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