COUNTY OF FRESNO
HAZARDOUS MATERIALS BUSINESS PLAN
AND
RISK MANAGEMENT PLAN
INFORMATION BOOKLET
Revised 2/08/07
FRESNO COUNTY DEPARTMENT OF COMMUNITY HEALTH
Environmental Health Division
1221 Fulton Mall, P.O. Box 11867
Fresno, CA 93775
Phone # (559) 445-3271
Fax # (559) 445-3301
http://www.fresnohumanservices.org/CommunityHealth/EnvironmentalHealth/CUPA/
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TABLE OF CONTENTS
SECTION I ...................................................................................................................... 1
What is a Business Plan? ....................................................................................................... 1
Who Must Comply? .............................................................................................. 1
What is a Hazardous Material? ............................................................................ 2
What is an EPCRA Listed Extremely Hazardous Substance?.............................. 2
What is a Regulated Substance? ......................................................................... 2
Are there Exemptions to the Business Plan? ....................................................... 2
What are the Review and Updating Requirements?............................................. 3
SECTION II ................................................................................................................... 4
Completing and Submitting the Business Plan..................................................... 4
Health and Safety Planning .................................................................................. 4
SECTION III ................................................................................................................... 7
Hazardous Materials Release or Threatened Release Reporting ........................ 7
SECTION VI .......... ........................................................................................................ 8
What is an RMP? ................................................................................................. 8
Who Must Comply? .............................................................................................. 8
When Must the RMP be Submitted ? ................................................................... 8
Who Receives the RMP? ..................................................................................... 8
SECTION V ................................................................................................................... 9
Additional Agency Requirements / Business Plan Resources.............................. 9
CAL/OSHA, California Code of Regulations, Title 8, General Industry
Safety Orders ..................................................................................... 9
CAL/EPA Department of Toxic Substances Control (DTSC), California Code of
Regulations, Title 22, Hazardous Waste Regulations ................................. 11
Central Valley Regional Water Quality Control Board, California Health and Safety Code,
Division 20, Chapter 6.67, Aboveground Storage of Petroleum ........................ 11
Local Fire Prevention Authority, Uniform Fire Code, Article 80, Hazardous Materials .... 12
SECTION VI ................................................................................................................. 13
Internet References ............................................................................................ 13
ATTACHMENTS
A - Extremely Hazardous Substances List ........................................................ 14
B - Fire Departments Within Fresno County....................................................... 19
C - Fact Sheet .................................................................................................... 21
D - Checklist - Initial Business Plan Submittal .................................................... 23
Checklist - Business Plan Annual Review/Update and EPCRA Annual
Review/Update.............................................................................................. 24
FORMS
Business Owner/Operator Identification Form
Business Activities Form
Hazardous Materials Inventory – Chemical Description Form
Site Map
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SECTION I
WHAT IS A BUSINESS PLAN?
The term ‘Business Plan’ refers to a comprehensive document designed to assist in emergency planning and response to hazardous
materials accidents that may occur at your facility. The plan consists of the following:
1.
“Business Owner/Operator Identification” Form: provides general information about the facility, including
business owner information and emergency contact information. This information is used by emergency
responders to contact a designated person in the event of an emergency or by this office to obtain documentation
and schedule site inspections. This form is used for the annual update of your business plan. The Business
Owner/Operator Identification form replaces the “Annual Business Plan Review Form”. This form is used if
claiming an exemption from filing a business plan.
2.
“Business Activities” Form: provides information regarding the various activities conducted at the facility. If
you have marked “yes” to any question, the specified Unified Program Consolidated Form must also be
submitted. This form is also used if claiming an exemption from filing a business plan.
3.
“Hazardous Materials Inventory – Chemical Description” Form: provides specific information of the hazardous
materials and/or hazardous wastes handled at your facility (equal to or above the threshold quantities), such as,
the quantities stored, how they are stored, and their hazards. Most of the information required to complete this
form may be obtained from the Material Safety Data Sheet (MSDS). Do not submit MSDSs in lieu of this form.
4.
Site Map and Building Diagram(s): indicates hazardous material/hazardous waste storage locations, emergency
shut-off switches, sewer inlets, staging areas, surrounding populations, etc., in relation to offices and other
structures at the facility. If the site diagram does not provide adequate detail, separate building diagrams must be
submitted.
5.
Written Emergency Response Plans and Procedures: involve site-specific procedures that are
implemented/conducted in the event of an emergency. More importantly, the procedures must address
hazardous materials related incidents, such as a spill or release.
6.
Written Employee Training Programs, which include procedures to familiarize employees with Emergency
Response Plans and Procedures (#5 above).
Please contact this office at (559) 445-3271 or visit the County of Fresno Environmental Health web site at
http://www.fresnohumanservices.org/. If you need any additional forms visit CalEPA’s web site at
www.calepa.ca.gov/publications/Title27/Default.htm. Examples of the above-mentioned forms and their instructions, located on
the back of each form, are attached.
WHO MUST COMPLY?
A Business Plan must be submitted by businesses that handle a hazardous material, or a mixture containing a hazardous material,
in quantities equal to or greater than:
1.
500 pounds of a solid.
2.
55 gallons of a liquid.
3.
200 cubic feet of a compressed gas at standard temperature and pressure.
4.
The federal Threshold Planning Quantity (TPQ) for Extremely Hazardous Substances (See ATTACHMENT A).
5.
Radioactive materials in quantities for which an Emergency Plan is required as per Parts 30, 40, or 70, Chapter 1
of Title 10 of Code of Federal Regulations (CFR).
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A separate Business Plan must be submitted for each separate site location. Any business that is required to submit a Business
Plan and fails to do so is liable for civil penalties of two thousand dollars ($2,000) for each day of the violation or five thousand
dollars ($5,000) for each day of the violation after reasonable notice has been given. (California Health and Safety Code [H & S
Code], Division 20, Chapter 6.95, Sections 25503.5 and 25514)
WHAT IS A HAZARDOUS MATERIAL?
A hazardous material is any material that because of its quantity, concentration, physical or chemical characteristics poses a
significant present or potential hazard to human health and safety, or the environment. ‘Hazardous materials’ include, but are not
limited to, hazardous substances, hazardous waste or any material that if released, may be harmful to humans or to the
environment. (Examples include: acids, solvents, fertilizers, gasoline, waste oil, compressed gases, etc.)
WHAT IS AN EPCRA LISTED EXTREMELY HAZARDOUS SUBSTANCE?
The Emergency Planning Community Right To Know Act (EPCRA) mandated that hazardous materials need to be disclosed to
local agencies. EPCRA is a list of Extremely Hazardous Substances (EHS’s) listed by the EPA that when released into the
environment may pose IMMEDIATE health effects resulting in significant injury or death. EHS’s are currently listed in Appendix
A, Part 355 of Subchapter J of Chapter I of Title 40 of CFR. A list of EPCRA/EHS’s and their respective threshold planning
quantities are provided in Attachment A. (Examples include: anhydrous ammonia, chlorine gas, methyl bromide, sulfuric acid,
sulfur dioxide, etc.) Handlers of EPCRA listed extremely hazardous substances (EHS) are required to update the following
forms by March 1st of every year regardless of whether a change has occurred: 1) a Business Activities Form, 2) a signed
Business Owner/Operator Identification Form and 3) a signed Chemical Description Form to certify current EPCRA listed EHS
inventory.
See annual Review/Update requirements on page 3.
WHAT IS A REGULATED SUBSTANCE?
A regulated substance is any substance that is listed in Section 68.103 of Title 40 in CFR or is defined as an Extremely Hazardous
Substance (see above).
ARE THERE EXEMPTIONS TO THE BUSINESS PLAN?
You may be exempt from submitting a Business Plan if your business handles or stores hazardous materials under any of the
following conditions:
1.
Your business does NOT handle, use or store hazardous materials in amounts equal to or greater than the
established thresholds.
2.
Your business handles hazardous materials that are pre-packaged for direct distribution to, and use by, the
general public ONLY.
3.
Your business stores hazardous materials for less than thirty (30) consecutive days while under active shipping
papers.
4.
You own or operate a retail food establishment and the ONLY hazardous materials are pressurized carbon
dioxide for carbonated beverages.
5.
You are a physician, dentist, podiatrist, veterinarian, or pharmacist and handle oxygen, nitrogen and nitrous
oxide at your office or place of business in quantities of not more than 1,000 cubic feet of each material at any
one time.
6.
Your business handles lubricating oil only. The volume of each type of lubricating oil does not exceed 55
gallons and the total volume of all types does not exceed 275 gallons, at any one time. Lubricating oil means
any oil intended for use in an internal combustion crankcase, or the transmission, gearbox, differential, or
hydraulic system of an automobile, bus, truck, vessel, plane, heavy equipment, or other machinery powered by
an internal combustion or electric powered engine. LUBRICATING OIL DOES NOT INCLUDE WASTE OIL.
7.
You own or operate an unstaffed remote facility located in an isolated sparsely populated area, provided that you
meet all of the requirements as per Section 25503.5 of Chapter 6.95 of the H & S Code (amended 1997).
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NOTE: If you own or operate a farm for purposes of cultivating the soil or raising or harvesting any agricultural or horticultural
commodity, you may be exempt from subdivisions (b) and (c) of Section 25504, provided that you meet all of the requirements as
per Section 25503.5 of Chapter 6.95 of the H & S Code (amended 1997).
If you determine that your business is exempt under one of the above conditions, submit the Business Activities and the Business
Owner/Operator Identification Form. On-site inspections may be conducted to confirm your exempt status.
WHAT ARE THE ANNUAL REVIEW / UPDATING REQUIREMENTS?
On an annual basis it is necessary to review the Business Owner/Operator Identification form, the Business Activities form and
Chemical Description form(s) to determine if any information has changed. (Refer to descriptions below for explanations).
If changes have not occurred submit the following:
1.
Business Owner/Operator Identification form
2.
Business Activities form
If changes have occurred submit the following:
1.
Business Owner/Operator Identification form
2.
Business Activities form
3.
Chemical Description form(s) for applicable changes to inventory - If changes have occurred to these
documents.
4.
Site Map and Health and Safety / Emergency Response Plan – If changes have occurred to these
documents.
If your facility has EPCRA listed EHS’s submit the following by March 1st of every year regardless of whether a change
has occurred:
1.
Business Owner/Operator Identification form
2.
Business Activities form
3.
Signed Chemical Description Form to certify current EHS inventory
You are required to notify this office within thirty (30) days of the following changes:
1.
One hundred percent (100%) or more increase in the quantity of any previously reported hazardous material.
2.
Any additions to your hazardous material inventory not previously reported.
3.
Change of business name, address, ownership, or emergency contact personnel.
Changes in your inventory? Complete and submit a signed Business Owner/Operator Form for the current reporting year and the
Chemical Description Form(s). Near the top of the form, mark “ADD”, if a chemical was added, mark “DELETE”, if a chemical
has been deleted or mark “REVISE”, if there has been a change to a previously reported chemical (i.e., amounts, storage container,
% weight in mixture).
Changes in your business name, phone numbers, billing address or emergency contacts? Complete and submit a new
Business Owner/Operator Identification Form.
Changes to your site map(s)? Submit an amended site map and/or building diagram. If you answered yes to “changes in your
inventory”, those changes shall be indicated on the map.
A change in your business location or a change in ownership requires the submission of a NEW, complete Business Plan.
The annual review/update certifies that your previous Business Plan is still accurate and implemented at your facility. The annual
review/update does not exempt you from the 30 day reporting requirements.
