllcngllr ol lln. ll nccdrd It?l/r0()/i;--I7(q'(:ScnsorCrllbrltlon-_ I -r0r._ lcsr PFocEDun€s27-1(-1LLq7-Iaa.R!rdlngltoItf,al4,ot 4,()14,0tt oIt-t 014 t)lt/ , ()lr/ o/4,0/,1{Ir"J,ot5.Lt7,{Il''l3,1r13'14,!,,#1,3ud(q+0!!,"!,0"/'l,orlrlIttlt!ttltuilrlrltLILttlt,lt,4Lirldhg8!0holn0olStriltglpl l.Yrlln lnchrtIrv.l lornbhilllor.d30. HYonosrArrcPRTSSURIc0[tFot, Lqa, 5I,o.40f),LfrO.l6r), ffl(t.(,((.).Sht), rl47, 32rs,2a,t,e37.7{a, o2o, ,1503?o, /?0, dl,0i'/t;-d,:,, cl'70t3€at lcn8rlOq,7fr0, L40,52.o. 40a, 2t0, I (to, *'di.>' bg(), 5(,0, *Qtt, 37tt. 7-as,740, sgD. sEc, .+€6,32.O, /40. 7b>.7 ; .'\t Q;a4zotAllatiodlnt32.trodl.l h0lldullr"l- t? o4' 12ol. tLo+,r70+,t7bI ltat.tl t+,t 2A) ,12rs* tZa{, t Z-t-th /'5ar.t8 ill-39 oI,t30L l3o),t3 o-+, 130+, tgal-, t ?o&. /7D+.12otrodlrll*ovrrd l.l$t. rroouct 'iolrcd Flv0tt rt xtAsunt$Er{ls fvlRtooiD r0 (Dr cAr.3122o7t47€"12o3tq'lll lt{lat6b17,]71tr7ht75{74s7101337 ?(,1Lo7tf1m7*tfb11h?3,f L?O35.firndtouri.rdlqt-L+.{+LH,+(t+{+(,+L+('+1+0+74-lr7+7+L+r+L+r+7++f338.Giir.Il;fr, rtorlt -tcJ,l7.t+t0l4,tul, l2l+, lal4.lort/2t+, tLl-1, tzt+. t4l+,121+, t4/-(, t bzJ, /41+t4t4 tzl*,tal+,1214.lol, t+t*,o? o+ ohD37Ctrilld..rlCrlrl.trtsrbr 'Caol,lcl&r.',AO I*,otl-.oa/*,/iO I-,OOlf,olq;, Ml-.rdd I1 Ool-1,62 |*.ool4. ool*. lzzt++ tgq-,olll.ooq*. o2?l,dorl+, d41-.az I+, a?il,oh olrcg11sllq.,ltrriltllia$.rthrrrlrrl.trrCanrlcliil Frn$ - niln+. olb+,0L7*.aoy'J,oa/+.olo'*,otl'.od3'rOO7-, oloatlFtaA.az.tzat.|frlqfolr|.rrtidmrc'lrll'otulrtr outffi3^lsrU$ FrCroN l.fllu.ftrnrrltllsg.. lrortiluic--rf t"/31|oiultr?oGlllmtII ,oFrado/rau,ro rytl'luruluorlAuaaqt ot pnpord lo 33ot lul,ol ,(trlnrll io luilqlruodse,lua ltrrnttt lou ra@ paltrodroJul rluallnruo3 rllraH 'utlrl!|lluol|n||odnq.Poderlwlofo In3e, I lt luouruorlrua aqlIplqgrrod oql pur plrrq pqgdurlftt |o $lxrotlultt lrcq pua .tq..rlApt l|cltlp.uruf ot urgtilsat{t ,o ,oFrrdo rc/pur ,eu{o cr11 1o {ppttuodse, .ql 3l tl'oze uo[rf,llqnd VdJN,{q pcqtltqrtrr ra rtlellrC lrcl uoFpard ctll ol 0ulprocce lrelrreutqOlt {url rql pqpl .r{ ural.Aa Outtpurq lJnpotd pur 1ue1 guo'l3el B lo uolsslurtodolsrlpul ot pepuetq lou tt .tql '640 uo[Bcilqnd 'V d J Nlq peq3llqrtae ti rlr.UrC lsel uolslcerd eq1 o1 6ulprocortq6tt petset uecq trq urets,(s Oullpurq lcnpord pul rugl n:luourel9ls zqd6- tsel uolstce.rd lo-Ql2'-od---;_-r :elso'5 -O:JBlsel lo ern1eu615ts e6usq3 eu.,nlo loN Iolul leuolllppvusrtc eteo lsal luel I-d.-r.o,-ttJ,',, L0/U.,:, Itl/.5t)a0f,,r{rQt ) r.:tt/,(.'//f ./' L y';, ,',, (7:J--I'I'L't!l/I t't-'l'ttitrttI3zl8'r t8' 21til8,il2I\'i t)tIt3.t i(",/'/('/'/0 fz{tl1tlltlIt,llItItItlt-zloh?'oig'Qhh'0ht'Qh'z 'Qh IaQh0'v'.>ri/hf&i'a Lt,qgl'Qfr/ 'QhdJ,8-ft9'0t?t7 'ay'i'(i,r|{'Qh/'Ql,2 'o6.F'ainfii 'QLT .o 9/',oa/ 't0v I t'ro0l 'toa t'+Q(/')-a(|i+0al'to?/'fo/ l'+e?l'+,: //'+ozl '+Q Z,I' +8aztt7LLT2LCL2Z7?'z1"5 6bJ j)Lhtthz7ta/tt-if?tJ+_.1 tS+j+-,tr})7h+Lt?+-f+1-rte/+tzt'-rlol'r(0t'rt8l',+(ol'rlOt'1-lQ/'+l9e t/nt'+tzt'rlQt't7l-I QQ'-tzo'^toa'-/QQ'-t@'-tao--tvo'-l Oe'-bla'+/ fto'-J 9e'-bl Q'+2 0a'-? oa'-j00?lo'+Lto'+8l o'qbl0 fe't 9'+a z,€' ttxa's2, oa '+the'rht o'+)rzQ '-tqo'-IL-/'za"o 'y'-_tzttc*o' l4l',LA.*--15. I-ANK TO TES1N.o,- .[5/ zJ Illt6! ol SupDlltr (if,nr? ot Oallrtldrnlily by gorilionF,?8,and rnd G.rda17. FILL.UP FOR TESTSllcl lvrtd 6onmt. lt lout pdnd tula tlqultad?2. Halghl lo 12" mart itom bollom ol llnl3 Pra$urr at botlm ol llnta. ftrGrurt ll toD ol ltnlDlplh ol burillYrnt dir.Addrrrr No tnd Skttlhl15a. BRIEF OIAGBAM 0F TANK Flu-.r16. CAPACITYGllyBt no.l lcqrrdacrlac[t chlrl t.lllbLSrlalto,iNDnnnOa. ol 16lgdlrn Cha.tlit u.flrlclut.r'l c'ulCoritlot C^gh..rlDe OdrC-h'lr r,pgll.d rlthOhi -loral OrldrOdbnrc. fadkrtl j,!:J, 4\'.:rz_ )J/ A)?-Qb ^.lrnl Ol.i!.l]lor.l qujlft htull lrnt ll0or l7ltall,.i 2q6f *rr.trrn.rc.prcir / g t?r#JDlfrf,llorytblCotlldf,tf ol fip.mhlt lo?.lmotrad pr!(lrcl/0, or *?orde;ttir t"lut llnt lltd l?l/o, n. / {2q6Eo?'tt 'Vddia clnfa linrhrd F.tT?ctr F Lha lI.b.lora flll-upln.loO.llonr1g. SpECIAL CgNDITISNS ANg pRSCEDURES T0 TEST THIS TANK D*.,.,rnrrnr l--l Lrn hf b.rnor..',d,nhrvlLrgaa naaual tGlloD rppllctbL. Chxt bdot lnd l*ord proclduta ln lo0 l27lnUtr mtrlmln tlhrblt latl prattu?a lo. all 16llF@r 9ilnd tulr do.l nol lpply lo dilbld.llad hnlt.Conpldt tlcllon bclowIrJtrl' blj b fira 2!.rc/t,P21. VAP0R RECOVERY SYSTEM Elt.e.t Dr.nn24b. CoEFFICTEilT 0F EXPANSIoIIRECIPROCAL METHOOly9. ol Pioduc.€es _.Q,. 7? -.,. 7{.,ta.rfaraun h lnlAltr ClrdlrtbtrtJrFa?irra ol llltrgL,,..,,,.Dli.?.nca l./-1........,,.,....Ot ..Yld AP.l. Ottit ...',....... rf,it/,9iacl'locdt-{23Prf. a/2,- d ,.f]_rJ2 ^_:-.!*,",1,4- tStP-"Lt lt---i- ln.oIItlir'.oc.llrbraNOTES:ln21c. FOR TESTING WITH WATER ro trDr o r Dhlr Lrtc.flhnr dl".r chculibntrbh C ,.,,,.....Co.ibbrl.l ffiLtl.ob O ......,...lvrr rllturrtt Otr fl* ?'rtrocrtu.ra.lta .bova c.lcul.llonl tra lo ba ul.d lot dty toll condlllona lo..lrbllah r porlllvc Ptatuta ldvrnlagc, orwhan ullng lhc lourpoundda to compcntala lot lht ptctrnc. of lubautlrcc wltat ln lha lankatcl.F.lcr ro N.F.P.A. 30, s.crbnl &3.2.a md *t.? md lha t.ntmrnuttclutct ragttdlng tiostbla lyllatn lall pTitturcl.25, (clcllqrlafi,t323Yolrlllr.clllgrIr0|bl|tf0't'7. oa,q4V.lli !ltl.t|.t.t0ll1_r V)t.22. tlcrnrt-Srnrot taadlng.llrr cltclLllon23. ogrrr prr'r lo nngr ol arPa€'ltd Gialrga0a?19. TANK MEASUREMENTS FORTSTT ASSEMBLYAdd t0' lor -T" troba trt. , ,. . .. . . . ..rotal lublne lo.ttitrbL - rp9rorlnda/ 70h.ln.ltO30h,lonorn ol lanl lo Orada'ErLod hora m ructloo luba a" ol ffiabalor lul lop'lt flll plt .rl.nA lbor. gra&. ut. lottpoz/ln.ln.ol fi|.20. EXTENSION HOSE SETTINGTant lop lo orad.'C0EFFICIENT 0F EXPANSI0N (Complete aller circulalion)24a. corr*rro ,'P.t. oravttyTrlnrlr COC lo lh. e5..7Obrcdrd Sanpla ?ant taluraltydromalar amploytdOb!.d.d A Pl. GrnltyCo.ltlclml ol ErpmrbnI'or lnFlvr<! ProduclFron T.Ua BCorroclrd A.P l. Oravw@ lO'F. From Tlbl. A.26volum. ohmg. p.t'? Itl ot ltlUllh 0..'? h l.llIF^6^"r. r^ r ii^l r.l nlr^..tht Ilrr ,ol.,rdo/rfua(t IUrle$ or ,,npoid to t't lur pi lurnrrr ,. ;ffi.1t5::/hr llrn.r' po ..op pql,odooul !tu.||n.uoor qlra]l 'uratalrlro lo arrlFl 9.prl9ut .qf lo wrrar t tt lulrrruo4Aul .qlq rro0otpdqq.trodui(ut p lulqFlod.ql pul pllllq pqpulArl p lltlroqln. lrcol prll .|rlr.al^pr lt.lffptulr4 o1 ure lrlri{l lo ,orrrdo rqpua ,.uro .{l lo ltilntluodroJ .ql tt tltq p.q.lrq! r," r. .rr.rrc,.". uo,.,J3it.uultll"l',:;1"# illirrculq6p ryrlcqlp.ltttttrq tr1clllrOqpurr1 lcnpord pul 1u4 gco'lr3l t lo uolrSlurredib--z*bBleOJot3el lo trnlru6rgta eoueqC eurnto^ leN 'lqd6- taol// a'-.trttpul ol pepuolul tou rl rlql 620 uoll.ctlqnd "Yd'J'N,(q peqlltqqac sr rpallrc lsal uolalJ.ld cql o1 0ulproc-ellq6rl pelscl uecq rrq unltll Ou;;purq ltnpord pul lutl:lueuettlsE'zolul leuoluppvlrBqc BlBo lsal lusl l-da,i.nY0t56 fr,'OJ/U. -,t, h/ '-ft? /"/(79;ti0.)/(),L-lII;ihltI)tp7tt7"Lt{t<fttilti1'711'Ll./ I' td) '/l1 ',7t?,2/1',z/1'7 ttat? /" I'ln)'l /1'zt?7t-7 I!lrlhIittltltl/lnIt/tu.o/fr 'n!t, '(),; ; 'QlrZ /a5 r'as/o//'Qlo'Q'E,qz-F'0/"-5',Q Lrlo/-r'0/fr'q/h "nlf.'<,t> ,()bt 'aL/'ago//7a/?'Gb9 'o95'aho'+c)rt'J'+*'abd'Ql;o'+We *thla'+afo'+obQ'+erlo +vho'+oba'+fi/tA"'laho'tllttfhafh2tnsth80rt8tiaLt/qh6Fh2_eh-rhhL+8+4fL+/+8+L+L-lE+L+ot+3+b4b60'+jhe f6to'+/ 50'+sho'+/..sv'+bt?'tsha'-l-6p'+Lto'1-eha +LEQ +l@'+/aa'ftw'-loa'fL/e'-;SW ''/ to'-teo'47 i;J@'-1@'l-t@'+-vo t-€/e'-?ro7/Q'-s( o'f&ta'-bto'-frp//o'*ele +/zQ'+-t//i ]'e-z: e'- -cQo -lt o'-270'-LIO'-'-s7a?g P-T TAI{K TEs;1r D}mA CHI\RTtlCdttional .foFp,t\Jl|I?t-*alrt/.nr,!., r..J /(tN1..",'/,.'7( la,ai :i'l:!;: oilol|[otft .fl oil orel 0tl otl otl oltoI otlol ofl otl -€ - rra 'rltllttlru ruttA trltll ltArrl rll ru 3lA 'rA3lA 3rl rtA -r -''vr& *I : lprrer I r!.lli,iir.iilirrilpiirillrli'iriif ift.,'i;li,lil-s,Tll.tiilift*it'in n , 'i -;""'iramrrlgr$11 't '.: " ! !i, l'ul'S l.iTrl I." a Isoiftpuci gctl . lPlrrqt ' ;.-x- F tutrrt purtdrl6tI rtrftl P0€ fP.il,rrr-0t ..,,.1ii!,rii?hlh'ii ilsill6ffi-itl . !l$l lorg- 't :&lltlrl Ptyllt mf uolr1 - rrndo iilJlir'il.r1lgg,.iilfirrrcs &,,*rrt.33rr!r.i'31'#l,iiii:llilii,$ltji*, ..a '* ;.Jll &iitr:t tt'ilt,llr,fitt'ilt ;;;;;;:,; ;{ii#ih r eotffpuotf llllo prpf :tllt :rt^trl locl Ftl ruirl ,llztJyl 't | : :u1t1drr roc rl 7'T lrtqrrttlrtr urldrpr pur sttrl rsdr: 11r rry ,.i jlilf iior?l3oilffii,ll'll' * :rdrtr .n;11/trloquq/uru1r1uo1 111d9'3 - r.rro - rrrrd prpruqr ffit.iittl*ttriWl! Yrull lJnlru 14r priltr qll ql rt3lln lr grulhn urln, I Jo, lurrrrl 3rslJ lll{l IJU lrutCur JqPurlr I q lrn, tltltlrtr lurl rn ll00 't r$0rltl u0ttrtHlJl! tgllrDt Ir rdoetl B] aurr rl{tr$ 3rl trlJII tI l.l arlrllttt1II orF nA- //f/ otr; - lll c[ - t.A n0tl 3il'= iii ='*" :iilir$liii t oy- tll- ti'*'l;iurrl ol- Culqrrrr I li r.E, ;l i iB,l':ri :'l.,ll'il,Tlt:"iiliir gt ffiIi.i'lt'ii - r stutH llll mr rc$td $vrm ult a4 !l$!:ulflit lllll g ) a la ?9/ n{=t J ffi !s5lusl i .;) | {' ::.' E .-(,.-.-vJlrcatlont'J ,' 7-Itodi andd. alrNFry.Raa, ol rraton, alcIFillrSrt.. lit.ftll h.t!. O,ootubat. R.nola FdltCe.t)ConrConcrotr. Slacl Too.L.dh..tcy'. Oood3?,4.ra z-Io. OAO4z/t /u(Ennd/SupphotCrprcrty/ o, ooold.ntrtv bt Df,.cl.on#lAptor. Ag.ZtoGodcData char- ror Tank sysrem"'Tighrn"*rJrlilE 'ilt1;S' .{tf"%CTBHPTCNIS PRECISICII EAI{K TESTN(Gocr _t: t i39ilPACIFIC BELL 2 North 2nd St., Room lf 673, San-Jose, Ca. 95113: i:: ;.; '!-l.lAdd.iltlalagho6aRa6ilalopho^aaddrdrl.r.Ono^aSTJBCIIAPTER 16 OF CHAPIER 3 OF TITLE 23 OF THE CALIFOP}IIA ADI',TIN]STRATIVE CODECI^INERf ilr.Cohqnr oa 4tril{tron.OI^INERC0hr6t. Aer^Ct otAuliOlErnCrtlaStataAnaiFn olO,6ar l.odltuclrodaVantrSrphon.iPumprILCAST PRINIl' owNER rrco'rv !Irnr(r| l-l2. OPERATOR3. REASON FORTTST(€robrn f ullvl'I. IVHO REOUESTEDTEST ANO TVHEII5. $IHO IS PAYINGTOR THIS TEST?6. TANK(S| INVoLVE07. rNSTALLAT|0r,lDATA8. UNOERGROUNOWATER9. HLL-UPARRANGEMIIITSHa6anz-fa(/-l r€ dsSuctron. Fla60la.M.la il tnow^D.pth lo th. Wtltr llbl.Trolr to br lillcrt - h.trrra p.oducl to'-rop oll" end lun TSTT. How rnd who to g.ovrdc' Conrrdcr NO LcrdTcrmrnll or othar conltctNOT APPLICABLESrt.. Mairtold.<tDt- En"O.tG Adrngcd bv -IO. CONTRACTOR.MECHANICS.r^V olhtt co^tlrcldrovolvedII. OTHERINFORMATIOI'IOR RTMARKSI2. TEST RESUTTS13. ciRTrFrcAn0Ni:-'i. ,r]-.ls noto orinqurryC oagr ntf "taohonaAddrt'o^al rnlormat,On on anV rtcnt abovtdu,.ng lltt CIClrcr.lr o. othcrr loldvri€d whan lcltrng ri in p.ogrcti oa comglctcd Vrlrto.t d obt!.vltt Itclcnlfaata ?c.a mrdc on thc rbov3 trnl ayatGmr ln rccordancc wrlh la3l p(occdurct p.ercnb.d torrt dctarlGd on rtttchad t.rt chrrlt wilh.crullt ri lollow!:fr^L ld.^t,lrcal'o^I: Lc.llndrc.t.dO.tc TGrtcde-pclrq nls* T-a'rt'fhra rt lo carfity lhal thara lrnt lyatcmr wara larlad on lhc d.iCa) rhown. Thor i^drcllad ll "Yighl mal ltra cflt(la ctllurrh.d byProlEtron Aaocialron Prmphlcl 129C:{A},{PION',S PRECISION TANK TESI'II.IGO. r.th.l4 s I oAKFTRSt:"iii\' ;"ir' s.J^.ru'.S-\CILAMI'r\-'10, CA 95822 P-T TANK TE T DATA GARTAddltional Infoofu22/taa't't'*-irt./Q-:",-{J\za *r'dK) uA!-15a. BRIEF DIAGRAM OF TANK FIELD0^)zi*.*-.*,lrii;''i'u.' 0o'/ h,il ni {u}rru,*- &- /-,"42 C /*a-&a e------Nsmr ol Suppllar. Owne, or OrllsrAdd.ot. No. rnd Stracl(r)ln.ln,Clty16. CAPACITYBy mort lccuratacrprclty chrrl lYrlhbla9rtaD!taTostQ-?-qa15. TANK TO TESTN-ot= ZSL # It2ldonlily by goritionE?Brsnd 8nd Grldo17. FILL.UP FOR TESTSlick tli.trr Bonomnromrnlrclprcrry / g R#,etrD!!!Slrllon Ch!rllrnk Mrnulacturar't ChsrtComprny Englnecring DstsChrrls supplied wilhOtherGEllon3Tolrl Grllonsrs. B€ldidg" botor. Fill-upln.7Gsllon.,,flfu, '"lalToid qumtlly lntull rrnk |tc or 17)ht L, . {L?69 oglnYantoryCattlcl.nl ot .rpanrlon lorlnrclvrd prgducl323/D s-t-4,)---+/2'18. SPECIAL C0NDITIONS AND PR0CEDURES TO TEST THIS TANK l-'1*",", rn trnr l-l Lrn.(rt borne ut.d wrth LvLLtr'lSca mlnurl rrctlonr rppllcrblo. Chek bolow !f,d r6ord procadur. ln tog (27). l-, Hlgh wrtct t!bl. ln llnl arcavtllon(JSa m6xlmum rllowsblc lost prsssur! lor lll l8rts.Four pound rul! door not lpply lo doublswrlled lanks.Complota 3ectlon bolow:to itrL 13 tout pound tulo toquirod?2. Height lo .l2" mark trom bollom ol l8nk3. PrGssurc rt boltom ol lanka. Pre3tu.s !t lop ol lanhO€plh ol burialTrnl dia.21. VAP0R RECOVERY SYSTEM Fr,"n", !srsgo llTrsnslor totrl to llno 25a24b. COEFFICIENT OF EXPANSIONRECIPROCAL METHODTyp. ol Producl . , ,\ . .. . . . . . , . . . . . .Itydromclrr EmployedTampcntura ln TrnkAtlff Circulrtlon ....,.Trmporllurc ol SlmploOlllttoncG ('/-).......Obrsry.d A"P.l. GrNlty)_{33€t:..vH2-2.. ______z__=_.F-/r'.. -_______!___!_,F, /1L..,J.Fi4,6q/,\*.f,, * [4 L^.3.7 ,",1,4t3oqboRcclprocrle"s", f7{ss/f), or or"ilidilltv I" 'w!&r lsblaNOTES:Tht ebovo cElculrllont rrc to ba urod lor dry rcll condllloo lo!rl!bllshrporltlv.prossurordv!nlagc,orwhenuslnglhcloutPoundrulr lo compensalo lo. the pr66nca ot lubaurlscc wrlet ln lho lrnkIrt&Rct6, lo N.F.P,A. 30, Soctlonr 2-3.2,1 rnd &7.2 lnd lhc llnkm.nuhclurot rogstdlng rllowrbla tyltom l63t prcslur0l.full llnk (16 o, t7)24c. F0R TESTING WITH WATER sos rlbrc c a DWrtar Tampantura rticr ClrcuhtlonTrbl. C . . .. . . . . . . .RsclprocrlVoluma chug. ln thlt tlnkp.t'F- 4*(Uvdumc chlngr inthlr trnl por 'FTrmslGr to Llnr 26t._.ForllonsCocttlclmt ol WrlrrTrbL D . . .. . . . ,. . .Add.d surlrcbnt? fJt- n No TnnstGr coE to Lln. 25b.lcl25.26.Volun. chmO. p.r 'F (25 ot zrb)19. TANK MEASUREMENTS FORTSTT ASSEMBLYBonom ot hnk lo gnd.' , , . .. . , . , , , ..Add 30' tor "T' prob. rsry. . ., . , . . .. ..Told lublng lo rlrcmbl. - rpprorlmrtaln,ln.ln./ zD/bo30Trnl lop to gnd.'Erland hoaa on auctlon tubc 6" or mor.bclow ltnk lop'lt Fill plp€ lxlonds rbov! grldo. us. lop ot llll.,32/20. EXTENSION HOSE SETTINGotLln.ln.22. Tnermat-sensor ru8din9 rllor clrculstlondlgllE/a3/74 .FEolw6on23. oignr pcr 'F tn 6n9! ol sxpectod chmgo//t /zaa f)dloltr323C0EFFICIENT 0F EXPANSION (Complete alter circulation)24a, coura"a xP.r. cnvttyObrcmd A.P.l. Gtlylty .....,.,,...FlI-HItydromclrr rmployrdOb3oryod Smpla Trmpettlu.a , .,T.mrtcr COE lo Un.25b.