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Home My WebLink AboutBUSINESS PLANBAKERSFIELD ENDOSCOPY 'Si,.~ : 015-021-002323 Manager : BusPhone: (661) 327-4455 Location: 1902 B ST Map : 102 CommHaz : City : BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 01r~L~l ~ SIC Code:8011 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title RAMESH GUPTA / MD / Business Phone: (661) 327-4455x Business Phone: ( ) - x 24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Contact : Phone: (661) 327-4455x MailAddr: 1902 B ST State: CA City : BAKERSFIELD Zip : 93301 Owner RAMESH GUPTA, MD Phone: (661) 327-4455x Address : 1902 B ST State: CA City : BAKERSFIELD Zip : 93301 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: I, ~--J""'~* ?o~,eo~-z. Do hereby certify that I have review~ the a~ached h~dous materials manage- ment plan for ~e~l ~~nd that it along with (~ of 8using) any ~rre~ions ~nstitute a complete and corr~ man- ,, ~ , .... ,, . ~ ~ement )lan for my facility. ~ESH ~A, M.D. Diplomate Americ~ Board of Gas~ocntcrology Phone: (661) 327~55 1902 B Street Fax: (661) 633-5484 B~crsficld, CA 93301~ -1- 07/02/200~ D/3"021 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r'~ Floor, Bakersfield, CA 93301 FACILITY NAME C,~,,~c",~. INSPECTION DATE 3/a/0Z. ADDRESS ( q 0 Z lg ~'(' PHONE NO. '~'2--7 - FACILITY CONTACT BUSINESS ID NO. 15-210- INSPECTION TIME NUMBER OF EMPLOYEES Section I: Business Plan and Inventory Program ,fO/[ ~ 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 O~7'tx, Verification of quantities /_~ Verification of location q 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 site?: ~ Yes '~No Explain: Questions regarding this inspection'?. Please call us at (661) 326-3979 BuSiness S~te Responsible Party White o Env.'Svcs. Yellow - Station Copy Pink - Business Copy Inspector: '; cITY OF BAKERSFIELD FIRE DEPARTMENT ' ' ,',, OFFICE OF ENVIRONMENTAL SERVICES ~ . ~.' UNIFIED PROGRAM INSPECTION CHE~KLIST" 1715 chester Ave., 3rd Floor, Bakersfieldl C A93301~ ~ FACILITWNAME a~~ ~SPECTiON DATE ' ~ ~' ADD.SS lqOZ ~ .St' · PHONENO. ~2~- ~ FACILITY CONTACT " BUSINESS ID NO. 15:210- INSPECTION TIME NUMBER OF Section 1: BusineSs Plan and invento~ Program foil. ' '~ - ~ Routine ~ COmbined . ~ Joint Agency ~ Multi-Agency ~ Complaint. ~ Re-inspection OPERATION, C V cOMMENTS' Business plan contact information accurate Visible address · Correct occupancy Verification of inventory materials ' O~7','x.,.,.~-~ · OeO' t,n/~P " Verification of quantities ~'~ ' ' ' Verification of location .~ q . .. 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 hazard;us waste on site?: [~ Yes ,~ No. ~ Questions regarding this inspection? Please call us at (661) 326-3979 . sponsible Party White- Env. S('~:s. Yellow- Stalion Copy Pink- Business Copy Inspector:· L,,,J iFICE OF ENVIRONMENTA RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 *""' ~'" ~*"" HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one form per mate~fal per budding or ama) f ~W ADD DELETE REVISE .............. 