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SECTION II
COMPLETING AND SUBMITTING THE BUSINESS PLAN
The Business Plan forms may be obtained from this office, if you do not already have them. Additional copies of each form will
need to be made to retain for future use. Be sure that you have enough Hazardous Materials Inventory - Chemical Description
Forms. An Inventory form is needed for each chemical handled at your facility that is over the specified quantities. Instructions
for completing the forms are on the back of each form. There is not a specific form provided for your Emergency Response and
Employee Training Plan. This must be written and developed separately and submitted along with your Business Plan forms. (See
“Health and Safety Planning” for more details).
If you believe that the required inventory involves the release of a TRADE SECRET for any material, it must be clearly identified as such
on the Inventory form. This office holds trade secret information confidential. Refer to the H & S Code, Chapter 6.95, Section 25511 for
further information pertaining to the release of trade secret information.
► The Business Plan must be submitted to the appropriate Certified Unified Program Agency or CUPA (Fresno County Environmental
Health System) and the local Fire Department (See ATTACHMENT B for a list of fire departments in Fresno County). A copy of the
Business Plan must be maintained and implemented on-site.
► Any business which is required to establish and implement a business plan and is located on leased or rented real property shall
notify, in writing, the owner of the property that the business is required to submit a business plan and has complied with its
provisions. A copy of the business plan shall be provided to the owner or the owner's agent within five working days after
receiving a request for a copy from the owner or the owner’s agent.
► If you determine that your business is exempt (see page two for exemptions), submit the Business Activities and the Business
Owner/Operator Identification Form. On-site inspections may be conducted to confirm your exempt status.
HEALTH AND SAFETY PLANNING
In addition to completing the Business Plan forms, an owner/operator shall develop procedures to protect the health and safety of
persons, property, and the environment in the event of a release or threatened release of a hazardous material. The procedures
shall be developed as part of the Business Plan. All of the following items may or may not apply to your facility, however, they
shall, at a minimum, address the topics of release prevention, notification and evacuation, and emergency response and cleanup.
► Your Business Plan will not be accepted if this is missing from your submittal.
RELEASE PREVENTION
Proper handling and storage of hazardous materials can effectively prevent most releases. Procedures shall be established to
outline how hazardous materials can be safely and properly handled at your facility. The following topics should be included in
your procedures.
1. Storage Criteria
•
Are materials stored in proper containers?
•
Are all containers properly labeled and clearly marked with common names, chemical names, and hazardous ingredients?
•
Are all containers protected from rain, wind, vehicular traffic, and moving machinery?
•
Are all containers covered and in good condition?
•
Are chemicals stored in locations away from or physically separated from:
a) incompatible materials;
b) drains;
c) property lines;
d) gutters, alleys, roads;
e) air conditioner/heater air intakes?
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2. Inspection Protocols
•
How often are inspections of storage areas conducted? The Fresno County Environmental Health System recommends
daily inspection of drum storage and tank farms for leaks, seepage, general housekeeping, drainage, etc.
•
Is all rainwater drained from secondary containment systems? Is the water tested if contamination is suspected?
•
Have you identified potential fire hazards and ignition sources (such as welding, smoking, etc.), their control procedures,
and the type of fire protection equipment or systems, which can control a fire involving them?
•
Is all necessary safety equipment properly stored and maintained?
3. Process Equipment and Transfer of Chemicals
•
Are procedures established for the safe transfer of chemicals from one container to another?
•
Are procedures in place for facility transfer operations, pumping, and in-plant processes?
•
Are procedures in place for the operation of facility tank car and tank truck loading/unloading racks?
•
Are pressurized product transfer lines adequately protected?
•
Are chemicals handled in accordance with established "industry standards" or manufacturer recommendations?
4. Employee Training
All employees must be trained to some level of emergency response. A training program must be developed which is reasonable
and appropriate for the size of the business and the nature of the hazardous materials handled. The level of training required is
dependent on the specific job function or duties of an employee during an emergency response action. The training program shall,
at a minimum, include:
•
Methods for safe handling of hazardous materials.
•
Procedures for coordination with local emergency response organizations.
•
Use of emergency response equipment and supplies under the control of the handler.
•
Familiarity with the plans and procedures specified in the Business Plan.
IMMEDIATE NOTIFICATION AND EVACUATION
Each business preparing a Business Plan is required to establish procedures for the immediate notification of employees,
evacuation of the site and notification of appropriate authorities. The following issues should be addressed in your procedures:
1. Notification of Employees
•
Who is responsible to ensure all employees are notified of a release?
•
How will emergency notification occur (alarms, verbal, etc.)?
•
Is a list available of the names, addresses, and phone numbers (office and home) of all persons qualified to act as
emergency coordinator at the facility?
2. Evacuation of Employees
•
Are procedures in place for employees who remain to operate critical plant operations before they evacuate?
•
Are specific employees trained for rescue and medical duties?
•
Are employees trained in the orderly evacuation of the facility?
•
Are exits clearly marked?
•
Are safe gathering (staging) areas identified?
•
Who is responsible for an employee head count?
3. Notification of Emergency Response Agencies
•
Include in your procedures a written description of arrangements agreed to by local police departments, fire departments,
hospitals, contractors, and State and local emergency response teams to coordinate emergency services.
•
Who will notify authorities?
•
What agencies will be notified and what are the current phone numbers? You may incorporate “Section III” of this
Instruction Booklet into your emergency response procedures.
•
When will notification occur?
•
What will be reported?
4. Notification of Other Resources
•
What other resources are available for assistance (i.e., contractors, consultants, organizations)? Include 24-hour phone
numbers for these resources.
5. Notification of Neighbors
•
Is it likely that a release will impact adjacent properties?
•
Who will notify neighbors and what are the contact phone numbers?
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EMERGENCY RESPONSE PROTOCOLS AND CLEANUP PROCEDURES
General evacuation and notification procedures outlined above may be adequate for your facility. However, if your facility
handles acutely hazardous materials and your employees are expected to respond in an emergency to conduct control, contain, and
cleanup activities, additional procedures and protocols must be in place.
1. Employee Training
•
Are employees trained in the proper cleanup of spilled materials?
•
What protective equipment is required?
•
Will employees be required to enter an environment that is Immediately Dangerous to Life or Health (IDLH)?
•
How many people will be available to respond?
2. Medical Assistance/First Aid
•
Who will administer first aid prior to the arrival of Emergency Medical Services (EMS)?
•
How will contaminated persons be decontaminated prior to medical treatment and transportation?
•
Who will transmit contamination information to Emergency Medical Services personnel and receiving medical facility if
needed?
3. Equipment
•
Is spill control or containment equipment available?
•
Are absorbent materials compatible with hazardous materials?
•
Do you have a list of all emergency equipment at the facility (such as fire extinguishing systems, spill control equipment,
communications and alarm systems, and decontamination equipment)?
•
Who can provide extra equipment?
•
What assistance will the local Fire Department provide?
4. Storage and Disposal of Wastes Generated
•
How will waste material from cleanup be stored?
•
Who will properly dispose of the waste?
5. Reentry Criteria
•
Will air monitoring be needed to reenter area of release?
•
Are there slip hazards that should be abated prior to reentry?
•
Who will certify the area is safe for reentry
► The forms provided by this office have been developed by the CUPA as an alternative version of the Unified Program
Consolidated Form (UPCF). Businesses have the option to use the forms provided or the UPCF adopted in state regulations. The
CUPA must accept the state UPCF and cannot require a business to use the alternative version developed by the CUPA. The
CUPA can require businesses to provide additional information on either the UPCF or a supplemental page to that document.
Additional UPCF forms may be downloaded at: http://www.calepa.ca.gov/CUPA/Publications/#ConsolidatedForms
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SECTION III
HAZARDOUS MATERIALS RELEASE OR THREATENED RELEASE REPORTING
In the event of a hazardous material release, or a threatened release, you are required to immediately notify the appropriate
authorities. This is to be done as soon as possible without delaying the immediate control of the release or threatened release, or
delaying emergency medical procedures. You must notify:
1.
911 - Police, fire, and medical
2.
445-3271 - Fresno County Environmental Health System
(After working hours or weekends use Sheriffs Office number 488-3111)
3.
1-800-852-7550 - California Office of Emergency Services (OES)
Notification shall include the following information:
1.
Exact location of release or threatened release.
2.
Name of person reporting and call back telephone number.
3.
Hazardous material(s) involved.
4.
Estimated quantity of the hazardous material(s) of the material involved.
5.
Potential hazards presented by the hazardous material(s).
Immediate reporting IS NOT required if there is a reasonable belief that the release poses no significant present or potential hazard
to human health and safety, property, or the environment. Be extremely cautious about reaching this conclusion in the absence of
consultation with the proper authorities. If you need assistance in evaluating the significance of a release, you may contact a
member of our Emergency Response Team at (559) 445-3271 during regular office hours, or (559) 488-3111 after office hours.
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SECTION IV
WHAT IS AN RMP?
A Risk Management Plan (RMP) includes safety information, hazard review, operating procedures, training, maintenance,
compliance audits, and incident investigation. The RMP must consider the proximity to sensitive populations (i.e., schools,
residential areas, hospitals, and child day care facilities, etc.). The California Accidental Release Prevention (Cal ARP) Program is
a merging of the federal and state programs for the prevention of accidental release of regulated toxic and flammable substances.
The Cal ARP and RMP Programs replaced the previous Risk Management and Prevention Program.
WHO MUST COMPLY?
Any business that has more than a threshold quantity of a regulated substance in a process is covered. A process includes any use,
storage, manufacturing, handling, or on-site movement or any combination of these activities. Regulated substances are those
chemicals either on the Federal list or the State list. These lists may be obtained through this department or on the Internet. The
web addresses are as follows. (See also “What is a Regulated Substance?” in Section 1).
Federal list - www.epa.gov/swercepp/rules/listrule.html
State list - http://www.oes.ca.gov/
WHEN MUST THE RMP BE SUBMITTED?
The RMP information required by U.S. Environmental Protection Agency (US EPA) shall be submitted to federal EPA, no later
than the latest of the following dates:
1.
June 21, 1999;
2.
Three years after the date on which a regulated substance is first listed under Section 68.130, Title 40 of CFR; or
3.
The date on which a regulated substance is first present in a process, above the threshold quantity.
If the quantities handled are less than the Federal requirements, but above the State’s quantities, you will receive notification from
this office requesting submission of an RMP. The RMP submittal shall not be required by the CUPA earlier than a year or later
than 3 years after notification.
WHO RECEIVES THE RMP?
Federal submittals are to be received by the US EPA, as well as the local CUPA or AA. While the federal submittal must only
include the data elements, the CUPA must receive the RMP in its entirety, including all the supporting documentation (i.e., process
hazard analysis, training, operating procedures, etc.). The entire RMP is necessary in order for the review to be conducted by the
CUPA and the public.
State submittals are to be received by the local CUPA only.
For more information, please contact our office at (559) 445-3271. Contact US EPA for general inquiries at (800) 424-9346 or
visit their web site at www.epa.gov/ceppo . For State Office of Emergency Services, call (916) 464-3221 or visit their web site at
www.oes.ca.gov/ .
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SECTION V
ADDITIONAL AGENCY REQUIREMENTS / BUSINESS PLAN RESOURCES
Your business may need to submit forms and / or written plans to the agencies outlined below. Contact these agencies to
determine if your business needs to comply with their requirements. In most cases the additional state requirements listed below
can be incorporated into one comprehensive health and safety document, with the exception of Cal/OSHA requirements for the
Injury and Illness Prevention/Hazard Communication Programs. If you are required to submit plans for the following agencies
you may adapt some or all of the information to fulfill the needs in your Health and Safety Plan. If you have questions regarding
any of the additional requirements, contact the appropriate agencies outlined below or this office for additional information and
guidance.