@rr.cl.d A.P.l. Grrylly@ 8O'F. F om Trbl. A,@rllkl.nl ol Erpmrlonlo, lnvolvad ProduotFron Trbla B ,.. .. . ..,,xDleltl p.r'F ln l..lRmoo l23lVglum. cheg. psr digltComgltc lo,a dcclBrl nlrce!.Thlr 13lasltdclor hl 39.ACCUMUTAI [,i,CHANGElJ , ozozAl Iow lavcl compul€Chan0e per Hour(NFPA crilcria)Fzeat/*,ot0-,OO1*, OoF*,ot/f,o/0l,Paf*. aa?+, aL7* oL(z38. xrt vor.uutCHAIIGINGEACH READINGIemperilurcAdluslmenlvolume Minu!Erpansioo {'} orConlraction {-lr33(V) - r37(I)*, 'P *0-,oz I+,crt/"i+, o,3:!*, o2?l,o oq*,#tl+ l?ct+, gL44. eo7* oal4 nz!lOol-.,ao /-,0olr,o /q- ,O'9 I-,d01-, OCIl+,o//-,oo /37.Compulalion(c) ' (a) .Expansion .Conlraction -+ lbo#,og o+, l+l1'tot+,121*,ta tI tLt{t+t1,141*,t t z+, t4/+,t2t+. t4l1, tzt+, tzl+i /214, lot+, 11,-lJ, lzl.L ILI+101J,ILI36.Chang!Highar .Lowor -(c)+3, ,lt't"+';+r+0+f,+L7+t7+y+7+L+1+u+L+(/+{+0+("I'1V-?5ILTEMPEMIUEE COMPENSAIIONUSE FACT0R (a)3435.ThcrmalSansoaReading6?0/(/"42b11*1 .'t*i,141t{72n7L(7337L| O74s75{7bl71tr11,)Itr6tg(D11llcil?o3Ae71422oJ!. Product 'f,eplaccd FlProduclSecovercd (.)+.1 2oF, t20t^, t20+, lgo1,1304.13 ot l3otr, t30l-39 a+.t8 bl: /5o{' lZ{)* lZo+, t20+,/20+.t20+ lLb+,lLb+,1704 tLo], l2o)- tZoAlt.rRcading, 470.€Qo? /0, tbD,) /q0.3 2-O. +€6,5*O3gD,7402a), 3Zo, ctt/-(l, fLo, b?o, *'orsl0oI, Ly)4oo, {Lo, c40, 70031VOTUME MEASUREMENTS {V)RECO8I) TO,OI GAL.32Producl inGradualrBctor!Reading3€oI, +'70.€q o.7/O, AlO, /?0, 320, Ll{0, o&o.7{o, o-{o?oo, 3212,44D,5L O.6 t06loa" l6o, 1-(o, +0/)5lo, L40lcvrl lowhlch8.sto,.d4Lr{tltllllttlilILtLrLrft)tlilIIIIttlr/tl30HYt)ROSTATICPRESSUREc0nl80tSlandpip? Lcvelln lnchcsgc0inningolRcrdlngl+0ryl,o4+04,1,trt3.l+,9LlqS4r13n'..l1.Et 5,2/+, (/4,otq,DlLl,0t4.Dt t1.0l4,ot,t,014,0t 4,0t4.ollf,oRcadin0I,lo.29r'IL3+5(7{ILln(/3/5477?r0III ?-.Vu-r^n Drl---*l Z*J 2.*#-i"t' .33.o1-.-- * ,iP'tRecord details ol setling upand running lest. (Usr lulllenglh ol linc il needed.l/Pt/ TEsr SrT€.'il;-,^/- /-t-J L>/fo.rz- /2.M)tSr*z- LL TzsTScnsor Galibrallon- I -IOG OF TEST PROCEOURES28. rhr.l6fr'i6oiIPq*)l.otCtFll a6t{%q{lzat/,/9o4"?s€ogt3@a{t0l5XD7{-&,3af O":P-T Tank Tesl Data ChartAddillonal lnlo2. Statomsnl:C tant and producl handling syslem has been tested tightaccording lo lhe Precision Tosl Cril€ria 8s eslablishod byN.F.P.A, publicalion 329. This is not intsnded lo indicalspermission of a leak.ORD Tank and product handling syst€m has lailod lhe tank tighlnessl€sl according to tho Procision Test Crileria 8s sslablished byN.F,P,A. publication 329.*, o2-{It is lho responsibility ol the owner andlor operalor ot thissyslem to immodiately advise stats and local aulhorities ol anyimpliod hazard and the possibilily ol any r€porlable pollution tothe environmenl as a rosult o[ lho indicaled lailuro of lhissystem. Healh Consullanls lncorporated does not assume anytesponsibilily or liability lor any loss ol producl to theonvironmenl.Tank Owner/Operalorl. Nel Volume Change alSignalurs ol Tester;-' @z-Tesl -gph+ e <///J.a4J+, ooLi r't{ , J.' ;.' .rl atq+,o /tl. ott+ ot6d,'j)!5 .-,aD 6zn ?il*, ot, I+, d I'q-,a6 /-, ot/ /+,d/q--oot-,ool'. aa/',e61- fi?!-,dDl-X r'l*lLt+,/Dt].tzl]-, / 4l+,08!t.,/cl-L ,10 I*,/ol+, )D)^.lo)l,tzt*,/d tI+c(,++?+rlu{+{+rr- c*+L+ilL0q6ltJl23L7q32117,) (q41149/7ez26127LL112€3298+,lzol, l2o-t, /2cl, toat /dai, /ro1, tdoi'too1./ao],too{, loo*, 100l, /oo, /{o, L7D, af'. 4/o,{?a,6?D, 140' 24t),3y'c, 440,540, bqb, 7/o, o30, /fb,27 0,s?6. 14/, {70,0 4bat qb, 2-./6,340,440. 5/o,640ILtlLlIIIttltltltlLI)4.0t4,Dt4,l/ ?.sI?t13,tr13, v13,g13,,{I 3.(8,trt 3.8t3.(t3t+/5/("t7t8t92o7t7Z/?2{2t{'L.a- Pu illEPD LL f-,*9s4o/s'€t'6{//aooi/0t{10Xr3rt9fOale:9-7'"aotDale ., ir-.,i5.14,vpe Bgz-/qQ S,l>.rrAa*.-&-^- X*i O*t*d^ C A-Namo ol Supplicr, Ownsr or O€a16.i 15. TANK TO TESTSLUldonlily by positionI l-uilAddrasr No. rnd Sl.o€tclClly$rl.Orl€ ol To$l9_9-?d16. CAPACITYNomln!l Clprclly/ D ,.qro,a/ arttonsStation CharlTsnk Mrnul.ctursr'r ChErlCompany Engine€ring OalaCh.rls supplied wilh'tr!!ntrB.and snd Grada17. FILL.UP FOR TESTstlcl Yrhtcr 80nom,nln.n?6ln.i bclor. Fill-upto %"G!llonrTanl Ohm.lrr]18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANKnWllcr ln lrnlnLln.(r, bclng lorlod wllh LVLLTSaa mrnurl racllonr rppllcrbl.. Chel bclow tnd rcord proc.dur. ln log (271.!- iurr muhlum tllowlblr loll proslurc lor lll loltt., Fou pound rula do$ nol tpply to doublowallEd l6nl3.n'ComDlctc t6cllon bslow:', .. .:,',1. lr lour pound rula tsquir6d?e Hcighl lo 12" msrk Irom bottom o, lrnk3. Pnatura rt bottom ol trnka. Prc$un tt lop ol tantDoplh ol bu.islBy mort lccurltr I h ^/,fi-crplciry chld wdtabtc --!4l1k:-/-OthorlnYcnloryG&llonr/de/oTnnslor totsl to llno 25a21. VAP0RRECOVERYSYSTEM Xo"n., !24b. COEFFICIENT OF EXPANSIONRECIPROCAL METHODryp. ot Producl .,.\.a5'7>ltdrom.lor Employcd ..T.mpcratun ln TmkAtl.r Clrcullllon ..,,Tolrl G8llonr08. Roading,/a o,,\.)Stago llH,-,K ^n !l+D ,^.i,ol ,.",.CI,9( ,.r,,34 ,^?(,73T.nl dir.ln.ln.Tamporulun ot Slmpl! .,Olll.rcnca (./-) .. ... ,. .. .Obrcrycd A.P.l. Gtelty i./? .r+2,v .F,-., ,/\n.1o,72Ea&728['Voluma chegr inlhir trnk por'FTnn3tlr to Llnc 26.--.Ft0a/o , /{9//Totrl qurnllly ln noclp.ocdfull lrnt (18 or 17)Coottlclml ot Wrl.rTlbL D .... . .. ... .t {eaprsur SV'RcclprocrlAdd.d Surtrctrnl?ot8ble,NOTES:24c. FOR TESTING WITH WATER s6rrbr6c&oWrlaa Tcmpcrrlura lllar CirculrtionTrbLC.,.........thc rbovc cslculallonr rro lo bo u3od lor dry toll condlllons loothblllhl poslllvc prsssuroldyantlgr.otwhon u!lng lho lout poundrult to componsste toa lha ptGonco of rub3urtaco waler ln lho lrnkItctRclcr lo N.F.P.A. 3Q Sectlonr 2-3.2.1 a d F7,2 lnd thc tlnkmlnulrctur€t tagsrdlng rllowabla gyttom loll pt69suta3.lalTotrl qulntlty lnlull rrnk (10 or t7)ht /,, {2r' uz g z25.lclVolumc chlngc ln lhb lsnkp.t 'F, ofuo+Voluma chmgo psr dlgitComputa to { doclmrl pl!cor.YarNo Tnnshr COE lo Llnr 25b.grllonrCotllclcnl ol .xpmrlon lorlnvolYcd produclg1EDlgltr p.t 'F ln lorlRrngo (231Thlr lrtosttsclor (!l15a. BRIEF DIAGRAM 0F TANK FIELDQeeUDL1I?rTfr,4 I19. TANK MEASUREMENTS FORTSTT ASSEMBLYBonom ot llnk lo etrdc' . ,. ,, , , . . .,, .Add 30" lo.'f' prob. llry.,....,.....Told tublng lo rllfirblr - rpprorlmrl. . .,... ., . ,.. .ln,ln.ln,lLt>lZo3020. EXTENSION HOSE SETTINGT.nk lop lo gnd.'Erland hor. on uctlon tub. 0" or morabllow lank lop'll Flll plpc cxlondr rbov! glld., utc top ol tlll,ln.40e22. Tncrmrt-sonror r.ldlng rlto; citculllion23. orgit. prr 'F ln nn!. ol.rpcctcd chmgc/77 23Fdigltr4-77C0EFFICIENT 0F EXPANSI0N (Complete alter circulation)24a. coro"r.o rP,r. c'vttyOba.ry.d A.P.l, Orrlly,...,.,,Hydromctcr lmployod ...,.....Ob3odod Slmplr fGmporllu,oco.rucrod A,P.l. G'rYll/@ 00PF. From Trblr A,Cootllclanl o, Exprntlonlor lnvolvcd ProduclFrom trblo B ...........,Trmrlor COE lo Lln. 25b,26.Volumc chsgr P.r'F {25 or 2ab} 39ACCUMUI-AItl)CHAN6E::Inr;4!.::'.il:i,' i.'r,G,slEidiidFsfi,,{i:ll:{;I Lt,::i'''4i,l{0Al Low Lrvcl computrChange pcr HourINFPA crilrra)/i,orutt-1",0 l,!\.4 h *] 'r'-.;*G' t.- r'\ ,1 4) i.'{!:-.,i- ,t2 a.\ 11 '?-4 t ("i? ..-+.o/8Ll,-2(J+.0/?r z tzi-1', ar /o/F| - t*1f , )/ '+^ ,t ar'--1t . o.wt /:-t-.ad ':-i,a ? it+'.o33,I ^ -ai. \/ e---i.^lJ. ,t';!+ ;2r'tt, L/!\-r4'? 1.t38. xrr voluurcHANGTNqEACH REAOINGTemperatuleAdluslmenlVolume Minu!Erpansion {.} orConlraclion (-)r33{V) - r37(I)+, 0 i'11 0 zz..472.-t)+=:tJv.L APqt t c//tr t9c) r-I. a r?ftoT{*,att+,a1"/*.ooi.o 'l i-.1- A Ll/t| 'v /v/1? ?*.o)iaol^4 t*.U; I*. r>ii:>-,06 I37.Computalion{c) ' (a) .Erpansion.Conlracliof, -{, {# /1, jZLr ,lLLi,/ zz+,t0L+,ab I+\, l0z1, tozr, l7Ll, toz+,0a 1f", a€|l,ctl'r'04 o+.091+, /ULl-.061+ o[ I'r.z(.14 D|+O+,obli,c6 t36.ChangeHigher .Lowct -(c)i-67Ui" in+{+3ts-+3-4-6r{+3+++4++t5+-3+3+-./t/)t-)f3te2IEMP€RAIURE COMP€NSATIOI{USE FACToR (a)3435.ThcrmalScnsorRcadin0/z 1t71.4/Ll1727?77+{'t(D7597637b{7 7rt'7117821fb7?c1C77937178oltuq80tt lt)tt3tt6JJ. Proouct 'Rctlaccd (-)ProductRccovcrcd (.11, /oo+. /06ht boh lool./oot /Do+, lN)t,./2o+,?@l,rzo*, a8o+. a30*,ogoto&bt, atof, oe){,or,o{. oco*.ado-t,ot c+.06 01, oaoAllerEcadin0, 12022o,37o?zo5zo,62O72o,?40, L'O, lu;.48 a. {to,0/o,7LOI 2-oaLNl-tro320,3fo, +40, {oo, o?a,[4031VOTUME MEASUREMET{TS (V}RECORO IO.MI GAL.32.Product inGraduahBe,orcRcading, DbD,l2Dt 22o,32o.4zo, {?o, bLo,-72D,090,2f ,,4oo,4fus.{to,040,lLoL@2ao.3zo.380, 440, o304t.oIIt(/t//I17-tiilt't//It/IItlII30, HYonosrAncPRESSUREc0r{r801olRcadingSlandpipr L.vclln lnchcrLcvrl lorvhlchRcslorcdI, 4s,0L{?.D213,olr,ols.o49,0+3,0tB,L/9,+l+,0t3.gl7,gl?./13,tr13,(I?,YI 3,+13,+t?.413"/13,4l7,t29.Rcadin0l{o.dL9q5L7,?-I?-3q{c7gqlot/l?--P,"-,1- V,>-*J b)"' Lf*rrtra- 2a E'oa,tlt>Record delails ol selling upand running tesl. (Usr lulllenolh of linr if needed.l*rZtl T2-/ gb/-t'y {.*/^- 4 ,a F,e,//rcn ,/ azez /a->rtlSzzo - ^L^1,. fas rf aroSensorCalibralion- / -27.LOG OF TEST PROCEDURESr.l1r8'46ngbl02€ll t02{+05rtLl02s40€sl9d)6/o6la46g(p96 P-T Tank Test Dala ChartAdditional lnlo^ 2. Slal€ment:Xfunt and producl handling syslem has been tested light' -according to the Ptecision T€st Criteria as establishod byN.F.P.A. publicalion 329. This is nol lntended lo indicatepermission ol a leak.ORE Tank and producl handling syslsm has lailod the lank lightnssstest 8ccotdlng to the Ptecision Test Criteria 8s establish€d byN.F,P.A. publlcation 329.J/-1 1It UL-.It is th€ responsibilily ot the owner and/or opstalol ot thissystem lo immediately advise slale anc, local authotilies ol anyimplied hazard and ths possibilily ol any reportable pollution totho environment as a result of the indicated lailure ol lhissystem. Heath Consultanls lncorporated doos nol assume anyrosponsibility or liabilily lor any loss ol product lo thoenvironm6nl.Tank Owner/Op€rator4tc/%i'l-.o//Test -gphl. Nel volume Change atSignaluro o, Teslet-i A 2Cl\,(.J(-a'T (.1...) /I _*.,<-r, ozGi'. r> :.:.::---; A ? i.^--- ') ,' !'- O/'3-t ,"i1ozz-, o//*:, oo /- ozl-t-. - '2 ..1! u +L.-'-, a4/*t o 7:-1-", r:f *i/*.6o,1/\ r'l Jool+{2+, oe/-+ t'fv /*, a.it].oLli. ..t,' iJn.t t| ,o/Le tI ot t+,ogl+. ()btf.oct* olt-L !\'' :1,o bll-+4t4-? (_.+3r5t-7-t L+t4+3+38/7723?1(U /'.J827fst?;:4UJqtti"zg+{r*t'6"\ !?{lg{7f o6b4. oco+.)bc4,aa o ,+,oft\+. o(rb+ ^/ /\t,/J/aL/'t, olol.ooc$, or"c+.oabf,c(,0r 06b. /{(),k/o,L/O.. 530,3f a, 1{o, {/o, {7a, b50, LEO, 7{c/ oo, /(o,6 30, c?a, a+0, / oe, c4n,/{c, L/D,L7033o2Qn,4,fO,.fto, ? /(-/t1t/IL)ll/t/tlII)Iiltltlr)13,+t3.4t 7.4l3;413, 4t3+t3,4.13,+/3,+13,4t3.4l?, -1t 3.1t3t4t/tct7Itt19D/llzp2l2-{1 ./. Azsl f)'trP.t#6o69l4a6lo?)t2blsqEqc%Oale4-*-qoolDats #-Jtl{. lo4oaoCdloni'€^*--N8m! ol Supglirr. Owncr ot Dollori 15. TANK TO TESTldonlily byg,8nd snd G[do17. FILL.UP FOR TEST$lck Ytirt.r BottmAddrcrr No. rnd Slroel(3)CitY16. CAPACITYNomlnrl C!p!cltyloLln.Tmk Olrmctcr! wrtcr rn rnt f] ,,n.,r) b.tnc rort.d wtth LVLLT! xtgt *lc, r.ut. tn trnl arc&ltlon(a), (b)9!trDrl€ o, TsstQ-3*?cl. lt tout pound tul. tcquitod?2. Hcighl lo 12" msrl lrolr bollom ol lrnk3. Pr.33urc !t botlom ol lrnll. Prct3urc 8t top ol tsnlDepth ol burisltlnk dir.o,-E *!1ffi,^.3, etr ,.r,.. 42 ,..,,.Lo ,^,l0L ,^.o 'n'lnvmloryCo.tllcl.nt ol axprnrlon lorlnvolvad producl3ztOlgltr p.r'F ln lorlRmgr {?3}atr!tr!1oa*" ,Tolrl qurntlty lnlull lrnk (16 or 17)Stalion ChsrlTank Msnutacturgr'3 ChsrtComprny Englneo.ing Oal8Chrrts tupplied withOth6r4t gft'ReclprgcEl. Dt€eaz---/..9x. _______J__:_.Fq4. ------Y:J-'F. ___--__-___=__'Faal 2J /tJ/, t3/ S b787tu,volumo chlnge lnthir lrnl por 'FTrln3ttr lo Lhc 26t.*.8y molt lccursr... .. a/ O O Oclplclty chrl."r',"bt. ' 6;ii;;lb.lor. Fill-upln.lo h'Gdlon3..] 18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANKSaa mrnurl rc€tlonr rppllcrblr. ChGk bclow rnd .cord ptoccdu.. ln log (2t).lJla mulnum rllowlblr ta3t ptotsura tor rll tostt,Four Pound rula dost nol lPply lo doublowllled lsnls'Complclo reclion bolow:Ia>tsblcNOTES:GsllonsTolrl G!llonrea. Rerding4Do",2,1'/./tto 7'Tranlfor totll to llne 25a21. VAPOR RECOVERY SYSTEM Is"e"r !Slage ll24b. COEFFICIENT OF EXPANSIONRECIPROCAL METHODIlp. ot Produsl \r...........,...,..Itydromclrr Employ.d . . . .. . . , . .. .. . . . , . . , . . . . 'Tamp.rrtur. ln TmtAtl.r Clrcul!tlonTampantlra ol Slmpl!Olttat.nc. (./-)Obraryed /tP.l. GtlvityRaclprocrl2tBlz/Pasa, -e--a)-24c. FOR TESTING WITH WATERsooTrbloC&Owltar Tlmparrtura rttrr CirculsllooTrbL C_'FTha rbovo crlculctlons lto to bo ussd lot dry loll condltlonl loestabll3h ! posltlvo ptesguro rdysntsge. or when uslng lho tour poundrula lo componsstc tor lhe P1s3ence ol subgurlsco wstot ln tho lsnkar6t,Rclcr to N.F.P.A, 30, Soctlonr 2-3.2,4 rnd F7.2 ind th. tlnkmrnstrcluror .agstding allowablo ryEt€m tosl ptoSsuro3.Tohl qurnllty lnlull lmh (10 or l7lht l, f3/ la9 * 72aLCo.ftlcldt ol W.lorTrbh D ............Add.d g/rhcirnt? f] t". nNo T.snslo. COE lo Llnc 25b.(c)g8llonsVolumc chmga ln lhls lEnkgt.'F. D od725.26.Volumt chmgr Pcr 'F (25 or 2ablVolum! chmg. por dl0llCompub lo { doclm!l pl!cet,Thlr lEtortlactor {s)15a. BRIEF DIAGRAM 0F TANK FIELDvu,I5/U1\z3Erland hor. on tucllon tuba 0" ot monb.low l.nk lop'1, Flll plpt cxlrndt tbov. gnd., ulo top ol llll.ln.LC9-o ,n.20. EXTENSION HOSE SETTINGTrnl lop to gr.d.' ..,22. Tncrmrt-sonror tocdlng rllot cl.culllloo23. ol9[. pcr 'F ln rrngr ot crp.clcd chmg./5 /5q6r-6 ?Bolweon9L/dlgll!dlOltrC0EFFICIENT 0F EXPANSION (Complete alter circulation)24a, cou"a"a A,P.t. Gn'ltyObscd.d A.P.l. GrrYliY,.....,'.'