Hazardous Materials Business Response and Contingency Plan

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					Yuba County                                                                EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                        Hazardous Materials Programs
I. FACILITY IDENTIFICATION
FACILITY NAME:                                                              FACILITY ID#: HM                       DATE:

FACILITY SITE ADDRESS:                                                  CITY/ZIP:                         WORK PHONE:

FACILITY/PROPERTY OWNER NAME:                                                                             HOME PHONE:

ELEMENTS COVERED BY THIS PLAN                           Hazardous Materials (HSC6.95/CCR Title 19) Hazardous Waste (CCR Title 22)
    Underground Storage Tanks (HSC 6.7)                Aboveground Storage Tank             Other:
PRINCIPAL BUSINESS ACTIVITY:                        DESCRIPTION OF       DAYS/HOURS OF OPERATION:
OPERATIONS:                                                                  NUMBER OF SHIFTS:
                                                                             NUMBER OF EMPLOYEES:
HAZARDS/EVENTS COVERED BY PLAN (i.e., chemical spills, fire, earthquake, etc.)
II. EMERGENCY COORDINATOR, EMERGENCY RESPONDERS, and TECHNICAL ADVISORS
Primary Emergency
Coordinator (EC)                     Name/Position:
EC has the expertise to classify the      Address:
release determine appropriate
response and the authority to make           Phone #’s    Business:                                   24-Hour:
management decisions &

                                           Responsible       spill prevention                              contacting facility responders
                                                  for:       emergency assessment/management               authorizing spill response work
                                      .                      initiating alarms                             interfacing with emergency responders
                                                             agency notification                           proper disposal of hazardous waste
                                                             other.(Specify)                          .

Alternate EC                           Name/Position
                                            Address
                                            City/Zip
                                      Day/Eve Phone
Technical Advisors                    Name:                                              Name:
Available to provide site-specific
technical advice to local emergency   Expertise:                                         Expertise:
responders.
Emergency Response                    Team Members                     Level of Training              Role/Responsibilities
Team (ERT) Personnel                  (name/position)
    ERT available on-site             1.
Team Members, level of                2.
training, and roles and               3.
responsibilities are listed.          4.
    Outside Contractor(s)             Company Name:                                                   Role/Responsibilities:
Will be contacted for spill           Address:
clean-up.                             24-hr. Phone#(s):
  Call Local Emergency Responders--911
Emergency Communications            Name:                                                             Name:
Individual(s) named is responsible to notify             Position:                                    Position:
INTERNAL: Verbal communications or                          personal contact                             public address/intercom system
evacuation notifications will occur via:                    telephone                                    pagers
                                                            alarm system:    Automatic     Manual        portable radio
EXTERNAL: Notification of neighbors who                     personal contact                             public address/intercom system
may be affected by a spill/release will occur               telephone                                    pagers
via:                                                        alarm system: Automatic        Manual        portable radio




CUPA04                                                                                                                          Page 1 of 6
Yuba County                                                         EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                 Hazardous Materials Programs

FACILITY IDENTIFICATION:                             HM#
III. EMERGENCY COMMUNICATIONS AND NOTIFICATIONS
                             Emergency Notifications
Emergency Phone Numbers  Ambulance, Fire, Sheriff      911
To be contacted for any hazardous          Yuba County CUPA                           (530) 749-5450 8-5 p.m.
Materials release                          Yuba County Sheriff                        (530) 749-7777 (24-hour)
                                           CA Office of Emergency Services            1-800-852-7550
                                           Warning Center
Nearest medical facility:                  Name/Address: Rideout Hospital             Phone: 749-4300
                                           426 4th Street Marysville, CA 95901
Designated medical facility,               Name/Address: Sutter North Occupational    Phone: 751-9675
urgent care facility, or occu-             Health 886 Plumas Ave. Yuba City
pational health care provider:
Agency Notification List                   National Response Center                   1-800-424-8802
The following agencies will be contacted   CA Central Valley RWQCB                    (916) 255-3000
as needed.                                 US EPA                                     (415)744-1500
                                           CA Dept. of Toxics Substances Control      (916)324-1824
                                           CA Dept. of Fish and Game                  (916) 445-0045
                                           US Coast Guard (Spill Response)            (510)437-3073
                                           Cal OSHA                                   (916) 263-2800
                                           State Fire Marshal                         (916) 445-8200
                                           Feather River Air Quality Mgmt. District   (530) 741-6484
                                           Yuba Co. Ag Commissioners Office           (530) 749-5400

Other Important Numbers                    Poison Control Center                      1-800-342-9293



                   Notification of Adjacent Properties/Businesses (adjacent to facility)
Orientation: North of Facility.                  Orientation: South of Facility.
Business Name:                                   Business Name:
Address:                                         Address:
Phone #                                          Phone #
Contact Name:                                    Contact Name:
Orientation: East of Facility.                   Orientation: West of Facility
Business Name:                                   Business Name:
Address:                                         Address:
Phone #                                          Phone #
Contact Name:                                    Contact Name:




CUPA04                                                                                                    Page 2 of 6
Yuba County                                                            EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                    Hazardous Materials Programs

FACILITY IDENTIFICATION:                                         HM#
IV. HAZARDOUS MATERIALS EMERGENCY PLANNING AND RESPONSE
              Methods for Prevention, Containment, and Clean-Up of a Release
Preventing spill and release             Containing spills, releases, fires or          Mitigating associated harm to persons,
                                         explosions                                     property and the environment.
    Daily visual inspection                  Provide structural, physical barrier and       Stop processes/operations
    Weekly visual inspection             secondary containment.                             Eliminate ignition sources
    Monthly visual inspection.               Cover or block floor /storm drains            Remove/isolate containers/area as needed.
    Containers/raw materials inspected       Built-in berms in storage area(s)              Call 911 for emergency assistance and
prior to acceptance                          Provide absorbent physical barrier         medical aid
    Monitor for leaks, ruptures,             Shut-off water, gas, and electrical            Notify and evacuate persons in all
pressure build-up, etc .                 utilities as appropriate.                      threatened areas
    Waste discharge points monitored         Automatic/electronic equipment shut-           Provide protective equipment for on-site
    Automatic shutoffs                   down system                                    response team
    Tank monitoring/testing                  Automatic fire suppression system              Account for evacuated persons immediately
    Storm water sampling                     Secondary containment of tanks/drums       after evacuation call.
    Air monitoring device                                                                   Other (Specify)
    Liquid monitoring device                Other (Specify)
    Routine preventative maintenance
    Other (Specify)
                                                       Clean-up Procedures
HAZWOPER Trained                             Use absorbent materials for spills and properly label,        Small Spill      Large Spill
Personnel:                               store and dispose of hazardous waste.
 Number of Personnel                         Suction using shop vacuum with subsequent proper              Small Spill      Large Spill
 Trained to HAZWOPER –                   storage, labeling, and hazardous waste disposal as
   Awareness Level:                      appropriate
   Operations Level:                         Wash/decontaminate equipment and dispose of effluent/         Small Spill      Large Spill
   Technician Level:                     rinsate as hazardous waste
   Incident Commander:                       Provide safe temporary storage of emergency-generated         Small Spill      Large Spill
                                         wastes.
                                             Hire licensed hazardous waste contractor                      Small Spill      Large Spill
                                             Other (Specify)

                                                     Emergency Evacuations
Evacuation Coordinator will initiate     Name/Position:
evacuations and account for all
employees and site visitors after an
evacuation
Emergency Assembly Area                  Location:

Location where Evacuation                Posting:
Procedures/Routes posted
Evacuation Procedures                    Procedures:

                                Arrangements with local emergency service providers
     Advance arrangements have been made with local fire and police departments, hospitals and/or contractors for emergency services
to familiarize them with this facility.
Special arrangements:




CUPA04                                                                                                                   Page 3 of 6
Yuba County                                                             EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                     Hazardous Materials Programs

FACILITY IDENTIFICATION:                                                                            HM #
                                                        Emergency Equipment
                       √ Indicates equipment available on site for response to chemical leaks, spills, or fires.
Use Category           Equipment Available                                      Location                    Capability/Description
Examples:              Portable fire extinguisher                               center of N wall/shop       rated as “5A,10BC”
                       Chemical protective gloves                               spill response kit          One-use, oil/solvent resistant
Safety and First          chemical protective suits, aprons or vests
Aid Equipment             chemical protective gloves          boots
                          safety glasses          goggles     shields
                          hard hats          shields
                          cartridge respirator        SCBA
                          first aid kits/ stations
                          emergency eye-wash            plumbed      portable
                          emergency shower
                          other
Fire                      portable fire extinguishers
Extinguishing             fixed fire prot.systems     sprinklers      CO2
                                fire hoses          fire hydrant
Equipment                 fire alarm boxes or stations
                          other
Spill Control             absorbent material
and Clean-up              container for used absorbent
Equipment                 berming/diking equipment
                          broom          shovel
                          shop vacuum
                          exhaust hood
                          emergency sump/holding tank
                          chemical neutralizers
                          gas cylinder leak repair kits
                          spill overpack drums
                          other
Communication             telephones, including cellular
& Alarm                   intercom/PA System
System                    portable radios
Equipment                 automatic alarm w/monitoring equipment
                          UST monitoring system operations manual
                          list of notification phone numbers
                          other
                                             Areas of Earthquake Vulnerability
Areas /systems vulnerable to                 hazardous materials/waste storage area             tanks (emergency shutoff)
releases / spills due to                     process lines/ piping                              portable gas cylinders
earthquake related motion                    laboratory                                         emergency shutoff/utility valves
The areas identified may require             waste treatment area                               sprinkler systems
 immediate isolation and inspection.         shelves, cabinets, & racks                         stationary pressurized containers
                                             other:                                             other:




CUPA04                                                                                                                      Page 4 of 6
Yuba County                                                                EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                        Hazardous Materials Programs

FACILITY IDENTIFICATION:                                                                  HM#
V. EMPLOYEE TRAINING PROGRAM
                                                             Training Plan
Training Requirements: Training is required for all employees handling hazardous materials or hazardous wastes as
part of routine job duties and day-to-day operations or who may be exposed in the event of a spill or emergency release.
Training Subject Areas: Training subject areas vary according to the assigned duties of the employees. Topics
includes the following::
All Personnel:                           Chemical Handlers:                           Special Assignments:
    Hazard Communication/MSDSs               safe handling of hazardous substances        UST monitoring equipment and procedures (if
    safety policies and procedures           fire hazards associated with materials   applicable)
    notification procedures              and processes                                    hazardous waste management procedures (if
    evacuation /re-entry procedures          conditions likely to worsen in an        applicable)
    location/contents of emergency       emergency                                        fire brigade/fire suppression
response plans                               coordination of emergency response           hazardous chemical spill clean-up and large spill
    spill reporting requirements             proper use of chemical protective        clean-up
    Injury and Illness Prevention        clothing and equipment                           CPR/First Aid
Program                                      use of emergency response equipment          Hearing Conservation
    personal protective clothing/            communications and alarm systems             Respiratory Protection
equipment issued -                           decontamination procedures                   Welding and Cutting
                                             control and containment procedures           Forklift Safety
   Other                                     Other                                        Ladder Safety
                                                                                          Spill Prevention, Control and Countermeasures
                                                                                      (SPCC) Plan requirements
                                                                                          Other

Formats                        Classroom

TRAINING TOPICS                Study guides
are listed under each          Safety/tail-gate meetings
format or as follows:
                               Videos
                               Manuals
                               OTHER:

Frequency                     prior to any work with or around hazardous materials or hazardous wastes
                              as necessary prior to change in process or work assignment
Employee training is          upon modification to emergency response/ contingency plan
provided as indicated         periodically to maintain awareness, competency and performance standard (i.e. Do employees know the
by .                       hazards of the materials they work with and how to work safely? What PPE to use and when?)
                              annually as required by HAZWOPER, HazWaste, and
                               Training frequency is, at a minimum, as described above.
                               Training frequency is, at a minimum, as follows:

Documentation              Written records of employee training include:
Training records are         Date and hours of training                            Employee name
kept for a minimum of        Brief job description (for hazardous waste workers)   Job Title
3 years.                     Training outline, agenda, or list of topics covered   Trainers name and qualifications
                             OTHER:
                             Employee training is provided, at a minimum, as described above.
                             A separate written Employee Training Plan is attached.
                             Employee training records are maintained in the following location _      _

                               Employee training records are maintained in the following manner:_                   _




CUPA04                                                                                                                         Page 5 of 6
Yuba County                                                           EMERGENCY RESPONSE AND CONTINGENCY PLAN
Certified Unified Program Agency                                                   Hazardous Materials Programs

FACILITY IDENTIFICATION:                                                          HM#
VI. RECORDKEEPING REQUIREMENTS
The following records are maintained at this facility: ( * Required, if applicable)
   Current employees training records to be retained until closure of this facility.*
   Former employees training records to be retained at least 3 years after termination of employment.*
   Training program (written description of initial and continuing training).*
   Current copy of the Hazardous Materials Emergency Response and Contingency Plan.*
   Record of hazardous materials/waste releases in Facility Log.*
   Monitoring and daily/weekly/monthly visual inspection records.*
   Documentation and description of facility emergency response drills.
   Uniform Hazardous Waste (HW) Manifests are kept for minimum of 3 years after shipment.*
   Record of all HW disposals, including manifests, recycling receipts, bills of lading are kept a minimum of 3 years.*
   Record of all UST alarm logs and responses are kept for 3 years.*
   Record of all AGT inspections and removals from secondary containment are kept for 3 years.*
   Other: specify

VII. SIGNATURE AND CERTIFICATION
I certify under penalty of perjury of law that I have personally examined and am familiar with the
information submitted and believe the information is true, accurate, and complete to the best of my
knowledge, and that a copy of this plan is available on-site.
Signature                                                                                  Date of completion


Print Name                                                                                 Title/Position




VIII. LIST OF ATTATCHMENTS:
The following documents are attached to this plan.
    Site/facility map        Training plan       Inspection forms            Aboveground Tank Storage Statement               SPCC
    Evacuation Plan          UST Monitoring Plan          Other:




CUPA04                                                                                                                    Page 6 of 6

				
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