Cal/OSHA, California Code of Regulations, Title 8, General Industry Safety Orders (www.dir.ca.gov/DOSH/dosh1.html)
Injury and Illness Prevention Program (CCR, Title 8, Section 3203)
Every employer shall establish, implement and maintain an effective Injury and Illness Prevention Program. The Program shall be
in writing and, shall, at a minimum:
1.
Identify the person or persons with authority and responsibility for implementing the Program.
2.
Include a system for ensuring that employees comply with safe and healthy work practices.
3.
Include a system for communicating with employees.
4.
Include procedures for identifying and evaluating work place hazards.
5.
Include a procedure to investigate occupational injury or occupational illness.
6.
Include methods and/or procedures for correcting unsafe or unhealthy conditions.
7.
Provide training and instruction for employees.
Emergency Action Plan (CCR, Title 8, Section 3220)
This plan is required if employees are not capable or permitted to assist in handling an emergency response and are only required
to evacuate. The plan shall cover those designated actions employers and employees must take to ensure employee safety from
fire and other emergencies. The following elements, at a minimum, shall be included in the plan:
1.
Emergency escape procedures and emergency escape route assignments.
2.
Procedures to be followed by employees who remain to operate critical plant operations before they evacuate.
3.
Procedures to account for all employees after emergency evacuation have been completed.
4.
Rescue and medical duties for those employees who are to perform them.
5.
The preferred means of reporting fires and other emergencies.
6.
Names or regular job titles of persons or departments who can be contacted for further information or explanation of
duties under the plan.
•
For those employers with 10 or fewer employees, the plan may be communicated orally to employees.
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Fire Prevention Plan (CCR, Title 8, Section 3221)
A written Fire Prevention Plan shall be developed and shall include, at a minimum, the following items:
1.
Potential fire hazards and their proper handling and storage procedures, potential ignition sources (such as welding,
smoking and others) and their control procedures, and the type of fire protection equipment or systems which can
control a fire involving them.
2.
Names or regular job titles of those responsible for maintenance of fire suppression systems and equipment.
3.
Names or regular job titles of those responsible for the control of accumulation of flammable or combustible waste
materials.
•
For those employers with 10 or fewer employees, the plan may be communicated orally to employees.
Hazardous Waste Operations and Emergency Response (CCR, Title 8, Section 5192)
If employees will be assisting in handling an emergency response to a release or threatened release of a hazardous material or
waste, a specific plan shall be developed to address employee responsibilities and actions. The plan shall include the following
items:
1.
Pre-emergency planning and coordination with outside parties.
2.
Personnel roles, lines of authority, training, and communication.
3.
Emergency recognition and prevention.
4.
Safe distances and places of refuge.
5.
Site security and control.
6.
Evacuation routes and procedures.
7.
Decontamination.
8.
Emergency medical treatment and first aid.
9.
Emergency alerting and response procedures.
10. Critique of response and follow-up.
11.
Personal protective equipment (PPE) and other emergency equipment.
Hazard Communication (CCR, Title 8, Section 5194)
All employers shall provide information to their employees about the hazardous substances to which they may be exposed. In
addition they shall develop, implement, and maintain at the workplace a written hazard communication program for their
employees. The program shall at least describe how the requirements for labels and other forms of warning, material safety data
sheets, and employee information and training will be met.
For more information about the requirements of Title 8 contact Cal/OSHA CONSULTATION SERVICE at
(559) 454-1295.
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Cal/EPA Department of Toxic Substances Control (DTSC), California Code of Regulations, Title 22, Hazardous Waste
Regulations (www.dtsc.ca.gov)
Personnel Training (CCR, Title 22, Section 66265.16)
All personnel at a hazardous waste facility shall successfully complete a program of classroom instruction or on-the-job training
that teaches them to perform their duties in a way that ensures the facility's compliance with applicable regulations. Written
procedures must be in place to ensure that facility personnel are able to respond effectively to emergencies. The written training
program shall include familiarizing personnel with emergency procedures, emergency equipment, and emergency systems,
including where applicable:
1.
Procedures for using, inspecting, repairing, and replacing facility emergency and monitoring equipment.
2.
Communications or alarm systems.
3.
Response to fires or explosions.
4.
Response to ground water contamination incidents.
5.
Shutdown of operations.
Contingency Plan (CCR, Title 22, Section 66265.51)
Each owner or operator of a facility that generates hazardous waste shall have a contingency plan for the facility. The contingency
plan shall be designed to minimize hazards to human health or the environment from fires, explosions, or any unplanned sudden or
non-sudden release of hazardous waste or hazardous waste constituents to air, soil, or surface water. The plan shall be in writing
and include, at a minimum, the following items:
1.
A description of arrangements agreed to by local police departments, fire departments, hospitals, contractors, and
State and local emergency response teams to coordinate emergency services.
2.
A list of names, addresses, and phone numbers (office and home) of all persons qualified to act as emergency
coordinator.
3.
A list of all emergency equipment at the facility (such as fire extinguishing systems, spill control equipment,
communications and alarm systems, and decontamination equipment).
4.
An evacuation plan for facility personnel where there is a possibility that evacuation could be necessary.
5.
The current telephone number of the State Office of Emergency Services.
For more information about the requirements of Title 22 contact Cal/EPA DEPARTMENT OF TOXIC SUBSTANCES
CONTROL at (559) 297-3901.
Central Valley Regional Water Quality Control Board, California Health and Safety Code, Division 20, Chapter 6.67,
Aboveground Storage of Petroleum (www.swrcb.ca.gov)
Spill Prevention Control and Countermeasure Plan (CA H&S Code, Division 20, Chapter 6.67, Section 25270.5)
Each owner or operator of a facility that stores petroleum products in a single tank greater than 660 gallons or in multiple storage
tanks with a cumulative storage capacity greater than 1,320 gallons in aboveground storage tanks shall prepare a Spill Prevention
Control and Countermeasure Plan (SPCC) in accordance with federal regulations. A Spill Prevention Control and Countermeasure
Plan should include the following items:
1. General facility information including contact personnel.
2.
Facility and tank inspection procedures.
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
11
3.
Employee training procedures.
4.
Facility drainage evaluation.
5. Bulk storage tank analysis.
6.
Facility transfer operations, pumping, and in-plant process procedures.
7.
Facility tank car and tank truck loading/unloading rack procedures.
8.
A discussion of security measures utilized at the facility.
Storage Statement (CA H&S Code, Division 20, Chapter 6.67, Section 25270.6)
Owners and operators of aboveground petroleum storage tank facilities with a single tank capacity greater than 660 gallons, or
with a cumulative storage capacity of greater than 1,320 gallons, must file a storage statement with the State Water Resources
Control Board with the following information:
1.
Name and address of the facility.
2.
A contact person for the tank facility.
3.
The total storage capacity of the tank facility.
4. For each tank that exceeds 10,000 gallons in capacity and which holds a substance with a petroleum concentrations
of 5 percent or greater:
a)
Tank location (at the facility).
b)
Tank size (in gallons).
c)
Age of the tank (in years)
d)
Contents of the tank (type of petroleum product).
For more information about the requirements of Chapter 6.67 contact the CENTRAL VALLEY REGIONAL
WATER QUALITY CONTROL BOARD at (559) 445-5116.
Local Fire Prevention Authority, Uniform Fire Code, Article 80, Hazardous Materials (osfm.fire.ca.gov/)
The purpose of this article is to provide requirements for the prevention, control and mitigation of dangerous conditions related to
hazardous materials and to provide information needed by emergency response personnel. This article includes requirements for
the classification, storage, dispensing, use, and handling of hazardous materials.
Any person, firm or corporation applying for a permit to store hazardous materials shall submit a Hazardous Materials
Management Plan (HMMP) to the local fire department. The HMMP shall include the following items:
1. A general site plan.
2. Building floor plan(s).
3. Hazardous materials handling procedures.
4. Chemical compatibility and separation instructions.
5. A monitoring program.
6. A description of security precautions.
7. Procedures for hazard labeling and warning signs.
8. Inspection and record keeping guidelines.
9. Employee training procedures.
10. A description of emergency equipment.
For more information about the requirements of Article 80 contact your local Fire Department (See ATTACHMENT B).
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
12
SECTION VI
INTERNET REFERENCES
Local Agencies
County of Fresno Environmental Health (CUPA) – All CUPA programs including hazardous materials business plan and risk
management plan information.
www.fresnohumanservices.org/CommunityHealth/EnvironmentalHealth/CUPA/
Fresno Metropolitan Flood Control District – Storm water pollution, prevention and control information.
www.fresnofloodcontrol.org
San Joaquin Valley Air Pollution Control District – Air quality control requirements and air quality information.
www.valleyair.org/
State Agencies
California CUPA Forum – Association information for Certified Unified Program Agencies (CUPA). Current hazardous
materials issues and hot topics.
www.calcupa.net/
CalEPA – Information on toxic/ hazardous materials and substances, enforcement/inspections and cross media programs that
involve air, water, waste and other environmental concerns.
www.calepa.ca.gov/
Department of Toxic Substance Control – Hazardous materials and waste information, publications and fact sheets
www.dtsc.ca.gov
Office of Emergency Services – Hazardous materials business plan information and requirements.
www.oes.ca.gov/
State Water Resource Control Board – Aboveground storage tank spill prevention control and countermeasure plan requirements.
www.swrcb.ca.gov/
State Fire Marshall – Hazardous materials and waste storage requirements.
osfm.fire.ca.gov/
California Legislative Information – Legal information (California Code of Regulations, Health and Safety Codes and Fire
regulations) for hazardous materials and wastes.
www.leginfo.ca.gov/
Cal/OSHA – Information on worker and public safety pertaining to California's occupational and public safety laws.
www.dir.ca.gov/DOSH/dosh1.html
Federal Agencies
U.S. Environmental Protection Agency – Information on hazardous materials and risk management plans.
http://www.epa.gov/ceppo
Other Resources
Unidocs – Source to obtain documents for required submissions to local agencies for hazardous materials and waste.
www.unidocs.org/
MSDS Databases – Source to obtain information to assist with completing chemical inventory forms.