..Fil-tdromgtot !mployadObronod Smpl! Tcmpotllurocorrcclcd A.P.l. G.!vlty@ 00'F, From Tlblo A.Coslllciml ol Erplnrlonlor lnvolvad ProduolFrom Trbl! B .,....,...'.Trmslor CO€ lo Lln. 25D.19. TANK MEASUREMENTS FORTSTT ASSEMBLYBottom ol llnk lo gndc',,.,..,..,,.........AddSO"lor'r'prob.t.ty......,,.... #".Totrl lublng to r$crnblr - rpprortmrl. .,. .. , .. , .. ,, / 3 L h,ln.IZZ- 39.ACCUMULA ti".CiIANGE.tAt IOw Lavcl comput{Changc pcr HourINFPA crilcria),4, oasT''t'j. .-,i.r -*, ch:"{,o"i Ct,o3i+,a72t oz-{38. rer vor.uueCHAIJGINGtlcx nelblncIemperaturrAdiuslmcnlVolum! Minu!€rpansion {.1 orConlraclion (-)f33(V) - r37(T)) ar,-,t ,c-.' '-.*-. .,:; I i.*,o tt1) /t *--- hiI "_/ -- ---. ,ai /^t t 3:1t ^ 'ts'r,0 /:-:.:,b1? , )*Lt-[, et I-.o /2--, DO-/A/r1rv"/-,aDa37.Compulalion(c) , (a) .Erpansion.Conlriction -1. ast-,0 Oi'*l a ,'-:J- a/ +I .QU a-+- ,/t/t'i ./\1.' l'r. oCz..:. /^) t' ;L ,t t/,.'J nQq': ,; !'. I; 0i1i.r-" ,()i'YJ- . ,4?,?f,0{/*, e{"'it', aaz+ d€7-" ,4{7+, D5'736.Chan0oHighcr rLowrt -(c)--/ (-)I t-1"t ut' tt+lci-t ttA-flt{+74"tiit:{lr- laf1+ i0It l,)+/of/o34.TEMP€RATUfiE COMPENSATIONUSE FACToR (a)35.ThcrmalSrnsorRctdingtrr14ttz//ib1VL"l1'/Lo74 lOr12ct/?l2r+Ltl7ti4 ft,i3d03/f2cl3,1(3t("3(4$J, Product 'S,placrd (-lProducl8.covcr6d (.14.oGr>f.ocDl- o€0t, o'(af , r-:€ ()f, aEohoto+, L+ot /66t , !,) b.)* ,*t'\:t1, adn'{,ctitt, abof,a{o1,o€oI o{bi.o{o+, a{o-f ,a{aAllrrRoadlnC, /42lbo,2-702,<r-,7go.44a, {40, 6to, 34c, 5*6c,, oqc, /{o,2*10Q.2.^,,3?O, 44A, 110,flO//0, //a,NO31VOLUME MEASUREMET{IS (V}RECORO IO .OI GAL.32.Producl inGnduatrEclor!Rcadin0. o /0. / ao, /(b,2-zo.3aa,9so,460, 540, /oc, 71o,03a, 010, l{0, Ll6,2'7O,33c,, 3?tt, 416,410, o60, //o, //o4Lt///tll/tLr/ILlttlIItltluUllIIlllt30. HYonosTATrcPRESSUREc0l{lB0LolR!.din0Standpipr lcvrlln lnchr3[!vrl towhlchRaslorrd13.043.04J.o43,643.c17,04t,(+3, (l{,2-I 4,013,0t3.013.0l3,D13.013,ol2,t12,?t2. trl2.gI L.Y/ 2.tr29.RcadingNo.I9t/{L77ILI7_3+c77qtblltLV,u,o P;,)-/ / /L.---tY),+ gnu^-" 4 A#Record delails ot setling upand running trst. (Usc tulll€ngth ol lin6 it needcd.lhLrr' f,-t *,rtIfr4 ntU 2a- Eaa r D/tSranr L/,- TatrLOG OF TEST PROCEOURESlolna7: .il : slnsor catibrarton- / -hr.t*rb:.i@eZa1035*o3{dolLo{?62{50,zaolol{,oZi9o3t4ewg6.50tlI3aJl4 -//tauJzt.-'P-T Tank Tesl Data ChartAdditlonal lnlo2.XStatemenl:Tank and producl handling system has be€n lest€d light8ccordino lo lho Paocision T€st Crite.i8 as eslablishod byN.F.P.A, publicalion 329. This is nol intended lo indical8p€rmi$sion ol 8 lsak.ORt, o z-,>It is lhe responsibilily ol the owner andlor operalor ol lhissystem to imm€dialely advise slalo and local aulhorities ol anyimpliod hazard 8nd the possibilily ol any reporlabl€ pollution tolhe environrnenl as a rosull ol lhe indicatod lailuts o, lhissyslem. Heath Consullanls lncorpotalsd doos not assume anyresponsibility or liabilily lor any loss ol producl lo lhesnvironmgnl.Tank Owner/OpeIatorl. Net Volume ChangeSignaruro ol Tsstet:ar Qqncluglon q]l Pletision ,^'!n*l/-tr//*A.*D Tank and product hsndling system has lailed tho lank lightnesslost accordlng lo lho Ptecision Test Cril€ria as sstablished byN.F.P.A. publlcation 329.Oale:*,oz/*, ato4.oo{-,o/2-', 2 //-. 0/6-, d/5--. a/?*. o/?-.OJ8*, o/7 --, 0z'z*-. o i/irr- oot-*,aol-.a/ /-,.Fd|"4,eoi-i', aa/f . ar>l'1 6A"+-.at1,ortl-,oof7v 2*.a7'if .as/{ r,zi{+.5{ ?t, oet-l 6ci{"*.o31{ a3t+ d4{+.o37*.o?q+,a4{'<?r0+7l-1ftr+10r7+tf7-t^ 74-7f7+1+73713il3qa3eg4ot+tfu7443o43711{4iz+514b7a, a?o+,o40f,o40+, a40t 0q/)* o?o*, a*6t ofo+. o40t.a,/of. orc-(.o'/o*,&/oI4 -/,*J(.)' Llrs,33c, 370, +/b,470,,f /0,55t-t. f,qa,/70. //o/56. /?b,7-/o, ,2€otuo.t2c), 77a, 1/o,47b, f/0' 5€0, d30,o70, //D,/5oILltt/tlIItlUltltIrll,6/2,012,0/2,L/ z,b//_,Ltz,L/z,L/2C12. L/zI/2, (/2,(l3Ht{I6/?t{t?,billL/3L/z{Ert/o LL Tz sr',1Lfr{flbr9{{o/4o{/-o', g{€ol(xfe3{60176,q-G-q'Data ttlO0RtSSlTll( lf,llStR:/ -7,- 3snt e$T cr PtRsoll rOu ltET ll[RE:IIfxK tqlllilG cl{tcr ttsrOAIE:li,llir:'liill'fi 'llili"!hi['Unil'l,ll'lot':l*:t!l:til: :il,lnron:t. Dort thl trnt rupply furl to r rtrndby lnglnr?Arr tJrln llnu pnrent for r futurr lnglnr?tt ttrr atglil. vr'lwd lfrf rt thr:llilll"rllli' - I:i r{ofutur: cnglnc llnrs I tri' ='H 't- ffrrr,li'r.#rli- llr- llolfno,lr!hr^llne:GsPpcr_thrtrdtdP|pt-othtr-Olroct:r of glgt: - -!, Splll Gontllncrrf{rnhohc/Rlrtr Crgr:* 'll,fttli##':rlirlg:l:ltl'q -f, vc, - *sArr rll crgr. tuls rnd rdrptrrt trrvlcerblc? .f Vos .- llolf oo. uPlrln:Rrturn. LlnrAIn tln?oQ.gn ouollnr trnks, Is the vtpor rccovcry r-tro p'fr:frJ:;'"6:tt,*' tr tir vrPor rrcc,vtrv rc'pt.r strr terrt'- lrr rlt crpr lockrblr?Do rll crsi hrvl I lock?ii aha aa6a ai idrotorr nmd to br rcalrccd. rhrlc th! dlrnetbr of thc rlrrr thcy 00 0n?Sotll Contrlners - Arr thcre rnY?Ttgt: 0PU81 -, 8{0 i, 0Pl{rlSrfon tou rtrtrd tutlng:illlonrj--Xt-ytor coax{rl -Yrr - lloI:: =[3Irr_lrr0oer0orrthr contrlncr clrrn?tf no, rhrt rrr ln lt?r llould ln lt?-lf jcr, rhrt rrr thc llquld?thddrrln vrlvr functlon Droperly?thr lld rrqulrt tn Q.v1nt7hr thr 0-rlno ln olrct?Dors thr 0.rliq slid yjelrclnelr thr llp of thc rplll'conttlnerrrlntrlirrd properly?- Ycr -X- ro- Yrr - llo--- fcs - Ho=fii =il- Yrr - llollotlofict:llotloxttf. -Orop lubr:Ifi'!$ffil'tmli lt rroovrblr?i: ll'*'fHii.g'3:ll..to, rrirtrrrrdlYesYrrtesIerX--5-Xfil =ffit. Ertrrctor Irlvrr rnd Foot Yrlver:Srrlr: (ctrret onr) Condltlon 'GoodNmCs RcRepl rcsduplrslng -thrrrdr - Sood condltlon?irtrrctor vrrnch on rltc?-- -tf no, lrngth of rlrrr_XYrl.c. lllrcrllrnlour:l: tli,tll'li?liill:1".1!i*,tn*1,*,1,,., . y?! r ll!'!.:i t t:: rltdl rs,?ll l',?l.i I l'l, r,,r,, r,r r Data Chai _- for TanInCIAHPICNIS PRECISTON. TAI{K IESTII(GPACII-IC BELL 2 North 2nd. St., Room ll 675t Sbn'JoseCa. 951'li.()I.1, PLCAST PRINTt. 0WNER roprcv [--lTrnt(rl l-lZ. OPERATOR3. REASON FORTEST(trglrrn Fvllyf'1. lvH0 RIOUESTI0TEST AND WHEII5. IVHO IS PAYINGFOR THIS TEST?5. TANK{S} TNV0LVE07. ttrlsTAtLATt0NOATA8. UNOERGROUNO$/ATER9. TITL.UPARRANGEMENTSLa6aaddr.iai.o.aar.l.traala0io^aNrNt{ahaAardr6rSUBCHAHER 16 OF CX{APTER 3 OF TITI.,E 23OF THE CALIFOPJ.IIA AD},IN]STRATIVE CODECI^JNEROa ta (rOr.rr.OIWNERo,Pa,ao^ Auliol[riCA.t6t6rcdvananbnOtha, ldrructrona/F rb..glrtrSrDhona3PumproaLo{or<H ta asSsctro^. R.6ola-Uata rl liow6lr th. wrrff dd tha tanl Iflt- E*"D.pth to th. W.tr tabl.Trnlr to b. lillad - h,- - O.tG Arl^god bYErrn p.odqct to "lop oll" rnd run TSTT. How .nd who to ptovrdc 'Tcrmrntl ol othar conlrctNOT APPLICABLEConrrdcr NO LcrdT) : Fl :.'{ t'fl* ,..fOIf,-7/If illrSrra, lit.ftll 6.rt, O.oglubat. Ra6ola FtllaCotJConrCoft,at!. ll.ct too.f.r.th..tct ocrtFn:// ;' -aao(i anail'a d.rtdlv.R.tr ol ataion. tlcS[.. Mahrlold.<t/tz-Vant.y'. aoo#3DtL.t€ *19, ooO4z/tlL-/Irrnd/SuoplnCrprcrtyI o, OOOld.nttly bt Drrctlon#lAgg.or. Ag.2t-Godrlq notcr orinqurryCongrntalrod on anv rtatlOllraalr orto b. rdwhan lclhig {i rnordur'ng lctt clcTlllt wcrc madc on lhc tbova lank ayalamr tn rccoadrnca wrth taSl p.cGduacr p.ct€rrbcd lo?pcto nlsar dctarlcd on rtlachad t.!l charlt wilh rc3ulli rt lollow3:IO. CONTRACTOR.MECHANICS..^y olha, conlrlcldInvolvtdlr.0THtRINFORMATIONOR RTMARKS12. T€ST RESULTS13. cf RTrficAIr0Ng Obtrrvcrl gr"tC6tt.^k ldcnt'lrc.tro^lL t-lnd'crl.dOatc Tc:tedI' T- '!,'fhr. I to cc.lity lhal thaL lrnl lyllomlProtGtton Atociatl0nwfa t..lcd on tha drtc.) rhdn. Thor indrc.tcd ar "Tighl" mal ltF cnl(rl 3tt.bftrh.d byPrmphlol 3?9O.TAMPION' S PRECISION TANK TES'I'II.IG. -:ii ,'"O.t.l.rr'.o Cr,^r..(r,,' o! (t,6o.ar dr 5'9^.-!ul. , _1451 OAKHURS'I' 1^lA\', SACIL\Mi'J\-'I'O, CA 91'd22 P-T TANK lEgT DATA C}TARTAddltional Info\:t ii4\I.dt"s,tb,ra-'4I ,..f lqt*t!r.,'NF t;'7'() 4')o3r.;/f"nl+-t.-1_f,\ uA!-15a. BRIEF DIAGRAM OF TANK FIELD4\,U,2,-.u.' 0o; bil n6 {eJ-d*-Sp* d-aqk C /,.t-t-&t e^*."-Nsmo ot Suppllcr, Ownc. or OGslerl. lt lour pound tul! toquircd?. Z Hclght lo 12' msrk trom botlom ol ttnl3. Prdtuta rl bottom ol llnl,1. Pao33urc rl top ol lsnlD€pth ol blrialTmldir.Y,H*!,2,^.J'l ,.".,./' 4 ,,,.l30 ,^ql, ^oAddrssr No. rnd Str.olF)25tlydromrlar Emplgyodf.mpcrtlura ln TmkAtt.r Clrcuhtlon . ,. . ,.Tlmp.rliura ol SrmploDlilcroncc (+/-)Obrcdcd AP.l. Gr&ltyR.clprsrlt{ZZ/2Totrlqumltty lnP"g", 57t&3€rf:Q,73 .,-r//7 .rJL,J.Fi4, g. ,/^u, {2-9-t!.-! g ,n: -CltylnYantoryCoatllclant ot arpmrlof, lorlnvolY.d ptoduc.l'42 3Ol9ll. p.r'F ln l..tFang€ l?3)FrcmrriL! Srarbn Charrl-l ,rntt Manul.ctursr's chsrl[-l *.orn, Engtn€e.ino oara[-l cnrr,. lupptied withOrtrut Q*Q*Q.)Tolrl G.llonsoa. RosdidgSrle':I 15. TANK TO TEST' N-or= ZSL # Ildsnlily by potilion0eeBrsnd and Grads17. FILL.UP FOR TESTi Sllcl Wrt.r Bonomr)o' bolor. Flll-upln.to *f,Grllonr18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANK' Scr mrnurt rcctloil rppllcrblc. Chcct brlow tnd rmord procadur. h lo9 (27).' (,br mprlnum allMblr lcsl prrssuta lor lll t6ls.Fout pound tula doer nol lpply to doublowllled l8nkt.ComPlgl! tsclion b€low16. CAPACITY8y morl lccunlrcrprcily ch!rl !YsllsblcqbTrnk Olrmrlarn wrr"r tn rrnt D a,n.1.y bctng t.rt.d wnh LVLLT! Hbh wrtcr tlblc ln lml axclvrlon(althlNomrnsrcsplcrry / ? ?rr#,'\fl. "n",O!llonr|'!tIiln.GEllon3Roclprocal/2ii)Trlnsfer lotal lo lln6 25r21. VAP0R RECOVERY SYSTEM El .,"0u, [-1r,,n",,24b. COEFFICIENT OF EXPANSIONRECIPROCAL METHODlyp. ot Producl , . .\ . . . . , , . . , .. . . . .W.tar tlblaNO'ES:. Tha rbova crlcultllont rtr to b. urod toa dty aoll condlllon! lo.3trbll!h! porlllvc pros3urosdvrnlsgo. orwhen !rlng lhe lour poundrulc lo componlrto lor lho pro3onco of !ubgurlcca watal ln lho llnktrttRcl.r to N,F.P.A. 30. Socllons 2-3,2.1 utd &7.2 6nd tho lrnkmanuhclurer rogardlng lllowablo !y3l6m tost prossursE.lull trnl (16or t7)24c. FOR TESTING WITH WATER 3os rrbr6 c e olflrttr Tcmpcntura rttrr ClrcullllonTrbL C .. ... ......voluma chtngo lntilr lml pcr 'FTarnslar lo Llnc 26s.-'FTol.l qurnuty lntull lmlhl /;'(10 0r rt){z?6 6 osCoattlcldl ol mlcrTrbhO,,.,,,,...,Add.d g,rtrctrnr? D r". f] *o Trln.frr coE ro Llnr 25b.= (c)OrllontVolum. chugr ln thlr llnkpar 'FA."),44. J A. tVVoluma chsgc p€r dlOltCodtgut! lo { doclmrl ol!co!.19. TANK MEASUREMENTS FORTSTT ASSEMBLYBotlom ol lmk lo gr.d.' , .. .. , , . . .., .Add 00' lgr -f prob. $.y.. ... .. ..,..Told lubl;g lo l.l.mbla - rpprorlrnrtr ... . , , ,.ln.ln.ln./ Zr)/ bt)30Trnk lop to grrd.''ll Flll plp. .xtonds !bo{. g[dr, u3. lop ol llll,lpo\34\ln.ln.20. EXTENSION HOSE SETTING22. Tnermrt-sonror t.ldlng tlt6; cltculsllondlgltr,zs/24 .,Bctwen23. otgtr. p., 'F ln nng. ot orpcctld chmgc/2 bc/ adloltr323C0EFFICIENT 0F EXPANSION (Complete aller circulation)24a, corrara tP.r. GnvttyObr.drd A.P.l. Grlvliy ., . .. . .. , . . .F|lydromalat amploycdOb3adad Slmpl. TGmpotltur.corfactad A.P.l. Grrylly@ 60'F, From Trblo 4 ,,, , .,..... ,.,,.,.@llllcl.nl ot Erpmdonlor lnvolYad ProduclFrom Trbl.8T?mtlsr COE lo Un. 25b,26.Voluma chmCo pat 'F (25 ot zab)Thlr lslostlaclor {sl 39ACCUMULAITOCHAI,IGElA,ozazAl Low Lavrl compulrChange p€r Hour(NFPA cril.ria)Fzoat/*,o/0-,OOj-. ooF{,0t/1-, O/ 0l,oo?t.oo7+,aL7+ OLG38. rrt voruutCHANGIITGEACH REAOIIIGTcmperaluraAdlustm€nlVolume MinurErpansion (') o,Conlraclion {-}r33(V) - r37(T){,poo*, p ?c',oz I+.ctlq+, oxl*, o2?l,o aq*,J}1I+ tv?+, gLE1. ao/*. oo 'l-1, oz- t1.oal-',Oo /-,0a1f,o/q-,o01-,oc I-,OO/1- ,o t7',2o /37.Compulalion(c) ' (al .!rpansion.Conlraction -+ 0(eD+. c€ /)+, l+l1. tc t+,121*,irl\1 tLt+tqt-], l4l1,tt z+, t4/+, t z.t+, l4l1, lzlr, tzlt /z I*, /at+, l'1-lJ, l2lllzr+1alJ,ILI36.ChangcHigh.t.Lowcr -(c)f3, ,lt't-+'l+r+f+r+L+7t7+y+7+(tt4it+u+b+b+{+(?+LIT+{ILTEMP€SATURE COMPENSATIONUSE FACTo8 (a)34SrnsotfhBrmalReadin035.'( c?o/,4?b?'1i:J\'7q-l t{7Lo-lt, fT L'-7 3374o7+s75f70t11f,l1,ltgbt{611ttq72tc3LG!71422o!J. Proouct 'Replacld (-lProduclRrcovcrod (.)+ l2ol- t?of,i20\ tgo1,130-1, t3 o* l3oI,t30h?q o1.t8 t,h /5o+",lZ{)* )Zo+,1?o+,t70l.tZa+ /Lb+,1L6+, t7D4. t7-o4,120I tLoAlt!tR!eding, 47o.€Qo7 /0, ?bo) /qo,3 2-O. +€6.'gc3gD,7402a)' 3LO. ++t), fLobgb, ?dc1(rO. Lt)- 40o, {Lo, L40, 70031VOTUME MEASUREMEI{IS (V}RECORI) TO .MI GAI.32.Producl inGraduatrEolorrRcadingt 3{O, +-10.€q o,7/0, AlO, /70. 32o, .t€?)'o&o.7{o. o-{o?eo,32o, (4D,5L O,6 t06lo," l6o,1*(o, +065ZD, Lq0lav.l lowhlchR!slorrd+Lrltltltl,t,lilILLrLrfqt)uilUIIIttlIIIIc0liTR0LPRESSURE30. HYoRosTATrcSlandplp. lrvrlln lmhltScgianin0olRr.dln0l+0+1,04*,041,trt3?,1,9%.3+al317,{t5.L/*, {/4,0t+,0lL/,0t4.0t4.Ol4,ott,o14,0t4,ot4.olLf,Ol{0.&adlno29.I4lL3+t({ILlu3/f,77?rOtll?-Yu^no ..Drl-*-y' A-/ 2*pdt"rJ'/J.*4A)JRecord details ot setting upand ruoning lest. (Usr lulllenglh ol linr il needed.)/pt/ TEfT ErT€.''rU*'t- Lz*"/ T-J{Ii,/,/ltS-*z- LL Tz.sz-l0bbScnsorCalibralion-l-TOG ()F TESI PROCEDURES'imo,tlPqrv)lotdtFl) att{?2(/l?z)/,{9o4"lt€ogt3aa{tbl5Xo7d"4,3:A5t +. a 14j1,a43+, doL4, ci'.1' t.t1 o,'s*,0 ,, Vi . ot:+ oi!- r/,/! ,- tlrt /aa?Iob+,d lq-106 |-, o4 /s /q--oo!-. ad/r>n I-. 0i;!-.dDt- ,1jc ':-x.1,l^lLr+,lDt-+. 12 )+-,/41+,a6!-r,/cl1,/O2J l.,t)+ I0)^.l0)I "nt*,td t+cL++l+4.+f-r<)l(-+E-r/^+i/702s/4 2,,/243/L/74rq4 (-l262a/-/Q I117].712{3"38+,lzDl, l2o-t,/2cr, Dat,lda1, /la+, /poftoo1,/cc], too*, /oo*, /oo*, /oo" /{o, L70, afD, 4/a,{7o,6XD, /4a.24J,3{c, 7/D, 440, 540, (rqb, O3O, /fb,22 0, s?6. y'49, {70,0 4bt Llb. z-tl6,340,440. 5{o,640ILtltlLltlIlttlnrlrlLI)4.0/4.Dt/l/ 7.st?It3,tr13, vt3 ,K11,{t3(t3.trl3.Bt3.(rSt+J/1(t7tgt92o7t2L232(.