HomeMy WebLinkAboutBUSINESS PLAN (2)ROBERT-J REDELSPERGER, DDS INC. SiteID: 015-021-002385 =
Manager : .
Location: 2106:20TH~ ST %%%~ MapBUsPh°ne:: 102 CommHaz(661) 324-6053:
City : BAKERSFIELD~ ~ Grid: 25B FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 01 SIC Code:8021
EPA Numb: ! DunnBrad:
Emergency Contact / Title Emergency Contact / Title
ROBERT REDELSPERGER ./ DDS /
Business Phone: (661) 324-6053x Business Phone: ( ) - x
24-Hour Phone : (. ) - x 24-Hour Phone : ( ) - x
Pager Phone : ( ) x Pager Phone : ( ) - x
.Hazmat Hazards React
Contact : DR ROBERT REDELSPERGER Phone: (661) 324-6053x
MailAddr: 2106 20TH ST State: CA
City : BAKERSFIELD Zip : 93301
Owner DR ROBERT REDELSPERGER Phone: (661) 324-6053x
Address : 2106,.20TH ST State: CA
City : BAKERSFIELD ~. Zip : 93301
Period : to TotalASTs: = Gal
Preparer: TotalUSTs: = Gal
Certif'd: RSs: No
ParcelNo:
Emergency Directives:
I,,~J~,,~ ~/~. Do hereby certify that I have
reviewed ~he a~achsd h~ardous mmsrials mana~e-
- . ..... any ~e~ions ~nsfi~e a ~mple~e and ~rr~ man-
e~emsm plan ~r my f~ili~y.
DR. ROBERT REDELS~RGER ~/ /~ -=
' We~tche~ter Dent~l Art~
~ ~o~ ~Oth ~treet
~ n..:L[ ' Bakersfield, CA 93301
'.OFFICE OF ENVIRONMENTAL SERVICES
~ FII~ W
~~ ~' . 1715 Chester Ave., Bakersfield, CA (661) 326-3979
HAZARDOUS .MATERIALS MANAGEMENT PLAN
INSTRUCTIONS: 7-'D ,/~0~ J.
1. To avoid further action, return this form within 30 days of receipt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be as brief and concise as possible.
5. You may also attach Business Owner / Operator Form and Chemical Description Form(s)
to the front of this plan instead of completing SECTION I. below for initial submission.
SECTION I: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: ROBERT J REDELSPERGER DDS TNC.
LOCATION: 2106 20t,h st.
MAILING ADDKESS.:. 2106 20th st
CITY: Bakersfield STATE: Ca ZIP: 93301pHONE:66-324-6053
PRIMARY ACTIVITY.: 0enti~tr¥
OWNER: Robert Redeisperger PHONE: 661-322-7240
MAILING ADDRESS: 2106 20th st Bakersfieid,Ca. 93301
EMERGENCY NOTIFICATION
CONTACT TITLE BUS. PHONE 24 HR. PHONE
1. Robert Redelsperger Pres±dent 324-6053 661-324-6053
1
OF ENVIRONMENTAII~RvICES
1715 Chester Ave., C_A 93301 (661) 326-3979
-.,......41~1~_~,~-.- BUSINESS OWNER / OPERATOR IDENTIFICATION
FACILITY INFORMATION
Page Of
~.. ,: ..... :., '.:... ..:.q'. FACILi NTIFICATiON .
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 i BUSINESS PHONE 102
Robez't; J. Rede[spez'gez' DDS ]'nc i 661-324-6053
SITE ADDRESS lO3
2106 20t;h Sl;
CITY Bakez'sfie]'d lo4: CA i ZIP93301 105
DUN & 106 SIC CODE 107
BRADSTREET t (4 Digit #)
COUNTY Kez'n
OPERATOR NAME Robez't; Redelspez'gez-
OWNERNAME Robe]?t; J Redelspe~ge~ 111 I OWNERPHONE661-324-6053 "21
OWNER MAILING
I ADDRESS 2106 20t;h st; 113
i CITY Bake]~sf±eld 114 STATECa ~5 ZIP93301
CONTACT NAME Robe]~'c Redelspe]~ge~
CONTACT MAILING
ADDRESS 2~06 20 'ch st;
CiTY Bake]~s£±eZd,:t 120 STATEI~ a 121 ZIP 93301 122
NAME Robez't J Redelspez-gez- 123 NAME 1291
TITLE Pz~esident 12s TITLE ~30~
BUSINESS PHONE 661-324-6053 12~ BUSINESS PHONE 131
24-HOUR PHONE 661-324-6053 12~ 24-HOUR PHONE 132
133
PAGER # ...