www.msdssearch.com/DBLinksN.htm
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
13
ATTACHMENT A
Emergency Planning Community Right To Know Act (EPCRA)
EXTREMELY HAZARDOUS SUBSTANCES LIST
Title 40 of CFR Part 355 Appendix A
Chemical Name
Acetone Cyanohydrin
Acetone Thiosemicarbazide
Acrolein
Acrylamide
Acrylonitrile
Acrylyl Chloride
Adiponitrile
Aldicarb
Aldrin
Allyl Alcohol
Allylamine
Aluminum Phosphide
Aminopterin
Amiton
Amiton Oxalate
Ammonia
Amphetamine
Aniline
Aniline, 2,4,6-TrimethylAntimony Pentafluoride
Antimycin A
ANTU
Arsenic Pentoxide
Arsenous Oxide
Arsenous Trichloride
Arsine
Azinphos-Ethyl
Azinphos-Methyl
Benzal Chloride
Benzenamine,
3-(Trifluoromethyl)Benzene, 1-(Chloromethyl)4-NitroBenzenearsonic Acid
Benzimidazole, 4,5-Dichloro2- (Trifluoromethyl)Benzotrichloride
Benzyl Chloride
Benzyl Cyanide
Bicyclo[2.2.1]Heptane-2Carbonitrile, 5-Chloro-6((((Methylamino)Carbonyl)Oxy)
Imino)-,(1s-(1-alpha, 2-beta,
4-alpha, 5-alpha, 6E))Bis(Chloromethyl) Ketone
Bitoscanate
Boron Trichloride
Boron Trifluoride
Threshold Planning
Quantity (Pounds)
1,000
1,000/10,000
500
1,000/10,000
10,000
100
1,000
100/10,000
500/10,000
1,000
500
500
500/10,000
500
100/10,000
500
1,000
1,000
500
500
1,000/10,000
500/10,000
100/10,000
100/10,000
500
100
100/10,000
10/10,000
500
500
500/10,000
10/10,000
500/10,000
100
500
500
500/10,000
10/10,000
500/10,000
500
500
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
Chemical Name
Boron Trifluoride Compound
with Methyl Ether (1:1)
Bromadiolone
Bromine
Cadmium Oxide
Cadmium Stearate
Calcium Arsenate
Camphechlor
Cantharidin
Carbachol Chloride
Carbamic Acid, Methyl-,
O-(((2,4-Dimethyl-1,
3-Dithiolan-2-yl)
Methylene)Amino)Carbofuran
Carbon Disulfide
Carbophenothion
Chlordane
Chlorfenvinfos
Chlorine
Chlormephos
Chlormequat Chloride
Chloroacetic Acid
Chloroethanol
Chloroethyl Chloroformate
Chloroform
Chloromethyl Ether
Chloromethyl Methyl Ether
Chlorophacinone
Chloroxuron
Chlorthiophos
Chromic Chloride
Cobalt, ((2,2'(1,2-Ethanediylbis
(Nitrilomethylidyne))Bis
(6-Fluorophenolato))(2-)N,N',O,O')Cobalt Carbonyl
Colchicine
Coumaphos
Coumatetralyl
Cresol, oCrimidine
Crotonaldehyde
Crotonaldehyde, (E)Cyanogen Bromide
Cyanogen lodide
Cyanophos
Threshold Planning
Quantity (Pounds)
1,000
100/10,000
500
100/10,000
1,000/10,000
500/10,000
500/10,000
100/10,000
500/10,000
100/10,000
10/10,000
10,000
500
1,000
500
100
500
100/10,000
100/10,000
500
1,000
10,000
100
100
100/10,000
500/10,000
500
1/10,000
100/10,000
10/10,000
10/10,000
100/10,000
500/10,000
1,000/10,000
100/10,000
1,000
1,000
500/10,000
1,000/10,000
1,000
14
Chemical Name
Cyanuric Fluoride
Cycloheximide
Cyclohexylamine
Decaborane(14)
Demeton
Demeton-S-Methy
Dialifor
Diborane
Dichloroethyl Ether
Dichloromethylphenylsilan
Dichlorvos
Dicrotophos
Diepoxybutane
Diethyl Chlorophospate
Diethylcarbamazine Citrate
Diethyl-p-Phenylenediamine
Digitoxin
Diglycidyl Ether
Digoxin
Dimefox
Dimethoate
Dimethyl
Phosphorochloridothioate
Dimethyl Sulfate
Dimethyldichlorosilane
Dimethylhydrazine
Dimethyl-p-Phenylenediamin
Dimetilan
Dinitrocresol
Dinoseb
Dinoterb
Dioxathion
Diphacinone
Diphosphoramide, OctamethylDisulfoton
Dithiazanine Iodide
Dithiobiuret
Emetine, Dihydrochloride
Endosulfan
Endothion
Endrin
Epichlorohydrin
EPN
Ergocalciferol
Ergotamine Tartrate
Ethanesulfonyl Chloride,
2-ChloroEthanol, 1.2-Dichloro-,
Acetate
Ethion
Ethoprophos
Threshold Planning
Quantity (Pounds)
100
100/10,000
10,000
500/10,000
500
500
100/10,000
100
10,000
1,000
1,000
100
500
500
100/10,000
10,000
100/10,000
1,000
10/10,000
500
500/10,000
500
500
500
1,000
10/10,000
500/10,000
10/10,000
100/10,000
500/10,000
500
10/10,000
100
500
500/10,000
100/10,000
1/10,000
10/10,000
500/10,000
500/10,000
1,000
100/10,000
1,000/10,000
500/10,000
500
1,000
1,000
1,000
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
Chemical Name
Ethylbis(2-Chloroethyl)
Amine
Ethylene Fluorohydrin
Ethylene Oxide
Ethylenediamine
Ethyleneimine
Ethylthlocyanate
Fenamiphos
Fenitrothion
Fensulfothion
Fluenetil
Fluorine
Fluoroacetamide
Fluoroacetic Acid
Fluoroacetyl Chloride
Fluorouracil
Fonofos
Formaldehyde
Formaldehyde Cyanohydrin
Formetanate Hydrochloride
Formothion
Formparanate
Fosthietan
Fuberidazole
Furan
Gallium Trichloride
Hexachlorocyclopentadiene
Hexamethylenediamine, N,N'DibutylHydrazine
Hydrocyanic Acid
Hydrogen Chloride (Gas Only)
Hydrogen Fluoride
Hydrogen Peroxide
(Conc > 52%)
Hydrogen Selenide
Hydrogen Sulfide
Hydroquinone
Iron, PentacarbonylIsobenzan
Isobutyronitrile
Isocyanic Acid,
3,4-Dichlorophenyl Ester
Isodrin
Isofluorphate
Isophorone Diisocyanate
Isopropyl Chloroformate
Isopropylmethylpyrazolyl
Dimethylcarbamate
Lactonitrile
Leptophos
Threshold Planning
Quantity (Pounds)
500
10
1,000
10,000
500
10,000
10/10,000
500
500
100/10,000
500
100/10,000
10/10,000
10
500/10,000
500
500
1,000
500/10,000
100
100/10,000
500
100/10,000
500
500/10,000
100
500
1,000
100
500
100
1,000
10
500
500/10,000
100
100/10,000
1,000
500/10,000
100/10,000
100
100
1,000
500
1,000
500/10,000
15
Chemical Name
Lewisite
Lindane
Lithium Hydride
Malononitrile
Manganese, Tricarbonyl
Methylcyclopentadienyl
Mechlorethamine
Mephosfolan
Mercuric Acetate
Mercuric Chloride
Mercuric Oxide
Methacrolein Diacetate
Methacrylic Anhydride
Methacrylonitrile
Methacryloyl Chloride
Methacryloyloxyethyl
Isocyanate
Methamidophos
Methanesulfonyl Fluoride
Methidathion
Methiocarb
Methomyl
Methoxyethylmercuric
Acetate
Methyl 2-Chloroacrylate
Methyl Bromide
Methyl Chloroformate
Methyl Hydrazine
Methyl Isocyanate
Methyl Isothiocyanate
Methyl Mercaptan
Methyl Phenkapton
Methyl Phosphonic
Dichloride
Methyl Thiocyanate
Methyl Vinyl Ketone
Methylmercuric Dicyanamide
Methyltnchlorosilane
Metolcarb
Mevinphos
Mexacarbate
Mitomycin C
Monocrotophos
Muscimol
Mustard Gas
Nickel Carbonyl
Nicotine
Nicotine Sulfate
Nitric Acid
Nitric Oxide
Nitrobenzene
Threshold Planning
Quantity (Pounds)
10
1,000/10,000
100
500/10,000
100
10
500
500/10,000
500/10,000
500/10,000
1,000
500
500
100
100
100/10,000
1,000
500/10,000
500/10,000
500/10,000
500/10,000
500
1,000
500
500
500
500
500
500
100
10,000
10
500/10,000
500
100/10,000
500
500/10,000
500/10,000
10/10,000
10,000
500
1
100
100/10,000
1,000
100
10,000
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
Chemical Name
Nitrocyclohexane
Nitrogen Dioxide
Nitrosodimethylamine
Norbormide
Organorhodium Complex
(PMN-82-147)
Ouabain
Oxamyl
Oxetane, 3,3-Bis
(Chloromethyl)Oxydisulfoton
Ozone
Paraquat
Paraquat Methosulfate
Parathion
Parathion-Methyl
Paris Green
Pentaborane
Pentadecylamine
Peracetic Acid
Perchloromethylmercaptan
Phenol
Phenol, 2,2'-Thiobis(4-Chloro6-Methyl-Phenol, 2,2'-Thiobis
(4-Chloro-6-Methyl)Phenol, 3-(1-Methylethyl)-,
Methylcarbamate
Phenoxarsine, 10,10'-OxydiPhenyl Dichloroarsine
Phenylhydrazine
Hydrochloride
Phenylmercury Acetate
Phenylsilatrane
Phenylthiourea
Phorate
Phosacetim
Phosfolan
Phosgene
Phosmet
Phosphamidon
Phosphine
Phosphonothioic Acid, Methyl-,
O-Ethyl O-(4-(Methylthio)
Phenyl) Ester
Phosphonothioic Acid, Methyl-,
S-(2-(Bis(1-Methylethyl)
Amino)Ethyl O-Ethyl Ester
Phosphonothioic Acid, Methyl-,
O-(4-Nitrophenyl) O-Phenyl
Ester
Threshold Planning
Quantity (Pounds)
500
100
1,000
100/10,000
10/10,000
100/10,000
100/10,000
500
500
100
10/10,000
10/10,000
100
100/10,000
500/10,000
500
100/10,000
500
500
500/10,000
100/10,000
500/10,000
500/10,000
500
1,000/10,000
500/10,000
100/10,000
100/10,000
10
100/10,000
100/10,000
10
10/10,000
100
500
500
100
500
16
Chemical Name
Phosphoric Acid, Dimethyl
4-(Methylthio) Phenyl Ester
Phosphorothioic Acid, O,
O-Dimethyl-S-(2-Methylthio)
Ethyl Ester
Phosphorus
Phosphorus Oxychloride
Phosphorus Pentachloride
Phosphorus Pentoxide
Phosphorus Trichloride
Physostigmine
Physostigmine,
Salicylate (1:1)
Picrotoxin
Piperidine
Pirimifos-Ethyl
Potassium Arsenite
Potassium Cyanide
Potassium Silver Cyanide
Promecarb
Propargyl Bromide
Propiolactone, BetaPropionitrile
Propionitrile, 3-ChloroPropiophenone, 4-AminoPropyl Chloroformate
Propylene Oxide
Propyleneimine
Prothoate
Pyrene
Pyridine, 2-Methyl-5-VinylPyridine, 4-AminoPyridine, 4-Nitro-, 1-Oxide
Pyriminil
Salcomine
Sarin
Selenious Acid
Selenium Oxychloride
Semicarbazide
Hydrochloride
Silane, (4-Aminobutyl)
DiethoxymethylSodium Arsenate
Sodium Arsenite
Sodium Azide (Na(N3))
Sodium Cacodylate
Sodium Cyanide (Na(CN))
Sodium Fluoroacetate
Sodium Selenate
Threshold Planning
Quantity (Pounds)
500
500
100
500
500
10
1,000
100/10,000
100/10,000
500/10,000
1,000
1,000
500/10,000
100
500
500/10,000
10
500
500
1,000
100/10,000
500
10,000
10,000
100/10,000
1,000/10,000
500
500/10,000
500/10,000
100/10,000
500/10,000
10
1,000/10,000
500
1,000/10,000
1,000
1,000/10,000
500/10,000
500
100/10,000
100
10/10,000
100/10,000
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
Chemical Name
Sodium Selenite
Sodium Tellurite
Stannane, AcetoxytriphenylStrychnine
Strychnine, Sulfate
Sulfotep
Sulfoxide, 3-Chloropropyl
Octy
Sulfur Dioxide
Sulfur Tetrafluoride
Sulfur Trioxide
Sulfuric Acid
Tabun
Tellurium
Tellurium Hexafluoride
TEPP
Terbufos
Tetraethyllead
Tetraethyltin
Tetramethyllead
Tetranitromethane
Thallium Sulfate
Thallous Carbonate
Thallous Chloride
Thallous Malonate
Thallous Sulfate
Thiocarbazide
Thiofanox
Thionazin
Thiophenol
Thiosemicarbazide
Thiourea, (2-Chlorophenyl)Thiourea, (2-Methylphenyl)Titanium Tetrachloride
Toluene 2,4-Diisocyanate
Toluene 2,6-Diisocyanate
Trans-1,4-Dichlorobutene
Triamiphos
Triazofos
Trichloroacety Chloride
Trichloroethylsilane
Trichloronate
Trichlorophenylsilane
Trichloro(Chloromethyl)Silane
Trichloro(Dichlorophenyl)
Silane
Triethoxysilane
Trimethylchlorosilane
Threshold Planning
Quantity (Pounds)
100/10,000
500/10,000
500/10,000
100/10,000
100/10,000
500
500
500
100
100
1,000
10
500/10,000
100
100
100
100
100
100
500
100/10,000
100/10,000
100/10,000
100/10,000
100/10,000
1,000/10,000
100/10,000
500
500
100/10,000
100/10,000
500/10,000
100
500
100
500
500/10,000
500
500
500
500
500
100
500
500
1,000
17
Chemical Name
Trimethylolpropane
Phosphite
Trimethyltin Chloride
Triphenyltin Chloride
Tris(2-Chloroethyl)Amine
Valinomycin
Vanadium Pentoxide
Vinyl Acetate Monomer
Threshold Planning
Quantity (Pounds)
100/10,000
500/10,000
500/10,000
100
1,000/10,000
100/10,000
1,000
Chemical Name
Threshold Planning
Quantity (Pounds)
Warfarin
Warfarin Sodium
Xyfylene Dichloride
Zinc, Dichloro(4,4-Dimethyl5((((Methylamino) Carbonyl)
Oxy)Imino)Pentanenitrile)-,
(T-4)Zinc Phosphide
500/10,000
100/10,000
100/10,000
100/10,000
500
To determine a Threshold Planning Quantity (TPQ) when two amounts are listed or the AHM is contained in a mixture use the
following guidelines:
•
AHM's that are fine powders (less than 100 microns) are subject to the lower quantity listed (i.e., 100/10,000
•
AHM's that are solids or powders with a particle size greater than 100 microns are reportable at the higher quantity listed
(i.e., 100/10,000).
