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Home My WebLink AboutBUSINESS PLAN (2) 2005 ' I 7Trt STREET FAX: 6lB 1'324'~)3 L.~WRENCE O. LEFF, M.D. pP~C't"ICE LIMITED TO UROLOGY YOUR NF_X~ APPOINTMENT IS MON. TUES. WED. THURS. FRI. TIME: DATE: IF UNABLE TO KEEP APPOINTMENT, KINDLY GIVE 24 HOURS NOTICE YOUR NEXT APPOINTMENT IS MON. ~ ~ T'U~ES. ~WED.~ THURS. FRI. TIME: ..... DATE: --IF UNaBLE-TO KEEP APPOINTMENT, KtNDLY GIVE 2~ HOURB NOllCE i-=-ROBERT: L:WAGUESPACK, MD A PROFESSIONAL CORPORATION _ ~ ' BOARD CERTIFIED UROLOGIST 2005- 17th Street Phone: 661-327-4252 LEFF, MD SiteID: 015-021-002251 Manager : ~%%~% BusPhone: (661) 327-4252 Location: 2005 17TH ST '% Map : 102 CommHaz : City : BAKERSFIELD ~ Grid: 25D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title / / Business Phone: ( ) - x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : Phone: (661) 327-4252x MailAddr: 2005 17TH ST State: CA City : BAKERSFIELD Zip : 93301 Owner LEFF, MD Phone: (661) 327-4252x Address : 2005 17TH ST State: CA City : BAKERSFIELD Zip : 93301 Period : to ...... Tot~alASTs: = Gal Preparer: TotalUS~Ts-: . = Gal Certif 'd: RSs: ParcelNo: Emergency Directives: o? Do .hereby certify that I have I, _ cry. o~ p~.~.~---- reviewed the attached hazardous materials manage- e~cl that it along with ment plan any corrections constitute a complete and correct man- agement plan for my facility. -- Signature -1-. 08/22/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROG~M INSPECTION CHECKLIST 1715 Chester Ave., 3~" Floor, Bakersfield, CA 93301 FACILITY NAME ~$ ~~~ ~ Routine ~Combined ~ Joint Agency ~ Multi-Agency ~ Complaim ~ Re-inspection OPERATION C V COMMENXS Appropriate pe~it on hand Business plan contact info~ation accurate Visible address Co.eot occupancy Verification of invento~ materials Verification o~ quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of H~z Mat training Verification of abatemenl supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: ~es Questions res.ding mis inspection? Please call us at (661) 326-39~9 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy In '. '. ., ~6~1 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST / 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~-')R-$ b~A~u,~:~(-.. ~ ~.C~.F INSPECTION DATE i.I ADDRE~ss 'ZOO.S-' ! '7 -r,a- ~5 t-,. PHONE NO. ~ Z'7 - ,~. ~ FACILIT, Y coNTACT BUSINESS ID NO. 15-210- INSPECTION TIMI~ NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~l Routine [~Combined [~ Joint Agency [~ Multi-Agency [~1 Complaint [~ Re-inspection 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 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 ~ ' , C=Compliance' V=Violation Questions regarding this inspection? Please call us at (661) 326--3979 Busine~ ~'~ie RespOnsible Party / White - Env. Svcs. Yellow- Station'Copy Pink - Business Copy Inspector: ~ t ,'x~C'~, ~ / CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME 'D8.,$ ~~$~e-../~ ~ /__~'1~ INSPECTION DATE Section 4: ttazardous Waste Generator Program EPA ID # [] Routine [~ Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made EPA ID Number (Phone: 916-324-1781 to obtain EPA ID #) Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurrence Established or maintains a contingency plan and training Hazardous waste accumulation time frames Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ig~aste located at least 50 feet from property line ~Secondary containmen)provided Conducts daily inspection of tanks Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal C=Compliance V=Violation Inspector: ~ t~ Office of Environmental Services (661) 326-3979 .gite Responsible Party White - Env. Svcs. Pink - Business Copy s~[~~.~,..--~., CITY OF BAKERSFIE~ OFFICE OF ENVIRONMENTAL SERVICES ~4a,~rz 1715 Chester Ave., CA 93301 (661) 326-3979 '~~'~' H~RDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one ~ per matedal per building or ama) ~ NEW D ADD ~ DELETE ~ REVISE 200 Page ~ ' ~*~* *,.-~:~:':> ~:i~ ~*: ?'~ ;";=~ ...... ' I.'FACILI~ INFORMATION 8usiNgss ~ME ~Si~s aS' F~C~u~ fih'~-E~g~'b'~[~"g6~$~¥~)' ........ 3 CHEMICAL LO~TION I ~ 5 ta ~ ~'~ ~ ~ 201~ CON¢IDEN~L (EPc~)CHEMIC& LO~TION ............................. L '~ ";;?';' ~ ~' '~,'; "~; q¥5;~¥~?'~; ~ ~ ' ' ' ~ · II. C~EMICAL INFORMATION , '. ........ ; ?'¥:~: ~'~ ':~: T~DE SECR~ ~ Y~ ~ No ~6 CHEMI~L ~ME 207 COM~. ~ME ~ ESS' D V~ D .o 20S ................. ~ .................................... ~ ., .:.~'~?~;7;,,;~,::~,:.;;f?~-':~.'~b.~*~[;,,;,~ .... ~ -~E~s i~:Y~' ~ ~~'~ FIRE CODE H~RD C~SSES (~plete if r~u~t~ by I~1 fire chie~ 210 ~PE ~ p PURE ~ m MIX. RE ~w WAST~ 2;; i R~OIOACTIV~ ~ Y~ ~ No 212 CURIES 213 PHYSI~LSTA~ ~ s SOLID ~LIQUID ~ g GAS 214~; ~RGESTCO~AINER ~ 215 FED H~RD CATE~RIES ~ 1 FIRE ~ 2 R~CTIVE ~ 3 PRESSURE RELEASE ~ ACUTE HEALTH ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ~ DAM~IMUMLy A~U~ 218 ~ AVENGE 219 I STA~ WAS~ CODE ANNUAL WASTE / 217 , ~ DAILYA~UNT a~U~ ~ ........... ~-- ~ --- [ ~ DAYS ON S~ ~.,=~-~ ~.~ m ~ c~ ~ ,. ~smt. ~o.s ~, , ;* If EHS. am~nt must be in lbs. STOOGE ~AINER ~ a ABOVEGROUND TANK ~ P~STI~NONM~ALMC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL (Check all ~at apply) ~ b UNDERGROUND TANK ~ f CAN ~ j BAG ~ n P~STIC BO~LE ~ r O~ER ~ c T~K INSIDE BUILDING ~ g ~RBOY ~ k BOX ~ o TO~ BIN ~ d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WA~N STOOGE PRESSURE ~a AMBIENT ~ aa ABOVE AMBIENT ~ ba 8ELOWAMBIENT ~4 STOOGE TEMPE~TURE ~ a AMBIENT ~ aa ABOVE AMBIENT ~ b3 BELOW AMBIENT ~ c CRYOGENIC ~5 12 ~ 230 231 D Y~ ~ No ~2 ~ ~3 ....................... 238 239 ~ Y~ ~ NO 2~ 241 242I 243 ~y~ ~No 2~ 245 PRINT NAME & T/~E OF AU~ORI~D COMPA~ REPRESENTATIVE S~GNATURE ~ ~DATE 246 UPCF (7199) S:\CUPAFORMS\OES2731 .TV4.wpd