{}),/,L.T QuiT.truD LZ- T*'*,!r']9i/4D/s-irt6sr/aoo,/otil0Xr3c:%'P-T Tank Tesl Data ChartAdditlonal lnlo2. Stat€menl:D Tant snd product handling syslem has been tesled tightaccordlng to the Prscision Tesl Crilsrls as €stablished byN.F,P.A, publication 329. This is not inl€nded lo indicalepermission ol a leak.ORD Tank and product handling syslem has lailed lhe lank lighlnesslosl sccording lo lhe Precision Tost Criloria as sslablished byN.F.P.A. publlcation 329./Ci*, o7-{It is the rosponsibilily ot lhe owner andlor operator ol lhissyslem to immediately advise state and local aulhorilies ol anyimplied hazard and the possibility ol any reportablo pollutron tolh€ environrnenl as a rosult ol lhe indicaled tailuto ot lhissystem. Healh Consultanls lncorporated doos nol assume anyr€sponsibilily or liability lor any loss ol producl to thgsnvironmenl.Tank Owner/OpBratorl. Nel Volume Change alSignalure ol T€sler:-,@LTesl -gphOaleQ-7-?aolDat€ 15a. BRIEF DIAGRAM OF TANK FIELDfZeaUDL1IL|afr,-al. u, VPe B gzz-/qh S il>-tl*.-&--- Xnt C,'rit-i-.', 3 4*1: 'rl illr: i.i....i.i: ,.'4"",i lNam€ ol Suppli6r. Ownor o. O€alet15. TANK TO TESTTSz gldenlily by positionI )-atI6rmd md G.rdr17. FILL.UP FOR TEST$bt Yt'rl.r Bonmobclot. Flll.upAddrdr No. rnd Slrostls)ln.Clly16. CAPACITYNomlnel CsplcllyBy most rccurltrcrpscity chrrl lYrillbla/ D r)rt.o/ ainont/ D, non/ - ctttontStslion ChsrtTanl Mrnulactursr'r ChartComprny Engineering Oal8Chrrt3 3uppliod wilhotherGallonsRociprocrlS.toTampontur! ln TrnkAtt.r Clrcuhllon -.. .Tcmpordun ot SamploOlfirtonc. (r/-)Obr.d.d A.P.l. Gr8vltyRc€lprocllt /-> ,r/ -./3+/ 0 a/o .Totrl qurntlty lnlull trnl (16 or 17)Dst6 ot Tosl9-9-q4Ft06Kl!ntrTorll G8tlon3€r. Rosding18. SPECIAL CONDITIONS ANt) PROCEDURES TO TEST THIS TANK!-: I , ' S.. mrnurl racllonr rppllc$la. Chack bclow tnd r.cord procadura ln log en.t" l', tJl.tout?6Trnl Olrmalaa[-l *.,r, tn rmr ! Lln.(r, b.lng t.rt.d wtrh LVLLT! Htgh wrtrr tlbh ln trnk.rc.vrtlon(a)/dg/oTrsn3lor lotrl to lln6 25a21. VAP0R RECOVERY SYSTEM Xouo.r !sraeerr24b. COEFFICIENT OF EXPANSIONRECIPROCAL METHODlYp. ot Producl . . .\. .Itdromclor Employcd64slo r,i'oOrllmrln.lnYanloryCo.lllclant o, arplnllon lotlnvolvad producl319Dlgltr p.r 'F ln l.rlR.ng. (23,73 .,/Q .,-r4-'Ft'r, . /J "Je"se t 58/{34 .0,fit//Li,7LtiVdum€ chrng€ inthlt trnk por 'FTrlnltcr lo Llnc 26s.//\ .j /\ /)H_'Fpound rula door nol rpply lo doublewrllsd t8nl3.It lout pound rulr roquirsd?2, Hslohl lo 12" tnark Itom boltom ol tlnk3. Prcarurc rl boltom ol lank,1. Pro3auro rl lop ol lsokOopth ol burialTrnl dir.t.i:t.i,,-,K * nt+o ,^.301 ,",.,q 2/u'tv e.s.t.2.1---!--I-t^.?4 ,^olsbls,NOTES:24c. FOR TESTING WITH WATER ses r.br. c l. oWrtrr Tampc[tura lltcr ClrcullllonTrbL CThc abova calculatlont rre io bo usod tot dry roll condltlom locltsbllrht podtlva pros3uac ldvanllgs, orwhen uslng the lourpoundrulc lo compen3rl. lor lho pr.3enco ol rubsurtacc walor ln lho lrnlartt.Rcfcr to N.F.P.A. 30. Socllont 2-3.21 tnd *7.2 and thc trnkmtnutrcluror argrtdlng lllowsblo Eystom lgll ptogsutcE.CoGfilclml ot W.trrTrbL D .. ,.,,. ,,..Add.d grrhctrnt? [ r., E "o Trlnrfar COE to Llnr 25b.(c)g.llontVoluma chlnga ln thlr trnkF.'Ft O/-of25.26.Tohl qurnllty lntull l.nl (lc or t7)Iat L. f2/4L 3 7Voluma chmg. P.t 'F (25 ot z/lblVolum. chDge p.r dlglt@mpulc to 4 dslm!l plrcor.Thh l!tosllsctor (!)19. TANK MEASUREMENTS FORTSTT ASSEMBLYBonom ot lml lo gndr' ............,Add E ' lot "f' prob. lrry. ..,. .. ,., ..l2aln.3o tn.l6b ,^.Told tublng lo llr.mblt - rpprorlmrla20. EXTENSION HOSE SETTINGTmk top lo 9ndr'Erland h6! on ructlon lubr 6" or morrb.low lml lop'll Flll plpo cxlsndr !bov. gtrde. ulo top ol tlll.ln.Z/D3422. tnermrt-Ssnrot totdlng !,1s. circulsllon23. orgir. por 'F tn nngc ol crpsctod chrngo/ /7 /-3Fdlgll!7Z-77C0EFFICIENT 0F EXPANSI0N (Complete after circulation)24a, cou"a"a L P.t. c.rvltyOb$ry.d A.P.l. Otrvlly ,,... ,,.. . ..-HFttydromotor rmployodObronad Slmplc TcmpcrltureCocttlcl.nl ot ErprntlonF om lrbl. B .,..,,...,,,Tr.nrl6? COE lo Lln. 25b.Corr.clcd A.P.l. Grrylt/@ 60'F, From Tlblr A .x 39.ACCUMUTATEOCHANGE,(0{0.il,;Il;l..Al Low tcvrl compulrChangc p.r HoutINFPA €IiIC'ia)/j,az"+l.0lt!n27*,o18* ,t-7 r).1. t, t:)a/ti, c{*ll//).de;-r,0 7 /-^<-:i ^ 4.,I.'/ e'-;- .aJ)\?/at, LlJ;/38. lrr voruuecHAilGrflqEACH BEAOINGTemperaluleAdiustmenlVolume Minus€rpansion {.} orConlraclion (-lr33(Vt - r37(T)+,o|q17ac*, a 71.-D?"J A9q' , Q/'' Itr.ar?frOT(4",att+.olnt--- fl4+ . c)1.ce nrl /*.oo1ocl*.pls-.06 I- nnl37.Compulalion(c) ' (a) .ExPansion .Conlraclion -{, (B /+ t id{-1" , ILL' t 44f,i L L-t,tcL+,0b I-r'i I Q c-I, tozi, l7Lt, toz+,0b IJ:, o€/l,,pti-r,04 o+.081+, t0?-t- 061+ o[ I-:,:stl1 arJO+,oblt ,,2L i36.Ch.ngtHighrr rlowcl -(c)t-l1^6+L+ f""1-(+3s--t-rl't'Q+<++rT+?++l-?1-3+.f,f\+-3+3TEMP€RATUf, E COMPEIIISATIOIIUSE FACT0f, (a)3435.ThcrmalScnsorRradin0l7/ts171')?27t77+{7(D7sg7137L{//Ta.a7821fb7?t'7q I7937178olt04-,0&gtD{t3tt633, Product 'Rcplaccd (-lProduclRGcovcr6d (.1l,too+. /0o!,t 66l-, loc*./ao* lDtr+, laI,.l ? o*,1rc*,lzo*.a8o+.,t*c+,o?Dlotb4, otof,0€0(,oco{. oc t:*.o6oi.ot o+,0601, oor>AllrtRcadln0, 120, 226, 37,2?zo. 5zo,62b,72 c,&40, Lf), lus,48 0. {lo,6fO,7LOI 2-o2-oo, ),^60320,9fo, +4c..foo, o?o,HO31VOLUME MEASUEEM€t{TS (V)RECORD TO .MI 6AL.32Product inGraduatcEolorrSeadin0, DbD, /2Dt 2?o.3zo. tlTp, {?ob2oa2o,0*D,2tl,4oo, 4 tt-,.{oo,04D, /^Lo;2-b26o.3zo, 380. 440, o?oL!vrl towhlchRcslorad4t,atll/I1Lt7-Jrt/)lI/tItlII30. HYoRosTATrcPRESSUREcoilTR0LStaodpipa Lrv!lln lnchltEc0inningolR,edinC/, 4s,o, tc.o./,9.0,17,olz.o43,04i,04?,18,4l+, 0t3.7t?,st?,trt3,tr13,(1?,YI 3,+13, +t?.4t3J13,4t7,129.Rcadingl{0.I2-3q5L7,I?-I?-3/{c7gqlo/Il?--V,*,a- ?>--J t lL{onr,<- Qe Bou,rrt>Record details ot setting upand running lest. (Usr lulllength ol linc ll needed.)*2t/ A,u/ {:2a,4tez / azcz /e->rtl5rzr, - ,/-/-. flas rfonScnsorCalibration- / -27tOG OF TESI PROC€DUREShr.lDATE28.6n&k)t01,ll t0x{+05't?-10L!//o€;l9d)6/o6lo4636g{!t0 LiJ /7'-'-+.o27'f A.') 11' ,a,i:.1'-t, az 6'*, o ts1.1 /1 a '.,*i rr.1,+'e1 ,-, t'-,!-,a/grl ,, 1?o z-z-, o//- rsZIJ-. -') ..--t Lz t-i-t-, 64/- 40 1-.ab/o o,//\ /1 .l* t1 '),/c>o I*, ae1lrzr/+ .)i; .)].o41+.tt( |J^/ t| .t-/te tI.a?iJ A?Jt ,UL):+.oblr.o t,t* oAti ,U|t'1,o bl+3IJ+4, -1- L-lst-7Tqf4+3t3+38/7723&tf82tfsttr348t7tt{-zg+{r+tQ(!?{+?{7l par>-f , oCo'/-,o0of 06()4. oGD+ )Lb1,aa o,+ ,o{b+. o6b*,a4c4, c)la{, oacf Olrb/</),k/o,270, ?_so,3f a,4{o, {/b, {7ts, b5a, Lqo, 7fc, / oo./(o, O4n,/5o.L/o, L7033o, 370,4,fO..fto, {7o,6 30, c?a, o+o, /orsIL1lt/iltlII0ilIItltl/Ir/12 tL13.4tt,4t3|4/3,4t3+t3,4, 13,+/3.+4l3t3.4t3, 1/ 3.1t3t4t/ILt7ls1I2D7llz732l2€1 ,"/, Azsr O'ttP.,t ,r,t..-l;t cit:l4a6?trtlo2b/6qg4a+Tb,:iil. Nel Volume Change atSignalure ol Tester:-.a//Test -gphP-T Tank Test Data ChartAdditional lnto- 2. ^statsmenl:-X[ Tank and product handling system has been lesled tight' 'accordlng lo lh€ Precision Test Criteria 8s sslablishod byN.F.P.A, publication 329. This is nol inlended to indicatopermission of I lesk.ORE Tank and producl handling syslem has lailed lho lank lightnesst€sl sccordlng to lhe Pr€cision Test Criletia 8s €stablished byN.F,P.A. publlcalion 329.It is lh€ responsibilily ol the owner and,/or ope.alot ol thissystem to immediately adviso slalo and local sulhorities of anyimplied hazard and the possibilily ol any teportab16 polluiion lolho environment as a result ot tho indicaled lailuts ol thissyslsm. Healh Consultants lncorpotated does not assume anyresponsibility or li8bilily lor any loss ol product lo thoenvironmenl.Tank Owner/OperatorDals:*9-aoolDate 15a. ERIEF DIAGRAM 0F TANK FIELD/UIz3t/i. Uon- A" /! p L F,, ,A:,tl---- ,g**- ,,too C&..o-A" .1?o*.-*'N8mo ol Suppli!., Ownct or OorlorI 15. TANK TO TESTl. lt lour pound rule taquitsd?2. Hoighl lo 12" msrk kom boltom ol l.nk3, Prcasuro sl boltom ol tanla. Prasruto 8l lop ol tsnlDeplh ot butirlTlnk di..Add,rrr No. md Slrcot(rlCltySrlaSlslion ChErtTsnk Msnufacturo,'s ChErlComprny Engln6€ring OalsChlrts tuppliod wilhOlhetGEllonrot test Q-f,-/-,.Tolal Glllontoo, Rs8ding4a-on;1-7Ja2e ?'/ (</ < h4<7.^.^l/ t) J. u q/ v/&.Voluma chlngr inthit trnl por'FTrrnttcr lo Llnc 26{.416. CAPACITYNomlnrl CrprcllyFro6xtrnnnoldenlily byg.!nd rnd G.!do17. FILL.UP FOR TESTSllct Till.r Eotloma>ln.ob.lor. Flll-upto!'6rllona18. SPECIAL CONOITIONS AND PROCEDURES TO TEST THIS TANKSlr mlaurl rcctlonr rppllcrbh. Chock bclow.nd rEord p.o€rdur. ln lo9 (27).,lJra mrximum lllowrblc lrsl ptotsut! lot lll lort3.Four pound rulo do$ not tpply lo doublow8lled l8nks.Complels section b€low:8ymorrrccurrt..... , 4OO Dclpacily chrrl &rilrbla -----j--tb7-Tmk Olrmat.tD *",r, tn trnf n Lln.(r) b.lng lclld wllh LvLLTE Htgtr wrtcr faut. ln ltnl arcelllon(a)xrhl21. VAPOR RECOVERY SYSTEM f o"n", !Slsge ll24b. COEFFICIENT OF EXPANSIONRECIPROCAL MFTHODI)t€tczL------l/-HvJ. t ,'\, t a- .F3q,3R.clprocrl2tg7z1Psg6, -2-4-ln.lnvanloryCotllclanl ol arpmalon torlnvolY.d produci3ztOlgltr p.r'F ln !il|R!f,oo (23)IYp. ol Product l, .....,.,llydromctGt Employed , ,,.Trmpcrdu,r ln TrnkAhrr ClrculrtlonlrmporltuG ol S8mpl€ . ,.Dlll...nc. (./-) ..,. ... .. . .ObarDod A.P.l. G.tYity ,..Tranllor tolal to lin6 25a,LIKfr'Reclproc!lj':",,tv"r.& * [176 ^.3, (t ,.".,..4? ,.r.,.L0 ,.l0L ,^O ,n.i'T.t'ti,4ocQ .Tot.l qurntlly lnlull lrnk (16 or 17)tlblcNO'ES:24c. FOR TESTING WITH WATER seo rrbrc c a Dwllr Tampantura .ttrr ClrculltlonTrbL C . , . . . .. , , , ,-'FThc rbovo crlcullllon, tto to bo u3ed tot diloll condltlonr loaslabllsht porlllyoptos3uto advanlsgc.oawhon u3lng lhe lour poundrulc lo compenrsla tor lhe Pto3enca ol rubsurlsco wrlot ln lhc ltnklrct.Srlcr to N.F.P.A. 30, Sosllon3 2'3.2.,t rnd ?7.2 .nd thc trnkmlnutlclurot rogslding lllowsblc lyEtgm togt prelsutot.Co.ttlclsl ol mtrrl$h o . .... .. ....Addad grrhclrnt?,". l-l "o Tnnslor coE to Lln.25b.(c)9Ellon3Voluma chugc ln thls trnkgtt 'F,DO{725.26,Told qumllty lntul tml fi6 0r 17,6t /, f3/ /69 3 72az- ,Volumr chmg. Pct rF (25 o. 24b)Volumr chlngo por digitComputa to,l doclm!l glrcoa.Thlr l!tosllsclor (!)19. TANK MEASUREMENTS FORTSTT ASSEMBLYEottom ol llnk lo grrdo' . .. . .Add 30' for'T' probc 8Ey,.,,...,,...,.,.Tolrl lublng lo l'rombl. - rpptoxlmrla ../fLln.ln.ln.30t2Z-20. EXTENSION HOSE SETTINGTrnk lop lo grldc'grt€nd hora on ructlon tubo 6" ot nor.bGlow llnk lop'lt Flll plps ortcnd! lbovc Atldr, uso top ot ,lll.ln.4/Lo ,n.22. Tnsrmrt-s6nror tsldlng rtloi cltculrtlon23. olort. pcr 'F h r!ng. ol.rp.cl€d chmgr/5 /57Eelwoon9L/dlolltdlglt!br-6VC0EFFICIENT 0F EXPANSION (Complete after circulation)24A. conoaca lP,t. GtrvltyObt.flrd A.P.l. Gtlvlly ."..'.. "..F-Hilydromrlat rmployadObrrffad Slmplc TampstltureTrrnrlar COE lo Lln. 25b.Corractcd A.P.l. Grrylly@ 60|F. F om T!bl. A ...Co.ltlclml o, Erpmrlonlor lnvolvad Producl .F orn Trblr B .....,..,.. 39.ACCUMULA iicCHANGE.50l3aAl Iow Laval compul.Changr pcr Hour(llFPA crilcria)I, oaET.1 ,: -,. .-L ,1 ,t;IVr.'|,pt,('-L n-Ct^-4t,o tL-t. o z-{38. nrt vor-uutCHAN6INGercx ntlblHcTemperllureAdluslmenlVolume MinusErpansion 1.1 stConlraclion {-)r33(Vt - r37{I}) ^/^ -a)t .L.-jf j a,* ,o'>4.*,a i8]- ..ia| ' Vt *-i- hi '.') tL/- +r. oi'{'.1-' .-',-lz-* !;: !].)?'i.2 t*\., il- s t'7,u' u.'t A -J,u?t-, OOi-.aoa37.Compulalion(cl ' {a}:Expansion.Conlraclion -) a<-7r,O08'-l .o {jf,oczl-, O&?+ /a4 -1+. obz--: /'' < '|1 -,/ /J n'2 4..j-l' ,*|'{4r jf,d{/t', auz+.D€7.E;+t ()i) /36.ChangrHighrt.Low€t. -(c)r/OI t-llQ+/0+tt+'t a-+lcl-t t+x+fr-t/i,. ?+r{J+7f7+ i0I1?{ 1,)+/of/D34TEMPERATURE COMPENSATIONUSE tACToB (a)35.ThcrmalS.nsotRradinCtr t14ttz//u ///Qt3L117Lo7L/173o12qL't' |2{r/A- tt ;'-7 3i2t'i4t';)3oba/{?c134(3{1.s((33. Product 'Eeplacrd (-lProductRacovc,6d (.)l.ocr>+,a6Af.o0 0+ 090*, otof, a6"of, o8ot;o?ct+.,1_+()i- / /,i:'.T ,:,.J,JJ'1 .;':'-".,r'r, a 4a1, a(tc1,0{a1,o €ol' O{tt{.o{o+, a{o+,a{2All6rRcading, /ao. /6o,270,3ot>,7go.44a, {406l ct, 310,{dth Q.), 1{Q,2"1(ta -i .,',4?t .., 310, 44'J,1f0,{40. //0. //o,NO31VOLUME MEASUREMENTS (V}RECOfiD IO .MI GAt.32Producl inGraduatcBclortB.adin0, o /0. /do, /(b, LLo, 3oa,9so,460, 540, /Oo, 740/)?A,oq0,lJ cs, L/$,2-7O.9dr,, 4'/a, a/610, o60, //o, //DLlvcl towhlchRrslorcd4z-///(t/tLtztttlllIItllt30. HYoRosTATrcPEESSUREc0ilTR0LStandpipc Llvclin lnchlgSeCinningotRmdinC( 3.043.043.04?,6Lls,c44,/,43,(+3. (/{, LI 4,013,0t3.0/ 3.0l3,c13,0t3,o!2,t12,?12. trl2.sI L.r/ 2,tr29.RcadingNo.I79t/{(77ILI7-3+L77gl0IIt1-U,u,o P>)J / /L--JY)"* g--**,4 A#Record delails ot setling upand running lest. (Usc lulllength ol linr il needed.l42ru fl.t g*Ifr4utt 2aEaoa.tDSranr L/- 1-gtrSensorCalibrallon-l-27LOG OF TEST PROCEDUSEShr.l28..i oArE*aa@c?2alotn1035a.o3{.'D1Lo{?63{5oanlot61.6Vi9o3f4?wt6.) t,. I3ce.i2o2.XStalsm€nl:Tank 8nd producl handling systsm has be€n lested lightaccordlng lo the Precision Tesl Criloris as ostablishod byN.F.P.A. publicalion 329. This is nol inlended to indicatop€rmission ol a leak.ORD Tanf and producl handling syslem has lailed tho tank lighlnesst€st sccording to th€ Precision Test Crileria 8s eslablished byN.F.P.A. publicalion 3?9.-r,+Z >It is tho responsibilily ol the owner andlor operalor ol thissystem to immedialely adviss slsls and local aulhorities ot anyimpli€d hazard and lhe possibilily ol any reporlable pollution lotho environmenl as a rosult oa lhe indicated lailure ol lhissyslem. Heath Consultants lncorporaled doss not assurne anyresponsibility or liability lor any loss ol product lo lhe€nvironm€nt.Tank Owner/OperalotP-T Tank Tesl Data ChartAddillonal lnfoL Nel Volume Change' Signalu,€ ol T6sler:ar Sonctuqion ol! Plegsion ,^'" 'r*l/'7fl.-A--*Oale:I*, oz/f, aic4.ce5--. olz-. 0/6a/5--. 0i*-, O/?-.o/8o/7-, o2'z--.o//ii,f.4t?!-l- ,-'7 /i i*- J/., i ':"-i-, ae/f . oc>l6m:t.a)l+,oo!*,oo{7/ 2*.05,/f /t2t..+.c{?t, rt7'i-"! dcr{"1,a311'o?s+ b4{t.o3?*.o3?+.04{ItL'+-1i"(-t- ! 