•
To determine the actual quantity of an AHM in a mixture, multiply the percent by weight of the AHM times the total weight
of the product.
part 05 - Revised B. P. Instruction Booklet.doc 02/12/07
18
ATTACHMENT B
FIRE DEPARTMENTS WITHIN FRESNO COUNTY
Auberry Volunteer Fire
Department
P.O. Box 191
Auberry, CA 93602
(559) 855-2777
Fresno Fire Department
450 "M" Street
Fresno, CA 93721
(559) 498-1542
Orange Cove Fire Department
550 Center Street
Orange Cove, CA 93646
(559) 626-7758 / 4365
Bald Mountain Fire Department
41967 Auberry Road
Auberry, CA 93602
(559) 855-8443
Huntington Lake Volunteer Fire
Department
P.O. Box 235
Lakeshore, CA 93634
(559) 893-2347
Parlier Fire Department
210 S. Academy Avenue
Sanger, CA 93657
(559) 485-7500
Big Creek Volunteer Fire
Department
P.O. Box 99
Big Creek, CA 93605
(559) 893-3629
Huron Fire Department
210 S. Academy Avenue
Sanger,CA 93657
(559) 485-7500
Reedley Fire Department
1060 “D” Street
Reedley, CA 93654
(559) 637-4230
California Department of
Forestry and Fire Protection
210 S. Academy Avenue
Sanger, CA 93657
(559) 485-7500
Kingsburg Fire Department
P.O. Box 2
Kingsburg, CA 93631
(559) 897-5457
Riverdale Fire Department
P.O. Box 727
Riverdale, CA 93656
(559) 485-7500
Clovis Fire Department
1233 Fifth Street
Clovis, CA 93612
(559) 324-2200
Laton Fire Department
P.O. Box 447
Laton, CA 93242
(559) 923-4802
San Joaquin Fire Department
210 S. Academy Avenue
Sanger,CA 93657
(559) 485-7500
Coalinga Fire Department
300 W. Elm Avenue
Coalinga, CA 93210
(559) 935-1652
Mendota Fire Department
210 S. Academy Avenue
Sanger,CA 93657
(559) 655-4107
Sanger Fire Department
1700 7th Street
Sanger, CA 93657
(559) 875-6568
Fig Garden Fire Department
210 S. Academy
Sanger, CA 93657
(559) 485-7500
Mid-Valley Fire Department
210 S. Academy Avenue
Sanger,CA 93657
(559) 485-7500
Selma Fire Department
2861 “A” Street
Selma, CA 93662
(559) 896-2511
Firebaugh Fire Department
1575 11th Street
Firebaugh, CA 93622
(559) 659-2061
Mountain Valley Fire
Department
P.O. Box 427
Dunlap, CA 93621
(559) 338-2049
Shaver Lake Fire Department
41640 Dinky Creek
Shaver Lake, CA 93664
(559) 841-3360 / 3746
Fowler Fire Department
Attn: California Dept. of Forestry,
Fresno/King ECC
2311 N. Clovis
Fresno, CA 93727
(559) 834-3111
North Central Fire Department
15850 W. Kearney
Kerman, CA, 93630
(559) 275-5531
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part 07 - Revised B. P. Instruction Booklet.doc 02/12/07
20
ATTACHMENT C
HAZARDOUS MATERIALS BUSINESS PLAN
FACT SHEET
A Hazardous Materials Business Plan must be submitted by businesses that handle a hazardous material, or a
mixture containing a hazardous material, in quantities equal to or greater than:
1.
500 pounds of a solid.
2.
55 gallons of a liquid.
3.
200 cubic feet of a compressed gas at standard temperature and pressure.
4.
The federal Threshold Planning Quantity (TPQ) for Extremely Hazardous Substances (See
ATTACHMENT A in the Business Plan Instruction Booklet).
5.
Radioactive materials in quantities for which an Emergency Plan is required as per Parts 30, 40,
or 70, Chapter 10 of Title 10 of Code of Federal Regulations (CFR).
As a general rule a hazardous material is anything that requires an MSDS. Hazardous Materials/Hazardous
Waste include, but are not limited to: oil (new & used), fuel, solvent (new & used), pesticides, compressed gases,
paint (new & used), fertilizers, etc.
A separate Business Plan must be submitted for each separate site location. Any business that is required to
submit a Business Plan and fails to do so is liable for civil penalties of two thousand dollars ($2,000) for each
day of the violation or five thousand dollars ($5,000) for each day of the violation after reasonable notice has
been given. (California Health and Safety Code [H & S Code], Division 20, Chapter 6.95, Sections 25503.5 and
25514)
The term ‘Business Plan’ refers to a comprehensive document designed to assist in emergency planning and
response to hazardous materials accidents that may occur at your facility. The plan consists of the following:
Prior to completing the forms, copies will need to be made in order to assist in future updates.
The forms provided by this office have been developed by the CUPA as an alternative version of the Unified Program
Consolidated Form (UPCF). Businesses have the option to use it or the UPCF adopted in state regulations. The CUPA
must accept the state UPCF and cannot require a business to use the alternative version developed by the CUPA. The
CUPA can require businesses to provide additional information on either the UPCF or a supplemental page to that
document.
1. “Business Owner/Operator Identification”
This form provides general information about the facility, including business owner information and
emergency contact information. This information is used by emergency responders to contact a designated
person in the event of an emergency or by this office to obtain documentation and schedule site inspections.
This is one of two forms necessary for annually updating your business plan.
2. “Business Activities”
This form provides information regarding the various activities conducted at the facility. If you have marked
“yes” to any question, the specified Unified Program Consolidated Form must also be submitted. This is one
of two forms necessary for annually updating your business plan.
G:\EH\CUPA Program\Business Plans\Business Plan docs, forms, etc\business plan\packet\part 08 - Fact Sheet.doc
revised 02/08/07
21
3. “Hazardous Materials Inventory – Chemical Description”
This form provides specific information of the hazardous materials and/or hazardous wastes handled at your
facility. This form must be completed and submitted for each chemical over the above-mentioned
thresholds. Most of the information required to complete this form could be obtained from the Material
Safety Data Sheet (MSDS). Do not submit an MSDS in lieu of this form.
4. Site Map and Building Diagram(s)
This indicates hazardous material/hazardous waste storage locations, emergency shut-off switches, sewer
inlets, staging areas, surrounding populations, etc., in relation to offices and other structures at the facility.
If the site diagram does not provide adequate detail, separate building diagrams must be submitted.
5. Health and Safety Plan / Written Emergency Response Plans and Procedures
In addition to completing the Business Plan forms, an owner/operator shall develop written procedures to
protect the health and safety of persons, property, and the environment in the event of a release or threatened
release of a hazardous material. The procedures need to be site specific to your business and the types of
materials that are handled. The procedures shall be developed as part of the Business Plan and shall, at a
minimum, address the topics of release prevention, notification and evacuation, and emergency response
and cleanup. ► There is no form provided for this aspect of the Business Plan. ► Your Business Plan will
not be accepted if this is lacking from your submittal.
6. Written Employee Training Programs,
This includes procedures in familiarizing employees with Emergency Response Plans and Procedures for
handling hazardous materials.
After completing the Business Plan, including the forms and the Health and Safety Plan:
1. Maintain and implement a copy on site
2. Submit a copy to:
• Health Department - Environmental Health System AND
• Local Fire Department
Reviewing and updating the Business Plan:
1. The Business Plan must be annually reviewed to ensure that the information provided to emergency
responders is still accurate. A copy of the Business Plan must be maintained on site for the purposes of
implementing and reviewing its contents. If no changes have occurred submit the Business Owner/Operator
and the Business Activities Forms to this office. If changes have occurred, submit the Owner/Operator
Form AND the appropriate additional form(s) (see above). Note: The owner/operator is responsible to
annually update the Business Plan. It is not Fresno County’s policy to send forms or notices to facilities
regarding annual Business Plan updates.
Please contact this office at (559) 445-3271 for additional forms or if you have any questions. A detailed
“Hazardous Materials Business Plan and Risk Management Plan Information Booklet” is also available for
further assistance. Instructions for the Unified Program Consolidated Forms may be found on the back of each
individual form. You can also download the forms from CalEPA’s web site at:
http://www.calepa.ca.gov/CUPA/Publications/#ConsolidatedForms
G:\EH\CUPA Program\Business Plans\Business Plan docs, forms, etc\business plan\packet\part 08 - Fact Sheet.doc
22
ATTACHMENT D
HAZARDOUS MATERIALS BUSINESS PLAN CHECKLIST
Please use this helpful checklist to ensure proper completion and processing of your Business Plan
document. After completing the paperwork, please submit this form to our office along with all the
necessary forms.
Initial Business Plan Submittal:
‰ Business Owner/Operator Identification – Has the form been filled out, signed and dated by the
owner/operator?
‰ Business Activities - Has the form been filled out, signed and dated by the owner/operator?
‰ Chemical Description Inventory Form – Has a form been completed for each chemical over 55
gallons, 500 pounds or 200 cubic feet? Note: Please do not submit Material Safety Data Sheets
‰ Site Map and/or a Building Diagram – Have the chemical storage location, surrounding areas,
adjacent streets/alleys, evacuation routes, etc. been indicated? See reverse side of Site Map/Building
Diagram Form for details.
‰ Health and Safety/Emergency Response Plan – Has a site specific plan been included? There is no
‘form’ available for this aspect of the Business Plan. Note: Relevant information from comparable
plans (i.e., Emergency Action Plan, Contingency Plan, Risk Management Plan) may be submitted.
‰ A copy has been mailed to Fresno County Community Health Department.
‰ A copy has been mailed to your local fire department.