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 in this inventory and believe the information is true, 'accurate, and complete.
SIGNATI I~F ~F CANNeR/OPERATOR DATE 134 NAME OF DOCUMENT PREPARER 135
~-~-rv~E-s oPZ OWNER/OPERATOR (print) 136 TITLE OF OWNER/OPERATOR 137
Robez't; Redelspez'gez- Pz'esident;
UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
..,~_~4~11~..~-.- HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
~one forth per matedal per building or area)
[] NEW ~j[ADD [] DELETE [] REVISE 200____ Page __ of __
BU'~INESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3
Robert; J Redelsper.qer BBS 'Tnc
201 CHEMICAL LOCATION [] Yes ~No 202
CHEMICAL LOCATION2106 201;h st; CONFIDENTIAL(EPCRA)
205 TRADE SECRET [] Yes [] No 206
CHEMICAL NAME If Subject to EPCRA. refer to instructions
207
COMMON NAME EHS° [] Yes .~ No 208
xray f~ xer
FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 210
n O n ¢ o~u s t a b le CURIES 213
TYPE [] p PURE [~ m- MIXTURE [] w WASTE 211 RADIOACTIVE [] Yes [~ No 212
PHYSICAL STATE 0, SOLID ~[~' LIQUID •g
FED HAZARD CATEGORIES [] 1 FIRE X~ 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 2n 6
(Check all that apply)
ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 S~i~b j~STE CODE 220
AMOUNT 8 g a I 1 o n-~ DALLY AMOUNT DALLY AMOUNT
DAYS ON SiTE 222
UNITS* j~] ga GAL [] cf CU FT [] lb LBS [] tn TONS 221
* If EHS, amount must be in lbs.
STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASs BO']-i'LE [] q RAIL CAR 223
(Check all that apply)
[] b UNDERGROUND TANK [] f CAN [] j BAG ~ n PLASTIC BOTTLE ' [] r OTHER
[] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN
[] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON
STORAGE PRESSURE ~ a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224
STORAGE TEMPERATURE [~ a AMBIENT [] aa ABOVE AMBIENT [] ha BELOW AMBIENT [] c CRYOGENIC 225
227 []Yes []No 228 i 229
i 1 226 Borax
233
2 230 231 [] Yes [] No 232
cltric acld
3 234 a i s u 1 f a t e 235 [] Yes [] NO 236 237
4 238 ~ ~,-I-; ...... '~ ~-; -t-,-, 239 []Yes []No 240 241
° sodium metabisulfate ~.es~.o~,~ .
~R'~'N~: I~:ME' & Ti%E'OF AU¥1:~OAizEI~'(~i3MPANY REPRESENTATIVE SIGNATURE
UPCF (7/99) S:\CUPAFORMS\OES2731 .TV4.wpd
. CITY oF BAKERSFIEsI~viCES ~
a r OF~CE OF ENVIRONMENTAL
1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979
HAZARDOUS MATERIALS MANAGEMENT PLAN
Section I1.1 - DISCOVERY AND NOTIFICATIONS
I. FACILITY IDENTIFICATION
BUSINESS NAME (Same as FACILITY NAME o~ DBA - Ooing Business As) 3
Robert J Redeisperger DDS Tnc
ADDRESS (For local use only) 476.
2106 20 th st
A. LEAK DETECTION AND MONITORING PROCEDURES:
visual
B. EMERGENCY AND AGENCY NOTIFICATION PROCEDURES:
Emergency 911
nonemergency 661-637-0404
· ;.':",.7. ~i~':; ?~,..'~; ~-i;:;: :.:'~-. .,*~,!:~';?*?' +': 3~ ':?~.:~,~:~:,~:'~{.~:E NVI RO N MENTAL MANAGEMENT.
