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Home My WebLink AboutBUSINESS PLAN ITE DIAGRAM ~~_~ FACILFI'Y DIAGRAM Business Name: t~ (~t¥/~~r_F/~ Business Address: t?/~- . ~ ~ $-~. / ~-~ ~ · REED CHIROPRACTIC f SiteID: 015-021-002192 Manager : ~%%%~ SusPhone: (661) 322-3997 Location: 17i5 30TH ST Map : 102 CommHaz : Minimal City : BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8041 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title KELLY REED / OWNER PIXIE MILLER / Business Phone: (661) 322-3991x Business Phone: (661) 322-3991x 24-Hour Phone : (661) 322-3997xMESs 24-Hour Phone : ( ) - x Pager Phone : (661) 636-8999x Pager Phone : ( ) - x Hazmat Hazards: React Contact : Phone: (661) 322-3997x MailAddr: 1715 30TH ST State: CA City : BAKERSFIELD Zip : 9330i Owner KELLY C REED DC Phone: (661) 322-3997x Address : 1715 30TH ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, ~'~(.t7 1?~-''~- Do hereby certify that l have (~pe or Ixint name) reviewed ~,he a~ached hazardous materials manage- ment plan fOr ~-~ C~°~'~and that it along with (Name of Bu~ne~) any corrections constitute a complete and correct man- agemsnt plan for my facility,. ' ~' ~ignature Date -1- 10/16/2003 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~1~4~ ~ ,a.o~'r~c INSPECTION DATE ~/I ~/O~.~ Section 4: . Hazardous Waste Generator Program EPA ID ~ ~Routine ~ Combined ~ Joint Agency ~ Multi-Agency ~ Complaint Re-inspection OPERATION C V COMMENTS Hazardous waste determinati6n 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 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 Office of Environmental' Services (661) 326-3979 ~ ness Site Responsible Party White - Env. Svcs. Pink - Business Copy \ REED CHIROPRACTIC CENTER SiteID: 015-021-002192 Manager : BusPhone: (661) 322-3991 Location: 1715 30TH ST Map : 102 CommHaz : Minimal City : BAKERSFIELD Grid: 24D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01 SIC Code:8041 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title KELLY REED / OWNER / Business Phone: (661) 322-3991x Business Phone: ( ) - x 24-Hour Phone : (661) ,322-3997xMESS 24-Hour Phone : ( ) - x Pager Phone : (661) 636-8999x Pager Phone : ( ) - x Hazmat H~zards: React Contact : - - ........ Phone.:. ~6~) 322-3991x MailAddr: 1715 30TH ST State: -CA City : BAKERSFIELD Zip : 93301 Owner KELLY C REED, DC Phone: (661) 322-3991x Address : 1715 30TH ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: = Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site HaZmat Common Name... ISpooHaz]EPA HazardsI Frm DailyMax .]UnitlMCP I, (1'y~orp' ~-~ ~ reviewed the attached haz,ardous materials mariage- merit plan for ~,,,~0 ~o ..and that it along with '-'-"'(Name of Business) any corre~ions constitute a complete and correct man- agement plan for my facility. Date · - ~irl.gnalure -1- 01/04/2001 REED CHIROPP~ACTIC CENTER SiteID: 015-021-002192 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site m COMMON NAME / CHEMICAL NAME WASTE FIXER Days On Site 365 Location within this.Facility Unit Map: Grid: IN XRAY PROCESSOR CAS# STATE i TYPE PRESSURE i TEMPERATURE I CONTAINER TYPE Liquid Waste Ambient Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container ] Daily MaximumI Daily Average 5.00 GAL 5.00 GAL 5.00 GAL HAZARDOUS COMPONENTS .... ~' ' J~ilver ..... %Wt ......... _ _~ S CAS ' -~ N 7440224 HAZARD ASSESSMENTS 1" ITSoorot'NoRSIBi°HaZNo No Radioactive/Amount No/ Curies EPA HazardsR NFPA/// USDOT# I MCP'Mis -2- 01/04/2001 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days ofrecmpt 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. Y°u~may also attach Business Owner'/Operator Form and chemiC-al D~scription Form(s) to the front of this plan instead of completing SECTION I. below for initial submission. SECTION I: BUSINESS IDENTIFICATION DATA Bal~f~kt, CA 93301-1909 LOCATION: ~ ~ 6~!