‰ A copy has been maintained on-site. Note: The plan must be implemented as required by Health
and Safety Code Chapter 6.95, Section 25503.5.
(Continued)
23
HAZARDOUS MATERIALS BUSINESS PLAN CHECKLIST (cont.)
Business Plan Annual Review/Update:
Forms preceded with an * need to be submitted regardless of any changes.
‰ *Business Owner/Operator Identification – Has the form been filled out, signed and dated by the
owner/operator?
‰ *Business Activities - Has the form been filled out, signed and dated by the owner/operator?
‰ Chemical Description Inventory Sheets, Site Map and Health and Safety/Emergency Response
Plan – If changes have occurred submit applicable forms. If no changes it is not necessary to submit.
‰ A copy has been mailed to Fresno County Community Health Department.
‰ A copy has been mailed to your local fire department.
‰ A copy has been maintained on-site. Note: The plan must be implemented as required by Health
and Safety Code Chapter 6.95, Section 25503.5.
EPCRA Annual Review/Update:
If your facility is required by EPCRA to submit forms the following needs to be submitted by March 1st of every year
regardless of whether a change has occurred.
‰ Business Owner/Operator Identification – Has the form been filled out, signed and dated by the
owner/operator?
‰ Business Activities - Has the form been filled out, signed and dated by the owner/operator?
‰ Chemical Description Inventory Sheets - Has the form been filled out and signed by the
owner/operator?
24
BUSINESS OWNER/OPERATOR IDENTIFICATION - FACILITY INFORMATION
UNIFIED PROGRAM CONSOLIDATED FORM
This Form is Required for Initial Submission and Annual Certifications
FRESNO COUNTY DEPARTMENT OF COMMUNITY HEALTH-ENVIRONMENTAL HEALTH DIVISION
1221 Fulton Mall, Post Office Box 11867, Fresno, California 93775 (559) 445-3271
Page
of
I. IDENTIFICATION
1
FACILITY ID#
100
BEGINNING DATE
3
BUSINESS NAME (Same as FACILITY NAME or DBA – Doing Business As)
ENDING DATE
BUSINESS PHONE
(
)
101
102
103
BUSINESS SITE ADDRESS
104
CITY
CA
106
DUN & BRADSTREET
ZIP CODE
105
SIC CODE (4 digit #)
107
108
COUNTY
109
BUSINESS OPERATOR NAME
BUSINESS OPERATOR PHONE
(
)
110
-
II. BUSINESS OWNER
111
OWNER NAME
112
OWNER PHONE
(
)
113
OWNER MAILING ADDRESS
114
CITY
115
STATE
ZIP CODE
116
III. ENVIRONMENTAL CONTACT
117
CONTACT NAME
118
CONTACT PHONE
(
)
119
CONTACT MAILING ADDRESS
120
CITY
-PRIMARY-
121
STATE
IV. EMERGENCY CONTACTS
ZIP CODE
122
-SECONDARY-
NAME
123
NAME
128
TITLE
124
TITLE
129
125
BUSINESS PHONE
(
)
126
24-HOUR PHONE
(
)
-
(
)
-
)
131
24-HOUR PHONE
(
127
PAGER #
130
BUSINESS PHONE
(
)
132
PAGER #
(
)
133
LOCAL REQUIREMENTS
BUSINESS PLAN ANNUAL CERTIFICATION (not to be completed upon initial submittal):
Y
N
Is there any change to your Business Owner/Operator Identification form, Business Activities form, Hazardous Materials Inventory (most
recently submitted), or Site map? If yes, complete and submit the appropriate forms.
The Business Plan has been reviewed every three years to determine if revisions need to be made? Date reviewed ____________________
Y
N
The information contained in the hazardous materials inventory most recently submitted is complete, accurate and up to date. All hazardous
materials handled at our facility subject to inventory requirements have been disclosed on the most recently submitted inventory.
Fire Department Copy Mailed To:
Date Mailed:
/
/
Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally
examined and am familiar with the information submitted and believe the information is true, accurate, and complete.
SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE
NAME OF SIGNER (print)
DATE
136
TITLE OF SIGNER
134
NAME OF DOCUMENT PREPARER
135
137
Business Owner/Operator Identification
Please submit the Business Activities page, the Business Owner/Operator Identification page (OES Form 2730), and Hazardous Materials - Chemical Description pages
(OES Form 2731) for all hazardous materials inventory submissions. For the inventory to be considered complete this page must be signed by the appropriate individual.
(Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used
for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.)
Please number all pages of your submittal. This helps the Department of Toxic Substances Control (DTSC) identify whether the submittal is complete and if any pages are
separated.
1. FACILITY ID NUMBER – Leave this blank. This number is assigned by DTSC. This is the unique number which identifies your facility.
3. BUSINESS NAME - Enter the full legal name of the business.
100. BEGINNING DATE - Enter the beginning year and date of the report. (YYYYMMDD)
101. ENDING DATE - Enter the ending year and date of the report. (YYYYMMDD)
102. BUSINESS PHONE - Enter the phone number, area code first, and any extension.
103. BUSINESS SITE ADDRESS - Enter the street address where the facility is located. No post office box numbers are allowed. This information must provide a means
to geographically locate the facility.
104. CITY - Enter the city or unincorporated area in which business site is located.
105. ZIP CODE - Enter the zip code of business site. The extra 4 digit zip may also be added.
106. DUN & BRADSTREET - Enter the Dun & Bradstreet number for the facility. The Dun & Bradstreet number may be obtained by calling
(610) 882-7748 or by Internet.
107. SIC CODE - Enter the primary Standard Industrial Classification Code number for primary business activity. NOTE: If code is more than
4 digits, report only the first four.
108. COUNTY - Enter the county in which the business site is located.
109. BUSINESS OPERATOR NAME - Enter the name of the business operator.
110. BUSINESS OPERATOR PHONE - Enter business operator phone number, if different from business phone, area code first, and any extension.
111. OWNER NAME - Enter name of business owner, if different from business operator.
112. OWNER PHONE - Enter the business owner's phone number if different from business phone, area code first, and any extension.
113. OWNER MAILING ADDRESS - Enter the owner's mailing address if different from business site address.
114. OWNER CITY - Enter the name of the city for the owner's mailing address.
115. OWNER STATE - Enter the 2 character state abbreviation for the owner's mailing address.
116. OWNER ZIP CODE - Enter the zip code for the owner’s address. The extra 4 digit zip may also be added.
117. ENVIRONMENTAL CONTACT NAME - Enter the name of the person, if different from the Business Owner or Operator, who receives all environmental
correspondence and will respond to enforcement activity.
118. CONTACT PHONE - Enter the phone number, if different from Owner or Operator, at which the environmental contact can be contacted, area code first, and any
extension.
119. CONTACT MAILING ADDRESS - Enter the mailing address where all environmental contact correspondence should be sent, if different from the site address.
120. CITY - Enter the name of the city for the environmental contact’s mailing address.
121. STATE - Enter the 2 character state abbreviation for the environmental contact’s mailing address.
122. ZIP CODE - Enter the zip code for the environmental contact’s mailing address. The extra 4 digit zip may also be added.
123. PRIMARY EMERGENCY CONTACT NAME - Enter the name of a representative that can be contacted in case of an emergency involving hazardous materials at the
business site. The contact shall have FULL facility access, site familiarity, and authority to make decisions for the business regarding incident mitigation.
124. TITLE - Enter the title of the primary emergency contact.
125. BUSINESS PHONE - Enter the business number for the primary emergency contact, area code first, and any extensions.
126. 24-HOUR PHONE - Enter a 24-hour phone number for the primary emergency contact. The 24-hour phone number must be one which is answered 24 hours a day. If
it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the individual stated above.
127. PAGER NUMBER - Enter the pager number for the primary emergency contact, if available.
128. SECONDARY EMERGENCY CONTACT NAME - Enter the name of a secondary representative that can be contacted in the event that the primary emergency
contact is not available. The contact shall have FULL facility access, site familiarity, and authority to make decisions for the business regarding incident
mitigation.
129. TITLE - Enter the title of the secondary emergency contact.
130. BUSINESS PHONE - Enter the business telephone number for the secondary emergency contact, area code first, and any extension.
131. 24-HOUR PHONE - Enter a 24-hour phone number for the secondary emergency contact. The 24 hour phone number must be one which is answered 24 hours a day.
If it is not the contact's home phone number, then the service answering the phone must be able to immediately contact the individual stated above.
132. PAGER NUMBER - Enter the pager number for the secondary emergency contact, if available.
133. ADDITIONAL LOCALLY COLLECTED INFORMATION - This space may be used for DTSC to collect any additional information necessary to meet the
requirements of their individual programs. Contact DTSC, or your local agency for guidance.
134. DATE - Enter the date that the document was signed. (YYYYMMDD)
135. NAME OF DOCUMENT PREPARER - Enter the full name of the person who prepared the inventory submittal information.
136. NAME OF SIGNER - Enter the full printed name of the person signing the page. The signer certifies to a familiarity with the information submitted and that based on
the signer’s inquiry of those individuals responsible for obtaining the information, all the information submitted is true, accurate and complete.
SIGNATURE OF OWNER/ OPERATOR OR DESIGNATED REPRESENTATIVE - The Business Owner/Operator, or officially designated representative of the
Owner/Operator, shall sign in the space provided. This signature certifies that the signer is familiar with the information submitted and that based on the signer’s
inquiry of those individuals responsible for obtaining the information it is the signer’s belief that the submitted information is true, accurate and complete.
137. TITLE OF SIGNER - Enter the title of the person signing the page.
BUSINESS ACTIVITIES
FACILITY INFORMATION
UNIFIED PROGRAM CONSOLIDATED FORM
This Form is Required for Initial Submission and Annual Certifications
FRESNO COUNTY DEPARTMENT OF COMMUNITY HEALTH-ENVIRONMENTAL HEALTH DIVSION
1221 Fulton Mall, Post Office Box 11867, Fresno, California 93775 (559) 445-3271
Page _ of _
I. FACILITY IDENTIFICATION
1
FACILITY ID #
BUSINESS NAME (Same as Facility Name of DBA-Doing Business As)
2
EPA ID # (Hazardous Waste Only)
3
BUSINESS SITE ADDRESS
II. ACTIVITIES DECLARATION
NOTE: If you check YES to any part of this list,
please submit the Business Owner/Operator Identification page (OES Form 2730).
Does your facility…
A. HAZARDOUS MATERIALS
If Yes, please complete these pages of the UPCF….
Have on site (for any purpose) hazardous materials at or above 55 gallons for
liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include
liquids in ASTs and USTs); or the applicable Federal threshold quantity for an
extremely hazardous substance specified in 40 CFR Part 355, Appendix A or
B; or handle radiological materials in quantities for which an emergency plan
is required pursuant to 10 CFR Parts 30, 40 or 70?
B. UNDERGROUND STORAGE TANKS (USTs)
ƒ
Own or operate underground storage tanks?
ƒ
ƒ
Intend to upgrade existing or install new USTs?
Need to report closing a UST?
C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs)
ƒ
Own or operate ASTs above these thresholds:
---any tank capacity is greater than 1320 gallons, or
---the total capacity for the facility is greater than 1,320 gallons?
D. HAZARDOUS WASTE
ƒ
Generate hazardous waste?
ƒ
ƒ
Recycle more than 100 kg/month of excluded or exempted
recyclable materials (per HSC 25143.2)?
Treat hazardous waste on site?
