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HomeMy WebLinkAboutBUSINESS PLAN ANDREW A. POUNDS, D.D.S., INC. ~. PERIODONTICS TELEPHONE 2320 - 17TH STREET (661 ) 395-3115 BAKERSFIELD, CA 93301 ANDREW A POUNDS, D.D.S. SiteID: 015-021-002283 Manager : BusPhone: (661) 395-3115 Location: 2320 17TH ST Map : 102 CommHaz : City : BAKERSFIELD Grid: 25D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8021 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title LINDA POUNDS / / Business Phone: (661) 395-3115x Business Phone: ( ) - x 24-Hour Phone : (~) ~-~[l~x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : LINDA POUNDS Phone: (661) 395-3115x MailAddr: 2320 1-7TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner ANDREW A POUNDS, DDS Phone: (661) 395-3115x Address : 2320 17TH ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: -1- 06/16/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES P.Oa M c. c us 1715 Chester Ave., 3~" Floor, Bakersfield, CA 93301 FACILITY NAME ~~ ~.e~5 005 ~SPECTIONDATE ADDRESS 23'~O 17~ 5r PHONE NO. FACILITY CONTACT_ W~A e~ BUSINESS ID NO. 15-210- ~SPECTION TIME ' NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program I~l Routine [~Combined I~ Joint Agency l~l Multi-Agency ~ Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand ~ ~ff/t4,~t~ Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand ?t.~ ~---rtneM ~0/ C=Compliance V=Violation Any hazardous waste on site?: [~Yes [~ No. (~_,~ ~ ~ [~. Explain: ~~ ~ .~ / White- Env. Svcs. Yellow - Station Copy Pink- Business Copy Inspector: _5 5~ /.,j ".~ crrY oF BAKERSFIELD FIRE DEPARTMENT //'b22~;/"~ [ OFFICE or ENVIRONMENTAL SERVICES ' , UNIFIED PROaanM ~S~CX~O~ ca~cmas~ ~6: / 1715 Chester Ave., 3;~'FIoor, Bakersfield, ~A 93301 ADD~ES'S :' ~o lq ~ ~v P~ONE NO. ~- ~te~ FACILITY CONTACT ~_.~M8~ e~ . BUSINESS ID NO. 15-210- ~ ~s~:cx~o~ Y~: ~u~:~ ov :~LOY~:S 4 Section 1: Business Plan and lnvemo~ Program ~ ~outine ~Combined ~ Joint Agency ~ Multi-Agenc~ ~ Complaint ~ R~-insp'ection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities . ,. Verification of location Proper segregation of material Verification of MSDS availabiiity ,, .... Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate Cont~i'ners properly labeled I Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance . V=Violation .Questions regarding this inspection? Please call us at'(661) 326-3979 Business Stte Responsible Party// / White- Env. Svcs. Yellow- Station Copy Pink. Business Copy Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3'd Floor, Bakersfield, CA 93301 Section 4: Hazardous Waste Generator Program EPA ID # ~__..A'-~. ~ ! 2'~;"~ [] Routine ~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided I~ {?(~t~ l°t?-~O~ tf'l--(t~.~ t/ Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation ~/0j~ f~(j~/~.../~ Inspector: ~ I P'} ~ Office of Environmental' Services (661) 326-3979 Busir~ss Si~e RespOnsible Party White - Env. Svcs. Pink - Business Copy "~ rlt~E ~ OFFIL'"E'OF ENVIRONMENTAL SERVItCES 4~,nRrtwwr 1715 Chester Ave., CA 93301 (661) 326-3979 CHEMICAL DESCRIPTION (one ~ per ma~dal ~r budding or a~a) ~NEW ~ A~D ~ DELETE ~ REVISE ~0 ~ . Page ........... __ ~ __ SUSINESS ~ME (S~e ~ FAClLI~ NAME or DBA - ~in9 Ousin~ ~) 3 CHEMICLLOCATION 1~5tO~ D~"~O~ 2011i CONFIDENTIAL(EPc~)CHEMICALLO~TION ~Y~ ~No 202 FACILI~ID~I I ~ I I [~{~-~--~[ ', 11 ~P~(op~naO ............ 203 ~ GEID~(optionaO 204 205 T~DE SECR~ ~ Y~ ~ No 2~ CHEMI~L ~ME ~--~ ~' ~' X C~ If Subj. ,O EPC~, ref. ,o insulins COM~N ~ME EHS* ~ Y~ ~ No 208 FIRE CODE H~RD C~SSES (~plete if r~u~t~ by ~1 fire ~i~ 210 ~PE ~ p PURE ~ m MIX. RE ~ WA~ ..... ~'(~ "RAOIOACTIVE ~ Y~ ~ No 212 ~ CURIES 213 . i ~RGEST CONTAINER ~ 215 PHYSI~LSTA~ ~ s SOLID ~IQUID ~ g ~S 214 ~ FED H~D CA~GORIES ~ 1 FIRE ~ 2 REACTI~ ~ 3 PRESSURE RELEASE ~ 'ACUTE HEAL~ ~ 5 CHRONIC H~LTH 216 (~ all that apply) ANNUAL WASTE 217 ~ ~IMUM ~ 218 ~ AVENGE ~ 219 STA~ WAS~ ~DE 220 A~UNT ~ .[ DAILY A~U~ "3 DAILY AMOUNT L DAYS ON S~ 222 UNITS' ~ga GAL ~ ~ CU ~ ~ lb LBS ~ tn TONS ' If EHS, am~nt must be in lbs. STOOGE ~NTAINER ~ a ABOVEGROUND TANK ~ e P~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BOGLE ~ q ~IL ~ 223 (Check a// that app/y) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ P~STIC BO~LE ~ r O~ER ~ c T~K INSIDE BUILDING ~ g ~R~Y ~ k BOX ~ o TOTE BIN ~ d S~EL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STO~GEPRESSURE ~a AMBIENT ~ aa ABOVE AMBIENT ~ ba BELOWA~IE~ 224 STOOGE TEMPE~TURE ~a AMBIENT ~ aa ABOVE AMBIENT ~ ba BELOW AMBIE~ ~ c CRYOGENIC 225 1 226 227 ~ ~y~ ~No 228 229 230 231 [ ~y~ ~o 232 233 2~ 2aS ~ ~ y~ ~ ~o 23~ 237 4 238 239 t 241 ................................................................... i D ~ D .o 2~0 5 242 243 ~ Y~ ~ ~o 2~ 245 PRINT ~ME & TI~E OF AU~ORIZED COMPANY REPRESENTATIVE SIGNATURE DA~ 246 UPCF (7/99) S:\CUPAFORMStOES2731.TV4.wpd