Emergency Response Contingency Plan Form – Fill Out and Use This PDF

Instructions For Completing CERS

Consolidated Emergency Response/Contingency Plan

Introduction

Health and Safety Code (HSC) §25504(b) requires that Hazardous Materials Business Plans (HMBP) contain Emergency Response Plans and Procedures in the event of a reportable release or threatened release of a hazardous material. HSC §25504(c) requires that HMBPs address training of employees in safety procedures in the event of a reportable or threatened release.

Title 22 California Code of Regulations (22 CCR) §66262.34(a) requires facilities that generate 1,000 kilograms or more of hazardous waste per month, or accumulate more than 6,000 kilograms of hazardous waste on-site at any one time, prepare a Contingency Plan. Facilities that generate in any month more than 1 kilogram of acutely hazardous waste (AHW), or more than 100 kilograms of debris resulting from the spill of an AHW, or which treat hazardous waste onsite under the Permit by Rule (PBR) onsite treatment tier must also prepare a Contingency Plan.

The California Environmental Reporting System (CERS) Consolidated Emergency Response/Contingency Plan has been prepared to: unify emergency response and contingency plan requirements for hazardous materials and hazardous wastes; provide for basic contingency planning for an average small to mid-size facility; and incorporate minimal regulatory requirements. Other supplements or amendments may be required for facilities of exceptional size or having exceptional operations or processes that warrant additional contingency planning. The CERS format is not mandatory. You may instead substitute another emergency planning document [e.g., Spill Prevention Control and Countermeasure (SPCC) Plan], provided that it satisfies the HSC and 22 CCR requirements for content.

General Instructions

This plan applies to both your non-waste hazardous materials and hazardous waste — keep both in mind as you address each plan section.

Mark sections that don’t apply to your facility with “N/A” for not applicable.

Be as specific as possible.

Facilities with unusual employee turnover (e.g., gas stations) may substitute position titles for specific employee names when identifying emergency coordinators or emergency response team members to avoid having to constantly revise the plan due to personnel turnover.

Review the specific line item instructions before completing your plan to avoid common errors.

After it is completed and signed/certified, the plan or its equivalent should be scanned and uploaded to CERS as a PDF- format document. Your HMBP will not be complete until it includes this information.

Specific Line Item Instructions

1.FACILITY ID NUMBER – Enter the “Agency Facility ID” number found on CERS.

A1. CERS ID – Enter the 8-digit identification number assigned to this facility in CERS.

A2. DATE OF PLAN PREPARATION/REVISION – Enter the date the plan was prepared or most recently revised.

3.BUSINESS NAME – Enter the name used to identify the facility on CERS.

103.BUSINESS SITE ADDRESS – Enter the site address where the facility is located.

104.CITY – Enter the city or unincorporated area in which the facility is located.

105.ZIP CODE – Enter the 5 or 9 digit zip code for the facility.

A3. TYPE OF BUSINESS – Briefly describe the type of business (e.g., Drycleaner, Auto Repair, Gas Station).

A4. INCIDENTAL OPERATIONS – Briefly describe any operations at the facility that are associated with hazardous materials storage or hazardous waste generation, but are not obvious from the description in A2.

A5. THIS PLAN COVERS CHEMICAL SPILLS, FIRES, AND EARTHQUAKES INVOLVING – Check box 2 “HAZARDOUS WASTES” if the facility generates hazardous waste. (Note: Box 1 should always be checked since both waste and non-waste hazardous chemicals are hazardous materials.)

B1. INTERNAL RESPONSE – Check one or more of the three boxes to indicate how the facility will respond internally to emergency incidents.

C1. INTERNAL FACILITY EMERGENCY COMMUNICATIONS OR ALARM NOTIFICATION WILL OCCUR VIA – Check one or more of the boxes to indicate how internal alarm notification will occur.

CALIFORNIA ENVIRONMENTAL REPORTING SYSTEM (CERS)

CONSOLIDATED EMERGENCY RESPONSE / CONTINGENCY PLAN

Prior to completing this Plan, please refer to the INSTRUCTIONS FOR COMPLETING A CONSOLIDATED CONTINGENCY PLAN

A. FACILITY IDENTIFICATION AND OPERATIONS OVERVIEW

CA

B. INTERNAL RESPONSE

1. CALLING PUBLIC EMERGENCY RESPONDERS (i.e., 9-1-1)

2. CALLING HAZARDOUS WASTE CONTRACTOR

3. ACTIVATING IN-HOUSE EMERGENCY RESPONSE TEAM

C. EMERGENCY COMMUNICATIONS, PHONE NUMBERS AND NOTIFICATIONS

Whenever there is an imminent or actual emergency situation such as an explosion, fire, or release, the Emergency Coordinator (or his/her designee when the Emergency Coordinator is on call) shall:

1.Activate internal facility alarms or communications systems, where applicable, to notify all facility personnel.

2.Notify appropriate local authorities (i.e., call 9-1-1).

3.Notify the California Emergency Management Agency at (800) 852-7550.

Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall notify the California Department of Toxic Substances Control (DTSC), the local Unified Program Agency (UPA), and the local fire department’s hazardous materials program that the facility is in compliance

with requirements to:

1.Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from an explosion, fire, or release at the facility; and

2.Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the facility affected by the incident until cleanup procedures are completed.

Rev. 06/27/11

H. EARTHQUAKE VULNERABILITY

Identify areas of the facility that are vulnerable to hazardous materials releases / spills due to earthquake-related motion. These areas require immediate isolation and inspection.

I. EMPLOYEE TRAINING

Explanation of Requirement: Employee training is required for all employees handling hazardous materials and hazardous wastes in day-to-day or clean-up operations including volunteers and/or contractors. Training must be:

∙Provided within 6 months for new hires;

∙Amended as necessary prior to change in process or work assignment;

∙Given upon modification to the Emergency Response / Contingency Plan, and updated/refreshed annually for all employees.

Large Quantity Generator (LQG) Training Records: Large quantity hazardous waste generators (i.e., who generate more than 270 gallons/1,000 kilograms of hazardous waste per month) must retain written documentation of employee hazardous waste management training sessions which includes:

∙A written outline/agenda of the type and amount of both introductory and continuing training that will be given to persons filling each job position having responsibility for the management of hazardous waste (e.g., labeling, manifesting, compliance with accumulation time limits, etc.).

∙The name, job title, and date of training for each hazardous waste management training session given to an employee filling such a job position; and

∙A written job description for each of the above job positions that describes job duties and the skills, education, or other qualifications required of personnel assigned to the position.

∙Current employee training records must be retained until closure of the facility.

∙Former employee training records must be retained at least three years after termination of employment.

K. SIGNATURE / CERTIFICATION

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, and that a copy is available on site.