1]+7+tt-7f1+-7f7+7+7'z'tl2<:t/b/3qo71C.4cf+t{utz43o4?714{4iz+514b7+, oloT,O4Of,040+, o40t- ,.,?")I a4o*, o*at ofo+. a44+.a40f, orbCo+to*,*/o? </), L70,33b, 370, (/i),4/0, €/o,550. f,qa,a70. //a, /50. /?b.2-/o, ,{sot L1o,5t(), 77a, 1/o,4?0, f,/ot 560, d30,a 70, //o,'60ILlttttlll/utlIIllltII12,617,0lz'c/ 2.c/Z, G12,(l2,c/z,L/2(12. Llz//2.c12,(l3tq/{I6t7/{{?,4illL/3L.lz.(E,o,'O LL fusr/G*b,7{o/#o{2a"g{€ol(xar60176,q-G-q'Oats flIDDRESS:TT( ilJIOER:/-2-3stn c$rAil PtRsoll r0ll llET HERE:IIfrK rqtrtxG ffiEcr tls?OAIE:q4'"2).l!:,llir:Tg;lrfi'llill"!ilfdtu.,Pl:lT.l':tt$l'3!iiil: -'ilrn".lli.#,!i- lrr - llotlnton:2. Oou thr trnt rupplt ?url to r rtrndby lnglnl?Arr thrrr llnu pnrnt for r futurr rnglnr?lr th lqrll* nlrld cfrf rt thr:#tl*'rllli' -l:l -nofuturc er,glae llnrs I rrc' -'P; ''-'fflf no, k lhr-llne: ccppcr - thrtrdtd plpc - othrl-0lrmtrr of glgt: -!. Splll Contrlncrrf{rnhohc/Rlstr Crgr:An rll flllr rrooerlY ldentlflad(trnk aunber' rnd- groduct)?llgllsArr rll crgr, tcrls rnd rdrptrrl rrr"vlctrblc?lf no' rxplrln:f,rturn. LlnrA-XLYcstrru?x,o:,?3l,ul?'i)oono 4rr. .rrDo rll. lf thc,llnr trnks, ls thc v.gor recovtry l-t: tir YrPor rccoYtrt adlPtor ltrlor coax{rl - AlnYrr -llo /'ISJilllunrX-Xst93loclrbl r?hrvr r lock?or rdrotorrdlrnclir of!. Extnctor Urlvrr rnd Foot Yrlver:Srrlr: (chrcl onr) Condltlon 'crpsCIDSthrnrrd to br rcDlrcrd, rhrtthc rlcar thci, 9o on?Solll Gontrlners - Arc therc rnv?' TtDr: 0PY81 -' e{D -, 0Pl{tl -Srfon you rtrtrd tutlng:- Ycs -)(- ro-Yrs -Ho;hs -llol{olloYrrYrrlloHolililoFIyIIuhsOocr0orr=I:i =[rner- Yer - llo{. 'Orop Tubr:Ifi'lHllfil',mk lt rraovrblr?i: llrtl:,,tT3ii.g'3:ll..to,. rri,trrrrdtJ+-x-lesYerftrIesthrrrdr - Sood condltlon?iltrrctor vrench on rltc?-lf no, lrngth of rlrrrGooC U[r.1s Rrplrclng _flca r lceoXllollollolol{ollol{ott,t3tvL:C. lllrcrllrnrour:t?'rltr??ell rrhrdlttl:' Ill !ll'!,?1.'ll!lu.t.a rn ernonIf nb. lr thirr r tlnk chlrt onlr thirr yitrr.flndlng grrtt on rttrt,.r- a.-l' l-a r.a la-rl'rlr? lrrnnltYrftlrYcYeYeYe :1.'. "' lt, :t:,:';-\l) qr) a''+ Ez#eEIGtP t3 $-oo1"" _TANK CERTIFICATIONREPORTRECEI\iFil$::P?*19$0?a33tlOWl.€RS.\AlvlEPropertyTanh(sld{,'( EaZ<-'ztz(5l.lOnO€ TO OWI€R A cory ol d bd na.ilr hrve b.rr l$ad with tr foper rcgrlatdy agpncy govening mdergandstcage rystornr. Yr tr ib tr It not n d. n rxy'rndion bcbrLoc8tior ol agrry wlnrrLL5-t{AtvE OFLOCATIONRECORD OFRLll'lc4b(ravr0 trElvrlo rlcovrCl rOvrrO ttovr0 rElvrcl tro(t-O ttClvro nO-. i15tvto rOv;O r(LgoooLJo/oD,'.F---<E,/ t2loo oAtror. ACa(f fr!5r)Gra'd/S.d.?''frtHY!rDrEtc o.rirhr-REASON FORTEST{Erdah FuIY)WIJO REOUESTEDTEST AND WHEN?NAIORSYSIEITTESTE)TA}0(oNLY {PROIXJCT UNE VVEMuNE {VAPORUNE OXIOF IHE AMVE OFILL.I,PArrhAnft:etvrc,na I i'OTI.ERhFonil/nToNOR REMARI(STEST RESTLTSTANKS d/PmflrcT Lwesd,/!ffiVart Ya€llrthcludcd NoO.-canncAroilq2 - tloaOrb7-/r-jo/zu;u a. ?t;tp,ar,1-NOTCe I b th. orlu I tlpoJrdny b contrcl t'lr rlviqrnrntrl h.ll't clprrtllrn ol lrry hlrr ylJrh 24 ]rr. ot th. r.$t!fivan to tr o*r!.ItrtL / frbtr6/tdbbrybitrhE rtdd!!9f tEi x0LduST.qk'e-AarOrho,ral urlorttrbo,t ofi r.ry i.llr! h ilca.t t ollrtl b Da -nEl rlr. l-.re n n p.o9t6 o' corrFad Vrl|5?r d OLw.'r pr.Lttt d,rrelttl dc.Cfdb- O.t *.rlr-rtdlrt -,ldp11111h|Or. tr.a-tr-?booooitn! b b€.tlyHtlt-.tn*ry-ilurrru or Oldrh(r) JErn. TtE lndceb<tlr'ngrf d t crfrrhStlrtrlt!yUr. rarbmd Frr ProocDon Atcit-.l ffi 329t.e4';Z //4.%'--^- ftfaUl fal*t\Prt. Fa.ttileDrltl LmrllelJobsltaIJHE/-TtiIiIl.Ii?6bqvAN5b,b'.IT7a^* * L4(ne k,'*1APtrA(-IITFITA}IKS€)6PUehicLE/1214; t-T B .D,I- |IIJRETUEEI rtnl,t F6bD;rgt g ?ooo c;.ct-l?I,ltl5IECEXD-rV r YIPOR DSOP@I r YETSEIDCI'RreToB vALtUr lollrToR 8YI gltBou 8Y8'rD{@Jobr"teAo.C-r,tr Vlt{lB DR0F I/OYI8IIP!I.EcartATrE Complclr SptcmtCtnilitd,lfllllCICHAMPION'S PRECISION TANK TESTINGI45I OAKHURST WAY SACRAMENTO, CA.958228OO-88 2-9tI43BONilER EZY-CHEI PNODUCT LII{E TESTIXGWaclc OilTrnkrSTATION IAHE /Ac,'F,-< /3etcf DDRBSS / ? e S.i Laa L,<n,CITI Scru Lq;t 6b;s btCOUIITI Sap L c< ,,3 6 b,'s.b oDATE OF TEST8-rr-€oPRODUCT ID llUllBER D,'€saz z-TYPE OF SYSTE}I - SUB}IERGEDAppLrED PnEssuRE /i,?5/ 4r /FodLI}IE STATT LIIIB EIIDe{ 6r rNESULT+l--r063TI}IE/ 7zgr.003r.003I.0036?c7ey(7c/6YrIilAL IESULT -.oa3REIIARIS r1/oz..t6/ ydo6r.003 .. at5-a{I.003r.003I.003r.003ON FAIL CNITENIA rES ? XO---t---6g/Ysr/q@SUCTIONTESTI}IG OPERATORc.A.92-L409IAHE aZe'"L { '//?24*----AIVIN L. MILBIIRN IINNK TtsTlllcJ{fcx LrslIDSRESS: /1L <r, hu-r lno ', ' 5T' SqN L4; s Ah;" b3SITE CO}ITACT PIRSOIi TOU IIET HIRE:dsprv o '''l/z-,ilir:'iinl,;ltlllli":l.llotl!,,1:'1,:lt;o!':i3l;:t:#i[, -tllITAllt l(llt8[R:OATE:-t<-qaItlrrron:2Dorr thr tul rupply furl to r rtrndby rnglnr?Arr thrrr llnrl pnrnt for r futurl rnglnc?tr ttr lrgtrte rrlwd sff rt ttrr:iiill'lll?il ,,".. =i:i =.[,l -nilrrrr,li'g.#rli- Yor - l{oaRrturn IlneA3lf no. lr th: I lns: c6pper - thrtrctc plF! --- othr'r -0lror[rr of glPr:Splll Contrlnerr/{lnholar/Rtrcr CrDl :^-'ll.n' h,,Hl':[]'olg:llltl'o- Yer -4. n,- Yts -- l{aArc rll crps, terls rnd rdrpterl ltrvlccrblc?lf no. rxPlrln:LonrqC€t-6R e*tctt,tfLln- /+N i>0n3J3ol30Ico?I lnrlil'i i oll ll:,1 :i!'.[iltli'l.i r'll Jill lurirlrr rll erpr lockrbJl?. -?r rli :1fi lilki*sii'rilo,t!.?.,ffii'i!.3rfn,,serttr!!!!rtg9[i,' ^'.,,!lb. .nr: opun _Srfon tou rtlrtrd tutlng:0rYrrYrrYrrcoaxl rllrllot/llollo1'/lcrYrsExorl. Drop Tubr:t. Ertrrctor Trlvrr rnd Foot Vrlvel:Srrll: (chrck onr) Condltlon 'Iloinllllffil ,mtt lt ratlovrbl.?i! ii'i[i'ttgti.g'f]!l.cto, rnrtrrrrd?hYrlrYtfrIrsItsItrYcrYrrYrYrYrYslloHohcl{ollol{oilol{ol{oNoYrrrl,nerCol/d ,uOf Reao't<GoodlimCRepls Rrplrclng -rccdNcYertt33thrcrdr . Sood condltlon!i;i;iiioro;;illl,fl ',?r lil.'.t/llollollollolloNot/7t. llllerllrncourlrltc?k. grrdurthrrt aftndlnordENln orllont?k chirt on cltr?tr on rltr?ttI illiiiliilpr3 DAIE?-ts--AoLocATbr{ - fn"- frstt-ADORESS ln 6 I ', bqn bent s f.crw9.q^/ Lq;sOb;s b oPto|tEtro{ _2>t - zrzlTmrp.hcicrtc@ B C D" 'itpe tr sYsrEM --Elffii'Vapor Recovery{ iror'e fuar{ 6tryr I ? svwa oI{,-r-tlrEl{,-I3UrlctcctorWORK SHEET-n *ir tA.tA ltsllnct$l ofiHnsTwAY -src.. c195822PROOUCT D,,{J"5d/f€GHT OF' Test Stando1 o/ ae l-r6fir-14,/ ?st IFl PrprlAra( (I^tWATER TAELE;3ic'lc.t uKnJola iLt tg- ra,rclO l/ra\Dl lltWATER ItI TANK{15il oH.nd Oerl,yrpr.B/Tubhr OMriltold Y O N8lplDn Y O NTYPE ol COvEiConcrete dBlrcktop OEgrth OVcnt Slre/,Fill SiizeRcrpleFiI YO Ny Ct X gilrrcrrr_._...+;_Prodcl lenp. ,zallerund Gnvitv 7".{Coelliclrnt Averp j@11l2 rz lz3'7 .3{ ? z7? ?7EEOINNING.os O .O2SCHART CALIBRATION|',-It t?.ZX A7 2lo3ENOING.05 O 325VGRAPH COLORE neo El6we?ao o.B FACTORx .oooq{e73. l,vto FlsrzEtrttto'/fsnll.Cttl. l.EwrItAtt IrOolrt106t-r12t/jt t371 t'/3I/o tc>'7tlI5t 23it23'77oc1.tI-eb5-5_2oT7oLa-kl67-I-v-7t7 o -_15_!T-t7o-5(r{aIb{-t/oaIbt'7oI-/7oeaI70IIA-6-L rat70 - b,-52oGZ-8 r{-7 rI-C r?oL7-t r?o4z-7 t---I-.oo7l. r,Alt ctil'-.ot2Lt',olo{t-,otzLt-rolzL'-.o/o{'-,oloit-,ofo\'''- o o8?':ol:LLt -.olL7t -.6tcr-l'-.otlLt:rot7C'- oro{t -, oo87..-.olLv'-,olgzIfY€LiEsrr.r61 . O9.5-t(}{owNAMot NTAVER^GECHART OISPUCEMENTOF PRODT'CIact{ART+ 12-. ,ooal tAlTo36 D{l*.oo6 ta7"lo3+'l,6oQaIo20o27/, Oa?Ito57067*. OO5- ro tr.ot77, ooi-aIo?7IoiA*,oo{ tD{7+,ooLt6Yrot7o?6r'o a7IIo6yot3#,OOfaI(>()3ooI*nOoS-aI@teo',t +,r,.- i ITa .oo/l,OoY7tIc)?{I7*,oOj I7?"?12af, oo2- r0AlloLOS3-f€ft / c TEr,lf^lt b f CxooL2b6C'4a'^./ to-7o6'75 'rA,ooS tocco-f o t +, ac,( i/-1r or llltacloi'*,oto?'+.at oT'f -o169''t',olA3'{. oi? 7' -+roo1 I'f ,oo?l''t ,OO7 I' l,oacl IIrOO'l Iaf ,oo57a':f^oo'?7'f,oofY'*"<:o3(lcpEtar.lt {.etctl2-'f, oo1 lt *rr"ro'7a-''-,o11'3'--o23f't -.a2t{I' : ot:?'-,oJs3t -.6r76'-,ol?Lt'-.o ri(-t '', a? l7t ^,O?t?dAo (a. -.ol?f(' -. oi/a,a..'-.oft3tt ALrtlrl'',oZl?' *. ot'77''-, o /66I2 ba^/ - tQ.._.rctsrodo@gN n A ^J[U?t,-FLl'---rultr0 sq lo ot"Us7ar -9-."h-esaI7-77, - aSat 7L'A-LaIar )-qiQ-caIIIaTIIaIaIIaIItaratItIrar--b8@'-.>YSQl o ".!a)ato'-.q,(?/I)gilltt{-a{a"ftrtiaLIaaaaaaaaaaaaaItwla-"L t-P5L| )"aQ'Iobar'*. LbOgae/eQa, IaI'.1aILt- c0ataraIreb@Q'* . a4arLIatItaIIfttIaraatrItItroo'p .T90r*.h9Qrf .a.a_coa r/ ta,faaaaaaaIaaaiaaaIIaaLtcr'-I&€. ) a'* .blo,- -aaaaI O'-aatO.-b?-er<l'-aaaaaIaataaaataET-EEnIIEEEatiaaIIaaIIIIC/ta tl53U'rb $()v\ol:eaifts.r't!agi,i:iQlfr.)o\' "'\4lo ,r/a--re'-==E--::E:@8R 55140d:;,tC,*&,, 80s-549-5544FacilityFacilityCOUNTY OF SAN LUIS OBISPO HEALTH DEPARTMENT Routine tnspectionDivision of Environmental Health Reinspection No.P.o. Box 1489, san Luis obispo, cA 93406 comptaint rnvestigation _HAZARDOUS MATERIAL/U N DERGRO U N D STORAGE TAN K/WASTE G EN ERATO RINSPECTION REPORT/NOTICE OF VIOLATION4t-Srt.L,r.,Contact Persona-l \-'rLC-lLTitle/Position:_HAZARDOUS MATERIALSMaterial stored in proper containers& labeledP# )UNDERGROUND STORAGE TANKS(coMP # )H&S Code, Div. 20,6.ATL, #- GENERALTANKH&S Code, Div. 20,BUSINESS I.D. FORMnumber3. Location of utilities4. Hazardous malerial & amounts listedViol2.5.6.Plot8.9.1112.14.15.'t6.not stored7I containmentPLANittedstreets &itdi10. Location ofmaterialsFiextisourceshuhoff13. Location & verification of MSDSafeaifications inrevtousEMERGENCY17.se18.evacuationTRAINICOMMENPLANThe above marked items represent violations of the California Health & Safety Code and the California Code ofRegulations and must be cdrrected.rT-37. Spill containment36. Fire extinguishersi PROCEDURES35. Storage - 90 daystogetherlncompatibles not storedt -"'33.Material stored in proper containers& labeled !.32. Contiprogram/records31. Traiiewersystem and/or storm drains!.' ''30. Waste oil29. Manifestsand/or exemptions28. Variances27. EPA identification numberWASTE GENERATORStakenc) Soil samolesb) Tanks rinsed,tft\purgeda) Tanksabandonment26. Removal/in?| Temporary closure24. Permit approvedLj,it23. Leak detectors22. Precision tank test?1. lnventory reconciliationCompl20. Permit to operateViolComplI-: t)Frrttt\YttY.^t(,lnspector's SignatuOwner/Operator SignatuNOTE: Signature indicatesof this document onlynot an admission of the facts.Page_ of_ SafetyDepartment 30Post Oflice Box 7631San Francisco, California 94120908-28th St., Paso RoblesL96 Suburban Rd., San Luis Obispo2053-l-0th St., Los Ocos931-5 Encina Ave., Santa Margarita5l-3 Main St., Templeton226 W. Dana St., NipomoBridge St. , Carnbria960 Dolliver, Posmo BeachSec. 33 T30S RI-BE MD8, Carrisa P1ain225 N. Halcyon, Arroyo Granda6220 Atascadero Rd., Atascadero7BB Main St., Morro Bay730-15th St., Paso Robles65-l-3th St., CayucosLyncy Canyon Rd., BradleyL33 San Rafael, Avila BeachPActFtclNBELLoA Pacitic Telesis CompanyMarcl. 27 , l-990County of San Luis ObispoHealth AgencyDivision of Environmental Health2L56 Sierra WaySan Luis Obispo, CA 93401RE: Annual Hazardous Materials Disclosure Permit FeesEnclosed is a draft for i3t424.oo for Permit Fees for Disclosureof Hazardous Materials for the following Pacific BelL Facilitieslocated in the County of San Luis Obispo:Pacific BeIl SiteAmount of Fee$374.00562 . OO257.OO72.OO72. OO72. OO72.OO72. OO72. OO257.OO257.OO257.OO257.OO257.OO257.OO257 -OOTotal: $3424.ooTen of the sixteen attached billings were sent to our Fuel Unitin Fresno causing a delay ny receiving thern. Pl-ease correct yourrecords to reflect the above mailing address (Attention:N. C1ancy). r.(^I apologize for the delay in getting the draft to you.contact me on (41-5) 542-3060 or Helen Lum-Leong on (4L5)with any questions.Nancy ClancyProgram ManagerEnclosure - Draft # 860 775 ($3,424.00)Please542-4046{ SaferyDepanment 30Post Office Box i631San Francrsco, California g4120encl0suresIas listed above]RECFIVEDMAR 2 2 p90Hnvironmental HealthPAC|FtclxfrBELroA Pacilic Telesis CompanyMarch 20, t-990ifrl:: ll"?-ill #;:i;:3:, prease contact the paciric Berr sarerySincerely,County of San Luis ObispoHealth AgencyDepartment of public Health2L9L Johnson AvenueP.O. Box l_489San Luj_s Obispo, CA 93406ATTN: Hazardous Materials Admin.Per your request, enclosed Sre updated__rrBusiness rdentificationBrl i " r"B" i r; ;::rin, :i ;iil;i* il';ffi?:., jii*" ro*he ; ; i i;; i ;;\E,931_5 Encinl Ayenue, Santa Margarita* 133 San- Rafael street, eviia-i"""n*73O j_sth Street, paso Robles\r.Bradtev Centraf 'oiiice, Bradleye'o snces isos R18E ltoil, carissa plaj-n* 5l-3 Main, Templeton-.,. 65 L3th_Street, Cayucos\L-hl7g Bridge streei,-' damfria-rn622O Atascadero avenue, Atascadero..P\Z\e_ uacimi;;r; ;;i;", paso Robres-r 960 Dolliver Road, pismo-ee.li"-=-+N,/S Dana St. W/O Mall, Nip;;;"=<loth Street, naywooa part<'\* zz5 N- Halcyon Road, Arroyo Grandetl7ee Main srieet, uJi"o auy-rr-908 2gth Street, pr=o Robles.*.196 Suburban Road, San f,uis Obispo//b,'rsr/,hrruoItancy' ctancy /pacific aeti Safety ,d,{,)llli{".COUNry OF SAN LUIS OBISPOHEALTH AGENCYDepartment of Public Health2'19'l JohnsonAvenue . P.O. Box 1489San Luis Obispo, California 93406(80s) s49-s500Reply to: Divlsilon of Environmental Health549-5544March 19, 1990TOBusiness Owners/OperatorsSan Luis Obispo County Health DepartmentAnnual Health Inspection FeesFROMSUBFINAI, NOTICEAs of this date this department has not received payment for this yeartshealth inspection fees. The 30 day grace period for payment has expired,.1990 Health Inspection Fee - $ 562.00Business I.D. /l : I74O7Please remi t payment and this letter to this office at the address below,within 7 d,ays, or further legal action rnay be taken.San Luis Obispo County Health DepartmentDivision of Environmental HealthP.O. Box 1489San Luis Obispo, CA 93406Thank you for your prompt attention in this matter.questions please call 549-5547.If you have anyTII4 I'IAZZACANO, R. E.H.S., DirectorDivision of Environmental HealthLMICHAEL McGEE, R.E.H.S.Environmental Health Officer IIITM:MM/cs \\ rl o)-Ew- -EARTH SCIENCE TECHNOLOCYTEST CERTIFICATEPACIT'IC BELL^fil] i :i 0 lg8gCONTACT PERSONIOI{ELL UARCUSTANK OWNERADDRESSCITY, STATETELEPHONETANK ADDRESSCITY, STATETEST METHODTEST DATETANK#66#67#68( 408 ) 491-433s2 NORTII SECOND STRRET. POOM 675SAN .TOSE. CAI.TFORNTA q51I1196 SuburbanSan Luis Obispo. CaliforniaHORNER EZY-CHEKSeptember 25. 