C. SPECIFIC RESPONSIBILITIES OF EMPLOYEES:
EmpIoyees will notify and initiate proper procedures
D. CLOSEST LOCAL MEDICAL FACILITY:
San Joaquin Hopspital o~ Mercy on Truxtun
UPCF (7/99) S:~PROCEDURE MANUAL~New HMMP form.wpd
HA~RDOUS MATERIALS MANAGEM~tl' PLAN
Section 11.2 - RELEASE RESPONSE PLAN
PRELIMINARY ASSESSMENT
A. HAZARD ASSESSMENT AND PREVENTION MEASURES:
Proper sa£tey equipment for disposal
· ' - .. , · - . ' , - ' '. ' ' 'L: . ~.~.*.;, . - - ,. ..._.,,~,~;~--~,-
B.RELEASE CONTAINMENT AND MITIGATION:
double dontainers
C. CLEAN-UP AND RECOVERY PROCEDURES:
soak op with absorbent materials
X-ray solutions Services 661-637-0404
; UPCF (7/99) $:~EDURE MANUAL~New HMMP fo~.w~J
HAZARDOUS MATERIALS MANAGEMENT PLAN
Section II1.1 - FACILITY AND.LOCALITY INFORMATION
UTILITY SHUT-OFFS . -
LOCATION OF SHUT-OFFS AT YOUR FACILITY:
NATURAL GAS/PROPANE: west side of no~'chwesl; co~'nez' of building, outside
ELECTRICAL: northwest side of buildi~.q, outside.
WATER: Aiiey
SPECIAL: -~
LOCK BOX: YES /('~)~ IF YES, LOCATION:
· . : PR!VATE:FI~REPROTECTION I WATER AVAILABILITY '.... '~:..'- . .
A. PRIVATE FIRE PROTECTION:
Alarm
B. WATER AVAILABILITY (FIRE HYDRANT):
alley between 19th and 20th on- I~ st
Alley between 19th and 20th on D st.
' '" ::~"' ":' ":~:"~;'~'~; :' '¥""~ ~:~' ';:~ ~ '~';' "' ~- '~' ' "~' ~ ' ' " "
I
· . , -. .... ... .... . . . .... *.:' . ... ... -.:,.~';*.';
A. NUMBER OF EMPLOYEES: 9
B. MATERIALS DATA SHEETS. ON FILE:
yes
C. BRIEF SUMMARY OF TRAINING PROGRAM:
OSHA~medical traing once per year
Based on my Inquiry of tho~e individuals responsible fo~ o/otaining the Informalion, I ce~'tify under penalty of law Ihat I have personnaly examined and am familiar with the Information submilted and believe Ihe
infom,.aUon la true, accurate, and complete.
SIGNATURE OF OWNER DESIGNATED REPRESENTATIVE DATE 477.
NAME OF SIONER ~_.~_ //~ 478. TITLE OF $,ONER
UPCF (7/99) S:~r~ROCEDURE MANUAL~New HMMP fm'm.wlxl
ITE DIAGRAM
Bmin.a Nan.: '
B~ ,aaldrm: ,.,
FAc~.rI~ DIAGRAM
Robert. d Redelsperger DOS I~c
P~ ?Orh st
,[ .
SITE DIAGRAM ! ] FACILITY DIAGRAM
Business Name:
Business Address:
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROG~M INSPECTION CHECKLIST
1715 Chester Ave., 3~ Floor, Bakersfield, CA 93301
FACILITY NAME i~c~ ~ ~' ~SPECTION DATE
ADD.SS ~Io6 ~ ~ S~ PHONENO, ~-
FACILITY CONTACT ~ ~ Reo~sPa~ BUSINESS ID NO. 15-210-
Section I: Business Plan and lnvento~ Program /~2' ~9~
~ Routine ~Combined ~ Joint Agency ~ Multi-Agency ~ 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
Any hazardous waste on Mte?: ~] Yes [~ No
Explain: //,,f,-6~5'~ ~ ! 'x.~?,_ ,~/~//,~
Questions regarding this inspection? Please call us at (66 i ) 326-3979 Bus~/~ite Responsible Party
White- Env. Svcs. Yellow- Station Copy Pink- Business Copy Inspector: (.A,J/~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME ~~ I3C'~'"~t.. ,4'ZT5 INSPECTION DATE C/z-SA'Z_
Section 4: Hazardous 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
Ignitable/reactive waste located at least 50 feet from property line
Secondary containment provided i~
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 ree.eipts for 3 years
Determines if waste is restricted from land disposal
C=Compliance V=Violation
Office of Environmental'Services (661) 326-3979 B esponsible Party
White - [:nv. Svcs. Pink - Business Copy