HAZARDOUS MATERIALS INVENTORY
– CHEMICAL DESCRIPTION (OES 2731)
YES
NO 4
YES
NO 5
UST FACILITY (Formerly SWRCB Form A)
UST TANK (one page per tank) (Formerly Form B)
YES
NO 6
UST FACILITY
YES
NO 7
UST TANK (one per tank)
UST INSTALLATION - CERTIFICATE OF
COMPLIANCE (one page per tank) (Formerly Form C)
UST TANK (closure portion –one page per tank)
YES
NO 8
NO FORM REQUIRED TO CUPAs
YES
NO 9
EPA ID NUMBER – provide at the top of this
page
YES
NO 10
per recycler)
YES
NO 11
ONSITE HAZARDOUS WASTE
TREATMENT – FACILITY (Formerly DTSC
RECYCLABLE MATERIALS REPORT (one
Forms 1772)
ONSITE HAZARDOUS WASTE
TREATMENT – UNIT (one page per unit) (Formerly
ƒ
ƒ
ƒ
DTSC Forms 1772 A,B,C,D and L)
Treatment subject to financial assurance requirements (for
Permit by Rule and Conditional Authorization)?
Consolidate hazardous waste generated at a remote site?
YES
NO 12
CERTIFICATION OF FINANCIAL
ASSURANCE (Formerly DTSC Form 1232)
YES
NO 13
REMOTE WASTE / CONSOLIDATION
SITE ANNUAL NOTIFICATION (Formerly
DTSC Form 1196)
Need to report the closure/removal of a tank that was classified as
hazardous waste and cleaned onsite?
YES
NO 14
HAZARDOUS WASTE TANK CLOSURE
CERTIFICATION (Formerly DTSC Form 1249)
15
E. LOCAL REQUIREMENTS
CERTIFICATION: I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the
information is true, accurate, and complete.
I am exempt from these requirements and understand that my business may be subject to inspections to confirm my exemption status.
SIGNATURE OF OWNER/OPERATOR:
DATE:
Business Activities
UPCF (1/99)
Please submit the Business Activities page, the Business Owner/Operator Identification page (OES Form 2730), and Hazardous Materials Inventory Chemical Description pages (OES Form 2731) for all submissions. (Note: the numbering of the instructions follows the data element numbers that are
on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business
Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or AA identify whether the submittal is complete and if
any pages are separated.
1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the Certified Unified Program Agency (CUPA) or Administering Agency (AA). This is the unique
number which identifies your facility.
2. EPA ID NUMBER - If you generate, recycle, or treat hazardous waste, enter your facility's 12-character U.S. Environmental Protection Agency (U.S. EPA) or California
Identification number. For facilities in California, the number usually starts with the letters “CA”. If you do not have a number, contact the Department of Toxic
Substances Control (DTSC) Telephone Information Center at (916) 324-1781, (800) - 61-TOXIC or (800) 61-86942, to obtain one.
3. BUSINESS NAME AND BUSINESS SITE ADDRESS - Enter the full legal name of the business. This is the same as the terms “Facility Name” or “DBA - Doing Business
As” that might have been used in the past. Enter the complete site address.
4. HAZARDOUS MATERIALS ONSITE - Check the box to indicate whether you have a hazardous material onsite. You have a hazardous material onsite if:
- It is handled in quantities equal to or greater than 500 pounds, 55 gallons, or 200 cubic feet of compressed gas (calculated at standard temperature and
pressure),
- It is handled in quantities equal to or greater than the applicable federal threshold planning quantity for an extremely hazardous substance listed in 40 CFR Part
355, Appendix A,
- Radioactive materials are handled in quantities for which an emergency plan is required to be adopted pursuant to Part 30, Part 40, or Part 70 of Chapter 10 of
10 CFR, or pursuant to any regulations adopted by the state in accordance with these regulations.
If you have a hazardous material onsite, then you must complete the Business Owner/Operator Identification page (OES Form 2730) and the Hazardous Materials
Inventory - Chemical Description page (OES Form 2731), as well as an Emergency Response Plan and Training Plan.
Do not answer “YES” to this question if you exceed only a local threshold, but do not exceed the state threshold.
5. OWN OR OPERATE UNDERGROUND STORAGE TANK (UST) - Check the appropriate box to indicate whether you own or operate USTs containing hazardous
substances as defined in Health and Safety Code (HSC) §25316. If “YES”, then you must complete one UST Facility page and UST Tank pages for each tank.
You must also submit a plot plan and a monitoring program plan.
6. UPGRADE/INSTALL UST - Check the appropriate box to indicate whether you intend to install or upgrade USTs containing hazardous substances as defined in HSC
§25316. If “YES”, then you must complete the UST Installation - Certificate of Compliance page in addition to UST Facility and Tank pages, plot plan and
monitoring program plan.
7. UST CLOSURE - Check the appropriate box if you are closing an UST and complete the closure portion of the UST Tank pages for each tank. (CUPAs may require
additional information.)
8. OWN OR OPERATE ABOVEGROUND PETROLEUM STORAGE TANK (AST) - Check the appropriate box to indicate whether there are ASTs onsite which exceed the
regulatory thresholds. (There is no UPCF page for ASTs.) This program applies to all facilities storing petroleum in aboveground tanks. Petroleum means crude
oil, or any fraction thereof, which is liquid at 60 degrees Fahrenheit temperature and 14.7 pounds per square inch absolute pressure (HSC §25270.2 (g)). The
facility must have a single tank greater than 1320 gallons, or cumulative storage capacity greater than 1,320 gallons for all ASTs. NOT Subject to the Act
(exemptions):
An aboveground petroleum storage tank (AST) facility with one or more of the following (see HSC§25270.2 (k)) is not subject to this act and is exempt:
- A pressure vessel or boiler which is subject to Division 5 of the Labor Code,
- A storage tank containing hazardous waste if a hazardous waste facility permit has been issued for the storage tank by DTSC,
- An aboveground oil production tank which is regulated by the Division of Oil and Gas,
- Certain oil-filled electrical equipment including but not limited to transformers, circuit breakers, or capacitors.
9. HAZARDOUS WASTE GENERATOR - Check the appropriate box to indicate whether your facility generates hazardous waste. A generator is the person or business
whose acts or processes produce a hazardous waste or who causes a hazardous substance or waste to become subject to State hazardous waste law. If your
facility generates hazardous waste, you must obtain and use an EPA Identification number (ID) in order to properly transport and dispose of it. Report your EPA
ID number in #2. Hazardous waste means a waste that meets any of the criteria for the identification of a hazardous waste adopted by DTSC pursuant to HSC
§25141. "Hazardous waste" includes, but is not limited to, federally regulated hazardous waste. Federal hazardous waste law is known as the Resource
Conservation and Recovery Act (RCRA). Unless explicitly stated otherwise, the term "hazardous waste" also includes extremely hazardous waste and acutely
hazardous waste.
10. RECYCLE - Check the appropriate box to indicate whether you recycle more than 100 kilograms per month of recyclable material under a claim that the material is
excluded or exempt per HSC §25143.2. Check “YES” and complete the Recyclable Materials Report pages, if you either recycled onsite or recycled excluded
recyclable materials which were generated offsite. Check “NO” if you only send recyclable materials to an offsite recycler. You do not need to report.
11. ONSITE HAZARDOUS WASTE TREATMENT - Check the appropriate box to indicate whether your facility engages in onsite treatment of hazardous waste. "Treatment"
means any method, technique, or process which is designed to change the physical, chemical, or biological character or composition of any hazardous waste or
any material contained therein, or removes or reduces its harmful properties or characteristics for any purpose. "Treatment" does not include the removal of
residues from manufacturing process equipment for the purposes of cleaning that equipment. Amendments (effective 1/1/99) add exemptions from the definition
of “treatment” for certain processes under specific, limited conditions. Refer to HSC §25123.5 (b) for these specific exemptions. Treatment of certain laboratory
hazardous wastes do not require authorization. Refer to HSC §25200.3.1 for specific information. Please contact your CUPA to determine if any exemptions
apply to your facility. If your facility engages in onsite treatment of hazardous waste then complete the Onsite Hazardous Waste Treatment Notification - Facility
page and one set of Onsite Hazardous Waste Treatment Notification - Unit pages with waste and treatment process information for each unit.
12. FINANCIAL ASSURANCE - Check the appropriate box to indicate whether your facility is subject to financial assurance requirements for closure of an onsite treatment
unit. Unless they are exempt, Permit by Rule (PBR) and Conditionally Authorized (CA) operations are required to provide financial assurance for closure costs
(per 22 CCR §67450.13 (b) and HSC §25245.4). If your facility is subject to financial assurance requirements or claiming an exemption, then complete the
Certification of Financial Assurance page.
13. REMOTE WASTE CONSOLIDATION SITE - Check the appropriate box to indicate whether your facility consolidates hazardous waste generated at a remote site.
Answer ”YES” if you are a hazardous waste generator that collects hazardous waste initially at remote sites and subsequently transports the hazardous waste to a
consolidation site you also operate. You must be eligible pursuant to the conditions in HSC §25110.10. If your facility consolidates hazardous waste generated
at a remote site, then complete the Remote Waste Consolidation Site Annual Notification page.
14. HAZARDOUS WASTE TANK CLOSURE - Check the appropriate box to indicate whether the tank being closed would be classified as hazardous waste after its contents
are removed. Classification could be based on:
- Your knowledge of the tank and its contents
- The mixture rule
- Testing of the tank
- The listed wastes in 40 CFR 261.31 or 40 CFR 261.32.
- Inability to remove hazardous materials stored in the tank.
If the tank being closed would be classified as hazardous waste after its contents are removed, then you must complete the Hazardous Waste Tank Closure
Certification page.
15. LOCAL REQUIREMENTS - Some CUPAs or AAs may require additional information. Check with your CUPA before submitting the UPCF to determine if any
supplemental information is required.
UPCF (1/99)
HAZARDOUS MATERIALS INVENTORY – CHEMICAL DESCRIPTION
UNIFIED PROGRAM CONSOLIDATED FORM - HAZARDOUS MATERIALS
FRESNO COUNTY DEPARTMENT OF COMMUNITY HEALTH-ENVIRONMENTAL HEALTH DIVISION
1221 Fulton Mall, Post Office Box 11867, Fresno, California 93775 (559) 445-3271
(one page per material per building or area)
ADD
DELETE
200
REVISE
Page ___ of ___
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA – Doing Business As)
BUSINESS ADDRESS
201
CHEMICAL LOCATION
1
3
CHEMICAL LOCATION CONFIDENTIAL EPCRA
YES
NO
203
MAP# (optional)
FACILITY ID #
202
204
GRID# (optional)
II. CHEMICAL INFORMATION
CHEMICAL NAME
205
COMMON NAME
207
CAS#
209
TRADE SECRET
Yes
No
206
If Subject to EPCRA, refer to instructions
208
EHS*
Yes
No
*If EHS is “Yes”, all amounts below must be in lbs.
210
FIRE CODE HAZARD CLASSES (required by CUPA)
213
HAZARDOUS MATERIAL
TYPE (Check one item only)
a. PURE
b. MIXTURE
c. WASTE
PHYSICAL STATE
(Check one item only)
a. SOLID
b. LIQUID
c. GAS
FED HAZARD CATEGORIES
(Check all that apply)
a. FIRE
211
RADIOACTIVE
Yes
214
LARGEST CONTAINER
No
212
CURIES
215
216
b. REACTIVE
217
AVERAGE DAILY AMOUNT
c. PRESSURE RELEASE
MAXIMUM DAILY AMOUNT
218
e. CHRONIC HEALTH
d. ACUTE HEALTH
219
ANNUAL WASTE AMOUNT
221
STATE WASTE CODE
DAYS ON SITE:
220
222
UNITS*
a. GALLONS
b. CUBIC FEET
c. POUNDS
d. TONS
(Check one item only)
* If EHS, amount must be in pounds.