1989CAPACITY10.000PRODUCTResularHICH TEST-.02634LOW TEST10.000Unleadedo2346Diesel-.ar222REMARKSThe above tanks and their associated pipine svstems were4certified product tieht.A11 of the tanks werefilled oneday prior t.o the testins daLe.SICNATUREHORNER EZY-CHEKAPPROVAL,I219 WEST IMPERIAL HIGHWAY, SUITE 104. BREA, CALIFORNIA 92621 t] 71+6SGB31B bbProductEARTH SCIENCE TECHNOLOCY1219 W. |MPERTAL HWY., SUITE 1(X, 8REA, CA926n D 714-68e8318i3 ? -'ir-:.1 St{ .l!Datel?,bft '= . cv-rz,s{ at+Tank#5p.CrNo.TestlevelProducttemp.levelfi6 utICapacityacrOtftlE)xx(A)(A)xxend-l'1Coefficientk-,o{Chartcal.| /oOzUTemp.caXrl*do6/(B)(B)b, E/' nii)r'/{final tresult timelevelstartgain *loss -levelresulttemp.starttemp.endgain *loss -temp.resultn{x{X,7,/t?=,OAzg)x5l bA- : tl477fqX4a st=oe7qtlX{o2s{ =pXN-zqf - lo> 4t+r\4x9a 1?8 *nb4tl01lx4b 3q 2 an(':alaq /X1Rl - 38b :oa4J.':a37 27x.\17 -}Sa aro5Xz1e -377 :oo{: alvolX,tt1 - 3lz =oa{= ,03V0?X,3bl - 1G'7: oo.b*(!,&7&'4s615-ots' IeoeT$qqleQt{-:ooC/f-{nt lir'/s(p/tf,/fI ? b glr._["^Tank locationAddressStateContactCertifiedtightLeak rate per hourOwner+p-Operatora0? EARTH SCIENCE TECHNOLOCY1n9W. IMPERtAL HWY., SUtTE 104, BREA, CA92621 n 71.{-68G8318,?vfe.{Temp.caltemp.o"o6Rx(B)x(B)Datetemp.result6a(r1bv"d'lg'1g1+/7t.Yd,739s> -Tank#Sp.Gr.TestlevelProducttemp.Prod0ot)-4stb,9t70($)Coefficient/60 ^bxNo.levelstartlevelendgain *loss -levelresulttemp.startfinalresult- 4r', )Q)Itime1gainlossend(A)(A)xxr{4tX:{Al:06/8'lX.l''=Ol0+XIYgarX70Z at7Xrb{ts t t1X(r tf(/8!ot$brXbz- b412X{-34hX-SbE = a- ;:o130- {{t>:o t)b.2-X- {bt:CI)bf)X-sb: ooA'81X- -t(cX,fbo _4wloox{bl 5@elt7b&,Xg= pTtO@g-=arlLlatot2?//'tirp}'{{erUC)fv9vTank locationAddressStateContact9qh 5.b*ou"'ur.-OO-3 7CertifiedtightLeak rate perOwnerOperator EARTFI SCIENCE TECHNOLOCY .;{:;:lngW. |MPERrAL HWY., SUITE 104, BREA, CA92621 tr 714-6808318Chartcal.,O{CapacityarldF Temp.cattemp.starttemp.+21 ,t4n coc.Ev{-\.oo/R3rn/,t@K rR)St, t: alYrt,'t *b3Date3132Tank/Sp.Cr.'. r"j .'No.levelstart, level'''1 gain *" loss -gain *loss -temp.resu ltfinalresult..iIil5 -f?;. ;level'estTProductX(B)(B)xxend(A)(A)xxendlevelresult:*6X3:*3X,L{Xb{frsX(, (lnV+zX.,b Il--^.,4"s(&+-oo- 8515x6x?Ll5q-r:60=n4 ^l "go'lt*tutolg9,950 -5s]-X/I397 :@b=g P(3xpX!atuu&A -nt s{x010*77x5o<qqg-t | _albXt oo%nbgdl -8(!0 ro{X(rtat- 8t' I+e*,'X= 6o /rL: Oo?oLoctl?9'=6 12J1V& 7a:7-:a3SV= ootl{=ffihR= oott{-{aK3-4'#C=6%1,s6F/{'/-w;-.. Tank location:ll--':ii:'5, f,^" l*1OA, <re5o,', /-ur sffiAddressStateContactCertifiedtishtLeakrateperI. li.i,1"tfti*iV:ftE+. .'iEj:::OwnerC*Operator- olzZz {COUNry OF SAN LUIS OBISPOHEALTH AGENCYReply to:Department of Public Health9191 Johnson Avenue . P.O. 8ox 1489San Luis Obispo, California 93406(805) 549-5s00Dlvlslon of Envlronmental Health549-ss44Nlareh 2, 1989Underground Tank Owner a:ndfor OperatorRE: PACIFIC BELL (SE-L64) - 196 SUBURBAN ROAD' SAN LUIS OBISPOWe have recelved your payment for your 1989 permlt to operate an undergroundstorage tank. Please note the box(es) checked off for lnformation needed tocomplete the processlng of your permlt. Your prompt reply to ensure yourpermlt ls finallzed would be appreclated.The following were not recieved:Monitoring alternative not lndlcated, see attached monltoringalternatives (lnclude frequency).Precision test results.Leak detector on pressure plplng.YES or N0 (ctrcle one).DoubleYES or'61plpes.circle one).Are pipes SUCTION or PRESSURE (clrcle one).Monitorlng alternative :Monitoring alternative is not applicable for location and/or sizeand number of tanks.Please return this letter within 15 days. If you have any questions,please contact this office at 549-5544.TIYI I{AZZACANO,Dlvision of EnvR.E.H.S., Directoronmental Health7*U".HEATHER PARIS, R.E.H.S.Envlronmental Health Officer IIITM/HP: KdREFERENCE N0: 251604 COUNry OF SAN LUIS OBISPOHEALTH AGENCYDepartment of Publlc Health9191 JohnsonAwnue . P.O. Box 1489San Luis Obispo, Califomia 93406(805) 549-5500Reply to: Dlvlslon of Envlronmental Health549-s544Febn:ary 22, I9B9*Son tr.trs Ob-rsg,Pacific 8e11, Attn: ClanqfP.O. Box 763L, Dept. 30San FYancj-so, CA,. 94L20We have recelved your check ll AOZV:_ ln the amount of $ t r152.0for rhehazardous materials busLness plan fees required by AB2l85jg7.Thank you for your cooperatlon.TIl4 MAZZACAIiIO, R.S., DirecrorDivLsion of Envlronmental Healthj/rrtlou A^Toproperly creHeather Parls, R.S.EnvLronmental Health Officer IIIease return thr-s porrion withdit your account pIfltlFIC BttL AIIlJIli, CTANCyPACIFIC BTI.tF0 80)( 7631 DtpI, 30$At{ FRAilcI$c0 9ll1201052 Aili DUt gt60Rt: tg6 )'lJBfRBAt{ F0,cr + Fes /a\your remittance.a%\ 0epartment 35Post 0lfice Box /031San Francisco, Caliiornia {}4120PAcIFIcFIFBELLoA Pacilic Telesis CompanyDecember 28,L988frFCS/YFDIrttAY t ? EBgEnvirsumsatal HeafthCITY OF SAN LOUIS OBISPOFi re Dept.748 Pismo StreetSan Louis Obispo, CA 93401Attention: Michael P. DolderEnclosed are Hazardous Materials Inventory documents forPacific BeIl facilities that are located in your jurisdiction.This L989 Hazardous Materials fnventory update has been preparedat the direction of the office of Ernergency Services for cornpliancewith Chapter 6.95, Section(s) 25505. (d) and 25509. ofthe California Health and Safety Code.P1ease forward to my office any questions or correspondence yournay have regarding this matter (4L5-542-3060).Nancy CIcyPacific BeIl Safetyenclosure (s)REtEIVID '1i:;i : t$33 te89Hrztnmus mrsnrtug nBLBlsB ngsPorss plrl (ousttlgis pLA[1Pagclot /-Ttuzlnmug trlEntALS tllvEllonYEurtncar Strcc3 ADDBBIiSIrlPacllltY llAIE:(31vltt4PP(5tT.tpc/Codc/3o/204/&70(4.(6)llll.LC.5Do5DO1?tt47?,272(?llr3.&L64LaAL(I)Unlt-5r/o Pu2^/o7-4,1/z(e)Locrtlon rlthlntblr PrcllltYI roll/ttilme D/c-l.l)o(.L(rrlDOl Progcr SbIPPln3 lleroor, ti ll.o.s. rrtn DmcelaobIRa77o633I1t365F'DOt llelClerr Codc( tll\ -c,LeDOtOrldctr$tzt ewl'u//9cAs llutBtn( 12l( '.?,( r8lTttle:lpfelY-Specialr slat c : -4&t/68nca -, ffi -54L,-72!*2Phonc/Af ter llrs :4t5-823-7777(tthun., clancy16ilaoe (Prlnt ) :Eoer. Contact:551211/9 rltlc:slgnature:irNKilIB.2( 19)( 19)Phonc/Bus( t9)( 19) .-: : .'.a..att'r':.. ' gO 9tm Ng9 oy Ny'lvnsng ?4/ @DtEELn^R N nFLr F: r&>Plrg;.\M\t) @Rtt/P I.'l I t't'i 33'ia.'1 TJ)p n z $ t. 0 la RR i: .,: . 'at I i.i i I :l,z sc FI zs .,'.i I : ::f: ': r' "'r|.:' E ou. ril Y{'{, r-( irri ri-I rl C E s ; '.1. Grre" l. 'q F z / ! )ti'-' ,\rs f,\ >: )--{ ,i..i: a rt3stn -e u'1 'lrIc3iIrTtrclltt 4trLllHlll-lHHHtrzlrrrrt \.'t!SOeA6eA,W?A> (ortC*SL6- Uea AtJl)e ?m g/oP,lf.EAIgrf€UEso&Lcs',axNlTlQtrttt&nte52-r?t-l+-l-l+Fl-t]-FrFH r IE t II l-l-t-Fi + l-l I ir/x$- tuetfunrt:)f_lliltlllltttrllllIllofr'tut:fitd, ( 06rts1€r( r i(,?*rrtO,'of-r Ofe)c.c-llllIll1|illItIS i-'196 Suburban Road, ;an Luis ObisPoPOLE STORAGE6OOOO GAL,. WATERTANKST'ORAGE SHACKTANKGAL. DIESELPOI^IER PANEL(o-eo-+r)CONC. PAD/ISL\I\DGARAGEFXISTINGIOOL STORAGE-250PHONE JACKaOFFICECONC. PADa.'*FIREHYDMNIDOFIRE EXTINGUISHERW1OOOO GAL. REGUIAR GASADDMINISTRATION(c-ao-ror-r)OOOO GAL. UNLEADED GAS(c-so-ror-z)BUILDINGIIPARKING\JPTANIERiI\'lSUBURBAN ROADPAC!FlCf,fBfU- sE-154DATti 4/28 / 86FACILITY STOMGE MAP SCI\Lii 1"=60' tr-r..Environmental l\ilanagemenl2600 Camino Ramon, Room 2E050San Ramon, Cali{ornia 94583Novernber 2I, 1988lvlf{PACIFICBELL'A Pacific Telesis CompanyOLD2<\i.rk:Mr. Randy MillerUnderground Tank InspectorCity Fire Departnent748 Pismo StreetSan Luis Obispo, CA 93401Dear Mr. MilLer:Enclosed for your records is theunderground storage tank locat,edLuis Obispo,t(tr l{14:''''1aattest tank test for our196 Suburban Road, SanIf you have any questions, I can be reached at 4L5-867-574I.dt^d^"il\fuLinda MontanoStaf f Associate/Environnental l{gmt. fTw!ry1',October 31, 1988Pacific BellLowell Marcus, Facility Engineer2 North Second Street, Room 675San Jose CA 95113Re: Pacific Bell196 Suburban RoadSan Luis Obispo, CADear Mr. Marcus:On October 28, 1988, a Petro Tite System Test(s) was performed at the above-referenced location. The test was performed by Ray Norman, E.L.I. Technician.The NFPA Code 329.02 criteria for a tight system is a maximum loss of .05gallons per hour. Because of the almost infinite variables involved, this is notthe permission of actual leakage.During the stand-pipe test procedure, the internal liquid hydrostatic Pressureapplied to the underground tank system is generally two to three times greaterthin normal liquid storage pressures. This increase in hydrostatic pressure willamplify the indicated rate of leak accordingly.SYSTEM TESTS:TankNo. I -SouthwestSize - 10,000 gallonsProduct - UnleadedThe test showed a minus .022 gallons per hour.Based on the above criteria, we find the tank tested mathematically tight.TankNo.2-NorthwestSize - 10,000 gallonsProduct - RegularThe test showed a minus .004 gallons per hour.Based on the above criteria, we find the tank tested mathematically tight.1477 E. Shaw Suite l50l Fresno, California 93710 / (209) 225-6698 JThis concludes our test and findings on October 28, 1988. If you have anyquestions regarding the results, please contact me. It is your. responsibility toriotify your-local-County Health Department, Environmental Healthr, .withinthirty (lO) Oays of the results of this test. This notification is required by theCalifornia Administrative Code, Title 23 Waters, Chapter 3, Water ResourcesControl Board, Sub-chapter 16, Underground Tank Regulations, Article 4.30.We have enjoyed working with you on this project. If you need any furtherinformation, please feel free to contact our office.Sirely,Office ManagerEncls1477 E.Shaw, Suite 150 / Fresno, California 93710 I (209) 225-6698cEnnrKfiE )1t18t2262 If,ENIIRONMENTALNIABOMTONESf,Ne.lT- fi*Data Ghart for Tank System Tightness TestPLEASE PhINTl. 0WNER eropeny firank(s) ffi2. OPERAT(]R3. REASON F()RTEST( Explein Fulty)4. WHO REOUESTEI)TEST AND WHEN5. WHO IS PAYINGFOR THIS TEST?6. TANK(S) TNVoLVE07, INSTALLATI()NDATA8. UNDERGR()UNDWATER9. FILL.UPARRANGEMENTSpanY,AddrossD€plh lo lho Waier tabloNrmeNameNamoAddrsssPersonTolephonoO6loTolophonoSteol/FiborolassPumps.S ua. /.- .2 n..i?ctzrn y't'7ek ly'crnSuctlon, Romolo,Mako ll knownmaolor lndividualslrtoOrdor No,Otho. Iz.B-' r'ls th6 walo? ovor tho iank ?I v". p-ft-oTanks to be filled - hrDate Arranged byExtra product to "top off" and run TSTT. How and who lo provide 7 Consider NO Lead'Terminal or olhe? conlactNamoTelophon€& f A/. t,tt'('/*. oD4Concrsts. Black lop.Eorth, otc.CoverC ">nz c.4 67aNorlh lnslds drivewoy,Re6r ol statlon, olc.Locarion/./tt l Stt/ea I yan.(Whlch te nk! ?.u1, tu ESiphonessiro- ManlloldodVonlsSizs, Tltoflll msko, Droplubes, nemols Fil13Fills?"41 A/. t.'?.).Grado/z,tt rz,/Brand/SupplierCapacilyldenlify by DirectiontlApprox. Agefor nolice or inquiryCompanyN6mowh6nngprogress or completed. Visilors or obsorvars prssonlD8t€ Tostodl€lophone10. CONTRACTOR,MECHANICS,any oth€r conlraclorinvolvedlI. OTHERINF()RMATIONOR REMARKS12. TEST RESULTS13. CERTtflCATT0NOot6/7/j:._ J-22_?Seflal No ol ThetmalS6nsorlesting Contractot or ComPanyE NVI RO N M E NTAL LABO RATO RI ES, I N C.1/H7 E. Shaw Ave. Suite 150 Fresno, CA 93710(209) 22s-6698Additionalon anyabove. Oflicials or others lo bedurino tost olc.Tests wero made on lha above tank systems in accordance wlth test proceduros prescrlb€d toras detelled on attached test charls wlth rosult$ as lollowe:Tank ldantilicationTLeakage lndicated4petrcilb-..F.. -4Thls l3 to certlty thal these tank rystems wera teltod on tho dalo(8! 3hown. Tho3e lndlcated a3 "Tlghl" meet tho crltorla Gitablllhed bytho Natlonal Flre Protoctlon A3oclatlon Pamphlot 329.q,/ q,F '/rt.F 4Tochnlcians iflcp lqofl lou to a@ 0q ot punot --azTgTtS:-- pepnpuor -:{7'''*r{* trf?t+ 'irw17 atr/ ;E; 'a4r/ "rfiW *a7p-r+ TFa-+ *4'f "74 -s 2f' '"FT/7*8" --:= l-7- J.6J'':fvtr1 3r'r? .L /Q '*"67{4 .-q Li ,t'f/ lTq'f ,ba6 ?'v/ 1/?',-'LY{/'/e-4 VF -964 ?2''I'q/ 7-/v' /L7 ()/t.u?osd -ycl'/'E/ ?.-:/7y?2 -e7 oJ Aotc z1 c/ /- L?L-/v '-l-t/.b/9/'--r4/(/6 /ct7n d 4-tr/ /4q'-(64'{E-/QLv''Q/d/(J LZ a-"/2 L '/e7a/'-t+v/O)?u'-QE''e77'2 QtF/ 77u ''t e, .t 6o?-9-9Q'-Q2z -.t-/a 1'/.)_s ) D/./ 7v/'-f Ev'a ?aQ ->.t(/'-s'/6'4.6€' -aw e'/h Qt // ob/'-:i+5Oa o 6,4/' -v6z 6'?22 -r/E' -oat'J ..5t vwZ/9/t edt?-b a->','3h z tstl l]Ail H9rH lnNllNoc aat't --tt 9Sd a) // '-_9,55'-taa'9 or5 9ilrovlu u0sNrs luvrs 5,, tt/ fn ONIOV]U UOSN]S ISUU a1-a/ ru6Q = v Jol3ej ouluun8 pue psurud ournd ? lcnp0Jd qlln luorllolnDl lsol illj olr& usa - l^ltta \!l.(rl LL l?l '8t '9t ( r lPrsonupp0rd tutp.el r.IV 6!!C..U ar0la8 Fqrau 6u0rW l0 furpr.! '62 papaau I guil lo qloual tmt asn) lsrl ouluun, pue dn oulllas lo sll8lap prolcu 'gz !r ralMI ItYo'tetliuultt{.1 tei.P.U ls9od 9laolu0 e( sqrq 4 tMrl &!{p!ts JUnrt! 0ilYln,.n%[ uroflu [lf]3t!ff!rl lrinlm Dx 'ge tr) rorlrr Jrn mrYsflilfr09 tmrYrxfiil tt -lfo rm 0l o803lr l8 tuumJ tu0sslud clrYrso{rH 08 8t!n0lJ08J lslr s 001 '92 rsSl dn-l3s 'e8nr Hsvlds oNv dvc ]'ilJ ot^ol Hu ------l0nqoud Jo AuorN3ANt xoot oNv'vNvr iJo orddor lSnur lHodsNvHr t401to8 )tNvI No u3IvM uoJ 03unsv3w oNv 3!s rsSl rv 0S^tuuv (Bl rcp8/ 15al 8t str{l t/QCu '80c€td leulcep t ol otoduoc 'Io|p Dd edu8qc eunto^ s-rh/ F a'E aQ/ qop -SE- c0uBqc pelc.dxo lo.6usr q J. nd 8I6tO 1t!t lo dot osn '.pBrO .