_32_9..~/ MAILING ADDRESS: CITY: STATE: ZIP: PHONE: PRIMARY ACTIV~ITY: OWNER: PHONE: EMERGENCY NOTIFICATION CONTACT TITLE BUS. 'PHONE- 24 HR. PHONE HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II. 1: DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: B. EMPLOYEE AND AGENCY NOTIFICATION: C. ENVIRONMENTAL RESPONSE MANAGEMENT: D. EMERGENCY MEDICAL PLAN: 2 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES: B. RELEASE CONTAINMENT AND/OR MITIGATION: C. CLEAN-UP AND RECOVERY PROCEDURES: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR' FACILITY) NATURAL GAS/PROPANE: ELECTRICAL: 07)~ ~ o,l'_, .~t~,~ ~ ~J' ~-0.,v_~,~ SPECIAL: ,JLr~ LOCK BOX: YE ~_.) IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: B. WATER AVAILABILITY (FIRE HYDRANT): HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: CERTIFICATION Pl~ Gall 661.32249~t I, CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV_. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES.PERJURY. SIO~A~TURE TITLE DATE .- i'~ CITY OF BAKERSFIELD~ ' O OFfiCE OF ENVIRONMENTAL S~VICES,_ 171.5 Chester Ave., CA 93301 (661)326-3979N~ a ~ ' ' BUSINESS OWNER / OPE~TOR IDENTIFICATI~'~":'. ~= FACILI~ ID · '~] ~' ~ . . ~ Year Beginning " lOO Year Ending - lol BUSINESS NAME (Same as FACILI~ NAME or DBA- Doing Bu~ness ~) 3 BUSINESS PHONE ~02 SITE ADDRESS I~ I~ 30~ ~' 103 DUN & ~o~ SIC CODE B~DSTREET .... ; :-'~ ~' . .... - (4 Digit g) -,c- .o. OWNER NAME ~ ~ ~ OWNER PHONE ' ~., ow.~ ~,...~ ~ ~ ~. ADDRESS cl~ ~ ~.' -~ STATE .~ ZiP . ~9 CONTACTADDRESs~ILING ¢O, g Ox t ~3 ~3 TITLE.- ~~ --: ..... ._.. _ ~s TITLE BUSINESS PHONE 126 BUSINES~ PHON~ ~3~ Cedifica[on: Based on my inqui~ of ~ose individuals responsible for obtainin9 the information, I ~di~ under penal~ of taw ~at I have pe~onally examined and am ~miliar ~th the information submi~ed in this invento~ and believe the info~ation is tree, accurate, and ~mplete. SIGNATURE OF OWNE~OPE~TOR DATE ~ NAME OF DOCUMENT PREPARER NAMES OF OWNE~TOR (p~nt) ~3s TITLE O[~WN~E~TOR ~37 UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd OF OF ENVIRONMENTAL ICES /- 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION .~ ' " ' ' (one form per mate~al per building or ama) [] NEW J--I~DD [] DELETE [] REVISE 200 Page __ of __ BUSINESSNAME(Sa~easFACILLTYNAMEoI:DBA,-DoineBusineSSAs),~ *. ....... ui.~/,, , .~.,.~ ....... .- .. 3 CHEMICAL LOCATION ~' ~ ' ~ ' ' ~.~--~ ' ' '~ ". , · ' ' "201 ,CHEMICALLO~ O FACILI~ ID ~ ~J j~ =: 1 ~P ~ (op~naO 203 GRID ~ (opt~naO 2~ ~ 205 ~ T~DE SECRET 207 ' EHS* FIRE CODE H~RD C~SSES (~plete if ~u~t~ by I~1 fire ~i~ 210 ~PE ~ ¢ PURE ~ m MIX.RE ~ w WASTE 211 ~ ~DIOACTNE ~ Y~ ~ No 212 j CURIES 213 PHYSICAL STATE D s SOLID ~1 LIQUID ~ g ~S 214 ~RGEST~AINER , ~.~ 215 FED H~RD CATEGORIES ~ 1 FIRE ~ 2 R~CTIVE ~ 3 PRESSURE REL~SE ~ 4 ACU~ H~L~ ~ 5 cHRONIC H~LTH 216 (Ch~ all that apply) .... ANNUAL WASTE 217 ~I~M,., ~ ~ 218 AVENGE · 219 ~ STA~ WASTE CODE 220 STOOGE CO~AINER ~ a ABOVEGROUND TANK ~ e P~STIONONM~ALLIC DRUM ~ i FIBER DRUM ~.m G~SS BO~LE ~ q ~IL CAR 223 (Check all that apply) ~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING ~ g CAR~Y ~ k BOX ~ o TOTE BIN ~ d S~EL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a AMBIE~ ~ aa ABOVEAMBIE~ ~ ba BELOW A~IENT 224 STOOGE TEMPE~TORE ~ a AMBIE~ ~ aa ABOVEAMBIE~ ~ ba BELOW A~IE~ ~ c CRYOGENIC 225 1 226 =7 ~ Y~ ~ No 228 J 229 2 230 231 ~ Y~ ~ No 232 233 3 234 235 ~ Y~ ~ No 236 237 4 2~8 239 ~ Y~ ~ No 240 241 5 242 243 ~ Y~ ~ No 2~ 245 PRINT NAME & TITLE OF AU~0RIZED coMPANY REPRESENTATIVE SIG~TURE ~'~ ' ..... ~ * DA~ 246 'U'PGF.(~/9g),. ~ACUPAFORMS~OES2T3~.~4.wpd '.