2O0 Page CHEMICAL LOCATION . _ 201 CHEMICAL LOCATION - [] Yes [] No 202 ~ "*'"" FIRE CODE HAZARD CLASSES (Complete if relluestel:l by local tire chief) 2~0 TYPE ,~]~PURE [] m MIXTURE [] w WASTE 21: ; RADIOACTIVE [] Yes [] No 2'12 i CURIES 213 FED HAZARD CATEGORIES ~t FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 2'16 (Cl~eck all that apply) , DAILY AMOUNT DAILY AMOUNT AMOUNT .g ....... ~ * If EHS. ameunt must he in lbs. STORAGE CONTAINER ]~ABOVEGROUND TANK [] · PLAS'TlC/NONMETAj~Uc DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all that apply) [] b UNDERGROUND TANK [] ir CAN E~ j BAG [] n PLASTIC BOTI'LE [] t OTHER [] c TANK INSIDE BUILDING [] g CAR!~:)Y [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE AMBIENT [] aa ABOVE AMBIENT [] ba 8ELOWAMBIENT 224 STORAGE TEMPERATURE I AMBIENT E] aa ABOVE AMB ENT E]ba BELOW AMBIENT [] c CRYOGEN ¢ 225 1 226 227 I E] yes [] No 228 229 2 2~0 231 [] Yes [] No 232 2~3 ................... ~- .................... 237 3 2~ 235 [] Yes [] 2~ 239 [] Yes [] No 240 24~ 5 242 243 [] Yes [] PRINT NAME & Tn~E OF i UTHOR~ED COi~RANY REPRESENTAT~E I ~i~R~f0'R~----/*--~ ............ DATE 248 UPCF (7199) S:\CUPAFORMS\OES2731 .'l'V4.wpd AFiCE CITY OF BAKERSFI OF ENVIRONMENT^ RVICES 1715 Chester Ave., CA 93301 (661) 326-3979 "~-"~~"~'<-' HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION (one fon'n per mater~al per buBdi~j Drama) //~EW I-I ADO r-I DELETE [] REVISE Page __ · :;,. '..- . ,' "',:~;7 5¢: ?":;?? -.!' -::'.,."¢,: ' ..... :'?:' ..... :...,: ..-*."-.~,',~:.,.~-?,,.,'~-;-'::. I. FACILITY INFORMATION BUSINESS NAME (Same as FACILI'~Y NAME ~ DBA - Doing Business As) ...................................... 3 CHEMICAL LOCATION 201 CHEMICAL LOCATION - ~ [] Yes r"'] No 202 CONFIDENTIAL (El)CRA) "~"~ FAC~UTY ID # I IIII ~ ' ,--T-~'T--~ .... I'--:"-':---~ MAP # (o~,~e/) ..........................~3-"T-~-giS~/'(6~,~-~/--- 2o4 - · '. ,? ,: ~'::% ':' '~ .'~- :~'t,~'!:~:.~.~'?t - ~:,' : ~. .... ~ :'. ' .' ..:..:' .~ '.~'.~..~'?,~.'~-'..'-~ ' ~' IL CklEMI L I,~IF,.,RMATION .... · .r~.'.~ -~:..~: · 205 = TRADE SECRET [:::] Yes ~ No 2~ CHEMICAL NAME '. 207 : CO~ON.~E f~J~ ~O~ ¢2~Y_d:-OUl~E ~<~u~C_-,,/T C-~:-~-J-C~ (~c~r~ I EHS' DY-- D.~ 20e FIRE CODE ~ CLASSES (Complete if requeste(I by local fire c~ie0 .......... 210 TYPE ~ PURE [] m MIXTURE [] w WASTE 2:: : RADIOACTIVE. [] Yes [] No 212 i CURIES 213 PHYSICAL STATE Ua SOLID Ell LIQUID C~AS , . ............ Z-~__..~:.~"~'_/~_ i ~ FED HAZARD CATEGOI~ES [] 1 FIRE r~ 2 REACTIVE J~i~E~RESSLIRE RELEASE [] 4 ACUTE HEALTH E] $ CHRONIC HEALTH 216 (Chec~ all that apply) ANNUAL WASTE 217 ~ "vIA'XlIvIUM 218 i AVERAGE 219 STATE WASTE CODE 220 AMOUNT I DALLY AMOUNT ~..~ '= DALLY AMOUNT L /~ DAYS ON SITE 222 UNITS* [] ge GAL CU FT [] lb LBS 1'-] tn TONS 221 · If EHS. amount must be in lbs. STORAGE CONTAINER [] a ABOVEGROUND TANK [] · PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check al~ that apply) J-'Ih UNDERGROUND TANK []f CAN [~j BAG I-'In PLASTIC Bo'n'LE l--Ir OTHER [] c TANK INS(DE BUILOING [] g cARBOY [] k BOX [] o TOTE BiN d STEEL DRUM [] h SiLO ~_,~YLINDER [] p TANK WAGON STORAGE PRESSURE a AMBIENT ~ ABOVE AMBIENT [] ha 8ELOWAMBIENT 224 STORAGE TEMPERATURE .~ a AMBIENT [] aa ABOVE AMBIENt. [] ha 8ELOWAI~IENT. [] C CRYOGENIC 225 2 I 230 231 [] Yes [] No 232 233 i I ................ 3~= 234 235 [] Yes [] No 236 237 242 243 [] Ye~ I--I No 244 J 245 UPCF (7199) S:\CUPAFORMS\OES2731.TV4.w~I