^oqs spueuo adtd ill tt. ?''" dol luel aotlq eDu ro J eqnl uollanS uo a6oq pu9lxl . "epei6 ot dol lusJ, oNtuts tsoH NorsN1l.xl '0e ' ' ' ' ' gtrulxorddv alquorfr ol lutqot lrtqt '' ' 18il rlr ro ,0 jol ",2 pPY '''''''''''''''l,t ro, -0e Ppv apBro rtuBl l0 Mllo€ A18r'llSSV IrSI uol srNlnlunsvil4r lNvl '6t EE h€/ oND 8. D oND r. fl oN fl ..^ D ryrl ul ralgM {gZ} 60l ut slnpccod proc.r put aotag lfq3 qqagltdd. ruollca. lrnuro cas )tNvl stHl lstr 0r slunotc0ud oNv sNotlr0N0c lvtclds 's I (Oa) 9OUBU l8et ul J" red 8t!6to .(tz) l" rcd oouBrlc ounto zl>ddL ?6v - J. rad luBl rlql ul o6urql ounlo^ ?uoil16 77F6rcgEzr2ra srt -7 tcopord Pe^l6ut rol uotru8dxa lo luetqlp@ , //-;r+L 9z-sz'2 (!t x Ot) {u8iltn, ul ,(ltturnb lBlol 'gz ,,2 'td 'zz -, r$p l"a)4 69/ ( - ,o r ) c0upqC pct..dx! J.- tcnrl uo tilpold dn-Itj 4- turl q tenpou n,rot@C E ru[M lrpol 8l xNVl slHl rsrr 0r (e) uorcvr t]lllnloA/lunlvuldnJlt 'tz t?/r/ z e 'oc ldv petooroc t'l't^'l qilr polsel outrq (s)cq'lr o6rls El I clels n ililsAs lu3^03ru uodv t5?pe^re8qo p9^rgtqo (.dtd U ot dn) ryrt {q q PnP{-' fd' -7-V,ae:r77 llll|vm at^uil o3uat:nHcY3 uo &ro rNgfluYdm3affl ullrY 0v tsjla x3ilE cr ul *TWw e fuFt r q.0 pg qao a&p..U IrnS lsll uoi dn-]]ti 't, _nqlo I.ttl ort.d qus pcilddnr 3t8qC L] rlro osr.culo{! terdqoC E lrtlc l,ornlillru3$l riu9l n lrqC uollrls n filoilto / v'vv q / gtltnu lsd Ig ,trl\ rj_j .A!CYdYC XilVl Srilrfrltllo. qp8..a VT- i,lilcrdrc en1l ol 8r lqnop ereqt 8l l9utuoN Allcvdvc '9r rsil 0r xNVl '9, a ._F 7 'il d'F.1415. TANKTO/TEST17. FILL.UP FOR TEST16. CAPACITYl.lomlnrl(200lsthorrdoubtstoTucCrprclly? f]'/L/e&. Sdlon'OETEFMINIre t NX CAP C[rBy mo8l aEurato,/a o.2ocapaclty charlOrlbntFrm! starlon chadf] lank Mlnufscturcrb CharlEl Company Englnorlng DrlrfJ Crrarta oupptleo wlth Poko TileI ortct-_-.--=.----SrH tu.dq.gdhr-1>--e-SdhrFil uA STlCk BEFGE ANO AffEa EACH CilP ntMENI DFOP S EACH MEIEnEO OEIIVEnY OUANIITY,/qdea7o/o/./,"ac2.7Q18. SPECIAL CONDITIONS AND PROCEDURES TO TEST THIS TANKSGo msnual lectlons spplicablo. Ch@k bllow 8nd rocord pr@odur. ln log (20).n wator ln l6nk D Hbh walor lablc ln lsnk cxcavtllon n Llnr(.) b.hg t.ltcd wllh LVLLTObsorv6dObs6rvod.24VAPOR RECOVERY SYSTEMfil steoe tn slisc ll724ae:2,a-LeL-c. o.- 7 /4E219. TANK MEASUREMENTS FORTSTT ASSEMPLYgotlom ot lank Grsde'Add 30' lor 4" L....,.,.......Add 24' lor 3' otllr s!|,..,..Tolal lublno lo rss€mble Approxlmals....,20. EXTENSION HOSE SETTINGTank top lo grado' ........,..,..,........Exlcnd ho3€ on sucllon lub€ 6'or mor€b€lw lank top..........,,,,,............/-<"/,/A+q2-621 . TEMPERATURE/VOLUME FACTOR (A) TO TEST THIS TANKlaTodryWlrn.rn Cootcr?D Producllnllnk-'F Flll.upProdudtonlruch-'F Etp.ol.dChrnga( + or - )22. Tmrmat-Senaor roadlng all6r clrculatlon23. Dlglt! p6r "F ln r8ngo of rxp€cled chanoo/sP?.<dioll.za./q//vuct3es-digila6.'t/ sP,/"4qqtotal quantlty lntull tank (18 x t7)€xpanglon lorlnvolvod produclpcr'F24gallonB. alaT25.=. rlZa66 laSy' tnsisVolumc ch.ngo per dlgll. loslComputo to 4 doclmal pleo!. taclor (a)volum! chango psr'F (24)Dlglts por 'F ln lo8lRange (23)'ll Flll pipo orl€nde abovo grado, uso lop ol tlll.ARRTVE TEST S|TE (DAy) - (TIME 24 HOUR) -AND MEASURED FOB WATEF ON TANK BOTTOM -TooKlNVENToRYoFPRoDUcTANDREMoVEDFlLLcAPANDREMoVEDSPLAsHTU8EINSTLLTrsr concrurrod (trmo?"4ft.1 €2rl€"2' -anrl lounrl to bq16fi?r,]ot tlshtonlhlsdav *a / 7^ ' levol rsadino ol -=22!--0all0ns por houtta"d /U2,1,2.aaa,/ L- ,:tf-, a*49/ 7.-a4...2 3A/2 *f./1.- 2-l._'n2.I,-_f.a-?1-",^12.t.23.)3tpr'r':t-L, ./ r/)/4 /-L&4q/),]. r17),2 1:o/J.7I//u<,1'h Qot' f|, 1.at-, 1-t:ill.2*L3.\r'.1.L.)- aac'1/o,ttr- ,2h'71' , Aa't--+-?tht* . t4.t-, -/9.f,9 709 1t. 1,-7'-a f ?(.nPS9/'ntto.2tu?FOtlt.l6// ta-,24-<-1-, a9?P?A-. tt/^n.2c1z//3-q/, ./g-.a /€+.tc-92-.2/3:its -?a+.oul+.2-efz-.27da-?a.l,AD" 2.9?- . lJt-av*,acSP?Aqnl. €1d.4a f'?r,<'LTEST-. s'f,?. /7?+j?stl',4Lo.29r.tu(?2.<,START SENSOR REAOINGt<,P1 tqAFIRST SFNSOR RFADING- -^ /tter,l^t AFFill TBstwith Product.3q$ -.ttr)37.lc) " lrl .36.rt15.ftoduclnocohcd l+)All.rno,din0l.lot.R.Min0R!!lordolnOdng29.Rudlryflo.?8.Rmord dstalls ol srtling uprnd runnln0 li3l. (Usa lulllonoth ol lln6 It ntsd8dltttl2l i40rIEophd! {-)32.GradurloS[idpipo t.6l3%uur,otrncHAi6t38. rrr vourrcHA[GtStrc8 Rtam]4.US FACTOR t3)31wtuME MEASURIMIII'S (VlRtc0RD ro -001 GAt.30. xvonosrmcPRTSSUNEcNT80t26.toc 0Ft[sr Pnoctounts fr-6r--dODBIlo f-rrr-tr=n rInvolce #''-Plot PlurJeDlttr lportlenr*a EelL) 96 Su-1u*-EntJ lU@wws//yFn t FEILe€deEaofT-s46uz^au ,QaIrEtIEOEIID-V T YAFOR DROP@ r l/EltTEIr l,lOllITOR EYSTE{rIr 8IPtloU gYSTD{O r VAFoB DnoP W/oVUgPttt ooIITAIUERFTANKglL f;ou//, t't:- ,/t5Aat?ttu. nnBIilEF r FfLLnR.a)*jft\,fTGat, f)/JfnTrnbl t DurlrlBrrnd of nrStlc of Trn!Brln0 et8lrr etLrt Drtreto!HnstorBnnA ofBfrretetovrrrDlllgtlo of 8ubCo-Ar or aIootterll|Errn0 oforrn$$ Cst U.rYrDexos{ter*ryErltr $ gllgtDbcrf/4ry'Es,./r:urt',/7)oltJ O?7t/fly'6s24{/$:'4I r.'t t;t;:/Xrlvo,za////"y'*lL-q/,dr/'d- l-Toltrrr Bocmrnilrtlon.a"3'/4JoD EIrlrrNNDIRf,,, 46 €46?z414 . F1 -:Ilm'l: t-- WorluPerformedE6stlng or C|r-onstructionEArrival Ilne 7.'Jet @p.m. // FueL Arrlva1 Tlne(l'tnlttals ofStation0perator8.Br -I).10.I . !1. -D. ltl o4j'iDcpurture TimeJO$ DSLD{ENTATION S}IEETIDrfr: ,/a - Le-- d tz!!ne:' ('.'zoCoovrrreSlons en//Trlcpboor ai 3 al' z a s' 6e? trDrfc:Tlse:CoovergttooiTelcpbooe ltDrgc:flne:GotwrggtooiTelepbonc l:b"set81ne:CoovrrgGtor3fdrgbonc l:DrgerTtneiGoovrrgrlon:trlrgboor ltDrrrtlllnerQpcvrrnrloola.m.-p.m, // I'uc:!. Dcparture Tlrnefo c iezP tz atty'l $aa*-,1 - -L-- -!- ffi .Tolttng er Construcilon nt'-q'rUob Photo FornrlJobBlte Locu,'blon:r ..i+' t'it / I,/ ql -:,'ttr':..SLt: fi')/,t/ fz..l.!:/,,r/ -/u. t' '..'.., .-s'./ C4'-ruDets:Detei./a-2?'t?FhotoFhoto!I"2 z./,, - Datet Environmental l\ilanagement2600 Camino Bamon, Hoom 2E050San Ramon, California 94583PACtFtCTTNBELLoA Paci{ic Telesis CompanyOctober 25, 1988Mr. Randy MillerUnderground Tank fnsPectorCity Fire Departnent748 Pismo StreetSan Luis Obispo, CA 93401Dear Mr. Miller:Enclosed for your records is the latest tank test for ourunderground slorage tank at 196 Suburban Road, San Luisobispo.If you have any questions, I can be reached at 415-867-574L.Linda MontanoStaf f Associate/Environmental Mgirnt. I?-September 30, 1988Pacific BellLowell Marcus, Facility Engineer2 North Second Street, Room 675San Jose CA 95113Re: Pacific Bell196 Suburban RoadSan Luis Obispo, CADear Mr. Marcus:On September 19, 1988, a Petro Tite System Test(s) was performed at the above-referenced location. The test was performed by Ray Norman, E.L.I. Technician.The NFPA Code 329.02 criteria for a tight system is a maximum loss of .05gallons per hour. Because of the almost infinite variables involved, this is notthe permission of actual leakage.During the stand-pipe test procedure, the internal liquid hydrostatic pressureapplied to the underground tank system is generally two to three times greaterthan normal liquid storage pressures. This increase in hydrostatic pressure willamplify the indicated rate of leak accordingly.SYSTEM TESTS:TankNo. l-NorthSize - 4,000 gallonsProduct - DieselThe test showed a minus .033 gallons per hour.Based on the above criteria, we find the tank tested mathematically tight.This concludes our test and findings on September 19, 1988. lf you have anyquestions regarding the results, please contact me. It is your responsibility tonotify your local County Health Department, Environmental Health, withinthirty (30) aays of the results of this test. This notification is required by theCalifornia Administrative Code, Title 23 Waters, Chapter 3, Water ResourcesControl Board, Sub-chapter 16, Underground Tank Regulations, Article 4.30.We have enjoyed working with you on this project. If you need any furtherinformation, please feel free to contact our office.Ytone ManagereaEncls1477 E. Shaw Suite l50l Fresno, California 937101 (209) 225-6698 IJENVIRONMENTALTL.ABOMIORIESr/Nc't' iData Ghart for Tank System Tightness TestPLEASE PRINT1. 0WNER ?tooeny flrank(s) [f2. ()PERAT()R3. REASON FORTEST(Explain FullylAddrBssaj rn ,r, t: :., ..t t;1t:---loam - - --Aopieienrarive lole phon6Name4. WHO REOUESTEOTEST AND WHEN5. WHO IS PAYINGFOR THIS TEST?6. TANK(S) INVoLVED7. INSTALLATI()NOATA8. UNDERGR()UNtlWATER9. FILL-UPARRANGEMENTS10. CONTRACTOR,MECHANICS,any olher conttaclorinvolvad14 V- 7. 1.t it. /.tfNamoCompsny o? Alllllotionztzt o * 4Q/O6ioAgoncvlndlviduslPerson AuthorizingOrder No.Tlileng AddrossAttonrion ol:Deplh to ths Water labl6z's-" -*'ls the watet over the tank 7Stael/Fib6rglass,z- rl-{.{Pumps7b k t/.M,,tSr:r-/i*Suctlon, Flamoto,Mak6 il knownW'i"Y€sTanks to be lilled4.:l-t"-n. ?'/ .?'i'F,loav Anansed 6, ,:,>,,'t r:l / .r';*t'<:''t '< 2r'?f,' / ,'l/' t'/'f"r:1"Nsmo TslephoneExlra product ro "top ofl" and run TSTT. How and who to provida ? Consider NO Lead.Tarminal or olhor contsctlor nolice or inouirvC-.p""t Name TeloPhona'\/AS-/1 ,' z<zz>t /y'd33Fills/"co - /4.(Siz6. Tllelill mako, D.oDtuLis, Romole Fill;&oc'/'t,41CoverConcrete. Black lop,Earth, ctc,zfu,-/./,.rut-s'l- -tzl:?-'dtlv6wsy,Localionc5 f:'Ronr ol stEtion, etc.Norlh insldolrlhich lrnks ?/1-ro /L/FSiphonesVgnls*€l ,--?t!{9iro, M6nibldodBrand/Supplisrfler;z,rn'Capacity4 anttldonlity by Diroction"4 ,/ 4r';).tl;AppUx. AseGradat4,1I. OTHERINFOHMATION()R REMARKS12. TEST RESULTS13. CEHTIFICATION?-.t o, */tAdditionalon anyOlficials orto bo advised when testing is in progress ororpresonlduring lest etc.Tests wero made on lhe above lank syslem8 in accordance wlth test procedures prescribed loras dotailed on attachod tesl charts wilh results as lollows:Tank ldentilicationLeakags lndicatedDalo Test6dThl3 ls to certlty that lhese tank systems ryere lested on lhe dat6(s) shown. Those indiceted a3 "Tighl" meel the crltorla establlshed bytho Nallonal Flro Protectlon Asociation Pamphlel 329.eetronlllOatofesting Contractor or CompanyENVI RON M ENTAL LA,BO RATO RI ES, I N C,1447 E. Shaw Ave. Suite 150 Fresno, CA 93710(20e) 22s-6698S.rflal N0. ol fhormalS6nsort, 1,,/,..i {.,:i, ^,,:::,snaluto ft?14cA-Slht R..ding.15. IANK TO TEST.I6. CAPACITYN0mlnrloa0l. thcru doubt a! lo Tiu. Clplclly? /"1)8.. S.clion "DEIFnMNINO T NK CAP ollY'17, FILL-UP FOR TESTerb !n ln.-eFil q STrcK AEFOFE ANO AFIEn €ACH CqPARilENI OBOP m EACh MEI€n€D oEllVEnY OUANTIIYF0mBv mosr,ccurdr. E slsllon charliJp'ffili".iiiJt'*"'{d!?ru{= flrtrnkManuracrurorhchril.& Company Engtnoorlnq ontaI cnarts supptted wllh P€lro TitoI otttotTotat Oillon4,?to_-'--T./ "4*)7.l el,<-*Fi6.*t lns-rPducr h lurr t'nr (uD ro rfrtro", 7A ^ , lL.I8. SPECIAL CONOITIONS AND PROCEDURES TO TEST THIS TANKSoe manual seclions appllcablo. Chock bolw and tocord prmgdure ln loo (28).Obssrvedc4VAPOR RECOVEEY SYSTEMn shse tfl stase ttObgervgdLlne(r) boing l€stcd wlth LVLLT,col€cted API77Weler in lenkIv"" !0lroil Y66 !51 l{ot-l v"" fBruo+P./q/c. o.19. TANK MEASUREMENTS FORTSTT ASSEMBLYEollom ol lank Gradc'.......,......,.,....Add 3Y lor il' 1......,,.......Total tublng lo assombls Approxlmalo.20. EXTENSION HOSE SETTINGt6nk lop lo qred.' .........,...........,,Erlrnd hoi6 on aucllon lubc 0'or morabolow lank lop,/,E a21. TEMPERATURE/VOLUME FACTOR (a) T0 TEST THIS TANKh lbday Wnrmcr fl Coolorz ! Producl ln Tonk -'F Flll'up Producl on lruck - "F Erp@t.d Chdnoc ( t or - )22, lhormal-sondor rosdlng allar chcuhllon/7967 -7-7./?Fdigil!23, Dblts per'F ln range ol expocled chang€3AJdlgil.24.I P3t r/ 9zo"?doltloni,/,/-/)r'z6lolnl qu0ntily lnlull llnk (10 t lt)2s. J,-tj,&./L,i- f26_'vo;umJ chango por "F (24)coolllclonl ol oxpenolon lorlnvolvad pfoducl?Atvolumo chanoo ln lhl. l6nkpot "F- r:.'t<i749 7/ 2-.Dloll! i)tr "F ln lestRange {23)Volu're chango por dloll.Compulo lo 4 docimal pl6cg6.'1, Flll plp€ erlrnds abovo grad., u8o lop ol tlll.TRANSPORT TRUCK TOPPED OFF TANK, ANO TOOK INVENTORY OFAFFIVED AT TEST SITE AND MEASUREO FOF WATER ON TANK BOTTOM.-*--__This lslosllactor (a),,'>nfJ--. ooc,-'. n2c).- .5",? tl.C,L.)() 1) _s1"-. atL- , a2:.7-+'it-l--. rr "- {'. .295/.i o// ..t4-- nt)-. d/t']-.n23-4Q1.7', J'':)/3d. lAot/.C?4 "tt-. nt9l-. al-l9,?- qn2t. lL/,. tpc-//.q2_a/. rlzrl/,f 5t9s/J. o/?u4./8. '-t-t'Dnon .r^./-a,,1 Lcua'L/q?4-.na2aL3-+'):r{-.n /9. /) r:.1 ln'?q,OP/*{/:-. o54/ttl9te-. r>"7Oalnv7a7-. o'€7*.naZ-+t9,:,')-.4)1).7<o- /,/ /Oq6.96-.ASkh29-g-. /t1;.<"4/Otl?s(n.e1ltv ('.a79Ata^1' ..t2:lt74** , /tQ 1.,49-5'.1'EO'.ola-.781':1'-./tq5,,gfroA7qt/d,2/.P/{nL/^- -rti 4.-'/.'Q',/.-/ao67q'7tzi4n.72,CONIINUE HIGH LEVEL TEST/,Fnn-./ol-.o)q-5q/;2-. /?o.1a-?d{40.4STABT SENSOR READIIIIG/ 744/?e| ?va.ilnsl srNson nFADlN0l/k,.1*'1Factor A =Fill last Eoul0msnt with Producl & Pumo Prlmod and Runnino,t ,/A 6I.)'Fl-36.t5.Al16tnrrdm08ilo',nrrdrn029.t'igl'o28.Racord drtNlls ot sollln0 upand runnho lrsl. {Usd lulllrnolh ol llne ll neodedt21 h427S6placos {.112.Prcdud itrGradudeShndprpc tovd39*uu,n roCHAreI38, rrrvourur0HAX0tstacs 8ta0r[G]4.IEMPTnATUit C0MPtfl Sllofi,$ r CToR lrl31. votuMr MrasunrMEflrs rv)ntcoRo To 00t 6At.30, HYDnosrAlrcPntssuitcorlRor26.t00 tr TIST PRocE0uRtslnll conr|lillnd "-/F-zz* ".-"--. tounrt to ho 6rtffi_ .Qt!_l,t!solor nol ll0hl '\.lork Performed U{restrng or ConstructlonElrvlnltlale ofStetlon'OperatorArrival Tlne3:.<a&.DcpurLure TlnreJOD DCI.TGNTATION STIEET:Drgc:'81rc:'Coovrrrrloo:Trlcgbeoe l:Drgc:81ne:Gosvcrsltlooifclcpbooc l:Drgelltne:Coowrgglooiblcpbonr l:DrCttttne:GoavrrggloslIclrpbonc llDrgrrTtnciGccvrrggloo:Trtrpboor ltDrgetElne r9eovrrgStons// Fuel Arrlval Tlne3;zo8.,6Pu. rn. -p. rn. // I'uel Dq'part,ure trLne 6tfrtl r lllr d-{ttField Documentation FormrlDate:Q-/? -f,dImportant Notes:/-)dl /4^)l/Tr<** /,t/l)Slgnature of EmployeeElfesting or ConstructionE $t", q${ qvlluATror rgryrvT.