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Home My WebLink AboutBUSINESS PLANJAMEs N CLARK, DDS SiteID: 015-021-002338 Manager : BusPhone: (661) - Location: 1805 28TH ST 101 Map : 102 CommHaz : City : BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCOde: BAKERSFIELD STATION 01 ~SIC Code:8621 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: ( ) - x MailAddr: 1805 28TH ST 101 State: CA City : BAKERSFIELD Zip : 93301 Owner JAMES N CLARK, DDS Phone: ( ) - x Address : 1805 28TH ST 101 State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~,~ ~ I~in~ name) revi~wod ~he at~ached hazardous mat, erials ment plan ~o~r~ ~ ~ P/~ and ~ha~ i~ along ~i~h (~~) ~n7 co~s~ions consti~uto ~ ~mplet~ ~d ~rr~ man- a~emem plan ~r my fa~i~. OR~OPEDIC SURGERY ~ ~ . , ~ a/ /~oo - ~'~.:., - ~ : :1- '~ 0 14 3 / ~KERSFIELD, CAL(F. PHONE: (66 I ) 327-2777 9330 I JAMES N CLARK, DDS SiteID: 015-021-002338 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax lUnitlMCP WASTE FIXER R L Min '2 08/14/2003 jAMES N CLARK, 'DDS SiteID: 015-021-002338 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site SPENT PHOTOGRAPHIC FIXER 365 Location within this Facility Unit Map: Grid: CAS# r STATE i TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 'HAZARDOUS COMPONENTS io SI Silver N 7440224 HAZARD ASSESSMENTS TSecret[ oRslBioHazI Radioactive/Amount EPA HazardsI NFPA USDOT# I MCP No N No No/ Curies R / / / Min -4- 08/14/2003 JAMES N CLARK, DDs SiteID: 015-021-002338 9 Fast Format ~ Notif./Evacuation/Medical Overall Site Agency Notification -- Employee Notif./Evacuation Public Notif./Evacuation Emergency Medical Plan -5- 08/14/2003 F JAMES N CLARK, DDS SiteID: 015-021-002338 Fast Format F Mitigation/Prevent/Abatemt Overall Site Release Prevention --Release Containment Clean Up Other Resource Activation 6 08/14/2003 JAMES N CLARK, DDS SiteID: 015-021-002338 Fast Format ~ Site Emergency Factors Overall Site Special Hazards -- Utility'Shut-Offs Fire Protec./Avail. Water Building Occupancy Level -7- 08/14/2003 JAMES N CLARK, DDS SiteID: 015-021-002338 Fast Format F Training Overall Site Employee Training -- Page 2 Held for Future Use Held for Future Use -8- 08/14/2003 JOEL D. MACK MD FACS · SiteID: 015-021-002327 = 4~%%~ BusPhone: (661) 327-2777 Manager : Location: 1801 28TH ST ~ Map : 102 CommHaz : City : BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title JOEL D. MACK / MD FACS / Business Phone: (661) 327-2777x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: React Contact : JOEL D MACK MD FACS Phone: (661) 327-2777x MailAddr: 1801 28TH ST State: CA City : BAKERSFIELD Zip. : 93301 Owner JOEL D MACK MD FACS Phone: (661) 327-2777x Address : 1801 28TH ST State: CA City : BAKERSFIELD " Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: (Type or ~nt name) ' reviewed the a~ched hazardous materials manage- ment plan for, I 0c [ P. ~T~ ~C.and that il along with ......... - ................ (Marne d Bu~im) any con'~cfionS consfitLA® a comp~®%e and corr~-~ rnano ~m~n~ p~an ~or my ~'aci~'. -1- 08/14/2003 CIITY OF BAKERSFIELD FIRE DEPARTMENT 4q/gq [ '7 OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ..~ 3.6/~:.~ ~ ~3 INSPECTION DATE i 7.- t/~ ADDRESS [f~,O ! '7_..~'ru PHONE NO. 'gZ.-) - FACILITY ~?ONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program ~ Routine ~f.~ombined [~ 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 Diagr~m Adequate & On Hand C=Compliance V=Violation Any hazarc~ou, Lwa_~_te ~~: ~es a No Explain: Questions regarding this inspection? Please call us at (661) 326-3979 Business Site 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., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME /~ ~ ~,.<f~ INSPECTION DATE (ZT~/O~ 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 b/' ~LC,,4XS~ p~-e)or{O~ 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'~ { k'f~c'~ ~ C ~'/'~ Office of Environmental' Services (661) 326-3979 Business Site Responsible Party White - Env. Svcs. Pink - Business Copy