STORAGE
a. ABOVE GROUND TANK
e. PLASTIC/NONMETALLIC DRUM
i. FIBER DRUM
m. GLASS BOTTLE
q. RAIL CAR
CONTAINER
b. UNDERGROUND TANK
f. CAN
j. BAG
n. PLASTIC BOTTLE
r. OTHER
c. TANK INSIDE BUILDING
d. STEEL DRUM
g. CARBOY
h. SILO
STORAGE PRESSURE
a. AMBIENT
b. ABOVE AMBIENT
STORAGE TEMPERATURE
a. AMBIENT
b. ABOVE AMBIENT
%WT
k. BOX
o. TOTE BIN
l. CYLINDER
p. TANK WAGON
223
c. BELOW AMBIENT
224
c. BELOW AMBIENT
HAZARDOUS COMPONENT (For mixture or waste only)
d. CRYOGENIC
EHS
225
CAS #
1
226
227
Yes
No
228
229
2
230
231
Yes
No
232
233
3
234
235
Yes
No
236
237
4
238
239
Yes
No
240
241
5
242
243
Yes
No
244
245
If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
246
If EPCRA (EHS), Please Sign Here ________________________________________________
UPCF (1/99)
OES Form 2731
Hazardous Materials Inventory - Chemical Description
You must complete a separate Hazardous Materials Inventory - Chemical Description page for each hazardous material (hazardous substances and hazardous waste) that
you handle at your facility in aggregate quantities equal to or greater than 500 pounds, 55 gallons, 200 cubic feet of gas (calculated at standard temperature and pressure) or
the federal threshold planning quantity for Extremely Hazardous Substances, whichever is less. Also complete a page for each radioactive material handled over quantities
for which an emergency plan is required to be adopted pursuant to 10 CFR Parts 30, 40, or 70. The completed inventory should reflect all reportable quantities of
hazardous materials at your facility, reported separately for each building or outside adjacent area, with separate pages for unique occurrences of physical state, storage
temperature and storage pressure. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers
are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please
number all pages of your submittal. This helps your CUPA or AA identify whether the submittal is complete and if any pages are separated.
1. FACILITY ID NUMBER - This number is assigned by the CUPA or AA. This is the unique number which identifies your facility.
3. BUSINESS NAME AND BUSINESS ADDRESS - Enter the full legal name and site address of the business.
200. ADD/DELETE/ REVISE - Indicate if the material is being added to the inventory, deleted from the inventory, or if the information previously submitted is being revised.
NOTE: You may choose to leave this blank if you resubmit your entire inventory annually.
201. CHEMICAL LOCATION - Enter the building or outside/ adjacent area where the hazardous material is handled. A chemical that is stored at the same pressure and
temperature, in multiple locations within a building, can be reported on a single page. NOTE: This information is not subject to public disclosure pursuant to HSC
25506.
202. CHEMICAL LOCATION CONFIDENTIAL - EPCRA - All businesses which are subject to the Emergency Planning and Community Right to Know Act (EPCRA) must
check Yes to keep chemical location information confidential. If the business does not wish to keep chemical location information confidential check No.
203. MAP NUMBER - If a map is included, enter the number of the map on which the location of the hazardous material is shown.
204. GRID NUMBER - If grid coordinates are used, enter the grid coordinates of the map that correspond to the location of the hazardous material. If applicable, multiple grid
coordinates can be listed.
205. CHEMICAL NAME - Enter the proper chemical name associated with the Chemical Abstract Service (CAS) number of the hazardous material. This should be the
International Union of Pure and Applied Chemistry (IUPAC) name found on the Material Safety Data Sheet (MSDS). NOTE: If the chemical is a mixture, do not
complete this field; complete the ΑCOMMON NAME" field instead.
206. TRADE SECRET - Check “Yes” if the information in this section is declared a trade secret, or “No” if it is not.
State requirement: If yes, and business is not subject to EPCRA, disclosure of the designated trade secret information is bound by HSC 25511.
Federal requirement: If yes, and business is subject to EPCRA, disclosure of the designated Trade Secret information is bound by 40 CFR and the business
must submit a ΑSubstantiation to Accompany Claims of Trade Secrecy≅ form (40 CFR 350.27) to USEPA.
207. COMMON NAME - Enter the common name or trade name of the hazardous material or mixture containing a hazardous material.
208. EHS - Check “Yes” if the hazardous material is an Extremely Hazardous Substance (EHS), as defined in 40 CFR, Part 355, Appendix A. If the material is a mixture
containing an EHS, leave this section blank and complete the section on hazardous components below.
209. CAS # - Enter the Chemical Abstract Service (CAS) number for the hazardous material. For mixtures, enter the CAS number of the mixture if it has been assigned a
number distinct from its components. If the mixture has no CAS number, leave this column blank and report the CAS numbers of the individual hazardous
components in the appropriate section below.
210. FIRE CODE NFPA 704 HAZARD CLASSES - Fire Code NFPA 704 Hazard Classes identifies to first responders the type and level of hazardous materials which a
business handles. This system has 3 principal categories: health, flammability and reactivity and indicates the order of severity numerically by 5 divisions ranging
from 4-a severe hazard, to 0- which indicates no special hazard. Enter the NFPA 704 number (0, 1, 2, 3, or 4) that designates the severity of the hazard for each
category. If a material has more than one applicable hazard class, include all. Almost all substances will have the information on its label or you can obtain a
Material Safety Data Sheet (MSDS) from your supplier. NFPA website: http://www.hazmat.msu.edu:591/nfpa/. Contact CUPA or AA for guidance.
211. HAZARDOUS MATERIAL TYPE - Check the one box that best describes the type of hazardous material: pure, mixture or waste. If waste material, check only that box.
If mixture or waste, complete hazardous components section.
212. RADIOACTIVE - Check “Yes” if the hazardous material is radioactive or “No” if it is not.
213. CURIES - If the hazardous material is radioactive, use this area to report the activity in curies. You may use up to nine digits with a floating decimal point to report
activity in curies.
214. PHYSICAL STATE - Check the one box that best describes the state in which the hazardous material is handled: solid, liquid or gas.
215. LARGEST CONTAINER - Enter the total capacity of the largest container in which the material is stored.
216. FEDERAL HAZARD CATEGORIES - Check all categories that describe the physical and health hazards associated with the hazardous material.
PHYSICAL HAZARDS
HEALTH HAZARDS
Fire: Flammable Liquids and Solids, Combustible Liquids, Pyrophorics, Oxidizers
Acute Health (Immediate): Highly Toxic, Toxic, Irritants, Sensitizers, Corrosives,
Reactive: Unstable Reactive, Organic Peroxides, Water Reactive, Radioactive
other hazardous chemicals with an adverse effect with short term exposure
Pressure Release: Explosives, Compressed Gases, Blasting Agents
Chronic Health (Delayed): Carcinogens, other hazardous chemicals with an
adverse effect with long term exposure
217. AVERAGE DAILY AMOUNT - Calculate the average daily amount of the hazardous material or mixture containing a hazardous material, in each building or adjacent/
outside area. Calculations shall be based on the previous yearσ inventory of material reported on this page. Total all daily amounts and divide by the number of
days the chemical will be on site. If this is a material that has not previously been present at this location, the amount shall be the average daily amount you
project to be on hand during the course of the year. This amount should be consistent with the units reported in box 221 and should not exceed that of maximum
daily amount.
218. MAXIMUM DAILY AMOUNT - Enter the maximum amount of each hazardous material or mixture containing a hazardous material, which is handled in a building or
adjacent/outside area at any one time over the course of the year. This amount must contain at a minimum last yearσ inventory of the material reported on this
page, with the reflection of additions, deletions, or revisions projected for the current year. This amount should be consistent with the units reported in box 221.
219. ANNUAL WASTE AMOUNT - If the hazardous material being inventoried is a waste, provide an estimate of the annual amount handled.
220. STATE WASTE CODE - If the hazardous material is a waste, enter the appropriate California 3-digit hazardous waste code as listed on the back of the Uniform
Hazardous Waste Manifest.
221. UNITS - Check the unit of measure that is most appropriate for the material being reported on this page: gallons, pounds, cubic feet or tons. NOTE: If the material is a
federally defined Extremely Hazardous Substance (EHS), all amounts must be reported in pounds. If material is a mixture containing an EHS, report the units that
the material is stored in (gallons, pounds, cubic feet, or tons).
222. DAYS ON SITE - List the total number of days during the year that the material is on site.
223. STORAGE CONTAINER - Check all boxes that describe the type of storage containers in which the hazardous material is stored. NOTE: If appropriate, you may
choose more than one.
224. STORAGE PRESSURE - Check the one box that best describes the pressure at which the hazardous material is stored.
225. STORAGE TEMPERATURE - Check the one box that best describes the temperature at which the hazardous material is stored.
226. HAZARDOUS COMPONENTS 1-5 (% BY WEIGHT) - Enter the percentage weight of the hazardous component in a mixture. If a range of percentages is available,
report the highest percentage in that range. (Report for components 2 through 5 in 230, 234, 238, and 242.)
227. HAZARDOUS COMPONENTS 1-5 NAME - When reporting a hazardous material that is a mixture, list up to five chemical names of hazardous components in that
mixture by percent weight (refer to MSDS or, in the case of trade secrets, refer to manufacturer). All hazardous components in the mixture present at greater
than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, should be reported. If more than five hazardous components are present above these
percentages, you may attach an additional sheet of paper to capture the required information. When reporting waste mixtures, mineral and chemical composition
should be listed. (Report for components 2 through 5 in 231, 235, 239, and 243.)
228. HAZARDOUS COMPONENTS 1-5 EHS - Check “Yes” if the component of the mixture is considered an Extremely Hazardous Substance as defined in 40 CFR,
Part 355, or “No” if it is not. (Report for components 2 through 5 in 232, 236, 240, and 244.)
229. HAZARDOUS COMPONENTS 1-5 CAS - List the Chemical Abstract Service (CAS) numbers as related to the hazardous components in the mixture. (Repeat for 2-5.)
246. LOCALLY COLLECTED INFORMATION - This space may be used by the CUPA or AA to collect any additional information necessary to meet the requirements of their
individual programs. Contact the CUPA or AA for guidance.
UPCF (1/99)
OES Form 2731
CALIFORNIA ANNOTATED SITE MAP
A
B
Business Name:
C
D
Site Address:
E
F
G
1
2
3
Map #:
H
I
J
For Site Map
•
Scale of Map
•
Loading Areas
•
Parking Lots
•
Internal Roads
•
Storm and Sewer
Drains
•
Adjacent Property
Use
•
Locations and
Names of Adjacent
Streets and Alleys
•
Access and Egress
Points and Roads
For Sub-Site Map
•
Scale of Map
•
Location of Each
Storage Area
•
Location of Each
Hazardous Material
Handling Area
• Location of
Emergency
Response
Equipment
4
5
Scale:
6
1” = _____ Ft.
7
Appendix E
G:\EH\CUPA Program\Business Plans\Business Plan docs, forms, etc\business plan\packet\part 13 - Site Map.doc
Indicate Directions
(N, S, E, W)
IV. California Annotated Site Map – Instructions
Attach a map of the facility using the standard grid. At a minimum, the map should show the following:
1. Site Layout
•
•
•
•
•
•
•
•
•
Scale of map
Site Orientation (north, south, etc.)
Loading areas
Parking lots
Internal roads
Storm and sewer drains
Adjacent property use
Locations and names of adjacent streets and alleys
Access and egress points and roads
2. Facility
•
•
•
Location of each storage area
Location of each hazardous material handling area
Location of emergency response equipment. For example, equipment for fire suppression, approach and
mitigation, protective clothing, medical response, etc.
G:\EH\CUPA Program\Business Plans\Business Plan docs, forms, etc\business plan\packet\part 13 - Site Map.doc