$L, t Eurbl Drptfi t,- {)/, t,,1 t;."i':i-{'-Brud ofi)r.1,rtri c'-tJ. qStrc of TrDlBnn0 ot81r elLrI DrtrotcErtnstolBnni ofrtrrgterOvrrrDtllEnn0 ofOrrn$ll Cst UrrYrpc9tzo of 8ubCo-Ar or 2xogftertl|XoBlter{nfSrtr t! llr.srrlod2t, t/ tru/h t'y'l"t:sSq//"fifirt unYyer/eaPoot#zaty',CHguto^''IITortrrr Bccomonibtton-riroD sutrt .:. 4llr {,,"'t :/,,', -''ritnnilletdliGsrSw JOD|rraInvetora"Plot Plrn'ilobrltr locrtlonL/autr'f-*l*f(J+Jol**zfLot9"Ill14#7TA}IKS1.'TECEI{Dv = VAPOR DROPffi = VB{TSEvA= MONITOR SYST ,t= SIPHON SYSTN4= VAPOR DROP W/OVERSPILL CONTAINFANsEoflil2IaLil5nTTURBINEF = FfLLrMISC= MISC t'f, nesltng or Construction I t',r1a '€x./ LffJob Ptroto Formr'.<r' -1.ga"/,;/'y'd 5'--'t' /,.sA:, :',<t^ r''Date rq- / /-,f-fPhotoPhotoDate:PhotoDate:l?'/ l.iate: L:..,.M.E. CORPORATION fA Petroleum Testing and Monitoring Co.3814 Auburn Blvd., Suite 62Sacramento, CA 95821(916) 9?2-9010lo{s-8?tn-ls-P+ro-rs-87\o-16-8 +lo-t 6-l ?James€f, rP. E.(TODATE:6E-es6SE-t(tlsE-r6\SE-I6LIsb6lrsE-6)S5i ou'r )h)S..n Luis Obirgo Cotnty Enur. \tt"LthP,o. Ro x \t8qSan{*uis Obtipo ,(A ct3\0(iq-'{.:;f Lrr,"., .*,, $.il' \.t .-.,t: {,i |J lggV'-'oo#I:$*i*,*.FROMIBME CorP.3814 Auburn Blvd. ' #62sacramento, cA 95821SUBJECT: Pacific BelI Underground Tank TestAttached are the underground tank test results for f987 for thebelow list.ed Pacif ic BeII sites:SiteDate TestedResultsto / rq 1e+Fai\r-t,o&tGpHt,0o3 cpgf .028 cpudOOf cPnt,OE cps-,OO} GPH\ithl*'rL-lrtALrlt t rthtrh)r0,4ti?, fnuu 'hac {I)U iJT7o '}Ql6'2r'n'"(th,w //\{iL.B.M.E. CORPORATIONA Petroleum Testing and Monitoring Co.3814 Auburn Blvd., Suite 62Sacramento, CA 95821(916) 972-9010q.\i.,"ki;"i:,DATE:October 23, L987TO:San Luis Obispo County Enivr. HealthP.O. Box 1489San Luis Obispo, CA 93406FROM:IBME Corp.3814 Auburn Blvd., *62Sacramento, CA 95821SUBJECT: Pacific Bell Underground Tank TestAttached are the underground tank test results for 1987 for thebelow listed Pacific Bell sites:S iteDate Tested ResultsSE-050 788 Main SLreetPoint Arena10-6-87-.007 GPH-.011 cPHr.000 cPH+.005 cpHTighLsE-1612053 10th Street, Baywood ParkL0-6-87TightSE-L62 133 San Rafael Rd. r Avila Beach10-6-87TightSE-253 225 N. HalyconRd., Arroyo Grande10-6-87TightGPHGPHJamer, I1:October 20, 1987Pacific Bell196 Suburban RoadSan Luis Obispo, CaATTN: Jamse ElderDear Mr. ElderOn October 15, 1987, a Petro Tite System Test was performed at the above-referenced location. The test was performed by Michael Stoverr E.L.I.Technician. The NFPA Code 329,02 criteria for a tight system is a maximumloss of .05 gallons per hour. Because of the almost infinite variables involved,this is not the permission of actual leakage.During the stand-pipe test procedure, the internal liquid hydrostatic Pressureapplied to the underground tank system is generally two to three times Sreaterthan normal liquid storage pressures. This increase in hydrostatic pressure willamplify the indicated rate of leak accordingly.TankNo.-lNorthSize - 4,000 GallonsProduct - DieselThe test showed a plus .003 gallons Per hour.Based on the above criteria, we find the tank tested mathematically tight.TankNo.2-MiddleSize - 10,000 GallonsProduct - RegularThe test showed a plus .028 gallons per hour.Based on the above criteria, we find the tank tested mathematically tight.TankNo.3-SouthSize - 10,000 GallonsProduct - UnleadedThe test showed a plus ,005 gallons per hour.Based on the above criteria, we find the tank tested mathematically tight.This concludes our test and findings on October L5, 1987. If you have anyquestions regarding the results, please contact me. It is your responsibility tonotify your local County Health Department, Environmental Health, withinthirty (30) days of the results of this test. This notification is required by theCalifornia Administrative Code, Title 23 Waters, Chapter 3, Water ResourcesControl Board, Sub-chapter 16, Underground Tank Regulations, Article 4.30.We have enjoyed working with you on this project. If you need any furtherinformation, please feel free to contact our office.OCIUNT'VSincerely,Johnny EnosOperations ManagerJE:lgEncls/4.4 tu' /'EOPV1477 E. Shavv Suite 150 / Fresno, California 93710 / (209) 225-6698 PLEASE PRINTData q{-rt tor Tffis,[[m Tisffi**ss TestTANK TESIER1. 0WNER Proporry, l--lTenk(a! [2. OPERATOIi3, REASON F()RTEST(Erplain Fully)4, WHO REOUESTEOTEST AND WHEN5. WHO IS PAYINGFOR THIS TEST?6. TANK(S) TNV0LVE07. INSTATLATIONDATA8. UNOERGR()UNt)WATER9. FILL.UPARRANGEMENTSIO. C[)NTRACT(]R,MECHANICS,rny othot conlrlctotinvolvcdComtlsny, A0oncy or I?RoprssonlolivclclophoncTolophoncAdordE$Addrqrif.lophon.PoasonOrdor No.Oih.r lntlructionsl,lrmoSteel/FiberglassTelsphon€Pumosgu$^Sucllor, Remotc,Mrk! il lnownls lho wator ovar lho tsnk I[-l v"" S HoOspth lo lho Walot lsbloTanks ro bo lillodn,. -Lhffi.2- ort. A'ranssd by/4t-Extra product lo "lop olf" and run TSfi. How and who lo provido ? Considsr NO Load.Tarminal or othor contactlor notice or inqCor'paoyNadroTalophonoStalo\/tasSttola--1 €-the datqs) lhown. Those lndlcated ar "Tlght" m€etThl! lr lo cortlty thsl lhoss lank syetoms wsle tesled onthc Nrtional Flro Protocllon Asoclrtlon Pamphlot 329'r . dooO"iH-#,6#n*fu.,,"o*.,,Roar ol strlion, clc./29FillsSu0, Titllrll.ffat0, Drgptubor, nonoto Fill3CAtvCoverConct0lc, Bldck totr,E8rlh, otc.Which itnks ?SiphondsSizs, Mrnitold.d7-"qVonlsldontaly byBrand/SupplisrCap6cityApprox. AgcI11. OTHERINFORMATI()NOR REMARKS12. TEST RESULTSI3. CERTIFICATI()Nto-/98tAdditduring lo6t olc.Taot! wrto madc on tha ebovc lank sylloms in accordanco wlth lort procoduroa prelcribod lorar doullod on atltchad loll cherlt with rarultt r! tollow3:on any iioms above,iii oiiieiiro ue "a"'soi-rrtt* rusrin'6 is iitlit,g[s-i ot co;ptotea. vii,i6rs oi oosoiviri priiinroelro rrleOslo TosledOrt6/ 7]s-rtt\S€rial No. ol ThormalSonsorhrLoalndica16d/o55 tl'a\Jc,Ea f....{3tdat-,,-,\a_tI/-r,E,a'.fl.Ore ro-?tbO.rlttF(:>.'i:-Fi*F.+.\-.;F11 TAtlI r0 ilslrtObrfn cFrsrtbUet+1lf rrnr-CS..iret5frodrrC h il. trtll'b ll FfaxilAC-F*h;r-:'ntrery..--Ir-ra?-lbbdrCrrCF.!*rtO-h---i.tsHriltrbltb--tln-C..*t d t*tr t- -OlTltrlHra t^xl CAtrCnfrt fr.L-ur fon ltsrSW.: lil-*rt'f r+snci rrfio,I aro rfill f^cl€ntArilll? EOt lACr Imrro OtLtWrl OU rflltQ2_"G-TctJGrh-,f..&f(o-.3*\ \b4 or-\'\'T'fr=>312d11 sPffilt coilomots ffio pnoc$mEs T0ltsr -7,fls TAI{Kller nrwd rGtbi .trfc.*. Cb.ct t tor ta st 'rrrar -r t (2al\V) r\i? \l-ffl -rrrrtlr E t"1r.r-Ebl*d I ErCral;--rGrlYlltIAPffiFEOVERY SYSIETE[s=0 srrrlll. IIrPEn ruRt/Yorut*E rAgroi Fl t0 IrsT tHls rAtIbtolrSrrdi! crr11 -.J tuda?--'t ta{}-rtr3-'t rHotqtlor-ln ffrn*Srrgn alll| d: ctslrth\\'l{ a (-7,lt 7tor-5ta,2t $f ptrrrtlrd.t.ct-t>z.Fll.Aoroa.c?oAb>rp. - \.ttvq3J ,rnco.tH-.!p-r.itb tr-'.Lrdhdrr;tr st (.oo erc)EqlrrEtlhata\,.6rLrn1 I.\? \"OA9.(^z qltl. T rt rrrsuffttfrIs tollslr ASS8HIUfclb t H I Crrfo........... _gr b f t -......-....r..-. Utf bf lr-.d..._tordrdl1aint AF*l-20. ofitr{st0t r0sE sgrnilc"d556r ....--..---;l-rrrr-t?rEt-rii.....\i\-1a')\c\>q3t d lrr trtaa'.)i:#:!tl.tItsF'f filr|r cr-hllrf rtsdlqt FtIrrrt trlhdtqrtail,OF,rfal-tE'Obgerttd, Grevlty .r-,h,1otccrrca-tenpcrat@@Corrcctcd, lPl Grrrlty .'ff.C. O. E. . ooc,t+*,rr --il-ri.t Fttrl+- r.ddn-+- <)c)-", cc)'._rIt-tl{(ttrffiarlrTESTr.cJ+ -Ccllrrcr*t^trtp!-l.ltCarral-1,3qvt-rtr(r}^qa.-J\6.JJIT TIIEI os(3r.a-l _>\ - Ottt,I _o50o5o{ - o5t"r.o50" -oA5O5La-rt05(]rE A.B-z-, \ro(05oI+- \O+\)tC4+\O\c-\{.-a7-: IOd \o53c+l5'd 1\Q.r35.tr--3di.lait C,'t'l5\o<t+|)5btE/'r \o5riDAY.O50{.o5()o\9L oLa{)tn-i.tL.J l-lft.rblrrrri t+fI . Oo.)\ .DOOI a)\a\nrRo&o\qolri-t-ii fAo, Abo4a9o31t.-i3r*r, \"\C | -,-LC>l^c-.. i '.^i.-r.!^,-4, (::(: C\ )-),(:'?L3FOR\ootrilrridfrrrra/.re oLz"a4; )lbdrirr trd- 1..-l{-iJLdiiIf.-Itt&ra fttib d rnirlatrrl narirl trf. (Ur f{haOl d lial it arldd.|zt.TOOK IMTffiNtORT OF PRODUCT OTSTAND AI{D STARIE) CIRCTII,ATTOil\4]c2t,|.r\9...-,-(l. rl\^ro<)[UIIttHAT A \2 " T,SYgt NEADoFt ti--a2- \\\ie-\\q-\.\o-&a taa...ra 3i.{aGTt-Oi -?tn*r\r*--t=-\:IIIItIIr. r rr0TEstr11 crPAcir!D--rG5.bI rnorl-i "rnrhdrorE C--e+-ireri-{e-ttn -f r I tar Cr.tttr tfr -OllliIlHia r^rt CltrglflicI Ot.pal*tsHd?E orrrt ru{r ruR lrstrStbFdlr':'hilart.-_-o-tcrJGrDrr.f..Ct\ocbc-.itsrrt.lcorlftiFrft iL-E+flr rroil rto ltttt t^ct eor? rrrall onot ot trcr r.|uto oluwrr OUI:tltt6+ \oI-Cr-qa"tnddhtla Irll' blltlti\<:c:\ rrlr. sPtqil. coilornoils Aflo pR0c€ouREs I0 fisr IHs TA[{K!3r eutd r-:orlr .Faa.t|. Ctrrcl b.loe ti rro, gcAn h bt (2Cl1\r) r\/^;$'* r, c* dth$ rrrr r.t b u* nerdo u *n b.rrt h.r rfii LvlltVAP0R REC0VERY gYSTEnOstr,flsarl k)e\ -.*-o.*-)t'. TAXr [lsuniltrtE toirSTr rS$m8U!cd11bC.-.--..y J b c I ...........-.....Xtf bILr-rJ.......tddtrri.|r-ilt lFdt*I. txINil losE stITtilG?ra1jrr ..,.........-...-.l-brdeEt-DIt't tt=n- tlrn*lrrtrctf fiH2t !ftptrrrrg.d.ttct\oc i t>ora3etFY.Oc>r:-\.tfA-fco.llHd C rrtrrir bbdr-Fa-1=-C-qtrFtrErrttrlu<(alr.-- C.\z-oz t41dtcrt.rp-ltt l-aSl" o\<1'-:\5Y-ictulrlrigll$ifltHtEil. ftrftn rufffloruuE rAgrn FlTo Trsf ltlls rAflrbf€r|'rrfi! 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'cc>, A2a. ?a-(:.ILril trL.lfcrrra)tA'\?"tbiirr trd- l..bl{i-iaf.JitdlAr,bL o,tA\. \A\ir r4\\\_o\1\\1-\]trrt2t\7AtA,TOOK I$TERIflIIRI OF PRODUCT OIt2t.L\$r.'Itcl lrt& rlSTA$D ASD STAiTED CIRCT'I.ATIOTt\o \tO-t.Z .tIT2r.0{ tJ\.fA\Zcx-\7 \.\\,:\elEE5IIrrIIEITEVEL READTf'G oF +AT A \2' ti\ot, lr, t),, l,-r...r.t.-.r,.o, C-Ea*.t-.O-- )r.*Z\-qa-Oe dttrt:.:'>:Ft*Htt tAil T0 IIS4t/- -'g<.- L--loo\\n- Jt\\"-lt crt gTl\ f-r ---dldc--ltf,-fi-t?nrCr.*t3rtfr-OlltlllHral^rlt C t Clft.qlf o-er-1!.c+.5b[ *orO--._{._e\ \-TdJC.rcrr,torel\ooo-(c\oo 1ca$c>!fi.!aIG.lsrl:l$strr rt'ol AF rtllt lH col' trrolt oro? ol c cx rml.o oruwll olrArntltr. tf,l.t t fon rtsrSB!r-&cnlll0b*q.7"--frQ;':'hn-t-'-'--\otrrlrrd h ia ldttril.f{lf. sPEcnl, c0flDm$.s rflo Fr.oct0untsI0 nsr IHls TAI|Kl3a nad rlrin rt'Utf. CLcf brr: L rrco{ pcrdrn h loe (2C}flot-"-. dr"- dr r.rb ur rrcrvrdc b-a-,n b..1 ffi -..n LvtttVAPOB RTCOVERY S.YSTETI sqrt[l-a;tr Srt= u-^.^.e-.\en11 TAtr ilusrffrgrlt ilTSIT TS$rEUlolh - trl f C,-.--....-_-.....'{lbel, -....._-...... |fltfbTf r-rd.......tadrrtrd l-*rr2G glutsloi l(Et sfllrrc?talrat-p --_...'.l-hrrrfrt?rEt*.rli.\->r-rn\'x---tar3:l-a.c,Jt t-W'fr=)r3n2d'.il. fitPcn ruRt YoLuE fAgm Flro n$ IHtr Trxrllfoerrnrdi: GryttJ -.j Hll--'t tar.*llt$-'l &dorlrlir-lat-tt clrrgr.'rrrrgrdr.t-ta qD ->3-L%, S( cz<oLra- dutt- t trl\oo t<.)rl-x+il.il,(->2-2-fE*'.cflq.ai5r-abrtlLt-aa\GtrtDT-7,$p?trIql3!l, a)r>- \4<OLdHlrFlHrp€bd $rrrdlthLd (rr tttq .1, 4rl-A-.xr>Llfrtdl-t'r ilf I-;-farHaF) EF, o\q?.clo\n- ilrrr*lrrrr.dlr1 f,darl(.or $-]'lGrfttrrl-;{,r-Jl- lSrdtdhaI-brr-l-#CrrfrrbFf,l5lTESTO\o4-{+.6+\- oc)lrrtrgrraFa-hlr[htrpilrl;t$uf-1341II{ TEE0l[t.C l_'- E-E-E--A- 2-,^-.4\v717+.\o o+ .OAOZ\- . o6a3tC.{drFl. Ft-&rriroCr*-ATa2A?ko++.2 o\+_oqzts.\aut\+tt++-\4L{*t"\\ . \l-\t2\ .\ X-38.t!-ttliab.lrr-l.ltltr1+\+\\r5.1.+ta- fo'+U++31llrdbbra-IT\r ,rES\'-14\e(bqo-lo+Ir+-17o-1At-l:A-rt-1h c>+grA(-r\o-\.>?tr5f.ta..J l-l?tarffrorrl t+f4--l^ . \-1o5o- ,\.2c>+-? \c>t.\'l .11 r \-/.DAY.t:f.di1obA<a53Ltrr-b9-ljaharFOR. Q.oc>lsot,{ro,72oa[51 Otl-o t-1i , 550AlobIbc\Ao711,.-larlafrcraAA/411"ORtrfi;1.ldh lr.l-aniiiaf.f{jnjq,\olr o,\cAoAo,1t\.\A\\\1.\r,f.-,I7tt-I-l(4tl5T€OK ITWERSTONT OF PRODUCT OITo\ZO:a-JOel\STAT{D ATD STARI@ CIRCIn,ATIOTtIrfluQa.oooQlo\\-)o\\A\aol-, r1?o\-.-^,4.7tEIIIIrIIIIrrrrAT A \2. LElrEL READIITC OF +.gnttR : v(ff=uw!A!fK EITALUAPI,OX FO$nkd & Burlalancl of l\reze of Tankrn0 of,lf Oftrl DcBcctorrtrrctorran0 ofrirrotorrcrrplllrrdl ofYcnptlllDOtze of SubpA:c or 2onltelalon1torln3yrtc 1! UrlIrboD.O---Brooo%ouV.{hvB,rgters Becomendatloa!8s[TnoE 8M- t a a a I ll - I ll,;,1L/-,l;4-ls6"( Ptot Plan For Jobslte )-)FlF+@oD+aoCt4/=!,-tl#2= tr-,o<n/'1#t: /62otsa u/A/q(/"r'/*e//llao@f p:-e'+. D*nn tr'or ilobette )tt-1'vIE EZY-CHEK I.'ORKSHEETWATER AHOUNTYq" ovEMLL LENGTH nzli' RrsERCHART CALCULATIoNS e,e?jl5o +/x .OsTRIAL #IRE-t"q : ?-\TRf AL#3 8t-toz zL9TRIAL #2gL-bb -- ?3 TRIAL#4CENTRAL COAST TANK TESTING SANTA BARBARA, CA.PAGE .l oFJ_LENGTH ?q:/r " TANKRECETVEDIAHETER 9}" TANK # 1 PRODUcr kqoht-OEFF I EC I ENT ^OI.CII.Z.9P.> TANK CAPAC ITY QqO.(t\tqTEI''IPERATURE CALCULATI0N .otrtol99} x qqqOloZko(B)oBSERVED GRAVrTylo{,8_0BSERvED PR0DUCT TEHP.56.5 C0RRIOTEBCffiRTY 3?4-?_-lCSNvIRON14EiYTALHFAf TU(A)TEST LEvEr- {Z" obove grurt"PRoBE A coLon-Bd_start t ime Z'.tEPrtl't..-;ve IstartI evelend\.8\sgain+I oss-+xxI evelta rtgain+I oss-temptempCertified TishtLeak Rate per Hourccosh.rr)BBxxtempresu I tfinal timeresu I tzx .eolnx .oor\o8Ix|(oa-Tank Location?rcr9,c- BettAdd res s\qb Suibv\bo" Sl .$:tStl:ri<5:ot3:5qtl:l<3l:tsrri:{<3:oo31rsz:30z:45+,ffis-. ollq-,@31+,s-to+.Cq3z-,04{l057:-- , i?f,<-.c.56.{+.QlllrAx8.6b2- B.G'll.= +.oto x b,z{p = +,06?'{ag.b.1f,- $,tEl = t,Wlb.zbx+ .0563B.r.Br - 8,@o= +.cCIq x b.ZJe = +,og<,3B,(st- &bSo= +,otqb.?{' = + ,llgqxg.(oEo- B.tloz= +olz x l47Jo= t,crlslx5B.bll-S8,rdll = -,o3lo'Llo -,OlQex8,5{o-l: 8,s8.{ = f.ol1 x [.ztr+.lC{rH8.58rl- 8,bD= t.ozgb.zb+,nsaxSg,.srfq 5A.StorL.z("t.loG.{t.ol-lE \ t.,"x8,{jt;r 8,5lf1+,o?fl(olr,7*lot,mQ,x1-x\It,ut{{xf5t{sB,coll'CC)IZx,cotz|,0b,18r5{1.5llxx+1|?ft x ,ect?+.$lkF'bb?1etntip otumt*rs =oloo - rts{ti++qsx8'o35+- 06110.oo\z+qt x .oo\? = +.$R?b11l^.oo\?- +. O{gO)(r+{ortrlBrlCity,StateLusch0perator/0"r" RxrtPlb,t$$nop! t4RlBto iIil1++{iit+{r.i\\\tilSlIililtIIIIiII1Ii;Iha*-^{ \i\4t:I :.::.::=r=,-1-50f-.-70,I